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Puzelli S, Facchini M, Piacentini S, Di Mario G, Colucci ME, Calzoletti L, Fabiani C, Di Martino A, Veronesi L, Biasucci G, Codeluppi M, Cascio GL, Schiavo R, Rampini A, Affanni P, Palamara AT, Stefanelli P. Characterization of an influenza B virus isolated from a fatal case of myocarditis in a pediatric patient in Italy. J Infect Public Health 2024; 17:417-420. [PMID: 38262078 DOI: 10.1016/j.jiph.2023.12.018] [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: 10/02/2023] [Revised: 12/20/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024] Open
Abstract
Influenza B is one of the infective agents that can cause rapid and fatal myocarditis in children. Here, we describe a fatal case of myocarditis in a previously healthy child, after infection with an influenza B/Victoria-lineage virus during the 2022-23 epidemic season in Italy. Influenza B virus was isolated also in a second case, a younger family member showing only a mild influenza-like illness. Genotypic and phenotypic analyses have been performed on both virus samples and results showed that HA1 sequences were identical and genetically and antigenically related to other B viruses circulating in 2022-23 season in Italy. However, a D129N substitution was found in the receptor binding domain of the HA of the two viruses, not detected in other circulating viruses in Italy but only in a proportion of those circulating in other European countries. Phenotypic analyses assessed the susceptibility towards either neuraminidase inhibitors and baloxavir. Annual influenza vaccination remains one of the best interventions to prevent complications such as myocarditis, particularly in children.
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Affiliation(s)
- Simona Puzelli
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy.
| | - Marzia Facchini
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Sara Piacentini
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Giuseppina Di Mario
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | | | - Laura Calzoletti
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Concetta Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Angela Di Martino
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giacomo Biasucci
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Pediatrics & Neonatology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Mauro Codeluppi
- Infectious Diseases Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - Roberta Schiavo
- Microbiology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Anna Teresa Palamara
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
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2
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Citterio C, Biasini C, Di Nunzio C, Lo Cascio G, Cavanna L. Humoral Response and Safety after a Fourth Dose of the SARS-CoV-2 BNT162b2 Vaccine in Cancer Patients Undergoing Active Treatment-Results of a Prospective Observational Study. Vaccines (Basel) 2024; 12:76. [PMID: 38250889 PMCID: PMC10821081 DOI: 10.3390/vaccines12010076] [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: 12/13/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Only a few studies have been carried out on the efficacy and safety of a fourth dose of the COVID-19 vaccine in patients with cancer. In this prospective observational study, we aimed to assess the serological response and safety of the fourth booster shot of the BNT162b2 vaccine in 79 cancer patients, vaccinated between 1 March and 25 August 2022, under systemic anticancer therapy. The primary endpoint was to assess the increase in the anti-SARS-CoV-2 antibodies; secondary endpoints were the vaccine safety and side effects. Consequently, 40 patients (50.63%) revealed the maximum detection values in their IgG titers before the fourth dose of the vaccine, while 39 patients (49.37%) did not. Primary endpoint: Of 39 patients, 36 (92.31%) showed a significant increase in the anti-SARS-CoV-2 IgG titers, and 32 of them (82.05%) reached the maximum titration values. Secondary endpoints: The most common adverse events were mild in severity and included injection site pain, erythema and tiredness. The majority of the adverse reactions reported were grade 1 and no grade 3 and 4 reactions were detected. Our data provide evidence that a fourth dose of the BNT162b2 anti-SARS-CoV-2 vaccine is effective and safe in patients with solid tumors in active anticancer treatment.
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Affiliation(s)
- Chiara Citterio
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy; (C.C.); (C.B.); (C.D.N.)
| | - Claudia Biasini
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy; (C.C.); (C.B.); (C.D.N.)
| | - Camilla Di Nunzio
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy; (C.C.); (C.B.); (C.D.N.)
| | - Giuliana Lo Cascio
- Clinical Pathology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy;
| | - Luigi Cavanna
- Casa di Cura Piacenza, Internal Medicine and Oncology, Via Morigi 41, 29121 Piacenza, Italy
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3
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Ortalli G, Oliva E, Lo Cascio G, On Behalf Of The Medical Mycology Committee CoSM-Italian Association Of Clinical Microbiologists Amcli, Farina C. In Vitro Activity of Isavuconazole and Amphotericin B in Association against Mucorales. Pathogens 2023; 12:948. [PMID: 37513795 PMCID: PMC10383810 DOI: 10.3390/pathogens12070948] [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: 06/13/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Mucormycoses can be treated with the combination of Amphotericin B and Isavuconazole. This study evaluates the effects of these drugs in vitro against 59 strains representing 12 Mucorales. In vitro testing of the two drugs together and alone was performed using the MIC Test strip "Epsilon test synergy-method" (ETSM), which is more standard in clinical practice than microbroth dilution testing. Amphotericin B and Isavuconazole have synergistic/additive effects against L. corymbifera, R. arrhizus and M. circinelloides. Different effects have been shown for other Mucorales. ETSM can help the clinical management of mucormycosis from a practical point of view, due to its feasibility in the laboratory.
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Affiliation(s)
- Gaia Ortalli
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Piazza OMS 1, 24127 Bergamo, Italy
| | - Ester Oliva
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Piazza OMS 1, 24127 Bergamo, Italy
| | - Giuliana Lo Cascio
- Microbiology and Virology Laboratory, Ospedale Guglielmo da Saliceto, Via Taverna 49, 29121 Piacenza, Italy
- Medical Mycology Committee (CoSM)-Italian Association of Clinical Microbiologists (AMCLI), Via Carlo Farini 81, 20159 Milano, Italy
| | | | - Claudio Farina
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Piazza OMS 1, 24127 Bergamo, Italy
- Medical Mycology Committee (CoSM)-Italian Association of Clinical Microbiologists (AMCLI), Via Carlo Farini 81, 20159 Milano, Italy
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4
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Azzini AM, Be G, Naso L, Lambertenghi L, Salerno ND, Coledan I, Bazaj A, Mirandola M, Miotti J, Mazzaferri F, Accordini S, Lo Cascio G, Tacconelli E. Risk factors for colonization with multidrug-resistant Gram-negative bacteria and Clostridioides difficile in Long Term Care Facilities (LTCFs) residents: the evidence from 27 facilities in a high endemic setting. Front Cell Infect Microbiol 2023; 13:1155320. [PMID: 37377644 PMCID: PMC10292821 DOI: 10.3389/fcimb.2023.1155320] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction Residency in LTCFs increases the likelihood of colonization with multidrug resistant Gram-negative bacteria (MDR-GNB). We assessed the prevalence and risk factors for enteric colonization by III-generation cephalosporins-resistant and carbapenem-resistant (CR) GNB in a large group of LTCFs in a high endemic setting. We also assessed the prevalence and risk factors for C. difficile colonization. Methods A point prevalence survey with rectal screening (RS) was conducted in 27 LTCFs in north Italy. Epidemiological and clinical variables on the survey day, history of hospitalization and surgery within one year, and antibiotics within three months, were collected. The presence of III-generation cephalosporin resistant and CR GNB was assessed using a selective culture on chromogenic medium and PCR for carbapenemase detection. The presence of C. difficile was assessed using ELISA for GDH and RT-PCR to identify toxigenic strains. Multi-variable analyses were performed using two-level logistic regression models. Results In the study period 1947 RSs were performed. The prevalence of colonization by at least one GNB resistant to III-generation cephalosporin was 51% (E. coli 65%, K. pneumoniae 14% of isolates). The prevalence of colonization by CR GNB was 6%. 6% of all isolates (1150 strains) resulted in a carbapenem-resistant K. pneumoniae, and 3% in a carbapenem-resistant E. coli. KPC was the most frequent carbapenemase (73%) identified by PCR, followed by VIM (23%). The prevalence of colonization by C. difficile was 11.7%. The presence of a medical device (OR 2.67) and previous antibiotic use (OR 1.48) were significantly associated with III-generation cephalosporin resistant GNB colonization. The presence of a medical device (OR 2.67) and previous hospitalization (OR 1.80) were significantly associated with CR GNB. The presence of a medical device (OR 2.30) was significantly associated with C. difficile colonization. Main previously used antibiotic classes were fluoroquinolones (32% of previously treated subjects), III-generation cephalosporins (21%), and penicillins (19%). Conclusion Antimicrobial stewardship in LTCFs is a critical issue, being previous antibiotic treatment a risk factor for colonization by MDR-GNB. The prevalence of colonization by III-generation cephalosporin and CR GNB among LTCF residents also underlines the importance to adhere to hand hygiene indications, infection prevention and control measures, and environmental hygiene protocols, more achievable than rigorous contact precautions in this type of social setting.
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Affiliation(s)
- Anna Maria Azzini
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giorgia Be
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- Infectious Disease Unit, Mater Salutis Hospital - ULSS 9 Scaligera, Legnago, Italy
| | - Laura Naso
- Microbiology and Virology Unit, AOUI Verona, Verona, Italy
| | - Lorenza Lambertenghi
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Nicola Duccio Salerno
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Ilaria Coledan
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- SerT Suzzara, SC Ser.D. Mantova, ASST Mantova, Suzzara, Italy
| | - Alda Bazaj
- Microbiology Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Massimo Mirandola
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jessica Miotti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Fulvia Mazzaferri
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Microbiology and Virology Unit, AOUI Verona, Verona, Italy
- Microbiology Unit, AUSL Piacenza, Piacenza, Italy
| | - Evelina Tacconelli
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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5
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Lasagna A, Cassaniti I, Arena F, Bergami F, Percivalle E, Comolli G, Sarasini A, Ferrari A, Cicognini D, Schiavo R, Lo Cascio G, Pedrazzoli P, Baldanti F. Persistence of Immune Response Elicited by Three Doses of mRNA Vaccine against SARS-CoV-2 in a Cohort of Patients with Solid Tumors: A One-Year Follow-Up. Int J Mol Sci 2023; 24:ijms24076731. [PMID: 37047704 PMCID: PMC10095115 DOI: 10.3390/ijms24076731] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
The role and durability of the immunogenicity of the BNT162b2 mRNA vaccine against severe acute respiratory virus 2 (SARS-CoV-2), in cancer patients one year after receiving the third dose have to be elucidated. We have prospectively evaluated the long-term immunogenicity of the third dose of the SARS-CoV-2 BNT162b2 mRNA vaccine in 55 patients undergoing active treatment. Neutralizing antibody (NT Ab) titers against Omicron variants and total anti-trimeric S IgG levels were measured one year after the third dose. Heparinized whole-blood samples were used for the assessment of the SARS-CoV-2 interferon-γ release assay (IGRA). Thirty-seven patients (67.3%) showed positive total anti-trimeric S IgG one year after the third dose. Looking at the T-cell response against the spike protein, the frequency of responder patients did not decrease significantly between six and twelve months after the third dose. Finally, less than 20% of cancer patients showed an undetectable NT Ab titer against BA.1 and BA.5 variants of concern (VOCs). Underlying therapies seem to not affect the magnitude or frequency of the immune response. Our work underlines the persistence of humoral and cellular immune responses against BNT162b2 in a cohort of cancer patients one year after receiving the third dose, regardless of the type of underlying therapy.
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Affiliation(s)
- Angioletta Lasagna
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Irene Cassaniti
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Francesca Arena
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Federica Bergami
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Elena Percivalle
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Giuditta Comolli
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Antonella Sarasini
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Alessandro Ferrari
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Daniela Cicognini
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Roberta Schiavo
- Microbiology Unit, Hospital Guglielmo da Saliceto, 29121 Piacenza, Italy
| | - Giuliana Lo Cascio
- Microbiology Unit, Hospital Guglielmo da Saliceto, 29121 Piacenza, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
| | - Fausto Baldanti
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Department of Clinical, Surgical, Diagnostics and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
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6
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Prigitano A, Blasi E, Calabrò M, Cavanna C, Cornetta M, Farina C, Grancini A, Innocenti P, Lo Cascio G, Nicola L, Trovato L, Cogliati M, Esposto MC, Tortorano AM, Romanò L. Yeast Bloodstream Infections in the COVID-19 Patient: A Multicenter Italian Study (FiCoV Study). J Fungi (Basel) 2023; 9:jof9020277. [PMID: 36836391 PMCID: PMC9962415 DOI: 10.3390/jof9020277] [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: 12/06/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Fungemia is a co-infection contributing to the worsening of the critically ill COVID-19 patient. The multicenter Italian observational study FiCoV aims to estimate the frequency of yeast bloodstream infections (BSIs), to describe the factors associated with yeast BSIs in COVID-19 patients hospitalized in 10 hospitals, and to analyze the antifungal susceptibility profiles of the yeasts isolated from blood cultures. The study included all hospitalized adult COVID-19 patients with a yeast BSI; anonymous data was collected from each patient and data about antifungal susceptibility was collected. Yeast BSI occurred in 1.06% of patients, from 0.14% to 3.39% among the 10 participating centers. Patients were mainly admitted to intensive or sub-intensive care units (68.6%), over 60 years of age (73%), with a mean and median time from the hospitalization to fungemia of 29 and 22 days, respectively. Regarding risk factors for fungemia, most patients received corticosteroid therapy during hospitalization (61.8%) and had a comorbidity (25.3% diabetes, 11.5% chronic respiratory disorder, 9.5% cancer, 6% haematological malignancies, 1.4% organ transplantation). Antifungal therapy was administered to 75.6% of patients, mostly echinocandins (64.5%). The fatality rate observed in COVID-19 patients with yeast BSI was significantly higher than that of COVID-19 patients without yeast BSI (45.5% versus 30.5%). Candida parapsilosis (49.8%) and C. albicans (35.2%) were the most fungal species isolated; 72% of C. parapsilosis strains were fluconazole-resistant (range 0-93.2% among the centers). The FiCoV study highlights a high prevalence of Candida BSIs in critically ill COVID-19 patients, especially hospitalized in an intensive care unit, a high fatality rate associated with the fungal co-infection, and the worrying spread of azole-resistant C. parapsilosis.
