Search

ABSTRACT Objective Methods Results Conclusion To evaluate long‐term infection rates in children aged 6 months to 5 years with moderate‐to‐severe atopic dermatitis (AD) treated with dupilumab.This was a post hoc analysis of an ongoing open‐label extension (OLE) study of dupilumab. Pediatric patients aged 6 months to 5 years with moderate‐to‐severe AD who had previously taken part in the LIBERTY AD PRESCHOOL phase 2 and 3 clinical trials received weight‐based subcutaneous dupilumab every 2 or 4 weeks. Exposure‐adjusted infection rates after a median dupilumab exposure of 52 weeks are compared with data from the earlier randomized, placebo‐controlled, 16‐week LIBERTY AD PRESCHOOL phase 3 trial.Infection rates were overall lower in the OLE study compared with the dupilumab and placebo groups in the earlier 16‐week trial, including total infections (101.0 patients/100 patient‐years [PY]), nonherpetic skin infections (22.7 patients/100PY), herpetic infections (7.3 patients/100PY), and nonskin infections (92.9 patients/100PY). The frequency of severe and serious infections was low (3.1 patients/100PY), compared with 17.1 placebo‐treated patients/100PY and 0 dupilumab‐treated patients in the earlier 16‐week trial, and no infections leading to treatment discontinuation were observed. Systemic anti‐infective medication use (58.9 patients/100PY) was lower in the OLE study compared with both the dupilumab and placebo groups in the 16‐week trial.Overall, reduced infection rates are observed in infants and young children with moderate‐to‐severe AD treated with dupilumab long‐term, supporting the known safety profile of dupilumab. [ABSTRACT FROM AUTHOR]

Chronic neutropenia causes involve nutritional deficiencies and inborn errors of immunity(IEI), such as severe congenital neutropenia. To classify common chronic neutropenia causes in a pediatric immunology unit. We enrolled 109 chronic neutropenia patients admitted to a pediatric immunology department between 2002–2022. We recorded clinical/laboratory features and genetic characteristics. The male/female ratio was 63/46. Fifty-eight patients had parental consanguinity(57.4%). 26.6% (n = 29) patients had at least one individual in their family with neutropenia. Common symtpoms at presentation were upper respiratory tract infections(URTI)(31.1%), oral aphthae(23.6%), skin infections(23.6%), pneumonia(20.8%), and recurrent abscesses(12.3%). Common infections during follow-up were URTI(56.8%), pneumonia(33%), skin infections(25.6%), gastroenteritis(18.3%), and recurrent abscesses(14,6%). Common long-term complications were dental problems(n = 51), osteoporosis(n = 22), growth retardation(n = 14), malignancy(n = 16)[myelodysplastic syndrome(n = 10), large granulocytic leukemia(n = 1), acute lymphoblastic leukemia(n = 1), Hodgkin lymphoma(n = 1), EBV-related lymphoma(n = 1), leiomyosarcoma(n = 1), and thyroid neoplasm(n = 1)]. We performed a genetic study in 86 patients, and 69(71%) got a genetic diagnosis. Common gene defects were HAX-1(n = 26), ELA-2 (ELANE)(n = 10), AP3B1(n = 4), and ADA-2(n = 4) gene defects. The IEI ratio(70.6%) was high. GCSF treatment(93.4%), immunoglobulin replacement therapy(18.7%), and HSCT(15.9%) were the treatment options. The mortality rate was 12.9%(n = 14). The most common long term complications were dental problems that is three times more common in patients with known genetic mutations. We prepared an algorithm for chronic neutropenia depending on the present cohort. An important rate of inborn errors of immunity, especially combined immunodeficiency(11.9%) was presented in addition to congenital phagocytic cell defects. Early diagnosis will allow us tailor the disease-specific treatment options sooner, preventing irreversible consequences. [ABSTRACT FROM AUTHOR]

Background: Acne vulgaris is a skin infection widely seen in adolescents between 10–19 years with males affected more than females. It mainly affects the face but may also affect the back and chest. The symptoms vary with mild acne manifesting as comedones and moderate acne as inflammatory lesions (papulopustular), nodules, and mild scarring while severe acne has the same symptoms that have not subsided within 6 months of treatment. Various treatments including topical medications containing different antibiotics are used to treat acne. Recently, herbal treatments have been shown as better alternatives to conventional treatment. Teucrium oliverianum Ging. ex Benth (Lamiaceae) is traditionally used for skin infections such as wound healing and biofilm formation. Methodology: Methanolic extract of T. oliverianum was subjected to liquid chromatography-mass spectrometry (LC-MS) analysis, and its antibacterial effect against Cutibacterium acnes. The anti-acne, anti-inflammatory, and antioxidant effects were also assessed using HaCaT cells infected with C. acnes. The cytotoxicity of the extract was evaluated using a neutral red uptake assay, and anti-inflammatory effects were determined by measuring TNF-α, IL-1β, INF-γ, and COX2 inhibition. The antioxidant action was assessed by ROS generation in HaCaT cells infected with C. acnes. Results: LC-MS analysis of the extract showed the presence of 16 different metabolites with L-carnitine, esculin sesquihydrate, and gamma-linoleic acid as major metabolites. The methanolic extract of T. oliverianum showed an antibacterial effect against C. acnes with an IC50 value of 263.2 μg/mL. The extract attenuated the cytotoxicity of C. acnes on the HaCaT cell and the IC50 was found to be 676.2 μg/mL. It also decreased dose-dependently the expression of TNF-α, IL-1β, INF-γ, and inhibited COX2 in the HaCaT cells infected with C. acnes. It also decreased the generation of reactive oxygen species. Conclusion: The results support the use of T. oliverianum as an anti-acne agent but it possesses mild antibacterial action. It showed anti-inflammatory effects in HaCaT cells infected with C. acnes. It is also an effective antioxidant and decreased the generation of reactive oxygen species. Comparison of the anti-acne effects and adverse reactions of extract with other treatments will provide more insight into its clinical efficacy and toxicity. [ABSTRACT FROM AUTHOR]

Introduction: The skin is the largest and most visible organ of the human body. As such, skin infections can have a significant impact on overall health, social wellbeing and self‐image. In 2019, we published a systematic review of the treatment, prevention and public health control of skin infections including impetigo, scabies, crusted scabies and tinea in resource‐limited settings where skin infections are endemic. This current review serves as an update to assess the evidence for treatment of these conditions as well as atopic dermatitis, molluscum contagiosum and head lice in endemic settings. The data from this systematic review have supported an update to the Australian National Healthy Skin guidelines. Methods: A systematic review was conducted using two separate searches in MEDLINE, PubMed, Embase, CINAHL, Cochrane and Web of Science. The first search was an update of the 2018 systematic review using the same search strategy for the same skin conditions to identify emerging literature from 2018 to 2022. The second search strategy used the same key terms but with the addition of atopic dermatitis, head lice and molluscum contagiosum from 1960 to 2022. Eligible studies included Indigenous peoples and populations in resource‐limited settings with a diagnosis of impetigo, scabies, crusted scabies, tinea capitis, atopic dermatitis, molluscum contagiosum or who presented with head lice. Studies conducted in high‐income countries were excluded. Articles were screened for inclusion independently by one author with a second group of reviewers independently double screening. Data extraction and an in‐depth quality assessment conducted by one author and checked by two others. Results: Of 1466 original articles identified, 68 studies were included and key findings outlined for impetigo, scabies, crusted scabies, atopic dermatitis, head lice and molluscum contagiosum. Recommendations for each condition based on the available evidence are provided. Conclusion: The importance of assessing literature relevant to the populations with heavy burden of skin infections is outlined in this systematic review. We have summarised updates to this literature, which may benefit in developing guidelines for skin infection management similar to the National Healthy Skin Guidelines for Australia. [ABSTRACT FROM AUTHOR]

Anaerobic bacteria can cause many infections in children. Because they predominant in the normal human skin and mucous membranes bacterial flora, they are often associated with bacterial infections that originate from these sites. They are difficult to isolate from infectious sites, and are frequently missed. Anaerobic infections can occur in all body sites, including the central nervous system, oral cavity, head and neck, chest, abdomen, pelvis, skin, and soft tissues. Anaerobes colonize the newborn after birth and have been isolated in several types of neonatal infections. These include cellulitis of the site of fetal monitoring, neonatal aspiration pneumonia, bacteremia, conjunctivitis, omphalitis, and infant botulism. Management of anaerobic infection is challenging because of the slow growth of these bacteria, by their polymicrobial nature and by the growing antimicrobial resistance of anaerobic. Antimicrobial therapy may be the only treatment required, and may also be an adjunct to a surgical approach. Polymicrobial aerobic-anaerobic infection generally requires delivering antimicrobial therapy effective against all pathogens. The antibiotics with the greatest activity against anaerobes include carbapenems, beta-lactam/beta-lactamase inhibitor combinations, metronidazole, and chloramphenicol. Antimicrobial resistance is growing among anaerobic bacteria. The major increased in resistance have been reported with clindamycin, cephamycins, and moxifloxacin against Bacteroides fragilis group and related strains. Resistance patterns vary between different geographic areas and medical facilities. [ABSTRACT FROM AUTHOR]

