Pseudomonas aeruginosa is causing increasing concern among clinicians due to its high mortality and resistance rates. This bacterium is responsible for various infections, especially in hospital settings, affecting some of the most vulnerable patients. Pseudomonas aeruginosa has developed resistance through multiple mechanisms, making treatment challenging. Diagnostic techniques are evolving, with rapid testing systems providing results within 4–6 h. New antimicrobial agents are continuously being developed, offering potential solutions to these complex clinical decisions. This article provides a review of the epidemiology, at-risk populations, resistance mechanisms, and diagnostic and treatment options for Pseudomonas aeruginosa.

Candida auris is a World Health Organization critical-priority fungal pathogen that has variable resistance to antifungal treatments. Multiple clades have been identified through genomic analysis and have appeared in different geographic locations simultaneously. Due to a combination of factors including antifungal resistance, ability to colonize and persist in the environment, and thermotolerance, it can thrive. Infected patients are associated with a high mortality rate, especially those with multiple health risk factors like those associated with other Candida species. This review highlights the current situation of this pathogen to help provide guidance for future work.

Candidozyma auris (C. auris) is a resistant fungal pathogen with high mortality. To evaluate the in vitro activity of 11 antifungal agents against C. auris from multiple hospitals. MIC was determined by microdilution testing for amphotericin B, anidulafungin, caspofungin, manogepix, micafungin, rezafungin and five triazoles. Sanger sequencing was performed on one echinocandin resistant isolate. There were 84 C. auris isolates from Michigan that were compared with 27 organisms from external sources. Manogepix had the lowest MIC₉₀ (0.03 mg/L). The next most active agent was micafungin. The echinocandins demonstrated a 98.8% susceptibility. A single isolate was found to have a S639F mutation. Amphotericin B demonstrated a 97.6% susceptibility. The MIC₉₀ demonstrated values of ≤0.5 mg/L for isavuconazole, itraconazole and posaconazole. When separating by colonization versus infection isolates, the MIC₉₀ values were identical for all agents, except micafungin, which showed 0.25 versus 0.12 mg/L, respectively. When comparing the reference isolates with Michigan isolates, the MIC₉₀ was identical for echinocandins and manogepix. Differences noted were with amphotericin B, for which 85.2% were susceptible for reference isolates compared to 97.6% from Michigan isolates, and fluconazole, where 25.9% were susceptible for the reference isolates compared with 4.8% from Michigan isolates. Manogepix and echinocandins demonstrated the greatest activity against C. auris irrespective of hospital and were like the reference isolates. Amphotericin B demonstrated greater activity compared with published studies. Fluconazole has poor activity; the activity of other triazoles remains unclear.