Microbiological Characteristics Research Articles

Epidemiological, clinical and microbiological characteristics of patients with biliary tract diseases with positive bile culture in a tertiary hospital

Epidemiological, clinical and microbiological characteristics of patients with biliary tract diseases with positive bile culture in a tertiary hospital

Effect of plant species on wastewater treatment performance of a subsurface vertical-flow constructed wetland with step-feeding at low temperature

To improve the treatment performance of constructed wetlands under low-temperature conditions, this study investigated the effects of plant species on wastewater treatment performance at low temperature and the associated microbiological characteristics in a subsurface vertical-flow constructed wetland (VFCW) with step-feeding. The results showed that the redox microenvironment in the VFCW filter with step-feeding could be restored and optimized by planting appropriate species that can tolerate low temperature, ensuring a high nitrification performance for the system. Correspondingly, the abundance and activity of three functional microbes (namely nitrifiers, denitrifiers, and anammox bacteria) increased to different degrees in the system, eventually ensuring ideal nitrogen removal by the VFCW. Compared with the VFCW planted with Phragmites australis and Acorus gramineus, the operation performance of the VFCW planted with Iris wilsonii could be recovered at low temperature, and its chemical oxygen demand, total phosphorus, total nitrogen, and ammonium nitrate removal rates could respectively reach 95.7%, 99.2%, 93.0%, and 94.4%, respectively. Moreover, nitrogen removal in the system relied on the nitrification/denitrification and partial denitrification - anaerobic ammonium oxidation processes. Nitrosomonas, Nitrospira, Thauera, and Candidatus Brocadia were the four dominant bacterial genera in the filter layer.

Five-year analysis of isolated pathogens and antibiotic resistance of ocular infections from two large tertiary comprehensive hospitals in east China.

To analyze the spectrum of isolated pathogens and antibiotic resistance for ocular infections within 5y at two tertiary hospitals in east China. Ocular specimen data were collected from January 2019 to October 2023. The pathogen spectrum and positive culture rate for different infection location, such as keratitis, endophthalmitis, and periocular infections, along with antibiotic resistance were analyzed. We included 2727 specimens, including 827 (30.33%) positive cultures. A total of 871 strains were isolated, 530 (60.85%) bacterial and 341 (39.15%) fungal strains were isolated. Gram-positive cocci (GPC) were the most common ocular pathogens. The most common bacterial isolates were Staphylococcus epidermidis (25.03%), Staphylococcus aureus (7.46%), Streptococcus pneumoniae (4.59%), Corynebacterium macginleyi (3.44%), and Pseudomonas aeruginosa (3.33%). The most common fungal genera were Fusarium spp. (12.74%), Aspergillus spp. (6.54%), and Scedosporium spp. (5.74%). Staphylococcus epidermidis strains showed more than 50% resistance to fluoroquinolones. Streptococcus pneumoniae and Corynebacterium macginleyi showed more than 90% resistance to erythromycin. The percentage of bacteria showing multidrug resistance (MDR) significantly decreased (χ 2=17.44, P=0.002). GPC are the most common ocular pathogens. Corynebacterium macginleyi, as the fourth common bacterium, may currently be the local microbiological feature of east China. Fusarium spp. is the most common fungus. More than 50% of the GPC are resistant to fluoroquinolones, penicillins, and macrolides. However, the proportion of MDR strains has been reduced over time.

Investigating the effect of ozone treatment on microbiological, proteolytic and lipolytic characteristics of brined ultrafiltered cheese during ripening

Investigating the effect of ozone treatment on microbiological, proteolytic and lipolytic characteristics of brined ultrafiltered cheese during ripening

Bacterial infections and outcomes of inpatients with COVID-19 in the intensive care unit during the delta-dominant phase: the worst wave of pandemic in Iran

