Addressing the existing problem in the microbiological diagnosis of infections associated with implants and the current debate about the real power of precision of sonicated fluid culture (SFC), the objective of this review is to describe the methodology and analyze and compare the results obtained in current studies on the subject. Furthermore, the present study also discusses and suggests the best parameters for performing sonication. A search was carried out for recent studies in the literature (2019-2023) that addressed this research topic. As a result, different sonication protocols were adopted in the studies analyzed, as expected, and consequently, there was significant variability between the results obtained regarding the sensitivity and specificity of the technique in relation to the traditional culture method (periprosthetic tissue culture - PTC). Coagulase-negative Staphylococcus (CoNS) and Staphylococcus aureus were identified as the main etiological agents by SFC and PTC, with SFC being important for the identification of pathogens of low virulence that are difficult to detect. Compared to chemical biofilm displacement methods, EDTA and DTT, SFC also produced variable results. In this context, this review provided an overview of the most current scenarios on the topic and theoretical support to improve sonication performance, especially with regard to sensitivity and specificity, by scoring the best parameters from various aspects, including sample collection, storage conditions, cultivation methods, microorganism identification techniques (both phenotypic and molecular) and the cutoff point for colony forming unit (CFU) counts. This study demonstrated the need for standardization of the technique and provided a theoretical basis for a sonication protocol that aims to achieve the highest levels of sensitivity and specificity for the reliable microbiological diagnosis of infections associated with implants and prosthetic devices, such as prosthetic joint infections (PJIs). However, practical application and additional complementary studies are still needed.

Micro- plastics (MPs) pose significant global threats, requiring an environment-friendly mode of decomposition. Microbial-mediated biodegradation and biodeterioration of micro-plastics (MPs) have been widely known for their cost-effectiveness, and environment-friendly techniques for removing MPs. MPs resistance to various biocidal microbes has also been reported by various studies. The biocidal resistance degree of biodegradability and/or microbiological susceptibility of MPs can be determined by defacement, structural deformation, erosion, degree of plasticizer degradation, metabolization, and/or solubilization of MPs. The degradation of microplastics involves microbial organisms like bacteria, mold, yeast, algae, and associated enzymes. Analytical and microbiological techniques monitor microplastic biodegradation, but no microbial organism can eliminate microplastics. MPs can pose environmental risks to aquatic and human life. Micro-plastic biodegradation involves fragmentation, assimilation, and mineralization, influenced by abiotic and biotic factors. Environmental factors and pre-treatment agents can naturally degrade large polymers or induce bio-fragmentation, which may impact their efficiency. A clear understanding of MPs pollution and the microbial degradation process is crucial for mitigating its effects. The study aimed to identify deteriogenic microorganism species that contribute to the biodegradation of micro-plastics (MPs). This knowledge is crucial for designing novel biodeterioration and biodegradation formulations, both lab-scale and industrial, that exhibit MPs-cidal actions, potentially predicting MPs-free aquatic and atmospheric environments. The study emphasizes the urgent need for global cooperation, research advancements, and public involvement to reduce micro-plastic contamination through policy proposals and improved waste management practices.

The increasing worldwide incidence of nontuberculous mycobacterial lung disease (NTM-LD) and the similarity of its manifestations to those of tuberculosis (TB) pose huge challenges in the diagnosis and treatment of NTM-LD, which is commonly misdiagnosed and mistreated as TB. Proper diagnosis and treatment at an early stage can greatly improve patient outcomes.
Mycobacterium avium was identified by mNGS in lung tissue of case 1 and bronchioalveolar fluid from case 2 that was not identified using conventional microbiological methods. Multiple NTM species were detected in the blood mNGS samples from case 3 who had disseminated NTM infection. Although NTM was isolated from blood culture, conventional methods failed to identify the organisms to the level of species. All three patients were suffering from and being treated for myelodysplastic syndrome, rheumatoid arthritis, systemic lupus erythematosus, or acute lymphoblastic leukemia, making them immunosuppressed and susceptible to NTM infections. Case 1 and Case 2 significantly improved after anti-NTM treatment, but case 3 succumbed to the infection due to her underlying medical illness despite aggressive treatment.
The cases in this study demonstrate the effectiveness of mNGS in facilitating and improving the clinical diagnosis of NTM infections. We propose combining mNGS with traditional diagnostic methods to identify pathogens at the early stages of the disease so that targeted treatment can be implemented.

