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1. SARS-CoV-2 detection in primary thyroid sarcoma: coincidence or interaction?

Author

Tanda, M. L., Ippolito, S., Gallo, D., Baj, A., Novazzi, F., Genoni, A., Annoni, M., Mancini, N., Clementi, N., Finzi, G., Piantanida, E., Premoli, P., Lai, A., Dalla Gasperina, D., Maggi, F., Uccella, S., Tanda, M L, Ippolito, S, Gallo, D, Baj, A, Novazzi, F, Genoni, A, Annoni, M, Mancini, N, Clementi, Nicola, Finzi, G, Piantanida, E, Premoli, P, Lai, A, Dalla Gasperina, D, Maggi, F, and Uccella, S

Subjects
Thyroid, SARS-CoV-2, viruses, Endocrinology, Diabetes and Metabolism, COVID-19, Sarcoma, Mice, Endocrinology, MDM2, Subacute thyroiditis, Animals, Humans, Thyroid Neoplasms, Thyroiditis, Subacute, Rapid Communication
Abstract

Introduction Thyroid dysfunctions associated with SARS-CoV-2 are emerging in scientific literature. During the second COVID-19 epidemic spread, we evaluated a patient with the suspect of subacute thyroiditis. Methods and results Specimen from fine-needle aspiration of a hypoechoic undefined area was analyzed for cytology and for SARS-CoV-2 detection. SARS-CoV-2 was retrieved by real-time polymerase chain reaction on the cytologic sample, which was then cultured on Vero E6 cells and demonstrated to be cytopathic. Whole-genome sequence was deposited. Histological exam diagnosed a rare case of primary thyroid sarcoma with diffuse and strong expression of mouse double minute 2 homolog (MDM2) oncoprotein. Ultrastructural examination confirmed, in several neoplastic cells, the presence of viral particles in cytoplasmic vacuoles. Conclusions In our hypothesis, SARS-CoV-2 and sarcoma coexistence could represent a synergistic interplay, ultimately favoring both viral persistence and tumor proliferation: the overexpression of MDM2 in tumor cells might have generated a favorable immunological niche for SARS-CoV-2 localization and, in turn, SARS-CoV-2 could have favored tumor growth by inducing MDM2-mediated p53 downregulation. Functional studies are needed to confirm this suggestive pathway.

Published
2022

2. Antibiotic treatment of infections caused by carbapenem-resistant Gram-negative bacilli: an international ESCMID cross-sectional survey among infectious diseases specialists practicing in large hospitals

