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Caccamo G, Franzè MS, Saffioti F, Pitrone C, Porcari S, Alibrandi A, Filomia R, Mondello P, Cacciola I, Saitta C, Squadrito G, Raimondo G, Maimone S. Cirrhotic Patients with Bacterial Infection and Negative Cultures Have a More Advanced Disease and an Increased Short-Term Mortality Rate. Dig Dis Sci 2022; 67:2655-2665. [PMID: 34041650 DOI: 10.1007/s10620-021-07047-6] [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] [Received: 01/02/2021] [Accepted: 05/09/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND The negative clinical impact of bacterial infections (BI) in patients with cirrhosis is well documented. In cirrhotic patients, failure to isolate the pathogen is a frequent event, occurring in 30-40% of cases. AIM The aim of this study was to compare the clinical characteristics, early (30-day) and short-term (90-day) mortality rates, in a cohort of cirrhotic patients with BI, between those with positive (C-pos) and those with negative (C-neg) microbiological cultures. METHODS We retrospectively enrolled 279 consecutive hospitalized cirrhotic patients with BI. Survival and predictors of 30-day and 90-day mortality were assessed by Kaplan-Meier curves and logistic regression analysis, respectively. RESULTS Cultures tested negative in 108/279 (38.7%) patients. C-neg patients were more frequently males (p = 0.035), had higher Child-Pugh-Turcotte (CPT; p = 0.007) and model for end-stage liver disease-sodium (MELD-Na; p = 0.043) scores, and had more frequently decompensated liver disease (p = 0.04). Mortality rate was higher in C-neg than in C-pos patients, both at 30 days (22.2% versus 11.7%, p = 0.024) and 90 days (46.3% versus 33.3%, p = 0.030). MELD-Na score and non-selective beta-blockers (NSBBs) were independent risk factors for 30-day and 90-day mortality. In particular, the use of NSBBs was independently associated with a lower 30-day and 90-day mortality risk (OR 0.41, CI95% 0.17-0.94, p = 0.040; and OR 0.43, CI95% 0.25-0.75, p = 0.003, respectively). CONCLUSIONS Cirrhotic patients with BI and negative microbiological cultures have significantly higher mortality compared to those with positive cultures. Early mortality and short-term mortality are mainly influenced by the underlying severity of liver disease. In this contest, therapy with NSBBs has a positive impact on short-term survival.
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Affiliation(s)
- Gaia Caccamo
- Division of Medicine and Hepatology, University Hospital of Messina "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy. .,Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.
| | - Maria Stella Franzè
- Division of Medicine and Hepatology, University Hospital of Messina "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Clinical and Experimental Medicine, University of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
| | - Francesca Saffioti
- Department of Gastroenterology and Hepatology, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Heading, Oxford, OX1 HP, UK
| | - Concetta Pitrone
- Division of Medicine and Hepatology, University Hospital of Messina "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Clinical and Experimental Medicine, University of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
| | - Serena Porcari
- Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Division of Gastroenterology and Inflammatory Bowel Diseases, University Hospital of Messina, Via Consolare Valeria 1, 98124, Messina, Italy
| | - Angela Alibrandi
- Department of Economics Unit of Statistical and Mathematical Science, University of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
| | - Roberto Filomia
- Division of Medicine and Hepatology, University Hospital of Messina "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
| | - Placido Mondello
- Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Division of Infectious Diseases, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
| | - Irene Cacciola
- Division of Medicine and Hepatology, University Hospital of Messina "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Clinical and Experimental Medicine, University of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
| | - Carlo Saitta
- Division of Medicine and Hepatology, University Hospital of Messina "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
| | - Giovanni Squadrito
- Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Clinical and Experimental Medicine, University of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Division of Internal Medicine, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
| | - Giovanni Raimondo
- Division of Medicine and Hepatology, University Hospital of Messina "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Clinical and Experimental Medicine, University of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
| | - Sergio Maimone
- Division of Medicine and Hepatology, University Hospital of Messina "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy.,Department of Medical Sciences, University Hospital of Messina, "Policlinico G. Martino", Via Consolare Valeria 1, 98124, Messina, Italy
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2
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Fama' F, Sindoni A, Donato R, Cascio A, Mondello P, Gaeta R. Tuberculous aortitis in an human immunodeficiency virus-positive Ivorian migrant: A case report. Int J STD AIDS 2021; 32:1361-1364. [PMID: 34410870 DOI: 10.1177/09564624211037523] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report an unusual case of a 35-year-old Ivorian migrant with an abdominal mass and medical history relevant for human immunodeficiency virus-2 positivity with a CD4/CD8 ratio of 0.63; Mantoux and lymphocyte stimulation tests (QuantiFERON) were positive. 3D-CT images revealed a voluminous non-homogeneous retroperitoneal mass in the right abdominal region presenting no significant contrast impregnation. Thoraco-abdominal aorta presented diffuse-altered morphology with multiple ectasias throughout its course and an aneurysm at the level of the subrenal tract. The patient underwent vascular surgery. Mycobacterium tuberculosis complex was detected by polymerase chain reaction performed on intraoperative tissue specimens. Postoperative course was uneventful. After surgery, 3D-CT images showed no signs of malfunction of the prosthesis. At last, at 6-month follow-up, the patient was well. Cross-sectional imaging techniques, such as contrasted-CT, are essential and allow for making diagnosis, assessing disease activity, and evaluating post-treatment condition. 3D reconstruction permits an appropriate patient care by means of an excellent visualization and staging of the disease process.
