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Nicolè S, Lanzafame M, Cucchetto G, Rigo F, Lattuada E, Concia E. Darunavir/ritonavir 600/100 mg once daily: it’s time for larger non-inferiority randomized trials. J Antimicrob Chemother 2018; 73:1728-1730. [DOI: 10.1093/jac/dky086] [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: 11/12/2022] Open
Affiliation(s)
- S Nicolè
- Università degli Studi di Verona, Scuola di Specializzazione in Malattie Infettive e Tropicali, Policlinico ‘G. B. Rossi’, Azienda Ospedaliera Universitaria integrata, Verona, Italia
| | - M Lanzafame
- Unità operative di Malattie Infettive e Tropicali, Policlinico ‘G. B. Rossi’, Azienda Ospedaliera Universitaria integrata, Verona, Italia
| | - G Cucchetto
- Università degli Studi di Verona, Scuola di Specializzazione in Malattie Infettive e Tropicali, Policlinico ‘G. B. Rossi’, Azienda Ospedaliera Universitaria integrata, Verona, Italia
| | - F Rigo
- Unità operative di Malattie Infettive e Tropicali, Policlinico ‘G. B. Rossi’, Azienda Ospedaliera Universitaria integrata, Verona, Italia
| | - E Lattuada
- Unità operative di Malattie Infettive e Tropicali, Policlinico ‘G. B. Rossi’, Azienda Ospedaliera Universitaria integrata, Verona, Italia
| | - E Concia
- Università degli Studi di Verona, Scuola di Specializzazione in Malattie Infettive e Tropicali, Policlinico ‘G. B. Rossi’, Azienda Ospedaliera Universitaria integrata, Verona, Italia
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Centonze A, Azzini A, Mazzi R, Merighi M, Concia E, Mazzariol A. Klebsiella pneumoniae (ST1519) producing KPC-19 carbapenemase in a patient undergoing selective digestive decontamination before liver transplantation. Clin Microbiol Infect 2018; 24:203-204. [DOI: 10.1016/j.cmi.2017.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 07/28/2017] [Accepted: 08/10/2017] [Indexed: 11/15/2022]
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Faggian F, Azzini A, Lanzafame M, Bonora A, Zorzi A, Concia E, Vento S. Hyperacute Unilateral Gonococcal Endophthalmitis in an HIV-Infected Man without Genital Infection. Eur J Ophthalmol 2018; 16:346-8. [PMID: 16703559 DOI: 10.1177/112067210601600226] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 11/17/2022]
Abstract
PURPOSE To demonstrate the necessity of obtaining an accurate history from patients presenting abnormal evolution of ophthalmologic diseases. METHODS A 42-year-old patient, denying any previous ocular or systemic morbidity, presented with an unusual severe and hyperacute gonococcal endophthalmitis with corneal abscess but no concurrent genitourinary infection. Only after a further interview did the patient reveal his human immunodeficiency virus status and a previous diagnosis of acquired immunodeficiency syndrome. RESULTS Adequate topical and intravenous antibiotic treatment and surgery led to salvage of the eye. CONCLUSIONS An accurate history should be obtained by patients with an abnormal course of an ophthalmologic disease, focusing on immunologic deficiencies that can cause extremely serious ophthalmologic complications with ensuing risk of visual impairment or ocular loss (bulbar enucleation).
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Affiliation(s)
- F Faggian
- Infectious Diseases Unit, Ospedale Civile Maggiore, Verona, Italy.
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Nicolè S, Lanzafame M, Cazzadori A, Vincenzi M, Mangani F, Colato C, El Dalati G, Brazzarola P, Concia E. Successful Antifungal Combination Therapy and Surgical Approach for Aspergillus fumigatus Suppurative Thyroiditis Associated with Thyrotoxicosis and Review of Published Reports. Mycopathologia 2017; 182:839-845. [PMID: 28555254 DOI: 10.1007/s11046-017-0145-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/12/2016] [Accepted: 05/10/2017] [Indexed: 10/19/2022]
Abstract
In immunocompromised patients, Aspergillus infections are important causes of morbidity and mortality. We describe a patient with cryoglobulinemic vasculitis who developed disseminated invasive aspergillosis with thyrotoxicosis caused by Aspergillus fumigatus. The diagnosis was based upon radiological, microbiological and pathological findings. The patient was treated successfully with voriconazole and caspofungin treatment followed by total thyroidectomy. We provide an overview of published reports on Aspergillus thyroiditis with an emphasis on therapeutic approaches.
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Affiliation(s)
- S Nicolè
- Department of Infectious and Tropical Diseases, "G. B. Rossi" University Hospital, Piazzale L. Scuro 10, 37134, Verona, Italy.
