Microbiological Samples Research Articles

HMicroDB: A Comprehensive Database of Herpetofaunal Microbiota Witha Focus on Host Phylogeny, Physiological Traits, and Environment Factors.

Symbiotic microbiota strongly impact host physiology. Amphibians and reptiles occupy a pivotal role in the evolutionary history of Animalia, and they are of significant ecological, economic, and scientific value. Many prior studies have found that symbiotic microbiota in herpetofaunal species are closely associated with host phylogeny, physiological traits, and environmental factors; however, insufficient integrated databases hinder researchers from querying, accessing, and reanalyzing these resources. To rectify this, we built the first herpetofaunal microbiota database (HMicroDB; https://herpdb.com/) that integrates 11,697 microbiological samples from 337 host species (covering 23 body sites and associated with 23 host phenotypic or environmental factors), and we identified 11,084 microbial taxa by consistent annotation. The standardised analysis process, cross-dataset integration, user-friendly interface, and interactive visualisation make the HMicroDB a powerful resource for researchers to search, browse, and explore the relationships between symbiotic microbiota, hosts, and environment. This facilitates research in host-microbiota coevolution, biological conservation, and resource utilisation.

The effect of melatonin and probiotics on radiation-induced enteritis in experimental rat models

Radiotherapy plays an important role in the treatment of tumors, and enteritis is a common side effect of this therapy. The aim of present study was to evaluate the protective effect of melatonin and probiotics on radiation-induced intestinal tissue damage in rats. Histopathological, biochemical and microbiological samples were examined. Thirty-two Wistar Albino rats were randomly distributed into four groups: the control group, only radiotherapy (RT) group, radiotherapy plus melatonin (RT + MEL) groups and radiotherapy plus probiotics (RT + PROB) groups. The abdominal-pelvic region of the experimental rat was irradiated with in a single dose of 16 Gy. The melatonin was administered at a single dose of 50 mg/kg through intraperitoneal injection, 15 min before radiation exposure. The probiotic was administered orally every day to the rats for 5 days starting before radiotherapy. There was a statistically significant changes in histopathological (villus atrophy, mitotic activity, apoptotic index, goblet cell swelling, degenerative changes, atypia) and biochemical (oxidant and antioxidant status, IL-1β, IL-6 and TNF- α levels) parameters in the small intestine in the radiotherapy group G2 compared to the G1 control group (p < 0.05). However, a significant decrease was observed with the administration of probiotics and melatonin (p < 0.05). In addition, although positive bacterial growth was detected in the mesenteric lymph node of all rats in the radiotherapy group, there was no statistically significant difference between all groups (p > 0.05). Melatonin and probiotics were found to have a potent radioprotective effect against radiotherapy-induced acute small intestinal tissue damage. However, their superiority over each other was not observed.

Evaluation of A. actinomycetemcomitans and P. gingivalis from the mouth of patients irradiated in the head and neck region: a cross-sectional study.

This study aimed to quantify Aggregatibacter actinomycetemcomitans (A.a) and Porphyromonas gingivalis (P.g) from the mouth of head and neck irradiated and cancer-free patients. Information such as age, presence of tongue coating, salivary flow, and biofilm were collected from head and neck irradiated patients (Group 1) and compared the results with a group of cancer-free individuals (Group 2). The presence of tongue coating was clinically examined. Sialometry was performed through a stimulating technique by chewing paraffin. Microbiological samples were collected from buccal and labial mucosa and tongue dorsum. Subsequently, the samples were processed and analyzed by qPCR to detect the presence and quantify the bacteria. There was a statistical difference in the quantity of bacteria among the 24 individuals in Group 1 (A.a, 2817 ± 8718; P.g, 3145 ± 11297) and 26 individuals in Group 2 (A.a, 133996 ± 398545; P.g, 60 ± 195) regarding tongue coating (Group 1, A.a 2194.6 ± 4641.5; Group 2, A.a 92767.8 ± 333385.7) and salivary volume (Group 1, 0.69mL; Group 2, 3.09mL). The linear regression analysis found that the variable group was the main responsible for the difference in the quantity of periodontal pathogens (p-value < 0.001). There was no statistical difference in the amount of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis between totally edentulous and partially edentulous (with 12 or fewer teeth) patients. Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were present in significant amounts in patients of both groups, with a greater quantity in cancer-free individuals.