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Affiliation(s)
- Fausto Fama'
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", 18980University Hospital of Messina, Messina, Italy
| | - Alessandro Sindoni
- Department of Public Health and Infectious Diseases, 9311Sapienza University of Rome, Rome, Italy
- Direzione Sanitaria, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy
| | - Rocco Donato
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, 18980University Hospital of Messina, Messina, Italy
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialities, 18998University of Palermo, Palermo, Italy
| | - Placido Mondello
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, 18980University Hospital of Messina, Messina, Italy
| | - Roberto Gaeta
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, 18980University Hospital of Messina, Messina, Italy
- Senior Fellow of European Association for Cardio-Thoracic Surgery
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3
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Gramaglia SMC, Cuppari C, Salpietro C, Ceravolo A, Cutrupi MC, Concolino D, De Sarro R, Amatruda M, Mondello P, Ceravolo G, Calabrò MP, Gitto E. Congenital heart disease in Down Syndrome. J BIOL REG HOMEOS AG 2020; 34:31-35. SPECIAL ISSUE: FOCUS ON PEDIATRIC CARDIOLOGY. [PMID: 33000597] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- S M C Gramaglia
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - C Salpietro
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | | | - M C Cutrupi
- DDepartment of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - D Concolino
- Department of Science of Health, University Magna Graecia of Catanzaro, Pediatric Unit, University of Catanzaro, Italy
| | - R De Sarro
- Department of Science of Health, University Magna Graecia of Catanzaro, Pediatric Unit, University of Catanzaro, Italy
| | - M Amatruda
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - P Mondello
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barres, University of Messina, 98125 Messina, Italy
| | - G Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - M P Calabrò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Cardiology, University of Messina, "G. Martino" Policlinic, Italy
| | - E Gitto
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
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4
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Sestito S, Roppa K, Parisi F, Moricca MT, Pensabene L, Chimenz R, Ceravolo MD, Cucinotta U, Ceravolo G, Calabrò MP, Cuppari C, Mondello P, Musolino D, Tallarico V, Concolino D. The heart in Anderson-Fabry disease. J BIOL REG HOMEOS AG 2020; 34:63-69. SPECIAL ISSUE: FOCUS ON PEDIATRIC CARDIOLOGY. [PMID: 33000603] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- S Sestito
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - K Roppa
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - F Parisi
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - M T Moricca
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - L Pensabene
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology, University of Messina, "G. Martino" Policlinic, Italy
| | - M D Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - G Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - M P Calabrò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Cardiology, University of Messina, "G. Martino" Policlinic, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - P Mondello
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 98125 Messina, Italy
| | - D Musolino
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - V Tallarico
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - D Concolino
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
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5
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Cama BAV, Ceccarelli M, Venanzi Rullo E, Ferraiolo F, Paolucci IA, Maranto D, Mondello P, Lo Presti Costantino MR, Marano F, D'Andrea G, Di Marco V, Puglisi G, Valenzise M, D'Angelo G, Mondello L, Strano G, Condorelli F, Spicola D, Nunnari G, Pellicanò GF. Outbreak of Brucella melitensis infection in Eastern Sicily: risk factors, clinical characteristics and complication rate. New Microbiol 2019; 42:43-48. [PMID: 30957869] [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] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
Brucellosis is one of the most common zoonoses in the world, especially in Southern Italy, where many cases are still recorded every year. 128 cases of brucellosis were observed in Messina (Sicily) in 2016, representing a tenfold increase in the number of cases of brucellosis expected. The aim of this multicenter retrospective study was to analyze clinical and microbiological aspects of a brucellosis outbreak in the province of Messina in 2016, the incidence of its complications and the treatment combinations applied. The principal transmission route was through the ingestion of unpasteurized fresh cheese. The mean latency period between the onset of the symptoms and diagnosis was 35.58±42.75 days. A late diagnosis increases the risk of developing complications. Drug-resistant strains of B. melitensis to Trimethoprim/ Sulfamethoxazole and Ciprofloxacin were found in blood cultures of 58.4% patients. Brucellosis is still present in Sicily. A diagnostic delay predisposes to complications requiring prolonged therapies. The finding of Brucella melitensis strains resistant to the most widespread treatments is worrisome and needs further investigation. Moreover, the use of alternative combination antibiotic therapy is recommended.
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Affiliation(s)
- Battistina A V Cama
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
| | - Manuela Ceccarelli
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
| | - Emmanuele Venanzi Rullo
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
- Department of Pathology and Laboratory Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Federica Ferraiolo
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
| | - Ivana A Paolucci
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Daniela Maranto
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Placido Mondello
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Maria R Lo Presti Costantino
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Fernanda Marano
- Department of Prevention, Provincial Health Authority Messina, Italy
| | - Giuseppa D'Andrea
- Department of Prevention, Provincial Health Authority Messina, Italy
| | - Vincenzo Di Marco
- Zoo-prophylactic Experimental Institute of Sicily, Barcellona P.G. (ME), Italy
| | - Giovanni Puglisi
- Department of Prevention, Provincial Health Authority Messina, Italy
| | - Mariella Valenzise
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - Gabriella D'Angelo
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | | | - Giuseppe Strano
- Unit of Infectious Diseases, "Papardo" Hospital, Messina, Italy
| | - Fabrizio Condorelli
- Department of Pharmacological Sciences, Università del Piemonte Orientale "A. Avogadro", Novara, Italy
| | - Daria Spicola
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
| | - Giovanni F Pellicanò
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
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6
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Cama BAV, Ceccarelli M, Venanzi Rullo E, Ferraiolo F, Paolucci IA, Maranto D, Mondello P, Lo Presti Costantino MR, Marano F, D'Andrea G, Di Marco V, Puglisi G, Valenzise M, D'Angelo G, Mondello L, Strano G, Condorelli F, Spicola D, Nunnari G, Pellicanò GF. Outbreak of Brucella melitensis infection in Eastern Sicily: risk factors, clinical characteristics and complication rate. New Microbiol 2018; 41:496N028. [PMID: 30311622] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Brucellosis is one of the most common zoonoses in the world, especially in Southern Italy, where many cases are still recorded every year. 128 cases of brucellosis were observed in Messina (Sicily) in 2016, representing a tenfold increase in the number of cases of brucellosis expected. The aim of this multicenter retrospective study was to analyze clinical and microbiological aspects of a brucellosis outbreak in the province of Messina in 2016, the incidence of its complications and the treatment combinations applied. The principal transmission route was through the ingestion of unpasteurized fresh cheese. The mean latency period between the onset of the symptoms and diagnosis was 35.58 ± 42.75 days. A late diagnosis increases the risk of developing complications. Drug-resistant strains of B. melitensis to Trimethoprim/Sulfamethoxazole and Ciprofloxacin were found in blood cultures of 58.4% patients. Brucellosis is still present in Sicily. A diagnostic delay predisposes to complications requiring prolonged therapies. The finding of Brucella melitensis strains resistant to the most widespread treatments is worrisome and needs further investigation. Moreover, the use of alternative combination antibiotic therapy is recommended.
