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(1) Background. A definition of healthcare-associated infections is essential also for the attribution of the restorative burden to healthcare facilities in case of harm and for clinical risk management strategies. Regarding M. chimaera infections, there remains several issues on the ecosystem and pathogenesis. We aim to review the scientific evidence on M. chimaera beyond cardiac surgery, and thus discuss its relationship with healthcare facilities. (2) Methods. A systematic review was conducted on PubMed and Web of Science on 7 May 2024 according to PRISMA 2020 guidelines for reporting systematic reviews, including databases searches with the keyword "Mycobacterium chimaera". Article screening was conducted by tree authors independently. The criterion for inclusion was cases that were not, or were improperly, consistent with the in-situ deposition of aerosolised M. chimaera. (3) Results. The search yielded 290 eligible articles. After screening, 34 articles (377 patients) were included. In five articles, patients had undergone cardiac surgery and showed musculoskeletal involvement or disseminated infection without cardiac manifestations. In 11 articles, respiratory specimen reanalyses showed M. chimaera. Moreover, 10 articles reported lung involvement, 1 reported meninges involvement, 1 reported skin involvement, 1 reported kidney involvement after transplantation, 1 reported tendon involvement, and 1 reported the involvement of a central venous catheter; 3 articles reported disseminated cases with one concomitant spinal osteomyelitis. (4) Conclusions. The scarce data on environmental prevalence, the recent studies on M. chimaera ecology, and the medicalised sample selection bias, as well as the infrequent use of robust ascertainment of sub-species, need to be weighed up. The in-house aerosolization, inhalation, and haematogenous spread deserve experimental study, as M. chimaera cardiac localisation could depend to transient bacteraemia. Each case deserves specific ascertainment before tracing back to the facility, even if M. chimaera represents a core area for healthcare facilities within a framework of infection prevention and control policies. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Tuberculosis (TB) is a rare but known reason for hypercalcemia usually in those with underlying conditions such as renal failure, diabetes, or severe anemia. It is essential to consider TB in those with refractory or resistant hypercalcemia. Hypercalcemia or a calcium level above 10.5 mg/dL can be a manifestation of TB that only became symptomatic in a small percentage of the patients. Patients with underlying diseases such as renal failure are more prone to poor prognosis. It is essential to use anti‐TB drugs besides hypercalcemia standard treatment to maintain a normal calcium level in TB‐related hypercalcemia. In thisstudy, we have presented a young adult with disseminated TB and persistent hypercalcemia who responded finally to anti‐TB drugs. [ABSTRACT FROM AUTHOR]

Purpose of Review: 18 F-Fluorodeoxyglucose positron emission tomography (PET) combined with computed tomography (CT), referred to as 18 F-FDG PET/CT, plays a significant role in the diagnosis and management of patients with systemic infectious and inflammatory conditions. This review provides an overview of 18 F-FDG PET/CT in systemic infectious and inflammatory conditions, including infective endocarditis (IE), cardiac implantable electrical device (CIED)/left ventricular assist device (LVAD) infection, sarcoidosis, and large-vessel vasculitis (LVV)., Recent Findings: This review highlights the past and present literature in the increasing role of 18 F-FDG PET/CT in cardiovascular inflammation and infection, including diagnostic and prognostic findings. They key aspects of this paper are to highlight the importance of 18 F-FDG PET/CT in cardiovascular infection and inflammation, and to provide illustrations of how it can contribute to patient diagnosis and management., (© 2024. The Author(s).)

The aim of the study was to determine the direction and rate of the projected changes of the start, end, and duration of the growing season in Poland in two-time horizons: 2021–2050 and 2071–2100. The main part of the paper was preceded by an analysis of changes in the start and end dates and the duration of the growing season in Poland in the period 1966–2020. The growing season in Poland is projected to be the shortest in mountain areas and in the north-eastern regions of Poland, where the date of growing season start is the latest and the date of the growing season end is the earliest. Whereas the longest growing season due to the projected earliest start and latest end dates is expected in the southwestern Poland. In the case of the coast, its late end will be of the greatest importance for its duration as a result of the warming effect of the sea in the autumn–winter period. The most intensive changes are forecasted in the long-term perspective in the case of the scenario regarding a high level of greenhouse gas emissions. The forecasts show that outside mountain areas, the growing season duration will vary from less than 255 days in the northeastern regions to more than 290 days in southwest and western Poland. In the duration of the mountains, the growing season will vary from 180 days on Kasprowy Wierch to 188 days on Śnieżka. This suggests significant changes in agroclimatic conditions in Poland. [ABSTRACT FROM AUTHOR]

