Author: "Posteraro B. (ORCID:0000-0002-1663-7546)" - Searchworks@Jio Institute Digital Library Search Results

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81 results on '"Posteraro B. (ORCID:0000-0002-1663-7546)"'

1. Curcumin-Functionalized Graphene Oxide Strongly Prevents Candida parapsilosis Adhesion and Biofilm Formation

Author: Cacaci, Margherita, Squitieri, Damiano, Palmieri, Valentina, Torelli, Riccardo, Perini, Giordano, Campolo, M, Di Vito, Maura, Papi, Massimiliano, Posteraro, Brunella, Sanguinetti, Maurizio, Bugli, Francesca, Cacaci, M (ORCID:0000-0002-5433-9400), Squitieri, D, Palmieri, V, Torelli, R, Perini, G (ORCID:0000-0001-9452-8479), Di Vito, M (ORCID:0000-0002-2991-0855), Papi, M (ORCID:0000-0002-0029-1309), Posteraro, B (ORCID:0000-0002-1663-7546), Sanguinetti, M (ORCID:0000-0002-9780-7059), Bugli, F (ORCID:0000-0001-9038-3233), Cacaci, Margherita, Squitieri, Damiano, Palmieri, Valentina, Torelli, Riccardo, Perini, Giordano, Campolo, M, Di Vito, Maura, Papi, Massimiliano, Posteraro, Brunella, Sanguinetti, Maurizio, Bugli, Francesca, Cacaci, M (ORCID:0000-0002-5433-9400), Squitieri, D, Palmieri, V, Torelli, R, Perini, G (ORCID:0000-0001-9452-8479), Di Vito, M (ORCID:0000-0002-2991-0855), Papi, M (ORCID:0000-0002-0029-1309), Posteraro, B (ORCID:0000-0002-1663-7546), Sanguinetti, M (ORCID:0000-0002-9780-7059), and Bugli, F (ORCID:0000-0001-9038-3233)
Abstract: Candida parapsilosis is the major non-C. albicans species involved in the colonization of central venous catheters, causing bloodstream infections. Biofilm formation on medical devices is considered one of the main causes of healthcare-associated infections and represents a global public health problem. In this context, the development of new nanomaterials that exhibit anti-adhesive and anti-biofilm properties for the coating of medical devices is crucial. In this work, we aimed to characterize the antimicrobial activity of two different coated-surfaces, graphene oxide (GO) and curcumin-graphene oxide (GO/CU) for the first time, against C. parapsilosis. We report the capacity of GO to bind and stabilize CU molecules, realizing a homogenous coated surface. We tested the anti-planktonic activity of GO and GO/CU by growth curve analysis and quantification of Reactive Oxigen Species( ROS) production. Then, we tested the antibiofilm activity by adhesion assay, crystal violet assay, and live and dead assay; moreover, the inhibition of the formation of a mature biofilm was investigated by a viability test and the use of specific dyes for the visualization of the cells and the extra-polymeric substances. Our data report that GO/CU has anti-planktonic, anti-adhesive, and anti-biofilm properties, showing a 72% cell viability reduction and a decrease of 85% in the secretion of extra-cellular substances (EPS) after 72 h of incubation. In conclusion, we show that the GO/CU conjugate is a promising material for the development of medical devices that are refractory to microbial colonization, thus leading to a decrease in the impact of biofilm-related infections.
Published: 2023

2. Multiplex PCR Detection of Respiratory Tract Infections in SARS-CoV-2-Negative Patients Admitted to the Emergency Department: an International Multicenter Study during the COVID-19 Pandemic

Author: Duclos, M., Hommel, B., Allantaz, F., Powell, M., Posteraro, Brunella, Sanguinetti, Maurizio, Habous, M., Dabal, L., Kilercik, M., Uyar, N. Y., Bozdayi, G., Caglar, K., Otlu, B., Yakupogullari, Y., Karalti, I., Tagiyev, B., Almaghrabi, R. S., Althawadi, S., Qasem, M. G., Alzahrani, A., Streinu-Cercel, A., Schvoerer, E., Hartard, C., Thibault, V., Pronier, C., Henquell, C., Brebion, A., Pillet, S., Labetoulle, R., Silke, P., Ganzenmueller, T., Schmauder, K., Munoz, P., Albizua, A. B., Kabera, B., Maranga, J., Wolter, N., Du Plessis, M., Famoroti, T., Wadula, J., Nunes, M. C., Rashed, H. G., Elkholy, M. M., Yahia, M. B., Elfattah, N. A., Ferjani, A., Boutiba-Ben, I., Hamammi, A., Hakim, H. K., Gdoura, M., Henda, T., Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Duclos, M., Hommel, B., Allantaz, F., Powell, M., Posteraro, Brunella, Sanguinetti, Maurizio, Habous, M., Dabal, L., Kilercik, M., Uyar, N. Y., Bozdayi, G., Caglar, K., Otlu, B., Yakupogullari, Y., Karalti, I., Tagiyev, B., Almaghrabi, R. S., Althawadi, S., Qasem, M. G., Alzahrani, A., Streinu-Cercel, A., Schvoerer, E., Hartard, C., Thibault, V., Pronier, C., Henquell, C., Brebion, A., Pillet, S., Labetoulle, R., Silke, P., Ganzenmueller, T., Schmauder, K., Munoz, P., Albizua, A. B., Kabera, B., Maranga, J., Wolter, N., Du Plessis, M., Famoroti, T., Wadula, J., Nunes, M. C., Rashed, H. G., Elkholy, M. M., Yahia, M. B., Elfattah, N. A., Ferjani, A., Boutiba-Ben, I., Hamammi, A., Hakim, H. K., Gdoura, M., Henda, T., Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: Respiratory tract infection (RTI) is a common cause of visits to the hospital emergency department. During the ongoing coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), nonpharmaceutical intervention has influenced the rates of circulating respiratory viruses. In this study, we sought to detect RTI etiological agents other than SARS-CoV-2 in emergency department patients from 13 countries in Europe, the Middle East, and Africa from December 2020 to March 2021. We sought to measure the impact of patient characteristics and national-level behavioral restrictions on the positivity rate for RTI agents. Using the BioFire Respiratory Panel 2.0 Plus, 1,334 nasopharyngeal swabs from patients with RTI symptoms who were negative for SARS-CoV-2 were tested. The rate of positivity for viral or bacterial targets was 36.3%. Regarding viral targets, human rhinovirus or enterovirus was the most prevalent (56.5%), followed by human coronaviruses (11.0%) and adenoviruses (9.9%). Interestingly, age stratification showed that the positivity rate was significantly higher in the children's group than in the adults' group (68.8% versus 28.2%). In particular, human rhinovirus or enterovirus, the respiratory syncytial virus, and other viruses, such as the human metapneumovirus, were more frequently detected in children than in adults. A logistic regression model was also used to determine an association between the rate of positivity for viral agents with each country's behavioral restrictions or with patients' age and sex. Despite the impact of behavioral restrictions, various RTI pathogens were actively circulating, particularly in children, across the 13 countries.
Published: 2022

3. Rapid Detection of the Omicron (B.1.1.529) SARS-CoV-2 Variant Using a COVID-19 Diagnostic PCR Assay

Author: Ippoliti, Chiara, De Maio, Flavio, Santarelli, Giulia, Marchetti, Simona, Vella, Antonietta, Santangelo, Rosaria, Sanguinetti, Maurizio, Posteraro, Brunella, Ippoliti C., De Maio F., Santarelli G., Marchetti S., Vella A., Santangelo R. (ORCID:0000-0002-8056-218X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Ippoliti, Chiara, De Maio, Flavio, Santarelli, Giulia, Marchetti, Simona, Vella, Antonietta, Santangelo, Rosaria, Sanguinetti, Maurizio, Posteraro, Brunella, Ippoliti C., De Maio F., Santarelli G., Marchetti S., Vella A., Santangelo R. (ORCID:0000-0002-8056-218X), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: The Omicron (B.1.1.529) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the last variant of concern (VOC) identified to date. Compared to whole-genome or gene-specific sequencing methods, reverse-transcription PCR assays may be a simpler approach to study VOCs. We used a point-of-care COVID-19 diagnostic PCR assay to detect the Omicron SARS-CoV-2 variant in the respiratory tract samples of COVID-19 patients who had tested positive for SARS-CoV-2 RNA between April 2021 and January 2022. Sequencing analyses had shown that 87 samples were positive for the Omicron variant and 43 samples were positive for a non-Omicron variant (Delta, 18 samples; Alpha, 13 samples; Gamma, 10 samples; Beta, 1 sample; or Epsilon, 1 sample). According to results by the PCR assay, whose primers anneal a nucleocapsid (N) gene region that comprises the E31/R32/S33 deletion (also termed the del31/33 mutation), we found that N gene target failure/dropout (i.e., a negative/low result) occurred in 86 (98.8%) of 87 Omicron variant-positive samples tested. These results were assessed in relation to those of the spike (S) gene, which expectedly, was detected in all (100%) 130 samples. A total of 43 (100%) of 43 Delta, Alpha, Gamma, Beta, or Epsilon variant-positive samples had a positive result with the N gene. Importantly, in 86 of 87 Omicron variant-positive samples, the del31/33 mutation was detected together with a P13L mutation, which was, instead, detected alone in the Omicron variant-positive sample that had a positive N-gene result. IMPORTANCE Rapid detection of the Omicron SARS-CoV-2 variant in patients’ respiratory tract samples may influence therapeutic choices, because this variant is known to escape from certain monoclonal antibodies. Our findings strengthen the importance of manufacturers’ efforts to improve the existing COVID-19 diagnostic PCR assays and/or to develop novel variant-specific PCR assays. Furthermore, our findings show that only a small fraction
Published: 2022

4. Two-Period Study Results from a Large Italian Hospital Laboratory Attesting SARS-CoV-2 Variant PCR Assay Evolution

Author: Liotti, Flora Marzia, De Maio, Flavio, Ippoliti, Chiara, Santarelli, Giulia, Monzo, F. R., Sali, Michela, Santangelo, Rosaria, Ceccherini-Silberstein, F., Sanguinetti, Maurizio, Posteraro, Brunella, Liotti F. M., De Maio F., Ippoliti C., Santarelli G., Sali M. (ORCID:0000-0003-3609-2990), Santangelo R. (ORCID:0000-0002-8056-218X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Liotti, Flora Marzia, De Maio, Flavio, Ippoliti, Chiara, Santarelli, Giulia, Monzo, F. R., Sali, Michela, Santangelo, Rosaria, Ceccherini-Silberstein, F., Sanguinetti, Maurizio, Posteraro, Brunella, Liotti F. M., De Maio F., Ippoliti C., Santarelli G., Sali M. (ORCID:0000-0003-3609-2990), Santangelo R. (ORCID:0000-0002-8056-218X), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: In keeping with the evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the COVID-19 causative agent, PCR assays have been developed to rapidly detect SARS-CoV-2 variants, which have emerged since the first (Alpha) variant was identified. Based on specific assortment of SARS-CoV-2 spike-protein mutations (DH69/V70, E484K, N501Y, W152C, L452R, K417N, and K417T) among the major variants known to date, Seegene Allplex SARS-CoV-2 Variants I and Variants II assays have been available since a few months before the last (Omicron) variant became predominant. Using S gene next-generation sequencing (NGS) as the SARS-CoV-2 variant identification reference method, we assessed the results of SARS-CoV-2-positive nasopharyngeal swab samples from two testing periods, before (n = 288, using only Variants I) and after (n = 77, using both Variants I and Variants II) the appearance of Omicron. The Variants I assay allowed correct identification for Alpha (37/37), Beta/Gamma (28/ 30), or Delta (220/221) variant-positive samples. The combination of the Variants I and Variants II assays allowed correct identification for 61/77 Omicron variant-positive samples. While 16 samples had the K417N mutation undetected with the Variants II assay, 74/77 samples had both DH69/V70 and N501Y mutations detected with the Variants I assay. If considering only the results by the Variants I assay, 6 (2 Beta variant positive, 1 Delta variant positive, and 3 Omicron variant positive) of 365 samples tested in total provided incorrect identification. We showed that the Variants I assay alone might be more suitable than both the Variants I and Variants II assays to identify currently circulating SARS-CoV-2 variants. Inclusion of additional variant-specific mutations should be expected in the development of future assays.
Published: 2022

5. SARS-CoV-2 Antigen Test Results to Infer Active or Non-Active Virus Replication Status in COVID-19 Patients

Author: De Angelis, Giulia, Menchinelli, Giulia, Liotti, Flora Marzia, Marchetti, Simona, Salustri, Alessandro, Vella, Antonietta, Santangelo, Rosaria, Posteraro, Brunella, Sanguinetti, Maurizio, De Angelis G. (ORCID:0000-0002-7087-7399), Menchinelli G., Liotti F. M., Marchetti S., Salustri A., Vella A., Santangelo R. (ORCID:0000-0002-8056-218X), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), De Angelis, Giulia, Menchinelli, Giulia, Liotti, Flora Marzia, Marchetti, Simona, Salustri, Alessandro, Vella, Antonietta, Santangelo, Rosaria, Posteraro, Brunella, Sanguinetti, Maurizio, De Angelis G. (ORCID:0000-0002-7087-7399), Menchinelli G., Liotti F. M., Marchetti S., Salustri A., Vella A., Santangelo R. (ORCID:0000-0002-8056-218X), Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: We used nasopharyngeal swab samples of patients with a symptomatic (n = 82) or asymp-tomatic (n = 20) coronavirus disease 2019 (COVID-19) diagnosis to assess the ability of antigen detection tests to infer active (potentially transmissible) or inactive (potentially non-transmissible) infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Using the subgenomic RNA (sgRNA) as an active replication marker of SARS-CoV-2, 48 (76.2%), 56 (88.9%), and 63 (100%) of 63 samples with sgRNA positive results tested positive with the SD BIOSENSOR STANDARD Q COVID-19 Ag (Standard Q), the SD BIOSENSOR STANDARD F COVID-19 Ag FIA (Standard F), or the Fujirebio LUMIPULSE G SARS-CoV-2 Ag (Lumipulse) assay, respectively. Conversely, 37 (94.9%), 29 (74.4%), and 7 (17.9%) of 39 samples with sgRNA negative results tested negative with Standard Q, Standard F, or Lumipulse, respectively. Stratifying results by the number of days of symptoms before testing revealed that most antigen positive/sgRNA positive results were among samples tested at 2–7 days regardless of the assay used. Conversely, most antigen negative/sgRNA negative results were among samples tested at 16–30 days only when Standard Q or Standard F were used. In conclusion, based on our findings, a negative antigen test, especially with the Lumipulse assay, or a positive antigen test, especially with the Standard F assay, may suggest, respectively, the absence or presence of replication-competent SARS-CoV-2.
Published: 2022

