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ABSTRACTIntroductionCommunity-acquired methicillin-resistant Staphylococcus aureus(CA-MRSA) infections represent a leading cause of purulent skin and soft tissue infections in some geographical regions. Traditionally, ‘old antibiotics’ such as trimethoprim-sulfamethoxazole, tetracyclines, clindamycin, chloramphenicol,vancomycin, and teicoplanin have been used to treat these infections, but these were often associated with low efficacy and excessive side effects and toxicity, especially nephrotoxicity. Along with the development of new compounds, the last decade has seen substantial improvements in the management of CA-MRSA infections.Areas coveredIn this review, the authors discuss the current and emerging drug treatment strategies to tackle invasive CA-MRSA infections. Articles reported in this review were selected from through literature searches using the PubMed database.Expert opinionThe availability of new drugs showing a potent in vitro activity against CA-MRSA represents a unique opportunity to face the threat of resistance while potentially reducing toxicity. All these compounds represent promising options to enhance our antibiotic armamentarium. However, data regarding the use of these new drugs in real-life studies are limited and their best placement in therapy and in terms of optimization of medical resources and balance of cost-effectiveness requires further investigation.

Introduction: Candida auris(C. auris) is an emerging nosocomial pathogen, and a sharp rise in cases of colonization and infection has been registered in intensive care units (ICUs) during the ongoing coronavirus disease 2019 (COVID-19) pandemic. The unfavorable resistance profile of C. aurisand the potential high mortality of C. aurisinfections represent an important challenge for physicians. Methods: We conducted a single-center retrospective study including all patients admitted to ICUs with isolation of C. aurisin any non-sterile body site between February 20, 2020, and May 31, 2021. The primary aim of the study was to assess the cumulative incidence of C. auriscandidemia in colonized patients. The secondary aim was to identify predictors of C. auriscandidemia in the study population. Results: During the study period, 157 patients admitted to ICUs in our hospital became colonized with C. auris; 59% of them were affected by COVID-19. Overall, 27 patients (17%) developed C. auriscandidemia. The cumulative risk of developing C. auriscandidemia was > 25% at 60 days after first detection of C. auriscolonization. Seven patients with C. auriscandidemia (26%) also developed a late recurrent episode. All C. aurisblood isolates during the first occurring episode were resistant to fluconazole and susceptible to echinocandins, while 15 (56%) were resistant to amphotericin B. During late recurrent episodes, emergent resistance to caspofungin and amphotericin B occurred in one case each. In the final multivariable model, only multisite colonization retained an independent association with the development of C. auriscandidemia. Conclusion: Candida auriscandidemia may occur in up to one fourth of colonized critically ill patients, and multisite colonization is an independent risk factor for the development of candidemia. Implementing adequate infection control measures remains crucial to prevent colonization with C. aurisand indirectly the subsequent development of infection.

Background: The goal of this study was to investigate the prevalence and factors associated with persistent viral shedding (PVS) in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods: This was a prospective observational study including all consecutive adults hospitalized with SARS-CoV-2 infection. When the first nasopharyngeal swab was positive for SARS-CoV-2 RNA (day 0), additional samples were obtained on days + 3, + 5, + 7 and then once every 7 days until virus detection was negative. PVS was defined as the duration of shedding of at least 21 days after diagnosis. The primary endpoint of this study was the prevalence of PVS. Results: Data were obtained regarding 121 consecutive hospitalized patients with SARS-CoV-2 infection (median age 66 years, male sex 65.3%). Overall, the prevalence of PVS was 38% (46/121 patients). According to univariate analysis, factors associated with PVS were immunosuppression (6.7% vs 21.7%, p= 0.02), increased interleukin-6 (IL-6) levels (≥ 35 ng/ml) at the time of diagnosis (43.4% vs 67.3%, p= 0.02), time from onset of symptoms to diagnosis (median days 7.0 vs 3.5, p= 0.001), intensive care unit admission (22.7% vs 43.5%, p= 0.02), and need for invasive mechanical ventilation (20.0% vs 41.3%, p= 0.01). The multivariate analysis indicated that immunosuppression, increased IL-6 levels at the time of diagnosis, time from onset of symptoms to diagnosis, and need for mechanical ventilation were independent factors associated with PVS. Conclusions: PVS was detected in up to 38% of hospitalized patients with SARS-CoV-2 infection and was strongly associated with immunosuppression, increased IL-6 levels, and the need for mechanical ventilation.

ABSTRACTIntroductionMethicillin-resistant Staphylococcus aureus(MRSA) is among the most frequent causative agents of acute bacterial skin and skin-structure infections (ABSSSI) and has been associated with increased risks of invasive disease and of treatment failure.Areas coveredIn this review, we focus on those novel anti-MRSA agents currently in phase I or II of clinical development that may enrich the armamentarium against ABSSSI caused by MRSA in the future.Expert opinionPromising agents belonging to either old or novel antibiotic classes are currently in early phases of clinical development and may become available in the future for the effective treatment of ABSSSI caused by MRSA. In particular, the future availability of agents belonging to novel classes will be important for guaranteeing an effective treatment and for allowing outpatient treatment/early discharge, with a consequent reduced impact on healthcare resources. However, this does not mean that we can relax our efforts directed toward improving the responsible use of already available agents. Indeed, preserving their activity in the long term is crucial for optimizing the use of healthcare resources.

Aggregation‐induced emission has eliminated the problem of fluorescence quenching in the solid state, making molecules with this property excellent candidates for vapor sensing due to their portability and ease of interpretation. Here, films of polystyrene / 2‐[4‐vinyl(1,10‐biphenyl)‐40‐yl]‐cyanovinyljulolidine copolymers are reported that exhibit aggregation‐induced emission behavior for the detection of toluene, m‐xylene, dichloromethane, and chloroform. After exposure to the analytes, the emission of the copolymers shows significant changes in intensity and spectral shape corresponding to the reduced microviscosity of the molecular environment. However, these changes are similar for different analytes, resulting in low chemical selectivity. Therefore, label‐free selectivity is achieved by controlling the molecular diffusion of the four vapor analytes within the films using the Flory–Huggins solution theory with capping layers of cellulose acetate (CA) and poly(vinyl alcohol) (PVA) polymers. Thin polymer films using moieties displaying aggregation‐induced emission are promising as optical transducers in chemical sensing. This is important for the development of fluorescent vapor sensors. In this work, the authors demonstrate the use of simple diffusion barrier layers to increase the selectivity of the films without the need for chemical labeling.