Search Results (3,755)

Background/Objectives: Klebsiella pneumoniae ST258 and ST11 are global high-risk antimicrobial-resistant clones known for their virulence and resistance gene dissemination. This study aims to identify these clones in a Greek tertiary hospital and understand their resistance profiles and transmission dynamics. Methods: In January 2025, we isolated two distinct carbapenem-resistant K. pneumoniae in a Greek tertiary hospital: INT18S from an ICU patient’s bronchioalveolar lavage and INT20U from a urine sample in the emergency unit. Antimicrobial susceptibility testing (via Microscan system) and Whole-Genome Sequencing (WGS) were conducted on both isolates and their genomes were submitted to the NCBI. Results: The INT18S isolate carried the bla_KPC-2 gene and belonged to the ST258 clone. The INT20U isolate carried the bla_NDM-1 gene and belonged to the ST11 clone lineage. Both isolates contained at least one of the extended spectra β-lactamase genes tested (TEM, SHV, OXA-1 and CTX-M group). Conclusions: The co-existence of the high-risk K. pneumoniae clones ST258 and ST11 in different hospital departments increases the risk of resistance gene transfer and suggests potential intra-hospital transmission pathways. Understanding their resistance profiles is critical for guiding treatment strategies and preventing the spread of multidrug-resistant pathogens. Full article

Background/Objectives: Since its emergence in late 2019, SARS-CoV-2 has demonstrated remarkable genetic diversity driven by mutations and recombination events that shaped the course of the COVID-19 pandemic. Continuous genomic monitoring is essential to track viral evolution, assess the spread of variants of concern (VOCs), and inform public health strategies. The present study aimed to characterize the molecular epidemiology of SARS-CoV-2 in northern Greece from the first national case in February 2020 through early 2025. Methods: A total of 66 respiratory samples collected from hospitalized patients across Northern Greece were subjected to whole-genome sequencing using Oxford Nanopore Technologies’ MinION Mk1C platform and the ARTIC protocol. Sequences were analyzed with PANGO, Nextclade, and GISAID nomenclature systems for lineage and clade assignment, and the WHO nomenclature for VOCs. Results: Across 66 genomes, 34 PANGO lineages were identified. Early introductions included B.1 (2/66), B.1.177 (3/66), and B.1.258 (1/66). Alpha (5/66) and Beta (5/66) circulated in February–June 2021. Delta (AY.43) was detected in early 2022 (2/66; Jan–Feb) but was rapidly displaced by Omicron and reached 100% of the sequences by May 2022. Omicron diversified into BA.1/BA.1.1 (3/66), BA.2 (6/66), BA.4/BA.5 (14/66), BF.5 (1/66), EG.5 (1/66; designated a WHO Variant of Interest in 2023), JN.1 (4/66; globally dominant lineage prompting vaccine updates in 2024–2025), KS.1 (2/66; together with KS.1.1 are recognized PANGO lineages that were tracked internationally but remained less prevalent), KP.3 (5/66; together with KP.3.1.1, prominent “FLiRT” descendants circulating in 2024), and recombinants XDK, XDD, and XEC (5/66), reported by their PANGO names in accordance with the WHO’s current framework, which reserves Greek letters only for newly designated VOCs. Conclusions: This five-year genomic analysis provides an insight into the continuous evolution of SARS-CoV-2 in northern Greece. The findings underscore the importance of sustained genomic surveillance, integrated with epidemiological data, to detect emerging variants, monitor recombination, and strengthen preparedness for future coronavirus threats. Full article

