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1. Human Campylobacter spp. infections in Italy

Author

Zerbato, Verena, Di Bella, Stefano, Pol, Riccardo, Luzzati, Roberto, Sanson, Gianfranco, Ambretti, Simone, Andreoni, Stefano, Aschbacher, Richard, Bernardo, Mariano, Bielli, Alessandra, Brigante, Gioconda, Busetti, Marina, Camarlinghi, Giulio, Carcione, Davide, Carducci, Antonella, Clementi, Nicola, Carretto, Edoardo, Chilleri, Chiara, Codda, Giulia, Consonni, Alessandra, Costantino, Venera, Cortazzo, Venere, Di Santolo, Manuela, Dodaro, Saveria, Fiori, Barbara, García-Fernández, Aurora, Foschi, Claudio, Gobbato, Elisa, Greco, Francesca, La Ragione, Roberto Marcello, Mancini, Nicasio, Maraolo, Alberto Enrico, Marchese, Anna, Marcuccio, Daniela, Marrollo, Roberta, Mauri, Carola, Mazzariol, Annarita, Morroni, Gianluca, Mosca, Adriana, Nigrisoli, Giacomo, Pagani, Elisabetta, Parisio, Eva Maria, Pollini, Simona, Sarti, Mario, Sorrentino, Annarita, Trotta, Domenico, Villa, Laura, Vismara, Chiara, and Principe, Luigi

Published
2024
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2. Synergistic Activity of Temocillin and Fosfomycin Combination against KPC-Producing Klebsiella pneumoniae Clinical Isolates

Author

Costantino, Venera, primary, Principe, Luigi, additional, Mehat, Jai, additional, Busetti, Marina, additional, Piccirilli, Alessandra, additional, Perilli, Mariagrazia, additional, Luzzati, Roberto, additional, Zerbato, Verena, additional, Meliadò, Antonietta, additional, La Ragione, Roberto, additional, and Di Bella, Stefano, additional

Published
2024
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3. Anaerobic bloodstream infections in Italy (ITANAEROBY): A 5-year retrospective nationwide survey

Author

Di Bella, Stefano, Antonello, Roberta Maria, Sanson, Gianfranco, Maraolo, Alberto Enrico, Giacobbe, Daniele Roberto, Sepulcri, Chiara, Ambretti, Simone, Aschbacher, Richard, Bartolini, Laura, Bernardo, Mariano, Bielli, Alessandra, Busetti, Marina, Carcione, Davide, Camarlinghi, Giulio, Carretto, Edoardo, Cassetti, Tiziana, Chilleri, Chiara, De Rosa, Francesco Giuseppe, Dodaro, Saveria, Gargiulo, Raffaele, Greco, Francesca, Knezevich, Anna, Intra, Jari, Lupia, Tommaso, Concialdi, Erika, Bianco, Gabriele, Luzzaro, Francesco, Mauri, Carola, Morroni, Gianluca, Mosca, Adriana, Pagani, Elisabetta, Parisio, Eva Maria, Ucciferri, Claudio, Vismara, Chiara, Luzzati, Roberto, and Principe, Luigi

Published
2022
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4. Is ultrasonography mandatory in all children at their first febrile urinary tract infection?

Author

Pennesi, Marco, Amoroso, Stefano, Pennesi, Giulia, Giangreco, Manuela, Cattaruzzi, Elisabetta, Pesce, Marco, and Busetti, Marina

Subjects
Urinary tract infections -- Diagnosis, Pediatric research, Kidney diseases -- Diagnosis, Diagnostic imaging -- Methods, Pathogenic microorganisms -- Health aspects, Health
Abstract

Background This study investigated whether performing kidney ultrasound (KUS) only in children presenting either a pathogen other than E. coli at their first febrile urinary tract infection (fUTI) or experiencing fUTI recurrence would increase missed diagnoses of kidney anomalies. Methods Patients aged 2-36 months with fUTI who underwent KUS evaluation from 2 January 2013 to 31 June 2018 were enrolled. Cystourethrography was performed after pathological KUS or recurring fUTIs. Thereafter, we retrospectively assessed the detection rate of kidney anomalies through performing KUS only in patients with atypical pathogen at first fUTI or with recurring fUTIs. Results In 263 patients included, the isolated pathogen was E. coli in 223 cases (84.8%) and atypical in 40 cases (15.2%). KUS detected kidney anomalies in 14/223 (6.3%) of fUTIs caused by E. coli and in 11/40 (27.5%) of fUTIs caused by an atypical pathogen (OR 5.5, 95%CI 2.5-14.5). Cystourethrography was performed in 40 patients and vesicoureteral reflux (VUR) found in 20 cases. None of the high grade VUR diagnoses or other kidney anomalies would have been lost through a different diagnostic protocol that required the presence of an atypical pathogen at the first fUTI or a fUTI recurrence to perform the KUS. Conclusions A diagnostic protocol that requires presence of an atypical pathogen at the first fUTI or a second episode of fUTI to perform the KUS would allow a reduction in the number of negative ultrasounds with a negligible risk of missed diagnoses of kidney anomalies., Author(s): Marco Pennesi [sup.1] , Stefano Amoroso [sup.2] , Giulia Pennesi [sup.3] , Manuela Giangreco [sup.1] , Elisabetta Cattaruzzi [sup.1] , Marco Pesce [sup.2] , Marina Busetti [sup.4] , Egidio [...]

Published
2021
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5. Risk Factors for 30-Day Mortality in Nosocomial Enterococcal Bloodstream Infections.

