Boggio CMT, Veronese F, Armari M
… +4 more, Zavattaro E, Esposto E, Savoia P, Azzimonti B
Clin Microbiol Rev
· 2025 Sep · PMID 40459300
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SUMMARYAtopic dermatitis (AD) is a prevalent chronic inflammatory skin disorder, affecting 10%-20% of the population, characterized by dryness, intense itching, and recurrent rashes. The pathophysiology of AD is multifac...SUMMARYAtopic dermatitis (AD) is a prevalent chronic inflammatory skin disorder, affecting 10%-20% of the population, characterized by dryness, intense itching, and recurrent rashes. The pathophysiology of AD is multifactorial, involving skin barrier dysfunction, immune dysregulation, genetic factors (such as filaggrin mutations), and environmental factors. The skin microbiota also plays a pivotal role in AD, serving both as a target and a driver of the disease. In AD, the delicate balance of the skin microbiota is disrupted, leading to a decrease in beneficial bacteria such as , , and . Concurrently, bacterial pathobionts, notably , proliferate and express their virulence factors excessively. This imbalance exacerbates symptoms by damaging the skin barrier, releasing toxins, and triggering a Th2-driven immune response, thus weakening the skin defenses and making individuals with AD more susceptible to bacterial, fungal, and viral infections, thereby complicating treatment and worsening disease outcomes. Effective AD management requires a thorough understanding of the interplay among the skin microbiota, the immune system, and microbial pathobionts. Strategies that restore the microbial balance, preserve the skin barrier, and modulate the immune response show significant potential for reducing infections and improving AD symptoms, highlighting the microbiota's dual role in AD pathology. This review examines the complex role of the skin microbiota in AD, emphasizing how dysbiosis both drives disease progression and influences immune responses, and vice versa. It also explores emerging microbiota-targeted therapies aimed at improving disease outcomes.
Mainil JG, Nakamura K, Ikeda R
… +6 more, Crombé F, Diderich J, Saulmont M, Piérard D, Thiry D, Hayashi T
Clin Microbiol Rev
· 2025 Sep · PMID 40439404
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SUMMARYAttaching-effacing (AE) lesion- and Shiga toxin-producing (.) (AE-STEC), previously known as "enterohemorrhagic " (EHEC), are responsible for (hemorrhagic) enterocolitis (HC) and hemolytic uremic syndrome (HUS)...SUMMARYAttaching-effacing (AE) lesion- and Shiga toxin-producing (.) (AE-STEC), previously known as "enterohemorrhagic " (EHEC), are responsible for (hemorrhagic) enterocolitis (HC) and hemolytic uremic syndrome (HUS) in humans. The most frequent and pathogenic AE-STEC belong to a few O:H major serotypes that are responsible for the majority of cases and outbreaks worldwide. From time to time, one or another non-major O:H serotype can emerge, causing either local outbreaks or a a progressive increase in clinical cases. One of these minor serotypes is O80:H2, which has been progressively emerging in Western Europe, especially in France, since 2010. AE-STEC O80:H2 are responsible for not only HC and HUS but also invasive infections with bacteremia and internal organ infection. In parallel to their emergence in humans, AE-STEC and enteropathogenic (EPEC) O80:H2 have also been emerging in young calves suffering diarrhea and enteritis and, more rarely septicemia, in Belgium since 2009. In this manuscript, an overview of AE-STEC and EPEC O80:H2 infections in humans and calves is presented, with particular focus on the clinical manifestations, the prevalence and incidence in Western Europe, and the identification of the potential reservoir(s). In addition, the results of a large-scale whole genome-based phylogenetic analysis of 417 published and unpublished genome sequences currently available in the literature and in the NCBI and EnteroBase databases are presented with hypotheses on the origin and evolution of this new hybrid AE-STEC and EPEC serotype.
