New Microbiologica最新文献

A dysbiotic cervicovaginal microbiota, characterized by the overgrowth of anaerobic bacteria, leads to bacterial vaginosis, known to increase the risk of acquiring sexually transmitted infections. The present umbrella review aims to summarize evidence from systematic reviews and meta-analyses on how cervicovaginal microbiota changes in relation to preventable sexually transmitted infections of public health importance, namely Chlamydia trachomatis, Neisseria gonorrhoeae, and human papillomavirus. The databases PubMed, Scopus, and Web of Science were searched with the following strategy: ((chlamydia trachomatis) OR (treponema pallidum) OR (HPV) OR (neisseria gonorrhoeae)) AND (((microbio*) OR (metagen*)) AND (genital)); a total of 12 studies were included. Overall, this umbrella review highlighted that a highly diverse cervicovaginal microbiota has been associated with C. trachomatis infection and can be considered a risk factor in pre-cancerous lesions/cervical cancer related to high-risk HPV infections, whereas the role of cervicovaginal microbiota in N. gonorrhoeae infection is still unclear. In conclusion, specific microbial profiles associated with a high risk for each sexually transmitted pathogen have not yet been identified, and, in the future, more advanced multi-omics approaches will be helpful to clearly describe the etiopathogenetic relationships between resident microorganisms and genital conditions.

Multidrug-resistant Acinetobacter baumannii is an important pathogen causing healthcare-associated infections. The onset of Pan Drug Resistant (PDR) strains of A. baumannii, which are also resistant to colistin due to its excessive consumption, makes these strains difficult to eradicate. The appearance of new aggressive phenotypes among sentinel microorganisms in the control of healthcare-associated infections (HAI) requires the molecular approach to define a database of local nosocomial strains. Whole Genome Sequencing (WGS) is a useful tool to monitor the emergence of new aggressive bacterial phenotypes among sentinel microorganisms for the control of HAI. We describe a case report of colistin-resistant A. baumannii strain isolated from a blood-stream infection and evaluate the presence of antibiotic resistance genes (ARGs) by whole-genome sequencing (WGS). A colistin-resistant, PDR A. baumannii strain was isolated from blood cultures, bile fluid and wound in a patient with bacteremia in "Santa Maria delle Grazie Hospital" , Pozzuoli Italy. The strain was characterized by both biochemical and Whole Genome Sequencing (WGS) analysis. We identified a colistin-resistant strain of A. baumannii from a human bloodstream infection. WGS results were integrated with diagnostic procedures for a better characterization of the co-occurrence of several distinct antibiotic resistance mechanisms.

This case report underscores the complexities in managing fungal keratitis caused by Scedosporium apiospermum, even in an immunocompetent patient. The pathogen's resistance to many antifungal agents, its ability to invade deep ocular structures, and the presence of posterior chamber involvement added to the treatment challenges. Effective management requires not only timely diagnosis and targeted antifungal therapy, such as voriconazole, but also careful consideration of adjunctive treatments like corticosteroids and surgical interventions to address inflammation and posterior chamber involvement. In such cases, timely diagnosis is critical. Given the challenges associated with accurate identification through routine mycological diagnostic methods and the limitations of reference spectral libraries for MALDI-TOF MS, the prompt application of molecular techniques should be regarded as the gold standard for Scedosporium spp. typing in instances of clinical suspicion. This approach facilitates rapid and targeted therapeutic interventions.

Refractory Mycoplasma pneumoniae pneumonia (RMPP) has been reported to be a common cause of bronchial malformations, shortness of breath, and dyspnea in children in recent years. With improvement in diagnosis and treatment, the incidence of RMPP is increasing. It has been reported that some patients develop resistance to macrolide antibiotics, in which the mechanism of action is complex and the treatment is harsh. Two children with RMPP underwent rapid progression 1 week after onset to acute respiratory distress syndrome. Ventilator-assisted ventilation was initiated and fiberoptic bronchoscopy was performed to assist in diagnosis and treatment. The treatment regimens were adjusted according to the rapid changes in status. The two children were cured and discharged from the hospital in stable condition.

Rift Valley fever virus (RVFV) is a zoonotic arbovirus that causes significant infectious diseases in humans and in a wide array of domestic livestock. A notable epidemic of RVFV occurred in Saudi Arabia and Yemen in 2000, resulting in severe public health ramifications and high mortality rates among both human and animal populations. Despite the urgency of the situation, no approved vaccine or specific antiviral treatment for human use has been developed to date. There are currently no commercially available ELISA assays for RVFV. This study aims to develop an in-house ELISA utilizing purified recombinant nucleoprotein (NP) of RVFV. A total of 232 serum samples from slaughterhouse workers were employed to optimize this assay, which was validated against the SNT. The developed assay demonstrated a specificity of 96.64% and a sensitivity of 100% with a cut-off value of 0.36 when using the in-house RVFV-NP as the coating antigen. In comparison, a commercially available RVFV-NP-based ELISA exhibited a specificity of 96.23% and a sensitivity of 100% with a cut-off value of 0.37. Furthermore, the absorbance values of positive samples showed a significant correlation with their corresponding SNT titers. The in-house ELISA developed in this study offers a robust diagnostic and screening tool for RVFV. It provides a valuable mechanism for early detection, surveillance, and control of RVFV infections, thereby contributing to effective management and prevention of future outbreaks.

