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Oliva A, Liguori L, Covino S, Petrucci F, Cogliati-Dezza F, Curtolo A, Savelloni G, Comi M, Sacco F, Ceccarelli G, Viscido A, Alessandri F, Raponi G, Pugliese F, Mastroianni CM, Venditti M. Clinical effectiveness of cefiderocol for the treatment of bloodstream infections due to carbapenem-resistant Acinetobacter baumannii during the COVID-19 era: a single center, observational study. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04833-8. [PMID: 38634975 DOI: 10.1007/s10096-024-04833-8] [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: 09/08/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND We assessed the clinical effectiveness of cefiderocol (CFDC) in comparison with colistin (COL) for the treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections (BSI). MATERIALS/METHODS Retrospective cohort study including adults with CRAB-BSI. Outcomes were mortality, clinical cure and adverse events during therapy. The average treatment effect of CFDC compared to COL was weighted with the inverse-probability treatment weight (IPTW). RESULTS Overall, 104 patients were included (50 CFDC, 54 COL), median age 66.5 years, median Charlson Comorbidity Index 5, septic shock in 33.6% of patients. Primary BSI accounted for 43.3% of cases, followed by ventilator-associated pneumonia (VAP) (26%), catheter-related BSI (20.2%) and hospital-acquired pneumonia (HAP) (9.6%). Although not significantly, mortality at all time points was lower for CFDC than COL, while clinical cure was higher in CFDC than COL (66% vs. 44.4%, p = 0.027). Adverse events were more frequent in COL than CFDC-group (38.8% vs. 10%, p < 0.0001), primarily attributed to acute kidney injury (AKI) in the COL group. Patients with bacteremic HAP/VAP treated with CFDC had a significant lower 30-d mortality and higher clinical cure than COL (p = 0.008 and p = 0.0008, respectively). Increment of CCI (p = 0.005), ICU (p = 0.025), SARS-CoV2 (p = 0.006) and ECMO (p < 0.0001) were independently associated with 30-d mortality, while receiving CFDC was not associated with survival. CONCLUSIONS CFDC could represent an effective and safe treatment option for CRAB BSI, especially in patients with bacteremic HAP/VAP and frail patients where the risk of acute renal failure during therapy should be avoided.
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Affiliation(s)
- Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy.
| | - L Liguori
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - S Covino
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - F Petrucci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - F Cogliati-Dezza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - A Curtolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - G Savelloni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - M Comi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - F Sacco
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - G Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - A Viscido
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - F Alessandri
- Department of General and Specialistic Surgery, Sapienza University of Rome, Rome, Italy
| | - G Raponi
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - F Pugliese
- Department of General and Specialistic Surgery, Sapienza University of Rome, Rome, Italy
| | - C M Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy
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2
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Princiotto S, Casciaro B, G Temprano A, Musso L, Sacchi F, Loffredo MR, Cappiello F, Sacco F, Raponi G, Fernandez VP, Iucci T, Mangoni ML, Mori M, Dallavalle S, Pisano C. The antimicrobial potential of adarotene derivatives against Staphylococcus aureus strains. Bioorg Chem 2024; 145:107227. [PMID: 38387400 DOI: 10.1016/j.bioorg.2024.107227] [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] [Received: 12/22/2023] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024]
Abstract
Multidrug-resistant (MDR) pathogens are severely impacting our ability to successfully treat common infections. Here we report the synthesis of a panel of adarotene-related retinoids showing potent antimicrobial activity on Staphylococcus aureus strains (including multidrug-resistant ones). Fluorescence and molecular dynamic studies confirmed that the adarotene analogues were able to induce conformational changes and disfunctions to the cell membrane, perturbing the permeability of the phospholipid bilayer. Since the major obstacle for developing retinoids is their potential cytotoxicity, a selected candidate was further investigated to evaluate its activity on a panel of human cell lines. The compound was found to be well tolerated, with IC50 5-15-fold higher than the MIC on S. aureus strains. Furthermore, the adarotene analogue had a good pharmacokinetic profile, reaching a plasma concentration of about 6 μM after 0.5 h after administration (150 mg/kg), at least twice the MIC observed against various bacterial strains. Moreover, it was demonstrated that the compound potentiated the growth-inhibitory effect of the poorly bioavailable rifaximin, when used in combination. Overall, the collected data pave the way for the development of synthetic retinoids as potential therapeutics for hard-to-treat infectious diseases caused by antibiotic-resistant Gram-positive pathogens.
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Affiliation(s)
- Salvatore Princiotto
- Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, via Celoria 2, 20133 Milano, Italy
| | - Bruno Casciaro
- Laboratory affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Department of Biochemical Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Alvaro G Temprano
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; Experimental Hepatology and Drug Targeting (HEVEPHARM) Group, Biomedical Research Institute of Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain
| | - Loana Musso
- Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, via Celoria 2, 20133 Milano, Italy
| | - Francesca Sacchi
- Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, via Celoria 2, 20133 Milano, Italy
| | - Maria Rosa Loffredo
- Laboratory affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Department of Biochemical Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Floriana Cappiello
- Laboratory affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Department of Biochemical Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Federica Sacco
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | | | | | - Maria Luisa Mangoni
- Laboratory affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, Department of Biochemical Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Mattia Mori
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy
| | - Sabrina Dallavalle
- Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, via Celoria 2, 20133 Milano, Italy.
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3
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Volpicelli L, Cairoli S, Al Ismail D, Baisi F, Sacco F, Goffredo BM, Venditti M, Oliva A. Simultaneous post-neurosurgical ventriculitis and bacteraemia by two different strains of KPC-producing K. pneumoniae successfully treated with meropenem/vaborbactam and high dose of fosfomycin. J Glob Antimicrob Resist 2024; 37:86-90. [PMID: 38519025 DOI: 10.1016/j.jgar.2024.03.003] [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: 09/25/2023] [Revised: 01/10/2024] [Accepted: 03/09/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVE A case of post-neurosurgical ventriculitis caused by a KPC-producing Klebsiella pneumoniae (KPC-Kp) with a ceftazidime/avibactam-resistant, meropenem-susceptible phenotype is reported. METHODS AND RESULTS The patient had a concomitant bloodstream infection with a wild-type KPC-Kp with a ceftazidime/avibactam-susceptible, meropenem-resistant phenotype. Prolonged treatment with intravenous fosfomycin and meropenem/vaborbactam achieved clinical success. Therapeutic drug monitoring performed during the first days of treatment showed for the first time that vaborbactam efficiently penetrates cerebrospinal fluid. In contrast, meropenem was undetectable in cerebrospinal fluid at each sampling, suggesting that additional doses of meropenem may be required to appropriately prescribe meropenem/vaborbactam for central nervous system infections. Plasma and cerebrospinal fluid levels of fosfomycin were adequate, confirming the potential of this agent possibly even in the fight against multidrug-resistant organisms. CONCLUSIONS This case highlights the need for therapeutic drug monitoring as a crucial tool for optimizing treatment in complicated cases where the pharmacokinetic behaviour of antibiotics is difficult to predict.
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Affiliation(s)
- Lorenzo Volpicelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Sara Cairoli
- Division of Metabolic Diseases and Drug Biology, Department of Pediatric Specialties and Liver-Kidney Transplantation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Dania Al Ismail
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Floriana Baisi
- Department of General and Specialistic Surgery, Sapienza University of Rome, Rome, Italy
| | - Federica Sacco
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Bianca Maria Goffredo
- Division of Metabolic Diseases and Drug Biology, Department of Pediatric Specialties and Liver-Kidney Transplantation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
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Rando E, Salvati F, Sangiorgi F, Catania F, Leone E, Oliva A, Di Gennaro F, Fiori B, Cancelli F, Figliomeni S, Bobbio F, Sacco F, Bavaro DF, Diella L, Belati A, Saracino A, Mastroianni CM, Fantoni M, Murri R. Association of piperacillin/tazobactam MIC and mortality in a cohort of ceftriaxone-resistant Escherichia coli bloodstream infections treated with piperacillin/tazobactam and carbapenems: a multicentric propensity score-weighted observational cohort study. J Antimicrob Chemother 2024; 79:453-461. [PMID: 38169441 PMCID: PMC10832597 DOI: 10.1093/jac/dkad404] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES To assess the impact of piperacillin/tazobactam MICs on in-hospital 30 day mortality in patients with third-generation cephalosporin-resistant Escherichia coli bloodstream infection treated with piperacillin/tazobactam, compared with those treated with carbapenems. METHODS A multicentre retrospective cohort study was conducted in three large academic hospitals in Italy between 2018 and 2022. The study population comprised patients with monomicrobial third-generation cephalosporin-resistant E. coli bloodstream infection, who received either piperacillin/tazobactam or carbapenem therapy within 48 h of blood culture collection. The primary outcome was in-hospital 30 day all-cause mortality. A propensity score was used to estimate the likelihood of receiving empirical piperacillin/tazobactam treatment. Cox regression models were performed to ascertain risk factors independently associated with in-hospital 30 day mortality. RESULTS Of the 412 consecutive patients included in the study, 51% received empirical therapy with piperacillin/tazobactam, while 49% received carbapenem therapy. In the propensity-adjusted multiple Cox model, the Pitt bacteraemia score [HR 1.38 (95% CI, 0.85-2.16)] and piperacillin/tazobactam MICs of 8 mg/L [HR 2.35 (95% CI, 1.35-3.95)] and ≥16 mg/L [HR 3.69 (95% CI, 1.86-6.91)] were significantly associated with increased in-hospital 30 day mortality, while the empirical use of piperacillin/tazobactam was not found to predict in-hospital 30 day mortality [HR 1.38 (95% CI, 0.85-2.16)]. CONCLUSIONS Piperacillin/tazobactam use might not be associated with increased mortality in treating third-generation cephalosporin-resistant E. coli bloodstream infections when the MIC is <8 mg/L.
