Search Results (5,392)

Anthrax is a zoonotic infectious disease characterized by high lethality and transmissibility. Its spores are highly stable and can persist in the environment for long periods. Furthermore, the overuse or improper use of antibiotics may contribute to bacterial resistance, complicating anthrax treatment. Phages can efficiently target and lyse Bacillus anthracis (B. anthracis), significantly reducing pathogen contamination and transmission risks in soil, water, and other environmental media. Compared to traditional chemical disinfectants and antibiotics, phages enable precise pathogen elimination while minimizing ecological disruption. In this study, two phages infecting B. anthracis, vB_BanM-JC307 (JC307) and vB_BanS-YL5 (YL5), were isolated and characterized. Both phages belong to the class Caudoviricetes. Genome sequencing revealed that JC307 and YL5 have sequence lengths of 148,323 bp and 74,568 bp, respectively. Phylogenetic analysis indicates that JC307 is located in the same evolutionary branch as the Nachito phage of the Herelleviridae family, while YL5, although grouped with the Basilisk-like phages, forms an independent branch. As these two phages have been observed to exhibit lytic activity against all nine tested strains of B. anthracis, they could serve as auxiliary tools for pathogen diagnosis and assist in ecological management of anthrax-contaminated areas. Full article

Background: Proton pump inhibitors (PPIs) are widely used to prevent acid-related complications, yet concerns persist about infectious harm. Observational studies have linked PPIs to Clostridioides difficile infection (CDI) and pneumonia whereas randomized controlled trials (RCTs) consistently show reductions in upper gastrointestinal bleeding. We therefore conducted a systematic review and meta-analysis restricted to randomized controlled trials to evaluate whether PPIs increase the risk of CDI, and to assess pneumonia and gastrointestinal bleeding to contextualize net clinical benefit. Methods: A comprehensive search of randomized controlled trials (RCTs) was conducted using several databases including PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and SCOPUS until July 2025. All published English-language RCTs that met the inclusion criteria were included. Random-effects models were utilized to calculate pooled odds ratios (ORs) with 95% confidence intervals. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 Tool, and heterogeneity was quantified using I² statistics. Analysis was performed using STATA version 18 and RevMan 5.3. Results: Across eight RCTs (n = 30,019), PPIs did not increase C. difficile infection versus placebo (OR 1.29, 95% CI 0.82–2.02; p = 0.27; I² = 16%) with leave-one-out (LOO) analyses showing stable estimates. In six trials reporting pneumonia, there was no significant difference between groups (OR 1.00, 95% CI 0.92–1.09; p = 0.99; I² = 0%). For clinically important upper GI bleeding (seven trials), PPIs were associated with a statistically significant lower risk when compared to placebo (OR 0.51, 95% CI 0.27–0.94; p = 0.03; I² = 56%). Conclusions: Across randomized trials with follow-up ranging from 30 days to 3 years, PPI prophylaxis significantly reduced upper gastrointestinal bleeding without increasing the risk of CDI or pneumonia. These findings support the use of PPIs for prophylaxis when clinically indicated, while recognizing that larger trials are needed to better assess rare adverse events. Full article

Persistent endodontic infections are frequently associated with Enterococcus faecalis, a microorganism capable of penetrating dentinal tubules and surviving conventional disinfection procedures. This in vitro study evaluated the antimicrobial activity of Chihuahuan propolis against E. faecalis using planktonic and intratubular infection models. Propolis extract was tested at concentrations of 15, 35, and 70 mg/mL and compared with triple antibiotic paste (TAP) as a clinically relevant intracanal medicament. Antimicrobial efficacy was assessed by disk diffusion, minimum inhibitory concentration (MIC), colony-forming unit (CFU) reduction in infected dentinal tubules, and scanning electron microscopy (SEM). Chihuahuan propolis exhibited concentration-dependent antimicrobial activity, with a MIC of 17.5 mg/mL. In the intratubular model, propolis at 70 mg/mL achieved a CFU reduction comparable to TAP after seven days of application. SEM analysis confirmed a marked reduction of bacterial colonization within dentinal tubules. Within the limitations of this in vitro, monoespecies model, Chihuahuan propolis demonstrated antimicrobial efficacy against E. faecalis comparable to TAP, supporting its further investigation as a potential non-antibiotic intracanal medicament. Full article

