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Infectious Diseases
18th Nov, 2025
The Lancet
Howard A, Reza N, Green PL et al. Artificial intelligence and infectious diseases: tackling antimicrobial resistance, from personalised care to antibiotic discovery. Lancet Infect Dis 2025; published online Sept 16. https://doi.org/10.1016/S1473-3099(25)00313-5—In this Series paper, the Acknowledgments have been updated to clarify the funders of CARB-X. This correction has been made to the online version as of Sept 30, 2025, and will be made to the printed version.
Ismail N, Moultrie H, Mwansa-Kambafwile J, et al. Effects of conditional cash transfers and pre-test and post-test tuberculosis counselling on patient outcomes and loss to follow-up across the continuum of care in South Africa: a randomised controlled trial. Lancet Infect Dis 2025; 25: 764–74—In this Article, Molebogeng X Rangaka should have been included as an author. This correction has been made to the online version as of Sept 26, 2025.
Wagner L, Obersriebnig M, Kadlecek V, et al. Immunogenicity and safety of different immunisation schedules of the VLA15 Lyme borreliosis vaccine candidate in adults, adolescents, and children: a randomised, observer-blind, placebo-controlled, phase 2 trial. Lancet Infect Dis 2025; 25: 986–99—In this Article, figure 1 has been updated to fix indenting errors in the top-right box. This correction has been made to the online version as of Sept 22, 2025.
Cholera has been endemic in Nepal for more than a century, with outbreaks recorded as early as 1885.1 Far from being an episodic crisis, it reappears almost every monsoon season, fuelled by fragile infrastructure and climate variability. The 2009 outbreak in Jajarkot highlighted systemic weaknesses in the response to outbreaks, and the 2010 Haiti epidemic was molecularly linked to Nepalese strains.2 These episodes give a clear warning: failures in local control can trigger global health emergencies.
We read with interest the Comment by Shamez N Ladhani and colleagues on the UK's gonorrhoea vaccination initiative.1 However, we wish to clarify that Galicia, Spain, became the first jurisdiction in the world to implement a structured public health programme to prevent gonorrhoea through vaccination, starting June 2, 2025.2 This regional policy predates the UK national rollout and offers a broader and more inclusive approach.
The ongoing monkeypox virus clade IIb outbreak in Sierra Leone has caused over 4800 confirmed cases in the first half of 2025, 5% of which are in children.1 Although the infection in most patients is not severe, mpox is often debilitating and life-threatening for those with advanced HIV disease. Caring for these patients is medically challenging and heartbreaking in equal measure.
We thank Thomas M Lietman and colleagues for the opportunity to clarify the robustness of our methodological approach and aspects of pneumococcal transmission and antimicrobial resistance (AMR) biology not considered in their assessment. WHO conditionally recommends azithromycin mass drug administration (MDA) as a potentially life-saving intervention in vulnerable populations, provided that AMR is closely monitored.1
Azithromycin mass drug administration (MDA) reduces childhood mortality, but benefits should be balanced against risks of antimicrobial resistance (AMR).1,2 In The Lancet Infectious Diseases, Akuzike Kalizang'oma and colleagues reported on the 3·5 years of follow-up after an earlier trial of twice-yearly azithromycin (around 20 mg/kg) intervention versus placebo for 2 years (MORDOR).3 Nasopharyngeal pneumococcus was isolated from swabs obtained from children aged 1–9 years and antibiotic resistance genes were identified with short-read whole-genome sequencing.
Gonorrhoea, the disease caused by Neisseria gonorrhoeae, is a bacterial sexually transmitted infection (STI) that remains a major public health concern globally, with rising incidence and increasing antimicrobial resistance (AMR) to multiple classes of antibiotics. In 2020, WHO estimated there were more than 82 million cases of gonorrhoea among people aged 15–49 years worldwide, with a global incidence of 19 (1·9%) per 1000 women and 23 (2·3%) per 1000 men. Given the growing international concern, WHO set targets to reduce annual gonorrhoea incidence by 90% by 2030.
Since 2022, with the emergence of highly transmissible omicron variants and the relaxation of social distancing measures, protecting individuals who are immunocompromised from SARS-CoV-2 exposure has become increasingly difficult. As a result, these patients have been more frequently reported to have severe and persistent COVID-19.1,2 Currently, most COVID-19-related consultations performed by infectious diseases' doctors concern managing COVID-19 in patients who are immunocompromised.
The recent progress in the development, evaluation, and global implementation of all oral, shorter, efficacious regimens ushered in a new era of optimism for the treatment of drug-resistant tuberculosis.1 This has largely been made possible through the discovery of novel chemical entities, including a diarylquinoline (bedaquiline) and nitroimidazoles (pretomanid and delamanid), and the repurposing of an oxazolidinone (linezolid), which was previously used for the treatment of drug-resistant Gram-positive infections.
In The Lancet Infectious Diseases, Enrico Ricchizzi and colleagues report the results of a year-long study of the incidence of health-care-associated infections (HAIs) in long-term care facilities (LTCFs) in nine European countries.1 Using prospective surveillance data from more than 3000 residents in 65 LTCFs, the authors show that 57% of residents had at least one HAI during the 12-month observation period, with respiratory tract infections (RTIs) and urinary tract infections (UTIs) being most common, and with an overall case fatality rate of 4·5% (95% CI 2·5–4·8).
The NIRSE-CL study by Juan Pablo Torres and colleagues,1 published in The Lancet Infectious Diseases, is a landmark analysis of the first nationwide implementation of nirsevimab in the southern hemisphere. In Chile's 2024 respiratory syncytial virus (RSV) season, 145 087 infants (coverage of 94%) were immunised with nirsevimab through a universal immunisation campaign. This effort was associated with substantial effectiveness of nirsevimab against hospitalisation for RSV-related lower respiratory tract infection (LRTI; 76·41% [95% CI 72·57–79·72]), severe RSV requiring ICU admission (84·94% [79·47–88·95]), all-cause LRTI hospitalisations (66·50% [61·97–70·50]), and all-cause hospitalisations (47·90% [44·35–51·21]).
Olorofim is a first-in-class compound from the novel orotomide class of antifungal agents. Among antifungals in the development pipeline,1 olorofim stands out because of its potent in vitro activity against various difficult-to-treat fungi, including moulds such as azole-resistant Aspergillosis spp, Scedosporium spp, and Lomentospora prolificans, as well as the dimorphic fungi Histoplasma spp and Coccidioides spp. Notable drawbacks include its lack of activity against yeasts and Mucorales and its higher minimum inhibitory concentrations for the Fusarium solani species complex and F dimerum than for other Fusarium spp.
A News piece in this issue reports on the sixth Conference on Vaccines hosted by the European Society of Clinical Microbiology and Infectious Diseases in Lisbon between Sept 10 and Sept 13. Adult immunisation was a key topic at the conference, with widespread support voiced for shifting industry and policy focus away from predominantly paediatric programmes towards lifelong vaccination initiatives. Despite the substantial global burden of vaccine-preventable disease among adults, most national vaccination programmes are still designed to reduce mortality and morbidity in children.
What's New: Drugs
6th Apr, 2026
FDA
Center,
Research
2nd Apr, 2026
3rd Apr, 2026
What's New: Vaccines, Blood and Biologics