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Affiliation(s)
- Emanuele Rando
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federica Salvati
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Flavio Sangiorgi
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Catania
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elisa Leone
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Francesco Di Gennaro
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Unit of Infectious Diseases, University of Bari ‘A. Moro’, Polyclinic Hospital, Bari, Italy
| | - Barbara Fiori
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Cancelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Sara Figliomeni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Francesca Bobbio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Federica Sacco
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Davide Fiore Bavaro
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Unit of Infectious Diseases, University of Bari ‘A. Moro’, Polyclinic Hospital, Bari, Italy
| | - Lucia Diella
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Unit of Infectious Diseases, University of Bari ‘A. Moro’, Polyclinic Hospital, Bari, Italy
| | - Alessandra Belati
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Unit of Infectious Diseases, University of Bari ‘A. Moro’, Polyclinic Hospital, Bari, Italy
| | - Annalisa Saracino
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Unit of Infectious Diseases, University of Bari ‘A. Moro’, Polyclinic Hospital, Bari, Italy
| | | | - Massimo Fantoni
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Rita Murri
- Dipartimento di Sicurezza e Bioetica—Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
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Arcari G, Cecilia F, Oliva A, Polani R, Raponi G, Sacco F, De Francesco A, Pugliese F, Carattoli A. Genotypic Evolution of Klebsiella pneumoniae Sequence Type 512 during Ceftazidime/Avibactam, Meropenem/Vaborbactam, and Cefiderocol Treatment, Italy. Emerg Infect Dis 2023; 29:2266-2274. [PMID: 37877547 PMCID: PMC10617348 DOI: 10.3201/eid2911.230921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
In February 2022, a critically ill patient colonized with a carbapenem-resistant K. pneumoniae producing KPC-3 and VIM-1 carbapenemases was hospitalized for SARS-CoV-2 in the intensive care unit of Policlinico Umberto I hospital in Rome, Italy. During 95 days of hospitalization, ceftazidime/avibactam, meropenem/vaborbactam, and cefiderocol were administered consecutively to treat 3 respiratory tract infections sustained by different bacterial agents. Those therapies altered the resistome of K. pneumoniae sequence type 512 colonizing or infecting the patient during the hospitalization period. In vivo evolution of the K. pneumoniae sequence type 512 resistome occurred through plasmid loss, outer membrane porin alteration, and a nonsense mutation in the cirA siderophore gene, resulting in high levels of cefiderocol resistance. Cross-selection can occur between K. pneumoniae and treatments prescribed for other infective agents. K. pneumoniae can stably colonize a patient, and antimicrobial-selective pressure can promote progressive K. pneumoniae resistome evolution, indicating a substantial public health threat.
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Fortini D, García-Fernández A, Lucarelli C, Dionisi AM, Arena S, Owczarek S, Equestre M, Carattoli A, Sacco F, Rossi S, Ortenzi R, Primavilla S, Villa L. Isolation and Characterisation of Human-Derived blaKPC-3-Producing Salmonella enterica Serovar Rissen in 2018. Antibiotics (Basel) 2023; 12:1377. [PMID: 37760674 PMCID: PMC10525129 DOI: 10.3390/antibiotics12091377] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
In this study, we describe a Salmonella enterica serovar (S.) Rissen strain with a reduced susceptibility to meropenem, isolated from a urinary infection in an 89-year-old woman in 2018 during activity surveillance in Italy (Enter-Net Italia). The genomic characteristics, pathogenicity, and antimicrobial resistance mechanisms were investigated via a genomic approach. Antimicrobial susceptibility testing revealed a "susceptible, increased exposure" phenotype to meropenem in the S. Rissen strain (4_29_19). Whole-genome sequencing (WGS) was performed using both the NovaSeq 6000 S4 PE150 XP platform (Illumina, San Diego, CA, USA) and MinION (Oxford Nanopore). The S. Rissen 4_29_19 strain harboured two plasmids: a pKpQIL-like plasmid carrying the blaKPC-3 resistance gene in a Tn4401a transposon (pKPC_4_29_19), and a ColE-like plasmid (p4_4_29_19) without resistance genes, highly prevalent among Enterobacterales. Comparative analysis revealed that the pKPC_4_29_19 plasmid was highly related to the pKpQIL reference plasmid (GU595196), with 57% coverage and 99.96% identity, but lacking a region of about 30 kb, involving the FIIK2 replicon region and the entire transfer locus, causing the loss of its ability to conjugate. To our knowledge, this is the first time that a pKpQIL-like plasmid, carrying blaKPC-3, highly diffused in Klebsiella pneumoniae strains, has been identified in a Salmonella strain in our country. The acquisition of blaKPC genes by Salmonella spp. is extremely rare, and is reported only sporadically. In zoonotic bacteria isolated from humans, the presence of a carbapenem resistance gene carried by mobile genetic elements, usually described in healthcare-associated infection bacteria, represents an important concern for public health.
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Affiliation(s)
- Daniela Fortini
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (D.F.); (A.G.-F.); (C.L.); (A.M.D.); (S.A.); (S.O.)
| | - Aurora García-Fernández
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (D.F.); (A.G.-F.); (C.L.); (A.M.D.); (S.A.); (S.O.)
| | - Claudia Lucarelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (D.F.); (A.G.-F.); (C.L.); (A.M.D.); (S.A.); (S.O.)
| | - Anna Maria Dionisi
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (D.F.); (A.G.-F.); (C.L.); (A.M.D.); (S.A.); (S.O.)
| | - Sergio Arena
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (D.F.); (A.G.-F.); (C.L.); (A.M.D.); (S.A.); (S.O.)
| | - Slawomir Owczarek
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (D.F.); (A.G.-F.); (C.L.); (A.M.D.); (S.A.); (S.O.)
| | - Michele Equestre
- Department of Neurosciences, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Alessandra Carattoli
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.C.); (F.S.)
| | - Federica Sacco
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.C.); (F.S.)
| | - Stefano Rossi
- Hospital Castiglione del Lago, USL Umbria n.1, 06061 Perugia, Italy;
| | - Roberta Ortenzi
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “T. Rosati”, 06126 Perugia, Italy; (R.O.); (S.P.)
| | - Sara Primavilla
- Istituto Zooprofilattico Sperimentale dell’Umbria e delle Marche “T. Rosati”, 06126 Perugia, Italy; (R.O.); (S.P.)
| | - Laura Villa
- Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy; (D.F.); (A.G.-F.); (C.L.); (A.M.D.); (S.A.); (S.O.)
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7
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Arcari G, Polani R, Santilli S, Capitani V, Sacco F, Bruno F, Garcia-Fernandez A, Raponi G, Villa L, Gentile G, Carattoli A. Multiplicity of blaKPC Genes and pKpQIL Plasmid Plasticity in the Development of Ceftazidime-Avibactam and Meropenem Coresistance in Klebsiella pneumoniae Sequence Type 307. Antimicrob Agents Chemother 2023; 67:e0036823. [PMID: 37428086 PMCID: PMC10433805 DOI: 10.1128/aac.00368-23] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/14/2023] [Indexed: 07/11/2023] Open
Abstract
In 2021, Klebsiella pneumoniae sequence type 307 (ST307) strains causing pulmonary and bloodstream infections identified in a hospital in Rome, Italy, reached high levels of resistance to ceftazidime-avibactam (CZA). One of these strains reached high levels of resistance to both CZA and carbapenems and carried two copies of blaKPC-3 and one copy of blaKPC-31 located on plasmid pKpQIL. The genomes and plasmids of CZA-resistant ST307 strains were analyzed to identify the molecular mechanisms leading to the evolution of resistance and compared with ST307 genomes at local and global levels. A complex pattern of multiple plasmids in rearranged configurations, coresident within the CZA-carbapenem-resistant K. pneumoniae strain, was observed. Characterization of these plasmids revealed recombination and segregation events explaining why K. pneumoniae isolates from the same patient had different antibiotic resistance profiles. This study illustrates the intense genetic plasticity occurring in ST307, one of the most worldwide-diffused K. pneumoniae high-risk clones.
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Affiliation(s)
- Gabriele Arcari
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Riccardo Polani
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Stefania Santilli
- Complex Operating Unit of Microbiology and Virology, Policlinico Umberto I, Rome, Italy
| | - Valerio Capitani
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Federica Sacco
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
- Complex Operating Unit of Microbiology and Virology, Policlinico Umberto I, Rome, Italy
| | - Francesco Bruno
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Giammarco Raponi
- Complex Operating Unit of Microbiology and Virology, Policlinico Umberto I, Rome, Italy
- Department of Public Health, Sapienza University of Rome, Rome, Italy
| | - Laura Villa
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Giuseppe Gentile
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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8
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Cogliati Dezza F, Covino S, Petrucci F, Sacco F, Viscido A, Gavaruzzi F, Ceccarelli G, Raponi G, Borrazzo C, Alessandri F, Mastroianni CM, Venditti M, Oliva A. Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization. JAC Antimicrob Resist 2023; 5:dlad096. [PMID: 37577156 PMCID: PMC10412853 DOI: 10.1093/jacamr/dlad096] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/21/2023] [Indexed: 08/15/2023] Open
Abstract
Background Among MDR bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) is a major concern due to the limited therapeutic options. During the COVID-19 pandemic, a worrying increase in the spread of CRAB infections was reported. Objectives The study assessed the risk factors for CRAB bloodstream infection (BSI) in patients admitted to the ICU with CRAB colonization, and the related mortality risk factors. Methods We conducted a single-centre, observational, prospective study; all consecutive patients with CRAB colonization admitted to the ICU of a tertiary hospital in Rome from January 2021 to September 2022 were included in the study. Univariate and multivariate analyses were performed to investigate BSI and mortality risk factors. Results Overall, 129 patients were included in the study; 57 (44%) out of these developed BSI. In our study population, at the multivariable analysis the Charlson comorbidity index (CCI) (P = 0.026), COVID-19 (P < 0.001), multisite colonization (P = 0.016) and the need for mechanical ventilation (P = 0.024) were risk factors independently associated with BSI development. Furthermore, age (P = 0.026), CCI (P < 0.001), septic shock (P = 0.001) and Pitt score (P < 0.001) were independently associated with mortality in the BSI patients. Instead, early appropriate therapy (P = 0.002) and clinical improvement within 72 h (P = 0.011) were shown to be protective factors. Conclusions In critically ill patients colonized by CRAB, higher CCI, multisite colonization and the need for mechanical ventilation were identified as risk factors for BSI onset. These predictors could be useful to identify patients at highest risk of BSI.
