bims-fagtap Biomed News
on Phage therapies and applications
Issue of 2026–03–15
forty-one papers selected by
Luca Bolliger, lxBio
  1. Deploying bacteriophage combinatorial therapy to eradicate resistant Klebsiella pneumoniae UTIs: innovative and personalized phage therapy.
  2. Searching for the perfect match: can non-antibiotic antimicrobials improve bacteriophage performance?
  3. Phages as antimicrobials against multi-drug resistant bacteria.
  4. Bacteriophage-Encoded Small RNAs: Emerging Tools for Phage Therapy and Antibacterial Intervention.
  5. Reimagining Phage Therapy for MDR Pathogens: From Biobanks to Health System Integration-A Review.
  6. Wound Care Basics in High-Risk Chronic Limb-Threatening Ischemia Patients.
  7. Smooth-to-rough morphotype switching, a mechanism of phage resistance in Mycobacterium abscessus.
  8. Isolation of Lytic Bacteriophages Against Carbapenem-Resistant Klebsiella pneumoniae of Capsular Type KL64 From Water Collected at Multiple Sites Across China.
  9. Predicting inter-microbial host specificity in oral biofilms using a lightweight relation-aware knowledge graph model.
  10. A hydrogel-based bacteriophage cocktail targeting carbapenem-resistant Pseudomonas aeruginosa in an ex vivo porcine skin model.
  11. Predominance of multidrug-resistant bacteria with high resistance to empiric antibiotics in diabetic foot ulcers: a cross-sectional study.
  12. Adjunctive hyperbaric oxygen therapy for chronic diabetic foot ulcer unresponsive to standard care: A case report.
  13. Editorial: Emerging trends in phage therapeutics to overcome antibiotic resistance.
  14. Negative pressure wound therapy use: recommendations from a South African panel of experts.
  15. Dual-Functional Photonic Crystal Hydrogel: Drug Release Monitoring and Immunomodulation for Chronic Infected Wounds.
  16. Multiple virulence attenuating strategies against Pseudomonas aeruginosa: Natural, synthetic, and synergistic approaches.
  17. Host modulation therapy in periodontitis: from established therapies to emerging technologies.
  18. The Microbial Mechanisms of Cardiovascular Disease: Oral Dysbiosis as a Systemic Instigator.
  19. AlphaFold 3-powered discovery of phage proteins that inhibit bacterial transcription initiation.
  20. Why diabetic foot ulcers continue to define the future of precision wound care.
  21. Nano-Enabled Herbal Therapeutics for Diabetic Foot Ulcers: Translating Ethnopharmacological Bioactives into Advanced Wound Care.
  22. Characterization and evaluation of a phage cocktail targeting Salmonella enterica in a Turkey farm.
  23. When phages fuel gut inflammation.
  24. Decolonizing the gut from multidrug-resistant bacteria: Current strategies and future perspectives.
  25. Developing Clinical Decision (Support) Systems Combining the Scientific and Regulatory Perspective: European Insights on Challenges, Requirements, and Practical Guidance.
  26. A longitudinal evaluation of localised chronic Pseudomonas aeruginosa infection in cystic fibrosis rat models.
  27. Phage-derived depolymerase targeting K27 capsule impairs Klebsiella pneumoniae virulence, biofilm formation, and promotes immune clearance.
  28. The bidirectional effects and mechanisms of the oral and gut microbiomes: a narrative review.
  29. Capturing dynamic phage-pathogen coevolution by clinical surveillance.
  30. The Gut-Liver Axis in Metabolic Dysfunction-Associated Steatotic Liver Disease: From Mechanistic Insights to Precision Therapeutics.
  31. Periodontal disease and neuroinflammation in multiple sclerosis: a systematic review of current evidence.
  32. Biofilm Control with Rare-Earth Oxides: A Mechanistic Framework for Next-Generation Antibiofilm Materials.
  33. Diabetic foot ulcer: a systematic review of risk factors.
  34. Modulation of macrophage survival during Klebsiella pneumoniae infections.
  35. Draft genome sequences of 109 gut bacteria isolated from colonoscopy samples of individuals with and without cystic fibrosis.
  36. 'The Hero's journey': Narratives on the transition to motherhood with cystic fibrosis.
  37. Disparities in Access to Cystic Fibrosis Therapy Across Countries.
  38. Ralstonia pickettii as an emerging pediatric pathogen: a mini-review of current evidence.
  39. Global Trends and Hotspot Analysis of Nanomaterials in the Field of Acne: A Bibliometric Perspective.
  40. DeepStackVEGF a stacking ensemble deep learning framework for vascular endothelial growth factor prediction.
  41. Porphyromonas gingivalis-Associated Modulation of β-Catenin Signaling in Oral Squamous Cell Carcinoma: Molecular Perspectives from Periodontal Dysbiosis.
  1. Arch Microbiol. 2026 Mar 10. pii: 249. [Epub ahead of print]208(5):
    Deploying bacteriophage combinatorial therapy to eradicate resistant Klebsiella pneumoniae UTIs: innovative and personalized phage therapy.
    Usamah Sayed, Waleed K Abdulsahib, Wael Waleed Mustafa, H Malathi, Rajashree Panigrahi, Y Swarna Latha, Vipasha Sharma, Aashna Sinha, Nigina Khalikova.
      Klebsiella pneumoniae (K. pneumoniae) is a WHO priority pathogen, with multidrug-resistant (MDR) and carbapenem-resistant (CRKP) strains causing severe, often untreatable urinary tract infections (UTIs). The therapeutic impasse has reignited interest in bacteriophage (phage) therapy, a precision antibacterial approach that uses viruses to selectively lyse bacterial pathogens. The potential of phage therapy for MDR K. pneumoniae UTIs is critically evaluated in this review. We summarize the underlying biological rationale, concentrating on phage-mediated lysis and biofilm disruption. We then examine the translational landscape, comparing promising preclinical and compassionate-use data with the limited outcomes from early controlled clinical trials. A key theme is the critical need for strategic frameworks to guide clinical deployment, including rational cocktail design, phage-antibiotic synergy (PAS), and personalized approaches. Lastly, we list the main issues that must be addressed to incorporate phage therapy into the clinical arsenal against these powerful infections.
    Keywords:  Clinical translation; Klebsiella pneumoniae; Phage therapy; Synergistic antibiotic-phage; Urinary tract infections
    DOI:  https://doi.org/10.1007/s00203-026-04788-8
  2. Front Cell Infect Microbiol. 2026 ;16 1758422
    Searching for the perfect match: can non-antibiotic antimicrobials improve bacteriophage performance?
    Katarzyna Kosznik-Kwaśnicka, Agnieszka Necel, Lidia Piechowicz.
      The rapid spread of multidrug-resistant (MDR) bacteria worldwide has significantly reduced the effectiveness of traditional antibiotics, leading to increased interest in bacteriophages as alternative or supplementary antimicrobial agents. While phage therapy has notable benefits, such as high specificity and minimal impact on beneficial microbiota, its use alone is limited by factors like a narrow host range, quick development of resistance, complex pharmacokinetics, and challenges in delivery within biological and environmental contexts. Although combining phages with antibiotics has been shown to improve antibacterial effects, growing regulatory restrictions and efforts to minimize antibiotic use call for the exploration of non-antibiotic combination approaches. This review explores the synergistic interactions between bacteriophages and various non-antibiotic antimicrobials, including essential oils, bacteriocins, nanoparticles, and other physicochemical or host-derived agents. We present evidence that these agents can boost phage effectiveness by altering bacterial membrane integrity, stress responses, biofilm structure, and phage stability, and by delaying the emergence of resistance. Importantly, we emphasize that the observed synergies are highly context-dependent and discuss limitations related to reproducibility, safety, and translational application. Overall, this review highlights the potential of non-antibiotic compounds as tailored adjuvants to broaden the use of phage-based antimicrobial strategies in clinical, food safety, and agricultural contexts.
    Keywords:  antibiotics; antimicrobial resistance; bacteriocins; bacteriophage; essential oils; nanoparticles; phage therapy; synergistic therapy
    DOI:  https://doi.org/10.3389/fcimb.2026.1758422
  3. Front Microbiol. 2026 ;17 1747240
    Phages as antimicrobials against multi-drug resistant bacteria.
    Salomé Plat, Gisèle LaPointe, Lawrence Goodridge.
      Multi-drug resistant bacteria (MDR) pose a major public health challenge. Their ability to exchange resistance genes through Horizontal Gene Transfer (HGT) promotes the appearance of resistant strains, limiting antibiotic treatments for infections caused by these MDR bacteria. Among alternative approaches, phage therapy stands out as a promising strategy that utilizes bacteriophages to specifically target and effectively eliminate bacteria. This narrative review provides an overview of the current knowledge on the use of whole bacteriophages as antimicrobial agents in human and veterinary medicine, as well as in the food industry whether used alone, in cocktails, or combined with antimicrobials. While whole phages offer high specificity and an efficient elimination of bacteria, their application is associated with several limitations, including their contribution to HGT, the emergence of bacterial resistance, their narrow host range, the immune recognition, and the difficulties posed by their regulation. To address these challenges, this review focuses on phage-derived enzymatically active proteins, such as endolysins and depolymerases, as alternative antimicrobial tools, used alone or in combination. These phage components, being smaller and structurally simpler than whole phages, behave more similarly to conventional antimicrobial compounds. They have so far presented a low risk of bacterial resistance appearance and less chance of immune response. In addition, their classification as antimicrobial enzymes or conventional biologics could facilitate regulatory approval by aligning with existing regulatory frameworks. A total of 40 studies were included in this narrative review, highlighting the outcomes of applications involving whole bacteriophages (n = 11) and phage-derived enzymes, including endolysins and depolymerases (n = 27).
