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Pipitò L, Zinna G, Trizzino M, Gioè C, Tolomeo M, Di Carlo P, Colomba C, Gibaldi L, Iaria C, Almasio P, Cascio A. Causes of hospitalization and predictors of in-hospital mortality among people living with HIV in Sicily-Italy between 2010 and 2021. J Infect Public Health 2023; 16:1703-1708. [PMID: 37729685 DOI: 10.1016/j.jiph.2023.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Despite the rising number of people living with human immunodeficiency virus (HIV), there is a lack of knowledge about the factors that lead to PLWHs being hospitalized in worldwide literature. Our study aimed to investigate PLWH admissions in Sicily (Italy) between January 2010 and September 2021 and to analyze the characteristics and risk factors for in-hospital mortality and differences between Italians and foreigners. METHODS Data from the hospital discharge forms of all people living with HIV (PLWH) hospitalized in Sicilian hospitals were retrospectively collected. Age, sex, nationality, length of stay, acquired immunodeficiency syndrome (AIDS), and non-AIDS-related diseases were evaluated using univariate analysis according to in-hospital mortality rates. The factors associated with mortality were included in the logistic regression model. RESULTS In total, 5281 admissions from 2726 PLWHs occurred, most of which were related to non-AIDS diseases. Approximately 20 % regarded foreign patients, mainly from Africa. Logistic regression analysis revealed an association between in-hospital mortality and some AIDS- and non-AIDS-related diseases (wasting syndrome, lymphomas, Kaposi sarcomas, progressive multifocal leukoencephalopathy, cryptococcosis, abscesses, sepsis, cardiovascular disease, nephropathy, and respiratory diseases). African patient admissions were significantly associated with tuberculosis, toxoplasmosis, Burkitt lymphoma, and hepatitis B diagnoses. CONCLUSIONS Our study showed that most hospitalizations were related to non-AIDS-defining diseases, with differences between Italian and foreign patients, mainly from Africa.
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Affiliation(s)
- Luca Pipitò
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Giuseppe Zinna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy
| | - Marcello Trizzino
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Claudia Gioè
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Manlio Tolomeo
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Paola Di Carlo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Claudia Colomba
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy; Pediatric Infectious Diseases Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127 Palermo, Italy
| | - Lidia Gibaldi
- Dipartimento per la pianificazione strategica, Assessorato della Salute Regione Siciliana, Palermo, Italy
| | - Chiara Iaria
- Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy; Infectious Diseases Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127 Palermo, Italy
| | - Piero Almasio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy.
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Sebastiani G, Milic J, Kablawi D, Gioè C, Al Hinai AS, Lebouché B, Tsochatzis E, Finkel J, Ballesteros LR, Ramanakumar AV, Bhagani S, Benmassaoud A, Mazzola G, Cascio A, Guaraldi G. Fibroscan-Aspartate Aminotransferase Score Predicts Liver-Related Outcomes, but Not Extrahepatic Events, in a Multicenter Cohort of People With Human Immunodeficiency Virus. Clin Infect Dis 2023; 77:396-404. [PMID: 37013396 DOI: 10.1093/cid/ciad203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/21/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is frequent in people with human immunodeficiency virus (PWH). The Fibroscan-aspartate aminotransferase (FAST) score was developed to identify patients with nonalcoholic steatohepatitis (NASH) and significant fibrosis. We investigated prevalence of NASH with fibrosis and the value of FAST score in predicting clinical outcomes in PWH. METHODS Transient elastography (Fibroscan) was performed in PWH without viral hepatitis coinfection from 4 prospective cohorts. We used FAST >0.35 to diagnose NASH with fibrosis. Incidence and predictors of liver-related outcomes (hepatic decompensation, hepatocellular carcinoma) and extrahepatic events (cancer, cardiovascular disease) were evaluated through survival analysis. RESULTS Of the 1472 PWH included, 8% had FAST >0.35. Higher body mass index (adjusted odds ratio [aOR], 1.21 [95% confidence interval {CI}, 1.14-1.29]), hypertension (aOR, 2.24 [95% CI, 1.16-4.34]), longer time since HIV diagnosis (aOR, 1.82 [95% CI, 1.20-2.76]), and detectable HIV RNA (aOR, 2.22 [95% CI, 1.02-4.85]) were associated with FAST >0.35. A total of 882 patients were followed for a median of 3.8 years (interquartile range, 2.5-4.2 years). Overall, 2.9% and 11.1% developed liver-related and extrahepatic outcomes, respectively. Incidence of liver-related outcomes was higher in patients with FAST >0.35 versus FAST ≤0.35 (45.1 [95% CI, 26.2-77.7] vs 5.0 [95% CI, 2.9-8.6] per 1000 person-years). FAST >0.35 remained an independent predictor of liver-related outcomes (adjusted hazard ratio, 4.97 [95% CI, 1.97-12.51]). Conversely, FAST did not predict extrahepatic events. CONCLUSIONS A significant proportion of PWH may have NASH with significant liver fibrosis. FAST score predicts liver-related outcomes and can help management of this high-risk population.
