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Bharadwaj P, Nicola L, Breau-Brunel M, Sensini F, Tanova-Yotova N, Atanasov P, Lobig F, Blankenburg M. Unlocking the Value: Quantifying the Return on Investment of Hospital Artificial Intelligence. J Am Coll Radiol 2024:S1546-1440(24)00292-8. [PMID: 38499053 DOI: 10.1016/j.jacr.2024.02.034] [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: 01/08/2024] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE A comprehensive return on investment (ROI) calculator was developed to evaluate the monetary and nonmonetary benefits of an artificial intelligence (AI)-powered radiology diagnostic imaging platform to inform decision makers interested in adopting AI. METHODS A calculator was constructed to calculate comparative costs, estimated revenues, and quantify the clinical value of using an AI platform compared with no use of AI in radiology workflows of a US hospital over a 5-year time horizon. Parameters were determined on the basis of expert interviews and a literature review. Scenario and deterministic sensitivity analyses were conducted to evaluate calculator drivers. RESULTS In the calculator, the introduction of an AI platform into the hospital radiology workflow resulted in labor time reductions and delivery of an ROI of 451% over a 5-year period. The ROI was increased to 791% when radiologist time savings were considered. Time savings for radiologists included more than 15 8-hour working days of waiting time, 78 days in triage time, 10 days in reading time, and 41 days in reporting time. Using the platform also provided revenue benefits for the hospital in bringing in patients for clinically beneficial follow-up scans, hospitalizations, and treatment procedures. Results were sensitive to the time horizon, health center setting, and number of scans performed. Among those, the most influential outcome was the number of additional necessary treatments performed because of AI identification of patients. CONCLUSIONS The authors demonstrate a substantial 5-year ROI of implementing an AI platform in a stroke management-accredited hospital. The ROI calculator may be useful for decision makers evaluating AI-powered radiology platforms.
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Affiliation(s)
| | - Lauren Nicola
- CEO/Partner, Triad Radiology Associates; Chair, Ultrasound Commission, ACR; Chair, Reimbursement Committee, ACR
| | | | | | | | - Petar Atanasov
- Principal Consultant, Amaris Consulting, London, United Kingdom
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Chen MM, Nicola L. Beyond the AJR: Evaluation and Management Payment Policy Changes Redistributed Money From Radiologists to Primary Care Practitioners. AJR Am J Roentgenol 2024; 222:e2329560. [PMID: 37162039 DOI: 10.2214/ajr.23.29560] [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: 05/11/2023]
Affiliation(s)
- Melissa M Chen
- Department of Neuroradiology, University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1482, Houston, TX 77030
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Cara ML, Becheru A, Nicola L, Cara C, Prejbeanu IM. Burned area mapping using satellite data – a tool for monitoring effects on environment. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.072] [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: 11/12/2022] Open
Abstract
Abstract
Background
Significant crop residue burning not only negatively affects local communities but is becoming an important public health issue for global climate change mitigation efforts. This practice is linked with air quality impairment, water contamination, soil degradation, fauna destruction. Chronic exposure to a high level of air pollution may cause permanent health injuries such as the development of lung diseases. The intentional burning of crop residues is a well-known practice across Romania even it is restricted by law.
Methods
We propose a generic software model capable of detecting burned areas based on a time series of multi-spectral optical images together with a multi-step algorithm that uses a pre-trained Gaussian Naive-Bayes classifier to map burned crop fields, named BCMA (Burned Crop Mapping Algorithm), using Copernicus Sentinel-2 acquisitions. BCMA can be trained and extended to recognize other user-defined burned areas and it can be used to produce burned crop fields maps at a global scale in near-real-time at high resolution. We focused on two restrained geographical areas where burned areas were signalized in local press as massive burning vegetation events.
Results
We provide burned area maps generated with an implementation of BCMA over two sites in Romania: Ostroveni - Dolj county and Domogled - Mehedinti county, based on acquisitions from July 2020.
