Search Medical Journals & Research Articles

[Review] Role of gut microbiota disruption in prosthetic joint infection: a scoping review

Prosthetic joint infection (PJI) is a serious complication of joint replacement surgery. Emerging evidence suggests that gut dysbiosis (characterised by reduced microbial diversity, altered immune responses, and increased intestinal permeability) could facilitate bacterial translocation from the gut to prosthetic joints and contribute to the development of PJI. In this scoping review, we analysed eight studies (three preclinical and five clinical) that investigated the potential link between gut microbiota alteration (dysbiosis) and PJIs.

[Articles] Duration of the serological response and effectiveness of the inactivated influenza vaccine in healthy adults aged 18–65 years: a systematic review and meta-analysis

IIV-induced HAI titres in healthy adults aged 18–65 years persisted 5–7 months after vaccination, but might not be significantly sustained at 11–13 months. For influenza A/H3 and influenza B, there was a significant decline in vaccine effectiveness beyond 5 months after vaccination. Evaluating the temporal changes in vaccine effectiveness remains challenging due to methodological biases; a greater understanding is needed to optimise vaccine design and timing to maximise effectiveness throughout the influenza season.

[Articles] Inferring the sensitivity of wastewater metagenomic sequencing for early detection of viruses: a statistical modelling study

The large variation in viral relative abundance after controlling for epidemiological factors indicates that other sources of inter-study variation, such as differences in sewershed hydrology and laboratory protocols, have a substantial impact on the sensitivity and cost of W-MGS. Well chosen hybridisation capture panels can greatly increase sensitivity and reduce cost for viruses in the panel, but might reduce sensitivity to unknown or unexpected pathogens.

[Articles] Estimating the association of antimicrobial resistance genes with minimum inhibitory concentration in Escherichia coli: an observational study

Quantitative estimates of the independent effect of the acquisition of ARGs on MIC add to the interpretability and utility of existing databases. Compared with approaches using machine learning models, the use of these estimates yields similar or better performance in the prediction of antibiotic resistance phenotype with more readily interpretable results. The methods outlined here could be readily applied to other antibiotic–pathogen combinations.

[Articles] A viral clonality evenness score to predict progression to adult T-cell leukaemia in asymptomatic carriers of human T-lymphotropic virus type 1 in Japan: a retrospective longitudinal cohort study

The implementation of VCE scoring in clinical practice could inform early pre-emptive therapeutic interventions, exclusively targeting individuals with HTLV-1 at high risk and aiming to prevent progression to aggressive, treatment-refractory disease. Further validation, including independent confirmation of the performance of VCE scoring in multiple populations and the characterisation of its temporal dynamics, will be crucial to determine its clinical utility and potential integration into care pathways.

[News] Hepatitis A outbreak in Europe

Four European countries have reported increases in hepatitis A virus (HAV) incidence in 2025, prompting the European Centre for Disease Prevention and Control (ECDC) to declare a multi-country outbreak. In a Rapid Risk Assessment published on June 18, 2025, the agency called for coordination, collaboration, timely detection, and targeted interventions in affected countries.

[News] UK Government dismantles the Fleming Fund

On July 15, 2025, the UK Government confirmed that it planned to dismantle the country’s flagship international programme for tackling antimicrobial resistance (AMR). The Fleming Fund is overseen by the Department of Health and Social Care (DHSC) and supports 25 low-income and middle-income countries (LMICs) in Africa and Asia. It was established in 2015 with a stated aim to “address chronic underinvestment in LMIC laboratory capacity and to support local, national and international AMR data use by strengthening surveillance systems”.

[Correspondence] Modelling drug resistance dynamics for long-term schistosomiasis management

We read with interest the Article by Benjamin J Singer and colleagues published in The Lancet Microbe1 on the potential impact of novel drugs against schistosomiasis. The study offers valuable insights; however, a key consideration is the omission of dynamic modelling for the emergence and spread of drug resistance, which could affect long-term projections.

