Summary
Infectious diseases encompass a vast array of disorders caused by bacteria, viruses, fungi and parasites. Their transmission routes—respiratory droplets, contaminated water or food, insect vectors, direct contact and zoonotic spill-overs—reflect the diversity of microbial life and human–environment interactions. Despite advances in vaccines, antimicrobials and sanitation, these illnesses remain among the leading causes of death and disability worldwide, particularly in low-resource settings. Rapid urbanisation, climate change and global travel facilitate the emergence and spread of novel pathogens, while antimicrobial resistance and gaps in healthcare access threaten to reverse decades of progress. Effective control demands integrated surveillance, laboratory capacity, preventive measures (including water, sanitation, vector control and immunisation), timely diagnostics and judicious antimicrobial stewardship. A One Health perspective, recognising human, animal and environmental interconnectedness, is essential to anticipate outbreaks, tailor interventions to local epidemiology and build resilient health systems that can adapt to evolving infectious threats.
Research from Nature Portfolio
Longitudinal serological surveys in a cholera‐endemic Bangladeshi community have revealed that fewer than one in a thousand Vibrio cholerae infections are captured by clinical surveillance. By combining antibody trajectories with reconstructed case timelines, annual O1 infection rates were recalculated to exceed 500 per 1,000 in some age groups, underscoring the importance of serological surveillance in revealing the true burden. Genomic epidemiology of the 2018–19 Yemen outbreak traced a multidrug‐resistance plasmid across seventh pandemic El Tor lineages. An IncC plasmid carrying an MDR transposon was found in both epidemic and endemic V. cholerae, highlighting horizontal gene transfer as a driver of resistance and the need for real-time genomic monitoring to inform antibiotic policy. In Staphylococcus aureus, human serum was shown to induce transient daptomycin tolerance via two host-triggered mechanisms: LL-37-activated GraRS signalling increased peptidoglycan accumulation, while GraRS-independent cardiolipin enrichment further impeded antibiotic killing. Blocking both pathways restored full daptomycin susceptibility in serum‐exposed bacteria, demonstrating how host factors can modulate antibiotic efficacy.
Research from all publishers
In the Democratic Republic of the Congo, a matched case–control study assessed the protection conferred by a single dose of killed oral cholera vaccine. Across two follow-up periods (12–17 and 24–36 months), adjusted effectiveness remained above 44% against medically attended cholera, with similar short-term protection in children and adults but evidence of waning immunity in under-fives by three years. This supports flexible single-dose strategies in high-burden settings facing vaccine shortages. Advances in bloodstream infection diagnostics have focused on rapid antimicrobial susceptibility testing. A sensor-based phenotypic AST system delivered minimum inhibitory concentrations for Gram-negative bacteremia within five hours, achieving over 96% categorical agreement with reference methods and requiring minimal hands-on time. Separately, an automated multiplex PCR panel processed positive blood cultures in under ninety minutes, identifying a broad spectrum of bacterial and fungal pathogens and resistance genes with high sensitivity and specificity. These tools enable early, targeted therapy and reinforce the role of integrated stewardship teams in optimising antimicrobial use.
Infectious Diseases publication trend
The graph below shows the total number of articles in infectious diseases across all publications each year (not limited to Nature Index journals).
Technical terms
Serological surveillance: Monitoring population antibody responses to estimate infection exposure beyond clinically reported cases.
Integrative and conjugative element (ICE): A mobile genetic element capable of integrating into bacterial chromosomes and mediating horizontal transfer of resistance genes.
IncC plasmid: A plasmid incompatibility group C element that facilitates the spread of multidrug resistance among Vibrio cholerae lineages.
GraRS two-component system: A bacterial regulatory pathway activated by host antimicrobial peptides (e.g., LL-37) that controls cell wall and membrane modifications.
Sensor-based AST: A technology that monitors biochemical or physical changes in microbes to determine antibiotic susceptibility rapidly.
Minimum inhibitory concentration (MIC): The lowest antimicrobial concentration that prevents visible microbial growth under standardized conditions.
Multiplex PCR panel: A molecular assay that simultaneously amplifies multiple pathogen-specific targets and resistance genes from clinical specimens.
References
- General Considerations on Infectious Diseases.
- Clinical surveillance systems obscure the true cholera infection burden in an endemic region. Nature Medicine (2024).
- Genomic epidemiology reveals multidrug resistant plasmid spread between Vibrio cholerae lineages in Yemen. Nature Microbiology (2023).
- Human serum triggers antibiotic tolerance in Staphylococcus aureus. Nature Communications (2022).
- Effectiveness of one dose of killed oral cholera vaccine in an endemic community in the Democratic Republic of the Congo: a matched case-control study. The Lancet Infectious Diseases (2024).
- Performance of the Reveal Rapid Antibiotic Susceptibility Testing System on Gram-Negative Blood Cultures at a Large Urban Hospital. Journal of Clinical Microbiology (2022).
- Usefulness of BioFire FilmArray BCID2 for Blood Culture Processing in Clinical Practice. Journal of Clinical Microbiology (2021).
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