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Rizzo A, Foschi A, Bracchitta F, Faggion I, Salari F, Borgonovo F, Fusetti C, Mileto D, Rizzardini G, Lombardi A, Gismondo MR, Micheli V. Persistent detection and sequencing of SARS-CoV-2 in the bloodstream of an immunocompromised patient. J Med Virol 2023; 95:e28381. [PMID: 36478593 PMCID: PMC9877964 DOI: 10.1002/jmv.28381] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/28/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Alberto Rizzo
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Antonella Foschi
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Fiorenza Bracchitta
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Ivano Faggion
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Federica Salari
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Fabio Borgonovo
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Chiara Fusetti
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Giuliano Rizzardini
- Department of Infectious DiseasesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Alessandra Lombardi
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Maria R. Gismondo
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
| | - Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and BioemergenciesASST Fatebenefratelli Sacco ‐ L. Sacco HospitalMilanItaly
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Mileto D, Micheli V, Fenizia C, Cutrera M, Gagliardi G, Mancon A, Bracchitta F, De Silvestri A, Rizzardini G, Lombardi A, Biasin M, Gismondo MR. Reduced neutralization of SARS-CoV-2 Omicron variant by BNT162b2 vaccinees' sera: a preliminary evaluation. Emerg Microbes Infect 2022; 11:790-792. [PMID: 35196967 PMCID: PMC8920392 DOI: 10.1080/22221751.2022.2045878] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- D Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - V Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - C Fenizia
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - M Cutrera
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - G Gagliardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - F Bracchitta
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A De Silvestri
- Clinical Epidemiology and Biometeric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Rizzardini
- Division of Infectious Diseases, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - A Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - M Biasin
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy
| | - M R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
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Mancon A, Rizzo A, Mileto D, Grosso S, Foschi A, Cutrera M, Capetti A, Faggion I, Anselmo A, Monte A, Fillo S, Rizzardini G, Gismondo MR, Micheli V. Viro-immunological evaluation in an immunocompromised patient with long-lasting SARS-CoV-2 infection. Emerg Microbes Infect 2022; 11:786-789. [PMID: 35209808 PMCID: PMC8920372 DOI: 10.1080/22221751.2022.2045877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - A Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - D Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - S Grosso
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - A Foschi
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M Cutrera
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - A Capetti
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - I Faggion
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - A Anselmo
- Scientific Department Army Medical Center, Rome, Italy
| | - A Monte
- Scientific Department Army Medical Center, Rome, Italy
| | - S Fillo
- Scientific Department Army Medical Center, Rome, Italy
| | - G Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy.,L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - V Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
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Modica S, Redi D, Gagliardini R, Giombini E, Bezenchek A, Di Carlo D, Maggiolo F, Lombardi F, Borghetti A, Farinacci D, Callegaro A, Gismondo MR, Colafigli M, Sterrantino G, Costantini A, Ferrara SM, Rusconi S, Zazzi M, Rossetti B, De Luca A, Gianotti N. Impact of NRTI resistance mutations on virological effectiveness of antiretroviral regimens containing elvitegravir: a multi-cohort study. J Antimicrob Chemother 2021; 75:194-199. [PMID: 31605107 DOI: 10.1093/jac/dkz424] [Citation(s) in RCA: 1] [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] [Received: 05/08/2019] [Revised: 09/04/2019] [Accepted: 09/10/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Antiretroviral drug resistance mutations remain a major cause of treatment failure. OBJECTIVES To evaluate the impact of NRTI resistance mutations on virological effectiveness of elvitegravir-containing regimens. MATERIALS AND METHODS We selected treatment-experienced HIV-1-infected patients starting elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) or elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (E/C/F/TDF), with at least one protease/reverse transcriptase genotype available before switching and at least one HIV-1 RNA viral load (VL) measurement during follow-up. The primary endpoint was virological failure (VF), defined as one VL value of ≥1000 copies/mL or two consecutive VL values of >50 copies/mL. RESULTS We included 264 ART regimens: 75.6% male, median (IQR) age 47 years (39-53), 7 years (3-16) of HIV infection, nadir CD4+ 247 cells/mm3 (105-361), 81.5% with VL ≤50 copies/mL and 11.7% with at least one NRTI mutation at baseline. Eleven (5.2%) VFs occurred in virologically suppressed patients versus eight (15.1%) in viraemic patients. The estimated probability of VF at 48 weeks with versus without any NRTI mutation was 7.4% (95% CI 2.3-12.5) versus 3.8% (2.1-5.5) in virologically suppressed patients and 66.7% (39.5-93.9) versus 11.2% (6.5-15.9) (P<0.001) in viraemic patients. The only predictor of VF was time on therapy (per 1 year more, adjusted HR 1.14, 95% CI 1.02-1.27, P=0.024) in viraemic patients. CONCLUSIONS A switch to E/C/F/TDF or E/C/F/TAF is safe for virologically suppressed patients without documented NRTI resistance, but not recommended in viraemic patients with a history of NRTI resistance. Although we did not detect a detrimental effect of past NRTI resistance in virologically suppressed patients, a fully active regimen remains preferred in this setting due to possible rebound of drug-resistant virus in the long term.
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Affiliation(s)
- Sara Modica
- Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - David Redi
- Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100, Siena, Italy.,Infectious Diseases Unit, AOU Senese, Viale Bracci, 16, 53100, Siena, Italy
| | - Roberta Gagliardini
- National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Via Portuense, 292, 00161, Rome, Italy
| | - Emanuela Giombini
- National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Via Portuense, 292, 00161, Rome, Italy
| | | | - Domenico Di Carlo
- University of Milan, Pediatric Clinical Research Center 'Romeo and Enrica Invernizzi', Via Giovanni Battista Grassi, 74, 20157, Milan, Italy
| | - Franco Maggiolo
- Infectious Diseases Unit, Ospedali Riuniti, Largo Barozzi, 1, 24128, Bergamo, Italy
| | - Francesca Lombardi
- UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Roma, Italia
| | - Alberto Borghetti
- UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Roma, Italia
| | - Damiano Farinacci
- UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Roma, Italia
| | - Annapaola Callegaro
- Microbiology and Virology Unit, Bergamo Hospital, Piazza OMS, 1, 24127, Bergamo, Italy
| | - Maria R Gismondo
- Microbiology Unit, Ospedale L. Sacco, Via G.B Grassi, 74, 20157, Milan, Italy
| | - Manuela Colafigli
- San Gallicano Dermatologic Institute, STI/HIV Unit, IRCCS, via Elio Chianesi, 53, 00144, Rome, Italy
| | - Gaetana Sterrantino
- Department di Clinical and Experimental Medicine, Clinic of Tropical and Infectious Diseases, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Andrea Costantini
- Clinical Immunology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Via Tronto, 10, 60121, Ancona, Italy
| | - Sergio M Ferrara
- Clinic of Infectious Diseases, Azienda ospedaliera-Universitaria Ospedali Riuniti, Viale Luigi Pinto, 1, 71122, Foggia, Italy
| | - Stefano Rusconi
- Infectious and Tropical Diseases Unit, DIBIC L. Sacco Hospital, University of Milano, Via G.B Grassi, 74, 20157, Milan, Italy
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100, Siena, Italy
| | - Barbara Rossetti
- Infectious Diseases Unit, AOU Senese, Viale Bracci, 16, 53100, Siena, Italy
| | - Andrea De Luca
- Department of Medical Biotechnologies, University of Siena, Viale Bracci, 16, 53100, Siena, Italy.,Infectious Diseases Unit, AOU Senese, Viale Bracci, 16, 53100, Siena, Italy
| | - Nicola Gianotti
- Infectious Diseases, IRCCS San Raffaele, Via Olgettina 60, 20132, Milan, Italy
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Micheli V, Rimoldi SG, Romeri F, Comandatore F, Mancon A, Gigantiello A, Perini M, Mileto D, Pagani C, Lombardi A, Gismondo MR. Geographical reconstruction of the SARS-CoV-2 outbreak in Lombardy (Italy) during the early phase. J Med Virol 2020; 93:1752-1757. [PMID: 32816316 PMCID: PMC7461481 DOI: 10.1002/jmv.26447] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 12/30/2022]
Abstract
The first identification of autochthonous transmission of SARS‐CoV‐2 in Italy was documented by the Laboratory of Clinical Microbiology, Virology and Bioemergencies of L. Sacco Hospital (Milano, Italy) on 20th February 2020 in a 38 years old male patient, who was found positive for pneumonia at the Codogno Hospital. Thereafter Lombardy has reported the highest prevalence of COVID‐19 cases in the country, especially in Milano, Brescia and Bergamo provinces. The aim of this study was to assess the potential presence of different viral clusters belonging to the six main provinces involved in Lombardy COVID‐19 cases in order to highlight peculiar province‐dependent viral characteristics. A phylogenetic analysis was conducted on 20 full length genomes obtained from patients addressing to several Lombard hospitals from February 20th to April 4th, 2020, aligned with 41 Italian viral genome assemblies available on GISAID database as of 30th March, 2020: two main monophyletic clades, containing 8 and 53 isolates, respectively, were identified. Noteworthy, Bergamo isolates mapped inside the small clade harbouring M gene D3G mutation. The molecular clock analysis estimated a cluster divergence approximately one month before the first patient identification, supporting the hypothesis that different SARS‐CoV‐2 strains had spread worldwide at different times, but their presence became evident only in late February along with Italian epidemic emergence. Therefore, this epidemiological reconstruction suggests that virus initial circulation in Lombardy was ascribable to multiple introduction. The phylogenetic reconstruction robustness, however, will be improved when more genomic sequences are available, in order to guarantee a complete epidemiological surveillance. Northern Italy was the most SARS‐CoV‐2 pandemic interested country area. A phylogeographical analysis was conducted to investigate virus entry and circulation in Italy. Two main monophyletic clades were identified, containing 8 and 53 isolates, respectively. The estimated cluster divergence in mid January supported the hypothesis of different viral strains spreading at different times and multiple inputs Lombardy region.