Microbial burden on environmental surfaces in long-term care facilities: a quantitative analysis.

We conducted a quantitative analysis of the microbial burden and prevalence of epidemiologically important pathogens (EIP) found on long-term care facilities (LTCF) environmental surfaces. Microbiological samples were collected using Rodac plates (25cm2/plate) from resident rooms and common areas in five LTCFs. EIP were defined as MRSA, VRE, C. difficile and multidrug-resistant (MDR) Gram-negative rods (GNRs). Rooms of residents with reported colonization had much greater EIP counts per Rodac (8.32 CFU, 95% CI 8.05, 8.60) than rooms of non-colonized residents (0.78 CFU, 95% CI 0.70, 0.86). Sixty-five percent of the resident rooms and 50% of the common areas were positive for at least one EIP. If a resident was labeled by the facility as colonized with an EIP, we only found that EIP in 30% of the rooms. MRSA was the most common EIP recovered, followed by C. difficile and MDR-GNR. We found frequent environmental contamination with EIP in LTCFs. Colonization status of a resident was a strong predictor of higher levels of EIP being recovered from his/her room.

Antimicrobial resistance trends in Italian hospitals: insights from two point prevalence surveys

Abstract Background Antimicrobial resistance (AMR) presents a critical challenge to global healthcare systems, necessitating vigilant surveillance efforts. The European Centre for Disease Prevention and Control (ECDC) conducts point prevalence surveys (PPSs) to monitor AMR trends across European hospitals. This study focuses on comparing AMR patterns in Italian hospitals using data from two surveys: PPS2 (2016-2017) and PPS3 (2022-2023). Methods A total of 140 hospitals enrolling 28991 patients participated in PPS2, while 325 hospitals with 58506 patients contributed data to PPS3. Microbiological samples were collected and tested for antimicrobial susceptibility. Prevalence ratios (PR) with corresponding 95% confidence intervals (CI) were calculated to assess changes in resistance patterns between PPS2 and PPS3. Statistical significance was determined with p-value &amp;lt;0.05. Results Staphylococcus aureus showed a trend towards decreased oxacillin resistance, (PR: 0.77, 95% CI: 0.60 - 0.99). Enterococcus faecalis exhibited a non-significant decrease in glycopeptide resistance. Pseudomonas aeruginosa and Acinetobacter baumannii maintained stable carbapenem resistance between the two surveys. Escherichia coli and Klebsiella pneumoniae showed a decreasing trend in resistance to carbapenems and third-generation cephalosporins, but only Klebsiella pneumoniae was found to be significant (PR: 0.69, 95% CI: 0.55 - 0.88, p 0.004 and PR: 0.78, 95% CI: 0.66 - 0.94, p 0.01, respectively). Conclusions These findings underscore the importance of surveillance in monitoring AMR trends. Observed decreases, especially in Klebsiella pneumoniae, suggest potential improvements. However, the overall stability of resistance highlights the ongoing challenge of combating AMR. A multifaceted approach, including antimicrobial stewardship and One Health initiatives, is crucial to address this global health threat effectively. Key messages • Surveillance efforts are crucial to understand antimicrobial resistance (AMR) trends, as demonstrated by comparing data from two surveys in Italian hospital. • Results highlight the need for data-driven interventions, guiding future strategies within a One Health framework to address antimicrobial resistance comprehensively.

Isolation of Candida Species Is Associated with Comorbidities, Prolonged Mechanical Ventilation, and Treatment Outcomes in Surgical ICU Patients, a Cross-Sectional Study

The isolation of Candida may be related to comorbidity, prolonged mechanical ventilation, and survival during intensive care unit (ICU) stay, especially with non-albicans Candida (NAC). To examine the frequency of Candida isolation, associated comorbidities and outcomes in the surgical ICU in Osijek University Hospital, Croatia, the data from the electronic database from May 2016 to 30 June 2023 were analyzed. In a cross-sectional study examining 15,790 microbiological samples, different strains of Candida were observed in 581 samples from 236 patients. The control group (N = 261) was 130 consecutive patients from March to May 2019 and 131 in the same months in 2020 (pre- and post-COVID-19). Comorbidities, duration of mechanical ventilation, and survival were compared. Patients with isolated Candida were more often non-elective and had significantly more heart, kidney, and liver diseases and sepsis than the control group (p &lt; 0.001). The duration of mechanical ventilation was 9.2 [2.2–9.24], 96 [24–146], 160 [19.5–343], and 224 [73.5–510] hours in the controls, in patients with Candida albicans, in patients with NAC, and in patients with ≥2 Candida species isolated, respectively. The mortality was significantly higher (42%) in patients with isolated Candida than in the control group (19%, p &lt; 0.001). In a multivariate analysis adjusted for patients’ age, the Simplified Acute Physiology Score II, days of ICU, and type of admission, only sepsis on admission was an independent predictor of mortality (odds ratio = 2.27).

