OBJECTIVES:Bacillus cereus sensu lato (s.l.) or B. cereus group increasingly causes severe infections in preterm neonates. However, species-level identification and virulence characterization remain limited. This study aimed to identify B. cereus group species responsible for invasive infections in preterm neonates and to correlate genomic virulence profiles with clinical outcomes. METHODS:We conducted a retrospective, multicentre study across 13 French hospitals (2010-2021), including 40 B. cereus group isolates from blood or cerebrospinal fluid of preterm neonates with invasive infections. Clinical data were extracted from patient records. Whole-genome sequencing (WGS) (Illumina and Oxford Nanopore) with hybrid assemblies enabled species identification using digital DNA-DNA hybridization and average nucleotide identity. Virulence genes were screened against a curated database of 65 virulence genes, and associations with clinical outcomes were analysed. RESULTS:Forty isolates were analysed, 42.5% (17 of 40) of patients developed septic shock, and 37.5% (15 of 40), died, usually after rapid clinical deterioration. WGS identified seven species, predominantly Bacillus paranthracis (47.5%, 19 of 40) and B. cereus sensu stricto (20%, 8 of 40). Virulence gene content varied by species. The presence of hblCDAB (60%, 9 of 15), nprB (46.5%, 7 of 15), asbABCDEF (80%, 12 of 15), and essC-cereus/esxA (66.7%, 10 of 15) genes correlated with mortality (p 0.00015, 0.002, 0.0027, and 0.02, respectively). B. cereus sensu stricto carried more virulence determinants and was associated with higher mortality than B. paranthracis and other species, at day 7 (p 0.05) and at day 28 (p 0.0065). The cesH gene (60%, 15 of 25) is significantly associated with survival (p 0.007), particularly with B. paranthacis, the predominant species in our cohort. CONCLUSIONS:Invasive B. cereus group infections in preterm neonates are associated with high mortality, particularly in cases due to B. cereus sensu stricto. WGS enables precise species identification and virulence profiling, which are essential insights for diagnostic refinement, outbreak control, and risk stratification in neonatal intensive care settings.

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

Abstract Introduction Streptococcus is the second genus involved in bone and joint infections (BJIs) after Staphylococcus. Streptococcus agalactiae is the predominant Streptococcus species implicated in BJIs. However, unlike Staphylococcus -related BJIs, data on S. agalactiae infections remain scarce. Methods We conducted a retrospective cohort study from the West Region cohort of the CRIOAc registry among six university hospitals including all microbiologically confirmed streptococcal BJI in adults between 2014 and 2023. Results 1454 patients were included, with a median age of 67 years and 65% male. S. agalactiae was the predominant streptococcal species involved 423/1454(29%). The most prevalent comorbidities identified were obesity (378/1454;26%) and diabetes mellitus (343/1454;24%). Prosthetic joint infections (PJIs) were the most common (653/1454;45%), although diabetic foot osteitis was less prevalent overall, it was significantly more associated with S. agalactiae infections (48/423;11% versus 70/1031;7%, p=0.05). S. agalactiae BJIs were more frequently lower-limb infections and chronic infections (240/423;57% versus 502/1031;49%, p=0.04). Half of the cohort had a polymicrobial infection and were slightly more frequent with S. agalactiae BJIs (235/423;56% versus 498/1031;48%, p=0.1). These results were consistent with a sensitivity analysis excluding diabetic foot related osteitis. Logistic regression analysis identified arteriopathy (OR: 4.16; IC95:1.64-11.24, p=0.003), and obesity (OR: 2.57; IC95: 1.41-4.78, p=0.002) as specific risk factors for S. agalactiae BJIs. Conclusion S. agalactiae emerges as a prominent and distinct pathogen in complex streptococcal BJIs, with specific risk factors such as arteriopathy, obesity and diabetes mellitus, and more chronic infections.

