Vancomycin is regarded as the last resort of defense for a wide range of infections due to drug resistance and toxicity. The detection of vancomycin in plasma has always aroused particular concern because the performance of the assay affects the clinical treatment outcome. This article reviews various methods for vancomycin detection in human plasma and analyzes the advantages and disadvantages of each technique. Immunoassay has been the first choice for vancomycin concentration monitoring due to its simplicity and practicality, occasionally interfered with by other substances. Chromatographic methods have mainly been used for scientific research due to operational complexity and the particular requirement of the instrument. However, the advantages of a small amount of sample needed, high sensitivity, and specificity makes chromatography irreplaceable. Other methods are less commonly used in clinical applications because of the operational feasibility, clinical application, contamination, etc. Simplicity, good performance, economy, and environmental friendliness have been points of laboratory methodological concern. Unfortunately, no one method has met all of the elements so far.

Neonatal pneumonia is a leading cause of infant mortality worldwide; however, a lack of microbial profiling, especially of low-abundance species, makes accurate diagnosis challenging. Traditional methods can fail to capture the complexity of the neonatal respiratory microbiota, thereby obscuring its role in disease progression. Here, we describe a novel approach that combines high-throughput sequencing with droplet-based microfluidic cultivation to investigate microbiome shifts in neonates with pneumonia. Using 16S ribosomal RNA (rRNA) gene sequencing of 71 pneumonia cases and 49 controls, we identified 1009 genera, including 930 low-abundance taxa, which showed significant compositional differences between groups. Linear discriminant analysis effect size identified key pneumonia-associated genera, such as Streptococcus, Rothia, and Corynebacterium. Droplet-based cultivation recovered 299 strains from 94 taxa, including rare species and ESKAPE pathogens, thereby supporting targeted antimicrobial management. Host–pathogen interaction assays showed that Rothia and Corynebacterium induced inflammation in lung epithelial cells, likely via dysregulation of the PI3K-Akt pathway. Integrating these marker taxa with clinical factors, such as gestational age and delivery type, offers the potential for precise diagnosis and treatment. The recovery of diverse species can support the construction of a biobank of neonatal respiratory microbiota to advance mechanistic studies and therapeutic strategies.

Heterogeneous vancomycin-intermediate and vancomycin-intermediate Staphylococcus aureus (hVISA and VISA) presents significant therapeutic challenges due to high treatment failure rates and limited options. Conventional monotherapies, including daptomycin and linezolid, are often compromised by cross-resistance and inconsistent efficacy. Combination therapies incorporating β-lactams, quinolones, or lipopeptides with vancomycin exploit synergistic mechanisms (eg, the “seesaw effect”) but exhibit variable success depending on bacterial strain, drug concentration, and experimental models. Novel antimicrobials, such as next-generation glycopeptides (LY333328, oritavancin, YV4465), synthetic agents (pyridyl disulfides, alpha-amyrin), and natural derivatives (plant flavonoids, cyanobacterial metabolites), have demonstrated enhanced activity against VISA/hVISA by disrupting membranes, suppressing virulence, or reversing resistance. Antimicrobial peptides and non-classical agents (eg, nybomycin, telomycin) further expand therapeutic options by targeting RNA degradation, biofilms, or toxin production. Additionally, advanced drug delivery systems, including nanoemulsions and nanoliposomes, improve drug stability, biofilm penetration, and localized efficacy. Despite these promising advances, clinical translation remains challenging, requiring rigorous validation of synergistic mechanisms, optimized dosing strategies, and resistance mitigation approaches. Continued innovation in antimicrobial development is essential to address the growing threat of multidrug-resistant Staphylococcus aureus infections.

Ovarian cancer (OC) has a limited immunotherapeutic response; hence, this study aimed to investigate the relationship between CXC-chemokine ligand 13 (CXCL13) expression and overall survival (OS) rate, key immune pathways, degree of immune cell infiltration, and progressive disease (PD)-1 checkpoint blockade. A total of 703 differentially expressed genes were obtained from “The Cancer Genome Atlas” (TCGA) database based on the immune and stromal scores of 379 OC patients for getting the targeted gene CXCL13. The association between CXCL13 and OS in OC patients, biological function annotation of CXCL13, and its correlation with immune components were assessed. The results indicated that upregulated CXCL13 expression was positively correlated with better OC patient prognosis. CXCL13 expression was associated with 6 immune-related pathways, 10 immune cells, and PD-1 expression of OC micro-environment. Moreover, high expression of CXCL13 was related to a better tumor response and more extended tumor-stable stage after PD-1 blocking therapy in IMvigor210. The study concluded that CXCL13 could be a prognostic marker and a potential immunotherapy target for OC patients, especially PD-1 checkpoint blockade.