Malaria remains a significant global health challenge, disproportionately affecting Sub-Saharan Africa. Pregnant women represent one of the most vulnerable populations. Despite numerous advances in malaria control measures, lost-to-follow-up (LTFU) in antenatal care (ANC) programs poses a critical barrier to achieving optimal maternal and neonatal outcomes and the success of public health interventions. The factors driving LTFU, particularly in rural, high-burden settings, are not completely understood. This study investigates the determinants of LTFU among pregnant women receiving malaria screening in the context of the ERASE-Rise Against Malaria project in Northern Uganda. An observational retrospective cohort study was conducted on 1,558 women, recruited from July 2022 to June 2024, during the operational research held to assess the impact of antimalarial resistance on malaria care among pregnant women in three healthcare facilities in Oyam and Kole districts. Data on individual level (sociodemographic and clinical) and health care-related factors were analyzed using a multilevel logistic regression model to identify predictors of LTFU, defined as the absence of cohort outcome data 30 days after the expected delivery date. Efforts to recover missing data included delivery register consultation, active phone calls, and contact tracing by village health team workers. 871 (55.9%) of the 1,558 women were LTFU. Recovery strategies reduced the missing data rate to 29.1% (n=454). Protective factors against LTFU included higher education (aOR=0.75, 95% CI: 0.54-1.03, p=0.0798), being primigravida (aOR=0.73, 95% CI: 0.56-0.97, p=0.0275), and experiencing malaria during pregnancy (aOR=0.61, 95% CI: 0.48-0.78, p<0.0001). Women attending Aboke Health Center IV (n=385) were over five times more likely to be LTFU than those at Aber Hospital (n=955) (aOR=5.57, 95% CI: 4.08-7.71, p<0.0001), highlighting significant geographic and structural barriers. The high rate of LTFU in malaria screening programs underscores the need for targeted interventions addressing individual, systemic and structural barriers. Strengthening community-level support, improving healthcare infrastructures, and integrating malaria prevention into broader maternal health services are crucial for enhancing retention in care. Addressing determinants of LTFU, systematically, through further qualitative and quantitative research, is essential to improving maternal and neonatal health outcomes and achieving malaria eradication goals in high-burden settings.

Stenotrophomonas maltophilia is an emerging, multidrug-resistant pathogen increasingly associated with nosocomial infections, particularly in immunocompromised patients such as those undergoing allogeneic hematopoietic stem cell transplantation or affected by oncological diseases. Therapeutic options are limited due to intrinsic and acquired resistance mechanisms, including β-lactamases and efflux pumps. Although minocycline and trimethoprim-ulfamethoxazole are standard treatments, recent evidence suggests that eravacycline, a novel fluorocycline, may be effective in vitro, though clinical data remain scarce. Two cases of S. maltophilia bloodstream infection (BSI) in immunocompromised patients were reviewed. Both patients received eravacycline as part of combination therapy, following microbiological identification of the pathogen. Clinical course, microbiological outcomes, and antibiotic regimens were analyzed. Both patients, affected by acute myeloid leukemia and cholangiocarcinoma, developed S. maltophilia BSI after prolonged exposure to broad-spectrum antibiotics. Eravacycline (1 mg/kg every 12 hours) was included in both regimens. Blood cultures cleared within 48 hours in both cases. One patient died due to fungal complications, but S. maltophilia BSI was microbiologically controlled in both. These findings suggest a potential role for eravacycline in treating S. maltophilia BSI when standard options are limited. Further clinical studies are needed to establish efficacy and appropriate therapeutic use.

This retrospective observational study assesses adherence to antiretroviral therapy before and after the transition to pharmacy-based treatment dispensation.

Pseudomonas aeruginosa infections in cystic fibrosis (CF) often present therapeutic challenges due to acquired resistance. This study analyzed 178 strains from adult CF patients at a single French university hospital. High in vitro activity was observed for newer antibiotics such as ceftolozane-tazobactam (83% susceptibility), ceftazidime-avibactam (85% susceptibility), and cefiderocol (89% susceptibility). Delafloxacin also showed promising activity, with 93% of the isolates exhibiting MICs below the EUCAST epidemiological cut-off value. Results emphasize the potential utility of these agents.

