bims-fagtap Biomed News
on Phage therapies and applications
Issue of 2026–07–05
forty-four papers selected by
Luca Bolliger, lxBio
  1. Reprogramming chronic wounds: the emerging role of microbiome-targeted therapies in diabetic foot ulcers.
  2. [The Oral Microbiome: Maintenance of Homeostasis, Disease Associations, and Mechanisms of Pathogenesis].
  3. Bacteriophage Heteroresistance as a Cause of Treatment Failure in Urinary Tract Infections.
  4. Mapping the Oral Microbiome's Role in Periodontal Disease Progression: A Systematic Review.
  5. The oral phageome in human health, disease, and clinical implications.
  6. Host Range Breadth Correlates with Genic Diversity in Honeybee Phages.
  7. Persistence of large P. aeruginosa aggregates despite reduced airway burden in people with cystic fibrosis on CFTR modulator therapy.
  8. Clinical Impact of Biofilm-Producing Carbapenem-Resistant Acinetobacter baumannii: Diagnosis and Treatment Challenges.
  9. Viruses, Periodontitis, and Systemic Diseases.
  10. Isolation and characterization of lytic Shigella bacteriophages with rapid in vitro and ex vivo bactericidal activity.
  11. Chloramphenicol and tetracycline synergize with bacteriophage SeKF_13 to inactivate antimicrobial-resistant Salmonella Typhimurium.
  12. [Oral-gut axis: the microbial and immune bridge linking periodontitis to inflammatory bowel disease].
  13. Chronic suppression of a multidrug-resistant Pseudomonas aeruginosa in prosthetic joint infection using personalized bacteriophage treatment.
  14. Of mice and men-The emerging oral-gut-brain axis of health and disease.
  15. A novel drug series optimized to address cystic fibrosis and other CFTR deficiency diseases of human airways.
  16. Wounds of the Body, Wounds of the Self: Addressing Shame in the Care of Patients Living With Obesity and Chronic Wounds.
  17. Synergistic potential of probiotics and bacteriophages in combating multidrug-resistant microbial infections: A novel therapeutic strategy for the post-antibiotic era.
  18. Intracellular barriers and receptor masking limit success of a Pseudomonas aeruginosa clinical phage family.
  19. A novel lytic bacteriophage BUCT791 effectively controls multidrug-resistant Klebsiella pneumoniae in vitro and in vivo.
  20. Innate immune recognition and immunomodulatory effects of bacteriophages: implications for phage therapy.
  21. Can Artificial Intelligence Be Utilised to Develop Point-of-Care Endodontic Microbiological Technologies?
  22. Regenerative polymer-based modalities for diabetic foot ulcers: From material design to clinical translation.
  23. Oral Health, Periodontitis, and Respiratory Diseases: Biological Pathways.
  24. Rapid and quantitative phage susceptibility test by ramanome.
  25. Pathogens in the bay: environmental Staphylococcus saprophyticus strains mirror clinical counterparts in virulence, biofilm formation, antimicrobial resistance, pathogenicity, and phage susceptibility.
  26. Self-powered thermoelectric gel dressings for chronic wound monitoring and therapy.
  27. Maternal, Infant, Reproductive and Child Health in Cystic Fibrosis (MATRIARCH_CF): a prospective, observational study to evaluate pregnancy and parenthood in females with cystic fibrosis and health of the offspring in the CFTR-modulator era.
  28. Is Fusobacterium nucleatum the key mediator between oral infections and systemic diseases? Mechanistic insights and therapeutic implications.
  29. Role of oral microbiome in cancer immunotherapy.
  30. Cystic fibrosis in a septuagenarian.
  31. Study on the role and clinical relevance of gut microbiota in diabetic foot ulcers.
  32. Healing cascades and infections in wounds monitored using a wearable sensor of gaseous flux.
  33. Precision nutrition in diabetic foot ulcers: multimodal artificial intelligence for personalized metabolic management.
  34. Antimicrobial Peptides Against Antimicrobial-Resistant Bacteria: Focus on Machine Learning.
  35. Transformations within cystic fibrosis model of care in the era of CFTR modulators: a Scoping Review.
  36. Early reported effects of the 2026 CMS Physician Fee Schedule on patient access to CAMPs in wound care: a national clinician and practice survey.
  37. The skin microbiome: from historical ecology to therapeutic frontiers.
  38. Bacterial keratitis: a global review of current practices, challenges and innovations.
  39. Host life-history strategy is a critical determinant of virulent phage infection propensity.
  40. Artificial Intelligence-Driven Virtual Reality in Physical Rehabilitation: A Review of Machine-Learning Kinematics, Educational Scaffolding, and Treatment Adherence Strategies.
  41. Double agent: how Escherichia coli switches from commensal to pathogen in the urinary tract infection.
  42. Where and when to strike: Spatiotemporally controlled smart nanomedicines for precision antibacterial therapy.
  43. NDM-Producing Klebsiella pneumoniae and Multidrug-Resistant Enterococcus faecium Bacteremia: A Report of Two Cases.
  44. Advancements in longevity pharmacology research - are we finally seeing clinical progression?
  1. Int J Pharm. 2026 Jun 27. pii: S0378-5173(26)00585-5. [Epub ahead of print] 127137
    Reprogramming chronic wounds: the emerging role of microbiome-targeted therapies in diabetic foot ulcers.
    Raj Kamal, Abhishek Chauhan, Shrey Kumar Bhargava, Sonia Dhiman, Thakur Gurjeet Singh, Dinesh Kumar, Ankit Awasthi.
      Diabetic foot ulcers (DFUs) represent one of the most severe complications of diabetes mellitus, frequently leading to chronic infection, delayed wound healing, and lower-limb amputations. Despite advances in wound care, current therapeutic strategies largely rely on broad-spectrum antibiotics and mechanical interventions, which often fail to address the complex biological environment of non-healing wounds. Emerging evidence indicates that DFUs are strongly associated with alterations in the wound microbiome, including microbial dysbiosis, polymicrobial biofilm formation, and persistent inflammatory responses. These factors collectively contribute to impaired tissue regeneration and resistance to conventional therapies. Consequently, microbiome-targeted therapeutic strategies are gaining increasing attention as a promising approach for DFU management. Novel interventions such as bacteriophage therapy, probiotic and postbiotic-based wound dressings, and CRISPR-mediated genome editing provide precise tools for disrupting pathogenic biofilms, attenuating microbial virulence, and overcoming antimicrobial resistance while preserving beneficial microbial communities. In parallel, advances in rapid microbiome diagnostics, smart wound dressings, nanotechnology-based drug delivery systems, and data-driven personalized treatment platforms are enabling more adaptive and targeted wound management. By shifting the perspective from treating DFUs as simple infections to understanding them as complex microbial ecosystems, these emerging strategies offer new opportunities to enhance healing outcomes.
    Keywords:  Biofilms; Dysbiosis; Genome-editing; Nanotherapeutics; Postbiotics
    DOI:  https://doi.org/10.1016/j.ijpharm.2026.127137
  2. Sichuan Da Xue Xue Bao Yi Xue Ban. 2026 May 20. 57(3): 861-869
    [The Oral Microbiome: Maintenance of Homeostasis, Disease Associations, and Mechanisms of Pathogenesis].
    Zeyuan Chen, Xu Zhang.
      The oral microbiome is a complex and highly structured ecosystem composed of diverse microorganisms, including bacteria, fungi, viruses, and other microbes, which establish an intimate symbiotic relationship with the host. Its composition across distinct ecological niches, such as teeth and mucosa, is modulated by multiple factors, including age, genetics, and lifestyle. A stable microbial community acts as an essential barrier for sustaining oral and systemic health. This review systematically examines the structure and function of the oral microbiome under healthy and diseased conditions, with an emphasis on the formation mechanisms of plaque biofilms and their pivotal roles in the initiation and progression of dental caries and periodontitis. Dental caries is predominantly driven by acidogenic and aciduric bacteria, such as Streptococcus mutans and Lactobacillus spp., accompanied by microenvironmental acidification and enamel demineralization. Periodontitis is closely associated with the enrichment of pathogenic microorganisms, including the "red complex" in subgingival plaque, and host immune dysregulation. Furthermore, ecological dysbiosis of the oral microbiome, particularly the abnormal proliferation of pathogens such as Fusobacterium nucleatum and Porphyromonas gingivalis, not only contributes to the development and progression of oral squamous cell carcinoma but also closely correlates with numerous systemic disorders, including cardiovascular diseases, diabetes mellitus, rheumatoid arthritis, and pancreatic cancer, via mechanisms such as inflammatory induction, immunosuppression, and microbial translocation. Systematic elucidation of the ecological characteristics and pathogenic mechanisms of the oral microbiome will provide a critical theoretical foundation for maintaining oral microecological homeostasis and for preventing and treating oral and systemic comorbidities.
    Keywords:  Dental caries; Dysbiosis; Oral microbiome; Periodontitis; Review
    DOI:  https://doi.org/10.12182/20260560206
  3. bioRxiv. 2026 Jun 27. pii: 2026.06.26.734749. [Epub ahead of print]
    Bacteriophage Heteroresistance as a Cause of Treatment Failure in Urinary Tract Infections.
    Serena Singh-Ward, Alysha S Ismail, Teresa Gil-Gil, Brandon A Berryhill, Michael H Woodworth, Hope E Shanks, Bruce R Levin.
      With the rise of antimicrobial resistance, urinary tract infections (UTIs) have become increasingly more difficult to treat, prompting renewed interest in bacteriophage (phage) therapy as an alternative or adjunct to antibiotics. UTIs are an attractive target for phage therapy because they generate a high density of actively replicating bacteria that supports phage propagation, and because the urinary tract is readily accessible for administration and monitoring. Yet studies of phage therapy for UTIs report mixed outcomes, including failures to meet clinical and microbiological endpoints. Here we follow the population dynamics of a clinical Escherichia coli UTI strain and two phages, HP3 and ES19, to which the strain appears susceptible by standard testing. Despite this apparent susceptibilty, both phages fail to suppress the strain, with resistance emerging almost immediately. Using the measured mutation rate, our mathematical model shows that traditional resistance cannot account for these dynamics. We instead demonstrate, including by a phage-specific population analysis profile assay we developed, that heteroresistance drives this rapid failure, offering a plausible explanation for treatment failures in UTI phage therapy.
    DOI:  https://doi.org/10.64898/2026.06.26.734749
  4. Cureus. 2026 Jun;18(6): e110078
    Mapping the Oral Microbiome's Role in Periodontal Disease Progression: A Systematic Review.
    Shaan R Patel, Vishnu S Vundamati, Riyana R Patel, Nisa Eriskin, Caiden J Friedrich, Brielle Tila-Cohen, Daniel Tupikin, Ashritha S Pidikiti, Kabir D Lall, Harvey N Mayrovitz.
