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Prigitano A, Cavanna C, Passera M, Gelmi M, Sala E, Ossi C, Grancini A, Calabrò M, Bramati S, Tejada M, Lallitto F, Farina C, Rognoni V, Fasano MA, Pini B, Romanò L, Cogliati M, Esposto MC, Tortorano AM. Evolution of fungemia in an Italian region. J Mycol Med 2019; 30:100906. [PMID: 31708424 DOI: 10.1016/j.mycmed.2019.100906] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 04/16/2019] [Revised: 09/09/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fungemia represents a public health concern. Knowing aetiology and activity of the antifungals is critical for the management of bloodstream infections. Therefore, surveillance on local/international levels is desirable for a prompt administration of appropriate therapy. METHODS Data on fungi responsible for fungemia and antifungal susceptibility profiles were collected from a laboratory-based surveillance over 2016-2017 in 12 hospitals located in Lombardia, Italy. The trend of this infection in twenty years was analysed. RESULTS A total of 1024 episodes were evaluated. Rate of candiaemia progressively increased up to 1.46/1000 admissions. C.albicans was the most common species (52%), followed by C. parapsilosis (15%) and C glabrata (13%). As in the previous surveys the antifungal resistance is rare (echinocandins<2%, fluconazole 6%, amphotericin B 0.6%). Fungi other than Candida were responsible for 18 episodes: Cryptococcus neoformans (5 cases), Fusarium spp. (4), Magnusiomyces clavatus (3), Saccharomyces cerevisiae (3), Rhodotorula spp. (2), Exophiala dermatitidis (1). All fungi, except S.cerevisiae, were intrinsically resistant to echinocandins. Some isolates showed also elevated azole MIC. CONCLUSIONS No particular changes in terms of species distribution and antifungal susceptibility patterns was noted. However, surveillance programs are needed to monitor trends in antifungal resistance, steer stewardship activities, orient empirical treatment.
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Affiliation(s)
- A Prigitano
- Department of Biomedical Science for Health, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy
| | - C Cavanna
- Microbiology and Virology Unit IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Passera
- Microbiology Institute, ASST 'Papa G iovanni XXIII', Bergamo, Italy
| | - M Gelmi
- Microbiology Laboratory, A.O. Spedali Civili, Brescia, Italy
| | - E Sala
- Microbiology - ASST Lariana, Como, Italy
| | - C Ossi
- Laboratory of Microbiology and Virology, San Raffaele Scientific Institute, Milano, Italy
| | - A Grancini
- Microbiology Laboratory, Fondazione IRCCS C à Granda O. Maggiore Policlinico, Milano, Italy
| | - M Calabrò
- Microbiology Section, Humanitas Research Hospital, Milano, Italy
| | - S Bramati
- Microbiology Laboratory, Ospedale San Gerardo, Monza, Italy
| | - M Tejada
- Medicina di Laboratorio, IRCCS Policlinico San Donato, Milano, Italy
| | - F Lallitto
- Microbiology and Virology Unit IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Farina
- Microbiology Institute, ASST 'Papa G iovanni XXIII', Bergamo, Italy
| | | | - M A Fasano
- Microbiology and Virology Unit, ASST Bergamo Ovest Treviglio, Italy
| | - B Pini
- Laboratory of Microbiology and Virology, ASST Lecco, Italy
| | - L Romanò
- Department of Biomedical Science for Health, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy
| | - M Cogliati
- Department of Biomedical Science for Health, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy
| | - M C Esposto
- Department of Biomedical Science for Health, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy
| | - A M Tortorano
- Department of Biomedical Science for Health, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.
