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Buonomo AR, Viceconte G, Fusco L, Sarno M, di Filippo I, Fanasca L, Salvatore P, Gentile I. Prevalence of Pneumocystis jirovecii Colonization in Non-Critical Immunocompetent COVID-19 Patients: A Single-Center Prospective Study (JiroCOVID Study). Microorganisms 2023; 11:2839. [PMID: 38137983 PMCID: PMC10745747 DOI: 10.3390/microorganisms11122839] [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: 11/02/2023] [Revised: 11/09/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Pneumocystis jirovecii pneumonia (PJP) is an invasive fungal infection (IFI) that occurs mainly in immunocompromised hosts. After observing a high prevalence of PJP as a complication of COVID-19 in immunocompetent patients, we conducted a study to evaluate the prevalence of P. jirovecii colonization with PCR on oral washing samples (OWS) among non-immunocompromised and non-critical patients admitted with COVID-19 pneumonia at our university hospital. METHODS All patients over 18 years of age admitted to the Infectious Diseases Unit for SARS-CoV-2 pneumonia between July 2021 and December 2022 were included. Patients undergoing invasive mechanical ventilation or ECMO, those with risk factors for developing PJP, and those receiving prophylaxis for P. jirovecii were excluded. Samples were collected by gargling with 10 mL of 0.9% NaCl on day 14 of the hospital stay or at discharge. RESULTS Of 290 screened patients, 59 (20%) met the inclusion criteria and were enrolled. Only 1 of 59 patients (1.7%) tested positive for P. jirovecii detection with PCR, and the same patient was the only one to develop PJP in the follow-up period. CONCLUSIONS Our results are in line with the previous findings of other studies that confirmed a very low prevalence of P. jirovecii colonization on OWS in the immunocompetent population. Despite the limitations of the study, the fact that the only patient who tested positive for P. jirovecii was the only one in our cohort to develop PJP leads us to reflect on the role of this non-invasive sample in predicting the risk of PJP in patients with COVID-19.
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Affiliation(s)
- Antonio Riccardo Buonomo
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (L.F.); (M.S.); (I.d.F.); (I.G.)
| | - Giulio Viceconte
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (L.F.); (M.S.); (I.d.F.); (I.G.)
| | - Ludovica Fusco
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (L.F.); (M.S.); (I.d.F.); (I.G.)
| | - Marina Sarno
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (L.F.); (M.S.); (I.d.F.); (I.G.)
| | - Isabella di Filippo
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (L.F.); (M.S.); (I.d.F.); (I.G.)
| | - Luca Fanasca
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, 8031 Naples, Italy; (L.F.); (P.S.)
| | - Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, 8031 Naples, Italy; (L.F.); (P.S.)
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (L.F.); (M.S.); (I.d.F.); (I.G.)
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Viceconte G, Buonomo AR, D’Agostino A, Foggia M, Di Fusco A, Pinchera B, Scotto R, Iacovazzo C, Fanasca L, Messina G, Cacciatore F, Salvatore P, Gentile I. Risk Factors for Pneumocystis jirovecii Pneumonia in Non-HIV Patients Hospitalized for COVID-19: A Case-Control Study. J Fungi (Basel) 2023; 9:838. [PMID: 37623609 PMCID: PMC10455879 DOI: 10.3390/jof9080838] [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: 07/08/2023] [Revised: 07/30/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Very few cases of Pneumocystis jirovecii pneumonia (PJP) have been reported in COVID-19 so far, and mostly in patients with concomitant HIV infection or in solid-organ transplant recipients. Despite COVID-19 being associated with lymphopenia and the use of steroids, there are no studies specifically aimed at investigating the risk factors for PJP in COVID-19. METHODS A retrospective case-control study was performed. We matched PJP cases with controls with a 1:2 ratio, based on age ± 10 years, solid-organ transplantation (SOT), hematological malignancies, and in the setting of PJP development (ICU vs. non-ICU). A direct immunofluorescence assay on bronchoalveolar lavage fluid was used to diagnose PJP. RESULTS We enrolled 54 patients. Among 18 cases of PJP, 16 were diagnosed as "proven". Seven of the eighteen cases were immunocompromised, while the other patients had no previous immunological impairment. Patients with PJP had significantly lower median lymphocyte values (p = 0.033), longer COVID-19 duration (p = 0.014), a higher dose of steroid received (p = 0.026), higher CRP values (p = 0.005), and a lower SARS-CoV-2 vaccination rate than the controls (p = 0.029). Cumulative steroid dose is the independent risk factor for PJP development (OR = 1.004, 95%CI = 1-1.008, p = 0.042). CONCLUSIONS PJP develops in COVID-19 patients regardless of immunosuppressive conditions and the severity of disease, and it is correlated to the corticosteroid dose received.
