AbstractBackground. The prevalence of antibiotic resistance continues to rise, rendering many valuable antimicrobial drugs ineffective. Pairwise cyclic ant

Aim Central venous catheters (CVCs) are essential for long-term therapies but carry a high risk of central line-associated bloodstream infections (CLABSIs), which significantly impact patient outcomes and healthcare costs. This study aimed to develop a causal model for CLABSI using expert knowledge to guide future clinical trials and prevention strategies. Methods We constructed a directed acyclic graph (DAG) informed by literature and expert knowledge elicitation. A multidisciplinary team of clinicians, including infectious disease and vascular access experts, participated in interviews and workshops to refine the DAG, resulting in a final model with 30 variables representing CLABSI development. Findings The expert-elicited DAG identified two main pathways, patient-related and CVC-related, each contributing to CLABSI risk. Variables and relationships in the DAG highlighted key patient characteristics, CVC management practices, and overlapping factors influencing infection. This model serves as a novel framework to understand CLABSI causation and supports trial design by identifying confounding factors, causal pathways, and meaningful endpoints. Conclusions/implications Our causal DAG provides a structured representation of CLABSI risk factors, which may support the design of clinical trials examining interventions to reduce CVC-related infections. By clarifying causal mechanisms, the DAG can enhance the specificity of endpoints and improve the rigor of prevention strategies.

Many antibiotics are less effective at killing pathogens under oxygen (O2)-limited conditions. Pathogens frequently encounter O2 limitation within host environments, which helps explain why antibiotic therapies often fail to resolve chronic infections. We are investigating the relationship between O2 availability and drug efficacy in the opportunistic pathogen, Pseudomonas aeruginosa. In agreement with prior work, we demonstrate that P. aeruginosa exhibits antibiotic recalcitrance under hypoxic conditions. We also explore the use of a novel therapeutic, chlorate, which kills P. aeruginosa under O2-limited conditions when the pathogen utilizes anaerobic metabolism (nitrate respiration). Excitingly, we find that chlorate-antibiotic combinations are highly lethal to P. aeruginosa across a wide range of O2 availabilities similar to those the pathogen encounters during infection. Our work demonstrates that we can leverage our understanding of pathogen physiology to propose novel drug combinations that hijack anaerobic metabolism to overcome antibiotic treatment failure in O2-limited environments.

This cohort study examines the patterns of broad-spectrum antibiotic use across defined end-of-life intervals in patients with advanced cancer.

Staphylococcus lugdunensis (SL) can cause infective endocarditis (IE), with unusually high complication and mortality rates. According to the 2023 Duke-ISCVID criteria, blood cultures positive for ...

Childhood mortality remains a major public health challenge in low-income and middle-income countries, particularly in sub-Saharan Africa, despite major advances in universal sanitation and immunisati...

This cohort study examines whether nontuberculous mycobacterial disease is associated with increased mortality risk among solid-organ transplant recipients.

Background Early-onset neonatal sepsis (EOS) is a critical condition primarily caused by maternal–fetal transmission of bacterial pathogens during delivery, with Escherichia coli and Group B Streptoco...

npj Biomedical Innovations - Self-assembled DNA nanocarrier-enabled drug delivery for bone remodeling and antimicrobial applications

This cohort study assesses the association of postoperative antibiotic prophylaxis with surgical site infections and other postoperative outcomes in children undergoing minimally invasive pectus excav...

Scientific Reports - Comparison of antimicrobial resistance in Pseudomonas aeruginosa from intensive care and non-intensive care units and its impact on treatment decisions

This cohort study estimates the incidence and attributable mortality of late-onset invasive Staphylococcus aureus infection among hospitalized infants in the US.

Background/introduction Antipseudomonal antibiotics are frequently used in patients admitted to hospitals. Many of these substances are classified as a reserve or watch status by the WHO. Inappropriat...

This population-based surveillance study investigates trends in the incidence, characteristics, antimicrobial resistance, and outcomes of invasive group A Streptococcus infections among individuals in...

ul { line-height: 1.75; } Measles Cases in 2025As of March 27, 2025, a total of 483 confirmed measles cases were reported by 20 jurisdictions: Alaska, California, Florida, Georgia, Kansas, Kentucky, M...

Bacteroides fragilis group species are the most frequently encountered bacteria involved in anaerobic bacteraemia and associated with high mortality rates. In 2012, we performed the first national ...

Attribution of <em>Salmonella enterica</em> to Food Sources

This systematic review and noninferiority meta-analysis applies bayesian statistics to randomized clinical trials comparing 7 vs 14 days of antibiotic therapy among patients with Gram-negative bloodst...

Chronic obstructive pulmonary disease (COPD) imposes a significant global health burden as the third leading cause of death worldwide. In 2019, COPD was responsible for 3.23 million deaths globally [1...

This qualitative study characterizes clinical decision-making about suppressive antibiotic therapy after prosthetic joint infection and identifies stewardship intervention opportunities to stop or red...

Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection globally. Although antibiotic treatment is highly effective, most infections go undetected and untreated because th...

This cohort study compares surgical site infection outcomes between children undergoing cholecystectomy who received prophylaxis and those who did not.

Despite the availability of a safe and effective vaccine, in 2018, around 350,000 measles cases were reported worldwide, which resulted in an estimate of 142,300 deaths from measles. Additionally, in ...