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Nannini G, Di Gloria L, Russo E, Sterrantino G, Kiros ST, Coppi M, Niccolai E, Baldi S, Ramazzotti M, Di Pilato V, Lagi F, Bartolucci G, Rossolini GM, Bartoloni A, Amedei A. Oral microbiota signatures associated with viremia and CD4 recovery in treatment-naïve HIV-1-infected patients. Microbes Infect 2024:105339. [PMID: 38636822 DOI: 10.1016/j.micinf.2024.105339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE Few reports focused on the role of oral microbiome diversity in HIV infection. We characterized the microbiota-immunity axis in a cohort of treatment-naïve HIV-1-infected patients undergoing antiretroviral therapy (ART) focusing on the oral microbiome (OM) and immunological responsivity. METHODS The sequencing of 16S rRNA V3-V4 hypervariable region was performed on salivary samples of 15 healthy control (HC) and 12 HIV+ patients before starting ART and after reaching virological suppression. Then, we correlated the OM composition with serum cytokines and the Short Chain Fatty acids (SCFAs). RESULTS The comparison between HIV patients and HC oral microbiota showed differences in the bacterial α-diversity and richness. We documented a negative correlation between oral Prevotella and intestinal valeric acid at before starting ART and a positive correlation between oral Veillonella and gut acetic acid after reaching virological suppression. Finally, an increase in the phylum Proteobacteria was observed comparing saliva samples of immunological responders (IRs) patients against immunological non-responders (INRs). CONCLUSIONS For the first time, we described an increase in the oral pro-inflammatory Proteobacteria phylum in INRs compared to IRs. We provided more evidence that saliva could be a non-invasive and less expensive approach for research involving the oral cavity microbiome in HIV patients.
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Affiliation(s)
- Giulia Nannini
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Leandro Di Gloria
- Department of Biomedical, Experimental and Clinical "Mario Serio", University of Florence, Florence 50134, Italy
| | - Edda Russo
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Gaetana Sterrantino
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Seble Tekle Kiros
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy; Clinical Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Elena Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Simone Baldi
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Matteo Ramazzotti
- Department of Biomedical, Experimental and Clinical "Mario Serio", University of Florence, Florence 50134, Italy
| | - Vincenzo Di Pilato
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Filippo Lagi
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Gianluca Bartolucci
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence 50019, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy; Clinical Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy.
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2
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Tascini C, Coppi M, Antonelli A, Niccolai C, Bartolini A, Pecori D, Sartor A, Giani T, Rossolini GM. In vivo evolution to high-level cefiderocol resistance of NDM-1-producing Klebsiella pneumoniae, followed by intra-hospital cross-transmission. Clin Microbiol Infect 2024; 30:398-400. [PMID: 37979689 DOI: 10.1016/j.cmi.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/20/2023]
Affiliation(s)
- Carlo Tascini
- Infectious Diseases Clinic, Department of Medicine, University of Udine, Udine, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Claudia Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Andrea Bartolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Davide Pecori
- Infectious Diseases Clinic, Department of Medicine, University of Udine, Udine, Italy
| | - Assunta Sartor
- Clinical Microbiology, Udine University Hospital, Udine, Italy
| | - Tommaso Giani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.
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3
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Mazzitelli M, Scaglione V, Cattarin L, Franchin E, Stano P, Paci L, Coppi M, Rossolini GM, Mengato D, Calò L, Cattelan AM. Off-label oritavancin treatment outcome and molecular characterization of a vancomycin- and linezolid-resistant Enterococcus faecium causing liver abscesses. J Antimicrob Chemother 2024; 79:689-691. [PMID: 38225167 DOI: 10.1093/jac/dkad410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Affiliation(s)
- Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy
| | - Vincenzo Scaglione
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy
| | - Leda Cattarin
- Nephrology Unit, Padua University Hospital, Padua, Italy
| | - Elisa Franchin
- Microbiology and Virology Unit, Padua University Hospital, Padua, Italy
| | - Paola Stano
- Microbiology and Virology Unit, Padua University Hospital, Padua, Italy
| | - Lorenzo Paci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Daniele Mengato
- Hospital Pharmacy Unit, Padua University Hospital, Padua, Italy
| | - Lorenzo Calò
- Nephrology Unit, Padua University Hospital, Padua, Italy
| | - Anna Maria Cattelan
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy
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4
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Camarlinghi G, Parisio EM, Antonelli A, Coppi M, Niccolai C, Giani T, Rossolini GM. Chloramphenicol activity against carbapenemase producing Enterobacterales. J Glob Antimicrob Resist 2024; 37:42-43. [PMID: 38417738 DOI: 10.1016/j.jgar.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/23/2024] [Accepted: 02/12/2024] [Indexed: 03/01/2024] Open
Affiliation(s)
| | | | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Claudia Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Tommaso Giani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
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5
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Antonelli A, Coppi M, Bonaiuto C, Giovacchini N, Vaggelli G, Farese A, Pollini S, Rossolini GM. Novel resistance ICEs carrying the blaFIM-1 metallo-β-lactamase gene from an ST235 Pseudomonas aeruginosa sublineage. Antimicrob Agents Chemother 2024; 68:e0120523. [PMID: 38206043 PMCID: PMC10848763 DOI: 10.1128/aac.01205-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024] Open
Abstract
FIM-1 is an acquired metallo-β-lactamase identified in a multidrug-resistant Pseudomonas aeruginosa (index strain FI-14/157) of clinical origin isolated in 2007 in Florence, Italy. Here we report on a second case of infection by FIM-1-positive P. aeruginosa (FI-17645), which occurred in 2020 in the same hospital. Both FIM-1-positive strains exhibited resistance to all anti-Pseudomonas antibiotics except colistin and cefiderocol. Comparative genomic characterization revealed that the two FIM-positive strains were closely related [core genome difference, 16 single nucleotide polymorphisms (SNPs)], suggesting a local circulation of similar strains. In the FI-14/157 index strain, the blaFIM-1 gene was associated with an ISCR19-like element that likely contributed to its capture downstream an integron platform inserted aboard a Tn21-like transposon, named Tn7703.1, which was associated with a large integrative and conjugative element (ICE) named ICE7705.1, integrated into an att site located within the 3'-end of tRNAGly CCC gene of the P. aeruginosa chromosome. In strain FI-17645, blaFIM-1 was associated with a closely related ICE, named ICE7705.2, integrated in the same chromosomal site. Similar ICE platforms, lacking the blaFIM-1-containing region, were detected in other ST235 P. aeruginosa strains from different geographic areas, suggesting a common ancestry and underscoring the role of these elements in the dissemination of resistance genes in P. aeruginosa. Sequence database mining revealed two draft P. aeruginosa genomes, one from Italy and one from the USA (both isolated in 2012), including a contig with blaFIM-1, suggesting that this resistance gene could have a broader distribution than originally anticipated.
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Affiliation(s)
- Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Chiara Bonaiuto
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Nicla Giovacchini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Guendalina Vaggelli
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Alberto Farese
- Infectious and Tropical Diseases Unit, Florence Careggi University Hospital, Florence, Italy
| | - Simona Pollini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
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Fabricci M, Trinca A, Talotti L, Busetti M, Fotakis EA, Merakou C, Koncan R, Ghiotti A, Negri C, Di Maso V, Bosco M, Antonelli A, Coppi M, Rossolini GM, Giuliani C, Scarpis E, Gregoretti B, Licastro D, Luzzati R, Costantino V. A urokinase-associated outbreak of Ralstonia mannitolilytica bloodstream infections in haemodialysis patients in north-eastern Italy, January to April 2023. Euro Surveill 2023; 28:2300328. [PMID: 37440346 PMCID: PMC10347894 DOI: 10.2807/1560-7917.es.2023.28.28.2300328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/13/2023] [Indexed: 07/15/2023] Open
Abstract
An outbreak of Ralstonia mannitolilytica bloodstream infections occurred in four hospitals in north-eastern Italy, involving 20 haemodialysis patients with tunnelled central vascular catheter access. We identified as the outbreak source a batch of urokinase vials imported from India contaminated with R. mannitolilytica. Whole genome sequences of the clinical and urokinase strains were highly related, and only urokinase-treated patients were reported with R. mannitolilytica infections (attack rate = 34%; 95% confidence interval: 22.1-47.4). Discontinuation of the contaminated urokinase terminated the outbreak.
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Affiliation(s)
| | - Anaïs Trinca
- Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Luca Talotti
- Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Marina Busetti
- Microbiology Unit, Trieste University Hospital (ASUGI), Trieste, Italy
| | - Emmanouil Alexandros Fotakis
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Italian National Institute of health (ISS), Rome, Italy
| | - Christina Merakou
- Italian National Institute of health (ISS), Rome, Italy
- ECDC fellowship Programme, Public Health Microbiology path (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Raffaella Koncan
- Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Camilla Negri
- Medical Directorate, Gorizia and Monfalcone Hospital (ASUGI), Gorizia and Monfalcone, Italy
| | - Vittorio Di Maso
- Nephrology and Dialysis Unit, Trieste University Hospital (ASUGI), Trieste, Italy
| | - Manuela Bosco
- Nephrology and Dialysis Unit, Gorizia and Monfalcone Hospital (ASUGI), Gorizia and Monfalcone, Italy
| | - Alberto Antonelli
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marco Coppi
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gian Maria Rossolini
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Claudia Giuliani
- Medical Directorate, Palmanova Hospital (ASUFC), Palmanova, Italy
| | - Enrico Scarpis
- Medical Directorate, Palmanova Hospital (ASUFC), Palmanova, Italy
| | - Barbara Gregoretti
- Medical Directorate, Trieste University Hospital (ASUGI), Trieste, Italy
| | | | - Roberto Luzzati
- Infectious Diseases Unit, Trieste University Hospital (ASUGI), Trieste, Italy
- Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Venera Costantino
- Microbiology Unit, Trieste University Hospital (ASUGI), Trieste, Italy
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7
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Riccobono E, Salvetti S, Coppi M, Montenora I, Di Pilato V, Rossolini GM. Citrobacter freundii resistant to novel β-lactamase inhibitor combinations and cefiderocol, co-producing class A, B and D carbapenemases encoded by transferable plasmids. J Antimicrob Chemother 2023:7173996. [PMID: 37207353 DOI: 10.1093/jac/dkad150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/02/2023] [Indexed: 05/21/2023] Open
Abstract
OBJECTIVES To characterize a carbapenem-resistant Citrobacter freundii (Cf-Emp) co-producing class A, B and D carbapenemases, resistant to novel β-lactamase inhibitor combinations (BLICs) and cefiderocol. METHODS Carbapenemase production was tested by an immunochromatography assay. Antibiotic susceptibility testing (AST) was performed by broth microdilution. WGS was performed using short- and long-read sequencing. Transfer of carbapenemase-encoding plasmids was assessed by conjugation experiments. RESULTS Cf-Emp was isolated on selective medium for carbapenem-resistant Enterobacterales from the surveillance rectal swab taken at hospital admission from a patient of Moroccan origin. Cf-Emp produced three different carbapenemases, including KPC-2, OXA-181 and VIM-1, and was resistant to all β-lactams including carbapenems, novel BLICs (ceftazidime/avibactam, meropenem/vaborbactam and imipenem/relebactam) and cefiderocol. MIC of aztreonam/avibactam was 0.25 mg/L. The strain belonged to ST22, one of the C. freundii lineages of global diffusion, known to be associated with carbapenemase production. Each carbapenemase gene was located aboard a different plasmid (named pCf-KPC, pCf-OXA and pCf-VIM, respectively), which also carried other clinically relevant resistance genes, such as armA (pCf-KPC), blaSHV-12 (pCf-VIM) and qnrS1 (pCf-OXA). Transferability to Escherichia coli J53 by conjugation was observed for all plasmids. CONCLUSIONS The finding of enterobacterial strains carrying multiple carbapenemase genes on transferable plasmids is alarming, because similar strains could provide an important reservoir for disseminating these clinically relevant resistance determinants.