Clin Microbiol Rev
· 2025 Sep · PMID 40439402
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SUMMARYSexually transmitted infections (STIs) represent a significant global health burden, with over one million new infections occurring daily. In some instances, the prevalence of antibiotic-resistant pathogens is ris...SUMMARYSexually transmitted infections (STIs) represent a significant global health burden, with over one million new infections occurring daily. In some instances, the prevalence of antibiotic-resistant pathogens is rising, which exacerbates the challenge. STIs cause severe complications, including infertility, ectopic pregnancies, pre-term births, and heightened risks of HIV acquisition. These outcomes underscore the need for innovative therapeutic and prophylactic strategies. In this review, we provide a comprehensive analysis of the current state of biologic drug development targeting key STIs, focusing on , , herpes simplex virus type 2 (HSV-2), and . We examine the complexity of host-pathogen interactions that inform biologic drug design, such as multiple mechanisms of infection, immune evasion strategies, and pathogenic latency. We also explore the role of mucosal immunity, highlighting advances in resident memory T cells and cytokine-driven responses that guide therapeutic targeting, concentrating on and , where recent advances in vaccine development appear promising. We conduct a comprehensive survey of platforms, including vaccines, and explore modalities such as monoclonal antibodies and protein therapeutics. Additionally, we examine emerging technologies like nucleic acid-based therapies, microbiome modulation, and phage-based interventions, highlighting their potential against challenging pathogens like HSV-2 and . By examining these established and emerging approaches, this review prioritizes critical opportunities for innovation in biologic therapeutics, addressing unmet needs in STI management. It advocates for integrated strategies leveraging antigenic conservation, host immunity modulation, and novel delivery platforms to achieve durable prophylaxis and effective treatment for high-burden infections globally.
Clin Microbiol Rev
· 2025 Jun · PMID 40434101
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SUMMARYVulvovaginal candidiasis (VVC) affects over half of women during their lifetime. There are two categorization systems for VVC: uncomplicated versus complicated and acute versus recurrent. Most uncomplicated or acu...SUMMARYVulvovaginal candidiasis (VVC) affects over half of women during their lifetime. There are two categorization systems for VVC: uncomplicated versus complicated and acute versus recurrent. Most uncomplicated or acute cases occur in postpubertal premenopausal girls and women as sporadic vaginitis due to . Complicated VVC includes recurrent, chronic, or severe cases, presence of non- species, and/or disease occurring in people with diabetes, immunosuppression, or pregnancy. These classification systems fail to distinguish the two distinct clinical categories of genital candidiasis: estrogen-dependent VVC and estrogen-independent cutaneous candidiasis. These entities are characterized by different pathogenesis, patient demographics, predisposing conditions, symptoms, signs, investigations, differential diagnosis, treatment, and ancillary measures. The current international and national guidelines on VVC are inadequate in their description of the clinical presentation, role and limitations of culture, biopsy findings, and management of cutaneous candidiasis. Progress toward improved patient outcomes will require the interdisciplinary collaboration of researchers and guideline authors to separate these two entities, unify terminology for each, explore the roles of medications and comorbid dermatoses, detail pragmatic and accessible diagnostic processes, define treatment goals, and discuss the long-term management strategies pertinent to each condition.
Theel ES, Kus JV, Grys TE
… +3 more, Ampel NM, Schwartz IS, Zhang SX
Clin Microbiol Rev
· 2025 Jun · PMID 40396718
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SUMMARYAntibody and antigen detection assays continue to play a significant role in the diagnosis of dimorphic fungal pathogens, including complex, , species, species species, and . The performance characteristics of...SUMMARYAntibody and antigen detection assays continue to play a significant role in the diagnosis of dimorphic fungal pathogens, including complex, , species, species species, and . The performance characteristics of serologic and antigen detection assays for these pathogens are variable, however, influenced by multiple factors, including sample type, disease presentation, patient immunostatus, and timing of specimen collection relative to symptom onset. As a result, there is a need for a centralized document summarizing the accuracy of currently available antibody and antigen detection assays for each of these agents, including discussion of individual assay nuances and caveats that should be considered by clinicians and laboratorians alike. In addition, this review provides expert recommendations for the utilization and interpretation of serologic and antigen detection assays for these dimorphic pathogens.
