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1. Candidemia: Evolution of Drug Resistance and Novel Therapeutic Approaches

Author

Tortorano AM, Prigitano A, Morroni G, Brescini L, and Barchiesi F

Subjects
candidemia, candida, antifungal resistance, management of candidemia, novel antifungals, Infectious and parasitic diseases, RC109-216
Abstract

Anna Maria Tortorano,1 Anna Prigitano,1 Gianluca Morroni,2 Lucia Brescini,2,3 Francesco Barchiesi2,4 1Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy; 2Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy; 3Clinic of Infectious Diseases, Azienda Ospedaliero Universitaria, Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona, Italy; 4Clinic of Infectious Diseases, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, ItalyCorrespondence: Anna Maria TortoranoDepartment of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, Milano, 20133, ItalyTel +39 02 50315145Fax +39 02 50315146Email annamaria.tortorano@unimi.itAbstract: Candidemia and invasive candidiasis are the most common healthcare-associated invasive fungal infections, with a crude mortality rate of 25– 50%. Candida albicans remains the most frequent etiology, followed by C. glabrata, C. parapsilosis and C. tropicalis. With the exception of a limited number of species (ie: C. krusei, C. glabrata and rare Candida species), resistance to fluconazole and other triazoles are quite uncommon. However, recently fluconazole-resistant C. parapsilosis, echinocandin-resistant C. glabrata and the multidrug resistant C. auris have emerged. Resistance to amphotericin B is even more rare due to the reduced fitness of resistant isolates. The mechanisms of antifungal resistance in Candida (altered drug-target interactions, reduced cellular drug concentrations, and physical barriers associated with biofilms) are analyzed. The choice of the antifungal therapy for candidemia must take into account several factors such as type of patient, presence of devices, severity of illness, recent exposure to antifungals, local epidemiology, organs involvement, and Candida species. The first-line therapy in non-neutropenic critical patient is an echinocandin switching to fluconazole in clinically stable patients with negative blood cultures and azole susceptible isolate. Similarly, an echinocandin is the drug of choice also in neutropenic patients. The treatment duration is 14 days after the first negative blood culture or longer in cases of organ involvement. An early removal of vascular catheter improves the outcome. The promising results of new antifungal molecules, such as the terpenoid derivative ibrexafungerp, the novel echinocandin with an enhanced half-life rezafungin, oteseconazole and fosmanogepix, representative of new classes of antifungals, are discussed.Keywords: candidemia, Candida, antifungal resistance, management of candidemia, novel antifungals

Published
2021

2. How to interpret MICs of antifungal compounds according to the revised clinical breakpoints v. 10.0 European committee on antimicrobial susceptibility testing (EUCAST)

Author

Arendrup, M.C., Meletiadis, J., Guinea, J., Friberg, N., Mares, M., Kahlmeter, G., Andersen, C.T., Arikan-Akdagli, S., Barchiesi, F., Chryssanthou, E., Hamal, P., Järv, H., Klimko, N., Kurzai, O., Lagrou, K., Lass-Flörl, C., Matos, T., Muehlethaler, K., Rogers, T.R., Velegraki, A., and Arikan, S.

Published
2020
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4. Corrigendum to: “Development and validation of a prediction model for severe respiratory failure in hospitalized patients with SARS-CoV-2 infection: a multicentre cohort study (PREDI-CO study)” Clinical Microbiology and Infection 26 (2020) 1545–1553 (Clinical Microbiology and Infection (2020) 26(11) (1545–1553), (S1198743X20304791), (10.1016/j.cmi.2020.08.003))

Author

Bartoletti M., Bartoletti, M, Giannella, M, Scudeller, L, Tedeschi, S, Rinaldi, M, Bussini, L, Fornaro, G, Pascale, R, Pancaldi, L, Pasquini, Z, Trapani, F, Badia, L, Campoli, C, Tadolini, M, Attard, L, Puoti, M, Merli, M, Mussini, C, Menozzi, M, Meschiari, M, Codeluppi, M, Barchiesi, F, Cristini, F, Saracino, A, Licci, A, Rapuano, S, Tonetti, T, Gaibani, P, Ranieri, V, Viale, P, Bartoletti M., Giannella M., Scudeller L., Tedeschi S., Rinaldi M., Bussini L., Fornaro G., Pascale R., Pancaldi L., Pasquini Z., Trapani F., Badia L., Campoli C., Tadolini M., Attard L., Puoti M., Merli M., Mussini C., Menozzi M., Meschiari M., Codeluppi M., Barchiesi F., Cristini F., Saracino A., Licci A., Rapuano S., Tonetti T., Gaibani P., Ranieri V. M., Viale P., Bartoletti M., Bartoletti, M, Giannella, M, Scudeller, L, Tedeschi, S, Rinaldi, M, Bussini, L, Fornaro, G, Pascale, R, Pancaldi, L, Pasquini, Z, Trapani, F, Badia, L, Campoli, C, Tadolini, M, Attard, L, Puoti, M, Merli, M, Mussini, C, Menozzi, M, Meschiari, M, Codeluppi, M, Barchiesi, F, Cristini, F, Saracino, A, Licci, A, Rapuano, S, Tonetti, T, Gaibani, P, Ranieri, V, Viale, P, Bartoletti M., Giannella M., Scudeller L., Tedeschi S., Rinaldi M., Bussini L., Fornaro G., Pascale R., Pancaldi L., Pasquini Z., Trapani F., Badia L., Campoli C., Tadolini M., Attard L., Puoti M., Merli M., Mussini C., Menozzi M., Meschiari M., Codeluppi M., Barchiesi F., Cristini F., Saracino A., Licci A., Rapuano S., Tonetti T., Gaibani P., Ranieri V. M., and Viale P.

Abstract

The authors regret that an author's name which should be on the list of the PREDICO study group was mistakenly listed in the appendix at the end of the article. Further, on Pubmed (https://pubmed.ncbi.nlm.nih.gov/32781244/) the name is wrongly reported as an affiliation (19Lucia Diella Infectious Disease Unit - Department of Biomedical Sciences and Human Oncology, University of Bari, Policlinico di Bari, Italy.) It should be 19Infectious Disease Unit - Department of Biomedical Sciences and Human Oncology, University of Bari, Policlinico di Bari, Italy. This affiliation belongs to Lucia Diella. The authors would like to apologise for any inconvenience caused.

Published
2023

5. How to: EUCAST recommendations on the screening procedure E.Def 10.1 for the detection of azole resistance in Aspergillus fumigatus isolates using four-well azole-containing agar plates

Author

Arendrup, M.C., Arikan-Akdagli, S., Barchiesi, F., Castanheira, M., Chryssanthou, E., Friberg, N., Guinea, J., Järv, H., Klimko, N., Kurzai, O., Lagrou, K., Lass-Flörl, C., Mares, M., Matos, T., Meletiadis, J., Moore, C.B., Mouton, J.W., Muehlethaler, K., Rogers, T.R., Andersen, C.T., Velegraki, A., and Verweij, P.E.

Published
2019
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7. Review of III mill. BCE graves in HD-7, HD-10 and HD-15 (Ra’s al-Hadd, Sultanate of Oman)

Author

Cattani M., Barchiesi F., Bonazzi L., and Cattani M., Barchiesi F., Bonazzi L.

Subjects
cemetery, Bronze Age, Oman
Abstract

Since the 1980s, thanks to the survey carried out by the British team headed by Julian Reade, several groups of cairns (HD-7 and HD-10) have been known at Ra’s al-Hadd, located on the margin of the rocky platform which borders with HD-6 settlement. In early 2022 we created a new map in a GIS with several images from Google Earth and other digital maps, locating features according to visibility and GPS points.

Published
2022

8. Efficacy of corticosteroid treatment for hospitalized patients with severe COVID-19: a multicentre study

Author

Bartoletti, M, Marconi, L, Scudeller, L, Pancaldi, L, Tedeschi, S, Giannella, M, Rinaldi, M, Bussini, L, Valentini, I, Ferravante, A, Potalivo, A, Marchionni, E, Fornaro, G, Pascale, R, Pasquini, Z, Puoti, M, Merli, M, Barchiesi, F, Volpato, F, Rubin, A, Saracino, A, Tonetti, T, Gaibani, P, Ranieri, V, Viale, P, Cristini, F, Bartoletti M., Marconi L., Scudeller L., Pancaldi L., Tedeschi S., Giannella M., Rinaldi M., Bussini L., Valentini I., Ferravante A. F., Potalivo A., Marchionni E., Fornaro G., Pascale R., Pasquini Z., Puoti M., Merli M., Barchiesi F., Volpato F., Rubin A., Saracino A., Tonetti T., Gaibani P., Ranieri V. M., Viale P., Cristini F., Bartoletti, M, Marconi, L, Scudeller, L, Pancaldi, L, Tedeschi, S, Giannella, M, Rinaldi, M, Bussini, L, Valentini, I, Ferravante, A, Potalivo, A, Marchionni, E, Fornaro, G, Pascale, R, Pasquini, Z, Puoti, M, Merli, M, Barchiesi, F, Volpato, F, Rubin, A, Saracino, A, Tonetti, T, Gaibani, P, Ranieri, V, Viale, P, Cristini, F, Bartoletti M., Marconi L., Scudeller L., Pancaldi L., Tedeschi S., Giannella M., Rinaldi M., Bussini L., Valentini I., Ferravante A. F., Potalivo A., Marchionni E., Fornaro G., Pascale R., Pasquini Z., Puoti M., Merli M., Barchiesi F., Volpato F., Rubin A., Saracino A., Tonetti T., Gaibani P., Ranieri V. M., Viale P., and Cristini F.

