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Tonelli M, Knutsson KA, Buffoli F, Carletti S, Gona F, Scifo E, Rizzi P, Prigitano A, Sampaolo M, Clementi N, Rama P, Mancini N. Photo Quiz: Therapeutic Contact Lens-Associated Fungal Keratitis. J Clin Microbiol 2023; 61:e0007423. [PMID: 37470478 PMCID: PMC10358178 DOI: 10.1128/jcm.00074-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Affiliation(s)
- M. Tonelli
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
| | - K. A. Knutsson
- IRCCS Ospedale San Raffaele, Cornea and Ocular Surface Unit, Milan, Italy
| | - F. Buffoli
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
| | - S. Carletti
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
| | - F. Gona
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
| | - E. Scifo
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
| | - P. Rizzi
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
| | - A. Prigitano
- Università degli studi di Milano, Medical Micology Laboratory, Milan, Italy
| | - M. Sampaolo
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
| | - N. Clementi
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
| | - P. Rama
- IRCCS Ospedale San Raffaele, Cornea and Ocular Surface Unit, Milan, Italy
| | - N. Mancini
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
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Tonelli M, Knutsson KA, Buffoli F, Carletti S, Gona F, Scifo E, Rizzi P, Prigitano A, Sampaolo M, Clementi N, Rama P, Mancini N. Answer to July 2023 Photo Quiz. J Clin Microbiol 2023; 61:e0007523. [PMID: 37470479 PMCID: PMC10358157 DOI: 10.1128/jcm.00075-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
Read the full article for the answer.
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Affiliation(s)
- M. Tonelli
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
| | - K. A. Knutsson
- IRCCS Ospedale San Raffaele, Cornea and Ocular Surface Unit, Milan, Italy
| | - F. Buffoli
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
| | - S. Carletti
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
| | - F. Gona
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
| | - E. Scifo
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
| | - P. Rizzi
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
| | - A. Prigitano
- Università degli studi di Milano, Medical Micology Laboratory, Milan, Italy
| | - M. Sampaolo
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
| | - N. Clementi
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
| | - P. Rama
- IRCCS Ospedale San Raffaele, Cornea and Ocular Surface Unit, Milan, Italy
| | - N. Mancini
- IRCCS Ospedale San Raffaele, Laboratory of Microbiology and Virology, Milan, Italy
- Vita-Salute San Raffaele University, Laboratory of Microbiology and Virology, Milan, Italy
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Mularoni A, Bertani A, Vizzini G, Gona F, Campanella M, Spada M, Gruttadauria S, Vitulo P, Conaldi P, Luca A, Gridelli B, Grossi P. Outcome of Transplantation Using Organs From Donors Infected or Colonized With Carbapenem-Resistant Gram-Negative Bacteria. Am J Transplant 2015; 15:2674-82. [PMID: 25981339 DOI: 10.1111/ajt.13317] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [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: 11/06/2014] [Revised: 03/08/2015] [Accepted: 03/13/2015] [Indexed: 02/06/2023]
Abstract
Donor-derived infections due to multidrug-resistant bacteria are a growing problem in solid organ transplantation, and optimal management options are not clear. In a 2-year period, 30/214 (14%) recipients received an organ from 18/170 (10.5%) deceased donors with infection or colonization caused by a carbapenem-resistant gram-negative bacteria that was unknown at the time of transplantation. Among them, 14/30 recipients (47%) received a transplant from a donor with bacteremia or with infection/colonization of the transplanted organ and were considered at high risk of donor-derived infection transmission. The remaining 16/30 (53%) recipients received an organ from a nonbacteremic donor with colonization of a nontransplanted organ and were considered at low risk of infection transmission. Proven transmission occurred in 4 of the 14 high-risk recipients because donor infection was either not recognized, underestimated, or not communicated. These recipients received late, short or inappropriate posttransplant antibiotic therapy. Transmission did not occur in high-risk recipients who received appropriate and prompt antibiotic therapy for at least 7 days. The safe use of organs from donors with multidrug-resistant bacteria requires intra- and inter-institutional communication to allow appropriate management and prompt treatment of recipients in order to avoid transmission of infection.
