Search Results (1,933)

Background: Pelvic inflammatory disease (PID) is a common and potentially severe infection of the upper genital tract. Complications such as tubo-ovarian abscess (TOA), sepsis, and diffuse peritonitis contribute significantly to reproductive morbidity, particularly when diagnosis or treatment is delayed. Aim: The aim of this review is to present an updated, clinically relevant synthesis of the current evidence on the epidemiology, microbiology, diagnostic approach, imaging modalities, and management of PID, with a focus on severe forms including TOA, sepsis, and peritonitis. Content: PID is most frequently initiated by sexually transmitted pathogens—primarily Chlamydia trachomatis and Neisseria gonorrhoeae—which rapidly progresses to a polymicrobial infection involving anaerobic and enteric organisms. Diagnosis is predominantly clinical, supported by nucleic acid amplification tests, inflammatory markers, and imaging. Transvaginal ultrasonography remains the first-line diagnostic approach for suspected TOA, while CT or MRI is reserved for unclear cases or to assess rupture. Mild to moderate disease is managed with broad-spectrum combination antibiotics, whereas severe PID or TOA requires hospitalization, parenteral therapy, and timely source control through image-guided drainage or surgery. Ruptured abscesses and PID-associated sepsis demand urgent surgical intervention and multidisciplinary supportive care. Tailored approaches are necessary in pregnancy, adolescence, and immunosuppressed and postmenopausal patients. Conclusions: Prompt recognition, a low threshold for empiric antimicrobial therapy, the appropriate use of imaging, and decisive escalation to drainage or surgery are essential to limit morbidity and preserve reproductive health. Integrating guideline-based practice with structured clinical pathways may improve outcomes and reduce long-term sequelae of PID. Full article

Background: Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition with limited treatment efficacy. Alternating current electroacupuncture (AC-EA) represents a novel neuromodulatory approach, though its mechanisms—particularly its influence on the gut–brain axis—remain underexplored. Methods: We investigated the neurobehavioral and microbiological effects of AC-EA in a rat model of PTSD induced by single prolonged stress. Animals received AC-EA at Baihui (GV20) and Mingmen (GV4) acupoints with varying parameters (0.5 mA/20 Hz, 1 mA/20 Hz, and 1 mA/2 Hz). Behavioral tests (open field test, elevated plus maze), histopathological assessments, immunofluorescence for TLR4, and 16S rRNA sequencing of gut microbiota were performed. Results: AC-EA at 1 mA/2 Hz significantly improved exploratory behavior and reduced anxiety-like responses (p < 0.05). This regimen also restored neuronal integrity in the hippocampus and cortex and reversed PTSD-induced gut dysbiosis, enriching beneficial genera such as Ligilactobacillus. Furthermore, AC-EA downregulated hepatic TLR4 expression, indicating suppression of neuroinflammatory signaling. Conclusions: Our findings demonstrate that AC-EA exerts neuromodulatory and microbiota-rebalancing effects via the gut–brain axis, highlighting its potential as a non-invasive therapeutic strategy for PTSD and related brain health disorders. Full article

Ballast water (BW) is a major pathway for the spread of invasive microorganisms and pathogens, posing significant ecological and public health risks. The International Maritime Organization (IMO) has established strict discharge standards, yet routine monitoring remains limited, and no reliable onboard test is currently available to assist crews in verifying BW quality before discharge. This study presents the development of a rapid, portable method for onboard microbiological assessment of BW, based on potentiometric detection and biosensors engineered with the Bioelectric Recognition Assay (BERA). Two complementary approaches were evaluated: (i) direct potentiometric measurements of contaminated and non-contaminated samples, which confirmed the feasibility of detecting microbial presence but were restricted by high detection limits, and (ii) development of biosensors specifically engineered for Escherichia coli and Enterococcus spp. to improve specificity and lower the limit of detection (LOD). Results demonstrated successful detection of both microorganisms, with performance characteristics of 83.3% sensitivity and 81.9% accuracy for Enterococcus spp. (LOD: 10² CFU 100 mL⁻¹), and 89.8% sensitivity and 85.1% accuracy for Escherichia coli (LOD: 250 CFU 100 mL⁻¹). These findings underscore the potential of biosensor-based systems as practical, crew-operated tools for early warning and real-time monitoring of ballast water quality, supporting compliance with IMO standards and contributing to safer, more sustainable maritime operations. Full article

