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Mosci D, Marmo GW, Sciolino L, Zaccaro C, Antonellini R, Accogli L, Lazzarotto T, Mongardi M, Landini MP. Automatic environmental disinfection with hydrogen peroxide and silver ions versus manual environmental disinfection with sodium hypochlorite: a multicentre randomized before-and-after trial. J Hosp Infect 2017; 97:175-179. [PMID: 28610932 DOI: 10.1016/j.jhin.2017.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 03/03/2017] [Accepted: 06/06/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND New technologies for automated disinfection have been developed, including the use of hydrogen peroxide atomized by specific equipment, with associated silver compounds. AIMS To compare the effectiveness of an automated disinfection system with hydrogen peroxide <8% and silver ion versus a manual method with 0.5% sodium hypochlorite solution when evaluating the reduction of microbial mesophilic contamination and Clostridium difficile presence; and to evaluate the time required for both of these processes. METHODS This was a randomized multicentre trial performed in different hospital wards that had been occupied previously by patients with Clostridium difficile infection. When patients were discharged their rooms were randomized to one of two decontamination arms. The surfaces where sampled using swabs, before and after disinfection. Swab samples were cultured for quantitative detection of microbial mesophilic contamination and qualitative detection of C. difficile. FINDINGS Before disinfection, 13% of surfaces decontaminated with hydrogen peroxide and silver ions and 20% of surfaces decontaminated with sodium hypochlorite showed presence of C. difficile spores. After disinfection, the samples containing C. difficile were 0% (P < 0.001) in the group decontaminated with hydrogen peroxide and silver ions, and were 3% (P < 0.001) in the group decontaminated with sodium hypochlorite. This difference was not statistically significant; nor was the difference in the reduction of the microbial mesophilic contamination. CONCLUSION The differences between the groups were not statistically significant; however, the disinfection with hydrogen peroxide and silver ions is preferable due to less dependence on operators.
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Affiliation(s)
- D Mosci
- ANIPIO - Scientific Society of Infection Control Nurses, Italy
| | - G W Marmo
- ANIPIO - Scientific Society of Infection Control Nurses, Italy
| | - L Sciolino
- ANIPIO - Scientific Society of Infection Control Nurses, Italy.
| | - C Zaccaro
- Arpae-ER - Agency for Prevention, Environment and Energy of Emilia-Romagna Region, Italy
| | - R Antonellini
- Arpae-ER - Agency for Prevention, Environment and Energy of Emilia-Romagna Region, Italy
| | - L Accogli
- Arpae-ER - Agency for Prevention, Environment and Energy of Emilia-Romagna Region, Italy
| | - T Lazzarotto
- Microbiology Ward, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - M Mongardi
- ANIPIO - Scientific Society of Infection Control Nurses, Italy
| | - M P Landini
- Rizzoli Scientific Orthopedic Institute, Bologna, Italy
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2
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Pierro A, Ficarelli S, Ayhan N, Morini S, Raumer L, Bartoletti M, Mastroianni A, Prati F, Schivazappa S, Cenni P, Vocale C, Rossini G, Gaibani P, Sambri V, Landini MP, Lewis RE, Charrel RN, Varani S. Characterization of antibody response in neuroinvasive infection caused by Toscana virus. Clin Microbiol Infect 2017; 23:868-873. [PMID: 28344163 DOI: 10.1016/j.cmi.2017.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 10/10/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Among sandfly-borne pathogens, Toscana virus (TOSV) is a prominent cause of summer meningitis in Mediterranean Europe. Here, we assessed the kinetics of anti-TOSV antibodies over time in 41 patients diagnosed with TOSV meningitis or meningoencephalitis in northeastern Italy. METHODS Acute and follow-up serum samples were collected up to 20 months after diagnosis of TOSV infection and tested for the presence of specific antibody using immunoenzymatic and indirect immunofluorescence assays. In addition, maturation of anti-TOSV IgG over time was evaluated as well as production of neutralizing antibodies. RESULTS Specific IgM and IgG response was present at diagnosis in 100% of patients; TOSV-specific IgM and IgG were detected in patients' sera up to 6 and 20 months after diagnosis, respectively. The avidity index (AI) increased over the first month after infection in 100% of patients and most cases exceeded 60% by Day 30 post infection. The AI subsequently plateaued then declined at 20 months after diagnosis. Finally, neutralization assay to TOSV was performed in 217 sera collected from 41 patients; 69.6% of tested samples resulted in reactive and moderate levels of neutralizing antibodies observed during all phases of infection despite high titres of total anti-TOSV IgG. CONCLUSIONS Specific antibody response develops rapidly and is long-lasting for neuroinvasive TOSV infection. Serodiagnosis of neuroinvasive TOSV requires simultaneous detection of specific IgM and IgG. Moderate levels of neutralizing antibodies were maintained over the study period, while the protective role of antibodies lacking neutralizing activity is unclear and requires further evaluation.
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Affiliation(s)
- A Pierro
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy; Unit of Microbiology, The Romagna Hub Laboratory, Pievesestina, Italy.
| | - S Ficarelli
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - N Ayhan
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille Univ - IRD 190 - Inserm1207 - EHESP) & Fondation IHU Méditerranée Infection, APHM Public Hospitals of Marseille, Marseille, France
| | - S Morini
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - L Raumer
- Infectious Disease Unit, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - M Bartoletti
- Infectious Disease Unit, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - A Mastroianni
- Infectious Disease Unit, G.B. Morgagni-Pierantoni Hospital, Forlì, Italy
| | - F Prati
- Infectious Disease Division, Reggio Emilia Hospital, Reggio Emilia, Italy
| | - S Schivazappa
- Infectious Disease Division, Reggio Emilia Hospital, Reggio Emilia, Italy
| | - P Cenni
- Emergency Department, St. Maria della Scaletta, Imola, Italy
| | - C Vocale
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Rossini
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - P Gaibani
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - V Sambri
- Unit of Microbiology, The Romagna Hub Laboratory, Pievesestina, Italy; Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M P Landini
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - R E Lewis
- Infectious Disease Unit, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - R N Charrel
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille Univ - IRD 190 - Inserm1207 - EHESP) & Fondation IHU Méditerranée Infection, APHM Public Hospitals of Marseille, Marseille, France
| | - S Varani
- Unit of Microbiology, CRREM Laboratory, St. Orsola-Malpighi University Hospital, Bologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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3
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La Placa M, Venturoli S, Barbieri D, Nocera M, Patrizi A, Landini MP, Fanti PA, Dika E. Presence of cutaneous human papillomavirus DNA in squamous cell carcinoma of the scalp: a case series. J Eur Acad Dermatol Venereol 2017; 31:e369-e371. [PMID: 28191672 DOI: 10.1111/jdv.14168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M La Placa
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - S Venturoli
- Microbiology Unit, Department of Diagnostic Medicine and Prevention, University of Bologna, Bologna, Italy
| | - D Barbieri
- Microbiology Unit, Department of Diagnostic Medicine and Prevention, University of Bologna, Bologna, Italy
| | - M Nocera
- Microbiology Unit, Department of Diagnostic Medicine and Prevention, University of Bologna, Bologna, Italy
| | - A Patrizi
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M P Landini
- Microbiology Unit, Department of Diagnostic Medicine and Prevention, University of Bologna, Bologna, Italy
| | - P A Fanti
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - E Dika
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Wurtz N, Papa A, Hukic M, Di Caro A, Leparc-Goffart I, Leroy E, Landini MP, Sekeyova Z, Dumler JS, Bădescu D, Busquets N, Calistri A, Parolin C, Palù G, Christova I, Maurin M, La Scola B, Raoult D. Survey of laboratory-acquired infections around the world in biosafety level 3 and 4 laboratories. Eur J Clin Microbiol Infect Dis 2016; 35:1247-58. [PMID: 27234593 PMCID: PMC7088173 DOI: 10.1007/s10096-016-2657-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 04/20/2016] [Indexed: 11/27/2022]
Abstract
Laboratory-acquired infections due to a variety of bacteria, viruses, parasites, and fungi have been described over the last century, and laboratory workers are at risk of exposure to these infectious agents. However, reporting laboratory-associated infections has been largely voluntary, and there is no way to determine the real number of people involved or to know the precise risks for workers. In this study, an international survey based on volunteering was conducted in biosafety level 3 and 4 laboratories to determine the number of laboratory-acquired infections and the possible underlying causes of these contaminations. The analysis of the survey reveals that laboratory-acquired infections have been infrequent and even rare in recent years, and human errors represent a very high percentage of the cases. Today, most risks from biological hazards can be reduced through the use of appropriate procedures and techniques, containment devices and facilities, and the training of personnel.
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Affiliation(s)
- N Wurtz
- URMITE, CNRS UMR 7278, IRD 198, Inserm 1095, Aix Marseille Université, IHU Méditerranée Infection, 27 bd Jean Moulin, 13005, Marseille, France
| | - A Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Hukic
- International Burch University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Department of Medical Science, Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - A Di Caro
- National Institute for Infectious Diseases L. Spallanzani, Rome, Italy
| | - I Leparc-Goffart
- ERRIT-IRBA, HIA Laveran, Centre National de Référence des Arboviroses, 13384, Marseille, France
| | - E Leroy
- Laboratoire MiVEGEC, UMR IRD 224 CNRS 5290 UMI, 911 Av. Agropolis, 34394, Montpellier Cedex 5, France
- International Center for Medical Research of Franceville, BP769, Franceville, Gabon
| | - M P Landini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
| | - Z Sekeyova
- Institute of Virology, Slovak Academy of Sciences, Dúbravská cesta 9, 845 05, Bratislava, Slovak Republic
| | - J S Dumler
- Departments of Pathology and Microbiology & Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - D Bădescu
- Cantacuzino National Institute of Research, Bucharest, Romania
| | - N Busquets
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - A Calistri
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - C Parolin
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - G Palù
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - I Christova
- Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - M Maurin
- Centre National de Référence des Francisella, Laboratoire de Bactériologie, Département des Agents Infectieux, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire de Grenoble, Université Joseph Fourier, Grenoble, France
| | - B La Scola
- URMITE, CNRS UMR 7278, IRD 198, Inserm 1095, Aix Marseille Université, IHU Méditerranée Infection, 27 bd Jean Moulin, 13005, Marseille, France
| | - D Raoult
- URMITE, CNRS UMR 7278, IRD 198, Inserm 1095, Aix Marseille Université, IHU Méditerranée Infection, 27 bd Jean Moulin, 13005, Marseille, France.
