The treatment of fungal infections remains a major clinical challenge. Efforts in antifungal research have led to the approval of several innovative therapies and the advancement of multiple promising agents currently in early and late stage development. This review provides an up-to-date overview of novel antifungal agents approved or in development, highlighting their novel characteristics and potential clinical impact. Three newly approved antifungals have reached clinical use, introducing new structural classes and dosing advantages including ibrexafungerp and oteseconazole for treatment of vulvovaginal candidiasis and rezafungin for invasive candidiasis. In addition, five emerging candidates including fosmanogepix, olorofim, opelconazole, turletricin and encochleated amphotericin B represent important advances in oral bioavailability, safety and resistance profiles. Together, these developments mark a pivotal shift in antifungal therapeutics, offering clinicians new opportunities to optimize care and improve outcomes for patients with serious and difficult to treat fungal infections.
Klebsiella pneumoniae is listed by the WHO as a priority pathogen, and resistance rates in Pakistan are known to be high. No national figures exist for how often it is isolated or how resistant it is. This review covers the Pakistani work published between 2015 and 2025. Forty studies were included, covering 36,233 specimens, of which 2,513 yielded K. pneumoniae. The pooled prevalence was 12
Zika virus (ZIKV) is a mosquito-borne flavivirus, most prevalent in tropical areas. ZIKV rose to prominence during 2015–2016 due to an outbreak in the Americas leading to the recognition of adverse outcomes with infection during pregnancy. This review highlights the advances of research a decade after this epidemic. During the last decade the epidemiology of ZIKV evolved with the incidence decreasing significantly. Critical advances have been made in the understanding pathophysiology of infection during pregnancy, the effect of prenatal ZIKV exposure in normocephalic infants, the immune response to the virus, and the challenges in vaccine development. ZIKV remains a global public health threat. There are ongoing challenges in preparedness, post-natal sequela care, and prevention strategies. Continued research is needed to fill these gaps.
Antimicrobial Resistance (AMR) is a major problem in microbial therapy, as it renders antibiotics ineffective. This arises from natural evolution, antibiotic misuse, healthcare factors, environmental pollution, and social inequalities. The most recent data indicate that environmental reservoirs such as wastewater, agriculture, and soil microbiome communities can contribute significantly to the spread of antimicrobial resistance genes. In addition, the development of genomics-based surveillance tools, along with the use of the One Health approach, has shed light on transmission routes. However, there remains a significant gap in practice due to inadequate stewardship and diagnostic capabilities. This narrative review presents the current evidence on the determinants, transmission, public health impact, and management of antimicrobial resistance, using the One Health approach. Antimicrobial resistance arises from complex interactions among human, animal, and environmental factors, further contributing to increased morbidity, mortality, and medical costs. While the problem of AMR is increasingly recognized worldwide, there are still deficiencies in environmental involvement and policy integration. Despite high-level global policy declarations (e.g., UNGA commitments), actual implementation remains fragmented. Therefore, immediate actions are required by implementing the One Health approach, improving surveillance, and adopting policy and regulatory measures.
This review moves beyond gastrointestinal disease to provide a comprehensive overview of extraintestinal salmonellosis. It seeks to answer: what mechanisms drive systemic invasion, which host factors predispose to disseminated infection, what is the full clinical spectrum, and how can diagnostic and therapeutic challenges be addressed. Emerging research highlights the rapid global spread of multidrug-resistant and extensively drug-resistant Salmonella Typhi, alongside resistant non-typhoidal Salmonella (NTS). Advanced molecular diagnostics and imaging are increasingly overcoming the limitations of conventional cultures. New insights into bacterial virulence factors and host susceptibility such as immunocompromise, sickle cell disease, and extremes of age are refining risk stratification. Extraintestinal salmonellosis causes life-threatening bacteremia, endovascular infections, osteomyelitis, meningitis, and visceral abscesses. Antimicrobial resistance severely complicates treatment, necessitating tailored regimens and source control. Prevention through vaccination and carrier management remains critical. Major knowledge gaps persist in pathogenesis, rapid diagnostics, and novel therapeutics, which demand intensified research to address this evolving threat.
