Low- and middle-income countries bear a disproportionate burden of antimicrobial resistance and often lack adequate surveillance due to a paucity of microbiological studies. In this 2022 study, our goal was to contribute to a more precise antimicrobial treatment by understanding the prevalence of resistance in a rural environment, promoting antibiotic stewardship, and raising awareness about antimicrobial resistance. We assessed the prevalence of Multidrug-Resistant (MDR) and Extensively Drug-Resistant (XDR) Enterobacterales in clinical samples from 2905 patients being treated at Saint Dominic’s Hospital, Akwatia, in the countryside of the Eastern Region, Ghana, in the year 2022. To this purpose, the samples were cultured on agar plates prepared in the laboratory using purified Oxoid™ Thermo Scientific™ agar (Thermo Fisher Scientific; Waltham, MA, USA). Cystine Lactose Electrolyte-Deficient (CLED) agar was used for urine samples, while blood agar, chocolate agar, and MacConkey agar were used for the rest of the specimens tested (HVS, blood, BFA, sputum). Antimicrobial susceptibility was determined on site using the disc diffusion method (Kirby-Bauer test). MDR bacteria accounted for more than half (53.7%) of all microorganisms tested for three or more antibiotics and 37.3% of these were XDR. Multivariate regression analysis was performed to identify risk factors associated with acquiring MDR/XDR bacteria. The results showed an increased likelihood of MDR acquisition linked to being male (OR 2.39, p < 0.001 for MDR and OR 1.95, p = 0.027 for XDR), higher age (OR 1.01, p = 0.049 for MDR), non-sputum samples (OR 0.32, p = 0.009 for MDR), and urine samples (OR 7.46, p < 0.001 for XDR). These findings emphasize the urgency for surveillance and control of antimicrobial resistance; to this end, making accurate diagnostics, studying the microorganism in question, and conducting susceptibility testing is of the utmost importance.

The clinical significance of Blastocystis sp. remains to be fully elucidated. This study assesses whether Blastocystis subtype diversity can affect the outcome of the infection and the occurrence of clinical manifestations in infected individuals. Stool samples from 219 Blastocystis-positive patients by PCR targeting the ssu rDNA gene were fully genotyped by Sanger sequencing analyses. Co-infections by other parasitic, viral, and bacterial enteropathogens were identified by molecular and culture methods. Sequence analyses revealed the presence of six Blastocystis subtypes including ST1 (21.5%), ST2 (17.8%), ST3 (29.7%), ST4 (22.8%), ST6 (5.5%), and ST7 (2.3%), with a single sample harbouring a ST1+ST3 co-infection (0.5%). Multivariate risk factor analyses using logistic regression models indicated that neither Blastocystis subtypes nor patient-associated variables including sex, country of origin, travelling history, and presence of nonspecific symptoms were positively associated with a higher likelihood of developing gastrointestinal symptoms (abdominal pain and diarrhoea). However, being of a young age (p-value: 0.003) and experiencing skin pruritus (p-value < 0.001) and eosinophilia (p-value: 0.016) were found to increase the odds of presenting gastrointestinal symptoms. Blastocystis subtypes based on variability within the ssu rDNA gene do not seem to be the main drivers of clinical manifestations in the surveyed clinical population.

The guanidine core has been one of the most studied functional groups in medicinal chemistry, and guanylation reactions are powerful tools for synthesizing this kind of compound. In this study, a series of five guanidine-core small molecules were obtained through guanylation reactions. These compounds were then evaluated against three different strains of Escherichia coli, one collection strain from the American Type Culture Collection (ATCC) of E. coli ATCC 35218, and two clinical extended-spectrum beta-lactamase (ESBL)-producing E. coli isolates (ESBL1 and ESBL2). Moreover, three different strains of Pseudomonas aeruginosa were studied, one collection strain of P. aeruginosa ATCC 27853, and two clinical multidrug-resistant isolates (PA24 and PA35). Among Gram-positive strains, three different strains of Staphylococcus aureus, one collection strain of S. aureus ATCC 29213, and two clinical methicillin-resistant S. aureus (MRSA1 and MRSA2) were evaluated. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) experiments were reported, and the drop plate (DP) method was used to determine the number of viable suspended bacteria in a known beaker volume. The results from this assessment suggest that guanidine-core small molecules hold promise as therapeutic alternatives for treating infections caused by clinical Gram-negative and Gram-positive bacteria, highlighting the need for further studies to explore their potential. The results from this assessment suggest that the chemical structure of CAPP4 might serve as the basis for designing more active guanidine-based antimicrobial compounds, highlighting the need for further studies to explore their potential.

