New Microbiologica最新文献

Candida auris has emerged globally as a multidrug-resistant health care-associated fungal pathogen. In the literature, nosocomial outbreaks are reported worldwide. In addition, C. auris diffusion occurs in high-dependency settings with infections typically affecting critically ill patients, resulting in life-threatening disease. We describe the first documented case of C. auris in northeastern Italy and the measures applied to contain the transmission that led to zero collateral infections.

We present a case of bloodstream infection with Saprochaete clavata following an abdominal steel impact injury in a 52-year-old man, whose non-healing abdominal wound was also highly suspected of being caused by Saprochaete clavata. Saprochaete clavata is a very uncommon fungal pathogen. Our case is distinctive in that previous reports have typically involved immunocompromised, malignant, or leukemic patients. In contrast, our case involved a middle-aged man in good health who had ileal perforation repair for gastrointestinal perforation. Post-surgery, Saprochaete clavata was isolated from the incision exudate and blood samples. The pathogen was characterized and the drug sensitivity test was performed, and based on their results a clinical treatment plan was devised. The combination antifungal treatment comprising voriconazole and caspofungin significantly controlled the patient's infection and gradually healed the wound. Therefore, early isolation and characterization are essential because invasive fungal diseases have a high death rate.

At 23 days of life a neonate presented to the emergency room with crying and decreased oral intake. His parents were positive to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), but he turned out negative. After one week he was admitted to NICU (neonatal intensive care unit) for respiratory failure, and nasopharyngeal swab (PCR test: polymerase chain reaction test) was positive for SARS-CoV-2. On examination the child had fever, tachy-dyspnea, reduced oxygen saturation, tachycardia, abdominal distension and tenderness, irritability and hypertonia. Blood exam showed respiratory acidosis, lymphocytopenia, hypoalbuminemia and coagulopathy; CRP (C reactive protein), procalcitonin, D-dimer, ferritin and NT-proBNP (N-terminal prohormone of brain natriuretic peptide) were elevated. Chest X-ray revealed bilateral interstitial infi ltration and abdomen ultrasound a thin fl uid effusion; echocardiography was normal. SARS-CoV-2 PCR tests on CSF (cerebrospinal fluid) and stool were also positive. He was started on non-invasive intermittent positive pressure respiratory ventilation, treated with antibiotic therapy, methylprednisolone, intravenous immunoglobulins, and antiplatelet therapy. Rapid clinical improvement was seen with remission of fever after eight days. The child complicated with bacterial super-infection presenting as pleural empyema. As presented in our case, it is not always easy to differentiate between severe forms of COVID-19 and MIS-C. Due to the rarity of these presentations in neonates, multicentric collaboration is needed to identify the specifi c characteristics of the two forms, better defi ne diagnostic criteria, and treatment options.

The in vitro antimicrobial activity of the active ingredient in antimicrobial magistral drug formulations and plant extracts used in folk medicine were investigated comparatively. Borax, sulfur colloid, hydrogen peroxide, benzoic acid, rivanol, brilliant green and plant extracts as active ingredients, namely: Helianthus tuberosus tuber-H2O (aqueous extract), Cydonia oblonga leaves-H2O, Allium porrum whole plant-H2O, Cistus laurifolius leaves-EtOH, Solanum muricalum-H2O, and Fumaria cilicica leaves-EtOH were studied to determine their antimicrobial activity against different bacteria and fungi (S. pyogenes, S. aureus, S. epidermidis, E. faecalis, K. pneumonia, H. influenza, P. aeruginosa, A. baumannii, E. coli, Candida albicans, C. tropicalis, C. parapsilosis, C. krusei) by using the microdilution method. The active ingredients and plant extracts showed different activities as MIC between 1->128 μg/mL. Brilliant green and rivanol as active ingredients had MIC values of 1 μg/mL against all tested microorganisms. C. oblonga leaves-H2O as well as C. laurifolius leaves-EtOH as plant extracts were indicated as having the highest antimicrobial effect in MIC value of 16 μg/ml against A. baumannii and S. pyogenes, respectively. On the other hand, F. cilicica leaves-EtOH and C. laurifolius leaves-EtOH showed the highest antifungal activity (MIC; 16 μg/mL).

People aging with 4 antiretroviral class resistant HIV are a very challenging population. It is difficult to build up a fully suppressive regimen, and the high prevalence of comorbidities and polypharmacy may cause drug-drug interactions and put adherence at risk. We herein present the case of an 80-year-old man, participating in the PRESTIGIO registry, asking for a reduction in his antiretroviral burden while on polypharmacy for his comorbidities.

Vibrio species represent the predominant and significant pathogen in global marine fish and shellfish aquaculture. Vibrio species are ubiquitously presented in Artemia cyst hatcheries, and their notable colonization in live prey, particularly Artemia nauplii, leads to the transmission of these pathogens into the digestive system of larval organisms, causing serious problems in Vibriosis in marine aquaculture. To eliminate the Vibriospecies in Artemia nauplii, trichloroisocyanuric acid (TCCA) was used for sterilization of the nauplii. In this study, 3 different concentrations, including 0.5 ppm (FA group), 1.0 ppm (FB group) and 1.5 ppm (FC group) of TCCA were used to treat nauplii for 25 min, and then genomic DNA of the different groups were extracted followed by metagenomic next-generation sequencing (NGS). Bioinformatics analysis was applied and the results indicated that Proteobacter constituted the predominant component within each group at the phylum level, albeit accounting for only 58.68% in the FB group, which was significantly lower than in other groups (>86%). The relative abundance of Vibrio species at genus level showed that when compared with the control group, the FB group (15.8%) was reduced by 25.5%. Beta diversity showed differences between the FB group and the other groups, suggesting that treatment with 1.0ppm TCCA for 25 min would obviously reduce the Vibrio in Artemia nauplii. In conclusion, the Vibrio species were significantly reduced after treatment with TCCA, indicating that TCCA might be an alternative to antibiotics used for live food sterilization in marine aquaculture.