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Affiliation(s)
- A Mularoni
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - A Bertani
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - G Vizzini
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - F Gona
- Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - M Campanella
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - M Spada
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - S Gruttadauria
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - P Vitulo
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - P Conaldi
- Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - A Luca
- Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - B Gridelli
- Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
| | - P Grossi
- Department of Infectious and Tropical Diseases, University of Insubria, Varese, Italy
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Falcone M, Vena A, Mezzatesta ML, Gona F, Caio C, Goldoni P, Trancassini AM, Conti C, Orsi GB, Carfagna P, Stefani S, Venditti M. Role of empirical and targeted therapy in hospitalized patients with bloodstream infections caused by ESBL-producing Enterobacteriaceae. Ann Ig 2014; 26:293-304. [PMID: 25001119 DOI: 10.7416/ai.2014.1989] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Bloodstream infection (BSI) due to extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae are a major cause of in-hospital mortality. The effect on survival of empirical and targeted antibiotic therapy in these patients remains controversial. METHODS A prospective cohort study was conducted analyzing data from 94 patients (age 59 ± 21 years) with BSI due to ESBL producing strains (Sixty-one E. coli, 26 K. pneumoniae, 4 Proteus spp and 3 Enterobacter spp). RESULTS Risk factors associated with 21-day mortality at univariate analysis were: recent administration of antibiotic therapy (p=0.049), higher SOFA score (p=0.05), ICU stay (p <0.01), hypotension at presentation (p =0.001) or septic shock (p <0.001) and bacteremia from source other than urinary tract (p=0.03). Regardless of antibiotic class used, no differences in survival were noted between patients receiving or not adequate initial antimicrobial treatment (37.1% vs 23.7% p=0.23); on the other hand, compared with the administration of other in vitro active antibiotics, the use of carbapenem as definitive therapy was associated with a significantly lower 21-day mortality (54.3% vs 28.5% p=0.02). CONCLUSIONS These findings suggest that the administration of an adequate initial therapy is not associated with mortality in hospitalized patients with BSI due to Enterobacteriaceae. The severity of clinical conditions at presentation and the administration of carbapenems as definitive therapy seems to be really important in affecting the outcome of patients with BSI due to ESBL producing strains.
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Affiliation(s)
- M Falcone
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - A Vena
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - M L Mezzatesta
- Department of Bio-Medical Sciences-Section of Microbiology, University of Catania, Italy
| | - F Gona
- Department of Bio-Medical Sciences-Section of Microbiology, University of Catania, Italy
| | - C Caio
- Department of Bio-Medical Sciences-Section of Microbiology, University of Catania, Italy
| | - P Goldoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - A M Trancassini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - C Conti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - G B Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | | | - S Stefani
- Department of Bio-Medical Sciences-Section of Microbiology, University of Catania, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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Gona F, Barbera F, Pasquariello AC, Grossi P, Gridelli B, Mezzatesta ML, Caio C, Stefani S, Conaldi PG. In vivo multiclonal transfer of bla(KPC-3) from Klebsiella pneumoniae to Escherichia coli in surgery patients. Clin Microbiol Infect 2014; 20:O633-5. [PMID: 24476498 DOI: 10.1111/1469-0691.12577] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [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: 10/10/2013] [Revised: 01/24/2014] [Accepted: 01/24/2014] [Indexed: 11/28/2022]
Abstract
During active surveillance at the Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT, Palermo, Italy) with the CARBA screening medium, five pairs of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae and Escherichia coli strains were isolated in each of five colonized patients. In each patient, lateral gene transfer was demonstrated by comparing K. pneumoniae and E. coli strains, both possessing KPC-3, Tn4401a and pKpQIL-IT elements. The isolates were found to be multiclonal by multilocus sequence typing (sequence type (ST) 512 related to ST258, and ST307 belonging to a clonal complex different from the habitual sequence clone ST258 isolated in Italy) and pulsed-field gel electrophoresis. The results of our study highlight the easy transfer of KPC among Enterobacteriaceae colonizing the human intestine, and the active and careful surveillance required to identify and prevent the spread of these multidrug-resistant microorganisms.
