bims-fagtap Biomed News
on Phage therapies and applications
Issue of 2026–05–24
fifty-four papers selected by
Luca Bolliger, lxBio
  1. CApEsid biOfilm: a suggested pipeline for clinical phage microbiology for biofilm infections based on comparative method study.
  2. Characterization and evaluation of the efficacy of phage E21 therapy in a wound animal model of biofilm-associated Pseudomonas aeruginosa infection.
  3. Bacteriophages as Immune Modulators: Current Insights and Future Directions.
  4. The effects of bacteriophage cocktail treatment on healthy gut microbiota: an in vitro human colon model study.
  5. Beyond antibiotics: innovative and translational strategies to overcome antimicrobial resistance.
  6. Genomic analysis of prophages from Burkholderia gladioli exposes extensive genetic diversity.
  7. Revisiting the life cycle of temperate phages.
  8. Elucidating bacteriophage dynamics and interactions with real-time label-free optical imaging.
  9. Phage therapy for recurrent urinary tract infections: A qualitative study using the theoretical framework of acceptability.
  10. Staphylococcus aureus and Staphylococcus lugdunensis Act in Concert to Disrupt the Nasal Epithelial Barrier.
  11. The role of Campylobacter group II phages in mitigating Campylobacter contamination across the poultry food chain: Current applications and future prospects.
  12. Cross-genus phage design through branching domain and conserved peptide interactions.
  13. Clinical Signs and Symptoms of Biofilm-Associated Infection in Chronic Wounds: A Systematic Review of Diagnostic Accuracy Studies.
  14. Multidrug-resistant tuberculosis: a comprehensive review of pathogenesis, drug resistance, current treatment and future prospects.
  15. In vitro concentration-dependent inhibition of early biofilm formation by Staphylococcus aureus isolated from dairy cattle using a bacteriophage cocktail.
  16. Effects of cold atmospheric plasma therapy on chronic wounds: A systematic review and meta-analysis.
  17. In Vivo Efficacy of Bacteriophage Therapy Against Streptococcus agalactiae in Nile Tilapia (Oreochromis niloticus): Delivery Route and a Dose-Dependent Effect of Survival, Immune Responses, and Tissue Recovery.
  18. Nanofibrous Platforms for Advanced Wound Therapeutics: Mechanisms, Materials, and Clinical Horizons.
  19. Phage enabled precision drug delivery: dual function platforms for therapeutics and genetic cargo transport.
  20. Cystic Fibrosis Transition From Pediatrics to Adult Care in Low-Middle Income Countries.
  21. Salivary microbial profiles across periodontal severity stage according to the 2018 AAP/EFP classifications: a cross-sectional study.
  22. Oral microbiome dysbiosis of Porphyromonas gingivalis in oral leukoplakia, oral squamous cell carcinoma and radiation-induced oral mucositis: a qPCR-based cross-sectional study.
  23. From phage display to tumor microcirculation regulation: A bibliometric review of phage in cancer immunotherapy research (2000-2024).
  24. Isolation and characterization of novel bacteriophage, vB_AbaA_SWMUZ8, targeting multidrug-resistant Acinetobacter baumannii strains.
  25. Bacteriophages: A Long-forgotten Past, or Hope for the Future?
  26. Ulcerative colitis-driven gut dysbiosis exacerbates periodontal bone loss through the gut-oral axis /Th17/Treg imbalance.
  27. Humanistic Care Needs of Hospitalised Patients With Diabetic Foot Ulcers: A Qualitative Descriptive Study From the Nurse-Patient Perspective.
  28. Functionalized nanoparticles for the precise treatment and prevention of bacterial infections.
  29. Hydrogen-delivering biomaterial carriers for diabetic foot ulcer healing: a systematic review and meta-analysis of preclinical animal studies.
  30. Optimizing Approach to Liver Biochemistry Abnormalities in Cystic Fibrosis Pediatrics: Balancing Efficiency and Risk-Benefit.
  31. DepoCatalog: mapping diversity of 129 recombinantly produced Klebsiella phage depolymerases.
  32. The gut-skin axis in wound healing: a bibliometric analysis of intestinal flora and chronic wounds (2005-2025).
  33. Modulator therapy: rates and stages of respiratory bacteriome restoration in cystic fibrosis patients chronically infected with Pseudomonadota.
  34. A polyvalent phage shapes bacterial dynamics.
  35. Osteoporosis and Periodontitis: Two-Way Epidemiological and Mechanistic Evidence.
  36. Promicrobial mucoadhesive micro-composites enable delivery of beneficial oral bacteria to restore and modulate oral biofilm communities.
  37. Microbial burden of periodontal diseases and its clinical application: The stage, grade, and furcation matter.
  38. Evaluation of the Potential Efficacy of Bacteriophage Therapy for the Management of Pressure Ulcers and Its Comparison to Conventional Therapy: A Randomized Controlled Trial.
  39. Comparative analysis of TNF-α, TLR-2, and TLR-4 in GCF before and after periodontal therapy.
  40. Circadian disruption and cellular senescence: emerging perspectives in periodontitis.
  41. Review of the Microbial Spectrum of Mixed Respiratory Fungal Infections.
  42. Mobile Health App Needs Among Patients With Diabetic Foot Ulcers in China: A Qualitative Study From the Perceptions of Patients, Caregivers, and Health Care Professionals.
  43. Artificial Intelligence-driven Drug Discovery: Transforming Pharmaceutical Innovation Through Computational Approaches.
  44. A review on phytochemical and bacteriophage based therapeutic strategies for the management of Brucellosis.
  45. Offloading orthotic insoles on healing of diabetic foot ulcers: a protocol for systematic review and meta-analysis.
  46. Machine learning reveals microbiome differences by periodontitis severity.
  47. Isolation and characterization of a bacteriophage targeting Proteus mirabilis for use in culture media.
  48. Artificial intelligence in periodontics and peri-implant medicine: from diagnosis to precision care.
  49. Using Large Language Models to Automate the Comparison and Integration of Evolving Clinical Practice Guidelines into Clinical Decision Support Systems.
  50. Does inflammatory bowel disease play a role in cognitive decline? A systematic review.
  51. Integrating Past and Present PHAGE Research.
  52. Topical therapies for diabetic foot ulcers: a systematic review and network meta-analysis.
  53. An Update and Overview of the Ocular and Extraocular Microbiome and Its Impact on Ophthalmic Care.
  54. Ventilator-associated pneumonia: newer insights that can drive improved outcomes.
  1. Sci Rep. 2026 May 21.
    CApEsid biOfilm: a suggested pipeline for clinical phage microbiology for biofilm infections based on comparative method study.
    Amit Rimon, Ron Braunstein, Ortal Yerushalmy, Noa Katz, Lidor Yosef, Yitzchak Gvili, Shunit Coppenhagen-Glazer, Ronen Hazan.
      The rise of antibiotic-resistant infections, particularly those involving biofilms, presents a significant global health threat. Phage therapy, the use of bacteriophages as antimicrobial agents, offers promising solutions to this crisis. A critical component of phage therapy is the assessment of phage efficacy, in both the presence and absence of antibiotics, prior to clinical application. While considerable progress has been made using planktonic bacterial cultures, there remains an urgent need for standardized methods to evaluate phage efficacy against biofilms. In this study, we address this gap by systematically comparing ten different methods for quantifying phage activity in biofilm settings. Each method was evaluated using a panel of five anti-Pseudomonas aeruginosa phages, which were tested against both planktonic and biofilm cultures. Based on these comparisons, we propose a robust pipeline for detecting phage activity in biofilms. This pipeline, termed CApEsid biOfilm, integrates modified colony-forming unit (CFU) assays using stainless steel washers, crystal violet staining, extracellular DNA quantification using a dye, and extracellular ATP measurements. The pipeline was further validated with additional bacterial species and their respective phages. We also demonstrate its utility in detecting interactions between phages and antibiotics. Overall, this work presents a foundational pipeline that may enhance the clinical matching of phages for treating biofilm-associated infections, thereby improving the outcomes of phage therapy.
    DOI:  https://doi.org/10.1038/s41598-026-52935-4
  2. Sci Rep. 2026 05 19. pii: 15490. [Epub ahead of print]16(1):
    Characterization and evaluation of the efficacy of phage E21 therapy in a wound animal model of biofilm-associated Pseudomonas aeruginosa infection.
    Ahmed M Salah Eldin, Ahmed S Abu Zaid, Rania Ibrahim Shebl, Mahmoud A Yassien.
      Skin infections caused by strong biofilm Pseudomonas aeruginosa (P. aeruginosa) are considered a serious public health issue because of the increased resistance toward the currently available antibiotics. Consequently, innovative therapeutic strategies have emerged to address these challenging infections. Among them, phage therapy stands out, in which highly potent lytic bacteriophages (phages) are specifically selected to target and eradicate the responsible pathogens. In this study, Pseudomonas phage E21 was recovered from sewage, and it genetically belongs to the Lavrentievirus genus, Casjensviridae family. The genetic characterization of the isolated phage reveals the presence of highly potent lytic enzymes, which play a critical role in effectively suppressing the growth of the targeted pathogens. The phage has high stability patterns over a wide range of temperatures and pH values (65 ℃ and 3-11). Carboxymethylcellulose was used to formulate a hydrogel for the evaluation of the bacteriophage's efficacy against biofilm-associated wound infection in a suitable animal model. The result of the preclinical study confirmed the efficacy of isolated phage in the therapy of biofilm-associated wound infection.
    Keywords:   Pseudomonas aeruginosa ; Carboxy methylcellulose; Phage therapy; Skin infection; Strong biofilm
    DOI:  https://doi.org/10.1038/s41598-026-52857-1
  3. Phage (New Rochelle). 2026 Jun;7(2): 108-117
    Bacteriophages as Immune Modulators: Current Insights and Future Directions.
    Kollawat Somsri, Nuttawut Sutnu, Sirikan Montathip, Thansita Bhunyakarnjanarat, Marcus J Schultz, Kent Doi, Wiwat Chancharoenthana, Asada Leelahavanichkul.
      Bacteriophages are by far the most abundant biological entities on Earth. A phage is a virus that targets bacterial hosts via the lysogenic cycle or lytic cycle, with the latter serving the principal mechanism in personalized phage therapy for treating bacterial infections. Although phage therapy has been routinely used in some countries for more than half a century ago, the rise of modern antibiotic production and its widespread adoption diminished interest. The emergence of increasingly severe antimicrobial resistance has prompted health care to explore nonantibiotic treatment options, including phage therapy and other bacteriophage-based applications. In examining phage-host cell interactions, this article explores bacteriophage infection cycles, mechanisms of inflammation modulation, their impact on health, and relevant current research. It also highlights phage-induced inflammatory responses and immune modulation, their potential as effective standalone or adjuvant immunological agents, and future directions in research on phages.
    Keywords:  anti-inflammation; bacteriophages; inflammation modulation; inflammatory; phage-therapy; phages; phage–host interaction
    DOI:  https://doi.org/10.1177/26416549251412046
  4. Microb Genom. 2026 May;12(5):
    The effects of bacteriophage cocktail treatment on healthy gut microbiota: an in vitro human colon model study.
    Teagan L Brown, Duncan Y K Ng, George M Savva, Claire K A Elek, James A D Docherty, Ryan Cook, Rebecca Ansorge, Andrea Telatin, Elizabeth Kutter, Evelien M Adriaenssens.
      The human gut microbiome is a complex community that plays an important role in health, where perturbations can result in dysbiosis and disease. Bacteriophages (phages) can provide treatment for bacterial gastrointestinal disease, and commercial preparations such as the Intesti bacteriophage cocktail can be taken orally to target bacterial pathogens. However, interactions between these phages and the native gut microbiota are understudied. To investigate the impact of phage treatment, we used simulated gut models seeded with healthy donor microbiota from three individuals, sequenced the DNA and analysed the bacterial and viral portions from samples obtained over time. Each donor had a unique bacterial composition that diverged with time. When comparing phage-treated to control samples, we observed that Escherichia coli abundance accounted for the largest portion of bacterial community variance and was more associated with the controls. The lower abundance in phage-treated samples may have resulted from the lytic action of phages from the cocktail. Additionally, our analyses of the viral portion revealed a phage bloom exclusive to phage-treated samples. A highly abundant phage in this bloom was matched with the Intesti bacteriophage cocktail, showed similarity to Enterobacteria phage phi92 and provided evidence of productive infection within the model. While we did observe fluctuations in relative abundance of additional viral sequences in the presence of the phage cocktail, these changes were often transient. Furthermore, we detected only slight differences from typical members of the virome and low numbers of active prophages. Our experiments suggest that the phage cocktail had minimal interruption to the native gut microbiota within the model.
    Keywords:  bacteriophage cocktail; gut microbiota; shotgun metagenomics; virome
    DOI:  https://doi.org/10.1099/mgen.0.001731
  5. 3 Biotech. 2026 Jun;16(6): 201
    Beyond antibiotics: innovative and translational strategies to overcome antimicrobial resistance.
    Anu Kumar, Bhanu Krishan, Sunny Dhiman, Anupam Sharma, Varsha Thadiyan, Wamik Azmi.
