Antibacterial activity of Hungarian varietal honeys against respiratory pathogens as a function of storage time.

Today, antibiotic therapies that previously worked well against certain bacteria due to their natural sensitivity, are becoming less effective. Honey has been proven to inhibit the biofilm formation of some respiratory bacteria, however few data are available on how the storage time affects the antibacterial effect. The activity of black locust, goldenrod, linden and sunflower honeys from three consecutive years (2020, 2021, 2022) was analyzed in 2022 against Gram-negative (Haemophilus influenzae, H. parainfluenzae, Pseudomonas aeruginosa) and Gram-positive (Streptococcus pneumoniae) bacteria using in vitro microbiological methods. After determining the physicochemical parameters of honey, broth microdilution was applied to determine the minimum inhibitory concentration of each honey type against each bacterium, and crystal violet assay was used to test their antibiofilm effect. The possible mechanism of action was explored with membrane degradation test, while structural changes were illustrated with scanning electron microscopy. Honeys stored for one or two years were darker than fresh honeys, while older honeys had significantly lower antibacterial activity. The most remarkable inhibitory effect was exerted by linden and sunflower honeys, and P. aeruginosa proved to be the most resistant bacterium. Based on our results, honey intended for medicinal purposes should be used as fresh as possible during a treatment.

Epidemiological and clinical insights into the enterovirus D68 upsurge in Europe 2021/22 and the emergence of novel B3-derived lineages, ENPEN multicentre study.

Enterovirus D68 (EV-D68) infections are associated with severe respiratory disease and acute flaccid myelitis (AFM). The European Non-Polio Enterovirus Network (ENPEN) aimed to investigate the epidemiological and genetic characteristics of EV-D68 and its clinical impact during the fall-winter season of 2021/22. From 19 European countries, 58 institutes reported 10,481 (6.8%) EV-positive samples of which 1,004 (9.6%) were identified as EV-D68 (852 respiratory samples). Clinical data was reported for 969 cases. 78.9% of infections were reported in children (0-5 years); 37.9% of cases were hospitalised. Acute respiratory distress was commonly noted (93.1%) followed by fever (49.4%). Neurological problems were observed in 6.4% of cases with six reported with AFM. Phylodynamic/Nextstrain and phylogenetic analyses based on 694 sequences showed the emergence of two novel B3-derived lineages, with no regional clustering. In conclusion, we describe a large-scale EV-D68 European upsurge with severe clinical impact and the emergence of B3-derived lineages.

Chestnut Honey Is Effective against Mixed Biofilms at Different Stages of Maturity.

The irresponsible overuse of antibiotics has increased the occurrence of resistant bacterial strains, which represents one of the biggest patient safety risks today. Due to antibiotic resistance and biofilm formation in bacteria, it is becoming increasingly difficult to suppress the bacterial strains responsible for various chronic infections. Honey was proven to inhibit bacterial growth and biofilm development, offering an alternative solution in the treatment of resistant infections and chronic wounds. Our studies included chestnut honey, valued for its high antibacterial activity, and the bacteria Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and S. epidermidis, known to form multi-species biofilm communities. Minimum inhibitory concentrations (MIC) of chestnut honey were determined for each bacterial strain. Afterwards, the mixed bacterial biofilms were treated with chestnut honey at different stages of maturity (incubation times: 2, 4, 6, 12, 24 h). The extent of biofilm inhibition was measured with a crystal violet assay and demonstrated by scanning electron microscopy (SEM). As the incubation time increased and the biofilm became more mature, inhibition rates decreased gradually. The most sensitive biofilm was the combination MRSA-S. epidermidis, with a 93.5% inhibition rate after 2 h of incubation. Our results revealed that chestnut honey is suitable for suppressing the initial and moderately mature stages of mixed biofilms.

Proposed mechanisms of action of herbal drugs and their biologically active constituents in the treatment of coughs: an overview.