Conclusions
This model provides a fast and reliable tool for detection of burned areas regardless of the landscape and vegetation that could help stakeholders to react and make a proper intervention. Our study highlights the meaningful implications of using this tool to track crop fields burning and to organize large scale awareness campaigns around sustainable crop residues management with positive impact on environment, human health, and agriculture. Further government agencies’ positions regarding using satellite monitoring of burning vegetables might be crucial.
Key messages
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Affiliation(s)
- ML Cara
- Public Health, University of Medicine and Pharmacy , Craiova, Romania
| | - A Becheru
- Computers & Information Technolgy, University of Craiova , Craiova, Romania
- Software Solutions for Applied Science, CS GROUP - ROMANIA , Craiova, Romania
| | - L Nicola
- Software Solutions for Applied Science, CS GROUP - ROMANIA , Craiova, Romania
| | - C Cara
- Software Solutions for Applied Science, CS GROUP - ROMANIA , Craiova, Romania
| | - IM Prejbeanu
- Department of Hygiene, University of Medicine and Pharmacy , Craiova, Romania
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Holmes TR, Al Matouq J, Holmes M, Sioda N, Rudd JC, Bloom C, Nicola L, Palermo NY, Madson JG, Lovas S, Hansen LA. Targeting 14-3-3ε activates apoptotic signaling to prevent cutaneous squamous cell carcinoma. Carcinogenesis 2021; 42:232-242. [PMID: 32816038 PMCID: PMC7905839 DOI: 10.1093/carcin/bgaa091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 12/12/2022] Open
Abstract
More than a million cases of cutaneous squamous cell carcinoma are diagnosed in the USA each year, and its incidence is increasing. Most of these malignancies arise from premalignant lesions, providing an opportunity for intervention before malignant progression. We previously documented how cytoplasmic mislocalization of CDC25A in premalignant and malignant skin cancers confers resistance to apoptotic cell death via a mechanism that depends on its interaction with 14-3-3ε. From these data, we hypothesized that 14-3-3ε overexpression drives skin tumor development and progression, such that targeting 14-3-3ε may be a useful strategy for skin cancer treatment. Like CDC25A, 14-3-3ε was overexpressed and mislocalized to the cytoplasm of both benign and malignant human skin cancer. Skin-targeted deletion of the 14-3-3ε gene reduced skin tumor development by 75% and blocked malignant progression. 14-3-3ε suppressed apoptosis through activation of Akt, leading to inhibition of BCL2 associated agonist of cell death and upregulation of Survivin. Using virtual tetrapeptide libraries, we developed a novel peptide that specifically blocked 14-3-3ε heterodimerization and thereby prevented its interaction with CDC25A. The peptide reduced prosurvival signaling, killed skin cancer cells and reduced skin tumor growth in xenograft. Normal skin keratinocytes were unaffected by inhibition or deletion of 14-3-3ε. Thus, targeting of 14-3-3ε dimerization is a promising strategy for the treatment of premalignant skin lesions.
