Search

Your search keyword '"Tetamo, R."' showing total 34 results
Start Over Author "Tetamo, R."
34 results on '"Tetamo, R."'

2. Medical nutrition therapy in adult critically-ill intensive care unit (ICU) patients in Europe: results from the Europn study

Author

Matejovic, M., primary, Huet, O., additional, Dams, K., additional, Elke, G., additional, Alonso, C. Vaquerizo, additional, Csomos, A., additional, Krzych, L., additional, Tetamo, R., additional, Puthucheary, Z., additional, Rooyackers, O., additional, Tjäder, I., additional, Hartl, W., additional, Kuechenhoff, H., additional, and Hiesmayr, M., additional

Published
2021
Full Text
View/download PDF

3. Impact of medical nutrition therapy on clinical outcomes in adult critically ill intensive care unit (ICU) patients in Europe: results from the europn study

Author

Matejovic, M., primary, Huet, O., additional, Dams, K., additional, Elke, G., additional, Alonso, C. Vaquerizo, additional, Csomos, A., additional, Krzych, L., additional, Tetamo, R., additional, Puthucheary, Z., additional, Rooyackers, O., additional, Tjäder, I., additional, Hartl, W., additional, Kuechenhoff, H., additional, and Hiesmayr, M., additional

Published
2021
Full Text
View/download PDF

4. A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study

Author

Guérin, C., Beuret, P., Constantin, J. M., Bellani, G., Garcia-Olivares, P., Roca, O., Meertens, J. H., Maia, P. Azevedo, Becher, T., Peterson, J., Larsson, A., Gurjar, M., Hajjej, Z., Kovari, F., Assiri, A. H., Mainas, E., Hasan, M. S., Morocho-Tutillo, D. R., Baboi, L., Chrétien, J. M., François, G., Ayzac, L., Chen, L., Brochard, L., Mercat, A., Hajjej, Zied, Sellami, Walid, Ferjani, M., Gurjar, Mohan, Assiri, Amer, Al Bshabshe, Ali, Almekhlafi, Ghaleb, Mandourah, Yasser, Hasan, Mohd Shahnaz, Rai, Vineya, Marzida, M., Corcoles Gonzalez, Virgilio, Sanchez Iniesta, Rafael, Garcia, Pablo, Garcia-Montesinos de la Peña, Manuel, Garcia Herrera, Adriana, Roca, Oriol, Garcia-de-Acilu, Marina, Masclans Enviz, Joan Ramon, Mancebo, Jordi, Heili, Sarah, Artigas Raventos, Antonio, Blanch Torra, Lluís, Roche-Campo, Ferran, Rialp, Gemma, Forteza, Catalina, Berrazueta, Ana, Martinez, Esther, Penuelas, Oscar, Jara-Rubio, Ruben, Mallat, Jihad, Thevenin, D., Zogheib, Elie, Mercat, Alain, Levrat, Albrice, Porot, Veronique, Bedock, B., Grech, Ludovic, Plantefeve, Gaetan, Badie, Julio, Besch, Guillaume, Pili-Floury, Sébastien, Guisset, Olivier, Robine, Adrien, Prat, Gwenael, Doise, Jean-Marc, Badet, Michel, Thouret, J. M., Just, Bernard, Perbet, Sébastien, Lautrette, Alexandre, Souweine, B., Chabanne, Russell, Danguy des Déserts, Marc, Rigaud, Jean-Philippe, Marchalot, Antoine, Rigaud, J. P., Bele, Nicolas, Beague, Sébastien, Hours, Sandrine, Marque, Sophie, Durand, Michel, Payen, J. F., Stoclin, Annabelle, Gaffinel, Alain, Winer, Arnaud, Chudeau, Nicolas, Tirot, Patrice, Thyrault, Martial, Paulet, Rémi, Thyrault, M., Aubrun, Frederic, Guerin, Claude, Floccard, Bernard, Rimmele, T., Argaud, Laurent, Hernu, Romain, Crozon Clauzel, Jullien, Wey, Pierre-François, Bourdin, Gael, Pommier, C., Cueuille, NadÃge, de Varax, null, Marchi, Elisa, Papazian, L., Jochmans, Sebastien, Monchi, M., Jaber, Samir, de Jong, Audrey, Moulaire, Valerie, Capron, Matthieu, Jarrige, L., Barberet, Guillaume, Lakhal, Karim, Rozec, B., Dellamonica, Jean, Robert, Alexandre, Bernardin, G., Danin, Pierre-Eric, Raucoules, M., Runge, Isabelle, Foucrier, Arnaud, Hamada, Sophie, Tesniere, Antoine, Fromentin, Mélanie, Samama, C. M., Mira, Jean-Paul, Diehl, Jean-Luc, Mekontso Dessap, Armand, Arbelot, Charlotte, Demoule, Alexandre, Roche, Anne, Similowski, T., Ricard, Jean-Damien, Gaudry, Stéphane, Dreyfuss, D., de Montmolin, Etienne, da Silva, Daniel, Verdiere, B., Ardisson, Fanny, Lemiale, Virginie, Azoulay, Elie, Bruel, Cédric, Tiercelet, Kelly, Fartoukh, Muriel, Voiriot, Guillaume, Hoffmann, Clement, Leclerc, T., Thille, Arnaud, Robert, Réné, Beuret, Pascal, Beduneau, Gaëtan, Beuzelin, Marion, Tamion, F., Morel, Jérôme, Tremblay, Aymeric, Molliex, S., Amal, Jean-Michel, Meaudre, Eric, Goutorbe, Philippe, Laffon, Marc, Gros, Antoine, Nica, Alexandru, Barjon, Genevieve, Dahyot-Fizelier, Claire, Imzi, Nadia, Gally, Josette, Real, null, Sauneuf, Bertrand, Souloy, Xavier, Girbes, Armand, Tuinman, Pieter Roel, Schultz, Marcus, Winters, Tineke, Mijzen, Lisa, Roekaerts, P. M. H. J., Vermeijden, Wytze, Beishuizen, Albertus, Trof, R., Corsten, Stijn, Kesecioglu, Jozef, Meertens, John, Dieperink, Wim, Pickers, Peter, Roovers, Noortje, Maia, Paulo, Duque, Melanie, Rua, Fernando, Pereira de Figueired, António Manuel, Ramos, Armindo, Fragoso, Elsa, Azevedo, Pilar, Gouveia, Joao, Costa E. Silva, Zélia, Silva, Goncalo, Chaves, Susana, Nobrega, J. J., Lopes, Luís, Valerio, Bernardino, Araujo, Ana Carolina, de Freitas, Paulo Telles, Bouw, Maria Jose, Melao, Maria, Granja, C., Marcal, Paulo, Fernandes, Antero, Joao, Gonçalves Pereira, Maia, Dionísio Faria, Spadaro, Savino, Volta, Carlo Alberto, Bellani, Giacomo, Citerio, G., Mauri, Tommaso, Alban, Laura, Pesenti, A., Mistraletti, Giovanni, Formenti, Paolo, Tommasino, C., Tardini, Francesca, Fumagalli, R., Colombo, Riccardo, Fossali, Tommaso, Catena, E., Todeschini, Manuel, Gnesin, Paolo, Cracchiolo, Andrea Neville, Palma, Daniela, Tetamo, R., Albiero, Daniela, Costantini, Elena, Raimondi, F., Coppadoro, Andrea, Vascotto, Ettore, Lusenti, F., Becher, Tobias, Schädler, Dirk, Weiler, N., Karagiannidis, Christian, Petersson, Johan, Konrad, D., Kawati, Rafael, Wessbergh, Joanna, Valtysson, J., Rockstroh, Matthias, Borgstrom, Sten, Larsson, Niklas, Thunberg, J., Camsooksai, Julie, Briggs, null, Kovari, Ferenc, Cuesta, J., Anwar, Sibs, O’Brien, B., Barberis, Luigi, Sturman, J., Mainas, Efstratios, Karatzas, S., Piza, Petr, Sottiaux, Thierry, Adam, J. F., Gawda, Ryszard, Gawor, Maen, Alqdah, M., Cohen, D., Brochard, Laurent, Baker, A., Ñamendys-Silva, Silvio Antonio, Garcia-Guillen, Francisco Javier, Morocho Tutillo, Diego Rolando, Jibaja Vega, Manuel, Zakalik, Graciela, Pagella, Gonzalo, Marengo, J., KARLI, Mélanie, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Université de Lyon, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Hospital General Universitario 'Gregorio Marañón' [Madrid], Vall d'Hebron University Hospital [Barcelona], CIBER de Epidemiología y Salud Pública (CIBERESP), University Medical Center Groningen [Groningen] (UMCG), Centro Hospitalar do Porto, Karolinska University Hospital [Stockholm], Karolinska Institutet [Stockholm], Uppsala University, University of Malaya [Kuala Lumpur, Malaisie], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Keenan Research Centre of the Li Ka Shing Knowledge Institute [Toronto], Université d'Angers - Faculté de médecine (UA UFR Médecine), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Other departments, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Critical Care, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), University of Malaya = Universiti Malaya [Kuala Lumpur, Malaisie] (UM), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Université d'Angers (UA), Guã©rin, C, Beuret, P, Constantin, J, Bellani, G, Garcia-Olivares, P, Roca, O, Meertens, J, Maia, P, Becher, T, Peterson, J, Larsson, A, Gurjar, M, Hajjej, Z, Kovari, F, Assiri, A, Mainas, E, Hasan, M, Morocho-Tutillo, D, Baboi, L, Chrã©tien, J, Franã§ois, G, Ayzac, L, Chen, L, Brochard, L, Mercat, A, Sellami, W, Ferjani, M, Al Bshabshe, A, Almekhlafi, G, Mandourah, Y, Rai, V, Marzida, M, Corcoles Gonzalez, V, Sanchez Iniesta, R, Garcia, P, Garcia-Montesinos de la Peña, M, Garcia Herrera, A, Garcia-de-Acilu, M, Masclans Enviz, J, Mancebo, J, Heili, S, Artigas Raventos, A, Blanch Torra, L, Roche-Campo, F, Rialp, G, Forteza, C, Berrazueta, A, Martinez, E, Penuelas, O, Jara-Rubio, R, Mallat, J, Thevenin, D, Zogheib, E, Levrat, A, Porot, V, Bedock, B, Grech, L, Plantefeve, G, Badie, J, Besch, G, Pili-Floury, S, Guisset, O, Robine, A, Prat, G, Doise, J, Badet, M, Thouret, J, Just, B, Perbet, S, Lautrette, A, Souweine, B, Chabanne, R, Danguy des Déserts, M, Rigaud, J, Marchalot, A, Bele, N, Beague, S, Hours, S, Marque, S, Durand, M, Payen, J, Stoclin, A, Gaffinel, A, Winer, A, Chudeau, N, Tirot, P, Thyrault, M, Paulet, R, Aubrun, F, Guerin, C, Floccard, B, Rimmele, T, Argaud, L, Hernu, R, Crozon Clauzel, J, Wey, P, Bourdin, G, Pommier, C, Cueuille, N, de Varax, N, Marchi, E, Papazian, L, Jochmans, S, Monchi, M, Jaber, S, de Jong, A, Moulaire, V, Capron, M, Jarrige, L, Barberet, G, Lakhal, K, Rozec, B, Dellamonica, J, Robert, A, Bernardin, G, Danin, P, Raucoules, M, Runge, I, Foucrier, A, Hamada, S, Tesniere, A, Fromentin, M, Samama, C, Mira, J, Diehl, J, Mekontso Dessap, A, Arbelot, C, Demoule, A, Roche, A, Similowski, T, Ricard, J, Gaudry, S, Dreyfuss, D, de Montmolin, E, da Silva, D, Verdiere, B, Ardisson, F, Lemiale, V, Azoulay, E, Bruel, C, Tiercelet, K, Fartoukh, M, Voiriot, G, Hoffmann, C, Leclerc, T, Thille, A, Robert, R, Beduneau, G, Beuzelin, M, Tamion, F, Morel, J, Tremblay, A, Molliex, S, Amal, J, Meaudre, E, Goutorbe, P, Laffon, M, Gros, A, Nica, A, Barjon, G, Dahyot-Fizelier, C, Imzi, N, Gally, J, Real, N, Sauneuf, B, Souloy, X, Girbes, A, Tuinman, P, Schultz, M, Winters, T, Mijzen, L, Roekaerts, P, Vermeijden, W, Beishuizen, A, Trof, R, Corsten, S, Kesecioglu, J, Dieperink, W, Pickers, P, Roovers, N, Duque, M, Rua, F, Pereira de Figueired, A, Ramos, A, Fragoso, E, Azevedo, P, Gouveia, J, Costa E. Silva, Z, Silva, G, Chaves, S, Nobrega, J, Lopes, L, Valerio, B, Araujo, A, de Freitas, P, Bouw, M, Melao, M, Granja, C, Marcal, P, Fernandes, A, Joao, G, Maia, D, Spadaro, S, Volta, C, Citerio, G, Mauri, T, Alban, L, Pesenti, A, Mistraletti, G, Formenti, P, Tommasino, C, Tardini, F, Fumagalli, R, Colombo, R, Fossali, T, Catena, E, Todeschini, M, Gnesin, P, Cracchiolo, A, Palma, D, Tetamo, R, Albiero, D, Costantini, E, Raimondi, F, Coppadoro, A, Vascotto, E, Lusenti, F, Schã¤dler, D, Weiler, N, Karagiannidis, C, Petersson, J, Konrad, D, Kawati, R, Wessbergh, J, Valtysson, J, Rockstroh, M, Borgstrom, S, Larsson, N, Thunberg, J, Camsooksai, J, Briggs, N, Cuesta, J, Anwar, S, O’Brien, B, Barberis, L, Sturman, J, Karatzas, S, Piza, P, Sottiaux, T, Adam, J, Gawda, R, Gawor, M, Alqdah, M, Cohen, D, Baker, A, Ñamendys-Silva, S, Garcia-Guillen, F, Morocho Tutillo, D, Jibaja Vega, M, Zakalik, G, Pagella, G, and Marengo, J

