Background: The COVID-19 pandemic has profoundly altered the clinical and microbiological landscape of respiratory tract infections (RTIs), potentially reshaping pathogen distribution and antimicrobial resistance (AMR) profiles across care settings. Objectives: The objective of this study was to assess temporal trends in respiratory bacterial pathogens, antimicrobial resistance, and polymicrobial infections across three pandemic phases—pre-COVID (2018–2019), COVID (2020–2022), and post-COVID (2022–2024)—in hospitalized and ambulatory patients. Methods: We retrospectively analyzed 1827 respiratory bacterial isolates (hospitalized patients, n = 1032; ambulatory patients, n = 795) collected at a tertiary care center in Northern Italy. Data were stratified by care setting, anatomical site, and pandemic phase. Species identification and susceptibility testing followed EUCAST guidelines. Statistical analysis included chi-square and Fisher’s exact tests. Results: In hospitalized patients, a significant increase in Pseudomonas aeruginosa (from 45.5% pre-COVID to 58.6% post-COVID, p < 0.0001) and Acinetobacter baumannii (from 1.2% to 11.1% during COVID, p < 0.0001) was observed, with 100% extensively drug-resistant (XDR) rates for A. baumannii during the pandemic. Conversely, Staphylococcus aureus significantly declined from 23.6% pre-COVID to 13.7% post-COVID (p = 0.0012). In ambulatory patients, polymicrobial infections peaked at 41.2% during COVID, frequently involving co-isolation of Candida spp. Notably, resistance to benzylpenicillin in Streptococcus pneumoniae reached 80% (4/5 isolates) in hospitalized patients during COVID, and carbapenem-resistant P. aeruginosa (CRPA) significantly increased post-pandemic in ambulatory patients (0% pre-COVID vs. 23.5% post-COVID, p = 0.0014). Conclusions: The pandemic markedly shifted respiratory pathogen dynamics and resistance profiles, with distinct trends observed in hospital and community settings. Persistent resistance phenotypes and frequent polymicrobial infections, particularly involving Candida spp. in outpatients, underscore the need for targeted surveillance and antimicrobial stewardship strategies.

The emergence of antibiotic resistance poses a significant threat to public health worldwide, affecting various medical fields, including ophthalmology. Eye infections, ranging from conjunctivitis to more severe conditions like keratitis, are commonly treated with antibiotics. However, the misuse and overuse of these drugs have led to the development of resistant strains of bacteria, allowing traditional treatments ineffective. This paper aims to examine the current situation of antibiotic resistance in eye infections globally, with a specific focus on a large group of hospitals located in Milan (Italy) with considerable experience in cataract and cornea surgery as well as in retinopathy. The results of the study show the prevalence of Gram-positives in the tested samples and a low resistance of fluoroquinolones and glycopeptides. The results also highlight the need to implement sample collection methods for ocular infections, as the quantity of positive samples is rather low compared to the total number of samples. In conclusion, the study, although with limited data, shows that resistance to aminoglycosides and cephalosporins is a situation to be monitored. These data also show the critical need to improve and guide the biological sample collection modalities in order to make the diagnosis more reliable.

Objectives: To evaluate the in vitro antimicrobial activity of TiAB, a compound based on silver-bound titanium dioxide, against clinical isolates from dermatological infections. Methods: We tested 155 strains clinically isolated from ulcers and skin infections, including MRSA, ESBL-producing Enterobacterales, and P. aeruginosa. MIC and MBC values were determined using broth microdilution according to CLSI guidelines. Time-kill assays were performed at 0.5×, 1×, and 2× MIC. Median values were used to describe susceptibility profiles. Results: TiAB exhibited strong bactericidal activity against Gram-negative bacteria, including ESBL-positive E. coli and K. pneumoniae, with complete killing at 2× MIC (4–8%) within 4–8 h. Gram-positive pathogens exhibited higher MICs (≥8%) and limited response within 24 h; however, extending exposure to 48 h resulted in enhanced activity. Conclusions: TiAB exhibited in vitro bactericidal activity with median MIC values ranging from 1% to 2% (w/v) against Gram-negative clinical isolates such as E. coli and P. aeruginosa, and 2% to 4% against Gram-positive strains including MRSA. Time-kill assays confirmed ≥3 log₁₀ CFU/mL reductions for Gram-negative bacteria at 2× MIC within 24 h. These results suggest TiAB’s potential as a topical antimicrobial agent, though further in vivo studies are needed to validate its safety and efficacy.

