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Oliva A, Volpicelli L, Di Bari S, Curtolo A, Borrazzo C, Cogliati Dezza F, Cona A, Agrenzano S, Mularoni A, Trancassini M, Mengoni F, Stefani S, Raponi G, Venditti M. Effect of ceftazidime/avibactam plus fosfomycin combination on 30 day mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae: results from a multicentre retrospective study. JAC Antimicrob Resist 2022; 4:dlac121. [PMID: 36506890 PMCID: PMC9728520 DOI: 10.1093/jacamr/dlac121] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 11/05/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction The primary outcome of the study was to evaluate the effect on 30 day mortality of the combination ceftazidime/avibactam + fosfomycin in the treatment of bloodstream infections (BSIs) caused by KPC-producing Klebsiella pneumoniae (KPC-Kp). Materials and methods From October 2018 to March 2021, a retrospective, two-centre study was performed on patients with KPC-Kp BSI hospitalized at Sapienza University (Rome) and ISMETT-IRCCS (Palermo) and treated with ceftazidime/avibactam-containing regimens. A matched cohort (1:1) analysis was performed. Cases were patients receiving ceftazidime/avibactam + fosfomycin and controls were patients receiving ceftazidime/avibactam alone or in combination with in vitro non-active drugs different from fosfomycin (ceftazidime/avibactam ± other). Patients were matched for age, Charlson comorbidity index, ward of isolation (ICU or non-ICU), source of infection and severity of BSI, expressed as INCREMENT carbapenemase-producing Enterobacteriaceae (CPE) score. Results Overall, 221 patients were included in the study. Following the 1:1 match, 122 subjects were retrieved: 61 cases (ceftazidime/avibactam + fosfomycin) and 61 controls (ceftazidime/avibactam ± other). No difference in overall mortality emerged between cases and controls, whereas controls had more non-BSI KPC-Kp infections and a higher number of deaths attributable to secondary infections. Almost half of ceftazidime/avibactam + fosfomycin patients were prescribed fosfomycin without MIC fosfomycin availability. No difference in the outcome emerged after stratification for fosfomycin susceptibility availability and dosage. SARS-CoV-2 infection and ICS ≥ 8 independently predicted 30 day mortality, whereas an appropriate definitive therapy was protective. Conclusions Our data show that fosfomycin was used in the treatment of KPC-Kp BSI independently from having its susceptibility testing available. Although no difference was found in 30 day overall mortality, ceftazidime/avibactam + fosfomycin was associated with a lower rate of subsequent KPC-Kp infections and secondary infections than other ceftazidime/avibactam-based regimens.
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Affiliation(s)
- A Oliva
- Corresponding author. E-mail:
| | | | - S Di Bari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - A Curtolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - C Borrazzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - F Cogliati Dezza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - A Cona
- Unit of Infectious Diseases, ISMETT-IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Via E. Tricomi, 5, Palermo 90127, Italy
| | - S Agrenzano
- Unit of Infectious Diseases, ISMETT-IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Via E. Tricomi, 5, Palermo 90127, Italy
| | - A Mularoni
- Unit of Infectious Diseases, ISMETT-IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Via E. Tricomi, 5, Palermo 90127, Italy
| | - M Trancassini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - F Mengoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - S Stefani
- Department of Biomedical and Biotechnological Sciences. Policlinico Hospital, University of Catania, Via Androne 81, Catania 95124, Italy
| | - G Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185, Italy
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Bibbolino G, Di Lella FM, Oliva A, Lichtner M, Del Borgo C, Raponi G, Trancassini M, Mengoni F, Arcari G, Antonelli G, Carattoli A. Molecular epidemiology of NDM-5-producing Escherichia coli high-risk clones identified in two Italian hospitals in 2017-2019. Diagn Microbiol Infect Dis 2021; 100:115399. [PMID: 34030105 DOI: 10.1016/j.diagmicrobio.2021.115399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/09/2021] [Accepted: 04/12/2021] [Indexed: 01/01/2023]
Abstract
Between November 2018 and October 2019, carbapenem-resistant Enterobacterales carrying New Delhi Metallo-β-lactamase (NDM) caused one of the largest and persistent outbreaks occurred in Italy and intensified surveillance measures have been taken in all Italian hospitals. In this study we analyzed NDM-5- producing Escherichia coli identified in 2 hospitals of the Lazio region in Italy. Epidemiological and microbiological data demonstrated that in 2018-2019 the NDM-5-producing high-risk E. coli ST167 clone circulated in patients from both hospitals. In 2019, another NDM-5-producing E. coli clone, identified by MLST as ST617 was introduced in one of the 2 hospitals and caused an outbreak. This study describes an application of genomics as a useful method to discern endemic and outbreak clones when applied to strains of the same species (E. coli) with the same resistance determinant (NDM-5) and the relevance of screening patients admitted in critical units for carbapenemase producers to prevent outbreaks.
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Affiliation(s)
- Giulia Bibbolino
- Dept. Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | | | - Alessandra Oliva
- Dept. of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Miriam Lichtner
- Dept. of Public Health and Infectious Diseases, Sapienza University of Rome, Infectious Disease Unit, SM Goretti Hospital, Latina, Italy
| | | | - Giammarco Raponi
- Dept. of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Maria Trancassini
- Dept. of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Fabio Mengoni
- Dept. of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Gabriele Arcari
- Dept. Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Guido Antonelli
- Dept. Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Bitossi C, Frasca F, Viscido A, Oliveto G, Scordio M, Belloni L, Cimino G, Pietropaolo V, Gentile M, d’Ettorre G, Midulla F, Trancassini M, Antonelli G, Pierangeli A, Scagnolari C. SARS-CoV-2 Entry Genes Expression in Relation with Interferon Response in Cystic Fibrosis Patients. Microorganisms 2021; 9:microorganisms9010093. [PMID: 33401565 PMCID: PMC7824643 DOI: 10.3390/microorganisms9010093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 01/14/2023] Open
Abstract
The expression rate of SARS-CoV-2 entry genes, angiotensin-converting enzyme 2 (ACE2), the main viral receptor and the proteases, furin and transmembrane serine protease 2 (TMPRSS2) in cystic fibrosis (CF) individuals is poorly known. Hence, we examined their levels in upper respiratory samples of CF patients (n = 46) and healthy controls (n = 45). Moreover, we sought to understand the interplay of type I interferon (IFN-I) with ACE2, furin and TMPRSS2 by evaluating their gene expression with respect to ISG15, a well-known marker of IFN activation, in upper respiratory samples and after ex vivo IFNβ exposure. Lower ACE2 levels and trends toward the reduction of furin and TMPRSS2 were found in CF patients compared with the healthy controls; decreased ACE2 amounts were also detected in CF individuals with pancreatic insufficiency and in those receiving inhaled antibiotics. Moreover, there was a strong positive correlation between ISG15 and ACE2 levels. However, after ex vivo IFNβ stimulation of nasopharyngeal cells, the truncated isoform (dACE2), recently demonstrated as the IFN stimulated one with respect to the full-length isoform (flACE2), slightly augmented in cells from CF patients whereas in those from healthy donors, dACE2 levels showed variable levels of upregulation. An altered expression of SARS-COV-2 entry genes and a poor responsiveness of dACE2 to IFN-I stimulation might be crucial in the diffusion of SARS-CoV-2 infection in CF.
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Affiliation(s)
- Camilla Bitossi
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia, Sapienza University, 00161 Rome, Italy; (C.B.); (F.F.); (A.V.); (G.O.); (M.S.); (M.G.); (G.A.); (A.P.)
| | - Federica Frasca
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia, Sapienza University, 00161 Rome, Italy; (C.B.); (F.F.); (A.V.); (G.O.); (M.S.); (M.G.); (G.A.); (A.P.)
| | - Agnese Viscido
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia, Sapienza University, 00161 Rome, Italy; (C.B.); (F.F.); (A.V.); (G.O.); (M.S.); (M.G.); (G.A.); (A.P.)
| | - Giuseppe Oliveto
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia, Sapienza University, 00161 Rome, Italy; (C.B.); (F.F.); (A.V.); (G.O.); (M.S.); (M.G.); (G.A.); (A.P.)
| | - Mirko Scordio
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia, Sapienza University, 00161 Rome, Italy; (C.B.); (F.F.); (A.V.); (G.O.); (M.S.); (M.G.); (G.A.); (A.P.)
| | - Laura Belloni
- Department of Internal Medicine, Sapienza University, 00161 Rome, Italy;
| | - Giuseppe Cimino
- Lazio Reference Center for Cystic Fibrosis, Policlinico Umberto I University Hospital, Sapienza University, 00161 Rome, Italy;
| | - Valeria Pietropaolo
- Department of Public Health and Infectious Diseases, Sapienza University, 00161 Rome, Italy; (V.P.); (G.d.); (M.T.)
