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PubMed2026

Drug-resistant genes, virulence characteristics, and molecular typing of clindamycin-resistant Streptococcus agalactiae in late pregnancy.

BACKGROUND: Streptococcus agalactiae increases the risk of adverse pregnancy outcomes and neonatal infections. Clindamycin is a key alternative for intrapartum prophylaxis in penicillin-allergic women, but the prevalence of clindamycin-resistant S. agalactiae is increasing, posing a significant clinical challenge. METHODS: A total of 178 strains isolated from tertiary hospitals in Jinan and Qingdao, Shandong Province, China, were characterized using antimicrobial susceptibility testing, whole-genome sequencing, multilocus sequence typing, serotyping, and analysis of resistance and virulence genes. RESULTS: All strains were susceptible to penicillin, ampicillin, linezolid, vancomycin, and tigecycline. In contrast, resistance rates to erythromycin, levofloxacin, and tetracycline were 95.5%, 60.1%, and 56.7%, respectively. Six serotypes and 15 sequence types belonging to eight clonal complexes were identified. Notable regional differences were observed. The Ib-ST10-CC12 lineage dominated in Jinan, whereas V-ST529-CC327 was predominant in Qingdao. The resistance gene mreA was ubiquitous (100%), followed by ermB (80.3%). The key virulence genes cylE, hylB, and pavA, were detected in all strains. fbsA (99.4%), the alpha protein family (98.9%), cfb (98.3%), the Pilus Island gene cluster (94.9%), and lmb (92.7%) were also highly prevalent. The two major clindamycin resistance genes, erm and lnuB, exhibited distinctly different enrichment patterns among S. agalactiae clonal complexes, despite a certain overlap in CC19 and CC327. Specifically, erm was significantly enriched in CC12 (serotype Ib), CC19 (III/V), and CC327 (III/V). In contrast, lnuB was predominantly restricted to CC19 and CC327, where it defined a unique phylogenetic subcluster. Significant differences in resistance and virulence gene profiles were observed across different clonal complexes. CONCLUSION: Clindamycin-resistant S. agalactiae in late-pregnancy women in Shandong Province, China exhibits a broad resistance spectrum, diverse molecular types, and significant regional heterogeneity. These findings underscore the need for continued surveillance and region-specific strategies for preventing neonatal S. agalactiae infections.

Humans↗

PubMed2026

The inoculum effect of methicillin-susceptible Staphylococcus aureus on cefazolin and other antimicrobial agents.

UNLABELLED: The inoculum effect (IE) refers to a reduced susceptibility of methicillin-susceptible Staphylococcus aureus (MSSA) to certain antibiotics under high bacterial inocula and may contribute to treatment failure. This exploratory study assessed IE prevalence among 234 nonduplicate MSSA isolates across 11 agents spanning major therapeutic classes, including cefazolin, and characterized IE-positive clones via whole-genome sequencing to inform clinical strategies. Minimum inhibitory concentrations (MICs) were determined by broth microdilution at standard and high inocula. Whole-genome sequencing was performed on IE-positive strains to identify β-lactamase types and conduct multilocus sequence typing. The highest prevalence of IE was observed for trimethoprim-sulfamethoxazole (9.4%), followed by erythromycin (8.8%), linezolid (6.8%), penicillin (6.1%), clindamycin (5.5%), vancomycin (3.8%), cefazolin (3.0%), levofloxacin (1.5%), tetracycline (0.5%), and oxacillin and gentamicin (0.0%). All cefazolin IE-positive strains carried blaZ type A, and ST25 was the most common sequence type (42.9%). For trimethoprim-sulfamethoxazole, erythromycin, and clindamycin IE, ST7 was the most common sequence type (22.7%, 26.7%, and 33.3%, respectively). ST1281 and ST188 were the predominant sequence types among strains exhibiting linezolid IE and vancomycin IE (25.0% and 33.3%, respectively). Among the 234 MSSA strains, 66.7% of ST59, 60.0% of ST25, 58.3% of ST5, and 54.2% of ST7 strains exhibited IE to at least one antimicrobial agent. Cefazolin IE was associated with blaZ type A, and ST5, ST7, ST59, and ST25 were the major sequence types associated with IE across the antimicrobial classes tested. IMPORTANCE: Methicillin-susceptible Staphylococcus aureus (MSSA) can show an inoculum effect on multiple antimicrobial agents, which may reduce antibiotic activity under high-burden conditions. In this study, MSSA isolates from Shanghai exhibited inoculum effects on several commonly used agents, although the overall detection rates were low. Cefazolin inoculum effect was specifically associated with blaZ type A, and several major sequence types were more likely to exhibit this phenotype. These findings improve our understanding of the epidemiology of the inoculum effect in MSSA and may help guide laboratory detection and antimicrobial treatment decisions.