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Affiliation(s)
- Battistina A V Cama
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
| | - Manuela Ceccarelli
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
| | - Emmanuele Venanzi Rullo
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
- Department of Pathology and Laboratory Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Federica Ferraiolo
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
| | - Ivana A Paolucci
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Daniela Maranto
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Placido Mondello
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Maria R Lo Presti Costantino
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Fernanda Marano
- Department of Prevention, Provincial Health Authority Messina 5, Messina, Italy
| | - Giuseppa D'Andrea
- Department of Prevention, Provincial Health Authority Messina 5, Messina, Italy
| | - Vincenzo Di Marco
- Zoo-prophylactic Experimental Institute of Sicily, Barcellona P.G. (ME), Italy
| | - Giovanni Puglisi
- Department of Prevention, Provincial Health Authority Messina 5, Messina, Italy
| | - Mariella Valenzise
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - Gabriella D'Angelo
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | | | - Giuseppe Strano
- Unit of Infectious Diseases, "Papardo" Hospital, Messina, Italy
| | - Fabrizio Condorelli
- Department of Pharmacological Sciences, Università del Piemonte Orientale "A. Avogadro", Novara, Italy
| | - Daria Spicola
- Department of Specialized Medicine, Unit of Infectious Diseases, University Hospital "G. Martino", Messina, Italy
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, Unit of Infectious Disease, University of Messina, Italy
| | - Giovanni F Pellicanò
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
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7
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Montagna MT, De Giglio O, Napoli C, Diella G, Rutigliano S, Agodi A, Auxilia F, Baldovin T, Bisetto F, Arnoldo L, Brusaferro S, Busetti M, Calagreti G, Casini B, Cristina ML, Di Luzio R, Fiorio M, Formoso M, Liguori G, Martini E, Molino A, Mondello P, Mura I, Novati R, Orsi GB, Patroni A, Poli A, Privitera G, Ripabelli G, Rocchetti A, Rose F, Sarti M, Savini S, Silvestri A, Sodano L, Spagnolo AM, Tardivo S, Teti V, Torregrossa MV, Torri E, Veronesi L, Zarrilli R, Pacifico C, Goglio A, Moro M, Pasquarella C. Control and prevention measures for legionellosis in hospitals: A cross-sectional survey in Italy. Environ Res 2018; 166:55-60. [PMID: 29864633 DOI: 10.1016/j.envres.2018.05.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/09/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
Risk assessment, environmental monitoring, and the disinfection of water systems are the key elements in preventing legionellosis risk. The Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine, and Public Health and the Italian Multidisciplinary Society for the Prevention of Health Care-Associated Infections carried out a national cross-sectional survey to investigate the measures taken to prevent and control legionellosis in Italian hospitals. A multiple-choice questionnaire was developed, comprising 71 questions regarding hospital location, general characteristics, clinical and environmental surveillance, and control and preventive measures for legionellosis in 2015. Overall, 739 hospitals were enrolled from February to June 2017, and 178 anonymous questionnaires were correctly completed and evaluated (response rate: 24.1%). The survey was conducted using the SurveyMonkey® platform, and the data were analyzed using Stata 12 software. Of the participating hospitals, 63.2% reported at least one case of legionellosis, of which 28.2% were of proven nosocomial origin. The highest case numbers were reported in the Northern Italy, in hospitals with a pavilion structure or cooling towers, and in hospitals with higher numbers of beds, wards and operating theaters. Laboratory diagnosis was performed using urinary antigen testing alone (31.9%), both urinary antigen testing and single antibody titer (17.8%), or with seroconversion also added (21.5%). Culture-based or molecular investigations were performed in 28.8% and 22.1% of the clinical specimens, respectively. The water systems were routinely tested for Legionella in 97.4% of the hospitals, 62% of which detected a positive result (> 1000 cfu/L). Legionella pneumophila serogroup 2-15 was the most frequently isolated species (58.4%). The most common control measures were the disinfection of the water system (73.7%), mostly through thermal shock (37.4%) and chlorine dioxide (34.4%), and the replacement (69.7%) or cleaning (70.4%) of faucets and showerheads. A dedicated multidisciplinary team was present in 52.8% of the hospitals, and 73% of the hospitals performed risk assessment. Targeted training courses were organized in 36.5% of the hospitals, involving nurses (30.7%), physicians (28.8%), biologists (21.5%), technicians (26.4%), and cleaners (11%). Control and prevention measures for legionellosis are present in Italian hospitals, but some critical aspects should be improved. More appropriate risk assessment is necessary, especially in large facilities with a high number of hospitalizations. Moreover, more sensitive diagnostic tests should be used, and dedicated training courses should be implemented.
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Affiliation(s)
- Maria Teresa Montagna
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Square G. Cesare 11, 70124 Bari, Italy.
| | - Osvalda De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Square G. Cesare 11, 70124 Bari, Italy
| | - Christian Napoli
- Department of Medical and S urgical Sciences and Translational Medicine, Sapienza University of Roma, Square A. Moro 5, 00185 Roma, Italy
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Square G. Cesare 11, 70124 Bari, Italy
| | - Serafina Rutigliano
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Square G. Cesare 11, 70124 Bari, Italy
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Str. S. Sofia, 87, Comparto 10 Edificio C, 95123 Catania, Italy
| | - Francesco Auxilia
- Department of Biomedical Sciences for Health, University of Milano, Str. Pascal 36, 20133 Milano, Italy
| | - Tatjana Baldovin
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Hygiene and Public Health Unit, Str. Loredan, 18.35131 Padova, Italy
| | - Francesco Bisetto
- Presidio Ospedaliero di Camposampiero, AULss6 Euganea Str. P. Cosma 1, 35012 Camposampiero, PD, Italy
| | - Luca Arnoldo
- Department of Medicine, University of Udine, Str. Colugna 50, 33100 Udine, Italy
| | - Silvio Brusaferro
- Department of Medicine, University of Udine, Str. Colugna 50, 33100 Udine, Italy
| | - Marina Busetti
- University Hospital ASUITS, Microbiology Unit, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Gioia Calagreti