BackgroundEpidemiological data regarding the prevalence of bacterial multidrug-resistant (MDR) Gram-negative infections in patients with COVID-19 in Iran are still ambiguous. Thus, in this study we have investigated the epidemiology, risk factors for death, and clinical outcomes of bacterial infections among patients with COVID-19 in the intensive care unit (ICU).MethodThis retrospective cohort study included patients with COVID-19 hospitalized in the ICU of a university hospital in Iran between June 2021 and December 2021. We evaluated the epidemiological, clinical, and microbiological features, outcomes and risk factors associated with death among all COVID-19 patients. Data and outcomes of these patients with or without bacterial infections were compared. Kaplan–Meier plot was used for survival analyses.ResultsIn total, 505 COVID-19 patients were included. The mean age of the patients was 52.7 ± 17.6 years and 289 (57.2%) were female. The prevalence of bacterial infections among hospitalized patients was 14.9%, most of them being hospital-acquired superinfections (13.3%). MDR Klebsiella pneumoniae and Staphylococcus aureus were the most common pathogens causing respiratory infections. Urinary tract infections were most frequently caused by MDR Escherichia coli and K. pneumoniae. The overall in-hospital mortality rate of COVID-19 patients was 46.9% (237/505), while 78.7% (59/75) of patients with bacterial infections died. Infection was significantly associated with death (OR 6.01, 95% CI = 3.03–11.92, p-value <0.0001) and a longer hospital stay (p < 0.0001). Multivariate logistic regression analysis showed that Age (OR = 1.04, 95% CI = 1.03–1.06, p-value <0.0001), Sex male (OR = 1.70, 95% CI = 1.08–2.70, p-value <0.0001), Spo2 (OR = 1.99, 95% CI = 1.18–3.38, p-value = 0.010) and Ferritin (OR = 2.33, 95% CI = 1.37–3.97, p-value = 0.002) were independent risk factors associated with in-hospital mortality. Furthermore, 95.3% (221/232) of patients who were intubated died.ConclusionOur findings demonstrate that bacterial infection due to MDR Gram-negative bacteria associated with COVID-19 has an expressive impact on increasing the case mortality rate, reinforcing the importance of the need for surveillance and strict infection control rules to limit the expansion of almost untreatable microorganisms.

Avocado oil used to modify rice starch and prepare gluten‐free cakes: physical–chemical, microbiological, sensory, and nutritional evaluations

SummaryThis study aimed to use modified rice starch by heat‐moisture treatment with avocado oil (AO) in gluten‐free cakes. Four cake formulations were prepared with native or modified rice starch with AO or soybean oil (control). The cake's sensory, microbiological, technological, nutritional, and bioactive compound characteristics were analysed. All formulations were sensorily acceptable (acceptance index: 72.44% to 79.44%) and microbiologically safe. The cake formulated with modified starch and AO exhibited the best textural properties, softness, and colour, and demonstrated the lowest in vitro digestibility (81.52 ± 2.75%) and glycaemic index (88.04 ± 3.83). AO resulted in higher levels of phenolic compounds in the cake (112.91 ± 1.8 to 237.38 ± 4.1 mg EAG.100 g−1). The use of modified rice starch and AO showed greater potential in the application of gluten‐free cake than those with native starch, resulting in improved product characteristics and good technological and sensory properties. It has also become a promising alternative in gluten‐free food products.

Relationship between the Presence of Human Papillomavirus in the Female Urethra and Recurrent Urinary Tract Infections.

