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Rotundo S, Tassone MT, Marascio N, Morrone HL, Gigliotti S, Quirino A, Russo A, Matera G, Trecarichi EM, Torti C. A systematic review on antibiotic therapy of cutaneous bacillary angiomatosis not related to major immunocompromising conditions: from pathogenesis to treatment. BMC Infect Dis 2024; 24:380. [PMID: 38589795 PMCID: PMC11000314 DOI: 10.1186/s12879-024-09253-9] [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: 11/19/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that mostly affects people living with HIV (PLWH), transplanted patients and those taking immunosuppressive drugs. Since cBA is mostly related to these major immunocompromising conditions (i.e., T-cell count impairment), it is considered rare in relatively immunocompetent patients and could be underdiagnosed in them. Moreover, antimicrobial treatment in this population has not been previously investigated. METHODS We searched the databases PubMed, Google Scholar, Scopus, OpenAIRE and ScienceDirect by screening articles whose title included the keywords "bacillary" AND "angiomatosis" and included case reports about patients not suffering from major immunocompromising conditions to provide insights about antibiotic treatments and their duration. RESULTS Twenty-two cases of cBA not related to major immunocompromising conditions were retrieved. Antibiotic treatment duration was shorter in patients with single cBA lesion than in patients with multiple lesions, including in most cases macrolides and tetracyclines. CONCLUSIONS cBA is an emerging manifestation of Bartonella spp. infection in people not suffering from major immunocompromising conditions. Until evidence-based guidelines are available, molecular tests together with severity and extension of the disease can be useful to personalize the type of treatment and its duration.
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Affiliation(s)
- Salvatore Rotundo
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Maria Teresa Tassone
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Nadia Marascio
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Helen Linda Morrone
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Simona Gigliotti
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Angela Quirino
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Alessandro Russo
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Giovanni Matera
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Carlo Torti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy.
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Pavia G, Scarpa F, Ciccozzi A, Romano C, Branda F, Quirino A, Marascio N, Matera G, Sanna D, Ciccozzi M. Changing and evolution of influenza virus: is it a trivial flu? Chemotherapy 2024:000538382. [PMID: 38508151 DOI: 10.1159/000538382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 03/09/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Influenza viruses are etiological agents which cause contagious respiratory, seasonal epidemics and, for Influenza A subtypes, pandemics. The clinical picture of Influenza has undergone continuous change over the years, due to intrinsic viral evolution as well as "reassortment" of its genomic segments. The history of Influenza highlights its ability to adapt and to rapidly evolve, without specific circumstances. This reflects the complexity of this pathology and poses the fundamental question about its assumption as a "common illness" and its impact on public health. SUMMARY The global influenza epidemics and pandemics claimed millions of deaths, leaving an indelible mark on public health, and showing the need for a better comprehension of the influenza virus. The clear understanding of genetic variations during the Influenza seasonal epidemics is a crucial point for developing effective strategies for prevention, treatment, and vaccine design. The recent advance in Next Generation Sequencing approaches, model systems to virus culture and bioinformatics pipeline played a key role in the rapid characterization of circulating Influenza strains. In particular, the increase of computational power allowed to perform complex tasks in healthcare setting through Machine Learning (ML) algorithms, which analyze different variables, such as medical and laboratory outputs, to optimize medical research and to improve public health systems. The early detection of emerging and re-emerging pathogens is of matter importance to prevent next pandemics. KEY MESSAGES The perception of influenza as a "trivial flu" or a more serious public health concern is a subject of ongoing debate, reflecting the multifaceted nature of this infectious disease. The variability in the severity of influenza shed the light on the unpredictability of the viral characteristics, coupled with the challenges in accurately predicting circulating strains. This adds complexity to the public health burden of Influenza and highlights the need of targeted interventions.
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Divenuto F, Marascio N, Quirino A, Giancotti A, Filice S, Gigliotti S, Campolo MP, Campolo M, Barreca GS, Lamberti AG, Castelli G, Bruno F, Matera G. Cellular mediators in human leishmaniasis: Critical determinants in parasite killing or disease progression. Acta Trop 2023; 248:107037. [PMID: 37805040 DOI: 10.1016/j.actatropica.2023.107037] [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: 08/08/2023] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023]
Abstract
Data on cellular immunity mediators in the early phase of human leishmaniasis are still limited and controversial. In order to mimic the changes of humoral mediators during the early phase of human natural infection, some Th1, Th2, Treg, and Breg cytokines, MCP-1, and the nitric oxide (NO) from human PBMC, stimulated by Leishmania infantum, Leishmania major, Leishmania donovani and Leishmania tropica infective metacyclic promastigotes, were determined. After 4 h of L. major, L. donovani, and L. tropica challenge, TNFα, IL-1β, IL-6 levels were significantly higher than negative control cultures with saline (SF) instead of Leishmania promastigotes, unlike L. infantum-stimulated TNFα and L. major-stimulated IL-1β. We obtained higher levels of IL-4 and IL-10 cytokines after stimulation of human PBMCs by L. infantum and L. donovani, compared to those observed after the challenge of PBMCs by L. major and L. tropica. Regarding IL-35, such cytokine levels were significantly increased following infection with L. infantum and L. donovani, in contrast to L. major and L. tropica. Up to our knowledge, we are the first to study the effect of four different species of Leishmania on IL-35 levels in human cells. Our study highlights how several Leishmania species can up-regulate different groups of cytokines (Th1, Th2, Treg and Breg) and modulate NO release in a different way. This original aspect can be explained by different Leishmania cell products, such as LPG, obtained from different strains/species of live parasites. Our findings would contribute to the development of new therapeutics or vaccination strategies.
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Affiliation(s)
- F Divenuto
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - N Marascio
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - A Quirino
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy.
| | - A Giancotti
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - S Filice
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - S Gigliotti
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - M P Campolo
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - M Campolo
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - G S Barreca
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - A G Lamberti
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - G Castelli
- National Reference Center for Leishmaniasis (C.Re.Na.L.), Istituto Zooprofilattico Sperimentale della Sicilia, 90129 Palermo, Italy
| | - F Bruno
- National Reference Center for Leishmaniasis (C.Re.Na.L.), Istituto Zooprofilattico Sperimentale della Sicilia, 90129 Palermo, Italy
| | - G Matera
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
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Pavia G, Marascio N, Matera G, Quirino A. Does the Human Gut Virome Contribute to Host Health or Disease? Viruses 2023; 15:2271. [PMID: 38005947 PMCID: PMC10674713 DOI: 10.3390/v15112271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/04/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
The human gastrointestinal (GI) tract harbors eukaryotic and prokaryotic viruses and their genomes, metabolites, and proteins, collectively known as the "gut virome". This complex community of viruses colonizing the enteric mucosa is pivotal in regulating host immunity. The mechanisms involved in cross communication between mucosal immunity and the gut virome, as well as their relationship in health and disease, remain largely unknown. Herein, we review the literature on the human gut virome's composition and evolution and the interplay between the gut virome and enteric mucosal immunity and their molecular mechanisms. Our review suggests that future research efforts should focus on unraveling the mechanisms of gut viruses in human homeostasis and pathophysiology and on developing virus-prompted precision therapies.
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Affiliation(s)
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University Hospital of Catanzaro, 88100 Catanzaro, Italy
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5
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Equestre M, Marcantonio C, Marascio N, Centofanti F, Martina A, Simeoni M, Suffredini E, La Rosa G, Bonanno Ferraro G, Mancini P, Veneri C, Matera G, Quirino A, Costantino A, Taffon S, Tritarelli E, Campanella C, Pisani G, Nisini R, Spada E, Verde P, Ciccaglione AR, Bruni R. Characterization of SARS-CoV-2 Variants in Military and Civilian Personnel of an Air Force Airport during Three Pandemic Waves in Italy. Microorganisms 2023; 11:2711. [PMID: 38004723 PMCID: PMC10672769 DOI: 10.3390/microorganisms11112711] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
We investigated SARS-CoV-2 variants circulating, from November 2020 to March 2022, among military and civilian personnel at an Air Force airport in Italy in order to classify viral isolates in a potential hotspot for virus spread. Positive samples were subjected to Next-Generation Sequencing (NGS) of the whole viral genome and Sanger sequencing of the spike coding region. Phylogenetic analysis classified viral isolates and traced their evolutionary relationships. Clusters were identified using 70% cut-off. Sequencing methods yielded comparable results in terms of variant classification. In 2020 and 2021, we identified several variants, including B.1.258 (4/67), B.1.177 (9/67), Alpha (B.1.1.7, 9/67), Gamma (P.1.1, 4/67), and Delta (4/67). In 2022, only Omicron and its sub-lineage variants were observed (37/67). SARS-CoV-2 isolates were screened to detect naturally occurring resistance in genomic regions, the target of new therapies, comparing them to the Wuhan Hu-1 reference strain. Interestingly, 2/30 non-Omicron isolates carried the G15S 3CLpro substitution responsible for reduced susceptibility to protease inhibitors. On the other hand, Omicron isolates carried unusual substitutions A1803V, D1809N, and A949T on PLpro, and the D216N on 3CLpro. Finally, the P323L substitution on RdRp coding regions was not associated with the mutational pattern related to polymerase inhibitor resistance. This study highlights the importance of continuous genomic surveillance to monitor SARS-CoV-2 evolution in the general population, as well as in restricted communities.
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Affiliation(s)
- Michele Equestre
- Department of Neurosciences, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Cinzia Marcantonio
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.M.); (F.C.); (A.C.); (S.T.); (E.T.); (R.N.); (E.S.); (A.R.C.); (R.B.)
| | - Nadia Marascio
- Clinical Microbiology Unit, Department of Health Sciences, “Magna Grecia” University, 88100 Catanzaro, Italy; (G.M.); (A.Q.)
| | - Federica Centofanti
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.M.); (F.C.); (A.C.); (S.T.); (E.T.); (R.N.); (E.S.); (A.R.C.); (R.B.)
| | - Antonio Martina
- Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.M.); (M.S.); (G.P.)
| | - Matteo Simeoni
- Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.M.); (M.S.); (G.P.)
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Giuseppina La Rosa
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.L.R.); (G.B.F.); (P.M.); (C.V.)
| | - Giusy Bonanno Ferraro
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.L.R.); (G.B.F.); (P.M.); (C.V.)
| | - Pamela Mancini
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.L.R.); (G.B.F.); (P.M.); (C.V.)
| | - Carolina Veneri
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.L.R.); (G.B.F.); (P.M.); (C.V.)
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, “Magna Grecia” University, 88100 Catanzaro, Italy; (G.M.); (A.Q.)
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, “Magna Grecia” University, 88100 Catanzaro, Italy; (G.M.); (A.Q.)
| | - Angela Costantino
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.M.); (F.C.); (A.C.); (S.T.); (E.T.); (R.N.); (E.S.); (A.R.C.); (R.B.)
| | - Stefania Taffon
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.M.); (F.C.); (A.C.); (S.T.); (E.T.); (R.N.); (E.S.); (A.R.C.); (R.B.)
| | - Elena Tritarelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.M.); (F.C.); (A.C.); (S.T.); (E.T.); (R.N.); (E.S.); (A.R.C.); (R.B.)
| | - Carmelo Campanella
- Clinical Analysis and Molecular Biology Laboratory Rome, Institute of Aerospace Medicine, 00185 Rome, Italy;
| | - Giulio Pisani
- Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.M.); (M.S.); (G.P.)
| | - Roberto Nisini
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.M.); (F.C.); (A.C.); (S.T.); (E.T.); (R.N.); (E.S.); (A.R.C.); (R.B.)
| | - Enea Spada
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.M.); (F.C.); (A.C.); (S.T.); (E.T.); (R.N.); (E.S.); (A.R.C.); (R.B.)
| | - Paola Verde
- Aerospace Medicine Department, Aerospace Test Division, Militay Airport Mario De Bernardi, Pratica di Mare, 00040 Rome, Italy;
| | - Anna Rita Ciccaglione
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.M.); (F.C.); (A.C.); (S.T.); (E.T.); (R.N.); (E.S.); (A.R.C.); (R.B.)
| | - Roberto Bruni
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.M.); (F.C.); (A.C.); (S.T.); (E.T.); (R.N.); (E.S.); (A.R.C.); (R.B.)
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Rotundo S, Borelli M, Scaglione V, Lionello R, Biamonte F, Olivadese V, Quirino A, Morrone HL, Matera G, Costanzo FS, Russo A, Trecarichi EM, Torti C. Interleukin-6 2/lymphocyte as a proposed predictive index for COVID-19 patients treated with monoclonal antibodies. Clin Exp Med 2023; 23:3681-3687. [PMID: 37097384 PMCID: PMC10127195 DOI: 10.1007/s10238-023-01081-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
In a convenience sample of 93 patients treated with monoclonal antibodies (moAbs) against SARS-CoV-2, the interleukin-62/lymphocyte count ratio (IL-62/LC) was able to predict clinical worsening both in early stages of COVID-19 and in oxygen-requiring patients. Moreover, we analysed 18 most at-risk patients with asymptomatic or mild disease treated with both moAbs and antiviral treatment and found that only 2 had clinical progression, while patients with a similar risk were reported to have an unfavourable outcome in most cases from recent data. In only one of our 18 patients, clinical progression was attributable to COVID-19, and in the other cases, clinical progression was observed despite IL-62/LC being above the risk cut-off. In conclusion, IL-62/LC may be a valuable method to identify patients requiring more aggressive treatments both in earlier and later stages of the disease; however, most at-risk patients can be protected from clinical worsening by combining moAbs and antivirals, even if levels of the IL-62/LC biomarker are lower than the risk cut-off.
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Affiliation(s)
- Salvatore Rotundo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy.
| | - Massimo Borelli
- UMG School of PhD Programmes, University "Magna Graecia", Catanzaro, Italy
| | - Vincenzo Scaglione
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Rosaria Lionello
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Flavia Biamonte
- Department of Clinical and Experimental Medicine, University "Magna Graecia", Catanzaro, Italy
| | - Vincenzo Olivadese
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Helen Linda Morrone
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | | | - Alessandro Russo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | | | - Carlo Torti
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
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Quirino A, Cicino C, Scarlata GGM, Marascio N, Di Gennaro G, Matera G, Licata F, Bianco A. Prevalence of Colonization with Multidrug-Resistant Bacteria: Results of a 5-Year Active Surveillance in Patients Attending a Teaching Hospital. Antibiotics (Basel) 2023; 12:1525. [PMID: 37887226 PMCID: PMC10604483 DOI: 10.3390/antibiotics12101525] [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: 07/26/2023] [Revised: 09/25/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
Combating antimicrobial resistance (AMR) requires comprehensive efforts, such as screening to identify patients colonized by multidrug-resistant microorganisms (MDROs). The primary purpose of this study was to estimate the AMR pattern of methicillin-resistant Staphylococcus aureus (MRSA) isolated from nasal surveillance swabs and MDROs isolated from pharyngeal and rectal surveillance swabs in patients attending a teaching hospital. Data were sought retrospectively, from 1 January 2017 to 31 December 2021, from the records produced by the hospital microbiology laboratory. Duplicate isolates, defined as additional isolates of the same microorganism with identical antibiograms, were excluded. Among Staphylococcus aureus isolates from nasal swabs, 18.2% were oxacillin-resistant. Among Gram-negative bacteria, 39.8% of Klebsiella pneumoniae and 83.5% of Acinetobacter baumannii isolates were carbapenem-resistant. Resistance to three antibiotic categories was high among Acinetobacter baumannii (85.8%) and Klebsiella pneumoniae (42.4%). The present data highlight a high prevalence of MDRO colonization among patients admitted to the hospital and suggest that screening for MDROs could be an important tool for infection control purposes, especially in geographical areas where limiting the spread of MDROs is crucial. The results also underline the importance of active surveillance, especially for carbapenem-resistant, Gram-negative bacteria in reducing their transmission, especially in high-risk units.
