Cases Of Infection Research Articles

Impact of rituximab on IgG and IgM levels in patients with autoimmune bullous diseases: a cohort study.

Rituximab (RTX) causes hypogammaglobulinemia in a variety of autoimmune diseases. However, the exact incidence and clinical significance in patients with autoimmune bullous diseases (AIBD) remain undetermined. In this cohort study, we enrolled patients with AIBD treated with RTX at a tertiary dermatology center between 2019 and 2021. Serum IgG and IgM levels, cumulative RTX dosage, and other factors were measured at baseline and during a follow-up visit. We used multivariate linear regression to assess the effect of RTX on immunoglobulin levels over time, adjusting for factors such as cumulative RTX dose, time since last infusion, and steroid use. Hypogammaglobulinemia was defined as IgG < 600mg/dL and IgM < 40mg/dL. Logistic regression was employed to evaluate adjusted risk factors for developing hypogammaglobulinemia. Age at first infusion was negatively correlated with both IgG (p < 0.0001) and IgM levels (p = 0.002). Total cumulative RTX dosage was negatively associated with IgM levels (p < 0.001). Daily steroid dosage was positively correlated with IgM levels (p = 0.023). Mycophenolate mofetil was associated with lower IgG levels (p = 0.029). Daily steroid dosage was found to be associated with a lower risk of hypo-IgM development (p = 0.0497). No serious infusion-related adverse effects or mortality were observed. There were four cases of infection with no association with cumulative RTX dosage (p = 0.299). Our study shows an association between RTX and lower serum IgM levels in patients with AIBD, highlighting the need to assess serum immunoglobulin levels before RTX therapy to optimize its use and minimize adverse effects.

Autochtonous Emergomyces pasteurianus subcutaneous infection in an Italian immunocompromised patient: a case report and review.

We describe the second case of infection by Emergomyces pasteurianus that occurred in Italy. The patient presented ulcerated nodular lesions primarily in the forehead, beneath the orbital and nasal areas, but also in the neck and fingers in the early stages. Treatment involved amphotericin B, followed by long-term itraconazole, which resulted in complete clinical resolution. A review of the literature is also included.

Evaluation of WHO Measles Eradication Programme for the European Region of 53 Countries with Emphasis on Poland in the Years 2003–2014

Background: The vaccination programmes after the 2nd World War and the application of safe and effective vaccines were expected to eliminate infectious diseases within the World Health Organization (WHO) European Region. However, epidemiological indexes show isolated cases and local epidemiology outbreaks of viral measles, that draw attention to re-evaluate the effectiveness and obstacles of infectious disease eradication programmes. Methodology: This study analyses the available Polish governmental epidemiological data concerning the WHO European Region for the years 2003–2014 and evaluates the effectiveness of the WHO Measles Eradication Programme implementation, since 2001. Most of these epidemiological data are either available in Polish or scattered in governmental reports only. Thus, we have compiled selected available data to present an overview focusing on Poland’s measles epidemiological situation. Results: The analysis of the available data clearly shows that infection cases of measles are on the rise in the European Region or are steady at a relatively high level depending on the country. The critical factors to prevent measles are maintaining a vaccination level at a minimum of 95% using two doses of MMR, adequate infection detection, rapid reporting, controlling and enforcing identification, and mass media campaigns to inform societies about the necessity of measles vaccination and the safety of using MMR. Conclusions: Besides the current SARS-CoV-2 pandemics, measles is possibly the most dominating infectious disease on the rise in the European Region, including Poland. The eradication programme modifications to increase its effectiveness are of upmost importance, as measles is one of the most infectious diseases with acute syndromes, especially affecting children.