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MESH Headings
- 14-3-3 Proteins/antagonists & inhibitors
- 14-3-3 Proteins/genetics
- 14-3-3 Proteins/metabolism
- 9,10-Dimethyl-1,2-benzanthracene/administration & dosage
- 9,10-Dimethyl-1,2-benzanthracene/toxicity
- Animals
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Apoptosis/drug effects
- Carcinogens/administration & dosage
- Carcinogens/toxicity
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/pathology
- Cell Line, Tumor
- Cytoplasm/drug effects
- Cytoplasm/metabolism
- Female
- Humans
- Keratinocytes
- Male
- Mice
- Mice, Knockout
- Neoplasms, Experimental/chemically induced
- Neoplasms, Experimental/drug therapy
- Neoplasms, Experimental/pathology
- Protein Multimerization/drug effects
- Skin Neoplasms/drug therapy
- Skin Neoplasms/pathology
- Tetradecanoylphorbol Acetate/administration & dosage
- Tetradecanoylphorbol Acetate/analogs & derivatives
- Tetradecanoylphorbol Acetate/toxicity
- Xenograft Model Antitumor Assays
- cdc25 Phosphatases/metabolism
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Affiliation(s)
- Thomas R Holmes
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
| | - Jenan Al Matouq
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
| | - Matti Holmes
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
| | - Natasha Sioda
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
| | - Justin C Rudd
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
| | - Celia Bloom
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
| | - Lauren Nicola
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
| | - Nicholas Y Palermo
- Holland Computing Center, University of Nebraska–Lincoln, Lincoln, NE, USA
| | | | - Sándor Lovas
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
| | - Laura A Hansen
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
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van Dokkum JS, Khajeh Salehani M, Irani N, Nicola L. On the Proportionality Between Area and Load in Line Contacts. Tribol Lett 2018; 66:115. [PMID: 30956514 PMCID: PMC6417384 DOI: 10.1007/s11249-018-1061-7] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/19/2018] [Indexed: 06/09/2023]
Abstract
The relative contact area of rough surface contacts is known to increase linearly with reduced pressure, with proportionality factor κ . In its common definition, the reduced pressure contains the root-mean-square gradient (RMSG) of the surface. Although easy to measure, the RMSG of the entire surface does not coincide, at small loads, with the RMSG over the actual contact area g ¯ r , which gives a better description of the contact between rough surfaces. It was recently shown that, for Hertzian contacts, linearity between area and load is indeed obtained only if the RMSG is determined over the actual contact area. Similar to surface contacts, in line contacts, numerical data are often studied using theories that predict linearity by design. In this work, we revisit line contact problems and examine whether or not the assumption of linearity for line contacts holds true. We demonstrate, using Green's function molecular dynamics simulations, that κ for line contacts is not a constant: It depends on both the reduced pressure and the Hurst exponent. However, linearity holds when the RMSG is measured over the actual contact area. In that case, we could compare κ for line and surface contacts and found that their ratio is approximately 0.9. Finally, by analytically deriving the proportionality factor using g ¯ r in the original model of Greenwood and Williamson, a value is obtained that is surprisingly in good agreement with our numerical results for rough surface contacts.
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Affiliation(s)
- J. S. van Dokkum
- Department of Materials Science and Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - M. Khajeh Salehani
- Department of Materials Science and Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - N. Irani
- Department of Materials Science and Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - L. Nicola
- Department of Materials Science and Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
- Department of Industrial Engineering, University of Padova, 35131 Padua, Italy
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Longa C, Nicola L, Antonielli L, Mescalchin E, Zanzotti R, Turco E, Pertot I. Soil microbiota respond to green manure in organic vineyards. J Appl Microbiol 2017; 123:1547-1560. [DOI: 10.1111/jam.13606] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/05/2017] [Accepted: 10/03/2017] [Indexed: 02/04/2023]
Affiliation(s)
- C.M.O. Longa