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Affiliation(s)
- Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (A.Q.); (C.C.); (G.G.M.S.); (N.M.); (G.M.)
| | - Claudia Cicino
- Unit of Clinical Microbiology, Department of Health Sciences, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (A.Q.); (C.C.); (G.G.M.S.); (N.M.); (G.M.)
| | - Giuseppe Guido Maria Scarlata
- Unit of Clinical Microbiology, Department of Health Sciences, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (A.Q.); (C.C.); (G.G.M.S.); (N.M.); (G.M.)
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (A.Q.); (C.C.); (G.G.M.S.); (N.M.); (G.M.)
| | - Gianfranco Di Gennaro
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy;
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (A.Q.); (C.C.); (G.G.M.S.); (N.M.); (G.M.)
| | - Francesca Licata
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy;
| | - Aida Bianco
- Department of Medical and Surgical Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy;
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Mimmi S, Zimbo AM, Rotundo S, Cione E, Nisticò N, Aloisio A, Maisano D, Tolomeo AM, Dattilo V, Lionello R, Fioravanti A, Di Loria A, Quirino A, Marascio N, Russo A, Trecarichi EM, Matera G, Quinto I, Torti C, Iaccino E. SARS CoV-2 spike protein-guided exosome isolation facilitates detection of potential miRNA biomarkers in COVID-19 infections. Clin Chem Lab Med 2023; 61:1518-1524. [PMID: 36972680 DOI: 10.1515/cclm-2022-1286] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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: 10/26/2022] [Accepted: 02/24/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES Nearly three years into the pandemic, SARS-CoV-2 infections are occurring in vaccinated and naturally infected populations. While humoral and cellular responses in COVID-19 are being characterized, novel immune biomarkers also being identified. Recently, an increase in angiotensin-converting enzyme 2 expressing (aka, ACE2 positive) circulating exosomes (ExoACE2) were identified in the plasma of COVID-19 patients (El-Shennawy et al.). In this pilot study, we describe a method to characterize the exosome-associated microRNA (exo-miRNA) signature in ACE2-positive and ACE2-negative exosomal populations (non-ExoACE2). METHODS We performed a sorting protocol using the recombinant biotin-conjugated SARS CoV-2 spike protein containing the receptor binding domain (RBD) on plasma samples from six patients. Following purification, exo-miRNA were characterized for ACE2-positive and ACE2-negative exosome subpopulations by RT-PCR. RESULTS We identified differential expression of several miRNA. Specifically let-7g-5p and hsa-miR-4454+miR-7975 were upregulated, while hsa-miR-208a-3p and has-miR-323-3p were downregulated in ExoACE2 vs. non-ExoACE2. CONCLUSIONS The SARS CoV-2 spike-protein guided exosome isolation permits isolation of ExoACE2 exosomes. Such purification facilitates detailed characterization of potential biomarkers (e.g. exo-miRNA) for COVID-19 patients. This method could be used for future studies to further the understanding mechanisms of host response against SARS CoV-2.
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Affiliation(s)
- Selena Mimmi
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Anna Maria Zimbo
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, CS, Italy
| | - Nancy Nisticò
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Annamaria Aloisio
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Anna Maria Tolomeo
- Department of Cardiac, Thoracic and Vascular Science and Public Health, University of Padova, Padua, Italy
| | - Vincenzo Dattilo
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rosaria Lionello
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Antonella Fioravanti
- Structural and Molecular Microbiology, Structural Biology Research Center, Brussels, Belgium
| | - Antonio Di Loria
- Department of Veterinary Medicine and Animal Productions, University Federico II of Napoli, Napoli, Italy
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Nadia Marascio
- Clinical Microbiology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Ileana Quinto
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Enrico Iaccino
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
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9
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Quirino A, Cicino C, Scaglione V, Marascio N, Serapide F, Scarlata GGM, Lionello R, Divenuto F, La Gamba V, Pavia G, Russo A, Torti C, Matera G, Trecarichi EM. In vitro Activity of Cefiderocol Against Carbapenem-Resistant Acinetobacter baumannii Clinical Isolates: a Single Center Experience. Mediterr J Hematol Infect Dis 2023; 15:e2023043. [PMID: 37435038 PMCID: PMC10332354 DOI: 10.4084/mjhid.2023.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/16/2023] [Indexed: 07/13/2023] Open
Affiliation(s)
- Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University of Catanzaro–“Mater Domini” teaching hospital; Catanzaro, Italy
| | - Claudia Cicino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University of Catanzaro–“Mater Domini” teaching hospital; Catanzaro, Italy
| | - Vincenzo Scaglione
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro – “Mater Domini” teaching hospital; Catanzaro, Italy
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University of Catanzaro–“Mater Domini” teaching hospital; Catanzaro, Italy
| | - Francesca Serapide
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro – “Mater Domini” teaching hospital; Catanzaro, Italy
| | - Giuseppe Guido Maria Scarlata
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University of Catanzaro–“Mater Domini” teaching hospital; Catanzaro, Italy
| | - Rosaria Lionello
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro – “Mater Domini” teaching hospital; Catanzaro, Italy
| | - Francesca Divenuto
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University of Catanzaro–“Mater Domini” teaching hospital; Catanzaro, Italy
| | - Valentina La Gamba
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro – “Mater Domini” teaching hospital; Catanzaro, Italy
| | - Grazia Pavia
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University of Catanzaro–“Mater Domini” teaching hospital; Catanzaro, Italy
| | - Alessandro Russo
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro – “Mater Domini” teaching hospital; Catanzaro, Italy
| | - Carlo Torti
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro – “Mater Domini” teaching hospital; Catanzaro, Italy
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University of Catanzaro–“Mater Domini” teaching hospital; Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro – “Mater Domini” teaching hospital; Catanzaro, Italy
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10
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Carullo N, Divenuto F, Marascio N, Adams NJ, Giancotti A, Comi N, Faga T, Bolignano D, Coppolino G, Serapide F, Costa C, Torti C, Matera G, Quirino A, Andreucci M. A Rare Complication of Ascariasis: A Case of Acute Interstitial Nephritis. Diagnostics (Basel) 2023; 13:2054. [PMID: 37370949 DOI: 10.3390/diagnostics13122054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Acute interstitial nephritis (AIN) due to helminths is a rare cause of acute kidney injury (AKI). Helminthiases often progresses insidiously, making diagnosis difficult. This was the case of a 72-year-old man, who presented with renal failure, itching and diarrhoea. Urinalysis revealed leukocyturia, microhaematuria and mild proteinuria. A full blood count revealed leucocytosis with eosinophilia. A stool parasitological examination revealed fertilised eggs of Ascaris lumbricoides. Tubulointerstitial nephropathy secondary to A. lumbricoides infection was suspected. A percutaneous renal biopsy was not performed since the patient refused the anti-platelet therapy discontinuation. Mebendazole, albendazole and prednisone therapy was administered. After worm eradiation and discharge, recovery from the parasitosis, absence of pruritus and eosinophilia, and progressive improvement of renal function were observed, strongly suggesting a causal relationship between Ascaris infection and AIN. Parasite infection should be considered in the differential diagnosis of unexplained renal failure because early diagnosis and treatment are necessary to avoid irreversible complications.
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Affiliation(s)
- Nazareno Carullo
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Francesca Divenuto
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Nadia Marascio
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Neill James Adams
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Aida Giancotti
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Nicolino Comi
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Teresa Faga
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Davide Bolignano
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Giuseppe Coppolino
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Francesca Serapide
- Infectious and Tropical Disease Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Chiara Costa
- Infectious and Tropical Disease Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Disease Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Michele Andreucci
- Nephrology and Dialysis Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
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11
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Marascio N, Scarlata GGM, Romeo F, Cicino C, Trecarichi EM, Quirino A, Torti C, Matera G, Russo A. The Role of Gut Microbiota in the Clinical Outcome of Septic Patients: State of the Art and Future Perspectives. Int J Mol Sci 2023; 24:ijms24119307. [PMID: 37298258 DOI: 10.3390/ijms24119307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Sepsis is a life-threatening multiple-organ dysfunction caused by a dysregulated host response to infection, with high mortality worldwide; 11 million deaths per year are attributable to sepsis in high-income countries. Several research groups have reported that septic patients display a dysbiotic gut microbiota, often related to high mortality. Based on current knowledge, in this narrative review, we revised original articles, clinical trials, and pilot studies to evaluate the beneficial effect of gut microbiota manipulation in clinical practice, starting from an early diagnosis of sepsis and an in-depth analysis of gut microbiota.
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Affiliation(s)
- Nadia Marascio
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, "Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Giuseppe Guido Maria Scarlata
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, "Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Francesco Romeo
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University, "Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Claudia Cicino
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, "Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University, "Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, "Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University, "Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, "Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Alessandro Russo
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University, "Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
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12
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Marascio N, Loria MT, Pavia G, Peronace C, Adams NJ, Campolo M, Divenuto F, Lamberti AG, Giancotti A, Barreca GS, Mazzitelli M, Trecarichi EM, Torti C, Perandin F, Bisoffi Z, Quirino A, Matera G. Evaluation of IL-35, as a Possible Biomarker for Follow-Up after Therapy, in Chronic Human Schistosoma Infection. Vaccines (Basel) 2023; 11:vaccines11050995. [PMID: 37243099 DOI: 10.3390/vaccines11050995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
The host response to helminth infections is characterized by systemic and tissue-related immune responses that play a crucial role in pathological diseases. Recently, experimental studies have highlighted the role of regulatory T (Tregs) and B (Bregs) cells with secreted cytokines as important markers in anti-schistosomiasis immunity. We investigated the serical levels of five cytokines (TNFα, IFN-γ, IL-4, IL-10 and IL-35) in pre- and post-treatment samples from chronic Schistosoma infected patients to identify potential serological markers during follow-up therapy. Interestingly, we highlighted an increased serum level of IL-35 in the pre-therapy samples (median 439 pg/mL for Schistosoma haematobium and 100.5 pg/mL for Schistsoma mansoni infected patients) compared to a control group (median 62 pg/mL and 58 pg/mL, respectively, p ≤ 0.05), and a significantly lower concentration in post-therapy samples (181 pg/mL for S. haematobium and 49.5 pg/mL for S. mansoni infected patients, p ≤ 0.05). The present study suggests the possible role of IL-35 as a novel serological biomarker in the evaluation of Schistosoma therapy follow-up.
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Affiliation(s)
- Nadia Marascio
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Maria Teresa Loria
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Grazia Pavia
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Cinzia Peronace
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Neill James Adams
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Morena Campolo
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Francesca Divenuto
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Angelo Giuseppe Lamberti
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Aida Giancotti
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Giorgio Settimo Barreca
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Padua University Hospital, 35128 Padua, Italy
| | - Enrico Maria Trecarichi
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Francesca Perandin
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy
| | - Zeno Bisoffi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
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13
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Russo A, Bruni A, Gullì S, Borrazzo C, Quirino A, Lionello R, Serapide F, Garofalo E, Serraino R, Romeo F, Marascio N, Matera G, Longhini F, Trecarichi EM, Torti C. Efficacy of cefiderocol- versus colistin-containing regimen for treatment of bacteremic ventilator-associated pneumonia caused by carbapenem-resistant Acinetobacter baumannii in COVID-19 patients. Int J Antimicrob Agents 2023; 62:106825. [PMID: 37088438 PMCID: PMC10121149 DOI: 10.1016/j.ijantimicag.2023.106825] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 01/03/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) in patients hospitalized in intensive care units (ICU) is an important and challenging complication, including in COVID-19 patients. Considering the poor lung penetration of most antibiotics, including intravenous colistin due to the poor PK/PD at the infection site, the choice of the best antibiotic regimen is still being debated. METHODS this was a single-center, observational study conducted from March 2020 to August 2022, including all patients hospitalized consecutively with VAP and concomitant bloodstream infection due to CRAB in the COVID-ICU. The main goal of the study was to evaluate risk factors associated with survival or death at 30 days from VAP onset. A propensity score for receiving therapy was added to the model. RESULTS during the study period, 73 patients who developed VAP and concomitant positive blood cultures caused by CRAB were enrolled in the COVID-ICU. Of these patients, 67 (91.7%) developed septic shock, 42 (57.5%) died at 14 days and 59 (80.8%) died at 30 days. Overall, 54 (74%) patients were treated with a colistin-containing regimen and 19 (26%) with a cefiderocol-containing regimen. COX regression analysis showed that COPD, and age were independently associated with 30-day mortality. Conversely, cefiderocol-containing regimens and the combination of a cefiderocol plus fosfomycin-containing regimen were independently associated with 30-day survival, as confirmed by propensity score analysis. CONCLUSIONS this real-life study in patients with bacteremic VAP caused by CRAB provides useful suggestions for clinicians, showing a possible benefit of cefiderocol and its association with fosfomycin.
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Affiliation(s)
- Alessandro Russo
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy.
| | - Andrea Bruni
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Sara Gullì
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Cristian Borrazzo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Rosaria Lionello
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Francesca Serapide
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Eugenio Garofalo
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Riccardo Serraino
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Francesco Romeo
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Nadia Marascio
- Clinical Microbiology Unit, Department of Health Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Federico Longhini
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Italy
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14
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Divenuto F, Pavia G, Marascio N, Barreca GS, Quirino A, Matera G. Role of Treg, Breg and other cytokine sets in host protection and immunopathology during human leishmaniasis: Are they potential valuable markers in clinical settings and vaccine evaluation? Acta Trop 2023; 240:106849. [PMID: 36731621 DOI: 10.1016/j.actatropica.2023.106849] [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: 01/01/2023] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 02/02/2023]
Abstract
Leishmaniasis is a vector-borne disease caused by obligate intracellular protozoan parasites that can infect humans and other mammals. Pro- and anti-inflammatory cytokines are important regulators of innate and specific responses in Leishmania infection. Resistance to leishmaniasis is related to T helper 1 (Th1) response with the production of pro-inflammatory cytokines: IL-12, IL-1β, IFN-γ, TNF-α, IL-2 leading to activation of macrophages and parasite killing. Instead, a more intense Th2 (IL-4, IL-5, IL-13), Treg (IL-10 and TGF-β) and Breg response (IL-10 and IL-35) are related to parasite persistence through the inhibition of macrophage activation, which promotes the escape from host immune system. Interestingly, a cytokine involved in the parasite killing in one form of leishmaniasis may be "pathogen friendly" in another form of the disease. To date, few studies are focusing on the role of Treg and Breg cytokines in human models of leishmaniasis; therefore, further investigations are needed to clarify their potential role in the diagnosis and prognosis of such protozoan infections, as well as in the development of vaccines against leishmaniasis. This review summarizes the current knowledge about the role of cytokines produced by Th1, Th2, Treg, and Breg cells involved in Leishmania disease progression and host protection. Some cytokines might play a role as diagnostic and prognostic clinical markers, or they could represent a novel approach leading to new anti-leishmaniasis therapies. Overall, advances in knowledge of the complex network of cytokines secreted by immune cells could help to better understand signaling pathways and host immune responses during Leishmania infection. This approach would allow these mediators to be used as therapeutic strategies against leishmaniasis.