Results of the audit of the pilot project "Technologies and means of surgical hand antisepsis in medical organizations of the Khanty-Mansiysk Autonomous Okrug - Yugra"

Background: One of the main factors in the transmission of pathogens during surgical interventions are considered to be the hands of the MR [1]. According to experts, it is through the hands that the pathogen is transmitted in more than 50.0% of cases of purulent-septic infections (PSI) [1,2]. Despite the constant improvement of technologies and means of surgical hand antisepsis during any type of surgical intervention, the problem remains relevant [3-5]. Aim. Based on the audit results, provide an expert assessment of compliance with the technology of hand antisepsis used in surgical practice to carry out the necessary corrective measures. Methods: The analysis was conducted based on the results of a survey of 214 employees directly involved in surgical interventions. The survey used the author's electronic questionnaire of 25 questions, which was posted on the Google platform. The work used epidemiological (descriptive-evaluative and analytical), sociological and statistical research methods. Results: The results revealed shortcomings in the organization of antisepsis: the use of soap with antibacterial additives before treatment with an antiseptic, the use of non-sterile wipes and towels after hand washing, failure to comply with the antiseptic application time of 1.5-4.5 minutes, the use of alcohol-free antiseptics based on other active substances and low commitment to hand care. A negative impact of detergents, soap and antiseptics on the skin of the hands and the well-being of MR was established. Corrective measures were proposed. Conclusions: The results revealed shortcomings in the organization of antisepsis: the use of soap with antibacterial additives followed by treatment with an antiseptic, the use of non-sterile wipes and towels after hand washing, failure to comply with the time of application of the antiseptic from 1.5 to 4.5 minutes against the time regulated by the instructions, the use of alcohol-free antiseptics based on other active substances and low commitment to hand care. A negative effect of a number of soap components and antiseptics on the skin of the hands and the well-being of MR was established. Corrective measures were proposed.

Application of ambulatory surgery management mode in total laparoscopic ileostomy reversal surgery

To explore the safety of application of ambulatory surgery management mode in total laparoscopic ileostomy reversal surgery. A retrospective analysis of clinical data was conducted on patients who had undergone total laparoscopic ileostomy reversal surgery at the First Affiliated Hospital of China Medical University from May 1, 2023, to March 31, 2024. A total of 34 patients were included in the study, comprising 22 males and 12 females, with the age of (60.6±12.4) years. They were divided into ambulatory laparoscopic surgery group (n=13) and original laparoscopic surgery group (n=21) according to the perioperative management mode. No statistically significant differences were observed between the two groups in terms of operative time, intraoperative blood loss and the time to first flatus after surgery (all P>0.05). The ambulatory surgery group experienced no complications, while the original surgery group encountered 2 cases of complications (1 case of incision infection and 1 case of intestinal obstruction), and there was no significant difference in the incidence of complications between the two groups [0 vs 9.5%(2/21), P=0.211]. It is safe to perform total laparoscopic ileostomy reversal surgery under ambulatory surgery mode.

Multicenter Retrospective Analysis of 702 Pediatric Cases of Bone and Joint Infections: Definition of Clinical and Biological Features to Discriminate K. kingae, S. aureus, and Other Bacterial Infections

This study aimed to identify key differences between K. kingae infections and those caused by S. aureus or other pathogens. Differentiating these infections is crucial due to their nonspecific clinical presentations and overlapping laboratory and radiological findings, particularly when isolates are unavailable. We retrospectively analyzed data from 702 pediatric patients with bone and joint infections from 2010 to 2023 across two hospitals. The most common diagnoses were osteomyelitis (35.3%) and arthritis (29.6%), with fever present in 46.0% of cases. Pathogen identification showed K. kingae (40.9%) and S. aureus (36.5%) as the most frequent. Patients with K. kingae were significantly younger (median age 1.5 years) than those with S. aureus (10.4 years) or other pathogens (6.8 years) (p &lt; 0.001). Fever was more common in S. aureus (64.3%) and other pathogens (57.5%) than in K. kingae (26.4%) (p &lt; 0.001). CRP levels were lower in K. kingae infections (median 1.5 mg/dl) compared to S. aureus (6.1 mg/dl) and other pathogens (5.0 mg/dl) (p &lt; 0.001). K. kingae infections were predominantly treated with penicillin–clavulanate and had shorter treatment durations and lower sequelae rates (2.3%) compared to other pathogens (19.0%). These findings emphasize K. kingae’s distinct clinical profile and milder course compared to S. aureus and other pathogens.