- Research and Innovation Centre Fondazione Edmund Mach (FEM) San Michele all' Adige (TN) Italy
| | - L. Nicola
- Research and Innovation Centre Fondazione Edmund Mach (FEM) San Michele all' Adige (TN) Italy
| | - L. Antonielli
- Research and Innovation Centre Fondazione Edmund Mach (FEM) San Michele all' Adige (TN) Italy
| | - E. Mescalchin
- Research and Innovation Centre Fondazione Edmund Mach (FEM) San Michele all' Adige (TN) Italy
| | - R. Zanzotti
- Research and Innovation Centre Fondazione Edmund Mach (FEM) San Michele all' Adige (TN) Italy
| | - E. Turco
- Research and Innovation Centre Fondazione Edmund Mach (FEM) San Michele all' Adige (TN) Italy
| | - I. Pertot
- Research and Innovation Centre Fondazione Edmund Mach (FEM) San Michele all' Adige (TN) Italy
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8
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De Vecchi E, Nicola L, Zucchetti E, Drago L. In VitroInduction of Resistance by Tissue Concentrations of Azithromycin, Clarithromycin, Cefixime and Amoxicillin/Clavulanate in Clinical Isolates ofStreptococcus pyogenes. J Chemother 2013; 18:379-88. [PMID: 17024793 DOI: 10.1179/joc.2006.18.4.379] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study evaluated the effects of exposure to serum, tonsils and breakpoint drug concentrations of clarithromycin, azithromycin, cefixime and amoxicillin/clavulanate on Streptococcus pyogenes susceptibility. Frequency of mutation and development of resistance after ten passages on antibiotic gradient plates, followed by ten passages without antibiotic, were determined. Phenotypes of macrolide-resistant strains grown at the end of multi-step selection were also determined. Azithromycin induced a surge of resistant strains more rapidly and frequently than clarithromycin, particularly at tonsils concentrations. With amoxicillin/clavulanate no strains showed minimum inhibitory concentrations (MICs) higher than the susceptibility breakpoint. Mutational frequencies were higher for azithromycin, at serum and breakpoint drug concentrations, than for the other drugs. Most of the macrolide resistant strains showed an MLS(B) phenotype. In conclusion, the ability to prevent the occurrence of resistance in clinical isolates of S. pyogenes was similar for amoxicillin/clavulanate and clarithromycin followed by cefixime > azithromycin when tonsil drug concentrations were considered, and greater for amoxicillin/clavulanate followed by clarithromycin > cefixime> azithromycin, at breakpoint and serum concentrations.
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Affiliation(s)
- E De Vecchi
- Laboratory of Microbiology and Clinical Microbiology, Dept of Preclinical Science LITA Vialba, University of Milan, Italy
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9
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Drago L, De vecchi E, Nicola L, Colombo A, Gismondo M. Microbiological Evaluation of Commercial Probiotic Products Available in Italy. J Chemother 2013. [DOI: 10.1179/joc.2004.16.5.436] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Drago L, De Vecchi E, Nicola L, Tocalli L, Gismondo MR. Effect of Moxifloxacin on Bacterial Pathogenicity Factors in Comparison with Amoxicillin, Clarithromycin and Ceftriaxone. J Chemother 2013; 16:30-7. [PMID: 15077996 DOI: 10.1179/joc.2004.16.1.30] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Moxifloxacin is a recent fluoroquinolone with an antibacterial spectrum encompassing both aerobic Gram-negative and Gram-positive strains, as well as anaerobic bacteria. In this study the activity of moxifloxacin against Streptococcus pneumoniae, Staphylococcus aureus, Moraxella catarrhalis, Haemophilus influenzae, Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa, and effects of subinhibitory concentrations on bacterial morphology and adhesion properties were compared with those of amoxicillin, clarithromycin and ceftriaxone. The in vitro activity of moxifloxacin against Gram-positive and Gram-negative pathogens was equal to or better than that of comparators. Subinhibitory concentrations of moxifloxacin significantly affected bacterial morphology of S. pneumoniae, M. catarrhalis, H. influenzae and P. aeruginosa, leading to formation of spherical forms and filaments. Moreover, bacterial adhesion to buccal cells and fibroblasts was reduced after treatment with 1/4 and 1/8 X MIC of moxifloxacin. In conclusion, subinhibitory concentrations of moxifloxacin remarkably interfere with some bacterial pathogenic factors, thereby contributing to its antimicrobial activity.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Department of Clinical Sciences, L. Sacco Teaching Hospital, University of Milan, Italy.
