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Delshad SD, Ferraro R. Arteriovenous Graft Infection Due to Granulicatella adiacens. Cureus 2024; 16:e61622. [PMID: 38966446 PMCID: PMC11222331 DOI: 10.7759/cureus.61622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 07/06/2024] Open
Abstract
Granulicatella adiacens is a gram-positive coccus that is normally found in the human oral cavity and gastrointestinal and urogenital tracts but can rarely cause infection. When it does cause infection, Granulicatella adiacens has been most associated with bacteremia and endovascular infection, but to our knowledge, there are no previously documented cases of arteriovenous graft (AVG) infection. We present a case of Granulicatella adiacens bacteremia with associated AVG infection.
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Affiliation(s)
- Sean D Delshad
- Medicine, University of California, Los Angeles, Los Angeles, USA
| | - Regan Ferraro
- Radiology, Rolling Oaks Radiology, Thousand Oaks, USA
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Tahir S, Hasanain R, Abuhammour W, Dsouza AP, Lone R, Kherani S. Granulicatella adiacens Causing a Parapharyngeal Abscess in a 10-Month-Old Infant: A Rare-Case Report and Literature Review of Deep Neck Infections (DNIs) in Children. Cureus 2023; 15:e42144. [PMID: 37602014 PMCID: PMC10438130 DOI: 10.7759/cureus.42144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Granulicatella adiacens is a rare variant of the Streptococcus bacteria. When isolated, G. adiacens has been described in cases of endocarditis and bacteremia, but less commonly seen in isolated pyogenic infections. We report a case of a parapharyngeal abscess caused by G. adiacens in an otherwise healthy 10-month-old infant, which was successfully treated with antibiotics and surgical drainage. To the best of our knowledge, this is the first described case of a pediatric deep soft tissue neck infection caused by G. adiacens with one other report in an adult. Additionally, of all localized infections from this bacteria, this is only the second reported case in the pediatric population. We also include an evidence-based literature review of the clinical presentation, microbiology, imaging modalities, and management approach to deep neck infections (DNIs).
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Affiliation(s)
- Saja Tahir
- Pediatrics, Al Jalila Children's Speciality Hospital, Dubai, ARE
| | - Rand Hasanain
- Pediatrics, Al Jalila Children's Speciality Hospital, Dubai, ARE
| | - Walid Abuhammour
- Infectious Diseases, Al Jalila Children's Speciality Hospital, Dubai, ARE
| | - Ajay P Dsouza
- Radiology, Al Jalila Children's Speciality Hospital, Dubai, ARE
| | - Rubina Lone
- Laboratory Medicine, Al Jalila Children's Speciality Hospital, Dubai, ARE
| | - Safeena Kherani
- Otolaryngology - Head and Neck Surgery, Al Jalila Children's Speciality Hospital, Dubai, ARE
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García-Casallas J, Patiño-Salazar K, Tuta-Quintero E, Molina-Ardila M. Liver abscess due to Granulicatella adiacens in an immunocompetent patient: Case report. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:22-26. [PMID: 37167469 PMCID: PMC10468023 DOI: 10.7705/biomedica.6504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/04/2023] [Indexed: 05/13/2023]
Abstract
Pyogenic liver abscesses due to Granulicatella adiacens are infections associated with high mortality, mainly in immunocompromised patients. The main microorganisms associated with liver abscesses are Klebsiella pneumoniae, and Escherichia coli, though it may also be polymicrobial. However, case reports describing liver infection by Granulicatella adiacens are scarce. We present the case of an immunocompetent adult patient who presented 15 days of evolution consisting of quantified fever peaks associated with asthenia, adynamia, chills, jaundice and coluria. The initial clinical examination revealed a generalized icteric tint without abdominal pain, and blood pressure with a tendency to hypotension. Biliopancreatic confluent neoplasia, secondary cholangitis and sepsis of biliary origin were suspected, initiating fluid resuscitation and antibiotic therapy; blood cultures and complementary diagnostic studies were taken. Hepatobiliary ultrasound with evidence of an abscess of 73 x 62 mm in segment IV; the bile duct and pancreas were within normal limits. To better characterize the lesion evidenced in the liver, a contrast-enhanced computed tomography of the abdomen was performed. The patient completed antibiotic management with ciprofloxacin, vancomycin, and metronidazole in good condition and was successfully discharged. This is the first pyogenic liver abscess reported caused by Granulicatella adiacens in an immunocompetent patient, in whom early microbiological diagnosis in conjunction with targeted antibiotic treatment and percutaneous drainage of the lesion was decisive in the clinical outcome.
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Affiliation(s)
- Julio García-Casallas
- Facultad de Medicina, Universidad de La Sabana, Chía, Colombia; Clínica Universidad de La Sabana, Chía, Colombia.