Various medicinal plants find their use in cough treatment, based on traditions and long-term experience. Pharmacological principles of their action, however, are much less known. Herbal drugs usually contain a mixture of potentially active compounds, which can manifest diverse effects. Expectorant or antitussive effects, which can be accompanied by others, such as anti-inflammatory or antibacterial, are probably the most important in the treatment of coughs. The aim of this review is to summarize the current state of knowledge of the effects of medicinal plants or their constituents on cough, based on reliable pharmacological studies. First, a comprehensive description of each effect is provided in order to explain the possible mechanism of action in detail. Next, the results related to individual plants and substances are summarized and critically discussed based on pharmacological in vivo and in vitro investigation.

Phenolic compounds in Hungarian acacia, linden, milkweed and goldenrod honeys.

Honey is a valuable source of nutrients, minerals and phenolic compounds. Phenolic acids and flavonoids are associated with health benefits of honey and can serve as markers for distinguishing honey types. This study aimed at determining the phenolic profile of four Hungarian unifloral honeys that were not analyzed previously. After verifying their botanical origin with melissopalynological analysis, total reducing capacity was determined with Folin-Ciocalteau method, and phenolic composition was analyzed with HPLC-DAD-MS. From the 25 phenolic substances examined, pinobanksin was the most abundant, followed by chrysin, p-hydroxybenzoic acid and galangin. Quercetin and p-syringaldehyde were detected only in acacia honey, which contained higher levels of chrysin and hesperetin compared to the other three honeys. Milkweed and linden honeys displayed higher levels of caffeic, chlorogenic, ferulic and p-coumaric acids compared to acacia and goldenrod honeys. Taxifolin may serve as a unique marker compound of milkweed honey. Goldenrod honey contained the highest level of syringic acid. Principal component analysis supported the indicator role of polyphenols in honey identification, discriminating clearly the four unifloral honeys. Our results suggest that phenolic profiles may be useful to find markers of honey's floral origin, but geographical origin can strongly influence the composition of characteristic compounds.

Antibacterial and Antibiofilm Effect of Unifloral Honeys against Bacteria Isolated from Chronic Wound Infections.

Honey is known as an alternative remedy for the treatment of wounds. To evaluate the potential of five Hungarian honey types against wound-associated bacteria, in vitro microbiological assays were conducted on Pseudomonas aeruginosa, Staphylococcus epidermidis and methicillin-resistant Staphylococcus aureus (MRSA). Minimum inhibitory concentration (MIC) was determined with the broth macrodilution method, and biofilm degradation capacity was tested with a crystal violet assay. To understand the underlying mechanisms, the effects of honey treatments were assessed on bacterial membrane integrity and quorum sensing (QS). The highest antibacterial activity, indicated by the lowest MIC values, as well as the highest biofilm inhibition rates and membrane disruption, was displayed by chestnut and linden honeys. The most sensitive bacterium was S. epidermidis. Bacterial membrane degradation took place 40 min after treatment with honey solutions of at least a 40% concentration. Each honey sample exhibited anti-QS activity, which was most pronounced in the case of chestnut honey. It was concluded that the antibacterial, biofilm-inhibiting and anti-QS activities of linden and chestnut honeys were superior to those of acacia, goldenrod and milkweed honeys. In addition to the floral source, the antibacterial effect of honey is influenced by the microbial species treated. The use of honey in wound treatment can be justified by its diverse antibacterial mechanisms.

Antibacterial and Biofilm Degradation Effects of Hungarian Honeys Linked With Botanical Origin, Antioxidant Capacity and Mineral Content.

