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Gavaruzzi F, Chinello P, Cucinotta G, Oliva G, Capone A, Granata G, Al Moghazi S, Caraffa E, Taglietti F. Streptococcus intermedius Brain Abscess with Lung Abscess and Aortic Valve Endocarditis: A Case Report and Literature Review. Infect Dis Rep 2023; 15:445-453. [PMID: 37623049 PMCID: PMC10454062 DOI: 10.3390/idr15040045] [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: 06/04/2023] [Revised: 06/21/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Streptococcus intermedius is frequently associated with brain and liver abscesses, while pleuropulmonary infections are considered rarer. Even less frequent is the association of lung and brain abscesses due to this agent with infective endocarditis. We describe the case of a 40-year-old man complaining of cough, fever, and headache who was diagnosed with a brain abscess due to S. intermedius, a concomitant lung abscess, and aortic native valve endocarditis. He was treated with surgical drainage of the brain abscess and a 4-week course of intravenous ceftriaxone, followed by oral amoxicillin/clavulanate, obtaining healing of the lesions without relapse of the infection.
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Affiliation(s)
| | - Pierangelo Chinello
- National Institute for Infectious Diseases “L. Spallanzani”, 00149 Rome, Italy
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Cogliati Dezza F, Covino S, Petrucci F, Sacco F, Viscido A, Gavaruzzi F, Ceccarelli G, Raponi G, Borrazzo C, Alessandri F, Mastroianni CM, Venditti M, Oliva A. Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization. JAC Antimicrob Resist 2023; 5:dlad096. [PMID: 37577156 PMCID: PMC10412853 DOI: 10.1093/jacamr/dlad096] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/21/2023] [Indexed: 08/15/2023] Open
Abstract
Background Among MDR bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) is a major concern due to the limited therapeutic options. During the COVID-19 pandemic, a worrying increase in the spread of CRAB infections was reported. Objectives The study assessed the risk factors for CRAB bloodstream infection (BSI) in patients admitted to the ICU with CRAB colonization, and the related mortality risk factors. Methods We conducted a single-centre, observational, prospective study; all consecutive patients with CRAB colonization admitted to the ICU of a tertiary hospital in Rome from January 2021 to September 2022 were included in the study. Univariate and multivariate analyses were performed to investigate BSI and mortality risk factors. Results Overall, 129 patients were included in the study; 57 (44%) out of these developed BSI. In our study population, at the multivariable analysis the Charlson comorbidity index (CCI) (P = 0.026), COVID-19 (P < 0.001), multisite colonization (P = 0.016) and the need for mechanical ventilation (P = 0.024) were risk factors independently associated with BSI development. Furthermore, age (P = 0.026), CCI (P < 0.001), septic shock (P = 0.001) and Pitt score (P < 0.001) were independently associated with mortality in the BSI patients. Instead, early appropriate therapy (P = 0.002) and clinical improvement within 72 h (P = 0.011) were shown to be protective factors. Conclusions In critically ill patients colonized by CRAB, higher CCI, multisite colonization and the need for mechanical ventilation were identified as risk factors for BSI onset. These predictors could be useful to identify patients at highest risk of BSI.