Abstract

Objective: To assess the efficacy of corticosteroids in patients with coronavirus disease 2019 (COVID-19). Methods: A multicentre observational study was performed from 22 February through 30 June 2020. We included consecutive adult patients with severe COVID-19, defined as respiratory rate ≥30 breath per minute, oxygen saturation ≤93% on ambient air or arterial partial pressure of oxygen to fraction of inspired oxygen ≤300 mm Hg. We excluded patients being treated with other immunomodulant drugs, receiving low-dose corticosteroids and receiving corticosteroids 72 hours after admission. The primary endpoint was 30-day mortality from hospital admission. The main exposure variable was corticosteroid therapy at a dose of ≥0.5 mg/kg of prednisone equivalents. It was introduced as binomial covariate in a logistic regression model for the primary endpoint and inverse probability of treatment weighting using the propensity score. Results: Of 1717 patients with COVID-19 evaluated, 513 were included in the study, and of these, 170 (33%) were treated with corticosteroids. During hospitalization, 166 patients (34%) met the criteria of the primary outcome (60/170, 35% in the corticosteroid group and 106/343, 31% in the noncorticosteroid group). At multivariable analysis corticosteroid treatment was not associated with lower 30-day mortality rate (adjusted odds ratio, 0.59; 95% confidence interval (CI), 0.20–1.74; p 0.33). After inverse probability of treatment weighting, corticosteroids were not associated with lower 30-day mortality (average treatment effect, 0.05; 95% CI, −0.02 to 0.09; p 0.12). However, subgroup analysis revealed that in patients with PO2/FiO2 < 200 mm Hg at admission (135 patients, 52 (38%) treated with corticosteroids), corticosteroid treatment was associated with a lower risk of 30-day mortality (23/52, 44% vs. 45/83, 54%; adjusted odds ratio, 0.20; 95% CI, 0.04–0.90; p 0.036). Conclusions: The effect of corticosteroid treatment on mortality might be l

Published
2021

10. SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients

Author

Montagna, M. T., Lovero, G., Coretti, C., Martinelli, D., Delia, M., De Giglio, O., Caira, M., Puntillo, F., D’Antonio, D., Venditti, M., Sambri, V., Di Bernardo, F., Barbui, A., Lo Cascio, G., Concia, E., Mikulska, M., Viscoli, C., Maximova, N., Candoni, A., Oliveri, S., Lombardi, G., Pitzurra, L., Sanguinetti, M., Masciari, R., Santantonio, T., Andreoni, S., Barchiesi, F., Pecile, P., Farina, C., Viale, P., Specchia, G., Caggiano, G., and Pagano, L.

Published
2014
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12. How to: perform antifungal susceptibility testing of microconidia-forming dermatophytes following the new reference EUCAST method E.Def 11.0, exemplified by Trichophyton

Author

Arendrup, M.C. Kahlmeter, G. Guinea, J. Meletiadis, J. Arendrup, M.C. Meletiadis, J. Guinea, J. Kahlmeter, G. Arikan-Akdagli, S. Friberg, F. Barchiesi, F. Castanheira, M. Hamal, P. Jarv, H. Hilmarsdottir, I. Klimko, N. Kurzai, O. Lagrou, K. Lass-Florl, C. Matos, T. Moore, C.B. Muehlethaler, K. Rogers, T.R. Velegraki, A. the Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST)

Abstract

Background: Antifungal drug resistance in dermatophytes was first reported shortly after the turn of the millennium and has today been reported in Trichophyton and occasionally in Microsporum, but not in Epidermophyton species. Although drug resistance in dermatophytes is not routinely investigated, resistance in Trichophyton spp. is increasingly reported worldwide. The highest rates are observed in India (36% and 68% for terbinafine (MIC ≥4 mg/L) and fluconazole (MICs ≥16 mg/L), respectively), and apparently involve the spread of a unique clade related to the Trichophyton mentagrophytes/Trichophyton interdigitale complex. Objectives: The European Committee on Antimicrobial Susceptibility Testing Subcommittee on Antifungal Susceptibility Testing (EUCAST-AFST) has released a new method (E.Def 11.0) for antifungal susceptibility testing against microconidia-forming dermatophytes including tentative MIC ranges for quality control strains and tentative breakpoints against Trichophyton rubrum and T. interdigitale. Here, the details of the new procedure E.Def 11.0 are described. Sources: This technical note is based on the multicentre validation of the EUCAST dermatophyte antifungal susceptibility testing method, the mould testing method (E.Def 9.3.2) and the updated quality control tables for antifungal susceptibility testing document, v 5.0 (available on the EUCAST website). Contents: The method is based on the EUCAST microdilution method for moulds but significant differences include: (a) an altered test medium selective for dermatophytes; (b) an altered incubation time and temperature; and (c) a different end-point criterion (spectrophotometric determination) of fungal growth. It can easily be implemented in laboratories already performing EUCAST microdilution methods and has been validated for terbinafine, voriconazole, itraconazole and amorolfine against T. rubrum and T. interdigitale. Implications: This standardized procedure with automated end-point reading will allow broader implementation of susceptibility testing of dermatophytes and so facilitate earlier appropriate therapy. This is important, as resistance is rapidly emerging and largely underdiagnosed. © 2020

Published
2021

13. Prevention Italy 2021 - An update of the 2018 Consensus document and recommendations for the prevention of cardiovascular disease in Italy

Author

Battistoni, A., Gallo, G., Aragona, C. O., Barchiesi, F., Basolo, A., Bellone, S., Bellotti, P., Bertolotti, M., Bianco, A., Biffi, A., Borghi, C., Cicero, A. F. G., Consoli, A., Corsini, A., Desideri, G., Di Giacinto, B., Fernando, F., Ferri, C., Galiuto, L., Grassi, D., Grassi, G., Icardi, G., Indolfi, C., Lodi, E., Modena, M. G., Muiesan, M. L., Nati, G., Orsi, A., Palermi, S., Parati, G., Passantino, A., Patelli, A., Pelliccia, A., Pengo, M., Filardi, P. P., Perseghin, G., Pirro, M., Pontremoli, R., Rengo, G., Ricotti, R., Rizzoni, D., Rocca, B., Rotella, C., Rubattu, S., Salvetti, G., Sciacqua, A., Serdoz, A., Sirico, F., Squeo, M. R., Tocci, G., Trimarco, B., Vigili de Kreutzenberg, S., Volpe, R., and Volpe, M.

Subjects
Consensus, Italy, Humans, Risk Assessment, Risk Factors, Cardiovascular Diseases
Published
2021

14. Prevention Italy 2021 - An update of the 2018 Consensus document and recommendations for the prevention of cardiovascular disease in Italy [Prevenzione Italia 2021 Un update del Documento di consenso e raccomandazioni per la prevenzione cardiovascolare in Italia]

Author

Battistoni, A, Gallo, G, Aragona, C, Barchiesi, F, Basolo, A, Bellone, S, Bellotti, P, Bertolotti, M, Bianco, A, Biffi, A, Borghi, C, Cicero, A, Consoli, A, Corsini, A, Desideri, G, Di Giacinto, B, Fernando, F, Ferri, C, Galiuto, L, Grassi, D, Grassi, G, Icardi, G, Indolfi, C, Lodi, E, Modena, M, Muiesan, M, Nati, G, Orsi, A, Palermi, S, Parati, G, Passantino, A, Patelli, A, Pelliccia, A, Pengo, M, Filardi, P, Perseghin, G, Pirro, M, Pontremoli, R, Rengo, G, Ricotti, R, Rizzoni, D, Rocca, B, Rotella, C, Rubattu, S, Salvetti, G, Sciacqua, A, Serdoz, A, Sirico, F, Squeo, M, Tocci, G, Trimarco, B, Vigili de Kreutzenberg, S, Volpe, R, Volpe, M, Battistoni, Allegra, Gallo, Giovanna, Aragona, Caterina Oriana, Barchiesi, Fabio, Basolo, Alessio, Bellone, Simonetta, Bellotti, Paolo, Bertolotti, Marco, Bianco, Andrea, Biffi, Alessandro, Borghi, Claudio, Cicero, Arrigo Francesco Giuseppe, Consoli, Agostino, Corsini, Alberto, Desideri, Giovambattista, Di Giacinto, Barbara, Fernando, Fredrik, Ferri, Claudio, Galiuto, Leonarda, Grassi, Davide, Grassi, Guido, Icardi, Giancarlo, Indolfi, Ciro, Lodi, Elisa, Modena, Maria Grazia, Muiesan, Maria Lorenza, Nati, Giulio, Orsi, Andrea, Palermi, Stefano, Parati, Gianfranco, Passantino, Andrea, Patelli, Alessandra, Pelliccia, Antonio, Pengo, Martino, Filardi, Pasquale Perrone, Perseghin, Gianluca, Pirro, Matteo, Pontremoli, Roberto, Rengo, Giuseppe, Ricotti, Roberta, Rizzoni, Damiano, Rocca, Bianca, Rotella, Carlo, Rubattu, Speranza, Salvetti, Guido, Sciacqua, Angela, Serdoz, Andrea, Sirico, Felice, Squeo, Maria Rosaria, Tocci, Giuliano, Trimarco, Bruno, Vigili de Kreutzenberg, Saula, Volpe, Roberto, Volpe, Massimo, Battistoni, A, Gallo, G, Aragona, C, Barchiesi, F, Basolo, A, Bellone, S, Bellotti, P, Bertolotti, M, Bianco, A, Biffi, A, Borghi, C, Cicero, A, Consoli, A, Corsini, A, Desideri, G, Di Giacinto, B, Fernando, F, Ferri, C, Galiuto, L, Grassi, D, Grassi, G, Icardi, G, Indolfi, C, Lodi, E, Modena, M, Muiesan, M, Nati, G, Orsi, A, Palermi, S, Parati, G, Passantino, A, Patelli, A, Pelliccia, A, Pengo, M, Filardi, P, Perseghin, G, Pirro, M, Pontremoli, R, Rengo, G, Ricotti, R, Rizzoni, D, Rocca, B, Rotella, C, Rubattu, S, Salvetti, G, Sciacqua, A, Serdoz, A, Sirico, F, Squeo, M, Tocci, G, Trimarco, B, Vigili de Kreutzenberg, S, Volpe, R, Volpe, M, Battistoni, Allegra, Gallo, Giovanna, Aragona, Caterina Oriana, Barchiesi, Fabio, Basolo, Alessio, Bellone, Simonetta, Bellotti, Paolo, Bertolotti, Marco, Bianco, Andrea, Biffi, Alessandro, Borghi, Claudio, Cicero, Arrigo Francesco Giuseppe, Consoli, Agostino, Corsini, Alberto, Desideri, Giovambattista, Di Giacinto, Barbara, Fernando, Fredrik, Ferri, Claudio, Galiuto, Leonarda, Grassi, Davide, Grassi, Guido, Icardi, Giancarlo, Indolfi, Ciro, Lodi, Elisa, Modena, Maria Grazia, Muiesan, Maria Lorenza, Nati, Giulio, Orsi, Andrea, Palermi, Stefano, Parati, Gianfranco, Passantino, Andrea, Patelli, Alessandra, Pelliccia, Antonio, Pengo, Martino, Filardi, Pasquale Perrone, Perseghin, Gianluca, Pirro, Matteo, Pontremoli, Roberto, Rengo, Giuseppe, Ricotti, Roberta, Rizzoni, Damiano, Rocca, Bianca, Rotella, Carlo, Rubattu, Speranza, Salvetti, Guido, Sciacqua, Angela, Serdoz, Andrea, Sirico, Felice, Squeo, Maria Rosaria, Tocci, Giuliano, Trimarco, Bruno, Vigili de Kreutzenberg, Saula, Volpe, Roberto, and Volpe, Massimo