Long-Term Lung Function and Pseudomonas aeruginosa Infection in Genotyped Primary Ciliary Dyskinesia.

Rationale: Primary ciliary dyskinesia is a rare genetic disorder characterized by progressive lung disease. Pseudomonas aeruginosa is a major pathogen in this disease, known to impact lung function. Previous genotype-phenotype studies have been limited by cross-sectional designs, isolated adult or pediatric populations, small numbers, or short follow-up durations. Objectives: We aimed to explore long-term lung function in primary ciliary dyskinesia grouped by genotypes and ultrastructural defects, considering the influence of P. aeruginosa. Methods: In this retrospective, observational study, we analyzed 43 years of spirometry and 20 years of microbiology data. Using linear mixed-effects models, we estimated FEV1 z-score trends and compared them at ages 10, 25, and 50 years, while Generalized Estimating Equations were used to assess P. aeruginosa prevalence between groups. In a secondary analysis, we matched spirometry and microbiology samples to evaluate the influence of P. aeruginosa on lung function. Measurements and Main Results: We included 127 genotyped subjects, 6,691 spirometries and 10,082 microbiology samples. CCDC39 and CCDC40 variants showed early onset and sustained decline in lung function, while DNAH11 and HYDIN variants demonstrated relative stability. Lung function in the proximity of positive P. aeruginosa cultures were on average 0.06 z-score lower. Despite this, differences between groups remained largely unaffected by P. aeruginosa. Conclusion: Long-term lung function in primary ciliary dyskinesia follows discrete genotype specific profiles and appear independent of P. aeruginosa infection. We confirm and extend previous findings of CCDC39 and CCDC40 as variants associated with early onset severe lung function impairment persisting in the long term.

Can bone SPECT/CT determine optimal sites for microbiological identification in post-traumatic or chronic osteomyelitis of extremities?

IntroductionAccurate microbiological identification is crucial when managing chronic osteomyelitis (COM) and post-traumatic osteomyelitis (PTO). Although bone single photon emission computed tomography/computed tomography (SPECT/CT) has helped in localizing osteomyelitis lesions, its effectiveness in guiding microbiological sampling remains unclear. This study aimed to determine whether bone SPECT/CT can improve microbiological identification rates in COM or PTO of the extremities. Patients and methodsFrom February 2020 to August 2024, 53 patients with suspected COM or PTO in the extremities were retrospectively analyzed. All patients underwent bone SPECT/CT, followed by microbiological sampling during surgery. Tissue samples were taken from the areas of high SPECT/CT uptake or based on intraoperative findings where no uptake was observed. Microorganism identification rates were analyzed, including a sub-group analysis based on antibiotic discontinuation. ResultsOf the 53 patients, 42 had positive bone SPECT/CT scan findings, with pathogen identification in 30 patients (71.4 %). In contrast, pathogen identification occurred in one out of twelve patients (9.1 %) with negative findings (odds ratio 25, p< 0.001). Bone SPECT/CT demonstrated a sensitivity of 96.8 % and an overall accuracy of 75.5 %. When antibiotics had been discontinued for ≥2 weeks, the pathogen identification rate increased to 90 %, compared with 50 % for <2 weeks of discontinuation (odds ratio 10.0, p= 0.006). In a sub-group of 30 patients with adequate antibiotic discontinuation duration, a positive bone SPECT/CT scan yielded a pathogen identification rate of 90.1 % (odds ratio 60.0, p= 0.001). ConclusionBone SPECT/CT effectively identifies optimal sites for microbiological sampling in COM and PTO of the extremities, particularly when antibiotics have been discontinued for ≥2 weeks, enhancing pathogen detection rates.

