24 results on '"Lauria, Francesco N."'
Search Results
2. Consensus document on controversial issues for the treatment of hospital-associated pneumonia
- Author
-
Franzetti, Fabio, Antonelli, Massimo, Bassetti, Matteo, Blasi, Francesco, Langer, Martin, Scaglione, Francesco, Nicastri, Emanuele, Lauria, Francesco N., Carosi, Giampiero, Moroni, Mauro, and Ippolito, Giuseppe
- Published
- 2010
- Full Text
- View/download PDF
3. Consensus document on controversial issues in the diagnosis and treatment of prosthetic joint infections
- Author
-
Leone, Sebastiano, Borrè, Silvio, Monforte, Antonella d’Arminio, Mordente, Gennaro, Petrosillo, Nicola, Signore, Alberto, Venditti, Mario, Viale, Pierluigi, Nicastri, Emanuele, Lauria, Francesco N., Carosi, Giampiero, Moroni, Mauro, and Ippolito, Giuseppe
- Published
- 2010
- Full Text
- View/download PDF
4. Consensus document on controversial issues in the treatment of complicated skin and skin-structure infections
- Author
-
Pan, Angelo, Cauda, Roberto, Concia, Ercole, Esposito, Silvano, Sganga, Gabriele, Stefani, Stefania, Nicastri, Emanuele, Lauria, Francesco N., Carosi, Giampiero, Moroni, Mauro, and Ippolito, Giuseppe
- Published
- 2010
- Full Text
- View/download PDF
5. Consensus document on controversial issues in the diagnosis and treatment of bloodstream infections and endocarditis
- Author
-
Boumis, Evangelo, Gesu, Giovanni, Menichetti, Francesco, Ranieri, Marco, Rinaldi, Mauro, Suter, Fredy, Nicastri, Emanuele, Lauria, Francesco N., Carosi, Giampiero, Moroni, Mauro, and Ippolito, Giuseppe
- Published
- 2010
- Full Text
- View/download PDF
6. Resistant and multi-resistant Gram-positive severe infections: the GISIG working methodology
- Author
-
Lauria, Francesco N., De Carli, Gabriella, and Nicastri, Emanuele
- Published
- 2010
- Full Text
- View/download PDF
7. Methicillin-resistant Staphylococcus aureus: the superbug
- Author
-
Ippolito, Giuseppe, Leone, Sebastiano, Lauria, Francesco N., Nicastri, Emanuele, and Wenzel, Richard P.
- Published
- 2010
- Full Text
- View/download PDF
8. Sexual behaviour of heterosexual individuals with HIV infection naive for antiretroviral therapy in Italy
- Author
-
Girardi, Enrico, Aloisi, Maria Stella, Serraino, Diego, Ferrara, Michele, Lauria, Francesco N, Carballo, Manuel, Monforte, Antonella d'Arminio, Rezza, Giovanni, Moroni, Mauro, Carosi, Giampiero, Alessandrini, Anna, Giacobbi, Donatella, Cremonini, Laura, Ranieri, Sergio, Montroni, Maria, and Ippolito, Giuseppe
- Published
- 2001
9. Detection of Pulmonary tuberculosis: comparing MR imaging with HRCT
- Author
-
Lauria Francesco N, Bevilacqua Nazario, Palmieri Fabrizio, Goletti Delia, Cristofaro Massimo, Schinina' Vincenzo, Busi Rizzi Elisa, Girardi Enrico, and Bibbolino Corrado
- Subjects
Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Computer Tomography (CT) is considered the gold standard for assessing the morphological changes of lung parenchyma. Although novel CT techniques have substantially decreased the radiation dose, radiation exposure is still high. Magnetic Resonance Imaging (MRI) has been established as a radiation- free alternative to CT for several lung diseases, but its role in infectious diseases still needs to be explored further. Therefore, the purpose of our study was to compare MRI with high resolution CT (HRCT) for assessing pulmonary tuberculosis. Methods 50 patients with culture-proven pulmonary tuberculosis underwent chest HRCT as the standard of reference and were evaluated by MRI within 24 h after HRCT. Altogether we performed 60 CT and MRI examinations, because 10 patients were also examined by CT and MRI at follow- up. Pulmonary abnormalities, their characteristics, location and distribution were analyzed by two readers who were blinded to the HRCT results. Results Artifacts did not interfere with the diagnostic value of MRI. Both HRCT and MRI correctly diagnosed pulmonary tuberculosis and identified pulmonary abnormalities in all patients. There were no significant differences between the two techniques in terms of identifying the location and distribution of the lung lesions, though the higher resolution of MRI did allow for better identification of parenchymal dishomogeneity, caseosis, and pleural or nodal involvement. Conclusion Technical developments and the refinement of pulse sequences have improved the quality and speed of MRI. Our data indicate that in terms of identifying lung lesions in non-AIDS patients with non- miliary pulmonary tuberculosis, MRI achieves diagnostic performances comparable to those obtained by HRCT but with better and more rapid identification of pulmonary tissue abnormalities due to the excellent contrast resolution.
