Background: International travel and global mobility have led to an increasing number of pediatric patients presenting with infections acquired outside Europe. However, epidemiological data on imported infectious diseases in children remain fragmented, with substantial heterogeneity across studies. This systematic review aimed to synthesize current evidence on the spectrum, distribution, and epidemiological characteristics of imported infections in children and adolescents returning to Europe. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251245531). PubMed, Scopus, and the Cochrane Library were searched for studies published between 2010 and December 2025. Studies reporting laboratory-confirmed or clinically diagnosed imported infections in pediatric populations (0–18 years) returning to Europe were included. Data were extracted and synthesized descriptively, with separate analyses for malaria-specific, non-malarial, and syndromic cohorts. Results: A total of 31 studies was included. Malaria was the most consistently reported infection, predominantly caused by Plasmodium falciparum and most frequently reported in association with travel to sub-Saharan Africa, which accounted for the largest proportion of reported exposures in clinical cohorts. Visiting friends and relatives (VFR) was the dominant travel category, representing between 45.8% and 87.4% of cases in disaggregated malaria cohorts and a substantial proportion across non-malarial studies. Non-malarial infections—including gastrointestinal, bacterial, parasitic, and viral diseases—represented a substantial proportion of cases in mixed and post-travel cohorts, with gastrointestinal illness frequently constituting the leading diagnosis. Considerable heterogeneity was observed across studies in terms of design, diagnostic approaches, and reporting practices, precluding formal meta-analysis. Conclusions: Imported infections in pediatric travelers encompass a broad and heterogeneous spectrum extending beyond malaria alone. Diagnostic approaches should integrate travel history, geographic exposure, and clinical presentation. Standardized pediatric-specific surveillance and harmonized reporting are needed to improve comparability and support more accurate epidemiological assessment.
Osteoarticular infections (OAIs) present a significant diagnostic and therapeutic challenge to paediatric clinical practice. When evaluating suspected paediatric OAIs, the principal pathogens commonly considered are Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and Kingella kingae. However, advances in molecular diagnostic techniques, particularly polymerase chain reaction assays and next-generation sequencing, have considerably improved the detection of less commonly identified pathogens responsible for OAIs. Consequently, familiarity with fastidious, emerging, exposure-related and uncommon bacterial pathogens is essential to ensure accurate diagnoses and appropriate therapeutic interventions. This review summarises bacterial pathogens responsible for OAIs in immunocompetent children that are fastidious, emerging, exposure-related or otherwise less commonly encountered. We describe their microbiological characteristics, clinical phenotypes, diagnostic pitfalls and organism-specific diagnostic strategies.
The continuous expression of HPV oncogenes E6 and E7 contributes to the maintenance of the cervical cancer (CC) phenotype by altering gene expression programs involved in tumor progression and aggressiveness. MicroRNAs (miRNAs) have emerged as critical regulators of gene expression in CC, including miR-218-5p, which has been described as a tumor suppressor. In this study, we investigated the impact of HPV-16 oncoproteins E6 and E7 on the regulation of miR-218-5p expression and its target gene PIK3C2A, as well as their functional and clinical relevance in CC. We found that miR-218-5p expression is significantly reduced in HPV-16-positive CC cell lines, while PIK3C2A expression is increased. Silencing the expression of the E6/E7 oncogenes in Ca Ski cells restored miR-218-5p levels and reduced PIK3C2A expression. Conversely, overexpression of the E6 and E7 oncogenes in C-33 A cells significantly decreased miR-218-5p expression and increased PIK3C2A expression. Functional assays performed on C-33 A cells expressing E6 and E7 revealed that ectopic expression of miR-218-5p suppresses cell proliferation and migration, effects that are partially mediated by PIK3C2A. Bioinformatics analysis showed that low miR-218-5p expression and high PIK3C2A expression are associated with reduced overall survival in patients with cervical cancer. Our findings identify the miR-218-5p/PIK3C2A axis as a novel regulatory pathway modulated by HPV-16 oncoproteins E6 and E7 that contributes to CC cell proliferation and migration. Furthermore, miR-218-5p and PIK3C2A emerge as potential prognostic biomarkers in CC.