Author

Zerbato, Verena, Pol, Riccardo, Sanson, Gianfranco, Suru, Daniel Alexandru, Pin, Eugenio, Tabolli, Vanessa, Monticelli, Jacopo, Busetti, Marina, Toc, Dan Alexandru, Crocè, Lory Saveria, Luzzati, Roberto, and Di Bella, Stefano

Subjects
ENTEROCOCCAL infections, ENTEROCOCCUS faecalis, ENTEROCOCCUS faecium, VANCOMYCIN resistance, MORTALITY risk factors, BACTEREMIA
Abstract

Enterococci commonly cause nosocomial bloodstream infections (BSIs), and the global incidence of vancomycin-resistant enterococci (VRE) BSIs is rising. This study aimed to assess the risk factors for enterococcal BSIs and 30-day mortality, stratified by Enterococcus species, vancomycin resistance, and treatment appropriateness. We conducted a retrospective cohort study (2014–2021) including all hospitalized adult patients with at least one blood culture positive for Enterococcus faecalis or Enterococcus faecium. We included 584 patients with enterococcal BSI: 93 were attributed to vancomycin-resistant E. faecium. The overall 30-day mortality was 27.5%; higher in cases of BSI due to vancomycin-resistant E. faecium (36.6%) and vancomycin-sensitive E. faecium (31.8%) compared to E. faecalis BSIs (23.2%) (p = 0.016). This result was confirmed by multivariable Cox analysis. Independent predictors of increased mortality included the PITT score, complicated bacteremia, and age (HR = 1.269, p < 0.001; HR = 1.818, p < 0.001; HR = 1.022, p = 0.005, respectively). Conversely, male gender, consultation with infectious disease (ID) specialists, and appropriate treatment were associated with reduced mortality (HR = 0.666, p = 0.014; HR = 0.504, p < 0.001; HR = 0.682, p = 0.026, respectively). In conclusion, vancomycin-resistant E. faecium bacteremia is independently associated with a higher risk of 30-day mortality. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Performance of 16S rRNA Gene Next-Generation Sequencing and the Culture Method in the Detection of Bacteria in Clinical Specimens.

Author

Botan, Alexandru, Campisciano, Giuseppina, Zerbato, Verena, Di Bella, Stefano, Simonetti, Omar, Busetti, Marina, Toc, Dan Alexandru, Luzzati, Roberto, and Comar, Manola

Subjects
DIAGNOSTIC microbiology, NUCLEOTIDE sequencing, COMMUNICABLE diseases, THERAPEUTICS, MASS spectrometry
Abstract

Effective treatment of infectious diseases requires prompt and accurate bacterial identification and tailored antimicrobial treatments. Traditional culture methods are considered the gold standard, but their effectiveness diminishes for fastidious and hard-to-grow microorganisms. In recent years, molecular diagnostic tools such as 16S rRNA gene next-generation sequencing (16S NGS) have gained popularity in the field. We analysed data from samples submitted for 16S NGS between July 2022 and July 2023 at the Department of Advanced Translational Microbiology in Trieste, Italy. The study included samples submitted for both culture-based identification and 16S NGS. Conventional media were used for culture, and bacterial identification was performed using MALDI-TOF mass spectrometry. The V3 region of the 16S rRNA gene was sequenced using the Ion PGM platform. Among the 123 samples submitted, drainage fluids (38%) and blood (23%) were the most common, with requests predominantly from the Infectious Diseases (31.7%) and Orthopedic (21.13%) Units. In samples collected from patients with confirmed infections, 16S NGS demonstrated diagnostic utility in over 60% of cases, either by confirming culture results in 21% or providing enhanced detection in 40% of instances. Among the 71 patients who had received antibiotic therapies before sampling (mean 2.3 prior antibiotic days), pre-sampling antibiotic consumption did not significantly affect the sensitivity of 16S NGS. In routine microbiology laboratories, combining 16S NGS with culture method enhances the sensitivity of microbiological diagnostics, even when sampling is conducted during antibiotic therapy. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Identification of IncA Plasmid, Harboring blaVIM-1 Gene, in S. enterica Goldcoast ST358 and C. freundii ST62 Isolated in a Hospitalized Patient

Author

Piccirilli, Alessandra, primary, Di Marcantonio, Sascia, additional, Costantino, Venera, additional, Simonetti, Omar, additional, Busetti, Marina, additional, Luzzati, Roberto, additional, Principe, Luigi, additional, Di Domenico, Marco, additional, Rinaldi, Antonio, additional, Cammà, Cesare, additional, and Perilli, Mariagrazia, additional

Published
2023
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9. A subanalysis of Clostridium perfringens bloodstream infections from a 5-year retrospective nationwide survey (ITANAEROBY)

Author

Maraolo, Alberto Enrico, Giacobbe, Daniele Roberto, Sepulcri, Chiara, Ambretti, Simone, Aschbacher, Richard, Bartolini, Laura, Bernardo, Mariano, Bielli, Alessandra, Busetti, Marina, Carcione, Davide, Camarlinghi, Giulio, Carretto, Edoardo, Cassetti, Tiziana, Chilleri, Chiara, De Rosa, Francesco Giuseppe, Dodaro, Saveria, Gargiulo, Raffaele, Greco, Francesca, Knezevich, Anna, Intra, Jari, Lupia, Tommaso, Concialdi, Erika, Bianco, Gabriele, Luzzaro, Francesco, Mauri, Carola, Morroni, Gianluca, Mosca, Adriana, Pagani, Elisabetta, Parisio, Eva Maria, Ucciferri, Claudio, Vismara, Chiara, Geremia, Nicholas, Sanson, Gianfranco, Principe, Luigi, Antonello, Roberta Maria, Zerbato, Verena, Luzzati, Roberto, and Di Bella, Stefano

Published
2024
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11. Identification of IncA Plasmid, Harboring bla VIM-1 Gene, in S. enterica Goldcoast ST358 and C. freundii ST62 Isolated in a Hospitalized Patient.