| | - M Lanzafame
- Department of Infectious and Tropical Diseases, "G. B. Rossi" University Hospital, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - A Cazzadori
- Department of Infectious and Tropical Diseases, "G. B. Rossi" University Hospital, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - M Vincenzi
- Department of Infectious and Tropical Diseases, "G. B. Rossi" University Hospital, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - F Mangani
- Department of Infectious and Tropical Diseases, "G. B. Rossi" University Hospital, Piazzale L. Scuro 10, 37134, Verona, Italy
| | - C Colato
- Department of Pathology, "G. B. Rossi" University Hospital, Verona, Italy
| | - G El Dalati
- Department of Radiology, "G. B. Rossi" University Hospital, Verona, Italy
| | - P Brazzarola
- Department of General Surgery and Pancreatic Surgery, "G. B. Rossi" University Hospital, Verona, Italy
| | - E Concia
- Department of Infectious and Tropical Diseases, "G. B. Rossi" University Hospital, Piazzale L. Scuro 10, 37134, Verona, Italy
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Rigo F, Cucchetto G, Lanzafame M, Nicolè S, Lattuada E, Concia E, Vento S. Dual therapy with a combination of unboosted atazanavir and lamivudine as maintenance treatment in virologically suppressed HIV-1-infected patients. HIV Med 2017; 18:790-792. [PMID: 28503915 DOI: 10.1111/hiv.12523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F Rigo
- Infectious Diseases Unit, "G.B. Rossi" University Hospital, Verona, Italy
| | - G Cucchetto
- Infectious Diseases Unit, "G.B. Rossi" University Hospital, Verona, Italy
| | - M Lanzafame
- Infectious Diseases Unit, "G.B. Rossi" University Hospital, Verona, Italy
| | - S Nicolè
- Infectious Diseases Unit, "G.B. Rossi" University Hospital, Verona, Italy
| | - E Lattuada
- Infectious Diseases Unit, "G.B. Rossi" University Hospital, Verona, Italy
| | - E Concia
- Infectious Diseases Unit, "G.B. Rossi" University Hospital, Verona, Italy
| | - S Vento
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan.,Nazarbayev University Medical Center, Astana, Kazakhstan
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Russo A, Concia E, Cristini F, De Rosa FG, Esposito S, Menichetti F, Petrosillo N, Tumbarello M, Venditti M, Viale P, Viscoli C, Bassetti M. Current and future trends in antibiotic therapy of acute bacterial skin and skin-structure infections. Clin Microbiol Infect 2017; 22 Suppl 2:S27-36. [PMID: 27125562 DOI: 10.1016/s1198-743x(16)30095-7] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [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: 03/26/2016] [Revised: 04/15/2016] [Accepted: 04/17/2016] [Indexed: 12/26/2022]
Abstract
In 2013 the US Food and Drug Administration (FDA) issued recommendations and guidance on developing drugs for treatment of skin infection using a new definition of acute bacterial skin and skin-structure infection (ABSSSI). The new classification includes cellulitis, erysipelas, major skin abscesses and wound infection with a considerable extension of skin involvement, clearly referring to a severe subset of skin infections. The main goal of the FDA was to better identify specific infections where the advantages of a new antibiotic could be precisely estimated through quantifiable parameters, such as improvement of the lesion size and of systemic signs of infection. Before the spread and diffusion of methicillin-resistant Staphylococcus aureus (MRSA) in skin infections, antibiotic therapy was relatively straightforward. Using an empiric approach, a β-lactam was the preferred therapy and cultures from patients were rarely obtained. With the emergence of MRSA in the community setting, initial ABSSSI management has been changed and readdressed. Dalbavancin, oritavancin and tedizolid are new drugs, approved or in development for ABSSSI treatment, that also proved to be efficient against MRSA. Dalbavancin and oritavancin have a long half-life and can be dosed less frequently. This in turn makes it possible to treat patients with ABSSSI in an outpatient setting, avoiding hospitalization or potentially allowing earlier discharge, without compromising efficacy. In conclusion, characteristics of long-acting antibiotics could represent an opportunity for the management of ABSSSI and could profoundly modify the management of these infections by reducing or in some cases eliminating both costs and risks of hospitalization.
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Affiliation(s)
- A Russo
- Department of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | - E Concia
- Division of Infectious Diseases, Department of Pathology, Azienda Ospedaliera Universitaria Integrata di Verona, Policlinico 'G.B. Rossi', Verona, Italy
| | - F Cristini
- Infectious Diseases Unit - Department of Medical and Surgical Sciences, University of Bologna, Teaching Hospital S. Orsola-Malpighi, Bologna, Italy
| | - F G De Rosa
- Department of Medical Sciences, University of Turin; Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy
| | - S Esposito
- Department of Infectious Diseases, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Università di Salerno, Salerno, Italy
| | - F Menichetti
- Infectious Disease Unit, Nuovo Santa Chiara Hospital, Pisa, Italy
| | - N Petrosillo
- National Institute for Infectious Diseases Lazzaro Spallanzani-INMI IRCCS, Rome, Italy
| | - M Tumbarello
- Institute of Infectious Diseases, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | - P Viale
- Infectious Diseases Unit - Department of Medical and Surgical Sciences, University of Bologna, Teaching Hospital S. Orsola-Malpighi, Bologna, Italy
| | - C Viscoli
- Infectious Diseases Division, University of Genoa and IRCCS San Martino-IST, Genoa, Italy
| | - M Bassetti
- Infectious Diseases Division, Santa Maria Misericordia Hospital, Udine, Italy.
