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Background: We investigated the possible role of the immune profile at ICU admission, among other well characterized clinical and laboratory predictors of unfavorable outcome in COVID-19 patients assisted in ICU. Methods: Retrospective analysis of clinical and laboratory data collected for all consecutive patients admitted to the ICUs of the General Hospital of Pescara (Abruzzo, Italy), between 1stMarch 2020 and 30thApril 2021, with a confirmed diagnosis of COVID-19 respiratory failure. Logistic regressions were used to identify independent predictors of bacteremia and mortality. Results: Out of 431 patients included in the study, bacteremia was present in N= 191 (44.3%) and death occurred in N= 210 (48.7%). After multivariate analysis, increased risk of bacteremia was found for viral reactivation (OR = 3.28; 95% CI:1.83–6.08), pronation (3.36; 2.12–5.37) and orotracheal intubation (2.51; 1.58–4.02). Increased mortality was found for bacteremia (2.05; 1.31–3.22), viral reactivation (2.29; 1.29–4.19) and lymphocytes < 0.6 × 103c/µL (2.32; 1.49–3.64). Conclusions: We found that viral reactivation, mostly due to Herpesviridae, was associated with increased risk of both bacteremia and mortality. In addition, pronation and intubation are strong predictors of bacteremia, which in turn together with severe lymphocytopenia due to SARS-CoV2 was associated with increased mortality. Most episodes of bacteremia, even due to Acinetobacter spp, were not predicted by microbiological evidence of colonization.

Staphylococcus aureusis a common human and livestock opportunistic pathogen, and there is evidence of animal to human transmission. This paper aimed to recognize properties of the isolates from collections of human and livestock S. aureusstrains and to estimate compatibility of results based on phenotypic tests, microarrays and the spatyping methods. The second goal was to study differences between human and animal isolates in terms of specificity of their hosts and the strain transmission among various hosts. Most strains showed multi-susceptible profiles and produced enzymes on a high level, and they were phenotypically and genetically similar. However, in contrast to the Polish bovine mastitis strains, the Slovakian strains were multi-resistant. In this research, the strains showed significant differences in terms of their phenotypic manifestations and the presence of hemolysins genes; however, other enzyme-encoding genes correlated to a higher extent with the microarrays results. Interestingly, there was a lack of enterotoxin genes in human Poultry-like protein A+ strains in comparison to other human strains. Our study showed that differences between virulence profiles of the human and animal strains correlated with their origin rather than their hosts, and any trait allowed clearly distinguishing between them based on the microarray results.

Enterococcus is an uncommon but emerging agent of upper and lower airway diseases, including sinuses, trachea, bronchi, lung and pleural infections. In particular, pneumonia and thoracic empyema may jeopardize the clinical outcome of compromised, hospitalized hosts, as well as affect outpatients. Treatment may feel the effects of inherent and acquired resistances such organisms show to commonly used drugs, with the spread of glycopeptide/vancomycin resistant enterococci (GRE/VRE, respectively) being of serious concern. With this work, we want to unearth the impact of members of the genus in the ambit of respiratory infections, and to increase the consciousness of their role as resourceful pathogens for human airways. Also, we are revising patents of interest aiming to timely screen GRE and soon provide clinicians with speciation and glycopeptide resistances.

Seriously compromised patients may acquire deep airway ailments by Gram positive, commensal bacteria including Kytococcus and Rothia, pathogenic tracts of which still remain quite unexplored. Resistances they express have been poorly investigated over the years, and no published guidelines for susceptibility testing and antibiotic therapy exist. We would therefore revise the current knowledge about these opportunistic organisms clinical impact, as well as discuss on recent patents focusing on lung infection management. Particularly, these deal with the use of inhalatory vancomycin, even as lipidic complex, that appears a promising adjunctive treatment to systemic antimicrobials.

In spite of the improvements in transfusion safety occurred in the last decades, platelet septic transfusions still represent a cause for concern. Microbial screening of blood products cannot ensure transfusion sterility, so that pathogen inactivation methods and a timely management of infectious events actually play the most relevant role. Biofilm production has been associated to several human illnesses; also, it promotes bacterial adherence to platelet bags and colonization of recipients catheter after transfusion. Therefore, facing biofilm communities is required to reduce the contamination risk and the occurrence of post-infusion events. In this context, the use of tigecycline as a wide-spectrum antibiofilm drug is discussed, along with recent patents about biofilm treatment by quorum-sensing blockers, bacteriophage-based therapy and antibiofilm oral compounds.

Staphylococcus pasteuri is a coagulase-negative, Gram positive organism which is emerging as an agent of nosocomial infections and a blood derivatives contaminant, though its role in causing human disease mostly remains controversial. Despite the paucity of isolates recovered, this bacterium has recently appeared to express resistance against several classes of antibiotic compounds, such as methicillin/oxacillin, macrolides, lincosamides, streptogramins, tetracyclines, chloramphenicol, streptomycin, fosfomycin, as well as quaternary ammonium compounds. Also, authors will discuss some essential patents related to the topic reviewed.