      Periodontal disease is an inflammatory condition characterized by progressive destruction of the tooth-supporting tissues and a shift from a symbiotic to a dysbiotic oral microbial community, rather than by a single pathogen. This review aimed to synthesize current evidence on how alterations in microbial composition, community structure, and functional activity contribute to periodontal disease severity and progression. A comprehensive literature search across four databases (PubMed, Web of Science, Google Scholar, and Embase) was conducted. Studies were included if they were peer-reviewed, human studies published between 2000 and 2026, and met the predefined inclusion and exclusion criteria. Twenty-two articles met these criteria and were analyzed for relationships between microbial patterns and clinical peritoneal outcomes. Across the studies reviewed, periodontal disease severity was consistently associated with compositional shifts in the oral microbiome rather than changes in overall microbial diversity or bacterial load. Increased prevalence and abundance of red-complex organisms, including Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, were strongly associated with worsening clinical parameters, whereas Aggregatibacter actinomycetemcomitans showed a stronger association with aggressive disease phenotypes. Functional analyses further revealed enrichment of inflammatory and metabolic pathways, which support the concept of functional dysbiosis as a factor influencing tissue destruction. Interventions that modified local ecological conditions or host-microbe interactions demonstrated improved microbial profiles and clinical outcomes.  These findings reinforce the idea that periodontal disease management is not just about targeting a single pathogen; it should focus on restoring microbial homeostasis and regulating the host's inflammatory response. Adopting this approach will help to create a more effective and personalized treatment strategy for the patient that will likely improve their symptoms, help prevent periodontal disease progression, and reduce their risk of developing complications associated with chronic oral inflammation.
    Keywords:  aggregatibacter actinomycetemcomitans; functional dysbiosis; microbial interactions; oral microbiome; periodontal disease; porphyromonas gingivalis; tannerella forsythia; treponema denticola
    DOI:  https://doi.org/10.7759/cureus.110078
  5. J Appl Microbiol. 2026 Jul 02. pii: lxag158. [Epub ahead of print]
    The oral phageome in human health, disease, and clinical implications.
    Miaomiao Wu, Yujie Xie, Shuai Le, Yan Li.
      The oral cavity harbors a complex and abundant viral community, collectively known as the oral virome, which is predominantly composed of bacteriophages. The oral phageome is highly heterogeneous across human populations and correlated with factors such as geography, ethnicity, lifestyle, and urbanization. This phageome is crucial for maintaining oral microbial homeostasis and is strongly associated with various oral diseases. Emerging studies greatly highlight the therapeutic promise of bacteriophages, which can not only be used to treat infectious diseases but to modulate the microbiota. However, their specific functions and applications within the oral cavity remain poorly explored. Here, we review relevant literature on the oral phageome, and the intricate interactions among phages, bacteria, and the human host underlying health and diseases. We shed light on emerging avenues of phage-based therapies and examined the underlying obstacles. Our review suggests that future efforts should prioritize mechanistic studies and therapeutic development to harness this enigmatic component of the human oral microbiome.
    Keywords:  oral bacteriophage; oral diseases; phage therapy; systemic diseases
    DOI:  https://doi.org/10.1093/jambio/lxag158
  6. Genome Biol Evol. 2026 Jul 01. pii: evag152. [Epub ahead of print]18(7):
    Host Range Breadth Correlates with Genic Diversity in Honeybee Phages.
    Chris R P Robinson, Adam G Dolezal, Ivan Liachko, Irene L G Newton.
      Bacteriophages can evolve rapidly. Mutation and recombination via horizontal gene transfer allow them to counter adaptive responses by microbial hosts. However, little is known about the genomic processes underlying phage evolution within an ecological context-especially within natural microbial communities. This is due in part to the difficulty in resolving aspects of phage ecology, such as host range. To better understand the interplay of phage ecology and evolution within natural microbial communities, we combined measures of phage host range in vivo with measures of genome evolution in order to infer the evolutionary pressures acting on phage genomes within individual honeybee worker microbiomes. We show that near-identical phage genomes, cooccurring across multiple honeybee colonies, exhibit large variation with respect to gene modules, despite retaining a highly similar core genome. Estimates of genic diversity suggest deviations from neutral evolutionary models and identify loci under putative diversifying selection. We then use HiC-resolved metagenomics and show that the honeybee gut contains a dense phage community that exhibits a wide degree of host range variation. This variation differed across individual metagenomes in both the number and phylogenetic distance of potential hosts. We show that common measures of genetic variation positively correlate with host range in bee-associated phages and that functional targets of diversifying selection are partitioned differently between broad or narrow host range phages. Our work underscores the high host range variation associated with phages within host-associated microbial communities and provides evidence that this variation impacts rates of phage evolution.
    Keywords:  Bacteriophage ecology; Bacteriophage evolution; Honeybee microbiome; Metagenomic hiC; Population genetics
    DOI:  https://doi.org/10.1093/gbe/evag152
  7. J Cyst Fibros. 2026 Jun 28. pii: S1569-1993(26)01654-1. [Epub ahead of print]
    Persistence of large P. aeruginosa aggregates despite reduced airway burden in people with cystic fibrosis on CFTR modulator therapy.
    Amanda J Morris, Shafinaz Eisha, Yvonne C W Yau, Sara Goel, Michelle Shaw, William H DePas, Isaac Martin, Arunan Selvarajah, Mellissa Gaudet, Elizabeth Tullis, Dao Nguyen, Valerie J Waters.
       BACKGROUND: Cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies improve lung function and reduce airway bacterial burden in people with cystic fibrosis (pwCF); however, chronic Pseudomonas aeruginosa infection can persist and recrudesce. This persistence may be mediated by bacterial aggregation, a phenotype associated with antibiotic tolerance and immune evasion that is not routinely assessed in clinical practice. In this study, we evaluated the impact of CFTR modulation on P. aeruginosa burden and aggregation in sputum from pwCF.
    METHODS: PwCF with chronic P. aeruginosa infection were enrolled at three Canadian CF centers (2022-2025). Sputum samples were processed using the Microbial Identification after Passive CLARITY Technique (MiPACT), followed by fluorescence in situ hybridization and confocal microscopy. Image analyses quantified P. aeruginosa biovolume and aggregate number, maximum size and size distribution. Mixed-effects models assessed longitudinal and cross-sectional differences by modulator status.
    RESULTS: Forty-two participants contributed 181 samples; 27 received modulators. Longitudinally, modulator therapy reduced P. aeruginosa biovolume (p = 0.01) and aggregate number (p = 0.04), with no significant changes observed in untreated individuals. Cross-sectional analyses showed no differences in biovolume and aggregate number by treatment status. Maximum aggregate size and the proportion of large aggregates were also comparable between groups with approximately 20% of P. aeruginosa persisting as large aggregates in both groups.
    CONCLUSIONS: CFTR modulators reduce P. aeruginosa density but not aggregation. Persistent aggregates may represent structurally resilient communities contributing to chronic infection, highlighting aggregation as a potential adjunctive therapeutic target.
    Keywords:  CFTR modulator therapy; Cystic fibrosis; Pseudomonas aeruginosa
    DOI:  https://doi.org/10.1016/j.jcf.2026.06.012
  8. Cureus. 2026 Jun;18(6): e110019
    Clinical Impact of Biofilm-Producing Carbapenem-Resistant Acinetobacter baumannii: Diagnosis and Treatment Challenges.
    Devika G Bhati, Harsha V Patil, Satish R Patil.
      Carbapenem-resistant Acinetobacter baumannii (CRAB) has emerged as a major nosocomial pathogen associated with significant morbidity and mortality, particularly in intensive care unit (ICU) settings. Its remarkable ability to survive in adverse environments, persist on medical devices, and rapidly acquire multidrug resistance has made it a critical global healthcare concern. This review aims to provide a comprehensive overview of the epidemiology, risk factors, antimicrobial resistance mechanisms, and pathogenicity of CRAB, with a special emphasis on the role of biofilm formation. CRAB infections are strongly associated with prolonged hospitalization, mechanical ventilation, previous antibiotic exposure, and invasive procedures. The organism exhibits multiple resistance mechanisms, including carbapenemase production, efflux pumps, porin modifications, and horizontal gene transfer, which significantly limit therapeutic options. A key virulence factor is its capacity to form biofilms on biotic and abiotic surfaces, enhancing bacterial survival, immune evasion, and resistance to antimicrobial agents. Biofilm-associated infections are often chronic, recurrent, and difficult to eradicate, particularly in device-related infections. The interplay between biofilm formation and antimicrobial resistance further complicates treatment outcomes. Current management strategies rely on last-resort antibiotics, combination therapy, antimicrobial stewardship, and strict infection control practices, while emerging therapies targeting biofilms offer promising alternatives. Understanding these complex mechanisms is essential for developing effective therapeutic and preventive strategies against CRAB infections.
    Keywords:  acinetobacter baumannii; antimicrobial resistance; biofilm; carbapenem resistance; crab; nosocomial infections
    DOI:  https://doi.org/10.7759/cureus.110019
  9. J Periodontal Res. 2026 Jul 01.
    Viruses, Periodontitis, and Systemic Diseases.
    K N Stolte, Y L Hernandez-Kapila, H Dommisch.
      Viruses are increasingly recognized as potential modulators of oral biofilm ecology and periodontal inflammation, expanding the traditional bacterial paradigm of periodontitis. Members of the Herpesviridae family, including Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), and herpes simplex virus (HSV), are frequently detected in periodontal tissues and may influence disease activity through latency, reactivation, immune modulation, epithelial barrier disruption, and interactions with bacteria. These processes may contribute to local dysbiosis and sustained periodontal inflammation. The potential systemic relevance of oral viruses is biologically plausible but remains incompletely established. Viral persistence or reactivation in oral niches may contribute to systemic immune activation through hematogenous spread, saliva-mediated dissemination, aspiration, or amplification of inflammatory mediators as IL-1β, IL-6, and TNF-α. Accordingly, viruses may act as disease modifiers within the broader relationship between periodontitis and systemic conditions including cardiovascular, metabolic, respiratory, neurogenerative, pregnancy-related, and cancer-associated outcomes. However, the strength of evidence differs across these conditions. Current data support a model in which oral viruses, bacteriophages, bacteria, and fungi form an interconnected biofilm ecosystem that may influence periodontitis progression and systemic inflammatory burden. Nevertheless, most available evidence is observational, associative, or derived from mechanistic experimental models, and definitive proof that viruses are independent etiopathogenic drivers of periodontitis is lacking. Future longitudinal and interventional studies are needed to determine whether viral detection reflects bystander association, disease amplification, or a true pathogenic role, and whether antiviral or phage-based strategies offer clinical benefit beyond established periodontal therapy.
    DOI:  https://doi.org/10.1111/jre.70137
  10. Front Cell Infect Microbiol. 2026 ;16 1837303
    Isolation and characterization of lytic Shigella bacteriophages with rapid in vitro and ex vivo bactericidal activity.
    Nida Shaheen, Maranda Stricklin, Martin Kordesch, Shaohua Wang.
