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The main mechanism that causes resistance to carbapenem, one of the most potent antibiotic available, in Enterobacterales bacterial isolates, is due to Klebsiella pneumoniae carbapenemase (KPC) production by the bacterium. KPC is spread worldwide, requiring laboratories to be capable of identifying this enzyme, however some methods can be expensive for small laboratories, especially in developing countries. Therefore, the development of methods with low cost of reagents for the detection of KPC enzyme is necessary. The objective of this study was to evaluate the detection of KPC enzyme by MALDI-TOF MS from inactivated bacteria impregnated in filter paper. A total of 129 Enterobacterales isolates were impregnated in filter paper, and after 7 days at room temperature, they were subjected to a protein extraction protocol and spectra acquisition, in triplicates, by MALDI-TOF MS. The spectra were evaluated and KPC was identified according to the presence of a peak of 28,712.62 ± 27.80 m/z. Considering the presence of the KPC peak in at least one spectrum of the triplicates, this method presented 60.8% sensitivity and 96.4% specificity. However, considering the presence of KPC peak in at least two spectra of the triplicate, a specificity of 100% was achieved. The detection of KPC enzyme from inactivated bacteria impregnated in filter paper can be used as a method to confirm the presence of KPC, which could be very significant for small laboratories with limited resources., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

With the evident increased prevalence of respiratory tract infections (RTIs) such as Respiratory Syncytial Virus (RSV), influenza, Group A Streptococcus (GAS), and COVID-19, the conventional diagnostic methods are considered sub-optimal in providing timely management to patients in the Kingdom of Saudi Arabia (KSA). Gaps in current diagnostics are magnified by the Kingdom's unique demographic composition, comprising 11.9 million foreign workers, and the annual influx of over 10 million pilgrims. Current gaps in timely diagnosis leads to delays in treatment, misuse of antibiotics, and protracted hospital stays, subsequently compromising patient care, and escalating healthcare costs. KSA healthcare stakeholders suggest that the integration of rapid molecular Point-of-Care Testing (POCT) into the Kingdom's healthcare infrastructure is an absolute necessity. This publication serves as an urgent call for action aimed at healthcare policymakers in Saudi Arabia, to review the existing diagnostic challenges and include rapid POCTs in the Saudi healthcare strategy for respiratory infections., Competing Interests: Declaration of competing interest AM Assiri received honoraria for roundtable discussions from IQVIA. HS is the IRB chairman at King Fahad Medical City (KFMC) and a board member of the Saudi Association for Pulmonary Hypertension (SAPH). HS, LD, and RV are employees of IQVIA., (Copyright © 2024. Published by Elsevier Inc.)

The paper and pulp industry (PPI) produces high quantities of solid and liquid discharge and is regarded as the most polluting industry in the world causing adverse effects to environments and human beings. Hence changes in the way PPI sludge and waste materials are treated is urgently required. Nearly, 10 million tons of waste is generated per year, however PPI waste is enriched with many organic chemicalscontaining a high percentage of lignin, cellulose, and hemicellulose which can be used as valuable raw materials for the production of bioenergy and value-added chemicals. Pretreatment of complex lignocellulosic materials of PPI waste is difficult because of the cellulose crystallinity and lignin barrier. At present most of this waste is recycled in a conventional treatment approach through biological and chemical processes, incurring high cost and low returns. Henceefficient pretreatment techniques are required by which complete conversion of PPI waste is possible. Therefore, the present chapter provides the scope of integration of pretreatment methods through which bioenergy recovery is possible during the PPI waste treatment. Detailed information is presented on the various pre-treatment techniques (chemical, mechanical, enzymatic and biological) in order to increase the efficiency of PPI waste treatment and energy recovery from PPI waste. Along with acid and alkali based efficient chemical treatment process, physical methods (i.e. shearing, high-pressure homogenization, etc.), biochemical techniques (whole cell-based and enzyme-based) and finally biological techniques (e.g. aerobic and anaerobic treatment) are discussed. During each of the treatment processes, scope of energy recovery and bottlenecks of the processes were elaborated. The review thus provides systemic insight into developing efficient pretreatment processes which could increase carbon recovery and treatment efficiency of PPI waste., (Copyright © 2019. Published by Elsevier B.V.)

Storage of stools for the detection of soil-transmitted helminths (STH) remains challenging for the molecular diagnostic testing of STH infections. This study aimed to overcome this challenge by assessing the capacity of Whatman filter papers to store stools for the molecular detection of STHs. Stool samples were collected from school-aged children of soil-transmitted helminthiasis endemic areas of Cameroon and then, analysed using Kato Katz technique. For this study, 128 and 40 stool samples respectively with and without STH eggs were analysed. From each sample, 10, 20, 40 and 80 mg of stool were weighted and spread on 6 grades of Whatman filter papers that were stored at room temperature from one to ten weeks. DNA was extracted from spread stool using CTAB based-method. The amount of stool to spread on filter papers and the grade of filter paper offering good storage were determined by amplifying specific DNA fragments of Ascaris lumbricoides. The capacity of filter papers to store stool samples for several weeks before the molecular detection of STH species was assessed by amplifying specific DNA fragments of different STHs. The amplification rates of A. lumbricoides were significantly higher (P < 0.0001) for 10 and 20 mg of stored stools. Stools spread on Whatman paper grade 2 yielded the highest amplification rate of 100% for A. lumbricoides, T. trichiura and hookworm. PCR revealed STH infections in all the 128 spread stools carrying STH eggs. It also revealed Necator americanus and Ancylostoma duodenale respectively in 10 and 13 of 15 spread stools contained hookworm eggs. PCR confirmed the co-infections of these hookworm species as well as that of A. lumbricoides and Trichuris trichiura in 7 spread stools. Out of 40 stools without STH eggs, PCR revealed that 5 (12.5%) and 9 (22.5%) had respectively A. lumbricoides and T. trichiura infections. The amplification rate of each STH species was 100% from one to 8 weeks and decreased to 86.7% after 10 weeks of storage. This study highlighted the capacity of filter papers to store stools for the molecular detection of STHs. Storing stools on these papers will enable to monitor and evaluate control programs and ensure post-elimination surveillance., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2023. Published by Elsevier B.V.)