Published
2021

16. EUCAST Definitive Document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts: Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST)∗

Author

Rodriguez-Tudela, J.L., Arendrup, M.C., Barchiesi, F., Bille, J., Chryssanthou, E., Cuenca-Estrella, M., Dannaoui, E., Denning, D.W., Donnelly, J.P., Dromer, F., Fegeler, W., Lass-Flörl, C., Moore, C., Richardson, M., Sandven, P., Velegraki, A., and Verweij, P.

Published
2008
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20. Atazanavir/ritonavir with lamivudine as maintenance therapy in virologically suppressed HIV-infected patients: 96 week outcomes of a randomized trial

Author

Fabbiani, M, Gagliardini, R, Ciccarelli, N, Roldan, E, Latini, A, D'Ettorre, G, Antinori, A, Castagna, A, Orofino, G, Francisci, D, Chinello, P, Madeddu, G, Grima, P, Rusconi, S, Del Pin, B, Lombardi, F, D'Avino, A, Foca, E, Colafigli, M, Cauda, R, Di Giambenedetto, S, De Luca, A, Mondi, A, Borghetti, A, Baldonero, E, Belmonti, S, Lamonica, S, Sidella, L, Tamburrini, E, Visconti, E, Giacometti, A, Barchiesi, F, Castelli, P, Cirioni, O, Mazzocato, S, Di Pietro, M, Blanc, P, Degli Esposti, A, Mariabelli, E, Marini, S, Poggi, A, Quiros Roldan, E, Amadasi, S, Apostoli, A, Biasi, L, Bonito, A, Brianese, N, Compostella, S, Ferraresi, A, Motta, D, Mughini, M, Celesia, B, Gussio, M, Sofia, S, Tana, M, Tundo, P, Viscoli, C, De Hoffer, L, Di Biagio, A, Grignolo, S, Parisini, A, Schenone, E, Taramasso, L, Manconi, P, Boccone, A, Ortu, F, Piano, P, Serusi, L, Puoti, M, Moioli, M, Rossotti, R, Travi, G, Ventura, F, Galli, M, Di Nardo Stuppino, S, Di Cristo, V, Giacomelli, A, Vimercati, V, Viale, P, Gori, A, Rizzardini, G, Capetti, A, Carenzi, L, Mazza, F, Meraviglia, P, Rosa, S, Zucchi, P, Mineo, M, Giuliani, M, Pacifici, A, Pimpinelli, F, Solivetti, F, Stivali, F, Angelici, F, Bellagamba, R, Delle Rose, D, Fezza, R, Libertone, R, Mosti, S, Narciso, P, Nicastri, E, Ottou, S, Tomassi, C, Vlassi, C, Zaccarelli, M, Zoppe, F, Vullo, V, Altavilla, F, Ceccarelli, G, Fantauzzi, A, Gebremeskel, S, Lo Menzo, S, Mezzaroma, I, Tierno, F, Petrosillo, N, Boumis, E, Cicalini, S, Grilli, E, Musso, M, Stella, C, Mura, M, Bagella, P, Mannazzu, M, Soddu, V, Caramello, P, Carcieri, C, Carosella, S, Farenga, M, Scotton, P, Rossi, M, Concia, E, Corsini, F, Gricolo, C, Lanzafame, M, Lattuada, E, Leonardi, S, Rigo, F, Lazzarin, A, Bigoloni, A, Carini, E, Nozza, S, Spagnuolo, V, Belfiori, B, Malincarne, L, Schiaroli, E, Sfara, C, Tosti, A, Sacchini, D, Ruggieri, A, Valdatta, C, Fabbiani M., Gagliardini R., Ciccarelli N., Roldan E. Q., Latini A., d'Ettorre G., Antinori A., Castagna A., Orofino G., Francisci D., Chinello P., Madeddu G., Grima P., Rusconi S., Del Pin B., Lombardi F., D'Avino A., Foca E., Colafigli M., Cauda R., Di Giambenedetto S., De Luca A., Mondi A., Borghetti A., Baldonero E., Belmonti S., Lamonica S., Sidella L., Tamburrini E., Visconti E., Giacometti A., Barchiesi F., Castelli P., Cirioni O., Mazzocato S., Di Pietro M., Blanc P., Degli Esposti A., Mariabelli E., Marini S., Poggi A., Quiros Roldan E., Amadasi S., Apostoli A., Biasi L., Bonito A., Brianese N., Compostella S., Ferraresi A., Motta D., Mughini M. T., Celesia B. M., Gussio M., Sofia S., Tana M., Tundo P., Viscoli C., De Hoffer L., Di Biagio A., Grignolo S., Parisini A., Schenone E., Taramasso L., Manconi P. E., Boccone A., Ortu F., Piano P., Serusi L., Puoti M., Moioli M. C., Rossotti R., Travi G., Ventura F., Galli M., Di Nardo Stuppino S., Di Cristo V., Giacomelli A., Vimercati V., Viale P., Gori A., Rizzardini G., Capetti A., Carenzi L., Mazza F., Meraviglia P., Rosa S., Zucchi P., Mineo M., Giuliani M., Pacifici A., Pimpinelli F., Solivetti F., Stivali F., Angelici F., Bellagamba R., Delle Rose D., Fezza R., Libertone R., Mosti S., Narciso P., Nicastri E., Ottou S., Tomassi C., Vlassi C., Zaccarelli M., Zoppe F., Vullo V., Altavilla F., Ceccarelli G., Fantauzzi A., Gebremeskel S., Lo Menzo S., Mezzaroma I., Tierno F., Petrosillo N., Boumis E., Cicalini S., Grilli E., Musso M., Stella C., Mura M. S., Bagella P., Mannazzu M., Soddu V., Caramello P., Carcieri C., Carosella S., Farenga M., Scotton P. G., Rossi M. C., Concia E., Corsini F., Gricolo C., Lanzafame M., Lattuada E., Leonardi S., Rigo F., Lazzarin A., Bigoloni A., Carini E., Nozza S., Spagnuolo V., Belfiori B., Malincarne L., Schiaroli E., Sfara C., Tosti A., Sacchini D., Ruggieri A., Valdatta C., Fabbiani, M, Gagliardini, R, Ciccarelli, N, Roldan, E, Latini, A, D'Ettorre, G, Antinori, A, Castagna, A, Orofino, G, Francisci, D, Chinello, P, Madeddu, G, Grima, P, Rusconi, S, Del Pin, B, Lombardi, F, D'Avino, A, Foca, E, Colafigli, M, Cauda, R, Di Giambenedetto, S, De Luca, A, Mondi, A, Borghetti, A, Baldonero, E, Belmonti, S, Lamonica, S, Sidella, L, Tamburrini, E, Visconti, E, Giacometti, A, Barchiesi, F, Castelli, P, Cirioni, O, Mazzocato, S, Di Pietro, M, Blanc, P, Degli Esposti, A, Mariabelli, E, Marini, S, Poggi, A, Quiros Roldan, E, Amadasi, S, Apostoli, A, Biasi, L, Bonito, A, Brianese, N, Compostella, S, Ferraresi, A, Motta, D, Mughini, M, Celesia, B, Gussio, M, Sofia, S, Tana, M, Tundo, P, Viscoli, C, De Hoffer, L, Di Biagio, A, Grignolo, S, Parisini, A, Schenone, E, Taramasso, L, Manconi, P, Boccone, A, Ortu, F, Piano, P, Serusi, L, Puoti, M, Moioli, M, Rossotti, R, Travi, G, Ventura, F, Galli, M, Di Nardo Stuppino, S, Di Cristo, V, Giacomelli, A, Vimercati, V, Viale, P, Gori, A, Rizzardini, G, Capetti, A, Carenzi, L, Mazza, F, Meraviglia, P, Rosa, S, Zucchi, P, Mineo, M, Giuliani, M, Pacifici, A, Pimpinelli, F, Solivetti, F, Stivali, F, Angelici, F, Bellagamba, R, Delle Rose, D, Fezza, R, Libertone, R, Mosti, S, Narciso, P, Nicastri, E, Ottou, S, Tomassi, C, Vlassi, C, Zaccarelli, M, Zoppe, F, Vullo, V, Altavilla, F, Ceccarelli, G, Fantauzzi, A, Gebremeskel, S, Lo Menzo, S, Mezzaroma, I, Tierno, F, Petrosillo, N, Boumis, E, Cicalini, S, Grilli, E, Musso, M, Stella, C, Mura, M, Bagella, P, Mannazzu, M, Soddu, V, Caramello, P, Carcieri, C, Carosella, S, Farenga, M, Scotton, P, Rossi, M, Concia, E, Corsini, F, Gricolo, C, Lanzafame, M, Lattuada, E, Leonardi, S, Rigo, F, Lazzarin, A, Bigoloni, A, Carini, E, Nozza, S, Spagnuolo, V, Belfiori, B, Malincarne, L, Schiaroli, E, Sfara, C, Tosti, A, Sacchini, D, Ruggieri, A, Valdatta, C, Fabbiani M., Gagliardini R., Ciccarelli N., Roldan E. Q., Latini A., d'Ettorre G., Antinori A., Castagna A., Orofino G., Francisci D., Chinello P., Madeddu G., Grima P., Rusconi S., Del Pin B., Lombardi F., D'Avino A., Foca E., Colafigli M., Cauda R., Di Giambenedetto S., De Luca A., Mondi A., Borghetti A., Baldonero E., Belmonti S., Lamonica S., Sidella L., Tamburrini E., Visconti E., Giacometti A., Barchiesi F., Castelli P., Cirioni O., Mazzocato S., Di Pietro M., Blanc P., Degli Esposti A., Mariabelli E., Marini S., Poggi A., Quiros Roldan E., Amadasi S., Apostoli A., Biasi L., Bonito A., Brianese N., Compostella S., Ferraresi A., Motta D., Mughini M. T., Celesia B. M., Gussio M., Sofia S., Tana M., Tundo P., Viscoli C., De Hoffer L., Di Biagio A., Grignolo S., Parisini A., Schenone E., Taramasso L., Manconi P. E., Boccone A., Ortu F., Piano P., Serusi L., Puoti M., Moioli M. C., Rossotti R., Travi G., Ventura F., Galli M., Di Nardo Stuppino S., Di Cristo V., Giacomelli A., Vimercati V., Viale P., Gori A., Rizzardini G., Capetti A., Carenzi L., Mazza F., Meraviglia P., Rosa S., Zucchi P., Mineo M., Giuliani M., Pacifici A., Pimpinelli F., Solivetti F., Stivali F., Angelici F., Bellagamba R., Delle Rose D., Fezza R., Libertone R., Mosti S., Narciso P., Nicastri E., Ottou S., Tomassi C., Vlassi C., Zaccarelli M., Zoppe F., Vullo V., Altavilla F., Ceccarelli G., Fantauzzi A., Gebremeskel S., Lo Menzo S., Mezzaroma I., Tierno F., Petrosillo N., Boumis E., Cicalini S., Grilli E., Musso M., Stella C., Mura M. S., Bagella P., Mannazzu M., Soddu V., Caramello P., Carcieri C., Carosella S., Farenga M., Scotton P. G., Rossi M. C., Concia E., Corsini F., Gricolo C., Lanzafame M., Lattuada E., Leonardi S., Rigo F., Lazzarin A., Bigoloni A., Carini E., Nozza S., Spagnuolo V., Belfiori B., Malincarne L., Schiaroli E., Sfara C., Tosti A., Sacchini D., Ruggieri A., and Valdatta C.

