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Background: While the benefits of sonication for improving periprosthetic joint infection (PJI) are well-documented, its potential therapeutic effect against bacterial biofilm remains unstudied. This study aimed to investigate the safety and efficacy of a novel nanoparticle ultrasonication process on methicillin-resistant Staphylococcus aureus (MRSA) bacterial biofilm formation in a PJI rat model. Methods: This novel ultrasonication process was designed to remove attached bacterial biofilm from implant and peri-articular tissues, without damaging native tissues or compromising implant integrity. Twenty-five adult Sprague–Dawley rats underwent a surgical procedure and were colonized with intra-articular MRSA, followed by the insertion of a titanium screw. Three weeks after the index surgery, the animals received a second procedure during which the screws were explanted, and soft tissue was sampled. The intraoperative use of the nanoparticle sonication treatment was employed to assess the device's safety, while ex vivo treatment on the retrieved tissue and implants was used to evaluate its efficacy. Results: Clinical and histological assessments did not indicate any macro- or micro-damage to the host tissue. Sonication of the retrieved tissues demonstrated an average bacterial removal of 2 × 103 CFU/mL and 1 × 104 CFU/gram of tissue. Compared to the standard-of-care group (n = 10), implants treated with sonication (n = 15) had significantly lower remaining bacteria, as indicated by crystal violet absorbance measurements (P = 0.012). Conclusions: This study suggests that nanoparticle sonication technology can successfully remove attached bacterial biofilms from explanted orthopedic hardware and the joint capsule, without negatively affecting native tissue. The study provides initial results supporting the potential of nanoparticle sonication as an adjuvant treatment option during a DAIR (debridement, antibiotics, and implant retention) procedure for PJI, paving the way for future clinical trials. [ABSTRACT FROM AUTHOR]

E. coli and total coliforms are the most widely used indicator organisms for microbial monitoring of drinking water and recreational freshwater. In many remote and low-resource settings, however, conventional laboratory methods for quantifying these indicators are challenging or infeasible to perform due to limited access to laboratory facilities. The availability of rapid, low-cost methods for quantifying indicator organisms in freshwater samples without the need for laboratory facilities is crucial to facilitate the rapid and robust monitoring of microbial water quality in these types of settings. The global misuse and abuse of antimicrobials have contributed to the rise of antimicrobial resistance. Thus, simple culture methods are needed to detect indicators of such bacteria in freshwaters. In 2021, the World Health Organization released the Tricycle protocol to address this issue by providing guidance for culture-based detection of extended-spectrum beta-lactamase (ESBL)-producing E. coli in environmental samples. Our research goal was to compare the 100-ml sample volume ESBL E. coli quantal and enumerative commercial tests against the more complex Tricycle protocol to detect and quantify ESBL E. coli in surface waters. Both commercial tests gave results comparable with the results obtained using the Tricycle protocol, and the quantal and enumerative commercial tests were easier and faster to perform than the Tricycle protocol. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) represent one of the most prevalent bacterial infections, with Enterococcus species now recognized as the second leading cause of these infections. This study focused on symptomatic UTI cases to investigate the risk factors associated with Enterococcus faecalis clinical isolates in patients from Tehran, Iran. Methods: Urine samples were collected from patients presenting with symptomatic UTIs. The identification of E. faecalis isolates was performed using standard microbiological techniques, with confirmation via polymerase chain reaction (PCR). Antibiotic susceptibility testing was conducted using the Kirby--Bauer disc diffusion method. The presence of virulence genes was determined through PCR, and biofilm formation was assessed using the microtiter plate method. Additionally, multi-locus sequence typing (MLST) was utilized to genotype linezolid-resistant isolates. Results: Out of 300 UTI cases, E. faecalis was identified as the causative agent in 160 instances. Notably, a high proportion of these isolates exhibited resistance to tetracycline (83.8%) and minocycline (82.5%). Linezolid resistance was observed in 1.3% (n = 2) of the isolates. Conversely, the highest susceptibility rates were observed for vancomycin, penicillin G, ampicillin, and nitrofurantoin, each demonstrating a 98.8% susceptibility rate. Biofilm formation was detected in 25% of the E. faecalis isolates. A significant majority (93.8%) of the isolates harbored the efbA and ace genes, with varying frequencies of esp (72.5%), asa1 (61.2%), cylA (52.5%), and gelE (88.8%) genes. MLST analysis demonstrated that both linezolid-resistant isolates, characterized by strong biofilm formation and the presence of virulence genes, were assigned to the ST150 lineage, which has not been previously documented in clinical settings. Conclusion: The emergence of the ST150 clonal lineage, underscores its clinical significance, particularly in relation to linezolid resistance in E. faecalis. This study adds to the growing body of evidence linking specific clonal lineages with antibiotic resistance, highlighting the critical need for ongoing surveillance and molecular characterization of resistant pathogens. [ABSTRACT FROM AUTHOR]

Background: Antibiotic resistance of Enterobacterales poses a major challenge in the treatment of urinary tract infections (UTIs). In low- and middle-income countries (LMICs), standard microbiological (i.e. urine culture and simple disk diffusion test) methods are considered the "gold standard" for bacterial identification and drug susceptibility testing, while PCR and DNA sequencing are less commonly used. In this study, we aimed to re-identifying Enterobacterales as the primary bacterial agents responsible for urinary tract infections (UTIs) by comparing the sensitivity and specificity of traditional microbiological methods with advanced molecular techniques for the detection of uropathogens in indigenous women from Otavalo, Ecuador. Methods: A facility-based cross-sectional study was conducted from October 2021 to February 2022 among Kichwa-Otavalo women. Pathogens from urine samples were identified using culture and biochemical typing. Morphological identification was doble-checked through PCR and DNA sequencing of 16S, recA, and rpoB molecular barcodes. The isolates were subjected to antimicrobial susceptibility-testing using disk diffusion test. Results: This study highlighted a 32% misidentification rate between biochemical and molecular identification. Using traditional methods, E. coli was 26.19% underrepresented meanwhile Klebsiella oxytoca was overrepresented by 92.86%. Furthermore, the genera Pseudomonas, Proteus, and Serratia were confirmed to be E. coli and Klebsiella spp. by molecular method, and one Klebsiella spp. was reidentified as Enterobacter spp. The susceptibility profile showed that 59% of the isolates were multidrug resistant strains and 31% produced extended spectrum beta-lactamases (ESBLs). Co-trimoxazole was the least effective antibiotic with 61% of the isolates resistant. Compared to previous reports, resistance to nitrofurantoin and fosfomycin showed an increase in resistance by 25% and 15%, respectively. Conclusions: Community-acquired UTIs in indigenous women in Otavalo were primarily caused by E. coli and Klebsiella spp. Molecular identification (16S/rpoB/recA) revealed a high rate of misidentification by standard biochemical and microbiological techniques, which could lead to incorrect antibiotic prescriptions. UTI isolates in this population displayed higher levels of resistance to commonly used antibiotics compared with non-indigenous groups. Accurate identification of pathogens causing UTIs and their antibiotic susceptibility in local populations is important for local antibiotic prescribing guidelines. [ABSTRACT FROM AUTHOR]

