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Staphylococcus aureus, a prevalent human pathogen and a leading cause of hospital-acquired infections, is increasingly evolving antibiotic-resistant strains, increasing mortality and morbidity rates. Anti-staphylococcal vaccine research for prevention and treatment has become a priority. Antibodies against specific S. aureus components, toxins, and polysaccharides have demonstrated encouraging results in animal studies regarding protection against colonization or infection. However, human immunization trials have yielded less optimistic outcomes, with no anti-staphylococcal having passed clinical trials up to now. Although multiple formulation attempts triggered strong antibody responses, the vaccines could not effectively prevent S. aureus infections. This article delves into the results of immunotherapeutic strategies against S. aureus in both animal and human studies, discussing the feasibility of adequate immunization approaches against S. aureus in humans. [ABSTRACT FROM AUTHOR]

Diarrhoea represents a significant public health concern worldwide and is responsible for an increase in mortality and morbidity, especially among children but also among adults. Cryptosporidium, one of the most common intestinal protozoan parasites, is the etiological agent of cryptosporidiosis, an acute infection with self-limiting evolution, but that can evolve into severe diarrhoea in children and immunosuppressed hosts. The main species that cause human cryptosporidiosis are C. parvum and C. hominis. Despite the progress made in order to control and monitor cryptosporidiosis at the global level, numerous outbreaks have been reported with the source of infection being food or water. Using Promedmail.org we have performed a review of Cryptosporidium related outbreaks reported in the last 10 years over the world. [ABSTRACT FROM AUTHOR]

Predecessors in the Romanian School of Microbiology established several golden guidelines for the clinical integration of the microbiology laboratory, the clinical rationale behind the infectious disease patients, and the antibiotic administration. However, without a determined mind to continue, strengthen, and nurture the work they have undertaken, professors Ion Cantacuzino, Victor Babes, and Matei Bals' expertise would have vanished [1-3]. Professor Angelescu proved to be the ideal individual right when he was most needed, determined to carry on their legacy, to further advance antibiotic knowledge, and a patient, father-like figure to his younger colleagues. He answered the invitation to become a leading authority at a time when advances in the science of antibiotics had doctors puzzled. The "Angelescu's Guide" was intended to be a lifeline for what would soon become one of the major challenges of the twenty-first century: antibiotic resistance in delicate clinical settings. Actual, achievable strategies for the care of an infectious illness patient are provided below, as are pertinent research recommendations for younger and fresher medical minds. [ABSTRACT FROM AUTHOR]

Despite the global economic development, diarrhoea remains an important health concern worldwide. The epidemiological importance of Shigella spp. infections is very high, being the leading cause of bacterial diarrhoea. Clinically, shigellosis can manifest as watery diarrhoea or dysentery, with bloody stool, accompanied by fever and abdominal pain. Children and the elderly are most susceptible to developing severe forms. In this review, we highlight the rise of antibiotic-resistant Shigella spp. strains and provide an overview of recent shigellosis outbreaks. Shigellosis is an infectious disease that should not be neglected, as evidenced by the many outbreaks reported throughout the world. [ABSTRACT FROM AUTHOR]

Malaria is a serious and, in some unfortunate cases, fatal disease caused by a parasite of the Plasmodium genus. It predominantly occurs in tropical areas where it is transmitted through the bite of an infected Anopheles mosquito. The pathogenesis of malaria is complex and incompletely elucidated. During blood-stage infection, in response to the presence of the parasite, the host's immune system produces proinflammatory cytokines including IL-6, IL-8, IFN-γ, and TNF, cytokines which play a pivotal role in controlling the growth of the parasite and its elimination. Regulatory cytokines such as transforming growth factor- (TGF-) β and IL-10 maintain the balance between the proinflammatory and anti-inflammatory responses. However, in many cases, cytokines have a double role. On the one hand, they contribute to parasitic clearance, and on the other, they are responsible for pathological changes encountered in malaria. Cytokine-modulating strategies may represent a promising modern approach in disease management. In this review, we discuss the host immune response in malaria, analyzing the latest studies on the roles of pro- and anti-inflammatory cytokines. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) poses a medical, social, and economic problem. In Romania since 2002, the prevention of HIV transmission and the care for HIV-positive people have been overseen by Governmental Law. HIV infection in Romania has some particularities, such as the high number of HIVinfected patients under treatment and the high percentage of long-term survivors. Romania reported its first case of AIDS to the World Health Organization in 1985, and its first case in the pediatric population in 1989. A year later, a new case definition, based on local possibilities was formulated together with the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC, Atlanta, GA). According to the latest report of the Compartment for Monitoring and Evaluation of HIV/AIDS in Romania, the cumulative number of HIV cases registered between 1985-2021 was 26,171, while the number of people living with HIV at the end of December 2021 was 17,271. [ABSTRACT FROM AUTHOR]