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Affiliation(s)
- Eleonora Riccobono
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Sara Salvetti
- Microbiology Unit, San Giuseppe Hospital, Empoli, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Clinical Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | | | - Vincenzo Di Pilato
- Clinical Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Clinical Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
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8
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Aiezza N, Antonelli A, Coppi M, Di Pilato V, Giani T, Rossolini GM. Up-regulation of resident chromosomal fosB gene expression: a novel mechanism of acquired fosfomycin resistance in MRSA. J Antimicrob Chemother 2023:7158806. [PMID: 37161536 DOI: 10.1093/jac/dkad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/17/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVES This study investigated fosfomycin susceptibility and mechanisms of resistance in a collection of 99 Staphylococcus aureus isolated from cases of hospital-acquired pneumonia, previously collected from a multicentre survey carried out in Italy. METHODS Fosfomycin susceptibility was tested by reference agar dilution. Bioinformatic and gene expression analysis, mutant selection experiments and WGS were executed to characterize fosfomycin resistance mechanisms. RESULTS Fosfomycin resistance rates were 0% (0 of 35) among MSSA and 22% (14 of 64) among MRSA, with no evidence of clonal expansion. Resistance mechanisms were putatively identified in 8 of the 14 resistant strains, including: (i) chromosomal mutations causing loss of function of the UhpT transporter; (ii) overexpression of the gene encoding the Tet38 efflux pump; and (iii) overexpression of a fosB gene encoding a fosfomycin-inactivating enzyme, which was found to be resident in the chromosome of several S. aureus lineages but not always associated with fosfomycin resistance. The latter mechanism, which had not been previously described and was confirmed by results of in vitro mutant selection experiments, was associated in two cases with transposition of an IS1182 element upstream of the chromosomal fosB gene, apparently providing an additional promoter. CONCLUSIONS This study showed that some S. aureus clonal lineages carry a resident chromosomal fosB gene and can evolve to fosfomycin resistance by overexpression of this gene.
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Affiliation(s)
- Noemi Aiezza
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Vincenzo Di Pilato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Tommaso Giani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
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9
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Marangoni D, Antonello RM, Coppi M, Palazzo M, Nassi L, Streva N, Povolo L, Malentacchi F, Zammarchi L, Rossolini GM, Vannucchi AM, Bartoloni A, Spinicci M. Combination regimen of nirmatrelvir/ritonavir and molnupiravir for the treatment of persistent SARS-CoV-2 infection: a case report and a scoping review of the literature. Int J Infect Dis 2023; 133:53-56. [PMID: 37150351 DOI: 10.1016/j.ijid.2023.04.412] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 03/15/2023] [Revised: 04/27/2023] [Accepted: 04/30/2023] [Indexed: 05/09/2023] Open
Abstract
Immunocompromised patients still experience unpredictable courses of COVID-19, despite effective vaccines and drugs against SARS-CoV-2 are now available. Antiviral combination regimens may have a role in SARS-CoV-2 infection in immunocompromised hosts, but current knowledge is still limited. We describe the case of a 73-year-old Italian man affected by follicular lymphoma with persistent SARS-CoV-2 infection who was successfully treated with co-administration of oral antivirals (10-day molnupiravir and nirmatrelvir/ritonavir). The therapy was well tolerated both from a clinical and biochemical standpoint, with no signs of toxicity. We also performed a scoping review to sum up available knowledge on combined antiviral regimens including remdesivir, molnupiravir or nirmatrelvir/ritonavir. Pending further studies on larger cohorts of patients, our report is consistent with available pre-clinical and clinical data, supporting the possible use of combination therapy in selected difficult-to-treat COVID-19 cases.
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Affiliation(s)
- Davide Marangoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Marianna Palazzo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Luca Nassi
- Department of Hematology, Careggi University Hospital, Florence, Italy
| | - Noemi Streva
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Laura Povolo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Alessandro Maria Vannucchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Department of Hematology, Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Michele Spinicci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
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10
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Graziani L, Gori L, Manciulli T, Basile G, Campolmi I, Borchi B, di Dio M, Mattei M, Ciurleo G, Ciliberti M, Malentacchi F, Coppi M, Morettini A, Parronchi P, Rossolini GM, Bartoloni A, Tomassetti S, Spinicci M. Successful use of nirmatrelvir/ritonavir in immunocompromised patients with persistent and/or relapsing COVID-19. J Antimicrob Chemother 2022; 78:555-558. [PMID: 36544352 PMCID: PMC9890247 DOI: 10.1093/jac/dkac433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Lucia Graziani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Leonardo Gori
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Tommaso Manciulli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gregorio Basile
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Irene Campolmi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Beatrice Borchi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Marta di Dio
- Internal Medicine Unit 2, Careggi University Hospital, Florence, Italy
| | - Marta Mattei
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Greta Ciurleo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Ciliberti
- Internal Medicine Unit 2, Careggi University Hospital, Florence, Italy
| | | | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Paola Parronchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy,Immunology and Cell Therapy Unit, Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy,Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy,Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Sara Tomassetti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy,Interventional Pneumology Unit, Careggi University Hospital, Florence, Italy
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Coppi M, Antonelli A, Niccolai C, Bartolini A, Bartolini L, Grazzini M, Mantengoli E, Farese A, Pieralli F, Mechi MT, Di Pilato V, Giani T, Rossolini GM. Nosocomial outbreak by NDM-1-producing Klebsiella pneumoniae highly resistant to cefiderocol, Florence, Italy, August 2021 to June 2022. Euro Surveill 2022; 27:2200795. [PMID: 36305334 PMCID: PMC9615416 DOI: 10.2807/1560-7917.es.2022.27.43.2200795] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/26/2022] [Indexed: 09/29/2023] Open
Abstract
A nosocomial outbreak by cefiderocol (FDC)-resistant NDM-1-producing Klebsiella pneumoniae (NDM-Kp) occurred in a large tertiary care hospital from August 2021-June 2022 in Florence, Italy, an area where NDM-Kp strains have become endemic. Retrospective analysis of NDM-Kp from cases observed in January 2021-June 2022 revealed that 21/52 were FDC-resistant. The outbreak was mostly sustained by clonal expansion of a mutant with inactivated cirA siderophore receptor gene, which exhibited high-level resistance to FDC (MIC ≥ 32 mg/L) and spread independently of FDC exposure.
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Affiliation(s)
- Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Claudia Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Bartolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Laura Bartolini
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Maddalena Grazzini
- Hospital Infection Prevention and Control Unit, Florence Careggi University Hospital, Florence, Italy
| | - Elisabetta Mantengoli
- Hospital Infection Prevention and Control Unit, Florence Careggi University Hospital, Florence, Italy
- Infectious and Tropical Diseases Unit, Florence Careggi University Hospital, Florence, Italy
| | - Alberto Farese
- Infectious and Tropical Diseases Unit, Florence Careggi University Hospital, Florence, Italy
| | - Filippo Pieralli
- Subintensive Care Unit, Florence Careggi University Hospital, Florence, Italy
| | - Maria Teresa Mechi
- Hospital Infection Prevention and Control Unit, Florence Careggi University Hospital, Florence, Italy
| | - Vincenzo Di Pilato
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Tommaso Giani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
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Parisio EM, Camarlinghi G, Antonelli A, Coppi M, Mosconi L, Rossolini GM. Epidemiology and antibiotic susceptibility profiles of obligate anaerobes in a hospital of central Italy during a one-year (2019) survey. Anaerobe 2022; 78:102666. [DOI: 10.1016/j.anaerobe.2022.102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/26/2022]
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13
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Antonelli A, Coppi M, Tellapragada C, Hasan B, Maruri A, Gijón D, Morecchiato F, de Vogel C, Verbon A, van Wamel W, Kragh KN, Frimodt-Møller N, Cantón R, Giske CG, Rossolini GM. Isothermal microcalorimetry versus checkerboard assay to evaluate in vitro synergism of meropenem-amikacin and meropenem-colistin combinations against multidrug-resistant Gram-negative pathogens. Int J Antimicrob Agents 2022; 60:106668. [PMID: 36038097 DOI: 10.1016/j.ijantimicag.2022.106668] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/28/2022] [Accepted: 08/21/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the activity of meropenem-amikacin and meropenem-colistin combinations with checkerboard broth microdilution (CKBM) compared to isothermal microcalorimetry (ITMC) assays against a multicentric collection of multidrug-resistant Gram-negative (MDR-GN) clinical isolates, to compare the Fractional inhibitory concentration index (FICI) and time to results of CKBM and ITMC assays. METHODS A collection of 333 MDR-GNs showing reduced susceptibility to meropenem (121 Klebsiella pneumoniae, 14 Escherichia coli, 130 Pseudomonas aeruginosa and 68 Acinetobacter baumannii) isolated from different centres (Florence, Madrid, Rotterdam, and Stockholm) was included in the study. The antimicrobial activity of selected combinations was evaluated with CKBM and ITMC. FICI results were interpreted as synergistic/additive and indifferent for values ≤0.5/0.5<x≤1 and >1, respectively. WGS data in a subset of strains was used to evaluate their clonality. RESULTS A total of 254 and 286 strains were tested with meropenem-colistin and meropenem-amikacin combinations with ITMC and CKBM, respectively. Synergism/additive effects were observed with 46 strains (20 K. pneumoniae, 4 E. coli, 22 P. aeruginosa) and 20 strains (3 K. pneumoniae, 11 P. aeruginosa and 6 A. baumannii) with meropenem-amikacin and meropenem-colistin combination, respectively, with CKBM. ITMC showed a good concordance with CKBM with 89.5% and 92.2% of cases interpreted within the same FICI category for meropenem-amikacin and meropenem-colistin combinations, respectively. Most of the synergism/additivity effects were detected within 6 hours by ITMC. CONCLUSIONS ITMC showed a very good concordance with CKBM against a large collection of MDR-GN and could be implemented for the rapid evaluation of in vitro activity of antimicrobial combinations.
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Affiliation(s)
- Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Chaitanya Tellapragada
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Badrul Hasan
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ainhize Maruri
- Servicio de Microbiologia, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Desiree Gijón
- Servicio de Microbiologia, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Fabio Morecchiato
- Department of Experimental and Clinical Medicine, University of Florence, Florence Italy
| | - Corné de Vogel
- Department of Medical Microbiology and Infectious Diseases, Erasmus University, Rotterdam, Netherlands
| | - Annelies Verbon
- Department of Medical Microbiology and Infectious Diseases, Erasmus University, Rotterdam, Netherlands
| | - Willem van Wamel
- Department of Medical Microbiology and Infectious Diseases, Erasmus University, Rotterdam, Netherlands
| | - Kasper Nørskov Kragh
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark; Costerton Biofilm Center, University of Copenhagen, Copenhagen, Denmark
| | | | - Rafael Cantón
- Servicio de Microbiologia, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER de Enfermedades Infecciosas. Instituto de Salud Carlos III. Madrid, Spain
| | - Christian G Giske
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Clinical microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy.