Simple Summary: Castration is a routine procedure in sheep farming, and immunocastration is beginning to be used in animal production as an alternative to surgical castration. Currently, there are few studies on the intra-rumen environment after immunocastration in sheep. Therefore, in this study, male Xizang sheep were selected for surgical castration and GnRH immunocastration treatment, the intact control group and immunocastrated group were selected in combination with body weight data, and microbiology and metabolomics techniques were used to analyze the effects of GnRH immunocastration on the rumen internal environment of male Xizang sheep. The results showed that GnRH immunocastration had a more obvious effect on body weight gain while achieving the effect of de-population; immunocastration increased the ratio of rumen thick-walled bacterial phylum to anamorphic bacterial phylum, which improved the digestive utilization of forage feed in male Xizang sheep. Secondly, GnRH immunocastration can maintain the balance of the rumen internal environment and the health of rumen epithelial cells by improving the levels of certain metabolites in the rumen. Castration is a prevalent and indispensable practice in sheep husbandry, aiding in enhancing meat quality, mitigating aggressive behavior, and managing unwanted reproduction. Nevertheless, the conventional surgical castration procedure poses several challenges, including heightened stress and pain, detrimental impacts on animal welfare, and diminished economic efficacy in farming operations. Consequently, immunocastration methods, serving as substitutes for surgical castration, are progressively finding application in livestock. The rumen, an essential and distinctive digestive and absorptive organ in ruminants, has been associated with enhanced meat quality and productive performance following castration in previous research studies, albeit fewer investigations have explored the potential impacts of GnRH immunization on the rumen's internal milieu in sheep post-de-escalation. Hence, the present study delved into evaluating the impact of GnRH immunocastration on the rumen microbiome and metabolomics in male Xizang sheep. This was achieved through the establishment of a GnRH immunocastration animal model and the collection of rumen fluid for microbiological and comprehensive metabolomics investigations. The outcomes of this investigation unveiled that the impact of GnRH immunocastration on body weight gain was more pronounced during the achievement of the castration objective. In addition, the Firmicutes-to-Bacteroidota ratio in the immune male (IM) group exceeded that of the control group (EM), suggesting that GnRH immunodeficiency may enhance the digestion and absorption of feed in male Xizang sheep. At the taxonomic level, the elevated presence of Prevotella and Quinella bacteria in the IM group compared to the EM group indicated that castration influenced a segment of the rumen microbiota in male Xizang sheep, thereby bolstering the digestive and metabolic efficacy of the rumen concerning nutrient utilization, particularly in the breakdown and absorption of proteins, carbohydrates, and lipids, ultimately expediting the fattening process and weight gain in male Xizang sheep following castration. Moreover, analysis of ruminal fluid metabolomics revealed that GnRH immunization had notable impacts on certain metabolites in the ruminal fluid of male Xizang sheep, with metabolites like 5-hydroxyindole acetic acid and 3-hydroxyindole acetic acid showing significant downregulation in the IM group compared to the EM group, while niacin and tyramine exhibited significant upregulation. These findings indicate a profound influence of GnRH immunization on the maintenance of ruminal equilibrium and ruminal health (including the health of ruminal epithelial cells). This study validates that GnRH immunocastration not only achieves the objectives of castration but also enhances ruminal health in male Xizang sheep, thus laying a foundational theoretical basis for the application and dissemination of GnRH immunocastration technology. [ABSTRACT FROM AUTHOR]

This study aims to determine the pathogen organisms' profile and risk factors for infection after acute ischemic stroke (AIS) during the COVID-19 pandemic because of few studies. We conducted a retrospective cross-sectional study using the medical records of AIS inpatients at the National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono, Jakarta, Indonesia, from 2020-2021. We found the species of pathogen organisms based on the positive growth of microbiological cultures of various specimens. Among 479 AIS patients, the infection prevalence was 12.3%. This study found the common pathogenic organisms were Gram-negative bacteria, and there were drugresistant strains in S. aureus, S. epidermidis, K. pneumoniae, and E. coli. The risk factors for infection in COVID-19-infected patients were pneumonia (OR 6.89, 95% CI 1.49-31.79, p = 0.013) and intensive care stay (OR 0.13, 95% CI 0.05-0.36, p < 0.001); meanwhile, in non-COVID-19 patients were HIV comorbidity (OR 1.55, 95% CI 1.18-2.06, p = 0.002), leukocytosis (OR 0.07, 95% CI 0.01-0.43, p = 0.004), use of CVC (OR 0.29, 95% CI 0.12-0.68, p = 0.005), use of steroids (OR 0.21, 95% CI 0.06-0.70, p = 0.011), and tracheostomy (OR 0.17, 95% CI 0.05-0.62, p = 0.007). To sum up, the growth of pathogenic organisms indicated that the prevalence of infections after AIS during the COVID-19 pandemic did not increase. The risk factor for infections depends on the characteristics of patients, whether they have COVID-19 or have not been infected. [ABSTRACT FROM AUTHOR]

The seabird intestinal microbiota, or bacteriome, predominantly consists of bacteria that establish during embryonic development through vertical transfer from females and horizontal transfer during growth and copulation. This study focuses on the Heermann's Gull (Larus heermanni), a seabird that breeds mainly within the Gulf of California. Our goal was to understand its gut bacteriome composition and its implications for conservation and public health. Using microbiological techniques, 16S rRNA gene sequencing, and mass spectrometry, we characterized the HG gut bacteriome and compared it with other bird species. Our findings reveal a diverse bacteriome, particularly in the intestine and rectum, with dominant phyla including Firmicutes, Proteobacteria, Bacteroidetes, Cyanobacteria, and Fusobacteria. Seasonal and sex-related differences were observed, with significant correlations between some pairs of bacteria. Notably, we identified various pathogens and potential zoonotic bacteria, underscoring the public health risks associated with Heermann's Gull interaction with humans and other animals. These results highlight the importance of the Heermann's Gull gut bacteriome in nutrient production, pathogen control, and digestive health, and emphasize the need for further research on pathogen transmission involving seabirds. Our study provides crucial insights for conservation strategies and underscores the role of wild birds in the epidemiology of zoonotic diseases. [ABSTRACT FROM AUTHOR]

Objective: Vulvovaginal Candidiasis (VVC) is a prevalent genital infection in women of reproductive age and requires effective non‐drug therapies. Therefore, this study aimed to investigate the effect of blue light emitting diode (LED) therapy as an alternative treatment for recurrent VVC due to its proven antimicrobial properties. The safety and non‐invasiveness of LED therapy make it a promising option for sensitive tissue applications. Materials and Methods: This randomized controlled trial recruited 60 women with culture‐confirmed VVC. Participants were randomly allocated to two groups. Group A (control group) received standard antifungal treatment with Gynoconazol 0.8% vaginal cream for three consecutive nights (n = 30). Group B (study group) received the same antifungal treatment plus two 60‐min sessions of blue LED therapy directed at the vagina and vulva, with the sessions separated by two days (n = 30). Candida count (via CHROMagar™ Candida) and vaginal pH (via AD110‐AD111 m) were assessed at baseline and one week after initiating treatment. Results: Post‐treatment, group (B) demonstrated a significantly greater reduction in Candida count compared to group (A) (mean difference (MD) 8.267; 95% Confidence Interval (CI) 6.723–9.811; p = 0.0001). However, there was no statistically significant difference in vaginal pH between the groups (MD −0.03; 95% CI −0.244–0.178; p = 0.749). Conclusion: Blue LED therapy effectively reduces Candida count in women with recurrent VVC without adversely affecting the vaginal pH, highlighting its safety and efficacy as a treatment modality. [ABSTRACT FROM AUTHOR]

Introduction: Medical therapy has become more difficult as drug-resistant Pseudomonas aeruginosa strains have evolved. Biofilm development and antibiotic resistance are two virulence mechanisms that contribute to the long-term maintenance of chronic diseases. Clinical isolates of P. aeruginosa have been shown to express the gene ExoT, which is a significant virulent element that contribute to the causation of infection. Aim and Objective: To Study the Molecular characterization of ExoT Gene from Pseudomonas aeruginosa and its Antibiogram with the ability of Biofilm Formation in patients. Material and Methods: This was a cross sectional study carried out in the Department of Microbiology at a tertiary care centre for a period of 12 months i.e, June 2023 to June 2024. A total of 150 Pseudomonas aeruginosa isolated from different clinical samples including urine, sputum, ear swab, wound swab, pus were identified by standard microbiological techniques according to the CLSI guidelines. The isolates were further tested for MBL by Imipenem - EDTA combined disc test and MBL E-test (Imipenem). The DNA was isolated by Qiagen DNA extraction kit as per the manufacture's guidelines and the virulent gene Exo T was detected by the conventional PCR. Results: In the present study a total of 450 clinical samples were studied out of which 150 P. aeruginosa isolates were obtained. The prevalence rate of Pseudomonas aeruginosa was observed to be 33.3%. It was observed that the ratio of Males 96 (64.6%) were more affected with the infection as compared to the Females 54 (36%). It was also noted that the age group of 21-30 years (45.3%) of age followed by 31-40 (24%) was affected the most. In the age group of 0-10 years (4%) and above 71 years (2%) was the least affected with the Pseudomonas aeruginosa infection. It was observed that the Sensitivities of Colistin was (97.3%), Piperacillin tazobactam (77.6%), Amikacin (76.6 %), and cefepime (76.6 %) were found to be the most effective Antibiotics. The resistance to ciprofloxacin was (46.6%), Levofloxacin (53.3%), Gentamicin (63.3%), Imipenem (65.3%), Tobramycin (68%), Ceftazidime (68%). There were 30 (20%) were MBL positive by Imipenem - EDTA combined disc test, and 29 (19.3%) by MBL E-test. In the present study it was found that 83 (55.3%) of the Pseudomonas aeruginosa isolates showed biofilm formation. The molecular characterization confirms 102 (68%) expression of exo T gene. Conclusion: The established significance of ExoT virulence genes in the pathogenicity of P. aeruginosa would aid in the treatment and prognosis of Pseudomonas infections. [ABSTRACT FROM AUTHOR]

