Early Release

Synopsis

• Stenotrophomonas maltophilia Bloodstream Infection Outbreak in Acute Care Hospital, California, USA, 2022–2023
  S. M. Khan et al. View Abstract

  Stenotrophomonas maltophilia is an opportunistic bacterial pathogen found in healthcare settings. During May 2022–September 2023, an acute care hospital in northern California, USA, identified 13 S. maltophilia bloodstream infections among intensive care unit patients. Whole-genome sequencing showed the isolates were highly related. We identified risk factors for infection by conducting a matched case–control study, targeted assessment of infection prevention and control practices, and laboratory testing of suspected environmental reservoirs. Among 13 case-patients and 39 control-patients, patients exposed to iodinated contrast (odds ratio [OR] 12.0; 95% CI 2.1–∞), injectable propofol (OR 12.2; 95% CI 1.5–101.4), or fentanyl (OR 9.2; 95% CI 1.8–∞) had increased odds of S. maltophilia bloodstream infection. Although we did not have culture confirmation of a source, we suspect S. maltophilia was transmitted by exposure to nonsterile water from a common source. We recommended infection prevention and control practices to reduce risk for contamination from nonsterile water.

Research

• Environmental and Phylogenetic Investigations of Aspergillus flavus Outbreak Linked to Contaminated Building Materials, Denmark, 2025
  A. Gewecke et al.
• Lymphocytic Choriomeningitis Virus Seroprevalence among Urban Pregnant Women and Newborns, Philadelphia, Pennsylvania, USA, 2021
  D. D. Flannery et al. View Abstract

  Lymphocytic choriomeningitis virus (LCMV) is a globally distributed rodentborne pathogen that can cause severe congenital infections. We conducted a retrospective cross-sectional seroepidemiologic study using remnant serum samples from pregnant women and newborns at 2 hospitals in Philadelphia, Pennsylvania, USA. We tested samples for LCMV IgG and IgM in 3 phases: a high-risk group determined by neighborhood deprivation index scores, a random sample of all birthing women, and a group with prenatally diagnosed neurologic malformations. We found LCMV IgG seroprevalence was 2.4% among 700 high-risk and 2.7% among 300 randomly selected pregnant women. Seroprevalence varied by hospital site, maternal race or ethnicity, and neighborhood deprivation level. All seropositive maternal samples were IgM-negative. Thirty-seven pregnant women carrying fetuses with neurologic malformations were seronegative. Our findings highlight the risk for LCMV exposure in urban settings and emphasize the need for pregnant women to avoid contact with rodents to prevent this rare but serious congenital infection.

• Genetically Similar High-Risk Strains of Carbapenemase-Producing Enterobacterales in Humans and Companion Animals, United States
  L. Xiaoli et al. View Abstract

  To elucidate the zoonotic potential of carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) in US companion animals (i.e., dogs and cats), we queried the National Center for Biotechnology Pathogen Detection database to identify One Health clusters containing CP-CRE isolates from companion animals and humans. The 11 One Health clusters we found included most (69% [169/246]) publicly available CP-CRE sequences from US companion animals and were from 8 internationally disseminated, high-risk sequence types from 3 bacterial species (Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae). All clustered isolates had New Delhi metallo-β-lactamase–family carbapenemases, and most (92%) carried the bla_NDM-5 allele. The One Health clusters included several closely related subclusters with geographically linked isolates from both humans and companion animals. Those results suggest that CP-CRE is an emerging One Health issue and that direct or indirect transmission of CP-CRE is occurring between humans and companion animals in the United States.

• Accelerated Increase in Candidozyma (Candida) auris Bloodstream Infections during COVID-19 Pandemic, South Africa
  H. Ismail et al.
• Strongyloides Genetic Diversity among Humans, Dogs, and Nonhuman Primates, Central African Republic, 2016–2022
  E. Nosková et al.
• Projected Effects of Changing Global Tuberculosis Epidemiology on Mycobacterium tuberculosis Prevalence and Immunoreactivity, 2024–2050
  M. Machado et al. View Abstract

  We assessed how evolving global tuberculosis (TB) trends might influence Mycobacterium tuberculosis immunoreactivity and TB risk among persons immigrating to low-incidence countries. We projected annual risk for infection (ARI) in 168 countries for 2024–2050, focusing on China, India, the Philippines, and Vietnam. We applied projections to the age profile of immigrants to 4 low-incidence countries to estimate changes in M. tuberculosis immunoreactivity prevalence and TB risk under status quo and accelerated ARI decline scenarios. In the status quo 2024 estimate, M. tuberculosis immunoreactivity prevalence ranged from 14.7% in China to 40.1% in the Philippines, declining to 5.8% in China and 23.0% in the Philippines by 2050; TB risk also declined. Accelerated ARI reductions yielded greater relative decreases in disease risk than immunoreactivity prevalence. Declining global TB incidence could reduce M. tuberculosis immunoreactivity and disease risk among immigrant populations, which could inform cost–benefit analyses for future TB screening strategies in low-incidence settings.

• Seroincidence Rate of Typhoidal Salmonella in Children, Kenya, 2017–2018
  A. Khan et al.
• Blastomyces antigen testing in urine for active case identification during a blastomycosis outbreak
  A. W. O’Connor et al.