Paper-based nucleic acid testing techniques are increasingly in demand. Hence, we have developed a simple and cheap paper fluidic device to detect multiple gene targets in Leptospira. Fluidic channels of the penta-clover device are drawn using a correction pen on Whatman filter paper 1. The fluid blocks the pores of the paper, avoiding leakage and ensuring the equal flow of sample to the reaction pads. The target genes are amplified by performing Loop-Mediated Isothermal Amplification (LAMP) with dry reaction components. Thecolor change of leuco crystal violetallows real-time monitoring of a positive amplification. The difference in color intensity is captured with a smartphone and analyzed using image processing software. The device amplifies the target within 15 min, detects the pathogen at a concentration as low as 50 attogram μL -1 , detects Leptospira in blood samples without prior treatment and differentiates the Leptospira species even after 21 days of storage at room temperature., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Cholera is now considered to be endemic in Haiti, often with increased incidence during rainy seasons. The challenge of cholera surveillance is exacerbated by the cost of sample collection and laboratory analysis. A diagnostic tool is needed that is low cost, easy-to-use, and able to detect and quantify Vibrio cholerae accurately in water samples within 18-24h, and perform reliably in remote settings lacking laboratory infrastructure and skilled staff. The two main objectives of this study were to develop and evaluate a new culture medium embedded in a new diagnostic tool (PAD for paper based analytical device) for detecting Vibrio cholerae from water samples collected in Haiti. The intent is to provide guidance for corrective action, such as chlorination, for water positive for V. cholerae epidemic strains. For detecting Vibrio cholerae, a new chromogenic medium was designed and evaluated as an alternative to thiosulfate citrate bile salts sucrose (TCBS) agar for testing raw water samples. Sensitivity and specificity of the medium were assessed using both raw and spiked water samples. The Vibrio cholerae chromogenic medium was proved to be highly selective against most of the cultivable bacteria in the water samples, without loss of sensitivity in detection of V. cholerae. Thus, reliability of this new culture medium for detection of V. cholerae in the presence of other Vibrio species in water samples offers a significant advantage. A new paper based device containing the new chromogenic medium previously evaluated was compared with reference methods for detecting V. cholerae from spiked water sample. The microbiological PAD specifications were evaluated in Haiti. More precisely, a total of 185 water samples were collected at five sites in Haiti, June 2014 and again in June 2015. With this new tool, three V. cholerae O1 and 17 V. cholerae non-O1/O139 strains were isolated. The presence of virulence-associated and regulatory genes, including ctxA, zot, ace, and toxR, was confirmed using multiplex PCR. The three V. cholerae O1 isolates were positive for three of the four virulence-associated and regulatory genes. Twelve of the V. cholerae non-O1/O139 isolates were found to carry toxR, but none were ctxA+, zot+, or ace+. However, six of the V. cholerae non-O1/O139 isolates were resistant to penicillin, ampicillin, trimethoprim/sulfamethoxazole, nalidixic acid, and ciprofloxacin. The paper based analytical device (PAD) provides advantages in that standard culture methods employing agar plates are not required. Also, intermediary isolation steps were not required, including transfer to selective growth media, hence these steps being omitted reduced time to results. Furthermore, experienced technical skills also were not required. Thus, PAD is well suited for resource-limited settings., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Host DNA may adversely affect metagenomic studies focusing on the prokaryotic microbiota. This study compared the levels of host DNA in subgingival plaque collected by paper points and curette, using quantitative PCR. Lower proportions of host DNA and higher proportions of bacterial DNA were recovered from samples collected with curettes., (Copyright © 2015 Elsevier B.V. All rights reserved.)

A novel approach to transport inactivated bacteria in filter paper for identification in the MALDI-TOF MS was evaluated. Seventy four bacterial isolates were evaluated and the approach presented sensitivity of 97.3% and specificity of 100%. Inactivated bacteria in filter paper are a safer alternative to transport bacteria for MALDI-TOF MS identification., Competing Interests: Declaration of Competing Interest None to declare., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: The increasing interest on the impact of the gut microbiota on health and disease has resulted in multiple human microbiome-related studies emerging. However, multiple sampling methods are being used, making cross-comparison of results difficult. To avoid additional clinic visits and increase patient recruitment to these studies, there is the potential to utilize at-home stool sampling. The aim of this pilot study was to compare simple self-sampling collection and storage methods., Methods: To simulate storage conditions, stool samples from three volunteers were freshly collected, placed on toilet tissue, and stored at four temperatures (-80, 7, 22 and 37°C), either dry or in the presence of a stabilization agent (RNAlater®) for 3 or 7days. Using 16S rRNA gene sequencing by Illumina, the effect of storage variations for each sample was compared to a reference community from fresh, unstored counterparts. Fastq files may be accessed in the NCBI Sequence Read Archive: Bioproject ID PRJNA418287., Results: Microbial diversity and composition were not significantly altered by any storage method. Samples were always separable based on participant, regardless of storage method suggesting there was no need for sample preservation by a stabilization agent., Discussion: In summary, if immediate sample processing is not feasible, short term storage of unpreserved stool samples on toilet paper offers a reliable way to assess the microbiota composition by 16S rRNA gene sequencing., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The term early repolarization has been in use for more than 50 years. This electrocardiographic pattern was considered benign until 2008, when it was linked to sudden cardiac arrest due to idiopathic ventricular fibrillation. Much confusion over the definition of early repolarization followed. Thus, the objective of this paper was to prepare an agreed definition to facilitate future research in this area. The different definitions of the early repolarization pattern were reviewed to delineate the electrocardiographic measures to be used when defining this pattern. An agreed definition has been established, which requires the peak of an end-QRS notch and/or the onset of an end-QRS slur as a measure, denoted Jp, to be determined when an interpretation of early repolarization is being considered. One condition for early repolarization to be present is Jp ≥0.1 mV, while ST-segment elevation is not a required criterion., (Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

There is an increased interest for finding strains able to contribute to plant nutrition and health, since these are desirable for the formulation of agricultural bioinoculants. Obtaining a safe and efficient product requires exhaustive evaluations from which most methods used for this purpose involve the use of substrates or are established under uncontrolled conditions, so that various factors can mask the results of the plant-microorganism interaction. In vitro methods mostly involve the use of Petri Dishes (PD) but limit the results to seed germination. Other methods of germination involve the use of acrylic boxes (GB) allowing for better plant development, but are little known. Methods such as ISTA are widely used to evaluate the physiological quality of seeds in productive terms. Despite their efficiency, these methods have not been previously used to evaluate the effect of plant-microorganism interaction on crops. In the present study, modifications were made to the germination between paper of ISTA (BP) method, and were compared to the PD anf GB methods to evaluate the impact of the bacterium Serratia liquefaciens 385 and the yeast Clavispora lusitaniae Y35 on maize, bean and squash. Through the evaluation of physiological parameters in seed and seedling, the results clearly showed the superiority of the BP method to evaluate the effect of microorganisms since it allows observing a better development in the seedlings in terms of growth of the plumule, a better architecture of the radical system in which the emergence of adventitious secondary roots and differentiated radical hairs is observed in comparison with seedlings obtained under the other methods. Similarly, it was possible to observe the different effects on each of the three crops with respect to the inoculation of the bacteria and yeast. These results were significantly better in seedlings obtained in the BP method independently of the type of crop evaluated, considering the BP method suitable to be applied in large-scale bioprospecting plant-growth-promoting microorganism studies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Statins are the most common drugs administered for patients with cardiovascular disease. However, due to statin-associated muscle symptoms, adherence to statin therapy is challenging in clinical practice. Certain nutraceuticals, such as red yeast rice, bergamot, berberine, artichoke, soluble fiber, and plant sterols and stanols alone or in combination with each other, as well as with ezetimibe, might be considered as an alternative or add-on therapy to statins, although there is still insufficient evidence available with respect to long-term safety and effectiveness on cardiovascular disease prevention and treatment. These nutraceuticals could exert significant lipid-lowering activity and might present multiple non-lipid-lowering actions, including improvement of endothelial dysfunction and arterial stiffness, as well as anti-inflammatory and antioxidative properties. The aim of this expert opinion paper is to provide the first attempt at recommendation on the management of statin intolerance through the use of nutraceuticals with particular attention on those with effective low-density lipoprotein cholesterol reduction., (Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