Abstract

Objectives: To investigate the long-term safety and efficacy of a treatment switch to dual ART with atazanavir/ritonavir+lamivudine versus continuing a standard regimen with atazanavir/ritonavir+2NRTI in virologically suppressed patients. Methods: ATLAS-M is a 96 week open-label, randomized, non-inferiority (margin -12%) trial enrolling HIV-infected adults on atazanavir/ritonavir+2NRTI, with stable HIV-RNA < 50 copies/mL and CD4 counts.200 cells/mm3. At baseline, patients were randomized 1:1 to switch to atazanavir/ritonavir+lamivudine or to continue the previous regimen. Here, we report the 96 week efficacy and safety data. The study was registered with ClinicalTrials.gov, number NCT01599364. Results: Overall, 266 subjects were enrolled (133 in each arm). At 96 weeks, in the ITT population, patients free of treatment failure totalled 103 (77.4%) with atazanavir/ritonavir+lamivudine and 87 (65.4%) with triple therapy (difference +12.0%, 95% CI +1.2/+22.8, P=0.030), demonstrating the superiority of dual therapy. Two (1.5%) and 9 (6.8%) virological failures occurred in the dual-therapy arm and the triple-therapy arm, respectively, without development of resistance to any study drug. Clinical adverse events occurred at similar rates in both arms. A higher frequency of grade 3-4 hyperbilirubinemia (66.9% versus 50.4%, P=0.006) and hypertriglyceridaemia (6.8% versus 1.5%, P=0.031) occurred with dual therapy, although this never led to treatment discontinuation. A significant improvement in renal function and lumbar spine bone mineral density occurred in the dual-therapy arm. The evolution of CD4, HIV-DNA levels and neurocognitive performance was similar in both arms. Conclusions: In this randomized study, a treatment switch to atazanavir/ritonavir+lamivudine was superior over the continuation of atazanavir/ritonavir+2NRTI in virologically suppressed patients, with a sustained benefit in terms of improved renal function and bone mineral density.

Published
2018

21. Multicentre validation of a EUCAST method for the antifungal susceptibility testing of microconidia-forming dermatophytes

Author

Arendrup, M.C. Jørgensen, K.M. Guinea, J. Lagrou, K. Chryssanthou, E. Hayette, M.-P. Barchiesi, F. Lass-Flörl, C. Hamal, P. Dannaoui, E. Chowdhary, A. Meletiadis, J.

Abstract

Terbinafine resistance is increasingly reported in Trichophyton, rendering susceptibility testing particularly important in non-responding cases. We performed a multicentre evaluation of six EUCAST-based methods. Methods: Ten laboratories susceptibility tested terbinafine, itraconazole, voriconazole and amorolfine against a blinded panel of 38 terbinafine WT and target gene mutant isolates. E.Def 9.3.1 modifications included: medium with/without addition of chloramphenicol and cycloheximide (CC), incubation at 25°C to 28°C for 5-7 days and three MIC endpoints [visually and spectrophotometrically (90%/50% inhibition)], generating 7829 MICs. Quality control (QC) strains were Aspergillus flavus ATCC 204304 and CNM-CM1813. Eyeball, ECOFFinder (where ECOFF stands for epidemiological cut-off) and derivatization WT upper limits (WT-ULs), very major errors (VMEs; mutants with MICs ≤WT-ULs) and major errors (MEs; WT isolates with MICs >WT-ULs) were determined. Results: MICs fell within the QC ranges for ATCC 204304/CNM-CM1813 for 100%/96% (voriconazole) and 84%/84% (itraconazole), respectively. Terbinafine MICs fell within 0.25-1 mg/L for 96%/92%, suggesting high reproducibility. Across the six methods, the number of terbinafine MEs varied from 2 to 4 (2.6%-5.2%) for Trichophyton rubrum and from 0 to 2 (0%-2.0%) for Trichophyton interdigitale. Modes for WT and mutant populations were at least seven 2-fold dilutions apart in all cases. Excluding one I121M/V237I T. rubrum mutant and two mixed WT/mutant T. interdigitale specimens, the numbers of VMEs were as follows: T. rubrum: CC visual, 1/67 (1.5%); CC spectrophotometric 90% inhibition, 3/59 (5.1%); and CC spectrophotometric 50% inhibition, 1/67 (1.5%); and T. interdigitale: none. Voriconazole and amorolfine MICs were quite uniform, but trailing growth complicated determination of itraconazole visual and spectrophotometric 90% inhibition MIC. Conclusions: Although none of the laboratories was experienced in dermatophyte testing, error rates were low. We recommend the CC spectrophotometric 50% inhibition method and provide QC ranges and WT-ULs for WT/non-WT classification. © 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Published
2020

22. How to: interpret MICs of antifungal compounds according to the revised clinical breakpoints v. 10.0 European committee on antimicrobial susceptibility testing (EUCAST)

Author

Arendrup, M.C. (Maiken Cavling), Friberg, N. (Nathalie), Mares, M. (Mihai), Kahlmeter, G. (Gunnar), Meletiadis, J. (Joseph), Guinea, J., Arendrup, M.C. (M. C.), Guinea, J. (J.), Friberg, N. (N.), Mares, M. (M.), Kahlmeter, G., Andersen, C.T. (C. T.), Barchiesi, F. (F.), Chryssanthou, E. (E.), Hamal, P. (P.), Järv, H. (H.), Klimko, N. (N.), Kurzai, O. (O.), Lagrou, K. (Katrien), Lass-Flörl, C. (Cornelia), Matos, T. (T.), Muehlethaler, K. (K.), Rogers, T.R. (Thomas), Velegraki, A. (A.), Arendrup, M.C. (Maiken Cavling), Friberg, N. (Nathalie), Mares, M. (Mihai), Kahlmeter, G. (Gunnar), Meletiadis, J. (Joseph), Guinea, J., Arendrup, M.C. (M. C.), Guinea, J. (J.), Friberg, N. (N.), Mares, M. (M.), Kahlmeter, G., Andersen, C.T. (C. T.), Barchiesi, F. (F.), Chryssanthou, E. (E.), Hamal, P. (P.), Järv, H. (H.), Klimko, N. (N.), Kurzai, O. (O.), Lagrou, K. (Katrien), Lass-Flörl, C. (Cornelia), Matos, T. (T.), Muehlethaler, K. (K.), Rogers, T.R. (Thomas), and Velegraki, A. (A.)

