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Santucciu C, Bozzi E, Profili S, Porcu A, Masala G, Babudieri S, Mastrandrea S. Investigation of patients with new infection of echinococcal cyst in Sardinia, Italy. Diagn Microbiol Infect Dis 2024; 109:116224. [PMID: 38382287 DOI: 10.1016/j.diagmicrobio.2024.116224] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
Cystic Echinococcosis (CE) is a zoonotic disease caused by the larval stage of a tapeworm of Taeniidae family, genus Echinococcus and species Echinococcus granulosus sensu lato (s.l.). CE is a worldwide public health problem and is highly incident in all Mediterranean areas. Following clinical, image techniques and serological investigations all 83 subjects involved in the study were diagnosed for CE. General and clinical data were entered into a database and evaluated. The 43.37% were female and 56.63% male, mean age was 50.71 while the range most represented (22.7%) was between 61->70 years. The purposes of our survey were to investigate these 83 patients enrolled in the study and to deeply examine 20 (24.10%) patients that developed a new echinococcal cyst. Moreover, the causes at the basis of the onset of a new cyst were analysed, together with a possible correlation with different treatments related to primary infection corresponding to surgery (n=7), albendazole (n=6), PAIR (n=3) and watch and wait (n=4). A possible link with medical treatments of the primary infection was observed in the subjects who underwent surgery or PAIR and a likely correlation attributable to high environmental contamination in subjects managed with drugs or watch and wait was detected. Moreover, our analysis evidenced that patients with a new infection presented a more severe diagnosis along with a major mortality rate. Finally, these data may have an important contribution for an epidemiological point of view concerning the percentage of CE in a specific geographical endemic area, such as Sardinia.
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Affiliation(s)
- Cinzia Santucciu
- WOAH and NRL for Echinococcosis, Animal Health, Istituto Zooprofilattico Sperimentale della Sardegna, Sassari 07100, Italy.
| | - Elena Bozzi
- U.O.C. di Malattie Infettive, A.O.U., Sassari 07100, Italy
| | | | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Italy
| | - Giovanna Masala
- WOAH and NRL for Echinococcosis, Animal Health, Istituto Zooprofilattico Sperimentale della Sardegna, Sassari 07100, Italy
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Drocchi G, Santucciu C, Mastrandrea S, Sanguedolce F, Madonia M. Diagnosis and treatment of unusual multiorgan Echinococcus hydatid cysts. Curr Urol 2024; 18:75-77. [PMID: 38505159 PMCID: PMC10946642 DOI: 10.1097/cu9.0000000000000130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 11/26/2022] Open
Abstract
Background Echinococcosis is a zoonotic disease caused by Echinococcus granulosus. Usually, the liver is the most affected organ, accounting for approximately 70% to 85% of cases. The lungs represent 20% of the cases. Fewer than 10% are found in other sites, including the bone, brain, spleen, and kidneys. Case presentation A young man was referred to a local hospital for dull pain in the right flank, fever, and mild cough. Computed tomography showed 2 large cysts: the first involved the left lung and measured 130 × 90.5 × 120 mm, whereas the second cyst was located in the right kidney and measured 130 × 100 × 120 mm. Surgery was performed to remove both lesions in 2 separate surgical sessions. Conclusions Echinococcosis is a compulsorily notifiable disease. Collaboration between medical doctors from different specializations is necessary. A multidisciplinary approach is important for the correct therapeutic management of the disease. Furthermore, the high possibility of recurrence makes the long-term follow-up mandatory.