Cefazolin↗

PubMed2026

Clinical and Microbiological Characteristics of Invasive Group A Streptococcus Infection: Four Case Series of Re-Emerging Pathogens.

INTRODUCTION: Group A Streptococcus (GAS), particularly the M1UK lineage, has re-emerged as a major global public health concern following the COVID-19 pandemic, with a rise in invasive GAS (iGAS) and streptococcal toxic shock syndrome (STSS). Although STSS is under national surveillance in Japan, comprehensive molecular monitoring of iGAS infections remains limited, and the clinical characteristics of M1UK-associated iGAS have not been fully elucidated. METHODS: We retrospectively reviewed four consecutive iGAS cases requiring intensive care between March and May 2024. Detailed clinical, microbiological, and genomic investigations were performed to characterize the causative strains and their associated virulence profiles. RESULTS: All patients required respiratory and/or circulatory support with surgical debridement. Three cases involved necrotizing fasciitis, and one involved intra-abdominal infection secondary to ovarian tumor rupture. All four patients received penicillin G and clindamycin as definitive antimicrobial therapy, with two developing severe drug-related adverse events. Genotypic analysis identified three isolates as emm1 strains, including two M1UK lineage strains. The two M1UK isolates commonly harbored multiple superantigen genes. All isolates remained susceptible to β-lactam, clindamycin, and macrolide antibiotics. CONCLUSION: This case series documents the identification of the M1UK lineage among critically ill patients with iGAS infections in Japan. Our findings support the need for continued molecular surveillance while reinforcing the importance of prompt surgical source control and appropriate antimicrobial therapy in the management of severe iGAS.

Group A Streptococcus↗

PubMed2026

Whole-genome sequencing reveals hidden antimicrobial resistance genes in phenotypically susceptible probiotic candidate lactic acid bacteria.

Phenotypic assays commonly used to evaluate probiotic safety may fail to detect clinically relevant antimicrobial resistance (AMR), potentially allowing genetically concerning strains to appear acceptable based on MIC testing alone. To explore this issue, we applied whole-genome sequencing (WGS) to three lactic acid bacteria (LAB) isolates previously identified as probiotic candidates based on acid and bile tolerance, antagonism against enteric pathogens, and biofilm formation in vitro: Lactiplantibacillus plantarum L25F and L22F (from pigs) and Ligilactobacillus salivarius AF2319 (from a chicken). Genome annotation identified extensive repertoires of probiotic-associated genes (46-47 per strain) linked to stress tolerance, adhesion, immunomodulation, and quorum sensing, supporting functional potential. The two L. plantarum strains exhibited broader predicted metabolic capacities than L. salivarius AF2319. However, genomic analysis revealed acquired AMR genes with complex genotype-phenotype relationships not fully apparent from phenotypic testing. The L. plantarum strains harbored lnu(A) (99.79% identity) on extrachromosomal DNA, conferring the L-phenotype (lincomycin resistance, clindamycin susceptibility); clindamycin MICs (1 mg/L) were concordant with this genotype, though lincomycin MICs were not determined. L. salivarius AF2319 carried tet(M), tet(L), and erm(C) (99.48%, 99.49%, and 99.45% identity by ResFinder, respectively) on extrachromosomal DNA; notably, the erythromycin MIC (1 mg/L) was precisely at the EFSA breakpoint (≤ 1 mg/L), representing borderline genotype-phenotype discordance potentially due to silent gene expression. Under current EFSA QPS criteria, these acquired ARGs would preclude all three strains from approval as probiotic feed additives despite favorable functional profiles, underscoring the indispensable role of WGS-based AMR gene detection in modern probiotic safety evaluation.

Probiotics↗

PubMed2026

Emerging trends in invasive Streptococcus dysgalactiae subsp. equisimilis infections in Denmark, 2014 to 2024: a nationwide genomic and registry-based study.