    Keywords:  antimicrobials; bacteriophages; depolymerases; endolysins; multi-drug resistant bacteria; phage therapy
    DOI:  https://doi.org/10.3389/fmicb.2026.1747240
  4. DNA Cell Biol. 2026 Mar 11. 10445498261431525
    Bacteriophage-Encoded Small RNAs: Emerging Tools for Phage Therapy and Antibacterial Intervention.
    Aviezer Silverman, Sahar Melamed.
      Bacteriophages (phages) are viruses that specifically infect bacteria and play a central role in shaping microbial communities and bacterial evolution. Beyond their protein-coding genes, phage genomes were found recently to encode small RNAs (sRNAs) that act post-transcriptionally to regulate host and viral gene expression. These phage-encoded sRNAs can influence infection dynamics, modulate host physiology, and determine the balance between lytic and lysogenic cycles. A prominent example is the phage lambda sRNA PreS, which enhances phage DNA replication by increasing translation of the host dnaN mRNA, linking host replication capacity to phage propagation. This review examines emerging evidence that phage-encoded sRNAs constitute a versatile and underappreciated class of molecular tools. We discuss how such RNAs could be repurposed as precision antibacterial agents in an era of increasing antibiotic resistance and outline key challenges and opportunities for developing RNA-based alternatives to conventional phage therapy.
    Keywords:  RIL-seq; phage therapy; phage–host interactions; post-transcriptional regulation; regulatory RNA; small RNA
    DOI:  https://doi.org/10.1177/10445498261431525
  5. Infect Dis Ther. 2026 Mar 07.
    Reimagining Phage Therapy for MDR Pathogens: From Biobanks to Health System Integration-A Review.
    Abay A Ayele, Wenfeng Liu, Minfeng Xiao, Alem A Kalayu, Woldaregay E Abegaz, Abel A Negash.
      Multidrug-resistant (MDR) pathogens, exemplified by Klebsiella pneumoniae, pose a critical and escalating threat in low- and middle-income countries (LMICs), where limited diagnostic and therapeutic options exacerbate mortality. Bacteriophage (phage) therapy has re-emerged as a promising alternative, offering high specificity, biofilm disruption, and potential for low-cost production. However, a significant translational gap persists; while in vitro studies and results personalized phage therapy demonstrate efficacy, the pathway to clinical integration, especially in LMICs, remains obstructed by systemic barriers including the lack of local phage banks and undefined regulatory pathways. This review moves beyond a summary of biological promise to propose a novel, structured framework for implementation tailored to resource-limited health systems. We synthesize current evidence to introduce the 5-P roadmap, a cohesive strategy encompassing the establishment of integrated phage-host biobanks; development of context-appropriate preparations; rigorous preclinical validation emphasizing phage-antibiotic synergy; the parallel development of policy and regulatory pathways; and pilot clinical trials designed for subsequent health system integration. By addressing these interconnected pillars simultaneously, this framework provides an actionable blueprint to advance phage therapy from a laboratory concept to a scalable, equitable, and sustainable adjunct within national antimicrobial resistance strategies in LMICs.
    Keywords:  Antimicrobial resistance; Bacteriophage therapy; Low-resource settings; Multidrug-resistant Klebsiella pneumoniae
    DOI:  https://doi.org/10.1007/s40121-026-01320-9
  6. Tech Vasc Interv Radiol. 2026 Mar;pii: S1089-2516(26)00005-3. [Epub ahead of print]29(1): 101102
    Wound Care Basics in High-Risk Chronic Limb-Threatening Ischemia Patients.
    Neil Trivedi, Robin Tsai, Laura Shin, Nallely Saldana-Ruiz, Jakob I Wepman, Robert Stillwell.
      The purpose of this chapter is to provide a broad summary of the different classes of wound care products and to show their indications for use while providing a list of the products which are most commonly used in the clinical setting. Wound care is a complex specialty and a thorough understanding of the underlying etiology of a wound is essential in determining which wound care products are best to use. Wound care is a large specialty within podiatric medicine and continues to have a significant impact on health-care expenses in the United States (US). Prompt treatment with a multidisciplinary approach is necessary to reduce the burden of healthcare expenses and prevent the detrimental effects caused by chronic wounds on the quality of life of patients. The different types of wounds will be identified and common diagnostic studies ordered for each type of wound will be discussed. Wound care is a dynamic specialty which requires constant evaluation as changes occur, including revascularization procedures and infections. The presence of simultaneous disease processes that interfere with wound healing also adds to the complexity of treatment. The goal of this chapter is to allow healthcare providers in multiple different specialties to learn more about wound care to treat patients with more effectiveness and efficiency.
    Keywords:  chronic limb-threatening ischemia; diabetes mellitus; foot ulcer; limb salvage; wound care
    DOI:  https://doi.org/10.1016/j.tvir.2026.101102
  7. Proc Natl Acad Sci U S A. 2026 Mar 17. 123(11): e2531197123
    Smooth-to-rough morphotype switching, a mechanism of phage resistance in Mycobacterium abscessus.
    Jun Hao Liew, Ayuni Norman, Morgane Illouz, Teck-Hui Teo, Riccardo Delli Ponti, Claire Hamela, Lalit Mohan, Renee Lew, Chanvutha Ron, Kay En Low, Wassim Daher, Aryeh Chiam, Joanna Maw, Yan Sun, Ria Sorayah, Stefan H Oehlers, Byung Woo Jhun, Jeanette W P Teo, Adeline Goulet, Isabelle Bonne, René Wintjens, Kevin Pethe, Roland G Huber, Laurent Kremer, Pablo Bifani.
      Mycobacterium abscessus infections represent a growing global health concern due to their severe pathology and difficulty of treatment, largely driven by their intrinsic antimicrobial resistance. While phage therapy has emerged as a promising alternative approach, studies have predominantly focused on glycopeptidolipids (GPL)-deficient M. abscessus rough variants instead of the GPL-producing smooth variants predominant in Asia. Here, we aim to develop phage cocktails targeting both smooth and rough morphotypes. In the process, we found that phage treatment of smooth variants can select for rough morphotype switching from smooth-to-rough variants in vitro and in vivo, resulting in phage resistance associated with mutations within the GPL biosynthetic locus. We validated our findings in vitro and in vivo, suggesting a two-layered phage combination that surpasses single-phage treatments and potentially improves clinical phage cocktail strategies. This work underlines the need to better understand mechanisms of phage resistance in phage therapy and associated potential adverse effects and solutions. Phage resistance in M. abscessus through morphotype switching is clinically significant, as it may complicate treatment outcomes but could be averted with proper phage combinations.
    Keywords:  Mycobacterium abscessus; morphotype; mycobacteriophage; phage resistance; phage therapy
    DOI:  https://doi.org/10.1073/pnas.2531197123
  8. J Infect Dis. 2026 Mar 13. 233(Supplement_1): S47-S55
    Isolation of Lytic Bacteriophages Against Carbapenem-Resistant Klebsiella pneumoniae of Capsular Type KL64 From Water Collected at Multiple Sites Across China.
    Juan Li, Qingqing Fang, Huan Luo, Yan Feng, Yu Feng, Zhiyong Zong.
       BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae causes difficult-to-treat infections. Lytic phages able to infect and lyse bacterial hosts have gained prominence as a potential countermeasure. Given the predominance of sequence type 11 and capsular type KL64 (ST11-KL64) lineage in China, we sought to develop a dedicated phage bank against this high-priority target.
    METHODS: We obtained 52 water samples collected at multiple sites from 18 provincial regions across China. Phages against ST11-KL64 carbapenem-resistant K pneumoniae clinical strains were isolated with a double-layer agar method. All phages were subjected to whole genome sequencing with Illumina HiSeq × 10. Phages were classified in accordance with the overall DNA similarity thresholds established by the International Committee on Taxonomy of Viruses. The 3-dimensional structure of phage tail fibers was predicted with AlphaFold.
    RESULTS: We isolated 22 lytic phages, which belonged to the family Autotranscriptaviridae (n = 21) or Ackermannviridae (n = 1). All Autotranscriptaviridae phages but one were of the genus Przondovirus, and the remaining one belonged to Benllochvirus. All Przondovirus and Benllochvirus phages here displayed a KL64-specific host range and encoded a single tail fiber protein containing a tail spike domain and 4 previously identified key residues, R405, Y526, W550, and F669, for governing the host range.
    CONCLUSIONS: The repeated recovery of Przondovirus phages from various sites illustrates a limited biogeographic diversity and restrained mutual phage-bacterium adaption. This suggests that for a common type of encapsulated bacterial pathogen, the attempt to recover phages from more sources may not be efficient and, conversely, phages recovered in one place have the potential to be used in another.
    Keywords:   Klebsiella pneumoniae ; antimicrobial resistance; bacteriophages; phage biology; phage therapy
    DOI:  https://doi.org/10.1093/infdis/jiaf607
  9. Front Cell Infect Microbiol. 2026 ;16 1775191
    Predicting inter-microbial host specificity in oral biofilms using a lightweight relation-aware knowledge graph model.
    Prabhu Manickam Natarajan, Sudhir Rama Varma, Jayaraj Kodangattil Narayanan, Ruba Odeh.