Background: Infections in hand surgery represent a clinically relevant complication, particularly in trauma-related procedures and in the presence of internal fixation devices. Data specifically addressing microbiological profiles and antimicrobial resistance patterns in hand surgery remain limited. Methods: A monocentric retrospective observational study was conducted, including 72 patients treated for hand surgery infections between January 2024 and June 2025. Microbiological isolates and antimicrobial susceptibility profiles were analyzed and stratified according to the clinical scenario, including trauma-related infections and infections associated with internal fixation devices. Monomicrobial and polymicrobial infections were evaluated separately. Results: Trauma-related infections accounted for 77.8% of cases, of which 64.3% were monomicrobial and 35.7% polymicrobial. Monomicrobial trauma-related infections were predominantly caused by Staphylococcus aureus, with methicillin resistance detected in 25.0% of cases. Polymicrobial trauma-related infections showed greater microbiological complexity but limited antimicrobial resistance. Infections associated with internal fixation devices represented 22.2% of cases and demonstrated a higher proportion of polymicrobial infections. Across all subgroups, no extended-spectrum beta-lactamase–producing Enterobacterales or carbapenem-resistant organisms were identified. Conclusions: This study fills an important evidence gap by characterizing pathogens and antimicrobial resistance in a dedicated hand surgery cohort, an area where published microbiological data remain limited compared with other orthopedic subspecialties. Hand surgery infections exhibit distinct microbiological and resistance profiles depending on the clinical scenario and microbial complexity. Despite frequent polymicrobial involvement, high-level antimicrobial resistance remains uncommon, supporting the value of local microbiological surveillance to guide empirical therapy.

Background: Gynecological infections, including bacterial vaginosis, vulvovaginal candidiasis, and recurrent urinary tract infections, represent a major clinical burden and are often complicated by biofilm formation and antimicrobial resistance. Novel non-antibiotic strategies are urgently needed. We previously demonstrated the antimicrobial activity of silver-bound titanium dioxide (TiAB) against multidrug-resistant bacteria isolated from dermatological infections. Objectives: We evaluated whether TiAB, at concentrations used in marketed medical devices, exerts antibacterial and antifungal effects against clinically relevant vaginal isolates by determining Minimum Inhibitory Concentration/ Minimum Bactericidal and Fungicidal Concentration (MIC, MBC/MFC), and time–kill kinetics. Methods: A total of 73 clinical isolates were collected from vaginal swabs, including Staphylococcus aureus (MSSA, MRSA), Escherichia coli (ESBL+ and non-ESBL), Klebsiella pneumoniae, Enterococcus spp., Streptococcus agalactiae, and Candida albicans. Minimum inhibitory concentrations (MICs) and minimum bactericidal/fungicidal concentrations (MBCs/MFCs) were determined by broth microdilution, and bactericidal activity was confirmed by time-kill assays. Results: TiAB exhibited potent activity against Gram-negative bacteria, with median MIC values of 1–2% (w/v) for E. coli and K. pneumoniae. Gram-positive isolates, including S. agalactiae and Enterococcus spp., showed higher MIC values (2–4%). Candida albicans displayed fungistatic inhibition at 4%. Time-kill assays confirmed rapid bactericidal effects for Gram-negative isolates within 8 h at 2× MIC, while Gram-positive bacteria required prolonged exposure. Conclusions: These findings extend previous evidence of TiAB’s antimicrobial properties to gynecological pathogens, supporting its potential as a topical, non-antibiotic option for managing vaginal infections in an era of rising antimicrobial resistance. Further in vivo validation is warranted.

To investigate factors associated with multidrug resistance (MDR) in diabetes-related foot infections (DFIs), focusing on polymicrobial infection and glycated hemoglobin (HbA1c). This retrospective single-center study included culture-positive deep-tissue biopsy specimens collected during 2025. Consecutive positive biopsies from the same patient were grouped into episodes when successive samples were obtained ≤7 days apart. MDR was assessed using organism-specific antimicrobial categories, counting resistant results and excluding expected resistance phenotypes. Logistic regression used patient-clustered robust standard errors. HbA1c was evaluated in a secondary model restricted to measurements within ±30 days of sampling. The 191 culture-positive biopsies yielded 175 episodes from 150 patients; 43 episodes (24.6%) were polymicrobial. The most frequently recovered species were Staphylococcus aureus (35.4% of episodes), Pseudomonas aeruginosa (20.6%) and Enterococcus faecalis (14.9%). Among 157 MDR-evaluable episodes, 49 (31.2%) were MDR-positive. MDR occurred in 46.5% of polymicrobial versus 25.4% of monomicrobial episodes (crude OR 2.55; p = 0.020). Polymicrobial infection remained associated with MDR after adjustment for Gram-negative involvement, age and sex (aOR 4.52, 95% CI 1.91–10.72). In the HbA1c-adjusted model (94 episodes; 85 patients), polymicrobial infection remained associated with MDR (aOR 4.04, 95% CI 1.38–11.84), whereas HbA1c was not significantly associated with MDR (aOR 0.91 per 1% increase, 95% CI 0.69–1.20). Polymicrobial infection was associated with MDR, although unmeasured clinical confounding limits interpretation. The HbA1c findings remain inconclusive because of limited precision. These associations require confirmation in larger studies incorporating detailed clinical exposures and wound characteristics.