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Affiliation(s)
| | - Sara Covino
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Flavia Petrucci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Federica Sacco
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Agnese Viscido
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesca Gavaruzzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Gianmarco Raponi
- Microbiology and Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Cristian Borrazzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Francesco Alessandri
- Department of General and Specialistic Surgery, Sapienza University of Rome, Rome, Italy
| | | | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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9
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Capitani V, Arcari G, Oliva A, Sacco F, Menichincheri G, Fenske L, Polani R, Raponi G, Antonelli G, Carattoli A. Genome-Based Retrospective Analysis of a Providencia stuartii Outbreak in Rome, Italy: Broad Spectrum IncC Plasmids Spread the NDM Carbapenemase within the Hospital. Antibiotics (Basel) 2023; 12:antibiotics12050943. [PMID: 37237846 DOI: 10.3390/antibiotics12050943] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Providencia stuartii is a member of the Morganellaceae family, notorious for its intrinsic resistance to several antibiotics, including last-resort drugs such as colistin and tigecycline. Between February and March 2022, a four-patient outbreak sustained by P. stuartii occurred in a hospital in Rome. Phenotypic analyses defined these strains as eXtensively Drug-Resistant (XDR). Whole-genome sequencing was performed on the representative P. stuartii strains and resulted in fully closed genomes and plasmids. The genomes were highly related phylogenetically and encoded various virulence factors, including fimbrial clusters. The XDR phenotype was primarily driven by the presence of the blaNDM-1 metallo-β-lactamase alongside the rmtC 16S rRNA methyltransferase, conferring resistance to most β-lactams and every aminoglycoside, respectively. These genes were found on an IncC plasmid that was highly related to an NDM-IncC plasmid retrieved from a ST15 Klebsiella pneumoniae strain circulating in the same hospital two years earlier. Given its ability to acquire resistance plasmids and its intrinsic resistance mechanisms, P. stuartii is a formidable pathogen. The emergence of XDR P. stuartii strains poses a significant public health threat. It is essential to monitor the spread of these strains and develop new strategies for their control and treatment.
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Affiliation(s)
- Valerio Capitani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Gabriele Arcari
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Federica Sacco
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Gaia Menichincheri
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Linda Fenske
- Bioinformatics and Systems Biology, Justus-Liebig-University Giessen, 35390 Giessen, Germany
| | - Riccardo Polani
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Guido Antonelli
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Alessandra Carattoli
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
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10
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Oliva A, Al Ismail D, Arcari G, Miele MC, Casali E, Sacco F, Volpicelli L, De Angelis M, Mascellino MT, Cancelli F, Raponi G, Carattoli A, Venditti M. Ceftazidime/avibactam-resistant meropenem-susceptible KPC-producing Klebsiella pneumoniae: analysis of cases and evaluation of in-vitro activity of fosfomycin-containing combinations. J Glob Antimicrob Resist 2023:S2213-7165(23)00058-9. [PMID: 37086891 DOI: 10.1016/j.jgar.2023.03.012] [Citation(s) in RCA: 2] [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: 01/12/2023] [Revised: 03/18/2023] [Accepted: 03/26/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Little is known regarding outcomes and optimal therapeutic regimens of infections caused by KPC-producing Klebsiella pneumoniae (KPC-Kp) resistant to ceftazidime/avibactam (CZA) and susceptible to meropenem (MEM). Although in-vitro susceptible to MEM, the possibility of developing MEM resistance overtime is a concern. We described the clinical characteristics of patients with colonization/infection due to KPC-variant with a focus on the in-vitro activity of fosfomycin (FOS)-containing combinations. MATERIALS/METHODS Patients with colonization/infection due to KPC-variant were included. FOS susceptibility was performed by agar dilution method. Synergistic activity of FOS-based combinations was evaluated by gradient strip-agar diffusion method. The emergence of in-vitro MEM resistance was also tested. RESULTS Eleven patients were included, 8 with infection [4 ventilator-associated pneumonia, 4 bloodstream infections], 3 with colonization. A previous therapy with CZA was administered to all the patients (mean cumulative duration 23 days). All subjects with infection received meropenem, in monotherapy (n=4) or with amikacin (n=2) or fosfomycin (n=2) and achieved clinical cure. A new CZA-susceptible and MEM-resistant KPC-Kp strain was subsequently isolated in 3 patients (27.3%). Meropenem/vaborbactam (MVB) showed high in-vitro activity, while FOS+MEM combination was synergistic in 40% of cases. In-vitro resistance to MEM was observed, with maintenance of CZA resistance. DISCUSSION Detection of KPC-variant may occur within the same patient, especially if CZA has been previously administered. Although clinical success has been obtained with carbapenems, the emergence of MEM resistance is a concern. Fosfomycin plus meropenem is synergistic and may represent a valuable combination option for KPC-variant, while MVB may be considered in monotherapy. IMPORTANCE The detection of KPC-variants in an endemic setting for KPC-Kp represents a worryingly emerging condition. The optimal therapeutic approach is still unknown and the development of meropenem resistance is a concern, which may finally lead to a therapeutic failure in the clinical practice. In these cases, the addition of fosfomycin to meropenem or a more potent antibiotic such as meropenem/vaborbactam may represent valuable therapeutic options.
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Affiliation(s)
- A Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
| | - D Al Ismail
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G Arcari
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - M C Miele
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - E Casali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - F Sacco
- Microbiology and Virology Unit, University Hospital Policlinico Umberto I, Rome, Italy
| | - L Volpicelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - M De Angelis
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - M T Mascellino
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - F Cancelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; Microbiology and Virology Unit, University Hospital Policlinico Umberto I, Rome, Italy
| | - A Carattoli
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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11
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Arcari G, Polani R, Bruno F, Capitani V, Sacco F, Menichincheri G, Raponi G, Carattoli A. Ceftazidime-avibactam resistance in Klebsiella pneumoniae sequence type 37: a decade of persistence and concealed evolution. Microb Genom 2023; 9:mgen000931. [PMID: 36752778 PMCID: PMC9997735 DOI: 10.1099/mgen.0.000931] [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] [Indexed: 02/09/2023] Open
Abstract
The first reports of carbapenem-resistant Enterobacterales in our hospital date back to 2006. In that period, few ertapenem-resistant but meropenem-susceptible Klebsiella pneumoniae isolates belonging to sequence type (ST) 37 were retrieved from clinical samples. These strains produced the CTX-M-15 extended spectrum β-lactamase, OmpK35 was depleted due to a nonsense mutation, and a novel OmpK36 variant was identified. Yet, starting from 2010, Klebsiella pneumoniae carbapenemase (KPC)-producing ST512 isolates started prevailing and ST37 vanished from sight. Since 2018 the clinical use of the combination of ceftazidime-avibactam (CZA) has been introduced in clinical practice for the treatment of bacteria producing serine-β-lactamases, but KPC-producing, CZA-resistant K. pneumoniae are emerging. In 2021, four CZA-resistant ST37 isolates producing KPC variants were isolated from the same number of patients. blaKPC gene cloning in Escherichia coli was used to define the role of those KPC variants on CZA resistance, and whole genome sequencing was performed on these isolates and on three ST37 historical isolates from 2011. CZA resistance was due to mutations in the blaKPC genes carried on related pKpQIL-type plasmids, and three variants of the KPC enzyme have been identified in the four ST37 strains. The four ST37 isolates were closely related to each other and to the historical isolates, suggesting that ST37 survived without notice in our hospital for 10 years, waiting to re-emerge as a CZA-resistant K. pneumoniae clone. The ancestor of these contemporary isolates derives from ST37 wild-type porin strains, with no other mutations in chromosomal genes involved in conferring antibiotic resistance (parC, gyrA, ramR, mgrB, pmrB).
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Affiliation(s)
- Gabriele Arcari
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Riccardo Polani
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Bruno
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Valerio Capitani
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Federica Sacco
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Gaia Menichincheri
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giammarco Raponi
- Department of Public Health, Sapienza University of Rome, Rome, Italy
| | - Alessandra Carattoli
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Laboratory affiliated to Istituto Pasteur Italia - Fondazione Cenci Bolognetti, Italy
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12
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Gonzalez-Martin P, Sacco F, Butakoff C, Doste R, Bederian C, Gutierrez Espinosa de los Monteros LK, Houzeaux G, Iaizzo PA, Iles TL, Vazquez M, Aguado-Sierra J. Ventricular anatomical complexity and sex differences impact predictions from electrophysiological computational models. PLoS One 2023; 18:e0263639. [PMID: 36780442 PMCID: PMC9925004 DOI: 10.1371/journal.pone.0263639] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 10/07/2022] [Indexed: 02/15/2023] Open
Abstract
The aim of this work was to analyze the influence of sex hormones and anatomical details (trabeculations and false tendons) on the electrophysiology of healthy human hearts. Additionally, sex- and anatomy-dependent effects of ventricular tachycardia (VT) inducibility are presented. To this end, four anatomically normal, human, biventricular geometries (two male, two female), with identifiable trabeculations, were obtained from high-resolution, ex-vivo MRI and represented by detailed and smoothed geometrical models (with and without the trabeculations). Additionally one model was augmented by a scar. The electrophysiology finite element model (FEM) simulations were carried out, using O'Hara-Rudy human myocyte model with sex phenotypes of Yang and Clancy. A systematic comparison between detailed vs smooth anatomies, male vs female normal hearts was carried out. The heart with a myocardial infarction was subjected to a programmed stimulus protocol to identify the effects of sex and anatomical detail on ventricular tachycardia inducibility. All female hearts presented QT-interval prolongation however the prolongation interval in comparison to the male phenotypes was anatomy-dependent and was not correlated to the size of the heart. Detailed geometries showed QRS fractionation and increased T-wave magnitude in comparison to the corresponding smoothed geometries. A variety of sustained VTs were obtained in the detailed and smoothed male geometries at different pacing locations, which provide evidence of the geometry-dependent differences regarding the prediction of the locations of reentry channels. In the female phenotype, sustained VTs were induced in both detailed and smooth geometries with RV apex pacing, however no consistent reentry channels were identified. Anatomical and physiological cardiac features play an important role defining risk in cardiac disease. These are often excluded from cardiac electrophysiology simulations. The assumption that the cardiac endocardium is smooth may produce inaccurate predictions towards the location of reentry channels in in-silico tachycardia inducibility studies.