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Affiliation(s)
- Anna Prigitano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
- Correspondence:
| | - Elisabetta Blasi
- Laboratory of Microbiology, AOU-Policlinic/CHIMOMO, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Maria Calabrò
- Clinical Microbiology and Virology Laboratory, Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Caterina Cavanna
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Maria Cornetta
- Operative Unit 1—Clinical Pathology, Department of Pathology and Laboratory Medicine, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Claudio Farina
- Microbiology and Virology Laboratory, ASST “Papa Giovanni XXIII”, 24100 Bergamo, Italy
| | - Anna Grancini
- U.O.S. Microbiology—Analysis Laboratory, IRCCS Foundation, Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Patrizia Innocenti
- Laboratorio Aziendale di Microbiologia e Virologia di Bolzano, Comprensorio Sanitario di Bolzano, 39100 Bolzano, Italy
| | - Giuliana Lo Cascio
- Dipartimento di Patologia Clinica-Unità Operativa di Microbiologia e Virologia-AUSL Piacenza, 29121 Piacenza, Italy
| | - Lucia Nicola
- ASST Melegnano e Martesana, Laboratorio Microbiologia PO Cernusco s/N, 20063 Cernusco sul Naviglio, Italy
| | - Laura Trovato
- U.O.C. Laboratory Analysis Unit, A.O.U. “Policlinico-San Marco”, 95125 Catania, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy
| | - Massimo Cogliati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
| | - Maria Carmela Esposto
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
| | - Anna Maria Tortorano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
| | - Luisa Romanò
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
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7
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Lo Cascio G, Bazaj A, Trovato L, Sanna S, Andreoni S, Blasi E, Conte M, Fazii P, Oliva E, Lepera V, Lombardi G, Farina C. Multicenter Italian Study on "In Vitro Activities" of Isavuconazole, Voriconazole, Amphotericin B, and Caspofungin for Aspergillus Species: Comparison between Sensititre TM YeastOne TM and MIC Test Strip. Infect Drug Resist 2022; 15:5839-5848. [PMID: 36217342 PMCID: PMC9547591 DOI: 10.2147/idr.s367082] [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: 03/19/2022] [Accepted: 09/16/2022] [Indexed: 11/05/2022] Open
Abstract
In this study the activity of Isavuconazole, Voriconazole, Amphotericin B, and Caspofungin against 224 clinical isolates of Aspergillus spp. originating from seven Italian hospitals, was comparatively evaluated with two commercial antifungal susceptibility tests (AST): SensititreTM YeastOneTM (SYO) and MIC Test Strip. More attention was focused on Isavuconazole activity, given the new introduction of the drug in widely distributed antifungal susceptibilities methods in the clinical microbiology lab. The minimum inhibitory concentrations of antifungal drug that can inhibit the growth of pathogen by 90% (MIC90) for Isavuconazole detected by SYO were 0.5, 1, 0.25, and 2 µg/mL for Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus, and Aspergillus niger, respectively, whilst they were 0.25, 0.25, 0.5, and 0.75 µg/mL by MIC Test Strip. Essential agreement between the two tested methods for Isavuconazole is 70% for all the species tested, 75.7% for A. fumigatus, 45.2% for A. flavus, 90.6% for A. terreus, and 40% for A. niger. Although the tested strains do not express any phenotypic resistance, MIC results were quite different if tested with microdilution broth or gradient agar method. This is the first Italian multicenter report on Isavuconazole MIC obtained employing the widely used SensititreTM Yeast OneTM (SYO) and MIC Test Strip on clinical isolates of Aspergillus.
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Affiliation(s)
- Giuliana Lo Cascio
- Clinical Microbiology and Virology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy,Medical Mycology Committee, Italian Society of Clinical Microbiologist, Milan, Italy,Clinical Microbiology and Virology Unit, Azienda USL, Piacenza, Italy,Correspondence: Giuliana Lo Cascio, Email
| | - Alda Bazaj
- Clinical Microbiology and Virology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Laura Trovato
- Medical Mycology Committee, Italian Society of Clinical Microbiologist, Milan, Italy,Clinical Microbiology, Azienda Ospedaliera Universitaria- Policlinico Vittorio Emanuele, Catania, Italy
| | - Silvana Sanna
- Medical Mycology Committee, Italian Society of Clinical Microbiologist, Milan, Italy,Microbiology and Virology Unit, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Stefano Andreoni
- Medical Mycology Committee, Italian Society of Clinical Microbiologist, Milan, Italy,Microbiology and Virology Unit, Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Italy
| | - Elisabetta Blasi
- Medical Mycology Committee, Italian Society of Clinical Microbiologist, Milan, Italy,Clinical Microbiology, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy
| | - Marco Conte
- Medical Mycology Committee, Italian Society of Clinical Microbiologist, Milan, Italy,Microbiology and Virology Unit, Grande Ospedale Metropolitano Bianchi- Melacrino- Morelli, Reggio, Calabria, Italy
| | - Paolo Fazii
- Medical Mycology Committee, Italian Society of Clinical Microbiologist, Milan, Italy,Clinical Microbiology and Virology P.O. Spirito Santo, Pescara, Italy
| | - Ester Oliva
- Clinical Microbiology and Virology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Valentina Lepera
- Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Gianluigi Lombardi
- Medical Mycology Committee, Italian Society of Clinical Microbiologist, Milan, Italy,Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Claudio Farina
- Medical Mycology Committee, Italian Society of Clinical Microbiologist, Milan, Italy,Clinical Microbiology and Virology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
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8
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Lasagna A, Cassaniti I, Bergami F, Lilleri D, Percivalle E, Quaccini M, Alessio N, Comolli G, Sarasini A, Camilla J, Ferrari A, Arena F, Secondino S, Cicognini D, Schiavo R, Lo Cascio G, Cavanna L, Baldanti F, Pedrazzoli P. Humoral and cell-mediated immune response to the third dose of BNT162b2 anti-SARS-CoV-2 vaccine in patients with cancer on active treatment: Focus on wild type, Delta and Omicron strains. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e13505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13505 Background: Although a full course of COVID-19 vaccine is effective in cancer patients, the duration of the protection and the efficacy of a booster dose against the new variants remain unknown. We prospectively evaluated the immunogenicity of the third dose of the SARS-CoV-2 BNT162b2 mRNA vaccine in cancer patients undergoing active treatment. Methods: Patients with solid cancer, vaccinated with a booster dose during active treatment, were prospectively enrolled in this study. Patients were classified in SARS-CoV-2 naïve (without previous COVID-19 infection) and SARS-CoV-2 experienced (with previous COVID-19 infection). Neutralizing antibody (NT Abs) titer and total anti-Spike IgG concentration were quantified in serum. Heparinized whole blood samples were used for SARS-CoV-2 Interferon Gamma Release Assay (IGRA). The primary endpoint was to assess the increase of IgG antibody level between baseline (T0) and 3 weeks after the booster (T1). Results: 142 consecutive patients were recruited. In SARS-CoV-2 naïve subjects, median level of IgG was 157 BAU/mL (interquartile range (IQR) 62-423) at T0 and reached median of 2080 (IQR 2080-2080) at three weeks after booster administration (T1; p < 0.0001). A median 16-fold increase of SARS-CoV-2 NT Abs titre (IQR 4-32) was observed in naïve subjects (from median 20 IQR 10-40 to median 640 IQR 160-640; p < 0.0001). Median IFN-γ level at T1 was significantly higher than that measured at T0 in SARS-CoV-2 naïve subjects (p = 0.0049) but not in SARS-CoV-2 experienced patients. No difference was observed in terms of median response between patients treated with immunotherapy and chemotherapy (p > 0.05). A stronger correlation between SARS-CoV-2 NT Abs and total IgG level was observed at T0 (r = 0.76; p < 0.0001) compared to T1 (r = 0.27, p = 0.0081). No correlation as regards the number of days was observed from the first to the third vaccination and SARS-CoV-2 NT Abs/total IgG. The median level of SARS-CoV-2 NT Abs was 32-fold lower against Omicron compared to wild type strain (p = 0.0004) and 12-fold lower compared to Delta strain (p = 0.0110). Conclusions: The third dose is able to trigger both the humoral and the cell-mediated immune response in cancer patients on active treatment. Our preliminary data about the neutralization of the SARS-CoV-2 vaccine against variants of concern (VOCs) seem to confirm the vaccine lower activity.
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Affiliation(s)
| | | | | | | | | | | | | | - Giuditta Comolli
- Microbiology and Virology, Biotechnology Laboratories, IRCCS San Matteo, Pavia, Italy
| | | | - Josè Camilla
- Fondazione Irccs Policlinico San Matteo, Pavia, Italy
| | | | | | | | | | | | | | - Luigi Cavanna
- Oncology & Hematology Department, Oncology Unit, Piacenza General Hospital, Piacenza, Italy
| | | | - Paolo Pedrazzoli
- Medical Oncology Unit, IRCCS Policlinico San Matteo, Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
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Pieralli F, Azzini AM, Concia E, Lo Cascio G, Tedesco A, Benedetti V, Piredda S, Giusti M, Santini C, Zagarrì E, Fontanella A, Manfellotto D. Predicting candidemia in internal medicine departments: are we chasing the Holy Grail? Pol Arch Intern Med 2021; 131. [PMID: 34622648 DOI: 10.20452/pamw.16112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Anna Maria Azzini
- Department of Diagnostic and Public Health, Infectious Disease Section, University of Verona, Verona, Italy
| | - Ercole Concia
- Department of Diagnostic and Public Health, Infectious Disease Section, University of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Department of Diagnostic and Public Health, Infectious Disease Section, University of Verona, Verona, Italy
| | - Andrea Tedesco
- Internal Medicine Department, G. Fracastoro Hospital, San Bonifacio, Verona, Italy
| | - Valentina Benedetti
- Internal Medicine Department, Regina Montis Regalis Hospital, Mondovì, Cuneo, Italy
| | - Sabrina Piredda
- Internal Medicine Department, Galliera Hospital, Genoa, Italy
| | - Massimo Giusti
- Internal Medicine Department, San Giovanni Bosco Hospital, Turin, Italy
| | | | | | - Andrea Fontanella
- Internal Medicine Department, Fatebenefratelli Hospital, Naples, Italy
| | - Dario Manfellotto
- Internal Medicine Department, AFaR Division, Fatebenefratelli Foundation, “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
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10
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Cavanna L, Citterio C, Biasini C, Madaro S, Bacchetta N, Lis A, Cremona G, Muroni M, Bernuzzi P, Lo Cascio G, Schiavo R, Mutti M, Tassi M, Mariano M, Trubini S, Bandieramonte G, Maestri R, Mordenti P, Marazzi E, Vallisa D. COVID-19 vaccines in adult cancer patients with solid tumours undergoing active treatment: Seropositivity and safety. A prospective observational study in Italy. Eur J Cancer 2021; 157:441-449. [PMID: 34601285 PMCID: PMC8410513 DOI: 10.1016/j.ejca.2021.08.035] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Patients with cancer are presumed a frail group at high risk of contracting coronavirus disease (COVID-19), and vaccination represents a cornerstone in addressing the COVID-19 pandemic. However, data on COVID-19 vaccination in cancer patients are fragmentary and poor. METHODS An observational study was conducted to evaluate the seropositivity rate and safety of a two-dose regimen of the BNT162b2 or messenger RNA-1273 vaccine in adult patients with solid cancer undergoing active anticancer treatment or whose treatment had been terminated within 6 months of the start of the study. The control group was composed of healthy volunteers. Serum samples were evaluated for SARS-COV-2 antibodies before vaccinations and 2-6 weeks after the administration of the second vaccine dose. Primary end-point: seropositivity rate. Secondary end-points: safety, factors influencing seroconversion, IgG titers of patients versus healthy volunteers, COVID-19 infection. RESULTS Between 20th March 2021 and 12th June 2021, 293 consecutive patients with cancer-solid tumours underwent a program of COVID-19 vaccinations; of these, 2 patients refused vaccination, 13 patients did not receive the second dose of the vaccine because of cancer progression, and 21 patients had COVID-19 antibodies at baseline and were excluded. The 257 evaluable patients had a median age of 65 years (range 28-86), 66.15% with metastatic disease. Primary end-point: seropositivity rate in patients was 75.88% versus 100% in the control group. Secondary end-points: no Grade 3-4 side-effects, no COVID-19 infections were reported. Patients median IgG titer was significantly lower than in the control group; male sex and active anticancer therapy influenced negative seroconversion. BNT162b2 or messenger RNA-1273 vaccines were immunogenic in cancer patients, showing good safety profile.
