Infectious Diseases

First-in-human Nipah mRNA-1215 vaccine shows favorable safety and durable immunity

Forty healthy adults received two intramuscular doses of mRNA-1215 (10–100 µg) four weeks apart in this phase 1 trial. Adverse events were mostly mild, dominated by injection-site pain or tenderness and malaise, and no serious adverse events occurred. The vaccine elicited robust binding antibody titers to pre-fusion F and G antigens across all dose groups. Neutralizing titers appeared in all dose groups within two weeks after the prime, increased after the boost, and persisted for at least one year. These data support further clinical development of mRNA-1215 for populations at risk of Nipah outbreaks. 1

Amphotericin B promotes respiratory viral infection through enhanced endosomal maturation

In 1,072 patients with culture-confirmed invasive pulmonary aspergillosis, systemic amphotericin B use was associated with more subsequent viral infections than other antifungals. Incidence of influenza or SARS-CoV-2 infection was higher with amphotericin B than comparators (21.55% vs 7.76%; P = 0.003). Multivariable analysis identified amphotericin B as an independent risk factor for subsequent viral infection (adjusted OR 3.45, 95% CI 2.20–5.41). Mechanistic studies showed amphotericin B activates glucocerebrosidase, increasing ceramide and RAB7, which enhances late endosomal maturation and viral entry. In influenza-infected mice and SARS-CoV-2–challenged hamsters, amphotericin B increased weight loss, viral loads, and tissue damage. 2

Xpert MTB/XDR in African field settings: high specificity, variable sensitivity

This multicenter study in nine sub-Saharan African countries evaluated Xpert MTB/XDR against targeted next-generation sequencing in 1,238 adults with pulmonary tuberculosis. Specificity was at least 98% for all drugs, indicating that detected resistance is highly reliable for programmatic decision-making. Sensitivity was 95% for isoniazid resistance, but only 67% for fluoroquinolones and 57% for ethionamide. The assay detected common in-target mutations yet frequently missed low-frequency heteroresistance and off-target ethionamide resistance variants. Sensitivity for fluoroquinolones improved to 78% among rifampicin-resistant cases, supporting its use as a reflex test in rifampicin-resistant TB. 3

Long-term sequelae after COVID-19 resemble those after other severe infections

This nationwide Danish cohort linked SARS-CoV-2 tests, prescription, and hospitalization data for over five million individuals with up to 40 months of follow-up. A positive PCR test without hospitalization was not associated with clinically relevant increases in new mental disorders versus test-negative individuals. Similarly, non-hospitalized COVID-19 was not associated with excess general medical diagnoses versus test-negative or anti-infective–treated comparators. Hospitalized and ICU-treated COVID-19 patients had elevated rates of mental and general medical conditions versus the general population. However, sequelae after hospitalized COVID-19 were comparable to those after non-COVID pulmonary or other severe infections. 4