Subjects
ARDS, RECEIVING MECHANICAL VENTILATION, Epidemiology, medicine.medical_treatment, cross-sectional studies, RESPIRATORY-DISTRESS-SYNDROME, vrouwelijk, buikligging, Critical Care and Intensive Care Medicine, respiratory distress syndrome, adult/therapy, law.invention, Positive-Pressure Respiration, Prone position, 0302 clinical medicine, Mechanical ventilation, prospectieve studies, Randomized controlled trial, law, middle aged, Medicine, FAILURE, adult/therapy, humans, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, RANDOMIZED CONTROLLED-TRIAL, respiratory distress syndrome, 3. Good health, cross-sectionele studies, ademnoodsyndroom, aged, female, SURVIVAL, middelbare leeftijd, medicine.medical_specialty, Pain medicine, positieve druk uitademing, NO, 03 medical and health sciences, male, mensen, Anesthesiology, ouderen, METAANALYSIS, business.industry, MORTALITY, 030208 emergency & critical care medicine, mannelijk, CARE, medicine.disease, prospective studies, EVOLUTION, body regions, 030228 respiratory system, Emergency medicine, Observational study, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Introduction: While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low.Aim: This study aimed to determine the prevalence of use of PP in ARDS patients (primary endpoint), the physiological effects of PP, and the reasons for not using it (secondary endpoints).Methods: The APRONET study was a prospective international 1-day prevalence study performed four times in April, July, and October 2016 and January 2017. On each study day, investigators in each ICU had to screen every patient. For patients with ARDS, use of PP, gas exchange, ventilator settings and plateau pressure (Pplat) were recorded before and at the end of the PP session. Complications of PP and reasons for not using PP were also documented. Values are presented as median (1st-3rd quartiles).Results: Over the study period, 6723 patients were screened in 141 ICUs from 20 countries (77% of the ICUs were European), of whom 735 had ARDS and were analyzed. Overall 101 ARDS patients had at least one session of PP (13.7%), with no differences among the 4 study days. The rate of PP use was 5.9% (11/187), 10.3% (41/399) and 32.9% (49/149) in mild, moderate and severe ARDS, respectively (P = 0.0001). The duration of the first PP session was 18 (16-23) hours. Measured with the patient in the supine position before and at the end of the first PP session, PaO2/FIO2 increased from 101 (76-136) to 171 (118-220) mmHg (P = 0.0001) driving pressure decreased from 14 [11-17] to 13 [10-16] cmH(2)O (P = 0.001), and Pplat decreased from 26 [23-29] to 25 [23-28] cmH(2)O (P = 0.04). The most prevalent reason for not using PP (64.3%) was that hypoxemia was not considered sufficiently severe. Complications were reported in 12 patients (11.9%) in whom PP was used (pressure sores in five, hypoxemia in two, endotracheal tube-related in two ocular in two, and a transient increase in intracranial pressure in one).Conclusions: In conclusion, this prospective international prevalence study found that PP was used in 32.9% of patients with severe ARDS, and was associated with low complication rates, significant increase in oxygenation and a significant decrease in driving pressure.