6. Fatigue in Covid-19 survivors: The potential impact of a nutritional supplement on muscle strength and function

Author: Galluzzo, Vincenzo, Zazzara, Maria Beatrice, Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, G., Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, F., Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, M., Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, L., Di Giorgio, A., Nesci, A., Popolla, Valentina, Galluzzo V., Zazzara M. B., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Tupputi S., Cocchi C., Pirone F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), Popolla V., Galluzzo, Vincenzo, Zazzara, Maria Beatrice, Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, G., Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, F., Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, M., Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, L., Di Giorgio, A., Nesci, A., Popolla, Valentina, Galluzzo V., Zazzara M. B., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Tupputi S., Cocchi C., Pirone F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), and Popolla V.
Abstract: Background: Fatigue with reduced tolerance to exercise is a common persistent long-lasting feature amongst COVID-19 survivors. The assessment of muscle function in this category of patients is often neglected.Aim.: To evaluate the potential impact of a daily supplementation based on amino acids, minerals, vi-tamins, and plant extracts (Apportal (R)) on muscle function, body composition, laboratory parameters and self-rated health in a small group of COVID-19 survivors affected by fatigue.Methods: Thirty participants were enrolled among patients affected by physical fatigue during or after acute COVID-19 and admitted to the post-COVID-19 outpatient service at Fondazione Policlinico Gemelli in Rome between 1st March 2021 and 30th April 2021. All participants were evaluated at first visit (t0) and at control visit (t1), after taking a daily sachet of Apportal (R) for 28 days. Muscle function was analyzed using hand grip strength test, exhaustion strength time and the number of repetitions at one -minute chair stand test. Body composition was assessed with bioelectrical impedance analysis (BIA). Laboratory parameters, including standard blood biochemistry and ferritin levels, were evaluated at the first visit and during the control visit. A quick evaluation of self-rated health, before COVID-19, at t0 and t1, was obtained through a visual analogue scale (VAS). Results: Participants aged 60 years and older were 13 (43%). Females represented the 70% of the study sample. Participants hospitalized for COVID-19 with low -flow oxygen supplementation represented the 43.3% of the study sample while 3.3% received noninvasive ventilation (NIV) or invasive ventilation. Hand grip strength improved from 26.3 Kg to 28.9 Kg (p < 0.05) at t1 as compared to t0. The mean time of strength exhaustion increased from 31.7 s (sec) at t0 to 47.5 s at t1 (p < 0.05). Participants performed a higher number of repetitions (28.3 vs. 22.0; p < 0.05) during the one-minute chair stand test at
Published: 2022

7. Fatigue in Covid-19 survivors: The potential impact of a nutritional supplement on muscle strength and function

Author: Galluzzo, Vincenzo, Zazzara, M. B., Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, Giovanni, Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, Federica, Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, Leonardo, Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, Michela, Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, Francesco, Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, Luca, Di Giorgio, Angela, Nesci, Antonio, Popolla, Valentina, Galluzzo V., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Spaziani G., Tupputi S., Cocchi C., Pirone F., D'Ignazio F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Stella L., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Sali M. (ORCID:0000-0003-3609-2990), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Di Giorgio A., Nesci A., Popolla V., Galluzzo, Vincenzo, Zazzara, M. B., Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, Giovanni, Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, Federica, Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, Leonardo, Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, Michela, Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, Francesco, Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, Luca, Di Giorgio, Angela, Nesci, Antonio, Popolla, Valentina, Galluzzo V., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Spaziani G., Tupputi S., Cocchi C., Pirone F., D'Ignazio F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Stella L., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Sali M. (ORCID:0000-0003-3609-2990), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Di Giorgio A., Nesci A., and Popolla V.
Abstract: Background: Fatigue with reduced tolerance to exercise is a common persistent long-lasting feature amongst COVID-19 survivors. The assessment of muscle function in this category of patients is often neglected. Aim.: To evaluate the potential impact of a daily supplementation based on amino acids, minerals, vi- tamins, and plant extracts (Apportal®) on muscle function, body composition, laboratory parameters and self-rated health in a small group of COVID-19 survivors affected by fatigue. Methods: Thirty participants were enrolled among patients affected by physical fatigue during or after acute COVID-19 and admitted to the post-COVID-19 outpatient service at Fondazione Policlinico Gemelli in Rome between 1st March 2021 and 30th April 2021. All participants were evaluated at first visit (t0) and at control visit (t1), after taking a daily sachet of Apportal® for 28 days. Muscle function was analyzed using hand grip strength test, exhaustion strength time and the number of repetitions at one- minute chair stand test. Body composition was assessed with bioelectrical impedance analysis (BIA). Laboratory parameters, including standard blood biochemistry and ferritin levels, were evaluated at the first visit and during the control visit. A quick evaluation of self-rated health, before COVID-19, at t0 and t1, was obtained through a visual analogue scale (VAS). Results: Participants aged 60 years and older were 13 (43%). Females represented the 70% of the study sample. Participants hospitalized for COVID-19 with low-flow oxygen supplementation represented the 43.3% of the study sample while 3.3% received noninvasive ventilation (NIV) or invasive ventilation. Hand grip strength improved from 26.3 Kg to 28.9 Kg (p < 0.05) at t1 as compared to t0. The mean time of strength exhaustion increased from 31.7 s (sec) at t0 to 47.5 s at t1 (p < 0.05). Participants performed a higher number of repetitions (28.3 vs. 22.0; p < 0.05) during the one-minute chair stand test at t1
Published: 2022

8. Comparative Fecal Microbiota Analysis of Infants With Acute Bronchiolitis Caused or Not Caused by Respiratory Syncytial Virus

Author: De Maio, Flavio, Buonsenso, Danilo, Bianco, D. M., Giaimo, M., Fosso, B., Monzo, F. R., Sali, Michela, Posteraro, Brunella, Valentini, Piero, Sanguinetti, Maurizio, De Maio F., Buonsenso D., Sali M. (ORCID:0000-0003-3609-2990), Posteraro B. (ORCID:0000-0002-1663-7546), Valentini P. (ORCID:0000-0001-6095-9510), Sanguinetti M. (ORCID:0000-0002-9780-7059), De Maio, Flavio, Buonsenso, Danilo, Bianco, D. M., Giaimo, M., Fosso, B., Monzo, F. R., Sali, Michela, Posteraro, Brunella, Valentini, Piero, Sanguinetti, Maurizio, De Maio F., Buonsenso D., Sali M. (ORCID:0000-0003-3609-2990), Posteraro B. (ORCID:0000-0002-1663-7546), Valentini P. (ORCID:0000-0001-6095-9510), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: Bronchiolitis due to respiratory syncytial virus (RSV) or non-RSV agents is a health-menacing lower respiratory tract (LRT) disease of infants. Whereas RSV causes more severe disease than other viral agents may, genus-dominant fecal microbiota profiles have been identified in US hospitalized infants with bronchiolitis. We investigated the fecal microbiota composition of infants admitted to an Italian hospital with acute RSV (25/37 [67.6%]; group I) or non-RSV (12/37 [32.4%]; group II) bronchiolitis, and the relationship of fecal microbiota characteristics with the clinical characteristics of infants. Group I and group II infants differed significantly (24/25 [96.0%] versus 5/12 [41.7%]; P = 0.001) regarding 90% oxygen saturation (SpO2), which is an increased respiratory effort hallmark. Accordingly, impaired feeding in infants from group I was significantly more frequent than in infants from group II (19/25 [76.0%] versus 4/12 [33.3%]; P = 0.04). Conversely, the median (IQR) length of stay was not significantly different between the two groups (seven [3–14] for group I versus five [5–10] for group II; P = 0.11). The 16S ribosomal RNA V3–V4 region amplification of infants’ fecal samples resulted in 299 annotated amplicon sequence variants. Based on alpha- and beta-diversity microbiota downstream analyses, group I and group II infants had similar bacterial communities in their samples. Additionally, comparing infants having <90% SpO2 (n = 29) with infants having ≥90% SpO2 (n = 8) showed that well-known dominant genera (Bacteroides, Bifidobacterium, Escherichia/Shigella, and Enterobacter/Veillonella) were differently, but not significantly (P = 0.44, P = 0.71, P = 0.98, and P = 0.41, respectively) abundant between the two subgroups. Overall, we showed that, regardless of RSV or non-RSV bronchiolitis etiology, no fecal microbiota-composing bacteria could be associated with the severity of acute bronchiolitis in infants. Larger and longitudinally conducted studies wil
Published: 2022

9. Setting-specific variability of false-positive result rates with rapid testing for SARS-CoV-2 antigen

Author: Posteraro, P., Errico, F. M., De Carolis, A., Menchinelli, Giulia, Sanguinetti, Maurizio, Posteraro, Brunella, Menchinelli G., Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Posteraro, P., Errico, F. M., De Carolis, A., Menchinelli, Giulia, Sanguinetti, Maurizio, Posteraro, Brunella, Menchinelli G., Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: Not available
Published: 2022

10. Old and New Insights into Sporothrix schenckii Complex Biology and Identification

Author: De Carolis, Elena, Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), De Carolis, Elena, Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: Sporothrix schenckii is a worldwide-distributed thermally dimorphic fungus, which usually causes a subacute to chronic infection through traumatic implantation or inoculation of its infectious propagules. The fungus encompasses a group of phylogenetically closely related species, thus named the S. schenckii complex, of which S. schenckii sensu stricto and S. brasiliensis are main causative species of sporotrichosis. Owing to a multifaceted molecular dynamic, the S. schenckii complex can switch between the mycelium and the yeast form. This characteristic along with a varying cell wall composition account for significant species-specific differences in the host range, virulence, and susceptibility to antifungal drugs. While culture remains the gold standard to diagnose sporotrichosis, polymerase chain reaction (PCR) or matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry-based methods have become an essential for accurate species identification in many clinical laboratories. If directly applied on tissue samples, molecular methods are helpful to improve both sensitivity of and time to the etiological diagnosis of sporotrichosis. This mini-review aims to put together the old and new knowledge on the S. schenckii complex biology and identification, with particular emphasis on the laboratory diagnosis-related aspects of dis-ease.
Published: 2022

11. Lumipulse G SARS-CoV-2 Ag assay evaluation using clinical samples from different testing groups

Author: Menchinelli, Giulia, Bordi, L., Liotti, Flora Marzia, Palucci, Ivana, Capobianchi, M. R., Sberna, G., Lalle, E., Romano, Lucio, De Angelis, Giulia, Marchetti, Simona, Sanguinetti, Maurizio, Cattani, P., Posteraro, Brunella, Menchinelli G., Liotti F. M., Palucci I., Romano L., de Angelis G. (ORCID:0000-0002-7087-7399), Marchetti S., Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Menchinelli, Giulia, Bordi, L., Liotti, Flora Marzia, Palucci, Ivana, Capobianchi, M. R., Sberna, G., Lalle, E., Romano, Lucio, De Angelis, Giulia, Marchetti, Simona, Sanguinetti, Maurizio, Cattani, P., Posteraro, Brunella, Menchinelli G., Liotti F. M., Palucci I., Romano L., de Angelis G. (ORCID:0000-0002-7087-7399), Marchetti S., Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: Objectives: Compared to RT-PCR, lower performance of antigen detection assays, including the Lumipulse G SARS-CoV-2 Ag assay, may depend on specific testing scenarios. Methods: We tested 594 nasopharyngeal swab samples from individuals with COVID-19 (RT-PCR cycle threshold [Ct] values ≤ 40) or non-COVID-19 (Ct values > 40) diagnoses. RT-PCR positive samples were assigned to diagnostic, screening, or monitoring groups of testing. Results: With a limit of detection of 1.2 × 104 SARS-CoV-2 RNA copies/ml, Lumipulse showed positive percent agreement (PPA) of 79.9% (155/194) and negative percent agreement of 99.3% (397/400), whereas PPAs were 100% for samples with Ct values of <18 or 18–<25 and 92.5% for samples with Ct values of 25–<30. By three groups, Lumipulse showed PPA of 87.0% (60/69), 81.1% (43/53), or 72.2% (52/72), respectively, whereas PPA was 100% for samples with Ct values of <18 or 18–<25, and was 94.4, 80.0, or 100% for samples with Ct values of 25–<30, respectively. Additional testing of RT-PCR positive samples for SARS-CoV-2 subgenomic RNA showed that, by three groups, PPA was 63.8% (44/69), 62.3% (33/53), or 33.3% (24/72), respectively. PPAs dropped to 55.6, 20.0, or 41.7% for samples with Ct values of 25–<30, respectively. All 101 samples with a subgenomic RNA positive result had a Lumipulse assay’s antigen positive result, whereas only 54 (58.1%) of remaining 93 samples had a Lumipulse assay’s antigen positive result. Conclusions: Lumipulse assay was highly sensitive in samples with low RT-PCR Ct values, implying repeated testing to reduce consequences of false-negative results.
Published: 2021

12. Simulated Pediatric Blood Cultures to Assess the Inactivation of Clinically Relevant Antimicrobial Drug Concentrations in Resin-Containing Bottles

Author: Giordano, Lucia, Liotti, Flora Marzia, Menchinelli, Giulia, De Angelis, Giulia, D'Inzeo, Tiziana, Morandotti, Grazia Angela, Sanguinetti, Maurizio, Spanu, Teresa, Posteraro, Brunella, Giordano L., Liotti F. M., Menchinelli G., De Angelis G. (ORCID:0000-0002-7087-7399), D'Inzeo T. (ORCID:0000-0003-1508-3518), Morandotti G. A., Sanguinetti M. (ORCID:0000-0002-9780-7059), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Giordano, Lucia, Liotti, Flora Marzia, Menchinelli, Giulia, De Angelis, Giulia, D'Inzeo, Tiziana, Morandotti, Grazia Angela, Sanguinetti, Maurizio, Spanu, Teresa, Posteraro, Brunella, Giordano L., Liotti F. M., Menchinelli G., De Angelis G. (ORCID:0000-0002-7087-7399), D'Inzeo T. (ORCID:0000-0003-1508-3518), Morandotti G. A., Sanguinetti M. (ORCID:0000-0002-9780-7059), Spanu T. (ORCID:0000-0003-1864-5184), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: The bacteremia level as well as the administration of antibiotics before blood collection may significantly affect the recovery of bacterial pathogens from pediatric blood cultures in BacT/Alert Virtuo or Bactec FX BC systems, which remain the common techniques to diagnose bacteremia in pediatric patients. We simulated pediatric blood cultures with low or intermediate bacteremia level to evaluate BacT/Alert PF Plus and Bactec Peds Plus blood culture bottles for resin-based inactivation of 16 antibiotic–bacterium combinations. Overall, 105/192 (54.7%) of BacT/Alert PF Plus bottles and 69/192 (36.0%) of Bactec Peds Plus bottles allowed organisms to grow when exposed to antibiotics. In particular, both BacT/Alert PF Plus and Bactec Peds Plus bottles proved to be effective with piperacillin/tazobactam and Pseudomonas aeruginosa or with oxacillin and methicillin-susceptible Staphylococcus aureus (100% growth), whereas no effectiveness was apparent with ceftriaxone and Escherichia coli, Streptococcus agalactiae, or Streptococcus pneumoniae or with cefepime and E. coli (0% growth). In some relevant instances (e.g., with vancomycin and methicillin-resistant S. aureus or Streptococcus pneumoniae), BacT/Alert PF Plus bottles were superior to Bactec Peds Plus bottles. Together, these findings underscore the potentiality of resin-containing bottles to enhance diagnosis of bacteremia in pediatric patients on antimicrobial therapy. This is particularly true with one of the evaluated BC systems and with simulated intermediate bacteremia level only.
Published: 2021