       Introduction: The emergence of shigellosis caused by Shigella spp. poses a significant threat to global health, and the prevalence of multidrug-resistant (MDR) strains necessitates the development of effective antimicrobial therapies. Bacteriophages present a promising approach for both prevention and treatment of MDR infections.
    Methods: Ten lytic bacteriophages targeting Shigella flexneri 2457T were isolated from wastewater using the double-layer agar method. Phage morphology, lytic activity spectrum, latent period, burst size, bacterial killing efficiency, and efficacy under ex vivo microbiota conditions were evaluated. Transmission electron microscopy, one-step growth assays, bacterial killing assays, anaerobic fecal slurry co-culture experiments, and whole-genome sequencing of the representative phage PSW32 were performed.
    Results: Transmission electron microscopy revealed that these phages possessed icosahedral heads and contractile tails, consistent with myovirus-like morphology commonly observed among tailed bacteriophages within the class Caudoviricetes. Most phages exhibited broad lytic activity against S. flexneri, S. sonnei, and S. dysenteriae, with limited activity against S. boydii in spot assay. Among them, phages PSW32, PSW37, PSW38, and PSW40 exhibited lytic activity against the largest number of tested Shigella strains under the spot assay conditions. One-step growth assays revealed latent periods of 30-70 minutes and burst sizes of 40-267 PFU/cell, indicating efficient host infection activity. At multiplicities of infection (MOIs) ranging from 10 to 0.001, all phages efficiently suppressed the growth of S. flexneri. Based on their lytic kinetics and host range, PSW32 and PSW40 were further evaluated in an ex vivo microbiota model using anaerobic fecal slurry co-cultures. PSW32 reduced CFUs by 88% at 2 h and decreased bacterial levels to below the limit of detection (LOD) by 3 h. PSW40 reduced CFUs by 69% at 2 h and reduced bacterial levels to below the limit of detection (LOD) by 3 h. Genomic analysis of PSW32 identified a T4-like lytic architecture with no detectable genes linked to antimicrobial resistance or virulence, supporting its potential applicability for further evaluation.
    Discussion: These newly isolated lytic phages exhibited rapid bacterial activity under both in vitro and ex vivo microbiota-associated conditions and broad lytic activity against multiple Shigella species, Collectively, the findings support their potential for further investigation as phage-based strategies for controlling Shigella infections and contamination.
    Keywords:  Shigella spp.; antimicrobial alternatives; ex vivo fecal microbiota model; host range; lytic bacteriophages; multidrug resistance; phage therapy
    DOI:  https://doi.org/10.3389/fcimb.2026.1837303
  11. Microbiol Spectr. 2026 Jun 24. e0136426
    Chloramphenicol and tetracycline synergize with bacteriophage SeKF_13 to inactivate antimicrobial-resistant Salmonella Typhimurium.
    Karen Fong, Thomas Guy, Ayesha Lone, Hany Anany.
      Non-typhoidal Salmonella is estimated to cause up to 1 billion cases of global foodborne illness per year. Salmonella Typhimurium is a serovar of gravest worldwide concern as it is capable of infecting animal and human hosts and can also acquire antimicrobial resistance (AMR) determinants at a rapid rate. Recent advances in phage research have positioned them as especially useful for inactivation of Salmonella where antibiotics have proven no longer effective. Even more recently, phage-antibiotic synergy (PAS) has been proposed as a solution for AMR Salmonella, where synergistic combinations of phages and antibiotics are more effective than application of phage or antibiotic alone. Utilizing an in-house phage isolate, SeKF_13, we sought to determine the existence of PAS against a strain of Salmonella enterica serovar Typhimurium 14028 2a that is clinically resistant to bacteriostatic antibiotics chloramphenicol and tetracycline. Checkerboard assays revealed the presence of synergy when sub-lethal (sub-MIC) levels of either tetracycline or chloramphenicol were combined with phage SeKF_13 (P < 0.05; two-way ANOVA). Compared to tetracycline or chloramphenicol alone, the addition of phage also decreased the MICs of both antibiotics twofold. We also monitored the development of resistance and found that PAS significantly suppressed emergence of resistance compared to the antibacterial agents alone (P < 0.05; Tukey's HSD). Whole-genome sequencing revealed that SeKF_13 is devoid of genes encoding integrase, antimicrobial resistance, and virulence, ensuring safety in future applications. Together, our results suggest that combined treatment of phage and antibiotic can improve antimicrobial efficacy against antibiotic-resistant Salmonella enterica.
    IMPORTANCE: Salmonella enterica is a foodborne pathogen that causes one of the highest rates of foodborne illness worldwide. They are also capable of becoming resistant to antimicrobials very rapidly (i.e., antimicrobial resistance; AMR) due to their ability to acquire AMR determinants, undermining the effectiveness of current treatments. Bacteriophages (phages), viral predators of bacteria, have been proven to be effective in some cases, but recently, phage-antibiotic synergy has been proposed as a more effective solution than phages or antibiotics alone. We found this was, indeed, the case; using phage SeKF_13 and tetracycline or chloramphenicol (to which the Salmonella strain was resistant), we found that combination treatment was significantly more effective than either treatment alone. These results demonstrate that combined treatment of phage and antibiotic can bolster treatment efficacy against AMR Salmonella.
    Keywords:  Salmonella; antibiotics; antimicrobial resistance; antimicrobials; bacteriophage; biocontrol; food safety; genomics
    DOI:  https://doi.org/10.1128/spectrum.01364-26
  12. Zhonghua Kou Qiang Yi Xue Za Zhi. 2026 Jul 02. 61(7): 1074-1080
    [Oral-gut axis: the microbial and immune bridge linking periodontitis to inflammatory bowel disease].
    Z Y Gu, J Cao, W J Hu, R F Lu, G Yang.
      Periodontitis and inflammatory bowel disease (IBD) are common chronic inflammatory diseases affecting the oral cavity and gut, respectively. Recent researches suggest a potential bidirectional link between them via the oral-gut axis. On one hand, periodontal pathogens, notably Porphyromonas gingivalis, can ectopically colonize the gut, driving and exacerbating intestinal inflammation through mechanisms such as disrupting the gut barrier and inducing helper T cell 17/regulatory T cell imbalance. On the other hand, the systemic inflammatory environment, immune-metabolic disturbances, and oral-specific lesions caused by IBD can significantly increase the risk and severity of periodontal tissue destruction. This review summarizes the current understanding of the microbial and immune mechanisms underlying the interrelationship between periodontitis and IBD. It aims to encourage further validation of causality through longitudinal cohort studies, exploration of microbiome-targeted interventions, and multidisciplinary collaboration, ultimately facilitating the development of integrated prevention and treatment strategies based on the oral-gut axis.
    DOI:  https://doi.org/10.3760/cma.j.cn112144-20260202-00083
  13. Nat Commun. 2026 Jun 27.
    Chronic suppression of a multidrug-resistant Pseudomonas aeruginosa in prosthetic joint infection using personalized bacteriophage treatment.
    Rekha Arya, Dongzhu Ma, Jewelia J Rempuszewski, Nadine M Sadaka, Andrew J Frear, Beth Knapick, Dana M Parker, Vaughn S Cooper, Daria Van Tyne, Neel B Shah, James B Doub, Umit Akbey, Joseph Fackler, Subhendu Basu, Arkadiy Garber, Erin M Nawrocki, Kenneth L Urish.
      Multidrug resistant (MDR) bacterial infections without antibiotic options are a public health emergency. Infections associated with medical implants serve as an example. Conventional antibiotics have limited ability to eradicate these infections as they are associated with antibiotic-tolerant biofilms. Here, we report the use of bacteriophage therapy for the treatment of a MDR, non-operable Pseudomonas aeruginosa periprosthetic joint infection that had failed multiple antibiotic and surgical interventions. Treatment with intermittent bacteriophage therapy alone without antibiotics over a 2 year time period resulted in clinical resolution of the infection, but not microbiological eradication. Bacteriophage therapy established this control, in part, by altering virulence as defined by disease severity and symptoms and disrupting biofilm. Whole genome sequencing demonstrated the continued presence of bacteriophage during treatment. This provides preliminary evidence that bacteriophage therapy can be used to treat MDR infections in salvage cases when surgical and antibiotic options do not exist.
    DOI:  https://doi.org/10.1038/s41467-026-74326-z
  14. Periodontol 2000. 2026 Jul 02.
    Of mice and men-The emerging oral-gut-brain axis of health and disease.
    Yvonne L Hernandez-Kapila, Daniel J Weisenberger.
       OBJECTIVES: Oral health's inextricable links to systemic health are highlighted by the emerging oral-gut-brain axis and other well-known axes. There is growing evidence of a complex oral-gut-brain axis linking mouth and gut microbiomes with the central nervous system. Axis disruptions, characterized as oral and gut dysbiosis or microbial imbalances, can trigger oral and systemic inflammation and neuroinflammation, contributing to diseases such as Alzheimer's disease and Parkinson's disease.
    MATERIALS AND METHODS: We summarize the oral-gut-brain axis mechanistic pathways, key evidence from human clinical and animal studies, and how the oral microbiome modulates human health and disease.
    RESULTS: Periodontal disease (PD) is associated with increased oral pathogen presence in diseased tissues throughout the human body. Preclinical models recapitulate these findings. Experimental periodontal infection induces dysbiosis that is linked to activation of inflammatory pathways that promote diseased phenotypes. Novel therapeutic approaches, including the probiotic fbacteriocin nisin, are increasingly recognized for targeted microbiome therapy at multiple inflection points across the axis. Nisin restores microbial balance, reduces inflammation, inhibits end-organ pathology, prevents periodontal bone loss, and reduces brain amyloid/tau accumulation and cytokine expression.
    CONCLUSIONS: These findings highlight the complexity of the oral-gut-brain axis and the ability to modulate the axis using bacteriocin-based approaches.
    CLINICAL RELEVANCE: Future probiotic or antimicrobial strategies aimed at ameliorating neuroinflammatory and metabolic diseases via microbiome-targeted therapy hold clinical promise.
    Keywords:  dysbiosis; nisin; oral microbiome; oral–gut–brain axis; periodontal disease
    DOI:  https://doi.org/10.1111/prd.70064
  15. NPJ Drug Discov. 2025 Nov 03. pii: 27. [Epub ahead of print]2(1):
    A novel drug series optimized to address cystic fibrosis and other CFTR deficiency diseases of human airways.
    Andras Rab, Jeong S Hong, Candela Manfredi, Disha Joshi, Sadhana Ponnaluri, William F Tracy, Yujie Luo, Xun Yang, Alexander A Kolykhalov, Huw M L Davies, Eric J Sorscher.