Background/Objectives: Maternal postpartum depressive symptoms and the COVID-19 pandemic have both been identified as potential risk factors for socioemotional difficulties in children. This study aimed to assess behavioral outcomes in young children born to mothers previously screened for postpartum depressive symptoms, comparing cohorts evaluated during and after the pandemic using the Child Behavior Checklist (CBCL 1½–5). Methods: An observational follow-up cohort study was conducted on 52 mother–child dyads derived from a previously established maternal cohort screened with the Edinburgh Postnatal Depression Scale (EPDS). Two cohorts were defined according to the child’s birth period: during-pandemic (January–April 2022) and post-pandemic (October–November 2023) groups. Behavioral outcomes were assessed using CBCL 1½–5. Group differences were tested using parametric or non-parametric methods for continuous variables and χ2 or Fisher’s exact tests for categorical variables. Exploratory regression models and sensitivity analyses were also performed. Results: Children assessed in the post-pandemic cohort showed a lower prevalence of non-normal internalizing scores than those assessed in the during-pandemic cohort, whereas externalizing outcomes and Total Problems did not significantly differ between groups. In exploratory models, a child’s age showed a near-significant association with internalizing outcomes, suggesting that developmental stage at assessment may have contributed to the observed cohort difference. Maternal SARS-CoV-2 infection at delivery was not associated with children’s behavioral outcomes. Conclusions: These findings suggest a possible difference in internalizing behavioral profiles between children assessed in during-pandemic and post-pandemic cohorts. However, this pattern should be interpreted cautiously because the cohorts differed substantially in age at follow-up, and age-related factors may have affected symptom detectability. Continued longitudinal follow-up will be important to clarify whether the observed differences persist over time. Full article

The neuroinvasive and neurotropic character of coronaviruses is a likely reason for neurological complications which may occur during acute COVID illness and sometimes persist or newly emerge in the post-acute phase. Terminology and temporal classification remain heterogeneous. A retrospective case series was conducted in a single center (Department of Neurology, Bielański Hospital, Warsaw, Poland). Medical records from March 2020 to December 2023 were screened. Inclusion criteria: (1) confirmed SARS-CoV-2 infection (polymerase chain reaction or antigen test and radiological findings), (2) new neurological syndrome within acute, post-acute, or post-COVID interval, and (3) diagnostic documentation. Exclusion criteria: alternative established etiology fully explaining the neurological condition. Six cases were selected for detailed analysis due to diagnostic completeness as well as etiological and temporal diversity. Cases included: (1) persistent neurocognitive and sensory symptoms (post-COVID), (2) acute ischemic stroke with internal carotid artery dissection during severe COVID-19, (3) cytotoxic lesion of the corpus callosum (CLOCC) during acute COVID-19, (4) Guillain–Barré syndrome (post-acute), (5) longitudinally extensive transverse myelitis (post-acute), and (6) delayed autoimmune cerebral vasculitis (post-COVID). Neurological presentations ranged from mild persistent symptoms to fatal outcome. Neurological complications span inflammatory, vascular, and autoimmune mechanisms across distinct temporal phases of SARS-CoV-2 infection. Precise temporal classification and systematic diagnostic protocols are essential. Prospective longitudinal studies integrating biomarkers and standardized neuroimaging are required. Full article

