Search Results (135)

Background/Objectives: Since 2023, a significant increase in measles cases has been reported worldwide, and Italy has been among the most affected European countries. In this context, the integration of laboratory and epidemiological data enables timely case classification and helps distinguish between imported and indigenous cases, supporting disease control. However, most studies address only selected aspects of surveillance. Therefore, this study aimed to provide an integrated analysis of virological and epidemiological surveillance activities conducted between November 2023 and December 2025 by the Regional Reference Laboratory in the Emilia-Romagna Region (ERR). Methods: A total of 806 clinical samples (269 urine, 267 oral fluids—saliva or oropharyngeal swabs—and 270 sera) from 291 suspected measles cases were tested by molecular and/or serological methods, and MV genotyping was performed. Samples from discarded cases were also analysed for parvovirus B19 (B19V), human herpesvirus 6 (HHV-6), enterovirus (EV), and varicella zoster virus (VZV), chikungunya virus (CHIKV) and dengue virus (DENV). Results: Of 291 suspected cases, 176 (60.5%) were confirmed. Median age was 33 years, with 46% in the 15–39 year group. Vaccination status was available for 165: 90.3% were unvaccinated, 5.4% had one dose, and 4.2% had two doses. Notably, over half of confirmed cases occurred in areas with vaccine-hesitant communities. MV strain characterisation was performed in 99.4% of MV-RNA positive cases, with 84.3% genotype D8 and 15.6% genotype B3; 83% of strains were of indigenous origin, suggesting an ongoing endemic circulation. Clinical data showed complications in 19.3%, mainly pneumonia and diarrhoea. Additionally, differential diagnosis enabled the identification of the etiological agent in 37.5% of measles/rubella discarded cases, and 37.6% (29/77) tested positive for B19V. Conclusions: The study results highlight that effective measles surveillance must be supported by integrating timely virological diagnosis, molecular and epidemiological investigations, and differential diagnosis, to achieve the WHO goals of eliminating measles transmission. Full article

Clostridioides difficile infection (CDI) remains a major cause of healthcare-associated morbidity and mortality, particularly among older adults and patients with recent healthcare exposure, underscoring the need for early risk stratification and accurate prognostic assessment. This retrospective observational study evaluated clinical, laboratory, and therapeutic factors associated with disease severity and in-hospital mortality, and assessed the predictive performance of the ATLAS score and the Charlson comorbidity index. A total of 101 adult inpatients with laboratory-confirmed CDI admitted to a Portuguese tertiary care hospital were included. Data were extracted from clinical records and analysed using comparative statistics, multivariable logistic regression, and Kaplan–Meier survival analysis. Advanced age, elevated white blood cell count, renal dysfunction, and prior exposure to multiple antibiotic classes were independently associated with increased disease severity and mortality. The ATLAS score demonstrated good discriminative ability, particularly for short-term mortality, and showed higher sensitivity compared with the Charlson comorbidity index. These findings provide additional evidence on clinical and laboratory factors associated with severe CDI and in-hospital mortality, while supporting the utility of the ATLAS score as a practical tool for early risk stratification in hospitalised patients. Full article

Transmissible viral proventriculitis (TVP) is an emerging disease in chickens, linked to chicken proventricular necrosis virus (CPNV), a recently identified birnavirus. Here, we provide the first molecular confirmation of TVP in Bangladesh from a coloured meat-type parent stock (PS) flock, while documenting a contemporaneous white layer flock with consistent clinical signs and characteristic gross lesions. Affected birds exhibited growth retardation, diarrhoea, and increased mortality, alongside hallmark gross changes in proventricular enlargement and wall thickening. From the meat-type PS, proventricular samples were collected for histopathology and molecular diagnostics. Histological analysis revealed severe glandular epithelial damage, necrosis, mononuclear infiltration, epithelial hyperplasia, and metaplasia. Using RT-PCR on nucleic acid extracted from FTA card samples, CPNV was detected. In addition, infectious bronchitis virus (IBV), infectious bursal disease virus (IBDV), and avian reovirus (ARV) nucleic acids were also identified. The amplified CPNV VP1 fragment was sequenced, and phylogenetic analysis placed the Bangladeshi strain within clades of previously reported CPNV isolates. This study represents the first molecularly confirmed report of CPNV associated with TVP in Bangladesh, highlighting the need for active surveillance in commercial and breeder poultry flocks to understand the virus’s epidemiology and support the development of control strategies. Full article