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Affiliation(s)
- Giada Sebastiani
- Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, Canada
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Canada
| | - Jovana Milic
- Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Dana Kablawi
- Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, Canada
| | - Claudia Gioè
- Infectious and Tropical Disease Unit, Azienda Ospedaliera Universitaria Policlinico "P. Giaccone," Palermo, Italy
| | - Al Shaima Al Hinai
- Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, Canada
| | - Bertrand Lebouché
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, Canada
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University Health Centre, Montreal, Canada
| | - Emmanuel Tsochatzis
- Institute for Liver and Digestive Health, Division of Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Jemima Finkel
- Institute for Liver and Digestive Health, Division of Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Luz Ramos Ballesteros
- Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, Canada
| | | | - Sanjay Bhagani
- Institute for Liver and Digestive Health, Division of Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Amine Benmassaoud
- Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, Canada
| | - Giovanni Mazzola
- Infectious Diseases Unit, Sant'Elia Hospital, Caltanissetta, Italy
| | - Antonio Cascio
- Infectious and Tropical Disease Unit, Azienda Ospedaliera Universitaria Policlinico "P. Giaccone," Palermo, Italy
- Department of Health Promotion Sciences and Mother and Child Care "Giuseppe D'Alessandro," University of Palermo, Italy
| | - Giovanni Guaraldi
- Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy
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Falcone M, Tiseo G, Carbonara S, Marino A, Di Caprio G, Carretta A, Mularoni A, Mariani MF, Maraolo AE, Scotto R, Dalfino L, Corbo L, Macera M, Medaglia AA, d'Errico ML, Gioè C, Sgroi C, Del Vecchio RF, Ceccarelli G, Albanese A, Buscemi C, Talamanca S, Raponi G, Foti G, De Stefano G, Franco A, Iacobello C, Corrao S, Morana U, Pieralli F, Gentile I, Santantonio T, Cascio A, Coppola N, Cacopardo B, Farcomeni A, Venditti M, Menichetti F. Mortality Attributable to Bloodstream Infections Caused by Different Carbapenem-Resistant Gram-Negative Bacilli: Results From a Nationwide Study in Italy (ALARICO Network). Clin Infect Dis 2023; 76:2059-2069. [PMID: 36801828 DOI: 10.1093/cid/ciad100] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Our aim was to analyze mortality attributable to carbapenem-resistant (CR) gram-negative bacilli (GNB) in patients with bloodstream infections (BSIs). METHODS Prospective multicentric study including patients with GNB-BSI from 19 Italian hospitals (June 2018-January 2020). Patients were followed-up to 30 days. Primary outcomes were 30-day mortality and attributable mortality. Attributable mortality was calculated in the following groups: Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacterales, metallo-β-lactamases (MBL)-producing Enterobacterales, CR-Pseudomonas aeruginosa (CRPA), CR-Acinetobacter baumannii (CRAB). A multivariable analysis with hospital fixed-effect was built to identify factors associated with 30-day mortality. Adjusted OR (aORs) were reported. Attributable mortality was calculated according to the DRIVE-AB Consortium. RESULTS Overall, 1276 patients with monomicrobial GNB BSI were included: 723/1276 (56.7%) carbapenem-susceptible (CS)-GNB, 304/1276 (23.8%) KPC-, 77/1276 (6%) MBL-producing CRE, 61/1276 (4.8%) CRPA, and 111/1276 (8.7%) CRAB BSI. Thirty-day mortality in patients with CS-GNB BSI was 13.7% compared to 26.6%, 36.4%, 32.8% and 43.2% in patients with BSI by KPC-CRE, MBL-CRE, CRPA and CRAB, respectively (P < .001). On multivariable analysis, age, ward of hospitalization, SOFA score, and Charlson Index were factors associated with 30-day mortality, while urinary source of infection and early appropriate therapy resulted protective factors. Compared to CS-GNB, MBL-producing CRE (aOR 5.86, 95% CI 2.72-12.76), CRPA (aOR 1.99, 95% CI 1.48-5.95) and CRAB (aOR 2.65, 95% CI 1.52-4.61) were significantly associated with 30-day mortality. Attributable mortality rates were 5% for KPC-, 35% for MBL, 19% for CRPA, and 16% for CRAB. CONCLUSIONS In patients with BSIs, carbapenem-resistance is associated with an excess of mortality, with MBL-producing CRE carrying the highest risk of death.
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Affiliation(s)
- Marco Falcone
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Giusy Tiseo
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Sergio Carbonara
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, University of Bari "Aldo Moro," Bari, Italy
| | - Andrea Marino
- Unit of Infectious Diseases, ARNAS Garibaldi, Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giovanni Di Caprio
- Infectious Diseases Unit, AORN Sant' Anna e San Sebastiano, Caserta, Italy
| | - Anna Carretta
- Department of Infectious Diseases, University Hospital "Ospedali Riuniti" of Foggia, Foggia, Italy
| | - Alessandra Mularoni
- Department of Infectious Diseases, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS ISMETT), Palermo, Italy
| | - Michele Fabiano Mariani
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, University of Bari "Aldo Moro," Bari, Italy
| | - Alberto Enrico Maraolo
- First Division of Infectious Diseases, Cotugno Hospital, AORN Ospedali dei Colli, Naples, Italy
| | - Riccardo Scotto
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples "Federico II," Naples, Italy
| | - Lidia Dalfino
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | - Lorenzo Corbo
- Medicina per la complessità assistenziale 1 AOU Careggi, Florence, Italy
| | - Margherita Macera
- Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Maria Luca d'Errico
- Department of Infectious Diseases, University Hospital "Ospedali Riuniti" of Foggia, Foggia, Italy
| | - Claudia Gioè
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone," Palermo, Italy
| | | | | | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | - Calogero Buscemi
- Infectious Diseases Unit, ARNAS Ospedale Civico of Palermo, Palermo, Italy
| | - Simona Talamanca
- Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, Università di Palermo, Palermo, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Microbiology and Virology Unit, University Hospital Policlinico Umberto I, Rome, Italy
| | - Giuseppe Foti
- Infetious Diseases Unit, "Bianchi-Melacrino-Morelli" Hospital, Reggio Calabria, Italy
| | - Giulio De Stefano
- Department of Infectious Diseases, Hospital of Potenza and Matera, Matera, Italy
| | - Antonina Franco
- Department of Infectious Diseases, Umberto I Public Hospital, Siracusa, Italy
| | - Carmelo Iacobello
- UOC Malattie Infettive, Azienda Ospedaliera per l'Emergenza, Cannizzaro, Catania, Italy
| | - Salvatore Corrao
- Department of Clinical Medicine, Internal Medicine Division, ARNAS Civico Di Cristina Benfratelli Hospital Trust, Palermo, Italy
| | | | - Filippo Pieralli
- Intermediate Care Unit, Careggi University Hospital, Florence, Italy
| | - Ivan Gentile
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples "Federico II," Naples, Italy
| | - Teresa Santantonio
- Department of Infectious Diseases, University Hospital "Ospedali Riuniti" of Foggia, Foggia, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties G D'Alessandro, University of Palermo, Palermo, Italy
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Bruno Cacopardo
- Unit of Infectious Diseases, ARNAS Garibaldi, Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alessio Farcomeni
- Department of Economics & Finance, University of Rome "Tor Vergata," Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Francesco Menichetti
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
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Pipitò L, Medaglia AA, Trizzino M, Bonura S, Gioè C, Di Carlo P, Colomba C, Cascio A. A case of syphilis associated with immune reconstitution inflammatory syndrome and review of the literature. AIDS Res Ther 2023; 20:28. [PMID: 37170352 PMCID: PMC10176857 DOI: 10.1186/s12981-023-00522-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Immune reconstitution inflammatory syndrome (IRIS) associated with syphilis has rarely been described in HIV-infected patients. Diagnosis can be challenging because it is not always possible to discern it from a recent infection or a worsening of an undiagnosed one. CASE PRESENTATION An HIV-positive 42-year-old man with a poor compliance history of antiretroviral therapy presented at our unit and complained of ocular symptoms. Ocular syphilis diagnosis was posed after initial misdiagnosing with cytomegalovirus infection, and antiretroviral therapy compliance improved after switching to a bictegravir-based regimen. Despite intravenous (IV) penicillin, we observed an initial worsening with the appearance of new skin lesions, and IRIS syphilis was suspected. In the literature, 14 cases of IRIS syphilis are described, all regarding male patients. Seven were HIV naïve to therapy, and 7 HIV-experienced with poor therapy compliance. Basal syphilis serology was negative in ten, with subsequent seroconversion after the development of IRIS. IRIS-syphilis development was observed after a median time of 28 days from ART initiation; 10 cases were considered "unmasking-IRIS" and 4 "paradoxical-IRIS". Skin and ocular involvement were the most often reported. In most cases, it was not necessary to use a systemic steroid. A good outcome was reported in 12. CONCLUSIONS Syphilis should be considered in differential diagnosis with other diseases associated with IRIS. A negative syphilis serology before beginning antiretroviral therapy could convey the impression that syphilis has been ruled out. Whereas a high index of suspicion should be maintained when symptoms suggestive of syphilis, such as ocular and skin manifestations, are noticed after therapy has begun.
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Affiliation(s)
- Luca Pipitò
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Alice Annalisa Medaglia
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Marcello Trizzino
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Silvia Bonura
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Claudia Gioè
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Paola Di Carlo
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Claudia Colomba
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy
- Pediatric Infectious Diseases Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Antonio Cascio
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy.
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy.
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy.
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Esposito S, Pagliano P, De Simone G, Pan A, Brambilla P, Gattuso G, Mastroianni C, Kertusha B, Contini C, Massoli L, Francisci D, Priante G, Libanore M, Bicocchi R, Borgia G, Maraolo AE, Brugnaro P, Panese S, Calabresi A, Amendola G, Savalli F, Geraci C, Tedesco A, Fossati S, Carretta A, Santantonio T, Cenderello G, Crisalli MP, Schiaroli E, Rovere P, Masini G, Ferretto R, Cascio A, Colomba C, Gioè C, Tumbarello M, Losito AR, Foti G, Prestileo T, Buscemi C, Iaria C, Iacobello C, Sonia S, Starnini G, Ialungo A, Sapienza M. Epidemiology, aetiology and treatment of skin and soft tissue infections: final report of a prospective multicentre national registry. J Chemother 2022; 34:524-533. [DOI: 10.1080/1120009x.2022.2075170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Silvano Esposito
- Department of Infectious Diseases, University of Salerno, Salerno, Italy
| | - Pasquale Pagliano
- Department of Infectious Diseases, University of Salerno, Salerno, Italy
| | - Giuseppe De Simone
- Department of Infectious Diseases, University of Salerno, Salerno, Italy
| | - Angelo Pan
- Department of Infectious Diseases, Istituti Ospitalieri of Cremona, Cremona, Italy
| | - Paola Brambilla
- Department of Infectious Diseases, Istituti Ospitalieri of Cremona, Cremona, Italy
| | - Gianni Gattuso
- Department of Infectious Diseases, Carlo Poma Hospital, Mantova, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University, Latina, Italy
| | - Blertha Kertusha
- Department of Public Health and Infectious Diseases, Sapienza University, Latina, Italy
| | - Carlo Contini
- Department of Medical Sciences, Section of Infectious Diseases and Dermatology, University of Ferrara, Ferrara, Italy
| | - Lorenzo Massoli