ABSTRACTWe first observed the phenomenon of small colony variants (SCVs) in a Staphylococcus pseudintermediussequence type 71 (ST71) strain, isolated from a non-pet owner. Although we found that small-sized colonies share main features with Staphylococcus aureusSCVs, they nevertheless show a novel, particular, and sticky phenotype, whose expression was extremely stable, even after subcultivation.

ABSTRACTStaphylococcus pseudintermediusis a veterinary pathogen that has seldom been described as an agent of human disease. Features of this probably underreported coagulase-positive Staphylococcusspecies are depicted here through the description of a graft-versus-host disease-related wound infection caused by a multidrug-resistant strain.

ABSTRACTHyperimmune globulins were reported to prevent and treat fetal cytomegalovirus (CMV) infection during pregnancy. Here, we report that infusions of standard human intravenous immunoglobulin significantly increase CMV IgG titers and avidity indexes in pregnant women, paving the way to their use for passive transfer of maternal CMV humoral immunity to fetuses. Preliminary data on perinatal outcomes of the first 67 newborns are encouraging.

We present two cases of exudative pharyngitis due to Streptococcus dysgalactiae subsp. equisimilis, Lancefield group G. While the participation of this organism as an agent of pharyngitis is well documented, we focus on failure of beta-lactam therapy, a phenomenon that is well described for pharyngitis due to Streptococcus pyogenes. Therefore, these case reports add to our knowledge of pharyngitis caused by non-S. pyogenes streptococci.

ABSTRACTWe present two cases of exudative pharyngitis due to Streptococcus dysgalactiaesubsp. equisimilis, Lancefield group G. While the participation of this organism as an agent of pharyngitis is well documented, we focus on failure of beta-lactam therapy, a phenomenon that is well described for pharyngitis due to Streptococcus pyogenes. Therefore, these case reports add to our knowledge of pharyngitis caused by non-S. pyogenesstreptococci.

A better knowledge of factors predicting the development of sepsis in patients hospitalized in intensive care unit (ICU) might help deploy more targeted preventive and therapeutic strategies. In addition to the known clinical and demographic predictors of septic syndromes, in this study, we investigated whether measuring T and B lymphocyte subsets upon admission in the ICU may help individualize the prediction of ensuing sepsis during ICU stay. Between May 2015 and December 2016, we performed a prospective cohort study evaluating peripheral blood lymphocyte T-CD4+ (T-helper cells), T-CD8+ (cytotoxic T-cells), T-CD56 + (natural killer cells), and T-CD19+ (B-lymphocytes), using flow cytometry on blood samples collected 2 days after admission in the ICU. We enrolled 176 patients, 65.3% males, with mean age of 61.1 ± 15.4 years. At univariate analyses, higher percentages of CD19 B-cells were significantly associated with ensuing sepsis (20.5% (15.7–27.7)% vs 16.9% (11.3–22)%, P= 0.0001), whereas median interquartile range (IQR) proportions of CD4 T-cells (41.2% (33.4–50.6)% vs 40% (35–47)%, P= 0.5), CD8 T-cells (21.1% (15.8–28.2)% vs 19.6% (14.6–25.1)%, P= 0.2) and CD56 T-cells (1.7% (0.9–3.1)% vs 1.45% (0.7–2.3)%, P= 0.4) did not reveal any significant association. An unexpected, highly significant inverse correlation of CD8 T-cells and CD19 B-cells proportions, however, was observed, suggesting that patients with lower CD19 and higher CD8 proportions might be somehow protected from ensuing sepsis. We therefore studied the ability of the CD8/CD19 ratio to predict ensuing sepsis in our sample. In final models of multivariate logistic regression, the following independent associations were found: previous antibiotic exposure (odds ratio (OR): 3.8 (95% confidence interval (CI): 1.35–10.87), P= 0.01), isolation of at least one multi-drug resistant organism at any time during ICU stay (OR: 8.4 (95% CI: 3.47–20.6), P< 0.0001), decreasing age (OR: 0.9 (95% CI: 0.93–0.99), P= 0.02) and a CD8/CD19 ratio >2.2 (OR: 10.3 (95% CI: 1.91–55.36), P= 0.007). Our data provide preliminary evidence that immune characterization of critically ill patients on ICU admission may help personalize the prediction of ensuing sepsis during their ICU stay. Further polycentric evaluation of the true potential of this new tool is warranted.

ABSTRACTA beta-hemolytic Lancefield antigen A-, B-, C-, D-, F-, and G-positive Enterococcus duransstrain was cultivated from the rectovaginal swab of a pregnant woman who underwent antenatal screening for Streptococcus agalactiae. The isolate raised concern as to what extent similar strains are misrecognized and lead to false diagnosis of group B streptococci.

ABSTRACTThis case report is a case history of a femoral prosthesis infection caused by Rhodotorula mucilaginosain a human immunodeficiency virus patient. Though the pathogenicity of this organism for bone tissue has been previously reported, this is the first reported case of an orthopedic prosthesis infection by this species of the genus Rhodotorula.

ABSTRACTWe report a case in which Escherichia fergusonii, an emerging pathogen in various types of infections, was associated with cystitis in a 52-year-old woman. The offending strain was found to be multidrug resistant. Despite in vitro activity, beta-lactam treatment failed because of a lack of patient compliance with therapy. The work confirms the pathogenic potential of E. fergusonii.