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Amadesi S, Palombo M, Bovo F, Liberatore A, Vecchi E, Cricca M, Lazzarotto T, Ambretti S, Gaibani P. Clonal Dissemination of Candida auris Clinical Isolates in Northern Italy, 2021. Microb Drug Resist 2024; 30:50-54. [PMID: 37851491 DOI: 10.1089/mdr.2023.0150] [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: 10/19/2023] Open
Abstract
Candida auris is a concerning pathogen in health care due to its ability to spread in medical settings. In this study, we characterized the genome of three C. auris clinical isolates collected in the Emilia-Romagna region of Northeastern Italy from January 2020 to May 2021. Whole-genome sequencing was performed using Illumina iSeq 100 and Oxford Nanopore MinION systems. Genomes were assembled with Flye. Phylogenetic analysis was carried out with RaxML. The ERG11, TAC1b, and FKS1 genes were examined for known substitutions associated with resistance to azoles and caspofungin using Diamond. All three C. auris isolates belonged to clade I (South Asian lineage) and showed high minimum inhibitory concentrations for fluconazole. Two of the three isolates were closely related to the first Italian index case of C. auris occurred in the 2019 and carried similar mutations associated to azole resistance. The third isolate showed a greater phylogenetic distance from these strains and had a different genetic determinant not previously seen in Italy. Our data suggest that two C. auris clinical isolates may have been epidemiologically related to the first outbreak previously observed in Italy, while the remaining isolate may have originated from a different source. Further research is needed to understand C. auris transmission and resistance and to control its spread.
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Affiliation(s)
- Stefano Amadesi
- Operative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marta Palombo
- Operative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federica Bovo
- Operative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Liberatore
- Operative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Elena Vecchi
- Department of Public Health of Emilia-Romagna Region, Bologna, Italy
| | - Monica Cricca
- Operative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- DIMEC, University of Bologna, Bologna, Italy
| | - Tiziana Lazzarotto
- Operative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- DIMEC, University of Bologna, Bologna, Italy
| | - Simone Ambretti
- Operative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- DIMEC, University of Bologna, Bologna, Italy
| | - Paolo Gaibani
- Operative Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Sticchi C, Raso R, Ferrara L, Vecchi E, Ferrero L, Filippi D, Finotto G, Frassinelli E, Silvestre C, Zozzoli S, Ambretti S, Diegoli G, Gagliotti C, Moro ML, Ricchizzi E, Tumietto F, Russo F, Tonon M, Maraglino F, Rezza G, Sabbatucci M. Increasing Number of Cases Due to Candida auris in North Italy, July 2019-December 2022. J Clin Med 2023; 12:jcm12051912. [PMID: 36902700 PMCID: PMC10003924 DOI: 10.3390/jcm12051912] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/01/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
Candida auris is an emerging fungus that represents a serious health threat globally. In Italy, the first case was detected in July 2019. Then, one case was reported to the Ministry of Health (MoH) on January 2020. Nine months later, a huge number of cases were reported in northern Italy. Overall, 361 cases were detected in 17 healthcare facilities between July 2019 and December 2022 in the Liguria, Piedmont, Emilia-Romagna, and Veneto regions, including 146 (40.4%) deaths. The majority of cases (91.8%) were considered as colonised. Only one had a history of travel abroad. Microbiological data on seven isolates showed that all but one strain (85.7%) were resistant to fluconazole. All the environmental samples tested negative. Weekly screening of contacts was performed by the healthcare facilities. Infection prevention and control (IPC) measures were applied locally. The MoH nominated a National Reference Laboratory to characterise C. auris isolates and store the strains. In 2021, Italy posted two messages through the Epidemic Intelligence Information System (EPIS) to inform on the cases. On February 2022, a rapid risk assessment indicated a high risk for further spread within Italy, but a low risk of spread to other countries.