- Department of Medical Sciences, Section of Infectious Diseases and Dermatology, University of Ferrara, Ferrara, Italy
| | - Daniela Francisci
- Infectious Diseases Clinic, University Hospital “S. Maria”, University of Perugia, Perugia, Italy
| | - Giulia Priante
- Infectious Diseases Clinic, University Hospital “S. Maria”, University of Perugia, Perugia, Italy
| | - Marco Libanore
- Infectious Diseases Unit, Department of Infectious Diseases, S. Anna University Hospital, Ferrara, Italy
| | - Roberto Bicocchi
- Infectious Diseases Unit, Department of Infectious Diseases, S. Anna University Hospital, Ferrara, Italy
| | - Guglielmo Borgia
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Albert Enrico Maraolo
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Pierluigi Brugnaro
- Infectious Diseases Department, Ospedale Civile “SS. Giovanni e Paolo”, Venice, Italy
| | - Sandro Panese
- Infectious Diseases Department, Ospedale Civile “SS. Giovanni e Paolo”, Venice, Italy
| | - Alessandra Calabresi
- Emergency Department, Hospital “Santi Antonio e Biagio e C. Arrigo”, Alessandria, Italy
| | - Giovanni Amendola
- Emergency Department, Hospital “Santi Antonio e Biagio e C. Arrigo”, Alessandria, Italy
| | | | - Consuelo Geraci
- Infectious Diseases Unit, Hospital of Trapani, Trapani, Italy
| | - Andrea Tedesco
- Infectious Diseases Unit, Hospital Fracastoro San Bonifacio, Verona, Italy
| | - Sara Fossati
- Infectious Diseases Unit, University Hospital of Trieste, Trieste, Italy
| | - Anna Carretta
- Department of Infectious Diseases, University Hospital “Ospedali Riuniti” of Foggia, Foggia, Italy
| | - Teresa Santantonio
- Department of Infectious Diseases, University Hospital “Ospedali Riuniti” of Foggia, Foggia, Italy
| | | | | | - Elisabetta Schiaroli
- Department of Medicine, Section of Infectious Diseases, University of Perugia, Perugia, Italy
| | | | - Giulia Masini
- Infectious Diseases Unit, Legnago Hospital, Verona, Italy
| | - Roberto Ferretto
- Infectious Diseases Unit, “Alto Vicentino” Santorso Hospital, Vicenza, Italy
| | - Antonio Cascio
- Infectious Diseases Unit, Universita degli Studi di Palermo, Palermo, Italy
| | - Claudia Colomba
- Infectious Diseases Unit, Universita degli Studi di Palermo, Palermo, Italy
| | - Claudia Gioè
- Infectious Diseases Unit, Universita degli Studi di Palermo, Palermo, Italy
| | - Mario Tumbarello
- Institute of Infectious Diseases, Foundation Policlinico Universitario A. Gemelli IRCCS, Cattolica del Sacro Cuore University, Rome, Italy
| | - Angela Raffaella Losito
- Institute of Infectious Diseases, Foundation Policlinico Universitario A. Gemelli IRCCS, Cattolica del Sacro Cuore University, Rome, Italy
| | - Giuseppe Foti
- Infetious Diseases Unit, “Bianchi-Melacrino-Morelli” Hospital, Reggio Calabria, Italy
| | | | | | - Chiara Iaria
- Infectious Diseases Unit, Arnas Civico Hospital, Palermo, Italy
| | | | - Sofia Sonia
- Infectious Diseases Unit, Cannizzaro Hospital, Catania, Italy
| | | | - Anna Ialungo
- Infectious Diseases Unit, Belcolle Hospital, Viterbo, Italy
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6
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Medaglia AA, Buffa S, Gioè C, Bonura S, Rubino R, Iaria C, Colomba C, Cascio A. Correction to: An emergent infectious disease: Clostridioides difficile infection hospitalizations, 10-year trend in Sicily. Infection 2021; 49:1231. [PMID: 34633633 PMCID: PMC8613075 DOI: 10.1007/s15010-021-01700-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | - Sergio Buffa
- Dipartimento per le Attività Sanitarie e Osservatorio Epidemiologico (DASOE), Palermo, Italy
| | - Claudia Gioè
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Silvia Bonura
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Raffaella Rubino
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Chiara Iaria
- Infectious Diseases Unit, ARNAS Civico, Palermo, Italy
| | - Claudia Colomba
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy.,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy
| | - Antonio Cascio
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy. .,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy.
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7
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Medaglia AA, Buffa S, Gioè C, Bonura S, Rubino R, Iaria C, Colomba C, Cascio A. An emergent infectious disease: Clostridioides difficile infection hospitalizations, 10-year trend in Sicily. Infection 2021; 49:1221-1229. [PMID: 34495497 PMCID: PMC8613107 DOI: 10.1007/s15010-021-01683-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
Background Clostridioides difficile is the most common cause of healthcare-associated diarrhoea worldwide and C. difficile infection is an emerging infectious disease. In the US, its rates are monitored trough an active surveillance system, but many European Union member states still lack this, and in Italy no epidemiological data on C. difficile infection are available except for a few single-centre data. Aim To provide data on the C. difficile infection incidence in Sicily (the biggest and 5th most populous region of Italy) during a 10-year period. Methods We revised all the regional standardized discharge forms between 2009 and June 2019 using the code ICD-9 00845 of the International Classification of Diseases, Ninth Revision Clinical Modification, which refers to C. difficile infection with or without complications. Results 1139 cases of CDI were identified. 97% were adults with a median age of 73.2 years and a male-to-female ratio of 1:1.4. Female patients were older than males and patients who died were older than patients who did not. The main comorbidities were renal disease, diabetes, pneumonia and hypertension. There were 65 reporting hospitals and 86% of cases were provided by level III and II hospitals. Between 2009 and 2019, the incidence increased 40-fold. 81.5% of cases were reported in Medicine Units, Infectious Diseases Units and long-term care facilities. The mean length of stay was 20 days. Mean case fatality rate was 8.3% over the 10-year period. Conclusion Clostridioides difficile infection is a dramatically increasing condition in Sicily. A high-quality surveillance system and shared diagnostic protocols are needed. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-021-01683-w.
