Clinical Microbiology Reviews

SUMMARYBacteria can enter a transient state of reduced metabolic activity to survive temporary unfavorable conditions. This phenomenon, sometimes referred to as dormancy, growth arrest, or quiescence, enables pathogen survival inside and outside of their host, with major clinical consequences for the management of infections. From spores to persister cells, these states associated with bacterial dormancy share molecular mechanisms for controlling cellular activity and for responding to related...

SUMMARYThe treatment and prevention of HIV have undergone significant transformations in the 16 years since the last major review of HIV therapeutics published in ASM's Journal of Virology (A. M. N. Tsibris and M. S. Hirsch, J Virol 84:5458-5464, 2010, https://doi.org/10.1128/jvi.02524-09). First-generation antiretroviral medications, many now discontinued, have been replaced by integrase strand transfer inhibitor-based regimens that offer superior efficacy, higher genetic barriers to...

SUMMARYBrucella spp. are highly adapted intracellular bacterial pathogens that remain a substantial global cause of zoonotic disease. The globally distributed species Brucella melitensis, Brucella abortus, Brucella suis, and Brucella canis account for the majority of human infections, reflecting their efficient transmission across animal hosts, and their exceptional capacity to survive and replicate within the intracellular niche. Although animal infections are often clinically silent, human...

SUMMARYThe traditional landscape of dermatophyte infections has changed over the past decade. The emergence and global expansion of Trichophyton indotineae have highlighted the impact of irrational and uncontrolled antifungal and topical corticosteroid use, presented treatment challenges, and highlighted the deficiencies of currently available diagnostic methods. Trichophyton mentagrophytes genotype VII, which has until recently been associated with animal reservoirs, is now associated with...

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SUMMARYAtypical pathogenic Neisseria infections, including disseminated gonococcal infection, primary meningococcal conjunctivitis, and urogenital meningococcal infection, are clinically important yet under-recognized syndromes that challenge traditional species-disease paradigms. The increasing use of whole-genome sequencing has revealed adaptive convergence within the Neisseria genus, providing new insights into the evolution, pathophysiology, and tissue tropism of these infections. This...

SUMMARYScrub typhus, caused by Orientia tsutsugamushi, remains a major cause of acute undifferentiated febrile illness with an expanding global footprint. Early diagnosis is frequently delayed because of nonspecific systemic manifestations and geographic heterogeneity. The eschar, traditionally regarded as a characteristic but unreliable clinical sign, is better understood as a dynamic and biologically active lesion rather than a static cutaneous finding. Accumulating clinical, epidemiologic,...

SUMMARYHuman vascular pythiosis is a rare, life-threatening angioinvasive infection caused predominantly by the oomycete Pythium insidiosum. Unlike ocular or cutaneous pythiosis, the vascular form is defined by arterial wall invasion, long-segment thrombosis, limb ischemia, aneurysmal complications, and high risks of amputation and death. Although P. insidiosum is broadly distributed in freshwater environments, reported human vascular disease remains concentrated in Thailand, indicating that...

SUMMARYTick-borne viral infections have emerged as a significant and growing public health concern. In East Asia, severe fever with thrombocytopenia syndrome (SFTS) has served as a prototypical disease in which pathological analyses have substantially advanced the understanding of disease pathogenesis. SFTS is characterized by profound immune dysregulation driven by viral tropism for plasmablast-lineage B cells, leading to cytokine storm and hemophagocytic syndrome. Complementary analyses of...

SUMMARYHighly pathogenic avian influenza (HPAI) viruses, especially subtype H5N1, have caused major outbreaks in poultry and serious human infections since the first description of "fowl plague" in 1878. Over time, these viruses have expanded their host range, causing huge losses in domestic poultry, spreading among wild bird populations, and occasionally infecting humans. Understanding how influenza viruses adapt and cross species barriers depends on analyzing their fundamental molecular...

SUMMARYStreptococcus suis is a swine pathogen causing significant economic losses and an important zoonotic agent in humans. Southeast Asia is a high-incidence region, where infection is strongly linked to consumption of raw or undercooked pork and occupational exposure to pigs or pork products. Thailand and Vietnam report the highest case numbers, with additional cases in Indonesia (Bali), Malaysia, Singapore, Lao PDR, and Cambodia. Serotype 2 predominates in both humans and pigs, followed by...

SUMMARYMycoplasma pneumoniae pneumonia (MPP) is an acute respiratory infection caused by Mycoplasma pneumoniae (MP) and constitutes the primary cause of community-acquired pneumonia (CAP) among children aged 5 years and older in China. The clinical manifestations of MP-associated respiratory disease in children are diverse, ranging from mild upper respiratory symptoms to life-threatening pneumonia. Notably, during the implementation of nonpharmaceutical interventions (NPIs) aimed at curbing...

SUMMARYLoop-mediated isothermal amplification (LAMP) is a type of isothermal nucleic acid amplification test (NAAT). Compared to more traditional NAATs, like polymerase chain reaction (PCR), LAMP is run at one consistent temperature, utilizes four to six primers, and uses Bst polymerase. Some advantages that are provided by these differences are that LAMP has lower equipment requirements, resiliency to common PCR inhibitors, and a rapid time to result. Unfortunately, some disadvantages are also...

SUMMARYDNA sequencing has revolutionized microbial surveillance in cystic fibrosis (CF), transforming pathogen identification from culture-dependent to total microbial community identification using molecular-based approaches. Techniques such as 16S rRNA gene sequencing have uncovered the complexity of the CF airway microbiome, while shotgun metagenomics, metatranscriptomics, and viromics now provide strain-level, functional, and viral insights beyond bacterial identification. Despite these...

SUMMARYIntra-amniotic infection is the main cause of spontaneous preterm birth and adverse maternal-fetal outcomes; therefore, rapid, robust, and accurate diagnosis remains a clinical priority. Conventional microbiological techniques, especially culture-based methods, are limited by long turnaround times and the inability to detect fastidious or unculturable organisms. This review summarizes the diagnosis, nomenclature, clinical significance, management, and laboratory approaches for diagnosing...