To develop and evaluate a new method for rapid susceptibility testing of Aspergillus spp. based on early metabolic signalling of high-inoculum biomass. Susceptibility to amphotericin B and voriconazole was studied in 39 clinical isolates of Aspergillus spp. (16 Aspergillus fumigatus, 11 Aspergillus flavus, 12 Aspergillus terreus). At 6 or 8 h after inoculation for A. fumigatus and A. flavus, and at 8 or 12 h after inoculation for A. terreus, 100 µg/mL of the tetrazolium salt XTT and 25 µM menadione were added and absorbance measured at 450 nm after 2 h of incubation at 37°C. Inocula used were 10⁶ conidia/mL for A. fumigatus and A. terreus and 10⁵ conidia/mL for A. flavus, as lower inocula exhibited very low metabolic activity at these time points. Data were analysed with the sigmoid E_max model and compared with visual (lowest drug concentration showing no growth) and spectrophotometric MIC determination at 48 h (CLSI M38-A method). The E_max model described well the concentration–effect relationship for early metabolic activity and 48 h fungal biomass (median r²: 0.97 and 0.93, respectively). Use of the model allowed characterization and quantification of species- and drug-related differences in pharmacological inhibition of early metabolic activity as well as calculation of appropriate cutoff levels for MIC determination with the XTT assay. Using these cutoff levels, for A. fumigatus and A. flavus at both time points (6 and 8 h) and for A. terreus at 12 h, the agreement (± one dilution) of the XTT assay with the CLSI method was 91–100% and its reproducibility was 97–100%. This newly developed high-inoculum-based method provides rapid and reproducible MIC determinations for Aspergillus spp.

Thiamine (vitamin B1) is a water-soluble vitamin that is not endogenously synthesized in humans. It is absorbed by the small intestine, where it is activated. Its active form acts as a coenzyme in many energy pathways. We report a rare case of thiamine deficiency in a 3.5-year old boy with short bowel syndrome secondary to extensive bowel resection due to necrotizing enterocolitis during his neonatal age. The patient was parenteral nutrition-dependent since birth and had suffered from recurrent central catheter-related bloodstream infections. He developed confusion with disorientation and unsteady gait as well as profound strabismus due to bilateral paresis of the abductor muscle. Based on these and a very low thiamine level he was diagnosed and treated for Wernicke encephalopathy due to incomplete thiamine acquisition despite adequate administration. He fully recovered after thiamine administration. After 1999 eight more cases have been reported in the PubMed mostly of iatrogenic origin.

The characteristics of nosocomial bloodstream infections (BSIs) in a neurosurgical department were studied over a 5-year period. The rate of nosocomial BSI was 3.0%. Gram-negative bacteria were the most commonly isolated pathogens (65.9% of isolates). For all the pathogens isolated, the rate of resistance to commonly used antimicrobial agents was high. Of the 101 patients with nosocomial BSI, 50 (49.5%) died during their stay at the Department of Neurosurgery. At the same time, overall mortality rate among neurosurgical inpatients without nosocomial BSI was 5.4% (ie, 175 of 3,216 patients died).

Background: Children with febrile urinary tract infections (fUTI), especially those with acute pyelonephritis (APN) and vesicoureteral reflux (VUR), may face several complications, especially kidney scarring. Different biomarkers, such as urinary neutrophil gelatinase-associated lipocalin (uNGAL) and procalcitonin (PCT), have been studied for predicting kidney scarring without the need for a DMSA scan. Objectives: This systematic review and meta-analysis examines the role of biomarkers in pediatric patients with a history of fUTI and their prognostic value in the diagnosis of APN and prediction of kidney scarring. Data sources: A search through major databases (MEDLINE/PubMed and Scopus) was conducted from inception until January 2, 2025. The mean difference (95% CI) was applied. A p < 0.05 was considered statistically significant. Results: The systematic review included 2300 participants from 28 studies. Procalcitonin and uNGAL were higher in individuals with scarring after a fUTI episode compared to those without scarring ( p = 0.035 and p < 0.0001, respectively). In addition, PCT was higher in patients with APN compared to those with lower UTI ( p < 0.0001). Finally, the good and moderate overall diagnostic accuracy (I ² = 29.8%) of PCT in predicting APN (AUC: 0.861) and uNGAL (I ² = 16.8%) in predicting kidney scarring after an episode of fUTI (AUC: 0.74), respectively, should be considered. Conclusions: This study showed that PCT and uNGAL can detect APN and kidney scarring after fUTI. More studies should be conducted exploring the role of other biomarkers in scarring after an episode of fUTI in pediatric patients with or without VUR. Graphical