Background: The COVID-19 pandemic led to an unprecedented global health and economic crisis, and vaccination emerged as a critical intervention to control the spread of the virus and mitigate its impact on health systems and economies. Despite the rapid development and deployment of vaccines, the financial commitments required for these vaccination programs are substantial, necessitating a comprehensive understanding of the associated costs to inform future public health strategies and resource allocation. Method: This analysis estimates the global, regional, and national economic costs of COVID-19 vaccination across 234 countries and regions in the period 2020–2023, consisting of vaccine procurement costs and administration costs. Result: As of 31 December 2023, the global costs of COVID-19 vaccination programs were estimated at USD 246.2 billion, with vaccine procurement accounting for approximately USD 140.2 billion and administration costs totaling USD 96.4 billion. Globally, a cumulative total of 136.9 billion doses of COVID-19 vaccines had been administered. Factoring in an estimated wastage rate of 10%, it is projected that approximately 150.6 billion doses were used. On a global scale, the average number of vaccine doses administered per capita was estimated at 1.73. The mean cost per capita was USD 17.70 (95% CI: USD 15.84–19.56) for vaccine procurement and USD 12.16 (95% CI: USD 10.29–14.02) for administration, resulting in a total average cost of USD 29.85 (95% CI: USD 26.33–33.37) per capita. Significant disparities in costs were observed across income groups and regions. High-income countries incurred a notably higher average cost per capita of USD 76.90 (95% CI: USD 72.38–81.41) in contrast to low-income countries, where the per capita cost was USD 7.20 (95% CI: USD 5.38–9.02). For middle-income countries, the average per capita costs were USD 15.02 (95% CI: USD 10.64–19.40) in lower-middle-income countries and USD 28.21 (95% CI: USD 23.60–32.83) in upper-middle-income countries. Regionally, the Americas (AMR) reported the highest total cost at USD 70.8 billion, with an average per capita cost of USD 65.23 (95% CI: USD 56.18–74.28). The Western Pacific Region (WPR) followed with a total cost of USD 63.9 billion and an average per capita cost of USD 31.93 (95% CI: USD 20.35–43.51). Conversely, the African Region (AFR) had the lowest total spending at USD 10.8 billion and a per capita cost of USD 8.85 (95% CI: USD 5.34–12.37), reflecting both lower vaccine procurement and administration costs. The European Region (EUR) recorded a high average per capita cost of USD 53.36 (95% CI: USD 46.79–59.94), with procurement costs at USD 31.28 (95% CI: USD 27.41–35.14) and administration costs of USD 22.09 (95% CI: USD 19.31–24.87). Conclusions: The global rollout of COVID-19 vaccination revealed substantial variation in cost structures across income groups. Procurement costs imposed greater burdens on low- and lower-middle-income countries, whereas delivery and administration costs dominated in higher-income settings. These disparities highlight persistent fiscal inequities and emphasize the need for stronger international coordination and cost transparency to enhance equity, efficiency, and preparedness in future vaccination efforts. Full article

The red-haired bark beetle (RHB), Hylurgus ligniperda (Fabricius, 1787) (Coleoptera: Curculionidae: Scolytinae), is a globally distributed quarantine pest, making effective management of infested wood essential. This study developed an integrated control system to achieve closed-loop management under various environmental and wood conditions. RHB eggs were the most fumigation-tolerant stage. Although sulfuryl fluoride (SF) showed higher potency, aluminum phosphide (AP) provided deeper penetration into wood (AP: 29.5% vs. SF: 12.6%). Both fumigants effectively reached all logs in the stacks. Fumigation efficacy was highest at moderate temperatures (18–22 °C) and lower wood moisture levels. In addition to chemical methods, thermal treatments were evaluated: heating to 60–65 °C achieved complete mortality, while effective freezing control required temperatures of −30 °C. For bark and chip debris generated during processing, beta-cypermethrin fumigation effectively eliminated residual pests. Our results confirm that both AP and SF are suitable for disinfecting infested Pinus thunbergii wood, that extreme temperatures can reduce dispersal risks, and that beta-cypermethrin is effective in the downgraded utilization of wood byproducts. This work provides a comprehensive and practical framework for controlling the spread of this invasive pest. Full article

The global spread of glyphosate (GLY) via agricultural runoff poses a significant threat to ecosystems, human health, and the environment, underscoring the need for sustainable agricultural practices. A comprehensive study on glyphosate contamination in runoff water, flowing surface waters, groundwater-influenced, and stagnant water samples was conducted from 2019 to 2021, across a diverse range of landscape types and environmental zones. This research constitutes a novel contribution to the field, focused on several distinct regions, including agricultural regions, tourist zones, and ecologically sensitive areas, including the Beka Natura Reserve, Natura 2000 sites and the Coastal Landscape Park in Poland. Glyphosate residues, with a maximum concentration range of 43.0–8406 ng/L, were detected in 63.5% of water samples collected from protected and unprotected areas. Glyphosate concentrations in water at high-tourism areas were highest in runoff samples from recreational and protected areas, including the Czarna Wda River in Ostrowo (512 ± 9.91 ng/L). Investigated water samples showed target hazard quotient values for glyphosate < 1, indicating no human health risk, and risk quotient values for GLY < 0.1, indicating a low ecotoxicological risk. The presented study is aligned with the United Nations’ 2030 Agenda for Sustainable Development, aiming to contribute to global sustainability goals. Full article