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Affiliation(s)
- Francesca Divenuto
- Clinical Microbiology Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Grazia Pavia
- Clinical Microbiology Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Nadia Marascio
- Clinical Microbiology Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
| | | | - Angela Quirino
- Clinical Microbiology Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy.
| | - Giovanni Matera
- Clinical Microbiology Unit, "Magna Graecia" University of Catanzaro, 88100 Catanzaro, Italy
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15
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Marascio N, Cilburunoglu M, Torun EG, Centofanti F, Mataj E, Equestre M, Bruni R, Quirino A, Matera G, Ciccaglione AR, Yalcinkaya KT. Molecular Characterization and Cluster Analysis of SARS-CoV-2 Viral Isolates in Kahramanmaraş City, Turkey: The Delta VOC Wave within One Month. Viruses 2023; 15:v15030802. [PMID: 36992510 PMCID: PMC10054778 DOI: 10.3390/v15030802] [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: 02/14/2023] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
The SARS-CoV-2 pandemic has seriously affected the population in Turkey. Since the beginning, phylogenetic analysis has been necessary to monitor public health measures against COVID-19 disease. In any case, the analysis of spike (S) and nucleocapsid (N) gene mutations was crucial in determining their potential impact on viral spread. We screened S and N regions to detect usual and unusual substitutions, whilst also investigating the clusters among a patient cohort resident in Kahramanmaraş city, in a restricted time span. Sequences were obtained by Sanger methods and genotyped by the PANGO Lineage tool. Amino acid substitutions were annotated comparing newly generated sequences to the NC_045512.2 reference sequence. Clusters were defined using phylogenetic analysis with a 70% cut-off. All sequences were classified as Delta. Eight isolates carried unusual mutations on the S protein, some of them located in the S2 key domain. One isolate displayed the unusual L139S on the N protein, while few isolates carried the T24I and A359S N substitutions able to destabilize the protein. Phylogeny identified nine monophyletic clusters. This study provided additional information about SARS-CoV-2 epidemiology in Turkey, suggesting local transmission of infection in the city by several transmission routes, and highlighting the necessity to improve the power of sequencing worldwide.
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Affiliation(s)
- Nadia Marascio
- Department of Health Sciences, Institute of Microbiology, "Magna Grecia" University, 88100 Catanzaro, Italy
| | - Merve Cilburunoglu
- Microbiology Department, Faculty of Medicine, Kahramanmaras Sutcü Imam University, 46050 Kahramanmaras, Turkey
| | - Elif Gulsum Torun
- Microbiology Department, Faculty of Medicine, Kahramanmaras Sutcü Imam University, 46050 Kahramanmaras, Turkey
| | - Federica Centofanti
- Department of Applied Clinical Sciences and Biotechnology, University of Aquila, 67100 L'Aquila, Italy
| | - Elida Mataj
- Instituti i Shendetit Publik (ISHP), 1000 Tirana, Albania
| | - Michele Equestre
- Department of Neurosciences, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Roberto Bruni
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Angela Quirino
- Department of Health Sciences, Institute of Microbiology, "Magna Grecia" University, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, Institute of Microbiology, "Magna Grecia" University, 88100 Catanzaro, Italy
| | | | - Kezban Tulay Yalcinkaya
- Microbiology Department, Faculty of Medicine, Kahramanmaras Sutcü Imam University, 46050 Kahramanmaras, Turkey
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16
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Pavia G, Spagnuolo R, Quirino A, Marascio N, Giancotti A, Simeone S, Cosco C, Tino E, Carrabetta F, Di Gennaro G, Nobile C, Bianco A, Matera G, Doldo P. COVID-19 Vaccine Booster Shot Preserves T Cells Immune Response Based on Interferon-Gamma Release Assay in Inflammatory Bowel Disease (IBD) Patients on Anti-TNFα Treatment. Vaccines (Basel) 2023; 11:vaccines11030591. [PMID: 36992175 DOI: 10.3390/vaccines11030591] [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] [Received: 12/30/2022] [Revised: 02/20/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
Immune-modifying treatment in inflammatory bowel disease (IBD) impairs the humoral response. The role of T lymphocytes in this setting is still unclear. This study aims to assess if a booster shot (third dose) of BNT162b2 mRNA COVID-19 vaccine enhanced the humoral response and elicited cellular immunity in IBD patients on different immuno-therapy regimens compared to healthy controls (HCs). Five months after a booster dose, serological and T-cell responses were assessed. The measurements were described using geometric means with 95% confidence intervals. The differences between study groups were assessed by Mann–Whitney tests. Seventy-seven subjects (n = 53 IBD patients and n = 24 HCs), who were fully vaccinated and not previously SARS-CoV-2 infected, were recruited. Regarding the IBD patients, 19 were affected by Crohn’s disease and 34 by ulcerative colitis. During the vaccination cycle, half of the patients (53%) were on stable treatment with aminosalicylates, and 32% were on biological therapy. No differences in antibody concentrations between IBD patients and HCs, nor T-cell responses, were found. Stratifying IBD patients based on the type of treatment (anti-TNFα agents vs. other treatment regimens), a decrease only in antibody titer (p = 0.008), but not in cellular response, was observed. Even after the COVID-19 vaccine booster dose, the TNFα inhibitors selectively decreased the humoral immune response compared to patients on other treatment regimens. The T-cell response was preserved in all study groups. These findings highlight the importance of evaluating T-cell immune responses following COVID-19 vaccination in a routine diagnostic setting, particularly for immunocompromised cohorts.
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Affiliation(s)
- Grazia Pavia
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Rocco Spagnuolo
- Unit of Gastroenterology, Department of Clinical and Experimental Medicine, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Aida Giancotti
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Silvio Simeone
- Unit of Gastroenterology, Department of Clinical and Experimental Medicine, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Cristina Cosco
- Unit of Gastroenterology, Department of Clinical and Experimental Medicine, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Elena Tino
- Unit of Gastroenterology, Department of Clinical and Experimental Medicine, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Federico Carrabetta
- Unit of Gastroenterology, Department of Clinical and Experimental Medicine, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Gianfranco Di Gennaro
- Department of Health Sciences, School of Medicine, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Carmelo Nobile
- Department of Health Sciences, School of Medicine, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Aida Bianco
- Department of Health Sciences, School of Medicine, "Magna Græcia" University of Catanzaro, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
| | - Patrizia Doldo
- Unit of Gastroenterology, Department of Clinical and Experimental Medicine, "Magna Græcia" University of Catanzaro-"Mater Domini" Teaching Hospital, 88100 Catanzaro, Italy
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17
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Veneziano C, Marascio N, De Marco C, Quaresima B, Biamonte F, Trecarichi EM, Santamaria G, Quirino A, Torella D, Quattrone A, Matera G, Torti C, De Filippo C, Costanzo FS, Viglietto G. The Spread of SARS-CoV-2 Omicron Variant in CALABRIA: A Spatio-Temporal Report of Viral Genome Evolution. Viruses 2023; 15:v15020408. [PMID: 36851622 PMCID: PMC9963258 DOI: 10.3390/v15020408] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
We investigated the evolution of SARS-CoV-2 spread in Calabria, Southern Italy, in 2022. A total of 272 RNA isolates from nasopharyngeal swabs of individuals infected with SARS-CoV-2 were sequenced by whole genome sequencing (N = 172) and/or Sanger sequencing (N = 100). Analysis of diffusion of Omicron variants in Calabria revealed the prevalence of 10 different sub-lineages (recombinant BA.1/BA.2, BA.1, BA.1.1, BA.2, BA.2.9, BA.2.10, BA.2.12.1, BA.4, BA.5, BE.1). We observed that Omicron spread in Calabria presented a similar trend as in Italy, with some notable exceptions: BA.1 disappeared in April in Calabria but not in the rest of Italy; recombinant BA.1/BA.2 showed higher frequency in Calabria (13%) than in the rest of Italy (0.02%); BA.2.9, BA.4 and BA.5 emerged in Calabria later than in other Italian regions. In addition, Calabria Omicron presented 16 non-canonical mutations in the S protein and 151 non-canonical mutations in non-structural proteins. Most non-canonical mutations in the S protein occurred mainly in BA.5 whereas non-canonical mutations in non-structural or accessory proteins (ORF1ab, ORF3a, ORF8 and N) were identified in BA.2 and BA.5 sub-lineages. In conclusion, the data reported here underscore the importance of monitoring the entire SARS-CoV-2 genome.
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Affiliation(s)
- Claudia Veneziano
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Nadia Marascio
- Department of Health Sciences, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Carmela De Marco
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Barbara Quaresima
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Flavia Biamonte
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- “Mater Domini” University Hospital of Catanzaro, 88100 Catanzaro, Italy
| | - Gianluca Santamaria
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- “Mater Domini” University Hospital of Catanzaro, 88100 Catanzaro, Italy
| | - Daniele Torella
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- “Mater Domini” University Hospital of Catanzaro, 88100 Catanzaro, Italy
| | - Aldo Quattrone
- Neuroscience Research Center, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- “Mater Domini” University Hospital of Catanzaro, 88100 Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- “Mater Domini” University Hospital of Catanzaro, 88100 Catanzaro, Italy
| | | | - Francesco Saverio Costanzo
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
- “Mater Domini” University Hospital of Catanzaro, 88100 Catanzaro, Italy
| | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy
- “Mater Domini” University Hospital of Catanzaro, 88100 Catanzaro, Italy
- Correspondence:
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18
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Bongiorno D, Bivona DA, Cicino C, Trecarichi EM, Russo A, Marascio N, Mezzatesta ML, Musso N, Privitera GF, Quirino A, Scarlata GGM, Matera G, Torti C, Stefani S. Omic insights into various ceftazidime-avibactam-resistant Klebsiella pneumoniae isolates from two southern Italian regions. Front Cell Infect Microbiol 2023; 12:1010979. [PMID: 36683697 PMCID: PMC9851273 DOI: 10.3389/fcimb.2022.1010979] [Citation(s) in RCA: 5] [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: 08/03/2022] [Accepted: 09/12/2022] [Indexed: 01/06/2023] Open
Abstract
Ceftazidime-avibactam (CZA) is one of the best therapeutic options available for infections caused by Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria. However, sporadic reports of CZA-resistant strains have been rapidly increasing in patients. Herein, we provide detailed case reports of the emergence of ceftazidime-avibactam resistance to identify their resistome and virulome using genomic molecular approaches. Sixteen isolates were collected from 13 patients at three hospitals in Catania and Catanzaro (Italy) between 2020-2021. Antimicrobial susceptibility was determined by broth microdiluition. The samples included in study were analyzed for resistome, virulome and Sequence Type (ST) using Whole Genome Sequencing (WGS). All strains were resistant to ceftazidime/avibactam, ciprofloxacin, extended-spectrum cephalosporins and aztreonam, 13/16 to meropenem, 8/16 to colistin and 7/16 to fosfomycin; 15/16 were susceptible to meropenem/vaborbactam; all strains were susceptible to cefiderocol. Molecular analysis showed circulation of three major clones: ST101, ST307 and ST512. In 10/16 strains, we found a bla KPC-3 gene; in 6/16 strains, four different bla KPC variants (bla KPC28-31-34-50) were detected. A plethora of other beta-lactam genes (bla SHV28-45-55-100-106-187-205-212, bla OXA1-9-48, bla TEM-181 and bla CTX-M-15) was observed; bla OXA-9 was found in ST307 and ST512, instead bla OXA48 in one out four ST101 strains. With regard to membrane permeability, ompK35 and ompK36 harbored frameshift mutations in 15/16 strains; analysis of ompK37 gene revealed that all strains harbored a non-functional protein and carry wild-type PBP3. There is an urgent need to characterize the mechanisms underlying carbapenem resistance and the intrinsic bacterial factors that facilitate the rapid emergence of resistance. Furthermore, it is becoming increasingly important to explore feasible methods for accurate detection of different KPC enzymes.
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Affiliation(s)
- Dafne Bongiorno
- Microbiology Section, Dept of Biomedical and Biotechnological Science, University of Catania, Catania, Italy,*Correspondence: Dafne Bongiorno,
| | - Dalida A. Bivona
- Microbiology Section, Dept of Biomedical and Biotechnological Science, University of Catania, Catania, Italy
| | - Claudia Cicino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Enrico M. Trecarichi
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Alessandro Russo
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Maria Lina Mezzatesta
- Microbiology Section, Dept of Biomedical and Biotechnological Science, University of Catania, Catania, Italy
| | - Nicolò Musso
- Microbiology Section, Dept of Biomedical and Biotechnological Science, University of Catania, Catania, Italy,Unità Operativa Complessa (UOC) Laboratory Analysis, University Hospital Policlinico-San Marco, Catania, Italy
| | - Grete F. Privitera
- Microbiology Section, Dept of Biomedical and Biotechnological Science, University of Catania, Catania, Italy
| | - Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Giuseppe G. M. Scarlata
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Carlo Torti
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Stefania Stefani
- Microbiology Section, Dept of Biomedical and Biotechnological Science, University of Catania, Catania, Italy,Unità Operativa Complessa (UOC) Laboratory Analysis, University Hospital Policlinico-San Marco, Catania, Italy
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19
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Quirino A, Marascio N, Scarlata GGM, Cicino C, Pavia G, Pantanella M, Carlisi G, Mercurio M, Familiari F, Rotundo S, Olivadese V, La Gamba V, Serapide F, Gasparini G, Matera G. Orthopedic Device-Related Infections Due to Emerging Pathogens Diagnosed by a Combination of Microbiological Approaches: Case Series and Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12123224. [PMID: 36553231 PMCID: PMC9778170 DOI: 10.3390/diagnostics12123224] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Orthopedic and trauma device-related infections (ODRI) due to high virulence microorganisms are a devastating complication after orthopedic surgery. Coagulase-negative Staphylococci (CoNS) are mainly involved but commensal bacteria, located in human mucous membranes, are emerging pathogens in ODRI. Currently, bacterial culture is the gold standard for ODRI but the diagnostic process remains time consuming and laborious. We evaluated a combination of microbiological approaches in the diagnosis of emerging pathogens involved in ODRI. We analyzed two synovial fluids, five tissue samples and five surgical wound swabs from two different patients with ODRI, attending the Department of Orthopedic and Trauma Surgery of Mater Domini Teaching Hospital, Catanzaro, Italy. Identification was carried out with a combination of microbiological approaches (culture, mass spectrometry and 16s rRNA gene sequencing). We demonstrated the importance of a combination of microbiological approaches for the diagnosis of emerging pathogens in ODRI, because the low number of cases in the literature makes it very difficult to formulate guidelines for the management of patients.
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Affiliation(s)
- Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
- Correspondence:
| | | | - Claudia Cicino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Grazia Pavia
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Marta Pantanella
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Giovanni Carlisi
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Michele Mercurio
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Filippo Familiari
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Salvatore Rotundo
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Vincenzo Olivadese
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Valentina La Gamba
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Francesca Serapide
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Giorgio Gasparini
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
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20
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Scaglione V, Rotundo S, Marascio N, De Marco C, Lionello R, Veneziano C, Berardelli L, Quirino A, Olivadese V, Serapide F, Tassone B, Morrone HL, Davoli C, La Gamba V, Bruni A, Cesana BM, Matera G, Russo A, Costanzo FS, Viglietto G, Trecarichi EM, Torti C, Russo A, Serapide F, Tassone B, Fusco P, Scaglione V, Davoli C, Lionello R, Gamba VL, Rotundo S, Morrone H, Berardelli L, Tassone MT, Olivadese V, Serraino R, Costa C, Alcaro S, Filippo CD, Sarro GD, Pujia A, Quattrone A, Costanzo FS, Cuda G, Foti DP, Viglietto G, Matera G, Longhini F, Bruni A, Garofalo E, Biamonte E, Brescia V, Laganà D, Petullà M, Bertucci B, Quirino A, Barreca GS, Giancotti A, Gallo L, Lamberti A, Marascio N, Francesco AED, Mirarchi S, Torti C. Publisher Correction: Lessons learned and implications of early therapies for coronavirus disease in a territorial service centre in the Calabria region: a retrospective study. BMC Infect Dis 2022; 22:883. [PMID: 36434528 PMCID: PMC9700875 DOI: 10.1186/s12879-022-07871-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Vincenzo Scaglione
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Salvatore Rotundo
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Nadia Marascio
- grid.411489.10000 0001 2168 2547Chair of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Carmela De Marco
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, “Magna Græcia” University, Catanzaro, Italy
| | - Rosaria Lionello
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Claudia Veneziano
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, “Magna Græcia” University, Catanzaro, Italy
| | - Lavinia Berardelli
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Angela Quirino
- grid.411489.10000 0001 2168 2547Chair of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Vincenzo Olivadese
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Francesca Serapide
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Bruno Tassone
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Helen Linda Morrone
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Chiara Davoli
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Valentina La Gamba
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Andrea Bruni
- grid.411489.10000 0001 2168 2547Chair of Intensive Care, Department of Medical and Surgical Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Bruno Mario Cesana
- grid.4708.b0000 0004 1757 2822Unit of Medical Statistics, Biometrics and Bioinformatics “Giulio A. Maccacaro”, Department of Clinical Sciences and Community Health, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Giovanni Matera
- grid.411489.10000 0001 2168 2547Chair of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Alessandro Russo
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Francesco Saverio Costanzo
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, “Magna Græcia” University, Catanzaro, Italy
| | - Giuseppe Viglietto
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, “Magna Græcia” University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Carlo Torti
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
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21
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Marascio N, Loria MT, Lamberti AG, Pavia G, Adams NJ, Quirino A, Divenuto F, Mazzitelli M, Greco G, Trecarichi EM, Perandin F, Bisoffi Z, Webster BL, Liberto MC, Torti C, Matera G. Molecular characterization of Schistosoma infections in African migrants: identification of a Schistosoma haematobium-bovis hybrid in bladder biopsies. J Travel Med 2022; 29:6485185. [PMID: 34962994 DOI: 10.1093/jtm/taab194] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/09/2021] [Indexed: 11/13/2022]
Abstract
Atypical Schistosoma haematobium eggs were found in a bladder biopsy from an African migrant with severe Schistosomiasis.