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Affiliation(s)
- F Gona
- Department of Laboratory Medicine and Advanced Biotechnologies, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
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Mezzatesta ML, Gona F, Caio C, Adembri C, Dell'utri P, Santagati M, Stefani S. Emergence of an extensively drug-resistant ArmA- and KPC-2-producing ST101 Klebsiella pneumoniae clone in Italy. J Antimicrob Chemother 2013; 68:1932-4. [DOI: 10.1093/jac/dkt116] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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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Mezzatesta M, D'Andrea M, Migliavacca R, Giani T, Gona F, Nucleo E, Fugazza G, Pagani L, Rossolini G, Stefani S. Epidemiological characterization and distribution of carbapenem-resistant Acinetobacter baumannii clinical isolates in Italy. Clin Microbiol Infect 2012; 18:160-6. [DOI: 10.1111/j.1469-0691.2011.03527.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Mezzatesta M, Gona F, Caio C, Petrolito V, Sciortino D, Sciacca A, Santangelo C, Stefani S. Outbreak of KPC-3-producing, and colistin-resistant, Klebsiella pneumoniae infections in two Sicilian hospitals. Clin Microbiol Infect 2011; 17:1444-7. [DOI: 10.1111/j.1469-0691.2011.03572.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [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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Veroux M, Corona D, Scriffignano V, Caglià P, Gagliano M, Giuffrida G, Gona F, Sciacca A, Giaquinta A, Oliveri S, Sinagra N, Tallarita T, Zerbo D, Sorbello M, Parrinello L, Veroux P. Contamination of preservation fluid in kidney transplantation: single-center analysis. Transplant Proc 2010; 42:1043-5. [PMID: 20534219 DOI: 10.1016/j.transproceed.2010.03.041] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Contamination of preservation fluid is common, with a reported incidence of 2.2% to 28.0%, and may be a major cause of early morbidity after transplantation. Herein, we report our experience with routine examination of preservation fluid collected just before implantation, focusing on the rate of contamination and the clinical consequences to recipients. MATERIALS AND METHODS We analyzed 62 samples of preservation fluid for microbial and fungal contamination. RESULTS Twenty-four samples (38.7%) were contaminated with at least 1 organism. Bacterial contamination alone was observed in 18 samples; all patients received prophylactic treatment with intravenous piperacillin/tazobactam, 4.5 g/d for 10 days, without clinical sequelae. Six samples were contaminated with Candida species; all patients received prophylactic treatment with fluconazole, 100 mg/d for 3 months. One patient developed reversible acute renal failure due to ureteral obstruction by fungus balls at 30 days after transplantation. CONCLUSION Contamination of preservation fluid occurs frequently after kidney transplantation. Bacterial contamination evolved without symptoms in most patients treated with prophylactic antibiotic therapy. Fungal contamination may be potentially life-threatening. However, graft nephrectomy is not mandatory if the involved Candida species is identified correctly and appropriate antifungal therapy is rapidly prescribed.
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Affiliation(s)
- M Veroux
- Department of Surgery, Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Catania, Italy.
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Mezzatesta ML, Gona F, Marchese G, Nicolosi D, Toscano MA, Stefani S, Nicoletti G. Cefditoren versus community-acquired respiratory pathogens: time-kill studies. J Chemother 2009; 21:378-82. [PMID: 19622454 DOI: 10.1179/joc.2009.21.4.378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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
The time-kill method was used to determine the bactericidal activity of cefditoren compared with oral cephalosporins, amoxicillin, amoxicillin/clavulanate and levofloxacin against a randomly selected group of strains isolated from community-acquired respiratory tract infections (CARTIs). Cefditoren was the only agent showing significant bactericidal activity (>or=3 log(10 )reduction of viable cells) within 4 h against all Streptococcus pneumoniae strains, both penicillin-susceptible (PEN S) or -resistant (PEN R), as well as against Streptococcus pyogenes, and Moraxella catarrhalis. Against beta-lactamase positive strains of Haemophilus influenzae, cefditoren was comparable to the quinolone and more active than other cephalosporins at 24 h. Cefditoren showed the best killing kinetic profiles and this observation may be important when choosing an oral third-generation cephalosporin as initial or sequential therapy.
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Affiliation(s)
- M L Mezzatesta
- Department of Microbioloical anf Gynecological Sciences, University of Catania, Catania, Italy
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