Introduction: Recurrent urinary tract infections (rUTIs) are highly prevalent health issues among women, significantly impacting their quality of life. Urethral pain or urethritis can arise from infectious or non-infectious origins. The presence of Human Papillomavirus (HPV) in the urogenital tract has been associated with high-risk sexual behaviors, but its presence in the female urethra without such behaviors has not been thoroughly investigated. Objectives: The study aims to determine the presence of HPV in the urethra of women with recurrent urinary tract infections (rUTIs) and concomitant urethral syndrome and to compare the clinical and microbiological characteristics of women with and without urethral HPV, specifically focusing on those without high-risk sexual behaviors. Methods: This prospective multicenter study included 138 women over 18 years old with rUTIs and concomitant urethral pain syndrome. High-risk sexual behaviors, sexually transmitted infections, and vaginitis were set as exclusion criteria. Participants were divided into two groups: NHPV (n = 72) with no urethral HPV and HPV (n = 66) with urethral HPV presence. Variables analyzed included age, body mass index (BMI), follow-up duration, comorbidities, treatments, toxic habits, surgical history, main symptoms, urine sediment findings, and cultures from urine and vaginal exudate. HPV genotyping was also performed. Descriptive statistics were used, along with Student's t-test, Chi-square, Fisher's exact test, ANOVA, and multivariate cluster analysis. Results: The NHPV group was older on average (48.75 years) compared to the HPV group (39.09 years). The HPV group had a longer follow-up period (2634 days vs. 1975 days in NHPV). Urinary incontinence was significantly more common in NHPV (63.89%) compared to HPV (18.18%) (p = 0.001). HPV-positive women had a higher prevalence of verrucous lesions in the vaginal introitus (64% vs. 8% in NHPV). Additionally, the HPV group showed higher rates of pyuria (27.27%), vaginal Candida albicans (36.26%), and positive urine cultures for Escherichia coli (47.83%), Enterococcus faecalis (36.36%), and Klebsiella pneumoniae (21.74%). No significant differences were observed between the groups concerning BMI, smoking habits, diabetes, or the main symptom at consultation. The most common HPV genotypes identified were G35, G42, and G66 (each 27%). Multivariate analysis revealed that sensitivity to nitrofurantoin was the most significant variable in the HPV group (importance of 0.96), followed by fosfomycin (0.79), trimethoprim (0.79), and amoxicillin (0.71). Conclusions: HPV was present in the urethra of 47.8% of women with rUTIs and concomitant urethral syndrome who did not exhibit high-risk sexual behaviors. These women were younger and had a longer duration of symptoms compared to those without urethral HPV. The identification of Enterococcus faecalis, Escherichia coli, and Klebsiella pneumoniae was more common in the HPV group. The sensitivity of bacteria to nitrofurantoin and fosfomycin is crucial for the clinical management of these patients. The presence of urethral HPV should be considered in the evaluation and treatment of women with rUTIs and urethral syndrome.

Physicochemical and microbiological analyzes of Tetragonisca angustula, Melipona mondury and Scaptotrigona postica honey from the first public meliponary in Marília City (São Paulo – Brazil)

Native stingless bees (NSBs) are widely distributed in Brazilian territory. They are responsible for pollinating plants, maintaining biodiversity, and producing honey, a natural and therapeutic sweetener, used by different populations. This study aimed to identify physical, chemical, and microbiological characteristics of honey samples collected during the first harvesting of Tetragonisca angustula, Melipona mondury, and Scaptotrigona postica bees kept in the first public meliponary situated in Marília, São Paulo state, Brazil. Samples were collected directly from NSB’s hives in the meliponary and sequentially matured in plastic bottles with airlock valves, duringn 90 days, in the Physicochemical Analyzes Laboratory at Fatec Marília. Subsequently, analyzes were carried out to determine pathogenic and spoilage microorganisms. In addition, analyzes to determine free acidity, reducing sugars, total soluble solids, apparent sucrose, humidity, insoluble solids, pH, water activity, and hydroxymethylfurfural were performed. Results showed the presence of molds and yeasts. Nevertheless, because the values agreed with the current legislation and the pathogenic and deteriorating contaminants were absent in the honey samples, one may suggest that they were brought to the hive by bees, since floral nectaries are their normal habitats. The physicochemical parameters, with the exception of reducing sugars, agreed with other scientific studies and reinforced the proposal for technical regulation, considering the absence of specific national legislation for NSB’s honey. Therefore, it is considered relevant to establish regulations for NSB’s honey to define identity and standard requirements to guarantee safe consumption and direction for scientific studies in the area.

Clinical and microbiological characteristics and follow-up of invasive Listeria monocytogenes infection among hospitalized patients: real-world experience of 16 years from Hungary