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5
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Foschi C, Compri M, Smirnova V, Denicolò A, Nardini P, Tamburini MV, Lombardo D, Landini MP, Ambretti S. Ease-of-use protocol for the rapid detection of third-generation cephalosporin resistance in Enterobacteriaceae isolated from blood cultures using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry. J Hosp Infect 2016; 93:206-10. [PMID: 27105753 DOI: 10.1016/j.jhin.2016.02.020] [Citation(s) in RCA: 8] [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: 12/08/2015] [Accepted: 02/15/2016] [Indexed: 11/26/2022]
Abstract
An ease-of-use protocol for the identification of resistance against third-generation cephalosporins in Enterobacteriaceae isolated from blood culture bottles was evaluated using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry. A cefotaxime hydrolysis assay from chocolate agar subcultures using antibiotic discs and without inoculum standardization was developed for routine work flow, with minimal hands-on time. This assay showed good performance in distinguishing between cefotaxime-susceptible and cefotaxime-resistant strains, with excellent results for Escherichia coli (sensitivity 94.7%, specificity 100%). However, cefotaxime resistance was not detected reliably in Enterobacteriaceae expressing AmpC genes or carbapenemase-producing Klebsiella pneumoniae.
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Affiliation(s)
- C Foschi
- Unit of Microbiology, Department of Specialized, Diagnostic and Experimental Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy.
| | - M Compri
- Unit of Microbiology, Department of Specialized, Diagnostic and Experimental Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - V Smirnova
- Unit of Microbiology, Department of Specialized, Diagnostic and Experimental Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - A Denicolò
- Unit of Microbiology, Department of Specialized, Diagnostic and Experimental Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - P Nardini
- Unit of Microbiology, Department of Specialized, Diagnostic and Experimental Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M V Tamburini
- Unit of Microbiology, Department of Specialized, Diagnostic and Experimental Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - D Lombardo
- Unit of Microbiology, Department of Specialized, Diagnostic and Experimental Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M P Landini
- Unit of Microbiology, Department of Specialized, Diagnostic and Experimental Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - S Ambretti
- Unit of Microbiology, Department of Specialized, Diagnostic and Experimental Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy
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6
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Dal Monte P, Lombardi G, Di Gregori V, Martelli G, Tadolini M, Landini MP. Smear-negative, culture positive TB: diagnosis improvement by Xpert MTB/RIF assay. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Vocale C, Rimoldi SG, Pagani C, Grande R, Pedna F, Arghittu M, Lunghi G, Maraschini A, Gismondo MR, Landini MP, Torresani E, Topin F, Sambri V. Comparative evaluation of the new xTAG GPP multiplex assay in the laboratory diagnosis of acute gastroenteritis. Clinical assessment and potential application from a multicentre Italian study. Int J Infect Dis 2015; 34:33-7. [PMID: 25749649 DOI: 10.1016/j.ijid.2015.02.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/16/2015] [Accepted: 02/17/2015] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Gastroenteritis caused by a single pathogen or multiple pathogens remains a major diagnostic challenge for the laboratory. The treatment of diarrhoea is based on microbiological results. Diagnosis is achieved using different laboratory techniques that have variable sensitivity and specificity. xTAG GPP is a new multiplex PCR assay that simultaneously detects 15 different pathogens responsible for diarrhoea. The results of the first multicentre study in Italy to evaluate the potential clinical application of the GPP assay in the laboratory diagnosis of diarrhoea are reported here. METHODS Faeces specimens (N=664) from hospitalized patients were tested with the GPP assay using a Luminex 200 instrument. All specimens were run using comparator methods following a routine algorithm: culture for bacteria, enzyme immunoassay and PCR for viruses, and microscopy for parasites. RESULTS Of the samples tested with the GPP, 53.61% (356/664) gave positive results, as compared to 45.33% by routine testing. Of the positive specimens, 34.55% showed the presence of genomic DNA from multiple pathogens. The Luminex method showed an increase in the percentage of positivity of 8.28%. CONCLUSIONS The GPP assay can be considered a helpful tool for the detection of gastrointestinal pathogens, with a hands-on time of 5h; it provides accurate data for the clinical management of hospitalized patients and for epidemiological surveillance.
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Affiliation(s)
- C Vocale
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, St. Orsola Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy.
| | - S G Rimoldi
- Laboratory of Clinical Microbiology, Virology and Bioemergency, "L. Sacco" University Hospital, Milan, Italy
| | - C Pagani
- Laboratory of Clinical Microbiology, Virology and Bioemergency, "L. Sacco" University Hospital, Milan, Italy
| | - R Grande
- Laboratory of Clinical Microbiology, Virology and Bioemergency, "L. Sacco" University Hospital, Milan, Italy
| | - F Pedna
- Unit of Clinical Microbiology, The Hub Laboratory of the Greater Romagna Area, Pievesestina, Cesena, Italy
| | - M Arghittu
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - G Lunghi
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Maraschini
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - M R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergency, "L. Sacco" University Hospital, Milan, Italy
| | - M P Landini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, St. Orsola Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy; DIMES, University of Bologna, Bologna, Italy
| | - E Torresani
- Department of Clinical Chemistry and Microbiology, Bacteriology and Virology Units, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - F Topin
- Luminex Corporation, Oosterhout NB, Netherlands
| | - V Sambri
- Unit of Clinical Microbiology, The Hub Laboratory of the Greater Romagna Area, Pievesestina, Cesena, Italy; DIMES, University of Bologna, Bologna, Italy
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8
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Calzolari M, Angelini P, Finarelli AC, Cagarelli R, Bellini R, Albieri A, Bonilauri P, Cavrini F, Tamba M, Dottori M, Gaibani P, Natalini S, Maioli G, Pinna M, Mattivi A, Sambri V, Pierro A, Landini MP, Rossini G, Squintani G, Cinotti S, Varani S, Vocale C, Bedeschi E. Human and entomological surveillance of Toscana virus in the Emilia-Romagna region, Italy, 2010 to 2012. Euro Surveill 2014; 19:20978. [DOI: 10.2807/1560-7917.es2014.19.48.20978] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Toscana virus (TOSV), transmitted by phlebotomine sandflies, is recognised as one of the most important causes of viral meningitis in summer in Mediterranean countries. A surveillance plan based on both human and entomological surveys was started in 2010 in the Emilia-Romagna region, Italy. Clinical samples from patients with neurological manifestations were collected during 2010 to 2012. The surveillance protocol was improved during these years, allowing the detection of 65 human infections. Most of these infections were recorded in hilly areas, where sandflies reach the highest density. Entomological sampling around the homes of the patients resulted in a low number of captured sandflies, while later sampling in a hilly area with high number of human cases (n=21) resulted in a larger number of captured sandflies. Using this approach, 25,653 sandflies were sampled, of which there were 21,157 females, which were sorted into 287 pools. TOSV RNA was detected by real-time PCR in 33 of the pools. The results highlighted the role of Phlebotomus perfiliewi as the main vector of TOSV and a potential link between vector density and virus circulation. This integrated system shows that an interdisciplinary approach improves the sensitiveness and effectiveness of health surveillance.
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Affiliation(s)
- M Calzolari
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - P Angelini
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - A C Finarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - R Cagarelli
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - R Bellini
- Centro Agricoltura Ambiente ‘G Nicoli’, Crevalcore, Italy
| | - A Albieri
- Centro Agricoltura Ambiente ‘G Nicoli’, Crevalcore, Italy
| | - P Bonilauri
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - F Cavrini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M Tamba
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - M Dottori
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - P Gaibani
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - S Natalini
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - G Maioli
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - M Pinna
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - A Mattivi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
| | - V Sambri
- Unit of Microbiology, Greater Romagna Area Hub Laboratory, Pievesestina, Italy
| | - A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M P Landini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Rossini
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Squintani
- Veterinary and Food Hygiene Service, Emilia-Romagna Region, Bologna, Italy
| | - S Cinotti
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna, Brescia, Italy
| | - S Varani
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - C Vocale
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - E Bedeschi
- Public Health Service, Emilia-Romagna Region, Bologna, Italy
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9
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Bellini R, Calzolari M, Mattivi A, Tamba M, Angelini P, Bonilauri P, Albieri A, Cagarelli R, Carrieri M, Dottori M, Finarelli AC, Gaibani P, Landini MP, Natalini S, Pascarelli N, Rossini G, Velati C, Vocale C, Bedeschi E. The experience of West Nile virus integrated surveillance system in the Emilia-Romagna region: five years of implementation, Italy, 2009 to 2013. ACTA ACUST UNITED AC 2014; 19. [PMID: 25394257 DOI: 10.2807/1560-7917.es2014.19.44.20953] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Predicting West Nile virus (WNV) circulation and the risk of WNV epidemics is difficult due to complex interactions of multiple factors involved. Surveillance systems that timely detect virus activity in targeted areas, and allow evidence-based risk assessments may therefore be necessary. Since 2009, a system integrating environmental (mosquitoes and birds) and human surveillance has been implemented and progressively improved in the Emilia-Romagna region, Italy. The objective is to increase knowledge of WNV circulation and to reduce the probability of virus transmission via blood, tissue and organ donation. As of 2013, the system has shown highly satisfactory results in terms of early detection capacity (the environmental surveillance component allowed detection of WNV circulation 3–4 weeks before human cases of West Nile neuroinvasive disease (WNND) occurred), sensitivity (capacity to detect virus circulation even at the enzootic level) and area specificity (capacity to indicate the spatial distribution of the risk for WNND). Strong correlations were observed between the vector index values and the number of human WNND cases registered at the province level. Taking into consideration two scenarios of surveillance, the first with environmental surveillance and the second without, the total costs for the period from 2009 to 2013 were reduced when environmental surveillance was considered (EUR 2.093 million for the first scenario vs EUR 2.560 million for the second). Environmental surveillance helped to reduce costs by enabling a more targeted blood unit testing strategy. The inclusion of environmental surveillance also increased the efficiency of detecting infected blood units and further allowed evidence-based adoption of preventative public health measures.