The aim of the study was to assess the impact of four unifloral honeys on the food-borne pathogens Pseudomonas aeruginosa and Staphylococcus aureus, by analyzing the honeys' antibacterial and biofilm degradation effects, as well as their antioxidant activity and element content. Linden and milkweed honeys represented light colored honeys, while goldenrod and chestnut honeys the darker ones. The botanical origin of the honeys and the relative frequency of their pollen types were established with melissopalynological analysis. The antioxidant capacities were calculated by two single electron transfer based methods (TRC - Total Reducing Capacity and TEAC - Trolox Equivalent Antioxidant Capacity) and a hydrogen atom transfer based assay (ORAC - Oxygen Radical Absorbance). The amount of four main macro- and two microelements was quantified. The antibacterial activity was determined by minimum inhibitory concentration (MIC) and membrane degradation assays. Furthermore, the biofilm degradation power of the samples was studied as well. The light colored linden honey with the lowest TRC and TEAC, but with the highest ORAC antioxidant activity and high element content showed the best antibacterial and biofilm degradation effects. Meanwhile, the dark colored chestnut honey with significantly higher single electron transfer based antioxidant capacities, with high element content, but lower ORAC showed significantly higher MIC and lower membrane degradation activity than linden honey. In case of biofilm degradation, both honey types gave similarly high inhibitory effect. Goldenrod honey was similarly effective regarding its MIC properties like chestnut honey, but had significantly lower antioxidant potential and ability to disrupt bacterial membranes and biofilms. Milkweed honey was the honey type with the lowest bioactivity and element content. The honeys, unequivocally characterized by their antioxidant characters and element content, displayed different antibacterial and biofilm degradation effects. In addition, some honey traits were found to be good predictors of the antimicrobial potential of honeys: ORAC assay showed correlation with the MIC values of both bacteria, and strict correlation was found between the mineral content and the antibiofilm activity of the studied honeys. Our studies indicate that unifloral honeys, such as linden and chestnut honeys, are plant-derived products with great potential as antimicrobial agents in food preservation, exhibiting remarkable antibacterial activity against food-borne pathogens.

Echovirus 9 genetic diversity detected in whole-capsid genome sequences obtained directly from clinical specimens using next generation sequencing.

Echovirus 9 (E9) has been detected in an increased number of symptomatic patient samples received by the National Enterovirus Reference Laboratory in Hungary during 2018 compared to previously reported years.Formerly identified E9 viruses from different specimen types detected from patients of various ages and showing differing clinical signs were chosen for the detailed analysis of genetic relationships and potential variations within the viral populations. We used next generation sequencing (NGS) analysis of 3,900 nucleotide long amplicons covering the entire capsid coding region of the viral genome without isolation, directly from clinical samples.Compared to the E9 reference strain, the viruses showed about 79% nucleotide and around 93% amino acid sequence similarity. The four new viral genome sequences had 1-20 nucleotide differences between them also resulting in 6 amino acid variances in the coding region, including 3 in the structural VP1 capsid protein. One virus from a patient with hand, foot, and mouth disease had two amino acid changes in the VP1 capsid protein. An amino acid difference was also detected in the non-structural 2C gene of one virus sequenced from a throat swab sample from a patient with meningitis, compared to the faecal specimen taken two days later. Two amino acid changes, one in the capsid protein, were found between faecal samples of meningitis patients of different ages.Sequencing the whole capsid genome revealed several nucleotide and amino acid differences between E9 virus strains detected in Hungary in 2018.

Antioxidant Capacity Determination of Hungarian-, Slovak-, and Polish-Origin Goldenrod Honeys.

The goldenrod (Solidago) species are flowering plants that produce nectar and can be the sources of unifloral honeys. S. canadensis and S. gigantea are native to North America and invasive in several European countries, while S. virgaurea is native to Europe. The aim of this work was to determine and compare the antioxidant capacity of goldenrod honeys collected in three central European countries (Hungary, Poland, and Slovakia), from three locations within each country. The botanical origin of each honey sample was checked with melissopalynological analysis. Color intensity was determined using the Pfund scale. The antioxidant activity was determined with different spectrophotometric methods (DPPH, ABTS, and FRAP). The content of total polyphenols, flavonoids, and phenolic acids was quantified using spectrophotometric methods. The highest radical-scavenging activity was identified for Hungarian samples with all three antioxidant capacity assays. Medium antioxidant activity was described for Slovak samples. The DPPH and ABTS assays discriminated Polish honeys with the lowest antioxidant activity. The highest flavonoid and phenolic acid content was detected in Hungarian and Slovak honeys, while the lowest values were measured in Polish samples. Our study shows that the antioxidant capacity of unifloral goldenrod honeys can be different in various countries of origin, correlating with color intensity and polyphenol content.