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Affiliation(s)
- Camilla Sticchi
- A.Li.Sa. Azienda Ligure Sanitaria, Ligurian Health Authority, 16121 Genova, Italy
| | - Roberto Raso
- Regional Epidemiology Reference Service for the Surveillance, Prevention and Control of Infectious Diseases—Local Health Unit of Alessandria, 15121 Alessandria, Italy
| | - Lorenza Ferrara
- Regional Epidemiology Reference Service for the Surveillance, Prevention and Control of Infectious Diseases—Local Health Unit of Alessandria, 15121 Alessandria, Italy
| | - Elena Vecchi
- Collective Prevention and Public Health Section—Directorate General for Personal Care, Health and Welfare—Emilia Romagna Region, 40100 Bologna, Italy
| | - Loredana Ferrero
- S.C. Health Directorate—P.O. Molinette—A.O.U. Città della Salute e della Scienza, 10126 Turin, Italy
| | - Daniela Filippi
- S.C. Health Directorate—P.O. Molinette—A.O.U. Città della Salute e della Scienza, 10126 Turin, Italy
| | - Giuseppe Finotto
- S.C. Health Directorate—P.O. Molinette—A.O.U. Città della Salute e della Scienza, 10126 Turin, Italy
| | - Elena Frassinelli
- S.C. Health Directorate—P.O. Molinette—A.O.U. Città della Salute e della Scienza, 10126 Turin, Italy
| | - Carlo Silvestre
- S.C. Health Directorate—P.O. Molinette—A.O.U. Città della Salute e della Scienza, 10126 Turin, Italy
| | - Susanna Zozzoli
- S.C. Health Directorate—P.O. Molinette—A.O.U. Città della Salute e della Scienza, 10126 Turin, Italy
| | - Simone Ambretti
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria Bologna, 40138 Bologna, Italy
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40126 Bologna, Italy
| | - Giuseppe Diegoli
- Collective Prevention and Public Health Section—Directorate General for Personal Care, Health and Welfare—Emilia Romagna Region, 40100 Bologna, Italy
| | - Carlo Gagliotti
- Regional Health and Social Agency—Emilia Romagna Region, 40127 Bologna, Italy
| | - Maria Luisa Moro
- Regional Health and Social Agency—Emilia Romagna Region, 40127 Bologna, Italy
| | - Enrico Ricchizzi
- Regional Health and Social Agency—Emilia Romagna Region, 40127 Bologna, Italy
| | - Fabio Tumietto
- UO Antimicrobial Stewardship—AUSL Bologna, 40124 Bologna, Italy
| | - Francesca Russo
- Veneto Region, Directorate for Prevention, Veterinary Food Safety, 30123 Venice, Italy
| | - Michele Tonon
- Veneto Region, Directorate for Prevention, Veterinary Food Safety, 30123 Venice, Italy
| | - Francesco Maraglino
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 00144 Rome, Italy
| | - Giovanni Rezza
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 00144 Rome, Italy
| | - Michela Sabbatucci
- Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 00144 Rome, Italy
- Department Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
- Correspondence:
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Casini B, Spagnolo AM, Sartini M, Tuvo B, Scarpaci M, Barchitta M, Pan A, Agodi A, Cristina ML, Castiglia P, De Giusti M, Distefano M, Longhitano A, Laganà P, Mentore B, Canale F, Mantero F, Opezzi M, Marciano E, Zurlo L, Segata A, Torre I, Vay D, Vecchi E, Vincenti S. Microbiological surveillance post-reprocessing of flexible endoscopes used in digestive endoscopy: a national study. J Hosp Infect 2023; 131:139-147. [PMID: 36244520 DOI: 10.1016/j.jhin.2022.09.024] [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] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/17/2022] [Accepted: 09/19/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Microbiological surveillance of endoscopes is a safety measure for verifying the quality of reprocessing procedures and identifying contaminated devices, but duodenoscope-related outbreaks are still reported. AIM To assess the effectiveness of duodenoscope reprocessing procedures in Italy. METHODS Between December 2019 and April 2020, data obtained from microbiological surveillance post-reprocessing in 15 Italian endoscopy units were collected. Sampling was carried out after reprocessing or during storage in a cabinet. In keeping with international guidelines and the Italian position paper, the micro-organisms were classified as high-concern organisms (HCOs) and low-concern organisms (LCOs). FINDINGS In total, 144 samples were collected from 51 duodenoscopes. Of these, 36.81% were contaminated: 22.92% were contaminated with HCOs and 13.89% were contaminated with LCOs [2.08% with an LCO load of 11-100 colony-forming units (CFU)/device and 0.69% with an LCO load of >100 CFU/device]. The contamination rate was 27.5% in samples collected after reprocessing, 40% in samples collected during storage in a cabinet that was compliant with EN 16442:2015 (C-I), and 100% in samples collected during storage in a cabinet that was not compliant with EN 16442:2015 (NC-I). The respective HCO rates were 15.00%, 27.27% and 66.67%. Correlation between LCO contamination and storage time was demonstrated (Spearman's rho=0.3701; P=0.0026). The Olympus duodenoscope TJFQ180V demonstrated the lowest rate of contamination (29.82%), although the contamination rate was 100% for duodenoscopes stored in an NC-I cabinet. CONCLUSION Microbiological surveillance, along with strict adherence to reprocessing protocols, may help to detect endoscope contamination at an early stage, and reduce the risk of duodenoscope-associated infections.
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Affiliation(s)
- B Casini
- Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A M Spagnolo
- Department of Health Sciences, University of Genova, Genova, Italy; Operating Unit Hospital Hygiene, Galliera Hospital, Genoa, Italy.
| | - M Sartini
- Department of Health Sciences, University of Genova, Genova, Italy; Operating Unit Hospital Hygiene, Galliera Hospital, Genoa, Italy.