Patients with multiple traumas, particularly those with traumatic brain injury (TBI), are among the most challenging cases in intensive care medicine. Although early orotracheal intubation and invasive mechanical ventilation (IMV) are essential for airway protection and neurological treatment, they significantly increase the risk of lower respiratory tract infection (LRTI), including ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT). These complications are particularly prevalent among neurocritical patients due to the distinctive interaction between the brain, lungs and immune system. This narrative review examines the current evidence on the mechanisms underlying the brain–lung–immune axis; the diagnostic challenges in identifying respiratory infections in mechanically ventilated TBI patients; and optimal approaches to empirical or quasi-targeted antimicrobial therapy based on diagnostic algorithms and rapid molecular techniques. Severe TBI induces neurogenic inflammation, autonomic dysregulation, and immunosuppression, thereby increasing susceptibility to pulmonary infections. The ‘triple hit hypothesis’ best explains this cascade: sympathetic hyperactivity (first hit), iatrogenic ventilatory injury (second hit), and intestinal dysbiosis with systemic immune dysregulation (third hit). VAP diagnosis remains challenging due to the lack of universal criteria, the overlap with systemic inflammatory response syndrome, and the low specificity of radiological and clinical signs. VAT may represent an intermediate stage within a continuum of ventilator-associated infection. Recent evidence supports the selective use of nebulized antibiotics for VAT, advocating an individualized, locally adapted empirical approach to VAP treatment. Syndromic molecular panels can accelerate the identification of pathogens, enabling the earlier and more appropriate selection of antimicrobials and improving outcomes while preserving stewardship. Understanding the brain–lung–immune axis and improving diagnostic accuracy are essential to enhancing the treatment of respiratory infections in neurocritical care. Integrating clinical assessment, biomarkers and rapid microbiological testing enables timely, targeted therapy and reduces the misuse of antimicrobials. Full article

In this study, the authors focus on optimizing the processing parameters for the fabrication of biodegradable polymer filaments intended for subsequent 3D printing of biomedical structures and implants. Following extrusion and additive manufacturing, the produced materials underwent a comprehensive evaluation that included mechanical, microbiological, biofilm formation, and electron microscopy analyses. The complexity of these tests aimed to determine the potential of the developed materials for biomedical applications, particularly in the field of scaffold fabrication. At the initial stage, three types of filaments (technical designations 111, 145, and 146) were produced using Fused Filament Fabrication (FFF) technology. These filaments were based on a PLA/PHB matrix with varying types and concentrations of plasticizers. Standardized destructive tensile and compressive mechanical tests were conducted using an MTS Insight 1 kN testing system equipped with an Instron 2620-601 extensometer. Among the tested samples, the filament labeled 111, composed of PLA/PHB thermoplastic starch and a plasticizer, exhibited the most favorable mechanical performance, with a Young’s modulus of elasticity of 4.63 MPa for 100% infill. The filament labeled 146 had a Young’s modulus of elasticity of 4.53 MPa for 100% infill and the material labeled 145 had a Young’s modulus of elasticity of 1.45 MPa for 100% infill. Microbiological assessments were performed to evaluate the capacity of bacteria and fungi to colonize the material surfaces. During bacterial activity assessment, we observed biofilm formation on the examined sample surfaces of each material from the smooth and rough sides. The colony-forming units (CFUs) increased directly with the exposure time. For all samples from each material, the Log10 (CFU) value reached above 9.41 during 72 h of incubation for the activity of each type of bacteria (Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans). Scanning electron microscopy provided insight into the surface quality of the material and revealed its local quality and purity. Surface defects were eliminated by this method. Overall, the results indicate that the designed biodegradable filaments, especially formulation 111, have promising properties for the development of scaffolds intended for hard tissue replacement and could also be suitable for regenerative applications in the future after achieving the desired biological properties. Full article

Groundwater is one of the main sources of water supply in tropical developing countries; however, its integrated management is often constrained by limited hydrogeological information and increasing anthropogenic pressures on aquifer systems. This study presents the numerical modeling of groundwater flow in the Neogene–Quaternary aquifer system of the Middle Magdalena Valley (Colombia), focusing on the rural area of Puerto Wilches, which is characterized by strong surface–groundwater interactions, particularly with the Yarirí wetland and the Magdalena River. A three-dimensional model was implemented and calibrated in FEFLOW v.8.1 under steady-state and transient conditions, integrating both primary and secondary data. The dataset included piezometric levels measured with water level meters and automatic loggers, hydrometeorological records, 21 physicochemical and microbiological parameters analyzed in 45 samples collected during three field campaigns under contrasting hydrological conditions, 79 pumping tests, detailed lithological columns from drilled wells, and complementary geological and geophysical models. The results indicate a predominant east–west groundwater flow from the Eastern Cordillera toward the Magdalena River, with seasonal recharge and discharge patterns controlled by the bimodal rainfall regime. Microbiological contamination (total coliforms in 69% of groundwater samples) and nitrate concentrations above 10 mg/L in 21% of wells were detected, mainly due to agricultural fertilizers and domestic wastewater infiltration. Particle tracking revealed predominantly horizontal flow paths, with transit times of up to 800 years in intermediate units of the Real Group and around 60 years in shallow Quaternary deposits, highlighting the differential vulnerability of the system to contamination. These findings provide scientific foundations for strengthening integrated groundwater management in tropical regions under agroindustrial and hydrocarbon pressures and emphasize the need to consolidate monitoring networks, promote sustainable agricultural practices, and establish preventive measures to protect groundwater quality. Full article

