Acta microbiologica et immunologica Hungarica最新文献

The 16S rRNA sequencing technology was used to investigate changes in the abundance of intestinal microbiota, metabolites of blood and fecal samples were analyzed and their relationships with neurotransmitters were evaluated in patients with liver cirrhosis after hepatitis B infection. The liver function phenotypes correlated with Phylum Proteobacteria, Class Clostridia and Gamma Proteobacteria, Family Enterobacteriaceae, Ruminococcaceae, Streptococcaceae, Lachnospiraceae and Lactobacillaceae, Genus Faecalibacterium, Streptococcus, species Escherichia coli, etc. Genus Streptococcus has a good diagnostic value for patients with liver cirrhosis in the COM (Compensated liver disease) group, with an AUC of 0.81 (95% CI: 0.70-0.92), while Genus Streptococcus, Veillonella, Faecalibacterium, Blautia, and Bacteroides have a better diagnostic value for patients with liver cirrhosis in the DECOM (Decompensated liver disease) group (including DECOM1 and DECOM2), with the combined AUC reaching 0.93 (95% CI: 0.88-0.98). The level of ammonia in the DECOM2 group was significantly higher than that of the COM group (P < 0.01). Patients with post-hepatitis B cirrhosis have intestinal flora disorder, which leads to abnormal amino acid metabolism and further leads to neurotransmitter disorder in patients with cirrhosis and accelerates the disease progression. Probiotics can reduce the serum ammonia level in patients with cirrhosis and may prevent the occurrence of hepatic encephalopathy.

Invasive fungal infections caused by resistant Candida species are a global public health problem. Increasing antifungal resistance makes antifungal susceptibility tests (AFST) crucial, necessitating rapid methods. This study aims to determine the fluconazole and anidulafungin susceptibility profiles of clinical Candida strains using matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and compare the results with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) reference broth microdilution method to assess the accuracy and reproducibility of MALDI-TOF MS in evaluating in vitro antifungal susceptibility. The susceptibilities of 40 Candida glabrata isolates for anidulafungin and fluconazole, and 40 Candida albicans and 40 Candida parapsilosis isolates for fluconazole were tested. Candida isolates were incubated for 3 h at two different antifungal concentrations ("maximum" and "breakpoint" concentrations) and a drug-free control (Anidulafungin: 16, 0.06, and 0 mg L-1; Fluconazole: 256, 16, and 0 mg L-1). MALDI-TOF MS spectra from these concentrations were used to create composite correlation index (CCI) matrices for each isolate. The strains with the "mean CCI of the breakpoint/maximum concentration" of which was higher than the "mean CCI of the breakpoint/null concentration" were classified as susceptible. Classifications defined by the MS-AFST method were compared to those based on the EUCAST broth microdilution method. The overall agreement between MS-AFST and EUCAST AFST ranged from 60% to 85%, highest for C. glabrata and anidulafungin. The reproducibility of the MS-AFST assay ranged from 45% to 75%, highest for C. parapsilosis and fluconazole. The study suggests that the MALDI-TOF MS method for assessing antifungal susceptibility in Candida strains is promising but requires further improvements for enhancing the accuracy and reproducibility.

The human gut microbiota plays a pivotal role in maintaining host immunity, regulating metabolism, and sustaining neurophysiological homeostasis. Increasing evidence implicates gut dysbiosis in the onset and progression of neurodegenerative disorders (NDDs), including Alzheimer's and Parkinson's disease, primarily through the gut-brain axis. Recent advances in high-throughput sequencing and multi-omics technologies, such as metagenomics, metabolomics, and metaproteomics have generated vast datasets, yet their clinical translation remains hindered by data heterogeneity, analytical complexity, and the absence of standardized workflows. Disjointed findings across studies underscore the urgent need for reproducible pipelines and integrative computational strategies. This review presents a comprehensive framework that leverages artificial intelligence (AI) and machine learning (ML) for systematic microbiome investigation in NDDs. We highlight how multi-omics integration with AI improves the resolution of host-microbiome interactions, while standardized preprocessing workflows ensure reproducibility and comparability across datasets. The role of explainable AI is emphasized in enhancing interpretability, improving biomarker discovery, and fostering trust in predictive models. We further examine the emerging field of pharmacomicrobiomics, where ML-driven approaches support the development of precision therapies tailored to microbiome-drug interactions in neurodegeneration. Sophisticated models, including random forests (RF), neural networks, and transfer learning, are critically assessed for predictive diagnostics, therapeutic target identification, and cross-cohort generalizability. Finally, the review proposes a roadmap to address current barriers, particularly challenges of heterogeneity and reproducibility, and advocates for validated pipelines and interdisciplinary collaboration. Collectively, AI-driven multi-omics strategies hold transformative potential for advancing microbiome-based precision medicine in NDDs.

