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1. In-label, off-label prescription, efficacy and tolerability of dalbavancin: report from a National Registry

Author

Esposito, S, Pagliano, P, De Simone, G, Guarino, A, Pan, A, Brambilla, P, Mastroianni, C, Lichtner, M, Brugnaro, P, Carretta, A, Santantonio, T, Brindicci, G, Carrega, G, Montagnani, F, Lapadula, G, Spolti, A, Luzzati, R, Schiaroli, E, Scaglione, V, Pallotto, C, Tacconi, D, Quintieri, F, Trecarichi, E, Esposito, S, Pagliano, P, De Simone, G, Guarino, A, Pan, A, Brambilla, P, Mastroianni, C, Lichtner, M, Brugnaro, P, Carretta, A, Santantonio, T, Brindicci, G, Carrega, G, Montagnani, F, Lapadula, G, Spolti, A, Luzzati, R, Schiaroli, E, Scaglione, V, Pallotto, C, Tacconi, D, Quintieri, F, and Trecarichi, E

Abstract

Purpose: Although dalbavancin is currently approved for the treatment of ABSSIs, several studies suggest its efficacy and tolerance as long-term therapy for other off-label indications requiring prolonged intravenous antibiotic administration. Methods: We conducted a prospective nationwide study of dalbavancin use in real-life settings for both approved and off-label indications analysing for each case the clinical and microbiological characteristics of infection the efficacy and safety of treatments. Results: During the study period (from December 2018 to July 2021), the ID specialists from 14 different centres enrolled 223 patients treated with dalbavancin [141 males (63%) and 82 females (37%); male/female ratio 1.72; mean age 59 (SD 17.2) years, (range 15–96). Most patients in the study population (136/223; 61.0%) came from community rather than health care facilities and most of them were visited in Infectious Diseases wards (93/223; 41.7%) and clinics (55/223; 24.7%) even though some patients were cured in other settings, such as surgery wards (18/223; 8.1%), orthopaedic wards (11/223; 4.9%), Emergency Rooms (7/223; 3.1%) and non-surgical other than ID wards (6/223; 2.7%). The most common ID diagnoses were osteomyelitis (44 cases/223; 19.7%; of which 29 acute and 15 chronic osteomyelitis), cellulitis (28/223; 12.5%), cutaneous abscess (23/223; 10.3%), orthopaedic prosthesis-associated infection (22/223; 9.9%), surgical site infection (20/223; 9.0%) and septic arthritis (15/223; 6.7%). Conclusion: In conclusion, by virtue of its PK/PD properties, dalbavancin represents a valuable option to daily in-hospital intravenous or outpatient antimicrobial regimens also for off-label indications requiring a long-term treatment of Gram-positive infections.

Published
2024

2. Multi-Criteria Decision Analysis to prioritize hospital admission of patients affected by COVID-19 in low-resource settings with hospital-bed shortage

Author

Durante Mangoni, E., Florio, L.L., Zampino, R., Mele, F., Gentile, I., Pinchera, B., Coppola, N., Pisaturo, M., Luzzati, R., Petrosillo, N., Nicastri, E., Corpolongo, A., Cataldo, M.A., D’Abramo, A., Maffongelli, G., Scorzolini, L., Palazzolo, C., Boumis, E., Pan, A., D’Arminio Monforte, A., Bai, F., Antinori, S., De Rosa, F.G., Corcione, S., Lupia, T., Pinna, S.M., Scabini, S., Canta, F., Belloro, S., Bisoffi, Z., Angheben, A., Gobbi, F., Turcato, E., Ronzoni, N., Moro, L., Calabria, S., Rodari, P., Bertoli, G., Marasca, G., Puoti, M., Gori, A., Bandera, A., Mangioni, D., Rizzi, M., Castelli, F., Montineri, A., Coco, C.A., Maresca, M., Frasca, M., Aquilini, D., Vincenzi, M., Lambertenghi, L., De Rui, M.E., Razzaboni, E., Cattaneo, P., Visentin, A., Erbogasto, A., Dalla Vecchia, I., Coledan, I., Vecchi, M., Be, G., Motta, L., Zaffagnini, A., Auerbach, N., Del Bravo, P., Azzini, A.M., Righi, E., Carrara, E., Savoldi, A., Sibani, M., Lattuada, E., Carolo, G., Cordioli, M., Soldani, F., Pezzani, M.D., Avallone, S., Bruno, R., Ricciardi, A., Saggese, M.P., Malerba, G., De Nardo, Pasquale, Gentilotti, Elisa, Mazzaferri, Fulvia, Cremonini, Eleonora, Hansen, Paul, Goossens, Herman, and Tacconelli, Evelina

Published
2020
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3. Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

Author

Salton, F, Confalonieri, P, Centanni, S, Mondoni, M, Petrosillo, N, Bonfanti, P, Lapadula, G, Lacedonia, D, Voza, A, Carpene, N, Montico, M, Reccardini, N, Meduri, G, Ruaro, B, Confalonieri, M, Citton, G, Bozzi, C, Tavano, S, Pozzan, R, Andrisano, A, Jaber, M, Mari, M, Trotta, L, Mondini, L, Barbieri, M, Ruggero, L, Antonaglia, C, Soave, S, Torregiani, C, Bogatec, T, Baccelli, A, Nalesso, G, Re, B, Pavesi, S, Barbaro, M, Giuliani, A, Ravaglia, C, Poletti, V, Scala, R, Guidelli, L, Golfi, N, Vianello, A, Achille, A, Lucernoni, P, Gaccione, A, Romagnoli, M, Fraccaro, A, Malacchini, N, Malerba, M, Ragnoli, B, Zamparelli, A, Bocchino, M, Blasi, F, Spotti, M, Miele, C, Piedepalumbo, F, Barone, I, Baglioni, S, Dodaj, M, Franco, C, Andrani, F, Mangia, A, Mancini, A, Carrozzi, L, Rafanelli, A, Casto, E, Rogliani, P, Ora, J, Carpagnano, G, Di Lecce, V, Tamburrini, M, Papi, A, Contoli, M, Luzzati, R, Zatta, M, Di Bella, S, Caraffa, E, Francisci, D, Tosti, A, Pallotto, C, De Rosa, F, Pecori, A, Franceschini, M, Carlin, M, Orsini, V, Pollastri, E, Rugova, A, Sabbatini, F, Soria, A, Rossi, M, Santantonio, T, Meli, R, Sauro, S, Fedeli, C, Mangini, E, Biolo, G, Nunnari, A, Pietrangelo, A, Corradini, E, Bocchi, D, Boarini, C, Zucchetto, A, Lanini, S, Salton F., Confalonieri P., Centanni S., Mondoni M., Petrosillo N., Bonfanti P., Lapadula G., Lacedonia D., Voza A., Carpene N., Montico M., Reccardini N., Meduri G. U., Ruaro B., Confalonieri M., Citton G. M., Bozzi C., Tavano S., Pozzan R., Andrisano A. G., Jaber M., Mari M., Trotta L., Mondini L., Barbieri M., Ruggero L., Antonaglia C., Soave S., Torregiani C., Bogatec T., Baccelli A., Nalesso G., Re B., Pavesi S., Barbaro M. P. F., Giuliani A., Ravaglia C., Poletti V., Scala R., Guidelli L., Golfi N., Vianello A., Achille A., Lucernoni P., Gaccione A. T., Romagnoli M., Fraccaro A., Malacchini N., Malerba M., Ragnoli B., Zamparelli A. S., Bocchino M., Blasi F., Spotti M., Miele C., Piedepalumbo F., Barone I., Baglioni S., Dodaj M., Franco C., Andrani F., Mangia A., Mancini A., Carrozzi L., Rafanelli A., Casto E., Rogliani P., Ora J., Carpagnano G. E., Di Lecce V., Tamburrini M., Papi A., Contoli M., Luzzati R., Zatta M., Di Bella S., Caraffa E., Francisci D., Tosti A., Pallotto C., De Rosa F. G., Pecori A., Franceschini M., Carlin M., Orsini V., Pollastri E., Rugova A., Sabbatini F., Soria A., Rossi M., Santantonio T., Meli R., Sauro S., Fedeli C., Mangini E., Biolo G., Nunnari A., Pietrangelo A., Corradini E., Bocchi D., Boarini C., Zucchetto A., Lanini S., Salton, F, Confalonieri, P, Centanni, S, Mondoni, M, Petrosillo, N, Bonfanti, P, Lapadula, G, Lacedonia, D, Voza, A, Carpene, N, Montico, M, Reccardini, N, Meduri, G, Ruaro, B, Confalonieri, M, Citton, G, Bozzi, C, Tavano, S, Pozzan, R, Andrisano, A, Jaber, M, Mari, M, Trotta, L, Mondini, L, Barbieri, M, Ruggero, L, Antonaglia, C, Soave, S, Torregiani, C, Bogatec, T, Baccelli, A, Nalesso, G, Re, B, Pavesi, S, Barbaro, M, Giuliani, A, Ravaglia, C, Poletti, V, Scala, R, Guidelli, L, Golfi, N, Vianello, A, Achille, A, Lucernoni, P, Gaccione, A, Romagnoli, M, Fraccaro, A, Malacchini, N, Malerba, M, Ragnoli, B, Zamparelli, A, Bocchino, M, Blasi, F, Spotti, M, Miele, C, Piedepalumbo, F, Barone, I, Baglioni, S, Dodaj, M, Franco, C, Andrani, F, Mangia, A, Mancini, A, Carrozzi, L, Rafanelli, A, Casto, E, Rogliani, P, Ora, J, Carpagnano, G, Di Lecce, V, Tamburrini, M, Papi, A, Contoli, M, Luzzati, R, Zatta, M, Di Bella, S, Caraffa, E, Francisci, D, Tosti, A, Pallotto, C, De Rosa, F, Pecori, A, Franceschini, M, Carlin, M, Orsini, V, Pollastri, E, Rugova, A, Sabbatini, F, Soria, A, Rossi, M, Santantonio, T, Meli, R, Sauro, S, Fedeli, C, Mangini, E, Biolo, G, Nunnari, A, Pietrangelo, A, Corradini, E, Bocchi, D, Boarini, C, Zucchetto, A, Lanini, S, Salton F., Confalonieri P., Centanni S., Mondoni M., Petrosillo N., Bonfanti P., Lapadula G., Lacedonia D., Voza A., Carpene N., Montico M., Reccardini N., Meduri G. U., Ruaro B., Confalonieri M., Citton G. M., Bozzi C., Tavano S., Pozzan R., Andrisano A. G., Jaber M., Mari M., Trotta L., Mondini L., Barbieri M., Ruggero L., Antonaglia C., Soave S., Torregiani C., Bogatec T., Baccelli A., Nalesso G., Re B., Pavesi S., Barbaro M. P. F., Giuliani A., Ravaglia C., Poletti V., Scala R., Guidelli L., Golfi N., Vianello A., Achille A., Lucernoni P., Gaccione A. T., Romagnoli M., Fraccaro A., Malacchini N., Malerba M., Ragnoli B., Zamparelli A. S., Bocchino M., Blasi F., Spotti M., Miele C., Piedepalumbo F., Barone I., Baglioni S., Dodaj M., Franco C., Andrani F., Mangia A., Mancini A., Carrozzi L., Rafanelli A., Casto E., Rogliani P., Ora J., Carpagnano G. E., Di Lecce V., Tamburrini M., Papi A., Contoli M., Luzzati R., Zatta M., Di Bella S., Caraffa E., Francisci D., Tosti A., Pallotto C., De Rosa F. G., Pecori A., Franceschini M., Carlin M., Orsini V., Pollastri E., Rugova A., Sabbatini F., Soria A., Rossi M., Santantonio T., Meli R., Sauro S., Fedeli C., Mangini E., Biolo G., Nunnari A., Pietrangelo A., Corradini E., Bocchi D., Boarini C., Zucchetto A., and Lanini S.