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Affiliation(s)
- Giovanni Drocchi
- Department of Medical, Surgical and Experimental Sciences, Università degli Studi di Sassari, Sassari, Italy
| | - Cinzia Santucciu
- OIE and National Reference Laboratory for Echinococcosis (CeNRE), Istituto Zooprofilattico Sperimentale della Sardegna, Sassari, Italy
| | - Scilla Mastrandrea
- Department of Infectious disease, Sassari University Hospital, Sassari, Italy
| | - Francesco Sanguedolce
- Department of Medical, Surgical and Experimental Sciences, Università degli Studi di Sassari, Sassari, Italy
| | - Massimo Madonia
- Department of Medical, Surgical and Experimental Sciences, Università degli Studi di Sassari, Sassari, Italy
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Santucciu C, Bonelli P, Peruzzu A, Fancellu A, Farà A, Mastrandrea S, Drocchi G, Cossu A, Profili S, Porcu A, Masala G. Genetic Characterization of Echinococcus granulosus sensu stricto Isolated from Human Cysts from Sardinia, Italy. Diseases 2023; 11:91. [PMID: 37489443 PMCID: PMC10366878 DOI: 10.3390/diseases11030091] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/26/2023] Open
Abstract
This study involved 20 patients affected by cystic echinococcosis (CE) who were referred to different hospitals of Sardinia (Italy) from 2017 to 2022. By means of a multidisciplinary approach, diagnosis was confirmed for CE in 18 patients and for different aetiologies in two subjects. Moreover, serology was positive for 15 subjects. Since multiple CE cysts were found in five patients, a total of 27 lesions were collected; however, only one for each patient was investigated for genetic characterization of E. granulosus s.s. DNA isolates. Our results included 15 fertile cysts that underwent DNA extraction and amplification by three different PCRs targeting nuclear (calreticulin) and mitochondrial genes (cox1 and nad5). DNA was sequenced, and by neighbour-joining phylogenetic trees we determined 10 G1 and five G3 genotypes previously reported in Sardinia. These sequences were used to construct a network, along with those circulating in Mediterranean areas. The haplotype network calculated on cox1 evidenced seven different haplotypes of the 15 isolates, with SAR2 the most represented, carried by seven cysts, and SAR17 never described in the Mediterranean area. Meanwhile, the nad5 sequences showed the most common haplotype as nd5SAR7, as well as two new haplotypes not previously described, nd5SAR13, isolated from a Sardinian patient, and nd5SAR14, isolated from a Romanian patient.
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Affiliation(s)
- Cinzia Santucciu
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Piero Bonelli
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Angela Peruzzu
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
| | - Alessandro Fancellu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Antonella Farà
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, 07100 Sassari, Italy
| | - Scilla Mastrandrea
- Unità Operativa Complessa di Malattie Infettive, Azienda Ospedaliero-Universitaria, 07100 Sassari, Italy
| | - Giovanni Drocchi
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16132 Genova, Italy
| | - Antonio Cossu
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, 07100 Sassari, Italy
| | - Stefano Profili
- Unità Operativa Complessa di Radiologia, Azienda Ospedaliero-Universitaria, 07100 Sassari, Italy
| | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Giovanna Masala
- WOAH and NRL for Echinococcosis, Animal Health, IZS della Sardegna, 07100 Sassari, Italy
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Santucciu C, Bonelli P, Peruzzu A, Fancellu A, Marras V, Carta A, Mastrandrea S, Bagella G, Piseddu T, Profili S, Porcu A, Masala G. Cystic Echinococcosis: Clinical, Immunological, and Biomolecular Evaluation of Patients from Sardinia (Italy). Pathogens 2020; 9:E907. [PMID: 33143032 PMCID: PMC7693143 DOI: 10.3390/pathogens9110907] [Citation(s) in RCA: 6] [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: 08/20/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023] Open
Abstract
Cystic echinococcosis (CE), a zoonotic disease caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato (s.l.), is a worldwide public health problem. Echinococcus granulosus sensu stricto (s.s.), associated with G1 and G3 genotypes, is endemic with high prevalence in the Mediterranean basin. The parasite's life cycle comprises definitive hosts (canids) and intermediate hosts (ruminants) and can occasionally involve humans. The main aim of this research was to confirm the diagnosis of 13 patients suspected of CE who presented different complications and needed the surgical removal of the cysts. We also wanted to understand and clarify more the diagnosis of echinococcosis in humans. For this purpose, the patients first underwent cyst evaluation by ultrasound (US), immunological analysis, and then total pericystectomy, followed by parasitological, histopathological, and molecular biology examinations of the cysts. US stadiated one CE1, one CE2, eight CE3b, one CE4, and two CE5; immunology evidenced nine positives; histopathology confirmed 11 CE cysts, of which 8 fertile presenting protoscoleces were identified as E. granulosus s.s. by molecular biology, genotyped as three G1 and four G3 by neighbor-joining (NJ) phylogenetic tree. In conclusion, the results showed that 11 patients were affected by E. granulosus s.s. G1 orG3, and 2 cystic neoformations were of non-parasitic origin.