Author

Piccirilli, Alessandra, Di Marcantonio, Sascia, Costantino, Venera, Simonetti, Omar, Busetti, Marina, Luzzati, Roberto, Principe, Luigi, Di Domenico, Marco, Rinaldi, Antonio, Cammà, Cesare, and Perilli, Mariagrazia

Subjects
INCAS, HOSPITAL patients, ACUTE myeloid leukemia, SALMONELLA enterica serovar Typhi, GENES
Abstract

In the present study, we analyzed the genome of two S. enterica strains TS1 and TS2 from stool and blood cultures, respectively, and one strain of C. freundii TS3, isolated from a single hospitalized patient with acute myeloid leukemia. The S. enterica Goldcoast ST358 (O:8 (C2-C3) serogroup), sequenced by the MiSeq Illumina system, showed the presence of β-lactamase genes (blaVIM-1, blaSHV-12 and blaOXA-10), aadA1, ant(2″)-Ia, aac(6′)-Iaa, aac(6′)-Ib3, aac(6′)-Ib-cr, qnrVC6, parC(T57S), and several incompatibility plasmids. A wide variety of insertion sequences (ISs) and transposon elements were identified. In C. freundii TS3, these were the blaVIM-1, blaCMY-150, and blaSHV-12, aadA1, aac(6′)-Ib3, aac(6′)-Ib-cr, mph(A), sul1, dfrA14, ARR-2, qnrVC6, and qnrB38. IncA plasmid isolated from E.coli/K12 transconjugant and C. freundii exhibited a sequence identity >99.9%. The transfer of IncA plasmid was evaluated by conjugation experiments. [ABSTRACT FROM AUTHOR]

Published
2023
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12. Seven Years of Culture Collection of Neisseria gonorrhoeae: Antimicrobial Resistance and Molecular Epidemiology

Author

Carannante, Anna, primary, Vacca, Paola, additional, Fontana, Stefano, additional, Dal Conte, Ivano, additional, Ghisetti, Valeria, additional, Cusini, Marco, additional, Prignano, Grazia, additional, Vocale, Caterina, additional, Barbui, Anna Maria, additional, Stroppiana, Elena, additional, Busetti, Marina, additional, Mencacci, Antonella, additional, Rotondi, Marina, additional, De Francesco, Maria Antonia, additional, Bonanno, Carmen Luciana, additional, Innocenti, Patrizia, additional, Latino, Maria Agnese, additional, Riccobono, Eleonora, additional, Poletti, Federica, additional, Casonato, Ines Clotilde, additional, Soldato, Graziella, additional, Ambrosio, Luigina, additional, Boros, Stefano, additional, Ciammaruconi, Andrea, additional, Lista, Florigio, additional, and Stefanelli, Paola, additional

Published
2023
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13. Seven Years of Culture Collection of Neisseria gonorrhoeae: Antimicrobial Resistance and Molecular Epidemiology

Author

Carannante, Anna, Vacca, Paola, Fontana, Stefano, Dal Conte, Ivano, Ghisetti, Valeria, Cusini, Marco, Prignano, Grazia, Vocale, Caterina, Barbui, Anna Maria, Stroppiana, Elena, Busetti, Marina, Mencacci, Antonella, Rotondi, Marina, De Francesco, Maria Antonia, Bonanno, Carmen Luciana, Innocenti, Patrizia, Latino, Maria Agnese, Riccobono, Eleonora, Poletti, Federica, Casonato, Ines Clotilde, Soldato, Graziella, Ambrosio, Luigina, Boros, Stefano, Ciammaruconi, Andrea, Lista, Florigio, and Stefanelli, Paola

Subjects
Microbiology (medical), Pharmacology, N. gonorrhoeae multiantigen sequence typing (NG-MAST), gonorrhea, antimicrobial resistance, genogroup, Immunology, Microbiology
Published
2023

15. A urokinase-associated outbreak of Ralstonia mannitolilytica bloodstream infections in haemodialysis patients in north-eastern Italy, January to April 2023.

Author

Fabricci, Massimiliano, Trinca, Anaïs, Talotti, Luca, Busetti, Marina, Fotakis, Emmanouil Alexandros, Merakou, Christina, Koncan, Raffaella, Ghiotti, Annachiara, Negri, Camilla, Di Maso, Vittorio, Bosco, Manuela, Antonelli, Alberto, Coppi, Marco, Rossolini, Gian Maria, Giuliani, Claudia, Scarpis, Enrico, Gregoretti, Barbara, Licastro, Danilo, Luzzati, Roberto, and Costantino, Venera

Published
2023
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16. Candida lipolytica Bloodstream Infection in an Adult Patient with COVID-19 and Alcohol Use Disorder: A Unique Case and a Systematic Review of the Literature.

Author

Simonetti, Omar, Zerbato, Verena, Sincovich, Sara, Cosimi, Lavinia, Zorat, Francesca, Costantino, Venera, Di Santolo, Manuela, Busetti, Marina, Di Bella, Stefano, Principe, Luigi, and Luzzati, Roberto

Subjects
ALCOHOLISM, CANDIDEMIA, COVID-19, INTRA-abdominal infections, MYCOSES, ALCOHOL withdrawal syndrome
Abstract

Candida lipolytica is an uncommon Candida species causing invasive fungemia. This yeast is mainly associated with the colonisation of intravascular catheters, complicated intra-abdominal infections, and infections in the paediatric population. Here, we report a case of C. lipolytica bloodstream infection in a 53-year-old man. He was admitted for an alcohol withdrawal syndrome and mild COVID-19. Among the primary risk factors for candidemia, only the use of broad-spectrum antimicrobials was reported. The empiric treatment was commenced with caspofungin and then targeted with intravenous fluconazole. Infective endocarditis was ruled out using echocardiography, and PET/TC was negative for other deep-seated foci of fungal infection. The patient was discharged after blood culture clearance and clinical healing. To the best of our knowledge, this is the first case of C. lipolytica candidemia in a patient with COVID-19 and alcohol use disorder. We performed a systematic review of bloodstream infections caused by C. lipolytica. Clinicians should be aware of the possibility of C. lipolytica bloodstream infections in patients with alcohol use disorder, especially in a COVID-19 setting. [ABSTRACT FROM AUTHOR]

