Molds are ubiquitous environmental microorganisms with major implications for human health, ranging from allergic reactions to invasive infections. Although the environmental seasonality of several fungal spores has long been recognized, its reflection in clinical isolates remains poorly explored. A total of 218,682 fungal spectra generated by 97 medical microbiology laboratories across France between 2020 and 2024 were analyzed, based on identifications performed using the MSI-2 MALDI-TOF MS web platform. Seasonal patterns were assessed through additive decomposition, autocorrelation, and formal statistical testing. Distinct seasonal variation patterns were identified across taxa. Significant seasonality was detected for multiple taxa, including Alternaria, Cladosporium, Aspergillus sections Nigri and Flavi, Talaromyces, several taxa of Basidiomycota, and Rhizopus arrhizus. Positive or negative correlations between fungal identification counts and national mean temperature values were observed depending on the taxon. This study highlights the importance of considering seasonality in understanding the epidemiology of fungal diseases and demonstrates the value of multicenter MALDI-TOF MS data as a tool for epidemiological surveillance. Based on identification results from medical microbiology laboratories using MALDI-TOF mass spectrometry and the MSI-2 application, we demonstrate seasonal patterns in the isolation of several mold taxa, including Aspergillus sections Nigri and Flavi, and Rhizopus arrhizus.
Outbreak investigations of two carbapenemase-producing bacteria (CPB)-clusters identified a link to utility room wastewater drains (URWD), prompting an investigation into CPB-colonization of the hospital's URWD and into utility room management to identify possible breaches in infection prevention and control (IPC) measures. At the University Hospital Basel, Switzerland, a cluster of four patients with VIM-1-producing Enterobacter hormaechei and two patients with KPC-3-producing Citrobacter freundii, occurred between 07/2022 - 07/2024. A multidisciplinary team (IPC specialists, nurses, cleaning experts) evaluated utility room management. Wastewater drains in affected patient rooms and 25 utility rooms of the hospital building (including two wards in which the two transmission-cluster occurred) affected by the clusters were screened for CPB-colonization and whole genome sequencing was performed on clinical and environmental CPB isolates. The blaVIM-1 and the blaKPC-3 gene corresponding to both clusters were identified in sequences of Citrobacter freundii and Klebsiella pneumoniae isolates colonizing the ward's URWD. Colonized drains were in proximity to affected patient's rooms, while none of the wastewater drains in the respective patient rooms was colonized with CPB. Overall, CPB were identified in 52% of all URWD. Several breaches in utility room management and design facilitating colonization with CPB and potentially leading to contamination of shared medical equipment by dispersal were observed, including lacking separation between clean and contaminated zones in utility rooms (34%), and improper use of contaminated zones for storage of clean shared medical equipment (88.7%). URWD serve as reservoirs for CPB. Breaches in utility room management and design, potentially leading to contamination of shared medical equipment by dispersal from contaminated wastewater drains, represent an intervention target for prevention of CPB-transmission.