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Arena F, Menchinelli G, Di Pilato V, Torelli R, Antonelli A, Henrici De Angelis L, Coppi M, Sanguinetti M, Rossolini GM. Resistance and virulence features of hypermucoviscous Klebsiella pneumoniae from bloodstream infections: Results of a nationwide Italian surveillance study. Front Microbiol 2022; 13:983294. [PMID: 36204614 PMCID: PMC9531727 DOI: 10.3389/fmicb.2022.983294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Among Enterobacterales, Klebsiella pneumoniae (Kp) is one of the major opportunistic pathogens causing hospital-acquired infections. The most problematic phenomenon linked to Kp is related to the dissemination of multi-drug resistant (MDR) clones producing carbapenem-hydrolyzing enzymes, representing a clinical and public health threat at a global scale. Over the past decades, high-risk MDR clones (e.g., ST512, ST307, ST101 producing blaKPC–type carbepenemases) have become endemic in several countries, including Italy. Concurrently, the spread of highly virulent Kp lineages (e.g., ST23, ST86) able to cause severe, community-acquired, pyogenic infections with metastatic dissemination in immunocompetent subjects has started to be documented. These clones, designated as hypervirulent Kp (hvKp), produce an extensive array of virulence factors and are highly virulent in previously validated animal models. While the prevalence and distribution of MDR Kp has been previously assessed at local and national level knowledge about dissemination of hvKp remains scarce. In this work, we studied the phenotypic and genotypic features of hypermucoviscous (HMV, as possible marker of increased virulence) Kp isolates from bloodstream infections (BSI), obtained in 2016–17 from 43 Italian Laboratories. Antimicrobial susceptibility testing, whole genome sequencing and the use of two animal models (G. mellonella and murine) were employed to characterize collected isolates. Over 1502 BSI recorded in the study period, a total of 19 Kp were selected for further investigation based on their HMV phenotype. Results showed that hvKp isolates (ST5, ST8, ST11, ST25) are circulating in Italy, although with a low prevalence and in absence of a clonal expansion; convergence of virulence (yersiniabactin and/or salmochelin, aerobactin, regulators of mucoid phenotype) and antimicrobial-resistance (extended-spectrum beta-lactamases) features was observed in some cases. Conventional MDR Kp clones (ST307, ST512) may exhibit an HMV phenotype, but with a low virulence potential in the animal models. To the best of our knowledge, this work represents the first systematic survey on HMV and hvKp in Italy, employing a functional characterization of collected isolates. Future surveillance programs are warranted to monitor the threatening convergence of virulence and resistance among MDR Kp and the spread of hvKp.
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Affiliation(s)
- Fabio Arena
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Microbiology and Virology Unit, University Hospital “Riuniti,”, Foggia, Italy
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Don Carlo Gnocchi ONLUS, Florence, Italy
- *Correspondence: Fabio Arena,
| | - Giulia Menchinelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Vincenzo Di Pilato
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Riccardo Torelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | | | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gian Maria Rossolini
- Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Don Carlo Gnocchi ONLUS, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
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15
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Gacci M, Coppi M, Baldi E, Sebastianelli A, Zaccaro C, Morselli S, Pecoraro A, Manera A, Nicoletti R, Liaci A, Bisegna C, Gemma L, Giancane S, Pollini S, Antonelli A, Lagi F, Marchiani S, Dabizzi S, Degl'Innocenti S, Annunziato F, Maggi M, Vignozzi L, Bartoloni A, Rossolini GM, Serni S. O-001 Semen impairment and occurrence of SARS-CoV-2 virus in semen after recovery from COVID-19. Hum Reprod 2022. [PMCID: PMC9384383 DOI: 10.1093/humrep/deac104.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in human semen and its role in virus contagion and semen quality after recovery from coronavirus disease 2019 (COVID-19) is still unclear. Recent reports evidence that, after SARS-CoV-2 infection, male reproductive function and semen quality may be damaged. Aim To evaluate the semen parameters and inflammation of sexually active men following recovery from SARS-CoV-2 infection at 1 month and 3 months follow-up after the second negative nasopharyngeal swab. Materials and methods A prospective cross-sectional study on sexually active men recovered from SARS-CoV-2 infection was performed. For previously hospitalized COVID-19 patients, data on serum inflammatory markers were retrospectively collected. One month after the second SARS-CoV-2 negative nasopharyngeal swab and 3 months later, four biological fluid samples, namely saliva, pre-ejaculation urine, semen, and post-ejaculation urine, were collected. The occurrence of SARS-CoV-2 RNA in the specimen was evaluated in all the biological fluids collected by RT-PCR. Female partners were retested if any specimen was found to be SARS-CoV-2 positive. Semen parameters were evaluated according to the World Health Organization manual edition V. Furthermore, semen inflammation was assessed by quantification of semen leukocytes and interleukin-8 (IL-8) levels and evaluation of a panel of sperm cytokine levels by a two-step ELISA method. Results A total of 43 men were enrolled in the study. Three patients (7%) tested positive for at least one sample (one saliva; one pre-ejaculation urine; one semen and one post-ejaculation urine), so the next day new nasopharyngeal swabs were collected. The results from these 3 patients and their partners were all negative for SARS-CoV-2. At 1-month follow-up, 25% of the men with recent SARS-Cov-2 infections and proven healing were oligo-cryptoazoospermic, despite the absence of virus RNA in semen. Of the 11 men with semen impairment, 8 were azoospermic and 3 were oligospermic. Serum inflammatory markers (procalcitonin and C-reactive protein) were analyzed in previously hospitalized patients both at admission and at peak of infection. Levels at admission were statistically significantly higher in patients resulting in crypto-azoospermic with respect to those resulting in normozoospermic (p = 0.05; p = 0.03 and p = 0.02, respectively) after healing. Oligo-crypto-azoospermia was significantly related to COVID-19 severity (P < 0.001). A total of 33 patients (76.7%) showed pathological levels of IL-8 in semen. Interleukin-1β and tumor necrosis factor-α levels were significantly negatively related to sperm total number and concentration, whereas interleukin-4 was correlated with sperm motility. At 3-months follow-up, 8/10 men with semen impairment showed an overall increase of semen parameters compared to levels assessed after 1 month. Of the 4 crypto-/azoo-spermic men 1 month after healing, 2 resulted oligozoospermic, 1 normozoospermic and only 1 remained azoospermic. Two of the 3 oligozoospermic men turned normozoozpermic. Semen cytokine levels remained elevated after 3 months, except for IL-6. Discussion and conclusion SARS-CoV-2 can be detected in saliva, urine, and semen in a small percentage of men who recovered from COVID-19. 25% of men who recovered from COVID-19 demonstrated oligo-crypto-azoospermia. Negative correlations between interleukin-1β and tumor necrosis factor-α and sperm number and the overall high levels of semen cytokines indicate a potential detrimental role of SARS-CoV-2 driven inflammation on spermatogenesis. An overall tendency to an improvement of semen parameters was found although a genital tract inflammatory condition appears to persist at least 3 months after COVID-19 recovery. Despite the low number of enrolled patients may limit the statistical power of study and the fact that the previous semen quality of these men was unknown, our results indicate that male of reproductive age recovering from COVID-19 deserve accurate follow-up for their fertility status.
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Affiliation(s)
- M Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - M Coppi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence , Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50134 Florence , Italy
| | - E Baldi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence , Italy
- Unit of Andrology, Female Endocrinology and Gender Incongruence, AOUC and Center of Excellence DeNothe
| | - A Sebastianelli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - C Zaccaro
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - S Morselli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - A Pecoraro
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - A Manera
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - R Nicoletti
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - A Liaci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - C Bisegna
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - L Gemma
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - S Giancane
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
| | - S Pollini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence , Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50134 Florence , Italy
| | - A Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence , Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50134 Florence , Italy
| | - F Lagi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence , Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence , Italy
| | - S Marchiani
- Unit of Andrology, Female Endocrinology and Gender Incongruence, AOUC and Center of Excellence DeNothe
| | - S Dabizzi
- Unit of Andrology, Female Endocrinology and Gender Incongruence, AOUC and Center of Excellence DeNothe
| | | | - F Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence , Italy
| | - M Maggi
- Endocrinology Unit and Department of Experimental, Clinical and Biomedical Sciences, University of Florence
| | - L Vignozzi
- Unit of Andrology, Female Endocrinology and Gender Incongruence, AOUC and Center of Excellence DeNothe
| | - A Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence , Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence , Italy
| | - G M Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence , Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50134 Florence , Italy
| | - S Serni
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC) University of Florence, 50134 Florence , Italy
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence , Italy
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16
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Gaibani P, Giani T, Bovo F, Lombardo D, Amadesi S, Lazzarotto T, Coppi M, Rossolini GM, Ambretti S. Resistance to Ceftazidime/Avibactam, Meropenem/Vaborbactam and Imipenem/Relebactam in Gram-Negative MDR Bacilli: Molecular Mechanisms and Susceptibility Testing. Antibiotics (Basel) 2022; 11:antibiotics11050628. [PMID: 35625273 PMCID: PMC9137602 DOI: 10.3390/antibiotics11050628] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/01/2022] [Accepted: 05/03/2022] [Indexed: 01/25/2023] Open
Abstract
Multidrug resistance (MDR) represents a serious global threat due to the rapid global spread and limited antimicrobial options for treatment of difficult-to-treat (DTR) infections sustained by MDR pathogens. Recently, novel β-lactams/β-lactamase inhibitor combinations (βL-βLICs) have been developed for the treatment of DTR infections due to MDR Gram-negative pathogens. Although novel βL-βLICs exhibited promising in vitro and in vivo activities against MDR pathogens, emerging resistances to these novel molecules have recently been reported. Resistance to novel βL-βLICs is due to several mechanisms including porin deficiencies, increasing carbapenemase expression and/or enzyme mutations. In this review, we summarized the main mechanisms related to the resistance to ceftazidime/avibactam, meropenem/vaborbactam and imipenem/relebactam in MDR Gram-negative micro-organisms. We focused on antimicrobial activities and resistance traits with particular regard to molecular mechanisms related to resistance to novel βL-βLICs. Lastly, we described and discussed the main detection methods for antimicrobial susceptibility testing of such molecules. With increasing reports of resistance to novel βL-βLICs, continuous attention should be maintained on the monitoring of the phenotypic traits of MDR pathogens, into the characterization of related mechanisms, and on the emergence of cross-resistance to these novel antimicrobials.
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Affiliation(s)
- Paolo Gaibani
- Division of Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.B.); (D.L.); (S.A.); (T.L.); (S.A.)
- Correspondence:
| | - Tommaso Giani
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy; (T.G.); (M.C.); (G.M.R.)
- Department of Experimental and Clinical Medicine, University of Florence, 50100 Florence, Italy
| | - Federica Bovo
- Division of Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.B.); (D.L.); (S.A.); (T.L.); (S.A.)
| | - Donatella Lombardo
- Division of Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.B.); (D.L.); (S.A.); (T.L.); (S.A.)
| | - Stefano Amadesi
- Division of Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.B.); (D.L.); (S.A.); (T.L.); (S.A.)
| | - Tiziana Lazzarotto
- Division of Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.B.); (D.L.); (S.A.); (T.L.); (S.A.)
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40100 Bologna, Italy
| | - Marco Coppi
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy; (T.G.); (M.C.); (G.M.R.)
- Department of Experimental and Clinical Medicine, University of Florence, 50100 Florence, Italy
| | - Gian Maria Rossolini
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy; (T.G.); (M.C.); (G.M.R.)