The human gut microbiota plays a key role in health and disease across the lifespan and is shaped by complex intrinsic and extrinsic factors. Dysbiosis is increasingly recognized as a contributor to a wide range of clinical conditions, with diarrhoea—particularly antibiotic-associated diarrhoea—representing an early clinical marker of microbiota disruption. This narrative review summarizes current evidence on the probiotic yeast Saccharomyces boulardii CNCM I-745 and its clinical applications in both paediatric and adult populations. Available clinical data support its safety and efficacy in the prevention and management of gastrointestinal disorders, particularly diarrhoeal conditions, and suggest a potential role in promoting microbiota resilience. Key mechanisms of action, safety considerations, and findings from randomized controlled trials and meta-analyses are discussed. However, current data remains limited by heterogeneity among studies and a lack of long-term, mechanistic data, highlighting the need for further well-designed studies to clarify its role across different clinical settings. Full article

Enteric infections remain a major health and economic challenge in swine production, with outcomes determined not only by pathogen virulence but also by the complex interplay between host genetics, immune competence, and the intestinal microbiota. This review synthesises current knowledge on host–pathogen genomic interactions in pigs, with a focus on resilience mechanisms against enteric diseases in swine. For this purpose, 103 articles were used as information sources, retrieved through structured keyword searches in PubMed. The review first addresses host genetic factors, highlighting genomic variants and quantitative trait loci associated with resistance or resilience to viral and bacterial pathogens such as porcine epidemic diarrhoea virus (PEDV) or Escherichia coli. Next, the key factors of the immune system to confer protection are also reviewed, emphasising the role of innate and adaptive responses in controlling each pathogen and disclosing the contribution of regulatory networks that balance pathogen clearance. Finally, the last section of the review is devoted to exploring current knowledge in the involvement of the microbiota in resilience against enteric pathogens, mostly, but not exclusively, enteric bacteria. In this sense, competitive exclusion is a concept which has gained attention in recent years. The review pinpoints and discusses the state of the art about how the microbial community provides colonisation resistance, shapes immune development, and influences pathogen fitness within the intestinal niche. As final perspectives, the review explores future drivers in the genetic immune and microbiota resistance. By bridging host genomic data with functional insights into immunity and microbial ecology, this review underscores the potential of multi-omics approaches to enhance resilience against enteric infections in pigs and advance sustainable swine health management. Full article

Background: Clostridioides difficile infections (CDIs) are caused by a Gram-positive, spore-forming bacillus and are defined by more than three episodes of watery diarrhoea per day. CDI is a major cause of morbidity and mortality in older adults, particularly over 65 years. Recurrent CDI leads to higher mortality and prolonged, debilitating illness. Case Presentations: This article presents two patients, aged over 80 years old, who developed recurrent CDI causing complicated and prolonged treatment courses. Patient 1 required an extended course of antibiotics for treatment of discitis and a congruent psoas abscess. Patient 2 developed CDI after multiple short courses of antibiotics for urinary tract infections (UTIs) in the context of multiple comorbidities. Both patients experienced three distinct episodes of CDI and were treated in collaboration with microbiology specialists. Following the third episode, both were successfully treated with oral capsule faecal microbiome transplants (FMTs). Their cases highlight the challenge of balancing systemic antibiotic use against CDI risk. Discussions: These cases underscore known risk factors for recurrent CDI, including advanced age and prolonged antibiotic exposure. Recurrence rates in patients over 65 can reach 58%. The British Society of Gastroenterology and Healthcare Infection Society support the use of FMTs in recurrent cases. Environmental decontamination, including terminal cleaning with sporicidal agents, is critical in reducing reinfection in hospital settings. Conclusions: Recurrent CDI in elderly patients reflects a complex interplay between infection control and managing comorbidities. New guidelines suggest that FMTs can significantly reduce morbidity and mortality. These cases emphasise the need for individualised, multidisciplinary care, adherence to guidelines, and further research to improve safe, effective CDI management in older adults. Full article

