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4. Dried plasma spot as an innovative approach to therapeutic drug monitoring of apixaban: Development and validation of a novel liquid chromatography‐tandem mass spectrometry method.

Author

Cafaro, Alessia, Stella, Manuela, Baiardi, Giammarco, Barco, Sebastiano, Pigliasco, Federica, Bandettini, Roberto, Nanni, Luca, Mattioli, Francesca, and Cangemi, Giuliana

Subjects
DRUG monitoring, MATRIX effect, MASS spectrometry, ORAL medication, ANTICOAGULANTS
Abstract

Apixaban, a direct oral anticoagulant drug (DOAC), typically does not require routine therapeutic drug monitoring (TDM), yet recent guidelines propose its use in specific clinical scenarios. While various antifactor Xa (anti‐FXa) chromogenic assays serve as useful proxies for measuring plasma exposure to apixaban in emergencies, they lack specificity compared with chromatographic methods. This research project is intended to the development and validation of a standardized protocol of liquid chromatography–tandem mass spectrometry (LC–MS/MS) in conformity with the ICH guidelines M10 for the measurement of apixaban in both plasma and dried plasma spots (DPSs). Samples preparation included protein precipitation after the addition of a deuterated internal standard (IS), and the chromatographic separation was carried out on a Thermo Scientific™ Accucore™ Polar Premium column (50 mm × 2.1 mm, i.d. 2.6 m). The newly developed LC–MS/MS method for apixaban mesurement from both plasma and DPS resulted linear over a wide concentration range (31.25–500 ng/mL), accurate, and reproducible without matrix effects, allowing for specific and rapid quantification. Stability was assessed on quality controls and a real sample, allowing the setting up of a robust TDM protocol that was applied to five anonymized plasma samples obtained from adult patients undergoing apixaban treatment at steady‐state. In conclusion our novel LC–MS/MS method is adequate for accurate apixaban quantitation from both plasma and DPS matrixes, and may thus facilitate the guidelines suggested implementation of apixaban TDM, even in peripheral hospitals through shipment of DPS at reference laboratories. [ABSTRACT FROM AUTHOR]

Published
2024
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5. The Etiology of Bloodstream Infections at an Italian Pediatric Tertiary Care Hospital: A 17-Year-Long Series.

Author

Russo, Chiara, Mariani, Marcello, Bavastro, Martina, Mesini, Alessio, Saffioti, Carolina, Ricci, Erica, Ugolotti, Elisabetta, Bandettini, Roberto, and Castagnola, Elio

Subjects
ESCHERICHIA coli, GRAM-negative bacteria, PEDIATRIC therapy, DRUG resistance in bacteria, AGE groups
Abstract

Knowledge of epidemiology is essential for guiding correct antibiotic prescription, reducing bacteremia-associated mortality, and implementing targeted infection control programs. However, only a few studies have reported on the epidemiology of bloodstream infections (BSIs) in pediatrics. We performed a retrospective analysis of all BSIs (excluding those caused by common skin contaminants) diagnosed from 2006 to 2022 in patients younger than 18 years who were treated at an Italian pediatric tertiary care hospital. Overall, 2395 BSIs were recorded, including 2207 (92.15%) due to bacteria and 188 (7.85%) due to fungi. The incidence rate (BSIs/10,000 hospital discharges, IR) of bacterial BSIs significantly increased during the study period. In particular, BSIs caused by S. aureus (including MRSA), Enterobacterales (including ESBL and AmpC producers), Enterococcus spp., and P. aeruginosa became more common. The frequency of carbapenem-resistant strains was <1% and stable over time. Conversely, there was a significant reduction in the incidence of BSIs due to S. pneumoniae. The BSIs were stratified by patient age, and S. aureus was the most frequent cause of BSIs in all age groups, while E. coli was the most frequent in the Enterobacterales family. S. agalactiae was the third most frequent cause of neonatal early-onset BSIs. The prevalence of Enterococcus spp. increased in the subgroups from 8 days to 5 years of age, while P. aeruginosa became more prevalent in children over 5 years of age. S. aureus was also the most frequent isolate in both community- and hospital-onset BSIs, followed by E. coli. The prevalence of multidrug-resistant (MDR) pathogens was very low. It was <5% for both Gram-positive (i.e., MRSA and VRE) and Gram-negative (ESBL, AmpC, and carbapenem-resistant) pathogens, and MDR pathogens were almost exclusively detected in hospital-onset BSIs. Fungi accounted for just under 8% of BSIs. C. albicans was the most frequently isolated strain, followed by C. parapsilosis. Notably, the IR of fungemia did not change significantly during the study period, in spite of an increase in the absolute number of events. The continuous monitoring of local epidemiology is essential to identify changes in the IRs of pathogens and antibiotic susceptibility and to guide antibiotic treatments, especially in the phase when antibiograms are not yet available. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Real-Life Vancomycin Therapeutic Drug Monitoring in Coagulase-Negative Staphylococcal Bacteremia in Neonatal and Pediatric Intensive Care Unit: Are We Underestimating Augmented Renal Clearance?

