115 results on '"DE CAROLIS, E"'
Search Results
2. “CORE” a new assay for rapid identification of Klebsiella pneumoniae COlistin REsistant strains by MALDI-TOF MS in positive-ion mode
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Foglietta, G., De Carolis, Elena, Mattana, G., Onori, M., Agosta, M., Niccolai, C., Di Pilato, V., Rossolini, G. M., Sanguinetti, Maurizio, Perno, C. F., Bernaschi, P., De Carolis E. (ORCID:0000-0003-4757-7256), Sanguinetti M. (ORCID:0000-0002-9780-7059), Foglietta, G., De Carolis, Elena, Mattana, G., Onori, M., Agosta, M., Niccolai, C., Di Pilato, V., Rossolini, G. M., Sanguinetti, Maurizio, Perno, C. F., Bernaschi, P., De Carolis E. (ORCID:0000-0003-4757-7256), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
Due to the global spread of pan resistant organisms, colistin is actually considered as one of the last resort antibiotics against MDR and XDR bacterial infections. The emergence of colistin resistant strains has been observed worldwide in Gram-negative bacteria, such as Enterobacteriaceae and especially in K. pneumoniae, in association with increased morbidity and mortality. This landscape implies the exploration of novel assays able to target colistin resistant strains rapidly. In this study, we developed and evaluated a new MALDI-TOF MS assay in positive-ion mode that allows quantitative or qualitative discrimination between colistin susceptible (18) or resistant (32) K. pneumoniae strains in 3 h by using the “Autof MS 1000” mass spectrometer. The proposed assay, if integrated in the diagnostic workflow, may be of help for the antimicrobial stewardship and the control of the spread of K. pneumoniae colistin resistant isolates in hospital settings.
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- 2023
3. Clusters of patients with candidaemia due to genotypes of Candida albicans and Candida parapsilosis: differences in frequency between hospitals
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Marcos-Zambrano, L.J., Escribano, P., Sanguinetti, M., Gómez G. de la Pedrosa, E., De Carolis, E., Vella, A., Cantón, R., Bouza, E., and Guinea, J.
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- 2015
- Full Text
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4. Old and New Insights into Sporothrix schenckii Complex Biology and Identification
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De Carolis, Elena, Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), De Carolis, Elena, Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
Sporothrix schenckii is a worldwide-distributed thermally dimorphic fungus, which usually causes a subacute to chronic infection through traumatic implantation or inoculation of its infectious propagules. The fungus encompasses a group of phylogenetically closely related species, thus named the S. schenckii complex, of which S. schenckii sensu stricto and S. brasiliensis are main causative species of sporotrichosis. Owing to a multifaceted molecular dynamic, the S. schenckii complex can switch between the mycelium and the yeast form. This characteristic along with a varying cell wall composition account for significant species-specific differences in the host range, virulence, and susceptibility to antifungal drugs. While culture remains the gold standard to diagnose sporotrichosis, polymerase chain reaction (PCR) or matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry-based methods have become an essential for accurate species identification in many clinical laboratories. If directly applied on tissue samples, molecular methods are helpful to improve both sensitivity of and time to the etiological diagnosis of sporotrichosis. This mini-review aims to put together the old and new knowledge on the S. schenckii complex biology and identification, with particular emphasis on the laboratory diagnosis-related aspects of dis-ease.
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- 2022
5. Species identification of Aspergillus, Fusarium and Mucorales with direct surface analysis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry
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De Carolis, E., Posteraro, B., Lass-Flörl, C., Vella, A., Florio, A.R., Torelli, R., Girmenia, C., Colozza, C., Tortorano, A.M., Sanguinetti, M., and Fadda, G.
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- 2012
- Full Text
- View/download PDF
6. Evaluation of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry in comparison to rpoB gene sequencing for species identification of bloodstream infection staphylococcal isolates
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Spanu, T., De Carolis, E., Fiori, B., Sanguinetti, M., D'Inzeo, T., Fadda, G., and Posteraro, B.
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- 2011
- Full Text
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7. Disseminated geosmithia argillacea infection in a patient with ph-positive acute lymphoblastic leukemia. Case report and literature review
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Giordano, A., Di Landro, Francesca, De Carolis, Elena, Criscuolo, Marianna, Dragonetti, Giulia, Fianchi, Luana, Pagano, Livio, Di Landro F., De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., Dragonetti G., Fianchi L., Pagano L. (ORCID:0000-0001-8287-928X), Giordano, A., Di Landro, Francesca, De Carolis, Elena, Criscuolo, Marianna, Dragonetti, Giulia, Fianchi, Luana, Pagano, Livio, Di Landro F., De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., Dragonetti G., Fianchi L., and Pagano L. (ORCID:0000-0001-8287-928X)
- Abstract
Invasive fungal infection (IFI) remains the major complication in patients with either acute leukemia, allogeneic stem cell transplantation setting, or both, especially regarding pulmonary lo-calization. We report an experience of a 74-year-old Caucasian male with a Philadelphia-positive (BCR-ABL p190) Common B-acute lymphoblastic leukemia (ALL) who developed a pulmonary infection due to Geosmithia argillacea. Furthermore, we describe the management of this complication and the results of microbiological tests useful to guide the treatment. All cases reported show failure of voriconazole treatment. In the majority of cases a good susceptibility to posaconazole has been reported, which seems to have a good clinical impact; however, only L-AmB shows a clinical effect to produce quick clinical improvement and so it should be a drug of choice. A literature revision shows that only a few papers have thus far described this infection, at present only one case was reported in a hematological setting like a gastrointestinal graft versus host disease in an allogeneic HSCT recipient. The severity of clinical conditions in hematological malignancy settings requires improving the management of this emerging invasive fungal infection. Indeed, a molecular diag-nostic approach with a tight laboratory collaboration and targeted therapy should become the gold standard.
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- 2021
8. A new pcr‐based assay for testing bronchoalveolar lavage fluid samples from patients with suspected pneumocystis jirovecii pneumonia
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Liotti, Flora Marzia, Posteraro, Brunella, Angelis, G. D., Torelli, Riccardo, De Carolis, Elena, Speziale, Domenico, Menchinelli, Giulia, Spanu, Teresa, Sanguinetti, Maurizio, Liotti F. M., Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Speziale D., Menchinelli G., Spanu T. (ORCID:0000-0003-1864-5184), Sanguinetti M. (ORCID:0000-0002-9780-7059), Liotti, Flora Marzia, Posteraro, Brunella, Angelis, G. D., Torelli, Riccardo, De Carolis, Elena, Speziale, Domenico, Menchinelli, Giulia, Spanu, Teresa, Sanguinetti, Maurizio, Liotti F. M., Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Speziale D., Menchinelli G., Spanu T. (ORCID:0000-0003-1864-5184), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
To support the clinical laboratory diagnosis of Pneumocystis jirovecii (PJ) pneumonia (PCP), an invasive fungal infection mainly occurring in HIV‐negative patients, in‐house or commercial PJ‐specific real‐time quantitative PCR (qPCR) assays are todays’ reliable options. The performance of these assays depends on the type of PJ gene (multi‐copy mitochondrial versus single‐copy nuclear) targeted by the assay. We described the development of a PJ‐PCR assay targeting the dihydrofolate reductase (DHFR)‐encoding gene. After delineating its analytical performance, the PJ‐PCR assay was used to test bronchoalveolar lavage (BAL) fluid samples from 200 patients (only seven were HIV positive) with suspected PCP. Of 211 BAL fluid samples, 18 (8.5%) were positive and 193 (91.5%) were negative by PJ‐PCR. Of 18 PJ‐PCR‐positive samples, 11 (61.1%) tested positive and seven (38.9%) tested negative with the immunofluorescence assay (IFA). All (100%) of the 193 PJ‐PCR‐negative samples were IFA negative. Based on IFA/PCR results, patients were, respectively, classified as having (n = 18) and not having (n = 182) proven (PJ‐ PCR+/IFA+) or probable (PJ‐PCR+/IFA−) PCP. For 182 patients without PCP, alternative infectious or non‐infectious etiologies were identified. Our PJ‐PCR assay was at least equivalent to IFA, fostering studies aimed at defining a qPCR‐based standard for PCP diagnosis in the future.
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- 2021
9. Are We Ready for Nosocomial Candida auris Infections? Rapid Identification and Antifungal Resistance Detection Using MALDI-TOF Mass Spectrometry May Be the Answer
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De Carolis, Elena, Marchionni, F., La Rosa, M., Meis, J. F., Chowdhary, A., Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), De Carolis, Elena, Marchionni, F., La Rosa, M., Meis, J. F., Chowdhary, A., Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
The occurrence of multidrug-resistant Candida auris isolates and the increased mortality associated with invasive infections or outbreaks due to this Candida species have been reported in many healthcare settings. Therefore, accurate and rapid identification at the species level of clinical C. auris isolates as well as their timely differentiation as susceptible or resistant to antifungal drugs is mandatory. Aims of the present study were to implement the MALDI-TOF mass spectrometry (MS) Bruker Daltonics Biotyper® database with C. auris spectrum profiles and to develop a fast and reproducible MS assay for detecting anidulafungin (AFG) resistance in C. auris isolates. After creation of main C. auris spectra, a score-oriented dendrogram was generated from hierarchical cluster analysis, including spectra of isolates from C. auris and other Candida (C. glabrata, C. guilliermondii, C. haemulonii, C. lusitaniae, and C. parapsilosis) or non-Candida (Rhodotorula glutinis) species. Cluster analysis allowed to group and classify the isolates according to their species designation. Then, a three-hour incubation antifungal susceptibility testing (AFST) assay was developed. Spectra obtained at null, intermediate, or maximum AFG concentrations were used to create composite correlation index matrices for eighteen C. auris isolates included in the study. All six resistant C. auris isolates were detected as resistant whereas 11 of 12 susceptible C. auris isolates were detected as susceptible by the MS-AFST assay. In conclusion, our MS-based assay offers the possibility of rapidly diagnosing and appropriately treating patients with C. auris infection.