- Microbiology and Virology Unit, Policlinico Umberto I University Hospital, Sapienza University, 00161 Rome, Italy
| | - Massimo Gentile
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia, Sapienza University, 00161 Rome, Italy; (C.B.); (F.F.); (A.V.); (G.O.); (M.S.); (M.G.); (G.A.); (A.P.)
- Microbiology and Virology Unit, Policlinico Umberto I University Hospital, Sapienza University, 00161 Rome, Italy
| | - Gabriella d’Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University, 00161 Rome, Italy; (V.P.); (G.d.); (M.T.)
| | - Fabio Midulla
- Department of Maternal Science, Sapienza University of Rome, 00161 Rome, Italy;
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Sapienza University, 00161 Rome, Italy; (V.P.); (G.d.); (M.T.)
- Microbiology and Virology Unit, Policlinico Umberto I University Hospital, Sapienza University, 00161 Rome, Italy
| | - Guido Antonelli
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia, Sapienza University, 00161 Rome, Italy; (C.B.); (F.F.); (A.V.); (G.O.); (M.S.); (M.G.); (G.A.); (A.P.)
- Microbiology and Virology Unit, Policlinico Umberto I University Hospital, Sapienza University, 00161 Rome, Italy
| | - Alessandra Pierangeli
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia, Sapienza University, 00161 Rome, Italy; (C.B.); (F.F.); (A.V.); (G.O.); (M.S.); (M.G.); (G.A.); (A.P.)
| | - Carolina Scagnolari
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia, Sapienza University, 00161 Rome, Italy; (C.B.); (F.F.); (A.V.); (G.O.); (M.S.); (M.G.); (G.A.); (A.P.)
- Correspondence:
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Arcari G, Raponi G, Sacco F, Bibbolino G, Di Lella FM, Alessandri F, Coletti M, Trancassini M, Deales A, Pugliese F, Antonelli G, Carattoli A. Klebsiella pneumoniae infections in COVID-19 patients: a 2-month retrospective analysis in an Italian hospital. Int J Antimicrob Agents 2020; 57:106245. [PMID: 33253903 PMCID: PMC7691820 DOI: 10.1016/j.ijantimicag.2020.106245] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/04/2020] [Accepted: 11/07/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Gabriele Arcari
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy
| | - Federica Sacco
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giulia Bibbolino
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | | | - Francesco Alessandri
- Sapienza University of Rome, Department of Anesthesia and Critical Care Medicine, Policlinico Umberto I, Rome, Italy
| | - Monica Coletti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy
| | - Alberto Deales
- Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy
| | - Francesco Pugliese
- Sapienza University of Rome, Department of Anesthesia and Critical Care Medicine, Policlinico Umberto I, Rome, Italy
| | - Guido Antonelli
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy; Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy.
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Scagnolari C, Bitossi C, Frasca F, Viscido A, Brazzini G, Trancassini M, Pietropaolo V, Midulla F, Cimino G, Palange P, Pierangeli A, Antonelli G. Differential toll like receptor expression in cystic fibrosis patients' airways during rhinovirus infection. J Infect 2020; 81:726-735. [PMID: 32712204 DOI: 10.1016/j.jinf.2020.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/27/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Since an inappropriate and sustained activation of TLRs may contribute to a chronic inflammatory response resulting in detrimental effects in cystic fibrosis (CF) patients, we sought to examine whether HRV infection might alter the respiratory expression of TLRs according to the microbiological status of CF patients. METHODS Respiratory samples were collected from the respiratory tract of CF patients (n = 294) over a period of 12 months. In addition to the usual microbiological investigation, HRV-RNA detection and typing were performed by RT-PCR and sequencing. HRV viral load and TLRs levels were measured by RT-Real Time PCR. RESULTS HRV-RNA was detected in 80 out of 515 respiratory samples (15.5%) with a similar rate in all age groups (0-10 years, 11-24 years, ≥ 25 years). Patients infected with different HRV A, B and C species exhibited higher levels of TLR2, TLR4 and TLR8 as compared to HRV negative patients. Moreover, the expression level of TLR2, TLR4 and TLR8 correlated with high level of HRV viral load. HRV positive patients co-colonized by Staphylococcus aureus or Pseudomonas aeruginosa showed also enhanced amounts of TLR2 and TLR2/4-mRNAs expression respectively. In the case of presence of both bacteria, TLR2, TLR4, TLR8 and TLR9 levels are elevated in positive HRV patients. CONCLUSIONS TLRs, especially TLR2 and TLR4, increased in HRV positive CF individuals and varies according to the presence of S. aureus, P. aeruginosa and both bacteria.
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Affiliation(s)
- Carolina Scagnolari
- Virology Laboratory, Department of Molecular Medicine, Affiliated to Pasteur Institute Italy, Cenci Bolognetti Foundation, Sapienza University, Viale di Porta Tiburtina, 28, 00185 Rome, Italy.
| | - Camilla Bitossi
- Virology Laboratory, Department of Molecular Medicine, Affiliated to Pasteur Institute Italy, Cenci Bolognetti Foundation, Sapienza University, Viale di Porta Tiburtina, 28, 00185 Rome, Italy
| | - Federica Frasca
- Virology Laboratory, Department of Molecular Medicine, Affiliated to Pasteur Institute Italy, Cenci Bolognetti Foundation, Sapienza University, Viale di Porta Tiburtina, 28, 00185 Rome, Italy
| | - Agnese Viscido
- Virology Laboratory, Department of Molecular Medicine, Affiliated to Pasteur Institute Italy, Cenci Bolognetti Foundation, Sapienza University, Viale di Porta Tiburtina, 28, 00185 Rome, Italy
| | - Gabriele Brazzini
- Virology Laboratory, Department of Molecular Medicine, Affiliated to Pasteur Institute Italy, Cenci Bolognetti Foundation, Sapienza University, Viale di Porta Tiburtina, 28, 00185 Rome, Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Valeria Pietropaolo
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Fabio Midulla
- Department of Pediatrics, Policlinico Umberto I University Hospital, Sapienza University, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Giuseppe Cimino
- Lazio Reference Center for Cystic Fibrosis, Policlinico Umberto I University Hospital, Sapienza University, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Alessandra Pierangeli
- Virology Laboratory, Department of Molecular Medicine, Affiliated to Pasteur Institute Italy, Cenci Bolognetti Foundation, Sapienza University, Viale di Porta Tiburtina, 28, 00185 Rome, Italy
| | - Guido Antonelli
- Virology Laboratory, Department of Molecular Medicine, Affiliated to Pasteur Institute Italy, Cenci Bolognetti Foundation, Sapienza University, Viale di Porta Tiburtina, 28, 00185 Rome, Italy
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Bressan A, Rodio DM, Stangherlin F, Puggioni G, Ambrosi C, Arcari G, Carattoli A, Antonelli G, Pietropaolo V, Trancassini M. In vitro activity of fosfomycin against mucoid and non-mucoid Pseudomonas aeruginosa strains. J Glob Antimicrob Resist 2020; 20:328-331. [PMID: 32105800 DOI: 10.1016/j.jgar.2020.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/31/2020] [Accepted: 02/14/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES Pseudomonas aeruginosa is the most frequent infectious agent in cystic fibrosis patients. P. aeruginosa resistance to first line antibiotics limits therapeutic options, but the therapeutic potential of older generation antibiotics, such as fosfomycin is under investigation. Fosfomycin does not belong to any other antibiotic class and acts by inhibiting the biosynthesis of the bacterial cell wall during the initial phases. A major problem for the use of fosfomycin against P. aeruginosa is the absence of a clinical breakpoint, the last one of 32 μg/mL was proposed in 2013 by the CA-SFM (Comité de l'Antibiogramme de la Société Française de Microbiologie). METHODS Sixty-one strains of P. aeruginosa (thirty mucoid and thirty-one non mucoid) were collected from respiratory samples of cystic fibrosis patients. All isolates were identified by MALDI-TOF (Bruker, Bremen, Germany). Fosfomycin MICs against P. aeruginosa were measured using an automated system and confirmed by the gold standard method. RESULTS There was no significant difference between mucoid and non-mucoid strains. MIC distribution and susceptibility rates were obtained by agar dilution method and from this data we measured MIC50 and MIC90 which were equal to 32 μg/mL and 64 μg/mL, respectively. From automated method results we measured a very major error (VME), major error (ME) and categorical agreement (CA) which were equal to 0%, 11% and 89%, respectively. Comparing automated and agar dilution methods, a Cohen's kappa equal to 73% (0.726) was measured. CONCLUSIONS Our data suggest that fosfomycin has good effect against mucoid and non-mucoid strains of P. aeruginosa and automated systems can be implemented in clinical microbiology laboratories to assess fosfomycin with rapid and reproducible results.