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Lattuada E, Lanzafame M, Concia E, Vento S. Intracranial mass lesions in HIV/AIDS patients from developing countries endemic for neurocysticercosis. Int J STD AIDS 2016; 18:144-5. [PMID: 17331296 DOI: 10.1258/095646207779949754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Matinella A, Lanzafame M, Bonometti MA, Gajofatto A, Concia E, Vento S, Monaco S, Ferrari S. Neurological complications of HIV infection in pre-HAART and HAART era: a retrospective study. J Neurol 2015; 262:1317-27. [PMID: 25877836 DOI: 10.1007/s00415-015-7713-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 03/15/2015] [Accepted: 03/16/2015] [Indexed: 02/02/2023]
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Blasi F, Concia E, Mazzei T, Moretti A, Nicoletti G, Novelli A, Tempera G. Role of the Oral Beta-Lactams in the Treatment of Exacerbations of Chronic Bronchitis: Critical Analysis and Therapeutic Recommendations. J Chemother 2013; 22 Suppl 1:3-4. [DOI: 10.1179/joc.2010.22.supplement-1.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Montagna MT, Lovero G, Coretti C, Martinelli D, Delia M, De Giglio O, Caira M, Puntillo F, D'Antonio D, Venditti M, Sambri V, Di Bernardo F, Barbui A, Lo Cascio G, Concia E, Mikulska M, Viscoli C, Maximova N, Candoni A, Oliveri S, Lombardi G, Pitzurra L, Sanguinetti M, Masciari R, Santantonio T, Andreoni S, Barchiesi F, Pecile P, Farina C, Viale P, Specchia G, Caggiano G, Pagano L. SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients. Infection 2013; 42:141-51. [PMID: 24150958 PMCID: PMC3906525 DOI: 10.1007/s15010-013-0539-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/24/2013] [Indexed: 11/29/2022]
Abstract
Purpose We compared the risk factors, the diagnostic tools and the outcome of filamentous fungal infections (FFIs) in hematological patients (HAEs) and non-hematological patients (non-HAEs). Methods Prospective surveillance (2009–2011) of proven and probable FFIs was implemented in 23 Italian hospitals. Results Out of 232 FFIs, 113 occurred in HAEs and 119 in non-HAEs. The most frequent infection was invasive aspergillosis (76.1 % for HAEs, 56.3 % for non-HAEs), and the localization was principally pulmonary (83.2 % for HAEs, 74.8 % for non-HAEs). Neutropenia was a risk factor for 89.4 % HAEs; the main underlying condition was corticosteroid treatment (52.9 %) for non-HAEs. The distribution of proven and probable FFIs was different in the two groups: proven FFIs occurred more frequently in non-HAEs, whereas probable FFIs were correlated with the HAEs. The sensitivity of the galactomannan assay was higher for HAEs than for non-HAEs (95.3 vs. 48.1 %). The overall mortality rate was 44.2 % among the HAEs and 35.3 % among the non-HAEs. The etiology influenced the patient outcomes: mucormycosis was associated with a high mortality rate (57.1 % for HAEs, 77.8 % for non-HAEs). Conclusions The epidemiological and clinical data for FFIs were not identical in the HAEs and non-HAEs. The differences should be considered to improve the management of FFIs according to the patients’ setting.
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Affiliation(s)
- M T Montagna
- Hygiene Section, Department of Biomedical Science and Human Oncology, University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy,
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Guglielmetti L, Cazzadori A, Conti M, Boccafoglio F, Vella A, Ortolani R, Concia E. Lymphocyte subpopulations in active tuberculosis: association with disease severity and the QFT-GIT assay [Short communication]. Int J Tuberc Lung Dis 2013; 17:825-8. [DOI: 10.5588/ijtld.12.0361] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- L. Guglielmetti
- Section of Infectious Diseases, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Policlinico ‘G. B. Rossi’, Verona, Italy
| | - A. Cazzadori
- Section of Infectious Diseases, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Policlinico ‘G. B. Rossi’, Verona, Italy
| | - M. Conti
- Section of Infectious Diseases, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Policlinico ‘G. B. Rossi’, Verona, Italy
| | - F. Boccafoglio
- Section of Infectious Diseases, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Policlinico ‘G. B. Rossi’, Verona, Italy; Department of Pneumology, Trento Hospital, Trento, Italy
| | - A. Vella
- Section of Immunology, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Policlinico ‘G. B. Rossi’, Verona, Italy
| | - R. Ortolani
- Section of Immunology, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Policlinico ‘G. B. Rossi’, Verona, Italy
| | - E. Concia
- Section of Infectious Diseases, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Policlinico ‘G. B. Rossi’, Verona, Italy
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Lucioni C, Ravasio R, Concia E. Terapia empirica con antibiotici parenterali in pazienti ospedalizzati affetti da infezioni alle basse vie respiratorie: una valutazione farmacoeconomica. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320578] [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: 11/28/2022]
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Guglielmetti L, Cazzadori A, Scardigli A, Valentinotti R, Conti M, Concia E. Tuberculosis Incidence at the Burundi-Rwanda Border 15 Years After the Civil War. Clin Infect Dis 2012; 54:155-6. [DOI: 10.1093/cid/cir779] [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: 11/12/2022] Open
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Mascarello M, Gobbi F, Angheben A, Gobbo M, Gaiera G, Pegoraro M, Lanzafame M, Buonfrate D, Concia E, Bisoffi Z. Prevalence of Strongyloides stercoralis infection among HIV-positive immigrants attending two Italian hospitals, from 2000 to 2009. Ann Trop Med Parasitol 2011; 105:617-23. [PMID: 22325821 PMCID: PMC4089805 DOI: 10.1179/2047773211y.0000000006] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 10/30/2011] [Accepted: 10/31/2011] [Indexed: 12/28/2022]
Abstract
In patients with Strongyloides stercoralis infection, a dysregulation of host immunity can lead to hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), characterized by high fatality rate. HS has been reported in HIV-positive patients following use of corticosteroids or during immune reconstitution inflammatory syndrome (IRIS). A retrospective study was conducted to estimate the prevalence of S. stercoralis infection among HIV-positive immigrants, attending two Italian hospitals. From January 2000 to August 2009, 138 HIV-positive immigrants were systematically screened for strongyloidiasis, as a part of their routine care, with an indirect immunofluorescent antibody test (IFAT) developed at the Centre for Tropical Diseases, Sacro Cuore Hospital of Negrar, Verona. The majority were also submitted to stool examination. Fifteen (11%) resulted infected by S. stercoralis, of whom four (27%) had a negative serology (diagnosis made with stool examination). A higher eosinophil count (0·94 versus 0·24×10(9)/l, P<0·01) and more frequent gastrointestinal and cutaneous symptoms (odds ratio: 4·8 and 5·8, respectively) were found in patients with strongyloidiasis compared with controls. The IFAT is more sensitive than direct parasitological methods. The proportion of false negative results was higher than expected based on the theoretical test sensitivity. Considering the high prevalence detected and the apparent, lower sensitivity of serology, we propose a systematic screening for Strongyloides infection, with both serology and stool culture, for all HIV-positive immigrants coming from endemic areas.
