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Vicenti I, Basso M, Pirola N, Bragato B, Rossi MC, Giobbia M, Pascoli S, Vinci A, Caputo S, Varasi I, Biba C, Fiaschi L, Zazzi M, Parisi SG. SARS-CoV-2 Neutralizing Antibodies to B.1 and to BA.5 Variant after Booster Dose of BNT162b2 Vaccine in HIV Patients COVID-Naïve and on Successful Antiretroviral Therapy. Vaccines (Basel) 2023; 11:vaccines11040871. [PMID: 37112782 PMCID: PMC10144758 DOI: 10.3390/vaccines11040871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Live virus neutralization is the gold standard to investigate immunity. This prospective observational study aimed to determine the magnitude of response against the original B.1 lineage and against the BA.5 lineage six months after the third BNT162b2 mRNA vaccine dose in patients with HIV infection on successful antiretroviral treatment and no previous SARS-CoV-2 infection. A total of 100 subjects (M/F 83/17, median age 54 years) were included in the analysis: 95 had plasma HIV RNA <40 copies/mL, the median CD4+ T cell count at the administration of the third dose was 580 cells/mm3, and the median nadir CD4+ T cell count was 258 cells/mm3. Neutralizing antibodies (NtAb) against B.1 were detectable in all the subjects, but those to BA.5 were only detected in 88 (p < 0.001). The median NtAb titer to B.1 was significantly higher than that to BA.5 (393 vs. 60, p < 0.0001), and there was a strong positive correlation between the paired measurements (p < 0.0001). Linear regression on a subset of 87 patients excluding outlier NtAb titers showed that 48% of the changes in NtAb titers to BA.5 are related to the changes in value titers to B.1. SARS-CoV-2 variants evolve rapidly, challenging the efficacy of vaccines, and data on comparative NtAb responses may help in tailoring intervals between vaccine doses and in predicting vaccine efficacy.
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Affiliation(s)
- Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Monica Basso
- Department of Molecular Medicine, University of Padova, 35100 Padova, Italy
| | - Nicole Pirola
- Department of Molecular Medicine, University of Padova, 35100 Padova, Italy
| | - Beatrice Bragato
- Department of Molecular Medicine, University of Padova, 35100 Padova, Italy
| | | | - Mario Giobbia
- Infectious Diseases Unit, Treviso Hospital, 31100 Treviso, Italy
| | - Susanna Pascoli
- Microbiology Unit, Department of Specialist and Laboratory Medicine, Ca' Foncello University Hospital, 31100 Treviso, Italy
| | - Antonio Vinci
- Hospital Health Management Area, Local Health Authority "Roma 1", Borgo Santo Spirito 3, 00193 Rome, Italy
| | - Sara Caputo
- Department of Molecular Medicine, University of Padova, 35100 Padova, Italy
| | - Ilenia Varasi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Camilla Biba
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Lia Fiaschi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
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Scarpa R, Dell'Edera A, Felice C, Buso R, Muscianisi F, Finco Gambier R, Toffolo S, Grossi U, Giobbia M, Barberio G, Landini N, Facchini C, Agostini C, Rattazzi M, Cinetto F. Impact of Hypogammaglobulinemia on the Course of COVID-19 in a Non-Intensive Care Setting: A Single-Center Retrospective Cohort Study. Front Immunol 2022; 13:842643. [PMID: 35359947 PMCID: PMC8960988 DOI: 10.3389/fimmu.2022.842643] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/01/2022] [Indexed: 12/11/2022] Open
Abstract
Background Severity and mortality of COVID-19 largely depends on the ability of the immune system to clear the virus. Among various comorbidities potentially impacting on this process, the weight and the consequences of an antibody deficiency have not yet been clarified. Methods We used serum protein electrophoresis to screen for hypogammaglobulinemia in a cohort of consecutive adult patients with COVID-19 pneumonia, hospitalized in non-intensive care setting between December 2020 and January 2021. The disease severity, measured by a validated score and by the need for semi intensive (sICU) or intensive care unit (ICU) admission, and the 30-day mortality was compared between patients presenting hypogammaglobulinemia (HYPO) and without hypogammaglobulinemia (no-HYPO). Demographics, comorbidities, COVID-19 specific treatment during the hospital stay, disease duration, complications and laboratory parameters were also evaluated in both groups. Results We enrolled 374 patients, of which 39 represented the HYPO cohort (10.4%). In 10/39 the condition was previously neglected, while in the other 29/39 hematologic malignancies were common (61.5%); 2/39 were on regular immunoglobulin replacement therapy (IgRT). Patients belonging to the HYPO group more frequently developed a severe COVID-19 and more often required sICU/ICU admission than no-HYPO patients. IgRT were administered in 8/39 during hospitalization; none of them died or needed sICU/ICU. Among HYPO cohort, we observed a significantly higher