Nearly half of Iranian E. coli isolates were ESBL producers; a Spanish consensus sets bismuth quadruple therapy for H. pylori

The edition in brief

A systematic review of 368 studies from Iran (2010 to January 2025) found pooled E. coli resistance highest to penicillins (71.7%, 95% CI 65.6 to 76.6) and lowest to fosfomycin (6.8%, 5.2 to 8.5). Phenotypically 47.2% of isolates were ESBL producers, 20.2% AmpC and 14.1% metallo-beta-lactamase producers, and resistance to several agents, including piperacillin-tazobactam, ertapenem and colistin, rose over time. The data are regional and do not describe resistance in India. An FDA supplement was recorded for a generic ketoconazole application; the record gives no detail on what changed. A descriptive case series from one Argentine hospital reported that four of five patients with severe hantavirus pulmonary syndrome given tocilizumab survived to ICU discharge, against none of five eligible untreated patients, but with five patients per group and non-random allocation it cannot guide treatment. A phase 1 trial of an mRNA mpox vaccine candidate in 64 adults found it tolerated, with antibody responses in all participants but neutralising titres that waned by 12 months. The VI Spanish Consensus on H. pylori treatment recommends regimens that reach at least a 90% cure rate empirically, with a 10-day bismuth quadruple regimen first line and a levofloxacin-based quadruple regimen after failure.