Published
2023
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17. Potential links between COVID-19-associated pulmonary aspergillosis and bronchiectasis as detected by high resolution computed tomography

Author

Baratella, Elisa, primary, Roman-Pognuz, Erik, primary, Zerbato, Verena, primary, Minelli, Pierluca, primary, Cavallaro, Marco Francesco Maria, primary, Cova, Maria Assunta, primary, Luzzati, Roberto, primary, Lucangelo, Umberto, primary, Sanson, Gianfranco, primary, Friso, Federica, primary, Bussani, Rossana, primary, Pinamonti, Maurizio, primary, Busetti, Marina, primary, Salton, Francesco, primary, Confalonieri, Marco, primary, Ruaro, Barbara, primary, and Bella, Stefano Di, primary

Published
2021
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19. Zidovudine in synergistic combination with fosfomycin: an in vitro and in vivo evaluation against multidrug-resistant Enterobacterales

Author

Antonello, Roberta Maria, primary, Di Bella, Stefano, additional, Betts, Jonathan, additional, La Ragione, Roberto, additional, Bressan, Raffaela, additional, Principe, Luigi, additional, Morabito, Stefano, additional, Gigliucci, Federica, additional, Tozzoli, Rosangela, additional, Busetti, Marina, additional, Knezevich, Anna, additional, Furlanis, Linda, additional, Fontana, Francesco, additional, Luzzaro, Francesco, additional, Luzzati, Roberto, additional, and Lagatolla, Cristina, additional

Published
2021
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20. Trends in the Incidence and Antibiotic Resistance of Enterococcal Bloodstream Isolates: A 7-Year Retrospective Multicenter Epidemiological Study in Italy

Author

Monticelli, Jacopo, primary, Di Bella, Stefano, additional, Giacobbe, Daniele Roberto, additional, Amato, Gerardino, additional, Antonello, Roberta Maria, additional, Barone, Eugenia, additional, Brachelente, Giovanni, additional, Busetti, Marina, additional, Carcione, Davide, additional, Carretto, Edoardo, additional, Conaldi, Pier Giulio, additional, Degl'Innocenti, Linda, additional, Del Puente, Filippo, additional, Knezevich, Anna, additional, Luzzaro, Francesco, additional, Mainelli, Maria Teresa, additional, Marchese, Anna, additional, Meledandri, Marcello, additional, Mencacci, Antonella, additional, Miragliotta, Giuseppe, additional, Monaco, Francesco, additional, Morabito, Francesca, additional, Mosca, Adriana, additional, Nardini, Paola, additional, Principe, Luigi, additional, Riggio, Daniela, additional, Viaggi, Valentina, additional, Viscoli, Claudio, additional, and Luzzati, Roberto, additional

Published
2021
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22. Clinical Features and Mortality of Nosocomial Candidemia in Very Old Patients: A Multicentre Italian Study

Author

Zatta, Marta, primary, Di Bella, Stefano, additional, Giacobbe, Daniele Roberto, additional, Del Puente, Filippo, additional, Merelli, Maria, additional, Azzini, Anna Maria, additional, Brugnaro, Pierluigi, additional, Vedovelli, Claudio, additional, Cattelan, Anna Maria, additional, Busetti, Marina, additional, Gatti, Giuseppe, additional, Bassetti, Matteo, additional, and Luzzati, Roberto, additional

Published
2020
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24. An outbreak of sepsis due to extensively drug-resistant Pseudomonas aeruginosa originating from an enviromental source in an Italian haematologic unit

Author

Knezevich, Anna, Busetti, Marina, Skert, Claudia, Festini, Gianluca, Vidus, Maria, Luzzati, Roberto, Monticelli, Jacopo, Pelusi, Lucia, Perulli, Alfredo, Piani, Rosanna, Monteverdi, Daniela, Lagatolla, Cristina, Bressan, Roberta., ESCMID, Knezevich, Anna, Busetti, Marina, Skert, Claudia, Festini, Gianluca, Vidus, Maria, Luzzati, Roberto, Monticelli, Jacopo, Pelusi, Lucia, Perulli, Alfredo, Piani, Rosanna, Monteverdi, Daniela, Lagatolla, Cristina, and Bressan, Roberta.

Subjects
sepsis, hematologic unit, Pseudomonas aeruginosa, enviromental source, sepsi
Published
2018

25. Risk factors and mortality of nosocomial candidaemia in very elderly compared with middle aged patients

Author

Luzzati, Roberto, Zatta, Marta, Rosin, Chiara, Merelli, Maria, Azzini, Annamaria, Cavinato, Silvia, Brugnaro, Pierpaolo, Vedovelli, Claudio, Cattelan, Annamaria, Busetti, Marina, Concia, Ercole, Bassetti, Matteo., ESCMID, Luzzati, Roberto, Zatta, Marta, Rosin, Chiara, Merelli, Maria, Azzini, Annamaria, Cavinato, Silvia, Brugnaro, Pierpaolo, Vedovelli, Claudio, Cattelan, Annamaria, Busetti, Marina, Concia, Ercole, and Bassetti, Matteo.

