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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]

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]

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]

(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]

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]

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]

Diabetic foot ulcers (DFUs) often become infected and are treated with antimicrobials, with samples collected to inform care. Swab samples are easier than tissue sampling but report fewer organisms. Compared with culture and sensitivity (C&S) methods, molecular microbiology identifies more organisms. Clinician perspectives on sampling and processing are unknown. We explored clinician perspectives on DFU sampling—tissue samples/wound swabs—and on processing techniques, culture and sensitivity or molecular techniques. The latter provides information on organisms which have not survived transport to the laboratory for culture. We solicited feedback on molecular microbiology reports. Qualitative study using semi‐structured interview, with analysis using a Framework approach. CODIFI2 clinicians from UK DFU clinics. Seven consultants agreed to take part. They reported, overall, a preference for tissue samples over swabbing. Clinicians were not confident replacing C&S with molecular microbiology as the approach to reporting was unfamiliar. The study was small and did not recruit any podiatrists or nurses, who may have discipline‐specific attitudes or perspectives on DFU care. Both sampling approaches appear to be used by clinicians. Molecular microbiology reports would not be, at present, suitable for replacement of traditional culture and sensitivity. [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]

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]

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]

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]

Antimicrobial photodynamic therapy (PDT) is a treatment that is gaining popularity in modern clinical medicine. However, little is known about the effect of PDT alone on reducing oral halitosis and the duration of the effect. This trial examined the effect of PDT on the tongue dorsum on reducing oral halitosis and the duration of the effect. This study was approved by the Ethics Committee of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, and Okayama University Hospital (CRB20-015), and it was registered in the Japan Registry of Clinical Trials (jRCTs061200060). Twenty-two participants were randomly assigned to two groups: an intervention group and control group. PDT was performed in the intervention group using red laser emission and methylene blue gel on the middle and posterior area of the tongue dorsum. The concentration of volatile sulfur compounds, bacterial count on the tongue dorsum, probing pocket depth, bleeding on probing, and simplified oral debris index score were determined before and 1 week after PDT. The Mann–Whitney U test was used to assess the significance of the differences in each parameter between the two groups. We found that the hydrogen sulfide concentration and bacterial count on the tongue dorsum were decreased in the intervention group, but there was no statistically significant difference between the two groups. These results indicated that performing only PDT on the tongue dorsum may not contribute to reducing halitosis. [ABSTRACT FROM AUTHOR]

Enterococcus is a relatively uncommon pathogen that causes urinary tract infections (UTIs) in healthy children. Most enterococcal infections occur in patients with risk factors such as anatomical or functional urinary tract anomalies, also known as CAKUT (congenital anomalies of kidney and urinary tract). Children who are suspected of having UTIs and who have certain risk factors are often treated specifically for enterococcal infection as part of their empiric regimen. Our primary objective was to determine the prevalence of enterococcal UTIs among high-risk children, and specifically among those with positive nitrite tests, with the goal of avoiding treatment with specific anti-enterococcal agents. This retrospective study included all the episodes of UTI treated at a tertiary pediatric center during 2010 to 2018. The data collected from medical records included nephrological and urological risk factors, nitrite status, and isolated pathogens. Of 931 episodes of UTI, 467 (50%) were considered high-risk. In all, 24 of the latter had Enterococcus as a single pathogen; 23 (96%) of these occurred in patients with negative nitrites in the first urine dipstick taken. The sole patient with high-risk factors, a positive nitrite test and coexisting enterococcal UTI had a history of previous enterococcal UTIs. In pediatric patients with nephrological and urological risk factors, who have positive nitrites in urinalysis, the risk for enterococcal UTI appears substantially low. Therefore, in this context, specific anti-enterococcal empirical antibiotic therapy may be unnecessary. [ABSTRACT FROM AUTHOR]