      The rapid rise of antimicrobial resistance demands therapeutic strategies that extend beyond conventional antibiotics. However, most existing reviews describe emerging alternatives without systematically linking their mechanistic advances to translational readiness and clinical implementation barriers. This review addresses this gap by integrating evidence across multiple beyond-antibiotic approaches, including antimicrobial peptides, bacteriophage therapy, CRISPR-based antimicrobials, nanotechnology-enabled delivery systems, anti-virulence agents, host-directed immunotherapies, microbiome modulation (engineered probiotics and fecal microbiota transplantation), and drug-repurposing or combination therapies. The principal contribution of this synthesis is a comparative framework that maps mechanisms of action, engineering innovations, and translational evidence across these diverse strategies. Advances such as peptidomimetics, engineered phages, and nanoparticle carriers that enhance stability, targeting, and therapeutic efficacy are highlighted, along with synergistic strategies including phage-antibiotic and CRISPR-nanocarrier combinations. The review further identifies major barriers limiting clinical translation, including delivery efficiency, toxicity and ecological concerns, large-scale production challenges, cost, inconsistent clinical outcomes, and regulatory fragmentation for biologics and live therapeutics. To facilitate clinical implementation, the study proposes a translational roadmap emphasizing standardized evaluation assays, physiologically relevant infection models, integrated rapid diagnostics, and regulatory frameworks tailored for emerging antimicrobial platforms, thereby supporting the development of sustainable therapies for the post-antibiotic era.
    Keywords:  Antimicrobial resistance; CRISPR-Cas antimicrobials; antimicrobial peptides; bacteriophage therapy; host-directed therapies; microbiome modulation; nanotechnology; non-antibiotic therapies; translational medicine
    DOI:  https://doi.org/10.1007/s13205-026-04836-6
  6. BMC Genomics. 2026 May 20.
    Genomic analysis of prophages from Burkholderia gladioli exposes extensive genetic diversity.
    Angelle P Britton, Jonathan J Dennis.
      The Burkholderia genus of Gram-negative bacteria are known for their extensive metabolic capabilities, their relatively plastic genomes, their high intrinsic resistance to antibiotics, and their ability to cause various diseases in humans, animals, and plants. Burkholderia gladioli is one such species, that is an opportunistic pathogen in people, causing sometimes fatal pneumonia, or in plants, causing onion bulb rot, mushroom soft rot, or rice panicle blight. Therapies that utilize bacterial viruses (bacteriophages, or phages) to counter or control pathogenic bacteria are a promising alternative to antibiotics. Here, we present genomic characterization of four new B. gladioli induced prophages, including their phage particle characteristics, host specificity, genomic content relatedness, and potential therapeutic activity. These findings indicate a widespread lysogenic state within the B. gladioli population. Further investigation of the interactions between bacteriophages / prophages and their targeted B. gladioli bacteria will inform on the genomic diversity, environmental survival, and pathogenic potential of B. gladioli, and importantly, the use of B. gladioli phages in phage therapy applications.
    Keywords:   Burkholderia gladioli ; Bacteriophage; Genomics; Lysogenic conversion; Phylogeny; Prophage
    DOI:  https://doi.org/10.1186/s12864-026-12923-4
  7. Nat Rev Microbiol. 2026 May 20.
    Revisiting the life cycle of temperate phages.
    Jakob T Rostøl, Cora Chmielowska, Alberto Marina, José R Penadés.
      Temperate bacteriophages (phages) are ubiquitous viruses that co-evolve with their bacterial hosts. They are defined by their ability to undergo two distinct life cycles: the lytic cycle, in which the phage produces more viral copies and kills the host, and the lysogenic cycle, in which the temperate phage exists as a prophage in the host. Temperate phages have long served as fundamental models in microbiology, genetics and evolutionary biology research, and their life cycles are among the most thoroughly characterized in virology. Historically, the phage life cycle was viewed primarily through the lens of how excision, replication and packaging drive the formation of infective particles. Although it captures the central processes of the phage life cycle, this narrow perspective overlooks the full range of interactions with the host and with other mobile genetic elements. In this Review, we re-examine the temperate phage life cycle in light of emerging insights that expand on this framework with unanticipated complexities. We argue that many properties of (pro)phages should be viewed as integral parts of their life cycle instead of being discussed separately. This holistic view is important to fully appreciate the intricacies of the temperate phage life cycle and the key roles of these viruses in microbiology and biotechnological applications.
    DOI:  https://doi.org/10.1038/s41579-026-01318-7
  8. J R Soc Interface. 2026 May 20. pii: 20260250. [Epub ahead of print]23(238):
    Elucidating bacteriophage dynamics and interactions with real-time label-free optical imaging.
    Francesco Giorgi, Samuel Chenery, Liberty Duignan, Joanne L Fothergill, Eann Patterson, Judith M Curran.
      Bacteriophages are the focus of extensive research, and monitoring their dynamics and interactions with bacterial hosts is crucial to characterize the mechanisms of infection and to support potential applications in biotechnology and medicine. Traditional monitoring techniques rely on the fluorescent labelling of bacteriophages due to their size being nanometric. In this paper, we propose a novel, label-free method to generate optical signatures of bacteriophages in a conventional microscopy set-up by exploiting the optical phenomenon of caustics. Using Pseudomonas aeruginosa phages (pelp20 and phiKZ) and a newly isolated Escherichia coli phage (EcoLiv25), we demonstrate the generation of distinct optical signatures that enable prolonged monitoring of phage dynamics in liquid media. The results obtained demonstrate caustics-based optical microscopy as a robust, non-invasive approach that complements existing imaging methods by enabling real-time observation and quantitative analysis of phage motion, transport and interactions. Building on these capabilities, the technique can accelerate fundamental studies of viral dynamics and ecology, enable real-time observation of phage-bacteria interactions and support the development of phage-based diagnostics and antimicrobial therapies.
    Keywords:  Brownian motion; bacteria; bacteriophages; diffusion; microscopy; random walk
    DOI:  https://doi.org/10.1098/rsif.2026.0250
  9. PLoS One. 2026 ;21(5): e0349568
    Phage therapy for recurrent urinary tract infections: A qualitative study using the theoretical framework of acceptability.
    David Wenzel, Michelle Crick, Carolyn Tarrant, Olivia Revitt, Jeni Senior, Melissa Haines.
       OBJECTIVES: To explore the anticipated acceptability of bacteriophage therapy for recurrent urinary tract infections (rUTIs) among key stakeholders in the United Kingdom, using the Theoretical Framework of Acceptability (TFA).
    DESIGN: Qualitative study using online focus groups, analysed with reflexive thematic analysis, and mapped to the constructs of the TFA.
    SETTING: United Kingdom, conducted online via Microsoft Teams.
    PARTICIPANTS: Forty-four participants across three stakeholder groups: individuals with lived experience of rUTIs, doctors involved in UTI management, and other healthcare professionals (HCPs: specialist nurses, pharmacists, and advanced care practitioners).
    RESULTS: Participants demonstrated high enthusiasm for phage therapy, reflecting positive affective attitude and strong perceptions of effectiveness. For patients with lived experience, enthusiasm was often grounded in desperation following repeated treatment failure, raising ethical concerns around vulnerability to poor-quality research or inequitable access. Across groups, opportunity costs were identified as key barriers, centred on financial impact and availability within the NHS. Gaps in understanding about mechanisms, safety, and delivery highlighted the importance of intervention coherence and, for doctors and other HCPs, self-efficacy. Lived experience participants described strong online communities that acted as informal knowledge networks, suggesting a potential channel for dissemination and education.
    CONCLUSIONS: Phage therapy was broadly viewed as acceptable, but acceptability is conditional on evidence of safety and effectiveness, equitable access, and clear communication. Application of the TFA demonstrated how enthusiasm, vulnerability, cost, and coherence intersect to shape overall perceptions. These findings emphasise the importance of ethical safeguards, patient-centred education, and integration with community networks to support the responsible adoption of phage therapy.
    DOI:  https://doi.org/10.1371/journal.pone.0349568
  10. Clin Transl Allergy. 2026 May;16(5): e70177
    Staphylococcus aureus and Staphylococcus lugdunensis Act in Concert to Disrupt the Nasal Epithelial Barrier.
    Sintayehu Ambachew, Mahnaz Ramezanpour, Clare M Cooksley, Gohar Shaghayegh, Isabella Burdon, Emma F Barry, Kevin Aaron Fenix, P J Wormald, Alkis J Psaltis, Sarah Vreugde.
       INTRODUCTION: Chronic rhinosinusitis (CRS) pathophysiology and its link to microbiome is an area of ongoing investigation. Certain pathogens, in particular Staphylococcus aureus described to contribute to recalcitrant CRS. In addition, different species of coagulase negative staphylococci (CoNS) are frequently isolated from the sinonasal cavity of CRS patients. However, the influence of Staphylococcal species coexisting in the same niche on the inflammatory process remains unclear. The aim of this study was to explore the impact of exoproteins from various Staphylococcus species isolated from the same patients on the mucosal barrier.
    METHODS: Staphylococcal species isolated from CRS and control patients were cultured from sinus swabs in planktonic and biofilm forms, and their exoproteins extracted. Primary human nasal epithelial cells (HNECs) from CRS patients were cultured at an air-liquid interface (ALI) and exposed to 20 μg/mL exoproteins or control. Barrier disruption and cytotoxicity were assessed by measuring the transepithelial electrical resistance (TEER), passage of fluorescein labeled dextrans and lactate dehydrogenase (LDH) levels. IL- 6 concentration was measured employing ELISA. Patient's matched sinonasal tissue samples were analyzed with flow cytometry to detect and quantify immune cells.
    RESULTS: Forty-four Staphylococcal species were isolated from 22 CRS and control patients including: 22 S. aureus, 12 S. epidermidis, and 10 S. lugdunensis. 15 out of 22 S. aureus exoproteins significantly enhanced cytotoxicity, reduced TEER values and increased paracellular permeability compared to control (p < 0.05). By contrast, S. epidermidis and S. lugdunensis exoproteins caused either mild or negligible effects on the TEER values, cell viability, and paracellular permeability. However, S. lugdunensis exoproteins induced significantly higher IL-6 compared to control. Correlation analysis indicated S. aureus and S. lugdunensis from the same patient acted in concert to disrupt the nasal epithelial barrier and induce toxicity.
    CONCLUSION: This study shows the significant and detrimental impact of the presence of S. aureus exoproteins on nasal epithelial cell barrier function. S. aureus and S. lugdunensis isolated from the same patients acted in concert to affect the nasal barrier and inducing toxicity.
    Keywords:  Chronic rhinosinusitis; Nasal epithelial cells; Staphylococcus species; biofilms; exoproteins
    DOI:  https://doi.org/10.1002/clt2.70177
  11. Food Res Int. 2026 Aug 01. pii: S0963-9969(26)01042-2. [Epub ahead of print]237 119365
    The role of Campylobacter group II phages in mitigating Campylobacter contamination across the poultry food chain: Current applications and future prospects.
    Muhammad Shahzad Rafiq, Syed Sami Haider, Ziyi Li, Muhammad Sarmad, Dongxin Ma, Muhammad Ali Khan, Junhao Wang, Shuaifeng Gu, Pan Tao, Muhammad Tanweer Khan, Haihong Hao.
      Campylobacteriosis is a major foodborne diseases, with an estimated 96 million cases worldwide annually. Campylobacter jejuni (C. jejuni) and Campylobacter coli (C. coli) are major causes of human gastroenteritis, and poultry products are the main transmission source. An increasing incidence of antimicrobial resistance (AMR) among Campylobacter strains further complicates the control of these pathogens in the food chain. Although various approaches have been explored, phage biocontrol, particularly with Campylobacter group II phages, has shown promise in controlled preharvest and postharvest studies. Group II phages are highly specific and lyse C. jejuni and C. coli with potential to reduce Campylobacter colonization in poultry. These phages offer a selective, eco-compatible alternative to conventional antimicrobial treatments that selectively kill pathogenic bacteria without significantly affecting gut microbiota. Applying phage therapy during poultry processing, such as spraying or dipping, has reduced Campylobacter loads on chicken skin and meat, as well as on the surfaces of poultry equipment, thereby diminishing the risk of food chain contamination. Moreover, consistent performance under commercial poultry conditions requires further large-scale validation and process-specific optimization (formulation stability, delivery logistics, and integration with existing biosecurity and processing hurdles). This review discusses antimicrobial resistance trends in Campylobacter, poultry as a key transmission route, and the use of group II phages to reduce Campylobacter contamination. It also highlights challenges and opportunities, including optimization of phage preparations for scale-up; rigorous genomic screening and safety evaluation; evaluation of effects on microbial communities and countering antibiotic-resistant bacteria; and exploration of transposase-associated functions for future phage engineering.
    Keywords:  Antimicrobial resistance; Bacteriophage; Campylobacter; Poultry
    DOI:  https://doi.org/10.1016/j.foodres.2026.119365
  12. J Biol Eng. 2026 May 18.
    Cross-genus phage design through branching domain and conserved peptide interactions.
    Agnieszka Latka, Dorien Dams, Lennert Scholiers, Britt Van Mieghem, Zuzanna Drulis-Kawa, Yves Briers.
       BACKGROUND: Branched receptor-binding protein (RBP) systems enable bacteriophages to broaden their host range through the incorporation of two or more RBPs. Using the Klebsiella podophages KP32, K11, and KP34 as model systems, we experimentally validated the interaction between the branching domain of the primary RBP (RBP1) and the conserved docking peptide of the secondary RBP (RBP2) as an essential architectural pair enabling dual-RBP incorporation into the virion.
