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Liotti FM, Posteraro B, De Angelis G, Torelli R, De Carolis E, Speziale D, Menchinelli G, Spanu T, Sanguinetti M. A New PCR-Based Assay for Testing Bronchoalveolar Lavage Fluid Samples from Patients with Suspected Pneumocystis jirovecii Pneumonia. J Fungi (Basel) 2021; 7:jof7090681. [PMID: 34575719 PMCID: PMC8466016 DOI: 10.3390/jof7090681] [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: 07/21/2021] [Revised: 08/18/2021] [Accepted: 08/22/2021] [Indexed: 11/23/2022] Open
Abstract
To support the clinical laboratory diagnosis of Pneumocystis jirovecii (PJ) pneumonia (PCP), an invasive fungal infection mainly occurring in HIV-negative patients, in-house or commercial PJ-specific real-time quantitative PCR (qPCR) assays are todays’ reliable options. The performance of these assays depends on the type of PJ gene (multi-copy mitochondrial versus single-copy nuclear) targeted by the assay. We described the development of a PJ-PCR assay targeting the dihydrofolate reductase (DHFR)-encoding gene. After delineating its analytical performance, the PJ-PCR assay was used to test bronchoalveolar lavage (BAL) fluid samples from 200 patients (only seven were HIV positive) with suspected PCP. Of 211 BAL fluid samples, 18 (8.5%) were positive and 193 (91.5%) were negative by PJ-PCR. Of 18 PJ-PCR-positive samples, 11 (61.1%) tested positive and seven (38.9%) tested negative with the immunofluorescence assay (IFA). All (100%) of the 193 PJ-PCR-negative samples were IFA negative. Based on IFA/PCR results, patients were, respectively, classified as having (n = 18) and not having (n = 182) proven (PJ-PCR+/IFA+) or probable (PJ-PCR+/IFA−) PCP. For 182 patients without PCP, alternative infectious or non-infectious etiologies were identified. Our PJ-PCR assay was at least equivalent to IFA, fostering studies aimed at defining a qPCR-based standard for PCP diagnosis in the future.
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Affiliation(s)
- Flora Marzia Liotti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy; (F.M.L.); (B.P.); (G.D.A.); (G.M.); (T.S.)
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (R.T.); (E.D.C.); (D.S.)
| | - Brunella Posteraro
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy; (F.M.L.); (B.P.); (G.D.A.); (G.M.); (T.S.)
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy
| | - Giulia De Angelis
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy; (F.M.L.); (B.P.); (G.D.A.); (G.M.); (T.S.)
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (R.T.); (E.D.C.); (D.S.)
| | - Riccardo Torelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (R.T.); (E.D.C.); (D.S.)
| | - Elena De Carolis
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (R.T.); (E.D.C.); (D.S.)
| | - Domenico Speziale
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (R.T.); (E.D.C.); (D.S.)
| | - Giulia Menchinelli
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy; (F.M.L.); (B.P.); (G.D.A.); (G.M.); (T.S.)
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (R.T.); (E.D.C.); (D.S.)
| | - Teresa Spanu
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy; (F.M.L.); (B.P.); (G.D.A.); (G.M.); (T.S.)
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (R.T.); (E.D.C.); (D.S.)
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy; (F.M.L.); (B.P.); (G.D.A.); (G.M.); (T.S.)
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (R.T.); (E.D.C.); (D.S.)