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Affiliation(s)
- Luigi Cavanna
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy.
| | - Chiara Citterio
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Claudia Biasini
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Serena Madaro
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Nicoletta Bacchetta
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Anna Lis
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Gabriele Cremona
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Monica Muroni
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Patrizia Bernuzzi
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Giuliana Lo Cascio
- Clinical Pathology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Roberta Schiavo
- Clinical Pathology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Martina Mutti
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Maristella Tassi
- Clinical Pathology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Maria Mariano
- Clinical Pathology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Serena Trubini
- Clinical Pathology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Giulia Bandieramonte
- Clinical Pathology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Raffaella Maestri
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Patrizia Mordenti
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Elisabetta Marazzi
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | - Daniele Vallisa
- Oncology and Hematology Department, Piacenza General Hospital, Via Taverna 49, 29121 Piacenza, Italy
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Diani E, Piccaluga PP, Lotti V, Di Clemente A, Ligozzi M, De Nardo P, Lambertenghi L, Pizzolo F, Friso S, Lo Cascio G, Vianello A, Marchi G, Concia E, Gibellini D. Assessment of SARS-CoV-2 IgG and IgM antibody detection with a lateral flow immunoassay test. Heliyon 2021; 7:e08192. [PMID: 34693063 PMCID: PMC8525011 DOI: 10.1016/j.heliyon.2021.e08192] [Citation(s) in RCA: 3] [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: 07/01/2020] [Revised: 03/19/2021] [Accepted: 10/13/2021] [Indexed: 01/28/2023] Open
Abstract
The dramatic impact of SARS-CoV-2 infection on the worldwide public health has elicited the rapid assessment of molecular and serological diagnostic methods. Notwithstanding the diagnosis of SARS-CoV-2 infection is based on molecular biology approaches including multiplex or singleplex real time RT-PCR, there is a real need for affordable and rapid serological methods to support diagnostics, and surveillance of infection spreading. In this study, we performed a diagnostic accuracy analysis of COVID-19 IgG/IgM rapid test cassette lateral flow immunoassay test (LFIA) assay. To do so, we analyzed different cohorts of blood samples obtained from 151 SARS-CoV-2 RT-PCR assay positive patients (group 1) and 51 SARS-CoV-2 RT-PCR assay negative patients (group 2) in terms of sensitivity, specificity, PPV, NPV and likelihood ratios. In addition, we challenged LFIA with plasma from 99 patients stored during 2015–2017 period. Our results showed that this LFIA detected SARS-CoV-2 IgM and/or IgG in 103 out of 151 (68.21%) samples of group 1, whereas no IgM and/or IgG detection was displayed both in the group 2 and in pre-pandemic samples. Interestingly, IgM and/or IgG positivity was detected in 86 out of 94 (91.49%) group 1 samples collected after 10 days from symptoms onset whereas only 17 out of 57 of group 1 samples obtained before day 10 were positive to SARS-CoV-2 specific antibodies. We also compared the performance of this LFIA test with respect to other four different LFIA assays in 40 serum samples from multiplex RT-PCR positive individuals. Within the limits of the study size, the results demonstrated that COVID-19 IgG/IgM rapid test cassette LFIA assay displayed valid performance in IgM and IgG detection when compared with the other four LFIA assays. Hence, this approach might be considered as an alternative point-of-care procedure for SARS-CoV-2 serological investigation.
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Affiliation(s)
- Erica Diani
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Italy
| | - Pier Paolo Piccaluga
- Department of Experimental, Diagnostic, and Experimental Medicine, Bologna University School of Medicine, Bologna, Italy.,Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy.,School of Health, Department of Pathology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Virginia Lotti
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Italy
| | - Andrea Di Clemente
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Italy
| | - Marco Ligozzi
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Italy
| | - Pasquale De Nardo
- Department of Diagnostics and Public Health, Division of Infectious Diseases, University of Verona, Italy
| | - Lorenza Lambertenghi
- Department of Diagnostics and Public Health, Division of Infectious Diseases, University of Verona, Italy
| | - Francesca Pizzolo
- Department of Medicine, Internal Medicine B, University of Verona, Italy
| | - Simonetta Friso
- Department of Medicine, Internal Medicine B, University of Verona, Italy
| | | | - Alice Vianello
- Department of Medicine, Internal Medicine D, Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | - Giacomo Marchi
- Department of Medicine, Internal Medicine D, Azienda Ospedaliera Universitaria Integrata Verona, Italy
| | - Ercole Concia
- Department of Diagnostics and Public Health, University of Verona, Italy
| | - Davide Gibellini
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Italy
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12
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Piccirilli A, Cherubini S, Azzini AM, Tacconelli E, Lo Cascio G, Maccacaro L, Bazaj A, Naso L, Amicosante G, Perilli M. Whole-Genome Sequencing (WGS) of Carbapenem-Resistant K. pneumoniae Isolated in Long-Term Care Facilities in the Northern Italian Region. Microorganisms 2021; 9:microorganisms9091985. [PMID: 34576880 PMCID: PMC8465262 DOI: 10.3390/microorganisms9091985] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 08/01/2021] [Revised: 09/03/2021] [Accepted: 09/14/2021] [Indexed: 01/05/2023] Open
Abstract
K. pneumoniae (KPN) is one of the widest spread bacteria in which combined resistance to several antimicrobial groups is frequent. The most common β-lactamases found in K. pneumoniae are class A carbapenemases, both chromosomal-encoded (i.e., NMCA, IMI-1) and plasmid-encoded (i.e., GES-enzymes, IMI-2), VIM, IMP, NDM, OXA-48, and extended-spectrum β-lactamases (ESBLs) such as CTX-M enzymes. In the present study, a total of 68 carbapenem-resistant KPN were collected from twelve long-term care facilities (LTCFs) in the Northern Italian region. The whole-genome sequencing (WGS) of each KPN strain was determined using a MiSeq Illumina sequencing platform and analysed by a bacterial analysis pipeline (BAP) tool. The WGS analysis showed the prevalence of ST307, ST512, and ST37 as major lineages diffused among the twelve LTCFs. The other lineages found were: ST11, ST16, ST35, ST253, ST273, ST321, ST416, ST1519, ST2623, and ST3227. The blaKPC-2, blaKPC-3, blaKPC-9, blaSHV-11, blaSHV-28, blaCTX-M-15, blaOXA-1, blaOXA-9, blaOXA-23, qnrS1, qnrB19, qnrB66, aac(6′)-Ib-cr, and fosA were the resistance genes widespread in most LTCFs. In this study, we demonstrated the spreading of thirteen KPN lineages among the LTCFs. Additionally, KPC carbapenemases are the most widespread β-lactamase.
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Affiliation(s)
- Alessandra Piccirilli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.P.); (S.C.); (G.A.)
| | - Sabrina Cherubini
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.P.); (S.C.); (G.A.)
| | - Anna Maria Azzini
- Infectious Disease Section, Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy; (A.M.A.); (E.T.)
| | - Evelina Tacconelli
- Infectious Disease Section, Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy; (A.M.A.); (E.T.)
| | - Giuliana Lo Cascio
- Microbiology and Virology Unit, Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata di Verona, 37134 Verona, Italy; (G.L.C.); (L.M.); (A.B.); (L.N.)
- Microbiology and Virology Unit, AUSL Piacenza, 29121 Piacenza, Italy
| | - Laura Maccacaro
- Microbiology and Virology Unit, Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata di Verona, 37134 Verona, Italy; (G.L.C.); (L.M.); (A.B.); (L.N.)
| | - Alda Bazaj
- Microbiology and Virology Unit, Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata di Verona, 37134 Verona, Italy; (G.L.C.); (L.M.); (A.B.); (L.N.)
| | - Laura Naso
- Microbiology and Virology Unit, Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata di Verona, 37134 Verona, Italy; (G.L.C.); (L.M.); (A.B.); (L.N.)
| | - Gianfranco Amicosante
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.P.); (S.C.); (G.A.)
| | | | - Mariagrazia Perilli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (A.P.); (S.C.); (G.A.)
- Correspondence:
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13
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Rovida F, Cassaniti I, Percivalle E, Sarasini A, Paolucci S, Klersy C, Cutti S, Novelli V, Marena C, Luzzaro F, De Vito G, Schiavo R, Lo Cascio G, Lilleri D, Baldanti F. Incidence of SARS-CoV-2 infection in health care workers from Northern Italy based on antibody status: immune protection from secondary infection- A retrospective observational case-controlled study. Int J Infect Dis 2021; 109:199-202. [PMID: 34242763 PMCID: PMC8260553 DOI: 10.1016/j.ijid.2021.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022] Open
Abstract
Immunity from natural SARS-CoV-2 infection is protective in healthcare workers Secondary infection is associated with low or absent serum neutralizing titer Anti-Spike IgG were not significantly lower in subjects with secondary infections Secondary infection is usually asymptomatic or mildly symptomatic Vaccination of SARS-CoV-2-seronegative subjects might be prioritized
Objective The protection from SARS-CoV-2 infection induced by SARS-CoV-2 anti-S1 and anti-S2 IgG antibody positivity resulting from natural infection was evaluated. Methods The frequency of SARS-CoV-2 infection (as determined by virus RNA detection) was evaluated in a group of 1,460 seropositive and a control group of 8,150 seronegative healthcare workers in three Centres of Northern Italy in the period June-November 2020. Neutralizing serum titers were analyzed in seropositive subjects with or without secondary SARS-CoV-2 infection. Results During the 6-month survey, 1.78% seropositive subjects developed secondary SARS-CoV-2 infection while 6.63% seronegative controls developed primary infection (odds ratio: 0.26; 95% confidence interval: 0.17-0.38). Secondary infection was associated with low or absent serum neutralizing titer (p<0.01) and was mildly symptomatic in 45.8% cases vs 71.4% symptomatic primary infections (odds ratio: 0.34; 95% confidence interval: 0.16-0.78). Conclusions Immunity from natural infection appears protective from secondary infection; therefore, vaccination of seronegative subjects might be prioritized.
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Affiliation(s)
- Francesca Rovida
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Irene Cassaniti
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Percivalle
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonella Sarasini
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefania Paolucci
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Catherine Klersy
- Biometry and Clinical Epidemiology Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sara Cutti
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Viola Novelli
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Marena
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Luzzaro
- Clinical Microbiology and Virology Unit, Lecco A. Manzoni Hospital, Lecco, Italy
| | - Giovanni De Vito
- Occupational Medicine Unit, A. Manzoni Hospital, Lecco, School of Medicine & Surgery, Milano Bicocca University
| | - Roberta Schiavo
- Microbiology Unit, Clinical Pathology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Giuliana Lo Cascio
- Microbiology Unit, Clinical Pathology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Daniele Lilleri
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia Italy
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14
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Porru S, Monaco MGL, Carta A, Spiteri G, Parpaiola M, Battaggia A, Galligioni G, Ferrazzi B, Lo Cascio G, Gibellini D, Peretti A, Brutti M, Tardivo S, Ghirlanda G, Verlato G, Gaino S, Peserico D, Bassi A, Lippi G. SARS-CoV-2 Infection in Health Workers: Analysis from Verona SIEROEPID Study during the Pre-Vaccination Era. Int J Environ Res Public Health 2021; 18:ijerph18126446. [PMID: 34198715 PMCID: PMC8296263 DOI: 10.3390/ijerph18126446] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 12/24/2022]
Abstract
Background: To report the baseline phase of the SIEROEPID study on SARS-CoV-2 infection seroprevalence among health workers at the University Hospital of Verona, Italy, between spring and fall 2020; to compare performances of several laboratory tests for SARS-CoV-2 antibody detection. Methods: 5299 voluntary health workers were enrolled from 28 April 2020 to 28 July 2020 to assess immunological response to SARS-CoV-2 infection throughout IgM, IgG and IgA serum levels titration by four laboratory tests. Association of antibody titre with several demographic variables, swab tests and performance tests (sensitivity, specificity, and agreement) were statistically analyzed. Results: The overall seroprevalence was 6%, considering either IgG and IgM, and 4.8% considering IgG. Working in COVID-19 Units was not associated with a statistically significant increase in the number of infected workers. Cohen’s kappa of agreement between MaglumiTM and VivaDiagTM was quite good when considering IgG only (Cohen’s kappa = 78.1%, 95% CI 74.0–82.0%), but was lower considering IgM (Cohen’s kappa = 13.3%, 95% CI 7.8–18.7%). Conclusion: The large sample size with high participation (84.7%), the biobank and the longitudinal design were significant achievements, offering a baseline dataset as the benchmark for risk assessment, health surveillance and management of SARS-CoV-2 infection for the hospital workforce, especially considering the ongoing vaccination campaign. Study results support the national regulator guidelines on using swabs for SARS-CoV-2 screening with health workers and using the serological tests to contribute to the epidemiological assessment of the spread of the virus.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (S.P.); (A.C.)