13. Profiling the Gastrointestinal Microbiota

Author: Posteraro, Brunella, De Maio, Flavio, Gasbarrini, Antonio, Posteraro B. (ORCID:0000-0002-1663-7546), De Maio F., Gasbarrini A. (ORCID:0000-0002-7278-4823), Posteraro, Brunella, De Maio, Flavio, Gasbarrini, Antonio, Posteraro B. (ORCID:0000-0002-1663-7546), De Maio F., and Gasbarrini A. (ORCID:0000-0002-7278-4823)
Abstract: In this chapter, we provide a methodological description of the process to perform gastrointestinal (GIT) microbiota profiling on human stool samples. The process includes: (i) collection of feces, (ii) isolation of DNA from fecal community bacteria, (iii) selection of both 16S rDNA sequencing target and next-generation sequencing platform, and (iv) analysis and interpretation of sequence data. The process culminates into a comprehensive report on the GIT microbiota composition and structure that may translate into clinically actionable results.
Published: 2021

14. Covid-19 seroprevalence among healthcare workers of a large covid-19 hospital in rome reveals strengths and limits of two different serological tests

Author: Vetrugno, Giuseppe, La Milia, Daniele Ignazio, D'Ambrosio, Floriana, Di Pumpo, Marcello, Pastorino, Roberta, Boccia, Stefania, Ricci, Rosalba, De-Giorgio, F., Cicconi, M., Foti, F., Pascucci, Domenico, Castrini, Francesco, Carini, Elettra, Cambieri, Andrea, D'Alfonso, Maria Elena, Capalbo, Gennaro, Fantoni, Massimo, Moscato, Umberto, Staiti, Domenico, De Simone, F. M., Berloco, Filippo, Damiani, Gianfranco, Zega, Maurizio, Cattani, P., Posteraro, Brunella, Sanguinetti, Maurizio, Laurenti, Patrizia, Vetrugno G. (ORCID:0000-0003-0181-2855), La Milia D. I., D'ambrosio F., Di Pumpo M., Pastorino R. (ORCID:0000-0001-5013-0733), Boccia S. (ORCID:0000-0002-1864-749X), Ricci R., Pascucci D. (ORCID:0000-0002-5804-2284), Castrini F., Carini E., Cambieri A., D'alfonso M. E., Capalbo G., Fantoni M. (ORCID:0000-0001-6913-8460), Moscato U. (ORCID:0000-0002-2568-3966), Staiti D. (ORCID:0000-0001-5179-9690), Berloco F., Damiani G. (ORCID:0000-0003-3028-6188), Zega M. (ORCID:0000-0002-7821-2615), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Laurenti P. (ORCID:0000-0002-8532-0593), Vetrugno, Giuseppe, La Milia, Daniele Ignazio, D'Ambrosio, Floriana, Di Pumpo, Marcello, Pastorino, Roberta, Boccia, Stefania, Ricci, Rosalba, De-Giorgio, F., Cicconi, M., Foti, F., Pascucci, Domenico, Castrini, Francesco, Carini, Elettra, Cambieri, Andrea, D'Alfonso, Maria Elena, Capalbo, Gennaro, Fantoni, Massimo, Moscato, Umberto, Staiti, Domenico, De Simone, F. M., Berloco, Filippo, Damiani, Gianfranco, Zega, Maurizio, Cattani, P., Posteraro, Brunella, Sanguinetti, Maurizio, Laurenti, Patrizia, Vetrugno G. (ORCID:0000-0003-0181-2855), La Milia D. I., D'ambrosio F., Di Pumpo M., Pastorino R. (ORCID:0000-0001-5013-0733), Boccia S. (ORCID:0000-0002-1864-749X), Ricci R., Pascucci D. (ORCID:0000-0002-5804-2284), Castrini F., Carini E., Cambieri A., D'alfonso M. E., Capalbo G., Fantoni M. (ORCID:0000-0001-6913-8460), Moscato U. (ORCID:0000-0002-2568-3966), Staiti D. (ORCID:0000-0001-5179-9690), Berloco F., Damiani G. (ORCID:0000-0003-3028-6188), Zega M. (ORCID:0000-0002-7821-2615), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Laurenti P. (ORCID:0000-0002-8532-0593)
Abstract: Healthcare workers are at the forefront against COVID-19, worldwide. Since Fondazione Policlinico Universitario A. Gemelli (FPG) IRCCS was enlisted as a COVID-19 hospital, the healthcare workers deployed to COVID-19 wards were separated from those with limited/no exposure, whereas the administrative staff were designated to work from home. Between 4 June and 3 July 2020, an investigation was conducted to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (IgG) antibodies among the employees of the FPG using point-of-care (POC) and venous blood tests. Sensitivity, specificity, and predictive values were determined with reverse-transcription polymerase chain reaction on nasal/oropharyngeal swabs as the diagnostic gold standard. The participants enrolled amounted to 4777. Seroprevalence was 3.66% using the POC test and 1.19% using the venous blood test, with a significant difference (p < 0.05). The POC test sensitivity and specificity were, respectively, 63.64% (95% confidence interval (CI): 62.20% to 65.04%) and 96.64% (95% CI: 96.05% to 97.13%), while those of the venous blood test were, respectively, 78.79% (95% CI: 77.58% to 79.94%) and 99.36% (95% CI: 99.07% to 99.55%). Among the low-risk populations, the POC test’s predictive values were 58.33% (positive) and 98.23% (negative), whereas those of the venous blood test were 92.86% (positive) and 98.53% (negative). According to our study, these serological tests cannot be a valid alternative to diagnose COVID-19 infection in progress.
Published: 2021

15. Diagnosis and Treatment of Bacterial Pneumonia in Critically Ill Patients with COVID-19 Using a Multiplex PCR Assay: A Large Italian Hospital’s Five-Month Experience

Author: Posteraro, Brunella, Cortazzo, Venere, Liotti, Flora Marzia, Menchinelli, Giulia, Ippoliti, Chiara, De Angelis, Giulia, la Sorda, M., Capalbo, Gennaro, Vargas, Joel, Antonelli, Massimo, Sanguinetti, Maurizio, De Pascale, Gennaro, Spanu Pennestri, Teresa, Posteraro B. (ORCID:0000-0002-1663-7546), Cortazzo V., Liotti F. M., Menchinelli G., Ippoliti C., de Angelis G. (ORCID:0000-0002-7087-7399), Capalbo G., Vargas J., Antonelli M. (ORCID:0000-0003-3007-1670), Sanguinetti M. (ORCID:0000-0002-9780-7059), de Pascale G. (ORCID:0000-0002-8255-0676), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro, Brunella, Cortazzo, Venere, Liotti, Flora Marzia, Menchinelli, Giulia, Ippoliti, Chiara, De Angelis, Giulia, la Sorda, M., Capalbo, Gennaro, Vargas, Joel, Antonelli, Massimo, Sanguinetti, Maurizio, De Pascale, Gennaro, Spanu Pennestri, Teresa, Posteraro B. (ORCID:0000-0002-1663-7546), Cortazzo V., Liotti F. M., Menchinelli G., Ippoliti C., de Angelis G. (ORCID:0000-0002-7087-7399), Capalbo G., Vargas J., Antonelli M. (ORCID:0000-0003-3007-1670), Sanguinetti M. (ORCID:0000-0002-9780-7059), de Pascale G. (ORCID:0000-0002-8255-0676), and Spanu T. (ORCID:0000-0003-1864-5184)
Abstract: Bacterial pneumonia is a challenging coronavirus disease 2019 (COVID-19) complication for intensive care unit (ICU) clinicians. Upon its implementation, the FilmArray pneumonia plus (FA-PP) panel’s practicability for both the diagnosis and antimicrobial therapy management of bacterial pneumonia was assessed in ICU patients with COVID-19. Respiratory samples were collected from patients who were mechanically ventilated at the time bacterial etiology and antimicrobial resistance were determined using both standard-of-care (culture and antimicrobial susceptibility testing [AST]) and FA-PP panel testing methods. Changes to targeted and/or appropriate antimicrobial therapy were reviewed. We tested 212 samples from 150 patients suspected of bacterial pneumonia. Etiologically, 120 samples were positive by both methods, two samples were culture positive but FA-PP negative (i.e., negative for on-panel organisms), and 90 were negative by both methods. FA-PP detected no culture-growing organisms (mostly Staphylococcus aureus or Pseudomonas aeruginosa) in 19 of 120 samples or antimicrobial resistance genes in two culture-negative samples for S. aureus organisms. Fifty-nine (27.8%) of 212 samples were from empirically treated patients. Antibiotics were discontinued in 5 (33.3%) of 15 patients with FA-PP-negative samples and were escalated/deescalated in 39 (88.6%) of 44 patients with FA-PP-positive samples. Overall, antibiotics were initiated in 87 (72.5%) of 120 pneumonia episodes and were not administered in 80 (87.0%) of 92 nonpneumonia episodes. Antimicrobial-resistant organisms caused 78 (60.0%) of 120 episodes. Excluding 19 colistin-resistant Acinetobacter baumannii episodes, AST confirmed appropriate antibiotic receipt in 101 (84.2%) of 120 episodes for one or more FA-PP-detected organisms. Compared to standard-of-care testing, the FA-PP panel may be of great value in the management of COVID-19 patients at risk of developing bacterial pneumonia in the ICU. IMPORTANCE Sinc
Published: 2021

16. Improved gut microbiota features after the resolution of SARS‐CoV‐2 infection

Author: De Maio, Flavio, Ianiro, Gianluca, Coppola, Gaetano, Santopaolo, Francesco, Abbate, Valeria, Bianco, D. M., Del Zompo, F., De Matteis, Giuseppe, Leo, Maria Laura, Nesci, Antonio, Nicoletti, Alberto, Pompili, Maurizio, Cammarota, Giovanni, Posteraro, Brunella, Sanguinetti, Maurizio, Gasbarrini, Antonio, Ponziani, Francesca Romana, De Maio F., Ianiro G. (ORCID:0000-0002-8318-0515), Coppola G., Santopaolo F., Abbate V., De Matteis G., Leo M., Nesci A., Nicoletti A., Pompili M. (ORCID:0000-0001-6699-7980), Cammarota G. (ORCID:0000-0002-3626-6148), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Gasbarrini A. (ORCID:0000-0002-7278-4823), Ponziani F. R. (ORCID:0000-0002-5924-6238), De Maio, Flavio, Ianiro, Gianluca, Coppola, Gaetano, Santopaolo, Francesco, Abbate, Valeria, Bianco, D. M., Del Zompo, F., De Matteis, Giuseppe, Leo, Maria Laura, Nesci, Antonio, Nicoletti, Alberto, Pompili, Maurizio, Cammarota, Giovanni, Posteraro, Brunella, Sanguinetti, Maurizio, Gasbarrini, Antonio, Ponziani, Francesca Romana, De Maio F., Ianiro G. (ORCID:0000-0002-8318-0515), Coppola G., Santopaolo F., Abbate V., De Matteis G., Leo M., Nesci A., Nicoletti A., Pompili M. (ORCID:0000-0001-6699-7980), Cammarota G. (ORCID:0000-0002-3626-6148), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Ponziani F. R. (ORCID:0000-0002-5924-6238)
Abstract: Background: The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has a tropism for the gastrointestinal tract and several studies have shown an alteration of the gut microbiota in hospitalized infected patients. However, long-term data on microbiota changes after recovery are lacking. Methods: We enrolled 30 patients hospitalized for SARS‐CoV‐2-related pneumonia. Their gut microbiota was analyzed within 48 h from the admission and compared with (1) that of other patients admitted for suspected bacterial pneumonia (control group) (2) that obtained from the same subject 6 months after nasopharyngeal swab negativization. Results: Gut microbiota alpha-diversity increased 6 months after the resolution of SARS-CoV-2 infection. Bacteroidetes relative abundance was higher (≈ 36.8%) in patients with SARS-CoV-2, and declined to 18.7% when SARS-CoV-2 infection resolved (p = 0.004). Conversely, Firmicutes were prevalent (≈ 75%) in controls and in samples collected after SARS-CoV-2 infection resolution (p = 0.001). Ruminococcaceae, Lachnospiraceae and Blautia increased after SARS-CoV-2 infection resolution, rebalancing the gut microbiota composition. Conclusion: SARS-CoV-2 infection is associated with changes in the gut microbiome, which tend to be reversed in long-term period.
Published: 2021

17. A new pcr‐based assay for testing bronchoalveolar lavage fluid samples from patients with suspected pneumocystis jirovecii pneumonia

Author: Liotti, Flora Marzia, Posteraro, Brunella, Angelis, G. D., Torelli, Riccardo, De Carolis, Elena, Speziale, Domenico, Menchinelli, Giulia, Spanu, Teresa, Sanguinetti, Maurizio, Liotti F. M., Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Speziale D., Menchinelli G., Spanu T. (ORCID:0000-0003-1864-5184), Sanguinetti M. (ORCID:0000-0002-9780-7059), Liotti, Flora Marzia, Posteraro, Brunella, Angelis, G. D., Torelli, Riccardo, De Carolis, Elena, Speziale, Domenico, Menchinelli, Giulia, Spanu, Teresa, Sanguinetti, Maurizio, Liotti F. M., Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Speziale D., Menchinelli G., Spanu T. (ORCID:0000-0003-1864-5184), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: To support the clinical laboratory diagnosis of Pneumocystis jirovecii (PJ) pneumonia (PCP), an invasive fungal infection mainly occurring in HIV‐negative patients, in‐house or commercial PJ‐specific real‐time quantitative PCR (qPCR) assays are todays’ reliable options. The performance of these assays depends on the type of PJ gene (multi‐copy mitochondrial versus single‐copy nuclear) targeted by the assay. We described the development of a PJ‐PCR assay targeting the dihydrofolate reductase (DHFR)‐encoding gene. After delineating its analytical performance, the PJ‐PCR assay was used to test bronchoalveolar lavage (BAL) fluid samples from 200 patients (only seven were HIV positive) with suspected PCP. Of 211 BAL fluid samples, 18 (8.5%) were positive and 193 (91.5%) were negative by PJ‐PCR. Of 18 PJ‐PCR‐positive samples, 11 (61.1%) tested positive and seven (38.9%) tested negative with the immunofluorescence assay (IFA). All (100%) of the 193 PJ‐PCR‐negative samples were IFA negative. Based on IFA/PCR results, patients were, respectively, classified as having (n = 18) and not having (n = 182) proven (PJ‐ PCR+/IFA+) or probable (PJ‐PCR+/IFA−) PCP. For 182 patients without PCP, alternative infectious or non‐infectious etiologies were identified. Our PJ‐PCR assay was at least equivalent to IFA, fostering studies aimed at defining a qPCR‐based standard for PCP diagnosis in the future.
Published: 2021

18. Post-prescription audit plus beta-d-glucan assessment decrease echinocandin use in people with suspected invasive candidiasis

