Yokenella regensburgei is a Gram-negative rod part of the Enterobacteriaceae family (order Enterobacterales) and a rare cause of human infections. Although improved diagnostic methods have led to an increase in reports of this elusive pathogen, information remains limited. In order to provide a better understanding of this bacterium, we developed the first comprehensive review of its biology, biochemical profile, antimicrobial resistance pattern, virulence factors, natural reservoir and involvement in various veterinary and human infections. Human infections with this bacterium are scarcely reported, most probably due to constraints regarding its identification and biochemical similarities to Hafnia alvei. Multiple systematic searches revealed 23 cases of human infection, with a seemingly worldwide distribution, mostly in middle-aged or elderly male patients, often associated with immunosuppression. To date, Y. regensburgei has been reported in skin and soft tissue infections, bacteremia and sepsis, osteoarticular infections and in others such as urinary tract and digestive infections. The unique ability of Y. regensburgei to degrade polystyrene presents a novel and promising avenue for addressing plastic pollution in the near future. However, large-scale applications of this bacterium will undoubtedly increase human exposure, highlighting the necessity for comprehensive research into its role in human and veterinary infections, pathogenicity and antibiotic resistance.

Background: Enterococcus faecalis is a common gastrointestinal commensal and an important opportunistic pathogen. While vancomycin resistance is well characterized, data on virulence-associated genes in colonizing isolates remain limited. Methods: A total of 44 colonizing E. faecalis isolates recovered from routine VRE screening (rectal swabs) were included in the study. The presence of the virulence-associated genes asa, esp, eep, ccf, and cpd was investigated by PCR. Antimicrobial susceptibility testing was performed using standardized methods, and isolates were subsequently classified as either vancomycin-resistant (VRE) or vancomycin-susceptible (VSE). A cumulative virulence gene score was calculated for each isolate and compared between the two groups. Results: Virulence-associated genes were heterogeneously distributed. Overall, the prevalence of the investigated virulence genes was cpd (33/44), eep (26/44), esp (24/44), ccf (22/44), and asa (8/44). Among these, only esp was significantly more prevalent in VRE than in VSE isolates (p < 0.01). VRE isolates showed a significantly higher median virulence gene score compared to VSE isolates (3 [IQR: 2–4] vs. 2 [IQR: 2–3]; p = 0.028, Mann–Whitney U test). The esp gene was more frequently detected among VRE isolates, while pheromone-associated genes displayed no clear group-specific pattern. Conclusions: Colonizing E. faecalis isolates carried a heterogeneous repertoire of the selected virulence-associated genes, with a higher burden of these genes among VRE isolates. These findings contribute additional data from Eastern Europe on the molecular characteristics of colonizing E. faecalis populations and support further investigation of their epidemiological relevance in healthcare settings.

Yet underdiagnosed sleep-related breathing disorder with significant cardiovascular implications. Besides hypertension, heart failure, and ischemic disease, SAHS has been increasingly associated with arrhythmias and conduction abnormalities. Sinus node dysfunction (SND) is among the rhythm disturbances most frequently reported, with clinical manifestations ranging from bradycardia to prolonged sinus pauses. The pathophysiology involves recurrent nocturnal hypoxemia, sympathetic-vagal imbalance, and intrathoracic pressure fluctuations, which together promote electrical instability. Traditionally, pacemaker implantation has been considered the treatment of choice for symptomatic or severe SND. However, growing evidence suggests that adequate management of SAHS with continuous positive airway pressure (CPAP) may reverse rhythm disorders, highlighting the importance of identifying reversible causes before committing to invasive procedures. The Case: We report the case of a 34-year-old man with morbid obesity (BMI 43.6) and no cardiovascular history, who presented with severe daytime sleepiness (Epworth score 17). Physical examination was unremarkable, with no structural heart disease. Baseline electrocardiogram showed sinus bradycardia at 56 bpm. Holter monitoring revealed sinus node dysfunction with nocturnal pauses up to 6.8 seconds. Based on these findings, dual-chamber pacemaker implantation was initially considered. Simultaneous overnight polysomnography confirmed severe SAHS, with an apnea-hypopnea index (AHI) of 70 events/hour, oxygen desaturation index of 52/hour, and a nadir oxygen saturation of 56%. Given the temporal overlap between apneic events and sinus pauses, an alternative strategy was pursued. The patient was started on CPAP therapy and received weight loss counseling. At one-month follow-up, he reported complete resolution of daytime symptoms. Repeat polysomnography demonstrated significant improvement, with AHI reduced to 38/hour, desaturation index to 19/hour, and minimum O₂ saturation improved to 70%. Holter monitoring confirmed normalization of sinus rhythm, with a mean heart rate of 68 bpm and no further pauses. Pacemaker implantation was therefore avoided. Conclusion: This case highlights the complete reversibility of sinus node dysfunction after treatment of severe SAHS with CPAP therapy. It underscores the need to systematically consider sleep-disordered breathing in patients with unexplained bradyarrhythmias, particularly in younger individuals without cardiac comorbidities. Identifying SAHS as an underlying cause may dramatically alter the therapeutic strategy, preventing unnecessary device implantation and its long-term complications. Beyond improving quality of life, CPAP should be recognized as a potential disease-modifying therapy for rhythm disturbances. Early screening, accurate diagnosis, and prompt initiation of noninvasive ventilation may represent a decisive step in redefining the management of SND in the context of sleep apnea.