Author

Sette, Claudia, primary, Mariani, Marcello, additional, Grasselli, Luca, additional, Mesini, Alessio, additional, Saffioti, Carolina, additional, Russo, Chiara, additional, Bandettini, Roberto, additional, Moscatelli, Andrea, additional, Ramenghi, Luca A., additional, and Castagnola, Elio, additional

Published
2023
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8. Proposta di un algoritmo diagnostico per il deficit di Adenosina Deaminasi-2 (DADA2).

Author

Cafaro, Alessia, Grossi, Alice, Barco, Sebastiano, Pigliasco, Federica, Biondi, Margherita, Schena, Francesca, Penco, Federica, Signa, Sara, Drago, Enrico, Matucci-Cerinic, Caterina, Volpi, Stefano, Caorsi, Roberta, Bandettini, Roberto, Ceccherini, Isabella, Gattorno, Marco, and Cangemi, Giuliana

Abstract

Deficiency of Adenosine deaminase 2 (DADA2) is a monogenic autoinflammatory disease caused by homozygous or compound heterozygous mutations in the ADA2 gene (formerly CECR1 Cat Eye Syndrome Chromosome Region 1). Clinical manifestations of DADA2 are highly variable and include systemic inflammation with fever, early stroke, vasculopathy, immune dysregulation (hypogammaglobulinemia, lymphoproliferation, increased rate of infections), and hematologic abnormalities (pure red cell aplasia, bone marrow failure, cytopenias). The most promising treatments are anti-TNF inhibitors, the only drugs that can prevent the serious consequences of the disease. Early diagnosis is therefore critical. DADA2 can be diagnosed by genetic analysis or functional tests (biochemical diagnosis) that allow the enzyme activity to be assayed. At the Giannina Gaslini Institute, a children's hospital in Italy, a method based on liquid chromatography coupled with tandem mass spectrometry has been developed to measure enzyme activity. A diagnostic workflow is adopted at the institute that involves the assay of ADA2 activity followed by genetic confirmation when the biochemical test is altered. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Biological Fluid Microsampling for Therapeutic Drug Monitoring: A Narrative Review.

Author

Cafaro, Alessia, Conti, Matteo, Pigliasco, Federica, Barco, Sebastiano, Bandettini, Roberto, and Cangemi, Giuliana

Subjects
DRUG monitoring, LIQUID chromatography-mass spectrometry, BLOOD sampling, CLINICAL pharmacology
Abstract

Therapeutic drug monitoring (TDM) is a specialized area of laboratory medicine which involves the measurement of drug concentrations in biological fluids with the aim of optimizing efficacy and reducing side effects, possibly modifying the drug dose to keep the plasma concentration within the therapeutic range. Plasma and/or whole blood, usually obtained by venipuncture, are the "gold standard" matrices for TDM. Microsampling, commonly used for newborn screening, could also be a convenient alternative to traditional sampling techniques for pharmacokinetics (PK) studies and TDM, helping to overcome practical problems and offering less invasive options to patients. Although technical limitations have hampered the use of microsampling in these fields, innovative techniques such as 3-D dried blood spheroids, volumetric absorptive microsampling (VAMS), dried plasma spots (DPS), and various microfluidic devices (MDS) can now offer reliable alternatives to traditional samples. The application of microsampling in routine clinical pharmacology is also hampered by the need for instrumentation capable of quantifying analytes in small volumes with sufficient sensitivity. The combination of microsampling with high-sensitivity analytical techniques, such as liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS), is particularly effective in ensuring high accuracy and sensitivity from very small sample volumes. This manuscript provides a critical review of the currently available microsampling devices for both whole blood and other biological fluids, such as plasma, urine, breast milk, and saliva. The purpose is to provide useful information in the scientific community to laboratory personnel, clinicians, and researchers interested in implementing the use of microsampling in their routine clinical practice. [ABSTRACT FROM AUTHOR]

Published
2023
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24. Azole resistance in Aspergillus isolates by different types of patients and correlation with environment ‐ An Italian prospective multicentre study (ARiA study)

Author

Prigitano, Anna, primary, Esposto, Maria C., additional, Grancini, Anna, additional, Biffi, Arianna, additional, Innocenti, Patrizia, additional, Cavanna, Caterina, additional, Lallitto, Fabiola, additional, Mollaschi, Eva Maria Giada, additional, Bandettini, Roberto, additional, Oltolini, Chiara, additional, Passera, Marco, additional, De Lorenzis, Gabriella, additional, Sargolzaei, Maryam, additional, Crespan, Manna, additional, Cogliati, Massimo, additional, Tortorano, Anna Maria, additional, and Romanò, Luisa, additional

Published
2021
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25. Bacterial Invasive infections in a neonatal intensive care unit: a 13 years microbiological report from a tertiary referral centre