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- 2021
10. Considerations on antimicrobial prophylaxis in patients with lymphoproliferative diseases: A SEIFEM group position paper
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Busca, A., Cattaneo, C., De Carolis, Elena, Nadali, G., Offidani, M., Picardi, M., Candoni, A., Ceresoli, E., Criscuolo, Marianna, Delia, M., Della Pepa, R., Del Principe, I., Fanci, R. R., Farina, F., Fracchiolla, N., Giordano, C., Malagola, M., Marchesi, F., Piedimonte, M., Prezioso, L., Quinto, A. M., Spolzino, A., Tisi, M. C., Trastulli, F., Trecarichi, E. M., Zappasodi, P., Tumbarello, Mario, Pagano, Livio, De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., Tumbarello M. (ORCID:0000-0002-9519-8552), Pagano L. (ORCID:0000-0001-8287-928X), Busca, A., Cattaneo, C., De Carolis, Elena, Nadali, G., Offidani, M., Picardi, M., Candoni, A., Ceresoli, E., Criscuolo, Marianna, Delia, M., Della Pepa, R., Del Principe, I., Fanci, R. R., Farina, F., Fracchiolla, N., Giordano, C., Malagola, M., Marchesi, F., Piedimonte, M., Prezioso, L., Quinto, A. M., Spolzino, A., Tisi, M. C., Trastulli, F., Trecarichi, E. M., Zappasodi, P., Tumbarello, Mario, Pagano, Livio, De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., Tumbarello M. (ORCID:0000-0002-9519-8552), and Pagano L. (ORCID:0000-0001-8287-928X)
- Abstract
The therapeutic armamentarium for the treatment of patients with lymphoproliferative diseases has grown considerably over the most recent years, including a large use of new immunotherapeutic agents. As a consequence, the epidemiology of infectious complications in this group of patients is poorly documented, and even more importantly, the potential benefit of antimicrobial prophylaxis remains a matter of debate when considering the harmful effect from the emergence of multidrug resistant pathogens. The present position paper is addressed to all hematologists treating patients affected by lymphoproliferative malignancies with the aim to provide clinicians with a useful tool for the prevention of bacterial, fungal and viral infections.
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- 2021
11. Correction for Cornu et al., “Evaluation of mass spectrometry-based detection of panfungal serum disaccharide for diagnosis of invasive fungal infections: Results from a collaborative study involving six European clinical centers”. (J Clin Microbiol (2019) 57, 5 (e01867-18) DOI: 10.1128/JCM.01867-18)
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Cornu, M., Sendid, B., Mery, A., François, N., Mikulska, M., Letscher-Bru, V., De Carolis, Elena, Damonti, L., Titecat, M., Bochud, P. Y., Alanio, A., Sanguinetti, Maurizio, Viscoli, C., Herbrecht, R., Guerardel, Y., Poulaina, D., de Carolis E. (ORCID:0000-0003-4757-7256), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cornu, M., Sendid, B., Mery, A., François, N., Mikulska, M., Letscher-Bru, V., De Carolis, Elena, Damonti, L., Titecat, M., Bochud, P. Y., Alanio, A., Sanguinetti, Maurizio, Viscoli, C., Herbrecht, R., Guerardel, Y., Poulaina, D., de Carolis E. (ORCID:0000-0003-4757-7256), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
No abstract
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- 2020
12. Infection caused by Sporothrix schenckii: an autochthonous case in Bari, Southern Italy
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Monno, R., Brindicci, G., Romeo, O., De Carolis, Elena, Criseo, G., Sanguinetti, Maurizio, Fumarola, L., Ingravallo, G., Mariani, M., Monno, L., De Carolis E. (ORCID:0000-0003-4757-7256), Sanguinetti M. (ORCID:0000-0002-9780-7059), Monno, R., Brindicci, G., Romeo, O., De Carolis, Elena, Criseo, G., Sanguinetti, Maurizio, Fumarola, L., Ingravallo, G., Mariani, M., Monno, L., De Carolis E. (ORCID:0000-0003-4757-7256), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
An autochthonous case of lymphocutaneous sporotrichosis caused by Sporothrix schenckii is reported. The patient developed skin lesions localized along the lymphatics that appeared after he suffered an injury while collecting wicker canes in marshy water. The fungus was identified as Sporothrix schenckii by MALDI-TOF and sequencing. Phylogenetic analysis was also performed. Low MIC values were detected for all tested echinocandins and azoles except for fluconazole. The patient was treated with itraconazole without significant improvement. A regression of lesions was observed after 3 months of therapy with voriconazole. Few cases of sporotrichosis have been reported in Europe. However, several cases of sporotrichosis have been described in Italy. The incidence of sporotrichosis in Italy may be underestimated and microbiologists, and clinicians must be aware of this fungal infection.
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- 2020
13. Pan-echinocandin-resistant candida glabrata bloodstream infection complicating covid-19: A fatal case report
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Posteraro, Brunella, Torelli, Riccardo, Vella, Antonietta, Leone, Paolo Maria, De Angelis, Giulia, De Carolis, Elena, Ventura, Giulio, Sanguinetti, Maurizio, Fantoni, Massimo, Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., Vella A., Leone P. M., De Angelis G. (ORCID:0000-0002-7087-7399), De Carolis E. (ORCID:0000-0003-4757-7256), Ventura G. (ORCID:0000-0002-0304-7264), Sanguinetti M. (ORCID:0000-0002-9780-7059), Fantoni M. (ORCID:0000-0001-6913-8460), Posteraro, Brunella, Torelli, Riccardo, Vella, Antonietta, Leone, Paolo Maria, De Angelis, Giulia, De Carolis, Elena, Ventura, Giulio, Sanguinetti, Maurizio, Fantoni, Massimo, Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., Vella A., Leone P. M., De Angelis G. (ORCID:0000-0002-7087-7399), De Carolis E. (ORCID:0000-0003-4757-7256), Ventura G. (ORCID:0000-0002-0304-7264), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Fantoni M. (ORCID:0000-0001-6913-8460)
- Abstract
Coinfections with bacteria or fungi may be a frequent complication of COVID-19, but coinfections with Candida species in COVID-19 patients remain rare. We report the 53-day clinical course of a complicated type-2 diabetes patient diagnosed with COVID-19, who developed bloodstream infections initially due to methicillin-resistant Staphylococcus aureus, secondly due to multidrug-resistant Gram-negative bacteria, and lastly due to a possibly fatal Candida glabrata. The development of FKS-associated pan-echinocandin resistance in the C. glabrata isolated from the patient after 13 days of caspofungin treatment aggravated the situation. The patient died of septic shock shortly before the prospect of receiving potentially effective antifungal therapy. This case emphasizes the importance of early diagnosis and monitoring for antimicrobial drug-resistant coinfections to reduce their unfavorable outcomes in COVID-19 patients.
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- 2020
14. Prevalence and Clonal Distribution of Azole-Resistant Candida parapsilosis Isolates Causing Bloodstream Infections in a Large Italian Hospital
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Martini, Cecilia, Torelli, Riccardo, de Groot, T., De Carolis, Elena, Morandotti, Grazia Angela, De Angelis, Giulia, Posteraro, Brunella, Meis, J. F., Sanguinetti, Maurizio, Martini C., Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Morandotti G. A., De Angelis G. (ORCID:0000-0002-7087-7399), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Martini, Cecilia, Torelli, Riccardo, de Groot, T., De Carolis, Elena, Morandotti, Grazia Angela, De Angelis, Giulia, Posteraro, Brunella, Meis, J. F., Sanguinetti, Maurizio, Martini C., Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Morandotti G. A., De Angelis G. (ORCID:0000-0002-7087-7399), Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
The most prevalent cause of nosocomial bloodstream infection (BSI) among non-C. albicans Candida species, Candida parapsilosis, may not only be resistant to azole antifungal agents but also disseminate to vulnerable patients. In this survey of BSIs occurring at a large Italian hospital between May 2014 and May 2019, C. parapsilosis accounted for 28.5% (241/844) of all Candida isolates causing BSI episodes. The majority of episodes (151/844) occurred in medical wards. Across the 5 yearly periods, the rates of azole non-susceptibility were 11.8% (4/34), 17.8% (8/45), 28.6% (12/42), 32.8% (19/58), and 17.7% (11/62), respectively, using the Sensititre YeastOne® method. Among azole non-susceptible isolates (54/241; 22.4%), 49 were available for further investigation. Using the CLSI reference method, all 49 isolates were resistant to fluconazole and, except one (susceptible dose-dependent), to voriconazole. Forty (81.6%) isolates harbored the Erg11p Y132F substitution and nine (18.4%) isolates the Y132F in combination with the Erg11p R398I substitution. According to their genotypes, as defined using a microsatellite analysis based on six short tandem repeat markers, 87.7% of isolates (43/49) grouped in two major clusters (II and III), whereas 4.1% of isolates (2/49) belonged to a separate cluster (I). Interestingly, all the isolates from cluster II harbored the Y132F substitution, and those from cluster III harbored both Y132F and R398I substitutions. Of 56 non-Italian isolates included as controls, two Indian isolates with the Y132F substitution had a genotype clearly differing from that of the isolates from clusters II and I. In conclusion, these findings show the dominance of clonal Y132F isolates in our hospital and suggest detection of the Y132F substitution as helpful tool to prevent transmission among hospitalized patients at risk of BSI.
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- 2020
15. Candidaemia in haematological malignancy patients from a SEIFEM study: Epidemiological patterns according to antifungal prophylaxis
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Posteraro, Brunella, De Carolis, Elena, Criscuolo, Marianna, Ballanti, S., De Angelis, Giulia, Del Principe, M. I., Delia, M., Fracchiolla, N., Marchesi, F., Nadali, G., Picardi, Stefano Maria, Piccioni, A. L., Verga, L., Candoni, A., Busca, A., Sanguinetti, Maurizio, Pagano, Livio, Muggeo, P., Stanzani, M., Cattaneo, C., Russo, D., Vacca, A., Fanci, R., De Paolis, M. R., Mancini, V., Lessi, F., Rossetti, E., Decembrino, N., Facchini, L., Dragonetti, Giulia, Ferrari, A., Vallero, S., Posteraro B. (ORCID:0000-0002-1663-7546), De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., De Angelis G. (ORCID:0000-0002-7087-7399), Picardi M., Sanguinetti M. (ORCID:0000-0002-9780-7059), Pagano L. (ORCID:0000-0001-8287-928X), Dragonetti G., Posteraro, Brunella, De Carolis, Elena, Criscuolo, Marianna, Ballanti, S., De Angelis, Giulia, Del Principe, M. I., Delia, M., Fracchiolla, N., Marchesi, F., Nadali, G., Picardi, Stefano Maria, Piccioni, A. L., Verga, L., Candoni, A., Busca, A., Sanguinetti, Maurizio, Pagano, Livio, Muggeo, P., Stanzani, M., Cattaneo, C., Russo, D., Vacca, A., Fanci, R., De Paolis, M. R., Mancini, V., Lessi, F., Rossetti, E., Decembrino, N., Facchini, L., Dragonetti, Giulia, Ferrari, A., Vallero, S., Posteraro B. (ORCID:0000-0002-1663-7546), De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., De Angelis G. (ORCID:0000-0002-7087-7399), Picardi M., Sanguinetti M. (ORCID:0000-0002-9780-7059), Pagano L. (ORCID:0000-0001-8287-928X), and Dragonetti G.
