The majority of chronic infections are associated with mono- or polymicrobial biofilms, having a significant impact on the patients' quality of life and survival rates. Although the use of medical devices revolutionized health care services and significantly improved patient outcomes, it also led to complications associated with biofilms and to the emergence of multidrug resistant bacteria. Immunocompromised patients, institutionalized or hospitalized individuals, elderly people are at greater risk due to life-threatening septic complications, but immunocompetent individuals with predisposing genetic or acquired diseases can also be affected, almost any body part being able to shelter persistent biofilms. Moreover, chronic biofilm-related infections can lead to the occurrence of systemic diseases, as in the case of chronic periodontitis, linked to atherosclerosis, cardiovascular disease and diabetes. The more researchers discover, new unknown issues add up to the complexity of biofilm infections, in which microbial species establish relationships of cooperation and competition, and elaborate phenotypic differentiation into functional, adapted communities. Their interaction with the host's immune system or with therapeutic agents contributes to the complex puzzle that still misses a lot of pieces. In this comprehensive review we aimed to highlight the microbial composition, developmental stages, architecture and properties of medical biofilms, as well as the diagnostic tools used in the management of biofilm related infections. Also, we present recently acquired knowledge on the etiopathogenesis, diagnosis and treatment of four chronic diseases associated with biofilm development in tissues (chronic periodontitis, chronic lung infection in cystic fibrosis, chronic wounds) and artificial substrata (medical devices-related infections).

We report on the genomic characterization of 47 multi-drug resistant, carbapenem resistant and ESBL-producing K. pneumoniae isolates from the influent (I) and effluent (E) of three wastewater treatment plants (WWTPs) and from Romanian hospital units which are discharging the wastewater in the sampled WWTPs. The K. pneumoniae whole genome sequences were analyzed for antibiotic resistance genes (ARGs), virulence genes and sequence types (STs) in order to compare their distribution in C, I and E samples. Both clinical and environmental samples harbored prevalent and widely distributed ESBL genes, i.e. bla SHV , bla OXA , bla TEM and bla CTX M . The most prevalent carbapenemase genes were bla NDM-1 , bla OXA-48 and bla KPC-2 . They were found in all types of isolates, while bla OXA-162 , a rare bla OXA-48 variant, was found exclusively in water samples. A higher diversity of carbapenemases genes was seen in wastewater isolates. The aminoglycoside modifying enzymes (AME) genes found in all types of samples were aac(6'), ant(2'') Ia, aph(3'), aaD, aac(3) and aph(6). Quinolone resistance gene qnrS1 and the multi-drug resistance oqxA/B pump gene were found in all samples, while qnrD and qnrB were associated to aquatic isolates. The antiseptics resistance gene qacEdelta1 was found in all samples, while qacE was detected exclusively in the clinical ones. Trimethroprim-sulfamethoxazole (dfrA, sul1 and sul2), tetracyclines (tetA and tetD) and fosfomycin (fosA6, known to be located on a transpozon) resistance genes were found in all samples, while for choramphenicol and macrolides some ARGs were detected in all samples (catA1 and catB3 / mphA), while other (catA2,

Decades of antibiotic misuse in clinical settings, animal feed, and within the food industry have led to a concerning rise in antibiotic-resistant bacteria. Every year, antimicrobial-resistant infections cause 700,000 deaths, with 10 million casualties expected by 2050, if this trend continues. Hence, innovative solutions are imperative to curb antibiotic resistance. Bacteria produce a potent arsenal of drugs with remarkable diversity that are all distinct from those of current antibiotics. Bacteriocins are potent small antimicrobial peptides synthetized by certain bacteria that may be appointed as alternatives to traditional antibiotics. These molecules are strategically employed by commensals, mostly Firmicutes, to colonize and persist in the human gut. Bacteriocins form channels in the target cell membrane, leading to leakage of low-molecular-weight, causing the disruption of the proton motive force. The objective of this review was to list and discuss the potential of bacteriocins as antimicrobial therapeutics for infections produced mainly by resistant pathogens.

The cobalt ferrite (CoFe2O4) and silver-cobalt ferrite (Ag-CoFe2O4) nanoparticles were obtained through self-combustion and wet ferritization methods using aqueous extracts ofHibiscus rosa-sinensisflower and leaf. X-ray diffraction, scanning electron microscopy, Fourier transform infrared spectroscopy, and magnetic measurements were used for the characterization of the obtained oxide powders. The antimicrobial activity of the cobalt ferrite and silver-cobalt ferrite nanoparticles against Gram-positive and Gram-negative bacteria, as well as fungal strains, was investigated by qualitative and quantitative assays. The most active proved to be the Ag-CoFe2O4nanoparticles, particularly those obtained through self-combustion using hibiscus leaf extract, which exhibited very low minimal inhibitory concentration values (0.031–0.062 mg/mL) against all tested microbial strains, suggesting their potential for the development of novel antimicrobial agents.

Textile materials can be easily used as a support for the nano-decoration with active particles in order to gain new features such as self-cleaning, antimicrobial efficiency, water repellency, mechanical strength, color change and protection against ultraviolet radiations. In this context, our present research reports the fabrication and characterization (physico-chemical analysis and surface morphology) of cotton fabrics treated with reduced graphene oxide decorated with two types of TiO2 nanoparticles co-doped with 1% iron and nitrogen atoms (TiO2/rGO NPs) and synthesized in different hydrothermal conditions by a simultaneous precipitation of Ti3+ and Fe3+ ions to achieve their uniform distribution or after a sequential precipitation of these two cations for obtaining a higher concentration of iron on the surface of Ti4+ oxyhydroxide. Further, the antimicrobial efficiency of these TiO2/rGO-treated textiles and their influence on human cells were assessed. We demonstrated the successful development of TiO2/rGO coating of cotton fabrics which are harmless for human skin cells and inhibit the growth of Staphylococcus aureus and Enterococcus faecalis. These findings confirm their great potential as novel graphene-based materials for biomedical and photocatalytic applications and this approach could be used for the large-scale fabrication of innovative self-cleaning and antimicrobial textiles.