Author

Mariani, Marcello, Bandettini, Roberto, La Masa, Daniela, Minghetti, Diego, Baldelli, Ivana, Serveli, Simona, Mesini, Alessio, Ramenghi, Luca A., and Castagnola, Elio

Subjects
NICU, invasive infections, colonization, Staphylococcus aureus, Bacteremia in NICU
Abstract

Introduction: To evaluate the aetiology of neonatal invasive diseases (positive cultures from blood or cerebrospinal fluid) due to bacteria other than coagulase-negative staphylococci in a large third-level centre and compare with results of surveillance cultures. Methods: Retrospective analysis of microbiological data of children admitted in neonatal intensive care unit (NICU) of a large third-level centre from 2005 to 2018. Results: 230 bacterial strains, 223 from blood and 7 from CSF, were detected as cause of invasive infections, while 152 were detected in surveillance cultures. Methicillin-susceptible Staphylococcus aureus (MSSA) was the most frequently isolated pathogen both in invasive infections (18%) and colonizations (23%) followed by Escherichia coli (16% on invasive disease and 20% of colonizations). Other common bacteria include Enterococcus faecalis and Streptococcus agalactiae for invasive disease and Meticillin-resistant Stapylococcus aureus (MRSA) with regard to colonization. Disease was due to a pathogen detected in surveillance cultures flora in 33%. In more than 50% of invasive diseases the identified pathogen was not present in surveillance cultures. Conclusion: The high percentage of invasive infections due to bacteria not previously identified in surveillance cultures raises doubts about the efficiency of this procedure and highlights the need to search for alternative infection sources. This finding and the high prevalence of invasive infections due to nosocomial pathogens such as Staphylococcus aureus could be the result of horizontal transmission between patients through the hands of health care professionals, emphasizing once again the importance of applying stringent hand hygiene procedures and isolation standards., Journal of Preventive Medicine and Hygiene, Vol. 61 No. 2 (2020): 2020612

Published
2020
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26. A prospective study on the epidemiology of febrile episodes during chemotherapy-induced neutropenia in children with cancer or after hemopoietic stem cell transplantation

Author

Castagnola, Elio, Fontana, Vincenzo, Caviglia, Ilaria, Caruso, Silvia, Faraci, Maura, Fioredda, Francesca, Garre, Maria Luisa, Moroni, Cristina, Conte, Massimo, Losurdo, Giuseppe, Scuderi, Franca, Bandettini, Roberto, Toma, Paolo, Viscoli, Claudio, and Haupt, Riccardo

Subjects
Cancer in children -- Care and treatment, Neutropenia -- Causes of, Fever -- Research, Hyperthermia -- Research, Chemotherapy -- Complications and side effects, Hematopoietic stem cells -- Transplantation, Hematopoietic stem cells -- Complications and side effects, Cancer -- Chemotherapy, Cancer -- Complications and side effects, Health, Health care industry
Published
2007

27. Abstracts from the 23rd Italian congress of Cystic Fibrosis and the 13th National congress of Cystic Fibrosis Italian Society