Indole, a volatile metabolite produced by bacterial tryptophanase (encoded by tnaA) during tryptophan metabolism, contributes to oral malodor and may influence the progression of periodontitis. However, the genetic features underlying strain-specific indole production and its association with bacterial virulence remain unclear. Analysis of a previously published periodontitis cohort revealed that periodontitis severity was associated with salivary indole-related metabolic signatures, which were positively correlated with the abundance of Porphyromonas gingivalis (P. gingivalis). Further analysis showed that W83, a reference strain previously reported to exhibit relatively high virulence-associated characteristics, produced significantly higher levels of indole than ATCC 33277 under the experimental conditions. Comparative genomic analysis of 36 complete P. gingivalis genomes showed that the amino acid sequences of TnaA were highly conserved. However, the transposase region adjacent to tnaA differed among strains: previously reported high-virulence strains, including W83, W50, and A7436, harbored the IS5-family transposase ISPg1, whereas several low-virulence reference strains carried the IS982-family transposase IS195. In saliva samples from periodontitis patients, ISPg1 expression was positively correlated with tnaA expression, and both were associated with periodontal clinical parameters. Together, these findings indicate that transposase-associated genomic variation near tnaA is associated with strain-specific tryptophan-indole metabolism, virulence-associated gene expression, and periodontal clinical parameters, while direct causality remains to be established in future functional studies.
To improve clinical decision-making about Carbapenem-resistant Gram-negative bacteria (CR-GNB) infections and halt the spread of resistant microbes, quicker and less expensive diagnostic techniques are required. Thus, the purpose of this study was to thoroughly evaluate the diagnostic efficiency (sensitivity, specificity, and concordance) of direct-from-specimen multiplex lateral flow immunoassay (LFIA) across diverse raw clinical specimens and pathogen types from critically sick patients. A total of 300 non-duplicate samples were tested to detect CR-GNB. Five major Carbapenemase genes were detected directly from the specimen using carbapenem-resistant K.N.I.V.O. detection K-Set and from culture using culture-enhanced multiplex PCR. Turnaround time (TAT) of each method was calculated. The direct LFIA revealed 100% specificity for NDM, KPC, and IMP enzymes in all tested clinical matrices (blood, urine, and respiratory samples). The study demonstrated 100% sensitivity and specificity with perfect categorical agreement (κ = 1.000) for the blaKPC in the Klebsiella pneumoniae and for blaOXA-48 and blaIMP in the Acinetobacter baumannii; however, sensitivity of blaVIM was significantly diminished across all isolates and samples. TAT decreased significantly (p < 0.001) from 30 to 70 h to about 50 min. The tested direct LFIA facilitates the prompt enhancement of lifesaving tailored antibiotic treatment for severe illnesses.
Acinetobacter baumannii is a significant pathogen of hospital-acquired infections, and its multidrug resistance (MDR) and extended drug resistance (XDR) have become increasingly severe, posing a global public health challenge. This article provides a narrative review of the major resistance mechanisms of Acinetobacter baumannii, including β-lactamase production, efflux pump overexpression, target site modification, reduced membrane permeability, and biofilm formation. Additionally, it summarizes the current main drugs and their target sites for treating MDR Acinetobacter baumannii infections, with a focus on the mechanism of action, antibacterial activity, and clinical research progress of the novel fully synthetic fluorocycline antibiotic—eravacycline. Eravacycline inhibits protein synthesis by high-affinity binding to the bacterial ribosomal 30S subunit and demonstrates activity against multidrug-resistant Acinetobacter baumannii (excluding Pseudomonas aeruginosa), providing a potential novel therapeutic option for MDR/XDR Acinetobacter baumannii infections. Finally, the article outlines future research directions and treatment strategies. Due to the narrative nature of this review, no systematic methodology (e.g., PRISMA) was applied, and the available clinical evidence, particularly for CRAB infections, remains limited.