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11
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Drago L, Iemoli E, Rodighiero V, Nicola L, De Vecchi E, Piconi S. Effects of Lactobacillus salivarius LS01 (DSM 22775) treatment on adult atopic dermatitis: a randomized placebo-controlled study. Int J Immunopathol Pharmacol 2012; 24:1037-48. [PMID: 22230409 DOI: 10.1177/039463201102400421] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Atopic dermatitis (AD) is a common inflammatory skin disease characterized by xerosis, pruritus and eczema. The role of probiotics in the prevention and the treatment of AD have been extensively studied in children with controversial results while there are few studies on an adult population. The aim of this randomized, double-blind, placebo-controlled study is to evaluate the clinical efficacy of the intake of a probiotic strain (Lactobacillus salivarius LS01) in the treatment of adult patients with AD. A group of 38 patients was treated with probiotics or placebo (maltodextrin) for 16 weeks. The study was performed from January (T0) to May, 2009 (T16). The assessment of efficacy was based on change in SCORAD (SCORing Atopic Dermatitis) index, dermatology life quality index (DLQI) improvement, cytokine production by PBMCs and ability to modify faecal microbial flora. No significant adverse events were recorded during the study. Patients treated with probiotics showed a statistically improvement of both clinical parameters (SCORAD p<0.0001 and DLQI p= 0.021) at the end of treatment (T16) compared with the placebo group. Furthermore, after four months of treatment there was a significant reduction of Th1 cytokines (IL-12+IFNgamma) (p= 0.03) and Th1/Th2 ratio (IL-12+IFNgamma/IL-4+IL-5) (p= 0.019) only in placebo-treated patients. A statistically relevant decrease of staphylococci in faeces of the probiotictreated group was also observed at the end of treatment. In our study, the administration of L. salivarius LS01 was well tolerated and was associated with a significant improvement of clinical manifestation and QoL. This probiotic strain could have an important role in modulating Th1/Th2 cytokine profiles and could be considered as an important adjunctive therapy in the treatment of adult AD.
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Affiliation(s)
- L Drago
- Department of Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy.
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12
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Drago L, Nicola L, Rodighiero V, Larosa M, Mattina R, De Vecchi E. Comparative evaluation of synergy of combinations of -lactams with fluoroquinolones or a macrolide in Streptococcus pneumoniae. J Antimicrob Chemother 2011; 66:845-849. [DOI: 10.1093/jac/dkr016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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De Vecchi E, Nicola L, Ossola F, Drago L. In vitro selection of resistance in Streptococcus pneumoniae at in vivo fluoroquinolone concentrations. J Antimicrob Chemother 2009; 63:721-7. [PMID: 19218275 DOI: 10.1093/jac/dkp020] [Citation(s) in RCA: 15] [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] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To compare the ability to select for resistance in Streptococcus pneumoniae of levofloxacin, moxifloxacin, ciprofloxacin and prulifloxacin. METHODS Twenty strains of S. pneumoniae susceptible to fluoroquinolones were used. The frequencies of spontaneous single-step mutations at plasma and epithelial lining fluid (ELF) peak and trough antibiotic concentrations were calculated. Multi-step selection of resistance was evaluated by performing 10 serial subcultures on agar plates containing a linear gradient from peak to trough antimicrobial concentrations, followed by 10 subcultures on antibiotic-free agar. Resistant strains selected after multi-step selection were characterized for DNA mutations by sequencing gyrA, gyrB, parC and parE genes. RESULTS Levofloxacin and moxifloxacin showed the lowest frequencies of mutations (median <10(-11)) at plasma peak and at ELF concentrations, while medians ranging from 10(-8) to 10(-6) were observed for ciprofloxacin and prulifloxacin. In a multi-step selection assay, ciprofloxacin and prulifloxacin selected for the highest number of resistant strains (19 and 31, respectively). No selection of resistance was observed for levofloxacin at ELF concentrations and for moxifloxacin at plasma and ELF concentrations. Mutations in parC, parE and gyrA genes were found in ciprofloxacin- and prulifloxacin-resistant strains, while only parC mutations were found for levofloxacin. CONCLUSIONS Levofloxacin and moxifloxacin are characterized by a lower propensity to select in vitro for resistance in S. pneumoniae than ciprofloxacin and prulifloxacin, when tested at plasma and lung concentrations.