| | - B Tuvo
- Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - M Scarpaci
- Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - M Barchitta
- Department of Medical, Surgical and Advanced Technology Sciences "G.F. Ingrassia", University of Catania, Catania, Italy
| | - A Pan
- Operating Unit of Infectious Diseases, ASST Cremona, Cremona, Italy
| | - A Agodi
- Department of Medical, Surgical and Advanced Technology Sciences "G.F. Ingrassia", University of Catania, Catania, Italy
| | - M L Cristina
- Department of Health Sciences, University of Genova, Genova, Italy; Operating Unit Hospital Hygiene, Galliera Hospital, Genoa, Italy
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Fede GD, Catania M, Colombo L, Sorrentino S, Cagnotto A, Lucchetti J, Barbagallo M, Vannetiello I, Vecchi E, Favagrossa M, Costanza M, Giaccone G, Salmona M, Tagliavini F. A novel bio-inspired strategy to prevent amyloidogenesis and synaptic damage in Alzheimer’s disease.. [DOI: 10.21203/rs.3.rs-1762247/v1] [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] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Alzheimer’s disease (AD) is an irreversible neurodegenerative disorder that affects millions of people worldwide. AD pathogenesis is intricate. It primarily involves two main molecular players – amyloid-β (Aβ) and tau - which actually have an intrinsic trend to generate molecular assemblies that are toxic to neurons. Incomplete knowledge of the molecular mechanisms inducing the onset and sustaining the progression of the disease, as well as the lack of valid models to fully recapitulate the pathogenesis of human disease, have until now hampered the development of a successful therapy for AD. The overall experience with clinical trials with a number of potential drugs – including the recent outcomes of studies with monoclonal antibodies against Aβ – seems to indicate that Aβ-targeting is not effective if it is not accompanied by an efficient challenge of Aβ neurotoxic properties. We took advantage from the discovery of a naturally-occurring variant of Aβ (AβA2V) that has anti-amyloidogenic properties, and designed a novel bio-inspired strategy for AD based on the intranasal delivery of a six-mer peptide (Aβ1-6A2V) retaining the anti-amyloidogenic abilities of the full-length AβA2V variant. This approach turned out to be effective in preventing the aggregation of wild type Aβ and averting the synaptic damage associated with amyloidogenesis in a mouse model of AD. The results of our preclinical studies inspired by a protective model already existing in nature, that is the human heterozygous AβA2V carriers which seem to be protected from AD, open the way to an unprecedented and promising approach for the prevention of the disease in humans.
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Meschiari M, Lòpez-Lozano JM, Di Pilato V, Gimenez-Esparza C, Vecchi E, Bacca E, Orlando G, Franceschini E, Sarti M, Pecorari M, Grottola A, Venturelli C, Busani S, Serio L, Girardis M, Rossolini GM, Gyssens IC, Monnet DL, Mussini C. A five-component infection control bundle to permanently eliminate a carbapenem-resistant Acinetobacter baumannii spreading in an intensive care unit. Antimicrob Resist Infect Control 2021; 10:123. [PMID: 34412693 PMCID: PMC8376111 DOI: 10.1186/s13756-021-00990-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/07/2021] [Indexed: 12/18/2022] Open
Abstract
Background Carbapenem-resistant Acinetobacter baumannii (CRAB) infection outbreaks are difficult to control and sometimes require cohorting of CRAB-positive patients or temporary ward closure for environmental cleaning. We aimed at controlling the deadly 2018 CRAB outbreak in a 12 bed- intensive care unit (ICU) including 9 beds in a 220 m2 open space. We implemented a new multimodal approach without ward closure, cohorting or temporarily limiting admissions. Methods A five-component bundle was introduced in 2018 including reinforcement of hand hygiene and sample extension of screening, application of contact precautions to all patients, enhanced environmental sampling and the one-time application of a cycling radical environmental cleaning and disinfection procedure of the entire ICU. The ICU-CRAB incidence density (ID), ICU alcohol-based hand rub consumption and antibiotic use were calculated over a period of 6 years and intervention time series analysis was performed. Whole genome sequencing analysis (WGS) was done on clinical and environmental isolates in the study period. Results From January 2013, nosocomial ICU-CRAB ID decreased from 30.4 CRAB cases per 1000 patients-days to zero cases per 1000 patients-days. Our intervention showed a significant impact (-2.9 nosocomial ICU-CRAB cases per 1000 bed-days), while no influence was observed for antibiotic and alcohol-based hand rub (AHR) consumption. WGS demonstrated that CRAB strains were clonally related to an environmental reservoir which confirms the primary role of the environment in CRAB ICU spreading. Conclusion A five-component bundle of continuous hand hygiene improvement, extended sampling at screening including the environment, universal contact precautions and a novel cycling radical environmental cleaning and disinfection procedure proved to be effective for permanently eliminating CRAB spreading within the ICU. Cohorting, admission restriction or ICU closure were avoided. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-00990-z.