Ticks are haematophagous ectoparasites and vectors of a diverse range of pathogens, exerting substantial impacts on wildlife, domestic animals and public health. In Australia, despite the country’s rich and unique biodiversity, a comprehensive understanding of ticks and tick-borne pathogens associated with wildlife remains limited. Environmental change, urban expansion and climate variability are increasingly disrupting wildlife habitats, potentially intensifying interactions between wildlife hosts, ticks and humans. A broad evidence synthesis of studies published between January 1940 and March 2024 was conducted, retrieving 133 eligible records from Web of Science, CABI Abstracts and PubMed databases. Fifty tick species parasitising 160 wildlife species were identified, predominantly from the genera Ixodes, Amblyomma and Haemaphysalis. The most commonly reported hosts included marsupials, particularly bandicoots, wallabies and possums, with notable tick species being Ixodes tasmani, Ixodes holocyclus and Amblyomma triguttatum. Microorganism records were relatively limited and mostly represented molecular detections or reported associations, including Babesia, Borrelia, Coxiella, Rickettsia and Theileria species, rather than confirmed vector competence, reservoir status or pathogenicity. Key limitations included geographic sampling biases towards eastern Australia, limited molecular identification of ticks and infrequent pathogen screening, particularly regarding the ecology, epidemiology and molecular diversity of host–vector–microorganism interactions. Improved surveillance, expanded molecular characterisation, and integrated One Health investigations are required to better understand the ecological and public health significance of these host–vector–microorganism interactions.
During construction of the Baku–Tbilisi–Kars railroad between Kars City in Türkiye and Tbilisi in Georgia, blasting operations in an anthrax-endemic region disrupted a burial pit containing carcasses of cattle that had died of anthrax. Railroad workers expressed concerns that release of this material could result in them developing anthrax infection. We therefore undertook a seroprevalence study six months later to seek evidence of exposure to Bacillus anthracis spores. We used an optimised Enzyme-Linked Immunosorbent Assay (ELISA) to screen serum for antigen-specific IgG antibodies to the anthrax toxin subunits Protective Antigen (PA) and Lethal Factor (LF). Stepwise linear regressions and t-tests were performed to compare results from railroad workers (n = 64) with a group of long-term Kars City residents (urban dwellers, n = 16), who had no history of possible contact with anthrax antigens. Anti-PA IgG concentrations were higher (p = 0.038) in railroad workers than in urban dwellers, but anti-LF IgG concentrations did not differ (p = 0.932) between the two groups. The anti-PA response is known to be dominant, and the difference was small. The lack of LF response did not preclude an antibody response to B. anthracis. Following the blasting operations, no cases of anthrax infection occurred in either railroad workers or villagers living nearby, suggesting that the spore exposure (evidenced by higher antibody titres) was at levels insufficient to initiate clinical infection. The elevated PA-specific antibody responses in railroad workers compared with urban dwellers might be consistent with the former having had previous subclinical exposure to B. anthracis. In anthrax-endemic regions, therefore, construction activities that involve blasting or large-scale excavation may pose risks of occupational exposure to Bacillus anthracis spores.
Orthoebolavirus causes severe Ebola virus disease (EVD) and deadly outbreaks in humans. This infection occurs through macropinocytosis and trafficking to late endosomes or lysosomes that utilize the receptor Niemann-Pick C1 (NPC1) to enter the cell cytoplasm. We designed peptide inhibitors based on the NPC1 receptor to target the NPC1 binding site to block viral entry. The results indicated that the ligand-based peptide inhibitors showed potent inhibition activities in vitro studies against pseudotyped or replication-competent Orthoebolavirus. Therefore, we further evaluated one of them in a mouse model challenged with mice-adapted Ebola viruses, which showed some protection efficacy compared with the control group. This study suggests that ligand-based peptides are encouraging inhibitors in the development of inhibitors against Ebola virus infection.
