Nosocomial pneumonia is one of the most frequent hospital-acquired infections. One of the types of nosocomial pneumonia is ventilator-associated pneumonia, which occurs in endotracheally intubated patients in intensive care units (ICU). Ventilator-associated pneumonia may be caused by multidrug-resistant pathogens, which increase the risk of complications due to the difficulty in treating them. Pneumonia is a respiratory disease that requires targeted antimicrobial treatment initiated as early as possible to have a good outcome. For the therapy to be as specific and started sooner, diagnostic methods have evolved rapidly, becoming quicker and simpler to perform. Polymerase chain reaction (PCR) is a rapid diagnostic technique with numerous advantages compared to classic plate culture-based techniques. Researchers continue to improve diagnostic methods; thus, the newest types of PCR can be performed at the bedside, in the ICU, so-called point of care testing—PCR (POC-PCR). The purpose of this review is to highlight the benefits and drawbacks of PCR-based techniques in managing nosocomial pneumonia.

Healthcare-associated pneumonia (HCAP) is a common nosocomial infection with high morbidity and mortality. Culture-based detection of the etiologic agent and drug susceptibility is time-consuming, potentially leading to the inadequate use of broad-spectrum empirical antibiotic regimens. The aim was to evaluate the diagnostic capabilities of rapid point-of-care multiplex polymerase chain reaction (PCR) assays from the endotracheal aspirate of critically ill patients with HCAP. A consecutive series of 29 intensive care unit (ICU) patients with HCAP and a control group of 28 patients undergoing elective surgical procedures were enrolled in the study. The results of the PCR assays were compared to the culture-based gold standard. The overall accuracy of the PCR assays was 95.12%, with a sensitivity of 92.31% and a specificity of 97.67%. The median time was 90 min for the rapid PCR tests (p < 0.001), while for the first preliminary results of the cultures, it was 48 h (46–72). The overall accuracy for rapid PCR testing in suggesting an adequate antibiotic adjustment was 82.98% (95% CI 69.19–92.35%), with a specificity of 90% (95% CI 55.50–99.75%), a positive predictive value of 96.77% (95% CI 83.30–99.92%), and a negative predictive value of 56.25 (95% CII 29.88–80.25%). This method of rapid point-of-care PCR could effectively guide antimicrobial stewardship in patients with healthcare-acquired pneumonia.

Introduction: Linezolid is a reserve antibiotic used to treat infections caused by Gram-positive bacteria with resistance genes. In critically ill patients, high intra- and interindividual variability has been observed, prompting the search for alternative methods to reduce this variability and achieve the pharmacokinetic/pharmacodynamic indices necessary for a favorable efficacy–safety balance. Aim of the study: We wished to compare the safety and effectiveness of a continuous infusion (CI) versus an intermittent infusion (II) of linezolid in patients requiring intensive care. Materials and Methods: This study, registered under the number NCT05801484), was a prospective, open-label, single-center, two-arm study. Data on hematologic safety and effectiveness were collected and compared between patients receiving CI and II, respectively, at the same daily dose of linezolid (1200 mg). Results: Twenty-nine patients from the intensive care unit were included, divided into two groups. No statistically significant difference was found in 30-day mortality between the groups, nor in the likelihood of post-treatment culture negativity. However, a significantly greater reduction in C-reactive protein levels was observed in the CI group compared to the II group. Regarding safety, at CrCl < 60 mL/min, the decrease in platelets was statistically significant in group II but not in group CI. Additionally, at the 30-day follow-up, recovery from thrombocytopenia was better in the CI group. Conclusions: Continuous infusion of linezolid proved to be non-inferior to intermittent infusion at the same daily dose in terms of effectiveness. Furthermore, a lower risk of adverse reactions was identified with continuous infusion.