Purpose: Accurate and rapid diagnosis of gastrointestinal infections is essential for effective patient management. This study compared the diagnostic performance of two multiplex PCR panels— the Seegene Allplex™ Gastrointestinal Panels (Seegene, Seoul, Korea) and the Luminex NxTAG ^® Gastrointestinal Pathogen Panel (Luminex Corporation, Austin, Texas, a Diasorin Company)—in detecting gastrointestinal pathogens from clinical stool samples. Methods: A total of 196 stool samples, collected from patients at a Spanish hospital during 2023, were analyzed using both assays through prospective and retrospective approaches. The performance of each test was assessed based on Positive Percentage Agreement (PPA), Negative Percentage Agreement (NPA), and overall agreement. Discrepancies between methods were resolved with a third confirmatory technique when available. Results: Both assays demonstrated high overall concordance, with NPA values consistently above 95% and overall Kappa values exceeding 0.8 for most pathogens. The average PPA was greater than 89% for nearly all targets; however, lower agreement was observed for Cryptosporidium spp. (86.6%). Notably, discrepancies were primarily observed for certain pathogens, such as Salmonella spp. and Cryptosporidium spp., highlighting the diagnostic challenges associated with these targets. Conclusion: To our knowledge, this is the first study to compare the novel Luminex NxTAG^® panels from Diasorin with the Seegene Allplex™. Both multiplex assays provide rapid and reliable detection of gastrointestinal pathogens, making them valuable tools in clinical diagnostics. Future research should focus on improving detection accuracy for challenging pathogens and expanding target panels to further enhance patient management and reduce disease burden.

Helicobacter pylori is a Gram-negative bacterium that causes chronic gastric inflammation, which can lead to gastric neoplasia. Therefore, early diagnosis of H. pylori infection is crucial for effective treatment and prevention of complications. The aim of this study was to compare the sensitivity and specificity of the STANDARD™ F H. pylori Ag FIA stool antigen test (SD Biosensor) with the LIAISON® Meridian H. pylori SA for the diagnosis of H. pylori infection. A total of 133 stool samples from patients with suspected H. pylori infection were compared using the STANDARD™ F H. pylori Ag FIA stool antigen test (SD Biosensor), based on lateral flow assay, with the LIAISON® Meridian H. pylori SA. Of the 45 positive samples with LIAISON, 44 were also positive while 1 was negative in the STANDARD™ antigen test. However, this discrepant sample showed a chemiluminescence index of 1.18, very close to the cut-off point of 1. On the other hand, of 88 negative samples obtained with LIAISON, 83 were negative and 5 were positive in the STANDARD™ antigen test. Moreover, STANDARD™ F H. pylori Ag FIA assay has shown a sensitivity of 97.8% (95% CI: 88.2-99.9), a specificity of 94.3% (95% CI: 87.2-98.1), a PPV of 83.9% (95% CI: 68.9-92.4) and a NPV of 99.3% ((95% CI: 95.3-99.9). In conclusion, the STANDARD™ F H. pylori Ag FIA (SD Biosensor) on the STANDARD™ F2400 analyser is a highly sensitive, specific and suitable assay for the detection of H. pylori in stool samples.

Purpose: Malaria remains a major global health challenge, particularly in sub-Saharan Africa and low- and middle-income countries (LMICs), contributing substantially to mortality and morbidity rates. In resource-limited settings, access to specialized diagnostic tests is often restricted, making basic blood analysis a valuable diagnostic tool. This study investigated the correlation between malaria infection and full blood count values in a rural region of Ghana during the 2022 rainy season, aiming to highlight diagnostic insights available from routine blood analyses. Methods: A retrospective case-control analysis was conducted on 544 confirmed malaria cases, comparing their blood values with those of matched malaria-negative controls. Results: Parasitaemia levels peaked during the rainy season, with July showing the highest values. Malaria-positive patients exhibited lower levels of haemoglobin, white blood cells, lymphocytes, and platelets, but higher neutrophil counts compared to controls. Middle-aged women had significantly lower haemoglobin levels than men, and younger individuals showed higher parasitaemia levels. A negative correlation was found between Plasmodium density and haemoglobin and platelet counts, while positive correlations were observed with white blood cell and neutrophil counts. Conclusion: This study highlights the significant burden of malaria in rural Ghana during the rainy season and underscores the impact of infection on blood values. Routine full blood count analysis provides a practical and accessible diagnostic tool in resource-limited settings. The findings emphasise the importance of targeted interventions for high-risk groups, particularly children and women, to improve patient management and reduce malaria-related morbidity. Graphical