Accurate detection of Campylobacter in chicken liver is hindered by strong matrix inhibition. This study evaluated sample-processing strategies to improve droplet digital PCR (ddPCR) quantification of Campylobacter coli and Campylobacter jejuni in chicken liver. Mechanical homogenization (Stomacher) and enzymatic/mechanical dissociation (gentleMACS), with and without 8 μm filtration, were compared. Particle-size analysis showed that filtration, especially following gentleMACS treatment, produced smaller, more uniform particles and reduced variability. Percent-degradation assays confirmed that gentleMACS achieved substantially greater tissue disruption than Stomacher homogenization. The multiplex ddPCR assay, which simultaneously targets C. coli and C. jejuni, produced droplet counts comparable to single-target reactions, indicating minimal interference between targets under the conditions tested. In inoculated liver samples, gentleMACS processing yielded droplet counts similar to those obtained from pure cultures, whereas unprocessed liver caused severe matrix interference and inconsistent quantification. Furthermore, gentleMACS-treated samples exhibited strong log-to-log linearity for quantifying C. coli and C. jejuni, enabling detection near 1 genome copy equivalent per reaction. Overall, the results indicate that enzymatic/mechanical dissociation combined with fine-pore filtration improves ddPCR detection of Campylobacter species in chicken liver.
Infectious prion adsorption on metal, minerals, wood, and plastic is well documented, raising the specter of food safety hazards for meat packing workers, sport hunters, and consumers. We previously demonstrated that sodium hypochlorite, and to a lesser extent, potassium peroxymonosulfate, and hypochlorous acid can decontaminate prion-contaminated nonporous surfaces. However, the extent to which chemical aging of surfaces affects subsequent recoverable prion seeding activity is unknown. In this study, we investigated the potential for four chemical decontaminants known for their anti-prion activity (sodium hypochlorite [bleach], hypochlorous acid [Briotech], potassium peroxymonosulfate [Virkon-S], and Wex-Cide-128) to alter the surfaces of steel knives and the subsequent prion decontamination efficacy of each. We found that hypochlorous acid, sodium hypochlorite, and potassium peroxymonosulfate corrode the surfaces of steel knives, resulting in significant physical alterations. Knives exposed to hypochlorous acid exhibited the most substantial corrosion (rust), which is consistent with its oxidizing effects. Oxidation of the knife surface was corroborated by complementary energy-dispersive X-ray spectroscopy data trends. Scanning electron microscopy data indicate corrosion is apparent after minimal exposure to oxidizing agents. Finally, we used the real-time quaking-induced conversion assay on swabs collected from chemically aged knife surfaces to evaluate recoverable surface-associated CWD-prion seeding activity detected by RT-QuIC after prion exposure and decontamination. Our results indicate decreased recoverable prion seeding activity from knife surfaces aged with 40% bleach. We also observed some recoverable seeding activity post-decontamination on knives chemically aged with 10% bleach and Wex-Cide-128, but largely similar efficacy to prior studies. This implies that existing chemical prion decontaminants are likely effective after repeated use on steel surfaces.
Orthohantavirus infections are classically associated with hemorrhagic fever with renal syndrome (HFRS) in Eurasia and hantavirus cardiopulmonary syndrome (HCPS) in the Americas. However, accumulating evidence indicates that the clinical spectrum is considerably broader, with frequent involvement of organ systems beyond the kidney and lung. Hepatic manifestations, in particular, may mimic acute viral hepatitis, leading to diagnostic challenges and underrecognition. This paper synthesizes published evidence on hepatic involvement in orthohantavirus infection, with a focus on clinical presentation, pathogenic mechanisms, differential diagnosis, biomarkers, and public health implications. Relevant literature was identified through searches of peer-reviewed articles, with emphasis on studies reporting hypertransaminasemia, hepatitis-like illness, and liver injury in confirmed hantavirus infections. Mild to moderate elevations in aminotransferases are common during acute orthohantavirus infection, and in some patients the clinical picture may be dominated by fever, thrombocytopenia, and hepatitis-like abnormalities, closely resembling dengue, leptospirosis, or classical viral hepatitis. Hepatic injury appears to result primarily from systemic endothelial dysfunction, immune-mediated inflammation, and microvascular leakage rather than direct hepatocytopathic effects. Emerging biomarkers of severity, including thrombocytopenia, neutrophil-to-lymphocyte ratio, soluble thrombomodulin, and IL-6 trans-signaling, reflect widespread vascular and inflammatory activation. Diagnostic delays are frequent, particularly in non-endemic regions, due to low clinical awareness and overlapping features with more common febrile hepatotropic syndromes. Orthohantavirus infection should be considered in the differential diagnosis of acute febrile illness with unexplained hypertransaminasemia and thrombocytopenia, especially when epidemiological clues suggest rodent exposure or compatible environmental contexts. Recognizing hepatic involvement as part of a systemic endothelial syndrome may improve diagnostic accuracy, reduce underreporting, and facilitate earlier supportive management. Increased awareness among hepatologists, infectious disease specialists, and emergency physicians is warranted.