       Introduction: The human oral cavity hosts a complex microbial ecosystem of bacteria, viruses, bacteriophages, and other microorganisms forming biofilms in different niches. Phage-bacteria host specificity is crucial in shaping microbial community, stability, and dysbiosis. mapping this specificity is limited by experimental constraints and traditional methods can't capture ecological complexity. The goal is to create a graph-based model that treats inter-microbial host specificity as a relational learning problem, integrating taxonomic, ecological, and infection data into a knowledge graph. This improves phage-bacteria host predictions and reveals microbial hubs and interaction patterns related to periodontal disease dysbiosis.
    Methods: This study introduces a lightweight, relation-aware knowledge graph for predicting microbial host specificity in oral biofilms. We built a heterogeneous graph of the oral microbiome, incorporating microbial taxa, anatomical sites, taxonomic hierarchies, enrichment patterns, and INFECTS relationships. The dataset includes 500 viral taxa across four oral niches, with 21,338 significant co-occurrence relationships and various biological features. To learn meaningful representations, we combined graph embeddings with microbial features. We developed a relation-aware graph neural network, IK-BRNet, to efficiently encode ecological and interaction semantics.
    Results: Model performance was evaluated against a conventional Graph Attention Network (GAT) using stratified training, validation, and test splits with class imbalance correction. IK-BRNet demonstrated faster convergence and superior discrimination ability, achieving a higher AUC-ROC (0.929 vs. 0.904) and markedly improved sensitivity for disease-associated viral taxa (93.8% vs. 56.3%). While the baseline GAT achieved higher accuracy and specificity, IK-BRNet consistently reduced false negatives, thereby improving its ability to detect disease-related microbial signals. Site-specific predictions confirmed biological validity, with the highest disease scores for dental plaque-associated viruses and lower scores in healthy niches such as the tongue and buccal mucosa.
    Conclsuion: This study shows that relation-aware graph learning offers a meaningful and efficient way to model inter-microbial host specificity in oral biofilms. The framework improves oral microbiome network inference and supports disease screening, ecological analysis, and microbiome-based dentistry.
    Keywords:  bacteriophages; hostspecificity; knowledge graph; oral biofilms; oral microbiome; periodontal disease; phage–host interactions; virome
    DOI:  https://doi.org/10.3389/fcimb.2026.1775191
  10. J Hosp Infect. 2026 Mar 05. pii: S0195-6701(26)00073-3. [Epub ahead of print]
    A hydrogel-based bacteriophage cocktail targeting carbapenem-resistant Pseudomonas aeruginosa in an ex vivo porcine skin model.
    Wichanan Wannasrichan, Titiya Thongbumrou, David Yembilla Yamik, Wattana Pelyuntha, Mingkwan Yingkajorn, Kitiya Vongkamjan.
       OBJECTIVES: Carbapenem-resistant P. aeruginosa (CRPA) causes challenging healthcare-associated infections, many of which arise from superficial sites. Here, we aim to develop an effective phage cocktail targeting CRPA and to evaluate its potential as a topical hydrogel to prevent wound infections using an ex vivo porcine skin model.
    METHODS: Phage EKU1, MHN1, and Bobae, isolated from wastewater were characterized. The cocktails of these phages were formulated against a CRPA strain. Phage-resistant isolates emerged after exposure to the cocktail were also analysed for fitness costs. Hydroxyethyl cellulose (HEC)-phage cocktail hydrogel was tested against a CRPA on ex vivo porcine skins. Shelf life of the gel was observed under storage in different temperatures RESULTS: EKU1 (Yuavirus), MHN1 (Bruynoghevirus), and Bobae (Chimallivirus) belonged to distinct evolutionary lineages. Their cocktail exhibited synergistic activity against CRPA over 5-log (CFU/mL) reduction after 24 hours at an MOI of 1000. Among 12 phage-resistant isolates, 11 exhibited slower growth rates than wild type, and 5 out of 12 isolates produced significantly less biofilm. On porcine skins, phage hydrogel significantly reduced bacterial load by 1.5 log CFU/mL after 12 hours compared to control. Phage titres in the gel stored at 4°C decreased by 1-1.5 log PFU/mL over 8 weeks.
    CONCLUSIONS: The cocktail from distinct phages shows strong synergy against CRPA with resistance-associated trade-offs. Incorporated into HEC hydrogel, the cocktail significantly suppressed CRPA growth on porcine skins and remained stable under refrigeration for months, supporting its potential as a promising topical prototype for wound infections.
    Keywords:  Bacteriophage cocktail; Carbapenem-resistant Pseudomonas aeruginosa; HEC hydrogel; Porcine skin model; Wound infection
    DOI:  https://doi.org/10.1016/j.jhin.2026.02.012
  11. Sci Rep. 2026 Mar 11.
    Predominance of multidrug-resistant bacteria with high resistance to empiric antibiotics in diabetic foot ulcers: a cross-sectional study.
    Natasha Nabila Mohammed Shoaib, Ebenezer Chitra, Jing Rou Ong, Willem B Jay Tan, Vasantha Kumari Neela, Ashraf Hakim Ab Halim, Fabian Davamani.
      Diabetic foot ulcers (DFUs) pose a serious clinical challenge due to their chronic nature and high risk of infection. DFUs present polymicrobial infections frequently involving antibiotic-resistant bacteria, complicating treatment and increasing the risk of amputations. We conducted a cross-sectional study of 153 DFU patients to analyze the bacterial profile of DFUs and prevailing patterns of antibiotic resistance. The pathogenic bacteria isolated from DFUs were predominantly Gram-positive (62%), with Staphylococcus aureus and coagulase-negative staphylococci (CoNS) being the most frequent isolates along with Gram-negative Pseudomonas aeruginosa and Klebsiella pneumoniae. Over 60% of Gram-positive bacteria and 95% of Gram-negative bacteria were multidrug resistant with a median resistance to 9-11 antibiotics, most of which are in the prescribed regimen for diabetic foot infections. Multidrug resistance (MDR) was observed in approximately 95% of Gram-negative and 60-87% of Gram-positive isolates. We categorized the antibiotics following the AWaRe (Access (A), Watch (W), Reserve (R)) classification and have identified the antibiotics that can be prioritized for treatment of DFU leaving out the reserve category only for treating MDR bacteria. The findings underscore the need for prudent use of antibiotics, microbiological profiling of DFU bacteria and periodic updates to the empirical treatment regimen to improve patient outcomes.
    Keywords:  AWaRe classification; Antibiotic resistance; Diabetic foot ulcer; Multidrug resistance
    DOI:  https://doi.org/10.1038/s41598-026-42418-x
  12. Biomedicine (Taipei). 2026 ;16(1): 69-74
    Adjunctive hyperbaric oxygen therapy for chronic diabetic foot ulcer unresponsive to standard care: A case report.
    Sukriyadi Adi, Ismail Ismail, Sitti Rahmatiah, Agustan Agustan.
       Background: Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus and are often challenging to treat, particularly in patients who fail to respond to standard wound care. Adjunctive therapies such as hyperbaric oxygen therapy (HBOT) have shown potential in promoting wound healing in chronic cases.
    Case presentation: A 66-year-old male with a 10-year history of type 2 diabetes mellitus presented with a chronic, non-healing DFU on the right foot. Despite oral antibiotic therapy and conventional wound management, the ulcer demonstrated progressive necrosis, persistent infection, and tissue exposure. Wound culture identified Klebsiella oxytoca. After targeted antibiotic treatment, the patient underwent 35 sessions of HBOT at 2.4 ATA for 90 min per session, five days per week, in conjunction with hydrogel dressings and structured wound care strategies.
    Results: Over the treatment course, the wound exhibited substantial clinical improvement, including reduced edema, infection control, emergence of granulation tissue, and near-complete epithelialization. No complications occurred during HBOT, and the patient tolerated the therapy well.
    Conclusion: This case demonstrates the potential benefits of HBOT as an adjunctive therapy in chronic DFUs unresponsive to standard care. HBOT, when combined with modern wound care strategies, may accelerate healing and reduce the risk of amputation in select patient populations. Further research is warranted to refine treatment protocols and establish evidence-based criteria for patient selection.
    Keywords:  Diabetic foot ulcer; Hyperbaric oxygen therapy; Wound healing
    DOI:  https://doi.org/10.37796/2211-8039.1693
  13. Front Antibiot. 2026 ;5 1788766
    Editorial: Emerging trends in phage therapeutics to overcome antibiotic resistance.
    William Calero-Cáceres, Ankush Gupta, Anju Kaushal, Paul Hyman.
      
    Keywords:  AMR (antimicrobial resistance); antibiotic resistance; bacteriophage; phage (bacteriophage); phage therapeutics
    DOI:  https://doi.org/10.3389/frabi.2026.1788766
  14. J Wound Care. 2026 Mar 02. 35(3): 221-228
    Negative pressure wound therapy use: recommendations from a South African panel of experts.
    Ethel Andrews, Fébé Bruwer, Jacques Goosen, Nick Kairinos, Saadia Laher, Maeyane S Moeng, Anati Ngcakani, Shaal Ramdial, Suléman Vadia, Jacques van Wyk, Jacobus Jg Viljoen, Deon W Weyers, Sadhana Trivedi.
       OBJECTIVE: The South African patient population is complex, with elevated traumatic injury rates and individuals living with multiple comorbidities. Healthcare provider and funding shortages, as well as wound care training not being a recognised subspecialty, have added to the burden of an already pressured South African healthcare system. With increases in non-specialist clinicians providing wound care, South Africa-specific wound care guidelines are needed.