Quality Assessment of Goldenrod, Milkweed and Multifloral Honeys Based on Botanical Origin, Antioxidant Capacity and Mineral Content.

The goal of the study was to evaluate the pollen spectrum, antioxidant capacity and mineral content of four Hungarian honey types, using multivariate statistical analysis. The light colored honeys were represented by milkweed honey and a multifloral (MF) honey with dominant pollen frequency of linden (MF-Tilia); the darker ones were goldenrod honey and a multifloral honey with Lamiaceae pollen majority (MF-Lamiaceae). The pollen spectrum of the samples was established with melissopalynological analysis. The absorbance of the honeys positively correlated with the antioxidant capacity determined with three of the used methods (TRC, TEAC, DPPH), but not with ORAC. The latter method correlated negatively also with other antioxidant methods and with most of the mineral values. MF-Tilia had high ORAC value, K and Na content. The MF-Lamiaceae had the highest K, Mg, P, S, Cu and Zn content, the last five elements showing strict correlation with the TRC method. The darker goldenrod honey had higher SET values and total mineral content, than the milkweed honey. The above character-sets facilitate identification of each honey type and serve as indicators of variety. The antioxidant levels and mineral content of honeys allowed their clear separation by principal component analysis (PCA).

Treatment of Benign Prostatic Hyperplasia by Natural Drugs.

Benign prostatic hyperplasia (BPH) is one of the most common urinary diseases affecting men, generally after the age of 50. The prevalence of this multifactorial disease increases with age. With aging, the plasma level of testosterone decreases, as well as the testosterone/estrogen ratio, resulting in increased estrogen activity, which may facilitate the hyperplasia of the prostate cells. Another theory focuses on dihydrotestosterone (DHT) and the activity of the enzyme 5α-reductase, which converts testosterone to DHT. In older men, the activity of this enzyme increases, leading to a decreased testosterone/DHT ratio. DHT may promote prostate cell growth, resulting in hyperplasia. Some medicinal plants and their compounds act by modulating this enzyme, and have the above-mentioned targets. This review focuses on herbal drugs that are most widely used in the treatment of BPH, including pumpkin seed, willow herb, tomato, maritime pine bark, Pygeum africanum bark, rye pollen, saw palmetto fruit, and nettle root, highlighting the latest results of preclinical and clinical studies, as well as safety issues. In addition, the pharmaceutical care and other therapeutic options of BPH, including pharmacotherapy and surgical options, are discussed, summarizing and comparing the advantages and disadvantages of each therapy.

Re-emergence of enterovirus D68 in Europe after easing the COVID-19 lockdown, September 2021.

We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe.

In Vitro Antibacterial and Antibiofilm Activity of Hungarian Honeys against Respiratory Tract Bacteria.

Honey is a rich source of carbohydrates, while minor compounds such as amino acids and polyphenols contribute to its health-promoting effects. Honey is one of the oldest traditional remedies applied for microbial infections, due to its antibacterial, anti-inflammatory, and antioxidant properties. The aim of this study was to investigate the antibacterial and antibiofilm effects of Hungarian black locust, linden, and sunflower honeys against the most common biofilm-forming respiratory tract pathogens Haemophilus spp., Pseudomonas aeruginosa, and Streptococcus pneumoniae. The unifloral character of all three honey types was confirmed by melissopalynological analysis. The antibacterial activity of each honey sample against each bacterium strain was proven with agar well diffusion assay and thin layer chromatography-direct bioautography. Kinetics and mechanisms of antibacterial action were clarified with time-kill assay and membrane degradation study. The anti-biofilm activity was evidenced using crystal violet assay. In each assay, linden honey was the most effective, followed by sunflower and black locust honey. In addition, each honey sample had greater potential to suppress respiratory tract bacteria, compared to major sugar components. In conclusion, honey in general and linden honey in particular, can have a role in the treatment of respiratory tract infections caused by biofilm-forming bacteria.