This case describes an outbreak of salmonellosis caused by Salmonella enterica subspecies enterica serotype Agona in a Rottweiler breeding kennel, associated with raw meat-based diet (RMBD) of unlicensed origin. The report presents the clinical, epidemiological, and microbiological characteristics of the outbreak, as well as the control and preventive measures undertaken. Methods: Samples of faeces, vomit, raw food, and environmental surfaces were collected and examined. The isolated pathogen was identified using bacteriological culture, biochemical testing, MALDI-TOF mass spectrometry, and serotyping according to the White–Kauffmann–Le Minor scheme. Antimicrobial susceptibility was determined by the broth microdilution method in accordance with standards of Clinical and Laboratory Standards Institute (CLSI). Results: Clinical signs included vomiting, diarrhoea, lethargy, and dehydration without fever, with disease exacerbation observed in post-partum animals. Extensive carriage and faecal shedding of S. Agona were detected in affected dogs, along with widespread contamination of food and the kennel environment. The isolate was susceptible to some antimicrobial agents but resistant to cephalexin, aminoglycosides, lincosamides, macrolides, and fusidic acid, and showed intermediate susceptibility to polymyxin B. Following discontinuation of raw meat feeding, targeted antimicrobial therapy, and environmental disinfection, all dogs recovered, and subsequent tests for Salmonella spp., were negative. All human contacts also tested negative. Conclusions: This represents the first documented outbreak of S. Agona infection in dogs in Bulgaria linked to a RMBD. The findings emphasise the importance of feed safety, biosecurity, and traceability of feed sources in kennels, as well as the potential zoonotic risk associated with raw feeding practices. The diagnostic and therapeutic measures implemented in this case provide an effective model for managing similar epidemiological events within the One Health framework. Full article

Background: Post-colonoscopy syndrome is an emerging clinical entity characterised by the onset of gastrointestinal symptoms following a colonoscopy. The current management of this syndrome has not yet been established, although probiotics have been proposed. The therapeutic potential of a combination nutraceutical compound based on HBQ-Complex^®, butyrate, and probiotics (Lactobacillus acidophilus, Bifidobacterium animalis, and Lactiplantibacillus plantarum) in this setting remains unknown. Methods: A retrospective, multicentre, observational study was conducted in adult patients undergoing colonoscopy in the absence of known gastrointestinal diseases, assessing the onset of upper and lower gastrointestinal symptoms post-colonoscopy immediately after the procedure (T₀), at 2 weeks (T₁), and 4 weeks (T₂) thereafter, using a VAS (0–10). Two groups were analysed, one undergoing nutraceutical supplementation and a control group. Results: A total of 599 patients were included (64.9% receiving nutraceutical supplementation and 35% in the control group). Several variations were observed involving the treated group compared to the control for abdominal pain (59.9% vs. 33.3%), meteorism (64.9% vs. 35.1%), diarrhoea (46.9% vs. 19.5%), and bloating (59.3% vs. 26.7%) (p < 0.001 for all). Logistic regression analysis showed a reduction in constipation (OR: 3.344) and bloating (OR: 3.791) scores. Conclusions: Nutraceutical supplementation based on this combinational compound was associated with a reduction in gastrointestinal symptoms arising after colonoscopy, suggesting potential benefit in this setting. These findings pose a rationale for controlled prospective studies to confirm such evidence in broader clinical settings. Full article

Escherichia coli is a significant cause of Neonatal Calf Diarrhoea (NCD). Its extensive antigenic diversity, coupled with the ability to acquire antimicrobial resistance determinants, hampers treatment effectiveness and compromises the control measures. This study investigated the link between the presence of multidrug-resistant (MDR) E. coli and virulence factors (VFs) in NCD from central France (Departments of Cantal, Haute-Loire, Loire, and Puy-de-Dôme), between 2016 and 2022. E. coli was identified at TERANA Laboratories, France, using API 20E (BioMérieux^®) and MALDI-TOF Mass Spectrometry. Virulence factors, namely adhesins, were assessed with the slide agglutination method, and antimicrobial susceptibility testing was conducted across various antimicrobial classes. Out of 2367 E. coli strains isolated from cases of NCD, a high percentage were resistant to aminopenicillins (88.8%), aminoglycosides (89.1%), tetracyclines (79.7%), quinolones (48.4%), and sulphonamides (42.4%). More than half (58.6%) carried VFs, and 84.9% exhibited MDR profile, of which 61.34% (1233/2010) also harboured VFs. The adhesin CS31A-producing E. coli was the most prevalent, followed by the fimbrial adhesins F5 and F17 (60.8%, 20.0%, and 8.3%, respectively), all of which were associated with a high prevalence of MDR strains (79.1–93.9%). The highest occurrence of MDR profiles was observed in E. coli strains carrying CS31A and in those lacking VFs, both groups showing co-resistance to aminopenicillins, aminoglycosides, and tetracyclines or sulphonamides. The calf production sector may act as a reservoir for MDR E. coli strains, regardless of the presence of VFs, posing a major threat to public health and safety. Full article

