The meteoric rise of antimicrobial resistance (AMR), marked by decreased antibiotic effectiveness against pathogenic bacteria, has sparked widespread concern. This phenomenon increases potential threats to public health by significantly hampering the clinical use of currently available antimicrobial agents, such as macrolides, β-lactam and glycopeptides antibiotics. Staphylococcus aureus (S. aureus), namely the Methicillin-Resistant Staphylococcus aureus (MRSA), is a common opportunistic pathogen that causes various types of infections and has become one of the top healthcare problems, particularly in low-income countries. In light of bacterial evolution and the unintentional use of antibiotics for medical purposes in communities and hospitals, as well as in agriculture and livestock for non-medical purposes. These events have contributed to the development and spread of antimicrobial resistance. Furthermore, resistant to our most muscular treatments against invasive S. aureus infections, such as vancomycin, is no longer successful due to the emergence of Vancomycin-Resistant S. aureus (VRSA). The scientific community is looking for creative and spectacularly effective strategies to address this global issue in response to this pandemic threat generated by the spread of antimicrobial resistance strains, with the threat of limited treatment choices against S. aureus. In this review, we highlighted the molecular mechanisms of antibiotic resistance and explained the antibiotic resistance profile of Methicillin-resistant S. aureus. On the other hand, we discuss distinguished tactics for manipulating S. aureus resistance mechanisms, such as the discovery of new chemical entities that possess antimicrobial activity with novel mechanisms of action, utilization of combinatorial antibiotic therapies, chemical derivatization and repurposing of existing known drugs to improve their antibacterial efficacy, design novel vaccine for S. aureus, antimicrobial peptides and nanoparticles as a magic bullet, and finally, by implementing the One Health Agenda against S. aureus, this holistic strategy seeks to address the spread of antibiotic resistance across the interrelated health loop of human, animals, and environments.

This study assesses the epidemiological trends of a multistate measles outbreak in Sudan amidst ongoing armed conflict, highlighting the urgent need for enhanced vaccination efforts and international support. A retrospective cross-sectional analysis was conducted using national surveillance data collected from January 2024 to June 2025. Epidemiological parameters, including case counts, fatalities, and vaccination coverage, were calculated and analyzed with R software 4.2.2 (Version 2025.05.1 + 513). A total of 3563 measles cases and 20 deaths were reported across 13 states. North Darfur recorded the highest number of cases (n = 1760), followed by Khartoum (n = 553) and River Nile (n = 380). The overall case fatality rate (CFR) decreased from 1.27% in 2024 to 0.28% in the first half of 2025. Vaccination coverage remained low in several hotspots, with notable deficits in displaced populations worsened by logistics disruptions. The resurgence emphasizes gaps in immunization coverage and underscores the impact of conflict-related healthcare infrastructure deterioration. The re-emergence of measles across multiple regions during Sudan's conflict underscores an urgent need for targeted mass vaccination campaigns, strengthened disease surveillance, and international assistance. Addressing these vulnerabilities is crucial to preventing future outbreaks and safeguarding vulnerable populations, particularly children and displaced communities.

This study describes the changing trends of multistate cholera outbreaks in Sudan during the ongoing conflict. This was a retrospective cross-sectional study based on cholera surveillance data available at the national level (from August 2023 to June 2025). Case fatality rates (CFRs) annually and per state were obtained, and the data were analyzed using R program 4.2.2 (Version 2025.05.1+513). The study used the anonymous secondary data provided by the Surveillance Directorate dashboard. In 2023, a total of 9581 cases and 254 fatalities (overall CFR of 2.7%) were reported in 10 states. The Red Sea state recorded the highest number of cases (n = 3379, with 101 deaths and a CFR of 3%). Then 2024 recorded the highest number of cases and fatalities (n = 50,832, with 1380 deaths and a CFR of 2.7%), compared to 2023 and the first half of 2025 (n = 23,488 cases, with 517 deaths and a CFR of 1.7%). Regarding the overall trend per state, Khartoum, White Nile, and the North Kordofan states showed an increasing trend between August 2023 and June 2025, while the Red Sea, Al Jazirah, Al Qadarif, and Kassala states showed a decreasing trend. The findings underscore the complex dynamics of cholera transmission influenced by conflict-related water and sanitation disruptions, displacement, and vaccination efforts. The dramatic (>5-fold) increase in cases from 2023 to 2024, followed by a declining CFR in 2025, suggests that although the outbreak surged quickly, interventions may have ultimately improved case outcomes. Continued surveillance, targeted interventions, and health infrastructure strengthening are paramount to controlling current outbreaks and preventing future resurgence in conflict-affected regions.

This study assesses the magnitude and epidemiological characteristics of the recent cholera resurgence in Kosti City, Sudan, amid ongoing armed conflict and water supply disruptions. This was a retrospective cross-sectional study based on hospital records that analyzed cholera surveillance data from Kosti Teaching Hospital from February 20, 2025, to February 24, 2025 (peak period). Epidemiological measures included case fatality rate (CFR) based on the following factors: age, sex, and displacement status. We analyzed the data using R software version 4.2.2. During the peak period, 1714 cholera cases and 69 fatalities were reported (CFR: 4.02%). 136 individuals were internally displaced, and age groups 1-4 and ≥65 years demonstrated the highest CFRs of 9.7% and 9.9%, respectively. By March 5, 2025, 1004 new cases had overwhelmed Kosti Teaching Hospital, with a lower fatality rate (2.3%) compared to the peak period's CFR. The resurgence of cholera in Kosti underscores the critical need for strengthened water, sanitation, and hygiene interventions and coordinated outbreak response strategies. Addressing underlying vulnerabilities is essential to prevent future outbreaks, especially in conflict-affected settings.

Key Clinical Message: Metformin‐associated lactic acidosis is a rare but serious complication in patients with type 2 diabetes, especially those with multiple health conditions. Prompt recognition and treatment, including potential renal replacement therapy, are crucial for managing severe acidosis and improving patient outcomes. Metformin (MTF) is commonly prescribed as a first‐line treatment for diabetes, effectively preventing microvascular and macrovascular complications. However, metformin‐associated lactic acidosis is a rare yet severe complication, associated with a mortality rate of up to 50%. We encountered a case involving a 73‐year‐old woman with type 2 diabetes, mental illness, and hypothyroidism, who developed life‐threatening lactic acidosis while on metformin therapy. Upon presenting to the emergency department with complaints of weakness, nausea, and decreased urination for 5 days, she also reported abdominal pain and shortness of breath. Hypotension was noted with a blood pressure of 80/50 mmHg. Initial laboratory results revealed severe acidosis, prompting discontinuation of MTF. Despite resuscitation efforts and vasopressor therapy, severe acidemia persisted, leading to the initiation of renal replacement therapy. Following treatment with continuous renal replacement therapy, her acidemia resolved, and she was discharged from the hospital on the sixth day without complications, with normal kidney function.