Corticosteroids combined with low-dose methotrexate in the treatment of pemphigus vulgaris: A retrospective cohort study.

The treatment of pemphigus vulgaris (PV) often requires long-term systemic corticosteroids. Although new biologicals like rituximab are changing the landscape, traditional immunosuppressants still prevail in many underdeveloped areas. One such medication is methotrexate (MTX), which has been widely used in autoimmune and autoinflammatory diseases, but its role in treating pemphigus remains somewhat unclear and controversial. This study aimed to evaluate the effect and safety profile of using low-dose MTX in PV patients receiving glucocorticoids. PV patients who visited the Department of Dermatology, Peking University First Hospital from January 2010 to December 2021 were retrospectively screened. Based on different treatment regimens, patients were automatically divided into a corticosteroid monotherapy group and a corticosteroid combined with low-dose MTX group (MTX was administered at a dose of no more than15 mg per week, with a minimum duration of 8 weeks). All patients were followed up for 1 year. A total of 142 patients with PV were eligible for the study (100 in the corticosteroid monotherapy group and 42 in the corticosteroid combined with low-dose MTX group). The Kaplan-Meier curve indicated that the corticosteroid combined with low-dose MTX group achieved a 50% reduction in glucocorticoid use faster, with a P value of 0.0132, especially among patients who initially received more than 60 mg of steroids per day. The inclusion of MTX reduced the occurrence of hyperpilidemia. There was not sufficient evidence to determine if the addition of MTX was associated with more bacterial infection cases for certain. The inclusion of low-dose MTX in the corticosteroid treatment regimen for patients with PV, particularly those receiving high doses, can facilitate the reduction of glucocorticoid dosages and lower the incidence of hyperlipidemia, without increasing the risk of other adverse effects.

Prenatal Screening for CMV Primary Infection: A Cost-Utility Model.

Congenital cytomegalovirus (CMV) infection is a major cause of deafness and neurodevelopmental disability in children. Our objective was to assess the cost utility of first-trimester serological CMV screening, compared to screening of high-risk pregnancies and no serological screening. A decision-analytic model was created to compare the cost utility of three strategies from a healthcare sector perspective: universal first-trimester serological screening, screening only of high-risk pregnant women (both including antiviral prophylaxis in cases of primary infection) and serological testing triggered by foetal morphological ultrasound (no CMV serological screening). Canada. Hypothetical population of 80 000 pregnant women. Probability, expected values and cost estimates were derived from published literature and local hospital and national insurance data. Cost per maternal and infant quality-adjusted life year (QALY) lost. Universal serological screening was superior to both screening of high-risk women and no screening (utility of -0.42, -0.63 and - 0.87 QALY lost, respectively). Sensitivity analysis demonstrated that universal screening was the most cost-effective strategy regardless of the incidence of primary infection, the acceptability of amniocentesis and the efficacy of antiviral prophylaxis. In the Monte Carlo analyses, universal serological screening was the most cost-effective option in 96.36% of simulations. Universal serological screening would allow detection of 152 cases of primary maternal CMV infection and would prevent 29 cases of congenital CMV infection annually. Our findings support the adoption of a population-based prenatal screening programme for the prevention of congenital CMV infection.