Author

Papst, Lea, Beović, Bojana, Pulcini, Céline, Durante-Mangoni, Emanuele, Rodríguez-Baño, Jesús, Kaye, Keith S, Daikos, George L, Raka, Lul, Paul, Mical, Esgap, Esgbis, ESGIE and the CRGNB treatment survey study group collaborators: Abbo, L, Abgueguen, P, Almirante, B, Azzini, Am, Bani-Sadr, F, Bassetti, M, Ben-Ami, R, Beović, B, Béraud, G, Botelho-Nevers, E, Bou, G, Boutoille, D, Cabié, A, Cacopardo, B, Cascio, A, Cassir, N, Castelli, F, Cecala, M, Charmillon, A, Chirouze, C, Cisneros, Jm, Colmenero, Jd, Coppola, N, Corcione, S, Daikos, Gl, Dalla Gasperina, D, De la Calle Cabrera, C, Delobel, P, Di Caprio, D, Durante Mangoni, E, Dupon, M, Ettahar, N, Falagas, Me, Falcone, M, Fariñas, Mc, Faure, E, Forestier, E, Foti, G, Gallagher, J, Gattuso, G, Gendrin, V, Gentile, I, Giacobbe, Dr, Gogos, Ca, Grandiere Perez, L, Hansmann, Y, Horcajada, Jp, Iacobello, C, Jacob, Jt, Justo, Ja, Kernéis, S, Komnos, A, Kotnik Kevorkijan, B, Lebeaux, D, Le Berre, R, Lechiche, C, Le Moing, V, Lescure, Fx, Libanore, M, Martinot, M, Merino de Lucas, E, Mondain, V, Mondello, P, Montejo, M, Mootien, J, Muñoz, P, Nir-Paz, R, Pan, A, Paño-Pardo, Jr, Patel, G, Paul, M, Pérez Rodríguez MT, Piroth, L, Pogue, J, Potoski, Ba, Pourcher, V, Pyrpasopoulou, A, Rahav, G, Rizzi, M, Rodríguez-Baño, J, Salavert, M, Scheetz, M, Sims, M, Spahija, G, Stefani, S, Stefos, A, Tamma, Pd, Tattevin, P, Tedesco, A, Torre-Cisneros, J, Tripolitsioti, P, Tsiodras, S, Uomo, G, Verdon, R, Viale, P, Vitrat, V, Weinberger, M, Wiener-Well, Y, Papst L., Beovic B., Pulcini C., Durante-Mangoni E., Rodriguez-Bano J., Kaye K.S., Daikos G.L., Raka L., Paul M., Abbo L., Abgueguen P., Almirante B., Azzini A.M., Bani-Sadr F., Bassetti M., Ben-Ami R., Beraud G., Botelho-Nevers E., Bou G., Boutoille D., Cabie A., Cacopardo B., Cascio A., Cassir N., Castelli F., Cecala M., Charmillon A., Chirouze C., Cisneros J.M., Colmenero J.D., Coppola N., Corcione S., Dalla Gasperina D., De la Calle Cabrera C., Delobel P., Di Caprio D., Durante Mangoni E., Dupon M., Ettahar N., Falagas M.E., Falcone M., Farinas M.C., Faure E., Forestier E., Foti G., Gallagher J., Gattuso G., Gendrin V., Gentile I., Giacobbe D.R., Gogos C.A., Grandiere Perez L., Hansmann Y., Horcajada J.P., Iacobello C., Jacob J.T., Justo J.A., Kerneis S., Komnos A., Kotnik Kevorkijan B., Lebeaux D., Le Berre R., Lechiche C., Le Moxing V., Lescure F.X., Libanore M., Martinot M., Merino de Lucas E., Mondain V., Mondello P., Montejo M., Mootien J., Munoz P., Nir-Paz R., Pan A., Pano-Pardo J.R., Patel G., Perez Rodriguez M.T., Piroth L., Pogue J., Potoski B.A., Pourcher V., Pyrpasopoulou A., Rahav G., Rizzi M., Salavert M., Scheetz M., Sims M., Spahija G., Stefani S., Stefos A., Tamma P.D., Tattevin P., Tedesco A., Torre-Cisneros J., Tripolitsioti P., Tsiodras S., Uomo G., Verdon R., Viale P., Vitrat V., Weinberger M., Wiener-Well Y., University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Monaldi Hospital, Hospital Virgen Macarena, University of Michigan Medical School [Ann Arbor], University of Michigan [Ann Arbor], University of Michigan System-University of Michigan System, National and Kapodistrian University of Athens (NKUA), University Clinical Center of Kosova, Rambam Health Care Campus, Jackson Memorial Hospital, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Vall d'Hebron University Hospital [Barcelona], University of Verona (UNIVR), Centre Hospitalier Universitaire de Reims (CHU Reims), Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Tel Aviv Sourasky Medical Centre, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Hospital Universitario, A Coruña, Centre hospitalier universitaire de Nantes (CHU Nantes), CHU de la Martinique [Fort de France], ARNAS 'Garibaldi, S. Luigi-Currò, Ascoli-Tomaselli', Università degli studi di Palermo - University of Palermo, Assistance Publique-Hôpitaux de Marseille (AP-HM), ASST Spedali Civili of Brescia, ARNAS Civico Palermo, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hospital Universitario Virgen del Rocío [Sevilla], Hospital Regional Universitario de Málaga [Spain], Università degli studi della Campania 'Luigi Vanvitelli', University of Turin, University of Insubria, Varese, Hospital Clínic de Barcelona, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], AO San Sebastiano, CHU Bordeaux [Bordeaux], CH Valenciennes, Henry Dunant Hospital, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Hospital Marques de Valdecillas, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Métropole Savoie [Chambéry], Ospedale di Reggio Calabria, Children’s Hospital of Philadelphia (CHOP ), Carlo Poma Hospital Mantova (ASST Mantova ), CH Belfort-Montbéliard, University of Naples Federico II, AUO San Martino IST Ist Nazl Ric Canc, I-16132 Genoa, Italy, University of Patras [Patras], Centre Hospitalier Le Mans (CH Le Mans), CHU Strasbourg, IMIM-Hospital del Mar, Generalitat de Catalunya, Cannizzaro Hospital, Emory University School of Medicine, Emory University [Atlanta, GA], University of South Carolina [Columbia], AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), General Hospital of Larissa, University medical centre Maribor (UKC Maribor), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), AP-HP - Hôpital Bichat - Claude Bernard [Paris], University of Ferrara at St. Anna Hospital, CH Colmar, Hospital General Universitario de Alicante, CHU Nice [Cimiez], Hôpital Cimiez [Nice] (CHU), AOU Policlinico 'G. Martino', Messina, Italy, Hospital Universitario Cruces = Cruces University Hospital, Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Hospital General Universitario 'Gregorio Marañón' [Madrid], Hadassah Hebrew University Medical Center [Jerusalem], Azienda Istituti Ospitalieri di Cremona, Lozano Blesa Clinical Hospital [Zaragoza, Spain], Mount Sinai Hospital [Toronto, Canada] (MSH), Complejo Hospitalario de Vigo, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Detroit Medical Center, University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis] (UPMC), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hippokration General Hospital, Sheba Medical Centre, Ramat Gan, Israel, ASST Papa Giovanni XXIII [Bergamo, Italy], Hospital Universitario La Fe, Valencia, Northwestern Hospital Chicago, Beaumont Hospital, Lagjia e Universitetit, Rruga 1, nr.32, 10000 Prishtina, Kosovo, parent, Università degli studi di Catania [Catania], Larissa University Hospital, Johns Hopkins University School of Medicine [Baltimore], CHU Pontchaillou [Rennes], Ospedale Fracastoro San Bonifacio [Verona], Hospital Reina Sofia, Cordoba, Agioi Anargiroi Hospital, Attikon University Hospital, Ospedale Cardarelli, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO), CH Annecy Genevois, Assah Harofeh Medical Centre, Zerifin, Israel, Shaare Zedek Medical Centre, Jerusalem, Israel, National Institutes of Health (US), Instituto de Salud Carlos III, Ministerio de Economía, Industria y Competitividad (España), Red Española de Investigación en Patología Infecciosa, European Commission, Papst, Lea, Beović, Bojana, Pulcini, Céline, Durante-Mangoni, Emanuele, Rodríguez-Baño, Jesú, Kaye, Keith S, Daikos, George L, Raka, Lul, Paul, Mical, Papst, L., Beovic, B., Pulcini, C., Durante-Mangoni, E., Rodriguez-Bano, J., Kaye, K. S., Daikos, G. L., Raka, L., Paul, M., Abbo, L., Abgueguen, P., Almirante, B., Azzini, A. M., Bani-Sadr, F., Bassetti, M., Ben-Ami, R., Beraud, G., Botelho-Nevers, E., Bou, G., Boutoille, D., Cabie, A., Cacopardo, B., Cascio, A., Cassir, N., Castelli, F., Cecala, M., Charmillon, A., Chirouze, C., Cisneros, J. M., Colmenero, J. D., Coppola, N., Corcione, S., Dalla Gasperina, D., De la Calle Cabrera, C., Delobel, P., Di Caprio, D., Dupon, M., Ettahar, N., Falagas, M. E., Falcone, M., Farinas, M. C., Faure, E., Forestier, E., Foti, G., Gallagher, J., Gattuso, G., Gendrin, V., Gentile, I., Giacobbe, D. R., Gogos, C. A., Grandiere Perez, L., Hansmann, Y., Horcajada, J. P., Iacobello, C., Jacob, J. T., Justo, J. A., Kerneis, S., Komnos, A., Kotnik Kevorkijan, B., Lebeaux, D., Le Berre, R., Lechiche, C., Le Moxing, V., Lescure, F. X., Libanore, M., Martinot, M., Merino de Lucas, E., Mondain, V., Mondello, P., Montejo, M., Mootien, J., Munoz, P., Nir-Paz, R., Pan, A., Pano-Pardo, J. R., Patel, G., Perez Rodriguez, M. T., Piroth, L., Pogue, J., Potoski, B. A., Pourcher, V., Pyrpasopoulou, A., Rahav, G., Rizzi, M., Salavert, M., Scheetz, M., Sims, M., Spahija, G., Stefani, S., Stefos, A., Tamma, P. D., Tattevin, P., Tedesco, A., Torre-Cisneros, J., Tripolitsioti, P., Tsiodras, S., Uomo, G., Verdon, R., Viale, P., Vitrat, V., Weinberger, M., Wiener-Well, Y., Università degli studi di Verona = University of Verona (UNIVR), Assistance Publique - Hôpitaux de Marseille (APHM), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], and Università degli studi di Torino = University of Turin (UNITO)