prevalence of neoplastic affections, of active oncologic treatment and bronchiectasis, together with higher prevalence of viral and bacterial superinfections, mechanical ventilation, convalescent plasma and SARS-CoV-2 monoclonal antibodies administration during hospital stay, and longer disease duration. Multivariate logistic regression analysis and Cox proportional hazard regression confirmed the impact of hypogammaglobulinemia on the COVID-19 severity and the probability of sICU/ICU admission. The analysis of the mortality rate in the whole cohort showed no significant difference between HYPO and no-HYPO. Conclusions Hypogammaglobulinemia, regardless of its cause, in COVID-19 patients hospitalized in a non-intensive care setting was associated to a more severe disease course and more frequent admission to s-ICU/ICU, particularly in absence of IgRT. Our findings emphasize the add-value of routine serum protein electrophoresis evaluation in patients admitted with COVID-19 to support clinicians in patient care and to consider IgRT initiation during hospitalization.
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Affiliation(s)
- Riccardo Scarpa
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy.,Department of Medicine, University of Padova, Padua, Italy
| | - Alessandro Dell'Edera
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy.,Department of Medicine, University of Padova, Padua, Italy
| | - Carla Felice
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy.,Department of Medicine, University of Padova, Padua, Italy
| | - Roberta Buso
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy
| | - Francesco Muscianisi
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy.,Department of Medicine, University of Padova, Padua, Italy
| | - Renato Finco Gambier
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy.,Department of Medicine, University of Padova, Padua, Italy
| | - Sara Toffolo
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy.,Department of Medicine, University of Padova, Padua, Italy
| | - Ugo Grossi
- Department of Surgery, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy
| | - Mario Giobbia
- Infectious Diseases Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy
| | - Giuseppina Barberio
- Laboratory Medicine, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy
| | - Nicholas Landini
- Radiology Unit, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy
| | - Cesarina Facchini
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy
| | - Carlo Agostini
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy.,Department of Medicine, University of Padova, Padua, Italy
| | - Marcello Rattazzi
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy.,Department of Medicine, University of Padova, Padua, Italy
| | - Francesco Cinetto
- Internal Medicine I, Ca' Foncello Hospital, Azienda Unità Locale Socio Sanitaria n. 2 (AULSS2) Marca Trevigiana, Treviso, Italy.,Department of Medicine, University of Padova, Padua, Italy
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Buso R, Cinetto F, Dell’Edera A, Veneran N, Facchini C, Biscaro V, Schiavon S, Vian E, Grossi U, Zanus G, Giobbia M, Scarpa R, Agostini C, Rattazzi M, Felice C. Comparison between Dexamethasone and Methylprednisolone Therapy in Patients with COVID-19 Pneumonia Admitted to Non-Intensive Medical Units. J Clin Med 2021; 10:jcm10245812. [PMID: 34945108 PMCID: PMC8703463 DOI: 10.3390/jcm10245812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/25/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Data on different steroid compounds for the treatment of hospitalized COVID-19 (coronavirus disease 2019) patients are still limited. The aim of this study was to compare COVID-19 patients admitted to non-intensive units and treated with methylprednisolone or dexamethasone. (2) Methods: This was a single-center retrospective study that included consecutive patients with COVID-19 hospitalized in medical wards during the second wave of the pandemic. Thirty-day mortality and the need for intensive or semi-intensive care were the main clinical outcomes analyzed in patients receiving methylprednisolone (60 mg/day) compared with dexamethasone (6 mg/day). Secondary outcomes included complication rates, length of hospital stay, and time to viral clearance. (3) Results: Two-hundred-forty-six patients were included in the analysis, 110 treated with dexamethasone and 136 with methylprednisolone. No statistically significant differences were found between the two groups of patients regarding 30-day mortality (OR 1.35, CI95% 0.71-2.56, p = 0.351) and the need for intensive or semi-intensive care (OR 1.94, CI95% 0.81-4.66, p = 0.136). The complication rates, length of hospital stay, and time to viral clearance did not significantly differ between the two groups. (4) Conclusions: In patients hospitalized for COVID-19 in non-intensive units, the choice of different steroid compounds, such as dexamethasone or methylprednisolone, did not affect the main clinical outcomes.
