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Bacillus cereus is a Gram-positive bacterium that is ubiquitously present. It is often involved in gastrointestinal infections and food poisoning, but it can rarely cause serious non-gastrointestinal tract infections, particularly in immunocompromised individuals. The pathogenicity of B. cereus is predominantly derived from the production of tissue-destructive exoenzymes, including hemolysins, phospholipases, and proteases. Here, we present a case of bacteremia due to B. cereus in an elderly patient, admitted to the emergency room for respiratory failure and rhabdomyolysis after a fall. The microorganism was detected through blood culture and identified using the MALDI-TOF technique. Despite the rapid start of antibiotic therapy, laboratory data have highlighted how this bacterium, through its virulence factors, can be lethal in the case of rhabdomyolysis, worsening the inflammatory response and subverting the host-microorganism relationship in its favor.

Yersinia pseudotuberculosis is a Gram-negative bacillus that can occasionally cause zoonosis. Infections of this bacterium typically present as self-limiting ileitis, often accompanied by diarrhea, but, especially in the case of immunocompromised patients, can also lead to serious secondary complications which, if not treated properly, can progress with a poor prognosis. Here, we present a case of successfully treated bacteremia due to Y. pseudotuberculosis in a multipathological obese patient. The diagnosis was possible through blood culture, and this highlights the importance of the search for unconventional pathogens, especially in certain categories of patients whose risk factors are strongly indicative and suggestive.

Background and aims: Meropenem (Mer) and vaborbactam (Vab) is a combination of a carbapenem and a new β-lactamase inhibitor used in adults to treat different types of infections caused by Gram-negative bacteria. This combination is chosen as an alternative in infections caused by Gram-negative bacteria when carbapenem-only therapies are unsatisfactory. Materials and methods: Based on this, we report our assessment of such meropenem/vaborbactam association through the E-test and the Microscan routine automated system. This evaluation was performed on 22 samples, carbapenem-resistant strains of Gram-negative bacteria isolated from different types of biological material. Five E. coli and 1 P. mirabilis were respectively susceptible to both carbapenems and Mer/Vab, 6 P. aeruginosa and 2 A. baumannii were respectively resistant to both carbapenems and Mer/Vab and out of 8 K. pneumoniae which were resistant to carbapenems only one was resistant to the Mer/Var combination. Results and conclusions: From the data obtained, it can be seen that resistance to carbapenems is 72%, and drops to 36% with the combined use of Mer/Vab. However, this combination cannot be used in the treatment of patients with diseases caused by P. aeruginosa and Acinetobacter spp., resistant to meropenem.