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Affiliation(s)
- A Bressan
- Department of Molecular Medicine, "Sapienza" University Rome, Rome, Italy
| | - D M Rodio
- Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - F Stangherlin
- Department of Clinical Medicine, "Sapienza" University Rome, Rome, Italy
| | - G Puggioni
- Department of Molecular Medicine, "Sapienza" University Rome, Rome, Italy
| | - C Ambrosi
- Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - G Arcari
- Department of Molecular Medicine, "Sapienza" University Rome, Rome, Italy
| | - A Carattoli
- Department of Molecular Medicine, "Sapienza" University Rome, Rome, Italy
| | - G Antonelli
- Department of Molecular Medicine, "Sapienza" University Rome, Rome, Italy
| | - V Pietropaolo
- Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - M Trancassini
- Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy.
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Bonfiglio G, Neroni B, Radocchia G, Pompilio A, Mura F, Trancassini M, Di Bonaventura G, Pantanella F, Schippa S. Growth Control of Adherent-Invasive Escherichia coli (AIEC) by the Predator Bacteria Bdellovibrio bacteriovorus: A New Therapeutic Approach for Crohn's Disease Patients. Microorganisms 2019; 8:microorganisms8010017. [PMID: 31861852 PMCID: PMC7023281 DOI: 10.3390/microorganisms8010017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/05/2019] [Accepted: 12/17/2019] [Indexed: 01/10/2023] Open
Abstract
In Crohn’s disease (CD) patients, intestinal dysbiosis with an overgrowth of Proteobacteria, mainly Escherichia coli, has been reported. A new pathotype of E. coli, the adherent-invasive Escherichia coli strain (AIEC), has been isolated from the mucosae of CD patients. AIEC strains play an important role in CD pathogenesis, increasing intestinal mucosa damage and inflammation. Several studies have been undertaken to find possible strategies/treatments aimed at AIEC strain reduction/elimination from CD patients’ intestinal mucosae. To date, a truly effective strategy against AIEC overgrowth is not yet available, and as such, further investigations are warranted. Bdellovibrio bacteriovorus is a predator bacterium which lives by invading Gram-negative bacteria, and is usually present both in natural and human ecosystems. The aim of this study was to evaluate a novel possible strategy to treat CD patients’ mucosae when colonized by AIEC strains, based on the utilization of the Gram-negative predatory bacteria, B. bacteriovorus. The overall results indicate that B. bacteriovorus is able to interfere with important steps in the dynamics of pathogenicity of AIEC strains by its predatory activity. We indicate, for the first time, the possibility of counteracting AIEC strain overgrowth by exploiting what naturally occurs in microbial ecosystems (i.e., predation).
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Affiliation(s)
- Giulia Bonfiglio
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome, 00185 Roma, Italy; (G.B.); (B.N.); (G.R.); (M.T.); (F.P.)
| | - Bruna Neroni
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome, 00185 Roma, Italy; (G.B.); (B.N.); (G.R.); (M.T.); (F.P.)
| | - Giulia Radocchia
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome, 00185 Roma, Italy; (G.B.); (B.N.); (G.R.); (M.T.); (F.P.)
| | - Arianna Pompilio
- Department of Medical, Oral and Biotechnological Sciences, and Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.P.); (G.D.B.)
| | - Francesco Mura
- Electrical and Energy Engineering, Sapienza Nanoscience & Nanotechnology Laboratories (SNN-Lab), ‘Sapienza’ University of Rome, 00185 Roma, Italy;
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome, 00185 Roma, Italy; (G.B.); (B.N.); (G.R.); (M.T.); (F.P.)
| | - Giovanni Di Bonaventura
- Department of Medical, Oral and Biotechnological Sciences, and Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.P.); (G.D.B.)
| | - Fabrizio Pantanella
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome, 00185 Roma, Italy; (G.B.); (B.N.); (G.R.); (M.T.); (F.P.)
| | - Serena Schippa
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome, 00185 Roma, Italy; (G.B.); (B.N.); (G.R.); (M.T.); (F.P.)
- Correspondence:
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Bruno G, Gagliardi A, Oliva A, Trancassini M, Macone A, Cicerone C, D'Abramo A, Iebba V, Auria S, Bonfiglio G, Zingaropoli MA, D'Ettorre G, Badiali D, Vullo V, Corazziari ES, Schippa S. Fecal Microbial Transplantation impact on gut microbiota composition and metabolome, microbial translocation and T-lymphocyte immune activation in recurrent Clostridium difficile infection patients. New Microbiol 2019; 42:221-224. [PMID: 31609455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
This short communication reports the preliminary results of Fecal Microbial Transplantation (FMT) impact on microbiota, microbial translocation (MT), and immune activation in four recurrent Clostridium difficile infection (R-CDI) patients. After FMT a restore of gut microbiota composition with a significant increase of fecal acetyl-putrescine and spermidine and fecal acetate and butyrate, a decrease of immune activation of T cells CD4+ and CD8+levels, and of LPS binding protein (LBP) level, were observed. Preliminary results indicate that FMT seems to be helpful not only as a CDI radical cure, with an impact on fecal microbiota and metabolome profiles, but also on MT and immune activation.
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Affiliation(s)
- Giovanni Bruno
- Department of Internal Medicine and Medical Specialties, Gastroenterology Unit, Sapienza University of Rome. Italy
| | - Antonella Gagliardi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome. Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome. Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome. Italy
| | - Alberto Macone
- Department of Biochemical Sciences "A.Rossi Fanelli", Sapienza University of Rome, Pizzale Aldo Moro 5, 00185 Rome, Italy
| | - Clelia Cicerone
- Department of Internal Medicine and Medical Specialties, Gastroenterology Unit, Sapienza University of Rome. Italy
| | - Alessandra D'Abramo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome. Italy
| | - Valerio Iebba
- Pasteur Cenci Bolognetti Foundation, Department of Public Health and Infectious Diseases, Sapienza University of Rome. Italy
| | - Stefania Auria
- Department of Internal Medicine and Medical Specialties, Gastroenterology Unit, Sapienza University of Rome. Italy
| | - Giulia Bonfiglio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome. Italy
| | | | - Gabriella D'Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome. Italy
| | - Danilo Badiali
- Department of Internal Medicine and Medical Specialties, Gastroenterology Unit, Sapienza University of Rome. Italy
| | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome. Italy
| | | | - Serena Schippa
- Department of Public Health and Infectious Diseases, Sapienza University of Rome. Italy
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9
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Savi D, Quattrucci S, Trancassini M, Dalmastri C, De Biase RV, Maggisano M, Palange P, Bevivino A. Impact of clonally-related Burkholderia contaminans strains in two patients attending an Italian cystic fibrosis centre: a case report. BMC Pulm Med 2019; 19:164. [PMID: 31464603 PMCID: PMC6714384 DOI: 10.1186/s12890-019-0923-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 08/19/2019] [Indexed: 11/11/2022] Open
Abstract
Background Burkholderia contaminans is one of the 20 closely related bacterial of the Burkholderia cepacia complex, a group of bacteria that are ubiquitous in the environment and capable of infecting people with cystic fibrosis (CF). This species is an emerging pathogen and it has been widely isolated from CF patients in Argentina, Spain, Portugal, Australia, Canada, USA with a low prevalence in Ireland, France, Russia, Switzerland, Czech Republic, and Italy. This is the first report of B. contaminans affecting two Italian CF patients attending the same CF Centre. We correlate B. contaminans colonisation with lung function decline and co-infection with other clinically relevant CF pathogens. Case presentation B. contaminans was identified by Multi Locus Sequence Typing in routine sputum analysis of two Caucasian CF women homozygous for Phe508del CFTR mutation. Sequence Type 102 was detected in both strains. It is known that B. contaminans ST102 was isolated both from CF and non-CF patients, with an intercontinental spread across the world. Random Amplified Polymorphic DNA analysis revealed the genetic relatedness between the two strains. We examined their susceptibility to antimicrobial agents, comparing the latter with that recorded for other B. contaminans isolated from different countries. We also described key virulence factors possibly linked with a clinical outcome. Specifically, we attempted to correlate colonization with the incidence of acute exacerbation of symptoms and lung function decline. Conclusions This case presentation suggests that acquisition of B. contaminans ST102 is not directly associated with a lung function decline. We retain that the presence of other CF pathogens (i.e. MRSA and Trichosporon) along with B. contaminans ST102 might have contributed to the worsening of clinical conditions in our CF patients. The circumstances leading to the establishment of B. contaminans ST102 infections are still unknown. We highlight the importance to proper detect and typing bacteria implicated in CF infection by using molecular techniques.