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Affiliation(s)
- Roberta Buso
- Medicine 1 Unit, Department of Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (R.B.); (F.C.); (A.D.); (N.V.); (C.F.); (R.S.); (C.A.); (C.F.)
| | - Francesco Cinetto
- Medicine 1 Unit, Department of Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (R.B.); (F.C.); (A.D.); (N.V.); (C.F.); (R.S.); (C.A.); (C.F.)
- Department of Medicine, DIMED, University of Padova, 35122 Padova, Italy
| | - Alessandro Dell’Edera
- Medicine 1 Unit, Department of Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (R.B.); (F.C.); (A.D.); (N.V.); (C.F.); (R.S.); (C.A.); (C.F.)
| | - Nicola Veneran
- Medicine 1 Unit, Department of Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (R.B.); (F.C.); (A.D.); (N.V.); (C.F.); (R.S.); (C.A.); (C.F.)
| | - Cesarina Facchini
- Medicine 1 Unit, Department of Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (R.B.); (F.C.); (A.D.); (N.V.); (C.F.); (R.S.); (C.A.); (C.F.)
| | - Valeria Biscaro
- Microbiology Unit, Department of Specialist and Laboratory Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (V.B.); (S.S.); (E.V.)
| | - Stefania Schiavon
- Microbiology Unit, Department of Specialist and Laboratory Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (V.B.); (S.S.); (E.V.)
| | - Elisa Vian
- Microbiology Unit, Department of Specialist and Laboratory Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (V.B.); (S.S.); (E.V.)
| | - Ugo Grossi
- Surgery 2 Unit, DISCOG, Ca’ Foncello University Hospital, University of Padua, 31100 Treviso, Italy; (U.G.); (G.Z.)
| | - Giacomo Zanus
- Surgery 2 Unit, DISCOG, Ca’ Foncello University Hospital, University of Padua, 31100 Treviso, Italy; (U.G.); (G.Z.)
| | - Mario Giobbia
- Infective Disease Unit, Department of Specialist and Laboratory Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy;
| | - Riccardo Scarpa
- Medicine 1 Unit, Department of Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (R.B.); (F.C.); (A.D.); (N.V.); (C.F.); (R.S.); (C.A.); (C.F.)
| | - Carlo Agostini
- Medicine 1 Unit, Department of Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (R.B.); (F.C.); (A.D.); (N.V.); (C.F.); (R.S.); (C.A.); (C.F.)
- Department of Medicine, DIMED, University of Padova, 35122 Padova, Italy
| | - Marcello Rattazzi
- Medicine 1 Unit, Department of Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (R.B.); (F.C.); (A.D.); (N.V.); (C.F.); (R.S.); (C.A.); (C.F.)
- Department of Medicine, DIMED, University of Padova, 35122 Padova, Italy
- Correspondence: or ; Tel.: +39-0498211867 or +39-0422322207; Fax: +39-0498754179
| | - Carla Felice
- Medicine 1 Unit, Department of Medicine, Ca’ Foncello University Hospital, 31100 Treviso, Italy; (R.B.); (F.C.); (A.D.); (N.V.); (C.F.); (R.S.); (C.A.); (C.F.)