- Published
- 2011
- Full Text
- View/download PDF
10. Duration of viral shedding in hospitalized patients infected with pandemic H1N1
- Author
-
Petrosillo Nicola, Ippolito Giuseppe, Ferraro Federica, Valli Maria B, Bordi Licia, Lalle Eleonora, Selleri Marina, Meschi Silvia, Lauria Francesco N, and Capobianchi Maria R
- Subjects
Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background The first influenza pandemic of the 21th century was ignited by a new strain of influenza A virus (A/H1N1pdm). Specific patient groups, including those with comorbidities, pregnant women, young children, older and immunocompromised patients, are at increased risk for serious influenza-related disease. This study was aimed at investigating the influence of clinical presentation, antiviral treatment and possible drug resistance-associated mutations, on the extent and duration of viral shedding in patients infected with A/H1N1pdm. Methods An observational study was performed, based on retrospective review of clinical and laboratory records of patients who were hospitalized for A/H1N1pdm infection at the National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy, between April 24 and December 31, 2009. Among 119 hospitalized patients, 39 were selected for a post hoc analysis, based on the availability of serial nasopharyngeal swabs samples and related information. Results Eleven out of the 39 study patients (28.2%) presented with pneumonia; 29 (74.4%) received antiviral treatment. Patients with pneumonia were significantly older than patients without pneumonia. The mean values of viral RNA concentration were not significantly increased in patients with pneumonia, but a significant increase in the duration of viral shedding was observed as compared to patients without pneumonia. In patients receiving antivirals, the viral RNA concentration was significantly reduced in comparison to untreated patients at days 4-5 after symptom onset, while the overall duration of viral shedding was only marginally affected. A significant correlation between duration of viral shedding and time elapsed between symptom onset and therapy start was observed, with a significant reduction of days of viral shedding when therapy was initiated within 2 days of symptoms appearance. No known drug resistance mutations were detected in patients with prolonged viral shedding. Conclusions Our results show that severe respiratory illness is associated with delayed virus clearance in patients with A/H1N1pdm infection. Antivirals caused an early reduction of viral load, but only marginally affected the overall duration of shedding. Prolonged shedding was not associated with the emergence of strains carrying known drug-resistance mutations.