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Affiliation(s)
- Daniela Savi
- Department of Public Health and Infectious Diseases, Adult Cystic Fibrosis Centre, "Sapienza" University of Rome, V.le Universita' 37, 00185, Rome, Italy. .,Cystic Fibrosis Unit, Bambino Gesù Children's Hospital, Rome, Italy.
| | - Serena Quattrucci
- Dipartimento Materno Infantile e Scienze Urologiche, Sapienza University of Rome, Rome, Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Laboratory of Microbiology, Policlinico Umberto I Hospital, Rome, Italy
| | - Claudia Dalmastri
- Department for Sustainability, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, ENEA C.R Casaccia, 00123, Rome, Italy
| | | | - Marta Maggisano
- Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Adult Cystic Fibrosis Centre, "Sapienza" University of Rome, V.le Universita' 37, 00185, Rome, Italy
| | - Annamaria Bevivino
- Department for Sustainability, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, ENEA C.R Casaccia, 00123, Rome, Italy
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10
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Rodio DM, Bressan A, Ambrosi C, Scribano D, Tolli R, Mansour W, Speziale F, Antonelli G, Trancassini M, Pietropaolo V. Yersinia enterocolitica in Italy: A Case of Septicemia and Abdominal Aortic Aneurysm Infection. Front Med (Lausanne) 2018; 5:156. [PMID: 29881725 PMCID: PMC5978273 DOI: 10.3389/fmed.2018.00156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/04/2018] [Indexed: 11/13/2022] Open
Abstract
We report a case of Yersinia enterocolitica septicemia in a 63-year-old patient admitted to the Vascular Surgery Department of Umberto I Hospital (Rome, Italy) for an abdominal aortic aneurysm. The microorganism, recovered from both peripheral blood cultures and aneurysmatic aortic wall specimens, was identified as Y. enterocolitica using matrix-assisted laser desorption ionization-time of flight analysis (MALDI-TOF MS) and 16S rDNA gene sequencing. The isolate responsible for septicemia belonged to the O:9 serotype (biogroup 2). A genetic screening of the isolate made it possible to detect the presence of both the yst and ail genes, encoding a heat-stable enterotoxin and a protein involved in invasion/adherence and serum resistance, respectively. Our case contributes in enriching epidemiological data concerning Y. enterocolitica infections, which might represent severe complications in patients suffering from cardiovascular diseases. Moreover, this study, together with the others, should be regarded as valuable and useful tools for monitoring the rate of infections worldwide.
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Affiliation(s)
- Donatella M. Rodio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alessia Bressan
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Cecilia Ambrosi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Dani Di Giò Foundation–Onlus, Rome, Italy
| | - Daniela Scribano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Rita Tolli
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana Mariano Aleandri, Rome, Italy
| | - Wassim Mansour
- Vascular and Endovascular Surgery Division, Department of Surgery Paride Stefanini, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Francesco Speziale
- Vascular and Endovascular Surgery Division, Department of Surgery Paride Stefanini, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Guido Antonelli
- Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Valeria Pietropaolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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11
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Prezioso C, Scribano D, Rodio DM, Ambrosi C, Trancassini M, Palamara AT, Pietropaolo V. COS-7-based model: methodological approach to study John Cunningham virus replication cycle. Virol J 2018; 15:29. [PMID: 29402297 PMCID: PMC5799914 DOI: 10.1186/s12985-018-0939-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 01/23/2018] [Indexed: 11/26/2022] Open
Abstract
John Cunningham virus (JCV) is a human neurotropic polyomavirus whose replication in the Central Nervous System (SNC) induces the fatal demyelinating disease, progressive multifocal leukoencephalopathy (PML). JCV propagation and PML investigation have been severely hampered by the lack of an animal model and cell culture systems to propagate JCV have been very limited in their availability and robustness. We previously confirmed that JCV CY strain efficiently replicated in COS-7 cells as demonstrated by the progressive increase of viral load by quantitative PCR (Q-PCR) during the time of transfection and that archetypal regulatory structure was maintained, although two characteristic point mutations were detected during the viral cycle. This short report is an important extension of our previous efforts in defining our reliable model culture system able to support a productive JCV infection. Supernatants collected from transfected cells have been used to infect freshly seeded COS-7 cell line. An infectious viral progeny was obtained as confirmed by Western blot and immunofluorescence assay. During infection, the archetype regulatory region was conserved. Importantly, in this study we developed an improved culture system to obtain a large scale production of JC virus in order to study the genetic features, the biology and the pathogenic mechanisms of JC virus that induce PML.
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Affiliation(s)
- C Prezioso
- Department of Public Health and Infectous Diseases, Sapienza University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy
| | - D Scribano
- Department of Public Health and Infectous Diseases, Sapienza University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy.,Department of Experimental and Clinical Sciences, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - D M Rodio
- Department of Public Health and Infectous Diseases, Sapienza University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy
| | - C Ambrosi
- Department of Public Health and Infectous Diseases, Sapienza University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy.,Dani Di Giò Foundation-Onlus, Rome, Italy
| | - M Trancassini
- Department of Public Health and Infectous Diseases, Sapienza University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy
| | - A T Palamara
- Department of Public Health and Infectious Diseases, Institute Pasteur, Cenci-Bolognetti Foundation, "Sapienza" University of Rome, Rome, Italy.,San Raffaele Pisana Scientific Institute for Research, Hospitalization and Health Care, Rome, Italy
| | - V Pietropaolo
- Department of Public Health and Infectous Diseases, Sapienza University of Rome, P.le Aldo Moro, 5, 00185, Rome, Italy.
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12
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Sauzullo I, Rodio DM, Facchinetti S, Puggioni G, De Angelis M, Goldoni P, Vullo V, Mengoni F, Trancassini M, Pietropaolo V. Diagnostic accuracy of Xpert MTB/RIF versus smear microscopy in the early diagnosis tuberculosis in the real life of "Umberto I" Hospital Rome. New Microbiol 2016; 39:304-306. [PMID: 27551727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023]
Abstract
Early diagnosis of tuberculosis (TB) is one of the primary challenges in curtailing the spread of TB. This study aimed to determine the diagnostic accuracy of Xpert MTB/RIF for the identification of M. tuberculosis in clinical specimens, and compare this to a microscopist's diagnostic performance. Xpert MTB/ RIF was positive in all specimens with culture-confirmed TB, giving a higher sensitivity than the smear microscopy (100% versus 63%). The use of the Xpert MTB/RIF, as part of routine assay, permits rapid diagnosis of TB and enables clinicians to start an effective treatment.
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Affiliation(s)
- Ilaria Sauzullo
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Donatella Maria Rodio
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Samantha Facchinetti
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Gianluca Puggioni
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | | | - Paola Goldoni
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Fabio Mengoni
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
| | - Valeria Pietropaolo
- Department of Public Health and Infectious Diseases, 'Sapienza' University, Rome, Italy
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13
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Febbraro F, Rodio DM, Puggioni G, Antonelli G, Pietropaolo V, Trancassini M. MALDI-TOF MS Versus VITEK ®2: Comparison of Systems for the Identification of Microorganisms Responsible for Bacteremia. Curr Microbiol 2016; 73:843-850. [PMID: 27620383 PMCID: PMC5059415 DOI: 10.1007/s00284-016-1121-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 08/08/2016] [Indexed: 11/28/2022]
Abstract
We evaluated the reliability and accuracy of the combined use of MALDI-TOF MS and classical ID VITEK2 to identify monomicrobial infection in blood culture bottles. In total, 70 consecutive positive blood cultures were included in this study. Positive blood culture bottles were subjected to Gram staining and subcultured on solid media. Isolates grown from such culture media were used for classical ID using VITEK2 system. In parallel, an aliquot was subjected to a lysing-centrifugation method and used for the identification with the MALDI-TOF system. Results evidenced the correct genus and species identification of 91.4 % of microorganisms responsible for bacteremia with an agreement to the species and the genus level. If compared with the standard method VITEK2, our simple and cost-effective sample preparation method would be very useful for rapid identification of microorganisms using blood culture bottles. In fact, the direct method showed rapid and reliable results, especially for the gram-negative group.