PurposeInvasive Listeria monocytogenes infection is rare, but can lead to life-threatening complications among high-risk patients. Our aim was to assess characteristics and follow-up of adults hospitalized with invasive L. monocytogenes infection.MethodsA retrospective observational cohort study was conducted at a national referral center between 2004 and 2019. Patients with proven invasive listeriosis, defined by the European Centre for Disease Prevention and Control criteria, were included. Data collection and follow-up were performed using the hospital electronic system, up until the last documented visit. The primary outcome was in-hospital all-cause mortality, secondary outcomes included residual neurological symptoms, brain abscess occurrence, and requirement for intensive care unit (ICU) admission.ResultsAltogether, 63 cases were identified (57.1% male, median age 58.8 ± 21.7 years), and 28/63 developed a complicated disease course (44.4%). At diagnosis, 38/63 (60.3%) presented with sepsis, 54/63 (85.7%) had central nervous system involvement, while 9/63 (14.3%) presented with isolated bacteremia. Frequent clinical symptoms included fever (53/63, 84.1%), altered mental state (49/63, 77.8%), with immunocompromised conditions apparent in 56/63 (88.9%). L. monocytogenes was isolated from blood (37/54, 68.5%) and cerebrospinal fluid (48/55, 87.3%), showing in vitro full susceptibility to ampicillin and meropenem (100% each), gentamicin (86.0%) and trimethoprim/sulfamethoxazole (97.7%). In-hospital all-cause mortality was 17/63 (27.0%), and ICU admission was required in 28/63 (44.4%). At discharge, residual neurological deficits (11/46, 23.9%) and brain abscess formation (6/46, 13.0%) were common.ConclusionAmong hospitalized adult patients with comorbidities, invasive L. monocytogenes infections are associated with high mortality and neurological complications during follow-up.

Molecular epidemiology, microbiological features and infection control strategies for carbapenem-resistant Acinetobacter baumannii in a German burn and plastic surgery center (2020–2022)

BackgroundCarbapenem-resistant Acinetobacter baumannii (CRAB) frequently causes both healthcare-associated infections and nosocomial outbreaks in burn medicine/plastic surgery and beyond. Owing to the high antibiotic resistance, infections are difficult to treat, and patient outcomes are often compromised. The environmental persistence capability of CRAB favors its transmission in hospitals. A comprehensive analysis and understanding of CRAB epidemiology and microbiology are essential for guiding management.MethodsA three-year retrospective cohort study (2020–2022) was conducted in a German tertiary burn and plastic surgery center. In addition to epidemiological analyses, microbiological and molecular techniques, including whole-genome sequencing, were applied for the comprehensive examination of isolates from CRAB-positive patients.ResultsDuring the study period, eight CRAB cases were found, corresponding to an overall incidence of 0.2 CRAB cases per 100 cases and an incidence density of 0.35 CRAB cases per 1000 patient-days. Six cases (75%) were treated in the burn intensive care unit, and four cases (50%) acquired CRAB in the hospital. Molecular analyses comprising 74 isolates supported the epidemiologic assumption that hospital acquisitions occurred within two separate clusters. In one of these clusters, environmental CRAB contamination of anesthesia equipment may have enabled transmission. Furthermore, molecular diversity of CRAB isolates within patients was observed.ConclusionsCRAB can pose a challenge in terms of infection prevention and control, especially if cases are clustered in time and space on a ward. Our study demonstrates that high-resolution phylogenetic analysis of several bacterial isolates from single patients can greatly aid in understanding transmission chains and helps to take precision control measures.

Clinico-microbiological profile of urosepsis patients in a tertiary care hospital in India: A 1-year study

Objectives: Urosepsis is a life-threatening bacterial infection resulting from a complicated urinary tract infection. Early diagnosis of urosepsis, its causative agent, and the susceptibility pattern are most important for accurate treatment to prevent mortality. Diagnosis includes recognition of the presence of sepsis and the investigations that help in the management of patients. The most common organism causing urosepsis is Escherichia coli, followed by other members of the Enterobacteriaceae family. With this background, this study was conducted to determine the clinical-microbiological profile of urosepsis patients in our tertiary care hospital. Materials and Methods: This was a prospective observational study; patients with clinical urosepsis and growing identical bacteria from both urine and blood cultures taken simultaneously are included in the study. The details of the clinical presentation and laboratory investigation results were recorded on an Excel sheet. Statistical analysis: Statistical analysis was done using IBM Statistical Package for the Social Sciences Statistics V.23. The categorical variables such as demographic, microbiological, and other laboratory characteristics and clinical outcomes were analyzed and expressed in terms of frequencies and percentages. Continuous variables were expressed in terms of median. Independent t-test, Mann–Whitney U-test, Chi-square test, or Fisher’s exact test were used wherever applicable. Results: We found 87 urosepsis patients in one year with a mortality rate of 22.98%. The mean age of the patients was 61.5 years, with majority (42.42%) above 65 years. Gram-negative bacilli were frequently isolated, with the highest number of E. coli (68.96%), followed by Klebsiella pneumoniae (20.68%). Sixteen (18.4%) of Gram-negative bacilli were Carbapenem-resistant Enterobacteriaceae. Multiple risk factors were seen in 58/87 (66.66%) patients, with diabetes mellitus as the most common risk factor. Conclusions: Urosepsis is a critical condition with a high mortality rate. Meropenem can be used as an empirical therapy with careful observation of patients in view of the occurrence of carbapenem resistance. A multidisciplinary team approach comprising intensive care specialists, urologists, radiologists, and microbiologists is very important for the effective and rapid management of urosepsis.