- Published
- 2011
- Full Text
- View/download PDF
11. IP-10 detection in urine is associated with lung diseases
- Author
-
Pucci Luigia, Lauria Francesco N, Vanini Valentina, Cuzzi Gilda, Chiacchio Teresa, Calvo Ludovica, Cannas Angela, Girardi Enrico, and Goletti Delia
- Subjects
Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background blood cytokines and chemokines have been proposed as biomarkers for tuberculosis (TB). Recently, some immune mediators found in the urine of patients with renal dysfunctions have also been suggested as potential biomarkers. Finding biomarkers for TB in urine would present several advantages over blood in terms of collection and safety. The objective of this study was to investigate the presence of cytokines and chemokines in the urine of patients with pulmonary TB at the time of diagnosis. In a subgroup, the evaluation was also performed during TB treatment and at therapy completion. Patients with lung diseases other than TB, and healthy subjects were also enrolled. Methods urine samples from 138 individuals, after exclusion of renal dysfunctions, were collected during an 18 month-period. Among them, 58 received a diagnosis of pulmonary TB, 28 resulted having lung diseases other than TB, and 34 were healthy subjects. Moreover, 18 TB patients, 9 of whom were tested 2 months after AFB smear sputum reversion and 9 of whom were cured of TB were also included. Cytokines and chemokines in urine were evaluated using a Cytometric-Bead-Array-Flex-Set. IP-10 detection in 49 subjects was also carried out in parallel by using an Enzyme Linked ImmunoSorbent Assay (ELISA). Results IFN-γ, TNF-α, IL-2, IL-8, MIP-1α, MIP-1β and RANTES were poorly detected in all urine samples. Conversely, IP-10 was consistently detected in urine and its level was significantly increased in patients with lung disease compared to healthy subjects (p < 0.001). Increased IP-10 levels were found in both pulmonary TB and lung diseases other than TB. Moreover lower IP-10 levels were found in cured-TB patients compared to the levels at the time of diagnosis, and this difference was close to significance (p = 0.06). Interestingly, we demonstrated a significant correlation between the data obtained by flow cytometry and ELISA (r2 0.82, p < 0.0001). Conclusions IP-10, in contrast to IFN-γ, TNF-α, IL-2, IL-8, MIP-1α, MIP-1β and RANTES, is detectable in the urine of patients with pulmonary diseases in the absence of renal dysfunctions. Moreover, the IP-10 level in cured-TB patients is comparable to that found in healthy subjects. More studies are needed to further investigate the clinical utility of these findings.
- Published
- 2010
- Full Text
- View/download PDF
12. A case of pulmonary tuberculosis presenting as diffuse alveolar haemorrhage: is there a role for anticardiolipin antibodies?
- Author
-
Lauria Francesco N, Tommasi Chiara, Corpolongo Angela, Marruchella Almerico, and Narciso Pasquale
- Subjects
Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Diffuse alveolar haemorrhage (DAH) has been rarely reported in association with pulmonary infections. Case Presentation We report the case of a 43 year old immunocompetent man presenting with dyspnoea, fever and haemoptysis. Chest imaging showed bilateral ground glass opacities. Microbiological and molecular tests were positive for Mycobacterium tuberculosis and treatment with isoniazid, rifampicin, ethambutol and pyrazinamide was successful. In this case the diagnosis of DAH relies on clinical, radiological and endoscopic findings. Routine blood tests documented the presence of anticardiolipin antibodies. In the reported case the diagnostic criteria of antiphospholipid syndrome were not fulfilled. Conclusions The transient presence of anticardiolipin antibodies in association with an unusual clinical presentation of pulmonary tuberculosis is intriguing although a causal relationship cannot be established.
