1
|
Ripa M, Chiappetta S, Castiglioni B, Agricola E, Busnardo E, Carletti S, Castiglioni A, De Bonis M, La Canna G, Oltolini C, Pajoro U, Pasciuta R, Tassan Din C, Scarpellini P. Impact of surgical timing on survival in patients with infective endocarditis: a time-dependent analysis. Eur J Clin Microbiol Infect Dis 2021; 40:1319-1324. [PMID: 33411176 DOI: 10.1007/s10096-020-04133-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
The purpose of this study was to evaluate the impact of surgical timing on survival in patients with left-sided infective endocarditis (IE). This was a retrospective study including 313 patients with left-sided IE between 2009 and 2017. Surgery was defined as urgent (US) or early (ES) if performed within 7 or 28 days, respectively. A multivariable Cox regression analysis including US and ES as time-dependent variables was performed to assess the impact on 1-year mortality. ES was associated with a better survival (aHR 0.349, 95% CI 0.135-0.902), as US (aHR 0.262, 95% CI 0.075-0.915). ES and US were associated with a better prognosis in patients with left-sided IE.
Collapse
Affiliation(s)
- Marco Ripa
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefania Chiappetta
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Barbara Castiglioni
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Eustachio Agricola
- Unit of Non-invasive Cardiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elena Busnardo
- Unit of Nuclear Imaging, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Carletti
- Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Michele De Bonis
- Unit of Cardiac Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni La Canna
- Unit of Non-invasive Cardiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Oltolini
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ursola Pajoro
- Unit of Nuclear Imaging, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Renée Pasciuta
- Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Tassan Din
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Scarpellini
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | | |
Collapse
|
2
|
Givone F, Peghin M, Vendramin I, Carletti S, Tursi V, Pasciuta R, Livi U, Bassetti M. Salvage heart transplantation for Mycoplasma hominis prosthetic valve endocarditis: A case report and review of the literature. Transpl Infect Dis 2020; 22:e13249. [PMID: 31977151 DOI: 10.1111/tid.13249] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/11/2019] [Accepted: 01/12/2020] [Indexed: 12/19/2022]
Abstract
Heart transplantation (HT) has been rarely performed in patients with infective endocarditis (IE) and is considered a "last resort" procedure. Orthotropic HT with bicaval technique was performed in a man with culture-negative endocarditis. Mycoplasma hominis was later detected using 16S ribosomal DNA PCR from surgically removed valve tissue. Literature review and previous results are summarized. HT may be considered as salvage treatment in selected patients with intractable IE. In cases when there is no growth in culture, 16S ribosomal DNA PCR sequencing can be used to identify the pathogen in excised valvular tissue. Mycoplasma spp. is extremely uncommon and difficult to diagnose cause of infective endocarditis (IE). There are no proposed or defined criteria for heart transplantation (HT) in patients with refractory IE, and HT has been rarely performed in this setting. We report a case of M hominis prosthetic valve endocarditis diagnosed by 16S ribosomal DNA PCR in a patient who underwent a salvage HT. We reviewed in the literature other cases of IE caused by Mycoplasma spp.