Author

Bevivino, Annamaria, Coiana, Alessandra, Fogazzi, Annalisa, Timelli, Fabiana, Signorini, Sandra, Lucarelli, Marco, Morelli, Patrizia, Padoan, Rita, Giordani, Barbara, Amato, Annalisa, Majo, Fabio, Ferrari, Gianluca, Quattrucci, Serena, Minicucci, Laura, Floridia, Giovanna, Fornaro, Gianna Puppo, Taruscio, Domenica, Salvatore, Marco, Seia, Manuela, Pierandrei, Silvia, Blaconà, Giovanna, Salvati, Valentina, Sette, Giovanni, Cimino, Giuseppe, Sangiuolo, Federica, Eramo, Adriana, Collura, Mirella, Parisi, Elisa, Ferlisi, Annalisa, Traverso, Gabriella, Bertolino, Marcella, Termini, Lisa, Orlando, Maria A., Di Girgenti, Caterina, Pavone, Valeria, Calamia, Maria A., Silvestro, Maria G., Piparo, Caterina Lo, Ficili, Francesca, Colombo, Carla, Tullis, Elizabeth, Davies, Jane C., Mckee, Charlotte, Desouza, Cynthia, Waltz, David, Savage, Jessica, Fisher, Marc, Shilling, Rebecca, Moskowitz, Sam, Robertson, Sarah, Tian, Simon, Taylor-Cousar, Jennifer L., Rowe, Steven M., Beccia, Elisa, Carbone, Annalucia, Favia, Maria, Castellani, Stefano, Angiolillo, Antonella, Casavola, Valeria, Conese, Massimo, Cesana, Bruno M., Falchetti, Diego, Battistini, Fiorella, Bignamini, Elisabetta, Braggion, Cesare, Cirilli, Natalia, Lucanto, Maria C., Lucidi, Vincenzina, Manca, Antonio, Raia, Valeria, Rotolo, Novella, Salvatore, Donatello, Volpi, Sonia, Nazzari, Erica, Guarise, Riccardo, Mileto, Palmiro, Garbarino, Francesca, Alicandro, Gianfranco, Battezzati, Alberto, Di Lullo, Antonella M., Comegna, Marika, Amato, Felice, Iacotucci, Paola, Carnovale, Vincenzo, Cantone, Elena, Iengo, Maurizio, Castaldo, Giuseppe, Orlando, Claudio, Casale, Alida, Sepe, Angela, De Gregorio, Fabiola, De Matteo, Antonia, Castaldo, Alice, Cimbalo, Chiara, Tosco, Antonella, Savi, Daniela, Mordenti, Michela, Bonci, Enea, Troiani, Patrizia, D’Alù, Viviana, Rossi, Paolo, Varchetta, Monica, Perelli, Tamara, Bertasi, Serenella, Palange, Paolo, Tardino, Lucia, Parisi, Giuseppe F., Portale, Anna, Franzonello, Chiara, Papale, Maria, Leonardi, Salvatore, Pennisi, Francesca, Bruno, Sabina M., Licciardello, Giulia, Ferraguti, Giampiero, Sterrantino, Manuela, Testino, Giancarlo, Buzzetti, Roberto, Surace, Cecilia, Sofia, Valentina M., Ullmann, Nicola, Novelli, Antonio, Angioni, Adriano, Liguori, Renato, Manzoni, Francesca, Di Palma, Chiara, Maietta, Sabrina, Zarrilli, Federica, Terlizzi, Vito, Alghisi, Federico, Tuccio, Giuseppe, Tradati, Valentina, di Stefano, Eliana, Dato, Patrizia, Sciarrabone, Maria G., Fondacaro, Carmela, Cresta, Federico, Baglioni, Valentina, Garuti, Silvia, Buffoni, Isabella, Landi, Francesca, Casciaro, Rosaria, Girelli, Daniela, Teri, Antonio, Sottotetti, Samantha, Biffi, Arianna, Vignati, Chiara, D’Accico, Monica, Maraschini, Anna, Arghittu, Milena, Pizzamiglio, Giovanna, Cariani, Elisa, Dolce, Daniela, Ravenni, Novella, Campana, Silvia, Camera, Erica, Castellani, Carlo, Taccetti, Giovanni, Calderone, Eleonora, Bandettini, Roberto, Innocenti, Chiara Degli, Castellani, Chiara, Masi, Eleonora, Cavicchi, Maria Chiara, Ferrari, Beatrice, Pezzotta, Ramona, Poli, Piercarlo, Messali, Serena, Timpano, Silvana, Scaltriti, Erika, Pongolini, Stefano, Fiorentini, Simona, Bresci, Silvia, Corsi, Lorenzo, Borchi, Beatrice, Cavallo, Annalisa, Bartalesi, Filippo, Pistolesi, Massimo, Bartoloni, Alessandro, Arcoleo, Federica, Pensabene, Tiziana, Bacci, Giovanni, Armanini, Federica, Fiscarelli, Ersilia V., Segata, Nicola, Mengoni, Alessio, Di Toppa, Maria V., Popa, Nicoleta, Felicetti, Francesco, Graziano, Sonia, Ciprandi, Riccardo, Pescini, Rita, Graffigna, Guendalina, Barello, Serena, Catastini, Paola, De Masi, Salvatore, Braggion, C., Guarnuto, Lucia, Di Liberti, Emanuela, Patti, Valentina, Castellazzi, Massimo Luca, Daccò, Valeria, Claut, Laura, Giuliari, Matteo, Vicentini, Luana, Tilotta, Fausto, Paciaroni, Antonella, Sala, Sabino Della, Guerzoni, Cristina, Andreatta, Elisa, Dinnella, Grazia, Granata, Orazia M., Aronica, Tommaso S., Crapisi, Mimì, Fogazza, Donatella, Alessi, Luca, Mulè, Flavia, Vitaliti, Marcello, Maresi, Mariarosaria, Catzola, Andrea, Salvadori, Laura, Colangelo, Carmela, Marsicovetere, Giovanni, D’Andria, Michele, Passarella, Domenica, Genovese, Carmela, Orlando, Mari A., Barrale, Stefania, Bonaccorso, Maria R., and D’Arpa, Annalisa

Subjects
lcsh:RJ1-570, lcsh:Pediatrics, Meeting Abstracts
Published
2018

28. Antibiotic susceptibility of Staphylococcus aureus isolated from skin lesions in children. A retrospective analysis from a tertiary care Italian pediatric hospital

Author

Lezzi, Marilea, primary, Bandettini, Roberto, additional, Ugolotti, Elisabetta, additional, Saffioti, Carolina, additional, Mesini, Alessio, additional, Pastorino, Carlotta, additional, Manunza, Francesca, additional, Ferretti, Marta, additional, Brisca, Giacomo, additional, and Castagnola, Elio, additional

Published
2020
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33. Ceftazidime plasma concentration in a patient with cystic fibrosis treated with ceftazidime/avibactam plus trimethoprim/sulfametoxazole for Bulkholderia cepacia reacutization