Amplification of mitochondrial (cox 1) and genomic (ITS2) DNA identified the presence of a S. haematobium-Schistosoma bovis hybrid.
Phylogenetic analysis clustered the hybrid sequence with other sequences from western Africa.
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Affiliation(s)
- Nadia Marascio
- Department of Health Sciences, Unit of Microbiology, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Maria Teresa Loria
- Department of Health Sciences, Unit of Microbiology, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Angelo Giuseppe Lamberti
- Department of Health Sciences, Unit of Microbiology, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Grazia Pavia
- Department of Health Sciences, Unit of Microbiology, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Neill James Adams
- Department of Health Sciences, Unit of Microbiology, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Angela Quirino
- Department of Health Sciences, Unit of Microbiology, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Francesca Divenuto
- Department of Health Sciences, Unit of Microbiology, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Maria Mazzitelli
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Giuseppe Greco
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Francesca Perandin
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, via Don A. Sempreboni 5, Negrar di Valpolicella, Verona 37024, Italy
| | - Zeno Bisoffi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, via Don A. Sempreboni 5, Negrar di Valpolicella, Verona 37024, Italy.,Department of Diagnostics and Public Health, University of Verona, Via S. Francesco 22, Verona 37129, Italy
| | - Bonnie L Webster
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, Cromwell Road, London SW7 5BD, UK
| | - Maria Carla Liberto
- Department of Health Sciences, Unit of Microbiology, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - Giovanni Matera
- Department of Health Sciences, Unit of Microbiology, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
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22
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Scaglione V, Rotundo S, Marascio N, De Marco C, Lionello R, Veneziano C, Berardelli L, Quirino A, Olivadese V, Serapide F, Tassone B, Morrone HL, Davoli C, La Gamba V, Bruni A, Cesana BM, Matera G, Russo A, Costanzo FS, Viglietto G, Trecarichi EM, Torti C. Lessons learned and implications of early therapies for coronavirus disease in a territorial service centre in the Calabria region: a retrospective study. BMC Infect Dis 2022; 22:793. [PMID: 36266619 PMCID: PMC9583059 DOI: 10.1186/s12879-022-07774-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 07/20/2022] [Accepted: 10/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Monoclonal antibodies (mAbs) and antivirals have been approved for early therapy of coronavirus disease (COVID-19), however, in the real-life setting, there are difficulties to prescribe these therapies within few days from symptom onset as recommended, and effectiveness of combined use of these drugs have been hypothesised in most-at-risk patients (such as those immunocompromised) but data supporting this strategy are limited. Methods We describe the real-life experience of SARS-CoV-2 antivirals and/or monoclonal antibodies (mAbs) and focus on the hospitalisation rate due to the progression of COVID-19. Clinical results obtained through our risk-stratification algorithm and benefits achieved through a strategic proximity territorial centre are provided. We also report a case series with an in-depth evaluation of SARS-CoV-2 genome in relationship with treatment strategy and clinical evolution of patients. Results Two hundred eighty-eight patients were analysed; 94/288 (32.6%) patients were treated with mAb monotherapy, 171/288 (59.4%) patients were treated with antivirals, and 23/288 (8%) patients received both mAbs and one antiviral drug. Haematological malignancies were more frequent in patients treated with combination therapy than in the other groups (p = 0.0003). There was a substantial increase in the number of treated patients since the opening of the centre dedicated to early therapies for COVID-19. The provided disease-management and treatment appeared to be effective since 98.6% patients recovered without hospital admission. Moreover, combination therapy with mAbs and antivirals seemed successful because all patients admitted to the hospital for COVID-19 did not receive such therapies, while none of the most-at-risk patients treated with combination therapy were hospitalized or reported adverse events. Conclusions A low rate of COVID-19 progression requiring hospital admission was observed in patients included in this study. The dedicated COVID-19 proximity territorial service appeared to strengthen the regional sanitary system, avoiding the overwhelming of other services. Importantly, our results also support early combination therapy: it is possible that this strategy reduces the emergence of escape mutants of SARS-CoV-2, thereby increasing efficacy of early treatment, especially in immunocompromised individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07774-9.
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Affiliation(s)
- Vincenzo Scaglione
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Salvatore Rotundo
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Nadia Marascio
- Chair of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Carmela De Marco
- Department of Experimental and Clinical Medicine, "Magna Græcia" University, Catanzaro, Italy
| | - Rosaria Lionello
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Claudia Veneziano
- Department of Experimental and Clinical Medicine, "Magna Græcia" University, Catanzaro, Italy
| | - Lavinia Berardelli
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Angela Quirino
- Chair of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Vincenzo Olivadese
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Francesca Serapide
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Bruno Tassone
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Helen Linda Morrone
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Chiara Davoli
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Valentina La Gamba
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Andrea Bruni
- Chair of Intensive Care, Department of Medical and Surgical Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Bruno Mario Cesana
- Unit of Medical Statistics, Biometrics and Bioinformatics "Giulio A. Maccacaro", Department of Clinical Sciences and Community Health, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Giovanni Matera
- Chair of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Alessandro Russo
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Francesco Saverio Costanzo
- Department of Experimental and Clinical Medicine, Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, "Magna Græcia" University, Catanzaro, Italy
| | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, "Magna Græcia" University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Carlo Torti
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy.
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23
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Marascio N, Quirino A, Scarlata GGM, Barreca GS, Giancotti A, Lamberti AG, Gallo L, Foti F, Laurendi DL, Dattola D, Marsico A, La Rocca A, Matera G. Are SARS-CoV-2 rapid antigen tests useful for the control of latest variants spreading? Infez Med 2022; 30:427-431. [PMID: 36148165 PMCID: PMC9448309 DOI: 10.53854/liim-3003-11] [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] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/05/2022] [Indexed: 06/16/2023]
Abstract
Reverse Transcription Polymerase Chain Reaction (RT-PCR) conducted on nasopharyngeal swabs is the gold standard in the diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In Italy, recent guidelines indicate that rapid antigen tests (RATs) can be used for the isolation of positive patients or for the interruption of quarantine, but they are often less sensitive to detect positive subjects. Indeed, the performance of these RATs depends on the timing and the population on which they are evaluated. Herein, we evaluated the performance of BIOCREDIT COVID-19 Ag and Fluorecare® SARS-CoV-2 Spike Protein Test during a population screening in the Calabria Region, Southern Italy. We report that both antigen test shows low sensitivity in contrast to the high sensitivity declared by manufacturer (90% and 92%, respectively) and that the area under the curve (AUC) was good for Fluorecare® SARS-CoV- 2 Spike Protein Test but very poor for BIOCREDIT COVID-19 Ag. We suggest that these RATs should be re-evaluated in the current pandemic era.
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Affiliation(s)
- Nadia Marascio
- Department of Health Sciences, Unit of Microbiology, “Magna Graecia” University, Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, Unit of Microbiology, “Magna Graecia” University, Catanzaro, Italy
| | | | - Giorgio Settimo Barreca
- Department of Health Sciences, Unit of Microbiology, “Magna Graecia” University, Catanzaro, Italy
| | - Aida Giancotti
- Department of Health Sciences, Unit of Microbiology, “Magna Graecia” University, Catanzaro, Italy
| | - Angelo Giuseppe Lamberti
- Department of Health Sciences, Unit of Microbiology, “Magna Graecia” University, Catanzaro, Italy
| | - Luigia Gallo
- Department of Health Sciences, Unit of Microbiology, “Magna Graecia” University, Catanzaro, Italy
| | - Fabio Foti
- Department of Health Sciences, Unit of Microbiology, “Magna Graecia” University, Catanzaro, Italy
| | | | | | | | | | - Giovanni Matera
- Department of Health Sciences, Unit of Microbiology, “Magna Graecia” University, Catanzaro, Italy
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24
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De Marco C, Veneziano C, Massacci A, Pallocca M, Marascio N, Quirino A, Barreca GS, Giancotti A, Gallo L, Lamberti AG, Quaresima B, Santamaria G, Biamonte F, Scicchitano S, Trecarichi EM, Russo A, Torella D, Quattrone A, Torti C, Matera G, De Filippo C, Costanzo FS, Viglietto G. Dynamics of Viral Infection and Evolution of SARS-CoV-2 Variants in the Calabria Area of Southern Italy. Front Microbiol 2022; 13:934993. [PMID: 35966675 PMCID: PMC9366435 DOI: 10.3389/fmicb.2022.934993] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
In this study, we report on the results of SARS-CoV-2 surveillance performed in an area of Southern Italy for 12 months (from March 2021 to February 2022). To this study, we have sequenced RNA from 609 isolates. We have identified circulating VOCs by Sanger sequencing of the S gene and defined their genotypes by whole-genome NGS sequencing of 157 representative isolates. Our results indicated that B.1 and Alpha were the only circulating lineages in Calabria in March 2021; while Alpha remained the most common variant between April 2021 and May 2021 (90 and 73%, respectively), we observed a concomitant decrease in B.1 cases and appearance of Gamma cases (6 and 21%, respectively); C.36.3 and Delta appeared in June 2021 (6 and 3%, respectively); Delta became dominant in July 2021 while Alpha continued to reduce (46 and 48%, respectively). In August 2021, Delta became the only circulating variant until the end of December 2021. As of January 2022, Omicron emerged and took over Delta (72 and 28%, respectively). No patient carrying Beta, Iota, Mu, or Eta variants was identified in this survey. Among the genomes identified in this study, some were distributed all over Europe (B1_S477N, Alpha_L5F, Delta_T95, Delta_G181V, and Delta_A222V), some were distributed in the majority of Italian regions (B1_S477N, B1_Q675H, Delta_T95I and Delta_A222V), and some were present mainly in Calabria (B1_S477N_T29I, B1_S477N_T29I_E484Q, Alpha_A67S, Alpha_A701S, and Alpha_T724I). Prediction analysis of the effects of mutations on the immune response (i.e., binding to class I MHC and/or recognition of T cells) indicated that T29I in B.1 variant; A701S in Alpha variant; and T19R in Delta variant were predicted to impair binding to class I MHC whereas the mutations A67S identified in Alpha; E484K identified in Gamma; and E156G and ΔF157/R158 identified in Delta were predicted to impair recognition by T cells. In conclusion, we report on the results of SARS-CoV-2 surveillance in Regione Calabria in the period between March 2021 and February 2022, identified variants that were enriched mainly in Calabria, and predicted the effects of identified mutations on host immune response.
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Affiliation(s)
- Carmela De Marco
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
- Interdepartmental Center of Services, Molecular Genomics and Pathology, “Magna Graecia” University, Catanzaro, Italy
- Carmela De Marco
| | - Claudia Veneziano
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
- Interdepartmental Center of Services, Molecular Genomics and Pathology, “Magna Graecia” University, Catanzaro, Italy
| | - Alice Massacci
- UOSD Biostatistics, Bioinformatics, and Clinical Trial Center, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Matteo Pallocca
- UOSD Biostatistics, Bioinformatics, and Clinical Trial Center, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Nadia Marascio
- Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy
- “Mater Domini” University Hospital, Catanzaro, Italy
| | | | | | - Luigia Gallo
- “Mater Domini” University Hospital, Catanzaro, Italy
| | | | - Barbara Quaresima
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
- Interdepartmental Center of Services, Molecular Genomics and Pathology, “Magna Graecia” University, Catanzaro, Italy
| | - Gianluca Santamaria
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
| | - Flavia Biamonte
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
- Interdepartmental Center of Services, Molecular Genomics and Pathology, “Magna Graecia” University, Catanzaro, Italy
| | - Stefania Scicchitano
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- “Mater Domini” University Hospital, Catanzaro, Italy
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Alessandro Russo
- “Mater Domini” University Hospital, Catanzaro, Italy
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Daniele Torella
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
- “Mater Domini” University Hospital, Catanzaro, Italy
| | - Aldo Quattrone
- Neuroscience Research Center, “Magna Graecia” University, Catanzaro, Italy
| | - Carlo Torti
- “Mater Domini” University Hospital, Catanzaro, Italy
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy
- “Mater Domini” University Hospital, Catanzaro, Italy
| | | | - Francesco Saverio Costanzo
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
- Interdepartmental Center of Services, Molecular Genomics and Pathology, “Magna Graecia” University, Catanzaro, Italy
- “Mater Domini” University Hospital, Catanzaro, Italy
| | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
- “Mater Domini” University Hospital, Catanzaro, Italy
- *Correspondence: Giuseppe Viglietto
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25
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Serapide F, Quirino A, Scaglione V, Morrone HL, Longhini F, Bruni A, Garofalo E, Matera G, Marascio N, Scarlata GGM, Cicino C, Russo A, Trecarichi EM, Torti C. Is the Pendulum of Antimicrobial Drug Resistance Swinging Back after COVID-19? Microorganisms 2022; 10:microorganisms10050957. [PMID: 35630400 PMCID: PMC9146770 DOI: 10.3390/microorganisms10050957] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 04/08/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic may have had an effect on antimicrobial resistance. We compared the prevalence of ESKAPE multidrug-resistant (MDR) bacterial infections in COVID-19 affected/unaffected patients admitted to intensive care units (ICU) or infectious disease units at the “Mater Domini” University Hospital of Catanzaro between 1 March 2020 and 31 July 2021. Moreover, an analysis of MDR rates in ICU comparing the pre-pandemic period with the pandemic period was performed, and the possible consequence on in-hospital mortality was explored. One hundred and eighty-four ESKAPE isolates were analyzed from 362 SARS-CoV-2 positive and 199 negative patients. In total, 116 out of 171 Gram-negative isolates were classified as MDR, and a higher frequency was observed in COVID-19 compared with non-COVID-19 patients (74.2% vs. 60.3%; p = 0.052). A higher rate of MDR ESKAPE bacteria was observed in COVID-19 patients admitted to the ICU compared with COVID-19 unaffected patients admitted to the same ward in 2019 (88% vs. 80.4%; p = 0.186). Acinetobacter baumannii was the main pathogen in COVID-19 patients (58.7%), where it was the most frequent cause of bloodstream infection with the highest mortality rate (68.7%). Increase in MDR appeared to be associated with COVID-19 but only in the ICU setting. Acinetobacter baumannii was associated with the risk of death, indicating the importance of implementing infection control measures urgently.
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Affiliation(s)
- Francesca Serapide
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (F.S.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88110 Catanzaro, Italy; (A.Q.); (G.M.); (N.M.); (G.G.M.S.); (C.C.)
| | - Vincenzo Scaglione
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (F.S.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Correspondence: ; Tel.: +39-0961-364-7833
| | - Helen Linda Morrone
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (F.S.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Federico Longhini
- Unit of Intensive Care, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (F.L.); (A.B.); (E.G.)
| | - Andrea Bruni
- Unit of Intensive Care, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (F.L.); (A.B.); (E.G.)
| | - Eugenio Garofalo
- Unit of Intensive Care, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (F.L.); (A.B.); (E.G.)