- Abstract
Background: Candidaemia is an important infectious complication for haematological malignancy patients. Antifungal prophylaxis reduces the incidence of candidaemia but may be associated with breakthrough candidaemia. Objective: To analyse the Candida species’ distribution and relative antifungal susceptibility profiles of candidaemia episodes in relation to the use of antifungal prophylaxis among Italian SEIFEM haematology centres. Methodology: This multicentre retrospective observational SEIFEM study included 133 single-species candidaemia episodes of haematological malignancy patients for whom antifungal susceptibility testing results of blood Candida isolates were available between 2011 and 2015. Each participating centre provided both clinical and microbiological data. Results: Non-Candida albicans Candida (NCAC) species were the mostly isolated species (89, 66.9%), which accounted for C parapsilosis (35, 26.3%), C glabrata (16, 12.0%), C krusei (14, 10.5%), C tropicalis (13, 9.8%) and uncommon species (11, 8.3%). C albicans caused the remaining 44 (33.1%) episodes. Excluding 2 C albicans isolates, 23 of 25 fluconazole-resistant isolates were NCAC species (14 C krusei, 6 C glabrata, 2 C parapsilosis and 1 C tropicalis). Fifty-six (42.1%) of 133 patients developed breakthrough candidaemia. Systemic antifungal prophylaxis consisted of azoles, especially fluconazole and posaconazole, in 50 (89.3%) of 56 patients in whom a breakthrough candidaemia occurred. Interestingly, all these patients tended to develop a C krusei infection (10/56, P =.02) or a fluconazole-resistant isolate’s infection (14/50, P =.04) compared to patients (4/77 and 10/77, respectively) who did not have a breakthrough candidaemia. Conclusions: Optimisation of prophylactic strategies is necessary to limit the occurrence of breakthrough candidaemia and, importantly, the emergence of fluconazole-resistant NCAC isolates’ infections in
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- 2020
16. Different detection capabilities by mycological media for Candida isolates from mono- or dual-species cultures
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De Angelis, Giulia, Menchinelli, Giulia, Torelli, Riccardo, De Carolis, Elena, Posteraro, P., Sanguinetti, Maurizio, Posteraro, Brunella, De Angelis G. (ORCID:0000-0002-7087-7399), Menchinelli G., Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), De Angelis, Giulia, Menchinelli, Giulia, Torelli, Riccardo, De Carolis, Elena, Posteraro, P., Sanguinetti, Maurizio, Posteraro, Brunella, De Angelis G. (ORCID:0000-0002-7087-7399), Menchinelli G., Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
- Abstract
The aim of this study was to compare the Candida bromcresol green (BCG) medium with the chromogenic (CHROM) Brilliance Candida agar and Sabouraud dextrose agar (SDA) media in regard to their capability of detecting Candida isolates from mono- or dual-species cultures. We prepared Candida isolates' suspensions to obtain mono-species (n = 18) or dual-species (n = 153) culture plates per each medium, and three readers independently observed 513 plates at 24-h, 48-h and 72-h incubation time. We scored reading results as correct, over or under detection compared to the expected species number(s). BCG showed significantly higher correct-detection and lower under-detection rates for all Candida species when observed by at least one reader. At 24-h reading, 12 mono-species cultures had correct (or over) detections in all media, whereas 106, 60 and 78 dual-species cultures had correct (or over) detections in BCG, CHROM or SDA, respectively. BCG provides the basis for an accurate laboratory diagnosis of Candida infections.
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- 2020
17. BIOF–HILO assay: A new MALDI–TOF mass spectrometry based method for discriminating between high-and low-biofilm-producing candida parapsilosis isolates
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De Carolis, Elena, Soldini, Silvia, La Rosa, M., Nucci, F., Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Soldini S., Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), De Carolis, Elena, Soldini, Silvia, La Rosa, M., Nucci, F., Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Soldini S., Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
Candida parapsilosis is the most frequent cause of catheter-related candidemia among non-Candida albicans species. This may be related to intrinsic capabilities as adhering and forming a biofilm on abiotic surfaces such as on medical devices. As previously demonstrated, patients infected with high biofilm-producing C. parapsilosis isolates had a greater mortality risk compared to patients infected with low biofilm-producing C. parapsilosis isolates. We developed the BIOF–HILO assay, a MALDI–TOF mass spectrometry (MS)-based assay, which compares mass spectra obtained from attached and suspended isolate cells during the early (i.e., 3-h) adhesion phase of in vitro biofilm formation. The composite correlation index (CCI) analysis was used to discriminate between mass spectra differences of the two cell types, classifying all 50 C. parapsilosis clinical isolates, included in the study, after only 3-h of testing, in high or low biofilm producers. All high (n = 25) or low (n = 25) biofilm producers had, according to CCI mass spectra comparison values, higher or lower than one CCI ratios, which were obtained by dividing the CCIsuspendedcells by the CCIattachedcells . In conclusion, the BIOF–HILO assay allows a rapid categorization of C. parapsilosis clinical isolates in high or low biofilm producers. This information, if timely provided to physicians, may improve treatment outcomes in patients with C. parapsilosis candidemia.
- Published
- 2019
18. T2Bacteria magnetic resonance assay for the rapid detection of ESKAPEc pathogens directly in whole blood
- Author
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De Angelis, Giulia, Posteraro, Brunella, De Carolis, Elena, Menchinelli, Giulia, Franceschi, Francesco, Tumbarello, Mario, De Pascale, Gennaro, Spanu, Teresa, Sanguinetti, Maurizio, De Angelis G. (ORCID:0000-0002-7087-7399), Posteraro B. (ORCID:0000-0002-1663-7546), De Carolis E. (ORCID:0000-0003-4757-7256), Menchinelli G., Franceschi F. (ORCID:0000-0001-6266-445X), Tumbarello M. (ORCID:0000-0002-9519-8552), De Pascale G. (ORCID:0000-0002-8255-0676), Spanu T. (ORCID:0000-0003-1864-5184), Sanguinetti M. (ORCID:0000-0002-9780-7059), De Angelis, Giulia, Posteraro, Brunella, De Carolis, Elena, Menchinelli, Giulia, Franceschi, Francesco, Tumbarello, Mario, De Pascale, Gennaro, Spanu, Teresa, Sanguinetti, Maurizio, De Angelis G. (ORCID:0000-0002-7087-7399), Posteraro B. (ORCID:0000-0002-1663-7546), De Carolis E. (ORCID:0000-0003-4757-7256), Menchinelli G., Franceschi F. (ORCID:0000-0001-6266-445X), Tumbarello M. (ORCID:0000-0002-9519-8552), De Pascale G. (ORCID:0000-0002-8255-0676), Spanu T. (ORCID:0000-0003-1864-5184), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
- Abstract
Objectives: To evaluate the magnetic resonance-based T2Bacteria Panel assay for direct detection of ESKAPEc (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli) pathogens in blood samples of patients with suspected bloodstream infection (BSI). Patients and methods: Adult patients admitted to the Emergency Medicine Department, Infectious Diseases Unit and ICU of a large tertiary-care hospital were included if they had a blood culture (BC) ordered concomitantly with a whole-blood sample for T2Bacteria testing. Results were compared with those of BC and other clinically relevant information. Results: A total of 140 samples from 129 BSI patients were studied. Single bacteria were detected in 15.7% (22/140) and 12.1% (17/140), and multiple bacteria in 2.9% (4/140) and 1.4% (2/140), of samples tested by T2Bacteria and BC, respectively. With respect to the six target (ESKAPEc) species, overall sensitivity and specificity of T2Bacteria across all detection channels in comparison with BC were 83.3% and 97.6%, respectively; these values increased to 89.5% and 98.4%, respectively, when a true-infection criterion (i.e. the same microorganism detected only by T2Bacteria was cultured from another sample type reflecting the source of infection) was used as the comparator. There were 808 T2Bacteria detection results across 112 samples, with concordant negative results, yielding a negative predictive value of 99.8%. The mean time to negative result was 6.1+1.5 h, whereas the mean time to detection/species identification was 5.5+1.4 h. Conclusions: The T2Bacteria Panel assay has the potential to provide accurate and timely diagnosis of ESKAPEc bacteraemia, which might support the direct therapeutic management of BSI patients.