      Pharmacologic activation of the cystic fibrosis transmembrane conductance regulator (CFTR) has transformed cystic fibrosis (CF) therapy. Other, more common airway diseases can also be associated with CFTR deficiency. For example, individuals with one dysfunctional CFTR variant (i.e., CF carriers), as well as those with acquired CFTR deficiency, are predisposed to both non-CF bronchiectasis and chronic rhinosinusitis, raising the possibility that CFTR stimulation in these settings could provide clinical improvement. This study describes a new triazolo-thiadiazine-based compound series optimized to augment mutant and wildtype CFTR function when administered topically to airway epithelium. Mechanism of action appears attributable-at least in part-to phosphodiesterase 4 inhibition (PDE4i), with effects on other PDEs also noted. Together with a growing body of previous and emerging evidence, our results suggest a novel therapeutic strategy for treating people with CF (PwCF) who lack access to effective modulator therapy-and addressing common diseases such as chronic bronchiectasis and rhinosinusitis in the non-CF population.
    DOI:  https://doi.org/10.1038/s44386-025-00026-1
  16. J Wound Ostomy Continence Nurs. 2026 Jul-Aug 01;53(4):53(4): 298-308
    Wounds of the Body, Wounds of the Self: Addressing Shame in the Care of Patients Living With Obesity and Chronic Wounds.
    Tim Porter O'Grady.
       PURPOSE: The purpose of this integrative review was to examine shame as a hidden determinant of outcomes among patients living with obesity and chronic leg and foot ulcers and to offer evidence-based strategies for wound, ostomy, and continence (WOC) nurses to recognize, mitigate, and transform shame in clinical practice.
    DESIGN: Integrative review and practice synthesis.
    SEARCH STRATEGY: Targeted integrative review of literature (2020-2025) using PubMed, CINAHL, PsycINFO, and Cochrane databases with supplemental ancestry or hand searching. Topics included weight stigma, psychosocial determinants of wound care engagement, trauma-informed and dignity-conserving approaches, and service models (telemedicine, peer support, integrated behavioral care).
    FINDINGS: Shame-amplified by weight stigma and structural inequities-erodes trust, adherence, and engagement, and is associated with poorer healing trajectories. Interventions grounded in the Presence-Partnership-Dignity framework-pairing technical excellence with relational competence-integrate behavioral health and redesign services for emotional safety, thereby improving participation and outcomes.
    IMPLICATIONS: Addressing shame is not an ancillary concern; it is central to wound care quality. WOC nurses are uniquely positioned to lead practice, education, and system redesign that restores dignity, strengthens self-efficacy, and advances equitable healing.
    Keywords:  Adverse childhood experiences; Chronic wounds; Diabetic foot; Dignity; Obesity; Shame; Stigma; Telemedicine professional governance; Trauma-informed care; Venous leg ulcer
    DOI:  https://doi.org/10.1097/WON.0000000000001298
  17. New Microbes New Infect. 2026 Aug;72 101804
    Synergistic potential of probiotics and bacteriophages in combating multidrug-resistant microbial infections: A novel therapeutic strategy for the post-antibiotic era.
    Sadaf Ataei-Alamdari, Fatemeh Alimardani, Hamed Afkhami, Mojtaba Kashfi, Mohammad Hasan Yousefi.
      In recent years, the rapid emergence of multidrug-resistant (MDR) pathogens has posed a global health crisis, necessitating the exploration of alternative therapeutic strategies beyond conventional antibiotics. Among emerging solutions, the combination of probiotics and bacteriophages has gained significant attention due to their complementary mechanisms in targeting pathogenic bacteria while preserving host microbiota. This review comprehensively evaluates the molecular interactions, synergistic effects, safety profiles, and clinical applicability of probiotic-phage combinations in managing MDR infections. We also discuss challenges related to formulation, delivery, regulatory considerations, and future directions for translating this approach into clinical practice. The integration of probiotics and phage therapy represents a promising avenue to address antibiotic resistance, offering a personalized, targeted, and microbiome-friendly antimicrobial strategy.
    Keywords:  Antibiotic resistance; Bacteriophages; Combination therapy; MDR pathogens; Microbiome modulation; Phage therapy; Probiotics
    DOI:  https://doi.org/10.1016/j.nmni.2026.101804
  18. bioRxiv. 2026 Jun 18. pii: 2026.06.18.732992. [Epub ahead of print]
    Intracellular barriers and receptor masking limit success of a Pseudomonas aeruginosa clinical phage family.
    Wearn-Xin Yee, Amy B Banta, Ryan D Ward, Sriharshita Musunuri, Miaoxi Liu, Erin Huiting, Julia Gordeeva, Suzanne C Letham, Tanmay A M Bharat, Jason M Peters, Joseph Bondy-Denomy.
      Bacteriophage therapy is needed to treat antibiotic resistant infections; however, when a clinical isolate resists a given phage, it is often unclear why. It is therefore currently unknown how to rationally fortify phage therapies to circumvent a priori resistance. Using a family of broad host range therapeutic Pseudomonas aeruginosa phages ( Pbunaviruses) , we show that cell surface receptor masking and intracellular defenses are both common barriers in distinct clinical isolates. In some cases these barriers can be bypassed by intrafamily phage engineering. Using unbiased genome-wide CRISPRi screens, we reveal that the broadly conserved L-Rhamnose in the core polysaccharide is the receptor for Pbunavirus family. This molecule is often masked by diverse O-antigen structures. In other isolates with the L-Rha receptor accessible, internal defense mechanisms commonly prevent Pbunavirus DNA replication. A single anti-defense locus often encoding 8-11 different genes within the Pbunavirus family is required for optimal host range, providing anti-defense genes that enable replication of both Pbunavirus phages and phages of other families. Our work demonstrates the importance of both internal and surface defense mechanisms in clinical isolates causally antagonizing a commonly used phage therapeutic and presents phage engineering strategies to circumvent a priori resistance.
    DOI:  https://doi.org/10.64898/2026.06.18.732992
  19. Comp Immunol Microbiol Infect Dis. 2026 Jul 02. pii: S0147-9571(26)00060-3. [Epub ahead of print]128 102498
    A novel lytic bacteriophage BUCT791 effectively controls multidrug-resistant Klebsiella pneumoniae in vitro and in vivo.
    Rashid Ahmad, Zakirullah, Amna Shafqat, Mengzhe Li, Yigang Tong.
      Acute infections caused by multidrug-resistant (MDR) Klebsiella pneumoniae immediately necessitate the development of novel therapeutic strategies. Phage therapy offers a viable alternative for combating MDR Klebsiella infections. Here, we report the isolation and comprehensive characterization of a novel lytic bacteriophage, BUCT791, recovered from hospital sewage. Phage BUCT791 exhibited a short latent period (20 min), a large burst size (∼275 PFU/cell), rapid adsorption efficiency (>90% within 15 min), and remarkable stability across a wide range of temperatures (4-50 °C) and pH values (3-12). Whole-genome sequencing revealed a 48,388 bp double-stranded DNA genome with a GC content of 50%, encoding 74 predicted open reading frames (ORFs) and lacking any virulence or antibiotic resistance genes, confirming its biosafety for therapeutic applications. Phylogenetic analysis assigned phage BUCT791 to the genus Jedunavirus (family Myoviridae) and identified it as a member of the species Klebsiella virus FZ14. In vitro assays demonstrated that BUCT791 effectively inhibited Klebsiella growth within 2 h and significantly inhibited biofilms formation. In vivo, phage treatment markedly improved Galleria mellonella larval survival from 10% to 80%. Collectively, these findings indicate that BUCT791 possesses potent antibacterial activity and represents a promising candidate for developing safe and effective phage-based therapeutics against MDR Klebsiella pneumoniae infections. IMPORTANCE: This study reports the isolation and characterization of BUCT791, a novel lytic bacteriophage active against multidrug-resistant Klebsiella pneumoniae. BUCT791 showed strong stability, efficient bacterial killing, antibiofilm activity, and improved survival in an in vivo infection model, supporting its potential as a promising alternative strategy against MDR K. pneumoniae infections.
    Keywords:  Galleria mellonella; Genomic analysis; Klebsiella pneumoniae; Phage BUCT791; Phage therapy
    DOI:  https://doi.org/10.1016/j.cimid.2026.102498
  20. Front Immunol. 2026 ;17 1851108
    Innate immune recognition and immunomodulatory effects of bacteriophages: implications for phage therapy.
    Tomoko Hanawa, Mayuko Tanaka, Debora Satie Nagano, Ken Shirato, Sanae Hasegawa-Ishii, Takeaki Matsuda.
      Bacteriophages (phages) have been explored as a potential treatment for infectious diseases owing to their bacteriolytic ability. However, accumulating evidence indicates that phages interact with the host immune system and modulate innate immune responses. Phage particles, genomes, and phage-derived components are sensed by pattern recognition receptors, including Toll-like receptors and cytosolic nucleic acid sensors, leading to context-dependent activation or suppression of inflammatory signaling pathways, such as nuclear factor κ-light-chain-enhancer of activated B cells and type I interferon responses. In clinical settings and in vivo experiments, phage-induced immunomodulation influences infection outcomes by promoting bacterial clearance, limiting excessive inflammation, and facilitating tissue repair. However, phage-mediated immune regulation is not uniformly beneficial and may impair antibacterial immunity or exacerbate inflammatory diseases in certain contexts. In this review, we summarize current knowledge of phage innate immune recognition, the immunomodulatory effects in infectious and inflammatory settings, and the implications of these interactions for the safety and efficacy of phage therapy. A deeper understanding of phage-immune system interactions is essential for optimizing phage selection and administration. This knowledge can facilitate the development of combination therapies tailored to the host immune status and specific disease contexts.
    Keywords:  Staphylococcus aureus; bacteriophage; immunomodulatory; innate immunity; phage therapy
    DOI:  https://doi.org/10.3389/fimmu.2026.1851108
  21. Int Endod J. 2026 Jun 29.
    Can Artificial Intelligence Be Utilised to Develop Point-of-Care Endodontic Microbiological Technologies?
    Ashraf F Fouad.
       BACKGROUND: Primary or persistent endodontic disease is caused by microbial biofilms that irritate the pulp and periapical tissues. Extensive microbiological analyses of these biofilms and their constituent pathogens have revealed their diversity and complexity. However, these studies have not resulted in many direct clinical chairside diagnostic, prognostic, or therapeutic technologies or paradigms. The overwhelming volume of endodontic antimicrobial strategies represents generic approaches that aim to reduce microbial loads to facilitate healing.
    OBJECTIVES: This narrative review explores the potential applications of artificial intelligence (AI) in endodontic microbiology, highlighting current challenges in endodontic treatment, advances in microbiology and potential future applications of AI in endodontic microbiology and treatment strategies.
    RESULTS AND CONCLUSION: AI continues to revolutionize various fields of medicine, including microbiology. The discipline of microbiology has already exploited AI to develop various diagnostic and biomarker technologies, as well as to facilitate and expedite common tasks. Several of these advances could be used to benefit research and clinical practice in endodontics.