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy;
| | - Maria Grazia Lourdes Monaco
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy;
- Correspondence: ; Tel.: +0039-0458123946
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (S.P.); (A.C.)
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy;
| | - Gianluca Spiteri
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy;
| | - Marco Parpaiola
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona, Italy; (M.P.); (A.B.); (G.G.); (B.F.)
| | - Andrea Battaggia
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona, Italy; (M.P.); (A.B.); (G.G.); (B.F.)
| | - Giulia Galligioni
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona, Italy; (M.P.); (A.B.); (G.G.); (B.F.)
| | - Beatrice Ferrazzi
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona, Italy; (M.P.); (A.B.); (G.G.); (B.F.)
| | | | - Davide Gibellini
- Section of Microbiology, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona, Italy; (A.P.); (M.B.)
| | - Angelo Peretti
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona, Italy; (A.P.); (M.B.)
| | - Martina Brutti
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona, Italy; (A.P.); (M.B.)
| | - Stefano Tardivo
- Section of Hygiene, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | | | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Stefania Gaino
- Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, 37134 Verona, Italy; (S.G.); (A.B.); (G.L.)
- Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Denise Peserico
- Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Antonella Bassi
- Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, 37134 Verona, Italy; (S.G.); (A.B.); (G.L.)
- Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Giuseppe Lippi
- Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, 37134 Verona, Italy; (S.G.); (A.B.); (G.L.)
- Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
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15
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Benoni R, Panunzi S, Campagna I, Moretti F, Lo Cascio G, Spiteri G, Porru S, Tardivo S. The Effect of Test Timing on the Probability of Positive SARS-CoV-2 Swab Test Results: Mixed Model Approach. JMIR Public Health Surveill 2021; 7:e27189. [PMID: 34003761 PMCID: PMC8176944 DOI: 10.2196/27189] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/08/2021] [Accepted: 05/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, swab tests proved to be effective in containing the infection and served as a means for early diagnosis and contact tracing. However, little evidence exists regarding the correct timing for the execution of the swab test, especially for asymptomatic individuals and health care workers. OBJECTIVE The objective of this study was to analyze changes in the positive findings over time in individual SARS-CoV-2 swab tests during a health surveillance program. METHODS The study was conducted with 2071 health care workers at the University Hospital of Verona, with a known date of close contact with a patient with COVID-19, between February 29 and April 17, 2020. The health care workers underwent a health surveillance program with repeated swab tests to track their virological status. A generalized additive mixed model was used to investigate how the probability of a positive test result changes over time since the last known date of close contact, in an overall sample of individuals who tested positive for COVID-19 and in a subset of individuals with an initial negative swab test finding before being proven positive, to assess different surveillance time intervals. RESULTS Among the 2071 health care workers in this study, 191 (9.2%) tested positive for COVID-19, and 103 (54%) were asymptomatic with no differences based on sex or age. Among 49 (25.7%) cases, the initial swab test yielded negative findings after close contact with a patient with COVID-19. Sex, age, symptoms, and the time of sampling were not different between individuals with an initial negative swab test finding and those who initially tested positive after close contact. In the overall sample, the estimated probability of testing positive was 0.74 on day 1 after close contact, which increased to 0.77 between days 5 and 8. In the 3 different scenarios for scheduled repeated testing intervals (3, 5, and 7 days) in the subgroup of individuals with an initially negative swab test finding, the probability peaked on the sixth, ninth and tenth, and 13th and 14th days, respectively. CONCLUSIONS Swab tests can initially yield false-negative outcomes. The probability of testing positive increases from day 1, peaking between days 5 and 8 after close contact with a patient with COVID-19. Early testing, especially in this final time window, is recommended together with a health surveillance program scheduled in close intervals.
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Affiliation(s)
- Roberto Benoni
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - Silvia Panunzi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Irene Campagna
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - Francesca Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Gianluca Spiteri
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Stefano Porru
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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16
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Medina N, Soto-Debrán JC, Seidel D, Akyar I, Badali H, Barac A, Bretagne S, Cag Y, Cassagne C, Castro C, Chakrabarti A, Dannaoui E, Cardozo C, Garcia-Rodriguez J, Guitard J, Hamal P, Hoenigl M, Jagielski T, Khodavaisy S, Lo Cascio G, Martínez-Rubio MC, Meletiadis J, Muñoz P, Ochman E, Peláez T, Perez-Ayala Balzola A, Prattes J, Roilides E, Ruíz-Pérez de Pipaón M, Stauf R, Steinmann J, Suárez-Barrenechea AI, Tejero R, Trovato L, Viñuela L, Wongsuk T, Żak I, Zarrinfar H, Lass-Flörl C, Arikan-Akdagli S, Alastruey-Izquierdo A. MixInYeast: A Multicenter Study on Mixed Yeast Infections. J Fungi (Basel) 2020; 7:jof7010013. [PMID: 33383783 PMCID: PMC7823447 DOI: 10.3390/jof7010013] [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: 11/20/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 01/08/2023] Open
Abstract
Invasive candidiasis remains one of the most prevalent systemic mycoses, and several studies have documented the presence of mixed yeast (MY) infections. Here, we describe the epidemiology, clinical, and microbiological characteristics of MY infections causing invasive candidiasis in a multicenter prospective study. Thirty-four centers from 14 countries participated. Samples were collected in each center between April to September 2018, and they were sent to a reference center to confirm identification by sequencing methods and to perform antifungal susceptibility testing, according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A total of 6895 yeast cultures were identified and MY occurred in 150 cases (2.2%). Europe accounted for the highest number of centers, with an overall MY rate of 4.2% (118 out of 2840 yeast cultures). Of 122 MY cases, the most frequent combinations were Candida albicans/C. glabrata (42, 34.4%), C. albicans/C. parapsilosis (17, 14%), and C. glabrata/C. tropicalis (8, 6.5%). All Candida isolates were susceptible to amphotericin B, 6.4% were fluconazole-resistant, and two isolates (1.6%) were echinocandin-resistant. Accurate identification of the species involved in MY infections is essential to guide treatment decisions.
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Affiliation(s)
- Narda Medina
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain; (N.M.); (J.C.S.-D.)
| | - Juan Carlos Soto-Debrán
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain; (N.M.); (J.C.S.-D.)
| | - Danila Seidel
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany;
- European Diamond Excellence Center for Medical Mycology of the European Confederation of Medical Mycology (ECMM), 50937 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany
| | - Isin Akyar
- Department of Medical Microbiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, 34758 Istanbul, Turkey;
- Acibadem Labmed Laboratories, 34752 Istanbul, Turkey
| | - Hamid Badali
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari 48157-33971, Iran;
| | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France;
- Department of Infectious Agents, Université de Paris, 75006 Paris, France
| | - Yasemin Cag
- Istanbul Medeniyet University Goztepe Training and Research Hospital, 34722 Istanbul, Turkey;
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University School of Medicine, 34093 Istanbul, Turkey
| | - Carole Cassagne
- Aix-Marseille University, UMR MD3 IP-TPT, 13885 Marseilles, France;
| | - Carmen Castro
- Microbiology Service, Clinical Unit of Infectious Diseases and Microbiology, Hospital Universitario Valme, 41014 Sevilla, Spain;
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India;
| | - Eric Dannaoui
- Unité de Parasitologie-Mycologie, Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP) Université de Paris, 75015 Paris, France;
| | - Celia Cardozo
- Hospital Universitario Clínic, 08036 Barcelona, Spain;
| | | | - Juliette Guitard
- Service de Parasitologie-Mycologie, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Sorbonne Université, Inserm, 75012 Paris, France;
| | - Petr Hamal
- Department of Microbiology, Palacky University, Faculty of Medicine and Dentistry and University Hospital, 775 15 Olomouc, Czech Republic;
| | - Martin Hoenigl
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA 92093, USA;
| | - Tomasz Jagielski
- Department of Medical Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096 Warsaw, Poland;
| | - Sadegh Khodavaisy
- Division of Molecular Biology & Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran 14167-53955, Iran;
| | - Giuliana Lo Cascio
- Microbiology and Virology Unit, Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata, 30126 Verona, Italy;
| | | | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Haidari, 12462 Athens, Greece;
| | - Patricia Muñoz
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañon, 28007 Madrid, Spain;
- Department of Medicine, Universidad Complutense de Madrid, CIBERES (CB06/06/0058), 28040 Madrid, Spain
| | - Elżbieta Ochman
- Department of Clinical Microbiology, The Maria Skłodowska-Curie Institute of Oncology, W. K. Roentgena 5, 02-781 Warsaw, Poland;
| | - Teresa Peláez
- Hospital Universitario Central de Asturias (HUCA), Fundación para la Investigación Biomédica y la Innovación Biosanitaria del Principado de Asturias (FINBA), 33011 Asturias, Spain;
| | | | - Juergen Prattes
- Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria;
| | - Emmanuel Roilides
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration General Hospital, 54642 Thessaloniki, Greece;
| | - Maite Ruíz-Pérez de Pipaón
- Department of Infectious Diseases, Microbiology and Preventive Medicine, University Hospital Virgen del Rocío, 41013 Seville, Spain;
| | - Raphael Stauf
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, 90419 Nuremberg, Germany; (R.S.); (J.S.)
- Institute of Medical Microbiology, University Hospital Essen, 45122 Essen, Germany
| | - Jörg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, 90419 Nuremberg, Germany; (R.S.); (J.S.)
- Institute of Medical Microbiology, University Hospital Essen, 45122 Essen, Germany
| | | | - Rocío Tejero
- Unit of Microbiology, Hospital Universitario Reina Sofía, 14004 Cordoba, Spain;
| | - Laura Trovato
- U.O.C. Laboratory Analysis Unit, A.O.U. “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy;
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Lourdes Viñuela
- Servicio de Microbiología Hospital Universitario Río Hortega, 47012 Valladolid, Spain;
| | - Thanwa Wongsuk
- Department of Clinical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand;
| | - Iwona Żak
- Department of Clinical Microbiology, Children’s University Hospital of Cracow, 30-663 Kraków, Poland;
| | - Hossein Zarrinfar
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad 91766-99199, Iran;
| | - Cornelia Lass-Flörl
- Department of Hygiene und Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Sevtap Arikan-Akdagli
- Department of Medical Microbiology, Hacettepe University Medical School, 06100 Ankara, Turkey;
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain; (N.M.); (J.C.S.-D.)
- Correspondence: ; Tel.: +34-918-223-784
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17
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Lippi G, Salvagno GL, Pegoraro M, Militello V, Caloi C, Peretti A, De Nitto S, Bovo C, Lo Cascio G. Preliminary evaluation of Roche Cobas Elecsys Anti-SARS-CoV-2 chemiluminescence immunoassay. Clin Chem Lab Med 2020; 58:e251-e253. [PMID: 32692698 DOI: 10.1515/cclm-2020-1042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Gian Luca Salvagno
- Section of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Manuela Pegoraro
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
| | - Valentina Militello
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
| | - Cecilia Caloi
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
| | - Angelo Peretti
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
| | - Simone De Nitto
- Section of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Chiara Bovo
- Medical Direction, University Hospital of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
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18
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Mauro M, Lo Cascio G, Balter R, Zaccaron A, Bonetti E, Vitale V, Chinello M, De Bortoli M, Brazzarola P, Bruno C, Cesaro S. The Diagnostic Pitfalls of Mucormycosis. Mediterr J Hematol Infect Dis 2020; 12:e2020079. [PMID: 33194153 PMCID: PMC7643780 DOI: 10.4084/mjhid.2020.079] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/17/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Invasive mucormycosis is a very aggressive fungal disease among immunocompromised pediatric patients caused by saprophytic fungi that belong to the order of the Mucorales. CASE REPORT We describe a case of of Lichtheimia corymbifera infection in a 15-year-old child with B-cell-Non-Hodgkin Lymphoma (B-NHL) involving lung, kidney and thyroid that initially was diagnosed as probable aspergillosis delaying the effective therapy for mucormycosis. CONCLUSIONS This case showed that also the intensive chemotherapy for B-NHL may represent a risk factor for mucormycosis infection. Liposomal amphotericin B and surgery remain the key tools for the successful treatment of this aggressive disease.