- Published
- 2018
19. Microbiologic and clinical characteristics of biofilm-forming Candida parapsilosis isolates associated with fungaemia and their impact on mortality
- Author
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Soldini, Silvia, Posteraro, Brunella, Vella, Antonietta, De Carolis, Elena, Borghi, E., Falleni, M., Losito, Angela Raffaella, Maiuro, Giuseppe, Trecarichi, Enrico Maria, Sanguinetti, Maurizio, Tumbarello, Mario, Soldini, S., Posteraro, B. (ORCID:0000-0002-1663-7546), Vella, A., De Carolis, E. (ORCID:0000-0003-4757-7256), Losito, A. R., Maiuro, G. (ORCID:0000-0002-4749-9713), Trecarichi, E. M., Sanguinetti, M. (ORCID:0000-0002-9780-7059), Tumbarello, M. (ORCID:0000-0002-9519-8552), Soldini, Silvia, Posteraro, Brunella, Vella, Antonietta, De Carolis, Elena, Borghi, E., Falleni, M., Losito, Angela Raffaella, Maiuro, Giuseppe, Trecarichi, Enrico Maria, Sanguinetti, Maurizio, Tumbarello, Mario, Soldini, S., Posteraro, B. (ORCID:0000-0002-1663-7546), Vella, A., De Carolis, E. (ORCID:0000-0003-4757-7256), Losito, A. R., Maiuro, G. (ORCID:0000-0002-4749-9713), Trecarichi, E. M., Sanguinetti, M. (ORCID:0000-0002-9780-7059), and Tumbarello, M. (ORCID:0000-0002-9519-8552)
- Abstract
Objectives: Biofilm formation (BF) by fungal isolates may dramatically complicate infection. We determined the ability of Candida parapsilosis isolates from single fungaemia episodes to form biofilms and we analysed biofilm subgroups for antifungal susceptibility and pathogenic potential. We then correlated BF with clinical characteristics and outcomes of the episodes. Methods: BF was measured using the crystal violet biomass assay. Antifungal susceptibility of preformed biofilms was assessed, and virulence was studied using the Galleria mellonella model. A retrospective analysis of patients' clinical records was performed. Results: Of 190 patient-unique isolates, 84, 38 and 68 were identified as having high BF (HBF), moderate BF (MBF) or low BF (LBF), respectively. Among 30 randomly selected isolates, nine (eight HBF and one MBF), six (all HBF) and one (HBF) isolates had elevated sessile minimum inhibitory concentrations to fluconazole, anidulafungin or amphotericin B; all HBF and MBF isolates had elevated voriconazole sessile minimum inhibitory concentrations. G. mellonella killing rates of HBF isolates were significantly greater than MBF (or LBF) isolates (50% vs. 20%, 2 days from infection). By comparing HBF/MBF (106 patients) and LBF (84 patients) groups, we found that HBF/MBF patients had more central venous catheter-related fungaemias (62/106 (58.5%) vs. 29/84 (34.5%), p 0.001) and were more likely to die at 30 days from fungaemia onset (61/106 (57.5%) vs. 28/84 (33.3%), p 0.01). In the HBF/MBF group, azole antifungal therapy and central venous catheter removal were significantly associated with a higher and lower 30-day mortality rate, respectively. Conclusions: C. parapsilosis BF influences the clinical outcome in patients with fungaemia.
- Published
- 2018
20. Legionella-Like and Other Amoebal Pathogens as Agents of Community-Acquired Pneumonia
- Author
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La Scola B, Didier Raoult, de Carolis E, Richard J. Birtles, and Thomas J. Marrie
- Subjects
Adult ,Male ,Canada ,community-acquired pneumonia ,Legionella ,amoebal pathogens ,lcsh:Medicine ,Microbiology ,lcsh:Infectious and parasitic diseases ,Community-acquired pneumonia ,Parachlamydia acanthamoebae ,medicine ,Pneumonia, Bacterial ,Animals ,Humans ,lcsh:RC109-216 ,Amoeba ,Pathogen ,Aged ,Aged, 80 and over ,Afipia felis ,Legionellosis ,biology ,Legionella-like pathogens ,lcsh:R ,Amebiasis ,Pneumonia ,Middle Aged ,biology.organism_classification ,medicine.disease ,Virology ,Acanthamoeba ,Community-Acquired Infections ,Parachlamydiaceae ,Parachlamydia ,Female ,Research Article - Abstract
We tested serum specimens from three groups of patients with pneumonia by indirect immunofluorescence against Legionella-like amoebal pathogens (LLAPs) 1-7, 9, 10, 12, 13; Parachlamydia acanthamoeba strains BN 9 and Hall's coccus; and Afipia felis. We found that LLAPs play a role (albeit an infrequent one) in community-acquired pneumonia, usually as a co-pathogen but sometimes as the sole identified pathogen.
- Published
- 2001
21. The Rethinking Resource Sharing Initiative: the NILDE case study in the frame of Italian experiences
- Author
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Brunetti F., De Carolis E., Domina P., Fuschini E., Magno R., Mangiaracina S., Stabene S., Bernardini E., Filippucci G., Fasano M., Grazioli M., Olimpieri S., and Salamone P.
- Subjects
Electronic Document Delivery Service ,NILDE ,Digital Libraries ,Cooperation in libraries - Abstract
NILDE (Network for Inter-Library Document Exchange) is born at the CNR Bologna Research Area Library to provide an effective answer to the needs of libraries in order to guarantee information accessibility, sharing resources through Inter Library Loan (ILL) of returnable and non-returnable items (books and journal articles).
- Published
- 2009
22. Strategies and Alliances into Action to Improve National Collaboration
- Author
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Filippucci G., Bernardini E., Mangiaracina S., Brunetti F., De Carolis E., Domina P., Fasano M., Fuschini E., Grazioli M., Magno R., Olimpieri S., Salamone P., and Stabene S.
- Subjects
Resource sharing ,Document Delivery ,Cooperation in libraries - Abstract
The Italian NILDE network of libraries continues to grow through the use of the NILDE system and currently comprises more than 600 Italian librarians and about 10.000 registered end-users.The system allows to daily manage and to record all the Inter-Library-Loan (ILL) operations, with a high national coverage. This paper presents the NILDE network governance and evolution and the strategies that have been put into action to improve collaboration in resource sharing among the participants. These strategies include: release of best practices and worst practices; activities to promote the knowledge about the network; cooperation with the Italian national catalogs and consortia; data analysis about ILL and its performance, related to: turn around time, reciprocity factor, requested/supplied documents imbalance analysis, analysis of ILL requested serial titles and their relationship with consortial e-only acquisitions. The availability of such a high volume of ILL data has allowed for the first time to analyze the trends and gaps of ILL and to help future cooperative acquisitions planning.
- Published
- 2009
23. Genetic diversity of bacterial strains isolated from soils, contaminated with polycyclic aromatic hydrocarbons, by 16S rRNA gene sequencing and amplified fragment length polymorphism fingerprinting
- Author
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La Rosa, G, De Carolis, E, Sali, M, Papacchini, M, Riccardi, C, Mansi, A, Papa, E, Alquati, C, Bestetti, G, Muscillo, M, Muscillo, M., BESTETTI, GIUSEPPINA, La Rosa, G, De Carolis, E, Sali, M, Papacchini, M, Riccardi, C, Mansi, A, Papa, E, Alquati, C, Bestetti, G, Muscillo, M, Muscillo, M., and BESTETTI, GIUSEPPINA
- Abstract
In order to study microbial diversity in a polycyclic aromatic hydrocarbon-impacted soil, 14 bacterial strains were analyzed by 16S rRNA gene sequencing and amplified fragment length polymorphism (AFLP) analysis. Bacterial strains isolated from two different hydrocarbon-polluted sites were identified to the species level by 165 rRNA full-gene sequencing using MicroSeq 16S rRNA gene sequencing. Their genome was subsequently analyzed by high-resolution genotyping with AFLP analysis, in order to monitor species variability and to differentiate closely related strains. Cluster analysis based on AFLP fingerprinting showed intraspecific polymorphism, even among strains with 100% 16S rRNA gene sequence identity. The results show that AFLP is a powerful, highly reproducible and discriminatory toot for revealing genetic relationships in bacterial populations. The ability to differentiate and track related closely microbes is fundamental for studying structure and dynamics of microbial communities in contaminated ecosystems. (C) 2005 Elsevier GmbH. All rights reserved.
- Published
- 2006
24. Rinvenimenti di superficie nell’area 'La Contessa', Campi Flegrei (NA)
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Giglio, Marco, De Carolis, E, Boenzi, G, and Guarino, A.
- Published
- 1994
25. Genetic diversity of bacterial strains isolated from soils, contaminated with polycyclic aromatic hydrocarbons, by 16S rRNA gene sequencing and amplified fragment length polymorphism fingerprinting
- Author
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La Rosa, G., primary, De Carolis, E., additional, Sali, M., additional, Papacchini, M., additional, Riccardi, C., additional, Mansi, A., additional, Paba, E., additional, Alquati, C., additional, Bestetti, G., additional, and Muscillo, M., additional
- Published
- 2006
- Full Text
- View/download PDF
26. Validation of a pXO2-A PCR Assay To Explore Diversity among Italian Isolates of Bacillus anthracis Strains Closely Related to the Live, Attenuated Carbosap Vaccine
- Author
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Muscillo, M., primary, La Rosa, G., additional, Sali, M., additional, De Carolis, E., additional, Adone, R., additional, Ciuchini, F., additional, and Fasanella, A., additional
- Published
- 2005
- Full Text
- View/download PDF
27. Purification, characterization, and kinetic analysis of a 2-oxoglutarate-dependent dioxygenase involved in vindoline biosynthesis from Catharanthus roseus.
- Author
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De Carolis, E., primary and De Luca, V., additional
- Published
- 1993
- Full Text
- View/download PDF
28. Validation of a pXO2-A PCR Assay To Explore Diversity among Italian Isolates of Bacillus anthracisStrains Closely Related to the Live, Attenuated Carbosap Vaccine
- Author
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Muscillo, M., La Rosa, G., Sali, M., De Carolis, E., Adone, R., Ciuchini, F., and Fasanella, A.
- Abstract
ABSTRACTSeveral circulating Bacillus anthracisstrains isolated in Italy and belonging to the A1.a cluster, genotype 3 (A1.a-3) are genotypically indistinguishable from Carbosap, a live attenuated vaccine strain, containing both pXO1 and pXO2 plasmids. The genotype was assessed by using eight-locus multilocus variable-number tandem repeat analysis. We describe here the use of a ninth locus able to explore variability among strains that have the same genotype. It is important to be able to genotype the wild isolate of B. anthracisstrains from outbreaks of anthrax in areas where Carbosap vaccination of cattle and sheep is common practice. A total of 27 representative field strains isolated in Italy and four vaccinal strains, namely, Carbosap, Sterne, Pasteur I, and Pasteur II, were characterized by a ninth marker, called pXO2-A. Twenty-three field strains were genotype 3 and therefore identical to Carbosap. The marker was in the pXO2 plasmid and is based on the polymorphism of the already-known VX2-3 locus. Detection was obtained by PCR with fluorescence-labeled forward primers in order to produce appropriate fragments for capillary electrophoresis with an ABI 310 genetic analyzer. Genetic relationships showed heterogeneity in all of the examined samples. Interestingly, with respect to genotype 3, samples grouped into eight different subtypes, A to H, and the subtype G, had only two samples indistinguishable from Carbosap. The results of the present study confirm the validity of a hierarchical progressive protocol for discrimination among closely related isolates.