- Published
- 2010
- Full Text
- View/download PDF
13. New tools for detecting latent tuberculosis infection: evaluation of RD1-specific long-term response
- Author
-
Laurenti Patrizia, Marruchella Almerico, Lauria Francesco N, Vecchi Marco, Dieli Francesco, Guggino Giuliana, Meraviglia Serena, Vanini Valentina, Casetti Rita, Carrara Stefania, Chiacchio Teresa, Butera Ornella, Singh Mahavir, Caccamo Nadia, Girardi Enrico, and Goletti Delia
- Subjects
Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Interferon-gamma (IFN-γ) release assays (IGRAs) were designed to detect latent tuberculosis infection (LTBI). However, discrepancies were found between the tuberculin skin test (TST) and IGRAs results that cannot be attributed to prior Bacille Calmètte Guerin vaccinations. The aim of this study was to evaluate tools for improving LTBI diagnosis by analyzing the IFN-γ response to RD1 proteins in prolonged (long-term response) whole blood tests in those subjects resulting negative to assays such as QuantiFERON-TB Gold In tube (QFT-IT). Methods The study population included 106 healthy TST+ individuals with suspected LTBI (recent contact of smear-positive TB and homeless) consecutively enrolled. As controls, 13 healthy subjects unexposed to M. tuberculosis (TST-, QFT-IT-) and 29 subjects with cured pulmonary TB were enrolled. IFN-γ whole blood response to RD1 proteins and QFT-IT were evaluated at day 1 post-culture. A prolonged test evaluating long-term IFN-γ response (7-day) to RD1 proteins in diluted whole blood was performed. Results Among the enrolled TST+ subjects with suspected LTBI, 70/106 (66.0%) responded to QFT-IT and 64/106 (60.3%) to RD1 proteins at day 1. To evaluate whether a prolonged test could improve the detection of LTBI, we set up the test using cured TB patients (with a microbiologically diagnosed past pulmonary disease) who resulted QFT-IT-negative and healthy controls as comparator groups. Using this assay, a statistically significant difference was found between IFN-γ levels in cured TB patients compared to healthy controls (p < 0.006). Based on these data, we constructed a receiver operating characteristic (ROC) curve and we calculated a cut-off. Based on the cut-off value, we found that among the 36 enrolled TST+ subjects with suspected LTBI not responding to QFT-IT, a long term response to RD1 proteins was detected in 11 subjects (30.6%). Conclusion These results indicate that IFN-γ long-term response to M. tuberculosis RD1 antigens may be used to detect past infection with M. tuberculosis and may help to identify additional individuals with LTBI who resulted negative in the short-term tests. These data may provide useful information for improving immunodiagnostic tests for tuberculosis infection, especially in individuals at high risk for active TB.
- Published
- 2009
- Full Text
- View/download PDF
14. Patient to patient transmission of hepatitis B virus: a systematic review of reports on outbreaks between 1992 and 2007
- Author
-
Lanini Simone, Puro Vincenzo, Lauria Francesco N, Fusco Francesco M, Nisii Carla, and Ippolito Giuseppe
- Subjects
Medicine - Abstract
Abstract Background Hepatitis B outbreaks in healthcare settings are still a serious public health concern in high-income countries. To elucidate the most frequent infection pathways and clinical settings involved, we performed a systematic review of hepatitis B virus outbreaks published between 1992 and 2007 within the EU and USA. Methods The research was performed using two different databases: the PubMed Database and the Outbreak Database, the worldwide database for nosocomial outbreaks. Selection of papers was carried out using the Quorom algorithm, and to avoid selection biases, the inclusion criteria were established before the articles were identified. Results Overall, 30 papers were analyzed, reporting on 33 hepatitis B virus outbreaks that involved 471 patients, with 16 fatal cases. Dialysis units accounted for 30.3% of outbreaks followed by medical wards (21.2%), nursing homes (21.2%), surgery wards (15.2), and outpatient clinics (12.1%). The transmission pathways were: multi-vial drugs (30.3%), non-disposable multi-patient capillary blood sampling devices (27.2%), transvenous endomyocardial biopsy procedures (9.1%), and multiple deficiencies in applying standard precautions (9.1%). Conclusion The analysis of transmission pathways showed that some breaches in infection control measures, such as administration of drugs using multi-vial compounds and capillary blood sampling, are the most frequent routes for patient-to-patient transmission of hepatitis B virus. Moreover some outbreak reports underlined that heart-transplant recipients are at risk of contracting hepatitis B virus infection during the transvenous endomyocardial biopsy procedure through indirect contact with infected blood as a result of environmental contamination. To prevent transmission, healthcare workers must adhere to standard precautions and follow fundamental infection control principles, such as the use of sterile, single-use, disposable needles and avoiding the use of multi-vial compounds in all healthcare settings including outpatient settings.
