Microorganisms and eukaryotic human cells coexist in synergistic relationships in nearly every niche of the human body. The female genital tract consisting of the vagina, uterus with its cervix and endometrium, uterine tubes and ovaries – harbors its own typical microbiota, which accounts for 9 % of the total bacterial population in females. To this organ system, we also assigned the microbiome of the placenta, which has not been studied much until now. Among the spectrum of microbial species, the female genital tract is mainly dominated by Lactobacillus species, which are considered to be one of the simplest yet most important microbial communities. However, this relationship between macro- and micro-organisms seems to have a number of physiological functions, e.g., the vaginal and cervical microbiota have unique impact on reproductive health. The aim of this review was to provide current view on female genital tract microbiota and its role in reproductive health. We describe in detail the association of vaginal or tubal epithelium with microbiota or the role of microbiota in normal placental function.

Escherichia coli (E. coli) is a major cause of urinary tract infections and bloodstream infections and an important agent in the resistance to antibiotics. The present study sought to determine associations between virulence, phylogenetic background and antimicrobial resistance of E. coli strains isolated from patients with extraintestinal infections. A total of three hundred ten E. coli strains were isolated from blood, skin and soft tissue and urine. PCR methods were used to detect four main phylogenetic groups (A, B1, B2 and D) and 11 virulence genes (3 toxins, 3 adhesins, 1 siderophore, 4 capsule synthesis proteins and protectins). Standard broth microdilution test was used to determine sensitivity to 12 antimicrobial drugs. The most common and the most virulent phylogenetic group B2 was found in 193 (62.3%) isolates. The lowest virulence was observed among the group A. Analysis of virulence factors revealed the kpsMTII gene in 212 (68.4%), aer in 194 (62.6%) and tra in 184 (59.4%) of isolates, respectively. Multi-drug resistant (MDR) phenotype was noticed in 165 (53.2%) isolates. Lower representation of the MDR phenotype was detected in E. coli containing all groups of virulence genes and in the avirulent E. coli. Our study documented that E. coli associated with 3 different extraintestinal infections contain various virulence factors. Genes afa, pap, aer, neuC show significant differences among the 3 groups of the strains tested and might be the prerequisite virulence factors in bloodstream infections. Isolates containing all groups of virulence genes predominantly originate in the blood and belong to the B2 phylogenetic group. Overall, we identified significantly higher incidence of all the groups of virulence genes examined among the B2 group. Prevalence of the MDR phenotype and high levels of resistance to ampicillin, ciprofloxacin and trimetoprim/sulfamethoxazole reflect the trend observed worldwide in recent years.

Dysbiosis of the gut microbiota, caused by antibiotics, plays a key role in the establishment of Clostridioides difficile CD). Toxin-producing strains are involved in the pathogenesis of Clostridioides difficile infection (CDI), one of the most common hospital-acquired infections. We cultured a total of 84 C. difficile isolates from stool samples of patients hospitalized at Louis Pasteur University Hospital in Kosice, Slovakia, that were suspected of CDI and further characterized by molecular methods. The presence of genes encoding toxin A, toxin B, and binary toxin was assessed by toxin-specific PCR. CD ribotypes were detected using capillary-based electrophoresis ribotyping. A total of 96.4% of CD isolates carried genes encoding toxins A and B, and 54.8% of them were positive for the binary toxin. PCR ribotyping showed the presence of three major ribotypes: RT 176 (n = 40, 47.6%); RT 001 (n = 23, 27.4%); and RT 014 (n = 7, 8.3%). Ribotype 176 predominated among clinical CD isolates in our hospital. The proportion of RT 176 and RT 001 in four hospital departments with the highest incidence of CDI cases was very specific, pointing to local CDI outbreaks. Based on our data, previous use of antibiotics represents a significant risk factor for the development of CDI in patients over 65 years of age.

Clostridioides difficile is a frequent cause of hospital-acquired diarrhea associated with antibiotics. Hypervirulent strains of Clostridioides difficile are associated with a severe course of Clostridioides difficile infection and a higher mortality. We have confirmed 322 non-duplicate Clostridioides difficile isolates in stool samples of patients hospitalized in three Slovak hospitals providing primary health care between January and December 2021 and determined genes encoding toxins, ribotypes and susceptibility to antimicrobials. 93.7% of them were toxigenic and co-occurrence of genes tcdA, tcdB, cdtA, cdtB, which encode toxins, was detected in 71.4% isolates. Nosocomially associated ribotypes 176, 001, and 027 were confirmed in 61.1%, 10.2%, and 5.2% of isolates, respectively, and found to be the most frequent. Although ribotype 176 predominated in all three hospitals, the highest incidence was recorded in Košice (73.5%). Results of antimicrobial susceptibility testing revealed 65.8% resistance rate for rifampicin, 5.2% for vancomycin, 1.5% for metronidazole, 1.2% for teicoplanin and 0.6% for doxycycline. The correlation of frequent ribotypes and results of antimicrobial susceptibility testing points to the predominance of rifampicin resistance in isolates belonging to ribotypes 176 and 027. The above results reflect the problematic situation in our hospitals during the COVID-19 pandemic, that was related to the misuse of broad-spectrum antibiotics and impossibility to follow epidemiological measures to prevent the spread of hypervilulent isolates.

Backgroud/Objectives: Clostridioides difficile infection (CDI) remains a major problem for healthcare facilities. The COVID-19 pandemic was associated with increased hospitalizations, frequent antibiotic use, and changes in infection prevention and control regulations, which may have influenced the epidemiological and clinical characteristics of CDI. The aim of this study was to evaluate whether a history of COVID-19 was associated with clinical characteristics, treatment exposure, recurrence, ribotype distribution, and mortality in patients with CDI. Methods: This retrospective study included patients diagnosed with CDI during the period 2020–2022 at the Louis Pasteur University Hospital in Košice, Slovakia. We analyzed 324 patients, of whom 172 (53.1%) had no history of COVID-19 and 144 (44.4%) had previous or concurrent COVID-19, defined as documented infection within three months before or at the time of CDI diagnosis. Eight patients (2.5%) developed COVID-19 after CDI diagnosis and were excluded from the comparative analyses. Results: Patients with previous or concurrent COVID-19 had higher exposure to PPIs (88.2% vs. 73.3%; p = 0.0009), corticosteroids (70.1% vs. 26.2%; p < 0.0001), cephalosporins (72.9% vs. 61.6%; p = 0.034) and macrolides (37.5% vs. 20.3%; p = 0.0007). Overall antibiotic exposure was high (93.8%) and did not differ significantly between patients with previous or concurrent COVID-19 and those without COVID-19 (93.8% vs. 94.2%; p = 0.871). Previous or concurrent COVID-19 was not associated with increased 90-day mortality after CDI (42.4% vs. 43.6%; p = 0.824). Conclusions: Our findings suggest that a history of COVID-19 was associated with the risk factor profile, recurrence rate and the molecular epidemiology of CDI, rather than with a more severe clinical course or worse prognosis.