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Affiliation(s)
| | - Sergio Buffa
- Dipartimento per le Attività Sanitarie e Osservatorio Epidemiologico (DASOE), Palermo, Italy
| | - Claudia Gioè
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Silvia Bonura
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Raffaella Rubino
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Chiara Iaria
- Infectious Diseases Unit, ARNAS Civico, Palermo, Italy
| | - Claudia Colomba
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy.,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy
| | - Antonio Cascio
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy. .,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy.
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8
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Medaglia AA, Siracusa L, Gioè C, Giordano S, Cascio A, Colomba C. Kawasaki disease recurrence in the COVID-19 era: a systematic review of the literature. Ital J Pediatr 2021; 47:95. [PMID: 33874991 PMCID: PMC8054252 DOI: 10.1186/s13052-021-01041-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/26/2021] [Indexed: 12/14/2022] Open
Abstract
Kawasaki disease (KD) is a vasculitis of unknown origin of small and medium caliber blood vessels, especially involving coronary arteries and is the leading cause of acquired heart disease in childhood in developed countries. Although rarely, it can recur: most recurrences occur within 2 years of the initial episode. No data are available on incidence of recurrent KD in Europe and multiple recurrences are rarely seen. We reviewed the medical literature on Kawasaki disease recurrence and reported a new case of Kawasaki disease recurrence in a child with SARS-CoV-2 infection. We believe that in our case SARS Cov2 acted as a trigger capable to determine, in a genetically susceptible individual, a second recurrence of the disease. In the Covid-19 era we affirm the importance for Kawasaki disease to be tested for SARS Cov2 infection.
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Affiliation(s)
- Alice Annalisa Medaglia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy.
- ARNAS Civico-Di Cristina, Pediatric Infectious Diseases Unit, Palermo, Italy.
| | - Lucia Siracusa
- ARNAS Civico-Di Cristina, Pediatric Infectious Diseases Unit, Palermo, Italy
| | - Claudia Gioè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy
- ARNAS Civico-Di Cristina, Pediatric Infectious Diseases Unit, Palermo, Italy
| | - Salvatore Giordano
- ARNAS Civico-Di Cristina, Pediatric Infectious Diseases Unit, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy
| | - Claudia Colomba
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Infectious Diseases Unit, University of Palermo, Palermo, Italy
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9
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Lazzerini M, Sforzi I, Trapani S, Biban P, Silvagni D, Villa G, Tibaldi J, Bertacca L, Felici E, Perricone G, Parrino R, Gioè C, Lega S, Conte M, Marchetti F, Magista A, Berlese P, Martelossi S, Vaienti F, Valletta E, Mauro M, Dall'Amico R, Fasoli S, Gatto A, Chiaretti A, Dragovic D, Pascolo P, Pilotto C, Liguoro I, Miorin E, Saretta F, Trobia GL, Di Stefano A, Orlandi A, Cardinale F, Lubrano R, Testa A, Binotti M, Moressa V, Barbi E, Armocida B, Mariani I. Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020. Euro Surveill 2021; 26:2001248. [PMID: 33834960 PMCID: PMC8034058 DOI: 10.2807/1560-7917.es.2021.26.14.2001248] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/19/2020] [Indexed: 12/14/2022] Open
Abstract
BackgroundVery few studies describe factors associated with COVID-19 diagnosis in children.AimWe here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.MethodsWe included cases aged 0-18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19.ResultsAmong 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52-90.55; p < 0.0001), cardiac disease (AOR: 3.10; 95% CI: 1.19-5.02; p < 0.0001), fever (AOR: 3.05%; 95% CI: 1.67-5.58; p = 0.0003) and anosmia/ageusia (AOR: 4.08; 95% CI: 1.69-9.84; p = 0.002). Among 190 (7.6%) children positive for SARS-CoV-2, only four (2.1%) required respiratory support and two (1.1%) were admitted to intensive care; all recovered.ConclusionRecommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.
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Affiliation(s)
- Marzia Lazzerini
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Idanna Sforzi
- Department of Pediatric Emergency Medicine and Trauma Center, Meyer Children's University Hospital, Florence, Italy
| | - Sandra Trapani
- Department of Health Sciences and Meyer Children's University Hospital, Florence, Italy
| | - Paolo Biban
- Department of Neonatal and Paediatric Critical Care, Verona University Hospital, Verona Italy
| | - Davide Silvagni
- Department of Neonatal and Paediatric Critical Care, Verona University Hospital, Verona Italy
| | - Giovanna Villa
- Pediatric Emergency Unit, IRCCS Gaslini Children's Hospital, Genoa, Italy
| | - Jessica Tibaldi
- Pediatric Emergency Unit, IRCCS Gaslini Children's Hospital, Genoa, Italy
| | - Luca Bertacca
- Pediatric Emergency Unit and Department of Pediatric and Neonatology, Misericordia Hospital, Grosseto, Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Giuseppina Perricone
- Pediatric and Pediatric Emergency Unit, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Roberta Parrino
- Pediatria d'Urgenza e Pronto Soccorso P.O.G. Di Cristina, Palermo, Italy
| | - Claudia Gioè
- Pediatric Infectious diseases, P.O.G. Di Cristina, Palermo, Italy
| | - Sara Lega
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Mariasole Conte
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | | | | | - Paola Berlese
- Department of Pediatrics, Treviso Hospital, Treviso, Italy