Policy Review

• Rethinking Leptospirosis Prevention, the Philippines
  R. V. Labana View Abstract

  Leptospirosis, the disease caused by infection with Leptospira spp. bacteria, remains a recurring public health challenge in the Philippines, particularly during monsoon floods and typhoon seasons. Despite responsive measures, such as Code White Alerts, standardized treatment protocols, and postflood prophylaxis, cases and associated deaths persist, emphasizing the limitations of reactive strategies. Structural challenges in flood control, urban sanitation, and rodent management hinder long-term prevention. This policy review applies a systems thinking approach to integrate national programs with community-led interventions, recognizing the interlinked roles of environmental management, behavioral change, and grassroots surveillance. Low-cost, context-sensitive actions, such as community drainage clearing, shared protective gear, local rodent-proofing, and barangay-level reporting, can address immediate risks while reinforcing structural initiatives. Embedding those actions within a feedback loop between local actions and national policies fosters resilience, reduces disease incidence, and shifts the paradigm from reactive response to sustainable prevention.

Dispatches

• Rapid Interventions to Limit Outbreak of Invasive Streptococcus pneumoniae in Correctional Facility, North Carolina, USA, 2024
  C. D. Gowler et al.
• Emerging Endemic Area for Blastomycosis, New York, USA, 2000–2024
  L. E. Ramirez et al. View Abstract

  Blastomycosis is not yet considered endemic in upstate New York, USA; however, cases have increased during the past decade. We performed a retrospective study of 54 laboratory-confirmed cases reported during 2000–2024. Our results demonstrate an increase in incidence over time, indicating that this region represents an emerging endemic area.

• Tuberculosis after TB Preventive Therapy in Persons Living with HIV Recently Initiating Antiretroviral Therapy, Mozambique
  L. Templin et al. View Abstract

  We investigated tuberculosis (TB) diagnoses among persons living with HIV recently initiated on antiretroviral therapy in Mozambique during 2021–2024 (N = 341,844). TB diagnosis rates were lower among those who completed TB preventive therapy (3.1/1,000 person-years) compared with those who had an incomplete course (11.0/1,000 person-years) or did not start (21.6/1,000 person-years).

• Optimal specimens and lesions for mpox diagnosis using real-time polymerase chain reaction in Korea: a retrospective observational study
  D. Kim et al.
• Life-threatening extraintestinal infection caused by Entamoeba moshkovskii in eastern India
  S. Sardar et al.
• Home-Based Monitoring of Treatment-Related Adverse Events during Drug-Resistant Tuberculosis Treatment, India, 2020–2024
  M. Ahson et al.
• Natural Hendra Virus Infections in Captive Australian Black Flying Foxes, Queensland
  V. Boyd et al.

Research Letters

• Detecting Influenza A(H5N1) Viruses through Severe Acute Respiratory Infection Surveillance, Cambodia
  W. W. Davis et al. View Abstract

  Of 19 human cases of avian influenza A(H5N1) virus infection detected during January 2023–March 2025 in Cambodia, 12 (63%) were detected directly by surveillance for severe acute respiratory infection (SARI) or indirectly by testing ill close contacts. SARI surveillance can supplement other surveillance sources for identifying H5N1 cases.

• Oestrus ovis Nasal Myiasis with Pupation in Human Host, Greece, October 2025
  I. P. Kioulos
• Costs of Extrapulmonary Nontuberculous Mycobacterial Disease, Denmark, 2005–2017
  V. Dahl et al.
• Crimean-Congo Hemorrhagic Fever Virus Seroprevalence among Hunter-Gatherers, Northeastern DRC
  D. M. Kasumba et al.
• Mycobacterium nanjing sp. nov., a Novel Slowly Growing Mycobacterium Isolated from Cutaneous Infection in China
  Y. Zou et al.
• Mycobacterium riyadhense Pulmonary Disease after Relocation from Saudi Arabia, Japan
  T. Ozawa et al.
• Occupational Transmission of Extensively Drug-Resistant Tuberculosis to a Healthcare Worker Receiving TNF-alpha inhibitor therapy.
  C. Poignon et al.
• lsaC and Tandem lsaE-lnuB Resistance Genes in Invasive Group A Streptococci
  B. Beall et al.
• High Proportion of Interferon-Gamma Release Assay in Refugee Children with Splenomegaly, Uganda, 2020–2023
  C. R. Phares et al.
• Cutaneous Paraconiothyrium cyclothyrioides Infection in Lung Transplant Recipient
  C. Mackey et al.

Another Dimension

• Everything is Tuberculosis: A Portrait of Connection
  N. M. M’ikanatha

Online Report

• New 2030 Global Target for Histoplasmosis
  A. C. Pasqualotto et al.

Correction

• Correction: Vol. 32, No. 1

About the Cover

• Romanticism at the Edge of Death
  T. Chorba

Synopsis

• Pediatric Meningoencephalitis Cluster Caused by Snowshoe Hare Virus, Whistler, British Columbia, Canada, 2024
  F. Ali et al.

Research

• Enhanced Detection of Coccidioides spp. Fungi from Environmental Samples Using Droplet Digital PCR
  J. Segovia-Mota et al.
• Hemolytic Uremic Syndrome Outbreak in Adults and Shiga Toxin–Producing Escherichia coli Negative for Locus of Enterocyte Effacement, France, 2025
  J. de Larminat et al.
• Dengue Incidence, Seroprevalence, and Expansion Factors from Active Surveillance, Brazil, 2016–2021
  E. de Barros et al.

Dispatch

• Chronic Wasting Disease in Farmed Cervids, South Korea, 2001–2024
  Y. Choi et al.

Research Letters

• Rickettsia lanei Rickettsiosis, Oregon, USA, 2025
  S. G. Ladd-Wilson et al.
• Seroepidemiologic Study of Oropouche Virus, Amazonas State, Brazil, 2015–2016
  J. Forato et al.