This paper is part of a clinical practice guideline update on the risk assessment, diagnostic imaging, and microbiological evaluation of complicated intra-abdominal infections in adults, children, and pregnant people, developed by the Infectious Diseases Society of America. In this paper, the panel provides recommendations for diagnostic imaging of suspected acute diverticulitis. The panel's recommendations are based on evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. [ABSTRACT FROM AUTHOR]

This article is part of a clinical practice guideline update on the risk assessment, diagnostic imaging, and microbiological evaluation of complicated intraabdominal infections in adults, children, and pregnant people, developed by the Infectious Diseases Society of America. In this article, the panel provides recommendations for diagnostic imaging of suspected acute cholecystitis and acute cholangitis. The panel's recommendations are based on evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. [ABSTRACT FROM AUTHOR]

Proteus mirabilis, a gram‐negative bacterium, poses a significant public health threat due to its multidrug‐resistant (MDR) characteristics. Here, for the first time, we report the isolation and comprehensive genome analysis of an MDR strain, P. mirabilis KUST‐1312, obtained from migratory birds in Yunnan Province, China. A total of 65 samples, including migratory bird feces, soil, and water from Dianchi Lake, were collected. Standard microbiological techniques were employed to isolate the P. mirabilis KUST‐1312 strain from these samples. Genomic sequencing was conducted using a hybrid assembly strategy, combining Illumina and Oxford nanopore sequencing technologies. Phenotypic testing revealed the MDR nature of P. mirabilis KUST‐1312, displaying resistance to various antibiotics except gentamicin and Cefotaxime. Notably, 15 antimicrobial resistance genes (ARGs), including aph(3′)‐Ia, cat, tet(J), bleO, dfrA12, aadA2, AAC(3)‐IId, bla-TEM-1B, erm(42),aph(6)‐Id, blaPER-1, sul2, aph(3′')‐Ib(2copies), and aph(3′)‐VIb, were identified on a single chromosome. These 15 ARGs were dispersed along three MDR regions, and the boundaries of these regions were consistently flanked by copies of insertion sequences and also contained other genetic elements. Phylogenetic analysis revealed the close relation of P. mirabilis KUST‐1312 with environmental and clinical isolates reported from other continents rather than with Asian isolates. In conclusion, this study reports the first‐ever isolation of an MDR P. mirabilis KUST‐1312 strain from migratory birds globally, particularly in China. There is a need to explore further its prevalence in detail in various ecological niches, including migratory birds. [ABSTRACT FROM AUTHOR]

The integration of autoclaves in podiatry is new and has been tested against two other bactericidal methods with a control. The methods were similarly sampled, and a microbiology department independently undertook bacterial counts. The difference between methods was not significant. While the autoclave remains the preferred method, operative error can arise, and an ultrasonic cleaner is recommended. Chlorhexidine gluconate (Hibitane) remains the choice for liquid disinfection but with attention to concentration and frequent fluid changes to provide an effective kill rate. Special attention is required to any jointed instruments and those with asperitous surfaces. Using an autoclave requires multiple instruments to meet the needs of a podiatry treatment session. [ABSTRACT FROM AUTHOR]

Background/Objectives: Urinary tract infection (UTI) is a prevalent microbial infection in medical practise, leading to significant patient morbidity and increased treatment costs, particularly in developing countries. This retrospective study, conducted at a tertiary care hospital in Dhaka, Bangladesh, aims to examine the antimicrobial resistance (AMR) patterns of uropathogens and evaluate whether these patterns are influenced by demographic factors such as gender, age, or patient status. Methods: Standard microbiological techniques were used to identify uropathogens, and AMR patterns were determined using the Kirby–Bauer disc diffusion method. Results: Out of 6549 urine samples, 1001 cultures were positive. The infection was more prevalent in females compared to males. The incidence of UTIs in children aged 0–10 years accounted for 12.59% of the total cases, with this age group also exhibiting the highest rate of polymicrobial infections. Among the bacterial uropathogens, 71.19% of isolates were multidrug resistant (MDR) and 84.27% were resistant to at least one antibiotic. Escherichia coli (n = 544, 73.90% MDR) and Klebsiella species (n = 143, 48.95% MDR) were the most common Gram-negative uropathogens, while Enterococcus species (n = 78, 94.87% MDR) was the predominant Gram-positive isolate in this study. Our results indicate that most uropathogens showed resistance against ceftazidime, followed by cefuroxime, trimethoprim-sulfamethoxazole, amoxicillin-clavulanate, and netilmicin. Moderate levels of resistance were observed against ciprofloxacin, levofloxacin, aztreonam, and cefpodoxime. Conclusions: Amikacin was observed to be effective against Gram-negative uropathogens, whereas cefixime was more active against Gram-positive microorganisms, such as Enterococcus species. Moreover, a principal coordinate analysis (PCoA) depicted no significant influence of gender, patient status, or age on AMR patterns. For the continued usefulness of most antibiotics, periodic analysis of the AMR patterns of uropathogens can help assess the rise of MDR bacteria, and therefore guide the selection of appropriate antibiotic treatment strategies. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa is a significant pathogen in healthcare-associated infections, particularly in immunocompromised and cystic fibrosis patients. This study aimed to assess the antibiotic susceptibility of 111 P. aeruginosa isolates from various clinical specimens collected between May 2023 and April 2024 at Integral Institute of Medical Sciences and Research, Lucknow. Isolates were identified using standard microbiological techniques and antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method according to CLSI guidelines. The study focused on multidrug-resistant (MDR), extensively drug-resistant (XDR) and pan-drug-resistant (PDR) classifications based on resistance patterns. The prevalence of P. aeruginosa was 16.5%, with 54% of isolates from males and 46% from females. The highest isolation rate was from pus samples (49.5%), followed by sputum (18%) and urine (15.3%). The majority of isolates came from the Department of Surgery (19.8%) and inpatient cases (52.3%). Resistance was highest to ceftazidime (57.7%) and imipenem (51.4%), while piperacillin-tazobactam showed the lowest resistance (19%). MDR isolates were most frequently found in pus samples (50%), while urine samples had the highest PDR rate (33.3%). These findings highlight the increasing antibiotic resistance in P. aeruginosa, with significant MDR and PDR rates, particularly in pus and urine samples. This study underscores the need for stringent antibiotic stewardship to mitigate resistance and develop effective treatment strategies. [ABSTRACT FROM AUTHOR]

Prosthetic joint infection is a serious complication of total joint arthroplasty that causes great morbidity in affected individuals. The most common cause of prosthesis associated infections are members of Staphylococcus spp., including Staphylococcus epidermidis. Culture has served as the gold standard for diagnosis, despite obvious shortcomings in terms of sensitivity and time. Bacterial genomic DNA extraction methodologies were evaluated for optimal recovery of genomic DNA from sterilised wash-out samples, spiked with S. epidermidis. Real time Polymerase chain reaction (PCR) assays targeting the S. epidermidis specific gseA gene were designed to reliably detect and quantify S. epidermidis. Sixty post-operative wash-out samples from primary hip and knee arthroplasties were taken aseptically. All were shown to be culture negative using the culture-dependent approach. These were samples were subjected to S. epidermidis-specific real time PCR. Standard curve showed good linearity. Sensitivity limit of the assay was <10 CFU S. epidermidis per sample. Reproducibility of the assay was confirmed. S. epidermidis was not identified in any of these samples using the novel species specific SYBR Green real time PCR technique. Results indicated that wash-out samples were true negatives and did not harbour S. epidermidis. To support this, patients displayed no symptoms of infection. To illustrate the full effectiveness of the novel real time PCR assay, a larger number of samples need to be tested (>1,000 patients). [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate retrospectively extrapulmonary tuberculosis patients followed and treated in the infectious diseases clinic and outpatient clinic. Methods: The study included patients aged 18 years and older who were followed and treated with a diagnosis of extrapulmonary tuberculosis between January 1, 2013, and December 31, 2019. Data on the patient's demographics, clinical and laboratory findings, microbiological tests, histopathological examination results, radiological findings, treatments, and treatment durations were collected from patient files and the electronic document management system. Results: Of the 81 patients in the study, 49 (60.4%) were female, and 32 (39.6%) were male. The mean age was 49.55±18.85 years. Hypertension and diabetes mellitus were the most common comorbidities. Gastrointestinal system tuberculosis, musculoskeletal system tuberculosis, lymph node tuberculosis, and central nervous system tuberculosis were the most frequently observed clinical forms. Conclusions: Contrary to literature data, gastrointestinal system tuberculosis was found to be the most common form of extrapulmonary tuberculosis. Histopathological examinations were found to be at least as important and valuable as microbiological tests in the diagnosis of extrapulmonary tuberculosis. The rate of extrapulmonary involvement in tuberculosis is increasing worldwide. Tuberculosis should always be considered in differential diagnosis. [ABSTRACT FROM AUTHOR]

