Baobab Index

Antimicrobial resistance (AMR) is a growing global health threat, particularly in sub-Saharan Africa. Klebsiella spp., as opportunistic pathogens, are commonly associated with urinary tract and wound infections, with an increasing prevalence of MDR and ESBL-producing strains. This study aimed to characterize the phenotypic antimicrobial resistance patterns of Klebsiella spp. isolates in Togo and to evaluate the extent of multidrug resistance using the multiple antibiotic resistance (MAR) index. A multicenter cross-sectional study was conducted between October 2024 and June 2025, including 409 clinical isolates obtained from urine and wound samples across major healthcare facilities nationwide. Identification was performed using standard microbiological methods, complemented by API 20E and VITEK 2 systems where required. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method and interpreted according to the Clinical and Laboratory Standards Institute (CLSI) M100 (2024) guidelines. ESBL production was assessed using the Double-Disk Synergy Test (DDST), and MAR index were calculated. Urinary isolates accounted for 80.2% of cases, with a slight female predominance (51.6%). Klebsiella pneumoniae subsp. pneumoniae was the most prevalent species (76.5%), followed by Klebsiella oxytoca (15.1%). Overall, 92.4% of isolates were MDR and 7.6% XDR. High resistance rates were observed for cephalosporins (85.8%), fluoroquinolones (81.4%), and sulfonamides (79.7%), while carbapenems and amikacin remained largely susceptible (< 6%). ESBL production was identified in 38.1% of isolates. The mean MAR index (0.258 ± 0.123) exceeded the critical threshold in most cases. These findings highlight a high AMR burden and the urgent need for strengthened surveillance and antimicrobial stewardship in Togo.

Enterococcus faecium, a member of the human gut microbiota and the second most abundant enterococcal species after E. faecalis, is an important agent of healthcare-associated infection. Its high capacity to acquire antimicrobial resistance genes (ARGs) makes infections difficult to treat. This study investigated ready-to-eat (RTE) meat products, typical of central Italy, as potential vectors of antibiotic-resistant enterococci, focusing on E. faecium. A total of 148 enterococcal strains, 36 of which were identified as E. faecium, were isolated. Among 22 distinct clones, eight were resistant to tetracycline (TET), two also to linezolid (LZD), and one showed a multidrug-resistance phenotype. Antibiotic susceptibility was determined by minimum inhibitory concentration testing, supported by whole-genome sequence analysis. Both LZD-resistant strains harbored LZD resistance genes (optrA or a combination of optrA and poxtA), while only one isolate demonstrated horizontal gene transfer via conjugation. The isolates were further characterized for virulence factors and biofilm formation capacity, both under basal conditions and following exposure to simulated upper gastrointestinal transit. All eight TET resistant strains presented genotypic virulence traits. Following exposure to simulated upper gastrointestinal transit, these isolates demonstrated high survival rates, maintaining both their antibiotic resistance phenotypes and biofilm-forming capacity. These findings highlight the potential role of the analyzed RTE meat products as vehicles for virulent and antibiotic-resistant E. faecium strains capable of surviving upper gastrointestinal exposure. The study underscores the need to implement enterococci surveillance in the food sector to improve monitoring of resistant E. faecium and to limit its possible dissemination and association in clinical risks.

The swine production chain represents a critical point for the spread of antimicrobial resistance, with slaughterhouses acting as potential hotspots for cross-contamination. The veterinary use of phenicols may promote resistance to oxazolidinones, a last-resort class of antibiotics. This study investigated the presence of oxazolidinone-resistant enterococci in a pig slaughterhouse in central Italy, analyzing 376 samples, 25.8% of which tested positive for

Advances in artificial intelligence (AI)-driven bioinformatics promise democratized discovery, yet major inequities persist. Equitable adoption of bioinformatics tools will require sustained investment in infrastructure, training, institutions, and global communities, not just access.