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Affiliation(s)
| | - Donatella Maria Rodio
- Department of Public Health and Infectious Diseases, "Sapienza" University Rome, P.le Aldo Moro, 5, 00185, Rome, Italy
| | - Gianluca Puggioni
- Department of Clinical Medicine, "Sapienza" University Rome, Rome, Italy
| | - Guido Antonelli
- Department of Molecular Medicine and Pasteur Institute-Cenci Bolognetti Foundation, "Sapienza" University Rome, Rome, Italy
| | - Valeria Pietropaolo
- Department of Public Health and Infectious Diseases, "Sapienza" University Rome, P.le Aldo Moro, 5, 00185, Rome, Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, "Sapienza" University Rome, P.le Aldo Moro, 5, 00185, Rome, Italy.
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14
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Rodio DM, Anzivino E, Mischitelli M, Bellizzi A, Scrivo R, Scribano D, Conte G, Prezioso C, Trancassini M, Valesini G, Palamara AT, Pietropaolo V. Increased Prevalence of Human Polyomavirus JC Viruria in Chronic Inflammatory Rheumatic Diseases Patients in Treatment with Anti-TNF α: A 18 Month Follow-Up Study. Front Microbiol 2016; 7:672. [PMID: 27242700 PMCID: PMC4861734 DOI: 10.3389/fmicb.2016.00672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/22/2016] [Indexed: 12/04/2022] Open
Abstract
Chronic inflammatory rheumatic diseases (CIRDs) are immune-mediated pathologies involving joints. To date, TNFα-blocking agents administration is the most promising therapy, although these treatments are associated with an increased Polyomavirus JC (JCPyV) reactivation, the etiological agent of the Progressive Multifocal Leukoencephalopathy (PML). The aim of this study was the recruitment and the analysis of a CIRDs cohort in order to investigate a possible correlation between JCPyV presence and the influence of anti-TNF-α agents on viral loads. Blood and urine samples were collected from 34 CIRDs subjects prior the first anti-TNF-α infusion (T0) and after 3 (T3), 6 (T6), 12 (T12), and 18 (T18) months. Results showed persistent JC viruria significantly higher than JC viremia throughout the 18 month follow-up study (p = 0.002). In JCPyV positive samples, the non-coding control region (NCCR) was analyzed. Results evidenced archetypal structures (type II-S) in all isolates with the exception of a sequence isolated from a plasma sample, that corresponds to the type II-R found in PML subjects. Finally, the viral protein 1 (VP1) genotyping was performed and results showed the prevalence of the European genotypes 1A, 1B, and 4. Since only few studies have been carried out to understand whether there is a PML risk in CIRDs population infected by JCPyV, this study contributes to enrich literature insight on JCPyV biology in this cluster. Further investigations are necessary in order to recognize the real impact of biologics on JCPyV life cycle and to identify possible and specific viral variants related to increased virulence in CIRDs patients.
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Affiliation(s)
- Donatella Maria Rodio
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome Rome, Italy
| | - Elena Anzivino
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome Rome, Italy
| | - Monica Mischitelli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome Rome, Italy
| | - Anna Bellizzi
- Department of Public Health and Infectious Diseases, Institute Pasteur, Cenci-Bolognetti Foundation, "Sapienza" University of Rome Rome, Italy
| | - Rossana Scrivo
- Department of Internal Medicine and Medical Disciplines, Rheumatology, "Sapienza" University of Rome Rome, Italy
| | - Daniela Scribano
- Department of Experimental and Clinical Sciences, "G. D'Annunzio" University of Chieti Chieti, Italy
| | - Gianlorenzo Conte
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome Rome, Italy
| | - Carla Prezioso
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome Rome, Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome Rome, Italy
| | - Guido Valesini
- Department of Internal Medicine and Medical Disciplines, Rheumatology, "Sapienza" University of Rome Rome, Italy
| | - Anna Teresa Palamara
- Department of Public Health and Infectious Diseases, Institute Pasteur, Cenci-Bolognetti Foundation, "Sapienza" University of RomeRome, Italy; San Raffaele Pisana Scientific Institute for Research, Hospitalization and Health CareRome, Italy
| | - Valeria Pietropaolo
- Department of Public Health and Infectious Diseases, "Sapienza" University of RomeRome, Italy; Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple UniversityPhiladelphia, PA, USA
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15
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Iebba V, Totino V, Gagliardi A, Santangelo F, Cacciotti F, Trancassini M, Mancini C, Cicerone C, Corazziari E, Pantanella F, Schippa S. Eubiosis and dysbiosis: the two sides of the microbiota. New Microbiol 2016; 39:1-12. [PMID: 26922981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/11/2015] [Indexed: 06/05/2023]
Abstract
The microbial ecosystem of the gastrointestinal tract is characterized by a great number of microbial species living in balance by adopting mutualistic strategies. The eubiosis/dysbiosis condition of the gut microbiota strongly influences our healthy and disease status. This review briefly describes microbiota composition and functions, to then focus on eubiosis and dysbiosis status: the two sides of the microbiota.
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Affiliation(s)
- Valerio Iebba
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome
| | - Valentina Totino
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome
| | - Antonella Gagliardi
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome
| | - Floriana Santangelo
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome
| | - Fatima Cacciotti
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome
| | - Carlo Mancini
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome
| | - Clelia Cicerone
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome
| | - Enrico Corazziari
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome
| | - Fabrizio Pantanella
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome
| | - Serena Schippa
- Department of Public Health and Infectious Diseases, Microbiology section, Sapienza University of Rome
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16
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Russo A, Campanile F, Falcone M, Tascini C, Bassetti M, Goldoni P, Trancassini M, Della Siega P, Menichetti F, Stefani S, Venditti M. Linezolid-resistant staphylococcal bacteraemia: A multicentre case-case-control study in Italy. Int J Antimicrob Agents 2014; 45:255-61. [PMID: 25600893 DOI: 10.1016/j.ijantimicag.2014.12.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/10/2014] [Accepted: 12/19/2014] [Indexed: 11/24/2022]
Abstract
The aim of this multicentre study was to analyse the characteristics of patients with bloodstream infections due to staphylococcal strains resistant to linezolid. This was a retrospective case-case-control study of patients hospitalised in three large teaching hospitals in Italy. A linezolid-resistant (LIN-R) Staphylococcus spp. group and a linezolid-susceptible (LIN-S) Staphylococcus spp. group were compared with control patients to determine the clinical features and factors associated with isolation of LIN-R strains. All LIN-R Staphylococcus spp. strains underwent molecular typing. Compared with the LIN-S group, central venous catheters were the main source of infection in the LIN-R group. The LIN-R and LIN-S groups showed a similar incidence of severe sepsis or septic shock, and both showed a higher incidence of these compared with the control group. Overall, patients in the LIN-R group had a higher 30-day mortality rate. Multivariate analysis found previous linezolid therapy, linezolid therapy >14 days, antibiotic therapy in the previous 30 days, antibiotic therapy >14 days, previous use of at least two antibiotics and hospitalisation in the previous 90 days as independent risk factors associated with isolation of a LIN-R strain. The G2576T mutation in domain V of 23S rRNA was the principal mechanism of resistance; only one strain of Staphylococcus epidermidis carried the cfr methylase gene (A2503), together with L4 insertion (71GGR72) and L3 substitution (H146Q). LIN-R strains are associated with severe impairment of clinical conditions and unfavourable patient outcomes. Reinforcement of infection control measures may have an important role in preventing these infections.
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Affiliation(s)
- Alessandro Russo
- Department of Public Health and Infectious Diseases, Policlinico Umberto I, 'Sapienza' University of Rome, Viale dell'Università 37, 00161 Rome, Italy
| | | | - Marco Falcone
- Department of Public Health and Infectious Diseases, Policlinico Umberto I, 'Sapienza' University of Rome, Viale dell'Università 37, 00161 Rome, Italy
| | - Carlo Tascini
- UO Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Matteo Bassetti
- Infectious Diseases Clinic, Santa Maria Misericordia, University Hospital, Udine, Italy
| | - Paola Goldoni
- Department of Public Health and Infectious Diseases, Policlinico Umberto I, 'Sapienza' University of Rome, Viale dell'Università 37, 00161 Rome, Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Policlinico Umberto I, 'Sapienza' University of Rome, Viale dell'Università 37, 00161 Rome, Italy
| | - Paola Della Siega
- Infectious Diseases Clinic, Santa Maria Misericordia, University Hospital, Udine, Italy
| | | | | | - Mario Venditti
- Department of Public Health and Infectious Diseases, Policlinico Umberto I, 'Sapienza' University of Rome, Viale dell'Università 37, 00161 Rome, Italy.
