Recently Candida auris has emerged as a multi-resistant fungal pathogen, with a significant clinical impact, and is able to persist for a long time on human skin and hospital environments. It is a critical issue on the WHO fungal priority list and therefore it is fundamental to reinforce hospital surveillance protocols to limit nosocomial outbreaks. The purpose of this study was to apply Fourier transform infrared spectroscopy (FT-IR) to investigate the phylogenetic relationships among isolated strains from a C. auris outbreak at the University Intensive Care Unit of a Tertiary University hospital in Turin (Italy). To calculate a clustering cut-off, intra- and inter-isolate, distance values were analysed. The data showed the presence of a major Alfa cluster and a minor Beta cluster with a defined C. auris clustering cut-off. The results were validated by an external C. auris strain and Principal Component and Linear Discriminant Analyses. The application of FT-IR technology allowed to obtain important information about the phylogenetic relationships between the analysed strains, defining for the first time a “not WGS-based” clustering cut-off with a statistical–mathematical approach. FT-IR could represent a valid alternative to molecular methods for the rapid and cost-saving typing of C. auris strains with important clinical implications.

Antimicrobial resistance (AMR) represents one of the most urgent global health threats, significantly impacting patient outcomes, healthcare systems, and economic sustainability. Rapid and accurate antimicrobial susceptibility testing (AST) are essential to guide targeted therapy, reduce inappropriate antimicrobial use, and support antimicrobial stewardship programs. However, conventional phenotypic AST methods, including broth microdilution, disk diffusion, agar dilution, and gradient strip tests, remain labor-intensive and require prolonged turnaround times, often delaying optimal therapeutic decisions. Although automated commercial platforms such as VITEK 2, BD Phoenix, MicroScan WalkAway, and Sensititre ARIS have improved laboratory workflow and standardization, they still rely on culture-based approaches and typically require 16–36 h to generate minimum inhibitory concentration (MIC) results. In recent years, several innovative rapid phenotypic AST technologies have emerged, aiming to significantly shorten the time to susceptibility results while maintaining high accuracy. This review provides an overview of currently available rapid automated phenotypic platforms for MIC determination, including VITEK^® Reveal™, ASTar, FASTinov^®AST, QuickMIC^®, and the Accelerate Pheno^® system. These systems employ advanced technologies such as volatile organic compound detection, flow cytometry, microfluidics, real-time imaging, and morphokinetic cellular analysis to deliver susceptibility results within a few hours directly from positive blood cultures. We summarize their technical principles, antibiotics and pathogens included, performances, and current limitations. Overall, the implementation of rapid phenotypic AST tools has the potential to substantially improve clinical decisions, optimize antimicrobial therapy, and contribute to fight AMR.

Recently Candida auris has emerged as a multi-resistant fungal pathogen, with a significant clinical impact, and has become a critical issue in WHO fungal priority list, due to its unique ability to persist for long time on human skin and hospital environments. It is therefore fundamental to reinforce hospital surveillance protocols to limit nosocomial outbreaks. The study purpose was the Fourier-Transform Infrared Spectroscopy (FT-IR) application to investigate the phylogenetic relationships between isolated strains within the C. auris outbreak at the university Intensive Care Unit of a Tertiary University hospital in Turin (Italy). In order to calculate a clustering cut-off, intra- and inter-isolates distance values were analysed. Data showed the presence of a major cluster Alfa and a minor cluster Beta with a defined C. auris clustering cut-off. The results were validated by an external C. auris strain and Principal Component and Linear Discriminant Analysis. The application of FT-IR technology had allowed to obtain important information about the phylogenetic relationships between the analysed strains, defining for the first time a “not WGS-based” clustering cut-off with a statistical-mathematical approach. FT-IR could represent a valid alternative to molecular methods for rapid and cost saving typing of C. auris strains with important clinical implications.