Graph neural networks (GNNs) are increasingly used for medical imaging analysis and biological data modeling, where the integration of radiomics, topology, geometry, and generative artificial intelligence (AI) may improve representation learning from medical images and related biomedical data. Across the reviewed literature, GNNs show particular value for modeling spatial relationships, multimodal interactions, graph-structured biological networks, and non-Euclidean imaging features that are difficult to capture using conventional convolutional architectures alone. Topology- and geometry-aware approaches further expand this capability by encoding multi-scale structure, higher-order relationships, curvature, geodesic organization, and equivariant spatial priors. Hybrid graph-transformer models and generative graph methods represent emerging directions for modeling long-range dependencies, augmenting scarce datasets, supporting synthetic pretraining, and improving representation learning in low-label or heterogeneous biomedical settings. However, clinical translation remains limited by variability in graph construction, limited external validation, computational cost, scalability constraints, interpretability challenges, and uncertainty regarding the biological realism of synthetic data. Overall, this review highlights that GNN-based medical imaging analysis is most likely to advance when graph construction is biologically justified, model performance is evaluated across diverse clinical cohorts, and technical gains are paired with transparent validation, interpretability, and implementation strategies.

Tuberculosis (TB) is the leading global cause of death from a single infectious agent. Recent reductions in global health funding have threatened TB control, making comprehensive assessment of TB, HIV-related TB, and drug-resistant TB burdens before these disruptions essential for shaping effective responses. The WHO End TB Strategy sets targets of a 95% reduction in TB deaths and a 90% reduction in TB incidence between 2015 and 2035. Using results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, this study aims to assess the burden of TB and multidrug-resistant TB (MDR-TB) across 204 countries and territories, and to evaluate progress towards the WHO End TB incidence and mortality targets. We quantified TB mortality using the Cause of Death Ensemble modelling platform with global vital registration, surveillance, verbal autopsy, and minimally invasive tissue sampling data. For TB morbidity estimation, we simultaneously modelled incidence, prevalence, and mortality by age and sex using DisMod-MR 2.1. A population attributable fraction (PAF) approach was applied to stratify morbidity and mortality estimates by HIV and drug-resistance status. We also calculated disability-adjusted life-years (DALYs) as the sum of years of life lost and years lived with disability. For the risk factor analysis, a comparative risk assessment framework was used and PAFs were derived for alcohol use, smoking, and high fasting plasma glucose to determine the proportion of TB burden associated with these risk factors. In 2023, there were an estimated 9·11 million (95% uncertainty interval 8·04-10·3) incident cases of all-form TB, 1·22 million (0·98-1·49) deaths, and 54·6 million (43·8-65·5) DALYs globally. HIV-related TB comprised 781 000 (690 000-879 000) incident cases and 210 000 (142 000-279 000) deaths, contributing 11·0 million (7·56-14·3) DALYs. MDR-TB accounted for 466 000 (198 000-1 080 000) incident cases, 102 000 (31 700-238 000) deaths, and 3·96 million (1·31-9·01) DALYs. From 2015 to 2023, global all-form TB incidence rates declined by 19·2% (17·8-20·5) and deaths declined by 22·6% (4·7-35·7); declines were larger for drug-susceptible TB than for MDR-TB. Sub-Saharan Africa and south Asia had the highest mortality burdens in 2023; reductions in all-form TB incidence and mortality were uneven between 2000 and 2023, with limited progress in both measures in Latin America and the Caribbean. Removing smoking, alcohol use, and high fasting plasma glucose would reduce global TB deaths to 768 000 (592 000-970 000) and DALYs to 34·9 million (27·8-43·8) in 2023; MDR-TB deaths would decrease to 77 200 (23 400-183 000) and DALYs to 3·12 million (1·03-7·29). Global progress towards WHO End TB targets is disparate and fragile. Although many regions achieved meaningful gains, others have stagnated in recent years. The complexity of TB prevention is amplified by divergent MDR-TB trends, the persistent burden of HIV, and growing exposure to modifiable risk factors. Recent volatility in global health financing threatens to further destabilise this vulnerable epidemiological landscape; concerted action is urgently needed to temper disruptions and preserve progress. Gates Foundation.

Soil microbiomes are critical for ecosystem functioning, yet the global influences of climate and agricultural practices on their diversity and structure remain incompletely characterized. Here we analyzed 1921 soil samples from 33 countries worldwide across diverse biomes to assess how climate gradients and agricultural inputs, including pesticides and fertilizers, shape prokaryotic and fungal communities. We found that microbial diversity peaks at intermediate temperatures and differs markedly between natural and agricultural soils, with agriculture increasing microbial diversity while altering community composition and ecological guilds. Pesticide use selectively reduced bacterial diversity and shifted fungal guilds, decreasing ectomycorrhizal fungi while increasing saprotrophs, whereas fertilization reduced microbial network cohesion, with organic and inorganic fertilizers eliciting distinct community responses. These findings reveal that climatic factors and agricultural management jointly influence soil microbial diversity, community structure, and network connectivity, with implications for soil health and ecosystem resilience in managed landscapes. Overall, our results demonstrate that agricultural practices, including the use of pesticides and both organic and inorganic fertilizers, act as strong ecological filters that reshape soil microbiomes worldwide-enhancing apparent diversity but driving a functional shift toward less mutualistic, more fragmented, and potentially less resilient communities.