Surgical site infection in severe trauma patients in intensive care: epidemiology and risk factors

BackgroundSevere trauma is the leading cause of disability and mortality in the patients under 35 years of age. Surgical site infections (SSI) represent a significant complication in this patient population. However, they are often inadequately investigated, potentially impacting the quality of patient outcomes. The aim of this study was to investigate the epidemiology of SSI and risk factors in severe trauma patients.MethodsWe conducted a multicenter retrospective cohort study screening the severe trauma patients (STP) admitted to two intensive care units of an academic institution in Marseille between years2018 and 2019. Those who underwent orthopedic or spinal surgery within 5 days after admission were included and classified into two groups according to the occurrence of SSI (defined by the Centers for Disease Control (CDC) international diagnostic criteria) or not. Our secondary goal was to evaluate STP survival at 48 months, risk factors for SSI and microbiological features of SSI.ResultsForty-seven (23%) out of 207 STP developed an SSI. Mortality at 48-months did not differ between SSI and non-SSI patients (12.7% vs. 10.0%; p = 0.59). The fractures of 22 (47%) severe trauma patients with SSI were classified as Cauchoix 3 grade and 18 (38%) SSI were associated with the need for external fixators. Thirty (64%) severe trauma patients with SSI had polymicrobial infection, including 34 (72%) due to Gram-positive cocci. Empirical antibiotic therapy was effective in 31 (66%) cases. Multivariate analysis revealed that risk factors such as low hemoglobin, arterial oxygenation levels, hyperlactatemia, high serum creatinine and glycemia, and Cauchoix 3 grade on the day of surgery were associated with SSI in severe trauma patients. The generated predictive model showed a good prognosis performance with an AUC of 0.80 [0.73–0.88] and a high NPV of 95.9 [88.6–98.5] %.ConclusionsOur study found a high rate of SSI in severe trauma patients, although SSI was not associated with 48-month mortality. Several modifiable risk factors for SSI may be effectively managed through enhanced perioperative monitoring and the implementation of a patient blood management strategy.

Bio-transformation of poultry litter and activated sewage sludge to produce biomixtures for the remediation of water polluted with pesticides

The aim of this study was to formulate novel biomixtures with the ability to dissipate globally used pesticides. For this, an effective stabilization of two wastes, poultry litter and activated sewage sludge, was achieved through a combination of composting and vermicomposting, with the aid of the earthworm Eisenia fetida. Hence, two different mixtures were prepared combining the wastes with and without the addition of sewage sludge, and their physicochemical and microbiological characterization was examined during both processes. Earthworms reproduction was promoted by more than fourteen times the initial number of individuals introduced. This step made it possible to obtain substrates rich in organic matter, stable and non-pathogenic. The resulting vermicomposted substrates (V-C1 and V-C2) were used to produce two different biomixtures with wheat stubble (WS) and soil (S): SWSV-C1 and SWSV-C2, and they were tested for the remediation of a solution of five pesticides (2,4-D, cypermethrin, imidacloprid, acetochlor and dimethoate) in a 119-days assay. Comparisons were made with a WS-only biomixture (SWS) and a soil control. All biomixtures were more successful in dissipating the pesticides than soil; 2,4-D, dimethoate, and acetochlor degradation reached more than 99% in the three biomixtures after 28-56 days of assay. Biomixtures containing either vermicomposts acted faster than SWS, particularly for 2,4-D, dimethoate and cypermethrin. The total microbial activity was found to be higher in the two biomixtures containing vermicompost, which can be linked to their enhanced performance in the degradation of pesticides. Although the germination of Lactuca sativa proved that neither of the three spent biomixtures were phytotoxic at the end (germination index > 60%), only SWSV-C1 and SWSV-C2 proved to be safe for the survival of E. fetida. This work confirms that vermicompost improves the success of biomixtures, not only in terms of pesticide removal, but also providing non-toxic spent biomixtures.