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Purohit G, Mishra B, Sahoo S, Mahapatra A. Granulicatella adiacens as an Unusual Cause of Empyema: A Case Report and Review of Literature. J Lab Physicians 2022; 14:343-347. [PMID: 36119420 PMCID: PMC9473932 DOI: 10.1055/s-0042-1744236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Granulicatella adiacens
, a nutritionally variant
Streptococcus
(NVS), is part of the normal commensal flora of human mouth, genital, and intestinal tracts and rarely causes disease. It has been mostly reported from bacteremia and endocarditis cases, but rarely can cause vertebral osteomyelitis, pancreatic abscess, otitis media, and endovascular, central nervous system, ocular, oral, bone and joint, and genitourinary infections. Due to requirement of fastidious culture conditions and non-specific colony morphology, serious diagnostic difficulties may arise in cases of NVS infections. Here, we are reporting a rare fatal infection of
G. adiacens
presented with empyema complicated to sepsis and necrotizing fasciitis.
Clinicians should be aware of the pathogenic potential of
Granulicatella adiacens
(a normal commensal flora of human mouth, genital and intestinal tracts). Appropriate supplemented media and a reliable detection system should be used to identify these fastidious organisms. We present this rare case to bring awareness among clinicians regarding such a rare but potentially fatal infection.
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Affiliation(s)
- Geetarani Purohit
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
- Department of Microbiology and Infection Control, Vikash Multispeciality Hospital, Bargarh, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Satyajeet Sahoo
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Ashoka Mahapatra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
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Pellissari BA, Sabino GSP, de Souza Lima RN, Motta RHL, Suzuki SS, Garcez AS, Basting RT, Barbosa JA, Martins Montalli VA. Antimicrobial resistance of bacterial strains in patients undergoing orthodontic treatment with and without fixed appliances. Angle Orthod 2021; 91:672-679. [PMID: 33901282 DOI: 10.2319/120720-990.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To identify microorganisms isolated from patients wearing fixed orthodontic appliances and to evaluate the resistance of isolated bacterial strains to different antimicrobials. MATERIALS AND METHODS Seventeen healthy patients wearing a fixed orthodontic appliance (group 1) and six nonwearers (group 2, control group) were evaluated. The biofilm that formed around the orthodontic brackets was collected, and the samples were then plated in a chromogenic medium (chromIDT, bioMérieux). Colony-forming units (CFUs) were isolated and inoculated in blood-agar medium. Automated biochemical tests (VITEK 2, bioMérieux) were carried out to identify the genus and species of the microorganisms and the resistance provided by 43 drugs (37 antibacterial and 6 antifungal). RESULTS The most prevalent microbial genera identified in group 1 were Streptococcus (24.0%), Staphylococcus (20.0%), Enterobacter (12.0%), Geobacillus (12.0%), and Candida (12.0%), and the most frequent species were Enterobacter cloacae complex (13.6%) and Staphylococcus hominis (13.6%). In group 2, the most prevalent genera were Streptococcus (57.1%), Staphylococcus (14.2%), Sphingomonas (14.2%), and Enterobacter (14.2%). With regard to antimicrobial resistance, 14 of 19 (74%) isolated bacterial strains were found to be resistant to at least 1 of the tested antimicrobials. CONCLUSIONS The findings of the present study suggest that patients undergoing orthodontic treatment with fixed appliances have a more complex biofilm with a higher level of bacterial resistance.
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Badrick TC, Nusem I, Heney C, Sehu M. Granulicatella adiacens: An uncommon diagnosis of prosthetic hip joint infection. A case report with review of the literature. IDCases 2021; 25:e01204. [PMID: 34258223 PMCID: PMC8255243 DOI: 10.1016/j.idcr.2021.e01204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022] Open
Abstract
Prosthetic hip infection caused by Granulicatella adiacens. Diagnosis was achieved using broad range 16S PCR gene analysis at an early stage, after joint aspiration and culture failed to yield a pathogen. Granulicatella adiacens is a nutritionally variant streptococcus (NVS). Staged revision surgery together with administration of appropriate antibiotics resulted in cure. Diagnosis challenging, and often delays appropriate antibiotic administration.
We report a case of prosthetic hip infection in a 79 year old man caused by Granulicatella adiacens. The diagnosis was achieved using broad range 16S PCR gene analysis at an early stage, after joint aspiration and culture failed to yield a pathogen. Staged revision surgery together with administration of appropriate antibiotics resulted in cure. Granulicatella adiacens is a nutritionally variant streptococcus (NVS). It has been increasingly reported to cause significant morbidities involving various systems. Its insidious growth due to complex growth requirements, has made its diagnosis challenging, and often delays appropriate antibiotic administration.