    RESULTS: Systematic engineering revealed that loss of either of these domains, the branching domain or the conserved peptide, abolishes RBP2 assembly, underscoring their structural role in organizing the branched configuration and demonstrating that the anchor domain is the sole element directly attaching the RBP complex to the virion. Exploiting this interaction, we engineered a chimeric phage based on the Klebsiella phage KP32 scaffold that was capable of cross-genus infection and productive propagation on both Klebsiella and Escherichia hosts. In contrast to previous approaches that required replacement of the entire RBP, the adaptor and nozzle proteins, this strategy achieved host-range reprogramming through modular domain swapping and positional relocation of RBPs (i.e., exchanging RBP1 and RBP2 positions). Conversely, an Escherichia phage K1F scaffold was also successfully engineered to infect Klebsiella.
    CONCLUSIONS: Our study confirms that the RBP branching domain and the conserved peptide function as specific interacting partners. Our findings establish the conserved peptide as a docking element and highlight the structural flexibility of podoviruses to accommodate RBPs from different positional and taxonomic contexts. Collectively, this work provides a mechanistic framework for rational phage engineering and defines a general design principle for generating customized therapeutic phages with an expanded host spectrum, including cross-genus infectivity.
    Keywords:  Branching domain; Conserved peptide; Depolymerase; Host range; Klebsiella phage; Receptor-binding protein; Tailspike
    DOI:  https://doi.org/10.1186/s13036-026-00682-5
  13. Int Wound J. 2026 May;23(5): e70877
    Clinical Signs and Symptoms of Biofilm-Associated Infection in Chronic Wounds: A Systematic Review of Diagnostic Accuracy Studies.
    Borja González-Suárez, Pablo López-Casanova, Hector González-de la Torre, Iván Durán-Saenz, Ana García-Rubio, José Verdú-Soriano, Miriam Berenguer-Pérez.
      The presence of biofilm in chronic wounds represents a major diagnostic challenge, as clinical manifestations are often subtle and laboratory confirmation remains limited. To identify clinical signs and symptoms (CSS) evaluated in validated tools or scales related to wound infection and biofilm, and to assess their diagnostic accuracy. A systematic review of diagnostic accuracy studies was conducted in accordance with PRISMA-DTA guidelines, searching six databases from inception to May 2025. Of 2064 records identified, four studies met inclusion criteria. All were focused on infection-related CSS; none were specifically designed to diagnose biofilm. Sensitivity and specificity varied substantially across CSS and study designs, and no validated, non-invasive diagnostic scale for biofilm was identified. The available evidence base is limited and heterogeneous. A preliminary list of candidate CSS is proposed to guide future validation studies and support earlier clinical recognition of biofilm-associated infection.
    Keywords:  biofilm; chronic wounds; clinical signs; diagnostic accuracy; infection; systematic review
    DOI:  https://doi.org/10.1111/iwj.70877
  14. Arch Microbiol. 2026 May 19. pii: 395. [Epub ahead of print]208(8):
    Multidrug-resistant tuberculosis: a comprehensive review of pathogenesis, drug resistance, current treatment and future prospects.
    Shweta Tiwari, Ankit Kumar Singh, Aarshu Acharya, Joyabroto Ghosh, Rashmi Prabha Singh.
      Tuberculosis (TB) accounted for almost 1.2 million deaths in 2024. It remains a leading cause of mortality due to an airborne infectious bacterium, Mycobacterium tuberculosis (MTB). Despite the development of vaccines and antibiotics to cure the disease, it remains a major global problem due to the development of several ingenious pathogenic pathways. This comprehensive review introduces the mechanisms of bacterial pathogenesis against the human defence system and the development of drugs against MTB, with particular emphasis on the mechanisms of drug resistance and mutations that render them ineffective globally. There is also a discussion of the MTB lineage and the mutant types. The mechanisms of multidrug resistance and ineffective treatment regimens have driven advances in drug development and alternative therapeutics. New molecules that can potentially disarm MTB have been explored, including SQ109, GuaB2, Q203, Largazole, and Auranofin. In addition, natural compounds, bacteriophage therapy, antimicrobial peptides, and probiotics are also explored to help address the global threat posed by MTB.
    Keywords:  Anti-tubercular drugs; Antimicrobial peptides; Bacteriophage therapy; Clinical trials drugs; Drug resistance mechanism; Multidrug-resistant tuberculosis
    DOI:  https://doi.org/10.1007/s00203-026-04938-y
  15. BMC Vet Res. 2026 May 22.
    In vitro concentration-dependent inhibition of early biofilm formation by Staphylococcus aureus isolated from dairy cattle using a bacteriophage cocktail.
    Edyta Kaczorek-Łukowska, Paweł Foksiński, Natalia Szyryńska, Agnieszka Maszewska, Marta Krzyżaniak.
      Bovine mastitis remains one of the most economically important diseases in dairy cattle, with Staphylococcus aureus being a major etiological agent, particularly in chronic and subclinical infections. The ability of S. aureus to form biofilms significantly contributes to antimicrobial tolerance and treatment failure, highlighting the need for alternative or adjunctive therapeutic approaches. Bacteriophage therapy has re-emerged as a promising strategy; however, data on its anti-biofilm efficacy against mastitis-associated S. aureus isolates are limited. In this study, we evaluated the anti-biofilm activity of a newly developed anti-Staphylococcus aureus bacteriophage cocktail against clinical isolates obtained from subclinical bovine mastitis. Twenty-eight non-duplicate field isolates of Staphylococcus aureus obtained from dairy cattle with subclinical mastitis on different farms in north-eastern Poland were examined using a MIC-like assay, followed by biofilm inhibition experiments conducted under high bacterial inoculum conditions. Biofilm formation was assessed after 24 and 48 h using crystal violet staining and confocal laser scanning microscopy with LIVE/DEAD™ fluorescence staining. Ultrastructural changes were analyzed by scanning electron microscopy. MIC-like values did not correspond to concentrations effective against biofilm formation. Biofilm biomass and viability were reduced in a concentration- and time-dependent manner, with the most pronounced effects observed at higher bacteriophage concentrations. Microscopic analyses confirmed biofilm disruption and bacteriophage-induced cellular damage. These findings demonstrate the potential of bacteriophage cocktails as anti-biofilm agents and support further investigation of bacteriophage-based strategies targeting early biofilm development in veterinary staphylococcal infections. This in vitro study was designed to evaluate the concentration-dependent effects of bacteriophages on early biofilm development rather than clinical treatment efficacy.
    Keywords:   Staphylococcus aureus ; Bacteriophages; Biofilm; Cattle; Mastitis
    DOI:  https://doi.org/10.1186/s12917-026-05565-x
  16. J Tissue Viability. 2026 May 16. pii: S0965-206X(26)00035-5. [Epub ahead of print]35(3): 101017
    Effects of cold atmospheric plasma therapy on chronic wounds: A systematic review and meta-analysis.
    Nanbing Yuan, Yanzhi Yang, Jing Cai, Cuixia Tan, Xingwu Ran.
       BACKGROUND: Chronic wounds, including diabetic foot ulcers (DFUs) and pressure ulcers (PUs), present major therapeutic challenges due to delayed healing, high recurrence, and persistent microbial colonization. Cold Atmospheric Plasma (CAP) has emerged as a potential adjunctive therapy, but its clinical efficacy has not been comprehensively evaluated.
    METHODS: This systematic review and meta-analysis, registered with PROSPERO (CRD42025640913), analyzed randomized controlled trials (RCTs) published from 2010 to 2025. A comprehensive search across PubMed, EMBASE, Cochrane Library, and Web of Science identified studies comparing CAP with standard care. Data synthesis employed random- or fixed-effects models. Risk of bias and certainty of evidence were assessed with the Cochrane Risk of Bias Tool and the GRADE framework. Subgroup analyses were conducted based on plasma generation technology, treatment frequency, and study quality.
    RESULTS: 12 RCTs (477 participants) were included. CAP significantly reduced wound area (MD = -1.36; 95% CI: -2.09 to -0.62; p = 0.0011) and DFU area (MD = -1.48; 95% CI: -2.81 to -0.15; p = 0.0296). CAP also improved healing rates (RR = 2.90; 95% CI: 1.45 to 5.80; p = 0.0052) and reduced bacterial load (MD = -0.36; 95% CI: -0.64 to -0.08; p = 0.0126). Subgroup analysis revealed variability by plasma technology (Dielectric Barrier Discharge vs Plasma Jet) and methodological quality.
    CONCLUSION: CAP therapy significantly improves wound healing and bacterial load reduction in chronic wounds, particularly DFUs. However, significant heterogeneity and limitations in study quality underscore the need for larger, high-quality trials with standardized protocols to validate long-term benefits.
    Keywords:  Chronic wounds; Cold atmospheric plasma (CAP); Diabetic foot ulcers (DFU); Wound healing
    DOI:  https://doi.org/10.1016/j.jtv.2026.101017
  17. Phage (New Rochelle). 2026 Jun;7(2): 118-130
    In Vivo Efficacy of Bacteriophage Therapy Against Streptococcus agalactiae in Nile Tilapia (Oreochromis niloticus): Delivery Route and a Dose-Dependent Effect of Survival, Immune Responses, and Tissue Recovery.
    Nashwa Abdel-Razek, Riad H Khalil, Tamer Mohammed Monir Abdelrahiem, Hend Abd Moneim Mohamed El-Saftawy, Sameh A Metwaly, Mohamed Fathi.
       Background: The sustainability of Nile tilapia (Oreochromis niloticus) aquaculture is increasingly threatened by bacterial pathogens, such as Streptococcus agalactiae, which cause severe economic losses and high mortality. The overuse of antibiotics in aquaculture has worsened antimicrobial resistance, highlighting the need for alternative therapeutic strategies. This study examines the effectiveness of bacteriophage therapy under experimental conditions as a targeted, potentially environmentally friendly approach to control S. agalactiae infections in Nile tilapia by measuring survival, immune, biochemical, and histological endpoints.
    Materials and Methods: Three lytic bacteriophages (STRA1, STRA2, STRA3) were isolated and characterized in vitro for host range and lytic activity against S. agalactiae. Experimental application used three administration methods: intramuscular injection of both bacteria and phage (Treat1), intramuscular bacterial infection followed by phage immersion (Treat2), and simultaneous immersion of fish in water containing both bacteria and phages (Treat3). Phage doses of 105, 107, and 109 plaque-forming unit (PFU)/mL were tested. Outcomes evaluated included survival rates, immune responses, biochemical markers, histopathological recovery, and cytokine expression.
    Results: The results showed a dose-dependent decrease in mortality, with Treat1 achieving 100% relative percent survival at 109 PFU/mL. Phage therapy significantly enhanced innate markers (nitroblue tetrazolium activity, lysozyme levels) and adaptive markers (total Ig, IgM), as well as glutathione S-transferase activity. Histological assessments revealed improved intestinal villus architecture, reduced kidney pathology, and enhanced tissue regeneration in groups treated with phages. Cytokine and gene expression analysis revealed a dose-dependent increase in interleukin (IL)-1β and IL-8 and in the antiviral MX gene, while TNF-α decreased at high doses. CXC2 (a chemokine) was also induced. Intramuscular administration consistently surpassed immersion methods, especially at intermediate doses, by providing more rapid and effective protection under the tested conditions.
    Conclusions: This research highlights the potential of bacteriophage therapy as an alternative to antibiotics in aquaculture. The findings emphasize the importance of optimizing phage dosage and delivery techniques to enhance therapeutic effectiveness while reducing environmental impact. Future studies should focus on field validation, phage formulation strategies, and the long-term effects of phage therapy on fish health and microbiomes.
    Keywords:  Nile tilapia; Streptococcus agalactiae; bacteriophage therapy; delivery route; dose-dependent
    DOI:  https://doi.org/10.1177/26416549261418873
  18. Macromol Biosci. 2026 May;26(5): e70189
    Nanofibrous Platforms for Advanced Wound Therapeutics: Mechanisms, Materials, and Clinical Horizons.
    Wanho Cho, Chungmo Yang, Hyuk Sang Yoo.
      Nanofibrous dressings have emerged as a transformative solution for acute and chronic wound management. This review evaluates recent advancements in wound therapeutics utilizing nanofiber platforms incorporating various bioactive agents. A comprehensive overview of the wound healing process across distinct physiological phases is provided, alongside a discussion of nanofiber fabrication methodologies and their underlying mechanisms. Particular emphasis is placed on the constituent materials and their inherent biofunctionality, specifically regarding how cellular interactions with these substrates enhance wound healing outcomes. Furthermore, we examine the clinical utility of these scaffolds in achieving hemostasis, modulating inflammation, preventing infection, and promoting angiogenesis. The review concludes by highlighting the cost-effectiveness and tunable architecture of nanofibers, underscoring their potential as the next generation of efficacious wound care systems.
    DOI:  https://doi.org/10.1002/mabi.70189
  19. Front Microbiol. 2026 ;17 1812871
    Phage enabled precision drug delivery: dual function platforms for therapeutics and genetic cargo transport.
    Md Sharifull Islam, Jie Fan, Marshia Ahmed Vabna, Nabila Haque, Sawda Binte Monir, Yikui Li, Ishatur Nime, Mrityunjoy Acharjee, Fan Pan.