| | | | - Francesca Vaienti
- Department of Pediatrics, G.B. Morgagni-L. Pierantoni Hospital, Forlì, Italy
| | - Enrico Valletta
- Department of Pediatrics, G.B. Morgagni-L. Pierantoni Hospital, Forlì, Italy
| | - Margherita Mauro
- Department of Pediatrics and Neonatology, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - Roberto Dall'Amico
- Department of Pediatrics and Neonatology, Santa Maria degli Angeli Hospital, Pordenone, Italy
| | | | - Antonio Gatto
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Chiaretti
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danica Dragovic
- Department of Pediatrics, San Polo Hospital, ASUGI, Monfalcone (GO), Italy
| | - Paola Pascolo
- Department of Pediatrics, San Polo Hospital, ASUGI, Monfalcone (GO), Italy
| | - Chiara Pilotto
- Division of Paediatrics, Department of Medicine DAME, Academic Hospital Santa Maria della Misericordia, University of Udine, Udine, Italy
| | - Ilaria Liguoro
- Division of Paediatrics, Department of Medicine DAME, Academic Hospital Santa Maria della Misericordia, University of Udine, Udine, Italy
| | | | | | - Gian Luca Trobia
- Pediatric and Pediatric Emergency Room Unit Cannizzaro Emergency Hospital, Catania, Italy
| | - Antonella Di Stefano
- Pediatric and Pediatric Emergency Room Unit Cannizzaro Emergency Hospital, Catania, Italy
| | - Azzurra Orlandi
- Giovanni XXIII Pediatric Hospital, Department of Pediatrics, University of Bari, Bari, Italy
| | - Fabio Cardinale
- Giovanni XXIII Pediatric Hospital, Department of Pediatrics, University of Bari, Bari, Italy
| | - Riccardo Lubrano
- Department of Pediatrics Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Alessia Testa
- Department of Pediatrics Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Marco Binotti
- Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità University Hospital, Novara, Italy
| | - Valentina Moressa
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Egidio Barbi
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
- University of Trieste, Trieste, Italy
| | - Benedetta Armocida
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Ilaria Mariani
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
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10
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Colomba C, Saporito L, Gioè C, Tramuto F, Firenze A, Cascio A. Fatal measles as
AIDS
presentation in Italy. HIV Med 2019; 20:e6-e7. [DOI: 10.1111/hiv.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C Colomba
- Department of Sciences for Health Promotion and Mother‐Child Care University of Palermo Palermo Italy
| | - L Saporito
- Department of Sciences for Health Promotion and Mother‐Child Care University of Palermo Palermo Italy
| | - C Gioè
- Department of Sciences for Health Promotion and Mother‐Child Care University of Palermo Palermo Italy
| | - F Tramuto
- Department of Sciences for Health Promotion and Mother‐Child Care University of Palermo Palermo Italy
| | - A Firenze
- Department of Sciences for Health Promotion and Mother‐Child Care University of Palermo Palermo Italy
| | - A Cascio
- Department of Sciences for Health Promotion and Mother‐Child Care University of Palermo Palermo Italy
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11
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Esposito S, De Simone G, Pan A, Brambilla P, Gattuso G, Mastroianni C, Kertusha B, Contini C, Massoli L, Francisci D, Priante G, Libanore M, Bicocchi R, Borgia G, Maraolo AE, Brugnaro P, Panese S, Calabresi A, Amendola G, Savalli F, Geraci C, Tedesco A, Fossati S, Carretta A, Santantonio T, Cenderello G, Crisalli MP, Schiaroli E, Rovere P, Masini G, Ferretto R, Cascio A, Colomba C, Gioè C, Tumbarello M, Losito AR, Foti G, Prestileo T, Buscemi C, Chiara I, Iacobello C, Sonia S, Starnini G, Ialungo A, Sapienza M. Epidemiology and Microbiology of Skin and Soft Tissue Infections: Preliminary Results of a National Registry. J Chemother 2018; 31:9-14. [PMID: 30508410 DOI: 10.1080/1120009x.2018.1536320] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Skin and soft tissue infections (SSTIs) represent a wide range of clinical conditions characterized by a considerable variety of clinical presentations and severity. Their aetiology can also vary, with numerous possible causative pathogens. While other authors previously published analyses on several types of SSTI and on restricted types of patients, we conducted a large nationwide surveillance programme on behalf of the Italian Society of Infectious and Tropical Diseases to assess the clinical and microbiological characteristics of the whole SSTI spectrum, from mild to severe life-threatening infections, in both inpatients and outpatients. Twenty-five Infectious Diseases (ID) Centres throughout Italy collected prospectively data concerning both the clinical and microbiological diagnosis of patients affected by SSTIs via an electronic case report form. All the cases included in our database, independently from their severity, have been managed by ID specialists joining the study while SSTIs from other wards/clinics have been excluded from this analysis. Here, we report the preliminary results of our study, referring to a 12-month period (October 2016-September 2017). During this period, the study population included 254 adult patients and a total of 291 SSTI diagnoses were posed, with 36 patients presenting more than one SSTIs. The type of infection diagnosed, the aetiological micro-organisms involved and some notes on their antimicrobial susceptibilities were collected and are reported herein. The enrichment of our registry is ongoing, but these preliminary results suggest that further analysis could soon provide useful information to better understand the national epidemiologic data and the current clinical management of SSTIs in Italy.