The classical microbiology techniques have inherent limitations in unraveling the complexity of microbial communities, necessitating the pivotal role of sequencing in studying the diversity of microbial communities. Whole genome sequencing (WGS) enables researchers to uncover the metabolic capabilities of the microbial community, providing valuable insights into the microbiome. Herein, we present an overview of the rapid advancements achieved thus far in the use of WGS in microbiome research. There was an upsurge in publications, particularly in 2021 and 2022 with the United States, China, and India leading the metagenomics research landscape. The Illumina platform has emerged as the widely adopted sequencing technology, whereas a significant focus of metagenomics has been on understanding the relationship between the gut microbiome and human health where distinct bacterial species have been linked to various diseases. Additionally, studies have explored the impact of human activities on microbial communities, including the potential spread of pathogenic bacteria and antimicrobial resistance genes in different ecosystems. Furthermore, WGS is used in investigating the microbiome of various animal species and plant tissues such as the rhizosphere microbiome. Overall, this review reflects the importance of WGS in metagenomics studies and underscores its remarkable power in illuminating the variety and intricacy of the microbiome in different environments. [ABSTRACT FROM AUTHOR]

Introduction: With the global COVID-19 pandemic, nasopharyngeal swabbing has become commonplace and can occasionally cause discomfort, tearing, and anxiety. Objective: To evaluate whether using a neural distraction device during nasopharyngeal swabbing can mitigate patient discomfort. Methods: Participants were randomized into nasal swab with vibration first (treatment-control or Tc) or nasal swab without vibration first (control-treatment or Ct). Then the swab was repeated with the opposite technique. The vibration device was used to stimulate the infraorbital nerve at the midpupillary line, while a nasopharyngeal swab was performed according to CDC protocol. After each swab, participants filled out a survey to assess pain, discomfort, and tearing. This procedure was replicated on the contralateral nostril for a total of 4 swabs and 4 surveys. Results: Thirty-four subjects were included in the analysis. In the Ct group, there was a median 1.0-point decrease in pain with the use of vibration (95% CI [−1.8, −0.3], P = 0.0117), 2.5-point decrease (95% CI [−3.0, −0.8], P = 00039) in discomfort, and a 1.0-point decrease (95% CI [−2.6, −0.2] P = 0.0303) in tearing when the vibratory device was used. In the Tc group, there was a median 2.0-point decrease in pain with vibration (95% CI [ −2.7, −1.1], P < 0.0001), 2.3-point decrease in discomfort (95% CI [−3.1, −1.5], P < 0.0001), and a 1.5-point decrease in tearing (95% CI [−2.5, −0.5], P = 0.0037) when vibration was used. Conclusion: Vibratory stimulation of the infraorbital nerve is safe and effectively reduced pain, discomfort, and tearing during nasopharyngeal swab. Vibration is a reasonable option to minimize patient discomfort during COVID-19 or other microbiological testing. [ABSTRACT FROM AUTHOR]

Objective: To study the recent trends and patterns of antibiotic sensitivity and resistance in infected wounds of burns patients. Study Design: Cross sectional study. Setting: Burns and Plastic Surgery Canter, Peshawar, Pakistan. Period: July 30th to January 30th, 2023. Methods: In this cross sectional study we adopted convenience sampling technique. A total of 75 samples collected from patients fitted to our infected patients criteria and culture and sensitivity tests were performed using standard microbiological techniques. Results: Among the positive infected wound samples, Klebsiella Species were found in 23 (30.7%), Pseudomonas Aeruginosa in 16 (21.3%), Acinetobacter Species in 14(18.7%), Proteus Species in 8(10.7%), Citrobacter species in 5(6.6%), Staph. Aureus in 5(6.6%), Enterobacter species in 3(4%) and E.coli in 1(1.4%) of the positive cultures. Each pathogen showed varying degree of sensitivity and resistance patterns to different antibiotics tested. Conclusion: Klebsiella Species was the most common pathogen in patients with infected burns wounds. Meropenem, imipenem, Doripenem, Piperacillin/Tazobactum, Colistin, and Tigecyclin were found to be effective against the majority of the bacteria. Conversely, most of the bacterial strains exhibited resistance to commonly prescribed antibiotics such as co-amoxiclave, ampicillin, ceftriaxone, ciprofloxacin, cefotaxime and co-trimoxazole. [ABSTRACT FROM AUTHOR]

This study was taken up to determine the prevalence of potential pathogens in most touched fomites in Neonatal Intensive Care Units (NICUs) and to determine their antibiogram. Fifty swabs each were collected from fomites from In-born (for babies born in our center) and out-born (for babies born elsewhere, brought to our center) NICUs, before and after cleaning. Samples were processed using standard Microbiological techniques. Antibiogram was determined by Kirby-Bauer disc diffusion method. From In-born NICU, before cleaning, 42 (84%) samples yielded growth with 48 bacterial isolates of which 31 (64.6%) were pathogens and after cleaning, 40 (80%) samples yielded growth with 41 bacterial isolates, of which 30 (73.1%) were pathogens. Most frequent isolates were non-fermenting gram-negative bacilli (NFGNB) and Klebsiella pneumoniae before and after cleaning, respectively. Prevalence of bacteria from In-born NICU before and after the cleaning was statistically significant (p = 0.025). From Out-born NICU, before cleaning, 42 (84%) samples yielded growth with 45 bacterial isolates, of which 25 (55.55%) were pathogens. Samples collected after cleaning; 42 (84%) samples yielded growth with 43 bacterial isolates of which 19 (44.18%) were pathogens. Most frequent isolates were NFGNB and Klebsiella pneumoniae from In-born NICU and K. pneumoniae and Escherichia coli from Out-born NICU before and after cleaning, respectively. Overall prevalence of pathogens was significant (p = 0.007). Staphylococcal isolates were resistant to Methicillin. NFGNB exhibited highest resistance (55.9%) towards Gentamicin. Significant decrease in the frequency of pathogens after cleaning indicates stringent practice of sterilization protocol would be essential in hospital environment. [ABSTRACT FROM AUTHOR]

Respiratory virus infections are related to over 80% of childhood asthma exacerbations. They enhance pro-inflammatory mediator release, especially for sensitized individuals exposed to pollens/molds. Using a time-series study design, we investigated possible effect modification by respiratory virus infections of the associations between aeroallergens/PM2.5 and asthma exacerbation rates. Outpatient, emergency department (ED), and inpatient visits for asthma exacerbation among children with asthma (28,540/24,444 [warm/cold season]), as well as viral infection counts were obtained from electronic health records of the Children's Hospital of Philadelphia from 2011 to 2016. Rate ratios (RRs, 90th percentile vs. 0) for late-season grass pollen were 1.00 (0.85–1.17), 1.04 (0.95–1.15), and 1.12 (0.96–1.32), respectively, for respiratory syncytial virus (RSV) counts within each tertile. However, similar trends were not observed for weed pollens/molds or PM2.5. Overall, our study provides little evidence supporting effect modification by respiratory viral infections. [ABSTRACT FROM AUTHOR]

Preserving cosmetic products from microbial contamination is crucial to ensuring their safety, efficacy, and shelf life. A number of synthetic antimicrobial preservatives are available, but, since the global market demand for natural ingredients is increasing, cosmetic manufacturers are considering replacing conventional preservatives with natural alternatives. In this context, the objective of this investigation was to characterize the antimicrobial activity of the natural preservative, intended for cosmetic purposes, Kopraphinol (INCI name: Lactobacillus/Radish Root Ferment Extract Filtrate). It was tested against a panel of selected bacteria and mycetes by using conventional microbiological techniques (determination of MIC, time killing assay), and a challenge test was used to verify its potential preservative in an O/W hydrophilic cream (Cetomacrogol cream base). Kopraphinol has shown an interesting antimicrobial effectiveness, with M.I.C.s ranging from 0.78% to 6.25% for bacteria and from 1.56% to 5% for mycetes. Moreover, it fulfilled challenge test criterion A and has proven effective against microbial contamination, leading to a 3 log reduction of inoculum after 7 days for bacteria and a 2 log reduction at 14 days for fungi. The results obtained show that Kopraphinol can be considered a promising and effective candidate for the antimicrobial preservation of cosmetics and could successfully complement or even replace conventional preservatives. [ABSTRACT FROM AUTHOR]

