Infectious Diseases
Klebsiella and Acinetobacter dominated infection-related newborn deaths in African and south Asian post-mortem study
Tissue sampling of 2,609 neonatal deaths puts Gram-negative bacteria at the centre of empirical treatment; a Lactobacillus add-on modestly raised H. pylori eradication; and high-dose influenza vaccine improved antibody responses in people with HIV.
Vonoprazan-based regimens cleared clarithromycin-resistant H. pylori far more often than PPI regimens
A meta-analysis puts P-CAB eradication at 75% against 53% with PPIs in resistant infection; testing every admitted HIV patient for TB did not beat symptom-guided testing; and an Indian dose-sparing polio vaccine was non-inferior to full-dose IPV on seroconversion.
Updated COVID-19 vaccines still roughly halve hospitalisation, with no new safety signal
A year of new evidence reviewed ahead of the 2026–27 season holds COVID-19 vaccine effectiveness near 53% against hospitalisation in older adults; RSV immunisation protects well but may wane in older adults; and AI sepsis-prediction models look better on paper than they have yet been shown to be at the bedside.
With local antibiotics in place, a week of systemic therapy matched four after bone infection surgery
SOLARIO found a short systemic course non-inferior to a long one, with far fewer side effects. Also: the evidence behind this season's influenza vaccines, a point-of-care mpox PCR that matched the laboratory in Uganda, and a generic tigecycline supplement.
Adding bismuth to amoxicillin-metronidazole lifted H. pylori eradication to about 85% in clarithromycin-resistant infection
A Korean trial finds a better-tolerated rescue for resistant H. pylori. Also: stopping endocarditis antibiotics early on response saved two weeks but tripled relapse, a third of mpox PCR positives in DR Congo were likely environmental DNA, how Pneumosil compares with PCV13, and a generic tigecycline supplement.
Nirmatrelvir-ritonavir does not help long COVID, even for 25 days
RECOVER-VITAL found no benefit on cognitive, autonomic or exertional symptoms at 90 days. Also: case finding beats vaccination in a Bundibugyo model, the thin evidence on neonatal antifungals, and a Baxter vancomycin recall.
Chagas: 30 days of once-daily benznidazole matched the 60-day standard with fewer side effects
A phase 2b trial in Bolivia supports a shorter, gentler benznidazole course. Also: a Class II recall of premixed vancomycin bags, Ebola post-exposure prophylaxis for health workers, and eight years of azithromycin at unscheduled caesarean.
A higher-dose cell-derived flu vaccine beats the adjuvanted egg-based one — except on H3N2
A 7,677-adult phase 3 trial sorts three influenza vaccines by strain, a Bayesian synthesis puts neurocysticercosis behind a quarter of epilepsy in endemic regions, and a Lancet ID argument asks whether sepsis is the right frame for malaria and leptospirosis deaths.
Klebsiella and Acinetobacter dominate neonatal sepsis deaths, and the empirical regimen does not cover them
Post-mortem data from 2,609 neonatal deaths across Africa and Bangladesh put Gram-negative organisms behind three-quarters of infection deaths; artemisinin resistance surveillance is using the wrong threshold in Africa; and a single-dose-plus-booster pneumococcal schedule holds at five and a half years.
Steroids in herpes encephalitis: 209 patients, and still no answer
A meta-analysis finds the randomised evidence for adjunctive corticosteroids too thin to support routine use; testing every admitted patient with HIV for tuberculosis did not beat symptom-based testing; and dihydroartemisinin-piperaquine holds vivax at bay while primaquine waits.
The season's vaccine evidence lands, and sepsis algorithms look better on paper than in wards
Updated COVID-19 vaccines cut hospitalisation by about half across age groups; pooled sepsis prediction models discriminate well in their own datasets and nowhere else demonstrably; and RSV protection for older adults looks weaker in the second season.
Azithromycin clears the bacteria in preschool wheeze and changes nothing, while seven days of antibiotics holds in bone infection
A futility-stopped trial separates bacterial clearance from clinical benefit in preschool wheezing; the annual evidence review for the 2026-27 respiratory season puts numbers on influenza vaccine effectiveness; a point-of-care mpox platform returns results in under 40 minutes in Ugandan clinics; and SOLARIO shortens systemic therapy after orthopaedic infection surgery to a week.