INTRODUCTION:Streptococcus is the second genus involved in bone and joint infections (BJIs) after Staphylococcus. Streptococcus agalactiae is the predominant Streptococcus species implicated in BJIs. However, unlike Staphylococcus-related BJIs, we lack epidemiological data on S. agalactiae BJIs. We aimed to describe its distinctive features compared with other streptococci. METHODS:This multicentre retrospective observational study included all microbiologically confirmed streptococcal BJI in adults between 2014 and 2023 from six referral centres for complex BJIs in France. Characteristics of S. agalactiae BJIs were compared to other streptococcal BJIs to identify risk factors for S. agalactiae infection. From this study, 143 S. agalactiae strains were characterised and compared by CRISPR1 typing method. RESULTS:1454 patients were included, with a median age of 67 years and 65% male. S. agalactiae was the predominant streptococcal species involved 423/1454(29%). The most prevalent comorbidities identified were obesity (378/1454;26%) and diabetes mellitus (343/1454;24%). Prosthetic joint infections (PJIs) were the most common (653/1454;45%), although diabetic foot osteitis was less prevalent overall, it was significantly more associated with S. agalactiae infections (48/423;11% versus 70/1031;7%, p=0.05). S. agalactiae BJIs were more frequently lower-limb infections and chronic infections (240/423;57% versus 502/1031;49%, p=0.04). Half of the cohort had a polymicrobial infection and were slightly more frequent with S. agalactiae BJIs (235/423;56% versus 498/1031;48%, p=0.1). These results were consistent with a sensitivity analysis excluding diabetic foot related osteitis. Logistic regression analysis identified arteriopathy (OR: 4.16; IC95:1.64-11.24, p=0.003), and obesity (OR: 2.57; IC95: 1.41-4.78, p=0.002) as specific risk factors for S. agalactiae BJIs. Molecular study revealed three main clonal complexes (CC) involved in BJI strains: CC1 (58/143;41%), CC23 (36/143;25%) and CC10 (22/143;15%). CONCLUSION:S. agalactiae emerges as a prominent and distinct pathogen in complex streptococcal BJIs, with specific risk factors such as arteriopathy and obesity, and more chronic infections.

SUMMARYInquilinus limosus is a nonfermentative Gram-negative rod that has been reported as an emergent pathogen, particularly in chronic respiratory diseases. I. limosus was first isolated from the airways of a lung transplant patient suffering from cystic fibrosis (CF). As I. limosus is almost exclusively recovered from the airways of CF patients, its identification may be challenging for non-CF specialists. Indeed, I. limosus is mainly isolated from the airways of CF patients, and its pathogenesis and treatments are still debated. We have extensively reported and reviewed the different clinical cases described in the literature, the identification methods used, and the antimicrobial susceptibility testing performed. Therefore, we provide here an exhaustive description of the phenotypic features and antimicrobial susceptibilities of I. limosus. Only seven I. limosus genomes are currently available in public databases. These genomes are not fully assembled and therefore allow only partial genomic analyses, which could not unveil antimicrobial resistance determinants or virulence factors. They are approximately 7 Mb in size and encode between 6,036 and 7,483 genes. Given that the available genomes are incomplete, our genomic analyses are still limited and would undoubtedly benefit from further fully sequenced and annotated genomes to provide additional information on the antibiotic resistance and pathogenesis of I. limosus. We anticipate that our review will be a starting point for more genome sequencing studies, as well as epidemiological studies, to provide additional information on I. limosus for better management of patients.

