Biofilm Formation by Hospital-Acquired Resistant Bacteria Isolated from Respiratory Samples.

BACKGROUND: Hospital-acquired resistant infections (HARI) are infections, which develop 48 h or more after admission to a healthcare facility. HARI pose a considerably acute challenge, due to limited treatment options. These infections are associated bacterial biofilms, which act as a physical barrier to diverse external stresses, such as desiccation, antimicrobials and biocides. We assessed the influence of multiple factors on biofilm production by HARI -associated bacteria. METHODS: Bacteria were isolated from samples of patients with respiratory HARI who were hospitalized during 2020-2022 in north Israel. Following antibiotic susceptibility testing by disc diffusion or broth microdilution, biofilm formation capacities of resistant bacteria (methicillin-resistant staphylococcus aureus, extended spectrum beta-lactamase-producing Escherichia coli and Klebsiela pneumonia, and multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii) was assessed using the crystalline violet staining method. Data regarding season, time to infection, bacterial species, patient age and gender, year, and medical department were collected from the patient medical records. RESULTS: Among the 226 study isolates, K. pneumonia was the most prevalent (35.4%) bacteria, followed by P. aeruginosa (23.5%), and methicillin-resistant staphylococcus aureus (MRSA) (21.7%). A significantly higher rate of HARI was documented in 2022 compared to 2020-2021. The majority of isolates (63.3%) were strong biofilm producers, with K. pneumonia (50.3%) being most dominant, followed by P. aeruginosa (29.4%). Biofilm production strength was significantly affected by seasonality and hospitalization length, with strong biofilm production in autumn and in cases where hospitalization length exceeded 30 days. CONCLUSION: Biofilm production by HARI bacteria is influenced by bacterial species, season and hospitalization length.

Cycle threshold responses in SARS-COV2 PCR tests depend on the method by which the samples were obtained and require strict global standardization.

PURPOSE: Since 2020, a SARS-COV2 epidemic has been raging worldwide. The cycle of the PCR test in which the virus is detected is called cycle threshold (CT). The method of obtaining the sample is not detailed in any published study and is based on general guidelines of the CDC. Our contention is that the manner in which the sample is obtained has a dramatic effect on CT values. METHODS: For each person suspected of having Covid-19 who arrives at the emergency room, two swabs are taken in succession, one according to CDC guidelines and the other according to "Ziv" guidelines. The Ziv method sample collection guidelines determine the depth of penetration, the number of rotations of the swab, and their direction. Each double sample was sent for analysis. RESULTS: Analysis of the CT results of the sample to results methods and of the Seegene platform clearly found (p = 0.003 and p = 0.001, respectively) that more rigorous sample collection yielded lower CT values. CONCLUSION: The method of obtaining the samples had a dramatic effect on CT results. Any publication that includes CT results, and certainly studies that discuss CT kinetics, must describe in detail the method by which the samples were obtained. In places where it is also important to detect the onset of illness (airports, hospitals, schools, etc.), it is important to use the Ziv method to reduce the risk of false negatives.

Assisted Reproductive Technology as a Transcutaneous Route for Bacterial Contamination of Ovarian Endometrioma with Coagulase-Negative Staphylococcus: Case Report and Review of the Literature.

Tubo-ovarian abscess may develop in women with endometrioma following assisted reproductive technology (ART). The infection, though rare, is typically late in onset and may present several months after the procedure, and in pregnancy-with the risks of abortion and premature labor. It is thought that transcutaneous oocyte retrieval during ART is the route for bacterial contamination resulting in infection of the endometrioma. Pathogens reported in the literature include Escherichia coli (E. coli) and Group B streptococcus (GBS) but Staphylococcus lugdunensis (S. lugdunensis), a coagulase-negative staphylococcus (CoNS), and groin and perineal skin commensal was isolated from the endometrioma in this case. We discuss the challenges in diagnosis and treatment of this rare condition and the implications of the discovery that an organism previously dismissed as a contaminant has emerged as a causative organism in severe, deep-seated infections of soft tissues in recent literature.

Cardiac device-related endocarditis: Epidemiology, pathogenesis, diagnosis and treatment - a review.

Cardiac device-related endocarditis (CDE) is a phenomenon for which incidence is on the rise; it presents difficult management problems to the clinician. On one hand, there is the patient who needs the implanted device, and the potential morbidity and mortality associated with its removal. On the other hand, there is the problem of a persistent infection - usually acquired during insertion of an electrical device - that is resistant to many antibiotics, has a high recurrence rate, and necessitates an extensive operation to remove the device if removal is delayed. Most studies recommend device and metal lead replacement if CDE occurs. The aim of the present review is to raise awareness of CDE among clinicians, and to provide an appropriate approach to its management.

[Q fever pericarditis].

Q fever is a zoonotic disease caused by Coxiella burnetii--an obligate, gram negative, intracellular bacteria. The term Q (Query) was first used because at the time the disease was named its etiology was unknown. Q fever is divided into acute and chronic infections characterized by different evolution, serological profiles and treatment. Pericarditis, as a manifestation of Q fever is rare and difficult to diagnose. This is due to the following: firstly, the clinical presentation of acute Q fever is pleomorphic, nonspecific and self limited, and secondly, the diagnosis relies on the physician's interest and the presence of a reliable diagnostic laboratory. The objective of that review is to increase the physician's awareness of the clinical presentation of Q fever, to discuss the importance of the diagnosis and laboratory tests and to guide the physician as to when to provide treatment and the relevant patient population to be treated.

Bacterial sacroiliitis probably induced by lumbar epidural analgesia.

BACKGROUND: Properly administered, lumbar epidural analgesia provides adequate pain relief during labor and delivery, and is considered to be a safe procedure with limited complications. The prevalence of infection after lumbar epidural analgesia is negligible. INTRODUCTION: Infection of the sacroiliac joint, although very close to the pucture area, has never been reported as a procedure complication. CASE: In this report, we describe a patient who experienced bacterial sacroiliitis a few days after lumbar epidural analgesia for labor. No portal of entry was identified, and we evoked a new potential risk factor that has never been proposed before, namely lumbar epidural analgesia. CONCLUSION: Sacroiliitis must be considered as a rare but serious complication of lumbar epidural analgesia.