The emergence and global dissemination of carbapenem-resistant Klebsiella spp. have seriously threatened global public health. Few genomic analyses of ceftazidime-avibactam-resistant and carbapenem-resistant Klebsiella spp. (CAR-CRKS) have been performed to date. This was a retrospective study of 12 CAR - CRKS isolates from 99 Klebsiella spp. collected in a Chinese tertiary hospital between 2018 and 2020. K. pneumoniae (eight cases, 66.67%), K. variicola (two cases, 16.67%), and K. quasipneumoniae (two cases, 16.67%) were identified in these isolates. Most of these patients had underlying hepatobiliary diseases or a history of receiving interventional procedures, and were hospitalised recurrently. The isolates were sensitive to amikacin, tigecycline, and polymyxin. blaIMP-4 was detected in six isolates, whereas blaNDM-1, blaNDM-5 and blaNDM-9 were detected in three, two, and one isolates, respectively. Only one strain harboured the rmpA, and exhibited a hypermucinous phenotype. The aerobactin (iucABCD) and yersiniabactin genes were absent in most of the strains. The strains containing blaIMP-4 exhibited higher virulence. These findings are of great significance for understanding the characteristics of CAR - CRKS and developing treatment strategies.

The unusual pneumonia outbreak that originated in the city of Wuhan, China in December 2019 was found to be caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19. In this study, we have evaluated the antiviral activity of Acutumine and Dauricumine compounds isolated from the Menispermum plant against SARS-CoV-2. The cells were infected by virus in 3 different experimental assay designs and treated at various concentrations from 0 to 48 hours post infection. The selected compounds were further tested under light-dependent anti-viral activities to measure the reduction of viral load using quantitative real-time polymerase chain reaction (qRT-PCR) on the cell culture assay. The in-silico results revealed that the active compounds known as Acutumine and Dauricumine could be better antiviral compounds with essential proteins of this virus, mainly protease (Mpro). Interestingly, the Acutumine and Dauricumine mixture (1:1 ratio100 mg/mL of each) of both compounds showed effective anti-viral activity in Vero E6 cells. Therefore, the results of Acutumine and Dauricumine compounds used in this study showed significant anti-viral and virucidal effects in the following increasing order of potency: Acutumine alone, Dauricumine alone, and mixture of both compounds or effective on SARS-CoV-2 infectious cycle. Thus, based on the outcome of this study, it is concluded that Dauricumine alone or in a mixture could be a better option as an antiviral than Acutumine alone against SARS-CoV-2.

This study assessed HIV and sexual health knowledge among undergraduate medical students in Milan, Italy. An anonymous online survey with nine multiple-choice questions was distributed by email to students at Vita-Salute San Raffaele University in November 2024. Of 1004 respondents, 48% reported comprehensive and 44% partial knowledge of HIV. Awareness of PrEP, PEP, and "U=U" was 47%, 45%, and 46%, respectively. HIV stigma persisted, with 36% considering it a taboo subject. Knowledge was significantly associated with prior sexual health education, highlighting the need for strengthened sexual health training to address gaps and reduce stigma.

We report a rare case of tertiary syphilis in a pregnant woman, presenting with cutaneous gumma and ocular involvement. This case highlights the diagnostic challenges of atypical syphilitic lesions and emphasizes the importance of considering syphilis in the differential diagnosis of facial skin lesions during pregnancy.

Plectosphaerella cucumerina (P. cucumerina) is a rare fungal pathogen that typically infects plants and crops, causing disease and reduced yields. Human infections are extremely uncommon. This case report describes the first case of peritoneal dialysis-associated peritonitis caused by P. cucumerina and highlights the diagnostic and therapeutic challenges posed by this rare fungal pathogen. A 79-year-old woman with peritoneal dialysis-associated peritonitis was diagnosed with a P. cucumerina infection through culture, MALDI-TOF MS, and sequencing. The patient's symptoms improved significantly within three days of antifungal treatment with fluconazole, and her inflammatory markers normalized after two weeks. Diagnosis of P. cucumerina infections often relies on culture and molecular techniques. In this case, fluconazole monotherapy was effective. Further research is needed to optimize diagnostic methods and treatment protocols. Early identification and targeted antifungal therapy are essential for the successful management of P. cucumerina-caused peritoneal dialysis-associated peritonitis.