Author

Saffioti, Carolina, primary, Barco, Sebastiano, additional, Cangemi, Giuliana, additional, Mesini, Alessio, additional, Casciaro, Rosaria, additional, Cresta, Federico, additional, Castellani, Carlo, additional, Bandettini, Roberto, additional, Morelli, Patrizia, additional, and Castagnola, Elio, additional

Published
2019
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35. Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia After Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey

Author

Girmenia, Corrado, Bertaina, Alice, Piciocchi, Alfonso, Perruccio, Katia, Algarotti, Alessandra, Busca, Alessandro, Cattaneo, Chiara, Raiola, Anna Maria, Guidi, Stefano, Iori, Anna Paola, Candoni, Anna, Irrera, Giuseppe, Milone, Giuseppe, Marcacci, Giampaolo, Scimè, Rosanna, Musso, Maurizio, Cudillo, Laura, Sica, Simona, Castagna, Luca, Corradini, Paolo, Marchesi, Francesco, Pastore, Domenico, Alessandrino, Emilio Paolo, Annaloro, Claudio, Ciceri, Fabio, Santarone, Stella, Nassi, Luca, Farina, Claudio, Viscoli, Claudio, Rossolini, Gian Maria, Bonifazi, Francesca, Rambaldi, Alessandro, Capria, Saveria, Bertaina, A., Mastronuzzi, Angela, Pagliara, Daria, Bernaschi, Paola, Amico, Lucia, Carotti, Alessandra, Mencacci, Antonella, Busca, A., Bruno, Benedetto, Costa, Cristina, Passi, Angela, Ravizzola, Giuseppe, Angelucci, Emanuele, Marchese, Anna, Pecile, Patrizia, Candoni, A., Ventura, Giovanna, Fanin, Renato, Scarparo, Claudio, Barbaro, Angelo, Milone, G., Leotta, Salvatore, Marchese, Anna Elisa, Marcacci, G., Becchimanzi, Cristina, Donnarumma, Daniela, Tringali, Stefania, Baldi, Maria Teresa, Scalone, Renato, Cudillo, L., Picardi, Alessandra, Arcese, William, Fontana, Carla, Sica, S., Giammarco, Sabrina, Spanu, Teresa, Castagna, L., Crocchiolo, Roberto, Casari, Erminia, Mussetti, Alberto, Conte, Eutilia, Ensoli, Fabrizio, Miragliotta, Giuseppe, Marone, Piero, Arghittu, Milena, Greco, Raffaella, Forcina, Alessandra, Chichero, Paola, Santarone, S., Di Bartolomeo, Paolo, Fazii, Paolo, Kroumova, Vesselina, Decembrino, Nunzia, Zecca, Marco, Pisapia, Giovanni, Palazzo, Giulia, Lanino, Edoardo, Faraci, Maura, Castagnola, Elio, Bandettini, Roberto, Pastano, Rocco, Sammassimo, Simona, Passerini, Rita, Stefani, Piero Maria, Gherlinzoni, Filippo, Rigoli, Roberto, Prezioso, Lucia, Cambò, Benedetta, Calderaro, Adriana, Carella, Angelo Michele, Cascavilla, Nicola, Labonia, Maria Teresa, Celeghini, Ivana, Mordini, Nicola, Piana, Federica, Vacca, Adriana, Sanna, Marco, Podda, Giovanni, Corsetti, Maria Teresa, Rocchetti, Andrea, Cilloni, Daniela, De Gobbi, Marco, Bianco, Ornella, Fagioli, Franca, Carraro, Francesca, De Intinis, Gianfranco, Severino, Alessandro, Proia, Anna, Parisi, Gabriella, Vallisa, Daniele, Confalonieri, Massimo, Russo, Domenico, Malagola, Michele, Galieni, Piero, Falcioni, Sadia, Travaglini, Valeria, Raimondi, Roberto, Borghero, Carlo, Pavan, Giacomina, Prete, Arcangelo, Belotti, Tamara, Ambretti, Simone, Imola, Manuela, Mianulli, Anna Maria, Pedna, Maria Federica, Cesaro, Simone, Lo Cascio, Giuliana, Ferrari, Antonella, Piedimonte, Monica, Santino, Iolanda, Calandrelli, Monica, Olivieri, Attilio, Orecchioni, Francesca, Mirabile, Milena, Centurioni, Riccardo, Gironacci, Luciana, Caravelli, Daniela, Gallo, Susanna, De Filippi, Marco, Cupelli, Luca, Dentamaro, Teresa, Falco, Silvana, Eugenio, Ospedale S, Marotta, Serena, Risitano, Antonio, Lula, Dora, Musto, Pellegrino, Pietrantuono, Giuseppe, Traficante, Antonio, Cerchiara, Elisabetta, Tirindelli, Maria