Providential personalities have been writing history since the beginning of times - personalities that could be found within and across Romania's borders [1]. In medicine, such brilliant figures have healed patients through diligence, dedication, and professionalism, but have also passed significant teachings to the next generations. They have rigorously respected an authentic professor's definition, a figure that teaches and prepares specialists for the future. The great medical personalities, Ion Cantacuzino and Victor Babeș, have been mentored by famous professors, have also become famous professors on their own, and they have educated doctors and professors who have carried on their research and medical teaching legacies. Through study, through diligence, and an impressive personal development, their students have also become proficient figures in medicine [1-2]. They have trained personalities in the medical field that could have reached higher peaks, were it not for the political and social climate of their country. Among those, now we shall bring into discussion professor Matei Balș, a remarkable man and teacher, whose contribution focused the necessity of employing strict and correct means of practice, tying together in an organic way the clinical and the laboratory work, a dogma which he has passed on to his students. He has funded the "School of Infectious Diseases" at Colentina Hospital and has formulated teachings that stand the test of time; his working approach is still appropriate and praised today. The current generation as well as future ones not only have the obligation to recognise the exceptional achievements of our ancestors in history, but to also keep them alive and develop upon them, in the interest of the Romanian people, Romania itself, but also for the public health system at an international level [1]. [ABSTRACT FROM AUTHOR]

The pathogenesis of chronic wounds (CW) involves a multifaceted interplay of biochemical, immunological, hematological, and microbiological interactions. Biofilm development is a significant virulence trait which enhances microbial survival and pathogenicity and has various implications on the development and management of CW. Biofilms induce a prolonged suboptimal inflammation in the wound microenvironment, associated with delayed healing. The composition of wound fluid (WF) adds more complexity to the subject, with proven pro-inflammatory properties and an intricate crosstalk among cytokines, chemokines, microRNAs, proteases, growth factors, and ECM components. One approach to achieve information on the mechanisms of disease progression and therapeutic response is the use of multiple high-throughput 'OMIC' modalities (genomic, proteomic, lipidomic, metabolomic assays), facilitating the discovery of potential biomarkers for wound healing, which may represent a breakthrough in this field and a major help in addressing delayed wound healing. In this review article, we aim to summarize the current progress achieved in host–microbiome crosstalk in the spectrum of CW healing and highlight future innovative strategies to boost the host immune response against infections, focusing on the interaction between pathogens and their hosts (for instance, by harnessing microorganisms like probiotics), which may serve as the prospective advancement of vaccines and treatments against infections. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis is an often-overlooked condition that otherwise negatively impacts both the individual and the community, prompting major public health concerns. Early diagnosis and treatment, as well as collaboration between specialties including surgery and parasitology, are essential for avoiding complications and disease relapse. To better illustrate this, we present the case of an elderly person with a rare localization of the disease at the muscular level. The patient underwent numerous surgical interventions, and received multiple courses of antiparasitic treatment over the course of 40 years as a result of the multivisceral dissemination of the parasite. [ABSTRACT FROM AUTHOR]

