Cardiac amyloidosis is increasingly recognized as a treatable form of heart failure. Highly effective specific therapies have recently become available for the 2 most frequent forms of cardiac amyloidosis: immunoglobulin light chain amyloidosis and transthyretin (ATTR) amyloidosis. Nevertheless, initiation of specific therapies requires recognition of cardiac amyloidosis and appropriate characterization of the amyloid type. Although noninvasive diagnosis is possible for ATTR cardiac amyloidosis, histological demonstration and typing of amyloid deposits is still required for a substantial number of patients with ATTR and in all patients with light chain amyloidosis and other rarer forms of cardiac amyloidosis. Amyloid histological typing can be performed using different techniques: mass spectrometry, immunohistochemistry, and immunoelectron microscopy. This review describes which patients require histological confirmation of cardiac amyloidosis along with when and how to type amyloid deposits in histologic specimens. Furthermore, it covers the characteristics and limitations of the different typing methods that are available in clinical practice.

This narrative review summarizes literature on C. difficile and C. difficile infections (CDI) that emerged from Latin America (LA) between 1984 and 2021. The revised information includes papers in English, Spanish, or Portuguese that were retrieved from the databases Pubmed, Scopus, Web of Science, Google Scholar, Scielo, and Lilacs. Information is presented chronologically and segregated in subregions, focusing on clinical presentation, risk factors, detection and typing methods, prevalence and incidence rates, circulating strains, and, when available, phenotypic traits, such as antimicrobial susceptibility patterns. Studies dealing with cases, clinical aspects of CDI, and performance evaluations of diagnostic methods predominated. However, they showed substantial differences in case definitions, measuring units, populations, and experimental designs. Although a handful of autochthonous strains were identified, predominantly in Brazil and Costa Rica, the presentation and epidemiology of CDI in LA were highly comparable to what has been reported in other regions of the world. Few laboratories isolate and type this bacterium and even less generate whole genome sequences or perform basic science on C. difficile. Less than ten countries lead academic productivity on C. difficile or CDI-related topics, and information from various countries in Central America and the Caribbean is still lacking. The review ends with a global interpretation of the data and recommendations to further develop and consolidate this discipline in LA.

BACKGROUND: Burkholderia cepacia complex (Bcc) is an emerging opportunistic pathogen among immunocompromised patients. It frequently contaminates saline, fluids and ultrasound (US) gel used in hospitals. This systematic review was conducted to analyze Bcc outbreaks due to ultrasound (US) gel for better management of these outbreaks.
METHODS: As per PRISMA guidelines, electronic databases \"Embase\" and \"Pubmed\" and \"Web of sciences\" were searched from 1991 to April, 2021 to identify studies causing Burkholderia spp outbreak due to contamination of US gels.
RESULTS: The search identified 14 outbreak reports that met our inclusion criteria. Bacteremia was the most common clinical presentation in ten studies followed by urinary tract infections in 4 studies. In most of the studies B. cepacia was the most common isolated organism. Other members like B. ambifaria, B. contaminans, and B. stabilis caused outbreaks in two studies. Pulsed field gel electrophoresis and multilocus sequence typing were commonly employed methods to study the clonal association. In 8 outbreaks, intrinsic contamination of the gel, that is, contamination from manufacturing site, was present and 4 studies, extrinsic contamination, that is, contamination from environment was responsible for outbreak.
CONCLUSIONS: This review highlights the importance of US gel as a source of outbreak in health-care facilities. Ensuring sterility of US gel, sound epidemiological investigation of outbreak and prompt response by infection control team can prevent these outbreaks.

Candida meningitis is a rare life-threatening yeast infection mostly involving immunocompromised or paediatric patients undergoing neurosurgical procedures or shunt placement. Due to difficulties in diagnosis because of diverse clinical manifestations, the number of patients affected is most likely underestimated. Therefore, the correct diagnosis may be delayed for months, and accurate species identification is highly recommended for administering appropriate antifungal therapy. We report the first case of fluconazole-resistant Candida auris meningitis in a paediatric patient in Iran. This strain was probably imported, as it genotypically belonged to Clade I from South Asia. Furthermore, we include a literature review of C auris meningitis cases, as the number of cases with C auris meningitis has increased with reports from the United Kingdom, India and Iran. This problem might increase further in the era of COVID-19 due to attrition of experienced healthcare personnel and a high workload of hospital healthcare workers. To understand the precise prevalence of this emerging multidrug resistance pathogen, epidemiological surveillance studies are urgently warranted.

Identification and classification of beneficial microbes is of the highest significance in food science and related industries. Conventional phenotypic approaches pose many challenges, and they may misidentify a target, limiting their use. Genotyping tools show comparatively better prospects, and they are widely used for distinguishing microorganisms. The techniques already employed in genotyping of lactic acid bacteria (LAB) are slightly different from one another, and each tool has its own advantages and disadvantages. This review paper compiles the comprehensive details of several fingerprinting tools that have been used for identifying and characterizing LAB at the species, sub-species, and strain levels. Notably, most of these approaches are based on restriction digestion, amplification using polymerase chain reaction, and sequencing. Nowadays, DNA sequencing technologies have made considerable progress in terms of cost, throughput, and methodology. A research journey to develop improved versions of generally applicable and economically viable tools for fingerprinting analysis is ongoing globally.

