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This review aims to synthesize genomic evidence on the convergence of antimicrobial resistance and hypervirulence in Klebsiella pneumoniae, focusing on high-risk clones, plasmid dynamics, and global epidemiology. Whole-genome sequencing studies revealed that convergence is increasingly reported but remains unevenly distributed across lineages. ST11 represents a consistent example of stable MDR–hypervirulence convergence, whereas ST15 and ST147 show more limited and context-dependent evidence. Advances in long-read sequencing highlight the role of hybrid plasmids and mobile genetic elements in these evolutionary processes. One Health studies indicate that environmental and non-clinical reservoirs contribute to persistence and dissemination of resistance determinants. Current evidence suggests that the success of K. pneumoniae is driven by a dynamic plasmidome and open pangenome. Although MDR–hypervirulent strains remain relatively uncommon, their clinical impact is significant. Integrating genomic surveillance with epidemiological data is essential for improving risk assessment, guiding infection control strategies, and informing future therapeutic development.
Among critically ill ICU patients under prolonged mechanical ventilation, Pseudomonas aeruginosa is one of the most common cause of ventilator-associated pneumonia (VAP), with antimicrobial pressure leading to emergence of multidrug, extensively drug and pandrug-resistant (PDR) strains. In Egypt, very little genomic data exist on P. aeruginosa associated with VAP. This study aimed at characterizing the antimicrobial resistance (AMR) determinants, virulence repertoire, MGEs, and sequence types of two highly drug-resistant Pseudomonas aeruginosa isolates, including one pandrug-resistant colistin-resistant isolate and one extensively drug-resistant colistin-susceptible isolate from respiratory tract of Egyptian ICU patients suffering from VAP. The two isolates were identified conventionally and confirmed to the species level using MALDI-TOF MS. Antibiotic susceptibility was assessed using the VITEK-2 Compact system and the broth microdilution method. Genome analysis was performed using PATRIC, ResFinder, CARD, and Mobile Element Finder. For both isolates, resistance was found to all antibiotics routinely tested, however, one isolate had high-level colistin resistance (MIC > 64 µg/mL), while the other isolate was still colistin susceptible. Whole-genome sequencing identified two rare sequence types, ST2023 and ST2685, both 6.5–7.6 Mb in size with a 66
Background: Understanding the prevalence and impact of post-renal transplant infectious complications, including both bacterial and viral infections, is vital for improving patient outcomes. This study aims to assess the prevalence of infectious diseases, along with their related outcomes and complications, within two years of renal transplantation in adult recipients. Methods: This multicenter case–control study was carried out across four transplant centers in Saudi Arabia, enrolling adult patients who underwent renal transplantation from January 2016 to December 2021. Patients were categorized into infection and noninfection groups and matched 1:1. The primary outcome was the prevalence of infectious complications following renal transplantation; other outcomes were considered secondary. Results: Out of 788 renal transplant patients, 364 developed infections within 2 years, with a prevalence of 46.2%. Bacterial infections predominated, with urinary tract infections (UTIs) being the most common infection (64.3%), followed by bloodstream infections (19.2%). After exact matching, the two-year graft rejection rate was significantly higher in the infection group (adjusted odds ratio [aOR] =1.69, 95% confidence interval [CI]: 1.060–2.704). Furthermore, multivariable stepwise logistic regression identified recurrent UTIs as a strong independent risk factor for rejection (aOR = 47.45), while chronic intermittent catheterization was protective (aOR = 0.67). Patients with infections had a higher and statistically significant risk of graft failure (aOR = 2.67, 95% CI: 1.098–6.479). In contrast, all-cause mortality failed to reach statistical significance. Conclusion: Infectious complications, predominantly bacterial but also including viral infections, were common after kidney transplantation and significantly increased the risk of 2-year graft rejection, especially with recurrent UTIs.
Background: The additive manufacturing (AM) has been introduced as a groundbreaking technology in the field of prosthodontics, which potentially has beneficial impacts compared to conventional subtractive manufacturing (SM) to produce dental ceramic restorations. Nevertheless, the clinical utility of AM dental ceramics is a controversial issue, where the accuracy, mechanical properties, and performance in the long-term are of concern.. Objective: This systematic review assessed the recent developments of additive manufacturing technologies in the domain of dentistry, specifically in the area of prosthodontics to evaluate their efficacy in the manufacture of dental ceramics relative to subtractive manufacturing procedures and define future research directions.. Methods: A thorough literature search was carried out in the databases of PubMed/MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library articles published between 2020 and 2026. They included studies that compared AM and SM of dental ceramics (zirconia, lithium disilicate, and other ceramic systems). Accuracy (trueness and precision), marginal and internal fit, mechanical properties (flexural strength, hardness, fracture toughness), biocompatibility, and clinical outcomes were all the focus of the data extraction. The Joanna Briggs Institute (JBI) critical appraisal tools were used to measure the risk of bias.. Results: There were 28 studies that qualified the inclusion criteria. Meta-analysis of accuracy data revealed that SM demonstrated superior overall accuracy compared with AM (Hedges' g = 0.679, 95% CI: 0.173–1.185, p = 0.009), particularly for marginal (g = 1.05, p = 0.004) and occlusal (g = 2.24, p = 0.004) surfaces. Nevertheless, AM demonstrated similar or even better results with axial surfaces and external contours. The flexural strength was greatly more important with SM ceramics (g = -2.868, p < 0.001). The nanoparticle jetting (NPJ) technology showed the best potential of accuracy among AM methods with some studies showing better adaptation than SM. Both of these procedures proved good biocompatibility. No clinical trials on AM zirconia crowns were found.. Conclusions: Although subtractive manufacturing has yet to yield to the overall accuracy and flexural strength, additive manufacturing technologies, especially NPJ and lithography-based ceramic manufacturing (LCM) have demonstrated clinically acceptable performance levels. Lack of long-term clinical data is a very important gap in evidence. Randomized controlled trials with longer follow-up periods, standardized post-processing protocols and development of novel formulations of ceramics that are optimized in AM should form the focus of future research.
The application of artificial intelligence in people's daily life has become inevitable, especially in the business environment. However, most organizations acknowledge the fact that the use of AI Systems is necessary, but guidelines are also necessary to adapt to the accelerated expansion of artificial intelligence. Security systems represent a particularly sensitive category when it comes to the application of artificial intelligence, given the huge unknowns about the risks that these systems carry with them. A substantive framework for risk assessment in this area is imposed as necessary because the existing risk assessment methods generally do not recognize AI risks, which prevents their comprehensive overview. This paper provides a comprehensive conceptual content of the risk assessment of the application of AI in security systems, which includes risks during the entire life cycle of the AI system, which enables the identification, analysis, assessment and treatment of recognized risks and the monitoring and control of their impact on the system.