The distribution of antimicrobial resistance in major pathogens was analyzed in a tertiary care hospital of Lodhran, Pakistan. Altogether, 1910 patients diagnosed and treated at Shahida Islam Medical Complex Hospital from December 2023 to August 2025 were selected. The antimicrobial resistance of major bacterial and fungal pathogens was quantified, and logistic regression analysis was used to identify the risk factors for infection. Methicillin-resistant Staphylococcus aureus (MRSA) isolates retained susceptibility to vancomycin (58.3%), while ceftazidime/avibactam showed activity against Escherichia coli (80%), Klebsiella pneumoniae (82%), and Pseudomonas aeruginosa (78%). Vancomycin-resistant Enterococcus (VRE) demonstrated resistance to nearly all antibiotics. PCR confirmed TEM and SHV in 23/51 (45%) of E. coli isolates, while in K. pneumoniae TEM and SHV were each detected in 20/35 (56%). Among P. aeruginosa isolates, VIM, NDM, and OXA-48 were each present in 14/37 (37%). The mecA was found in 47/49 (95%) of S. aureus isolates (MRSA), vanA in 34/49 (70%) of S. aureus (VRSA), and vanA in 34/43 (80%) of Enterococcus isolates (VRE). MLST analysis of representative multidrug-resistant isolates identified ST131 (1/3, 33%) among E. coli, ST11 (1/3, 33%) and ST258 (1/3, 33%) among K. pneumoniae, ST175 (1/3, 33%) and ST233 (1/3, 33%) among P. aeruginosa, ST5 (1/3, 33%) and ST22 (1/3, 33%) among S. aureus, and ST17 (1/3, 33%) among Enterococcus spp. PCA revealed distinct clustering of species, with Gram-negatives overlapping, Gram-positives forming separate groups, and fungi clustering independently. Logistic regression identified age ≥65, ICU admission, comorbidities, prior antibiotic exposure, invasive procedures, and immunosuppressive therapy as significant AMR risk factors, while infection control and stewardship reduced risk (P < 0.05). This study demonstrates a high burden of antimicrobial resistance, primarily mediated by TEM and SHV β-lactamases in E. coli and K. pneumoniae, and by VIM, NDM, and OXA-48 carbapenemases in P. aeruginosa. Additionally, MRSA, VRSA, and VRE showed multidrug resistance. Effective infection control and antibiotic stewardship remain critical to limit the spread of resistant pathogens and to reduce hospital-acquired AMR risk.

Antibiotic-associated diarrhea (AAD) is a prevalent iatrogenic complication of antibiotic therapy, primarily triggered by dysbiosis and loss of intestinal homeostasis. The traditional interventions, such as empirical probiotic use, have shown a modest and a heterogeneous efficacy. This review integrates the current mechanistic understanding of AAD through the lens of the microbiota-mucosal-immune axis and provides a comprehensive overview of emerging therapeutic strategies. By integrating evidence from metagenomics, metabolomics, and immunology, we highlight next-generation approaches, including rationally engineered probiotics, standardized fecal microbiota transplantation (FMT), and synthetic-biology-derived interventions. Recent progress in multi-omics technologies and machine learning has enabled patient-stratified modulation of the gut microbiota, moving beyond empirical supplementation toward precision ecological reprogramming. These advanced therapies demonstrate superior outcomes in restoring microbial diversity, strengthening epithelial barrier function, and re-establishing immunological homeostasis. Ultimately, the management of AAD requires a systems-biology strategy that leverages real-time microbiome analytics for targeted, accurate, and sustainable restoration of gut health.