Severe Plasmodium falciparum malaria remains a major cause of paediatric morbidity in sub-Saharan Africa. While mortality has declined in many settings, severe disease requiring escalation of care persists. Data on predictors of intensive care unit (ICU) transfer among children with severe malaria remain limited in Central Africa. This study aimed to describe the clinical and biological profiles of paediatric severe malaria in an urban Gabonese setting and to identify factors associated with ICU transfer as an early marker of clinical deterioration. A retrospective analytical study was conducted at the Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori (CHUMEFJE) in Libreville, Gabon. Medical records of children below 17 years and hospitalised between January 2021 and July 2022 with microscopically confirmed P. falciparum malaria were reviewed. Severe malaria was defined according to WHO 2014 criteria. ICU transfer among survivors was the primary adverse outcome. Clinical, laboratory, and demographic variables were analysed using univariate and multivariable logistic regression. A cumulative count of WHO severe malaria criteria was used as an indicator of disease severity. Among 3.009 hospitalised children, 480 (15.9%) met WHO criteria for severe malaria and were included. The median age was 6 [1-10] years. Overall mortality was low (0.7%), while 8.5% (n = 41) required ICU transfer. Neurological manifestations (64.2%) predominated, particularly prostration (49.2%), impaired consciousness (10.8), and coma (4.2%). ICU transfer was significantly associated with delayed consultation (p = 0.01) and neurological signs (p < 0.01). In multivariable analysis, impaired consciousness (aOR: 14.86; 95%IC [5.58-42.40], p < 0.01) and coma (aOR: 53.3; 95%IC [10.9-178.1], p < 0.01) remained the strongest independent predictors of ICU transfer, whereas isolated biological abnormalities such as severe anaemia or hyperparasitaemia were not. The risk of ICU transfer increased markedly with the number of concurrent severe malaria criteria, especially beyond three criteria (aOR: 10.59; 95%IC [2.38-42.87], p < 0.01). ICU transfer was frequent and primarily driven by neurological and accumulated severity features. Assessing the number of concurrent WHO criteria offers a pragmatic tool for risk stratification. Although conducted in a referral centre capturing the city's transmission heterogeneity, multicentre studies are needed to validate these predictors across diverse healthcare systems. Not applicable.
We report an imported case of co-infection with fascioliasis and schistosomiasis in a 37-year-old patient with no known medical history, originally from Djibouti, a country in sub-Saharan East Africa. The diagnosis was confirmed by the detection of Schistosoma ova, suggestive clinical symptoms, positive serologies to both fascioliasis and schistosomiasis, and the atypical appearance of hepatic lesions on MRI. The patient was in France as a tourist. He was treated with a dual therapy of triclabendazole and praziquantel. His clinical condition improved without treatment-related side effects. This case highlights the necessity to search for these two parasitic infections in the presence of suggestive liver involvement, particularly in case of epidemiological risk.
The intestinal microbiota is essential for maintaining intestinal homeostasis by regulating mucosal immune responses. Identifying bacterial traits that support stable host interactions is therefore crucial for developing next-generation mucosal probiotics. RNase T2 is a conserved ribonuclease with species-specific functions. In Escherichia coli, RNase T2 (RNase I) suppresses biofilm formation, a key process for intestinal colonization. We previously showed that an RNase I-deficient E. coli (Δrna) strain stably colonizes the mouse intestine. Here, we analyzed the immunogenic properties of the Δrna strain. Heat-killed Δrna induced an early IL-1β and TNF-α-skewed cytokine response in RAW264.7 macrophages, with reduced IL-6 expression compared to wild type. In mice, Δrna colonization caused no intestinal tissue injury but enhanced IL-6 and IL-22 expression in the cecum and colon. Selected TLR-specific reporter assays identified TLR5-dependent signaling driven by increased FliC expression. These findings show that RNase I deficiency modulates immune activation while maintaining non-pathogenic mucosal interactions.
SUMMARYThe Aspergillus niger complex, also known as the black aspergilli or section Nigri, comprises a diverse group of filamentous fungi with wide-ranging ecological, industrial, and pathogenic significance. While traditionally associated with food spoilage and industrial fermentation, black aspergilli have emerged as opportunistic pathogens affecting humans, animals, and plants. This review provides a comprehensive synthesis of the taxonomy, ecology, pathogenicity, and antifungal resistance of the A. niger complex. Advances in phylogenetics and whole-genome sequencing have clarified the taxonomy of section Nigri, now comprising six core species in series Nigri. Clinically, A. niger complex is implicated in various conditions, including otomycosis, keratitis, cutaneous infections, onychomycosis, chronic pulmonary aspergillosis, and, less commonly, invasive aspergillosis. In animals, black aspergilli have been isolated from respiratory, cutaneous, and systemic infections, particularly in immunocompromised or stressed hosts. Plant pathogenicity is significant, with A. niger complex contributing to pre- and post-harvest spoilage and producing mycotoxins such as ochratoxin A and oxalic acid. The common finding of elevated minimum inhibitory concentrations (MICs) to triazoles, particularly in both environmental and clinical isolates, raises concern, with underlying mechanisms differing from those characterized in A. fumigatus. Reduced susceptibility is potentially driven by efflux pumps and environmental exposure to azole fungicides. Due to commonly higher MICs, antifungal therapy with itraconazole and isavuconazole may have reduced efficacy, and alternatives such as voriconazole or posaconazole should be considered, guided by susceptibility testing where available. This review emphasizes the need for a One Health approach to managing black aspergilli, integrating surveillance, diagnostics, and targeted interventions across human, veterinary, and agricultural sectors.
