Timely diagnosis and treatment to prevent tuberculosis (TB) transmission and the consequent replenishment of the TB infection reservoir are essential for the control and elimination of TB worldwide [1], ultimately contributing the World Health Organization (WHO)'s End TB goals [2].

The possibility to rely on rapid and accurate diagnostic techniques has proved itself crucial during the past year to contain the spread of SARS-CoV-2 infection [1]. Even if quantitative RT-PCR (RT-qPCR) on nasopharyngeal swab (NPS) is still considered the standard for coronavirus disease 2019 (COVID-19) diagnosis, saliva has been evaluated in several studies as a possible alternative to NPS and is currently extensively utilised in South Korea, Germany and Japan [2, 3]. Nonetheless, the use of saliva is still debated, and a rigorous standardisation of the analysis protocol is greatly needed [4–6]. The application of point-of-care technologies on saliva, able to rapidly perform highly specific and sensitive molecular testing, could prove invaluable to allow the diagnosis also in challenging and remote settings by simplifying and speeding up the diagnostic process [1].

Cytomegalovirus (CMV) is the leading infectious cause of brain defects and neurological dysfunctions, including sensorineural hearing loss (SNHL). Targeted screening in neonates failing the hearing screen is currently recommended in Italy according to national guidelines. However, SNHL may not be present at birth; also, congenital CMV (cCMV) may manifest with subtle signs other than SNHL. Therefore, the inclusion of additional criteria for cCMV screening appears clinically valuable. Starting January 2021, we have implemented expanded targeted cCMV screening at our center, with testing in case of maternal CMV infection during pregnancy, inadequate antenatal care, maternal HIV infection or immunosuppression, birthweight and/or head circumference < 10th centile, failed hearing screen, and prematurity. During the first three years of use of this program (2021–2023), 940 (12.3%) of 7651 live-born infants were tested. The most common indication was birthweight < 10th centile (n = 633, 67.3%). Eleven neonates were diagnosed as congenitally infected, for a prevalence of 1.17% (95%CI 0.48–1.86) on tested neonates and of 0.14% (95%CI 0.06–0.23) on live-born infants. None of the cCMV-infected newborns had a failed hearing screen as a testing indication. Implementation of an expanded cCMV screening program appears feasible and of clinical value.

Toxoplasmosis (TG) is a zoonotic disease that, if contracted during pregnancy, can lead to fetal infection with severe complications. Currently, the only way to prevent maternal infection during pregnancy is to adopt hygiene practices. Our study aimed to evaluate pregnant women’s awareness of TG infection, their knowledge of TG-specific preventive hygiene measures, and factors linked to inadequate knowledge as potential targets for intervention. A prospective survey study was conducted at a university hospital between May and November 2023. A self-administered questionnaire was given to pregnant women. Out of 402 participants, 95.3% were aware that TG could be a potential issue in pregnancy. However, only 22.5% of them were able to identify all four correct hygiene behaviors to prevent TG infection acquisition during gestation. Women with a higher level of education, of European origin, and who had heard of other potentially serious conditions in pregnancy were more likely to have an appropriate level of knowledge about TG. Healthcare professionals and mass media, when employed as sources of information before conception, played a positive role in enhancing pregnant women’s awareness of TG. In conclusion, while pregnant women showed high levels of awareness of TG infection, their knowledge of preventive measures was limited, with only less than one-fourth with appropriate knowledge. This highlights the need for innovative strategies, possibly face-to-face interactions, digital tools, and public health campaigns, to improve the ability of healthcare professionals to deliver accurate and accessible information to reduce the risk of infection acquisition during gestation.

It has been shown that vertical transmission of the SARS-CoV-2 strain is relatively rare, and there is still limited information on the specific impact of maternal SARS-CoV-2 infection on vertical transmission. The current study focuses on a transcriptomics analysis aimed at examining differences in gene expression between placentas from mother–newborn pairs affected by COVID-19 and those from unaffected controls. Additionally, it investigates the in situ expression of molecules involved in placental inflammation. The Papa Giovanni XXIII Hospital in Bergamo, Italy, has recorded three instances of intrauterine transmission of SARS-CoV-2. The first two cases occurred early in the pandemic and involved pregnant women in their third trimester who were diagnosed with SARS-CoV-2. The third case involved an asymptomatic woman in her second trimester with a twin pregnancy, who unfortunately delivered two stillborn fetuses due to the premature rupture of membranes. Transcriptomic analysis revealed significant differences in gene expression between the placentae of COVID-19-affected mother/newborn pairs and two matched controls. The infected and control placentae were matched for gestational age. According to the Benjamani–Hochberg method, 305 genes met the criterion of an adjusted p-value of less than 0.05, and 219 genes met the criterion of less than 0.01. Up-regulated genes involved in cell signaling (e.g., CCL20, C3, MARCO) and immune response (e.g., LILRA3, CXCL10, CD48, CD86, IL1RN, IL-18R1) suggest their potential role in the inflammatory response to SARS-CoV-2. RNAscope^® technology, coupled with image analysis, was utilized to quantify the surface area covered by SARS-CoV-2, ACE2, IL-1β, IL-6, IL-8, IL-10, and TNF-α on both the maternal and fetal sides of the placenta. A non-statistically significant gradient for SARS-CoV-2 was observed, with a higher surface coverage on the fetal side (2.42 ± 3.71%) compared to the maternal side (0.74 ± 1.19%) of the placenta. Although not statistically significant, the surface area covered by ACE2 mRNA was higher on the maternal side (0.02 ± 0.04%) compared to the fetal side (0.01 ± 0.01%) of the placenta. IL-6 and IL-8 were more prevalent on the fetal side (0.03 ± 0.04% and 0.06 ± 0.08%, respectively) compared to the maternal side (0.02 ± 0.01% and 0.02 ± 0.02%, respectively). The mean surface areas of IL-1β and IL-10 were found to be equal on both the fetal (0.04 ± 0.04% and 0.01 ± 0.01%, respectively) and maternal sides of the placenta (0.04 ± 0.05% and 0.01 ± 0.01%, respectively). The mean surface area of TNF-α was found to be equal on both the fetal and maternal sides of the placenta (0.02 ± 0.02% and 0.02 ± 0.02%, respectively). On the maternal side, ACE-2 and all examined interleukins, but not TNF-α, exhibited an inverse mRNA amount compared to SARS-CoV-2. On the fetal side, ACE-2, IL-6 and IL-8 were inversely correlated with SARS-CoV-2 (r = −0.3, r = −0.1 and r = −0.4, respectively), while IL-1β and IL-10 showed positive correlations (r = 0.9, p = 0.005 and r = 0.5, respectively). TNF-α exhibited a positive correlation with SARS-CoV-2 on both maternal (r = 0.4) and fetal sides (r = 0.9) of the placenta. Further research is needed to evaluate the correlation between cell signaling and immune response genes in the placenta and the vertical transmission of SARS-CoV-2. Nonetheless, the current study extends our comprehension of the molecular and immunological factors involved in SARS-CoV-2 placental infection underlying maternal–fetal transmission.