Antibiotics have revolutionized medicine and animal production, yet their extensive use has accelerated the emergence and spread of antimicrobial resistance (AMR). Beyond clinical contexts, livestock and aquaculture are now recognized as major contributors to the global resistome. This review synthesizes evidence across cattle, poultry, swine, sheep and goats, and aquaculture, highlighting how antimicrobial usage shapes resistance at the human–animal–environment interface. A substantial proportion of administered drugs is excreted unmetabolized, leading to the accumulation of unmetabolized antimicrobial residues, antibiotic-resistant bacteria (ARB), and antibiotic resistance genes (ARGs) in soils, manures, waters, sediments, and air. These reservoirs function as long-term sources and dissemination pathways through runoff, leaching, bioaerosols, effluents, and biological vectors. Despite different production systems, similar ARG families dominate, particularly those conferring resistance to tetracyclines, sulfonamides, and β-lactams. Mobile genetic elements and co-selectors such as heavy metals, disinfectants, and microplastics reinforce their persistence. Aquaculture, where water serves both as habitat and vector, emerges as a critical hotspot, while small ruminant systems remain under-researched despite their importance in many low- and middle-income countries. This synthesis highlights convergent patterns across sectors: antimicrobial use drives ARG enrichment; manures, litters, sediments, and effluents act as persistent reservoirs; and dissemination routes connect farms, ecosystems, and human populations. Within a One Health framework, mitigation requires preventive strategies—vaccination, biosecurity, and optimized waste management—supported by harmonized stewardship policies and integrated environmental surveillance. Full article

The global spread of carbapenem-resistant Acinetobacter baumannii (CRAB) poses a severe public health threat, driving growing interest in phage-based precision antibacterial strategies. This systematic review synthesizes recent advances in the field of A. baumannii phage. Modern taxonomy, based on whole-genome phylogeny, has reclassified the majority of A. baumannii phages into the class Caudoviricetes, revealing distinct evolutionary clades that correlate with host tropism and biological properties, superseding the traditional morphological families (Myoviridae, Siphoviridae, Podoviridae). To overcome limitations of natural phage therapy, such as narrow host range, cocktail therapies (ex vivo resistance mutation rates < 5%) and phage-antibiotic synergism (enabling antibiotic efficacy at 1/4 minimum inhibitory concentration) have significantly enhanced antibacterial efficacy. Preclinical models demonstrate that phage therapy efficiently clears pathogens in pneumonia models and promotes the healing of burn wounds and diabetic ulcers via immunomodulatory mechanisms. Technical optimizations include nebulized inhalation delivery achieving 42% alveolar deposition, and thermosensitive hydrogels enabling sustained release over 72 h. Genetic engineering approaches, such as host range expansion through tail fiber recombination and CRISPR/Cas-mediated elimination of lysogeny, show promise. However, the genetic stability of engineered phages requires further validation. Current challenges remain, including limited host spectrum, the absence of clinical translation standards, and lagging regulatory frameworks. Future efforts must integrate metagenomic mining and synthetic biology strategies to establish a precision medicine framework encompassing resistance monitoring and personalized phage formulation, offering innovative solutions against CRAB infections. Full article

Urinary tract infections (UTIs) constitute a severe global health problem, placing a significant burden on healthcare systems worldwide. These infections often lead to frequent hospitalizations, sick leaves, and serious post-infectious complications. One of the most critical aspects of UTI treatment is rapid and accurate identification of pathogens, which increasingly develop resistance to commonly used antibiotics, as well as to newer ones, despite the expectation of sustained efficacy. This alarming trend signals the widespread presence of strains equipped with multiple resistance factors. In this review, attention has been drawn to the current classification of UTIs based on age, gender, risk factors, and preferred treatment strategies. Additionally, this article reviews diagnostic solutions used in this matter, starting from those applied in routine diagnostics and ending with the latest, cutting-edge approaches that are gradually coming into use. Each method varies in its specificity, sensitivity, and costs of implementation, and therefore, the limitations associated with adopting these technologies in widespread UTI diagnostics are also discussed. The review emphasizes the need for further research to optimize these innovations and integrate them into broad clinical practice, ultimately enabling more effective combat against UTIs and limiting the spread of bacterial resistance. Full article