Published
2018

7. The role of the intensive care unit in real-time surveillance of emerging pandemics: the Italian GiViTI experience

Author

Bertolini, G, Nattino, G, Langer, M, Tavola, M, Crespi, D, Mondini, M, Rossi, C, Previtali, C, Marshall, J, Poole, D, Abascià, A, Acquarolo, A, Adorni, A, Agnelli, V, Agostini, F, Alampi, D, Alberti, A, Alborghetti, A, Alleva, S, Ambrosoni, S, Antonini, B, Arditi, E, Avalli, L, Babini, M, Bagalini, G, Balata, A, Balicco, B, Barbagallo, M, Bartoli, T, Bassi, G, Becarelli, S, Beck, E, Bellin, M, Bellonzi, A, Bellorini, M, Benanti, C, Bensi, M, Bernasconi, Mo, Berruto, F, Bertolini, R, Besozzi, A, Biamino, C, Bianchi, T, Bianchin, A, Boccalatte, D, Bocchi, A, Bonaccorso, G, Bonazzi, M, Balsamo, C, Bonicalzi, V, Boniotti, C, Bonizzoli, M, Bottazzi, A, Breschi, C, Brizio, E, Brunetti, B, Brunori, E, Bubbico, G, Buscaglia, G, Calicchio, G, Calligaro, P, Calva, S, Candido, M, Capitanio, G, Caroleo, S, Casagli, S, Casalini, P, Castiglione, G, Cerana, M, Chiani, C, Chierego, G, Ciani, A, Ciceri, R, Cigada, Mg, Cima, M, Cingolani, E, Cinque, E, Coletta, Rp, Colombo, L, Colombo, R, Converso, M, Corrado, A, Cortis, G, Costagli, V, Crema, L, Crestan, E, Da, D, Cero, Pd, Ferro, Md, De Blasi RA, De Blasio, E, De Cristofaro MG, De Luca, A, Di Pasquale, D, Doroni, L, Fabi, Mc, Facondini, F, Fagoni, Nazzareno, Falzetti, G, Faraldi, L, Fiore, G, Fiume, C, Galeotti, E, Galleschi, N, Gallo, M, Gamberini, E, Garelli, A, Giacomello, S, Gianni, M, Giudici, R, Giuntini, R, Gnesin, P, Gorietti, A, Grassitelli, S, Greco, M, Irpino, A, Guadagna, A, Guadagnucci, A, Guagliardi, C, Laici, C, Lain, G, Lanza, G, Lefons, U, Leggieri, C, Lembo, R, Librenti, M, Liverani, C, Longobardo, A, Madeira, Sm, Madonna, R, Magatti, Mf, Mamprin, F, Mannolini, G, Marafon, S, Marchesi, G, Marifoglou, D, Martinelli, P, Martinelli, S, Escobar, Rm, Mastroianni, A, Mastropierro, R, Mediani, Ts, Messina, M, Milan, B, Molesi, A, Alberto, Cm, Mongelli, P, Morigi, A, Mosti, G, Muttini, S, Nardini, M, Nascimben, E, Natalini, G, Negri, G, Negro, G, Neri, M, Netto, R, Nonini, S, Odetto, L, Olivieri, C, Candida, Mo, Osti, D, Palmer, M, Parnigotto, A, Parrini, V, Pasculli, M, Pasetti, G, Passafiume, M, Pastorini, S, Patrignani, L, Pedeferri, M, Pegoraro, M, Pelati, E, Pelosi, G, Pera, L, Perino, P, Pero, A, Perzolla, D, Peta, M, Pinna, C, Pizzali, M, Postiglione, M, Potalivo, A, Raffaeli, M, Randellini, R, Rech, A, Renda, B, Ricciardi, G, Rizzi, S, Romagnoli, S, Rossi, G, Rossi, M, Rutta, C, Sagliaschi, U, Salcuni, R, Salvi, G, Scalera, M, Scarrone, S, Schiavuzzi, M, Aurelio, Ps, Selvaggi, P, Sicignano, A, Sorbara, C, Spagarino, E, Sparicio, D, Spinazzola, Ar, Sucre, Mj, Terzitta, M, Tetamo, R, Tibaldi, G, Todesco, L, Tomaselli, P, Torta, M, Turriziani, I, Ughi, L, Vaccari, C, Vaj, M, Vanzino, R, Vardanega, A, Vecchiarelli, P, Vedovati, S, Zanni, V, Zappa, S, Zardin, M, Zaro, G, Zuccaro, F, Barattini, M, Chieregato, A, Fumagalli, R, Livigni, S, Mengoli, F, Nardi, G, Palma, D, Portolani, L, Radrizzani, D, Terzitta, M., Bertolini, G, Nattino, G, Langer, M, Tavola, M, Crespi, D, Mondini, M, Rossi, C, Previtali, C, Marshall, J, Poole, D, Abascia, A, Acquarolo, A, Adorni, A, Agnelli, V, Agostini, F, Alampi, D, Alberti, A, Alborghetti, A, Alleva, S, Ambrosoni, S, Antonini, B, Arditi, E, Avalli, L, Babini, M, Bagalini, G, Balata, A, Balicco, B, Barbagallo, M, Bartoli, T, Bassi, G, Becarelli, S, Beck, E, Bellin, M, Bellonzi, A, Bellorini, M, Benanti, C, Bensi, M, Bernasconi, M, Berruto, F, Besozzi, A, Biamino, C, Bianchi, T, Bianchin, A, Boccalatte, D, Bocchi, A, Bonaccorso, G, Bonazzi, M, Balsamo, C, Bonicalzi, V, Boniotti, C, Bonizzoli, M, Bottazzi, A, Breschi, C, Brizio, E, Brunetti, B, Brunori, E, Bubbico, G, Buscaglia, G, Calicchio, G, Calligaro, P, Calva, S, Candido, M, Capitanio, G, Caroleo, S, Casagli, S, Casalini, P, Castiglione, G, Cerana, M, Chiani, C, Chierego, G, Ciani, A, Ciceri, R, Cigada, M, Cima, M, Cingolani, E, Cinque, E, Coletta, R, Colombo, L, Colombo, R, Converso, M, Corrado, A, Cortis, G, Costagli, V, Crema, L, Crestan, E, Da, D, Cero, P, Ferro, M, De Blasi, R, De Blasio, E, De Cristofaro, M, De Luca, A, Di Pasquale, D, Doroni, L, Fabi, M, Facondini, F, Fagoni, N, Falzetti, G, Faraldi, L, Fiore, G, Fiume, C, Galeotti, E, Galleschi, N, Gallo, M, Gamberini, E, Garelli, A, Giacomello, S, Gianni, M, Giudici, R, Giuntini, R, Gnesin, P, Gorietti, A, Grassitelli, S, Greco, M, Irpino, A, Guadagna, A, Guadagnucci, A, Guagliardi, C, Laici, C, Lain, G, Lanza, G, Lefons, U, Leggieri, C, Lembo, R, Librenti, M, Liverani, C, Longobardo, A, Madeira, S, Madonna, R, Magatti, M, Mamprin, F, Mannolini, G, Marafon, S, Marchesi, G, Marifoglou, D, Martinelli, P, Martinelli, S, Escobar, R, Mastroianni, A, Mastropierro, R, Mediani, T, Messina, M, Milan, B, Molesi, A, Alberto, C, Mongelli, P, Morigi, A, Mosti, G, Muttini, S, Nardini, M, Nascimben, E, Natalini, G, Negri, G, Negro, G, Neri, M, Netto, R, Nonini, S, Odetto, L, Olivieri, C, Candida, M, Osti, D, Palmer, M, Parnigotto, A, Parrini, V, Pasculli, M, Pasetti, G, Passafiume, M, Pastorini, S, Patrignani, L, Pedeferri, M, Pegoraro, M, Pelati, E, Pelosi, G, Pera, L, Perino, P, Pero, A, Perzolla, D, Peta, M, Pinna, C, Pizzali, M, Postiglione, M, Potalivo, A, Raffaeli, M, Randellini, R, Rech, A, Renda, B, Ricciardi, G, Rizzi, S, Romagnoli, S, Rossi, G, Rossi, M, Rutta, C, Sagliaschi, U, Salcuni, R, Salvi, G, Scalera, M, Scarrone, S, Schiavuzzi, M, Aurelio, P, Selvaggi, P, Sicignano, A, Sorbara, C, Spagarino, E, Sparicio, D, Spinazzola, A, Sucre, M, Terzitta, M, Tetamo, R, Tibaldi, G, Todesco, L, Tomaselli, P, Torta, M, Turriziani, I, Ughi, L, Vaccari, C, Vaj, M, Vanzino, R, Vardanega, A, Vecchiarelli, P, Vedovati, S, Zanni, V, Zappa, S, Zardin, M, Zaro, G, Zuccaro, F, Barattini, M, Chieregato, A, Fumagalli, R, Livigni, S, Mengoli, F, Nardi, G, Palma, D, Portolani, L, and Radrizzani, D