Cho M-Y, Eom J-H, Choi E-M
… +5 more, Yang S-J, Lee D, Kim YY, Kim H-S, Hwang I
Clin Microbiol Rev
· 2025 Jun · PMID 40261032
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SUMMARYRecent advances in therapeutic probiotics have shown promising results across various health conditions, reflecting a growing understanding of the human microbiome's role in health and disease. However, comprehens...SUMMARYRecent advances in therapeutic probiotics have shown promising results across various health conditions, reflecting a growing understanding of the human microbiome's role in health and disease. However, comprehensive reviews integrating the diverse therapeutic effects of probiotics in human subjects have been limited. By analyzing randomized controlled trials (RCTs) and meta-analyses, this review provides a comprehensive overview of key developments in probiotic interventions targeting gut, liver, skin, vaginal, mental, and oral health. Emerging evidence supports the efficacy of specific probiotic strains and combinations in treating a wide range of disorders, from gastrointestinal (GI) and liver diseases to dermatological conditions, bacterial vaginosis, mental disorders, and oral diseases. We discuss the expanding understanding of microbiome-organ connections underlying probiotic mechanisms of action. While many clinical trials demonstrate significant benefits, we acknowledge areas requiring further large-scale studies to establish definitive efficacy and optimal treatment protocols. The review addresses challenges in standardizing probiotic research methodologies and emphasizes the importance of considering individual variations in microbiome composition and host genetics. Additionally, we explore emerging concepts such as the oral-gut-brain axis and future directions, including high-resolution microbiome profiling, host-microbe interaction studies, organoid models, and artificial intelligence applications in probiotic research. Overall, this review offers a comprehensive update on the current state of therapeutic probiotics across multiple domains of human health, providing insights into future directions and the potential for probiotics to revolutionize preventive and therapeutic medicine.
Liu Z, Yang H, Huang R
… +3 more, Li X, Sun T, Zhu L
Clin Microbiol Rev
· 2025 Jun · PMID 40261031
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SUMMARYVulvovaginal candidiasis (VVC) is a prevalent global health burden, particularly among reproductive-aged women. Recurrent VVC affects a significant proportion of this population, presenting therapeutic challenges....SUMMARYVulvovaginal candidiasis (VVC) is a prevalent global health burden, particularly among reproductive-aged women. Recurrent VVC affects a significant proportion of this population, presenting therapeutic challenges. The predominant pathogen, , opportunistically transitions from a commensal organism to a pathogen when microenvironmental conditions become dysregulated. Recently, non- species have gained attention for their reduced antifungal susceptibility and recurrence tendencies. Diagnosis is constrained by the limitations of conventional microbiological techniques, while emerging molecular assays offer enhanced pathogen detection yet lack established thresholds to differentiate between commensal and pathogenic states. Increasing resistance issues are encountered by traditional azole-based antifungals, necessitating innovative approaches that integrate microbiota modulation and precision medicine. Therefore, this review aims to systematically explore the pathogenic diversity, drug resistance mechanisms, and biofilm effects of species. Vaginal microbiota (VMB) alterations associated with VVC were also examined, focusing on the interaction between spp. and pathogenic fungi, emphasizing the role of microbial dysbiosis in disease progression. Finally, the potential therapeutic approaches for VVC were summarized, with a particular focus on the use of probiotics to modulate the VMB composition and restore a healthy microbial ecosystem as a promising treatment strategy. This review addresses antifungal resistance and adopts a microbiota-centric approach, proposing a comprehensive framework for personalized VVC management to reduce recurrence and improve patient outcomes.