- Department of Experimental and Clinical Medicine, University of Florence, 50100 Florence, Italy
| | - Simone Ambretti
- Division of Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.B.); (D.L.); (S.A.); (T.L.); (S.A.)
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17
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Paganini I, Sani C, Chilleri C, Baccini M, Antonelli A, Bisanzi S, Burroni E, Cellai F, Coppi M, Mealli F, Pompeo G, Viti J, Rossolini GM, Carozzi FM. Assessment of the feasibility of pool testing for SARS-CoV-2 infection screening. Infect Dis (Lond) 2022; 54:478-487. [PMID: 35239458 DOI: 10.1080/23744235.2022.2044512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND SARS-CoV-2 pandemic represented a huge challenge for national health systems worldwide. Pooling nasopharyngeal (NP) swabs seems to be a promising strategy, saving time and resources, but it could reduce the sensitivity of the RT-PCR and exacerbate samples management in terms of automation and tracing. In this study, taking advantage of the routine implementation of a screening plan on health workers, we evaluated the feasibility of pool testing for SARS-CoV-2 infection diagnosis in the presence of low viral load samples. METHOD Pools were prepared with an automated instrument, mixing 4, 6 or 20 NP specimens, including one, two or none positive samples. Ct values of positive samples were on average about 35 for the four genes analyzed. RESULTS The overall sensitivity of 4-samples and 6-samples pools was 93.1 and 90.0%, respectively. Focussing on pools including one sample with Ct value ≥35 for all analyzed genes, sensitivity decreased to 77.8 and 75.0% for 4- and 6-samples, respectively; pools including two positive samples, resulted positive in any size as well as pools including positive samples with Ct values <35. CONCLUSION Pool testing strategy should account the balance between cost-effectiveness, dilution effect and prevalence of the infection. Our study demonstrated the good performances in terms of sensitivity and saving resources of pool testing mixing 4 or 6 samples, even including low viral load specimens, in a real screening context possibly affected by prevalence fluctuation. In conclusion, pool testing strategy represents an efficient and resources saving surveillance and tracing tool, especially in specific context like schools, even for monitoring changes in prevalence associated to vaccination campaign.
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Affiliation(s)
- Irene Paganini
- Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy
| | - Cristina Sani
- Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy
| | - Chiara Chilleri
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Michela Baccini
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy
| | - Alberto Antonelli
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Elena Burroni
- Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy
| | - Filippo Cellai
- Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy
| | - Marco Coppi
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Fabrizia Mealli
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy
| | - Giampaolo Pompeo
- Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy
| | - Jessica Viti
- Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy
| | - Gian Maria Rossolini
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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18
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Bartoletti M, Antonelli A, Bussini L, Corcione S, Giacobbe DR, Marconi L, Pascale R, Dettori S, Shbaklo N, Ambretti S, Gaibani P, Giani T, Coppi M, Bassetti M, De Rosa FG, Marchese A, Cavallo R, Lewis R, Rossolini GM, Viale P, Giannella M. Clinical consequences of very major and errors with semi-automated testing systems for antimicrobial susceptibility of carbapenem-resistant enterobacterales. Clin Microbiol Infect 2022; 28:1290.e1-1290.e4. [DOI: 10.1016/j.cmi.2022.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 11/29/2022]
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19
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Mazzoni A, Vanni A, Spinicci M, Capone M, Lamacchia G, Salvati L, Coppi M, Antonelli A, Carnasciali A, Farahvachi P, Giovacchini N, Aiezza N, Malentacchi F, Zammarchi L, Liotta F, Rossolini GM, Bartoloni A, Cosmi L, Maggi L, Annunziato F. SARS-CoV-2 Spike-Specific CD4+ T Cell Response Is Conserved Against Variants of Concern, Including Omicron. Front Immunol 2022; 13:801431. [PMID: 35154116 PMCID: PMC8826050 DOI: 10.3389/fimmu.2022.801431] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/10/2022] [Indexed: 12/16/2022] Open
Abstract
Although accumulating data have investigated the effect of SARS-CoV-2 mutations on antibody neutralizing activity, less is known about T cell immunity. In this work, we found that the ancestral (Wuhan strain) Spike protein can efficaciously reactivate CD4+ T cell memory in subjects with previous Alpha variant infection. This finding has practical implications, as in many countries only one vaccine dose is currently administered to individuals with previous COVID-19, independently of which SARS-CoV-2 variant was responsible of the infection. We also found that only a minority of Spike-specific CD4+ T cells targets regions mutated in Alpha, Beta and Delta variants, both after natural infection and vaccination. Finally, we found that the vast majority of Spike-specific CD4+ T cell memory response induced by natural infection or mRNA vaccination is conserved also against Omicron variant. This is of importance, as this newly emerged strain is responsible for a sudden rise in COVID-19 cases worldwide due to its increased transmissibility and ability to evade antibody neutralization. Collectively, these observations suggest that most of the memory CD4+ T cell response is conserved against SARS-CoV-2 variants of concern, providing an efficacious line of defense that can protect from the development of severe forms of COVID-19.
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Affiliation(s)
- Alessio Mazzoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Anna Vanni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Michele Spinicci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Disease Unit, Careggi University Hospital, Florence, Italy
| | - Manuela Capone
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giulia Lamacchia
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Lorenzo Salvati
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alberto Carnasciali
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Parham Farahvachi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Nicla Giovacchini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Noemi Aiezza
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Disease Unit, Careggi University Hospital, Florence, Italy
| | - Francesco Liotta
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Immunology and Cell Therapy Unit, Careggi University Hospital, Florence, Italy.,Flow Cytometry Diagnostic Center and Immunotherapy, Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Disease Unit, Careggi University Hospital, Florence, Italy
| | - Lorenzo Cosmi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Immunology and Cell Therapy Unit, Careggi University Hospital, Florence, Italy
| | - Laura Maggi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Flow Cytometry Diagnostic Center and Immunotherapy, Careggi University Hospital, Florence, Italy
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20
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Russo E, Nannini G, Sterrantino G, Kiros ST, Di Pilato V, Coppi M, Baldi S, Niccolai E, Ricci F, Ramazzotti M, Pallecchi M, Lagi F, Rossolini GM, Bartoloni A, Bartolucci G, Amedei A. Effects of viremia and CD4 recovery on gut “microbiome-immunity” axis in treatment-naïve HIV-1-infected patients undergoing antiretroviral therapy. World J Gastroenterol 2022; 28:635-652. [PMID: 35317423 PMCID: PMC8900548 DOI: 10.3748/wjg.v28.i6.635] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/30/2021] [Accepted: 01/12/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus type 1 (HIV-1) infection is characterized by persistent systemic inflammation and immune activation, even in patients receiving effective antiretroviral therapy (ART). Converging data from many cross-sectional studies suggest that gut microbiota (GM) changes can occur throughout including human immunodeficiency virus (HIV) infection, treated by ART; however, the results are contrasting. For the first time, we compared the fecal microbial composition, serum and fecal microbial metabolites, and serum cytokine profile of treatment-naïve patients before starting ART and after reaching virological suppression, after 24 wk of ART therapy. In addition, we compared the microbiota composition, microbial metabolites, and cytokine profile of patients with CD4/CD8 ratio < 1 (immunological non-responders [INRs]) and CD4/CD8 > 1 (immunological responders [IRs]), after 24 wk of ART therapy.
AIM To compare for the first time the fecal microbial composition, serum and fecal microbial metabolites, and serum cytokine profile of treatment-naïve patients before starting ART and after reaching virological suppression (HIV RNA < 50 copies/mL) after 24 wk of ART.
METHODS We enrolled 12 treatment-naïve HIV-infected patients receiving ART (mainly based on integrase inhibitors). Fecal microbiota composition was assessed through next generation sequencing. In addition, a comprehensive analysis of a blood broad-spectrum cytokine panel was performed through a multiplex approach. At the same time, serum free fatty acid (FFA) and fecal short chain fatty acid levels were obtained through gas chromatography-mass spectrometry.
RESULTS We first compared microbiota signatures, FFA levels, and cytokine profile before starting ART and after reaching virological suppression. Modest alterations were observed in microbiota composition, in particular in the viral suppression condition, we detected an increase of Ruminococcus and Succinivibrio and a decrease of Intestinibacter. Moreover, in the same condition, we also observed augmented levels of serum propionic and butyric acids. Contemporarily, a reduction of serum IP-10 and an increase of IL-8 levels were detected in the viral suppression condition. In addition, the same components were compared between IRs and INRs. Concerning the microflora population, we detected a reduction of Faecalibacterium and an increase of Alistipes in INRs. Simultaneously, fecal isobutyric, isovaleric, and 2-methylbutyric acids were also increased in INRs.
CONCLUSION Our results provided an additional perspective about the impact of HIV infection, ART, and immune recovery on the “microbiome-immunity axis” at the metabolism level. These factors can act as indicators of the active processes occurring in the gastrointestinal tract. Individuals with HIV-1 infection, before ART and after reaching virological suppression with 24 wk of ART, displayed a microbiota with unchanged overall bacterial diversity; moreover, their systemic inflammatory status seems not to be completely restored. In addition, we confirmed the role of the GM metabolites in immune reconstitution.
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Affiliation(s)
- Edda Russo
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Giulia Nannini
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Gaetana Sterrantino
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Seble Tekle Kiros
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Vincenzo Di Pilato
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa 16126, Italy
| | - Marco Coppi
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Simone Baldi
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Elena Niccolai
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Federica Ricci
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Matteo Ramazzotti
- Department of Biomedical, Experimental and Clinical "Mario Serio", University of Florence, Florence 50134, Italy
| | - Marco Pallecchi
- Department of Biomedical, Experimental and Clinical "Mario Serio", University of Florence, Florence 50134, Italy
| | - Filippo Lagi
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Gian Maria Rossolini
- Microbiology and Virology Unit, Florence Careggi University Hospital, University of Florence, Florence 50134, Italy
| | - Alessandro Bartoloni
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
| | - Gianluca Bartolucci
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence 50019, Italy
| | - Amedeo Amedei
- Department of Clinical and Experimental Medicine, University of Florence, Florence 50134, Italy
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21
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Morselli S, Sebastianelli A, Liaci A, Zaccaro C, Pecoraro A, Nicoletti R, Manera A, Bisegna C, Campi R, Pollini S, Antonelli A, Lagi F, Coppi M, Baldi E, Marchiani S, Nicolò S, Torcia M, Annunziato F, Maggi M, Vignozzi L, Bartoloni A, Rossolini GM, Serni S, Gacci M. Male reproductive system inflammation after healing from coronavirus disease 2019. Andrology 2021; 10:1030-1037. [PMID: 34889528 DOI: 10.1111/andr.13138] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is evidence that, after severe acute respiratory syndrome coronavirus 2 infection, male reproductive function and semen quality may be damaged OBJECTIVES: To evaluate a panel of inflammatory mediators in semen in patients recovered from coronavirus disease 2019. MATERIAL AND METHODS Sexually active men with previous severe acute respiratory syndrome coronavirus 2 infection and proven recovery from coronavirus disease 2019 were enrolled in a prospective cohort study. Clinical, uro-andrological data and semen specimens were prospectively collected. For previously hospitalized coronavirus disease 2019 patients, data on serum inflammatory markers were retrospectively collected. RESULTS A total of 43 men were enrolled in the study. Of these, 32 men were normozoospermic, three were oligozoospermic, and eight were crypto-azoospermic. Serum inflammatory markers (procalcitonin and C-reactive protein) were analyzed in previously hospitalized patients both at admission and at peak of infection. Levels at admission were statistically significantly higher in patients resulting in crypto-azoospermic with respect to those resulting in normozoospermic (p = 0.05; p = 0.03 and p = 0.02, respectively) after healing. Seminal cytokine levels were similar among all groups. Interleukin-1β and tumor necrosis factor-α levels were significantly negatively related to sperm total number and concentration, whereas interleukin-4 was correlated with sperm motility. DISCUSSION AND CONCLUSION Negative correlations between interleukin-1β and tumor necrosis factor-α and sperm number and the overall high levels of semen cytokines indicate a potential detrimental role of severe acute respiratory syndrome coronavirus 2 driven inflammation on spermatogenesis. Overall, our results indicate that male patients recovering from coronavirus disease 2019 deserve accurate follow-up for their fertility status.