Subjects
medicine.medical_specialty, Epidemiology, surveillance system, law.invention, 03 medical and health sciences, Influenza A Virus, H1N1 Subtype, 0302 clinical medicine, Public health surveillance, law, Infectious disease epidemiology, influenza, pandemic, Humans, Influenza, Human, Intensive Care Units, Italy, Public Health Surveillance, Pandemics, Pandemic, medicine, human, 030212 general & internal medicine, medicine (all), Intensive care medicine, business.industry, Public health, Outbreak, 030208 emergency & critical care medicine, Monitoring system, medicine.disease, Intensive care unit, infectious disease epidemiology, humans, influenza a virus, h1n1 subtype, intensive care units, italy, public health surveillance, pandemics, infectious diseases, epidemiology, Infectious Diseases, Human mortality from H5N1, Medical emergency, business
Abstract

SUMMARYThe prompt availability of reliable epidemiological information on emerging pandemics is crucial for public health policy-makers. Early in 2013, a possible new H1N1 epidemic notified by an intensive care unit (ICU) to GiViTI, the Italian ICU network, prompted the re-activation of the real-time monitoring system developed during the 2009–2010 pandemic. Based on data from 216 ICUs, we were able to detect and monitor an outbreak of severe H1N1 infection, and to compare the situation with previous years. The timely and correct assessment of the severity of an epidemic can be obtained by investigating ICU admissions, especially when historical comparisons can be made.

Published
2015

8. The prognostic importance of chronic end-stage diseases in geriatric patients admitted to 163 Italian ICUs

Author

Poole, D., Finazzi, S., Nattino, G., Radrizzani, D., Gristina, G., Malacarne, P., Livigni, S., Bertolini, G., Sorgato, C., Mannoni, R., Agnelli, V., Chiani, C., Lanza, G., Venturini, E., Gianni, M., Olivieri, M. C., Guerriero, B., Della Mora, E., Palmer, M., Blasetti, A., Coletta, R., Covani Frigieri, F., Guarducci, M. D., Caracciolo, A., Lain, G., Bernard, M., DE Blasio, E., Zanni, V., Marchesi, G., Madeira, S. M., Spagarino, E., Potalivo, A., Mengoli, F., Parrini, V., Sagliaschi, U., Prandini, A., Rosano, A., Natalini, G., Piccioni, G., Schiavuzzi, M., Bronzini, N., Piva, S., Besozzi, A., Napoleone, A., Patrignani, L., Pisu, M., Mancosu, S., Chiarello, M., Pastorini, S., Bassi, G., Negro, G., Orsini, I., Marifoglou, D., Pota, V., Pegoraro, M., Sucre, M. J., DI Masi, P., Castiglione, G., Morello, G., Garofalo, G., Caroleo, S., Visconti, M. G., Gamberini, E., Mastroianni, A., Liccardi, M. M., Anelati, D., Martinelli, S., Bonato, A., Adorni, A., Colombo, D., Dal Cero, P., Crema, L., Petrucci, N., Beck, E., Alleva, S., Giuntini, R., DA Re, D., Casalini, P., Fabi, M. C., Galeotti, E., Bagalini, G., Bellonzi, A., Zoppellari, R., Lamborghini, S., Pera, L., Doni, L., Bonizzoli, M., Librenti, M., Barattini, M., Mangani, V., Terzitta, M., Guagliardi, C., Bruzzone, C., Arditi, E., Cerana, M., Tavola, M., Falini, S., Vespignani, M. G., Salvi, G., Ramello, P. L., Molesi, A., Ceradelli, M., Buonanno, R., Righini, E., DI Cocco, A., DI Martino, R., Cinque, E., Bonfiglio, M., Ciceri, R., Colombo, L., Nardini, M., Rossi, G., Boccalatte-Rosa, D. L., Babini, M., Zompanti, V., Negri, G., Antonini, B., Baratta, A., Zuccaro, F., Rossi, M., Pedeferri, M., Bellin, M., Sicignano, A., Pezzi, A., Leggieri, C., Fontana, G., Faraldi, L., Cigada, M. G., Magenta, P., Colombo, R., Colombo, S., Gonzi, S., Pizzali, M., Girardis, M., Piccinini, P., Bignone, P., Padovan, L., Bianchin, A., Caria, F. C., Randellini, R., Roticiani, V., Grassi, M., Belluomo Anello, C., Decristofaro, M., Postiglione, M., Giacomello, S., Olivieri, C., Vaccari, C., Dal Ferro, M., Messina, M., Belgiorno, N., Odetto, L., Pasetti, G. S., Balicco, B., Pizzaballa, M. L., Muraro, L., Pignataro, A., Guadagna, A., Fabbri, P. G., Tetamo, R., Bottazzi, A., Mediani, T. S., Gorietti, A., Breschi, C., Ciani, A., Segalini, P., Codeluppi, V., Berruto, F., Pastorelli, M., Comite, C., Pelati, E., Bertolini, R., Lefons, U., DI Pasquale, D. A., Mannolini, G., Vlassich, F., Becarelli, S., Garelli, A., Salsi, P., Rossi, S., Facondini, F., Alampi, D., Cingolani, E., Molino, F. M., Nardi, G., Casula, M., DE Blasi, R. A., Vulcano, G. A., Azzolini, M., Bernasconi, M. O., Bellato, V., Calicchio, G., Righetti, F., Turati, M., Dei Poli, M., Zaro, G., Brizio, E., Coaloa, M., Falzetti, G., Mamprin, F., Liverani, C. M., Clementi, S., Bonucci, P., Varesio, V., Pannacci, R., Fiore, G., Gallo, M., Torta, M., Selvaggi, P., Bert, P. P., Segala, V., Pettazzi, G., Bensi, M., Bocchi, A., Cima, M., Morbelli, M., Peta, M., DI Stella, R., Maggiolo, C., Lembo, R., Pero, A., Marafon, S., Carnevale, L., Vanzino, R., Vecchiarelli, P., and Marino, G.

