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Antibiotic resistance in Klebsiella pneumoniae strains is an increasing problem in a lot of hospitals. It is a public health emergency because it relates with high mortality rate among patients in Intensive Care Unit (ICU). From 1/1/2009 to 31/08/2010, in ICU of SS Annunziata Hospital of Taranto, 140 isolated Klebsiella pneumoniae strains were detected. The strain identification and antimicrobial susceptibility testing were performed using a Vitek2 automated system. These isolate showed a low level of susceptibility to levofloxacin (3.4%), ciprofloxacin (6.2%), ceftazidime (2.8%) and piperacillin/tazobactam (8%). We reported also that the 10% and 13.9% of them were susceptible to meropenem and imipenem. An anti-Klebsiella pneumoniae activity in vitro to tigecycline was present in 64.6% of isolates while almost all strains (56/58) tested to colistin were susceptible. In order to our data of worryng high multiclass drug resistance including tygecicline, it needs to apply appropriate measures of surveillance and antibiotic prescription to avoid rapid spread of these mutiresistant strains in other areas.

At today, neurologic desorders associated with novel influenza A (H1N1) virus were reported only in children but not in adult. We report two cases of encephalitis associated to H1N1 virus infection occurred in females of age 28 and 37 years. In both cases disease was less severe without neurologic sequelae. In one case PCR analysis of CSF sample showed a positivity for HSV1. Novel influenza A (H1N1) viral RNA by real time PCR was detected in nasopharyngeal specimens.

Non typhi-salmonella is the most common cause of hospitalization or death associated with acute diarrhea. It is usually a self limiting disease and antibiotic therapy is not required, but in immunocompromised people it is essential. Increasing antimicrobial resistance in salmonella, in future, would limit the therapeutic options. During 2002, 198 persons were hospitalized for acute gastroenteritis. The 55% of cases were female, the age ranged between 4 and 94 years and the 25% of them were > 60 years old. The 58.5% of hospitalizations occurred between June and October. Non-typhi salmonella was isolated in the stool of 49 persons, with a rate of hospitalization of 24.7% respect to other causes of gastroenteritis. The incidence of resistance that was defined as resistance to one or more drugs was 14.3%. Only one non-typhi salmonella showed a multiple resistance (> four drugs). Among all antibiotics tested, only the fluorquinolones showed a susceptibility in vitro in all strains. Non typhoidal Salmonellosis is a public healt problem in the world and it will be important to restrict the use of antibiotics in medicine and veterinary to reduce the spread of multiresistant strains.

The use of protease inhibitors (PIs) in the antiretroviral therapy (ART) of HIV-1 infection has reduced the rate of morbidity and mortality; but, unfortunately, this therapy has several side effects and a long term toxicity. Unexpected lipid abnormalities and cardiovascular complications are observed. We report a case of myocardial infarction in a young man HIV-1 positive patient without a history of metabolic disorders and cardiovascular pathologies undergoing PI treatment. The new ART without PI was not suppressive, while hypertriglyceridemia value improved by omega 3 fatty acids use. Our opinion is to continue ART with PI and to correct lipid abnormalities with the use of antidislipidemic drugs instead to change a demonstrated suppressive ART.

Objective: To evaluate the effects of the use of protease inhibitors (IP) on the out-patient department's activities and hospitalizations of HIV-1 infected subjects., Methods: From the December 1996 IP was available in our hospital, so the years 1996 and 1997 were studied., Results: In the year 1997, 336 patients were visited with an increase of the 41% compared with the year 1996. In the 1997 the 45.2% of hospitalizations were related to AIDS, while in the year 1996 the 65.4% of them were related to AIDS., Conclusions: The use of IP had increased the activities of the out-patient department and certainly had a role in reducing the hospitalizations related to AIDS.