Marathon runners, subjected to intense training regimens and prolonged, exhaustive exercises, often experience a compromised immune response. Probiotic supplementation has emerged as a potential remedy to mitigate the impact of prolonged exercise on athletes. Consequently, this study sought to assess the influence of probiotic supplementation on monocyte functionality both before and after the official marathon race. Twenty-seven runners were randomly and double-blindly assigned to two groups: placebo (n 13) and probiotic (PRO) (n 14). Over 30 d, both groups received supplements – placebo sachets containing maltodextrin (5 g/d) and PRO sachets containing 1 × 1010 colony-forming unit Lactobacillus acidophilus and 1 × 1010 colony-forming unit Bifidobacterium bifidum subsp. lactis. Blood samples were collected, and immunological assays, including phagocytosis, hydrogen peroxide production, cytokine levels and monocyte immunophenotyping, were conducted at four different intervals: baseline (start of supplementation/30 d pre-marathon), 24 h-before (1 d pre-marathon), 1 h-after (1 h post-marathon) and 5 d-after (5 d post-marathon). Monocyte populations remained consistent throughout the study. A notable increase in phagocytosis was observed in the PRO group after 30 d of supplementation. Upon lipopolysaccharide stimulation, both PRO and placebo groups exhibited decreased IL-8 production. However, after the marathon race, IL-15 stimulation demonstrated increased levels of 5 d-after, while IL-1- β , IL-8, IL-10, IL-15 and TNF- α varied across different intervals, specifically within the PRO group. Probiotic supplementation notably enhanced the phagocytic capacity of monocytes. However, these effects were not sustained post-marathon. [ABSTRACT FROM AUTHOR]

Background. Helicobacter pylori (H. pylori), a widespread bacterial pathogen, is associated with various gastrointestinal diseases, including gastric cancer. Statins, widely prescribed cholesterol‐lowering agents, have demonstrated pleiotropic effects, including potential antimicrobial properties. This in vitro study investigated the direct antibacterial effects of three clinically approved statins, simvastatin, atorvastatin, and rosuvastatin, against H. pylori isolates. Methods. H. pylori strains were isolated from gastric biopsies of dyspeptic patients and identified by microbiological techniques. The minimum inhibitory concentrations (MICs) of statins were determined using the agar dilution method, and their antimicrobial activity was evaluated by the disc diffusion method using different concentrations of simvastatin, atorvastatin, rosuvastatin, tetracycline, and amoxicillin. Scanning electron microscopy (SEM) was employed to examine the morphology of H. pylori cells. Results. The minimum inhibitory concentration (MIC) values (μg/mL) of atorvastatin, rosuvastatin, simvastatin, tetracycline, and amoxicillin against H. pylori were 240 ± 20, 450 ± 20, 460 ± 15, 155 ± 30, and 140 ± 20, respectively. In the disc diffusion assay, atorvastatin and rosuvastatin produced significantly larger inhibition zones compared to simvastatin at all concentrations tested (p < 0.05). The inhibition zone diameters (mm) increased with higher statin concentrations, ranging from 9 ± 1.4 to 13 ± 1.4 for atorvastatin, 8 ± 0.9 to 11 ± 0.6 for rosuvastatin, and 5 ± 1.3 to 6 ± 1.4 for simvastatin at the highest tested concentration (1200 μg/ml). SEM analysis revealed the characteristic spiral morphology of H. pylori cells. Conclusion. Statins demonstrated varying degrees of antibacterial activity against H. pylori isolates, with atorvastatin exhibiting the highest potency. While the observed effects were lower than those of conventional antibiotics, these findings suggest the potential of statins as adjunctive agents or alternative therapeutic options, warranting further investigation through in vivo studies and clinical trials. [ABSTRACT FROM AUTHOR]

Background: Meningitis poses a significant challenge to public health in low-income nations, such as Ethiopia, with a particular impact on newborns. The magnitude and etiologies of meningitis vary based on geographic location and age of patients. There is limited data regarding the magnitude and etiology of meningitis from Sidama Regional State, Ethiopia. This study aimed to determine the magnitude and bacterial profile of meningitis among newborns aged less than 90 days at Hawassa University Comprehensive Specialized Hospital (HUCSH). Methods: A retrospective cross-sectional study was conducted among newborns under 90 days who were suspected of meningitis at HUCSH from January 2019 to July 2023, and for whom Cerebrospinal fluid (CSF) culture was performed. At HUCSH, bacteria are isolated and identified using standard microbiological techniques. Socio-demographic characteristics and culture results were extracted from the laboratory register. Data were entered into Excel and exported it to SPSS version 20 for analysis. Results: Overall 1061 newborns suspected of meningitis were included in the study. Among the participants, 767 individuals (72.3%) fell within the age range of 8 to 90 days. Of the total participants, 437 (41.2%) were females. The magnitude of culture-confirmed meningitis was 90(8.5%) 95% CI: 6.8%−10.1%. The magnitude of culture-confirmed meningitis among newborns aged 0−7 days and 8−90 days were 1.6% and 6.9% respectively. The proportion of bacteria among newborns aged 0−7 days and 8−90 days were 18.9% and 81.1% respectively. Coagulase-negative Staphylococci (CONS) were the most common bacteria (n = 26; 28.9%) recovered followed by Acinetobacter species (n = 12, 13.3%), Escherichia coli (n = 9; 10%), and Klebsiella pneumoniae (n = 7; 7.8%). K. pneumoniae was the predominant bacteria among newborns within the age group of 0 to 7 days while Acinetobacter species was the most common among newborns within the 8 to 90 days age group. The prevalence of culture-confirmed neonatal meningitis was found to be greater in male newborns (x2 = 1.74, p = 0.18), newborns aged between 8 to 90 days (x2 = 0.07, p = 3.4), and newborns admitted in 2022 (x2 = 2.4, p = 0.66), Conclusions: In this study, the overall magnitude of culture-confirmed meningitis was relatively high. Culture-confirmed meningitis was high in newborns within the age range of 8 to 90 days. The most common bacteria were CONS in both age groups followed by Acinetobacter species, E. coli, and K. pneumoniae. [ABSTRACT FROM AUTHOR]

Background: Hypereosinophilic syndrome can produce cardiac involvement and endomyocardial fibrosis, which have a poor prognosis. However, there is limited information regarding cardiac involvement among migrants from Latin America with eosinophilia related to helminthiasis. Methods: We conducted a pilot observational study where an echocardiography was performed on migrants from Latin America with both eosinophilia (>450 cells/μL) and a diagnosis of helminth infection, and on migrants from Latin America without eosinophilia or helminth infection. Microbiological techniques included a stool microscopic examination using the Ritchie's formalin-ether technique, and a specific serology to detect Strongyloides stercoralis antibodies. Results: 37 participants were included, 20 with eosinophilia and 17 without eosinophilia. Twenty (54.1%) were men with a mean age of 41.3 (SD 14.3) years. Helminthic infections diagnosed in the group with eosinophilia were: 17 cases of S. stercoralis infection, 1 case of hookworm infection, and 2 cases of S. stercoralis and hookworm coinfection. Among participants with eosinophilia, echocardiographic findings revealed a greater right ventricle thickness (p = 0.001) and left atrial area and volume index (p = 0.003 and p = 0.004, respectively), while showing a lower left atrial strain (p = 0.006) and E-wave deceleration time (p = 0.008). An increase was shown in both posterior and anterior mitral leaflet thickness (p = 0.0014 and p = 0.004, respectively) when compared with participants without eosinophilia. Conclusions: Migrants from Latin America with eosinophilia related to helminthic infections might present incipient echocardiographic alterations suggestive of early diastolic dysfunction, that could be related to eosinophilia-induced changes in the endomyocardium. Author summary: A recent study in migrants from Sub-Saharan Africa with eosinophilia related to helminth infection describes initial findings on cardiac ultrasound in the form of thickening of the posterior leaflet of the mitral valve, but with no clinical manifestations, representing the early stage of the endomyocardial fibrosis process. The aim of the present study is to evaluate the relationship between eosinophilia secondary to helminth infection and cardiac involvement in Latin American patients. In our cohort, eosinophilia in patients was mainly due to Strongyloides stercoralis infection. Among patients with eosinophilia, echocardiographic findings revealed a greater right ventricle thickness and left atrial area and volume index, while showing a lower left atrial strain and E-wave deceleration time when compared with patients without eosinophilia. These alterations are suggestive of early diastolic dysfunction that could be related to eosinophilia-induced changes in the endomyocardium. [ABSTRACT FROM AUTHOR]