Subjects
Male, medicine.medical_specialty, Cirrhosis, Disease, Severity of Illness Index, law.invention, 03 medical and health sciences, 0302 clinical medicine, Patient Admission, Postoperative Complications, law, Internal medicine, 80 and over, aged, critical care, prognosis, Medicine, Dementia, Humans, Hospital Mortality, Elective surgery, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Critical care, Prognosis, Female, Intensive Care Units, Italy, Chronic Disease, 030208 emergency & critical care medicine, Odds ratio, medicine.disease, Comorbidity, Intensive care unit, Anesthesiology and Pain Medicine, 030228 respiratory system, Cohort, business
Abstract

BACKGROUND The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in five years (2011-2015) to 163 Italian general ICUs. METHODS Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analyzed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours. RESULTS 44,551 elderly patients (19.2%) underwent emergency (47.3%) or elective surgery (52.7%). At least one severe comorbidity was present in 14.6% of them, yielding a higher hospital mortality (32.4%, vs. 21.1% without severe comorbidity). In the models for patients staying in the ICU 24 hours or more, cirrhosis, NYHA class IV, and severe COPD were constant independent predictors of death (adjusted odds ratios [ORs] range 1.67-1.97, 1.54-1.91, and 1.34-1.50, respectively), while dementia was statistically significant in four out of five models (adjusted ORs 1.23-1.28). End-stage renal disease, instead, never resulted to be an independent prognostic factor. For patients staying in the ICU less than 24 hours, chronic comorbidities were only occasionally independent predictors of death. CONCLUSIONS Our study confirms that elderly surgical patients represent a relevant part of all ICUs admissions. About one of seven bear at least one severe chronic comorbidity, that, excluding end-stage renal disease, are all strong independent predictors of hospital death.

Published
2017

9. Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection

Author

Martin Loeches, I, Lisboa, T, Rhodes, A, Moreno, Rp, Silva, E, Sprung, C, Chiche, Jd, Barahona, D, Villabon, M, Balasini, C, Pearse, Rm, Matos, R, Rello, J, Rodriguez, A, Capuzzo, M, Reina, R, Marsh, B, Flaaten, H, Sigurdsson, G, Ivana, Z, Cerny, V, Quintel, M, Welte, T, Mayorga, M, Offenstadt, G, Guidet, B, Levin, P, Rothen, Hu, Gomersall, C, Hashemian, Sm, Katsanoulas, C, Mouloudi, H, Kapadia, F, Valentin, A, Hedenstierna, G, Perner, A, Bugedo, G, Ruokonen, E, Soriano Arandes, A, Montejo, Jc, Peñíscola, R, Hermosa, C, Gordo, F, Latour, J, Vidaur, L, Alvarez Gonzalez, M, Alvarez Rocha, L, De Pablo, A, Ferri, C, Lopez De Arbina Martinez, Cânones, C, Insausti, J, Cambronero, J, Galvan, B, Luna, J, Blancas, R, Garcia, C, Sierra, R, Fernández Dorado, F, Monedero, P, Llagunes, J, Cobo, P, Socias, A, Leon Lopez, R, Esteban, E, Lacueva, M, Magret, M, Del Nogal, F, Dinis, A, Bártolo, A, Ramos, A, Franca, C, Estevens, C, Granja, C, Fidalgo, C, Almeida, E, Lafuente, E, Rua, F, Esteves, F, Clemente, J, Nóbrega, Jj, Pereira, Jm, Moura, Jp, Silva LP, Trindade E., Telo, L, Santos, L, Pedrosa, Mj, Oliveira, M, Resende, M, Catorze, N, Coutinho, P, Ribeiro, R, Miranda, I, Cardoso, T, Branco, V, Bellani, G, Urbino, R, Peris, A, Amatu, A, Berlot, G, Marzani, Fc, Corbanese, U, David, Antonio, Chiarandini, P, Della Corte, F, Caspani, Ml, Conio, A, Mangani, V, Tetamo, R, Wolfler, A, Tappatà, G, Vivaldi, N, Bertolini, G, Pelagalli, L, Molin, A, Girardis, M, Gristin, G, Lam, A, Crabb, I, Cusack, R, Jackson, R, Veerappan, C, Whiteley, C, Ware, T, Krueper, S, Mckinstry, C, Ferguson, A, Rubulotta, F, Valencia, E, Gonzalez, S, Cevallos, V, Zazu, A, Chaparro Fresco JN, Galindez, G, Barrios, C, Lovesio, C, Villamagua, B, Cadena, M, Salgado, E, García, Mf, Paredes, G, Donnelly, M, O'Croinin, D, Bates, J, Kavanagh, N, O'Brien, B, Plant, R, Scully, M, Farragher, R, Oliveira, L, Mataloun, S, Dantas, Vs, Simvoulidis, L, Duarte, P, Grion, C, Germano, A, Laake, Jh, Helset, E, Klausen, D, Flaatten, H, Bruheim, K, Kristinsson, B, Sigurdsson, Se, Hrubý, J, Valkova, R, Janda, R, Zykova, I, Kernchen, A, Bloos, F, Rosseau, S, Krassler, J, Fischer, F, Arroyo Sanchez, A, Barrionuevo Poquet, A, Ramos Palomino, I, Rafael, F, Salasfoch, J, Dubar, G, Tonnelier, Jm, Barbar, S, Dobrzynski, M, Mignon, A, Jakobson, D, Klein, M, Segal, E, Barlavie, Y, Hersch, M, Salomón, Zs, Zender, H, Chan, K, Buckley, T, Batranovic, U, Schaffer, I, Sretkovic, J, Koulenti, D, Mouloudi, E, Clouva Molyvdas PM, Gurjar, M, Vijayan, D, Hinterholzer, G, Kulier, A, Verlaat, C, Ebel, D, Persson, J, Walther, S, Petersen, P, Swinnen, W, Collin, V, Olsen, H, Gutierrez, P, Thiery, G, Laine, H, Rumba, A, Maiyalagan, S, Bui, T., Martin-Loeches, I., Lisboa, T., Rhodes, A., Moreno, R. P., Silva, E., Sprung, C., Chiche, J. -D., Barahona, D., Villabon, M., Balasini, C., Pearse, R., Matos, R., Rello, J., Rodriguez, A., Capuzzo, M., Reina, R., Marsh, B., Flaaten, H., Sigurdsson, G., Ivana, Z., Cerny, V., Quintel, M., Welte, T., Mayorga, M., Offenstadt, G., Guidet, B., Levin, P., Rothen, H. -U., Gomersall, C., Hashemian, S. M., Katsanoulas, C., Mouloudi, H., Kapadia, F., Valentin, A., Hedenstierna, G., Perner, A., Bugedo, G., Ruokonen, E., Arandes, A. S., Montejo, J. C., Peniscola, R., Hermosa, C., Gordo, F., Latour, J., Vidaur, L., Alvarez-Gonzalez, M., Alvarez-Rocha, L., De Pablo, A., Ferri, C., De Arbina Martinez, L., Canones, C., Insausti, J., Cambronero, J., Galvan, B., Luna, J., Blancas, R., Garcia, C., Sierra, R., Dorado, F. F., Monedero, P., Llagunes, J., Cobo, P., Socias, A., Leon-Lopez, R., Esteban, E., Lacueva, M., Magret, M., Del Nogal, F., Dinis, A., Bartolo, A., Ramos, A., Franca, C., Estevens, C., Granja, C., Fidalgo, C., Almeida, E., Lafuente, E., Rua, F., Esteves, F., Clemente, J., Nobrega, J. J., Pereira, J. M., Moura, J. P., Trindade E Silva, L. P., Telo, L., Santos, L., Pedrosa, M. J., Oliveira, M., Resende, M., Catorze, N., Coutinho, P., Ribeiro, R., Moreno, R., Miranda, I., Cardoso, T., Branco, V., Bellani, G., Urbino, R., Peris, A., Amatu, A., Berlot, G., Marzani, F. C., Corbanese, U., David, A., Chiarandini, P., Corte, F. D., Caspani, M. L., Alessandra, C., Mangani, V., Tetamo, R., Wolfler, A., Tappata, G., Nicoletta, V., Bertolini, G., Pelagalli, L., Molin, A., Girardis, M., Gristin, G., Lam, A., Crabb, I., Cusack, R., Jackson, R., Veerappan, C., Whiteley, C., Ware, T., Krueper, S., Mckinstry, C., Ferguson, A., Rubulotta, F., Valencia, E., Gonzalez, S., Cevallos, V., Zazu, A., Fresco, J. N. C., Galindez, G., Barrios, C., Lovesio, C., Villamagua, B., Cadena, M., Salgado, E., Garcia, M. F., Paredes, G., Donnelly, M., O'Croinin, D., Bates, J., Kavanagh, N., O'Brien, B., Plant, R., Scully, M., Farragher, R., Oliveira, L., Mataloun, S., Dantas, V. S., Simvoulidis, L., Duarte, P., Grion, C., Germano, A., Laake, J. H., Helset, E., Klausen, D., Flaatten, H., Bruheim, K., Kristinsson, B., Sigurdsson, S. E., Hruby, J., Valkova, R., Janda, R., Zykova, I., Kernchen, A., Bloos, F., Rosseau, S., Krassler, J., Fischer, F., Arroyo-Sanchez, A., Poquet, A. B., Palomino, I. R., Rafael, F., Salasfoch, J., Dubar, G., Tonnelier, J. -M., Barbar, S., Dobrzynski, M., Mignon, A., Jakobson, D., Klein, M., Segal, E., Barlavie, Y., Hersch, M., Salomon, Z. S., Zender, H., Rothen, H. U., Chan, K., Buckley, T., Batranovic, U., Schaffer, I., Sretkovic, J., Koulenti, D., Mouloudi, E., Clouva-Molyvdas, P. -M., Gurjar, M., Vijayan, D., Hinterholzer, G., Kulier, A., Verlaat, C., Ebel, D., Persson, J., Walther, S., Petersen, P., Swinnen, W., Collin, V., Olsen, H., Gutierrez, P., Thiery, G., Laine, H., Rumba, A., Maiyalagan, S., Bui, T., Martin Loeches, I, Lisboa, T, Rhodes, A, Moreno, R, Silva, E, Sprung, C, Chiche, J, Barahona, D, Villabon, M, Balasini, C, Pearse, R, Matos, R, Rello, J, and Pesenti, A