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Affiliation(s)
- E De Vecchi
- Laboratory of Microbiology, Department of Preclinical Sciences LITA Vialba, University of Milan, Milan, Italy
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15
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Drago L, Nicola L, De Vecchi E. A comparative in-vitro evaluation of resistance selection after exposure to teicoplanin, vancomycin, linezolid and quinupristin–dalfopristin in Staphylococcus aureus and Enterococcus spp. Clin Microbiol Infect 2008; 14:608-11. [DOI: 10.1111/j.1469-0691.2008.01993.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Drago L, De Vecchi E, Nicola L, Gismondo M. In vitro antimicrobial activity of a novel propolis formulation (Actichelated propolis). J Appl Microbiol 2007; 103:1914-21. [DOI: 10.1111/j.1365-2672.2007.03421.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Drago L, De Vecchi E, Nicola L, Legnani D, Gismondo MR. Kinetic bactericidal activity of telithromycin, azithromycin and clarithromycin against respiratory pathogens. APMIS 2006; 113:655-63. [PMID: 16309423 DOI: 10.1111/j.1600-0463.2005.apm_195.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The present study assessed the comparative in vitro killing kinetics of telithromycin, azithromycin and clarithromycin. Minimal inhibitory concentrations (MIC) and minimal bactericidal concentrations (MBC) were determined against Streptococcus pneumoniae, beta-haemolytic streptococci, Haemophilus influenzae and Moraxella catarrhalis strains characterized by different susceptibilities to beta-lactams and macrolides. For each bacterial species, representative strains were chosen for time-kill studies. Telithromycin showed high activity against all the tested strains with MIC ranging from < or = 0.004 to 0.5 mg/L for streptococci, from 0.008 to 8 mg/L for H. influenzae, and from 0.008 to 0.5 mg/L for M. catarrhalis. In time-kill studies, telithromycin showed an overall superior bactericidal activity in respect to macrolides, particularly against resistant strains. In conclusion, telithromycin proved to possess bactericidal activity against a wide range of respiratory pathogens, including strains resistant to common macrolides.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Department of Clinical Sciences L. Sacco, University of Milan, Italy.
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Drago L, De Vecchi E, Nicola L, Legnani D, Prenna M, Ripa S. In vitro selection of resistance to clarithromycin in Streptococcus pneumoniae clinical isolates. J Chemother 2005; 17:161-8. [PMID: 15920900 DOI: 10.1179/joc.2005.17.2.161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
In this study the effects of exposure to serum, lung and breakpoint concentrations on Streptococcus pneumoniae susceptibility to clarithromycin, azithromycin, amoxicillin/clavulanate, levofloxacin and moxifloxacin were evaluated. Development of resistance was determined by multi-step and single-step methodologies. In the first experimental set, minimum inhibitory concentrations (MICs) were determined after 10 passages on antibiotic-gradient plates and 10 passages on antibiotic-free plates. Acquisition of resistance was defined as an increase of > or = 4-fold from the starting MIC. In single-step studies, the rate of spontaneous mutations was calculated after a passage on antibiotic-containing agar plates. Azithromycin and levofloxacin gave the highest number of strains with MIC increased of at least 4 times the starting value, followed by moxifloxacin and by clarithromycin which only at the lowest concentration tested selected for resistance in 5 strains. Amoxicillin/clavulanate never displayed > or = 4-fold MIC increase. Frequencies of mutation were lower for clarithromycin and moxifloxacin than for the comparators. At lung concentrations clarithromycin had limited potential to select for resistance.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Dept of Clinical Sciences, L. Sacco Teaching Hospital, University of Milan.