    Keywords:  artificial intelligence; endodontic infections; machine learning; microbiome; next generation sequencing; resistome; whole genome shotgun sequencing
    DOI:  https://doi.org/10.1111/iej.70212
  22. Nanomedicine. 2026 Jul 03. pii: S1549-9634(26)00089-4. [Epub ahead of print] 102988
    Regenerative polymer-based modalities for diabetic foot ulcers: From material design to clinical translation.
    Ankur Das, Madhulika Pradhan, Ajazuddin, Sanjay Kumar Gupta, Kushagra Nagori, Parag Jain, Mukesh Sharma, Krishna Yadav.
      Diabetic foot ulcers (DFUs) cause one amputation every 20 s globally, driven by ischemia, dysregulated growth factors, recalcitrant biofilms, and oxidative stress that render conventional therapies ineffective. This review examines smart polymer dressings that actively sense pathological cues and respond with spatiotemporal precision. Natural polymers (chitosan, collagen, hyaluronic acid) provide biochemical signals for cell recruitment and angiogenesis, while synthetic polymers (Polylactic glycolic acid, Polycaprolactone, Polyethylene glycol) enable controlled degradation and drug release. Hybrid systems include glucose-responsive hydrogels, VEGF-loaded nanofibers for hypoxic zones, and microneedles that disrupt biofilms while delivering antimicrobials. Selected preclinical studies have reported wound closure rates exceeding 90% in diabetic animal models. However, clinical translation is hindered by GMP manufacturing challenges, regulatory complexity, and cost barriers. This review analyses the state-of-the-art polymer design and engineering transforming passive dressings into active therapeutics and identifies critical gaps between laboratory breakthroughs and clinical implementation.
    Keywords:  Controlled release; Diabetic foot ulcer; Nanofibers; Regenerative polymers; Wound healing
    DOI:  https://doi.org/10.1016/j.nano.2026.102988
  23. J Periodontal Res. 2026 Jun 27.
    Oral Health, Periodontitis, and Respiratory Diseases: Biological Pathways.
    Raluca P Vacaru, Andreea C Didilescu, Frank A Scannapieco.
      Poor oral hygiene and periodontitis influence lung diseases such as pneumonia, chronic obstructive pulmonary disease (COPD), COVID-19, and asthma. The normal lung is not sterile, with a distinct microbial ecosystem that is spatially varied along the respiratory tract. The biogeography of the lung microbiome is balanced between microbial microaspiration from the oral-pharynx and clearance. The mouth is an important reservoir for respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Staphylococcus aureus, as well as oral microbes (Porphyromonas, Prevotella, Fusobacterium, etc.). Poor oral hygiene and periodontitis increase the bacterial load that can be aspirated, and the host produces pro-inflammatory components that enhance microbial virulence and compromize epithelial integrity. Both poor oral hygiene and periodontitis have been associated with pneumonia, particularly in hospitals and nursing home settings. Periodontitis may also facilitate viral pneumonia (including COVID-19) by altering receptor expression and immune function. Periodontitis correlates with COPD severity and exacerbation frequency through pathways involving matrix metalloproteinases and cytokines. Periodontitis also is associated with asthma and acute exacerbations. Inflammation shapes the lung microbiome by impacting microbial nutrient availability through vascular leakage, inducing changes to epithelial cells which facilitate bacterial adherence, and inducing the production of cytokines, leading to mucus overproduction, inhibition of phagocytosis, and enhancement of microbial pathogen virulence. Multiple biological pathways have been examined in vitro that suggest how "the oral-lung axis" influences pneumonia, COPD, and asthma. Periodontal treatment and effective oral hygiene should be well integrated into medical care to prevent and manage respiratory diseases.
    Keywords:  oral health; periodontal diseases; pulmonology; respiratory tract infections
    DOI:  https://doi.org/10.1111/jre.70126
  24. mLife. 2026 Jun;5(3): 369-382
    Rapid and quantitative phage susceptibility test by ramanome.
    Xiao Han, Xiaofu Wan, Yang Zhou, Xiaoting Fu, Xiaoshan Zheng, Bo Gao, Shi Huang, Anle Ge, Jiadong Huang, Hongzhou Lu, Jian Xu.
      Antimicrobial resistance poses an escalating global threat, renewing interest in bacteriophage therapy as a precision alternative to antibiotics. However, clinical translation remains hindered by the lack of rapid and quantitative phage susceptibility testing (PST) platforms capable of evaluating host range, infection potency, and effective multiplicity of infection (MOI). Here, we present a ramanome-based phage susceptibility test (RPST), a phenotypic platform that captures infection-induced remodeling of bacterial macromolecular composition to unify these diagnostic requirements within a single workflow. RPST integrates four Raman biomarkers into a Composite Infection Index (CII), enabling rapid and lysis-independent discrimination between susceptible and resistant bacterial populations within ~1 h, with 96.0% categorical concordance (24/25) to plaque assays. As a continuous population-level metric, CII quantifies the proportion of infected cells, allowing quantitative ranking of phage potency against shared hosts. By resolving CII trajectories across the MOI and time, RPST further determines the minimal effective MOI, which is the lowest phage-to-bacterium ratio sustaining self-propagating infection, thereby defining the lower boundary for therapeutic feasibility. Together, these capabilities transform PST from static compatibility assays into a dynamic and quantitative framework that bridges in vitro infectivity assessment and infection dynamics relevant to phage therapy.
    Keywords:  antimicrobial resistance (AMR); biomarker discovery; phage susceptibility test (PST); precision phage therapy; ramanome
    DOI:  https://doi.org/10.1002/mlf2.70089
  25. Antonie Van Leeuwenhoek. 2026 Jun 28. pii: 150. [Epub ahead of print]119(7):
    Pathogens in the bay: environmental Staphylococcus saprophyticus strains mirror clinical counterparts in virulence, biofilm formation, antimicrobial resistance, pathogenicity, and phage susceptibility.
    Isabella Monteiro Carvalho, Erica Cristina Soares E Silva, Geovana Lacerda Rodrigues, Natállia Duarte Dos Santos, Raienne Vitória da Silva Soares, Monalessa Fábia Pereira, Ciro César Rossi, Marcia Giambiagi-deMarval.
      Staphylococcus saprophyticus is a leading cause of urinary tract infections, yet little is known about its environmental reservoirs and traits outside clinical settings. This study aimed to compare clinical and environmental S. saprophyticus strains isolated from a polluted coastal ecosystem in Brazil, assessing their virulence-associated traits, antimicrobial resistance, biofilm formation, and susceptibility to bacteriophages. Forty strains (20 clinical, 20 environmental) were characterized using GTG5-PCR, virulence gene screening, antibiotic susceptibility testing, biofilm assays, exposure to sub-inhibitory concentrations of ciprofloxacin, Tenebrio molitor infection model, and phage activity tests. Genetic fingerprinting and virulence gene profiles revealed a high degree of similarity between environmental and clinical isolates, indicating the presence of shared virulence-associated determinants. Environmental strains exhibited resistance to multiple antibiotics and showed biofilm formation and larval survival patterns comparable to those observed for clinical isolates. Exposure to sub-inhibitory concentrations of ciprofloxacin increased biofilm formation in several strains. Bacteriophage CSF, originally isolated from swine farm effluent, displayed lytic and antibiofilm activity against a substantial proportion of the isolates. These findings highlight the presence of clinically relevant traits among environmental S. saprophyticus strains and underscore the importance of continued microbiological surveillance in anthropized aquatic environments.
    Keywords:   Staphylococcus saprophyticus ; Antimicrobial resistance; Biofilm; Environmental reservoirs; Phage therapy
    DOI:  https://doi.org/10.1007/s10482-026-02367-x
  26. J Mater Chem B. 2026 Jun 29.
    Self-powered thermoelectric gel dressings for chronic wound monitoring and therapy.
    Jie Zhang, Chunjing Wang, Suyi Wen, Kunjiao Liu, Haonan Yue, Shaojie Liu, Xiaojing Cui, Shengli Cao, Hulin Zhang.
      Chronic wounds constitute a major global clinical challenge, whereas traditional dressings lack real-time monitoring and active therapeutic capabilities. Self-powered thermoelectric gel dressings that integrate thermoelectric conversion and flexible gel networks have emerged as a transformative platform for wound care, enabling the seamless integration of sensing and therapy. This review systematically summarizes the fundamental energy conversion mechanisms and multi-scale material design strategies of thermoelectric gels, along with the essential fabrication processes, electrode engineering, and integration technologies for practical applications. It further highlights two core functions of these dressings: self-powered multimodal monitoring of wound temperature, pressure, and biomarkers, and in situ pro-healing effects through electrical stimulation that modulates inflammation, cellular behavior, and angiogenesis. Recent advances in the personalized management of diabetic foot ulcers, infected wounds, and athletic injuries using these dressings are also summarized. Finally, the key existing challenges and future development trends are critically analyzed, providing a comprehensive theoretical and technical framework for the advancement of next-generation intelligent wound dressings.
    DOI:  https://doi.org/10.1039/d6tb00979d
  27. BMJ Open Respir Res. 2026 Jun 30. pii: e004270. [Epub ahead of print]13(1):
    Maternal, Infant, Reproductive and Child Health in Cystic Fibrosis (MATRIARCH_CF): a prospective, observational study to evaluate pregnancy and parenthood in females with cystic fibrosis and health of the offspring in the CFTR-modulator era.
    Amy Downes, Idan Bokobza, Ladina Weitnauer, Rebecca Scott, Rebecca Dobra, Christopher Short, Thomas Semple, Olivia Beaumont, Catherine Williamson, Jane C Davies, Imogen Felton.
       INTRODUCTION: Cystic fibrosis transmembrane conductance regulator (CFTR) modulators (CFTRm) have altered the landscape of pregnancy and parenthood in cystic fibrosis (CF). As pregnant and breastfeeding females with CF (FwCF) were excluded from pivotal CFTRm trials, evidence to guide management and counsel families on maternal and child outcomes is limited. While CFTRm are unlicensed for use in pregnancy, substantial clinical benefit means most continue therapy. Early studies indicate that CFTRm cross the placenta and are detectable in breastmilk; reported associations include infant liver dysfunction and cataracts but risks remain poorly characterised. We describe the protocol for the first UK-based prospective study evaluating pregnancy and parenthood in FwCF and health outcomes in their children in the CFTRm era.
    METHODS AND ANALYSIS: A single protocol underpins three linked prospective observational substudies in the MATRIARCH_CF research programme. The 'Mama' cohort recruits FwCF planning pregnancy or pregnant, with follow-up from preconception to 24 months postpartum, assessing physical and psychological health, lung function and CF-related complications. 'Mini' recruits children aged 0-24 months born to a parent with CF and compares offspring exposed and unexposed to CFTRm in utero and/or through breastfeeding; measures include birth outcomes, congenital anomalies, liver biochemistry, growth and neurodevelopment. 'Midi' recruits children aged 3-6 years from the same exposure groups and assesses neurodevelopment and lung function. Longitudinal data across cohorts will strengthen the evidence base, support risk-benefit discussions and inform clinical guidance.