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Affiliation(s)
- Silvano Esposito
- a Department of Infectious Diseases , University of Salerno , Salerno , Italy
| | - Giuseppe De Simone
- a Department of Infectious Diseases , University of Salerno , Salerno , Italy
| | - Angelo Pan
- b Department of Infectious Diseases , Istituti Ospitalieri of Cremona , Cremona , Italy
| | - Paola Brambilla
- b Department of Infectious Diseases , Istituti Ospitalieri of Cremona , Cremona , Italy
| | - Gianno Gattuso
- c Department of Infectious Diseases , Carlo Poma Hospital , Mantova , Italy
| | - Claudio Mastroianni
- d Department of Public Health and Infectious Diseases , Sapienza University , Latina , Italy
| | - Blerta Kertusha
- d Department of Public Health and Infectious Diseases , Sapienza University , Latina , Italy
| | - Carlo Contini
- e Department of Medical Sciences, Section of Infectious Diseases and Dermatology , University of Ferrara , Ferrara , Italy
| | - Lorenzo Massoli
- e Department of Medical Sciences, Section of Infectious Diseases and Dermatology , University of Ferrara , Ferrara , Italy
| | - Daniela Francisci
- f Infectious Diseases Clinic, University Hospital "S. Maria" , University of Perugia , Perugia , Italy
| | - Giulia Priante
- f Infectious Diseases Clinic, University Hospital "S. Maria" , University of Perugia , Perugia , Italy
| | - Marco Libanore
- g Infectious Diseases Unit, Department of Infectious Diseases , S. Anna University Hospital , Ferrara , Italy
| | - Roberto Bicocchi
- g Infectious Diseases Unit, Department of Infectious Diseases , S. Anna University Hospital , Ferrara , Italy
| | - Guglielmo Borgia
- h Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples Federico II , Naples , Italy
| | - Alberto Enrico Maraolo
- h Department of Clinical Medicine and Surgery, Section of Infectious Diseases , University of Naples Federico II , Naples , Italy
| | - Pierluigi Brugnaro
- i Infectious Diseases Department , Ospedale Civile "SS. Giovanni e Paolo" , Venice , Italy
| | - Sandro Panese
- i Infectious Diseases Department , Ospedale Civile "SS. Giovanni e Paolo" , Venice , Italy
| | - Alessandra Calabresi
- j Emergency Department , Hospital "Santi Antonio e Biagio e C. Arrigo" , Alessandria , Italy
| | - Giovanni Amendola
- j Emergency Department , Hospital "Santi Antonio e Biagio e C. Arrigo" , Alessandria , Italy
| | | | - Consuelo Geraci
- k Infectious Diseases Unit , Hospital of Trapani , Trapani , Italy
| | - Andrea Tedesco
- l Infectious Diseases Unit , Hospital Fracastoro San Bonifacio , Verona , Italy
| | - Sara Fossati
- m Infectious Diseases Unit , University Hospital of Trieste , Trieste , Italy
| | - Anna Carretta
- n Department of Infectious Diseases , University Hospital "Ospedali Riuniti" of Foggia , Foggia , Italy
| | - Teresa Santantonio
- n Department of Infectious Diseases , University Hospital "Ospedali Riuniti" of Foggia , Foggia , Italy
| | | | | | - Elisabetta Schiaroli
- p Department of Medicine, Section of Infectious Diseases , University of Perugia , Perugia , Italy
| | | | - Giulia Masini
- q Infectious Diseases Unit , Legnago Hospital , Verona , Italy
| | - Roberto Ferretto
- r Infectious Diseases Unit , "Alto Vicentino" Santorso Hospital , Vicenza , Italy
| | - Antonio Cascio
- s Infectious Diseases Unit , Università degli Studi di Palermo , Palermo , Italy
| | - Claudia Colomba
- s Infectious Diseases Unit , Università degli Studi di Palermo , Palermo , Italy
| | - Claudia Gioè
- s Infectious Diseases Unit , Università degli Studi di Palermo , Palermo , Italy
| | - Mario Tumbarello
- t Institute of Infectious Diseases , Foundation Policlinico Universitario A. Gemelli IRCCS, Cattolica del Sacro Cuore University , Rome , Italy
| | - Angela Raffaella Losito
- t Institute of Infectious Diseases , Foundation Policlinico Universitario A. Gemelli IRCCS, Cattolica del Sacro Cuore University , Rome , Italy
| | - Giuseppe Foti
- u Infetious Diseases Unit , "Bianchi-Melacrino-Morelli" Hospital , Reggio Calabria , Italy
| | - Tullio Prestileo
- v Infectious Diseases Unit , Arnas Civico Hospital , Palermo , Italy
| | - Calogero Buscemi
- v Infectious Diseases Unit , Arnas Civico Hospital , Palermo , Italy
| | - Iaria Chiara
- v Infectious Diseases Unit , Arnas Civico Hospital , Palermo , Italy
| | | | - Sofia Sonia
- w Infectious Diseases Unit , Cannizzaro Hospital , Catania , Italy
| | - Giulio Starnini
- x Infectious Diseases Unit , Belcolle Hospital , Viterbo , Italy
| | - Anna Ialungo
- x Infectious Diseases Unit , Belcolle Hospital , Viterbo , Italy
| | - Mauro Sapienza
- y UOC Medicina Interna , Ospedale Umberto I , Enna , Italy
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12
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Colomba C, Cascio A, Caruso C, Trizzino M, Gioè C, Guadagnino G, Tuttolomondo A, Pinto A, Saracino A, Angarano G, Di Bona D. [Role of combination NK/KIRs in the natural history of viral infections.]. Recenti Prog Med 2018; 108:333-337. [PMID: 28845855 DOI: 10.1701/2731.27839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Immunological mechanisms involved in the genesis of the immune response against viral infections take into account the activation of both innate adaptative response. Innate immune defenses trigger a rapid local response, which is often sufficient to control viral infection, and promotes the subsequent activation of specific immune defenses. Natural killer (NK) cells that constitute a subpopulation of lymphocyte-related cells are a key factor of innate immune response and play a role in defense against viral infections by killing infected cells or by producing cytokines and interacting with adaptative immune system's cells. Killer immunoglobulin-like receptors (KIRs) regulate the activation of NK cells through their interaction with human leukocyte antigens (HLA). KIRs and HLA loci are highly polymorphic and certain HLA-KIRs combinations have been found to protect against viral infections. In this study we review how the KIRs/HLA repertoire may influence the course of hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV) and Herpes Simplex Virus 1 (HSV-1) infection. Results of our study suggest that a combination of KIRs/HLA gene/alleles is able to predict the outcome of viral infection and allows to plan successful customized therapeutic strategies.