Exposure to broad-spectrum antibiotics, particularly to third-generation cephalosporins (3GC), increases the risk of colonization by extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E). While clinical risk factors for ESBL-E acquisition are well established, the role of the gut microbiome and resistome remains unclear. We conducted a prospective study of patients with suspected bacterial infections receiving ceftriaxone to identify microbiome and resistome features associated with ESBL-E acquisition. Rectal samples collected before antibiotic administration, during treatment, and 30 d after initiation were analyzed by shotgun metagenomic sequencing. Among 80 patients, 12 (15%) acquired ESBL-E colonization by day 30. Ceftriaxone exposure induced a profound and sustained reduction in microbial richness and diversity across all patients. However, no specific taxonomic signature predicted subsequent ESBL-E colonization. In contrast, patients who did not acquire ESBL-E displayed a significantly richer and more diverse repertoire of β-lactamase-encoding genes at baseline, which was independently associated with protection against colonization. Moreover, patients exposed to multiple antibiotics experienced greater and more sustained microbiome disruption compared with those receiving ceftriaxone alone. These findings provide the first real-world evidence that pre-existing β-lactamasome diversity may confer ecological protection against antibiotic-driven colonization by ESBL-E in infected patients, highlighting the importance of functional resistome diversity over taxonomic composition in colonization resistance.

Introduction Aeromonas species are Gram-negative bacilli capable of causing bloodstream infections in both immunocompromised and otherwise healthy individuals. However, data on their epidemiology and antimicrobial resistance remain limited in Europe. Methods We conducted a multicentre, retrospective, observational study that included all Aeromonas species isolates recovered from blood cultures in 56 European hospitals between January 1st 2020 and December 31st 2024. Epidemiological features and antimicrobial susceptibility profiles were analyzed. Results A total of 590 Aeromonas isolates were included. Most were recovered from polymicrobial blood cultures (73.1%), and catheter-related bloodstream infections were frequent (21.7%). The most commonly reported species were A. caviae (30.1%), isolates without conclusive species identification (Aeromonas spp., 24.8%), A. hydrophila (20.7%), and A. veronii (19.1%). At the genus level, susceptibility to aztreonam, ceftazidime, and cefepime exceeded 90%. Resistance to fluoroquinolones (∼10%) and sulfamethoxazole/trimethoprim (up to 11%) was observed. Species-level analyses showed higher resistance rates to fluoroquinolones and sulfamethoxazole/trimethoprim among A. caviae and A. hydrophila, and increased resistance to ceftazidime among Aeromonas spp. Conclusions Aeromonas species in Europe showed high susceptibility to ceftazidime and cefepime, alongside with emerging resistance to fluoroquinolones and sulfamethoxazole/trimethoprim. Species-specific findings should be interpreted cautiously due to limitations in routine identification methods, underscoring the need for sustained surveillance and harmonised diagnostic standards across Europe.

Acne is a common inflammatory dermatosis with a prolonged and heterogeneous course, potentially leading to scarring, psychosocial burden, and repeated healthcare use. However, most available data derive from cross-sectional studies, randomised controlled trials, or administrative databases, which rarely integrate detailed clinical phenotyping, patient-reported outcomes, exposome-related factors, and routine clinical data within the same longitudinal real-world framework. The COPACNE cohort was designed to address this gap by providing a prospective, multidimensional characterisation of acne in routine clinical practice and by exploring factors associated with severity, scarring, and treatment response. COPACNE is a monocentric prospective observational cohort conducted in the Department of Dermatology of Nantes University Hospital. Patients consulting for acne are eligible regardless of age, acne type, or severity and are followed as part of routine care. Data are collected prospectively using electronic case report forms and include clinical severity and scarring scores, patient-reported outcome measures, environmental and lifestyle factors, therapeutic exposure, and, when performed as part of routine care according to the investigator’s clinical judgement, biological tests and bacteriological swabs for microbiological analysis. By integrating clinical, psychosocial, exposome-related, and routine care data within a single prospective framework, COPACNE is expected to generate evidence complementary to that provided by trials and administrative database studies and to support more personalised and sustainable acne management.