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Affiliation(s)
- Valeria Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Sara G Rimoldi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Francesca Romeri
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Francesco Comandatore
- Department of Biomedical and Clinical Sciences, Romeo ed Enrica Invernizzi Pediatric Research Center, L. Sacco University Hospital, University of Milan, Milan, Italy
| | - Alessandro Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Anna Gigantiello
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Matteo Perini
- Department of Biomedical and Clinical Sciences, Romeo ed Enrica Invernizzi Pediatric Research Center, L. Sacco University Hospital, University of Milan, Milan, Italy
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Cristina Pagani
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Alessandra Lombardi
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
| | - Maria R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, L. Sacco University Hospital, Milan, Italy
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Zanzani SA, Rimoldi SG, Manfredi M, Grande R, Gazzonis AL, Merli S, Olivieri E, Giacomet V, Antinori S, Cislaghi G, Bestetti G, Nan K, Sala V, Gismondo MR, Atzori C, De Faveri E. Lyme borreliosis incidence in Lombardy, Italy (2000-2015): Spatiotemporal analysis and environmental risk factors. Ticks Tick Borne Dis 2019; 10:101257. [PMID: 31285164 DOI: 10.1016/j.ttbdis.2019.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 01/13/2019] [Revised: 06/29/2019] [Accepted: 07/02/2019] [Indexed: 11/16/2022]
Abstract
Lyme borreliosis cases have been reported from Lombardy in northern Italy, where Ixodes ricinus is the main vector of Borrelia burgdorferi sensu lato. However, spatial and temporal variation in the incidence of Lyme borreliosis is not well understood. In the present study, based on new notified cases of Lyme borreliosis from 2000 to 2015, an average of 1.24 new cases per million residents per year was documented. New cases, georeferenced at the municipal level, were analyzed by retrospective space-time analysis (using SaTScan v. 9.3.1); and land cover, extrapolated from a Corine Land Cover dataset (using QGIS 2.8.1), was used to implement an environmental risk factor analysis. Firstly, a temporal high-risk cluster was detected in Lombardy: the relative risk of Lyme borreliosis was 3.73 times higher during 2008-2015 compared with the entire study period. Moreover, in a spatiotemporal high-risk cluster with a circular base, land cover consisting of wildland-urban interface, meadow, forest and meadow-forest transition were significantly higher compared to low-risk areas. Results of the present study demonstrate that the incidence of Lyme borreliosis is increasing in Lombardy and that environmental conditions are suitable for I. ricinus ticks infected with B. burgdorferi s.l.: citizens and health systems should be aware of Lyme borreliosis to reduce tick bites with personal protective behaviors and to avoid misdiagnosis, particularly within the area including the observed high-risk cluster. Economic resources should be invested to inform about methods to prevent tick bites, how to check people and pets after frequenting risk areas, and ways of removing the biting ticks when they are found.
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Affiliation(s)
- Sergio A Zanzani
- Department of Veterinary Medicine, Università degli Studi di Milano, 20133, Milano, Italy.
| | - Sara G Rimoldi
- Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, 20157, Milano, Italy.
| | - MariaTeresa Manfredi
- Department of Veterinary Medicine, Università degli Studi di Milano, 20133, Milano, Italy.
| | - Romualdo Grande
- Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, 20157, Milano, Italy.
| | - Alessia L Gazzonis
- Department of Veterinary Medicine, Università degli Studi di Milano, 20133, Milano, Italy.
| | - Stefania Merli
- I Division of Infectious Diseases, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, 20157, Milan, Italy.
| | - Emanuela Olivieri
- Department of Biology and Biotechnology "L. Spallanzani", Università degli Studi di Pavia, 27100, Pavia, Italy.
| | - Vania Giacomet
- Unit of Pediatrics Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, 20157, Milano, Italy.
| | - Spinello Antinori
- III Division of Infectious Diseases, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, 20157, Milano, Italy.
| | - Giuliana Cislaghi
- Unit of Neurology, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, 20157, Milano, Italy.
| | - Giovanna Bestetti
- III Division of Infectious Diseases, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, 20157, Milano, Italy.
| | - Katiuscia Nan
- Unit of Dermatology and Venearology Ospedale Maggiore di Trieste, 34125, Trieste, Italy.
| | - Vittorio Sala
- Department of Veterinary Medicine, Università degli Studi di Milano, 20133, Milano, Italy.
| | - Maria R Gismondo
- Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, 20157, Milano, Italy.
| | - Chiara Atzori
- I Division of Infectious Diseases, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, 20157, Milan, Italy.
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7
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Rimoldi SG, Merli S, Bestetti G, Giacomet V, Cislaghi G, Grande R, Zanzani S, Pagani C, Trevisan G, De Faveri E, Gismondo MR, Ruzić-Sabljić E. Occurrence of Lyme disease infection in a non-endemic area in Northern Italy. GIORN ITAL DERMAT V 2018; 155:320-324. [PMID: 29600690 DOI: 10.23736/s0392-0488.18.05941-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In Italy, the incidence of human tick-borne disease has increased over the last decades. Since 2015 a multidisciplinary group has been established in Sacco Hospital for the management of the patients affected by Lyme disease (LD). A retrospective evaluation (2015-2017) was performed for LD in non-endemic areas. METHODS Retrospective analysis of all 1000 samples for 800 patients screened for LD antibodies at the Sacco Hospital in 3 years (2015-2017). Clinical and epidemiological data were collected and compared with the serological results. RESULTS Among the 800 patients screened, 134 of them were diagnosed with borreliosis during 2015 (37 cases), 2016 (31 cases) and 2017 (66 cases). Localized LD was diagnosed 100 out of 134 cases (69%): in most of them (N.=63) erythema migrans has been documented; in 37 out of 100 it was not possible to detect it. In only three cases, patients complained of different clinical symptoms such as headache, arm and facial pain respectively. 23 out of 134 cases (16%) showed a persistence of serological positivity and symptoms with osteomuscular involvement and fatigue, despite the therapy (late LD). In that same study 11 out of 134 patients (7%) received a diagnosis of neuroborreliosis. CONCLUSIONS Our data reported a high percentage of LD infection (19%) in a non-endemic area. The definition of a Multidisciplinary Working Group and a clinical care pathway allowed a better clinical management of LD cases treated in Sacco Hospital, Milan.
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Affiliation(s)
- Sara G Rimoldi
- Laboratory of Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy -
| | - Stefania Merli
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Giovanna Bestetti
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Vania Giacomet
- Unit of Pediatrics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Romualdo Grande
- Laboratory of Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Sergio Zanzani
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Cristina Pagani
- Laboratory of Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | | | - Maria R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Eva Ruzić-Sabljić
- Laboratory for Boreliosis and Leptospirosis, University of Ljubljana, Ljubljana, Slovenia
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8
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Antinori S, Galimberti L, Grande R, Bianco R, Oreni L, Traversi L, Ricaboni D, Bestetti G, Lai A, Mileto D, Gismondo MR, Petullà M, Garelli S, De Maio G, Cogliati C, Torzillo D, Villa AM, Egidi AM, Repetto EC, Ridolfo AL, Corbellino M, Galli M. Chagas disease knocks on our door: a cross-sectional study among Latin American immigrants in Milan, Italy. Clin Microbiol Infect 2018; 24:1340.e1-1340.e6. [PMID: 29555394 DOI: 10.1016/j.cmi.2018.03.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 03/05/2018] [Accepted: 03/08/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We aimed to assess the prevalence and risk factors for Chagas disease (CD) in Latin American immigrants and to evaluate the accuracy of diagnostic tests. Moreover, we offered to all positive subjects a complete free-of-charge clinical/instrumental evaluation as well as benznidazole treatment in order to stage the disease and verify drug tolerability. METHODS A cross-sectional survey of CD among Latin Americans living in Milan and its metropolitan area was conducted between July 2013 and July 2014. Blood samples were tested for serologic evidence of CD together with a questionnaire covering demographic and clinical-epidemiological information. RESULTS Forty-eight (9.6%) of the 501 tested subjects were conclusively diagnosed as having CD. The highest prevalence of CD was among those from Bolivia (43/169, 25.4%) and El Salvador (4/68, 5.9%). Older age (adjusted odds ratio (aOR)] 1.05, p =0.004), a Bolivian origin (aOR 8.80; p =0.003), being born in the department of Santa Cruz (aOR 3.72, p =0.047), having lived in mud houses (aOR 2.68; p =0.019), and having an affected relative (aOR 12.77, p =0.001) were independently associated with CD. The ARCHITECT Chagas test showed the highest sensitivity (100%) and specificity (99.8%). Twenty-nine of the subjects with CD (60.4%) underwent disease staging, 10 of whom (35.7%) showed cardiac and/or digestive involvement. Benznidazole treatment was associated with high frequency of adverse reactions (19/27, 70.4%) and permanent discontinuation (8/27, 29.6%). CONCLUSIONS CD is highly prevalent among Bolivians and Salvadorans living in Milan. Regions with a large Latin American immigrant population should implement programmes of active detection and treatment.