Stopping endocarditis antibiotics on clinical response saved two weeks of treatment, but relapse tripled
POET II tests response-tailored therapy for left-sided endocarditis, bismuth rescued an amoxicillin–metronidazole regimen for clarithromycin-resistant H. pylori, and a third of positive mpox PCRs in DR Congo may have been environmental DNA.
Adding cefixime to azithromycin did not reduce typhoid treatment failure
A South Asian trial of 1831 patients backs azithromycin alone. Also: a mortality signal for cefepime, carbapenem resistance in Asian hospitals, nirmatrelvir for long COVID, and a Baxter vancomycin recall.
Premixed vancomycin under recall, and a caesarean antibiotic that took eight years to reach four in ten operations
Two ready-to-use vancomycin presentations are under an ongoing Class II recall for manufacturing deviations. Plus what adoption of adjunctive azithromycin actually looked like, and a COVID trial that recruited 29 people.
Who actually clears HBsAg on peg-interferon add-on, and a quarter of seizure patients in endemic areas have neurocysticercosis
Pooled individual data from eight trials show functional cure on peg-IFN add-on depends almost entirely on where the surface antigen starts: 37.7% below 100 IU/mL, 2.3% above 1000.
Which hepatitis A vaccine you stock may matter more than you thought
A meta-analysis separates the two inactivated hepatitis A vaccine strains on antibody response; the first mRNA influenza vaccine clears the FDA; and a suction access sheath cuts the inflammatory response after surgery on infected stones.
When severe malaria is called sepsis, and why African artemisinin resistance may be invisible
A proposal to stratify endemic infections on their own terms, evidence that the standard resistance threshold does not transfer to Africa, and the modifiable risks behind infected knee replacements.
HPV vaccine works well in HIV — if it is given before CD4 falls
Pooled seroconversion above 97% for HPV16 across all three vaccine generations, but 71% in those with a CD4 count of 200 or below. Plus what molecular surveillance shows about artemisinin partner-drug resistance in Africa, five mpox rapid tests measured against PCR, the case for combination antifungal therapy, and ivermectin against permethrin for head lice.
MIC-based susceptibility testing is dependable for the drugs that decide a regimen
Pooled across 1,728 isolates, Sensititre MYCOTB matched reference testing closely for rifampicin and isoniazid and poorly for cycloserine. Plus what modelling says about ring versus community vaccination in a Bundibugyo outbreak, thirty-five years of HIV-1 subtype distribution, and why adjunctive steroids in herpes encephalitis remain unsupported.
The season's vaccine evidence arrives, and it is steady rather than dramatic
Two large syntheses set the numbers for COVID-19 and RSV immunisation ahead of the 2026-27 season. Also: maribavir's first large real-world experience in stem cell transplant recipients, and pooled evidence that MIP immunotherapy speeds bacterial clearance in multibacillary leprosy.
What the influenza vaccine actually buys, and a 40-minute mpox result
A season's worth of evidence puts influenza vaccine effectiveness against death in children at 80% and against hospitalisation in older adults at 19% to 43%; a point-of-care platform matched laboratory PCR for mpox in Kampala; and a Vietnamese cluster trial says one priming dose of PCV10 holds at five and a half years.
Testing everyone for TB on admission did not save lives
EXULTANT put sputum, stool and urine Xpert Ultra plus urine LAM into every HIV admission regardless of symptoms — and found no more confirmed tuberculosis started on treatment and no mortality benefit. Plus a shorter antibiotic course for endocarditis, and an oral option that may spare carbapenems.
Shorter antibiotics for endocarditis buy thirteen drug-free days and cost some relapses
POET II shortens left-sided endocarditis therapy safely but with more relapse, post-mortem data from Africa and South Asia put Klebsiella and Acinetobacter at the centre of neonatal sepsis deaths, and nirmatrelvir does nothing for long COVID.
Expanded tuberculosis screening of HIV inpatients did not get more people onto treatment, or reduce deaths
EXULTANT randomised 1,172 hospital admissions in Tanzania and Mozambique to universal Xpert Ultra and urine LAM testing or to symptom-triggered testing. Confirmed tuberculosis started within 72 hours in 16.0% against 15.3%, and eight-week mortality was 25.8% against 28.8%. Separately, dihydroartemisinin-piperaquine cut Plasmodium vivax recurrence from 27.3% to 2.4%.