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Affiliation(s)
| | - Federica Sacco
- Barcelona Supercomputing Center, Barcelona, Spain
- Physense, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Ruben Doste
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Carlos Bederian
- Instituto de Física Enrique Gaviola - CONICET, Córdoba, Argentina
| | | | | | - Paul A. Iaizzo
- Visible Heart Laboratories, Department of Surgery and the Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN, United States of America
| | - Tinen L. Iles
- University of Minnesota Medical School, Minneapolis, MN, United States of America
| | - Mariano Vazquez
- Barcelona Supercomputing Center, Barcelona, Spain
- ELEM Biotech S.L., Barcelona, Spain
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13
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Sacco F, Raponi G, Oliva A, Bibbolino G, Mauro V, Lella FMD, Volpicelli L, Antonelli G, Venditti M, Carattoli A, Arcari G. An outbreak sustained by ST15 Klebsiella pneumoniae carrying 16S rRNA methyltransferases and bla NDM: evaluation of the global dissemination of these resistance determinants. Int J Antimicrob Agents 2022; 60:106615. [PMID: 35691602 DOI: 10.1016/j.ijantimicag.2022.106615] [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: 10/19/2021] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 11/05/2022]
Abstract
The spread of extremely-drug resistant Klebsiella pneumoniae has become a major health threat worldwide. This is largely mediated by certain lineages, recognized as high-risk clones dispersed in all the world. The analysis of an outbreak of nine ST15, NDM-1 metallo-β-lactamase producing K. pneumoniae was performed. An IncC plasmid carrying the blaNDM-1 gene also carried the rare rmtC gene, encoding for a 16S rRNA methyltransferases (16RMTases), conferring resistance to all aminoglycosides. We studied the global spread of NDM variants and their association with the 16RMTases among K. pneumoniae complete genomes available in GenBank, producing a complete overview of the association of 16RMTases and NDM in K. pneumoniae genomics. NDM is more and more often associated with16RMTases and both are spreading in K. pneumoniae, conferring resistance to every beta-lactam and aminoglycoside. Our analysis suggest that aminoglycosides have limited future as second line treatment against NDM-producing K. pneumoniae.
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Affiliation(s)
- Federica Sacco
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome; Microbiology and Virology Unit, University Hospital Policlinico Umberto I, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome
| | - Giulia Bibbolino
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples
| | - Vera Mauro
- Department of Public Health and Infectious Diseases, Sapienza University of Rome
| | | | - Lorenzo Volpicelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome
| | - Guido Antonelli
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome
| | | | - Gabriele Arcari
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
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14
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Dalbeni A, Villani R, Bevilacqua M, Sacco F, Faccincani D, Cattazzo F, Cavallone F, Mantovani A, Ceruti V, Ieluzzi D, Paon V, Mantovani A, Serviddio G, Sacerdoti D. Effects of direct-acting antiviral agents on lipid and glucose profile in HCV patients with type 2 diabetes: A real-life Italian experience. J Dig Dis 2022; 23:324-330. [PMID: 35700113 DOI: 10.1111/1751-2980.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Hepatitis C virus (HCV) infection is associated with an increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular diseases. The impact of HCV eradication on the metabolic profile in diabetic patients treated with direct-acting antiviral agents (DAAs) is not well defined. The aim of our study was to evaluate the effects of DAAs on a lipid and glucose profile in a cohort of diabetic patients with different liver fibrotic stages. METHODS T2DM patients with active HCV infection were consecutively enrolled in this prospective trial. Glycolipidic status was assessed, before starting DAA treatment (T0) and at 12 months after the beginning of treatment (T1). Liver fibrotic stage was assessed by FibroScan. RESULTS In all, 131 patients were enrolled and all of them achieved a sustained virologic response. At baseline, no significant differences were found in lipid and glucose profiles in subgroup analysis by liver fibrosis, HCV genotype, and cardiovascular risk factors. At T1, total cholesterol and low-density lipoprotein cholesterol, but not triglycerides, significantly increased irrespective of liver fibrotic stage and baseline anthropometric and clinical profiles, while glycated hemoglobin significantly decreased only in F4 patients. CONCLUSIONS HCV eradication in diabetic patients is associated with a worsening lipid profile that could impact future cardiovascular risk. A careful global monitoring of cardiovascular risk factors in all diabetic patients after HCV eradication is needed.
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Affiliation(s)
- Andrea Dalbeni
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.,Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Rosanna Villani
- Liver Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - Michele Bevilacqua
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Federica Sacco
- Liver Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - Diego Faccincani
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Filippo Cattazzo
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Francesco Cavallone
- Liver Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - Anna Mantovani
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Vittoria Ceruti
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Donatella Ieluzzi
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Veronica Paon
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.,Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Alessandro Mantovani
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Gaetano Serviddio
- Liver Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - David Sacerdoti
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.,Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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15
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Ranard LS, Cheng Y, Yi GH, Sacco F, Ghillani P, Righini G, Vahl TP. CARDIAC COMPUTED TOMOGRAPHY ANGIOGRAPHY PLANNING FOR PRE-CLINICAL TRANSSEPTAL MITRAL VALVE REPLACEMENT WITH THE SATURN BIOPROSTHESIS IN A PORCINE MODEL. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01876-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Arcari G, Oliva A, Sacco F, Di Lella FM, Raponi G, Tomolillo D, Curtolo A, Venditti M, Carattoli A. Interplay between Klebsiella pneumoniae producing KPC-31 and KPC-3 under treatment with high dosage meropenem: a case report. Eur J Clin Microbiol Infect Dis 2022; 41:495-500. [PMID: 34988712 PMCID: PMC8731190 DOI: 10.1007/s10096-021-04388-y] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/29/2021] [Indexed: 12/28/2022]
Abstract
The objective was to study ceftazidime-avibactam resistant and susceptible Klebsiella pneumoniae isolated from a patient admitted to the Policlinico Umberto I of Rome for SARS-CoV2. Data on the evolution of patient's conditions, antimicrobial therapies, and microbiological data were collected. Whole-genome sequencing performed by Illumina and Nanopore sequencing methods were used to type the strains. During the hospitalization, a SARS-CoV2-infected patient was colonized by a KPC-producing K. pneumoniae strain and empirically treated with ceftazidime-avibactam (CZA) when presenting spiking fever symptoms. Successively, ST2502 CZA-resistant strain producing the KPC-31 variant gave a pulmonary infection to the patient. The infection was treated with high doses of meropenem. The KPC-31-producing strain disappeared but the patient remained colonized by a KPC-3-producing K. pneumoniae strain. An interplay between highly conserved KPC-31- and KPC-3-producing ST2502 strains occurred in the SARS-CoV2 patient during the hospitalization, selected by CZA and carbapenem treatments, respectively.
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Affiliation(s)
- Gabriele Arcari
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Federica Sacco
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.,Microbiology and Virology Unit, University Hospital Policlinico Umberto I, Rome, Italy
| | | | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.,Microbiology and Virology Unit, University Hospital Policlinico Umberto I, Rome, Italy
| | - Dario Tomolillo
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Ambrogio Curtolo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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17
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Oliva A, Ceccarelli G, De Angelis M, Sacco F, Miele MC, Mastroianni CM, Venditti M. Cefiderocol for compassionate use in the treatment of complicated infections caused by extensively and pan-resistant Acinetobacter baumannii. J Glob Antimicrob Resist 2020; 23:292-296. [PMID: 33065329 DOI: 10.1016/j.jgar.2020.09.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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] [Received: 07/06/2020] [Revised: 09/11/2020] [Accepted: 09/25/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE This study presents real-life experience with cefiderocol used on a compassionate basis for treatment of three patients with severe infections caused by extensively/pan-drug resistant (XDR/PDR) Acinetobacter baumannii (Ab). METHODS Serum bactericidal activity was determined and considered as a surrogate of cefiderocol susceptibility. RESULTS Clinical improvement and microbiological eradication of A. baumannii were observed in all three patients, who were affected by extremely complex conditions either for type of infection, adverse effect or resistance profile of A. baumannii. CONCLUSION Cefiderocol for XDR/PDR-Ab infections might be reconsidered, especially in light of the recent disappointing results of the CREDIBLE-CR study.
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Affiliation(s)
- Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | | | - Federica Sacco
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Maria Claudia Miele
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Claudio M Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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18
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Arcari G, Raponi G, Sacco F, Bibbolino G, Di Lella FM, Alessandri F, Coletti M, Trancassini M, Deales A, Pugliese F, Antonelli G, Carattoli A. Klebsiella pneumoniae infections in COVID-19 patients: a 2-month retrospective analysis in an Italian hospital. Int J Antimicrob Agents 2020; 57:106245. [PMID: 33253903 PMCID: PMC7691820 DOI: 10.1016/j.ijantimicag.2020.106245] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/04/2020] [Accepted: 11/07/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Gabriele Arcari
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy
| | - Federica Sacco
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giulia Bibbolino
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | | | - Francesco Alessandri
- Sapienza University of Rome, Department of Anesthesia and Critical Care Medicine, Policlinico Umberto I, Rome, Italy
| | - Monica Coletti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy
| | - Maria Trancassini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy; Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy
| | - Alberto Deales
- Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy
| | - Francesco Pugliese
- Sapienza University of Rome, Department of Anesthesia and Critical Care Medicine, Policlinico Umberto I, Rome, Italy
| | - Guido Antonelli
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy; Sapienza University Hospital 'Policlinico Umberto I', Rome, Italy.
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19
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Pavone P, Oliva A, Raponi G, Pugliese F, Martelli S, Celli P, Sacco F, Vullo V, Mastroianni CM, Russo G. Disseminated fungal infection due to Saprochaete clavata in a kidney transplant recipient. J Mycol Med 2019; 29:278-281. [PMID: 31202517 DOI: 10.1016/j.mycmed.2019.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/24/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
Saprochaete clavata and Saprochaete capitata are closely related fungal species (family Dipodascaceae, order Saccharomycetales) that are rarely involved in the etiology of systemic infections in humans. In recent years, these yeasts are emerging as cause of life-threatening infections in patients with severe neutropenia and haematological malignancies. Infections by these fungi have been reported mostly from Mediterranean countries. To the best of our knowledge, only 2 cases of infection due to S. capitata have been reported in solid organ transplant recipients and none due to S. clavata. Herein we report a fatal case of S. clavata disseminated infection occurring in a patient with recent kidney transplantation and severe neutropenia. Patient was receiving antifungal echinocandin prophylaxis and the yeast was isolated from the blood and multiple non contiguous sites. Saprochaete spp. should be considered in the differential diagnosis of invasive mycoses in transplant recipients, especially if they are neutropenic and living or travelling in Mediterranean countries.