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Affiliation(s)
- Cinzia Santucciu
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
| | - Piero Bonelli
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
| | - Angela Peruzzu
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
| | - Alessandro Fancellu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.F.); (A.P.)
| | - Vincenzo Marras
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, 07100 Sassari, Italy;
| | - Antonello Carta
- U.O.C. di Radiologia, A.O.U., 07100 Sassari, Italy; (A.C.); (S.P.)
| | - Scilla Mastrandrea
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
- U.O.C. di Malattie Infettive, A.O.U., 07100 Sassari, Italy
| | - Giorgio Bagella
- Radiology Unit, University Hospital of Sassari, 07100 Sassari, Italy;
| | - Toni Piseddu
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
| | - Stefano Profili
- U.O.C. di Radiologia, A.O.U., 07100 Sassari, Italy; (A.C.); (S.P.)
| | - Alberto Porcu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (A.F.); (A.P.)
| | - Giovanna Masala
- OIE Reference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), IZS della Sardegna, 07100 Sassari, Italy; (P.B.); (A.P.); (S.M.); (T.P.); (G.M.)
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Bonelli P, Dei Giudici S, Peruzzu A, Piseddu T, Santucciu C, Masu G, Mastrandrea S, Delogu ML, Masala G. Genetic diversity of Echinococcus granulosus sensu stricto in Sardinia (Italy). Parasitol Int 2020; 77:102120. [PMID: 32259586 DOI: 10.1016/j.parint.2020.102120] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 03/29/2020] [Accepted: 03/31/2020] [Indexed: 11/28/2022]
Abstract
Cystic echinococcosis (CE) is a severe parasitic zoonosis caused by the metacestode of the tapeworm Echinococcus granulosus sensu lato (s.l.). The disease has a global distribution representing a significant public health concern. Based on mitochondrial DNA analysis E. granulosus s.l. has been subdivided into five species: E. granulosus sensu stricto (s.s.) (G1, G3 genotype), E. equinus (G4 genotype), E. ortleppi (G5 genotype), E. canadensis (G6-G8, G10 genotype) and E. felidis. E. granulosus s.s., and in particular G1, is the most widespread genotype and the major responsible of human CE cases worldwide. In Italy G1 genotype is higly represented with larger percentages in some hyperendemic areas such as Sardinia. Molecular studies represent a valuable tool to improve our understanding of the E. granulosus epidemiology and CE control strategies. In the present study we investigated genetic variability of E. granulosus s.s. in Sardinia. To this purpose 83 hydatid cysts were collected from different animal species including humans and the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was partially sequenced (720 bp). Nucleotide sequences from Mediterranean basin were also analyzed for comparison. The phylogenetic network revealed 30 haplotypes grouped around a predominant isolate that had been already reported from other world regions. Haplotype diversity (0.8495 ± 0.0336) and nucleotide diversity (0.003305 ± 0.002014) were similar in Sardinia respect to other Mediterranean countries. Neutrality indices obtained by Tajima's D and Fu's Fs test were significantly negative (p ≤ .01) suggesting expansion of Sardinian population. Low Fixation indices (Fst), ranging from negative values (Algeria, Greece, Spain, other part of Italy) to 0.089 (Albania, France), indicated absence of genetic differentiation, and gene flow between Sardinia and other Mediterranean countries.
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Affiliation(s)
- Piero Bonelli
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy.
| | - Silvia Dei Giudici
- Laboratory of Diagnostic Virology, Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Angela Peruzzu
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Toni Piseddu
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Cinzia Santucciu
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Gabriella Masu
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | - Scilla Mastrandrea
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
| | | | - Giovanna Masala
- OIE Reference Laboratory for Echinococcosis, National Reference Laboratory for Cystic Echinococcosis (CeNRE), Istituto Zooprofilattico della Sardegna (IZS), Via Vienna 2, 07100 Sassari, Italy
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Polo MF, Mastrandrea S, Santoru L, Arcadu A, Masala G, Marras V, Bagella G, Sechi MM, Tanda F, Pirina P. Pulmonary inflammatory pseudotumor due to Coxiella burnetii. Case report and literature review. Microbes Infect 2015; 17:795-8. [PMID: 26342254 DOI: 10.1016/j.micinf.2015.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 11/17/2022]
Abstract
A 58-year-old man was admitted because of respiratory failure, episodic fever with chilling, cough, malaise, fatigue, myalgia and weight loss lasting for at least one month. Chest x-rays and CT scan of the chest showed bilateral pulmonary consolidations in upper lobes, the left lower lobe, and mediastinal lymphadenopathy. Bronchoscopy with cytology was unremarkable. A needle CT-guided lung biopsy documented an inflammatory pseudotumor, lymphoplasmacytic type. Serology showed high titer antibodies to phase II Coxiella burnetii infection. Therapy with doxycycline and hydroxychloroquine for three months led to a complete resolution of symptoms and radiological findings, and a marked decrease in titers to Q fever.