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Affiliation(s)
- Simone Morselli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Arcangelo Sebastianelli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Andrea Liaci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Claudia Zaccaro
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Alessio Pecoraro
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Rossella Nicoletti
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Alekseja Manera
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Claudio Bisegna
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Riccardo Campi
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Simona Pollini
- Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, University of Florence, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, University of Florence, Florence, Italy
| | - Filippo Lagi
- Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy.,Infectious and Tropical Diseases Unit, Careggi University Hospital, University of Florence, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, University of Florence, Florence, Italy
| | - Elisabetta Baldi
- Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy.,Unit of Sexual Medicine and Andrology, Center of Excellence DeNothe, University of Florence, Florence, Italy
| | - Sara Marchiani
- Department of Experimental and Clinical Biomedical Sciences Mario Serio University of Florence, Florence, Italy
| | - Sabrina Nicolò
- Department of Experimental and Clinical Biomedical Sciences Mario Serio University of Florence, Florence, Italy
| | - Maria Torcia
- Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, University of Florence, Florence, Italy
| | - Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Mario Maggi
- Department of Experimental and Clinical Biomedical Sciences Mario Serio University of Florence, Florence, Italy.,Sexual Medicine & Andrology Unit - Department of Experimental and Clinical Biomedical Sciences Mario Serio University of Florence, Florence, Italy
| | - Linda Vignozzi
- Department of Experimental and Clinical Biomedical Sciences Mario Serio University of Florence, Florence, Italy.,Sexual Medicine & Andrology Unit - Department of Experimental and Clinical Biomedical Sciences Mario Serio University of Florence, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy.,Infectious and Tropical Diseases Unit, Careggi University Hospital, University of Florence, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, University of Florence, Florence, Italy
| | - Sergio Serni
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
| | - Mauro Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Florence, Italy
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22
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Spinicci M, Mazzoni A, Borchi B, Graziani L, Mazzetti M, Bartalesi F, Botta A, Tilli M, Pieralli F, Coppi M, Giovacchini N, Colao MG, Saccardi R, Rossolini GM, Annunziato F, Bartoloni A. AIDS patient with severe T cell depletion achieved control but not clearance of SARS-CoV-2 infection. Eur J Immunol 2021; 52:352-355. [PMID: 34822185 PMCID: PMC9015404 DOI: 10.1002/eji.202149574] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/21/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022]
Abstract
A late presenter AIDS patient with severe T cell depletion presented non-severe COVID-19 symptoms, with prolonged viral shedding. Our case report supports the hypothesis that an effective T cell response may be dispensable for the control of COVID-19 progression to severe forms, while it may be necessary for SARS-CoV-2 clearance.
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Affiliation(s)
- Michele Spinicci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Alessio Mazzoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Beatrice Borchi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Lucia Graziani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marcello Mazzetti
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Filippo Bartalesi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Annarita Botta
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marta Tilli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Filippo Pieralli
- Intermediate Care Unit, Careggi University Hospital, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Nicla Giovacchini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Grazia Colao
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Riccardo Saccardi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Department of Cellular Therapies and Transfusion Medicine, Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Flow Cytometry Diagnostic Center and Immunotherapy (CDCI), Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
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23
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Giovacchini N, Coppi M, Aiezza N, Baccani I, Malentacchi F, Pollini S, Antonelli A, Rossolini GM. Rapid screening for SARS-CoV-2 VOC-Alpha (202012/01, B.1.1.7) using the Allplex™ SARS-CoV-2/FluA/FluB/RSV Assay. Int J Infect Dis 2021; 113:207-209. [PMID: 34628023 PMCID: PMC8496923 DOI: 10.1016/j.ijid.2021.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/01/2021] [Accepted: 10/02/2021] [Indexed: 11/26/2022] Open
Abstract
Background The emergence of SARS-CoV-2 variants of concern (VOCs) for increased transmissibility and being potentially capable of immune-escape mandates for epidemiological surveillance. Genomic alterations present in VOCs can affect the results of RT-qPCR assays for routine diagnostic purposes, leading to peculiar profiles that can be used for rapid screening of variants. This study reports a peculiar profile observed with the Allplex™ SARS-CoV-2/FluA/FluB/RSV assay and VOC-Alpha (202012/01, lineage B.1.1.7, also named VOC-UK), which was the first identified SARS-CoV-2 VOC. Methods Samples were analyzed by two RT-qPCR assays: the Allplex™ SARS-CoV-2/FluA/FluB/RSV assay (ASFR, Seegene Technologies Inc; Seoul, South Korea) and the TaqPath COVID-19 RT-PCR (Thermo Fisher Scientific, USA). Definition of the SARS-CoV-2 variant was carried out by Sanger sequencing of the relevant S-gene regions and, in some cases, by whole genome sequencing (WGS) using the ARTIC-nCoV workflow on a MiniION (Oxford Nanopore Technologies, Oxford, UK) or a Illumina MiSeq platform (San Diego, California, USA). Results Of the 173 SARS-CoV-2-positive specimens, all those of lineage B.1.1.7 (N=71) showed an average Cq difference between the N and S genes of +11±2 (range, +8/+15). None of the other specimens, including several different lineages (Wild-type for the analyzed regions, N=22; Gamma, N=63; Delta, N=9; B.1.258Δ, N=3; B.1.160, N=3; B.1.177.7, N=1; B.1.1.420, N=1), exhibited a similar difference in Cq values. Conclusions The peculiar pattern of delayed N gene positivity could constitute a convenient method for VOC-Alpha screening, simultaneous to viral detection, when using the Allplex™ SARS-CoV-2/FluA/FluB/RSV assay.
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Affiliation(s)
- Nicla Giovacchini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Noemi Aiezza
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Ilaria Baccani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Simona Pollini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.
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24
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Morecchiato F, Coppi M, Baccani I, Maggini N, Ciccone N, Antonelli A, Rossolini GM. Evaluation of extraction-free RT-PCR methods for faster and cheaper detection of SARS-CoV-2 using two commercial systems. Int J Infect Dis 2021; 112:264-268. [PMID: 34563710 PMCID: PMC8458106 DOI: 10.1016/j.ijid.2021.09.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 12/19/2022] Open
Abstract
Objective When using high-throughput batched diagnostic platforms based on RT-PCR for SARS-CoV-2 detection, avoidance of the conventional nucleic acid extraction step can help to reduce the turnaround time and increase processivity. This approach can also spare reagents and plasticware, which have experienced a shortage during the initial waves of the pandemic, reducing the overall testing costs. Methods This study evaluated the performance of extraction-free protocols based on simple dilution of the specimen in sterile RNAse free water (with or without a heating step) in comparison to standard RNA extraction protocols, using two commercial kits for molecular detection of SARS-CoV-2 (Allplex™ SARS-CoV-2 assay and Allplex™ SARS-CoV-2/FluA/FluB/RSV assay) in nasopharyngeal swabs (NPS). Results Compared with conventional protocols, extraction-free protocols based on sample dilution without a heating step exhibited a lower analytical sensitivity: 74.0% and 82.1% with the Allplex™ SARS-CoV-2 assay (tested with 139 NPS samples) and the Allplex™ SARS-CoV-2/FluA/FluB/RSV assay (tested with 69 NPS samples), with a mean increase of Ct values of +2.04 and +1.32, respectively. Most false negative results were observed with sampled low viral load. Including a step of heat exposure did not improve but actually decreased the analytical sensitivity of the assay. Conclusions Results confirmed that extraction-free protocols could be a faster and cheaper approach to SARS-CoV-2 detection in NPS samples, which could improve processivity of diagnostic platforms.
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Affiliation(s)
- Fabio Morecchiato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Ilaria Baccani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Niccolò Maggini
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Nunziata Ciccone
- Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.
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25
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Kragh KN, Gijón D, Maruri A, Antonelli A, Coppi M, Kolpen M, Crone S, Tellapragada C, Hasan B, Radmer S, de Vogel C, van Wamel W, Verbon A, Giske CG, Rossolini GM, Cantón R, Frimodt-Møller N. Effective antimicrobial combination in vivo treatment predicted with microcalorimetry screening. J Antimicrob Chemother 2021; 76:1001-1009. [PMID: 33442721 PMCID: PMC7953322 DOI: 10.1093/jac/dkaa543] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/30/2020] [Indexed: 02/01/2023] Open
Abstract
Objectives The worldwide emergence of antibiotic resistance calls for effective exploitation of existing antibiotics. Antibiotic combinations with different modes of action can synergize for successful treatment. In the present study, we used microcalorimetry screening to identify synergistic combination treatments against clinical MDR isolates. The synergistic effects were validated in a murine infection model. Methods The synergy of meropenem combined with colistin, rifampicin or amikacin was tested on 12 isolates (1 Escherichia coli, 5 Klebsiella pneumoniae, 3 Pseudomonas aeruginosa and 3 Acinetobacter baumannii) in an isothermal microcalorimeter measuring metabolic activity. One A. baumannii strain was tested with two individual pairings of antibiotic combinations. The microcalorimetric data were used to predict in vivo efficacy in a murine peritonitis/sepsis model. NMRI mice were inoculated intraperitoneally and after 1 h treated with saline, drug X, drug Y or X+Y. Bacterial load was determined by cfu in peritoneal fluid and blood after 4 h. Results In vitro, of the 13 combinations tested on the 12 strains, 3 of them exhibited a synergistic reduction in MIC (23% n = 3/13), 5 showed an additive effect (38.5% n = 5/13) and 5 had indifferent or antagonistic effects (38.5% n = 5/13). There was a significant correlation (P = 0.024) between microcalorimetry-screening FIC index values and the log reduction in peritoneal fluid from mice that underwent combination treatment compared with the most effective mono treatment. No such correlation could be found between chequerboard and in vivo results (P = 0.16). Conclusions These data support microcalorimetic metabolic readout to predict additive or synergistic effects of combination treatment of MDR infections within hours.