Abstract

Background Dysregulated systemic inflammation is the primary driver of mortality in severe coronavirus disease 2019 (COVID-19) pneumonia. Current guidelines favour a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg daily. A comparative randomised controlled trial (RCT) with a higher dose and a longer duration of intervention was lacking. Methods We conducted a multicentre, open-label RCT to investigate methylprednisolone 80 mg as a continuous daily infusion for 8 days followed by slow tapering versus dexamethasone 6 mg once daily for up to 10 days in adult patients with COVID-19 pneumonia requiring oxygen or noninvasive respiratory support. The primary outcome was reduction in 28-day mortality. Secondary outcomes were mechanical ventilation-free days at 28 days, need for intensive care unit (ICU) referral, length of hospitalisation, need for tracheostomy, and changes in C-reactive protein (CRP) levels, arterial oxygen tension/inspiratory oxygen fraction (PaO2/FIO2) ratio and World Health Organization Clinical Progression Scale at days 3, 7 and 14. Results 677 randomised patients were included. Findings are reported as methylprednisolone (n=337) versus dexamethasone (n=340). By day 28, there were no significant differences in mortality (35 (10.4%) versus 41 (12.1%); p=0.49) nor in median mechanical ventilation-free days (median (interquartile range (IQR)) 23 (14) versus 24 (16) days; p=0.49). ICU referral was necessary in 41 (12.2%) versus 45 (13.2%) (p=0.68) and tracheostomy in 8 (2.4%) versus 9 (2.6%) (p=0.82). Survivors in the methylprednisolone group required a longer median (IQR) hospitalisation (15 (11) versus 14 (11) days; p=0.005) and experienced an improvement in CRP levels, but not in PaO2/FIO2 ratio, at days 7 and 14. There were no differences in disease progression at the prespecified time-points. Conclusion Prolonged, higher dose methylprednisolone did not reduce mortality at 28 days compared with conventional dexamethasone in COVID

Published
2023

5. Predictors of choice of initial antifungal treatment in intraabdominal candidiasis

Author

Ansaldi, F., Scarparo, C., Diaz-Martin, A., Palacios-Garcia, I., Rosin, C., Almirante, B., Baldin, G., Vena, A., Bouza, E., de Egea, V., Tascini, C., Menichetti, F., Tagliaferri, E., Sanguinetti, M., Mesini, A., Sganga, G., Busetti, M., Pumarola, T., Martin, M.T., Nouér, S.A., Pelaez, T., Raise, E., Grandesso, S., Del Bono, V., Esteves, P., Trucchi, C., Sartor, A., De Pascale, G., Posteraro, B., Lagunes, L., Borgatta, B., Martín-Gomez, M.T., Rey-Pérez, A., Antonelli, M., Righi, E., Merelli, M., Brugnaro, P., Dimopoulos, G., Garnacho-Montero, J., Colombo, A.L., Luzzati, R., Muñoz, P., Nucci, M., Scotton, G., Viscoli, C., Tumbarello, M., Bassetti, M., and Rello, J.

Published
2016
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6. Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

Author

Salton F., Confalonieri P., Centanni S., Mondoni M., Petrosillo N., Bonfanti P., Lapadula G., Lacedonia D., Voza A., Carpene N., Montico M., Reccardini N., Meduri G. U., Ruaro B., Confalonieri M., Citton G. M., Bozzi C., Tavano S., Pozzan R., Andrisano A. G., Jaber M., Mari M., Trotta L., Mondini L., Barbieri M., Ruggero L., Antonaglia C., Soave S., Torregiani C., Bogatec T., Baccelli A., Nalesso G., Re B., Pavesi S., Barbaro M. P. F., Giuliani A., Ravaglia C., Poletti V., Scala R., Guidelli L., Golfi N., Vianello A., Achille A., Lucernoni P., Gaccione A. T., Romagnoli M., Fraccaro A., Malacchini N., Malerba M., Ragnoli B., Zamparelli A. S., Bocchino M., Blasi F., Spotti M., Miele C., Piedepalumbo F., Barone I., Baglioni S., Dodaj M., Franco C., Andrani F., Mangia A., Mancini A., Carrozzi L., Rafanelli A., Casto E., Rogliani P., Ora J., Carpagnano G. E., Di Lecce V., Tamburrini M., Papi A., Contoli M., Luzzati R., Zatta M., Di Bella S., Caraffa E., Francisci D., Tosti A., Pallotto C., De Rosa F. G., Pecori A., Franceschini M., Carlin M., Orsini V., Pollastri E., Rugova A., Sabbatini F., Soria A., Rossi M., Santantonio T., Meli R., Sauro S., Fedeli C., Mangini E., Biolo G., Nunnari A., Pietrangelo A., Corradini E., Bocchi D., Boarini C., Zucchetto A., Lanini S., Salton, F, Confalonieri, P, Centanni, S, Mondoni, M, Petrosillo, N, Bonfanti, P, Lapadula, G, Lacedonia, D, Voza, A, Carpene, N, Montico, M, Reccardini, N, Meduri, G, Ruaro, B, Confalonieri, M, Citton, G, Bozzi, C, Tavano, S, Pozzan, R, Andrisano, A, Jaber, M, Mari, M, Trotta, L, Mondini, L, Barbieri, M, Ruggero, L, Antonaglia, C, Soave, S, Torregiani, C, Bogatec, T, Baccelli, A, Nalesso, G, Re, B, Pavesi, S, Barbaro, M, Giuliani, A, Ravaglia, C, Poletti, V, Scala, R, Guidelli, L, Golfi, N, Vianello, A, Achille, A, Lucernoni, P, Gaccione, A, Romagnoli, M, Fraccaro, A, Malacchini, N, Malerba, M, Ragnoli, B, Zamparelli, A, Bocchino, M, Blasi, F, Spotti, M, Miele, C, Piedepalumbo, F, Barone, I, Baglioni, S, Dodaj, M, Franco, C, Andrani, F, Mangia, A, Mancini, A, Carrozzi, L, Rafanelli, A, Casto, E, Rogliani, P, Ora, J, Carpagnano, G, Di Lecce, V, Tamburrini, M, Papi, A, Contoli, M, Luzzati, R, Zatta, M, Di Bella, S, Caraffa, E, Francisci, D, Tosti, A, Pallotto, C, De Rosa, F, Pecori, A, Franceschini, M, Carlin, M, Orsini, V, Pollastri, E, Rugova, A, Sabbatini, F, Soria, A, Rossi, M, Santantonio, T, Meli, R, Sauro, S, Fedeli, C, Mangini, E, Biolo, G, Nunnari, A, Pietrangelo, A, Corradini, E, Bocchi, D, Boarini, C, Zucchetto, A, Lanini, S, Salton, Francesco, Confalonieri, Paola, Centanni, Stefano, Mondoni, Michele, Petrosillo, Nicola, Bonfanti, Paolo, Lapadula, Giuseppe, Lacedonia, Donato, Voza, Antonio, Carpenè, Nicoletta, Montico, Marcella, Reccardini, Nicolò, Meduri, Gianfranco Umberto, Ruaro, Barbara, MEDEAS Collaborative, Group, and Confalonieri, Marco

Subjects
Pulmonary and Respiratory Medicine, glucocorticoids, Settore MED/10 - Malattie dell'Apparato Respiratorio, pneumonia, COVID-19, glucocorticoid, dexamethasone, ARDS, acute respiratory distress syndrome, methylprednisolone
Abstract

BackgroundDysregulated systemic inflammation is the primary driver of mortality in severe coronavirus disease 2019 (COVID-19) pneumonia. Current guidelines favour a 7–10-day course of any glucocorticoid equivalent to dexamethasone 6 mg daily. A comparative randomised controlled trial (RCT) with a higher dose and a longer duration of intervention was lacking.MethodsWe conducted a multicentre, open-label RCT to investigate methylprednisolone 80 mg as a continuous daily infusion for 8 days followed by slow taperingversusdexamethasone 6 mg once daily for up to 10 days in adult patients with COVID-19 pneumonia requiring oxygen or noninvasive respiratory support. The primary outcome was reduction in 28-day mortality. Secondary outcomes were mechanical ventilation-free days at 28 days, need for intensive care unit (ICU) referral, length of hospitalisation, need for tracheostomy, and changes in C-reactive protein (CRP) levels, arterial oxygen tension/inspiratory oxygen fraction (PaO2/FIO2) ratio and World Health Organization Clinical Progression Scale at days 3, 7 and 14.Results677 randomised patients were included. Findings are reported as methylprednisolone (n=337)versusdexamethasone (n=340). By day 28, there were no significant differences in mortality (35 (10.4%)versus41 (12.1%); p=0.49) nor in median mechanical ventilation-free days (median (interquartile range (IQR)) 23 (14)versus24 (16) days; p=0.49). ICU referral was necessary in 41 (12.2%)versus45 (13.2%) (p=0.68) and tracheostomy in 8 (2.4%)versus9 (2.6%) (p=0.82). Survivors in the methylprednisolone group required a longer median (IQR) hospitalisation (15 (11)versus14 (11) days; p=0.005) and experienced an improvement in CRP levels, but not inPaO2/FIO2ratio, at days 7 and 14. There were no differences in disease progression at the prespecified time-points.ConclusionProlonged, higher dose methylprednisolone did not reduce mortality at 28 days compared with conventional dexamethasone in COVID-19 pneumonia.

Published
2022

8. Clinical management of imported malaria in Italy: Results from a national cross-sectional survey in 2015

Author

Lepore, L, Vairo, F, D'Abramo, A, Grilli, E, Corpolongo, A, Scorzolini, L, Nisii, C, Calleri, G, Castelli, F, Chirianni, A, Ippolito, G, Nicastri, E, Andreoni, M, Angarano, G, Anselmo, M, Ascoli Bartoli, T, Bartoloni, A, Bassi, P, Bevilacqua, N, Bisoffi, Z, Cacopardo, B, Caligaris, S, Calzetti, C, Casolari, S, Cassola, G, Chianura, L, Chiodera, A, Conforto, M, Coppola, N, De Luca, A, Feasi, M, Ferrari, C, Filippini, P, Foti, G, Francavilla, E, Fusco, F, Tekle, S, Giancola, M, Giammario, A, Giobbia, M, Giordani, M, Gobbi, F, Gori, A, Grossi, P, Iacobello, C, Iannetta, M, Libanore, M, Luzzati, R, Magnani, G, Manfrin, V, Mariano, A, Mastroianni, C, Mazzotta, F, Mecocci, L, Mondardini, V, Montineri, A, Nicolini, L, Oliva, A, Palazzolo, C, Pasquale, G, Portelli, V, Puoti, M, Quirino, T, Santantonio, T, Sarmati, L, Sciotti, M, Scotton, P, Tomasoni, L, Toscanini, F, Tunesi, S, Vanino, E, Viale, P, Vigano, P, Viscoli, C, Vullo, V, Lepore L., Vairo F., D'Abramo A., Grilli E., Corpolongo A., Scorzolini L., Nisii C., Calleri G., Castelli F., Chirianni A., Ippolito G., Nicastri E., Andreoni M., Angarano G., Anselmo M., Ascoli Bartoli T., Bartoloni A., Bassi P., Bevilacqua N., Bisoffi Z., Cacopardo B., Caligaris S., Calzetti C., Casolari S., Cassola G., Chianura L., Chiodera A., Conforto M., Coppola N., De Luca A., Feasi M., Ferrari C., Filippini P., Foti G., Francavilla E., Fusco F. M., Tekle S. G., Giancola M. L., Giammario A., Giobbia M., Giordani M. T., Gobbi F., Gori A., Grossi P., Iacobello C., Iannetta M., Libanore M., Luzzati R., Magnani G., Manfrin V., Mariano A., Mastroianni C., Mazzotta F., Mecocci L., Mondardini V., Montineri A., Nicolini L. A., Oliva A., Palazzolo C., Pasquale G., Portelli V., Puoti M., Quirino T., Santantonio T. A., Sarmati L., Sciotti M. P., Scotton P., Tomasoni L. R., Toscanini F., Tunesi S., Vanino E., Viale P., Vigano P., Viscoli C., Vullo V., Lepore, L, Vairo, F, D'Abramo, A, Grilli, E, Corpolongo, A, Scorzolini, L, Nisii, C, Calleri, G, Castelli, F, Chirianni, A, Ippolito, G, Nicastri, E, Andreoni, M, Angarano, G, Anselmo, M, Ascoli Bartoli, T, Bartoloni, A, Bassi, P, Bevilacqua, N, Bisoffi, Z, Cacopardo, B, Caligaris, S, Calzetti, C, Casolari, S, Cassola, G, Chianura, L, Chiodera, A, Conforto, M, Coppola, N, De Luca, A, Feasi, M, Ferrari, C, Filippini, P, Foti, G, Francavilla, E, Fusco, F, Tekle, S, Giancola, M, Giammario, A, Giobbia, M, Giordani, M, Gobbi, F, Gori, A, Grossi, P, Iacobello, C, Iannetta, M, Libanore, M, Luzzati, R, Magnani, G, Manfrin, V, Mariano, A, Mastroianni, C, Mazzotta, F, Mecocci, L, Mondardini, V, Montineri, A, Nicolini, L, Oliva, A, Palazzolo, C, Pasquale, G, Portelli, V, Puoti, M, Quirino, T, Santantonio, T, Sarmati, L, Sciotti, M, Scotton, P, Tomasoni, L, Toscanini, F, Tunesi, S, Vanino, E, Viale, P, Vigano, P, Viscoli, C, Vullo, V, Lepore L., Vairo F., D'Abramo A., Grilli E., Corpolongo A., Scorzolini L., Nisii C., Calleri G., Castelli F., Chirianni A., Ippolito G., Nicastri E., Andreoni M., Angarano G., Anselmo M., Ascoli Bartoli T., Bartoloni A., Bassi P., Bevilacqua N., Bisoffi Z., Cacopardo B., Caligaris S., Calzetti C., Casolari S., Cassola G., Chianura L., Chiodera A., Conforto M., Coppola N., De Luca A., Feasi M., Ferrari C., Filippini P., Foti G., Francavilla E., Fusco F. M., Tekle S. G., Giancola M. L., Giammario A., Giobbia M., Giordani M. T., Gobbi F., Gori A., Grossi P., Iacobello C., Iannetta M., Libanore M., Luzzati R., Magnani G., Manfrin V., Mariano A., Mastroianni C., Mazzotta F., Mecocci L., Mondardini V., Montineri A., Nicolini L. A., Oliva A., Palazzolo C., Pasquale G., Portelli V., Puoti M., Quirino T., Santantonio T. A., Sarmati L., Sciotti M. P., Scotton P., Tomasoni L. R., Toscanini F., Tunesi S., Vanino E., Viale P., Vigano P., Viscoli C., and Vullo V.