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Affiliation(s)
- M Mascarello
- Policlinico GB Rossi, University of Verona, Italy.
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Luzzati R, Confalonieri M, Cazzadori A, Della Loggia P, Cifaldi R, Fabris C, Biolo M, Borelli M, Longo C, Concia E. Prolonged hospitalisation for immigrants and high risk patients with positive smear pulmonary tuberculosis. Monaldi Arch Chest Dis 2011; 75:141-5. [PMID: 21932701 DOI: 10.4081/monaldi.2011.229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Tuberculosis (TB) occurring in immigrants and resistance to drugs are major problems for TB control in Western countries. Directly observed therapy (DOT) reduces disease transmission, but this approach may have poor results among illegal immigrants. Our aim was to evaluate a prolonged hospitalisation programme to improve early outcome of TB treatment in high risk patients. METHODS All the consecutive adult patients with sputum smear-positive pulmonary TB admitted to 2 Italian referral TB Centres were evaluated. Hospital-based DOT was provided to high risk patients up-to smear conversion. Demographic, microbiological and clinical conditions, as potential factors associated with confirmed smear conversion at 60 and 90 days of anti-tuberculous therapy were evaluated. RESULTS 122 patients were studied, 45.9% of them were immigrants (20% illegal) from high-prevalence TB countries. HIV testing was negative in all cases. Twelve patients had M. tuberculosis resistant to > or = 1 first-line anti-tuberculous agents. The rate of defaulting from TB treatment was 73%. Sputum smear became negative in 84.4% cases after 60 days and 933% cases after 90 days. At such time, smear conversion rates were similar among different high risk subgroups such as illegal immigrants (95.9%), legal foreign-born (92.5%) and Italian persons (94.8%). Persistent sputum smear positivity was independently correlated with the extent of pulmonary lesions at 60 (p < 0.0001) and 90 days (p = 0.038) of hospital-based DOT. CONCLUSIONS These findings suggest that prolonged hospitalisation for illegal immigrants and high risk TB patients, may positively influence the early outcome of TB treatment despite of drug resistance and legal status.
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Affiliation(s)
- R Luzzati
- Infectious Diseases Unit, University Hospital, Trieste, Italy
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Del Zotti F, Guglielmetti L, Conti M, Valentinotti R, Cazzadori A, Concia E. [Herpes zoster in general medicine: experience of the Italian group Netaudit]. Infez Med 2011; 19:106-112. [PMID: 21753250] [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: 05/31/2023]
Abstract
Herpes zoster is caused by the reactivation of the varicella-zoster virus (VZV) and usually appears many years after primary infection (varicella), induced by immunosuppression due to underlying diseases. Few epidemiological data in Italy are available concerning Herpes zoster, mainly because disease notification is not mandatory. An observational perspective trial was conducted for 12 months by 41 Italian general practitioners belonging to the Netaudit network to determine herpes zoster incidence and its correlation to patients' characteristics (age, gender, educational qualification, co-morbidities), the delay from correct diagnosis to the start of treatment and different drug prescription. In all, the study involved 193 patients with herpes zoster: this population included mostly female (60.6%) and elderly subjects (59.6%) with a mean age of 60.4 years. 46.1% of patients presented underlying diseases (diabetes 13%, solid tumours 5.7%). Correct diagnosis was achieved after a mean delay of 49 hours while therapy was started within 48 hours in most cases (75.1%). Aciclovir (51%) and valaciclovir (24%) were the most commonly used drugs. A significant correlation between educational level and prompt treatment suggests the major role of education in primary health prevention campaigns.