Urinary Tract Infections in Children: Changing Trends in Etiology and Local Resistance Patterns over a Three-Year Period

Introduction: Urinary tract infections are common in pediatrics. Knowledge of local resistance patterns is crucial to guide empirical antibiotic therapy. We aimed to review the pathogens implicated in urinary tract infections, local resistance patterns, and the impact of switching first-line empirical antibiotic regimens.Methods: We conducted a cross-sectional study including pediatric patients performing urine cultures in a hospital in northern Portugal over two periods: 2019 (group 1) and 2022 (group 2). Between time periods, an internal guideline was implemented recommending cefuroxime as the first-line choice for empirical treatment of urinary tract infections, according to local resistance patterns. Uropathogens, empirical antibiotic choices and resistance patterns were compared among groups.Results: The final sample included 402 cases of urinary tract infections in group 1 and 398 in group 2. Escherichia coli was the most common uropathogen (79.4 - 83.3%), followed by Proteus mirabilis and Klebsiella spp. The most common empirical antibiotic in group 1 was amoxicillin-clavulanate (A-C), as opposed to cefuroxime in group 2 (p &lt; 0.001). The most common resistance was to ampicillin (39.3% - 39.7%). Resistance to A-C slightly decreased (33.1% vs 27.4%, p = 0.079), while resistance to cefuroxime (4.7% vs 3.3%, p = 0.292) and trimethoprim-sulfamethoxazole (TMP-SMX) remained similar (15.2% vs 14.1%, p = 0.659). Resistances to nitrofurantoin (9.0% vs 0.3%, p &lt; 0.001) and fosfomycin (1.7% vs 0.3%, p &lt; 0.036) significantly decreased from group 1 to group 2.Conclusion: E.coli remains the predominant pathogen in pediatric urinary tract infections. Resistance to A-C in our sample was high (33.1%). The switch from A-C to cefuroxime as first-line agent resulted in a decreasing trend in A-C resistance, while cefuroxime resistance remained low and even slightly lower.

Lung-homing nanoliposomes for early intervention in NETosis and inflammation during acute lung injury

Acute lung injury (ALI) is characterized by severe inflammation in lung tissue, excessive immune response and impaired lung function. In hospitalized high-risk patients and cases of secondary infection due to surgical contamination, it can lead to higher mortality rates and require immediate intervention. Currently, clinical treatments are limited in symptomatic therapy as mechanical ventilation and corticosteroids, having insufficient efficacy in mitigating the cause of progression to severe illness. Here we report a pulmonary targeting lung-homing nanoliposome (LHN) designed to attenuate excessive Neutrophil Extracellular Trap formation (NETosis) through sivelestat and DNase-1, coupled with an anti-inflammatory effect mediated by 25-hydroxycholesterol (25-HC), offering a promising intervention for the acute phase of ALI. Through intratracheal delivery, we intend prompt and constant action within the lungs to effectively prevent excessive NETosis. Isolated neutrophils from blood samples of severe ARDS patients demonstrated significant anti-NETosis effects, as well as reduced proinflammatory cytokine secretion. Furthermore, in a murine model of LPS-induced ALI, we confirmed improvements in lung histopathology, and early respiratory function. Also, attenuation of systemic inflammatory response syndrome (SIRS), with notable reductions in NETosis and neutrophil trafficking was investigated. This presents a targeted therapeutic approach that can be applied in early stages of high-risk patients to prevent severe pulmonary disease progression.

Interpretation of indoor air surveillance for respiratory infections: a prospective longitudinal observational study in a childcare setting.

Sampling the air in indoor congregate settings, where respiratory pathogens are ubiquitous, may constitute a valuable yet underutilised data source for community-wide surveillance of respiratory infections. However, there is a lack of research comparing air sampling and individual sampling of attendees. Therefore, it remains unclear how air sampling results should be interpreted for the purpose of surveillance. In this prospective observational study, we compared the presence and concentration of several respiratory pathogens in the air with the number of attendees with infections and the pathogen load in their nasal mucus. Weekly for 22 consecutive weeks, we sampled the air in a single childcare setting in Belgium. Concurrently, we collected the paper tissues used to wipe the noses of 23 regular attendees: children aged zero to three and childcare workers. All samples were tested for 29 respiratory pathogens using PCR. Air sampling sensitively detected most respiratory pathogens found in nasal mucus. Some pathogens (SARS-CoV-2, Pneumocystis jirovecii) were found repeatedly in the air, but rarely in nasal mucus, whilst the opposite was true for others (Human coronavirus NL63). All three pathogens with a clear outbreak pattern (Human coronavirus HKU-1, human parainfluenza virus 3 and 4) were found in the air one week before or concurrent with the first detection in paper tissue samples. The presence and concentration of pathogens in the air was best predicted by the pathogen load of the most infectious case. However, air pathogen concentrations also correlated with the number of attendees with infections. Detection and concentration in the air were associated with CO2 concentration, a marker of ventilation and occupancy. Our results suggest that air sampling could provide sensitive, responsive epidemiological indicators for the surveillance of respiratory pathogens. Using air CO2 concentrations to normalise such signals emerges as a promising approach. KU Leuven; DURABLE project, under the EU4Health Programme of the European Commission; Thermo Fisher Scientific.