Author: Murri, Rita, Lardo, S., De Luca, Alessio, Posteraro, Brunella, Torelli, Riccardo, De Angelis, Giulia, Giovannenze, Francesca, Taccari, Francesco, Pavan, L., Parroni, L., Sanguinetti, Maurizio, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), De Luca A., Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., De Angelis G. (ORCID:0000-0002-7087-7399), Giovannenze F., Taccari F., Sanguinetti M. (ORCID:0000-0002-9780-7059), Fantoni M. (ORCID:0000-0001-6913-8460), Murri, Rita, Lardo, S., De Luca, Alessio, Posteraro, Brunella, Torelli, Riccardo, De Angelis, Giulia, Giovannenze, Francesca, Taccari, Francesco, Pavan, L., Parroni, L., Sanguinetti, Maurizio, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), De Luca A., Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., De Angelis G. (ORCID:0000-0002-7087-7399), Giovannenze F., Taccari F., Sanguinetti M. (ORCID:0000-0002-9780-7059), and Fantoni M. (ORCID:0000-0001-6913-8460)
Abstract: Background and Objectives: Overtreatment with antifungal drugs is often observed. Antifungal stewardship (AFS) focuses on optimizing the treatment for invasive fungal diseases. The objective of the present study was to evaluate the utility of a post-prescription audit plus beta-D-glucan (BDG) assessment on reducing echinocandin use in persons with suspected invasive candidiasis. Materials and Methods: This is a prospective, pre-post quasi-experimental study of people starting echinocandins for suspected invasive candidiasis. The intervention of the study included review of each echinocandin prescription and discontinuation of treatment if a very low probability of fungal disease or a negative BDG value were found. Pre-intervention data were compared with the intervention phase. The primary outcome of the study was the duration of echinocandin therapy. Secondary outcomes were length of hospital stay and mortality. Results: Ninety-two echinocan-din prescriptions were reviewed, 49 (53.3%) in the pre-intervention phase and 43 (46.7%) in the intervention phase. Discontinuation of antifungal therapy was possible in 21 of the 43 patients in the intervention phase (48.8%). The duration of echinocandin therapy was 7.4 (SD 4.7) in the pre-intervention phase, 4.1 days (SD 2.9) in persons undergoing the intervention, and 8.6 (SD 7.3) in persons in whom the intervention was not feasible (p at ANOVA = 0.016). Length of stay and mortality did not differ between pre-intervention and intervention phases. Conclusions: An intervention based on pre-prescription restriction and post-prescription audit when combined with BDG measurement is effective in optimizing antifungal therapy by significantly reducing excessive treatment duration.
Published: 2021

19. Staphylococcus aureus ventilator-associated pneumonia in patients with COVID-19: clinical features and potential inference with lung dysbiosis

Author: De Pascale, Gennaro, De Maio, Flavio, Carelli, Simone, De Angelis, Giulia, Cacaci, Margherita, Montini, Luca, Bello, Giuseppe, Cutuli, S. L., Pintaudi, G., Tanzarella, E. S., Xhemalaj, Rikardo, Grieco, D. L., Tumbarello, Mario, Sanguinetti, Maurizio, Posteraro, Brunella, Antonelli, Massimo, De Pascale G. (ORCID:0000-0002-8255-0676), De Maio F., Carelli S., De Angelis G. (ORCID:0000-0002-7087-7399), Cacaci M. (ORCID:0000-0002-5433-9400), Montini L. (ORCID:0000-0003-4602-5134), Bello G. (ORCID:0000-0003-2648-7235), Xhemalaj R., Tumbarello M. (ORCID:0000-0002-9519-8552), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Antonelli M. (ORCID:0000-0003-3007-1670), De Pascale, Gennaro, De Maio, Flavio, Carelli, Simone, De Angelis, Giulia, Cacaci, Margherita, Montini, Luca, Bello, Giuseppe, Cutuli, S. L., Pintaudi, G., Tanzarella, E. S., Xhemalaj, Rikardo, Grieco, D. L., Tumbarello, Mario, Sanguinetti, Maurizio, Posteraro, Brunella, Antonelli, Massimo, De Pascale G. (ORCID:0000-0002-8255-0676), De Maio F., Carelli S., De Angelis G. (ORCID:0000-0002-7087-7399), Cacaci M. (ORCID:0000-0002-5433-9400), Montini L. (ORCID:0000-0003-4602-5134), Bello G. (ORCID:0000-0003-2648-7235), Xhemalaj R., Tumbarello M. (ORCID:0000-0002-9519-8552), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), and Antonelli M. (ORCID:0000-0003-3007-1670)
Abstract: Background: Hospitalized patients with COVID-19 admitted to the intensive care unit (ICU) and requiring mechanical ventilation are at risk of ventilator-associated bacterial infections secondary to SARS-CoV-2 infection. Our study aimed to investigate clinical features of Staphylococcus aureus ventilator-associated pneumonia (SA-VAP) and, if bronchoalveolar lavage samples were available, lung bacterial community features in ICU patients with or without COVID-19. Methods: We prospectively included hospitalized patients with COVID-19 across two medical ICUs of the Fondazione Policlinico Universitario A. Gemelli IRCCS (Rome, Italy), who developed SA-VAP between 20 March 2020 and 30 October 2020 (thereafter referred to as cases). After 1:2 matching based on the simplified acute physiology score II (SAPS II) and the sequential organ failure assessment (SOFA) score, cases were compared with SA-VAP patients without COVID-19 (controls). Clinical, microbiological, and lung microbiota data were analyzed. Results: We studied two groups of patients (40 COVID-19 and 80 non-COVID-19). COVID-19 patients had a higher rate of late-onset (87.5% versus 63.8%; p = 0.01), methicillin-resistant (65.0% vs 27.5%; p < 0.01) or bacteremic (47.5% vs 6.3%; p < 0.01) infections compared with non-COVID-19 patients. No statistically significant differences between the patient groups were observed in ICU mortality (p = 0.12), clinical cure (p = 0.20) and microbiological eradication (p = 0.31). On multivariable logistic regression analysis, SAPS II and initial inappropriate antimicrobial therapy were independently associated with ICU mortality. Then, lung microbiota characterization in 10 COVID-19 and 16 non-COVID-19 patients revealed that the overall microbial community composition was significantly different between the patient groups (unweighted UniFrac distance, R2 0.15349; p < 0.01). Species diversity was lower in COVID-19 than in non COVID-19 patients (94.4 ± 44.9 vs 152.5 ± 41.8; p &
Published: 2021

20. A machine-learning parsimonious multivariable predictive model of mortality risk in patients with Covid-19

Author: Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, C., Fantoni, Massimo, Damiani, Andrea, Marchetti, A., Sergi, P. D. A., Arcuri, G., Cesario, Alfredo, Patarnello, S., Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Anna Rita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani Franchi, Paola, Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, A. M., D'Alfonso, Maria Elena, De Angelis, Giulia, De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, M., Gambassi, Giovanni, Garcovich, M., Gremese, Elisa, Grieco, D. L., Iaconelli, A., Iorio, Raffaele, Landi, Francesco, Larici, Anna Rita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gian Ludovico, Rinaldi, R., Rossi, Elena, Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, Antonia Carla, Tosoni, A., Trani, Carlo, Varone, Francesco, Verme, L. Z. D., Murri R. (ORCID:0000-0003-4263-7854), Lenkowicz J., Masciocchi C., Fantoni M. (ORCID:0000-0001-6913-8460), Damiani A., Cesario A. (ORCID:0000-0003-4687-0709), Antonelli M. (ORCID:0000-0003-3007-1670), Bellantone R. (ORCID:0000-0002-0844-3469), Bernabei R. (ORCID:0000-0002-9197-004X), Boccia S. (ORCID:0000-0002-1864-749X), Calabresi P. (ORCID:0000-0003-0326-5509), Cambieri A., Cauda R. (ORCID:0000-0002-1498-4229), Colosimo C. (ORCID:0000-0003-3800-3648), Crea F. (ORCID:0000-0001-9404-8846), De Maria R. (ORCID:0000-0003-2255-0583), De Stefano V. (ORCID:0000-0002-5178-5827), Franceschi F. (ORCID:0000-0001-6266-445X), Gasbarrini A. (ORCID:0000-0002-7278-4823), Parolini O. (ORCID:0000-0002-5211-6430), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Urbani A. (ORCID:0000-0001-9168-3174), Zega M. (ORCID:0000-0002-7821-2615), Scambia G. (ORCID:0000-0003-2758-1063), Valentini V. (ORCID:0000-0003-4637-6487), Armuzzi A. (ORCID:0000-0003-1572-0118), Barba M. (ORCID:0000-0001-6084-7666), Baroni S. (ORCID:0000-0002-3410-2617), Bellesi S., Bentivoglio A. (ORCID:0000-0002-9663-095X), Biasucci L. M. (ORCID:0000-0002-6921-6497), Biscetti F. (ORCID:0000-0001-7449-657X), Candelli M. (ORCID:0000-0001-8443-7880), Capalbo G., Cattani P. (ORCID:0000-0003-4678-4763), Chiusolo P. (ORCID:0000-0002-1355-1587), Cingolani A. (ORCID:0000-0002-3793-2755), Corbo G. (ORCID:0000-0002-8104-4659), Covino M. (ORCID:0000-0002-6709-2531), D'Alfonso M., De Angelis G. (ORCID:0000-0002-7087-7399), De Pascale G. (ORCID:0000-0002-8255-0676), Frisullo G., Gambassi G. (ORCID:0000-0002-7030-9359), Gremese E. (ORCID:0000-0002-2248-1058), Iorio R. (ORCID:0000-0002-6270-0956), Landi F. (ORCID:0000-0002-3472-1389), Larici A. (ORCID:0000-0002-1882-6244), Liuzzo G. (ORCID:0000-0002-5714-0907), Maviglia R., Miele L. (ORCID:0000-0003-3464-0068), Montalto M. (ORCID:0000-0001-8819-3684), Natale L. (ORCID:0000-0002-7949-5119), Nicolotti N., Ojetti V. (ORCID:0000-0002-8953-0707), Pompili M. (ORCID:0000-0001-6699-7980), Posteraro B. (ORCID:0000-0002-1663-7546), Rapaccini G. (ORCID:0000-0002-6467-857X), Rossi E. (ORCID:0000-0002-7572-9379), Santoliquido A. (ORCID:0000-0003-1539-4017), Sica S. (ORCID:0000-0003-2426-3465), Tamburrini E. (ORCID:0000-0003-4930-426X), Teofili L. (ORCID:0000-0002-7214-1561), Testa A. (ORCID:0000-0003-2217-8726), Trani C. (ORCID:0000-0001-9777-013X), Varone F., Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, C., Fantoni, Massimo, Damiani, Andrea, Marchetti, A., Sergi, P. D. A., Arcuri, G., Cesario, Alfredo, Patarnello, S., Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Anna Rita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani Franchi, Paola, Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, A. M., D'Alfonso, Maria Elena, De Angelis, Giulia, De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, M., Gambassi, Giovanni, Garcovich, M., Gremese, Elisa, Grieco, D. L., Iaconelli, A., Iorio, Raffaele, Landi, Francesco, Larici, Anna Rita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gian Ludovico, Rinaldi, R., Rossi, Elena, Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, Antonia Carla, Tosoni, A., Trani, Carlo, Varone, Francesco, Verme, L. Z. D., Murri R. (ORCID:0000-0003-4263-7854), Lenkowicz J., Masciocchi C., Fantoni M. (ORCID:0000-0001-6913-8460), Damiani A., Cesario A. (ORCID:0000-0003-4687-0709), Antonelli M. (ORCID:0000-0003-3007-1670), Bellantone R. (ORCID:0000-0002-0844-3469), Bernabei R. (ORCID:0000-0002-9197-004X), Boccia S. (ORCID:0000-0002-1864-749X), Calabresi P. (ORCID:0000-0003-0326-5509), Cambieri A., Cauda R. (ORCID:0000-0002-1498-4229), Colosimo C. (ORCID:0000-0003-3800-3648), Crea F. (ORCID:0000-0001-9404-8846), De Maria R. (ORCID:0000-0003-2255-0583), De Stefano V. (ORCID:0000-0002-5178-5827), Franceschi F. (ORCID:0000-0001-6266-445X), Gasbarrini A. (ORCID:0000-0002-7278-4823), Parolini O. (ORCID:0000-0002-5211-6430), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Urbani A. (ORCID:0000-0001-9168-3174), Zega M. (ORCID:0000-0002-7821-2615), Scambia G. (ORCID:0000-0003-2758-1063), Valentini V. (ORCID:0000-0003-4637-6487), Armuzzi A. (ORCID:0000-0003-1572-0118), Barba M. (ORCID:0000-0001-6084-7666), Baroni S. (ORCID:0000-0002-3410-2617), Bellesi S., Bentivoglio A. (ORCID:0000-0002-9663-095X), Biasucci L. M. (ORCID:0000-0002-6921-6497), Biscetti F. (ORCID:0000-0001-7449-657X), Candelli M. (ORCID:0000-0001-8443-7880), Capalbo G., Cattani P. (ORCID:0000-0003-4678-4763), Chiusolo P. (ORCID:0000-0002-1355-1587), Cingolani A. (ORCID:0000-0002-3793-2755), Corbo G. (ORCID:0000-0002-8104-4659), Covino M. (ORCID:0000-0002-6709-2531), D'Alfonso M., De Angelis G. (ORCID:0000-0002-7087-7399), De Pascale G. (ORCID:0000-0002-8255-0676), Frisullo G., Gambassi G. (ORCID:0000-0002-7030-9359), Gremese E. (ORCID:0000-0002-2248-1058), Iorio R. (ORCID:0000-0002-6270-0956), Landi F. (ORCID:0000-0002-3472-1389), Larici A. (ORCID:0000-0002-1882-6244), Liuzzo G. (ORCID:0000-0002-5714-0907), Maviglia R., Miele L. (ORCID:0000-0003-3464-0068), Montalto M. (ORCID:0000-0001-8819-3684), Natale L. (ORCID:0000-0002-7949-5119), Nicolotti N., Ojetti V. (ORCID:0000-0002-8953-0707), Pompili M. (ORCID:0000-0001-6699-7980), Posteraro B. (ORCID:0000-0002-1663-7546), Rapaccini G. (ORCID:0000-0002-6467-857X), Rossi E. (ORCID:0000-0002-7572-9379), Santoliquido A. (ORCID:0000-0003-1539-4017), Sica S. (ORCID:0000-0003-2426-3465), Tamburrini E. (ORCID:0000-0003-4930-426X), Teofili L. (ORCID:0000-0002-7214-1561), Testa A. (ORCID:0000-0003-2217-8726), Trani C. (ORCID:0000-0001-9777-013X), and Varone F.
Abstract: The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n = 1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk sc
Published: 2021

21. Saliva is a valid alternative to nasopharyngeal swab in chemiluminescence-based assay for detection of sars-cov-2 antigen