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Affiliation(s)
- Kasper Nørskov Kragh
- Department of Clinical Microbiology, Rigshospitalet, 2200 Copenhagen N, Denmark.,Costerton Biofilm Center, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Desiree Gijón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Ainhize Maruri
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50121 Firenze, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50121 Firenze, Italy
| | - Mette Kolpen
- Department of Clinical Microbiology, Rigshospitalet, 2200 Copenhagen N, Denmark
| | - Stephanie Crone
- Department of Clinical Microbiology, Rigshospitalet, 2200 Copenhagen N, Denmark
| | | | - Badrul Hasan
- Department of Laboratory Medicine, Karolinska Institutet, 14183 Stockholm, Sweden
| | - Stine Radmer
- Department of Clinical Microbiology, Rigshospitalet, 2200 Copenhagen N, Denmark
| | - Corné de Vogel
- Department of Medical Microbiology and Infectious Diseases, Erasmus University, Erasmus MC, 3000CA Rotterdam, The Netherlands
| | - Willem van Wamel
- Department of Medical Microbiology and Infectious Diseases, Erasmus University, Erasmus MC, 3000CA Rotterdam, The Netherlands
| | - Annelies Verbon
- Department of Medical Microbiology and Infectious Diseases, Erasmus University, Erasmus MC, 3000CA Rotterdam, The Netherlands
| | - Christian G Giske
- Department of Laboratory Medicine, Karolinska Institutet, 14183 Stockholm, Sweden.,Clinical Microbiology, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50121 Firenze, Italy
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
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Gacci M, Coppi M, Baldi E, Sebastianelli A, Zaccaro C, Morselli S, Pecoraro A, Manera A, Nicoletti R, Liaci A, Bisegna C, Gemma L, Giancane S, Pollini S, Antonelli A, Lagi F, Marchiani S, Dabizzi S, Nicolò S, Torcia M, Degl'innocenti S, Annunziato F, Maggi M, Vignozzi L, Bartoloni A, Rossolini GM, Serni S. Reply: COVID-19: semen impairment may not be related to the virus. Hum Reprod 2021; 36:2065-2066. [PMID: 33793848 PMCID: PMC8083456 DOI: 10.1093/humrep/deab083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Mauro Gacci
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Elisabetta Baldi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Andrology, Female Endocrinology and Gender Inconsistency, AOUC and Center of Excellence DeNothe, Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Florence, Italy
| | - Arcangelo Sebastianelli
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Claudia Zaccaro
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Simone Morselli
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Alessio Pecoraro
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Alekseja Manera
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Rossella Nicoletti
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Andrea Liaci
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Claudio Bisegna
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Luca Gemma
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Saverio Giancane
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy
| | - Simona Pollini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Filippo Lagi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Sara Marchiani
- Unit of Andrology, Female Endocrinology and Gender Inconsistency, AOUC and Center of Excellence DeNothe, Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Florence, Italy
| | - Sara Dabizzi
- Unit of Andrology, Female Endocrinology and Gender Inconsistency, AOUC and Center of Excellence DeNothe, Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Florence, Italy
| | - Sabrina Nicolò
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Torcia
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Selene Degl'innocenti
- Unit of Andrology, Female Endocrinology and Gender Inconsistency, AOUC and Center of Excellence DeNothe, Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Florence, Italy
| | - Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Mario Maggi
- Unit of Andrology, Female Endocrinology and Gender Inconsistency, AOUC and Center of Excellence DeNothe, Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Florence, Italy
| | - Linda Vignozzi
- Unit of Andrology, Female Endocrinology and Gender Inconsistency, AOUC and Center of Excellence DeNothe, Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Sergio Serni
- Department of Minimally Invasive, Robotic Urologic Surgery & Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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27
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Gacci M, Coppi M, Baldi E, Sebastianelli A, Zaccaro C, Morselli S, Pecoraro A, Manera A, Nicoletti R, Liaci A, Bisegna C, Gemma L, Giancane S, Pollini S, Antonelli A, Lagi F, Marchiani S, Dabizzi S, Degl’Innocenti S, Annunziato F, Maggi M, Vignozzi L, Bartoloni A, Rossolini GM, Serni S. Semen impairment and occurrence of SARS-CoV-2 virus in semen after recovery from COVID-19. Hum Reprod 2021; 36:1520-1529. [PMID: 33522572 PMCID: PMC7953947 DOI: 10.1093/humrep/deab026] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/28/2020] [Indexed: 12/11/2022] Open
Abstract
STUDY QUESTION How is the semen quality of sexually active men following recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection? SUMMARY ANSWER Twenty-five percent of the men with recent SARS-Cov-2 infections and proven healing were oligo-crypto-azoospermic, despite the absence of virus RNA in semen. WHAT IS KNOWN ALREADY The presence of SARS-CoV-2 in human semen and its role in virus contagion and semen quality after recovery from coronavirus disease 2019 (COVID-19) is still unclear. So far, studies evaluating semen quality and the occurrence of SARS-CoV-2 in semen of infected or proven recovered men are scarce and included a limited number of participants. STUDY DESIGN, SIZE, DURATION A prospective cross-sectional study on 43 sexually active men who were known to have recovered from SARS-CoV2 was performed. Four biological fluid samples, namely saliva, pre-ejaculation urine, semen, and post-ejaculation urine, were tested for the SARS-CoV-2 genome. Female partners were retested if any specimen was found to be SARS-CoV-2 positive. Routine semen analysis and quantification of semen leukocytes and interleukin-8 (IL-8) levels were performed. PARTICIPANTS/MATERIALS, SETTING, METHODS Questionnaires including International Index of Erectile Function and Male Sexual Health Questionnaire Short Form were administered to all subjects. The occurrence of virus RNA was evaluated in all the biological fluids collected by RT-PCR. Semen parameters were evaluated according to the World Health Organization manual edition V. Semen IL-8 levels were evaluated by a two-step ELISA method. MAIN RESULTS AND THE ROLE OF CHANCE After recovery from COVID-19, 25% of the men studied were oligo-crypto-azoospermic. Of the 11 men with semen impairment, 8 were azoospermic and 3 were oligospermic. A total of 33 patients (76.7%) showed pathological levels of IL-8 in semen. Oligo-crypto-azoospermia was significantly related to COVID-19 severity (P < 0.001). Three patients (7%) tested positive for at least one sample (one saliva; one pre-ejaculation urine; one semen and one post-ejaculation urine), so the next day new nasopharyngeal swabs were collected. The results from these three patients and their partners were all negative for SARS-CoV-2. LIMITATIONS, REASONS FOR CAUTION Although crypto-azoospermia was found in a high percentage of men who had recovered from COVID-19, clearly exceeding the percentage found in the general population, the previous semen quality of these men was unknown nor is it known whether a recovery of testicular function was occurring. The low number of enrolled patients may limit the statistical power of study. WIDER IMPLICATIONS OF THE FINDINGS SARS-CoV-2 can be detected in saliva, urine, and semen in a small percentage of men who recovered from COVID-19. One-quarter of men who recovered from COVID-19 demonstrated oligo-crypto-azoospermia indicating that an assessment of semen quality should be recommended for men of reproductive age who are affected by COVID-19. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - M Coppi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50134 Florence, Italy
| | - E Baldi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Unit of Andrology, Female Endocrinology and Gender Incongruence, AOUC and Center of Excellence DeNothe, University of Florence, 50134 Florence, Italy
| | - A Sebastianelli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - C Zaccaro
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - S Morselli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - A Pecoraro
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - A Manera
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - R Nicoletti
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - A Liaci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - C Bisegna
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - L Gemma
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - S Giancane
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
| | - S Pollini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50134 Florence, Italy
| | - A Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50134 Florence, Italy
| | - F Lagi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy
| | - S Marchiani
- Unit of Andrology, Female Endocrinology and Gender Incongruence, AOUC and Center of Excellence DeNothe, University of Florence, 50134 Florence, Italy
| | - S Dabizzi
- Unit of Andrology, Female Endocrinology and Gender Incongruence, AOUC and Center of Excellence DeNothe, University of Florence, 50134 Florence, Italy
| | | | - F Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - M Maggi
- Endocrinology Unit and Department of Experimental, Clinical and Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - L Vignozzi
- Unit of Andrology, Female Endocrinology and Gender Incongruence, AOUC and Center of Excellence DeNothe, University of Florence, 50134 Florence, Italy
| | - A Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy
| | - G M Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, 50134 Florence, Italy
| | - S Serni
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi University Hospital (AOUC), University of Florence, 50134 Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
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28
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Parisio EM, Camarlinghi G, Coppi M, Niccolai C, Antonelli A, Nardone M, Vettori C, Giani T, Mattei R, Rossolini GM. Evaluation of the commercial AD fosfomycin test for susceptibility testing of multidrug-resistant Enterobacterales and Pseudomonas aeruginosa. Clin Microbiol Infect 2020; 27:S1198-743X(20)30725-4. [PMID: 33285277 DOI: 10.1016/j.cmi.2020.11.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/04/2020] [Revised: 11/16/2020] [Accepted: 11/27/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare fosfomycin susceptibility testing with the commercial agar dilution (AD) test, AD Fosfomycin (Liofilchem, Roseto degli Abruzzi, Italy) and the reference AD method, using a collection of multidrug-resistant (MDR) Enterobacterales and Pseudomonas aeruginosa clinical isolates. METHODS The collection included 119 carbapenemase-producing Enterobacterales, 53 Enterobacterales producing acquired AmpC-type and/or extended-spectrum β-lactamases and 38 carbapenemase-producing P. aeruginosa, including representatives of different high-risk clones. AD Fosfomycin and AD reference method (ISO 20776-1:2019) were performed starting from the same microbial suspension. Results were interpreted according to EUCAST clinical breakpoints (10.0). Essential agreement (EA), category agreement (CA) and error rates were calculated as described by the International Organization for Standardization. RESULTS Of 172 Enterobacterales, 143 (83.1%, including 92.9% (52 of 56) of the NDM-producers and 84.2% (48 of 57) of the KPC-producers) were susceptible to fosfomycin using reference AD. A CA of 91.9% (158 of 172; 95% CI 87.1%-95.3%) and an EA of 92.5% (136 of 147; 95% CI 87.4%-96.0%), respectively, were calculated for the commercial AD Fosfomycin test, with 9.8% (14 of 128) of major errors and no very major errors (0 of 29). Overall, 86.8% (33 of 38) of P. aeruginosa showed a fosfomycin MIC ≤128 mg/L using reference AD. An EA of 84.8% (95% CI 66.3%-92.0%) was calculated for the commercial AD Fosfomycin test, with a CA of 100% (95% CI 93.6%-100%) when considering a tentative breakpoint at 128 mg/L. CONCLUSIONS AD Fosfomycin showed an overall good concordance compared with reference AD.
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Affiliation(s)
- Eva Maria Parisio
- Clinical Chemistry and Microbiology Analysis Unit, San Luca Hospital, USL Toscana Nord Ovest, Lucca, Italy
| | - Giulio Camarlinghi
- Clinical Chemistry and Microbiology Analysis Unit, San Luca Hospital, USL Toscana Nord Ovest, Lucca, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy.
| | - Claudia Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Maria Nardone
- Clinical Chemistry and Microbiology Analysis Unit, San Luca Hospital, USL Toscana Nord Ovest, Lucca, Italy
| | - Chiara Vettori
- Clinical Chemistry and Microbiology Analysis Unit, San Luca Hospital, USL Toscana Nord Ovest, Lucca, Italy
| | - Tommaso Giani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Romano Mattei
- Clinical Chemistry and Microbiology Analysis Unit, San Luca Hospital, USL Toscana Nord Ovest, Lucca, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
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29
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Tellapragada C, Hasan B, Antonelli A, Maruri A, de Vogel C, Gijón D, Coppi M, Verbon A, van Wamel W, Rossolini GM, Cantón R, Giske CG. Isothermal microcalorimetry minimal inhibitory concentration testing in extensively drug resistant Gram-negative bacilli: a multicentre study. Clin Microbiol Infect 2020; 26:1413.e1-1413.e7. [PMID: 32006694 DOI: 10.1016/j.cmi.2020.01.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/27/2019] [Accepted: 01/21/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To evaluate the performance of an isothermal microcalorimetry (IMC) method for determining the MICs among extensively drug-resistant Gram-negative bacilli. METHODS A collection of 320 clinical isolates (n = 80 of each) of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii from Sweden, Spain, Italy and the Netherlands were tested. The MICs were determined using the IMC device calScreener (Symcel, Stockholm, Sweden) and ISO-broth microdilution as the reference method. Essential agreement, categorical agreement, very major errors (VME), major errors (ME) and minor (mE) errors for each antibiotic were determined. RESULTS Data from 316 isolates were evaluated. Four errors (two ME, one VME, one mE) among 80 K. pneumoniae, six errors (four ME, one VME, one mE) among 79 E. coli, 15 errors (seven VME, three ME, five mE) among 77 P. aeruginosa and 18 errors (12 VME, two ME, four mE) among 80 A. baumannii were observed. Average essential agreement and categorical agreement of the IMC method were 96.6% (95% confidence interval, 94.2-99) and 97.1% (95% confidence interval, 95.4-98.5) respectively when the MICs were determined at the end of 18 hours. Categorical agreement of the IMC method for prediction of MIC by the end of 8 hours for colistin, meropenem, amikacin, ciprofloxacin and piperacillin/tazobactam were 95%, 91.4%, 94%, 95.2% and 93.7% respectively. CONCLUSIONS The IMC method could accurately determine the MICs among extensively drug-resistant clinical isolates of E. coli, K. pneumoniae, P. aeruginosa and A. baumannii isolates.