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88110 Catanzaro, Italy; (A.Q.); (G.M.); (N.M.); (G.G.M.S.); (C.C.)
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88110 Catanzaro, Italy; (A.Q.); (G.M.); (N.M.); (G.G.M.S.); (C.C.)
| | - Giuseppe Guido Maria Scarlata
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88110 Catanzaro, Italy; (A.Q.); (G.M.); (N.M.); (G.G.M.S.); (C.C.)
| | - Claudia Cicino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88110 Catanzaro, Italy; (A.Q.); (G.M.); (N.M.); (G.G.M.S.); (C.C.)
| | - Alessandro Russo
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (F.S.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Enrico Maria Trecarichi
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (F.S.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Carlo Torti
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy; (F.S.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
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26
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Quirino A, Marascio N, Peronace C, Barreca GS, Gallo L, Giancotti A, Lamberti AG, Trecarichi EM, Torti C, Mazzitelli M, Bonofiglio M, Divenuto F, Matera G, Liberto MC. Role of IgG and IgM and proinflammatory aspecific markers in the diagnosis and prognosis of COVID-19 patients stratified by number of positive SARS-CoV-2 genes. Minerva Med 2022:S0026-4806.22.08030-2. [PMID: 35384437 DOI: 10.23736/s0026-4806.22.08030-2] [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: 11/08/2022]
Abstract
BACKGROUND A prompt set of suitable biomarkers is needed in suspected COVID-19 patients. This study aims to assess patients positive for one or more gene associated with the C reactive protein (CRP) and procalcitonin (PCT) as non-specific pro-inflammatory markers and IgG and IgM kinetic as specific diagnostic and prognostic tools in SARS-CoV-2 RT-PCR positive patients. METHODS We enrolled 101 patients within a two month time span (March 26, 2020 to May 31, 2020). A reverse transcription-Real-Time PCR assay on nasopharyngeal/oropharyngeal swabs was used for SARS-CoV-2 identification. Serum anti-SARS-COV-2 IgM and IgG were measured by enzyme immunoassay , PCT levels by Enzyme linked fluorescent assay (ELFA)and CRP by nephelometry. RESULTS We found that older patients were significantly associated with a worse prognosis. Serum IgM levels were significantly lower during the late stage of the disease, regardless of the presence of one or three genes and patients' outcome. On the contrary, IgG levels exhibited a higher concentration in the late phases of the illness, regardless of the gene found or patients' prognosis. With the exception of the very first sample tested, an increase in CRP in surviving patients (both one and three genes) and a time-dependent decrease of deceased patients CRP was found. PCT levels were always within the normal reference range. The difference between one gene and three genes patients was significant during late disease stages regarding IgG levels and also between three genes survivors vs. three genesdeceased , where the IgG levels were progressively increasing over time. CONCLUSIONS The relevant finding of the present study is the significant and consistent increase of IgG and IgM in deceased patients. The associated evaluation of antibody kinetics and non specific inflammatory markers (CRP and PCT) in positive patients stratified according to the presence of one gene or three genes could help the clinician in both the diagnosis and prognosis of COVID-19 patients.
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Affiliation(s)
- Angela Quirino
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
| | - Nadia Marascio
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
| | - Cinzia Peronace
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
| | - Giorgio S Barreca
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
| | - Luigia Gallo
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
| | - Aida Giancotti
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
| | - Angelo G Lamberti
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
| | - Enrico M Trecarichi
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Maria Mazzitelli
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Martina Bonofiglio
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
| | - Francesca Divenuto
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy -
| | - Maria C Liberto
- Department of Health Sciences, Unit of Microbiology, Magna Graecia University, Catanzaro, Italy
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27
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De Marco C, Marascio N, Veneziano C, Biamonte F, Trecarichi EM, Santamaria G, Leviyang S, Liberto MC, Mazzitelli M, Quirino A, Longhini F, Torella D, Quattrone A, Matera G, Torti C, Costanzo FS, Viglietto G. Whole-genome analysis of SARS-CoV-2 in a 2020 infection cluster in a nursing home of Southern Italy. Infection, Genetics and Evolution 2022; 99:105253. [PMID: 35189404 PMCID: PMC8855624 DOI: 10.1016/j.meegid.2022.105253] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/16/2022] [Indexed: 12/23/2022]
Abstract
Background Nursing homes have represented important hotspots of viral spread during the initial wave of COVID-19 pandemics. The proximity of patients inside nursing homes allows investigate the dynamics of viral transmission, which may help understand SARS-Cov2 biology and spread. Methods SARS-CoV-2 viral genomes obtained from 46 patients infected in an outbreak inside a nursing home in Calabria region (South Italy) were analyzed by Next Generation Sequencing. We also investigated the evolution of viral genomes in 8 patients for which multiple swabs were available. Phylogenetic analysis and haplotype reconstruction were carried out with IQ-TREE software and RegressHaplo tool, respectively. Results All viral strains isolated from patients infected in the nursing home were classified as B.1 lineage, clade G. Overall, 14 major single nucleotide variations (SNVs) (frequency > 80%) and 12 minor SNVs (frequency comprised between 20% and 80%) were identified with reference to the Wuhan-H-1 sequence (NC_045512.2). All patients presented the same 6 major SNVs: D614G in the S gene; P4715L, ntC3037T (F924F) and S5398P in Orf1ab gene; ntC26681T (F53F) in the M gene; and ntC241T in the non-coding UTR region. However, haplotype reconstruction identified a founder haplotype (Hap A) in 36 patients carrying only the 6 common SNVs indicated above, and 10 other haplotypes (Hap B—K) derived from Hap A in the remaining 10 patients. Notably, no significant association between a specific viral haplotype and clinical parameters was found. Conclusion The predominant viral strain responsible for the infection in a nursing home in Calabria was the B.1 lineage (clade G). Viral genomes were classified into 11 haplotypes (Hap A in 36 patients, Hap B—K in the remaining patients).
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Affiliation(s)
- Carmela De Marco
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Italy; Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, "Magna Græcia" University of Catanzaro, Italy
| | - Nadia Marascio
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Italy
| | - Claudia Veneziano
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Italy; Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, "Magna Græcia" University of Catanzaro, Italy
| | - Flavia Biamonte
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Italy; Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, "Magna Græcia" University of Catanzaro, Italy
| | | | - Gianluca Santamaria
- Department of Medicine I Molecular Cardiology, Technical University of Munich, Munich, Germany
| | - Sivan Leviyang
- Department of Mathematics, Georgetown University, Washington, DC, USA
| | - Maria Carla Liberto
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Italy
| | | | - Angela Quirino
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Italy
| | - Federico Longhini
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Italy
| | - Daniele Torella
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Italy
| | - Aldo Quattrone
- Neuroscience Research Center, "Magna Graecia" University of Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Italy
| | - Francesco Saverio Costanzo
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Italy; Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, "Magna Græcia" University of Catanzaro, Italy
| | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Italy; "Mater Domini" University Hospital of Catanzaro, Italy.
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28
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Marascio N, Rotundo S, Quirino A, Matera G, Liberto MC, Costa C, Russo A, Trecarichi EM, Torti C. Similarities, differences, and possible interactions between hepatitis E and hepatitis C viruses: Relevance for research and clinical practice. World J Gastroenterol 2022; 28:1226-1238. [PMID: 35431515 PMCID: PMC8968488 DOI: 10.3748/wjg.v28.i12.1226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/06/2022] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
Hepatitis E virus (HEV) and hepatitis C virus (HCV) are both RNA viruses with a tropism for liver parenchyma but are also capable of extrahepatic manifestations. Hepatitis E is usually a viral acute fecal-oral transmitted and self-limiting disease presenting with malaise, jaundice, nausea and vomiting. Rarely, HEV causes a chronic infection in immunocompromised persons and severe fulminant hepatitis in pregnant women. Parenteral HCV infection is typically asymptomatic for decades until chronic complications, such as cirrhosis and cancer, occur. Despite being two very different viruses in terms of phylogenetic and clinical presentations, HEV and HCV show many similarities regarding possible transmission through organ transplantation and blood transfusion, pathogenesis (production of antinuclear antibodies and cryoglobulins) and response to treatment with some direct-acting antiviral drugs. Although both HEV and HCV are well studied individually, there is a lack of knowledge about coinfection and its consequences. The aim of this review is to analyze current literature by evaluating original articles and case reports and to hypothesize some interactions that can be useful for research and clinical practice.
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Affiliation(s)
- Nadia Marascio
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro 88100, Italy
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
| | - Angela Quirino
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro 88100, Italy
| | - Giovanni Matera
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro 88100, Italy
| | - Maria Carla Liberto
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro 88100, Italy
| | - Chiara Costa
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
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Quirino A, Giorgi V, Palma E, Marascio N, Morelli P, Maletta A, Divenuto F, De Angelis G, Tancrè V, Nucera S, Gliozzi M, Musolino V, Carresi C, Mollace V, Liberto MC, Matera G. Citrus bergamia: Kinetics of Antimicrobial Activity on Clinical Isolates. Antibiotics (Basel) 2022; 11:antibiotics11030361. [PMID: 35326824 PMCID: PMC8944555 DOI: 10.3390/antibiotics11030361] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/24/2022] [Accepted: 03/04/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The inappropriate use of antibiotics has increased selective pressure and the spread of multi-drug-resistant (MDR) pathogens, which reduces the possibility of effective treatment. A potential alternative therapeutic approach may be represented by essential oils, such as the distilled extract of bergamot (Citrus bergamia Risso et Poiteau). Such natural products exercise numerous biological activities, including antimicrobial effects. Methods: This work aimed to evaluate the kinetics of the bactericidal and fungicidal activity of the distilled extract of bergamot on MDR bacteria and fungi from clinical specimens using the time-kill assay. Furthermore, the antimicrobial activity of the distilled extract of bergamot on the morphology and cellular organization of clinical pathogens was evaluated by confocal laser scanning microscopy. Results: Our results demonstrated that the distilled extract of bergamot exhibited significant antimicrobial activity and a specific bactericidal effect against the bacterial and fungal strains tested. Furthermore, confocal microscope images clearly showed compromised membrane integrity, damage and cell death in bacterial samples treated with the distilled extract of bergamot. In addition, progressive alterations in cell-wall composition, cytoplasmic material and nucleus structure triggered by exposure to the distilled extract of bergamot were identified in the fungal samples considered. Conclusions: Our data suggest that the use of essential oils, such as distilled extract of bergamot (Citrus bergamia Risso et Poiteau), can represent a valid alternative therapeutic strategy to counteract antibiotic resistance of pathogens.
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Affiliation(s)
- Angela Quirino
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
| | - Valeria Giorgi
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
| | - Ernesto Palma
- Institute of Research for Food Safety & Health (IRC-FSH), “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (E.P.); (S.N.); (M.G.); (V.M.); (V.M.)
| | - Nadia Marascio
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
| | - Paola Morelli
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
| | - Angelo Maletta
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
| | - Francesca Divenuto
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
| | - Giuseppe De Angelis
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
| | - Valentina Tancrè
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
| | - Saverio Nucera
- Institute of Research for Food Safety & Health (IRC-FSH), “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (E.P.); (S.N.); (M.G.); (V.M.); (V.M.)
| | - Micaela Gliozzi
- Institute of Research for Food Safety & Health (IRC-FSH), “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (E.P.); (S.N.); (M.G.); (V.M.); (V.M.)
| | - Vincenzo Musolino
- Institute of Research for Food Safety & Health (IRC-FSH), “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (E.P.); (S.N.); (M.G.); (V.M.); (V.M.)
| | - Cristina Carresi
- Institute of Research for Food Safety & Health (IRC-FSH), “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (E.P.); (S.N.); (M.G.); (V.M.); (V.M.)
- Correspondence:
| | - Vincenzo Mollace
- Institute of Research for Food Safety & Health (IRC-FSH), “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (E.P.); (S.N.); (M.G.); (V.M.); (V.M.)
| | - Maria Carla Liberto
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
| | - Giovanni Matera
- Department of Health Sciences, Institute of Clinical Microbiology, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (A.Q.); (V.G.); (N.M.); (P.M.); (A.M.); (F.D.); (G.D.A.); (V.T.); (M.C.L.); (G.M.)
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30
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Quirino A, Scaglione V, Marascio N, Mazzitelli M, Garofalo E, Divenuto F, Serapide F, Bruni A, Lionello R, Pavia G, Costa C, Giancotti A, Peronace C, Longhini F, Russo A, Liberto MC, Matera G, Torti C, Trecarichi EM. Role of the T2Dx magnetic resonance assay in patients with suspected bloodstream infection: a single-centre real-world experience. BMC Infect Dis 2022; 22:113. [PMID: 35105333 PMCID: PMC8805379 DOI: 10.1186/s12879-022-07096-w] [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: 10/27/2021] [Accepted: 01/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND T2Dx was approved by the US Food and Drug Administration for the rapid detection of a modified panel of ESKAPE bacterial species or Candida spp. causing bloodstream infection (BSI). PATIENTS AND METHODS We performed a retrospective, observational study from January 1, 2018 to December 31, 2019 of all hospitalised patients with suspected BSI who underwent assessment using T2Dx in addition to standard blood culture (BC). T2-positive patients (cases) were compared to a matched group of patients with BSI documented only by BC (1:2 ratio) to investigate the possible impact of T2Dx on the appropriateness of empirical antimicrobial therapy and 21-day mortality. RESULTS In total, 78 T2Dx-analysed samples (49 patients) were analysed. The T2Dx assay result was positive for18 patients and negative for 31 patients. The concordance rates of the T2Bacteria Panel and T2Candida Panel results with those of standard BC were 74.4% and 91.4%, respectively. In the matched analysis, inappropriate empiric antimicrobial therapy administration was significantly less frequent in cases than in comparators (5.5% vs. 38.8%). The 21-day mortality rate was twofold lower in cases than in comparators (22.2% vs. 44.4%), although the difference was not significant. No other analysed variables were significantly different between the two groups. CONCLUSIONS This study illustrated that T2Dx might be associated with an increase in the appropriateness of empiric antimicrobial therapy in patients with BSI. Further studies are needed to evaluate whether the T2Dx assay can improve patient outcomes.
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Affiliation(s)
- Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Vincenzo Scaglione
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Maria Mazzitelli
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Eugenio Garofalo
- Unit of Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | | | - Francesca Serapide
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Andrea Bruni
- Unit of Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Rosaria Lionello
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Grazia Pavia
- "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Chiara Costa
- "Mater Domini" Teaching Hospital, Catanzaro, Italy
| | | | - Cinzia Peronace
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Federico Longhini
- Unit of Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Alessandro Russo
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Maria Carla Liberto
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Carlo Torti
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy.
| | - Enrico Maria Trecarichi
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro-"Mater Domini" Teaching Hospital, Catanzaro, Italy
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Scaglione V, Reale M, Davoli C, Mazzitelli M, Serapide F, Lionello R, La Gamba V, Fusco P, Bruni A, Procopio D, Garofalo E, Longhini F, Marascio N, Peronace C, Giancotti A, Gallo L, Matera G, Liberto MC, Cesana BM, Costa C, Trecarichi EM, Quirino A, Torti C. Prevalence of Antibiotic Resistance Over Time in a Third-Level University Hospital. Microb Drug Resist 2021; 28:425-435. [PMID: 34910885 PMCID: PMC9058886 DOI: 10.1089/mdr.2021.0109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study evaluated the spread and possible changes in resistance patterns of ESKAPE bacteria to first-choice antibiotics from 2015 to 2019 at a third-level university hospital after persuasive stewardship measures were implemented. Isolates were divided into three groups (group 1, low drug-resistant; group 2, multidrug/extremely drug-resistant; and group 3, pan-resistant bacteria) and a chi-squared test (χ2) was applied to determine differences in their distributions. Among the 2,521 isolates, Klebsiella pneumoniae was the most frequently detected (31.1%). From 2015 to 2019, the frequency of isolates in groups 2 and 3 decreased from 70.1% to 48.6% (χ2 = 63.439; p < 0.0001). Stratifying isolates by bacterial species, for K. pneumoniae, the frequency of PDR isolates decreased from 20% to 1.3% (χ2 = 15.885; p = 0.003). For Acinetobacter baumannii, a statistically significant decrease was found in groups 2 and 3: from 100% to 83.3% (χ2 = 27.721; p < 0.001). Also, for Pseudomonas aeruginosa and Enterobacter spp., the frequency of groups 2 and 3 decreased from 100% to 28.3% (χ2 = 225.287; p < 0.001) and from 75% to 48.7% (χ2 = 15.408; p = 0.003), respectively. These results indicate that a program consisting of persuasive stewardship measures, which were rolled out during the time frame of our study, may be useful to control drug-resistant bacteria in a hospital setting.