Antimicrobial evaluation of root canal irrigants of natural sources with and without gamma radiation activation (in vitro study)

ABSTRACT Aims: The present study aimed to evaluate the antibacterial effectiveness of newly formulated root canal irrigants derived from natural sources. In particular, this study investigated how these irrigants’ antimicrobial properties were affected by gamma radiation activation. Materials and Methods: Fifty-three single-rooted extracted human teeth with straight canals were selected, fully prepared, and sterilized. The roots were then infected with Escherichia coli, Enterococcus faecalis, and Candida albicans for 21 days at 37°C. Based on the irrigating solution utilized, the roots were divided into seven groups: Group I: chitosan irrigant, Group II: chitosan irrigant gamma irradiated, Group III: curcumin irrigant, Group IV: curcumin irrigant gamma irradiated, Group V: sodium hypochlorite (NaOCl) 5% irrigant, Group VI: positive control (infected roots without treatment), and Group VII: negative control (uncontaminated roots). After cleaning and shaping, microbiological sampling was performed. The samples were then transferred to sterile centrifuge tubes containing 1 mL of saline to determine the microbial growth. Colony-forming unit counts were employed for assessing the antimicrobial action. Statistical analysis was conducted to compare the percentage reduction in the microbial count from the initial count. Results: Group V and Group IV showed significantly higher values in microbial reduction than Group III and Group I. In addition, the results showed that Group II and Group III have significantly higher values than Group I. Conclusion: Natural irrigating solutions exposed to gamma radiation exhibited promising antimicrobial activity that is comparable to that of NaOCl and may be used as effective antimicrobial agents in endodontic treatment.

Bronchoscopic Diagnosis of Severe Respiratory Infections

The diagnosis of severe respiratory infections in intensive care remains an area of uncertainty and involves a complex balancing of risks and benefits. Due to the frequent colonisation of the lower respiratory tract in mechanically ventilated patients, there is an ever-present possibility of microbiological samples being contaminated by bystander organisms. This, coupled with the frequency of alveolar infiltrates arising from sterile insults, risks over-treatment and antimicrobial-associated harm. The use of bronchoscopic sampling to obtain protected lower respiratory samples has long been advocated to overcome this problem. The use of bronchoscopy further enables accurate cytological assessment of the alveolar space and direct inspection of the proximal airways for signs of fungal infection or alternative pathologies. With a growing range of molecular techniques, including those based on nucleic acid amplification and even alveolar visualisation and direct bacterial detection, the potential for bronchoscopy is increasing concomitantly. Despite this, there remain concerns regarding the safety of the technique and its benefits versus less invasive sampling techniques. These discussions are reflected in the lack of consensus among international guidelines on the topic. This review will consider the benefits and challenges of diagnostic bronchoscopy in the context of severe respiratory infection.

The impact of cosmetic tourism across one year on an NHS breast surgery unit

BackgroundThis is a review of patients managed by our single-site breast surgery service for complications of cosmetic surgeries performed abroad and within the UK, across September 2022-2023. MethodsA retrospective review of outpatient clinic and emergency theatre lists was used to identify patients; data was collected from their electronic records. Results25 patients (23 female) were identified, 20 had surgery abroad. Turkey was the most common destination that patients travelled to (n=15), with bilateral breast augmentation being the most common procedure (n=15). Post-operative infection and wound dehiscence (n=10 and n=8 respectively) were the most common complications; 72% (n=18) of patients presented within 8 weeks of their surgery. There was incomplete recording of surgical details including precise date (recorded for 48%), clinic name (8%), and name of the surgeon (0%). 17 microbiological samples were sent, with 11 resulting in a named organism - Staphylococcus Aureus was most common (n=5). 17 (68%) cases were treated conservatively, without radiological or surgical interventions. When surgical management occurred (n=6), it was for removal of breast implants (n=5) or evacuation of haematoma (n=1). The cost of managing these complications was at least £37,000. ConclusionComplications from cosmetic tourism present more commonly to the NHS than those resulting from private surgery performed in the UK. This has significant financial implications for the NHS. More accurate recording of relevant data, engagement in audits, and disseminating findings may help raise awareness of the risks and complications of cosmetic surgery performed abroad.

Medical residents' knowledge, attitudes and practices regarding antibiotics, antimicrobial stewardship and multidrug-resistant bacteria: a cross-sectional study in a major university in Iran.