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Affiliation(s)
- Margherita Mauro
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giuliana Lo Cascio
- Unità Operativa Complessa di Microbiologia e Virologia, Dipartimento di Patologia e diagnostica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Rita Balter
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Ada Zaccaron
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Elisa Bonetti
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Virginia Vitale
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Matteo Chinello
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Massimiliano De Bortoli
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Paolo Brazzarola
- Endocrine Surgery Unit, Department of Surgery and Oncology, University and Hospital Trust of Verona, Verona, Italy
| | - Costanza Bruno
- Department of Radiology, Radiology Institute, Verona, Italy
| | - Simone Cesaro
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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19
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De Pastena M, Paiella S, Azzini AM, Zaffagnini A, Scarlini L, Montagnini G, Maruccio M, Filippini C, Romeo F, Mazzariol A, Cascio GL, Bazaj A, Secchettin E, Bassi C, Salvia R. Antibiotic Prophylaxis with Piperacillin-Tazobactam Reduces Post-Operative Infectious Complication after Pancreatic Surgery: An Interventional, Non-Randomized Study. Surg Infect (Larchmt) 2020; 22:536-542. [PMID: 33095107 DOI: 10.1089/sur.2020.260] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: This study aimed to evaluate the effectiveness of piperacillin-tazobactam as antibiotic prophylaxis in patients affected by a peri-ampullary tumor submitted to pancreatic surgery. Methods: A prospective, non-randomized, non-blinded, interventional study was conducted from January 2015 to March 2018. Patients were screened pre-operatively for Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBL-PE). During the baseline period (January 2015-October 2016), surgical prophylaxis was performed with ampicillin-sulbactam. In the intervention phase (November 2016-March 2018), patients received piperacillin-tazobactam. Statistical analysis was performed by univariable and multivariable analysis with logistic regression models. Results: Overall, 383 patients were included in the baseline period and 296 in the intervention period. The surveillance strategy identified 47 ESBL-PE carriers (14%) in the baseline phase and 29 (10%) in the intervention phase. In the baseline period, the patients had a higher rate of hospital-acquired infection (43% versus 33%; p = 0.004), superficial surgical site infection (SSI) (11% versus 2%; p < 0.001), and pneumonia (16% versus 9%; p = 0.006). After the logistic regression, the baseline group had an odds ratio to develop superficial SSI and pneumonia of 7.7 (95% confidence interval [CI] 3-20) and 1.8 (95% CI 1-3.3), respectively. The ESBL colonization increased the mortality rate significantly (8% versus 3%; p = 0.017). Conclusions: Adopting antibiotic prophylaxis based on piperacillin-tazobactam is associated with a reduction in post-operative SSI, particularly superficial-SSIs. Further randomized studies would be warranted to evaluate this antibiotic combination more extensively in preventive strategies.
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Affiliation(s)
- Matteo De Pastena
- General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - Salvatore Paiella
- General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - Anna Maria Azzini
- Infectious Diseases Unit, Department of Diagnostic and Public Health, Department of Pathology and Diagnostic, University of Verona, Verona, Italy
| | - Amina Zaffagnini
- Infectious Diseases Unit, Department of Diagnostic and Public Health, Department of Pathology and Diagnostic, University of Verona, Verona, Italy
| | - Luigi Scarlini
- Infectious Diseases Unit, Department of Diagnostic and Public Health, Department of Pathology and Diagnostic, University of Verona, Verona, Italy
| | - Greta Montagnini
- General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - Martina Maruccio
- General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - Chiara Filippini
- General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - Francesco Romeo
- General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - Annarita Mazzariol
- Department of Diagnostic and Public Health, Microbiology Division, and Department of Pathology and Diagnostic, University of Verona, Verona, Italy.,Microbiology and Virology Operating Unit, Department of Pathology and Diagnostic, University of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Department of Diagnostic and Public Health, Microbiology Division, and Department of Pathology and Diagnostic, University of Verona, Verona, Italy.,Microbiology and Virology Operating Unit, Department of Pathology and Diagnostic, University of Verona, Verona, Italy
| | - Alda Bazaj
- Department of Diagnostic and Public Health, Microbiology Division, and Department of Pathology and Diagnostic, University of Verona, Verona, Italy
| | - Erica Secchettin
- General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - Claudio Bassi
- General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - Roberto Salvia
- General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
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20
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Pegoraro M, Militello V, Salvagno GL, Gaino S, Bassi A, Caloi C, Peretti A, Bizzego S, Poletto L, Bovo C, Lippi G, Lo Cascio G. Evaluation of three immunochromatographic tests in COVID-19 serologic diagnosis and their clinical usefulness. Eur J Clin Microbiol Infect Dis 2020; 40:897-900. [PMID: 33078222 PMCID: PMC7572234 DOI: 10.1007/s10096-020-04040-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/10/2020] [Indexed: 01/20/2023]
Abstract
Results of three rapid immunochromatographic tests (ICTs) were compared with those obtained with two automated immunoassays for evaluation of their usefulness. One hundred fifty-nine patients and 67 healthy volunteers were included. Different assays demonstrate 41–45% of diagnostic sensitivities and 91–98% of specificities, with substantial agreement (89.3–91.2%), but a high percentage of weak positive results (13–22%) was observed with ICTs. ICTs performances were comparable to those of automated immunoassays. ICTs could have a role as screening approach due to their easy usability. Subjective interpretation, significant rate of uncertain results, uncertainty on viral antigens source are undoubtedly drawbacks.
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Affiliation(s)
- Manuela Pegoraro
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
| | - Valentina Militello
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | | | - Stefania Gaino
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Antonella Bassi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Cecilia Caloi
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Angelo Peretti
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Silvia Bizzego
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Laura Poletto
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Chiara Bovo
- Medical Direction, University Hospital of Verona, Verona, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
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21
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Franchi M, Bosco M, Barbieri B, Diani E, Lo Cascio G, Laganà AS, Casarin J, Garzon S, Sangaletti M. Prevalence of SARS-CoV-2 infection in the obstetric population before the hospital admission. ACTA ACUST UNITED AC 2020; 72:429-430. [PMID: 32969632 DOI: 10.23736/s0026-4784.20.04654-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Massimo Franchi
- Department of Obstetrics and Gynecology, University Hospital of Verona, University of Verona, Verona, Italy
| | - Mariachiara Bosco
- Department of Obstetrics and Gynecology, University Hospital of Verona, University of Verona, Verona, Italy
| | - Beatrice Barbieri
- Department of Obstetrics and Gynecology, University Hospital of Verona, University of Verona, Verona, Italy
| | - Erica Diani
- Unit of Microbiology and Virology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Unit of Microbiology and Virology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Antonio S Laganà
- Department of Obstetrics and Gynecology, Filippo Del Ponte Hospital, University of Insubria, Varese, Italy
| | - Jvan Casarin
- Department of Obstetrics and Gynecology, Filippo Del Ponte Hospital, University of Insubria, Varese, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, University Hospital of Verona, University of Verona, Verona, Italy -
| | - Marina Sangaletti
- Department of Obstetrics and Gynecology, University Hospital of Verona, University of Verona, Verona, Italy
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Plebani M, Padoan A, Fedeli U, Schievano E, Vecchiato E, Lippi G, Lo Cascio G, Porru S, Palù G. SARS-CoV-2 serosurvey in health care workers of the Veneto Region. Clin Chem Lab Med 2020; 58:2107-2111. [PMID: 32845861 DOI: 10.1515/cclm-2020-1236] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [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: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/12/2022]
Abstract
Objectives The ongoing outbreak of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses formidable challenges to all health care systems. Serological assays may be used for improving disease management when appropriately applied, for investigating the antibody responses mounted against SARS-CoV-2 infection and for assessing its real prevalence. Although testing the whole population is impractical, well-designed serosurveys in selected subpopulations in specific risk groups may provide valuable information. We evaluated the prevalence of SARS-CoV-2 infection in health care workers (HCW) who underwent molecular testing with reverse transcription real-time polymerase chain reaction (rRT-PCR) in the main hospitals of the Veneto Region of Italy by measuring specific antibodies (Abs). Methods Both immunoglobulin (Ig)M and IgG antibodies against SARS-Cov-2 S-antigen and N-protein were measured using a validated chemiluminescent analytical system (CLIA) called Maglumi™ 2000 Plus (New Industries Biomedical Engineering Co., Ltd [Snibe], Shenzhen, China). Results A total of 8,285 HCW were tested. SARS-CoV-2 specific antibodies (IgM, IgG or both) were detectable in 378 cases (4.6%, 95% CI 4.1-5.0%). Seroconversion was observed in 4.4% of women vs. 5.0% of men, but this difference was not significant. Although detectable antibodies were found in all HCW who developed severe COVID-19 infection (100%), lower seropositivity was found in mild disease (83%) and the lowest prevalence (58%) was observed in asymptomatic subjects. Conclusions Seroprevalence surveys are of utmost importance for understanding the rate of population that has already developed antibodies against SARS-CoV-2. The present study defined precisely the circulation of SARS-CoV-2 in a cohort of HCW in the Veneto Region, with its prevalence (4.6%) reflecting a relatively low circulation. Symptomatic individuals or those hospitalized for medical care were 100% antibody positive, whilst Abs were only detectable in 58% of asymptomatic carriers.
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Affiliation(s)
- Mario Plebani
- Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy.,Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Andrea Padoan
- Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy.,Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Ugo Fedeli
- Epidemiological Department, Azienda Zero, Veneto Region, Padova, Italy
| | - Elena Schievano
- Epidemiological Department, Azienda Zero, Veneto Region, Padova, Italy
| | - Elena Vecchiato
- Department of Information Technology, Azienda Zero, Veneto Region, Padova, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Department of Microbiology and Virology, University of Verona, Verona, Italy
| | - Stefano Porru
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giorgio Palù
- University of Padova, Azienda Zero, Veneto Region, Padova, Italy
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23
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Lombardi G, Lo Cascio G, Andreoni S, Blasi E, Conte M, Farina C, Fazii P, Sanna S, Trovato L. Superficial and subcutaneous mycoses. Microbiol Med 2020. [DOI: 10.4081/mm.2020.9156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Tegument mycoses are classified into three groups: 1) Superficial skin mycoses or superficial mycoses: infections sustained by fungi limited to the skin horny layer or the hair extrafollicular portion, without a significant inflammatory response in the host. 2) Skin mycoses (dermatophytosis) sensu stricto: fungal infections in which skin and its annexes, at the level of the keratinized layers, are involved with an evident immune response by the host 3) Mycosis of the subcutaneous tissue: fungal infections that mainly affect the subcutaneous tissue and secondarily, by contiguity, skin, bones and other tissues, with a strong immune response by the host [...].
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24
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Porru S, Carta A, Monaco MGL, Verlato G, Battaggia A, Parpaiola M, Lo Cascio G, Pegoraro M, Militello V, Moretti F, Tardivo S. Health Surveillance and Response to SARS-CoV-2 Mass Testing in Health Workers of a Large Italian Hospital in Verona, Veneto. Int J Environ Res Public Health 2020; 17:ijerph17145104. [PMID: 32679773 PMCID: PMC7399926 DOI: 10.3390/ijerph17145104] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/27/2020] [Accepted: 07/09/2020] [Indexed: 12/15/2022]
Abstract
Italy presented the first largest COVID-19 outbreak outside of China. Veneto currently ranks fourth among the Italian regions for COVID-19 confirmed cases (~19,000). This study presents health surveillance data for SARS-CoV-2 in 6100 health workers (HW) employed in a large public hospital. Workers underwent oropharyngeal and nasopharyngeal swabs, with a total of 5942 participants (97.5% of the population). A total of 11,890 specimens were tested for SARS-CoV-2 infection using PCR, identifying the viral genes E, RdRP, and N. Positive tests were returned for 238 workers (cumulative incidence of 4.0%, similar in both COVID and nonCOVID units). SARS-CoV-2 risk was not affected by gender, age, or job type, whereas work setting and occupation were both predictors of infection. The risk was higher in medical wards (OR 2.7, 95% CI 1.9–3.9) and health services (OR 4.3, 95% CI 2.4–7.6), and lower in surgical wards and administration areas. To our knowledge, this study represents the largest available HW case list swab-tested for SARS-CoV-2, covering almost the total workforce. Mass screening enabled the isolation of HW, improved risk assessment, allowed for close contacts of and infected HW to return to work, provided evidence of SARS-CoV-2 diffusion, and presented solid ground to prevent nosocomial SARS-CoV-2 infections. The ongoing concurrent sero-epidemiological study aims to enable the improvement of health surveillance to maintain the safety of HWs and the communities they serve.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona VR, Italy;
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona VR, Italy;
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona VR, Italy;
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona VR, Italy;
- Correspondence: ; Tel.: +39-0458128270
| | | | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona VR, Italy;
| | - Andrea Battaggia
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona VR, Italy; (A.B.); (M.P.)
| | - Marco Parpaiola
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona VR, Italy; (A.B.); (M.P.)
| | - Giuliana Lo Cascio
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona VR, Italy; (G.L.C.); (M.P.); (V.M.)
| | - Manuela Pegoraro
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona VR, Italy; (G.L.C.); (M.P.); (V.M.)
| | - Valentina Militello
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona VR, Italy; (G.L.C.); (M.P.); (V.M.)
| | - Francesca Moretti
- Section of Hygiene, Department of Diagnostics and Public Health, University of Verona and Medical Direction, University Hospital of Verona, 37134 Verona VR, Italy; (F.M.); (S.T.)
| | - Stefano Tardivo
- Section of Hygiene, Department of Diagnostics and Public Health, University of Verona and Medical Direction, University Hospital of Verona, 37134 Verona VR, Italy; (F.M.); (S.T.)