The aim of this study was to investigate the prevalence of intestinal colonization by major multidrug-resistant (MDR) bacteria and fungi in patients with hematological malignancies (HM) and its relationship with subsequent bloodstream infections (BSIs). The study was performed between December 2023 and June 2024 at the University Hospital "Saint Marina", Varna, Bulgaria. A total of 180 HM patients were screened for intestinal colonization by 3rd generation cephalosporin-resistant (3rdGCephR) and carbapenem-resistant (CR) Enterobacterales, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Vancomycin-Resistant Enterococci (VRE) and Candida sp. according to our own protocol. Blood cultures were taken according to clinical indications. Multiplex PCR was used to detect beta-lactamase genes in all invasive Enterobacterales isolates. A total of 100 patients (55.6%) were colonized by one or more of the screened agents. Among these, 88 patients were MDR carriers (48.9%, 88/180) and the highest colonization rates were found for CR Klebsiella pneumoniae (CRKP) (42%), Candida sp. (34%), VRE (25%) and 3rdGCephR Escherichia coli (23%). A total of 29 patients (16.1%; 29/180) developed BSIs, with K. pneumoniae responsible for 44.8%. Of these, 76.9% (10/13) were CR and blaNDM positive isolates. Related BSIs were diagnosed in 57.9% of the MDR carriers with BSIs (11/19). The related BSIs percentage according to the colonizing agent was 21.4% for CRKP (9/42), 7.1% for 3rdGCephR K. pneumoniae (1/14) and 25% for P. aeruginosa (1/4). CRKP colonization was significantly higher among patients with CRKP BSIs than those with non-CRKP BSIs (P < 0.001). The MDR intestinal colonization, specifically by CRKP is an important source for subsequent BSIs in this high-risk patient population.

Despite the clinical importance of the human cytomegalovirus (CMV) infections especially in pregnant women and immunocompromised patients, there are only a few CMV seroprevalence studies in certain risk groups from Hungary. In this study, the results of CMV-specific IgG antibody tests were analysed by calendar year, gender, and 5-year age groups (from 0 to 97) among the population of South Transdanubia, Hungary from blood samples (N = 13,777), between January 1, 2010, and December 31, 2024, covering 15-years.The average CMV-specific IgG seropositivity was 69.2% (9,522/13,761 patients), which increased with age between 31 and 50 years (+∼1%/year). Seroprevalence was lowest (37.8%) in the 1-5 age group, reached 50% in the 21-25 age group, and exceeded 80% in those over 50 years. In certain age groups (16-20, 26-30, 46-50, 51-55, and 66-70 years old), CMV seroprevalence was significantly higher among women. Women of child-bearing age between 16 and 45 years showed 61.2% seroprevalence. Between 2020 and 2023, the yearly CMV seroprevalence decreased (from 70.8 to 64.7%) by ∼6%.This summary of CMV IgG seroprevalence fills gaps in terms of both the number of elements, the size of the studied population, and its age diversity in Hungary. The average CMV seropositivity in South Transdanubia follows the level of socio-economic development of the countries. Basic knowledge of CMV seroepidemiological data helps physicians with CMV risk assessment and find the optimal infection prevention strategies in different age and sex groups.