This study aimed to report a tularemia outbreak in Sivas and describe the epidemiological and diagnostic characteristics of the patients. Patients aged 18 and over followed up with a diagnosis of tularemia in Sivas Cumhuriyet University Hospital, Sivas Numune State Hospital, and Sivas State Hospital Infectious Diseases Outpatient Clinics and wards between November 2023 and May 2024 were evaluated. 205 adult patients with tularemia were included. The most common symptoms were sore throat (73.2 %, n=150), swelling in the neck (70.2 %, n = 144), and fatigue (55.1 %, n = 113). The most common form was oropharyngeal (82.4 %, n = 169) and glandular (14.6 %, n = 30). Lymphadenopathy was detected in 182 (88.8 %) patients, the most is cervical lymphadenopathy (60 %, n = 123). Lymph node drainage/excision was performed on 50 patients (24.3 %). There have been no deaths in this outbreak. This study presents patient data from the tularemia outbreak in Sivas., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This study assessed antimicrobial susceptibility, biofilm formation, hypervirulence traits, and virulence-related genes in K. pneumoniae. 119 isolates underwent antibiotic susceptibility testing using the Kirby-Bauer method, biofilm assessment through Congo red agar and Microtiter plate assays, PCR for various genes, and the String test for hypermucoviscosity. Clinical characteristics and virulence factors of hypervirulent (hvKP) were compared to classic K. pneumoniae (cKP) strains. Among the isolates, 77.3% were multi-drug resistant (MDR), and 83.2% showed biofilm-forming ability, with a higher MDR incidence in biofilm producers. A significant correlation was found between biofilm formation and the presence of the bla CTX-M15 gene. Genes luxS, mrkA, pgaA, and wzm were significantly related to biofilm production. Three K. pneumoniae (2.5%) were identified as hvKP, with higher prevalence of capsular serotypes K1/K2 and virulence-related genes iuc, rmpA, and rmpA2 than cKP. The study underscores the importance of surveillance and stewardship in combating MDR, biofilm-forming, highly virulent K. pneumoniae., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Masoud Yousefi reports financial support was provided by Birjand University of Medical Sciences. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Although Providencia species are recognised as important causes of bloodstream infections (BSI), their epidemiology is not well defined due to their infrequent occurrence. Our objective was to determine the overall incidence, determinants, and outcomes of Providencia species BSI, and compare the epidemiology of P. stuartii and P. rettgeri in a large population., Methods: All patients within Queensland, Australia with Providencia species BSI between 2000-2019 were included with clinical and outcome data collected from state-wide datasets., Results: Among 268 residents, there was 273 incident episodes of Providencia species BSI; with 118 cases (43.2%) due to P. rettgeri, 150 cases (55.0%) due to P. stuartii, for age and sex adjusted incidence rates of 1.5, and 2.1 per million respectively. Five cases (<2.0%) were due to other Providencia species. The median age was 73.9 years, 80% were male, and most episodes were of community onset. As compared to P. rettgeri, patients with P. stuartii BSI were more likely to have dementia, peptic ulcer disease, and hemiplegia but less likely to have comorbid liver disease. The overall distribution of infection foci were different with P. stuartii more commonly associated with lower respiratory tract source and P. rettgeri with urinary source. All cause 30-day case fatality was significantly higher for P. rettgeri versus P. stuartii (35; 29.7% vs. 24; 16%; p=0.007)., Conclusions: Providencia species are important causes of community onset BSI especially in older males. Although they share similar incidence, P. stuartii and P. rettgeri BSI differ on many clinical aspects., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Patrick Harris reports a relationship with OpGen Inc that includes: consulting or advisory. Patrick Harris reports a relationship with Merck Sharp & Dohme UK Ltd that includes: consulting or advisory. Patrick Harris reports a relationship with Sandoz Inc that includes: consulting or advisory. Patrick Harris reports a relationship with Pfizer that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: This study aimed to assess the prevalence of colistin resistance in the study group and compare alternative methods with the gold standard. It sought to evaluate the prevalence of plasmid-mediated colistin resistance genes., Material and Methods: The colistin susceptibility of 151 K. pneumoniae strains was determined using Sensititre™, CBDE, ETEST®, and VITEK®2. Results were compared with BMD. The presence of the mcr gene was assessed using polymerase chain reaction., Results: The colistin resistance rate was 16,6 %. The categorical agreement of Sensititre™, CBDE, and ETEST® was 100 %. VITEK®2 had a CA of 98 %, a major error of 0.79 %, and a very major error of 8 %. Essential agreement for Sensititre™, ETEST®, and VITEK®2 was 92.7 %, 52.3 %, and 78.1 %, respectively. There were no mcr genes in any strains., Conclusions: Due to the difficulty of applying BMD, colistin resistance data are insufficient globally. Continuous epidemiological studies and validation of alternative methods are needed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for Diagnostic Microbiology & Infectious Disease and was not involved in the editorial review or the decision to publish this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

We evaluated the diagnostic performance of Rapiim SARS-CoV-2-H (Rapiim-H)-a point-of-care qualitative antigen test-using nasopharyngeal swabs (NPS) and saliva samples and compared its results with those from antigen quantification and nucleic acid amplification tests. NPS and saliva were collected from patients with confirmed and suspected coronavirus disease (COVID-19). In total, 142 NPS and saliva samples were collected. In symptomatic cases, in which the first NPS sample was collected within 10 days of disease onset, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for COVID-19 diagnosis were 91.7 %, 88.6 %, 93.2 %, and 86.1 %, respectively. A similar analysis was performed on saliva samples, and the sensitivity, specificity, PPV, and NPV were 50.8 %, 91.4 %, 91.2 %, and 51.6 %, respectively. The Rapiim-H test using NPS demonstrated approximately 90 % sensitivity and specificity, particularly within the first 10 days after disease onset., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Kei Yamamoto reports financial support was provided by Canon Medical Systems Corporation. Hideaki Kato reports a relationship with Shionogi and Co Ltd that includes: funding grants. Hideaki Kato reports a relationship with Asahi Kasei Pharma Corporation that includes: funding grants. Kei Yamamoto reports a relationship with FUJIREBIO Inc that includes: funding grants. Kei Yamamoto reports a relationship with Mizuho Medy Co Ltd that includes: funding grants. Kei Yamamoto reports a relationship with VisGene Co. Ltd. that includes: funding grants. Kei Yamamoto reports a relationship with Sanyo Chemical Industries Ltd that includes: funding grants. Kei Yamamoto reports a relationship with CarbGeM Inc. that includes: funding grants. Kei Yamamoto reports a relationship with Sysmex Corp that includes: funding grants. Kei Yamamoto reports a relationship with Toyobo Co Ltd that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