Prostatic abscesses are a rare clinical entity in the antibiotic era and are most often encountered in elderly and immunocompromised patients. Patients with diabetes, following chemotherapy or radiation therapy and AIDS patients, are particularly at risk of developing the condition. The most common group of affected patients is between 50 and 60 years old. A prostatic abscess is a localized process that usually begins in the peripheral zone of the prostate gland but may spread to other areas. The majority of lesions result from urinary tract infections with E. coli and Proteus. Abscesses can be secondary to prostatitis but can also develop from the hematogenous spread of inciting agents. Hematogenous dissemination occurs from a septic focus elsewhere, including solid organ abscesses and skin infections. Despite their rarity, untreated abscesses remain potentially lifethreatening. Early diagnosis is important because prostatic abscesses may require surgical drainage and prolonged treatment protocols. As a possible complication, prostatic abscesses can rupture into the urethra, the rectum, the perineum, and less frequently into the peritoneum. Clinical examination alone makes the differential diagnosis between acute bacterial prostatitis and prostatic abscess difficult to make. Imaging studies should be considered when patients with acute prostatitis show signs of voiding disturbance or a delay in treatment. In this case report, we will present the MRI findings of a 29-year-old man who presented to the emergency department with a fever of up to 38.5 degrees Celsius, pain in the perineal region, and urethral discharge for the past month. He was found to have a prostatic abscess which was surgically drained. [ABSTRACT FROM AUTHOR]

Background: "Kaposi varicelliform eruption" (KVE), also known as "eczema herpeticum," refers to a rare widespread skin infection. The primary causal agent is thought to be the herpes simplex virus (HSV). Though common in patients with underlying skin dermatosis, systemic immunosuppression can at times lead to KVE. Case Presentation: A 27‐years male, a renal transplant recipient, under systemic immunosuppressants, presented with lesions over the whole body for 2 weeks and fever for 10 days. Skin examination revealed multiple flaccid vesicles with hemorrhagic fluid over the face, trunk, and bilateral extremities. Multiple erythematous erosions over the chest and abdomen, multiple petechiae and purpura over bilateral legs, palms, soles, and abdomen, erosions over the hard palate along with thick crusts over the scalp. A tzanck smear showed plenty of acantholytic cells. With a diagnosis of KVE, he was managed with an injection of acyclovir that led to resolution of his symptoms. Conclusion: KVE is a serious condition that may have fatal outcomes. Early diagnosis and appropriate treatment of patients at risk for viral complications are very important medical considerations. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsAlcoholism increases the risk of skin and skin structure infections (SSSIs). Furthermore, in complicated SSSIs (cSSSIs) alcoholism is associated with delayed treatment response and a higher risk of blood culture positivity, suggesting poor outcomes. In pneumonia and bacteremia alcoholism is linked with higher mortality, longer hospital treatment and more ICU treatment.We conducted a population-based retrospective cohort study including all cases of complicated skin and skin structure infections (n = 460) treated in Gothenburg, Sweden and Helsinki, Finland from 2008 − 2011. Patients were stratified as alcoholics (9%) and non-alcoholics (91%) and patient and disease factors, treatment, and outcomes were compared.Alcoholics were comparatively younger and more often male, with more liver diseases. We observed higher rates of bacteraemia, intensive care unit admission, surgical intervention, and clinical failure in alcoholics. Alcoholism was associated with longer length of stay and more interdepartmental transfers. We did not observe differences in infection type or time from symptom onset to diagnosis. Mortality was low and equivalent in alcoholics and non-alcoholics.Alcoholism is associated with increased cSSSI disease severity and resource utilisation. [ABSTRACT FROM AUTHOR]

The persisting life‐expectancy ‘gap’ between First Nations and non‐First Nations Australians is fundamentally driven by the social determinants of health. These include income and social protection, access to adequate housing and food security, among others. These factors are particularly prominent in Central Australia. Inadequate housing has led to some of the highest rates of Streptococcus pyogenes infection in the world, which in turn drives an extremely high prevalence of rheumatic heart disease. Food insecurity and inadequate social protection manifesting as energy insecurity result in inadequate nutrition and have resulted in a huge burden of diabetes in Central Australia. These factors, combined with social exclusion, racism and the pervasive effect of colonisation, also drive a high rate of alcohol misuse. Only by prioritising equity in these ‘social determinants’ and emphasising the importance of First Nations leadership in formulating and implementing solutions will health inequity be addressed. [ABSTRACT FROM AUTHOR]

Background Objectives Materials and Methods Results Conclusions and Clinical Relevance Canine superficial pyoderma is a common bacterial skin infection of dogs, generally caused by Staphylococcus pseudintermedius. The C4 strain of Staphylococcus felis was recently discovered to have strong antimicrobial activity against S. pseudintermedius in mice.We aimed to evaluate in vitro if this antimicrobial activity was maintained using a novel canine skin explant model.Punch biopsies (8 mm) of skin from recently euthanised dogs were collected and placed into six‐well plates on top of an agarose pedestal.Histological examination of the skin explants showed an intact dermal–epidermal organisation and a stratum corneum that was successfully colonised by S. pseudintermedius after topical application. The number of colony forming units of S. pseudintermedius showed a 2 log increase after 24 h colonisation, indicating that the explant supported bacterial growth. By contrast, co‐treatment with S. felis C4 live bacteria and its sterile protein product significantly reduced the growth of a methicillin‐susceptible (ST540, p = 0.0357) and a methicillin‐resistant (MR) strain (ST71, p = 0.0143) of S. pseudintermedius. No detectable bacteria were recovered from or visualised on skin 24 h posttreatment with the S. felis C4 sterile protein product.Using a novel canine explant model, we demonstrate that the S. felis C4 strain inhibits the growth of S. pseudintermedius and that it is a promising candidate for a new probiotic therapy to treat cutaneous infections caused by S. pseudintermedius, including MR strains. [ABSTRACT FROM AUTHOR]

Dermatophyte infections of the skin and nails are frequent, but current antimycotics have several drawbacks. In search of new treatments, we looked into the vast array of herbal active agents. Derived from plants, they are sustainable, agreeable for patients, and may have less side effects than traditional antimycotics. In this study, we assessed 43 herbal agents for their effectiveness against Trichophyton rubrum (T. rubrum), Trichophyton benhamiae (T. benhamiae), Trichophyton tonsurans (T. tonsurans), and Microsporum canis (M. canis), four major human dermatophyte pathogens. The antifungal effect was tested by incorporating the agents into agar plates and measuring the dermatophyte growth after 7 days. Against T. rubrum, 16 out of 43 herbal agents showed total inhibition of dermatophyte growth. 14 out of 43 herbal agents inhibited the growth of T. benhamiae completely. 18 out of 43 herbal agents were effective against T. tonsurans. Against M. canis, 15 out of 43 herbal agents showed total growth inhibition. Twelve herbal agents inhibited the growth of all tested dermatophytes completely. This study demonstrates the high antimycotic potential of herbal therapeutics and identified promising candidates for the topical treatment of dermatomycoses. Substances are highly agreeable and should be tolerated well. Some might even provide new options for the systemic treatment of fungal diseases. [ABSTRACT FROM AUTHOR]

Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare severe cutaneous adverse reactions to medications characterized by keratinocyte necrosis leading to loss of protective barrier function and increased susceptibility to infection. Infection is a major cause of morbidity, and septicemia is the leading cause of mortality in this population. This systematic review and meta‐analysis aimed to determine infectious complications' prevalence and risk factors in adults with SJS and TEN. This review was registered with the International Platform of Registered Systematic Review and Meta‐Analysis Protocols (INPLASY) and conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) reporting guidelines. Thirty‐six articles describing results from 1446 cases were included. Skin infection was the most commonly diagnosed infection. The pooled prevalence of sepsis, respiratory tract infection, skin infection, and urinary tract infection was 27.3%, 21.5%, 37.5%, and 21.8%, respectively. Staphylococcus aureus was the most commonly identified organism. The overall quality of the studies was suboptimal, and the level of heterogeneity was high. The skin, bloodstream, respiratory, and urinary tracts are most commonly infected in the course of adult SJS and TEN. During hospitalization, clinicians should closely monitor and promptly investigate for these as well as several other infectious complications. More research is needed, with greater attention to the risk factors and causative organisms that cause these infections. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus is a versatile bacterium responsible for conditions ranging from mild skin and soft-tissue infections to serious disorders such as pneumonia and sepsis. Monocytes play a role in protection against pathogens by migrating to inflamed tissues and differentiating into macrophages but their specific role in the context of S. aureus pulmonary infection has not been fully elucidated. Using a CCR2-DTR transgenic mouse model we demonstrate that over the course of infection monocyte depletion resulted in worse airway clearance of S. aureus. The bronchoalveolar lavage fluid (BALF) of CCR2-DTR mice after S. aureus infection displayed significant decreases in interleukin-12 (IL-12), IFN-γ, IP-10, MIG and RANTES, all IFN-γ regulated, compared to wild-type (WT) infected controls. NK cells were identified as the main producers of IFN-γ, but both NK cells and IFN-γ were dispensable for clearance. We demonstrated through cytokine production and RNA-seq analysis that IL-12 and IL-12 regulated genes are strongly induced in monocytes upon S. aureus infection. Administration of IL-12 during infection restored the bacterial burdens in the BALF and lungs of monocyte-depleted CCR2-DTR mice to the levels of WT mice, independent of IFN-γ. In the absence of monocytes, alveolar macrophages are the primary phagocytic cells, and IL-12 influences their capacity to produce reactive oxygen species and clear S. aureus. These results show that production of IL-12 contributes to the control of S. aureus via its influence on alveolar macrophage function. Author summary: Staphylococcus aureus is an important cause of infections across numerous bodily sites. One area of significant disease is the respiratory tract, leading to pneumonia. The monocyte is a cell of the immune system that is recruited to the airway during infection. The full role this cell plays during S. aureus infection is not completely understood. We show here that it is important for clearance of S. aureus from the airway. We also demonstrate that its role is not in direct bacterial clearance but through effects exerted upon another cell, the alveolar macrophage. We show that monocytes secrete important signaling molecules, including one, IL-12, that impacts the capacity of the alveolar macrophage kill S. aureus. This work demonstrates that different cells of the immune system can accentuate the antimicrobial ability of other cell types during infection. [ABSTRACT FROM AUTHOR]