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Affiliation(s)
- P Pavone
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy.
| | - A Oliva
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - G Raponi
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - F Pugliese
- Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Sapienza University of Rome, Rome, Italy
| | - S Martelli
- Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Sapienza University of Rome, Rome, Italy
| | - P Celli
- Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Sapienza University of Rome, Rome, Italy
| | - F Sacco
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - V Vullo
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - C M Mastroianni
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
| | - G Russo
- Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy
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20
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Sacco F, Paun B, Lehmkuhl O, Iles TL, Iaizzo PA, Houzeaux G, Vázquez M, Butakoff C, Aguado-Sierra J. Evaluating the roles of detailed endocardial structures on right ventricular haemodynamics by means of CFD simulations. Int J Numer Method Biomed Eng 2018; 34:e3115. [PMID: 29892995 DOI: 10.1002/cnm.3115] [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] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/28/2018] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
Computational modelling plays an important role in right ventricular (RV) haemodynamic analysis. However, current approaches use smoothed ventricular anatomies. The aim of this study is to characterise RV haemodynamics including detailed endocardial structures like trabeculae, moderator band, and papillary muscles. Four paired detailed and smoothed RV endocardium models (2 male and 2 female) were reconstructed from ex vivo human hearts high-resolution magnetic resonance images. Detailed models include structures with ≥1 mm2 cross-sectional area. Haemodynamic characterisation was done by computational fluid dynamics simulations with steady and transient inflows, using high-performance computing. The differences between the flows in smoothed and detailed models were assessed using Q-criterion for vorticity quantification, the pressure drop between inlet and outlet, and the wall shear stress. Results demonstrated that detailed endocardial structures increase the degree of intra-ventricular pressure drop, decrease the wall shear stress, and disrupt the dominant vortex creating secondary small vortices. Increasingly turbulent blood flow was observed in the detailed RVs. Female RVs were less trabeculated and presented lower pressure drops than the males. In conclusion, neglecting endocardial structures in RV haemodynamic models may lead to inaccurate conclusions about the pressures, stresses, and blood flow behaviour in the cavity.
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Affiliation(s)
- Federica Sacco
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- PhySense, ETIC, Universitat Pompeu Fabra, Barcelona, Spain
| | - Bruno Paun
- PhySense, ETIC, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Tinen L Iles
- Visible Heart Laboratory, Department of Surgery, University of Minnesota, Minneapolis, USA
| | - Paul A Iaizzo
- Visible Heart Laboratory, Department of Surgery, University of Minnesota, Minneapolis, USA
| | | | - Mariano Vázquez
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- IIIA-CSIC, Bellaterra, Barcelona, Spain
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21
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Sacco F, Paun B, Lehmkuhl O, Iles TL, Iaizzo PA, Houzeaux G, Vázquez M, Butakoff C, Aguado-Sierra J. Left Ventricular Trabeculations Decrease the Wall Shear Stress and Increase the Intra-Ventricular Pressure Drop in CFD Simulations. Front Physiol 2018; 9:458. [PMID: 29760665 PMCID: PMC5936785 DOI: 10.3389/fphys.2018.00458] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 11/27/2017] [Accepted: 04/13/2018] [Indexed: 11/13/2022] Open
Abstract
The aim of the present study is to characterize the hemodynamics of left ventricular (LV) geometries to examine the impact of trabeculae and papillary muscles (PMs) on blood flow using high performance computing (HPC). Five pairs of detailed and smoothed LV endocardium models were reconstructed from high-resolution magnetic resonance images (MRI) of ex-vivo human hearts. The detailed model of one LV pair is characterized only by the PMs and few big trabeculae, to represent state of art level of endocardial detail. The other four detailed models obtained include instead endocardial structures measuring ≥1 mm2 in cross-sectional area. The geometrical characterizations were done using computational fluid dynamics (CFD) simulations with rigid walls and both constant and transient flow inputs on the detailed and smoothed models for comparison. These simulations do not represent a clinical or physiological scenario, but a characterization of the interaction of endocardial structures with blood flow. Steady flow simulations were employed to quantify the pressure drop between the inlet and the outlet of the LVs and the wall shear stress (WSS). Coherent structures were analyzed using the Q-criterion for both constant and transient flow inputs. Our results show that trabeculae and PMs increase the intra-ventricular pressure drop, reduce the WSS and disrupt the dominant single vortex, usually present in the smoothed-endocardium models, generating secondary small vortices. Given that obtaining high resolution anatomical detail is challenging in-vivo, we propose that the effect of trabeculations can be incorporated into smoothed ventricular geometries by adding a porous layer along the LV endocardial wall. Results show that a porous layer of a thickness of 1.2·10−2 m with a porosity of 20 kg/m2 on the smoothed-endocardium ventricle models approximates the pressure drops, vorticities and WSS observed in the detailed models.
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Affiliation(s)
- Federica Sacco
- Barcelona Supercomputing Center (BSC), Barcelona, Spain.,PhySense, ETIC, Universitat Pompeu Fabra, Barcelona, Spain
| | - Bruno Paun
- PhySense, ETIC, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Tinen L Iles
- Visible Heart Laboratory, Department of Surgery, University of Minnesota, Minneapolis, MN, United States
| | - Paul A Iaizzo
- Visible Heart Laboratory, Department of Surgery, University of Minnesota, Minneapolis, MN, United States
| | | | - Mariano Vázquez
- Barcelona Supercomputing Center (BSC), Barcelona, Spain.,IIIA - CSIC, Bellaterra, Spain
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22
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Abstract
Plasma concentration of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4) were measured by radioimmunoassay in 45 patients with benign and malignant ovarian diseases. All patients with ovarian carcinoma showed increased beta-TG and PF4 levels. Among benign ovarian diseases the patients with serous cystadenoma more frequently showed signs of platelet activation, whereas those with endometriotic cyst and mucinous cystadenoma generally had normal beta-TG and PF4 values. These results indicate that an increased platelet activation is consistently associated with malignant tumors of the ovary, whereas benign tumors show a different capacity to induce platelet activation.
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23
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Słabicki M, Lee KS, Jethwa A, Sellner L, Sacco F, Walther T, Hüllein J, Dietrich S, Wu B, Lipka DB, Oakes CC, Mamidi S, Pyrzyńska B, Winiarska M, Oleś M, Seifert M, Plass C, Kirschfink M, Boettcher M, Gołąb J, Huber W, Fröhling S, Zenz T. Dissection of CD20 regulation in lymphoma using RNAi. Leukemia 2016; 30:2409-2412. [PMID: 27560109 DOI: 10.1038/leu.2016.230] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- M Słabicki
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K S Lee
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Jethwa
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - L Sellner
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - F Sacco
- Department of Proteomics and Signal Transduction, Max-Planck Institute for Biochemistry, Martinsried, Germany
| | - T Walther
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J Hüllein
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Dietrich
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany.,Department of Genome Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - B Wu
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D B Lipka
- Department of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C C Oakes
- Department of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH, USA
| | - S Mamidi
- Department of Immunology, University of Heidelberg, Heidelberg, Germany
| | - B Pyrzyńska
- Department of Immunology, Center for Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - M Winiarska
- Department of Immunology, Center for Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - M Oleś
- Department of Genome Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - M Seifert
- Department of Cell Biology (Cancer Research), Medical School, University of Duisburg-Essen, Essen, Germany
| | - C Plass
- Department of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Kirschfink
- Department of Immunology, University of Heidelberg, Heidelberg, Germany
| | - M Boettcher
- Department of Functional Genome Analysis, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Microbiology and Immunology, UCSF Diabetes Center, University of California, San Francisco, CA, USA
| | - J Gołąb
- Department of Immunology, Center for Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - W Huber
- Department of Genome Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - S Fröhling
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Section for Personalized Oncology, Heidelberg University Hospital, Heidelberg, Germany.,DKTK, Heidelberg, Germany
| | - T Zenz
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany.,Department of Genome Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
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24
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Darino MA, Rochi L, Lia VV, Kreff ED, Pergolesi MF, Ingala LR, Dieguez MJ, Sacco F. Virulence Characterization and Identification of Maize Lines Resistant to Puccinia sorghi Schwein. Present in the Argentine Corn Belt Region. Plant Dis 2016; 100:770-776. [PMID: 30688610 DOI: 10.1094/pdis-06-15-0639-re] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Puccinia sorghi Schwein., the causal agent of maize common rust, is an endemic disease in the Argentine Corn Belt region. Virulence surveys of the pathogen population within the region have not been performed; thus, the understanding of the pathogen population is low and it is difficult to deploy resistance genes that could be effective at controlling the disease. In total, 58 single-uredinial isolates derived from infected maize leaves collected in different locations throughout the Argentine Corn Belt region during 2010 to 2012 were tested on a set of 25 maize lines carrying different Rp genes. Maize lines Rp3-A and PIO19802 showed the lowest virulence frequencies (3.4 and 1.7%, respectively) for all tested isolates. Moreover, the combination in a single genotype of the resistance genes carried by lines Rp3-A and PIO19802 or either of these lines combined with the resistance genes from PIO12345 would confer resistance to all isolates tested. Virulent isolates on maize lines Rp-G, Rp1-K, and Rp-GI were most frequent in 2012. Twenty-four virulence phenotypes were identified, with phenotypes TCCG (17.2%), TTBB (15.5%), and TCFG (10.3%) being the most common throughout the region. Adult plant resistance associated with hypersensitive response was identified at vegetative stage 6 in maize lines PIO68752, PIO28427, and PIO36420.
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Affiliation(s)
- M A Darino
- Instituto de Genética "Ewald A. Favret", CICVyA-INTA CC25 (1712) Castelar, Buenos Aires, Argentina
| | - L Rochi
- Instituto de Genética "Ewald A. Favret", CICVyA-INTA CC25 (1712) Castelar, Buenos Aires, Argentina
| | - V V Lia
- Instituto de Biotecnología, CICVyA-INTA CC25 (1712) Castelar, Buenos Aires, Argentina
| | - E D Kreff
- Pioneer Hi-Bred International, Inc., Ruta Nacional 178 km 11 Pergamino, Buenos Aires, Argentina
| | - M F Pergolesi
- Instituto de Genética "Ewald A. Favret", CICVyA-INTA CC25 (1712) Castelar, Buenos Aires, Argentina
| | - L R Ingala
- Instituto de Genética "Ewald A. Favret", CICVyA-INTA CC25 (1712) Castelar, Buenos Aires, Argentina
| | - M J Dieguez
- Instituto de Genética "Ewald A. Favret", CICVyA-INTA CC25 (1712) Castelar, Buenos Aires, Argentina
| | - F Sacco
- Instituto de Genética "Ewald A. Favret", CICVyA-INTA CC25 (1712) Castelar, Buenos Aires, Argentina
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25
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Fattorini L, Tirabasso A, Lunghi A, Di Giovanni R, Sacco F, Marchetti E. Muscular forearm activation in hand-grip tasks with superimposition of mechanical vibrations. J Electromyogr Kinesiol 2015; 26:143-8. [PMID: 26597087 DOI: 10.1016/j.jelekin.2015.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 07/02/2015] [Revised: 09/09/2015] [Accepted: 10/27/2015] [Indexed: 10/22/2022] Open
Abstract
The purpose of this paper is to evaluate the muscular activation of the forearm, with or without vibration stimuli at different frequencies while performing a grip tasks of 45s at various level of exerted force. In 16 individuals, 9 females and 7 males, the surface electromyogram (EMG) of extensor carpi radialis longus and the flexor carpi ulnari muscles were assessed. At a short latency from onset EMG, RMS and the level of MU synchronization were assessed to evaluate the muscular adaptations. Whilst a trend of decay of EMG Median frequency (MDFd) was employed as an index of muscular fatigue. Muscular tasks consists of the grip of an instrumented handle at a force level of 20%, 30%, 40%, 60% of the maximum voluntary force. Vibration was supplied by a shaker to the hand in mono-frequential waves at 20, 30, 33 and 40Hz. In relation to EMG, RMS and MU synchronization, the muscular activation does not seem to change with the superimposition of the mechanical vibrations, on the contrary a lower MDFd was observed at 33Hz than in absence of vibration. This suggests an early muscular fatigue induced by vibration due to the fact that 33Hz is a resonance frequency for the hand-arm system.
