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1. Emerging treatment options for acute bacterial skin and skin structure infections: focus on intravenous delafloxacin

Author

Righi E, Carnelutti A, Vena A, and Bassetti M

Subjects
bacterial skin and skin structure infections, multidrug-resistant bacteria, methicillin-resistant Staphylococcus aureus, delafloxacin, Infectious and parasitic diseases, RC109-216
Abstract

Elda Righi, Alessia Carnelutti, Antonio Vena, Matteo Bassetti Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy Abstract: The increase in hospitalization due to acute bacterial skin and skin structure infections (ABSSSI) caused by resistant pathogens supports the need for new treatment options. Antimicrobial options for ABSSSI that provide broad-spectrum coverage, including gram-negative pathogens and multidrug-resistant gram-positive bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), are limited. Delafloxacin is a novel fluoroquinolone available as intravenous and oral formulations and is characterized by an increased efficacy in acidic environments and activity on bacterial biofilm. Delafloxacin displays enhanced in vitro activity against MRSA, and enterococci, while maintaining efficacy against gram-negative pathogens and anaerobes. Delafloxacin has been studied for the treatment of ABSSSI and respiratory infections. Phase III studies have demonstrated noninferiority of delafloxacin compared to vancomycin, linezolid, tigecycline, and the combination of vancomycin plus aztreonam in the treatment of ABSSSI. Due to its favorable pharmacokinetic characteristics, the wide spectrum of action, and the potential for sequential therapy, delafloxacin represents a promising option in the empirical and targeted treatment of ABSSSI, both in hospital- and in community-based care. Keywords: bacterial skin and skin structure infections, multidrug-resistant bacteria, methicillin-resistant Staphylococcus aureus, delafloxacin

Published
2018

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

Author

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

Published
2020
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8. Predictors of choice of initial antifungal treatment in intraabdominal candidiasis

Author

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

Published
2016
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14. COVID-19: opinions and behavior of Italian general population during the first epidemic phase

Author

Genovese, C., La Fauci, V., Di Pietro, A., Trimarchi, G., Odone, A., Casuccio, A., Costantino, C., Restivo, V., Fantini, M., Gori, D., Azzara, A., Deiana, G., Castaldi, S., Righi, E., Palandri, L., Panciroli, G., Bianco, A., Licata, F., Cosentino, S., Mistretta, A., Marranzano, M., Ragusa, R., Gabutti, G., Stefanati, A., Prato, R., Fortunato, F., Martinelli, D., Icardi, G., Panatto, D., Amicizia, D., Fabiani, L., Moretti, A., Di Risio, D., Siliquini, R., Voglino, G., Bert, F., Lorini, C., Bonaccorsi, G., Torre, I., Pennino, F., Pavia, M., Di Giuseppe, G., Paolantonio, A., Villari, P., Marzuillo, C., Messina, G., Rivieri, C., Nante, N., Majori, S., Tardivo, S., Moretti, F., D'Amato, S., Mazzitelli, F., Giunta, I., Lo Giudice, D., Panto, G., Signorelli, C., Squeri, R., Genovese, Cristina, La Fauci, Vincenza, Di Pietro, Angela, Trimarchi, Giuseppe, Odone, Anna, Casuccio, Alessandra, Costantino, Claudio, Restivo, Vincenzo, Fantini, Mariapia, Gori, Davide, Azara, Antonio, Deiana, Giovanna, Castaldi, Silvana, Righi, Elena, Palandri, Lucia, Panciroli, Giovanni, Bianco, Aida, Licata, Francesca, Cosentino, Sofia, Mistretta, Antonio, Marranzano, Marina, Ragusa, Rosalia, Gabutti, Giovanni, Stefanati, Armando, Prato, Rosa, Fortunato, Francesca, Martinelli, Domenico, Icardi, Giancarlo, Panatto, Donatella, Amicizia, Daniela, Fabiani, Leila, Moretti, Annalucia, Di Risio, Damiana, Siliquini, Roberta, Voglino, Gianluca, Bert, Fabrizio, Lorini, Chiara, Bonaccorsi, Guglielmo, Torre, Ida, Pennino, Francesca, Pavia, Maria, Di Giuseppe, Gabriella, Paolantonio, Andrea, Villari, Paolo, Marzuillo, Carolina, Messina, Gabriele, Rivieri, Cesare, Nante, Nicola, Majori, Silvia, Tardivo, Stefano, Moretti, Francesca, D'Amato, Smeralda, Mazzitelli, Francesco, Giunta, Ioselita, Lo Giudice, Daniela, Pantò, Giuseppe, Signorelli, Carlo, Squeri, Raffaele, Genovese C., La Fauci V., Di Pietro A., Trimarchi G., Odone A., Casuccio A., Costantino C., Restivo V., Fantini M., Gori D., Azzara A., Deiana G., Castaldi S., Righi E., Palandri L., Panciroli G., Bianco A., Licata F., Cosentino S., Mistretta A., Marranzano M., Ragusa R., Gabutti G., Stefanati A., Prato R., Fortunato F., Martinelli D., Icardi G., Panatto D., Amicizia D., Fabiani L., Moretti A., Di Risio D., Siliquini R., Voglino G., Bert F., Lorini C., Bonaccorsi G., Torre I., Pennino F., Pavia M., Di Giuseppe G., Paolantonio A., Villari P., Marzuillo C., Messina G., Rivieri C., Nante N., Majori S., Tardivo S., Moretti F., D'amato S., Mazzitelli F., Giunta I., Lo Giudice D., Panto G., Signorelli C., and Squeri R.