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Affiliation(s)
- Marianna Meschiari
- Infectious Disease Clinic, Azienda Ospedaliero-Universitaria Policlinico and University of Modena and Reggio Emilia, Modena, Italy.
| | | | - Vincenzo Di Pilato
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | | | - Elena Vecchi
- Hospital Hygiene and Infection Control, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Erica Bacca
- Infectious Disease Clinic, Azienda Ospedaliero-Universitaria Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Gabriella Orlando
- Infectious Disease Clinic, Azienda Ospedaliero-Universitaria Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Erica Franceschini
- Infectious Disease Clinic, Azienda Ospedaliero-Universitaria Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Mario Sarti
- Clinical Microbiology Laboratory, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Monica Pecorari
- Laboratory of Virology and Molecular Biology, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Antonella Grottola
- Laboratory of Virology and Molecular Biology, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Claudia Venturelli
- Clinical Microbiology Laboratory, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Stefano Busani
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Lucia Serio
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Girardis
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Policlinico and University of Modena and Reggio Emilia, Modena, Italy
| | - Gian Maria Rossolini
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Inge C Gyssens
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Dominique L Monnet
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Cristina Mussini
- Infectious Disease Clinic, Azienda Ospedaliero-Universitaria Policlinico and University of Modena and Reggio Emilia, Modena, Italy
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Pecoraro V, Cassetti T, Meacci M, Gargiulo R, Capobianchi MR, Mussini C, Vecchi E, Pecorari M, Gagliotti C, Trenti T, Sarti M. Accuracy of the serological detection of IgG and IgM to SARS-Cov-2: a prospective, cross-sectional study. Eur J Clin Microbiol Infect Dis 2021; 40:1891-1898. [PMID: 33839972 PMCID: PMC8036011 DOI: 10.1007/s10096-021-04224-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 03/08/2021] [Indexed: 11/25/2022]
Abstract
In response to the rapidly evolving of SARS-CoV-2 infection, numerous serological tests have been developed but their sensitivity and specificity are unclear. We collected serum samples of patients and health-care professionals to assess the accuracy of chemiluminescent (CLIA) and two lateral flow immunochromatographic assays (LFIA) to determine IgG and IgM antibodies to SARS-CoV-2 virus. We calculated the φ correlation for qualitative results and test accuracy, adopting the following case definition: either real-time-PCR positivity or serological positivity with at least two different tests. We analyzed 259 samples, obtaining strong correlation between CLIA and both LFIA for IgG (φ=0.9), and moderate correlation for IgM (φ=0.6). For patients, the sensitivity was suboptimal for all methods (CLIA 81%, LFIA A 85%, LFIA B 78%), while it was poor in asymptomatic health-care workers (CLIA 50%, LFIA A 50%, LFIA B 33%). Overall, CLIA is more sensitive and specific for the determination of both IgG and IgM, whilst both LFIA methods reported good sensitivity and specificity for IgG, but scarce sensitivity for the IgM determination. The determination of SARS-CoV-2-specific IgG is useful to detect infection 6 days from symptom onset.
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Affiliation(s)
- Valentina Pecoraro
- Department of Laboratory Medicine and Pathology, Azienda USL of Modena, Modena, Italy.
| | | | - Marisa Meacci
- Clinical Microbiology Unit, University Hospital Polyclinic, Modena, Italy
| | | | | | - Cristina Mussini
- Infectious Diseases Clinic, University Hospital Polyclinic, Modena, Italy
| | - Elena Vecchi
- Hospital Hygiene, University Hospital Polyclinic, Modena, Italy
| | - Monica Pecorari
- Virology and Molecular Microbiology Unit, University Hospital Polyclinic, Modena, Italy
| | - Carlo Gagliotti
- Regional Agency for Health and Social Care of Emilia-Romagna, Bologna, Italy
| | - Tommaso Trenti
- Department of Laboratory Medicine and Pathology, Azienda USL of Modena, Modena, Italy
| | - Mario Sarti
- Clinical Microbiology Unit, University Hospital Polyclinic, Modena, Italy
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Meschiari M, Kaleci S, Orlando G, Selmi S, Santoro A, Bacca E, Menozzi M, Franceschini E, Puzzolante C, Bedini A, Sarti M, Venturelli C, Vecchi E, Mussini C. Risk factors for nosocomial rectal colonization with carbapenem-resistant Acinetobacter baumannii in hospital: a matched case-control study. Antimicrob Resist Infect Control 2021; 10:69. [PMID: 33832538 PMCID: PMC8028794 DOI: 10.1186/s13756-021-00919-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During the last decade carbapenem-resistant Acinetobacter baumannii (CRAB) became hyper-endemic in hospitals due to difficult to control spreading. Our aim is to identify risk factors for nosocomial rectal CRAB colonization in an endemic hospital. METHODS A retrospective matched case-control study (ratio 1:2) with a prospective inclusion of cases and concurrent selection of controls was conducted from January 2017 to December 2018 in a tertiary-care hospital. Universal active surveillance for CRAB was implemented. Univariate and multivariate logistic regression was carried out using a stepwise selection method to compare prognostic factors between cases and controls. A sub-analysis was carried out according to the type of department. RESULTS Forty-five cases with nosocomial rectal CRAB colonization and 90 controls were included. One hundred and two (75%) patients were hospitalized in medical departments. At multivariable analysis significant risk factors associated with CRAB colonization were: use of permanent devices (OR 10.15, 95% CI 2.27-45.39; P = 0.002), mechanical ventilation (OR 40.01, 95% CI 4.05-395.1; P = 0.002), urinary catheters (OR 4.9, 95% CI 1.52-16.19; P = 0.008), McCabe score (OR 5.45, 95% CI 1.87-15.89; P = 0.002), length of stay (OR 1.03, 95% CI 1.01-1.05; P = 0.002), carbapenem use (OR 5.39, 95% CI 1.14-25.44; P = 0.033). The sub-analysis showed that patients admitted to different departments had different risk factors. In geriatric department a fatal disease and a longer hospital stay represented significant risk factors both in univariate and multivariate analysis, while in internal medicine department the use of permanent devices, current antibiotic therapy and antibiotic polytherapy represented significant risk factors for CRAB at the univariate analysis, also confirmed in multivariate analysis. CONCLUSIONS Our data suggest that active surveillance for rectal CRAB colonization should be addressed to patients with an unfavourable prognosis, longer hospitalizations and carriers of multiple devices. To counter CRAB spreading in endemic settings, clinicians must limit the use of carbapenems, and reinforce interventions aimed at proper use of devices.
