Among the findings were a rise in nightmare bacteria and the Mediterranean diet showing effectiveness for IBS.<\/li>\n<\/ul>\nSAN FRANCISCO \u2014 A speaker at ACP\u2019s Internal Medicine Meeting discussed several articles recently published in Annals of Internal Medicine<\/i> that are of particular relevance to primary care providers.<\/p>\n
During the presentation, <\/b>Christina Wee, MD, MPH, FACP<\/b>, <\/b>senior deputy editor and vice president of Annals of Internal Medicine<\/i>, highlighted articles that generated high views, almetric scores and attention from media, were topical to clinical practice, and are a priority area for ACP.<\/p>\nAluminum-adsorbed vaccines and chronic diseases<\/h2>\n
Among the articles was a Danish-based nationwide cohort study, where the researchers found that aluminum-adsorbed vaccines were not tied to 50 allergic, autoimmune or neurodevelopmental disorders among 1,224,176 youth.<\/p>\n
The study drew further attention after HHS Secretary Robert F. Kennedy Jr. in an opinion piece criticized its limitations and called for Annals of Internal Medicine<\/i> to retract it, which the journal did not.<\/p>\n
Wee pointed out that the incidence of chronic diseases in youth was rare, with incidence rates ranging from 0.8 to 50.5 per 100,000 person-years.<\/p>\n
Because some of the chronic conditions \u201chad pretty wide CIs,\u201d she said, the researchers \u201ccouldn\u2019t exclude small relative increases in risk for some of the conditions.\u201d<\/p>\n Enlarge\u00a0Data derived from: Andersson NW, et al. Ann Intern Med. 2025;doi:10.7326\/ANNALS-25-00997.<\/em><\/figcaption><\/p>\nWee also noted that \u201cas with any observational studies,\u201d the analysis possessed several limitations, including misclassification of outcomes, residual confounding and a shorter follow-up.<\/p>\n
Still, \u201cby and large, their findings were not compatible with a moderate or large increased risk associated with aluminum in vaccines and most compatible with no increase in risk for most of the outcomes,\u201d she said.<\/p>\n
Mediterranean diet promising as IBS treatment<\/h2>\n Another analysis indicated that the Mediterranean diet has potential as a first-line treatment for irritable bowel syndrome.<\/p>\n
IBS \u201cis a complicated condition that\u2019s managed via diet, medication and behavioral interventions,\u201d Wee said, with American and British gastrointestinal societies recommending traditional dietary advice vs. the low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet.<\/p>\n
But she pointed out that recent cross-sectional studies suggest the Mediterranean diet \u201cmay hold some promise\u201d as a treatment strategy.<\/p>\n
In the randomized controlled trial, 62% of 68 people with IBS assigned to the Mediterranean diet for 6 weeks achieved a 50-point or greater reduction in the IBS Symptom Severity Scale compared with 42% of 71 people assigned to traditional dietary advice.<\/p>\n
The Mediterranean diet \u201cprimarily produces improvement through a reduction in abdominal pain,\u201d Wee said.<\/p>\n Enlarge\u00a0Data derived from: Bamidele JO, et al. Ann Intern Med. 2025;doi:10.7326\/ANNALS-25-01519.\u00a0<\/em><\/figcaption><\/p>\nShe acknowledged there were several important limitations, as it \u201cwas a small study. It really only focused on adults, and there are a lot of kids with IBS, so whether this generalizes to children is not clear.\u201d<\/p>\n
She also added that the study\u2019s length was small and \u201ca fairly low-effort intervention. Clearly, these need to be replicated in a larger, more definitive trial, although I think it does show some promise.\u201d<\/p>\n
\u2018Nightmare bacteria\u2019 surged from 2019 to 2023<\/h2>\n A brief research report showed that cases of carbapenemase-producing carbapenem-resistant Enterobacterales, or CP-CRE, significantly increased in the U.S. between 2019 to 2023.<\/p>\n
CP-CRE, known as the \u201cnightmare bacteria,\u201d \u201crepresents heterogenous resistance mechanisms,\u201d Wee explained. \u201cHistorically, the primary mechanism is through the K<\/i>lebsiella pneumoniae<\/i> carbapenemase. However, there\u2019s been data to suggest an uptake in some other mechanisms, and so these authors wanted to describe the incidence of this change over the 4-year period.\u201d<\/p>\n
The researchers assessed the trends using data from the CDC\u2019s Antimicrobial Resistance Laboratory Network, which were collected from 24 states in 2019 and 29 states from 2021 to 2023.<\/p>\n
They found that CP-CRE incidence rose by 69% during the study period, while New Delhi metallo-beta-lactamase-producing-CRE and OXA-48-like-CRE rose by 461% and 5%, respectively.<\/p>\n Enlarge\u00a0Data derived from: Rankin DA, et al. Ann Intern Med. 2025;doi:10.7326\/ANNALS-25-02404.\u00a0\u00a0<\/em>Wee noted that the study excluded large states including California, Florida, New York and Texas.<\/p>\n
Still, the findings are important, she said, \u201cbecause when you have a patient with a resistant organism, what you choose to treat as an alternative antibiotic really depends on what\u2019s the underlying mechanism of the resistance because FDA-approved agents target these specifically.\u201d<\/p>\n
\u201cOne of the challenges is that these tests, these isolates, are not done in routine laboratories. If you send it to the CDC, there\u2019s somewhat of a delay,\u201d Wee said. \u201cSo, this is worrisome and something to be addressed from a public health standpoint.\u201d<\/p>\n
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Sources\/Disclosures<\/h3>\n Source: <\/h2>\n Wee C, et al. Annals of Internal Medicine<\/i>: Recent articles that you should know about. Presented at: ACP Internal Medicine Meeting; April 16-18, 2026; San Francisco.<\/p>\nReferences:<\/h2>\n\n
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