The Role of Rapid and Advanced Microbiological Methods in Critical Care: 2025 EMANUELE RUSSO Delphi Consensus.

Scope: Interpretation of rapid and advanced microbiological test results remains nonstandardized, with no existing reference guidelines. This study aimed to analyze the existing evidence and provide expert guidance on the use of these techniques in critically ill patients.

Methods: A Delphi consensus process was conducted by a multidisciplinary panel of experts, including microbiologists, infectious disease specialists, intensivists, surgeons, and pulmonologists.

Potential role of avibactam in restoring susceptibility in Escherichia coli with two copies of bla and PBP3 mutations.

Unlabelled: The emergence of carbapenemase-producing represents a significant clinical challenge. Resistance mechanisms involve carbapenemase production, porin and efflux pump alterations, penicillin-binding protein (PBP) modifications, and biofilm formation. This study characterizes a KPC- and a concurrent isolate harboring the same resistance genes, with also exhibiting PBP3 mutations.

Clinical relevance of bacterial and/or viral coinfection in acute bronchiolitis in an Italian neonatal unit during the 2021-2023 seasons.

Background: Acute bronchiolitis is a leading cause of hospitalization in young children worldwide, and literature reports conflicting data regarding the role of coinfections.

Objective: To evaluate the possible clinical relevance of bacterial and/or viral respiratory coinfection in a cohort of newborns/infants hospitalized for bronchiolitis.

Methods: Neonates and infants younger than three months admitted to neonatal units from October 2021 to March 2023 because of acute bronchiolitis were included in this retrospective study.

Unraveling Pediatric Group A Streptococcus Meningitis: Lessons from Two Case Reports and a Systematic Review.

meningitis is a rare invasive disease, accounting for less than 2% of bacterial meningitis. We presented two case reports and conducted a systematic review using PUBMED, covering the database from its inception up to 31 December 2024, of pediatric cases of Streptococcus pyogenes meningitis. Only case reports and case series were included.

The accuracy of presepsin in diagnosing neonatal late-onset sepsis in critically ill neonates: a prospective study.

Objectives: The diagnostic accuracy of presepsin (P-SEP) in the newborn is still under evaluation.

Methods: In a multicenter study, we studied the accuracy of P-SEP as a diagnostic marker of late-onset sepsis (LOS) in critical newborns with underlying disorders, to define the most accurate cut-off to distinguish infected from uninfected patients.

Results: Sixty-nine/351 newborns without infections at admission developed LOS.

An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric Patients.

Paediatric osteoarticular infections (POAIs) present unique diagnostic and therapeutic challenges. Microbiological culture (MC) is typically time-consuming and lacks sensitivity, especially when patients have received antibiotics. The BIOFIRE Joint Infection Panel (BJIP) is a syndromic molecular assay for the direct identification of most pathogens causing POAIs.

The First Case of the Identification of a Microorganism Directly from Whole Blood Using MALDI-TOF Mass Spectrometry in an Onco-Hematological Pediatric Patient with Bloodstream Infection.

Background: Bloodstream infections affect up to 20% of pediatric cancer patients receiving intensive care, contributing significantly to morbidity and mortality, with infection-related mortality rates reported to be as high as 16%.

Methods: The identification of microorganisms directly from whole blood is difficult due to several factors, such as interference from host genomic material, low bacterial load, the endogenous components of whole blood and exogenous substances, which can interfere with the identification process. Nevertheless, rapid microbial diagnosis remains of paramount importance in these patients.

Therapeutic Drug Monitoring-Guided Linezolid Therapy for the Treatment of Multiple Staphylococcal Brain Abscesses in a 3-Month-Old Infant.

Brain abscesses are invasive infections of the central nervous system with a high level of treatment complexity especially in pediatric patients. Here, we describe a 3-month-old infant with multiple brain abscesses caused by methicillin-susceptible (MSSA). The patient was initially treated with empirical antibiotics (ceftriaxone, metronidazole, vancomycin).

A new epidemic wave of Bordetella pertussis in paediatric population: impact and role of co-infections in pertussis disease.

Background: In recent months, Bordetella pertussis has reappeared after maintaining a low rate for many years. Although pertussis is usually characterized by a favorable course, several factors can contribute to the severity of the disease, such as mixed respiratory infections. In this study, we evaluate B.

Integrating Diagnostic Approaches in Infant Bacterial Meningitis Caused by a Non-K1 : A Case Report.

Background: Infant meningitis, particularly caused by , remains a life-threatening condition, especially in premature and low-weight infants. Infections of the central nervous system can be fatal, necessitating prompt diagnosis and appropriate treatment. Acute infections caused by various pathogens, including , often present with similar clinical symptoms.

The Challenging Life of Mutators: How Survives between Persistence and Evolution in Cystic Fibrosis Lung.

Cystic fibrosis (CF) is a life-threatening genetic disease characterised by chronic lung infections sustained by opportunistic pathogens such as During the chronic long-lasting lung infections, adapts to the host environment. Hypermutability, mainly due to defects in the DNA repair system, resulting in an increased spontaneous mutation rate, represents a way to boost the rapid adaptation frequently encountered in CF isolates. We selected 609 isolates from 51 patients with CF chronically colonised by to study, by full-length genome sequencing, the longitudinal evolution of the bacterium.