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17
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Iebba V, Totino V, Santangelo F, Gagliardi A, Ciotoli L, Virga A, Ambrosi C, Pompili M, De Biase RV, Selan L, Artini M, Pantanella F, Mura F, Passariello C, Nicoletti M, Nencioni L, Trancassini M, Quattrucci S, Schippa S. Bdellovibrio bacteriovorus directly attacks Pseudomonas aeruginosa and Staphylococcus aureus Cystic fibrosis isolates. Front Microbiol 2014; 5:280. [PMID: 24926292 PMCID: PMC4046265 DOI: 10.3389/fmicb.2014.00280] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 05/22/2014] [Indexed: 01/05/2023] Open
Abstract
Bdellovibrio bacteriovorus is a predator bacterial species found in the environment and within the human gut, able to attack Gram-negative prey. Cystic fibrosis (CF) is a genetic disease which usually presents lung colonization by Pseudomonas aeruginosa or Staphylococcus aureus biofilms. Here, we investigated the predatory behavior of B. bacteriovorus against these two pathogenic species with: (1) broth culture; (2) "static" biofilms; (3) field emission scanning electron microscope (FESEM); (4) "flow" biofilms; (5) zymographic technique. We had the first evidence of B. bacteriovorus survival with a Gram-positive prey, revealing a direct cell-to-cell contact with S. aureus and a new "epibiotic" foraging strategy imaged with FESEM. Mean attaching time of HD100 to S. aureus cells was 185 s, while "static" and "flow" S. aureus biofilms were reduced by 74 (at 24 h) and 46% (at 20 h), respectively. Furthermore, zymograms showed a differential bacteriolytic activity exerted by the B. bacteriovorus lysates on P. aeruginosa and S. aureus. The dual foraging system against Gram-negative (periplasmic) and Gram-positive (epibiotic) prey could suggest the use of B. bacteriovorus as a "living antibiotic" in CF, even if further studies are required to simulate its in vivo predatory behavior.
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Affiliation(s)
- Valerio Iebba
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Valentina Totino
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Floriana Santangelo
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Antonella Gagliardi
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Luana Ciotoli
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Alessandra Virga
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Cecilia Ambrosi
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Monica Pompili
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Riccardo V De Biase
- Department of Pediatrics and Neuropsychiatry, "Sapienza" University Rome, Italy
| | - Laura Selan
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Marco Artini
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Fabrizio Pantanella
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Francesco Mura
- Sapienza Nanoscience and Nanotecnology Laboratories, Department of Fundamental and Applied Sciences for Engineering, "Sapienza" University Rome, Italy
| | - Claudio Passariello
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Mauro Nicoletti
- Section of Microbiology, Department of Biomedical Sciences, University G. D'Annunzio Chieti, Italy
| | - Lucia Nencioni
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Maria Trancassini
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
| | - Serena Quattrucci
- Department of Pediatrics and Neuropsychiatry, "Sapienza" University Rome, Italy
| | - Serena Schippa
- Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University Rome, Italy
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Trancassini M, Iebba V, Citerà N, Tuccio V, Magni A, Varesi P, De Biase RV, Totino V, Santangelo F, Gagliardi A, Schippa S. Outbreak of Achromobacter xylosoxidans in an Italian Cystic fibrosis center: genome variability, biofilm production, antibiotic resistance, and motility in isolated strains. Front Microbiol 2014; 5:138. [PMID: 24772108 PMCID: PMC3982067 DOI: 10.3389/fmicb.2014.00138] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/18/2014] [Indexed: 12/30/2022] Open
Abstract
Cystic fibrosis (CF) patients have chronic airway infection and frequent exposure to antibiotics, which often leads to the emergence of resistant organisms. Achromobacter xylosoxidans is a new emergent pathogen in CF spectrum. From 2005 to 2010 we had an outbreak in A. xylosoxidans prevalence in our CF center, thus, the present study was aimed at deeply investigating virulence traits of A. xylosoxidans strains isolated from infected CF patients. To this purpose, we assessed A. xylosoxidans genome variability by randomly amplified polymorphic DNA (RAPD), biofilm production, antibiotic resistances, and motility. All A. xylosoxidans strains resulted to be biofilm producers, and were resistant to antibiotics usually employed in CF treatment. Hodge Test showed the ability to produce carbapenemase in some strains. Strains who were resistant to β-lactamics antibiotics, showed the specific band related to metal β-lactamase (blaIMP-1), and some of them showed to possess the integron1. Around 81% of A. xylosoxidans strains were motile. Multivariate analysis showed that RAPD profiles were able to predict Forced Expiratory Volume (FEV1%) and biofilm classes. A significant prevalence of strong biofilm producers strains was found in CF patients with severely impaired lung functions (FEV1% class 1). The outbreak we had in our center (prevalence from 8.9 to 16%) could be explained by an enhanced adaptation of A. xylosoxidans in the nosocomial environment, despite of aggressive antibiotic regimens that CF patients usually undergo.
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Affiliation(s)
- Maria Trancassini
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
| | - Valerio Iebba
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
| | - Nicoletta Citerà
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
| | - Vanessa Tuccio
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
| | - Annarita Magni
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
| | - Paola Varesi
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
| | - Riccardo V De Biase
- Pediatrics Department, Regional Cystic Fibrosis Center, Sapienza University Rome, Italy
| | - Valentina Totino
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
| | - Floriana Santangelo
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
| | - Antonella Gagliardi
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
| | - Serena Schippa
- Microbiology Section, Department of Public Health Sciences, Sapienza University Rome, Italy
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Magni A, Giordano A, Mancini C, Pecoraro C, Varesi P, Quattrucci S, Trancassini M. Emerging cystic fibrosis pathogens: incidence and antimicrobial resistance. New Microbiol 2007; 30:59-62. [PMID: 17319602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We examined the frequency of isolation and the antimicrobial resistance of Burkholderia cepacia complex, Stenotrophomonas maltophilia and Achromobacter xylosoxidans in cystic fibrosis patients from 2000 to 2004. Strains susceptibility to tobramycin, piperacillin/tazobactam, imipenem, gentamicin, ciprofloxacin and ceftazidime was determined by disc diffusion assay. B. cepacia complex showed a very high resistance also to ciprofloxacin reaching 100% in 2004. S. maltophilia and A. xvylosoxidans showed high rates of antimicrobial resistance both aminoglycoside and ciprofloxacin. It is very important to monitor the percentage of isolation of these species over time to verify strains resistance to antibiotics and also to test new combinations of antimicrobial agents.
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Affiliation(s)
- Annarita Magni
- Department of Public health Sciences, La Sapienza University of Rome, Italy
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20
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Giordano A, Magni A, Trancassini M, Varesi P, Turner R, Mancini C. Identification of respiratory isolates of Stenotrophomonas maltophilia by commercial biochemical systems and species-specific PCR. J Microbiol Methods 2006; 64:135-8. [PMID: 15927289 DOI: 10.1016/j.mimet.2005.04.020] [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] [Received: 06/07/2004] [Revised: 04/15/2005] [Accepted: 04/18/2005] [Indexed: 11/22/2022]
Abstract
One hundred strains of Stenotrophomonas maltophilia isolates from respiratory specimens were biochemically identified using the API 20NE strip and the VITEK2 ID-GNB card. The identification was confirmed by a species-specific PCR using two primers specific for the 23S rRNA gene. The API 20NE showed only 1 strain with "low discrimination" whereas the VITEK2 gave 12. In any case, the two biochemical systems showed good reliability compared to SS-PCR.
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Affiliation(s)
- A Giordano
- Dipartimento di Scienze di Sanità Pubblica Sezione di Microbiologia Università degli Studi di Roma La Sapienza, Via M. Fascetti, 67, 00136 Rome, Italy.
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21
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Campana S, Taccetti G, Ravenni N, Favari F, Cariani L, Sciacca A, Savoia D, Collura A, Fiscarelli E, De Intinis G, Busetti M, Cipolloni A, d'Aprile A, Provenzano E, Collebrusco I, Frontini P, Stassi G, Trancassini M, Tovagliari D, Lavitola A, Doherty CJ, Coenye T, Govan JRW, Vandamme P. Transmission of Burkholderia cepacia complex: evidence for new epidemic clones infecting cystic fibrosis patients in Italy. J Clin Microbiol 2005; 43:5136-42. [PMID: 16207975 PMCID: PMC1248445 DOI: 10.1128/jcm.43.10.5136-5142.2005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To analyze national prevalence, genomovar distribution, and epidemiology of the Burkholderia cepacia complex in Italy, 225 putative B. cepacia complex isolates were obtained from 225 cystic fibrosis (CF) patients attending 18 CF centers. The genomovar status of these isolates was determined by a polyphasic approach, which included whole-cell protein electrophoresis and recA restriction fragment length polymorphism (RFLP) analysis. Two approaches were used to genotype B. cepacia complex isolates: BOX-PCR fingerprinting and pulsed-field gel electrophoresis (PFGE) of genomic macrorestriction fragments. A total of 208 (92%) of 225 isolates belonged to the B. cepacia complex, with Burkholderia cenocepacia as the most prevalent species (61.1%). Clones delineated by PFGE were predominantly linked to a single center; in contrast, BOX-PCR clones were composed of isolates collected either from the same center or from different CF centers and comprised multiple PFGE clusters. Three BOX-PCR clones appeared of special interest. One clone was composed of 17 B. cenocepacia isolates belonging to recA RFLP type H. These isolates were collected from six centers and represented three PFGE clusters. The presence of insertion sequence IS 1363 in all isolates and the comparison with PHDC reference isolates identified this clone as PHDC, an epidemic clone prominent in North American CF patients. The second clone included 22 isolates from eight centers and belonged to recA RFLP type AT. The genomovar status of strains with the latter RFLP type is not known. Most of these isolates belonged to four different PFGE clusters. Finally, a third clone comprised nine B. pyrrocinia isolates belonging to recA RFLP type Se 13. They represented three PFGE clusters and were collected in three CF centers.