- Published
- 2009
- Full Text
- View/download PDF
15. A multi-society position paper on the prevention and management of nosocomial and severe infections: the Italian Society for Infectious Diseases, the Italian Multidisciplinary Society of Hospital Infections, the Italian Society of Chemotherapy, the Italian Society of Respiratory Medicine, the Italian Society of Clinical Microbiology, the Italian Society of Microbiology, and GISIG (Italian Study Group on Severe Infections)
- Author
-
Ippolito, Giuseppe, Carosi, Giampiero, Moroni, Mauro, Nicastri, Emanuele, Lauria, Francesco N., Mazzotta, Francesco, Goglio, Antonio, Pea, Federico, Blasi, Francesco, Fortina, Giacomo, and Rossano, Fabio
- Published
- 2010
- Full Text
- View/download PDF
16. Rhinovirus and lower respiratory tract infection in adults
- Author
-
Puro, Vincenzo, Minosse, Claudia, Cappiello, Giuseppina, Lauria, Francesco N., and Capobianchi, Maria R.
- Subjects
Respiratory tract diseases -- Risk factors ,Respiratory tract diseases -- Diagnosis ,Respiratory tract diseases -- Research ,Rhinoviruses -- Risk factors ,Rhinoviruses -- Diagnosis ,Rhinoviruses -- Research ,Health ,Health care industry - Published
- 2005
17. Improved detection of human influenza A and B viruses in respiratory tract specimens by hemi-nested PCR
- Author
-
Minosse, Claudia, Selleri, Marina, Zaniratti, Maria S., Lauria, Francesco N., Puro, Vincenzo, Carletti, Fabrizio, Cappiello, Giuseppina, Gualano, Gina, Bevilacqua, Nazario, and Capobianchi, Maria R.
- Published
- 2007
- Full Text
- View/download PDF
18. Tuberculosis in Sheltered Homeless Population of Rome: An Integrated Model of Recruitment for Risk Management.
- Author
-
Laurenti, Patrizia, Bruno, Stefania, Quaranta, Gianluigi, La Torre, Giuseppe, Cairo, Antonio G., Nardella, Pierangela, Delogu, Giovanni, Fadda, Giovanni, Pirronti, Tommaso, Geraci, Salvatore, Pelargonio, Salvatore, Lauria, Francesco N., Goletti, Delia, and Ricciardi, Gualtiero
- Subjects
TUBERCULOSIS risk factors ,TUBERCULIN test ,HOMELESS persons ,DISEASE prevalence ,CHEST X rays ,MEDICAL screening - Published
- 2012
- Full Text
- View/download PDF
19. Duration of viral shedding in hospitalized patients infected with pandemic H1N1.
- Author
-
Meschi, Silvia, Selleri, Marina, Lalle, Eleonora, Bordi, Licia, Valli, Maria B., Ferraro, Federica, Ippolito, Giuseppe, Petrosillo, Nicola, Lauria, Francesco N., and Capobianchi, Maria R.