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Affiliation(s)
- Timothy C Badrick
- Princess Alexandra Hospital, Queensland Health, Queensland, Australia.,University of Queensland, Queensland, Australia
| | - Iulian Nusem
- Logan Hospital, Queensland Health, Queensland, Australia
| | - Claire Heney
- Queensland Pathology, Queensland Health, Australia
| | - Marjoree Sehu
- Princess Alexandra Hospital, Queensland Health, Queensland, Australia.,Queensland Pathology, Queensland Health, Australia.,University of Queensland, Queensland, Australia
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Stahl-Rommel S, Jain M, Nguyen HN, Arnold RR, Aunon-Chancellor SM, Sharp GM, Castro CL, John KK, Juul S, Turner DJ, Stoddart D, Paten B, Akeson M, Burton AS, Castro-Wallace SL. Real-Time Culture-Independent Microbial Profiling Onboard the International Space Station Using Nanopore Sequencing. Genes (Basel) 2021; 12:genes12010106. [PMID: 33467183 PMCID: PMC7830261 DOI: 10.3390/genes12010106] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 12/23/2022] Open
Abstract
For the past two decades, microbial monitoring of the International Space Station (ISS) has relied on culture-dependent methods that require return to Earth for analysis. This has a number of limitations, with the most significant being bias towards the detection of culturable organisms and the inherent delay between sample collection and ground-based analysis. In recent years, portable and easy-to-use molecular-based tools, such as Oxford Nanopore Technologies’ MinION™ sequencer and miniPCR bio’s miniPCR™ thermal cycler, have been validated onboard the ISS. Here, we report on the development, validation, and implementation of a swab-to-sequencer method that provides a culture-independent solution to real-time microbial profiling onboard the ISS. Method development focused on analysis of swabs collected in a low-biomass environment with limited facility resources and stringent controls on allowed processes and reagents. ISS-optimized procedures included enzymatic DNA extraction from a swab tip, bead-based purifications, altered buffers, and the use of miniPCR and the MinION. Validation was conducted through extensive ground-based assessments comparing current standard culture-dependent and newly developed culture-independent methods. Similar microbial distributions were observed between the two methods; however, as expected, the culture-independent data revealed microbial profiles with greater diversity. Protocol optimization and verification was established during NASA Extreme Environment Mission Operations (NEEMO) analog missions 21 and 22, respectively. Unique microbial profiles obtained from analog testing validated the swab-to-sequencer method in an extreme environment. Finally, four independent swab-to-sequencer experiments were conducted onboard the ISS by two crewmembers. Microorganisms identified from ISS swabs were consistent with historical culture-based data, and primarily consisted of commonly observed human-associated microbes. This simplified method has been streamlined for high ease-of-use for a non-trained crew to complete in an extreme environment, thereby enabling environmental and human health diagnostics in real-time as future missions take us beyond low-Earth orbit.
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Affiliation(s)
| | - Miten Jain
- UCSC Genomics Institute, University of California, Santa Cruz, CA 95064, USA; (M.J.); (B.P.); (M.A.)
| | - Hang N. Nguyen
- JES Tech, Houston, TX 77058, USA; (S.S.-R.); (H.N.N.); (C.L.C.)
| | - Richard R. Arnold
- Astronaut Office, NASA Johnson Space Center, Houston, TX 77058, USA; (R.R.A.); (S.M.A.-C.)
| | | | | | | | - Kristen K. John
- Project Management and Systems Engineering Division, NASA Johnson Space Center, Houston, TX 77058, USA;
| | - Sissel Juul
- Oxford Nanopore Technologies, New York, NY 10013, USA;
| | - Daniel J. Turner
- Oxford Nanopore Technologies, Oxford Science Park, Oxford OX4 4DQ, UK; (D.J.T.); (D.S.)
| | - David Stoddart
- Oxford Nanopore Technologies, Oxford Science Park, Oxford OX4 4DQ, UK; (D.J.T.); (D.S.)
| | - Benedict Paten
- UCSC Genomics Institute, University of California, Santa Cruz, CA 95064, USA; (M.J.); (B.P.); (M.A.)
| | - Mark Akeson
- UCSC Genomics Institute, University of California, Santa Cruz, CA 95064, USA; (M.J.); (B.P.); (M.A.)