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Inojosa WO, Giobbia M, Muffato G, Minniti G, Baldasso F, Carniato A, Farina F, Forner G, Rossi MC, Formentini S, Rigoli R, Scotton PG. Mycobacterium chimaera infections following cardiac surgery in Treviso Hospital, Italy, from 2016 to 2019: Cases report. World J Clin Cases 2019; 7:2776-2786. [PMID: 31616692 PMCID: PMC6789390 DOI: 10.12998/wjcc.v7.i18.2776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 08/19/2019] [Accepted: 09/09/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND An epidemic of Mycobacterium chimaera (M. chimaera) infections following cardiac surgery is ongoing worldwide. The outbreak was first discovered in 2011, and it has been traced to a point source contamination of the LivaNova 3T heater-cooler unit, which is used also in Italy. International data are advocated to clarify the spectrum of clinical features of the disease as well as treatment options and outcome. We report a series of M. chimaera infections diagnosed in Treviso Hospital, including the first cases notified in Italy in 2016.
CASE SUMMARY Since June 2016, we diagnosed a M. chimaera infection in nine patient who had undergone cardiac valve surgery between February 2011 and November 2016. The time between cardiac surgery and developing symptoms ranged from 6 to 97 mo. Unexplained fever, psychophysical decay, weight loss, and neurological symptoms were common complaints. The median duration of symptoms was 32 wk, and the longest was almost two years. A new cardiac murmur, splenomegaly, choroidoretinitis, anaemia or lymphopenia, abnormal liver function tests and hyponatremia were common findings. All the patients presented a prosthetic valve endocarditis, frequently associated to an ascending aortic pseudoneurysm or spondylodiscitis. M. chimaera was cultured from blood, bioprosthetic tissue, pericardial abscess, vertebral tissue, and bone marrow. Mortality is high in our series, reflecting the poor outcome observed in other reports. Three patients have undergone repeat cardiac surgery. Five patients are being treated with a targeted multidrug antimycobacterial regimen.
CONCLUSION Patients who have undergone cardiac surgery in Italy and presenting with signs and symptoms of endocarditis must be tested for M. chimaera.
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Affiliation(s)
- Walter O Inojosa
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | - Mario Giobbia
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | | | | | | | | | - Francesca Farina
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | - Gabriella Forner
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | - Maria C Rossi
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | | | - Roberto Rigoli
- Microbiology Unit, Treviso Hospital, Treviso 31100, Italy
| | - Pier G Scotton
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
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Rossi MC, Inojosa WO, Battistella G, Carniato A, Farina F, Giobbia M, Fuser R, Scotton PG. Desimplification to multi-tablet antiretroviral regimens in human immunodeficiency virus-type 1 infected adults: A cohort study. World J Clin Cases 2019; 7:1814-1824. [PMID: 31417927 PMCID: PMC6692266 DOI: 10.12998/wjcc.v7.i14.1814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/02/2019] [Accepted: 05/23/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Highly active antiretroviral therapy (HAART) is provided free of charge to all human immunodeficiency virus (HIV) positive residents in Italy. As fixed dose coformulations (FDCs) are often more expensive in comparison to the same drugs administered separately in a multi-tablet regimen (MTR), we considered a cost-effective strategy involving patients in the switch from their FDCs to corresponding MTRs including generic antiretrovirals.
AIM To verify if this would affect the virological and immunological response in comparison to maintaining the FDC regimens.
METHODS From January 2012 to December 2013, we assessed the eligibility of all the HIV-1 positive adults on stable HAART being treated at our hospital-based outpatient clinic in Treviso, Italy. Participants who accepted to switch from their FDC regimen to the corresponding MTR joined the MTR group, while those who maintained a FDC regimen joined the FDC group. Clinical data, including changes in HAART regimens, respective reasons why and adverse effects, were recorded at baseline and at follow-up visits occurring at weeks 24, 48 and 96. All participants were assessed for virological and immunological responses at baseline and at weeks 24, 48 and 96.