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Affiliation(s)
- S Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy.
| | - L Galimberti
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - R Grande
- Laboratory of Clinical Microbiology, Virology and Bioemergency, ASST Fatebenefratelli Sacco, Milan, Luigi Sacco Hospital, Italy
| | - R Bianco
- Radiology Unit, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - L Oreni
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - L Traversi
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - D Ricaboni
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - G Bestetti
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - A Lai
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - D Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergency, ASST Fatebenefratelli Sacco, Milan, Luigi Sacco Hospital, Italy
| | - M R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergency, ASST Fatebenefratelli Sacco, Milan, Luigi Sacco Hospital, Italy
| | - M Petullà
- Radiology Unit, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - S Garelli
- II Division of Internal Medicine, ASST Fatebenefratelli Sacco, Milan, Italy
| | - G De Maio
- II Division of Internal Medicine, ASST Fatebenefratelli Sacco, Milan, Italy
| | - C Cogliati
- Médecins San Frontières, Medical Department, Operational Centre Rome, MSF, Italy
| | - D Torzillo
- Médecins San Frontières, Medical Department, Operational Centre Rome, MSF, Italy
| | - A M Villa
- Opera San Francesco per i Poveri, Milan, Italy
| | - A M Egidi
- II Division of Internal Medicine, ASST Fatebenefratelli Sacco, Milan, Italy
| | - E C Repetto
- II Division of Internal Medicine, ASST Fatebenefratelli Sacco, Milan, Italy
| | - A L Ridolfo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - M Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - M Galli
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
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Rimoldi SG, De Vecchi E, Pagani C, Zambelli A, Di Gregorio A, Bosisio E, Vanelli P, Scrofani R, Gismondo MR, Cagnoni G, Antona C. Use of Dithiothreitol to Dislodge Bacteria From the Biofilm on an Aortic Valve in the Operating Theatre: A Case of Infective Endocarditis Caused by Staphylococcus aureus and Proteus mirabilis. Ann Thorac Surg 2017; 102:e357-9. [PMID: 27645982 DOI: 10.1016/j.athoracsur.2016.03.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 02/24/2016] [Revised: 03/03/2016] [Accepted: 03/10/2016] [Indexed: 10/21/2022]
Abstract
This is the first reported case of 2 biofilm-producing bacteria, Staphylococcus aureus and Proteus mirabilis, identified from an aortic valve using an innovative device with dithiothreitol solution, able to dislodge bacterial biofilm. The method is usable in the operating theatre and recommended in infective endocarditis nonresponders to empiric therapy.
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Affiliation(s)
- Sara G Rimoldi
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy.
| | - Elena De Vecchi
- Laboratorio di Analisi Chimico-Cliniche e Microbiologiche-IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Cristina Pagani
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Agostino Zambelli
- Divisione I di Malattie Infettive, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Annamaria Di Gregorio
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Enrica Bosisio
- Unità Operativa di Cardiochirurgia, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Paolo Vanelli
- Unità Operativa di Cardiochirurgia, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Roberto Scrofani
- Unità Operativa di Cardiochirurgia, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Maria R Gismondo
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Giovanni Cagnoni
- Unità Operativa di Cardiochirurgia, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Carlo Antona
- Unità Operativa di Cardiochirurgia, ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
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10
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Ridolfo AL, Rimoldi SG, Pagani C, Marino AF, Piol A, Rimoldi M, Olivieri P, Galli M, Dolcetti L, Gismondo MR. Diffusion and transmission of carbapenem-resistant Klebsiella pneumoniae in the medical and surgical wards of a university hospital in Milan, Italy. J Infect Public Health 2015; 9:24-33. [PMID: 26116453 DOI: 10.1016/j.jiph.2015.05.008] [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] [Received: 03/12/2015] [Revised: 05/04/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022] Open
Abstract
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is emerging as a public health problem worldwide. In Italy, a remarkable increase in CRKP cases has been reported since 2010. In this study, CRKP diffusion, distribution and in-hospital transmission trends were evaluated in a university hospital in Milan, Italy, from January 2012 to December 2013. Isolates from 63 newly detected CRKP-positive patients were genotyped, and possible transmission was determined by combining the molecular results with data concerning the patients' admission and in-hospital transfers. Most of the cases (90.4%) were from general medical and surgery wards, and the remaining 9.6% were from the intensive care unit. Fifteen of the 46 hospital-associated cases (32.6%) were attributable to in-hospital transmission. After the introduction of targeted and hospital-wide control measures, the transmission index significantly decreased from 0.65 to 0.13 (p=0.01). There was also a decrease in the overall nosocomial case incidence, from 0.37 to 0.17 per 1000 person-days (p=0.07). Our findings indicate that the spread of CRKP in Northern Italy hospitals may go far beyond high-risk settings (i.e., intensive care units) and that strict surveillance should be extended to general areas of care.
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Affiliation(s)
- Anna L Ridolfo
- Direzione Medica di Presidio, Azienda Ospedaliera-Polo Universitario Luigi Sacco, Via G.B. Grassi 74, 20156 Milano, Italy; Sezione di Malattie Infettive e Immunopatologia, Dipartimento di Scienze Cliniche, Ospedale Luigi Sacco, Università degli Studi di Milano, Via G.B. Grassi 74, 20156 Milano, Italy.
| | - Sara G Rimoldi
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica Bioemergenze, Ospedale Luigi Sacco, Università degli Studi di Milano, Via G.B. Grassi 74, 20156 Milano, Italy
| | - Cristina Pagani
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica Bioemergenze, Ospedale Luigi Sacco, Università degli Studi di Milano, Via G.B. Grassi 74, 20156 Milano, Italy
| | - Andrea F Marino
- Direzione Medica di Presidio, Azienda Ospedaliera-Polo Universitario Luigi Sacco, Via G.B. Grassi 74, 20156 Milano, Italy
| | - Anna Piol
- Direzione Medica di Presidio, Azienda Ospedaliera-Polo Universitario Luigi Sacco, Via G.B. Grassi 74, 20156 Milano, Italy
| | - Matteo Rimoldi
- Direzione Medica di Presidio, Azienda Ospedaliera-Polo Universitario Luigi Sacco, Via G.B. Grassi 74, 20156 Milano, Italy
| | - Pietro Olivieri
- Direzione Medica di Presidio, Azienda Ospedaliera-Polo Universitario Luigi Sacco, Via G.B. Grassi 74, 20156 Milano, Italy
| | - Massimo Galli
- Sezione di Malattie Infettive e Immunopatologia, Dipartimento di Scienze Cliniche, Ospedale Luigi Sacco, Università degli Studi di Milano, Via G.B. Grassi 74, 20156 Milano, Italy
| | - Lucia Dolcetti
- Direzione Medica di Presidio, Azienda Ospedaliera-Polo Universitario Luigi Sacco, Via G.B. Grassi 74, 20156 Milano, Italy
| | - Maria R Gismondo
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica Bioemergenze, Ospedale Luigi Sacco, Università degli Studi di Milano, Via G.B. Grassi 74, 20156 Milano, Italy
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11
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Vocale C, Rimoldi SG, Pagani C, Grande R, Pedna F, Arghittu M, Lunghi G, Maraschini A, Gismondo MR, Landini MP, Torresani E, Topin F, Sambri V. Comparative evaluation of the new xTAG GPP multiplex assay in the laboratory diagnosis of acute gastroenteritis. Clinical assessment and potential application from a multicentre Italian study. Int J Infect Dis 2015; 34:33-7. [PMID: 25749649 DOI: 10.1016/j.ijid.2015.02.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/16/2015] [Accepted: 02/17/2015] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Gastroenteritis caused by a single pathogen or multiple pathogens remains a major diagnostic challenge for the laboratory. The treatment of diarrhoea is based on microbiological results. Diagnosis is achieved using different laboratory techniques that have variable sensitivity and specificity. xTAG GPP is a new multiplex PCR assay that simultaneously detects 15 different pathogens responsible for diarrhoea. The results of the first multicentre study in Italy to evaluate the potential clinical application of the GPP assay in the laboratory diagnosis of diarrhoea are reported here. METHODS Faeces specimens (N=664) from hospitalized patients were tested with the GPP assay using a Luminex 200 instrument. All specimens were run using comparator methods following a routine algorithm: culture for bacteria, enzyme immunoassay and PCR for viruses, and microscopy for parasites. RESULTS Of the samples tested with the GPP, 53.61% (356/664) gave positive results, as compared to 45.33% by routine testing. Of the positive specimens, 34.55% showed the presence of genomic DNA from multiple pathogens. The Luminex method showed an increase in the percentage of positivity of 8.28%. CONCLUSIONS The GPP assay can be considered a helpful tool for the detection of gastrointestinal pathogens, with a hands-on time of 5h; it provides accurate data for the clinical management of hospitalized patients and for epidemiological surveillance.