- Correspondence: ; Tel.: +39-06-3054-411; Fax: +39-06-3051-152
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Buonsenso D, Valentini P, De Rose C, Pata D, Sinatti D, Speziale D, Ricci R, Carfì A, Landi F, Ferrari V, De Maio F, Palucci I, Sanguinetti M, Sali M. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in children with household exposure to adults with COVID-19: Preliminary findings. Pediatr Pulmonol 2021; 56:1374-1377. [PMID: 33470561 PMCID: PMC8014267 DOI: 10.1002/ppul.25280] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/11/2021] [Accepted: 01/15/2021] [Indexed: 11/07/2022]
Abstract
Weather and the susceptibility of children to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still a debated question and currently a hot topic, particularly in view of important decisions regarding opening schools. Therefore, we performed this prospective analysis of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies in children with known household exposure to SARS-CoV-2 and compared their IgG status with the other adults exposed to the index case in the same household. A total of 30 families with a documented COVID-19 index case were included. A total of 44 out of 80 household contacts (55%) of index patients had anti SARS-CoV-2 IgG antibodies. In particular, 16/27 (59,3%) adult partners had IgG antibodies compared with 28/53 (52,3%) of pediatric contacts (p > .05). Among the pediatric population, children ≥5 years of age had a similar probability of having SARS-CoV-2 IgG antibodies (21/39, 53.8%) compared to those less than 5 years old (7/14, 50%) (p > .05). Adult partners and children also had a similar probability of having SARS-CoV-2 IgG antibodies. Interestingly, 10/28 (35.7%) of children and 5/27 (18.5%) of adults with SARS-CoV-2 IgG antibodies were previously diagnosed as COVID-19 cases. Our study shows evidence of a high rate of IgG antibodies in children exposed to SARS-CoV-2. This report has public health implications, highlighting the need to establish appropriate guidelines for school openings and other social activities related to childhood.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario, Rome, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario, Rome, Italy
| | - Davide Pata
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario, Rome, Italy
| | - Dario Sinatti
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario, Rome, Italy
| | - Domenico Speziale
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rosalba Ricci
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Angelo Carfì
- Geriatrics Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Landi
- Geriatrics Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Flavio De Maio
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ivana Palucci
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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3
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Dajko M, Poscia A, Posteraro B, Speziale D, Volpe M, Mancinelli S, Ricciardi W, de Waure C. Microbiological ascertainment in patients with pneumonia: the experience of a teaching hospital in Rome. Ann Ist Super Sanita 2020; 56:277-284. [PMID: 32959793 DOI: 10.4415/ann_20_03_05] [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: 11/06/2022]
Abstract
OBJECTIVES Pneumonia still remains a problem from the clinical and public health viewpoint because of the relevant epidemiological burden. The etiological diagnosis is important in the light of avoiding unnecessary antibiotic treatment and choosing the most appropriate therapeutical approach. This study is aimed at providing evidence on the proportion of microbiological ascertainment in pneumonia-related hospitalizations in one of the most important teaching hospitals in Rome. METHODS The study relied on the record linkage of two administrative databases of the same hospital: the electronic hospital discharge register and the microbiology laboratory surveillance database. RESULTS 2819 records were identified, where 46% had a microbiological ascertainment, significantly higher in males than in females (51% vs 40%) and in cases of pneumonia reported in secondary diagnosis instead of primary diagnosis (52% vs 42%). Medical patients had significantly lower proportion of ascertainment compared to surgical patients (43% vs 67%) whereas there were not differences between patients with emergency and elective admission. The overall mortality was 17%. Mortality was significantly higher: in surgical compared to medical patients (27% vs 15%), in ventilated compared to not ventilated patients (41% vs 11%), in cases with secondary diagnosis of pneumonia compared to a primary diagnosis (23% vs 11% ) and in hospitalized in intensive care unit-ICU- rather than in non-ICU (71% vs 12%). CONCLUSION The proportion of microbiological ascertaiment in pneumonia remains less than 50%. Albeit in line with other evidence, this result should call the attention on the impact of unknown etiological diagnosis on antibiotic treatment and resistance.
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Affiliation(s)
- Marianxhela Dajko
- Centro di Epidemiologia, Biostatistica e Informatica Medica, Università Politecnica delle Marche, Ancona, Italy
| | - Andrea Poscia
- ASUR Marche - AV2 - UOC ISP Prevenzione e Sorveglianza Malattie Infettive e Cronico Degenerative, Jesi (Ancona), Italy
| | - Brunella Posteraro
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenico Speziale
- Istituto di Microbiologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimo Volpe
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Walter Ricciardi
- Dipartimento Scienze della salute della donna, del bambino e di sanità pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Chiara de Waure
- Dipartimento di Medicina Sperimentale, Università degli Studi di Perugia, Perugia, Italy
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Dajko M, Poscia A, Posteraro B, Speziale D, Volpe M, Ricciardi W, de Waure C. Streptococcus pneumoniae in hospitalized patients with pneumonia: epidemiology and implications. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Streptococcus pneumoniae (SP) is a major cause of pneumonia worldwide representing a significant problem from the public health viewpoint. The aim of our study was to assess the frequency of SP in hospitalized patients with pneumonia and investigate its relationship with patients' characteristics.