Subjects
Registrie, Male, Original, H1N1 Influenza, Adrenal Cortex Hormone, Critical Care and Intensive Care Medicine, Severity of Illness Index, law.invention, Influenza A Virus, H1N1 Subtype, Community-acquired pneumonia, Adrenal Cortex Hormones, law, Prospective Studies, Registries, 610 Medicine & health, Prospective cohort study, H1N1 Subtype, Influenza, Acute Respiratory Distress Syndrome, Cross Infection, Likelihood Functions, COPD, Acinetobacter, Hazard ratio, Middle Aged, Likelihood Function, Intensive care unit, Europe, Intensive Care Units, Community acquired pneumonia, Corticosteroid therapy, Pandemic (H1N1)v influenza A infection, Female, Survival Analysi, Human, Adult, medicine.medical_specialty, Chronic Obstructive Pulmonary Disease, ARDS, Community acquired pneumonia, Corticosteroid therapy, Pandemic (H1N1)v influenza A infection, Intensive Care Unit, Internal medicine, Correspondence, Influenza, Human, Severity of illness, medicine, Humans, H1N1 Subtype, Intensive care medicine, Pandemics, Pandemic, business.industry, Pneumonia, Odds ratio, medicine.disease, Survival Analysis, Influenza, Asthma, Prospective Studie, business
Abstract

Introduction: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. Methods: Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. Results: Two hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. Conclusions: Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections. © Copyright jointly held by Springer and ESICM 2010.

Published
2011

10. One-year surveillance of methicillin-resistant Staphylococcus aureus in health-care setting, Palermo, Italy

Author

DI CARLO, Paola, BONURA, Celestino, CALA', Cinzia, PLANO, Maria Rosa Anna, TITONE LANZA DI SCALEA, Lucina, MAMMINA, Caterina, GUADAGNINO, G, MONASTERO,M, ROMANO,A, TETAMO, R, TRIZZINO,M, DI CARLO, P, BONURA, C, CALÀ, C, GUADAGNINO, G, MONASTERO,M, PLANO, MRA, ROMANO,A, TETAMO, R, TITONE LANZA DI SCALEA,L, TRIZZINO,M, and MAMMINA, c.

Subjects
Settore MED/07 - Microbiologia E Microbiologia Clinica, Settore MED/17 - Malattie Infettive, health-care setting, surveillance, MRSA, Settore MED/42 - Igiene Generale E Applicata
Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of infections outside of health care settings. We carried out a survey to determine the prevalence and characteristics of MRSA isolates (CA-MRSA, HA-MRSA) identified among in- and outpatients by the clinical microbiology laboratories of four general hospitals in Palermo, Italy during the period February-January 2010. Methods: Participating laboratories performed isolation, confirmed methicillin-resistance by their routine method and weekly sent their strains to the coordinating laboratory at the Department of Sciences for Health Promotion “G. D’Alessandro”, University of Palermo, Italy. The isolates were test for antimicrobial susceptibility by E-test and using the disk diffusion test. Presence of the mecA gene was investigated by PCR using primers and standard conditions. Multiplex PCR was performed to determine SCCmec types I to V.9 Strains assigned to SCCmec type IVa were submitted to polymerase chain reaction (PCR) for detection of the Panton-Valentine leukocidin toxin genes lukS-PV and lukF-PV. Multiple-locus variable-number tandem-repeat analysis (MLVA) was performed. Pulsed field gel electrophoresis (PFGE) was performed as previous reported. Multilocus sequence typing (MLST) was performed on the MRSA strains following the recommended procedure at the S. aureus MLST. Results: we collected 227 isolates from 185 patients. The distribution of MRSA from different wards was: intensive-care 25%, surgery 20%, internal medicine 33%, other 15,5% unknown 6,5%. 69% of MRSA strains were resistant to ciproflox and/or levofloxacin, 40% to macrolide and 38% to gentamycin. SCCmec type IVa has been found in 42 isolates from hospitalized patients. PFGE analysis showed 81 MLVA different banding patterns. Strains of MRSA ST398 were found. Conclusions: Detect circulation of MRSA clinically relevant strains through surveillance, timely hygienic interventions and cooperation by health care personnel are crucial to minimize or control health care-associated infections. The changing epidemiology of MRSA indicates that collaborative surveillance plans integrating human and animal information should be increased.