Fungi are very common infectious pathogens, which may cause invasive and potentially life-threatening infections. However, the efficacy of antifungal medications remains limited. Herein, a Cu2+-phenolic nanoflower is designed to combat fungal infections by combining cuproptosis and cell wall digestion. Firstly, protocatechuic acid (PA)-Cu2+ (PC) nanopetals are prepared by coordination interaction. Lywallzyme (Lyw) is then added to induce the self-assembly of PC to form Lyw loaded PC (PCW) nanoflowers. PCW nanoflowers can effectively adhere to fungal surface and Lyw can digest fungal cell walls to facilitate Cu2+ to penetrate into fungal interior, thereby exerting a synergistic fungicidal effect. PCW nanoflowers exhibit excellent fungicidal activity even in protein-rich and high-salt conditions, where dissociative Cu2+ completely loses fungicidal activity. Transcriptome sequencing analysis reveals that PCW can lead to fungal cuproptosis. The in vivo fungicidal effect of PCW nanoflowers is confirmed on a murine skin fungal infection model and a murine fungal keratitis model. Fungal infections can be debilitating and life-threatening. Here, the authors report a fungicidal strategy by the combination of cell wall digestion and cuproptosis using lywallzyme-assembled copper-phenolic nanoflowers demonstrating synergistic effects in fungal infection and fungal keratitis models. [ABSTRACT FROM AUTHOR]

The question being posed by scientists around the world is how different chemical modifications of naturally occurring compounds will affect their antimicrobial properties. In the current study, sulfur derivatives of camphor containing a sulfur atom were tested to detect their antimicrobial and antibiofilm potentials. The new compounds were tested on eight Gram-positive strains (S. aureus (3 isolates), S. epidermidis (4 isolates), and E. faecalis (1 isolate)) and eight Gram-negative strains (E. coli (6 isolates), A. baumannii (1 isolate), and P. aeruginosa (1 isolate)). The ability of the strains to eradicate a biofilm was evaluated under standard stationary and flow-through conditions using the Bioflux system. Two synthesized compounds, namely rac-thiocamphor (1a) and (S, S)-(+)-thiocamphor (2a), exhibited an effect on the 24 h biofilm formed by the Gram-positive strains. Our results are an important contribution to the science of natural compounds and allow us to classify our sulfur derivatives of camphor as potential prophylactic agents in treating skin infections, antiseptics, and disinfectants. The Gram-negative strains were excluded from further stages of the tests due to their high activity (MIC ≥ 512 µg/mL). On the other hand, the compound with the strongest antimicrobial activity against the Gram-positive strains was 2a, as it led led to a reductions in cell viability of 17–52% (for MIC), 37–66% (for 2MIC), and 40–94% (for 4MIC). In addition, the experimental retention index of thiocamphor was calculated for the first time. [ABSTRACT FROM AUTHOR]

Povidone-iodine is identified as one of the widely applicable antiseptic reagents for treatment of skin infection and wound healing. Controllable releasing of povidone-iodine is extensively required for healing of chronic wounds. The release of povidone-iodine was systematically studied from the composites based on carboxymethyl starch (CMS). Currently, different ratios from copper precursor and L-aspartic acid (L-AA) were interacted with CMS to obtain Cu-L-AA@CMS composites. Increment the percentage of L-AA was reflected in clustering of dense masses from the desirable composite with highly crystalline/stable structural network. Regardless to pH conditions, Cu-L-AA(30%)@CMS composite showed the highest efficiency for controllable release of povidone-iodine, whereas, the release percentages were estimated to be 58%, 32% and 18% at pH 5, 7 and 9, respectively. The kinetic results revealed the impossibility of povidone-iodine releasing via diffusion/erosion for further support of the hypothesis of releasing via swelling process. Moreover, the release of povidone-iodine using column technique showed that the lowest release was estimated at using high rate of 6 mL/min. Besides the biocompatibility and biodegradability of the prepared Cu-L-AA@CMS composites, it showed the superiority for controllable release of povidone-iodine antiseptic reagent to regulate its beneficial effect in curing of the skin. [ABSTRACT FROM AUTHOR]

Prostate cancer (PCa) is the most common malignant tumor of male genitourinary system, ranking second among all male malignant tumors and showing a trend toward younger age. However, for metastatic prostate cancer, commonly used androgen deprivation therapy combined with docetaxel chemotherapy or neoendocrine therapy is prone to complications (incontinence, erectile dysfunction, and rectal damage), resulting in reduced quality of life or serious side effects for patients. Therefore, the designed GO-DAA-Ce6 nanoparticles were constructed to couple graphene oxide and Ce6 via diacylhydrazine adipate (DAA) as a bridge. The combination therapy of PTT and PDT is made possible by the outstanding photothermal conversion ability of GO and the high singlet oxygen generation of Ce6. GO-DAA-Ce6 demonstrated low toxicity and great biocompatibility in cytotoxicity and hemolysis assays. According to the outcomes of in vitro anti-tumor tests, GO-DAA-Ce6 greatly outperformed the photothermal and photodynamic efficacy of GO alone and Ce6 alone in terms of tumor suppression rates. The findings of the anticancer mechanism study point to the possibility that GO-DAA-Ce6 may cause cancer cells to undergo apoptosis and necrosis by initially damaging suborganelles such mitochondria. The straightforward design of the photothermal and photodynamic collaboration platform kills prostate cancer effectively and offers a general method for the treatment of various conditions including inflammation and skin infections. [ABSTRACT FROM AUTHOR]

