Human Immunodeficiency Virus (HIV) remains a major public health challenge globally. Recent innovations in diagnostic technology have opened new pathways for early detection, ongoing monitoring, and more individualized patient care, yet significant barriers persist in translating these advancements into clinical settings. This review highlights the cutting-edge diagnostic methods emerging from basic science research, including molecular assays, biosensors, and next-generation sequencing, and discusses the practical and logistical challenges involved in their implementation. By analyzing current trends in diagnostic techniques and management strategies, we identify critical gaps and propose integrative approaches to bridge the divide between laboratory innovation and effective clinical application. This work emphasizes the need for comprehensive education, supportive infrastructure, and multi-disciplinary collaborations to enhance the utility of these diagnostic innovations in improving outcomes in patients with HIV.

The emergence and global expansion of hyper-virulent and multidrug resistant (MDR) Klebsiella pneumoniae is an increasing healthcare threat worldwide. The epidemiology of MDR K. pneumoniae is under-characterized in many parts of the world, particularly Africa. In this study, K. pneumoniae isolates from hospitals in Khartoum, Sudan, have been whole-genome sequenced to investigate their molecular epidemiology, virulence, and resistome profiles. Eighty-six K. pneumoniae were recovered from patients in five hospitals in Khartoum between 2016 and 2020. Antimicrobial susceptibility was performed by disk-diffusion and broth microdilution. All isolates underwent whole genome sequencing using Illumina MiSeq; cgMLST was determined using Ridom SeqSphere+, and 7-loci MLST virulence genes and resistomes were identified. MDR was observed at 80%, with 35 isolates (41%) confirmed carbapenem-resistant. Thirty-seven sequence types were identified, and 14 transmission clusters (TC). Five of these TCs involved more than one hospital. Ybt9 was the most common virulence gene detected, in addition to some isolates harbouring iuc and rmp1. There is a diverse population of K. pneumoniae in Khartoum hospitals, harbouring multiple resistance genes, including genes coding for ESBLs, carbapenemases, and aminoglycoside-modifying enzymes, across multiple ST’s. The majority of isolates were singletons and transmissions were rare.

Introduction: Antibiotic resistance (ABR) is a global issue that requires a One Health approach, addressing human, animal, and environmental health sectors together. The PRESAR network aims to reduce the emergence and spread of ABR in the Nile Valley, seeks to fill research gaps in ABR. This scoping review (ScR) focuses on mapping the existing literature and data on ABR in Egypt, Ethiopia, and Sudan, specifically examining the application of the One Health approach and reviewing the national action plans (NAPs) of these countries.Methods: The ScR was conducted using the PCC framework (population, concept, and context) and incorporated relevant keywords and MeSH terms in: Medline, Scopus, and Web of Knowledge. Two reviewers per sector (animal, environment/agriculture, human) screened articles, including peer-reviewed studies published in English across all years. Studies on non-bacterial or mycobacterial infections, and systematic reviews, were excluded. Data such as infection type, sample source, and observed resistance were recorded. The NAPs were compared with the WHO Global Action Plan (GAP) to assess similarities and differences.Results: The review included 492 articles from Ethiopia, 331 from Egypt, and 31 from Sudan. Preliminary findings show that multidrug-resistant (MDR) S. aureus and K. pneumoniae dominate human infections, while Staphylococcus spp. and ESBL-producing Enterobacterales are more prevalent in animal and environmental sectors. There was large variability in diagnostic methodologies used across the sectors and countries, which in turn may lead to discrepancies in identification of bacteria at the species level and thereby inaccurate epidemiological data on prevalence and burden. While NAPs are generally aligned with the GAP, variations exist in areas like process ownership, research capacity, and funding.Discussion: The review underscores the need for more research in non-human sectors and highlights the importance of One Health in tackling ABR. We strongly advocate for a unified and strategic approach among local stakeholders, scientists, and international agencies to prioritize and fund research, aiming for a sustainable reduction in antibiotic resistance.

Aim: This study aims to evaluate knowledge levels, attitudes, and practices regarding antibiotic use and resistance among healthcare professionals and the public in Oman, and to identify gaps in antimicrobial stewardship awareness to inform evidence-based interventions. Methods: A comprehensive cross-sectional survey was conducted using a validated online questionnaire (n = 239). The survey assessed four key domains: knowledge about antibiotics, beliefs regarding antibiotic use and resistance, personal experiences with antibiotic treatment, and practices related to antibiotic prescribing. Data were analyzed using descriptive statistics and comparative analyses. Responses were evaluated for both healthcare professionals and public participants. Results: Analysis revealed that 130/239 (54.4%) of participants actively engaged in discussions about antimicrobial resistance, while 145/239 (60.7%) demonstrated awareness of the relationship between agricultural antibiotic use and human resistance patterns. Healthcare professionals showed strong adherence to best practices, with 81/84 (96.2%) emphasizing the importance of completing prescribed antibiotic courses and 76/84 (90.3%) considering resistance patterns in prescribing decisions. However, 133/239 (55.6%) of respondents reported experiencing antibiotic treatment failure. Conclusions: This study revealed a moderate to high level of awareness about antibiotic use and resistance among participants. However, the high prevalence of reported treatment failure indicates a critical gap between awareness and practical outcomes. These findings suggest the need for targeted interventions, including enhanced professional development programs and comprehensive public education campaigns.