- Hospital "Alto Tevere", AUSL Umbria 1, Città di Castello, PG, Italy
| | - Beatrice Casini
- Department of Translational Research, N.T.M.S. - Hygiene and Epidemiology Unit, University of Pisa, Str. S. Zeno 35-39, 56127 Pisa, Italy
| | - Maria Luisa Cristina
- Department of Health Sciences, University of Genova, Str. A. Pastore 1, 16132 Genova, Italy
| | | | | | - Maurizio Formoso
- Hospital "Miulli", Str. 127 km 4.1, Santeramo-Acquaviva delle Fonti, BA, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University "Parthenope", Napoli, Italy
| | - Enrica Martini
- AOU "Ospedali Riuniti", Str. Conca, 71, 60126 Ancona, Italy
| | - Andrea Molino
- Hospital "Madonna delle Grazie", Contrada Cattedra Ambulante s.nc. 75100 Matera, Italy
| | | | - Ida Mura
- Department of Biomedical Science, University of Sassari, Sassari, Italy
| | | | - Giovanni Battista Orsi
- Department of Public Health and Infectious Disease, Sapienza University of Roma, Roma, Italy
| | - Andrea Patroni
- ASST Valcamonica, Str. Manzoni 142, 25040 Esine, BS, Italy
| | - Anna Poli
- Hospital "San Giovanni di Dio", Str. Torre Galli 3, 50143 Firenze, Italy
| | - Gaetano Privitera
- Department of Translational Research, N.T.M.S. - Hygiene and Epidemiology Unit, University of Pisa, Str. S. Zeno 35-39, 56127 Pisa, Italy
| | - Giancarlo Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Andrea Rocchetti
- ASO "SS. Antonio, Biagio and C. Arrigo", Str. Venezia 17, 15121 Alessandria, Italy
| | | | - Mario Sarti
- Hospital "OCSAE", Str. Giardini 1355, Baggiovara, MO, Italy
| | - Sandra Savini
- AOU "Ospedali Riuniti", Str. Conca, 71, 60126 Ancona, Italy
| | - Antonio Silvestri
- Hospital "San Camillo Forlanini", Circonvallazione Gianicolense 87, 00152 Roma, Italy
| | - Luisa Sodano
- Hospital "San Camillo Forlanini", Circonvallazione Gianicolense 87, 00152 Roma, Italy
| | - Anna Maria Spagnolo
- Department of Health Sciences, University of Genova, Str. A. Pastore 1, 16132 Genova, Italy
| | - Stefano Tardivo
- Department of Diagnostic and Public Health, University of Verona, Str. Le Grazie 8, 37134 Verona, Italy
| | | | - Maria Valeria Torregrossa
- Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Str. Vespro, 133, 90127 Palermo, Italy
| | - Emanuele Torri
- Department of Health ans Social Policy, Str. Gilli 4, 38123 Trento, Italy
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Str. Volturno 39, Parma, Italy
| | - Raffaele Zarrilli
- Department of Public Health, University of Napoli "Federico II", Str. S. Pansini, 5, Napoli, Italy
| | - Claudia Pacifico
- Centre of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | | | - Matteo Moro
- Hospital "San Raffaele", Str. Olgettina 60, 20132 Milano, Italy
| | - Cesira Pasquarella
- Department of Medicine and Surgery, University of Parma, Str. Volturno 39, Parma, Italy
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Ardesia M, Mondello P, Fries W. Biofilm-producing fungi as emergent cause of bloodstream infections in patients with inflammatory bowel disease. Med Clin (Barc) 2017; 149:272-273. [PMID: 28602213 DOI: 10.1016/j.medcli.2017.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/06/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Marco Ardesia
- Clinical Unit for Chronic Bowel Disorders, IBD-Unit, Department of Clinical and Experimental Medicine, Messina, Italy.
| | - Placido Mondello
- Infectious Diseases, Department of Human Pathology, University of Messina, Messina, Italy
| | - Walter Fries
- Clinical Unit for Chronic Bowel Disorders, IBD-Unit, Department of Clinical and Experimental Medicine, Messina, Italy
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Casey E, Bournazos S, Mo G, Mondello P, Tan KS, Ravetch JV, Scheinberg DA. A new mouse expressing human Fcγ receptors to better predict therapeutic efficacy of human anti-cancer antibodies. Leukemia 2017; 32:547-549. [PMID: 28924242 PMCID: PMC5803448 DOI: 10.1038/leu.2017.293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 12/16/2022]
Affiliation(s)
- E Casey
- Gerstner Sloan Kettering Graduate School, Memorial Sloan Kettering, New York, NY, USA.,Molecular Pharmacology Program, Memorial Sloan Kettering, New York, NY, USA
| | - S Bournazos
- Laboratory of Molecular Genetics and Immunology, The Rockefeller University, New York, NY, USA
| | - G Mo
- Molecular Pharmacology Program, Memorial Sloan Kettering, New York, NY, USA
| | - P Mondello
- Molecular Pharmacology Program, Memorial Sloan Kettering, New York, NY, USA
| | - K S Tan
- Epidemiology & Biostatistics, Memorial Sloan Kettering, New York, NY, USA
| | - J V Ravetch
- Laboratory of Molecular Genetics and Immunology, The Rockefeller University, New York, NY, USA
| | - D A Scheinberg
- Gerstner Sloan Kettering Graduate School, Memorial Sloan Kettering, New York, NY, USA.,Molecular Pharmacology Program, Memorial Sloan Kettering, New York, NY, USA.,Weill Cornell Medicine, New York, NY, USA
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Visalli G, Currò M, Facciolà A, Riso R, Mondello P, Laganà P, Di Pietro A, Picerno I, Spataro P. Prevalence of human papillomavirus in saliva of women with HPV genital lesions. Infect Agent Cancer 2016; 11:48. [PMID: 27570540 PMCID: PMC5000464 DOI: 10.1186/s13027-016-0096-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 05/13/2016] [Accepted: 07/26/2016] [Indexed: 11/18/2022] Open
Abstract
Background The human papilloma viruses (HPVs) are DNA viruses associated with benign and malignant lesions of skin and mucous membranes. The HPVs has been implicated as the cause of virtually all cervical cancers worldwide but studies showed that these viruses can cause numerous cancers in several tissues including Oral Squamous Cell Carcinoma (OSCC). At least 90 % of HPV-positive OSCCs are associated with high-risk (or oncogenic) HPV-16 and oral infection confers an approximate 50-fold increase in risk for HPV-positive OSCC. HPV-positive OSCCs are associated with sexual behaviors in contrast to HPV-negative OSCCs that are associated with chronic tobacco and alcohol use. The aim of this study was to estimate the prevalence of HPV-DNA in saliva samples collected from women in which it has been previously established the HPV infection of the cervix with relative genotyping and, then, to study the possible correlation. Methods Saliva samples were collected from 100 women with HPV cervical lesions, aged between 22 and 52 years old, and 25 healthy women with normal cytology (control group), aged between 20 and 49 years old. PCR assay was used to detect HPV DNA. Results The prevalence of oral HPV infection in saliva samples was 24 % in women with HPV cervical lesions while in the control group was 8 %. It has been demonstrated a strong association between high grade squamous intraepithelial lesion and oral infection due to HPV16 and 18, that are the most frequently detected HPV genotypes. Conclusion This study shows that patients with genital HPV infection are at risk for oral infection and, consequently, for the development of OSCC.