The excessive and prolonged use of antibiotics contributes to the emergence of drug‐resistant S. aureus strains and potential dysbacteriosis‐related diseases, necessitating the exploration of alternative therapeutic approaches. Herein, we present a light‐activated nanocatalyst for synthesizing in situ antimicrobials through photoredox‐catalytic click reaction, achieving precise, site‐directed elimination of S. aureus skin infections. Methylene blue (MB), a commercially available photosensitizer, was encapsulated within the CuII‐based metal–organic framework, MOF‐199, and further enveloped with Pluronic F‐127 to create the light‐responsive nanocatalyst MB@PMOF. Upon exposure to red light, MB participates in a photoredox‐catalytic cycle, driven by the 1,3,5‐benzenetricarboxylic carboxylate salts (BTC−) ligand presented in the structure of MOF‐199. This light‐activated MB then catalyzes the reduction of CuII to CuI through a single‐electron transfer (SET) process, efficiently initiating the click reaction to form active antimicrobial agents under physiological conditions. Both in vitro and in vivo results demonstrated the effectiveness of MB@PMOF‐catalyzed drug synthesis in inhibiting S. aureus, including their methicillin‐resistant strains, thereby accelerating skin healing in severe bacterial infections. This study introduces a novel design paradigm for controlled, on‐site drug synthesis, offering a promising alternative to realize precise treatment of bacterial infections without undesirable side effects. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is an increasing global concern in small animal veterinary practices. The overuse and misuse of antimicrobials in companion animals can contribute to the spread of AMR between animals and humans. This study aimed to assess small animal veterinarians' knowledge, attitudes, and behaviors towards antimicrobial use (AMU) and AMR in North Macedonia. A web-based questionnaire was developed, including questions addressing demographics, owner influence on antibiotic prescription and prescribing practices. The response rate of the small animal veterinarians was 47.50% (57/120), with most of them (84.20%) having 1-15 years of work experience. Pearson's chi-square test of independence was used for contingency tables that met the chi-square assumption, and Fisher's exact test was conducted for contingency tables that did not. Most veterinarians responded that they had perceived pressure and direct demands from pet owners to prescribe antimicrobials (35.09% frequently, 45.61% occasionally). In the survey, 50.77% of the veterinarians reported frequently administering antibiotics without conducting bacteriological or antimicrobial susceptibility testing. They typically resorted to these tests in cases with recurrent infections, such as skin infections (19.63%), or when empirical therapy is ineffective (14.72%). Based on the findings, it can be concluded that veterinarians play a crucial role in tackling the AMR in North Macedonia. The lack of stewardship programs or guidelines for responsible antimicrobial use in companion animals is a critical issue that requires urgent attention, emphasizing the vital role of veterinarians in combating AMR. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus poses a significant threat in both community and hospital settings due to its infective and pathogenic nature combined with its ability to resist the action of chemotherapeutic agents. Methicillin-resistant S. aureus (MRSA) represents a critical challenge. Metal-chelating thiosemicarbazones (TSCs) have shown promise in combating MRSA and while previous studies hinted at the antimicrobial potential of TSCs, their mechanisms of action against MRSA are still under investigation. We screened a chemical library for anti-staphylococcal compounds and identified a potent molecule named R91 that contained the NNSN structural motif found within TSCs. We identified that R91 and several structural analogs exhibited antimicrobial activity against numerous S. aureus isolates as well as other Gram-positive bacteria. RNAseq analysis revealed that R91 induces copper and oxidative stress responses. Checkerboard assays demonstrated synergy of R91 with copper, nickel, and zinc. Mutation of the SrrAB two-component regulatory system sensitizes S. aureus to R91 killing, further linking the oxidative stress response to R91 resistance. Moreover, R91 was found to induce hydrogen peroxide production, which contributed to its antimicrobial activity. Remarkably, no mutants with elevated R91 resistance were identified, despite extensive attempts. We further demonstrate that R91 can be used to effectively treat an intracellular reservoir of S. aureus in cell culture and can reduce bacterial burdens in a murine skin infection model. Combined, these data position R91 as a potent TSC effective against MRSA and other Gram-positive bacteria, with implications for future therapeutic development. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the in vitro and in vivo antibacterial and cytoprotective activities of marine fungal tripeptide derivatives with cinnamic acid moiety asterripeptides A–C (1–3). Methods: The antimicrobial and antibiofilm activities of asterripeptides A–C were tested using the Staphylococcus aureus ATCC 21027 strain. Human HaCaT keratinocytes infected with S. aureus were used for the in vitro investigation of the various aspects of the influence of asterripeptides A–C by lumino- and fluorospectrometry, ELISA, flow cytometry, Western blotting, and microscopy techniques. In the in vivo experiments, mice with burns and scalped S. aureus-infected wounds were used according to ethical committee resolution. Results: Asterripeptides A–C (10 µM) inhibited S. aureus growth and biofilm formation. Asterripeptides A–C increased the viability, proliferation, and migration of S. aureus-infected HaCaT cells and reduced the release of reactive oxygen species (ROS), NO, TNF-α, and IL-18. Asterripeptides A–C protected HaCaT cells against TNF-α-induced inflammation, decreased the transcriptional level of NF-κB in JB6 Cl41 cells, and increased the protein levels of Nrf2 and glutathione synthetase in HaCaT cells. More active asterripeptide C was tested in in vivo burn wounds and S. aureus-infected incised wounds. Asterripeptide C significantly enhanced wound healing, normalized cytokine levels and profiles of peripheral blood samples, and decreased S. aureus contamination of wounds and blood in mice with infected incised wounds. Conclusions: Taken together, these results confirm the dual antibacterial and Nrf2-dependent anti-inflammatory activities of asterripeptides A-C in in vitro and in vivo assays. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Chromoblastomycosis, though rare in non‐endemic regions like Lebanon, should be considered in patients presenting with chronic, verrucous skin lesions unresponsive to conventional therapies. Multimodal treatment combining oral antifungals, cryotherapy, and adjunctive topical 5‐Fluorouracil demonstrates efficacy in managing refractory cases. Follow‐up visits three and 6 months after treatment cessation showed sustained lesion clearance and no recurrence. [ABSTRACT FROM AUTHOR]

Background Increasing antibiotic resistance in Helicobacter pylori necessitates research on new active molecules. In 2017, delafloxacin, a new fluoroquinolone with chemical properties of activity under acidic conditions, was approved for treatment of community-acquired bacterial pneumonia and acute bacterial skin and soft-tissue infections. Mutations in gyrA are responsible for fluoroquinolone resistance, but certain clinical isolates of H. pylori appear to display a dual phenotype: resistance to levofloxacin associated with very low delafloxacin MICs. Objectives To estimate epidemiological cut-off (ECOFF) values and to identify mutations in the gyrA gene, specific to FQ resistance, without increasing the MICs of delafloxacin. Methods Clinical strains (n  = 231) were collected in the bacteriology laboratory of Poitiers University Hospital over a 2 year period to determine the ECOFF of delafloxacin. Retrospectively, 101 clinical strains with an levofloxacin-resistant phenotype (MIC > 1 mg/L) were selected from 2018 to 2022 for delafloxacin MIC determination and QRDR (gyrA) sequencing. Results The estimated ECOFF of delafloxacin was ≤0.125 mg/L. No H. pylori isolate showed a levofloxacin-sensitive phenotype with a delafloxacin MIC of >0.125 mg/L. Among the levofloxacin-resistant H. pylori isolates, 53.5% had delafloxacin MICs of ≤0.125 mg/L. The N87I mutation was associated with dual levofloxacin/delafloxacin resistance (P  < 0.001) in contrast to the N87K and D91N mutations (P  > 0.05). Mutations D91G and D91Y were not associated with a delafloxacin resistance phenotype (P  > 0.05). Conclusions Delafloxacin seems to be a therapeutic alternative for levofloxacin-resistant strains with greater in vitro activity. However, further clinical/biological investigations are required to determine its efficacy in H. pylori eradication. [ABSTRACT FROM AUTHOR]

We report the case of a cochlear implant patient who developed multiple infections with device extrusion necessitating explanation and reimplantation twice. An approach using a vancomycin washout followed by a temporalis muscle rotation and scalp rotation flap was utilized to salvage the device. [ABSTRACT FROM AUTHOR]

Background: Tinea versicolor is a common cutaneous fungal infection of the skin caused by a part of the resident flora of skin known as Malassezia species. This infection is recognized by pigmentation disturbance in the form of lesions and superficial scaling in the skin. Materials and Methods: This study was conducted on 350 students between the ages of 18-25 years who lived in a school dormitory and were suspected of clinical diagnosis of Tinea versicolor. The Scotch tape method was used to take samples from the infected skin of students, and methylene blue staining was used to prepare smears. Results: After mycological examinations, among the 350 suspected students, 30 cases tested positive for Tinea versicolor, including 17 males and 13 females. 43.3% (n: 13) of patients had hypopigmentation followed by hyperpigmentation (33.3%, n:10) and erythematous (23.3%, n:7). Conclusion: This study demonstrated a significant prevalence of Tinea versicolor among the students located in the dormitories, with a higher rate among male students. Different infection periods and lesions were observed in the cases, but no severe lesion was seen. [ABSTRACT FROM AUTHOR]

Clinical manifestations of dermatological and musculoskeletal conditions can sometimes overlap, leading to confusion in diagnosis. Patients with nail and skin infections may undergo imaging examinations with suspicions of muscle, tendon, or joint injuries. Dermatological infections often involve soft tissues and musculoskeletal structures, and their etiology can range from fungi, bacteria, viruses, to protozoa. Relying solely on physical examination may not be sufficient for accurate diagnosis and treatment planning, necessitating the use of complementary imaging exams. The objective of this paper is to present and discuss imaging findings of the main infectious conditions affecting the nail apparatus and skin. The paper also highlights the importance of imaging in clarifying diagnostic uncertainties and guiding appropriate treatment for dermatological conditions. [ABSTRACT FROM AUTHOR]

Approximately 22% of moderately to severely affected atopic dermatitis (AD) patients have a history of eczema herpeticum, a disseminated rash primarily caused by herpes simplex virus type 1 (HSV‐1). Reduced activity of antimicrobial peptides may contribute to the increased susceptibility of AD patients to HSV‐1. We previously demonstrated that the antimicrobial protein RNase 7 limits HSV‐1 infection of human keratinocytes by promoting self‐DNA sensing. Here, we addressed whether RNase 7 has any effect on HSV‐1 infection when infecting keratinocytes without exogenously added costimulatory DNA, and which step(s) of the infection cycle RNase 7 interferes with. We quantified viral gene expression by RT‐qPCR and flow cytometry, viral genome replication by qPCR, virucidal effects by plaque titration, and plaque formation and the subcellular localization of incoming HSV‐1 particles by microscopy. Recombinant RNase 7 restricted HSV‐1 gene expression, genome replication, and plaque formation in human keratinocytes. It decreased HSV‐1 immediate‐early transcripts independently of the induction of interferon‐stimulated genes. Its main effect was on intracellular infection processes and not on extracellular virions or virus binding to cells. RNase 7 reduced the amount of cell‐associated capsids and the HSV‐1 envelope glycoprotein D at 3 but not at 0.5 h postinfection. Our data show that RNase 7 directly restricts HSV‐1 infection of human keratinocytes, possibly by promoting the degradation of incoming HSV‐1 particles. This suggests that RNase 7 may limit HSV‐1 spread in the skin and that mechanisms that reduce its activity in the lesional skin of AD patients may increase their susceptibility to eczema herpeticum. [ABSTRACT FROM AUTHOR]