The global efforts to eliminate malaria infection are continuing. Certain countries such as Belize and Cabo Verde were declared free status and Iran ended up in the elimination phase, but imported and subsequent autochthonous cases pose a public health challenge. Primary data on autochthonous and imported malaria were collected from Hormozgan province, Iran from CDC surveillance and control programmes between April 2018 and May 2023. Health professionals entered the data of malaria patients into Microsoft Excel and separated them into two categories: public data (demographic and socioeconomic) and clinical symptoms relevant to the local community, such as age, sex, nationality, occupation, residential status, and parasite species. The data was organized and statistical analyses were done using SPSS. The study included 289 cases (including imported and autochthonous cases): 87.5% male, and 12.5% female; Most of them were 11-29 years old. Vivax malaria was found in 78.9% of the total malaria cases. Afghans (imported) represented 56.7%, Pakistanis (imported) 30.8% and Iranians (autochthonous) 12.5%. In 2023, the number of cases reached its peak, especially in Jask County. Asymptomatic cases accounted for 45.25%, and the majority were treated. Imported malaria significantly contribute to maintenance of malaria transmission among native populations and has the potential to increase autochthonous malaria. The issue of illegal entry and unauthorized immigration demand systemic solutions through formal legal processes, such as legalization or deportation. There is a requirement to develop cost-effective approach, including active surveillance, rapid diagnosis, treatment, and follow-up for imported and asymptomatic cases.
Cancer immunotherapy has transformed oncology by enabling durable responses in multiple malignancies; however, its clinical efficacy remains limited by immune evasion, therapeutic resistance, and treatment-related toxicity. In this context, parasites-long considered pathogenic organisms-have emerged as context-dependent immunomodulatory systems capable of reshaping host immunity in both beneficial and detrimental directions. This mini-review critically synthesizes preclinical evidence on parasite-based cancer biotherapy, focusing on protozoa (Plasmodium spp., Toxoplasma gondii, Leishmania spp.) and selected helminths (Trichinella spiralis, Echinococcus granulosus). We emphasize their dual biological role: while certain parasitic infections demonstrate antitumor activity in experimental models, others are strongly implicated in carcinogenesis through chronic inflammation, fibrosis, oxidative stress, and genomic instability. Reported antitumor mechanisms include activation of cytotoxic T lymphocytes and NK cells, modulation of Th1/Th2 immune balance, inhibition of angiogenesis and epithelial-mesenchymal transition, induction of apoptosis, and reprogramming of the tumor microenvironment. In parallel, parasite-derived components such as excretory-secretory products, antigenic proteins, and extracellular vesicles have shown consistent immunomodulatory effects in murine cancer models. Notably, the current evidence base remains largely restricted to preclinical systems, with only limited early translational exploration. Parasite-based biotherapy represents a biologically compelling yet experimentally constrained approach in cancer immunotherapy. Its clinical translation is limited by biosafety concerns, parasite lifecycle complexity, heterogeneity of host-parasite interactions, and lack of standardized delivery platforms. Future work should focus on mechanistic dissection, rigorous safety evaluation, and rational integration with immune checkpoint blockade and other established immunotherapies to enable meaningful clinical advancement.