Published
2010

11. Piperacillina/tazobactam in terapia empirica

Author

TETAMO R, SAPUPPO F, PALMA D, ABBAGNATO L, ROMANO A, GIORDANO S, ARDIZZONE, Salvatore, TITONE LANZA DI SCALEA, Lucina, TETAMO R, SAPUPPO F, ARDIZZONE S, PALMA D, ABBAGNATO L, ROMANO A, GIORDANO S, and TITONE L

Published
2006

12. Un caso di infezione da Geotrichum capitatum

Author

ROMANO A, GIORDANO S, ABBAGNATO L, SAPUPPO F, LAZZARO G, TETAMO R, DI CARLO, Paola, TITONE LANZA DI SCALEA, Lucina, ROMANO A, GIORDANO S, DI CARLO P, ABBAGNATO L, SAPUPPO F, LAZZARO G, TETAMO R, and TITONE L

Published
2005

13. INFEZIONE POLMONARE DA BLASTOSCHIZOMICES CAPITATUS

Author

ROMANO A, GIORDANO S, DI CARLO, Paola, ABBAGNATO L, SAPUPPO F, LAZZARO G, TETAMO R, TITONE LANZA DI SCALEA, Lucina, ROMANO A, GIORDANO S, DI CARLO P, ABBAGNATO L, SAPUPPO F, LAZZARO G, TETAMO R, and TITONE L

Subjects
Immunocompromised Host, Blastomyces isolation & purification, Blastomycosis diagnosi, Antifungal Agents herapeutic use, Lung Diseases, Fungal diagnosis
Abstract

Geotrichum capitatum, now known as Blastoschizomyces capitatus, can be responsible for several opportunistic infections (systemic infection or localized at lungs, liver, kidney, encephalitis or meningitis) in an immunocompromised host, especially in those patients affected by leukaemia or under immunosuppressive therapies. A 66-year-old woman with polimyosite under steroid and immunosuppressant therapy was hospitalized in ICU for an acute respiratory distress with moderate hypoxaemia and normocapnia. Pulmonary X-ray revealed a bilateral pneumonia. Hypoxaemia became severe 48 hours later and the patient underwent mechanical ventilation and empirical antibiotic therapy. Blood cultures, urine cultures and serological tests were negative, while yeast was identified by Gram's stain of bronchoaspirate. Before identifying the yeasts Fluconazole was added to therapy. At day 5 the clinical conditions remained severe and Candida spp were excluded: so Fluconazole was switched to liposomal Amphotericin B. At day 8 B. capitatus was identified. At day 26 the patient died of refractory respiratory insufficiency. B. capitatus infection is infrequent and its prognosis is severe, with a high mortality rate (>50%). Microbiological diagnosis requires time to characterize the yeast. At present no standard therapy is available although some authors report a good susceptibility to Amphotericin B and Voriconazole (100%), according to NCCLS guidelines.

Published
2005

14. Multicenter, Prospective Surveillance Study of Staphylococcus aureus Nasal Colonization in 28 Italian Intensive Care Units: The ISABEL Study

Author

Viale, P, Gesu, G, Privitera, G, Allaria, B, Petrosillo, N, Zamparini, E, Scudeller, L, Albertario, F, Ferrari, L, Alvisi, R, Rita Rossi, M, Betto, C, Ripamonti, M, Castiglione, G, Di Vincenzo, F, Cerchiari, E, Gaspari, G, Pizzardi, Ca, Corsi, A, Piscina, A, De Zen, G, Tesser, A, Dei Poli, M, Costa, E, Ortisi, G, De Vivo, P, Libergoli, M, Della Rocca, G, Lanzafame, P, Favaro, M, Viola, G, Guarino, A, Capuzzo, R, Villa, Ao, Laudi, C, Sturla, C, Antonio Abate, S, Martinelli, G, Nannetti, A, Orsola, Os, Massei, R, Vaiani, R, Alessandra Manzoni, O, Mastroni, P, Sanna, S, Minoja, G, Tognolo, A, Onali, S, Sardi, B, Pelaia, P, Manso, E, Peris, A, Nicoletti, P, Perugini, M, Baldasarri, G, Piccinni, P, Rassu, M, Sinardi, A, Costa, G, Tetamo, R, Monastero, R, Tufano, R, Rossano, F, Tulli, G, Zamponi, E, Milano, F., Viale P, Gesu G, Privitera G, Allaria B, Petrosillo N, Zamparini E, and Scudeller L

Subjects
Microbiology (medical), Male, Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, Staphylococcus aureus, Epidemiology, intensive care units, Staphylococcal infections, medicine.disease_cause, law.invention, law, Intensive care, medicine, Humans, Colonization, Prospective Studies, Intensive care medicine, Prospective cohort study, Proportional Hazards Models, Cross Infection, business.industry, biochemical phenomena, metabolism, and nutrition, Staphylococcal Infections, prospective multicenter study, bacterial infections and mycoses, medicine.disease, Methicillin-resistant Staphylococcus aureus, Intensive care unit, nasal colonization, Nasal Mucosa, Staphylococcus aureus, nasal colonization, intensive care units, Italy, prospective multicenter study, Infectious Diseases, Carriage, Italy, Emergency medicine, Female, business, Sentinel Surveillance
Abstract

The role of methicillin-resistant Staphylococcus aureus (MRSA) colonization as a predictor of invasive disease in intensive care unit (ICU) patients was established many years ago. The role of mefhicillin-susceptible Staphylococcus aureus (MSSA) colonization is more debated, although in a recent report patients who were carriers of MRSA or MSSA at ICU admission were found to be at increased risk. Whether carriage at ICU admission involves a higher risk of invasive infection than carriage acquired during an ICU stay has not been established. We report the results of a study aimed at estimating the frequency of S. aureus (MRSA and MSSA) colonization at admission and at discharge in patients admitted to several ICUs in Italy and at estimating the relationship between colonization status and infection by S. aureus.

Published
2011

15. External validation of the Simplified Acute Physiology Score (SAPS) 3 in a cohort of 28,357 patients from 147 Italian intensive care units