Background: From 2013 onwards, a large outbreak of Mycobacterium chimaera (MC) invasive infection, which was correlated with the use of contaminated heater–cooler units (HCUs) during open chest surgery, was reported from all over the world. Here, we report the results of the epidemiological and molecular investigations conducted in Italy after the alarm raised about this epidemic event. Methods: MC strains isolated from patients or from HCU devices were characterized by genomic sequencing and molecular epidemiological analysis. Results: Through retrospective epidemiological analysis conducted between January 2010 and December 2022, 40 possible cases of patients infected with MC were identified. Thirty-six strains isolated from these patients were analysed by whole genome sequencing (WGS) and were found to belong to the genotypes 1.1 or 1.8, which are the genotypes correlated with the outbreak. Most of the cases presented with prosthetic valve endocarditis, vascular graft infection or disseminated infection. Among the cases found, there were 21 deaths. The same analysis was carried out on HCU devices. A total of 251 HCUs were found to be contaminated by MC; genotypes 1.1 or 1.8 were identified in 28 of those HCUs. Conclusions: To ensure patients' safety and adequate follow-up, clinicians and general practitioners were made aware of the results and public health measures, and recommendations were issued to prevent further cases in the healthcare settings. The Italian Society of Cardiac Surgery performed a national survey to assess the incidence of HCU-related MC prosthetic infections in cardiac surgery. No cases were reported after HCU replacement or structural modification and disinfection and possibly safe allocation outside surgical rooms. [ABSTRACT FROM AUTHOR]

Background The recently published 2023 Duke-ISCVID Criteria for Infective Endocarditis for the first time consider mycobacteria (esp. Mycobacterium chimaera) as 'typical' microorganisms for prosthetic valve endocarditis (major criteria). This reflects the ongoing worldwide outbreak of M. chimaera prosthetic valve endocarditis. Case summary Our case series demonstrates a diagnostic pathway for mycobacterial endocarditis. Symptoms are unspecific, and standard microbiological testing does not result in identification of the causative agent (see Graphical Abstract); therefore patients require special microbiological and imaging diagnostics. One patient with early diagnosis and stringent antibiotic and surgical therapy survived. Two patients with disseminated infection at the time point of diagnosis had fatal outcomes. Discussion The diagnostic approach in our small retrospective case series is in line with the new modified Duke criteria and underlines the diagnostic gap in the previous definitions. Outcome of M. chimaera prosthetic valve endocarditis is related to timely diagnosis and anti-mycobacterial as well as surgical treatment. Non-tuberculous mycobacteria should be given more attention in future endocarditis guidelines. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose of Review: Pathologies of the prostate in men are one of the most prevalent clinical conditions today [1]. Specifically, pelvic inflammatory disease such as prostatitis can cause symptoms and syndromes different from urological ones, such as bowel or nervous system manifestations. This has a largely negative impact on the quality of life of patients. Therefore, it is convenient to know and update the information about the therapeutic approach to prostatitis, which is a challenge that involves different medical specialties. The aim of this article is to provide summarized and focused evidence to help in the therapeutic approach of patients with prostatitis. A computer-based search of the PubMed and Cochrane Library databases was used to perform a comprehensive literature review on prostatitis, with special interest in recent findings and latest therapeutic guideline recommendations. Recent Findings: Recent discoveries about the epidemiology and clinical classifications of prostatitis seem to incur in an increasingly individualized and directed management, with the aim of covering all the confluent factors in prostatic inflammatory pathology. In addition, the role of new drugs and combination with phytotherapy open up a range of new treatment possibilities, although future randomized studies will be necessary to better understand how to use all treatment modalities. Summary: Despite all the knowledge acquired about the pathophysiology of prostate diseases, and due to their interrelation with other pelvic systems and organs, there are still gaps that make it difficult for us to provide an optimal and standardized treatment in many of our patients. Being aware of the influence of all the factors potentially involved in prostate symptoms is crucial for a correct diagnosis and establishing an effective treatment plan. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Adaptation is a key strategy to mitigate the detrimental effects of climate change on agriculture. Econometric studies are extensively used to account for adaptation within impact assessment, but are generally based on the assumption of fully adapted farms. Building on increasing evidence of potential limitations of adaptation, we develop a conceptual framework which allows us to relax this assumption and empirically analyse climate change adaptation at the farm level. Our findings indicate under-adaptation of Austrian farms, contradicting the assumption of full adaptation. In the context of ongoing climate change, this calls for further development and implementation of effective farm-level adaptation measures. [ABSTRACT FROM AUTHOR]