CADASIL is a hereditary cerebral small vessel disease caused by NOTCH3 mutations, leading to age-dependent vascular and neurological impairments. Despite its clinical impact, the underlying pathogenic mechanisms remain poorly understood, partly because existing murine models often fail to fully replicate the broad pathological spectrum observed in humans. Here, we established and characterized a novel zebrafish (Danio rerio) model carrying the Notch3 p.C680S mutation. Our mutant zebrafish mimicked key age-related CADASIL features, including cerebrovascular dysfunction, telencephalic atrophy, cognitive impairment, and the deposition of granular osmiophilic material (GOM). Integrated transcriptomic and proteomic analyses revealed a significant downregulation of type IV collagen-related molecules, including serpinh1b, col4a1, and col4a2. These molecular findings were corroborated by immunostaining, which confirmed reduced perivascular accumulation of type IV collagen around cerebral blood vessels. Furthermore, AlphaFold 3-based structural modeling categorized the p.C680S variant as a "nonconventional" NOTCH3 mutation. These findings validate the zebrafish as a valuable vertebrate model for CADASIL and raise the possibility that diminished type IV collagen levels contribute to CADASIL pathogenesis, particularly in cases of nonconventional NOTCH3 mutations.
We report a fatal case of a 40-year-old man who developed rhino-orbito-cerebral mucormycosis complicated by central retinal artery occlusion, cavernous sinus thrombosis, and internal carotid artery occlusion. Mechanical thrombectomy was performed for the internal carotid artery occlusion, with subsequent Sanger sequencing of the fungal components within the retrieved thrombus to identify Rhizopus arrhizus. To the best of our knowledge, this is the first report establishing the species-level identification of R. arrhizus in mucormycosis-associated large-vessel occlusion. These findings provide direct histopathological evidence of angioinvasive mucormycosis attributable to R. arrhizus.
Resistance to platinum chemotherapy remains a major obstacle in ovarian cancer treatment and is often associated with overexpression of adenosine triphosphate (ATP)-binding cassette (ABC) transporters such as ABCC2. Agents that retain cytotoxic efficacy in resistant cells through transporter-independent mechanisms may provide a therapeutic advantage. Brefeldin A (BFA), a fungal metabolite with known anticancer activity, was isolated from the endophytic fungus Dactylonectria torresensis and characterized by nuclear magnetic resonance (NMR) spectroscopy. Cytotoxicity and chemosensitization were evaluated using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assays in cisplatin-sensitive (A2780) and cisplatin-resistant ovarian cancer cell line (A2780/RCIS). Cisplatin efflux transporter expression level was analyzed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), while transporter activity was assessed by flow cytometry using 5-carboxyfluorescein diacetate (5-CFDA). Cell cycle distribution and apoptosis-associated cell death (based on Sub-G1 accumulation) were examined by propidium iodide (PI) staining and flow cytometry. BFA exhibited comparable cytotoxicity in sensitive and resistant cells (inhibitory concentration (IC)₅₀ 47.2 ± 2.3 and 53.6 ± 3.8 nM, respectively), indicating that ABCC2 overexpression in resistant cells did not affect cellular responsiveness. Treatment with a non-cytotoxic concentration of BFA did not alter ABCC1/ABCC2 expression or transporter activity. Instead, co-treatment with cisplatin and BFA enhanced G2/M cell cycle arrest and increased the Sub-G1 population in both cell lines, consistent with apoptosis-associated cell death. Co-treatment resulted in a modest increase in cisplatin-induced growth inhibition, suggesting apoptotic priming rather than efflux inhibition. BFA maintains cytotoxic efficacy in cisplatin-resistant ovarian cancer cells through apoptosis-associated mechanisms that are independent of ABCC2-mediated drug efflux. These findings indicate that BFA avoids classical transporter-mediated resistance and could be a candidate for targeting drug-resistant ovarian cancer.