- Published
- 2005
- Full Text
- View/download PDF
29. Considerations on antimicrobial prophylaxis in patients with lymphoproliferative diseases: A SEIFEM group position paper
- Author
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Elena De Carolis, Michele Malagola, Livio Pagano, Angelica Spolzino, Monica Piedimonte, Angela Maria Quinto, Roma Rosa Fanci, Eleonora Ceresoli, Francesca Farina, Ilaria Del Principe, Fabio Trastulli, Francesco Marchesi, Marco Picardi, Maria Chiara Tisi, Patrizia Zappasodi, Mario Delia, Anna Candoni, Mario Tumbarello, Lucia Prezioso, Marianna Criscuolo, Gianpaolo Nadali, Chiara Cattaneo, Roberta Della Pepa, Alessandro Busca, Claudia Giordano, Enrico Maria Trecarichi, Massimo Offidani, Nicola Stefano Fracchiolla, Busca, A., Cattaneo, C., De Carolis, E., Nadali, G., Offidani, M., Picardi, M., Candoni, A., Ceresoli, E., Criscuolo, M., Delia, M., Della Pepa, R., Del Principe, I., Fanci, R. R., Farina, F., Fracchiolla, N., Giordano, C., Malagola, M., Marchesi, F., Piedimonte, M., Prezioso, L., Quinto, A. M., Spolzino, A., Tisi, M. C., Trastulli, F., Trecarichi, E. M., Zappasodi, P., Tumbarello, M., and Pagano, L.
- Subjects
Anti-Infective Agent ,Lymphoproliferative disorders ,0301 basic medicine ,medicine.medical_specialty ,Antimicrobial prophylaxis ,Antimicrobial stewardship ,Bacterial ,Fungal and viral infections ,03 medical and health sciences ,0302 clinical medicine ,Fungal and viral infection ,Anti-Infective Agents ,Anti-Bacterial Agent ,medicine ,Humans ,Antimicrobial prophylaxi ,Antibiotic prophylaxis ,Intensive care medicine ,Antiinfective agent ,business.industry ,Anti-Bacterial Agents ,Lymphoproliferative Disorders ,Hematology ,Settore MED/15 ,Antimicrobial ,medicine.disease ,Multiple drug resistance ,Settore MED/15 - MALATTIE DEL SANGUE ,030104 developmental biology ,Lymphoproliferative disorder ,Oncology ,030220 oncology & carcinogenesis ,Position paper ,business ,Human - Abstract
The therapeutic armamentarium for the treatment of patients with lymphoproliferative diseases has grown considerably over the most recent years, including a large use of new immunotherapeutic agents. As a consequence, the epidemiology of infectious complications in this group of patients is poorly documented, and even more importantly, the potential benefit of antimicrobial prophylaxis remains a matter of debate when considering the harmful effect from the emergence of multidrug resistant pathogens. The present position paper is addressed to all hematologists treating patients affected by lymphoproliferative malignancies with the aim to provide clinicians with a useful tool for the prevention of bacterial, fungal and viral infections.
- Published
- 2021
30. Ceramiche tardo antiche da Pompei
- Author
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Vincenzo Brescia Morra, Ernesto De Carolis, Celestino Grifa, Alessio Langella, Gianluca Soricelli, De Carolis, E., Grifa, C., Langella, A., Morra, Vincenzo, and Soricelli, G.
- Subjects
Archaeology ,archéologie ,media_common.quotation_subject ,céramique gallo-romaine ,céramique romaine ,Art ,production artisanale ,commerce ,media_common - Abstract
I risultati di scavi recenti mostrano la relativa vitalità dell’area vesuviana dopo la disastrosa eruzione del 79 d.C. In particolare, i materiali ceramici provenienti dallo scavo di via Lepanto possono offrire una esemplificazione dei prodotti circolanti in quest’area tra lo scorcio del IV e gli inizi del V secolo. Essi provengono da una serie di scarichi che almeno in un’area dello scavo risultavano sigillati da un piano di battuto a sua volta coperto dal materiale piroclastico dell’eruzione cd. di «Pollena» (473 d.C.) Sulla base della sigillata chiara D, questi materiali possono essere datati al più tardi ai primi decenni del V secolo. Le analisi archeometriche eseguite su un ampio campione di materiali suggeriscono per larga parte delle ceramiche comuni e da fuoco una produzione locale, pur non mancando prodotti di importazione
- Published
- 2009
31. Genetic diversity of bacterial strains isolated from soils, contaminated with polycyclic aromatic hydrocarbons, by 16S rRNA gene sequencing and amplified fragment length polymorphism fingerprinting
- Author
-
Antonella Mansi, Maddalena Papacchini, E. De Carolis, C. Alquati, Giuseppina Bestetti, Carmela Riccardi, Michela Sali, E. Paba, G. La Rosa, Michele Muscillo, La Rosa, G, De Carolis, E, Sali, M, Papacchini, M, Riccardi, C, Mansi, A, Papa, E, Alquati, C, Bestetti, G, and Muscillo, M
- Subjects
DNA, Bacterial ,16S ,AFLP ,PAH degrading bacteria ,Biology ,Microbiology ,Genome ,Polymerase Chain Reaction ,Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA ,law.invention ,law ,RNA, Ribosomal, 16S ,Genetic variation ,Soil Pollutants ,Cluster Analysis ,Polycyclic Aromatic Hydrocarbons ,16S rRNA ,Polymorphism ,Genotyping ,Polymerase chain reaction ,Soil Microbiology ,Phylogeny ,Genetics ,Ribosomal ,Genetic diversity ,Bacteria ,bacterial diversity ,Bacterial ,Genetic Variation ,DNA ,Ribosomal RNA ,16S ribosomal RNA ,Polycyclic Hydrocarbons, Aromatic ,PCR ,Restriction Fragment Length ,Italy ,Polycyclic Hydrocarbons ,RNA ,Amplified fragment length polymorphism ,Polymorphism, Restriction Fragment Length ,Aromatic - Abstract
In order to study microbial diversity in a polycyclic aromatic hydrocarbon-impacted soil, 14 bacterial strains were analyzed by 16S rRNA gene sequencing and amplified fragment length polymorphism (AFLP) analysis. Bacterial strains isolated from two different hydrocarbon-polluted sites were identified to the species level by 165 rRNA full-gene sequencing using MicroSeq 16S rRNA gene sequencing. Their genome was subsequently analyzed by high-resolution genotyping with AFLP analysis, in order to monitor species variability and to differentiate closely related strains. Cluster analysis based on AFLP fingerprinting showed intraspecific polymorphism, even among strains with 100% 16S rRNA gene sequence identity. The results show that AFLP is a powerful, highly reproducible and discriminatory toot for revealing genetic relationships in bacterial populations. The ability to differentiate and track related closely microbes is fundamental for studying structure and dynamics of microbial communities in contaminated ecosystems. (C) 2005 Elsevier GmbH. All rights reserved.
- Published
- 2006
32. Prognostic value of serial (1,3)-β-D-glucan measurements in ICU patients with invasive candidiasis.
- Author
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Carelli S, Posteraro B, Torelli R, De Carolis E, Vallecoccia MS, Xhemalaj R, Cutuli SL, Tanzarella ES, Dell'Anna AM, Lombardi G, Cammarota F, Caroli A, Grieco DL, Sanguinetti M, Antonelli M, and De Pascale G
- Subjects
- Humans, Middle Aged, Male, Female, Prognosis, Adult, Cohort Studies, Italy epidemiology, Biomarkers blood, Biomarkers analysis, Proteoglycans blood, Proteoglycans analysis, Predictive Value of Tests, Candidiasis, Invasive blood, Candidiasis, Invasive mortality, Candidiasis, Invasive diagnosis, Intensive Care Units statistics & numerical data, Intensive Care Units organization & administration, beta-Glucans blood, beta-Glucans analysis
- Abstract
Background: To determine whether a decrease in serum (1,3)-β-D-glucan (BDG) was associated with reduced mortality and to investigate the performance of BDG downslope in predicting clinical outcome in invasive candidiasis., Methods: Observational cohort study in ICU patients over a ten-year period (2012-2022) in Italy. Proven invasive candidiasis with at least 2 BDG determinations were considered., Results: In the study population of 103 patients (age 47 [35-62] years, SAPS II score 67 [52-77]) 68 bloodstream and 35 intrabdominal infections were recorded. Serial measurements showed that in 54 patients BDG decreased over time (BDG downslope group) while in 49 did not (N-BDG downslope group). Candida albicans was the pathogen most frequently isolated (61%) followed by C. parapsilosis (17%) and C. glabrata (12%), in absence of any inter-group difference. Invasive candidiasis related mortality was lower in BDG downslope than in N-BDG downslope group (17% vs 53%, p < 0.01). The multivariate Cox regression analysis showed the association of septic shock at infection occurrence and chronic liver disease with invasive candidiasis mortality (HR [95% CI] 3.24 [1.25-8.44] p = 0.02 and 7.27 [2.33-22.66] p < 0.01, respectively) while a BDG downslope was the only predictor of survival (HR [95% CI] 0.19 [0.09-0.43] p < 0.01). The area under the receiver operator characteristic curve for the performance of BDG downslope as predictor of good clinical outcome was 0.74 (p = 0.02) and our model showed that a BDG downslope > 70% predicted survival with both specificity and positive predictive value of 100%., Conclusions: A decrease in serum BDG was associated with reduced mortality and a steep downslope predicted survival with high specificity in invasive candidiasis., (© 2024. The Author(s).)
- Published
- 2024
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33. Evaluation of Autof MS2600 and MBT Smart MALDI-TOF MS Systems for Routine Identification of Clinical Bacteria and Yeasts.
- Author
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De Carolis E, Ivagnes V, Magrì C, Falasca B, Spanu T, and Sanguinetti M
- Abstract
The identification of microorganisms at the species level has always constituted a diagnostic challenge for clinical microbiology laboratories. The aim of the present study has been the evaluation in a real-time assay of the performance of Autobio in comparison with the Bruker mass spectrometry system for the identification of bacteria and yeasts. A total of 535 bacteria and yeast were tested in parallel with the two systems by direct smear or fast formic acid extraction for bacteria and yeasts, respectively. Discordant results were verified by 16S, ITS rRNA or specific gene sequencing. Beyond giving comparable results for bacteria with respect to the MBT smart system, Autof MS2600 mass spectrometer provided excellent accuracy for the identification of yeast species of clinical interest.