Objective: The complete blood count (CBC) parameters and the ratios regarding these parameters have been demonstrated to be useful diagnostic biomarkers for many infectious diseases. Herein, we aimed to evaluate and compare the usefulness of the predictive role of the CBC in the differential diagnosis of pulmonary tuberculosis (TB) from community-acquired pneumonia (CAP) in children. We also compared serum electrolyte levels between the 2 diseases. Materials and Methods: In this retrospective study, we analyzed the efficacy of CBC parameters and neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), plateletto-lymphocyte ratio (PLR), neutrophil-to-monocyte-plus-lymphocyte ratio (NMLR), and serum electrolyte levels in the differential diagnosis of pulmonary TB from CAP in children. We also classified patients with TB into 2 groups according to the microbiologic confirmation. We investigated whether there is any difference regarding these parameters in patients with positive microbiologic results. Results: A total of 163 patients diagnosed with TB and CAP were included in this study. The WBC, neutrophil and monocyte counts, NLR, MLR, NMLR, mean platelet volume (MPV), and C-reactive protein (CRP) values were higher in CAP. There was statistical significance among serum sodium and phosphorus (P) levels between the 2 groups. Microbiologic confirmation was determined in 37 (35.5%) patients with the diagnosis of TB. The NLR, MLR, NMLR, CRP, and P values were significantly higher in patients with microbiologic confirmation. Conclusion: The results of the present study suggest that complete blood count parameters, NLR, MLR, NMLR, and CRP can be useful and cost-effective markers in differentiating pulmonary TB from CAP in the early stages of diagnosis. [ABSTRACT FROM AUTHOR]

Patients living in low- and middle-income countries (LMICs) shoulder the greatest burden of infections caused by antimicrobial-resistant pathogens. Speedy access to appropriate broad-spectrum antimicrobials significantly improves health outcomes and reduces transmission of antimicrobial-resistant pathogens, but persons living in LMICs have compromised access to these antimicrobials. This article considers how inequities in microbiology diagnostics, antimicrobial access, and antimicrobial affordability influence outcomes for patients infected with antimicrobial-resistant pathogens who live in resource-limited settings. [ABSTRACT FROM AUTHOR]

Microbiota are present everywhere in human existence and have an impact on every facet of it. Many species can be found within the human mouth. The human oral cavity is home to a variety of habitats. The combination and cooperation of the modified oral microbes protect the human body from the intrusion of external stimuli. On the other hand, systemic and oral illnesses are linked to an imbalance in the microbial flora. The human microbial community is significantly influenced by oral microbiomes. The use of recently noticed molecular tools has significantly improved our understanding of the makeup and roles of the oral microbiome in both wellness and sickness. Research on oral microbiomes and their relationships to microbiomes in different body locations and health conditions is essential to understanding our bodies and understanding how to improve human health. The purpose of this review is to go over the most recent information that explains the possible mechanisms underlying the relationships between oral and overall systemic health. The theory is that the influence of oral diseases on overall health may be partially explained by the oral microbiota. We will discuss the basic principles, the primary techniques in microbiology for describing oral organisms, and the most important information pointing to a biologically tenable connection between systemic illnesses and the oral microbiota. [ABSTRACT FROM AUTHOR]

The timely and accurate identification of causative agents is crucial for effectively managing fracture-related infections (FRIs). Among various diagnostic methods, the "time to positivity" (TTP) of cultures has emerged as a valuable predictive factor in infectious diseases. While sonication of implants and inoculation of blood culture bottles with sonication fluid have enhanced sensitivity, data on the TTP of this microbiological technique remain limited. Therefore, patients with ICM criteria for confirmed FRI treated at our institution between March 2019 and March 2023 were retrospectively identified and their microbiological records were analyzed. The primary outcome parameter was TTP for different microorganism species cultured in a liquid culture collected from patients with confirmed FRI. A total of 155 sonication fluid samples from 126 patients (average age 57.0 ± 17.4 years, 68.3% males) was analyzed. Positive bacterial detection was observed in 78.7% (122/155) of the liquid culture pairs infused with sonication fluid. Staphylococcus aureus was the most prevalent organism (42.6%). Streptococcus species exhibited the fastest TTP (median 11.9 h), followed by Staphylococcus aureus (median 12.1 h) and Gram-negative bacteria (median 12.5 h), all of which had a 100% detection rate within 48 h after inoculation. Since all Gram-negative pathogens yielded positive culture results within 24 h, it could be discussed if empirical antibiotic therapy could be de-escalated early and limited towards the Gram-positive germ spectrum if no Gram-negative pathogens are detected up to this time point in the context of antibiotic stewardship. [ABSTRACT FROM AUTHOR]

This randomized controlled experimental study aims to evaluate the effect of different concentrations of ethyl alcohol solutions on bacterial growth. Alcohol solutions with different volüme concentrations were prepared as a preliminary process. In the first step, alcohol solutions of different concentrations by volume were prepared.. Microbiological agar was used as the medium. In the third process, sterile Petri dishes were obtained, and the dishes to be used were labeled with dirty hands, ethyl alcohol solutions of 10%, 30%, 60%, 70%, 80%, and 96%. A laptop (monitor and keyboard), which is one of the devices frequently used in everday life, was chosen as the sample material. As a result, it was found that the number of colonies in the Petri dishes visibly decreased with increasing alcohol concentration. No bacterial colonies were observed at concentrations of ≥70%. The lowest and most effective ethyl alcohol concentration was found to be 70%. We think that observing bacterial growth at different alcohol concentrations with samples from different environments will provide us with more data on the effect of disinfectants and antiseptics in future studies. [ABSTRACT FROM AUTHOR]