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Affiliation(s)
- C Vocale
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, St. Orsola Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy.
| | - S G Rimoldi
- Laboratory of Clinical Microbiology, Virology and Bioemergency, "L. Sacco" University Hospital, Milan, Italy
| | - C Pagani
- Laboratory of Clinical Microbiology, Virology and Bioemergency, "L. Sacco" University Hospital, Milan, Italy
| | - R Grande
- Laboratory of Clinical Microbiology, Virology and Bioemergency, "L. Sacco" University Hospital, Milan, Italy
| | - F Pedna
- Unit of Clinical Microbiology, The Hub Laboratory of the Greater Romagna Area, Pievesestina, Cesena, Italy
| | - M Arghittu
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - G Lunghi
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Maraschini
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - M R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergency, "L. Sacco" University Hospital, Milan, Italy
| | - M P Landini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, St. Orsola Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy; DIMES, University of Bologna, Bologna, Italy
| | - E Torresani
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - F Topin
- Luminex Corporation, Oosterhout NB, Netherlands
| | - V Sambri
- Unit of Clinical Microbiology, The Hub Laboratory of the Greater Romagna Area, Pievesestina, Cesena, Italy; DIMES, University of Bologna, Bologna, Italy
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12
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Drago L, De Vecchi E, Nicola L, Tocalli L, Gismondo MR. Effect of Moxifloxacin on Bacterial Pathogenicity Factors in Comparison with Amoxicillin, Clarithromycin and Ceftriaxone. J Chemother 2013; 16:30-7. [PMID: 15077996 DOI: 10.1179/joc.2004.16.1.30] [Citation(s) in RCA: 9] [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: 10/31/2022]
Abstract
Moxifloxacin is a recent fluoroquinolone with an antibacterial spectrum encompassing both aerobic Gram-negative and Gram-positive strains, as well as anaerobic bacteria. In this study the activity of moxifloxacin against Streptococcus pneumoniae, Staphylococcus aureus, Moraxella catarrhalis, Haemophilus influenzae, Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa, and effects of subinhibitory concentrations on bacterial morphology and adhesion properties were compared with those of amoxicillin, clarithromycin and ceftriaxone. The in vitro activity of moxifloxacin against Gram-positive and Gram-negative pathogens was equal to or better than that of comparators. Subinhibitory concentrations of moxifloxacin significantly affected bacterial morphology of S. pneumoniae, M. catarrhalis, H. influenzae and P. aeruginosa, leading to formation of spherical forms and filaments. Moreover, bacterial adhesion to buccal cells and fibroblasts was reduced after treatment with 1/4 and 1/8 X MIC of moxifloxacin. In conclusion, subinhibitory concentrations of moxifloxacin remarkably interfere with some bacterial pathogenic factors, thereby contributing to its antimicrobial activity.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Department of Clinical Sciences, L. Sacco Teaching Hospital, University of Milan, Italy.
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13
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Drago L, De Vecchi E, Nicola L, Legnani D, Gismondo MR. Kinetic bactericidal activity of telithromycin, azithromycin and clarithromycin against respiratory pathogens. APMIS 2006; 113:655-63. [PMID: 16309423 DOI: 10.1111/j.1600-0463.2005.apm_195.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 11/27/2022]
Abstract
The present study assessed the comparative in vitro killing kinetics of telithromycin, azithromycin and clarithromycin. Minimal inhibitory concentrations (MIC) and minimal bactericidal concentrations (MBC) were determined against Streptococcus pneumoniae, beta-haemolytic streptococci, Haemophilus influenzae and Moraxella catarrhalis strains characterized by different susceptibilities to beta-lactams and macrolides. For each bacterial species, representative strains were chosen for time-kill studies. Telithromycin showed high activity against all the tested strains with MIC ranging from < or = 0.004 to 0.5 mg/L for streptococci, from 0.008 to 8 mg/L for H. influenzae, and from 0.008 to 0.5 mg/L for M. catarrhalis. In time-kill studies, telithromycin showed an overall superior bactericidal activity in respect to macrolides, particularly against resistant strains. In conclusion, telithromycin proved to possess bactericidal activity against a wide range of respiratory pathogens, including strains resistant to common macrolides.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Department of Clinical Sciences L. Sacco, University of Milan, Italy.
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14
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Drago L, De Vecchi E, Nicola L, Legnani D, Lombardi A, Gismondo MR. In vitro synergy and selection of resistance by fluoroquinolones plus amikacin or beta-lactams against extended-spectrum beta-lactamase-producing Escherichia coli. J Chemother 2005; 17:46-53. [PMID: 15828443 DOI: 10.1179/joc.2005.17.1.46] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 10/31/2022]
Abstract
This study compared the potential synergy of levofloxacin and ciprofloxacin in combination with cefepime, ceftazidime, imipenem, piperacillin/tazobactam or amikacin, against extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli by using checkerboard and time kill studies. Moreover, selection of resistance was determined by frequency of mutations and by calculating the increase in minimum inhibitory concentrations (MICs) after five serial subcultures on antibiotic-containing plates. Synergy occurred more often with levofloxacin combined with imipenem (7/10 strains) and with levofloxacin or ciprofloxacin with amikacin (10/10) than for the other combinations. Time kill studies showed synergy for levofloxacin combined with amikacin, ceftazidime, imipenem or piperacillin/tazobactam, and for ciprofloxacin combined with amikacin, cefepime or imipenem. Antibiotic combinations selected for resistance less frequently than antibiotics alone. Mutation frequency was <10(-12) for all combinations. In conclusion, the combination of a fluoroquinolone with a beta-lactam or amikacin may provide improved antimicrobial activity and help limit the occurrence of resistance in ESBL-producing E. coli strains.
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Affiliation(s)
- L Drago
- Lab Clinical Microbiology, Dept Clinical Science L Sacco, Via GB Grassi 74, 20157 Milano, Italy.
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15
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Drago L, De Vecchi E, Nicola L, Colombo A, Gismondo MR. Microbiological evaluation of commercial probiotic products available in Italy. J Chemother 2004; 16:463-7. [PMID: 15565913] [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: 05/01/2023]
Abstract
Scientific evidence of the prevention and therapy of some intestinal diseases is accumulating in regard to probiotic products. However, sufficient information on the use of probiotics in specific therapies is not yet available and, above all, there is no clear legislation about these products in Europe. In this study, we evaluated five different probiotic products commercially available in Italy for their qualitative and quantitative microbial content after about 12 and 22 months of storage. We also evaluated the stability of lactobacilli to 0.3% bile salts and to pH of 3.58 and 7.98. There were discrepancies between the declared content and our results found after storage for 4 of the tested products. Bile salts and basic pH did not affect the growth of the lactobacilli tested, while for 2 tested products 6 hours at acid pH produced a complete inhibition of bacterial growth. Our results suggest the need for clear legislation and adequate control of the manufacturing of probiotic products.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Dept of Clinical Sciences L. Sacco, L. Sacco Teaching Hospital, University of Milan, Italy.
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Drago L, De Vecchi E, Nicola L, Gismondo MR. Antimicrobial activity and interference of tobramycin and chloramphenicol on bacterial adhesion to intraocular lenses. Drugs Exp Clin Res 2003; 29:25-35. [PMID: 12866361] [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: 03/03/2023]
Abstract
The antimicrobial activities of tobramycin and chloramphenicol were evaluated by determining minimum inhibitory and bactericidal concentrations against Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, group A, group B and group G streptococci, Klebsiella spp., Stenotrophomonas maltophilia and ciprofloxacin-resistant and -susceptible Pseudomonas aeruginosa, as well as by evaluating interference on adhesion of slime producer strains of S. aureus and P. aeruginosa to intraocular lens from tobramycin and chloramphenicol pharmaceutical products by scanning electron microscopy. Chloramphenicol was more active against Gram-positive bacteria than was tobramycin, which instead showed higher activity against ciprofloxacin-susceptible P. aeruginosa. Treatment of lenses with the antimicrobial products eradicated the bacterial biofilm, which was already notably reduced after 5 min. This activity was more pronounced for chloramphenicol against S. aureus and for tobramycin against P. aeruginosa. Bacterial adhesion was also significantly reduced when lenses colonized by P. aeruginosa were treated with chloramphenicol, even if they were resistant to this drug. In conclusion, the tested drugs showed marked antibacterial activity, particularly by interfering with bacterial biofilms. The data obtained in this study suggest a specific use of chloramphenicol in topical prophylaxis aimed at avoiding bacterial contaminations. However, further specific in vivo studies are needed to confirm these data.
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Affiliation(s)
- L Drago
- Microbiology Laboratory, Department of Clinical Sciences, L. Sacco Teaching Hospital, University of Milan, Milan, Italy.
