Burden of multidrug and extensively drug-resistant ESKAPEE pathogens in a secondary hospital care setting in Greece.

Bacterial antibiotic resistance (AMR) is a significant threat to public health, with the sentinel 'ESKAPEE' pathogens, being of particular concern. A cohort study spanning 5.5 years (2016-2021) was conducted at a provincial general hospital in Crete, Greece, to describe the epidemiology of ESKAPEE-associated bacteraemia regarding levels of AMR and their impact on patient outcomes. In total, 239 bloodstream isolates were examined from 226 patients (0.7% of 32 996 admissions) with a median age of 75 years, 28% of whom had severe comorbidity and 46% with prior stay in ICU. Multidrug resistance (MDR) was lowest for Pseudomonas aeruginosa (30%) and Escherichia coli (33%), and highest among Acinetobacter baumannii (97%); the latter included 8 (22%) with extensive drug-resistance (XDR), half of which were resistant to all antibiotics tested. MDR bacteraemia was more likely to be healthcare-associated than community-onset (RR 1.67, 95% CI 1.04-2.65). Inpatient mortality was 22%, 35% and 63% for non-MDR, MDR and XDR episodes, respectively (P = 0.004). Competing risks survival analysis revealed increasing mortality linked to longer hospitalisation with increasing AMR levels, as well as differential pathogen-specific effects. A. baumannii bacteraemia was the most fatal (14-day death hazard ratio 3.39, 95% CI 1.74-6.63). Differences in microbiology, AMR profile and associated mortality compared to national and international data emphasise the importance of similar investigations of local epidemiology.

Masticatory dysfunction is associated with osteoporosis in older men.

AIM: Thirty per cent of hip fractures occur in men. Nevertheless, the determinants of osteoporosis in men are unclear. Masticatory dysfunction is associated with malnutrition, and might represent an emergent cause of osteoporosis. The aim of this study was to assess the association of bone mineral density and self-assessed masticatory dysfunction in a general older population. MATERIAL AND METHODS: We assessed the association of masticatory dysfunction with standard parameters of bone mineral density (T-score, Z-score and the stiffness index) in all 310 subjects aged 75+ living in Tuscania (Italy). RESULTS: Among men, self-assessed masticatory dysfunction was associated with T-score [beta=0.86, confidence intervals (CI)=0.15-1.57; p=0.019], Z-score (beta=0.86, CI=0.16-1.56; p=0.017) and the stiffness index (beta=9.12, CI=0.47-17.77; p=0.039) in linear regression modeling, after adjusting. No significant associations were observed in women. CONCLUSIONS: Masticatory dysfunction is independently associated with osteoporosis in elderly men. Evaluation of masticatory function should enter the routine assessment of older men with osteoporosis.