The emergence and spread of multidrug-resistant pathogens like Pseudomonas aeruginosa are major concerns for public health worldwide. This study aimed to assess the prevalence of P. aeruginosa in clinical, environmental, and poultry sources in Bangladesh, along with their antibiotic susceptibility and the profiling of β-lactamase and virulence genes using standard molecular and microbiology techniques. We collected 110 samples from five different locations, viz., BAU residential area (BAURA; n = 15), BAU Healthcare Center (BAUHCC; n = 20), BAU Veterinary Teaching Hospital (BAUVTH; n = 22), Poultry Market (PM; n = 30) and Mymensingh Medical College Hospital (MCCH; n = 23). After overnight enrichment in nutrient broth, 89 probable Pseudomonas isolates (80.90%) were screened through selective culture, gram-staining and biochemical tests. Using genus- and species-specific PCR, we confirmed 22 isolates (20.0%) as P. aeruginosa from these samples. Antibiogram profiling revealed that 100.0% P. aeruginosa isolates (n = 22) were multidrug-resistant isolates, showing resistance against Doripenem, Penicillin, Ceftazidime, Cefepime, and Imipenem. Furthermore, resistance to aztreonam was observed in 95.45% isolates. However, P. aeruginosa isolates showed a varying degree of sensitivity against Amikacin, Gentamicin, and Ciprofloxacin. The blaTEM gene was detected in 86.0% isolates, while blaCMY, blaSHV and blaOXA, were detected in 27.0%, 18.0% and 5.0% of the P. aeruginosa isolates, respectively. The algD gene was detected in 32.0% isolates, whereas lasB and exoA genes were identified in 9.0% and 5.0% P. aeruginosa isolates. However, none of the P. aeruginosa isolates harbored exoS gene. Hence, this study provides valuable and novel insights on the resistance and virulence of circulating P. aeruginosa within the clinical, environmental, and poultry environments of Bangladesh. These findings are crucial for understanding the emergence of β-lactamase resistance in P. aeruginosa, highlighting its usefulness in the treatment and control of P. aeruginosa infections in both human and animal populations. [ABSTRACT FROM AUTHOR]

Background: Infections caused by Acinetobacter baumannii are becoming a rising public health problem due to its high degree of acquired and intrinsic resistance mechanisms. Bacterial lipases penetrate and damage host tissues, resulting in multiple infections. Because there are very few effective inhibitors of bacterial lipases, new alternatives for treating A. baumannii infections are urgently needed. In recent years, Brassica vegetables have received a lot of attention since their phytochemical compounds have been directly linked to diverse antimicrobial actions by inhibiting the growth of various Gram-positive and Gram-negative bacteria, yeast, and fungi. Despite their longstanding antibacterial history, there is currently a lack of scientific evidence to support their role in the management of infections caused by the nosocomial bacterium, A. baumannii. This study aimed to address this gap in knowledge by examining the antibacterial and lipase inhibitory effects of six commonly consumed Brassica greens, Chinese cabbage (CC), curly and Tuscan kale (CK and TK), red and green Pak choi (RP and GP), and Brussels sprouts (BR), against A. baumannii in relation to their chemical profiles. Methods: The secondary metabolites of the six extracts were identified using LC-QTOF-MS/MS analysis, and they were subsequently correlated with the lipase inhibitory activity using multivariate data analysis and molecular docking. Results: In total, 99 metabolites from various chemical classes were identified in the extracts. Hierarchical cluster analysis (HCA) and principal component analysis (PCA) revealed the chemical similarities and variabilities among the specimens, with glucosinolates and phenolic compounds being the major metabolites. RP and GP showed the highest antibacterial activity against A. baumannii, followed by CK. Additionally, four species showed a significant effect on the bacterial growth curves and demonstrated relevant inhibition of A. baumannii lipolytic activity. CK showed the greatest inhibition (26%), followed by RP (21%), GP (21%), and TK (15%). Orthogonal partial least squares-discriminant analysis (OPLS-DA) pinpointed 9 metabolites positively correlated with the observed bioactivities. Further, the biomarkers displayed good binding affinities towards lipase active sites ranging from −70.61 to −30.91 kcal/mol, compared to orlistat. Conclusion: This study emphasizes the significance of Brassica vegetables as a novel natural source of potential inhibitors of lipase from A. baumannii. [ABSTRACT FROM AUTHOR]