      The rising concern of antimicrobial resistance, coupled with the continually challenging management of complicated diseases such as cancer, has provided momentum toward precision molecular medicine. This review provides an overview of bacteriophage enabled strategies encompassing both conventional antibacterial applications and advanced bioengineered delivery systems. Recent advances in phage therapy include the use of tailored phage formulations, phage immobilization approaches and phage antibiotic combinations to achieve targeted bacterial lysis particularly against multidrug-resistant pathogens and biofilm-associated infections. Beyond their intrinsic antibacterial activity, phages can be genetically and chemically engineered as nanoscale scaffolds. Phage display technologies enable the incorporation of targeting ligands for selective binding to specific tissues including tumor cells. Furthermore, phage capsids can be modified to encapsulate and deliver diverse therapeutic payloads such as small-molecule drugs, nucleic acids and gene-editing systems such as CRISPR-Cas, thereby expanding their utility beyond infectious diseases. The integration of phage biology with nanobiotechnology positions these viral platforms at the forefront of next generation therapeutics. Engineered phages have demonstrated potential as precision delivery vectors for cytotoxic agents, immunomodulators and genetic material with improved specificity and reduced off-target effects. Emerging strategies including phage antibiotic conjugates and enzyme functionalized phages further enhance therapeutic efficacy and facilitate penetration of physiological barriers. Collectively, phage-based platforms represent a versatile and transformative approach with significant implications for the treatment of infectious, oncologic and genetic disorders, supporting the advancement of targeted and personalized medicine.
    Keywords:  antimicrobial resistance; combination therapy; nanotherapy; phage delivery; phage engineering; precision medicine
    DOI:  https://doi.org/10.3389/fmicb.2026.1812871
  20. Pediatr Pulmonol. 2026 May;61(5): e71645
    Cystic Fibrosis Transition From Pediatrics to Adult Care in Low-Middle Income Countries.
    Ahmet Uluer, Leah Ratner, Fadi Asfour, Noor Elshaar, Chandra Swanson.
       BACKGROUND: As survival improves for individuals with cystic fibrosis (CF) worldwide, the number of adolescents requiring transition from pediatric to adult care is rapidly growing. In addition to limited resources and lack of uniform access to medical care, traditional treatments, and advanced therapies, the increasing number of transitioning young adults in low- and middle-income countries (LMICs) face barriers and challenges to safe transition from pediatric to adult healthcare that are both universal and unique. This shift in demographics presents distinct challenges due to an underdeveloped and under-resourced adult CF care infrastructure, sociopolitical variation, and cultural complexities.
    METHODS: We conducted a structured literature to identify and synthesize published evidence on healthcare transition (HCT) for people with CF (pwCF) in LMICs.
    RESULTS: This manuscript summarizes available literature and insights on HCT for pwCF in LMICs, identifies key barriers, and explores cultural, religious, and health system factors. Additionally, we emphasize the practical need to transition adolescents to adult care to maintain pediatric hospital capacity for younger children, as well as the developmental and educational needs of young adults entering a medical system that is challenging for adults even without chronic disease.
    CONCLUSION: With much of the transition literature reflecting health systems in high-income countries (HIC), this integrated socio-ecological and socio-cultural overview underscores the urgent need for context-specific, culturally sensitive transition frameworks focused on reproductive and mental health, the integration of adolescent-responsive, family-inclusive, and even faith-informed care models in LMICs. Our review and observations informed the author's recommendations.
    Keywords:  adolescent‐responsive care; cystic fibrosis; healthcare transition; low‐middle‐income‐countries; pediatric to adult healthcare; resource‐denied; resource‐limited
    DOI:  https://doi.org/10.1002/ppul.71645
  21. Front Oral Health. 2026 ;7 1811009
    Salivary microbial profiles across periodontal severity stage according to the 2018 AAP/EFP classifications: a cross-sectional study.
    Paola E García-Vázquez, Marco Antonio Pita-Galeana, Mireya Martínez García, S Aída Borges-Yáñez, Adriana-Patricia Rodríguez-Hernández, Enrique Hernández Lemus.
       Background: Periodontitis is a chronic inflammatory disease characterized by progressive destruction of the periodontal supporting tissues and is strongly associated with shifts in the oral microbiota. Saliva has emerged as a promising diagnostic fluid; however, few studies have analyzed its microbial composition at the species level according to the 2018 American Academy of Periodontology/European Federation of Periodontology (AAP/EFP) classification of periodontal diseases.
    Objectives: To characterize salivary microbial profiles in a systemically healthy Mexican population across different stages of periodontitis according to the AAP/EFP 2018 classification system, and to evaluate sociodemographic, anthropometric, and clinical characteristics as potential risk factors for periodontitis.
    Methods: A cross-sectional study was conducted by analyzing 133 adults classified in four groups: periodontally healthy (n = 33), gingivitis (n = 34), stage I-II periodontitis (n = 18), or stage III-IV periodontitis (n = 48). Unstimulated saliva from all participants was sampled and analyzed for 40 bacterial species using Checkerboard, a DNA-DNA hybridization technique. Microbial levels, prevalence, and proportions were compared among groups. Ordinal logistic regression was then used to identify independent predictors of disease severity.
    Results: The Porphyromonas gingivalis and Tannerella forsythia bacteria showed significantly higher levels in advanced periodontitis (p < 0.001). Bacteria from the Orange complex, such as Campylobacter rectus and Campylobacter showae, also increased with disease severity. In contrast, commensal species, notably Gemella morbillorum, were diminished. Ordinal logistic regression identified age (OR = 1.10, p < 0.001), the presence of dental biofilm (OR = 1.03, p = 0.005), and higher counts of the Aggregatibacter actinomycetemcomitans (OR = 1.19, p = 0.005), and P. gingivalis (OR = 1.21, p < 0.001) microbial species, as positive predictors of periodontitis.
    Conclusions: The salivary microbiota shows distinct abundance signatures across periodontal severity stages. These patterns are characterized by an enrichment of pathogenic microbial complexes and depletion of commensal species. This aligns with current frameworks placing dysbiosis as a relevant risk factor for periodontitis. These findings also support saliva as a feasible matrix for periodontal screening and risk stratification. This may result particularly useful in resource-limited clinical laboratory settings.
    Keywords:  Checkerboard DNA–DNA hybridization; microbial profiles; microbiota; oral dysbiosis; periodontitis; saliva
    DOI:  https://doi.org/10.3389/froh.2026.1811009
  22. Future Microbiol. 2026 May 21. 1-10
    Oral microbiome dysbiosis of Porphyromonas gingivalis in oral leukoplakia, oral squamous cell carcinoma and radiation-induced oral mucositis: a qPCR-based cross-sectional study.
    Ajay Kumar Verma, Anjali Narwal, Mala Kamboj, Anju Devi, Shikha Tewari, Rashmi Bhardwaj.
       BACKGROUND: Porphyromonas gingivalis is a key periodontal pathogen increasingly implicated in periodontitis and oral carcinogenesis. Among its virulence determinants, fimbriae encoded by the fimA gene exhibit pathogenic potential. While previous studies have mainly focused on fimA II and IV genotypes in periodontitis, limited data exist on the role of fimA I in oral squamous cell carcinoma (OSCC), and radiation-induced oral mucositis (RIOM). The present study aimed to evaluate the relative abundance of the fimA I genotype across different oral disease conditions and to assess its potential role as a biomarker of disease associated microbial dysbiosis.
    METHODS: In total, 96 oral swab samples were collected from six groups: healthy nonsmokers, healthy smokers, periodontitis, OL, OSCC, and RIOM. Quantitative real-time PCR was performed to assess the relative abundance of the genotype using genotype-specific primers.
    RESULTS: FimA I expression was highest in RIOM, followed by OSCC and periodontitis, and lowest in OL and healthy groups. A statistically significant increase was observed in RIOM and OSCC compared to controls (p < 0.05).
    CONCLUSION: The fimA I genotype shows higher abundance in OSCC and RIOM, suggesting its potential role as a microbial biomarker in disease monitoring and therapeutic targeting.
    Keywords:  Porphyromonas gingivalis; fimA I; oral leukoplakia; oral squamous cell carcinoma; qPCR; radiation-induced oral mucositis
    DOI:  https://doi.org/10.1080/17460913.2026.2678151
  23. Medicine (Baltimore). 2026 May 15. 105(20): e48497
    From phage display to tumor microcirculation regulation: A bibliometric review of phage in cancer immunotherapy research (2000-2024).
    Hefei Wang, Jiantao Yin, Hongna Yin.
      This study aimed to conduct a bibliometric analysis of the literature related to phages in cancer immunotherapy to reveal the research hotspots and evolutionary trends in this field. We extracted all relevant publications from the Web of Science Core Collection database for the period from 2000 to 2024. CiteSpace, VOSviewer, and R software were used to evaluate and visualize core authors, journals, countries, literature, trending topics, and research hotspots in this field. Among 485 publications, the number of annual publications showed a general upward trend. North America and East Asia were the main contributing regions, with the United States and China being the most productive countries. The University of Pennsylvania became one of the most influential research institutions, and the Journal of Immunology was the most prolific and highly cited. Gao Yanfeng is the most published scholar in the field, and Nicole F is the most cited book. Keyword co-occurrence and clustering analysis revealed that the research hotspots encompassed 5 areas: phage display, cancer immunotherapy, immune cell function regulation, target identification and protein action, and biomarker mining. This study employs bibliometric analysis methods to systematically review research progress in the field of phage and cancer immunotherapy from 2000 to 2024, identify key research directions in this field, and predict future research trends. The aim is to provide valuable directions and recommendations for subsequent research in the field of phage and cancer immunotherapy.
    Keywords:  CiteSpace; VOSviewer; bibliometrics; cancer immunotherapy; hotspots; phage; research trends
    DOI:  https://doi.org/10.1097/MD.0000000000048497
  24. BMC Microbiol. 2026 May 18.
    Isolation and characterization of novel bacteriophage, vB_AbaA_SWMUZ8, targeting multidrug-resistant Acinetobacter baumannii strains.
    Jing Li, Chunhong Yang, Ruyi Yang, Kaitao Zhang, Pan Yang, Ling Yin, Jinping Zhang, Zhangyong Song.
       BACKGROUND: Acinetobacter baumannii is a significant opportunistic pathogen causing severe nosocomial infections that poses increasing clinical challenges due to escalating multidrug resistance. Phage therapy has emerged as a promising alternative strategy to combat multidrug-resistant (MDR) infections.
    RESULTS: In this study, a lytic phage targeting ST208/KL2-type A. baumannii strain Ac28 was isolated and purified from hospital sewage. Whole-genome sequencing and a bioinformatics analysis successfully identified a novel podovirus, designated "vB_AbaA_SWMUZ8". A host-range analysis demonstrated a lysis rate of 58.33% against 84 clinically derived A. baumannii isolates of diverse multilocus sequence types, with particularly high efficacy against 88% of ST208 strains. Notably, vB_AbaA_SWMUZ8 lysed 100% of geographically co-localized isolates. It inhibited the growth of MDR A. baumannii strain Ac28 in vitro and improve survival rates in a Galleria mellonella infection model.
    CONCLUSIONS: In this work, we identified a therapeutically promising lytic phage and provided evidence for the phage-based control of MDR A. baumannii infections.
    Keywords:   Acinetobacter baumannii ; In vitro ; In vivo ; Bacteriophage; Host range; Multidrug resistance
    DOI:  https://doi.org/10.1186/s12866-026-05164-8
  25. Indian J Crit Care Med. 2026 Mar;30(3): 185-188
    Bacteriophages: A Long-forgotten Past, or Hope for the Future?
    Umang Agrawal.
      How to cite this article: Agrawal U. Bacteriophages: A Long-forgotten Past, or Hope for the Future? Indian J Crit Care Med 2026;30(3):185-188.
    Keywords:  Bacteriophages; India; Personalized medicine; Precision medicine; Review
    DOI:  https://doi.org/10.5005/jp-journals-10071-25167
  26. NPJ Biofilms Microbiomes. 2026 May 23.
    Ulcerative colitis-driven gut dysbiosis exacerbates periodontal bone loss through the gut-oral axis /Th17/Treg imbalance.
    Yue Huang, Yu Hu, Yifei Zhao, Yuerui Li, Yunkun Liu, Miao Wang, Qian Wang, Huan Hu.
      Ulcerative colitis (UC) and periodontitis, both microbial dysbiosis-driven chronic inflammatory disorders, coexist and mutually exacerbate, but the causal mechanisms remain unclear. Using ligature-induced periodontitis plus DSS-colitis mice, we found UC doubles alveolar bone loss, heightens systemic inflammation, oxidative stress, and osteoclastogenesis. 16S rRNA and LC-MS metabolomics showed UC enriches oral pathogens, depletes gut Firmicutes, expands Bacteroides, and correlates with suppressed amino-acid/bile-acid biosynthesis. Fecal microbiota transplantation (FMT) from DSS donors into antibiotic-pretreated periodontitis-prone mice replicated aggravated bone loss, systemic inflammation, gut-barrier leakage, and Th17/Treg imbalance, while healthy-donor FMT protected. GC-MS revealed 35-60% reductions in acetate, propionate, and butyrate; keystone taxa Parabacteroides and Muribaculum inversely correlated with SCFAs and host inflammatory genes. Collectively, UC-driven gut dysbiosis is a transmissible causal factor that simultaneously remodels oral and intestinal biofilms, erodes epithelial barriers, and amplifies osteoclastic bone resorption. SCFAs-producing microbes or supplementation may be potential therapeutics for UC-associated periodontitis patients.