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Affiliation(s)
- Giuseppa Visalli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via C. Valeria, Gazzi, 98100 Messina, Italy
| | - Monica Currò
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via C. Valeria, Gazzi, 98100 Messina, Italy
| | - Alessio Facciolà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via C. Valeria, Gazzi, 98100 Messina, Italy
| | - Romana Riso
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via C. Valeria, Gazzi, 98100 Messina, Italy
| | | | - Pasqualina Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via C. Valeria, Gazzi, 98100 Messina, Italy
| | - Angela Di Pietro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via C. Valeria, Gazzi, 98100 Messina, Italy
| | - Isa Picerno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via C. Valeria, Gazzi, 98100 Messina, Italy
| | - Pasquale Spataro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via C. Valeria, Gazzi, 98100 Messina, Italy
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11
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Pan A, Carnevale G, Catenazzi P, Colombini P, Crema L, Dolcetti L, Ferrari L, Mondello P, Signorini L, Tinelli C, Quiros Roldan E, Carosi G. Trends in Methicillin-ResistantStaphylococcus aureus(MRSA) Bloodstream Infections: Effect of the MRSA “Search and Isolate” Strategy in a Hospital in Italy with Hyperendemic MRSA. Infect Control Hosp Epidemiol 2016; 26:127-33. [PMID: 15756881 DOI: 10.1086/502515] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractObjective:To evaluate the secular trends in MRSA BSIs after the introduction of a nosocomial MRSA control intervention.Design:Before-after study.Setting:An 850-bed community hospital with an ICU and vascular surgery, neurosurgery, bone marrow transplantation, and AIDS units. MRSA is endemic at this hospital; the prevalence of methicillin resistance among patients withS. aureusinfection is greater than 50%.Patients:Among all inpatients, MRSA BSI was identified, its origin defined, and incidence rates calculated by ward and origin.Intervention:A MRSA control program was implemented based on active surveillance cultures to identify MRSA-colonized patients, followed by isolation using contact precautions. Incidence rates of MRSA BSI during the intervention (ie, July 1, 1997, to December 31, 2001) and preintervention (ie, January 1, 1996, to June 30, 1997) periods were compared.Results:Sixty-nine MRSA BSIs were identified. When compared with the preintervention period, the incidence rate of MRSA BSI was reduced from 0.64 to 0.30 per 1,000 admissions (RR, 0.46; CI95, 0.25–0.87;P= .02) during the intervention period. The impact was greater in the ICU, with an 89% reduction (RR, 0.11; CI95, 0.01–0.98;P= .03), and for CVC-associated MRSA BSIs, with an 82% decrease (RR, 0.17; CI95, 0.05–0.55;P= .002). Methicillin resistance amongS. aureusblood isolates decreased from 46% to 17% (RR, 0.36; CI95, 0.22–0.62;P= .0002).Conclusion:A reduction in MRSA bacteremia is achievable through use of the MRSA “search and isolate” intervention even in a hospital with high rates of endemic MRSA.
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Affiliation(s)
- Angelo Pan
- Divisione di Malattie Infettive, Istituti Ospitalieri di Cremona, Cremona, Italy.
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12
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Mondello P, Mian M, Pitini V, Cuzzocrea S, Sindoni A, Galletti M, Mandolfino M, Santoro D, Mondello S, Aloisi C, Altavilla G, Benvenga S. Thyroid hormone autoantibodies: are they a better marker to detect early thyroid damage in patients with hematologic cancers receiving tyrosine kinase inhibitor or immunoregulatory drug treatments? Curr Oncol 2016; 23:e165-70. [PMID: 27330353 PMCID: PMC4900836 DOI: 10.3747/co.23.3026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Unlike cytotoxic agents, novel antineoplastic drugs can variably affect thyroid function and so impair patient outcomes. However, the widely used standard thyroid tests have demonstrated low sensitivity for detecting early thyroid damage that leads to dysfunction of the gland. To find a more reliable thyroid marker, we assessed the presence of antibodies binding thyroid hormones (thAbs) in a cancer population undergoing potentially thyrotoxic treatment. METHODS From April 2010 to September 2013, 82 patients with hematologic malignancies treated with tyrosine kinase inhibitors or immunoregulatory drugs were recruited. Healthy volunteers (n = 104) served as control subjects. Thyroid function, autoimmunity tests, thAbs, and thyroid sonography were assessed once during treatment. RESULTS Overall, thAb positivity was recorded in 13% of the entire cohort. In most cases, the thAbs were of a single type, with a predominance of T3 immunoglobulin G. More specifically, thAbs were detected in 11 cancer patients; and abnormal levels of thyroid-stimulating hormone, thyroglobulin antibody, and thyroperoxidase antibody were detected in 6 (p = 0.05), 0 (p = 0.0006), and 2 cancer patients (p = 0.001) respectively. Ultrasonographic alterations of the thyroid were observed in 12 cancer patients. In contrast, of the 104 healthy control subjects, only 1 was positive for thAbs (1%). CONCLUSIONS We have demonstrated for the first time that thAbs are a reliable marker of early thyroid dysfunction when compared with the widely used standard thyroid tests. A confirmatory prospective trial aiming at evaluating thAbs at various time points during treatment could clarify the incidence and timing of antibody appearance.
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Affiliation(s)
- P. Mondello
- Department of Human Pathology, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, U.S.A
| | - M. Mian
- Department of Hematology and CBMT, Hospital of Bolzano, Bolzano, Italy
| | - V. Pitini
- Department of Human Pathology, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - S. Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - A. Sindoni
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - M. Galletti
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M. Mandolfino
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - D. Santoro
- Department of Internal Medicine, University of Messina, Messina, Italy
| | - S. Mondello
- Department of Neurosciences, University of Messina, Messina, Italy
| | - C. Aloisi
- Department of Internal Medicine, University of Messina, Messina, Italy
| | - G. Altavilla
- Department of Human Pathology, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - S. Benvenga
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Mondello P, Steiner N, Cuzzocrea S, Willenbacher W, Arrigo C, Pitini V, Mian M. 3219 90Y-ibritumomab-tiuxetan consolidation for advanced stage mantle cell lymphoma after first line autologous stem cell transplantation: Is it time for a step forward? Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31796-8] [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: 10/22/2022]
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14
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Visalli G, Riso R, Facciolà A, Mondello P, Caruso C, Picerno I, Di Pietro A, Spataro P, Bertuccio MP. Higher levels of oxidative DNA damage in cervical cells are correlated with the grade of dysplasia and HPV infection. J Med Virol 2015; 88:336-44. [DOI: 10.1002/jmv.24327] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2015] [Indexed: 01/08/2023]
Affiliation(s)
- Giuseppa Visalli
- Department of Biomedical Sciences and Morphological and Functional Images; University of Messina; Messina Italy
| | - Romana Riso
- Department of Biomedical Sciences and Morphological and Functional Images; University of Messina; Messina Italy
| | - Alessio Facciolà
- Department of Biomedical Sciences and Morphological and Functional Images; University of Messina; Messina Italy
| | | | - Carmela Caruso
- Department of Paediatric, Gynaecological, Microbiological and Biomedical Sciences; University of Messina; Messina Italy
| | - Isa Picerno
- Department of Biomedical Sciences and Morphological and Functional Images; University of Messina; Messina Italy
| | - Angela Di Pietro
- Department of Biomedical Sciences and Morphological and Functional Images; University of Messina; Messina Italy
| | - Pasquale Spataro
- Department of Biomedical Sciences and Morphological and Functional Images; University of Messina; Messina Italy
| | - Maria Paola Bertuccio
- Department of Biomedical Sciences and Morphological and Functional Images; University of Messina; Messina Italy
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Pan A, Mondello P, Posfay-Barbe K, Catenazzi P, Grandi A, Lorenzotti S, Patroni A, Poli N, Soavi L, Carnevale G. Hand Hygiene and Glove Use Behavior in an Italian Hospital. Infect Control Hosp Epidemiol 2015; 28:1099-102. [DOI: 10.1086/518457] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Accepted: 11/22/2006] [Indexed: 11/03/2022]
Abstract
In an Italian hospital, we observed that hand hygiene was performed in 638 (19.6%) of 3,253 opportunities, whereas gloves were worn in 538 (44.2%) 1,218 of opportunities. We observed an inverse correlation between the intensity of care and the rate of hand hygiene compliance (R2=0.057; P<.001), but no such association was observed for the rate of glove use compliance (R2 = 0.014; P = .078). Rates of compliance with hand hygiene and glove use recommendations follow different behavioral patterns.