Cristina, Dicuonzo, Giordano, Chierichini, Anna, Anaclerico, Barbara, Placanica, Paola, Girmenia, C, Bertaina, A, Piciocchi, A, Perruccio, K, Algarotti, A, Busca, A, Cattaneo, C, Raiola, Am, Guidi, S, Iori, Ap, Candoni, A, Irrera, G, Milone, G, Marcacci, G, Scimè, R, Musso, M, Cudillo, L, Sica, S, Castagna, L, Corradini, P, Marchesi, F, Pastore, D, Alessandrino, Ep, Annaloro, C, Ciceri, F, Santarone, S, Nassi, L, Farina, C, Viscoli, C, Rossolini, Gm, Bonifazi, F, Rambaldi, A, for the Gruppo Italiano Trapianto di Midollo Osseo, (GITMO), Associazione Microbiologi Clinici Italiani, (AMCLI), Girmenia, Corrado, Bertaina, Alice, Piciocchi, Alfonso, Perruccio, Katia, Algarotti, Alessandra, Busca, Alessandro, Cattaneo, Chiara, Raiola, Anna Maria, Guidi, Stefano, Iori, Anna Paola, Candoni, Anna, Irrera, Giuseppe, Milone, G., Marcacci, Giampaolo, Scimè, Rosanna, Musso, Maurizio, Cudillo, Laura, Sica, Simona, Castagna, Luca, Corradini, Paolo, Marchesi, Francesco, Pastore, Domenico, Alessandrino, Emilio Paolo, Annaloro, Claudio, Ciceri, Fabio, Santarone, Stella, Nassi, Luca, Farina, Claudio, Viscoli, Claudio, Rossolini, Gian Maria, Bonifazi, Francesca, Rambaldi, Alessandro, Capria, Saveria, Bertaina, A., Mastronuzzi, Angela, Pagliara, Daria, Bernaschi, Paola, Amico, Lucia, Carotti, Alessandra, Mencacci, Antonella, Busca, A., Bruno, Benedetto, Costa, Cristina, Passi, Angela, Ravizzola, Giuseppe, Angelucci, Emanuele, Marchese, Anna, Pecile, Patrizia, Candoni, A., Ventura, Giovanna, Fanin, Renato, Scarparo, Claudio, Barbaro, Angelo, Leotta, Salvatore, Marchese, Anna Elisa, Marcacci, G., Becchimanzi, Cristina, Donnarumma, Daniela, Tringali, Stefania, Baldi, Maria Teresa, Scalone, Renato, Cudillo, L., Picardi, Alessandra, Arcese, William, Fontana, Carla, Sica, S., Giammarco, Sabrina, Spanu, Teresa, Castagna, L., Crocchiolo, Roberto, Casari, Erminia, Mussetti, Alberto, Conte, Eutilia, Ensoli, Fabrizio, Miragliotta, Giuseppe, Marone, Piero, Arghittu, Milena, Greco, Raffaella, Forcina, Alessandra, Chichero, Paola, Santarone, S., Di Bartolomeo, Paolo, Fazii, Paolo, Kroumova, Vesselina, Decembrino, Nunzia, Zecca, Marco, Pisapia, Giovanni, Palazzo, Giulia, Lanino, Edoardo, Faraci, Maura, Castagnola, Elio, Bandettini, Roberto, Pastano, Rocco, Sammassimo, Simona, Passerini, Rita, Stefani, Piero Maria, Gherlinzoni, Filippo, Rigoli, Roberto, Prezioso, Lucia, Cambò, Benedetta, Calderaro, Adriana, Carella, Angelo Michele, Cascavilla, Nicola, Labonia, Maria Teresa, Celeghini, Ivana, Mordini, Nicola, Piana, Federica, Vacca, Adriana, Sanna, Marco, Podda, Giovanni, Corsetti, Maria Teresa, Rocchetti, Andrea, Cilloni, Daniela, De Gobbi, Marco, Bianco, Ornella, Fagioli, Franca, Carraro, Francesca, De Intinis, Gianfranco, Severino, Alessandro, Proia, Anna, Parisi, Gabriella, Vallisa, Daniele, Confalonieri, Massimo, Russo, Domenico, Malagola, Michele, Galieni, Piero, Falcioni, Sadia, Travaglini, Valeria, Raimondi, Roberto, Borghero, Carlo, Pavan, Giacomina, Prete, Arcangelo, Belotti, Tamara, Ambretti, Simone, Imola, Manuela, Mianulli, Anna Maria, Pedna, Maria Federica, Cesaro, Simone, Lo Cascio, Giuliana, Ferrari, Antonella, Piedimonte, Monica, Santino, Iolanda, Calandrelli, Monica, Olivieri, Attilio, Orecchioni, Francesca, Mirabile, Milena, Centurioni, Riccardo, Gironacci, Luciana, Caravelli, Daniela, Gallo, Susanna, De Filippi, Marco, Cupelli, Luca, Dentamaro, Teresa, Falco, Silvana, Eugenio, Ospedale S, Marotta, Serena, Risitano, Antonio, Lula, Dora, Musto, Pellegrino, Pietrantuono, Giuseppe, Traficante, Antonio, Cerchiara, Elisabetta, Tirindelli, Maria Cristina, Dicuonzo, Giordano, Chierichini, Anna, Anaclerico, Barbara, and Placanica, Paola