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Drago L, De Vecchi E, Nicola L, Legnani D, Lombardi A, Gismondo MR. In vitro synergy and selection of resistance by fluoroquinolones plus amikacin or beta-lactams against extended-spectrum beta-lactamase-producing Escherichia coli. J Chemother 2005; 17:46-53. [PMID: 15828443 DOI: 10.1179/joc.2005.17.1.46] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study compared the potential synergy of levofloxacin and ciprofloxacin in combination with cefepime, ceftazidime, imipenem, piperacillin/tazobactam or amikacin, against extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli by using checkerboard and time kill studies. Moreover, selection of resistance was determined by frequency of mutations and by calculating the increase in minimum inhibitory concentrations (MICs) after five serial subcultures on antibiotic-containing plates. Synergy occurred more often with levofloxacin combined with imipenem (7/10 strains) and with levofloxacin or ciprofloxacin with amikacin (10/10) than for the other combinations. Time kill studies showed synergy for levofloxacin combined with amikacin, ceftazidime, imipenem or piperacillin/tazobactam, and for ciprofloxacin combined with amikacin, cefepime or imipenem. Antibiotic combinations selected for resistance less frequently than antibiotics alone. Mutation frequency was <10(-12) for all combinations. In conclusion, the combination of a fluoroquinolone with a beta-lactam or amikacin may provide improved antimicrobial activity and help limit the occurrence of resistance in ESBL-producing E. coli strains.
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Affiliation(s)
- L Drago
- Lab Clinical Microbiology, Dept Clinical Science L Sacco, Via GB Grassi 74, 20157 Milano, Italy.
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Drago L, De Vecchi E, Nicola L, Colombo A, Gismondo MR. Microbiological evaluation of commercial probiotic products available in Italy. J Chemother 2004; 16:463-7. [PMID: 15565913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Scientific evidence of the prevention and therapy of some intestinal diseases is accumulating in regard to probiotic products. However, sufficient information on the use of probiotics in specific therapies is not yet available and, above all, there is no clear legislation about these products in Europe. In this study, we evaluated five different probiotic products commercially available in Italy for their qualitative and quantitative microbial content after about 12 and 22 months of storage. We also evaluated the stability of lactobacilli to 0.3% bile salts and to pH of 3.58 and 7.98. There were discrepancies between the declared content and our results found after storage for 4 of the tested products. Bile salts and basic pH did not affect the growth of the lactobacilli tested, while for 2 tested products 6 hours at acid pH produced a complete inhibition of bacterial growth. Our results suggest the need for clear legislation and adequate control of the manufacturing of probiotic products.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Dept of Clinical Sciences L. Sacco, L. Sacco Teaching Hospital, University of Milan, Italy.
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Drago L, De Vecchi E, Nicola L, Gismondo MR. Antimicrobial activity and interference of tobramycin and chloramphenicol on bacterial adhesion to intraocular lenses. Drugs Exp Clin Res 2003; 29:25-35. [PMID: 12866361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The antimicrobial activities of tobramycin and chloramphenicol were evaluated by determining minimum inhibitory and bactericidal concentrations against Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, group A, group B and group G streptococci, Klebsiella spp., Stenotrophomonas maltophilia and ciprofloxacin-resistant and -susceptible Pseudomonas aeruginosa, as well as by evaluating interference on adhesion of slime producer strains of S. aureus and P. aeruginosa to intraocular lens from tobramycin and chloramphenicol pharmaceutical products by scanning electron microscopy. Chloramphenicol was more active against Gram-positive bacteria than was tobramycin, which instead showed higher activity against ciprofloxacin-susceptible P. aeruginosa. Treatment of lenses with the antimicrobial products eradicated the bacterial biofilm, which was already notably reduced after 5 min. This activity was more pronounced for chloramphenicol against S. aureus and for tobramycin against P. aeruginosa. Bacterial adhesion was also significantly reduced when lenses colonized by P. aeruginosa were treated with chloramphenicol, even if they were resistant to this drug. In conclusion, the tested drugs showed marked antibacterial activity, particularly by interfering with bacterial biofilms. The data obtained in this study suggest a specific use of chloramphenicol in topical prophylaxis aimed at avoiding bacterial contaminations. However, further specific in vivo studies are needed to confirm these data.
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Affiliation(s)
- L Drago
- Microbiology Laboratory, Department of Clinical Sciences, L. Sacco Teaching Hospital, University of Milan, Milan, Italy.
