New Microbiologica最新文献

Sexually transmitted infections (STIs) continue to pose a major public health challenge and have profound social, economic and health impacts. These infections, which are caused by a variety of bacteria, viruses and parasites, are primarily transmitted through sexual contact, but can also be passed from mother to child during childbirth or through contaminated needles and blood products. Despite advances in medicine and public health, the prevalence of STIs continues to rise, fueled by factors such as stigma, limited access to sexual health services, and evolving pathogens. This review will examine the global burden of STIs and highlight their prevalence and impact on different populations. It will discuss some of the diagnostic challenges that hinder the effective management and control of these infections. It will also discuss the wider public health implications, including the economic costs, and identify emerging challenges and potential strategies to mitigate their impact.

Candiduria is a common problem especially in advanced stage oncology/hematology cases. Herein, we aimed to analyze the efficacy of caspofungin treatment in Candida auris isolated from urine culture. We conducted an observational retrospective study in a tertiary-care educational hemato-oncology hospital from October 2021 to November 2022. The patients hospitalized in our center and having at least two consecutive urine cultures that yielded C. auris with significant pyuria were included in the study. The effectiveness of caspofungin was evaluated based on clinical and microbiological outcomes. In total, 10 patients (two female, aged 55.3 ± 15) were included in the study. Four (40%) patients had urinary tract infections, and six (60%) patients had asymptomatic C. auris candiduria which required antifungal therapy. Nine cases had urinary instrumentation: two nephrostomy, one suprapubic catheter, and six urinary catheters. The 10 cases received a mean of 13.4 ± 3.5 days of caspofungin. Four of 10 cases (40%) had at least 1 negative culture between day 1 and the end of caspofungin treatment. Relapse and re-infection rates 30 days after the end of therapy in microbiologically successful cases were 3/4 and 2/4. Caspofungin resistance developed in three cases (30%) within 30 days after treatment. Overall day-30 mortality was 3/10 (30%) while overall success (microbiological success + no relapse/reinfection during 30 days follow up after end of therapy) was 10%. Caspofungin demonstrated limited efficacy in treating C. auris-related urinary tract infection/colonization in hospitalized cancer patients.

Acute respiratory infections (ARIs) are among the most common infections, with variable etiology, affecting both community and hospital settings. Vulnerable populations include children, the elderly, and patients with chronic debilitating disease. Early identification of the causative pathogen can reduce inappropriate empirical antibiotic therapy, particularly in viral infection cases, which are the leading cause of ARIs, especially in outpatient settings. Rapid molecular diagnostic methods such as FilmArray Respiratory Panel (FA RP) enable the prompt identification of viral and bacterial pathogens. A retrospective observational study was conducted at Santa Maria Goretti Hospital in Latina, Italy, from January 1, 2022, to April 30, 2023. A total of 232 nasopharyngeal swabs from patients were analyzed using the BioFire FA RP. Eligible patients exhibited fever, cough, or other symptoms suggestive of respiratory infection. The test distribution shows that the Pediatric and Neonatology Units had the highest number of tests and a high proportion of clinically relevant outcomes. The findings underscore the effectiveness of the FA RP in swiftly identifying pathogens, significantly reducing diagnostic turnaround times, and minimizing unnecessary antibiotic prescriptions. The 38% rate of negative tests highlights the importance of appropriate test prescription based on clinical assessment.

To understand the resistance phenotype and the carriage of resistance genes in carbapenem-resistant Serratia marcescens in our hospital. Two S. marcescens clinical isolates were analyzed retrospectively to determine their sensitivity to 27 antimicrobial agents using the BD Phoenix™ M50 System (Becton, Dickinson and Company, Franklin Lakes, NJ, USA) and Kirby-Bauer disk diffusion method (Oxoid, Hampshire, UK). Whole-genome sequencing of both strains was performed using the Illumina platform. ABRicate software was used to predict the resistance genes and plasmid replicon types carried by the strains. Sequence type (ST) analysis was performed using multilocus sequence typing. A phylogenetic tree was constructed, and homology analysis was conducted by comparing the two strains with 106 blaKPC-2-carrying carbapenem-resistant S. marcescens isolates downloaded from the NCBI database. Two S. marcescens strains were isolated from the sputum samples of patients with lower respiratory tract infections after ICU surgery. Antimicrobial sensitivity testing revealed that both strains were resistant to antimicrobial agents, including β-lactams, sulfonamides, and carbapenems, whereas they were susceptible to tigecycline and ceftazidime/avibactam. In total, 12 resistance genes were predicted, with both WF0070 and WF0071 carrying the carbapenem resistance gene blaKPC-2. Among the remaining resistance genes, the aminoglycoside resistance genes were most commonly predicted, with five types identified. The two strains in this study and the 106 blaKPC-2-carrying carbapenem-resistant S. marcescens isolates downloaded from NCBI were divided into five evolutionary groups, and both strains in this experiment were categorized into clade E. Meanwhile, 18 STs were predicted, and both strains in this study belonged to ST366. In terms of phylogenetic relationships, these strains exhibited high homology with a strain isolated in France in 2018. The two S. marcescens strains in this study displayed high resistance to multiple antimicrobial agents, and both carried the carbapenem resistance gene blaKPC-2 along with several other resistance genes. The two strains displayed close phylogenetic relationships, and the possibility of nosocomial transmission cannot be dismissed.