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Affiliation(s)
- L Fattorini
- Sapienza Università di Roma, Department of Physiology and Pharmacology "V. Erspamer", Italy.
| | - A Tirabasso
- National Institute for Insurance Against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - A Lunghi
- National Institute for Insurance Against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - R Di Giovanni
- National Institute for Insurance Against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - F Sacco
- National Institute for Insurance Against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - E Marchetti
- Sapienza Università di Roma, Department of Physiology and Pharmacology "V. Erspamer", Italy; National Institute for Insurance Against Accidents at Work, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
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26
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Diéguez MJ, Pergolesi MF, Velasquez SM, Ingala L, López M, Darino M, Paux E, Feuillet C, Sacco F. Fine mapping of LrSV2, a race-specific adult plant leaf rust resistance gene on wheat chromosome 3BS. Theor Appl Genet 2014; 127:1133-1141. [PMID: 24553966 DOI: 10.1007/s00122-014-2285-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 02/04/2014] [Indexed: 06/03/2023]
Abstract
Fine mapping permits the precise positioning of genes within chromosomes, prerequisite for positional cloning that will allow its rational use and the study of the underlying molecular action mechanism. Three leaf rust resistance genes were identified in the durable leaf rust resistant Argentinean wheat variety Sinvalocho MA: the seedling resistance gene Lr3 on distal 6BL and two adult plant resistance genes, LrSV1 and LrSV2, on chromosomes 2DS and 3BS, respectively. To develop a high-resolution genetic map for LrSV2, 10 markers were genotyped on 343 F2 individuals from a cross between Sinvalocho MA and Gama6. The closest co-dominant markers on both sides of the gene (3 microsatellites and 2 STMs) were analyzed on 965 additional F2s from the same cross. Microsatellite marker cfb5010 cosegregated with LrSV2 whereas flanking markers were found at 1 cM distal and at 0.3 cM proximal to the gene. SSR markers designed from the sequences of cv Chinese Spring BAC clones spanning the LrSV2 genetic interval were tested on the recombinants, allowing the identification of microsatellite swm13 at 0.15 cM distal to LrSV2. This delimited an interval of 0.45 cM around the gene flanked by the SSR markers swm13 and gwm533 at the subtelomeric end of chromosome 3BS.
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Affiliation(s)
- M J Diéguez
- Instituto de Genética "Ewald A. Favret" CICVyA-INTA CC25 (1712) Castelar, Buenos Aires, Argentina,
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27
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Cannas R, Marcias S, Sacco F, Cau A, Deiana AM. First isolation and characterization of genomic SSR markers for the giant red shrimp Aristaeomorpha foliacea (Risso, 1827). Genet Mol Res 2012; 11:2745-8. [PMID: 22930408 DOI: 10.4238/2012.august.17.1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Fourteen microsatellite markers were isolated from the giant red shrimp Aristaeomorpha foliacea (Risso, 1827) using the FIASCO protocol (fast isolation by AFLP of sequences containing repeats). Polymorphism was assessed in 30 individuals from two localities of the western Mediterranean basin (N = 20 from Sardinia and N = 10 from Sicily); nine loci showed polymorphism with 2 to 19 alleles per locus (average: 8.9). Polymorphic information content ranged from 0.36 to 0.91, and the observed and expected heterozygosities ranged from 0.50 to 0.97 and from 0.47 to 0.93, respectively. Two loci showed significant deviation from Hardy-Weinberg equilibrium, and evidence of linkage disequilibrium was found for only one locus pair. These loci are the first to be characterized in A. foliacea and could be effective tools for the investigation of genetic diversity, population structure, and demographic connectivity, useful information for the management of this important commercial resource.
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Affiliation(s)
- R Cannas
- Department of Life Sciences and Environment, University of Cagliari, Cagliari, Italy.
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28
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Ingala L, López M, Darino M, Pergolesi MF, Diéguez MJ, Sacco F. Genetic analysis of leaf rust resistance genes and associated markers in the durable resistant wheat cultivar Sinvalocho MA. Theor Appl Genet 2012; 124:1305-1314. [PMID: 22278178 DOI: 10.1007/s00122-012-1788-8] [Citation(s) in RCA: 6] [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] [Received: 10/05/2011] [Accepted: 01/10/2012] [Indexed: 05/31/2023]
Abstract
In the cross of the durable leaf rust resistant wheat Sinvalocho MA and the susceptible line Gama6, four specific genes were identified: the seedling resistance gene Lr3, the adult plant resistance (APR) genes LrSV1 and LrSV2 coming from Sinvalocho MA, and the seedling resistance gene LrG6 coming from Gama6. Lr3 was previously mapped on 6BL in the same cross. LrSV1 was mapped on chromosome 2DS where resistance genes Lr22a and Lr22b have been reported. Results from rust reaction have shown that LrSV1 from Sinvalocho is not the same allele as Lr22b and an allelism test with Lr22a showed that they could be alleles or closely linked genes. LrSV1 was mapped in an 8.5-cM interval delimited by markers gwm296 distal and gwm261 proximal. Adult gene LrSV2 was mapped on chromosome 3BS, cosegregating with gwm533 in a 7.2-cM interval encompassed by markers gwm389 and gwm493, where other disease resistance genes are located, such as seedling gene Lr27 for leaf rust, Sr2 for stem rust, QTL Qfhs.ndsu-3BS for resistance to Fusarium gramineum and wheat powdery mildew resistance. The gene LrG6 was mapped on chromosome 2BL, with the closest marker gwm382 at 0.6 cM. Lines carrying LrSV1, LrSV2 and LrG6 tested under field natural infection conditions, showed low disease infection type and severity, suggesting that this kind of resistance can be explained by additive effects of APR and seedling resistance genes. The identification of new sources of resistance from South American land races and old varieties, supported by modern DNA technology, contributes to sustainability of agriculture through plant breeding.
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Affiliation(s)
- L Ingala
- Instituto de Genética Ewald A Favret CICVyA-INTA CC25, 1712 Castelar, Buenos Aires, Argentina
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Grimaldi A, Ammirati E, Piraino D, Vermi AC, Arendar I, Sacco F, La Canna G, Alfieri O. Sudden hypotensive syndrome mimicking acute pulmonary embolism after major abdominal surgery. HSR Proc Intensive Care Cardiovasc Anesth 2011; 3:73-4. [PMID: 23441266 PMCID: PMC3484605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Ferrari E, Sacco F, Tinti M, Corallino S, Nardozza A, Palma A, Costa S, Ceol A, Chatr-aryamontri A, Castagnoli L. The human phosphatase network. J Biotechnol 2010. [DOI: 10.1016/j.jbiotec.2010.09.895] [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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Sacco F, Spezzaferro M, Amitrano M, Grossi L, Manzoli L, Marzio L. Efficacy of four different moxifloxacin-based triple therapies for first-line H. pylori treatment. Dig Liver Dis 2010; 42:110-4. [PMID: 19846355 DOI: 10.1016/j.dld.2009.05.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2008] [Revised: 05/12/2009] [Accepted: 05/20/2009] [Indexed: 12/11/2022]
Abstract
UNLABELLED Moxifloxacin has been used in the first-line treatment of Helicobacter pylori infection. The optimal dosage and duration have not been assessed. AIM To evaluate the effectiveness of moxifloxacin, amoxicillin and esomeprazole in four regimens, in previously untreated patients infected by H. pylori. METHODS AND PATIENTS Patients were randomly assigned to: esomeprazole 20 mg b.i.d., amoxicillin 1g b.i.d., and one of each of the four following dosages of moxifloxacin: moxifloxacin 400 mg b.i.d. for 10 days (EAM800x10), moxifloxacin 400 mg b.i.d. for 7 days (EAM800x7), moxifloxacin 400 mg b.i.d. for 5 days (EAM800x5), moxifloxacin 400 mg o.i.d. for 10 days (EAM400x10). Eradication was assessed by the Urea Breath Test (UBT) 2 months following the end of therapy. RESULTS Ninety-four, 102, 92 and 105 patients were recruited in EAM800x10, EAM800x7, EAM800x5, and EAM400x10 respectively. The eradication rate was for Intention-To-Treat (ITT) and Per Protocol (PP) analyses: EAM800x10 group ITT: 90.4%, PP: 94.4%; EAM800x7 group ITT: 80.3%, PP: 86.3%; EAM800x5 group ITT: 71.4%, PP: 75.2%; EAM400x10 group ITT: 80.0%, PP 84.8%. A statistically significant difference was reached between EAM800x10 vs. EAM800x7 (ITT and PP: P<0.05), and between EAM800x10 vs. EAM800x5 (ITT and PP: P<0.01) and vs. EAM400x10 (ITT: P<0.05; PP: P<0.04). Thirty patients treated unsuccessfully with EAM800x5 and EAM400x10 were re-treated with EAM800x10 with an eradication rate of 86.7% (ITT) and 92.2% (PP). Nineteen patients with positive UBT after EAM800x10 and EAM800x7 underwent a second-line rifabutin-based therapy with an eradication rate of 84.2% (ITT and PP). CONCLUSION A triple therapy with 800 mg of moxifloxacin a day for 10 days is more effective than the same treatment for 5 or 7 days and a treatment with 400mg of moxifloxacin a day for 10 days for the first-line eradication of H. pylori infection. The high cost of moxifloxacin-based treatment however, may limit its wide use as first-line treatment of H. pylori infection.