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Affiliation(s)
- R Bellini
- Centro Agricoltura Ambiente G.Nicoli , Crevalcore, Italy
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10
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Gaibani P, Lombardo D, Lewis RE, Mercuri M, Bonora S, Landini MP, Ambretti S. In vitro activity and post-antibiotic effects of colistin in combination with other antimicrobials against colistin-resistant KPC-producing Klebsiella pneumoniae bloodstream isolates. J Antimicrob Chemother 2014; 69:1856-65. [DOI: 10.1093/jac/dku065] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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11
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Pierro A, Landini MP, Gaibani P, Rossini G, Vocale C, Finarelli AC, Cagarelli R, Sambri V, Varani S. A model of laboratory surveillance for neuro-arbovirosis applied during 2012 in the Emilia-Romagna region, Italy. Clin Microbiol Infect 2013; 20:672-7. [PMID: 24329773 DOI: 10.1111/1469-0691.12436] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 07/24/2013] [Revised: 10/03/2013] [Accepted: 10/21/2013] [Indexed: 11/30/2022]
Abstract
Arboviruses with neuroinvasive potential are gaining more attention due to the increased number of cases of autochthonous and imported infections in the human host. Diagnosis of infection caused by these viruses in patients with central nervous system (CNS) diseases is still underestimated and these infections represent an emerging threat to public health. We describe a model suitable for the laboratory surveillance of neuro-arbovirosis that was applied in the Emilia-Romagna region, north-eastern Italy, during the 2012 summer season. One hundred and twenty cases of suspected neuroinvasive infection were tested for arboviral agents on the basis of clinical and laboratory signs and epidemiological data. The most common virus detected was Toscana virus (TOSV): anti-TOSV specific antibodies or viral components were detected in 28.3% of the cases; 79.4% of the TOSV cases were in the acute phase of infection. No cases resulted in acute phase for West Nile (WNV), Usutu (USUV), Chikungunya (CHIKV) or Dengue (DENV) virus infection. Conversely, two patients with a history of staying in a tick-borne encephalitis virus (TBEV) endemic area showed a probable TBEV infection. These results emphasize the importance of a complete and 'ready to act' laboratory diagnostic system to be implemented within the larger frame of a regional integrated surveillance system.
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Affiliation(s)
- A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
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12
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Varani S, Cagarelli R, Melchionda F, Attard L, Salvadori C, Finarelli AC, Gentilomi GA, Tigani R, Rangoni R, Todeschini R, Scalone A, Di Muccio T, Gramiccia M, Gradoni L, Viale P, Landini MP. Ongoing outbreak of visceral leishmaniasis in Bologna Province, Italy, November 2012 to May 2013. Euro Surveill 2013. [DOI: 10.2807/1560-7917.es2013.18.28.20530] [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: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- S Varani
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - R Cagarelli
- Public Health Authority Emilia-Romagna, Bologna, Italy
| | - F Melchionda
- Department of Pediatric Hematology and Oncology, St. Orsola Malpighi University Hospital, Bologna, Italy
| | - L Attard
- Infectious Disease Unit, St. Orsola Malpighi Hospital, University of Bologna, Italy
| | - C Salvadori
- Infectious Disease Unit, St. Orsola Malpighi Hospital, University of Bologna, Italy
| | - A C Finarelli
- Public Health Authority Emilia-Romagna, Bologna, Italy
| | - G A Gentilomi
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - R Tigani
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
| | - R Rangoni
- Public Health Department of Imola, Bologna, Italy
| | - R Todeschini
- Public Health Department of Casalecchio di Reno, Bologna, Italy
| | - A Scalone
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - T Di Muccio
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - M Gramiccia
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - L Gradoni
- Unit of Vector-Borne Diseases and International Health, Istituto Superiore di Sanità, Rome, Italy
| | - P Viale
- Infectious Disease Unit, St. Orsola Malpighi Hospital, University of Bologna, Italy
| | - M P Landini
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
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13
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Varani S, Cagarelli R, Melchionda F, Attard L, Salvadori C, Finarelli AC, Gentilomi GA, Tigani R, Rangoni R, Todeschini R, Scalone A, Di Muccio T, Gramiccia M, Gradoni L, Viale P, Landini MP. Ongoing outbreak of visceral leishmaniasis in Bologna Province, Italy, November 2012 to May 2013. Euro Surveill 2013. [DOI: 10.2807/1560-7917.es2013.18.29.20530] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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14
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Varani S, Cagarelli R, Melchionda F, Attard L, Salvadori C, Finarelli AC, Gentilomi GA, Tigani R, Rangoni R, Todeschini R, Scalone A, Di Muccio T, Gramiccia M, Gradoni L, Viale P, Landini MP. Ongoing outbreak of visceral leishmaniasis in Bologna Province, Italy, November 2012 to May 2013. Euro Surveill 2013; 18:20530. [PMID: 23929116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
An increased number of autochthonous visceral leishmaniasis (VL) cases has recently been reported in Bologna Province in northern Italy. Over six months from November 2012 to May 2013, 14 cases occurred, whereas the average number of cases per year was 2.6 (range: 0-8) in 2008 to 2012. VL was diagnosed in a median of 40 days (range: 15-120) from disease onset. This delay in diagnosis shows the need for heightened awareness of clinicians for autochthonous VL in Europe.
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Affiliation(s)
- S Varani
- Unit of Microbiology, Regional Reference Center for Microbiological Emergencies (CRREM), St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
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15
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Pierro A, Gaibani P, Spadafora C, Ruggeri D, Randi V, Parenti S, Finarelli AC, Rossini G, Landini MP, Sambri V. Detection of specific antibodies against West Nile and Usutu viruses in healthy blood donors in northern Italy, 2010-2011. Clin Microbiol Infect 2013; 19:E451-3. [PMID: 23663225 DOI: 10.1111/1469-0691.12241] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [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: 02/11/2013] [Revised: 03/21/2013] [Accepted: 04/04/2013] [Indexed: 11/30/2022]
Abstract
Neutralizing antibodies against West Nile (WNV) and Usutu (USUV) viruses were measured in 6000 samples collected, between 1 September 2010 and 30 June 2011, from blood donors living in different districts of Emilia-Romagna, northeastern Italy. On the basis of the microneutralization assay (MNTA), 47 (0.78%) subjects were positive for WNV and 14 (0.23%) for USUV. These results were compared with those obtained 2 years ago and suggest an increased circulation of USUV among humans in Emilia-Romagna.
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Affiliation(s)
- A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
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16
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Sambri V, Capobianchi M, Charrel R, Fyodorova M, Gaibani P, Gould E, Niedrig M, Papa A, Pierro A, Rossini G, Varani S, Vocale C, Landini MP. West Nile virus in Europe: emergence, epidemiology, diagnosis, treatment, and prevention. Clin Microbiol Infect 2013; 19:699-704. [PMID: 23594175 DOI: 10.1111/1469-0691.12211] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
West Nile virus (WNV), a mosquito-borne flavivirus in the Japanese encephalitis antigenic group, has caused sporadic outbreaks in humans, horses and birds throughout many of the warmer regions of Europe for at least 20 years. Occasional cases of West Nile encephalitis have also been associated with infected blood transfusions and organ donations. Currently, WNV appears to be expanding its geographical range in Europe and causing increasing numbers of epidemics/outbreaks associated with human morbidity and mortality. This brief review reports on the current epidemic situation regarding WNV in Europe, highlighting the clinical, diagnostic and preventive measures available for controlling this apparently emerging human pathogen.