Background: Presently, many laboratories are equipped with automated system for antimicrobial susceptibility testing (AST) for minimum inhibitory concentration-based reporting which enables the clinician to choose the right antimicrobial for timely treatment of sepsis. The study aimed to assess performance of direct AST from blood culture positive broth using automated AST system for accuracy and time taken to release the report. Materials and methods: The present study conducted in a 25-bedded ICU in North India for 12 months. Single morphotype of bacteria on gram stain from positively flagged blood culture bottles were included, which was directly identified (using an in-house protocol) with MALDI-TOF-MS from positive blood culture broths. DAST was carried out from 200 such blood culture broths and results were compared with reference AST (RAST) which was also done using VITEK-2 using overnight grown bacterial colonies as per standard protocol. Results: Among 60 isolates of Enterobacterales, 99% categorical agreement for both E. coli and K. pneumoniae observed by two methods were tested for AST. Among non-fermenters, Pseudomonasaeruginosa showed a categorical agreement of 99.6%, as compared with Acinetobacterspp. and exotic GNBs, which showed 95-96% agreement. A significant difference of 18-24 hours was noted in time to release the report between DAST and RAST, for GNB and GPC both. Conclusion: Direct AST from positive flagged blood culture bottles can significantly reduce the time to release the bacterial susceptibility report by up to 24 hours, at the same time maintaining the accuracy. [ABSTRACT FROM AUTHOR]

Background: It has been determined that Escherichia coli is the prevailing uropathogen (50-90%) in both complicated and uncomplicated urinary tract infections. Uropathogenic Escherichia coli (UPEC) possesses an extensive array of virulence factors, which confers the potential to induce urinary tract infections and is correlated with the development of antibiotic resistance. The purpose of this research was to detect the distribution of virulence genes and their association with antibiotic resistance rates at the molecular level. Materials & Methods: This study was conducted in the microbiology laboratory at Al-Hussein Medical city teaching hospital, Laboratory of microbiology in Karbala province, Iraq. Urine samples were collected b/w October 2023 to January 2024, and transported for further analysis using standard microbiological and biochemical techniques. The sampling technique used in the study can be described as convenience sampling. The identification of E.coli isolates was confirmed using 16rRNA, resistance and sensitivity to various antibiotics were determined with Vitek2 system. Identification of genes (fimH, KpsmII, Pap, ompT) by uniplex PCR. Results: E.Coli was shown to be the most often isolated bacterium for various urine samples, with a percentage of 16(35.5%). The most virulent gene observed were Fim H, KpsMII, pap and OmpT were16 (100%), 13 (81.3%), 9(56.3%) and 8(50%) respectively. Thirteen type of antibiotics were identified sensitive to E.coli isolate the most common resistant rate was Ticarcillin, Pipraciilin had high resistance rate 14(87.5), Ciprofloxacin 9(56.3%), Minocycline, Aztreonam, Trimethoprim had rate of 8(50). Sensitivity rate of Meropenem, Imipenem, Gentamicin was 14(87.5), Cefepime 13(81.25), Amikacin 12(75.0). Conclusion: The study concluded that there is distribution of virulence gene in E.coli isolates, specially fimH, pap correlated with resistance to antibiotics specially with MDR and XDR patterns. [ABSTRACT FROM AUTHOR]

Objective: To investigate the frequency of exoU and exoY genes in patients with Pseudomonas aeruginosa infection. Methods: In this study, 100 clinical isolates of Pseudomonas aeruginosa were collected from patients hospitalized in educational-therapeutic hospitals and were identified using standard microbiological tests. Then, the antibiotic resistance pattern of the isolates was determined by the disk agar diffusion method. The bacterial DNAs were extracted by the alkaline lysis method. Finally, the presence of exoU and exoY genes was evaluated by the PCR test. Results: In this study, 47%, 72%, 29%, 39%, 40%, and 44% of the isolates were non-susceptible to piperacillin, aztreonam, ceftazidime, imipenem, tobramycin, and ciprofloxacin, respectively. In addition, 95% and 93% of the clinical isolates carried the exoU and exoY genes. Blood and fecal isolates had both virulence genes, while only one wound isolate had neither genes. Meanwhile, all urinary isolates contained the exoY gene and only one isolate lacked the exoU gene. Also, 88 isolates simultaneously had both exoU and exoY genes. Conclusions: High prevalence of exoU and exoY genes in this region indicates a significant role of type III secretion system in pathogenesis of Pseudomonas aeruginosa. The type III secretion system may be a suitable target to reduce the pathogenicity of this bacterium. [ABSTRACT FROM AUTHOR]