Root-knot nematodes (Meloidogyne javanica and M. incognita) constrain olive (Olea europaea L.) production and require safer alternatives to chemical nematicides. Despite the growing interest in microbial biocontrol agents, limited information is available on how application timing and microbial consortia influence nematode suppression and host biochemical responses in olive. This greenhouse study evaluated endophytic Trichoderma (T. harzianum) and Bacillus (B. subtilis), applied alone or in combination, either before or after nematode inoculation, to determine how biocontrol treatment timing influences nematode suppression, plant performance, and host biochemical responses. Across both nematode species, preventive application consistently outperformed curative application, and the combined treatment delivered the strongest overall protection. Preventive co-application reduced nematode infection, improved root and shoot growth, attenuated oxidative damage, and preserved chlorophyll more effectively than single-agent or post-inoculation treatments. Spectroscopic (Fourier Transform Infrared (FTIR)) and multivariate analyses further showed that effective treatments were associated with lower nematode-associated protein and lipid signals and stronger signatures of structural defense in root tissues. Although M. javanica caused greater physiological disruption than M. incognita, both species responded to the same general treatment pattern. These findings show that early establishment of microbial biocontrol agents is critical for durable suppression of root-knot nematodes in olive and supports preventive microbial consortia as a promising strategy for integrated nematode management.
Ticks are widely distributed in China and can carry and transmit a variety of pathogens that potential to cause serious impacts on public health and the economy. Little is known about the broader spectrum of Coxiella-like endosymbiont (CLE) in ticks under natural conditions in China. The aim of this study was to detect, analyze, and characterize phylogenetically CLE found in ticks in Hebei Province, China. A total of 947 ticks collected from Hebei Province were identified as Haemaphysalis longicornis based on morphological characteristics and cytochrome c oxidase gene PCR analysis of extracted DNA. Subsequently, DNA was analyzed via PCR for the IS1111 gene (frequently associated with Coxiella burnetii), and the amplified DNA was then sequenced and analyzed phylogenetically using a set of primers targeting the 16S rRNA, groEL, and rpoB genes. A total of 8.24% (78/947) of ticks from the Chengde, Baoding, and Cangzhou regions were positive in the IS1111 PCR. Phylogenetic analysis using the 16S rRNA, groEL, and rpoB genes revealed the presence of CLE in Ha. longicornis ticks from these regions and the formation of two distinct clades, suggesting horizontal gene transfer events. Our results strengthen the growing evidence that CLE, not Coxiella burnetii, is ubiquitously associated with ticks across diverse geographic locations—a distinction critical for accurately interpreting tick microbiome surveys and avoiding false assumptions of zoonotic risk.
Ventilator-associated pneumonia (VAP) is linked to high mortality rates, especially in developing countries. This cross-sectional survey study was conducted across three central hospitals in the Hail region of Saudi Arabia, King Salman Specialist Hospital, Hail General Hospital, and King Khalid Hospital, to assess the knowledge and adherence of intensive care unit (ICU) healthcare practitioners to the ventilator bundle (VB) for VAP prevention. It also looked at the practitioners’ perceived barriers to effective VB deployment. The study (n = 86) revealed significant disparities in VAP prevention knowledge across educational levels regarding the recommended degree of head-of-bed (HOB) elevation (p < 0.001), the use of endotracheal tubes with extra lumens for subglottic drainage (p < 0.001), and the protective effects of 0.12% chlorhexidine gluconate antiseptic oral rinse (p = 0.019). Professional experience significantly influenced knowledge of non-standard VB components (p < 0.001), the recommended frequency of awakening and spontaneous breathing trials (SBTs) (p < 0.001), and knowledge of extra-lumen tubes (p = 0.038) and kinetic beds vs. standard beds (p = 0.005). Significant differences were found between professional categories regarding knowledge of hand hygiene performance (p = 0.032), the correct degree of HOB elevation (p = 0.007), and patient positioning (semi-recumbent vs. supine) (p = 0.023). Years of experience significantly impacted reported compliance with institutional VB (p = 0.013), adherence to oral care protocols (p = 0.035), and the assessment of sedation depth (p = 0.002). While basic measures like HOB elevation practice and DVT prophylaxis showed universal reported compliance (100%), significant performance gaps were identified in more complex tasks, such as interrupting continuous sedative infusions and performing SBTs as recommended (p < 0.001), particularly among novice practitioners. The primary implementation barrier preventing full compliance with the VB was identified as educational deficit, which was prioritized as the most important area for quality improvement, highlighting the need for targeted training for newly hired ICU staff.