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Affiliation(s)
- V Sambri
- Section of Microbiology, DIMES, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
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17
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Gaibani P, Finarelli AC, Cagarelli R, Pierro A, Rossini G, Calzolari M, Dottori M, Bonilauri P, Landini MP, Sambri V. Retrospective screening of serum and cerebrospinal fluid samples from patients with acute meningo-encephalitis does not reveal past Japanese encephalitis virus infection, Emilia Romagna, Italy, 2011. Euro Surveill 2012; 17:20257. [PMID: 22958609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
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18
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Gaibani P, Finarelli AC, Cagarelli R, Pierro A, Rossini G, Calzolari M, Dottori M, Bonilauri P, Landini MP, Sambri V. Retrospective screening of serum and cerebrospinal fluid samples from patients with acute meningo-encephalitis does not reveal past Japanese encephalitis virus infection, Emilia Romagna, Italy, 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.35.20257-en] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P Gaibani
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - A C Finarelli
- Public Health Authority, Emilia Romagna Region, Bologna, Italy
| | - R Cagarelli
- Public Health Authority, Emilia Romagna Region, Bologna, Italy
| | - A Pierro
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - G Rossini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M Calzolari
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna ‘B. Ubertini’ (IZSLER; Experimental veterinary institute of Lombardy and Emilia Romagna), Reggio Emilia, Italy
| | - M Dottori
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna ‘B. Ubertini’ (IZSLER; Experimental veterinary institute of Lombardy and Emilia Romagna), Reggio Emilia, Italy
| | - P Bonilauri
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna ‘B. Ubertini’ (IZSLER; Experimental veterinary institute of Lombardy and Emilia Romagna), Reggio Emilia, Italy
| | - M P Landini
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - V Sambri
- Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna, Italy
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19
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Gabrielli L, Bonasoni MP, Santini D, Piccirilli G, Chiereghin A, Petrisli E, Dolcetti R, Guerra B, Piccioli M, Lanari M, Landini MP, Lazzarotto T. Congenital cytomegalovirus infection: patterns of fetal brain damage. Clin Microbiol Infect 2012; 18:E419-27. [PMID: 22882294 DOI: 10.1111/j.1469-0691.2012.03983.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Cytomegalovirus (CMV) is the most prevalent infectious agent causing neurological dysfunction in the developing brain. This study analysed the different patterns of tissue damage, particularly in the brain, of fetuses with documented CMV infection. We studied 45 fetuses at 20-21 weeks of gestation with congenital CMV infection documented by invasive positive prenatal diagnosis. At the time of amniocentesis, abnormal ultrasound findings had been recorded for 13 of the 45 fetuses (29%). Histological and immunohistochemical characterization was performed on the placenta, brain, heart, lung, liver, kidney, and pancreas. The different degrees of brain damage were correlated with tissue viral load, inflammatory response, placental functionality, and extramedullary haematopoiesis. Even though a high CMV load was detected in all amniotic fluids, brain infection occurred in only 62% of the fetuses and with different degrees of severity. Tissues with a low viral load showed a globally weak inflammatory response, and fetuses had only mild brain damage, whereas tissues with a high CMV load showed prominent infiltration of the activated cytotoxic CD8(+) T-lymphocytes responsible for immune-mediated damage. Furthermore, severe placental infection was associated with diffuse villitis and necrosis, consistent with functional impairment and possible consequent hypoxic cerebral damage. Brain injury induced by CMV congenital infection may be the result of uncontrolled viral replication, immune-mediated damage by cytotoxic CD8(+) T-lymphocytes, and, in the presence of placental insufficiency, fetal hypoxia.
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Affiliation(s)
- L Gabrielli
- Operative Unit of Clinical Microbiology, St Orsola-Malpighi University Hospital, Bologna, Italy.
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20
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Gaibani P, Ambretti S, Berlingeri A, Cordovana M, Farruggia P, Panico M, Landini MP, Sambri V. Outbreak of NDM-1-producing Enterobacteriaceae in northern Italy, July to August 2011. Euro Surveill 2011; 16:20027. [PMID: 22152705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Between July 2011 and August 2011, the New Delhi metallo-beta-lactamase 1 (NDM-1) gene was detected in Klebsiella pneumoniae and Escherichia coli isolates obtained from six patients hospitalised in four healthcare facilities in northern Italy. The patient who had been hospitalised in New Delhi, India, from February to May 2011 and subsequently in the Bologna area, Italy, from May to July 2011, may have been the source of the outbreak. Our findings suggest ongoing spread of this carbapenem-resistance gene in Italy and highlight the need for intensive surveillance.
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Affiliation(s)
- P Gaibani
- Operative Unit of Clinical Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
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21
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Gaibani P, Ambretti S, Berlingeri A, Cordovana M, Farruggia P, Panico M, Landini MP, Sambri V. Outbreak of NDM-1-producing Enterobacteriaceae in northern Italy, July to August 2011. Euro Surveill 2011. [DOI: 10.2807/ese.16.47.20027-en] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Between July 2011 and August 2011, the New Delhi metallo-beta-lactamase 1 (NDM-1) gene was detected in Klebsiella pneumoniae and Escherichia coli isolates obtained from six patients hospitalised in four healthcare facilities in northern Italy. The patient who had been hospitalised in New Delhi, India, from February to May 2011 and subsequently in the Bologna area, Italy, from May to July 2011, may have been the source of the outbreak. Our findings suggest ongoing spread of this carbapenem-resistance gene in Italy and highlight the need for intensive surveillance.
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Affiliation(s)
- P Gaibani
- These authors contributed equally to this paper
- Operative Unit of Clinical Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - S Ambretti
- Operative Unit of Clinical Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
- These authors contributed equally to this paper
| | - A Berlingeri
- Operative Unit of Clinical Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - M Cordovana
- Operative Unit of Clinical Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | | | - M Panico
- Bellaria Hospital, Bologna, Italy
| | - M P Landini
- Operative Unit of Clinical Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - V Sambri
- Operative Unit of Clinical Microbiology, S. Orsola-Malpighi University Hospital, Bologna, Italy
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22
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Pierro A, Varani S, Rossini G, Gaibani P, Cavrini F, Finarelli AC, Macini P, Cagarelli R, Mattivi A, Angelini P, Landini MP, Sambri V. Imported cases of dengue virus infection: Emilia-Romagna, Italy, 2010. Clin Microbiol Infect 2011; 17:1349-52. [PMID: 21745260 DOI: 10.1111/j.1469-0691.2011.03544.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dengue is a significant mosquito-borne infection in humans, and its worldwide prevalence is rapidly increasing. In 2010, 83 serum samples from febrile travellers returning from dengue-endemic countries to a region in north-eastern Italy, densely infested with Aedes albopictus, were analysed for dengue virus (DENV). DENV RNA was detected in 20.5% of patients. By RT-PCR, DENV serotypes 1 and 3 were the most common. DENV must be identified early in symptomatic travellers returning from high-risk countries, to prevent outbreaks where potential vectors exist.
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Affiliation(s)
- A Pierro
- Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies (CRREM), St Orsola-Malpighi University Hospital, Bologna, Italy
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23
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Gaibani P, Ambretti S, Berlingeri A, Gelsomino F, Bielli A, Landini MP, Sambri V. Rapid increase of carbapenemase-producing Klebsiella pneumoniae strains in a large Italian hospital: surveillance period 1 March - 30 September 2010. Euro Surveill 2011; 16:19800. [PMID: 21371414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
The first case of carbapenemase-producing Enterobacteriaceae in Italy was reported in 2009. We performed a study over a period of seven months in 2010 to survey the circulation of Klebsiella pneumoniae carbapenemases (KPC) ina 1,500-bed university hospital in northern Italy and report the presence and rapid increase of these multidrug-resistant bacteria. The results raise a major concern about these pathogens and demonstrate the urgent need for infection control and antibiotic stewardship programmes.
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Affiliation(s)
- P Gaibani
- Regional Reference Centre for Microbiological Emergencies (CRREM), Bologna, Italy
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24
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Gaibani P, Ambretti S, Berlingeri A, Gelsomino F, Bielli A, Landini MP, Sambri V. Rapid increase of carbapenemase-producing Klebsiella pneumoniae strains in a large Italian hospital: surveillance period 1 March – 30 September 2010. Euro Surveill 2011. [DOI: 10.2807/ese.16.08.19800-en] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The first case of carbapenemase-producing Enterobacteriaceae in Italy was reported in 2009. We performed a study over a period of seven months in 2010 to survey the circulation of Klebsiella pneumoniae carbapenemases (KPC) in a 1,500-bed university hospital in northern Italy and report the presence and rapid increase of these multidrug-resistant bacteria. The results raise a major concern about these pathogens and demonstrate the urgent need for infection control and antibiotic stewardship programmes.
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Affiliation(s)
- P Gaibani
- These authors contributed equally to this paper
- Regional Reference Centre for Microbiological Emergencies (CRREM), Bologna, Italy
| | - S Ambretti
- Bacteriology Section of the Operative Unit of Clinical Microbiology, S.Orsola-Malpighi University Hospital, Bologna, Italy
- These authors contributed equally to this paper
| | - A Berlingeri
- Bacteriology Section of the Operative Unit of Clinical Microbiology, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - F Gelsomino
- Regional Reference Centre for Microbiological Emergencies (CRREM), Bologna, Italy
| | - A Bielli
- Bacteriology Section of the Operative Unit of Clinical Microbiology, S.Orsola-Malpighi University Hospital, Bologna, Italy
| | - M P Landini
- Bacteriology Section of the Operative Unit of Clinical Microbiology, S.Orsola-Malpighi University Hospital, Bologna, Italy
- Regional Reference Centre for Microbiological Emergencies (CRREM), Bologna, Italy
| | - V Sambri
- Regional Reference Centre for Microbiological Emergencies (CRREM), Bologna, Italy
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25
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Capobianchi MR, Sambri V, Castilletti C, Pierro AM, Rossini G, Gaibani P, Cavrini F, Selleri M, Meschi S, Lapa D, Di Caro A, Grossi P, De Cillia C, Venettoni S, Landini MP, Ippolito G, Nanni Costa A. Retrospective screening of solid organ donors in Italy, 2009, reveals unpredicted circulation of West Nile virus. ACTA ACUST UNITED AC 2010; 15. [PMID: 20807488 DOI: 10.2807/ese.15.34.19648-en] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Since the occurrence of West Nile virus (WNV) infection in humans in 2008 in Italy, concerns have been raised about the potential risks associated with solid organ transplantation (SOT). A nationwide retrospective survey showed that 1.2% of SOT donors in 2009 were WNV-seropositive and demonstrated that human WNV infection is distributed throughout several Italian regions. Transmission of WNV or other arboviruses through SOT is a possibility and risk assessment should be carried out before SOT to avoid infection through transplantation.
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Affiliation(s)
- M R Capobianchi
- National Institute for Infectious Diseases (INMI) L. Spallanzani , Rome, Italy.