Subjects
0301 basic medicine, Acinetobacter baumannii, Carbapenem, Antibiotics, Drug Resistance, Drug resistance, Tigecycline, Carbapenem-resistant Gram-negative bacilli, Combination therapy, Enterobacteriaceae, Polymyxin, Pseudomonas aeruginosa, Survey, 0302 clinical medicine, Surveys and Questionnaires, polycyclic compounds, 030212 general & internal medicine, Anti-Bacterial Agents, Carbapenems, Cross Infection, Cross-Sectional Studies, Drug Resistance, Bacterial, Gram-Negative Bacteria, Gram-Negative Bacterial Infections, Hospitals, Humans, Microbial Sensitivity Tests, Microbiology (medical), Infectious Diseases, biology, Microbial Sensitivity Test, Bacterial, antibiotic management, carbapenem-resistant Gram-negative bacteria, General Medicine, 3. Good health, medicine.drug, Human, medicine.medical_specialty, medicine.drug_class, 030106 microbiology, Fosfomycin, carbapenem-resistant Gram-negative bacteria, 03 medical and health sciences, Hospital, Internal medicine, Anti-Bacterial Agent, medicine, Gram-Negative Bacterial Infection, Cross-Sectional Studie, business.industry, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, bacterial infections and mycoses, Infectious disease (medical specialty), Carbapenem-resistant gram-negative bacilli, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, antibiotic management, business, Rifampicin
Abstract

