In Vitro Activity of Isavuconazole and Amphotericin B in Association against Mucorales

Mucormycoses can be treated with the combination of Amphotericin B and Isavuconazole. This study evaluates the effects of these drugs in vitro against 59 strains representing 12 Mucorales. In vitro testing of the two drugs together and alone was performed using the MIC Test strip "Epsilon test synergy-method" (ETSM), which is more standard in clinical practice than microbroth dilution testing. Amphotericin B and Isavuconazole have synergistic/additive effects against L. corymbifera, R. arrhizus and M. circinelloides. Different effects have been shown for other Mucorales. ETSM can help the clinical management of mucormycosis from a practical point of view, due to its feasibility in the laboratory.

Evaluation of antiseptic disinfectant activity with static light scattering technology

Background and aims. Healthcare-associated infections (HAI) are an increasingly important issue, for this reason disinfection and antisepsis practices acquire importance. The use of products with antiseptic activity and reports of resistance to these molecules, pose the need to test, in the local area, the sensitivity pattern. The aim of this study is to verify the ability of the analytical system Alfred 60AST (Alifax Spa Isola dell’Abbà, Polverara - PD - Italy) in evaluating the antimicrobial effectiveness in vitro of different molecules in comparison to the membrane filtration reference method, in accordance with the procedure NF T72- 152 proposed by the Association Française de Normalisation (AFNOR). Materials and Methods. We used four antiseptic-disinfectant substances, commonly used in hospital practic: Iodopovidone, Ethanol, Chlorhexidine and DECS. ATCC strains were assessed both with clinical isolates. The eventual development occurs by means of microbial ALFRED AST60 was carried out in progressive times (30, 60 and 120 minutes) with different dilutions for each of the disinfectant molecules tested. Results and Conclusions. Comparison tests carried out between membrane filtration method and instrumentation Alfred 60AST gave results almost totally concordant. The analyzer Alfred 60AST can then be appropriately adapted to the in vitro evaluation of antiseptics, representing a valuable aid in the periodic monitoring of their activities and the prior assessment of sensitivity for therapeutic use. Though preliminary, the study confirms the existence of bacteria resistant to alcohols and biguanides, and it emphasizes the opportunity to verify the in vitro sensitivity profile.

Innovative textile technology with antimicrobial activity: preliminary tests

The prevalence of urinary tract infections (UTI) and antibiotic resistance prompts researchers to develop strategies for bacterial containment, such as antiseptic-active textiles. We verified the in vitro antimicrobial effect of innovative Nexus Energy Fiber compared to conventional cotton fabrics. The analytical procedure is performed in accordance with ASTM E-2180-07 document. Tests are realized both against clinical and reference UTI-responsible microorganisms by comparing CFUs declines on the two textiles, at different contact times (0, 6, 24, 48 hours) and at different distances between the fabrics and the microbial strains (0, 0.5-1 cm). Results show that Nexus Energy Fiber has a measurable bactericidal effect which depends on the distances and is directly proportional to the contact time on most of the tested microbial strains.

Rapid detection of cryptococcal antigen by a flow assay

Cryptococcosis is a life-threatening infection caused by <em>Cryptococcus neoformans</em> and <em>C.</em> <em>gattii</em>. Tests for quick detection of the cryptococcal antigen are needed. This study compares the performance of a lateral flow assay (LFA) to the latex agglutination method. Thirty-five cryopreserved positive samples (sera and cerebrospinal fluids) plus three negative sera for control have been examined. LFA does not need high-temperature incubation or enzyme pre-treatment. All the results, except for one serum, agree with previous obtained with latex agglutination method. LFA has an important clinical utility for its rapidity and sensitivity, and it also can be used as a point-of-care test.

Rapid Diagnosis of Mycobacterium genavense Disseminated Infection by the Microseq 500: A Case Report in A Two Year Old HIV-Negative Child

This paper evaluates the capability of MicroSeq 500 instrument to improve the diagnosis of Mycobacterium genavense The strain was isolated from a two year old child admitted to our hospital for hepatosplenomegaly and massive abdominal lymphadenopathies. DNA was extracted from a lymph node and examined by amplifying 500 bp at the 5' end of 16S rRNA gene using MicroSeq 500 16S rDNA Bacterial Identification PCR kit. Sequencing reactions were performed with MicroSeq 500 16S rDNA Bacterial Identification Sequencing kit (Applied Biosystems, USA). Afterwards, sequences were analyzed by GenBank database and identified as Mycobacterium genavense, a slow-growing nontuberculous mycobacterium. The use of 16S rRNA gene sequencing for the identification of bacteria allows the recognition of new clinically relevant agents, eliminating the culture result waiting times.

[A case of neonatal extracorporeal membrane oxygenation after heart surgery]

There is international experience of Extracorporeal Membrane Oxygenation (ECMO) in children suffering acute Respiratory failure (eg. meconium aspiration syndrome); on the contrary there is a lack of consistent experience in pediatric ECMO application in cardiac surgery as bridge to cardiac transplantation and as heart mechanical support after postcardiotomy failure. In fact there are good standardization criteria for selection, inclusion and exclusion in ECMO application for neonatal respiratory failure; differently pediatric ECMO timing (that is when to start and to stop this ventricular support) is not clear and standardized. We present one case of pediatric ECMO application in a neonate, who underwent cardiac operation for pulmonary valve aplasia and who was impossible to wean from cardiopulmonary bypass.

[A case of double valve substitution in a female patient carrier of a factor X deficiency]

We present the clinical case of a patient affected by mitral and aortic valvular disease submitted to double valvular replacement. This patient was also affected by congenital deficiency of factor X. We describe the normal problems encountered in cardiac surgery and the specific implications of this clinical case.

[Gorlin-Goltz syndrome. Observation of a case]

A young girl (16 years old) came to our attention because she needed dental surgery for multiple cysts; she was affected by Gorlin-Goltz syndrome and by a partial deficit of clotting factor V. This syndrome is characterized by many alterations, some of which can interfere with a normal conduct of anesthesia, especially at intubation (prognathism, kyphoscoliosis, incomplete segmentation of cervical-thoracic vertebrae). Moreover this patient was heterozygote for factor V (it was reduced to 48%), so that she had some clotting alteration. We present therefore this case and the treatment undertaken.