Subjects
risk factor, nosocomial candidemia, risk factors, elderly
Published
2018

28. Vancomycin-resistant Enterococcus faecium endemic outbreak in Trieste hospital

Author

Knezevich, Anna, Santolo, Manuela DI, Fabris, Clara, Busetti, Marina, Campanile, Floriana, Santagati, Maria, Bongiorno, Dafne, Stefani, A., Monticelli, Jacopo, LAGATOLLA, CRISTINA, BRESSAN, RAFFAELA, DOLZANI, LUCILLA, LUZZATI, ROBERTO, Knezevich A, Di Santolo M, Fabris C, Busetti M, Lagatolla C, Bressan R, Dolzani L, Campanile F, Santagati M, Bongiorno D, Stefani S, Monticelli J, Luzzati R., Knezevich, Anna, Santolo, Manuela DI, Fabris, Clara, Busetti, Marina, Lagatolla, Cristina, Bressan, Raffaela, Dolzani, Lucilla, Campanile, Floriana, Santagati, Maria, Bongiorno, Dafne, Stefani, A., Monticelli, Jacopo, and Luzzati, Roberto

Subjects
Enterococcus faecium, endemic, Vancomycin resistance
Published
2017

30. Nosocomial candidemia in patients admitted to medicine wards compared to other wards: a multicentre study

Author

Silvia Cavinato, Claudio Vedovelli, Pierluigi Brugnaro, Matteo Bassetti, Busetti Marina, Maria Merelli, Roberto Luzzati, Anna Maria Azzini, Anna Maria Cattelan, Chiara Rosin, Ercole Concia, Filippo Ansaldi, Giuseppe Gatti, Luzzati, Roberto, Merelli, Maria, Ansaldi, Filippo, Rosin, Chiara, Azzini, Annamaria, Cavinato, Silvia, Brugnaro, Pierluigi, Vedovelli, Claudio, Cattelan, Annamaria, Busetti, Marina, Gatti, Giuseppe, Concia, Ercole, and Bassetti, Matteo

Subjects
Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Multivariate analysis, Referral, Epidemiology, medicine.medical_treatment, 030106 microbiology, Sepsis, Candidemia, Elderly, Medicine wards, Mortality, Risk factors, Aged, Aged, 80 and over, Cross Infection, Female, Hospital Units, Humans, Italy, Retrospective Studies, Risk Factors, Infectious Diseases, 03 medical and health sciences, 0302 clinical medicine, Intensive care, 80 and over, Medicine, 030212 general & internal medicine, Medicine ward, business.industry, Septic shock, Retrospective cohort study, General Medicine, medicine.disease, Emergency medicine, Risk factor, business, Central venous catheter
Abstract

PURPOSE: Risk factors for nosocomial candidemia, severity of sepsis, treatment, and outcome were compared between patients admitted to medicine wards and those to surgical and intensive care units (ICUs). METHODS: Data were retrospectively collected from patients belonging to six referral hospitals in Italy between January 2011 and December 2013. Risk factors for 30-day mortality were evaluated in the whole patient population. RESULTS: A total of 686 patients (mean age 70 ± 15 years) with candidemia were included. 367 (53.5 %) patients were in medicine wards, and 319 in surgery and ICUs. Host-related risk factors for candidemia were more common in medicine patients whereas healthcare-related factors in surgery/ICU patients. These patients showed severe sepsis and septic shock more commonly (71.7 %) than medicine patients (59.9 %) (p 0.003). The latter underwent central venous catheter (CVC) removal and adequate antifungal therapy less frequently than surgery/ICU patients. 149 (40.6 %) patients died with candidemia in medicine wards and 69 (21.6 %) in other wards (p < 0.001). Overall, the 30-day mortality was 36.3 %. At multivariate analysis, independent risk factors for death were aging, higher Charlson score, severe sepsis and septic shock, and no antifungal therapy, while major surgery and CVC removal were associated with higher probability of survival. CONCLUSIONS: The burden of risk factors for candidemia was different between medicine patients and those in other wards. Despite the lower severity of candidemia in medicine patients, their mortality turned out to be higher than in surgery or ICU patients. Awareness of the best management of candidemia should be pursued, especially in medicine wards.

Published
2016

32. Control and prevention measures for legionellosis in hospitals: A cross-sectional survey in Italy

Author

Montagna, Maria Teresa, primary, De Giglio, Osvalda, additional, Napoli, Christian, additional, Diella, Giusy, additional, Rutigliano, Serafina, additional, Agodi, Antonella, additional, Auxilia, Francesco, additional, Baldovin, Tatjana, additional, Bisetto, Francesco, additional, Arnoldo, Luca, additional, Brusaferro, Silvio, additional, Busetti, Marina, additional, Calagreti, Gioia, additional, Casini, Beatrice, additional, Cristina, Maria Luisa, additional, Di Luzio, Rossano, additional, Fiorio, Maurizio, additional, Formoso, Maurizio, additional, Liguori, Giorgio, additional, Martini, Enrica, additional, Molino, Andrea, additional, Mondello, Placido, additional, Mura, Ida, additional, Novati, Roberto, additional, Orsi, Giovanni Battista, additional, Patroni, Andrea, additional, Poli, Anna, additional, Privitera, Gaetano, additional, Ripabelli, Giancarlo, additional, Rocchetti, Andrea, additional, Rose, Francesco, additional, Sarti, Mario, additional, Savini, Sandra, additional, Silvestri, Antonio, additional, Sodano, Luisa, additional, Spagnolo, Anna Maria, additional, Tardivo, Stefano, additional, Teti, Valeria, additional, Torregrossa, Maria Valeria, additional, Torri, Emanuele, additional, Veronesi, Licia, additional, Zarrilli, Raffaele, additional, Pacifico, Claudia, additional, Goglio, Antonio, additional, Moro, Matteo, additional, and Pasquarella, Cesira, additional

Published
2018
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33. Spread of Vancomycin-ResistantEnterococcus faeciumIsolates Despite Validated Infection Control Measures in an Italian Hospital: Antibiotic Resistance and Genotypic Characterization of the Endemic Strain