Methods
A deterministic record linkage of hospital discharge and microbiology laboratory surveillance databases of a teaching hospital in Rome was used to identify all patients over 15 years old (y) with a diagnosis of pneumonia and a microbiological ascertainment between November 2010 and March 2013. Pneumonia ICD-9-CM codes were used to identify the study population. The frequency of SP was assessed with respect to patients' characteristics.
Results
1216 (64% males) of a mean age 65 (SD = 18) y patients with pneumonia were identified. Of them, 707 (58%) had a positive microbiological result. Among the latter, mixed bacterial co-infections were detected in 552 (74%) cases. The most frequently isolated organism was SP in 288 (41%) cases. Nevertheless, SP was the sole isolated agent in only 6 (0.8%) cases. There were no significant differences between men and women with respect to the frequency of SP. Eventually, the frequency of SP among patients with a positive microbiological result was higher in the age group 15-64 y than in 65+ y (45% vs 37%, p = 0.038). When considering only subjects with at least one comorbidity the frequency of SP was higher among the 15-64 y age group (53% vs 44% in 15-64 y and 65+ y respectively, p = 0.040).
Conclusions
Our study revealed that SP was the most frequent isolated pathogen in hospitalized patients with pneumonia. However, the SP coexistence with other pathogens was present in the vast majority of cases. Interestingly, SP was highly frequent among people with comorbidities, in particular in the age group 15-64 y. This emphasizes the importance of vaccination in this group of patients.
Key messages
This study shows that more than 40% of pneumonia with a positive microbiological result are caused by Streptococcus pneumoniae. Preventive strategies to limit Streptococcus pneumoniae infections among adults and individuals affected by comorbidities are needed.
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Affiliation(s)
- M Dajko
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Poscia
- ASUR Marche – AV2, UOC ISP Prevenzione e Sorveglianza Malattie Infettive e Cronico Degenerative, Jesi, Italy
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - B Posteraro
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D Speziale
- Institute of Microbiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M Volpe
- Health Management, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - W Ricciardi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C de Waure
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Borghetti A, Moschese D, Cingolani A, Baldin G, Speziale D, Ciccullo A, Lombardi F, Emiliozzi A, Belmonti S, Antinori A, Cauda R, Di Giambenedetto S. Lamivudine-based maintenance antiretroviral therapies in patients living with HIV-1 with suppressed HIV RNA: derivation of a predictive score for virological failure. HIV Med 2019; 20:624-627. [PMID: 31240860 DOI: 10.1111/hiv.12759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Two-drug antiretroviral regimens based on lamivudine (3TC) plus either a protease inhibitor (PI) or dolutegravir (DTG) are becoming increasingly popular in switch strategies. Our goal was to derive a predictive score for virological failure (VF). METHODS We retrospectively analysed data for a cohort of 587 virologically suppressed (HIV RNA < 37 HIV-1 RNA copies/mL), adult (≥ 18 years old) patients starting lamivudine plus either a boosted PI or dolutegravir. Predictors of VF (defined as a single HIV RNA measurement ≥ 1000 copies/mL or two consecutive HIV RNA measurements ≥ 50 copies/mL) were identified using a multivariate Cox regression model. A 'weighted' score was assigned to each variable associated with VF; the discriminative power of the score obtained was expressed as the area under the receiver-operator characteristic curve (ROC-AUC). RESULTS During a median 2 years of follow-up time, 35 VFs occurred; predictors of VF were baseline residual HIV RNA between 20 and 36 copies/mL, African ethnicity, ≥ 10 therapeutic lines, the presence of at least one resistance-associated mutation (RAM) for resistance to current drugs (excluding M184V), a non-B viral subtype and a baseline CD4 count < 200 cells/μL. A score of 2 was assigned to non-B viral subtype, 3 to residual viraemia ≥ 20 copies/mL, ≥ 10 previous therapeutic lines and African ethnicity, 4 to baseline CD4 count < 200 cells/μL, and 7 to the presence of at least one RAM (excluding M184V). The ROC-AUC was 0.67 (95% confidence interval 0.57-0.77). CONCLUSIONS The presence of at least one RAM, higher residual viraemia and African ethnicity were among the major predictors of VF in our cohort. Studies with larger sample sizes are warranted to improve the predictive value of the derived score.