Antimicrobial resistance (AMR) is one of the biggest threats to global public health systems. This study aimed to assess the knowledge, attitudes and practice about AMR, antimicrobial stewardship programs (ASPs) and multidrug-resistant (MDR) bacteria. A web-based questionnaire survey was conducted among the residents of Isfahan University of Medical Sciences from May to November 2023. Data analysis was done using SPSS version 24.0 software. Overall, 400 out of 450 medical residents responded to the questionnaire, giving a response rate of 88.9%. The participants' ages ranged from 26 to 54 years, and the majority were female (227/400 56.8%). Average scores for knowledge, attitudes, and practices were 53.70 ± 15.88, 36.97 ± 5.89 and 24.69 ± 4.24, respectively. In terms of knowledge, only 26.8% had heard the term "ASPs" and knew what it was. Most incorrect answers appeared to the treatment of infection caused by MDR bacteria including ESBL-producing Escherichia coli (27.8%) and carbapenem-resistant Klebsiella pneumoniae (30.8%), as well as the atypical bacteria (45.5%). Approximately, 50 and 71.7% said they had received no specific training in the fields of microbiological sampling methods and the appropriate time to prescribe antibiotics, respectively. Surprisingly, regarding practice, 81.8% of the respondents stated that antibiotics are used to treat flu or the common cold. Residents considered their training on important issues including ASPs, MDR bacteria and the spectrum of antibiotics insufficient. This result highlights the need for targeted training interventions about antibiotic prescription in the curriculum at the university with more emphasis on ASPs to limit the development of resistance.

Safety of Intraoperative Cell Salvage in Two-Stage Revision of Septic Hip Arthroplasties.

(1) Background: The aim of this study was to evaluate the safety of intraoperative cell salvage (ICS) during reimplantation in the two-stage revision of septic hip arthroplasties. (2) Methods: As part of an internal quality control study, blood cultures were taken from the processed ICS blood during reimplantation and examined for possible bacterial load (study group). Due to a high rate of bacterial detection with uncertain clinical significance, consecutive ICS samples were also examined from patients undergoing aseptic revision hip arthroplasty (control group). Microbiological samples, patient and surgical characteristics and the follow-up data were analyzed retrospectively. (3) Results: 9 out of 12 (75%) patients in the study group and 5 out of 8 (63%) patients in the control group had positive ICS blood cultures. There was no significant difference between the groups (p = 0.642). The initial pathogens causing the periprosthetic joint infection (PJI) were not detected, but the bacterial spectrum resembled skin flora, with a high proportion of coagulase-negative staphylococci. No complications due to possible bloodstream-associated infections were observed. In summary, the detected pathogens were interpreted as contamination without clinical significance. (4) Conclusions: ICS in the context of reimplantation was considered a safe and recommendable procedure to optimize patient blood management.

The long-term time course of septic arthritis.

The aims of this study were to: 1) report on a cohort of skeletally mature patients with native hip and knee septic arthritis over a 14-year period; 2) to determine the rate of joint failure in patients who had experienced an episode of hip or knee septic arthritis; and 3) to assess the outcome following septic arthritis relative to the infecting organism, whether those patients infected by Staphylococcus aureus would be more likely to have adverse outcomes than those infected by other organisms. All microbiological samples from joint aspirations between March 2000 and December 2014 at our institution were reviewed in order to identify cases of culture-proven septic arthritis. Cases in children (aged < 16 years) and prosthetic joints were excluded. Data were abstracted on age at diagnosis, sex, joint affected (hip or knee), type of organisms isolated, cause of septic arthritis, comorbidities within the Charlson Comorbidity Index (CCI), details of treatment, and outcome. A total of 142 patients were confirmed to have had an episode of septic arthritis in a native hip (n = 17) or knee joint (n = 125). S. aureus accounted for 57.7% of all hip and knee joint infections. There were 13 inpatient deaths attributed to septic arthritis. The median age of the patients who died was 77.5 (46.9 to 92.2) and their median age-adjusted CCI was 8 (6 to 12). A failure of the joint occurred in 26 knees (21%) and nine hips (53%). Of the knee joints infected by S. aureus (n = 71), 23 knees (32%) went into failure of joint, whereas of those infected by other organisms (n = 54), only three knees (6%) failed. Based on our study findings, hip and knee septic arthritis long-term outcomes were substantially worse than their immediate outcome suggested. Failure of knee joint is 6.1 times more likely to occur in those infected with S. aureus.

Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review.

