Shafie Abdulkadir Hassan, Bashir Abdirahman Guled, Abdifetah Ibrahim Omar Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu, SomaliaCorrespondence: Shafie Abdulkadir Hassan, Email shafici@just.edu.soAbstract: The frequency of emerging infectious diseases has risen over the twenty-first century, driven by anthropogenic pressures including wildlife trade, rapid urbanization, deforestation, and climate change, which increasingly force human, animal, and environmental systems into closer proximity and create conditions favorable to zoonotic spillover. The COVID-19 pandemic exposed vulnerabilities in global health infrastructure while also catalyzing advances in genomic epidemiology and medical countermeasure platforms. This narrative review synthesizes recent peer-reviewed and policy literature (see Search Strategy) on pathogen emergence, the operationalization of the One Health framework, and the intersection of antimicrobial resistance (AMR) with viral outbreaks, including the well-documented rise in empirical antibiotic use and secondary multidrug-resistant infections during acute respiratory pandemics. We also review gaps in laboratory biosecurity, including governance of Dual-Use Research of Concern (DURC), the expansion of high-containment laboratories, and emerging cyberbiosecurity risks. Building on this literature, we propose an integrated preparedness framework organized around three pillars-One Health surveillance, genomic and environmental surveillance, and laboratory biosecurity and governance-with AMR and artificial intelligence (AI) treated as cross-cutting considerations, and with particular attention to the constraints facing low- and middle-income countries (LMICs) and fragile, conflict-affected settings. We argue that strengthening global biosecurity will require decentralized genomic surveillance, sustained local laboratory capacity, and equitable international cooperation, while noting that the feasibility of these measures depends on financing, governance, and workforce constraints that are not yet fully resolved in the literature.Keywords: novel pathogens, biosecurity, One Health, genomic surveillance, antimicrobial resistance, pandemic preparedness, zoonotic spillover, dual-use research of concern
Deka Ahmed Abdi,1,2 Abdullahi Abdi Yusuf,1,2 Aden Mohamed Hirsi,1,2 Ayan Mohamed Hassan,1,2 Ayan Ahmed Mohamed,1,2 Khalid Hussein Ulusow,1,2 Abdihamid Hirsi Abdulle,1,2 Mohamed Mustaf Ahmed3 1Faculty of Medicine and Surgery, Somali National University, Mogadishu, Somalia; 2BENAADIR Research, Consultancy and Evaluation Center, Mogadishu, Somalia; 3Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, SomaliaCorrespondence: Deka Ahmed Abdi, Email dekaahmed150@gmail.comAbstract: Procalcitonin has emerged as a promising biomarker for antimicrobial stewardship; however, its clinical value differs substantially across the antibiotic treatment pathways. Evidence supporting its use to determine whether antibiotics should be initiated remains limited, particularly in patients with suspected sepsis or physiological instability, in whom a low initial concentration cannot safely exclude serious bacterial infections. Its more consistent value appears after empirical treatment has begun, when serial measurements can support clinical reassessment, de-escalation, shorter treatment duration, and earlier discontinuation of treatment. Nevertheless, procalcitonin thresholds and trends should function as decision-support criteria rather than automatic prescribing rules and must be interpreted alongside clinical trajectory, microbiological findings, imaging, organ recovery, infection type, and adequacy of source control. The implementation of this strategy presents additional challenges in resource-limited hospitals, where test availability, turnaround time, repeated measurement, affordability, clinician adherence, and formal stewardship capacity may be inconsistent. Therefore, introducing procalcitonin as an isolated laboratory test may increase expenditure without meaningfully changing antibiotic use. This Perspective proposes selective procalcitonin use among patients already receiving empirical antibiotics whose need for continued treatment remains uncertain, particularly where timely serial testing and structured 24– 72-hour antibiotic review is feasible. In the absence of these conditions, strengthening basic stewardship practices may provide greater value. Therefore, procalcitonin should function as a targeted checkpoint for reassessment and discontinuation rather than as an independent gatekeeper for antibiotic initiation.Plain Language Summary: Procalcitonin is a blood test that may help doctors decide how long a patient needs to be on antibiotics. However, doctors should not use it alone to decide whether to start antibiotics in patients with suspected sepsis because a low result cannot safely rule out a serious bacterial infection. Procalcitonin appears to be more useful after the initiation of treatment. Doctors can use repeated measurements together with the patient’s clinical improvement, laboratory findings, imaging, and control of the infection source to help decide whether antibiotics can be stopped earlier.Resource-limited hospitals may find this approach difficult to implement. Hospitals need affordable testing, rapid results, access to repeat measurements, and regular antibiotic review so that clinicians can act on the findings. Introducing the test without these systems may increase costs without reducing antibiotic use. Resource-limited hospitals should therefore use procalcitonin selectively for patients already receiving empirical antibiotics when clinicians remain uncertain about the need for continued treatment. Where hospitals cannot provide timely repeat testing and structured antibiotic review, strengthening basic antimicrobial stewardship practices should remain the priority.Keywords: procalcitonin, antimicrobial stewardship, antibiotic discontinuation, sepsis, resource-limited hospitals, low- and middle-income countries
Yu L, Fei Q, Lin J, Yang Y, Xu Y. Infect Drug Resist. 2020;13:2083–2091. https://doi.org/10.2147/IDR.S261767 We, the Editors and Publisher of the journal Infection and Drug Resistance, have retracted the published article. After publication, concerns have been raised by a third party in 2025 about the integrity of the data in Figures 1 and 2 of the article. Further investigation conducted by the Journal and Publisher confirmed unusual similarities present in the image panels representative of different treatment conditions in Figures 1 and 2A. When approached for an explanation, the authors responded; they explained that due to the time that has elapsed since the experiments were conducted, the raw data for Figures 1 and 2 is unavailable. As a result, these concerns cannot be corrected. As verifying the validity of published work is core to the integrity of the scholarly record, we are therefore retracting the article. The corresponding author listed in this publication has been informed. We have been informed in our decision-making by our editorial policies and the COPE guidelines. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as ‘Retracted’.