ESGAP, ESGBIS, ESGIE and the CRGNB treatment survey study group., [Objectives] To explore contemporary antibiotic management of infections caused by carbapenem-resistant Gram-negative bacteria in hospitals., [Methods] Cross-sectional, internet-based questionnaire survey. We contacted representatives of all hospitals with more than 800 acute-care hospital beds in France, Greece, Israel, Italy, Kosovo, Slovenia, Spain and selected hospitals in the USA. We asked respondents to describe the most common actual practice at their hospital regarding management of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa through close-ended questions., [Results] Between January and June 2017, 115 of 141 eligible hospitals participated (overall response rate 81.6%, country-specific rates 66.7%–100%). Most were tertiary-care (99/114, 86.8%), university-affiliated (110/115, 89.1%) hospitals and most representatives were infectious disease specialists (99/115, 86.1%). Combination therapy was prescribed in 114/115 (99.1%) hospitals at least occasionally. Respondents were more likely to consider combination therapy when treating bacteraemia, pneumonia and central nervous system infections and for Enterobacteriaceae, P. aeruginosa and A. baumannii similarly. Combination of a polymyxin with a carbapenem was used in most cases, whereas combinations of a polymyxin with tigecycline, an aminoglycoside, fosfomycin or rifampicin were also common. Monotherapy was used for treatment of complicated urinary tract infections, usually with an aminoglycoside or a polymyxin. The intended goal of combination therapy was to improve the effectiveness of the treatment and to prevent development of resistance. In general, respondents shared the misconception that combination therapy is supported by strong scientific evidence., [Conclusions] Combination therapy was the preferred treatment strategy for infections caused by carbapenem-resistant Gram-negative bacteria among hospital representatives, even though high-quality evidence for carbapenem-based combination therapy is lacking., EDM received funding by NIH for project HHSN272201000039C. JRB received funding for research from Plan Nacional de I + D + i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001)—co-financed by European Development Regional Fund A way to achieve Europe, Operative Programme Intelligent Growth 2014–2020.

Published
2018
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3. Pneumonia in solid organ transplant recipients: A prospective multicenter study

Author

Giannella, M, Muñoz, P, Alarcón, Jm, Mularoni, A, Grossi, P, Bouza, E, Ranghino, Andrea, Segoloni, Giuseppe, Durante Mangoni, E, Pinto, D, Utili, R, Maiello, C, Vizzini, G, Gandolfini, I, Maggiore, U, Dalla Gasperina, D, Lappa, A, Musumeci, F, Forni, A, Faggian, G, Giaquinta, A, Veroux, P, Antonelli, B, Rossi, G, Parisi, F, Alfieri, S, Balzano, E, Filipponi, F, Valerio, F, Sandrini, S, Onano, B, Piredda, G, Frascà, Gm, Gaffi, G, Dello Strologo, L, Guzzo, I, Berardinelli, L, Pasciucco, A, Bonofiglio, R, Leone, F, Musso, M, Petrosillo, N, Lopez Medrano, F, Aguado, Jm, Charo, L, de la Torre Cisneros, J, Ulica, Ih, Moreno Camacho, A, Fernandez, Ns, Carratala, J, Eworo, A, Valerio, M, Roca, C, Cordero Matia ME, Arribi Vilela, A, Picazo de la Garza JJ, Portilla Sogorb, J, De Lucas EM, Munoz Sanz, A, Vera Tome, A, Montejo, Jm, Gurgui Ferrer, M, Mirabet, S, Canas, L, Lausturica Valdemoros, R, Silva, I, Guirado, L, Meije Castillo, Y, Fortun Abete, J, Diaz Molina, B, Bernardo Rodriguez MJ, Farinas, C, Luzano, F, and de Valdecilla, M.