Subjects
0301 basic medicine, Male, Transplantation Conditioning, Drug Resistance, Bacteremia, 0302 clinical medicine, epidemiology, Gram negative bacteremia, multidrug resistance, stem cell transplant, survival, Risk Factors, Drug Resistance, Multiple, Bacterial, Epidemiology, Medicine, Age Factor, Prospective Studies, Prospective cohort study, Child, Transplantation, Homologou, education.field_of_study, Incidence (epidemiology), Incidence, Bacterial, Age Factors, Hematopoietic Stem Cell Transplantation, Middle Aged, Transplantation, Autologou, surgical procedures, operative, Infectious Diseases, Italy, Child, Preschool, Female, medicine.symptom, Multiple, Autologous, Human, Homologous, Microbiology (medical), Adult, medicine.medical_specialty, Adolescent, 030106 microbiology, Population, Transplantation, Autologous, 03 medical and health sciences, Young Adult, Internal medicine, Gram-Negative Bacteria, Gram-Negative Bacterial Infection, Escherichia coli, Humans, Transplantation, Homologous, Preschool, education, Aged, Gram-Negative Bacterial Infections, Infant, Transplantation, business.industry, Risk Factor, medicine.disease, Prospective Studie, Carriage, Otitis, business, Settore MED/15 - Malattie del Sangue, 030215 immunology
Abstract

Background Gram-negative bacteremia (GNB) is a major cause of illness and death after hematopoietic stem cell transplantation (HSCT), and updated epidemiological investigation is advisable. Methods We prospectively evaluated the epidemiology of pre-engraftment GNB in 1118 allogeneic HSCTs (allo-HSCTs) and 1625 autologous HSCTs (auto-HSCTs) among 54 transplant centers during 2014 (SIGNB-GITMO-AMCLI study). Using logistic regression methods. we identified risk factors for GNB and evaluated the impact of GNB on the 4-month overall-survival after transplant. Results The cumulative incidence of pre-engraftment GNB was 17.3% in allo-HSCT and 9% in auto-HSCT. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most common isolates. By multivariate analysis, variables associated with GNB were a diagnosis of acute leukemia, a transplant from a HLA-mismatched donor and from cord blood, older age, and duration of severe neutropenia in allo-HSCT, and a diagnosis of lymphoma, older age, and no antibacterial prophylaxis in auto-HSCT. A pretransplant infection by a resistant pathogen was significantly associated with an increased risk of posttransplant infection by the same microorganism in allo-HSCT. Colonization by resistant gram-negative bacteria was significantly associated with an increased rate of infection by the same pathogen in both transplant procedures. GNB was independently associated with increased mortality at 4 months both in allo-HSCT (hazard ratio, 2.13; 95% confidence interval, 1.45–3.13; P Conclusions Pre-engraftment GNB is an independent factor associated with increased mortality rate at 4 months after auto-HSCT and allo-HSCT. Previous infectious history and colonization monitoring represent major indicators of GNB. Clinical Trials registration NCT02088840.

Published
2017

42. Antibiotic susceptibility of Staphylococcus aureusisolated from skin lesions in children. A retrospective analysis from a tertiary care Italian pediatric hospital

Author

Lezzi, Marilea, Bandettini, Roberto, Ugolotti, Elisabetta, Saffioti, Carolina, Mesini, Alessio, Pastorino, Carlotta, Manunza, Francesca, Ferretti, Marta, Brisca, Giacomo, and Castagnola, Elio

Abstract

Antibiotic susceptibility of S. aureuswas retrospectively assessed in 1833 strains isolated from skin lesions observed in an Italian tertiary care hospital. Methicillin resistance was more frequent in outpatients than in inpatients (18% vs. 14%, p = 0.04) as well as resistance to cotrimoxazole (8% vs. 4.1%, p < 0.001). Resistance to ampicillin was 99% in both groups, while for clindamycin it was 11% and 14%, respectively. Among topical antibiotics fusidic acid showed the better resistance profile (3%). Antibiotic resistance in pediatric skin infection in outpatients could represent a therapeutic problem in Italy.

Published
2021
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43. Prolonged antibiotic administration for surgical site infection in pediatric laryngotracheal surgery.