Background/Objectives: A new multivalent vaccine (DIVENCE^® PENTA), containing Bovine viral diarrhoea virus (BVDV) types 1 and 2 recombinant proteins, live gE/tk double gene deleted Bovine Herpesvirus type 1 (BoHV-1 or IBR), live attenuated Bovine respiratory syncytial virus (BRSV) and inactivated parainfluenza-3 virus (PI-3) has been designed to protect cattle against the main viral pathogens associated with Bovine respiratory disease (BRD). The aim of this study was to demonstrate the efficacy of DIVENCE^® PENTA against experimental infections with BVDV-1, BVDV-2, IBR, BRSV and PI-3 in young calves. Methods: Ten-week-old calves were given two intramuscular doses three weeks apart. The efficacy was evaluated by means of an experimental challenge three weeks after vaccination. Serology, clinical signs, rectal temperature, white blood cell count, viral shedding and lung lesions were monitored after the challenge. Results/Conclusions: The results demonstrated a significant sparing of BRD in calves vaccinated with DIVENCE^® PENTA, as evidenced by fewer clinical signs, lower rectal temperatures, reduced viral shedding and less severe pulmonary lesions compared to control animals. A significant reduction in hyperthermia, leukopenia and viraemia post-challenge was also observed, highlighting the efficacy of the multivalent vaccine against BVDV types 1 and 2, IBR, BRSV and PI-3 in young calves. Full article

Neonatal calf diarrhoea (NCD) is the leading cause of mortality in calves under 30 days old. Although several pathogens are usually involved in outbreaks, most previous research has focused on specific enteropathogens or on the four agents traditionally associated with this syndrome. This study aimed to determine the prevalence of thirteen enteropathogens in 420 diarrhoeic calves under a month of age from north-western Spain and to identify the most frequent co-occurrences. Four diarrhoeagenic pathotypes of Escherichia coli, bovine rotavirus A, coronavirus, norovirus, nebovirus and torovirus were identified using qPCR. Presence of Salmonella spp. was studied using a serum agglutination test. A direct immunofluorescence assay was employed to identify Cryptosporidium and Giardia duodenalis oo/cysts. Eimeria oocysts were found by the floatation technique. Our results confirm the co-occurrence of agents in most cases of NCD. A total of 172 pathogen combinations, involving up to seven agents, were identified. Cases involving one or more viral agents and Cryptosporidium parvum were predominant, maybe because viral immunosuppression facilitates the protozoan life-cycle. The frequent detection of agents typically overlooked in the aetiological diagnosis of NCD suggests that they may play a role in this syndrome and thus should be included in routine diagnostic panels, allowing implementing the most effective control measures. Full article

Cinnamaldehyde (CA) is a potential substitute for antibiotic growth promoters in animal breeding. In this study, we investigated its effects as a dietary supplement on growth performance, serum antioxidant capacity, intestinal digestive enzyme activities, intestinal morphology, and caecal microbiota in meat rabbits. Weaned meat rabbits (n = 450) were randomly assigned to five groups, Groups A, B, C, D, and E, and fed 0, 50, 100, 150, and 200 mg/kg CA diets, respectively, for 47 days. Biological samples including serum (antioxidants), duodenal/caecal content (enzymes), intestinal tissue (morphology), and caecal digesta (microbiota) were collected at day 47 postweaning for analysis. Groups C and D showed significantly higher final body weights than Group A, with Group D (150 mg/kg CA) demonstrating superior growth performance including 11.73% longer duodenal villi (p < 0.05), 28.6% higher microbial diversity (p < 0.01), and 62% lower diarrhoea rate versus controls. Digestive enzyme activity as well as serum antioxidant capacity increased with increasing CA dose, Microbiota analysis revealed CA increased fibre-fermenting Oscillospiraceae (+38%, p < 0.01) while reducing Ruminococcaceae (−27%, p < 0.05). Thus, dietary CA supplementation at 150 mg/kg was identified as the optimal CA dose for improving meat rabbit production. These findings highlight CA as a functional feed additive for promoting sustainable rabbit production. Full article

The bovine viral diarrhoea virus (BVDV) impacts the health and performance of bovine herds. In the present retrospective study, the impact of BVDV control on the production performance of suckler herds was tested by vaccinating all female cows of the herd on the same day (DV). The performance of cows in two commercial suckler herds was analysed during 12 months before DV (PREVAC, n = 497 cows) and 9 to 21 months after vaccination (POSTVAC, n = 531 cows). The proportion of calves born compared to the initial number of cows subjected to mating did not differ (PREVAC and POSTVAC, 87% and 84%, respectively). The proportion of calves weaned compared to the initial number of cows subjected to mating also did not differ between PREVAC (71%) and POSTVAC (74%). However, the proportion of calves weaned compared to the number of calves born was higher than POSTVAC (87%) when compared to PREVAC (81%). Thus, the data demonstrate that a BVDV control programme using vaccination in suckler herds can improve calf survival. Full article