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25
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Lippi G, Salvagno GL, Pegoraro M, Militello V, Caloi C, Peretti A, Gaino S, Bassi A, Bovo C, Lo Cascio G. Assessment of immune response to SARS-CoV-2 with fully automated MAGLUMI 2019-nCoV IgG and IgM chemiluminescence immunoassays. Clin Chem Lab Med 2020; 58:1156-1159. [PMID: 32301750 DOI: 10.1515/cclm-2020-0473] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University Hospital of Verona, Verona, Italy
| | - Gian Luca Salvagno
- Section of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University Hospital of Verona, Verona, Italy
| | - Manuela Pegoraro
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
| | - Valentina Militello
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
| | - Cecilia Caloi
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
| | - Angelo Peretti
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
| | - Stefania Gaino
- Section of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University Hospital of Verona, Verona, Italy
| | - Antonella Bassi
- Section of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University Hospital of Verona, Verona, Italy
| | - Chiara Bovo
- Medical Direction, University Hospital of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Microbiology and Virology Unit, Department of Pathology, University Hospital of Verona, Verona, Italy
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26
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Lo Cascio G, Vincenzi M, Soldani F, De Carolis E, Maccacaro L, Sorrentino A, Nadali G, Cesaro S, Sommavilla M, Niero V, Naso L, Grancini A, Azzini AM, Sanguinetti M, Tacconelli E, Cornaglia G. Outbreak of Saprochaete clavata Sepsis in Hematology Patients: Combined Use of MALDI-TOF and Sequencing Strategy to Identify and Correlate the Episodes. Front Microbiol 2020; 11:84. [PMID: 32082293 PMCID: PMC7004961 DOI: 10.3389/fmicb.2020.00084] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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] [Accepted: 01/15/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction New fungal species are increasingly reported in immunocompromised patients. Saprochaete clavata (S. clavata), an ascomycetous fungus formerly called Geotrichum clavatum, is intrinsically resistant to echinocandins and is often misidentified. Objective We describe a cluster of seven S. clavata infections in hospitalized hematology patients who developed this rare fungemia within a span of 11 months. Three of the seven patients died. Identification of the isolates was determined only with the Saramis database of VitekMS system and sequencing of the internal transcribed spacer (ITS) region. Clonal relatedness of the isolates was determined by matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF) analysis; clonal correlation between the strains was investigated by means of phylogenetic analysis, based on single-nucleotide variants (SNPs). Clinical presentation, 1–3 β-D-glucan (BG) and galactomannan (GM) antigen results and analysis of possible sources of contamination are also described with a prospective case–control study of the outbreak. Results MALDI-TOF MS-Vitek (bioMerieux, Marcy l’Etoile, France) failed to identify the six isolates, while SARAMIS (bioMerieux, Marcy l’Etoile, France) identified the isolates as S. clavata. Initially, Vitek 2 identified the strains as Geotrichum capitatum in two of the seven cases. Molecular identification gave 99% homology with S. clavata. BG was positive in three out of six patients (range 159 to >523 pg/ml), GM results were always negative. All the isolates were resistant to echinocandins (anidulafungin, micafungin, and caspofungin) and Fluconazole, but susceptible to Flucytosine and Voriconazole. One isolate showed acquired resistance to Flucytosine and Amphotericin B during treatment. Both the correlation-based dendrograms obtained by MALDI-TOF MS (Bruker Daltonics) and MS-Vitek not only clustered six of the seven bloodstream infection (BSI) isolates in the same group, but also showed their strong relatedness. Phylogenetic analysis using SNPrelate showed that the seven samples recorded during the investigation period clustered together. We observed a split between one case and the remainder with a node supported by a z-score of 2.3 (p-value = 0.021) and 16 mutations unique to each branch. Conclusion The use of proteomics for identification and evaluation of strain clonality in outbreaks of rare pathogens is a promising alternative to laborious and time-consuming molecular methods, even if molecular whole-genome sequencing (WGS) typing will still remain the reference method for rare emergent pathogens.
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Affiliation(s)
- Giuliana Lo Cascio
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Marcello Vincenzi
- Infectious Disease Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Fabio Soldani
- Infectious Disease Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Elena De Carolis
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Laura Maccacaro
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Annarita Sorrentino
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Gianpaolo Nadali
- Haematology Unit, Department of Medicine, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Simone Cesaro
- Division of Pediatric Oncohaematology, Department of Pediatrics, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Michele Sommavilla
- Direzione Medica Ospedaliera, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Valentina Niero
- Sezione di Igiene e Medicina Preventiva, Ambientale e Occupazionale, Dipartimento Diagnostica e Sanità Pubblica, Università di Verona, Verona, Italy
| | - Laura Naso
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Anna Grancini
- Laboratorio di Analisi Chimico - Cliniche e Microbiologia, Fondazione IRCCS Cà Granda O. Maggiore Policlinico, Milan, Italy
| | - Anna Maria Azzini
- Infectious Disease Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - E Tacconelli
- Infectious Disease Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giuseppe Cornaglia
- Microbiology and Virology Unit, Department of Pathology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
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27
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Esposto MC, Prigitano A, Lo Cascio G, Ossi C, Grancini A, Cavanna C, Lallitto F, Tejada M, Bandettini R, Mularoni A, Tortorano AM. Yeast-like filamentous fungi: Molecular identification and in vitro susceptibility study. Med Mycol 2020; 57:909-913. [PMID: 30521007 DOI: 10.1093/mmy/myy133] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 07/18/2018] [Revised: 09/20/2018] [Accepted: 11/07/2018] [Indexed: 11/14/2022] Open
Abstract
Yeast-like filamentous fungi, collected in Italy from 1985 to 2018, were submitted to molecular identification and antifungal susceptibility testings. Clinical isolates were identified as Magnusiomyces capitatus (28), M. clavatus (18), and Geotrichum candidum (2). M. clavatus was prevalent among blood isolates (18/24), M. capitatus among isolates from other biological materials. The intrinsic echinocandin resistance was confirmed. Both species had low minimum inhibitory concentrations (MICs) of itraconazole, posaconazole, and voriconazole, while M. clavatus had lower MIC of flucytosine and higher MIC of isavuconazole than M. capitatus. The intrinsic resistance of these species to echinocandins could be the reason of the recent increase of M. clavatus bloodstream infections.
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Affiliation(s)
| | - Anna Prigitano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano
| | | | - Cristina Ossi
- Laboratory Medicine Service, Ospedale San Raffaele, Milano
| | - Anna Grancini
- IRCCS Foundation, Cà Granda Ospedale Maggiore Policlinico, Milano
| | - Caterina Cavanna
- Microbiology and Virology Unit, IRCCS San Matteo Hospital Foundation, Pavia
| | - Fabiola Lallitto
- Microbiology and Virology Unit, IRCCS San Matteo Hospital Foundation, Pavia
| | | | - Roberto Bandettini
- Clinical Pathology and Microbiology Laboratory Unit, Istituto Giannina Gaslini, Genova
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28
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Staffolani S, Riccardi N, Farina C, Lo Cascio G, Gulletta M, Gobbi F, Rodari P, Ursini T, Bertoli G, Ronzoni N, Bisoffi Z, Angheben A. Acute histoplasmosis in travelers: a retrospective study in an Italian referral center for tropical diseases. Pathog Glob Health 2020; 114:40-45. [PMID: 31959091 DOI: 10.1080/20477724.2020.1716517] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Purpose: Histoplasmosis is a fungal infection acquired through inhalation of Histoplasma capsulatum microconidia, mostly present in the Americas. Both immunocompetent and immunocompromised patients can present a wide spectrum of signs/symptoms, ranging from mild disease to a severe, disseminated infection. The aim of this observational study is to describe histoplasmosis cases diagnosed in travelers and their clinical/radiological and therapeutic pattern.Methods: Retrospective study at the Department of Infectious - Tropical Diseases and Microbiology (DITM) of Negrar, Verona, Italy, between January 2005 and December 2015.Results: Twenty-three cases of acute histoplasmosis were diagnosed, 17 of which belong to the same cluster. Seven of the 23 patients (30.4%) were admitted to hospital, four of whom underwent invasive diagnostic procedures. Thirteen patients (56.5%) received oral itraconazole. All patients recovered, although nine (39.1%) had radiological persisting lung nodules at 12 month follow up.Conclusions: Clinical, laboratory and radiological features of histoplasmosis can mimic other conditions, resulting in unnecessary invasive diagnostic procedures. However, a history of travel to endemic areas and of exposure to risk factors (such as visits to caves and presence of bats) should trigger the clinical suspicion of histoplasmosis. Treatment may be indicated in severe or prolonged disease.
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Affiliation(s)
- Silvia Staffolani
- SOD Malattie Infettive Emergenti e Degli Immunodepressi, Azienda Ospedaliero Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Niccolò Riccardi
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Claudio Farina
- UOC Microbiologia e Virologia, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Giuliana Lo Cascio
- Microbiology and Virology Operating Unit, Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Maurizio Gulletta
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, Italy
| | - Federico Gobbi
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Paola Rodari
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Tamara Ursini
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Giulia Bertoli
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Niccolò Ronzoni
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy.,Department of Clinical and Experimental Medicine, School of Infectious Diseases and Tropical Medicine, University of Sassari, Sassari, Italy
| | - Zeno Bisoffi
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy.,Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Andrea Angheben
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
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Piccirilli A, Perilli M, Piccirilli V, Segatore B, Amicosante G, Maccacaro L, Bazaj A, Naso L, Cascio GL, Cornaglia G. Molecular characterization of carbapenem-resistant Klebsiella pneumoniae ST14 and ST512 causing bloodstream infections in ICU and surgery wards of a tertiary university hospital of Verona (northern Italy): co-production of KPC-3, OXA-48, and CTX-M-15 β-lactamases. Diagn Microbiol Infect Dis 2020; 96:114968. [PMID: 31924425 DOI: 10.1016/j.diagmicrobio.2019.114968] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/02/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
Klebsiella pneumoniae strain is an important opportunistic pathogen that causes severe nosocomial infections. In the present study a molecular characterization of carbapenem resistant K. pneumoniae, isolated from blood samples of hospitalized patients of Verona University Hospital, was performed. The simultaneous presence of SHV-1/CTX-M-15/KPC-3 and SHV-1/CTX-M-15/OXA-48 serin-β-lactamases was ascertained in the 89% and 11% of K. pneumoniae ST512 and K. pneumoniae ST14, respectively. Molecular characterization of bla genes showed that blaKPC-3 was found in Tn4401a transposon with the tnpR, tnpA, ISKpn6, and ISKpn7 mobile elements whereas blaCTX-M-15 was detected downstream ISEcp1 genetic element. A class 1 integron with a gene cassette of 780 bp corresponding to aadA2 gene was identified in 33 K. pneumoniae ST512 isolates.
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Affiliation(s)
- Alessandra Piccirilli
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Mariagrazia Perilli
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli Studi dell'Aquila, L'Aquila, Italy.