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Affiliation(s)
- S Campana
- Department of Pediatrics, Cystic Fibrosis Center, University of Florence, 50132 Florence, Italy.
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22
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Campana S, Ravenni N, Favari F, Cariani L, Sciacca A, Savoia D, Collura A, Fiscarelli E, De Intinis G, Busetti M, Cipolloni A, D’Aprile A, Provenzano E, Collebrusco I, Frontini P, Stassi G, Trancassini M, Tovagliari D, Lavitola A, Taccetti G. EPIDEMIOLOGIA MOLECOLARE DI Burkholderia cepacia complex: UN MODELLO PER UN CONFRONTO DI METODI. Microbiol Med 2005. [DOI: 10.4081/mm.2005.3430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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23
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Di Fulvio A, Ierfone N, Standoli M, Trancassini M, Giordano A, Magni A, Pontone P. [Study of fecal antigens against Helicobacter pylori as non-invasive test compared with the 13C-urea breath-test. Personal experience]. G Chir 2003; 24:312-4. [PMID: 14664190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The target of this study is the evaluation of two different noninvasive tests: 13C-urea Breath-Test, as gold standard, versus the HpSA test, as new method to research the faecal antigen of Helicobacter Pylori (HP). Thirty patients, affected by dyspeptic symptomatology and never treated before by antibiotic therapy to eradicate the HP, was subjected, by Authors, to this evaluation. This study say that the 13C-urea Breath-test represent the gold standard in the pre-endoscopic research of HP presence concerning specificity and sensibility. However, the HpSA test need more improvement.
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Affiliation(s)
- A Di Fulvio
- Dipartimento di Scienze Chirurgiche, Università degli Studi La Sapienza, Roma
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24
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Trancassini M, Mosca G, Margiotta MC, Pecoraro C, Quattrucci S, Venuta F, Cipriani P. Microbiologic investigation on patients with cystic fibrosis subjected to bilateral lung transplantation. Transplantation 2001; 72:1575-7. [PMID: 11707748 DOI: 10.1097/00007890-200111150-00017] [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: 11/26/2022]
Abstract
BACKGROUND In cystic fibrosis (CF) patients, lung transplantation is the only way to improve both quality and length of life. Data in the literature show that, in 80% of the cases, mortality after lung transplantation in CF patients is due to infections. METHODS We microbiologically monitored 34 patients subjected to bilateral lung transplantation in during 1996 to 1999 to ascertain whether a change in the bacterial species isolated from the lower respiratory tract took place that might have influenced the clinical conditions of the patients. RESULTS Our results show that the percentage of nonfermenting Gram-negative bacteria isolated from the lower respiratory tract remains high even in the posttransplantation phase. Nevertheless, the general clinical conditions of most of the patients were good and the three patients who died did not do as a consequence of an infection. CONCLUSIONS Lung transplantation constitutes a valid therapeutic choice for CF patients because the microorganisms that we isolated from the lungs of the patients in our study behave mostly as contaminants rather than as colonizers. However, the transplanted patients remain at risk and thus require constant microbiological surveillance.
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Affiliation(s)
- M Trancassini
- Institute of Microbiology, University of Rome La Sapienza, Rome, Italy
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25
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Magni A, Giordano A, Trancassini M, Graziani C, De Vito D, Antonelli M, Cipriani P. Antibody response to P. aeruginosa in patients with cystic fibrosis: evaluation of two methods. New Microbiol 1999; 22:277-80. [PMID: 10423747] [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: 02/13/2023]
Abstract
The immunological response to Ps. aeruginosa antigens may be a sensitive and early indicator of the colonisation of the lungs with these organisms in patients with cystic fibrosis. This study used an immunoenzymatic system and immunoblotting to evaluate the antibody response of 20 patients without apparent Ps. aeruginosa lung infection. These was an agreement in the results obtained with the two methods in 87.5% of cases.
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Affiliation(s)
- A Magni
- Institute of Microbiology, University La Sapienza Rome, Italy
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26
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Trancassini M, De Vito D, Quattrucci S, Cipriani P. Pseudomonas aeruginosa antibody detection in cystic fibrosis patients. New Microbiol 1999; 22:85-9. [PMID: 10322606] [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: 02/12/2023]
Abstract
Chronic respiratory infection due to Pseudomonas aeruginosa remains the most important prognostic factor in cystic fibrosis patients. One method to lengthen the patient's life is to extend the initial state of the illness with an early diagnosis, before Ps. aeruginosa infection becomes chronic. Often this is difficult because of the young age of the patients. This study tested an immunoenzymatic system to evaluate antibody response against three Ps. aeruginosa purified antigens, alkaline protease, elastase and exotoxin A. We studied 40 patients with cystic fibrosis, 20 affected and 20 unaffected by apparent Ps. aeruginosa infection, also from the bacteriological point of view. Serological and bacteriological results were compared for each patient and showed that serological screening can be useful in young subjects, who often have no bacteriological evidence of Ps. aeruginosa colonization.
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Affiliation(s)
- M Trancassini
- Institute of Microbiology, Medical School, University of Rome La Sapienza, Rome, Italy
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27
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Cipriani P, Trancassini M, Chiossi MR, De Vito D, Filadoro F. Antibiotics at sub-inhibitory concentrations and virulence factors of Pseudomonas aeruginosa. New Microbiol 1998; 21:285-8. [PMID: 9699211] [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 difficulty of instituting an efficacious therapy against Pseudomonas aeruginosa infections is principally due to the microorganism's antibiotic resistance. The aim of our study was to evaluate the activity of four antibacterial drugs, two penems and two quinolones, on the production of virulence factors. Our results demonstrated that the antibiotics tested have a different behaviour depending on the P. aeruginosa phenotype. Therefore it would be advisable to choose the drug on the basis of the isolated strain phenotype.
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Affiliation(s)
- P Cipriani
- Institute of Microbiology, Medical School La Sapienza, University of Rome, Italy
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28
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Magni A, Trancassini M, Giordano A, De Vito D, Cimino G, Quattrucci S, Antonelli M, Cipriani P. Different serological examinations in cystic fibrosis patients: response to Pseudomonas aeruginosa St-Ag. New Microbiol 1997; 20:295-302. [PMID: 9385598] [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: 02/05/2023]
Abstract
Crossed immunoelectrophoresis (CIE), enzyme linked immunosorbent assay (ELISA) and immunoblotting (IMB) were used to look for the presence of anti-bodies to Pseudomonas aeruginosa standard antigen in the sera of cystic fibrosis patients with intermittent (CF +/- P) and chronic (CF + P) colonization. Our results show that CIE is too complex a method to use when monitoring the infection over time, that with ELISA a correlation with the patient's clinical status may be made and that IMB can evidence an early, albeit low, reaction in the CF +/- P patient.
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Affiliation(s)
- A Magni
- Institute of Microbiology, Medical School, La Sapienza University of Rome, Italy
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Trancassini M, de Vito D, Cimino G, Antonelli M, Quattrucci S, Cipriani P. Precipitating Pseudomonas aeruginosa antibodies and antimicrobial therapy in cystic fibrosis patients. Eur J Clin Microbiol Infect Dis 1996; 15:309-12. [PMID: 8781882 DOI: 10.1007/bf01695663] [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: 02/02/2023]
Abstract
Forty patients with cystic fibrosis were studied bacteriologically and serologically. Precipitating Pseudomonas aeruginosa antibodies were monitored by crossed-immunoelectrophoresis (CIE) in order to evaluate the possibility of preventing chronic colonization by Pseudomonas aeruginosa by cycles of antimicrobial therapy. Sputum or pharyngeal aspirate and serum samples from all patients were analyzed by means of spread on selective media and CIE, respectively. Significant differences in the number of precipitins were obtained: noncolonized and intermittently colonized patients had no precipitins, whereas the number of precipitins in the chronically colonized patients varied from 11 to 44. An increase in the number of precipitins could be a good marker for initiation of therapy with antimicrobial agents that are either active against Pseudomonas aeruginosa or able to inhibit the release of virulence factors.