Abstract

BACKGROUND: EUCAST has revised the definition of the susceptibility category "I" from "Intermediate" to "Susceptible, Increased exposure". This implies that "I" can be used where the drug-concentration at the site of infection is high, either because of dose escalation or through other means to ensure efficacy. Consequently, "I" is no longer used as a buffer-zone to prevent technical facto

Published
2020
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23. How to interpret MICs of antifungal compounds according to the revised clinical breakpoints v. 10.0 European committee on antimicrobial susceptibility testing (EUCAST)

Author

Arendrup, M. C., Friberg, N., Mares, M., Kahlmeter, G., Meletiadis, J., Guinea, J., Andersen, C. T., Arikan, S., Barchiesi, F., Chryssanthou, E., Hamal, P., Järv, H., Klimko, N., Kurzai, O., Lagrou, K., Lass-Flörl, C., Matos, T., Muehlethaler, K., Rogers, T. R., Velegraki, A., Arendrup, M. C., Friberg, N., Mares, M., Kahlmeter, G., Meletiadis, J., Guinea, J., Andersen, C. T., Arikan, S., Barchiesi, F., Chryssanthou, E., Hamal, P., Järv, H., Klimko, N., Kurzai, O., Lagrou, K., Lass-Flörl, C., Matos, T., Muehlethaler, K., Rogers, T. R., and Velegraki, A.

Abstract

Background: EUCAST has revised the definition of the susceptibility category I from ‘Intermediate’ to ‘Susceptible, Increased exposure’. This implies that I can be used where the drug concentration at the site of infection is high, either because of dose escalation or through other means to ensure efficacy. Consequently, I is no longer used as a buffer zone to prevent technical factors from causing misclassifications and discrepancies in interpretations. Instead, an Area of Technical Uncertainty (ATU) has been introduced for MICs that cannot be categorized without additional information as a warning to the laboratory that decision on how to act has to be made. To implement these changes, the EUCAST-AFST (Subcommittee on Antifungal Susceptibility Testing) reviewed all, and revised some, clinical antifungal breakpoints. Objectives: The aim was to present an overview of the current antifungal breakpoints and supporting evidence behind the changes. Sources: This document is based on the ten recently updated EUCAST rationale documents, clinical breakpoint and breakpoint ECOFF documents. Content: The following breakpoints (in mg/L) have been revised or established for Candida species: micafungin against C. albicans (ATU = 0.03); amphotericin B (S ≤/> R = 1/1), fluconazole (S ≤/> R = 2/4), itraconazole (S ≤/> R = 0.06/0.06), posaconazole (S ≤/> R = 0.06/0.06) and voriconazole (S ≤/> R = 0.06/0.25) against C. dubliniensis; fluconazole against C. glabrata (S ≤/> R = 0.001/16); and anidulafungin (S ≤/> R = 4/4) and micafungin (S ≤/> R = 2/2) against C. parapsilosis. For Aspergillus, new or revised breakpoints include itraconazole (ATU = 2) and isavuconazole against A. flavus (S ≤/> R = 1/2, ATU = 2); amphotericin B (S ≤/> R = 1/1), isavuconazole (S ≤ /> R = 1/2, ATU = 2), itraconazole (S ≤/> R = 1/1, ATU = 2), posaconazole (ATU = 0.25) and voriconazole (S ≤/> R = 1/1, ATU = 2) against A. fumigatus; itraconazole (S ≤/> R = 1/1, ATU

Published
2020

24. How to interpret MICs of antifungal compounds according to the revised clinical breakpoints v. 10.0 European committee on antimicrobial susceptibility testing (EUCAST)

Author

Arendrup, MC, Friberg, N, Mares, M, Kahlmeter, G, Meletiadis, Joseph, Guinea, J, Andersen, CT, Arikan-Akdagli, S, Barchiesi, F, Chryssanthou, E, Hamal, P, Järv, H, Klimko, N, Kurzai, O, Lagrou, K, Lass-Flörl, C, Matos, T, Muehlethaler, K, Rogers, TR, Velegraki, A, Arikan, S, Arendrup, MC, Friberg, N, Mares, M, Kahlmeter, G, Meletiadis, Joseph, Guinea, J, Andersen, CT, Arikan-Akdagli, S, Barchiesi, F, Chryssanthou, E, Hamal, P, Järv, H, Klimko, N, Kurzai, O, Lagrou, K, Lass-Flörl, C, Matos, T, Muehlethaler, K, Rogers, TR, Velegraki, A, and Arikan, S

Published
2020

31. Treatment simplification to atazanavir/ritonavir+lamivudine versus maintenance of atazanavir/ritonavir+two NRTIs in virologically suppressed HIV-1-infected patients: 48 week results from a randomized trial (ATLAS-M)

