Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus. Although the World Health Organization (WHO) has defined CE as a neglected disease, it is the second most important foodborne parasitic disease, and it remains an important public health issue, considering its zonal endemicity and potential morbidity. The control and prevention of CE is a relevant WHO target, especially from a One Health perspective, as the disease affects not only animals and humans but also the food chain. Since not all countries have a CE surveillance strategy or reporting system and specific management guidelines, recent epidemiological data are relatively scarce, and research concerning the specific geographical distribution of the disease is ongoing. To add new information to the subject, we have analyzed and collected data from national guidelines and several medical databases. Out of the 751 research articles that were originally identified, only 52 were included in the investigation after applying specific inclusion and exclusion criteria. Notable international projects that have provided significant contributions and had a positive impact are presented. The available data were correlated with WHO recommendations on the subject, thus showcasing the measures taken and those that are still needed to properly control the disease’s spread.

Background: The increasing incidence of infection with Gram-negative bacilli (GNB) producing broad-spectrum β-lactamases, such as extended-spectrum β-lactamases (ESBLs), cephalosporinases (AmpCs), and carbapenemases, has become a great clinical concern. AmpCs are found in many clinically relevant Enterobacterales, where they may compromise the effectiveness of most β-lactams, including carbapenems when associated with an impaired outer membrane. Detection and distinction between these resistance mechanisms are crucial for antimicrobial therapy and for implementation of proper infection control procedures to prevent further spread. Methods: The disk diffusion antibiogram using Mueller-Hinton agar (MHA) supplemented with cloxacillin (MHC), which inhibits AmpCs, was validated to identify AmpC-producing Enterobacterales (AmpC-PE). As cloxacillin is not available in several countries, we investigated the use of oxacillin as an alternative compound to inhibit AmpCs. The ability of MHA supplemented with oxacillin (MHO) to distinguish between carbapenem-resistant Enterobacterales (CREs) due to AmpC hyperproduction and the presence of a carbapenemase has particularly been investigated. Results: MHOs containing several concentrations of oxacillin were compared to MHA and MHC containing 250 mg/L cloxacillin (MHC250). A set of well-characterized Enterobacterales with different β-lactam resistance mechanisms were evaluated. MHO containing 300 mg/L of oxacillin (MHO300) gave similar results to MHC250. Conclusions: The use of MHO300 proved to be efficient in inhibiting AmpCs, allowing differentiation between AmpC hyperproducers and carbapenemase producers. In addition, the use of MHO300 allowed detection of resistance mechanisms hidden by AmpCs, such as ESBLs.

Background: Alveolar echinococcosis (AE) is a neglected parasitic disease caused by Echinococcus multilocularis that is difficult to diagnose and treat. Methods: This systematic review has gathered articles presenting original data from the past 5 years, from January 2020 to December 2025, with epidemiological data (incidence, prevalence), treatment options, case reports, and other findings relevant to the prevention and control of this disease, representing the inclusion criteria of this study. Three medical databases were searched for the study: PubMed, Web of Science, and ScienceDirect. To improve our understanding of the available data, no spatial or temporal restrictions were imposed on the study’s duration or follow-up period. Results: A total of 248 articles are included in this review, which describe atypical sites and complications owing to Echinococcus multilocularis infection, the heterogeneity of epidemiological studies in different endemic and non-endemic regions, diagnosis techniques based on imaging, histopathology, and molecular techniques, as well as surgical and non-surgical treatment options (and lack thereof regarding the latter). Conclusions: Although advances have been made in the diagnosis, management, and treatment of AE, challenges remain, particularly with regard to misdiagnosis, delayed diagnosis, and limited antiparasitic therapy.

Background/Objectives: The European Medicines Agency (EMA) approved new antimicrobial agents against Gram-negative bacteria, such as cefiderocol, eravacycline, and aztreonam-avibactam, for the treatment of infection with carbapenem-resistant (CR)/carbapenemase-producing microorganisms. However, real-life data regarding their efficacy in clinical settings is still scarce. This systematic review refers to relevant studies aiming to establish whether these novel therapeutic options remain viable alternatives in treating infections caused by highly resistant Gram-negative microorganisms. Methods: To conduct our study, Pubmed, Web of Science, Science Direct, and ClinicalTrials.gov were screened. Studies published between the validation report provided by EMA for each molecule and 15 September 2024 were selected and then assessed based on their reference to patient clinical outcomes. The main inclusion criteria were first-hand results of their clinical experience with the molecules, treatment regimens, and clinical and microbiological outcomes (mortality, cure rates, and recurrence). Exclusion criteria included the absence of clinical data, studies not belonging to the specified time frame, and others. Results: Most studies using eravacycline and cefiderocol demonstrated at least non-inferiority regarding their clinical efficacy compared to the best-available therapy. Studies have yet to emerge on the aztreonam-avibactam combination. Conclusions: Eravacycline and cefiderocol present promising results, offering similar or superior results to the already available antibiotic options. They create new possibilities for treating patients with highly resistant Gram-negative microorganisms. More studies are required to draw definite conclusions. Nonetheless, the new molecules offer hope for an otherwise grim future.

Background/Objectives: Given the ongoing threat of antimicrobial resistance, the identification and characterization of multidrug-resistant isolates are essential. An increase in antimicrobial-resistant bacteria has been reported in Romania, but national data are still scarce. This study aimed to evaluate beta-lactamase-producing Gram-negative bacteria (GNB) isolated over two years at a Romanian nephrology hospital, while comparing carbapenemase detection phenotypic methods. Methods: Gram-negative bacterial isolates collected between January 2022 and May 2024 that met antimicrobial resistance screening criteria were evaluated. After identification, extensive disk diffusion antibiograms were performed, read, and interpreted, complemented by testing on cloxacillin/oxacillin-supplemented Mueller–Hinton agar. The colistin minimum inhibitory concentration (MIC) was not assessed, and aztreonam–avibactam was not tested for Enterobacterales. For non-fermenter GNB, the colistin MIC was determined. Phenotypic carbapenemase production tests were performed for all strains (BlueCarba Test, CIM, mCIM, zCIM, and rCIM). Carbapenemase detection immunochromatographic tests were performed for a set of strains. Results: Among the 397 evaluated strains, 335 (84.38%) were Enterobacterales and 62 (15.62%) non-fermenter GNB, showing high antimicrobial resistance levels. Of these, 188 (47.35%) were Klebsiella pneumoniae; 139/188 (73.93%) showed carbapenem resistance and carbapenemase production; 49/188 (26.06%) produced two carbapenemases; and 45/188 (23.93%) presented resistance to all tested antimicrobials. MALDI-TOF identified 28 KPC-producing K. pneumoniae strains. Lateral flow assays revealed NDM, VIM, KPC, and OXA-48-like enzymes in 48 of 56 tested Enterobacterales; 12/48 strains produced two carbapenemases. Of the 62 non-fermenter GNB, 33 were Pseudomonas spp. and 20 Acinetobacter baumannii; one Pseudomonas spp. was susceptible only to colistin and seven only to cefiderocol; four A. baumannii were susceptible only to colistin and three only to cefiderocol. Lateral flow assays detected VIM or IMP enzymes in 13/33 Pseudomonas spp. and OXA-23 and/or OXA-40/-58 enzymes in all 20 A. baumannii. Conclusions: Among the evaluated strains, many showed resistance to multiple antimicrobial classes. Furthermore, strains co-producing two carbapenemases were identified.