Antibacterial effect of Aloe Vera on Bacteria Isolated from Cases of Wound Infection.

Antimicrobial resistance exhibited by bacteria against the majority of antibiotics has resulted in research on alternative methods of treatment. Aloe vera has a strong tradition as a medical plant with a wide range of therapeutic uses. The objective of this study is to determine the antibacterial activity of gel and crude ethanol leaf extract of Aloe vera against Staphylococcus aureus and Enterobacterales isolated from wound infections. It is a cross-sectional study conducted over a period of 7 months. Antibacterial effect of the ethanol leaf extract and gel was determined by the punch well method. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the ethanol leaf extract were determined by macro broth dilution technique. Aloe vera ethanol leaf extract induced a mean zone size of 13.0 ± 6.0 mm and 16.7 ± 8.4 mm, respectively, for S. aureus and Enterobacterales by Punch Well method (p≤0.002). Whereas Aloe vera gel failed to induce any zone of inhibition for all the isolates p<0.001. Mean MIC of Aloe vera leaf extract against 74 S. aureus was 94 ± 41.23 mg/ml and against 73 Enterobacterales, it was 45.6 ± 20 mg/ml p < 0.001. Mean MBC of Aloe vera leaf extract against 74 S.aureus isolates was 188 ± 82.46 mg/ml and against 73 Enterobacterales was 91.18±40 mg/ml p < 0.001. Aloe vera ethanol leaf extract showed a good antibacterial effect against the different strains of bacteria causing wound infection. The present article shows the possibility of future use of natural products for the treatment of wound infections.

Frontal sinus mucosa suture closure technique for prevention of cerebrospinal fluid rhinorrhea after bifrontal craniotomy: long-term follow-up results.

Bifrontal craniotomy often involves the bony opening and mucosal disruption of the frontal sinus (FS), which can lead to cerebrospinal fluid (CSF) leakage and meningitis. These complications are particularly associated with surgical treatments for skull base tumors and anterior cerebral artery aneurysms. The authors initially reported on the basic technique in 2014 with 51 cases. This study presents a detailed description of their technique and postoperative management for sealing the exposed FS during bifrontal craniotomy, including long-term follow-up results and outcomes. To objectively evaluate the effectiveness of suturing FS mucosa in preventing CSF leakage during bilateral frontal craniotomy, the authors focused only on anterior cerebral artery aneurysms. This limitation was necessary as other conditions, like extensive tumors or trauma, might lack intact FS mucosa or require its removal due to infection. The records of 34 consecutive patients (median age 62.0 years, mean 60.4 years, range 33-78 years) who underwent bifrontal craniotomy for anterior cerebral artery aneurysms between January 2014 and December 2023 were retrospectively analyzed. All patients had bony opening and mucosal injury of the FS (with exposure to the nasal cavity) that required mucosal suturing. This technique for sealing the exposed FS involves careful dissection of the mucosa from the entire sinus, sterilization with iodine-soaked surgical cotton, and preparation for closure. After the microsurgical procedure is completed, the exposed mucosa is sealed with 6-0 nylon sutures and further secured with fibrin glue-soaked Gelfoam. The bony exposure is covered with an autologous bone flap created from the inner table of the craniotomy bone flap. Finally, the frontal periosteal flap is sutured to the frontal base dura mater. Patients were instructed not to blow their noses for 2 months postoperatively. Two patients experienced transient non-CSF leakage from the nasal cavity, likely due to irrigation fluid, which resolved within 2 days postoperatively. No recurrence was observed during a mean follow-up period of 52.8 ± 41.7 months (median 49 months, range 3-127 months). No cases of meningitis or other intracranial infections were reported. The long-term results demonstrate the sustained effectiveness of this technique in preventing postoperative complications related to FS exposure during bifrontal craniotomy.

