The chromogenic βLacta test developed for the rapid detection of β-lactamase-hydrolyzing extended-spectrum cephalosporins in Enterobacteriaceae revealed good performance with extended-spectrum β-lactamase (ESBL) producers (97.5% true-positive results). However, false-negative results occurred with chromosomal AmpC hyperproducers and plasmid AmpC producers, whereas uninterpretable results were mostly due to VIM-1 carbapenemase producers and possibly low levels of expressed ESBLs.

In December 2020, UK authorities warned of the rapid spread of a new SARS-CoV-2 variant, belonging to the B.1.1.7 lineage, known as the Alpha variant. This variant is characterized by 17 mutations and 3 deletions. The deletion 69–70 in the spike protein can be detected by commercial platforms, allowing its real-time spread to be known. From the last days of December 2020 and over 4 months, all respiratory samples with a positive result for SARS-CoV-2 from patients treated in primary care and the emergency department were screened to detect this variant based on the strategy S gene target failure (SGTF). The first cases were detected during week 53 (2020) and reached >90% of all cases during weeks 15–16 (2021). During this period, the B.1.1.7/SGTF variant spread at a rapid and constant replacement rate of around 30–36%. The probability of intensive care unit admission was twice higher among patients infected by the B.1.1.7/SGTF variant, but there were no differences in death rate. During the peak of the third pandemic wave, this variant was not the most prevalent, and it became dominant when this wave was declining. Our results confirm that the B.1.1.7/SGTF variant displaced other SARS-CoV-2 variants in our healthcare area in 4 months. This displacement has led to an increase in the burden of disease.

Introduction. The antimicrobial resistance is a significant public health threat, particularly for healthcare-associated infections caused by carbapenem-resistant Gram-negative pathogens which are increasingly reported worldwide. The aim of this study was to provide data on the in vitro antimicrobial activity of cefiderocol and that of commercially available comparator antibiotics against a defined collection of recent clinical multi-drug resistant (MDR) microorganisms, including carbapenem resistant Gram-negative bacteria collected from different regions in Spain and Portugal. Material and methods. A total of 477 clinical isolates of Enterobacterales, Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia were prospectively (n=265) and retrospectively (n=212) included (2016-2019). Susceptibility testing was performed using standard broad microdilution and results were interpreted using CLSI-2021 and EUCAST-2021 criteria. Results. Overall, cefiderocol showed a good activity against Enterobacterales isolates, being 99.5% susceptible by CLSI and 94.5% by EUCAST criteria. It also demonstrated excellent activity against P. aeruginosa and S. maltophilia isolates, all being susceptible to this compound considering CLSI breakpoints. Regarding A. baumannii (n=64), only one isolate was resistant to cefiderocol. Conclusions. Our results are in agreement with other studies performed outside Spain and Portugal highlighting its excellent activity against MDR gram-negative bacteria. Cefiderocol is a therapeutic alternative to those available for the treatment of infections caused by these MDR bacteria.

Background/Objectives: Periprosthetic joint infection (PJI) is a challenging problem in orthopedic surgery and is often associated with high morbidity. The treatment becomes even more challenging whenever the microorganism is virulent and/or not widely known as a causative organism on these occasions. This study aims to report on the clinical outcomes of hip hemiarthroplasty prosthetic hip joint infection by an atypical, rare microorganism, Morganella morganii (M. morganii), focusing on morbidity, revisions, and mortality. Methods: This is a retrospective series of four cases of prosthetic joint infections with Morganella morganii, a rare Gram-negative opportunistic facultative anaerobic pathogen, in four patients who received hip hemiarthroplasty for displaced femoral neck fractures at a level 1 trauma center. Clinical notes, laboratory findings, and radiographs were reviewed to extract relevant information regarding the history and outcomes. Results: The patients were four females, with a mean age of 84.27 years at the time of surgery. Two cases (50%) underwent surgical debridement and implant retention, followed by lifelong antibiotic suppression for symptomatic control of persistent wound drainage, and the other two underwent implant removal and resection arthroplasty (one patient) or received an antibiotic spacer (one patient), followed by chronic antibiotic therapy until wound closure. Conclusions: Periprosthetic hemiarthroplasty infection secondary to M. morganii was associated with overall poor outcomes. Antibiotic suppression could be a reasonable option after the surgical debridement or implant removal in M. morganii PJI to control the symptoms.