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Affiliation(s)
| | - Sara Covino
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Flavia Petrucci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Federica Sacco
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Agnese Viscido
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesca Gavaruzzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Gianmarco Raponi
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Cristian Borrazzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Francesco Alessandri
- Department of General and Specialistic Surgery, Sapienza University of Rome, Rome, Italy
| | | | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Ceci FM, Ferraguti G, Lucarelli M, Angeloni A, Bonci E, Petrella C, Francati S, Barbato C, Di Certo MG, Gabanella F, Gavaruzzi F, Mastroianni CM, Minni A, Greco A, Ralli M, Ceccanti M, Tarani L, Fiore M. Investigating Biomarkers for COVID-19 Morbidity and Mortality. Curr Top Med Chem 2023:CTMC-EPUB-129692. [PMID: 36815637 DOI: 10.2174/1568026623666230222094517] [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: 08/07/2022] [Revised: 11/29/2022] [Accepted: 12/16/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND AND OBJECTIVE This retrospective study aims to disclose further early parameters of COVID-19 morbidity and mortality. METHODS Three hundred and eighty-two COVID-19 patients, recruited between March and April 2020, were divided into three groups according to their outcome: (1) hospital ward group (patients who entered the hospital wards and survived); (2) intensive care unit (ICU) group (patients who attended the ICU and survived); (3) the deceased group (patients admitted to ICU with a fatal outcome). We investigated routine laboratory parameters such as albumin, glycemia, hemoglobin amylase, lipase, AST, ALT, GGT, LDH, CK, MGB, TnT-hs, IL-6, ferritin, CRP, PCT, WBC, RBC, PLT, PT, INR, APTT, FBG, and D-dimer. Blood withdrawal was carried out at the beginning of the hospitalization period. RESULTS ANOVA and ROC data evidenced that the concomitant presence of alterations in albumin, lipase, AST, ALT, LDH, MGB, CK, IL-6, ferritin in women, CRP and D-dimer is an early sign of fatal outcomes. CONCLUSION The present study confirms and extends the validity of routine laboratory biomarkers (i.e., lipase, AST, ALT, LDH, CK, IL-6, ferritin in women, CRP and D-dimer) as indicators of COVID-19 morbidity and mortality. Furthermore, the investigation suggests that both gross changes in albumin and MGB, markers of liver and heart damage, may early disclose COVID-19 fatal outcomes.
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Affiliation(s)
- Flavio Maria Ceci
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giampiero Ferraguti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Marco Lucarelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonio Angeloni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Enea Bonci
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Rome, Italy
| | - Silvia Francati
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | | | | | | | - Francesca Gavaruzzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | - Antonio Minni
- Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Massimo Ralli
- Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Mauro Ceccanti
- Società Italiana per il Trattamento dell'Alcolismo e le sue Complicanze (SITAC), Rome, Italy
| | - Luigi Tarani
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Rome, Italy
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Chinello P, Gavaruzzi F, Epifani AC, Taglietti F. Giant cell arteritis after COVID-19 vaccination/disease: suggestions for further shots? Vascular 2022:17085381221140161. [PMID: 36395736 PMCID: PMC9679323 DOI: 10.1177/17085381221140161] [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: 11/18/2022]
Affiliation(s)
- Pierangelo Chinello
- 2nd Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani”, Rome, Italy
| | - Francesca Gavaruzzi
- 2nd Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani”, Rome, Italy
| | - Anna Chiara Epifani
- 2nd Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani”, Rome, Italy
| | - Fabrizio Taglietti
- 2nd Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani”, Rome, Italy
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Oliva A, Curtolo A, Volpicelli L, Cancelli F, Borrazzo C, Cogliati Dezza F, Marcelli G, Gavaruzzi F, Di Bari S, Ricci P, Turriziani O, Mastroianni CM, Venditti M. Correction: Clinical course of Coronavirus Disease-19 in patients with haematological malignancies is characterized by a longer time to respiratory deterioration compared to non-haematological ones: results from a case-control study. Infection 2022; 50:1383. [PMID: 35900672 PMCID: PMC9330932 DOI: 10.1007/s15010-022-01892-x] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy.