    ETHICS AND DISSEMINATION: The protocol was approved by NHS ethics HSC REC A committee (25/NI/0027 19 March 2025). Assessments align with routine care where possible. Visit windows are flexible and participants may decline individual assessments. The research team does not influence CFTRm initiation, cessation or dose adjustment. People with CF contributed throughout study design to ensure acceptability. Findings will be disseminated through PhD theses, conference presentations and peer-reviewed publications.
    TRIAL REGISTRATION NUMBER: NCT06797206.
    Keywords:  Bronchiectasis; Cystic Fibrosis; Imaging/CT MRI etc; Surveys and Questionnaires
    DOI:  https://doi.org/10.1136/bmjresp-2026-004270
  28. Gut Microbes. 2026 Dec 31. 18(1): 2694819
    Is Fusobacterium nucleatum the key mediator between oral infections and systemic diseases? Mechanistic insights and therapeutic implications.
    Gautham Siddarth Ragunagam, Anand Anbarasu, Gothandam Kodiveri Muthukaliannan.
      Fusobacterium nucleatum has emerged as a pathobiont that associates oral dysbiosis with systemic diseases through coaggregation, hematogenous dissemination, and immune modulation. This review provides molecular insights through which they are involved in systemic diseases such as colorectal cancer, adverse pregnancy outcomes, cardiovascular diseases, neurodegenerative disorders, and diabetes mellitus. Key virulence factors include the adhesins of FadA, Fap2, and RadD, lipopolysaccharides, and outer membrane vesicles, which mediate epithelial invasion and endothelial permeafbility and facilitate immune suppression through TLR4-NF-κB, β-catenin/Wnt, and MAPK signaling pathways. These interactions result in impaired tissue homeostasis, propagate chronic inflammation, and promote oncogenic and metabolic modulation. Systemic pleiotropy of F. nucleatum is further substantiated by its involvement in chemoresistance, placental dysfunction, vascular inflammation, and neuronal injury, substantiating its systemic pleiotropy. Emerging therapeutic strategies, such as blocking adhesins, neutralizing outer membrane vesicles, microbiome manipulation, and using CRISPR-based clearance, provide precision techniques for mitigating diseases. Therefore, this review identifies F. nucleatum as the primary microbial mediator of oral-systemic pathology and its translational significance in the development of targeted antimicrobial and host-directed therapies.
    Keywords:  Fusobacterium nucleatum; host–microbiome interactions; microbial translocation; oral dysbiosis; systemic diseases
    DOI:  https://doi.org/10.1080/19490976.2026.2694819
  29. Semin Cancer Biol. 2026 Jul 03. pii: S1044-579X(26)00069-6. [Epub ahead of print]
    Role of oral microbiome in cancer immunotherapy.
    Wafa Khalil, Haicheng Song, Ziwei Li, Yan He, Chun Xu, Qingsong Ye.
      The oral microbiome is comparable to the gut microbiome in ecological complexity and is now recognized as a contributor to anticancer immune responses. Although the relationship between the gut microbiome and anticancer immunity is well established, the connection between the oral microbiome and anticancer immunity has received increasing attention, with accumulating evidence pointing to the direct effects of the oral microbiome on immune cell populations. The relationship between cancer and the oral microbiome is bidirectional: each influences the behavior of the other. The tumor microenvironment (TME) and oncological therapies such as chemotherapy and radiation can cause oral microbiome dysbiosis. Once dysbiosis is established, it creates conditions that favor tumor initiation and recurrence through chronic inflammation and impaired immune surveillance. Furthermore, the oral microbiome indirectly affects distant cancers and contributes to systemic inflammation and microbial dissemination through gastrointestinal, respiratory, hematogenous, neurological, and lymphatic pathways. Prebiotics, probiotics, postbiotics, and microbiota transplantation represent promising therapies targeting this microbial community to enhance the efficacy of cancer immunotherapy.
    Keywords:  Cancer immunotherapy; Microbiota metabolites; Oral microbiome; Oral microbiota transplantation (OMT)
    DOI:  https://doi.org/10.1016/j.semcancer.2026.06.006
  30. BMJ Case Rep. 2026 Jun 29. pii: e271848. [Epub ahead of print]19(6):
    Cystic fibrosis in a septuagenarian.
    Jessie Johnson, Nawaid Ahmad.
      Cystic fibrosis (CF) is traditionally regarded as a paediatric disorder, with over 75% of cases diagnosed before the age of 2 years. We describe the case of CF diagnosed in a man in his 70s following investigations prompted by an incidental finding of a pulmonary nodule and bronchiectasis on imaging. Further multidisciplinary assessment raised the possibility of CF. The diagnosis was confirmed through elevated sweat chloride levels and CFTR genotyping identifying compound heterozygosity for F508del and R347H This case serves as a timely reminder, particularly for clinicians outside specialist CF services, to consider CF when the constellation of features is suggestive, irrespective of age. It highlights that practice around CF screening in adults with bronchiectasis varies between centres and invites reflection on whether more standardised approaches might help reduce diagnostic delay. For specialist readers, the case further underscores that genotype-phenotype correlations in CF do not always align with expected clinical patterns.
    Keywords:  Cystic fibrosis; Lung function
    DOI:  https://doi.org/10.1136/bcr-2025-271848
  31. 3 Biotech. 2026 Jul;16(7): 287
    Study on the role and clinical relevance of gut microbiota in diabetic foot ulcers.
    Huayan Zheng, Jing Zhuang, Qinghua Lin, Tingting Wang, Guoxiang Guo, Limin Huang, Wei Lin.
      Diabetic foot ulcers (DFU) are severe and costly complications of diabetes, predisposing to infection, amputation, and mortality, highlighting the urgent need to clarify their mechanisms for optimized clinical management. This study integrated clinical biochemistry data and multi-omics analyses (including metagenomic sequencing) from 11 patients to reveal the critical role of gut microbiota in the pathogenesis of DFU. Results showed significant host metabolic disorders in DFU patients, characterized by hypoalbuminemia (mean ± SD:32.35 ± 6.02 g/L), persistent hyperglycemia (mean ± SD:8.25 ± 3.21 mmol/L), and imbalances in trace elements such as magnesium (mean ± SD:0.84 ± 0.08 mmol/L). Concurrently, the gut microbiota composition was markedly altered, with enrichment of the phylum Bacillota_A (formerly Firmicutes; 48.7% in patients vs. 32.1% in controls) and elevated genetic potential of virulence genes (e.g., type VI secretion systems, capsular polysaccharide gene cps4J/L). Metagenomic tracing revealed that antibiotic resistance genes (ARGs) such as tet(A) and blaOXA-1 were co-localized with mobile genetic elements (MGEs) including IncF plasmids and tnpA transposases. 99.2% of key ARGs shared sequence homology with gut-derived metagenome-assembled genomes (MAGs) and co-localized with MGEs, indicating potential cross-niche transfer capacity. Furthermore, renal (mean ± SD:11.81 ± 5.75 mmol/L) and hepatic (ALT: 35.67 ± 18.22 U/L) dysfunction correlated with aggravated gut dysbiosis and ARG enrichment. In conclusion, this study confirms that host metabolic deficiencies contribute to DFU refractoriness by altering gut microbiota ecology and enhancing horizontal gene transfer of virulence and resistance determinants, providing a novel framework for precision therapies targeting the host-microbe metabolic interface.
    Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-026-04745-8.
    Keywords:  Antibiotic resistance gene transmission; Diabetic foot ulcer; Gut microbiota; Host-microbe interaction; Hypothesis-generating study; Metabolic dysregulation
    DOI:  https://doi.org/10.1007/s13205-026-04745-8
  32. bioRxiv. 2026 Jun 22. pii: 2026.06.18.733171. [Epub ahead of print]
    Healing cascades and infections in wounds monitored using a wearable sensor of gaseous flux.
    Seunghee Cho, Ansen Tan, Zixi Chen, Kyung Rok Pyun, Shupeng Li, Fujie Yin, Aiwa Zhang, Neena Feldman, Evan J Neuhart, Amara Devi Moreno, Joyce Eunsung Yoon, Jaeho Shin, Joseph Woojin Song, Jacob Trueb, Yonggang Huang, Guillermo A Ameer, John A Rogers.
      Capabilities for quantitative monitoring of chronic wounds remain an unmet clinical need, as existing diagnostic approaches rely on semiquantitative evaluation of symptoms that lack sensitivity especially during early stages of infection. Here we present a scheme for tracking wound physiology that leverages a miniature, wireless skin-interfaced device for non-contact, transient measurements of the flux of volatile organic compounds (VOCs) and water vapor from the wound microenvironment. Unlike emerging smart bandage platforms that rely on physical contact with the fragile wound bed to interrogate liquid-phase biomarkers, this strategy uses an engineered microclimate and suspended suite of sensors to measure the diffusive transport of wound-derived gases across the wound surface but separated from it. The result enables quantitative evaluation of metabolic activity and healing progression without perturbing the healing tissues. In biofilm growth models of Staphylococcus aureus , measurements demonstrate that trends in VOC flux correlate strongly with bacterial growth kinetics and precede any visible biofilm formation. Longitudinal monitoring in infected murine wound healing models shows that concurrent measurements of water vapor and VOC flux provide complementary physiological insights, capturing both the trajectory of barrier restoration and the dynamics of bacterial burden. The findings establish this non-contact sensing scheme as a distinct and clinically translatable paradigm for wound monitoring, with broad implications for non-invasive surveillance of disease states in which tissue metabolic activity and skin barrier integrity serve as actionable physiological readouts.
    Significance Statement: Limited capabilities in continuous, quantitative assessment of a wound make early diagnosis and effective management challenging, particularly in cases of infection that rapidly progress before symptoms appear. Non-contact approaches for wound monitoring that preserve fragile tissue can transform wound care. In this context, gaseous flux from the wound bed provides an integrative measure of microbial activity and barrier restoration. This study establishes a wearable sensing platform that quantifies these fluxes in real time, enabling early infection detection and temporal tracking of wound healing. These results highlight a path toward personalized treatment strategies and reduced reliance on episodic clinical evaluation.
    DOI:  https://doi.org/10.64898/2026.06.18.733171
  33. Front Nutr. 2026 ;13 1821103
    Precision nutrition in diabetic foot ulcers: multimodal artificial intelligence for personalized metabolic management.
    Hongbin Sun, Xilin Liu, Hong Li.
      This review synthesizes AI applications in diabetic foot ulcer (DFU) management, with a particular focus on nutritional and metabolic data integration. Emerging AI methodologies-including image-based dietary assessment, natural language processing-driven chatbots, and continuous glucose monitoring-integrated predictive models-have shown promise in adjacent fields such as general type 2 diabetes management and hemodialysis. However, none have been directly validated in DFU populations, and their applicability to DFU care remains a future research direction rather than a current reality. The main obstacles include the paucity of standardized nutritional data in existing DFU cohorts, methodological barriers in multi-modal data fusion, and the need for robust validation across diverse populations. A future research agenda is proposed, emphasizing the convergence of AI, nutritional science, and multidisciplinary care pathways. By addressing these foundational gaps, AI-enabled approaches may eventually contribute to reducing the global burden of diabetes-related amputations, but substantial methodological and validation work is required before clinical translation can be realistically anticipated.
