September 22, 2025
An infection from bacteria often found in the mouth is associated with sudden cardiac death.
Results from a molecular analysis of coronary plaques from sudden death victims and from surgical patients revealed the predominance of oral viridans group streptococcal DNA (>42 percent in both sample types). Viridans streptococci, a typically harmless commensal bacteria found in the oral cavity, colonized atherosclerotic plaques as biofilms but evaded recognition by innate immune cells. Virulent, strongly immunopositive streptococci that were dispersed from the biofilm were seen infiltrating ruptured or symptomatic atherosclerotic plaques and activated adaptive immunity. Viridans streptococcal immunopositivity correlated with the severity of atherosclerosis and with death due to coronary heart disease or myocardial infarction, highlighting the bacteria’s potential role in converting stable coronary atherosclerotic tissue into plaques at risk for rupture. [Journal of the American Heart Association]
Competing priorities influenced Brazil’s pneumococcal vaccine strategy.
An intrinsic explanatory case study of Brazil’s 2022-2023 deliberations over replacing the 10-valent pneumococcal vaccine (PCV10) with PCV13 for children found that the decision to not introduce PCV13 in the public health system immunization program was driven by concerns about technological sovereignty and domestic vaccine production capacity rather than purely clinical considerations. The case demonstrates how decisions to adopt a vaccine involve competing priorities such as maintaining partnerships with domestic manufacturers, ensuring robust disease surveillance systems, and balancing cost-effectiveness with national strategic interests. These results highlight the importance of strong public health institutions and transparent decision-making when navigating these complex trade-offs in resource-constrained settings. [Journal of Infection and Public Health]
The current landscape of vaccine innovation in Europe
Vaccines Europe’s 2024 annual report identifies 98 vaccine candidates across 12 technology platforms, with 42 percent targeting diseases with no existing authorized vaccine. However, the European Union/European Economic Area’s share of global vaccine clinical trials dropped from 17 percent in 2018 to just 8 percent in 2023, resulting in 60,000 fewer European patients accessing innovative treatments. Simplifying clinical trial procedures and coordinating effective policy action are necessary to modernize and accelerate Europe’s vaccine trial landscape. [Vaccines Europe]
A machine learning model may accurately predict AMR in P. aeruginosa.
A machine learning-based pipeline was developed to predict antimicrobial resistance (AMR) in Pseudomonas aeruginosa using only genomic sequencing. With 70 percent specificity and 84 percent sensitivity, the two-tier model leveraged statistically significant subsequences of P. aeruginosa DNA to identify resistant and susceptible P. aeruginosa isolates and 13 specific antibiotics associated with AMR. Validation of the first tier of the model with an independent dataset demonstrated 98 percent accuracy, indicating the robustness of the model and its potential to enhance predictions for resistance in P. aeruginosa. [Bioinformatics Advances]
AMR pathogens may be linked to higher rates of in-hospital infection and mortality.
A systematic review and meta-analysis revealed that 36.5 percent of infections in hospital settings globally were caused by drug-resistant organisms. Infections caused by AMR pathogens were further associated with higher in-hospital mortality compared to non-AMR infections (adjusted pooled risk ratio: 1.58). Notably, none of the studies included in the review were conducted in Africa, the Middle East, India, or Russia. There was also a lack of distinction between community- and hospital-acquired infections, potentially clouding the link between hospitalization and AMR infections and related deaths. [eClinicalMedicine]
Estimating the global pooled prevalence of nitrofurantoin-resistant uropathogenic E. coli
Results of a systematic review and meta-analysis of data collected between 1996 and 2024 revealed that the global pooled prevalence of nitrofurantoin-resistant uropathogenic Escherichia coli (UPEC) is 6.9 percent. The pooled prevalence of UPEC increased from 2.8 percent between 1996-2004 to 8.2 percent in the 2005-2014 period, suggesting the rapidly decreasing effectiveness of antibiotic treatment and rise of resistant strains. Regional analysis found higher prevalence of UPEC in low- and middle-income countries, possibly due to the affordability of antibiotics, self-medication practices, and a lack of knowledge about AMR and its associated hazards. [Journal of Antimicrobial Chemotherapy]
Antibiotic data enhances the predictive ability of machine learning models.
Machine learning models, created using the Pfizer ATLAS Antibiotics surveillance dataset, were assessed for their ability to predict antibiotic resistance in bacteria. Antibiotics were the most critical predictor in these models, aligning with current knowledge that antibiotic exposure creates selective pressure that results in the development of resistance. Since each antibiotic exerts varying pressures across bacterial species, models that incorporate antibiotic data perform better as they account for specific drug-bug interactions. Future implementation of such models should incorporate enhanced AMR surveillance data, particularly from low- and middle-income countries, to improve representation and accuracy. [Nature Scientific Reports]
Regulatory factors affecting the vaccine development pipeline in Asia and the Pacific
A qualitative study of industry experts and policymakers in Asia and the Pacific identified that regulatory factors such as collaboration, regulatory capacity building, regulatory alignment, strengthened regulatory systems, and regulatory agility affect the sustainability of vaccine manufacturing pipelines. Digitalization, particularly the integration of machine learning and artificial intelligence, was noted as an opportunity to support processes across various points in the vaccine life cycle. Experts recommend prioritizing digitalizing regulatory processes in low-resource countries in the Asia/Pacific region and understanding how vaccine regulatory timelines differ across countries to better guide policy and supply chain decisions. [Vaccine]
Healthcare support interventions promote breastfeeding among mothers living with HIV.
A systematic review and meta-analysis of randomized controlled trials of maternal-child healthcare support interventions supporting breastfeeding among people living with HIV (PLWH) revealed that facility-based professional support, community-based peer support, nutritional support, and remote support may all increase exclusive breastfeeding (EBF) in PLWH compared to standard care (risk ratio: 1.38). While these results correspond to an additional 92 mothers living with HIV per 1,000 practicing EBF, the high risk of bias in the included trials clouds the certainty of these estimates. Given the World Health Organization’s recommendation that mothers receiving antiretroviral HIV therapy practice EBF, integrating maternal-child healthcare support into existing HIV care is crucial to optimize infant health outcomes. [International Journal of Infectious Diseases]
Exploring the relationship between poverty and multidrug resistance
A mixed-methods study conducted in three provinces in Pakistan found that the risk of antibiotic resistance in physician-confirmed urinary tract infection samples rose with increasing levels of deprivation (measured by the multi-dimensional poverty index). After adjusting for confounding factors such as antibiotic misuse and poor water, sanitation, and hygiene conditions, the risk of multidrug resistance was higher in the severely deprived subgroup compared to subgroups of lower deprivation (adjusted odds ratios: 4.28 vs. 3.01 and 3.03). Qualitative data from participating patients revealed that financial constraints and limited access to healthcare drove them to self-medicate with leftover antibiotics and not adhere to treatment regimens, highlighting the fact that structural barriers, rather than individual decisions, mediate the link between poverty and multidrug resistance. [The Lancet Regional Health – Southeast Asia]
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