Candida albicans is a common opportunistic pathogen. Genotyping based on the 25S rDNA and mating type locus (MTL) allows for epidemiological and genetic profiling. This study aimed to characterize the genotypes and mating types of C. albicans isolates from various clinical sources in Iran. Ninety-four isolates from clinical samples (saliva, urine, vaginal swabs, and skin scrapings) were cultured on CHROMagar Candida and identified by standard phenotypic methods. Genotyping was performed using CAINT primers, and mating type analysis was conducted using MTLa1 and MTLα1 primers. In this study, 94 isolates of C. albicans from various sources were analyzed. Genotype A was the most frequent (65%), followed by genotypes C (24.5%), B (9.6%), and D (1.1%). Most isolates (97.9%) were heterozygous at the MTL locus, only two isolates homozygous (α/α). Genotype A and MTL-heterozygous strains were predominant among C. albicans isolates, suggesting a consistent molecular pattern across different clinical sources and regions.
Rhino-orbito-cerebral infection is a rare but potentially life-threatening condition that usually occurs in immunocompromised patients. Identification of the causative organism is often challenging. A 71-year-old man without overt immunosuppression, such as corticosteroid use or chemotherapy, presented with visual loss in the left eye and was found to have internal carotid artery occlusion complicated by ischemic stroke. Despite extensive investigations, including surgical biopsy, a definitive diagnosis could not be established for nearly 4 months. Fungal infection was eventually confirmed by culturing a large volume (10 mL) of cerebrospinal fluid (CSF), which revealed a mixed infection with Cladosporium halotolerans and Penicillium corylophilum by Internal Transcribed Spacer rDNA sequencing and β-tubulin gene sequencing. The patient was treated with liposomal amphotericin B followed by voriconazole, resulting in gradual clinical and radiologic improvement. Clinicians should consider fungal infection in patients with unexplained carotid artery occlusion and stroke. Submitting an adequate volume of CSF may improve the diagnostic yield for identifying the causative fungi.
Toxocariasis is an emerging zoonotic threat linked to environmental contamination and poor animal hygiene. Despite its relevance, integrated studies addressing human exposure and environmental contamination remain limited, especially in underexplored regions. This study provides baseline data on the emergence of toxocariasis in Abadeh City, Iran, using One Health approach. This cross-sectional study employed a One Health approach to evaluate Toxocara spp.: seroprevalence among 289 residents of Abadeh City, alongside soil contamination assessments in seven surrounding areas. Serological testing for anti-Toxocara IgG antibodies was conducted using ELISA, while soil samples were examined microscopically for Toxocara eggs using Sheather's sugar flotation method. While human seroprevalence was low at 1.73%, overall soil contamination reached 17.10%, with higher occurrence rates in residential alleys and peri-urban settings. Animal care significantly increased seropositivity risk (OR = 13.4769; 95% CI = 1.4803, 122.6952; p = 0.0210), highlighting zoonotic pathways. Environmental contamination pattern suggests ongoing risk despite low infection rates. Using a One Health framework, feedback loops between human behaviors and environmental contamination reinforce the need for targeted control measures. This study reveals an environmental reservoir of Toxocara spp. that could drive future human infections in Abadeh City. Integrating surveillance across human, animal, and environmental interfaces is essential to mitigate future zoonotic risks.
Chronic wounds remain a significant clinical challenge due to impaired angiogenesis, persistent inflammation, defective tissue remodeling, and the limited effectiveness of current therapies. Consequently, the development of regenerative approaches capable of modulating multiple stages of wound repair has gained considerable attention. Among emerging therapeutic candidates, sphingosine-1-phosphate (S1P), a bioactive lipid, has shown substantial potential in promoting tissue regeneration. This review summarizes the biological functions of S1P during the hemostasis, inflammation, proliferation, and remodeling phases of wound repair. Particular emphasis is placed on receptor-mediated signaling through S1P receptors (S1PR1-S1PR5) and their downstream pathways, including phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), mitogen-activated protein kinase (MAPK), and Rho GTPase signaling. These pathways regulate key cellular processes such as immune modulation, angiogenesis, fibroblast activation, keratinocyte migration, and extracellular matrix remodeling. S1P also promotes myofibroblast differentiation and vascular maturation while balancing pro- and anti-inflammatory responses, thereby reducing chronic inflammation and excessive fibrosis. Recent advances in biomaterial-based delivery systems have enhanced the therapeutic application of S1P. Hydrogels, nanofibers, decellularized scaffolds, liposomal formulations, and extracellular vesicle-based platforms enable localized and controlled S1P release, leading to improved healing outcomes in diabetic and chronic wounds. Furthermore, biomaterial properties, including surface chemistry, porosity, and mechanical characteristics, significantly influence cell-material interactions and S1P-mediated responses. Despite promising findings, the efficacy of S1P-based therapies depends on receptor selectivity, dosage, release kinetics, and the local wound microenvironment. Future studies should focus on designing bioresponsive, receptor-targeted delivery systems to achieve precise spatiotemporal control of S1P signaling and maximize regenerative outcomes with minimal adverse effects.