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Affiliation(s)
- A Borghetti
- Fondazione Policlinico Agostino Gemelli IRCCS, Infectious Diseases Unit, Rome, Italy
| | - D Moschese
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - A Cingolani
- Fondazione Policlinico Agostino Gemelli IRCCS, Infectious Diseases Unit, Rome, Italy.,Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - G Baldin
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - D Speziale
- Institute of Microbiology, Catholic University of the Sacred Heart, Rome, Italy
| | - A Ciccullo
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - F Lombardi
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - A Emiliozzi
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - S Belmonti
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - A Antinori
- UOC Immunodeficienze Virali, Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - R Cauda
- Fondazione Policlinico Agostino Gemelli IRCCS, Infectious Diseases Unit, Rome, Italy.,Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - S Di Giambenedetto
- Fondazione Policlinico Agostino Gemelli IRCCS, Infectious Diseases Unit, Rome, Italy.,Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
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Ciccullo A, Gagliardini R, Baldin G, Borghetti A, Moschese D, Emiliozzi A, Lombardi F, Ricci R, Speziale D, Pallavicini F, Di Giambenedetto S. An outbreak of acute hepatitis A among young adult men: clinical features and HIV coinfection rate from a large teaching hospital in Rome, Italy. HIV Med 2018; 19:369-375. [PMID: 29380498 DOI: 10.1111/hiv.12597] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Italy is a low-incidence region for hepatitis A; however, during the last 2 years an increase in the incidence of hepatitis A virus (HAV) infection was reported in Europe. The aim of this study was to describe this recent outbreak. METHODS We retrospectively analysed all cases of acute hepatitis A diagnosed at our laboratory between January 2010 and June 2017. We evaluated the following variables at the time of diagnosis: sex, age, nationality, glutamic oxaloacetic transaminase (GOT/AST), glutamic pyruvic transaminase (GPT/ALT), bilirubin concentration, international normalized ratio (INR) and the presence or absence of anti-HIV-1/2 antibodies. Hospitalization was also considered. We analysed these parameters using the χ2 test and Mann-Whitney U-test. RESULTS A total of 225 cases were analysed; 82.7% were in male patients, 94.2% were in Italians and the median age of the patients was 36.4 years. At diagnosis, the median GOT value was 306 U/L, the median GPT was 1389 U/L, and the median total bilirubin value was 5.88 mg/dL. Hospitalization was required for 142 patients, with a median duration of hospital stay of 8.5 days. In 2016-2017 we registered 141 cases, with a higher prevalence of male patients, higher GPT values and a higher prevalence of patients aged 20-39 years compared with older (2010-2015) cases. Homosexual intercourse was reported as the HAV risk factor in 70.2% of patients. HIV serology was available for 120 patients: 24 were HIV-positive, four of whom represented new diagnoses. HIV-positive patients showed lower bilirubin and GPT values and fewer hospitalizations than HIV-negative patients. CONCLUSIONS In 2016-2017, we saw a rise in the number of hepatitis A cases, with a higher prevalence of adult male patients. No significant differences regarding the prevalence of HIV coinfection emerged.
