LITERATURE UPDATE
immunocompromised populations. Understanding early immune responses is crucial, as they precede clinical symptoms; however, comprehensive studies remain limited. This research investigates immune-related genes to improve BM diagnosis and treatment. Mendelian randomisation, differential gene expression analysis, and co-expression network analysis identified key genes associated with BM. Immune cell ratio
calculations and infiltration analyses demonstrated altered immune cell proportions. Spearman correlation analysis revealed relationships between gene expression and immune cell types. Single- cell RNA sequencing, gene set enrichment analysis, and pseudotime analysis explored changes in gene expression and cell proportions across disease stages, focusing on the roles of key genes in specific immune cells. Ring Finger Protein 144B (RNF144B) was
checklist. This review was registered with PROSPERO (CRD42019155379). The search yielded 1503
studies. After the removal of 606 duplicates, 665 from title and abstract screening, and 140 from full-text screening, 92 reports were eligible for inclusion. A further four were removed due to duplicate datasets. The authors included 88 reports and extracted data on 16,441 clinical isolates from 37 countries across all WHO regions, mostly LMICs. For S. pneumoniae (81
Cytospin slide of CSF from a patient with bacterial meningitis which grew Streptococcus pneumoniae when cultured (Wright-Giemsa stain).
Collaborators. Lancet Microbe. 2026 Feb; 7 (2): 101238. doi: 10.1016/
j.lanmic.2025.101238.
identified as a risk gene predominantly expressed in monocytes and neutrophils. Conversely, FYN Proto-Oncogene (FYN) was identified as a protective gene primarily associated with NKT cells. During BM onset, increased RNF144B expression positively correlated with elevated neutrophil levels, while reduced FYN expression correlated with decreased NKT cell levels. During remission and recovery, RNF144B expression and neutrophil proportions decreased, whereas FYN expression and NKT cell proportions increased. NKT cells appeared to play a protective role, with FYN potentially modulating T-cell receptor function in these cells, thereby reducing BM risk. RNF144B and FYN expression exhibit opposing trends in peripheral blood across BM stages, suggesting their potential as biomarkers for diagnosis and monitoring. These findings provide a valuable
reference for early intervention strategies and personalised treatment approaches tailored to specific disease stages in the clinic.
Antimicrobial resistance in bacterial meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae (2010-24): a systematic review and meta-analysis Lazarus G, Caddey B, Dean A et al.; WHO AMR Prevalence Systematic Review
There are fragmented data on the paterns of antimicrobial resistance in the main bacterial pathogens causing meningitis, especially in low-income and middle-income countries (LMICs) where the disease burden is highest. This review aimed to estimate meningitis-specific prevalence of antimicrobial resistance and time trends, globally and for each of the WHO regions, for the main antimicrobials used to treat or prevent meningitis. In this systematic review and meta-
analysis, the authors systematically searched Embase, Global Health Database, and MEDLINE for original, peer-reviewed articles in any language, published between Jan 1, 2010, and May 16, 2024, describing people diagnosed with a microbiologically confirmed meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae, with antimicrobial susceptibility testing results. They excluded reports that did not describe specimen type, sampling period, geographical seting, denominators, or proportions for single- agent and class resistance. They used multilevel random-effect meta-analysis on summary data to estimate the prevalence and time trends of antimicrobial resistance for relevant pathogen-antimicrobial combinations in each WHO region and globally. To assess article quality, they adopted the Microbiology Investigation Criteria for Reporting Objectively (MICRO)
54
WWW.PATHOLOGYINPRACTICE.COM April 2026
reports, 13,295 isolates), prevalence of antimicrobial resistance was highest in the Western Pacific and Eastern Mediterranean regions, ranging across WHO regions from 14.7% (95% CI 4.5–29.5) to 58.0% (34.9–79.5) for
benzylpenicillin (27.4% [19.0–36.6] globally), and from 3.8% (0.0–13.7) to 20.6% (2.2–50.8) for third-generation cephalosporins (3GCs; 8.8% [4.3–14.6] globally). Benzylpenicillin resistance in S. pneumoniae meningitis increased over time in LMICs, whereas benzylpenicillin and 3GC resistance decreased over time in high-income countries. For N. meningitidis (11 reports, 3,001
isolates), prevalence of antimicrobial resistance was highest in the African region, ranging across WHO regions from 9.4% (7.2–11.8) to 44.9% (0.0–100.0) for benzylpenicillin (24.7% [5.3–52.3] globally, increasing over time); from 0.0% (0.0–0.1) to 17.0% (0.0–100.0) for 3GCs (4.6% [0.0– 19.4] globally); and from 0.0% (0.0–0.2) to 17.1% (0.0–100.0) for ciprofloxacin (3.7% [0.0–25.9] globally). Among H. influenzae isolates (five
reports, 145 isolates), 51.2% (0.0–100.0) were ampicillin resistant and 8.4% (0.1–28.4) were 3GC resistant globally; data were insufficient for WHO regions. None of the included reports described all 13 MICRO mandatory items, with a median of four (range one to six) items missing. Treatment of bacterial meningitis is
challenged by a rise of antimicrobial- resistant pathogens, particularly affecting patients in LMICs where access to effective treatment might be limited. These findings call for the strengthening of national antimicrobial resistance surveillance systems to beter tailor treatment guidelines and public health interventions. PPi
Spicy CC BY 4.0 Wikimedia Commons
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56