Abstract

In Italy, malaria continues to be one of the most common imported parasitoses; therefore, continuous surveillance of epidemiological data and clinical management is needed. In 2016, the National Institute for Infectious Diseases 'Lazzaro Spallanzani' in Rome promoted a retrospective questionnaire-based survey to assess the clinical management of imported malaria cases in Italy in 2015. The questionnaire was sent to 104 Tropical and/or Infectious Diseases Units in the country, and 37 of them filled out and returned the questionnaires. A total of 399 malaria cases were reported in 2015, mostly caused by Plasmodium falciparum and imported from Africa. Malaria chemoprophylaxis was correctly used by a minority of patients. Most patients presented with uncomplicated malaria and were treated orally. In severe cases, intravenous artesunate or quinine alone or in combination were administered, although one third of these severe cases received oral treatment. This retrospective survey reveals a lack of homogeneity in management of malaria-imported cases in Italy. Improvement of malaria chemoprophylaxis, standardization of clinical management of malaria cases and harmonization of oral and intravenous drug availability are needed throughout the country.

Published
2020

9. Burden of Disease in PWH Harboring a Multidrug-Resistant Virus: Data from the PRESTIGIO Registry

Author

Galli, L, Parisi, M, Poli, A, Menozzi, M, Fiscon, M, Garlassi, E, Francisci, D, DI Biagio, A, Sterrantino, G, Fornabaio, C, Degli Antoni, A, Angarano, G, Fusco, F, D'Arminio Monforte, A, Corbelli, G, Santoro, M, Zazzi, M, Castagna, A, Gianotti, N, Maggiolo, F, Calza, L, Foca, E, Cenderello, G, Rusconi, S, Mussini, C, Antinori, A, Gagliardini, R, Bonora, S, Ferrara, M, Galli, A, Carini, E, Bigoloni, A, Tavio, M, Butini, L, Giacometti, A, Vaccher, E, Martellotta, F, Da Ros, V, Saracino, A, Balena, F, Comi, L, DI Filippo, E, Valenti, D, Suardi, C, Mazzola, B, Viale, P, Del Turco, E, Ramirez, M, Castelli, F, Celotti, A, Brognoli, F, Bonoldi, G, Menzaghi, B, Abeli, C, Farinazzo, M, Ortu, F, Campus, M, Cacopardo, B, Celesia, M, Pan, A, Bartoloni, A, Rinaldi, F, Giache, S, Pierluigi, B, Vichi, F, Santantonio, T, Ferrara, S, Bruno, S, Cassola, G, Marcello, F, Calautti, F, Bassetti, M, Bruzzone, B, Artioli, S, Lazzarin, A, Canetti, D, Galli, M, Formenti, T, Morena, V, Gabrieli, A, Gazzola, L, Merlini, E, Minieri, V, Gori, A, Bandera, A, Pastore, V, Ferroni, V, Puoti, M, Moioli, C, Vassalli, S, Enrica, R, Giulia, N, Beghetto, B, Manzillo, E, Franco, A, Cattelan, A, Marinello, S, Cavinato, S, Macario, A, Cascio, A, Mazzola, G, Antoni, A, Ferrari, C, Laccabue, D, Filice, G, Gulminetti, R, Pagnucco, L, Asti, A, Schiaroli, E, Papalini, C, Italiani, F, DI Pietro, M, Magnani, G, Elisa, G, Barchi, E, Corsini, R, Vergori, A, Cicalini, S, Onnelli, G, Giannetti, A, Cauda, R, Ciccullo, A, La Monica, S, Vullo, V, Dettorre, G, Cavallari, E, Andreoni, M, Malagnino, V, Ceccarelli, L, Viviani, F, Sasset, L, Dentone, C, Rossetti, B, Modica, S, Borgo, V, DI Perri, G, Carcieri, C, Malena, M, Padovani, B, Luzzati, R, Centonze, S, Valentinotti, R, Galli L., Parisi M. R., Poli A., Menozzi M., Fiscon M., Garlassi E., Francisci D., DI Biagio A., Sterrantino G., Fornabaio C., Degli Antoni A., Angarano G., Fusco F. M., D'Arminio Monforte A., Corbelli G. M., Santoro M. M., Zazzi M., Castagna A., Gianotti N., Maggiolo F., Calza L., Foca E., Cenderello G., Rusconi S., Mussini C., Antinori A., Gagliardini R., Bonora S., Ferrara M., Santoro M., Galli A., Carini E., Bigoloni A., Tavio M., Butini L., Giacometti A., Vaccher E., Martellotta F., Da Ros V., Saracino A., Balena F., Comi L., DI Filippo E., Valenti D., Suardi C., Mazzola B., Viale P., Del Turco E. R., Ramirez M. V., Castelli F., Celotti A., Brognoli F., Bonoldi G., Menzaghi B., Abeli C., Farinazzo M., Ortu F., Campus M., Cacopardo B., Celesia M., Pan A., Bartoloni A., Rinaldi F., Giache S., Pierluigi B., Vichi F., Santantonio T., Ferrara S., Bruno S. R., Cassola G., Marcello F., Calautti F., Bassetti M., Bruzzone B., Artioli S., Lazzarin A., Canetti D., Galli M., Formenti T., Morena V., Gabrieli A., Gazzola L., Merlini E., Minieri V., Gori A., Bandera A., Pastore V., Ferroni V., Puoti M., Moioli C., Vassalli S., Enrica R., Giulia N., Beghetto B., Manzillo E., Franco A., Cattelan A. M., Marinello S., Cavinato S., MacArio A., Cascio A., Mazzola G., Antoni A. M. D., Ferrari C., Laccabue D., Filice G., Gulminetti R., Pagnucco L., Asti A., Schiaroli E., Papalini C., Italiani F., DI Pietro M., Magnani G., Elisa G., Barchi E., Corsini R., Vergori A., Cicalini S., Onnelli G., Giannetti A., Cauda R., Ciccullo A., La Monica S., Vullo V., Dettorre G., Cavallari E. N., Andreoni M., Malagnino V., Ceccarelli L., Viviani F., Sasset L., Dentone C., Rossetti B., Modica S., Borgo V., DI Perri G., Carcieri C., Malena M., Padovani B., Luzzati R., Centonze S., Valentinotti R., Galli, L, Parisi, M, Poli, A, Menozzi, M, Fiscon, M, Garlassi, E, Francisci, D, DI Biagio, A, Sterrantino, G, Fornabaio, C, Degli Antoni, A, Angarano, G, Fusco, F, D'Arminio Monforte, A, Corbelli, G, Santoro, M, Zazzi, M, Castagna, A, Gianotti, N, Maggiolo, F, Calza, L, Foca, E, Cenderello, G, Rusconi, S, Mussini, C, Antinori, A, Gagliardini, R, Bonora, S, Ferrara, M, Galli, A, Carini, E, Bigoloni, A, Tavio, M, Butini, L, Giacometti, A, Vaccher, E, Martellotta, F, Da Ros, V, Saracino, A, Balena, F, Comi, L, DI Filippo, E, Valenti, D, Suardi, C, Mazzola, B, Viale, P, Del Turco, E, Ramirez, M, Castelli, F, Celotti, A, Brognoli, F, Bonoldi, G, Menzaghi, B, Abeli, C, Farinazzo, M, Ortu, F, Campus, M, Cacopardo, B, Celesia, M, Pan, A, Bartoloni, A, Rinaldi, F, Giache, S, Pierluigi, B, Vichi, F, Santantonio, T, Ferrara, S, Bruno, S, Cassola, G, Marcello, F, Calautti, F, Bassetti, M, Bruzzone, B, Artioli, S, Lazzarin, A, Canetti, D, Galli, M, Formenti, T, Morena, V, Gabrieli, A, Gazzola, L, Merlini, E, Minieri, V, Gori, A, Bandera, A, Pastore, V, Ferroni, V, Puoti, M, Moioli, C, Vassalli, S, Enrica, R, Giulia, N, Beghetto, B, Manzillo, E, Franco, A, Cattelan, A, Marinello, S, Cavinato, S, Macario, A, Cascio, A, Mazzola, G, Antoni, A, Ferrari, C, Laccabue, D, Filice, G, Gulminetti, R, Pagnucco, L, Asti, A, Schiaroli, E, Papalini, C, Italiani, F, DI Pietro, M, Magnani, G, Elisa, G, Barchi, E, Corsini, R, Vergori, A, Cicalini, S, Onnelli, G, Giannetti, A, Cauda, R, Ciccullo, A, La Monica, S, Vullo, V, Dettorre, G, Cavallari, E, Andreoni, M, Malagnino, V, Ceccarelli, L, Viviani, F, Sasset, L, Dentone, C, Rossetti, B, Modica, S, Borgo, V, DI Perri, G, Carcieri, C, Malena, M, Padovani, B, Luzzati, R, Centonze, S, Valentinotti, R, Galli L., Parisi M. R., Poli A., Menozzi M., Fiscon M., Garlassi E., Francisci D., DI Biagio A., Sterrantino G., Fornabaio C., Degli Antoni A., Angarano G., Fusco F. M., D'Arminio Monforte A., Corbelli G. M., Santoro M. M., Zazzi M., Castagna A., Gianotti N., Maggiolo F., Calza L., Foca E., Cenderello G., Rusconi S., Mussini C., Antinori A., Gagliardini R., Bonora S., Ferrara M., Santoro M., Galli A., Carini E., Bigoloni A., Tavio M., Butini L., Giacometti A., Vaccher E., Martellotta F., Da Ros V., Saracino A., Balena F., Comi L., DI Filippo E., Valenti D., Suardi C., Mazzola B., Viale P., Del Turco E. R., Ramirez M. V., Castelli F., Celotti A., Brognoli F., Bonoldi G., Menzaghi B., Abeli C., Farinazzo M., Ortu F., Campus M., Cacopardo B., Celesia M., Pan A., Bartoloni A., Rinaldi F., Giache S., Pierluigi B., Vichi F., Santantonio T., Ferrara S., Bruno S. R., Cassola G., Marcello F., Calautti F., Bassetti M., Bruzzone B., Artioli S., Lazzarin A., Canetti D., Galli M., Formenti T., Morena V., Gabrieli A., Gazzola L., Merlini E., Minieri V., Gori A., Bandera A., Pastore V., Ferroni V., Puoti M., Moioli C., Vassalli S., Enrica R., Giulia N., Beghetto B., Manzillo E., Franco A., Cattelan A. M., Marinello S., Cavinato S., MacArio A., Cascio A., Mazzola G., Antoni A. M. D., Ferrari C., Laccabue D., Filice G., Gulminetti R., Pagnucco L., Asti A., Schiaroli E., Papalini C., Italiani F., DI Pietro M., Magnani G., Elisa G., Barchi E., Corsini R., Vergori A., Cicalini S., Onnelli G., Giannetti A., Cauda R., Ciccullo A., La Monica S., Vullo V., Dettorre G., Cavallari E. N., Andreoni M., Malagnino V., Ceccarelli L., Viviani F., Sasset L., Dentone C., Rossetti B., Modica S., Borgo V., DI Perri G., Carcieri C., Malena M., Padovani B., Luzzati R., Centonze S., and Valentinotti R.

Abstract

Background: Currently, no data are available on the burden of morbidity and mortality in people with HIV-1 (PWH) harboring a 4-class drug-resistant (4DR) virus (nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase strand transfer inhibitors). The study aimed to assess the incidence of clinical events and death in this population. Methods: This was a cohort study on PWH from the PRESTIGIO Registry with a documented 4DR virus. Burden of disease was defined as the occurrence of any new event including an AIDS-defining event (ADE) or non-AIDS-defining event (NADE) or death from any cause after 4DR evidence (baseline). Cox regression models evaluated factors associated with the risk of new clinical events/death. Results: Among 148 PWH followed for a median (interquartile range) of 47 (32-84) months after 4DR evidence, 38 PWH had 62 new events or died from any cause (incidence rate, 9.12/100 person-years of follow-up; 95% CI = 6.85-11.39): 12 deaths (6 AIDS-related and 6 non-AIDS-related), 18 ADEs, 32 NADEs; 20 of the 38 NADEs (45%) of the incident clinical events were malignancies. The 4-year cumulative incidence of death was 6% (95% CI, 3%-13%), and that of ≥1 event or death was 22% (95% CI, 16%-31%). A higher risk of new clinical events/death was more likely in PWH with previous clinical events (adjusted hazard ratio [aHR], 2.67; 95% CI, 1.07-6.67) and marginally associated with lower baseline CD4+/CD8+ ratio (aHR, 0.82; 95% CI, 0.65-1.02). Conclusions: PWH harboring 4DR have a high burden of disease with a worrying incidence of malignancies, strongly advising for close prevention and monitoring interventions as well as access to innovative therapeutic strategies, especially in people with a history of clinical events and low CD4+/CD8+ ratio.