Herpesvirus infections belong to major pathogens in the human population. This study aimed at evaluating diagnostic data for eight human herpesviruses, based on datasets derived from a large European tertiary care center. Specifically, we analyzed 118,692 herpesvirus submittals to the Diagnostic Division of the Virological Institute, University Hospital Erlangen (UKER), Germany, between July 2014 and June 2024. Our points of focus were the following: (i) the frequencies of herpesvirus diagnostic results with positivity rates, (ii) departments representing main sample submitters, (iii) the specific importance of intensive care units (ICUs), (iv) the COVID-19 pandemic period, and (v) distinct properties of sample types. Overall, we are stating the highest frequencies of diagnostic assessment for herpes simplex virus (HSV), human cytomegalovirus (HCMV), and Epstein-Barr virus (EBV) infections, pointing to their dominant relevance for clinical practice. Notably, HCMV submittals (46.6% of total), together with EBV (26.2%) and HSV (15.7), accounted for almost 90% of all herpesviral diagnostic samples during this period. Within these key groups, HCMV, EBV and HSV showed positivity rates of 14.5%, 35.0%, and 18.5%, respectively. Concerning a main input of sample submittals, two departments were predominant in our center, i.e., the Departments of Haematology-Oncology and Anaesthesiology. These included patients under multifold types of treatment associated with an increased risk of herpesvirus reactivation or primary infection. Furthermore, another high portion of submittals was noted for ICUs and external sources. In addition, a numerical, transient increase in herpesvirus diagnostic submittals, from various sources, was shown for the COVID-19 pandemic years (mostly 2021) as compared to other periods. Combined, these data underlined the importance of clinical monitoring of herpesvirus infections, particularly for high-risk patients, and the steady need of improvements in preventive measures, therapeutic options, and safe diagnostic tools.
Background: Oral candidiasis is an opportunistic infection caused by Candida albicans (C. albicans), highlighting the need to evaluate candidate substances that ensure both antifungal efficacy and mucosal safety. This study aimed to assess the potential of Sambucus williamsii var. coreana (S. williamsii var. coreana) extract as a naturally derived antifungal agent for topical oral application by investigating its antifungal activity against C. albicans and its cytotoxicity in human keratinocyte (HaCaT) cells. Methods: S. williamsii var. coreana was extracted with 70% ethanol, concentrated, and freeze-dried. The extract was prepared at concentrations of 1–40 mg/mL and applied under 6 h and 24 h exposure conditions. Antifungal activity against cultured C. albicans was evaluated using colony-forming unit (CFU) analysis, while cytotoxicity in HaCaT cells was assessed via the Water-soluble Tetrazolium Salt-1 assay after incubation at 37 °C in 5% CO2 for 2 h. Statistical significance was analyzed using Student’s t-test, ANOVA, and Tukey’s HSD test (p < 0.05). Results: The S. williamsii var. coreana extract exhibited concentration- and time-dependent antifungal activity. A 99.99% inhibition of C. albicans was observed at 5 mg/mL. No detectable CFUs were observed at 30 mg/mL after 6 h and at 10 mg/mL after 24 h. HaCaT cell viability decreased in a concentration-dependent manner, with the half-maximal inhibitory concentration determined to be 10 mg/mL. Conclusions: The extract of S. williamsii var. coreana exhibited concentration- and time-dependent in vitro antifungal activity against C. albicans. However, the concentration associated with no detectable CFUs overlapped with the cytotoxic concentration range in HaCaT cells, indicating that further studies are required to define an appropriate concentration range for potential oral application.