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Affiliation(s)
- C Tellapragada
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institute, Stockholm, Sweden
| | - B Hasan
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institute, Stockholm, Sweden
| | - A Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - A Maruri
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - C de Vogel
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, the Netherlands
| | - D Gijón
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - M Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - A Verbon
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, the Netherlands
| | - W van Wamel
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, the Netherlands
| | - G M Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - R Cantón
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - C G Giske
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institute, Stockholm, Sweden; Division of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
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30
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Arena F, Di Pilato V, Vannetti F, Fabbri L, Antonelli A, Coppi M, Pupillo R, Macchi C, Rossolini GM. Population structure of KPC carbapenemase-producing Klebsiella pneumoniae in a long-term acute-care rehabilitation facility: identification of a new lineage of clonal group 101, associated with local hyperendemicity. Microb Genom 2020; 6:e000308. [PMID: 32003322 PMCID: PMC7067035 DOI: 10.1099/mgen.0.000308] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/27/2019] [Indexed: 01/15/2023] Open
Abstract
In this work, we used a whole-genome sequencing (WGS) approach to study the features of KPC-producing Klebsiella pneumoniae (KPC-Kp) spreading in a large Italian long-term acute-care rehabilitation facility (LTACRF), and to track the dynamics of dissemination within this setting. Thirty-eight, non-replicated, KPC-Kp isolates from colonized patients (either already colonized at admission or colonized during admission), collected during 2016, were subjected to antimicrobial-susceptibility testing and WGS. All isolates were resistant to β-lactams, with the exception of ceftazidime/avibactam (97.4 % susceptible). The second most effective agent was fosfomycin, followed by colistin, trimethoprim/sulfamethoxazole, gentamicin and amikacin (92.1, 86.8, 60.5, 44.7 and 50 % of susceptibility, respectively). A large proportion of isolates (n=18/38, 47.4%) belonged to clonal group (CG) 101, and most of them (n=15) to a new sequence type (ST) designated as ST2502. All the CG101 isolates had a capsule locus type KL17. The ST2502 harboured the genes encoding for the yersiniabactin siderophore and the ArmA methylase, conferring high-level resistance to aminoglycosides. The second most represented lineage of isolates (16/38, 42.1%) belonged to ST512 of CG258. Analysing WGS data, we were able to ascertain the common origin of some isolates imported from other hospitals, and to track several clusters of in-LTACRF cross-transmissions. The results revealed that, in peculiar epidemiological settings such as LTACRF, new KPC-Kp clones different from those prevailing in acute-care hospitals and associated with uncommon resistance and virulence determinants can successfully emerge and disseminate.
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Affiliation(s)
- Fabio Arena
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Present address: Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Present address: Don Carlo Gnocchi Foundation, Florence, Italy
| | - Vincenzo Di Pilato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Present address: Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | | | | | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | | | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
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Antonelli A, Giani T, Coppi M, Di Pilato V, Arena F, Colavecchio OL, Conte V, Santerre Henriksen A, Rossolini GM. Staphylococcus aureus from hospital-acquired pneumonia from an Italian nationwide survey: activity of ceftobiprole and other anti-staphylococcal agents, and molecular epidemiology of methicillin-resistant isolates. J Antimicrob Chemother 2019; 74:3453-3461. [PMID: 31652323 DOI: 10.1093/jac/dkz371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine the prevalence of Staphylococcus aureus from hospital-acquired pneumonia (HAP) in Italy and the susceptibility to ceftobiprole and comparators of MSSA and MRSA isolates. A secondary objective was to characterize the clonality and acquired resistance and virulence genes of MRSA. METHODS Consecutive non-replicate isolates from HAP were collected from 13 laboratories distributed across Italy, from January to May 2016. Antimicrobial susceptibility testing was performed by broth microdilution, and results were interpreted according to the EUCAST breakpoints. All MRSA isolates were subjected to WGS using an Illumina platform. Clonality and resistance and virulence gene content were investigated with bioinformatics tools. RESULTS Among 333 isolates from HAP, S. aureus was the third most common pathogen (18.6%). The proportion of MRSA was 40.3%. Susceptibility to ceftobiprole was 100% for MSSA and 95.5% for MRSA. Lower susceptibility rates of 78.4% and 94.6% in MSSA and 36.4% and 12.1% in MRSA isolates were observed for erythromycin and levofloxacin, respectively. The MRSA from HAP mostly belonged to clonal complex (CC) 22 (47.0%), CC5 (25.8%) and CC8 (15.2%), with a minority of other lineages (ST1, ST6, ST7, ST30, ST152 and ST398). Acquired resistance and virulence genes in most cases exhibited a clonal distribution. The three ceftobiprole-resistant isolates exhibited an MIC of 4 mg/L and belonged to ST228-MRSA-I of CC5. CONCLUSIONS S. aureus is an important cause of HAP in Italy. Ceftobiprole exhibited good in vitro activity against S. aureus isolated from HAP, including MRSA. A trend to replacement of ST228 with ST22 was noticed compared with previous studies.
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Affiliation(s)
- Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Tommaso Giani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Vincenzo Di Pilato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Fabio Arena
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Viola Conte
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
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Antonelli A, Coppi M, Camarlinghi G, Parisio EM, Nardone M, Riccobono E, Giani T, Mattei R, Rossolini GM. Variable performance of different commercial systems for testing carbapenem susceptibility of KPC carbapenemase-producing Escherichia coli. Clin Microbiol Infect 2019; 25:1432.e1-1432.e4. [PMID: 31425743 DOI: 10.1016/j.cmi.2019.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/19/2019] [Accepted: 08/07/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The aim was to evaluate different methods for testing carbapenem susceptibility of Escherichia coli producing KPC-type carbapenemase. METHODS Susceptibility to imipenem, meropenem and ertapenem was assayed using the reference broth microdilution method and several commercial methods (Vitek2, MicroScan, Etest, MIC Test Strip) starting from the same bacterial suspension. Susceptibility to imipenem and meropenem was also tested by Sensititre and disc diffusion (Bio-Rad). Results were interpreted according to EUCAST clinical breakpoints. Essential agreement (EA), category agreement (CA) and error rates were calculated as described by the International Organization for Standardization (ISO) guidelines and also considering the new EUCAST definitions. Genotypic diversity of isolates was evaluated with a RAPD profiling protocol. RESULTS Of 54 KPC-positive E. coli isolates, 5.6%, 7.4% and 0% were susceptible standard dosing regimen (S), 55.6%, 72.2% and 0% susceptible increased exposure (I), and 38.9%, 20.4% and 100.0% resistant (R) to imipenem, meropenem and ertapenem, respectively, using the reference broth microdilution method. CA lower than 90% were observed with all systems for imipenem and meropenem using both the ISO and the modified EUCAST criteria. With ertapenem, CA >90% was observed with all methods except Vitek2. RAPD profiling revealed a remarkable genotypic diversity of the isolates, supporting that results were not biased by an oligoclonal nature of the collection. CONCLUSIONS Commercial methods can be unreliable for testing susceptibility to carbapenems of KPC-producing E. coli. Susceptibility should be confirmed by reference broth microdilution.
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Affiliation(s)
- A Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - M Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Camarlinghi
- Operative Unit of Chemical-Clinical and Microbiological Analysis San Luca Hospital Usl Toscana Nord Ovest, Lucca, Italy
| | - E M Parisio
- Operative Unit of Chemical-Clinical and Microbiological Analysis San Luca Hospital Usl Toscana Nord Ovest, Lucca, Italy
| | - M Nardone
- Operative Unit of Chemical-Clinical and Microbiological Analysis San Luca Hospital Usl Toscana Nord Ovest, Lucca, Italy
| | - E Riccobono
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - T Giani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - R Mattei
- Operative Unit of Chemical-Clinical and Microbiological Analysis San Luca Hospital Usl Toscana Nord Ovest, Lucca, Italy
| | - G M Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy.
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Camarlinghi G, Parisio EM, Antonelli A, Nardone M, Coppi M, Giani T, Mattei R, Rossolini GM. Discrepancies in fosfomycin susceptibility testing of KPC-producing Klebsiella pneumoniae with various commercial methods. Diagn Microbiol Infect Dis 2019; 93:74-76. [DOI: 10.1016/j.diagmicrobio.2018.07.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/19/2018] [Accepted: 07/24/2018] [Indexed: 12/27/2022]
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Coppi M, Cannatelli A, Antonelli A, Baccani I, Di Pilato V, Sennati S, Giani T, Rossolini G. A simple phenotypic method for screening of MCR-1-mediated colistin resistance. Clin Microbiol Infect 2018; 24:201.e1-201.e3. [DOI: 10.1016/j.cmi.2017.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/11/2017] [Accepted: 08/12/2017] [Indexed: 10/19/2022]
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Coppi M, Antonelli A, Giani T, Spanu T, Liotti FM, Fontana C, Mirandola W, Gargiulo R, Barozzi A, Mauri C, Principe L, Rossolini GM. Multicenter evaluation of the RAPIDEC® CARBA NP test for rapid screening of carbapenemase-producing Enterobacteriaceae and Gram-negative nonfermenters from clinical specimens. Diagn Microbiol Infect Dis 2017; 88:207-213. [PMID: 28502395 DOI: 10.1016/j.diagmicrobio.2017.04.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 01/17/2017] [Revised: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 12/21/2022]
Abstract
The rapid diagnosis of carbapenemase-producing (CP) bacteria is essential for the management of therapy and infection control. In this study, RAPIDEC® CARBA NP (RCNP) was evaluated for the rapid screening of CP Enterobacteriaceae, Acinetobacter baumannii complex, and Pseudomonas aeruginosa from clinical specimens collected at five Italian hospitals. Firstly, each site tested 20 well-characterized strains in a blinded fashion. Secondly, each center prospectively tested 25 isolates from blood cultures processed with a rapid workflow (6h after subculture) and 25 isolates from other specimens processed after an overnight culture. The presence of carbapenemases was confirmed by multiplex real-timePCRs targeting carbapenemase genes. RCNP presented an overall sensitivity, specificity, positive predictive value, and negative predictive value of 70%, 94%, 82%, and 89%, respectively, with a higher performance in detection of CP Enterobacteriaceae and a poorer performance in detection of CP A. baumannii complex. With isolates from blood cultures, RCNP could significantly reduce the time required for identification of CP Enterobacteriaceae (less than 9h since the positivization of blood cultures).