While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pancreatitis (AP) is recommended, studies indicate a high rate of inadequate treatment. A search of PubMed, Scopus, and Cochrane databases was conducted, focusing on primary research and meta-analyses. Data were categorized based on core concepts, and a narrative synthesis was performed. The search identified a total of 1016 publications. After evaluating 203 full texts and additional sources from the grey literature, 80 studies were included in the review. The answers obtained were: (1) Preventive treatment does not decrease the incidence of IPN or mortality. Given the risks of bacterial resistance and fungal infections, antibiotics should be reserved for highly suspected or confirmed IPN; (2) The diagnosis of IPN does not always require microbiological samples, as clinical suspicion or computed tomography signs can suffice. Early diagnosis and treatment may be improved by using biomarkers such as procalcitonin and novel microbiological methods; (3) When indicated, early initiation of antibiotics is a key determinant in reducing mortality associated with IPN; (4) Antibiotics with good penetration into pancreatic tissue covering Gram-negative and Gram-positive bacteria should be used. Routine antifungal therapy is not recommended; (5) The step-up approach, including antibiotics, is the standard for IPN management; (6) Antibiotic duration should be kept to a minimum and should be based on the quality of source control and patient condition. Early antibiotic therapy is essential for the treatment of IPN, but prophylactic antibiotics are not recommended in AP. High-quality randomized controlled trials are required to better understand the role of antibiotics and antifungals in AP management.

Antibacterial Efficacy of Rotary and Reciprocating Instrumentation Techniques.

To clinically evaluate the effectiveness of rotary (ProTaper Next [PTN]) and reciprocating (Wave One Gold [WOG]) instrumentation techniques in eliminating bacteria from the root canals of teeth with apical periodontitis during a single-visit root canal treatment. Forty patients were randomly assigned to the WOG or PTN instrumentation techniques groups. A single-visit root canal treatment was performed on all the patients. In both groups, root canals were irrigated with 10 ml of sodium hypochlorite (NaOCl) and the final irrigation protocol was applied. Microbiological samples from the root canal were collected initially (Sample 1), after chemo-mechanical instrumentation (Sample 2), and after the final irrigation protocol (Sample 3). Quantification of bacteria at each stage of root canal treatment was performed using the culture method (colony-forming units [CFUs]), and bacterial species were identified using MALDI-TOF mass spectrometry. There were 55 aerobic and anaerobic bacterial species identified. Chemo-mechanical root canal treatment with both instrumentation techniques and the final irrigation protocol significantly reduced the number of CFUs (p<0.001). There were no statistically significant differences in antibacterial efficacy between WOG and PTN groups (p>0.05). Although both root canal instrumentation techniques were highly effective in removing bacteria from the necrotic canals of teeth with chronic apical periodontitis, no complete eradication of bacteria was found in any sample.

Quantitative release assessment for beta-lactamase-producing Escherichia coli of dairy origin into vegetables

Abstract Outbreaks of food poisoning associated with vegetables contaminated with Escherichia coli have been reported globally. This study was conducted to assess the probability of releasing beta-lactamase-producing E . coli of dairy farm origin into vegetables in Japan. A release assessment model connecting dairy farms to vegetable farms was developed. Data on the indicated diseases and antimicrobial use in dairy cattle were obtained from the agricultural insurance program in Hokkaido Prefecture between 2016 and 2019. Data on bla -harboring E . coli in cattle were obtained from the Japan Veterinary Antimicrobial Resistance Monitoring System. Microbiological field sampling was conducted at dairy and vegetable farms. Inoculation experiments in vegetables were conducted. All processes in the model simulation were iterated for 1000 times. The estimated proportion of dairy farms holding cattle with bla -harboring E . coli was 6.00% (95% CI: 4.81–7.35%). Beta-lactams were used in 71.76% (333,098/464,204 average annual cases) of indicated diseases. The estimated concentration of bla -harboring E . coli in mixed fresh manure at affected farms was 3.33 log 10 CFU/g (95% CI: 3.33–3.34). The concentrations were reduced to 0.83 (95% CI: 0.34–1.25) and −0.54 log 10 CFU/g (95% CI: −1.04 to −0.05) in soil after immature manure, and slurry spraying, respectively. The estimated concentrations in the soil of fields of radish, leafy vegetables, tomato, and spring-seeded and autumn-seeded onions at harvest were −1.99 (95% CI: −2.48 to −1.57), −2.87 (95% CI: −3.36 to −2.42), −3.82 (95% CI: −4.32 to −3.40), −5.36 (95% CI: −5.85 to −4.93), and −5.94 (95% CI: −6.43 to −5.52) log 10 CFU/g, respectively. The concentrations in the bodies of leafy green spinach and lettuce were −9.88 (95% CI: −10.38 to −9.43) and −10.91 (95% CI, −11.52 to −8.05) log 10 CFU/g, respectively. The probability of ingesting bla -harboring E . coli of dairy origin with raw vegetables in Japan was thus assessed to be very low. One Health impact statement This study applied a release assessment in the World Organisation for Animal Health framework for antimicrobial resistance risk assessment to connect the antimicrobial use for dairy cattle, manure production and vegetable farming. As vegetable is often consumed raw, the assessment is directly associated with human health. Although the environmental continuum was not explored, the reduction of the hazard on the soil of vegetable farms was considered. The study involved the engagement with dairy and vegetable farmers and the agriculture industry in understanding farming behavior and value chain. The approach in this study can be applied to the complex problems across the animal-human-environment interface.