This study evaluates the impact of psychosomatic interventions on the immune system and microbiome composition of pregnant women diagnosed with gestational hypertension. A case-control study on 200 pregnant women diagnosed with gestational hypertension was conducted between June 2021 and December 2024. The control group (n = 100) included pregnant women diagnosed with gestational hypertension and under only pharmacological treatment with antihypertensive drugs such as labetalol. The case group (n = 100) received standard care for hypertensive disorders in pregnancy like control group, but in addition to it, we incorporated evidence based psychosomatic medicine to this group. Psychosomatic medicine included stress management, relaxation techniques, and counseling for the study group. Primary outcomes included blood pressure levels, psychological state (SAS and SDS scores), mode of delivery, incidence of complications, neonatal outcomes, patient satisfaction, reductions in inflammatory cytokines (e.g., IL-6, TNF-alpha), and improvements in microbiome diversity. Psychosomatic intervention led to a significant increase in microbiome diversity (Shannon Index, P < 0.05). Beta-diversity analysis revealed a distinct separation in microbial community composition between the study and control groups (P = 0.02). The case group also showed a reduction in pro-inflammatory cytokines, IL-6 decreased from 40.0 to 28.0 pg mL-1 (P = 0.008) and TNF-alpha from 25.0 to 18.0 pg mL-1 (P = 0.004). The case group demonstrated significant improvements in systolic (P = 0.020) and diastolic (P = 0.003) blood pressures, psychological well-being (SAS, P = 0.006; SDS: P = 0.026), and delivery outcomes (P = 0.032). Complications were significantly lower in the case group (P = 0.013), with better neonatal outcomes, including lower rates of intrauterine distress (P = 0.011), premature birth (P = 0.003), and asphyxia (P = 0.013). Emotional resilience, coping confidence, and patient satisfaction were significantly higher in the case group (P < 0.05). These findings suggest that psychosomatic medicine may offer a novel approach for managing gestational hypertension through microbiome modulation.

Colorectal cancer (CRC) is a malignant disease associated with substantial morbidity and mortality rates, and the implementation of early screening has been shown to greatly enhance survival outcomes. Currently, early screening methods for CRC rely on stool-based tests and colonoscopy; however, the limited adherence of patients to these screening protocols hinders their widespread adoption. The utilization of innovative microbiological sequencing technique known as 2bRAD-M holds promise for the detection of low biomass samples. In this study, the 2bRAD-M technique was employed to ascertain a diverse microbiota consisting of different microorganisms in the serum of patients diagnosed with CRC, as well as in the serum of healthy control individuals. This study included 3 patients with non-metastatic CRC and 3 healthy individuals. Additionally, the microbiota present in CRC tumor tissues and paraneoplastic tissues were also examined. Furthermore, the metabolic pathways of these microorganisms were predicted. The findings indicated that the microbiota community structures in serum and tissues were distinct, while the microbiota composition in tumor tissues and adjacent tissues was largely similar. Microbiota in serum such as Enterobacteriaceae and tissue-associated RC9、Ralstonia may serve as novel biomarkers for CRC screening. Our results suggest that both serum microbiota and cancer tissue microbiota can serve as a valuable basis for conducting early in vitro screening for CRC.

Escherichia coli is a highly adaptable Gram-negative bacterium, commonly part of the gut microbiota in humans and animals, yet capable of causing severe extraintestinal infections. Among its lineages, Sequence Type 131 (ST131) has emerged as a globally disseminated, multidrug-resistant, high-risk clone with remarkable capacity for systemic infections. This study provides a comprehensive molecular epidemiological characterization of 160 clinical E. coli isolates, collected between 15.09.2021 and 28.02.2022, assessing antimicrobial resistance profiles, virulence gene carriage, phylogenetic group distribution, prevalence of ST131 and H30Rx subclone, and biofilm-forming capacity. Isolates were identified by conventional and automated methods, with molecular analyses performed via in-house PCR assays. Our results reveal a striking 69.38% prevalence of ST131, with 95.5% harboring virulence genes and 81.99% exhibiting biofilm formation. Notably, ST131-positive isolates demonstrated extensive resistance to multiple antimicrobial classes, including ESBL production, and were dominated by the H30Rx subclone. Specifically, 73.87% of ST131 isolates were ESBL-positive, fluoroquinolone resistance was observed in 81.37%, while aminoglycoside resistance rate remained very low. The H30Rx subclone was strongly associated with ESBL positivity and multidrug resistance. Moreover, integron carriage diversity and strong association with fimA virulence gene further highlight the adaptive versatility of this clone. Given that ST131 and its H30Rx subclone are recognized as global pandemic lineages associated with multidrug resistance and severe infections, their detection in our cohort emphasizes both the clinical relevance and the public health risk posed by these clones. Our findings underscore the urgent need for targeted surveillance and control strategies, offering novel epidemiological insights into the molecular diversity and clinical threat posed by E. coli ST131 in Turkey.