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Affiliation(s)
- Marianna Meschiari
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy.
| | - Shaniko Kaleci
- Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Gabriella Orlando
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy
| | - Silvia Selmi
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy
| | - Antonella Santoro
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy
| | - Erica Bacca
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy
| | - Marianna Menozzi
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy
| | - Erica Franceschini
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy
| | - Cinzia Puzzolante
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy
| | - Andrea Bedini
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy
| | - Mario Sarti
- Clinical Microbiology Laboratory, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Venturelli
- Clinical Microbiology Laboratory, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Vecchi
- Hospital Hygiene and Infection Control, Azienda Ospedaliero-Universitaria, Modena, Italy
| | - Cristina Mussini
- Department of infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122, Modena, Italy
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Marchesi I, Paduano S, Frezza G, Sircana L, Vecchi E, Zuccarello P, Oliveri Conti G, Ferrante M, Borella P, Bargellini A. Safety and Effectiveness of Monochloramine Treatment for Disinfecting Hospital Water Networks. Int J Environ Res Public Health 2020; 17:ijerph17176116. [PMID: 32842654 PMCID: PMC7503937 DOI: 10.3390/ijerph17176116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/12/2020] [Accepted: 08/20/2020] [Indexed: 11/16/2022]
Abstract
The formation of potentially carcinogenic N-nitrosamines, associated with monochloramine, requires further research due to the growing interest in using this biocide for the secondary disinfection of water in public and private buildings. The aim of our study was to evaluate the possible formation of N-nitrosamines and other toxic disinfection by-products (DBPs) in hospital hot water networks treated with monochloramine. The effectiveness of this biocide in controlling Legionella spp. contamination was also verified. For this purpose, four different monochloramine-treated networks, in terms of the duration of treatment and method of biocide injection, were investigated. Untreated hot water, municipal cold water and, limited to N-nitrosamines analysis, hot water treated with chlorine dioxide were analyzed for comparison. Legionella spp. contamination was successfully controlled without any formation of N-nitrosamines. No nitrification or formation of the regulated DBPs, such as chlorites and trihalomethanes, occurred in monochloramine-treated water networks. However, a stable formulation of hypochlorite, its frequent replacement with a fresh product, and the routine monitoring of free ammonia are recommended to ensure a proper disinfection. Our study confirms that monochloramine may be proposed as an effective and safe strategy for the continuous disinfection of building plumbing systems, preventing vulnerable individuals from being exposed to legionellae and dangerous DBPs.
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Affiliation(s)
- Isabella Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
- Correspondence: ; Tel.: +39-059-2055460
| | - Stefania Paduano
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
| | - Giuseppina Frezza
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
| | - Luca Sircana
- University Hospital Policlinico of Modena, Largo del Pozzo 71, 41124 Modena, Italy; (L.S.); (E.V.)
| | - Elena Vecchi
- University Hospital Policlinico of Modena, Largo del Pozzo 71, 41124 Modena, Italy; (L.S.); (E.V.)
| | - Pietro Zuccarello
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (P.Z.); (G.O.C.); (M.F.)
| | - Gea Oliveri Conti
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (P.Z.); (G.O.C.); (M.F.)
| | - Margherita Ferrante
- Environmental and Food Hygiene Laboratory (LIAA), Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (P.Z.); (G.O.C.); (M.F.)
| | - Paola Borella
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
| | - Annalisa Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (S.P.); (G.F.); (P.B.); (A.B.)
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Paduano S, Marchesi I, Casali ME, Valeriani F, Frezza G, Vecchi E, Sircana L, Romano Spica V, Borella P, Bargellini A. Characterisation of Microbial Community Associated with Different Disinfection Treatments in Hospital hot Water Networks. Int J Environ Res Public Health 2020; 17:ijerph17062158. [PMID: 32213901 PMCID: PMC7143765 DOI: 10.3390/ijerph17062158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/20/2020] [Accepted: 03/22/2020] [Indexed: 12/16/2022]
Abstract
Many disinfection treatments can be adopted for controlling opportunistic pathogens in hospital water networks in order to reduce infection risk for immunocompromised patients. Each method has limits and strengths and it could determine modifications on bacterial community. The aim of our investigation was to study under real-life conditions the microbial community associated with different chemical (monochloramine, hydrogen peroxide, chlorine dioxide) and non-chemical (hyperthermia) treatments, continuously applied since many years in four hot water networks of the same hospital. Municipal cold water, untreated secondary, and treated hot water were analysed for microbiome characterization by 16S amplicon sequencing. Cold waters had a common microbial profile at genera level. The hot water bacterial profiles differed according to treatment. Our results confirm the effectiveness of disinfection strategies in our hospital for controlling potential pathogens such as Legionella, as the investigated genera containing opportunistic pathogens were absent or had relative abundances ≤1%, except for non-tuberculous mycobacteria, Sphingomonas, Ochrobactrum and Brevundimonas. Monitoring the microbial complexity of healthcare water networks through 16S amplicon sequencing is an innovative and effective approach useful for Public Health purpose in order to verify possible modifications of microbiota associated with disinfection treatments.