Background: Disseminated Mycobacterium chimaera (M. chimaera) infection following cardiac surgery has been associated with a high mortality. The long-term impact of surgery and the appropriate surgical approach are still matters of debate. Methods: From 2015 to 2019, seven patients with M. chimaera infection following cardiac surgery were isolated. Results: The median incubation time was 30 months (IQR 18–38). Echocardiography was unremarkable in three patients (43%). We decided to redo cardiac surgery in all patients and explanted all previously implanted prosthetic material. All explant cultures yielded M. chimaera. One patient (14%) died in-hospital seven months after the redo surgery. After a median follow-up of 59.6 months (IQR 39.1–69.6), we observed three infection relapses among the survivors (43%), presumably due to concomitant extracardiac infection and recurrent cardiac implant infection. Conclusions: M. chimaera infection following cardiac surgery is associated with a delayed and unspecific clinical presentation. Echocardiogaphy has a limited sensitivity for prosthetic valve infection with M. chimaera, and negative findings should not preclude the surgical decision. The extraction of all previously implanted material is crucial to achieving the source control, as the re-implantation of prosthetic material as well as uncontrolled extracardiac infection at the time of the redo cardiac surgery appear to be key factors for persisting/relapsing infection. [ABSTRACT FROM AUTHOR]

Background: Disseminated Mycobacterium chimaera infection is an emerging disease in people undergone to cardiothoracic surgery, which need to be suspected also with atypical presentations. Case presentation: We report the case of a 74-year-old man with fever of unknown origin, purple nodules on both feet and a history of open-heart surgery. Imaging investigations showed an abscess near aortic bioprosthesis but screening for endocarditis resulted negative and pyrexia did not respond to antibiotic therapy. A biopsy of cutaneous lesions showed HHV8-related Kaposi's sarcoma, so bone marrow biopsy was executed with evidence of HHV8 localization. Bone marrow and urine mycobacterial cultures resulted positive for M. chimaera and a specific antimicrobial therapy was started, with apyrexia after 7 weeks. Conclusions: M. chimaera infection should be always investigated as a possible etiology of fever of unknow origin in people with a history of open-heart surgical intervention, even with negative mycobacterial blood cultures. The possible role of disseminated infection in inducing immunodepression with the occurrence of other opportunistic diseases (such as Kaposi's sarcoma) cannot be excluded. [ABSTRACT FROM AUTHOR]

Simple Summary: Nowadays, most consumers prefer table eggs from free-range laying hens. At the same time, relatively few studies exist on the possible effects of free-range rearing on the oxidative status of fowls and their egg production. This trial studied the influence of environmental conditions (cold, thermoneutral and hot period) on the oxidative status of different genotypes of free-range laying hens and the effect of oxidative stress (OS) on their egg production. The factor "temperature period", compared to "year" and "genotype", had the most significant influence on all biochemical parameters determining OS. The chicken genotypes showed differences in their susceptibility to OS, and this had an effect on egg production. The OS is genotypically specific and can play a significant role in determining welfare and egg production in free-range systems. This study aimed to assess the changes in the oxidative status of six genotypes of free-range laying hens during cold, thermoneutral, and hot periods by measuring the levels of lipid peroxidation (LPO), total glutathione (tGSH), and the activity of antioxidant enzymes catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) in erythrocyte suspension, in relation with their egg production. Two identical experiments were conducted in two consecutive years. Thermal stress adversely affected the oxidative status of hens. The induced OS is expressed by an increase in LPO and the activities of antioxidant enzymes SOD and GPx during cold and hot periods and a decrease in CAT and tGSH during the cold period in both years. The factor "temperature period", compared to "year" and "genotype", had the most significant influence on all biochemical parameters (p < 0.001). Significant phenotypic correlations (p < 0.05) were detected among studied biochemical parameters, except between SOD and tGSH. The chicken genotypes showed differences in their susceptibility to OS and this had an effect on egg production—from 37.87% to 74.93%. The OS is genotypically specific and can play a significant role in determining welfare and egg production in free-range systems. [ABSTRACT FROM AUTHOR]

