Antibiotics

Background. The aim of this study is to analyze changing trends in isolated organisms and antibiotic resistance of bacterial keratitis (BK) over 26 years. Methods. A retrospective medical record review included 542 strains isolated from 462 BK patients between 1998 and 2023. We analyzed routinely generated in vitro antibiotic susceptibility testing results recorded in the laboratory information system and did not perform additional susceptibility testing for research purposes. The entire period was divided into two (first half: 1998–2010, 297 isolates from 255 patients; second half: 2011–2023, 245 isolates from 207 patients) and compared. Results. During the entire period, Staphylococcus spp. (32.3%) and Pseudomonas spp. (18.1%) were common isolates, and a significant increase in Acinetobacter spp. (1.3% vs. 10.6%, p < 0.001) was observed. Among Gram-positive bacteria, methicillin resistance rates remained stable between the two periods (52.6% vs. 46.7%, p = 0.525), and an increase in vancomycin-resistant Enterococci (VRE, 0% vs. 26.1%, p = 0.074) was found. Among Gram-negative bacteria (GNB), ciprofloxacin (7.5% vs. 14.4%, p = 0.108) and imipenem (2.9% vs. 6.5%, p = 0.255) resistance increased slightly, resistance to ceftazidime (resistance to ceftazidime (8.3% vs. 8.8%, p > 0.999) was maintained, and resistance to aminoglycosides (17.8% vs. 7.2%, p = 0.010) decreased. Conclusions. Our study suggests that conventional topical fortified antibiotic eye drops (tobramycin, ceftazidime) can still be considered as an empirical treatment option for BK. However, our findings revealed a long-term trend of increasing Acinetobacter spp. and VRE, as well as a slight trend of increasing resistance to ciprofloxacin and imipenem in GNB, which may present future challenges in BK treatment.

Background: Listeria monocytogenes infection during pregnancy remains an underrecognized cause of severe neonatal disease, frequently leading to central nervous system (CNS) involvement with high mortality and long-term neurological sequelae. Case presentation: We report a case series of four neonates with confirmed neonatal listeriosis and neurological complications, managed in a tertiary neonatal intensive care unit (NICU). Clinical features, microbiological findings, neuroimaging, treatments, and outcomes were analyzed. Our cases presented with early-onset disease and severe clinical courses, including sepsis, meningitis, ventriculitis, hydrocephalus, and seizures. Neuroimaging revealed extensive CNS injury, ranging from intraventricular hemorrhage to multiloculated hydrocephalus. Outcomes varied from near-normal neurodevelopment to profound neurological impairment, despite appropriate antimicrobial therapy. A narrative review of previous cases of neonatal listeriosis was also performed to contextualize our findings. Conclusions: Neonatal listeriosis remains associated with severe neurological morbidity. Early recognition, advanced neuroimaging, multidisciplinary management, and preventive maternal strategies are essential to improve outcomes.

The hands of dental students and practitioners are a key epidemiological factor in the transmission of infections associated with dental care. Strict adherence to the established hand hygiene protocols, combined with regular training and monitoring the quality of the performed hygienic hand disinfection, is crucial for ensuring safe dental practice. Objectives: The aim of the study is to assess the quality of hand antisepsis performed with alcohol-containing preparation among dental students and practicing dentists. Methods: A prospective epidemiological and microbiological study was conducted on 225 people—149 students from the 4th, 5th and 6th year of training at the Faculty of Dental Medicine, Plovdiv, and 76 dentists. The skin antiseptic was applied according to the “six steps” method with alcohol-based antiseptics. The samples were taken with a dry sterile swab. Results: The comparison between students and practicing dental medical doctors shows that the latter have a higher relative share of samples with microbiological growth 12 (15.8%), including coagulase-negative staphylococci (CoNS) above 10⁵ CoNS, compared to students 6 (4.0%), (p = 0.004). Gram-negative microbiological isolates indicate a statistically significant gender dependence (p = 0.016)—15 in men (15.8%), compared to 7 in women (5.4%). Growth of fungi (yeasts and mols) is statistically significant depending on gender (p = 0.015) and is observed only in men. Conclusions: The presence of significant microbial counts of CoNS is an indicator of insufficiently effective hygienic hand disinfection. The recovery of Gram-negative enteric bacteria is unacceptable and suggests serious shortcomings in the hygienic disinfection of some of the samples studied. Students demonstrated superior hand antisepsis performance compared to practicing dentists.