Subjects
risk perception, Male, knowledge, SARS-CoV-2, attitude, COVID-19, perception, population, attitude, COVID-19, knowledge, perception, population, risk perception, Attitude, Humans, Female, Public Health, Epidemics, Human
Abstract

Background and aim: On January 9, 2020, the World Health Organization (WHO) declared that Chinese health authorities had identified a new coronavirus strain never before isolated in humans, the 2019-nCoV later redefined SARS-CoV-2, that still today represent a public health problem. The present survey started on 10 February 2020 with the aim of a) assessing the risk perception in healthcare workers and young students, following the evolution of attitudes, perception and knowledge over time, b) provide useful information to the general population during survey. Results: A study sample consisting of 4116 Italian in-dividuals of both sexes was enrolled. High levels of risk perception, low perception of self-efficacy and low levels of knowledge scores (24.55 ± 5.76 SD) were obtained indicating the need for continuous population monitoring as well as further communication strategies carried out at institution levels. Conclusion: The results of the present study could help public health authorities in carrying out informative campaigns for general population and could be an important tool in evaluating public knowledge and misperceptions during the management of the COVID-19. (www.actabiomedica.it).

Published
2022

33. Clinical management of severe infections caused by carbapenem-resistant Gram-negative bacteria: a worldwide cross-sectional survey addressing the use of antibiotic combinations

Author

Carrara, E, Savoldi, A, Piddock, LJ, Franceschi, F, Ellis, S, Sharland, M, John Brink, A, Harris, PN, Levy-Hara, G, Rohit, A, Tsioutis, C, Zayyad, H, Giske, C, Chiamenti, M, Bragantini, D, Righi, E, and Gorska, A

Abstract

OBJECTIVES: Optimal treatment of carbapenem-resistant Gram-negative (CR-GNB) infections is uncertain due to the lack of good-quality evidence and the limited effectiveness of available antibiotics. The aim of this survey was to investigate clinicians' prescribing strategies for treating CR-GNB infections worldwide. METHODS: A 36-items-questionnaire was developed addressing the following aspects of antibiotic prescribing: respondent's background, diagnostic and therapeutic availability, preferred antibiotic strategies and rationale for selecting combination therapy. Prescribers were recruited following the snowball-sampling approach, and a post-stratification correction with inverse proportional weights was used to adjust the sample's representativeness. RESULTS: 1012 respondents from 95 countries participated in the survey. Overall, 298 (30%) of respondents had local guidelines for treating CR-GNB at their facility and 702 (71%) had access to Infectious Diseases consultation, with significant discrepancies according to country economic status: 85% (390/502) in High-Income-Countries vs 59% (194/283) in Upper-Medium-Income-Countries and 30% (118/196) in Lower-Middle-Income-Countries/Lower-Income-Countries). Targeted regimens varied widely, ranging from 40 regimens for CR-Acinetobacter spp. to more than 100 regimens for CR-Enterobacteriaceae. Although the majority of respondents acknowledged the lack of evidence behind this choice, dual combination was the preferred treatment scheme and carbapenem-polymyxin was the most prescribed regimen, irrespective of pathogen and infection source. Respondents noticeably disagreed around the meaning of 'combination therapy' with 20% (150/783) indicating the simple addition of multiple compounds, 42% (321/783) requiring the presence of in vitro activity and 38% (290/783) of in vitro-synergism. CONCLUSIONS: Management of CR-GNB infections is far from being standardized. Strategic public health focussed randomised controlled trials are urgently required to inform evidence-based treatment guidelines.