Quality Evaluation of Light- and Dark-Colored Hungarian Honeys, Focusing on Botanical Origin, Antioxidant Capacity and Mineral Content.

Melissopalynology, antioxidant capacity and mineral and toxic element contents were analyzed in eight types of Hungarian honeys. Based on color, two groups were distinguished: light honeys comprised acacia, amorpha, phacelia and linden honeys; while dark honeys included sunflower, chestnut, fennel and sage honeys, with 100 to 300 and 700 to 1500 mAU, respectively. The unifloral origin of each sample was supported using pollen analysis. The absorbance of honey correlated positively with antioxidant capacity determined by three different methods (TRC, DPPH, ORAC), and also with mineral content. The exception was the light amber linden honey with significantly higher K content and antiradical activity than other light honeys. The Mn, Zn and Fe contents were the highest in chestnut, sunflower and fennel honeys, respectively. The black meadow sage honey performed best regarding the content of other elements and antioxidant activity. The concentrations of several toxic elements were below the detection limit in the samples, indicating their good quality. The principal component analysis (PCA) revealed correlations between different antioxidant assays and minerals, and furthermore, confirmed the botanical authentication of the honeys based on the studied parameters. To our best knowledge, the present study is the first to provide a complex analysis of quality parameters of eight unifloral Hungarian honeys.

Molecular Epidemiology and Evolutionary Trajectory of Emerging Echovirus 30, Europe.

In 2018, an upsurge in echovirus 30 (E30) infections was reported in Europe. We conducted a large-scale epidemiologic and evolutionary study of 1,329 E30 strains collected in 22 countries in Europe during 2016-2018. Most E30 cases affected persons 0-4 years of age (29%) and 25-34 years of age (27%). Sequences were divided into 6 genetic clades (G1-G6). Most (53%) sequences belonged to G1, followed by G6 (23%), G2 (17%), G4 (4%), G3 (0.3%), and G5 (0.2%). Each clade encompassed unique individual recombinant forms; G1 and G4 displayed >2 unique recombinant forms. Rapid turnover of new clades and recombinant forms occurred over time. Clades G1 and G6 dominated in 2018, suggesting the E30 upsurge was caused by emergence of 2 distinct clades circulating in Europe. Investigation into the mechanisms behind the rapid turnover of E30 is crucial for clarifying the epidemiology and evolution of these enterovirus infections.

Soil Humus, Iron, Sulphate and Magnesium Content Affect Nectar Traits of Wild Garlic (Allium ursinum L.).

Recent studies revealed that from various ecological factors influencing nectar yield and quality of a plant, soil properties can be as important as microclimatic features. To date, few studies have investigated the relationship of soil characters to nectar traits of bee pollinated plants growing in natural associations. Our study intended to reveal which soil properties had the most powerful impact on nectar variables of wild garlic (Allium ursinum L.). Specimens were collected from fourteen habitats in two different years, and were potted in their original soil under the same climatic conditions. Nectar volumes and sugar concentrations were measured and soil samples were analysed for fourteen parameters. Statistical analyses revealed that the number of nectar producing Allium flowers, as well as the nectar volume and sugar content of nectar in individual flowers were influenced by both year and habitat. The humus, iron and sulphate content of soil showed negative correlation with the number of flowers producing nectar; total nectar volumes were negatively correlated with humus and iron content, but positively affected by magnesium content of the soil. Our results suggest that in addition to the effect of microclimatic factors, certain soil properties can have significant impact on nectar traits.

Distribution of enterovirus genotypes detected in clinical samples in Hungary, 2010-2018.