Author

Bressan, Raffaela, primary, Knezevich, Anna, additional, Monticelli, Jacopo, additional, Campanile, Floriana, additional, Busetti, Marina, additional, Santagati, Maria, additional, Dolzani, Lucilla, additional, Milan, Annalisa, additional, Bongiorno, Dafne, additional, Di Santolo, Manuela, additional, Tonin, Enrico A., additional, Stefani, Stefania, additional, Luzzati, Roberto, additional, and Lagatolla, Cristina, additional

Published
2018
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35. Children under 5 years are at risk for tuberculosis after occasional contact with highly contagious patients: outbreak from a smear-positive healthcare worker

Author

Luzzati, Roberto, primary, Migliori, Giovanni Battista, additional, Zignol, Matteo, additional, Cirillo, Daniela Maria, additional, Maschio, Massimo, additional, Tominz, Riccardo, additional, Ventura, Giovanna, additional, Patussi, Valentino, additional, D'Ambrosio, Lia, additional, Centis, Rosella, additional, Michieletto, Franco, additional, Trovato, Alberto, additional, Salton, Francesco, additional, Busetti, Marina, additional, Di Santolo, Manuela, additional, Raviglione, Mario, additional, and Confalonieri, Marco, additional

Published
2017
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36. Changing Antimicrobial Resistance Profiles among Neisseria gonorrhoeae Isolates in Italy, 2003 to 2012

Author

Carannante, Anna, Renna, Giovanna, Dal Conte, Ivano, Ghisetti, Valeria, Matteelli, Alberto, Prignano, Grazia, Impara, Giampaolo, Cusini, Marco, D'Antuono, Antonietta, Vocale, Caterina, Antonetti, Raffaele, Gaino, Marina, Busetti, Marina, Latino, Maria Agnese, Mencacci, Antonella, Bonanno, Carmen, Cava, Maria Carmela, Giraldi, Cristina, Stefanelli, Paola, Del Re, S., Milano, R., Di Carlo, A., Cristaudo, A., Palamara, G., Scioccati, L., Ramoni, S., DE FRANCESCO, Maria Antonia, Sambri, V., Landini, M. P., Cavrini, F., Fiore, J., Di Taranto, A., De Nittis, R., Predazzer, R., Ober, P., Urbani, F., Petix, V., Rossi, T., Pauri, P., Meucci, M., Tagliaferro, L., Colaci, C., Carannante, Anna, Renna, Giovanna, Conte, Ivano Dal, Ghisetti, Valeria, Matteelli, Alberto, Prignano, Grazia, Impara, Giampaolo, Cusini, Marco, D'Antuono, Antonietta, Vocale, Caterina, Antonetti, Raffaele, Gaino, Marina, Busetti, Marina, Latino, Maria Agnese, Mencacci, Antonella, Bonanno, Carmen, La Cava, Maria Carmela, Giraldi, Cristina, and Stefanelli, Paola

Subjects
Male, Anti-Bacterial Agents, Azithromycin, Cefixime, Ciprofloxacin, Humans, Italy, Neisseria gonorrhoeae, Penicillinase, Penicillins, Retrospective Studies, Tetracycline, Pharmacology (medical), Pharmacology, Infectious Diseases, Gonorrhea, Infectious Disease, Biology, medicine.disease_cause, urologic and male genital diseases, Microbiology, Epidemiology and Surveillance, Antibiotic resistance, Retrospective Studie, Anti-Bacterial Agent, medicine, Etest, Medicine (all), Penicillin, Antimicrobial, medicine.disease, Virology, Human, medicine.drug
Abstract

The emergence of Neisseria gonorrhoeae isolates displaying resistance to antimicrobial agents is a major public health concern and a serious issue related to the occurrence of further untreatable gonorrhea infections. A retrospective analysis on 1,430 N. gonorrhoeae isolates, collected from 2003 through 2012, for antimicrobial susceptibility by Etest and molecular characterization by Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) was carried out in Italy. Azithromycin-resistant gonococci decreased from 14% in 2007 to 2.2% in 2012. Similarly, isolates with high MICs to cefixime (>0.125 mg/liter) decreased from 11% in 2008 to 3.3% in 2012. The ciprofloxacin resistance rate remains quite stable, following an increasing trend up to 64% in 2012. The percentage of penicillinase-producing N. gonorrhoeae (PPNG) significantly declined from 77% in 2003 to 7% in 2012. A total of 81 multidrug-resistant (MDR) gonococci were identified, showing 11 different antimicrobial resistance patterns. These were isolated from men who have sex with men (MSM) and from heterosexual patients. Two sequence types (STs), ST661 and ST1407, were the most common. Genogroup 1407, which included cefixime-, ciprofloxacin-, and azithromycin-resistant isolates, was found. In conclusion, a change in the antimicrobial resistance profiles among gonococci was identified in Italy together with a percentage of MDR isolates.

Published
2014

37. Prima segnalazione di Klebsiella pneumoniae produttrice di KPC nell'area di Trieste

Author

Busetti, Marina, Petix, V, Rossi, T, Zanin, Valentina, Znidarcic, C, Fungone, L, Cian, Franca, Knezevich, A, Dolzani, Lucilla, comitato scientifico, Busetti, Marina, Petix, V, Rossi, T, Zanin, Valentina, Znidarcic, C, Fungone, L, Cian, Franca, Knezevich, A, and Dolzani, Lucilla

Subjects
Klebsiella pneumoniae, KPC, Nord Italia, Klebsiella pneumoniae, KPC, Nord Italia
Abstract