Fungal infections pose a growing threat in hospital settings, particularly among critically ill or immunocompromised patients. A multidisciplinary consensus among fifteen clinical experts from Northern Italy examined the increasing challenge of invasive fungal infections, especially in patients with high-risk complications and in critical settings. The report emphasizes early diagnostic integration through clinical assessment, biomarker evaluation, and the essential role of therapeutic drug monitoring in optimizing outcomes. This consensus aims to consolidate clinical strategies for timely diagnosis, personalized pharmacologic intervention, and antifungal stewardship. Azoles are identified as first-line treatment options. Isavuconazole emerged as a preferred therapeutic agent due to its favorable pharmacokinetic profile, safety in renal impairment, and lack of QT interval prolongation. This consensus supports integrated strategies combining early recognition, rapid diagnostics, individualized pharmacology, and antifungal stewardship to improve outcomes, particularly in critical care settings.

In this narrative review, inspired by the observation of changes in clinical practice implemented at our centre (IRCCS San Gerardo dei Tintori), we describe the evolution of care for pregnant women living with HIV (WLWH) and the current issues regarding ARV therapy, delivery, prophylaxis and breastfeeding. Over the years, advances in the care of HIV in pregnancy have significantly reduced the risk of perinatal transmission, making the experience of motherhood in WLWH comparable to that of people without HIV infection. However, some issues remain to be overcome to separate the real risks of transmission from the perceived fears and reduce the medicalization of pregnancy in WLWH. Notably, the rate of caesarean section remains higher than that of the general population, highlighting the need to further promote vaginal birth for WLWH in clinical practice and to reassure both women and physicians on its safety. Moreover, certain areas remain uncertain or subject to conflicting guidelines, such as the use of post-exposure prophylaxis for low-risk neonates and breastfeeding.

Persistent low-level viremia (LLV) in heavily treatment-experienced (HTE) people with HIV (PWH) harboring multidrug-resistant virus remains a challenging clinical scenario. We report two cases from the PRESTIGIO Registry of individuals with longstanding HIV infection, high cumulative genotypic resistance, and sustained LLV despite no current adherence issues. In both cases, a regimen confidently containing ≥2 fully active agents was not achievable without incorporating entry and/or capsid inhibitors. Through these cases, we highlight diagnostic and therapeutic uncertainties in the management of LLV, including: the unfeasibility of RNA-based genotyping, the limited availability of data on resistance assessment by DNA-based genotypic testing, and the possibility that such viremia stems from clonal viral production rather than active replication. Although both individuals maintained a stable immune profile and low transmission risk, these cases underscore the need for tailored guidance in managing LLV in HTE PWH.

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant public health concern due to its resistance to commonly used antibiotics. Its prevalence varies widely across different regions and healthcare settings. This study aimed to determine the prevalence of MRSA among patients hospitalised at King Fahad Specialist Hospital in Al Qassim City, Saudi Arabia, and identify the distribution of MRSA across various demographics and healthcare settings. This cross-sectional, hospital-based study involved 10,936 patients (63.6% male, 36.4% female), with ages ranging from infants (1-10 years) to older adults (≥88 years). The prevalence of MRSA was determined through clinical samples, and isolates underwent antibiotic sensitivity testing. The overall prevalence of MRSA was 25.3%. High MRSA prevalences were observed in wound infections (35.6%), nasal swabs (14.0%), and aerobic blood cultures (10.6%). Antibiotic sensitivity testing showed that 72.2% of samples were sensitive to the tested antibiotics, while 27.0% were resistant to antibiotics like Amikacin, Aztreonam, Cefepime, and various carbapenems. The mortality rate was 17.4% in the study population during the study period. These findings underscore the need for enhanced infection control measures, targeted antibiotic stewardship programs, and continuous surveillance to effectively manage and reduce MRSA infections.