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Affiliation(s)
- M F Polo
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
| | - S Mastrandrea
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - L Santoru
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - A Arcadu
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - G Masala
- Experimental Zooprophylactic Institute of Sardinia, Sassari, Italy
| | - V Marras
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, Sassari, Italy
| | - G Bagella
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - M M Sechi
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - F Tanda
- Department of Biomedical Sciences, Institute of Pathology, University of Sassari, Sassari, Italy
| | - P Pirina
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
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Pagnozzi D, Biosa G, Addis MF, Mastrandrea S, Masala G, Uzzau S. An easy and efficient method for native and immunoreactive Echinococcus granulosus antigen 5 enrichment from hydatid cyst fluid. PLoS One 2014; 9:e104962. [PMID: 25119821 PMCID: PMC4132071 DOI: 10.1371/journal.pone.0104962] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 07/15/2014] [Indexed: 12/30/2022] Open
Abstract
Background Currently, the serodiagnosis of cystic echinococcosis relies mostly on crude Echinococcus granulosus hydatid cyst fluid as the antigen. Consequently, available immunodiagnostic tests lack standardization of the target antigen and, in turn, this is reflected on poor sensitivity and specificity of the serological diagnosis. Methodology/Principal Findings Here, a chromatographic method enabling the generation of highly enriched Antigen 5 (Ag5) is described. The procedure is very easy, efficient and reproducible, since different hydatid cyst fluid (HCF) sources produced very similar chromatograms, notwithstanding the clearly evident and extreme heterogeneity of the starting material. In addition, the performance of the antigen preparation in immunological assays was preliminarily assessed by western immunoblotting and ELISA on a limited panel of cystic echinococcosis patients and healthy controls. Following western immunoblotting and ELISA experiments, a high reactivity of patient sera was seen, with unambiguous and highly specific results. Conclusions/Significance The methods and results reported open interesting perspectives for the development of sensitive diagnostic tools to enable the timely and unambiguous detection of cystic echinococcosis antibodies in patient sera.
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Affiliation(s)
- Daniela Pagnozzi
- Porto Conte Ricerche Srl, Tramariglio, Alghero, Sassari, Italy
- * E-mail:
| | - Grazia Biosa
- Porto Conte Ricerche Srl, Tramariglio, Alghero, Sassari, Italy
| | | | - Scilla Mastrandrea
- Centro Nazionale di Riferimento per l’Echinococcosi, IZS “G. Pegreffi”, Sassari, Italy
- Unità Operativa Complessa di Malattie Infettive, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Giovanna Masala
- Centro Nazionale di Riferimento per l’Echinococcosi, IZS “G. Pegreffi”, Sassari, Italy
| | - Sergio Uzzau
- Porto Conte Ricerche Srl, Tramariglio, Alghero, Sassari, Italy
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Mastrandrea S, Stegel G, Piseddu T, Ledda S, Masala G. A retrospective study on burden of human echinococcosis based on Hospital Discharge Records from 2001 to 2009 in Sardinia, Italy. Acta Trop 2012; 123:184-9. [PMID: 22634205 DOI: 10.1016/j.actatropica.2012.05.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [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: 06/16/2011] [Revised: 05/07/2012] [Accepted: 05/13/2012] [Indexed: 11/29/2022]
Abstract
Cystic Echinococcosis (CE) is an infective zoonosis that represents a worldwide important public health problem. In humans, its manifestations may range from asymptomatic infection to severe disease and possible death, and lead to economic losses from treatment costs and lost wages. Recent studies suggest that this disease has a large social impact in endemic areas, and estimates of burden in terms of monetary and no-monetary impact on human health are essential to allocate financial and technical resources. In Sardinia, the most affected Italian region per number of inhabitants, CE is still endemic, although three eradication campaigns have been carried out in 1962, 1978, and 1987, respectively. To date, the burden of human CE in Sardinia remains poorly defined. In this work, a retrospective study was carried out using public Hospital Discharge Records spanning from 2001 to 2009. During these years, a total of 1409 discharges were recorded: 1196 (84.88%) records corresponding to patients hospitalized for symptoms directly correlated to CE (primary diagnosis), and 213 (15.11%) records corresponding to patients hospitalized for symptoms not directly correlated to CE and with an afterwards or concurrent diagnosis of echinococcosis made during the hospitalization (secondary diagnosis). The annual regional average record (discharge rate) was 9.3/100,000 inhabitants. Direct cost associated with diagnosis, surgery or chemotherapy, medical care, and hospitalization in humans were evaluated in this work. Furthermore, burden of disease was also evaluated by using the disability-adjusted life years (DALYs), the preferred disease-burden measure of the World Health Organization. Knowing the burden of human CE in Sardinia is extremely important to enable the prioritization of control measures for this preventable neglected disease. This is the first study describing the measure of the overall disease burden in an Italian region endemic for this disease, performed by calculating the number of CE patients from Hospital Discharge Records.