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Manganaro D, Del Giudice E, Ferretti E, Di Maria A, Luzzati R, Concia E, Toigo G. [Survey on the ability to prescribe antibiotic therapy among Italian residents in geriatrics and internal medicine]. Infez Med 2011; 19:91-99. [PMID: 21753248] [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: 05/31/2023]
Abstract
Antibiotic therapy is a crucial and often life-saving strategy. This study assessed the ability to prescribe antibiotic therapy among a series of Italian postgraduate students in geriatrics and internal medicine. Participants were administered an anonymous questionnaire consisting of self-assessment of their ability to prescribe antibiotics and then manage a case of community-acquired pneumonia. The Wilcoxon test for comparisons between two independent samples was used for statistical analysis. Almost half the 70 students considered their knowledge of antibiotic therapy insufficient and were not satisfied with the notions received during their studies. Indeed, the change in antibiotic therapy required to control acute exacerbation of pneumonia was correctly identified by only 36% of students. Moreover, 38% of them gave the correct answer on factors influencing the duration of antibiotic therapy in the presence of definite improvement of pneumonia. No significant difference was found between the responses of residents in geriatrics and internal medicine. Overall, our study shows that nearly half of our students think they have inadequate antibiotic prescribing skills. This is confirmed by a low ability to establish the best management of the clinical case. To repair this severe shortcoming, different training methods need to be compared and more effective forms of instruction adopted.
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Affiliation(s)
- D Manganaro
- Scuola di Specializzazione in Geriatria, Universita di Trieste, Italy
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Blasi F, Concia E, Mazzei T, Moretti AM, Nicoletti G, Novelli A, Tempera G. Etiology issues and problems of antibiotic resistance. J Chemother 2010; 22 Suppl 1:8-13. [PMID: 21097388 DOI: 10.1179/joc.2010.22.supplement-1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Blasi F, Concia E, Mazzei T, Moretti AM, Nicoletti G, Novelli A, Tempera G. Pharmacological and pharmaeconomic considerations. J Chemother 2010; 22 Suppl 1:14-24. [PMID: 21097389 DOI: 10.1179/joc.2010.22.supplement-1.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Blasi F, Concia E, Mazzei T, Moretti AM, Nicoletti G, Novelli A, Tempera G. Description of the disease and diagnostic and epidemiologic aspects. J Chemother 2010; 22 Suppl 1:4-7. [PMID: 21097387 DOI: 10.1179/joc.2010.22.supplement-1.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Blasi F, Concia E, Mazzei T, Moretti AM, Nicoletti G, Novelli A, Tempera G. Conclusions. Role of the oral Beta-lactams in the treatment of exacerbations of chronic bronchitis: critical analysis and therapeutics recommendations. J Chemother 2010; 22 Suppl 1:25-28. [PMID: 21097390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Lattuada E, Vallone A, Lanzafame M, Corsini F, Concia E, Vento S. Prior Mycobacterium aviumcomplex infection is linked to immunological nonresponsiveness in HIV-infected patients on highly active antiretroviral therapy. HIV Med 2010; 11:542-3. [PMID: 20236362 DOI: 10.1111/j.1468-1293.2009.00821.x] [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: 11/29/2022]
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Lanzafame M, Ferrari S, Lattuada E, Corsini F, Deganello R, Vento S, Concia E. Mirtazapine in an HIV-1 infected patient with progressive multifocal leukoencephalopathy. Infez Med 2009; 17:35-37. [PMID: 19359824] [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: 05/27/2023]
Abstract
We describe the clinical course of an HIV-infected patient with progressive multifocal leukoencephalopathy who took mirtazapine for his depression. After six months of therapy the clinical symptoms had not worsened and the neuroradiological image of the brain was unchanged. Further studies are necessary to determine the effect of serotonin receptor antagonist in treating PML associated to HIV.
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Affiliation(s)
- M Lanzafame
- Unit of Infectious Diseases, University of Verona, Ospedale Policlinico,Verona, Italy
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Concia E, Novelli A, Schito GC, Marchese A. Ideal microbiological and pharmacological characteristics of a quality antimicrobial agent: comparing original and generic molecules. J Chemother 2008; 19:609-19. [PMID: 18230541 DOI: 10.1179/joc.2007.19.6.609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This article critically evaluates the main in vitro and in vivo studies published which compare generic with the original molecules, both those administered orally and parenterally. The authors indicate that caution should be used in assuming bioequivalence of the generic drug with its clinical efficacy in clinical practice. In fact, mild differences in the content of the active ingredient, less relevant in healthy volunteers, may have an impact in the actual population, which is heterogeneous for age, sex, weight, concomitant risk factors and severity of the underlying disease, as in critically ill patients, with consequences for the patient and ecosystem. Nowadays the requirements for authorization to commercialize a generic antimicrobial agent are focused on demonstration of bioequivalence to the original molecule, with a range variability of +/-20%. However this kind of trial is not sufficient to predict the actual profile in clinical practice, particularly in critically ill patients. Thus while generics can represent an opportunity for physicians, patients and healthcare systems the regulatory procedures do not seem exhaustive, and it is probably necessary to define an ad hoc technical standard of quality before their commercialization and to perform adequate clinical trials regarding efficacy and safety of the "equivalent molecule", especially for drugs used in critically ill patients.
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Affiliation(s)
- E Concia
- Dipartimento di Malattie Infettive, University of Verona, Italy
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Angheben A, Mascarello M, Zavarise G, Gobbi F, Monteiro G, Marocco S, Anselmi M, Azzini A, Concia E, Rossanese A, Bisoffi Z. Outbreak of imported trichinellosis in Verona, Italy, January 2008. Euro Surveill 2008; 13:18891. [PMID: 18761961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- A Angheben
- Centre for Tropical Diseases, Hospital Sacro Cuore-Don Calabria, Negrar, Verona, Italy.