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Affiliation(s)
- A Ciccullo
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - R Gagliardini
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - G Baldin
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - A Borghetti
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - D Moschese
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - A Emiliozzi
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - F Lombardi
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - R Ricci
- Institute of Microbiology, Catholic University of the Sacred Heart, Rome, Italy
| | - D Speziale
- Institute of Microbiology, Catholic University of the Sacred Heart, Rome, Italy
| | - F Pallavicini
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - S Di Giambenedetto
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
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7
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Dajko M, Poscia A, Posteraro B, Speziale D, Volpe M, Ricciardi W, de Waure C. Microbiological ascertainment in patients with pneumonia: is there room for improvement? Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.151] [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: 11/13/2022] Open
Affiliation(s)
- M Dajko
- Institute of Public Health - Section of Hygiene -, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Poscia
- Institute of Public Health - Section of Hygiene -, Università Cattolica del Sacro Cuore, Rome, Italy
| | - B Posteraro
- Institute of Public Health - Section of Hygiene -, Università Cattolica del Sacro Cuore, Rome, Italy
| | - D Speziale
- Institute of Microbiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario, Rome, Italy
| | - M Volpe
- Health Management, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - W Ricciardi
- Institute of Public Health - Section of Hygiene -, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C de Waure
- Institute of Public Health - Section of Hygiene -, Università Cattolica del Sacro Cuore, Rome, Italy
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8
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Laurenti L, Autore F, Innocenti I, Vannata B, Piccirillo N, Sorà F, Speziale D, Pompili M, Efremov D, Sica S. Prevalence, characteristics and management of occult hepatitis B virus infection in patients with chronic lymphocytic leukemia: a single center experience. Leuk Lymphoma 2015; 56:2841-6. [PMID: 25682966 DOI: 10.3109/10428194.2015.1017822] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 02/06/2023]
Abstract
Several reports have emphasized the risk of hepatitis B virus (HBV) reactivation in patients with lymphoproliferative disorders undergoing cytotoxic treatment. To determine the prevalence of occult B infection (OBI) in a population with chronic lymphocytic leukemia (CLL) and management with universal prophylaxis (UP) in all patients undergoing chemoimmunotherapy or targeted prophylaxis (TP) in patients experiencing seroreversion during therapy, we analyzed 397 patients with CLL from our database. The prevalence of OBI in our patients with CLL was 8.6% (34 patients). When comparing patients with OBI/CLL with those with CLL, we did not find any statistical difference among clinical-biological parameters and time dependent endpoints except for a lower peripheral blood lymphocyte count in the OBI/CLL group (p = 0.036). From 2000 to 2010 careful follow-up and TP were adopted; two out of 10 patients (20%) showed seroreversion. From June 2010 we adopted UP during and 12 months after immunosuppressive treatment in all patients with CLL with OBI; no evidence of seroreversion was detected.
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Affiliation(s)
- Luca Laurenti
- a Department of Hematology , Catholic University of the Sacre Heart , Rome , Italy
| | - Francesco Autore
- a Department of Hematology , Catholic University of the Sacre Heart , Rome , Italy
| | - Idanna Innocenti
- a Department of Hematology , Catholic University of the Sacre Heart , Rome , Italy
| | - Barbara Vannata
- a Department of Hematology , Catholic University of the Sacre Heart , Rome , Italy
| | - Nicola Piccirillo
- a Department of Hematology , Catholic University of the Sacre Heart , Rome , Italy
| | - Federica Sorà
- a Department of Hematology , Catholic University of the Sacre Heart , Rome , Italy
| | - Domenico Speziale
- b Department of Laboratory Medicine , Catholic University of the Sacre Heart , Rome , Italy
| | - Maurizio Pompili
- c Internal Medicine, Catholic University of the Sacre Heart , Rome , Italy
| | - Dimitar Efremov
- d ICGEB Outstation-Monterotondo, CNR Campus "A. Buzzati-Traverso" , Rome , Italy
| | - Simona Sica
- a Department of Hematology , Catholic University of the Sacre Heart , Rome , Italy
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9
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Valentini P, Buonsenso D, Barone G, Serranti D, Calzedda R, Ceccarelli M, Speziale D, Ricci R, Masini L. Spiramycin/cotrimoxazole versus pyrimethamine/sulfonamide and spiramycin alone for the treatment of toxoplasmosis in pregnancy. J Perinatol 2015; 35:90-4. [PMID: 25211284 DOI: 10.1038/jp.2014.161] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 07/16/2014] [Accepted: 07/25/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To compare the effectiviness of spiramycin/cotrimoxazole (Sp/C) versus pyrimethamine/sulfonamide (Pyr/Sul) and spiramycin alone (Spy) on mother-to-child transmission of toxoplasmosis infection in pregnancy. STUDY DESIGN Retrospective study of pregnant women evaluated for suspected toxoplasmosis between 1992 and 2011. RESULT A total of 120 mothers and their 123 newborns were included. Prenatal treatment consisted of spiramycin in 43 mothers (35%), spiramycin/cotrimoxazole in 70 (56.9%) and pyrimethamine/sulfonamide in 10 (8.1%). A trend toward reduction in toxoplasmosis transmission was found when Sp/C was compared with Pyr/Sul and particularly with Spy alone (P=0.014). In particular, Spy increased the risk of congenital infection when compared with Sp/C (odds ratio (OR) 4.368; 95% CI: 1.253 to 15.219), but there was no significant reduction when Sp/C was compared with Pyr/Sul (OR 1.83; 95% CI: 0.184 to 18.274). CONCLUSION The treatment based on Sp/C has significant efficacy in reducing maternal-fetal transmission of Toxoplasma gondii when compared with Pyr/Sul and particularly to Spy. Randomized controlled trials would be required.