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Affiliation(s)
- S Mastrandrea
- Istituto Zooprofilattico Sperimentale della Sardegna - CeNRE, Sassari, Italy.
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Mastrandrea S, Taras MS, Capitta P, Tola S, Marras V, Strusi G, Masala G. Detection of Bartonella henselae – DNA in macronodular hepatic lesions of an immunocompetent woman. Clin Microbiol Infect 2009; 15 Suppl 2:116-7. [DOI: 10.1111/j.1469-0691.2008.02190.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zobba R, Chessa G, Mastrandrea S, Pinna Parpaglia ML, Patta C, Masala G. Serological and molecular detection of Bartonella spp. in humans, cats and dogs from northern Sardinia, Italy. Clin Microbiol Infect 2009; 15 Suppl 2:134-5. [PMID: 19456814 DOI: 10.1111/j.1469-0691.2008.02203.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R Zobba
- Dipartimento di Patologia e Clinica Veterinaria, Università degli Studi di Sassari, Sassari, Italy
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Mastrandrea S, Mura MS, Tola S, Patta C, Tanda A, Porcu R, Masala G. Two Cases of Human Granulocytic Ehrlichiosis in Sardinia, Italy Confirmed by PCR. Ann N Y Acad Sci 2006; 1078:548-51. [PMID: 17114774 DOI: 10.1196/annals.1374.107] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this work we report the first two cases of human granulocytic ehrlichiosis (HGE) in Sardinia. In early September 2004, a 69-year-old woman (patient 1) was admitted to the Infectious Diseases Institute of Sassari for rickettsiosis like-syndrome: high fever (39.5-40 degrees C), dyspnea, reduced consciousness, vomiting, and cutaneous rash. In late September 2004, a 30-year-old man (patient 2) with high fever was admitted for an evident palmar and oral erythema, edema of the labium, very intense arthralgia, myalgia, and dyspnea. In these two hospitalized patients, the diagnosis was made through indirect IgM and IgG immunofluorescent technique and confirmed by the presence of the specific DNA in the leukocytes. The two patients were A. phagocytophilum-PCR positive.
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Affiliation(s)
- S Mastrandrea
- Istituto Zooprofilattico Sperimentale della Sardegna, Via Duca degli Abruzzi 8, 07100 Sassari, Sardinia, Italy
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Folgosa E, Mastrandrea S, Cappuccinelli P, Uzzau S, Rappelli P, Brian MJ, Colombo MM. Molecular identification of pathogenicity genes and ERIC types in Vibrio cholerae O1 epidemic strains from Mozambique. Epidemiol Infect 2001; 127:17-25. [PMID: 11561970 PMCID: PMC2869724 DOI: 10.1017/s0950268801005623] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The phenotypic and genotypic profiles of the V. cholerae strains causing the Mozambican 1997-8 epidemic were characterized to provide a reference for comparison with other epidemic strains. A total of 75 strains of V. cholerae O1 isolated in different provinces, were analysed. Strains were characterized by PCR for detecting toxin genes (ctxA, zot and ace), virulence associated genes (tcpA. nanH, hlyA and torR) and ERIC sequences. All V. cholerae strains were serotype O1, Ogawa, biotype El Tor. MIC testing showed a high proportion of strains multi-resistant to drugs (100% to cotrimoxazole and 52% to tetracycline) and susceptibility to ciprofloxacin. The isolates contained two intact copies of the CTX genetic element and all other genes tested. PCR of restricted DNA revealed two ERIC types: the first in provincial isolates, also predominant in other African epidemic strains, and the second in Maputo isolates (the national capital).
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Affiliation(s)
- E Folgosa
- Department of Microbiology, Faculty of Medicine, University E. Mondlane, Mozambique
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Abstract
We report an outbreak of laboratory-acquired Brucella abortus infection originating in the accidental breakage of a centrifuge tube. A total of 12 laboratory workers were infected (attack rate of 31%), with an incubation time ranging from 6 weeks to 5 months. Antibody titers were evaluated weekly in all personnel exposed, allowing the diagnosis of the infection in most cases before the onset of clinical symptoms, so that specific therapy could be administrated.
