Moraxella species are fastidious Gram-negative bacteria capable of causing opportunistic infections, including bloodstream infections, especially in immunocompromised patients. Data on their epidemiology, antimicrobial susceptibility, and phylogenomics in Europe remains limited. We conducted a multicentre, retrospective, observational study across 56 European hospital centres between January 1st 2020 and December 31st 2024. All Moraxella species isolated from blood cultures (BCs) were included. Species distribution and antimicrobial susceptibility profiles were analysed. We also performed a phylogenomic analysis of Moraxella genomes deposited in GenBank. A total of 709 Moraxella isolates were included. Moraxella osloensis (61.1
Accurate diagnosis of pneumococcal pneumonia remains challenging due to suboptimal sensitivity of conventional microbiological methods. Molecular techniques may improve Streptococcus pneumoniae detection, but their clinical utility remains uncertain. In this prospective observational study, we compared conventional diagnostics with qPCR-based detection of lytA and piaB genes in nasopharyngeal, oropharyngeal, saliva, and sputum samples collected from adults with community-acquired pneumonia (CAP) and three control groups without acute respiratory symptoms. Stringent sample-specific cut-offs (lowCq), defined by the lowest cycle threshold (Cq) values observed among controls, were applied to reduce classification of background carriage as pneumococcal CAP. S. pneumoniae was detected by conventional methods in 53 (21.1
Predisposing risks to recurrent urinary tract infections caused by uropathogenic Escherichia coli (UPEC) include the formation of intracellular bacterial communities (IBCs) as a reservoir for persistence within bladder epithelial cells and sustained elevation of proinflammatory mediators that interfere with wound healing. Here we investigated the efficacy of oral agents (nitrofurantoin, doxycycline, and gepotidacin) in intracellular bacterial clearance and proinflammatory signaling in bladder epithelial cell infection in-vitro. Our findings suggested variable and strain-dependent host inflammatory responses to UPEC infection and that mechanistically distinct oral antibiotics differentially affected the expression of proinflammatory mediators (TNFα and PTGS2) and efficacy in clearing intracellular bacteria.
Siccibacter turicensis is a rare environmental member of the Enterobacteriaceae family that has seldom been implicated in human infection. We report what is, to our knowledge, the first case of S. turicensis-associated urinary tract infection (UTI). A 17-year-old male with traumatic spinal cord injury and catheter-dependent neurogenic bladder presented with fever and dysuria three months after a motorcycle accident. Urine culture grew a Gram-negative bacillus identified as S. turicensis by MALDI-TOF mass spectrometry and confirmed by 16 S rRNA Sanger sequencing. The isolate was susceptible to ceftriaxone (MIC 0.064 mg/L), and intravenous ceftriaxone therapy produced complete clinical and microbiological resolution within seven days. This case broadens the recognized clinical spectrum of S. turicensis beyond superficial mucosal infections and underscores the importance of advanced identification methods for detecting rare environmental pathogens in vulnerable patient populations.
To evaluate the impact of multiplex PCR results on antimicrobial management in patients undergoing evaluation for sexually transmitted infections (STIs), specifically focusing on treatment initiation, modification, or withholding following test results. This retrospective single-center study included adult outpatients who underwent multiplex STI PCR testing at Gazi University Hospital between July 2019 and November 2022. Clinical and treatment data were reviewed, and the effect of PCR results on antimicrobial management was assessed using predefined clinical scenarios. A total of 731 patients were included, and PCR positivity was detected in 39.7
Anaerobic bacteraemia is an uncommon but clinically significant bloodstream infection associated with substantial mortality. The respective roles of pathogen-specific and host-related factors in determining outcomes are not fully elucidated. To identify predictors of mortality in anaerobic bacteraemia and to evaluate whether genus-based microbiological classification offers prognostic value beyond established clinical risk factors. A retrospective cohort study was performed involving patients with anaerobic bacteraemia (n = 96) treated at a tertiary-care centre in Hungary from January 2021 to December 2025. Survival was analysed using Kaplan–Meier estimates and Cox proportional hazards regression. The incremental prognostic value of anaerobic genus was assessed using nested multivariable models, with Firth-penalised logistic regression applied as a sensitivity analysis. Among 96 patients (median age 68 years), the most common isolates were Bacteroides spp. (33
The spread of the transferable optrA gene poses an increasing threat to the clinical efficacy of oxazolidinones. Here, we characterized a novel optrA-carrying plasmid, pEfa-optrA-Arg, from a linezolid-resistant Enterococcus faecalis clinical isolate from Argentina. The 68,653-bp conjugative plasmid harbored optrA together with multiple antimicrobial resistance genes and showed high similarity to a plasmid previously identified in a bovine isolate from Switzerland. pEfa-optrA-Arg, or a closely related variant, was also detected in E. faecalis isolates from several Argentinian hospitals, highlighting the role of horizontal gene transfer in the spread of antimicrobial resistance across human and animal reservoirs within the One Health continuum.