Candiduria is a common problem especially in advanced stage oncology/hematology cases. Herein, we aimed to analyze the efficacy of caspofungin treatment in Candida auris isolated from urine culture. We conducted an observational retrospective study in a tertiary-care educational hemato-oncology hospital from October 2021 to November 2022. The patients hospitalized in our center and having at least two consecutive urine cultures that yielded C. auris with significant pyuria were included in the study. The effectiveness of caspofungin was evaluated based on clinical and microbiological outcomes. In total, 10 patients (two female, aged 55.3 ± 15) were included in the study. Four (40%) patients had urinary tract infections, and six (60%) patients had asymptomatic C. auris candiduria which required antifungal therapy. Nine cases had urinary instrumentation: two nephrostomy, one suprapubic catheter, and six urinary catheters. The 10 cases received a mean of 13.4 ± 3.5 days of caspofungin. Four of 10 cases (40%) had at least 1 negative culture between day 1 and the end of caspofungin treatment. Relapse and re-infection rates 30 days after the end of therapy in microbiologically successful cases were 3/4 and 2/4. Caspofungin resistance developed in three cases (30%) within 30 days after treatment. Overall day-30 mortality was 3/10 (30%) while overall success (microbiological success + no relapse/reinfection during 30 days follow up after end of therapy) was 10%. Caspofungin demonstrated limited efficacy in treating C. auris-related urinary tract infection/colonization in hospitalized cancer patients.

Yersinia enterocolitica is a food-borne bacterium related to a disease called yersiniosis (gastroenteritis) in animals and humans. It is widely distributed in nature and is controlled with various antibiotics, such as second- and third-generation cephalosporins, gentamicin and fluoroquinolones and ciprofloxacin. In addition to antibiotic resistance, these antibiotics have side effects in the host because of drug-host interaction. To overcome these problems, this study focused on finding putative drug targets in the pathogen Y. enterocolitica and identifying novel molecules to tackle the function of this pathogen. In the present study, two new drug targets were found in Y. enterocolitica. Apart from using antibiotics, chlorogenic acid, hesperidin, neohesperidin, and naringin had indicated good binding affinity with the recognized targets through molecular docking experiments. Accordingly, this investigation suggests that the newly-found drug targets may be a fertile field in the pharmaceutical community for finding inhibitors similar to chlorogenic acid, hesperidin, neohesperidin, and naringin, as well as designing new drug molecule formulations to tackle the foodborne illness caused by pathogen Y. enterocolitica.

hand hygiene is vital for preventing healthcare-associated infections, yet compliance among healthcare workers is low. To address this, we created an interactive online quiz using gamification to promote self-assessment and education.

Acute respiratory infections (ARIs) are among the most common infections, with variable etiology, affecting both community and hospital settings. Vulnerable populations include children, the elderly, and patients with chronic debilitating disease. Early identification of the causative pathogen can reduce inappropriate empirical antibiotic therapy, particularly in viral infection cases, which are the leading cause of ARIs, especially in outpatient settings. Rapid molecular diagnostic methods such as FilmArray Respiratory Panel (FA RP) enable the prompt identification of viral and bacterial pathogens. A retrospective observational study was conducted at Santa Maria Goretti Hospital in Latina, Italy, from January 1, 2022, to April 30, 2023. A total of 232 nasopharyngeal swabs from patients were analyzed using the BioFire FA RP. Eligible patients exhibited fever, cough, or other symptoms suggestive of respiratory infection. The test distribution shows that the Pediatric and Neonatology Units had the highest number of tests and a high proportion of clinically relevant outcomes. The findings underscore the effectiveness of the FA RP in swiftly identifying pathogens, significantly reducing diagnostic turnaround times, and minimizing unnecessary antibiotic prescriptions. The 38% rate of negative tests highlights the importance of appropriate test prescription based on clinical assessment.

