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Elbahr U, Tekin R, Papić M, Pandak N, Erdem H, Can F, Alpat S, Pekok A, Pehlivanoglu F, Karamese M, Petru P, Kulzhanova S, Tosun S, Doğan M, Moroti R, Ramosaco E, Alay H, Puca E, Arapovic J, Pshenichnaya N, Fasciana T, Giammanco A. Factors leading to dissemination of cutaneous anthrax: an international ID-IRI study. New Microbes New Infect 2022; 48:101028. [PMID: 36193102 PMCID: PMC9526185 DOI: 10.1016/j.nmni.2022.101028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 02/08/2023] Open
Abstract
Background Although anthrax is a rare zoonotic infection, it still causes significant mortality and morbidity. In this multicenter study, which is the largest anthrax case series ever reported, we aimed to describe the factors leading to dissemination of cutaneous anthrax. Methods Adult patients with cutaneous anthrax from 16 referral centers were pooled. The study had a retrospective design, and included patients treated between January 1, 1990 and December 1, 2019. Probable, and confirmed cases based upon CDC anthrax 2018 case definition were included in the study. A descriptive statistical analysis was performed for all variables. Results A total of 141 cutaneous anthrax patients were included. Of these, 105 (74%) patients had probable and 36 (26%) had confirmed diagnosis. Anthrax meningitis and bacteremia occurred in three and six patients, respectively. Sequelae were observed in three patients: cicatricial ectropion followed by ocular anthrax (n = 2) and movement restriction on the left hand after surgical intervention (n = 1). One patient had gastrointestinal anthrax. The parameters related to poor outcome (p < 0.05) were fever, anorexia, hypoxia, malaise/fatigue, cellulitis, fasciitis, lymphadenopathy, leukocytosis, high CRP and creatinine levels, longer duration of antimicrobial therapy, and combined therapy. The last two were seemingly the consequences of dissemination rather than being the reasons. The fatality rate was 1.4%. Conclusions Rapid identification of anthrax is crucial for prompt and effective treatment. Systemic symptoms, disseminated local infection, and high inflammatory markers should alert the treating physicians for the dissemination of the disease.
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Affiliation(s)
- U.S. Elbahr
- Bahrain Oncology Center, King Hamad University Hospital, Department of Infectious Diseases, AlMuharraq, Bahrain
| | - R. Tekin
- Department of Infectious Diseases, School of Medicine, Dicle University, Diyarbakir, Turkey
| | - M. Papić
- Libertas International University, Zagreb, Croatia
| | | | - H. Erdem
- Bahrain Oncology Center, King Hamad University Hospital, Department of Infectious Diseases, AlMuharraq, Bahrain
- Corresponding author. Hakan Erdem, Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital. Muharraq, Bahrain.
| | - F.K. Can
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - S.N. Alpat
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - A.U. Pekok
- Department of Infectious Diseases, VM Medical Park, Pendik Hospital, Istanbul, Turkey
| | - F. Pehlivanoglu
- Department of Clinical Microbiology and Infectious Diseases, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - M. Karamese
- Department of Medical Microbiology, Kafkas University, Kars, Turkey
| | - P.C. Petru
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - S. Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
| | - S. Tosun
- Department of Infectious Diseases and Clinical Microbiology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - M. Doğan
- Department of Infectious Diseases, Namık Kemal University School of Medicine, Tekirdag, Turkey
| | - R. Moroti
- National Institute for Infectious Diseases ‘Matei Bals', and ‘Carol Davila’ University of Medicine and Pharmacy’, Bucharest, Romania
| | - E. Ramosaco
- Infectious Diseases Clinic, University Hospital Center “Mother Teresa”, Tirana, Albania
| | - H. Alay
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - E. Puca
- Infectious Diseases Clinic, University Hospital Center “Mother Teresa”, Tirana, Albania
| | - J. Arapovic
- Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | | | - T. Fasciana
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D'Alessandro, University of Palermo, 90127 Palermo, Italy
| | - A. Giammanco
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence G. D'Alessandro, University of Palermo, 90127 Palermo, Italy
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Polizzotto G, Barone E, Ponticello G, Fasciana T, Barbera D, Corona O, Amore G, Giammanco A, Oliva D. Isolation, identification and oenological characterization of non-Saccharomyces yeasts in a Mediterranean island. Lett Appl Microbiol 2017; 63:131-8. [PMID: 27261362 DOI: 10.1111/lam.12599] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 04/01/2016] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 01/27/2023]
Abstract
UNLABELLED We isolated, identified and characterized yeast strains from grapes, and their fermented musts, sampled in the small island of Linosa, where there are no wineries and therefore the possibility of territory contamination by industrial strains is minimal. By traditional culture-dependent methods, we isolated 3805 colonies, distinguished by molecular methods in 17 different species. Five hundred and forty-four isolates were analysed for the main oenological characteristics such as fermentative vigour with and without sulphites, sugar consumption and production of alcohol, volatile acidity, hydrogen sulphide, glycerol and β-glucosidase. This analysis identified Kluyveromyces marxianus (seldomly used in winemaking) as the most interesting candidate yeast for the production of innovative wines. SIGNIFICANCE AND IMPACT OF THE STUDY In recent years, interest is growing for wine production by non-Saccharomyces yeasts, both in research and in the industry. This study describes the yeast population of the grapes in a small-secluded island in the Mediterranean Sea, useful site for the search of new strains. Evaluation of fundamental oenological characters identifies potential best yeasts to assay in experimental vinifications. We also describe, for the first time, 14 new colony morphologies on WL Nutrient Agar, culture medium used to monitor the yeast population dynamics.