    METHOD: An in-person meeting was held with wound care experts across South Africa to develop treatment recommendations for the use of negative pressure wound therapy (NPWT)-based systems. The publication panel convened on 8-9 December 2023 in Johannesburg, South Africa. The group of 14 panel members, including surgeons, wound care nurses and nurse practitioners, discussed clinical evidence regarding NPWT-based system use, followed by the development of a therapy-use algorithm.
    RESULTS: Panel members recommended NPWT use for both simple/low-risk and complex/large/high-risk wounds. NPWT with instillation and dwell time was recommended for both simple and complex wounds requiring cleansing. NPWT or closed incision negative pressure therapy use was recommended, as needed, following wound closure as per the reconstructive ladder.
    CONCLUSION: Limited published evidence supporting the use of NPWT-based systems exists for South Africa. These panel recommendations are a starting point and should be revised as more clinical evidence on NPWT-based system use within South Africa is published.
    Keywords:  South Africa; closed incision negative pressure therapy; negative pressure wound therapy; panel recommendations; with instillation; wound; wound care; wound dressing; wound healing
    DOI:  https://doi.org/10.12968/jowc.2025.0219
  15. Adv Healthc Mater. 2026 Mar 13. e71039
    Dual-Functional Photonic Crystal Hydrogel: Drug Release Monitoring and Immunomodulation for Chronic Infected Wounds.
    Xinran Kang, Yuemin Wang, Xue Zhao, Chen Chen, Fangyuan Li, Jie Weng, Jianshu Li, Xingyu Chen.
      Chronic bacterial-infected wounds are difficult to treat due to persistent inflammation, biofilm formation, and antibiotic resistance. Conventional therapeutic approaches, such as systemic or topical antibiotics, are limited by the inability to dynamically monitor drug release at the wound site. To address this issue, we have designed a dual-functional photonic crystal hydrogel (PP/DG@MOF) that not only promotes wound healing by modulating local immune responses and facilitating tissue regeneration but also enables real-time, noninvasive monitoring of drug release and wound healing progress. The PP/DG@MOF hydrogel is embedded with a metal-organic framework possessing both antimicrobial and anti-inflammatory properties (DG@MOF), combined with photonic crystals (PAM-PCH) for visual monitoring of drug release. The DG@MOF hydrogel responds to collagenase activity at the wound site, releasing a mixture composed of ZIF-8 encapsulating the Salvianolic acid B and antimicrobial quaternary ammonium groups, effectively combating bacterial infection at the wound site. As the drug-loaded hydrogel degrades, the embedded photonic crystal layer undergoes tunable structural color changes, providing real-time, noninvasive feedback on drug release and wound healing. This strategy offers a novel approach for the management of chronic infected wounds and holds significant promise for translation into clinical practice as a next-generation wound care material.
    Keywords:  antibacterial; drug release monitoring; hydrogel; infected wounds; photonic crystal
    DOI:  https://doi.org/10.1002/adhm.71039
  16. World J Microbiol Biotechnol. 2026 Mar 10. pii: 125. [Epub ahead of print]42(3):
    Multiple virulence attenuating strategies against Pseudomonas aeruginosa: Natural, synthetic, and synergistic approaches.
    Mulugeta Mulat, Nazia Tabassum, Taehyeong Kim, Fazlurrahman Khan.
      Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen that causes severe acute and chronic infections, particularly in immunocompromised patients, those with cystic fibrosis, burn wounds, and structural lung disease. It has numerous virulence factors, including biofilm formation, quorum-sensing (QS) systems, exotoxins, and degradative enzymes, which make it pathogenic. All these factors combine to enhance tenaciousness, tissue destruction, and antimicrobial resistance. These virulence factors are being explored to inhibit multidrug-resistant microbes that are not susceptible to conventional antibiotics. Recent research has shown that synthetic molecules (such as enzyme antagonists, QS inhibitors, and novel chemical scaffolds), natural compounds (such as phytochemicals derived from plants, essential oils, and microbial metabolites), and synergistic combinations represent promising anti-virulence strategies. The use of nanomaterial-based synergistic delivery systems is vital for enhancing efficacy and targeted delivery. This review paper discusses the intriguing therapeutic properties of natural and synthetic agents, as well as their synergistic inhibitory effects, against various virulence factors that influence the strategies of multidrug-resistant bacteria, such as P. aeruginosa. Overall, these inhibitors enhance bactericidal activity by targeting multiple microbial pathways, with an emphasis on biofilm and QS systems, thereby addressing the problems of resilience and resistance development associated with conventional antibiotics. There are still issues with maximizing biocompatibility, pharmacokinetics, and clinical translation despite encouraging in vitro and preclinical results. This multifaceted strategy offers a lasting remedy for antibiotic-resistant P. aeruginosa infections, representing a paradigm shift from conventional bactericidal approaches to virulence attenuation. However, the possible adaptations of the pathogen and compensatory mutations to anti-virulence strategies need careful consideration.
    Keywords:  Anti-virulence; Biofilm; Natural compound; Quorum-sensing; Synergetic approach; Synthetic inhibitors
    DOI:  https://doi.org/10.1007/s11274-026-04850-z
  17. Front Immunol. 2026 ;17 1762187
    Host modulation therapy in periodontitis: from established therapies to emerging technologies.
    Aonjittra Phanrungsuwan, Jiaqi Huang, Neeraja Dharmaraj, Alejandra Cobos Perez, Omid Veiseh, Simon Young, Chun-Teh Lee.
      Periodontitis is a biofilm-induced chronic inflammatory disease, characterized by gingival inflammation and alveolar bone loss. According to a national survey, approximately half of the U.S. adults are affected by periodontal disease. To effectively prevent and treat periodontitis, it is essential to address its underlying causes. The primary etiological factors include polymicrobial synergy and dysbiosis of the oral microbiota, and a dysregulated immune response. The standard therapeutic approach, mechanical removal of biofilm through debridement, sometimes demonstrates limited efficacy, particularly in cases of severe periodontitis, which may require adjunctive or additional therapy. Emerging evidence indicates that periodontal tissue destruction is initiated by biofilm but primarily driven by a sustained, dysregulated host inflammatory response characterized by excessive cytokine production, osteoclast activation, and impaired inflammation resolution. In recent years, research has focused on targeting both the oral microbiota and immune response by utilizing antimicrobial therapeutics to diminish bacterial load and by modulating immune activity. Specifically, host modulation therapies (HMTs), such as the delivery of anti-inflammatory cytokines, nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose doxycycline, and lipid mediators, via various techniques, have been explored. However, challenges associated with its use encompass adverse effects resulting from prolonged administration, and systemic delivery methods are associated with an elevated risk of infection and the potential development of malignancy, as well as the disease rebound after cessation of treatment. This review examines current trends in HMTs for periodontitis and identifies potential limitations of these approaches. The insights gained may contribute to the development of improved strategies to enhance periodontal treatment outcomes.
    Keywords:  cytokines; drug delivery systems; genetics; immunomodulation; microbial; periodontitis
    DOI:  https://doi.org/10.3389/fimmu.2026.1762187
  18. J Cardiovasc Transl Res. 2026 Mar 12. pii: 42. [Epub ahead of print]19(1):
    The Microbial Mechanisms of Cardiovascular Disease: Oral Dysbiosis as a Systemic Instigator.
    Laresh N Mistry, Sumeet Agarwal, Sankalp Dattaram Bhandarkar, Vivek Sharma, Himmat Jaiswal, Saudamini More.
      Oral dysbiosis, particularly through periodontal disease, links strongly to cardiovascular risks by driving chronic inflammation and microbial translocation. Key pathogens invade vascular tissues, triggering systemic cytokines and metabolites that damage endothelial function and promote atherosclerosis. This creates a vicious cycle where oral inflammation worsens heart disease progression. Clinical interventions like intensive periodontal therapy show promise, reducing blood pressure and inflammatory markers in at-risk patients, much like established lifestyle changes. Salivary microbial profiles emerge as early warning signs for vascular issues and poor outcomes. This review bridges epidemiology, mechanisms, trials, biomarkers, and practical strategies, clarifying causal gaps through structured evidence analysis. Future multi-omics research and standardized approaches will refine oral health's role in heart disease prevention, offering actionable public health steps.
    Keywords:   Aggregatibacter actinomycetemcomitans ; Fusobacterium nucleatum ; Porphyromonas gingivalis ; AI; Artificial Intelligence; Cardiovascular disease; Oral Dysbiosis; Oral microbiology; Periodontitis; Risk Factor
    DOI:  https://doi.org/10.1007/s12265-026-10761-z
  19. Cell Rep. 2026 Mar 12. pii: S2211-1247(26)00160-9. [Epub ahead of print]45(3): 117082
    AlphaFold 3-powered discovery of phage proteins that inhibit bacterial transcription initiation.
    Linggang Yuan, Qingyang Liu, Xiaojian Xiao, Liqiao Xu, Liang Liang, Yang Guo, Yue Yao, Hui Wang, Youjun Feng, Xiaoting Hua, Yu Feng.