Introduzione Una delle emergenze nell'ambito della terapia antibiotica è rappresentata dall'aumento di Enterobacteriaceae resistenti ai carbapenemi. Questa è dovuta all'espressione di geni che codificano per enzimi definiti carbapenemasi. La diffusione di ceppi resistenti è un problema epidemiologico attuale nei confronti del quale i Laboratori di Microbiologia sono tenuti alla sorveglianza. Metodi Nel maggio 2012 è stata ricoverata presso il Reparto di Oncoematologia del nostro Istituto una paziente di 3 anni, proveniente dal Venezuela, sottoposta a trapianto di midollo osseo. Dal tampone rettale di sorveglianza è stata isolata una Klebsiella pneumoniae resistente ai carbapenemi che ha richiesto ulteriori accertamenti: sono state confermate le MIC per i carbapenemi mediante Etest ; effettuati i test fenotipici (test di sinergia con inibitori delle carbapenemasi, test NP); il ceppo è stato sottoposto a PCR con primers specifici per le principali carbapenemasi. Un successivo campione per emocoltura inviatoci per l'insorgere di una sepsi è risultato positivo per Klebsiella pneumoniae resistente ai carbapenemi; il ceppo è stato sottoposto agli stessi test fenotipici e molecolari. Si è proceduto ad uno screening dei pazienti del Reparto di Oncoematologia mediante tampone rettale, con semina su agar McKonkey con dischetto di meropenem, per verificare che il ceppo non fosse presente e circolante. Risultati I test fenotipici sui ceppi isolati da tampone e da emocoltura hanno indicato che la resistenza ai carbapenemi fosse dovuta alla presenza di una KPC (test di sinergia con a.boronico positivo); il risultato è stato confermato dalla positività della PCR per il gene blaKPC. Lo screening sugli altri pazienti ricoverati ha dato esito negativo. Conclusioni Questa, a nostra conoscenza, è la prima segnalazione di Klebsiella pneumoniae produttrice di KPC in provincia di Trieste, verosimilmente di importazione in paziente proveniente dal Venezuela. Il microrganismo non si è diffuso ulteriormente, anche grazie alla tempestiva segnalazione ed alle misure di contenimento.

Published
2013

38. Isolamento di Klebsiella pneumoniae resistente ai carbapenemi e Klebsiella pneumoniae sensibile da un campione urinario

Author

Cian, Franca, Knezevich, A, Dolzani, Lucilla, Bressan, Raffaela, Lagatolla, Cristina, Busetti, Marina, Petix, V, Deiana, M. L., Comitato Scientifico, Cian, Franca, Knezevich, A, Dolzani, Lucilla, Bressan, Raffaela, Lagatolla, Cristina, Busetti, Marina, Petix, V, and Deiana, M. L.

Subjects
Klebsiella pneumoniae, KPC, PCR, test di sinergia, test di Hodge, Klebsiella pneumoniae, KPC, test di sinergia, test di Hodge, PCR
Abstract

Introduzione. La diffusione di enterobatteri resistenti ai carbapenemi (CRE) è in preoccupante aumento in ospedali e lungodegenze, dove la selezione operata dalle terapie crea condizioni ideali per la loro moltiplicazione e trasmissione. Nel 2009 è comparso all’Ospedale di Cattinara di Trieste un cluster di K.pneumoniae con resistenza ai carbapenemi dovuta a modifica della permeabilità di membrana. Mancavano finora all’appello ceppi produttori di KPC-carbapenemasi già diffusi in tutta Italia. Scopo dello studio è caratterizzare il meccanismo di resistenza in un ceppo di K.pneumoniae isolato di recente e valutare strategie per facilitare l’isolamento dei ceppi resistenti in campioni con flora polimicrobica. Metodi. In luglio 2013 è stato isolato da un campione di urine un ceppo di K.pneumoniae CRE associato a K.pneumoniae sensibile. L’isolato resistente è stato confrontato con i ceppi CRE del 2009 conservati a -40°C. Identificazione e antibiogramma sono stati eseguiti utilizzando il sistema Vitek2; per conferma della produzione di carbapenemasi sono stati usati test di sinergia: meropenem/meropenem+EDTA; test KPC/MBL/OXA-48 (ROSCO diagnostica); test di Hodge modificato. I ceppi sono stati testati con PCR specifica per il gene blaKPC. La tipizzazione dei ceppi è stata effettuata mediante macrorestrizione con XbaI. Risultati. L’isolamento del ceppo CRE dal ceppo sensibile è stato possibile dopo passaggi in piastra con utilizzo di dischetti di meropenem. L’antibiogramma è sovrapponibile a quello dei ceppi CRE del 2009. I test fenotipici rilevano produzione di β-lattamasi tipo KPC, confermata da PCR. I profili PFGE del ceppo CRE e di quello sensibile differiscono per tre bande. Il lignaggio dei due isolati verrà ulteriormente indagato mediante MLST. Conclusioni. Campioni con flora polimicrobica rendono difficile l’isolamento di eventuali microrganismi MDR; una semplice strategia che utilizzi dischetti di meropenem in terreni selettivi per Gram negativi, risolve la differenziazione fra batteri CRE e ceppi fenotipicamente non distinguibili ma sensibili. I test di conferma con dischetti sono di facile uso e in grado di identificare la produzione di carbapenemasi tipo MBL o KPC, ma richiedono tempi di risposta maggiori rispetto al test molecolare.

Published
2013

40. Infezioni da Cytomegalovirus in pazienti immunocompromessi

Author

Busetti, Marina, D'Agaro, Pierlanfranco, Giuliani, C., Leder, D., Andolina, M., Crosato, I. M., Roscioli, Brunello, Majori, Luigi, Busetti, Marina, D'Agaro, Pierlanfranco, Giuliani, C., Leder, D., Andolina, M., Crosato, I. M., Roscioli, Brunello, and Majori, Luigi

Subjects
cytomegaloviru, immune deficiency, cytomegalovirus
Published
1994

42. Changing Antimicrobial Resistance Profiles among Neisseria gonorrhoeae Isolates in Italy, 2003 to 2012

Author

Carannante, Anna, primary, Renna, Giovanna, additional, Dal Conte, Ivano, additional, Ghisetti, Valeria, additional, Matteelli, Alberto, additional, Prignano, Grazia, additional, Impara, Giampaolo, additional, Cusini, Marco, additional, D'Antuono, Antonietta, additional, Vocale, Caterina, additional, Antonetti, Raffaele, additional, Gaino, Marina, additional, Busetti, Marina, additional, Latino, Maria Agnese, additional, Mencacci, Antonella, additional, Bonanno, Carmen, additional, Cava, Maria Carmela, additional, Giraldi, Cristina, additional, and Stefanelli, Paola, additional