    Keywords:  artificial intelligence; diabetic ulcers; dietary intervention; machine learning; nutritional assessment; personalized nutrition
    DOI:  https://doi.org/10.3389/fnut.2026.1821103
  34. Infect Drug Resist. 2026 ;19 602699
    Antimicrobial Peptides Against Antimicrobial-Resistant Bacteria: Focus on Machine Learning.
    Hamed Tahmasebi, Mohammad Reza Arabestani.
      Antimicrobial resistance (AMR) represents a pressing public health threat of the 21st century, with an estimated ten million deaths annually from drug-resistant infections by 2050. Diminishing pipelines and the accelerating emergence of multidrug-resistant pathogens make the development of novel antibacterials more urgent than ever. Antimicrobial peptides (AMPs) are among the most promising alternatives to conventional drugs, exhibiting broad antimicrobial spectra, rapid kinetics, and mechanisms that are difficult for bacteria to circumvent. However, the problem of discovering and engineering clinically useful AMPs with desirable properties out of large sequence spaces remains unsolved by traditional approaches. Machine learning (ML) enables fast screening of millions of compounds, generation of de novo sequences with predicted therapeutic potential, and simultaneous multiobjective optimisation of efficacy, safety, stability, and manufacturability. This review provides a critical appraisal of the current advances and prospective directions in computational discovery of AMPs that can combat resistant strains, focusing on available resources for machine learning in the domain of bioinformatics, evaluation of existing approaches to modeling peptide structure, activity, and interactions ranging from classical ML algorithms to DL and generative artificial intelligence (AI) models, and a practical roadmap of how the AMP discovery pipeline could proceed towards animal studies and clinical application through the use of active learning, fine-tuned protein language models, structural graph neural networks, and other modern techniques. Finally, we discuss challenges that may hinder a successful transition from ML-assisted design to the clinic and offer actionable recommendations to overcome them.
    Keywords:  DL; antimicrobial peptides; antimicrobial resistance; clinical trials; drug discovery; geometric DL; machine learning; protein language models
    DOI:  https://doi.org/10.2147/IDR.S602699
  35. Respir Med. 2026 Jun 30. pii: S0954-6111(26)00382-3. [Epub ahead of print]261 109014
    Transformations within cystic fibrosis model of care in the era of CFTR modulators: a Scoping Review.
    Raphaëlle Gautiez, Philippe Reix, Stéphanie Poupon-Bourdy, Quitterie Reynaud, Romain Fayolle, Sara Cornec, Isabelle Durieu, Julie Haesebaert.
       BACKGROUND: Highly effective CFTR modulator therapies have substantially transformed the clinical course of cystic fibrosis (CF), raising questions regarding the organisation and delivery of CF care. However, how CF care models are adapting to this new therapeutic context remains unclear.
    METHODS: A scoping review was conducted to identify literature published from 2012 onwards addressing organisational changes and stakeholder needs related to CF care in the context of CFTR modulator therapies. We included empirical studies evaluating organisational interventions, opinion or position papers proposing adaptations of care organisation, and studies exploring the needs and perceptions of people with CF, families, and healthcare professionals.
    RESULTS: Nineteen publications were included, most originating from North America and Western Europe. The available literature suggests that organisational adaptations in CF care remain at an early stage and are primarily characterised by targeted or incremental changes rather than comprehensive redesign of care models. Telehealth and hybrid follow-up approaches were the most frequently described adaptations, alongside evolving multidisciplinary team roles and increasing interest in personalised care pathways. However, robust empirical evaluations of system-level organisational transformation remain limited.
    CONCLUSIONS: While highly effective CFTR modulators are reshaping the clinical landscape of CF, evidence supporting large-scale transformation of CF care organisation remains limited. Current findings suggest a gradual evolution toward more flexible and individualised care models, but further longitudinal and system-level evaluations are needed to guide evidence-based adaptation of CF care delivery.
    Keywords:  CFTR modulator; Care organisation; Care pathway; Cystic fibrosis; Health services; Model of care
    DOI:  https://doi.org/10.1016/j.rmed.2026.109014
  36. J Wound Care. 2026 Jul 02. 35(Sup7a): S5-S14
    Early reported effects of the 2026 CMS Physician Fee Schedule on patient access to CAMPs in wound care: a national clinician and practice survey.
    William H Tettelbach, David G Armstrong, Travis Tucker, Alisha Oropallo, Naz Wahab, Lee C Rogers, Mervin Low, Vickie Driver, Daniel L Kapp, Lynnette Morrison, Kevin Nolan, Marta Ostler, Will Tettelbach, Justin Gooden, Gregory A Bohn, Jeffery A Niezgoda, Michael N Desvigne, Robert J Snyder, Thomas Davenport, Marcus Gitterle, Martha R Kelso.
       OBJECTIVE: In 2026, the US Centers for Medicare & Medicaid Services implemented an update to the Physician Fee Schedule establishing a unified reimbursement rate for skin substitutes, also referred to as cellular, acellular and matrix-like products (CAMPs). This policy change introduced a fixed payment of [Formula: see text]127.14 per cm2, regardless of product type or regulatory classification. The aim of this work was to assess perceived impacts of the revised fee schedule that went into effect on 1 January 2026.
    METHOD: The Wound and Hyperbaric Association conducted an online national survey of wound care practitioners and practices from 4 February 2026 to 14 April 2026. The Access Crisis Feedback Form consisted of 13 questions, including two open-ended items.
    RESULTS: Over the 69 days that the survey was open, 130 (~3%) responses were received from a comparative pool of 4551 National Provider Identifiers that had applied a CAMP in 2024. Collectively, respondents reported providing care to approximately 12,000 patients with wounds per week. Geographic representation included 36 of 50 (72%) states and Washington DC, and 8 of 12 (67%) Medicare Administrative Contractors. Most respondents (82%) practiced in non-facility settings; however, hospital-affiliated outpatient wound centres, and ambulatory surgery centres were also represented. The most severe concern identified was the 'Closure or planned closure of a wound care practice or service line', reported by just over 45% of responding settings. Only five (4%) respondents reported no significant impact, indicating that 96% perceived at least one operational impact following implementation of the revised payment policy. The most frequently cited concern (61%) was 'Authorisation delays for clinically eligible patients'.
    CONCLUSION: Analysis of the survey data suggests widespread impacts of the implemented CAMPs universal fee schedule across diverse wound care delivery settings in the US, including a substantial risk of service line closures. These findings raise concerns that a uniform CAMP product payment may not achieve site-of-care neutrality when hospital outpatient departments receive a separate application facility payment, while non-facility providers do not. Respondents reported that patients are already experiencing reduced access to advanced wound care, with associated complications such as: infection; sepsis; amputation; wound deterioration or enlargement; hospital readmission; the need for surgical debridement in the operating room setting; and flap- or graft-based salvage procedures. Responding wound care providers and practices, across diverse care settings and geographic regions, urge reevaluation of the current reimbursement framework to ensure the financial sustainability of wound care services, and to protect patient access and outcomes.
    Keywords:  CAMPs; Centers for Medicare & Medicaid Services; Physician Fee Schedule; cellular, acellular, and matrix-like products; skin substitutes; wound; wound care; wound dressing; wound healing
    DOI:  https://doi.org/10.12968/jowc.2026.0290
  37. An Bras Dermatol. 2026 Jun 27. pii: S0365-0596(26)00106-6. [Epub ahead of print]101(4): 501393
    The skin microbiome: from historical ecology to therapeutic frontiers.
    Sabri Saeed Sanabani.
       BACKGROUND: Human skin, the body's largest organ, hosts a diverse ecosystem of bacteria, fungi, viruses, and mites collectively known as the skin microbiome. This microbiome supports cutaneous homeostasis through barrier defense, immune education, and metabolic functions.
    OBJECTIVE: To narratively review the historical evolution of skin microbiome research, synthesize current knowledge on its composition, biogeography, and functional roles in health and disease, and highlight emerging microbiome-based therapeutic strategies in dermatology.
    METHODS: This review integrates seminal historical works with contemporary evidence from culture-independent sequencing and multi-omic investigations of the skin microbiome, identified through a selective search of recent dermatology and microbiome literature.
    RESULTS: Modern molecular and multi-omic approaches have revealed microbial diversity across sebaceous, moist, and dry skin niches and clarified key functions of the skin microbiome, including colonization resistance, immune modulation, metabolite production, and participation in the gut-skin axis. Dysbiosis of these communities is linked to inflammatory conditions such as atopic dermatitis, acne vulgaris, psoriasis, and chronic wounds. A growing body of work supports microbiome-targeted interventions, including probiotics, prebiotics, postbiotics, and microbiome engineering, as promising personalized strategies.
    STUDY LIMITATIONS: As a narrative review, this work may be subject to selection bias and does not provide a quantitative synthesis of all available studies on the skin microbiome.
    CONCLUSIONS: By integrating historical context with mechanistic insights from modern microbiome research, this review underscores the skin microbiome as a central ecological determinant of cutaneous health and disease and provides a framework for translating microbiome science into clinical applications and precision dermatology.
    Keywords:  Atopic dermatitis; Gastrointestinal microbiome; Infectious skin diseases; Microbial dysbiosis; Skin microbiome; Therapeutics
    DOI:  https://doi.org/10.1016/j.abd.2026.501393
  38. Br J Ophthalmol. 2026 Jun 29. pii: bjo-2025-328808. [Epub ahead of print]
    Bacterial keratitis: a global review of current practices, challenges and innovations.
    Emilia Koestel, Rémi Yaïci, Thibaud Garcin, Léa Dormegny, David Gaucher, Arnaud Sauer, Nacim Bouheraoua, Tristan Bourcier.
      Bacterial keratitis is a major cause of corneal blindness worldwide, with marked differences in clinical presentation and risk factors across regions. In high-income countries, contact lens use is the leading risk factor, while in low- and middle-income countries, trauma-related infections are more prevalent. Management relies on timely diagnosis and sensitivity-guided topical antibiotic therapy. Staphylococcus and Streptococcus species are the most frequently isolated Gram-positive organisms, while Pseudomonas aeruginosa is the leading Gram-negative pathogen, especially in contact lens-related cases. Rising antimicrobial resistance complicates care and underscores the importance of performing corneal scraping to ascertain microbiological identification, particularly in severe infections. Fluoroquinolone resistance is increasing among both Gram-positive and Gram-negative isolates. The primary goals of treatment are to eliminate infection, control inflammation, preserve corneal structure and ultimately restore vision. Prompt initiation of antibiotics is essential following microbiological sampling. Conventional diagnostic methods are increasingly complemented by molecular tools such as PCR. Next-generation sequencing offers the potential for unbiased, comprehensive pathogen identification though calibration is needed before clinical implementation. Deep learning-based systems show promise in supporting diagnosis through automated image analysis. Several new antibiotics, primarily fluoroquinolones, may help address multidrug-resistant infections pending clinical validation for ophthalmic use. Primary prevention remains central to reducing disease burden through contact lens hygiene education and simple, low-cost prophylactic measures after corneal trauma.