Candidaemia is the most common healthcare-associated invasive fungal infection. The evolution of the epidemiology of candidaemia in Italy has not been assessed, except at the local level. The primary objective of this study is monitoring changes in the epidemiology of candidaemia and in the susceptibility profiles of Candida isolates between 2015 and 2023. This retrospective multicentre study (2015–2023), involved 11 tertiary-care hospital microbiology laboratories across the Italian country. The confirmed candidaemia episodes were included and demographic data, hospital ward, species identification, and antifungal susceptibility profiles (Sensititre Yeast One) were collected. 6,927 candidaemia cases were identified; incidence increased from 1.1/1000 hospitalisations in 2017 to 2.3/1000 in 2020–2021, peaking during the COVID-19 pandemic, and declined in 2023 while remaining above prepandemic levels. Patients older than 65 years accounted for most infections. Medical wards represented the main setting of occurrence, followed by intensive care units, especially during pandemic years. C. albicans remained the most common species (45.4
Complicated urinary tract infections (cUTIs) are a frequent indication for admission to Hospital-at-Home (HaH) and outpatient parenteral antimicrobial therapy (OPAT) programmes. We describe the clinical, urological and microbiological profile, antimicrobial treatment and outcomes of a cUTI cohort managed in a HaH unit, and explored, in an exploratory analysis, factors associated with the 30-day composite of unplanned readmission or death. Prospective observational single-centre cohort of 262 consecutive cUTI episodes managed in a tertiary HaH unit (March 2023-October 2025). Baseline, urological, microbiological, treatment and outcome variables were recorded prospectively. Bivariate comparisons and an exploratory multivariable logistic regression were used to examine associations with the composite endpoint. Median age was 79.7 years (Q1-Q3 66.1–87.2); 76.0
Nasal Staphylococcus aureus (S. aureus) colonisation is a key risk factor for serious infections. Statins, used for hypercholesterolaemia and cardiovascular disease prevention, have been linked to gut microbiome dysbiosis, but their impact on nasal bacterial colonisation remains unclear. To examine whether statin use, individual statins, and statin dose intensity are associated with nasal S. aureus colonisation, and whether associations differ between methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) colonisation. A retrospective case–controlled study included 4,005 nasal swabs obtained from 3,983 patients at a tertiary hospital in Western Australia. Swabs were classified as S. aureus-positive (MRSA or MSSA); controls were negative. Statin exposure and dose intensity were assessed, and multivariable logistic regression adjusted for confounders. Statin use was associated with increased odds of nasal S. aureus colonisation (OR 1.34; p < 0.001), driven by MSSA. Atorvastatin (OR 1.31; p = 0.005) and rosuvastatin (OR 1.56; p < 0.001) were independently associated with colonisation. A dose–response effect was observed: moderate-intensity (OR 1.26; p = 0.024) and high-intensity therapy (OR 1.47; p < 0.001) increased the odds of colonisation. MRSA showed no association. Diabetes was independently associated with S. aureus colonisation (OR 1.27; p = 0.004). Statin therapy, particularly atorvastatin and rosuvastatin at moderate to high dose intensities, was associated with increased nasal S. aureus colonisation. These findings may have implications for infection prevention in high-risk patients, though they do not diminish the established cardiovascular benefits of statins. Prospective studies are required to confirm causality, elucidate mechanisms, and determine whether these findings should inform screening or decolonisation strategies.