BACKGROUNDIncreasing incidence rates of invasive Streptococcus dysgalactiae subspecies equisimilis (iSDSE) have been detected worldwide.AIMWe aimed to investigate iSDSE infection incidence rates in Denmark during 2014-2024, and characterise the genomic population structure of a subset of iSDSE isolates and their antimicrobial resistance (AMR).METHODSUsing national register data, we estimated overall and sex-/age-stratified iSDSE incidences during 2014-2024, by retrospectively identifying cases of invasive infections with group C and G streptococci or S. dysgalactiae (including specified as subspecies equisimilis). From the voluntary national beta-haemolytic streptococci laboratory surveillance system, whole-genome-sequenced isolates from August 2020-September 2022 were used to investigate the iSDSE genomic population structure. Susceptibility to penicillin, erythromycin and clindamycin was determined and AMR genes identified.RESULTSDuring 2014-2024, iSDSE incidence rates increased significantly (linear trend analysis p < 0.001) with mean annual incidence ranging between 10.3 and 16.4 per 100,000, peaking in 2023. Incidence was higher in males, increasing with older age. Nearly 75% of the 1,223 iSDSE isolates belonged to four of 14 genetic clusters. Sequence types (STs) ST20 and ST17 were most prevalent, while emm-type stG62647, a variant associated internationally with higher virulence, dominated. All isolates were phenotypically susceptible to penicillin but approximately 10% were respectively erythromycin and clindamycin resistant. High erythromycin resistance prevalence (57%; 39/68), coinciding with gene ermA, occurred in one genetic cluster.CONCLUSIONThe findings illustrate the need for national registry-based surveillance to detect epidemiological changes and potential outbreaks. Further, continuous genomic surveillance can monitor the occurrence and expansion of genetic clades and AMR genes.

Denmark↗

PubMed2026

Molecular epidemiology and antimicrobial resistance of human Streptococcus suis isolates in Guangxi, China, 2015-2021.

BACKGROUND: Streptococcus suis (S. suis) is an important zoonotic pathogen and a common colonizer of the upper respiratory tract of pigs. Human infections have been reported in several regions of China, including Guangxi, but genomic and antimicrobial resistance data from this region remain limited. This study investigated the molecular epidemiology, antimicrobial susceptibility, and genomic characteristics of human S. suis isolates collected in Baise City, Guangxi, from 2015 to 2021. METHODS: This retrospective study included 39 non-duplicate clinical isolates confirmed as S. suis by whole-genome analysis. Antimicrobial susceptibility testing was performed using a broth microdilution-based system and interpreted according to the Clinical and Laboratory Standards Institute guidelines. Serotypes were determined by agglutination using type-specific antisera. Whole-genome sequencing was used for species confirmation, multilocus sequence typing, detection of antimicrobial resistance and virulence-associated genes, and core-protein phylogenetic analysis. RESULTS: The median patient age was 55 years, and 36/39 (92.3%) patients were male. Meningitis was documented in 34/39 (87.2%) patients, and hearing impairment occurred in 21/39 (53.8%). Pig- or pork-related exposure was recorded in 15/39 (38.5%) patients. Resistance was highest to tetracycline (38/39, 97.4%), followed by erythromycin and clindamycin (26/39, 66.7% each). Four isolates (10.3%) showed intermediate susceptibility to penicillin, but none were resistant. All isolates remained susceptible to ampicillin, ceftriaxone, levofloxacin, linezolid, vancomycin, and meropenem. Serotype 2 predominated (32/39, 82.1%), followed by serotype 14 (7/39, 17.9%), while ST1 (29/39, 74.4%) and ST7 (7/39, 17.9%) were the two major sequence types. Resistance genes were mainly associated with tetracyclines, macrolides, lincosamides, and aminoglycosides. All ST1 isolates carried mrp and lacked tet(40), while all ST7 isolates showed the reverse pattern. CONCLUSION: Serotype 2 and ST1 predominated among the human S. suis isolates collected at this center. Resistance to tetracycline, erythromycin, and clindamycin was common, while susceptibility to the β-lactams tested was largely preserved. Differences in virulence- and resistance-associated gene profiles were also observed between the major lineages, indicating distinct genetic characteristics among the locally circulating isolates.

Streptococcus suis↗

PubMed2026

Nasopharyngeal Carriage Rate, Risk Factors, and Co-Resistance Patterns of Methicillin-Resistant Staphylococcus aureus in Ethiopia: Systematic Review and Meta-Analysis.