Author: Amendola, A., Sberna, G., Lalle, E., Colavita, F., Castilletti, C., Menchinelli, Giulia, Posteraro, Brunella, Sanguinetti, Maurizio, Ippolito, G., Bordi, L., Capobianchi, M. R., Menchinelli G., Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Amendola, A., Sberna, G., Lalle, E., Colavita, F., Castilletti, C., Menchinelli, Giulia, Posteraro, Brunella, Sanguinetti, Maurizio, Ippolito, G., Bordi, L., Capobianchi, M. R., Menchinelli G., Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: Diagnostic methods based on SARS-CoV-2 antigens detection are a promising alternative to SARS-CoV-2 RNA amplification. We evaluated the automated chemiluminescence-based Lumipulse® G SARS-CoV-2 Ag assay on saliva samples, using SimplexaTM COVID-19 Direct assay as a reference test. Analytical performance was established on a pool of healthy donors’ saliva samples spiked with the 2019-nCoV/Italy-INMI1 isolate, whereas clinical performance was assessed on fresh saliva specimens collected from hospitalized patients with suspect or confirmed COVID-19 diagnosis. The limit of detection (LOD) was 0.65 Log TCID50/mL, corresponding to 18,197 copies/mL of SARS-CoV-2 RNA. Antigen concentrations and SARS-CoV-2 RNA were highly correlated (r = 0.99; p < 0.0001). Substantial agreement (80.3%) and significant correlation (r = −0.675; p = 0.0006) were observed between Lumipulse® G assay results and Ct values on clinical samples, with 52.4% sensitivity and specificity 94.1%. Sensitivity exceeded 90.0% when calculated on samples with Ct < 25, and specificity was 100% when excluding samples from recovered patients with previous COVID-19 diagnosis. Overall, chemiluminescence-based antigen assay may be reliably applied to saliva samples to identify individuals with high viral loads, more likely to transmit the virus. However, the low positive predictive value in a context of low SARS-CoV-2 prevalence underscores the need for confirmatory testing in SARS-CoV-2 antigen-positive cases.
Published: 2021

22. Sars-cov-2 antigen detection to expand testing capacity for covid-19: Results from a hospital emergency department testing site

Author: Menchinelli, G., De Angelis, G., Cacaci, M., Liotti, F. M., Candelli, M., Palucci, I., Santangelo, R., Sanguinetti, M., Vetrugno, G., Franceschi, F., Posteraro, B., Menchinelli G., De Angelis G. (ORCID:0000-0002-7087-7399), Cacaci M. (ORCID:0000-0002-5433-9400), Liotti F. M., Candelli M. (ORCID:0000-0001-8443-7880), Palucci I., Santangelo R. (ORCID:0000-0002-8056-218X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Vetrugno G. (ORCID:0000-0003-0181-2855), Franceschi F. (ORCID:0000-0001-6266-445X), Posteraro B. (ORCID:0000-0002-1663-7546), Menchinelli, G., De Angelis, G., Cacaci, M., Liotti, F. M., Candelli, M., Palucci, I., Santangelo, R., Sanguinetti, M., Vetrugno, G., Franceschi, F., Posteraro, B., Menchinelli G., De Angelis G. (ORCID:0000-0002-7087-7399), Cacaci M. (ORCID:0000-0002-5433-9400), Liotti F. M., Candelli M. (ORCID:0000-0001-8443-7880), Palucci I., Santangelo R. (ORCID:0000-0002-8056-218X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Vetrugno G. (ORCID:0000-0003-0181-2855), Franceschi F. (ORCID:0000-0001-6266-445X), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: Background: SARS-CoV-2 antigen detection has currently expanded the testing capacity for COVID-19, which yet relies on the SARS-CoV-2 RNA RT-PCR amplification. Objectives: To report on a COVID-19 testing algorithm from a tertiary care hospital emergency department (ED) that combines both antigen (performed on the ED) and RT-PCR (performed outside the ED) testing. Methods: Between December 2020 and January 2021, in a priori designated, spatially separated COVID-19 or non-COVID-19 ED areas, respectively, symptomatic or asymptomatic patients received SARS-CoV-2 antigen testing on nasopharyngeal swab samples. Antigen results were promptly accessible to guide subsequent, outside performed confirmatory (RT-PCR) testing. Results: Overall, 1083 (100%) of 1083 samples in the COVID-19 area and 1815 (49.4%) of 3670 samples in the non-COVID-19 area had antigen results that required confirmation by RT-PCR. Antigen positivity rates were 12.4% (134/1083) and 3.7% (66/1815), respectively. Compared to RT-PCR testing results, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of antigen testing were, respectively, 68.0%, 98.3%, 88.8%, and 94.1% in the COVID-19 area, and 41.9%, 97.3%, 27.3%, and 98.6% in non-COVID-19 area. Practically, RT-PCR tests were avoided in 50.6% (1855/3670) of non-COVID-19 area samples (all antigen negative) from patients who, otherwise, would have needed antigen result confirmation. Conclusions: Our algorithm had value to preserve RT-PCR from avoidable usage and, importantly, to save time, which translated into a timely RT-PCR result availability in the COVID-19 area.
Published: 2021

23. Re-evaluating positive serum samples for SARS-CoV-2-specific IgA and IgG antibodies using an in-house serological assay

Author: Cacaci, Margherita, Menchinelli, Giulia, Ricci, Rosalba, De Maio, Flavio, Mariotti, Melinda, Torelli, Riccardo, Morandotti, Grazia Angela, Bugli, Francesca, Sanguinetti, Maurizio, Posteraro, Brunella, Cacaci M. (ORCID:0000-0002-5433-9400), Menchinelli G., Ricci R., De Maio F., Mariotti M., Torelli R., Morandotti G. A., Bugli F. (ORCID:0000-0001-9038-3233), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Cacaci, Margherita, Menchinelli, Giulia, Ricci, Rosalba, De Maio, Flavio, Mariotti, Melinda, Torelli, Riccardo, Morandotti, Grazia Angela, Bugli, Francesca, Sanguinetti, Maurizio, Posteraro, Brunella, Cacaci M. (ORCID:0000-0002-5433-9400), Menchinelli G., Ricci R., De Maio F., Mariotti M., Torelli R., Morandotti G. A., Bugli F. (ORCID:0000-0001-9038-3233), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: Not available
Published: 2021

24. Are We Ready for Nosocomial Candida auris Infections? Rapid Identification and Antifungal Resistance Detection Using MALDI-TOF Mass Spectrometry May Be the Answer

Author: De Carolis, Elena, Marchionni, F., La Rosa, M., Meis, J. F., Chowdhary, A., Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), De Carolis, Elena, Marchionni, F., La Rosa, M., Meis, J. F., Chowdhary, A., Posteraro, Brunella, Sanguinetti, Maurizio, De Carolis E. (ORCID:0000-0003-4757-7256), Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: The occurrence of multidrug-resistant Candida auris isolates and the increased mortality associated with invasive infections or outbreaks due to this Candida species have been reported in many healthcare settings. Therefore, accurate and rapid identification at the species level of clinical C. auris isolates as well as their timely differentiation as susceptible or resistant to antifungal drugs is mandatory. Aims of the present study were to implement the MALDI-TOF mass spectrometry (MS) Bruker Daltonics Biotyper® database with C. auris spectrum profiles and to develop a fast and reproducible MS assay for detecting anidulafungin (AFG) resistance in C. auris isolates. After creation of main C. auris spectra, a score-oriented dendrogram was generated from hierarchical cluster analysis, including spectra of isolates from C. auris and other Candida (C. glabrata, C. guilliermondii, C. haemulonii, C. lusitaniae, and C. parapsilosis) or non-Candida (Rhodotorula glutinis) species. Cluster analysis allowed to group and classify the isolates according to their species designation. Then, a three-hour incubation antifungal susceptibility testing (AFST) assay was developed. Spectra obtained at null, intermediate, or maximum AFG concentrations were used to create composite correlation index matrices for eighteen C. auris isolates included in the study. All six resistant C. auris isolates were detected as resistant whereas 11 of 12 susceptible C. auris isolates were detected as susceptible by the MS-AFST assay. In conclusion, our MS-based assay offers the possibility of rapidly diagnosing and appropriately treating patients with C. auris infection.
Published: 2021

25. Risk Factors for Mortality in Adult COVID-19 Patients Who Develop Bloodstream Infections Mostly Caused by Antimicrobial-Resistant Organisms: Analysis at a Large Teaching Hospital in Italy

Author: Posteraro, Brunella, De Angelis, Giulia, Menchinelli, Giulia, D’Inzeo, T., Fiori, Barbara, De Maio, Flavio, Cortazzo, Venere, Sanguinetti, Maurizio, Spanu Pennestri, Teresa, Posteraro, B. (ORCID:0000-0002-1663-7546), De Angelis, G. (ORCID:0000-0002-7087-7399), Menchinelli, G., Fiori, B. (ORCID:0000-0003-3318-5809), De Maio, F., Cortazzo, V., Sanguinetti, M. (ORCID:0000-0002-9780-7059), Spanu, T (ORCID:0000-0003-1864-5184), Posteraro, Brunella, De Angelis, Giulia, Menchinelli, Giulia, D’Inzeo, T., Fiori, Barbara, De Maio, Flavio, Cortazzo, Venere, Sanguinetti, Maurizio, Spanu Pennestri, Teresa, Posteraro, B. (ORCID:0000-0002-1663-7546), De Angelis, G. (ORCID:0000-0002-7087-7399), Menchinelli, G., Fiori, B. (ORCID:0000-0003-3318-5809), De Maio, F., Cortazzo, V., Sanguinetti, M. (ORCID:0000-0002-9780-7059), and Spanu, T (ORCID:0000-0003-1864-5184)
Abstract: The aim of this study was to characterize COVID-19 (SARS-CoV-2-infected) patients who develop bloodstream infection (BSI) and to assess risk factors associated with in-hospital mortality. We conducted a retrospective observational study of adult patients admitted for 48 h to a large Central Italy hospital for COVID-19 (1 March to 31 May 2020) who had or had not survived at discharge. We included only patients having blood cultures drawn or other inclusion criteria satisfied. Kaplan–Meier survival or Cox regression analyses were performed of 293 COVID-19 patients studied, 46 patients (15.7%) had a hospital-acquired clinically relevant BSI secondary to SARS-CoV-2 infection, accounting for 58 episodes (49 monomicrobial and 9 polymicrobial) in total. Twelve episodes (20.7%) occurred at day 3 of hospital admission. Sixty-nine species were isolated, including Staphylococcus aureus (32.8%), Enterobacterales (20.7%), Enterococcus faecalis (17.2%), Candida (13.8%) and Pseudomonas aeruginosa (10.3%). Of 69 isolates, 27 (39.1%) were multidrug-resistant organisms. Twelve (54.5%) of 22 patients for whom empirical antimicrobial therapy was inappropriate were infected by a multidrug-resistant organism. Of 46 patients, 26 (56.5%) survived and 20 (43.5%) died. Exploring variables for association with in-hospital mortality identified > 75-year age (HR 2.97, 95% CI 1.15–7.68,p = 0.02), septic shock (HR 6.55, 95% CI 2.36–18.23, p < 0.001) and BSI onset 3 days (HR 4.68, 95% CI 1.40–15.63, p = 0.01) as risk factors independently associated with death. In our hospital, mortality among COVID-19 patients with BSI was high. While continued vigilance against these infections is essential, identification of risk factors for mortality may help to reduce fatal outcomes in patients with COVID-19.
Published: 2021

26. Comparing BioFire FilmArray BCID2 and BCID panels for direct detection of bacterial pathogens and antimicrobial resistance genes from positive blood cultures

Author: Cortazzo, Venere, D'Inzeo, Tiziana, Giordano, Liliana, Menchinelli, Giulia, Liotti, Flora Marzia, Fiori, Barbara, Demaio, F., Luzzaro, F., Sanguinetti, Maurizio, Posteraro, Brunella, Spanu Pennestri, Teresa, Cortazzo V., D'Inzeo T. (ORCID:0000-0003-1508-3518), Giordano L., Menchinelli G., Liotti F. M., Fiori B. (ORCID:0000-0003-3318-5809), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Spanu T. (ORCID:0000-0003-1864-5184), Cortazzo, Venere, D'Inzeo, Tiziana, Giordano, Liliana, Menchinelli, Giulia, Liotti, Flora Marzia, Fiori, Barbara, Demaio, F., Luzzaro, F., Sanguinetti, Maurizio, Posteraro, Brunella, Spanu Pennestri, Teresa, Cortazzo V., D'Inzeo T. (ORCID:0000-0003-1508-3518), Giordano L., Menchinelli G., Liotti F. M., Fiori B. (ORCID:0000-0003-3318-5809), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), and Spanu T. (ORCID:0000-0003-1864-5184)
Abstract: This study evaluated and compared the accuracy of BCID2 with that of BCID to identify bacterial species and relative antimicrobial resistance genes directly from positive BCs. We used archived samples from positive BCs (1.5 ml thereof mixed with 100 ml of dimethyl sulfoxide and stored at 280°C), which had prospectively been processed with the BD Bactec 9240 (BD Diagnostic Systems, Sparks, MD), BacTAlert 3D (bioMérieux), or BacTAlert Virtuo (bioMérieux) system at two hospital microbiology laboratories from January 2018 to August 2020.
Published: 2021

27. Nonlinear machine learning pattern recognition and bacteria-metabolite multilayer network analysis of perturbed gastric microbiome

Author: Duran, C., Ciucci, S., Palladini, A., Ijaz, U. Z., Zippo, A. G., Sterbini, F. P., Masucci, Luca, Cammarota, Giovanni, Ianiro, Gianluca, Spuul, P., Schroeder, M., Grill, S. W., Parsons, B. N., Pritchard, D. M., Posteraro, Brunella, Sanguinetti, Maurizio, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Cannistraci, C. V., Masucci L. (ORCID:0000-0002-8358-6726), Cammarota G. (ORCID:0000-0002-3626-6148), Ianiro G. (ORCID:0000-0002-8318-0515), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Gasbarrini G., Gasbarrini A. (ORCID:0000-0002-7278-4823), Duran, C., Ciucci, S., Palladini, A., Ijaz, U. Z., Zippo, A. G., Sterbini, F. P., Masucci, Luca, Cammarota, Giovanni, Ianiro, Gianluca, Spuul, P., Schroeder, M., Grill, S. W., Parsons, B. N., Pritchard, D. M., Posteraro, Brunella, Sanguinetti, Maurizio, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Cannistraci, C. V., Masucci L. (ORCID:0000-0002-8358-6726), Cammarota G. (ORCID:0000-0002-3626-6148), Ianiro G. (ORCID:0000-0002-8318-0515), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Gasbarrini G., and Gasbarrini A. (ORCID:0000-0002-7278-4823)
Abstract: The stomach is inhabited by diverse microbial communities, co-existing in a dynamic balance. Long-term use of drugs such as proton pump inhibitors (PPIs), or bacterial infection such as Helicobacter pylori, cause significant microbial alterations. Yet, studies revealing how the commensal bacteria re-organize, due to these perturbations of the gastric environment, are in early phase and rely principally on linear techniques for multivariate analysis. Here we disclose the importance of complementing linear dimensionality reduction techniques with nonlinear ones to unveil hidden patterns that remain unseen by linear embedding. Then, we prove the advantages to complete multivariate pattern analysis with differential network analysis, to reveal mechanisms of bacterial network re-organizations which emerge from perturbations induced by a medical treatment (PPIs) or an infectious state (H. pylori). Finally, we show how to build bacteria-metabolite multilayer networks that can deepen our understanding of the metabolite pathways significantly associated to the perturbed microbial communities.
Published: 2021

28. EUCAST rapid antimicrobial susceptibility testing of blood cultures positive for Escherichia coli or Klebsiella pneumoniae: experience of three laboratories in Italy