    DOI:  https://doi.org/10.1038/s41522-026-01015-6
  27. Int Wound J. 2026 May;23(5): e70950
    Humanistic Care Needs of Hospitalised Patients With Diabetic Foot Ulcers: A Qualitative Descriptive Study From the Nurse-Patient Perspective.
    Panpan Huang, Li Wang, Daijun Chen, Lan Yi, Jing Yang, Xueyu Zhang, Yi Ouyang, Zhongjing Wang, Adan Fu.
      Diabetic foot ulcer care extends beyond wound management alone, yet the humanistic care needs of hospitalised patients with diabetic foot ulcers remain insufficiently understood in clinical practice. This qualitative descriptive study explored these needs from a nurse-patient perspective to inform more responsive humanistic nursing care. Purposive sampling was used to recruit 12 hospitalised patients with diabetic foot ulcers and 13 nurses involved in the care of patients with diabetic foot ulcers from a tertiary Grade A hospital in Wuhan, China. Individual semi-structured face-to-face interviews were conducted between July and August 2023, and data were analysed using thematic content analysis. Three interrelated themes were identified across the two participant groups: (1) need for a humanistic care environment, (2) need for nurses' humanistic care competencies, and (3) need for humanistic nursing support. Although patients and nurses shared many concerns, they differed in emphasis. Nurses focused more on safety, clinical judgement and on-going support, whereas patients more often highlighted lived suffering, dignity, emotional reassurance and practical needs during hospitalisation and beyond. These findings suggest that humanistic care is a core component of care for hospitalised patients with diabetic foot ulcers rather than an adjunct to wound treatment, and should be more systematically considered in efforts to strengthen person-centred diabetic foot ulcer care.
    Keywords:  diabetic foot ulcer; nurse–patient relations; nursing care; qualitative research; wound healing
    DOI:  https://doi.org/10.1111/iwj.70950
  28. J Control Release. 2026 May 20. pii: S0168-3659(26)00438-4. [Epub ahead of print] 115035
    Functionalized nanoparticles for the precise treatment and prevention of bacterial infections.
    Xiaodong Hu, Jian Huang, Shuhang Dong, Kuishuai Xu, Minzhe Zheng, Jiadong Cai, Yujiong Chen, Tianrui Wang, Yingze Zhang.
      Multidrug-resistant (MDR) bacterial infections are an escalating health issue, and their rise poses a major threat worldwide. Inappropriate antibiotic use, including unnecessary prophylaxis, and nonpathogen-directed therapy, accelerates resistance, diminishing the effectiveness of conventional antibiotics. Consequently, novel antimicrobial strategies are urgently required to achieve precise prevention and treatment of bacterial infections while minimizing selective pressure for resistance. Nanotechnology-based antimicrobials are promising candidates because of their unique advantages: payload concentration at infection sites, biofilm penetration and disruption, synergism with conventional antibiotics, and modulation of host immunity via innate/adaptive immune activation (e.g., macrophage polarization, dendritic cell maturation, and immunogenic cell death induction). This review describes the current classifications and antibacterial mechanisms of nanoantibacterial agents and summarizes strategies for targeted antibacterial and immunoregulatory nanoparticle therapies. We also identify key translational challenges, including safety and immunotoxicity, biodistribution and clearance, microbiome and environmental impacts, scalable manufacturing, assay standardization, regulatory issues, and clinical validation. Finally, we outline future directions, such as rational design of stimulus-responsive nanocarriers, data-driven optimization, theranostics, and clinically aligned evaluation. These efforts aim to advance nanoantibacterials that complement antibiotics, enabling precise MDR infection management, thereby bridging the gap between prevention and treatment to address the global antimicrobial resistance crisis.
    Keywords:  Antibacterials; Immune therapy; Nanomaterials; Targeted therapy
    DOI:  https://doi.org/10.1016/j.jconrel.2026.115035
  29. Diabetol Metab Syndr. 2026 May 16.
    Hydrogen-delivering biomaterial carriers for diabetic foot ulcer healing: a systematic review and meta-analysis of preclinical animal studies.
    Xiaona Wang, Lei Pan, Haijun Shen.
       OBJECTIVE: This study aimed to systematically evaluate the preclinical evidence on the therapeutic efficacy and underlying mechanisms of hydrogen-delivering biomaterial carriers in the treatment of diabetic foot ulcer (DFU).
    METHOD: We conducted a comprehensive search across eight databases (PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, Wanfang, and VIP) to identify randomized animal studies investigating biomaterial-based hydrogen delivery for DFUs from database inception through November 2025. After screening, eleven studies met inclusion criteria and were included in the final meta-analysis. Data synthesis and statistical analyses were performed using RevMan 5.4; risk of bias was assessed using the SYRCLE's tool for animal studies.
    RESULTS: The delivery of hydrogen via biomaterial carriers effectively promotes diabetic wound repair by enhancing wound closure rates, stimulating angiogenesis, and improving collagen deposition. Smart delivery systems, such as hydrogen-generating hydrogels, responsive microneedle patches, and photocatalytic dressings, enabled spatiotemporally controlled, sustained H₂ release. This modulation effectively attenuated oxidative stress and suppressed pro-inflammatory cytokine expression (e.g., TNF-α, IL-6). Collectively, biomaterial-mediated hydrogen delivery confers dual therapeutic actions: direct promotion of tissue regeneration and dynamic reprogramming of the impaired wound microenvironment, supporting its potential as a targeted, mechanism-informed intervention for DFUs.
    CONCLUSION: Biomaterial-based hydrogen delivery systems demonstrate multifaceted therapeutic benefits in preclinical DFU models, primarily through anti-inflammatory, pro-angiogenic, and collagen-enhancing mechanisms. The emergence of smart delivery systems enables localized, tunable, and prolonged hydrogen release, which improves bioavailability and therapeutic precision. Future research should prioritize optimization of release kinetics, pharmacokinetic-pharmacodynamic modeling in diabetic wound beds, and exploration of synergistic combinations (e.g., with growth factors or antimicrobial agents) to advance toward clinically translatable, precision wound therapeutics.
    Keywords:  Animal models; Biomaterial carrier; Diabetic foot ulcer; Hydrogen therapy; Meta-analysis; Wound healing
    DOI:  https://doi.org/10.1186/s13098-026-02181-5
  30. Clin Res Hepatol Gastroenterol. 2026 May 18. pii: S2210-7401(26)00095-1. [Epub ahead of print] 102849
    Optimizing Approach to Liver Biochemistry Abnormalities in Cystic Fibrosis Pediatrics: Balancing Efficiency and Risk-Benefit.
    Sarah B Lowry Adamitis, Wikrom Karnsakul.
      Liver biochemistry abnormalities are common and may reflect benign transient changes or underlying liver disease. An evidence-based, stepwise approach can optimize diagnostic efficiency while minimizing unnecessary testing in the pediatric population with cystic fibrosis (CF). This review presents a structured framework to differentiate transient (<6 months) from chronic (>6 months) liver biochemistry abnormalities, with a particular focus on drug-induced liver injury (DILI), including cystic fibrosis transmembrane conductance regulator (CFTR) modulators-associated hepatotoxicity and emerging fatty liver disease or metabolic dysfunction-associated steatotic liver disease (MASLD). Risk stratification should guide decisions on monitoring versus escalation to imaging and invasive diagnostics. Special considerations for high-risk CF populations with portal hypertension or cirrhosis are discussed to inform effective clinical management.
    DOI:  https://doi.org/10.1016/j.clinre.2026.102849
  31. Nat Commun. 2026 May 22.
    DepoCatalog: mapping diversity of 129 recombinantly produced Klebsiella phage depolymerases.
    Aleksandra Otwinowska, Sebastian Olejniczak, Agnieszka Latka, Maria Pozniak, Grazyna Majkowska-Skrobek, Barbara Maciejewska, Janusz Koszucki, Vyshakh R Panicker, Sara Jablonska, Mathilde Hulsens, Jana Stender, Maha Niazi, Sabrina Green, Joachim J Bugert, Régis Tournebize, Stan J J Brouns, Flavia Squeglia, Rita Berisio, Jens A Hammerl, Rob Lavigne, Yves Briers, Rafal J Mostowy, Zuzanna Drulis-Kawa.
      Our understanding of how depolymerase sequence and structure determine substrate specificity is fragmentary due to the limited number of experimentally characterized enzymes. Here we show DepoCatalog - an experimentally validated collection of 129 recombinantly prepared Klebsiella phage depolymerases (90 enzymes produced in this study and 39 homologs from the literature), with specificity spanning 75 KL-types. Enzymes originated from podo-, sipho-, myo-, jumbo phages, and prophages. Using activity profiling, structural modeling, and domain dissection, we propose a five‑class framework that captures the architectural and functional diversity of these enzymes. DepoCatalog uncovers cross-reactivity and taxa‑specific enzymes. Structural comparisons indicate that specificity switching or extension is associated with modifications to the C‑terminal domain. We further hypothesize that podoviruses encoding up to two RBPs show greater receptor adaptability than jumbo phages with multiple specialized RBPs. Finally, we develop a publicly accessible, DepoCat dataset (https://depocat.uwr.edu.pl) for specificity, structural classification and comparison of newly identified depolymerases.
    DOI:  https://doi.org/10.1038/s41467-026-73570-7
  32. Front Cell Infect Microbiol. 2026 ;16 1800070
    The gut-skin axis in wound healing: a bibliometric analysis of intestinal flora and chronic wounds (2005-2025).
    Jing Chen, Aode Tian, Jianliang Huang, Zhenghe Wang, Hongjin Wang.
       Background: The delayed healing of chronic wounds is a major challenge in clinical treatment, with complex pathogenesis involving multisystem dysfunction. In recent years, the role of intestinal flora imbalance in the impairment of chronic wound healing has received increasing attention. Given the physiological similarities and pathological correlations between the skin and the intestine, some scholars have proposed the concept of the "skin-gut axis" and believe that there is a close connection between the skin microbiota, skin condition, and intestinal flora. However, systematic analysis of research trends remains limited. This bibliometric study comprehensively evaluates the research status in the fields of chronic refractory wounds and intestinal microbiota from 2005 to 2025.
    Methods: We used CiteSpace, VOSviewer, and Bibliometrix software to analyze 553 English articles from the Web of Science Core Collection. Bibliometric assessments included publication trends, collaborative networks, geographical distribution, journal impact, and keyword clustering.
    Results: A total of 553 papers were included. The number of publications in this field increased markedly from 2020 to 2025, with 2025 being the most productive year. The leading contributing countries were the United States and China; key institutions included the University of Pennsylvania and the University of Copenhagen. Elizabeth A. Grice was the most impactful author. Keyword analysis identified high-frequency terms: wound healing, biofilm, chronic wound, bacteria, and microbiota. Timeline visualization of keywords revealed emerging research hotspots, including diabetic foot ulcer and in situ detection.
    Conclusion: To the best of our knowledge, this study represents the first bibliometric analysis in the field of chronic wounds and intestinal microbiota. Core research foci include disease-associated microbiota characteristics, probiotic therapy, microecological intervention, and the distal gut-target organ axis. Future research should prioritize microbe-targeted therapy, regulation of the immune-barrier metabolic network, and integrative medicine combining traditional Chinese and Western medicine.
    Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/ID=CRD420261362660, identifier CRD420261362660.
    Keywords:  Citespace; VOSviewer; bibliometrics; chronic wound; microbiota; refractory wound; the gut-skin axis
    DOI:  https://doi.org/10.3389/fcimb.2026.1800070
  33. BMC Pulm Med. 2026 May 22.
    Modulator therapy: rates and stages of respiratory bacteriome restoration in cystic fibrosis patients chronically infected with Pseudomonadota.
    Olga L Voronina, Natalia N Ryzhova, Marina S Kunda, Ekaterina I Ermolova, Elena L Amelina, Rezuan U Kagazezhev, Alexander L Gintsburg.
       BACKGROUND: Chronic lung infection caused by Pseudomonadota (PCH) in patients with cystic fibrosis (pwCF) is difficult to eradicate. CFTR modulators have a potential role in the prevention of airway infections, but their ability to eradicate chronic infection remains to be investigated. The aim of our study was to evaluate the impact of combination (antibacterial (AT) and modulator (MT)) therapy on the lung bacteriome composition (LBC) in the pwCF cohort.
    RESULTS: The bacteriomes of sputum samples longitudinally collected from 57 Russian adult pwCFs chronically infected with Pseudomonadota CF pathogens (PCH) were analyzed. MT tended to reduce the bacterial load. The LMC did not significantly change in PCH pwCFs that received MT for less than three years. Two-component MT resulted in a temporary decrease in the proportion of the CF pathogen only when combined with a course of AT. Three-component MT has been successful in inducing favorable bacteriome changes (in terms of the abundance and diversity of anaerobic taxa) over a period of more than 3 years but not for all cases of Burkholderiales infection.
    CONCLUSIONS: The respiratory system damaged by bronchiectasis is susceptible to new infections, so patient management requires constant monitoring of the LBC and replenishment of the therapeutic landscape with both new modulators and new antibacterial drugs.
    Keywords:  Anaerobes; Bacterial load; CF pathogens; CFTR modulator therapy; Cystic fibrosis; Lung bacteriome; Marker taxa; Microbial diversity
    DOI:  https://doi.org/10.1186/s12890-026-04356-2
  34. J Virol. 2026 May 19. e0136325
    A polyvalent phage shapes bacterial dynamics.