Author

Torre, Michele, Paraboschi, Irene, Loy, Anna, Mesini, Alessio, Pistorio, Angela, Simonini, Alessandro, Mattioli, Girolamo, Mazzei, Oscar, Piro, Liliana, Bandettini, Roberto, and Castagnola, Elio

Abstract

Objectives/hypothesis: Incidence of surgical site infection (SSI) after laryngotracheal (LT) surgery is relatively high, especially in children.Study Design: Retrospective and prospective cohort study.Methods: Clinical records of children who underwent open LT surgery at the Istituto Giannina Gaslini Children's Hospital from January 2008 to August 2017 were reviewed for development of SSI. Standard antibiotic prophylaxis was administered until February 2015. In March 2015, an antibiotic treatment tailored on pathogens isolated from surveillance cultures and prolonged until extubation was introduced. Incidence and risk factors for SSI before and after the new protocol implementation were analyzed by means of univariate and multivariable analyses.Results: A total of 57 procedures were analyzed. SSI incidence was 36% in patients receiving standard prophylaxis and 4% in those treated with the new strategy (P = .004), with an absolute benefit increase of 32% (95% confidence interval: 11%-52%), in absence of any difference in clinical conditions between the two groups.Conclusions: The new management protocol had a highly favorable impact on the development of an SSI.Level Of Evidence: 2b Laryngoscope, 129:2634-2639, 2019. [ABSTRACT FROM AUTHOR]

Published
2019
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44. Yeast-like filamentous fungi: Molecular identification and in vitro susceptibility study.

Author

Esposto, Maria Carmela, Prigitano, Anna, Cascio, Giuliana Lo, Ossi, Cristina, Grancini, Anna, Cavanna, Caterina, Lallitto, Fabiola, Tejada, Milvana, Bandettini, Roberto, Mularoni, Alessandra, and Tortorano, Anna Maria

Abstract

Yeast-like filamentous fungi, collected in Italy from 1985 to 2018, were submitted to molecular identification and antifungal susceptibility testings. Clinical isolates were identified as  Magnusiomyces capitatus (28), M. clavatus  (18), and Geotrichum candidum (2).  M. clavatus  was prevalent among blood isolates (18/24),  M. capitatus  among isolates from other biological materials. The intrinsic echinocandin resistance was confirmed. Both species had low minimum inhibitory concentrations (MICs) of itraconazole, posaconazole, and voriconazole, while  M. clavatus  had lower MIC of flucytosine and higher MIC of isavuconazole than  M. capitatus. The intrinsic resistance of these species to echinocandins could be the reason of the recent increase of M. clavatus bloodstream infections. [ABSTRACT FROM AUTHOR]

Published
2019
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45. Daptomycin for children in clinical practice experience

Author

Garazzino, Silvia, Castagnola, Elio, Di Gangi, Maria, Ortolano, Rita, Krzysztofiak, Andrzej, Nocerino, Agostino, Esposito, Susanna, D'Argenio, Patrizia, Galli, Luisa, Losurdo, Giuseppe, Calitri, Carmelina, Tovo, Pier Angelo, for the SITIP Daptomycin Study Group including Bandettini, Roberto, Giordano, Salvatore, Dones, Piera, Ziino, Ottavio, Mosa, Clara, Robazza, Margherita, Tagliabue, Claudia, Lancella, Laura, and Carraro, Francesca

Subjects
Male, 0301 basic medicine, Pediatrics, medicine.disease_cause, 0302 clinical medicine, polycyclic compounds, 030212 general & internal medicine, Child, Children, Medicine (all), Osteomyelitis, Bacterial Infections, Perinatology and Child Health, Anti-Bacterial Agents, Clinical Practice, Infectious Diseases, Child, Preschool, Administration, Intravenous, Female, lipids (amino acids, peptides, and proteins), Daptomycin, Methicillin-resistant Staphylococcus aureus, Sepsis, Pediatrics, Perinatology and Child Health, Microbiology (medical), medicine.drug, medicine.medical_specialty, Adolescent, Drug-Related Side Effects and Adverse Reactions, 030106 microbiology, 03 medical and health sciences, medicine, Humans, Adverse effect, Retrospective Studies, business.industry, Infant, Newborn, Infant, Retrospective cohort study, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, medicine.disease, carbohydrates (lipids), business, Prolonged treatment
Abstract

Data on daptomycin use in the pediatric setting are scanty. We conducted a multicenter, retrospective study on 46 children treated with intravenous daptomycin at a mean dosage of 7.0 mg/kg/d, for a median of 14 days. Three children had adverse events possibly related to daptomycin. The drug was overall well tolerated, even with prolonged treatment.

Published
2016

47. Listeria Meningitis in an Immunocompetent Child

Author

Villa, Giovanna, primary, Diana, Maria Cristina, additional, Solari, Nicoletta, additional, Bandettini, Roberto, additional, Sorrentino, Stefania, additional, Loy, Anna, additional, Losurdo, Giuseppe, additional, and Renna, Salvatore, additional

Published
2017
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49. Epidemiology of invasive fungal diseases in children with solid tumours undergoing autologous haematopoietic stem cell transplantation: a 10-year experience in a tertiary Italian centre

Author

Tatarelli, Paola, primary, Faraci, Maura, additional, Caviglia, Ilaria, additional, Bandettini, Roberto, additional, Cangemi, Giuliana, additional, Magnano, Gian Michele, additional, Garaventa, Alberto, additional, Viscoli, Claudio, additional, and Castagnola, Elio, additional

Published
2017
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