      Many phages encode proteins that specifically inhibit host RNA polymerase activity, thereby sabotaging and, in some cases, hijacking the host transcription machinery to serve their needs. Traditional methods for identifying new phage proteins that inhibit bacterial transcription are labor intensive and require access to live phages. To overcome these limitations, we develop a highly efficient pipeline for AlphaFold 3-guided discovery of phage proteins that inhibit bacterial transcription initiation. Using this pipeline, three phage proteins are identified and characterized. Structural and biochemical analyses demonstrate that these phage proteins bind to distinct sites on RNA polymerase and inhibit transcription initiation via different mechanisms. This study showcases the power of AlphaFold 3 in discovering novel binders of large protein complexes, and the pipeline developed here could be readily adapted to screen modulators of other large targets, such as the ribosome, proteasome, and CRISPR-Cas systems.
    Keywords:  AlphaFold 3; CP: Molecular biology; RNA polymerase; phage; transcription regulation; σ factor
    DOI:  https://doi.org/10.1016/j.celrep.2026.117082
  20. J Wound Care. 2026 Mar;35(Sup3a): S5-S6
    Why diabetic foot ulcers continue to define the future of precision wound care.
    Windy Cole.
      
    DOI:  https://doi.org/10.12968/jowc.2026.0069
  21. Chem Biodivers. 2026 Mar;23(3): e03644
    Nano-Enabled Herbal Therapeutics for Diabetic Foot Ulcers: Translating Ethnopharmacological Bioactives into Advanced Wound Care.
    Manoj Kumar Mishra, Wasim Akram, Shivangi Sharma, Sagar Pamu.
      Diabetic foot ulcer (DFU) is a common and serious complication in individuals with diabetes, representing a leading cause of hospitalization and frequently resulting in severe outcomes such as amputations, increased morbidity, and mortality. The development of diabetic foot infection (DFI) is typically attributed to a combination of factors, including persistent hyperglycemia, impaired immune function, peripheral neuropathy, and vascular insufficiency. Early diagnosis and prompt treatment are crucial for favorable outcomes; however, the growing prevalence of antibiotic-resistant pathogens presents a significant challenge, placing additional strain on healthcare systems. Considering these concerns, there is an increasing interest in herbal therapies with antimicrobial, anti-inflammatory, and wound-healing properties-such as garlic (Allium sativum), turmeric (Curcuma longa), and neem (Azadirachta indica)-as potential adjunct or alternative treatments. This review explores key aspects of DFI, including its pathophysiology, global prevalence, statistical data, risk factors, diagnostic approaches, current and potential herbal treatments, associated challenges, and future directions.
    Keywords:  diabetic foot ulcer; herbal treatment; neuropathy; pathophysiology; wound healing
    DOI:  https://doi.org/10.1002/cbdv.202503644
  22. BMC Microbiol. 2026 Mar 12.
    Characterization and evaluation of a phage cocktail targeting Salmonella enterica in a Turkey farm.
    María Gabriela Vela-Chauvin, Darío X Ramirez-Villacis, Carolina E Armijos, Michael Narvaez, Francisco Quelal-Madrid, Gabriela Bustamante, Carla Torres-Sobrevilla, Alexis Debut, Fernando Corredor, William Calero-Cáceres, António Machado, Sonia Zapata-Mena.
      
    Keywords:   Salmonella enterica ; Metagenome assembled genomes; Phage therapy; Turkey production
    DOI:  https://doi.org/10.1186/s12866-026-04849-4
  23. Cell Host Microbe. 2026 Mar 11. pii: S1931-3128(26)00082-X. [Epub ahead of print]34(3): 376-378
    When phages fuel gut inflammation.
    Cyriel Y Ponsioen, Hilde Herrema.
      Inflammatory bowel disease is associated with the gut microbiome, with many of its mechanistic underpinnings yet to be unraveled. In this issue of Cell Host & Microbe, Wen and colleagues show that Crohn's disease pathology is amplified by phage-bacteria interactions and that the gut virome might be a driver of disease severity.
    DOI:  https://doi.org/10.1016/j.chom.2026.02.014
  24. World J Methodol. 2026 Mar 20. 16(1): 108646
    Decolonizing the gut from multidrug-resistant bacteria: Current strategies and future perspectives.
    Anjali Mishra, Deven Juneja.
      The rise of multidrug-resistant organisms (MDROs) represents a serious global health crisis, with the gastrointestinal tract serving as a major reservoir for these pathogens. This review highlights the burden of gut colonization by MDROs, its role in spreading antimicrobial resistance, and explores current and emerging strategies for decolonization. Various non-antibiotic approaches such as probiotics, prebiotics, bacterial consortia, selective digestive decontamination, faecal microbiota transplantation, bacteriophage therapy, and Clustered Regularly Interspersed Short Palindromic Repeats-CRISPR-associated protein systems along with dietary interventions have been assessed for their potential to restore microbial balance and reduce MDRO carriage. While promising results have emerged from early studies and animal models, most interventions remain investigational. Rigorous clinical trials, standardized protocols, and safety assessments are essential before these approaches can be integrated into routine practice for MDRO management.
    Keywords:  Antimicrobial resistance; Fecal microbiota transplantation; Gut decolonisation; Multidrug-resistant organisms; Selective digestive decontamination
    DOI:  https://doi.org/10.5662/wjm.v16.i1.108646
  25. JMIR Med Inform. 2026 Mar 09. 14 e72809
    Developing Clinical Decision (Support) Systems Combining the Scientific and Regulatory Perspective: European Insights on Challenges, Requirements, and Practical Guidance.
    Sanne E W Vrijlandt, Sanne W C M Janssen, Annemarie M C van Rossum, Niek B Achten, Rianne Oostenbrink.
       Unlabelled: Clinical decision-making is a critical process where physicians balance risks and benefits. Clinical Decision Support Systems (CDSSs) are increasingly used to help in this process. The regulatory landscape for CDSSs is evolving significantly, with the new European Medical Device Regulation (MDR) now requiring, CE certification for certain CDSSs. This shift poses challenges for health care providers to develop CDSSs in an effective and useful manner while adhering to regulations. This viewpoint comments on diverse challenges and provides solutions to develop a reliable, well integrated and practical tool for clinical use. Using three tools (the Early Onset Sepsis Calculator, Feverkidstool, and Neonatal Procalcitonin Intervention Study algorithm) as examples, we explore the development of CDSSs across four core characteristics: scientific basis, technical aspects, safety, and sustainability. These characteristics recur across the main development processes; scientific development, regulatory assessment, and implementation in routine practice. Successful integration of CDSSs into clinical practice requires a comprehensive understanding of the interconnections between these processes. For example, decisions on algorithm validation and platform selection in the scientific process influence choices for technical safety during the regulatory process. Developers should consider both regulation requirements and clinical needs, to create CDSSs that are not only compliant but also adaptable to the rapidly changing healthcare landscape. We outline a developer's checklist, for practical guidance, but also appeal for structural support, including national protocols and dedicated hospital roles, to help developers implement CDSSs successfully.
    Keywords:  clinical decision support systems; diagnostic reasoning; infection diseases; pediatrics; regulatory requirements
    DOI:  https://doi.org/10.2196/72809
  26. BMC Microbiol. 2026 Mar 10.
    A longitudinal evaluation of localised chronic Pseudomonas aeruginosa infection in cystic fibrosis rat models.
    Nicole Reyne, Bernadette Boog, Patricia Cmielewski, Alexandra McCarron, Ronan Smith, Nathan Rout-Pitt, Nina Eikelis, Kris Nilsen, John Finnie, Jennie Louise, David Parsons, Martin Donnelley.
      Recurrent bacterial infections with Pseudomonas aeruginosa result in chronic airway inflammation, lung damage and eventual respiratory failure, and are the major cause of morbidity and mortality in people with cystic fibrosis (CF). Animal models are essential for understanding disease progression and assessing potential treatments in the presence of infection. Previously reported P. aeruginosa lung infection rodent models for CF research have weaknesses that include being acute rather than chronic infections, high levels of associated mortality, use laboratory strains of P. aeruginosa, or do not utilise CF rodents. The aim of this study was to create a localised single-lung P. aeruginosa infection in wildtype and two CF rat models, by using a miniature bronchoscope to deliver bacteria embedded in agar beads generated from a clinical CF bacterial isolate. Cohorts of animals were assessed at days 7, 14, 21 and 63. The number of colony forming units were measured, along with bronchoalveolar lavage, flexiVent mechanics, X-ray Velocimetry (XV) ventilation analysis, and histopathology. The resulting infection was well tolerated by all animals of all genotypes with no mortality associated with the procedure or infection. The right-lung exhibited localised acute bronchopneumonia and lymphocytic vasculitis early, progressing to chronic interstitial pneumonia with fibrosis and emphysema. Bacteria persisted for 9 weeks (63 days) in all genotypes, with lung mechanics changes observed by day 63 of the infection. The precise delivery of bacterial laden beads using a miniature bronchoscope generated a controlled and reproducible infection that persisted for up to nine weeks, with minimal impact on animal health.
    Keywords:   Pseudomonas aeruginosa ; Animal model; Cystic fibrosis; Lung infection
    DOI:  https://doi.org/10.1186/s12866-026-04893-0
  27. Emerg Microbes Infect. 2026 Mar 13. 2645857
    Phage-derived depolymerase targeting K27 capsule impairs Klebsiella pneumoniae virulence, biofilm formation, and promotes immune clearance.
    Magdalena Pelka, Weronika Czekala, Agnieszka Kwiatek, Marta Polanska, Barbara Maciejewska, Aleksandra Otwinowska, Piotr Golec, Agnieszka Wyszyńska, Zuzanna Drulis-Kawa, Monika Adamczyk-Popławska.