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17
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Drago L, De Vecchi E, Nicola L, Valli M, Marchetti F, Gismondo MR. Comparative bactericidal activity of fluoroquinolones against clinical isolates resistant to fluoroquinolones. J Chemother 2003; 15:118-23. [PMID: 12797386 DOI: 10.1179/joc.2003.15.2.118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 10/31/2022]
Abstract
The bactericidal activity of levofloxacin, ciprofloxacin, moxifloxacin and norfloxacin against clinical isolates conventionally classified as resistant to fluoroquinolones were compared at their maximum concentrations in serum, urine (except moxifloxacin) and bronchial mucosa (except norfloxacin). Time killing curves against Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus epidermidis, and Streptococcus pneumoniae were performed. Serum concentrations of the tested drugs were not able to produce a bactericidal effect on fluoroquinolone-resistant strains. In the urine series, levofloxacin was always bactericidal (decrease > or = 3 logs CFU/ml), while norfloxacin and ciprofloxacin were bactericidal on E. coli (both), P. mirabilis (norfloxacin) and P. aeruginosa (ciprofloxacin). In the bronchial mucosa series, S. pneumoniae was rapidly killed by levofloxacin and moxifloxacin, and K. pneumoniae by levofloxacin after 12 hours. In conclusion, the maximum levofloxacin concentrations achievable at certain body sites allowed killing even of strains defined as resistant by conventional breakpoints.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Dept of Clinical Sciences, L. Sacco Teaching Hospital, University of Milan, Italy.
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18
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Blasi F, Drago L, Gismondo MR, Cosentini R, Tarsia P, Valenti V, Capone P, Allegra L. In vitro antibiotic activity against Chlamydia pneumoniae clinical isolates. J Chemother 2003; 15:93-4. [PMID: 12678424 DOI: 10.1179/joc.2003.15.1.93] [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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19
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Atzori C, Valerio A, Fantoni G, Drago L, Gismondo MR, Cargnel A. Pneumocystis carinii ITS typing: doubtful evidence of genotype-related virulence. J Eukaryot Microbiol 2002; Suppl:147S. [PMID: 11906034 DOI: 10.1111/j.1550-7408.2001.tb00492.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C Atzori
- II Department of Infectious Diseases, L. Sacco Hospital, Milano, Italy.
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Drago L, De Vecchi E, Nicola L, Valli M, Gismondo MR. Effects of subinhibitory concentrations of ibuprofen isobuthanolammonium on virulence factors of uropathogenic Escherichia coli. J Chemother 2002; 14:314-5. [PMID: 12120890 DOI: 10.1179/joc.2002.14.3.314] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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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21
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Drago L, De Vecchi E, Valli M, Nicola L, Gismondo MR. Effect of linezolid in comparison with that of vancomycin on glycocalix production: in vitro study. Antimicrob Agents Chemother 2002; 46:598-9. [PMID: 11796388 PMCID: PMC127078 DOI: 10.1128/aac.46.2.598-599.2002] [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: 11/20/2022] Open
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22
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Drago L, De Vecchi E, Mombelli B, Nicola L, Valli M, Gismondo MR. Activity of levofloxacin and ciprofloxacin against urinary pathogens. J Antimicrob Chemother 2001; 48:37-45. [PMID: 11418511 DOI: 10.1093/jac/48.1.37] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [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: 11/13/2022] Open
Abstract
This study compares the antibacterial activities of levofloxacin and ciprofloxacin against recently isolated urinary tract pathogens, by evaluating their MICs and MBCs in accordance with NCCLS susceptibility tests, time-kill curves and interference with bacterial adhesion to uroepithelial cells. A total of 200 clinical isolates was tested, including the species Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus and Staphylococcus epidermidis. All E. coli isolates were susceptible to levofloxacin and only one was resistant to ciprofloxacin, and there were no differences between beta-lactamase-positive and -negative strains. K. pneumoniae strains resistant to ciprofloxacin were also resistant to levofloxacin. Methicillin-resistant S. aureus seemed to be less susceptible than methicillin-susceptible strains to these quinolones. S. epidermidis strains were susceptible to levofloxacin and ciprofloxacin, with the exception of two isolates. Incubation of S. aureus and E. coli with subinhibitory antimicrobial concentrations reduced their capacity to adhere to uroepithelial cells; this was statistically significant at 0.25 x MIC with respect to controls (P < 0.05). Inhibition of adhesion ranged from 36 to 43% when bacteria were incubated in the presence of 0.25 x MIC of levofloxacin and ciprofloxacin, and from 10 to 27% at 0.125 x MIC. These findings suggest that levofloxacin is an effective alternative to ciprofloxacin in the treatment of urinary tract infections and that sub-inhibitory concentrations may contribute to efficacy.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Department of Preclinical Science, LITA Vialba, University of Milan, Via G. B. Grassi 74, 20157 Milano, Italy.
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Lombardi A, Drago L, De Vecchi E, Mombelli B, Gismondo MR. Antimicrobial activity of thiamphenicol-glycinate-acetylcysteinate and other drugs against Chlamydia pneumoniae. Arzneimittelforschung 2001; 51:264-7. [PMID: 11304944 DOI: 10.1055/s-0031-1300034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Chlamydia pneumoniae is responsible for respiratory tract infections of both upper and lower respiratory tract. Although this bacterium is one of the most wide-spread pathogens of man, there are limited data on the antibiotic treatment of C. pneumoniae infections. The aim of this study has been to evaluate the in vitro activity of thiamphenicol glycinate acetylcysteinate (TGA, CAS 20192-91-0) in comparison with molecules with established activity against C. pneumoniae, as well as macrolides and quinolones. The results have shown that TGA and clarithromycin (CAS 81103-11-9) are the most active drugs tested, but it is important to underline that the minimal inhibitory concentration (MIC) ranges of TGA are very much lower than the breakpoint of thlamphenicol for the respiratory pathogens. In conclusion, the good antimicrobial in vitro activity of TGA against C. pneumoniae together with its in vivo characteristics, in particular the high concentration reached in lung and the combination with the mucolytic agent N-acetylcysteine (NAC, CAS 616-91-1), can make a valid choice in the treatment of respiratory tract infections caused by C. pneumoniae. These findings need further evaluation by clinical studies.
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Affiliation(s)
- A Lombardi
- Laboratory of Clinical Microbiology, L. Sacco Teaching Hospital, University of Milan, Milan, Italy
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24
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Drago L, De Vecchi E, Fassina MC, Mombelli B, Tocalli L, Gismondo MR. Comparative in vitro activity of thiamphenicol-glycinate and thiamphenicol-glycinate-acetylcysteinate and other antimicrobials against respiratory pathogens. Arzneimittelforschung 2001; 51:315-24. [PMID: 11367873 DOI: 10.1055/s-0031-1300044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Thiamphenicol-glycinate-acetylcysteinate (TGA; CAS 20192-91-0) is widely used for the treatment of infections of varied aetiology. The aim of this study was to compare the antibacterial activity of thiamphenicol-glycinate (TG; CAS 15318-45-3), TGA, amoxicillin (CAS 61336-70-7) plus clavulanic acid (CAS 58001-44-8), azithromycin (CAS 83905-01-5) and ceftriaxone (CAS 104376-79-6). Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined against Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae according to the National Committee for Clinical Laboratory Standards (NCCLS) methods. The effects of changes in assay conditions were also examined. The activity of TG and TGA was similar to that of amoxicillin plus clavulanic acid, with the exception of methicillin resistant S. aureus. Azithromycin and ceftriaxone were characterised by a limited activity against gram-positive cocci and methicillin resistant and cefinase-positive S. aureus, respectively. TG and TGA are characterized by a wide spectrum of activity, comparable to that of recent commercialized antibiotics for treatment of respiratory tract infections.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, L. Sacco Teaching Hospital, University of Milan, Milan, Italy.
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25
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Abstract
Probiotics are defined as living organisms, beneficial to health when ingested. Different species of microorganisms such as lactic acid bacteria or yeasts have been proposed for human use. These microorganisms differ from each other and it is, therefore, unlikely that they will act in the same way. Probiotics could be used for several conditions such as diarrhoea, candidal vaginitis, urinary tract infections, immune disorders, lactose intolerance, hypercholesterolaemia and food allergy. The effects of probiotics in some of these conditions have been directly observed, in others it has been only suggested on the basis of in vitro studies and from experimental animal models. Controlled trials are needed to determine the scientific basis for their use, the correct formulation and ways of administration in different clinical situations.
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Affiliation(s)
- B Mombelli
- Clinical Microbiology Department. L. Sacco Teaching Hospital, University of Milan, Via G.B. Grassi, 74, 20157 Milan, Italy.
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26
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Abstract
The preliminary results of a study to show the possibility that Candida albicans can internalize into epithelial cells are reported. The study was performed on buccal, vaginal and HeLa cells. Buccal and vaginal cells, at a concentration of 5 x 10(4) cells/ml and HeLa monolayers were incubated for 2, 3 and 4 h with 10(5) colony forming units of a Candida albicans isolate. After incubation, non-internalised yeasts were eliminated and samples were processed for examination by Scanning Electron Microscopy. Results suggest that receptor-mediated endocytosis could be involved in the pathogenesis of recurrent oral and vaginal infections. This phenomenon could represent an interesting experimental model to testing drug interference in the development of therapeutic strategies against C. albicans infections.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Department of Preclinical Science and L. Sacco Teaching Hospital, University of Milan, L.I.T.A. Vialba, Via G.B. Grassi 74, 20157 Milan, Italy.