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Affiliation(s)
- Vincenzo Scaglione
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Mariaconcetta Reale
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Chiara Davoli
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Maria Mazzitelli
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Francesca Serapide
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Rosaria Lionello
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Valentina La Gamba
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Paolo Fusco
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Andrea Bruni
- Unit of Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Daniela Procopio
- Unit of Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Eugenio Garofalo
- Unit of Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Federico Longhini
- Unit of Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Cinzia Peronace
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Aida Giancotti
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Luigia Gallo
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Maria Carla Liberto
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Bruno Mario Cesana
- Unit of Medical Statistics, Biometrics and Bioinformatics "Giulio A. Maccacaro", Department of Clinical Sciences and Community Health, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Chiara Costa
- Unit of Infectious and Tropical Diseases, "Mater Domini" Teaching Hospital, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Carlo Torti
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
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Mancuso C, Curcio A, Lamberti A, Santarpia G, Quirino A, Franzese A, Trecarichi EM, Torti C, Matera G, Indolfi C. 598 Are risk scores sufficient to stratify patients undergoing lead extraction? A single-centre analysis. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab127.016] [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: 11/14/2022]
Abstract
Abstract
Aims
Device implantation is growing exponentially, as well as associated infections, ranging from isolated pocket erosion to endocarditis and bacteraemia, all worsening the prognosis of patients with frailty and comorbidity. Transvenous lead extraction (TLE) can resolve the complications, although a 1-year mortality risk of up to 25% is reported; despite higher health costs, prolonged hospitalization, and poor quality of life, strategies for predicting increased infection risk and reduced infection incidence are yet missing. Currently applied clinical scores do not consider etiologic microbial agents. We aimed to assess whether PADIT and UPCM scores could be implemented when bacteria or fungi are known to be causative of infection, and how these agents affected the outcome.
Methods and results
A retrospective analysis of patients undergone cardiac implantable electronic device (CIED) pocket revision, and/or TLE between 2016 and 2021 was performed. For each procedure, microbiological samples of both generator pocket tissue and intracardiac portions of the leads were analysed. In addition, blood cultures were performed in three sets. Transesophageal echocardiography was performed in all cases for ruling out suspected endocarditis. Spearman ad Pearson coefficients were tested for correlation among microorganism, prior infection and/or procedure, PADIT and UPCM scores; a P-value less than 0.05 was considered significant. We analysed 14 patients (10 males, 4 females, mean age ± SD: 72 ± 13): one case (4%) affected by pocket erosion, seven cases (50%) affected by both pocket site and lead infection (with associated bacteraemia in one subject), and one case (4%) due to lead-related infective endocarditis. Of these, five (36%) underwent device replacement, while nine (64%) to extraction or pocket/lead revision. Nine (64%) patients had positive culture examinations (Figure 1). The correlation method gave a statistically significant association between Gram- infection and prior sepsis (r 0.63; P-value 0.02). We considered the number of procedures on the same pocket and/or CIED previous infections as markers of frailty and increased infectious risk. As expected, the PADIT score, but not UPCM, significantly correlated with the number of previous procedures (r 0.70; P-value 0.006). Indeed, both scores had a similar infectious risk prediction.
Conclusions
In our analysis, predictive PADIT score of infectious risk performed better than UPCM, while both proved their reliability in identifying high-risk patients. The absence of correlation between UPCM score and infective agents is not conclusive, but probably due to the small sample size. Interestingly, growing rate of device reinfection correlates with the risk of Gram- bacterial infection. Thus, the integration of the microbiological data in the current prediction models could significantly increase their performance.
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Affiliation(s)
- Cinzia Mancuso
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Antonio Curcio
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Angelo Lamberti
- Unit of Clinical Microbiology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Giuseppe Santarpia
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Antonella Franzese
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Gianni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
- Mediterranea Cardiocentro, Naples, Italy
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Bruni A, Garofalo E, Mazzitelli M, Voci CP, Puglisi A, Quirino A, Marascio N, Trecarichi EM, Matera G, Torti C, Longhini F. Multidisciplinary approach to a septic COVID-19 patient undergoing veno-venous extracorporeal membrane oxygenation and receiving thoracic surgery. Clin Case Rep 2021; 9:e04828. [PMID: 34631063 PMCID: PMC8489392 DOI: 10.1002/ccr3.4828] [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: 06/11/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 11/06/2022] Open
Abstract
A multidisciplinary approach appears to be fundamental for the treatment of critically ill patients with COVID-19, improving clinical outcomes, even in the most severe cases. Such severe cases are advisable to be collegially discussed between intensivists, surgeons, infectious disease, and other physicians potentially involved.
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Affiliation(s)
- Andrea Bruni
- Anesthesia and Intensive Care Department of Medical and Surgical Sciences Magna Graecia University Catanzaro Italy
| | - Eugenio Garofalo
- Anesthesia and Intensive Care Department of Medical and Surgical Sciences Magna Graecia University Catanzaro Italy
| | - Maria Mazzitelli
- Infectious and Tropical Disease Unit Department of Medical and Surgical Sciences Magna Graecia University Catanzaro Italy
| | - Carlo P Voci
- Thoracic Surgery Department of Medical and Surgical Sciences Magna Graecia University Catanzaro Italy
| | - Armando Puglisi
- Thoracic Surgery Department of Medical and Surgical Sciences Magna Graecia University Catanzaro Italy
| | - Angela Quirino
- Clinical Microbiology Unit Department of Health Sciences Magna Graecia University Catanzaro Italy
| | - Nadia Marascio
- Clinical Microbiology Unit Department of Health Sciences Magna Graecia University Catanzaro Italy
| | - Enrico M Trecarichi
- Infectious and Tropical Disease Unit Department of Medical and Surgical Sciences Magna Graecia University Catanzaro Italy
| | - Giovanni Matera
- Clinical Microbiology Unit Department of Health Sciences Magna Graecia University Catanzaro Italy
| | - Carlo Torti
- Infectious and Tropical Disease Unit Department of Medical and Surgical Sciences Magna Graecia University Catanzaro Italy
| | - Federico Longhini
- Anesthesia and Intensive Care Department of Medical and Surgical Sciences Magna Graecia University Catanzaro Italy
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Quirino A, Marascio N, Peronace C, Gallo L, Barreca GS, Giancotti A, Lamberti AG, Colosimo M, Minchella P, Trecarichi EM, Torti C, Liberto MC, Matera G. Direct antimicrobial susceptibility testing (AST) from positive blood cultures using Microscan system for early detection of bacterial resistance phenotypes. Diagn Microbiol Infect Dis 2021; 101:115485. [PMID: 34365091 DOI: 10.1016/j.diagmicrobio.2021.115485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 11/25/2022]
Abstract
Antimicrobial Susceptibility Testing is mandatory for Bloodstream Infections management in order to establish appropriate antimicrobial therapy. Herein we evaluated new approach based on AST results directly from positive blood cultures, using Microscan WA to carry out rapid phenotypical profile of antibiotic resistance. Our investigations allow to reduce time versus traditional results.
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Affiliation(s)
- A Quirino
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - N Marascio
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - C Peronace
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - L Gallo
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - G S Barreca
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - A Giancotti
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - A G Lamberti
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - M Colosimo
- Department of Microbiology, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy
| | - P Minchella
- Department of Microbiology, Pugliese-Ciaccio Hospital of Catanzaro, Catanzaro, Italy
| | - E M Trecarichi
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - C Torti
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - M C Liberto
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - G Matera
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
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35
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Marascio N, Costantino A, Taffon S, Lo Presti A, Equestre M, Bruni R, Pisani G, Barreca GS, Quirino A, Trecarichi EM, Costa C, Mazzitelli M, Serapide F, Matera G, Torti C, Liberto MC, Ciccaglione AR. Phylogenetic and Molecular Analyses of More Prevalent HCV1b Subtype in the Calabria Region, Southern Italy. J Clin Med 2021; 10:jcm10081655. [PMID: 33924449 PMCID: PMC8068798 DOI: 10.3390/jcm10081655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 12/15/2022] Open
Abstract
Hepatitis C virus subtype 1b (HCV1b) is still the most prevalent subtype worldwide, with massive expansion due to poor health care standards, such as blood transfusion and iatrogenic procedures. Despite safe and effective new direct antiviral agents (DAA), treatment success can depend on resistance-associated substitutions (RASs) carried in target genomic regions. Herein we investigated transmission clusters and RASs among isolates from HCV1b positive subjects in the Calabria Region. Forty-one NS5B and twenty-two NS5A sequences were obtained by Sanger sequencing. Phylogenetic analysis was performed using the maximum likelihood method and resistance substitutions were analyzed with the Geno2pheno tool. Phylogenetic analysis showed sixteen statistically supported clusters, with twelve containing Italian sequences mixed with foreign HCV1b isolates and four monophyletic clusters including only sequences from Calabria. Interestingly, HCV1b spread has been maintained by sporadic infections in geographically limited areas and by dental treatment or surgical intervention in the metropolitan area. The L159F NS5B RAS was found in 15 isolates and in particular 8/15 also showed the C316N substitution. The Y93H and L31M NS5A RASs were detected in three and one isolates, respectively. The A92T NS5A RAS was found in one isolate. Overall, frequencies of detected NS5B and NS5A RASs were 36.6% and 22.7%, respectively. For the eradication of infection, improved screening policies should be considered and the prevalence of natural RASs carried on viral strains.
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Affiliation(s)
- Nadia Marascio
- Department of Health Sciences, Institute of Microbiology, “Magna Grecia” University, 88100 Catanzaro, Italy; (G.S.B.); (A.Q.); (G.M.); (M.C.L.)
- Correspondence: ; Tel.: +39-0961-3697-742; Fax: +39-0961-3697-760
| | - Angela Costantino
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.C.); (S.T.); (A.L.P.); (R.B.); (A.R.C.)
| | - Stefania Taffon
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.C.); (S.T.); (A.L.P.); (R.B.); (A.R.C.)
| | - Alessandra Lo Presti
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.C.); (S.T.); (A.L.P.); (R.B.); (A.R.C.)
| | - Michele Equestre
- Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Roberto Bruni
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.C.); (S.T.); (A.L.P.); (R.B.); (A.R.C.)
| | - Giulio Pisani
- National Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Giorgio Settimo Barreca
- Department of Health Sciences, Institute of Microbiology, “Magna Grecia” University, 88100 Catanzaro, Italy; (G.S.B.); (A.Q.); (G.M.); (M.C.L.)
| | - Angela Quirino
- Department of Health Sciences, Institute of Microbiology, “Magna Grecia” University, 88100 Catanzaro, Italy; (G.S.B.); (A.Q.); (G.M.); (M.C.L.)
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, “Magna Graecia” University, 88100 Catanzaro, Italy; (E.M.T.); (C.C.); (M.M.); (F.S.); (C.T.)
| | - Chiara Costa
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, “Magna Graecia” University, 88100 Catanzaro, Italy; (E.M.T.); (C.C.); (M.M.); (F.S.); (C.T.)
| | - Maria Mazzitelli
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, “Magna Graecia” University, 88100 Catanzaro, Italy; (E.M.T.); (C.C.); (M.M.); (F.S.); (C.T.)
| | - Francesca Serapide
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, “Magna Graecia” University, 88100 Catanzaro, Italy; (E.M.T.); (C.C.); (M.M.); (F.S.); (C.T.)
| | - Giovanni Matera
- Department of Health Sciences, Institute of Microbiology, “Magna Grecia” University, 88100 Catanzaro, Italy; (G.S.B.); (A.Q.); (G.M.); (M.C.L.)
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, “Magna Graecia” University, 88100 Catanzaro, Italy; (E.M.T.); (C.C.); (M.M.); (F.S.); (C.T.)
| | - Maria Carla Liberto
- Department of Health Sciences, Institute of Microbiology, “Magna Grecia” University, 88100 Catanzaro, Italy; (G.S.B.); (A.Q.); (G.M.); (M.C.L.)
| | - Anna Rita Ciccaglione
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (A.C.); (S.T.); (A.L.P.); (R.B.); (A.R.C.)
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36
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Aquila I, Ricci P, Bonetta CF, Sacco MA, Longhini F, Torti C, Mazzitelli M, Garofalo E, Bruni A, Trecarichi EM, Serapide F, Gratteri S, Quirino A, Barreca GS, Abenavoli L, Arena V, Oliva A, Giancotti A, Iavicoli I, Liberto MC, Matera G. Analysis of the persistence time of the SARS-CoV-2 virus in the cadaver and the risk of passing infection to autopsy staff. Med Leg J 2021; 89:40-53. [PMID: 33475037 DOI: 10.1177/0025817220980601] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The activity of the SARS-CoV-2 virus has not yet been studied in a post-mortem setting. The absence of these data has led to the prohibition of exposure of infected corpses during burial procedures. Our aim was to assess the virus's persistence and the possibility of transmission in the post-mortem phase including autopsy staff. The sample group included 29 patients who were admitted to our Covid-19 Centre who died during hospitalisation and the autopsy staff. All the swabs were subjected to a one-step real-time reverse transcription polymerase chain reaction with cycle threshold (Ct) values. Swab collection was performed at 2 h, 4 h, 6 h, 12 h, over 24 since death. The following were the analysis of patients' swabs: 10 cases were positive 2 h after death; 10 cases positive 4 h after death; 9 cases were found positive 6 h after death; 7 cases positive 12 h after death; 9 cases remained positive 24 h after death. The swabs performed on all the forensic pathologist staff on duty who performed the autopsies were negative. The choice to avoid rituals and the display of corpses before and at the burial procedures given appears cautiously valid due to the persistence of the SARS-CoV-2 virus in the post-mortem period. Although the caution in choosing whether or not to perform an autopsy on infected corpses is acceptable, not to perform autopsies is not biologically supported.