      The global rise of multidrug-resistant Klebsiella pneumoniae underscores the urgent need for alternative therapeutic strategies. Bacteriophage-derived depolymerases have emerged as promising antimicrobial factors, selectively degrading bacterial capsules and impairing key pathogenic traits. We characterize a novel depolymerase, PRA33gp45, associated with the structural protein of bacteriophage vB_KpnP_PRA33. Bioinformatic structural analyses predicted endo-N-acetyl neuraminidase-like activity and canonical depolymerase domain architecture. The recombinant PRA33gp45 specifically hydrolysed capsular polysaccharides (CPS) of K27-serotype K. pneumoniae and produced characteristic halo zones on bacterial lawns, confirming its enzymatic activity. Capsule staining demonstrated rapid and progressive capsule degradation within 120 minutes of treatment. PRA33gp45 significantly inhibited biofilm formation, disrupted mature biofilms, and altered biofilm architecture as visualized by confocal microscopy. Depolymerase pre-treatment markedly reduced K. pneumoniae survival within A549 human lung epithelial cells, without exhibiting any cytotoxic effect and sensitized bacteria to complement-mediated killing in human serum. Finally, PRA33gp45 treatment of K. pneumoniae lowers morbidity and mortality in the Galleria mellonella larvae model. Collectively, these findings identify PRA33gp45 as a novel and highly specific depolymerase that diminishes K. pneumoniae virulence by targeting its protective capsule, impairing persistence as biofilm, and enhancing innate immune clearance. Its safety and efficacy suggest potential as an antimicrobial or adjuvant therapeutic agent against K27-type K. pneumoniae infections, particularly in the context of multidrug resistance and emerging pathogens.
    Keywords:  Klebsiella pneumoniae; antimicrobial therapy; capsular polysaccharide; depolymerase
    DOI:  https://doi.org/10.1080/22221751.2026.2645857
  28. Front Immunol. 2026 ;17 1697413
    The bidirectional effects and mechanisms of the oral and gut microbiomes: a narrative review.
    Tiantian Huo, Xiaofei Huang, Jiayi Liao, Huo Zhang, Li Hu, Mengru Xie.
      Among the microbial ecosystems of the human body, the gut and oral microbiota constitute the two largest communities, collectively harboring thousands of bacteria, fungi, and viruses. Under physiological conditions, these microbiotas maintain internal homeostasis and stability, thereby protecting the host against pathogenic colonization. However, when pathogens such as Porphyromonas gingivalis translocate from the oral cavity to the gut, disruption of gut microbial homeostasis may occur, increasing the risk of disease development. Potential mechanisms underlying this association include the establishment of new symbiotic relationships, the disruption of the intestinal barrier, the activation or suppression of inflammatory cells-particularly the balance between T helper 17 (Th17) cells and regulatory T cells (Tregs)-and the induction of systemic inflammation. Conversely, gut microbiota dysbiosis, as observed in patients with inflammatory bowel disease, irritable bowel syndrome (IBS), or colorectal cancer, is also associated with alterations in the composition and diversity of the oral microbiota. Factors such as immune cell migration, malnutrition, and taste disturbances may contribute to oral microbial imbalance. In this review, we summarize the bidirectional influences on the composition and diversity of the oral and gut microbiomes and propose potential mechanisms underlying their interactions. A deeper understanding of these processes will enhance our knowledge of microbiota-host interactions and systemic health, and may shed light on the prevention and treatment of systemic diseases related to oral and gut microbiota dysbiosis.
    Keywords:  Porphyromonas gingivalis; gut microbiome; oral microbiome; periodontal disease/periodontitis; systemic health/disease
    DOI:  https://doi.org/10.3389/fimmu.2026.1697413
  29. Nature. 2026 Mar 11.
    Capturing dynamic phage-pathogen coevolution by clinical surveillance.
    Yamini Mathur, Caroline M Boyd, Jeannette E Farnham, Md Mamun Monir, Mohammad Tarequl Islam, Marzia Sultana, Tahmeed Ahmed, Munirul Alam, Kimberley D Seed.
      Bacteria harness diverse defence systems that protect against phage predation1, many of which are encoded on horizontally transmitted mobile genetic elements2. In turn, phages evolve counter-defences3, driving a dynamic arms race that remains underexplored in human disease contexts. For the diarrhoeal pathogen Vibrio cholerae, a higher burden of its lytic phage ICP1 in patient stool correlates with reduced disease severity4. However, direct molecular evidence of lytic phages driving selection of epidemic V. cholerae has not been demonstrated. Here, through clinical surveillance in cholera-endemic Bangladesh, we capture the acquisition of a parasitic anti-phage mobile genetic element, PLE11, that initiated a selective sweep coinciding with the largest cholera outbreak in recent records. PLE11 showed potent anti-phage activity against cocirculating ICP1, explaining its rapid and dominating emergence. We identify PLE11-encoded Rta as the defence responsible and provide evidence that Rta restricts phage tail assembly. Using experimental evolution, we predict phage counteradaptations against PLE11 and document the eventual emergence and selection of clinical ICP1 that achieve a convergent evolutionary outcome. Finally, we discover how PLEs balance their dependence on ICP1 tail proteins for horizontal transmission with the restriction of phage tail assembly by Rta: PLEs construct chimeric tails composed of both mobile genetic element-encoded and phage-encoded proteins to ensure their transmission. Collectively, our findings reveal the molecular basis of the natural selection of a globally important pathogen and its virus in a clinically relevant context.
    DOI:  https://doi.org/10.1038/s41586-026-10136-z
  30. FASEB J. 2026 Mar 31. 40(6): e71687
    The Gut-Liver Axis in Metabolic Dysfunction-Associated Steatotic Liver Disease: From Mechanistic Insights to Precision Therapeutics.
    Shaoliang Zhu, Mengjie Zou, Qijun Wu, Yan Zou, Tingting Tan, Zhangnan Huang, Zheng Gong, Honglin Luo, Xiaofeng Dong.
      Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most prevalent chronic liver condition globally, shifting the diagnostic paradigm toward an affirmative, metabolism-focused framework. The gut-liver axis is a central pathophysiological pathway. This review aims to synthesize revolutionary advances from 2023 to 2025 in understanding and treating MASLD by focusing on the gut microbiome's role. This comprehensive review analyzes cutting-edge research published between 2023 and 2025. We examined evidence from landmark clinical trials, developments in next-generation probiotics, the integration of artificial intelligence (AI) with multiomics for diagnostics, and studies clarifying the interplay between host genetics and the microbiome in MASLD pathogenesis. Causal links between gut dysbiosis and MASLD pathology are now firmly established. Fecal microbiota transplantation (FMT) effectively prevents hepatic encephalopathy recurrence, and next-generation probiotics like Akkermansia muciniphila have entered MASLD-specific trials. AI-driven diagnostic tools have achieved regulatory qualification from the European Medicines Agency. Furthermore, host genetics, particularly PNPLA3 variants, are shown to not only predispose to MASLD but also shape specific microbial communities that functionally contribute to disease progression. The field is rapidly advancing from correlative observations to causal evidence, enabling the development of microbiome-based biomarkers and personalized therapies. The future of MASLD management lies in precision strategies, such as bacteriophage therapy and functionally defined probiotics, which integrate metabolic, microbial, and genetic factors into individualized care, heralding a new therapeutic era.
    Keywords:  MASLD; fecal microbiota transplantation; gut‐liver axis; microbiome; precision medicine
    DOI:  https://doi.org/10.1096/fj.202503607RR
  31. Front Dent Med. 2026 ;7 1701357
    Periodontal disease and neuroinflammation in multiple sclerosis: a systematic review of current evidence.
    Srijanani Santhanakrishnan, Karunanidhi Kannappan, Chandrasekaran Krithika, Chitathoor Sridhar, Jaideep Mahendra.
       Background: Multiple Sclerosis (MS) is a chronic, immune-mediated neurological disorder characterized by demyelination and neurodegeneration. Emerging evidence suggests a link between MS and Periodontal Diseases (PD) through shared immune-inflammatory pathways. This review assesses the association between periodontal diseases and multiple sclerosis, focusing on immune-inflammatory interactions and clinical correlations. Despite emerging evidence, the strength of association remains unclear due to methodological heterogeneity.
    Aim: To review and evaluate the literature on the epidemiological association between PD and MS in adults.
    Materials and methods: A systematic search was conducted in PubMed, Scopus, and Cochrane. Studies with full text articles that are available in English, without time restrictions, that assessed periodontitis, oral microbiome, and salivary biomarkers in relation to MS were included. Observational studies evaluating clinical, microbiological, or immunological associations were selected. Data extraction covered periodontal parameters, salivary biomarkers, periodontal pathogens and disease severity. The risk of bias was evaluated using Newcastle-Ottawa Scale.
    Results: The findings indicated that patients with MS had poorer periodontal health, when compared to healthy controls. Dysbiosis in the oral microbiome was observed, with a higher abundance of periodontal pathogens. Patients with MS exhibited elevated neutrophil-lymphocyte ratios and total oxidative stress, indicating a potential link between systemic inflammation and periodontal dysbiosis. While some studies established positive association between PD and MS, others highlighted the need for further investigation due to inconsistent findings in periodontal parameters between MS patients and controls.
    Conclusion: Despite methodological heterogeneity, the available limited evidence indicates the association between periodontitis and MS. This highlights the need for standardized periodontal assessments in research involving MS and suggests that periodontal care may hold potential as an adjunct in management of MS.