We investigated CMV DNA pulmonary viral loads in adults in asymptomatic patients without classic immunosuppressive conditions undergoing bronchoalveolar lavage (BAL) for screening non-acute, non-infectious pulmonary diseases with a six-month follow-up. Over 31 months, 73 out of 352 BAL samples (20.7%) tested positive, with wide viral load variability (median 829 copies/mL, IQR 1457 copies/mL). None of the patients received antiviral treatment or developed CMV-related disease during follow-up. Nine patients died during follow-up. Patients presented a range of risk factors, and none was associated with higher VL. These findings suggest that CMV pulmonary behavior deserves further attention across various populations.

Eravacycline, a novel synthetic fluorocycline, exhibits broad-spectrum antimicrobial activity against multidrug-resistant (MDR) Gram-positive, Gram-negative, and anaerobic bacteria, making it a promising option for complicated intra-abdominal infections (cIAI). Engineered to overcome common tetracycline resistance mechanisms, eravacycline has demonstrated efficacy in vitro against MDR pathogens, including carbapenem-resistant Enterobacterales and Acinetobacter baumannii. Clinical trials (IGNITE1 and IGNITE4) established its noninferiority to carbapenems in treating cIAI, with comparable clinical cure rates but higher adverse gastrointestinal events. This retrospective study evaluates real-world eravacycline use in 13 hospitalized patients treated for complicated infections at a single center between April 2023 and August 2024. Data collected include patient demographics, infection characteristics, microbiological profiles, antibiotic regimens, and clinical outcomes. The clinical cure rate was 69.2%, with a mortality rate of 38.5%. Resistance mechanisms such as VIM-producing Klebsiella pneumoniae and Enterobacter cloacae and inadequate source control were prevalent among non-survivors. Most patients received combination therapy, primarily with beta-lactams. One suspected case of drug-induced hepatotoxicity was observed. Our findings align closely with previous case series, underscoring eravacycline's efficacy in MDR infections. However, limitations such as small sample size and retrospective design warrant further controlled studies to refine its role in complex infections beyond cIAI.

Staphylococcus aureus, commonly colonizing the mucous membranes and skin of humans, is a prevalent pathogen responsible for Skin and Soft Tissue Infections (SSTIs), with a notably high prevalence of methicillin-resistant Staphylococcus aureus (MRSA). The antimicrobial resistance profiles of MRSA vary across different regions, with differences in population structure and epidemiological characteristics over time and geography. Molecular typing is frequently employed to investigate the population structure and transmission features among strains. The purpose of this study is to investigate the molecular epidemiological characteristics, virulence genes, and drug resistance of MRSA isolated from patients with skin and soft tissue infections in the Shaoxing region. Seventy-seven MRSA strains isolated from patients with SSTIs in the Shaoxing area from 2017 to 2022 were subjected to drug sensitivity testing using the VITEK 2 Compact fully automated system. The study utilized next-generation sequencing to conduct Staphylococcal Chromosome Cassette mec (SCCmec) typing, Staphylococcal Protein A (SPA) typing, Multilocus Sequence Typing (MLST), and investigate virulence genes in MRSA strains. The variations in antimicrobial resistance, virulence genes, and molecular typing among different genders and age groups were analyzed. The findings revealed that the resistance rate of MRSA to penicillin was 100%, while it was 61.04% for erythromycin and 59.74% for clindamycin. The resistance rate to other antibiotics was below 20%. MLST typing is mainly dominated by ST59 (22.08%) and ST398 (18.18%), while SCCmec typing is predominantly represented by IV (38 strains) and V (27 strains). SPA typing is mainly characterized by t437 (19.48%) and t34 (14.29%). The major clones of SSTIs in the Shaoxing area are ST59-t437-IV and ST398-t34-V. The strains carry 17 enterotoxin genes, with the highest detection rates found in sek and seq (32.47%), PVL (12.99%), and tst (7.79%).This study demonstrates that skin and soft tissue infections in the Shaoxing region are caused mainly by ST59-t437-IV and ST398-t34-V strains, which carry multiple virulence genes. PVL is identified as a significant virulence factor in MRSA strains.