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26
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Chiereghin A, Gabrielli L, Zanfi C, Petrisli E, Lauro A, Piccirilli G, Baccolini F, Dazzi A, Cescon M, Morelli MC, Pinna AD, Landini MP, Lazzarotto T. Monitoring cytomegalovirus T-cell immunity in small bowel/multivisceral transplant recipients. Transplant Proc 2010; 42:69-73. [PMID: 20172283 DOI: 10.1016/j.transproceed.2009.12.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) is a major cause of graft failure and posttransplantation mortality in intestinal/multivisceral transplantation. CMV infection exhibits a wide range of clinical manifestations from asymptomatic infection to severe CMV disease. STUDY'S PURPOSE: The purposes of this study were to assess the utility of measuring CMV-specific cellular immunity in bowel/multivisceral transplant recipients and to provide additional information on the risk of infection and development of CMV disease. METHODS We studied 10 bowel/multivisceral transplant recipients to investigate the kinetics of CMV infection using real-time polymerase chain reaction (on blood and biopsy tissue samples) and CMV-specific T-cell reconstitution by Enzyme-linked ImmunoSPOT Assay (ELISPOT) that enumerates Interferon-gamma-secreting CMV-specific T cells upon in vitro stimulation with viral antigens (pp65 and IE-1). RESULTS All patients were seropositive for CMV. According to the pattern of T-cell reconstitution occurring either within the first month after transplantation or later, patients were classified as early (n = 7) or late responders (n = 3). Clinically, early responder patients (3/7; 43%) experienced asymptomatic or mild CMV infections, whereas all late responders (3/3; 100%) developed moderate or severe CMV disease. A reduction in mean and peak CMV viral load was observed in early responders, whereas the onset time of infection did not differ significantly between early and late CMV responders. CONCLUSIONS A good and early reconstitution of CMV-specific T-cell immune responses after transplantation is a critical determinant in controlling CMV infections. Simultaneous monitoring of CMV infection and CMV-specific T-cell immunity predicts T-cell-mediated control of CMV infection.
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Affiliation(s)
- A Chiereghin
- St. Orsola Malpighi General Hospital, University of Bologna, Bologna, Italy
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Petrisli E, Chiereghin A, Gabrielli L, Zanfi C, Lauro A, Piccirilli G, Baccolini F, Altimari A, Bagni A, Cescon M, Pinna AD, Landini MP, Lazzarotto T. Early and late virological monitoring of cytomegalovirus, Epstein-Barr virus, and human herpes virus 6 infections in small bowel/multivisceral transplant recipients. Transplant Proc 2010; 42:74-8. [PMID: 20172284 DOI: 10.1016/j.transproceed.2009.12.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are the major causes of graft failure and posttransplantation mortality among small bowel and multivisceral transplantations (SB/MVT). Little is known about human herpes virus 6 (HHV-6) infections in transplant recipients. STUDY PURPOSE The purposes of this study were to analyze the clinical relevance of CMV, EBV, and HHV-6 infections after small bowel transplantation and to establish whether routine monitoring for HHV-6 infection should be recommended for the prevention of severe complications in this population. METHODS Ten adult patients were monitored based on CMV, EBV, and HHV6 DNA quantifications in blood and biopsy tissue samples. Three patients were monitored for at least 5 months (early period) and 7 patients were monitored for 1 to 5 years after transplantation (late period). RESULTS In the early period, despite prophylaxis all 3 patients developed symptomatic CMV infections: 1 fever/diarrhea, 1 enteritis and rejection, as well as 1 fever and pneumonia. Only 1 patient developed EBV and HHV-6 infections. The average time of onset of CMV infection was 3 months after transplantation and only 24 days for HHV6 infection. In the late period, of the 7 SB/MVT recipients only 1 developed an EBV infection at 2 years after transplantation. No CMV or HHV-6 infections were identified in any patient. CONCLUSIONS CMV infection is a major cause of organ disease and rejection in the early period after transplantation. EBV infection in adult recipients must be considered also in the late period, particularly in association with severe immunosuppression. Because HHV-6 infection occurs earlier than CMV/EBV, it may serve as an indicator for more intense virological surveillance.
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Affiliation(s)
- E Petrisli
- St.Orsola Malpighi General Hospital, University of Bologna, Bologna, Italy
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Cavrini F, Gaibani P, Longo G, Pierro AM, Rossini G, Bonilauri P, Gerunda GE, Di Benedetto F, Pasetto A, Girardis M, Dottori M, Landini MP, Sambri V. Usutu virus infection in a patient who underwent orthotropic liver transplantation, Italy, August-September 2009. Euro Surveill 2009. [DOI: 10.2807/ese.14.50.19448-en] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report a case of Usutu virus (USUV)-related illness in a patient that underwent an orthotropic liver transplant (OLT). Post transplant, the patient developed clinical signs of a possible neuroinvasive disease with a significant loss of cerebral functions. USUV was isolated in Vero E6 cells from a plasma sample obtained immediately before the surgery, and USUV RNA was demonstrated by RT-PCR and sequencing. This report enlarges the panel of emerging mosquito-borne flavivirus-related disease in humans.
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Affiliation(s)
- F Cavrini
- These Authors contributed equally to this paper and are listed in alphabetical order
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - P Gaibani
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
- These Authors contributed equally to this paper and are listed in alphabetical order
| | - G Longo
- Oncology and Haematology Unit, Modena University Hospital, Modena, Italy
| | - A M Pierro
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - G Rossini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - P Bonilauri
- Experimental Institute for Animal Health and Protection of Lombardia and Emilia-Romagna, Brescia, Italy
| | - G E Gerunda
- Liver and Multivisceral Transplant Center, University of Modena and Reggio Emilia, Modena, Italy
| | - F Di Benedetto
- Liver and Multivisceral Transplant Center, University of Modena and Reggio Emilia, Modena, Italy
| | - A Pasetto
- Anaestesiology and Intensive Care Unit 1, Modena University Hospital, Modena, Italy
| | - M Girardis
- Anaestesiology and Intensive Care Unit 1, Modena University Hospital, Modena, Italy
| | - M Dottori
- Experimental Institute for Animal Health and Protection of Lombardia and Emilia-Romagna, Brescia, Italy
| | - M P Landini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - V Sambri
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies – CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
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Cavrini F, Gaibani P, Longo G, Pierro AM, Rossini G, Bonilauri P, Gerunda GE, Di Benedetto F, Pasetto A, Girardis M, Dottori M, Landini MP, Sambri V. Usutu virus infection in a patient who underwent orthotropic liver transplantation, Italy, August-September 2009. Euro Surveill 2009; 14:19448. [PMID: 20070935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
We report a case of Usutu virus (USUV)-related illness in a patient that underwent an orthotropic liver transplant (OLT). Post transplant, the patient developed clinical signs of a possible neuroinvasive disease with a significant loss of cerebral functions. USUV was isolated in Vero E6 cells from a plasma sample obtained immediately before the surgery, and USUV RNA was demonstrated by RT-PCR and sequencing. This report enlarges the panel of emerging mosquito-borne flavivirus-related disease in humans.
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Affiliation(s)
- F Cavrini
- Clinical Microbiology Unit, Regional Reference Centre for Microbiological Emergencies-CRREM, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
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Pignatelli S, Dal Monte P, Landini MP. Cytomegalovirus primary envelopment at large nuclear membrane infoldings: what's new? J Virol 2007; 81:7320-1; author reply 7321-2. [PMID: 17567708 PMCID: PMC1933327 DOI: 10.1128/jvi.00503-07] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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31
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Pignatelli S, Dal Monte P, Rossini G, Chou S, Gojobori T, Hanada K, Guo JJ, Rawlinson W, Britt W, Mach M, Landini MP. Human cytomegalovirus glycoprotein N (gpUL73-gN) genomic variants: identification of a novel subgroup, geographical distribution and evidence of positive selective pressure. J Gen Virol 2003; 84:647-655. [PMID: 12604817 DOI: 10.1099/vir.0.18704-0] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Human cytomegalvirus (HCMV) ORF UL73 is a polymorphic locus, encoding the viral glycoprotein gpUL73-gN, a component of the gC-II envelope complex. The previously identified gN genomic variants, denoted gN-1, gN-2, gN-3 and gN-4, were further investigated in this work by analysing a large panel of HCMV clinical isolates collected from all over the world (223 samples). Sequencing and phylogenetic analysis confirmed the existence of the four gN genotypes, but also allowed the identification of a novel subgroup belonging to the gN-3 genotype, which was designated gN-3b. The number of non-synonymous (d(N)) and synonymous (d(S)) nucleotide substitutions and their ratio (d(N)/d(S)) were estimated among the gN genotypes to evaluate the possibility of positive selection. Results showed that the four variants evolved by neutral (random) selection, but that the gN-3 and gN-4 genotypes are maintained by positive selective pressure. The 223 HCMV clinical isolates were subdivided according to their geographical origin, and four main regions of gN prevalence were identified: Europe, China, Australia and Northern America. The gN variants were found to be widespread and represented within the regions analysed without any significant difference, and no new genotype was detected. Finally, for clinical and epidemiological purposes, a rapid and low-cost method for genetic grouping of the HCMV clinical isolates was developed based on the RFLP revealed by SacI, ScaI and SalI digestion of the PCR-amplified UL73 sequence. This technique enabled us to distinguish all four gN genomic variants and also their subtypes.
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Affiliation(s)
- S Pignatelli
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - P Dal Monte
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - G Rossini
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - S Chou
- Medical and Research Services, VA Medical Center and Division of Infectious Diseases, Oregon Health Sciences University, Portland, OR, USA
| | - T Gojobori
- Center of Information Biology, National Institute of Genetics, Mishima, Japan
| | - K Hanada
- Center of Information Biology, National Institute of Genetics, Mishima, Japan
| | - J J Guo
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - W Rawlinson
- Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, NSW, Australia
| | - W Britt
- Department of Pediatrics and Microbiology, University of Alabama, Birmingham, AL, USA
| | - M Mach
- Institute of Clinical and Molecular Virology, University of Erlangen-Nurnberg, Germany
| | - M P Landini
- Department of Clinical and Experimental Medicine, Division Microbiology - St Orsola General Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
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Abstract
Human Cytomegalovirus (HCMV) UL73 encodes for a polymorphic structural glycoprotein, gpUL73(gN), conserved among herpesviruses. This study analyzed the intracellular and intraviral localization of gpUL73 by immunoelectron-microscopy comparing the reactivity of two different antibodies. We found that gN is an envelope component of the mature viral particle with at least a portion exposed at the virus surface and another at the internal side of the envelope. Furthermore, gpUL73 is also present in the matrix of dense bodies and "black holes". These results, as well as immunoblotting analysis, suggest that the two antibodies recognize different forms, fully processed or unprocessed, of gpUL73-gN.