Clin Microbiol Rev
· 2025 Jun · PMID 40172233
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SUMMARYLymphatic filariasis (LF), a debilitating tropical disease caused by parasitic filarial worms, , , and , remains a significant public health challenge in tropical and subtropical settings where the disease is ende...SUMMARYLymphatic filariasis (LF), a debilitating tropical disease caused by parasitic filarial worms, , , and , remains a significant public health challenge in tropical and subtropical settings where the disease is endemic. The disease affects millions worldwide, leading to severe disability and social stigma. Following the World Health Assembly resolution WHA50.29 in 1997 encouraging Member States to eliminate LF as a public health problem, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) was established in 2000. The establishment of the GPELF paced the way for global eradication efforts, with commitments from non-governmental organizations and Merck donating the drug ivermectin as long as it is needed to control the disease. The advances in the diagnosis and control of LF have shown promising results, including developing novel diagnostic tools, therapeutic agents, and integrated vector management and surveillance strategies. This review explores the latest advances in our understanding of LF epidemiology, transmission assessments, clinical manifestations, and immune response to infection. We further discuss the current state of diagnostic development, treatment approaches, and control measures, highlighting the importance of continued research in the fight against this disease.
Liu X, Shi F, Zeng J
… +5 more, Bi J, Mo C, Chai Y, Wu B, Xu S
Clin Microbiol Rev
· 2025 Jun · PMID 40172191
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SUMMARYThe oral microbiota, characterized by its complexity and density, is increasingly recognized for its significant association with respiratory diseases and their pathogenesis. Changes in the oral microbiome, includ...SUMMARYThe oral microbiota, characterized by its complexity and density, is increasingly recognized for its significant association with respiratory diseases and their pathogenesis. Changes in the oral microbiome, including shifts in the relative abundance of certain harmful microbes, their byproducts, and virulence elements, have been linked to respiratory disease development and progression. The use of oral microbiome indicators and treatments is essential for the detection, prognosis, and management of respiratory illnesses, providing significant practical benefits. Hence, a thorough understanding of the correlation between oral microbiota and respiratory illnesses is imperative for generating novel therapeutic approaches rooted in the oral microbiota to address these ailments. This review summarizes how oral microbiota are connected to respiratory diseases, explores the mechanisms of their influence, and discusses treatment approaches.
Clin Microbiol Rev
· 2025 Jun · PMID 40111053
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SUMMARYBacillus Calmette-Guérin (BCG) has been the standard treatment for non-muscle-invasive bladder cancer for over 30 years. Despite its proven efficacy, challenges persist, including unclear mechanisms of action, res...SUMMARYBacillus Calmette-Guérin (BCG) has been the standard treatment for non-muscle-invasive bladder cancer for over 30 years. Despite its proven efficacy, challenges persist, including unclear mechanisms of action, resistance in 30%-50% of patients, and significant side effects. This review presents an updated and balanced discussion of the antitumor mechanisms of BCG, focusing on its direct effects on bladder cancer and its interactions with various cell types within the bladder tumor microenvironment. Notably, recent research on the interactions between BCG and the bladder microbiome is also incorporated. We further summarize and analyze the latest preclinical and clinical studies regarding both intrinsic and adaptive resistance to BCG in bladder cancer. Based on the current understanding of BCG's therapeutic principles and resistance mechanisms, we systematically explore strategies to improve BCG-based tumor immunotherapy. These include the development of recombinant BCG, combination therapy with different drugs, optimization of therapeutic regimens and management, and the exploration of new approaches by targeting changes in the bladder microbiota and its metabolites. These measures aim to effectively address the BCG resistance in bladder cancer, reduce its toxicity, and ultimately enhance the clinical anti-tumor efficacy. Bacterial therapy, represented by genetically engineered oncolytic bacteria, has gradually emerged in the field of cancer treatment in recent years. As the only bacterial drug successfully approved for oncology use, BCG has provided decades of clinical experience. By consolidating lessons from BCG's successes and limitations, we hope to provide valuable insights for the development and application of bacterial therapies in cancer treatment.