Infectious urolithiasis is a relatively rare form of urolithiasis in children. The predisposing factors in the pediatric population mainly include urinary tract defects and neurogenic bladder. Here we present a case of a 3-year-old boy with staghorn calculi, diagnosed during the diagnostic management for persistent leukocyturia. The boy had a history of recurrent urinary tract infections (rUTIs) caused by Proteus mirabilis and Klebsiella pneumoniae. Based on laboratory tests and imaging studies, the patient was diagnosed with a dysfunctional right kidney and a significant risk due to a large staghorn calculus to the left kidney. Bilateral ureteroscopic lithotripsy was performed, the deposit from the left kidney was removed via open surgery, and the narrowed sections of the ureters were excised. During the follow-up period, the patient's glomerular filtration rate remained normal. In the case of rUTIs kidney calculi may be diagnosed incidentally as they produce no clear clinical symptoms. [ABSTRACT FROM AUTHOR]

Background: Infectious etiologies of lower respiratory tract infections (LRTIs) by the conventional microbiology tests (CMTs) can be challenging. Metagenomic next-generation sequencing (mNGS) has great potential in clinical use for its comprehensiveness in identifying pathogens, particularly those difficult-to-culture organisms. Methods: We analyzed a total of 205 clinical samples from 201 patients with suspected LRTIs using mNGS in parallel with CMTs. mNGS results were used to guide treatment adjustments for patients who had negative CMT results. The efficacy of treatment was subsequently evaluated in these patients. Results: mNGS-detected microorganisms in 91.7% (188/205) of the clinical samples, whereas CMTs demonstrated a lower detection rate, identifying microorganisms in only 37.6% (77/205) of samples. Compared to CMT results, mNGS exhibited a detection sensitivity of 93.5% and 95.4% in all 205 clinical samples and 180 bronchoalveolar lavage fluid (BALF) samples, respectively. A total of 114 patients (114/201; 56.7%) showed negative CMT results, among which 92 received treatment adjustments guided by their positive mNGS results. Notably, 67.4% (62/92) of patients demonstrated effective treatment, while 25% (23/92) experienced a stabilized condition. Subgroup analysis of cancer patients revealed that 41.9% (13/31) exhibited an effective response to treatment, and 35.5% (11/31) maintained a stable condition following medication adjustments guided by mNGS. Conclusion: mNGS demonstrated great potential in identifying microorganisms of clinical significance in LRTIs. The rapid turnaround time and reduced susceptibility to the impact of antimicrobial administration make mNGS a valuable supplementary tool for diagnosis and treatment decision-making for suspected LRTIs in clinical practice. [ABSTRACT FROM AUTHOR]

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Several studies have been conducted to find the best treatment for endophthalmitis. The present study investigates the effect of eye drops based on iodine nanoparticles in treating rabbit endophthalmitis. 15 New Zealand rabbits infected with Staphylococcus aureus (ATCC 25,923) endophthalmitis were randomly divided into three groups of five. (I, II, and III). Group I was used as the control group (without treatment). The second group received an iodine solution (1.25%) without a nanoparticle structure (betadine). The third group received iodine eye drops with nanoparticle structure. Microbial counts and disease severity scores were measured on the first, second, fifth, and fourteenth days. In terms of microbial load, there was a significant difference between the two groups receiving iodine based on nanoparticles and betadine and the untreated group. The use of iodine nanoparticles led to a further decrease in bacterial load. Betadine and untreated groups showed worsening of the disease in rabbits with endophthalmitis, but the severity of the disease decreased in the nano-iodine group. There was a significant difference between the untreated and nano-iodine groups (p = 0.008). Using eye drops based on iodine nanoparticles effectively reduces the microbial load and disease severity in rabbits with endophthalmitis. [ABSTRACT FROM AUTHOR]

