Carbapenem-resistant organisms, particularly Gram-negative carbapenemase-producing organisms (CPOs), pose a major threat to successful treatment of bacterial infections. In recent years, metallo-β-lactamases (MBLs), class B carbapenemases, have increasingly been found in CPO infections in many countries. MBLs confer resistance to carbapenems and many β-lactam/β-lactamase inhibitor (BL/BLI) drug combinations used to treat CPO infections. Aztreonam/avibactam (AZA), a BL/BLI, was developed as a treatment option for infections caused by MBL-producing Gram-negative bacteria. Aztreonam is stable to hydrolysis by MBLs, while avibactam inhibits many clinically relevant serine β-lactamases, allowing the combination to retain activity against many multidrug-resistant Gram-negative bacteria. Here, we provide insights into AZA activity, use, and susceptibility testing practices.
Viral hepatitis heavily burdens the global population, causing over 300 million annual cases across all types. Acute infections stem primarily from hepatitis A and E viruses. While their contribution to global mortality is relatively low, early diagnosis remains critical to prevent severe bodily complications. Current early diagnosis methods vary by detection technique, device, and underlying principle, but face major challenges. A primary obstacle is asymptomatic infection, which frequently produces false-negative results in conventional tests. Additionally, cross-reactivity with other liver inflammation biomarkers and familial antigens often hinders diagnostic accuracy. To overcome these limitations, novel technologies are emerging by modifying conventional approaches. Advanced techniques like qRT-PCR, modified CRISPR, and Next-Generation Sequencing (NGS) now target hepatitis A and E detection. Evaluating and comparing these innovative tools is essential to identify the most accurate and suitable method for early, reliable diagnosis.
The human microbiome has rapidly emerged as a powerful and dynamic regulator of cancer biology, influencing tumor initiation, progression, and response to therapy. Growing evidence links microbial dysbiosis to a wide spectrum of malignancies, including gastrointestinal, hepatic, pulmonary, breast, and skin cancers. This review provides a comprehensive synthesis of current clinical and preclinical insights into the complex interplay between host and microbiota in carcinogenesis. Key microbial players such as Fusobacterium nucleatum, Helicobacter pylori, Bacteroides fragilis, and Escherichia coli, along with oncogenic viruses, fungi, and parasites, drive cancer development through multifaceted mechanisms, including chronic inflammation, immune evasion, genotoxicity, and metabolic reprogramming. Importantly, the microbiome has been shown to critically modulate the efficacy and toxicity of conventional and advanced cancer therapies, particularly immunotherapy, chemotherapy, and radiotherapy. Emerging microbiome-based interventions—such as probiotics, prebiotics, bacteriophage therapy, fecal microbiota transplantation, and postbiotics—offer promising avenues for precision oncology by enhancing therapeutic outcomes and minimizing adverse effects. Collectively, these findings position the microbiome as both a biomarker and a therapeutic target, paving the way for innovative strategies in cancer prevention, diagnosis, and treatment.
Salmonella Typhi is a bacterium responsible for typhoidal salmonellosis. We report a case of an immunocompetent 12-year-old girl who presented with a 5-day history of fever accompanied by right-sided abdominal pain, loose stools, and vomiting. She was diagnosed with acute appendicitis and underwent laparoscopic appendicectomy. Blood cultures grew S. Typhi. To our knowledge, this is the first reported case of S. Typhi presenting as acute appendicitis in Malaysia. This case highlights the diagnostic challenges associated with atypical presentations of typhoid fever and emphasizes the need for clinicians to consider S. Typhi as a possible underlying cause in similar clinical scenarios.