Water pollution has been a major issue across the globe because of industrial activities to meet the needs of people. Many chemicals are released into the environment through these processes, which affect human health and the environment. Hence, the study aimed to assess the concentration of heavy metals (Cu, Zn, Mn, Ni, Hg, and Fe) and the physicochemical and biological properties of the Dankra River. The samples were taken from three locations, Konyaw, Jumako, and Anwiankwanta, and subjected to standard laboratory tests using Atomic Absorption Spectroscopy (AAS) and Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). Results revealed that the Dankran river was not polluted with the selected heavy metals under study. The physicochemical properties, the biological oxygen demand (BOD), chemical oxygen demand (COD), and nitrogen, phosphorus, and potassium (NPK) concentrations were all within the allowable healthy limits according to WHO standards. Iron was the predominant metal in the Dankran river, with the highest concentration of 6.5913 mg/l. Thus, the river is safe to use, but there is a need for regular monitoring to support life. The order of concentration of the investigated metals follows this pattern in descending order: Fe > Mn > Cu > Zn > Ni > Hg. [ABSTRACT FROM AUTHOR]

Infections due to Klebsiella pneumoniae have been increasing in intensive care units (ICUs) in the last decade. Such infections pose a serious problem, especially when antimicrobial resistance is present. We created a task force of experts, including specialists in intensive care medicine, anaesthesia, microbiology and infectious diseases, selected on the basis of their varied experience in the field of nosocomial infections, who conducted a comprehensive review of the recently published literature on the management of carbapenemase-producing Enterobacterales (CPE) infections in the intensive care setting from 2012 to 2022 to summarize the best available treatment. The group established priorities regarding management, based on both the risk of developing infections caused by K. pneumoniae and the risk of poor outcome. Moreover, we reviewed and updated the most important clinical entities and the new antibiotic treatments recently developed. After analysis of the priorities outlined, this group of experts established a series of recommendations and designed a management algorithm. [ABSTRACT FROM AUTHOR]

Mycobacterium chimaera is a slow-growing, nontuberculous mycobacterium (NTM) belonging to the Mycobacterium avium complex (MAC). It was identified as a unique species in 2004. Since 2013 it has been reported as a cause of disseminated infection in patients after cardiac surgeries. Only a few cases associated with underlying lung diseases have been noted. M. chimaera infection is characterized by ambiguous symptoms. There is no treatment with proven effectiveness, and it has a poor prognosis. Silicosis is a disease that can predispose to mycobacterial infection. Silica damages pulmonary macrophages, inhibiting their ability to kill mycobacteria. We present a case of M. chimaera infection in a patient with silicosis and without other comorbidities. To our knowledge, it is the first case of silicosis associated with M. chimaera disease. A 45-year-old man presented with a persistent low-grade fever. Based on the clinical and radiological picture, positive cultures, and histological examination, the nontuberculous mycobacterial disease was diagnosed. First, multidrug therapy according to the treatment guidelines for MAC was implemented, then antibiotics were administrated, based on drug sensitivity. Despite the treatment, eradication was not achieved and the patient died. The analysis of M. chimaera infection cases could contribute to developing recommendations and thus improve the prognosis. [ABSTRACT FROM AUTHOR]

Background: Mycobacterium chimaera ocular infection is a rare disease that is linked to bypass devices used during cardiothoracic surgeries. Reported cases in the literature of ocular involvement preceding CNS involvement are based on clinical exam with no neuroimaging. Here we present a case of M. chimaera ocular infection with no CNS M. chimaera lesions on brain magnetic resonance imaging (MRI).Case Presentation: A 59-year-old female presented with altered mental status and blurred vision in February 2021. Her past medical history was significant for aortic valve replacement and ascending aortic aneurysm repair in 2017 complicated by known M. chimaera infection. She had been receiving azithromycin, ethambutol, rifampin, and amikacin as systemic anti-mycobacterium treatment. Her dilated fundus exam showed numerous yellow placoid circular lesions scattered throughout the macula and peripheral retina in both eyes with associated vitritis. Systemic workup, including brain MRI showed no acute infectious lesions. Her infections workup was unremarkable except for a positive toxoplasma IgM, for which she was treated with sulfamethoxazole/trimethoprim. One month later, a head computed tomography showed new numerous scattered round foci of hyperdensity throughout the cerebrum and brainstem thought to be foci of M. chimaera infection. Clofazimine was added per culture and sensitivity. MRI brain 1 month later showed mild decrease in conspicuity and number of these intensities while on anti-mycobacterium treatment. Her cognition had improved at that time as well. She was seen in retina clinic 2 months later where her exam showed similar retinal lesions with no associated vitritis or anterior chamber cell in bilateral eyes, suggesting a lack of active infection. Optical coherence tomography macula showed parafoveal cystoid macular edema bilaterally. She was started on steroidal and non-steroidal anti-inflammatory eye drops.Conclusions: To the best of our knowledge, this is the first case in the literature to report M. chimaera chorioretinitis with concomitant negative neuroimaging. Chorioretinal M. chimaera lesions should motivate high suspicion of CNS involvement prompting early neurological work up. [ABSTRACT FROM AUTHOR]