Collapse
Affiliation(s)
- Filippo Givone
- Department of Medicine, Infectious Diseases Clinic, University of Udine and Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Maddalena Peghin
- Department of Medicine, Infectious Diseases Clinic, University of Udine and Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Igor Vendramin
- Cardiothoracic Department, University Hospital of Udine, Udine, Italy
| | - Silvia Carletti
- Laboratory of Microbiology, San Raffaele Scientific Institute, Milan, Italy
| | - Vincenzo Tursi
- Cardiothoracic Department, University Hospital of Udine, Udine, Italy
| | - Renée Pasciuta
- Laboratory of Microbiology, San Raffaele Scientific Institute, Milan, Italy
| | - Ugolino Livi
- Cardiothoracic Department, University Hospital of Udine, Udine, Italy
| | - Matteo Bassetti
- Department of Medicine, Infectious Diseases Clinic, University of Udine and Azienda Sanitaria Universitaria Integrata, Udine, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| |
Collapse
|
3
|
Amato V, Papaleo E, Pasciuta R, Viganò P, Ferrarese R, Clementi N, Sanchez AM, Quaranta L, Burioni R, Ambrosi A, Salonia A, Clementi M, Candiani M, Mancini N. Differential Composition of Vaginal Microbiome, but Not of Seminal Microbiome, Is Associated With Successful Intrauterine Insemination in Couples With Idiopathic Infertility: A Prospective Observational Study. Open Forum Infect Dis 2019; 7:ofz525. [PMID: 31915713 PMCID: PMC6942492 DOI: 10.1093/ofid/ofz525] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 12/09/2019] [Indexed: 12/13/2022] Open
Abstract
Background Vaginal and seminal microbiomes have gained increasing interest for their involvement in reproductive health and fertility. However, their role in reproductive outcome is not fully understood yet. In this study, we aimed to correlate the vaginal and the seminal microbiome of 23 couples with idiopathic infertility to the clinical pregnancy rate after intrauterine insemination (IUI). Methods Vaginal swabs and seminal fluids were collected on the day of IUI procedure and analyzed through polymerase chain reaction amplification of variable regions 3 and 4 (V3–V4) of 16S ribosomal ribonucleic acid genes and Illumina MiSeq sequencing. The taxonomic data were then correlated to IUI success. Results Idiopathic infertile women showed a different average composition of vaginal microbiome compared with control sequences, whereas for seminal counterpart no relevant differences were observed. Furthermore, among idiopathic infertile women, different patterns of Lactobacillus species dominations were observed, with a predominance either of Lactobacillus crispatus, a marker of a healthy vaginal ecosystem, or of Lactobacillus iners and Lactobacillus gasseri, associated with a more dysbiosis-prone environment. More important, considering all investigated variables, vaginal L crispatus domination was the only factor strongly associated to IUI success (P = .0002). Conclusions Our results strengthen the potential role of L crispatus in promoting a favorable environment for pregnancy and suggest that microbiome characterization could be useful, together with standard clinical and laboratory assessments, in the pre-IUI evaluation of infertile couples.
Collapse
Affiliation(s)
- Virginia Amato
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Renée Pasciuta
- Microbiology and Virology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Viganò
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Ferrarese
- Microbiology and Virology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Clementi
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Ana Maria Sanchez
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lavinia Quaranta
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Burioni
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Alessandro Ambrosi
- Faculty of Medicine and Surgery, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Massimo Clementi
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy.,Microbiology and Virology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Department of Obstetrics and Gynecology, "Vita-Salute" San Raffaele University School of Medicine, IRCCS, Ospedale San Raffaele, Milan, Italy
| | - Nicasio Mancini
- Microbiology and Virology Unit, "Vita-Salute" San Raffaele University, Milan, Italy.,Microbiology and Virology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
4
|
Greco R, Barbanti MC, Mancini N, Infurnari L, Pasciuta R, Forcina A, Oltolini C, Casirati G, Mannina D, Giglio F, Messina C, Morelli M, Lorentino F, Mastaglio S, Perini T, Vago L, Scarpellini P, Carrabba MG, Stanghellini MTL, Marktel S, Assanelli A, Bernardi M, Corti C, Peccatori J, Clementi M, Ciceri F. Nanosphere's Verigene ® Blood Culture Assay to Detect Multidrug-Resistant Gram-Negative Bacterial Outbreak: A Prospective Study on 79 Hematological Patients in a Country with High Prevalence of Antimicrobial Resistance. Clin Hematol Int 2019; 1:120-123. [PMID: 34595420 PMCID: PMC8432392 DOI: 10.2991/chi.d.190321.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 03/18/2019] [Indexed: 12/02/2022] Open
Abstract
Infections are a major cause of morbidity and mortality in hematological patients. We prospectively tested a new molecular assay (Verigene®) in 79 consecutive hematological patients, with sepsis by gram-negative bacteria. A total of 82 gram-negative microorganisms were isolated by blood cultures, of which 76 cases were mono-microbial. Considering the bacteria detectable by the system, the concordance with standard blood cultures was 100%. Resistance genes were detected in 20 of the isolates and 100% were concordant with the phenotypic antibiotic resistance. Overall, this new assay correctly identified 66/82 of all the gram-negative pathogens, yielding a general sensitivity of 80.5%, and providing information on genetic antibiotic resistance in a few hours. This new molecular assay could ameliorate patient management, resulting in a more rational use of antibiotics.