    Keywords:  autoimmune response; neurodegeneration; oral microbiome; oral-Immune axis; periodontal disease
    DOI:  https://doi.org/10.3389/fdmed.2026.1701357
  32. Nanomaterials (Basel). 2026 Feb 27. pii: 302. [Epub ahead of print]16(5):
    Biofilm Control with Rare-Earth Oxides: A Mechanistic Framework for Next-Generation Antibiofilm Materials.
    John H T Luong.
      Biofilm-associated infections remain a major barrier to wound healing, implant integration, and chronic infection management. Rare-earth oxides (REOs) have emerged as promising antibiofilm materials, though their mechanisms, limitations, and translational potential are still being defined. Cerium oxide (CeO2) serves as the benchmark due to its redox adaptability, oxygen-vacancy-driven catalytic activity, and host compatibility. In contrast, non-ceria REOs show antibiofilm effects under more restricted conditions, often requiring surface functionalization, composite architectures, or hybrid organic-inorganic interfaces-such as polyphenol coatings or hydroxyapatite-based composites-to achieve comparable activity. Across systems, biofilm control arises not from bactericidal potency but from matrix-level mechanisms including extracellular polymeric substance (EPS) destabilization, extracellular DNA (eDNA) sequestration, redox modulation, and quorum-sensing interference. Preclinical and near-clinical evidence, particularly in chronic wound models, supports the translational relevance of these mechanisms, though the evidence base remains preliminary. This review synthesizes mechanistic data across cerium-, samarium-, lanthanum-, and strontium-based systems to establish a unified framework for REO-mediated biofilm disruption. REOs are positioned as biofilm-modulating platforms that complement antibiotics, enhance healing, and improve outcomes. Design rules emphasize controlled redox activity, targeted coordination chemistry, functional surface engineering, and host-compatible performance, alongside regulatory and manufacturing guidance for future development.
    Keywords:  antibiofilm; antimicrobial; cerium oxides; cytotoxicity; lanthanum oxide; nanoparticles; rare earth oxides; reactive oxygen species; samarium oxide
    DOI:  https://doi.org/10.3390/nano16050302
  33. J Wound Care. 2026 Mar 02. 35(3): 246-259
    Diabetic foot ulcer: a systematic review of risk factors.
    Andreas M Lazaris, Katerina Angeli-Doulami, Adriane E Napp, Günther Silbernagel, Mihai Ionac, Nikolaos Doulamis, Anastasios Doulamis, Eftychios Protopapadakis, Michael A Lazaris, Georgios Pappas, Vaia Lampadiari, Panagiotis Halvatsiotis, Maria-Erofili S Lazari, George Geroulakos.
       BACKGROUND: This study used a systematic analysis to identify risk factors that may be used to predict which patients with diabetes will develop a foot ulcer.
    METHODS: A systematic review of the literature was conducted, which included observational cohort studies that followed patients with diabetes to see whether they developed a diabetic foot ulcer (DFU). A random-effect meta-analysis was performed, and odds ratios were used for nominal data or mean differences for continuous data. This study was registered at PROSPERO (CRD42020182527).
    RESULTS: The analysis included eight studies. From 4914 patients, 607 developed a DFU (12%) within a median of 30 months follow-up, indicating a 4.8% annual rate. The following parameters were found to be related to DFU development: a history of DFUs; cerebrovascular accident; peripheral arterial disease and lower extremity amputation; duration of diabetes; glycated haemoglobin; use of insulin; visual impairment; claudication; altered monofilament sensitivity; foot deformity; onychomycosis; foot oedema; and local hyperkeratosis. The quality of evidence for most of the factors was either low or very low.
    CONCLUSION: The development of DFUs may be associated with various factors, including: a history of previous DFUs; amputation or clinical atherosclerosis syndrome, such as peripheral arterial and cerebrovascular disease; the severity of diabetes; and various clinical signs regarding the patient's foot. The low certainty of evidence for most of these factors indicates that there is still a gap in knowledge regarding the early detection of foot ulcers in people with diabetes. A large prospective study could identify more precisely which factors are the most significant. Contemporary technology could use such data to create devices that would be able to predict DFUs so they can be prevented or treated earlier, which would reduce the possibility of lower limb amputation.
    Keywords:  cerebrovascular accident; diabetes; diabetic foot ulcer; insulin; lower extremity amputation; peripheral arterial disease; wound; wound care; wound dressing; wound healing
    DOI:  https://doi.org/10.12968/jowc.2023.0017
  34. Front Cell Infect Microbiol. 2026 ;16 1757662
    Modulation of macrophage survival during Klebsiella pneumoniae infections.
    Nithya N, Anjoom Mohamed Ali, Sruthi K P, Subhash Mehto, Cecil Antony.
      Klebsiella pneumoniae, a facultative anaerobe and Gram-negative bacterium, has high clinical significance in public health concerns. K. pneumoniae is given its name in recognition of the German-Swiss microbiologist Edwin Klebs. Carl Friedlander first identified K. pneumoniae as a bacterium isolated from the lungs of individuals who had died from pneumonia. K. pneumoniae is a prominent member of the Enterobacteriaceae family, an opportunistic pathogen, and one of the pathogens sweeping the world in the antibiotic resistance pandemic. This organism accounts for approximately one-third of all Gram-negative infections, including pneumonia, urinary tract infections, liver abscesses, and bacteremia. Classically, these infections commonly occur in individuals who are hospitalized or immunocompromised and regularly treated with β-lactams along with other antibiotics effective against Enterobacteriaceae. Unfortunately, the emergence of multidrug-resistant infections in patients treated at intensive care units (ICUs) has been a serious problem faced by clinicians globally. K. pneumoniae has been recently added to the critical list of microorganisms by the World Health Organization (WHO), highlighting the urgent requirement for new therapeutic options to combat this bacterium. Developing new therapeutic interventions requires a comprehensive understanding of host-pathogen interactions and the role of immune cells in clearing the bacteria. To that end, macrophages play a crucial role in safeguarding our body against infectious agents, as well as contributing to processes such as pathogen clearance and tissue homeostasis. Calcium, a secondary messenger, refines the macrophage protective responses and influences cell survival. Many pathogens have evolved tactics to circumvent the innate immune clearance mechanisms exerted by macrophages. Therefore, this review will focus on the modulation of macrophage innate immune responses and survival upon K. pneumoniae infection.
    Keywords:  Klebsiella pneumoniae; calcium homeostasis; infection; innate immunity; macrophage; survival
    DOI:  https://doi.org/10.3389/fcimb.2026.1757662
  35. Microbiol Resour Announc. 2026 Mar 12. e0111425
    Draft genome sequences of 109 gut bacteria isolated from colonoscopy samples of individuals with and without cystic fibrosis.
    Sarvesh V Surve, Rebecca A Valls, George A O'Toole.
      We report draft genome sequences of gut bacterial isolates recovered from colonoscopy samples obtained from individuals with and without cystic fibrosis. These genomes expand the representation of cultured gut microbes from distinct colonic regions and provide a resource for studying microbial diversity, adaptation, and host-microbe interactions in health and disease.
    Keywords:  culturomics; cystic fibrosis; intestine; microbiome
    DOI:  https://doi.org/10.1128/mra.01114-25
  36. Br J Health Psychol. 2026 May;31(2): e70064
    'The Hero's journey': Narratives on the transition to motherhood with cystic fibrosis.
    Alena J Haines, Lynette Mackenzie, Anne Honey, Peter Middleton.
       OBJECTIVES: This study aimed to explore the impact of cystic fibrosis (CF) on the transition to motherhood using a strength-based narrative approach. It sought to elevate the voices of women with CF and examine how they navigate pregnancy and early motherhood in the context of chronic illness.
    DESIGN: A qualitative narrative study was conducted, led by a researcher with lived experience of CF and motherhood. The study adopted a co-constructed, interpretive epistemology to centre participant perspectives and challenge deficit-based clinical narratives.
    METHODS: Ten Australian women with CF who had given birth within the past 5 years participated in in-depth, semi-structured interviews. Narratives were analysed using holistic and categorical methods, including thematic coding and story mapping. Reflexive collaboration and participant validation were used to enhance trustworthiness.
    FINDINGS: Narratives consistently followed the 'Hero's Journey' archetype, with participants portraying themselves as resilient protagonists. Key strengths included hope, leadership, discernment, child-focus and optimism. While healthcare providers were often described as supportive allies, antagonistic interactions-particularly during pre-pregnancy counselling-undermined trust and joy. Postpartum, women struggled to balance CF treatment with mothering roles, often prioritising their child over medical compliance. Breastfeeding emerged as a specific area of conflict between maternal values and clinical expectations.
    CONCLUSIONS: Women with CF demonstrate significant strengths in navigating motherhood, yet face systemic challenges in receiving holistic, collaborative care. This study highlights the value of lived experience-led research and calls for healthcare teams to offer more tailored postpartum support and nuanced guidance around treatment, parenting and breastfeeding.
    Keywords:  cystic fibrosis; family planning; parenthood; pregnancy; qualitative interviews
    DOI:  https://doi.org/10.1111/bjhp.70064
  37. Pediatr Pulmonol. 2026 Mar;61(3): e71560
    Disparities in Access to Cystic Fibrosis Therapy Across Countries.
    Bulent Karadag.