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Mian M, Marcheselli L, Rossi A, Visco C, Chiappella A, Volpetti S, Zaja F, Mondello P, Fiegl M, Billio A, Federico M, Luminari S, Rambaldi A, Cortelazzo S. A diachronic-comparative analysis for the identification of the most powerful prognostic index for localized diffuse large B-cell lymphoma. Ann Oncol 2014; 25:2398-2404. [PMID: 25274614 DOI: 10.1093/annonc/mdu462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In the rituximab era, the conventional International Prognostic index (IPI) lost at least in part its predictive power, while the National Comprehensive Cancer Network-IPI (NCCN-IPI) seems to be a new and valid prognosticator. However, it has not yet been evaluated in patients with localized disease and it has not been compared with the modified IPI (mIPI) of the pre-rituximab era. In order to evaluate the different prognosticators and to assess the importance of rituximab and radiotherapy (RT), we carried out the so far largest retrospective analysis of patients with localized diffuse large B-cell lymphoma (DLBCL). PATIENTS AND METHODS We retrospectively assessed clinical and therapeutical data of 1405 patients treated in from 1987 to 2012 in 10 cancer centers in Italy and 1 in Austria. RESULTS All patients underwent an anthracycline containing polychemotherapy and 254 additional rituximab. The median follow-up was 5.7 years (range 0.1-23 years). The 5-year overall survival (OS) was 75%, being significantly superior in those who underwent additional rituximab, while RT consolidation did not improve the outcome of those who received immunochemotherapy. Patients with extranodal disease benefited from the addition of rituximab, while RT did not improve OS of the immunochemotherapy subgroup. In the pre-rituximab era, the mIPI showed a better performance than the others. In rituximab-treated patients, the NCCN-IPI had the highest discriminant value and the 5-years OS varied significantly (P < 0.001) between the three risk groups and was 98% in low-risk patients, 82% in those with a low-intermediate risk and 57% among high-intermediate and high-risk cases. CONCLUSIONS The NCCN-IPI is so far the best prognosticator for patients with localized DLBCL who underwent R-CHOP(-like). The addition of rituximab is indispensable regardless of the risk category and site of involvement, while the addition of RT should be reserved to those cases who are ineligible to rituximab.
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Affiliation(s)
- M Mian
- Division of Hematology, Hospital of Bolzano, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Austria.
| | - L Marcheselli
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena
| | - A Rossi
- USC Hematology, A.O. Papa Giovanni XXIII, Bergamo
| | - C Visco
- Department of Hematology, Ospedale San Bortolo, Vicenza
| | - A Chiappella
- Division of Hematology 2, Azienda Ospedaliera Città Della Salute e Della Scienza, Turin
| | - S Volpetti
- Division of Hematology and Bone Marrow Transplantation, Azienda Ospedaliero-Universitaria Udine, Udine
| | - F Zaja
- Division of Hematology and Bone Marrow Transplantation, Azienda Ospedaliero-Universitaria Udine, Udine
| | - P Mondello
- Department of Medical Oncology, University of Messina, Messina
| | - M Fiegl
- Department of Hematology and Oncology, University Hospital Innsbruck, Austria
| | - A Billio
- Division of Hematology, Hospital of Bolzano, Bolzano, Italy
| | - M Federico
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena
| | - S Luminari
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena
| | - A Rambaldi
- USC Hematology, A.O. Papa Giovanni XXIII, Bergamo
| | - S Cortelazzo
- Department of Medical Oncology and Hematology, Humanitas Cancer Center, Bergamo, Italy
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Mian M, Wasle I, Gamerith G, Mondello P, Melchardt T, Jäger T, Linkesch W, Fiegl M. R-CHOP versus R-COMP: Are They Really Equally Effective? Clin Oncol (R Coll Radiol) 2014; 26:648-52. [DOI: 10.1016/j.clon.2014.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 04/28/2014] [Accepted: 04/29/2014] [Indexed: 10/25/2022]
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Cascio A, Famà F, Mondello P, Barberi G, Pernice LM, Iaria C. Cytomegalovirus infections, kidney transplantation, and secondary hemophagocytic lymphohistiocytosis. Transpl Infect Dis 2014; 16:1039-41. [PMID: 25219298 DOI: 10.1111/tid.12296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 07/30/2014] [Accepted: 07/30/2014] [Indexed: 11/30/2022]
Affiliation(s)
- A Cascio
- Department of Human Pathology, University of Messina, Messina, Italy
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Mondello P, Altavilla G, Steiner N, Wasle I, Pitini V, Mian M. Radiotherapy for Stage I/II Follicular Lymphoma (Fl): is It Time for a Reappraisal? Ann Oncol 2014. [DOI: 10.1093/annonc/mdu339.2] [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: 11/13/2022] Open
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Santoro D, Benedetto F, Mondello P, Pipitò N, Barillà D, Spinelli F, Ricciardi CA, Cernaro V, Buemi M. Vascular access for hemodialysis: current perspectives. Int J Nephrol Renovasc Dis 2014; 7:281-94. [PMID: 25045278 PMCID: PMC4099194 DOI: 10.2147/ijnrd.s46643] [Citation(s) in RCA: 163] [Impact Index Per Article: 16.3] [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] [Indexed: 11/25/2022] Open
Abstract
A well-functioning vascular access (VA) is a mainstay to perform an efficient hemodialysis (HD) procedure. There are three main types of access: native arteriovenous fistula (AVF), arteriovenous graft, and central venous catheter (CVC). AVF, described by Brescia and Cimino, remains the first choice for chronic HD. It is the best access for longevity and has the lowest association with morbidity and mortality, and for this reason AVF use is strongly recommended by guidelines from different countries. Once autogenous options have been exhausted, prosthetic fistulae become the second option of maintenance HD access alternatives. CVCs have become an important adjunct in maintaining patients on HD. The preferable locations for insertion are the internal jugular and femoral veins. The subclavian vein is considered the third choice because of the high risk of thrombosis. Complications associated with CVC insertion range from 5% to 19%. Since an increasing number of patients have implanted pacemakers and defibrillators, usually inserted via the subclavian vein and superior vena cava into the right heart, a careful assessment of risk and benefits should be taken. Infection is responsible for the removal of about 30%-60% of HD CVCs, and hospitalization rates are higher among patients with CVCs than among AVF ones. Proper VA maintenance requires integration of different professionals to create a VA team. This team should include a nephrologist, radiologist, vascular surgeon, infectious disease consultant, and members of the dialysis staff. They should provide their experience in order to give the best options to uremic patients and the best care for their VA.