Background and Aims: Superficial fungal infections are common dermatological reasons to visit a doctor in primary care in Finland. However, their variable clinical picture and minor symptoms may lead to delayed diagnosis. We aimed to investigate the epidemiology and patient profile of fungal infections treated in secondary care over a decade. Methods: This is a retrospective study including adult patients with a fungal infection in the scalp, nails, or superficial skin diagnosed at the Oulu University Hospital, Finland between the years 2010 and 2021. Results: There were 573 patients with male predominance (57.6%). All studied fungal infections were more common in the oldest age group (>61 years). The number of fungal infections increased from the year 2017 onward. Only one‐third (37.7%) of the patients were referred to the dermatology clinic because of a suspected dermatophyte infection, and in 46.0% of cases, the diagnostic delay exceeded 6 months. The most common fungal infection was tinea pedis (n = 295, 51.5%) followed by tinea unguium (n = 275, 48.0%); as concomitant infection, they were present in 108 (18.8%) of all patients. The most common pathogen causing a fungal infection was Trichophyton rubrum. Conclusion: During the study period, the incidence of diagnosed superficial fungal skin infections increased. There was a remarkable diagnostic delay from the onset of symptoms to diagnosis in these most common dermatological conditions. Key points: Superficial fungal infections are highly prevalent and they cause burden and decrease the quality of life.We found that the incidence of superficial fungal infections treated in secondary care was increasing.Fungal infections affect both genders, but more often males and especially those who are older.There was a remarkable diagnostic delay in these diseases. [ABSTRACT FROM AUTHOR]

Purpose of review: Adolescent wrestlers undergo intense physical combat. While guidelines are effective in keeping the sport safer, concerns specific to the adolescent wrestler may be missed at primary care visits without knowledge of the unique challenges faced by these athletes. The following review highlights important characteristics of the adolescent wrestler which are of interest to primary care providers. Recent findings: Recommendations for concussion management are evolving to gradual return-to-sport after physician clearance rather than total sport removal. Prolonged skin-to-skin contact also places athletes at greater risk of dermatologic infections, which often require removal from competition, treatment, and/or coverage. Finally, adolescent nutritional literature recommends limiting pre-match weight loss to 3–5% body weight due to noted kidney damage that may result from larger deficits. Summary: Adolescent wrestlers are more prone to acute injuries than chronic overuse injuries, with most injuries occurring above the trunk. Primary care providers should consider obtaining imaging to rule out severe injuries or referring to specialist providers. Current guidelines for skin infections require frequent pre-match skin checks and mandatory waiting periods when certain infections are identified. However, the primary care provider is well-equipped for more in-depth skin examination, discussion of skin hygiene, and appropriate treatment of skin infections. Athletes attempting to meet lower weight classes may put themselves at risk of acute kidney damage, under-fueling, and eating disorders. Current guidelines attempt to mitigate excessive weight changes in the adolescent wrestler during competition season, but primary care providers should emphasize healthier methods of weight fluctuation and look for indicators of physiological or psychological effects. [ABSTRACT FROM AUTHOR]

The development of effective therapy is necessary because the patients have to contend with long-term therapy as skin fungal infections usually relapse and are hardly treated. Despite being a potent antifungal agent, luliconazole (LCZ) has certain shortcomings such as limited skin penetration, low solubility in aqueous medium, and poor skin retention. Solid Lipid Nanoparticles (SLNs) were developed using biodegradable lipids by solvent injection method and were embodied into the gel base for topical administration. After in-vitro characterizations of the formulations, molecular interactions of the drug with excipients were analyzed using in-silico studies. Ex-vivo release was determined in contrast to the pure LCZ and the commercial formulation followed by in-vivo skin localization, skin irritation index, and antifungal activity. The prepared SLNs have an average particle size of 290.7 nm with no aggregation of particles and homogenous gels containing SLNs with ideal rheology and smooth texture properties were successfully prepared. The ex-vivo LCZ release from the SLN gel was lower than the commercial formulation whereas its skin deposition and skin retention were higher as accessed by CLSM studies. The drug reaching the systemic circulation and the skin irritation potential were found to be negligible. The solubility and drug retention in the skin were both enhanced by the development of SLNs as a carrier. Thus, SLNs offer significant advantages by delivering long lasting concentrations of LCZ at the site of infection for a complete cure of the fungal load together with skin localization of the topical antifungal drug. [ABSTRACT FROM AUTHOR]

Natural herbal remedies have always been important in the management of skin disorders and the treatment of skin infections due to limited access to pharmaceuticals and the affordable cost of herbal products. K. Pinnata is a plant used as a medicinal herb by almost all traditional medicines in tropical Africa. The aim of the present work is to evaluate the antioxidant and healing properties of K. pinnata (Lam) pers extract from Togolese flora. The hydroethanol extract of K. pinnata (Lam) pers was subjected to in vitro antioxidant activity screening models, such as molybdate reduction, iron reduction assay (FRAP) and DPPH radical scavenging assay. A 1.5 cm diameter excision wound model was also used to assess the plant's healing activity. Wistar rats were treated after excision by topical application of vaseline, vaseline supplemented with 3% (EHKP 3%) and 10% (EHKP 10%) hydroethanol extract of K. pinnata (Lam) pers leaves, sulfadiazine (reference), or no treatment (negative control). Total antioxidant activity by the molybdate reduction method was 0.12 ± 0.01 µg EAA/mg EL, while the iron reduction assay (FRAP) showed an antioxidant capacity of 4.21 ± 0.04 mol Eq FeS04/ g extract and 10.17 ± 0.03 mol Eq FeS04/ g extract respectively for extract concentrations of 100 µg/ml and 200 µg/ml. In addition, the extract showed a dose-dependent ability to trap the DPPH radical. Results showed a significant reduction in wound surface area in animals treated with 10% EHKP. The hydroxyproline assay showed a significant difference in collagen production in animals treated with 10% EHKP, compared with the control group (P < 0.001) and the vaseline group (P < 0.01) on the last day. Histological analysis showed rapid re-epithelialization in animals treated with the extracts. [ABSTRACT FROM AUTHOR]

This article presents the findings of a study on the use of mini-dose glucagon for the treatment of post-bariatric hypoglycemia (PBH). The study found that self-administration of ready-to-use glucagon effectively restored normal blood glucose levels in most cases, without the need for glucose tablets. Rebound hypoglycemia was observed in a small percentage of cases, but this was more common when participants consumed glucose tablets. The study suggests that mini-dose glucagon could be a promising treatment option for PBH, although additional treatment options are still needed for chronic cases. [Extracted from the article]

Dermal white adipose tissue (DWAT) is a distinctive adipose depot located within the lower dermis of the skin. Its significance as an ancillary fat in skin homoeostasis has recently received increased attention. New research has revealed that DWAT responses to skin pathology and physiology changes, impacting skin development, hair cycling, defense mechanisms, and fibrotic conditions. In this review, we explore the developmental process of DWAT and the adipose commitment timing of hypodermal. We explore the development process of DWAT and its pivotal role in regulating the hair cycle. We conclude the antibacterial activity and reversible dedifferentiation of dermal adipocytes in response to skin defense. Furthermore, we underscore the potentially crucial yet underestimated anti‐fibrotic functions of DWAT‐derived adipokines and adipocyte‐myofibroblast transition. [ABSTRACT FROM AUTHOR]