Acne vulgaris is a chronic inflammatory skin disease of the pilosebaceous unit. Its pathogenesis is multifactorial and involves the overlap between four main processes: alteration of the keratinization, increased sebum production, colonization with Cutibacterium acnes, and inflammation. The role of oxidative stress (OS) has been intensively studied in inflammatory skin conditions such as psoriasis, vitiligo, or atopic dermatitis. However, the involvement of OS in the pathogenesis of acne is less known. The evidence accumulated over the last decade suggests that in the case of acne patients, there is an imbalance between oxidants and antioxidants. In this review, we analyzed studies that evaluated markers of OS in patients with acne, published in the last ten years, with the aim of providing new insights into the pathogenesis of acne. [ABSTRACT FROM AUTHOR]

Neisseria meningitidis (Nm) is the pathogen carried asymptomatically in the nasopharynx but which under certain conditions can produce meningitis or even multi-organ failure. Experimental induction of meningitis in an animal model is necessary for testing new nanopharmaceutical products. Thus, the aim of the study was to establish the concentration of Nm capable of inducing the disease. We carried out 2 studies where we tested different concentrations of Nm obtained by the nephelometric and spectrophotometric methods. In the first study we included 20 BALB/c mice, and in the second 24. Local and general clinical signs, complete with body temperature values, body weight, hematological, microbiological and histopathological examination were important indicators for the assessment of the establishment of meningitis. The clinical results have pronounced depression in the first 2 days after inoculation, then the general condition will appear. The microbiological and histopathological examination indicated the presence of bacteria at the brain level and specific meningeal lesions only in the case of the second attempt, but the early mortality, requires additional testing of the bacterial concentration that induces meningites in a stable and persistent way so that treatment against the condition can be tested later. [ABSTRACT FROM AUTHOR]

Background: Romania is one of the European countries reporting very high antimicrobial resistance (AMR) rates and consumption of antimicrobials. We aimed to characterize the AMR profiles and clonality of 304 multi-drug resistant (MDR) Acinetobacter baumannii (Ab) and Pseudomonas aeruginosa (Pa) strains isolated during two consecutive years (2018 and 2019) from hospital settings, hospital collecting sewage tanks and the receiving wastewater treatment plants (WWTPs) located in the main geographical regions of Romania. Methods: The strains were isolated on chromogenic media and identified by MALDI-TOF-MS. Antibiotic susceptibility testing and confirmation of ESBL- and CP- producing phenotypes and genotypes were performed. The genetic characterization also included horizontal gene transfer experiments, whole-genome sequencing (WGS), assembling, annotation and characterization. Results: Both clinical and aquatic isolates exhibited high MDR rates, especially the Ab strains isolated from nosocomial infections and hospital effluents. The phenotypic resistance profiles and MDR rates have largely varied by sampling point and geographic location. The highest MDR rates in the aquatic isolates were recorded in Galați WWTP, followed by Bucharest. The Ab strains harbored mostly blaOXA-23, blaOXA-24, blaSHV, blaTEM and blaGES, while Pa strains blaIMP, blaVIM, blaNDM, blaVEB, blaGES and blaTEM, with high variations depending on the geographical zone and the sampling point. The WGS analysis revealed the presence of antibiotic resistance genes (ARGs) to other antibiotic classes, such as aminoglycosides, tetracyclines, sulphonamides, fosfomycin, phenicols, trimethoprim-sulfamethoxazole as well as class 1 integrons. The molecular analyses highlighted: (i) The presence of epidemic clones such as ST2 for Ab and ST233 and ST357 for Pa; (ii) The relatedness between clinical and hospital wastewater strains and (iii) The possible dissemination of clinical Ab belonging to ST2 (also proved in the conjugation assays for blaOXA-23 or blaOXA-72 genes), ST79 and ST492 and of Pa strains belonging to ST357, ST640 and ST621 in the wastewaters. Conclusion: Our study reveals the presence of CP-producing Ab and Pa in all sampling points and the clonal dissemination of clinical Ab ST2 strains in the wastewaters. The prevalent clones were correlated with the presence of class 1 integrons, suggesting that these isolates could be a significant reservoir of ARGs, being able to persist in the environment. [ABSTRACT FROM AUTHOR]