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- 2024
- Full Text
- View/download PDF
34. Chip-Based Molecular Evaluation of a DNA Extraction Protocol for Candida Species from Positive Blood Cultures.
- Author
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Ivagnes V, Menchinelli G, Liotti FM, De Carolis E, Torelli R, De Lorenzis D, Recine C, Sanguinetti M, D'Inzeo T, and Posteraro B
- Abstract
The diagnosis of Candida bloodstream infection (BSI) may rely on a PCR-based analysis of a positive blood culture (PBC) obtained from the patient at the time of BSI. In this study, a yeast DNA extraction protocol for use on PBCs was developed and evaluated with the molecular mouse (MM) yeast blood (YBL) chip-based PCR assay, which allowed us to detect nine medically relevant Candida species. We studied 125 simulated or clinical PBCs for Candida species. A positive correlation between the DNA concentration and colony-forming unit count was found for simulated (Spearman's ρ = 0.58; p < 0.0001) and clinical (Spearman's ρ = 0.23, p = 0.09) PBCs. The extracted DNA yielded positive results with the MM YBL chip assay that agreed with the Candida species-level identification results for 63 (100%) of 63 isolates from simulated PBCs and 66 (99.5%) of 67 isolates from clinical PBCs. The false-negative result was for one C. tropicalis isolate that grew together with C. albicans in PBC. None of the 30 ( Candida )-negative clinical BCs included as negative controls yielded a positive result with the MM YBL chip assay. Our DNA extraction protocol for the Candida species couples efficiency and simplicity together. Nevertheless, further studies are needed before it can be adopted for use with the MM YBL chip assay.
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- 2023
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35. The Fourier-transform infrared spectroscopy-based method as a new typing tool for Candida parapsilosis clinical isolates.
- Author
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De Carolis E, Posteraro B, Falasca B, Spruijtenburg B, Meis JF, and Sanguinetti M
- Abstract
The Fourier-transform infrared spectroscopy-based IR Biotyper is a straightforward typing tool for bacterial species, but its use with Candida species is limited. We applied IR Biotyper to Candida parapsilosis , a common cause of nosocomial bloodstream infection (BSI), which is aggravated by the intra-hospital spread of fluconazole-resistant isolates. Of 59 C . parapsilosis isolates studied, n = 56 (48 fluconazole-resistant and 8 fluconazole-susceptible) and n = 3 (2 fluconazole-resistant and 1 fluconazole-susceptible) isolates, respectively, had been recovered from BSI episodes in 2 spatially distant Italian hospitals. The latter isolates served as an outgroup. Of fluconazole-resistant isolates, n = 40 (including one outgroup) harbored the Y132F mutation alone and n = 10 (including one outgroup) harbored both Y132F and R398I mutations in the ERG11 -encoded azole-target enzyme. Using a microsatellite typing method, which relies on the amplification of genomic short tandem repeats (STR), two major clusters were obtained based on the mutation(s) (Y132F or Y132F/R398I) present in the isolates. Regarding IR Biotyper, each isolate was analyzed in quintuplicate using an automatic (i.e., proposed by the manufacturer's software) or tentative (i.e., proposed by us) cutoff value. In the first case, four clusters were identified, with clusters I and II formed by Y132F or Y132F/R398I isolates, respectively. In the second case, six subclusters (derived by the split of clusters I and II) were identified. This allowed to separate the outgroup isolates from other isolates and to increase the IR Biotyper typeability. The agreement of IR Biotyper with STR ranged from 47% to 74%, depending on type of cutoff value used in the analysis. IMPORTANCE Establishing relatedness between clinical isolates of Candida parapsilosis is important for implementing rapid measures to control and prevent nosocomial transmission of this Candida species. We evaluated the FTIR-based IR Biotyper, a new typing method in the Candida field, using a collection of fluconazole-resistant C. parapsilosis isolates supposed to be genetically related due to the presence of the Y132F mutation. We showed that IR Biotyper was discriminatory but not as much as the STR method, which is still considered the method of choice. Further studies on larger series of C. parapsilosis isolates or closely related Candida species will be necessary to confirm and/or extend the results from this study.
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- 2023
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36. "CORE" a new assay for rapid identification of Klebsiella pneumoniae COlistin REsistant strains by MALDI-TOF MS in positive-ion mode.
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Foglietta G, De Carolis E, Mattana G, Onori M, Agosta M, Niccolai C, Di Pilato V, Rossolini GM, Sanguinetti M, Perno CF, and Bernaschi P
- Abstract
Due to the global spread of pan resistant organisms, colistin is actually considered as one of the last resort antibiotics against MDR and XDR bacterial infections. The emergence of colistin resistant strains has been observed worldwide in Gram-negative bacteria, such as Enterobacteriaceae and especially in K. pneumoniae, in association with increased morbidity and mortality. This landscape implies the exploration of novel assays able to target colistin resistant strains rapidly. In this study, we developed and evaluated a new MALDI-TOF MS assay in positive-ion mode that allows quantitative or qualitative discrimination between colistin susceptible (18) or resistant (32) K. pneumoniae strains in 3 h by using the "Autof MS 1000" mass spectrometer. The proposed assay, if integrated in the diagnostic workflow, may be of help for the antimicrobial stewardship and the control of the spread of K. pneumoniae colistin resistant isolates in hospital settings., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer AL declared a past co-authorship with the authors GMR, VDP to the handling editor at the time of review., (Copyright © 2023 Foglietta, De Carolis, Mattana, Onori, Agosta, Niccolai, Di Pilato, Rossolini, Sanguinetti, Perno and Bernaschi.)
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- 2023
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37. Phaeohyphomycosis in Solid Organ Transplant Recipients: A Case Series and Narrative Review of the Literature.
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Lo Porto D, Cona A, Todaro F, De Carolis E, Cardinale F, Hafeez N, Di Martino G, Conaldi PG, Sanguinetti M, Grossi PA, and Mularoni A
- Abstract
Phaeohyphomycosis comprises a variety of infections caused by pigmented fungi. Solid organ transplant (SOT) recipients are particularly at risk of invasive infections due to their prolonged immunosuppression. Here, we describe three cases of phaeohyphomycosis in SOT recipients who were successfully treated with surgical excision and/or antifungal therapy. We additionally carried out a narrative review of the literature on phaeohyphomycosis in 94 SOT recipients from 66 published studies describing 40 different species of fungi. The most reported fungus was Alternaria (21%). The median time from transplant to diagnosis was 18 months (IQR 8.25-48), and kidney transplants were the most reported. Antifungal regimens were not homogeneous, though there was a prevalence of itraconazole- and voriconazole-based treatments. Clinical outcomes included recovery in 81% and death in 5% of infected SOT recipients. Susceptibility testing was done in 26.6% of the cases, with heterogeneous results due to the variety of species isolated. While the wide diversity of dematiaceous fungi and their host range make it difficult to offer a uniform approach for phaeohyphomycosis, an early diagnosis and therapy are critical in preventing the dissemination of disease in the immunocompromised host.
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- 2023
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38. Old and New Insights into Sporothrix schenckii Complex Biology and Identification.
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De Carolis E, Posteraro B, and Sanguinetti M
- Abstract
Sporothrix schenckii is a worldwide-distributed thermally dimorphic fungus, which usually causes a subacute to chronic infection through traumatic implantation or inoculation of its infectious propagules. The fungus encompasses a group of phylogenetically closely related species, thus named the S. schenckii complex, of which S. schenckii sensu stricto and S. brasiliensis are main causative species of sporotrichosis. Owing to a multifaceted molecular dynamic, the S. schenckii complex can switch between the mycelium and the yeast form. This characteristic along with a varying cell wall composition account for significant species-specific differences in the host range, virulence, and susceptibility to antifungal drugs. While culture remains the gold standard to diagnose sporotrichosis, polymerase chain reaction (PCR) or matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry-based methods have become an essential for accurate species identification in many clinical laboratories. If directly applied on tissue samples, molecular methods are helpful to improve both sensitivity of and time to the etiological diagnosis of sporotrichosis. This mini-review aims to put together the old and new knowledge on the S. schenckii complex biology and identification, with particular emphasis on the laboratory diagnosis-related aspects of disease.
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- 2022
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39. Disseminated Geosmithia argillacea Infection in a Patient with Ph-Positive Acute Lymphoblastic Leukemia. Case Report and Literature Review.
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Giordano A, Di Landro F, De Carolis E, Criscuolo M, Dragonetti G, Fianchi L, and Pagano L
- Abstract
Invasive fungal infection (IFI) remains the major complication in patients with either acute leukemia, allogeneic stem cell transplantation setting, or both, especially regarding pulmonary localization. We report an experience of a 74-year-old Caucasian male with a Philadelphia-positive (BCR-ABL p190) Common B-acute lymphoblastic leukemia (ALL) who developed a pulmonary infection due to Geosmithia argillacea . Furthermore, we describe the management of this complication and the results of microbiological tests useful to guide the treatment. All cases reported show failure of voriconazole treatment. In the majority of cases a good susceptibility to posaconazole has been reported, which seems to have a good clinical impact; however, only L-AmB shows a clinical effect to produce quick clinical improvement and so it should be a drug of choice. A literature revision shows that only a few papers have thus far described this infection, at present only one case was reported in a hematological setting like a gastrointestinal graft versus host disease in an allogeneic HSCT recipient. The severity of clinical conditions in hematological malignancy settings requires improving the management of this emerging invasive fungal infection. Indeed, a molecular diagnostic approach with a tight laboratory collaboration and targeted therapy should become the gold standard.
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- 2021
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40. A New PCR-Based Assay for Testing Bronchoalveolar Lavage Fluid Samples from Patients with Suspected Pneumocystis jirovecii Pneumonia.