Skin infections cause significant health burden and affect underserved communities such as the indigenous Negrito communities disproportionately. There is only one study that has addressed skin infections among the Negrito communities, which is the smallest and most isolated indigenous tribe in Peninsular Malaysia, with approximately 6,500 individuals remaining in northern and central Peninsular Malaysia. This study, which aims to update the infection patterns of scabies and tinea among the Negrito communities, recruited 361 participants from eight villages representing all six Negrito subtribes. The results revealed an overall skin infection prevalence of 35.6%, with scabies (11.7%), tinea versicolor (11.3%), and tinea imbricata (7.5%) as major infections, with no co-infection. Notably, infection rates were significantly higher in resettled villages (55.2%) compared to inland villages (24.8%). Scabies and tinea versicolor were more prevalent in resettled villages (21.2% and 23.6%, respectively) than inland villages (6.4% and 4.7%, respectively), while tinea imbricata was more common in inland villages (9.4% vs 3.9%). Furthermore, there exist predisposition of scabies among Kensiu. High prevalence of tinea imbricata was observed among the inland Bateq while prevalence of tinea versicolor was high among the resettled Bateq. Risk analysis revealed specific associations: scabies with Kensiu subtribe (P = 0.002), high income (P = 0.001) and underweight individuals (P = 0.009); tinea versicolor with Bateq subtribe (P = 0.003), resettled villagers (P < 0.001), males (p = 0.040), and overweight/obese individuals (P = 0.015); and tinea imbricata with Bateq (P = 0.011) and smokers (P = 0.004). These findings highlight a complex interplay between environment and lifestyle in skin infection prevalence. Addressing these infections requires targeted interventions, including regular medical care in inland villages and socio-economic support for resettled communities, considering the distinct predispositions in different village types. Author summary: Skin infections (tinea and scabies) are significant health concerns among the indigenous Negrito communities in Peninsular Malaysia. Given that there was only one documented study among Negrito communities previously, the present study enrolled 361 participants from eight Negrito categorised into resettled or inland villages in Peninsular Malaysia to update the epidemiological status and risk factors. We found a high overall skin infection prevalence of 35.6%. Scabies, tinea versicolor, and tinea imbricata accounted for 11.7%, 11.3%, and 7.5%, respectively with no co-infection. Higher prevalence was observed among resettled villages (55.2%) compared to inland villages (24.8%). Risk factor analysis among these Negrito communities identified different predictors associated with each type of infection, generally linked to the type of village category. We highlighted that scabies and tinea versicolor were more common in resettled communities. However, rare infection like tinea imbricata, which require high treatment compliance, was more localized in inland villages. Village-specific measures including regular medical interventions in inland villages and socio-economic aid to resettled communities to address urban/semi-urban poverty are essential, considering the existing predisposition of skin infections in different types of villages. [ABSTRACT FROM AUTHOR]

Background: The continuous emergence and spread of polymyxin-resistant Acinetobacter baumannii pose a significant global health challenge, necessitating the development of novel therapeutic strategies. Aloe, with its long-standing history of medicinal use, has recently been the subject of substantial research for its efficacy against pathogenic infections. Methods: This study investigates the potential application of anthraquinone components in aloe against polymyxin-resistant A. baumannii by liquid chromatography-mass spectrometry, in vitro activity assessment, and construction of animal infection models. Results: The findings demonstrate that aloe emodin, emodin, rhein, and their mixtures in equal mass ratios (EAR) exhibit strain-specific antibacterial activities against polymyxin-resistant A. baumannii. Co-administration of EAR with EDTA synergistically and universally enhanced the antibacterial activity and bactericidal efficacy of polymyxins against polymyxin-resistant A. baumannii, while also reducing the frequency of polymyxin-resistant mutations in polymyxinssensitive A. baumannii. Following toxicity assessment on human hepatic and renal cell lines, the combination therapy was applied to skin wounds in mice infected with polymyxin-resistant A. baumannii. Compared to monotherapy, the combination therapy significantly accelerated wound healing and reduced bacterial burden. Conclusions: The combination of EAR and EDTA with polymyxins offers a novel therapeutic approach for managing skin infections caused by polymyxinresistant A. baumannii. [ABSTRACT FROM AUTHOR]

Dermatomycoses are the most widespread fungal skin infections worldwide and directly affect patients' quality of life. They are challenging to manage because of the need for prolonged treatment and the development of resistance to antifungal agents. This article studies the antifungal activity of trifluoromethylthiolated cinnamate derivatives on Candida species and dermatophytes as well as possible mechanisms of action, irritability, and cytotoxicity tests. These molecules show activity against dermatophyte fungi with minimum inhibitory concentrations (MIC) as low as 0.39 μg mL−1. In particular, chloroaromatic derivatives demonstrated the best inhibition profile (1.56–6.25 μg mL−1). Importantly, our series of molecules were not active against Candida spp., being selective for dermatophytes. A study of the mechanism of action suggests that our SCF3 cinnamates do not bind directly to ergosterol or the cell wall. The physicochemical parameters and the absence of irritability resulting from the HET‐CAM test demonstrate that compound 8 can be considered a future candidate for the therapy of dermatophytosis. [ABSTRACT FROM AUTHOR]

Nowadays, there has been an increasing research interest into N-halamine compounds due to their wide antimicrobial properties and no drug resistance. Most of the research mainly focuses on small molecular N-halamines, while few studies are on macromolecule N-halamines. In this work, antibacterial N-halamine polymer materials based on proteins (GS-Cl) were synthesized with an antibacterial component of oxidative chlorine, a support component of a gelatin sponge. After carrying out systematic characterization, the GS-Cls exhibited well-defined porous morphology and had a high efficiency in the killing of Gram-positive bacteria (E. coli) and Gram-negative bacteria (S. aureus). The loading of oxidative chlorine (Cl+%) could be controlled by changing the NaClO concentrations and chlorination times. The biocompatibility was confirmed as well. In vivo experiments suggested that the GS-Cl sample could effectively promote the healing of skin wounds in mice E. coli and S. aureus infection models. These studies show that proteins can be chlorinated and endowed with antimicrobial properties, which has great application potential in the treatment of bacteria-infected wounds. [ABSTRACT FROM AUTHOR]

Background. Streptococcus pyogenes is the most frequent cause of pharyngitis and skin infections in children and causes immune complications like rheumatic fever and rheumatoid heart disease (RHD), particularly in developing countries like Ethiopia. The aim of this study was to determine the prevalence, antibiotic resistance pattern, and associated factors of Streptococcus pyogenes among pediatric patients suspected of acute pharyngitis in Sidama Region, Southern Ethiopia. Methods. A cross‐sectional study was conducted on 213 acute pharyngitis suspected pediatric patients from April to September 2022 at Hawassa University Compressive Specialized Hospital and Yirgalem Hospital. Sociodemographic and clinical data were collected using a structured questionnaire. A throat swab was cultured to isolate S. pyogenes, and antimicrobial susceptibility testing was done using standard bacteriological techniques. Data were analyzed using SPSS version 25, and P value of <0.05 was considered as statistically significant. Result. Out of 213 throat swabs cultured, 22 (10.3%) with 95% CI (6.6–14.6%) were S. pyogenes positive. All isolates of S. pyogenes were sensitive to penicillin and amoxicillin. In contrast, 8 (36.4%) isolates exhibited resistance to tetracycline, 7 (31.8%) to ceftriaxone, 6 (27.3%) to erythromycin, and 5 (22.7%) isolates showed multidrug resistance. The presence of palatal petechiae (P = 0.037) and tonsillar swelling or exudate (P = 0.007) were significantly associated with S. pyogenes carriage in children suspected of having acute pharyngitis. Conclusion. In this study, the prevalence of S. pyogenes among children suspected with acute pharyngitis was low compared to other studies. The isolates showed a high level of resistance to commonly used antibiotics. Therefore, the treatment of pediatric acute S. pyogenes pharyngitis should depend on an antimicrobial susceptibility test. Furthermore, evaluation of S. pyogenes pediatric acute pharyngitis risk factors and tracking of antibiotic resistance are crucial in the controlling of pediatric acute S. pyogenes pharyngitis. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Patients/Methods Results Conclusions The field of cosmetic filler injection has experienced rapid development over the past two decades, especially in facial augmentation utilizing hyaluronic acid (HA) fillers. Gram‐negative bacteria are found to be the main pathogens of infective nodules after HA injection. The occurrence of cutaneous infections attributed to Serratia marcescens is exceedingly rare and predominantly noted in patients with compromised immune systems.To summarize the clinical features, diagnosis, and treatment of subcutaneous infection caused by Serratia marcescens following hyaluronic acid injection.A rare case of cutaneous Serratia marcescens infection following hyaluronic acid injection was presented. A comprehensive review of the published literature describing the management of skin infection caused by S. marcescens in immunocompetent patients was then conducted, which encompassed three case series and eight case reports published between 1999 and 2017. Data extraction included information on authors, gender, age, signs and symptoms, previous treatment, corresponding management strategies, and follow‐up duration.Serratia marcescens were isolated in abscesses (n = 6, 35.29%), painful nodules (n = 2, 11.76%), ulcers (n = 6, 35.29%), and others (n = 3, 17.65%). In cases providing salvage plans (n = 11), quinolones were shown to be the most effective antibiotics for salvage, with eight full recoveries (72.73%), and trimethoprim‐sulfamethoxazole was the second most useful antibiotic (18.18%).With the help of pathogen examination and drug‐sensitive tests, sensitive aminoglycosides, quinolone (especially moxifloxacin), or TMP‐SMX for at least 2 weeks can be considered as the first‐line treatment of late subcutaneous infection caused by Serratia marcescens following hyaluronic acid injection. [ABSTRACT FROM AUTHOR]