| | - Aaron S. Burton
- Astromaterials Research and Exploration Science Division, NASA Johnson Space Center, Houston, TX 77058, USA;
| | - Sarah L. Castro-Wallace
- Biomedical Research and Environmental Sciences Division, NASA Johnson Space Center, Houston, TX 77058, USA
- Correspondence: ; Tel.: +1-281-483-7254
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Farraj SA, El-Kafrawy SA, Kumosani TA, Yousef JM, Azhar EI. Evaluation of Extraction Methods for Clinical Metagenomic Assay. Microorganisms 2020; 8:microorganisms8081128. [PMID: 32727010 PMCID: PMC7465710 DOI: 10.3390/microorganisms8081128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/23/2020] [Accepted: 07/25/2020] [Indexed: 02/02/2023] Open
Abstract
(1) Background: Clinical metagenomics is a promising approach that helps to identify etiological agents in cases of unknown infections. For the efficient detection of an unknown pathogen, the extraction method must be carefully selected for the maximum recovery of nucleic acid from different microorganisms. The aim of this study was to evaluate different extraction methods that have the ability to isolate nucleic acids from different types of pathogens with good quality and quantity for efficient use in clinical metagenomic identification. (2) Methods: A mock sample spiked with five different pathogens was used for the comparative evaluation of different commercial extraction kits. Extracted samples were subjected to library preparation and run on MiSeq. The selected extraction method based on the outcome of the comparative evaluation was used subsequently for the nucleic acid isolation of all infectious agents in clinical respiratory samples with multiple infections. (3) Results: The protocol using the PowerViral® Environmental RNA-DNA Isolation Kit with a 5-min bead beating step achieved the best results with a low starting volume. The analysis of the tested clinical specimens showed the ability to successfully identify different types of pathogens. (4) Conclusions: The optimized extraction protocol in this study is recommended for clinical metagenomics application in specimens with multiple infections from different taxa.
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Affiliation(s)
- Suha A. Farraj
- Biochemistry Department, Faculty of Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (S.A.F.); (T.A.K.); (J.M.Y.)
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Shreif A. El-Kafrawy
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Clinical Pathology Department, National Liver Institute, Menoufia University, Shebin El-Kom 32511, Egypt
- Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Taha A. Kumosani
- Biochemistry Department, Faculty of Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (S.A.F.); (T.A.K.); (J.M.Y.)
- Central Laboratory for Food and Nutrition, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Jehad M. Yousef
- Biochemistry Department, Faculty of Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (S.A.F.); (T.A.K.); (J.M.Y.)
- Department of Biochemistry, College of Sciences, University of Jeddah, Jeddah 23890, Saudi Arabia
| | - Esam I. Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence:
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Perna A, Ricciardi L, Sturiale CL, Fantoni M, Tamburrelli FC, Bonfiglio N, Proietti L. Skipped vertebral spontaneous spondylodiscitis caused by Granulicatella adiacens: Case report and a systematic literature review. J Clin Orthop Trauma 2020; 11:937-941. [PMID: 32879584 PMCID: PMC7452249 DOI: 10.1016/j.jcot.2019.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/23/2019] [Accepted: 07/11/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Granulicatella adiacens is a nutritional variant of streptococcus (NVS), which has been rarely reported as an etiologic agent in spondylodiscitis (SD). MATERIAL AND METHODS We report a case of a 51-year-old male with from chronic low-back pain associated with right sciatica and ipsilateral monoparesis. Spinal MRI showed radiological signs on L1-L2 and L5-S1 discs consistent with SD. We also performed a systematic review of the pertinent literature in order to retrieve all the key information regarding microbiological and clinical features. RESULTS Including our patients, seven cases with a mean age 56 ± 10.2 years were reported in English literature. Six patients were conservatively managed with antibiotic therapy (66%), whereas three with surgery in combination with antibiotics (33%). An endocarditis was associated in three cases, and a pacemaker infection in one. All patients received targeted antibiotic therapy resulting in a quick improvement of clinical symptoms with favorable outcome. Our case is the only with a skip spontaneous SD, which needed a surgical decompression due to the associated neurological symptoms. CONCLUSIONS This incidence of SD sustained by Granulicatella adiances could be underestimated due to their particular microbiological conditions requested for their cultures. However, this infection should be suspected in cases of culture-negative SD, especially when associated with endocarditis.
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Affiliation(s)
- Andrea Perna
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di ortopedia e traumatologia, unità di chirurgia vertebrale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Ricciardi
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
- Corresponding author. Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy, Largo A. Gemelli 1, 00168, Rome, Italy.
| | | | - Massimo Fantoni
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di Malattie infettive, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Ciro Tamburrelli
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di ortopedia e traumatologia, unità di chirurgia vertebrale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nadia Bonfiglio
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di ortopedia e traumatologia, unità di chirurgia vertebrale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Proietti
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di ortopedia e traumatologia, unità di chirurgia vertebrale, Università Cattolica del Sacro Cuore, Rome, Italy
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