      Cystic fibrosis has been transformed by the development of CFTR modulator therapies, with substantial improvements in survival and quality of life. However, access to these therapies remains profoundly unequal worldwide. The greatest benefits have been realized in high-income countries, while people with cystic fibrosis in low- and middle-income countries and underserved populations within high-income settings continue to face limited access and poorer outcomes. Underdiagnosis is a major contributor to these disparities, as limited newborn screening, restricted access to sweat testing, and incomplete genetic characterization directly limit treatment eligibility and registry inclusion. Beyond diagnosis, disparities are driven by differences in genetic variant distribution, pricing and reimbursement policies, regulatory processes, and health system capacity. This review examines how these interrelated factors shape global access to therapies, with particular emphasis on CFTR modulators. Emerging strategies-including differential pricing, licensing mechanisms, regulatory adaptation, international collaboration, and health system strengthening-are discussed. Achieving equitable access will require coordinated action across diagnostic, economic, and policy domains to ensure that advances in cystic fibrosis care benefit patients regardless of geographic or socioeconomic context.
    DOI:  https://doi.org/10.1002/ppul.71560
  38. Front Pediatr. 2026 ;14 1763328
    Ralstonia pickettii as an emerging pediatric pathogen: a mini-review of current evidence.
    Christian Alberto Rodriguez-Saldaña, Mirtha Chiroque-Zavala, Milagros Quindes-Jaimes, Gianella María Muñoz-Vílchez, Karla Inés Alcántara-Sánchez, Adriana Montoya-Reátegui, Anabella Quiroga-Taboada, Luis Gabriel Farfán-Chávez, Daniel Reyes-Chávez, Juan José Flores-Rodriguez.
       Background: Ralstonia pickettii has gained relevance in pediatric healthcare due to its persistence in water systems, biofilm formation and contamination of medical solutions. This review summarizes current evidence on its epidemiology, environ-mental reservoirs, clinical features, diagnostic limitations and therapeutic considera-tions in children.
    Methods: A narrative search was conducted in PubMed, Scopus, Web of Science and Embase for studies published from January 1990 to 30 November 2025. Pediatric cases, outbreak reports, environmental studies with clinical relevance and microbiological reviews were included. Heterogeneity in design and reporting justified a narrative synthesis.
    Results: R. pickettii is the predominant Ralstonia species in pedi-atric infections and is closely linked to contaminated aqueous products and respiratory equipment. Neonates and immunocompromised children are most affected, with man-ifestations ranging from colonization to severe sepsis. Diagnostic systems frequently misidentify the organism, and molecular tools improve accuracy when combined with clinical assessment. Susceptibility patterns are variable and influenced by intrinsic re-sistance mechanisms and biofilm. Effective treatment often requires targeted therapy and device removal. Outbreak investigations consistently identify contaminated solu-tions and water systems as primary sources.
    Conclusions: R. pickettii is an emerging pathogen in pediatric care. Improving diagnostic accuracy, strengthening environ-mental control and ensuring safe handling of water-based solutions and medical devices are essential to reduce its clinical impact.
    Keywords:  Ralstonia pickettii; bacteremia; bio-film; contaminated solutions; healthcare-associated infection; neonatal intensive care; outbreak investigation; pediatric infections
    DOI:  https://doi.org/10.3389/fped.2026.1763328
  39. Clin Cosmet Investig Dermatol. 2026 ;19 586477
    Global Trends and Hotspot Analysis of Nanomaterials in the Field of Acne: A Bibliometric Perspective.
    Ruiqi Chen, Yan Tang, Linghan Duan, Zhihong Jiang, Mingfang Zhu.
       Background: Acne is a chronic inflammatory disease. Recent studies have revealed significant progress in the application of nanomaterials for acne treatment; however, a systematic analysis of research trends and hotspots remains lacking. This study aims to comprehensively present the current status of research in this field and summarize frontier directions using bibliometric methods.
    Methods: Publications with the subject terms "nanomaterials" and "acne" were retrieved from the Web of Science Core Collection for the period 2012-2025. Bibliometric analysis and visualization were conducted using CiteSpace, VOSviewer, Scimago Graphica, and R language.
    Results: A total of 301 articles from 547 institutions across 51 countries were analyzed. Annual publications increased from 7 in 2012 to 25 in 2025, showing a continuous upward trend. India emerged as the leading contributor in this field. Notably, Folle Camila from the University of Barcelona was identified as the most prolific author, Cairo University as the most productive institution, and the International Journal of Pharmaceutics as the core journal in this domain. Keyword analysis indicated that current research focuses primarily on optimizing nanomaterial-based delivery systems, exploring combination formulations, and developing strategies for acne scar repair. Furthermore, our study suggests that potential future hotspots may include adjuvant photodynamic therapy (PDT), safety evaluation of nanomaterials, and the development of intelligent responsive systems.
    Conclusion: This study systematically summarizes the research landscape and developmental trends of nanomaterials in acne treatment. The findings provide clinicians and researchers with a rapid overview of the academic frontiers in this area, offering valuable references for clinical decision-making and the identification of future research directions.
    Keywords:  acne; bibliometric; nanomaterials; treatment
    DOI:  https://doi.org/10.2147/CCID.S586477
  40. Sci Rep. 2026 Mar 11.
    DeepStackVEGF a stacking ensemble deep learning framework for vascular endothelial growth factor prediction.
    Farman Ali, Majdi Khalid, Abdulmohsen Algarni, Naif Waheb Rajkhan, Othman Asiry, Meng-Ze Du.
      Vascular Endothelial Growth Factor (VEGF) plays a central role in angiogenesis, regulating both physiological processes such as wound healing, tissue repair, and bone formation, and pathological events including tumor progression, metastasis, and diabetic retinopathy. Due to its crucial role in vascular biology, VEGF serves as an important therapeutic target in anti-angiogenic drug development and precision medicine. However, conventional experimental methods for VEGF identification are costly and time-consuming, emphasizing the need for efficient computational approaches. To address this challenge, we introduce DeepStack-VEGF, an advanced deep learning framework designed for accurate and robust VEGF prediction. The model integrates diverse sequence-derived features, including physicochemical descriptors, sequential patterns, evolutionary information, and secondary structure motifs, further enhanced by pretrained embeddings from UniProt and ProtBert. Feature optimization was achieved using Support Vector Machine-Recursive Feature Elimination. DeepStack-VEGF employs a stacking ensemble of three architectures including Feedback Generative Adversarial Network Gated Recurrent Unit and Capsule Convolutional Neural Network each contributing distinct representational capabilities. Comprehensive evaluations demonstrate that the fused feature set and stacking ensemble substantially outperform individual models, achieving superior accuracy, robustness, and generalization. By combining deep learning with biological insight, DeepStack-VEGF provides a reliable and scalable computational framework for VEGF identification, supporting rational drug discovery, anti-angiogenic therapy design, and precision medicine applications.
    Keywords:  Deep learning; Pre-trained language model; Stacking ensemble learning
    DOI:  https://doi.org/10.1038/s41598-026-40134-0
  41. Molecules. 2026 Mar 09. pii: 901. [Epub ahead of print]31(5):
    Porphyromonas gingivalis-Associated Modulation of β-Catenin Signaling in Oral Squamous Cell Carcinoma: Molecular Perspectives from Periodontal Dysbiosis.
    Nada Tawfig Hashim, Rasha Babiker, Riham Mohammed, Mariam Elsheikh, Vivek Padmanabhan, Md Sofiqul Islam, Malaz Gesm Elseed, Nallan C S K Chaitanya, Bogahawatte Samarakoon Mudiyanselage Samadarani Siriwardena, Muhammed Mustahsen Rahman, Bakri Gobara Gismalla.
      Periodontal disease and oral squamous cell carcinoma (OSCC) are highly prevalent conditions that contribute substantially to global morbidity, as documented by recent Global Burden of Disease analyses. The growing epidemiologic and experimental literature has prompted interest in potential links between chronic periodontal dysbiosis-particularly infection with Porphyromonas gingivalis-and molecular pathways involved in oral carcinogenesis, including β-catenin signaling. This narrative review synthesizes epidemiologic, clinical, and experimental studies examining associations between periodontal disease, P. gingivalis, and OSCC, with focused evaluation of β-catenin as a context-dependent signaling component within broader inflammatory and metabolic networks. Population-based studies report heterogeneous associations between periodontitis and OSCC that are frequently confounded by tobacco use, alcohol consumption, and socioeconomic factors, supporting correlation rather than causal inference. Experimental investigations in vitro and in vivo demonstrate that P. gingivalis can influence β-catenin availability and transcriptional activity through noncanonical mechanisms, including junctional disruption, proteolytic interference with regulatory complexes, and interaction with inflammatory, immune, and metabolic pathways. However, these findings derive largely from simplified model systems and should be interpreted as biologically plausible rather than definitive for human disease. Rather than acting as a dominant oncogenic driver, β-catenin appears to function as an integrative signaling node within a complex network shaped by chronic microbial and inflammatory stress. The principal contribution of this review lies in critically integrating dispersed evidence across study types while explicitly distinguishing association, mechanistic plausibility, and causality. Future longitudinal human studies and mechanistically informed experimental models are required to clarify whether modulation of periodontal dysbiosis or associated signaling pathways has relevance for OSCC risk assessment or prevention.
    Keywords:  P. gingivalis; Wnt signalling; epithelial–mesenchymal transition; gingipains; oral squamous cell carcinoma; periodontitis; β-catenin
    DOI:  https://doi.org/10.3390/molecules31050901
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