Subjects
Graft Rejection, Male, Lung Diseases, Prevalence, Drug Resistance, Organ transplantation, law.invention, Solid organ transplantation, law, Drug Resistance, Multiple, Bacterial, Epidemiology, Medicine, Hospital Mortality, Prospective Studies, Viral, Prospective cohort study, education.field_of_study, Cross Infection, Incidence (epidemiology), Bacterial, Middle Aged, Intensive care unit, Community-Acquired Infections, Infectious Diseases, Fungal, Italy, Female, Multiple, medicine.medical_specialty, Critical Care, Population, Pneumonia, Viral, Health care-associated pneumonia, Internal medicine, Pneumonia, Bacterial, Humans, education, Aged, Transplantation, Lung Diseases, Fungal, business.industry, Pneumonia, Organ Transplantation, medicine.disease, Surgery, Spain, business, health care-associated pneumonia, pneumonia, solid organ transplantation
Abstract

Background Pneumonia frequently affects solid organ transplant (SOT) recipients, with high morbidity and mortality. However, the few studies on pneumonia in this population are mainly retrospective, single-center, and long-term studies, or include patients with only one type of SOT or a specific etiology. We performed a point prevalence study to investigate epidemiology, diagnosis, therapy, and outcome of pneumonia in an unselected SOT population. Methods Italian and Spanish transplant centers were invited to report on all SOT recipients with pneumonia treated during 2 separate weeks (1 each in February and June 2012). Results In total, 35 centers (18 in Italy, 17 in Spain) agreed to participate and collected 54 cases. The incidence of pneumonia was 10.1 episodes/1000 recipients/year. Pneumonia was classified as late (>6 months) in 70.4% of cases. Pneumonia was also classified as community-acquired (CAP), healthcare-associated (HCAP), and hospital-acquired (HAP) pneumonia in 40.7%, 38.9%, and 20.4% of cases, respectively. An attempt to microbiological diagnosis (≥1 sample) was made in 94.4% of patients, with a diagnostic yield of 60.7%. Causative agents included bacteria (87.1%), virus (29%), and fungi (6.4%). A multidrug-resistant bacterium was isolated in 18.2%, 40%, and 100% of patients with CAP, HCAP, and HAP (P = 0.007), respectively. Overall, 11.1% of patients were admitted to the intensive care unit, 3.7% developed graft rejection, and graft function deteriorated in 18.5%. In-hospital mortality was 1.9%. Conclusion Pneumonia remains a frequent problem in SOT recipients, although it occurs later in patients who are in better physical health. Therefore, harmful pathogens and worse outcome are less common than previously thought.

Published
2014

4. Predicting the occurrence of embolic events: An analysis of 1456 episodes of infective endocarditis from the Italian Study on Endocarditis

Author

Rizzi, Marco, Ravasio, Veronica, Carobbio, Alessandra, Mattucci, Irene, Crapis, Massimo, Stellini, Roberto, Pasticci, Maria B., Chinello, Pierangelo, Falcone, Marco, Grossi, Paolo, Barbaro, Francesco, Pan, Angelo, Viale, Pierluigi, Durante, Mangoni, Emanuele, Biglino, A, Brusa MT, Crivelli P, Moglia, R, Leone, S, Ravasio, V, Rizzi, M, Suter, F, Viale, P, Mian, P, Spoladore, G, Castelli, F, Magri, S, Stellini, R, Di Caprio, D, Van Hauwermeiren, E, Pan, A, Zacchi, F, Barzaghi, N, Libanore, M, Pantaleoni, M, Del Bono, V, Viscoli, C, Gattuso, G, Scalzini, A, Villa, Mr, Bernardo, M, Casillo, R, Cuccurullo, S, Dialetto, G, Durante Mangoni, E, Mattucci, I, Ragone, E, Tripodi, Mf, Utili, R, Barbaro, F, Erne, E, Minoli, L, Seminari, Em, Martinelli, L, Pallotto, C, Pasticci, Mb, Canovari, B, Stoppini, L, Chinello, P, Falcone, M, Petrosillo, N, Venditti, M, Delle Foglie, P, Giobbia, M, Inoiosa, W, Scotton, G, Vaglia, A, Bassetti, Matteo, Crapis, M, Venturini, S, Dalla Gasperina, D, Grossi, P, Tebini, A, Concia, E, Del Bravo, P, Tedesco, A, Nicolin, R, Pellizzer, G., Rizzi, M., Ravasio, V., Carobbio, A., Mattucci, I., Crapis, M., Stellini, R., Pasticci, M.B., Chinello, P., Falcone, M., Grossi, P., Barbaro, F., Pan, A, Viale, P, Durante-Mangoni, E., Rizzi, M, Ravasio, V, Carobbio, A, Mattucci, I, Crapis, M, Stellini, R, Pasticci, Mb, Chinello, P, Falcone, M, Grossi, P, Barbaro, F, and DURANTE MANGONI, Emanuele