This study aims to evaluate associations between the immunochromatographic rapid test technique and Trichomonas vaginalis (TV) infection in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in Taiwan. All patients received post-prostate massage urine (VB3) Trichomonas rapid tests. The demographic characteristics and urogenital symptoms of CP/CPPS were recorded. Routine urinalysis of VB3 was also performed, and laboratory examination results of semen were recorded if available. A total of 29 patients with TV infection and 109 without TV infection were enrolled, which reflected that the prevalence in patients with TV infection was approximately 21%. Patients with TV infection displayed a significantly higher frequency of suprapubic/lower abdominal pain (p = 0.034), semen leukocyte > 5/high-power field (HPF) (p = 0.020), and an inflammatory type (category IIIA) (p = 0.005) than patients without TV infection. A higher prevalence of TV infection was found in patients with category IIIA (47.37%). No significant difference was found in the symptom duration and other clinical symptoms. In conclusion, the high prevalence of TV infection was revealed in CP/CPPS patients using the VB3 rapid Trichomonas test, especially in CP/CPPS patients with category IIIA. Thus, rapid TV testing might be vital for CP/CPPS patients in the hospital. [ABSTRACT FROM AUTHOR]

Extreme droughts have a strong impact on agricultural production. In France, the 2003 drought generated records of yield losses at a national scale for grassland (more than 30%) and for cereals (more than 10% for soft winter wheat and winter barley). These extreme events raise the question of farm resilience in the future. Studying them makes it possible to adapt risk management policy to climate change. Therefore, the objective of this paper was to analyze the frequency and the intensity of extreme drought in 2050 and their impact on crop yield losses (grassland and cereals) in France. We used the DOWKI (Drought and Overwhelmed Water Key Indicator) meteorological index based on a cumulative water anomaly, which can explain droughts and their consequences on agricultural yield losses at a departmental scale. Then, using the ARPEGE-Climat Model developed by Meteo-France, DOWKI was projected in 2050 and grassland, soft winter wheat, and winter barley yield losses were simulated. The results compare the frequency and intensity of extreme droughts between the climate in 2000 and 2050. Our results show that the frequency of extreme droughts (at least as intense as in 2003) doubled in 2050. In addition, the yield losses due to 10-year droughts increased by 35% for grassland and by more than 70% for cereals. [ABSTRACT FROM AUTHOR]

In 2018, Mycobacterium canariasense bloodstream infection was diagnosed in Israel. Further investigation had identified additional five cases in three medical centers, including isolates from blood (1), cornea (1), and sputum (3). Isolates were susceptible to all the antimicrobial tested. All but one isolate was related by whole-genome phylogeny. [ABSTRACT FROM AUTHOR]

Mycobacterium chimaera is a non-tuberculous mycobacterium, member of the Mycobacterium avium complex (MAC), which has become a global public health concern due to infection following cardiac surgery performed with contaminated heater-cooler units. M. chimaera infection is characterized by a long latency, non-specific signs and symptoms and high mortality rates. Thus, the diagnosis is still challenging both for forensic pathologists and for clinicians. Clinical manifestations of M. chimaera infection include endocarditis, hepatitis, nephritis, encephalitis and chorioretinitis. A constant histopathologic finding is the presence of non-caseating granulomas, with multinucleated giant cells and histiocytes. Hereby, we present two cases of fatal disseminated M. chimaera infection following aortic valve surgery reporting clinical history and post-mortem findings. Further, we provide a brief overview of the literature with a special focus on histopathological characteristics of M. chimaera infection. The aim of this article is to provide a complete synopsis of histopathological characteristics useful for forensic pathologists. [ABSTRACT FROM AUTHOR]