Background: Efflux-mediated macrolide resistance represents an emerging threat in Streptococcus infections globally. However, molecular epidemiological data from the Gulf region, particularly the United Arab Emirates (UAE), remain limited. This study addresses this knowledge gap by investigating efflux pump resistance mechanisms in clinical Streptococcus isolates. Methods: A cross-sectional study analyzed 100 clinical isolates (99 Streptococcus and 1 Enterococcus) from Thumbay Hospital, Ajman, UAE (October–December 2024). Antimicrobial susceptibility testing for minimum inhibitory concentration (MIC) determination was performed using the DxM 1096 MicroScan WalkAway system (Beckman Coulter Inc., Brea, CA, USA; LabProv4.42). PCR detected mef(A/E), msr(D), and tet(K) resistance genes with sequencing confirmation. Comparative genomic analysis was performed using a total of 30 publicly available Streptococcus genomes: 15 from India and 15 from Saudi Arabia. Statistical analysis employed chi-square tests, Fisher’s exact tests, and multivariate logistic regression with Bonferroni correction (α = 0.05). Results: Among the isolates, erythromycin resistance occurred in 39 isolates (39%, 95% CI: 29.4–49.2%) and clindamycin resistance in 31 isolates (31%, 95% CI: 22.1–40.9%). The mef(A/E) gene was detected in 31 isolates (31%, 95% CI: 22.1–40.9%), and msr(D) in 3 isolates (3%, 95% CI: 0.6–8.5%), with co-occurrence in 3 isolates (3%). No isolates harbored tet(K). Multivariate analysis identified mef(A/E) as the strongest predictor of macrolide resistance (OR = 18.7, 95% CI: 7.9–44.2, p < 0.001). Regional comparison revealed significant differences: mef(A/E) prevalence was 31% (UAE), 87% (India), and 0% (Saudi Arabia) (p < 0.001). Conclusions: This study provides the first molecular characterization of efflux-mediated macrolide resistance in UAE Streptococcus isolates. The predominance of mef(A/E)-mediated resistance with confirmed efflux activity highlights the clinical significance of active surveillance and targeted antimicrobial stewardship in the region.

Background: Norovirus is the leading cause of viral gastroenteritis globally, with environmental persistence contributing significantly to transmission dynamics. Despite the recognized burden in the Middle East, systematic environmental surveillance data from restaurant settings remain critically limited, particularly regarding the role of cleaning materials as reservoirs for viruses. Middle East region. Methods: A cross-sectional environmental surveillance study was conducted across 20 restaurants in Muscat and A’Sharqiyah regions, Oman (September 2020–August 2021). Forty environmental samples comprising 20 dishcloths and 20 tabletop swabs were collected from diverse restaurant types. Viral RNA was extracted using QIA amp Viral RNA MiniKit and analyzed using real-time RT-PCR following ISO/TS 15216-1:2017 protocols with genogroup-specific primers. Results: Norovirus RNA was detected in 4 of 40 samples (10%, 95% CI: 2.8–23.7%) with higher prevalence on dishcloths (3/20, 15%, 95% CI: 3.2–37.9%) versus tabletops (1/20, 5%, 95% CI: 0.1–24.9%). All positive samples were genogrouped II with cycle threshold values of 31.8–36.2. Positive samples originated from three restaurants in high-traffic urban areas, with fast-food establishments showing the highest contamination. Field observations revealed substandard 41 sanitation practices, including frequent dishcloth reuse without disinfection. Conclusions: This paper fills a gap in the current body of knowledge by offering initial systematized evidence on norovirus contamination of the environment in restaurants within the Gulf region. The results indicate that cleaning things, especially the dishwasher cloths, are the main viral reservoirs, and the contamination rates are three times higher than food-containing surfaces. These results underscore the urgent need for enhanced sanitation protocols that specifically target cleaning implements rather than surfaces alone and emphasize the importance of routine environmental surveillance in understanding and interrupting norovirus transmission dynamics in food service settings.