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Affiliation(s)
- Isabella Aquila
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Carlo Filippo Bonetta
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Matteo Antonio Sacco
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Federico Longhini
- Intensive Care Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Eugenio Garofalo
- Intensive Care Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Andrea Bruni
- Intensive Care Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Francesca Serapide
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Santo Gratteri
- Institute of Legal Medicine, Department of Surgical and Medical Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Giorgio Settimo Barreca
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Ludovico Abenavoli
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Vincenzo Arena
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Anatomia Patologica, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Aida Giancotti
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Maria Carla Liberto
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Italy
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37
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Citraro R, Lembo F, De Caro C, Tallarico M, Coretti L, Iannone LF, Leo A, Palumbo D, Cuomo M, Buommino E, Nesci V, Marascio N, Iannone M, Quirino A, Russo R, Calignano A, Constanti A, Russo E, De Sarro G. First evidence of altered microbiota and intestinal damage and their link to absence epilepsy in a genetic animal model, the WAG/Rij rat. Epilepsia 2021; 62:529-541. [PMID: 33428780 DOI: 10.1111/epi.16813] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 09/12/2020] [Revised: 12/23/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE A large number of studies have highlighted the important role of the gut microbiota in the pathophysiology of neurological disorders, suggesting that its manipulation might serve as a treatment strategy. We hypothesized that the gut microbiota participates in absence seizure development and maintenance in the WAG/Rij rat model and tested this hypothesis by evaluating potential gut microbiota and intestinal alterations in the model, as well as measuring the impact of microbiota manipulation using fecal microbiota transplantation (FMT). METHODS Initially, gut microbiota composition and intestinal histology of WAG/Rij rats (a well-recognized genetic model of absence epilepsy) were studied at 1, 4, and 8 months of age in comparison to nonepileptic Wistar rats. Subsequently, in a second set of experiments, at 6 months of age, untreated Wistar or WAG/Rij rats treated with ethosuximide (ETH) were used as gut microbiota donors for FMT in WAG/Rij rats, and electroencephalographic (EEG) recordings were obtained over 4 weeks. At the end of FMT, stool and gut samples were collected, absence seizures were measured on EEG recordings, and microbiota analysis and histopathological examinations were performed. RESULTS Gut microbiota analysis showed differences in beta diversity and specific phylotypes at all ages considered and significant variances in the Bacteroidetes/Firmicutes ratio between Wistar and WAG/Rij rats. FMT, from both Wistar and ETH-treated WAG/Rij donors to WAG/Rij rats, significantly decreased the number and duration of seizures. Histological results indicated that WAG/Rij rats were characterized by intestinal villi disruption and inflammatory infiltrates already at 1 month of age, before seizure occurrence; FMT partially restored intestinal morphology while also significantly modifying gut microbiota and concomitantly reducing absence seizures. SIGNIFICANCE Our results demonstrate for the first time that the gut microbiota is modified and contributes to seizure occurrence in a genetic animal model of absence epilepsy and that its manipulation may be a suitable therapeutic target for absence seizure management.
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Affiliation(s)
- Rita Citraro
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesca Lembo
- Department of Pharmacy, Federico II University of Naples, Naples, Italy.,Task Force on Microbiota Studies, Federico II University of Naples, Naples, Italy
| | - Carmen De Caro
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Martina Tallarico
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Lorena Coretti
- Department of Pharmacy, Federico II University of Naples, Naples, Italy.,Task Force on Microbiota Studies, Federico II University of Naples, Naples, Italy
| | - Luigi Francesco Iannone
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Antonio Leo
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Domenico Palumbo
- Department of Pharmacy, Federico II University of Naples, Naples, Italy
| | - Mariella Cuomo
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy
| | | | - Valentina Nesci
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Nadia Marascio
- Division of Microbiology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Michelangelo Iannone
- National Council of Research, Institute of Neurological Science, Catanzaro, Italy
| | - Angela Quirino
- Division of Microbiology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Roberto Russo
- Department of Pharmacy, Federico II University of Naples, Naples, Italy
| | - Antonio Calignano
- Department of Pharmacy, Federico II University of Naples, Naples, Italy
| | - Andrew Constanti
- Department of Pharmacology, University College London School of Pharmacy, London, UK
| | - Emilio Russo
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giovambattista De Sarro
- System and Applied Pharmacology@University Magna Grecia (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
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38
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Pelle MC, Tassone B, Ricchio M, Mazzitelli M, Davoli C, Procopio G, Cancelliere A, La Gamba V, Lio E, Matera G, Quirino A, Barreca GS, Trecarichi EM, Torti C. Late-onset myocardial infarction and autoimmune haemolytic anaemia in a COVID-19 patient without respiratory symptoms, concomitant with a paradoxical increase in inflammatory markers: a case report. J Med Case Rep 2020; 14:246. [PMID: 33339534 PMCID: PMC7746982 DOI: 10.1186/s13256-020-02595-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 08/22/2020] [Accepted: 11/19/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In December 2019, a new coronavirus (named severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) spread from China, causing a pandemic in a very short time. The main clinical presentation of SARS-CoV-2 infection (COVID-19, coronavirus disease-2019) is pneumonia, but several cardiovascular complications may also occur (e.g., acute coronary syndromes, pulmonary embolism, stroke, arrhythmias, heart failure and cardiogenic shock). Direct or indirect mechanisms induced by SARS-CoV-2 could be implicated in the pathogenesis of these events. CASE PRESENTATION We report herein the third case of COVID-19 autoimmune haemolytic anaemia (AIHA) reported so far, which occurredwithout any other possible explanations in a Caucasian patient. The patient also suffered from ST-elevation myocardial injury. CONCLUSIONS Both complications occurred quite late after COVID-19 diagnosis and were probably precipitated by systemic inflammation, as indicated by a significant delayed increase in inflammatory markers, including interleukin-6 (IL-6).
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Affiliation(s)
- Maria Chiara Pelle
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
| | - Bruno Tassone
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Marco Ricchio
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Maria Mazzitelli
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Chiara Davoli
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Giada Procopio
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Anna Cancelliere
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Valentina La Gamba
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Elena Lio
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, Unit of Clinical Microbiology, University "Magna Graecia", Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, Unit of Clinical Microbiology, University "Magna Graecia", Catanzaro, Italy
| | | | - Enrico Maria Trecarichi
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
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Spaccarotella C, Migliarino S, Mongiardo A, Curcio A, de Rosa S, Corcione N, Quirino A, Barreca GS, Giancotti A, Peronace C, Marascio N, Matera G, Indolfi C. Fast-track ruling in/out SARS-CoV-2 infection with rapid 0/1.5 h molecular test in patients with acute coronary syndromes. J Cardiovasc Med (Hagerstown) 2020; 21:975-979. [PMID: 33156158 DOI: 10.2459/jcm.0000000000001117] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Patients with acute coronary syndrome (ACS) often arrive in the catheterization (cath) lab directly from the field or an emergency department without an accurate triage for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.Although in the pandemic period the treatment in the cath laboratory of high-risk ACS should not be delayed because the operators wear special protection systems, the subsequent risk of contagion in a non-Covid coronary care unit could be high in the case of patients positive for SARS-CoV-2. METHODS We tested the possibility of a fast-track protocol in 51 consecutive patients (mean age 65 ± 12 years) transferred from spokes centres or from the field to our HUB centre and admitted to our coronary care unit (CCU). Once the patient had arrived in the cath lab, the nasopharyngeal swab was performed. The real-time PCR to extract RNA for SARS-CoV-2 detection was performed with an automated rapid molecular Xpert Xpress test. Meanwhile, coronary angiography or percutaneous coronary intervention was performed if necessary. RESULTS In this fast-track protocol, the time to perform nasopharyngeal swab was 11 ± 11 min; time spent to transport nasopharyngeal swab to the laboratory was 29 ± 20 min; time to detect viral nucleic acid was 68 ± 16 min. The overall time from the execution of nasopharyngeal swab to the result was 109 ± 26 min. The results were immediately put into the hospital computer system and made readily available. Depending on the test result, patients were then transferred to the regular CCU or Covid area. CONCLUSION This study demonstrates that 0-1.5 h fast-track triage for coronavirus disease 2019 (COVID 19) is feasible in patients with ACS. The execution of nasopharyngeal swab in the cath lab and its analysis with a rapid molecular test allows rapid stratification of SARS-CoV-2 infection.
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Affiliation(s)
- Carmen Spaccarotella
- Division of Cardiology.,Center for Cardiovascular Research University, Magna Graecia, Catanzaro
| | | | | | - Antonio Curcio
- Division of Cardiology.,Center for Cardiovascular Research University, Magna Graecia, Catanzaro
| | - Salvatore de Rosa
- Division of Cardiology.,Center for Cardiovascular Research University, Magna Graecia, Catanzaro
| | - Nicola Corcione
- Division of Cardiology Clinica Pineta Mare, Castel Volturno, Neaples, Italy
| | - Angela Quirino
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro
| | - Giorgio Settimo Barreca
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro
| | - Aida Giancotti
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro
| | - Cinzia Peronace
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro
| | - Nadia Marascio
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro
| | - Giovanni Matera
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro
| | - Ciro Indolfi
- Division of Cardiology.,Center for Cardiovascular Research University, Magna Graecia, Catanzaro.,Mediterranea Cardiocentro, Naples
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Mazzitelli M, Barone S, Greco G, Serapide F, Valentino P, Giancotti A, Costa C, Pisani V, Quirino A, Liberto MC, Matera G, Gambardella A, Trecarichi EM, Torti C. Listeria infection after treatment with alemtuzumab: a case report and literature review. Would antibiotic prophylaxis be considered? Infez Med 2020; 28:258-262. [PMID: 32487792] [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: 06/11/2023]
Abstract
Few cases of complicated infections with Listeria monocytogenes (LM) have been reported to date in patients with multiple sclerosis (MS) treated with alemtuzumab. Primary prevention strategies may be suggested in such patients to avoid infections. However, these may be ineffective because patients may already be carriers of LM. We report herein a case of bloodstream infection due to LM in a 25-year-old woman with MS treated with alemtuzumab. We searched the UMC/WHO Vigibase system for all reported cases of LM in patients treated with alemtuzumab and found 29 cases overall up to 21 July 2019. We also performed a literature review of MS cases with LM on alemtuzumab, in order to evaluate epidemiology, clinical characteristics, and outcome of this complication. Since the published cases (N=8) were mainly reported in recent years but more cases were found in the UMC/WHO Vigibase system (although not necessarily in patients with MS), we hypothesize that this complication is more frequent than currently believed and may become even more important in the future. Therefore, it is worth reaching a consensus on appropriate algorithms to stratify individuals by risk so as to implement targeted prevention strategies (whether primary or secondary).
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Affiliation(s)
- Maria Mazzitelli
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University, Catanzaro, Italy; Research and Development Department, Chelsea and Westminster Hospital Foundation Trust, London, United Kingdom
| | - Stefania Barone
- Institute of Neurology, "Magna Graecia" University, Catanzaro, Italy
| | - Giuseppe Greco
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Francesca Serapide
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Paola Valentino
- Institute of Neurology, "Magna Graecia" University, Catanzaro, Italy
| | - Alda Giancotti
- Department of Health Sciences, Clinical Microbiology Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Chiara Costa
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Vincenzo Pisani
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, Clinical Microbiology Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Maria Carla Liberto
- Department of Health Sciences, Clinical Microbiology Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, Clinical Microbiology Unit, "Magna Graecia" University, Catanzaro, Italy
| | | | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University, Catanzaro, Italy
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41
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Marano V, Marascio N, Pavia G, Lamberti AG, Quirino A, Musarella R, Casalinuovo F, Mazzitelli M, Trecarichi EM, Torti C, Matera G, Liberto MC. Identification of pmrB mutations as putative mechanism for colistin resistance in A. baumannii strains isolated after in vivo colistin exposure. Microb Pathog 2020; 142:104058. [PMID: 32058026 DOI: 10.1016/j.micpath.2020.104058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/20/2020] [Accepted: 02/10/2020] [Indexed: 12/13/2022]
Abstract
Colistin resistance among extensively-resistant Acinetobacter baumannii isolates is a serious health-care problem. Alterations in PmrA-PmrB two-component system have been associated with resistance to colistin. We investigated three pairs of colistin-susceptible and colistin-resistant A. baumannii, sequentially isolated from three patients before and after colistin treatment, respectively. The pmrA and pmrB genes were sequenced by Sanger method. Amino acidic positions and their effect on protein were predicted by InterPro and PROVEAN tools. Expression of pmrA, pmrB and pmrC genes was assessed by semi-quantitative reverse transcription-PCR (qRT-PCR). We found three different nonsynonymous substitutions P233T, E301G and L168K in pmrB coding region, each one in a different colistin resistance strain. The E301G and L168K substitutions represent novel mutations in pmrB, not previously described. Relative expression of pmrA, pmrB and pmrC mRNA increased in all colistin resistant strains. In our study, pmrB substitutions were associated with pmrC over-expression and colistin resistance. Further studies are necessary to understand their impact on modification of lipid A components.
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Affiliation(s)
- Vito Marano
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Nadia Marascio
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, 88100, Catanzaro, Italy.
| | - Grazia Pavia
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Angelo G Lamberti
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Rosanna Musarella
- Institute for Experimental Veterinary Medicine of Southern Italy, 88100, Catanzaro, Italy
| | - Francesco Casalinuovo
- Institute for Experimental Veterinary Medicine of Southern Italy, 88100, Catanzaro, Italy
| | - Maria Mazzitelli
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Enrico M Trecarichi
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Maria Carla Liberto
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, 88100, Catanzaro, Italy
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Mazzitelli M, Garofalo E, Bruni A, Barreca GS, Quirino A, Giancotti A, Serapide F, Indolfi C, Matera G, Navalesi P, Trecarichi EM, Torti C, Longhini F. Severe myocarditis due to influenza A(H1N1)pdm09 viral infection in a young woman successfully treated with intravenous zanamivir: A case report. Clin Case Rep 2019; 7:2336-2340. [PMID: 31893053 PMCID: PMC6935647 DOI: 10.1002/ccr3.2499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 12/16/2022] Open
Abstract
In patients with influenza-related myocarditis, prompt diagnosis and treatment are important. Intravenous zanamivir can be an alternative to oral oseltamivir, especially in severe cases and when drug intestinal malabsorption is suspected or proven.
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Affiliation(s)
- Maria Mazzitelli
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit“Magna Graecia” UniversityCatanzaroItaly
| | - Eugenio Garofalo
- Department of Medical and Surgical SciencesUnit of Intensive Care, “Magna Graecia” UniversityCatanzaroItaly
| | - Andrea Bruni
- Department of Medical and Surgical SciencesUnit of Intensive Care, “Magna Graecia” UniversityCatanzaroItaly
| | - Giorgio Settimo Barreca
- Department of Health SciencesUnit of Clinical Microbiology“Magna Graecia” UniversityCatanzaroItaly
| | - Angela Quirino
- Department of Health SciencesUnit of Clinical Microbiology“Magna Graecia” UniversityCatanzaroItaly
| | - Aida Giancotti
- Department of Health SciencesUnit of Clinical Microbiology“Magna Graecia” UniversityCatanzaroItaly
| | - Francesca Serapide
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit“Magna Graecia” UniversityCatanzaroItaly
| | - Ciro Indolfi
- Department of Medical and Surgical SciencesDivision of cardiology“Magna Graecia” UniversityCatanzaroItaly
| | - Giovanni Matera
- Department of Health SciencesUnit of Clinical Microbiology“Magna Graecia” UniversityCatanzaroItaly
| | - Paolo Navalesi
- Department of Medical and Surgical SciencesUnit of Intensive Care, “Magna Graecia” UniversityCatanzaroItaly
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit“Magna Graecia” UniversityCatanzaroItaly
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit“Magna Graecia” UniversityCatanzaroItaly
| | - Federico Longhini
- Department of Medical and Surgical SciencesUnit of Intensive Care, “Magna Graecia” UniversityCatanzaroItaly
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43
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Trecarichi EM, Quirino A, Scaglione V, Longhini F, Garofalo E, Bruni A, Biamonte E, Lionello R, Serapide F, Mazzitelli M, Marascio N, Matera G, Liberto MC, Navalesi P, Torti C. Successful treatment with cefiderocol for compassionate use in a critically ill patient with XDR Acinetobacter baumannii and KPC-producing Klebsiella pneumoniae: a case report. J Antimicrob Chemother 2019; 74:3399-3401. [PMID: 31369095 DOI: 10.1093/jac/dkz318] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Enrico Maria Trecarichi
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Vincenzo Scaglione
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Federico Longhini
- Unit of Intensive Care, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Eugenio Garofalo
- Unit of Intensive Care, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Andrea Bruni
- Unit of Intensive Care, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Eugenio Biamonte
- Unit of Intensive Care, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Rosaria Lionello
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Francesca Serapide
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Maria Mazzitelli
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Maria Carla Liberto
- Unit of Clinical Microbiology, Department of Health Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Paolo Navalesi
- Unit of Intensive Care, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
| | - Carlo Torti
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy
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Torti C, Mazzitelli M, Longhini F, Garofalo E, Bruni A, Giancotti A, Barreca GS, Quirino A, Liberto MC, Serapide F, Matera G, Trecarichi EM, Navalesi P. Clinical outcomes of patients treated with intravenous zanamivir for severe influenza A(H1N1)pdm09 infection: a case report series. BMC Infect Dis 2019; 19:858. [PMID: 31619209 PMCID: PMC6796355 DOI: 10.1186/s12879-019-4530-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 10/01/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Intravenous (IV) zanamivir could be a suitable alternative for the treatment of severe influenza A(H1N1)pdm09 infection in patients who are unable to take oral or inhaled medication, for example, those on mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, data on the clinical outcomes of such patients is limited. CASE PRESENTATION We report the clinical outcomes of four patients who were admitted at the intensive care unit during the 2017-2018 influenza season with severe sepsis (SOFA score > 11) and acute respiratory distress syndrome requiring ECMO and mechanical ventilation. Two patients were immune-compromised. The A(H1N1)pdm09 genome was confirmed by polymerase chain reaction (PCR) on nasopharyngeal specimen swabs prior to administration of IV zanamivir at a dose of 600 mg twice daily. Weekly qualitative PCR analysis was done to monitor viral clearance, with zanamivir treatment being discontinued upon receipt of negative results. In addition, the patients were managed for concomitant multidrug-resistant bacterial infections, with infection resolution confirmed with blood cultures. The median time for zanamivir treatment was 10 days (IQR 10-17). The clinical outcome was favourable with all four patients surviving and improving clinically. All four patients achieved viral clearance of A(H1N1)pdm09 genome, and resolution of multidrug-resistant bacterial infections. CONCLUSIONS IV zanamivir could be a good therapeutic option in patients with severe influenza A(H1N1)pdm09 infection who are unable to take oral or aerosolised antiviral medication. We recommend prospective randomized control trials to support this hypothesis.