Methicillin-resistant Staphylococcus aureus (MRSA) nasopharyngeal carriage is a major global health concern linked to severe infections and transmission. However, comprehensive evidence on the burden of MRSA carriage, antimicrobial resistance, and associated risk factors in Ethiopia remains limited. This study aimed to estimate pooled prevalence, resistance pattern, and determinants of nasopharyngeal MRSA carriage. PubMed, ScienceDirect, Scopus, Web of Science, Google Scholar, and gray literature were searched for cross-sectional studies published between January 2015 and December 2025. Two groups of reviewers screened studies based on predefined criteria. The risk of bias was assessed using the Joanna Briggs Institute tool. Pooled prevalence and resistance proportions were estimated using a random-effects model, and pooled odds ratios (ORs) were calculated using the Mantel-Haenszel method. Heterogeneity and publication bias were assessed, and a sensitivity analysis was conducted. A total of 1040 records were identified, and 20 studies (6869 participants) were included. The pooled carriage prevalence was 7.3% (95% CI, 5.0-10.8), with substantial heterogeneity (I2 = 95.5%). Resistance was highest to tetracycline (55.75%) and lowest to clindamycin (12.66%). Increased odds of carriage were associated with prior hospitalization (OR, 3.49) and antibiotic use (OR, 2.35). Inconsistent variable coding across included studies limited the inclusion of other potential risk factors. Evidence of publication bias was detected, suggesting that the pooled prevalence should be interpreted with appropriate caution. The findings indicate a considerable burden of MRSA and highlight the need for strengthened antimicrobial stewardship, improved surveillance, and targeted prevention efforts in higher-risk populations. This review was registered in PROSPERO (CRD420251047192).

Ethiopia↗

PubMed2026

Antimicrobial resistance in Staphylococcus pseudintermedius isolated from asymptomatic and symptomatic dogs in Montevideo, Uruguay: characterization of MRSP strains and genetic determinants of resistance.

Staphylococcus pseudintermedius is a common opportunistic pathogen in dogs and an increasing concern in veterinary medicine due to rising antimicrobial resistance, particularly to methicillin. This study aimed to characterize resistance profiles and genetic mechanisms in isolates from healthy and diseased dogs in Montevideo, Uruguay. A total of 133 isolates was analyzed (83 from clinical infections and 50 from asymptomatic carriers). Antimicrobial susceptibility was assessed by disk diffusion following veterinary guidelines. Resistance genes and SCCmec types were detected by PCR. Ten representative isolates underwent whole genome sequencing. High resistance rates were observed for penicillin (81%), erythromycin (49.6%), and clindamycin (45%). Overall, 48.9% of isolates were multidrug-resistant. Phenotypic resistance to oxacillin was detected in 26% of isolates; however, 23% carried mecA gene and were therefore classified as genotypic MRSP. These isolates were more frequent among dogs with clinical infections. These strains showed higher resistance to all antimicrobials tested. SCCmec type V was the most prevalent, and greater genetic diversity was found among isolates from symptomatic dogs. Genomic analysis revealed circulating strains of unassigned sequence types (STs), a variety of resistance genes within specific lineages, the circulation of SCCmec XIV cassette carrying strains, and an Oxacillin-susceptible Methicillin-resistant Staphylococcus pseudintermedius (OS-MRSP) isolate. These findings demonstrate the clinical and epidemiological relevance of S. pseudintermedius in Uruguay and the role of asymptomatic dogs as reservoirs of resistant strains. The results emphasize the need for surveillance, prudent antimicrobial use, and integrated control strategies within a One Health framework.

Animals↗

PubMed2026

Phylogeographic analysis of Staphylococcus nepalensis reveals global occurrence of antimicrobial-resistant lineages carrying the sal(E) resistance gene.

BACKGROUND: Staphylococcus nepalensis is an emerging species first described in 2003 from the respiratory tract of goats in Nepal. We report the identification of S. nepalensis of a hypersaline lagoon in Brazil, along with in-depth phylogeographical and resistome analysis of publicly available genomes. METHODS AND RESULTS: During a local survey from hypersaline aquatic environments in Rio de Janeiro, Brazil, two staphylococcal strains were recovered, designated as COLB and AM1. These isolates were subjected to antimicrobial susceptibility testing, genomic sequencing, and comprehensive phylogenomic analyses. Genomic analysis confirmed the taxonomic identity of COLB and AM1 as S. nepalensis. Both isolates harbored the sal(E) conferring resistance to pleuromutilins and streptogramin A, whereas tet(K) conferring to tetracyclines. Additionally, AM1 carried lnu(A), consistent with the reduced susceptibility to clindamycin (MIC = 2 µg/mL) relative to COLB. Genes associated with arsenic and copper tolerance, and the replicons rep7a and rep19c, were confirmed. Phylogenomic analysis indicated that COLB and AM1 were clonally related (1 cgSNP-difference) but distinct from global isolates. Phylogeographic analysis revealed wide geographic occurrence, with some lineages carrying blaZ and mecA associated with beta-lactamase production and methicillin resistance, respectively. Strikingly, sal(E) is conserved across all S. nepalensis genomes. CONCLUSIONS: The findings confirm the presence of S. nepalensis in South America as early as 2016 and documented among available genomes from environmental, human, and animal-associated sources. Furthermore, reveal the circulation of some lineages carrying clinically relevant antimicrobial genes, underscoring the importance of accurate species identification and continuous genomic surveillance and potential One Health relevance.

