Maternal carriage and vertical transmission of extended-spectrum, beta-lactamase-producing Enterobacteriaceae (ESBL-E), such as Escherichia coli, hamper the treatment of infections, resulting in high morbidity. E. coli is the most frequent cause of early-onset neonatal sepsis (EOS) in preterm infants, where ESBL-E are more frequently isolated. In this prospective, case-controlled study, maternal rectovaginal ESBL-E colonization and vertical transmission to preterm infants were assessed in 160 women with preterm premature rupture of membranes (PPROM; 57.4%) or preterm labor (42.6%); additional cultures were obtained from the placenta, amnion, and umbilical cord during preterm labor. Maternal and neonatal ESBL-E-carriage rates were 17.5% and 12.9%, respectively, and the vertical-transmission rate was 50%. Maternal ESBL-E colonization among women with PPROM was 21.3%, and in women with premature labor it was 12.6%. No correlation was observed between maternal ESBL-E-colonization and previous hospitalization or antibiotic administration during pregnancy. However, a correlation was found between placental inflammation and maternal ESBL-E colonization (p = 0.007). ESBL-E-colonized infants were delivered at an earlier gestational age and were more likely to have complications. Thus, the high ESBL-E carriage rate in women with threatened preterm labor, without obvious risk factors for carriage, and a high vertical transmission rate, combined with a correlation between placental inflammation and ESBL-E carriage, support maternal–neonatal ESBL-E-colonization surveillance and active measures to prevent ESBL-E-related EOS.

Early identification of patients with COVID-19 who will develop severe or critical disease symptoms is important for delivering proper and early treatment. We analyzed demographic, clinical, immunological, hematological, biochemical and radiographic findings that may be of utility to clinicians in predicting COVID-19 severity and mortality. Electronic medical record data from patients diagnosed with COVID-19 from November 2020 to June 2021 in the COVID-19 Department in the Galilee Medical Center, Nahariya, Israel, were collected. Epidemiologic, clinical, laboratory and imaging variables were analyzed. Multivariate stepwise regression analyses and discriminant analyses were used to identify and validate powerful predictors. The main outcome measure was invasive ventilation, or death. The study population included 390 patients, with a mean age of 61 ± 18, and 51% were male. The non-survivors were mostly male, elderly and overweight and significantly suffered from hypertension, diabetes mellitus type 2, lung disease, hemodialysis and past use of aspirin. Four predictive factors were found that associated with increased disease severity and/or mortality: age, NLR, BUN, and use of high flow oxygen therapy (HFNC). The AUC or diagnostic accuracy was 87%, with a sensitivity of 97%, specificity of 60%, PPV of 87% and NPP of 91%. The cytokine levels of CXCL-10, GCSF, IL-2 and IL-6 were significantly reduced upon the discharge of severely ill COVID-19 patients. The predictive factors associated with increased mortality include age, NLR, BUN, and use of HFNC upon admission. Identifying those with higher risks of mortality could help in early interventions to reduce the risk of death.

Coronavirus disease (COVID-19) is a contagious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This case report presents a patient who had difficulty eradicating the corona virus due to being treated with Rituximab, which depletes B lymphocyte cells and therefore disables the production of neutralizing antibodies. The combined use of external anti-viral agents like convalescent plasma, IVIG and Remdesivir successfully helped the patient’s immune system to eradicate the virus without B-cell population recovery. In vitro studies showed that convalescent plasma is the main agent that helped in eradicating the virus.

Objectives: As the COVID-19 pandemic wanes, understanding maternal–fetal antibody transfer remains crucial for optimizing vaccination strategies. This study evaluates anti-SARS-CoV-2 antibody levels in amniotic fluid following maternal BNT162b2 mRNA vaccination and/or COVID-19 infection during early pregnancy, focusing on the first and second trimesters. Methods: A retrospective cohort study was conducted at a tertiary university-affiliated hospital, involving 149 pregnant women who underwent amniocentesis. Anti-SARS-CoV-2 spike IgG levels were measured in amniotic fluid samples. Participants were categorized based on vaccination and infection status: vaccine-only, infection-only, vaccine + infection, and no vaccine/infection. Correlations between antibody levels and the time since vaccination or infection were analyzed. Results: The vaccine + infection group had a higher proportion of positive antibody levels compared to the vaccine-only group (63.6% vs. 35.9%, p = 0.029). Median SARS-CoV-2 IgG levels were significantly higher in the vaccine + infection group (283.0 AU/mL) than in the vaccine-only group (64.1 AU/mL, p = 0.006). Women who received three vaccine doses had higher antibody levels and more positive antibody rates compared to those with one or two doses. A significant negative correlation was found between antibody levels and the interval since the last vaccine dose or infection. Conclusions: Our results indicate the presence of anti-SARS-CoV-2 antibodies in the amniotic fluid, reflecting antibody transfer during early pregnancy. However, a noticeable decrease in immunity was observed, as indicated by declining amniotic fluid antibody levels over time. Further studies are needed to determine the optimal timing and number of boosters required to protect against new variants of SARS-CoV-2.

Pseudomonas aeruginosa is the most frequently isolated pathogen in acute otitis externa (AOE), with ototopical antibiotics being the mainstay of treatment. The incidence of ciprofloxacin resistance in P.aeruginosa has been steadily increasing. This study aimed to evaluate the in vitro susceptibility of P.aeruginosa to a ciprofloxacin-containing ototopical solution. In this prospective study we examined the in vitro growth of ciprofloxacin-resistant P.aeruginosa isolates when exposed to varying concentrations of a ciprofloxacin-containing ototopical solution. Concentration of the ototopical solution was strongly associated with the diameter of inhibition on sensitive strains. Sensitive strains of P.aeruginosa showed inhibition of growth with an extrapolated MIC value of 0.0686 µg/µL. Resistant strains demonstrated inhibition to all dilutions of the ototopical solution, including undiluted concentration. Ciprofloxacin-sensitive strains demonstrated resistance at higher ototopical concentrations compared with the reported serum concentration after standard systemic administration. The current use of commercially available ciprofloxacin topical ear drops for treating AOE does not appear to hold promise for the fight against resistant strains of P.aeruginosa and might be at risk of becoming ineffective in the treatment of sensitive species. Therefore, further investigation is needed to gain a deeper understanding of ototopical solutions, as well as to establish a database of MICs for topical antibiotics.