Background: Lung transplantation is a life-saving option for patients with end-stage respiratory diseases, but risk of infections remains critical for ensuring long-term organ function. This study aimed to assess immune recovery in lung transplant recipients by measuring IFN-γ levels using the QuantiFERON Monitor Test (QFM). Results were correlated with episodes of infection and organ rejection to explore the assay’s predictive potential. Methods: A retrospective study was conducted on 15 lung transplant recipients at the Lung Transplant Centre of Turin (Città della Salute e della Scienza di Torino, Italy) between December 2019 and January 2023. Patients were divided into a High Infection (HI) group (with >3 infections) and Low Infection (LI) group (with ≤3 infections). QFM assays were performed after 18 months post-transplant. Results: HI patients had lower QFM levels compared to LI (68.84 ± 21.98 vs. 380.54 ± 104.64 UI/mL, p = 0.033). A QFM value <89.5 UI/mL was associated with increased infection risk (p < 0.05). Patients with lower QFM levels also exhibited higher rates of MRSA bacteremia during hospitalization (50% HI vs. 0% LI, p = 0.04). No differences were observed in acute or chronic rejection rates, but LI patients showed more frequent alveolar neutrophilia at the fourth month post-transplant (0% HI vs. 55.5% LI, p = 0.04). Conclusion: lower QFM values were associated with higher infection risk, highlighting the assay’s potential for immune monitoring. In this study, a QFM value of 89.5 UI/mL showed good predictive accuracy for infections beyond 18 months. Further studies are needed to refine QFM’s role in post-transplant care.

Background. Over the past decade, the World Health Organization has highlighted the need for rapid molecular diagnostics as first-line tools for detecting Mycobacterium tuberculosis complex (MTBC) to strengthen global tuberculosis control. At the same time, infections caused by non-tuberculous mycobacteria (NTM) have become increasingly prevalent, particularly in low TB-burden countries such as Italy. This changing epidemiological scenario underscores the necessity for fast and reliable methods capable of distinguishing NTM from MTBC, a critical step for guiding appropriate treatment. This study evaluated the diagnostic accuracy and potential applications of the STANDARD™ M10 MTB/NTM assay, which simultaneously detects and differentiates MTBC and NTM. Methods. A total of 155 clinical specimens (78.1% respiratory) from patients with suspected mycobacterial infection were tested by fluorescence microscopy, GeneXpert MTB/RIF Ultra (respiratory samples only), STANDARD™ M10 MTB/NTM and culture, used as the reference method. Results. Culture detected MTBC in 54% and NTM (predominantly slow-growing species) in 46% of samples. STANDARD™ M10 showed overall sensitivity and specificity of 70% and 100%, respectively. For MTBC, sensitivity was 85.1% with almost perfect agreement with culture (κ = 0.866), while for NTM, sensitivity was 50% with moderate agreement (κ = 0.566). Sensitivity decreased in microscopy-negative/culture-positive specimens, particularly for NTM. Compared with GeneXpert MTB/RIF Ultra, STANDARD™ M10 exhibited slightly lower sensitivity for MTBC but retained excellent specificity. Conclusions. STANDARD™ M10 MTB/NTM represents a rapid, fully automated tool to support early etiological diagnosis and MTB/NTM differentiation, mainly in selected samples or high-risk patients, but it does not replace culture or molecular tests providing species identification and MTBC drug-resistance profiling.

The global spread of extended-spectrum beta-lactamase (ESBL) producing Enterobacterales represents a major clinical challenge often requiring carbapenem use with the consequent risk of selecting carbapenemase-producing strains. Recently, new beta-lactam plus beta-lactamase inhibitor formulations available could provide effective carbapenem-sparing alternatives. Among these, cefepime/enmetazobactam (FEP-ET) is tailored for ESBL infection treatment. Here, we tested cefepime/enmetazobactam against a multicentric collection of 112 CTX-M producing E. coli and K. pneumoniae isolated in Northern Italy in order to evaluate the performance of gradient strip and disk diffusion (DD) test compared to broth microdilution, and to assess the in vitro antimicrobial activity of this new formulation. Molecular testing for bla genes and CTX-M typing were also performed. The results showed 100% of categorical agreement and no major error or very major error. All strains were susceptible to cefepime/enmetazobactam while resistance was observed only in carbapenemase-producing strains. CTX-M-1 was predominant and several strains carried blaTEM and blaSHV. These data demonstrate a good in vitro activity of cefepime/enmetazobactam against CTX-M producing E. coli and K. pneumoniae . Moreover, DD proved reliable and reproducible for routine testing while gradient strips underestimated MIC values which could be critical for isolates near the breakpoint.