Mycobacterium tuberculosis cough aerosol culture status associates with host characteristics and inflammatory profiles

Interrupting transmission events is critical to tuberculosis control. Cough-generated aerosol cultures predict tuberculosis transmission better than microbiological or clinical markers. We hypothesize that highly infectious individuals with pulmonary tuberculosis (positive for cough aerosol cultures) have elevated inflammatory markers and unique transcriptional profiles compared to less infectious individuals. We performed a prospective, longitudinal study using cough aerosol sampling system. We enrolled 142 participants with treatment-naïve pulmonary tuberculosis in Kenya and assessed the association of clinical, microbiologic, and immunologic characteristics with Mycobacterium tuberculosis aerosolization and transmission in 129 household members. Contacts of the forty-three aerosol culture-positive participants (30%) are more likely to have a positive interferon-gamma release assay (85% vs 53%, P = 0.006) and higher median IFNγ level (P < 0.001, 4.28 IU/ml (1.77-5.91) vs. 0.71 (0.01-3.56)) compared to aerosol culture-negative individuals. We find that higher bacillary burden, younger age, larger mean upper arm circumference, and host inflammatory profiles, including elevated serum C-reactive protein and lower plasma TNF levels, associate with positive cough aerosol cultures. Notably, we find pre-treatment whole blood transcriptional profiles associate with aerosol culture status, independent of bacillary load. These findings suggest that tuberculosis infectiousness is associated with epidemiologic characteristics and inflammatory signatures and that these features may identify highly infectious persons.

Association between pertactin-producing Bordetella pertussis and fulminant pertussis in infants: a multicenter study in France, 2008-2019

ObjectivesVirulence factors of the causative agent, Bordetella pertussis, may be involved in fulminant pertussis, the most severe form of whooping cough (pertussis) in infants. We aimed to assess the association between fulminant pertussis and the status of pertactin (PRN) production of B. pertussis clinical isolates. MethodsSymptomatic infants aged <6 months and with a positive B. pertussis culture from 2008-2019 were included. B. pertussis isolates and clinical data were collected from French hospital laboratories through the national pertussis surveillance network. Fulminant pertussis was defined as a case with a leukocyte count > 40 x 109/L and at least one of the following criteria: respiratory failure, pulmonary hypertension, shock, or multiple organ failure. PRN production was assessed by western blotting. Baseline characteristics of infants and microbiological findings were compared between patients with and without fulminant pertussis. To identify patient and microbiological features associated with fulminant pertussis, a multivariable modified Poisson regression model was developed with confounders selected using a directed acyclic graph. ResultsWe included 361 infants with pertussis (median age 63 days [interquartile range, 39-86]), of which 32 (9%) progressed to fulminant pertussis. None of the mothers was vaccinated during pregnancy. Of the 361 implicated B. pertussis isolates, 294 (81%) produced PRN. Patients with fulminant pertussis were more often neonates (adjusted relative risk [aRR] 3.62, 95% confidence interval [CI] 1.76–7.44), infants with a history of prematurity (aRR 7.08, 95%CI 3.06–16.36), unvaccinated infants (aRR 4.42, 95%CI 1.02–19.24), and infants infected by PRN-producing isolates (aRR 3.76, 95%CI 1.02–13.83). ConclusionsPRN-producing B. pertussis was independently associated with an increased risk of fulminant pertussis. In a context where PRN-containing aP vaccines favor the emergence of PRN-deficient isolates, our study suggests a positive role for such vaccines in driving the evolution of B. pertussis populations towards reduced virulence.