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27
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Lombardi A, Drago L, Bartolone MR, Gismondo MR. Cytomegalovirus pp65 antigenemia in HIV patients: retrospective on 3 years study. Int J Antimicrob Agents 2000; 16:461-2. [PMID: 11118858 DOI: 10.1016/s0924-8579(00)00275-2] [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)
- A Lombardi
- Laboratory of Clinical Microbiology, L. Sacco Teaching Hospital, University of Milan, Via G.B. Grassi, 74 20157, Milan, Italy.
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Drago L, Mombelli B, De Vecchi E, Tocalli L, Nardi G, Gismondo MR. Epidemiology of Gram-negative antibiotic resistance in outpatients: a year of surveillance. Int J Antimicrob Agents 2000; 16:479-81. [PMID: 11118862 DOI: 10.1016/s0924-8579(00)00280-6] [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: 11/18/2022]
Affiliation(s)
- L Drago
- Clinical Microbiology Laboratory, L. Sacco Teaching Hospital, Via G. B. Grassi, 74, 20157 Milan, Italy.
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29
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Abstract
The epidemiology of HIV-1 genomic mutations causing antiretroviral drug resistance, in 145 HIV-1 infected patients were obtained using a new sequencing technique. All patients were in a follow up treatment for at least 4 months with all drugs available in clinical practice in accordance to international guidelines. The percentage of the mutations were calculated both on the number of all participants and on the number of patients who received the drugs selecting for that specific resistance. It was possible then to evaluate patients who showed the mutation without receiving the drug. We consider this new sequencing method reliable and hopeful in clinical practice, giving the opportunity for a guided therapy for the single patient and in detecting and monitoring the antiretroviral drug resistance mutations in the pertinent geographic area following a periodic surveillance program.
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Affiliation(s)
- M Rosina
- Clinical Microbiology Laboratory, University of Milan, L. Sacco Hospital, Via GB Grassi 74, 20174 Milan, Italy.
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30
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Drago L, De Vecchi E, Fassina MC, Mombelli B, Bonaccorso C, Gismondo MR. Antimycotic activity and phagocytosis effects of econazole in combination with ibuprofen isobuthanolammonium against vaginal strains. J Chemother 2000; 12:509-15. [PMID: 11154035 DOI: 10.1179/joc.2000.12.6.509] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 10/31/2022]
Abstract
Vaginal infections caused by Candida spp., other yeasts and Trichomonas vaginalis are problematic mainly due to the various factors involved in development of infection and to the failure of common treatments. In this study we investigated the presence of synergistic activity of econazole and ibuprofen isobuthanolammonium against 310 different vaginal isolates, by using the microdilution broth assay to test in vitro antimicrobial activity and the effect of the two drugs on phagocytosis and intramacrophagic cellular killing of mouse peritoneal macrophages. The effect of sub-inhibitory concentrations of econazole / ibuprofen isobuthanolammonium combination on Candida albicans germ tube formation was also evaluated. The in vitro antifungal activity of econazole was notably improved by addition of ibuprofen isobuthanolammonium. Macrophage killing of C. albicans was significantly increased by the two drugs and also germ-tube formation was significantly affected. We conclude that the addition of ibuprofen isobuthanolammonium to econazole provides better in vitro antifungal activity. However, further studies are needed to elucidate the in vivo action of this formulation.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Department of Preclinical Science, LITA Vialba, Milan, Italy.
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31
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Abstract
In this study the antibacterial and antifungal properties of propolis, a natural product of bees, have been investigated against different pathogens. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined according to NCCLS standards on 320 strains including Staphylococcus aureus, Group A beta-hemolytic streptococci, Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae, Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa and Candida albicans. Time-kill curves were assessed for susceptible microorganisms, testing 0, 0.5, 1, 2, 4 x MIC for propolis, by counting viable bacteria after 0, 3, 6, 24 hours and viable yeasts after 0, 3, 6, 24 and 48 hours. Propolis showed good antimicrobial activity against most of the isolates, particularly S. pneumoniae, H. influenzae and M. catarrhalis, but not against Enterobacteriaceae. Time-kill curves demonstrated bacteriostatic rather than bactericidal activity of propolis, the latter being evident only at high concentrations.
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Affiliation(s)
- L Drago
- Clinical Microbiology, L. Sacco Teaching Hospital, University of Milan, Italy.
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32
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Zanchetta N, Nardi G, Tocalli L, Drago L, Bossi C, Pulvirenti FR, Galli C, Gismondo MR. Evaluation of the abbott LCx HIV-1 RNA quantitative, a new assay for quantitative determination of human immunodeficiency virus type 1 RNA. J Clin Microbiol 2000; 38:3882-6. [PMID: 11015428 PMCID: PMC87501 DOI: 10.1128/jcm.38.10.3882-3886.2000] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 11/20/2022] Open
Abstract
A new quantitative reverse transcription (RT)-PCR assay for human immunodeficiency virus type 1 (HIV-1) RNA (Abbott LCx HIV RNA Quantitative assay) has been compared with the Organon NucliSens assay on 521 retrospective samples obtained from HIV-1-positive patients monitored during highly active antiretroviral therapy, 79 of whom were assayed also by the Chiron Quantiplex 3.0 system and on characterized panels. The LCx system showed a moderate correlation (r = 0.795) and gave higher results than the NucliSens system on 245 of 327 concordant positive samples, with similar sensitivity. Correlation with Quantiplex system results was higher (r = 0.943). LCx reproducibility was very good; the procedure was simple, well controlled, and rapid (up to 48 results in 7 h). The HIV RNA quantitative assay on the LCx system is suitable for routine use.
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Affiliation(s)
- N Zanchetta
- Microbiology, "L. Sacco" Teaching Hospital, Milan, Italy
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33
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Drago L, Fassina MC, Mombelli B, De Vecchi E, Lombardi A, Gismondo MR. Comparative effect of thiamphenicol glycinate, thiamphenicol glycinate N-acetylcysteinate, amoxicillin plus clavulanic acid, ceftriaxone and clarithromycin on pulmonary clearance of Haemophilus influenzae in an animal model. Chemotherapy 2000; 46:275-81. [PMID: 10859433 DOI: 10.1159/000007299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/19/2022]
Abstract
BACKGROUND Thiamphenicol glycinate (TG) and its derivative thiamphenicol glycinate N-acetylcysteinate (TGA) could be a valid therapeutic option in the treatment of respiratory tract infections. METHODS Time-kill curves of TG and TGA and pulmonary clearance in Haemophilus influenzae infected guinea pigs were compared with those of clarithromycin, ceftriaxone and amoxicillin plus clavulanic acid. RESULTS The bacterial activities of the tested antibiotics were comparable. When compared to the control group, lung bacterial counts were significantly lower for the TGA group at 3 h vs. controls, while for the other treatments, significant decreases were recorded after 6 h. All drugs showed a log count of <2.0 at 24 h with respect to the control while at 48 h all groups demonstrated a log count of <2.0. CONCLUSIONS Although the in vitro activity of the tested drugs evaluated by time-kill curves seemed comparable, some pharmacokinetic and pharmacodynamic characteristics of TGA contribute to improving the resolution of the infective process.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Department of Preclinical Science, L.I.T.A. Vialba, Milan, Italy.
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Drago L, Fassina MC, De Vecchi E, Mombelli B, Lombardi A, Gismondo MR. Lack of in vitro and in vivo selection of bacterial resistance by roxithromycin. Chemotherapy 2000; 46:160-5. [PMID: 10765029 DOI: 10.1159/000007272] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The in vitro and in vivo selective pressure exerted by roxithromycin on Lancefield group A beta-haemolytic streptococci (GABHS) was investigated. In vitro antimicrobial activity on fifty GABHS strains was determined by the microdilution method and by boundary concentration (BC) determination. Insorgence of resistance was evaluated by redetermining MIC and BC after exposure to 16 x MIC roxithromycin concentration. In vivo insorgence of resistance was evaluated by MIC and BC determinations on the GABHS strain recovered from infected mice peritoneum, after treatment with 20 mg/kg roxithromycin. The roxithromycin serum kinetics was established in healthy and infected mice. Neither significant changes in GABHS MIC or BC after in vitro or in vivo exposure to roxithromycin nor a difference in roxithromycin serum levels between healthy and infected mice were detected, suggesting that the roxithromycin selection of resistance in GABHS is low.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, LITA, 'L. Sacco' Teaching Hospital, Milan, Italy.
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35
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Drago L, De Vecchi E, Fassina MC, Mombelli B, Gismondo MR. Serum and lung levels of thiamphenicol after administration of its glycinate N-acetylcysteinate ester in experimentally infected guinea pigs. Int J Antimicrob Agents 2000; 13:301-3. [PMID: 10755245 DOI: 10.1016/s0924-8579(99)00130-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 11/18/2022]
Abstract
Thiamphenicol is an analogue of chloramphenicol and is characterised by a broad spectrum of action. In this study, serum and lung levels of thiamphenicol (TAP) were studied in infected guinea pigs after the administration of thiamphenicol glycinate N-acetylcysteinate (TGA). Animals received a single dose of TGA (15 mg/kg, subcutaneously) immediately after intra-tracheal infection with Haemophilus influenzae (about 10(7) CFU/animal). Serum and lung concentrations of TAP were determined at 0, 1, 3, 6, 12 and 24 h after drug administration by means of HPLC. TAP serum levels were elevated at 1 h and remained detectable for 24 h after drug administration. Tissue lung levels were comparable to peak serum concentrations but remained higher and decreased more slowly than serum concentrations.
