ETIDIOH - NEW

  Abstract The ongoing panzootic of the highly pathogenic avian influenza (HPAI) H5N1 virus, dominated by clade 2.3.4.4b, constitutes a significant global threat to wildlife, animal health, and public health . Once characterized by sporadic outbreaks, H5N1 has evolved into a sustained, year-round infection with an expanded host range that now includes numerous mammalian species . Its high pathogenicity is primarily driven by the acquisition of a polybasic haemagglutinin cleavage site , enabling systemic viral spread , alongside emerging endothelial and neurotropic properties that contribute to severe disease and high mortality in mammals . Although zoonotic transmission remains limited, H5N1 continues to accumulate mutations associated with mammalian adaptation , particularly within the haemagglutinin and polymerase complex . Notably, recent outbreaks in U.S. dairy cattle highlight the emergence of novel mammalian reservoirs with increased human exposure risk. Concurrently, vaccina...

  Summary Background Difficult-to-treat resistant (DTR) Gram-negative infections show resistance to all first-line antibiotics (ie, β-lactams and fluoroquinolones) and have a 40% greater mortality rate than susceptible infections . New antibiotics are now available with improved safety and efficacy and with in-vitro activity against DTR infections; however, their influence on the outcomes of patients with DTR infections remains unclear. We aimed to evaluate whether and why mortality in patients with DTR infections has changed since the introduction of these newer antibiotics in the USA. Methods In this retrospective cohort study in the USA, adult patients (aged ≥18 years) with a DTR Gram-negative infection , defined as microbiological evidence of DTR Enterobacterales, Pseudomonas aeruginosa , or Acinetobacter baumannii and receipt of at least 3 consecutive days of any antibiotic therapy , were identified from hospitals reporting microbiology data in the PINC-AI Healthcare Database....