Phylogeography↗

PubMed2026

Screening, isolation, and identification of Latilactobacillus sakei strains from kimchi with potential probiotic properties.

UNLABELLED: The study aimed to screen 40 lactic acid bacterial isolates from kimchi types to isolate Latilactobacillus (L.) sakei strains for their probiotic potential. Based on random amplified polymorphic DNA-based initial screening, 16 S rRNA-based phylogeny, and species-specific PCR, three sakei strains (RKA, RKC, and TAB) were selected for evaluating their probiotic and functional attributes. The selected strains demonstrated probiotic characteristics, including acid tolerance (33-85%), bile salt tolerance (49-68%), cell surface hydrophobicity with ethyl acetate (11.5-25.6%) and hexane (21.0-47.4%), and auto-aggregation (12.6-44.0%). The safety of strains was assessed by γ-hemolytic activity and susceptibility to most tested antibiotics, including carbenicillin, clindamycin, chloramphenicol, ampicillin, erythromycin, and tetracycline, with resistance to cefoxitin and metronidazole. Both crude and cell-free supernatants (CFSs) of selected strains were tested for antimicrobial and antioxidant activities, as well as for cytotoxic effects against human colon adenocarcinoma (Caco-2) cells. CFSs displayed DPPH and ABTS radical scavenging activities of 34.1-37.9% and 41.6-43.1%, whereas the crude ranged from 3.9 to 8.7% and 11.0-17.3%, respectively, supported by the presence of the sod and katA genes. All strains showed good resistance to hydrogen peroxide at various concentrations. Notably, RKC showed superior antimicrobial activity against Escherichia coli, Bacillus subtilis, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans, compared to RKA and TAB. No significant cytotoxicity was observed in Caco-2 cells. In summary, these findings indicate the probiotic potential of L. sakei isolates and the preliminary functional properties of their CFSs; further genome-based characterization of selected strains is warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1007/s13205-026-04978-7.

Antimicrobial↗

PubMed2026

Antimicrobial resistance in Staphylococcus spp. isolated from sporotrichosis-affected cats in Brazil: Detection of MRSP and MRSA.

Recently, Brazil has experienced a zoonotic emergence of sporotrichosis. The associated cutaneous lesions are often extensive and slow to heal, thereby providing a gateway for opportunistic bacteria belonging to the normal skin microbiota. Among these, Staphylococcus spp. are of particular concern due to their high prevalence and notable levels of antimicrobial resistance. The objective of this study was to identify and characterize Staphylococcus spp. isolated from the cutaneous wounds of domestic cats undergoing treatment for sporotrichosis and exhibiting clinical signs of secondary bacterial infection. A total of 233 samples from 203 cats were analyzed. Staphylococcus spp. was isolated from 156 samples (67%), with S. aureus (42.3%) and S. felis (25.6%) being the most prevalent. Antimicrobial susceptibility testing revealed high levels of resistance to penicillin (51.9%), erythromycin (28.8%), and clindamycin (19.2%). In contrast, most isolates were susceptible to chloramphenicol (98%), ciprofloxacin (96.7%), and nitrofurantoin (93%). Multidrug-resistant strains were identified in 24% (38/156) of the isolates. Overall, 12 isolates (7.7%) were classified as methicillin-resistant staphylococci, including four methicillin-resistant S. pseudintermedius (MRSP) and one methicillin-resistant S. aureus (MRSA). To investigate the genetic profiles and epidemiological relationships of these isolates, all the MRSP and MRSA strains were subjected to whole-genome sequencing. Among the MRSP isolates, four sequence types (STs) were identified, including ST551, the founder of clonal complex (CC)551, which is commonly associated with infection in dogs. The MRSA isolate belonged to ST1176, a member of CC5, which is a globally prevalent lineage and is frequently associated with nosocomial infections in humans. This study demonstrates that Staphylococcus species, including methicillin-resistant isolates, are frequently present in the wounds of sporotrichosis-infected cats exhibiting clinical signs of secondary bacterial infection. The detection of MRSA and MRSP in a cat highlights an additional public health concern associated with feline sporotrichosis and further reinforces the growing concern regarding antimicrobial resistance in companion animals.

Animals↗

PubMed2026

Canine cholecystitis in the presence of Hammondia spp. infection.