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant public health concern due to its resistance to commonly used antibiotics. Its prevalence varies widely across different regions and healthcare settings. This study aimed to determine the prevalence of MRSA among patients hospitalised at King Fahad Specialist Hospital in Al Qassim City, Saudi Arabia, and identify the distribution of MRSA across various demographics and healthcare settings. This cross-sectional, hospital-based study involved 10,936 patients (63.6% male, 36.4% female), with ages ranging from infants (1-10 years) to older adults (≥88 years). The prevalence of MRSA was determined through clinical samples, and isolates underwent antibiotic sensitivity testing. The overall prevalence of MRSA was 25.3%. High MRSA prevalences were observed in wound infections (35.6%), nasal swabs (14.0%), and aerobic blood cultures (10.6%). Antibiotic sensitivity testing showed that 72.2% of samples were sensitive to the tested antibiotics, while 27.0% were resistant to antibiotics like Amikacin, Aztreonam, Cefepime, and various carbapenems. The mortality rate was 17.4% in the study population during the study period. These findings underscore the need for enhanced infection control measures, targeted antibiotic stewardship programs, and continuous surveillance to effectively manage and reduce MRSA infections.

The treatment landscape for HIV is rapidly evolving, particularly with the advent of two-drug regimens (2DR). Traditionally, three-drug regimens (3DR) have been the standard, providing effective treatment but often at the cost of tolerability and increased pill burden. Recent studies demonstrate that 2DR can achieve non-inferior virological suppression compared to 3DR, while potentially offering enhanced safety and reduced long-term drug exposure. This review evaluates the current evidence on the efficacy and safety of dolutegravir (DTG) plus lamivudine (3TC) in both adult and pediatric populations. The pediatric population presents unique challenges due to complexities in treatment adherence and limited available options, underscoring the urgency for effective treatments tailored to their needs. Emerging data from ongoing clinical trials highlight the potential of DTG/3TC to maintain viral suppression with fewer side effects and improve treatment adherence through simplified regimens. The review highlights the need for further research to support the use of 2DR in children and adolescents, particularly regarding long-term safety and efficacy. With increasing focus on quality of life and affordability, the integration of 2DR into pediatric HIV care may represent a critical advance in improving treatment outcomes for this vulnerable population and warrants continued clinical investigation and careful implementation into practice.

Central nervous system infections are recognized as a serious complication in patients, particularly in those with external ventricular drains. Here, we report the case of a 76-year-old woman who presented with nausea, dizziness, and cerebral discomfort following meningioma resection surgery and subsequent external ventricular drain placement. Perioperative ceftriaxone was initiated. During her stay in the intensive care unit, the patient developed a loss of consciousness and respiratory distress, necessitating reoperation for ventricular drain placement. Initial cerebrospinal fluid (CSF) analysis revealed no white blood cells or bacteria, and the first CSF culture showed no growth. However, the patient's respiratory failure and oxygen desaturation progressively worsened. Escherichia coli was detected in deep tracheal aspirate culture, prompting a revision of treatment to piperacillin-tazobactam. Subsequently, Gram-negative coccobacilli were detected in the CSF, which was inoculated into blood culture bottles, yielding a positive signal within three hours. Multiplex PCR analysis using the Biofire BCID-2 sepsis panel identified Acinetobacter baumannii and Klebsiella pneumoniae, both harboring carbapenemase genes (OXA-48 and CTX-M in A. baumannii, KPC in K. pneumoniae). Identification and antibiotic susceptibility testing were performed using Vitek-2 and conventional disc diffusion methods. Urgent intraventricular colistin, in combination with meropenem administered by prolonged infusion, was initiated. This antibiotic regimen successfully eradicated the bacteria from the CSF. Despite microbiological clearance, the patient succumbed to systemic hypotension, worsening oxygen saturation, and uncontrolled complications of diabetes. This case underscores the critical risk of central nervous system infections caused by A. baumannii and K. pneumoniae in patients undergoing neurosurgical procedures, particularly those involving external ventricular drains. Moreover, it highlights the importance of vigilant postoperative monitoring and a multidisciplinary approach in managing complex complications following posterior fossa meningioma surgery.