Post-exposure prophylaxis for the prevention of measles: A systematic review.

In susceptible individuals, post-exposure prophylaxis (PEP) is often recommended following exposure to measles, however the data that these recommendations are based on are limited. The objective of this systematic review was to evaluate the efficacy/effectiveness and safety of immunoglobulins (Ig) or measles-containing vaccine (MCV) for the prevention of measles. Prospective studies evaluating the use of Ig or MCV as PEP in susceptible individuals exposed to measles were eligible for inclusion. For studies evaluating Ig, only studies published since 1970 were eligible. Critical outcomes included confirmed cases of measles infection, and death due to measles. The Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and CINAHL were searched (until May 23, 2024). Risk of bias was assessed using the Cochrane ROBINS-I tool. Nine studies were included, totalling 660 patients receiving PEP (434 Ig and 226 MCV). Three studies were in children, one in adults, and five included both children and adults. Data were limited in immunocompromised or pregnant individuals. Details regarding intensity of exposure, time from exposure to treatment, and dose of Ig were poorly reported, and all studies presented moderate/serious concerns regarding the risk of bias. Measles infection rates in those who received Ig PEP ranged from 0 to 30% and from 0 to 15% in those receiving MCV PEP. Estimates of effectiveness ranged from 76% (95% CI 0-94) to 100% (95% CI 56.2-99.8%) for Ig PEP, and from 83.4% (95% CI 34.4-95.8) to 100% (95% CI not estimable) for MCV PEP. Our systematic review provides a contemporary estimate of measles PEP effectiveness in the context of decreased measles antibody titres in donor-derived blood products over time, and highlights the key limitations to available evidence. Future research should seek to estimate effectiveness of measles PEP in populations of special interest, including immunocompromised and/or pregnant populations.

Managing Fetal Anemia: A Case of Parvovirus Infection in Pregnancy.

Managing Fetal Anemia: A Case of Parvovirus Infection in Pregnancy.

Lethal Case of Microbacterium paraoxydans Bloodstream Infection Associated with Mitral Endocarditis in Human: A Case Report, analyses of the 16S DNA sequences and review of the literature.

Lethal Case of Microbacterium paraoxydans Bloodstream Infection Associated with Mitral Endocarditis in Human: A Case Report, analyses of the 16S DNA sequences and review of the literature.

411 A case of pediatric skin and soft tissue infection with interdisciplinary management due to underlying fibrodysplasia ossificans progressiva

411 A case of pediatric skin and soft tissue infection with interdisciplinary management due to underlying fibrodysplasia ossificans progressiva

A 10-year Retrospective Analysis on HPV Genotype Switching in a Tertiary Center in China: Infection Characterization and Clinical Outcome.

