The rise of multidrug-resistant bacteria in hospitals, especially methicillin-resistant Staphylococcus aureus (MRSA), presents a major challenge in managing pneumonia, a leading cause of morbidity and mortality in intensive care. Early exclusion of MRSA infection is vital for guiding appropriate antibiotic therapy, as unnecessary or prolonged anti-MRSA treatment increases mortality, hospital stay, and adverse effects such as nephrotoxicity.

Carbapenem-resistant Gram-negative bacilli (CR-GNB) represents an escalating threat to global public health due to its resistance to last-resort of antibiotics. One potential treatment strategy to combat these resistant microorganisms is the combination therapy like ceftazidime-avibactam (CZA) and aztreonam (ATM). The study evaluated the in vitro activity of the CZA-ATM combination against 156 CR-GNB including Klebsiella spp., Escherichia coli (E. coli), and Pseudomonas spp. using E-strip disk diffusion, broth disk elution (BDE), and disk stacking plus micro-elution (DSE) method at the Department of Microbiology & Immunology, Bangladesh Medical University (BMU), Bangladesh. Among the 156 isolates, Klebsiella spp. was the most prevalent (62.8 %), followed by Pseudomonas spp. (30.1 %) and E. coli (7.1 %). Of these, 52.6 % (82/156) were identified as carbapenemases producers. The mCIM and eCIM methods identified 23 (28.1 %) as serine carbapenemases and 59 (71.9 %) as metallo β-lactamases (MBL) producers. Resistance rates for CZA and ATM were 74.4 % and 94.2 % respectively. The E-strip disk diffusion method showed susceptibility in 65.52 % of isolates, while the BDE and DSE methods demonstrated susceptibility in 54.31 % and 58.62 %, respectively. Resistance to the CZA-ATM combination was notably high in Pseudomonas spp., likely due to non-carbapenemases mechanisms like efflux pump activity or porin mutations. Compared to the E-strip disk diffusion method, BDE method showed an agreement of 78.4 %, while DSE method exhibited an agreement of 89.7 %. The in vitro evaluation of the CZA-ATM combination highlights its potential as a therapeutic option for treating carbapenemase producing organisms.

The new SPOTFIRE Respiratory/Sore Throat (R/ST) Panel, approved as a Point of Care Test (POCT), enables the detection of 15 respiratory pathogens from nasopharyngeal swabs (NPS) or throat swabs (TS) within 17 min. This study aimed to verify the performance of the assay. A total of 28 NPS specimens (23 positive for 1 or 2 targets; 5 negative) and 37 TS (20 culture positive for Streptococcus pyogenes or Streptococcus dysgalactiae; 17 culture negative) were analyzed. Results were compared to the BioFire respiratory panel 2.1 (RP2.1) for NPS and S. pyogenes and S. dysgalactiae culture for TS. Contrived TS were created to assess the detection of influenza A/B and SARS-CoV-2, as well as the limit of detection (LoD) of the Streptococcus targets. For NPS, the SPOTFIRE R menu demonstrated 100 % positive percent agreement (PPA) with reference results for all targets included, and 92-100 % negative percent agreement (NPA). The PPA and NPA for the detection of S. pyogenes and S. dysgalactiae from TS and culture were 100 %. All TS replicates at concentrations around the LoD for S. pyogenes and S. dysgalactiae yielded positive results. Data from this study suggest that influenza A/B, RSV and SARS-CoV-2 are effectively detected from TS by the SPOTFIRE. In conclusion, the SPOTFIRE R/ST Panel demonstrated high agreement with the reference methods for the detection of viral and bacterial targets from NPS and the detection of S. pyogenes and S. dysgalactiae from TS Additionally, prospective studies will be required to establish the clinical impact of ultra-rapid POCT.

Tuberculosis (TB) is the leading cause of death caused by a single infectious pathogen. Currently, a variety of conventional methods are widely used for detecting Mycobacterium tuberculosis (Mtb) or diagnosing TB, which have made significant contributions to controlling the TB epidemic. However, these existing TB diagnostic methods still face some difficulties and cannot provide rapid, low-cost, high-sensitivity, and high-accuracy diagnostic results simultaneously. Therefore, it is imperative to develop new TB diagnostic methods that are rapid, cost-effective, and sensitive through rigorous evaluation of potential biomarkers and new detection methods. In this study, a three-dimensional nanofiber (3D NFs) paper-based electrochemical sensor was prepared using electrospinning technology, and Mtb secretory protein Ag85B was utilized as a biomarker to achieve point-of-care detection of TB clinical samples. The 3D NFs paper-based electrochemical sensor can achieve a wide range of Bacillus Calmette-Guérin detection of 10-10 CFU/mL with good specificity. When the clinical bronchoalveolar lavage fluid samples were diluted 10 or 10 times, the 3D NFs paper-based electrochemical sensor could detect TB clinical samples with a sensitivity of up to 92.9 % and a specificity of 60 % within 5 min. 3D NFs paper-based electrochemical sensor has the advantages of low cost, high sensitivity, and fast response speed, and can realize rapid preliminary screening of TB patients.