Antimicrobial resistance (AMR) is one of the most critical challenges to global public health in the 21st century, posing a significant threat to healthcare systems and human health due to treatment failure and high mortality. The World Health Organization (WHO) estimates that, without effective interventions, AMR-associated infections could cause 10 million deaths annually and economic losses of up to 100 trillion US dollars by 2050. The rapid spread of drug-resistant strains, especially in hospital and community settings, has significantly reduced the efficacy of traditional antibiotics. With the continuous advancements in relevant research, bacteriophage (Phage) therapy is constantly innovating in the antimicrobial field. The application of frontier technologies, such as phage cocktails and engineered phages, has significantly enhanced the broad spectrum and high efficiency of phage therapy, which is gradually becoming a new generation of tools to replace antibiotics and effectively combat pathogenic bacteria. However, phage therapy is facing several challenges, including phage inactivation by gastric acid, enzymes, ultraviolet light, and mechanical stress, as well as the potential risk of bacterial phage resistance. Advanced encapsulation technologies such as electrospun fibers, liposomes, chitosan nanoparticles, and electrospray provide solutions to these problems by protecting phage activity and enabling controlled release and targeted delivery. This review addresses phage therapeutic studies of Salmonella, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, and Listeria monocytogenes, summarizes the recent advances in phage research, and details the current development and applications of encapsulated phage technologies across various delivery modes. Full article

The fall webworm Hyphantria cunea (Lepidoptera: Erebidae) is a globally invasive species that causes serious damage to agriculture and forestry. Since the first invasion reported in Liaoning Province, China, it has spread extensively southward and was found in Shanghai in 2019. Owing to the climatic and environmental differences between these regions, the biology and population dynamics of H. cunea may have undergone changes in its newly invaded areas. In this study, we investigated the biology of H. cunea in Shanghai and monitored the population dynamics using sex-pheromone-baited traps. We analyzed the relationships between population dynamics and local meteorological factors, including temperature, precipitation, and sunshine duration. Our result indicates high temperatures and large diurnal temperature ranges have significant effects (R² = 0.723, p < 0.001) on the survival and development of H. cunea. Consequently, they play an important role in shaping its population dynamics. These findings enhance our understanding of how H. cunea responds to Shanghai’s environmental conditions, provide a scientific basis for local pest management, and contribute to predicting its population trends. Full article

The COVID-19 pandemic has profoundly influenced healthcare systems and infection control worldwide, with important implications for the epidemiology of antimicrobial resistance. This study examined the prevalence and characteristics of carbapenem-resistant Enterobacterales (CRE) isolates in Southeastern Austria from 2018 to 2022 to assess potential pandemic-related effects. A total of 63 isolates were analyzed using phenotypic and molecular methods, including carbapenemase detection, genotyping, and multilocus sequence typing. The number of CRE isolates appeared to decline during the pandemic years (2021–2022) compared to the pre-pandemic period, with Enterobacter cloacae notably detected in both full pandemic years. Carbapenemase-producing CRE accounted for 44 out of the 63 isolates (69.8%), with metallo-beta-lactamases (VIM-1 and NDM-1) and OXA-48-like carbapenemases predominating. Resistance mechanisms not based on carbapenemase production were more common before the pandemic but rarely detected thereafter. To our knowledge, this is the first report of dual-carbapenemase-producing CRE isolates in Austria. Multi-locus-sequence typing indicated limited nosocomial transmission, with most isolates representing independent introductions linked to external sources. The decline in CRE prevalence may reflect reduced international travel and healthcare access during the pandemic, which could have limited the importation of resistant strains. These findings reflect the potential role of global mobility in the spread of CRE and illustrate how public health interventions can shape antimicrobial resistance trends. Full article

Airborne microplastics (MPs) are a global issue, and there is an urgent need to prevent their spread in the environment. Sensitive and reliable methods are also needed to assess their deposition and effectively evaluate risk in terrestrial ecosystems. Current automated monitoring devices are expensive and do not enable large-scale mapping of MP deposition. As with other persistent atmospheric contaminants, developing accurate, cost-effective and easily applicable biomonitoring methods would therefore be highly beneficial. Cryptogams are among the most suitable biomonitors of airborne contaminants, and preliminary surveys show that epiphytic lichens accumulate higher concentrations of MPs in urban areas and near landfills than in control sites. However, the interaction between lichen thalli and MPs is weak and, as discussed in this review, the anthropogenic fibres and plastic fragments intercepted and retained by lichens probably do not reflect the levels in bulk atmospheric deposition. While emphasizing the need for studies evaluating the effectiveness of cryptogams in accumulating different types of airborne MPs under various meteorological conditions, this review also suggests directing future research efforts toward mosses, which seem to accumulate much higher concentrations of MPs than lichens in both active and passive biomonitoring surveys. Full article