    Keywords:  Cornea; Infection; Ocular surface
    DOI:  https://doi.org/10.1136/bjo-2025-328808
  39. ISME J. 2026 Jun 29. pii: wrag168. [Epub ahead of print]
    Host life-history strategy is a critical determinant of virulent phage infection propensity.
    Chuncheng Wu, Jacques Mathieu, Cory Schwarz, Madelyn Whitaker, Jenny A Laverde Gomez, Pedro J J Alvarez.
      Bacteriophages shape microbial communities through two major lifestyles: virulent (obligately lytic) and temperate (capable of lysogeny). Prevailing phage ecology frameworks focus on how environmental conditions, host density, and physiological state modulate infection modality. This perspective overlooks how host traits exert selective pressure on the distribution of virulent and temperate lifestyles across bacterial species, which limits understanding of phage ecology. To address this critical knowledge gap, we adopt a host-centric, trait-based perspective and used 5,821 complete bacterial genomes to build a host life-history space predominantly defined by genome size, metabolic capacity and growth rate potential. After mapping phage lifestyle association signals, prophage burden formed a continuous gradient across this space. Also, virulent phage association was positively correlated with prophage burden, revealing a nested structure of lifestyle signals. Functional trait analysis identified enrichment of resource-acquisition modules underlying both temperate and virulent associations. Overall, these findings indicate that phage lifestyle is significantly influenced by host life-history strategies, highlighting fast-growing, metabolically versatile hosts as favorable targets for virulent phage isolation and biocontrol applications.
    Keywords:  Bacteriophage; Host life-history strategy; Lysogeny; Microbial genomics; Phage lifestyle; Virulent phage
    DOI:  https://doi.org/10.1093/ismejo/wrag168
  40. Cureus. 2026 Jun;18(6): e110057
    Artificial Intelligence-Driven Virtual Reality in Physical Rehabilitation: A Review of Machine-Learning Kinematics, Educational Scaffolding, and Treatment Adherence Strategies.
    Magalli Diaz Bravo.
      Physical rehabilitation increasingly depends on interventions that are intensive, personalized, and sustained outside the clinic. Yet contemporary rehabilitation systems face persistent barriers, including workforce shortages, geographic inequities, rising costs, fragmented follow-up, and poor adherence to home exercise programs. This comprehensive review examines how artificial intelligence (AI) and virtual reality (VR) can function together as a digital therapeutic framework for physical rehabilitation. The review argues that the core problem is not simply the absence of technology but the absence of continuous, meaningful supervision between clinic visits. AI-driven pose estimation, multimodal sensing, low-latency feedback, explainable analytics, and adaptive exercise progression allow rehabilitation programs to move from episodic observation to real-time, data-informed guidance. At the same time, principles of adult learning and motor learning help explain why immersion alone is not enough unless the system also teaches, motivates, and gradually transfers responsibility to the patient. Across musculoskeletal, neurological, cardiovascular, oncological, and chronic pain populations, the evidence suggests that VR-supported rehabilitation can improve engagement, exercise capacity, movement quality, and patient satisfaction, particularly when paired with personalized coaching and home-based monitoring. This paper therefore proposes AI-VR rehabilitation not as a replacement for clinicians, but as a clinically governed co-pilot that extends supervision, strengthens adherence, and expands equitable access to therapy.
    Keywords:  adherence to therapy; artificial intelligence (ai); digital therapeutics; educational technology; explainable artificial intelligence (xai); kinematic analysis; machine learning; physical medicine and rehabilitation (pm&r); telerehabilitation; virtual reality-based rehabilitation
    DOI:  https://doi.org/10.7759/cureus.110057
  41. Infection. 2026 Jul 03.
    Double agent: how Escherichia coli switches from commensal to pathogen in the urinary tract infection.
    Sabiha Gul.
      Escherichia coli exhibits a dual nature as both a beneficial gut commensal and the predominant cause of community-acquired urinary tract infections (UTIs) worldwide. This review synthesizes current evidence establishing phenotypic plasticity the capacity for dynamic, non-heritable, and reversible adaptation as a central determinant of uropathogenic E. coli pathogenesis, distinct from stable genetic resistance. From a multilayered perspective, a comprehensive analysis is provided of how genomic diversity, host-pathogen interactions at the bladder epithelium, and exposure to clinically relevant antibiotics collectively drive morphological and regulatory reprogramming. These adaptations include surface roughening, filamentation, and RpoS-mediated persistence, along with (p)ppGpp stringent response and EnvZ/OmpR two-component system signaling, which enhance bacterial survival independently of genetic resistance mutations. The review further discusses how these mechanisms establish a coordinated survival matrix, creating a fundamental disconnect between standard antibiotic susceptibility testing and the host-associated phenotypes that characterize actual infections. Unlike genetically resistant bacteria that grow at elevated antibiotic concentrations, phenotypically tolerant cells exhibit normal MICs but require prolonged killing times, explaining why recurrent UTIs occur despite appropriate therapy. Finally, recent advances, including phage vB_EcoP_P64441 combined with cefotaxime for biofilm disruption, glucose-mediated gentamicin tolerance targeting metabolic pathways, and HDAC inhibitors such as valproic acid for host-directed epigenetic reprogramming, offer new opportunities to break the debilitating cycle of recurrent UTIs affecting millions worldwide.
    Keywords:   Uropathogenic Escherichia coli ; Antibiotic tolerance; Host-pathogen interaction; Phenotypic plasticity; Urinary tract infection
    DOI:  https://doi.org/10.1007/s15010-026-02872-1
  42. Acta Pharm Sin B. 2026 Jun;16(6): 3372-3399
    Where and when to strike: Spatiotemporally controlled smart nanomedicines for precision antibacterial therapy.
    Zhipeng Li, Yutong Li, Zhiyong Liao, Jianliang Shen.
      The global rise of antimicrobial resistance calls for new therapeutic approaches that move beyond conventional broad-spectrum antibiotics toward precision-guided nanotherapeutics. This review examines how smart antibacterial nanomedicines achieve better therapeutic outcomes through two key control dimensions: Spatial precision (where) and temporal activation (when). We first discuss active targeting strategies that direct therapeutic payloads to infection sites while sparing healthy tissues. We then analyze microenvironment-responsive mechanisms that keep therapeutic agents inactive until they encounter specific pathological signals. Moving beyond a simple catalog of material properties, we propose a "Hierarchical Intelligence Framework" that organizes nanoparticles along a spectrum of increasing complexity-from basic ligand-guided systems to integrated, logic-responsive nanodevices operating through "Target-Trigger-Treat" protocols. By examining design principles and practical challenges in pharmaceutical development, this work outlines a path toward resistance-overcoming nanomedicines that may reshape infection management in the coming decades.
    Keywords:  Active targeting; Antimicrobial resistance; Biofilm eradication; Hierarchical intelligence framework; Precision antibacterial therapy; Smart nanomedicine; Spatiotemporal control; Stimuli-responsive systems
    DOI:  https://doi.org/10.1016/j.apsb.2026.04.004
  43. Cureus. 2026 May;18(5): e109960
    NDM-Producing Klebsiella pneumoniae and Multidrug-Resistant Enterococcus faecium Bacteremia: A Report of Two Cases.
    Nikolaos Iason Davanellos, Polyxeni Stefa, Rafail Giannas, Dimitrios Peichamperis, Despoina Paraskeva.
      Antimicrobial resistance (AMR) has emerged as a major global healthcare challenge, significantly complicating the management of healthcare-associated infections and limiting available therapeutic options. We present two cases of severe bloodstream infections caused by multidrug-resistant pathogens in patients with prolonged healthcare exposure and multiple comorbidities. The first case involved urinary-source bacteremia caused by NDM (New Delhi metallo-β-lactamase)-producing Klebsiella pneumoniae exhibiting extensive AMR. Despite limited therapeutic options and apparent in vitro resistance, treatment with ceftazidime-avibactam was associated with marked clinical and laboratory improvement, resulting in clinical recovery and hospital discharge. The second case involved urinary-source bacteremia caused by multidrug-resistant Enterococcus faecium in an elderly patient with significant comorbidities and recent broad-spectrum antimicrobial exposure. Despite escalation of antimicrobial therapy and supportive management, the patient experienced progressive clinical deterioration and ultimately died. These cases highlight the substantial therapeutic challenges posed by highly resistant pathogens and emphasize the importance of early microbiological diagnosis, individualized interpretation of antimicrobial susceptibility results, prompt optimization of antimicrobial therapy, and strict infection prevention measures in the management of severe multidrug-resistant infections.
    Keywords:  antimicrobial resistance; bloodstream infection; ceftazidime–avibactam; enterococcus faecium; extensively drug-resistant klebsiella pneumoniae; linezolid resistance; ndm carbapenemase; urosepsis
    DOI:  https://doi.org/10.7759/cureus.109960
  44. Expert Opin Investig Drugs. 2026 Jul 03.
    Advancements in longevity pharmacology research - are we finally seeing clinical progression?
    Madia Lozupone.
       INTRODUCTION: Longevity pharmacology has evolved from descriptive gerontology into a mechanistically driven field aiming to modulate fundamental processes of biological aging. Despite rapid scientific advances, whether this progress has translated into meaningful clinical outcomes remains uncertain.
    AREAS COVERED: This critical perspective evaluates recent developments in longevity pharmacology and examines whether they represent genuine clinical progression or continued translational delay. A narrative literature review was conducted using PubMed/MEDLINE, Scopus, and Web of Science to identify English-language publications related to longevity pharmacology, gerotherapeutics, biomarkers of aging, and translational geroscience published between January 2000 and April 2026. We review evidence from senescence biology (including frailty), autophagy and mitophagy modulation, metabolic and nutrient-sensing pathways, stem cell and natural product - based rejuvenation strategies, microbiome-targeted interventions, and AI-enabled biomarker development. Particular emphasis is placed on systemic chronic inflammation as a central integrative driver of age-related disease. While selected interventions show early clinical signals, most remain preclinical or lack long-term validation. Key barriers include biomarker deficits, biological heterogeneity, safety concerns, regulatory misalignment, and limitations of animal models.
    EXPERT OPINION: Although mechanistic maturity is advancing rapidly, clinical translation remains incremental and fragmented. Near-term progress is most likely to arise from low-risk, system-level interventions supported by validated biomarkers and geroscience-informed clinical trial designs.
    Keywords:  Longevity; clinical research; epigenetic aging; frailty; lifestyle; pharmacotherapy, small molecules; precision medicine
    DOI:  https://doi.org/10.1080/13543784.2026.2698526
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