To understand the resistance phenotype and the carriage of resistance genes in carbapenem-resistant Serratia marcescens in our hospital. Two S. marcescens clinical isolates were analyzed retrospectively to determine their sensitivity to 27 antimicrobial agents using the BD Phoenix™ M50 System (Becton, Dickinson and Company, Franklin Lakes, NJ, USA) and Kirby-Bauer disk diffusion method (Oxoid, Hampshire, UK). Whole-genome sequencing of both strains was performed using the Illumina platform. ABRicate software was used to predict the resistance genes and plasmid replicon types carried by the strains. Sequence type (ST) analysis was performed using multilocus sequence typing. A phylogenetic tree was constructed, and homology analysis was conducted by comparing the two strains with 106 blaKPC-2-carrying carbapenem-resistant S. marcescens isolates downloaded from the NCBI database. Two S. marcescens strains were isolated from the sputum samples of patients with lower respiratory tract infections after ICU surgery. Antimicrobial sensitivity testing revealed that both strains were resistant to antimicrobial agents, including β-lactams, sulfonamides, and carbapenems, whereas they were susceptible to tigecycline and ceftazidime/avibactam. In total, 12 resistance genes were predicted, with both WF0070 and WF0071 carrying the carbapenem resistance gene blaKPC-2. Among the remaining resistance genes, the aminoglycoside resistance genes were most commonly predicted, with five types identified. The two strains in this study and the 106 blaKPC-2-carrying carbapenem-resistant S. marcescens isolates downloaded from NCBI were divided into five evolutionary groups, and both strains in this experiment were categorized into clade E. Meanwhile, 18 STs were predicted, and both strains in this study belonged to ST366. In terms of phylogenetic relationships, these strains exhibited high homology with a strain isolated in France in 2018. The two S. marcescens strains in this study displayed high resistance to multiple antimicrobial agents, and both carried the carbapenem resistance gene blaKPC-2 along with several other resistance genes. The two strains displayed close phylogenetic relationships, and the possibility of nosocomial transmission cannot be dismissed.

We investigated CMV DNA pulmonary viral loads in adults in asymptomatic patients without classic immunosuppressive conditions undergoing bronchoalveolar lavage (BAL) for screening non-acute, non-infectious pulmonary diseases with a six-month follow-up. Over 31 months, 73 out of 352 BAL samples (20.7%) tested positive, with wide viral load variability (median 829 copies/mL, IQR 1457 copies/mL). None of the patients received antiviral treatment or developed CMV-related disease during follow-up. Nine patients died during follow-up. Patients presented a range of risk factors, and none was associated with higher VL. These findings suggest that CMV pulmonary behavior deserves further attention across various populations.

The aim of this study is to describe a rare case of dual isolation of Candida albicans and Lactobacillus delbrueckii from blood cultures of an 86-year-old female patient. The patient, an elderly individual, had a medical history remarkable for diabetes mellitus, which was currently being managed with an SGLT-2 inhibitor. The patient exhibited elevated fevers, which were attributed to candidemia and bacteremia caused by Lactobacillus delbrueckii. The patient's candidemia originated from a urinary tract infection. The isolation of Lactobacillus delbrueckii in three sets of blood cultures was linked to the regular consumption of yogurts, some of which were past their expiration date. The patient's bacteremia may be attributed to the ingestion of yogurts, which could have facilitated bacterial translocation from the gastrointestinal tract to the systemic circulation.

Candida parapsilosis is an infrequent opportunistic pathogen, responsible for approximately 7% of Candida osteomyelitis cases. While infections in immunocompetent individuals are rare, they present significant therapeutic challenges due to intrinsic resistance mechanisms and biofilm formation, requiring a multidisciplinary management approach. We report the case of a 27-year-old immunocompetent man who developed Candida parapsilosis osteomyelitis following surgical fixation of a clavicular fracture sustained in a road traffic accident. After multiple surgical interventions due to persistent infection, C. parapsilosis was identified in bone samples, along with Klebsiella pneumoniae. The patient underwent prolonged antifungal and antibiotic therapy, combined with surgical debridement and bone reconstruction using a microsurgical fibular flap. He remained clinically stable, with no signs of recurrence at 11-month follow-up. This case underscores the diagnostic and therapeutic challenges of Candida parapsilosis osteomyelitis, particularly in immunocompetent individuals, who are often not considered at risk for fungal infections. It highlights the importance of early clinical suspicion, prolonged microbiological cultures, and a multidisciplinary team approach integrating both surgical and medical management to optimize patient outcomes. Additionally, a review of the literature on C. parapsilosis osteomyelitis is provided.