Collapse
Affiliation(s)
- Raffaella Greco
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Maria Chiara Barbanti
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Laura Infurnari
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Renée Pasciuta
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Alessandra Forcina
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Chiara Oltolini
- Infectious Disease Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Gabriele Casirati
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Daniele Mannina
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Fabio Giglio
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Carlo Messina
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Mara Morelli
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Francesca Lorentino
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Sara Mastaglio
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Tommaso Perini
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Luca Vago
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Paolo Scarpellini
- Infectious Disease Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Matteo Giovanni Carrabba
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | | | - Sarah Marktel
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Andrea Assanelli
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Massimo Bernardi
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Consuelo Corti
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Jacopo Peccatori
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita-Salute San Raffaele University, Milano, Italy
| | - Fabio Ciceri
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita-Salute San Raffaele University, Milano, Italy
| |
Collapse
|
5
|
Mancini N, Greco R, Pasciuta R, Barbanti MC, Pini G, Morrow OB, Morelli M, Vago L, Clementi N, Giglio F, Lupo Stanghellini MT, Forcina A, Infurnari L, Marktel S, Assanelli A, Carrabba M, Bernardi M, Corti C, Burioni R, Peccatori J, Sormani MP, Banfi G, Ciceri F, Clementi M. Enteric Microbiome Markers as Early Predictors of Clinical Outcome in Allogeneic Hematopoietic Stem Cell Transplant: Results of a Prospective Study in Adult Patients. Open Forum Infect Dis 2017; 4:ofx215. [PMID: 29226172 PMCID: PMC5714175 DOI: 10.1093/ofid/ofx215] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 09/28/2017] [Indexed: 12/18/2022] Open
Abstract
Background Infections and graft-vs-host disease (GvHD) still represent major, not easily predictable complications in allogeneic hematopoietic stem cell transplant (allo-HSCT). Both conditions have been correlated to altered enteric microbiome profiles during the peritransplant period. The main objective of this study was to identify possible early microbiome-based markers useful in pretransplant risk stratification. Methods Stool samples were collected from 96 consecutive patients at the beginning of the pretransplant conditioning regimen (T0) and at 10 (T1) and 30 (T2) days following transplant. When significant in univariate analysis, the identified microbiome markers were used in multivariate regression analyses, together with other significant clinical variables for allo-HSCT-related risk stratification. Four main outcomes were addressed: (1) septic complications, (2) GvHD, (3) relapse of the underlying disease, and (4) mortality. Results The presence of >5% proinflammatory Enterobacteriaceae at T0 was the only significant marker for the risk of microbiologically confirmed sepsis. Moreover, ≤10% Lachnospiraceae at T0 was the only significant factor for increased risk of overall mortality, including death from both infectious and noninfectious causes.Finally, a low bacterial alpha-diversity (Shannon index ≤ 1.3) at T1 was the only variable significantly correlating with an increased risk of GvHD within 30 days. Conclusions Microbiome markers can be useful in the very early identification of patients at risk for major transplant-related complications, offering new tools for individualized preemptive or therapeutic strategies to improve allo-HSCT outcomes.
Collapse
Affiliation(s)
- Nicasio Mancini
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy.,Department of Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Raffaella Greco
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Renée Pasciuta
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Chiara Barbanti
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Pini
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
| | - Olivia Beatrice Morrow
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
| | - Mara Morelli
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Luca Vago
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Clementi
- Department of Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Fabio Giglio
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Teresa Lupo Stanghellini
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Alessandra Forcina
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Laura Infurnari
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
| | - Sarah Marktel
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Assanelli
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Carrabba
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Bernardi
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Consuelo Corti
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Burioni
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy.,Department of Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Jacopo Peccatori
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | | | - Giuseppe Banfi
- Galeazzi Scientific Institute and University "Vita-Salute" San Raffaele, Milan, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy.,Department of Hematology and Bone Marrow Transplantation, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy.,Department of Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| |
Collapse
|
6
|