Introduction: Blood culture is a proven gold standard method for the identification of causative agents of bloodstream infections. Prompt identification (ID) and antimicrobial susceptibility testing (AST) of organisms causing blood stream infections has a significant impact on the morbidity and mortality associated with these infections. The need to circumvent the slow turnaround time of conventional gold standard methods has paved way for the rapid automated systems. In this regard automated identification aid in rapid diagnosis/treatment of bacterial pathogens. Aims: Evaluation of automated system Vitek-2 compact system with conventional blood culture method for the identification of organisms causing neonatal septicaemia. Materials and Methods: In this hospital-based retrospective study conducted in the Department of Microbiology in a tertiary care hospital, New Delhi. A total of 170 non duplicate isolates of both Gram Positive and Gram-Negative organisms recovered from blood samples were included. Organisms were processed on the Vitek-2 compact system and simultaneously from conventional method (ID) for comparison. Descriptive statistics was used for the presentation and comparison of data and appropriate statistical charts were used to present the data. Results: Concordant identification (ID) results of Vitek-2 compact system were seen with all the isolates of S. aureus, S. epidermidis, S. pneumonia, E. faecalis and E. faecium. Discordant results of Vitek-2 were noticed with S. hominis (5 isolates of the organism misidentified as S. epidermidis). Conclusion: The organisms having slow metabolic rates and late lactose fermenters (S. hominis) are prone to errors by the Vitek-2 compact system; hence need to be reconfirmed with other possible method. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to compare the diagnostic efficacy of metagenomic next-generation sequencing (mNGS) to traditional diagnostic methods in patients with lower respiratory tract infections (LRTIs), elucidate the etiological spectrum of these infections, and explore the impact of mNGS on guiding antimicrobial therapy. Methods: We retrospectively analyzed data from 128 patients admitted to the Respiratory Department of Anqing 116 Hospital between July 2022 and July 2023. All patients had undergone both mNGS and conventional microbiological techniques (CMT) for LRTI diagnosis. We assessed the diagnostic performance of these methods and examined the influence of mNGS on antimicrobial decision-making. Results: Overall, mNGS demonstrated superior sensitivity (96.8%) and accuracy (96.8%) compared to CMT. For Mycobacterium tuberculosis detection, the accuracy and sensitivity of mNGS was 88.8% and 77.6%, which was lower than the 94.7% sensitivity of the T-spot test and the 79.6% sensitivity of CMT. In fungal pathogen detection, mNGS showed excellent sensitivity (90.5%), specificity (86.7%), and accuracy (88.0%). Bacteria were the predominant pathogens detected (75.34%), with Mycobacterium tuberculosis (41.74%), Streptococcus pneumoniae (21.74%), and Haemophilus influenzae (16.52%) being most prevalent. Bacterial infections were most common (62.10%), followed by fungal and mixed infections (17.74%). Of the 118 patients whose treatment regimens were adjusted based on mNGS results, 102 (86.5%) improved, 7 (5.9%) did not respond favorably, and follow-up was lost for 9 patients (7.6%). Conclusions: mNGS offers rapid and precise pathogen detection for patients with suspected LRTIs and shows considerable promise in diagnosing Mycobacterium tuberculosis and fungal infections. By broadening the pathogen spectrum and identifying polymicrobial infections, mNGS can significantly inform and refine antibiotic therapy. [ABSTRACT FROM AUTHOR]

Traditional fermented beverages are culturally and socially accepted products for consumption, drinking, entertainment, customary practices, and for religious purposes. The purpose of this review was to identify some cereal-based fermented beverages and determine the differences in their production technologies. There are many unique regional variations in the preparation of each of the identified fermented beverages. They are prepared from raw materials such as maize, millet, rice, and sorghum. Majority of the fermented alcoholic beverages (binuburan, amba beer, sake, dolo, pito, and tchoukoutou) were produced using spontaneous fermentation and industrial fermentation (use of starter cultures) techniques. The various microbial communities associated with the traditional fermentation processes were dominated by Limosilactobacillus fermentum and Lactiplantibacillus plantarum for Lactic acid bacterial (LAB) species, Saccharomyces cerevisiae and Candida mycoderma for Saccharomyces and Candida species (yeasts), respectively; and Aspergillus aceti and Rhizopus stolonifer for Aspergillus and Rhizopus species (molds), respectively. Acetobacter, Pseudomonas, Klebsiella, Weissella, Achromobacter, Flavobacterium, Micrococcus, and Bacillus dominated other microbial genera. The involvement of lactic acid bacteria contributed to the safety and extension of the shelf life of the final products. Most of these beverages were found to be very rich in proteins, carbohydrates, calories, and B-group vitamins including thiamine, folic acid, riboflavin, and nicotinic acid. This article reviewed the available information, such as processing techniques of African traditional beverages, the raw materials used to producing them, and the microorganisms associated with the production processes. [ABSTRACT FROM AUTHOR]