    Cristian V Crisan, Daria Van Tyne, Joanna B Goldberg.
      Bacteria and the viruses that infect them (known as bacteriophages or phages) are important microbial ecosystem members. Antagonistic interactions between different bacteria or between bacteria and phages can profoundly impact population dynamics. Lytic phages are efficient killers that generally infect strains from a single genus or species. Polyvalent phages that target multiple unrelated hosts have been described, but their ecological significance is largely unknown. Here, we investigated how a polyvalent phage (PSA39) alters bacterial dynamics during co-cultures with susceptible hosts. Pseudomonas aeruginosa and Stenotrophomonas maltophilia are unrelated bacterial species that inhabit the same ecological niches, are often co-members of microbial ecosystems, cause similar infections, share mobile genetic elements, and can engage in complex interactions. In the presence of P. aeruginosa and S. maltophilia, PSA39 significantly reduces the recovery of both bacteria but has a stronger impact on S. maltophilia. P. aeruginosa adapts in the presence of PSA39, but S. maltophilia survival is impaired when the two bacteria are grown together and with phage. Furthermore, propagation in the presence of S. maltophilia cells results in higher viral titers. Both bacterial species evolve mutations in pili genes when exposed to PSA39. We propose that P. aeruginosa, S. maltophilia, and PSA39 can serve as a model system to study how polyvalent phages alter co-existing bacterial populations.IMPORTANCEPhages are the most abundant biological entity on the planet, but polyvalent phages that infect multiple bacterial species are poorly understood. Here, we investigated how the polyvalent phage PSA39 affects two susceptible but unrelated bacterial hosts (Pseudomonas aeruginosa and Stenotrophomonas maltophilia). During co-cultures with S. maltophilia, P. aeruginosa quickly develops resistance to this virus and has an antagonistic effect on its bacterial competitor. We find that both bacterial species evolve mutations in Type IV pili genes to resist PSA39 lysis. Our study provides novel insights into the impact that polyvalent phages can have on susceptible bacteria, such as those from natural environments or from infections.
    Keywords:  Pseudomonas aeruginosa; Stenotrophomonas maltophilia; bacterial dynamics; polyvalent bacteriophages
    DOI:  https://doi.org/10.1128/jvi.01363-25
  35. J Periodontal Res. 2026 May 18.
    Osteoporosis and Periodontitis: Two-Way Epidemiological and Mechanistic Evidence.
    Jia Chang, Geeta Madhuri Bhuvanagiri, Megan Dulkanchainun, Cunyu Wang.
      Osteoporosis and periodontitis are highly prevalent, chronic inflammatory diseases that constitute a major global health burden. Strong epidemiological evidence shows an association between the two diseases, in which osteoporosis patients have an increased risk of periodontitis, specifically in postmenopausal women. Osteoporosis and periodontitis are linked by bidirectional relationships through shared inflammatory and bone-resorptive pathways. Such a connection is explained by shared osteo-immunologic pathways, particularly as highlighted by recent breakthrough findings in the field. In this review, we comprehensively examined the seven links between osteoporosis and periodontitis across microbial translocation, systemic meta-inflammation, maladaptive myelopoiesis, immune cell trafficking, masticatory dysfunction-diet interactions, underlying vulnerabilities, and functional alterations of the oral microbiome, drawing on current biological findings and clinical evidence. This bidirectional relationship underscores the importance of integrated medical and dental screening and management strategies to improve patient outcomes for both conditions.
    DOI:  https://doi.org/10.1111/jre.70125
  36. J Control Release. 2026 May 21. pii: S0168-3659(26)00447-5. [Epub ahead of print] 115044
    Promicrobial mucoadhesive micro-composites enable delivery of beneficial oral bacteria to restore and modulate oral biofilm communities.
    Harry J Harvey, Sarah Corrigan, Daniele Baiocco, Zhibing Zhang, Tariq H Iqbal, Wim Teughels, Iain Chapple, Richard D Horniblow.
      Imbalances within the oral microbiome, composed of over 700 phylotypes, drive both local diseases, including periodontitis, and systemic conditions, such as rheumatoid arthritis and cardiovascular disease. Given the overuse of conventional antimicrobial agents to manage oral diseases and the relapsing nature associated with current intervention strategies, innovative promicrobial approaches to oral biofilm community restoration are needed. Importantly, there is a critical unmet clinical need for active restoration and sustained delivery of beneficial oral commensals rather than continued disruption of already-imbalanced communities. We have developed a promicrobial formulation encapsulating live, health-associated, oral bacteria within mucoadhesive micro-composites to promote the establishment of beneficial biofilms under simulated oral flow conditions. We encapsulated and characterised a five-species bioactive consortia of oral bacteria in alginate micro-composites, surface modified with poly-l-lysine to enhance their adhesion to artificial saliva-coated surfaces in vitro. Dissemination of the encapsulated bacteria from the micro-composites led to the formation of stable oral biofilms. Notably, biofilm composition could be modulated by altering the encapsulated bioactive composition, enabling a tailored and targeted pathway to biofilm restoration. Under representative saliva flow, delivery of bioactives following their bioencapsulation resulted in strong biofilm-forming capacity, even in the presence of pre-existing oral bacterial communities containing pathobionts, highlighting their potential clinical applications in dental biofilm bioengineering. In experiments designed to simulate periodontal pocket debridement, we observed immunomodulation following treatment with bioactive formulations and pathobiont reduction when Limosilactobacillus reuteri was also incorporated into the consortia. These findings establish a framework for using sustained-release encapsulated probiotics to modulate the oral microbiome, offering a paradigm shift towards biofilm-promoting therapies for oral healthcare and paving the way for oral microbiome transplantation.
    Keywords:  Biopolymer; Encapsulation; Hydrogel; Microbiome modulation; Microfluidics; Oral microbiome; Probiotic; Promicrobial
    DOI:  https://doi.org/10.1016/j.jconrel.2026.115044
  37. J Periodontol. 2026 May 17.
    Microbial burden of periodontal diseases and its clinical application: The stage, grade, and furcation matter.
    Anbo Dong, Susanna Paju, Jaakko Leskelä, Muhammed Manzoor, Jukka Putaala, Pauli Ylikotila, Eija Könönen, Pirkko Pussinen, Svetislav Zaric.
       BACKGROUND: Periodontal diseases are associated with dysbiotic oral microbial communities, but clinically applicable measures that reflect microbial burden across disease severity and progression remain limited. This study aimed to assess the oral microbial burden of periodontal diseases by evaluating salivary and subgingival lipopolysaccharide (LPS) activity and lipoteichoic acid (LTA) levels, to explore their relationships with microbial dysbiosis and clinical periodontal parameters in individuals with periodontal health (n = 52), gingivitis (n = 194), and periodontitis of varying stages, grades, and furcation involvement (n = 78), and to assess their diagnostic potential.
    METHODS: Saliva and subgingival plaque samples from 324 SECRETO cohort participants were analyzed for microbial virulence factors using a recombinant Factor C assay for LPS and enzyme-linked immunosorbent assay (ELISA) for LTA. Microbial dysbiosis was assessed using a sequencing-derived, simplified dysbiosis index, calculated from subgingival 16S rRNA gene sequencing and salivary shotgun metagenomic profiles, based on the relative abundances of health-associated and periodontitis-associated taxa.
    RESULTS: Subgingival LPS activity was significantly higher in periodontitis patients compared to healthy individuals and increased progressively across disease stages and grades. Salivary LPS activity differed only by periodontal diagnosis and correlated with full-mouth bleeding score (FMBS). LTA levels showed no statistical variations across periodontal conditions. Subgingival LPS activity and LPS/LTA ratio were strongly associated with simplified dysbiosis index. Salivary dysbiosis index was significantly higher in patients with furcation involvement. Receiver operating characteristic (ROC) analyses identified subgingival LPS, salivary LPS, and simplified dysbiosis index as diagnostic biomarkers with good clinical utility (area under the curve [AUC] 0.59-0.87).
    CONCLUSIONS: This study highlights the importance of periodontitis diagnoses, stages and grades of periodontitis and furcation involvement as determining factors for increased salivary and subgingival bioburden. In addition, LPS activity could be used as a reliable periodontal biomarker, while the LPS/LTA ratio is an indirect indicator of microbial dysbiosis.
    TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01934725.
    PLAIN LANGUAGE SUMMARY: Periodontitis is a common inflammatory disease that affects the tissues supporting the teeth and can lead to tooth loss and broader health consequences if not properly managed. This study explored whether measures of oral microbial burden, particularly bacterial components such as lipopolysaccharide (LPS) and lipoteichoic acid (LTA), could help explain differences in periodontal disease severity and progression. Saliva and subgingival plaque samples were analyzed from individuals with periodontal health, gingivitis, and different stages and grades of periodontitis. We found that microbial burden, especially subgingival LPS activity, increased consistently with more severe and rapidly progressing forms of periodontitis and was closely associated with clinical signs of inflammation. In contrast, LTA levels showed limited variation across disease categories. Importantly, LPS-related measures demonstrated good ability to distinguish periodontal health from disease. These findings suggest that assessing microbial burden, particularly LPS activity, may provide clinically useful information beyond traditional periodontal assessments and could support improved disease classification, risk assessment, and the development of more personalized periodontal care strategies.
    Keywords:  biomarkers; dysbiosis; lipopolysaccharide (LPS); lipoteichoic acid (LTA); microbial burden; oral microbiome; periodontal diseases
    DOI:  https://doi.org/10.1002/jper.70140
  38. Indian J Crit Care Med. 2026 Mar;30(3): 196-203
    Evaluation of the Potential Efficacy of Bacteriophage Therapy for the Management of Pressure Ulcers and Its Comparison to Conventional Therapy: A Randomized Controlled Trial.
    Kavita Meena, Rajesh K Meena, Sarita Kumari, Premkumar Thambidurai, Gopal Nath.
       Background and aims: Pressure ulcers (PUs) are common in physical trauma patients who require prolonged stays in the intensive care unit (ICU). Despite standard preventive and therapeutic measures, healing is often a slow process. Conventional systemic antibiotics offer limited therapeutic benefits due to inadequate tissue penetration and the associated risk of driving antimicrobial resistance. Bacteriophage therapy, with its ability to target resistant and biofilm-associated bacteria, offers a potential "alternative." We aimed to evaluate the efficacy and safety of topical bacteriophage therapy for the management of PUs in critically ill ICU patients and its comparison to conventional therapy.
    Patients and methods: This prospective, randomized, double-blind controlled trial was conducted in the ICU of a tertiary care center between April 2024 and May 2025. Seventy-six adult patients with grade II-IV PUs were screened, and 68 were enrolled (34 in each group). Group C received conventional therapy, while group B received conventional plus customized topical bacteriophage therapy. Healing was assessed using the Pressure Ulcer Scale for Healing (PUSH) tool; tissue type, exudate amount, and ulcer dimensions were assessed at baseline and on days 5, 7, 14, 21, and 28. The primary objective was to evaluate the efficacy of bacteriophage therapy for the management of PUs. The secondary objective was to observe the safety profile of bacteriophage therapy.
    Results: Both groups demonstrated healing over time, but group B demonstrated significantly greater improvement as compared to group C. The reduction in the mean PUSH score was higher in group B (p < 0.05). Group B also showed faster epithelialization, an earlier decrease in exudate, and more closed ulcers. These differences became statistically significant from day 7 onward. No adverse events were reported.
    Conclusion: Topical bacteriophage therapy is a safe and effective adjunct to conventional care in the management of PUs among ICU patients.
    How to cite this article: Meena K, Meena RK, Kumari S, Thambidurai P, Nath G. Evaluation of the Potential Efficacy of Bacteriophage Therapy for the Management of Pressure Ulcers and Its Comparison to Conventional Therapy: A Randomized Controlled Trial. Indian J Crit Care Med 2026;30(3):196-203.
    Keywords:  Antibiotics; Bacteriophages; Intensive care unit; Pressure ulcers; Trauma
    DOI:  https://doi.org/10.5005/jp-journals-10071-25143
  39. Braz Oral Res. 2026 ;pii: S1806-83242026000109801. [Epub ahead of print]40 e012
    Comparative analysis of TNF-α, TLR-2, and TLR-4 in GCF before and after periodontal therapy.
    Mithat Terzi, Fatma Altiparmak, Fatma Ucan Yarkac.
      Periodontitis is a chronic inflammatory disease characterized by progressive destruction of tooth-supporting tissues, primarily driven by a dysregulated host immune response to subgingival biofilms. Toll-like receptors (TLR-2 and TLR-4) and tumor necrosis factor-alpha (TNF-α) are key mediators of immune signaling and tissue breakdown, making them potential biomarkers of periodontal disease activity. This prospective, non-randomized interventional study evaluated TLR-2, TLR-4, and TNF-α levels in gingival crevicular fluid (GCF) for periodontal disease monitoring and assessed the effects of nonsurgical periodontal therapy (NSPT) on clinical parameters. Forty systemically healthy individuals were enrolled and assigned to either periodontitis or healthy groups. Clinical indices-gingival index, plaque index, clinical attachment loss, and probing pocket depth-were recorded at baseline and 8 weeks after NSPT. GCF samples were analyzed using enzyme-linked immunosorbent assay to determine biomarker concentrations. At baseline, TNF-α and TLR-2 levels were significantly higher in periodontitis patients compared with healthy controls (p < 0.001). Following therapy, marked clinical improvements were observed, accompanied by significant reductions in TNF-α and TLR-4 levels (p < 0.05), while TLR-2 levels remained stable. receiver operating characteristic analysis demonstrated that TNF-α and TLR-2 reliably distinguished disease from health. In conclusion, NSPT effectively improved clinical outcomes and reduced TNF-α and TLR-4 levels in GCF, reflecting a decreased local inflammatory burden. The persistence of TLR-2 expression post-treatment suggests a stable role in immune surveillance rather than acute inflammatory response.