Occult Serious Bacterial Infections in Neonates and Infants Up to Three Months of Age with Bronchiolitis: Are Invasive Cultures Required?

(1) Background: The literature reports a low risk of serious bacterial infections (SBIs) in febrile infants presenting with bronchiolitis or respiratory syncytial virus infection, but current microbiological techniques have a higher accuracy. (2) Methods: We assessed the risk of SBIs in neonates and infants with bronchiolitis from 2021 to 2023. We also evaluated C-reactive protein, procalcitonin, and leukocyte values.

First Evidence of Streptococcus pyogenes M1 UK Clone in Pediatric Invasive Infections in Italy by Molecular Surveillance.

Invasive group A streptococci infections are increasing worldwide, mainly due to the emm1 lineage M1 UK emergence. Although this variant has recently been described in adult Italian patients, its circulation in children has not yet been established. Characterizing by whole genome sequencing 6 invasive group A streptococci strains isolated between 2022 and 2023, we highlighted M1 UK lineage circulation in pediatric patients in Italy.

Impact of SARS-CoV-2 Pandemic on Emergency Hospitalizations for Acute Respiratory Infections: The Experience of a Paediatric Tertiary Care Hospital in Italy.

Background: Acute respiratory infections (ARIs) are a major healthcare issue in children. The SARS-CoV-2 pandemic changed the epidemiology of ARIs; the aims of this study are to characterize the epidemiological trend of ARI emergency hospitalizations and virology results and to estimate the association of ARI emergency hospitalizations with respiratory viruses from January 2018 to June 2023.

Methods: This study was carried out in an Italian tertiary care children's hospital (Bambino Gesù Children's Hospital).

Presence and Significance of Multiple Respiratory Viral Infections in Children Admitted to a Tertiary Pediatric Hospital in Italy.

Viral co-infections are frequently observed among children, but whether specific viral interactions enhance or diminish the severity of respiratory disease is still controversial. This study aimed to investigate the type of viral mono- and co-infections by also evaluating viral correlations in 3525 respiratory samples from 3525 pediatric in/outpatients screened by the Allplex Respiratory Panel Assays and with a Severe Acute Respiratory Syndrome-COronaVirus 2 (SARS-CoV-2) test available. Overall, viral co-infections were detected in 37.

Whooping Cough Cases Increase in Central Italy after COVID-19 Pandemic.

Pertussis continues to be a highly contagious respiratory infection, especially in children, with cyclical peaks of disease spread every three to five years. Here, we report relevant cases of infection between August 2023 and January 2024, and compare them with prevalence in pediatric patients admitted to the Reference Italian Pediatric Hospital, located in Rome, from January 2015 to July 2023. A total of 5464 tests for were performed during the study period, and 6.

Stop in Time: How to Reduce Unnecessary Antibiotics in Newborns with Late-Onset Sepsis in Neonatal Intensive Care.

The fear of missing sepsis episodes in neonates frequently leads to indiscriminate use of antibiotics, and prescription program optimization is suggested for reducing this inappropriate usage. While different authors have studied how to reduce antibiotic overprescription in the case of early onset sepsis episodes, with different approaches being available, less is known about late-onset sepsis episodes. Biomarkers (such as C-reactive protein, procalcitonin, interleukin-6 and 8, and presepsin) can play a crucial role in the prompt diagnosis of late-onset sepsis, but their role in antimicrobial stewardship should be further studied, given that different factors can influence their levels and newborns can be subjected to prolonged therapy if their levels are expected to return to zero.

Identification of the Gene in the First Mucoid XDR Isolated from a Patient with Cystic Fibrosis.

is one of the pathogens most involved in health care-associated infections in recent decades. Known for its ability to accumulate several antimicrobial resistance mechanisms, it possesses the oxacillinase , a carbapenemase now endemic in Italy. species are not frequently observed in patients with cystic fibrosis, and multidrug-resistant is a rare event in these patients.

Impact of Continuous Kidney Replacement Therapy and Hemoadsorption with CytoSorb on Antimicrobial Drug Removal in Critically Ill Children with Septic Shock: A Single-Center Prospective Study on a Pediatric Cohort.

Extracorporeal therapies (ET) are increasingly used in pediatric settings as adjuvant therapeutic strategies for overwhelming inflammatory conditions. Although these treatments seem to be effective for removing inflammatory mediators, their influence on antimicrobials pharmacokinetic should not be neglected. A prospective observational study of children admitted to the pediatric intensive care unit (PICU) with a diagnosis of sepsis/septic shock.

The Prevalence of Carbapenemase-Producing Microorganisms and Use of Novel Cephalosporins for the Treatment of Severe Infections Caused by Carbapenem-Resistant Gram-Negative Bacteria in a Pediatric Cardiac Intensive Care Unit.

Background: The spread of carbapenem-resistant organisms (CROs) is an increasingly serious threat globally, especially in vulnerable populations, such as intensive care unit (ICU) patients. Currently, the antibiotic options for CROs are very limited, particularly in pediatric settings. We describe a cohort of pediatric patients affected by CRO infections, highlighting the important changes in carbapenemase production in recent years and comparing the treatment with novel cephalosporins (N-CEFs) to Colistin-based regimens (COLI).