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Angheben A, Mascarello M, Zavarise G, Gobbi F, Monteiro G, Marocco S, Anselmi M, Azzini A, Concia E, Rossanese A, Bisoffi Z. Outbreak of imported trichinellosis in Verona, Italy, January 2008. Euro Surveill 2008. [DOI: 10.2807/ese.13.22.18891-en] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe an outbreak of trichinellosis in Verona, Italy, in early 2008 that was imported from Romania.
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Affiliation(s)
- A Angheben
- Centre for Tropical Diseases, Hospital Sacro Cuore – Don Calabria, Negrar, Verona, Italy
| | - M Mascarello
- Infectious Disease Department, Policlinic Hospital G.B.Rossi, Verona, Italy
| | - G Zavarise
- Division of Paediatrics, Hospital Sacro Cuore – Don Calabria, Negrar, Verona, Italy
| | - F Gobbi
- Regional Reference Centre for Travel Medicine, Verona, Italy
| | - G Monteiro
- Centre for Tropical Diseases, Hospital Sacro Cuore – Don Calabria, Negrar, Verona, Italy
| | - S Marocco
- Centre for Tropical Diseases, Hospital Sacro Cuore – Don Calabria, Negrar, Verona, Italy
| | - M Anselmi
- Centre for Tropical Diseases, Hospital Sacro Cuore – Don Calabria, Negrar, Verona, Italy
| | - A Azzini
- Infectious Disease Department, Policlinic Hospital G.B.Rossi, Verona, Italy
| | - E Concia
- Infectious Disease Department, Policlinic Hospital G.B.Rossi, Verona, Italy
| | - A Rossanese
- Centre for Tropical Diseases, Hospital Sacro Cuore – Don Calabria, Negrar, Verona, Italy
| | - Z Bisoffi
- Centre for Tropical Diseases, Hospital Sacro Cuore – Don Calabria, Negrar, Verona, Italy
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Concia E, Azzini A. Treating bacteremia in critical patients: a long course of combined antimicrobial therapy or a short course with a single antibiotic? Minerva Anestesiol 2008; 74:153-154. [PMID: 18414357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Bonora S, Lanzafame M, D'Avolio A, Trentini L, Lattuada E, Concia E, Di Perri G. Drug Interactions between Warfarin and Efavirenz or Lopinavir-Ritonavir in Clinical Treatment. Clin Infect Dis 2008; 46:146-7. [DOI: 10.1086/524086] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Abstract
During the past few years, efavirenz has been increasingly used in the treatment of HIV1 infection. Its main side effect is a syndrome of central nervous system stimulation occurring in 40-50% of adults in the first few weeks of therapy which might be observed at increased frequency in subjects concurrently using recreational substances. We therefore conducted a single center, retrospective study in 134 patients treated with efavirenz and found no significant differences in CNS side effects or discontinuation rates between recreational substance (cocaine, ecstasy, cannabis) users and non-users. Although our study is limited, the results support the idea that efavirenz can be safely prescribed to patients using recreational substances.
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Affiliation(s)
- F Faggian
- Infectious Diseases Unit, Civile Maggiore Hospital, and Section of Infectious Diseases, Department of Pathology, University of Verona, Verona, Italy
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Luzzati R, Allegranzi B, Antozzi L, Masala L, Pegoraro E, Azzini A, Concia E. Secular trends in nosocomial candidaemia in non-neutropenic patients in an Italian tertiary hospital. Clin Microbiol Infect 2005; 11:908-13. [PMID: 16216107 DOI: 10.1111/j.1469-0691.2005.01268.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [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: 11/28/2022]
Abstract
A retrospective study was performed in an Italian tertiary hospital to evaluate trends in candidaemia between 1992 and 2001, and to compare the characteristics of episodes of fungaemia between 1992--1997 and 1998--2001. In total, 370 episodes of candidaemia were identified, with an average incidence of 0.99 episodes/10 000 patient-days/year (range 0.49--1.29 episodes). On an annual trend basis, the overall incidence was essentially stable in surgical and medical wards, but decreased in intensive care units (ICUs) (p 0.0065). The average use of fluconazole was 37.9 g/10 000 patient-days/year (range 21.4--56.1 g), and did not change significantly during the 10-year period. Nearly two-thirds of patients were in ICUs at the onset of candidaemia, but none was neutropenic in either study period. Candida albicans remained the predominant species isolated (53.8% vs. 48.1%), followed by Candida parapsilosis, Candida glabrata and Candida tropicalis, the distribution of which did not change significantly. The 30-day crude mortality rate was essentially similar (44% vs. 35%) in both study periods. Thus the incidence of nosocomial candidaemia, although high in this institution, decreased among critically-ill patients during the 10-year period. This finding seemed to be related to an improvement in infection control practices, particularly regarding the prevention of intravascular catheter-related infections in ICUs. Although the overall use of fluconazole was considerable, no increase in azole-resistant non-albicans Candida spp. was detected.
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Affiliation(s)
- R Luzzati
- Department of Infectious Diseases, University Hospital of Verona, Verona, Italy.