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Drago L, De Vecchi E, Nicola L, Valli M, Marchetti F, Gismondo MR. Comparative bactericidal activity of fluoroquinolones against clinical isolates resistant to fluoroquinolones. J Chemother 2003; 15:118-23. [PMID: 12797386 DOI: 10.1179/joc.2003.15.2.118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The bactericidal activity of levofloxacin, ciprofloxacin, moxifloxacin and norfloxacin against clinical isolates conventionally classified as resistant to fluoroquinolones were compared at their maximum concentrations in serum, urine (except moxifloxacin) and bronchial mucosa (except norfloxacin). Time killing curves against Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus epidermidis, and Streptococcus pneumoniae were performed. Serum concentrations of the tested drugs were not able to produce a bactericidal effect on fluoroquinolone-resistant strains. In the urine series, levofloxacin was always bactericidal (decrease > or = 3 logs CFU/ml), while norfloxacin and ciprofloxacin were bactericidal on E. coli (both), P. mirabilis (norfloxacin) and P. aeruginosa (ciprofloxacin). In the bronchial mucosa series, S. pneumoniae was rapidly killed by levofloxacin and moxifloxacin, and K. pneumoniae by levofloxacin after 12 hours. In conclusion, the maximum levofloxacin concentrations achievable at certain body sites allowed killing even of strains defined as resistant by conventional breakpoints.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Dept of Clinical Sciences, L. Sacco Teaching Hospital, University of Milan, Italy.
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Drago L, De Vecchi E, Nicola L, Valli M, Gismondo MR. Effects of subinhibitory concentrations of ibuprofen isobuthanolammonium on virulence factors of uropathogenic Escherichia coli. J Chemother 2002; 14:314-5. [PMID: 12120890 DOI: 10.1179/joc.2002.14.3.314] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Drago L, De Vecchi E, Valli M, Nicola L, Gismondo MR. Effect of linezolid in comparison with that of vancomycin on glycocalix production: in vitro study. Antimicrob Agents Chemother 2002; 46:598-9. [PMID: 11796388 PMCID: PMC127078 DOI: 10.1128/aac.46.2.598-599.2002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Drago L, De Vecchi E, Mombelli B, Nicola L, Valli M, Gismondo MR. Activity of levofloxacin and ciprofloxacin against urinary pathogens. J Antimicrob Chemother 2001; 48:37-45. [PMID: 11418511 DOI: 10.1093/jac/48.1.37] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study compares the antibacterial activities of levofloxacin and ciprofloxacin against recently isolated urinary tract pathogens, by evaluating their MICs and MBCs in accordance with NCCLS susceptibility tests, time-kill curves and interference with bacterial adhesion to uroepithelial cells. A total of 200 clinical isolates was tested, including the species Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococcus aureus and Staphylococcus epidermidis. All E. coli isolates were susceptible to levofloxacin and only one was resistant to ciprofloxacin, and there were no differences between beta-lactamase-positive and -negative strains. K. pneumoniae strains resistant to ciprofloxacin were also resistant to levofloxacin. Methicillin-resistant S. aureus seemed to be less susceptible than methicillin-susceptible strains to these quinolones. S. epidermidis strains were susceptible to levofloxacin and ciprofloxacin, with the exception of two isolates. Incubation of S. aureus and E. coli with subinhibitory antimicrobial concentrations reduced their capacity to adhere to uroepithelial cells; this was statistically significant at 0.25 x MIC with respect to controls (P < 0.05). Inhibition of adhesion ranged from 36 to 43% when bacteria were incubated in the presence of 0.25 x MIC of levofloxacin and ciprofloxacin, and from 10 to 27% at 0.125 x MIC. These findings suggest that levofloxacin is an effective alternative to ciprofloxacin in the treatment of urinary tract infections and that sub-inhibitory concentrations may contribute to efficacy.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Microbiology, Department of Preclinical Science, LITA Vialba, University of Milan, Via G. B. Grassi 74, 20157 Milano, Italy.
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Francesco P, Nicola L. Nosological difference between the Bartsocas-Papas syndrome and lethal multiple pterygium syndrome. Am J Med Genet 1988; 29:699-700. [PMID: 3377016 DOI: 10.1002/ajmg.1320290338] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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