Kensiski A, Gavzy SJ, Wu L
… +3 more, Mas V, Ma B, Bromberg JS
Clin Microbiol Rev
· 2025 Jun · PMID 40042298
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SUMMARYTransplant recipients require lifelong, multimodal immunosuppression to prevent rejection by dampening alloreactive immunity. These treatments have long been known to lack antigen specificity. Despite empirically...SUMMARYTransplant recipients require lifelong, multimodal immunosuppression to prevent rejection by dampening alloreactive immunity. These treatments have long been known to lack antigen specificity. Despite empirically selected long-term immunosuppression regimens, most allografts succumb to alloimmune responses that result in chronic inflammation and scarring. Additionally, immunosuppressive medications themselves contribute to unintended intestinal dysbiosis and metabolic disorders. This review focuses on the effect of immunosuppressant treatments on alloimmunity, gut microbiome, and metabolism, with a particular emphasis on the effects on metabolic disorders. We also outline the shared and unique microbial and metabolic signatures produced by each immunosuppressant class, underlining their distinct impacts on immunity and metabolic homeostasis. These observations underscore the need for a holistic understanding of these drugs' on- and off-target effects to refine therapeutic strategies, enhance immunosuppression efficacy, and ultimately enhance graft and patient survival. By characterizing these complex interactions, strategies informed by the gut microbiome and host metabolism may offer a promising adjunctive approach to optimizing immunosuppressive regimens and promoting sustained graft acceptance.
Blader I, Goodrum F, Imperiale MJ
… +17 more, Casadevall A, Arias CA, Baumler A, Burnham C-AD, Cuomo CA, Detweiler CS, Forrest GN, Gilbert JA, Lovett S, Maloy S, McAdam A, Newton I, Reguera G, O'Toole GA, Schloss PD, Shade A, Whiteley M
Clin Microbiol Rev
· 2025 Jun · PMID 40013868
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Duarte LF, Carbone-Schellman J, Bueno SM
… +3 more, Kalergis AM, Riedel CA, González PA
Clin Microbiol Rev
· 2025 Mar · PMID 39982077
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SUMMARYAntivirals play important roles in restricting viral diseases. Nevertheless, they act on a relatively limited number of viruses and occasionally display partial effectiveness in some tissues or against escape vari...SUMMARYAntivirals play important roles in restricting viral diseases. Nevertheless, they act on a relatively limited number of viruses and occasionally display partial effectiveness in some tissues or against escape variants. Although vaccination remains the most cost-effective approach for preventing microbial diseases, developing prophylactic or therapeutic solutions for pathogens, such as herpes simplex viruses (HSVs), that effectively reduce their clinical manifestations in the skin has proven exceptionally challenging despite extensive research. Alternatively, a less explored approach for tackling HSV skin infection involves using topical immunomodulatory molecules to potentiate the host's innate antiviral immune responses. When applied directly to herpetic skin lesions where viral antigen is present, this strategy has the potential to elicit virus-specific adaptive immunity. Based on currently available data, we foresee substantial potential for this approach in addressing HSV skin infections, along with additional prospects to advance understanding of skin biology and apply relevant new findings to other dermatological conditions. However, due to the limited number of case studies evaluating this method and its safety profile, particularly in immunocompromised individuals and pregnant women, further research is crucial, especially to assess the effects of immunomodulators in these vulnerable populations. Here, we revisit and discuss the use of immunomodulatory molecules for potentiating the host immune response against HSV skin infection and call for action for increased research and clinical trials regarding the possible benefits of this latter strategy for treating HSV cutaneous disease and recurrences. We also revisit and discuss antivirals and vaccine candidates against HSVs.