Subjects
Adult, Male, medicine.medical_specialty, Embolism, infective endocarditis embolic events, Risk Factors, Internal medicine, medicine, Endocarditis, Humans, Risk factor, Prospective cohort study, Aged, Retrospective Studies, Framingham Risk Score, Infective endocarditis, Risk score, Stroke, Endocarditis, Bacterial, Female, Italy, Middle Aged, business.industry, Medicine (all), Bacterial, Retrospective cohort study, Odds ratio, medicine.disease, Surgery, Infectious Diseases, business, Research Article
Abstract

BACKGROUND: Embolic events are a major cause of morbidity and mortality in patients with infective endocarditis. We analyzed the database of the prospective cohort study SEI in order to identify factors associated with the occurrence of embolic events and to develop a scoring system for the assessment of the risk of embolism. METHODS: We retrospectively analyzed 1456 episodes of infective endocarditis from the multicenter study SEI. Predictors of embolism were identified. Risk factors identified at multivariate analysis as predictive of embolism in left-sided endocarditis, were used for the development of a risk score: 1 point was assigned to each risk factor (total risk score range: minimum 0 points; maximum 2 points). Three categories were defined by the score: low (0 points), intermediate (1 point), or high risk (2 points); the probability of embolic events per risk category was calculated for each day on treatment (day 0 through day 30). RESULTS: There were 499 episodes of infective endocarditis (34%) that were complicated by ≥ 1 embolic event. Most embolic events occurred early in the clinical course (first week of therapy: 15.5 episodes per 1000 patient days; second week: 3.7 episodes per 1000 patient days). In the total cohort, the factors associated with the occurrence of embolism at multivariate analysis were prosthetic valve localization (odds ratio, 1.84), right-sided endocarditis (odds ratio, 3.93), Staphylococcus aureus etiology (odds ratio, 2.23) and vegetation size ≥ 13 mm (odds ratio, 1.86). In left-sided endocarditis, Staphylococcus aureus etiology (odds ratio, 2.1) and vegetation size ≥ 13 mm (odds ratio, 2.1) were independently associated with embolic events; the 30-day cumulative incidence of embolism varied with risk score category (low risk, 12%; intermediate risk, 25%; high risk, 38%; p