To investigate differences in the clinical features of patients with sporotrichosis and cutaneous Mycobacterium marinum infection, and develop a prediction model for the initial identification. A total of 121 patients were selected based on the results from etiological culture. Logistic regression analyses were employed to identify the most valuable variables. In the multivariate logistic regression analysis, the following were finally considered independent predictors (OR = 3.650∼14.024, P<0.05) of cutaneous M. marinum infection: age<60 years (P = 0.031); female (P = 0.001); only the extremities involved (P = 0.031); clear triggers (P = 0.022); and presence of swelling (P = 0.024). A nomogram was developed based on these factors, and the area under the curve was 0.860. The model presented is based on clinical features and can help identify patients with sporotrichosis and cutaneous M. marinum infection. This may help increase the accuracy of doctors' initial examination and diagnostic outcomes., Competing Interests: Declaration of competing interest The authors declare no financial interests or personal relationships that could have appeared to influence the work reported in this paper. No conflict of interest was reported., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Trimethoprim/sulfamethoxazole (TMP/SMZ), traditionally a second-line drug, is now proposed as the primary alternative treatment for macrolide-resistant Bordetella pertussis (B.pertussis). Thus, there is an urgent need to evaluate the phenotypic profile of B. pertussis regarding susceptibility to TMP/SMZ., Methods: Kirby-Bauer (KB) disk diffusion methods and E-test strips were employed to assess the in vitro susceptibility profiles of 128 B. pertussis strains isolated in China between 2017 and 2022 against TMP/SMZ. Additionally, whole genome sequencing was performed on one strain exhibiting a heterogeneous phenotype., Results: B. pertussis displayed three phenotypes to TMP/SMZ based on the first 10 days of culture: a predominant fuzzy-bordered phenotype (118/128, 92.2 %), a minority with a clear-bordered phenotype (8/128, 6.3 %), and a sporadic heterogeneous phenotype (2/128, 1.6 %) where TMP/SMZ heterozygous colonies emerged on the 9th day of incubation. The diameter of the inhibition zone around the paper disk will decrease as the culture time extends, while the MIC value will change in the opposite direction. Almost in all tests, the bacterial colony will cover the entire inhibitory zone after 10-14 days of incubation. Strains exhibiting heterogeneity were compared with the complete genomes of Tohama I and CS strains, and 191 and 179 point mutation sites were identified, respectively, with multiple variants associated with the expression of transcriptional regulators., Conclusion: This study highlights the diverse drug sensitivity phenotypes of B. pertussis to TMP/SMZ and the importance of uniform testing protocols. Continuous and dynamic monitoring of B. pertussis isolates for TMP/SMZ sensitivity, along with investigating its correlation with epidemiological changes, is essential for establishing a scientific foundation for the effective management and control of pertussis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Tuberculous lymphadenitis is one of the most common extrapulmonary manifestation of tuberculosis. Lymphadenitis due to Listeria monocytogenes is rarely described. We present a case of a 59-year-old woman from Mexico presented to the Emergency Department with a 2-week history of erythematous and painful swelling in the right retromandibular area. An ultrasound-guided bedside needle aspiration of the lump was performed by an infectious diseases specialist and a diagnosis of Listeria monocytogenes and tuberculous coinfection was done. To our knowledge this is the first case of tuberculous and Listeria-associated lymphadenitis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

In recent years, the widespread emergence of drug resistance in yeasts and filamentous fungi to existing antifungal armamentariums has become a severe threat to global health. There is also concern regarding increased rates of azole resistance in Aspergillus fumigatus and Terbinafine resistance in Trichophyton species. To overcome this concern of resistance to regular therapies, new antifungal drugs with novel and effective mechanisms are crucially needed. Herbal remedies may be promising strategies for the treatment of resistant infections. We aimed to investigate the in vitro and silico activity of piperlongumine against clinical azole susceptible/resistant A. fumigatus and terbinafine-susceptible/resistant Trichophyton species. In the current study, piperlongumine demonstrated potent antifungal activity, with minimum inhibitory concentrations (MICs) ranging from 0.016-4 μg/mL against Trichophyton isolates and 0.25-2 μg/mL for A. fumigatus isolates. Additionally, molecular docking studies indicated that piperlongumine has a strong binding affinity to the active sites of squalene epoxidase and sterol 14-alpha demethylase. However, further studies are warranted to correlate these findings with clinical outcomes and provide the basis for further investigations to pave the way for developing novel antifungal agents., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Iman Haghani reports financial support was provided by Mazandaran University of Medical Sciences. This research was financially supported by grant number 17588 from Mazandaran University of Medical Sciences. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Concerning the progression of dermatophytosis and its prognosis, quantification studies play a significant role. Present work aims to develop an automated grading system for quantifying fungal loads in KOH microscopic images of skin scrapings collected from dermatophytosis patients. Fungal filaments in the images were segmented using a U-Net model to obtain the pixel counts. In the absence of any threshold value for pixel counts to grade these images as low, moderate, or high, experts were assigned the task of manual grading. Grades and corresponding pixel counts were subjected to statistical procedures involving cumulative receiver operating characteristic curve analysis for developing an automated grading system. The model's specificity, accuracy, precision, and sensitivity metrics crossed 92%, 86%, 82%, and 76%, respectively. 'Almost perfect agreement' with Fleiss kappa of 0.847 was obtained between automated and manual gradings. This pixel count-based grading of KOH images offers a novel, cost-effective solution for quantifying fungal load., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Rajitha KV: Execution of the experimental steps, result analysis, its validation, and drafting of the manuscript; Sreejith Govindan: Involvement in conceptualization of the project, specimen curing, microscopic examination for confirmation of dermatophytes in the specimen, manual grading, and checklist preparation; Prakash PY: Discussion of the microbiological aspects involved in the work including the manual grading and checklist preparation, assessment of the medical relevance and suggestions to improve clinical insights; Asha Kamath: Conception of the statistical method, result analysis and review of the manuscript; Raghavendra Rao: Confirmation of diagnostic aspects of the fungal infection and providing the required clinical s p e c i m e n ; Keerthana Prasad: Study conception, critical evaluation of the results, their discussion, review of the manuscript and overall guidance., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The importance of cytomegalovirus in clinical practice remains and samples are monitored for CMV DNA titers to predict the development of disease. LAMP assays have gained increasing interest in the diagnosis of many pathogens since they do not require thermocycling, reduce the complexity of the required instrumentation as well as providing sensitivity and rapidity. So far, very few studies on CMV detection by LAMP have been reported in the literature and therefore the performance of LAMP CMV assays needs to be further characterized. In a set-up for biometrological evaluation of the suitability of the LAMP assay for CMV diagnosis, a LAMP assay was performed on a total of 192 samples with 24 replicates of 8 different hCMV DNA concentrations. The LOD was calculated as 39.09 copy/reaction (25.33 copy/reaction to 65.84 copy/reaction) with 95 % confidence, representing a range that is suitable for qualitative detection. Furthermore, the lower limit of quantification was estimated at approximately 100 copy/reaction. The LOD and LLOQ values obtained in this first study to assess the biometrological relevance of LAMP CMV tests are consistent when compared to studies published before. However further study under different conditions is needed for the use of LAMP tests in clinical applications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