- Subjects
HOSPITAL patients ,H1N1 influenza ,COMORBIDITY ,PREGNANT women ,INFLUENZA ,PATIENTS - Abstract
Background: The first influenza pandemic of the 21th century was ignited by a new strain of influenza A virus (A/ H1N1pdm). Specific patient groups, including those with comorbidities, pregnant women, young children, older and immunocompromised patients, are at increased risk for serious influenza-related disease. This study was aimed at investigating the influence of clinical presentation, antiviral treatment and possible drug resistance-associated mutations, on the extent and duration of viral shedding in patients infected with A/H1N1pdm. Methods: An observational study was performed, based on retrospective review of clinical and laboratory records of patients who were hospitalized for A/H1N1pdm infection at the National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy, between April 24 and December 31, 2009. Among 119 hospitalized patients, 39 were selected for a post hoc analysis, based on the availability of serial nasopharyngeal swabs samples and related information. Results: Eleven out of the 39 study patients (28.2%) presented with pneumonia; 29 (74.4%) received antiviral treatment. Patients with pneumonia were significantly older than patients without pneumonia. The mean values of viral RNA concentration were not significantly increased in patients with pneumonia, but a significant increase in the duration of viral shedding was observed as compared to patients without pneumonia. In patients receiving antivirals, the viral RNA concentration was significantly reduced in comparison to untreated patients at days 4-5 after symptom onset, while the overall duration of viral shedding was only marginally affected. A significant correlation between duration of viral shedding and time elapsed between symptom onset and therapy start was observed, with a significant reduction of days of viral shedding when therapy was initiated within 2 days of symptoms appearance. No known drug resistance mutations were detected in patients with prolonged viral shedding. Conclusions: Our results show that severe respiratory illness is associated with delayed virus clearance in patients with A/H1N1pdm infection. Antivirals caused an early reduction of viral load, but only marginally affected the overall duration of shedding. Prolonged shedding was not associated with the emergence of strains carrying known drug-resistance mutations. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
20. IP-10 detection in urine is associated with lung diseases.
- Author
-
Cannas, Angela, Calvo, Ludovica, Chiacchio, Teresa, Cuzzi, Gilda, Vanini, Valentina, Lauria, Francesco N., Pucci, Luigia, Girardi, Enrico, and Goletti, Delia
- Subjects
BIOMARKERS ,TUBERCULOSIS ,LUNG diseases ,URINALYSIS ,CHEMOKINES - Abstract
Background: blood cytokines and chemokines have been proposed as biomarkers for tuberculosis (TB). Recently, some immune mediators found in the urine of patients with renal dysfunctions have also been suggested as potential biomarkers. Finding biomarkers for TB in urine would present several advantages over blood in terms of collection and safety. The objective of this study was to investigate the presence of cytokines and chemokines in the urine of patients with pulmonary TB at the time of diagnosis. In a subgroup, the evaluation was also performed during TB treatment and at therapy completion. Patients with lung diseases other than TB, and healthy subjects were also enrolled. Methods: urine samples from 138 individuals, after exclusion of renal dysfunctions, were collected during an 18 month-period. Among them, 58 received a diagnosis of pulmonary TB, 28 resulted having lung diseases other than TB, and 34 were healthy subjects. Moreover, 18 TB patients, 9 of whom were tested 2 months after AFB smear sputum reversion and 9 of whom were cured of TB were also included. Cytokines and chemokines in urine were evaluated using a Cytometric-Bead-Array-Flex-Set. IP-10 detection in 49 subjects was also carried out in parallel by using an Enzyme Linked ImmunoSorbent Assay (ELISA). Results: IFN-γ, TNF-α, IL-2, IL-8, MIP-1α, MIP-1&3x03B2; and RANTES were poorly detected in all urine samples. Conversely, IP-10 was consistently detected in urine and its level was significantly increased in patients with lung disease compared to healthy subjects (p < 0.001). Increased IP-10 levels were found in both pulmonary TB and lung diseases other than TB. Moreover lower IP-10 levels were found in cured-TB patients compared to the levels at the time of diagnosis, and this difference was close to significance (p = 0.06). Interestingly, we demonstrated a significant correlation between the data obtained by flow cytometry and ELISA (r2 0.82, p < 0.0001). Conclusions: IP-10, in contrast to IFN-γ, TNF-α, IL-2, IL-8, MIP-1α, MIP-1&3x03B2; and RANTES, is detectable in the urine of patients with pulmonary diseases in the absence of renal dysfunctions. Moreover, the IP-10 level in cured-TB patients is comparable to that found in healthy subjects. More studies are needed to further investigate the clinical utility of these findings. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
21. A case of pulmonary tuberculosis presenting as diffuse alveolar haemorrhage: is there a role for anticardiolipin antibodies?