Background Management of prosthetic joint infections (PJIs) due to Candida spp. remains challenging and poorly standardized. Epidemiological patterns and therapeutic strategies may vary between centers and countries, potentially reflecting differences in access to antifungal agents.Methods We performed a secondary analysis of an international, multicenter, retrospective study supported by the European Society of Clinical Microbiology and Infectious Diseases, including Candida PJI diagnosed between 2010 and 2020. Cases met European Bone and Joint Infection Society criteria, combining clinical signs of infection with at least 2 intraoperative samples positive for Candida spp. Follow-up was 2 years. Epidemiology, management, and outcomes were compared across 5 groups: France, Spain, England, Austria, and other countries.Results Overall, 268 cases were included: France (n = 142), Spain (n = 42), England (n = 38), Austria (n = 36), and others (Brazil, Lithuania, Italy; n = 9). Distribution of infected sites was similar across countries (hip 53.4%, knee 43.3%, and other 3.3%), as was species epidemiology (Candida albicans 55.6%, Candida parapsilosis 29.5%, Candida glabrata 7.8%, and Candida tropicalis 5.6%). Surgical strategies differed: 1-stage exchange was more frequent in France (36.0%) and Austria (34.3%), whereas 2-stage exchange predominated in England (42.1%) and Spain (37.2%). Echinocandins were prescribed significantly more often in France (41.8%) than elsewhere. Overall outcomes were poor, with a global failure rate of 43%, without significant differences between countries.Conclusions International differences in epidemiology and management of Candida PJI appear limited. Variations in surgical and antifungal strategies did not translate into improved outcomes, highlighting the need for optimized and standardized management approaches in future collaborative prospective studies worldwide and clinical.

Introduction:Congenital brucellosis is a rare but serious transplacental infection. Patients and methods:Brucellosis is a bacterial zoonosis, that has become extremely rare in France unlike many countries in the Mediterranean basin, where it remains endemic and is a cause of travel-related morbidity. We have reported the first case of neonatal brucellosis in France since 1990, involving a preterm infant born at 26 weeks with Brucella melitensis chorioamnionitis, due to mother-to-fetal transmission. A PubMed review (2000-2024) identified 13 additional neonatal cases. Results:The mother had consumed unpasteurized cheese during early pregnancy in Spain. Maternal Blood cultures at delivery were positive for B. melitensis. The neonate remained asymptomatic until day 13, when blood culture -negative at birth- became positive. Despite delayed treatment, clinical respone was favorable. Since 2000, most cases have involved B. melitensis, presenting with respiratory distress, sepsis, or hepatomegaly. Infants were mainly treated with Rifampicin and TMP-SMX for six weeks, with overall favorable outcomes despite occasional severe or chronic cases. Conclusion:This rare case highlights the need to consider brucellosis in maternal fever or unexplained neonatal sepsis, with travel and dietary history guiding early diagnosis.

Sanguibacteroides justesenii is a rarely reported Gram-negative anaerobic bacillus of uncertain clinical significance. Its identification is challenging using conventional methods. We report the case of a 58-year-old woman admitted for acute heart failure who developed septic shock following colonic perforation. Blood cultures grew an obligate anaerobic Gram-negative bacillus. MALDI-TOF MS (Bruker®) identified the isolate as Gabonibacter massiliensis (score 2.19). Given the unexpected result, the strain was referred to a reference laboratory, where 16S rRNA gene sequencing identified S. justesenii. Repeated MALDI-TOF analyses in two laboratories reproduced the same misidentification, underscoring database limitations for rare species. The patient was treated with amoxicillin and metronidazole and recovered without complications at 6-month follow-up. This is the third reported case of S. justesenii in blood cultures and a rare associated with abdominal sepsis, emphasizing the need for molecular confirmation when MALDI-TOF results are uncertain.