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Affiliation(s)
- Carlo Torti
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
| | - Maria Mazzitelli
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Federico Longhini
- Department of Medical and Surgical Sciences, Unit of Intensive Care, "Magna Graecia" University, Catanzaro, Italy
| | - Eugenio Garofalo
- Department of Medical and Surgical Sciences, Unit of Intensive Care, "Magna Graecia" University, Catanzaro, Italy
| | - Andrea Bruni
- Department of Medical and Surgical Sciences, Unit of Intensive Care, "Magna Graecia" University, Catanzaro, Italy
| | - Aida Giancotti
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro, Italy
| | - Giorgio Settimo Barreca
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro, Italy
| | - Maria Carla Liberto
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro, Italy
| | - Francesca Serapide
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, Unit of Clinical Microbiology, "Magna Graecia" University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Paolo Navalesi
- Department of Medical and Surgical Sciences, Unit of Intensive Care, "Magna Graecia" University, Catanzaro, Italy
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Marascio N, Quirino A, Barreca GS, Galati L, Costa C, Pisani V, Mazzitelli M, Matera G, Liberto MC, Focà A, Torti C. Discussion on critical points for a tailored therapy to cure hepatitis C virus infection. Clin Mol Hepatol 2019; 25:30-36. [PMID: 30669818 PMCID: PMC6435970 DOI: 10.3350/cmh.2018.0061] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022] Open
Abstract
Hepatitis C virus (HCV) infects around 71 million people worldwide and in 2018 it is still a major health problem. Since 2011, anti-HCV therapy with availability of direct-acting antiviral drugs has revolutionized the clinical response and paved the way to eradication strategies. However, despite the high rate of sustained virological response, treatment failure may occur in a limited percentage of patients, possibly due to resistance-associated substitutions (RASs), either emergent or pre-existent even in minority viral populations. Clearly this problem may impair success of eradication strategies. With this background, several questions marks still exist around HCV treatment, including whether pan-genotypic treatments with complete effectiveness in any clinical conditions really exist outside clinical trials, the actual cost-effectiveness of genotyping testing, and utility of RAS detection in viral quasispecies by next generation sequencing approach. In this review, we describe these critical points by discussing recent literature data and our research experience.
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Affiliation(s)
- Nadia Marascio
- Department of Health Sciences, Unit of Clinical Microbiology, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, Unit of Clinical Microbiology, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Giorgio Settimo Barreca
- Department of Health Sciences, Unit of Clinical Microbiology, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Luisa Galati
- Department of Health Sciences, Unit of Clinical Microbiology, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Chiara Costa
- Department of Health Sciences, Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Vincenzo Pisani
- Department of Health Sciences, Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Maria Mazzitelli
- Department of Health Sciences, Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, Unit of Clinical Microbiology, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Maria Carla Liberto
- Department of Health Sciences, Unit of Clinical Microbiology, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Alfredo Focà
- Department of Health Sciences, Unit of Clinical Microbiology, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
| | - Carlo Torti
- Department of Health Sciences, Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, Magna Graecia University, Catanzaro, Italy
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Quirino A, Morelli P, Capua G, Arena G, Matera G, Liberto MC, Focà A. Synergistic and antagonistic effects of Citrus bergamia distilled extract and its major components on drug resistant clinical isolates. Nat Prod Res 2018; 34:1626-1629. [DOI: 10.1080/14786419.2018.1522631] [Citation(s) in RCA: 3] [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: 10/27/2022]
Affiliation(s)
- Angela Quirino
- Department of Health Sciences, Institute of Microbiology, University “Magna Graecia” of Catanzaro, Italy
| | - Paola Morelli
- Department of Health Sciences, Institute of Microbiology, University “Magna Graecia” of Catanzaro, Italy
| | | | | | - Giovanni Matera
- Department of Health Sciences, Institute of Microbiology, University “Magna Graecia” of Catanzaro, Italy
| | - Maria Carla Liberto
- Department of Health Sciences, Institute of Microbiology, University “Magna Graecia” of Catanzaro, Italy
| | - Alfredo Focà
- Department of Health Sciences, Institute of Microbiology, University “Magna Graecia” of Catanzaro, Italy
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47
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Mazzitelli M, Torti C, Greco G, Strazzulla A, Costa C, Pisani V, Sorace C, Giancotti A, Lamberti A, Barreca GS, Quirino A, Liberto MC, Focà A, Matera G. Prevalence of parasitic infections in migrants: do official symptom-driven guidelines apply to the current situation? Infez Med 2018; 26:347-355. [PMID: 30555139] [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: 06/09/2023]
Abstract
In recent years, migration has become a significant challenge in Western countries. Migrant populations, coming from hyper-endemic areas, may present parasitic infections that remain latent and asymptomatic even for years, eventually leading to severe complications. Italian guidelines have been established to perform screening guided by the presence of symptoms and/or hypereosinophilia. Parasitological screening was conducted in a migrant population to carry out preventative measures. All migrants were asked to report any symptoms suggesting parasitic infections and list any previous treatment received. Travel data were recorded. Parasitological examination of stools and urine were conducted in all patients regardless of symptoms. In all, 208 consecutive patients were enrolled in our outpatient clinic from November 2016 to August 2017. Thirty-four patients were excluded due to the previous assumption of albendazole or because they did not exhibit suitable samples. Prevalence of parasitic infections was 33/174 (18.9%). A statistically significant difference for the prevalence of parasitic infections was not found between patients who were asymptomatic and without hypereosinophilia compared to those who presented symptoms and/or hypereosinophilia (27/151 [17.9%] vs. 6/23 [26.0%]; p=0.39). By contrast, a statistically significant difference was found for the length of time between arrival in Italy and parasitological examinations (4/51 [7.8%] migrants who arrived in Italy more than six months prior to screening vs. 29/123 [23.6%] migrants who arrived within six months; p= 0.016). Our results did not demonstrate any significant differences in prevalence of parasitic infections between symptomatic or hypereosinophilic and asymptomatic migrants. Thus we feel it inappropriate to support recent guidelines recommending parasitological examinations only in migrants with symptoms and/or hypereosinophilia. By contrast, it would appear important to perform parasitological screening in migrants as soon as possible after their arrival. Since such infestations, if untreated, could result in chronic diseases and complications, and could be transmitted in the host countries, our results have potential implications for public health.
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Affiliation(s)
- Maria Mazzitelli
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Giuseppe Greco
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Alessio Strazzulla
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Chiara Costa
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Vincenzo Pisani
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Chiara Sorace
- Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Aida Giancotti
- Department of Health Sciences, Microbiology and Virology Unit, "Magna Graecia" University of Catanzaro, Italy
| | - Angelo Lamberti
- Department of Health Sciences, Microbiology and Virology Unit, "Magna Graecia" University of Catanzaro, Italy
| | - Giorgio Settimo Barreca
- Department of Health Sciences, Microbiology and Virology Unit, "Magna Graecia" University of Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, Microbiology and Virology Unit, "Magna Graecia" University of Catanzaro, Italy
| | - Maria Carla Liberto
- Department of Health Sciences, Microbiology and Virology Unit, "Magna Graecia" University of Catanzaro, Italy
| | - Alfredo Focà
- Department of Health Sciences, Microbiology and Virology Unit, "Magna Graecia" University of Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, Microbiology and Virology Unit, "Magna Graecia" University of Catanzaro, Italy
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Fiorentino TV, Succurro E, Arturi F, Giancotti A, Peronace C, Quirino A, Sesti F, Andreozzi F, Hribal ML, Perticone F, Focà A, Sesti G. Serum IgG2 levels are specifically associated with whole-body insulin-mediated glucose disposal in non-diabetic offspring of type 2 diabetic individuals: a cross-sectional study. Sci Rep 2018; 8:13616. [PMID: 30206293 PMCID: PMC6134058 DOI: 10.1038/s41598-018-32108-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/03/2018] [Indexed: 12/13/2022] Open
Abstract
Preclinical studies suggested that IgG2c isotype may specifically impair skeletal muscle insulin sensitivity in mice. In this study we investigated the association between serum levels of the four IgG subclasses and insulin sensitivity in non-diabetic individuals. Total IgG, IgG1, IgG2, IgG3 and IgG4 levels were measured in 262 subjects. Whole-body insulin sensitivity was assessed by euglycemic hyperinsulinemic clamp. IgG2 levels were positively correlated with BMI, waist circumference, 2-h post-load glucose levels and complement C3. Serum IgG2, but not IgG1, IgG3 and IgG4 levels were negatively correlated with whole-body insulin sensitivity (r = -0.17; P = 0.003) and muscle insulin sensitivity index (r = -0.16; P = 0.03) after adjustment for age and gender. No significant correlation was found between IgG2 levels and hepatic insulin resistance assessed by HOMA-IR and liver IR index. In a multivariable regression analysis including variables known to affect insulin sensitivity such as age, gender, BMI, smoking, lipids, inflammatory markers, fasting and 2-h post-load glucose levels, IgG2 levels were independently associated with insulin-stimulated glucose disposal (β = -0.115, 95% CI: -0.541 to -0.024; P = 0.03). These data demonstrate the independent association between higher levels of IgG2 and decreased whole-body insulin sensitivity, thus confirming in humans the animal-based evidence indicating the pathogenic role of IgG2 in insulin resistance.
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Affiliation(s)
- Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy
| | - Aida Giancotti
- Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Cinzia Peronace
- Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Franz Sesti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, 00161, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy
| | - Marta Letizia Hribal
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy
| | - Alfredo Focà
- Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, 88100, Italy.
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Mazzitelli M, Lamberti AG, Quirino A, Marascio N, Barreca GS, Costa C, Pisani V, Strazzulla A, Greco G, Liberto MC, Focà A, Torti C. Utility of Molecular Identification and Quantitation of Bartonella Species with Species-Specific Real-Time PCR for Monitoring Treatment Response: A Case Series. Open Microbiol J 2018; 12:148-153. [PMID: 29997699 PMCID: PMC5997851 DOI: 10.2174/1874285801812010148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/01/2018] [Accepted: 05/05/2018] [Indexed: 11/22/2022] Open
Abstract
Background: Bartonella species are intracellular bacteria capable of producing several diseases in humans. The three most common and wellknown diseases are cat scratch disease (CSD), caused by B. henselae, trench fever, caused by B. quintana and Carrion’s Disease, caused by B. bacilliformis. Signs and symptoms are very different and aspecific: Fatigue, fever, headache, lymphadenopathy, malaise, loss of weight. No data exist to support guidelines’ recommendations to decide which drugs should be optimally used and how long they should be administered. Therefore, a marker of treatment response is needed to guide treatment strategies. Methods: We report herein three cases in which a species specific Reverse-Transcriptase Polymerase-Chain-Reaction (RT PCR) developed in-house was performed and compared to serology in order to make diagnosis and to evaluate treatment response. Results: Our species-specific RT PCR seemed to play a fundamental role both in diagnosis and treatment. Moreover, a discrepancy with the serology results was found. Conclusion: Further studies are necessary to validate these results and elucidate what is the best treatment for this pleomorphic disease. However, in absence of clear guidelines, RT PCR may be useful to orientate kind of treatment ad its duration.
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Affiliation(s)
- Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Angelo G Lamberti
- Institute of Microbiology, Department of Health Sciences, "Magna Græcia" University, Viale Europa, 88100, Catanzaro, Italy
| | - Angela Quirino
- Institute of Microbiology, Department of Health Sciences, "Magna Græcia" University, Viale Europa, 88100, Catanzaro, Italy
| | - Nadia Marascio
- Institute of Microbiology, Department of Health Sciences, "Magna Græcia" University, Viale Europa, 88100, Catanzaro, Italy
| | - Giorgio S Barreca
- Institute of Microbiology, Department of Health Sciences, "Magna Græcia" University, Viale Europa, 88100, Catanzaro, Italy
| | - Chiara Costa
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Vincenzo Pisani
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Alessio Strazzulla
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Giuseppe Greco
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Maria C Liberto
- Institute of Microbiology, Department of Health Sciences, "Magna Græcia" University, Viale Europa, 88100, Catanzaro, Italy
| | - Alfredo Focà
- Institute of Microbiology, Department of Health Sciences, "Magna Græcia" University, Viale Europa, 88100, Catanzaro, Italy
| | - Carlo Torti
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
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50
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Varano M, Gaspari M, Quirino A, Cuda G, Liberto MC, Focà A. Temperature-dependent regulation of the Ochrobactrum anthropi proteome. Proteomics 2017; 16:3019-3024. [PMID: 27753207 DOI: 10.1002/pmic.201600048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 09/13/2016] [Accepted: 10/12/2016] [Indexed: 02/05/2023]
Abstract
Ochrobactrum anthropi is a Gram-negative rod belonging to the Brucellaceae family, able to colonize a variety of environments, and actually reported as a human opportunistic pathogen. Despite its low virulence, the bacterium causes a growing number of hospital-acquired infections mainly, but not exclusively, in immunocompromised patients. The aim of this study was to obtain an overview of the global proteome changes occurring in O. anthropi in response to different growth temperatures, in order to achieve a major understanding of the mechanisms by which the bacterium adapts to different habitats and to identify some potential virulence factors. Combined quantitative mass spectrometry-based proteomics and bioinformatics approaches were carried out on two O. anthropi strains grown at temperatures miming soil/plants habitat (25°C) and human host environment (37°C), respectively. Proteomic analysis led to the identification of over 150 differentially expressed proteins in both strains, out of over 1200 total protein identifications. Among them, proteins responsible for heat shock response (DnaK, GrpE), motility (FliC, FlgG, FlgE), and putative virulence factors (TolB) were identified. The study represents the first quantitative proteomic analysis of O. anthropi performed by high-resolution quantitative mass spectrometry.
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Affiliation(s)
- Mariaconcetta Varano
- Institute of Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.,Laboratory Proteomics@UMG, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Marco Gaspari
- Laboratory Proteomics@UMG, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Angela Quirino
- Institute of Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Giovanni Cuda
- Laboratory Proteomics@UMG, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Maria Carla Liberto
- Institute of Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Alfredo Focà
- Institute of Microbiology, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
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