Wound healing represents a complex biological process often hampered by bacterial infections, in particular those caused by Staphylococcus aureus, which is already multiresistant to many antibiotics. In this sense, enzybiotics have additional advantages over conventional antibiotics, since they provide pathogen specificity and do not contribute to antibiotic resistance. However, their soluble administration at the wound site would result in enzyme leakage. On the other hand, bacterial cellulose (BC) pellicles present a very promising dressing and scaffold, given its high purity, water retention capacity, and barrier effect in the wound against possible contaminants. In this study, we present a novel approach that incorporates the enzybiotic CHAPK into BC to develop functionalized membranes that exhibit targeted and controlled antimicrobial activity against S. aureus. The kinetic tests revealed a continuous loading of the enzybiotic into BC until it reaches a maximum and a two-stage release process, characterized by an initial fast release followed by a sustained release. Attenuated total Reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR), Scanning Electron Microscopy (SEM), and Confocal Laser Scanning Microscopy (CLSM) confirmed the incorporation and the preferential surface localization of CHAPK within the BC membranes. Finally, the BC/CHAPK materials demonstrated the sustained reduction of up to 4 logarithmic units in the viability of S. aureus. Overall, the biomaterials developed here exhibit promising antimicrobial efficacy against S. aureus, offering a potential strategy for wound management and skin infection control while maintaining unharmed the commensal skin microbiota, which impairment could compromise the integrity of the skin barrier function. [ABSTRACT FROM AUTHOR]

Background: Cutaneous infectious granulomas (CIG) are localized and chronic skin infection caused by a variety of pathogens such as protozoans, bacteria, worms, viruses and fungi. The diagnosis of CIG is difficult because microbiological examination shows low sensitivity and the histomorphological findings of CIG caused by different pathogens are commonly difficult to be distinguished. Objective: The objective of this study is to explore the application of mNGS in tissue sample testing for CIG cases, and to compare mNGS with traditional microbiological methods by evaluating sensitivity and specificity. Methods: We conducted a retrospective study at the Department of Dermatology of Sun Yat-sen Memorial Hospital, Sun Yat-sen University from January 1st, 2020, to May 31st, 2024. Specimens from CIG patients with a clinical presentation of cutaneous infection that was supported by histological examination were retrospectively enrolled. Specimens were delivered to be tested for microbiological examinations and mNGS. Results: Our data show that mNGS detected Non-tuberculosis mycobacteria, Mycobacterium tuberculosis, fungi and bacteria in CIG. Compared to culture, mNGS showed a higher positive rate (80.77% vs. 57.7%) with high sensitivity rate (100%) and negative predictive value (100%). In addition, mNGS can detect more pathogens in one sample and can be used to detect variable samples including the samples of paraffin-embedded tissue with shorter detective time. Of the 21 patients who showed clinical improvement within a 30-day follow-up, eighteen had their treatments adjusted, including fifteen who continued treatment based on the results of mNGS. Conclusions: mNGS could provide a potentially rapid and effective alternative detection method for diagnosis of cutaneous infectious granulomas and mNGS results may affect the clinical prognosis resulting from enabling the patients to initiate timely treatment. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus spp. are widely distributed in nature and can cause nosocomial, skin infections, and foodborne illness, and it may lead to severe financial losses in birds by causing systemic infection in numerous organs. Aim: This study was conducted to determine the prevalence of Staphylococcus spp. in humans and birds in Baghdad city. Methods: Seventy-six oral cavity swabs were collected, including 41 from birds and 35 from breeders. All samples were examined by bacteriological methods and identified by using the VITEK technique, the samples were then further studied to test the ability of biofilm formation, and multidrug-resistant (MDR) factors and MAR index were tested with the use of seven antibiotics. Results: Among the 76 oral swabs, 37 samples were positive (48.68%) for Staphylococcus spp.: 7 human samples (20%) and 30 bird samples (73.17%). In humans, Staphylococcus lentus was the most prevalent (42.85%) followed by Staphylococcus aureus (28.57%), Staphylococcus hominis and Staphylococcus sciuri were at (14.29%) to each. In birds, Staphylococcus pseudintermedius, Staphylococcus gallinarum, S. lentus, Staphylococcus haemolyticus, Staphylococcus spp, S. sciuri, and Staphylococcus xylosus were detected in 36.67%, 16.67%, 10%, 10%, 13.33%, 3.33% and 3.33%, respectively. Staphylococcus isolates from the human samples demonstrated that only S. lentus was resistant 33.33% to ME, OX, and SXT. Furthermore, one of them was MDR and high MAR index value. The antimicrobial pattern of Staphylococcus spp. isolated from birds was as follows S. pseudintermedius isolates demonstrated 100% resistance to CN, CIP, SXT, and MDR (100%) and high MAR indices value; S. xylosus was resistant 100% against ME, CN, SXT, and Do and it was MDR with high MAR index; S. lentus was resistant 25% against ME, OX, C, and SXT, whereas, S. gallinarum was resistant 33.33% against ME and OX. The results demonstrated that biofilm formation of the Staphylococcus spp. isolated from human samples were weak biofilm formers: S. lentus, S. hominis, and S. aureus, while other S. aureus (50%) was moderate. In birds, the majority of the isolates had non-biofilm-producing capabilities, while 80% of S. lentus and 100% of S. xylosus showed moderate biofilm formation. Conclusion: Healthcare problem was observed in this study due to high MDR and MAR index among Staphylococcus spp. isolated from pet birds to their owners and vice versa. [ABSTRACT FROM AUTHOR]

Background: The most typical dermatologic disorders worldwide include tinea infections. Skin ringworm infections, such as tinea corporis and tinea cruris, are caused by Trichophyton rubrum, Epidermophyton, and Microsporum canis. These are the main dermatophytes responsible for tinea. Red, scaly, itchy, and growing lesions should be tinea. It is most seen in males compared to females. All skin illnesses are categorized in Ayurveda as Kushta Roga (skin diseases), while Dadru Kushta (tinea) has a connection to the diseases caused by fungi. The illness has aggravated Pitta and Kapha dosha. The line of treatments for these illnesses includes palliative, purificatory intervention, and peripheral biocleansing procedures. However, in this case, we utilize palliative, mild laxative, and peripheral biocleansing procedures. Here, mild laxatives act as purificatory therapy to treat the illness. Purpose: To study the effect of Ayurvedic intervention in the management of tinea (Dadru). Methods: In this case report, a 41-year-old male patient receives Ayurveda treatment after 2 months of experiencing relief from ring-like patches, discoloration, and itching in the groin, upper back, and upper and lower thighs. He is diagnosed by presenting clinical symptoms, and pathological examination is the specific tool for diagnosis of fungal infection. Results: Significant improvements were seen in the parameters, including increased circular skin lesions, eruptions, erythema, and itching. He experienced 70% relief. Conclusion: Treated with the Ayurveda line of treatment is the best tinea infection treatment. [ABSTRACT FROM AUTHOR]

Skin and soft-tissue infections require significant consideration because of their prolonged treatment duration and propensity to rapidly progress, resulting in severe complications. The primary challenge in their treatment stems from the involvement of drug-resistant microorganisms that can form impermeable biofilms, as well as the possibility of infection extending deep into tissues, thereby complicating drug delivery. Dissolving microneedle patches are an innovative transdermal drug-delivery system that effectively enhances drug penetration through the stratum corneum barrier, thereby increasing drug concentration at the site of infection. They offer highly efficient, safe, and patient-friendly alternatives to conventional topical formulations. This comprehensive review focuses on recent advances and emerging trends in dissolving-microneedle technology for antimicrobial skin-infection therapy. Conventional antibiotic microneedles are compared with those based on emerging antimicrobial agents, such as quorum-sensing inhibitors, antimicrobial peptides, and antimicrobial-matrix materials. The review also highlights the potential of innovative microneedles incorporating chemodynamic, nanoenzyme antimicrobial, photodynamic, and photothermal antibacterial therapies. This review explores the advantages of various antimicrobial therapies and emphasizes the potential of their combined application to improve the efficacy of microneedles. Finally, this review analyzes the druggability of different antimicrobial microneedles and discusses possible future developments. [ABSTRACT FROM AUTHOR]