Author

Di Giambenedetto, S, Fabbiani, M, Quiros Roldan, E, Latini, A, D'Ettorre, G, Antinori, A, Castagna, A, Orofino, G, Francisci, D, Chinello, P, Madeddu, G, Grima, P, Rusconi, S, Di Pietro, M, Mondi, A, Ciccarelli, N, Borghetti, A, Foca, E, Colafigli, M, De Luca, A, Cauda, R, Baldonero, E, Belmonti, S, D'Avino, A, Gagliardini, R, Lamonica, S, Lombardi, F, Sidella, L, Tamburrini, E, Visconti, E, Giacometti, A, Barchiesi, F, Castelli, P, Cirioni, O, Mazzocato, S, Blanc, P, Degli Esposti, A, Del Pin, B, Mariabelli, E, Marini, S, Poggi, A, Amadasi, S, Apostoli, A, Biasi, L, Bonito, A, Brianese, N, Compostella, S, Ferraresi, A, Motta, D, Mughini, M, Celesia, B, Gussio, M, Sofia, S, Tana, M, Tundo, P, Viscoli, C, De Hoffer, L, Di Biagio, A, Grignolo, S, Parisini, A, Schenone, E, Taramasso, L, Manconi, P, Boccone, A, Ortu, F, Piano, P, Serusi, L, Puoti, M, Moioli, M, Rossotti, R, Travi, G, Ventura, F, Galli, M, Di Nardo Stuppino, S, Di Cristo, V, Giacomelli, A, Vimercati, V, Viale, P, Gori, A, Rizzardini, G, Capetti, A, Carenzi, L, Mazza, F, Meraviglia, P, Rosa, S, Zucchi, P, Mineo, M, Giuliani, M, Pacifici, A, Pimpinelli, F, Solivetti, F, Stivali, F, Angelici, F, Bellagamba, R, Delle Rose, D, Fezza, R, Libertone, R, Mosti, S, Narciso, P, Nicastri, E, Ottou, S, Tomassi, C, Vlassi, C, Zaccarelli, M, Zoppe, F, Vullo, V, Altavilla, F, Ceccarelli, G, Fantauzzi, A, Gebremeskel, S, Lo Menzo, S, Mezzaroma, I, Tierno, F, Petrosillo, N, Boumis, E, Cicalini, S, Grilli, E, Musso, M, Stella, C, Mura, M, Bagella, P, Mannazzu, M, Soddu, V, Caramello, P, Carcieri, C, Carosella, S, Farenga, M, Scotton, P, Rossi, M, Concia, E, Corsini, F, Gricolo, C, Lanzafame, M, Lattuada, E, Leonardi, S, Rigo, F, Lazzarin, A, Bigoloni, A, Carini, E, Nozza, S, Spagnuolo, V, Belfiori, B, Malincarne, L, Schiaroli, E, Sfara, C, Tosti, A, Sacchini, D, Ruggieri, A, Valdatta, C, Di Giambenedetto S., Fabbiani M., Quiros Roldan E., Latini A., D'Ettorre G., Antinori A., Castagna A., Orofino G., Francisci D., Chinello P., Madeddu G., Grima P., Rusconi S., Di Pietro M., Mondi A., Ciccarelli N., Borghetti A., Foca E., Colafigli M., De Luca A., Cauda R., Baldonero E., Belmonti S., D'Avino A., Gagliardini R., Lamonica S., Lombardi F., Sidella L., Tamburrini E., Visconti E., Giacometti A., Barchiesi F., Castelli P., Cirioni O., Mazzocato S., Blanc P., Degli Esposti A., Del Pin B., Mariabelli E., Marini S., Poggi A., Amadasi S., Apostoli A., Biasi L., Bonito A., Brianese N., Compostella S., Ferraresi A., Motta D., Mughini M. T., Celesia B. M., Gussio M., Sofia S., Tana M., Tundo P., Viscoli C., De Hoffer L., Di Biagio A., Grignolo S., Parisini A., Schenone E., Taramasso L., Manconi P. E., Boccone A., Ortu F., Piano P., Serusi L., Puoti M., Moioli M. C., Rossotti R., Travi G., Ventura F., Galli M., Di Nardo Stuppino S., Di Cristo V., Giacomelli A., Vimercati V., Viale P., Gori A., Rizzardini G., Capetti A., Carenzi L., Mazza F., Meraviglia P., Rosa S., Zucchi P., Mineo M., Giuliani M., Pacifici A., Pimpinelli F., Solivetti F., Stivali F., Angelici F., Bellagamba R., Delle Rose D., Fezza R., Libertone R., Mosti S., Narciso P., Nicastri E., Ottou S., Tomassi C., Vlassi C., Zaccarelli M., Zoppe F., Vullo V., Altavilla F., Ceccarelli G., Fantauzzi A., Gebremeskel S., Lo Menzo S., Mezzaroma I., Tierno F., Petrosillo N., Boumis E., Cicalini S., Grilli E., Musso M., Stella C., Mura M. S., Bagella P., Mannazzu M., Soddu V., Caramello P., Carcieri C., Carosella S., Farenga M., Scotton P. G., Rossi M. C., Concia E., Corsini F., Gricolo C., Lanzafame M., Lattuada E., Leonardi S., Rigo F., Lazzarin A., Bigoloni A., Carini E., Nozza S., Spagnuolo V., Belfiori B., Malincarne L., Schiaroli E., Sfara C., Tosti A., Sacchini D., Ruggieri A., Valdatta C., Di Giambenedetto, S, Fabbiani, M, Quiros Roldan, E, Latini, A, D'Ettorre, G, Antinori, A, Castagna, A, Orofino, G, Francisci, D, Chinello, P, Madeddu, G, Grima, P, Rusconi, S, Di Pietro, M, Mondi, A, Ciccarelli, N, Borghetti, A, Foca, E, Colafigli, M, De Luca, A, Cauda, R, Baldonero, E, Belmonti, S, D'Avino, A, Gagliardini, R, Lamonica, S, Lombardi, F, Sidella, L, Tamburrini, E, Visconti, E, Giacometti, A, Barchiesi, F, Castelli, P, Cirioni, O, Mazzocato, S, Blanc, P, Degli Esposti, A, Del Pin, B, Mariabelli, E, Marini, S, Poggi, A, Amadasi, S, Apostoli, A, Biasi, L, Bonito, A, Brianese, N, Compostella, S, Ferraresi, A, Motta, D, Mughini, M, Celesia, B, Gussio, M, Sofia, S, Tana, M, Tundo, P, Viscoli, C, De Hoffer, L, Di Biagio, A, Grignolo, S, Parisini, A, Schenone, E, Taramasso, L, Manconi, P, Boccone, A, Ortu, F, Piano, P, Serusi, L, Puoti, M, Moioli, M, Rossotti, R, Travi, G, Ventura, F, Galli, M, Di Nardo Stuppino, S, Di Cristo, V, Giacomelli, A, Vimercati, V, Viale, P, Gori, A, Rizzardini, G, Capetti, A, Carenzi, L, Mazza, F, Meraviglia, P, Rosa, S, Zucchi, P, Mineo, M, Giuliani, M, Pacifici, A, Pimpinelli, F, Solivetti, F, Stivali, F, Angelici, F, Bellagamba, R, Delle Rose, D, Fezza, R, Libertone, R, Mosti, S, Narciso, P, Nicastri, E, Ottou, S, Tomassi, C, Vlassi, C, Zaccarelli, M, Zoppe, F, Vullo, V, Altavilla, F, Ceccarelli, G, Fantauzzi, A, Gebremeskel, S, Lo Menzo, S, Mezzaroma, I, Tierno, F, Petrosillo, N, Boumis, E, Cicalini, S, Grilli, E, Musso, M, Stella, C, Mura, M, Bagella, P, Mannazzu, M, Soddu, V, Caramello, P, Carcieri, C, Carosella, S, Farenga, M, Scotton, P, Rossi, M, Concia, E, Corsini, F, Gricolo, C, Lanzafame, M, Lattuada, E, Leonardi, S, Rigo, F, Lazzarin, A, Bigoloni, A, Carini, E, Nozza, S, Spagnuolo, V, Belfiori, B, Malincarne, L, Schiaroli, E, Sfara, C, Tosti, A, Sacchini, D, Ruggieri, A, Valdatta, C, Di Giambenedetto S., Fabbiani M., Quiros Roldan E., Latini A., D'Ettorre G., Antinori A., Castagna A., Orofino G., Francisci D., Chinello P., Madeddu G., Grima P., Rusconi S., Di Pietro M., Mondi A., Ciccarelli N., Borghetti A., Foca E., Colafigli M., De Luca A., Cauda R., Baldonero E., Belmonti S., D'Avino A., Gagliardini R., Lamonica S., Lombardi F., Sidella L., Tamburrini E., Visconti E., Giacometti A., Barchiesi F., Castelli P., Cirioni O., Mazzocato S., Blanc P., Degli Esposti A., Del Pin B., Mariabelli E., Marini S., Poggi A., Amadasi S., Apostoli A., Biasi L., Bonito A., Brianese N., Compostella S., Ferraresi A., Motta D., Mughini M. T., Celesia B. M., Gussio M., Sofia S., Tana M., Tundo P., Viscoli C., De Hoffer L., Di Biagio A., Grignolo S., Parisini A., Schenone E., Taramasso L., Manconi P. E., Boccone A., Ortu F., Piano P., Serusi L., Puoti M., Moioli M. C., Rossotti R., Travi G., Ventura F., Galli M., Di Nardo Stuppino S., Di Cristo V., Giacomelli A., Vimercati V., Viale P., Gori A., Rizzardini G., Capetti A., Carenzi L., Mazza F., Meraviglia P., Rosa S., Zucchi P., Mineo M., Giuliani M., Pacifici A., Pimpinelli F., Solivetti F., Stivali F., Angelici F., Bellagamba R., Delle Rose D., Fezza R., Libertone R., Mosti S., Narciso P., Nicastri E., Ottou S., Tomassi C., Vlassi C., Zaccarelli M., Zoppe F., Vullo V., Altavilla F., Ceccarelli G., Fantauzzi A., Gebremeskel S., Lo Menzo S., Mezzaroma I., Tierno F., Petrosillo N., Boumis E., Cicalini S., Grilli E., Musso M., Stella C., Mura M. S., Bagella P., Mannazzu M., Soddu V., Caramello P., Carcieri C., Carosella S., Farenga M., Scotton P. G., Rossi M. C., Concia E., Corsini F., Gricolo C., Lanzafame M., Lattuada E., Leonardi S., Rigo F., Lazzarin A., Bigoloni A., Carini E., Nozza S., Spagnuolo V., Belfiori B., Malincarne L., Schiaroli E., Sfara C., Tosti A., Sacchini D., Ruggieri A., and Valdatta C.

Abstract

Background: Combination ART (cART)-related toxicities and costs have prompted the need for treatment simplification. The ATLAS-M trial explored 48 week non-inferior efficacy of simplification to atazanavir/ritonavir + lamivudine versus maintaining three-drug atazanavir/ritonavir-based cART in virologically suppressed patients. Methods: We performed an open-label, multicentre, randomized, non-inferiority study, enrolling HIV-infected adults on atazanavir/ritonavir+two NRTIs, with stable HIV-RNA <50 copies/mL and CD4+>200 cells/mm3. Main exclusion criteria were hepatitis B virus coinfection, past virological failure on or resistance to study drugs, recent AIDS and pregnancy. Patients were randomly assigned 1:1 to either switch to 300mg of atazanavir/ 100mg of ritonavir once daily and 300mg of lamivudine once daily (atazanavir/ritonavir+lamivudine arm) or to continue the previous regimen (atazanavir/ritonavir+two NRTIs arm). The primary study outcome was the maintenance of HIV-RNA <50 copies/mL at week 48 of the ITT-exposed (ITT-e) analysis with switch"failure. The non-inferiority margin was 12%. This study is registered at ClinicalTrials.gov, number NCT01599364. Results: Between July 2011 and June 2014, 266 patients were randomized (133 to each arm). After 48 weeks, the primary study outcome was met by 119 of 133 patients (89.5%) in the atazanavir/ritonavir+lamivudine arm and 106 of 133 patients (79.7%) in the atazanavir/ritonavir+two NRTIs arm [difference atazanavir/ritonavir+ lamivudine versus atazanavir/ritonavir+two NRTIs arm: +9.8% (95% CI+1.2 to+18.4)], demonstrating non-inferiority and superior efficacy of the atazanavir/ritonavir+lamivudine arm. Virological failure occurred in two (1.5%) patients in the atazanavir/ritonavir+lamivudine arm and six (4.5%) patients in the atazanavir/ritonavir+ two NRTIs arm, without resistance selection. A similar proportion of adverse events occurred in both arms. Conclusions: Treatment simplification to atazanavir/rito

Published
2017

36. How to: EUCAST recommendations on the screening procedure E.Def 10.1 for the detection of azole resistance in Aspergillus fumigatus isolates using four-well azole-containing agar plates

Author

Guinea, J. Verweij, P.E. Meletiadis, J. Mouton, J.W. Barchiesi, F. Arendrup, M.C. Arikan-Akdagli, S. Castanheira, M. Chryssanthou, E. Friberg, N. Järv, H. Klimko, N. Kurzai, O. Lagrou, K. Lass-Flörl, C. Mares, M. Matos, T. Moore, C.B. Muehlethaler, K. Rogers, T.R. Andersen, C.T. Velegraki, A.