RESULTS Two hundred and forty-three eligible HIV-1 adults on HAART were enrolled: 163 (67%) accepted to switch to a MTR, joining the MTR group, while 80 (33%) maintained their FDCs, joining the FDC group. In a parallel analysis, there were no significant differences in linear trend of distribution of HIV-RNA levels between the two groups and there were no significant odds in favour of a higher level of HIV-RNA in either group at any follow-up and on the overall three strata analysis. In a before-after analysis, both FDC and MTR groups presented no significant differences in distribution of HIV-RNA levels at either weeks 48 vs 24 and weeks 96 vs 24 cross tabulations. A steady increase of mean CD4 count was observed in the MTR group only, while in the FDC group we observed a slight decrease (-23 cells per mmc) between weeks 24 and 48.
CONCLUSION Involving patients in the switch from their FDC regimens to the corresponding MTRs for economic reasons did not affect the effectiveness of antiretroviral therapy in terms of virological response and immunological recovery
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Affiliation(s)
- Maria C Rossi
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | - Walter O Inojosa
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | - Giuseppe Battistella
- Epidemiology and Statistic Unit, Azienda ULSS 2 “Marca Trevigiana”, Treviso 31100, Italy
| | | | - Francesca Farina
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | - Mario Giobbia
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | - Rodolfo Fuser
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
| | - Pier G Scotton
- Infectious Diseases Unit, Treviso Hospital, Treviso 31100, Italy
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6
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Buonfrate D, Baldissera M, Abrescia F, Bassetti M, Caramaschi G, Giobbia M, Mascarello M, Rodari P, Scattolo N, Napoletano G, Bisoffi Z. Epidemiology of Strongyloides stercoralis in northern Italy: results of a multicentre case-control study, February 2013 to July 2014. ACTA ACUST UNITED AC 2017; 21:30310. [PMID: 27525375 PMCID: PMC4998510 DOI: 10.2807/1560-7917.es.2016.21.31.30310] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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: 10/16/2015] [Accepted: 02/18/2016] [Indexed: 12/04/2022]
Abstract
Strongyloides stercoralis is a soil-transmitted helminth widely diffused in tropical and subtropical regions of the world. Autochthonous cases have been also diagnosed sporadically in areas of temperate climate. We aimed at defining the epidemiology of strongyloidiasis in immigrants and Italians living in three northern Italian Regions. Screening for S. stercoralis infection was done with serology, confirmation tests were a second serological method or stool agar culture. A case–control approach was adopted and patients with a peripheral eosinophil count ≥ 500/mcL were classified as cases. Of 2,701 individuals enrolled here 1,351 were cases and 1,350 controls; 86% were Italians, 48% women. Italians testing positive were in 8% (97/1,137) cases and 1% (13/1,178) controls (adjusted odds ratio (aOR) 8.2; 95% confidence interval (CI): 4.5–14.8), while positive immigrants were in 17% (36/214) cases and in 2% (3/172) controls (aOR 9.6; 95% CI: 2.9–32.4). Factors associated with a higher risk of infection for all study participants were eosinophilia (p < 0.001) and immigration (p = 0.001). Overall, strongyloidiasis was nine-times more frequent in individuals with eosinophilia than in those with normal eosinophil count.
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Affiliation(s)
- Dora Buonfrate
- Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar (Verona), Italy
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Gobbi F, Capelli G, Angheben A, Giobbia M, Conforto M, Franzetti M, Cattelan AM, Raise E, Rovere P, Mulatti P, Montarsi F, Drago A, Barzon L, Napoletano G, Zanella F, Pozza F, Russo F, Rosi P, Palù G, Bisoffi Z. Human and entomological surveillance of West Nile fever, dengue and chikungunya in Veneto Region, Italy, 2010-2012. BMC Infect Dis 2014; 14:60. [PMID: 24499011 PMCID: PMC3922982 DOI: 10.1186/1471-2334-14-60] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 09/25/2013] [Accepted: 01/30/2014] [Indexed: 11/23/2022] Open
Abstract