OBJECTIVES:To characterize the intrinsic carbapenemase of Sphingobacterium spp. MATERIALS AND METHODS:Sphingobacterium spp. clinical isolates (n = 63) were collected in several French laboratories from 2012 to 2022. Antibiotic susceptibility was assessed by disc diffusion. MICs of last resort antimicrobials (including carbapenems, ceftazidime-avibactam, cefepime-enmetazobactam and cefiderocol) were determined by broth microdilution. WGS was performed on all isolates using the Illumina method. Cloning of the Sphingobacterium spiritivorum β-lactamase encoding gene, blaSPI-1, allowed expression of a novel metallo-β-lactamase (MBL), SPI-1, in Escherichia coli. Enzymatic kinetic parameters were determined with β-lactams as substrates. RESULTS:Among the 64 Sphingobacterium isolates collected we identified six species, of which S. spiritivorum (n = 24) was the most prevalent followed by S. multivorum (n = 20), S. siyangense (n = 16), S. lactis (n = 2), S. thalpophilum (n = 1) and S. faecium (n = 1). Sphingobacterium isolates displayed a phenotype of multidrug resistance including resistance to last resort β-lactams and β-lactam-β-lactamase inhibitors (with MIC50 at 4, 4 and 2 mg/L for ceftazidime-avibactam, cefepime-enmetazobactam and cefiderocol, respectively). The most effective drugs were fluoroquinolones, tigecycline and eravacycline. All S. spiritivorum displayed a carbapenemase activity that correlated with the identification of SPI-1 encoding genes. SPI-like variants (n = 10) shared 93.7% amino-acid identity, but only 50.6% identity with the closest CGB-1 MBL intrinsic of Chryseobacterium gleum. Characterization of SPI-1 showed a strong hydrolytic activity towards most β-lactams including carbapenems. CONCLUSION:S. spiritivorum was the most prevalent species of Sphingobacterium identified in clinical samples. All S. spiritivorum-like species produced a chromosomally encoded SPI-like MBL that might be challenging for the treatment of infections caused by this bacterial species.

Enterococci are considered indicators of fecal contamination from mammals and birds and of antimicrobial resistance (AMR) from the environment. This longitudinal observational study assessed the persistence of Enterococcus spp. in a recirculating aquaculture system (RAS), determined AMR phenotypes and compared them with isolates recovered from human infections. Over five monthly sampling events, 95 samples were collected from all compartments of the RAS rearing rainbow trout at a French experimental facility: water (n = 33), biofilm (n = 23), sediment (n = 5), fish feces (n = 30) and commercial fish feed (n = 4). Enterococcus isolates from feed and RAS, in addition to 15 E. faecium from human infections retrieved at Nantes University Hospital, were tested using broth microdilution method against 12 antibiotics of importance for human or animal health. Minimum inhibitory concentrations (MICs) were interpreted using epidemiological cutoff (ECOFF) values and clinical breakpoints reported by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Clinically important species (E. faecium, E. gallinarum, and E. casseliflavus) were found in commercial fish feed (3/4). However, only environmental Enterococcus species were isolated within the RAS, and at a low overall rate (7/91). The isolation rate of Enterococcus spp. within the RAS was significantly higher (p < 0.05) in May, probably due to both warmer water temperature and higher biomass. For four antibiotics, E. faecium isolates from human infections showed higher resistance rates than E. faecium from fish feed (p < 0.01). Although clinically important enterococci introduced via feed do not appear to persist within a RAS, the potential risk of AMR-gene transfer to environmental Enterococcus spp. and its spread via effluents needs further investigation.

Bone and joint infections (BJI), particularly periprosthetic joint infections (PJI), remain major postoperative complications. Although international guidelines have clarified diagnostic criteria, recommendations on clinical strain preservation remain scarce. Microbiology laboratories routinely store isolates from severe infections, but protocols and storage duration vary widely. This narrative review synthesizes international and national guidelines (ICM, EBJIS, IDSA, SPILF), French regulatory texts, and published data on bacterial preservation techniques. Methods of conservation (serial subculture, preservation media, freezing at various temperatures, desiccation, and lyophilization) and their impact on strain viability and genetic stability were examined. Most guidelines recommend preserving strains involved in BJI or infective endocarditis for molecular comparison, follow-up, or medico-legal purposes, yet few specify concrete duration or storage conditions. French SPILF guidelines require at least one year at − 80 °C. Preservation methods differ in cost, practicality, and long-term genetic integrity, with − 80 °C–− 130 °C offering optimal stability. Inadequate storage conditions—temperature fluctuations, humidity, oxygen exposure—may lead to contamination, DNA degradation, or genetic drift. Given the clinical, epidemiological, and medico-legal value of archived isolates, long-term standardized storage in dedicated biobanks is essential. A minimum five-year preservation period appears both feasible and beneficial to strengthen diagnostic reliability, outbreak investigations, and future research.