Cameroon lacks a national screening algorithm for Human papilloma virus (HPV) infection. In order to standardize HPV screening using molecular detection tools in Cameroon, this study aimed to evaluate the concordance of HPV detection via two multiplex systems and profile the epidemiology of High-risk oncogenic HPV (HR-HPV) circulating locally. A cross-sectional study was conducted on endocervical samples collected among women in Cameroon. HR-HPV detection and genotyping was done using Abbott and Sacace kits simultaneously. Discordant results were retested using Anyplex II HPV28 kit. Of 364 participants enrolled (median-age: 42 [IQR:34-50] years), overall HR-HPV positivity was 21.4% (78/364) versus 15.4% (56/364) using Abbott and Sacace, respectively. Detection concordance between the test kits was strong (kappa-value = 0.8). Of 22 samples with discordant results, 86.36% (19/22) were further confirmed with Anyplex II HPV28; yielding an overall HR-HPV positivity prevalence of 20.6% (75/364), with 12 genotypes circulating. The most prevalent genotypes were HR-HPV_16 (18.8%), HR-HPV_18 (16.0%), HR-HPV_39 (16.0%), and HR-HPV_58 (13.0%). Discrepancy in the detection of different and/or same genotype was more prominent for HPV 18 (6/9). Though Sacace is suitable to further discriminate among genotypes, cost-analysis showed that Abbott was 50.6% cheaper in reagents per test. This study revealed a strong concordance between Abbott and Sacace kits for HR-HPV detection, demonstrating interoperability of these two multiplex systems available locally.

Human cytomegalovirus (CMV) is a globally widespread pathogen associated with significant morbidity in immunocompromised individuals. Despite its clinical importance, no licensed vaccine is currently available. This study aimed to design a rational multi-epitope vaccine candidate targeting CMV using an integrative approach combining immunoinformatics and structural biology. Viral proteins were screened to identify epitopes with high affinity for B cells, cytotoxic T cells (CTLs), and helper T cells (HTLs) using the Immune Epitope Database (IEDB). Selected epitopes were filtered according to their antigenicity and toxicity and then assembled into a chimeric construct incorporating an immunostimulatory adjuvant. The designed vaccine was evaluated for its physicochemical properties, validated by Ramchandran and ERRAT analyses. Molecular modeling demonstrated strong and stable interactions with key innate immunity receptors, including TLR7 and TLR9, interactions confirmed by molecular dynamics simulations. In silico immune simulation predicted a robust and durable immune response, characterized by high levels of IgM and IgG, as well as significant activation of CD4 + and CD8 + lymphocytes and innate immunity components. These results highlight the potential of the proposed multi-epitope construct as a promising vaccine candidate against HCMV. However, experimental validation is essential to confirm its immunogenicity, safety, and translational applicability.

Chronic filarial infections remain a global health burden, with limited adulticidal therapies highlighting the need for new drugs. We explored repurposing human GPCR antagonists, including clemizole, pimozide, proroxan, and suloctidil, along with 45 rationally designed analogs for activity against Brugia pahangi and two Onchocerca species. Of those, 27 showed in vitro adulticidal activity. In vivo, clemizole and analog C-8 significantly reduced worm burden by 60.5% and 50.8%, respectively, while S-17 and PMZ-6 modestly reduced worm burden (36% and 25%, respectively); however, all three significantly reduced worm fecundity. C-8 also downregulated GPCR expression in surviving adult females after in vivo treatment. Radioligand binding assays revealed selective human GPCR affinities, with clemizole and suloctidil analogs having increased parasite selectivity. Caenorhabditis elegans reverse genetics screen identified gar-3 and ser-7 as putative nematode targets of clemizole and its analogs. Clemizole, C-8, and S-17 represent promising leads for further optimization as antifilarial drugs.