Diagnostic utility of LightCycler SeptiFast and procalcitonin assays in the diagnosis of bloodstream infection in immunocompromised patients

Sepsis is an increasingly prevalent cause of death, and management in the early stage is a critical issue. However, microbiological findings are generally obtained late during the course of the disease. In this study, we evaluated the clinical utility of procalcitonin (PCT) in improving the diagnosis of bloodstream infections and the potential utility of the SeptiFast (SF) test, a multiplex pathogen detection system, in the etiological diagnosis of immunocompromised patients. Seventy-nine hospitalized immunocompromised patients were included in this study. Our results demonstrate that while the PCT value correlates highly with sepsis, the results do not discriminate adequately enough to justify its independent use as a diagnostic tool. The SF test, combined with blood cultures, improves microbiological data in immunocompromised patients, especially in cases of previous antibiotic therapy and invasive fungal infection.

[A case of diphyllobothriasis: description and diagnosis]

We describe a case of asymptomatic infection caused by Diphyllobothrium latum, probably following a meal of "sushi" in a Japanese restaurant in Rome one year before. The diagnosis was obtained observing morphology and seizures of proglottids and ova. We recall the life cycle of this cestode and report criteria for a differential diagnosis with other species of the Diphyllobothrium genus, usually rare in humans, and caused by the ingestion of marine fish and not freshwater fish.

Sludge accumulation in polishing ponds treating anaerobically digested wastewater

When ponds are used for wastewater treatment, settleable solids will form a steadily growing bottom sludge layer, which reduces their effective volume. Eventually this sludge must be removed to ensure that the pond maintains the required retention time to keep performing properly. The settleable solids may either be present in the influent or they are formed during the treatment as a result of algal flocculation. An experimental investigation was carried out to evaluate bottom sludge accumulation in a polishing pond used for treatment of UASB effluent. The mass and composition of the bottom sludge formed in a polishing pond was evaluated after the pilot scale pond had been in operation for 1 year and about 60 m3 of digested wastewater had been treated per m3 of pond. The bottom sludge mass represented a solids accumulation of 70 g per m3 of digested wastewater. About half of these solids were the result of settling of influent solids in the first part of the pond, while the other half was attributable to settling of algae, formed in the pond. It is concluded that the bottom sludge growth in a polishing pond is so low, that desludging during the useful life span of the pond will most likely not be necessary. This leads to the important conclusion that excess sludge discharge from UASB reactors (a major factor in operational costs) may be omitted, if a polishing pond is used for post-treatment. The bottom sludge had a high volatile solids concentration (58%) and the macronutrient fractions were also high (3.9% N and 1.1% P of the TSS mass). The bottom sludge was stable and could be dried directly without problems. The hygienic quality of the bottom sludge was very poor: about half the influent helminth eggs during one year of operation were found in the bottom sludge and the faecal coliform concentration was very high.

[Update on HIV infection in the province of Cosenza. HIV infections and respiratory disease]

The aim of the present study was to evaluate the incidence of HIV infection and concomitant pathologies, paying special attention to those involving the respiratory tract, in the Province of Cosenza through a retrospective study of patients monitored by the Divisions of Infectious Diseases and Pneumology with the collaboration of the Virology Unit of the United Hospitals of Cosenza. The results obtained show that there is a lower incidence of AIDS and HIV-correlated respiratory pathologies in this area compared to the rest of Italy but, in spite of this, the authors highlight the need in Calabria for those centres and structures that have been planned but never completely realised (Law 135/90; DPR 7/4/94; etc.) which would enable infected subjects to be identified and the necessary measures for prevention, diagnosis and treatment to be implemented.

[The lung in AIDS]

The aim of this study was to underline the important role played by respiratory tract pathologies in HIV-infected subjects and to evaluate the incidence of respiratory pathologies in HIV-positive subjects in the province of Cosenza. After examining recently reported data, the authors analyse the patients studied by the Infectious Disease and Pneumology Divisions of the United Hospitals of Cosenza with the collaboration of the Virology Unit over the two-year period 1992-1994. As well as the lower incidence of HIV infection in this area compared to the rest of Italy, the paper highlights the reduced percentage of concomitant respiratory pathologies. The authors attempt to interpret the significance of these results.

A person to person hepatitis A outbreak

A person to person outbreak of hepatitis A is described: 90 cases of hepatitis A occurred in a small town in Calabria, southern Italy; all cases were under 18 years of age with the highest age-specific incidence rate in the 6-10 year age group. Transmission was identified by tracing close contacts with other incubating or active cases; only eight out of 90 cases were not identified as having a very probable or possible contact with an infecting case. Transmission was high between family members leading to a secondary family attack rate of 51% in children under 16. An enteric disease educational campaign was carried out together with IgG and no cases of hepatitis A were reported in the two years following the investigation.

[Compared evaluation of The "in vitro" activity of some aminoglicosides with semi-automatic method (author's transl)]

It is valued the antibacterial activity in vitro of amikacin, tobramicin and gentamicin on 154 bacterial Gram-negative urinary strains using a semi-automatic method ("Abac"). This evaluation is after that one on its accuracy comparing the results with those of the agar diffusion test (Kirby-Bauer).