Background Pneumonia is a common cause of morbidity and mortality, yet a causative pathogen is identified in a minority of cases. Plasma microbial cell-free DNA sequencing may improve diagnostic yield in immunocompromised patients with pneumonia. Methods In this prospective, multicenter, observational study of immunocompromised adults undergoing bronchoscopy to establish a pneumonia etiology, plasma microbial cell-free DNA sequencing was compared to standardized usual care testing. Pneumonia etiology was adjudicated by a blinded independent committee. The primary outcome, additive diagnostic value, was assessed in the Per Protocol population (patients with complete testing results and no major protocol deviations) and defined as the percent of patients with an etiology of pneumonia exclusively identified by plasma microbial cell-free DNA sequencing. Clinical additive diagnostic value was assessed in the Per Protocol subgroup with negative usual care testing. Results Of 257 patients, 173 met Per Protocol criteria. A pneumonia etiology was identified by usual care in 52/173 (30.1%), plasma microbial cell-free DNA sequencing in 49/173 (28.3%) and the combination of both in 73/173 (42.2%) patients. Plasma microbial cell-free DNA sequencing exclusively identified an etiology of pneumonia in 21/173 patients (additive diagnostic value 12.1%, 95% confidence interval [CI], 7.7% to 18.0%, P <.001). In the Per Protocol subgroup with negative usual care testing, plasma microbial cell-free DNA sequencing identified a pneumonia etiology in 21/121 patients (clinical additive diagnostic value 17.4%, 95% CI, 11.1% to 25.3%). Conclusions Non-invasive plasma microbial cell-free DNA sequencing significantly increased diagnostic yield in immunocompromised patients with pneumonia undergoing bronchoscopy and extensive microbiologic and molecular testing. Clinical Trials Registration NCT04047719. [ABSTRACT FROM AUTHOR]

Background: Wiping is an effective and established method for decontaminating surfaces, it involves applying liquid while simultaneously removing soils. Chlorine dioxide is a high-level disinfectant that can be applied to surfaces, including those of medical devices, with the aid of mechanical action or wiping. The European Standard (EN) 16615 evaluates the microbiocidal efficacy of a chemical disinfectant when it is applied with mechanical action, i.e., when applied by wiping. It has been suggested that manual methods employing human intervention can lead to variations in a validated process. One such assumption is that variable wiping force that exists between users may influence the effectiveness of the process. Method: The average wiping force of individuals with varying physical characteristics was investigated. A bespoke testing apparatus was employed in a series of EN 16615 four-field tests, with the aim to investigate if variable wiping force between individuals impacts the microbiocidal efficacy of a chlorine dioxide-based wipe disinfectant if tested as applied as in practice. Results: Individuals applied variable forces when wiping. Physical attributes such as hand dominance and body build were shown to influence the force applied. The average wiping force calculated from this pool of participants was found to be lower than the stated range given by the EN 16615. The pre-impregnated chlorine dioxide-based wipe achieved biocidal efficacy in the series of EN 16615 tests. No trend relating to the efficacy of the product and the different forces applied could be drawn. Conclusion: The data demonstrates that individuals apply different forces to a surface when wiping. However, the variability expressed when wiping has no impact on the microbiocidal efficacy of a manually applied chlorine dioxide-based disinfectant. [ABSTRACT FROM AUTHOR]

Introduction: Bacterial contamination of blood products presumably occurs mainly during blood collection, starting from low initial concentrations of 10–100 colony-forming units (CFUs) per bag. As little is known about bacterial growth behavior and distribution in stored whole blood (WB) and WB-derived blood products, this study aims to provide data on this subject. Methods: WB units were inoculated with transfusion-relevant bacterial species (Acinetobacter baumannii, Bacillus cereus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Pseudomonas fluorescens, Serratia marcescens, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus dysgalactiae, Streptococcus pyogenes, Yersinia enterocolitica; n = 12 for each species), stored for 22–24 h at room temperature, and then centrifuged for separation into plasma, red blood cells (RBCs), and buffy coats (BCs). The latter were pooled with 3 random donor BCs and one unit of PAS-E each to yield plasma-reduced platelet concentrates (PCs). Samples for bacterial colony counting were collected after WB storage and immediately after blood component production. Sterility testing in PCs (n = 12 for each species) was performed by bacterial culture after 7 days of storage. Results: Bacterial growth in WB varied remarkably between donations and species. Streptococcus species produced the highest titers in WB, whereas Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas fluorescens did not multiply. Centrifugation resulted in preferential accumulation of bacteria in BCs, with titers of up to 3.5 × 103 CFU/mL in BCs and up to ≤0.9 × 103 CFU/mL in BC-derived PCs. Overall, 72/144 PCs (50%) tested positive for bacteria after storage. Sterility test results were species-dependent, ranging from 12 of 12 PCs tested positive for Streptococcus pyogenes to 1 of 12 PCs positive for Escherichia coli. Bacterial contamination of RBC and plasma units was much less common and was associated with higher initial bacterial counts in the parent WB units. Conclusions: Bacterial growth in WB is species-dependent and varies greatly between donations. Preferential accumulation of bacteria in BCs during manufacturing is a critical determinant of the contamination risk of BC-derived pooled PCs. [ABSTRACT FROM AUTHOR]