Background: Nonfermenting Gram-negative bacilli other than Pseudomonas and Acinetobacter species are increasingly recognized as opportunistic pathogens in pediatric populations, yet their epidemiology and antimicrobial resistance remain poorly defined. Methods: We conducted a multicenter retrospective analysis across 56 hospital centers in 25 European countries, including pediatric blood culture isolates collected between January 2020 and December 2024. Species distribution and antimicrobial susceptibility profiles according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) and Clinical and Laboratory Standards Institute (CLSI) current guidelines were analyzed. Results: A total of 382 isolates were included, spanning 19 genera and 40 species. Stenotrophomonas maltophilia was the most frequently identified species (46.9%; n = 179), followed by Roseomonas mucosa (10%; n = 38) and Sphingomonas paucimobilis (7.6%; n = 29). Susceptibility profiles were heterogeneous, with notable resistance across several species. For S. maltophilia , resistance to trimethoprim/sulfamethoxazole exceeded 10% (EUCAST), while full in vitro susceptibility to aztreonam/avibactam was observed. Preserved activity of carbapenems but high resistance to ceftazidime (EUCAST/CLSI), piperacillin/tazobactam (EUCAST/CLSI) and ciprofloxacin (CLSI) was observed for S. paucimobilis . Achromobacter several species showed concerning resistance patterns to carbapenems, piperacillin/tazobactam and trimethoprim/sulfamethoxazole (CLSI). Conclusions: Nonfermenting Gram-negative bacilli other than Pseudomonas and Acinetobacter species were frequently associated with healthcare exposure and complex resistance profiles. Their management is challenged by a lack of evidence and standardized susceptibility criteria. To optimize management, enhanced surveillance, improved diagnostic standardization and further clinical studies on emerging therapies are needed.

INTRODUCTION:Non-fermenting Gram-negative bacilli (NFGNB) other than Pseudomonas and Acinetobacter species remain largely underrepresented in systematic surveillance programs across Europe. METHODS:We conducted a multicentre retrospective observational study analysing all minor NFGNB isolates recovered from blood cultures in 56 European Hospital Centres over a 5-year period (2020-2024). Diagnostic approach, epidemiology and antimicrobial susceptibility according to European Committee on Antimicrobial Susceptibility Testing v. 15.0 were investigated. RESULTS:A total of 4420 minor NFGNB isolates were included. In 43.6% of cases, the isolates were recovered from polymicrobial blood cultures, and 40.6% were detected during microbiologically defined catheter-related bloodstream infections. Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-ToF) mass spectrometry was the most widely used tool for species identification (98%). Antimicrobial susceptibility testing was conducted in all centres, using mostly broth microdilution commercial systems (57%), disk diffusion (57%) and gradient diffusion MIC strip (54%) methods, mainly according to European Committee on Antimicrobial Susceptibility Testing guidelines (67.9%). The most prevalent species were Stenotrophomonas maltophilia (52.4%), Achromobacter xylosoxidans (7.8%), Sphingomonas paucimobilis (5.3%) and the Burkholderia cepacia complex (4.8%). S. maltophilia displayed a high rate of resistance to sulfamethoxazole/trimethoprim (11%), and 2% of the isolates were found to be likely resistant to cefiderocol. A. xylosoxidans showed high resistance to meropenem (10%), piperacillin/tazobactam (24%) and sulfamethoxazole/trimethoprim (53%) when tested by MIC methods, while showing over 90% susceptibility to meropenem when tested by disk diffusion. S. paucimobilis displayed over 90% susceptibility to amoxicillin/clavulanate, ampicillin/sulbactam, imipenem, meropenem and tetracycline. CONCLUSIONS:This study provides an updated overview of the diagnostic approaches and epidemiology of minor NFGNB across Europe, supporting future comparative analyses and improved diagnostic and antimicrobial strategies.