Infective endocarditis (IE) is a fatal disease caused by a wide range of pathogens, with a strong prevalence of Gram-positive bacteria. In this paper we describe two peculiar cases of Cardiobacterium spp. endocarditis in young men. These case reports emphasize the insidious clinical presentation of HACEK IE and lead to a brief review of the literature and discussion on this uncommon cause of infective endocarditis. One case is a man with a prior diagnosis of myxomatous mitral valve, presenting with neurological symptoms and a mycotic aneurysm of the right anterior cerebral artery. The second case was a man with no prior medical history, presenting with fever, lumbar and right-leg pain, which led to a diagnosis of atrial myxoma. The presence of congenital cardiac malformations and an insidious onset with early presentation but unusual or non-specific symptoms are evidenced with a high prevalence in this group of patients. The diagnostic workup including cultural examinations are analyzed in the discussion. We noticed, in accordance with recent literature, a time to positivity of blood cultures longer than for typical agents, but mostly inferior to 5 days. The majority of the reported cases went to surgery, while therapeutical regimens alternative to cephalosporins, especially quinolones, are recently gaining interest. While mortality rates are lower than those observed in other cases of IE, Cardiobacterium spp. IE is characterized by a high burden of complications, leading to an often-atypical presentation.

Clinical trials of triple regimen bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) demonstrated potent efficacy and favorable safety in both antiretroviral therapy-naïve and -experienced people living with HIV (PLWH), in association with a low risk of drug-drug interactions (DDIs), but data about older people are still lacking. This retrospective cohort study evaluated records from suppressed PLWH aged ≥60 years and who switched to BIC/FTC/TAF. One hundred and nine patients were included: median age was 67.2 years (range, 60-81) and 82% were men. The most common reasons for switch were DDIs (in 66% of cases), followed by simplification (51.3%), and toxicity (26.6%). Overall, 139 potential DDIs between antiretroviral drugs and other concomitant agents were registered in 72 individuals. The most common DDIs included statins in 45 cases (33%), antidepressants in 27 (19%), cardiologic drugs in 23 (17%), proton pump inhibitors in 15 (11%), and benzodiazepines in 12 (9%). After the switch to BIC/FTC/TAF, the number of potential DDIs decreased significantly (from 139 to 18, -87%; p<0.001). The median DDI score also decreased significantly after the switch (from 0.64 to 0.14, -78%; p<0.001). After 12 months, 101 patients (92.7%) had HIV RNA <20 copies/mL. Eight patients discontinued BIC/FTC/TAF: three for virological failure, two for adverse events, and three for missing data. In this real-world cohort, switching to BIC/FTC/TAF in virologically suppressed PLWH aged over 60 years led to a remarkable reduction in potential DDIs, in association with high virological efficacy and good tolerability profile.

Providencia rettgeri is an uncommon opportunistic pathogen of nosocomial infection in humans. It often occurs in urinary tract infection and skin damage. Few reports have revealed providencia rettgeri infection in hepatic failure patients. A 29-year-old man admitted to our hospital with a crushing injury caused by a falling object in a construction site, which caused hepatorrhexis and hepatic failure. During the therapy period in the infectious intensive care unit (IICU), the patient was given tracheal intubation to support breathing. Providencia rettgeri was cultured positive in bronchoalveolar lavage fluid (BALF) upon fiber bronchoscopy. Providencia rettgeri is associated with the patient's terrible health conditions, for example, huge postoperative complication, large area skin burn, liver failure, etc. Few patients assisted with ventilation are infected with providencia rettgeri. Due to the pathogen's character of antimicrobial resistance, infection with providencia rettgeri raises mortality and prolongs recovery time. Thereafter, great attention should be paid to those patients in their recovery period.

The CD4/CD8 ratio is a crucial marker of immune dysregulation, immune senescence, and inflammation, predicting outcomes such as non-AIDS conditions and mortality. A low CD4/CD8 ratio is common in late HIV diagnoses, which remain frequent in Italy, where 58% of new cases occur with advanced immune suppression (CD4 <350 cells/μL). Recent advancements in cART, particularly bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF), have demonstrated superior efficacy in restoring immune function, especially in late-stage HIV. BIC/FTC/TAF offers high virological suppression, durable immune reconstitution, and a favorable safety profile. Comparative studies highlight its advantages in improving CD4 counts, reducing HIV RNA, and mitigating inflammatory markers, suggesting potential cardiovascular benefits. These findings position BIC/FTC/TAF as an effective option for advanced HIV treatment, contributing to better immune recovery and reduced systemic inflammation.

The purpose of the study was to evaluate the therapeutic success and adverse events (AEs) of dalbavancin on-label and off-label use in clinical practice. This was a retrospective, observational, multicentre study that enrolled consecutive patients treated with dalbavancin from January 2017 to May 2024 in the Italian SUSANA cohort. Therapeutic success was defined as clinical cure or infection control if chronic suppressive therapy was performed. Risk factors for treatment failure were evaluated using a logistic regression model. A total of 281 patients were enrolled in the study. On-label administration occurred in 162 (57.6%) cases and off-label in 119 (42.6%). The main off-label prescriptions included 29 cases of osteomyelitis and 25 cases of prosthetic joint infections. Dalbavancin was used mainly as empirical therapy (70.4% of cases) in the on-label group, while in the off-label group as targeted therapy for methicillin-resistant Staphylococcus aureus (29.4%). The therapeutic success rate was similar in both groups (82.7% on-label versus 84.0% off-label). Only one adverse event caused discontinuation of treatment in the on-label group. In addition, one grade-3 AE was observed in each cohort, without treatment interruption. Dalbavancin was widely used in clinical practice for on-label and off-label indications with a comparable success rate of 82.8% and 84.0%, respectively, and a good safety profile.