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Coppadoro A, Bellani G, Bronco A, Eronia N, Barletta A, Teggia Droghi M, Borsa R, Battistini M, Bramati S, Berra L, Pesenti A. Assessment of an endotracheal tube cleaning closed-suctioning system by micro-computed tomography: preliminary clinical data. Crit Care 2014. [PMCID: PMC4069493 DOI: 10.1186/cc13508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Coppadoro A, Bellani G, Mauri T, Borsa R, Meroni V, Barletta A, Droghi MT, Lucchini A, Marcolin R, Patroniti N, Bramati S, Pesenti A. Quantitative assessment of endotracheal tube (ETT) biofilm by micro-CT scan: evaluation of the effectiveness of ETT cleaning devices. Crit Care 2013. [PMCID: PMC3642424 DOI: 10.1186/cc12094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Cocuzza CE, Mattina R, Mazzariol A, Orefici G, Rescaldani R, Primavera A, Bramati S, Masera G, Parizzi F, Cornaglia G, Fontana R. High incidence of erythromycin-resistant Streptococcus pyogenes in Monza (North Italy) in untreated children with symptoms of acute pharyngo-tonsillitis: an epidemiological and molecular study. Microb Drug Resist 2000; 3:371-8. [PMID: 9442490 DOI: 10.1089/mdr.1997.3.371] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A retrospective analysis of susceptibility data available for Group A streptococcal isolates collected between January 1990 and January 1996 at the Hospital Microbiology Laboratory of Monza (North Italy), showed a sharp rise in the erythromycin resistance rates during the last 3 years. Streptococcus pyogenes resistant to erythromycin accounted for approximately 1% of strains isolated between 1990 and 1992; the percentage then rose from 5% in 1993 to almost 39% in 1995. In January 1996, the resistance rates peaked to 81%. A prospective controlled study performed between March and May of 1996 to determine the percentage of erythromycin-resistant Group A streptococci isolated in Monza from untreated children with acute pharyngo-tonsillitis, gave further confirmation of a high rate of erythromycin resistance (47%) in this area. Molecular characterization by T-serotyping and pulse-field gel electrophoresis analysis of 25 erythromycin-resistant Group A streptococcal isolates, showed a relatively high degree of heterogeneity among these strains, demonstrating that the increased resistance is not caused by the spread of a single clone.
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Affiliation(s)
- C E Cocuzza
- Istituto di Microbiologia Medica, Università di Milano, Italy
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Visca P, Goldoni P, Lück PC, Helbig JH, Cattani L, Giltri G, Bramati S, Castellani Pastoris M. Multiple types of Legionella pneumophila serogroup 6 in a hospital heated-water system associated with sporadic infections. J Clin Microbiol 1999; 37:2189-96. [PMID: 10364584 PMCID: PMC85115 DOI: 10.1128/jcm.37.7.2189-2196.1999] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Five sporadic cases of nosocomial Legionnaires' disease were documented from 1989 to 1997 in a hospital in northern Italy. Two of them, which occurred in a 75-year-old man suffering from ischemic cardiopathy and in an 8-year-old girl suffering from acute leukemia, had fatal outcomes. Legionella pneumophila serogroup 6 was isolated from both patients and from hot-water samples taken at different sites in the hospital. These facts led us to consider the possibility that a single clone of L. pneumophila serogroup 6 had persisted in the hospital environment for 8 years and had caused sporadic infections. Comparison of clinical and environmental strains by monoclonal subtyping, macrorestriction analysis (MRA), and arbitrarily primed PCR (AP-PCR) showed that the strains were clustered into three different epidemiological types, of which only two types caused infection. An excellent correspondence between the MRA and AP-PCR results was observed, with both techniques having high discriminatory powers. However, it was not possible to differentiate the isolates by means of ribotyping and analysis of rrn operon polymorphism. Environmental strains that antigenically and chromosomally matched the infecting organism were present at the time of infection in hot-water samples taken from the ward where the patients had stayed. Interpretation of the temporal sequence of events on the basis of the typing results for clinical and environmental isolates enabled the identification of the ward where the patients became infected and the modes of transmission of Legionella infection. The long-term persistence in the hot-water system of different clones of L. pneumophila serogroup 6 indicates that repeated heat-based control measures were ineffective in eradicating the organism.
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Affiliation(s)
- P Visca
- Laboratorio di Batteriologia e Micologia Medica, Istituto Superiore di Sanità, 00100 Rome, Italy.
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