The use of lower crude protein (CP) diets immediately after weaning has long been associated with reduced post-weaning diarrhoea (PWD). However, failing to maintain an appropriate standardized ileal digestible lysine ratio (SID: Lys) may outweigh the benefits in improving PWD outcomes. In this experiment, 560 weaners were fed either a control diet (CON; 20.6% crude protein 1.34% standardized ileal digestible lysine, SID Lys: CP = 0.06), LH: a low crude protein, higher SID Lys: CP ratio diet (19.0% CP, 1.34% SID Lys, SID Lys: CP = 0.07), or LL: a low crude protein control SID Lys: CP ratio diet (18.7% CP, 1.1% SID Lys, SID Lys: CP = 0.05) for 1 week after weaning. Pigs were scored for the presence or absence of diarrhoea for 12 days after weaning. Blood samples were taken on days 5, 12 and 28 for inflammatory marker analyses and plasma creatinine analyses. Relative to the CON diet, there was a 42% reduction in the diarrhoea index in pigs fed the LH diet and a 63% reduction in those fed the LL diet (p < 0.05), but LH was significantly higher than LL. There tended to be a greater average daily gain in the LH diet in the first week post-wean (p = 0.054). In summary, lower crude protein diets, irrespective of Lys: CP ratio, were found to be effective at reducing PWD. Moreover, increasing the SID Lys: CP ratio by reducing the CP content of diets from 20.6 to 19% appeared to improve post-weaning growth. Full article

Background: Cachexia worsens prognosis, quality of life and chemotherapy treatment compliance of patients with lung cancer. Chemotherapy-induced cachexia has also been implicated in lowered mortality. This study aimed to evaluate the frequency of cachexia-related measures and symptoms as outcomes in lung cancer chemotherapy trial protocols and to examine how key trial characteristics influence them. Method: We conducted a cross-sectional data analysis of randomised controlled chemotherapy trials of lung cancer registered in four public trial registries between 2012 and 2023. Trial outcome measures included overall survival, treatment toxicity/side effects and cachexia-related indicators such as physical activity, weight/body mass index (BMI), dietary limitations, caloric intake and lean muscle mass. Symptom-related outcomes, including appetite loss, diarrhoea, pain, fatigue/insomnia, constipation, nausea, vomiting, dysphagia, dyspnoea and oral mucositis, were also extracted. Additionally, the number and type of performance status and assessment tool were recorded. Data were summarised descriptively. Chi-square tests were used to examine associations between trial outcomes and characteristics including cancer type, trial location, lead investigator/funding source, assessment tools and trial commencement year. A p < 0.05 was considered statistically significance. Results: Of the 335 trial protocols (non-small cell (87.2%) and small cell (12.8%)), most were from Europe (50.4%). The trial lead investigator was from industry (56.7%) followed by academia (25.1%). Allied health professional involvement was minimal (0.6%). Trial protocols mostly recorded overall survival (96.4%) and toxicity (83.9%). However, physical activity, weight/BMI, dysphagia, dyspnoea and oral mucositis were recorded in <30%, with dietary limitations, caloric intake and lean muscle mass recorded in <3% of the trials. Measures and symptoms were not associated with cancer type. Trial location was associated with the measures toxicity, physical activity and caloric intake and all symptoms. Lead investigator was associated with the measures toxicity and weight/BMI and all symptoms except for dyspnoea. Performance status and assessment tools were mentioned in 93.4% and 41.8% of the trials, respectively, with significant associations between assessment tools and outcomes, except for weight/BMI, dietary limitations, lean muscle mass, dysphagia and oral mucositis. There was a significant trend with trial commencement year for the measures physical activity (p = 0.002) and weight/BMI (p = 0.000) and all symptoms, except for appetite loss (p = 0.115) and pain (p = 0.433). Conclusions: While the reporting of measures and outcomes was generally higher compared to gastrointestinal chemotherapy cancer trials, it still faced significant under-reporting. Assessment tools should include cachexia-specific symptoms to accurately assess the quality of life in patients with lung cancer undergoing chemotherapy clinical trials. Full article