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Tsukamurella spp. are an infrequent and underdiagnosed cause of bacterial respiratory infection, usually occurring in patients with structural lung disease or immune compromise. We describe T. tyrosinosolvens respiratory infection in a patient in Australia without structural lung disease or known immune deficiency. The patient was successfully treated with oral ciprofloxacin and clarithromycin.

The reported patient is a middle-aged farmer from West Sudan who presented with a painless mass in the right upper eyelid that progressively enlarged over time. His medical treatment journey was prolonged and difficult. The mass was initially misdiagnosed as lacrimal gland pleomorphic adenoma. The patient was later referred to a specialised center, where wide local excision confirmed the diagnosis of Actinomadura madurae actinomycetoma. Although orbital mycetoma is uncommon, it is a serious condition that should be considered in the differential diagnosis in endemic areas.

The efficacy of transfusion with hyperimmune plasma (HIP) for preventing pneumonia caused by Rhodococcus equi remains ill-defined. Quarter Horse foals at 2 large breeding farms were randomly assigned to be transfused with 2 L of HIP from adult donors hyperimmunized either with R . equi (RE HIP) or a conjugate vaccine eliciting antibody to the surface polysaccharide β-1→6-poly- N -acetyl glucosamine (PNAG HIP) within 24 hours of birth. Antibody activities against PNAG and the rhodococcal virulence-associated protein A (VapA), and to deposition of complement component 1q (C՛1q) onto PNAG were determined by ELISA, and then associated with either clinical pneumonia at Farm A (n = 119) or subclinical pneumonia at Farm B (n = 114). Data were analyzed using multivariable logistic regression. Among RE HIP-transfused foals, the odds of pneumonia were approximately 6-fold higher (P = 0.0005) among foals with VapA antibody activity ≤ the population median. Among PNAG HIP-transfused foals, the odds of pneumonia were approximately 3-fold (P = 0.0347) and 11-fold (P = 0.0034) higher for foals with antibody activities ≤ the population median for PNAG or C՛1q deposition, respectively. Results indicated that levels of activity of antibodies against R . equi antigens are correlates of protection against both subclinical and clinical R . equi pneumonia in field settings. Among PNAG HIP-transfused foals, activity of antibodies with C՛1q deposition (an indicator of functional antibodies) were a stronger predictor of protection than was PNAG antibody activity alone. Collectively, these findings suggest that the amount and activity of antibodies in HIP ( i . e ., plasma volume and/or antibody activity) is positively associated with protection against R . equi pneumonia in foals.

Trueperella pyogenes is one of the most important microorganisms causing metritis in post-partum cattle. Co-infection with other bacterial species such as Escherichia coli or Fusobacterium necrofurom increases the severity of the disease and the persistence of bacteria in utero. The aim of this study was to investigate the frequency of T. pyogenes strains, and their virulence and antimicrobial resistant profiles in metritis cases. The study was carried out on 200 samples obtained from metritis discharges of postpartum cattle on 18 farms around Tehran, Iran. Sixty-five T. pyogenes isolates (32.5%) were identified, of which 16 isolates were detected as pure cultures and the other 49 isolates from cultures most commonly mixed with E. coli or F. necrofurom. In terms of diversity in biochemical characteristic of T. pyogenes strains, 8 different biotypes were identified among the isolates. Single or multi antimicrobial resistance was observed in 48 isolates (73.9%), which was mostly against trimethoprim sulfamethoxazole, azithromycin, erythromycin and streptomycin. The tetracycline resistance gene tetW and macrolide resistance genes ermB and ermX were detected in 30, 18 and 25 isolates, respectively. In the screening of genes encoding virulence factors, fimA and plo genes were identified in all tested isolates. Genes encoding nanP, nanH, fimC, fimG, fimE and cbpA were detected in 50, 54, 45, 40, 50 and 37 of isolates, respectively. Thirteen different genotypes were observed in these T. pyogenes isolates. A significant association between clonal types and virulence factor genes, biochemical profile, CAMP test result, severity of the disease and sampling time was detected.

Trueperella pyogenes is an opportunistic pathogen frequently associated with bovine endometritis, yet the mechanisms by which it induces uterine inflammation remain incompletely understood. In this study, we investigated the effects of T. pyogenes and its membrane vesicles (MVs) on bovine endometrial epithelial cells (BEECs) and explored the underlying inflammatory pathways involved. Bovine endometrial epithelial cells (BEECs) were treated with T. pyogenes (MOI = 100) or MVs at various concentrations (1 × 10 8 , 1 × 10 7 , or 1 × 10 6 particles/mL) for 6–24 h. Inflammatory cytokines (IL-1β, IL-6, IL-18, or TNF-α) and the activation of the NLRP3 and MyD88/NF-κB signalling pathways were analysed by ELISA, qRT‒PCR, and western blotting. Cell death mechanisms were assessed by flow cytometry and scanning electron microscopy. T. pyogenes significantly upregulated inflammatory cytokine mRNA expression at 6 and 12 h and protein expression at 12 and 24 h. Compared with bacterial stimulation at 12 h, MVs induced earlier activation of the NLRP3 inflammasome at 6 h. High-concentration MVs induced necrosis-like membrane disruption, whereas moderate concentrations promoted apoptosis and pyroptosis. Both T. pyogenes and its MVs activated the MyD88/NF-κB signalling pathway, with significantly increased phosphorylation of P65 at 12 h. Cytokine secretion exhibited time- and dose-dependent trends, aligning with transcriptional changes. Collectively, these findings demonstrate that T. pyogenes MVs contribute to endometrial inflammation through the NLRP3 and MyD88/NF-κB signalling pathways, with distinct forms of cell death determined by MV concentration. These findings highlight MVs as key virulence factors and potential therapeutic targets for bovine endometritis.