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Affiliation(s)
- F Sacco
- Section of Digestive Sciences, Department of Medicine, G.d'Annunzio University, Chieti-Pescara, Italy
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Esprooz E, Sacco F, Testa G, De Blasi RA. ICU admittance prediction of the seventh-day organ dysfunction clustering. Crit Care 2009. [PMCID: PMC4084388 DOI: 10.1186/cc7666] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cavallaro G, Agazzani E, Andaloro L, Bottura C, Cristofori G, Mussini P, Sacco F, Compagnoni G. [Sildenafil and nitric oxide inhalation in neonatal pulmonary hypertension. Three case reports]. Pediatr Med Chir 2008; 30:149-155. [PMID: 19024859] [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: 05/27/2023] Open
Abstract
INTRODUCTION Neonatal persistent pulmonary hypertension (NPPH) is characterised by persistently high pulmonary vascular resistance (PVR). Sildenafil has recently been suggested as an alternative to or an associative therapy with inhaled nitric oxide (iNO) to reduce mortality (10-40%) and morbidity (major neurologic disabilities among surviving newborns remains approximately 15-60%). The objective is to report three cases of NPPH treated with sildenafil in association of iNO. CASE REPORTS Echocardiography examination of three newborn babies with respiratory distress syndrome and a gestational age between 33 and 39 weeks revealed pulmonary hypertension following early onset sepsis. Synchronized intermittent mandatory ventilation (SIMV) and surfactant therapy had no effect on oxygen saturation (SatO2) and oxygen alveolar-arterial difference (AaDO2). High frequency oscillatory ventilation (HFOV) and iNO therapy proved to be equally ineffective. Oral sildenafil was administered at 2 mg/Kg/6 hs. A gradual but significant improvement in oxygenation was achieved and a reduction in AaDO2 along with oxygenation index (OI) and pulmonary arterial pressure (PAP) was observed in the first 6-10 hrs after administration of sildenafil. The therapy was maintained for 36-48 hrs with total success. CONCLUSIONS A beneficial pulmonary vasodilator effect was obtained in treating NPPH with sildenafil where conventional methods had failed. Sildenafil used in association with iNO reduces the duration of treatment, the quantity of iNO normally required and the associated toxic effects. A multicentric, randomized trial could be useful in demonstrating the safety, efficacy, doses and forms of administration of sildenafil.
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Affiliation(s)
- G Cavallaro
- Neonatal Intensive Care Unit, "Carlo Poma" Hospital, Mantova.
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McMahon BJ, Bruce MG, Hennessy TW, Bruden DL, Sacco F, Peters H, Hurlburt DA, Morris JM, Reasonover AL, Dailide G, Berg DE, Parkinson AJ. Reinfection after successful eradication of Helicobacter pylori: a 2-year prospective study in Alaska Natives. Aliment Pharmacol Ther 2006; 23:1215-23. [PMID: 16611283 DOI: 10.1111/j.1365-2036.2006.02880.x] [Citation(s) in RCA: 32] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Limited information exists regarding risk factors for reinfection after cure of Helicobacter pylori infection. AIM To determine the 2-year reinfection rate of H. pylori in a cohort of urban Alaska Natives. METHODS Participants over 18 years of age undergoing oesophagogastroduodenoscopy had (13)C urea breath test, culture, CLOtest and histology performed. Those diagnosed with H. pylori who tested urea breath test-negative at 8 weeks after treatment were followed prospectively at 4 months, 6 months, 1 year and 2 years. Subjects experiencing H. pylori reinfection as defined by a positive urea breath test were compared with those who did not become reinfected using univariable and multivariable analysis. Risk of reinfection over time was estimated by the Kaplan-Meier method. RESULTS Helicobacter pylori reinfection occurred in 14 of 98 subjects successfully treated. The cumulative reinfection rate was 5.1% (95% CI: 0.7%-9.5%) at 4 months, 7.2% (2.0-12.3%) at 6 months, 10.3% (4.2-16.3%) at 1-year and 14.5% (7.5-21.6%) at 2 years. In multivariable analysis, a history of previous peptic ulcer disease or presence of ulcer at time of study oesophagogastroduodenoscopy were the only risk factors associated with reinfection (P = 0.01). CONCLUSIONS Based on the findings from our study, subjects with a history of or current peptic ulcer disease should be followed, after successful treatment for H. pylori, with periodic urea breath test to detect reinfection, as reinfection would put them at high risk for ulcer recurrence.
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Affiliation(s)
- B J McMahon
- Department of Internal Medicine, Alaska Native Medical Center, Anchorage, USA.
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Diéguez MJ, Altieri E, Ingala LR, Perera E, Sacco F, Naranjo T. Physical and genetic mapping of amplified fragment length polymorphisms and the leaf rust resistance Lr3 gene on chromosome 6BL of wheat. Theor Appl Genet 2006; 112:251-7. [PMID: 16215730 DOI: 10.1007/s00122-005-0122-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Accepted: 09/15/2005] [Indexed: 05/04/2023]
Abstract
The Argentinian wheat cultivar Sinvalocho MA carries the Lr3 gene for leaf rust resistance on distal chromosome 6BL. In this cultivar, 33 spontaneous susceptible lines were isolated and cytogenetically characterized by C-banding. The analysis revealed deletions on chromosome 6BL in most lines. One line was nulli-6B, two lines were ditelo 6BS, two, three, and ten lines had long terminal deletions of 40, 30, and 20%, respectively, three lines showed very small terminal deletions, and one line had an intercalary deletion of 11%. Physical mapping of 55 amplified fragment length polymorphism (AFLP) markers detected differences between deletions and led to the division of 6BL into seven bins delimited by deletion breakpoints. The most distal bin, with a length smaller than 5% of 6BL, contained 22 AFLP markers and the Lr3 gene. Polymorphism for nine AFLPs between Sinvalocho MA and the rust leaf susceptible cultivar Gamma 6 was used to construct a linkage map of Lr3. This gene is at a genetic distance of 0.9 cM from a group of seven closely linked AFLPs. The location of the gene in a high recombinogenic region indicated a physical distance of approximately 1 Mb to the markers.
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Affiliation(s)
- M J Diéguez
- Instituto de Genética Ewald A. Favret CICVyA-INTA CC25 (1712), Castelar, Argentina.
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Danna H, Sacco F, Ingala R, Saione A, Ugalde A. Cloning and mapping of genes involved in wheat-leaf rust interaction through gene-expression analysis using chromosome-deleted near-isogenic wheat lines. Theor Appl Genet 2002; 105:972-979. [PMID: 12582923 DOI: 10.1007/s00122-002-0990-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2001] [Accepted: 01/17/2002] [Indexed: 05/24/2023]
Abstract
Molecular markers on wheat chromosome 6BL were isolated using mRNA differential display. Two wheat isolines inoculated with Puccinia recondita were analysed: Sinvalocho MA line carrying the Lr3 gene for leaf rust resistance on distal chromosome 6BL, and a rust-susceptible derivative of the Sinvalocho MA line with a deletion at the distal end of chromosome 6BL. Comparison of mRNA fingerprinting profiles, obtained from control and rust-inoculated plants, let to the isolation of 34 differentially displayed cDNAs. All these genes, except TaRr16, were up-regulated in the rust-inoculated resistant line. TaRr16 has constitutive expression in the rust-resistant line while no expression was detected in the rust-susceptible line. A number of those cDNAs revealed homology to genes previously identified in other plant-pathogen interactions. Two out of the 34 cDNAs, mapped in the distal part of chromosome 6BL and TaRr16, was genetically linked to the Lr3 gene. DNA sequence differences and differential expression between non-allelic copies of TaRr16, are also reported.
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Affiliation(s)
- H. Danna
- Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico Chascomús-CONICET-Universidad Nacional de General San Martín (IIB-INTECH-CONICET-UNSAM), Av. General Paz s/n. I.N.T.I. edificio 24, San Martín, 1650, Provincia de Buenos Aires, Argentina
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McMahon BJ, Bulkow L, Harpster A, Snowball M, Lanier A, Sacco F, Dunaway E, Williams J. Screening for hepatocellular carcinoma in Alaska natives infected with chronic hepatitis B: a 16-year population-based study. Hepatology 2000; 32:842-6. [PMID: 11003632 DOI: 10.1053/jhep.2000.17914] [Citation(s) in RCA: 264] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The benefits of screening hepatitis B surface antigen (HBsAg)-positive carriers for hepatocellular carcinoma (HCC) in terms of long-term survival have not been established. We conducted a prospective 16-year, population-based cohort study to determine the impact of screening for HCC in 1,487 HBsAg-positive Alaska native carriers with alpha-fetoprotein (AFP) determinations every 6 months. Men and nonpregnant women with an elevated AFP level were evaluated for the presence of HCC by ultrasound (US) examination. The long-term survival rate for patients whose HCC was detected by the screening program was compared with a historical control group of Alaska native patients with HCC from the same population who were clinically diagnosed with HCC between 1969 and October 1982, through a National Cancer Institute-sponsored Cancer Registry. Between October 1982 and December 1998, 26,752 AFP determinations in HBsAg carriers were performed. One or more AFP elevations were found in 61 men and 39 nonpregnant women. HCC was diagnosed in 32 patients (24 men and 8 women). HCC tumors less than 6 cm were found in 23 patients; 22 patients had resections, and 1 patient refused a resection. Compared with 12 patients with hepatitis B virus (HBV)-related HCC diagnosed from 1969 to October 1982, before this program, the 5- and 10-year survival rate for the 32 patients with HCC were 42% (P =.008) and 30% (P =.07), respectively. Five- and 10-year tumor-free survival rates for carriers who had a normal AFP level on initial screening and subsequently developed HCC were 29% (P =.004) and 24% (P =.024), respectively. Screening of HBsAg carriers with semiannual AFP was effective in detecting most HCC tumors at a resectable stage and significantly prolonged survival rates when compared with historical controls in this population.
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Affiliation(s)
- B J McMahon
- Departments of Internal Medicine and Surgery, Alaska Native Medical Center, Indian Health Service, Public Health Service, U.S. Department of Health and Human Services, Anchorage, Alaska, USA.
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Trada M, Garzoli E, Falzoni PU, De Franco S, Sacco F, Aguzzi A, Bona G. Abdominal pain in children: a case of acalculous cholecystitis. Minerva Pediatr 2000; 52:231-3. [PMID: 11995207] [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: 02/24/2023]
Abstract
Acalculous cholecystitis is a rare disease in children. Most cases are associated with systemic infections or with autoimmune pathologies, but it may also occur without predisposing factors. A case observed in an otherwise healthy child is reported.