Cytomegalovirus (CMV) infections are uncommon in immunocompetent individuals, often posing diagnostic challenges due to their clinical overlap with other gastrointestinal disorders and sexually transmitted infections (STIs). Here, we report a case of a 37-year-old Immunocompetent Caucasian male who presented with rectal pain, bleeding, and fever following a recent sexual encounter. Initially treated for rectal gonorrhea, his symptoms persisted and worsened, prompting further investigation. Diagnostic evaluation revealed elevated liver enzymes, positive CMV IgM, and characteristic mucosal changes on sigmoidoscopy. Histopathological examination and CMV DNA testing confirmed the diagnosis of CMV proctitis. Treatment with intravenous ganciclovir led to clinical improvement and resolution of symptoms. This case underscores the importance of considering CMV infection in Immunocompetent patients with refractory rectal symptoms post-STI treatment, highlighting the need for thorough diagnostic assessment and timely initiation of antiviral therapy for effective management.

Pediatric tuberculosis (TB) management remains an underemphasized area plagued by diagnostic and treatment challenges that are compounded further due to rising levels of drug-resistant tuberculosis (DR-TB). Even though TB incidence is high in China, limited data exists on pediatric and adolescent DR-TB across local settings.

Rapid and precise detection of Mycobacterium tuberculosis (MTB) is essential for effective management and control of tuberculosis. The diagnostic challenge is particularly acute for extrapulmonary TB, which accounts for approximately 15-20% of cases and often presents with paucibacillary samples. Clustered regularly interspaced short palindromic repeats (CRISPR) technology has emerged as a promising tool for pathogenic diagnosis across diverse sample types owing to its specificity and adaptability. This systematic review and meta-analysis aimed to appraise the diagnostic accuracy of CRISPR-based techniques in identifying MTB.

The NeuMoDx™ HPV assay (QIAGEN, MI, USA) is a PCR assay that detects 15 high-risk human papillomavirus (HPV) types in cervical samples, with separate identification for HPV16 and HPV18. Although it has been validated for primary HPV-based cervical cancer screening, its performance in the triage of atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesion (LSIL) in cytology-based screening algorithms has not yet been evaluated. This multicentre study assessed the clinical performance of the NeuMoDx assay for ASC-US/LSIL triage. A total of 447 residual clinician-collected cervical samples were analysed. At site 1 (Ljubljana, Slovenia), NeuMoDx was compared with the Alinity m HR HPV assay (Abbott Molecular, IL, USA), and at site 2 (Ghent, Belgium), it was compared with the APTIMA HPV assay (HOLOGIC, MA, USA). NeuMoDx demonstrated 91.3% (95% CI: 85.8-94.7%) concordance with Alinity and 96.2% (95% CI: 93.3-97.8%) concordance with APTIMA, with excellent kappa values of 0.824 (95% CI:0.737-0.912) for site 1 and 0.779 (95% CI: 0.653-0.905) for site 2. The relative sensitivity of NeuMoDx for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was 0.91 and 1.08 compared to Alinity and Aptima, respectively. Relative clinical specificity of NeuMoDx was 1.05 compared to Alinity and 1.00 compared to Aptima. In conclusion, the NeuMoDx HPV assay showed reliable clinical performance in triaging ASC-US/LSIL samples.

Serology remains the first-line diagnostic method for Bartonella henselae infection. Indirect immunofluorescence assay (IFA) is considered the reference serological assay to detect anti-B. henselae antibodies. However, IFA has the drawbacks associated with manual techniques. Thus, the automated VirClia® Lotus analyser (VLA) was presented as an easy-to-use solution for B. henselae serology. The aim of our study was to evaluate the clinical and analytical performance of the VLA in comparison with a commercial IFA on a population that was representative of the various forms of bartonellosis. This retrospective study included 340 serum samples (one sample per patient). B. henselae infection was diagnosed in 65 patients (20 %): 77 % of patients had regional lymphadenopathy and 17 % had disseminated infection. At the manufacturer's recommended cut-off (0.9), 223 samples had positive or equivocal IgG results by the VLA, and 117 samples were negative. Using IgG IFA as a reference, the sensitivity for IgG VLA reached 87.9 % but the specificity was 46.8 %. As regards clinical performance, the sensitivity for IgG VLA was 92.3 % but the specificity fell to 42.1 %. In comparison, IgG IFA had a sensitivity of 95.4 % and a specificity of 80.5 %. To address the insufficient specificity of IgG VLA, while maintaining optimal sensitivity and the advantages of automated screening, we propose combining this VLA screening with an IFA confirmation test for any serum with an index ≥ 0.9. This two-tiered serological strategy showed a diagnostic sensitivity of 87.7 % and a specificity of 84.0.