Published
2020

10. Ceftolozane/Tazobactam for Treatment of Severe ESBL-Producing

Author

Bassetti, M., Vena, A., Giacobbe, D. R., Falcone, M., Tiseo, G., Giannella, M., Pascale, R., Meschiari, M., Digaetano, M., Oliva, A., Rovelli, C., Carannante, N., Losito, A. R., Carbonara, S., Mariani, M. F., Mastroianni, A., Angarano, G., Tumbarello, M., Tascini, C., Grossi, P., Mastroianni, C. M., Mussini, C., Viale, P., Menichetti, F., Viscoli, C., Russo, A., Verdenelli, S., Fabiani, S., Castaldo, N., Pecori, D., Carnellutti, A., Givone, F., Graziano, E., Merelli, M., Cadeo, B., Peghin, M., Cattelan, A., Cipriani, L., Coletto, D., Gianluca, R., Ciardi, M. R., Ajassa, C., Tieghi, T., Pontino, P., Raffaelli, F., Artioli, S., Caruana, G., Luzzati, R., Bontempo, G., Petrosillo, N., Capone, A., Rizzardini, G., Coen, M., Passerini, M., Guadagnino, G., Urso, F., Borgia, G., Gentile, I., Maraolo, A. E., Crapis, M., Venturini, S., Parruti, G., Trave, F., Girardis, M., Cascio, A., Gioe, C., Anselmo, M., Malfatto, E., Bassetti, Matteo, Vena, Antonio, Giacobbe, Daniele Roberto, Falcone, Marco, Tiseo, Giusy, Giannella, Maddalena, Pascale, Renato, Meschiari, Marianna, Digaetano, Margherita, Oliva, Alessandra, Rovelli, Cristina, Carannante, Novella, Losito, Angela Raffaella, Carbonara, Sergio, Mariani, Michele Fabiano, Mastroianni, Antonio, Angarano, Gioacchino, Tumbarello, Mario, Tascini, Carlo, Grossi, Paolo, Mastroianni, Claudio Maria, Mussini, Cristina, Viale, Pierluigi, Menichetti, Francesco, Viscoli, Claudio, Russo, Alessandro, Bassetti M., Vena A., Giacobbe D.R., Falcone M., Tiseo G., Giannella M., Pascale R., Meschiari M., Digaetano M., Oliva A., Rovelli C., Carannante N., Losito A.R., Carbonara S., Mariani M.F., Mastroianni A., Angarano G., Tumbarello M., Tascini C., Grossi P., Mastroianni C.M., Mussini C., Viale P., Menichetti F., Viscoli C., Russo A., Verdenelli S., Fabiani S., Castaldo N., Pecori D., Carnellutti A., Givone F., Graziano E., Merelli M., Cadeo B., Peghin M., Cattelan A., Cipriani L., Coletto D., Gianluca R., Ciardi M.R., Ajassa C., Tieghi T., Pontino P., Raffaelli F., Artioli S., Caruana G., Luzzati R., Bontempo G., Petrosillo N., Capone A., Rizzardini G., Coen M., Passerini M., Guadagnino G., Urso F., Borgia G., Gentile I., Maraolo A.E., Crapis M., Venturini S., Parruti G., Trave F., Girardis M., Cascio A., Gioe C., Anselmo M., Malfatto E., Russo, Alessandro &amp, and Luzzati, R.

Subjects
medicine.medical_specialty, ceftolozane/tazobactam, medicine.medical_treatment, CRRT, Tazobactam, Enterobacterales, Enterobacterale, Internal medicine, ESBL, septic shock, Major Article, medicine, Clinical endpoint, Renal replacement therapy, business.industry, Septic shock, Retrospective cohort study, Odds ratio, medicine.disease, Ceftolozane/tazobactam, AcademicSubjects/MED00290, Infectious Diseases, Oncology, Ceftolozane, business, Empiric therapy, medicine.drug
Abstract

Background Few data are reported in the literature about the outcome of patients with severe extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) infections treated with ceftolozane/tazobactam (C/T), in empiric or definitive therapy. Methods A multicenter retrospective study was performed in Italy (June 2016–June 2019). Successful clinical outcome was defined as complete resolution of clinical signs/symptoms related to ESBL-E infection and lack of microbiological evidence of infection. The primary end point was to identify predictors of clinical failure of C/T therapy. Results C/T treatment was documented in 153 patients: pneumonia was the most common diagnosis (n = 46, 30%), followed by 34 cases of complicated urinary tract infections (22.2%). Septic shock was observed in 42 (27.5%) patients. C/T was used as empiric therapy in 46 (30%) patients and as monotherapy in 127 (83%) patients. Favorable clinical outcome was observed in 128 (83.7%) patients; 25 patients were considered to have failed C/T therapy. Overall, 30-day mortality was reported for 15 (9.8%) patients. At multivariate analysis, Charlson comorbidity index >4 (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.9–3.5; P = .02), septic shock (OR, 6.2; 95% CI, 3.8–7.9; P < .001), and continuous renal replacement therapy (OR, 3.1; 95% CI, 1.9–5.3; P = .001) were independently associated with clinical failure, whereas empiric therapy displaying in vitro activity (OR, 0.12; 95% CI, 0.01–0.34; P < .001) and adequate source control of infection (OR, 0.42; 95% CI, 0.14–0.55; P < .001) were associated with clinical success. Conclusions Data show that C/T could be a valid option in empiric and/or targeted therapy in patients with severe infections caused by ESBL-producing Enterobacterales. Clinicians should be aware of the risk of clinical failure with standard-dose C/T therapy in septic patients receiving CRRT.

Published
2020

11. Burden of Disease in PWH Harboring a Multidrug-Resistant Virus: Data from the PRESTIGIO Registry

Author

Galli, L., Parisi, M. R., Poli, A., Menozzi, M., Fiscon, M., Garlassi, E., Francisci, D., DI Biagio, A., Sterrantino, G., Fornabaio, C., Degli Antoni, A., Angarano, G., Fusco, F. M., D'Arminio Monforte, A., Corbelli, G. M., Santoro, M. M., Zazzi, M., Castagna, A., Gianotti, N., Maggiolo, F., Calza, L., Foca, E., Cenderello, G., Rusconi, S., Mussini, C., Antinori, A., Gagliardini, R., Bonora, S., Ferrara, M., Santoro, M., Galli, A., Carini, E., Bigoloni, A., Tavio, M., Butini, L., Giacometti, A., Vaccher, E., Martellotta, F., Da Ros, V., Saracino, A., Balena, F., Comi, L., DI Filippo, E., Valenti, D., Suardi, C., Mazzola, B., Viale, P., Del Turco, E. R., Ramirez, M. V., Castelli, F., Celotti, A., Brognoli, F., Bonoldi, G., Menzaghi, B., Abeli, C., Farinazzo, M., Ortu, F., Campus, M., Cacopardo, B., Celesia, M., Pan, A., Bartoloni, A., Rinaldi, F., Giache, S., Pierluigi, B., Vichi, F., Santantonio, T., Ferrara, S., Bruno, S. R., Cassola, G., Marcello, F., Calautti, F., Bassetti, M., Bruzzone, B., Artioli, S., Lazzarin, A., Canetti, D., Galli, M., Formenti, T., Morena, V., Gabrieli, A., Gazzola, L., Merlini, E., Minieri, V., Gori, A., Bandera, A., Pastore, V., Ferroni, V., Puoti, M., Moioli, C., Vassalli, S., Enrica, R., Giulia, N., Beghetto, B., Manzillo, E., Franco, A., Cattelan, A. M., Marinello, S., Cavinato, S., Macario, A., Cascio, A., Mazzola, G., Antoni, A. M. D., Ferrari, C., Laccabue, D., Filice, G., Gulminetti, R., Pagnucco, L., Asti, A., Schiaroli, E., Papalini, C., Italiani, F., DI Pietro, M., Magnani, G., Elisa, G., Barchi, E., Corsini, R., Vergori, A., Cicalini, S., Onnelli, G., Giannetti, A., Cauda, R., Ciccullo, A., La Monica, S., Vullo, V., Dettorre, G., Cavallari, E. N., Andreoni, M., Malagnino, V., Ceccarelli, L., Viviani, F., Sasset, L., Dentone, C., Rossetti, B., Modica, S., Borgo, V., DI Perri, G., Carcieri, C., Malena, M., Padovani, B., Luzzati, R., Centonze, S., Valentinotti, R., Galli L., Parisi M.R., Poli A., Menozzi M., Fiscon M., Garlassi E., Francisci D., DI Biagio A., Sterrantino G., Fornabaio C., Degli Antoni A., Angarano G., Fusco F.M., D'Arminio Monforte A., Corbelli G.M., Santoro M.M., Zazzi M., Castagna A., Gianotti N., Maggiolo F., Calza L., Foca E., Cenderello G., Rusconi S., Mussini C., Antinori A., Gagliardini R., Bonora S., Ferrara M., Santoro M., Galli A., Carini E., Bigoloni A., Tavio M., Butini L., Giacometti A., Vaccher E., Martellotta F., Da Ros V., Saracino A., Balena F., Comi L., DI Filippo E., Valenti D., Suardi C., Mazzola B., Viale P., Del Turco E.R., Ramirez M.V., Castelli F., Celotti A., Brognoli F., Bonoldi G., Menzaghi B., Abeli C., Farinazzo M., Ortu F., Campus M., Cacopardo B., Celesia M., Pan A., Bartoloni A., Rinaldi F., Giache S., Pierluigi B., Vichi F., Santantonio T., Ferrara S., Bruno S.R., Cassola G., Marcello F., Calautti F., Bassetti M., Bruzzone B., Artioli S., Lazzarin A., Canetti D., Galli M., Formenti T., Morena V., Gabrieli A., Gazzola L., Merlini E., Minieri V., Gori A., Bandera A., Pastore V., Ferroni V., Puoti M., Moioli C., Vassalli S., Enrica R., Giulia N., Beghetto B., Manzillo E., Franco A., Cattelan A.M., Marinello S., Cavinato S., MacArio A., Cascio A., Mazzola G., Antoni A.M.D., Ferrari C., Laccabue D., Filice G., Gulminetti R., Pagnucco L., Asti A., Frsdi E., Schiaroli E., Papalini C., Italiani F., DI Pietro M., Magnani G., Elisa G., Barchi E., Corsini R., Vergori A., Cicalini S., Onnelli G., Giannetti A., Cauda R., Ciccullo A., La Monica S., Vullo V., Dettorre G., Cavallari E.N., Andreoni M., Malagnino V., Ceccarelli L., Viviani F., Sasset L., Dentone C., Rossetti B., Modica S., Borgo V., DI Perri G., Carcieri C., Malena M., Padovani B., Luzzati R., Centonze S., Valentinotti R., Galli, L, Parisi, M, Poli, A, Menozzi, M, Fiscon, M, Garlassi, E, Francisci, D, DI Biagio, A, Sterrantino, G, Fornabaio, C, Degli Antoni, A, Angarano, G, Fusco, F, D'Arminio Monforte, A, Corbelli, G, Santoro, M, Zazzi, M, Castagna, A, Gianotti, N, Maggiolo, F, Calza, L, Foca, E, Cenderello, G, Rusconi, S, Mussini, C, Antinori, A, Gagliardini, R, Bonora, S, Ferrara, M, Galli, A, Carini, E, Bigoloni, A, Tavio, M, Butini, L, Giacometti, A, Vaccher, E, Martellotta, F, Da Ros, V, Saracino, A, Balena, F, Comi, L, DI Filippo, E, Valenti, D, Suardi, C, Mazzola, B, Viale, P, Del Turco, E, Ramirez, M, Castelli, F, Celotti, A, Brognoli, F, Bonoldi, G, Menzaghi, B, Abeli, C, Farinazzo, M, Ortu, F, Campus, M, Cacopardo, B, Celesia, M, Pan, A, Bartoloni, A, Rinaldi, F, Giache, S, Pierluigi, B, Vichi, F, Santantonio, T, Ferrara, S, Bruno, S, Cassola, G, Marcello, F, Calautti, F, Bassetti, M, Bruzzone, B, Artioli, S, Lazzarin, A, Canetti, D, Galli, M, Formenti, T, Morena, V, Gabrieli, A, Gazzola, L, Merlini, E, Minieri, V, Gori, A, Bandera, A, Pastore, V, Ferroni, V, Puoti, M, Moioli, C, Vassalli, S, Enrica, R, Giulia, N, Beghetto, B, Manzillo, E, Franco, A, Cattelan, A, Marinello, S, Cavinato, S, Macario, A, Cascio, A, Mazzola, G, Antoni, A, Ferrari, C, Laccabue, D, Filice, G, Gulminetti, R, Pagnucco, L, Asti, A, Schiaroli, E, Papalini, C, Italiani, F, DI Pietro, M, Magnani, G, Elisa, G, Barchi, E, Corsini, R, Vergori, A, Cicalini, S, Onnelli, G, Giannetti, A, Cauda, R, Ciccullo, A, La Monica, S, Vullo, V, Dettorre, G, Cavallari, E, Andreoni, M, Malagnino, V, Ceccarelli, L, Viviani, F, Sasset, L, Dentone, C, Rossetti, B, Modica, S, Borgo, V, DI Perri, G, Carcieri, C, Malena, M, Padovani, B, Luzzati, R, Centonze, S, Valentinotti, R, Galli, Laura, Parisi, Maria Rita, Poli, Andrea, Menozzi, Marianna, Fiscon, Marta, Garlassi, Elisa, Francisci, Daniela, Di Biagio, Antonio, Sterrantino, Gaetana, Fornabaio, Chiara, Degli Antoni, Anna, Angarano, Gioacchino, Fusco, Francesco Maria, D'Arminio Monforte, Antonella, Corbelli, Giulio Maria, Santoro, Maria Mercede, Zazzi, Maurizio, and Castagna, Antonella