One of the main concerns of the medical community during the COVID-19 pandemic has been the management of the immunosuppression accompanying the disease, particularly in ICU (Intensive Care Unit) patients. More recently, the focus has shifted towards the management of the persistent immunosuppression post-acute COVID-19 and its complications. The rate of healthcare-associated infections (HAIs) had been declining before the pandemic, but has since started to increase once more. Due to multiple factors - unnecessary antibiotherapy, disorganized medical facilities, inadequate personal protection equipment etc. - there have been increasing reports of coinfections and secondary infections with multidrug-resistant bacteria in COVID-19 patients. We present a case report of a patient with no history of clinically overt immunosuppression before developing critical SARS-CoV-2 pneumonia. The patient had no need for antibiotic treatment during his hospitalization and was discharged in a stable state, being consequently readmitted multiple times for different healthcare-associated multidrug-resistant infections, over time developing other hospital-related complications. The case raises a discussion about the bidirectional relationship between post-COVID immunosuppression and the possible inadvertent excess in antibiotic therapy that has accompanied the pandemic. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 infection increases the risk of multi-organ systemic complications and venous and arterial thromboembolism. The development of vaccines has proven to be an effective method to combat severe forms of infection. Adverse effects reported after COVID-19 vaccination consisted of local injection site reaction, fatigue, myalgia, or fever as well as sporadic cases of vaccine-induced thrombotic immune thrombocytopenia, especially viral vector vaccines. Objectives: The aim of the study was to evaluate the repeated dose toxicity of a candidate vaccine against SARS- CoV-2, a test in which several parameters were analyzed, including coagulation factors. Materials and methods: The test included 120 rats, of both sexes, divided into six groups (main group, recovery group and control group) at which the human dose, 10X human dose and 1 control adjuvant were tested. The vaccine was administered intranasally, 4 times every two weeks. The final day was after the last administration to the main group and another 30 days from the last administration to the recovery group. On day 0 and the final day, blood was collected for hematological, biochemical, immunological examinations and coagulation tests (Fibrinogen, Prothrombin Time-PT, Activated Partial Thromboplastin Time-aPTT and Thrombin Time-TT). Results: Fibrinogen, in the case of all groups, increased on the final day, except for females from the recovery groups where this parameter decreased by 25%. PT, aPTT and TT, regardless of group or sex, had low values compared to the initial time of the study. On day 0, the values of the coagulation factors were homogeneous, the fibrinogen being between 155- 347mg / dL, PT 25.5-57.8 sec, aPTT 61.9-120 sec and TT values of 53-60 sec. On the final day, the group analysis also showed unit values. Fibrinogen increased between 90-116%, PT decreased by 48-71%, aPTT decreased by 59-80%, and TT had values lower by 10-14% compared to the initial day. Conclusions: Increased fibrinogen associated with decreased PT and aPTT is common in human clinical pathology. Fibrinogen, PT, aPTT and TT are the standard parameters of blood clotting assessed in toxicity tests. The results obtained in the study represent a preliminary phase which, corroborated with the results of the other tests, supports the conclusion that the candidate vaccine does not have toxicological potential, the coagulation factors not being influenced after its repeated administration. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa (HS) is a chronic inflammatory disease affecting intertriginous skin areas of young adults. Although HS was historically defined as an infectious disease, the role of microorganisms in its pathogenesis is now controversial. We investigated the lesion microbiota of a recently diagnosed 24-year-old male patient with axillary HS, who shared features of the metabolic syndrome. The microbiological analysis of the patient's lesion was indicative of colonization with bacteria including aerobes - Staphylococcus (S.) aureus, S. lugdunensis, S. epidermidis, anaerobes - Anaerococcus (A.) octavius, and microaerophiles - Cutibacterium (C.) acnes; this last one was also isolated in monoculture from a patient's healthy skin control sample. In vitro antibiotic susceptibility evaluation revealed Methicillin-resistant S. aureus (MRSA) and highly susceptible S. lugdunensis and S. epidermidis. Profiles of A. octavius and C. acnes showed that both strains were susceptible to Vancomycin, Clindamycin, Doxycycline and Linezolid; the anaerobe was Benzylpenicillin-resistant and Tetracycline and the microaerophile was intrinsically Metronidazole-resistant. We conclude that the intralesional microbial diversity in this case shows low variety of species and similarities to healthy skin microbiota, although the presence of S. aureus, particularly MRSA, S. lugdunensis or C. acnes - frequently involved in chronic skin pathologies - may be relevant for the disease severity. MRSA carriage in the patient's lesion represents a significant epidemiological risk for the healthcare environment. Antibiotic treatment in the early stages of HS should be administered with caution. Extended studies of HS microbiota could identify relevant colonization patterns for the outcome of the disease and offer important keys for selecting personalised, efficient therapeutic schemes. [ABSTRACT FROM AUTHOR]

