IDSA’s Journal of Infectious Diseases has launched a monthly roundup of JID papers with direct relevance to clinicians. Read on to learn more about a cluster of novel enterovirus cases associated with a child care facility, a new potential strategy to mitigate resistance development in cavitary tuberculosis and other research ready to inform clinical practice. (Titles and summaries are adapted from the September 2025 issue of JID.)
Daptomycin in combination with beta-lactams (cloxacillin or ceftaroline) significantly improves the activity of monotherapies in sterilizing valve vegetations and in preventing daptomycin-non-susceptible isolates in an experimental rabbit model of MSSA endocarditis, supporting potential clinical use and the need for further clinical trial studies.
Tetracyclines (tetracycline, doxycycline, minocycline, tigecycline), but not other relevant antibiotics, inhibit Las B, a metalloprotease enzyme (elastase) that is a critical virulence factor of Pseudomonas aeruginosa. Using in vitro and in vivo models plus computational modeling, this paper shows that tetracyclines sensitize Pseudomonas to neutrophil killing and reduce lung pathology, even for MDR strains.
Cavitary tuberculosis is difficult to cure and constitutes a site of relapse. Emergence of resistance threatens bedaquiline’s tremendous success in multidrug-resistant TB treatment. Using preclinical and human data modeling, pharmacokinetic-pharmacodynamic simulations in TB cavity caseum revealed that bedaquiline only slowly reaches steady state and efficacious concentrations in deep caseum (weeks to months) and lingers at subtherapeutic concentrations up to three years after therapy ends. Slow distribution in and out of recalcitrant site-of-disease may contribute to acquired bedaquiline resistance. Emerging next generation diarylquinolines achieve caseum bactericidal concentrations more rapidly, a potential strategy to mitigate resistance development and guide the design of clinical trials for cavitary TB.
In this nationwide population-based cohort of people with HIV (N = 6,125) followed up to 25 years, no increased risk of cancer following TB disease was observed. These results suggest that standardized cancer surveillance guidelines remain appropriate and that TB is not a major cancer driver in this population.
Early Childhood Antibiotics and Chronic Pediatric Conditions: A Retrospective Cohort Study
Early-childhood antibiotic exposure has been implicated in the development of chronic pediatric conditions, but many studies leave concerns about unmeasured confounding. Using electron health records (United Kingdom, 1987-2020), among 1,091,449 children, repeated exposure to antibiotics before age 2 was associated with heightened risks of asthma, food allergy, allergic rhinitis and learning disorders. Stronger associations were observed following multiple antibiotic courses. Sibling-matched results and a negative control (forearm fracture) outcome suggested minimal confounding bias. However, risks of antibiotic exposure were minimal for most autoimmune, neurodevelopmental and psychiatric conditions studied.
Cerebrospinal fluid from a day care teacher and nasal swabs from symptomatic children were positive for a novel recombinant enterovirus derived from Echovirus E6 and Coxsackievirus B1. These data highlight potential for emergence of new recombinant enterovirus strains with modified virulence and capable of causing meningoencephalitis.