Mancini N, Greco R, Pasciuta R, Barbanti MC, Pini G, Morrow OB, Morelli M, Vago L, Clementi N, Giglio F, Lupo Stanghellini MT, Forcina A, Infurnari L, Marktel S, Assanelli A, Carrabba M, Bernardi M, Corti C, Burioni R, Peccatori J, Sormani MP, Banfi G, Ciceri F, Clementi M. Enteric Microbiome Markers as Early Predictors of Clinical Outcome in Allogeneic Hematopoietic Stem Cell Transplant: Results of a Prospective Study in Adult Patients. Open Forum Infect Dis 2017. [PMID: 29226172 DOI: 10.1093/ofid/ofx215/4367678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Infections and graft-vs-host disease (GvHD) still represent major, not easily predictable complications in allogeneic hematopoietic stem cell transplant (allo-HSCT). Both conditions have been correlated to altered enteric microbiome profiles during the peritransplant period. The main objective of this study was to identify possible early microbiome-based markers useful in pretransplant risk stratification. METHODS Stool samples were collected from 96 consecutive patients at the beginning of the pretransplant conditioning regimen (T0) and at 10 (T1) and 30 (T2) days following transplant. When significant in univariate analysis, the identified microbiome markers were used in multivariate regression analyses, together with other significant clinical variables for allo-HSCT-related risk stratification. Four main outcomes were addressed: (1) septic complications, (2) GvHD, (3) relapse of the underlying disease, and (4) mortality. RESULTS The presence of >5% proinflammatory Enterobacteriaceae at T0 was the only significant marker for the risk of microbiologically confirmed sepsis. Moreover, ≤10% Lachnospiraceae at T0 was the only significant factor for increased risk of overall mortality, including death from both infectious and noninfectious causes.Finally, a low bacterial alpha-diversity (Shannon index ≤ 1.3) at T1 was the only variable significantly correlating with an increased risk of GvHD within 30 days. CONCLUSIONS Microbiome markers can be useful in the very early identification of patients at risk for major transplant-related complications, offering new tools for individualized preemptive or therapeutic strategies to improve allo-HSCT outcomes.
Collapse
Affiliation(s)
- Nicasio Mancini
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
- Department of Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Raffaella Greco
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Renée Pasciuta
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Chiara Barbanti
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Pini
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
| | - Olivia Beatrice Morrow
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
| | - Mara Morelli
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Luca Vago
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Clementi
- Department of Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Fabio Giglio
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Teresa Lupo Stanghellini
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Alessandra Forcina
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Laura Infurnari
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
| | - Sarah Marktel
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Assanelli
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Carrabba
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Bernardi
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Consuelo Corti
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Burioni
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
- Department of Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Jacopo Peccatori
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
| | | | - Giuseppe Banfi
- Galeazzi Scientific Institute and University "Vita-Salute" San Raffaele, Milan, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, Division of Regenerative Medicine, Stem Cells and Gene Therapy, San Raffaele Scientific Institute, Milan, Italy
- Department of Hematology and Bone Marrow Transplantation, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milan, Italy
- Department of Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| |
Collapse
|
7
|
Gherlone EF, Capparé P, Pasciuta R, Grusovin MG, Mancini N, Burioni R. Evaluation of resistance against bacterial microleakage of a new conical implant-abutment connection versus conventional connections: an in vitro study. New Microbiol 2016; 39:49-56. [PMID: 26922985] [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: 09/01/2015] [Accepted: 12/15/2015] [Indexed: 06/05/2023]
Abstract
The aim of the present in vitro study was to evaluate bacterial microleakage from inside to outside the implant-abutment assembly in a new design of internal conical connection compared to eight different internal connections. The design of this connection should prevent or limit microbiologic leakage into the surrounding implant tissue, that could contribute to infections without bone loss (mucositis) or with bone loss (peri-implantits). In order to investigate bacterial microleakage, the inner part of each system was inoculated with an Escherichia coli suspension. Eight different groups were considered; each group was composed of 10 dental implants, for a total of 80 implants. Groups 1-7 were considered controls, while group 8 was the test connection (an internal connection characterized by a double taper principle). Results showed that in control implants (Group 1 to 7), little microleakage was observed after the first 6 hours (500 CFU/ μl) and, after 24 hours of incubation, they showed a significant bacterial contamination in all samples (>100.000 CFU/ μl). In group 8 (test connection) no contamination was found in the first 6 hours, with 7 out of 10 implants showing no contamination even after 96 hours. Statistically significant differences were found between Group 8 and the other groups (p<0.05), whereas no significant differences were found among implants of the control groups (from group 1 to 7). Within the limits of the present study, the new connection studied presented significantly less microleakage at 96 h in comparison with the other control internal connections.
Collapse
Affiliation(s)
- Enrico Felice Gherlone
- Dental School, Vita-Salute University, Milan, Italy and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - Paolo Capparé
- Dental School, Vita-Salute University, Milan, Italy and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - Renée Pasciuta
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria Gabriella Grusovin
- Dental School, Vita-Salute University, Milan, Italy and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberto Burioni
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|