Emerging and uncommon Candida species have been reported as an increasing cause of invasive Candida infections (ICI). We aim to systematize the global epidemiology associated with emergent uncommon Candida species responsible for invasive infections in adult patients. A systematic review (from 1 January 2001 to 28 February 2023) regarding epidemiological, clinical, and microbiological data associated to invasive Candida infections by uncommon Candida spp. were collected. In total, 1567 publications were identified, and 36 were selected according to inclusion criteria (45 cases). The chosen studies covered: C. auris (n = 21), C. haemulonii (n = 6), C. fermentati (n = 4), C. kefyr (n = 4), C. norvegensis (n = 3), C. nivariensis (n = 3), C. bracarensis (n = 1), C. duobushaemulonii (n = 1), C. blankii (n = 1), and C. khanbhai (n = 1). Over the recent years, there has been an increase in the number of invasive infections caused by uncommon Candida spp. Asia and Europe are the continents with the most reported cases. The challenges in strain identification and antifungal susceptibility interpretation were significant. The absence of clinical breakpoints for the susceptibility profile determination for uncommon Candida spp. makes interpretation and treatment options a clinical challenge. It is crucial that we focus on new and accessible microbiology techniques to make fast and accurate diagnostics and treatments. [ABSTRACT FROM AUTHOR]

Bacteriophages are emerging as a promising alternative in combating antibiotic-resistant bacteria amidst the escalating global antimicrobial resistance crisis. Recently, there has been a notable resurgence of interest in phages, prompting extensive research into their therapeutic potential. Beyond conventional microbiology and virology techniques, such as genomics and proteomics, novel phenotypic and chemical characterization methods are being explored. Among these, there is a growing interest in vibrational spectroscopy, especially in advanced modalities such as surface-enhanced Raman spectroscopy (SERS), tip-enhanced Raman spectroscopy (TERS), and atomic force microscopy-infrared spectroscopy (AFM-IR), which offer improved sensitivity and spatial resolution. This review explores the spectrum of uses of vibrational spectroscopy for bacteriophages, including its role in diagnostics, biosensing, phage detection, assistance in phage-based therapy, and advancing basic research. [ABSTRACT FROM AUTHOR]

This document, titled "Empirical antimicrobials in the intensive care unit," provides guidance on prescribing empirical antimicrobial treatment for patients in the intensive care unit (ICU) with suspected infections. The document emphasizes the importance of proper diagnostic assessment, including clinical examination, imaging, and laboratory testing, to determine the need for antimicrobial therapy. It also discusses the urgency of administering antimicrobials promptly in cases of sepsis or septic shock. The document highlights the need for pathogen profiling and selecting the appropriate antimicrobial regimen based on factors such as the severity of illness, presumed source of infection, and risk of multidrug-resistant organisms. It also mentions the importance of considering pharmacokinetic/pharmacodynamic factors and the potential for future advancements in diagnosing sepsis and identifying causative microorganisms. [Extracted from the article]

Tahini is a globally recognized creamy paste made from sesame seeds, whose seeds are widely produced in Colombia but little used in the production of products. Therefore, the objective of this study was to evaluate the quality attributes through proximal, microbiological, and sensory analysis, and the rheological behavior of tahini with the addition of natural sweetener, honey, and cocoa liquor as sensory additives, using local crops. A 2X2X2 factorial design with sesame paste, honey concentration, and cocoa liquor as factors were used to prepare tahini. Proximal, microbiological, and sensory analyses were carried out to determine the bromatology, microbiological suitability, and sensory acceptability, respectively. The rheological behavior was studied by shear rate sweep, controlling the deformation 1x10-2 s-1 to 1x10-2 s-1 with a fit to the Ostwald de Waele model. The rheological characterization of the formulations showed that all of them exhibited pseudoplastic flow behavior, with F4 standing out as having a higher apparent viscosity. Finally, formulation F4 showed the best bromatological, rheological, and sensory characteristics, demonstrating that the incorporation of new ingredients can modify traditional tahini to promote its consumption. [ABSTRACT FROM AUTHOR]

(1) Background: The literature reports a low risk of serious bacterial infections (SBIs) in febrile infants presenting with bronchiolitis or respiratory syncytial virus infection, but current microbiological techniques have a higher accuracy. (2) Methods: We assessed the risk of SBIs in neonates and infants with bronchiolitis from 2021 to 2023. We also evaluated C-reactive protein, procalcitonin, and leukocyte values. (3) Results: We included 242 infants. Blood cultures (BCs) were performed in 66/242 patients, with a positivity rate of 9.1% (including one BC with Staphylococcus hominis, considered as a contaminant). The cerebrospinal fluid culture was performed in 6/242 patients, and the results were all negative. Infection markers did not discriminate infants with positive BCs from those with negative ones. (4) Conclusions: Blood cultures should be performed in neonates and young infants with bronchiolitis fever, as the sepsis risk is not negligible. Conversely, our proposed algorithm is to wait for the respiratory panel results before decision-making for a lumbar puncture. Further studies are needed to understand lumbar puncture requirements. [ABSTRACT FROM AUTHOR]

Introduction: Vernonia amygdalina (V. amygdalina ) (Del.) has been reported to have medicinal values, and the phytochemical constituents which is present in different parts of the plant have been found to be responsible for the antimicrobial efficacy of the plant. This study focuses on the antibacterial activity of the stem bark extracts of V. amygdalina against multiple antibiotic-resistant (MAR) bacteria isolated from wound samples and characterize the bioactive compounds present in the plant. Methods: Bacteria were isolated from wound samples using standard microbiological techniques and disc diffusion method was used to determine the sensitivity patterns of the isolated bacteria to conventional antibiotics and to the various extracts of V. amygdalina stem bark. Ciprofloxacin was used as control during the antibacterial assay. GC-MS analysis was carried out to identify the bioactive compounds in the stem bark extracts of the plant. Results: Pseudomonas aeruginosa (36%), Staphylococcus aureus (29%), Staphylococcus epidermidis (14%), Bacillus subtilis (6%), Escherichia coli (6%), Klebsiella pneumoniae (5%), and Proteus mirabilis (4%) were the bacteria isolated from the wound swabs sampled in this study. The ethyl acetate extract of V. amygdalina (300 mg/ml) inhibited the growth of these organisms with the greatest effect on S. aureus with inhibition zone of 23.17±0.60 mm. The GC-MS analysis of the plant extracts revealed the presence of bioactive compounds such as coumarin and oleic acid, among others. Conclusion: The findings from this study have further established that V. amygdalina is a promising candidate and effective alternative treatment means for MAR bacteria that are associated with wound infections. [ABSTRACT FROM AUTHOR]

Objective The significance of the presence of microorganisms and polymorphonuclear cells in the tracheal aspirates (TAs) of ventilated preterm infants is not well known. Our aim was to correlate information about the presence of polymorphonuclear cells with microbial growth and the cytokine milieu in the TAs of infants who have been intubated for >7 days. Study Design TAs were collected from infants who had been intubated for 7 days or longer. Respiratory cultures were performed, and infants were stratified based on the presence and abundance of polymorphonuclear cells and microbial growth. Cytokines were measured in the TAs of each of the respective groups. Results In the 19 infants whose TAs were collected, the presence of at least moderate WBC with presence of microbial growth was positively associated with the presence of interleukin (IL)-10, IL-1β, IL-8, and tumor necrosis factor (TNF)-α. The presence of at least moderate WBC, with or without microbial growth, was correlated positively with the presence of IL-8 and TNF-α. Conclusion There are higher levels of proinflammatory cytokines (especially, IL-10, IL-1β, and TNF-α) in TAs with higher cell counts and presence of microbial growth. The findings suggest that the presence of microbial growth correlated with inflammatory burden and warrant a larger study to see if treatment of microbial growth can ameliorate the inflammatory burden. Key Points Concomitant evaluation of inflammatory cells, microbial growth, and cytokines in tracheal aspirates. Moderate TA WBC with presence of microbial growth associated with IL-10, IL-1β, IL-8, and TNF-α. Moderate TA WBC, with/without microbial growth, correlated with the presence of IL-8 and TNF-α. Higher levels of IL-10, IL-1β, and TNF-α correlated with higher TA cell counts and microbial growth. [ABSTRACT FROM AUTHOR]

An argon‐based low‐temperature plasma jet (LTPJ) was used to treat chronically infected wounds in Staphylococcus aureus‐laden mice. Based on physicochemical property analysis and in vitro antibacterial experiments, the effects of plasma parameters on the reactive nitrogen and oxygen species (RNOS) content and antibacterial capacity were determined, and the optimal treatment parameters were determined to be 4 standard litre per minute and 35 W. Additionally, the plasma‐treated activation solution had a bactericidal effect. Although RNOS are related to the antimicrobial effect of plasma, excess RNOS may be detrimental to wound remodelling. In vivo studies demonstrated that medium‐dose LTPJ promoted MMP‐9 expression and inhibited bacterial growth during the early stages of healing. Moreover, LTPJ increased collagen deposition, reduced inflammation, and restored blood vessel density and TGF‐β levels to normal in the later stages of wound healing. Therefore, when treating chronically infected wounds with LTPJ, selecting the medium dose of plasma is more advantageous for wound recovery. Overall, our study demonstrated that low‐temperature plasma jets may be a potential tool for the treatment of chronically infected wounds. [ABSTRACT FROM AUTHOR]