Abstract

Background: The emergence of azole-resistant Aspergillus fumigatus isolates is a matter of significant concern in Europe, with countries reporting resistance rates (which can be as high as 30%) in hospitalized patients. Consequently, the treatment guidelines in The Netherlands, the country with the highest documented prevalence of azole-resistant A. fumigatus, has just been revised to now recommend initial therapy with combination therapy until the susceptibility pattern is known. Therefore, susceptibility testing of clinically relevant isolates has been strongly recommended in the ESCMID-EFISG aspergillosis guidelines. Furthermore, mixed azole-susceptible and azole-resistant (isogenic as well as non-isogenic) infections have been reported to occur, which implies that colonies of clinical cultures may harbour various phenotypes of azole susceptibility. Objectives: The EUCAST-AFST (European Committee on Antimicrobial Susceptibility Testing Subcommittee on Antifungal Susceptibility Testing) has released a new screening method document (E.Def 10.1) for the detection of azole-resistant A. fumigatus isolates and updated the QC tables for antifungal susceptibility testing with associated QC endpoints. This review described in detail how to perform the screening test. Sources: This “How to document” is based on the EUCAST azole agar screening method document E.Def 10.1 and the QC tables for antifungal susceptibility testing document, v 2.0 (available at http://www.eucast.org/ast_of_fungi/qcafsttables/) Contents: The method is based on the inoculation of azole-containing and azole-free agars and visual determination of fungal growth after one and two days of incubation. It can easily be implemented in routine laboratories of clinical microbiology and has been validated for simultaneous testing of up to five A. fumigatus colonies using itraconazole and voriconazole (mandatory), and posaconazole (optional). Implications: This easy-to-use screening procedure for the detection of azole resistance in clinical A. fumigatus isolates will allow rapid testing in the daily routine of the microbiology laboratory and thus facilitate earlier appropriate therapy. © 2018 European Society of Clinical Microbiology and Infectious Diseases

Published
2019

38. How to: EUCAST recommendations on the screening procedure E.Def 10.1 for the detection of azole resistance in Aspergillus fumigatus isolates using four-well azole-containing agar plates.

Author

Guinea, J., Verweij, P.E., Meletiadis, J., Mouton †, J.W., Barchiesi, F., Arendrup, M.C., Guinea, J., Verweij, P.E., Meletiadis, J., Mouton †, J.W., Barchiesi, F., and Arendrup, M.C.

Abstract

1 juni 2019, Item does not contain fulltext, BACKGROUND: The emergence of azole-resistant Aspergillus fumigatus isolates is a matter of significant concern in Europe, with countries reporting resistance rates (which can be as high as 30%) in hospitalized patients. Consequently, the treatment guidelines in The Netherlands, the country with the highest documented prevalence of azole-resistant A. fumigatus, has just been revised to now recommend initial therapy with combination therapy until the susceptibility pattern is known. Therefore, susceptibility testing of clinically relevant isolates has been strongly recommended in the ESCMID-EFISG aspergillosis guidelines. Furthermore, mixed azole-susceptible and azole-resistant (isogenic as well as non-isogenic) infections have been reported to occur, which implies that colonies of clinical cultures may harbour various phenotypes of azole susceptibility. OBJECTIVES: The EUCAST-AFST (European Committee on Antimicrobial Susceptibility Testing Subcommittee on Antifungal Susceptibility Testing) has released a new screening method document (E.Def 10.1) for the detection of azole-resistant A. fumigatus isolates and updated the QC tables for antifungal susceptibility testing with associated QC endpoints. This review described in detail how to perform the screening test. SOURCES: This "How to document" is based on the EUCAST azole agar screening method document E.Def 10.1 and the QC tables for antifungal susceptibility testing document, v 2.0 (available at http://www.eucast.org/ast_of_fungi/qcafsttables/) CONTENTS: The method is based on the inoculation of azole-containing and azole-free agars and visual determination of fungal growth after one and two days of incubation. It can easily be implemented in routine laboratories of clinical microbiology and has been validated for simultaneous testing of up to five A. fumigatus colonies using itraconazole and voriconazole (mandatory), and posaconazole (optional). IMPLICATIONS: This easy-to-use screening procedure for the detection

Published
2019

39. How to:EUCAST recommendations on the screening procedure E.Def 10.1 for the detection of azole resistance in Aspergillus fumigatus isolates using four-well azole-containing agar plates

Author

Guinea, J., Verweij, P. E., Meletiadis, J., Mouton, J. W., Barchiesi, F., Arendrup, M. C., Arikan-Akdagli, S., Castanheira, M., Chryssanthou, E., Friberg, N., Järv, H., Klimko, N., Kurzai, O., Lagrou, K., Lass-Flörl, C., Mares, M., Matos, T., Moore, C. B., Muehlethaler, K., Rogers, T. R., Andersen, C. T., Velegraki, A., Guinea, J., Verweij, P. E., Meletiadis, J., Mouton, J. W., Barchiesi, F., Arendrup, M. C., Arikan-Akdagli, S., Castanheira, M., Chryssanthou, E., Friberg, N., Järv, H., Klimko, N., Kurzai, O., Lagrou, K., Lass-Flörl, C., Mares, M., Matos, T., Moore, C. B., Muehlethaler, K., Rogers, T. R., Andersen, C. T., and Velegraki, A.

Abstract

Background: The emergence of azole-resistant Aspergillus fumigatus isolates is a matter of significant concern in Europe, with countries reporting resistance rates (which can be as high as 30%) in hospitalized patients. Consequently, the treatment guidelines in The Netherlands, the country with the highest documented prevalence of azole-resistant A. fumigatus, has just been revised to now recommend initial therapy with combination therapy until the susceptibility pattern is known. Therefore, susceptibility testing of clinically relevant isolates has been strongly recommended in the ESCMID-EFISG aspergillosis guidelines. Furthermore, mixed azole-susceptible and azole-resistant (isogenic as well as non-isogenic) infections have been reported to occur, which implies that colonies of clinical cultures may harbour various phenotypes of azole susceptibility. Objectives: The EUCAST-AFST (European Committee on Antimicrobial Susceptibility Testing Subcommittee on Antifungal Susceptibility Testing) has released a new screening method document (E.Def 10.1) for the detection of azole-resistant A. fumigatus isolates and updated the QC tables for antifungal susceptibility testing with associated QC endpoints. This review described in detail how to perform the screening test. Sources: This “How to document” is based on the EUCAST azole agar screening method document E.Def 10.1 and the QC tables for antifungal susceptibility testing document, v 2.0 (available at http://www.eucast.org/ast_of_fungi/qcafsttables/) Contents: The method is based on the inoculation of azole-containing and azole-free agars and visual determination of fungal growth after one and two days of incubation. It can easily be implemented in routine laboratories of clinical microbiology and has been validated for simultaneous testing of up to five A. fumigatus colonies using itraconazole and voriconazole (mandatory), and posaconazole (optional). Implications: This easy-to-use screening procedure for the detecti

Published
2019

41. Multicenter evaluation of the reproducibility of the proposed antifungal susceptibility testing method for fermentative yeasts of the Antifungal Susceptibility Testing Subcommittee of the European Committee on Antimicrobial Susceptibility Testing (AFST-EUCAST)

Author

Cuenca-Estrella, M., Moore, C. B., Barchiesi, F., Bille, J., Chryssanthou, E., Denning, D. W., Donnelly, J. P., Dromer, F., Dupont, B., Rex, J. H., Richardson, M. D., Sancak, B., Verweij, P. E., and Rodríguez-Tudela, J. L.

Published
2003

45. Treatment simplification to atazanavir/ritonavir+lamivudine versus maintenance of atazanavir/ritonavir+two NRTIs in virologically suppressed HIV-1-infected patients: 48 week results from a randomized trial (ATLAS-M)

