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Rifampin is one of the most important biofilm-active antibiotics in the treatment of periprosthetic joint infection (PJI), and antibiotic regimens not involving rifampin were shown to have higher failure rates. Therefore, an emerging rifampin resistance can have a devastating effect on the outcome of PJI. The aim of this study was to compare the incidence of rifampin resistance between two groups of patients with a PJI treated with antibiotic regimens involving either immediate or delayed additional rifampin administration and to evaluate the effect of this resistance on the outcome. In this retrospective analysis of routinely collected data, all patients who presented with an acute/chronic PJI between 2018 and 2020 were recorded in the context of a single-center comparative cohort study. Two groups were formed: Group 1 included 25 patients with a PJI presenting in 2018–2019. These patients received additional rifampin only after pathogen detection in the intraoperative specimens. Group 2 included 37 patients presenting in 2019–2020. These patients were treated directly postoperatively with an empiric antibiotic therapy including rifampin. In all, 62 patients (32 females) with a mean age of 68 years and 322 operations were included. We found a rifampin-resistant organism in 16% of cases. Rifampin resistance increased significantly from 12% in Group 1 to 19% in Group 2 (p < 0.05). The treatment failure rate was 16% in Group 1 and 16.2% in Group 2 (p = 0.83). The most commonly isolated rifampin-resistant pathogen was Staphylococcus epidermidis (86%) (p < 0.05). The present study shows a significant association between the immediate start of rifampin after surgical revision in the treatment of PJI and the emergence of rifampin resistance, however with no significant effect on outcome.

Background: Dialister pneumosintes (D. pneumosintes) is known to cause dental, periodontal or sinus infections. To date, the pathogen has only been described in a small number of cases with a severe infection. Case report: We describe the clinical case of a 13-year-old, obese female patient that presented with acute respiratory failure and sepsis. A CT-scan showed extensive bilateral patchy areas, subpleural and peribronchovascular consolidations with surrounding ground-glass opacity, extensive consolidations in the lower lobes of both lungs matching to a severe pneumonia and clinically emerging acute respiratory distress syndrome. Moreover, it showed extensive sinusitis of the right sinus frontalis, maxillaris and right cellulae ethmoidales. D. pneumosintes was isolated from an anaerobic blood culture obtained at admission. The antibiotic treatment included piperacillin/tazobactam and oral switch to ampicillin/sulbactam plus ciprofloxacin. Conclusions: We describe the first adolescent with severe systemic D. pneumosintes infection. Since the pathogen is difficult to culture the systemic virulence remains unclear. This work aims to sensitize health care specialists to consider D. pneumosintes infection in patients with periodontal or sinusal infection.

Background: Lung cancer is worldwide one of the most common types of cancer with still very high mortality rates. The aim of this study was to identify and demonstrate correlations between lung cancer mortality rates and potential influencing factors in EU countries. Methods: This retrospective study investigated the connections between the mortality rates in the EU countries (n = 28) and potential influencing factors. The significant factors from the correlation analysis were identified using a stepwise multiple regression analysis. Results: The most important factors for both genders are the incidence of lung cancer, the price of tobacco, and the number of doctors per 100,000 inhabitants. Conclusion: Lung cancer is a significant global health challenge. The study identified potential strategies for reducing the mortality rate from lung cancer. These strategies include an increase in the number of physicians, enhanced accessibility to cutting-edge antineoplastic medications, and state-funded coverage of the associated costs. It would be beneficial for politicians to consider implementing LDCT screening for the early detection of the disease. The implementation of uniform healthcare system optimization across the EU, combined with improvements in socio-economic conditions, has the potential to mitigate the risk of developing lung cancer.