Background Since 2010 Veneto region (North-Eastern Italy) planned a special integrated surveillance of summer fevers to promptly identify cases of West Nile Fever (WNF), dengue (DENV) and chikungunya (CHIKV). The objectives of this study were (i) To increase the detection rate of imported CHIKV and DENV cases in travellers from endemic areas and promptly identify potential autochthonous cases.(ii) To detect autochthonous cases of WNF, besides those of West Nile Neuroinvasive Disease (WNND) that were already included in a national surveillance. Methods Human surveillance: a traveler who had returned within the previous 15 days from endemic countries, with fever >38°C, absence of leucocytosis (leukocyte count <10,000 μL), and absence of other obvious causes of fever, after ruling out malaria, was considered a possible case of CHIKV or DENV. A possible autochthonous case of WNF was defined as a patient with fever >38°C for <7 days, no recent travel history and absence of other obvious causes of fever. Entomologic surveillance: for West Nile (WNV) it was carried out from May through November placing CDC-CO2 traps in five provinces of Veneto Region, while for DENV and CHIKV it was also performed around residences of viremic cases. Results Human surveillance: between 2010 and 2012, 234 patients with fever after travelling were screened, of which 27 (11,5%) were found infected (24 with DENV and 3 with CHIKV). No autochthonous case of DENV or CHIKV was detected. Autochthonous patients screened for WNF were 408, and 24 (5,9%) were confirmed cases. Entomologic surveillance: the WNV was found in 10, 2 and 11 pools of Culex pipiens from 2010 to 2012 respectively, in sites of Rovigo, Verona, Venezia and Treviso provinces). No infected Aedes albopictus with DENV or CHIKV was found. Conclusions Veneto is the only Italian region reporting WNV human cases every year since 2008. WNV is likely to cause sporadic cases and unforeseeable outbreaks for decades. Including WNF in surveillance provides additional information and possibly an early alert system. Timely detection of DENV and CHIKV should prompt vector control measures to prevent local outbreaks.
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Affiliation(s)
- Federico Gobbi
- Centre for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy.
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8
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Carniato A, Fuser R, Giobbia M, Rossi C, Farina F, Inojosa W, Pintaldi S, Scotton PG. [Tuberculous peritonitis: experience in Treviso from 2000 to 2010]. Infez Med 2012; 20:195-199. [PMID: 22992560] [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: 06/01/2023]
Abstract
Peritonitis is an uncommon localization of tuberculosis in Italy; diagnosis and treatment are often difficult and delayed. Fifteen cases, followed by Infectious Diseases Department in Treviso from 2000 to 2010, are described. Mortality and long term complications were absent, in contrast with medical literature. The usefulness of steroid therapy is still uncertain. Other sites of infection were present in 60 percent of patients (pulmonary TB in 47%), urging the clinician to examine the case promptly to determine infectiousness status.
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MESH Headings
- Adult
- Aged
- Antitubercular Agents/therapeutic use
- Diagnosis, Differential
- Emigrants and Immigrants/statistics & numerical data
- Endometritis/diagnosis
- Endometritis/drug therapy
- Endometritis/epidemiology
- Endometritis/microbiology
- Female
- Hospitals, County
- Hospitals, Isolation
- Humans
- Incidence
- Inpatients/statistics & numerical data
- Italy/epidemiology
- Male
- Medical Records Systems, Computerized
- Middle Aged
- Mycobacterium tuberculosis/isolation & purification
- Peritonitis, Tuberculous/diagnosis
- Peritonitis, Tuberculous/drug therapy
- Peritonitis, Tuberculous/epidemiology
- Poverty
- Risk Factors
- Treatment Outcome
- Tuberculosis, Female Genital/diagnosis
- Tuberculosis, Female Genital/drug therapy
- Tuberculosis, Female Genital/epidemiology
- Tuberculosis, Pulmonary/diagnosis
- Tuberculosis, Pulmonary/drug therapy
- Tuberculosis, Pulmonary/epidemiology
- Tuberculosis, Renal/diagnosis
- Tuberculosis, Renal/drug therapy
- Tuberculosis, Renal/epidemiology
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9
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Inojosa W, Rossi MC, Laurino L, Giobbia M, Fuser R, Carniato A, Farina F, De Pieri M, Baldasso F, Forner G, Scotton P. Progressive disseminated histoplasmosis among human immunodeficiency virus-infected patients from West-Africa: report of four imported cases in Italy. Infez Med 2011; 19:49-55. [PMID: 21471748] [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: 05/30/2023]
Abstract
We report four imported cases of progressive disseminated histoplasmosis (PDH) due to Histoplasma capsulatum variety capsulatum in Human Immunodeficiency Virus-infected patients from West Africa. This report highlights the need to consider diagnosis of PDH among patients with acquired immunodeficiency syndrome who originate from West Africa and present with a prolonged febrile illness and very low CD4 count.