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Affiliation(s)
- S Pignatelli
- Department of Clinical and Experimental Medicine, Division of Microbiology and Virology, University of Bologna, St. Orsola General Hospital, Italy
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33
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Dal Monte P, Pignatelli S, Zini N, Maraldi NM, Perret E, Prevost MC, Landini MP. Analysis of intracellular and intraviral localization of the human cytomegalovirus UL53 protein. J Gen Virol 2002; 83:1005-1012. [PMID: 11961254 DOI: 10.1099/0022-1317-83-5-1005] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human cytomegalovirus (HCMV) UL53 belongs to a family of conserved herpesvirus genes. In this work, the expression and localization of the UL53 gene product was analysed. Results obtained showed that pUL53 is a new structural protein. In infected human fibroblasts, pUL53 localizes in cytoplasmic perinuclear granular formations together with other structural viral proteins. In the nucleus, pUL53 forms patches at the nuclear periphery and co-localizes with lamin B at the internal nuclear membrane level. Immunoelectron microscopy studies have disclosed that nuclear pseudo-inclusions are labelled, whereas nucleocapsid formations within the intranuclear skein are negative. Furthermore, the mature virus particle maintains pUL53 at its tegumental level. These data suggest that pUL53 could be involved either in nucleocapsid maturation or in the egress of nucleocapsids from the nucleus to the cytoplasm through the nuclear membrane, a role compatible with the function hypothesized for UL31, its positional homologue in herpes simplex virus type 1.
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Affiliation(s)
- P Dal Monte
- Department of Clinical and Experimental Medicine, Division of Microbiology, University of Bologna, St Orsola General Hospital, Via Massarenti 9, 40138 Bologna, Italy1
| | - S Pignatelli
- Department of Clinical and Experimental Medicine, Division of Microbiology, University of Bologna, St Orsola General Hospital, Via Massarenti 9, 40138 Bologna, Italy1
| | - N Zini
- Institute of Normal and Pathologic Cytomorphology, CNR, c/o IOR, Bologna, Italy2
| | - N M Maraldi
- Institute of Normal and Pathologic Cytomorphology, CNR, c/o IOR, Bologna, Italy2
| | - E Perret
- Unité d'Oncologie Virale, Institut Pasteur, Paris, France3
| | - M C Prevost
- Unité d'Oncologie Virale, Institut Pasteur, Paris, France3
| | - M P Landini
- Department of Clinical and Experimental Medicine, Division of Microbiology, University of Bologna, St Orsola General Hospital, Via Massarenti 9, 40138 Bologna, Italy1
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34
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Lanari M, Lazzarotto T, Papa I, Venturi V, Bronzetti G, Guerra B, Faldella G, Corvaglia L, Picchio FM, Landini MP, Salvioli GP. Neonatal aortic arch thrombosis as a result of congenital cytomegalovirus infection. Pediatrics 2001; 108:E114. [PMID: 11731641 DOI: 10.1542/peds.108.6.e114] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Thrombotic disease is rare in neonates. The main risk factors at this age are perinatal asphyxia, maternal diabetes, sepsis, polycythemia, dehydration, a low cardiac output, and in primis the catheterization of central lines. Another important risk factor is inherited thrombophilia. Arterial thrombosis is even more rare than venous thrombosis and less related to most of the risk factors listed above; it occurs more frequently in the iliac, femoral, and cerebral arteries but very rarely in the aorta. Most of the described cases of aortic thrombosis are associated with the catheterization of an umbilical artery and involve the descending tract and the renal arteries; very few relate to the ascending tract and the aortic arch. The possible role of virus-induced primary vascular endothelium damage in the etiopathogenesis of neonatal arterial thrombosis has been previously hypothesized. Herpesviruses, particularly human cytomegalovirus (HCMV), can infect endothelial cells and directly damage intact vascular endothelium, altering its thromboresistant surface as a result of procoagulant activity mediated by specific viral surface phospholipids, necessary for the coagulation enzyme complex assembly that leads to thrombin generation. We describe a case of congenital aortic arch thrombosis. The clinical, laboratory, and virologic pictures; the anatomopathologic findings (fully compatible with viral infection); the detection of HCMV in various tissues (including the aorta); and the absence of other causes of aortic thrombosis make it possible to attribute the case to a severe congenital HCMV infection with multiple organ involvement, after the primary infection of the mother. The hemostatic system disorders and hemodynamic disturbances related to viral cardiac damage explain the clinical features of the case and indicate that congenital HCMV infection should be included among the causes of neonatal aortic thrombosis.
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Affiliation(s)
- M Lanari
- Department of Preventive Pediatrics and Neonatology, University of Bologna, Bologna, Italy.
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35
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Pignatelli S, Dal Monte P, Landini MP. gpUL73 (gN) genomic variants of human cytomegalovirus isolates are clustered into four distinct genotypes. J Gen Virol 2001; 82:2777-2784. [PMID: 11602789 DOI: 10.1099/0022-1317-82-11-2777] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Clinical isolates of human cytomegalovirus (HCMV) show differences in tissue tropism, severity of clinical manifestations and ability to establish persistent or latent infections, characteristics that are thought to be related to genomic variation among strains. This work analysed the genomic variants of a new HCMV polymorphic locus, open reading frame (ORF) UL73. This ORF encodes the envelope glycoprotein gpUL73 (gN), which associates in a high molecular mass complex with its counterpart, gM, and induces a neutralizing antibody response in the host. Detailed sequence analysis of ORF UL73 and its gene product from clinical isolates and laboratory-adapted strains shows that this glycoprotein is highly polymorphic, in the N-terminal region in particular. gpUL73 hypervariability is not randomly distributed, but the identified genomic variants are clearly clustered into four distinct genotypes (gN-1, gN-2, gN-3 and gN-4), which are not associated with the gB subtype.
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Affiliation(s)
- S Pignatelli
- Department of Clinical and Experimental Medicine, Division of Microbiology, University of Bologna, St Orsola General Hospital, Via Massarenti 9, 40138 Bologna, Italy1
| | - P Dal Monte
- Department of Clinical and Experimental Medicine, Division of Microbiology, University of Bologna, St Orsola General Hospital, Via Massarenti 9, 40138 Bologna, Italy1
| | - M P Landini
- Department of Clinical and Experimental Medicine, Division of Microbiology, University of Bologna, St Orsola General Hospital, Via Massarenti 9, 40138 Bologna, Italy1
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36
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Barbieri L, Valbonesi P, Bondioli M, Alvarez ML, Dal Monte P, Landini MP, Stirpe F. Adenine glycosylase activity in mammalian tissues: an equivalent of ribosome-inactivating proteins. FEBS Lett 2001; 505:196-7. [PMID: 11557068 DOI: 10.1016/s0014-5793(01)02789-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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37
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Muratori L, Sztul E, Muratori P, Gao Y, Ripalti A, Ponti C, Lenzi M, Landini MP, Bianchi FB. Distinct epitopes on formiminotransferase cyclodeaminase induce autoimmune liver cytosol antibody type 1. Hepatology 2001; 34:494-501. [PMID: 11526534 DOI: 10.1053/jhep.2001.27179] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Liver cytosol antibody type 1 (LC1) is regarded as a serologic marker of type 2 autoimmune hepatitis, in addition to liver kidney microsomal antibody type 1. Among 38 patients with type 2 autoimmune hepatitis, 23 were positive for LC1 antibodies. The antigen recognized by LC1 has been identified as a liver-specific 58-kd metabolic enzyme named formiminotransferase cyclodeaminase (FTCD). All 23 LC1-positive sera immunoprecipitated rat FTCD, and 22 gave an identity reaction with rat FTCD by immunodiffusion. No reaction was observed with sera from 10 patients with type 1 autoimmune hepatitis, 10 with primary biliary cirrhosis, 10 with chronic hepatitis C, and 10 healthy controls. By Western immunoblotting all 23 LC1-positive sera and all the controls tested negative, suggesting that all the antigenic epitopes were destroyed by denaturation. FTCD is a bifunctional protein composed of distinct globular FT and CD domains connected by a short linker. To identify epitopes that trigger the LC1 autoimmune response, we tested LC1 antibodies against FTCD constructs encoding the N-terminal FT domain (amino acids 1-339), or the C-terminal CD domain (amino acids 332-541). Of 20 sera positive against full-length FTCD, 8 (40%) recognized the FT domain and the CD domain, 7 (35%) recognized only the FT domain, and 5 (25%) did not recognize either construct. No sera reacted with only the CD domain. These data indicate that multiple regions of FTCD trigger the LC1 autoimmune response, and that LC1 reactivity is mainly directed to conformation-sensitive epitopes located in the FT region of FTCD.
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Affiliation(s)
- L Muratori
- Department of Internal Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
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38
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Gabrielli L, Losi L, Varani S, Lazzarotto T, Eusebi V, Landini MP. Complete replication of human cytomegalovirus in explants of first trimester human placenta. J Med Virol 2001; 64:499-504. [PMID: 11468735 DOI: 10.1002/jmv.1077] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Tissue integrity and viability of first trimester placenta explants were obtained in culture for 3 weeks. Explants were infected with human cytomegalovirus (HCMV), several cycles of HCMV replication were obtained and the progression of the infection was observed within a tissue that maintains its normal cellular organization. In agreement with recent clinical data, 3 weeks were necessary for the virus to colonize the placenta fully. Complete HCMV replication was observed in trophoblasts, followed by subsequent transmission of the infection to the stromal fibroblasts and fetal endothelial capillary cells. Viral DNA replication was monitored and the production of infectious viral progeny documented.