[Correspondence] Import of multidrug-resistant Vibrio cholerae from Ethiopia to Germany and the UK

Since 2018, the emergence of multidrug-resistant Vibrio cholerae strains in eastern Africa has raised serious public health concerns due to the potential loss of effective treatment options.1–3 Recently, concurrent cholera outbreaks among travellers from Germany and the UK returning from Ethiopia as well as among residents were traced to a sacred fountain contaminated with a highly drug-resistant V cholerae O1 strain. Whole-genome sequencing and comparative genomics of V cholerae isolates from both patients and water samples confirmed the fountain as the source of infection, and antimicrobial susceptibility testing showed a multidrug-resistant phenotype.

[Correspondence] Clostridioides difficile should be considered a bacterial priority pathogen

In 2024, WHO published its Bacterial Priority Pathogen list,1 which was thoughtfully highlighted by Timothy Jesudason in a News article in The Lancet Microbe.2 The impact of this list is substantial. Although WHO states that the list is intended “to guide research, development, and strategies”, policy makers and funders often use the list to impose eligibility criteria that directly influence public health and drug development decisions by academic, government, and private organisations, thereby affecting patient care.

[Correspondence] Host cell entry and neutralisation sensitivity of SARS-CoV-2 BA.3.2

The COVID-19 pandemic and the ensuing endemic have been characterised by the continuous emergence of novel SARS-CoV-2 variants, each showing augmented antibody evasion due to mutations in the viral spike (S) protein. These new variants usually harbour a few S protein mutations, conferring a modest growth advantage within the population. However, a quantum leap of SARS-CoV-2 evolution was observed on two occasions. The first occurred at the end of 2021, when the highly mutated omicron variant (B.1.1.529) became dominant, showing unprecedented antibody evasion.

[Correspondence] Mycoplasma pneumoniae: re-emergence and beyond

The re-emergence of Mycoplasma pneumoniae in late 2023 placed a considerable burden on health-care systems and raised concerns regarding the severity of pneumonia outbreaks.1 The European Society of Clinical Microbiology and Infectious Diseases Study Group for Mycoplasma and Chlamydia Infections (ESGMAC) Mycoplasma pneumoniae surveillance (MAPS) study2 was able to attribute these outbreaks to M pneumoniae and found no statistically significant global increase in the proportion of severe outcomes compared with that of pre-pandemic epidemics.

[Comment] Evolution’s double-edged sword: SARS-CoV-2 adaptation in HIV reveals nature’s safety valve

In their Article published in The Lancet Microbe, Joseline M Velasquez-Reyes and colleagues present a remarkable chronicle of SARS-CoV-2 evolution spanning 750 days in an individual with untreated HIV, offering unprecedented insights into viral adaptation dynamics that challenge the current understanding of variant emergence.1 This extraordinary case reveals a fundamental evolutionary paradox: although the virus accumulated mutations reminiscent of the omicron (B.1.1.529) variant of the SARS-CoV-2 virus months before its global emergence, the virus apparently lost its ability to transmit—nature’s unexpected safety valve against runaway viral evolution.

[Comment] Repopulate, not just decolonise—a microbial ecological strategy against multidrug resistance in intensive care units

The fight against multidrug-resistant organisms (MDROs) in hospitals, especially in critical care settings, has led to the widespread use of universal decolonisation with chlorhexidine and mupirocin. However, growing evidence raises concerns regarding unintended consequences, notably the selective pressure that biocides exert, promoting microbial communities dominated by resistant strains. In their recent Article published in The Lancet Microbe, Sara Sharaf and colleagues1 highlight the risk of unintended consequences of biocides, showing that shifting from universal to targeted decolonisation in intensive care units (ICUs) considerably reduced meticillin-resistant Staphylococcus epidermidis bloodstream infections, without increasing overall infection rates.

[Comment] Keeping our feet on the ground: the role of innovation in scaling up diagnosis to counter antimicrobial resistance

At the second UN General Assembly High-Level Meeting on antimicrobial resistance (AMR) held on September 26, 2024, UN member states made important commitments to strengthen global efforts to counter drug-resistant infections, including to “[i]mprove access to diagnosis and care, so at least 80% of countries can test resistance in all bacterial and fungal GLASS [World Health Organization (WHO)’s Global Antimicrobial Resistance and Use Surveillance System] pathogens by 2030”.1 Access to quality-assured microbiology laboratories is indispensable for any successful effort to identify and counter AMR, and yet, scarce in many countries in sub-Saharan Africa, south Asia, and the Middle East, particularly in the least-resourced tiers of health-care delivery.