Bacterial vaginosis (BV) is the most common vaginal disorder of reproductive-age women. Yet the cause of BV has not been established. To uncover key determinants of BV, we employed a multi-omic, systems-biology approach, including both deep 16S rRNA gene-based sequencing and metabolomics of lavage samples from 36 women. These women varied demographically, behaviorally, and in terms of health status and symptoms. 16S rRNA gene-based community composition profiles reflected Nugent scores, but not Amsel criteria. In contrast, metabolomic profiles were markedly more concordant with Amsel criteria. Metabolomic profiles revealed two distinct symptomatic BV types (SBVI and SBVII) with similar characteristics that indicated disruption of epithelial integrity, but each type was correlated to the presence of different microbial taxa and metabolites, as well as to different host behaviors. The characteristic odor associated with BV was linked to increases in putrescine and cadaverine, which were both linked to Dialister spp. Additional correlations were seen with the presence of discharge, 2-methyl-2-hydroxybutanoic acid, and Mobiluncus spp., and with pain, diethylene glycol and Gardnerella spp. The results not only provide useful diagnostic biomarkers, but also may ultimately provide much needed insight into the determinants of BV.

Bloodstream infections are associated with high morbidity and mortality. Accurate identification of blood isolates to the species level and identification of the source of infection and/or the portal of entry are crucial for optimal management of these infections. These investigations—in addition to clinical findings and laboratory and imaging studies—are central to informing and directing efficient and effective diagnostic examinations and to choosing the optimal antimicrobial regimen. Four case studies that demonstrate the importance of identifying the causative agents and the source of infection are discussed to illustrate the central importance of microbiological findings in the diagnosis of bacteremia and bloodstream infections associated with infections at other sites.

Rhodococcus equi is a veterinary pathogen that can cause substantial morbidity in patients that are immunocompromised and are occupationally and recreationally exposed to farming, livestock, and dry soil environments. Although the clinical spectrum of disease associated with R equi is broad, pulmonary involvement is a predominant feature in most cases. We present a case of occupationally acquired R equi pneumonia and mediastinal lymphadenitis in a patient that has had a renal transplant and is in receipt of a stable immunosuppression regimen. We review the pathogenesis and clinical characteristics of infections with Rhodococcus spp, and discuss approaches to treatment of this disease entity in populations of patients who are immunocompromised.

To enhance the current clinical understanding and improve the diagnosis and treatment of Actinotignum schaalii infections, we have presented here a report of the case of recurrent infections at a periumbilical scar, induced by Actinotignum schaalii and complicated by abscess formation in a 50-year-old woman with persistent festering at the site of a periumbilical scar after laparoscopy 9 years ago, with subsequent ruptures over the past 2 years. Physical examination revealed a radial fold scar with localized redness and slight swelling of the skin below the navel. Although no significant increase in the local skin temperature was noted, tenderness was present. A rupture at the site was also observed, and gentle compression produced a small amount of odorless and yellowish viscous pus. Anerobic culturing of the pus for 3 days revealed gray-white, non-hemolytic, spore-free, gram-positive, slightly curved rod-shaped bacteria. These bacteria were identified as A. schaalii using matrix-assisted laser desorption ionization time-of-flight mass spectrometry. The patient was subsequently treated with a 1-month course of oral amoxicillin, combined with debridement and drainage. Her condition improved with regular dressing changes. However, during follow-up 6-month later, the patient presented with a recurrence of the local infection at the scar site, again accompanied by abscess formation and rupture. Notably, the wound size was smaller, and after a 1-week treatment with silver ion, without any systemic antibiotic administration, her condition improved. Next, triamcinolone acetonide combined with lidocaine was injected into the scar three times. No further local infections were observed at the scar site during the subsequent 12-month follow-up.

Propionibacterium spp. are a rare cause of infective endocarditis (IE). The diagnosis is difficult because the bacteria are slow-growing and growth in blood cultures is often misinterpreted as contamination from the skin flora. The aim of this study was to describe all cases of Propionibacterium spp. endocarditis in the Swedish national registry of IE. The registry was searched for all cases of IE from 1995 to 2016 caused by Propionibacterium spp. Data concerning clinical characteristics, treatment, and outcome were registered. A total of 51 episodes of definitive prosthetic valve endocarditis (PVE) caused by Propionibacterium spp. were identified, comprising 8% of cases of PVE during the study period. Almost all cases (n = 50) were male. The median time from surgery to diagnosis of IE was 3 years. Most patients were treated mainly with beta-lactams, partly in combination with aminoglycosides. Benzyl-penicillin was the most frequently used beta-lactam. A total of 32 patients (63%) underwent surgery. Overall, 47 patients (92.1%) were cured, 3 (5.9%) suffered relapse, and 1 (2.0%) died during treatment. IE caused by Propionibacterium spp. almost exclusively affects men with a prosthetic valve and findings of Propionibacterium spp. in blood cultures in such patients favors suspicion of a possible diagnosis of IE. In patients with prosthetic valves, prolonged incubation of blood cultures up to 14 days is recommended. The prognosis was favorable, although a majority of patients required cardiac surgery during treatment. Benzyl-penicillin should be the first-line antibiotic treatment option for IE caused by Propionibacterium spp.