Author: Cortazzo, Venere, Giordano, Liliana, D'Inzeo, Tiziana, Fiori, B., Brigante, G., Luzzaro, F., Liotti, Flora Marzia, Menchinelli, Giulia, Sanguinetti, Maurizio, Spanu, Teresa, Posteraro, Brunella, Cortazzo V., Giordano L., D'Inzeo T. (ORCID:0000-0003-1508-3518), Liotti F. M., Menchinelli G., Sanguinetti M. (ORCID:0000-0002-9780-7059), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Cortazzo, Venere, Giordano, Liliana, D'Inzeo, Tiziana, Fiori, B., Brigante, G., Luzzaro, F., Liotti, Flora Marzia, Menchinelli, Giulia, Sanguinetti, Maurizio, Spanu, Teresa, Posteraro, Brunella, Cortazzo V., Giordano L., D'Inzeo T. (ORCID:0000-0003-1508-3518), Liotti F. M., Menchinelli G., Sanguinetti M. (ORCID:0000-0002-9780-7059), Spanu T. (ORCID:0000-0003-1864-5184), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: Sir, Recently, EUCAST developed a rapid antimicrobial susceptibility testing (RAST) method for direct use on positive blood culture (BC) samples, which relies on EUCAST standard disc diffusion (DD) methodology and allows inhibition zone reading within 4–8 h of BC positivity.We herein report on EUCAST RAST results for BCs consecutively collected between June 2019 and December 2019 that contained E. coli (n = 134)or K. pneumoniae (n = 66) isolates.
Published: 2021

29. Bordetella pertussis DNA detected in a tracheostomized child blood before seroconversion

Author: Liotti, Flora Marzia, De Angelis, Giulia, Speziale, Domenico, Morandotti, Grazia Angela, Genovese, Orazio, Sanguinetti, Maurizio, Posteraro, Brunella, Liotti F. M., De Angelis G. (ORCID:0000-0002-7087-7399), Speziale D., Morandotti G. A., Genovese O., Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Liotti, Flora Marzia, De Angelis, Giulia, Speziale, Domenico, Morandotti, Grazia Angela, Genovese, Orazio, Sanguinetti, Maurizio, Posteraro, Brunella, Liotti F. M., De Angelis G. (ORCID:0000-0002-7087-7399), Speziale D., Morandotti G. A., Genovese O., Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: NA
Published: 2021

30. Predictors of mortality among adult, old and the oldest old patients with bloodstream infections: An age comparison

Author: Giovannenze, F., Murri, Rita, Palazzolo, C., Taccari, F., Camici, M., Spanu, Teresa, Posteraro, Brunella, Sanguinetti, Maurizio, Cauda, Roberto, Onder, Graziano, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cauda R. (ORCID:0000-0002-1498-4229), Onder G. (ORCID:0000-0003-3400-4491), Fantoni M. (ORCID:0000-0001-6913-8460), Giovannenze, F., Murri, Rita, Palazzolo, C., Taccari, F., Camici, M., Spanu, Teresa, Posteraro, Brunella, Sanguinetti, Maurizio, Cauda, Roberto, Onder, Graziano, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cauda R. (ORCID:0000-0002-1498-4229), Onder G. (ORCID:0000-0003-3400-4491), and Fantoni M. (ORCID:0000-0001-6913-8460)
Abstract: Background: Bloodstream infections (BSIs) are a major cause of mortality in elderly. Objective of the study is to identify factors predictive of mortality in old and oldest old patients. Methods: This is a single centre retrospective observational study, including all patients admitted to Fondazione Policlinico A. Gemelli university hospital and diagnosed with BSI. Patients were stratified into three groups according to age: adult (A), younger than 65; old (O), aged between 65 and 80; oldest old (OO), older than 80. Primary outcome was 30-day in-hospital mortality. Secondary outcomes were duration of antimicrobial therapy (DOT) and length of hospital stay (LOS). Results: Of the 1034 patients included in the study, 346 were in group A, 447 in group O and 241 in group OO. The rate of 30-day mortality raised from 6.9% (24/346) in group A to 10.8% (84/447) in group O and 33.2% (80/241) in group OO (p<0.01), while DOT and LOS significantly decreased moving from adults to oldest old (p<0.01). Methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus spp were both independently correlated to an increased 30-day mortality risk selectively in patients older than 80 (MRSA: HR 2.37, p=0.03; Enterococcus spp: HR 2.44, p=0.01). Conclusions: BSIs have a high impact on survival in old and oldest old patients. BSIs by gram-positive pathogens, in particular MRSA and Enterococcus spp, should be a wake-up call for physicians, who should focus efforts on adequate and prompt antibiotic and support treatment.
Published: 2021

31. Performance of a novel diagnostic assay for rapid SARS-CoV-2 antigen detection in nasopharynx samples

Author: Liotti, F. M., Menchinelli, G., Lalle, E., Palucci, I., Marchetti, S., Colavita, F., La Sorda, M., Sberna, G., Bordi, L., Sanguinetti, M. (ORCID:0000-0002-9780-7059), Cattani, P. (ORCID:0000-0003-4678-4763), Capobianchi, M. R., Posteraro, B. (ORCID:0000-0002-1663-7546), Liotti, F. M., Menchinelli, G., Lalle, E., Palucci, I., Marchetti, S., Colavita, F., La Sorda, M., Sberna, G., Bordi, L., Sanguinetti, M. (ORCID:0000-0002-9780-7059), Cattani, P. (ORCID:0000-0003-4678-4763), Capobianchi, M. R., and Posteraro, B. (ORCID:0000-0002-1663-7546)
Abstract: N/A
Published: 2020

32. Potent in vitro activity of citrus aurantium essential oil and vitis vinifera hydrolate against gut yeast isolates from irritable bowel syndrome patients—the right mix for potential therapeutic use

Author: Di Vito, Maura, Grazia Bellardi, M., Sanguinetti, Maurizio, Mondello, F., Girolamo, A., Barbanti, L., Garzoli, S., Sabatino, M., Ragno, R., Vitali, Alberto, Palucci, Ivana, Posteraro, Brunella, Gasbarrini, Antonio, Maria Prati, G., Aragona, G., Mattarelli, P., Bugli, Francesca, Di Vito M. (ORCID:0000-0002-2991-0855), Sanguinetti M. (ORCID:0000-0002-9780-7059), Vitali A., Palucci I., Posteraro B. (ORCID:0000-0002-1663-7546), Gasbarrini A. (ORCID:0000-0002-7278-4823), Bugli F. (ORCID:0000-0001-9038-3233), Di Vito, Maura, Grazia Bellardi, M., Sanguinetti, Maurizio, Mondello, F., Girolamo, A., Barbanti, L., Garzoli, S., Sabatino, M., Ragno, R., Vitali, Alberto, Palucci, Ivana, Posteraro, Brunella, Gasbarrini, Antonio, Maria Prati, G., Aragona, G., Mattarelli, P., Bugli, Francesca, Di Vito M. (ORCID:0000-0002-2991-0855), Sanguinetti M. (ORCID:0000-0002-9780-7059), Vitali A., Palucci I., Posteraro B. (ORCID:0000-0002-1663-7546), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Bugli F. (ORCID:0000-0001-9038-3233)
Abstract: Background: Irritable bowel syndrome (IBS) is a functional disorder without any pathological alteration, in which the alterations of the Candida/Saccharomyces ratio of the gut microbiota, the balance of pro and anti-inflammatory cytokines and the brain-gut-microbiome axis are important for the development and progression of IBS. The aim of the study was to identify natural products, including essential oils or hydrolates, which were contextually harmless for the gut beneficial strains (e.g. Saccharomyces spp.) but inhibitory for the pathogenic ones (Candida spp.). Methods: The effectiveness of 6 essential oils and 2 hydrolates was evaluated using microbiological tests, carried out on 50 clinical isolates (Candida, Saccharomyces and Galattomyces species) and 9 probiotic strains (Saccharomyces cerevisiae, Lactobacillus species, Akkermansia muciniphila and Faecalibacterium prausnitzii) and immunological and antioxidant assays. Results: The study led to a mixture based on a 1/100 ratio of Citrus aurantium var. amara essential oil/Vitis vinifera cv Italia hydrolate able to contextually reduce, in a concentration-dependent manner, the ability of Candida species to form hyphal filaments and have an interesting immunomodulatory and anti-oxidant action. This mixture can potentially be useful in the IBS treatment promoting the restoration of the intestinal microbial and immunological balance.
Published: 2020

33. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in children with household exposure to adults with COVID-19: Preliminary findings

Author: Buonsenso, Danilo, Valentini, Piero, De Rose, Cristina, Pata, Davide, Sinatti, Dario, Speziale, Domenico, Ricci, R., Carfi, A., Landi, Francesco, Ferrari, V., De Maio, Flavio, Palucci, Ivana, Sanguinetti, Maurizio, Sali, Michela, Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Ciciarello, F., Lo Monaco, M. R., Martone, A. M., Marzetti, Emanuele, Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, Riccardo, Catalano, L., Picca, A., Savera, G., Cauda, R., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, Maria Assunta, Sanguinetti, M., Cattani Franchi, Paola, Marchetti, S., Posteraro, Brunella, Sali, M., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, Maria Cristina, Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, Luca, Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, Luigi, Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Tolusso, B., Alivernini, S., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), De Rose C., Pata D., Sinatti D., Speziale D., Landi F. (ORCID:0000-0002-3472-1389), De Maio F., Palucci I., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sali M. (ORCID:0000-0003-3609-2990), Marzetti E. (ORCID:0000-0001-9567-6983), Calvani R. (ORCID:0000-0001-5472-2365), Zocco M. A. (ORCID:0000-0002-0814-9542), Cattani P. (ORCID:0000-0003-4678-4763), Posteraro B. (ORCID:0000-0002-1663-7546), Savastano M. C. (ORCID:0000-0003-1397-4333), Richeldi L. (ORCID:0000-0001-8594-1448), Natale L. (ORCID:0000-0002-7949-5119), Buonsenso, Danilo, Valentini, Piero, De Rose, Cristina, Pata, Davide, Sinatti, Dario, Speziale, Domenico, Ricci, R., Carfi, A., Landi, Francesco, Ferrari, V., De Maio, Flavio, Palucci, Ivana, Sanguinetti, Maurizio, Sali, Michela, Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Ciciarello, F., Lo Monaco, M. R., Martone, A. M., Marzetti, Emanuele, Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, Riccardo, Catalano, L., Picca, A., Savera, G., Cauda, R., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, Maria Assunta, Sanguinetti, M., Cattani Franchi, Paola, Marchetti, S., Posteraro, Brunella, Sali, M., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, Maria Cristina, Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, Luca, Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, Luigi, Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Tolusso, B., Alivernini, S., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), De Rose C., Pata D., Sinatti D., Speziale D., Landi F. (ORCID:0000-0002-3472-1389), De Maio F., Palucci I., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sali M. (ORCID:0000-0003-3609-2990), Marzetti E. (ORCID:0000-0001-9567-6983), Calvani R. (ORCID:0000-0001-5472-2365), Zocco M. A. (ORCID:0000-0002-0814-9542), Cattani P. (ORCID:0000-0003-4678-4763), Posteraro B. (ORCID:0000-0002-1663-7546), Savastano M. C. (ORCID:0000-0003-1397-4333), Richeldi L. (ORCID:0000-0001-8594-1448), and Natale L. (ORCID:0000-0002-7949-5119)
Abstract: Weather and the susceptibility of children to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still a debated question and currently a hot topic, particularly in view of important decisions regarding opening schools. Therefore, we performed this prospective analysis of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies in children with known household exposure to SARS-CoV-2 and compared their IgG status with the other adults exposed to the index case in the same household. A total of 30 families with a documented COVID-19 index case were included. A total of 44 out of 80 household contacts (55%) of index patients had anti SARS-CoV-2 IgG antibodies. In particular, 16/27 (59,3%) adult partners had IgG antibodies compared with 28/53 (52,3%) of pediatric contacts (p >.05). Among the pediatric population, children ≥5 years of age had a similar probability of having SARS-CoV-2 IgG antibodies (21/39, 53.8%) compared to those less than 5 years old (7/14, 50%) (p >.05). Adult partners and children also had a similar probability of having SARS-CoV-2 IgG antibodies. Interestingly, 10/28 (35.7%) of children and 5/27 (18.5%) of adults with SARS-CoV-2 IgG antibodies were previously diagnosed as COVID-19 cases. Our study shows evidence of a high rate of IgG antibodies in children exposed to SARS-CoV-2. This report has public health implications, highlighting the need to establish appropriate guidelines for school openings and other social activities related to childhood.
Published: 2020

34. Gut microbiota analysis in systemic sclerosis according to disease characteristics and nutritional status

Author: Natalello, Gerlando, Bosello, Silvia Laura, Sterbini, F. P., Posteraro, Brunella, de Lorenzis, E., Canestrari, G. B., Gigante, Laura, Verardi, Lucrezia, Ferraccioli, Gianfranco, Sanguinetti, Maurizio, Gremese, Elisa, Natalello G., Bosello S. L. (ORCID:0000-0002-4837-447X), Posteraro B. (ORCID:0000-0002-1663-7546), Gigante L., Verardi L., Ferraccioli G. (ORCID:0000-0001-6246-2428), Sanguinetti M. (ORCID:0000-0002-9780-7059), Gremese E. (ORCID:0000-0002-2248-1058), Natalello, Gerlando, Bosello, Silvia Laura, Sterbini, F. P., Posteraro, Brunella, de Lorenzis, E., Canestrari, G. B., Gigante, Laura, Verardi, Lucrezia, Ferraccioli, Gianfranco, Sanguinetti, Maurizio, Gremese, Elisa, Natalello G., Bosello S. L. (ORCID:0000-0002-4837-447X), Posteraro B. (ORCID:0000-0002-1663-7546), Gigante L., Verardi L., Ferraccioli G. (ORCID:0000-0001-6246-2428), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Gremese E. (ORCID:0000-0002-2248-1058)
Abstract: Objective. Systemic sclerosis (SSc) is a rare multi-organ disorder with a prominent gastrointestinal (GI) involvement. Altered gut microbiota is now considered a pivotal factor associated with the development of immune-mediated and inflammatory diseases. We performed a 16S ribosomal RNA (rRNA) gene-sequencing analysis of fecal microbiota in a cohort of SSc patients and matched healthy controls (HCs), with the aim to obtain some hints about a possible role of dysbiosis in the onset, progression, and severity of the disease. Methods. We analysed stool samples from 63 SSc patients with different disease duration, phenotype, and nutritional status and from 17 HCs through 16S ribosomal RNA (rRNA) gene-sequencing. Results. Microbial richness was lower for patients with long-standing disease. A similar observation was made for patients with diffuse cutaneous SSc (dsSSc) compared to those with limited variant (lcSSc) and for patients who reported a recent weight loss. Consistent with previous reports, we noted a deviation of the intestinal microbial composition in patients with SSc compared to HCs, with a greater expression of Lactobacillus and Streptococcus and a depletion of Sutterella. Nutritional status, assessed using BMI as a surrogate, appeared to have a marked impact on the gut microbiota, with overweight patients showing lower richness compared both to underweight and normal-BMI patients. Conclusion. Our findings expand the current knowledge of gut microbiota in SSc and could be useful to identify patients who would most benefit from treatments aimed at restoring the eubiosis.
Published: 2020