Bacterial co-infections in cancer patients with COVID-19: predictors and antimicrobial resistance trends.

Within the context of the coronavirus disease 2019 (COVID-19) pandemic, this study investigated the multifaceted challenges of bacterial infections in cancer patients with COVID-19. It focuses on clinical predictors, resistance patterns, and microbiological characteristics. Over 18 months, 112 adult cancer patients with coronavirus infection confirmed by reverse transcription polymerase chain reaction (RT-PCR) were enrolled. Bloodstream and respiratory samples were evaluated for bacterial infection using the Phoenix automation system for definitive species identification. In vitro susceptibility testing followed the Clinical Laboratory Standards Institute (CLSI) M100-Ed30 guidelines. Bacterial infections affected 25.0% of patients, encompassing bacteremia (21.4%) and respiratory tract infections (8.0%). Multivariable analysis identified hypertension, age < 60, and critical COVID-19 as significant predictors for bacterial infections (p-values = 0.024, 0.029, and 0.039, respectively). Most patients received antimicrobial therapy (93.8%), including last-resort carbapenems (52.7%) and colistin (8.9%). Thirty-three bacterial isolates were identified, with secondary infections doubling co-infection rates. Escherichia coli, Klebsiella species, and Staphylococcus aureus were the most common co-infecting species, while Klebsiella, Acinetobacter, and Pseudomonas species were more frequently associated with secondary infections. Alarmingly, 84.8% of isolates displayed high resistance patterns. All isolated S. aureus species were methicillin-resistant, and 62.5% of Gram-negative bacteria were exclusively sensitive to colistin. The dominance of highly transmissible hospital-acquired bacterial species, with increased resistance and extensive antibiotic use in COVID-19 patients, necessitates strict infection control and antimicrobial stewardship. Developing customized antimicrobial strategies for cancer patients with COVID-19 is crucial to managing bacterial infections effectively and improving patient outcomes.

CHARACTERISTICS OF JUWET FRUIT YOGHURT WITH THE ADDITION OF SKIM MILK AND LACTIC ACID BACTERIA STARTER

In this study, the manufacture of juwet fruit yoghurt was studied with different treatments of adding skim milk and lactic acid bacteria starter. Yogurt is a processed milk product made through bacterial fermentation. Yogurt is known as a good source of protein, calcium, and probiotics, which can support digestive health and the immune system. Juwet fruit has a high antioxidant and vitamin C content so that juwet fruit has interesting potential to be made into yoghurt. Skim milk is used to utilize high lactose and protein so that the growth of lactic acid bacteria can grow optimally. Lactic acid bacteria are used for preservation, providing texture, and adding flavor to yoghurt drinks. The purpose of this study was to determine the addition of skim milk and lactic acid bacteria starter on the physicochemical, microbiological, and organoleptic characteristics of juwet yoghurt. This study used a Completely Randomized Design (CRD) factorial pattern consisting of two factors. Factor 1 addition of skim milk (5%, 7%, 9%). Factor 2 addition of starter (5%, 7%, 9%). Each treatment was repeated three times. The data obtained were analyzed using analysis of variance (ANOVA). If there is a significant difference between treatments, it is continued with the Duncan test (DMRT) and organoleptic test using the Scoring test with 25 trained panelists. The treatment of adding 9% skim milk and 9% starter was the best treatment that produced juwet yoghurt with a protein content of 2.1% ± 0.036, total titratable acid 2.1% ± 0.1, total soluble solids 22.7ºBrix ± 1.53, total lactic acid bacteria 10.5 log CFU/ml ± 0.023, pH 3.7 ± 0.058, antioxidants 34.0% ± 0.117, viscosity 6.8% ± 0.058, Vitamin C 5.8 ± 0.3, and organoleptic tests of color 2.88 (rather like), taste 3.24 (rather like), aroma 2.68 (rather like), texture 3.76 (like).