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Affiliation(s)
- Domenico Santoro
- Department of Clinical and Experimental Medicine, Unit of Nephrology, University of Messina, Italy
| | | | | | | | - David Barillà
- Unit of Vascular Surgery, University of Messina, Italy
| | | | - Carlo Alberto Ricciardi
- Department of Clinical and Experimental Medicine, Unit of Nephrology, University of Messina, Italy
| | - Valeria Cernaro
- Department of Clinical and Experimental Medicine, Unit of Nephrology, University of Messina, Italy
| | - Michele Buemi
- Department of Clinical and Experimental Medicine, Unit of Nephrology, University of Messina, Italy
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Costantino G, Mondello P, Previti M, Fries W, Villanacci V. Pan-digestive tract colonization by cytomegalovirus in common variable immunodeficiency. Int Arch Allergy Immunol 2014; 164:30-1. [PMID: 24853073 DOI: 10.1159/000362188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 03/10/2014] [Indexed: 11/19/2022] Open
Affiliation(s)
- Giuseppe Costantino
- Clinical Unit for Chronic Bowel Disorders, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Offidani M, Corvatta L, Maracci L, Liberati AM, Ballanti S, Attolico I, Caraffa P, Alesiani F, Caravita di Toritto T, Gentili S, Tosi P, Brunori M, Derudas D, Ledda A, Gozzetti A, Cellini C, Malerba L, Mele A, Andriani A, Galimberti S, Mondello P, Pulini S, Coppetelli U, Fraticelli P, Olivieri A, Leoni P. Efficacy and tolerability of bendamustine, bortezomib and dexamethasone in patients with relapsed-refractory multiple myeloma: a phase II study. Blood Cancer J 2013; 3:e162. [PMID: 24270324 PMCID: PMC3880441 DOI: 10.1038/bcj.2013.58] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [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: 09/17/2013] [Accepted: 09/25/2013] [Indexed: 11/25/2022] Open
Abstract
Bendamustine demonstrated synergistic efficacy with bortezomib against multiple myeloma (MM) cells in vitro and seems an effective treatment for relapsed-refractory MM (rrMM). This phase II study evaluated bendamustine plus bortezomib and dexamethasone (BVD) administered over six 28-day cycles and then every 56 days for six further cycles in patients with rrMM treated with ⩽4 prior therapies and not refractory to bortezomib. The primary study end point was the overall response rate after four cycles. In total, 75 patients were enrolled, of median age 68 years. All patients had received targeted agents, 83% had 1–2 prior therapies and 33% were refractory to the last treatment. The response rate⩾partial response (PR) was 71.5% (16% complete response, 18.5% very good PR, 37% partial remission). At 12 months of follow-up, median time-to-progression (TTP) was 16.5 months and 1-year overall survival was 78%. According to Cox regression analysis, only prior therapy with bortezomib plus lenalidomide significantly reduced TTP (9 vs 17 months; hazard ratio=4.5; P=0.005). The main severe side effects were thrombocytopenia (30.5%), neutropenia (18.5%), infections (12%), neuropathy (8%) and gastrointestinal and cardiovascular events (both 6.5%). The BVD regimen is feasible, effective and well-tolerated in difficult-to-treat patients with rrMM.
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Affiliation(s)
- M Offidani
- Clinica di Ematologia, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy
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23
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Pan A, Bombana E, Tura G, Curti C, Lorenzotti S, Mondello P, Patroni A, Tacconelli E, Rigobello V, Signorini L, Vizio M, Goglio A. A survey of methicillin-resistant Staphylococcus aureus control strategies in Italy. Infection 2013; 41:783-9. [PMID: 23543436 DOI: 10.1007/s15010-013-0454-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 11/18/2012] [Accepted: 03/19/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE Data regarding the implementation of state-of-the-art methicillin-resistant Staphylococcus aureus (MRSA) control procedures in Italy are lacking. There is a need to evaluate compliance with MRSA recommendations (CR) in Italian hospitals. METHODS A 67-question closed-answer survey was sent to all Italian hospitals, in order to analyze and evaluate program consistency with CR [hand hygiene (HH), contact precautions, screening of high-risk patients, decolonization, feedback on surveillance data, and antimicrobial guidelines and education programs]. RESULTS 205 hospitals, which account for 42 % of national admissions, returned questionnaires. 131 hospitals (64 %) did not have written MRSA control guidelines. Hospitals reported the following levels of compliance with CR: (1) HH: 67 hospitals (33 %); (2) contact precautions: 33 (16 %); (3) MRSA screening: 66 (32 %); (4) MRSA decolonization: 42 (20 %); (5) surveillance data feedback: 87 (43 %); and (6) antimicrobial guidelines and education programs: 41 (20 %). One hospital (0.5 % of responses) had implemented all recommendations and 28 hospitals (14 %) had implemented four or five recommendations. 31 % of hospitals surveyed had implemented none. Multivariate analysis showed that the only factor identified as being associated with the implementation of MRSA control recommendations was the number of meetings/year of the infection control team (ICT) (p = 0.004). CONCLUSIONS Written MRSA control guidelines are available in only one-third of Italian facilities. An organized system, with ≥4 interventions, has been implemented in just 1 out of 7 hospitals. HH programs and ICT activity are related to better MRSA control. In Italy, there is significant opportunity for improvement in MRSA control.
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Affiliation(s)
- A Pan
- Divisione di Malattie Infettive e Tropicali, Istituti Ospitalieri di Cremona, Largo Priori, 1, 26100, Cremona, Italy.