Throughout human history, contagious infectious diseases have significantly impacted societies, shaping the fate of great dynasties and challenging economic and political systems, social relations, and the overall well-being of the human species. The SARS-CoV-2 pandemic brought unprecedented challenges, emerging in the context of extreme globalization and rapid technological development. The speed of viral spread, the highest absolute mortality rate caused by a viral agent in the last 100 years, and the severe economic and social consequences imposed an urgent need for vaccine development on a previously unimaginable timescale. The proven safety and efficacy of inactivated vaccines enabled the development and large-scale application of the first immunizer against SARS-CoV-2 in less than a year after the World Health Organization (WHO) declared the pandemic. In this review, we discuss the importance of inactivated antiviral vaccines and their historical impact in containing highly harmful diseases affecting humanity. We also explore the cellular mechanisms by which inactivated vaccines may induce immunogenic responses against viral pathogens. In addition, we bring to light a discussion about a fast, cost-effective, potentially efficient technology for large-scale immunizer production: High hydrostatic pressure (HHP), a method long supported by decades of preclinical studies and which is especially effective in the context of enveloped viruses. Finally, we discuss the role of inactivated antiviral vaccines in the face of advances in biotechnology and, therefore, the emergence of vaccines that use genetic engineering in their production, such as RNA, DNA and viral vaccines, which have gained special prominence during the COVID-19 pandemic. Full article

Antimicrobial resistance (AMR) in bacteria is a critical global health threat, yet the impact of environmental stressors such as aerosolization on resistance remains unclear. We previously showed that aerosolization can induce antibiotic resistance in Escherichia coli MG1655, a gram-negative pathogen simulant. Here, we investigated Bacillus globigii, a surrogate for the gram-positive pathogen Bacillus anthracis, to assess how aerosolization affects bacterial survival and antibiotic resistance. B. globigii vegetative cells and spores were aerosolized under varying conditions and durations (5, 10, 15, 30, and 45 min) into a sterile, airtight chamber and collected using the wetted wall cyclone (WWC) system. Samples were analyzed via antibiotic susceptibility testing, culture-based assay, and quantitative polymerase chain reaction (qPCR). Vegetative cells exhibited the lowest culturability after 5 and 30 min aerosolization, while spores showed reduced culturability at 15–45 min. Both vegetative cells and spores displayed lowest antibiotic susceptibility profiles after 15 min of aerosolization. Our findings suggest that aerosolization duration and bacterial state (vegetative vs. spores) can influence bacterial survival and development of antibiotic resistance. Understanding these dynamics is essential for designing strategies to mitigate the airborne spread of antibiotic-resistant bacteria. Full article

Background: Non-small-cell lung cancer (NSCLC) is often diagnosed at stage IV, when prognosis depends on metastatic spread. The impact of histopathology on the first metastatic site remains underexplored. Methods: We retrospectively analyzed 364 patients with stage IV NSCLC diagnosed at OncoHelp Medical Center, Timișoara, Romania (2020–2024). All underwent baseline CT chest–abdomen–pelvis, whole-body FDG PET-CT, and brain MRI within seven days of histological confirmation. Patients were stratified into adenocarcinoma (n = 164), squamous cell carcinoma (n = 112), and large-cell carcinoma (n = 88). The first metastatic site was defined as the earliest confirmed location. Associations were evaluated using Fisher’s exact test and multinomial logistic regression. Results: Histology was associated with the first metastatic site (global p = 0.013). Adenocarcinoma was more likely than squamous carcinoma to present with brain metastases (RRR 3.74, 95% CI 1.48–9.45; p = 0.005; p_FDR = 0.053) and showed directional signals toward bone and adrenal involvement. Squamous carcinoma more frequently spread to the pleura as the first site (adjusted p = 0.008). Large-cell carcinoma showed no consistent differences compared to squamous carcinoma. In adenocarcinoma subgroups, EGFR-mutant tumors most often metastasized to the brain (55.6%), KRAS-mutant tumors to the liver (44.4%), and ALK-rearranged tumors to bone (100%). Conclusions: The first metastatic site in NSCLC follows histology-specific patterns, with adenocarcinoma favoring hematogenous spread and squamous carcinoma showing locoregional involvement. Molecular status further refines these patterns in adenocarcinoma. Incorporating histology into baseline staging may improve diagnostic efficiency and prognostic accuracy. Full article