We conducted a systematic review and meta-analysis of studies and reports comparing the performance of antigen rapid diagnostic tests (Ag RDT) for diagnosing Ebola disease (EVD). We searched PubMed, EMBASE, and Web of Science for diagnostic studies published between 1976 and 2023, evaluating them with QUADAS-2. Using a bivariate random-effects model, we estimated the pooled sensitivity and specificity of Ag RDTs. Of 64 eligible full studies and reports, 16 met the inclusion criteria. Pooled sensitivity and specificity were 82.1% (95%CI: 75.2 - 88.0) and 97.0% (95%CI: 95.1-98.2), respectively. We conducted subgroup analysis on 4 Ag RDTs, 3 RT-PCR tests, and 4 sample types, showing varied performance. The high specificity and positive predictive value of Ag RDTs support their use to "rule-in" patients with EVD. However, high-sensitivity RDTs suitable for field settings and capable of detecting multiple ebolavirus species are needed., Competing Interests: Declaration of competing interest That there is no conflict of interest for this paper, (Copyright © 2024. Published by Elsevier Inc.)

This study assessed the diagnostic potential of nonpolar lipid extracts in enzyme-linked immunosorbent assays (ELISAs) for tuberculosis (TB) serodiagnosis. Nonpolar lipid extracts were harvested from Mycobacterium tuberculosis (Mtb) knockout in mce1 operon (∆mce1) and its parental wild type (WT) strains. IgM and IgG anti-nonpolar lipid serum levels were measured in TB patients (n=45), healthy individuals with positive (n=22) and negative (n=44) interferon-gamma release assay (IGRA) results, and symptomatic respiratory (SR) patients with negative TB tests (n=9). IgG anti-WT lipid distinguished TB patients from IGRA-positive individuals with 60% sensitivity and 77.3% specificity. Conversely, IgG anti-∆mce lipid levels didn't vary significantly across groups. Interestingly, most SR patients exhibited significantly higher IgM and IgG anti-WT lipid titers than the IGRA-positive and -nega groups. While the overall diagnostic potential of Mtb nonpolar lipids was limited, the impaired immunogenecity of Δmce1 lipid extract suggests that some missing lipid classes in this extract can potentially induce antibody production in TB patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: In vitro activity of β-lactam enhancer/β-lactam combination zidebactam/cefepime was evaluated against carbapenem- and colistin-resistant Klebsiella pneumoniae isolates., Methods: Non duplicate K. pneumoniae (n=185), resistant to colistin as well as non-susceptible to carbapenems were collected (2018-2019) at two large tertiary care hospitals in India. Colistin resistance-conferring genes mcr1 and mcr3 were screened among 123 of 185 randomly-selected isolates. These isolates were also subjected to multi-locus sequence typing (MLST). Additionally, alterations in mgrB were screened in 109 of these 123 isolates. All the study isolates were screened for presence of carbapenemases genes. MICs of zidebactam/cefepime, colistin, carbapenems, ceftazidime/avibactam, imipenem/relebactam, amikacin and piperacillin/tazobactam were determined by reference CLSI broth dilution method., Results: Among the isolates, 65.4% (121/185) carried bla OXA-48-like gene and 27.6% isolates (51/185) carried dual carbapenemase genes; bla OXA-48-like and bla NDM . Of the remainder, 8 isolates carried bla NDM and 5 isolates lacked carbapenemases gene despite being carbapenem-resistant. None of the isolates showed presence of mcr1 and mcr3. Out of 109 isolates analysed for mgrB, 36 showed mutational changes. The MLST profile revealed at least 14 unique sequence types with ST231 being the dominant clone. All the isolates showed colistin MICs >2 mg/L and were non-susceptible to carbapenems. Zidebactam/cefepime demonstrated potent activity with MIC 50 and MIC 90 of 1 and 2 mg/L, respectively. MIC 90 s of amikacin, ceftazidime/avibactam and imipenem/relebactam were >32 mg/L., Conclusion: Zidebactam/cefepime combination was highly active against multi-clonal, carbapenem-non-susceptible and colistin-resistant K. pneumoniae isolates producing OXA-48-like (Ambler class D) or/and NDM (Ambler class B) carbapenemases, thus potentially offering a valuable treatment options for infections caused by such pan-drug resistant resistotypes. Though, zidebactam is not an inhibitor of class B and D β-lactamases, potent activity of zidebactam/cefepime combination is attributable to β-lactam enhancer mechanism., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Objective: To compare outcomes of ceftriaxone to AmpC-stable therapies in patients with bacteremia caused by low-risk AmpC harboring Enterobacterales., Methods: IRB-approved, retrospective cohort of hospitalized patients ≥18 years old with Serratia marcescens, Morganella morganii, or Providencia spp. bacteremia from 1/1/2017-2/28/2024. Patients were compared by definitive therapy with ceftriaxone vs AmpC-stable therapy (cefepime, carbapenem). The primary endpoint was 30-day all-cause mortality; secondary endpoints were clinical failure and development of ceftriaxone resistance., Results: 163 patients were included; 33.1 % received ceftriaxone, 66.9 % AmpC-stable therapies. 30-day all-cause mortality was 9.3 % ceftriaxone vs 10.1 % AmpC stable patients (P = 0.87); ceftriaxone definitive therapy was not associated with 30-day all-cause mortality (adjOR, 0.79; 95 %CI, 0.23-2.3). There were no differences in clinical failure (9.3 % vs 21.1 %, P = 0.059) or relapsing infection (5.6 % vs 9.3 %, P = 0.55) between ceftriaxone and AmpC-stable treated patients., Conclusions: Patients treated with definitive ceftriaxone for low-risk AmpC Enterobacterales bacteremia had similar outcomes to AmpC stable therapies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Antimicrobial resistance and biofilm production in healthcare-associated infections is a health issue worldwide. This study aimed to identify potential biomarker peaks for resistance or biofilm production in ESKAPE pathogens using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Antimicrobial susceptibility and biofilm production were assessed on selected isolates. Biomarker peaks were identified using MALDI Biotyper and ClinProTools software. Among resistant strains, 90.0 % were carbapenem-resistant Acinetobacter baumannii (CRAB), 39.0 % were methicillin-resistant Staphylococcus aureus (MRSA), 17.98 % were multidrug-resistant (MDR) Pseudomonas aeruginosa, 21.6 % were vancomycinresistant Enterococcus (VRE), and 2.55 % were carbapenem-resistant Enterobacterales (CRE). Biofilm production was 40.0 % in VRE and 45.8 % in MRSA. Although no potential biomarker peaks for biofilm production were detected, several potential biomarker peaks for drug resistance in VRE (n=5), MRSA (n=4), and MDR P. aeruginosa (n=4) were detected, suggesting avenues for the development of rapid diagnostic tools., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