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Affiliation(s)
- L Gabrielli
- Department of Clinical and Experimental Medicine, Section of Microbiology, St. Orsola General Hospital, University of Bologna, Bologna, Italy
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Abstract
Recent advances in the screening of pregnant women with Cytomegalovirus (CMV) IgM, CMV IgG and CMV IgG avidity serologic tests, has led to a more accurate diagnosis of CMV infection. When serologic screening is performed early in gestation, it is possible to identify those women at risk of intrauterine transmission of the virus, i.e., those women with a primary CMV infection, who should be enrolled in prenatal diagnosis. The use of quantitative PCR on amniotic fluid from pregnant women at 21-22 weeks of gestation in prenatal diagnosis is an effective diagnostic tool to distinguish between CMV infection and CMV disease in the fetus and newborn. Quantitative PCR on peripheral blood leukocytes from CMV infected newborns can be used to monitor viral load, especially during treatment with ganciclovir. These advances in serology and quantitative virology should lead to more accurate diagnosis of maternal and congenital CMV infection.
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Affiliation(s)
- G T Maine
- Dept. of Congenital Infectious Disease Diagnostics, Abbott Laboratories, 200 Abbott Park Road, Bldg. AP31 D-9JW, Abbott Park, IL 60064, USA.
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Ruan Q, Ripalti A, Landini MP. [Amino acid sequence analysis of peptides that can react to the nuclear localization signals of human cytomegalovirus PPUL44]. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi 2001; 15:69-72. [PMID: 12526308] [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: 02/28/2023]
Abstract
OBJECTIVE To find the peptides that have strong binding ability to the nuclear localization signals (NLS) of human Cytomegalovirus (HCMV) PPUL44 protein, and to analyze their amino acid sequences. METHODS Peptide clones that have binding ability to the NLSs were selected from a random peptide display library by using synthesized HCMV PPUL44 NLSA and NLSB respectively. The DNA sequences of these clones were detected by using "ABI Prism BigDye Terminator Cycle Sequencing Ready Reaction Kit". The amino acid sequences of the clones were analyzed for their homology, and the homologous sequences were compared with known sequences in protein bank. RESULTS The peptides that can bind to the HCMV PPUL44 NLSA(named as bNLSApep) have higher homologous amino acid sequence to importin alpha subunit, the bNLSApep48 sequence AVVTPVLTEILK is more similar to the sequence of the importin alpha subunit Arm 7 from amino acid 18 to 29, ANIFPVLTEILQ; The bNLSBpep 39 is similar to the sequence of all 8 Arm regions of importin alpha subunit from amino acid 10 to 21. CONCLUSION It is possible that the HCMV PPUL44 NLSA is a specific recognition site by importin alpha subunit, it can bind to the Arm 7 region of importin alpha subunit; HCMV PPUL44 NLSB is a non-specific recognition site for importin alpha subunit. This study provided an experimental data for the proposal that the Arm repeat region of importin alpha subunit is the binding region of NLS.
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Affiliation(s)
- Q Ruan
- Virus Laboratory, Second Affiliated Hospital of China Medical University, Shenyang 110003, China
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Halling VW, Maine GT, Groettum CM, Wilson JA, Spesard J, Brojanac S, Combs B, Wachta D, Holas C, Wilson T, Wang D, Tomazic-Allen S, Lazzarotto T, Landini MP, Jevremovic-Simovic S, Wiesner RH, Paya CV, Smith TF. Clinical evaluation of a new recombinant antigen-based cytomegalovirus immunoglobulin M immunoassay in liver transplant recipients. Transplantation 2001; 71:395-7. [PMID: 11233899 DOI: 10.1097/00007890-200102150-00009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Human cytomegalovirus (CMV) is a significant cause of morbidity and mortality among transplant recipients. Monitoring transplant recipients by CMV IgM serology has been questioned by several studies due to the reported insensitivity of serologic tests relative to antigen detection methods. METHODS In this retrospective study, we have evaluated the performance of the new recombinant antigen-based Abbott AxSYM CMV IgM assay and compared it with CMV culture technique in a cohort of 40 liver transplant recipients who did not receive antiviral prophylaxis. RESULTS The sensitivity, specificity, and positive and negative predictive values for detection of CMV disease by the AxSYM CMV IgM assay were 90.0%, 60.0%, 69.2%, and 85.7%, respectively, and by culture the values were 100%, 55.0%, 69.0%, and 100%, respectively. Detection of CMV IgM occurred before or at the time of CMV disease in only R+ recipients. CONCLUSION Although this assay is a sensitive test for CMV-specific IgM, detection of CMV IgM preceded detection of virus by culture in patients only when the liver transplant recipient was CMV immune before transplantation (R+).
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Affiliation(s)
- V W Halling
- Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA
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Genser B, Truschnig-Wilders M, Stünzner D, Landini MP, Halwachs-Baumann G. Evaluation of five commercial enzyme immunoassays for the detection of human cytomegalovirus-specific IgM antibodies in the absence of a commercially available gold standard. Clin Chem Lab Med 2001; 39:62-70. [PMID: 11256803 DOI: 10.1515/cclm.2001.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the recent years the number of commercially available immunoassays for the detection of human cytomegalovirus (HCMV)-specific immunoglobulin M (IgM) antibodies has rapidly increased. The aim of the present study was to evaluate five commercial immunoassays for the serological diagnosis of HCMV-infection. These methods, namely the IMx CMV IgM assay, the AxSYM CMV IgM assay (both Abbott), the Gull CMV IgM, the CMV-IgM-ELA test PCS Medac and the Biotest Anti-HCMV recombinant IgM ELISA, were compared for their diagnostic effectiveness and interference with substances eventually producing cross-reactions with HCMV-IgM (Epstein-Barr-virus (EBV)-IgM, rheumatoid factor (RF)). In addition, repeated measurements on samples from kidney and heart transplant recipients with active HCMV infection were examined to compare the temporal development of the HCMV-IgM measured with the five assay systems. Since there is no commercially available gold standard, it was assumed that the true classification, of whether the patient sample is HCMV-IgM positive or negative, was unknown. Hence sensitivity and specificity were assessed based on a maximum likelihood approach using a "latent class" model. The cross-reactions were quantified by a Bayesian statistical model using prior information for the expected prevalences in the EBV-IgM and rheumatoid factor sample groups. The results of the study demonstrated that there are great differences in sensitivity and specificity as well as in cross-reactions with EBV-IgM and RF between the tested ELISAs.
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Affiliation(s)
- B Genser
- Gemeinsame Einrichtung für Med.-Chem. Labordiagnostik, Blocklabor II, Universitätsklinikum Graz, Austria.
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Dal Monte P, Pignatelli S, Mach M, Landini MP. The product of human cytomegalovirus UL73 is a new polymorphic structural glycoprotein (gpUL73). J Hum Virol 2001; 4:26-34. [PMID: 11213930] [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: 02/19/2023]
Abstract
OBJECTIVES This work focuses on human cytomegalovirus (HCMV) UL73, which encodes for a putative transmembrane glycoprotein that is highly conserved among herpesviruses. STUDY DESIGN pUL73 expression was analyzed both in transiently transfected and in HCMV-infected cells using a pUL73-specific antiserum by immunoblot and immunofluorescence. Sequencing analysis from several clinical isolates and laboratory-adapted strains was also performed. RESULTS pUL73 expressed in transiently transfected cells consists in a polypeptide of the expected size (15-18 kd) with cytoplasmic localization. In infected cells, pUL73 is expressed with true-late kinetics and localizes both in perinuclear granular formations and on the cell surface. A broad band (39-53 kd), sensitive to O-glycosidase digestion was detected in purified virus. In addition, sequence analysis showed that the N-terminal portion of pUL73 from clinical isolates is highly polymorphic. CONCLUSIONS UL73 encodes for a new structural glycoprotein (gpUL73) expressed on the cell surface of infected cells and highly polymorphic among clinical isolates.
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Affiliation(s)
- P Dal Monte
- Department of Clinical and Experimental Medicine, University of Bologna, Italy.
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Lazzarotto T, Galli C, Pulvirenti R, Rescaldani R, Vezzo R, La Gioia A, Martinelli C, La Rocca S, Agresti G, Grillner L, Nordin M, van Ranst M, Combs B, Maine GT, Landini MP. Evaluation of the Abbott AxSYM cytomegalovirus (CMV) immunoglobulin M (IgM) assay in conjunction with other CMV IgM tests and a CMV IgG avidity assay. Clin Diagn Lab Immunol 2001; 8:196-8. [PMID: 11139220 PMCID: PMC96035 DOI: 10.1128/cdli.8.1.196-198.2001] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The measurement of the avidity of cytomegalovirus (CMV) immunoglobulin G (IgG) antibodies has been shown by several investigators to be useful in identifying and excluding primary CMV infections in pregnant women. In this work, we examined the diagnostic utility of reflex testing of CMV IgM-positive specimens from pregnant women by using a CMV IgG avidity assay. The utility of this approach was directly dependent on the sensitivity of the CMV IgM assay employed during the initial screen. The higher initial reactivity rate of the AxSYM CMV IgM assay was necessary in order to detect CMV IgM in specimens containing low-avidity CMV IgG antibodies, indicative of a primary CMV infection, which other CMV IgM assays (Behring, Vidas, Captia, and Eurogenetics) fail to detect in some cases. The use of the AxSYM CMV IgM assay, followed by an avidity test, should result in more accurate diagnosis of CMV infection in pregnant women.
