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New Insights into the Antimicrobial Susceptibility of Stenotrophomonas maltophilia

Stenotrophomonas maltophilia is an opportunistic gram-negative bacillus with intrinsic resistance to a variety of antibiotics. Since clinical trial data are lacking, the optimal antimicrobial regimen is unknown. These factors make S. maltophilia increasingly challenging for the treating clinician. A recent study by Sader and colleagues analyzed the antimicrobial susceptibility of 1,400 S. maltophilia isolates collected from U.S. medical centers between 2019 and 2023. Aztreonam-avibactam, which inhibited 99.6% of isolates at ≤ 8 mcg/mL, was found to have the highest levels of in vitro activity. Trimethoprim-sulfamethoxazole, which has historically been a preferred agent, had slightly lower activity (96.9% susceptible), followed by minocycline (89.2%) and levofloxacin (78.9%). The results from this in vitro study suggest that aztreonam-avibactam may be a highly effective option for treating S. maltophilia infections, especially in multidrug-resistant cases.

Bacterial Vaginosis: Treat the Man, Too

In a randomized trial, treatment of the regular male partner with oral and topical agents was strongly associated with a reduced risk of recurrence of bacterial vaginosis in the female partner.

Malaria Management: From ACT to TACT

Artemisinin resistance of Plasmodium falciparum is expanding in Southeast Asia and in parts of Africa. Among older children and adults in West Africa, the addition of low-dose primaquine to standard artemisinin combination therapy successfully blocked gametocyte survival and parasite transmission.

Measles Vaccination in Adults in 2025

The Centers for Disease Control and Prevention has updated measles vaccination recommendations.

Shortages of Antimicrobial Agents

Shortages of antimicrobial drugs are frequent and represent a danger to patients and to public health.

Noninferiority of Seven vs. 14 Days of Antibiotic Therapy for Bloodstream Infections

In this multinational, noninferiority trial that included more than 3,600 hospitalized patients with bloodstream infections from various pathogens and infectious syndromes, seven days of antibiotic therapy was noninferior to 14 days with respect to death from any cause by 90 days. Patients were excluded if they had severe immunosuppression or foci requiring prolonged treatment, or if their blood cultures yielded Staphylococcus aureus or possible contaminants. Various secondary outcomes were similar between the two groups.

Infectious Disease Updates

Post-COVID Cryptococcosis — Even in Those Without Immunosuppression; Think Tularemia

RSV Vaccination in Severely Immunocompromised Individuals

The antibody response to respiratory syncytial virus vaccination is significantly impaired in many severely immunocompromised individuals.

Agreeing to Care for Unvaccinated Children

Many primary care clinicians choose not to enroll pediatric patients in their practices when the parents disagree with standard childhood immunization. However, such refusal to provide primary care raises significant controversy and ethical concerns.

A Plasma Cell-Free DNA PCR Panel Test for Invasive Mold Disease

Lieu and colleagues performed a retrospective study of patients with suspected invasive mold disease that showed a high degree of concordance between noninvasive plasma cell-free deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) testing and invasive specimen fungal test results.