Introduction: Infections caused by the opportunistic Stenotrophomonas maltophilia pathogen in immunocompromised patients are complicated to treat due to antibiotic resistance and the ability of the bacteria to produce biofilm. Areas covered: A MEDLINE/PubMed search was performed of available literature to describe the role of biofilm produced by S. maltophilia in the diseases it causes, including biofilm-influencing factors, the biofilm forming process and composition. The antimicrobial resistance due to S. maltophilia biofilm production and current antibiofilm strategies is also included. Expert opinion: Through the production of biofilm, S. maltophilia strains can easily adhere to the surfaces in hospital settings and aid in its transmission. The biofilm can also cause antibiotic tolerance rendering some of the therapeutic options ineffective, causing setbacks in the selection of an appropriate treatment. Conventional susceptibility tests do not yet offer therapeutic guidelines to treat biofilm-associated infections. Current S. maltophilia biofilm control strategies include natural and synthetic compounds, chelating agents, and commonly prescribed antibiotics. As biofilm age and matrix composition affect the level of antibiotic tolerance, their characterization should be included in biofilm susceptibility testing, in addition to molecular and proteomic analyses. As for now, several commonly recommended antibiotics can be used to treat biofilm-related S. maltophilia infections.

Rapid identification and characterisation of drug-resistant bacterial pathogens have an important role in diagnostic and antimicrobial stewardship. Response time in the diagnosis of not only the etiological agent but also in antimicrobial susceptibility results is of utmost importance in patient treatment. In this study, matrix-assisted laser desorption ionisation–time of flight (MALDI-TOF) mass spectrometry (MS) was used to screen for biomarkers of ESCAPE (vancomycin-resistant Enterococcus faecium, methicillin-resistant Staphylococcus aureus, hypervirulent NAP1/ribotype 027 Clostridioides [Clostridium] difficile, multidrug resistant Acinetobacter baumannii, multidrug resistant Pseudomonas aeruginosa, and carbapenem-resistant Enterobacteriaceae) pathogens to predict antimicrobial resistance or hypervirulence. Several biomarkers of drug-resistant genotypes in S. aureus, A. baumannii, P. aeruginosa, and K. pneumoniae, as well as hypervirulence in C. difficile, were detected. The fastest possible susceptibility testing with MALDI-TOF MS is simultaneous detection of a characteristic drug-resistant peak and species identification in the same spectra generated in routine processing. According to our approach, resistance or virulence biomarker peaks can be identified while performing routine microbiology analysis, and no additional assays nor prolonged incubation time is needed. Outstanding biomarker peaks detected in our study should be further analysed by additional methods to identify the specific proteins involved.

Chronic kidney disease (CKD) is a progressive loss of renal function in which gut dysbiosis is involved. Fecal microbiota transplantation (FMT) may be a promising alternative for restoring gut microbiota and treating CKD. This study evaluated the changes in CKD progression in patients treated with FMT. Patients with diabetes and/or hypertension with CKD clinical stages 2, 3, and 4 in this single-center, double-blind, randomized, placebo-controlled clinical trial (NCT04361097) were randomly assigned to receive either FMT or placebo capsules for 6 months. Laboratory and stool metagenomic analyses were performed. A total of 28 patients were included (15 FMT and 13 placebo). Regardless of CKD stages, patients responded similarly to FMT treatment. More patients (53.8%) from the placebo group progressed to CKD than the FMT group (13.3%). The FMT group maintained stable renal function parameters (serum creatinine and urea nitrogen) compared to the placebo group. Adverse events after FMT treatment were mild or moderate gastrointestinal symptoms. The abundance of Firmicutes and Actinobacteria decreased whereas Bacteroidetes, Proteobacteria and Roseburia spp. increased in the FMT group. CKD patients showed less disease progression after FMT administration. The administration of oral FMT in patients with CKD is a safe strategy, does not represent a risk, and has potential benefits.

We report the successful treatment of a bloodstream infection due toK. pneumoniae harboring NDM-1 in a neutropenic patient using aztreonam-ceftazidime-avibactam, who previously failed colistin and meropenem therapy. The clinical isolate was evaluated to determine the presence of NDM, TEM, SHV, CTX and CMY. Also killing kinetics of ATM (4 μg/mL), ATM-AVI (4/4 μg/mL), and colistin (2 and 4 μg/mL) were tested. Aztreonam-avibactam showed in vitro activity, whereas colistin allowed re-growth. CZA/ATM use should be kept in mind as an option perhaps sooner than colistin.

BACKGROUND:Infections affecting burn patients are frequently caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae species. Infections with these pathogens have become increasingly difficult to treat due to evolving antibiot...

Information regarding the efficacy of the recombinant adenovirus type-5-vectored (CanSino Bio) vaccine against the COVID-19 disease in a real-life setting is limited. A retrospective cohort study was carried out in the teaching university community of the metropolitan area of Monterrey, Mexico, through a four-section survey, and during the COVID-19 delta wave. Determination of IgG antibodies against SARS-CoV-2 spike (S) protein was performed in a subset of participants vaccinated with CanSino Bio. A total of 7468 teachers responded to the survey, and 6695 of them were fully vaccinated. Of those, 72.7% had CanSino Bio, 10.3% Pfizer, 8.4% AstraZeneca, 1.2% Moderna, and 2.7% others. Symptomatic breakthrough infections were recorded in those vaccinated with CanSino Bio (4.1%), AstraZeneca (2.1%), and Pfizer (2.2%). No difference was found between CanSino Bio and other vaccines regarding hospitalization, the need for mechanical ventilation, and death. For CanSino Bio recipients, anti-S antibodies were >50 AU/mL in 73.2%. In conclusion, primary breakthrough symptomatic infections were higher in the CanSino vaccinated group compared to other brands. Individuals with a previous infection had higher antibody levels than those who were reinfected and without infection. A boosted dose of CanSino is recommended for those individuals without a previous infection.