Definitive data on the long-term success of the latest antiretroviral therapy (ART) strategies are still lacking. A panel of infectious diseases specialists was convened to develop a consensus on how to tailor and follow ART over time. Panelists used a Delphi technique to develop a list of statements describing preferred management approaches for ART and patient monitoring and quality of life evaluation. Ninety infectious diseases specialists from several Infectious Diseases Centers in Italy participated in the consensus process. A consensus was reached on virological and immunological parameters to use to monitor long-term efficacy of antiretroviral treatment, while there was no consensus on the use of specific inflammation and immune-activation markers in clinical routine. The panel agreed on the need for an antiretroviral treatment with the lowest impact on bone, kidney and cardiovascular toxicity and on the utility of quality-of-life monitoring during the standard follow up of people living with HIV. The consensus statements developed by a panel of infectious diseases specialists may provide guidance to practitioners for a person-centered approach aimed at obtaining long-term virological and clinical success for people living with HIV.

Staphylococcus aureus is a gram-positive bacterium that can produce biofilm, and biofilm-associated infections are difficult to control. Biofilm prevents antibiotics from penetrating and killing the bacteria. Combined use of antimicrobials is a common strategy to treat S. aureus biofilm-related infections. In this in vivo study, the clinically isolated strain of S. aureus 17546 (t037) was selected to establish a biofilm-associated infection rat model, and baicalin and linezolid were used to treat the infection. CFU counting was used to determine the bacteria within the biofilm, the biofilm structure was viewed using scanning electron microscopy (SEM), histopathology was performed, and inflammatory factors were analyzed by ELISA. Baicalin was efficient in destroying the biofilm and exerted a synergistic bactericidal effect when combined with linezolid. Based on these findings, baicalin combined with linezolid may be efficacious in controlling S. aureus biofilm-related infections.

Carbapenemase-producing Enterobacteriaceae (CPE) are an increasing threat to global public health. Treatment of CPE isolates, like New Delhi metallo-β-lactamase (NDM), is limited and often necessitates combination therapies. The aim of this study was to evaluate the synergistic meropenem/fosfomycin combination against K.pneumoniae-producing NDM isolates. Fosfomycin/meropenem, fosfomycin/colistin and meropenem/colistin were tested alone and in combination, using e-test and time-kill assay against 20 clinical carbapenemase-producing K. pneumonia (CPKp NDM) isolates collected from September 2022 to December 2022. K. pneumoniae strains were resistant to meropenem, ceftazidime/avibactam and ceftolozano/tazobactam, 75% and 80% of isolates were susceptible for cefiderocol and for colistin respectively. Fosfomycin/meropenem combination was synergic in 95% (n=19) strains. Fosfomycin/colistin and colistin/meropenem combination showed only 10% synergistic combination strains. In 16 isolates (80%) indifference action for fosfomycin/colistin and colistin/meropenem was reported. For 0.8% of CpKP NDM isolates colistin/meropenem and fosfomycin/colistin combinations found to be antagonistic. In this study, time kill assay showed combination therapies action versus K.pneumoniae metallo-b-lactamase producing (NDM) strains and confirmed the synergistic action of fosfomycin/meropenem combination. In vitro synergy testing should be routinely performed in multidrug resistance infections and combo therapies can be used as a possible alternative in targeted patients with the goal of reducing overall antibiotic costs.

T.marneffei, encountered mostly in Southeast Asia, leads to a systemic infection, especially in immunocompromised individuals such as HIV-infected patients with low CD4 level. A 32-year-old male patient, residing in Hong Kong for the last two years, admitted with fever, cough, weakness, and weight loss. Physical examination revealed bilateral cervical and axillary multiple lymph nodes and hepatosplenomegaly. Screening of the pancytopenic patient revealed HIV infection. Histopathological examination of the cervical lymph node revealed plasmoblastic lymphoma. Blood and urine cultures remained sterile. Antiretroviral therapy was started. Fungal hyphae were detected in Gram staining of hemocultures taken in the third week due to ongoing fever, and antifungal therapy was started empirically. Red pigment around colonies on Sabouraud dextrose agar and microscopic appearance arose suspicion of Talaromyces spp. T.marneffei was identified by ITS 1-4 sequence analysis. Chemotherapy was started when fungemia was controlled. On the fifth day of chemotherapy, the patient's general condition deteriorated, broad-spectrum antibiotics were started and the patient was transferred to ICU. The cultures remained sterile and he expired five days later. In conclusion, although talaromycosis is not endemic in Turkey, it should be considered in patients with travel history to endemic regions and/or an underlying immunosuppressive disease such as HIV infection.