Subjects
0301 basic medicine, medicine.medical_specialty, 4-class drug resistance, AIDS-defining event, cancer, death, non-AIDS-defining event, Population, Major Articles, Settore MED/07, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, medicine, Cumulative incidence, 030212 general & internal medicine, education, Disease burden, education.field_of_study, Proportional hazards model, business.industry, Incidence (epidemiology), Hazard ratio, 030112 virology, AcademicSubjects/MED00290, Infectious Diseases, Oncology, business, Cohort study
Abstract

BackgroundCurrently, no data are available on the burden of morbidity and mortality in people with HIV-1 (PWH) harboring a 4-class drug-resistant (4DR) virus (nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, integrase strand transfer inhibitors). The study aimed to assess the incidence of clinical events and death in this population.MethodsThis was a cohort study on PWH from the PRESTIGIO Registry with a documented 4DR virus. Burden of disease was defined as the occurrence of any new event including an AIDS-defining event (ADE) or non-AIDS-defining event (NADE) or death from any cause after 4DR evidence (baseline). Cox regression models evaluated factors associated with the risk of new clinical events/death.ResultsAmong 148 PWH followed for a median (interquartile range) of 47 (32–84) months after 4DR evidence, 38 PWH had 62 new events or died from any cause (incidence rate, 9.12/100 person-years of follow-up; 95% CI = 6.85–11.39): 12 deaths (6 AIDS-related and 6 non-AIDS-related), 18 ADEs, 32 NADEs; 20 of the 38 NADEs (45%) of the incident clinical events were malignancies. The 4-year cumulative incidence of death was 6% (95% CI, 3%–13%), and that of ≥1 event or death was 22% (95% CI, 16%–31%). A higher risk of new clinical events/death was more likely in PWH with previous clinical events (adjusted hazard ratio [aHR], 2.67; 95% CI, 1.07–6.67) and marginally associated with lower baseline CD4+/CD8+ ratio (aHR, 0.82; 95% CI, 0.65–1.02).ConclusionsPWH harboring 4DR have a high burden of disease with a worrying incidence of malignancies, strongly advising for close prevention and monitoring interventions as well as access to innovative therapeutic strategies, especially in people with a history of clinical events and low CD4+/CD8+ ratio.

Published
2020

12. Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study

Author

Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., Montravers, P., Bassetti, M., Vena, A., Giacobbe, D.R., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Brugnaro, P., Carannante, N., Peghin, M., Berruti, M., Carnelutti, A., Castaldo, N., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., García-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Lebihan, C., Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Van den Berg, C., Veber, B., Venditti, M., Voiriot, G., Wauters, J., Zappella, N., and Montravers, P.

Abstract

Contains fulltext : 249005.pdf (Publisher’s version ) (Open Access), INTRODUCTION: Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10-30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. METHODS: We performed a case-control study in 26 European ICUs during the period January 2015-December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did not develop episodes of IAC during ICU admission. Matching was performed at a ratio of 1:1 according to time at risk (i.e. controls had to have at least the same length of ICU stay as their matched cases prior to IAC onset), ICU ward and period of study. RESULTS: During the study period, 101 case patients with a diagnosis of IAC were included in the study. On univariate analysis, severe hepatic failure, prior receipt of antibiotics, prior receipt of parenteral nutrition, abdominal drain, prior bacterial infection, anastomotic leakage, recurrent gastrointestinal perforation, prior receipt of antifungal drugs and higher median number of abdominal surgical interventions were associated with IAC development. On multivariate analysis, recurrent gastrointestinal perforation (OR 13.90; 95% CI 2.65-72.82, p = 0.002), anastomotic leakage (OR 6.61; 95% CI 1.98-21.99, p = 0.002), abdominal drain (OR 6.58; 95% CI 1.73-25.06, p = 0.006), prior receipt of antifungal drugs (OR 4.26; 95% CI 1.04-17.46, p = 0.04) or antibiotics (OR 3.78; 95% CI 1.32-10.52, p = 0.01) were independently associated with IAC. CONCLUSIONS: Gastrointestinal perforation, anastomotic leakage, abdominal drain and prior receipt of antifungals or antibiotics may help to identify critically ill patients with higher probability

Published
2022

13. Non-Hodgkin’s Lymphomas in Patients with AIDS

Author

Tirelli, U., Vaccher, E., Errante, D., Crosato, I., Rezza, G., Lazzarin, A., Foà, R., Pileri, S., Carbone, A., Ambrosini, G., Andriani, A., Barberis, M., Barbui, M., Bernasconi, C., Silvestroni, I. Bianco, Borri, A., Bottinelli, G., Broccia, G., Bullian, P. L., Cajozzo, A., Cargnel, A., Cazzaniga, P., Chiodo, F., Chisesi, T., Clerici, M., Costigliola, P., Crocchiolo, P., De Lalla, F., Della Santa, M., Dessalvi, P., Fiaccadori, F., Figoli, F., Florentino, M., Franchi, M., Garavelli, P. L., Gherlinzoni, F., Gianelli, F., Giudici, M. G., Guglielmi, C., Deliliers, G. Lambertenghi, Lanza, F., Lombardi, F., Luzi, G., Luzzati, R., Malfitano, A., Malleo, C., Mandelli, F., Marangolo, M., Maringos, A., Martignoni, G., Milo, D., Montesarchio, V., Ortona, L., Palmieri, G., Parrinello, E. A., Piersantelli, N., Pizzoccaro, G., Pristerà, C., Puppo, F., Quaglino, A., Raise, E., Riccardi, A., Ricchi, E., Rizzardini, G., Rizzi, M., Rizzo, F., Rosci, A. M., Rossi, G., Sabbatani, S., Saliva, G., Salvi, G., Saracchini, S., Scalise, G., Scanni, A., Sinicco, A., Sorio, R., Squadrini, V. A., Stellini, R., Pansa, V. Stracca, Sulis, E., Surbone, A., Terragna, A., Tognetti, A., Vaglia, A., Zagni, R., Zagonel, V., Gavosto, F., Monfardini, S., Veronesi, U., editor, and Monfardini, Silvio, editor

Published
1990
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14. Prospective Study on Incidence, Risk Factors and Outcome of Recurrent Clostridioides difficile Infections

Author

Granata, G, Petrosillo, N, Adamoli, L, Bartoletti, M, Bartoloni, A, Basile, G, Bassetti, M, Bonfanti, P, Borromeo, R, Ceccarelli, G, De Luca, A, Di Bella, S, Fossati, S, Franceschini, E, Gentile, I, Giacobbe, D, Giacometti, E, Ingrassia, F, Lagi, F, Lobreglio, G, Lombardi, A, Lupo, L, Luzzati, R, Maraolo, A, Mikulska, M, Mondelli, M, Mularoni, A, Mussini, C, Oliva, A, Pandolfo, A, Rogati, C, Trapani, F, Venditti, M, Viale, P, Caraffa, E, Cataldo, M, Granata, Guido, Petrosillo, Nicola, Adamoli, Lucia, Bartoletti, Michele, Bartoloni, Alessandro, Basile, Gregorio, Bassetti, Matteo, Bonfanti, Paolo, Borromeo, Raffaella, Ceccarelli, Giancarlo, De Luca, Anna, Di Bella, Stefano, Fossati, Sara, Franceschini, Erica, Gentile, Ivan, Giacobbe, Daniele, Giacometti, Enrica, Ingrassia, Fabrizio, Lagi, Filippo, Lobreglio, Giambattista, Lombardi, Andrea, Lupo, Laura, Luzzati, Roberto, Maraolo, Alberto, Mikulska, Malgorzata, Mondelli, Mario, Mularoni, Alessandra, Mussini, Cristina, Oliva, Alessandra, Pandolfo, Alessandro, Rogati, Carlotta, Trapani, Filippo, Venditti, Mario, Viale, Pierluigi, Caraffa, Emanuela, Cataldo, Maria, Granata, G, Petrosillo, N, Adamoli, L, Bartoletti, M, Bartoloni, A, Basile, G, Bassetti, M, Bonfanti, P, Borromeo, R, Ceccarelli, G, De Luca, A, Di Bella, S, Fossati, S, Franceschini, E, Gentile, I, Giacobbe, D, Giacometti, E, Ingrassia, F, Lagi, F, Lobreglio, G, Lombardi, A, Lupo, L, Luzzati, R, Maraolo, A, Mikulska, M, Mondelli, M, Mularoni, A, Mussini, C, Oliva, A, Pandolfo, A, Rogati, C, Trapani, F, Venditti, M, Viale, P, Caraffa, E, Cataldo, M, Granata, Guido, Petrosillo, Nicola, Adamoli, Lucia, Bartoletti, Michele, Bartoloni, Alessandro, Basile, Gregorio, Bassetti, Matteo, Bonfanti, Paolo, Borromeo, Raffaella, Ceccarelli, Giancarlo, De Luca, Anna, Di Bella, Stefano, Fossati, Sara, Franceschini, Erica, Gentile, Ivan, Giacobbe, Daniele, Giacometti, Enrica, Ingrassia, Fabrizio, Lagi, Filippo, Lobreglio, Giambattista, Lombardi, Andrea, Lupo, Laura, Luzzati, Roberto, Maraolo, Alberto, Mikulska, Malgorzata, Mondelli, Mario, Mularoni, Alessandra, Mussini, Cristina, Oliva, Alessandra, Pandolfo, Alessandro, Rogati, Carlotta, Trapani, Filippo, Venditti, Mario, Viale, Pierluigi, Caraffa, Emanuela, and Cataldo, Maria

Abstract

Background: Limited and wide-ranging data are available on the recurrent Clostridioides difficile infection (rCDI) incidence rate. Methods: We performed a cohort study with the aim to assess the incidence of and risk factors for rCDI. Adult patients with a first CDI, hospitalized in 15 Italian hospitals, were prospectively included and followed-up for 30 d after the end of antimicrobial treatment for their first CDI. A case-control study was performed to identify risk factors associated with 30-day onset rCDI. Results: Three hundred nine patients with a first CDI were included in the study; 32% of the CDI episodes (99/309) were severe/complicated; complete follow-up was available for 288 patients (19 died during the first CDI episode, and 2 were lost during follow-up). At the end of the study, the crude all-cause mortality rate was 10.7% (33 deaths/309 patients). Two hundred seventy-one patients completed the follow-up; rCDI occurred in 21% of patients (56/271) with an incidence rate of 72/10,000 patient-days. Logistic regression analysis identified exposure to cephalosporin as an independent risk factor associated with rCDI (RR: 1.7; 95% CI: 1.1-2.7, p = 0.03). Conclusion: Our study confirms the relevance of rCDI in terms of morbidity and mortality and provides a reliable estimation of its incidence.

Published
2021

15. Ceftazidime-avibactam use for KPC-Kp infections: a retrospective observational multicenter study

Author

Tumbarello, M, Raffaelli, F, Giannella, M, Mantengoli, E, Mularoni, A, Venditti, M, De Rosa, F, Sarmati, L, Bassetti, M, Brindicci, G, Rossi, M, Luzzati, R, Grossi, P, Corona, A, Capone, A, Falcone, M, Mussini, C, Trecarichi, E, Cascio, A, Guffanti, E, Russo, A, De Pascale, G, Tascini, C, Gentile, I, Losito, A, Bussini, L, Conti, G, Ceccarelli, G, Corcione, S, Compagno, M, Giacobbe, D, Saracino, A, Fantoni, M, Antinori, S, Peghin, M, Bonfanti, P, Oliva, A, De Gasperi, A, Tiseo, G, Rovelli, C, Meschiari, M, Shbaklo, N, Spanu, T, Cauda, R, Viale, P, Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, Viale, Pierluigi, Tumbarello, M, Raffaelli, F, Giannella, M, Mantengoli, E, Mularoni, A, Venditti, M, De Rosa, F, Sarmati, L, Bassetti, M, Brindicci, G, Rossi, M, Luzzati, R, Grossi, P, Corona, A, Capone, A, Falcone, M, Mussini, C, Trecarichi, E, Cascio, A, Guffanti, E, Russo, A, De Pascale, G, Tascini, C, Gentile, I, Losito, A, Bussini, L, Conti, G, Ceccarelli, G, Corcione, S, Compagno, M, Giacobbe, D, Saracino, A, Fantoni, M, Antinori, S, Peghin, M, Bonfanti, P, Oliva, A, De Gasperi, A, Tiseo, G, Rovelli, C, Meschiari, M, Shbaklo, N, Spanu, T, Cauda, R, Viale, P, Tumbarello, Mario, Raffaelli, Francesca, Giannella, Maddalena, Mantengoli, Elisabetta, Mularoni, Alessandra, Venditti, Mario, De Rosa, Francesco Giuseppe, Sarmati, Loredana, Bassetti, Matteo, Brindicci, Gaetano, Rossi, Marianna, Luzzati, Roberto, Grossi, Paolo Antonio, Corona, Alberto, Capone, Alessandro, Falcone, Marco, Mussini, Cristina, Trecarichi, Enrico Maria, Cascio, Antonio, Guffanti, Elena, Russo, Alessandro, De Pascale, Gennaro, Tascini, Carlo, Gentile, Ivan, Losito, Angela Raffaella, Bussini, Linda, Conti, Giampaolo, Ceccarelli, Giancarlo, Corcione, Silvia, Compagno, Mirko, Giacobbe, Daniele Roberto, Saracino, Annalisa, Fantoni, Massimo, Antinori, Spinello, Peghin, Maddalena, Bonfanti, Paolo, Oliva, Alessandra, De Gasperi, Andrea, Tiseo, Giusy, Rovelli, Cristina, Meschiari, Marianna, Shbaklo, Nour, Spanu, Teresa, Cauda, Roberto, and Viale, Pierluigi