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Affiliation(s)
- Claudia Colomba
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | - Antonio Cascio
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | - Calogero Caruso
- Dipartimento di Biopatologia e Biotecnologie Mediche, Università di Palermo
| | - Marcello Trizzino
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | - Claudia Gioè
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | - Giuliana Guadagnino
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | | | - Antonio Pinto
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo
| | | | | | - Danilo Di Bona
- Dipartimento dell'Emergenza e dei Trapianti d'Organo, Università di Bari Aldo Moro
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13
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La Manna MP, Guadagnino G, De Luca AM, Iaria C, Scarlata F, Serra N, Rea T, Mancuso S, Mililli D, Gioè C, Romanin B, Colomba C. Conventional T cells and non-conventional T cells during Mycobacterium tuberculosis infection. An emerging issue in adult and children population. Gazz Med Ital - Arch Sci Med 2018. [DOI: 10.23736/s0393-3660.18.03818-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Colomba C, Trizzino M, Gioè C, Coelho F, Lopo I, Pinheiro P, Sousa J, Cascio A. Malaria and the heart: Two rare case reports of Plasmodium falciparumassociated pericarditis. J Vector Borne Dis 2017; 54:372-374. [DOI: 10.4103/0972-9062.225845] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Colomba C, Siracusa L, Trizzino M, Gioè C, Giammanco A, Cascio A. Myocarditis in Mediterranean spotted fever: a case report and a review of the literature. JMM Case Rep 2016; 3:e005039. [PMID: 28348768 PMCID: PMC5330236 DOI: 10.1099/jmmcr.0.005039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/19/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Mediterranean spotted fever (MSF) is a tick-borne acute febrile disease caused by Rickettsia conorii. Most cases follow a benign course, with a case fatality rate of 3-7 % among hospitalized patients. Complications are described mainly in adult patients and include hepatic, renal, neurological and cardiac impairment. Among cardiac complications, pericarditis, myocarditis and heart rhythm disorders are uncommon complications in MSF and only a few cases have been reported in the literature. CASE PRESENTATION We describe a new case of acute myocarditis complicating MSF in an immunocompetent adult patient without risk factors for severe MSF. CONCLUSION Myocarditis is an uncommon but severe complication of MSF. Clinicians should be aware of a possible cardiac involvement in patients with MSF. Close monitoring and an aggressive approach are essential to reduce mortality rates of MSF.
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Affiliation(s)
- Claudia Colomba
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Lucia Siracusa
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Marcello Trizzino
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Claudia Gioè
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Anna Giammanco
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Antonio Cascio
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
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Colomba C, Di Carlo P, Guadagnino G, Siracusa L, Trizzino M, Gioè C, Cascio A. A Case of Epididymo-orchitis after intravesical bacille Calmette-Guérin therapy for superficial bladder carcinoma in a patient with latent tuberculosis infection. Infect Agent Cancer 2016; 11:25. [PMID: 27257433 PMCID: PMC4890504 DOI: 10.1186/s13027-016-0072-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/22/2016] [Indexed: 11/10/2022] Open
Abstract
Background Intravesical instillation of bacille Calmette-Guérin (BCG) has been established as efficient therapy for superficial bladder carcinoma. Overall, intravesical BCG is well tolerated and results in complications of less than 5 %. However, adverse effects such as granulomatous prostatitis, pneumonitis, hepatitis, sepsis, and hypersensitivity reactions may occur. The reported rate for tuberculous orchitis after BCG intravesical therapy is 0.4 %. Findings We report a case of monolateral tuberculous orchitis occurring one month after the second course of intravescical instillation of bacille Calmette-Guérin in a patient with proven superficial bladder carcinoma and latent tuberculosis infection. Conclusions In our opinion intravesical instillation of BCG should be considered on an individual patient basis, with full patient disclosure of the potentially significant risks. A screening with an intradermal Mantoux before starting the first cycle of BCG instillation should be recommended and isoniazid would be indicated as the treatment for latent tuberculosis infection.
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Affiliation(s)
- C Colomba
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - P Di Carlo
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - G Guadagnino
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - L Siracusa
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - M Trizzino
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - C Gioè
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - A Cascio
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
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Colomba C, Trizzino M, Gioè C, Di Bona D, Mularoni A, Cascio A. HIV infection with viro-immunological dissociation in a patient with polycystic kidney disease: Candidate for transplantation? IDCases 2016; 6:74-76. [PMID: 27752472 PMCID: PMC5066192 DOI: 10.1016/j.idcr.2016.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022] Open
Abstract
Autosomal dominant polycystic kidney disease is the most common among inherited cystic kidney diseases. Patients with HIV infection are at risk of developing acute kidney injury and chronic kidney disease. We provide the first report of HIV infection in a patient with polycystic kidney disease. Lymphopenia should not contraindicate kidney transplantation in patients with HIV infection.
Here we describe the case of a HIV-infected patient with polycystic kidney disease and end stage renal diseases not transplantable due to the persistence of a CD4 count <200 notwithstanding a good virological response to highly active antiretroviral therapy and suggest that such limitation to kidney transplantation in such as cases might be bypassed.
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Affiliation(s)
- Roberta Onesimo
- Pediatrics Department, Catholic University of Sacred Heart, Rome, Italy.
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