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Affiliation(s)
- Giulio Viceconte
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Antonio Riccardo Buonomo
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Alessia D’Agostino
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Maria Foggia
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Antonio Di Fusco
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Biagio Pinchera
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Riccardo Scotto
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Carmine Iacovazzo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy;
| | - Luca Fanasca
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, 8031 Naples, Italy; (L.F.); (P.S.)
| | - Gaetana Messina
- Thoracic Surgery Unit, University of Campania “Luigi Vanvitelli”, Via Sergio Pansini n.5, 8031 Naples, Italy;
| | - Francesco Cacciatore
- Department of Translational Medical Sciences, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy;
| | - Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, 8031 Naples, Italy; (L.F.); (P.S.)
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
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Scaglione E, Mantova G, Caturano V, Fanasca L, Carraturo F, Farina F, Pagliarulo C, Vitiello M, Pagliuca C, Salvatore P, Colicchio R. Molecular Epidemiology of Genital Infections in Campania Region: A Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12081798. [PMID: 35892509 PMCID: PMC9394247 DOI: 10.3390/diagnostics12081798] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
This study provides updated information on the prevalence and co-infections caused by genital microorganisms and pathogens: Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, Ureaplasma urealyticum, Trichomonas vaginalis, and Gardnerella vaginalis, by retrospectively analyzing a cohort of patients living in the Naples metropolitan area, Campania region, Southern Italy. To investigate the genital infections prevalence in clinical specimens (vaginal/endocervical swabs and urines) collected from infertile asymptomatic women and men from November 2018 to December 2020, we used a multiplex real-time PCR assay. Of the 717 specimens collected, 302 (42.1%) resulted positive for at least one of the targets named above. Statistically significant differences in genital prevalence of selected microorganisms were detected in both women (62.91%) and men (37.08%). G. vaginalis and U. parvum represented the most common findings with an 80.2% and 16.9% prevalence in vaginal/endocervical swabs and first-voided urines, respectively. Prevalence of multiple infections was 18.18% and 8.19% in women and men, respectively. The most frequent association detected was the co-infection of G. vaginalis and U. parvum with 60% prevalence. Our epidemiological analysis suggests different infection patterns between genders, highlighting the need to implement a preventative screening strategy of genital infections to reduce the complications on reproductive organs.
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Affiliation(s)
- Elena Scaglione
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
- Department of Chemical, Materials and Production Engineering, University of Napoli Federico II, Piazzale V. Tecchio 80, 80125 Naples, Italy
| | - Giuseppe Mantova
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Valeria Caturano
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Luca Fanasca
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Francesca Carraturo
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Fabrizio Farina
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Piazza Arechi II, 82100 Benevento, Italy;
| | - Caterina Pagliarulo
- Department of Science and Technology, University of Sannio, Via De Sanctis, 82100 Benevento, Italy;
| | - Mariateresa Vitiello
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Chiara Pagliuca
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
| | - Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
- CEINGE Biotecnologie Avanzate s.c.ar.l., Via Gaetano Salvatore 486, 80145 Naples, Italy
- Correspondence: (P.S.); (R.C.)
| | - Roberta Colicchio
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy; (E.S.); (G.M.); (V.C.); (L.F.); (F.C.); (M.V.); (C.P.)