Abstract

Background: A growing body of observational evidence supports the value of ceftazidime-avibactam (CAZ-AVI) in managing infections caused by carbapenem-resistant Enterobacteriaceae. Methods: We retrospectively analyzed observational data on use and outcomes of CAZ-AVI therapy for infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) strains. Multivariate regression analysis was used to identify variables independently associated with 30-day mortality. Results were adjusted for propensity score for receipt of CAZ-AVI combination regimens versus CAZ-AVI monotherapy. Results: The cohort comprised 577 adults with bloodstream infections (n = 391) or nonbacteremic infections involving mainly the urinary tract, lower respiratory tract, and intra-abdominal structures. All received treatment with CAZ-AVI alone (n = 165) or with ≥1 other active antimicrobials (n = 412). The all-cause mortality rate 30 days after infection onset was 25% (146/577). There was no significant difference in mortality between patients managed with CAZ-AVI alone and those treated with combination regimens (26.1% vs 25.0%, P =. 79). In multivariate analysis, mortality was positively associated with presence at infection onset of septic shock (P =. 002), neutropenia (P <. 001), or an INCREMENT score ≥8 (P =. 01); with lower respiratory tract infection (LRTI) (P =. 04); and with CAZ-AVI dose adjustment for renal function (P =. 01). Mortality was negatively associated with CAZ-AVI administration by prolonged infusion (P =. 006). All associations remained significant after propensity score adjustment. Conclusions: CAZ-AVI is an important option for treating serious KPC-Kp infections, even when used alone. Further study is needed to explore the drug's seemingly more limited efficacy in LRTIs and potential survival benefits of prolonging CAZ-AVI infusions to ≥3 hours.

Published
2021

17. Consulenza cardiologica e gestione perioperatoria del paziente cardiopatico. Protocollo dell’Azienda Sanitaria Universitaria Integrata di Trieste – Anno 2019

Author

Massa, L., Mascaretti, L. G., Ratti, C., Zecchin, M., Perkan, A., Fabris, E., Vitrella, G., Fabro, M., Luzzati, R., Di Lenarda, A., Pelusi, L., Bergamini, P. R., Sinagra, G., Massa, L., Mascaretti, L. G., Ratti, C., Zecchin, M., Perkan, A., Fabris, E., Vitrella, G., Fabro, M., Luzzati, R., Di Lenarda, A., Pelusi, L., Bergamini, P. R., and Sinagra, G.

Subjects
Invasive procedure, Endocarditis, Antiplatelet therapy, Cardiac implantable electronic device, Anticoagulant, Anticoagulants, Invasive procedures, Cardiovascular risk, Direct oral anticoagulants, Cardiac implantable electronic devices, Surgery, Endocarditi, Direct oral anticoagulant
Abstract

La gestione dei pazienti con nota o sospetta cardiopatia, che sono ricoverati o che devono essere sottoposti ad intervento chirurgico non cardiaco o ad una procedura invasiva, è molto complessa, sia per le comorbilità spesso presenti, sia per le molteplici terapie assunte, sia perché spesso sono portatori di dispositivi cardiaci impiantabili. Scopo di questo documento è di fornire indicazioni e standardizzare i comportamenti dei vari medici nella gestione dei pazienti cardiopatici o sospetti tali, al fine di (a) gestire le acuzie cardiologiche con timing e accuratezza adeguati, e (b) definire il rischio cardiologico nel singolo paziente con tempi ed indicazioni appropriate, permettendogli di affrontare la procedura chirurgica o invasiva con il rischio più basso correlato alla presenza della cardiopatia.

Published
2019

22. Multi-Criteria Decision Analysis to prioritize hospital admission of patients affected by COVID-19 in low-resource settings with hospital-bed shortage

Author

De Nardo, Pasquale, primary, Gentilotti, Elisa, additional, Mazzaferri, Fulvia, additional, Cremonini, Eleonora, additional, Hansen, Paul, additional, Goossens, Herman, additional, Tacconelli, Evelina, additional, Durante Mangoni, E., additional, Florio, L.L., additional, Zampino, R., additional, Mele, F., additional, Gentile, I., additional, Pinchera, B., additional, Coppola, N., additional, Pisaturo, M., additional, Luzzati, R., additional, Petrosillo, N., additional, Nicastri, E., additional, Corpolongo, A., additional, Cataldo, M.A., additional, D’Abramo, A., additional, Maffongelli, G., additional, Scorzolini, L., additional, Palazzolo, C., additional, Boumis, E., additional, Pan, A., additional, D’Arminio Monforte, A., additional, Bai, F., additional, Antinori, S., additional, De Rosa, F.G., additional, Corcione, S., additional, Lupia, T., additional, Pinna, S.M., additional, Scabini, S., additional, Canta, F., additional, Belloro, S., additional, Bisoffi, Z., additional, Angheben, A., additional, Gobbi, F., additional, Turcato, E., additional, Ronzoni, N., additional, Moro, L., additional, Calabria, S., additional, Rodari, P., additional, Bertoli, G., additional, Marasca, G., additional, Puoti, M., additional, Gori, A., additional, Bandera, A., additional, Mangioni, D., additional, Rizzi, M., additional, Castelli, F., additional, Montineri, A., additional, Coco, C.A., additional, Maresca, M., additional, Frasca, M., additional, Aquilini, D., additional, Vincenzi, M., additional, Lambertenghi, L., additional, De Rui, M.E., additional, Razzaboni, E., additional, Cattaneo, P., additional, Visentin, A., additional, Erbogasto, A., additional, Dalla Vecchia, I., additional, Coledan, I., additional, Vecchi, M., additional, Be, G., additional, Motta, L., additional, Zaffagnini, A., additional, Auerbach, N., additional, Del Bravo, P., additional, Azzini, A.M., additional, Righi, E., additional, Carrara, E., additional, Savoldi, A., additional, Sibani, M., additional, Lattuada, E., additional, Carolo, G., additional, Cordioli, M., additional, Soldani, F., additional, Pezzani, M.D., additional, Avallone, S., additional, Bruno, R., additional, Ricciardi, A., additional, Saggese, M.P., additional, and Malerba, G., additional

Published
2020
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27. Incidence and outcome of invasive candidiasis in intensive care units (icus) in europe: Results of the eucandicu project

Author

Bassetti, M. Giacobbe, D.R. Vena, A. Trucchi, C. Ansaldi, F. Antonelli, M. Adamkova, V. Alicino, C. Almyroudi, M.-P. Atchade, E. Azzini, A.M. Carannante, N. Carnelutti, A. Corcione, S. Cortegiani, A. Dimopoulos, G. Dubler, S. García-Garmendia, J.L. Girardis, M. Cornely, O.A. Ianniruberto, S. Kullberg, B.J. Lagrou, K. Le Bihan, C. Luzzati, R. Malbrain, M.L.N.G. Merelli, M. Marques, A.J. Martin-Loeches, I. Mesini, A. Paiva, J.-A. Peghin, M. Raineri, S.M. Rautemaa-Richardson, R. Schouten, J. Brugnaro, P. Spapen, H. Tasioudis, P. Timsit, J.-F. Tisa, V. Tumbarello, M. Van Den Berg, C.H.S.B. Veber, B. Venditti, M. Voiriot, G. Wauters, J. Montravers, P.

Abstract

Background: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. Methods: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). Results: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. Conclusions: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions. © 2019 The Author(s).

Published
2019

30. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project

Author

Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., Montravers, P., Bassetti, M., Giacobbe, D.R., Vena, A., Trucchi, C., Ansaldi, F., Antonelli, M., Adamkova, V., Alicino, C., Almyroudi, M.P., Atchade, E., Azzini, A.M., Carannante, N., Carnelutti, A., Corcione, S., Cortegiani, A., Dimopoulos, G., Dubler, S., Garcia-Garmendia, J.L., Girardis, M., Cornely, O.A., Ianniruberto, S., Kullberg, B.J., Lagrou, K., Bihan, C. Le, Luzzati, R., Malbrain, M., Merelli, M., Marques, A.J., Martin-Loeches, I., Mesini, A., Paiva, J.A., Peghin, M., Raineri, S.M., Rautemaa-Richardson, R., Schouten, J.A., Brugnaro, P., Spapen, H., Tasioudis, P., Timsit, J.F., Tisa, V., Tumbarello, M., Berg, C. van den, Veber, B., Venditti, M., Voiriot, G., Wauters, J., and Montravers, P.

Abstract

Contains fulltext : 206779.pdf (publisher's version ) (Open Access), BACKGROUND: The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. METHODS: A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). RESULTS: During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02-1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31-8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04-1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24-3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. CONCLUSIONS: The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.

Published
2019

32. Role of fecal microbiota transplantation in inflammatory bowel disease

Author

D'Odorico, I., Di Bella, S., Monticelli, J., Giacobbe, D. R., Boldock, E., Luzzati, R., D'Odorico, Irene, Di Bella, Stefano, Monticelli, Jacopo, Giacobbe, Daniele R, Boldock, Emma, and Luzzati, Roberto

Subjects
Crohn disease, fecal microbiota transplantation, inflammatory bowel diseases, ulcerative colitis, Gastroenterology, Donor Selection, Fecal Microbiota Transplantation, Gastrointestinal Microbiome, Humans, Inflammatory Bowel Diseases, Tissue Donors, Treatment Outcome, ulcerative coliti, inflammatory bowel disease
Abstract

There is increasing evidence of the key role played by altered intestinal microbiota in the pathogenesis of inflammatory bowel disease (IBD). Management strategies involving immune modulation are effective and widely used, but treatment failures and side effects occur. Fecal microbiota transplantation (FMT) provides a novel, perhaps complementary, strategy to restore the normal gut microbiota in patients with IBD. This review summarizes the available efficacy and safety data on the use of FMT in patients with IBD. Several aspects remain to be clarified about the clinical predictors of the response to FMT, its most appropriate route of administration, and the most appropriate quantity and quality of microbiota to be transplanted. Further studies focusing on long-term outcomes and safety are also warranted.

Published
2018

38. Compassionate use of tenofovir alafenamide, coformulated with elvitegravir, cobicistat, and emtricitabine, in HIV-infected patients with renal impairment: an Italian experience

Author

Maffongelli, G., Cerva, C., Stingone, C., Plazzi, M. M., Fabbri, G., Vergori, A., Vitiello, P., Quirino, T., Rossotti, R., Danieli, E., Tau, P., Puoti, M., Gazzola, L., D’Arminio, A., Lanza, P., Castelli, F., Trizzino, M., Cascio, A., Costenaro, P., Manfrin, V., Ferretto, R., Colafigli, M., Latini, A., Cristaudo, C., Valentinotti, R., Luzzati, R., Salpietro, S., Carini, E., Castagna, A., Lazzarin, A., Di Biagio, A., Gianserra, L., Pennica, A., Rossetti, B., Modica, S., De Luca, A., Vittozzi, P., Pavone, P., Dettorre, G., Palmiero, G., Borgia, G., Nardini, G., Guaraldi, G., Mussini, C., Schiaroli, E., Baldelli, F., Lapadula, G., Pastore, V., Gori, A., La Monica, S., Cauda, R., Badia, L., Viale, P., Marino, R., Sozio, F., Parruti, G., Corsini, R., Magnani, G., Carleo, M. A., Pellicano', Giovanni Francesco, Nunnari, Giuseppe, Marinello, S., Cattelan, A. M., Trentalange, A., Marinaro, L., Bonora, S., Ferrara, S., Santantonio, T., Chirianni, A., Antinori, A., Sarmati, L., and Andreoni, M.