- Author
-
Marruchella, Almerico, Corpolongo, Angela, Tommasi, Chiara, Lauria, Francesco N., and Narciso, Pasquale
- Subjects
TUBERCULOSIS ,HEMORRHAGE ,DYSPNEA ,TUBERCULIN ,PYRAZINAMIDE - Abstract
Background: Diffuse alveolar haemorrhage (DAH) has been rarely reported in association with pulmonary infections. Case Presentation: We report the case of a 43 year old immunocompetent man presenting with dyspnoea, fever and haemoptysis. Chest imaging showed bilateral ground glass opacities. Microbiological and molecular tests were positive for Mycobacterium tuberculosis and treatment with isoniazid, rifampicin, ethambutol and pyrazinamide was successful. In this case the diagnosis of DAH relies on clinical, radiological and endoscopic findings. Routine blood tests documented the presence of anticardiolipin antibodies. In the reported case the diagnostic criteria of antiphospholipid syndrome were not fulfilled. Conclusions: The transient presence of anticardiolipin antibodies in association with an unusual clinical presentation of pulmonary tuberculosis is intriguing although a causal relationship cannot be established. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
22. Tuberculosis in sheltered homeless population of Rome: an integrated model of recruitment for risk management.
- Author
-
Laurenti P, Bruno S, Quaranta G, La Torre G, Cairo AG, Nardella P, Delogu G, Fadda G, Pirronti T, Geraci S, Pelargonio S, Lauria FN, Goletti D, and Ricciardi G
- Subjects
- Adult, Female, Humans, Logistic Models, Male, Middle Aged, Prevalence, Rome epidemiology, Tuberculosis diagnosis, Ill-Housed Persons, Models, Statistical, Risk Management organization & administration, Tuberculosis epidemiology
- Abstract
The authors show the results of an integrated model for risk management of tuberculosis in a sample of sheltered homeless in Rome. Tuberculin skin test (TST) was used for evaluating the prevalence of latent infection (LTBI). In TST positives, expectorate was collected and chest X-ray was achieved. Multiple logistic regression analysis was performed to investigate determinants of infection. Out of 288 recruited subjects, 259 returned for the TST reading; 45.56% were positive and referred to a specialized center; 70 accessed the health facility and completed the clinical pathway. The risk factors associated to LTBI were male gender (OR = 3.72), age over 60 years (OR = 3.59), immigrant status (OR = 3.73), and obesity (OR = 2.19). This approach, based on an integrated social network, guarantees high adherence to screening (89.93%), allowing patients testing positive for latent tuberculosis infection to be diagnosed and rapidly referred to a specialized center.
- Published
- 2012
- Full Text
- View/download PDF
23. Detection of Pulmonary tuberculosis: comparing MR imaging with HRCT.
- Author
-
Rizzi EB, Schinina' V, Cristofaro M, Goletti D, Palmieri F, Bevilacqua N, Lauria FN, Girardi E, and Bibbolino C
- Subjects
- Adult, Female, Humans, Lung diagnostic imaging, Male, Middle Aged, Magnetic Resonance Imaging methods, Radiography, Thoracic methods, Tomography, X-Ray Computed methods, Tuberculosis, Pulmonary diagnosis
- Abstract
Background: Computer Tomography (CT) is considered the gold standard for assessing the morphological changes of lung parenchyma. Although novel CT techniques have substantially decreased the radiation dose, radiation exposure is still high. Magnetic Resonance Imaging (MRI) has been established as a radiation- free alternative to CT for several lung diseases, but its role in infectious diseases still needs to be explored further. Therefore, the purpose of our study was to compare MRI with high resolution CT (HRCT) for assessing pulmonary tuberculosis., Methods: 50 patients with culture-proven pulmonary tuberculosis underwent chest HRCT as the standard of reference and were evaluated by MRI within 24 h after HRCT. Altogether we performed 60 CT and MRI examinations, because 10 patients were also examined by CT and MRI at follow- up. Pulmonary abnormalities, their characteristics, location and distribution were analyzed by two readers who were blinded to the HRCT results., Results: Artifacts did not interfere with the diagnostic value of MRI. Both HRCT and MRI correctly diagnosed pulmonary tuberculosis and identified pulmonary abnormalities in all patients. There were no significant differences between the two techniques in terms of identifying the location and distribution of the lung lesions, though the higher resolution of MRI did allow for better identification of parenchymal dishomogeneity, caseosis, and pleural or nodal involvement., Conclusion: Technical developments and the refinement of pulse sequences have improved the quality and speed of MRI. Our data indicate that in terms of identifying lung lesions in non-AIDS patients with non- miliary pulmonary tuberculosis, MRI achieves diagnostic performances comparable to those obtained by HRCT but with better and more rapid identification of pulmonary tissue abnormalities due to the excellent contrast resolution.