Strongyloidiasis is a neglected tropical disease that frequently coexists with Chagas disease (CD) among individuals from Latin America. Serology is increasingly used for the diagnosis and post-treatment follow-up of strongyloidiasis; however, comparative data on commercially available assays remain limited. We conducted a cross-sectional evaluation in a cohort of fifty-five patients with previously treated CD attending a Tropical Medicine Unit in Spain. All patients underwent serological screening for Strongyloides stercoralis using two commercial ELISA assays: the Strongyloides IgG ELISA kit (DRG Instruments GmbH) (DRG) and Anti-Strongyloides ELISA IgG (Euroimmun Medizinische Labordiagnostika AG) (Euroimmun). A composite reference standard defined infection as seropositivity in combination with eosinophil count (>0.5 × 103 eosinophils per µL) or seropositivity in both assays. Infected individuals received ivermectin and were reassessed one-year post-treatment. Thirty-seven patients (67.3%) met the criteria for strongyloidiasis. Concordance between the assays was substantial (κ = 0.80). According to the composite study definition, both assays identified most patients as infected. At one-year follow-up, significant reductions were observed in DRG and Euroimmun indexes, as well as in eosinophil count (all p < 0.001). Treatment response rates were 83.3% with DRG and 73.3% with Euroimmun. Both ELISA assays showed comparable performance in identifying patients at risk of strongyloidiasis and in monitoring serological response after ivermectin treatment, supporting their usefulness in the management of patients with CD and suspected strongyloidiasis. Routine serological screening should be considered in this high-risk population.
Avian influenza virus (AIV), a zoonotic pathogen capable of cross-species transmission, poses a significant global health threat due to its rapid evolutionary adaptation. This review consolidates evidence from the past decade on AIV-autophagy interactions, emphasizing mechanistic insights and therapeutic potential. Research indicates that various AIV strains can trigger autophagosome formation via viral components, although the completeness of autophagic flux is not fully understood. These virus–host interactions are notably influenced by viral genotypes (e.g., H5N1 vs. H9N2) and host species (avian vs. mammalian). Current studies suggest that modulating autophagy may reduce AIV-induced acute lung injury, with pharmacological agents showing potential in mitigating inflammatory responses. We systematically explore three research areas: (1) strain-specific mechanisms of autophagy induction, (2) host-specific autophagic responses in poultry and human models, and (3) the therapeutic potential of stage-specific autophagy manipulation. This synthesis clarifies critical knowledge gaps, particularly the need for standardized autophagic flux assessment in avian cells, while providing a conceptual framework for developing autophagy-targeted strategies against AIV pathogenesis.
Background: Infections remain a major complication in patients with left ventricular assist devices (LVADs). Enterococcal infections are increasingly recognized and are therapeutically challenging because of antimicrobial tolerance, biofilm formation on prosthetic material, and the frequent impossibility of device removal. Objective and method: We report two clinical cases of Enterococcus faecalis LVAD infection and a PRISMA-based systematic review of cases published between 1996 and 2025 that were identified through PubMed/MEDLINE. Primary outcomes were clinical cure, relapse or recurrence, mortality, and device removal. Results were synthesized descriptively. Results: Seventeen cases were analyzed, including 15 previously reported cases and two new cases. E. faecalis accounted for 47% of infections, Enterococcus faecium for 29%, and Enterococcus spp. without species identification for 24%. Bacteremia was the most common presentation, occurring in 76%, whereas LVAD-associated endocarditis occurred in 18%. Driveline or pocket involvement was reported in 41%. Suppressive antimicrobial therapy (SAT) was used in 29%, often as a bridge to heart transplantation. Cultures from explanted LVAD components were positive in 47% of cases despite prolonged antimicrobial therapy. Recurrence or relapse and overall mortality each occurred in 18% of patients. Conclusions: Enterococcal LVAD infections may be associated with microbiological persistence despite prolonged therapy. SAT may help control infection in selected patients and bridge to heart transplantation when device removal is not feasible.