AIM:The aim of this study was to describe the bacterial epidemiology and antibiotic resistance rates of bacterial isolates collected from urine specimens in male patients with suspected urinary tract infection (UTI). METHODS:This retrospective multicenter study included routine data from midstream urine cultures of adult male patients with suspected UTI admitted to the emergency departments of 15 hospitals from 2019 to 2023. Urinalysis was performed according to the recommendations of the French Society for Microbiology and bacterial identification was carried out using MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed by disk diffusion or semi-automated methods and interpreted according to the CA-SFM/EUCAST guidelines. RESULTS:Overall, 38,279 bacterial isolates were detected among 33,113 male patients (mean age = 70.7 years). The most frequently encountered pathogen was E. coli (40.0 %) followed by E. faecalis (13.2 %), K. pneumoniae (7.8 %) and P. mirabilis (5.8 %). Overall prevalence of ESBL-E was 9.0 %, represented mainly by K. pneumoniae (22.8 %), E. cloacae complex (19.3 %) and E. coli (8.4 %). Prevalence of resistance to fluoroquinolones and cotrimoxazole was high (usually > 15-20 %). The resistance rates in E. coli were very low (around 1 %) for fosfomycin and nitrofurantoin, as was the overall prevalence of carbapenemase-producing Enterobacterales (0.1 %). In S. aureus, 20.4 % of isolates were resistant to methicillin, and only three vancomycin-resistant enterococci (<0.01 %) were detected. CONCLUSION:This original study provides recent, nationwide and helpful data on bacterial epidemiology and antibiotic resistance rates of isolates recovered from urines in male patients with suspected UTIs.

Infections caused by anaerobes are common in children. However, limited data are available on bloodstream infections caused by these bacteria in Europe. A multicentre retrospective observational study was conducted over a 4-year period (2020-2023) across 44 European hospitals to analyze all anaerobes isolated from blood cultures. The study examined the epidemiology and antimicrobial resistance profiles of anaerobes identified in paediatric patients, comparing the findings with those observed in adults. Among the 14,527 total anaerobic isolates, 186 (1.3%) were detected from paediatric patients. These were predominantly Gram-positive (70%) and Gram-negative (22%) bacilli. The most prevalent species in paediatric patients were Cutibacterium acnes (24.7%), Schaalia odontolytica (9.7%), Actinomyces oris (8.1%), and Bacteroides fragilis (7.5%). Relative feature importance based on the mean SHAP (SHapley Additive exPlanations) values distinguished paediatric patients and adults based on their antibiotic resistance patterns with high accuracy. Compared to those from adult patients, Gram-positive bacilli detected in paediatric samples displayed higher resistance rates for meropenem (15% vs. 9%), metronidazole (52% vs. 24%), and vancomycin (27% vs. 6%), and lower resistance to benzylpenicillin (11% vs. 17%), amoxicillin/clavulanate (9% vs. 17%), and clindamycin (30% vs. 36%). Gram-negative bacilli in paediatric samples displayed lower resistance to benzylpenicillin (18% vs. 29%), piperacillin/tazobactam (26% vs. 33%), and clindamycin (20% vs. 27%), and they were highly susceptible to imipenem, meropenem, and metronidazole as those detected in adult patients. Bacteroides species detected in paediatric and adult patients displayed high resistance to piperacillin/tazobactam (33% vs. 39%) and clindamycin (38% vs. 29%), while they were highly susceptible to metronidazole. Compared to those from adult samples, Cutibacterium acnes in paediatric patients displayed lower resistance to benzylpenicillin (none vs. 15%) and clindamycin (17% vs. 29%). The comparison of species and susceptibility profiles of anaerobes detected in paediatric and adult patients highlighted the importance of reporting antimicrobial susceptibility surveillance data by age group.