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Affiliation(s)
- Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Tommaso Giani
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Teresa Spanu
- Institute of Microbiology, Catholic University of the Sacred Heart, Agostino Gemelli Hospital, Rome, Italy
| | - Flora Marzia Liotti
- Institute of Microbiology, Catholic University of the Sacred Heart, Agostino Gemelli Hospital, Rome, Italy
| | - Carla Fontana
- Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy; Clinical Microbiology Laboratories, Polyclinic of Tor Vergata Foundation, Rome, Italy
| | - Walter Mirandola
- Clinical Microbiology Laboratories, Polyclinic of Tor Vergata Foundation, Rome, Italy
| | - Raffaele Gargiulo
- Provincial Laboratory of Clinical Microbiology, S. Agostino-Estense Hospital, Modena, Italy
| | - Agostino Barozzi
- Provincial Laboratory of Clinical Microbiology, S. Agostino-Estense Hospital, Modena, Italy
| | - Carola Mauri
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - Luigi Principe
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy.
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Castriota-Scanderbeg A, Popolizio T, Sacco M, Coppi M, Scarale MG, Cammisa M. [Diagnosis of mycoplasma pneumonia in children: which is the role of thoracic radiography?]. Radiol Med 1995; 89:782-6. [PMID: 7644728] [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: 01/26/2023]
Abstract
Despite its frequency, pneumonia is often surprisingly difficult to diagnose in children and young adults. In particular, the etiologic agent of pneumonia is difficult to recognize in an early stage, which obviously implies an empirical or delayed treatment. Chest radiography is one of the most common procedures required when pneumonia is suspected. This retrospective study was carried out to investigate the capabilities of chest radiography to identify the specific patterns of mycoplasma pneumonia in children. The chest radiographs of 76 children and adolescents (aged 4.2 to 16.4 years) with a radiographic diagnosis of pneumonia were reviewed. All patients were tested twice for serum antimycoplasma antibodies. Thirty-eight subjects (50%) with markedly increased antimycoplasma antibody levels were diagnosed as having mycoplasma infection. In the remaining 38 patients, viral (22 patients, 29%), bacterial (13 patients, 17%) and mixed (3 patients, 4%) infections were diagnosed on the grounds of clinical and laboratory data. Parahilar peribronchial infiltrates were found to be associated with both viral and mycoplasma infections, whereas segmental or lobar consolidation was associated with bacterial, viral and mycoplasma infections. Reticulonodular infiltrates were a specific pattern of mycoplasma pneumonia. The authors conclude that, in the presence of a reticulonodular infiltrate in a lobe, mycoplasma pneumonia can be confidently diagnosed.
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Affiliation(s)
- A Castriota-Scanderbeg
- Dipartimento di Diagnostica per Immagini, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia
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Castriota-Scanderbeg A, Orsi E, De Micheli V, Pedrazzi G, Letico M, Coppi M. [Ultrasonography in the diagnosis and follow-up of hip pain in children]. Radiol Med 1993; 86:808-14. [PMID: 8296000] [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: 01/29/2023]
Abstract
Fifty-seven subjects aged 1.5-14 years (mean: 6.5; standard deviation: 3.3) complaining of hip pain and/or limp underwent clinical, US and radiologic examinations on admission and after variable time intervals. Twenty-eight of them were found to be affected with transient synovitis, 2 with rheumatic fever, 2 with slipped capital femoral epiphysis and 5 with Legg-Calvè-Perthes disease. The extant 20 subjects with normal US and X-ray findings were diagnosed as having irritable hip without effusion. No false-negative results were obtained from US (100% sensitivity), whereas X-ray provided false-negative results in 28 of 37 patients with hip disorders other than irritable hip without effusion (24.3% sensitivity). No significant difference in the extent of hip joint effusion was found at US between the various groups. In the transient synovitis group, joint effusion was apparent on X-ray image in 3 of 28 patients, in whom the effusion was significantly more severe than in the extant 25 patients. Capsular joint effusion resolved more rapidly in transient synovitis than in Legg-Calvè-Perthes disease. The patients with both rheumatic fever and transient synovitis exhibited the most rapid onset of symptoms. On the basis of our results, we suggest that each patient complaining of hip pain and/or limp should undergo US first and that X-rays be performed second, in selected cases only.
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Brunkhorst BA, Kraus E, Coppi M, Budnick M, Niederman R. Propionate induces polymorphonuclear leukocyte activation and inhibits formylmethionyl-leucyl-phenylalanine-stimulated activation. Infect Immun 1992; 60:2957-68. [PMID: 1319407 PMCID: PMC257260 DOI: 10.1128/iai.60.7.2957-2968.1992] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Short-chain carboxylic acids (SCCA) are metabolic by-products of bacterial pathogens which can alter cytoplasmic pH and inhibit a variety of polymorphonuclear leukocyte (PMN) motile functions. Since cytoskeletal F-actin alterations are central to PMN mobility, in this study we examined the effects of SCCA on cytoskeletal F-actin. Initially, we tested nine SCCA (formate, acetate, propionate, butyrate, valerate, caproate, lactate, succinate, and isobutyrate). We document here that while eight altered cytoplasmic pH, only six altered cytoskeletal F-actin. We then selected one SCCA that altered both F-actin and cytoplasmic pH (propionate) and one SCCA that altered only cytoplasmic pH (lactate) for further study. Propionate, but not lactate, caused an irregular cell shape and F-actin distribution. Furthermore, propionate, but not lactate, inhibited formylmethionyl-leucyl-phenylalanine (fMLP)-stimulated PMN polarization, F-actin localization, and cytoplasmic pH oscillation. Propionate-induced changes in cytoskeletal F-actin and cytoplasmic acidification were not affected by the fMLP receptor antagonist N-t-BOC-1-methionyl-1-leucyl-1-phenylalanine; however, alkalinization was affected. Pertussis toxin treatment completely inhibited propionate-induced changes in F-actin but had no effect on propionate-induced cytoplasmic pH oscillation. These results indicate that propionate (i) bypasses the fMLP receptor and G protein(s) to induce cytoplasmic pH oscillation, (ii) operates through G protein(s) to induce actin oscillation, cell shape changes (to irregular), and F-actin localization, and (iii) inhibits fMLP-stimulated cytoplasmic pH and actin oscillation, PMN polarization, and F-actin localization.
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Affiliation(s)
- B A Brunkhorst
- Department of Cell Biology, Forsyth Research Institute, Boston, Massachusetts 02115
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Merlini E, Seymandi PL, Scarsi P, Durante GF, Sartirana P, Coppi M. [Acute epididymitis in children]. Pediatr Med Chir 1990; 12:85-6. [PMID: 2377568] [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: 12/31/2022] Open
Abstract
Fifteen cases of epididymitis in children are reviewed, six of these occurring in children under twelve months of age, and nine in older children. In five of the six cases occurring in infants a U.T.I. and a malformation of the urinary tract were found, while in children over one year only three infections and two urinary malformations were discovered. Authors recommend that in infants under 1 year presenting with epididymitis a thorough investigation of the urinary tract is performed.
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Affiliation(s)
- E Merlini
- Ospedale Infantile Cesare Arrigo, Divisione di Chirurgia Pediatrica, Alessandria, Italia
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Coppi M, Niederman R. Effects of ammonia on human neutrophil N-formyl chemotactic peptide receptor-ligand interaction and cytoskeletal association. Biochem Biophys Res Commun 1989; 165:377-83. [PMID: 2590235 DOI: 10.1016/0006-291x(89)91081-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Ammonia is a bacterial metabolite which is commonly used to alter cytoplasmic and lysosomal pH of eukaryotic cells. Here we examine its effect on external N-formyl peptide receptors of human neutrophils. Ammonia does not affect the number of N-formyl peptide receptors on the cell surface, nor the association of the ligand-receptor complex with the cytoskeleton. However, ammonia causes a marked decrease in the affinity of the chemotactic peptide receptor for its ligand. The Kd of untreated cell for the chemotactic peptide was 0.65 +/- 0.06 nM, whereas that of ammonia treated cells was 1.02 +/- 0.10 nM (Mean +/- SEM, N = 6). These results suggest that ammonia can affect external as well as internal cellular components. Since ammonia is used to alter lysosomal and cytoplasmic pH, and is a metabolite of common bacterial pathogens, these results bear directly on its use in cell biology and on its potential as a virulence factor.
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Affiliation(s)
- M Coppi
- Department of Cell Biology, Forsyth Dental Research Center, Boston, MA 02115
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41
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Seymandi PL, Merlini E, Scarsi PL, Coppi M. [Simple testicular cysts in children. Presentation of a case]. Pediatr Med Chir 1989; 11:471-2. [PMID: 2694111] [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: 01/02/2023] Open
Abstract
A case of simple intraparenchymal testicular cyst in a two and half months old child is reported. Dysplastic cysts of the testicle are exceedingly rare, in children only eight such cases have been described in the Literature, all, except one, treated by orchiectomy. In the herein reported case a conservative approach with cyst enucleation and sparing of the residual testicular parenchyma has been satisfactorily employed.
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de Filippi G, Canestri G, Bosio U, Derchi LE, Coppi M. Thoracic neuroblastoma: antenatal demonstration in a case with unusual post-natal radiographic findings. Br J Radiol 1986; 59:704-6. [PMID: 3524731 DOI: 10.1259/0007-1285-59-703-704] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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De Filippi G, Vay P, Coppi M. [Invasive pulmonary aspergillosis in chronic granulomatous disease in an infant (a case report)]. Radiol Med 1983; 69:158-60. [PMID: 6836156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
Congenital urethral polyps are an uncommon cause of urethral obstruction in male children. The diagnosis is obtained at voiding cystography by demonstrating a filling defect which (typically) moves during micturition. A small polypoid mass with a stalk arising from the region of the verumontanum was observed by sonography in one such patient. We believe sonographic findings may be considered specific of this condition.
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Coppi M, Vay P. [Urinary tract injuries in the infant: radiographic images (proceedings)]. Radiol Med 1978; 64:913-4. [PMID: 748998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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46
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Coppi M, Moretti E. [Osteopathy in the premature infant (proceedings)]. Radiol Med 1978; 64:911-2. [PMID: 748997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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47
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Coppi M, Spreafico PL, Casale G. Treatment of the experimental hemorrhagic radiation syndrome by means of placental extracts with high phospholipidic content. Farmaco Prat 1976; 31:133-9. [PMID: 1253957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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48
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Pasotti C, Marchesani F, Coppi M. [Action of ellagic acid on the time and intensity of hemorrhage in irradiated rats]. Minerva Med 1969; 60:4954-8. [PMID: 5357561] [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: 01/14/2023]
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de Nicola P, Lüscher EF, Coppi M, Montanaro G. The survival rate of irradiated rats after treatment with platelet lipid extracts alone and in combination with an antifibrinolytic agent. Vox Sang 1968; 14:224-7. [PMID: 5301806 DOI: 10.1111/j.1423-0410.1968.tb03408.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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50
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De Nicola P, Lüscher E, Coppi M, Montanaro G. The Survival Rate of Irradiated Rats After Treatment
with Platelet Lipid Extracts Alone and in Combination
with an Antifibrinolytic Agent. Vox Sang 1968. [DOI: 10.1159/000464690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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