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Affiliation(s)
- M Trancassini
- Institute of Microbiology, Medical School, University of Rome La Sapienza, Italy
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30
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Trancassini M, Giordano A, Magni A, Cipriani P. Subinhibitory concentrations of antibacterial drugs and Pseudomonas aeruginosa virulence factors. New Microbiol 1993; 16:275-9. [PMID: 8366823] [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: 01/30/2023]
Abstract
Pseudomonas aeruginosa is an important, opportunistic pathogen responsible for nosocomial infections in the immunocompromised host and resistant to antibacterial drugs. Its pathogenicity is related to many virulence factors such as proteases, alginate, exotoxin A and exoenzyme S. Our previous study showed a down-regulation of some P. aeruginosa virulence factors by subinhibitory concentrations of antibacterial drugs. This study aimed to compare the effects of subinhibitory concentrations of a new difluoroquinolone, PD 131,628, a betalactam, aztreonam and an aminoglycoside, netilmicin.
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Affiliation(s)
- M Trancassini
- Chair of Clinical Microbiology I, Faculty of Medicine and Surgery, La Sapienza University, Rome, Italy
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31
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Giordano A, Magni A, Trancassini M, Cipriani P. Outer membrane proteins and lipopolysaccharide changes after exposure of Pseudomonas aeruginosa to antibacterial drugs. New Microbiol 1993; 16:281-6. [PMID: 8366824] [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: 01/30/2023]
Abstract
Many studies show the low sensitivity of P. aeruginosa to antimicrobial agents, due to the permeability degree of the outer membrane (OM). Since the alterations of porins and lipopolysaccharides (LPS) are responsible for permeability to antibacterial drugs, the aim of this study was to evaluate the sub-M.I.C. effects of different antibiotics on the OM components. The M.I.C.s of five P. aeruginosa strains were determined and sub-M.I.C.s. versus PD-131,628, a new difluoroquinolone, aztreonam and netilmicin were calculated. The OM components were extracted before and after contact with the antibacterial drugs. We noted a decrease in M.I.C. values in two strains, and simultaneously an increase in the 19 and 38 Kd bands after using aztreonam. The M.I.C.s tended to increase in three strains after using netilmicin. The electrophoresis profile showed a decrease in the 38, 41 and 45 Kd bands and in one strain also in the 19 Kd band. The use of the quinolone did not significantly modify the M.I.C. values, although an evident increase in 38 and 41 Kd bands occurred in three strains. LPS alterations were observed with aztreonam and netilmicin, but not when PD 131,628 was used.
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Affiliation(s)
- A Giordano
- Chair of Clinical Microbiology I, Faculty of Medicine and Surgery, La Sapienza University of Rome, Italy
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Cipriani P, Giordano A, Magni A, Trancassini M, Filadoro F. In Vitro Activity of PD 131628 and Effects on Virulence and OMPs. Drugs 1993. [DOI: 10.2165/00003495-199300453-00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Trancassini M, Brenciaglia MI, Ghezzi MC, Cipriani P, Filadoro F. Modification of Pseudomonas aeruginosa virulence factors by sub-inhibitory concentrations of antibiotics. J Chemother 1992; 4:78-81. [PMID: 1385831 DOI: 10.1080/1120009x.1992.11739144] [Citation(s) in RCA: 6] [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: 12/26/2022]
Abstract
This study's objectives were to evaluate the effects of subminimum inhibitory concentrations (MICs) of tobramycin, gentamicin, netilmicin, streptomycin, ciprofloxacin, cefotaxime and piperacillin on proteinase production, alginate and siderophore synthesis by two strains of Pseudomonas aeruginosa. One of these strains, of recent clinical isolation, was mucoid. In fact it is well known that mucoid strains are more resistant than non-mucoid; there is, moreover, evidence that in cystic fibrotic lungs the non-mucoid P. aeruginosa are invariably replaced by mucoid variants. Our results show that subinhibitory concentrations of beta-lactams and quinolones significantly reduced the amount of alginate. Protease production was affected by all antibiotics tested.
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Affiliation(s)
- M Trancassini
- II Cattedra di Microbiologia, Facoltà di Medicina e Chirurgia, Università degli Studi di Roma, La Sapienza, Italy
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Trancassini M, Ghezzi MC, Magni A, Nazzari C, Brenciaglia MI. Adherence of Pseudomonas aeruginosa elastase deficient mutant. Microbiologica 1990; 13:97-100. [PMID: 2112680] [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: 12/30/2022]
Abstract
Pseudomonas aeruginosa produces several extracellular substances such as enzymes and toxins which seem to contribute to its pathogenicity. In particular, alkaline protease and elastase production seems to affect bacterial adherence. Aim of this study was to isolate an elastase deficient mutant of P. aeruginosa and to demonstrate a possible correlation between enzyme production and adherence to WEHI cells. Mutant strain showed a significant reduction of elastase and protease alkaline activity, as the decrease of absorbance values demonstrate. Furthermore the adherence to WEHI cells of mutant strain was strongly reduced with respect to the wild strain. Our results prove that proteolytic enzymes play an important role in adherence, probably modifying the cell surfaces and so enhancing adherence.
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Affiliation(s)
- M Trancassini
- II Cattedra di Microbiologia Facoltà di Medicina e Chirurgia, Università degli Studi di Roma, La Sapienza, Italy
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Trancassini M, Magni A, Ghezzi MC, Nazzari C, Brenciaglia MI, Filadoro F. Role of alkaline protease and elastase in the adherence of Pseudomonas aeruginosa to WEHI cells. Microbiologica 1989; 12:257-61. [PMID: 2506409] [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: 01/01/2023]
Abstract
Recent clinical isolates were tested for production of some extracellular factors such as alkaline protease and elastase. They were also assayed for adhesiveness to WEHI cells. It is well known that extracellular production of substances other than toxins is related to virulence and may increase adherence. The present investigation aimed to evaluate the role of extracellular proteins in adherence. Alkaline protease production was assayed using a test performed with casein as substrate while elastase activity was investigated with the elastin-congored method. Our results demonstrated that P. aeruginosa strains which are good alkaline protease and elastase producers adher better than those showing no or low protease and elastase activity.
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Affiliation(s)
- M Trancassini
- II Cattedra di Microbiologia-Facoltà di Medicina e Chirurgia, Università degli Studi di Roma, La Sapienza, Italy
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Brenciaglia MI, Ghezzi MC, Cipriani P, Mancini C, Trancassini M. The influence of antifungal drugs on adherence of Candida albicans to buccal epithelial cells. Chemioterapia 1986; 5:200-3. [PMID: 3521918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The adherence of two strains of Candida albicans serotype A to human epithelial cells was measured after exposure to different concentrations of amphotericin B, 5-fluorocytosine, nystatin, miconazole and ketoconazole. Germ-tube formation after different exposure times to the antifungal drugs as a preliminary test was carried out. Pretreatment of blastospores with minimum inhibitory concentrations (MIC) and sub-MIC (1/2 and 1/4 of MIC values) for 3 and 72 h did not affect adherence for all drugs tested except amphotericin B. This antimycotic agent reduces significantly the adherence either after 3 or 72 h exposure time. The other antifungal drugs interfere with adherence only after 72 h and at the highest concentrations tested, above MIC values. The decrease in adherence by antifungal drugs suggests that some of these drugs would be useful in the prophylaxis of patients at high risk for candidosis.
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Ghezzi MC, Trancassini M, Cipriani P, Mancini C, Alfani D, Pretagostini R, Brenciaglia MI. Candida contamination in renal transplant recipients: Candida albicans serotypes and sera-antibodies. G Batteriol Virol Immunol 1984; 77:3-8. [PMID: 6399272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Candida spp. is an important parasite for the immunocompromised host, and transplant recipients are at high risk for invasive and potentially lethal infections caused by this microorganism. The frequency of colonization at one or more sites and the correlation with humoral antibodies in renal transplant recipients have been studied. Candida strains were identified by cultural and biochemical tests, and moreover serological types of C. albicans were detected. Sera antibodies have been also determined by agglutination and immunodiffusion tests. Our results indicate that about 48.8% of patients had Candida spp. at one or more sites and these yeasts may be of different species or serotypes. None of the patients has had systemic candidiasis and none of them showed any convincing clinical or pathological evidence of invasive Candida disease.
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