The increasing use of Technology-Critical Elements (TCEs) in modern technology has led to widespread environmental release, raising questions about their biological effects, as emerging evidence suggests significant toxicity. We investigated the effects of three technology-critical elements, Indium oxide (In₂O₃), Lanthanum nitrate hexahydrate (La(NO₃)₃·6H₂O) and Cerium(III) nitrate hexahydrate (Ce(NO₃)₃·6H₂O), on human dermal fibroblasts (BJ) and hepatocarcinoma cells (HepG2), assessing their uptake, impact on viability, and induced cellular stress responses, quantified by markers of inflammation, oxidative stress, and membrane damage. Our results show a strong differential susceptibility: normal BJ fibroblasts proved vulnerable, whereas HepG2 cells were highly resistant. This divergence occurred despite substantial and comparable accumulation of all three TCEs in both cell lines, indicating that toxicity is uncoupled from the magnitude of the uptake. Mechanistically, the differential toxicity correlated strongly with opposing antioxidant responses. Additionally, low concentrations of cerium (III) nitrate (12.5–50 µg/mL) uniquely stimulated the proliferation of HepG2 cells (up to 129% of control). While these findings identify multiple mechanistic hazards regarding the potential of low-level technology-critical element exposure, they must be interpreted cautiously and warrant further investigation in more complex biological models.

Graphene-based nanomaterials (GBNs) have emerged as promising candidates for diverse biomedical applications, but their clinical translation has been hindered by inherent cytotoxicity. We synthesized three distinct cerium-containing graphene nanocomposites using a single-step, in situ electrochemical exfoliation process and investigated their structure–activity relationships in normal dermal fibroblasts (BJ) and hepatocarcinoma cells (HepG2). The properties of the resulting nanocomposites, including their morphology, cerium loading, and the surface redox state (Ce³⁺/Ce⁴⁺ ratio) were directly dictated by the employed synthesis parameters, such as the cerium salt precursor and its concentration. These distinct materials induced differential cellular responses that ranged from preferential cytotoxicity in HepG2 cells to a significant cytostimulatory effect and increased ATP levels in BJ fibroblasts, particularly in EXF3-treated cells. Our findings indicate that by employing the in situ electrochemical exfoliation method, the hybrid graphene compounds might be further tailored for specific purposes, moving the narrative beyond the mere functionalization of the graphene in order to achieve biocompatibility.

Background/Objectives: The COVID-19 pandemic complicated the diagnosis of Ventilator-Associated Pneumonia (VAP), leading to empiric antibiotic overuse due to the difficulty in distinguishing viral progression from bacterial superinfection. However, it remains unclear whether COVID-19-associated VAP displays a distinct antimicrobial resistance profile compared to classical VAP. Methods: This monocentric, retrospective cohort study primarily investigated differences in clinical phenotypes and antibiotic resistance profiles between patients with VAP-COVID (n = 26) and non-COVID-VAP (n = 26). Logistic regression was used to identify factors associated with the COVID-19 phenotype and predictors of antimicrobial resistance. As a secondary objective, we evaluated the diagnostic efficacy of a multiplex Point-of-Care PCR (POC-PCR) system (n = 22) compared to standard culture (n = 26) regarding turnaround time and resistance detection. Results: Patients with VAP-COVID exhibited significantly higher resistance rates to carbapenems (76.9% vs. 50%, p = 0.04) and fluoroquinolones (88.5% vs. 61.5%, p = 0.02) despite fewer traditional risk factors at admission. The clinical profile of the VAP-COVID group was distinguished by a significantly lower incidence of parapneumonic pleural effusion (19.2% vs. 84.6%, p < 0.001) and a higher median Neutrophil-to-Lymphocyte Ratio (41.36 vs. 9.63, p < 0.001). Regarding diagnostic speed, POC-PCR significantly reduced the time to result validation compared to standard culture (~1 h vs. ~62.5 h, p < 0.001). Conclusions: VAP in COVID-19 patients presents a distinct microbiological profile characterized by higher antimicrobial resistance. In this context, the integration of rapid molecular diagnostics may support earlier microbiological guidance compared to standard methods.