Hanft W, Stankiewicz Karita H, Khorsandi N
… +2 more, Vohra P, Plotzker R
Clin Microbiol Rev
· 2025 Mar · PMID 39950806
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SUMMARYMore than 40 types of sexually transmitted human papillomavirus (HPV) infect the oropharyngeal and anogenital mucosa-high-risk types are associated with precancerous and cancerous lesions of the cervix, vagina, vu...SUMMARYMore than 40 types of sexually transmitted human papillomavirus (HPV) infect the oropharyngeal and anogenital mucosa-high-risk types are associated with precancerous and cancerous lesions of the cervix, vagina, vulva, penis, anus, and oropharynx, and low-risk types cause non-malignant disease, such as anogenital warts. Though most HPV infections resolve spontaneously, immunodeficiencies may result in persistent infection and increased risk of HPV-related sequelae. The mechanism by which HPV results in malignant transformation is multifaceted, involving interactions with numerous cellular pathways, the host immune system, and potentially the host microbiome. Vaccination against HPV is highly efficacious in the prevention of infection and related sequelae, and there now exist several approved formulations that protect against both high- and low-risk types. Despite the advent of vaccination, early detection and treatment of cervical and anal precancerous lesions continues to be integral to secondary prevention-molecular HPV testing, cytology, and tissue biopsy allow for triaging of patients, after which appropriate treatment with close follow-up can avert cancer development.
Liatsos GD, Mariolis I, Hadziyannis E
… +2 more, Bamias A, Vassilopoulos D
Clin Microbiol Rev
· 2025 Mar · PMID 39932308
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SUMMARYFor several decades, intravesical Calmette-Guérin (iBCG) immunotherapy has been the gold standard adjuvant treatment for high-risk and selected intermediate-risk patients with non-muscle-invasive bladder cancer (...SUMMARYFor several decades, intravesical Calmette-Guérin (iBCG) immunotherapy has been the gold standard adjuvant treatment for high-risk and selected intermediate-risk patients with non-muscle-invasive bladder cancer (NMIBC). In this review, the mechanisms of iBCG immune-mediated anti-cancer activity and resistance are presented. Furthermore, a literature review of short-term and systemic iBCG-related side effects was performed. A high incidence (75.5%) of iBCG-related short-term, self-limiting adverse events was observed, while more severe iBCG-related local/systemic complications (iBCG-rL/SCs) that required medical treatment or hospitalization occurred at a lower rate (2.35%). Disseminated was the most common form of iBCG-rSCs, while two-thirds of the cases were classified as infectious. The implementation of molecular-based techniques resulted in significantly higher diagnostic rates. Anti-tuberculous treatment (ATT) is the mainstay of treatment, while in patients with any iBCG-rL/SC form involving the vasculature, ATT should be combined with surgery. Local and osteoarticular forms have the lowest mortality, but their management necessitates severe and debilitating surgical procedures. The overall iBCG-attributed mortality in patients with iBCG-rL/SC was 7.4%, with disseminated, vascular, and lung involvements exhibiting the highest rates. Given the global shortage of BCG for the last two decades, as well as the paucity of effective options for iBCG-refractory or relapsing NMIBC patients, new therapeutic strategies are being tested with promising early results.
Rodriguez E, Tzeng Y-L, Berry I
… +3 more, Howie R, McNamara L, Stephens DS
Clin Microbiol Rev
· 2025 Mar · PMID 39887238
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SUMMARYThe human pathogen () is the causative agent of invasive meningococcal disease (IMD), usually presenting as meningitis, bacteremia, or sepsis. Unlike , antibiotic resistance in has developed slowly. However, in...SUMMARYThe human pathogen () is the causative agent of invasive meningococcal disease (IMD), usually presenting as meningitis, bacteremia, or sepsis. Unlike , antibiotic resistance in has developed slowly. However, in the last two decades and with the reemergence of IMD following the COVID-19 pandemic, antibiotic-resistant isolates, especially to penicillin and fluoroquinolones, have progressively increased. Recent worldwide studies of penicillin intermediate and resistant isolates and the PubMLST global database reveal a notable increase in fully penicillin-resistant isolates since 2016, mediated by mosaic alleles or the β-lactamase genes and . Fluoroquinolone-resistant isolates, mediated by mutations, have increased since 2005. Also, while still exceptionally rare, four isolates have been identified with third-generation cephalosporin-resistance since 2011. We review the emergence of antibiotic resistance determinants and lineages in the resistance to agents previously or currently used in treatment or chemoprophylaxis, and summarize updated treatment and prevention guidelines for IMD. Special populations (e.g., individuals on complement inhibitors) and antibiotic resistance in urethritis isolates are also reviewed. The increasing number of resistant isolates worldwide affects chemoprophylaxis and treatment options for IMD and emphasizes the need for enhanced global surveillance of antibiotic resistance in .