Published
2014

5. Use of colistin in adult patients: a cross-sectional study

Author

Giacobbe, Daniele Roberto, Saffioti, Carolina, Losito, Angela Raffaella, Rinaldi, Matteo, Aurilio, Caterina, Bolla, Cesare, Boni, Silvia, Borgia, Guglielmo, Carannante, Novella, Cassola, Giovanni, Ceccarelli, Giancarlo, Corcione, Silvia, Gasperina, Daniela Dalla, De Rosa, Francesco Giuseppe, Dentone, Chiara, Di Bella, Stefano, Di Lauria, Nicoletta, Feasi, Marcello, Fiore, Marco, Fossati, Sara, Franceschini, Erica, Gori, Andrea, Granata, Guido, Grignolo, Sara, Grossi, Paolo Antonio, Guadagnino, Giuliana, Lagi, Filippo, Maraolo, Alberto Enrico, Marinò, Valeria, Mazzitelli, Maria, Mularoni, Alessandra, Oliva, Alessandra, Pace, Maria Caterina, Parisini, Andrea, Patti, Francesca, Petrosillo, Nicola, Pota, Vincenzo, Raffaelli, Francesca, Rossi, Marianna, Santoro, Antonella, Tascini, Carlo, Torti, Carlo, Trecarichi, Enrico Maria, Venditti, Mario, Viale, Pierluigi, Signori, Alessio, Del Bono, Valerio, Giannella, Maddalena, Mikulska, Malgorzata, Tumbarello, Mario, Viscoli, Claudio, Passavanti, Maria Beatrice, Rogati, C, Sansone, Pasquale, Sarteschi, G, Roberto Giacobbe, Daniele, Saffioti1, Carolina, Raffaella Losito, Angela, Rinaldi, Matteo, Aurilio, Caterina, Bolla, Cesare, Boni, Silvia, Borgia, Guglielmo, Carannante, Novella, Cassola, Giovanni, Ceccarelli, Giancarlo, Corcione, Silvia, Dalla Gasperina, Daniela, Giuseppe De Rosa, Francesco, Dentone, Chiara, DI BELLA, Stefano, Di Lauria, Nicoletta, Feasi, Marcello, Fiore, Marco, Fossati, Sara, Franceschini, Erica, Gori, Andrea, Granata, Guido, Grignolo, Sara, Antonio Grossi, Paolo, Guadagnino, Giuliana, Lagi, Filippo, Enrico Maraolo, Alberto, Marinò, Valeria, Mazzitelli, Maria, Mularoni, Alessandra, Oliva, Alessandra, Caterina Pace, Maria, Parisini, Andrea, Patti, Francesca, Petrosillo, Nicola, Pota, Vincenzo, Raffaelli, Francesca, Rossi, Marianna, Santoro, Antonella, Tascini, Carlo, Torti, Carlo, Maria Trecarichi, Enrico, Venditti, Mario, Viale, Pierluigi, Signori, Alessio, Bassetti, Matteo, Del Bono, Valerio, Giannella, Maddalena, Mikulska, Malgorzata, Tumbarello, Mario, Viscoli, Claudio, Giacobbe, Daniele Roberto, Saffioti, Carolina, Losito, Angela Raffaella, Gasperina, Daniela Dalla, De Rosa, Francesco Giuseppe, Di Bella, Stefano, Grossi, Paolo Antonio, Maraolo, Alberto Enrico, Pace, Maria Caterina, Trecarichi, Enrico Maria, Passavanti, Maria Beatrice, Rogati, C, Sansone, Pasquale, Sarteschi, G, Giacobbe D.R., Saffioti C., Losito A.R., Rinaldi M., Aurilio C., Bolla C., Boni S., Borgia G., Carannante N., Cassola G., Ceccarelli G., Corcione S., Dalla Gasperina D., De Rosa F.G., Dentone C., Di Bella S., Di Lauria N., Feasi M., Fiore M., Fossati S., Franceschini E., Gori A., Granata G., Grignolo S., Grossi P.A., Guadagnino G., Lagi F., Maraolo A.E., Marino V., Mazzitelli M., Mularoni A., Oliva A., Pace M.C., Parisini A., Patti F., Petrosillo N., Pota V., Raffaelli F., Rossi M., Santoro A., Tascini C., Torti C., Trecarichi E.M., Venditti M., Viale P., Signori A., Bassetti M., Del Bono V., Giannella M., Mikulska M., Tumbarello M., and Viscoli C.

Subjects
0301 basic medicine, Male, Endemic Diseases, Drug Resistance, Carbapenem-resistant enterobacteriaceae, Pseudomona, 0302 clinical medicine, Interquartile range, Levofloxacin, Drug Resistance, Multiple, Bacterial, Klebsiella, polycyclic compounds, Acinetobacter, Antimicrobial resistance, Colistimethate, Colistin, Pseudomonas, Administration, Intravenous, Aged, Anti-Bacterial Agents, Cross-Sectional Studies, Drug Prescriptions, Drug Therapy, Combination, Female, Gram-Negative Bacterial Infections, Humans, Italy, Middle Aged, Respiratory Tract Infections, Sepsis, Immunology and Allergy, 030212 general & internal medicine, colistin, colistimethate, Bacterial, QR1-502, Administration, Combination, lipids (amino acids, peptides, and proteins), antimicrobial resistance, Intravenous, Multiple, medicine.drug, Microbiology (medical), medicine.medical_specialty, Cefepime, 030106 microbiology, Immunology, Microbiology, Loading dose, 03 medical and health sciences, Drug Therapy, Internal medicine, Lower respiratory tract infection, medicine, business.industry, biochemical phenomena, metabolism, and nutrition, medicine.disease, business
Abstract