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Affiliation(s)
- Stefania Paduano
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
| | - Isabella Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
| | - Maria Elisabetta Casali
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
- University Hospital Policlinico of Modena, 41124 Modena, Italy; (E.V.); (L.S.)
| | - Federica Valeriani
- Department of Movement, Human and Health Sciences, Public Health Unit, University of Rome ‘Foro Italico’, 00135 Rome, Italy; (F.V.); (V.R.S.)
| | - Giuseppina Frezza
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
| | - Elena Vecchi
- University Hospital Policlinico of Modena, 41124 Modena, Italy; (E.V.); (L.S.)
| | - Luca Sircana
- University Hospital Policlinico of Modena, 41124 Modena, Italy; (E.V.); (L.S.)
| | - Vincenzo Romano Spica
- Department of Movement, Human and Health Sciences, Public Health Unit, University of Rome ‘Foro Italico’, 00135 Rome, Italy; (F.V.); (V.R.S.)
| | - Paola Borella
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
| | - Annalisa Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.P.); (I.M.); (M.E.C.); (G.F.); (P.B.)
- Correspondence:
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Ricci ML, Grottola A, Fregni Serpini G, Bella A, Rota MC, Frascaro F, Pegoraro E, Meacci M, Fabio A, Vecchi E, Girolamo A, Rumpianesi F, Pecorari M, Scaturro M. Improvement of Legionnaires' disease diagnosis using real-time PCR assay: a retrospective analysis, Italy, 2010 to 2015. Euro Surveill 2018; 23:1800032. [PMID: 30563592 PMCID: PMC6299505 DOI: 10.2807/1560-7917.es.2018.23.50.1800032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 08/06/2018] [Indexed: 12/29/2022] Open
Abstract
AimTo evaluate real-time PCR as a diagnostic method for Legionnaires' disease (LD). Detection of Legionella DNA is among the laboratory criteria of a probable LD case, according to the European Centre for Disease Prevention and Control, although the utility and advantages, as compared to culture, are widely recognised.MethodsTwo independent laboratories, one using an in-house and the other a commercial real-time PCR assay, analysed 354 respiratory samples from 311 patients hospitalised with pneumonia between 2010-15. The real-time PCR reliability was compared with that of culture and urinary antigen tests (UAT). Concordance, specificity, sensitivity and positive and negative predictive values (PPV and NPV, respectively) were calculated.ResultsOverall PCR detected eight additional LD cases, six of which were due to Legionella pneumophila (Lp) non-serogroup 1. The two real-time PCR assays were concordant in 99.4% of the samples. Considering in-house real-time PCR as the reference method, specificity of culture and UAT was 100% and 97.9% (95% CI: 96.2-99.6), while the sensitivity was 63.6% (95%CI: 58.6-68.6) and 77.8% (95% CI: 72.9-82.7). PPV and NPV for culture were 100% and 93.7% (95% CI: 91.2-96.3). PPV and NPV for UAT were 87.5% (95% CI: 83.6-91.4) and 95.8% (95% CI: 93.5-98.2).ConclusionRegardless of the real-time PCR assay used, it was possible to diagnose LD cases with higher sensitivity than using culture or UAT. These data encourage the adoption of PCR as routine laboratory testing to diagnose LD and such methods should be eligible to define a confirmed LD case.