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Affiliation(s)
- L Drago
- Department of Preclinical Science, L.I.T.A. Vialba, L. Sacco Teaching Hospital, University of Milan, Italy.
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Abstract
There is evidence that the oral consumption of micro-organisms produces a protective effect on the gut flora. A significant number of studies suggests that probiotics might have beneficial effects on several microbial disorders of the gut, but it is very difficult to define the clinical efficacy of such products. In this review, we report the results of studies on traveller's diarrhoea (TD), antibiotic associated diarrhoea (AAD) and acute diarrhoea (AD) in which various probiotic preparations have been used in controlled trials and been shown to have a beneficial therapeutic or prophylactic effect.
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Affiliation(s)
- M R Gismondo
- Clinical Microbiology Laboratory, L. Sacco Teaching Hospital, University of Milan, Italy.
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37
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Drago L, Mombelli B, Ciardo G, De Vecchi E, Gismondo MR. Effects of three different fish oil formulations on Helicobacter pylori growth and viability: in vitro study. J Chemother 1999; 11:207-10. [PMID: 10435683 DOI: 10.1179/joc.1999.11.3.207] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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: 10/31/2022]
Abstract
Helicobacter pylori infection is currently treated with antimicrobial agents in combination with antacids. Recent studies have described the in vitro bactericidal activity of fish oils and polyunsaturated fatty acids on H. pylori, and reduced rates of duodenal ulcer in people with high intake of these substances. In this study we have tested the in vitro activity of three different fish oil formulations on H. pylori strains using the Kirby Bauer method and an in vitro antibacterial test on bacteria adhered to cellular monolayers. Our results demonstrate that one of the oils is active. In this study we cannot speculate on which component of the active oil is effective and its mechanism of action, but we hypothesize that a higher concentration of icosapentaenoic acid and docosahexaenoic acid occurs in the active oil. Further in vitro and in vivo studies are needed before proposing fish oils as treatment of H. pylori infection.
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Affiliation(s)
- L Drago
- L. Sacco Teaching Hospital, University of Milan, Milano, Italy.
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38
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Rüsch-Gerdes S, Domehl C, Nardi G, Gismondo MR, Welscher HM, Pfyffer GE. Multicenter evaluation of the mycobacteria growth indicator tube for testing susceptibility of Mycobacterium tuberculosis to first-line drugs. J Clin Microbiol 1999; 37:45-8. [PMID: 9854062 PMCID: PMC84164 DOI: 10.1128/jcm.37.1.45-48.1999] [Citation(s) in RCA: 71] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In a multicenter study involving three reference centers for mycobacteria, the reliability of the Mycobacteria Growth Indicator Tube (MGIT) for rapid antimicrobial susceptibility testing (AST) of Mycobacterium tuberculosis was evaluated and compared to the radiometric method (BACTEC 460TB). Test cultures for which the results of the MGIT and BACTEC 460TB tests were discordant were checked by the conventional proportion method on solid medium. Four hundred forty-one isolates have been tested for susceptibility to isoniazid (INH), rifampin (RMP), ethambutol (EMB), and streptomycin (SM). Discrepant results were obtained for three isolates (0.7%) with INH (susceptible by MGIT, resistant by BACTEC 460TB), for four isolates (0.9%) with RMP (susceptible by MGIT, resistant by BACTEC 460TB), for six isolates (1.9%) with EMB (four susceptible by MGIT, resistant by BACTEC 460TB; two resistant by MGIT, susceptible by BACTEC 460TB), and for four isolates (0.9%) with SM (two susceptible by MGIT, resistant by BACTEC 460TB; two resistant by MGIT, susceptible by BACTEC 460TB). When cultures with discordant results were tested by the conventional proportion method, about half of the cultures yielded results similar to the BACTEC 460TB results, while the other half yielded results similar to the MGIT results. Turnaround times were 3 to 14 days (median, 8.8 days) for MGIT and 3 to 15 days (median, 7.8 days) for BACTEC 460TB. There was no statistically significant difference between the susceptibility testing results of the two methods (P > 0.05). These data demonstrate that the MGIT system is an accurate, nonradiometric alternative to the BACTEC 460TB method for rapid susceptibility testing of M. tuberculosis.
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Affiliation(s)
- S Rüsch-Gerdes
- National Reference Center for Mycobacteria, Forschungszentrum Borstel, D-23845 Borstel, Germany.
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39
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Abstract
Glutamine represents the principal metabolic substrate for all rapidly proliferating cells. Since part of the glutamine efficacy could be related to immunoregulating properties, we assessed the effects of orally administered glutamine on serum interleukin-2 (IL-2) levels and intestinal T-cell populations in 48 athymic (nude) mice. Twenty-four mice received a standard diet enriched by glutamine (added to drinking water at a 4% concentration), while the other 24 served as the control group and received the same diet without glutamine. In glutamine-fed animals, we observed a marked increase in IL-2 concentrations after 10 days of treatment in comparison with control group and a modest but significant increase in intestinal T-cell counts. These results suggest that oral glutamine is able to exert local and systemic immunostimulating activity that could be of relevance in the prevention of gut integrity and immune defense loss associated, for example, with trauma, surgery, and starvation.
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Affiliation(s)
- M R Gismondo
- Clinical Microbiology Lab, L. Sacco Teaching Hospital, University of Milan, Italy
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40
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Marchisio P, Esposito S, Zanchetta N, Tornaghi R, Gismondo MR, Principi N. Effect of superimposed infections on viral replication in human immunodeficiency virus type 1-infected children. Pediatr Infect Dis J 1998; 17:755-7. [PMID: 9726356 DOI: 10.1097/00006454-199808000-00020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- P Marchisio
- Pediatric Department 4, University of Milan Medical School, Italy.
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41
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Abstract
Helicobacter pylori is the causative agent of gastritis and a co-agent in other gastroduodenal diseases. Gastroduodenal ulcer and MALT-lymphoma in particular, regress when patients are administered antimicrobial agents to eradicate infection. Sometimes eradication is not definitive and is difficult to check. The aim of our study was to test the antimicrobial activity of omeprazole on H. pylori in comparison with ampicillin and other anti-H2 drugs (ranitidine and famotidine), and to evaluate their interference with bacterial adhesion of H. pylori. We also compared results of the agar dilution antibacterial sensitivity test on H. pylori to those obtained using a bacteria adherence to cell monolayers model, to see if drug activity was different against adhered bacteria. We evaluated omeprazole and ampicillin MIC90s (minimum inhibitory concentrations) against 20 H. pylori isolates by traditional agar dilution method and by exposing previously adhered bacteria to an Hep-2 monolayer to different drug concentrations. The activity against bacteria adhered to cell lines was evaluated by counting viable adhered bacteria after 1, 6, 12 hours of contact with drug. Interference with adherence to Hep-2 cells was also tested. Omeprazole and ampicillin MICs were comparable to other findings (omeprazole MIC90 was 12.5 microg/ml and ampicillin MIC90 was 0.016 microg/ml), while higher concentrations were necessary (4 x MIC90) against adhered bacteria. These findings suggest that MICs evaluated with traditional assays can have different predictivity than tests on adhered H. pylori.
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Affiliation(s)
- M R Gismondo
- L. Sacco Teaching Hospital-University of Milan, Milano, Italy
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Tortoli E, Cichero P, Chirillo MG, Gismondo MR, Bono L, Gesu G, Simonetti MT, Volpe G, Nardi G, Marone P. Multicenter comparison of ESP Culture System II with BACTEC 460TB and with Lowenstein-Jensen medium for recovery of mycobacteria from different clinical specimens, including blood. J Clin Microbiol 1998; 36:1378-81. [PMID: 9574709 PMCID: PMC104832 DOI: 10.1128/jcm.36.5.1378-1381.1998] [Citation(s) in RCA: 50] [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: 02/07/2023] Open
Abstract
The recently developed ESP Culture System II (AccuMed, Chicago, Ill.) was compared with radiometric BACTEC 460TB (Becton Dickinson, Towson, Md.) and with Lowenstein-Jensen medium for recovery of mycobacteria from over 2,500 clinical specimens both of respiratory and nonrespiratory origin, including blood. The majority of the 219 mycobacterial isolates (129) belonged to the Mycobacterium tuberculosis complex, followed by 37 isolates of the Mycobacterium avium complex (MAC) and 53 isolates of eight other mycobacterial species. Rates of recovery obtained with BACTEC, ESP, and Lowenstein-Jensen medium were 89, 79, and 64%, respectively, with such differences being statistically significant. Different media and systems appeared to behave differently when the more frequently detected organisms were considered: M. tuberculosis complex isolates grew better with BACTEC, and MAC isolates grew better with ESP. An analysis of the combinations of Lowenstein-Jensen medium with BACTEC and with ESP did not reveal significant differences in recovery rates. With regard to the times needed for the detection of positive cultures, they were significantly longer on Lowenstein-Jensen medium (average, 28 days) than with the remaining two systems, between which there was no difference (average, 18 days). We conclude, therefore, that the ESP system, when used in combination with a solid medium, performs as well as the thoroughly validated radiometric BACTEC system and offers the advantages of full automation and absence of radioisotopes.