Donated human milk is the best possible alternative when mother's own milk is not available. The aim of this study is to investigate whether there are differences in the milk donation volumes and microbiological quality of donated milk depending on human milk donors (HMDs) characteristics. We analyzed data on the HMDs who donated milk in the first three years of work of human milk bank (HMB) – November 2019 to January 2023. The data on the volume of donated milk in L and suitable microbiological quality assessed by the number and isolated species of bacteria were collected from questionnaires filled out by HMDs and documentation administered by HMB employees and are presented using descriptive and comparative statistics. Two hundred HMDs were included in this study. The majority of them are between 26 and 35 years of age, reside in capital city or the surrounding county, have given birth to a full-term child vaginally, and express surplus milk through a breast pump. Donor mothers of preterm born infants (14.5 %) donated greater quantities, there is statistically significant difference in the median of volume of milk donated (9.6 vs. 6.4, p=0.026). Milk expressed manually shows better results in microbiological quality (median percentage 100 vs. 82 vs. 100, p=0.040), while by comparing other characteristics of the donors, no difference was found between the groups. It is important to be aware of the characteristics of previous HMDs in order to direct the HMB future promotional and educational activities. [ABSTRACT FROM AUTHOR]

Objective: Listeriosis is caused by the bacterium, Listeria monocytogenes, and is a significant health concern because of high hospitalization and mortality rates. This study reports seven cases of pregnancy‐associated listeriosis diagnosed with matrix‐assisted laser desorption ionization‐time of flight (MALDI‐TOF) mass spectrometry performed on infection‐positive blood culture. Methods: Blood culture‐positive samples of seven patients whose pregnancy was complicated by Listeria infection and treated at Xuanwu Hospital of Capital Medical University between January 2016 and December 2021 were analyzed retrospectively. Strains identified by MALDI‐TOF mass spectrometry were compared with colony identification results. Identification accuracy and consistency were assessed. Results: A total of seven strains of Listeria were collected from seven pregnant women presented with fever (37.6–39.9°C). Clinical abnormalities included abnormal liver function, emaciation, hypoalbuminemia, hypocalcemia, hypokalemia, hyponatremia, ketosis, mild to moderate anemia, leukopenia, and thrombocytopenia. Compared with the traditional culture method, MALDI‐TOF mass spectrometry led to much earlier identification (4–6 h vs. 3–4 days) with 100% identification accuracy. Of the seven pregnancies complicated by Listeria, only two led to live births. Of the five fetal deaths, three occurred in the second trimester. Conclusion: In this series of pregnancy‐associated listeriosis cases, the fetal mortality rate was 71%. MALDI‐TOF mass spectrometry is a valuable method that can identify Listeria from blood culture rapidly and accurately. [ABSTRACT FROM AUTHOR]

Introduction Actinotignum schaalii is a Gram-positive coccobacillus, and a member of the normal human microbiota. A. schaalii is considered as an emerging pathogen causing urinary tract infections among the elderly. Because of an anaerobic growth requirement and lack of knowledge on pathogenic potential following conventional microbiology laboratory techniques, A. schaalii is difficult to identify. Case report A previously well 24-year-old male presented to a tertiary care unit with fever, left flank pain, and dysuria for two days. He was initially treated with empiric oral ciprofloxacin by the general practitioner. Following admission, blood cultures and urine cultures were done, and empirical intravenous piperacillin-tazobactam was started. X-ray of the pelvis revealed left-sided pyelonephritis and left ureteric calculi. A nephrostomy tube was inserted to relieve the obstruction which drained pus and was sent to microbiology laboratory in aerobic and anaerobic blood culture bottles. Two days later blood culture flagged positive for Gram-positive bacilli from the anaerobic bottle, and the pus from enriched anaerobic culture grew A. schaalii. The urine culture remained negative. By VITEK 2 anaerobic card and MALDI-TOF analysis, it was identified as A. schaalii. Following clinical improvement, he was discharged with oral doxycycline. Ureteric calculus was removed and remained sterile following 16s DNA analysis. Conclusions The urine Gram staining may have a role in detecting and considering anaerobic media to isolate A. schaalii. The novel diagnostic platforms are important to speciate the pathogen. Also, the lack of pathogen-specific breakpoints for antimicrobial susceptibilities made it a problem to decide on appropriate therapy. [ABSTRACT FROM AUTHOR]