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Affiliation(s)
- Maria Luisa Ricci
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonella Grottola
- Unit of Microbiology and Virology, Polyclinic University Hospital, Modena, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Scientists with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Frascaro
- Unit of Microbiology and Virology, Polyclinic University Hospital, Modena, Italy
| | - Emanuela Pegoraro
- U.O.C. of Microbiology and Virology, Azienda Ospedaliero-Universitaria, Verona, Italy
| | - Marisa Meacci
- Unit of Microbiology and Virology, Polyclinic University Hospital, Modena, Italy
| | - Anna Fabio
- Unit of Microbiology and Virology, Polyclinic University Hospital, Modena, Italy
| | - Elena Vecchi
- Hospital Hygiene, Polyclinic University Hospital, Modena, Italy
| | - Antonietta Girolamo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Fabio Rumpianesi
- Unit of Microbiology and Virology, Polyclinic University Hospital, Modena, Italy
| | - Monica Pecorari
- Unit of Microbiology and Virology, Polyclinic University Hospital, Modena, Italy
| | - Maria Scaturro
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Borella P, Bargellini A, Marchegiano P, Vecchi E, Marchesi I. Hospital-acquired Legionella infections: an update on the procedures for controlling environmental contamination. Ann Ig 2017; 28:98-108. [PMID: 27071320 DOI: 10.7416/ai.2016.2088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The waterborne healthcare-associated infections are mainly sustained by Legionella and Pseudomonas spp. Various water factors and plumbing characteristics, and the interaction with other water microorganisms are considered to be predictive of Legionella contamination. It is therefore mandatory to organize plans of surveillance, prevention and control in order to avoid disease appearance in immunosuppressed patients, with higher risk of death. Guidelines for the prevention of Legionnaires' disease have been published, benefiting those who face this problem, but definitive standardized solutions do not exist yet. Here we describe fifteen years of activity, during which our study group gathered interesting data on the control of Legionella contamination. Water disinfection is not generally sufficient to control the risk of infection, but a complex water safety plan should be developed, including system maintenance, training of staff and implementation of a clinical surveillance system aimed at early detection of cases. Concerning the control measures, we evaluated the effectiveness of different treatments suggested to reduce Legionella spp contamination, comparing our results with the current literature data. The performance ranking was highest for the filter, followed by boilers at high temperature, monochloramine and, at a lower level, chlorine dioxide; the effectiveness of hyperchlorination was limited, and thermal shock was even more ineffective.
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Affiliation(s)
- P Borella
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - A Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - P Marchegiano
- University Hospital Policlinico of Modena, Modena, Italy
| | - E Vecchi
- University Hospital Policlinico of Modena, Modena, Italy
| | - I Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
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Pecorari M, Tamassia M, Fabio G, Nanni N, Tagliazucchi S, Della Casa Muttini E, Leporati G, La Regina A, Marchegiano P, Scaltriti S, Vecchi E, Casolari C. RIPETUTI CLUSTERS DA S. MARCESCENS IN UN REPARTO DI TERAPIA INTENSIVA NEONATALE: ASPETTI MICROBIOLOGICI E CLINICO-EPIDEMIOLOGICI. Microbiol Med 2006. [DOI: 10.4081/mm.2006.3327] [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: 11/23/2022] Open
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13
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Pecone L, Vecchi E. REVISIONE LETTERARIA DI CASI DOCUMENTATI DI TETANO PER STIMARNE INCIDENZA E PREVALENZA DI DAL 1980 AL 2003. Microbiol Med 2004. [DOI: 10.4081/mm.2004.3888] [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: 11/22/2022] Open
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Pecone L, Vecchi E, Melchionda D, Cagarelli R, Errani F, Nacci G, Ferrari A, Lambertini A. LIVELLI DI S-TETANO IgG IN SOGGETTI CHE ESEGUONO LA VACCINAZIONE ANTITETANICA. Microbiol Med 2004. [DOI: 10.4081/mm.2004.3889] [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: 11/22/2022] Open
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Vecchi E, Pecone L, Marchegiano P. VACCINAZIONE ANTIINFLUENZALE 2003/04 NEI SERVIZI DI DIAGNOSTICA DI LABORATORIO DELL’AO POLICLINICO DI MODENA. Microbiol Med 2004. [DOI: 10.4081/mm.2004.4030] [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: 11/23/2022] Open
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16
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Vecchi E, Righi E, Cavazzuti L, Bicocchi M, Aggazzotti G. [Analysis of a complex health division at the Modena General Hospital by means of DRG indicators]. Ig Sanita Pubbl 2003; 59:277-87. [PMID: 14981549] [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: 04/29/2023]
Abstract
The authors have assessed the activity of a complex division (three wards) at the Modena General Hospital. The parameters used were DRG indicators: Case-Mix Index; Performance Index and Resources Index. It is a in-house hospital analysis, since the benchmark is based on the three units average figures. The analysis covers 1479 patients hospitalized during the first 6 months of the year 2000. The authors have taken into account overall DGRs, surgical DGRs and recurrent DGRs. Making allowance for the limits of such comparison, the study shows some differences as regards efficiency and cost-curbing policies, with the surgical unit having the largest and most diversified number of cases.