Dung Mai Ba Tien,1,2,* Trung Nguyen Hoang,3,* Minh Tong Duc,3 Outha Thavixay,4 Thanh Bui Duc51Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam; 2Department of Urology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam; 3Department of Military Hygiene, Vietnam Military Medical University, Hanoi, Vietnam; 4Department of Military Medicine, Lao Military Medical Academy, Vientiane, Lao People’s Democratic Republic; 5Department of Surgical Intensive Care, Military Hospital 175, Ho Chi Minh City, Vietnam*These authors contributed equally to this workCorrespondence: Thanh Bui Duc, Department of Surgical Intensive Care, Military Hospital 175, 786 Nguyen Kiem Street, Hanh Thong Ward, Ho Chi Minh City, Vietnam, Tel +84 975 430 258, Email drthanhbd175@gmail.comAbstract: Genital mollicutes, namely Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum, colonize the lower urogenital tract of a substantial minority of healthy adults yet are rarely considered in postoperative urological, andrological or renal transplant infection. This narrative review examines the diagnostic and prophylactic gap they create. Their lack of a cell wall makes Gram staining uninformative and confers intrinsic resistance to beta-lactams and glycopeptides. Routine microbiology also has limited sensitivity: Ureaplasma spp. generally require specialized culture or molecular detection, whereas M. hominis may grow slowly on enriched routine media but is easily overlooked. Reported disease ranges from sterile pyuria and graft pyelonephritis to perinephric or prostatic abscess, encrusting uropathy, recurrent struvite calculi and hyperammonemia syndrome. Commonly recommended perioperative agents provide little or no reliable activity against these organisms. Acquired resistance is strongly regional: among Ureaplasma isolates from North America and Germany, reported resistance to several key agents remains below 8%, whereas Vietnamese surveillance found ciprofloxacin resistance of 76.0% in U. urealyticum and 88.0% in M. hominis; doxycycline and josamycin retained greater activity but were not uniformly active. We propose five pragmatic clinical triggers, compartment-directed sampling and region-aware empiric management while emphasizing that these recommendations rest predominantly on case-level evidence. Prospective surgical studies are needed to define incidence, diagnostic thresholds and the role of screening.Keywords: Mycoplasma hominis, Ureaplasma urealyticum, postoperative infection, urological surgery, antimicrobial resistance, culture-negative infection
Zhongrui Su,1,* Jianliang Huang,2,* Wei Mo,3 Jin Li,4 Qiyu Zeng,1 Huiwen Chen,1 Shuangyin Deng,1 Xueming Xiang,1 Kehua Xiang11Department of Infectious Diseases, Zhangjiajie People’s Hospital, Zhangjiajie Hospital Affiliated to Hunan Normal University, Zhangjiajie, Hunan, People’s Republic of China; 2The Key Laboratory of Carcinogenesis of the Chinese Ministry of Health, the Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, Central South University, Changsha, Hunan, 410078, People’s Republic of China; 3Jishou University, Xiangxi Tujia and Miao Autonomous Prefecture, Hunan, People’s Republic of China; 4Department of Pulmonary Disease, The Fourth People’s Hospital of Yiyang, Yiyang, Hunan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kehua Xiang; Xueming Xiang, Email 747144057@qq.com; 454515869@qq.comBackground: Tuberculosis (TB) remains a major global infectious disease, and novel host-derived biomarkers are needed to improve diagnosis. Circulating microRNAs (miRNAs) are promising biomarkers due to their stability and immune regulatory functions; however, clinically validated TB-associated miRNAs remain limited. This study aimed to identify circulating miRNAs associated with active pulmonary TB.Methods: This study included 90 participants: active pulmonary TB (n=30), cured TB (n=30), and healthy controls (n=30). Candidate miRNAs were screened by pooled plasma miRNA profiling and further examined using three publicly available miRNA datasets. Circulating miR-26b-5p was quantified by RT-qPCR. Associations with active TB status were assessed using logistic regression, and discriminatory performance was evaluated by ROC analysis. Putative miR-26b-5p target genes and enriched pathways were explored using bioinformatic analyses.Results: Microarray screening identified 108 candidate miRNAs, and cross-dataset analysis identified miR-26b-5p as the only overlapping candidate with consistent downregulation. Circulating miR-26b-5p was lower in active TB and higher in the clinically cured group. It remained associated with active-TB status after adjustment for BMI and PLR. miR-26b-5p showed an AUC of 0.867, while the combined model achieved an AUC of 0.956. Bioinformatic analysis identified 74 putative genes, with EP300, GSK3B, and PTEN as network hubs and PI3K-Akt among the enriched pathways.Conclusion: Circulating miR-26b-5p was associated with active pulmonary TB and showed preliminary discriminatory value, supporting its further evaluation as a candidate host-response marker.Keywords: tuberculosis, miR-26b-5p, microRNA, circulating biomarker, immune regulation, inflammation