Objective Coagulase-negative Staphylococcus (CoNS) is the most frequent pathogen causing late-onset sepsis (LOS) in neonatal intensive care units (NICUs). Technical difficulties hinder blood culture (BC) collection and obtaining only one culture before initiating antibiotic therapy is a common practice. We sought to assess specific clinical information and CoNS cultures for the diagnosis of true bacteremia in the NICU. Study Design This historical cohort study was conducted in NICUs at the Hadassah-Hebrew University Medical Center of Jerusalem in Israel. Clinical and laboratory data in every CoNS bacteremia were collected and compared between bacteremia groups as follows: true positive, two positive BCs; contaminant, one positive BC out of two; undefined, one BC obtained and found positive. Results For 3.5 years, CoNS was isolated in 139 episodes. True positive was identified in 44 of 139 (31.7%), contaminant in 42 of 139 (30.2%), and the event was undefined in 53 of 139 (38.1%). Vancomycin treatment was more frequent in the true positive and undefined groups than the contaminant group (100, 90.6, and 73.8% respectively, p = 0.001); treatment was also prolonged in these two groups (p < 0.001). No clinical variables were associated with true bacteremia on multivariable analysis. Conclusion Diagnosis should definitely be based on at least two positive BCs, despite objective difficulties in obtaining BCs in neonates. Key Points CoNS is a frequent pathogen causing LOS in neonates. Due to technical difficulties, often only one culture is collected prior to antibiotic therapy. No clinical/laboratory variables were associated with the diagnosis of true CoNS bacteremia. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTI) constitute a major public health problem, especially in developing countries such as Burkina Faso. They are commonly encountered in hospitals, particularly in patients suffering from chronic kidney disease whose management requires special measures to avoid treatment failures which are frequent. The objective of this study is to determine the microbial profiles of urinary tract infections (UTIs) in these patients. Methodology: This was a cross-sectional study of hospitalized patients with UTIs in the nephrology-haemodialysis department of the CHUB from August 1 to November 31, 2020. Socio-demographic and clinical data of selected patients were collected by a well-designed data collection form. Cytobacteriological analysis of urine (CBAU) was carried out on voided or catheter-urine sample of each patient using standard microbiological technique. The disc diffusion method in agar medium modified according to the recommendations of the 2020 CA-SFM-EUCAST was used to determine the antibiotic susceptibility of each isolate. Data were processed and analyzed using Excel 2013, IBM SPSS Statistics 25.0 and CSpro 7.5 software. Results: Urine samples were collected from a total of 77 eligible participants, 49 (63.6%) of which were CBAU positive, with 56 microbial pathogens isolated. Enterobacterales represented 58.9% (n=33), including 39.4% Escherichia coli (n=13) and 36.4% Klebsiella spp (n=12). Non-fermentative Gram-negative bacilli represented 7.1% (n=4) including Acinetobacter baumannii (n=3) and Pseudomonas aeruginosa (n=1). Staphylococcus aureus was isolated in 5.4% (n=3) and Candida spp in 28.6% (n=16). The most active antimicrobials in vitro against the bacterial pathogens were amikacin and imipenem, and clotrimazole and nystatin against the Candida spp. A total 35.7% (n=20) were multi-drug resistant bacteria with 32.1% by ESBL in Gram-negative bacteria and 66.7% (2/3) by MRSA in Grampositive bacteria. Conclusion: The high resistance of pathogens to antimicrobials, resulting in therapeutic failures, constitutes a significant challenge in the management of urinary tract infection, especially in people with chronic kidney disease. It is therefore necessary to put in place urgent measures aimed at the rational use of antimicrobials and strict compliance with good hospital hygiene practices. [ABSTRACT FROM AUTHOR]

Background: Brucellosis vaccines are designed to induce cellular immunity. An effective brucellosis vaccine could induce both cellular and humoral immunity. Serum Bactericidal Assay (SBA) is an important method for determining vaccine humoral immunity. This study is the first to observe humoral immunity in brucellosis by SBA. Methods: Extracted Brucella abortus (B. abortus) Lipopolysaccharide (LPS) and Outer Membrane Proteins (OMPs) were injected into rabbits. Group 1 was injected with 25 µg of LPS, Group 2 was injected with 50 µg of OMPs, and Group 3 was injected with 1 ml of combined vaccine, 3 times every 2 weeks. The groups were challenged with B. abortus 544 in the second injection. Sera were separated 2 weeks after the last injection. SBA was performed, and each well was streak-cultured into a plate of Brucella agar. A colony count was done for each plate. Results: Results have shown, the third injection of the combined vaccine had the highest titer of 1/64, and the efficacy of the vaccine was 87.71%. Conclusion: As a conclusion, the results of this study showed that LPS and OMP's from B. abortus can provide acceptable immunity. [ABSTRACT FROM AUTHOR]

Aims: Oral candidosis is common in patients with end‐of‐life cancer; however, its prognosis is unclear. We aimed to assess oral candidosis and Candida species as prognostic indicators in palliative care for these patients. Methods: We consecutively included palliative care patients, assessed for candidosis via microbiological techniques, and classified into three groups by the extent of oral lesions. The association between oral candidosis and overall survival was assessed using a Cox proportional hazards model adjusted by performance status (PS). Results: We studied 142 patients (median age 77; 52.8% women) with a 76.1% oral candidosis prevalence. Candida albicans (80.6%) was the most common species. Oral lesions were classified as none, grade 1 (28.7%), or ≥ grade 2 (14.8%). During follow‐up, Cox models identified ≥grade 2 lesions (aHR = 2.04; 95% CI: 1.18–3.54; p =.011) and Candida tropicalis (aHR = 2.38; 95% CI: 1.03–5.55; p =.044) as predictors. Conclusion: The extent of oral candidosis lesions or the presence of C. tropicalis may serve as prognostic indicator in patients with end‐of‐life cancer. Therefore, solely concentrating on the prevalence and frequency of fungal species may be insufficient for predicting life prognosis; it is advisable to assess these parameters through both visual examination and culture. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa is an opportunistic pathogen in HAIs with two facets: the most studied is the high rate of antimicrobial resistance, and the less explored is the long list of virulence factors it possesses. This study aimed to characterize the virulence genes carried by strains as well as the profile of cytokines related to inflammation, according to the resistance profile presented. This study aims to identify the virulence factors associated with MDR strains, particularly those resistant to carbapenems, and assess whether there is a cytokine profile that correlates with these characteristics. As methodology species were identified by classical microbiological techniques and confirmed by molecular biology, resistance levels were determined by the minimum inhibitory concentration and identification of MDR strains. Virulence factor genotyping was performed using PCR. In addition, biofilm production was assessed using crystal violet staining. Finally, the strains were cocultured with PBMC, and cell survival and the cytokines IL‐1β, IL‐6, IL‐10, IL‐8, and TNF‐α were quantified using flow cytometry. Bacteremia and nosocomial pneumonia in adults are the most frequent types of infection. In the toxigenic aspect, genes corresponding to the type III secretion system were present in at least 50% of cases. In addition, PBMC exposed to strains of four different categories according to their resistance and toxicity showed a differential pattern of cytokine expression, a decrease in IL‐10, IL‐6, and IL‐8, and an over‐secretion of IL‐1b. In conclusion, the virulence genes showed a differentiated appearance for the two most aggressive exotoxins of T3SS (exoU and exoS) in multidrug‐resistant strains. Moreover, the cytokine profile displays a low expression of cytokines with anti‐inflammatory and proinflammatory effects in strains carrying the exoU gene. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is a recessive inherited disorder caused by genetic mutations in the CF transmembrane conductance regulator (CFTR) gene. It is a multisystem condition that primarily induces abnormal mucus accumulation in the respiratory system and obstructs the intrapancreatic common bile duct, causing a reduction in the delivery of digestive enzymes to the small intestine. Thus, patients with CF are characterized by maldigestion, malabsorption, and recurrent airway bacterial infections. Clinical monitoring of the health status of patients with CF is mandatory for increasing the patients’ lifespan. To assess the feasibility of monitoring life quality (LQ) in pediatric patients with cystic fibrosis (CF) and to explore the relationship between biochemical parameters and clinical symptoms, our study analyzed inflammatory responses related to CF, medication, and pulmonary bacterial infections in 52 patients diagnosed with CF. Blood, hypo-pharyngeal exudate, and fecal samples were analyzed using clinical biochemistry, hematology, and microbiology techniques at the Alessandrescu-Rusescu National Institute for Mother and Child Health central laboratory in Bucharest, Romania. All the participants adhered to their prescribed outpatient CF regimens and appeared clinically stable. The overall clinical status of patients with CF was observed and compared with that of a healthy control group, which consisted of individuals similar in number and age. The screened patients with CF presented an impaired lipid status and chronic infections with various bacteria, iron, and vitamin (A, D, and E) deficiencies. Our findings provide insights into the pathophysiological mechanisms of CF and suggest that tailored monitoring and personalized therapeutic strategies could improve patient management. [ABSTRACT FROM AUTHOR]