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Baussano I, Cazzadori A, Scardigli A, Concia E. Clinical and demographic aspects of extrathoracic tuberculosis: experience of an Italian university hospital. Int J Tuberc Lung Dis 2004; 8:486-92. [PMID: 15141743] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE The decline of tuberculosis in industrialised countries concerns mainly its pulmonary forms. We have analysed all the cases of non-respiratory tuberculosis admitted to our hospital between January 2000 and June 2002, and compared epidemiological, clinical and diagnostic features in our area with those observed in other industrialised countries with high immigration rates. DESIGN Patients' records were retrospectively analysed for demographic, clinical, laboratory and instrumental data. Delays in the introduction of treatment were also measured. Characteristics of immigrants were compared with those of native-born persons. We also investigated specific features of extrathoracic tuberculosis affecting different body sites. RESULTS Forty-eight patients were identified, two thirds of whom were from industrialised countries. Age distribution was characteristically bimodal. Vertebral (n = 18) and lymph node (n = 11) tuberculosis were the most frequently detected forms. The therapeutic delay among individuals from industrialised countries was found to be significantly longer than that of their counterparts from developing countries (P = 0.05). CONCLUSION We hypothesise that the complex and non-standardised diagnostic approach to the different forms of extrathoracic tuberculosis forms and physicians' lack of awareness of the specific risk of each epidemiological group strongly influence the unacceptably long therapeutic delay. Extrathoracic tuberculosis was more neglected in native-born individuals than in immigrants.
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Affiliation(s)
- I Baussano
- Department of Epidemiology, University of Turin, Torino, Italy.
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Masala L, Luzzati R, Maccacaro L, Antozzi L, Concia E, Fontana R. Nosocomial Cluster of Candida guillermondii Fungemia in Surgical Patients. Eur J Clin Microbiol Infect Dis 2003; 22:686-8. [PMID: 14566575 DOI: 10.1007/s10096-003-1013-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [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: 10/26/2022]
Abstract
A nosocomial cluster of Candida guillermondii fungemia ( n=5 episodes) occurred in a surgical unit over a 2-week period. The five infected patients had received parenteral nutrition through central lines and three of them had catheter-related candidemia. All of the isolates were resistant to 5-flucytosine (MIC >32 microg/ml) and they had strictly related fingerprints, as generated by randomly amplified polymorphic DNA analysis. Although no isolate of Candida guillermondii was recovered from other clinical, surveillance or environmental samples, nosocomial spread of this yeast stopped following the reinforcement of infection control measures. Candida guillermondii may require an intravascular foreign body to cause fungemia, but the outbreak reported here shows that it can be transmitted nosocomially and cause epidemics.
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Affiliation(s)
- L Masala
- Servizio Microbiologia e Virologia, Università ed Azienda Ospedaliera, Strada Le Grazie 8, 37100 Verona, Italy
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Lanzafame M, Faggian F, Lattuada E, Ramarli D, Concia E, Vento S. Is there a role for TNF-alpha in HIV1-associated lipodystrophy? Eur J Clin Invest 2003; 33:735-6. [PMID: 12864788 DOI: 10.1046/j.1365-2362.2003.01211.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lanzafame M, Mazzi R, Di Pace C, Trevenzoli M, Concia E, Vento S. Unusual, rapidly growing ulcerative genital mass due to herpes simplex virus in a human immunodeficiency virus-infected woman. Br J Dermatol 2003; 149:216-7. [PMID: 12890233 DOI: 10.1046/j.1365-2133.2003.05415.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Allegranzi B, Luzzati R, Luzzani A, Girardini F, Antozzi L, Raiteri R, Di Perri G, Concia E. Impact of antibiotic changes in empirical therapy on antimicrobial resistance in intensive care unit-acquired infections. J Hosp Infect 2002; 52:136-40. [PMID: 12392905 DOI: 10.1053/jhin.2002.1277] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [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: 11/11/2022]
Abstract
We conducted a one-year prospective study on intensive care unit (ICU)-acquired infections and antimicrobial resistance patterns in an 18-bed medical-surgical ICU of a tertiary-care university hospital. We divided the study into two six-month periods in order to evaluate the impact of antibiotic changes in empirical therapy on antimicrobial resistance profiles of the principal isolated micro-organisms. In the first period no changes were made to the previously applied empirical antibiotic protocol; at the end of this period we found high rates of methicillin resistance (MR) among staphylococci, 93% for Staphylococcus aureus (69 isolates) and 79% for coagulase-negative staphylococci (CNS) (48 isolates), and of multiple drug resistance for Pseudomonas aeruginosa (57 isolates), in particular 67% resistance to piperacillin/tazobactam (PIP/TZ). We therefore decided to substitute PIP/TZ with imipenem in nosocomial pneumonia and with cefepime plus metronidazole in peritonitis. We also considered the previous use of amoxicillin/clavulanate (AM/CL) at admission in critically ill patients inadequate; we therefore advised that no antibiotics should be given unless fever developed and eventually to replace AM/CL with trimethoprim/sulfamethoxazole (TMP/SMX). At the end of this intervention period, we observed a significant decrease of S. aureus MR (93 vs. 73%, P = 0.003) and of P. aeruginosa resistance to PIP/TZ (67 vs. 29%, P < 0.001). A reduction in MR was also seen in CNS (79 vs. 64%, P = 0.09). Other resistance patterns also improved among staphylococci; in contrast P. aeruginosa resistance to imipenem increased in the second period (24 vs. 41%, P = 0.06). A non-premeditated change of antibiotics in empirical therapy, on the basis of detected resistance patterns, provided promising results in reducing some antimicrobial resistance rates. We believe, however, that antibiotic changes must be tailored to local microbiological situation monitoring, and that a repeated rotation is crucial to limit the emergence of new resistance profiles. Furthermore the adoption of this policy should be accompanied by other infection control practices aimed at reducing antimicrobial resistance and nosocomial infection rates.