IntroductionMALDI-TOF MS represents a new technological era for microbiology laboratories. Improved sample processing and expanded databases have facilitated rapid and direct identification of microorganisms from some clinical samples. Automated analysis of protein spectra from different microbial populations is emerging as a potential tool for epidemiological studies and is expected to impact public health.AimTo demonstrate how implementation of MALDI-TOF MS has changed the way microorganisms are identified, how its applications keep increasing and its impact on public health and hospital hygiene.MethodsA review of the available literature in PubMED, published between 2009 and 2018, was carried out.ResultsOf 9,709 articles retrieved, 108 were included in the review. They show that rapid identification of a growing number of microorganisms using MALDI-TOF MS has allowed for optimisation of patient management through prompt initiation of directed antimicrobial treatment. The diagnosis of Gram-negative bacteraemia directly from blood culture pellets has positively impacted antibiotic streamlining, length of hospital stay and costs per patient. The flexibility of MALDI-TOF MS has encouraged new forms of use, such as detecting antibiotic resistance mechanisms (e.g. carbapenemases), which provides valuable information in a reduced turnaround time. MALDI-TOF MS has also been successfully applied to bacterial typing.ConclusionsMALDI-TOF MS is a powerful method for protein analysis. The increase in speed of pathogen detection enables improvement of antimicrobial therapy, infection prevention and control measures leading to positive impact on public health. For antibiotic susceptibility testing and bacterial typing, it represents a rapid alternative to time-consuming conventional techniques.

OBJECTIVE: This study systematically reviewed the research on computer text entry by people with physical disabilities, and conducted a quantitative synthesis of text entry rates associated with individuals\' diagnosis, body site used with the interface and their level of experience.
METHODS: We searched 10 databases and included studies in which: typing speed was reported; the access interface was available for public use; and individuals with physical impairments were in the study population. For quantitative synthesis, we used only the text entry rates (TER) reported for individuals with physical impairments; studies also had to report the sample size, and the average and standard deviation for the text entry rates.
RESULTS: Thirty-nine studies involving 248 subjects met the criteria for quantitative synthesis. Cerebral palsy was associated with significantly slower TER, at 5.5 wpm, than muscular dystrophy (12.5 wpm), spina bifida (10.4 wpm), SCI high cervical (10.1 wpm) and SCI low cervical (13.3 wpm). Among the 19 body sites represented, the Fingers bilateral category had the highest average, at 17.72 wpm. Head (2.92 wpm) and Hand (non-typing) (3.95 wpm) were each associated with significantly slower TER than Hands unspecified, Fingers bilateral, Hand with control enhancer, Voice and Mouth. The three levels of experience examined, LowPlus, Medium and High, provided very similar TER.
CONCLUSIONS: This study contributes external evidence for service providers who provide computer access interventions for individuals with disabilities. The analyzed text entry performances serve as benchmarks to be used as guidelines during interface selection and training. Implications for Rehabilitation The median text entry rate (TER) across the literature for individuals with physical disabilities is 7.0 wpm. TER is affected by a user\'s diagnosis and the body site used for typing. These TER data can serve as diagnostic norms and benchmarks to be used as guidelines during interface selection and training. We recommend that practitioners measure text entry rate with clients, to place their performance in the context of these results and provide a baseline against which to measure effectiveness of an intervention.

This study systematically reviewed the research on assistive technology (AT) access interfaces used for text entry, and conducted a quantitative synthesis of text entry rates (TER) associated with common interfaces. We searched 10 databases and included studies in which: typing speed was reported in words per minute (WPM) or equivalent; the access interface was available for public use; and individuals with physical impairments were in the study population. For quantitative synthesis, we used only the TER reported for individuals with physical impairments. Studies also had to report the sample size, and the average and standard deviation for the TER data. Thirty-nine studies met the criteria for quantitative synthesis. Studies involved seven interface types: standard keyboard typing, on-screen keyboard (OSK) with cursor selection, OSK with scanning selection, automatic speech recognition (ASR), Morse code, brain-computer interface (BCI), and other. ASR, standard keyboard, cursor OSK, and scanning OSK had at least four studies and 30 subjects, with TER averaging 15.4, 12.5, 4.2, and 1.7 WPM, respectively. When combined with measurements of a particular client\'s text entry performance, the TER from this review can be used within an evidence-based decision-making process for selecting control interfaces.

The genus Acidithiobacillus comprises several species of Gram-negative acidophilic bacteria that thrive in natural and man-made low pH environments in a variety of geo-climatic contexts. Beyond their fundamental interest as model extreme acidophiles, these bacteria are involved in the processing of minerals and the desulfurization of coal and natural gas, and are also sources of environmental pollution due to their generation of acid mine drainage and corrosion of cement and concrete structures. Acidithiobacillus spp. are therefore considered a biotechnologically relevant group of bacteria, and their identification and screening in natural and industrial environments is of great concern. Several molecular typing methodologies have been instrumental in improving knowledge of the inherent diversity of acidithiobacilli by providing information on the genetic subtypes sampled in public and private culture collections; more recently, they have provided specific insight into the diversity of acidithiobacilli present in industrial and natural environments. The aim of this review is to provide an overview of techniques used in molecular detection, identification and typing of Acidithiobacillus spp. These methods will be discussed in the context of their contribution to the general and specific understanding of the role of the acidithiobacilli in microbial ecology and industrial biotechnology. Emerging opportunities for industrial and environmental surveillance of acidithiobacilli using next-generation molecular typing methodologies are also reviewed.