Published
2017

39. Erratum to: An Italian consensus for invasive candidiasis management (ITALIC) (Infection DOI: 10.1007/s15010-013-0558-0)

Author

Scudeller, L, Viscoli, C, Menichetti, F, Del Bono, V, Cristini, F, Tascini, C, Bassetti, M, Viale, P, Adembri, C, Antonelli, M, Borgonovo, G, Bruno, F.,, De Rosa, F, Emmi, V.,, Fumagalli, R, Girardis, M, Grossi, P, Luzzati, R, Malacarne, P, Pasero, D, Pelosi, P, Petrosillo, N, Sartelli, M, Sganga, G, Signorini, L, Tetamo, R, Tumbarello, M, Venditti, M, Scudeller, L., Viscoli, C., Menichetti, F., Del Bono, V., Cristini, F., Tascini, C., Bassetti, M., Viale, P., Adembri, C., Antonelli, M., Borgonovo, G., F. : Concia, De Rosa, F. G., V. : Esposito, Fumagalli, R., Girardis, M., Grossi, P. A., Luzzati, R., Malacarne, P., Pasero, D., Pelosi, P., Petrosillo, N., Sartelli, M., Sganga, G., Signorini, L., Tetamo, R., Tumbarello, M., Venditti, M., Scudeller, L, Viscoli, C, Menichetti, F, Del Bono, V, Cristini, F, Tascini, C, Bassetti, M, Viale, P, Adembri, C, Antonelli, M, Borgonovo, G, Bruno, F.,, De Rosa, F, Emmi, V.,, Fumagalli, R, Girardis, M, Grossi, P, Luzzati, R, Malacarne, P, Pasero, D, Pelosi, P, Petrosillo, N, Sartelli, M, Sganga, G, Signorini, L, Tetamo, R, Tumbarello, M, Venditti, M, Scudeller, L., Viscoli, C., Menichetti, F., Del Bono, V., Cristini, F., Tascini, C., Bassetti, M., Viale, P., Adembri, C., Antonelli, M., Borgonovo, G., F. : Concia, De Rosa, F. G., V. : Esposito, Fumagalli, R., Girardis, M., Grossi, P. A., Luzzati, R., Malacarne, P., Pasero, D., Pelosi, P., Petrosillo, N., Sartelli, M., Sganga, G., Signorini, L., Tetamo, R., Tumbarello, M., and Venditti, M.

Published
2014

40. Erratum to: An Italian consensus for invasive candidiasis management (ITALIC) (Infection DOI: 10.1007/s15010-013-0558-0)

Author

Scudeller, L., Scudeller, L, Viscoli, C, Menichetti, F, Del Bono, V, Cristini, F, Tascini, C, Bassetti, M, Viale, P, Adembri, C, Antonelli, M, Borgonovo, G, Bruno, F.,, De Rosa, F, Emmi, V.,, Fumagalli, R, Girardis, M, Grossi, P, Luzzati, R, Malacarne, P, Pasero, D, Pelosi, P, Petrosillo, N, Sartelli, M, Sganga, G, Signorini, L, Tetamo, R, Tumbarello, M, Venditti, M, Scudeller, L., Viscoli, C., Menichetti, F., Del Bono, V., Cristini, F., Tascini, C., Bassetti, M., Viale, P., Adembri, C., Antonelli, M., Borgonovo, G., F. : Concia, De Rosa, F. G., V. : Esposito, Fumagalli, R., Girardis, M., Grossi, P. A., Luzzati, R., Malacarne, P., Pasero, D., Pelosi, P., Petrosillo, N., Sartelli, M., Sganga, G., Signorini, L., Tetamo, R., Tumbarello, M., Venditti, M., Scudeller, L., Scudeller, L, Viscoli, C, Menichetti, F, Del Bono, V, Cristini, F, Tascini, C, Bassetti, M, Viale, P, Adembri, C, Antonelli, M, Borgonovo, G, Bruno, F.,, De Rosa, F, Emmi, V.,, Fumagalli, R, Girardis, M, Grossi, P, Luzzati, R, Malacarne, P, Pasero, D, Pelosi, P, Petrosillo, N, Sartelli, M, Sganga, G, Signorini, L, Tetamo, R, Tumbarello, M, Venditti, M, Scudeller, L., Viscoli, C., Menichetti, F., Del Bono, V., Cristini, F., Tascini, C., Bassetti, M., Viale, P., Adembri, C., Antonelli, M., Borgonovo, G., F. : Concia, De Rosa, F. G., V. : Esposito, Fumagalli, R., Girardis, M., Grossi, P. A., Luzzati, R., Malacarne, P., Pasero, D., Pelosi, P., Petrosillo, N., Sartelli, M., Sganga, G., Signorini, L., Tetamo, R., Tumbarello, M., and Venditti, M.

Published
2014

41. Clinical characteristics and predictors of mortality in cirrhotic patients with candidemia and intra-abdominal candidiasis: a multicenter study

Author

Bassetti, M., Peghin, M., Carnelutti, A., Righi, E., Merelli, M., Ansaldi, F., Trucchi, C., Alicino, C., Sartor, A., Toniutto, P., Wauters, J., Laleman, W., Tascini, C., Menichetti, F., Luzzati, R., Brugnaro, P., Mesini, A., Raviolo, S., De Rosa, F. G., Lagunes, L., Rello, J., Dimopoulos, G., Colombo, A. L., Nucci, M., Vena, A., Bouza, E., Munoz, P., Tumbarello, M., Losito, R., Martin-Loeches, I., Viscoli, C., Tumbarello M. (ORCID:0000-0002-9519-8552), Bassetti, M., Peghin, M., Carnelutti, A., Righi, E., Merelli, M., Ansaldi, F., Trucchi, C., Alicino, C., Sartor, A., Toniutto, P., Wauters, J., Laleman, W., Tascini, C., Menichetti, F., Luzzati, R., Brugnaro, P., Mesini, A., Raviolo, S., De Rosa, F. G., Lagunes, L., Rello, J., Dimopoulos, G., Colombo, A. L., Nucci, M., Vena, A., Bouza, E., Munoz, P., Tumbarello, M., Losito, R., Martin-Loeches, I., Viscoli, C., and Tumbarello M. (ORCID:0000-0002-9519-8552)

Abstract

Purpose: The aim of the study was to describe the characteristics of cirrhotic patients with candidemia and intra-abdominal candidiasis (IAC) and to evaluate the risk factors associated with 30-day mortality. Methods: A multicenter multinational retrospective study including all consecutive episodes of candidemia and IAC in adult patients with liver cirrhosis in 14 European hospitals during the period 2011–2013 was performed. Results: A total of 241 episodes (169 candidemia, 72 IAC) were included. Most Candida infections were acquired in hospital (208, 86.3%), mainly in the intensive care unit (ICU) (121, 50.2%). At clinical presentation, fever was seen in 60.6% of episodes (146/241) and septic shock in 34.9% (84/241). C. albicans was the most common species (found in 131 episodes, 54.4%), followed by C. glabrata (35, 14.5%) and C. parapsilosis (34, 14.1%). Overall, the 30-day mortality was 35.3%. Multivariable analysis identified candidemia (OR 2.2, 95% CI 1.2–4.5) and septic shock (OR 3.2, 95% CI 1.7–6) as independent factors associated with 30-day mortality. Adequate antifungal treatment (OR 0.4, 95% CI 0.3–0.9) was associated with survival benefit. Conclusions: A shift towards increasing prevalence of C. glabrata and C. parapsilosis species in patients with liver disease was documented. Candidemia and IAC were associated with significant mortality in cirrhotic patients. Thirty-day mortality was associated with candidemia and severe clinical presentation, whereas adequate antifungal treatment improved the prognosis.

Published
2017

42. Tick-borne encephalitis in north-east Italy: a 14-year retrospective study, January 2000 to December 2013

Author

Rezza, G, Farchi, F., Pezzotti, P., Ruscio, M., Lo Presti, A., Ciccozzi, M., Mondardini, V., Paternoster, C., Bassetti, Matteo, Merelli, M., Scotton, P. G., Luzzati, R., Simeoni, J., Mian, P., Mel, R., Carraro, V., Zanin, A., Ferretto, R., Francavilla, E., Ciufolini, Maria Grazia, Remoli, Maria Elena, Fiorentini, Cristiano, Marchi, Antonella, Fortuna, Claudia, D'Agaro, Pierlanfranco, Pedrotti, Cristina, Bassetti, Danila, Pagani, Elisabetta, Rezza, G, Farchi, F, Pezzotti, P, Ruscio, M, Presti, A. Lo, Ciccozzi, M, Mondardini, V, Paternoster, C, Bassetti, M, Merelli, M, Scotton, Pg, Luzzati, Roberto, Simeoni, J, Mian, P, Mel, R, Carraro, V, Zanin, A, Ferretto, R, Francavilla, E, TBE Virology, Group, and D'Agaro, Pierlanfranco

Subjects
Tick-Borne, Adult, Male, Veterinary medicine, tick-borne encephalitis virus, North east, Polymerase Chain Reaction, Encephalitis Viruses, Tick-Borne, Italy, epidemiology, tick-borne encephalitis, tick-borne virus, Aged, Animals, Encephalitis, Tick-Borne, Female, Humans, Incidence, Ixodes, Middle Aged, RNA, Viral, Retrospective Studies, Seasons, Sex Distribution, Epidemiology, Public Health, Environmental and Occupational Health, Virology, Altitude, medicine, Viral, Incidence (epidemiology), Environmental and Occupational Health, Tick-borne encephalitis, Retrospective cohort study, Seasonality, medicine.disease, Encephalitis Viruses, Friuli venezia giulia, Geography, Encephalitis, RNA, tick-borne encephaliti, Public Health
Abstract

Italy is considered at low incidence of tick-borne encephalitis (TBE), and the occurrence of human cases of TBE appears to be geographically restricted to the north east of the country. However, most information to date derives from case series, with no systematic data collection. To estimate incidence rates (IR) and spatial distribution of TBE cases, we conducted a retrospective study in north-eastern Italy. Data were collected through the infectious disease units and public health districts of three regions (Friuli Venezia Giulia, Trentino Alto Adige and Veneto) between 2000 and 2013. Overall, 367 cases were identified (IR: 0.38/100,000). The cases’ median age was 56 years and 257 (70%) were male. Central nervous system involvement was reported in 307 cases (84%). Annual fluctuations in case numbers occurred, with peaks in 2006 and in 2013, when 44 and 42 cases were respectively observed. A strong seasonality effect was noted, with the highest number of cases in July. In terms of geographical location, three main endemic foci with high TBE IR (> 10/100,000) were identified in three provinces, namely Belluno (Veneto region), Udine (Friuli Venezia Giulia) and Trento (Trentino Alto-Adige). When investigating the whole study area in terms of altitude, the IR between 400 and 600 m was greater (2.41/100,000) than at other altitudes (p< 0.01). In conclusion, the incidence of TBE in Italy is relatively low, even considering only the three known affected regions. However, three endemic foci at high risk were identified. In these areas, where the risk of TBEV infection is likely high, more active offer of TBE vaccination could be considered.

Published
2015

43. Simit Epidemiological Multicentric Study on Hospitalized Immigrants in Italy During 2002

Author

Scotto, G., Saracino, A., Pempinello, R., El Hamad, I., Geraci, S., Panunzio, M., Palumbo, Ernesto, Cibelli, D. C., Angarano, G., Quirino, T., Vigevani, G. M., Balducci, M., Petrelli, E., Bergamasco, A., Cadeo, G., Elhamad, I., Carosi, G., Vitucci, N., Gobbi, M., Allegri, M. P., Toti, M., Piretti, B., De Stefano, C., Mannozzi, P., Mastropietro, C., Paffetti, A., Losappio, R., Fontana, T., Sfara, C., Stagni, G., Salome, G., Soscia, F., Maggi, P., Pastore, G., Miccolis, S., Scalzini, A., Brogi, A., Renda, V., Lancella, L., Ticca, F., Gabbati, A., Mazzotta, A., Villa, M., Viganò, P., Salatino, A., Andreoni, M., Drenaggi, D., Scalise, G., Ciardi, M., D'Elia, S., Limodio, M., Gallo, A. I., Delia, S., Caltabiano, E., Cosentino, G., Raspaglieli, M., Di Gregorio, P., Mariani, R., Paolini, M., Sabbatani, S., Chiodo, F., Casabianca, A., Biglino, A., Galloni, D., Carnevale, G., Pantaleoni, M., Ghinelli, F., Purificato, F., Pompei, A. G., Portelli, V., Chasseur, R., Tassara, A., Benenat, B., Sapienza, M., Sabatini, P., Sabusco, G., Bellardini, G., Zauli, T., Valencic, A., Luzzati, R., Milini, P., Chiodera, A., Sebbia, F., Davi', A., Pizzigallo, E., Scerbo, P., Ferraro, T., Consorte, A., Mariani Toro, G., Gioia, M., Grossi, P., Coviello, G., Sagnelli, E., Azzimi, A., Concia, A., Allegra, M., and Todaro, Gianmarco

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Tuberculosis, Adolescent, Epidemiology, HIV Infections, infectious diseases, Communicable Diseases, Article, Hepatitis, HIV, Hospitalization, Immigration, Infectious diseases, Female, Humans, Italy, Middle Aged, Multicenter Studies as Topic, Poverty, Surveys and Questionnaires, Emigration and Immigration, Public Health, Environmental and Occupational Health, medicine, business.industry, Public health, Environmental and Occupational Health, medicine.disease, Country of origin, tuberculosis, Infectious disease (medical specialty), Immunology, Public Health, business, Viral hepatitis, Malaria, immigration
Abstract

The aim of this article is to retrospectively evaluate the patient characteristics and the most common infectious diseases in immigrant patients hospitalized in 46 Italian infectious disease clinics during 2002. The main Italian infectious disease clinics were invited to fill in a questionnaire that regarded the number and type of hospital admissions, the country of origin, and demographic features (age, sex, and resident state) of immigrants. A total of 46 clinics including 2255 patients participated in the study. Most patients were men (63%) with an age between 16 and 40 years (63.4%) covered by the National Health Service (71%) and coming from Africa (44.3%). The main infectious diseases observed were: 378 (16.76%) cases of HIV infection, 303 (13.43%) cases of tuberculosis diseases, 282 (12.5%) cases of various forms of viral hepatitis, 177 (7.84%) cases of respiratory diseases, and 196 (8.69%) gastrointestinal diseases. Tropical diseases found were 134 (5.94%) including 95 cases of malaria (70.9%). In conclusion, a broad range of diseases was noted in immigrants which were directly correlated with conditions of poverty. Only a few tropical diseases were diagnosed and therefore the immigrant should not be considered as an infectious disease carrier.