35. Assessment of SARS-CoV-2 RNA Test Results among Patients Who Recovered from COVID-19 with Prior Negative Results

Author: Liotti, Flora Marzia, Menchinelli, Giulia, Marchetti, Simona, Posteraro, Brunella, Landi, Francesco, Sanguinetti, Maurizio, Cattani Franchi, Paola, Liotti F. M., Menchinelli G., Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Landi F. (ORCID:0000-0002-3472-1389), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Liotti, Flora Marzia, Menchinelli, Giulia, Marchetti, Simona, Posteraro, Brunella, Landi, Francesco, Sanguinetti, Maurizio, Cattani Franchi, Paola, Liotti F. M., Menchinelli G., Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Landi F. (ORCID:0000-0002-3472-1389), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Cattani P. (ORCID:0000-0003-4678-4763)
Abstract: N/A
Published: 2020

36. Genotyping Reveals High Clonal Diversity and Widespread Genotypes of Candida Causing Candidemia at Distant Geographical Areas

Author: Guinea, J., Arendrup, M. C., Canton, R., Canton, E., Garcia-Rodriguez, J., Gomez, A., de la Pedrosa, E. G. G., Hare, R. K., Orden, B., Sanguinetti, Maurizio, Peman, J., Posteraro, Brunella, Ruiz-Gaitan, A., Parisi, G., Da Matta, D. A., Colombo, A. L., Sanchez-Carrillo, C., Reigadas, E., Munoz, P., Escribano, P., Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Guinea, J., Arendrup, M. C., Canton, R., Canton, E., Garcia-Rodriguez, J., Gomez, A., de la Pedrosa, E. G. G., Hare, R. K., Orden, B., Sanguinetti, Maurizio, Peman, J., Posteraro, Brunella, Ruiz-Gaitan, A., Parisi, G., Da Matta, D. A., Colombo, A. L., Sanchez-Carrillo, C., Reigadas, E., Munoz, P., Escribano, P., Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: The objectives of this study were to gain further insight on Candida genotype distribution and percentage of clustered isolates between hospitals and to identify potential clusters involving different hospitals and cities. We aim to genotype Candida spp. isolates causing candidemia in patients admitted to 16 hospitals in Spain, Italy, Denmark, and Brazil. Eight hundred and eighty-four isolates (Candida albicans, n = 534; C. parapsilosis, n = 282; and C. tropicalis, n = 68) were genotyped using species-specific microsatellite markers. CDC3, EF3, HIS3, CAI, CAIII, and CAVI were used for C. albicans, Ctrm1, Ctrm10, Ctrm12, Ctrm21, Ctrm24, and Ctrm28 for C. tropicalis, and CP1, CP4a, CP6, and B for C. parapsilosis. Genotypes were classified as singletons (genotype only found once) or clusters (same genotype infecting two or more patients). Clusters were defined as intra-hospital (involving patients admitted to a single hospital), intra-ward (involving patients admitted to the same hospital ward) or widespread (involving patients admitted to different hospitals). The percentage of clusters and the proportion of patients involved in clusters among species, genotypic diversity and distribution of genetic diversity were assessed. Seven hundred and twenty-three genotypes were detected, 78 (11%) being clusters, most of which (57.7%; n = 45/78) were intra-hospital clusters including intra-ward ones (42.2%; n = 19/45). The proportion of clusters was not statistically different between species, but the percentage of patients in clusters varied among hospitals. A number of genotypes (7.2%; 52/723) were widespread (found at different hospitals), comprising 66.7% (52/78) of clusters, and involved patients at hospitals in the same city (n = 21) or in different cities (n = 31). Only one C. parapsilosis cluster was a widespread genotype found in all four countries. Around 11% of C. albicans and C. parapsilosis isolates causing candidemia are clusters that may result from patient-to-pa
Published: 2020

37. Pan-echinocandin-resistant candida glabrata bloodstream infection complicating covid-19: A fatal case report

Author: Posteraro, Brunella, Torelli, Riccardo, Vella, Antonietta, Leone, Paolo Maria, De Angelis, Giulia, De Carolis, Elena, Ventura, Giulio, Sanguinetti, Maurizio, Fantoni, Massimo, Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., Vella A., Leone P. M., De Angelis G. (ORCID:0000-0002-7087-7399), De Carolis E. (ORCID:0000-0003-4757-7256), Ventura G. (ORCID:0000-0002-0304-7264), Sanguinetti M. (ORCID:0000-0002-9780-7059), Fantoni M. (ORCID:0000-0001-6913-8460), Posteraro, Brunella, Torelli, Riccardo, Vella, Antonietta, Leone, Paolo Maria, De Angelis, Giulia, De Carolis, Elena, Ventura, Giulio, Sanguinetti, Maurizio, Fantoni, Massimo, Posteraro B. (ORCID:0000-0002-1663-7546), Torelli R., Vella A., Leone P. M., De Angelis G. (ORCID:0000-0002-7087-7399), De Carolis E. (ORCID:0000-0003-4757-7256), Ventura G. (ORCID:0000-0002-0304-7264), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Fantoni M. (ORCID:0000-0001-6913-8460)
Abstract: Coinfections with bacteria or fungi may be a frequent complication of COVID-19, but coinfections with Candida species in COVID-19 patients remain rare. We report the 53-day clinical course of a complicated type-2 diabetes patient diagnosed with COVID-19, who developed bloodstream infections initially due to methicillin-resistant Staphylococcus aureus, secondly due to multidrug-resistant Gram-negative bacteria, and lastly due to a possibly fatal Candida glabrata. The development of FKS-associated pan-echinocandin resistance in the C. glabrata isolated from the patient after 13 days of caspofungin treatment aggravated the situation. The patient died of septic shock shortly before the prospect of receiving potentially effective antifungal therapy. This case emphasizes the importance of early diagnosis and monitoring for antimicrobial drug-resistant coinfections to reduce their unfavorable outcomes in COVID-19 patients.
Published: 2020

38. New Data on the in Vitro Activity of Fenticonazole against Fluconazole-Resistant Candida Species

Author: Cacaci, Margherita, Menchinelli, Giulia, Torelli, Riccardo, Sanglard, D., Sanguinetti, Maurizio, Posteraro, Brunella, Cacaci M. (ORCID:0000-0002-5433-9400), Menchinelli G., Torelli R., Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Cacaci, Margherita, Menchinelli, Giulia, Torelli, Riccardo, Sanglard, D., Sanguinetti, Maurizio, Posteraro, Brunella, Cacaci M. (ORCID:0000-0002-5433-9400), Menchinelli G., Torelli R., Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: N/A
Published: 2020

39. Prevalence and Clonal Distribution of Azole-Resistant Candida parapsilosis Isolates Causing Bloodstream Infections in a Large Italian Hospital

Author: Martini, Cecilia, Torelli, Riccardo, de Groot, T., De Carolis, Elena, Morandotti, Grazia Angela, De Angelis, Giulia, Posteraro, Brunella, Meis, J. F., Sanguinetti, Maurizio, Martini C., Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Morandotti G. A., De Angelis G. (ORCID:0000-0002-7087-7399), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Martini, Cecilia, Torelli, Riccardo, de Groot, T., De Carolis, Elena, Morandotti, Grazia Angela, De Angelis, Giulia, Posteraro, Brunella, Meis, J. F., Sanguinetti, Maurizio, Martini C., Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Morandotti G. A., De Angelis G. (ORCID:0000-0002-7087-7399), Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: The most prevalent cause of nosocomial bloodstream infection (BSI) among non-C. albicans Candida species, Candida parapsilosis, may not only be resistant to azole antifungal agents but also disseminate to vulnerable patients. In this survey of BSIs occurring at a large Italian hospital between May 2014 and May 2019, C. parapsilosis accounted for 28.5% (241/844) of all Candida isolates causing BSI episodes. The majority of episodes (151/844) occurred in medical wards. Across the 5 yearly periods, the rates of azole non-susceptibility were 11.8% (4/34), 17.8% (8/45), 28.6% (12/42), 32.8% (19/58), and 17.7% (11/62), respectively, using the Sensititre YeastOne® method. Among azole non-susceptible isolates (54/241; 22.4%), 49 were available for further investigation. Using the CLSI reference method, all 49 isolates were resistant to fluconazole and, except one (susceptible dose-dependent), to voriconazole. Forty (81.6%) isolates harbored the Erg11p Y132F substitution and nine (18.4%) isolates the Y132F in combination with the Erg11p R398I substitution. According to their genotypes, as defined using a microsatellite analysis based on six short tandem repeat markers, 87.7% of isolates (43/49) grouped in two major clusters (II and III), whereas 4.1% of isolates (2/49) belonged to a separate cluster (I). Interestingly, all the isolates from cluster II harbored the Y132F substitution, and those from cluster III harbored both Y132F and R398I substitutions. Of 56 non-Italian isolates included as controls, two Indian isolates with the Y132F substitution had a genotype clearly differing from that of the isolates from clusters II and I. In conclusion, these findings show the dominance of clonal Y132F isolates in our hospital and suggest detection of the Y132F substitution as helpful tool to prevent transmission among hospitalized patients at risk of BSI.
Published: 2020

40. Nasopharyngeal Microbiota Profiling of SARS-CoV-2 Infected Patients

Author: De Maio, Flavio, Posteraro, Brunella, Ponziani, Francesca Romana, Cattani Franchi, Paola, Gasbarrini, Antonio, Sanguinetti, Maurizio, De Maio F., Posteraro B. (ORCID:0000-0002-1663-7546), Ponziani F. R. (ORCID:0000-0002-5924-6238), Cattani P. (ORCID:0000-0003-4678-4763), Gasbarrini A. (ORCID:0000-0002-7278-4823), Sanguinetti M. (ORCID:0000-0002-9780-7059), De Maio, Flavio, Posteraro, Brunella, Ponziani, Francesca Romana, Cattani Franchi, Paola, Gasbarrini, Antonio, Sanguinetti, Maurizio, De Maio F., Posteraro B. (ORCID:0000-0002-1663-7546), Ponziani F. R. (ORCID:0000-0002-5924-6238), Cattani P. (ORCID:0000-0003-4678-4763), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: We analyzed the bacterial communities of the nasopharynx in 40 SARS-CoV-2 infected and uninfected patients. All infected patients had a mild COVID-19 disease. We did not find statistically significant differences in either bacterial richness and diversity or composition. These findings suggest a nasopharyngeal microbiota at least early resilient to SARS-CoV-2 infection.
Published: 2020

41. Evaluating the newly developed BioFire COVID-19 test for SARS-CoV-2 molecular detection

Author: Liotti, F. M., Menchinelli, G., Marchetti, S., Morandotti, G. A., Sanguinetti, M., Posteraro, B., Cattani, P., Liotti F. M., Menchinelli G., Marchetti S., Morandotti G. A., Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Cattani P. (ORCID:0000-0003-4678-4763), Liotti, F. M., Menchinelli, G., Marchetti, S., Morandotti, G. A., Sanguinetti, M., Posteraro, B., Cattani, P., Liotti F. M., Menchinelli G., Marchetti S., Morandotti G. A., Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), and Cattani P. (ORCID:0000-0003-4678-4763)
Abstract: N/A
Published: 2020

42. Lack of relationship between genotype and virulence in Candida species

Author: Diaz-Garcia, J., Arendrup, M. C., Canton, R., Garcia-Rodriguez, J., de la Pedrosa, E. G. G., Parisi, G., Peman, J., Posteraro, Brunella, Sanguinetti, Maurizio, Da Matta, D. A., Colombo, A. L., Munoz, P., Sanchez-Carrillo, C., Guinea, J., Escribano, P., Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Diaz-Garcia, J., Arendrup, M. C., Canton, R., Garcia-Rodriguez, J., de la Pedrosa, E. G. G., Parisi, G., Peman, J., Posteraro, Brunella, Sanguinetti, Maurizio, Da Matta, D. A., Colombo, A. L., Munoz, P., Sanchez-Carrillo, C., Guinea, J., Escribano, P., Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: Background: The virulence of isolates among different Candida species causing candidemia may play a role in the prognosis of the patients. Furthermore, the potential relationship between genotype and virulence is still unclear and need to be further studied. Aims: We aim to assess the relationship between genotype and virulence in Candida species using a Galleria mellonella larvae infection model. Methods: One hundred and ninety-four isolates from 68 clusters (Candida albicans, 114/41; Candida parapsilosis, 74/24; Candida tropicalis, 6/3) were compared against the same number of each species singleton genotypes in terms of survival of G. mellonella larvae. Results: The median of survival and the IQR ranges of clusters and singleton were as follows: C. albicans (2 days, IQR 1.5–2 vs. 2 days, IQR 1–2.25), C. parapsilosis (2 days, IQR 1.5–2.6 vs. 2 days, IQR 2–3.3), and C. tropicalis (1 day, IQR 1–3.5 vs. 2 days, IQR 2–3.5; p < 0.05). High intra-cluster variability in terms of median of survival was found regardless the species. Conclusions: No relationship between genotype and virulence in Candida was observed with the G. mellonella model.
Published: 2020

43. Candidaemia in haematological malignancy patients from a SEIFEM study: Epidemiological patterns according to antifungal prophylaxis

Author: Posteraro, Brunella, De Carolis, Elena, Criscuolo, Marianna, Ballanti, S., De Angelis, Giulia, Del Principe, M. I., Delia, M., Fracchiolla, N., Marchesi, F., Nadali, G., Picardi, Stefano Maria, Piccioni, A. L., Verga, L., Candoni, A., Busca, A., Sanguinetti, Maurizio, Pagano, Livio, Muggeo, P., Stanzani, M., Cattaneo, C., Russo, D., Vacca, A., Fanci, R., De Paolis, M. R., Mancini, V., Lessi, F., Rossetti, E., Decembrino, N., Facchini, L., Dragonetti, Giulia, Ferrari, A., Vallero, S., Posteraro B. (ORCID:0000-0002-1663-7546), De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., De Angelis G. (ORCID:0000-0002-7087-7399), Picardi M., Sanguinetti M. (ORCID:0000-0002-9780-7059), Pagano L. (ORCID:0000-0001-8287-928X), Dragonetti G., Posteraro, Brunella, De Carolis, Elena, Criscuolo, Marianna, Ballanti, S., De Angelis, Giulia, Del Principe, M. I., Delia, M., Fracchiolla, N., Marchesi, F., Nadali, G., Picardi, Stefano Maria, Piccioni, A. L., Verga, L., Candoni, A., Busca, A., Sanguinetti, Maurizio, Pagano, Livio, Muggeo, P., Stanzani, M., Cattaneo, C., Russo, D., Vacca, A., Fanci, R., De Paolis, M. R., Mancini, V., Lessi, F., Rossetti, E., Decembrino, N., Facchini, L., Dragonetti, Giulia, Ferrari, A., Vallero, S., Posteraro B. (ORCID:0000-0002-1663-7546), De Carolis E. (ORCID:0000-0003-4757-7256), Criscuolo M., De Angelis G. (ORCID:0000-0002-7087-7399), Picardi M., Sanguinetti M. (ORCID:0000-0002-9780-7059), Pagano L. (ORCID:0000-0001-8287-928X), and Dragonetti G.
Abstract: Background: Candidaemia is an important infectious complication for haematological malignancy patients. Antifungal prophylaxis reduces the incidence of candidaemia but may be associated with breakthrough candidaemia. Objective: To analyse the Candida species’ distribution and relative antifungal susceptibility profiles of candidaemia episodes in relation to the use of antifungal prophylaxis among Italian SEIFEM haematology centres. Methodology: This multicentre retrospective observational SEIFEM study included 133 single-species candidaemia episodes of haematological malignancy patients for whom antifungal susceptibility testing results of blood Candida isolates were available between 2011 and 2015. Each participating centre provided both clinical and microbiological data. Results: Non-Candida albicans Candida (NCAC) species were the mostly isolated species (89, 66.9%), which accounted for C parapsilosis (35, 26.3%), C glabrata (16, 12.0%), C krusei (14, 10.5%), C tropicalis (13, 9.8%) and uncommon species (11, 8.3%). C albicans caused the remaining 44 (33.1%) episodes. Excluding 2 C albicans isolates, 23 of 25 fluconazole-resistant isolates were NCAC species (14 C krusei, 6 C glabrata, 2 C parapsilosis and 1 C tropicalis). Fifty-six (42.1%) of 133 patients developed breakthrough candidaemia. Systemic antifungal prophylaxis consisted of azoles, especially fluconazole and posaconazole, in 50 (89.3%) of 56 patients in whom a breakthrough candidaemia occurred. Interestingly, all these patients tended to develop a C krusei infection (10/56, P =.02) or a fluconazole-resistant isolate’s infection (14/50, P =.04) compared to patients (4/77 and 10/77, respectively) who did not have a breakthrough candidaemia. Conclusions: Optimisation of prophylactic strategies is necessary to limit the occurrence of breakthrough candidaemia and, importantly, the emergence of fluconazole-resistant NCAC isolates’ infections in
Published: 2020

