Background: Echinocandins are recommended for the treatment of suspected or confirmed invasive candidiasis (IC) in adults. Less is known about the use of echinocandins for the management of IC in children. The aim of this study was to investigate the overall efficacy and safety of echinocandin class in neonatal and pediatric patients with IC.Methods: PubMed, Cochrane Central, Scopus and Clinical trial registries were searched up to July 27, 2017. Eligible studies were randomized controlled trials that evaluated the efficacy and safety of any echinocandin versus agents of other antifungal classes for the treatment of IC in pediatric patients. The primary outcome was treatment success with resolution of symptoms and signs, and absence of IC. In the meta-analysis a random effects model was used, and the odds ratio (OR) and 95% confidence intervals (CIs) were calculated.Results: Four randomized clinical trials (324 patients), 2 confirmed IC (micafungin vs. liposomal amphotericin B (L-AmB) and caspofungin vs. L-AmB) and 2 empirical therapy trials (caspofungin vs. deoxycholate amphotericin B and caspofungin vs. L-AmB) were included. There was no significant difference between echinocandins and comparator in terms of treatment success (OR = 1.61, 95% CI: 0.74–3.50) and incidence of treatment-related adverse events (OR = 0.70, 95% CI: 0.39–1.26). However, fewer children treated with echinocandins discontinued treatment because of adverse events than amphotericin B formulations (OR = 0.26, 95% CI: 0.08–0.82,P= 0.02).Conclusions: In the treatment of IC in children, echinocandins show non-inferior efficacy compared with amphotericin B formulations with fewer discontinuations than in comparator arm.

Background: Hospitalized COVID-19 patients are particularly vulnerable to secondary bacterial infections, which can significantly worsen clinical outcomes. The aim of the study was to identify the cause of bacteremia in a group of hospitalized COVID-19 patients and find out the source of the outbreak to prevent further spread. Methods: Pathogen identification in blood cultures and sensitivity testing were carried out using the automated VITEK2 system. A total of 110 samples were tested; these were collected from patients’ colonization sites and from surfaces, materials and fluids used in the setting. Furthermore, multilocus sequence typing (MLST) and next-generation sequencing (NGS) were employed to characterize the isolates. Results: Achromobacter xylosoxidans was detected in the blood of nine hospitalized patients and in cotton used for disinfection; all isolates presented an identical antibiotic resistance pattern, and all carried the bla_OXA-114 gene which is intrinsic to this species. Infection control measures were implemented promptly. With one exception, all patients recovered and were discharged in good health. Conclusions: This outbreak underscores the urgent need for investigation and control of hospital infections, as bacteremia is associated with increased morbidity, mortality, hospitalization time, and cost. It also highlights the importance of close collaboration among healthcare professionals.

Τhe objective of this study was to assess the in vitro synergy between the new antibacterial agents CZA, M/V and I/R combined with aztreonam (AZM), colistin (COL) and fosfomycin (FOS) against MBL producing Klebsiella pneumoniae strains. This was done to identify the most effective combination regimen that could offer alternative treatment options for infections caused by MBL carbapenemase-producing Klebsiella pneumoniae.A total of 169 MBL-producing Klebsiella pneumoniae single clinical isolates (89 NDM, 66 NDM+KPC and 14 VIM) were included in the study, collected between 1 March 2023 and 30 September 2024. Of these, 86 were isolated from urine, 45 from blood, 27 from wound cultures and 11 from bronchoalveolar secretions. the strongest synergistic effects were observed with the combination of AZM plus CZA, MV, and IR, followed by combinations of FOS plus CZA, MV, and IR, suggesting promising therapeutic options for MBL-producing CRKP infections. Additionally, COL-based combinations with CZA, MV, and IR provided a better additive effect, emphasizing the need for tailored therapeutic strategies.