The IR Biotyper is a novel real-time typing tool, based on a Fourier-transform infrared (FTIR) spectroscopy system. It has emerged as a promising method for the strain typing of various microorganisms and for the detection of their clonal spread within hospitals. In this review, we aim to present the applications and accuracy of the IR Biotyper in hospital epidemiology. Twenty-nine studies that evaluated the use of IR Biotyper for organism strain typeability and outbreak investigations within hospitals, were included in our review. Twenty studies assessed gram negative bacteria, seven studies assessed gram positive cocci, three studies assessed Candida spp., and one study assessed Mycobacterium abscessus complex (MABSC). A total of 3140 isolates were typed in the studies included in this review. The overall average accuracy of the IR Biotyper for typing of all organisms assessed was 84 % (SD: 22, 95 % CI: 83-85). Higher accuracy was achieved among glucose non-fermenting gram negative bacilli (93 %, SD: 12, 95 % CI: 93-94), followed by gram positive cocci (84 %, SD: 10, 95 % CI: 83-84), Enterobacterales (78 %, SD: 20, 95 % CI: 76-80), and Candida spp (56 %, SD: 26, 95 % CI: 52-60). Summary: The IR Biotyper may be a promising strain typing tool with useful utility within hospital settings. The tool provided microbial strain discrimination at an effective turnaround time, with comparable accuracy as genome-based methods for most organisms assessed in this review. Further research is necessary for the confirmation of these findings and for the evaluation of its use for other organisms of significance to hospital epidemiology., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Manal Tadros reports a relationship with Bruker Daltonik GmbH that includes: non-financial support. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Alpha-toxin of Staphylococcus aureus belongs to the pore-forming toxin (PFT) family, which can lyse red and white blood cells. In addition to the existence of the hla gene in the majority of S. aureus strains (about 95 %), higher expression exhibits enhanced pathogenicity to the bacteria. Various methods, such as antibodies and aptamers, could serve to detect this toxin. In the current study, for the first time, an improved sandwich aptamer-antibody-based method was developed using specific murine polyclonal antibodies and a specific aptamer to detect a wide range of α-toxin levels. Denatured recombinant α-toxin was administered to mice to trigger the production of specific antibodies, which were subsequently purified from immune sera. These antibodies served as capturers in the designed apta-qPCR assay, with an aptamer employed as a detector. The results showed that spiked α-toxin in the undiluted serum samples could detect α-toxin between 300 and 0.5 ng/mL with no cross-reactivity. The coefficient of variation (CV) percent of intra- and inter-assays were 0.84 and 1.06, respectively. Since in the apta-qPCR assay, a combination of specific polyclonal antibodies as capture and specific aptamer along with real-time PCR (qPCR) sensitivity is used, this robust method could be used in diagnostic laboratories to detect various levels of the toxin in human serum samples., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

It is estimated that two billion people worldwide are infected with hepatitis B. In such cases, patients exposed to the virus may experience HBV-reactivation(HBVr), which is usually due to immunosuppression. It is not anticipated that spontaneous-HBVr will occur in the absence of immunosuppression in resolved HBV. In the literature, only 3 cases with spontaneous-HBVr have been reported in this setting. Our case is an 81-year-old female patient who was hospitalized for intracranial hemorrhage and spontaneous-HBVr was detected on the 24th day of hospitalization. Initially, HBsAg:(-) and anti-HBs were 77.5IU/L. Subsequent follow-up, liver function tests were increased, HBsAg:(+), anti-HBs:(-), and HBV-DNA:2513IU/ml were detected. The patient had several comorbidities such as diabetes-mellitus, hypertension, and chronic-obstructive-pulmonary-disease, but no history of immunosuppressive treatment. Following the diagnosis of spontaneous-HBVr, entecavir was initiated, resulting in the achievement of HBV-DNA negativity. It should be kept in mind that comorbidities like aging, surgery, or diabetes may trigger spontaneous-HBVr., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The simultaneous amplification/testing for tuberculosis (SAT-TB) targets specific 16s rRNA for detecting Mycobacterium tuberculosis in real-time., Objective: To evaluate SAT-TB's performance in detecting intestinal and urinary TB using stool and urine samples., Methods: Stool (94) and urine samples (69) (From 2021 to 2022), were collected from pulmonary combined with suspected intestinal or urinary tuberculosis. Simultaneous detection of Mycobacterium tuberculosis was performed using the SAT-TB method, Xpert MTB/RIF assay, and MGIT960 culture., Results: For stool samples, the sensitivity, specificity, and area under the curve (AUC) were 53.33 %, 93.88 %, and 0.736 for SAT-TB; 60 %, 81.63 %, and 0.708 for Xpert; and 40 %, 95.92 %, and 0.680 for MGIT960. For urine samples, the sensitivity, specificity, and AUC for SAT-TB, Xpert, and MGIT960 were 27.27 %, 98.28 %, 0.628; 54.55 %, 96.35 %, 0.755; and 45.45 %, 100 %, 0.727, respectively., Conclusion: ROC analysis indicated that SAT-TB had the highest diagnostic efficacy for stool samples when tested individually., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

The Covid-19 pandemic uncovered several lacunae in healthcare systems exposing global unpreparedness and triggering unprecedented challenges worldwide- necessitating a shift towards mitigation and robust surveillance strategies. Here, we report the use of Whole Genome Sequencing (WGS) to detect SARS-CoV-2 variants in clinical samples of Meghalaya, India, using Oxford Nanopore Technology. SARS-CoV-2 positive samples collected from various districts of Meghalaya from August 2021 to May 2023 were subjected to WGS. Out of a total of 965 samples, Alpha (0.1 %), Delta (47.2 %) and Omicron (52.7 %) variants were detected. The Delta variant affected 53 % of individuals under the age of 18 years, while the Omicron sub variant BA.2 affected all age groups in a similar manner. The study underscores the efficacy of using a user-friendly sequencing device coupled with simplified bioinformatics, enabling remote regions to effectively combat Covid-19. This approach, characterized by rapidity, simplicity and accuracy, holds promise in confronting future health crises., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Streptococcus suis is a porcine pathogen that causes severe zoonotic infections in humans resulting in meningitis and sepsis. The main risk factors for S. suis zoonotic infections are consumption of raw pork products and direct contact with live pigs or pork, in particular in the presence of skin injuries. Most human infections are caused by clonal complex 1 (CC1) serotype 2 isolates. We describe an unusual case of S. suis bacteraemia caused by a CC1 strain carrying a serotype 14 capsule in a patient without a history of consumption of raw pork products or contact with either pig or pork. The isolate formed a serotype 14 clade with three German serotype 14 strains that has diverged from the main CC1 serotype 2 lineage. This is the first report of a human infection caused by a serotype 14 S. suis in the Netherlands, which in combination with its unknown transmission route and severity of the disease, calls for its notification., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