Effect of Sucrose Concentration on Microbiological, Physicochemical, Antioxidant Activity, and Organoleptic Characteristics of Salak Fruit Juice Beverage Fermented with Lactobacillus Plantarum InaCC B153

Salak is a tropical fruit that has great potential to be made into a healthy fermented beverage. The carbohydrate content and bioactive compounds such as phenolics in salak provide benefits as a source of antioxidants. The fermentation process will produce a probiotic drink that is good for digestive health. The fermentation process involves Lactobacillus plantarum bacteria as probiotic agents. This study aims to determine the effect of sucrose concentration on the characteristics of salak fruit juice probiotic drinks. This study used a completely randomised design (CRD) factorial pattern with sucrose concentration factor (3%, 6%, 9% b/v). The data obtained were analysed using ANOVA followed by DMRT further test at the 5% level. The results showed a significant interaction (p≤0.05). Fermented salak fruit juice using 9% sucrose was the best treatment with characteristics of pH 3.80; total microbes 9.023 log CFU/ml; total acid 1,11%; total sugar 13,88%; viscosity 118,35 mPa.s; DPPH antioxidant activity 89.99%. The resulting organoleptic properties including colour, aroma, and taste, overall were 3.40 (moderately liked), 3.08 (moderately liked), 3.76 (moderately liked), and 3,48 (moderately liked).

Carbapenem resistance in Enterobacterales: Predicting clinical outcomes in bloodstream infections

PurposeCarbapenem-resistant Enterobacterales (CRE) are a global concern due to their high mortality rates and limited therapeutics. CRE-caused bloodstream infections (BSIs) are challenging to manage, especially in healthcare settings. This study aimed to investigate the predictors of mortality in BSI patients caused by CRE. MethodsA single center prospective study to examine the characteristics of BSI caused by CRE in a large academic hospital over 15 months. The main outcomes were microbiological characteristics and clinical outcomes of patients at 28 days based on a step-wise regression analysis. ResultsA total of 76 episodes of BSI due to CRE were included. The study found that the most common type of carbapenemase was OXA-48 (69.7 %, n = 53), followed by the co-existence of OXA-48 and MBL (26.3 %, n = 20), with Klebsiella pneumoniae being the most common (90 %, n = 69). Patients with OXA-48-BSI were more likely to have a urinary source of infection, while patients with MBL-BSI were more likely to have a non-urinary source of infection. All cases (100 %) had medical devices. Around 30.3 % of patients received effective empirical treatment, while 61.8 % received adequate therapy at 48 h. The overall mortality rate was 42.1 % (n = 32), and the main predictors of mortality in this study were the presence of sepsis and inadequate initial therapy, while age >65 predicted mortality in the linear regression but not the stepwise regression model. ConclusionCRE-BSIs are a serious health threat. The study highlights the need for preventive strategies focused on high-risk patients and proper device management to reduce BSI.

Functional and Microbiological Responses of Iron–Carbon Galvanic Cell-Supported Autotrophic Denitrification to Organic Carbon Variation and Dissolved Oxygen Shaking

Iron–carbon galvanic-cell-supported autotrophic denitrification (IC-ADN) is a burgeoning efficient and cost-effective process for low-carbon wastewater treatment. This study revealed the influence of organic carbon (OC) and dissolved oxygen (DO) on IC-ADN in terms of functional and microbiological characteristics. The nitrogen removal efficiency increased to 91.6% and 94.7% with partial organic carbon source addition to COD/TN of 1 and 3, respectively. The results of 16S rRNA high-throughput sequencing with nirS and cbbL clone libraries showed that Thiobacillus was the predominant autotrophic denitrifying bacteria (ADB) in the micro-electrolysis-based autotrophic denitrification, which obtained nitrogen removal efficiency of 80.9% after 96 h. The ADBs shifted gradually to heterotrophic denitrifying bacteria Thauera with increasing COD/TN ratio. DO concentration of 0.8 rarely affected the denitrification efficiency and the denitrifying communities. When the DO concentration increased to 2.8 mg/L, the nitrogen removal efficiency decreased to 69.1%. These results demonstrated that autotrophic denitrification was notably affected by COD/TN and high DO concentration, which could be used to acquire optimum conditions for nitrogen removal. These results provided an in-depth understanding of the influential factors for galvanic-cell-based denitrification and helped us construct a stable and highly efficient treatment process for insufficient carbon source wastewater.