Uropathogenic Escherichia coli strains secrete the alpha-hemolysin (HlyA) toxin to create a favorable environment for infection. At high concentrations, HlyA forms pores in eukaryotic membranes, leading to cell lysis, while at lower concentrations, it disrupts host-cell signaling pathways, triggering apoptosis. However, the frequency at which HlyA reaches lytic levels in host cells during infection remains unclear.

Our laboratory has demonstrated that, once in circulation, low concentrations of HlyA increase intracellular calcium levels, activating calpains that degrade cytoskeletal proteins and promoting phosphatidylserine (PS) exposure on the outer membrane of erythrocytes and platelets. These changes are associated with erythrocyte suicidal death (eryptosis) and a necrotic-like procoagulant state in platelets. HlyA-treated erythrocytes undergo morphological and functional alterations, including microvesicle release, echinocyte formation that affects deformability, and increased aggregability. Additionally, HlyA-treated platelets adopt a procoagulant state, indicing a ballon-like morphology and the release of procoagulant extracellular vesicles (EVs), raising new questions about how blood cell interactions are altered in the presence of the toxin and their impact on circulation.

In this way, targeting HlyA presents a promising therapeutic approach to counteract the detrimental effects of E. coli infections, particularly in South American regions where these infections are endemic, highlighting the toxin as a critical target for intervention.

Reverse total shoulder arthroplasty (RTSA) has become a widely accepted surgical treatment for
various complex conditions. It has demonstrated excellent clinical outcomes in alleviating pain and
restoring function in challenging cases where traditional anatomic replacements are less effective.
Unfortunately, complications may occur, such as periprosthetic joint infection (PJI). PJIs could be
caused by Staphylococcus aureus, coagulase-negative staphylococci (CoNS), mainly S.
epidermidis, and Cutibacterium acnes. Several approaches, during hip and knee arthroplasties, have
been explored with the aim of reducing PJIs intraoperatively, particularly the use of intraoperative
iodopovidone irrigation. However, no data referred to its use after shoulder arthroplasty are still
available. Therefore, the aim of the present multidisciplinary research is to establish if an
intraoperative iodopovidone irrigation could be able to reduce microbial contamination in shoulder
arthroplasty and to determine the bacterial isolates’ virulence features. Fifty-five patients
undergoing RTSA were included. They were enrolled from 3 different hospitals, specifically 29
from San Luigi Gonzaga Hospital (Orbassano, Turin), 11 from Mauriziano-Umberto I Hospital
(Turin), and 5 from Presidio CTO, Città della Salute e della Scienza Hospital (Turin). Most of them
had various comorbidities. At the end of RTSA surgery, three different specimens were collected
from the surgical field before and after an irrigation with iodopovidone. The specimens were
cultured on various agar media suitable for the growth of aerobic and anaerobic bacteria and
incubated. Subsequently, bacteriological investigations were carried out, and the resulting
predominant bacterial types were identified and characterized to evidence resistant or biofilmproducing bacterial strains. The microbiological analysis revealed a reduction in both anaerobic
(75%) and aerobic (100%) bacterial load, as well as the positivity rate, in samples collected after the
post-operative irrigation compared to pre-operative ones. C. acnes was the predominant anaerobic
pathogen isolated, whereas the most representative aerobic strains were CoNS, and rarely Gramnegative bacteria. The virulence factor’s characterisation revealed that a low number of isolates
were resistant to the assayed antibiotics, and notably, among the biofilm producers both C. acnes
and CoNS isolates were strongly adherent. PJI is a devastating complication following total joint
arthroplasty, which significantly increases the risk of patient morbidity. These preliminary results
corroborate the efficacy of the intraoperative irrigation in reducing the bacterial load in the
operatory field, and in turn it might contribute to prevent the risk of PJIs in shoulder arthroplasty.
An appropriate prophylaxis therapy and a multifaceted microbiological approach could ensure a
significant reduction in patient infection rate and a potential decrease in associated economic costs.

In Mexico, mucormycosis is an emerging opportunistic fungal infection that is associated with a mortality rate of more than 50%. Rhizopus spp. are the most frequent etiologic agents in 59% of the cases of rhinocerebral mucormycosis reported in the country . The most frequently identified clinical forms are the rhino-orbito-cerebral form (75.9%), the cutaneous form (8.41%) and the pulmonary form (7.47%), according to a 35-year retrospective study conducted at a tertiary care center .

Multidisciplinary microsurgical treatment is essential to limit damage and allow a good response to antifungals. Resection of the injured tissue at the base of the skull involves management of neurovascular structures that compromise the patient’s life and neurological function. Adequate reconstruction of the base of the skull is essential to avoid cerebrospinal fluid fistulas, meningitis or some other neuroinfection. Assisting in adequate prosthetic reconstruction

Brucellosis is a zoonotic disease caused by Brucella, which infects a wide variety of vertebrate animals including human beings. The aim was to carry out a randomized survey to evaluate the frequency of Brucella positive-raw milk artisanal cheese (RMAC) in five traditional Brazilian microregions, as well as evaluating the associated factors and  to analyze the relationships between spatial clusters of Brucella positive-RMAC and those of human exposures and positive livestock. During the period from October/2017 to April/2018, 100 RMAC samples were collected from different rural family-based cheese-processing agroindustries (RFCPA) in four and one regions from the states of Minas Gerais and Piauí, respectively, and were analysed for Brucella by direct polymerase chain reaction (PCR) species-specific DNA detection and cultivation-based approaches. Among 100 RMAC that were analysed, we found 33 Brucella DNA-positive samples by PCR and, for the first time, from one Minas artisanal cheese, viable Brucella abortus was recovered by cultivation. RMAC with a lower ripening period and three of the five regions had higher concentrations of positive samples (p < 0.05), showing two clusters by Kernel density estimator, one being significant by Scan (p < 0.05). Links between clusters of high-density human expositions to Brucella and positive-RMAC were found. In conclusion, RMAC may be a source of Brucella for humans, since the positive samples were from batches that were sold by cheesemakers. This should be of concern and encourage cooperation between the health and agriculture sectors in order to mitigate this public health risk through One Health integrated approaches.