Background: Acute otitis media (AOM) is one of the most common pediatric infections. We aimed to investigate the bacterial profile of AOM in children, the serotype distribution, and the main genetic virulence factors involved in adhesion, immune evasion, and tissue spread. Methods: In total, 121 AOM cases involving children aged 0 to 14 years were studied. Middle ear fluids (MEF) (n = 42) and nasopharyngeal samples (n = 79) were collected. All strains were identified using routine microbiological tests, conventional PCRs and real-time PCR methods. Molecular serotyping was performed for S. pneumoniae and H. influenzae isolates. An immunofluorescence serotyping technique was employed for M. catarrhalis. Target genetic factors were determined for all involved bacterial agents using singleplex or multiplex PCRs. Results: We analyzed 148 nasopharyngeal and MEF. Among 121 AOM cases, a total of 127 bacterial agents were identified, including S. aureus (n = 41), S. pneumoniae (n = 28), H. influenzae (n = 23), M. catarrhalis (n = 19), and S. pyogenes (n = 16). The leading three serotypes among S. pneumoniae were: 19A (18.0%), 6A (14.3%), and 15B (14.3%). 91.3% of H. influenzae isolates were non-typeable (lacking a capsule—NTHi). The M. catarrhalis isolates were distributed in serotypes A (57.9%), B (26.3%), and C (15.8%). Presence of pili type 1 was detected in 21.4% pneumococci, and the fimbrial gene hifA was found in 34.8% of the H. influenzae strains. In 73.6% of the M. catarrhalis strains, ompCD was identified, while 84.2% contained ompE. 62.5% of the S. pyogenes isolates harbored the sdc gene, and 56.2% possessed the sdaD gene, predominantly in the MEF isolates. The cna adhesin was found in 28.0% of the S. aureus strains. Conclusions: The monitoring of bacterial pathogens responsible for otitis media, along with their serotype distribution and the prevalence of genetic factors involved in disease pathogenesis, is essential for public health and can help predict disease severity and treatment options. Full article

Background: Antimicrobial photodynamic therapy (aPDT) is a useful adjunct for managing oral biofilm diseases. Natural photosensitizers may be safer and more biocompatible than synthetic ones, but their dental effectiveness is still unclear. Methods: A PRISMA compliant review (PROSPERO ID: CRD420251233910) searched PubMed, Embase, Scopus, and the Cochrane Library for randomized controlled trials published from 2015 to 2025 that used natural photosensitizers for aPDT in dental settings. Three reviewers screened studies, extracted data, and assessed bias with a nine-domain tool adapted for photodynamic therapy. Results: Eleven of 249 records met the established criteria. Natural photosensitizers included curcumin, riboflavin, phycocyanin, chlorophyll derivatives, and plant extracts, tested in periodontitis, peri-implant mucositis, denture stomatitis, caries-related biofilms, and general oral decontamination. Most trials showed short-term microbial reductions and modest clinical gains, with performance comparable to chlorhexidine, methylene blue, or standard care. Adverse effects were minimal. Study quality was generally good, but wide variation in photosensitizer type, light settings, and outcomes, and short follow-up periods hindered meta-analysis and limited conclusions about long-term effectiveness. Conclusions: Natural photosensitizer-based aPDT appears effective and safe as an adjunct, offering consistent short-term microbiological improvements. Current evidence does not support replacing established antimicrobial approaches. Larger, well-controlled trials with standardized methods and longer follow-up periods are needed to define best practice and clarify the role of aPDT in routine dentistry. Full article