Leishmaniasis is a neglected tropical disease that urgently requires safer and more effective therapeutic strategies. Rhoifolin (RF), a natural flavonoid with anti-inflammatory and antiparasitic potential, has shown promising biological activities against several infectious diseases. In the present study, the antileishmanial effects of free RF and its niosomal formulation (NRF), alone and in combination with meglumine antimoniate (MA), were investigated against Leishmania major. Niosomes were prepared using Span 40, Tween 40, and cholesterol, resulting in high encapsulation efficiency (90.9%) and a sustained drug-release profile. The antileishmanial activity of RF, NRF, MA, and their combinations against promastigotes was evaluated using both MTT and trypan blue exclusion assays, while anti-amastigote activity was assessed in infected macrophages. NRF exhibited greater efficacy than free RF against both promastigote and amastigote forms of L. major. Combination treatments demonstrated additive interactions (combination index ≈ 1.0) and higher selectivity indices, indicating enhanced efficacy and safety. In addition, treatment with RF, NRF, and their combinations significantly increased LDH release and ROS production in infected macrophages compared with untreated controls. Molecular docking analysis revealed a strong binding affinity of RF toward caspase-3. Furthermore, treatment with RF and NRF significantly modulated apoptosis-related mediators, including increased expression of CASP3, CASP8, and Bax, along with reduced Bcl-2 expression. Immunological analyses also demonstrated macrophage polarization toward the M1 phenotype through upregulation of TNF-α, IFN-γ, IL-12, and iNOS/NO, accompanied by downregulation of IL-10, TGF-β, and ARG1. These immunomodulatory and apoptosis-associated effects were more pronounced in the NRF and NRF + MA groups. Overall, our findings suggest that niosomal RF represents a promising lipid-based delivery system for enhancing the antileishmanial efficacy of RF. The NRF + MA combination may provide a potential therapeutic strategy for improving treatment outcomes and reducing the limitations associated with current therapies for cutaneous leishmaniasis.
Production of sterigmatocystin (ST) in Aspergillus nidulans involves the ST biosynthetic gene cluster, which has been considered to comprise 26 genes. However, functions of several genes within this cluster remain unclear. In this study, we investigated the role of the stcX gene in ST biosynthesis. As the open reading frame of stcX has been undefined, we deleted three putative genes adjacent to stcW simultaneously. Deletion of the region did not significantly impact growth rate across various growth conditions compared to the control strain. Chemical analyses revealed no significant change in ST production in the deletion strain compared to the control. Furthermore, the three transcripts were largely undetectable during ST biosynthesis, and the expression of other ST cluster genes was unaffected by the deletion. Our results suggest that these genes are not essential for ST biosynthesis in A. nidulans, indicating that the cluster should be delineated to exclude stcX.