Author

Di Giambenedetto, S., Fabbiani, M., Quiros Roldan, E., Latini, A., D'Ettorre, G., Antinori, A., Castagna, A., Orofino, G., Francisci, D., Chinello, P., Madeddu, G., Grima, P., Rusconi, S., Di Pietro, M., Mondi, A., Ciccarelli, N., Borghetti, A., Focà, E., Colafigli, M., De Luca, A., Cauda, R., Baldonero, E., Belmonti, S., D'Avino, A., Gagliardini, R., Lamonica, S., Lombardi, F., Sidella, L., Tamburrini, E., Visconti, E., Giacometti, A., Barchiesi, F., Castelli, P., Cirioni, O., Mazzocato, S., Blanc, P., Degli Esposti, A., Del Pin, B., Mariabelli, E., Marini, S., Poggi, A., Amadasi, S., Apostoli, A., Biasi, L., Bonito, A., Brianese, N., Compostella, S., Ferraresi, A., Motta, D., Mughini, M. T., Celesia, B. M., Gussio, M., Sofia, S., Tana, M., Tundo, P., Viscoli, C., De Hoffer, L., Di Biagio, A., Grignolo, S., Parisini, A., Schenone, E., Taramasso, L., Manconi, P. E., Boccone, A., Ortu, F., Piano, P., Serusi, L., Puoti, M., Moioli, M. C., Rossotti, R., Travi, G., Ventura, F., Galli, M., Di Nardo Stuppino, S., Di Cristo, V., Giacomelli, A., Vimercati, V., Viale, P., Gori, A., Rizzardini, G., Capetti, A., Carenzi, L., Mazza, F., Meraviglia, P., Rosa, S., Zucchi, P., Mineo, M., Giuliani, M., Pacifici, A., Pimpinelli, F., Solivetti, F., Stivali, F., Angelici, F., Bellagamba, R., Delle Rose, D., Fezza, R., Libertone, R., Mosti, S., Narciso, P., Nicastri, E., Ottou, S., Tomassi, C., Vlassi, C., Zaccarelli, M., Zoppè, F., Vullo, V., Altavilla, F., Ceccarelli, G., Fantauzzi, A., Gebremeskel, S., Lo Menzo, S., Mezzaroma, I., Tierno, F., Petrosillo, N., Boumis, E., Cicalini, S., Grilli, E., Musso, M., Stella, C., Mura, M. S., Bagella, P., Mannazzu, M., Soddu, V., Caramello, P., Carcieri, C., Carosella, S., Farenga, M., Scotton, P. G., Rossi, M. C., Concia, E., Corsini, F., Gricolo, C., Lanzafame, M., Lattuada, E., Leonardi, S., Rigo, F., Lazzarin, A., Bigoloni, A., Carini, E., Nozza, S., Spagnuolo, V., Belfiori, B., Malincarne, L., Schiaroli, E., Sfara, C., Tosti, A., Sacchini, D., Ruggieri, A., Valdatta, C., Di Giambenedetto, S, Fabbiani, M, Quiros Roldan, E, Latini, A, D'Ettorre, G, Antinori, A, Castagna, A, Orofino, G, Francisci, D, Chinello, P, Madeddu, G, Grima, P, Rusconi, S, Di Pietro, M, Mondi, A, Ciccarelli, N, Borghetti, A, Foca, E, Colafigli, M, De Luca, A, Cauda, R, Baldonero, E, Belmonti, S, D'Avino, A, Gagliardini, R, Lamonica, S, Lombardi, F, Sidella, L, Tamburrini, E, Visconti, E, Giacometti, A, Barchiesi, F, Castelli, P, Cirioni, O, Mazzocato, S, Blanc, P, Degli Esposti, A, Del Pin, B, Mariabelli, E, Marini, S, Poggi, A, Amadasi, S, Apostoli, A, Biasi, L, Bonito, A, Brianese, N, Compostella, S, Ferraresi, A, Motta, D, Mughini, M, Celesia, B, Gussio, M, Sofia, S, Tana, M, Tundo, P, Viscoli, C, De Hoffer, L, Di Biagio, A, Grignolo, S, Parisini, A, Schenone, E, Taramasso, L, Manconi, P, Boccone, A, Ortu, F, Piano, P, Serusi, L, Puoti, M, Moioli, M, Rossotti, R, Travi, G, Ventura, F, Galli, M, Di Nardo Stuppino, S, Di Cristo, V, Giacomelli, A, Vimercati, V, Viale, P, Gori, A, Rizzardini, G, Capetti, A, Carenzi, L, Mazza, F, Meraviglia, P, Rosa, S, Zucchi, P, Mineo, M, Giuliani, M, Pacifici, A, Pimpinelli, F, Solivetti, F, Stivali, F, Angelici, F, Bellagamba, R, Delle Rose, D, Fezza, R, Libertone, R, Mosti, S, Narciso, P, Nicastri, E, Ottou, S, Tomassi, C, Vlassi, C, Zaccarelli, M, Zoppe, F, Vullo, V, Altavilla, F, Ceccarelli, G, Fantauzzi, A, Gebremeskel, S, Lo Menzo, S, Mezzaroma, I, Tierno, F, Petrosillo, N, Boumis, E, Cicalini, S, Grilli, E, Musso, M, Stella, C, Mura, M, Bagella, P, Mannazzu, M, Soddu, V, Caramello, P, Carcieri, C, Carosella, S, Farenga, M, Scotton, P, Rossi, M, Concia, E, Corsini, F, Gricolo, C, Lanzafame, M, Lattuada, E, Leonardi, S, Rigo, F, Lazzarin, A, Bigoloni, A, Carini, E, Nozza, S, Spagnuolo, V, Belfiori, B, Malincarne, L, Schiaroli, E, Sfara, C, Tosti, A, Sacchini, D, Ruggieri, A, Valdatta, C, Roldan, Eq, Focà, E, and on behalf of the Atlas-M Study, Group

Subjects
Male, 0301 basic medicine, HIV Infections, ART HIV, Gastroenterology, law.invention, 0302 clinical medicine, Randomized controlled trial, immune system diseases, law, Antiretroviral Therapy, Highly Active, HIV Infection, Pharmacology (medical), Viral, 030212 general & internal medicine, Adult, Atazanavir Sulfate, Coinfection, Drug Therapy, Combination, Female, HIV-1, Humans, Lamivudine, Middle Aged, RNA, Viral, Ritonavir, Viral Load, Young Adult, Pharmacology, Infectious Diseases, virus diseases, dual therapy, Combination, Viral load, Human, medicine.drug, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, Antiretroviral Therapy, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, Drug Therapy, Internal medicine, medicine, Highly Active, Adverse effect, business.industry, Surgery, Atazanavir, Regimen, RNA, business
Abstract

Background: Combination ART (cART)-related toxicities and costs have prompted the need for treatment simplification. The ATLAS-M trial explored 48 week non-inferior efficacy of simplification to atazanavir/ritonavir + lamivudine versus maintaining three-drug atazanavir/ritonavir-based cART in virologically suppressed patients. Methods: We performed an open-label, multicentre, randomized, non-inferiority study, enrolling HIV-infected adults on atazanavir/ritonavir+two NRTIs, with stable HIV-RNA 200 cells/mm3. Main exclusion criteria were hepatitis B virus coinfection, past virological failure on or resistance to study drugs, recent AIDS and pregnancy. Patients were randomly assigned 1:1 to either switch to 300mg of atazanavir/ 100mg of ritonavir once daily and 300mg of lamivudine once daily (atazanavir/ritonavir+lamivudine arm) or to continue the previous regimen (atazanavir/ritonavir+two NRTIs arm). The primary study outcome was the maintenance of HIV-RNA

Published
2017

47. How to: EUCAST recommendations on the screening procedure E.Def 10.1 for the detection of azole resistance in Aspergillus fumigatus isolates using four-well azole-containing agar plates

Author

Guinea, J., primary, Verweij, P.E., additional, Meletiadis, J., additional, Mouton, J.W., additional, Barchiesi, F., additional, Arendrup, M.C., additional, Arikan-Akdagli, S., additional, Castanheira, M., additional, Chryssanthou, E., additional, Friberg, N., additional, Guinea, J., additional, Järv, H., additional, Klimko, N., additional, Kurzai, O., additional, Lagrou, K., additional, Lass-Flörl, C., additional, Mares, M., additional, Matos, T., additional, Moore, C.B., additional, Muehlethaler, K., additional, Rogers, T.R., additional, Andersen, C.T., additional, and Velegraki, A., additional

Published
2019
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50. Lupin and pea extrusion decreases the ruminal degradability and improves the true ileal digestibility of crude protein

Author

Barchiesi F., Claudia, Williams, Pamela, Velásquez, Alejandro, Barchiesi F., Claudia, Williams, Pamela, and Velásquez, Alejandro

Abstract

The aim of this work was to evaluate the effect of the extrusion of dehulled lupins (Lupinus albus L.) and peas (Pisum sativum L.) on the ruminal degradability and intestinal digestibility of their protein contents. Ruminal degradability was evaluated in situ in the rumens of two fistulated cows. The true ileal crude protein (CP) digestibility was evaluated via a bioassay with Sprague Dawley laboratory rats as the animal model. Extrusion caused soluble fraction decreases in both feeds (P<0.05), with a 29 % decrease in the extruded dehulled lupins (EDL) and a 59 % decrease in the extruded peas (EP). The degradable fraction (B) in EP increased by 19 % compared to that in raw peas (RP) (P<0.05), and there was no effect of extrusion on the degradable fraction in lupins (P>0.05). Extrusion decreased the effective degradability (ED) of lupins by 12 % (P<0.05). Moreover, in EP, extrusion presented no effect on the ED (P>0.05). The extrusion process had a greater impact on the reduction of the effective degradability in lupins than it did in peas. Nevertheless, extrusion increased the true ileal CP digestibility of the ruminal postfermentation residues in both feeds., Resumen Se evaluó el efecto de la extrusión en la degradabilidad ruminal y la digestibilidad intestinal de la proteína del lupino descascarado (Lupinus albus L.) y de arveja (Pisum sativum L.). La degradabilidad ruminal se evaluó in situ en el rumen de dos vacas fistuladas. La digestibilidad ileal verdadera de la proteína cruda (PC) se evaluó mediante un bioensayo con ratas de laboratorio Sprague Dowley como modelo animal. Los alimentos extruidos, en relación a los alimentos originales, mostraron una disminución de la fracción soluble (P<0.05) del 29% en el lupino descascarado extruido (LDE) y el 59% en arveja extruida (AE). La fracción degradable (B) sólo aumentó en AE en 19% en comparación con la arveja cruda (AC) (P<0.05), sin embargo, en el lupino no hubo efectos sobre la extrusión en esta fracción (P>0.05). La degradabilidad efectiva (DE) en el lupino disminuyó en un 12% mediante extrusión (P<0.05). Por otra parte, en AE la DE no presentó ningún efecto como resultado de la extrusión (P>0.05). El proceso de extrusión tuvo un mayor impacto en la reducción de la degradabilidad efectiva en el lupino que en la arveja. Sin embargo, la extrusión aumentó la digestibilidad ileal verdadera de la PC de los residuos post-fermentación ruminal en ambos alimentos.

Published
2018

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