Managing bacterial infections and the spread of microbial resistance is one of the most critical and complex tasks of modern healthcare infrastructures. Antiseptics and disinfectants such as biocides play a significant role in controlling microbial resistance by reducing the microbial load on surfaces, skin, and environments, thereby limiting the opportunity for pathogens to proliferate and develop resistance. Herein, we tested the different interactions of quaternary ammonium compound (QAC)-based biocide compositions in pursuit of a better antimicrobial performance. An extensive microbiological analysis was conducted for 12 selected compositions of various combinations of mono-QACs, bis-QACs, and alcohols on 17 strains of bacteria of the ESKAPEE group and fungi, including 11 clinical highly resistant varieties, highlighting synergistic or additive dynamics. The evaluation showed noticeable improvements in activity, with up to 16-fold MBC and 32-fold MBEC reductions for alcohol-based compositions of lead QAC. Moreover, synergistic interactions were detected and confirmed via an optimized checkerboard assay for pyridinium QAC combinations against planktonic Gram-positive S. aureus with a fractional inhibitory concentration index (FICI) and fractional bactericidal concentration index (FBCI) of 0.39–0.5 and Gram-negative A. baumannii biofilms. The studied biocides demonstrated the long-term preservation of antimicrobial efficiency without resistance development during a 40-day period and do not induce QAC-associated cross-resistance for four commercially available antibiotics with similar mechanisms of action. Full article

Purpureocillium lilacinum is an emerging pathogen that can cause severe ocular infections. This study aimed to investigate the risk factors, clinical manifestations, antifungal susceptibilities, and outcomes of ocular infections caused by P. lilacinum at a large ophthalmic center in Southern China. This retrospective study reviewed the medical records of 34 patients with culture-proven P. lilacinum oculomycosis treated at the Zhongshan Ophthalmic Center from January 2020 to December 2024. The study included 34 patients (17 males, 17 females). The most common risk factor was ocular trauma (38.2%). In vitro susceptibility testing revealed high resistance to fluconazole and caspofungin, but general susceptibility to voriconazole (median MIC 0.25 mg/L). Despite 97.1% of patients receiving voriconazole therapy, outcomes were generally poor, with 54.5% of patients experiencing a poor outcome (vision worse than counting fingers). A significantly shorter time to microbiological diagnosis was associated with a favorable outcome (median 26 days vs. 65 days, p = 0.007). In conclusion, the visual outcomes of this infection remain generally poor, with the major clinical challenge being the delay in diagnosis. Therefore, prompt microbiological investigation is recommended for patients with suspected intraocular infection. Voriconazole remains the first-line therapeutic choice, the therapeutic potential of newer triazoles warrants further investigation. Full article

To tackle grape branch and leaf waste and alleviate global feed shortages, this study tested silage made from Xinjiang ‘Seedless White’ grape foliage. Three treatments were established: CK (control, only grape branches and leaves), PL (inoculated with 5 × 10⁶ CFU·g⁻¹ fresh weight Lactiplantibacillus plantarum), and PLC (inoculated with 5 × 10⁶ CFU·g⁻¹ L. plantarum and 0.3% cellulase). Silages were fermented at 18–23 °C and analyzed on days 7, 15, 30, and 60. PLC reduced dry matter loss in the late fermentation stage, while lowering Neutral detergent fiber (NDF) and Acid detergent fiber (ADF) contents to solve the high-fiber issue of grape foliage silage. It also maintained a lower pH in the mid-to-late stage and higher Lactic acid (LA) content to ensure anti-spoilage. Microbiologically, PLC had the highest Lactiplantibacillus abundance on day 7; on day 60, its Simpson index was higher, meaning stronger microbial community stability. Firmicutes replaced Cyanobacteria as the new dominant phylum, with Lactiplantibacillus remaining the absolute dominant genus, and the growth of molds and yeasts was effectively inhibited. In conclusion, the combined application of L. plantarum and cellulase enhances the quality of grape branch and leaf silage. This study turns low-value grape branches and leaves into high-quality feed, providing support for grape branch and leaf resource utilization and helping alleviate global feed shortages. Full article

An innovative approach to improving the quality of meat products is to change their recipe composition. The aim of the study was to improve the quality of poultry products with different proportions of plant components. The test groups consisted of paste products: P₁—with 50% slaughter turkey meat and 40% plant additives; P₂—with 30%, respectively. The control group consisted of classic poultry pâté in paste form. The assessment of paste quality considered the physical characteristics (pH, color), nutritional value (basic chemical composition, fatty acid profile, fiber content, vitamin E, cholesterol, minerals), microbiological quality (total number of aerobic bacteria, Pseudomonas) and sensory quality of the samples. It was found that poultry products containing plant components had increased nutritional value, including reduced fat and cholesterol content, while maintaining a favorable fatty acid profile, increased fiber, vitamin E and mineral content (Mg, Mn, K, Na, Ca, Fe) as well as microbiological safety and acceptable sensory characteristics compared to the control group. Within the research groups, the product from group P2, with a 60% share of plant components, received a higher recommendation with regard to health-promoting properties (higher fiber, Mn, Mg, Na, Ca, Zn content, optimal ratio of omega 6 to omega 3 fatty acids) and sensory characteristics (tastiness, spreadability). Full article