Polymicrobial Klebsiella pneumoniae(KP) bloodstream infection is clinically important and may indicate greater healthcare intensity and antimicrobial resistance. We examined baseline characteristics, prior exposures, and independent risk factors for polymicrobial KP-BSI using a large real-world microbiology dataset. We performed a retrospective cohort study using the Antimicrobial Resistance Monitoring Database (ARMD). Patients with blood culture-confirmed KP and available resistance and admission-source data were included. The final cohort comprised 10,216 patients, classified as monomicrobial KP-BSI or polymicrobial KP-BSI. Demographic and clinical characteristics, prespecified time windows for prior antibiotic exposure and prior infection, and Area Deprivation Index (ADI) state rank were compared. Logistic regression was used to identify factors associated with polymicrobial KP-BSI. Among 10,216 patients, 1,999 (19.6
Although acute respiratory tract infections are common in outpatient practice, the association between symptom duration and the diagnostic yield of SPOTFIRE®, a rapid multiplex assay, is unclear. We herein aimed to evaluate the current use of SPOTFIRE®, examine the association between symptom duration and test positivity, and identify factors associated with positivity. This retrospective cohort study included patients with a fever and/or respiratory symptoms who received a SPOTFIRE® assay between June 2024 and June 2025 at a single outpatient clinic in Tokyo, Japan. The overall positivity rate and predicted probabilities of the test positivity according to the interval from symptom onset to testing were evaluated. Multivariable logistic regression was performed to detect factors associated with positivity. The overall positivity rate in 481 episodes was 62.0
Hyperammonaemic encephalopathy (HE) is a rare but life-threatening complication increasingly linked to disseminated Ureaplasma infection in severely immunocompromised patients. We report a 31-year-old hematopoietic cell transplant (HCT) recipient who developed HE caused by U. urealyticum on day + 11 post-HCT, diagnosed by molecular testing and successfully treated with doxycycline and supportive therapy. Two months later, she developed relapsing septic arthritis with U. urealyticum detected in synovial fluid. Our literature review identified 17 cases of patients with haematological malignancies or cellular therapies and Ureaplasma infection: nine presented with arthritis alone, seven with HE alone, and one developed both manifestations sequentially.
Non-polio enteroviruses (NPEVs) have emerged as the leading etiological cause of childhood meningitis globally, yet the long-term disease burden and its epidemiological trends within G20 countries remain insufficiently characterized. This study aims to systematically evaluate the burden of pediatric NPEV-associated meningitis in G20 countries from 1990 to 2023 and to project future trends to 2050. Data were extracted from the Global Burden of Disease Study 2023 (GBD 2023) database. The primary outcome measures were mortality and disability-adjusted life years (DALYs) due to NPEV-associated meningitis in children aged 0–14 years. Estimated annual percentage changes (EAPCs) were calculated to quantify temporal trends. Spearman‘s rank correlation was used to assess the relationship between disease burden and the Socio-demographic Index (SDI) across G20 countries. A Bayesian age-period-cohort (BAPC) model was employed to forecast disease burden to 2050. In G20 countries, the mortality rate for pediatric NPEV-associated meningitis declined from 1.153 per 100,000 (95
This review aims to critically synthesize how Staphylococcus aureus (S. aureus) interacts with the vascular endothelium during invasive infection and to link endothelial pathogenic mechanisms with emerging therapeutic opportunities. We reviewed the literature on S. aureus virulence factors, endothelial barrier dysfunction, host immune amplification, complement modulation, immunothrombosis, antimicrobial resistance, and adjunctive therapeutic strategies. The evidence was organized according to functional virulence modules, biological stages of endothelial interaction, host-driven amplification pathways, and mechanism-linked therapeutic opportunities. S. aureus–induced endothelial injury arises from the convergence of bacterial virulence and host vascular responses. Adhesins and surface-associated proteins promote endothelial attachment and invasion; toxins disrupt membrane integrity, junctional stability, and immune homeostasis; and enzymes together with immune-evasion factors support dissemination and persistence. These bacterial mechanisms are amplified by complement activation and evasion, neutrophil extracellular traps, inflammasome signaling, immunothrombosis, and immunometabolic reprogramming, ultimately leading to vascular leakage, procoagulant conversion, impaired repair, and organ dysfunction. Evidence is strongest for selected adhesion pathways and α-haemolysin (Hla)-mediated endothelial barrier injury, whereas several host-amplification mechanisms are inferred from non-S. aureus inflammatory or sepsis models. Mechanistic understanding of S. aureus–endothelium interactions provides a rationale for adjunctive strategies beyond standard antimicrobial therapy, including anti-adhesion approaches, toxin neutralization, host-directed modulation of excessive inflammation and immunothrombosis, and candidate endothelial biomarker-guided risk stratification. However, most emerging strategies remain preclinical or lack prospective validation in well-defined S. aureus infection cohorts.