Published
2014
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44. Effects of hormonal contraception on vaginal flora

Author

De Seta, Francesco, primary, Restaino, Stefano, additional, De Santo, Davide, additional, Stabile, Guglielmo, additional, Banco, Rubina, additional, Busetti, Marina, additional, Barbati, Giulia, additional, and Guaschino, Secondo, additional

Published
2012
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47. pKBuS13, a KPC-2-Encoding Plasmid from Klebsiella pneumoniaeSequence Type 833, Carrying Tn4401bInserted into an Xer Site-Specific Recombination Locus

Author

Garbari, Luigi, Busetti, Marina, Dolzani, Lucilla, Petix, Vincenzo, Knezevich, Anna, Bressan, Raffaela, Gionechetti, Fabrizia, Tonin, Enrico A., and Lagatolla, Cristina

Abstract

ABSTRACTHere, we report the first detection of a Klebsiella pneumoniaecarbapenemase 2 (KPC-2)-producing Klebsiella pneumoniaestrain belonging to sequence type 833 (ST833), collected in an Italian hospital from a patient coming from South America. Its blaKPCdeterminant was carried by a ColE1 plasmid, pKBuS13, that showed the Tn4401b::blaKPC-2transposon inserted into the regulatory region of an Xer site-specific recombination locus. This interfered with the correct resolution of plasmid multimers into monomers, lowering plasmid stability and leading to overestimation of the number of plasmids harbored by a single host cell. Sequencing of the fragments adjacent to Tn4401bdetected a region that did not have significant matches in databases other than the genome of a carbapenem-resistant Escherichia colistrain collected during the same year at a hospital in Boston. This is interesting in an epidemiologic context, as it suggests that despite the absence of tragenes and the instability under nonselective conditions, the circulation of pKBuS13 or of analogous plasmids might be wider than reported.

Published
2015
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48. Changing Antimicrobial Resistance Profiles among Neisseria gonorrhoeaeIsolates in Italy, 2003 to 2012

Author

Carannante, Anna, Renna, Giovanna, Dal Conte, Ivano, Ghisetti, Valeria, Matteelli, Alberto, Prignano, Grazia, Impara, Giampaolo, Cusini, Marco, D'Antuono, Antonietta, Vocale, Caterina, Antonetti, Raffaele, Gaino, Marina, Busetti, Marina, Latino, Maria Agnese, Mencacci, Antonella, Bonanno, Carmen, Cava, Maria Carmela, Giraldi, Cristina, and Stefanelli, Paola

Abstract

ABSTRACTThe emergence of Neisseria gonorrhoeaeisolates displaying resistance to antimicrobial agents is a major public health concern and a serious issue related to the occurrence of further untreatable gonorrhea infections. A retrospective analysis on 1,430 N. gonorrhoeaeisolates, collected from 2003 through 2012, for antimicrobial susceptibility by Etest and molecular characterization by Neisseria gonorrhoeaemultiantigen sequence typing (NG-MAST) was carried out in Italy. Azithromycin-resistant gonococci decreased from 14% in 2007 to 2.2% in 2012. Similarly, isolates with high MICs to cefixime (>0.125 mg/liter) decreased from 11% in 2008 to 3.3% in 2012. The ciprofloxacin resistance rate remains quite stable, following an increasing trend up to 64% in 2012. The percentage of penicillinase-producing N. gonorrhoeae(PPNG) significantly declined from 77% in 2003 to 7% in 2012. A total of 81 multidrug-resistant (MDR) gonococci were identified, showing 11 different antimicrobial resistance patterns. These were isolated from men who have sex with men (MSM) and from heterosexual patients. Two sequence types (STs), ST661 and ST1407, were the most common. Genogroup 1407, which included cefixime-, ciprofloxacin-, and azithromycin-resistant isolates, was found. In conclusion, a change in the antimicrobial resistance profiles among gonococci was identified in Italy together with a percentage of MDR isolates.

Published
2014
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49. HHV-6 is Frequently Detected in Dried Cord Blood Spots from Babies Born to HIV-Positive Mothers

Author

DAgaro, Pierlanfranco, Burgnich, Paola, Comar, Manola, Molin, Gianna, Bernardon, Maria, Busetti, Marina, Alberico, Salvatore, Poli, Albino, Campello, Cesare, and Group, the SIGO Italian

Abstract

Intrauterine transmission of HHV-6 is well established in immunocompetent women while few data are available on infections in babies born to HIV-positive mothers. To assess the rate of HHV-6 vertical transmission in comparison to CMV, we analyzed cord blood spots dried on cards (Dried Blood Spots, DBS) collected during a multi-center study on HIV congenital infections in Italy. DBS were tested by PCR for HHV-6 and CMV footprints. HHV-6 amplimers were sequenced and characterized. As control group, cards taken from babies born to HIV-negative mothers were analyzed. DBS of 187 babies born to HIV-positive and 372 to HIV-negative mothers were analyzed. The prevalence of HHV-6 was 3.2 in babies born to HIV-positive mothers. CMV was found in the HIV-positive group with a prevalence rate of 1.6. In newborns of control pregnant women, HHV-6 prevalence rate was 1.1 (p0.09), while CMV was not detected (p0.04). Sequence analysis could distinguish between HHV-6 A and B variant in both groups and one A/B coinfection was found in a baby born to a HIV-positive mother. HIV-infected mothers transmit HHV-6 and CMV viruses to their babies more frequently than uninfected women.

Published
2008

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