Clin Microbiol Rev
· 2025 Mar · PMID 39887237
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SUMMARYXenotransplantation, the transplantation of living organs, tissues, or cells between species, carries the potential to address the global shortage of human organs for patients with end-stage organ failure. Recent...SUMMARYXenotransplantation, the transplantation of living organs, tissues, or cells between species, carries the potential to address the global shortage of human organs for patients with end-stage organ failure. Recent advances in genetic engineering have improved prospects for clinical xenotransplantation by reducing immune and inflammatory responses to grafts, controlling coagulation on endothelial surfaces, and modifying viral risks, including the porcine endogenous retrovirus (PERV). Management of infectious risks posed by clinical xenotransplantation requires meticulous attention to the biosecure breeding and microbiological surveillance of source animals and recipients and consideration of novel infection control requirements. Infectious risks in xenotransplantation stem from both known human pathogens in immunosuppressed transplant recipients and from porcine organisms for which the clinical manifestations, microbial assays, and therapies are generally limited. Both known and unknown zoonoses may be transmitted from pigs to humans. Some pig-specific pathogens do not infect human cells but have systemic manifestations when active within the xenograft, including porcine cytomegalovirus/porcine roseolovirus (PCMV/PRV), which contributes to graft rejection and consumptive coagulopathy. The role of porcine endogenous retrovirus (PERV) in humans remains uncertain despite the absence of documented transmissions and the availability of swine with inactivated genomic PERV. New technologies, such as metagenomic sequencing and multi-omics approaches, will be essential for detection of novel infections and for understanding interactions between the xenograft, the host's immune system, and potential pathogens. These approaches will allow development of infection control protocols, pathogen surveillance requirements, and tailored antimicrobial therapies to enhance the safety and success of clinical xenotransplantation.
Ganaie FA, Beall BW, Yu J
… +8 more, van der Linden M, McGee L, Satzke C, Manna S, Lo SW, Bentley SD, Ravenscroft N, Nahm MH
Clin Microbiol Rev
· 2025 Mar · PMID 39878373
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SUMMARY (the "pneumococcus") is a significant human pathogen. The key determinant of pneumococcal fitness and virulence is its ability to produce a protective polysaccharide (PS) capsule, and anti-capsule antibodies medi...SUMMARY (the "pneumococcus") is a significant human pathogen. The key determinant of pneumococcal fitness and virulence is its ability to produce a protective polysaccharide (PS) capsule, and anti-capsule antibodies mediate serotype-specific opsonophagocytic killing of bacteria. Notably, immunization with pneumococcal conjugate vaccines (PCVs) has effectively reduced the burden of disease caused by serotypes included in vaccines but has also spurred a relative upsurge in the prevalence of non-vaccine serotypes. Recent advancements in serotyping and bioinformatics surveillance tools coupled with high-resolution analytical techniques have enabled the discovery of numerous new capsule types, thereby providing a fresh perspective on the dynamic pneumococcal landscape. This review offers insights into the current pneumococcal seroepidemiology highlighting important serotype shifts in different global regions in the PCV era. It also comprehensively summarizes newly discovered serotypes from 2007 to 2024, alongside updates on revised chemical structures and the de-novo determinations of structures for previously known serotypes. Furthermore, we spotlight emerging evidence on non-pneumococcal Mitis-group strains that express capsular PS that are serologically and biochemically related to the pneumococcal capsule types. We further discuss the implications of these recent findings on capsule nomenclature, pneumococcal carriage detection, and future PCV design. The review maps out the current status and also outlines the course for future research and vaccine strategies, ensuring a continued effective response to the evolving pneumococcal challenge.