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Affiliation(s)
- G Polizzotto
- Regional Institute of Wine and Oil, Palermo, Italy
| | - E Barone
- Regional Institute of Wine and Oil, Palermo, Italy
| | - G Ponticello
- Regional Institute of Wine and Oil, Palermo, Italy
| | - T Fasciana
- Regional Institute of Wine and Oil, Palermo, Italy.,Department of Sciences for Health Promotion and Mother-Child Care 'G. D' Alessandro', University of Palermo, Palermo, Italy
| | - D Barbera
- Regional Institute of Wine and Oil, Palermo, Italy
| | - O Corona
- Department of Agricultural Sciences and Forestry, University of Palermo, Palermo, Italy
| | - G Amore
- Regional Institute of Wine and Oil, Palermo, Italy
| | - A Giammanco
- Department of Sciences for Health Promotion and Mother-Child Care 'G. D' Alessandro', University of Palermo, Palermo, Italy
| | - D Oliva
- Regional Institute of Wine and Oil, Palermo, Italy
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Colomba C, Scarlata F, Di Carlo P, Giammanco A, Fasciana T, Trizzino M, Cascio A. Fourth case of louse-borne relapsing fever in Young Migrant, Sicily, Italy, December 2015. Mini Review Article. Public Health 2016; 139:22-26. [PMID: 27340042 DOI: 10.1016/j.puhe.2016.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/12/2016] [Accepted: 05/23/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Currently louse-borne relapsing fever (LBRF) is primarily found in limited endemic foci in Ethiopia, Somalia and Sudan; no case of imported LBRF has been reported in Europe in the 9 years prior to 2015. The aim of our paper is to describe a new case of imported LBRF detected in Sicily, Italy, and to review all cases reported in migrants arrived in Europe in the last 10 years. STUDY DESIGN Mini review of all published cases of louse-borne relapsing fever in Europe in the last 10 years. METHODS A computerized search without language restriction was conducted using PubMed combining the terms '(louse-borne relapsing fever or LBRF or recurrentis) and (refugee or Europe or migrant)' without limits. Furthermore, the 'Ahead-of-Print Articles' of the top 10 journals (ranked by Impact factor - Web of Science) of Infectious diseases and of Epidemiology were checked. RESULTS Our search identified 26 cases of LBRF between July and October 2015 in migrants recently arrived in Europe: 8 had been described in Italy; 1 in Switzerland; 2 in the Netherlands; 15 in Germany. We describe data regarding the clinical characteristics, diagnostic methods, therapy and outcome of these patients and of the new case. CONCLUSIONS LBRF by Borrelia recurrentis should be considered among the clinical hypotheses in migrants presenting with fever, headache, chills, sweating, arthralgia, myalgia, dizziness, nausea and vomiting.
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Affiliation(s)
- C Colomba
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy.
| | - F Scarlata
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - P Di Carlo
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - A Giammanco
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - T Fasciana
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - M Trizzino
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - A Cascio
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
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Geraci DM, Bonura C, Giuffrè M, Saporito L, Graziano G, Aleo A, Fasciana T, Di Bernardo F, Stampone T, Palma DM, Mammina C. Is the monoclonal spread of the ST258, KPC-3-producing clone being replaced in southern Italy by the dissemination of multiple clones of carbapenem-nonsusceptible, KPC-3-producing Klebsiella pneumoniae? Clin Microbiol Infect 2014; 21:e15-7. [PMID: 25658574 DOI: 10.1016/j.cmi.2014.08.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 07/17/2014] [Accepted: 08/05/2014] [Indexed: 10/24/2022]
Affiliation(s)
- D M Geraci
- Department of Sciences for Health Promotion and Mother-Child Care 'G. D'Alessandro', University of Palermo, Italy
| | - C Bonura
- Postgraduate Specialty School in Hygiene and Preventive Medicine, University of Palermo, Italy
| | - M Giuffrè
- Department of Sciences for Health Promotion and Mother-Child Care 'G. D'Alessandro', University of Palermo, Italy
| | - L Saporito
- Postgraduate Specialty School in Hygiene and Preventive Medicine, University of Palermo, Italy
| | - G Graziano
- Postgraduate Specialty School in Hygiene and Preventive Medicine, University of Palermo, Italy
| | - A Aleo
- Department of Sciences for Health Promotion and Mother-Child Care 'G. D'Alessandro', University of Palermo, Italy
| | - T Fasciana
- Department of Sciences for Health Promotion and Mother-Child Care 'G. D'Alessandro', University of Palermo, Italy
| | - F Di Bernardo
- Laboratory of Microbiology, General Hospital ARNAS 'Civico, Di Cristina & Benfratelli', Italy
| | - T Stampone
- Laboratory of Microbiology, General Hospital Azienda Ospedaliera 'Villa Sofia-V, Cervello', Italy
| | - D M Palma
- II Intensive Care Unit, General Hospital ARNAS 'Civico, Di Cristina & Benfratelli', Palermo, Italy
| | - C Mammina
- Department of Sciences for Health Promotion and Mother-Child Care 'G. D'Alessandro', University of Palermo, Italy.