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Affiliation(s)
- M Trada
- Università del Piemonte Orientale A. Avogadro, Novara
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Abstract
The Lr3 gene for resistance to race 66 of Puccinia recondita present in hexaploid wheat cv. Sinvalocho MA was mapped on chromosome 6B, using intervarietal polymorphic RFLP loci and the Amp-B1 isozyme gene as a centromere marker. The RFLP markers were located mainly in two subregions of chromosome 6BL. Six RFLP loci clustered in the centromeric region and one other, Xmwg798, cosegregated with the Lr3 gene. C-banding analysis of the leaf rust resistant standard 'Sinvalocho MA' line and three naturally occurring susceptible lines of 'Sinvalocho MA' revealed a terminal deletion on 6BL that covered 20% of its length in one susceptible line. Because Xmwg798 was missing in this line, both Xmwg798 and Lr3 were allocated to the deleted segment. Distorted segregations were observed for the proximal markers, suggesting a selection against gametes carrying the centromeric region of 'Sinvalocho MA'.Key words: wheat, RFLP, Lr3 gene, chromosome 6B, C-banding.
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Bona G, Cadario F, Benevenuta E, Sacco F, Garzoli E, Passaro R. [Sepsis caused by Haemophilus influenzae type B with septic arthritis in an infant]. Minerva Pediatr 1998; 50:193-6. [PMID: 9842217] [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: 02/09/2023]
Abstract
Septic arthritis is a serious pyogenic infection that may lead to permanent orthopedic sequelae. Infants represent the most of the cases. It usually develops as a result of bacterial seeding into the capillary-rich synovium in the course of a bacteremic episode. Etiology changes according to different ages; in children after the neonatal period but younger than 24 months, Haemophilus influenzae is the most frequent causative organism. A case of sepsis due to Haemophilus influenzae type b (Hib) with septic arthritis in a patient 3 months old, is reported. The child was admitted to the hospital with a very high temperature (39 degrees C) for five days. His right wrist and ankle appeared swelling and hyperemic. He was affected by congenital cardiopathy from birth. He was not immunizated against Hib. The blood colture was positive for Hib. The leukocyte count was 21,400 cell/mm3 with 55% of polymorphonuclear cells. During the second day of recovery, the patient was transfused, because of the very low value of hemoglobin (5.2 g/dl). The child was treated with netilmycina and ceftriaxone for 15 days. The temperature fell in two days. The articular pathology resolved in nearly ten days. The case reported confirms the importance of septic arthritis as a pathology that necessarily requires an early diagnosis and treatment. The Haemophilus influenzae vaccine, is recommended especially in immunocompromised or cardiopathic subjects and before the age of 2 years.
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Affiliation(s)
- G Bona
- Dipartimento di Scienze Mediche, Clinica Pediatrica di Novara, Università degli Studi, Torino
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Sacco F, Rigon G, Sacchini D. [Forceps delivery and long term follow-up urinary incontinence]. Minerva Ginecol 1996; 48:355-8. [PMID: 8999382] [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: 02/03/2023]
Abstract
553 patients undergoing complete urodynamic evaluation were investigated concerning mode of delivery. Forceps delivery was not associated with worsened urethral competence and significant risk of subsequent incontinence.
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Affiliation(s)
- F Sacco
- Istituto di Clinica Ostetrica e Ginecologica, Facoltà di Medicina e Chirurgia A. Gemelli, Università Cattolica del Sacro Cuore, Roma
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Sacco F, Rigon G, Sacchini D. [Unstable bladder and Sjögren syndrome. Clinical case]. Minerva Med 1996; 87:257-9. [PMID: 8700353] [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: 02/01/2023]
Abstract
A female patient developed severe detrusor instability years after a diagnosis of Sjogren syndrome. A common etiology could be possible if an association with viral demyelinization in Sjogren patients is confirmed. Vaginal Sicca syndrome was present and responded to a topical androgen-oestriol association with definite cytologic improvement. Anticholinergics were tolerated and moderately effective. Low initial dose were slowly increased (over three months) to avoid excessive mouth dryness and avoid gastrooesophageal symptoms.
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Affiliation(s)
- F Sacco
- Instituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Roma
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Sacco F, Rigon G, Carbone A, Sacchini D, Castaldo F, Conte M, Sacco R. [Ultrasonographic and urodynamic evaluation in stress incontinence]. Minerva Ginecol 1993; 45:519-25. [PMID: 8121598] [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: 01/28/2023]
Abstract
Transvaginal sonography can show partial urinary penetration in the urethra in patients with no clinical incontinence. The Fluid Bridge Test-Pressure urodynamically demonstrates the same phenomenon. We compared these two technics in women with stress urinary incontinence (SUI). 49 patients underwent urodynamic testing and transvaginal sonography; 18 had SUI, 20 were asymptomatic postoperatively (Burch procedure) and 11 were normal controls. Urodynamics consisted of filling cystometry with saline (infusion speed: ml 70/min) using transurethral Foley catheter (n degree 14 Fr), and a profilometric-pressure Bard catheter (10 Fr); micturitional cystometry; uroflowmetry; clino- and orthostatic urethral pressure profile (UPP) (extraction speed: cm 0.5-1/sec; infusion speed: cm 1.2/min); sphincteric electromyography (EMG); FBT-P with the Bard catheter only. During extraction patients were requested to cough (stress condition). If the urethra is incompetent pressure is transmitted to the water column connected to the pressure transducer, and a "spike" is observed. A competent urethra shows little pressure variation. Ultrasound (US) equipment consisted in a General Electric (RT 3600) sonograph with an electronic transvaginal probe (7.5 MHz) inserted in a gel-lubricated condom. The probe was positioned in the vaginal vestibule in direct proximity to the urethra. Axial and coronal scannings were performed. Echo-imagings were submitted to "post-processing" on US recording equipment. Fluid penetration in the urethra was evident if iperchogenic "turbulence" was observed on playback of the dynamic sonogram on a videocassette recorder (VCR) connected to the sonograph. The SUI group shows leakage of water under stress without detrusorial activity and dynamic UPP with reduced transmission of abdominal pressure on the urethra.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- F Sacco
- Istituto di Clinica Ostetrica e Ginecologica, UCSC, Roma
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Rigon G, Sacco F, Sacchini D, Carbone A, Castaldo F, Sacco R. [Comparison of methods for the diagnosis of urinary obstruction in women]. MINERVA UROL NEFROL 1993; 45:5-9. [PMID: 8322117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The International Continence Society does not offer secure guidelines for the diagnosis of micturitional obstruction. The problem has been extensively addressed in relation to male voiding difficulties. Little is known on the subject in female patients. Two criteria for the diagnosis of obstructed micturition are in clinical use. The Sussett formula divides the maximum micturitional pressure by the square of the corresponding maximum urinary flow rate. Two cutoffs, corresponding approximately to the 90th and 95th centiles can be used (0.15, and 0.5). A more complex graphic nomogram developed by Schafer plots maximum flow versus maximum detrusor pressure, identifying obstruction and detrusor dysfunction simultaneously according to the author. We feel that these methods, extensively tested on a male population, can both be used on a female population. We noticed that in some instances the results were different. 469 women referred for micturitional disturbances underwent pressure/flow studies. 62 (13.2%) were obstructed according to the Schafer nomogram, 103 (21.9%) and 31 (6.6%) respectively using the Sussett mathematical formula using two different cutoffs (0.15 and 0.5). The two methods identify the same patients only if micturitional pressures are normal (40 to 60 cmH2O) to high (over 60 cmH2O) and the Sussett formula is used with a higher (95th centile) cutoff. This means that both methods are clearly insufficient in the diagnosis of obstruction if detrusor function is impaired. This can happen in case of chronic retention due to detrusor failure after a long-standing obstruction or for primary failures due to central nervous system lesions. Extreme care should be exercised if pressure-flow studies indicate obstruction at low micturitional pressures.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- G Rigon
- Prima Divisione di Ginecologia e Ostetricia, Ospedale S. Camillo di Roma
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Sacco F, Rigon G, Castaldo F, Carbone A, Sacchini D, Sacco R. [Acute urinary obstruction in pregnancy]. Minerva Ginecol 1993; 45:101-4. [PMID: 8332273] [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: 01/29/2023]
Abstract
Five cases of acute urinary obstruction during pregnancy are presented. A complete urodynamic workup, including pressure-flow studies showed high micturitional pressures with little or no flow, with at least 60% residual urine. Filling cystometry, urethral profilometry (static and dynamic), pelvic electromyography were normal. Two cases were due to uterine pelvic incarceration. One of these cases happened very early during pregnancy, because of extensive fibroids. Any cause of abnormal uterine enlargement can lead to early obstruction. Three cases were associated with paraurethral abscess (skenitis in 2 cases, urethral diverticulum in 1). Manual reduction in case of pelvic incarceration or surgical draining and antibiotic therapy in case of abscess were effective in all cases. Immediate catheterization is possible and indicated as soon as urinary obstruction is diagnosed. This prevents neuromuscular dysfunction due to excessive bladder distention. The transurethral catheter might work as a stent, and periurethral surgical drainage is probably safer with a catheter in place. Suprapubic catheterization is probably less useful in this respect. An indwelling catheter removes any urgency in treatment. Voiding difficulties can persist for some days after surgical treatment. Urodynamic testing performed in all indicated acute micturitional obstruction. Anyway, it added little to the clinical understanding of the problem, which was obvious, and the Authors feel that extensive urodynamic testing should be limited to cases presenting with a complex preexisting dysfunction or performed after treatment if symptoms do not disappear completely. All clinically doubtful cases should likewise be investigated. If periurethral abscess or incarceration are evident, simple evaluation of residual urine percentage should be sufficient in establishing the diagnosis.
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Affiliation(s)
- F Sacco
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del S. Cuore, Roma
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Rigon G, Sacco F, Carbone A, Sacchini D, Castaldo F, Donadio C, Pellizzari G, Nazzicone P, Sacco R. Danno Urologico Funzionale Dopo Isterectomia Radicale. Urologia 1991. [DOI: 10.1177/039156039105800607] [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: 11/15/2022]
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Rigon G, Sacco F, Carbone A, Sacchini D, Castaldo F, Donadio C, Pellizzari G, Sacco R. Reperti Urodinamici Dopo Isterectomia Radicale. Urologia 1991. [DOI: 10.1177/039156039105800617] [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: 11/17/2022]
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Rigon G, Sacco F, Carbone A, Sacchini D, Castaldo F, Carvelli G, Gneo S, Nazzicone P, Sacco R. Nomogrammi Di Normalità Della Profilometria Uretrale Statica in Donne Con “Fluid Bridge Test” Negativo. Urologia 1991. [DOI: 10.1177/039156039105800606] [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: 11/15/2022]
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