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Affiliation(s)
- Elena Vecchi
- Scuola di Specializzazione in Igiene e Medicina Preventiva, Dipartimento di Scienze Igienistiche, Microbiologiche e Biostatistiche, Università di Modena e Reggio Emilia
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Pecone L, Vecchi E, Righi E. RASSEGNA DI EPISODI DI GASTROENTERITI ACUTE DA NORWALK LIKE VIRUS. Microbiol Med 2003. [DOI: 10.4081/mm.2003.4380] [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: 11/23/2022] Open
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18
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Vecchi E, Pecone L, Righi E. VALUTAZIONE EPIDEMIOLOGICA DI UNA EPIDEMIA DI GASTROENTERITE DA NORWALK LIKE VIRUS. Microbiol Med 2003. [DOI: 10.4081/mm.2003.4387] [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: 11/23/2022] Open
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Leprini A, Gherzi R, Vecchi E, Borsi L, Zardi L, Siri A. Rat tenascin-R gene: structure, chromosome location and transcriptional activity of promoter and exon 1. Cytogenet Cell Genet 2000; 83:115-23. [PMID: 9925948 DOI: 10.1159/000015146] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Tenascin-R is an extracellular matrix protein expressed exclusively in the central nervous system where it is thought to play a relevant role in regulating neurite outgrowth. We have i) cloned the cDNA of the rat tenascin-R 5' region; ii) defined its genomic organization, obtaining the sequence of two novel untranslated exons; iii) mapped the gene to rat chromosome 13q23 and suggested a previously unreported synteny between rat chromosome 13q23, human chromosome 1q24, and mouse chromosome 4E; and iv) sequenced and characterized the elements responsible for its neural cell-restricted transcription. We found that two discrete regions of the rat gene (the first in the proximal promoter, the second in the first exon) are independently able to activate to a high degree the transcription of a reporter gene in either human or rat neuroblastoma cell lines but not in other cell lines. Based on this observation, we re-evaluated the arrangement of transcriptionally active regions in the human tenascin-R gene we recently cloned and found that the human gene also contains an exon sequence able to initiate and sustain transcription independently of promoter sequences.
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Affiliation(s)
- A Leprini
- Cell Biology Laboratory, Istituto Nazionale per la Ricerca sul Cancro (IST)/Advanced Biotechnology Center (CBA), Genoa (Italy).
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Bonarelli S, Vecchi E, Altimari G, Bellocchio A. [Axillary block of the brachial plexus. The needle angle: a different methodological approach]. Minerva Anestesiol 1986; 52:405-9. [PMID: 3574710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Di Maio G, Portalone G, Spagna R, Vecchi E, Zeuli E. The molecular structure of trans 3,6-dimethyl-6-phenyltetrahydro-2-pyrone in the crystal. Z KRIST-CRYST MATER 1986. [DOI: 10.1524/zkri.1986.175.14.131] [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: 11/24/2022]
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Di Maio G, Vecchi E, Zeuu E, Delfini M. δ Lactones from δ-ketoesters-II. Tetrahedron 1984. [DOI: 10.1016/s0040-4020(01)91103-2] [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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Di Maio D, Vecchi E, Zeuli E. Alkylation of δ-ketoesters : a mechanism change depending on conformational mobility and substituent effects on stereoselection. Tetrahedron Lett 1982. [DOI: 10.1016/s0040-4039(00)85800-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Antonelli A, Cazzavillan A, Gaini R, Grandori F, Oldini C, Vecchi E. Some effects of the stimulus repetition rate on N1 and N2 in transtympanic and surface recordings. Scand Audiol 1981; 10:13-9. [PMID: 7209368 DOI: 10.3109/01050398109076157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The early auditory evoked electrical activity has been recorded in man at the promontory (transtympanic approach) and on the scalp vertex-mastoid derivation), in response to clicks delivered at different rates. Latency and amplitude of the first two peaks (N1 and N2), as a function of the repetition rate, have been measured and compared. The differences between the latencies of transtympanic and surface N1 are very small, at any rate, with a maximum value of 0.08 msec. In the transtympanic recording, the latency difference between N2 and N1 is constant throughout the whole range of rate values, from 3 to 100 clicks per second. In the surface responses, on the contrary, the latency difference between N2 and N1 tends to increase as the rate is increased. The amplitude of the transtympanic N2 is consistently reduced at click rates above 20-50 per second (more markedly than the amplitude of N1), while the amplitude of the surface N2 is much more insensitive to the rate increase. Some implications of these results are discussed with respect to the origin of N2 in the two recording conditions.
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Ambrogi V, Artini D, De Carneri I, Castellino S, Dradi E, Logemann W, Meinardi G, Di Somma M, Tosolini G, Vecchi E. Studies on the antibacterial and antifungal properties of 1, 4-naphthoquinones. Br J Pharmacol 1970; 40:871-80. [PMID: 4992959 PMCID: PMC1702923 DOI: 10.1111/j.1476-5381.1970.tb10662.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
1. New halogenated 1,4-naphthoquinones were synthesized and together with other known 1,4-naphthoquinones, were screened for antibacterial activity by a turbidimetric method, and for antifungal activity by the diffusion method on agar plates.2. The half-wave potentials and the influence on the oxidative phosphorylation of some of these compounds were determined.3. 2-chloro-3,2'-chloro-ethyl-1,4-naphthoquinone (half-wave potential=-187 mV) was the most active compound, completely inhibiting cell respiration.4. While the natural active naphthoquinones, vitamin K and ubiquinones, possess, as substituent, the electron repelling methyl group, the microbiologically active 1,4-naphthoquinones are substituted, in the quinone moiety, with electron attracting groups such as OH or Cl.5. The half-wave potentials can give only an initial indication of the activity of the compounds studied; a good correlation, on the contrary, can be found between the ultraviolet spectra of such compounds and their activity which seems to depend on the ability of active compounds to exist in an extensively conjugated structure and to form hydrogen bonds.
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