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24
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Giordano G, Mondello P, Tambaro R, de Maria M, d'Amico F, Sticca G, di Falco C. 273 Erythropoietin plus danazole, prednisone, B12 and folate in refractory cytopenia with multilineage dysplasia (RCMD). Monocentric prospective study. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70275-2] [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: 10/18/2022]
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Seminari E, Tinelli C, Ravasi G, Ripamonti D, Ladisa N, Marino N, Sighinolfi L, Mondello P, Migliorino M, Carosi G, Maserati R. Hepatitis C infection on immune recovery in HIV-positive patients on successful HAART: the role of genotype 3. Curr HIV Res 2010; 8:186-93. [PMID: 20163342 DOI: 10.2174/157016210791111070] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 07/25/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The primary objective of this study was to investigate the impact of HCV infection and of HCV genotypes on immune restoration in HIV-infected patients on a successful HAART regimen. METHODS Patients from the MASTER Study were included in this current longitudinal study if they met the following criteria: being on any successful HAART, availability of CD4+ cell count and HIV RNA level before starting the suppressive HAART and 12 months after suppressive therapy, availability of HCV antibodies. The primary endpoints of the study were defined as achieving a difference above 100 cell/mmc between CD4+ at baseline and at time of HIV RNA suppression while on therapy (DeltaCD4+early), or 12 month after a suppressive therapy (DeltaCD4+late). RESULTS 844 HIV-positive patients were included in the analysis: 673 were HCV-negative and 171 were HCV-positive [92 (53.8%) subjects had HCV genotype 1; 58 (33.9%), genotype 3; 21 (12.3%), genotype 4]. Plasma HIV RNA (both baseline as highest value), nadir CD4+, being naïve, time to reach undetectable plasma HIV RNA, treatment with PI vs NNRTI were associated with an early immunological recovery; the occurrence of previous AIDS event, a history of injection drug use, and HCV infection were associated with failure to achieve an early immunological recovery. Variables associated with DeltaCD4+late immune recovery were baseline CD4+ value, plasma HIV RNA (both baseline as highest value), being naïve and time to reach undetectable plasma HIV RNA. HCV infection per se was not associated with a worse probability to reach late immunologic response, although among HCV infected patients, having a genotype 3 was associated with a worse immune recovery. At multivariable analysis, factors that remained associated with failure to achieve an early immunological response were being HCV infected and history of injection drug use, while those associated with a failure to achieve a late immunological response were being infected with HCV genotype 3 and older age. CONCLUSIONS A blunted early immune recovery was observed in HCV infected patients, compared with HCV negative subjects, while late immune recovery was not different among HCV infected as a whole and not infected subjects; only the subgroup of subjects infected with genotype 3 showed an impaired late immune recovery.
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Affiliation(s)
- Elena Seminari
- Servizio Biometria ed Epidemiologia Clinica - Direzione Scientifica - Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
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Fenga C, Foti M, Daidone A, Sturniolo G, Maviglia P, Di Nola C, Polito I, Mondello P. [Prevalence of Staphylococcus aureus methicillin-resistant (MRSA) among health care workers]. G Ital Med Lav Ergon 2007; 29:416-417. [PMID: 18409753] [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: 05/26/2023]
Abstract
Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of Staphylococcus that is resistant to certain antibiotics. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. Staphylococcus infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities. The present study was performed to investigate the in vitro activity of oxacillin and other antimicrobial agents against S. aureus strains obtained from nursing personnel. The study included 56 hospital personnel of Universitary Policlinic of Messina. S. aureus strain was isolated in 14 samples (25%); resistent patterns have been studied and results have demonstrated: none methicillin resistant, while 14% oxacillin and tetraciclin resistant. The incidence of methicillin sensitive was 100%, while 86% proved to be sensitive to oxacillin and tetraciclin. In conclusion, the usually hygienic methods (disposable gowns, hygienic hand disinfection after each patients contact, masks use when is a risk of aerosolization of MRSA) are indicate for significantly reducing of these strains. Continuing education programmes can help to increase awareness among hospital staff.
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Affiliation(s)
- C Fenga
- Dipartimento di Medicina Sociale del territorio, Sezione di Medicina del Lavoro
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27
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Pan A, Soavi L, Mondello P, Catenazzi P, Lorenzotti S, Signorini L, Testa S, Carnevale G, Carosi G. P1313 Topical treatment with mupirocine/chlorexydine and long-term risk of methicillin-resistant Staphylococcus aureus infection. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71153-6] [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: 10/23/2022]
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Mondello P, Ferrari L, Carnevale G. Nosocomial Brevundimonas vesicularis meningitis. Infez Med 2006; 14:235-7. [PMID: 17380092] [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: 05/14/2023]
Abstract
Brevundimonas vesicularis infrequently causes human infections. We describe a case of meningitis due to Brevundimonas vesicularis, resistant to piperacillin, gentamicin and amikacin as well as to cephalosporins, aztreonam, imipenem and meropenem. The meningitis was acquired in hospital by a patient operated for astrocytoma and represents a classical hospital infection.
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Affiliation(s)
- Placido Mondello
- Unitá Operativa di Malattie Infettive, Istituti Ospitalieri di Cremona, Cremona, Italy
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Giuffré G, Mondello P, Inferrera A, Furchì A, Gentile HM, Speciale G. Unexpected cytological diagnosis of two cases of echinococcosis. Pathologica 1993; 85:747-53. [PMID: 8170723] [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: 01/29/2023] Open
Abstract
The Authors report two cases of hydatid cysts localized in the soft tissues of the thigh and in para-renal region respectively. In both cases the cystic nature of the lesion was revealed by echography while the common serologic and hematologic preoperative tests did not show pathologic values. The working diagnosis was traumatic or developmental lesion and the patients were undergone to fine needle aspiration (FNA) cytology which permitted to make the unexpected diagnosis of hydatid cysts. The enzyme linked immunosorbent assay for echinococcus, done at the time in monitoring the disease, was positive only in one case. Although the routine use of FNA cytology for the diagnosis of echinococcosis should be discouraged, this procedure may represent a real aid in the definitive diagnose of clinically unsuspected hydatid cysts.
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Affiliation(s)
- G Giuffré
- Dipartimento di Patologia Umana, Università degli Studi di Messina
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Mondello P, Patti S, Vitale MG, D'Accardo AM, Spanó C. Anti-HCV antibodies in household contacts of patients with cirrhosis of the liver — Preliminary results. Infection 1992; 20:51-2. [PMID: 1373409 DOI: 10.1007/bf01704900] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Spanò C, Patti S, Mondello P. Hepatitis b virus markers in diabetic patients: Preliminary findings in Palermo. Infection 1980. [DOI: 10.1007/bf01639038] [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: 10/25/2022]
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Abstract
The presence of HBV markers was determined in 149 serum samples obtained from diabetic patients and was compared with a normal population. Diabetics have the same incidence of HBsAg but significantly higher anti-HBc antibodies. These differences were seen in the group of diabetics on oral hypoglycemic therapy. These results cannot yet be explained.
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