This study aims to investigate the phenomenon of human papillomavirus (HPV) genotype switching (HGS), assess the potential influencing factors, and evaluate the clinical impact on the severity of cervical lesions. A total of 2569 HPV positive female patients with records of more than two follow-up visits were included from the gynecology department at the Obstetrics and Gynecology Hospital of Fudan University, covering the period from May 2012 to September 2022. Patients' age, treatments, vaccination, HPV genotypes before and after HGS, and the final pathology results from colposcopy were recorded. Multifactorial analyses and correlation tests were performed. Single HPV infections accounted for 67% of the total population, while multiple HPV infections comprised 33%. The most prevalent genotypes in single HPV infections were HPV52 (18.6%), HPV16 (12.28%), HPV58 (11.72%), HPV53 (8.63%), and HPV81 (6.81%). Among cases of multiple infections, the most common genotype combinations were HPV52 + HPV53 (3.02%), HPV52 + HPV58 (3.13%), and HPV52 + HPV81 (3.02%). HGS was detected in 38.2% of the total cases (458/1200). The status of medication treatment was not found to correlate with the occurrence of HGS. However, age, surgical treatment status, vaccination status, and the genotype of HPV infection may be correlated with HGS. HPV52, HPV58, HPV53, HPV56, and HPV81 showed a positive association with the occurrence of HGS transitioning from multiple infections to a single infection (HGS-MS) (p < 0.05). In contrast, HPV52, HPV16, HPV58, HPV39, HPV56, and HPV18 significantly influenced the occurrence of HGS from one single infection to another (HGS-SS) (p < 0.05), albeit negatively. Notably, only one type of HGS, HGS-MS, demonstrated a positive correlation with the severity of cervical lesions. Our findings suggest that HPV genotype switching from multiple infections to single infections is associated with cervical intraepithelial neoplasia (CIN). Different patterns of HGS could result from specific HPV genotype infections, particularly HPV16. HGS-MS is revealed to plays a catalytic role in the progression of cervical lesions.

Elizabethkingia anophelis: An uncommon cause of hospital-acquired septic meningitis and a rare cause of community-acquired meningitis in children: A case series

Elizabethkingia is one among several new organisms which heve emerged as an important human pathogen in the past few decades. We present the first two cases of Elizabethkingia anophelis infection reported from our institution. The first case was of septic meningitis in a 10-day-old preterm neonate after 10 days of hospital stay and another case was of community-acquired meningitis in a 2-month-old infant. The organism was isolated from the cerebrospinal fluid of both the patients and the blood of only the neonate. E. anophelis is now being identified as the most prevalent species under the genus Elizabethkingia. Among the two cases, one was a health-care-associated infection and another was a community-acquired infection. Both cases improved after giving appropriate antibiotics. Hence, we should look for these kind of cases for early identification and to prevent mortality in patients by starting the right antibiotic.

Molecular Tracking of Emerging Fusarium Species in Keratitis: F. veterinarium, F. contaminatum, and F. curvatum.

Fungal keratitis, which is caused primarily by Neocosmospora and Fusarium species, is a significant global health issue that affects more than a million people annually in tropical and subtropical regions. Neocosmospora solani (formerly Fusarium solani) is a leading cause of corneal infections, along with members of the Fusarium oxysporum species complex (FOSC). This study provides new insights by reporting a series of ocular fusariosis cases caused by FOSC members and presenting molecular evidence linking specific haplotypes within FOSC to human infections. We describe three cases of Fusarium keratitis selected from a comprehensive review of clinicopathological data in our institution's archives. These cases were chosen for their distinctive clinical presentations and the involvement of less common Fusarium species. Two of these patients were diagnosed with keratitis and anterior endophthalmitis, and the third patient had a corneal ulcer previously treated with topical antivirals and antibiotics. All patients were successfully treated with topical amphotericin B. The Fusarium isolates from these patients were subjected to detailed molecular characterization, including DNA sequencing (tef1α, rpb2, CaM, tub2, and LSU), amplified fragment length polymorphism (AFLP) marker analysis, and MALDI-TOF MS analysis. Remarkably, our study reports the first case of human infection by F. veterinarium, alongside cases involving F. contaminatum and F. curvatum. Furthermore, a molecular survey using haplotypic networks based on tef1α sequences identified genotypes associated with human infections and revealed the emergence of F. veterinarium clade VII. Our findings emphasize the need for vigilance regarding emerging species within the FOSC, particularly F. veterinarium. This highlights the need for improved diagnostic tools and targeted research to combat fusarioid-related infections effectively.