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Affiliation(s)
- E Tortoli
- Laboratorio di Microbiologia e Virologia, Ospedale di Careggi, Florence, Italy.
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Rosina M, Ragni MC, Drago L, Gismondo MR. [Lights and shadows on the molecular diagnosis of hepatitis C]. Recenti Prog Med 1998; 89:258-64. [PMID: 9676135] [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: 02/08/2023]
Abstract
The rational application of molecular biology to clinical diagnostics must take in consideration the economic demands, as the waste of sophisticated and expensive assays is of no use for the physician prescribing the assays and burdensome for the individual or the community paying them. Sometimes it is useless to apply to the molecular biology, and the information obtainable through serology answer our demands. This brief survey of the principal means available today for Hepatitis C diagnosis and monitoring, besides summarising the principles on which the different techniques are based, wants to underline the most noteworthy aspects of the different assays--from general indication to specific application to a single case--in the attempt to improve the efficacy of the test, which may be the right one at the right moment. There are qualitative and quantitative methods for viremia determination, which not always are alternative; on the contrary they must sometimes be complementary in order to obtain a complete clinical pattern. As a matter of fact the clinician should choose according to protocol susceptibility and considering what the expected viremia could be. The risk of false negatives is very dreadful for the clinician, as that of false positives (from contamination) is threatening for the laboratory, which must carry out more work than its capabilities consent. One must not misuse these diagnostic means, but they must be used correctly in order not to transform an important service into a harmful inefficiency with unpleasant consequences both for the physician and the patient.
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Affiliation(s)
- M Rosina
- Laboratorio di Microbiologia Clinica, Università, Ospedale Sacco, Milano
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Drago L, De Vecchi E, Fassina MC, Gismondo MR. Serum and bone concentrations of teicoplanin and vancomycin: study in an animal model. Drugs Exp Clin Res 1998; 24:185-90. [PMID: 10051964] [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: 04/12/2023]
Abstract
Teicoplanin and vancomycin are antibiotics widely used in the therapy of bone and joint infections. The aim of this study was to compare bone and serum concentrations of each antibiotic in guinea pigs after administration of 50 mg/kg of teicoplanin or vancomycin by the intravenous route. Serum and bone concentrations were determined immediately before and 0.5, 1, 2, 6, 12 and 24 h after drug administration by means of high performance liquid chromatography. Teicoplanin concentrations were always higher than vancomycin levels. Area under the concentration/time curve was significantly greater for teicoplanin than for vancomycin. In bone, teicoplanin concentration increased up to 6 h, while vancomycin reached its peak after 2 h. Moreover, teicoplanin showed markedly higher levels at 6, 12 and 24 h than vancomycin. In conclusion, the ability of teicoplanin to penetrate bone in greater amount than vancomycin confirms the potential use of teicoplanin in the treatment of bone infections and in the prophylaxis of orthopedic surgery.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, L.I.T.A., L. Sacco Teaching Hospital, University of Milan, Italy
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Abstract
The development of in vitro experimental chemotherapy against P.carinii has been hindered by the lack of efficient methods for continuous cultivation of the microorganism. Various short-term systems, allowing the production of infectious forms of Pneumocystis, can be employed for in vitro experimental chemotherapy. The purpose of the present study is to describe a statistically relevant algorithmic model for the evaluation of P.carinii in short-term in vitro culture and drug screening.
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Affiliation(s)
- C Atzori
- II Div. Inf. Dis., L. Sacco Hosp. Milan, Italy
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Drago L, Gismondo MR, Lombardi A, de Haën C, Gozzini L. Inhibition of in vitro growth of enteropathogens by new Lactobacillus isolates of human intestinal origin. FEMS Microbiol Lett 1997; 153:455-63. [PMID: 9271875 DOI: 10.1111/j.1574-6968.1997.tb12610.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.6] [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: 02/05/2023] Open
Abstract
Three human Lactobacillus strains, coded B21060, B21070 and B21190, have recently been isolated. The strains show a series of features (acid and bile resistance, adhesion to various types of mucosal cell) which make them particularly promising for the preparation of probiotic products. In the present study, the ability of the strains to inhibit the growth of pathogens in coculture was investigated. Lactobacilli were incubated simultaneously or after one overnight growth with enterotoxigenic Escherichia coli, Salmonella enteritidis or Vibrio cholerae. After 24 and 48 h, bacterial counts of the pathogens and of the lactobacilli were performed. The results showed that these Lactobacillus strains inhibited the in vitro growth of E. coli and S. enteritidis under both conditions. Moreover, a cumulative effect was observed for mixtures of lactobacilli. In contrast, no significant inhibition of Vibrio cholerae growth was observed, provided that the pH of the medium was kept constant. The presence of the pathogens did not affect the growth of the Lactobacillus strains. Moreover, each of the Lactobacillus strains showed coaggregation ability with two pathogenic E. coli strains, namely ATCC 25922 and ATCC 35401.
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Affiliation(s)
- L Drago
- Chair of Clinical Microbiology, L. Sacco Teaching Hospital, Milan, Italy
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Gismondo MR, Drago L, Lombardi A, Fassina C, Cesana M. Impact of rufloxacin and ciprofloxacin on the intestinal microflora in a germ-free mice model. Chemotherapy 1995; 41:281-8. [PMID: 7555209 DOI: 10.1159/000239357] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [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: 01/25/2023]
Abstract
The impact of rufloxacin and ciprofloxacin on faecal microflora was investigated in an experimental germ-free mice model into which human gastrointestinal flora was introduced and stabilized. Animals received oral doses of 10, 40 or 80 mg rufloxacin/kg, 30 or 60 mg ciprofloxacin/kg once daily for 10 days, or no treatment. Microflora was studied before, during and 1 week after treatment. No significant effect ( < 2 log reduction, p > 0.05) on aerobic microflora was observed after rufloxacin as compared to controls, except for a marked decrease in enterobacteria and a slight decrease in enterococci, staphylococci and anaerobes at the highest dose. Both doses of ciprofloxacin significantly reduced enterobacteria and clostridia, while the lower dose slightly reduced peptococci, bifidobacteria and eubacteria. The depression of the intestinal ecosystem was reversible, except for enterobacteria at the higher ciprofloxacin dose. No bacterial resistance was detected after either treatment.
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Affiliation(s)
- M R Gismondo
- Institute of Medical Microbiology, University of Milan, Italy
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48
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Gismondo MR, Drago L, Lombardi A, Fassina MC, Mombelli B. [Antimicrobial and sporicidal efficacy of various disinfectant solutions]. Minerva Med 1995; 86:21-32. [PMID: 7753434] [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: 01/26/2023]
Abstract
The often indiscriminate use of antimicrobial agents has led to increased bacterial resistance over the past years. This phenomenon is above all evident in nosocomial environments but also at a community level. It is therefore important that, in addition to the rational use of antibiotics, an accurate prophylaxis is performed which includes the correct use of disinfectants. This study examines the antimicrobial activity of various commercially available disinfectant solutions consisting of one or more active ingredients. An analysis of the results reveals that products consisting of an association of individual components (quaternary ammonium chloride with o-phenylphenol and/or isopropyl alcohol; chlorhexidine with benzalkonium chloride or with diazolidinylurea and isopropanol) demonstrate a greater efficacy in terms of microbicidal concentration and contact times.
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Affiliation(s)
- M R Gismondo
- Facoltà di Medicina e Chirurgia, Cattedra di Microbiologia Clinica, Università degli Studi, Milano
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Abstract
In our study we considered the possible interference of cefetamet-pivoxil with the intestinal microflora. We used 60 germ-free mice in which an intestinal microflora similar to the human one had been implanted. They were treated with 14.3 mg/Kg/die (standard dose) and a 28.6 mg/kg/die (daily dose) of cefetamet-pivoxil by oral route. The results obtained in vivo proved that cefetamet-pivoxil at therapeutic doses does not influence the normal intestinal microflora.
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Affiliation(s)
- M R Gismondo
- Institute of Medical Microbiology, University of Milan, Italy
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50
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Abstract
The aim of our study was to evaluate the interference of fosfomycin trometanol (F.T.), at subinhibitory concentrations (1/4 and 1/8 MICs), on some urovirulence factors of Escherichia coli (12 strains). We tested fimbriae production, adhesion to uroepithelial cells, hydrophobicity, motility and hemolysin production of E. coli grown in the presence or absence of F.T. The strains tested, grown in the presence of F.T. (1/8 MIC), were less capable of adhering to uroepithelial cells, had less hemagglutination and reduced motility. This behavior was enhanced at 1/4 MIC of F.T. The hemolysin production and hydrophobicity properties present in some of our tested strains also were significantly decreased when the E. coli were grown in the presence of sub-MIC concentrations of F.T. These results suggest that F.T. may be of clinical use as treatment for acute urinary tract infection and in pyelonephritis prophylaxis.
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