Organisms in the genus Kocuria are Gram-positive, coagulase-negative, coccoid actinobacteria belonging to the family Micrococcaceae, suborder Micrococcineae, order Actinomycetales. Sporadic reports in the literature have dealt with infections by Kocuria species, mostly in compromised hosts with serious underlying conditions. Nonetheless, the number of infectious processes caused by such bacteria may be higher than currently believed, given that misidentification by phenotypic assays has presumably affected estimates of the prevalence over the years. As a further cause for concern, guidelines for therapy of illnesses involving Kocuria species are lacking, mostly due to the absence of established criteria for evaluating Kocuria replication or growth inhibition in the presence of antibiotics. Therefore, breakpoints for staphylococci have been widely used throughout the literature to try to understand this pathogen's behaviour under drug exposure; unfortunately, this has sometimes created confusion, thus higlighting the urgent need for specific interpretive criteria, along with a deeper investigation into the resistance determinants within this genus. We therefore review the published data on cultural, genotypic and clinical aspects of the genus Kocuria, aiming to shed some light on these emerging nosocomial pathogens. IntroductionThe genus Kocuria was named after Miroslav Kocur, a Slovakian microbiologist, and belongs to the family Micrococcaceae, suborder Micrococcineae, order Actinomycetales, class Actinobacteria (Takarada et al., 2008;Zhou et al., 2008;Lee et al., 2009;Stackebrandt et al., 1995). It includes Gram-positive, strictly aerobic (a few exceptions are Kocuria kristinae, which is facultatively anaerobic, Kocuria marina, which may grow in 5 % CO 2 , and Kocuria rhizophila strain DC2201, which can proliferate anaerobically), catalasepositive, coagulase-negative, non-haemolytic cocci. These are also non-encapsulated, non-endospore-forming, non-halophilic, mesophilic, non-motile and Voges-Proskauer (production of indole and acetoin)-negative, and do not possess mycolic or teichoic acids. Kocuria species can be differentiated from other members of the Actinomycetales based on the presence of galactosamine and glucosamine as main cell wall amino sugars, the peptidoglycan type L-Lys-Ala 3/4 , the fatty acid anteisio-C 15 : 0 , the polar lipids diphosphatidylglycerol and phosphatidylglycerol, MK-7(H 2 ) and MK-8(H 2 ) as major menaquinones and a DNA G+C content of 60.0-75.3 mol%, depending on the species. Organisms in the genus are environmental bacteria, as well as human skin and oropharynx mucosa commensals; nevertheless, they can be responsible for infectious processes which mostly complicate severe underlying diseases. Owing to misidentification by phenotypic typing over the years, clinical syndromes caused by these agents are believed to be rare; however, the prevalence of such infectious pathologies is presumably higher and will surely increase in the coming years, as soon as genome-based identification i...

Staphylococcus pasteuri is a coagulase-negative, Gram positive organism which is emerging as an agent of nosocomial infections and a blood derivatives contaminant, though its role in causing human disease mostly remains controversial. Despite the paucity of isolates recovered, this bacterium has recently appeared to express resistance against several classes of antibiotic compounds, such as methicillin/oxacillin, macrolides, lincosamides, streptogramins, tetracyclines, chloramphenicol, streptomycin, fosfomycin, as well as quaternary ammonium compounds. Also, authors will discuss some essential patents related to the topic reviewed.

Isolation of Candida non-albicans yeasts as commensals or pathogens from hospitalised hosts is acquiring increasing importance, due to the frequent drug resistance expressed by such organisms.Particularly, the recover of antifungal resistant C. guilliermondii is of worrisome concern, even if recovered as a saprophyte, since commensal yeasts may behave as reservoirs for resistance elements;furthermore, they may enter the bloodstream after chemotherapy-related mucosal damage has developed,thus causing life-threatening and difficult-to-treat fungemias. This communication deals with the unusual isolation of a pan-azole resistant C. guilliermondii strain from a leukaemic patient with silent candiduria and emphasizes the importance of monitoring less recurring species within the nosocomial setting to better understand fungal epidemiology within the wards and face the spread of resistance determinants. Also, we highlight the controversial significance of silent candiduria, clinical relevance of which should be investigated case by case, to exclude and/or prevent candiduria as well as renal impairment.

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Meticillin-heteroresistant Staphylococcus pasteuri from an apheresis platelet product About 1 in 1000-2000 apheresis platelet units is contaminated by bacteria. The platelet products are stored in oxygenpermeable bags, at 20-24 u C, for up to 5 days before being transfused, to preserve cell survival and function. Unfortunately, this may also permit growth of bacteria and transmission of these to recipients. Coagulase-negative staphylococci, Staphylococcus aureus, a-haemolytic streptococci, diphtheroids, Propionibacterium acnes, Acinetobacter species, Escherichia coli, Serratia species, Klebsiella species, Enterobacter species, Providencia rettgeri and Yersinia enterocolitica are known to contaminate platelet units (Riedel et al., 2006; Savini et al., 2008). Though contaminating staphylococci generally exert b-lactam susceptibility (as they are mostly donors' skin contaminants, not nosocomial isolates), meticillin resistance should always be excluded to avoid b-lactam failure when treating transfusion-related bacteraemias.