Top 5 Infectious Disease New Stories Week of March 15-March 22

Mandimycin: A New Weapon Against Multidrug-Resistant Fungal Pathogens

Mandimycin, a new polyene antifungal antibiotic discovered by Zhuo Shang, PhD, offers a promising solution to the growing problem of multidrug-resistant fungal pathogens like Candida auris. Unlike traditional antifungals, which target ergosterol in fungal membranes, mandimycin disrupts the membrane by binding to phospholipids, leading to ion leakage and cell death. This novel mechanism reduces the likelihood of resistance development, a key challenge for current treatments. In preclinical studies, mandimycin showed strong efficacy against resistant pathogens, including Candida auris, and demonstrated lower renal toxicity compared to existing drugs. Further research is needed to assess its safety and clinical potential, particularly regarding off-target toxicity due to its interaction with phospholipids in all cell membranes.

CDC: Hospitals Experiencing Inconsistent Declines in Resistant Infections

A 10-year study by the CDC reveals that hospital-onset antimicrobial resistance (AMR) generally declined from 2012 to 2019 but spiked during the COVID-19 pandemic, particularly in 2020-2021. Resistance rates for pathogens like MRSA, VRE, CRE, CRAsp, and MDR P. aeruginosa remained stable or decreased over the decade, while infections caused by extended-spectrum cephalosporin-resistant E. coli and Klebsiella spp. increased, especially in sterile and nonsterile body sites. The pandemic led to higher hospital-onset resistant cases due to factors such as increased patient severity, longer stays, and weakened infection control practices. Regional, species, and demographic differences were observed, with older adults and males showing higher infection rates. The study highlights the need for continued, adaptable infection prevention efforts, particularly during times of healthcare system strain.

Phase II Study Shows Efficacy of 6-Month Regimen of Lenacapavir, Teropavimab, and Zinlirvimab for HIV

At CROI 2025, Onyema Ogbuagu, MBBCh, presented findings from a Phase II study evaluating the efficacy and safety of a long-acting regimen (LTZ) consisting of lenacapavir (LEN), teropavimab (TAB), and zinlirvimab (ZAB) every six months (Q6M) in comparison to daily oral antiretroviral therapy (SBR) in virologically suppressed individuals with HIV-1. After 26 weeks, 96% of participants in both arms maintained virologic suppression (HIV-1 RNA <50 copies/mL). The LTZ regimen, administered via subcutaneous LEN and intravenous TAB and ZAB, showed comparable efficacy to daily oral ART with mild injection site reactions as the most common side effect. The study supports the potential of LTZ as a long-acting, Q6M HIV treatment option, offering convenience and simplifying treatment for patients who struggle with daily regimens. Further research will assess the durability of virologic suppression and the long-term safety of the regimen.

Fear, Misconceptions Discourage International Hepatitis B and C Testing

A global survey conducted across Africa, Asia, and Latin America reveals widespread fear and misconceptions about hepatitis B (HBV) and C (HCV), discouraging people from seeking testing and treatment. Nearly one-third of respondents showed no interest in getting tested, and over half did not believe they were at risk. The survey highlighted geographic disparities, with countries like Morocco and South Africa showing even higher reluctance to seek testing. Despite the availability of preventable and treatable treatments, the underdiagnosis of hepatitis remains a major issue, especially in low- and middle-income countries, where only a small fraction of people with HBV or HCV are diagnosed or receive antiviral treatment. The World Health Organization reports that chronic hepatitis B and C lead to 1.3 million deaths annually. The report emphasizes the need for increased education, expanded testing access, and workplace policies that support preventive care to address the ongoing hepatitis crisis.

Lassa Fever Vaccine Study Enrollment Begins

Enrollment has begun for a clinical study at the University of Maryland School of Medicine to test the safety and immune response of LASSARAB, an experimental vaccine for Lassa fever. Developed by researchers at Thomas Jefferson University, LASSARAB is based on an inactivated rabies vaccine modified to include Lassa virus proteins. The study will involve 55 healthy adults aged 18 to 50, with the goal of determining if the vaccine can protect against both rabies and Lassa fever. Previous trials in nonhuman primates showed complete protection after two doses. Lassa fever, a viral illness endemic to West Africa, is transmitted by rodents and can cause severe symptoms such as bleeding and difficulty breathing, with occasional cases reported in travelers to the US.