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Affiliation(s)
- P Valentini
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - D Buonsenso
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - G Barone
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - D Serranti
- Department of Pediatrics, Meyer Pediatric Hospital, Florence, Italy
| | - R Calzedda
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - M Ceccarelli
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - D Speziale
- Department of Microbiology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - R Ricci
- Department of Microbiology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - L Masini
- Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy
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10
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Valentini P, Annunziata ML, Angelone DF, Masini L, Santis M, Testa A, Grillo RL, Speziale D, Ranno O. Role of spiramycin/cotrimoxazole association in the mother-to-child transmission of toxoplasmosis infection in pregnancy. Eur J Clin Microbiol Infect Dis 2009. [DOI: 10.1007/s10096-009-0756-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Lanza GA, Sestito A, Cammarota G, Grillo RL, Vecile E, Cianci R, Speziale D, Dobrina A, Maseri A, Crea F. Assessment of systemic inflammation and infective pathogen burden in patients with cardiac syndrome X. Am J Cardiol 2004; 94:40-4. [PMID: 15219506 DOI: 10.1016/j.amjcard.2004.03.027] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2004] [Revised: 03/04/2004] [Accepted: 03/04/2004] [Indexed: 02/06/2023]
Abstract
Inflammation plays a key role in coronary artery disease (CAD), but whether it is involved in the pathogenesis of syndrome X (SX) is not known. Thus, we assessed the presence of systemic inflammation in patients with SX and its possible relation to infections from Helicobacter pylori, Chlamydia pneumoniae, cytomegalovirus, and Epstein-Barr virus. We studied 55 patients with SX (57 +/- 8 years old; 27 women), 49 with stable angina and obstructive CAD (56 +/- 8 years old; 24 women), and 60 healthy controls (57 +/- 11 years old; 24 women). Plasma levels of high-sensitivity C-reactive protein and interleukin-1 receptor antagonist were measured in all patients. Infection from Helicobacter pylori, Chlamydia pneumoniae, cytomegalovirus, and Epstein-Barr virus was assessed in 43 patients with SX, 40 patients with CAD, and in 39 controls. Patients with SX had lower serum levels of C-reactive protein than did patients with CAD (4.06 +/- 6.8 vs 5.99 +/- 7.8 mg/L, p = 0.013) but higher levels of C-reactive protein than did controls (1.75 +/- 1.98 mg/L; p = 0.008). Plasma levels of interleukin-1 receptor antagonist were higher in patients with CAD (570 +/- 738 pg/ml) and patients with SX (494 +/- 677 pg/ml) than in controls (254 +/- 174, pg/ml; p = 0.0003 vs CAD and p = 0.013 vs SX) but did not differ significantly between patients with CAD or SX (p = 0.20). There were no differences across groups in the prevalence of infection from Helicobacter pylori, Chlamydia pneumoniae, cytomegalovirus, and Epstein-Barr virus and in the prevalence of 1, 2, 3, and 4 infections (p = 0.99). Among patients with SX, no correlation was found between markers of inflammation and indexes of disease activity (angina episodes, exercise test results). Our data show evidence of increased low-grade systemic inflammation in patients with cardiac SX, which was unrelated to an increased infectious pathogen burden.