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Liotti FM, Posteraro B, De Angelis G, Torelli R, De Carolis E, Speziale D, Menchinelli G, Spanu T, and Sanguinetti M
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To support the clinical laboratory diagnosis of Pneumocystis jirovecii ( PJ ) pneumonia (PCP), an invasive fungal infection mainly occurring in HIV-negative patients, in-house or commercial PJ -specific real-time quantitative PCR (qPCR) assays are todays' reliable options. The performance of these assays depends on the type of PJ gene (multi-copy mitochondrial versus single-copy nuclear) targeted by the assay. We described the development of a PJ -PCR assay targeting the dihydrofolate reductase (DHFR)-encoding gene. After delineating its analytical performance, the PJ -PCR assay was used to test bronchoalveolar lavage (BAL) fluid samples from 200 patients (only seven were HIV positive) with suspected PCP. Of 211 BAL fluid samples, 18 (8.5%) were positive and 193 (91.5%) were negative by PJ -PCR. Of 18 PJ -PCR-positive samples, 11 (61.1%) tested positive and seven (38.9%) tested negative with the immunofluorescence assay (IFA). All (100%) of the 193 PJ -PCR-negative samples were IFA negative. Based on IFA/PCR results, patients were, respectively, classified as having ( n = 18) and not having ( n = 182) proven ( PJ -PCR+/IFA+) or probable ( PJ -PCR+/IFA-) PCP. For 182 patients without PCP, alternative infectious or non-infectious etiologies were identified. Our PJ -PCR assay was at least equivalent to IFA, fostering studies aimed at defining a qPCR-based standard for PCP diagnosis in the future.
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- 2021
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41. Direct Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry Testing from Positive Blood Cultures for Rapid Identification of Bloodstream Infection-Causing Anaerobic Bacteria.
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D'Inzeo T, Fiori B, Liotti FM, Cortazzo V, Talamonti D, Ventriglia F, De Maio F, De Carolis E, Sanguinetti M, Posteraro B, and Spanu T
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- Bacteria, Anaerobic, Blood Culture, Humans, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Bacteremia diagnosis, Sepsis
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- 2021
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42. Are We Ready for Nosocomial Candida auris Infections? Rapid Identification and Antifungal Resistance Detection Using MALDI-TOF Mass Spectrometry May Be the Answer.
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De Carolis E, Marchionni F, La Rosa M, Meis JF, Chowdhary A, Posteraro B, and Sanguinetti M
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- Candidiasis, Invasive, Humans, Microbial Sensitivity Tests, Rhodotorula, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Antifungal Agents therapeutic use, Cross Infection
- Abstract
The occurrence of multidrug-resistant Candida auris isolates and the increased mortality associated with invasive infections or outbreaks due to this Candida species have been reported in many healthcare settings. Therefore, accurate and rapid identification at the species level of clinical C. auris isolates as well as their timely differentiation as susceptible or resistant to antifungal drugs is mandatory. Aims of the present study were to implement the MALDI-TOF mass spectrometry (MS) Bruker Daltonics Biotyper
® database with C. auris spectrum profiles and to develop a fast and reproducible MS assay for detecting anidulafungin (AFG) resistance in C. auris isolates. After creation of main C. auris spectra, a score-oriented dendrogram was generated from hierarchical cluster analysis, including spectra of isolates from C. auris and other Candida ( C. glabrata , C. guilliermondii , C. haemulonii , C. lusitaniae , and C. parapsilosis ) or non- Candida ( Rhodotorula glutinis ) species. Cluster analysis allowed to group and classify the isolates according to their species designation. Then, a three-hour incubation antifungal susceptibility testing (AFST) assay was developed. Spectra obtained at null, intermediate, or maximum AFG concentrations were used to create composite correlation index matrices for eighteen C. auris isolates included in the study. All six resistant C. auris isolates were detected as resistant whereas 11 of 12 susceptible C. auris isolates were detected as susceptible by the MS-AFST assay. In conclusion, our MS-based assay offers the possibility of rapidly diagnosing and appropriately treating patients with C. auris infection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 De Carolis, Marchionni, La Rosa, Meis, Chowdhary, Posteraro and Sanguinetti.)- Published
- 2021
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43. Considerations on antimicrobial prophylaxis in patients with lymphoproliferative diseases: A SEIFEM group position paper.
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Busca A, Cattaneo C, De Carolis E, Nadali G, Offidani M, Picardi M, Candoni A, Ceresoli E, Criscuolo M, Delia M, Della Pepa R, Del Principe I, Fanci RR, Farina F, Fracchiolla N, Giordano C, Malagola M, Marchesi F, Piedimonte M, Prezioso L, Quinto AM, Spolzino A, Tisi MC, Trastulli F, Trecarichi EM, Zappasodi P, Tumbarello M, and Pagano L
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- Anti-Bacterial Agents therapeutic use, Humans, Anti-Infective Agents therapeutic use, Lymphoproliferative Disorders drug therapy, Lymphoproliferative Disorders epidemiology, Lymphoproliferative Disorders etiology
- Abstract
The therapeutic armamentarium for the treatment of patients with lymphoproliferative diseases has grown considerably over the most recent years, including a large use of new immunotherapeutic agents. As a consequence, the epidemiology of infectious complications in this group of patients is poorly documented, and even more importantly, the potential benefit of antimicrobial prophylaxis remains a matter of debate when considering the harmful effect from the emergence of multidrug resistant pathogens. The present position paper is addressed to all hematologists treating patients affected by lymphoproliferative malignancies with the aim to provide clinicians with a useful tool for the prevention of bacterial, fungal and viral infections., (Copyright © 2020. Published by Elsevier B.V.)
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- 2021
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44. Pan-Echinocandin-Resistant Candida glabrata Bloodstream Infection Complicating COVID-19: A Fatal Case Report.
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Posteraro B, Torelli R, Vella A, Leone PM, De Angelis G, De Carolis E, Ventura G, Sanguinetti M, and Fantoni M
- Abstract
Coinfections with bacteria or fungi may be a frequent complication of COVID-19, but coinfections with Candida species in COVID-19 patients remain rare. We report the 53-day clinical course of a complicated type-2 diabetes patient diagnosed with COVID-19, who developed bloodstream infections initially due to methicillin-resistant Staphylococcus aureus , secondly due to multidrug-resistant Gram-negative bacteria, and lastly due to a possibly fatal Candida glabrata . The development of FKS -associated pan-echinocandin resistance in the C. glabrata isolated from the patient after 13 days of caspofungin treatment aggravated the situation. The patient died of septic shock shortly before the prospect of receiving potentially effective antifungal therapy. This case emphasizes the importance of early diagnosis and monitoring for antimicrobial drug-resistant coinfections to reduce their unfavorable outcomes in COVID-19 patients.
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- 2020
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45. (1,3)-β-D-Glucan-based empirical antifungal interruption in suspected invasive candidiasis: a randomized trial.
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De Pascale G, Posteraro B, D'Arrigo S, Spinazzola G, Gaspari R, Bello G, Montini LM, Cutuli SL, Grieco DL, Di Gravio V, De Angelis G, Torelli R, De Carolis E, Tumbarello M, Sanguinetti M, and Antonelli M
- Subjects
- Aged, Antifungal Agents administration & dosage, Antifungal Agents therapeutic use, Critical Illness therapy, Female, Humans, Intensive Care Units organization & administration, Intensive Care Units trends, Male, Middle Aged, Proteoglycans therapeutic use, Candidiasis, Invasive drug therapy, Proteoglycans administration & dosage
- Abstract
Background: (1,3)-β-D-Glucan has been widely used in clinical practice for the diagnosis of invasive Candida infections. However, such serum biomarker showed potential to guide antimicrobial therapy in order to reduce the duration of empirical antifungal treatment in critically ill septic patients with suspected invasive candidiasis., Methods: This was a single-centre, randomized, open-label clinical trial in which critically ill patients were enrolled during the admission to the intensive care unit (ICU). All septic patients who presented invasive Candida infection risk factors and for whom an empirical antifungal therapy was commenced were randomly assigned (1:1) in those stopping antifungal therapy if (1,3)-β-D-glucan was negative ((1,3)-β-D-glucan group) or those continuing the antifungal therapy based on clinical rules (control group). Serum 1,3-β-D-glucan was measured at the enrolment and every 48/72 h over 14 days afterwards. The primary endpoint was the duration of antifungal treatment in the first 30 days after enrolment., Results: We randomized 108 patients into the (1,3)-β-D-glucan (n = 53) and control (n = 55) groups. Median [IQR] duration of antifungal treatment was 2 days [1-3] in the (1,3)-β-D-glucan group vs. 10 days [6-13] in the control group (between-group absolute difference in means, 6.29 days [95% CI 3.94-8.65], p < 0.001). Thirty-day mortality was similar (28.3% [(1,3)-β-D-glucan group] vs. 27.3% [control group], p = 0.92) as well as the overall rate of documented candidiasis (11.3% [(1,3)-β-D-glucan group] vs. 12.7% [control group], p = 0.94), the length of mechanical ventilation (p = 0.97) and ICU stay (p = 0.23)., Conclusions: In critically ill septic patients admitted to the ICU at risk of invasive candidiasis, a (1,3)-β-D-glucan-guided strategy could reduce the duration of empirical antifungal therapy. However, the safety of this algorithm needs to be confirmed in future, multicentre clinical trial with a larger population., Trial Registration: ClinicalTrials.gov, NCT03117439 , retrospectively registered on 18 April 2017.
- Published
- 2020
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46. Comparative performance evaluation of Wako β-glucan test and Fungitell assay for the diagnosis of invasive fungal diseases.