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Affiliation(s)
- B Allegranzi
- Department of Infectious Diseases, University of Verona, Italy.
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Lanzafame M, Trevenzoli M, Faggian F, Marcati P, Gatti F, Carolo G, Concia E. Interaction between levothyroxine and indinavir in a patient with HIV infection. Infection 2002; 30:54-5. [PMID: 11876520 DOI: 10.1007/s15010-002-2092-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Drug interactions are an important and emerging problem in the treatment of HIV-infected patients. Protease inhibitors, like nonnucleoside reverse transcriptase inhibitors, are metabolized by the cytochrome P-450 enzyme system and each of these antiretroviral agents may interact with other drugs metabolized by this system. Some protease inhibitors may also interact with glucuronosyl transferase activity affecting plasma concentrations of drugs metabolized through this pathway. We describe a case of an HIV-infected patient, taking levothyroxine for hypothyroidism and clinically stable, who, after the introduction of an antiretroviral regimen containing indinavir, developed a pharmacological hyperthyroidism.
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Cainelli F, Concia E, Vento S. A case of visceral leishmaniasis with protracted incubation in a nonendemic area. Eur J Clin Microbiol Infect Dis 2001; 20:908-9. [PMID: 11837649 DOI: 10.1007/s100960100626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- F Cainelli
- Department of Pathology, University of Verona, Italy.
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Cainelli F, Concia E, Vento S. Mortality due to hepatitis C virus-related cirrhosis in patients infected with HIV type 1: a role for alcohol. Clin Infect Dis 2001; 33:1795-7. [PMID: 11641833 DOI: 10.1086/323011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Mazzi R, Parisi SG, Sarmati L, Uccella I, Nicastri E, Carolo G, Gatti F, Concia E, Andreoni M. Efficacy of cidofovir on human herpesvirus 8 viraemia and Kaposi's sarcoma progression in two patients with AIDS. AIDS 2001; 15:2061-2. [PMID: 11600842 DOI: 10.1097/00002030-200110190-00026] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Luzzati R, Antozzi L, Bellocco R, Del Bravo P, Mirandola M, Procaccio F, Cirillo FM, Romiti P, Sarti A, Manani G, Concia E. [Prevalence of nosocomial infections in Intensive Care Units in Triveneto area, Italy]. Minerva Anestesiol 2001; 67:647-52. [PMID: 11731755] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Nosocomial infection is one of the most common complications affecting patients admitted in intensive care units (ICU). The aim of this study is to evaluate rates of ICU-acquired infections, potential risk factors for these infections, causative microorganisms and antibiotic resistance patterns. METHODS A 1-day point-prevalence study was conducted in 39 ICUs in Triveneto area (Italy) in November 1998. The overall study population included 188 patients with mean age of 61.4+/-19.3 years; the mean SAPS II score at entry into the ICU was 44.4+/-16.8 and the median duration of hospitalization was 9 days (range 2-636). RESULTS A total of 59 patients (31.4%) had 79 episodes of ICU-acquired infections; pneumonia (45.5%), bloodstream infection (30.4%), and urinary tract infection (11.4%) were the most frequent types of infection. The leading causative microorganisms were S. aureus (24.4%, 77% of them were resistant to methicillin), Enterobacteriaceae (24.4%), P. aeruginosa (23.2%), fungi (12.2%), coagulase-negative staphylococci (7.3%) and Enterococcus spp (4.9%). Independent risk factors for nosocomial infections were duration of hospitalization >7 days (OR 4.29, 95% CI 1.82-10.1), SAPS II score >30 (OR 3.34, 95% CI 1.0-11.18), total parenteral nutrition (OR 2.69, 95% CI 1.19-6.07) and tracheostomy (OR 1.88, 95% CI 0.84-4.20). CONCLUSIONS Nosocomial infections are relatively frequent in Triveneto area ICUs. The predominance of pneumonia and bloodstream infection, and the high frequency of antibiotic-resistant pathogens indicate that resources had to be assigned towards the implementation of control programs of those infections, monitoring of antibiotic resistance and prescription, and antibiotic therapy guidelines.
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Affiliation(s)
- R Luzzati
- Istituto di Malattie Infettive, Università ed Azienda Ospedaliera, Verona, Italy
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Affiliation(s)
- E Concia
- Department of Infectious Diseases, University of Verona, Verona, Italy
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Longhi MS, Cainelli F, Concia E, Vento S. No increase in liver decompensation risk with atypical hepatitis C virus antibody pattern. J Infect Dis 2001; 183:1428. [PMID: 11294682 DOI: 10.1086/319872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Cainelli F, Longhi MS, Concia E, Vento S. Failure of lamivudine therapy for chemotherapy-induced reactivation of hepatitis B. Am J Gastroenterol 2001; 96:1651-1652. [PMID: 11374725 DOI: 10.1016/s0002-9270(01)02387-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
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