BACKGROUND: Chromoblastomycosis is a skin infection caused by dematiaceous fungi that take the form of muriform cells in the tissue. It mainly manifests as verrucous plaques on the lower limbs of rural workers in tropical countries.
OBJECTIVE: The primary objective of this review is to evaluate the accuracy of diagnostic methods for the identification of chromoblastomycosis, considering the histopathological examination as the reference test.
METHODS: MEDLINE, LILACS and Scielo databases were consulted using the terms \"chromoblastomycosis\" AND \"diagnosis\". The eligibility criteria were: studies that evaluated the accuracy of tests for the diagnosis of chromoblastomycosis. Eleven studies were selected. Statistical analysis included the calculation of sensitivity and specificity of the diagnostic methods.
RESULTS: Considering the histopathological examination as the reference test, the culture showed a sensitivity (S) of 37.5% - 90.9% and a specificity (Sp) of 100%; while direct mycological examination showed S =  50% - 91.6% and Sp of 100% . Considering the culture as the reference test, the serology (precipitation techniques) showed S  of 36% - 99%; and Sp  of 80% - 100%; while the intradermal test showed S  of 83.3% - 100% and Sp  of 99.4% - 100%.
CONCLUSIONS: The small number of studies and very discrepant sensitivity results among them do not allow the calculation of summary measures through a meta-analysis.
CONCLUSIONS: Direct mycological examination, culture, intradermal test and serology show sensitivity and specificity values ​​for the diagnosis of chromoblastomycosis with no significant difference between the studies.

Rapid and precise diagnostic methods are required to control emerging infectious diseases effectively. Human body fluids are attractive clinical samples for discovering diagnostic targets because they reflect the clinical statuses of patients and most of them can be obtained with minimally invasive sampling processes. Body fluids are good reservoirs for infectious parasites, bacteria, and viruses. Therefore, recent clinical proteomics methods have focused on body fluids when aiming to discover human- or pathogen-originated diagnostic markers. Cutting-edge liquid chromatography-mass spectrometry (LC-MS)-based proteomics has been applied in this regard; it is considered one of the most sensitive and specific proteomics approaches. Here, the clinical characteristics of each body fluid, recent tandem mass spectroscopy (MS/MS) data-acquisition methods, and applications of body fluids for proteomics regarding infectious diseases (including the coronavirus disease of 2019 [COVID-19]), are summarized and discussed.

Accelerated emergence of drug- resistant pathogenic microbes, their unbeatable virulence and a gradual loss of efficacy of currently used antimicrobial agents over the last decade, have expanded the scope of herbal medicine to combat this emerging challenge to have a wide spectrum of activity to develop effective medicines with lesser untoward side effects. Plant-based natural products should be of utmost interest to today\'s pharmaceutical industries since they are a primary source of new chemical entities directed at new drug targets. Apocynaceae or \'Dogbane\' family has attained a global reputation as a source of some life-saving plant-derived products and novel compounds. Members of this family have also been extensively investigated against several nosocomial pathogenic microbes through in vitro and in vivo experimental settings. Several plant-derived components obtained from members of this family have also exhibited remarkable microbial growth inhibitory properties. Popular and widely accepted international databases such as PubMed, Science Direct, ResearchGate, Scopus, Google Scholar, JSTOR and more were searched using the various search strings such as Apocynaceae, antimicrobials, multidrug resistance, resistance modifying agents and pathogenic microorganisms were used in various combinations to retrieve several citations related to the topic. The current review encompasses recent developments in experimental studies and phytochemical analyses which correlates with antimicrobial efficacy of selected Apocynaceous plants along with synergistic mechanism and structural details. The present review recognizes and leverages the importance of Apocynaceae plants, which could be of significant interest in the development of more effective and less toxic antimicrobial drugs which may surmount multidrug resistance. Three different paradigm models harnessing clinical antimicrobial resistance (AMR) including the plant family Apocynaceae, Gram-positive and Gram-negative bacterial species have been broadly discussed in this review. In a nutshell, the present review represents a comprehensive account on the antimicrobials and resistance modifying agents obtained from the members of the plant family Apocynaceae and derived phytochemicals. It also gives an insight into the underlying mode of action of these phytochemicals against an array of pathogenic bacteria, their mechanism of antibiosis, plant parts from which the phytochemicals were isolated or the extracts was prepared with a critical discussion on the botanically-derived antibiotics as a template for antimicrobial drug development.

Pneumocystis jirovecii can cause life-threatening pneumonia in immunocompromised patients. Traditional diagnostic testing has relied on staining and direct visualization of the life-forms in bronchoalveolar lavage fluid. This method has proven insensitive, and invasive procedures may be needed to obtain adequate samples. Molecular methods of detection such as polymerase chain reaction (PCR), loop-mediated isothermal amplification (LAMP), and antibody-antigen assays have been developed in an effort to solve these problems. These techniques are very sensitive and have the potential to detect Pneumocystis life-forms in noninvasive samples such as sputum, oral washes, nasopharyngeal aspirates, and serum. This review evaluates 100 studies that compare use of various diagnostic tests for Pneumocystis jirovecii pneumonia (PCP) in patient samples. Novel diagnostic methods have been widely used in the research setting but have faced barriers to clinical implementation including: interpretation of low fungal burdens, standardization of techniques, integration into resource-poor settings, poor understanding of the impact of host factors, geographic variations in the organism, heterogeneity of studies, and limited clinician recognition of PCP. Addressing these barriers will require identification of phenotypes that progress to PCP and diagnostic cut-offs for colonization, generation of life-form specific markers, comparison of commercial PCR assays, investigation of cost-effective point of care options, evaluation of host factors such as HIV status that may impact diagnosis, and identification of markers of genetic diversity that may be useful in diagnostic panels. Performing high-quality studies and educating physicians will be crucial to improve the rates of diagnosis of PCP and ultimately to improve patient outcomes.