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Affiliation(s)
- T Lazzarotto
- Department of Clinical and Experimental Medicine, Section of Microbiology, University of Bologna, Bologna, Italy
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Emery VC, Cope AV, Sabin CA, Burroughs AK, Rolles K, Lazzarotto T, Landini MP, Brojanac S, Wise J, Maine GT. Relationship between IgM antibody to human cytomegalovirus, virus load, donor and recipient serostatus, and administration of methylprednisolone as risk factors for cytomegalovirus disease after liver transplantation. J Infect Dis 2000; 182:1610-5. [PMID: 11069231 DOI: 10.1086/317636] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/1999] [Revised: 07/07/2000] [Indexed: 11/03/2022] Open
Abstract
A retrospective study was performed on a selected cohort of 40 liver transplant recipients derived from the previous prospective follow-up of 162 liver transplant patients. The criterion for selection of this cohort was the presence of human cytomegalovirus (HCMV) DNAemia after transplantation, as determined by qualitative polymerase chain reaction (PCR). These 40 patients were followed longitudinally by quantitative PCR and by the new recombinant antigen-based AxSYM immunoassay for IgM to HCMV. The detection of IgM to CMV after transplantation was significantly associated with the development of HCMV disease in patients who had evidence of active HCMV replication in the blood by PCR (P=.01). On the basis of multivariate logistic regression analyses, the maximum titer of IgM detected after transplantation was a risk factor that was independent of augmented methylprednisolone and donor seropositivity. However, in multivariate analyses, elevated virus load continued to be the predominant risk factor for progression to HCMV disease.
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Affiliation(s)
- V C Emery
- Dept. of Virology, Royal Free and University College Medical School, Royal Free Campus, London NW3 2PF, UK, USA.
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Vivarelli M, De Ruvo N, Lazzarotto T, Bellusci R, Landini MP, Varani S, Cavallari A. Abstension from treatment of low-level pp65 cytomegalovirus antigenemia after liver transplantation: a prospective study. Transplantation 2000; 70:1183-7. [PMID: 11063338 DOI: 10.1097/00007890-200010270-00010] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Ganciclovir is a highly effective and relatively safe drug to treat cytomegalovirus (CMV) infection in liver transplant patients; CMV resistance to ganciclovir is progressively emerging due to the extensive use of the drug in transplant and AIDS patients; CMV pp65 antigenemia allows early diagnosis of CMV infection and quantitation of the viral load; preemptive antigenemia-guided therapy of CMV infection can prevent CMV disease but the threshold of antigenemia value above which treatment has to be instituted is unclear. METHODS To demonstrate the safety of abstention from preemptive treatment in the presence of low levels of antigenemia 77 consecutive liver transplant recipients were prospectively evaluated. Antigenemia was tested twice a week from transplantation until discharge, then once a week until the third postoperative month. In absence of risk factors for CMV disease, namely donor positive/recipient negative CMV serology, treatment with antibodies to lymphocytes and retransplantation, only patients with antigenemia of more than 50 or symptoms possibly related to CMV infection had preemptive treatment. RESULTS A total of 32 patients had at least one positive antigenemia test with a value less than 50; 22 (68.7%) spontaneously cleared the virus, 3 were treated with i.v. ganciclovir for the presence of fever, and the other 7 (21,8%) progressed to values of antigenemia of more than 50 and were treated even if asymptomatic. No CMV disease was observed in these patients. CONCLUSION CMV antigenemia less than 50 in liver transplant recipients with low and intermediate risk for CMV disease does not mandate preemptive ganciclovir treatment. Close surveillance with repeated determination of antigenemia until its negativization and careful clinical and laboratory monitoring is advisable.
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Affiliation(s)
- M Vivarelli
- Dipartimento di Discipline Chirurgiche Rianimatorie e dei Trapianti-Chirurgia II, University of Bologna, S. Orsola Hospital, Italy
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Varani S, Lazzarotto T, Margotti M, Masi L, Gramantieri L, Bolondi L, Landini MP. Laboratory signs of acute or recent cytomegalovirus infection are common in cirrhosis of the liver. J Med Virol 2000. [PMID: 10935984 DOI: 10.1002/1096-9071(200009)62:1<25::aid-jmv4>3.0.co;2-e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Human cytomegalovirus (CMV) is an ubiquitous pathogen that can cause severe and often fatal infections in immunocompromised patients. Patients with cirrhosis often show various degrees of impaired cellular immunity that could lead to acute CMV reactivation. The aim of the present study was to determine whether laboratory findings of active CMV infections are common in patients with cirrhosis. Fifty-five patients with cirrhosis were studied for acute CMV infection by virological (antigenemia and quantitative polymerase chain reaction in polymorphonuclear leukocytes) and serological (detection of anti-CMV IgM by immunoblot) methods. The same tests were carried out on 50 blood donors and on 20 chronic hepatitis patients, considered as control populations. Acute or recent CMV infection had occurred in 31 (56%) of 55 patients with cirrhosis, whereas only 1 out of 20 (5%) patients with chronic non-cirrhotic liver disease and none of the 50 blood donors had laboratory signs of active CMV infection. The difference between patients with cirrhosis and the control groups was significant (P < 0.001, chi(2) test). CMV in patients with cirrhosis was not related to age, gender, hepatitis C virus infection or hepatocellular carcinoma. There was no significant correlation between impairment of liver function and the presence of active CMV infection. Patients with cirrhosis should be considered at risk for CMV infection, that seems to be mild and asymptomatic.
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Affiliation(s)
- S Varani
- Department of Clinical and Experimental Medicine, Section of Microbiology and Virology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy
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Varani S, Lazzarotto T, Margotti M, Masi L, Gramantieri L, Bolondi L, Landini MP. Laboratory signs of acute or recent cytomegalovirus infection are common in cirrhosis of the liver. J Med Virol 2000; 62:25-8. [PMID: 10935984 DOI: 10.1002/1096-9071(200009)62:1<25::aid-jmv4>3.0.co;2-e] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Human cytomegalovirus (CMV) is an ubiquitous pathogen that can cause severe and often fatal infections in immunocompromised patients. Patients with cirrhosis often show various degrees of impaired cellular immunity that could lead to acute CMV reactivation. The aim of the present study was to determine whether laboratory findings of active CMV infections are common in patients with cirrhosis. Fifty-five patients with cirrhosis were studied for acute CMV infection by virological (antigenemia and quantitative polymerase chain reaction in polymorphonuclear leukocytes) and serological (detection of anti-CMV IgM by immunoblot) methods. The same tests were carried out on 50 blood donors and on 20 chronic hepatitis patients, considered as control populations. Acute or recent CMV infection had occurred in 31 (56%) of 55 patients with cirrhosis, whereas only 1 out of 20 (5%) patients with chronic non-cirrhotic liver disease and none of the 50 blood donors had laboratory signs of active CMV infection. The difference between patients with cirrhosis and the control groups was significant (P < 0.001, chi(2) test). CMV in patients with cirrhosis was not related to age, gender, hepatitis C virus infection or hepatocellular carcinoma. There was no significant correlation between impairment of liver function and the presence of active CMV infection. Patients with cirrhosis should be considered at risk for CMV infection, that seems to be mild and asymptomatic.
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Affiliation(s)
- S Varani
- Department of Clinical and Experimental Medicine, Section of Microbiology and Virology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy
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Lazzarotto T, Spezzacatena P, Pradelli P, Abate DA, Gabrielli L, Varani S, Landini MP. Cytomegalovirus infection in pregnancy: a still complicated diagnostic problem. Intervirology 2000; 41:149-57. [PMID: 10213889 DOI: 10.1159/000024929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The diagnostic problems linked to human cytomegalovirus (HCMV) in pregnancy are many and not all have been fully defined. In long-term seropositive women there is a tacit agreement that no laboratory testing for HCMV should be carried out. In seronegative women a test for HCMV-specific IgG should be performed at least twice during the first 4 months of pregnancy, and if the seronegativity persists, further follow-up might be stopped. On the other hand, if a seropositivity appears the diagnosis of a primary HCMV infection is established and prenatal diagnosis should be offered to the mother. Finally, in the case of a pregnant woman with unknown serological status, the diagnosis of HCMV infection is a complex problem and several different questions need to be addressed. In our opinion they should be screened with a reliable IgM test (confirmed by blot if necessary) followed, in the case of positivity, by an avidity assay. Pregnant women undergoing a primary HCMV infection should be encouraged to seek prenatal diagnosis to be performed by PCR and virus isolation from amniotic fluid at the 21st to 23rd week of gestation.
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Affiliation(s)
- T Lazzarotto
- Department of Clinical and Experimental Medicine, Division of Microbiology, University of Bologna, Italy
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Guerra B, Lazzarotto T, Quarta S, Lanari M, Bovicelli L, Nicolosi A, Landini MP. Prenatal diagnosis of symptomatic congenital cytomegalovirus infection. Am J Obstet Gynecol 2000; 183:476-82. [PMID: 10942490 DOI: 10.1067/mob.2000.106347] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate whether the amniotic viral load of mothers with primary cytomegalovirus infection correlate with fetal or neonatal outcomes. STUDY DESIGN Sixty-eight of 138 pregnant women with primary infection defined by immunoglobulin G seroconversion or the presence of immunoglobulin M with low immunoglobulin G avidity accepted amniocentesis. Polymerase chain reaction and quantitative polymerase chain reaction were used to detect amniotic fluid cytomegalovirus. Cytomegalovirus infection in neonates was determined by means of urinary viral isolation during the first week after birth or the histologic examination of tissue from aborted fetuses. RESULTS Cytomegalovirus infection was found in 16 fetuses and neonates (23%), 5 of whom had symptoms. Quantitative polymerase chain reaction showed that the presence of >/=10(3) genome equivalents predicted mother-child infection with 100% probability; >/=10(5) genome equivalents predicted the development of a symptomatic infection. CONCLUSION Fewer than expected cytomegalovirus-infected fetuses are at risk for development of cytomegaloviral disease, and this fact may be useful in counseling pregnant women with primary cytomegalovirus infection.
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Affiliation(s)
- B Guerra
- II Department of Obstetrics and Gynecology, Bologna, Italy. and the D
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