Biliary protozoal infections are becoming increasingly recognized in dogs. Sarcocystidae protozoal infections (i.e Toxoplasma, Neospora, Hammondia, Besnoitia, and Sarcocystis spp.) are uncommon and host-specific. Diagnosis is traditionally dependent on tissue or serologic evaluation; sensitivity and specificity for these techniques can vary. PCR amplification and genetic sequencing provide a technique to expedite diagnosis and species identification in clinical biliary protozoal infections. Bile samples were collected percutaneously from two dogs presented to a referral hospital with mixed hepatopathies and hyperbilirubinemia. Diagnostic imaging revealed changes consistent with hepatobiliary inflammation, and tachyzoites were identified via bile cytology. Sera were positive for anti-Toxoplasma sp. (n = 1/2) and anti-Neospora sp. (n = 2/2) antibodies. Genomic isolation from bile and pan-Sarcocystidae (18S rRNA) PCR amplification were consistent with Hammondia spp. Additional 28S rRNA (LSU), alpha-tubulin (aTUB) and cytochrome b (CytB) gene-specific fragments were PCR amplified and sequenced. Phylogenetic analysis of LSU DNA fragment (584 bp) suggested both patients were infected with Hammondia spp. closely related to H. heydorni. Sequencing of aTUB (234 bp) and CytB (344 bp) revealed Patient 1 Hammondia spp. was more closely related to H. triffittae, while Patient 2 was more similar to H. heydorni. Treatment with clindamycin, and in one case additional enrofloxacin, resolved clinical and clinicopathologic changes in both dogs. This report highlights the importance of multilocus sequencing in protozoal identification in atypical infections, clinical manifestations of canine hepatobiliary hammondiasis, and need for regional Sarcocystidae prevalence studies.

Animals↗

PubMed2026

Identification and in-depth characterization of clinical isolates of Peribacillus frigoritolerans.

UNLABELLED: Peribacillus frigoritolerans is a bacterial species commonly found in the environment and used as a plant-growth promoter and biocontrol agent in agriculture. Recent evidence has proven that Peribacillus spp. are also able to cause severe infections in humans, thus emerging as new human pathogens. In this study, for the first time, 10 P. frigoritolerans strains were isolated from human samples (both superficial and sterile deep body sites) and characterized in terms of morphology, lifestyle, genetics, and virulence. The molecular identification by MALDI-TOF mass spectrometry and 16S rRNA gene sequencing was inconclusive, while whole-genome sequencing was effective in properly identifying isolates within the species P. frigoritolerans. The pangenome analysis provided an overview of the virulence potential of P. frigoritolerans, revealing the presence of genes involved in antibiotic resistance and toxin/exoenzyme production. Phenotypically, the strains displayed different features and behaviors, indicating strain-specific properties and high intra-species variability. A part of the strains exhibited virulence factors, being able to swim and swarm, form biofilms, and produce enzymes and toxins. Antibiotic susceptibility testing revealed resistance to ampicillin for all strains and resistance to erythromycin and clindamycin for some of them. Antimicrobial activity against Gram-positive bacteria and fungi was demonstrated, further corroborating the presence of putative bacteriocin/antimicrobial peptide-encoding genes. An association between the overall virulence potential and infection site/severity was hypothesized. Altogether, these findings highlight the extreme diversity within the species, reveal the strain-dependent pathogenic potential of P. frigoritolerans, and support its role as a candidate human pathogen. IMPORTANCE: This study provides insights into the infectious role of Peribacillus frigoritolerans, an almost unknown bacterial species with agrobiotechnological potential but no history of human infections. This is the first report of P. frigoritolerans isolation from human clinical samples. Ten P. frigorit-olerans strains were herein characterized for their morphology, lifestyle, genetics, and virulence, highlighting an extreme intra-species variability and the potential to act as pathogens in humans. Importantly, this study points out the need for unconventional methods for proper identification of this species, since traditional techniques result inconclusive. Resistance to commonly prescribed antibiotics was also evidenced, confirming the importance of antimicrobial testing on clinical iso-lates. This study lays the foundation for a more in-depth characterization of Peribacillus spp. in the clinical context.

Humans↗

PubMed2026

Longitudinal surveillance of antibiotic resistance and virulence evolution in Clostridioides difficile: a 4-year retrospective study of hospitalized patients in a tertiary hospital in China.