We describe results from a multicenter pilot study evaluating the eQUANT TM system for rapid generation of a standardized inoculum (0.5 McFarland equivalent) directly from blood cultures positive for target gram-negative bloodstream pathogens for same-day antimicrobial susceptibility testing (AST) by disk diffusion, MicroScan and Vitek2 methods. Out of 167 blood cultures that met study criteria (monomicrobial with one of 9 target gram-negative species), colony counts from eQUANT suspensions of 164 (98.2 %) were within the acceptable range of 1-2e8 ± 0.6 log 10 CFU/mL (2.51×10 7 to 7.96×10 8 CFU/mL). Average eQUANT testing time was 72 min and AST results were available an average of 22.3 h earlier compared to next day testing. Overall performance of direct versus next day AST was excellent, with categorical agreement of 97.5 %, 96.9 % and 96.7 %, respectively, by disk diffusion, MicroScan and Vitek methods. For clinical application this could facilitate antibiotic stewardship and provide targeted antibiotic therapy recommendations earlier., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Michael R. Jacobs reports financial support was provided by Avails Medical Inc. Paul A. Granato reports financial support was provided by Avails Medical Inc. Niaz Banaei reports financial support was provided by Avails Medical Inc. Oren Knopfmacher reports being a founder and employee of Avails Medical Inc. Meike Herget reports being a founder and employee of Avails Medical Inc. Eszter Deak reports being an employee of Avails Medical Inc. Nitin Rajan reports being an employee of Avails Medical Inc. Adrian Hoyos-Urias reports being an employee of Avails Medical Inc. Suzanne Putney reports being an employee of Avails Medical Inc. Other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

This study evaluates the performance of I-dOne, the first CE-IVD marked software for microbial species identification based on Attenuated Total Reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR) and compares its results with MALDI-TOF MS technology (Vitek MS, bioMérieux). A total of 410 clinical isolates were analyzed, spanning 45 species and 24 genera. I-dOne demonstrated a high agreement rate (97.3 %) with the Vitek MS, meeting CLSI standard for microbial identification accuracy. Additionally, this study explored the development of a novel algorithm within I-dOne to discriminate between Bacteroides fragilis and Bacteroides ovatus strains, overcoming the current limitations in species-level differentiation. Finally, the influence of ageing under prolonged aerobic exposure on ATR-FTIR profiles was investigated, highlighting no significant spectral changes in Bacteroides fragilis strains under prolonged aerobic exposure. These findings underscore the accuracy of I-dOne software in microbial identification, offering a reliable alternative to conventional methods., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

This study aims to evaluate the risk factors associated with the mortality of S. maltophilia infections. Patients aged 18 years and older with S. maltophilia infection. Patients were divided into two groups primary bacteraemia and pneumonia. Of 176 S. maltophilia infections, 85 (48.2 %) were classified as bacteremia and 91 (51.8 %) as pneumonia. The mortality rate was 56 %, with no significant difference observed between the groups. Invasive mechanical ventilation, history of carbapenem use, and high Charlson Comorbidity Index (CCI) were significantly higher in the pneumonia group. In univariate analysis, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, higher Sequential Organ Failure Assessment (SOFA) score, and use of total parenteral nutrition (TPN) were identified as independent risk factors for 28-day mortality. This study demonstrates a mortality rate of 56 % in S. maltophilia infections and provides concrete data on risk factors for mortality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The study evaluated the efficacy of HPV 16/18 E6/E7 mRNA detection in women with abnormal cervical histology. A total of 99 cervical biopsy samples were analyzed, including 49 benign, 16 with cervical intraepithelial neoplasia grade 1 (CIN1), 9 with CIN2/3, and 25 with cervical cancers. Samples were tested for HPV 16/18 using both DNA and mRNA RT-PCR methods. The findings revealed a sensitivity of 85.3 % (29/34) for the HPV DNA test and 76.5 % (26/34) for the mRNA test in detecting CIN2+ lesions. Notably, the E6/E7 mRNA test demonstrated greater specificity for CIN2+ at 75.4 % (49/65), compared to 52.3 % (34/65) for the DNA test. The prevalence of positive results for both tests increased with the severity of squamous cell abnormalities. However, the HPV 16/18 E6/E7 mRNA test provided superior specificity, making it a more effective method for cervical cancer screening in this region, offering more precise results than DNA testing alone., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Hamid Sadeghi reports financial support was provided by Qazvin University of Medical Sciences. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