44. Different detection capabilities by mycological media for Candida isolates from mono- or dual-species cultures

Author: De Angelis, Giulia, Menchinelli, Giulia, Torelli, Riccardo, De Carolis, Elena, Posteraro, P., Sanguinetti, Maurizio, Posteraro, Brunella, De Angelis G. (ORCID:0000-0002-7087-7399), Menchinelli G., Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), De Angelis, Giulia, Menchinelli, Giulia, Torelli, Riccardo, De Carolis, Elena, Posteraro, P., Sanguinetti, Maurizio, Posteraro, Brunella, De Angelis G. (ORCID:0000-0002-7087-7399), Menchinelli G., Torelli R., De Carolis E. (ORCID:0000-0003-4757-7256), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Posteraro B. (ORCID:0000-0002-1663-7546)
Abstract: The aim of this study was to compare the Candida bromcresol green (BCG) medium with the chromogenic (CHROM) Brilliance Candida agar and Sabouraud dextrose agar (SDA) media in regard to their capability of detecting Candida isolates from mono- or dual-species cultures. We prepared Candida isolates' suspensions to obtain mono-species (n = 18) or dual-species (n = 153) culture plates per each medium, and three readers independently observed 513 plates at 24-h, 48-h and 72-h incubation time. We scored reading results as correct, over or under detection compared to the expected species number(s). BCG showed significantly higher correct-detection and lower under-detection rates for all Candida species when observed by at least one reader. At 24-h reading, 12 mono-species cultures had correct (or over) detections in all media, whereas 106, 60 and 78 dual-species cultures had correct (or over) detections in BCG, CHROM or SDA, respectively. BCG provides the basis for an accurate laboratory diagnosis of Candida infections.
Published: 2020

45. Update on matrix-assisted laser desorption ionization-time of flight mass spectrometry identification of filamentous fungi

Author: Wilkendorf, L. S., Bowles, E., Buil, J. B., Van der Lee, H. A. L., Posteraro, Brunella, Sanguinetti, Maurizio, Verweij, P. E., Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Wilkendorf, L. S., Bowles, E., Buil, J. B., Van der Lee, H. A. L., Posteraro, Brunella, Sanguinetti, Maurizio, Verweij, P. E., Posteraro B. (ORCID:0000-0002-1663-7546), and Sanguinetti M. (ORCID:0000-0002-9780-7059)
Abstract: Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-based species identification has found its place in many clinical routine diagnostic laboratories over the past years, allowing significantly reduced turnaround times and high-precision results. With regard to MALDI-TOF MS for filamentous fungi, here, we discuss different approaches for sample processing and growth conditions before analysis. In particular, we review the performances of different commercially available databases as well as the potential of complementary (self-constructed) in-house databases.
Published: 2020

46. Confirmed or unconfirmed cases of 2019 novel coronavirus pneumonia in Italian patients: a retrospective analysis of clinical features

Author: De Angelis, G., Posteraro, B., Biscetti, F., Ianiro, G., Zileri Dal Verme, L., Cattani, P., Franceschi, F., Sanguinetti, M., Gasbarrini, A., De Angelis G. (ORCID:0000-0002-7087-7399), Posteraro B. (ORCID:0000-0002-1663-7546), Biscetti F. (ORCID:0000-0001-7449-657X), Ianiro G. (ORCID:0000-0002-8318-0515), Zileri Dal Verme L., Cattani P. (ORCID:0000-0003-4678-4763), Franceschi F. (ORCID:0000-0001-6266-445X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Gasbarrini A. (ORCID:0000-0002-7278-4823), De Angelis, G., Posteraro, B., Biscetti, F., Ianiro, G., Zileri Dal Verme, L., Cattani, P., Franceschi, F., Sanguinetti, M., Gasbarrini, A., De Angelis G. (ORCID:0000-0002-7087-7399), Posteraro B. (ORCID:0000-0002-1663-7546), Biscetti F. (ORCID:0000-0001-7449-657X), Ianiro G. (ORCID:0000-0002-8318-0515), Zileri Dal Verme L., Cattani P. (ORCID:0000-0003-4678-4763), Franceschi F. (ORCID:0000-0001-6266-445X), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Gasbarrini A. (ORCID:0000-0002-7278-4823)
Abstract: Background: Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel etiologic agent of viral pneumonia. We aimed to compare clinical features of 165 Italian patients with laboratory confirmed or unconfirmed 2019-nCoV pneumonia. Methods: On March 31, 2020, hospitalized patients who presented with fever and/or respiratory symptoms, exposures, and presence of lung imaging features consistent with 2019-nCoV pneumonia were included. Before admission to a hospital ward, patients underwent RT-PCR based SARS-CoV-2 RNA detection in their nasopharyngeal swab samples. Results: Of 165 patients studied, 119 had positive RT-PCR results and 46 were RT-PCR negative for 2 days or longer (i.e., when the last swab sample was obtained). The median age was 70 years (IQR, 58–78), and 123 (74.6%) of 165 patients had at least one comorbidity. The majority of patients (101/165, 61.2%) had a mild pneumonia, and the remaining patients (64/165, 38.8%) a severe/critical pneumonia. We did not find any substantial difference in symptoms, incubation periods, and radiographic/CT abnormalities as well as in many of the biological abnormalities recorded. However, at multivariable analysis, higher concentrations of hemoglobin (OR, 1.34; 95% CI, 1.11–1.65; P = 0.003) and lower counts of leukocytes (OR, 0.81; 95% CI, 0.72–0.90; P < 0.001) were statistically associated with confirmed COVID-19 diagnosis. While mortality rates were similar, patients with confirmed diagnosis were more likely to receive antivirals (95% vs 19.6%, P < 0.001) and to develop ARDS (63% vs 37%, P = 0.003) than those with unconfirmed COVID-19 diagnosis. Conclusions: Our findings suggest that unconfirmed 2019-nCoV pneumonia cases may be actually COVID-19 cases and that clinicians should be cautious when managing patients with presentations compatible with COVID-19.
Published: 2020

47. Day 10 post-prescription audit optimizes antibiotic therapy in patients with bloodstream infections

Author: Murri, Rita, Palazzolo, C., Giovannenze, F., Taccari, F., Camici, M., Spanu, Teresa, Posteraro, Brunella, Sanguinetti, Maurizio, Cauda, Roberto, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cauda R. (ORCID:0000-0002-1498-4229), Fantoni M. (ORCID:0000-0001-6913-8460), Murri, Rita, Palazzolo, C., Giovannenze, F., Taccari, F., Camici, M., Spanu, Teresa, Posteraro, Brunella, Sanguinetti, Maurizio, Cauda, Roberto, Fantoni, Massimo, Murri R. (ORCID:0000-0003-4263-7854), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cauda R. (ORCID:0000-0002-1498-4229), and Fantoni M. (ORCID:0000-0001-6913-8460)
Abstract: This study aimed to investigate the clinical and organizational impact of an active re-evaluation (on day 10) of patients on antibiotic treatment diagnosed with bloodstream infections (BSIs). A prospective, single center, pre-post quasi-experimental study was performed. Patients were enrolled at the time of microbial BSI confirmation. In the pre-intervention phase (August 2014–August 2015), clinical status and antibiotic regimen were re-evaluated at day 3. In the intervention phase (January 2016–January 2017), clinical status and antibiotic regimen were re-evaluated at day 3 and day 10. Primary outcomes were rate of optimal therapy, duration of antibiotic therapy, length of hospitalization, and 30-day mortality. A total of 632 patients were enrolled (pre-intervention period, n = 303; intervention period, n = 329). Average duration of therapy reduced from 18.1 days (standard deviation (SD), 11.4) in the pre-intervention period to 16.8 days (SD, 12.7) in the intervention period (p < 0.001). Similarly, average length of hospitalization decreased from 24.1 days (SD, 20.8) to 20.6 days (SD, 17.7) (p = 0.001). No inter-group difference was found for the rate of 30-day mortality. In patients with BSI, re-evaluation of clinical status and antibiotic regimen at day 3 and 10 after microbiological diagnosis was correlated with a reduction in the duration of antibiotic therapy and hospital stay. The intervention is simple and has a low impact on overall costs.
Published: 2020

48. Neonatal Late Onset Infection with Severe Acute Respiratory Syndrome Coronavirus 2

Author: Buonsenso, Danilo, Costa, S., Sanguinetti, Maurizio, Cattani Franchi, Paola, Posteraro, Brunella, Marchetti, Simona, Carducci, Brigida, Lanzone, Antonio, Tamburrini, Enrica, Vento, Giovanni, Valentini, Piero, Buonsenso D., Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Posteraro B. (ORCID:0000-0002-1663-7546), Marchetti S., Carducci B., Lanzone A. (ORCID:0000-0003-4119-414X), Tamburrini E. (ORCID:0000-0003-4930-426X), Vento G. (ORCID:0000-0002-8132-5127), Valentini P. (ORCID:0000-0001-6095-9510), Buonsenso, Danilo, Costa, S., Sanguinetti, Maurizio, Cattani Franchi, Paola, Posteraro, Brunella, Marchetti, Simona, Carducci, Brigida, Lanzone, Antonio, Tamburrini, Enrica, Vento, Giovanni, Valentini, Piero, Buonsenso D., Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Posteraro B. (ORCID:0000-0002-1663-7546), Marchetti S., Carducci B., Lanzone A. (ORCID:0000-0003-4119-414X), Tamburrini E. (ORCID:0000-0003-4930-426X), Vento G. (ORCID:0000-0002-8132-5127), and Valentini P. (ORCID:0000-0001-6095-9510)
Abstract: Objective To date, no information on late-onset infection in newborns to mother with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contracted in pregnancy are available. This study aimed to evaluate postdischarge SARS-CoV-2 status of newborns to mothers with COVID-19 in pregnancy that, at birth, were negative to SARS-CoV-2. Study Design This is an observational study of neonates born to mothers with coronavirus disease 2019 (COVID-19). Results Seven pregnant women with documented SARS-CoV-2 infection have been evaluated in our institution. One woman had a spontaneous abortion at 8 weeks of gestational age, four women recovered and are still in follow-up, and two women delivered. Two newborns were enrolled in the study. At birth and 3 days of life, newborns were negative to SARS-CoV-2. At 2-week follow-up, one newborn tested positive although asymptomatic. Conclusion Our findings highlight the importance of follow-up of newborns to mothers with COVID-19 in pregnancy, since they remain at risk of contracting the infection in the early period of life and long-term consequences are still unknown. Key Points Newborns to mothers with coronavirus disease 2019 (COVID-19) in pregnancy can acquire the infection later after birth. Newborns to mothers with COVID-19 in pregnancy need a long-term follow-up, even if they tested negative at birth. Specific guidelines for the long-term follow-up of newborns to mothers with COVID-19 in pregnancy are needed.
Published: 2020

49. Excretion of SARS-CoV-2 in human breast milk

Author: Costa, Simonetta, Posteraro, Brunella, Marchetti, Simona, Tamburrini, Enrica, Carducci, Brigida, Lanzone, Antonio, Valentini, Piero, Buonsenso, Danilo, Sanguinetti, Maurizio, Vento, Giovanni, Cattani Franchi, Paola, Costa, S, Posteraro, B (ORCID:0000-0002-1663-7546), Marchetti, S, Tamburrini, E (ORCID:0000-0003-4930-426X), Carducci, B, Lanzone, A (ORCID:0000-0003-4119-414X), Valentini, P (ORCID:0000-0001-6095-9510), Buonsenso, D, Sanguinetti, M (ORCID:0000-0002-9780-7059), Vento, G (ORCID:0000-0002-8132-5127), Cattani, P (ORCID:0000-0003-4678-4763), Costa, Simonetta, Posteraro, Brunella, Marchetti, Simona, Tamburrini, Enrica, Carducci, Brigida, Lanzone, Antonio, Valentini, Piero, Buonsenso, Danilo, Sanguinetti, Maurizio, Vento, Giovanni, Cattani Franchi, Paola, Costa, S, Posteraro, B (ORCID:0000-0002-1663-7546), Marchetti, S, Tamburrini, E (ORCID:0000-0003-4930-426X), Carducci, B, Lanzone, A (ORCID:0000-0003-4119-414X), Valentini, P (ORCID:0000-0001-6095-9510), Buonsenso, D, Sanguinetti, M (ORCID:0000-0002-9780-7059), Vento, G (ORCID:0000-0002-8132-5127), and Cattani, P (ORCID:0000-0003-4678-4763)
Abstract: We detected SARS-CoV-2 RNA in multiple breastmilk samples that were collected and tested after the first lactation from a woman with a laboratory-confirmed Covid-19 diagnosis. We showed the potentiality of mother-to-child transmission by extra-respiratory routes. Thus, we believe that SARS-CoV-2 testing of breastmilk samples should became a common practice to prevent neonatal infections
Published: 2020

50. Clinical microbiology laboratory adaptation to COVID-19 emergency: experience at a large teaching hospital in Rome, Italy

Author: Posteraro, Brunella, Marchetti, Simona, Romano, Lucio, Santangelo, Rosaria, Morandotti, Grazia Angela, Sanguinetti, Maurizio, Cattani Franchi, Paola, Posteraro B. (ORCID:0000-0002-1663-7546), Marchetti S., Romano L., Santangelo R. (ORCID:0000-0002-8056-218X), Morandotti G. A., Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Posteraro, Brunella, Marchetti, Simona, Romano, Lucio, Santangelo, Rosaria, Morandotti, Grazia Angela, Sanguinetti, Maurizio, Cattani Franchi, Paola, Posteraro B. (ORCID:0000-0002-1663-7546), Marchetti S., Romano L., Santangelo R. (ORCID:0000-0002-8056-218X), Morandotti G. A., Sanguinetti M. (ORCID:0000-0002-9780-7059), and Cattani P. (ORCID:0000-0003-4678-4763)
Abstract: No abstract
Published: 2020

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