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Mammina C, Bonura C, Di Bernardo F, Aleo A, Fasciana T, Sodano C, Saporito MA, Verde MS, Tetamo R, Palma DM. Ongoing spread of colistin-resistant Klebsiella pneumoniae in different wards of an acute general hospital, Italy, June to December 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.33.20248-en] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- C Mammina
- Department of Sciences for Health Promotion G D’Alessandro, University, Palermo, Italy
| | - C Bonura
- Department of Sciences for Health Promotion G D’Alessandro, University, Palermo, Italy
| | - F Di Bernardo
- Laboratory of Clinical Microbiology, ARNAS General Hospital Civico, di Cristina e Benfratelli, Palermo, Italy
| | - A Aleo
- Department of Sciences for Health Promotion G D’Alessandro, University, Palermo, Italy
| | - T Fasciana
- Department of Sciences for Health Promotion G D’Alessandro, University, Palermo, Italy
| | - C Sodano
- Laboratory of Clinical Microbiology, ARNAS General Hospital Civico, di Cristina e Benfratelli, Palermo, Italy
| | - M A Saporito
- Laboratory of Clinical Microbiology, ARNAS General Hospital Civico, di Cristina e Benfratelli, Palermo, Italy
| | - M S Verde
- Laboratory of Clinical Microbiology, ARNAS General Hospital Civico, di Cristina e Benfratelli, Palermo, Italy
| | - R Tetamo
- II Intensive Care Unit, ARNAS General Hospital Civico, di Cristina e Benfratelli, Palermo, Italy
| | - D M Palma
- II Intensive Care Unit, ARNAS General Hospital Civico, di Cristina e Benfratelli, Palermo, Italy
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Mammina C, Bonura C, Di Bernardo F, Aleo A, Fasciana T, Sodano C, Saporito MA, Verde MS, Tetamo R, Palma DM. Ongoing spread of colistin-resistant Klebsiella pneumoniae in different wards of an acute general hospital, Italy, June to December 2011. Euro Surveill 2012; 17:20248. [PMID: 22913977] [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: 06/01/2023] Open
Abstract
We describe polyclonal spread of colistin-resistant Klebsiella pneumoniae in an acute general hospital in Italy. Between June and December 2011, 58 colistin-resistant K. pneumoniae isolates were recovered from 28 patients admitted to different wards, but mainly in the intensive care units. All isolates were tested for drug susceptibility and the presence of beta-lactamase (bla) genes. Clonality was investigated by repetitive extragenic palindromic (rep)-PCR and multilocus sequence typing (MLST). Fifty-two isolates had minimum inhibitory concentrations (MICs) for colistin of 6-128 mg/L, carried bla(KPC3) and were attributed to sequence type ST258. The remaining six isolates were susceptible to carbapenems, exhibited MICs for colistin of 3-32 mg/L, and belonged to two different types, ST15 and ST273. Rep-PCR included all isolates in three clusters, one containing all ST258 KPC-3-producing isolates and two containing ST15 and ST273 isolates.Cross-transmission containment measures and intensification of staff and environmental hygiene could not stop the outbreak. Selective pressure and horizontal transmission probably contributed to emergence and spread of three different strains of colistin-resistant K. pneumoniae in the hospital. Strict implementation of the above measures and a wider awareness of the antimicrobial resistance threat are crucial to preserve the last therapeutic options of the multidrug-resistant Gram-negative infections.
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Affiliation(s)
- C Mammina
- Department of Sciences for Health Promotion G D'Alessandro, University, Palermo, Italy.
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Mammina C, Bonura C, Aleo A, Calà C, Caputo G, Cataldo M, Benedetto AD, Distefano S, Fasciana T, Labisi M, Sodano C, Palma D, Giammanco A. Characterization of Acinetobacter baumannii from intensive care units and home care patients in Palermo, Italy. Clin Microbiol Infect 2011; 17:E12-5. [DOI: 10.1111/j.1469-0691.2011.03654.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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