The World Health Organization (WHO) has set a target of eliminating viral hepatitis B and C by 2030. Vaccination against hepatitis B (HepB) remains the most effective strategy for controlling and eliminating Hepatitis B Virus (HBV) infection. The development of HepB vaccines started with plasma-derived vaccines, which have since been largely replaced by safer and more effective recombinant vaccines, now considered the gold standard for preventing HBV infections. More recently, mRNA-based vaccines have emerged as a promising platform. This study aims to review and provide an up-to-date comparative analysis of the characteristics, efficacy, effectiveness, and the impact of variants of concern across 17 HepB vaccines. It also highlights the global progress of HepB vaccination, with 191 implementing HepB vaccination for the entire country, and an estimated HBV prevalence of 0.7 % among children under 5 years in 2022. This achievement is driven by the strong safety profiles, high immunogenicity, and robust efficacy of current vaccines, which have demonstrated minimal side effects. Nevertheless, challenges persist in certain populations that do not respond adequately to vaccination. Here, we report the updated guidelines and propose strategies to improve the effectiveness of HepB vaccination for these specific populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Currently there is no detailed, internationally agreed protocol defined to evaluate antimicrobial susceptibility testing (AST) for Legionella pneumophila (required to establish epidemiological cut-off value or "ECOFF" boundaries); therefore, antimicrobial resistance in these isolates cannot be defined. AST methods utilising media containing activated charcoal as an ingredient, to enable Legionella growth, are unreliable as noted in an internationally authored opinion paper and a new gold standard is required. Here we define a detailed protocol for broth microdilution (BMD) using defined cell culture collection-deposited control reference strains (Philadelphia-1 and Knoxville-1) as well as two accessible reference strains with moderately (lpeAB-carrying) and markedly (23S rRNA mutation-carrying) elevated azithromycin minimum inhibitory concentration (MIC). The defined protocol enables up to eight L. pneumophila strains to be set up on a single 96-well plate per antimicrobial tested. Initial ranges to routinely capture an MIC for these reference strains using clinically relevant antimicrobials azithromycin (0.01-0.25 mg/L), levofloxacin (0.008-0.03 mg/L), lefamulin (0.01-2 mg/L), rifampicin (0.0002-0.0008 mg/L) and doxycycline (0.25-16 mg/L) following incubation for 48 h at 37 °C in a shaking incubator have been empirically determined. Establishment of this internationally agreed protocol sets the scene for the next step: validation and comparison of antimicrobial ranges between international Legionella reference laboratories to establish putative resistance cut-off thresholds for these clinically relevant antimicrobials., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Professor Owen B. Spiller, and all associated authors reports financial support was provided by European Society of Clinical Microbiology and Infectious Diseases. Max Sewell reports financial support was provided by Cardiff University. Professor Owen B. Spiller, and all associated authors reports equipment, drugs, or supplies was provided by Nabriva Therapeutics AG. Susanne Paukner reports financial support was provided by Nabriva Therapeutics AG. Susanne Paukner reports a relationship with Nabriva Therapeutics AG that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Congenitally corrected transposition of the great arteries (ccTGA) is a rare cardiac anomaly. The management strategy historically consisted of physiologic repair, leaving the morphologic right ventricle to support the systemic circulation. More recently, anatomic repair has been implemented to bring the left ventricle into the systemic circulation. Uncertainty persists about which repair strategy has the best outcome., Objectives: This meta-analysis aimed to summarize the long-term mortality risks following anatomic and physiologic repair of ccTGA., Methods: PubMed, Embase, and the Cochrane Database were searched. Data were extracted using prespecified data forms. The primary outcome was the composite risk of all-cause mortality or heart transplantation during hospitalization and at 1, 5, and 10 years of follow-up. Secondary outcomes included reintervention risk., Results: Forty-seven studies totaling 2,844 patients were included. The incidence risk of mortality at 10 years was 11.7% (95% CI: 8.5%-15.3%) and 17.4% (95% CI: 12.4%-23.0%) in the anatomic and physiologic repair groups, respectively. The incidence risk of reintervention at 10 years was 24.5% (95% CI: 19.2%-30.1%) and 30.3% (95% CI: 23.5%-37.6%), respectively. The primary outcome was significantly lower at 10 years in anatomically repaired patients who had surgery at <5 years of age and who had preoperative pulmonary artery banding (P heterogeneity  < 0.01)., Conclusions: Anatomic repair of ccTGA patients results in higher overall and reintervention-free survival compared to physiologic repair. Specifically, patients who had anatomic repair at <5 years of age or who had preoperative pulmonary artery banding have better survival., Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 American College of Cardiology Foundation. All rights reserved.)

Background: Oxidized phospholipids (OxPLs) are carried by apolipoprotein B-100-containing lipoproteins (OxPL-apoB) including lipoprotein(a) (Lp[a]). Both OxPL-apoB and Lp(a) have been associated with calcific aortic valve disease (CAVD)., Objectives: This study aimed to evaluate the associations between OxPL-apoB, Lp(a) and the prevalence, incidence, and progression of CAVD., Methods: OxPL-apoB and Lp(a) were evaluated in MESA (Multi-Ethnic Study of Atherosclerosis) and a participant-level meta-analysis of 4 randomized trials of participants with established aortic stenosis (AS). In MESA, the association of OxPL-apoB and Lp(a) with aortic valve calcium (AVC) at baseline and 9.5 years was evaluated using multivariable ordinal regression models. In the meta-analysis, the association between OxPL-apoB and Lp(a) with AS progression (annualized change in peak aortic valve jet velocity) was evaluated using multivariable linear regression models., Results: In MESA, both OxPL-apoB and Lp(a) were associated with prevalent AVC (OR per SD: 1.19 [95% CI: 1.07-1.32] and 1.13 [95% CI: 1.01-1.27], respectively) with a significant interaction between the two (P < 0.01). Both OxPL-apoB and Lp(a) were associated with incident AVC at 9.5 years when evaluated individually (interaction P < 0.01). The OxPL-apoB∗Lp(a) interaction demonstrated higher odds of prevalent and incident AVC for OxPL-apoB with increasing Lp(a) levels. In the meta-analysis, when analyzed separately, both OxPL-apoB and Lp(a) were associated with faster increase in peak aortic valve jet velocity, but when evaluated together, only OxPL-apoB remained significant (ß: 0.07; 95% CI: 0.01-0.12)., Conclusions: OxPL-apoB is a predictor of the presence, incidence, and progression of AVC and established AS, particularly in the setting of elevated Lp(a) levels, and may represent a novel therapeutic target for CAVD., Competing Interests: Funding Support and Author Disclosures Dr Bhatia is supported by National Institutes of Health (NIH) grants 1K08HL166962 and 1KL2TR001444. Dr Dweck is supported by the British Heart Foundation (FS/SCRF/21/32010) and is the recipient of the Sir Jules Thorn Award for Biomedical Research 2015 (15/JTA). Dr Craig is supported by the Medical Research Council (MR/Y009932/1). Dr Rikhi is supported by the National Heart, Lung, and Blood Institute (NHLBI) of NIH under Award Number T32HL076132. Dr Budoff was supported by R01 HL071739 and R01HL146666. Dr Thanassoulis was supported by NIH R01 HL128550-04 and is funded by the FRQS as a Senior Clinician Scientist. Dr Tsimikas is supported by NHLBI grants R01 HL159156 and HL170224. The MESA was supported by contracts 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from NHLBI, and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences (NCATS). The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH. Dr Bhatia has served on the scientific advisory boards for Novartis, Abbott, and Arrowhead; and has served as a consultant for Kaneka and Novartis. Dr Dweck has received speaker fees from Pfizer, Radcliffe Cardiology, Amarin, Bristol Myers Squibb, Edwards, and Novartis; and has received consultancy fees from Novartis, Jupiter Bioventures, AstraZeneca, Beren, and Silence therapeutics. Dr Capoulade has received an honorarium from Novartis. Dr Shapiro has received grants from Amgen, Boehringer Ingelheim, 89Bio, Esperion, Genentech, Novartis, Ionis, Merck, and New Amsterdam; has served on scientific advisory boards of Amgen, Agepha, Ionis, Novartis, Precision BioScience, and New Amsterdam; and has served as a consultant for Ionis, Novartis, Regeneron, Aidoc, Shanghai Pharma Biotherapeutics, Kaneka, and Novo Nordisk. Dr Budoff has received grant support from Amgen. Dr Tsimikas is a co-inventor and receives royalties from patents owned by the University of California-San Diego (UCSD); is a co-founder and has an equity interest in Oxitope and Kleanthi Diagnostics; is a consult to Novartis; and has a dual appointment at UCSD and Ionis Pharmaceuticals (the terms of this arrangement have been reviewed and approved by UCSD in accordance with its conflict-of-interest policies). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)