Linking epidemiological and genomic data in cases of enteric fever in England to inform clinical management and public health action

Research progress on immunoprotective mechanisms of enteric fever and vaccine development

BACKGROUND

Enteric fever remains a serious global health challenge. Effective control of enteric fever depends on clean water and proper sanitation, which remains unattainable in resource-limited settings. Vaccination is therefore one of critical preventive measures. Nevertheless, there exists a paucity of systematic reviews integrating pathogenesis, the protective mechanisms, and translational vaccinology developments associated with enteric fever.

AIM OF REVIEW

To enhance the mechanistic understanding of enteric fever, this review summarizes the recent advances of pathogenesis, protective immune mechanism, as well as current challenges and innovations in vaccinology.

KEY SCIENTIFIC CONCEPTS OF REVIEW

CD4+ T cells, CD8+ T cells and B cells collectively play critical roles in the protective immune mechanisms against enteric fever. Currently licensed vaccines for enteric fever exhibit suboptimal efficacy and limited cross-protection. The absence of licensed paratyphoid vaccines underscores the imperative to develop novel vaccines, particularly multivalent vaccines.

Enhancing antimicrobial resistance surveillance and research: a systematic scoping review on the possibilities, yield and methods of data linkage studies

BACKGROUND

Surveillance data on antimicrobial resistance (AMR) determinants such as antibiotic use, prevalence of AMR, antimicrobial stewardship, and infection prevention and control are mostly analysed and reported separately, although they are inextricably linked to each other. The impact of surveillance and research can be enhanced by linking these data. This systematic scoping review aims to summarize the studies that link AMR data and evaluate whether they yield new results, implications, or recommendations for practice.

METHODS

For this review, data linkage is defined as the process of linking records, from at least two independent data sources on either (I) at least two AMR determinants or (II) one AMR determinant and one or more general population characteristics. Data linkage should be performed on the level of a certain entity which, in the context of this review, can encompass persons, healthcare institutes, geographical regions or countries. A systematic literature search was performed on February 7th 2025 in Embase.com, PubMed and Scopus to identify AMR data linkage studies.

RESULTS

Forty-eight articles were included in our review. Most data linkage studies used two data sources, and most studies were published in the last 5 years (n = 23 in 2020-2024). A predominance of studies linked data on geographical location, and thirteen studies linked data on individual patient level. Findings demonstrate that the majority of studies (43/48) had added value and provided recommendations for clinical practice and future policies or had suggestions for further research and surveillance. Additionally, data linkage studies appeared to be suitable for hypothesis generating. Several limitations were identified. Most studies had ecological designs, which are prone to ecological fallacy and unobserved confounding, making it hard to establish causality.

CONCLUSION

This systematic scoping review showed that AMR data linkage studies are increasingly performed. They have potential to gain a more comprehensive understanding of AMR dynamics by generating hypotheses, assisting in optimisation of surveillance, and interpretation of data in the context of guideline/policy development. To increase the added value of data linkage, more studies should be performed to improve knowledge on methodological approaches, data access, data management, and governance issues.

CLINICAL TRIAL NUMBER

Not applicable.