Background and Objectives: Osteonecrosis of the jaw (ONJ) occurring after infection with SARS-CoV-2 has emerged as an increasingly reported complication in the post-COVID-19 era. Post-COVID-19 osteonecrosis of the jaw (PC-ONJ) has been described in association with both COVID-19-associated mucormycosis (CAM) and non-fungal phenotypes. This narrative review aims to synthesize and critically analyze the available evidence regarding terminology and classification, epidemiology and risk factors, pathophysiological mechanisms, clinical and imaging characteristics, diagnostic challenges, and management strategies relevant to oral and maxillofacial surgery practice. Materials and Methods: An extensive literature search was conducted in the PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, and Google Scholar databases. The search targeted peer-reviewed publications published between 2020 and 2025, reflecting the post-pandemic emergence of this clinical spectrum. Original studies, systematic and narrative reviews, multicenter case series, consensus guidelines, and well-documented case reports were considered. Results: Available data, largely derived from case reports and small series, demonstrate a predominance of maxillary involvement and frequent association with diabetes mellitus and systemic corticosteroid therapy. Proposed mechanisms include COVID-19-associated endothelial dysfunction, microvascular thrombosis, immune dysregulation, metabolic imbalance, and treatment-related effects. Clinically, patients may present with persistent orofacial pain, tooth mobility, exposed or probeable bone, and frequent sinonasal extension, with symptoms sometimes preceding bone exposure. Diagnostic challenges arise from the overlap with medication-related osteonecrosis of the jaw (MRONJ), osteoradionecrosis (ORN), and chronic osteomyelitis. Imaging is essential for assessing disease extent but remains insufficient for etiologic differentiation, making histopathological examination and targeted microbiological investigations necessary, particularly to exclude invasive fungal infection. Conclusions: Management must be etiology-driven. CAM requires urgent antifungal therapy combined with surgical debridement, whereas non-fungal forms are generally managed with conservative surgery and appropriate antimicrobial stewardship. Standardized diagnostic criteria and prospective multicenter studies are needed to reduce nosological ambiguity and optimize clinical decision-making in this emerging post-viral condition. Full article

Invasive candidiasis (IC) remains a significant cause of morbidity and mortality among critically ill, hematologic, and neonatal patients worldwide. Rapid and accurate diagnosis is essential to guide timely antifungal therapy and improve outcomes. Among available diagnostic tools, 1,3-β-D-glucan (BDG), a polysaccharide component of the fungal cell wall, has emerged as a key biomarker. BDG assays allow for early detection of probable IC, often preceding positive blood cultures, and offer prognostic information based on serial measurements. Species-specific differences in Candida cell wall composition influence BDG release and diagnostic sensitivity. Candida albicans generally correlates with high BDG levels, whereas Nakaseomyces glabrata, Candida parapsilosis, and Candida auris exhibit variable or lower glucan exposure, limiting assay sensitivity. BDG performance is affected by patient-specific factors, such as prior surgery, transfusions, or coexisting bacterial infections, which may lead to false-positive results. Molecular techniques, including PCR-based assays, provide complementary diagnostic accuracy and species identification, and their combination with BDG testing enhances sensitivity up to 90%. Serial BDG monitoring supports risk stratification and treatment response assessment, with persistent elevations predicting worse outcomes. In neonatal and pediatric populations, optimal cut-off values remain under investigation, highlighting the need for integration with clinical and microbiological data. Overall, BDG represents a valuable adjunct in a multimodal diagnostic workflow, providing both diagnostic and prognostic insights in invasive candidiasis management. Full article

Parainfluenza virus 5 (PIV5) can establish persistent infections in host cells despite encountering innate immune defenses, including the complement (C′) system. The host determinants that enable persistently infected cells (PI) to evade C’-mediated clearance remain largely undefined. Here, we identify the mitochondrial antiviral signaling (MAVS) protein, a central adaptor in double-stranded RNA-triggered antiviral and pro-survival signaling pathways, as a critical mediator of both PIV5 persistence and acquired resistance to C’ lysis. Wild-type (WT) PIV5-infected A549 cells were initially sensitive to C’-directed killing, but these cells rapidly establish a PI in culture with ~25% of the cell population becoming resistant to C’ lysis by day 2 and ~75% by day 4. In contrast, PIV5-infected A549 MAVS-deficient (MAVS KO) cells exhibited elevated viral gene expression, increased deposition of C3 and the membrane attack complex, and were more susceptible than WT cells to C′ killing. PIV5-infected MAVS KO cells showed rapid cytopathic effects and never established a stable PI. While pharmacological suppression of viral gene expression with ribavirin (RBV) restored the survival of PIV5-infected MAVS KO cells into a long-term PI-like state, these RBV-induced PI cells remained sensitive to C’ lysis. Collectively, these findings demonstrate a role of MAVS in modulating a PIV5 infection in culture, to facilitate both the conversion of a PIV5 acute infection to a PI and development of resistance to C’ killing. Full article