Published
2022

37. A regional audit system for stillbirth: a way to better understand the phenomenon

Author

Po G., Monari F., Zanni F., Grandi G., Lupi C., Facchinetti F., Mancini L., Lugli L., Lanzoni C., Sgarbi L., Chiossi C., Ricchieri F., Roberta C., Contiero R., Garani G., Pedriali M., Rossi S., Fini S., Di Bartolo M., Radi D., Vancini A., Donati A., Guadalupi E., Righetti F., Salerno A., Cocchi G., Morandi R., Gabrielli L., Graziano C., Seri M., Caprara G., Mario S. N. C., Fantuz F., Ferlini F., Righi E., Silvestrini D., Foschi F., Fieni S., Frusca T., Ferretti A., Galli L., Magnani C., Silini E., Balduzzi L., Bellini M., Rodolfi A. M., Sgarabotto M. P., Fragni G., Comitini G., Bonasoni M. P., Fioroni L., Rozzi C., Tuzio A., Vito I., Mammoliti P., De Ambrosi E., Ricci M., Bandini A., Belosi C., Muratori C., Zago S., Turci A., Vitarelli M., Po G., Monari F., Zanni F., Grandi G., Lupi C., Facchinetti F., Mancini L., Lugli L., Lanzoni C., Sgarbi L., Chiossi C., Ricchieri F., Roberta C., Contiero R., Garani G., Pedriali M., Rossi S., Fini S., Di Bartolo M., Radi D., Vancini A., Donati A., Guadalupi E., Righetti F., Salerno A., Cocchi G., Morandi R., Gabrielli L., Graziano C., Seri M., Caprara G., Mario S.N.C., Fantuz F., Ferlini F., Righi E., Silvestrini D., Foschi F., Fieni S., Frusca T., Ferretti A., Galli L., Magnani C., Silini E., Balduzzi L., Bellini M., Rodolfi A.M., Sgarabotto M.P., Fragni G., Comitini G., Bonasoni M.P., Fioroni L., Rozzi C., Tuzio A., Vito I., Mammoliti P., De Ambrosi E., Ricci M., Bandini A., Belosi C., Muratori C., Zago S., Turci A., and Vitarelli M.

Subjects
Clinical audit, Multivariate analysis, Placenta Diseases, Perinatal Death, Eastern, Umbilical Cord, Africa, Northern, Pregnancy, Risk Factors, Cause of Death, Northern, Europe, Eastern, Pregnancy Complications, Infectious, Multivariate Analysi, Causes of death, Cause of death, Fetal Growth Retardation, Obstetrics, Placenta Disease, Infectious, Obstetrics and Gynecology, Stillbirth, Perinatal audit, Quality of care, Adult, Africa South of the Sahara, Clinical Audit, Female, Fetal Death, Fetal Diseases, Humans, India, Italy, Multivariate Analysis, Pregnancy Complications, Quality of Health Care, Pregnancy Complication, Europe, Gestation, Human, Research Article, medicine.medical_specialty, Reproductive medicine, Fetal Disease, Audit, lcsh:Gynecology and obstetrics, medicine, lcsh:RG1-991, Late Stillbirth, business.industry, Risk Factor, medicine.disease, Africa, Pregnancy Complications, Infectiou, business
Abstract

Background Implementation of high-quality national audits for perinatal mortality are needed to improve the registration of all perinatal deaths and the identification of the causes of death. This study aims to evaluate the implementation of a Regional Audit System for Stillbirth in Emilia-Romagna Region, Italy. Methods For each stillbirth (≥ 22 weeks of gestation, ≥ 500 g) occurred between January 1, 2014 to December 1, 2016 (n = 332), the same diagnostic workup was performed and a clinical record with data about mother and stillborn was completed. Every case was discussed in a multidisciplinary local audit to assess both the cause of death (ReCoDe classification) and the quality of care. Data were reviewed by the Regional Audit Group. Stillbirth rates, causes of death and the quality of care were established for each case. Results Total stillbirth rate was 3.09 per 1000 births (332/107,528). Late stillbirth rate was 2.3 per 1000 (251/107,087). Sixteen stillbirths were not registered by the Regional Birth Register. The most prevalent cause of death was placental disorder (33.3%), followed by fetal (17.6%), cord (14.2%) and maternal disorders (7.6%). Unexplained cases were 14%. Compared to local audits, the regional group attributed different causes of death in 17% of cases. At multivariate analysis, infections were associated with early stillbirths (OR 3.38, CI95% 1.62–7.03) and intrapartum cases (OR 6.64, CI95% 2.61–17.02). Placental disorders were related to growth restriction (OR 1.89, CI95% 1.06–3.36) and were more frequent before term (OR 1.86, CI95% 1.11–3.15). Stillbirths judged possibly/probably preventable with a different management (10.9%) occurred more frequently in non-Italian women and were mainly related to maternal disorders (OR 6.64, CI95% 2.61–17.02). Conclusions Regional Audit System for Stillbirth improves the registration of stillbirth and allows to define the causes of death. Moreover, sub-optimal care was recognized, allowing to identify populations which could benefit from preventive measures.

Published
2019

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