Rapid SARS-CoV-2 detection is essential in limiting transmission. We evaluated the performance of RT-PCR on the same nasopharyngeal swab used for Panbio antigen testing. High concordance with standard PCR and improved case detection-including asymptomatic infections-demonstrates this one-swab-two-test strategy enhances diagnostic yield while reducing patient discomfort and resource burden.

Mycoplasma pneumoniae (MP) is a common cause of pediatric respiratory infections, but its diagnosis remains challenging due to nonspecific clinical features and the limitations of conventional laboratory tests.

Urosepsis is a severe complication of urinary tract infections with high morbidity and mortality. Reliable biomarkers for early diagnosis and risk stratification remain limited. This study aimed to investigate the clinical value of the circulating exosomal miR-21-5p/miR-181b-5p ratio (miR-Ratio) in the early diagnosis and 28-day prognostic prediction of urosepsis.

To evaluate clinical features, diagnosis, treatment, and prognosis of HHV-6 encephalitis in immunocompetent adults, a rare and challenging condition.

Maternal colonisation with Streptococcus agalactiae (GBS) is the most important risk factor for early-onset sepsis in newborns. We aimed to determine the rate of GBS colonisation in pregnant women evaluate the concordance between culture and a novel commercial polymerase chain reaction (PCR) test for screening. We also aimed to investigate the presence of the hypervirulent ST-17 clone and the potential risk factors that may affect colonisation.

This study evaluated the performance of the Abbott ID NOW™ STREP A 2, a rapid isothermal nucleic acid amplification test (NAAT), for the detection of Streptococcus pyogenes (S.pyogenes) in non-pharyngeal specimens, primarily from skin and soft tissue infections (SSTIs). A total of 180 non-pharyngeal samples submitted for bacterial culture were analyzed, comprising 120 culture-positive and 60 culture-negative specimens for S. pyogenes. Compared to culture, the ID NOW assay demonstrated a sensitivity of 99.2 % (95 % CI: 95.4-99.98 %) and a specificity of 100.0 % (95 % CI: 94.0-100.0 %). Although the ID NOW STREP A 2 assay is currently approved only for pharyngeal swab specimens, our findings indicate that it may also be a reliable method for detecting S. pyogenes in SSTI samples.

The presence of bacteremia is described as a cause of false-positive (FP) elevation of serum (1→3)-β-D-glucan (BDG) levels measured with the Fungitell colorimetric assay. The experience with the increasingly used turbidimetric Wako BDG assay in this scenario is limited.

We investigated the genetic characteristics of non-IMP type carbapenemase-producing Enterobacterales isolates detected in Japan. The isolates were found to carry diverse plasmids with high sequence similarity to those previously reported in other countries, underscoring the critical imperative for comprehensive nationwide epidemiological surveillance for the silent pandemic of the nightmare pathogen.

Serum and synovial biomarker levels are affected during periprosthetic joint infection (PJI), but it is unknown how different microorganisms influence these responses. The objective was to analyze serum levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count, and synovial human β-defensin-1 (hBD-1) levels according to the type of microorganism isolated in patients with suspected PJI. In this retrospective observational study, 105 synovial samples were collected during revision arthroplasty, of which 64 were classified as PJI and 41 as aseptic failure (AF) according to MSIS criteria Serum CRP, ESR, WBC and synovial hBD-1 were quantified using standardized methods. Descriptive and comparative statistical analyses were performed using SPSS software, and P-values <0.05 were considered significant. Seven bacterial species were identified (Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus sp, Peptoniphilus assaccharolyticus, Finegoldia magna, and Morganella morganii.) and no polymicrobial infections were detected. Synovial hBD-1 levels were significantly elevated in infections caused by P. aeruginosa, S. aureus, S. epidermidis, and Enterococcus sp (P<0.00001). Similarly, serum CRP levels were higher in infections due P. aeruginosa and S. epidermidis (P<0.00001), S. aureus (P=0.001), Enterococcus sp and P. asaccharolyticus (P<0.0001), and F. magna (P=0.002). ESR and WBC counts also differed significantly from the AF group. These findings demonstrate that biomarker responses vary by pathogen, suggesting that pathogen-specific biomarker profiles could improve diagnostic accuracy, support early triage, and guide empirical antimicrobial therapy in PJI management. Incorporating these profiles into clinical decision-making may facilitate timely treatment initiation and personalized strategies for patient care. Further multicenter studies are warranted to validate these observations.

The aim of this study was to characterize the clinical features of nocardiosis and to enhance understanding of its diagnostic and therapeutic challenges.

the association of Non-polio Enteroviruses (NPEVs) with acute flaccid paralysis (AFP) is growing anxiety worldwide, particularly, In Iraq.