Objectives The aim of this study was to assess colistin use in a country endemic for multidrug-resistant Gram-negative bacteria (MDR-GNB). Methods Colistin prescription patterns were evaluated in 22 Italian centres. Factors associated with use of colistin in combination with other anti-MDR-GNB agents were also assessed. Results A total of 221 adults receiving colistin were included in the study. Their median age was 64 years (interquartile range 52–73 years) and 134 (61%) were male. Colistin was mostly administered intravenously (203/221; 92%) and mainly for targeted therapy (168/221; 76%). The most frequent indications for colistin therapy were bloodstream infection and lower respiratory tract infection. Intravenous colistin was administered in combination with at least another anti-MDR-GNB agent in 80% of cases (163/203). A loading dose of 9 MU of colistimethate was administered in 79% of patients receiving i.v. colistin and adequate maintenance doses in 85%. In multivariable analysis, empirical therapy [odds ratio (OR) = 3.25, 95% confidence interval (CI) 1.24–8.53;P = 0.017] and targeted therapy for carbapenem-resistant Enterobacterales infection (OR = 4.76, 95% CI 1.69–13.43; P = 0.003) were associated with use of colistin in combination with other agents, whilst chronic renal failure (OR = 0.39, 95% CI 0.17–0.88; P = 0.024) was associated with use of colistin monotherapy. Conclusion Colistin remains an important option for severe MDR-GNB infections when other treatments are not available. Despite inherent difficulties in optimising its use owing to peculiar pharmacokinetic/pharmacodynamic characteristics, colistin was mostly used appropriately in a country endemic for MDR-GNB.

Published
2020

6. The impact of infection by multidrug-resistant agents in patients with cirrhosis. A multicenter prospective study

Author

Salerno, Francesco, Borzio, Mauro, Pedicino, Claudia, Simonetti, Rosa, Rossini, Angelo, Boccia, Sergio, Cacciola, Irene, Burroughs, Andrew K., Manini, Matteo A., La Mura, Vincenzo, Angeli, Paolo, Bernardi, Mauro, Dalla Gasperina, Daniela, Dionigi, Elena, Dibenedetto, Clara, Arghittu, Milena, Francavilla, Antonio, Trevisani, Franco, Salmi, Andrea, Fatuzzo, Filippo, Arvaniti, Vassiliki, Cambieri, Patrizia, Raguzzi, Ivana, Aghemo, Alessio, Trotta, Elisa, Cottone, Mario, Perricone, Giovanni, Giusti, Massimo, Cazzaniga, Massimo, Gobbo, Giulia, Monti, Valentina, Tejada, Milvana, Costa, Elena, Andriulli, Angelo, Grossi, Paolo, Salerno, F, Borzio, M, Pedicino, C, Simonetti, R, Rossini, A, Boccia, S, Cacciola, I, Burroughs, Ak, Manini, Ma, La Mura, V, Angeli, P, Bernardi, M, Dalla Gasperina, D, Dionigi, E, Dibenedetto, C, Arghittu, M, and Trevisani, F.

Subjects
Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, bacterial resistance, cirrhosis, portal hypertension, survival, medicine.drug_class, Antibiotics, survival, 03 medical and health sciences, 0302 clinical medicine, Spontaneous bacterial peritonitis, Antibiotic resistance, Drug Resistance, Multiple, Bacterial, Internal medicine, medicine, Humans, Hospital Mortality, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aged, Cross Infection, Bacteria, Hepatology, business.industry, cirrhosis, Mortality rate, portal hypertension, Bacterial Infections, bacterial resistance, Middle Aged, Prognosis, medicine.disease, Anti-Bacterial Agents, Surgery, Logistic Models, Italy, Hepatocellular carcinoma, Multivariate Analysis, Female, 030211 gastroenterology & hepatology, business
Abstract

Background & Aims Bacterial strains resistant to antibiotics are a serious clinical challenge. We assessed the antibiotic susceptibility of bacteria isolated from infections in patients with cirrhosis by a multicentre investigation. Results Three hundred and thirteen culture-positive infections (173 community acquired [CA] and 140 hospital acquired [HA]) were identified in 308 patients. Urinary tract infections, spontaneous bacterial peritonitis and bacteremias were the most frequent. Quinolone-resistant Gram-negative isolates were 48%, 44% were extended-spectrum beta-lactamase producers and 9% carbapenem resistant. In 83/313 culture-positive infections (27%), multidrug-resistant agents (MDRA) were isolated. This prevalence did not differ between CA and HA infections. MDRA were identified in 17 of 37 patients on quinolone prophylaxis, and in 46 of 166 not on prophylaxis (45% vs 27%; P

Published
2016
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