- Correspondence: (P.S.); (R.C.)
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Pagano S, Negri P, Coniglio M, Bruscoli S, Di Michele A, Marchetti MC, Valenti C, Gambelunghe A, Fanasca L, Billi M, Cianetti S, Marinucci L. Heat-not-burn tobacco (IQOS), oral fibroblasts and keratinocytes: cytotoxicity, morphological analysis, apoptosis and cellular cycle. An in vitro study. J Periodontal Res 2021; 56:917-928. [PMID: 34018192 PMCID: PMC8518503 DOI: 10.1111/jre.12888] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/15/2021] [Accepted: 04/25/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVES The aim of this work is to investigate the biological effects of IQOS smoking on human gingival fibroblasts and human keratinocytes analysing cell viability, morphology, migration, apoptosis and cell cycle. BACKGROUND Electronic cigarettes and tobacco heating systems have been marketed to reduce smoking damages caused by combustion. METHODS Human gingival fibroblasts and human keratinocytes viability was determined by a colorimetric assay measuring mitochondrial dehydrogenase activity (MTT assay); after an in vitro exposure of 24 h, cell morphology was analysed with scanning electron microscope and cell migration was tested by Scratch assay, a method to mimic the migration of the cells during wound healing in vivo. Apoptosis and cell cycle were analysed with flow cytometry, and the expression of related genes (p53, Bcl2, p16 and p21) was indagated using real-time polymerase chain reaction. RESULTS IQOS extracts increased both cell viability (23%-41% with fibroblasts and 30%-79% with keratinocytes) and migration. No morphological alterations were observed. IQOS extracts did not induced an increase in cell death, but rose the number of S- and G2/M-phase cells. IQOS extracts also significantly increased p53 expression by fibroblasts (undiluted and 6.25% dilution, 2- and 3.6-fold higher, respectively) and reduced both Bcl2 (about two- and fivefold, respectively) and p21 expressions (about twofold with both extracts), while on keratinocytes both undiluted and 6.25% dilution extracts increased Bcl2 expression (about four- and threefold higher, respectively) and reduced p53 expression (about two- and fivefold, respectively). CONCLUSION IQOS smoke seemed to induce proliferation as highlighted by a viability assay, and migration and cell cycle analysis. The increased cell proliferation induced by IQOS devices must be carefully investigated for its possible clinical effects on oral cell populations.
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Affiliation(s)
- Stefano Pagano
- Department of Medicine and SurgeryOdontostomatological University Centre: Chair Prof. Stefano CianettiUniversity of PerugiaPerugiaItaly
| | - Paolo Negri
- Department of Medicine and SurgeryOdontostomatological University Centre: Chair Prof. Stefano CianettiUniversity of PerugiaPerugiaItaly
| | - Maddalena Coniglio
- Department of Medicine and SurgeryOdontostomatological University Centre: Chair Prof. Stefano CianettiUniversity of PerugiaPerugiaItaly
| | - Stefano Bruscoli
- Department of Medicine and SurgerySection of PharmacologyUniversity of PerugiaPerugiaItaly
| | | | | | - Chiara Valenti
- Department of Medicine and SurgeryOdontostomatological University Centre: Chair Prof. Stefano CianettiUniversity of PerugiaPerugiaItaly
| | - Angela Gambelunghe
- Department of Medicine and SurgerySection of Occupational Medicine, Respiratory Diseases and ToxicologyUniversity of PerugiaPerugiaItaly
| | - Luca Fanasca
- Department of Molecular Medicine BiotechnologyUniversity of Naples Federico IINaplesItaly
| | - Monia Billi
- Department of Medicine and SurgerySection of General PathologyUniversity of PerugiaPerugiaItaly
| | - Stefano Cianetti
- Department of Medicine and SurgeryOdontostomatological University Centre: Chair Prof. Stefano CianettiUniversity of PerugiaPerugiaItaly
| | - Lorella Marinucci
- Department of Medicine and SurgerySection of Biosciences and Medical EmbryologyUniversity of PerugiaPerugiaItaly
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