UNLABELLED: Clostridioides difficile (C. difficile) is the primary pathogen responsible for nosocomial infectious diarrhea and pseudomembranous colitis. In China, metronidazole and vancomycin are the preferred treatments for C. difficile infection (CDI). This study aimed to investigate the evolution of vancomycin (VA) and metronidazole (MTZ) resistance, as well as the longitudinal changes in virulence over time, using next-generation sequencing, drug susceptibility tests, and analysis of resistance and virulence genes. Additionally, we monitored the emergence of the highly virulent C. difficile strain RT027 and the spread and potential outbreak of C. difficile in the hospital setting. A random stratified sampling method was used to select 114 fecal samples from inpatients at Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, between 2021 and 2024. Clinical data from the enrolled patients were also collected. We conducted antigen and toxin protein detection for C. difficile, strain isolation and identification, drug sensitivity tests, whole genome sequencing, and bioinformatics analysis. This included comparisons of drug resistance genes, detection of toxin genes, and the construction of phylogenetic trees based on pan-genome analysis to investigate the resistance and toxin gene variations in C. difficile. Among the 114 samples collected from Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, no vancomycin- or metronidazole-resistant strains were identified. However, the average minimum inhibitory concentration (MIC) of C. difficile to vancomycin increased annually (H = 33.208, P < 0.05). The average MIC of C. difficile to metronidazole was highest in 2022 but decreased in 2023 and 2024 (H = 41.990, P < 0.05). Notably, in 2024, one C. difficile strain exhibited an MIC for metronidazole at the resistance threshold (2.00 μg/mL). Further Spearman correlation analysis of the strain years with drug sensitivity results revealed a positive correlation between strain years and the MIC levels of vancomycin and metronidazole (r = 0.528, P < 0.05; r = 0.377, P < 0.05). The proportion of toxin-producing strains increased annually, with 100% of strains in 2024 producing toxins, representing the highest proportion compared to the previous three years (X² =11.75, P < 0.05). Both vancomycin and metronidazole remain effective for the treatment of CDI in clinical practice. However, the sensitivity of C. difficile to these two drugs is gradually decreasing, and the rate of toxin gene carriage is also rising in clinical cases. No hospital outbreaks of C. difficile infections were identified in this study. IMPORTANCE: Clostridioides difficile has developed resistance to multiple antibiotics, including cephalosporins, clindamycin, and fluoroquinolones. This has exacerbated the global antibiotic resistance crisis. In China, according to current treatment guidelines, vancomycin and metronidazole are the preferred first-line drugs for treating C. difficile infections. However, there are reports indicating the emergence of new resistance to both vancomycin and metronidazole. Although there is extensive research on the long-term antibiotic resistance of C. difficile abroad, research on the continuous monitoring of antibiotic resistance and potential outbreaks of C. difficile in China is relatively limited. To fill this gap, we studied positive C. difficile strains from a tertiary general hospital in China. Through Next-Generation Sequencing (NGS), drug sensitivity testing, and analysis of drug resistance and virulence genes, we revealed the evolution of C. difficile's resistance to vancomycin and metronidazole, as well as changes in virulence, and monitored the spread within the hospital and potential outbreaks of C. difficile.

Humans↗

PubMed2025

Bacterial skin colonization with a specific Cutibacterium avidum clade as a risk factor for periprosthetic joint infections-a multicenter study.

Cutibacterium avidum is increasingly recognized as a causative agent of periprosthetic joint infections (PJIs), yet data on its pathogenic potential and distinguishing features from commensal strains remain limited. In this multicenter study, we compared 11 C. avidum isolates from PJIs with 32 isolates from healthy skin collected across four European hospitals. We investigated phylogenetic relationships, antibiotic susceptibility, biofilm formation, and bacterial fitness. Phylogenomic analysis revealed two main clades within the C. avidum population. All PJI isolates belonged exclusively to Clade 1, which also included skin isolates. Within Clade 1, gene content analysis showed no consistent genetic differences between PJI and skin isolates. All isolates exhibited moderate to strong biofilm formation, with no significant differences in either data set. Minimal inhibitory concentration (MIC) and minimal biofilm inhibitory concentration (MBIC) values were low and largely concordant, while minimal biofilm eradication concentration (MBEC) values were elevated for all antibiotics except rifampin. One isolate was resistant to clindamycin due to the erm(X) gene. Rifampin consistently showed the lowest MIC, minimal bactericidal concentration, MBIC, and MBEC values. Bacterial fitness, assessed via bacterial quantitative fitness analysis, was significantly lower in PJI isolates compared to skin isolates when all strains were analyzed (P = 0.039), but this difference was not statistically significant when restricted to Clade 1. In conclusion, C. avidum isolates are strong biofilm producers irrespective of clinical origin. PJI isolates are restricted to a single phylogenetic clade, yet lack distinct biofilm or fitness traits within that clade, suggesting that multiple Clade 1 strains may have the potential to cause PJIs. IMPORTANCE Cutibacterium avidum has long been considered a skin commensal, but it is increasingly associated with prosthetic joint infections (PJIs). Despite its clinical emergence, little is known about its virulence potential or how invasive strains differ from commensal ones. This multicenter study provides the most comprehensive comparative analysis to date, integrating phenotypic and genomic data from both PJI-associated and skin-derived isolates. We show that all isolates are strong biofilm formers and that invasive isolates exhibit reduced growth fitness-a phenotype linked to persistence and treatment failure in other pathogens. Notably, all PJI isolates belonged to a single phylogenetic clade, suggesting that specific lineages of C. avidum may be more likely to cause infection. These findings help clarify the biology of this emerging pathogen and provide a foundation for improved diagnostics, susceptibility testing, and future infection prevention and treatment strategies.