The aim of this study was to evaluate the diagnostic performance of immunochromatographic tests (ICTs) for the detection of Mycoplasma pneumoniae. Medline/Pubmed, Embase, the Cochrane Library, and ISI Web of Science were searched through June 12, 2019 for relevant studies that used ICTs for the detection of M. pneumoniae infection with polymerase chain reaction (PCR) or microbial culturing as reference standards. Pooled diagnostic accuracy with 95% confidence interval (CI) was calculated using a bivariate random effects model. We also constructed summary receiver operating characteristic curves and calculated the area under the curve (AUC). Statistical heterogeneity was evaluated by χ2 test or Cochrane\'s Q test. Thirteen studies including 2,235 samples were included in the meta-analysis. The pooled sensitivity and specificity for diagnosing M. pneumoniae infection were 0.70 (95% CI: 0.59-0.79) and 0.92 (95% CI: 0.87-0.95), respectively. The positive likelihood ratio (LR) was 8.94 (95% CI: 4.90-14.80), negative LR 0.33 (95% CI: 0.22-0.46), diagnostic odds ratio 29.20 (95% CI: 10.70-64.20), and AUC 0.904. In subgroup analysis, ICTs demonstrated similar pooled sensitivities and specificities in populations of children only and mixed populations (children + adults). Specimens obtained from oropharyngeal swabs exhibited a higher sensitivity and specificity than those of nasopharyngeal swab. Moreover, pooled estimates of sensitivity and accuracy for studies using PCR as a reference standard were higher than those using culture. The pooled sensitivity and specificity of Ribotest Mycoplasma®, the commercial kit most commonly used in the included studies, were 0.66 and 0.89, respectively. Overall, ICT is a rapid user-friendly method for diagnosing M. pneumoniae infection with moderate sensitivity, high specificity, and high accuracy. This suggests that ICT may be useful in the diagnostic workup of M. pneumoniae infection; however, additional studies are needed for evaluating the potential impact of ICT in clinical practice.

OBJECTIVE: Results of a study evaluating the impact of privileging pharmacists to manage microbiologic test results for patients discharged from the emergency department (ED) are reported.
METHODS: This was a single-center, retrospective pre-post study that was conducted at an urban academic medical center. Patients discharged from the ED with a subsequent positive microbiologic test result before and after privileging of an ED specialty practice pharmacist (ED-SPP) to manage the results independently were screened for inclusion. Time to patient notification of a required change in antimicrobial therapy was compared between groups. Numbers of erroneous interventions before and after pharmacist privileging were compared to assess the safety of implementation.
RESULTS: One hundred seventy-eight positive microbiologic test results (n = 92 pre- and n = 86 postimplementation) were included. The median time to patient notification in the pre-implementation group was 23.6 hours (range, 12.4-93 hours) and in the postimplementation group was 14.9 hours (range, 2.5-27.9 hours; P = 0.0023). As determined by the board-certified infectious disease physician, 1.1% of reviewed microbiologic test results (1 of 92) was erroneous prior to implementation of pharmacist privileging compared with 2.3% (2 of 86) after implementation (P = 0.6105).
CONCLUSIONS: Privileging ED-SPPs to assess microbiologic test results improved the time to patient notification with no statistical difference in the number of erroneous interventions between groups. These findings demonstrate the benefit of clinical privileging and provide support for expansion of this role to other ED-SPPs.

Case report: We present a case of a 66-year-old female diagnosed with R. gnavus bacteremia associated with fecal peritonits secondary to small-bowel herniation and perforation. Identification  as R. gnavus was delayed because of absence of this species in the MALDI-TOF MS database (Vitek MS, bioMérieux). Identification was provided by 16S rRNA gene sequencing. Review: R. gnavus, a Gram-positive, strictly anaerobic bacterium, is a member of the human gut microbiota. Dysbiosis in the gut microbiota, with increased amounts of R. gnavus, has been described in inflammatory bowel disease. R. gnavus has only been reported occasionally as the cause of infections. Hence the potential pathogenicity is not yet fully recognized, and data regarding the antimicrobial susceptibility profile are rare. Identification of anaerobic bacteria such as R. gnavus is greatly accelerated  as a result of the introduction of MALDI-TOF MS. However, as illustrated in this case report, an extensive and up-to-date MALDI-TOF MS database is necessary for providing an accurate identification.