Parapharyngeal abscess in an infant is a very rare condition. We present the case of a 4-month-old girl with large masses on the neck's left side. Computed tomography showed an extensive parapharyngeal abscess. Left tonsillectomy was performed under general anesthesia from a transoral approach, followed by an incision and evacuation of the abscess from the parapharyngeal space. Microbiological analysis identified a massive occurrence of Streptococcus intermedius. [ABSTRACT FROM AUTHOR]

Background: Risk factors for aseptic preparation of parenteral medicines encompass the growth-promoting nature of the preparation. Although many aqueous parenteral preparations do not have growth-promoting properties, inadvertently introduced microorganisms may remain viable. Knowledge about the viability of microorganisms in parenteral preparations can add useful information for assigning shelf life to preparations used to treat cancer patients. Aim: The aim of the study was to assess the viability of four different facultative pathogenic microorganisms in 20 ready-to-administer parenteral preparations aseptically prepared in hospital pharmacies. Methods: Samples of 20 different biologics and small molecules for systemic anti-cancer therapy were inoculated either with different bacteria (i.e., Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecium) or with Candida albicans suspension. The resulting test concentrations were 104–105 microorganisms per mL. Aliquots of inoculated test solutions were transferred in duplicate to tryptic soy agar plates at the time points 0, 4, 24, 48, 144 h. The plates were incubated for 24 h (bacterial strains) and 72 h (C. albicans) at 37 °C and colony forming units (CFUs) were counted. Results: In most test solutions, especially in monoclonal antibody solutions, increased CFU counts of P. aeruginosa and unchanged or increased CFU counts of E. faecium and S. aureus were registered. Pronounced nutritive properties of monoclonal antibodies and filgrastim were not registered. Azacitidine, pixantrone and vinflunine containing test solutions revealed species-specific bacteriostatic and even bactericidal activity. All test solutions, except nivolumab and pixantrone containing solutions, showed constant or increasing CFU counts of C. albicans after incubation. Conclusion: Viability of the selected pathogenic microorganisms was retained in most of the tested biological and small molecule preparations used to treat cancer patients. Therefore, in pharmacy departments strict aseptic conditions should be regarded and the lack of antimicrobial activity should be considered when assigning shelf life to RTA parenteral preparations. [ABSTRACT FROM AUTHOR]

Objective: To establish the frequency of emerging pathogens and their susceptibility profiles amongst various healthcareassociated infections. Study Design: Cross-sectional study. Place and Duration of Study: Department of Microbiology, Combined Military Hospital, Lahore Pakistan, from Jan to Dec 2020. Methodology: One hundred and ninety-six samples with a history of hospital-acquired infections were received and processed folowing standard microbiological techniques. Antibiotic susceptibility testing was done by the Kirby-Bauer Disk Diffusion technique for the commonly used antibiotics. For colistin susceptibility, the Clinical and Laboratory Standards Institute recommends broth microdilution, colistin broth disk elution, or colistin agar testing MIC methods, however, colistin susceptibility was performed by the E-strip method. Results: One hundred and ninety-six clinical samples with bacterial isolates causing healthcare-associated infections were processed. Specimens were from patients with surgical site infections (59,30.1%), Catheter-associated bloodstream infection (52, 26.5%); Ventilator-associated pneumonia (48, 24.5%) and Urinary tract infection (37,18.9%). Klebsiela pneumoniae (64, 32.7%), E.coli (51, 26%) and Acinetobacter baumani (45,23%) were the leading bacterial pathogens. A total of 72(36.7%) isolates showed multidrug resistance whereas extensively drug-resistant isolates were calculated to be 124(63.3%). Conclusion: High level of bacterial resistance amongst common health-care-associated infections is an eye-opener and impacts applying strict infection control measures along with antimicrobial stewardship. It wil also help clinicians modify empiric treatment regimes in affected patients. [ABSTRACT FROM AUTHOR]

Purpose: The growing incidence of implant-associated infections (IAIs) caused by biofilm-forming Staphylococcus aureus in combination with an increasing resistance to antibiotics requires new therapeutic strategies. Lysostaphin has been shown to eliminate this biofilm. Own studies confirm the effectiveness in a murine model. The current study characterizes the effects of lysostaphin-coated plates in an IAI minipig model. Methods: The femur of 30 minipigs was stabilized with a five-hole plate, a bone defect was created, and in 20 cases methicillin-resistant Staphylococcus aureus was applied. Ten animals served as control group. After 14 days, local debridement, lavage, and plate exchange (seven-hole plate) were performed. Ten of the infected minipigs received an uncoated plate and 10 a lysostaphin-coated plate. On day 84, the minipigs were again lavaged, followed by euthanasia. Bacterial load was quantified by colony-forming units (CFU). Immunological response was determined by neutrophils, as well as interleukins. Fracture healing was assessed radiologically. Results: CFU showed significant difference between infected minipigs with an uncoated plate and minipigs with a lysostaphin-coated plate (p = 0.0411). The infection-related excessive callus formation and calcification was significantly greater in the infected animals with an uncoated plate than in animals with a lysostaphin-coated plate (p = 0.0164/p = 0.0033). The analysis of polymorphonuclear neutrophils and interleukins did not reveal any pioneering findings. Conclusion: This study confirms the minipig model for examining IAI. Furthermore, coating of plates using lysostaphin could be a promising tool in the therapeutic strategies of IAI. Future studies should focus on coating technology of implants and on translation into a clinical model. [ABSTRACT FROM AUTHOR]

An increased efflux activity is one of the major reasons for bacterial antibiotic resistance. The usage of efflux pump inhibitors could be a promising approach to restoring the activity of inefficient antibiotics. The interaction of the RND family efflux pump inhibitor phenylalanyl-arginyl-β-naphthylamide (PAβN) with Salmonella enterica ser. Typhimurium cells was assayed using traditional microbiological techniques and a novel PAβN-selective electrode. Monitoring the PAβN concentration in the medium using the electrode enabled the real-time measurements of this compound's interaction with bacterial cells. We showed that S. Typhimurium cells accumulate a high amount of PAβN because of its high affinity to lipopolysaccharides (LPSs), the major constituent of the outer layer of the outer membrane, and does not affect the functioning of the plasma membrane. EDTA enhanced the binding of PAβN to S. Typhimurium cells and the purified E. coli LPSs, but the energization of the cells by glucose does not affect the cell-bound amount of this inhibitor. Polycationic antibiotic Polymyxin B released both the cells accumulated and the suspended LPS-bound PAβN. [ABSTRACT FROM AUTHOR]

Infectious diseases seriously threaten the lives of children. Timely and accurate detection of pathogenic microorganisms and targeted medication are the keys to the diagnosing and treatment of infectious diseases in children. The next-generation metagenomic sequencing technology has attracted great attention in infectious diseases because of its characteristics such as no culture, high throughput, short detection cycle, wide coverage, and a good application prospect. In this paper, we review the studies of metagenomic next-generation sequencing in pediatric infectious diseases and analyze the challenges of its application in pediatric diseases. [ABSTRACT FROM AUTHOR]

Biofilm formation is a serious problem that relatively often causes complications in orthopedic surgery. Biofilm-forming pathogens invade implanted foreign bodies and surrounding tissues. Such a condition, if not limited at the appropriate time, often requires reoperation. This can be partially prevented by selecting an appropriate prosthesis material that prevents the development of biofilm. There are many modern techniques available to detect the formed biofilm. By applying them we can identify and visualize biofilm-forming microorganisms. The most common etiological factors associated with biofilms in orthopedics are: Staphylococcus aureus, coagulase-negative Staphylococci (CoNS), and Enterococcus spp., whereas Gram-negative bacilli and Candida spp. also deserve attention. It seems crucial, for therapeutic success, to eradicate the microorganisms able to form biofilm after the implantation of endoprostheses. Planning the effective targeted antimicrobial treatment of postoperative infections requires accurate identification of the microorganism responsible for the complications of the procedure. The modern microbiological testing techniques described in this article show the diagnostic options that can be followed to enable the implementation of effective treatment. [ABSTRACT FROM AUTHOR]