Published
2005

44. Predictors of choice of initial antifungal treatment in intraabdominal candidiasis.

Author

Universitat Rovira i Virgili, Lagunes L, Borgatta B, Martín-Gomez MT, Rey-Pérez A, Antonelli M, Righi E, Merelli M, Brugnaro P, Dimopoulos G, Garnacho-Montero J, Colombo AL, Luzzati R, Menichetti F, Muñoz P, Nucci M, Scotton G, Viscoli C, Tumbarello M, Bassetti M, Rello J, IAC Study Investigators, Universitat Rovira i Virgili, and Lagunes L, Borgatta B, Martín-Gomez MT, Rey-Pérez A, Antonelli M, Righi E, Merelli M, Brugnaro P, Dimopoulos G, Garnacho-Montero J, Colombo AL, Luzzati R, Menichetti F, Muñoz P, Nucci M, Scotton G, Viscoli C, Tumbarello M, Bassetti M, Rello J, IAC Study Investigators

Abstract

Intraabdominal candidiasis (IAC) is the second most frequent form of invasive candidiasis, and is associated with high mortality rates. This study aims to identify current practices in initial antifungal treatment (IAT) in a real-world scenario and to define the predictors of the choice of echinocandins or azoles in IAC episodes. Secondary analysis was performed of a multinational retrospective cohort at 13 teaching hospitals in four countries (Italy, Greece, Spain and Brazil), over a 3-year period (2011-2013). IAC was identified in 481 patients, 323 of whom received antifungal therapy (classified as the treatment group). After excluding 13 patients given amphotericin B, the treatment group was further divided into the echinocandin group (209 patients; 64.7%) and the azole group (101 patients; 323%). Median APACHE II scores were significantly higher in the echinocandin group (p 0.013), but IAT did not differ significantly with regard to the Candida species involved. Logistic multivariate stepwise regression analysis, adjusted for centre effect, identified septic shock (adjusted OR (aOR) 1.54), APACHE II >15 (aOR 1.16) and presence in surgical ward at diagnosis (aOR 1.16) as the top three independent variables associated with an empirical echinocandin regimen. No differences in 30-day mortality were observed between groups. Echinocandin regimen was the first choice for IAT in patients with IAC. No statistical differences in mortality were observed between regimens, but echinocandins were administered to patients with more severe disease. Some disagreements were identified between current clinical guidelines and prescription of antifungals for IAC at the bedside, so further educational measures are required to optimize therapies. L. Lagunes, (C) 2016 European Society of C

Published
2016

45. Predictors of choice of initial antifungal treatment in intraabdominal candidiasis

Author

Lagunes, L., Borgatta, B., Martín-Gomez, M. T., Rey-Pérez, A., Antonelli, M. (ORCID:0000-0003-3007-1670), Righi, E., Merelli, M., Brugnaro, P., Dimopoulos, G., Garnacho-Montero, J., Colombo, A. L., Luzzati, R., Menichetti, F., Muñoz Tavira, P., Nucci, M., Scotton, G., Viscoli, C., Tumbarello, M. (ORCID:0000-0002-9519-8552), Bassetti, M., Rello, J., Ansaldi, F., Scarparo, C., Diaz-Martin, A., Palacios-Garcia, I., Rosin, C., Almirante, B., Baldin, G., Vena, A., Bouza, E., de Egea, V., Tascini, C., Tagliaferri, E., Sanguinetti, M. (ORCID:0000-0002-9780-7059), Mesini, A., Sganga, G. (ORCID:0000-0001-5079-0395), Busetti, M., Pumarola, T., Martin, M. T., Nouér, S. A., Pelaez, T., Raise, E., Grandesso, S., Del Bono, V., Esteves, P., Trucchi, C., Sartor, A., De Pascale, G., Posteraro, B. (ORCID:0000-0002-1663-7546), Lagunes, L., Borgatta, B., Martín-Gomez, M. T., Rey-Pérez, A., Antonelli, M. (ORCID:0000-0003-3007-1670), Righi, E., Merelli, M., Brugnaro, P., Dimopoulos, G., Garnacho-Montero, J., Colombo, A. L., Luzzati, R., Menichetti, F., Muñoz Tavira, P., Nucci, M., Scotton, G., Viscoli, C., Tumbarello, M. (ORCID:0000-0002-9519-8552), Bassetti, M., Rello, J., Ansaldi, F., Scarparo, C., Diaz-Martin, A., Palacios-Garcia, I., Rosin, C., Almirante, B., Baldin, G., Vena, A., Bouza, E., de Egea, V., Tascini, C., Tagliaferri, E., Sanguinetti, M. (ORCID:0000-0002-9780-7059), Mesini, A., Sganga, G. (ORCID:0000-0001-5079-0395), Busetti, M., Pumarola, T., Martin, M. T., Nouér, S. A., Pelaez, T., Raise, E., Grandesso, S., Del Bono, V., Esteves, P., Trucchi, C., Sartor, A., De Pascale, G., and Posteraro, B. (ORCID:0000-0002-1663-7546)

Abstract

Intraabdominal candidiasis (IAC) is the second most frequent form of invasive candidiasis, and is associated with high mortality rates. This study aims to identify current practices in initial antifungal treatment (IAT) in a real-world scenario and to define the predictors of the choice of echinocandins or azoles in IAC episodes. Secondary analysis was performed of a multinational retrospective cohort at 13 teaching hospitals in four countries (Italy, Greece, Spain and Brazil), over a 3-year period (2011–2013). IAC was identified in 481 patients, 323 of whom received antifungal therapy (classified as the treatment group). After excluding 13 patients given amphotericin B, the treatment group was further divided into the echinocandin group (209 patients; 64.7%) and the azole group (101 patients; 32.3%). Median APACHE II scores were significantly higher in the echinocandin group (p 0.013), but IAT did not differ significantly with regard to the Candida species involved. Logistic multivariate stepwise regression analysis, adjusted for centre effect, identified septic shock (adjusted OR (aOR) 1.54), APACHE II >15 (aOR 1.16) and presence in surgical ward at diagnosis (aOR 1.16) as the top three independent variables associated with an empirical echinocandin regimen. No differences in 30-day mortality were observed between groups. Echinocandin regimen was the first choice for IAT in patients with IAC. No statistical differences in mortality were observed between regimens, but echinocandins were administered to patients with more severe disease. Some disagreements were identified between current clinical guidelines and prescription of antifungals for IAC at the bedside, so further educational measures are required to optimize therapies.

Published
2016

46. Predictors of choice of initial antifungal treatment in intraabdominal candidiasis

Author

Lagunes, L, Borgatta, B, Martín Gomez, M. T, Rey Pérez, A, Antonelli, Massimo, Righi, E, Merelli, M, Brugnaro, P, Dimopoulos, G, Garnacho Montero, J, Colombo, A. L, Luzzati, R, Menichetti, F, Muñoz, P, Nucci, M, Scotton, G, Viscoli, C, Tumbarello, Mario, Bassetti, M, Rello, J., Antonelli, Massimo (ORCID:0000-0003-3007-1670), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Lagunes, L, Borgatta, B, Martín Gomez, M. T, Rey Pérez, A, Antonelli, Massimo, Righi, E, Merelli, M, Brugnaro, P, Dimopoulos, G, Garnacho Montero, J, Colombo, A. L, Luzzati, R, Menichetti, F, Muñoz, P, Nucci, M, Scotton, G, Viscoli, C, Tumbarello, Mario, Bassetti, M, Rello, J., Antonelli, Massimo (ORCID:0000-0003-3007-1670), and Tumbarello, Mario (ORCID:0000-0002-9519-8552)

Abstract

Intraabdominal candidiasis (IAC) is the second most frequent form of invasive candidiasis, and is associated with high mortality rates. This study aims to identify current practices in initial antifungal treatment (IAT) in a real-world scenario and to define the predictors of the choice of echinocandins or azoles in IAC episodes. Secondary analysis was performed of a multinational retrospective cohort at 13 teaching hospitals in four countries (Italy, Greece, Spain and Brazil), over a 3-year period (2011-2013). IAC was identified in 481 patients, 323 of whom received antifungal therapy (classified as the treatment group). After excluding 13 patients given amphotericin B, the treatment group was further divided into the echinocandin group (209 patients; 64.7%) and the azole group (101 patients; 32.3%). Median APACHE II scores were significantly higher in the echinocandin group (p 0.013), but IAT did not differ significantly with regard to the Candida species involved. Logistic multivariate stepwise regression analysis, adjusted for centre effect, identified septic shock (adjusted OR (aOR) 1.54), APACHE II >15 (aOR 1.16) and presence in surgical ward at diagnosis (aOR 1.16) as the top three independent variables associated with an empirical echinocandin regimen. No differences in 30-day mortality were observed between groups. Echinocandin regimen was the first choice for IAT in patients with IAC. No statistical differences in mortality were observed between regimens, but echinocandins were administered to patients with more severe disease. Some disagreements were identified between current clinical guidelines and prescription of antifungals for IAC at the bedside, so further educational measures are required to optimize therapies.

Published
2016

47. Erratum to: A multicenter study of septic shock due to candidemia: Outcomes and predictors of mortality (Intensive Care Medicine (2014) 40, (839-845) DOI: 10.1007/s00134-014-3310-z)

Author

Bassetti, M., Righi, E., Ansaldi, F., Merelli, M., Trucchi, C., De Pascale, G., Diaz-Martin, A., Luzzati, R., Rosin, C., Lagunes, L., Trecarichi, E. M., Sanguinetti, M., Posteraro, B., Garnacho-Montero, J., Sartor, A., Rello, J., Rocca, G. D., Antonelli, M., and Tumbarello, M.

Subjects
erratum
Published
2014

48. Predictors of choice of initial antifungal treatment in intraabdominal candidiasis

Author

Lagunes, L., primary, Borgatta, B., additional, Martín-Gomez, M.T., additional, Rey-Pérez, A., additional, Antonelli, M., additional, Righi, E., additional, Merelli, M., additional, Brugnaro, P., additional, Dimopoulos, G., additional, Garnacho-Montero, J., additional, Colombo, A.L., additional, Luzzati, R., additional, Menichetti, F., additional, Muñoz, P., additional, Nucci, M., additional, Scotton, G., additional, Viscoli, C., additional, Tumbarello, M., additional, Bassetti, M., additional, Rello, J., additional, Ansaldi, F., additional, Scarparo, C., additional, Diaz-Martin, A., additional, Palacios-Garcia, I., additional, Rosin, C., additional, Almirante, B., additional, Baldin, G., additional, Vena, A., additional, Bouza, E., additional, de Egea, V., additional, Tascini, C., additional, Tagliaferri, E., additional, Sanguinetti, M., additional, Mesini, A., additional, Sganga, G., additional, Busetti, M., additional, Pumarola, T., additional, Martin, M.T., additional, Nouér, S.A., additional, Pelaez, T., additional, Raise, E., additional, Grandesso, S., additional, Del Bono, V., additional, Esteves, P., additional, Trucchi, C., additional, Sartor, A., additional, De Pascale, G., additional, and Posteraro, B., additional

Published
2016
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49. A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality

Author

Bassetti, M, Righi, E, Ansaldi, F, Merelli, M, Scarparo, C, Antonelli, Massimo, Garnacho Montero, J, Diaz Martin, A, Palacios Garcia, I, Luzzati, R, Rosin, C, Lagunes, L, Rello, J, Almirante, B, Scotton, Pg, Baldin, G, Dimopoulos, G, Nucci, M, Munoz, P, Vena, A, Bouza, E, De Egea, V, Colombo, Al, Tascini, C, Menichetti, F, Tagliaferri, E, Brugnaro, P, Sanguinetti, Maurizio, Mesini, A, Sganga, Gabriele, Viscoli, C, Tumbarello, Mario, Antonelli, Massimo (ORCID:0000-0003-3007-1670), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Sganga, Gabriele (ORCID:0000-0001-5079-0395), Tumbarello, Mario (ORCID:0000-0002-9519-8552), Bassetti, M, Righi, E, Ansaldi, F, Merelli, M, Scarparo, C, Antonelli, Massimo, Garnacho Montero, J, Diaz Martin, A, Palacios Garcia, I, Luzzati, R, Rosin, C, Lagunes, L, Rello, J, Almirante, B, Scotton, Pg, Baldin, G, Dimopoulos, G, Nucci, M, Munoz, P, Vena, A, Bouza, E, De Egea, V, Colombo, Al, Tascini, C, Menichetti, F, Tagliaferri, E, Brugnaro, P, Sanguinetti, Maurizio, Mesini, A, Sganga, Gabriele, Viscoli, C, Tumbarello, Mario, Antonelli, Massimo (ORCID:0000-0003-3007-1670), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Sganga, Gabriele (ORCID:0000-0001-5079-0395), and Tumbarello, Mario (ORCID:0000-0002-9519-8552)

Abstract

Clinical data on patients with intra-abdominal candidiasis (IAC) is still scarce.

Published
2015

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