Water scarcity is an increasingly critical global issue, particularly in arid regions like Morocco. Innovative approaches, such as the use of alternative water sources like landfill leachate, offer promising solutions. In this study, phosphate washing sludge was used to treat landfill leachate with the aim of producing irrigation-quality water and recovering nitrogen from the resulting sediment. A total of 40 L of raw leachate was treated with three concentrations of phosphate washing sludge (25%, 37%, and 50%). This volume was processed at the laboratory scale as a proof of concept for potential larger-scale applications. After 24 to 36 h of mixing and agitation, the mixture underwent sedimentation, yielding clear supernatants and nitrogen-rich sludge pellets. These pellets showed a significant increase in organic matter content, from 6.4% to 13.5%, representing an enhancement of 110.9%, thus demonstrating partial leachate depollution and organic matter enrichment. Microbiological analyses revealed a 98.9% reduction in fecal streptococci. The supernatants met irrigation water standards in terms of pH and electrical conductivity, and phytotoxicity tests on maize seeds confirmed their suitability for irrigation. Additionally, the recovered nitrogen-rich sediment presents a valuable input for composting and soil amendment. Full article

The study aimed to assess the effect of applying selected strains of lactic acid bacteria (LAB) to the surface of poultry bones before mechanical deboning on the microbiological quality and selected physicochemical characteristics of the mechanically separated poultry meat (MSPM) obtained. Three selected LAB strains—Lactiplantibacillus plantarum SCH1, Limosilactobacillus fermentum S8, and Pediococcus pentosaceus KL14—were applied to chicken bones (carcasses) and subjected to cold storage for 3 days, and then the meat was mechanically deboned using high-pressure separation. The obtained product (MSPM) was tested after 1, 3, and 5 days of refrigerated storage. A comprehensive set of physicochemical analyses was performed, including pH and redox potential, TBARS, fatty acid profile, and colour assessment. The following microbiological determinations were also carried out: total viable count, mesophilic lactic acid bacteria, Escherichia coli count, Enterobacteriaceae count, and coagulase-positive staphylococci count. The strains used, especially L. plantarum SCH1, reduced the number of coagulase-positive staphylococci in MSPM, providing protection compared to the control samples (p < 0.05). No inhibitory effect of the LAB used was observed on Enterobacteriaceae and E. coli. The total number of microorganisms and the number of lactic acid bacteria were similar in all treatments. Significant effects of adding selected strains of LAB on lowering the pH and changing the redox potential of MSPM were observed (p < 0.05). The L* parameter (lightness) of the MSPM colour increased, while the proportion of red colour (a*) decreased (p < 0.05). However, the bacteria used did not protect against oxidation processes, which proceeded faster in MSPM samples containing bacterial strains, as demonstrated by the TBARS test and fatty acid profile. The research conducted is promising, particularly in terms of reducing coagulase-positive staphylococci in MSPM production. However, further research on the impact of selected LAB on oxidative processes in MSPM is necessary. Full article

The aim of this study was to evaluate the effect of surface modification of porous hyaluronic acid (HA)-based materials with a titanium dioxide (TiO₂) layer deposited via atomic layer deposition (ALD) on the selected structural, physicochemical, and antimicrobial properties of materials intended for applications in regenerative medicine. The obtained HA-based materials, enriched with silk and elastin, were analyzed in terms of their rheological behavior, wettability, solubility, and resistance to colonization by clinically relevant bacterial pathogens (Staphylococcus aureus, Klebsiella pneumoniae) and environmental filamentous fungi (Aspergillus niger, Chaetomium globosum). The results demonstrated that even a thin, continuous TiO₂ layer formed after 200 ALD cycles reduced the hydrophilicity of the foams, indicating improved durability in aqueous environments. Microbiological tests confirmed enhanced antimicrobial properties of the foams after TiO₂ modification—showing inhibition of both tested bacterial strains and C. globosum within 24 h. These findings suggest that surface functionalization of hyaluronic acid-based foams with a TiO₂ layer can improve both their environmental stability and, to some extent, reduce microbiological risk, while preserving the layered-porous structure of the foams, which is advantageous for biomedical applications. Full article