| | - Valentina Piccirilli
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Bernardetta Segatore
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Gianfranco Amicosante
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Laura Maccacaro
- U.O.C. di Microbiologia e Virologia, Dipartimento di Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Alda Bazaj
- Dipartimento di Diagnostica e Sanità Pubblica, Università di Verona, Verona, Italy
| | - Laura Naso
- U.O.C. di Microbiologia e Virologia, Dipartimento di Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Giuliana Lo Cascio
- U.O.C. di Microbiologia e Virologia, Dipartimento di Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Giuseppe Cornaglia
- Dipartimento di Diagnostica e Sanità Pubblica, Università di Verona, Verona, Italy
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30
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Zoran T, Sartori B, Sappl L, Aigner M, Sánchez-Reus F, Rezusta A, Chowdhary A, Taj-Aldeen SJ, Arendrup MC, Oliveri S, Kontoyiannis DP, Alastruey-Izquierdo A, Lagrou K, Lo Cascio G, Meis JF, Buzina W, Farina C, Drogari-Apiranthitou M, Grancini A, Tortorano AM, Willinger B, Hamprecht A, Johnson E, Klingspor L, Arsic-Arsenijevic V, Cornely OA, Meletiadis J, Prammer W, Tullio V, Vehreschild JJ, Trovato L, Lewis RE, Segal E, Rath PM, Hamal P, Rodriguez-Iglesias M, Roilides E, Arikan-Akdagli S, Chakrabarti A, Colombo AL, Fernández MS, Martin-Gomez MT, Badali H, Petrikkos G, Klimko N, Heimann SM, Uzun O, Roudbary M, de la Fuente S, Houbraken J, Risslegger B, Sabino R, Lass-Flörl C, Lackner M. Corrigendum: Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon? Front Microbiol 2019; 9:3245. [PMID: 30692970 PMCID: PMC6340063 DOI: 10.3389/fmicb.2018.03245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/05/2018] [Accepted: 12/13/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Tamara Zoran
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Bettina Sartori
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Laura Sappl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Maria Aigner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ferran Sánchez-Reus
- Servei de Microbiologia, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Antonio Rezusta
- Microbiologia, Hospital Universitario Miguel Servet, IIS Aragon, Universidad de Zaragoza, Zaragoza, Spain
| | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
| | - Saad J Taj-Aldeen
- Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Maiken C Arendrup
- Unit of Mycology, Department of Clinical Microbiology, Statens Serum Institute, Copenhagen University, Rigshospitalet, Copenhagen, Denmark
| | - Salvatore Oliveri
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Katrien Lagrou
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Giuliana Lo Cascio
- Unità Operativa Complessa di Microbiologia e virologia, Dipartimento di Patologia e diagnostica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, Netherlands
| | - Walter Buzina
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Claudio Farina
- Microbiology Institute, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Miranda Drogari-Apiranthitou
- Infectious Diseases Research Laboratory, 4th Department of Internal Medicine, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Grancini
- Laboratorio Centrale di Analisi Chimico Cliniche e Microbiologia, IRCCS Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna M Tortorano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Axel Hamprecht
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany
| | - Elizabeth Johnson
- Mycology Reference Laboratory, Public Health England, Bristol, United Kingdom
| | - Lena Klingspor
- Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Valentina Arsic-Arsenijevic
- National Reference Medical Mycology Laboratory, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
| | - Oliver A Cornely
- Department I of Internal Medicine, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Clinical Trials Centre Cologne, Center for Integrated Oncology (CIO Köln-Bonn), German Centre for Infection Research, University of Cologne, Cologne, Germany
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, National Kapodistrian University of Athens, ATTIKON University Hospital Athens, Athens, Greece
| | - Wolfgang Prammer
- Department of Hygiene and Medical Microbiology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Vivian Tullio
- Department of Public Health and Pediatrics, Microbiology Division, Turin, Italy
| | - Jörg-Janne Vehreschild
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.,German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Laura Trovato
- A.O.U. Policlinico Vittorio Emanuele Catania, Biometec - University of Catania, Catania, Italy
| | - Russell E Lewis
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Esther Segal
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg- Essen, Essen, Germany
| | - Petr Hamal
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czechia
| | | | - Emmanuel Roilides
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
| | - Sevtap Arikan-Akdagli
- Department of Medical Microbiology, Hacettepe University Medical School, Ankara, Turkey
| | - Arunaloke Chakrabarti
- Division of Mycology, Department of Medial Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arnaldo L Colombo
- Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Mariana S Fernández
- Departmento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Resistencia, Argentina
| | - M Teresa Martin-Gomez
- Division of Clinical Mycology, Department of Microbiology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Hamid Badali
- Department of Medical Mycology and Parasitology, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Nikolai Klimko
- Department of Clinical Mycology, Allergy and Immunology, North Western State Medical University, Saint Petersburg, Russia
| | - Sebastian M Heimann
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Omrum Uzun
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Medical School, Ankara, Turkey
| | - Maryam Roudbary
- Department of Medical Mycology and Parasitology, School of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Sonia de la Fuente
- Department of Dermatology, Hospital Ernest Lluch Martin, Zaragoza, Spain
| | - Jos Houbraken
- Department Applied and Industrial Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | - Brigitte Risslegger
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Raquel Sabino
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health Coutor Ricardo Jorge, Lisbon, Portugal
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michaela Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
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Zoran T, Sartori B, Sappl L, Aigner M, Sánchez-Reus F, Rezusta A, Chowdhary A, Taj-Aldeen SJ, Arendrup MC, Oliveri S, Kontoyiannis DP, Alastruey-Izquierdo A, Lagrou K, Cascio GL, Meis JF, Buzina W, Farina C, Drogari-Apiranthitou M, Grancini A, Tortorano AM, Willinger B, Hamprecht A, Johnson E, Klingspor L, Arsic-Arsenijevic V, Cornely OA, Meletiadis J, Prammer W, Tullio V, Vehreschild JJ, Trovato L, Lewis RE, Segal E, Rath PM, Hamal P, Rodriguez-Iglesias M, Roilides E, Arikan-Akdagli S, Chakrabarti A, Colombo AL, Fernández MS, Martin-Gomez MT, Badali H, Petrikkos G, Klimko N, Heimann SM, Uzun O, Roudbary M, de la Fuente S, Houbraken J, Risslegger B, Lass-Flörl C, Lackner M. Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon? Front Microbiol 2018; 9:516. [PMID: 29643840 PMCID: PMC5882871 DOI: 10.3389/fmicb.2018.00516] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [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: 01/19/2018] [Accepted: 03/06/2018] [Indexed: 11/22/2022] Open
Abstract
Objectives: Invasive mold infections associated with Aspergillus species are a significant cause of mortality in immunocompromised patients. The most frequently occurring aetiological pathogens are members of the Aspergillus section Fumigati followed by members of the section Terrei. The frequency of Aspergillus terreus and related (cryptic) species in clinical specimens, as well as the percentage of azole-resistant strains remains to be studied. Methods: A global set (n = 498) of A. terreus and phenotypically related isolates was molecularly identified (beta-tubulin), tested for antifungal susceptibility against posaconazole, voriconazole, and itraconazole, and resistant phenotypes were correlated with point mutations in the cyp51A gene. Results: The majority of isolates was identified as A. terreus (86.8%), followed by A. citrinoterreus (8.4%), A. hortai (2.6%), A. alabamensis (1.6%), A. neoafricanus (0.2%), and A. floccosus (0.2%). One isolate failed to match a known Aspergillus sp., but was found most closely related to A. alabamensis. According to EUCAST clinical breakpoints azole resistance was detected in 5.4% of all tested isolates, 6.2% of A. terreus sensu stricto (s.s.) were posaconazole-resistant. Posaconazole resistance differed geographically and ranged from 0% in the Czech Republic, Greece, and Turkey to 13.7% in Germany. In contrast, azole resistance among cryptic species was rare 2 out of 66 isolates and was observed only in one A. citrinoterreus and one A. alabamensis isolate. The most affected amino acid position of the Cyp51A gene correlating with the posaconazole resistant phenotype was M217, which was found in the variation M217T and M217V. Conclusions:Aspergillus terreus was most prevalent, followed by A. citrinoterreus. Posaconazole was the most potent drug against A. terreus, but 5.4% of A. terreus sensu stricto showed resistance against this azole. In Austria, Germany, and the United Kingdom posaconazole-resistance in all A. terreus isolates was higher than 10%, resistance against voriconazole was rare and absent for itraconazole.
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Affiliation(s)
- Tamara Zoran
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Bettina Sartori
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Laura Sappl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Maria Aigner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ferran Sánchez-Reus
- Servei de Microbiologia, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Antonio Rezusta
- Microbiologia, Hospital Universitario Miguel Servet, IIS Aragon, Universidad de Zaragoza, Zaragoza, Spain
| | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
| | - Saad J Taj-Aldeen
- Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Maiken C Arendrup
- Unit of Mycology, Department of Clinical Microbiology, Statens Serum Institute, Copenhagen University, Rigshospitalet, Copenhagen, Denmark
| | - Salvatore Oliveri
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Katrien Lagrou
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Giuliana Lo Cascio
- Unità Operativa Complessa di Microbiologia e Virologia, Dipartimento di Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, Netherlands
| | - Walter Buzina
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Claudio Farina
- Microbiology Institute, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Miranda Drogari-Apiranthitou
- Infectious Diseases Research Laboratory, 4th Department of Internal Medicine, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Grancini
- Laboratorio Centrale di Analisi Chimico Cliniche e Microbiologia, IRCCS Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna M Tortorano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Axel Hamprecht
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany
| | - Elizabeth Johnson
- Mycology Reference Laboratory, Public Health England, Bristol, United Kingdom
| | - Lena Klingspor
- Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Valentina Arsic-Arsenijevic
- National Reference Medical Mycology Laboratory, Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
| | - Oliver A Cornely
- Department I of Internal Medicine, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Clinical Trials Centre Cologne, Center for Integrated Oncology (CIO Köln-Bonn), German Centre for Infection Research, University of Cologne, Cologne, Germany
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, National Kapodistrian University of Athens, ATTIKON University Hospital Athens, Athens, Greece
| | - Wolfgang Prammer
- Department of Hygiene and Medical Microbiology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Vivian Tullio
- Department of Public Health and Pediatrics, Microbiology Division, Turin, Italy
| | - Jörg-Janne Vehreschild
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany.,German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Laura Trovato
- A.O.U. Policlinico Vittorio Emanuele Catania, Biometec-University of Catania, Catania, Italy
| | - Russell E Lewis
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Esther Segal
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Petr Hamal
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czechia
| | | | - Emmanuel Roilides
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
| | - Sevtap Arikan-Akdagli
- Department of Medical Microbiology, Hacettepe University Medical School, Ankara, Turkey
| | - Arunaloke Chakrabarti
- Division of Mycology, Department of Medial Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arnaldo L Colombo
- Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Mariana S Fernández
- Departmento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Resistencia, Argentina
| | - M Teresa Martin-Gomez
- Division of Clinical Mycology, Department of Microbiology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Hamid Badali
- Department of Medical Mycology and Parasitology, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Nikolai Klimko
- Department of Clinical Mycology, Allergy and Immunology, North Western State Medical University, Saint Petersburg, Russia
| | - Sebastian M Heimann
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Omrum Uzun
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Medical School, Ankara, Turkey
| | - Maryam Roudbary
- Department of Medical Mycology and Parasitology, School of Medicine, Iran University of Medical Science, Tehran, Iran
| | - Sonia de la Fuente
- Department of Dermatology, Hospital Ernest Lluch Martin, Zaragoza, Spain
| | - Jos Houbraken
- Department Applied and Industrial Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | - Brigitte Risslegger
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michaela Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
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Prigitano A, Esposto MC, Biffi A, De Lorenzis G, Favuzzi V, Koncan R, Lo Cascio G, Barao Ocampo M, Colombo C, Pizzamiglio G, Romanò L, Tortorano AM. Triazole resistance in Aspergillus fumigatus isolates from patients with cystic fibrosis in Italy. J Cyst Fibros 2017; 16:64-69. [DOI: 10.1016/j.jcf.2016.06.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/08/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022]
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Koncan R, Favuzzi V, Ligozzi M, Sorrentino A, Cornaglia G, Cascio GL. Cross-reactivity of Nocardia spp. in the fungal (1-3)-β-d-glucan assay performed on cerebral spinal fluid. Diagn Microbiol Infect Dis 2014; 81:94-5. [PMID: 25497418 DOI: 10.1016/j.diagmicrobio.2014.11.002] [Citation(s) in RCA: 15] [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: 08/06/2014] [Accepted: 11/05/2014] [Indexed: 10/24/2022]
Abstract
Cerebral spinal fluid from a patient affected by a brain abscess caused by Nocardia abscessus gave a positive result for (1-3)-β-d-glucan (BG) assay, in absence of any fungal infection. This study aimed to assess whether Nocardia spp. show cross-reactivity with BG assay. All Nocardia spp. analyzed provided positive reactions.
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Affiliation(s)
- Raffaella Koncan
- Department of Pathology and Diagnostic, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy.
| | - Vincenza Favuzzi
- Department of Pathology and Diagnostic, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
| | - Marco Ligozzi
- Department of Pathology and Diagnostic, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
| | - Annarita Sorrentino
- U.O. of Microbiology and Virology, Department of Pathology, Azienda Ospedaliera Universitaria Integrata-Verona, P.le Scuro 10, 37134 Verona, Italy
| | - Giuseppe Cornaglia
- Department of Pathology and Diagnostic, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
| | - Giuliana Lo Cascio
- U.O. of Microbiology and Virology, Department of Pathology, Azienda Ospedaliera Universitaria Integrata-Verona, P.le Scuro 10, 37134 Verona, Italy
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Kocsis E, Lo Cascio G, Piccoli M, Cornaglia G, Mazzariol A. KPC-3 Carbapenemase Harbored in FIIk Plasmid fromKlebsiella pneumoniaeST512 andEscherichia coliST43 in the Same Patient. Microb Drug Resist 2014; 20:377-82. [DOI: 10.1089/mdr.2013.0152] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Erika Kocsis
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Department of Pathology and Diagnostics, Servizio di Microbiologia, Virologia e Immunologia, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Marta Piccoli
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Giuseppe Cornaglia
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy
- Department of Pathology and Diagnostics, Servizio di Microbiologia, Virologia e Immunologia, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Annarita Mazzariol
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy
- Department of Pathology and Diagnostics, Servizio di Microbiologia, Virologia e Immunologia, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
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Falcone M, Concia E, Iori I, Lo Cascio G, Mazzone A, Pea F, Violi F, Venditti M. Identification and management of invasive mycoses in internal medicine: a road-map for physicians. Intern Emerg Med 2014; 9:501-11. [PMID: 24871636 DOI: 10.1007/s11739-014-1077-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 04/21/2014] [Indexed: 01/30/2023]
Abstract
Invasive mycoses are a rising problem, not only in traditional categories of patients like hematologic or neutropenic ones, but also in elderly non-neutropenic patients admitted to internal medicine wards. Patients being admitted to medical wards are usually older, have multiple comorbidities, e.g., liver cirrhosis or chronic obstructive respiratory disease, may be malnourished or receive peripheral or total parenteral nutrition, and frequently are undergoing chronic corticosteroid therapy, chemotherapy for cancer or monoclonal antibodies for autoimmune diseases. Such risk factors may be contemporarily present in a single patient increasing the risk for the development of invasive mycoses. Diagnosis of candidemia and invasive aspergillosis is particularly difficult in patients hospitalized on medical wards, since symptoms and signs have low specificity, and most diagnostic tests have been only validated in neutropenic hematologic patients, but not in those without neutropenia. Both candidemia and invasive aspergillosis carry significant morbidity and mortality. The aim of this paper is to provide a simple guide to physicians for a prompt identification and treatment of patients with possible or suspected invasive mycoses.