    DOI:  https://doi.org/10.1590/1807-3107bor-2026.vol40.012
  40. Odontology. 2026 May 21.
    Circadian disruption and cellular senescence: emerging perspectives in periodontitis.
    Qian Liu, Zhihao Gao, Yan Wu.
      Periodontitis is a chronic inflammatory disease characterized by progressive destruction of periodontal tissues and alveolar bone, traditionally attributed to microbial dysbiosis. Emerging evidence suggests that host-intrinsic factors, including circadian rhythm disruption (CRD) and cellular senescence, may critically influence disease susceptibility and progression. CRD, resulting from misalignment between central and peripheral clocks, is known to impair stem cell function, alter telomere maintenance, and disrupt oxidative stress and metabolic homeostasis across multiple tissues. In parallel, cellular senescence exacerbates tissue damage through the senescence-associated secretory phenotype (SASP), which promotes inflammation and extracellular matrix degradation. Although direct evidence linking CRD and cellular senescence to periodontitis remains limited, mechanistic studies in related models suggest that these processes may converge to dysregulate immune responses, metabolic activity, and bone remodeling in the periodontium. Circadian disruption may impair stem cell regenerative capacity, alter immune cell rhythmicity, and enhance osteoclastogenesis, whereas senescent cells may further aggravate chronic inflammation and tissue destruction. This conceptual framework integrates circadian biology with aging-related mechanisms, highlighting potential pathways through which CRD and cellular senescence may modulate periodontitis. Understanding these interactions may inform novel preventive and therapeutic strategies, including circadian alignment, senolytic approaches, and metabolic modulation, for the early and precise management of periodontal disease.
    Keywords:  Periodontitis, Circadian disruption, Cellular senescence, Telomere maintenance, Oxidative stress, Metabolic homeostasis, Immunity.
    DOI:  https://doi.org/10.1007/s10266-026-01419-y
  41. J Epidemiol Glob Health. 2026 May 19.
    Review of the Microbial Spectrum of Mixed Respiratory Fungal Infections.
    Aiah M Khateb.
       BACKGROUND: This review examines the increasing clinical challenge of mixed respiratory fungal infections (MRFIs), emphasizing interkingdom interactions and their impact on disease progression and patient outcomes.
    MAIN BODY: We critically analyze current literature on the clinical implications, risk factors, and diagnostic complexities of MRFIs, with a primary focus on fungal-bacterial, fungal-viral, and fungal-parasitic co-infections. Fungal-bacterial co-infections, often involving Candida spp. and Pseudomonas aeruginosa, significantly worsen disease severity. Fungal-viral co-infections, particularly in COVID-19 patients with Candida albicans and Aspergillus fumigatus, represent a major threat. While rare, fungal-parasitic co-infections pose risks for immunocompromised individuals. The review highlights diagnostic difficulties due to non-specific symptoms and the vital need to distinguish colonization from true infection. It also explores the complex symbiotic, synergistic, and antagonistic relationships between fungi and other microorganisms, alongside the immune-modulating role of commensal fungi.
    CONCLUSION: Ultimately, this review seeks to enhance understanding of MRFIs to improve diagnostic and therapeutic strategies and patient care.
    Keywords:  Bacteria; Fungal; Infections; Mixed; Resistance; Treatment; Virial
    DOI:  https://doi.org/10.1007/s44197-026-00583-2
  42. Adv Skin Wound Care. 2026 May 18.
    Mobile Health App Needs Among Patients With Diabetic Foot Ulcers in China: A Qualitative Study From the Perceptions of Patients, Caregivers, and Health Care Professionals.
    Jia-Li Yao, Ying-Jie Gu, Yuan-Yuan Yin, Hai-Ping Yu, Hui-Ren Zhuang.
       OBJECTIVE: To explore the specific needs of patients with diabetic foot ulcers (DFUs), caregivers, and health care professionals (HCPs) for a mobile health (mHealth) app, aiming to inform the design and development of effective mHealth service solutions.
    METHODS: This descriptive qualitative study was conducted from June to September 2024 in the wound care clinics of 2 local hospitals. Participants included patients with DFUs, caregivers, and HCPs directly involved in their care. Interview data were analyzed, synthesized, and refined using content analysis.
    RESULTS: Five key themes emerged: the pressing need to implement mHealth app services, convenient and personalized access to information, continuous and specialized health guidance, a multidisciplinary approach to disease management, and free access alongside privacy and legal protections.
    CONCLUSIONS: This study provides valuable insights for the design and development of an mHealth app for DFU. During the development process, it is essential to consider user needs and ensure the app meets the expectations of patients and related groups for personalized, continuous, and specialized health guidance; free access; privacy protection; and multidisciplinary collaboration. A balance should be struck between convenience and security of the app's features, to encourage user engagement and enhance the app's value and effectiveness.
    Keywords:  app; diabetic foot ulcer; mHealth; mobile health; qualitative study
    DOI:  https://doi.org/10.1097/ASW.0000000000000477
  43. Mini Rev Med Chem. 2026 May 13.
    Artificial Intelligence-driven Drug Discovery: Transforming Pharmaceutical Innovation Through Computational Approaches.
    Affan Ahmad, Priyanshu Nema, Shashi Kiran Mishra, Shubham Kanaujiya, Anupriya Kapoor, Shweta Singh Verma, Varsha Kashaw, Sushil Kumar Kashaw, Ajay Kumar.
      The process of identifying and optimizing new drugs has long been recognized as expensive and complex. Many promising compounds have failed during the late stages of development, resulting in lost time and investment. Despite major advances in pharmaceutical sciences, challenges such as low efficacy, toxicity, and poor pharmacological properties remain significant roadblocks to innovation. Recently, the use of artificial intelligence (AI), advanced computing, and innovative laboratory technologies has revolutionized this process. By integrating AI models, predictive algorithms, and machine learning techniques into drug discovery, scientists can rapidly identify promising lead compounds, predict potential toxicities, optimize pharmacological properties, and accelerate the transition from the laboratory to the patient's bedside. Computational approaches are also being explored for repurposing existing drugs for new therapeutic applications, which may help reduce development costs and risks. Genomic therapies and precision medicine offer a new paradigm by tailoring treatments to individual patients to enhance efficacy and minimize toxicities. Collectively, these emerging approaches not only accelerate development but also improve the likelihood of producing drugs that are highly targeted, safe, bioavailable, and effective. This review examines the current literature on drug discovery and development, highlighting the role of AI and computational technologies in transforming the pharmaceutical and healthcare sectors. It also emphasizes the importance of drug repurposing, AI-assisted design, and genomic approaches in modern drug discovery for reducing trial costs and failure rates.
    Keywords:  Artificial intelligence; clinical trial.; drug discovery; drug repurposing; genomics; precision medicines
    DOI:  https://doi.org/10.2174/0113895575443361260512074458
  44. Front Vet Sci. 2026 ;13 1727080
    A review on phytochemical and bacteriophage based therapeutic strategies for the management of Brucellosis.
    Rajshree Vidyashankar, Subhash Verma.
      Brucellosis, a zoonotic disease, triggers severe inflammation and reproductive complications in both humans and animals. The standard treatment protocol relies on prolonged antibiotic courses, often combining streptomycin and doxycycline, or gentamicin and doxycycline, for a duration of six to eight weeks. However, concerns have arisen regarding the efficacy, with a notable 15% failure rate and frequent relapses. The lack of suitable vaccines and the rise of antimicrobial resistance in Brucella spp., due to prolonged antibiotic use further complicate the issue. This review underscores the pressing issue of antibiotic resistance, prompting an exploration of alternative treatment avenues. Phytochemicals like polyphenols and terpenoid rich essential oils have been reported to possess strong anti-Brucellar activity and function by disrupting cell wall and membrane functions, prevent binding to host cells and internalization and inhibit DNA replication and transcription and enzyme synthesis. Similarly, bacteriophages, have demonstrated promise as diagnostic, therapeutic and biocontrol agents in Brucellosis management. The efficacy of bacteriophage mediated strategies can be enhanced by site specific delivery through nano-encapsulation techniques while engineered phages can be used for diagnosis and modulate immune response in host. These alternative therapies have even been found to stimulate innate immunity in host. However, the precise mechanisms through which these treatments operate remain elusive, warranting further investigation. In conclusion, this paper advocates for the integration of novel plant-based therapy as adjuvant treatment option for both human and livestock brucellosis, while phage therapy as complementary strategy to augment the conventional treatments in livestock brucellosis. These non-antibiotic alternatives aim to improve treatment efficacy, reduce the required duration of conventional antibiotic regimens, and minimize economic losses in agriculture. The future of brucellosis management may lie in a multi-faceted approach that combines antibiotics with innovative, natural alternatives.
    Keywords:  Brucella spp.; antimicrobial resistance; bacteriophage; botanicals; innate immunity; phage engineering
    DOI:  https://doi.org/10.3389/fvets.2026.1727080
  45. BMJ Open. 2026 May 21. 16(5): e113984
    Offloading orthotic insoles on healing of diabetic foot ulcers: a protocol for systematic review and meta-analysis.
    Ayesha Jamil, Hira Bano Javaid.
       INTRODUCTION: Diabetic foot ulcers (DFUs) are a complication of uncontrolled and long-standing diabetes, often associated with peripheral neuropathy, and can result in amputation, prolonged hospitalisation and reduced quality of life. Orthotic insoles are commonly used to redistribute plantar pressure, offload the ulcer site and potentially accelerate wound healing. This systematic review aims to evaluate the effectiveness of offloading insoles in the healing of DFUs, with a focus on ulcer size reduction, recovery time, pain management, pressure redistribution and limb function, such as balance. A secondary objective is to compare the effects of different insole materials on healing outcomes, including satisfaction level towards the insole and overall quality of life.
    METHODS AND ANALYSIS: A comprehensive literature search will be conducted in PubMed, MEDLINE, CINAHL and Google Scholar. Randomised controlled trials (RCTs) will be prioritised, while non-randomised studies that meet the eligibility criteria will also be considered. Studies published in English between 2000 and 2026 will be included. Eligible studies must assess the impact of orthotic insoles on DFUs, with outcome measures including pain intensity, pressure redistribution, wound healing and recovery time. Methodological quality will be assessed using the PEDro scale, while the Cochrane Risk of Bias tool (RoB 2) and the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) will be applied as appropriate. Data will be extracted using a standardised form.
    ETHICS AND DISSEMINATION: This review does not require ethical approval. The results will be shared through publications in peer-reviewed journals and conference presentations.
    PROSPERO REGISTRATION NUMBER: CRD420251145215.
    Keywords:  Diabetic foot; REHABILITATION MEDICINE; WOUND MANAGEMENT
    DOI:  https://doi.org/10.1136/bmjopen-2025-113984
  46. PLoS One. 2026 ;21(5): e0349686
    Machine learning reveals microbiome differences by periodontitis severity.
    Soo Hyun Seo, Jae Won Lee, Sujin Oh, Jin-Sil Hong, Ban Seok Lee, Sun Jae Kwon, Keun-Suh Kim, Jung Soo Park, Ju Sun Heo, Ki Hoon Ahn, Hyo-Jung Lee, Kyoung Un Park.
      Periodontitis is a chronic inflammatory disease driven by microbial dysbiosis, yet the microbial signatures associated with severity remain incompletely understood. This study investigated changes in subgingival microbial composition across clinically defined severity groups and evaluated the performance of microbiome-based machine-learning models for classifying periodontitis severity. Subgingival plaque samples from 84 patients were analyzed using 16S rRNA gene sequencing. Microbial diversity showed a modest decreasing trend with increasing severity, although differences were not statistically significant. Five machine learning models were applied to classify periodontitis. Random Forest and XGBoost achieved AUC values of 0.98, indicating statistically significant classification performance (p < 0.05) after feature selection. Validation using three external cohorts demonstrated substantial performance variability across populations, reflecting differences in oral microbiome composition, sample type, and periodontal status definitions. Feature importance analysis identified Fusobacterium, Campylobacter, Stomatobaculum, Leptotrichia and Segatella as key contributors to periodontitis severity classification, consistent with their established roles in periodontal dysbiosis. These findings highlight the potential of microbiome-based models for classifying periodontitis severity while underscoring the need to incorporate diverse populations and robust feature-selection strategies to enhance generalizability.
    DOI:  https://doi.org/10.1371/journal.pone.0349686
  47. BMC Microbiol. 2026 May 18.
    Isolation and characterization of a bacteriophage targeting Proteus mirabilis for use in culture media.
    Songül Ötkün, Müzeyyen Demir, Erdal Polat, Sevil Erdenliğ Gürbilek.
