This Week's Top 5 Infectious Disease News Stories: August 15-August 21, 2026

When Daptomycin Fails: Practical Approaches to Resistant Enterococcus faecium

A liver transplant recipient who requires reoperation for biliary leak develops vancomycin- resistant Enterococcus faecium (VREfm) bacteremia and is treated with a prolonged course of high-dose daptomycin, abdominal washout, and biliary stent placement. Three weeks after stopping antibiotics, he presents with sepsis secondary to recurrent VREfm bacteremia that is now resistant to daptomycin (sensitive to linezolid, tigecycline, and eravacycline). What are the next steps?

Daptomycin-resistant E faecium (DREfm) is an emerging threat, particularly among transplant recipients and patients with hematologic malignancies. As daptomycin remains the first-line treatment for ampicillin- and vancomycin-resistant E faecium, the bacteria’s increasing resistance poses significant therapeutic challenges.

Identifying Prescribing Patterns that Pressure Antimicrobial Resistance

Fluoroquinolone prescribing was associated with antimicrobial resistance (AMR) in multiple major pathogens, in a retrospective cohort study conducted at US Veterans Affairs medical centers (VAMCs).¹

"The understanding of the drugs that most strongly drive specific resistance patterns remains incomplete, partly because of methodological challenges in assessing this association," observe Thi Mui Pham, PhD, Department of Epidemiology and Center for Communicable Disease Dynamics, Harvard TH Chan School of Public Health, Boston, MA, and colleagues.

What Are the Legalities of the Executive Order on Childhood Vaccines?

A presidential executive order changed the childhood vaccine schedule this past week, yet one of the outstanding questions is if this is legally binding for everyone to follow? The short answer is, yes, they are binding, but they do have limits. They do have the “force of the law” but it is the same as laws passed by Congress.

“Once issued, federal agencies and officials generally treat an executive order as presumptively lawful and will begin to effectuate the order by issuing regulations, revising policies, altering enforcement priorities, and even changing content and language on government websites and publications,” according to the American Constitution Society (ACS).¹

Understanding Vaccine Exemptions

This week, the Centers for Disease Control and Prevention (CDC) released the latest childhood vaccination numbers.¹ Within the statistics, the exemption rate jumped more sharply than in any prior year to 4.2%, which is up from the previous year (3.6%).¹ In the 2019-2020 school year, which is considered prepandemic, the exemption rate was 2.5%. This shows a 1.7% increase in exemptions over the last 6 years.

While these increases in the exemption rates are incremental, the number of children exposed to vaccine-preventable disease is in the thousands across the country. For example, the number of kindergartners exempt from one or more vaccines was about 155,000 during the 2025-2026 school year.²

Childhood Immunization Rates Continue Downward Slide, Raising Risk of Vaccine-Preventable Disease Outbreaks

Earlier this week, the Centers for Disease Control and Prevention (CDC) released the childhood vaccination rates, which showed they have continued to decline.¹

According to the latest CDC figures, coverage for the measles, mumps, and rubella (MMR) vaccine among kindergartners now sits at 92.4%, below the 95% threshold generally considered necessary to maintain herd immunity at the community level. The consequences are already visible: the US recorded historic numbers of measles cases in 2025 and 2026. And it is quite possible with the current vaccination rates and exemptions, the pattern will continue for measles cases to increase for 2026-2027.¹