MicroRNAs (miRNAs) and the gut microbiome are key regulators of human health, with emerging evidence highlighting their complex, bidirectional interactions in chronic diseases. miRNAs, influence gene expression and can modulate the composition and function of the gut microbiome, impacting metabolic and immune processes. Conversely, the microbiome can affect host miRNA expression, influencing inflammatory pathways and disease susceptibility. This systematic review examines recent studies (2020–2024) focusing exclusively on human subjects, selected through rigorous inclusion and exclusion criteria. Studies were included if they investigated the interaction between miRNAs and the gut microbiome in the context of gastrointestinal diseases, obesity, autoimmune diseases, cognitive and neurodegenerative disorders, and autism. In vitro , in vivo and in silico analyses were excluded to ensure a strong translational focus on human pathophysiology. Notably, miRNAs, stable and abundant in patients, are emerging as promising biomarkers of microbiome-driven inflammation. This systematic review provides an overview of miRNAs, their regulatory effects on bacterial strains, and their associations with specific diseases. It also explores therapeutic advances and the potential of miRNA-based therapies to restore microbial balance and reduce inflammation.

Synovial fluid (SF) plays a critical role in joint lubrication, load distribution, and maintaining homeostasis within the synovial cavity. Its rheological properties, primarily influenced by hyaluronic acid (HA) and other macromolecules, are essential for normal joint function. However, alterations in the physicochemical characteristics of SF can occur due to septic conditions, including septic arthritis (SA) and periprosthetic joint infections (PJIs), which significantly impact joint health. Bacterial colonization in infected joints often leads to the formation of biofilms, microbial aggregates encased in an extracellular matrix, which confer resistance to antibiotics and host immune responses. Biofilm formation in SF-altered environments is a major challenge in treating joint infections, particularly in patients with prosthetic implants. Viscosupplementation, primarily through intra-articular hyaluronic acid (HA) injections, has been widely used to restore SF viscosity and function in degenerative joint diseases. More recently, polyacrylamide (PAA)-based gels have emerged as an alternative viscosupplementation strategy. However, concerns have been raised regarding the potential impact of viscosupplements on biofilm formation and bacterial adhesion in septic joints, as changes in SF viscosity and composition may influence bacterial colonization and persistence. This review aims to assess the interaction between viscosupplementation and biofilm formation in septic joint pathologies, examining the effects of HA and PAA on SF rheology and bacterial adhesion. Understanding these interactions is crucial for optimizing therapeutic strategies and mitigating the risk of biofilm-associated infections in patients undergoing viscosupplementation.

Implant-related infections (IRIs) represent a significant challenge to modern surgery. The occurrence of these infections is due to the ability of pathogens to aggregate and form biofilms, which presents a challenge to both the diagnosis and subsequent treatment of the infection. Biofilms provide pathogens with protection from the host immune response and antibiotics, making detection difficult and complicating both single-stage and two-stage revision procedures. This narrative review examines advanced chemical antibiofilm techniques with the aim of improving the detection and identification of pathogens in IRIs. The articles included in this review were selected from databases such as PubMed, Scopus, MDPI and SpringerLink, which focus on recent studies evaluating the efficacy and enhanced accuracy of microbiological sampling and culture following the use of chemical antibiofilm. Although promising results have been achieved with the successful application of some antibiofilm chemical pre-treatment methods, mainly in orthopedics and in cardiovascular surgery, further research is required to optimize and expand their routine use in the clinical setting. This is necessary to ensure their safety, efficacy and integration into diagnostic protocols. Future studies should focus on standardizing these techniques and evaluating their effectiveness in large-scale clinical trials. This review emphasizes the importance of interdisciplinary collaboration in developing reliable diagnostic tools and highlights the need for innovative approaches to improve outcomes for patients undergoing both single-stage and two-stage revision surgery for implant-related infections.

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.