Mutations in the Neisseria gonorrhoeae (NG) gyrA codons 91 and 95 are known to confer resistance to ciprofloxacin, but questions remain over whether all the various permutations of these codons are needed for optimal molecular detection of NG ciprofloxacin susceptibility. Here, we used publicly available sequence data to answer this question to help inform the design of next-generation NG gyrA assays. NG gyrA alleles (n = 73) were downloaded from the NG-STAR platform, as were all NG sequences and associated metadata from Pathogenwatch (n = 38,367 records; n= 31,114 following de-duplication). Analyses focused on understanding the frequency of NG gyrA 91 and 95 alterations and the applicability of assay designs to detect ciprofloxacin resistance. While the 73 NG-STAR alleles reflect considerable gyrA sequence diversity, just four amino acid combinations at codons 91 and 95 (wild-type; S91F/D95A; S91F/D95G; S91F/D95N) comprised > 99
Prospective real-world evidence on the effectiveness and safety of the World Health Organization-recommended 6-month fluoroquinolone-containing regimen (FqREZ) for isoniazid mono-resistant tuberculosis (Hr-TB) remain limited. We conducted a multicenter prospective observational cohort study within the Korean national TB program between 2016 and 2024. Adults with pulmonary Hr-TB received either a 6-month FqREZ or alternative non-FqREZ. The primary outcome was a favorable outcome, defined as treatment success without recurrence within 12 months after treatment completion. The secondary outcome was the occurrence of serious adverse events during treatment. Multivariable logistic regression was performed to assess factors associated with study outcomes. Among 99 participants with pulmonary Hr-TB, 55 (55.6
Streptococcus pyogenes cause invasive infections with variable incidence over time. In 2023, an increase in invasive S. pyogenes infections caused by emm-types 1 and 12 was reported globally. In Southern Sweden an increase in S. pyogenes emm12 severe infections was also noted and we set out to determine if this increase was caused by a single genetic sublineage. Data on severe S. pyogenes infections notified between July 1st 2016 and June 30th 2023, including emm-types, was obtained from the Regional Centre for Communicable Disease Control. All emm12 isolates recovered during November-April each season were sequenced, analysed by core genome multilocus sequence typing (cgMLST), and compared with international emm12 isolates. Clinical information was obtained from the medical records. During the 2022/23 season, 157 cases of severe S. pyogenes infection were reported, of which 32 (20
Vaccination programmes against invasive pneumococcal disease (IPD) for adults aged 18–59 years in the Community of Madrid (CM) are targeted exclusively at people with risk factors. The aim of the study is to describe the epidemiology of IPD in adults aged 18 to 59 years between 2007 and 2025, evaluating serotype distribution temporal changes and its implications for PCVs use in the CM. A retrospective population-based descriptive study was conducted on clinical, epidemiological, vaccination status and microbiological information of IPD cases reported through the Notifiable Disease Surveillance System of the CM between 2007 and 2025. Incidence rates (IRs) and IR ratios (IRRs) were calculated overall, by vaccine and serotypes, using 2015–2019 as the reference period. Overall, 3,632 cases of IPD were reported in the population aged 18–59 years, 2,253 (62.0
The clinical spectrum and management of infective endocarditis (IE) in non-referral centers are poorly characterized. We aimed to analyze long-term trends in IE in a university hospital without on-site cardiac surgery. Retrospective analysis of prospectively collected population-based data from IE patients across four time periods (1988–2024) at Hospital Universitario Lucus Augusti. 698 episodes were included (86.5