Bovine viral diarrhea virus (BVDV), a globally persistent pathogen, causes bovine viral diarrhea-mucosal disease (BVD-MD), a contagious bovine disease posing significant pressures on both public health and economic development. Baicalin (BA), a flavonoid derived from Scutellaria baicalensis, exhibits broad antiviral activities but suffers from poor aqueous solubility and low bioavailability, limiting its therapeutic potential against BVDV. To address this limitation, we developed BA-loaded poly (ethylene gly-col)-poly (lactic-co-glycolic acid) (PEG-PLGA) nanoparticles (BA-PEG-PLGA NPs). While autophagy and NLRP3 inflammasome activation have been individually implicated in viral pathogenesis, their functional crosstalk during BVDV infection remains uncharacterized. Herein, we evaluated the antiviral efficacy of BA-PEG-PLGA NPs through integrated in vitro and in vivo experiments. We employed quantitative polymerase chain reaction (qPCR), transcriptome sequencing, Western blot analysis, immunofluorescence microscopy, flow cytometry, and enzyme-linked immunosorbent assay (ELISA) to investigate the mechanisms by which BA and BA-PEG-PLGA NPs combat bovine viral diarrhea virus (BVDV) infection. We found that both free BA and BA-PEG-PLGA NPs effectively attenuated BVDV replication in vitro and in vivo; notably, the nano-formulation exhibited superior efficacy. Mechanistically, BA and its nano-formulation restored autophagy homeostasis, suppressed ROS overproduction, and blocked NLRP3 inflammasome activation and pyroptotic cell death effects comparable to the specific NLRP3 inhibitor MCC950. These findings establish the autophagy–NLRP3/pyroptosis axis as a critical pathogenic mechanism in BVDV infection and reveal that nano-formulated baicalin represents an antiviral strategy by coordinately targeting this axis. This work not only provides a translatable nanomedicine approach for BVDV control but also expands the mechanistic understanding of flavonoid-based interventions in viral inflammatory diseases. Full article

Objectives: Despite vaccination being the most effective way of preventing infections and vaccination rates recovering worldwide after the COVID-19 pandemic, vaccine hesitancy persists. Some factors, such as psychological and social barriers, can negatively impact views on vaccines and can contribute to vaccine hesitancy. The primary objective of this structured literature review is to investigate the available evidence relating to factors affecting vaccine hesitancy within several countries in Southeastern Europe. Methods: An electronic database search was conducted to identify studies assessing the public and healthcare professionals’ (HCPs) attitudes towards vaccination in Southeastern Europe. These searches were supplemented with grey literature searches. Included studies were conducted in Bulgaria, Croatia, Romania, Serbia, and Slovenia between 1 January 2012 and 31 December 2022. Results: Of the 35 studies identified from the database searches, the most prominent theme observed across Romania, Croatia, and Bulgaria was low confidence in COVID-19 vaccines. Across all age groups, COVID-19 vaccine confidence in these regions was highly dependent on whether individuals thought vaccines were safe and effective, as well as their general trust in vaccines. Confidence in COVID-19 vaccines was seen as relatively high, with attitudes towards routine and elective vaccines being generally positive amongst the general public and HCPs, in Romania, Croatia, Serbia and Slovenia. However, uncertainty around the effectiveness of the vaccine still exists. In Bulgaria, trust in routine and elective vaccines remained low in the general public. Complacency and financial constraints were also identified as underlying causes of vaccine hesitancy. Conclusions: The main cause behind vaccine hesitancy in several countries in Southeastern Europe is distrust in vaccine effectiveness and safety. These key findings can be utilised to support evidence-based decisions regarding where to focus resources to improve public and HCP perception of vaccines in Southeastern Europe. Full article