Severe acute pancreatitis in the era of endoscopically placed lumen-apposing metal stents (LAMS): critical care outcomes from a large UK pancreatobiliary centre

Objectives1. Describe characteristics of patients with severe acute pancreatitis (SAP) requiring admission to Critical Care, including interventional management of pancreatic fluid collections.2. Quantify whether patients requiring drainage of collections via...

Current and Future Directions in Fluorescence Imaging-Guided Debridement.

Significance: Sterility and reduction of the bioburden are crucial for healing in chronic wounds such as diabetic foot ulcers. Although there are methods for measuring bioburdens, such as semiquantitative analysis of swab/biopsy samples, microbiological sampling, and molecular diagnostics, these tools are less accessible owing to costs or not being as quick as other methods. These methods are also dependent on clinical assessment by the clinician, and high bacterial burden may appear asymptomatic. Recent Advances: Autofluorescence (AF) imaging is a novel technology for identifying and quantifying chronic inhibitory bacterial load in chronic wounds. Eighty-seven percent of bacteria that frequent chronic wounds have fluorophores that fluoresce under violet light as red or cyan, depending on the type of fluorophore. Therefore, AF image-guided treatment is becoming increasingly effective for physicians to implement wound dressing changes and debridement because bacterial burdens are difficult to locate clinically. Critical Issue: Products such as the commercially available MolecuLight i:X and MolecuLight DX function as handheld cameras for physicians to use as a reference but require additional work to ensure that the photograph will be taken with adequate lighting. Future Directions: Designs for Vision Inc. introduced a device called REVEAL, an AF imaging form factor that allows the device to be worn on top of a pair of glasses, which the physician would wear intraoperatively. The benefits of this form factor include not requiring certain lighting conditions and not having to interpret the results using a handheld camera, allowing the device to be used during active surgical debridement.

Enhancing Pathogen Detection in Implant-Related Infections through Chemical Antibiofilm Strategies: A Comprehensive Review.

Implant-related infections (IRIs) represent a significant challenge to modern surgery. The occurrence of these infections is due to the ability of pathogens to aggregate and form biofilms, which presents a challenge to both the diagnosis and subsequent treatment of the infection. Biofilms provide pathogens with protection from the host immune response and antibiotics, making detection difficult and complicating both single-stage and two-stage revision procedures. This narrative review examines advanced chemical antibiofilm techniques with the aim of improving the detection and identification of pathogens in IRIs. The articles included in this review were selected from databases such as PubMed, Scopus, MDPI and SpringerLink, which focus on recent studies evaluating the efficacy and enhanced accuracy of microbiological sampling and culture following the use of chemical antibiofilm. Although promising results have been achieved with the successful application of some antibiofilm chemical pre-treatment methods, mainly in orthopedics and in cardiovascular surgery, further research is required to optimize and expand their routine use in the clinical setting. This is necessary to ensure their safety, efficacy and integration into diagnostic protocols. Future studies should focus on standardizing these techniques and evaluating their effectiveness in large-scale clinical trials. This review emphasizes the importance of interdisciplinary collaboration in developing reliable diagnostic tools and highlights the need for innovative approaches to improve outcomes for patients undergoing both single-stage and two-stage revision surgery for implant-related infections.