To compare efficacy, recovery, pigmentary safety, and patient-reported outcomes of radiofrequency microneedling (RFMN) and fractional carbon dioxide laser (FCO2) for facial atrophic acne scars. In this prospective, randomized, split-face, evaluator-blinded exploratory trial, 33 patients were enrolled, and 30 completed the study. Each facial side was assigned to RFMN or FCO2. Three treatment sessions were performed at 8-week intervals. The primary endpoint was the change in Echelle d'Evaluation Clinique des Cicatrices d'Acné (ECCA) score. Secondary outcomes included physician-rated improvement, satisfaction, Dermatology Life Quality Index, pain, recovery-related outcomes, and adverse events. Both modalities significantly improved acne scars over time. Mean ECCA scores decreased from 54.73 to 30.53 with RFMN and from 53.67 to 31.03 with FCO2, without a significant between-treatment difference. Physician-rated improvement was comparable. RFMN showed higher efficacy satisfaction after the first session and higher safety satisfaction at all follow-up assessments. RFMN was associated with shorter erythema, pain, swelling, and scab-detachment durations and fewer post-inflammatory hyperpigmentation events. Both treatments improved facial atrophic acne scars in this exploratory split-face sample. RFMN offered faster recovery, fewer pigmentary events, and higher safety satisfaction.
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a globally disseminated pathogen of significant public health concern. Mobile genetic elements, including prophages, frequently drive their multidrug resistance and virulence. However, the contribution of prophages to the genetic landscape of food-derived CRKP remains poorly characterized. The study aimed to characterize the diversity, genetic features, and evolutionary relationships of prophages in CRKP isolates recovered from animal-derived food sources, and to evaluate their potential role in disseminating antimicrobial resistance (AMR) and virulence within the food chain. Whole-genome sequencing was performed on 23 CRKP isolates obtained from foods of animal origin in Egypt. Prophage mining and annotation were conducted to identify and classify prophage elements, detect resistance-and virulence-associated genes, and assess evolutionary relationships through phylogenetic analysis. Eighteen intact prophages were classified as members of the class Caudoviricetes. Based on structural protein analysis, 61.11% exhibited a Siphovirus-morphotype (long, non-contractile tails), while 38.88% were identified as Peduoviridae/Myovirus-morphotype (contractile tails). The blaSHV resistance gene was detected in three incomplete prophages related to PHAGE_Escher_RCS47_NC_042128. Prophage regions also encoded lysozyme-like endolysins, suggesting potential use as lytic agents, and phylogenetic analysis revealed high prophage diversity, likely contributing to CRKP accessory genome evolution, fitness, and virulence. Animal-derived food may serve as a reservoir for CRKP that carry diverse prophages and other mobile genetic elements. Prophage-associated resistance, virulence, and lysis-related genes highlight the potential for dissemination of AMR and pathogenic traits through the food chain, underscoring the importance of surveillance of foodborne CRKP and their mobilome.
Fascioliasis is a zoonotic disease in regard to public health, which is sporadically reported from different parts of the world. Adult worms infect the liver and bile ducts, but extrahepatic involvement and the development of parasitic myositis and muscle mass caused by Fasciola hepatica are uncommon and very rare. A 55-year-old Iranian female presented with a history of abdominal pain, epigastric tenderness without pallor and jaundice, along with significant weight loss for the past five months. Microscopic examination of the stool did not identify adult worms or parasite eggs. Laboratory findings were almost normal, while erythrocyte sedimentation rate (ESR) was 32 mm/hour, triglyceride 330 mg/dL and eosinophil 6%. Hepatitis B surface antigen (HBsAg) and anti-Hepatitis C virus (HCV) were non-reactive, whereas Hepatitis B surface antibody (HBsAb) was 260.7 IU/L. Ultrasound of the tissue revealed a mass in the abdominal wall in the right upper quadrant. After her admission to the hospital, a flatworm emerged from the rectus abdominis muscle of the patient. Histopathological examination of the excised lesion showed parasite-induced myositis with abscess formation and a granulomatous foreign body reaction. Based on the morphological characteristics of the worm and serological assessment, the worm was identified as Fasciola hepatica. The patient was treated with triclabendazole and underwent clinical and paraclinical follow-up for 90 days. This case highlights the importance of diagnosing Fasciola hepatica in the differential diagnosis of unexplained subcutaneous or intramuscular nodules, especially in patients with a history of travel to endemic areas. The current case is one of the rarest cases of extrahepatic involvement (muscular fascioliasis) reported in Iran, a country where Fasciola infection is endemic in its northern regions.