Biofilms↗

PubMed2026

Lawsonella clevelandensis: a normal flora that bites deep.

Since its formal description in 2016, Lawsonella clevelandensis-a strictly anaerobic, partially acid-fast bacterium-has been increasingly recognized as a cause of deep-seated abscesses, yet its fastidious nature and absence from routine diagnostic databases contribute to significant underdiagnosis. This narrative review synthesizes current knowledge on its microbiology, expanding clinical spectrum, diagnostic strategies, and treatment, based on a literature search of PubMed and Web of Science up to April 2026. Analysis of 27 documented publications, comprising 18 clinical cases, reveals a potential association with host risk factors including diabetes, immunosuppression, and prior surgical procedures, alongside a notable predilection for fat-rich tissues such as the breast and abdomen. While metagenomic next-generation sequencing and 16S rRNA gene amplification have become indispensable for definitive identification, antimicrobial susceptibility data-derived primarily from a single strain-demonstrate uniformly low minimum inhibitory concentrations for penicillins, carbapenems, clindamycin, and metronidazole, with no acquired resistance genes identified by whole-genome sequencing. However, the absence of established clinical breakpoints and limited tested isolates precludes definitive conclusions about universal susceptibility. Clinicians should maintain a high index of suspicion for L. clevelandensis in culture-negative deep abscesses, particularly those with acid-fast rods, as prompt diagnosis and empirical therapy with β-lactam/β-lactamase inhibitors or carbapenems appear reasonable based on current in vitro and clinical evidence, though further susceptibility surveillance is essential.

Humans↗

PubMed2026

Molecular Characterization of Listeria monocytogenes Isolated from Retail Yak Meat in Nyingchi, Xizang, China.

Listeria monocytogenes is a Gram-positive zoonotic pathogen responsible for listeriosis, a severe foodborne disease with high mortality in humans and animals. This study aimed to investigate the molecular epidemiology and genomic characteristics of L. monocytogenes isolated from raw yak meat in Nyingchi, Xizang, China. A total of 231 yak-related samples were collected in Nyingchi, consisting of 214 retail raw yak meat samples, 14 farm environmental samples, and 3 nearby water source samples. L. monocytogenes isolates were identified and characterized using culture-based methods, PCR serotyping, and whole-genome sequencing (WGS). Bioinformatic analyses were performed for virulence, antimicrobial resistance, and functional gene annotation using KEGG and COG databases. The overall contamination rate of Lm was 13.08% (28/214) for retail raw yak meat samples, whereas no isolates were recovered from 14 farm environmental samples (0.00%, 0/14) and 3 nearby water source samples (0.00%, 0/3). The serotypes of isolates were 1/2a (9/28, 32.14%), 1/2b (7/28, 25.00%), and 1/2c (12/28, 42.86%). These 28 isolates exhibited varied antimicrobial resistance profiles, with universal resistance to trimethoprim-sulfamethoxazole, high resistance to erythromycin and clindamycin, and low resistance to vancomycin. MLST analysis revealed seven sequence types (STs): ST9 (12/28, 42.86%), ST619 (6/28, 21.43%), ST8 (6/28, 21.43%), ST7 (1/28, 3.57%), ST87 (1/28, 3.57%), ST121 (1/28, 3.57%), ST297 (1/28, 3.57%). ST619 isolates harbored multiple virulence genes, including those located on Listeria pathogenicity islands LIPI-1, LIPI-3, and LIPI-4, indicating high genomic potential for virulence. Representative isolate Y2 (ST619) possessed a 3,009,858 bp genome with 3036 coding genes, four genomic islands, and two prophages. Functional annotation revealed enrichment of genes involved in carbohydrate transport and metabolism and amino acid biosynthesis pathways. Our findings provide the first genomic insight into L. monocytogenes contamination in yak meat from Nyingchi, Xizang, China, highlighting the urgent need to strengthen food safety monitoring and hygiene management in this region.

Listeria monocytogenes↗