Protein-losing enteropathy (PLE) is an uncommon and often underrecognized manifestation of lymphoproliferative disorders and may be difficult to diagnose when conventional gastrointestinal investigations are unrevealing. We present an 82-year-old woman with recurrent hospital admissions initially spanning six months for diarrhea, weight loss, peripheral edema, and persistent hypoalbuminemia. Initial upper gastrointestinal endoscopy was normal, and colonoscopy was deferred due to intercurrent infection. Despite extensive laboratory and radiologic evaluation, including routine biochemical testing and imaging, the etiology of PLE remained unclear. Peripheral blood flow cytometry subsequently identified a small kappa-restricted monoclonal B-cell population compatible with marginal zone lymphoma, later confirmed on bone marrow biopsy, raising suspicion for gastrointestinal involvement. Video capsule enteroscopy demonstrated diffuse erosive and ulcerative disease throughout the small intestine, providing an anatomical explanation for the patient’s protein loss. Following lymphoma-directed therapy, repeat capsule enteroscopy showed complete normalization of the small bowel mucosa. This case highlights the diagnostic value of combining peripheral blood flow cytometry and capsule endoscopy in unexplained protein-losing enteropathy, a rare and diagnostically challenging presentation of indolent lymphoma, and illustrates the role of capsule imaging in both disease localization and treatment monitoring. As a single-case report, these findings are not generalizable, and further studies are required to evaluate the broader applicability of this diagnostic approach. Full article

Background/Objectives: Staphylococcus epidermidis (RP62A) and Staphylococcus aureus (UAMS-1) are clinically relevant pathogens frequently implicated in implant-associated infections due to their ability to form biofilms. RP62A is typically linked to persistent, chronic, low-grade infections, whereas UAMS-1 is associated with acute, invasive disease. Both strains serve as representative models for chronic and acute periprosthetic joint infections (PJIs). The objective of this study was to examine and compare in vitro biofilm formation by RP62A and UAMS-1 on orthopaedic materials/disc surfaces of defined composition. Methods: In vitro biofilm formation assays were performed using orthopaedic disc surfaces composed of cobalt–chromium alloy (CoCr), titanium alloy (Ti), and polyethylene (PE) after 72 h of incubation. Biofilm biomass was quantified using crystal violet staining, with absorbance measured at OD₅₇₀. A polystyrene (PS) surface served as a control. Additionally, retrieved orthopaedic explant components were used as substrates for in vitro biofilm assays, in which RP62A was incubated for 72 h on the explanted surfaces. Supporting assays on glass slides were conducted to examine strain-specific biofilm-related architecture. Results: In vitro biofilm mass quantification assays showed strong biofilm formation by RP62A across all tested surfaces, with the highest absorbance on CoCr (OD₅₇₀ = 5.80 ± 0.19). Notably, biofilm formation on CoCr was 76% higher compared to PS (p < 0.0001). No significant differences were observed among all three surface discs (p > 0.1). Biofilm formation was highest on PE for UAMS-1 (OD₅₇₀ = 1.29 ± 0.09) and was significantly greater than on Ti (178%, p < 0.001) and CoCr (196%, p < 0.0001). In the in vitro assays performed on retrieved explant components, RP62A showed pronounced biofilm accumulation on polyethylene tibial inserts, particularly in regions of mechanical wear and friction. Supporting assays on glass slides were performed to examine strain-specific surface microstructural, revealing dense network-like structures for RP62A and thinner, discontinuous layers for UAMS-1. Conclusions: RP62A formed dense biofilms in vitro on multiple orthopaedic implant materials and retrieved explant components, consistent with its association with chronic periprosthetic joint infections. Increased biofilm accumulation was observed on mechanically worn polyethylene surfaces. In contrast, UAMS-1 showed lower biofilm formation on metallic disc surfaces, indicating strain- and material-dependent differences. These findings highlight the relevance of implant material selection and surface integrity for strategies targeting biofilm-associated implant infections. Full article