Objectives: Detection of carbapenemase-producing Enterobacterales (CPEs) is sometimes difficult with AmpC-hyperproducing Enterobacterales (AHEs), as they may falsely be classified as CPEs. Here, we present a rapid Carbapenem Inactivation Method (rCIM) optimized for AmpC producers (rCIM-A) that allows rapid and easy discrimination between AHEs and CPEs.Methods: Enterobacterales (n = 249), including natural AmpC producers, AHEs, CPEs and non-carbapenemase-producing carbapenem-resistant control strains were evaluated, using Carba NP, rCIM and rCIM-A. The rCIM-A differs from the rCIM by the addition of cloxacillin (400 μg/mL) to the initial antibiotic incubation step.Results: The rCIM-A yielded a sensitivity and specificity of 84.26% (95% CI: 76.00%-90.55%) and 99.29% (95% CI: 96.11%-99.98%), respectively, while those of the rCIM were 86.11% (95% CI: 78.13%-92.01%) and 80.85% (95% CI: 73.38%-86.99%), respectively; those of Carba NP were lower at 84.04% (95% CI: 75.05%-90.78%) and 91.37% (95% CI: 85.41%-95.46%), respectively, due to indeterminate results. The rCIM-A was capable of discriminating between AHEs and true CPEs, but still failed to identify OXA-23-producing Proteus mirabilis isolates and remained only partially reliable for identifying IMI-like producers and a few MBL (2 NDM-1, 1 LMB-1, 1 TMB-1 and 1 IMP-13) producers. One chromosomally encoded AmpC variant, MIR-10, gave repeatedly positive results using all three tests and was thus considered a false positive.Conclusions: Specificity for AHEs greatly improved with the rCIM-A without altering the test performance for the other resistance mechanisms. It may replace the rCIM as a cheap, easy, rapid and accurate CPE detection test. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) represents a growing public health problem worldwide. Infections with such bacteria lead to longer hospitalization times, higher healthcare costs and greater morbidity and mortality. Thus, there is a greater need for rapid detection methods in order to limit their spread. The ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) are a series of epidemiologically-important microorganisms of great concern due to their high levels of resistance. This review aimed to update the background information on the ESKAPE pathogens as well as to provide a summary of the numerous phenotypic and molecular methods used to detect their AMR mechanisms. While they are usually linked to hospital acquired infections, AMR is also spreading in the veterinary and the environmental sectors. Yet, the epidemiological loop closes with patients which, when infected with such pathogens, often lack therapeutic options. Thus, it was aimed to give the article a One Health perspective. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is an important public health issue, in terms of incidence and mortality, with approximately 1.8 million new cases reported worldwide in 2018. Advancements in understanding pathophysiological key steps in CRC tumorigenesis have led to the development of new targeted therapies such as those based on epidermal growth factor receptor inhibitors (EGFR inhibitors). The cutaneous adverse reactions induced by EGFR inhibitors, particularly papulopustular rash, often require long-term antibiotic treatment with tetracycline agents (mostly minocycline and doxycycline). However, this raises several issues of concern: possible occurrence of gut dysbiosis in already vulnerable CRC patients, selection of highly antibiotic resistant and/or virulent clones, development of adverse reactions related to tetracyclines, interference of antibiotics with the response to oncologic therapy, with a negative impact on disease prognosis etc. In the context of scarce information regarding these issues and controversial opinions regarding the role of tetracyclines in patients under EGFR inhibitors, our aim was to perform a thorough literature review and discuss the main challenges raised by long-term use of tetracyclines in advanced CRC patients receiving this targeted therapy. [ABSTRACT FROM AUTHOR]