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Affiliation(s)
- Marco Falcone
- Department of Public Health and Infectious Diseases, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy,
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Guglielmetti L, Mazzaferri F, Cordioli M, Conti M, Lo Cascio G, Concia E, Cazzadori A. Rebound in QuantiFERON-TB Gold In-Tube response after active tuberculosis treatment. J Infect 2014; 70:96-8. [PMID: 25068223 DOI: 10.1016/j.jinf.2014.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/18/2014] [Accepted: 07/21/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Lorenzo Guglielmetti
- Department of Pathology and Diagnostics, Section of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata - Policlinico "G.B. Rossi", Verona, Italy.
| | - Fulvia Mazzaferri
- Department of Pathology and Diagnostics, Section of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata - Policlinico "G.B. Rossi", Verona, Italy
| | - Maddalena Cordioli
- Department of Pathology and Diagnostics, Section of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata - Policlinico "G.B. Rossi", Verona, Italy
| | - Michela Conti
- Department of Pathology and Diagnostics, Section of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata - Policlinico "G.B. Rossi", Verona, Italy.
| | - Giuliana Lo Cascio
- Department of Pathology and Diagnostics, Section of Microbiology, Azienda Ospedaliera Universitaria Integrata - Policlinico "G.B. Rossi", Verona, Italy
| | - Ercole Concia
- Department of Pathology and Diagnostics, Section of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata - Policlinico "G.B. Rossi", Verona, Italy
| | - Angelo Cazzadori
- Department of Pathology and Diagnostics, Section of Infectious Diseases, Azienda Ospedaliera Universitaria Integrata - Policlinico "G.B. Rossi", Verona, Italy
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Sakarikou C, Parisato M, Lo Cascio G, Fontana C. Beacon-based (bbFISH®) technology for rapid pathogens identification in blood cultures. BMC Microbiol 2014; 14:99. [PMID: 24750976 PMCID: PMC3997747 DOI: 10.1186/1471-2180-14-99] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 02/04/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diagnosis and treatment of bloodstream infections (BSI) are often hampered by the delay in obtaining the final results of blood cultures. Rapid identification of pathogens involved in BSI is of great importance in order to improve survival of septic patients. Beacon-based fluorescent in situ hybridization (hemoFISH® Gram positive and hemoFISH® Gram negative test kits, miacom diagnostics GmbH Düsseldorf, Germany) accelerates the identification of most frequent bacterial pathogens of sepsis. RESULTS In this study a total of 558 blood culture (377 blood culture positive and 181 negative) were tested with the hemoFISH® method and the results were evaluated in comparison with the traditional culture based methods. The overall sensitivity and specificity of the hemoFISH® tests were 94.16% and 100%, while, the PPV and NPV were 100 and 89.16%, respectively. As the hemoFISH® results were obtained within 45 mins, the time difference between the final results of the traditional culture method and the hemoFISH® assay was about two days. CONCLUSIONS Considering the good sensitivity and specificity of the hemoFISH® assays as well as the significant time saving in obtaining the final results (p-value 0.0001), the introduction of the system could be rialable in the microbiology laboratories, even alongside the traditional systems.
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Affiliation(s)
| | | | | | - Carla Fontana
- Department of Experimental Medicine and Surgery, "Tor Vergata" University of Rome, Via Montpellier 1, 00133 Rome, Italy.
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Cascio GL, Soldani F, Mazzariol A, Lleo MM. The high incidence of carbapenem-resistant Klebsiella pneumoniae in urine from elderly hospital patients may facilitate the spread of resistant strains to the community. Microb Drug Resist 2013; 20:67-72. [PMID: 23962153 DOI: 10.1089/mdr.2013.0036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Almost all European countries are affected by the expansion of carbapenem-resistant Enterobacteriaceae occurring during recent years. In the two hospitals of Verona, Italy, the incidence of carbapenem-nonsusceptible Klebsiella pneumoniae (CNSKP) began to increase by the first months of 2011, reached a peak in the summer of the same year, and currently is around 30%. Contrary to what was reported by other hospitals and although significant percentages of CNSKP were detected in respiratory samples, blood and pus, urine from hospitalized patients, mainly geriatrics, are the clinical samples with the highest incidence of these strains. Elder patients are frequently transferred from the hospital to their own homes or long-term care facilities and vice-versa. Moreover, urinary tract infections are not considered as a severe pathology and frequently is asymptomatic in elderly. For these reasons, the presence of carbapenem non-susceptible bacteria in the urinary tract of geriatric patients might be an underestimated cause of multiresistant strain spreading to the non-hospitalized population and the community.
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Affiliation(s)
- Giuliana Lo Cascio
- 1 Dipartimento di Patologia e Diagnostica, Azienda Ospedaliera Universitaria Integrata , Verona, Italy
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Guglielmetti L, Conti M, Cazzadori A, Lo Cascio G, Sorrentino A, Concia E. [Diagnostic sensitivity of QuantiFERON-TB Gold In-Tube and tuberculin skin test in active tuberculosis: influence of immunocompromission and radiological extent of disease]. Infez Med 2012; 20:16-24. [PMID: 22475656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Tuberculosis (TB) is a pathology whose control is still unsatisfactory at global level. Traditional diagnostic techniques for active TB diagnosis are inadequate: the diagnostic gold standard is the cultural exam which suffers from lengthy processing and requires highly specialized laboratories. This study analyzed the diagnostic sensitivity of the tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube (QFT-IT) in 135 active, microbiologically confirmed TB cases. Sensitivity was 76% for both tests and reached cumulative levels close to 90%. QFT-IT revealed a statistically higher sensitivity than TST in a group of patients affected by various causes of immunosuppression, but was less sensitive in subjects with low levels of circulating CD4+ cells. The number of circulating CD4+ cells showed a direct correlation with the stimulated IFN-gamma production. QFT-IT also demonstrated a decreased IFN-gamma production, with a significant sensitivity reduction, in patients affected by advanced forms of pulmonary TB.
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Affiliation(s)
- Lorenzo Guglielmetti
- Sezione di Malattie Infettive, Dipartimento di Patologia, Azienda Ospedaliera Universitaria Integrata di Verona, Policlinico G. B. Rossi, Verona, Italy
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Morace G, Borghi E, Iatta R, Amato G, Andreoni S, Brigante G, Farina C, Lo Cascio G, Lombardi G, Manso E, Mussap M, Pecile P, Rigoli R, Tangorra E, Valmarin M, Montagna MT. Antifungal susceptibility of invasive yeast isolates in Italy: the GISIA3 study in critically ill patients. BMC Infect Dis 2011; 11:130. [PMID: 21586108 PMCID: PMC3111364 DOI: 10.1186/1471-2334-11-130] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [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: 01/26/2011] [Accepted: 05/17/2011] [Indexed: 01/01/2023] Open
Abstract
Background Yeasts are a common cause of invasive fungal infections in critically ill patients. Antifungal susceptibility testing results of clinically significant fungal strains are of interest to physicians, enabling them to adopt appropriate strategies for empiric and prophylactic therapies. We investigated the antifungal susceptibility of yeasts isolated over a 2-year period from hospitalised patients with invasive yeast infections. Methods 638 yeasts were isolated from the blood, central venous catheters and sterile fluids of 578 patients on general and surgical intensive care units and surgical wards. Etest strips and Sensititre panels were used to test the susceptibility of the isolates to amphotericin B, anidulafungin, caspofungin, fluconazole, itraconazole, posaconazole and voriconazole in 13 laboratories centres (LC) and two co-ordinating centres (CC). The Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution method was used at the CCs for comparison. Results Etest and Sensititre (LC/CC) MIC90 values were, respectively: amphotericin B 0.5/0.38, 1/1 mg/L; anidulafungin 2/1.5 and 1/1 mg/L; caspofungin 1/0.75 and 0.5/0.5 mg/L; fluconazole 12/8 and 16/16 mg/L; itraconazole 1/1.5, 0.5/0.5 mg/L; posaconazole 0.5 mg/L and voriconazole 0.25 mg/L for all. The overall MIC90 values were influenced by the reduced susceptibility of Candida parapsilosis isolates to echinocandins and a reduced or lack of susceptibility of Candida glabrata and Candida krusei to azoles, in particular fluconazole and itraconazole. Comparison of the LC and CC results showed good Essential Agreement (90.3% for Etest and 92.9% for Sensititre), and even higher Categorical Agreement (93.9% for Etest and 96% for Sensititre); differences were observed according to the species, method, and antifungal drug. No cross-resistance between echinocandins and triazoles was detected. Conclusions Our data confirm the different antifungal susceptibility patterns among species, and highlight the need to perform antifungal susceptibility testing of clinically relevant yeasts. With the exception of a few species (e.g. C. glabrata for azoles and C. parapsilosis for echinocandins), the findings of our study suggest that two of the most widely used commercial methods (Etest and Sensititre) provide valid and reproducible results.
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Affiliation(s)
- Giulia Morace
- Department of Public Health-Microbiology-Virology, Università degli Studi di Milano, and Laboratory of Microbiology and Virology, Ospedale San Carlo Borromeo, Milan, Italy.
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Cascio GL, Macaccaro L, Centonze AR, Sóki J, Fontana R, Mazzariol A. A new insertion sequence element containing a cfiA gene in the first imipenem-resistant Bacteroides fragilis strain isolated in Italy. Int J Antimicrob Agents 2009; 34:610-1. [DOI: 10.1016/j.ijantimicag.2009.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 07/16/2009] [Indexed: 11/29/2022]
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Bonora MG, Olioso D, Lo Cascio G, Fontana R. Phylogenetic Analysis of Vancomycin-ResistantEnterococcus faeciumGenotypes Associated with Outbreaks or Sporadic Infections in Italy. Microb Drug Resist 2007; 13:171-7. [DOI: 10.1089/mdr.2007.739] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maria Grazia Bonora
- Microbiology Section, Department of Pathology, University of Verona, Verona, Italy
| | - Debora Olioso
- Microbiology Section, Department of Pathology, University of Verona, Verona, Italy
| | - Giuliana Lo Cascio
- Microbiology Section, Department of Pathology, University of Verona, Verona, Italy
| | - Roberta Fontana
- Microbiology Section, Department of Pathology, University of Verona, Verona, Italy
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Spanu T, Santangelo R, Andreotti F, Cascio GL, Velardi G, Fadda G. Antibiotic therapy for severe bacterial infections: correlation between the inhibitory quotient and outcome. Int J Antimicrob Agents 2004; 23:120-8. [PMID: 15013036 DOI: 10.1016/j.ijantimicag.2003.06.006] [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: 02/07/2003] [Accepted: 06/17/2003] [Indexed: 11/16/2022]
Abstract
In severe bacterial infections, treatment failure can occur even when the infecting organism has displayed in vitro susceptibility to the antibiotics used. Several pharmacokinetic-pharmacodynamic parameters show better correlation with therapeutic outcome than susceptibility results. This study was devised to assess the relation between the inhibitory quotient (IQ), i.e., the ratio of achievable antibiotic concentration at the infection site to the minimum inhibitory concentration for the infecting organism, and both clinical and bacteriological outcomes in 290 severe bacterial infections. Multivariate analysis showed that the IQ was a strong predictor of therapeutic outcome ( P< 0.001-0.002): values <4 predicted failure, and those >or=6 cure. This simple parameter could be routinely used to guide effective antibiotic therapy.
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Affiliation(s)
- Teresa Spanu
- Department of Microbiology, Catholic University of the Sacred Heart, Largo F Vito 1, 00168 Rome, Italy.
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Franchini M, Capra F, Veneri D, Lo Cascio G, de Maria E, Manzato F, Lippi G, Gandini G. [Hepatitis C in hemophiliacs]. Recenti Prog Med 2004; 95:30-4. [PMID: 15032339] [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: 04/29/2023]
Abstract
Hepatitis C virus (HCV) infection is an important cause of morbidity and mortality in patients with hereditary bleeding disorders treated with non virus inactivated clotting factor concentrates during the 1970s. In this article, we briefly report the actual knowledge about HCV infection in hemophiliacs, by analyzing the prevalence of HCV infection, the genotype distribution, the natural history of the infection and the most important factors involved in the progression of chronic hepatitis into liver cirrhosis, hepatic decompensation and hepatocellular carcinoma. Finally, we describe the main advances in the treatment of HCV infection.
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