- Published
- 2011
- Full Text
- View/download PDF
24. New tools for detecting latent tuberculosis infection: evaluation of RD1-specific long-term response.
- Author
-
Butera O, Chiacchio T, Carrara S, Casetti R, Vanini V, Meraviglia S, Guggino G, Dieli F, Vecchi M, Lauria FN, Marruchella A, Laurenti P, Singh M, Caccamo N, Girardi E, and Goletti D
- Subjects
- Adult, Antigens, Bacterial immunology, Female, Humans, Interferon-gamma immunology, Latent Tuberculosis immunology, Male, Middle Aged, Mycobacterium tuberculosis isolation & purification, Tuberculin Test methods, Young Adult, Antigens, Bacterial blood, Interferon-gamma blood, Latent Tuberculosis diagnosis, Reagent Kits, Diagnostic
- Abstract
Background: Interferon-gamma (IFN-gamma) release assays (IGRAs) were designed to detect latent tuberculosis infection (LTBI). However, discrepancies were found between the tuberculin skin test (TST) and IGRAs results that cannot be attributed to prior Bacille Calmètte Guerin vaccinations. The aim of this study was to evaluate tools for improving LTBI diagnosis by analyzing the IFN-gamma response to RD1 proteins in prolonged (long-term response) whole blood tests in those subjects resulting negative to assays such as QuantiFERON-TB Gold In tube (QFT-IT)., Methods: The study population included 106 healthy TST+ individuals with suspected LTBI (recent contact of smear-positive TB and homeless) consecutively enrolled. As controls, 13 healthy subjects unexposed to M. tuberculosis (TST-, QFT-IT-) and 29 subjects with cured pulmonary TB were enrolled. IFN-gamma whole blood response to RD1 proteins and QFT-IT were evaluated at day 1 post-culture. A prolonged test evaluating long-term IFN-gamma response (7-day) to RD1 proteins in diluted whole blood was performed., Results: Among the enrolled TST+ subjects with suspected LTBI, 70/106 (66.0%) responded to QFT-IT and 64/106 (60.3%) to RD1 proteins at day 1. To evaluate whether a prolonged test could improve the detection of LTBI, we set up the test using cured TB patients (with a microbiologically diagnosed past pulmonary disease) who resulted QFT-IT-negative and healthy controls as comparator groups. Using this assay, a statistically significant difference was found between IFN-gamma levels in cured TB patients compared to healthy controls (p < 0.006). Based on these data, we constructed a receiver operating characteristic (ROC) curve and we calculated a cut-off. Based on the cut-off value, we found that among the 36 enrolled TST+ subjects with suspected LTBI not responding to QFT-IT, a long term response to RD1 proteins was detected in 11 subjects (30.6%)., Conclusion: These results indicate that IFN-gamma long-term response to M. tuberculosis RD1 antigens may be used to detect past infection with M. tuberculosis and may help to identify additional individuals with LTBI who resulted negative in the short-term tests. These data may provide useful information for improving immunodiagnostic tests for tuberculosis infection, especially in individuals at high risk for active TB.
- Published
- 2009
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.