The past, the present, and the future of preclinical mouse models for Alzheimer's disease and related dementias.

The global emergence of Carbapenem-resistant Enterobacterales (CRE) represents one of the most significant challenges to modern medicine, often described as a “triple threat” due to its multi-drug resistance, high transmissibility, and association with severe clinical outcomes. In Intensive Care Units (ICUs), CRE infections are particularly devastating, with reported mortality rates ranging from 40% to 50%. To mitigate the silent spread of these pathogens, the WHO and the CDC emphasize Active Surveillance Culture (ASC). Operationally, ASC targets high-risk populations, including patients admitted directly to ICUs, those transferred from long-term care facilities, or individuals epidemiologically linked to known CRE-positive index cases. The protocol dictates that screening occurs immediately upon admission, followed by periodic (e.g, weekly) intervals if the initial screening is negative. The standard specimen types utilize rectal or perirectal swabs, as stool carriage provides the highest diagnostic yield. Upon sample collection, implementation procedures require preemptive contact precautions or patient isolation until laboratory confirmation via selective chromogenic media or molecular assays is finalized. It aims to identify asymptomatic carriers and prevent cross-transmission before outbreaks occur. Beyond universal CDC-recommended culture surveillance, alternative screening strategies exist along a spectrum of cost and diagnostic speed. These include targeted clinical risk-score screening—which tests only patients with pre-specified risks like prior antibiotic exposure or recent hospitalization—and universal molecular screening using rapid Polymerase Chain Reaction (PCR) assays. While molecular testing offers a rapid turnaround time of under 2 hours compared to traditional 24-to-48-hour cultures, its implementation costs are often prohibitive for resource-limited facilities. Conversely, risk-score screening reduces laboratory overhead but routinely misses up to a third of asymptomatic carriers, highlighting the need for a localized evaluation of strategy feasibility before deployment.