| | - A Curtolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - L Volpicelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - F Cancelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - C Borrazzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - F Cogliati Dezza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - G Marcelli
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - F Gavaruzzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - S Di Bari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - P Ricci
- Unit of Emergency Radiology, Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - O Turriziani
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - C M Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro, 500185, Rome, Italy
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Ceci FM, Fiore M, Gavaruzzi F, Angeloni A, Lucarelli M, Scagnolari C, Bonci E, Gabanella F, Di Certo MG, Barbato C, Petrella C, Greco A, Vincentiis MD, Ralli M, Passananti C, Poscia R, Minni A, Ceccanti M, Tarani L, Ferraguti G. Early Routine Biomarkers of SARS-CoV-2 Morbidity and Mortality: Outcomes from an Emergency Section. Diagnostics (Basel) 2022; 12:diagnostics12010176. [PMID: 35054342 PMCID: PMC8774587 DOI: 10.3390/diagnostics12010176] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 12/19/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 12/28/2022] Open
Abstract
Background. COVID-19 is a severe acute respiratory disease caused by SARS-CoV-2, a virus belonging to the Coronaviridae family. This disease has spread rapidly around the world and soon became an international public health emergency leading to an unpredicted pressure on the hospital emergency units. Early routine blood biomarkers could be key predicting factors of COVID-19 morbidity and mortality as suggested for C-reactive protein (CRP), IL-6, prothrombin and D-dimer. This study aims to identify other early routine blood biomarkers for COVID-19 severity prediction disclosed directly into the emergency section. Methods. Our research was conducted on 156 COVID-19 patients hospitalized at the Sapienza University Hospital “Policlinico Umberto I” of Rome, Italy, between March 2020 and April 2020 during the paroxysm’s initial phase of the pandemic. In this retrospective study, patients were divided into three groups according to their outcome: (1) emergency group (patients who entered the emergency room and were discharged shortly after because they did not show severe symptoms); (2) intensive care unit (ICU) group (patients who attended the ICU after admission to the emergency unit); (3) the deceased group (patients with a fatal outcome who attended the emergency and, afterward, the ICU units). Routine laboratory tests from medical records were collected when patients were admitted to the emergency unit. We focused on Aspartate transaminase (AST), Alanine transaminase (ALT), Lactate dehydrogenase (LDH), Creatine kinase (CK), Myoglobin (MGB), Ferritin, CRP, and D-dimer. Results. As expected, ANOVA data show an age morbidity increase in both ICU and deceased groups compared with the emergency group. A main effect of morbidity was revealed by ANOVA for all the analyzed parameters with an elevation between the emergency group and the deceased group. Furthermore, a significant increase in LDH, Ferritin, CRP, and D-dimer was also observed between the ICU group and the emergency group and between the deceased group and ICU group. Receiver operating characteristic (ROC) analyses confirmed and extended these findings. Conclusions. This study suggests that the contemporaneous presence of high levels of LDH, Ferritin, and as expected, CRP, and D-dimer could be considered as potential predictors of COVID-19 severity and death.
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Affiliation(s)
- Flavio Maria Ceci
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy; (F.M.C.); (A.A.); (M.L.); (E.B.); (G.F.)
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy; (F.G.); (M.G.D.C.); (C.B.); (C.P.)
- Correspondence:
| | - Francesca Gavaruzzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Roma, Italy;
| | - Antonio Angeloni
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy; (F.M.C.); (A.A.); (M.L.); (E.B.); (G.F.)
| | - Marco Lucarelli
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy; (F.M.C.); (A.A.); (M.L.); (E.B.); (G.F.)
| | - Carolina Scagnolari
- Laboratory of Virology, Department of Molecular Medicine, Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Sapienza University of Rome, 00185 Roma, Italy;
| | - Enea Bonci
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy; (F.M.C.); (A.A.); (M.L.); (E.B.); (G.F.)
| | - Francesca Gabanella
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy; (F.G.); (M.G.D.C.); (C.B.); (C.P.)
| | - Maria Grazia Di Certo
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy; (F.G.); (M.G.D.C.); (C.B.); (C.P.)
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy; (F.G.); (M.G.D.C.); (C.B.); (C.P.)