This report provides the findings of a retrospective surveillance study on the emergence and circulation of enteroviruses with their associated clinical symptoms over a nine-year period detected at the National Enterovirus Reference Laboratory in Hungary between 2010-2018.Enterovirus (EV) detection and genotyping were performed directly from clinical samples. From 4,080 clinical specimens 25 EV types were identified with a median age of patients of 5 years and 68% of all cases affected children aged 10 years or younger, although infections occurred in all age-groups. In 130 cases neurological symptoms were recorded, in 123 cases the infection presented in skin related signs including hand, foot, and mouth disease (HFMD), herpangina and rash. In 2010 EV-A71 was found to cause the majority of diagnosed EV infections while in 2011 and from 2014-2018, Coxsackievirus (CV)-A6 was identified most often. Echovirus E6 accounted for the most cases in 2012 and Echovirus 30 dominated in 2013. EV-D68 was identified only in 2010 and 2013.Widespread circulation of several EV-A and EV-B viruses with occasional occurrence of EV-C and EV-D was detected. The ability of EVs to cause severe infections in sporadic cases and regular outbreaks highlight the importance of continued monitoring of circulating EV types.

Determining the effect of different environmental conditions on Ebola virus viability in clinically relevant specimens.

In 2013-2016, West Africa experienced the largest and longest Ebola virus disease outbreak ever documented. The wide geographic spread and magnitude of the outbreak often limited the timely and rapid testing of diagnostic samples from patients with suspected Ebola virus disease, raising questions regarding the optimal storage and shipping conditions of clinically relevant specimens, including EDTA-whole blood, plasma, capillary blood, urine and seminal fluid (associated with sexual transmission of the Ebola virus after recovery from the disease). Therefore, the aim of our study was to identify the extent to which storage temperature and clinical specimen type influence Ebola virus viability. Virus infectivity was determined using a fluorescent focus-forming assay. In our study, we show that Ebola virus was the most stable in EDTA-whole blood and plasma samples, whereas rapid decay of infectivity was observed in simulated capillary blood, urine and semen samples, especially when these samples were stored at higher temperatures. The analysis of variance results demonstrated that both temperature and clinical specimen type have significant effects on virus viability, whereas donor differences were not observed. Repeated freeze and thaw cycles of the samples also had a notable impact on virus viability in EDTA-whole blood and urine. Due to the rapid temperature- and specimen-dependent degradation of the virus observed here, our study highlights the importance of proper clinical sample storage at low temperatures during transportation and laboratory analysis.

First report of Acanthamoeba genotype T8 human keratitis.

Acanthamoeba has a worldwide distribution in the environment and it is capable of causing a painful sight-threatening disease of the cornea designated as Acanthamoeba keratitis (AK). Nowadays, the cases of AK have surged all over the world along with its disease burden due to increasing use of contact lenses used not only for optical correction but also for cosmetic purposes. In our present work, epithelial abrasion of a 27-year-old female soft contact lens wearer with keratitis was examined. Genotype identification was carried out with a real-time fluorescence resonance energy transfer polymerase chain reaction (PCR) assay based on sequence analysis of the 18S rRNA gene. Genotyping allowed the identification of a T8 group isolate. The analysis confirmed the importance of a complete diagnostic protocol, including a PCR assay, for the clinical diagnosis of AK from human samples. Acanthamoeba T8 should be considered as potential causative organism in keratitis in human.

First detection of tick-borne encephalitis virus RNA in clinical specimens of acutely ill patients in Hungary.

Tick-borne encephalitis virus (TBEV) is one of the endemic flaviviruses in Hungary, which is responsible for human infections every year. Neurological involvement in the disease is characterized by meningitis, encephalitis or meningoencephalitis which can result in long-term neurological and neuropsychiatric sequelae. Microbiological diagnosis of acute cases is predominantly based on serological tests due to the limited duration of viremia and long incubation period, however, the application of molecular methods can also supplement the serological diagnosis and provides epidemiological data. The aim of this study was to determine how viral RNA could successfully be detected from different body fluids of serologically confirmed acute cases. Serum, whole blood, cerebrospinal fluid and urine samples of 18 patients from the total of the 19 serologically diagnosed cases were investigated by using the RT-PCR method. Two sera and one urine sample of three patients tested positive and the European subtype of TBEV could be identified. As far as we know this was the first time that TBEV RNA could be detected from human clinical samples in Hungary. Our finding highlights that the application of molecular methods besides serological tests can be a valuable tool in differential diagnosis especially in areas like Hungary, where two or more flaviviruses are co-circulating.