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De Carolis E, Marchionni F, Torelli R, Angela MG, Pagano L, Murri R, De Pascale G, De Angelis G, Sanguinetti M, and Posteraro B
- Subjects
- Adult, Aged, Aspergillosis blood, Aspergillosis microbiology, Aspergillus immunology, Aspergillus isolation & purification, Candida albicans immunology, Candida albicans isolation & purification, Candidiasis, Invasive blood, Candidiasis, Invasive microbiology, Diagnostic Tests, Routine classification, Female, Humans, Male, Middle Aged, Pneumocystis carinii immunology, Pneumocystis carinii isolation & purification, Pneumonia, Pneumocystis blood, Pneumonia, Pneumocystis microbiology, ROC Curve, Aspergillosis diagnosis, Candidiasis, Invasive diagnosis, Diagnostic Tests, Routine methods, Pneumonia, Pneumocystis diagnosis, beta-Glucans analysis
- Abstract
The Fungitell assay (FA) and the Wako β-glucan test (GT) are employed to measure the serum/plasma 1,3-β-D-glucan (BDG), a well-known invasive fungal disease biomarker. Data to convincingly and/or sufficiently support the GT as a valuable alternative to the FA are yet limited. In this study, we evaluated the FA and the GT to diagnose invasive aspergillosis (IA), invasive candidiasis (IC), and Pneumocystis jirovecii pneumonia (PJP). The FA and GT performances were compared in sera of patients with IA (n = 40), IC (n = 78), and PJP (n = 17) with respect to sera of control patients (n = 187). Using the manufacturer's cutoff values of 80 pg/mL and 11 pg/mL, the sensitivity and specificity for IA diagnosis were 92.5% and 99.5% for the FA and 60.0% and 99.5% for the GT, respectively; for IC diagnosis were 100.0% and 97.3% for the FA and 91.0% and 99.5% for the GT, respectively; for PJP diagnosis were 100.0% and 97.3% for the FA and 88.2% and 99.5% for the GT, respectively. When an optimized cutoff value of 7.0 pg/mL for the GT was used, the sensitivity and specificity were 80.0% and 97.3% for IA diagnosis, 98.7% and 97.3% for IC diagnosis, and 94.1% and 97.3% for PJP diagnosis, respectively. At the 7.0-pg/mL GT cutoff, the agreement between the assays remained and/or became excellent for IA (95.1%), IC (97.3%), and PJP (96.5%), respectively. In conclusion, we show that the GT performed as well as the FA only with a lowered cutoff value for positivity. Further studies are expected to establish the equivalence of the two BDG assays., Competing Interests: I declare that FUJIFILM Wako Pure Chemical Corporation provided reagents and funding for this study. This does not alter our adherence to PLOS ONE policies on sharing data and materials. FUJIFILM Wako Pure Chemical Corporation had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
- Published
- 2020
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47. Prevalence and Clonal Distribution of Azole-Resistant Candida parapsilosis Isolates Causing Bloodstream Infections in a Large Italian Hospital.
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Martini C, Torelli R, de Groot T, De Carolis E, Morandotti GA, De Angelis G, Posteraro B, Meis JF, and Sanguinetti M
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- Antifungal Agents pharmacology, Antifungal Agents therapeutic use, Azoles pharmacology, Drug Resistance, Fungal, Fluconazole, Hospitals, Humans, Italy epidemiology, Microbial Sensitivity Tests, Prevalence, Candida parapsilosis genetics, Sepsis
- Abstract
The most prevalent cause of nosocomial bloodstream infection (BSI) among non- C. albicans Candida species, Candida parapsilosis , may not only be resistant to azole antifungal agents but also disseminate to vulnerable patients. In this survey of BSIs occurring at a large Italian hospital between May 2014 and May 2019, C. parapsilosis accounted for 28.5% (241/844) of all Candida isolates causing BSI episodes. The majority of episodes (151/844) occurred in medical wards. Across the 5 yearly periods, the rates of azole non-susceptibility were 11.8% (4/34), 17.8% (8/45), 28.6% (12/42), 32.8% (19/58), and 17.7% (11/62), respectively, using the Sensititre YeastOne® method. Among azole non-susceptible isolates (54/241; 22.4%), 49 were available for further investigation. Using the CLSI reference method, all 49 isolates were resistant to fluconazole and, except one (susceptible dose-dependent), to voriconazole. Forty (81.6%) isolates harbored the Erg11p Y132F substitution and nine (18.4%) isolates the Y132F in combination with the Erg11p R398I substitution. According to their genotypes, as defined using a microsatellite analysis based on six short tandem repeat markers, 87.7% of isolates (43/49) grouped in two major clusters (II and III), whereas 4.1% of isolates (2/49) belonged to a separate cluster (I). Interestingly, all the isolates from cluster II harbored the Y132F substitution, and those from cluster III harbored both Y132F and R398I substitutions. Of 56 non-Italian isolates included as controls, two Indian isolates with the Y132F substitution had a genotype clearly differing from that of the isolates from clusters II and I. In conclusion, these findings show the dominance of clonal Y132F isolates in our hospital and suggest detection of the Y132F substitution as helpful tool to prevent transmission among hospitalized patients at risk of BSI., (Copyright © 2020 Martini, Torelli, de Groot, De Carolis, Morandotti, De Angelis, Posteraro, Meis and Sanguinetti.)
- Published
- 2020
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48. Different detection capabilities by mycological media for Candida isolates from mono- or dual-species cultures.
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De Angelis G, Menchinelli G, Torelli R, De Carolis E, Posteraro P, Sanguinetti M, and Posteraro B
- Subjects
- Candidiasis microbiology, Humans, Microbiological Techniques methods, Agar chemistry, Candida isolation & purification, Candidiasis diagnosis, Culture Media chemistry, Indicators and Reagents chemistry
- Abstract
The aim of this study was to compare the Candida bromcresol green (BCG) medium with the chromogenic (CHROM) Brilliance Candida agar and Sabouraud dextrose agar (SDA) media in regard to their capability of detecting Candida isolates from mono- or dual-species cultures. We prepared Candida isolates' suspensions to obtain mono-species (n = 18) or dual-species (n = 153) culture plates per each medium, and three readers independently observed 513 plates at 24-h, 48-h and 72-h incubation time. We scored reading results as correct, over or under detection compared to the expected species number(s). BCG showed significantly higher correct-detection and lower under-detection rates for all Candida species when observed by at least one reader. At 24-h reading, 12 mono-species cultures had correct (or over) detections in all media, whereas 106, 60 and 78 dual-species cultures had correct (or over) detections in BCG, CHROM or SDA, respectively. BCG provides the basis for an accurate laboratory diagnosis of Candida infections., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2020
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49. Occurrence of Albifimbria verrucaria in the Blood of a Female Child With Neuroblastoma.
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Masetti R, Prodi A, Liberatore A, Carfagnini F, Cappelletti E, Leardini D, Pession A, De Carolis E, and Cricca M
- Abstract
We report for the first time the occurrence of a filamentous fungus, Albifimbria verrucaria , in the blood of a pediatric neuroblastoma patient. The Albifimbria genus comprises common soil-inhabiting and saprophytic fungi and has been isolated as a plant pathogen in Northern and Southern Italy. As a human pathogen, A. verrucaria has been implicated in keratitis and can produce trichothecene toxins, which are weakly cytotoxic for mammalian cell lines. A. verrucaria was isolated from blood during the follow-up of a previous coagulase-negative Staphylococcus catheter-related infection. Lung nodules, compatible with fungal infection, had been observed on a CT scan 6 months earlier; they still persist. Possible routes of transmission were considered to be airborne, catheter related, or transfusion dependent, as the patient had undergone platelet and red blood cell transfusions during rescue chemotherapy. No filamentous fungi were isolated from sputum or CVCs. In conclusion, we describe an unprecedented fungemia caused by A. verrucaria and show how an unexpected pathogen may be acquired from the environment by patients at high risk due to immunosuppression. The route of transmission remains unknown., (Copyright © 2020 Masetti, Prodi, Liberatore, Carfagnini, Cappelletti, Leardini, Pession, De Carolis and Cricca.)
- Published
- 2020
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50. Outbreak of Saprochaete clavata Sepsis in Hematology Patients: Combined Use of MALDI-TOF and Sequencing Strategy to Identify and Correlate the Episodes.
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Lo Cascio G, Vincenzi M, Soldani F, De Carolis E, Maccacaro L, Sorrentino A, Nadali G, Cesaro S, Sommavilla M, Niero V, Naso L, Grancini A, Azzini AM, Sanguinetti M, Tacconelli E, and Cornaglia G
- Abstract
Introduction: New fungal species are increasingly reported in immunocompromised patients. Saprochaete clavata ( S. clavata ), an ascomycetous fungus formerly called Geotrichum clavatum , is intrinsically resistant to echinocandins and is often misidentified., Objective: We describe a cluster of seven S. clavata infections in hospitalized hematology patients who developed this rare fungemia within a span of 11 months. Three of the seven patients died. Identification of the isolates was determined only with the Saramis database of VitekMS system and sequencing of the internal transcribed spacer (ITS) region. Clonal relatedness of the isolates was determined by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF) analysis; clonal correlation between the strains was investigated by means of phylogenetic analysis, based on single-nucleotide variants (SNPs). Clinical presentation, 1-3 β-D-glucan (BG) and galactomannan (GM) antigen results and analysis of possible sources of contamination are also described with a prospective case-control study of the outbreak., Results: MALDI-TOF MS-Vitek (bioMerieux, Marcy l'Etoile, France) failed to identify the six isolates, while SARAMIS (bioMerieux, Marcy l'Etoile, France) identified the isolates as S. clavata . Initially, Vitek 2 identified the strains as Geotrichum capitatum in two of the seven cases. Molecular identification gave 99% homology with S. clavata . BG was positive in three out of six patients (range 159 to >523 pg/ml), GM results were always negative. All the isolates were resistant to echinocandins (anidulafungin, micafungin, and caspofungin) and Fluconazole, but susceptible to Flucytosine and Voriconazole. One isolate showed acquired resistance to Flucytosine and Amphotericin B during treatment. Both the correlation-based dendrograms obtained by MALDI-TOF MS (Bruker Daltonics) and MS-Vitek not only clustered six of the seven bloodstream infection (BSI) isolates in the same group, but also showed their strong relatedness. Phylogenetic analysis using SNPrelate showed that the seven samples recorded during the investigation period clustered together. We observed a split between one case and the remainder with a node supported by a z -score of 2.3 ( p -value = 0.021) and 16 mutations unique to each branch., Conclusion: The use of proteomics for identification and evaluation of strain clonality in outbreaks of rare pathogens is a promising alternative to laborious and time-consuming molecular methods, even if molecular whole-genome sequencing (WGS) typing will still remain the reference method for rare emergent pathogens., (Copyright © 2020 Lo Cascio, Vincenzi, Soldani, De Carolis, Maccacaro, Sorrentino, Nadali, Cesaro, Sommavilla, Niero, Naso, Grancini, Azzini, Sanguinetti, Tacconelli and Cornaglia.)
- Published
- 2020
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