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Affiliation(s)
- P L Fiori
- Dipartimento di Scienze Biomediche, Sezione di Microbiologia Sperimentale e Clinica, Università di Sassari, 07100 Sassari, Italy.
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Colombo MM, Mastrandrea S, Leite F, Santona A, Uzzau S, Rappelli P, Pisano M, Rubino S, Cappuccinelli P. Tracking of clinical and environmental Vibrio cholerae O1 strains by combined analysis of the presence of toxin cassette, plasmid content and ERIC PCR. FEMS Immunol Med Microbiol 1997; 19:33-45. [PMID: 9322067 DOI: 10.1111/j.1574-695x.1997.tb01070.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Clinical and environmental Vibrio cholerae O1 strains associated with the cholera epidemic in the Luanda province of Angola from 1991 to 1994 were tracked by toxin distribution, plasmid content and chromosomal polymorphism of the enterobacterial repetitive intergenic consensus (ERIC) sequences by PCR fingerprinting. To follow the distribution of ace, zot and ctxA toxin genes, 6 specific PCR tests were applied to 100 Vibrio strains, after preliminary hybridization experiments. Clinical isolates of Vibrio cholerae O1 were characterized by high stability of the toxigenic cassette and the presence of a large conjugative multi-resistant plasmid of incompatibility class C. Such characteristics were present in all isolates during the four years of the epidemic. Environmental strains, isolated from the river supplying water to the Luanda population showed three different genetic profiles: the presence of both cassette and plasmid, the presence of cassette only or absence of both. To assess the clonal relationship between the clinical isolates and the three groups of environmental strains, the strains were analyzed by PCR ERIC polymorphism. This analysis, supported by the toxin and plasmid content, suggested the stability of the epidemic strain in clinical cases during the epidemic and led to the finding that there was a strict genetic relationship of the epidemic strain with the environmental ones as characterized by the presence of the toxin cassette. The role of the water supply from Bengo River as a reservoir of the Vibrio epidemic strain is discussed.
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Affiliation(s)
- M M Colombo
- Dipartimento di Biologia Cellulare e dello Sviluppo, Università La Sapienza, Roma, Italy.
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Coppo A, Colombo M, Pazzani C, Bruni R, Mohamud KA, Omar KH, Mastrandrea S, Salvia AM, Rotigliano G, Maimone F. Vibrio cholerae in the horn of Africa: epidemiology, plasmids, tetracycline resistance gene amplification, and comparison between O1 and non-O1 strains. Am J Trop Med Hyg 1995; 53:351-9. [PMID: 7485686 DOI: 10.4269/ajtmh.1995.53.351] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The prevalence of Vibrio cholerae O1 and non-O1 has been investigated in numerous Somali regions of the Horn of Africa from 1983 to 1990. From January 1983 to January 1985 and between December 1986 and December 1990, no strains of V. cholerae O1 and 226 strains (5.3%) of V. cholerae non-O1 were isolated from 4,295 diarrhea cases. During a cholera epidemic in 1985 and 1986, the overall case-fatality rate was 13% and the attack rate was 3-3.5 per 1,000 population. Matched case-control studies identified a waterborne route of transmission. A drug-susceptible Ogawa strain from Ethiopia caused the introduction of the disease into northern Somalia. There were two major resistant derivatives of the original strain, and the one resistant to ampicillin, kanamycin, streptomycin, sulfonamide, and tetracycline (TC) predominated in the spreading disease. In 1986, susceptible Ogawa strains quickly displaced this resistant strain. The two incompatibility group C plasmids responsible for the resistance patterns had complex and scattered differences in their structures. Physical analysis of the plasmid DNA region coding for TC resistance demonstrated its genetic amplification in highly resistant variants of Ogawa strains.
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Affiliation(s)
- A Coppo
- Dipartimento di Biologia Cellulare e dello Sviluppo, Universita di Roma La Sapienza, Roma, Italia
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Colombo MM, Mastrandrea S, Santona A, de Andrade AP, Uzzau S, Rubino S, Cappuccinelli P. Distribution of the ace, zot, and ctxA Foxin genes in clinical and environmental Vibrio cholerae. J Infect Dis 1994; 170:750-1. [PMID: 8077743 DOI: 10.1093/infdis/170.3.750] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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