Detection of brown spot needle blight (BSNB) disease caused by the fungal pathogen Lecanosticta acicola (Thum.) Syd. has increased significantly at commercial loblolly pine (Pinus taeda L.) plantations across the southeastern United States in recent years. Historically, it has been a serious problem in longleaf pine (Pinus palustris Mill) during the grass stage of seedlings, when the environment is more conducive to fungal infection. However, since 2016, confirmed cases of the disease on loblolly pines have increased in several states, including AL, AR, FL, GA, LA, MS, SC, TN, and TX. We investigated the distribution pattern of confirmed cases of BSNB on loblolly pine between 2016 and 2023, identified site-specific factors, and evaluated the historical standardized precipitation index (SPI) value record over the past four decades. Our results showed that extended periods of above-normal SPI values are associated with BSNB spatial distribution patterns, particularly where the disease has been widely reported in AL, AR, LA, and MS. We observed significant reduction in tree height and dbh in severely infected versus healthy trees at the six study sites evaluated in 2023. Excessive rainfall and prolonged water saturation associated with historical 5-Year SPI values suggest that vulnerable loblolly pine seedlings (depending on genetic family) are more likely to be predisposed to L. acicola infection due to persistent stress from reduced soil nutrient flux and other physiological processes of the host. Understanding the effect of precipitation patterns on cases of BSNB is an important step toward preventing or minimizing the future impact of the disease on commercial plantations in the Southeast. Full article

Host lipid metabolism is a critical determinant of viral pathogenesis. Although the interferon-inducible cholesterol 25-hydroxylase (CH25H) typically acts as a broad-spectrum antiviral protein, its expression and regulatory patterns during Japanese Encephalitis Virus (JEV) infection display unique features. Here, we demonstrate that 25-hydroxycholesterol (25HC), the product of CH25H, potently inhibits JEV proliferation by suppressing SREBP2 activation. Distinct from the majority of viral infections that induce CH25H upregulation, JEV infection elicits a transient reduction in CH25H abundance immediately after infection, coupled with a persistent elevation in SREBP2 expression. This inverse correlation suggests that JEV actively suppresses the CH25H-mediated metabolic checkpoint to maintain a cholesterol-synthetic environment favorable for replication. By pharmacologically simulating the activity of 25HC, we further verify that targeting the SREBP2 signaling axis can efficiently counteract this virally induced metabolic reprogramming. Our study identifies CH25H downregulation and concomitant SREBP2 activation as a key metabolic signature of JEV pathogenesis. Full article

Vertical transmission of plant pathogenic viruses is an important component of viral persistence, survival, and spread in agricultural production systems. This type of transmission is of considerable economic significance as it can cause major crop losses by serving as the initial focus of infection for future epidemics. Vertical transmission occurs when a virus is passed on to offspring either by direct invasion of the developing seed embryo from infected mother plants or through infected pollen grains after fertilization. We have recently demonstrated via high-throughput sequencing that mature seeds of the agriculturally important forage crop alfalfa (Medicago sativa L.) are associated with a broad range of viruses, some of which could potentially spread over long distances via seed. With the exception of the alfalfa mosaic virus, little is currently known about viral transmission through alfalfa pollen and its subsequent impact on the disease epidemiology of the crop. The objective of this study was to screen pollen from diverse alfalfa genotypes for pathogenic viruses and assess their risk of transmission. The pollen was collected from alfalfa genotypes selected for fungal disease resistance and agronomic performance in the USDA ARS pre-breeding program in Prosser, WA. Full article