      Proteus mirabilis is an important opportunistic bacterium that affects both animal and human health. One of the key characteristics of this bacterium is its distinctive zonal spreading on solid media. This movement, known as swarming, complicates the isolation and identification of pathogenic agents present alongside P. mirabilis in clinical samples. The aim of this study was to isolate a lytic bacteriophage targeting P. mirabilis to prevent its growth and evaluate the use of these phages in cultures of clinical samples contaminated with Proteus. A phage designated as P5663 was isolated using general phage isolation and purification methods. Genomic and electron microscopic analyses suggested that the phage belongs to the class Caudoviricetes, and genome-based comparisons supported its close relatedness to bacteriophages within the family Casjensviridae. The isolated phage was analyzed for its lytic activity against 16 P. mirabilis, one P. vulgaris, and 19 different non-Proteus bacterial species. The growth of P. mirabilis on Tryptic Soy Agar (TSA) medium prepared with the isolated phage was evaluated. All Proteus isolates analyzed in the study were lysed by P5663 Φ, while the other bacterial species were not affected. It was observed that while P. mirabilis suspensions of varying concentrations exhibited growth in the inoculation area on TSA containing P5663 Φ, the zonal spreading (swarming) was inhibited. In conclusion, this study presents a novel perspective on the use of bacteriophages, which have a wide range of applications. It was concluded that phages could be used to inhibit the swarming behavior of P. mirabilis in culture media without affecting the growth of non-target bacteria.
    Keywords:   P. mirabilis ; Bacteriophage; Contamination; Culture media; Swarming
    DOI:  https://doi.org/10.1186/s12866-026-05141-1
  48. Front Dent Med. 2026 ;7 1816844
    Artificial intelligence in periodontics and peri-implant medicine: from diagnosis to precision care.
    Poojita Yadavalli, Saravanan Sampoornam Pape Reddy, L Kesavalu.
       Background: Artificial intelligence (AI) has substantial potential to advance periodontal and peri- implant care through novel diagnostic, prognostic, and therapeutic opportunities. Nevertheless, the evidence is scattered over several fields.
    Objective: To provide a narrative synthesis of the recent evidence regarding applications of AI to periodontology and peri-implant medicine specifically diagnostic imaging, disease prediction, biomarker discovery, peri-implant disease assessment and clinical decision support.
    Methods: A systematic search of PubMed, MEDLINE, Scopus, and Embase for studies from August 2020 to August 2025 was performed. We included only original research articles on AI applications in periodontal or peri-implant settings. After screening the identified records and conducting full-text assessments, a total of 32 studies were included based on established inclusion criteria.
    Results: AI showed high diagnostic performance at imaging-based applications, with accuracy from 0.85 to 0.98 reported for the detection and quantification of alveolar bone loss using two- and three-dimensional radiographs. Using this data, machine learning (ML) models were developed for identifying potential molecular biomarkers that could support disease prediction and gain insight into biological processes. AI-aided immune profiling and risk stratification models demonstrated robust predictive capabilities in peri-implant maintenance. mHealth is one of the types of AI-based digital health devices and has succeeded in enhancing patient compliance and periodontal prognosis.
    Conclusions: AI has considerable promise to impact non-invasive periodontal and peri-implant diagnostics, risk-assessment and enhanced treatment-planning through advanced imaging analysis, molecular profiling as well as patient-centred digital tools. These need to be further validated, standardized, and integrated into clinical care before widespread uptake.
    Keywords:  artificial intelligence; implantology; machine learning; neural networks; peri-implant medicine; periodontics
    DOI:  https://doi.org/10.3389/fdmed.2026.1816844
  49. Stud Health Technol Inform. 2026 May 21. 336 313-317
    Using Large Language Models to Automate the Comparison and Integration of Evolving Clinical Practice Guidelines into Clinical Decision Support Systems.
    Chaïma Abdellaoui, Akram Redjdal, Brigitte Seroussi.
      Clinical decision support systems (CDSSs) can improve the compliance of therapeutic decisions with clinical practice guidelines (CPGs). However, the rapid evolution of CPGs creates major challenges in keeping CDSS knowledge bases up to date. This study investigates the use of Large Language Models (LLMs) to automate the comparison of breast cancer CPGs over time, focusing on AP-HP (2016), implemented in the DESIREE guideline-based CDSS, and SENORIF (2021-2022). The aim was to automatically identify guideline-derived recommendations in both CPGs and update DESIREE knowledge base accordingly. The top-performing LLM, a fine-tuned Mistral Large model, achieved an average performance (F1 score: 0.49), and many inconsistencies were observed. While fine-tuned LLMs show promising potential for supporting guideline maintenance, they still face significant limitations, highlighting the need for structured CPG formats to ensure reliable CDSS integration.
    Keywords:  Breast cancer; Clinical decision support systems; Clinical practice guidelines; Large Language Models; Prompt Engineering
    DOI:  https://doi.org/10.3233/SHTI260168
  50. J Crohns Colitis. 2026 May 08. pii: jjag057. [Epub ahead of print]20(5):
    Does inflammatory bowel disease play a role in cognitive decline? A systematic review.
    Annagiulia Motisi Bertulli, Cristina Bezzio, Silvia Marsano, Irene Corradini, Saverio Stranges, Michela Matteoli, Alessandro Armuzzi.
       BACKGROUND & AIMS: Inflammatory bowel disease (IBD) has been increasingly linked to cognitive impairment (CI) and dementia, yet the underlying mechanisms driving this association remain poorly understood and population, clinical and experimental studies show controversial results. Among others, factors such as chronic inflammation, gut-brain axis dysfunction, and psychological comorbidities have been proposed as contributors to cognitive deficits in IBD patients. The objective of this systematic review was to evaluate the existing literature on the relationship between IBD and cognitive function, considering observational and preclinical studies, with the aim to identify key factors influencing CI and potential clinical implications. The main focus of this review is on the use of IBD treatments, which may have a potential impact on CI.
    METHODS: We conducted a systematic review according to PRISMA guidelines. PubMed and Scopus were searched from database inception up to August 30, 2024, for studies assessing cognitive performance in individuals with IBD. Clinical and epidemiological studies, genetic investigations (Mendelian Randomization and Genome-wide Association studies), and preclinical models examining memory, attention, and executive functions were included. Two reviewers independently extracted data and assessed methodological quality and risk of bias.
    RESULTS: The research yielded 66 included studies, including 31 populations studies, 13 genetics studies, and 22 preclinical research studies. Our findings suggest that patients with IBD may exhibit impaired cognitive function, particularly in memory, attention, and executive processing. Disease activity, chronic inflammation and psychological stress appear to contribute to these deficits, while some treatment strategies seem to mitigate the risk of CI.
    CONCLUSION: IBD is associated with CI and increased dementia risk, with biologics potentially mitigating neuroinflammation-related decline. More longitudinal studies and randomized clinical trials, also on intermediate endpoints, are needed to clarify the neuroprotective role of some therapies and optimize treatment strategies.
    Keywords:  Alzheimer’s disease; IBD; biologic therapy; cognitive impairment; dementia; inflammatory bowel disease
    DOI:  https://doi.org/10.1093/ecco-jcc/jjag057
  51. Phage (New Rochelle). 2026 Mar;7(1): 1-2
    Integrating Past and Present PHAGE Research.
    Martha Clokie, Thomas Sicheritz-Pontén.
      
    DOI:  https://doi.org/10.1177/26416549261430532
  52. BMJ Open Diabetes Res Care. 2026 May 21. pii: e006026. [Epub ahead of print]14(3):
    Topical therapies for diabetic foot ulcers: a systematic review and network meta-analysis.
    Lihong Chen, Jui-Ching Chen, Ting Lin, Feiyan Shi, Dawei Chen, Chun Wang, Yun Gao, Harikrishna K Ragavan Nair, Xingwu Ran.
       OBJECTIVE: Diabetic foot ulcer (DFU) is a life-threatening complication associated with high amputation and mortality rates. While numerous topical therapies exist, their comparative efficacy and safety remain unclear. We aimed to compare the efficacy and safety of topical therapies for DFUs to identify optimal treatment strategies.
    RESEARCH DESIGN AND METHODS: We searched PubMed, Embase, and CENTRAL from inception to February 1, 2025, for randomized clinical trials (RCTs) evaluating topical therapies for DFUs. We excluded non-topical interventions to ensure clinically relevant comparisons. A Bayesian network meta-analysis was performed. The primary outcome was wound healing rate.
    RESULTS: We included 51 RCTs involving 6161 patients and 23 interventions. 12 topical therapies, including placenta-derived products, platelet-related products, ON101, epidermal growth factor, and tissue-engineered skin substitutes, significantly improved wound healing rates vs standard of care (SOC). Placenta-derived products showed the greatest efficacy (OR 7.85 (95% credible interval (CrI) 4.62 to 14.15)) and were the only intervention to significantly reduce adverse events vs SOC (0.25 (95% CrI 0.10 to 0.60)). No interventions differed significantly from SOC in time to wound healing, serious adverse events, or infections.
    CONCLUSIONS: Placenta-derived products and other biological or advanced topical therapies may demonstrate greater efficacy than the SOC in facilitating the healing of DFUs. Nevertheless, the certainty of evidence for most comparisons remains in the low-to-moderate range. These findings suggest potential benefits in integrating these therapies into the management of DFUs. However, high-quality RCTs are necessary to verify long-term outcomes.
    Keywords:  Diabetic Foot; Meta-Analysis; Wound Healing
    DOI:  https://doi.org/10.1136/bmjdrc-2026-006026
  53. Adv Ther. 2026 May 19.
    An Update and Overview of the Ocular and Extraocular Microbiome and Its Impact on Ophthalmic Care.
    Konstantinos Benekos, Andreas Katsanos, Panagiotis Laspas, Georgios D Panos, Iordanis Vagiakis, Fotios S Fousekis, Robert Luca, Beryl Zhou, Charilaos Kostoulas, Ioannis Georgiou, Konstantinos H Katsanos, Dimitra Skondra, Anastasios G Konstas.
      The microbiome has been described as the last human "organ" and is currently the topic of great research interest worldwide. The application of culture-independent methods, like 16S ribosomal next-generation sequencing, has offered researchers the opportunity to identify bacterial populations that were impossible to detect previously using conventional culture methods. Further standardization of these new approaches to characterizing the microbiome is desirable. The present review discusses the mounting evidence suggesting that alterations in the microbiome and microbial metabolites, such as short-chain fatty acids in the gut, mouth, and ocular surface, may play a key role in the pathogenesis of ocular pathologies such as ocular surface disease, glaucoma, uveitis, age-related macular degeneration, and diabetic retinopathy. Clarifying the probable role of the microbiome in ocular diseases would not only offer valuable insights into pathogenesis but could also enable the development of novel therapeutic approaches. As yet, microbial-based therapeutic applications in ophthalmology are limited. Nevertheless, recently emerging strategies utilizing probiotics and prebiotics, or even fecal transplantation to regulate microbiome composition, offer promising research avenues for developing future innovative therapies for ocular diseases. Further studies employing standardized methodological protocols are needed to ensure the reproducibility of results and to eventually unlock the precise links between the microbiome and the eye.
    Keywords:  Dry eye disease; Gut–eye axis; Metabolomics; Metagenomics; Microbial therapeutics; Microbiome; Microbiome sequencing; Ophthalmic diseases; Ophthalmology; Uveitis
    DOI:  https://doi.org/10.1007/s12325-026-03620-5
  54. Curr Opin Crit Care. 2026 May 15.
    Ventilator-associated pneumonia: newer insights that can drive improved outcomes.
    Andrew F Shorr, Marya D Zilberberg.
       PURPOSE OF REVIEW: Ventilator-associated pneumonia (VAP) results in substantial morbidity and results in high crude mortality rates. Many recent studies address multiple aspects of VAP ranging from its evolving epidemiology and microbiology to novel means for prevention and treatment.
    RECENT FINDINGS: The true incidence of VAP remains difficult to assess given definitional issues, which confound accurate diagnostic conclusions. The lack of a clear gold standard for identifying VAP makes comparisons across different studies difficult, as it remains unclear if like syndromes are actually being described. Nonetheless, VAP remains a clinical and costly challenge. Earlier discussion of achieving 'zero' VAP were clearly misplaced. Furthermore, the microbiology of VAP continues to evolve with the spread of antimicrobial resistance. New attention on the microbiome, though, may prove helpful and enhance our understanding of the pathogenesis of VAP. Simple interventions such a toothbrushing appear to successfully reduce rates of VAP and should be more broadly adopted. Rapid diagnostic tools, which are increasingly utilized to identify the causative pathogen in VAP, appear to have more limitations than previously thought. Several novel antibiotics are now available for treating multidrug-resistant organisms (MDROs) often encountered in VAP. With respect to antibiotic treatment more generally, it appears that shorter durations of therapy are well tolerated and effective, even in cases of VAP caused by MDROs.
    SUMMARY: Although our knowledge and understanding of VAP continues to advance, many of the general questions of the last decade remain unresolved. We continue to lack a clear and simple means for defining VAP and have yet to identify the optimal approach for prevention. Likewise, despite the availability of newer antimicrobials, we continue to lack rapid diagnostics that can clearly be shown to improve patient-centered endpoints. The availability of newer antibiotics may allow us to more easily and safely treat MDROs, but they have not revolutionized outcomes or been shown to reduce mortality.
    Keywords:  antibiotics; epidemiology; microbiology; nosocomial; pneumonia; prevention; treatment
    DOI:  https://doi.org/10.1097/MCC.0000000000001390
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