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy; (F.G.); (M.G.D.C.); (C.B.); (C.P.)
| | - Antonio Greco
- Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy; (A.G.); (M.D.V.); (M.R.); (A.M.)
| | - Marco De Vincentiis
- Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy; (A.G.); (M.D.V.); (M.R.); (A.M.)
| | - Massimo Ralli
- Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy; (A.G.); (M.D.V.); (M.R.); (A.M.)
| | - Claudio Passananti
- Institute of Molecular Biology and Pathology (IBPM-CNR), 00185 Rome, Italy;
| | - Roberto Poscia
- Unita di Ricerca Clinica e Clinical Competence-Direzione Generale, AOU Policlinico Umberto I, 00161 Roma, Italy;
| | - Antonio Minni
- Department of Sensory Organs, Sapienza University of Rome, 00185 Roma, Italy; (A.G.); (M.D.V.); (M.R.); (A.M.)
| | - Mauro Ceccanti
- Società Italiana per il Trattamento dell’Alcolismo e le sue Complicanze (SITAC), 00184 Roma, Italy;
| | - Luigi Tarani
- Department of Pediatrics, Sapienza University of Rome, 00185 Roma, Italy;
| | - Giampiero Ferraguti
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy; (F.M.C.); (A.A.); (M.L.); (E.B.); (G.F.)
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Di Bari S, Gavaruzzi F, De Meo D, Cera G, Raponi G, Ceccarelli G, Villani C. Candida parapsilosis osteomyelitis following dog bite: a case report and review of the literature. J Mycol Med 2021; 32:101208. [PMID: 34758425 DOI: 10.1016/j.mycmed.2021.101208] [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: 05/21/2021] [Revised: 08/28/2021] [Accepted: 10/04/2021] [Indexed: 11/27/2022]
Abstract
Candida osteomyelitis is uncommon, especially after dog bites. We describe a case of a 63-year-old man without significant comorbidities presenting progressing swelling of the distal interphalangeal joint (DIJ) of right index finger following a dog bite. Despite empiric antibiotic therapy and local medications, there were no clinical signs of improvement. Clinical examination revealed fistula with purulent drainage on the volar region. Even though laboratory data showed inflammatory markers on range, magnetic resonance imaging (MRI) demonstrated signs of osteomyelitis. The patient was taken to exploration and debridement of the bite wound. Culture of the bone biopsy showed growth of Candida parapsilosis. Therefore, the patient was diagnosed with isolated fungal osteomyelitis and was initiated on fluconazole therapy. The treatment was effective and all symptoms were resolved in 8 weeks after the surgery. There were no signs of recurrence after 20 months of follow-up. The patient had no cosmetic abnormalities or sequelae. Concurrently with the description of the case report a review of the literature was provided. According to the authors, there are three main etiopathogenesis for this infection. The first pathogenic mechanism is direct inoculation into the deep tissues through the dog bite. The second hypothesis is direct translocation of the pathogen from the skin to the deep tissue and to the bone. The last mode of transmission is hematogenous dissemination. Fungal osteomyelitis are really rare conditions, especially after dog bites, but nevertheless it should be considered as a possible diagnosis when there is no response to antibiotics.
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Affiliation(s)
- Silvia Di Bari
- Department of Public Health and Infectious Diseases "Sapienza", University of Rome, Viale del Policlinico 155, Rome, Italy; M.I.T.O. Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I, University Hospital, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Francesca Gavaruzzi
- Department of Public Health and Infectious Diseases "Sapienza", University of Rome, Viale del Policlinico 155, Rome, Italy; M.I.T.O. Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I, University Hospital, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Daniele De Meo
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, University of Rome, Viale del Policlinico 155, Rome, Italy; M.I.T.O. Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I, University Hospital, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Gianluca Cera
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, University of Rome, Viale del Policlinico 155, Rome, Italy; M.I.T.O. Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I, University Hospital, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases "Sapienza", University of Rome, Viale del Policlinico 155, Rome, Italy; M.I.T.O. Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I, University Hospital, Viale del Policlinico, 155, 00161 Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases "Sapienza", University of Rome, Viale del Policlinico 155, Rome, Italy; M.I.T.O. Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I, University Hospital, Viale del Policlinico, 155, 00161 Rome, Italy.
| | - Ciro Villani
- Department of Anatomical, Histological, Forensic Medicine and Orthopaedic Science, University of Rome, Viale del Policlinico 155, Rome, Italy; M.I.T.O. Group (Infectious Diseases in Traumatology and Orthopedics Surgery), Policlinico Umberto I, University Hospital, Viale del Policlinico, 155, 00161 Rome, Italy
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