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Santino I, Grillo R, Nicoletti M, Santapaola D, Speziale D, Sessa R, Fadda G, Del Piano M. Prevalence of IgG antibodies against Borrelia Burgdorferi s.l. and Ehrlichia Phagocytophila in sera of patients presenting symptoms of Lyme disease in a central region of Italy. Int J Immunopathol Pharmacol 2002; 15:245-248. [PMID: 12575927 DOI: 10.1177/039463200201500313] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to evaluate the prevalence (seroprevalence) of antibodies against Borrelia burgdorferi and Ehrlichia phagocytophila among patients resident in Lazio, a region of central Italy. Of a sample of 1,050 patients, which presented clinical manifestations related to Lyme disease, 34 (3.2%) were Borrelia-seropositive (Lyme index value >/= 1.2). The sera of 25 out of the 34 patients that were Borrelia-positive were also analysed for the presence of antibodies against E. phagocytophila and 3 (12%) were found Ehrlichia-positive (titres >1:64). No Ehrlichia positive samples were found among sera of 250 Borrelia-negative patients. Since both B. burgdorferi s.l. and Ehrlichia species share the same tick vector (Ixodes ricinus), our results indicate that concurrent transmission of these microbial pathogens might have been occurred among the patients included in this study.
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Affiliation(s)
- I. Santino
- Dip. Sanità Pubblica, University of Rome "La Sapienza", Rome, Italy
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13
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Portincasa P, Grillo R, Pauri P, Colao MG, Valcavi PP, Speziale D, Mazzarelli G, De Majo E, Varaldo PE, Fadda G, Chezzi C, Dettori G. Multicenter evaluation of the new HIV DUO assay for simultaneous detection of HIV antibodies and p24 antigen. New Microbiol 2000; 23:357-65. [PMID: 11061624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
A multicenter survey was performed to evaluate a new semi-automated human immunodeficiency virus fourth generation antibodies and antigen simultaneous assay. This assay showed a sensitivity of 100% and specificity of 99.6% among sera obtained from hospitalized patients or blood donors. Sera obtained from commercially available as well as in-house seroconversions were tested showing that HIV DUO is able to reveal an infected state in 11 out of 14 cases earlier than conventional tests. This new assay improves old test performances in terms of sensitivity, maintaining specificity at very high levels.
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Affiliation(s)
- P Portincasa
- Dipartimento di Patologia e Medicina di Laboratorio, Università degli Studi di Parma
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Gattari P, Speziale D, Grillo R, Cattani P, Zaccarelli M, Spizzichino L, Valenzi C. Syphilis serology among transvestite prostitutes attending an HIV unit in Rome, Italy. Eur J Epidemiol 1994; 10:683-6. [PMID: 7672047 DOI: 10.1007/bf01719281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Sixty-seven transvestite prostitutes from Latin America (49 from Brazil and 18 from Colombia) who attended an HIV unit located in the inner city of Rome between January 1991 and June 1992 were studied for syphilis markers by means of both the Treponema pallidum haemoagglutination test (TPHA) and a solid phase haemadsorption test for detection of specific IgM (SPHA-IgM) which are typically present in recent infections. All participants reported more than 500 sexual partners in the past year, and 67.1% of them more than 1500 partners (between 5 and 10 partners per working day). The overall prevalence of anti-HIV antibodies in this population was 65.7%. The prevalence of positive TPHA tests in the population studied was 73.1%, while that of positive SPHA-IgM tests was 10.4%. The prevalence of positive TPHA and SPHA-IgM tests was higher among Columbians than among Brazilians (83.3% vs 69.4% and 22.2% vs 6.1%, respectively) and also showed a positive correlation with the duration of their permanence in Italy. The TPHA and SPHA-IgM positivities were significantly higher among subjects older than 29 years. Positive TPHA was also significantly higher in subjects who reported a history of heroin and/or cocaine abuse while positive SPHA-IgM was higher in subjects who did not use condoms or reported irregular use of them than in subjects who regularly used condoms. No overall correlation was evident between TPHA positivity and anti-HIV positivity, while SPHA-IgM positivity was found to be higher among anti-HIV-negative subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P Gattari
- AIDS Unit, S. Spirito Hospital, Rome, Italy
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