Crop planting dates control the yield and cropping intensity of rainfed agriculture, and modifying planting dates can be a major adaptation strategy under climate change. However, shifts in rainfall seasonality may constrain farmers’ ability to adapt planting dates, and imperfect knowledge of how farmers currently select planting dates makes it difficult to predict how adaptations will proceed. This study analyzes variations in soybean planting and wet season onset dates across the agricultural state of Mato Grosso (MT), Brazil, for 2004 to 2014. It starts by exploring the strength of relationships between planting date and several precipitation-based definitions of the wet season onset, and shows that planting date is better correlated to easily observed onset definitions based on rainfall frequency than to climatological definitions. Next, a regression analysis shows that the sensitivity of planting dates to wet season onset exhibits large variations with cropping intensity and across farm fields, and that planting dates trended earlier over the study period, independently of onset variations. Finally, the results are used to predict soy planting dates in Mato Grosso under the RCP 8.5 climate scenario. Predictions show that planting dates will likely become delayed relative to preferred times, and that this may preclude double cropping in some parts of the state. This study demonstrates that the simple assumptions about farmers’ behavior often used in agricultural forecasting omit important spatio-temporal variations. Improved understanding of planting choices can reduce uncertainty in projected agricultural responses to climate change and highlight important areas for policy and agronomic adaptation. [ABSTRACT FROM AUTHOR]

Infective endocarditis (IE) is a life-threatening disease with stable prevalence despite prophylactic, diagnostic, and therapeutic advances. In parallel to the growing number of cardiac devices implanted, the number of patients developing IE on prosthetic valves and cardiac implanted electronic device (CIED) is increasing at a rapid pace. The diagnosis of IE is particularly challenging, and currently relies on the Duke-Li modified classification, which include clinical, microbiological, and imaging criteria. While echocardiography remains the first line imaging technique, especially in native valve endocarditis, the incremental value of two nuclear imaging techniques, 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG-PET/CT) and white blood cells single photon emission tomography with computed tomography (WBC-SPECT), has emerged for the management of prosthetic valve and CIED IE. In this review, we will summarize the procedures for image acquisition, discuss the role of 18F-FDG-PET/CT and WBC-SPECT imaging in different clinical situations of IE, and review the respective diagnostic performance of these nuclear imaging techniques and their integration into the diagnostic algorithm for patients with a suspicion of IE. [ABSTRACT FROM AUTHOR]

Due to their non-specific diagnostic patterns of ocular infection, differential diagnosis between Mycobacterium (M.) chimaera and tuberculosis can be challenging. In both disorders, ocular manifestation can be the first sign of a systemic infection, and a delayed diagnosis might reduce the response to treatment leading to negative outcomes. Thus, it becomes imperative to distinguish chorioretinal lesions associated with M. chimaera, from lesions due to M. tuberculosis and other infectious disorders. To date, multimodal non-invasive imaging modalities that include ultra-wide field fundus photography, fluorescein and indocyanine green angiography, optical coherence tomography and optical coherence tomography angiography, facilitate in vivo examination of retinal and choroidal tissues, enabling early diagnosis, monitoring treatment response, and relapse detection. This approach is crucial to differentiate between active and inactive ocular disease, and guides clinicians in their decisional-tree during the patients' follow-up. In this review, we summarized and compared the available literature on multimodal imaging data of M. chimaera infection and tuberculosis, emphasizing similarities and differences in imaging patterns between these two entities and highlighting the relevance of multimodal imaging in the management of the infections. [ABSTRACT FROM AUTHOR]

Non-tuberculous mycobacteria (NTM) are opportunistic pathogens that cause illness primarily in the elderly, in the immunocompromised or in patients with underlying lung disease. Since 2013, a global outbreak of NTM infection related to heater-cooler units (HCU) used in cardio-thoracic surgery has been identified. This outbreak was caused by a single strain of Mycobacterium intracellulare subsp. chimaera. In order to estimate the prevalence of this outbreak strain in Israel, we sampled Mycobacterium intracellulare subsp. chimaera from several HCU machines in Israel, as well as from patients, sequenced their genomes and compared them to the outbreak strain. The presence of mixed mycobacteria species in the samples complicated the analysis of obtained sequences. By applying a metagenomic binning strategy, we were able to obtain, and characterize, genomes of single strains from the mixed samples. Mycobacterium intracellulare subsp. chimaera strains were compared to each other and to previously reported genomes from other countries. The strain causing the outbreak related to the HCU machines was identified in several such machines in Israel but not in any clinical sample. [ABSTRACT FROM AUTHOR]