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Affiliation(s)
- Walter Inojosa
- Unita Operativa di Malattie Infettive, Ospedale Regionale di Treviso, Italy
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10
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Giobbia M, Tonon E, Zanatta A, Cesaris L, Vaglia A, Bisoffi Z. Late recrudescence of Plasmodium falciparum malaria in a pregnant woman: a case report. Int J Infect Dis 2005; 9:234-5. [PMID: 15916911 DOI: 10.1016/j.ijid.2004.08.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2004] [Revised: 07/27/2004] [Accepted: 08/10/2004] [Indexed: 11/28/2022] Open
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11
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Giobbia M, Scotton PG, Carniato A, Cruciani M, Farnia A, Daniotti E, Scarpa G, Vaglia A. Community-acquired Klebsiella pneumoniae bacteremia with meningitis and endophthalmitis in Italy. Int J Infect Dis 2003; 7:234-5. [PMID: 14563231 DOI: 10.1016/s1201-9712(03)90060-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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12
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Giobbia M, Scotton P, Carniato A, Vaglia A. Primary dorsal localization of invertebrate hydatidosis. Infez Med 2003; 7:54-56. [PMID: 12728207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
We describe patient with Echinococcus granulosus disease primary localized on the back. This case is uncommon because of the lack of risk exposure history and the sole muscular localization. The patient received several surgical operations on the back, without eradication of the infestation. At the end we discuss the clinical considerations that induced the choice of the usual medical therapy
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Affiliation(s)
- M. Giobbia
- Divisione Malattie Infettive, Ospedale Civile di Treviso, Italy
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13
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Scotton PG, Pea F, Giobbia M, Baraldo M, Vaglia A, Furlanut M. Cerebrospinal fluid penetration of levofloxacin in patients with spontaneous acute bacterial meningitis. Clin Infect Dis 2001; 33:e109-11. [PMID: 11577376 DOI: 10.1086/323406] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2001] [Revised: 05/14/2001] [Indexed: 11/03/2022] Open
Abstract
We have assessed levofloxacin penetration in cerebrospinal fluid (CSF) and the liquor-to-plasma ratio (C(L)/C(P)) at 2 hours after dosing in 5 patients with spontaneous acute bacterial meningitis. CSF levofloxacin concentration at 2 hours after dosing was 1.99+/-0.67 microg/mL, and the C(L)/C(P) at 2 hours after dosing was 0.34+/-0.09.
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Affiliation(s)
- P G Scotton
- Department of Infectious Diseases, Regional Hospital Cà Foncello, Treviso, Italy.
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14
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Scotton PG, Tonon E, Giobbia M, Gallucci M, Rigoli R, Vaglia A. Rhodococcus equi nosocomial meningitis cured by levofloxacin and shunt removal. Clin Infect Dis 2000; 30:223-4. [PMID: 10619769 DOI: 10.1086/313628] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- P G Scotton
- Department of Infectious Diseases, Regional Hospital Cà Foncello, Treviso, Italy.
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15
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16
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Abstract
Cytomegalovirus (CMV)-associated transverse myelitis is rare in immunocompetent patients. The case of a 54-year-old man is reported here who developed acute transverse myelitis with cerebrospinal fluid (CSF) alterations, suggesting a central nervous system infection. CMV-IgM positivity in serum and CMV isolated from blood, positive CMV PCR and positivity for pp65 antigen in blood, without viral antigens in the CSF and a positive response to therapy with ganciclovir (followed by progressive improvement) supported the diagnosis.
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Affiliation(s)
- M Giobbia
- Infectious Disease Dept., General Hospital Ca Foncello, Treviso, Italy
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17
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Raiteri R, Baussano I, Giobbia M, Fora R, Sinicco A. Lesbian sex and risk of HIV transmission. AIDS 1998; 12:450-1. [PMID: 9520184] [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: 02/06/2023]
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