In this study, we aimed to examine the relationship between the serum cytokine levels of patients with pemphigus vulgaris (PV) and the Pemphigus Disease Area Index (PDAI), along with the presence of anti‐desmoglein (Dsg) 1 antibody, anti‐Dsg3 antibody and co‐infection among patients with pemphigus vulgaris. This retrospective study included 62 PV patients and 59 healthy individuals who attended the Second Affiliated Hospital of Kunming Medical University from November 2014 to November 2022. The serum concentrations of cytokines and chemokines were assessed using the Luminex 200 System (a high‐throughput cytokine detection method). Additionally, anti‐Dsg1 and anti‐Dsg3 antibodies were determined through enzyme‐linked immunosorbent assay, while disease severity was evaluated using the PDAI scoring system. The PV group exhibited elevated levels of Th1 cytokines (such as interleukin (IL)‐1RA, IL‐1β, IL‐2, IL‐12p70, GM‐CSF, TNF‐α, IL‐18, IFN‐γ), Th2 cytokines (IL‐5, IL‐10, IL‐13) and Th17/Th22‐related cytokines (IL‐17A, IL‐22) compared to the healthy control group (p < 0.05). Conversely, the levels of chemokines (macrophage inflammatory protein‐1 alpha (MIP‐1α), stromal cell‐derived factor‐1 alpha (SDF‐1α), interferon‐inducible protein‐10 (IP‐10), Regulated on Activation in Normal T‐Cell Expressed And Secreted (RANTES), growth‐regulated on‐gene‐alpha (GRO‐α), MIP‐1β) and Th2 (IL‐31) were lower in the PV group compared to the healthy control group (p < 0.05). No significant differences were observed in other cytokines and chemokines (p > 0.05). Additionally, IL‐7, IFN‐γ, IL‐18 and GRO‐α showed positive correlations with PDAI, IL‐6 correlated positively with anti‐Dsg3 antibody levels, and IL‐12p70, IL‐18, and IFN‐γ correlated positively with anti‐Dsg1 antibody levels. Furthermore, IL‐15 exhibited a positive association with skin infections. PV patients have elevated levels of various cytokines and chemokines, and there are different degrees of elevation in cytokines and chemokines associated with the activation of various T cell subsets. PDAI and the Dsg1 antibody levels are mainly related to the Th1‐related cytokines. [ABSTRACT FROM AUTHOR]

Background: Chromoblastomycosis (CBM) is a chronic infection of skin and subcutaneous tissue. CBM cases have been reported in local literature from Pakistan with heterogenous demographic, diagnostic and therapeutic information. The objective of this study is to share the experience of CBM from a large tertiary care hospital laboratory in Pakistan. Method: This was a retrospective observational study. Histopathology and microbiology data of suspected CBM between 2016 and 2022 was retrieved. Patients' demographics, site of involvement, histopathological findings and positive microbiology cultures were assessed. Literature search on Google Scholar, PubMed and PakMediNet was done between 1990 and 2023 with multiple terms. Result: A total of 16 CBM cases were identified; 14 were histopathology positive and two were both histopathology and culture positive. The median age was 21 years, and 11 patients were male. The predominant site was lower extremities followed by the face. Severe acanthosis, hyperkeratosis and granuloma with sclerotic bodies were observed in all histopathology slides. Alternaria spp. and Phialophora spp. were isolated from two culture‐positive cases. A total of nine cases of CBM were reported from Pakistan in PubMed non‐indexed journal. Conclusion: CBM is not a commonly thought of disease when evaluating skin lesions in Pakistan. A high index of suspicion when assessing patients who may have a history of trauma, exposure to soil and suggestive lesions is reasonable. An integrated approach between clinicians, histopathologist and microbiologist is required to do early identification and therapeutic interventions. [ABSTRACT FROM AUTHOR]

Objective: To determine the antibiotic spectrum of deep skin and soft tissue infections in Pakistan. Study Design: Cross-sectional study. Setting: Department of Dermatology at Madinah Teaching Hospital, Faisalabad. Period: June, 2023 to December 2023. Methods: Inclusion criteria covered consenting patients aged 15-60, excluding those with specific conditions. The study aimed to ascertain antibiotic sensitivity patterns in deep skin and soft tissue infections. Ethical approval was obtained, and subjects meeting criteria were enrolled after informed consent, contributing valuable insights into healthcare-associated infections. Results: Examining 60 patients, the age distribution indicates a prevalent cohort up to 50 years (61.7%), highlighting potential health concerns in earlier years. Those above 50 constitute 38.3%, signifying distinct challenges in older age. With 61.7% males, Gram stain analysis reveals microbial diversity. Notably, Ciprofloxacin (90%) and Cefipime (98.3%) exhibit high resistance, while Cephradine (48.3%) and Cefoxitin (20%) show sensitivity. Meropenem and Vancomycin display moderate resistance (28.3% and 25%), while Tigecycline (10%) and Teicoplanin (1.7%) exhibit lower resistance, offering insights for effective treatment strategies. Conclusion: Our study reveals notable antibiotic resistance, with Ciprofloxacin (90%) and Cefipime (98.3%) exhibiting high resistance. Conversely, Cephradine (48.3%) and Cefoxitin (20%) show sensitivity, guiding tailored treatment strategies for deep skin and soft tissue infections. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus (S. aureus) is a very common human pathogenic microorganism that can cause a variety of infectious diseases, including skin and soft tissue infections, endocarditis, osteomyelitis, bacteremia, and lethal pneumonia. About one-third of the common population is colonized with S. aureus. MRSA is a formidable pathogen known to cause high mortality & morbidity, that poses a significant threat to public health worldwide. Presence of MRSA strains, resistant to multiple antibiotics especially in hospital stay, has complicated the management of infections caused by this bacterium. The aim of this study was to shed light on the prevalence and antimicrobial sensitivity pattern of MRSA among patients in a tertiary care center located in Faridabad, Haryana. This cross-sectional observational study was conducted in the Department of Microbiology, ESIC Medical College & Hospital, a 510 bedded tertiary care teaching hospital in Faridabad, Haryana, India. All wound samples including pus, exudates, wound swab and tissue samples received for aerobic culture and antimicrobial sensitivity from various clinical departments from January 2019 to July 2019 were included in this study. A total of 747 samples were received from January 2019-July 2019. Mean age of this study population was found to be 50.7 ± 14.8 years. Out of 747 samples, 226 (30.25%) were culture positive. Among the S. aureus isolates, methicillin resistance was seen amongst 39 (58.2%). Antibiotic Susceptibility results of S. aureus showed 100% resistance to Penicillin along with 100% resistance to Fluoroquinolones in both MRSA and MSSA. High prevalence of MRSA amongst patients highlights the importance of continued surveillance and implementation of antimicrobial stewardship program to control the menace of antimicrobial resistance. Strict adherence to Infection Control practices its regular follow up to assess the effectiveness of any hospital infection control measures taken is the key. [ABSTRACT FROM AUTHOR]

Background Fosfomycin is gaining increasing attention for its activity against MDR or XDR pathogens. Currently, IV fosfomycin is a potential option for treating various infections, including urinary tract infections, pneumonia and skin infections when first-line treatments fail. Objectives To evaluate the demographic, clinical, microbiological and treatment modality of children received IV fosfomycin to treat infections caused by MDR pathogens since there are few data on the use of fosfomycin in children. Methods This study was conducted retrospectively with patients under 18 years of age who were treated with IV fosfomycin for at least 72 h due to infections caused by MDR pathogens between January 2019 and October 2023 at Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye. Data on demographic and clinical features, microbiological findings, treatment modalities and side effects were evaluated. Results Twenty-five children, for a total of 32 cases of infection episodes, with a mean age of 11.4 ±   3.92 years who received IV fosfomycin were included. The most frequent comorbidity was chronic pulmonary diseases, and the most common infection needed for IV fosfomycin was MDR Pseudomonas aeruginosa pneumonia. In all cases, fosfomycin was administered in combination with other antibiotics, mainly meropenem–colistin (68.7%) or meropenem (15.6%). Twenty-two (71.9%) cases had favourable clinical responses at the end of therapy. Conclusions Our results suggest that IV fosfomycin may be an effective treatment option for MDR pathogens in the paediatric population. Nevertheless, careful stewardship is necessary to maintain efficacy and reduce antimicrobial resistance selection risk. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus causes a spectrum of ailments, from slight skin infections to severe infections due to its virulence and antibiotic resistance. Developing new antibacterial and antibiofilm drugs is crucial for combating S. aureus infections. Increasing the bioactivity of compounds by biotransformation is a potential strategy. Rhizopus oryzae was employed to convert proximadiol (1) into pterocarptriol (2) with a satisfactory yield of 47 % (w/w). The antibacterial and antibiofilm actions of 1 and 2 were evaluated against S. aureus clinical isolates. The produced metabolite (2) showed superior antimicrobial activity with MIC values (32–128 µ g/mL) compared to that of the substrate (1) (128 to 1024 µ g/mL). It also demonstrated higher antibiofilm activity by the crystal violet assay than the substrate (1), as evidenced by the reduction of the percentages of strong and moderate biofilm forming strains from 88.89 % to 38.89 % and 66.67 %, respectively. Furthermore, the metabolite (2) has been shown to downregulate biofilm-related genes (ica A, fnb A, and cna) in a broad range of S. aureus clinical isolates compared to the substrate (1) using qRT-PCR. The antibacterial and antibiofilm activity was remarkably enhanced in pterocarptriol compared to proximadiol. Yet, future studies are needed to benefit from the antibacterial and antibiofilm activities of these compounds. [Display omitted] • Developing new antibacterial and antibiofilm drugs against S. aureus infections is crucial. • Rhizopus oryzae was used to transform proximadiol into pterocarptriol with a satisfactory yield. • The activity of substrate and metabolite was tested against a range of S. aureus clinical isolates. • Pterocarptriol showed enhanced antibacterial and antibiofilm activities. • Pterocarptriol showed abilities to downregulate the biofilm-related genes (icaA, fnbA , and cna). [ABSTRACT FROM AUTHOR]