Author

Poole, D, Rossi, C, Anghileri, A, Giardino, M, Latronico, N, Radrizzani, D, Langer, M, Bertolini, G, Acciarri, C, Acquarolo, A, Adorni, A, Alberti, A, Alborghetti, A, Antonini, B, Archi, D, Arditi, E, Badii, F, Balata, A, Barattini, M, Barbagli, R, Barbieri, P, Baroncia, M, Bartoccini, A, Bartoli, T, Bassi, F, Beck, E, Bellato, V, Bellorini, M, Belluomo Anello, C, Benanti, C, Berardino, M, Bernasconi, Mo, Besozzi, A, Bianchin, A, Bindi, Ml, Biolino, P, Blasetti, A, Boccalatte, D, Bonaccorso, G, Bonfà, A, Bonfiglio, M, Boniotti, C, Bonizzoli, M, Bottari, V, Breschi, C, Brunori, E, Buonanno, R, Buzzetti, V, Calicchio, G, Calva, S, Capannolo, B, Caracciolo, A, Carnevale, L, Carsana, C, Casadei, E, Casagli, S, Casagrande, L, Casalini, P, Castiglione, G, Cavallo, R, Chiarello, M, Chieregato, A, Chinelli, E, Cigada, M, Coaloa, M, Colombo, R, Colombo, S, Corsini, W, Corvi, D, Cosentino, E, Costa, R, Costanzo, E, Cottignoli, T, Crema, L, Crestan, E, Da Re, D, Dal Cero, P, Dal Ferro, M, David, Antonio, De Blasi RA, De Blasio, E, De Luca, A, De Negri, P, Dei Poli, M, Del Sarto, P, Di Lorenzo, G, Di Masi, P, Di Pasquale, D, Di Serafino, G, Donato, I, Fabbri, L, Fabbri, E, Fabbri, Pg, Fabi, Mc, Faccio, L, Ferla, F, Ferri, F, Fiore, G, Fognani, G, Galeotti, E, Gamberini, E, Garelli, A, Garofalo, G, Garzilli, T, Giacopuzzi, L, Gianni, M, Giannoni, S, Giugiaro, Pm, Gorietti, A, Grassi, P, Greco, M, Guadagnucci, A, Guagliardi, C, Isetta, M, Lapolla, A, Lefons, U, Livigni, S, Madonna, R, Maestrone, C, Magatti, Mf, Maggiolo, C, Malacarne, P, Mancosu, S, Mangani, Va, Mantovani, G, Marafon, S, Martinez Escobar, R, Mastroianni, A, Mastropierro, R, Meloni, A, Messina, M, Miglioranzi, R, Molino, Fm, Morigi, A, Mosca, C, Murri, V, Nardi, G, Nascimben, E, Natalini, G, Negri, G, Negro, G, Neri, M, Nicolini, A, Nuovo, D, Odetto, L, Olivieri, C, Ortoleva, A, Pacini, Dm, Paganini, G, Paganoni, G, Palmer, M, Papiri, S, Parma, A, Parrini, V, Pastorelli, M, Pastorini, S, Pegoraro, M, Pezzi, A, Pinciroli, D, Piredda, G, Piva, S, Pizzaballa, M, Possamai, C, Postiglione, M, Potalivo, A, Pulici, M, Quattrocchi, P, Raffaeli, M, Ranzini, L, Righini, E, Rona, R, Rossi, G, Rossi, S, Rossi, M, Rottoli, F, Salcuni, R, Salvi, G, Savioli, M, Scarrone, S, Schellino, Mm, Segala, V, Segalini, Pa, Sera, G, Sforza, D, Sicignano, A, Sorbara, C, Spadini, E, Staccioli, P, Stefani, M, Sucre, Mj, Tartari, S, Tavola, M, Tetamo, R, Tibaldi, G, Tinacci, S, Todesco, L, Torta, M, Tosi, L, Tripepi, C, Ughi, L, Vaj, M, Vecchiarelli, P, Vespignani, Mg, Visconti, Mg, Vulcano, Ga, Zappa, S, Zocaro, R, and Zuccaro, F.

Subjects
Male, medicine.medical_specialty, Time Factors, genetic structures, Critical Care, Critical Illness, Critical Care and Intensive Care Medicine, law.invention, Bias, law, Predictive Value of Tests, Risk Factors, Intensive care, Anesthesiology, Outcome Assessment, Health Care, medicine, Humans, Hospital Mortality, Prospective Studies, Simplified Acute Physiology Score, Intensive care medicine, Prospective cohort study, Diagnosis-Related Groups, APACHE, Aged, Chi-Square Distribution, business.industry, Data Collection, Benchmarking, Critical care, Hospital mortality, Outcome assessment, Validation study, Discriminant Analysis, Middle Aged, Prognosis, Intensive care unit, Intensive Care Units, Logistic Models, Italy, ROC Curve, Predictive value of tests, Cohort, Calibration, Female, business, Chi-squared distribution
Abstract

To evaluate the SAPS 3 score predictive ability of hospital mortality in a large external validation cohort.Prospective observational study.A total of 28,357 patients from 147 Italian ICUs joining the Project Margherita national database of the Gruppo italiano per la Valutazione degli interventi in Terapia Intensiva (GiViTI).None.Evaluation of discrimination through ROC analysis and of overall goodness-of-fit through the Cox calibration test.Although discrimination was good, calibration turned out to be poor. The general and the South-Europe Mediterranean countries equations overestimated hospital mortality overall (SMR values 0.73 with 95% CI 0.72-0.75 for both equations) and homogeneously across risk classes. Overprediction was confirmed among important subgroups, with SMR values ranging between 0.47 and 0.82.The result strictly supported by our data is that the SAPS 3 score calibrates inadequately in a large sample of Italian ICU patients and thus should not be used for benchmarking, at least in Italian settings.

Published
2009

18. Reactive oxygen species and antioxidants: Implications for clinical nutrition

Author

Zanetti, M., Biolo, G., Biffp, R., Nicolaas Deutz, Guglielmi, F. W., Palmo, A., Singer, P., Tetamo, R., Muscaritoli, M., Zanetti, Michela, Biolo, Gianni, Biffp, R., Deutz, N. E., Guglielmi, F. W., Palmo, A., Singer, P., Tetamo, R., and Muscaritoli, M.

Subjects
reactive oxygen species, reactive oxygen specie, oxidative stre, neurological, Nutrition, oxidative stress, antioxidants, clinical nutrition, critically ill, artificial nutrition, cancer

19. Epidemiology of intensive care unit-acquired sepsis in Italy: Results of the SPIN-UTI network

Author

Agodi, Antonella, Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, P., Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, Mary Rose, Alliani, Cristina, Amatucci, Maria Rita, Antoci, Manuela, Antonelli, Massimo, Astuto, Marinella, Arnoldo, Luca, Arru, Benedetto, Baccari, Giorgio, Barbadoro, Pamela, Barbara, Andrea, Barilaro, Cynthia, Battaglia, Pietro, Bellocchi, Patrizia, Bernasconi, Mara Olga, Bianco, Aida, Bissolo, Emanuela, Bocchi, Anna, Bruno, Anna, Brusaferro, Marco, Buccheri, Margherita, Campanella, Francesca, Canino, Rosario, Cannistrà, Antonino, Carini, Santa Adele, Catalano, Sebastiano, Castellani, Paola, Castiglione, Giacomo, Coniglio, Salvatore, Consolante, Ciriaco, Conte, Carmela, Contrisciani, Roberta, Corallini, Rosy, Crollari, Patricia, Damiani, Gianfranco, Denaro, Carmelo, De Remigis, Santa, Diana, Francesca, Di Bartolo, Rosario, Di Benedetto, Antonino, Di Fabio, Gianna, Di Falco, Carlo, Digeronimo, Vito, Di Gregorio, Pietro, Distefano, Roberta, Egitto, Giovanni, Falciani, Elena, Farruggia, Patrizia, Fenaroli, Salesia, Ferlazzo, Giuseppe, Garofalo, Giuseppe, Girardis, Massimo, Giovanelli, Linda, Giubbini, Gabriele, Graceffa, Adriana, Guadagna, Antonina, Gregu, Giovanna, Ingala, Franco, Innocenzi, Ludovico, La Camera, Giuseppa, La Rosa, Maria Clara, Lesa, Lucia, Longhitano, Anna Maria, Luppino, Giuseppe, Maida, Carmelo Massimo, Manta, Giuseppe, Marino, Giovanni, Masia, Maria Dolores, Maviglia, Riccardo, Mazzetti, Magda, Maugeri, Andrea, Megna, Maria Teresa, Mella, Laura Maria, Milazzo, Marina, Milia, Mario, Minari, Caterina, Minerva, Massimo, Mordacci, Marco, Murgia, Paola, Oliveri, Pietro, Olori, Maria Patrizia, Pagliarulo, Riccardo, Palermo, Rosanna, Pandiani, Irene, Pappalardo, Federico, Papetti, Cristina, Partenza, Adolfo, Pascu, Diana, Pasculli, Marcello, Pavia, Maria, Pavone, Maria Luisa, Pellegrino, Maria Giovanna, Pelligra, Fabrizio, Pillon, Danila, Pintaudi, Sergio, Pitzoi, Lucia, Pinto, Andrea, Piotti, Paola, Pupo, Simona, Quattrocchi, Rosalba, Righi, Elena, Rigo, Alberto, Rigo, Annalisa, Romeo, Antonina, Rosa, Emilio, Rutigliano, Serafina, Sarchi, Pierangelo, Scimonello, Guglielmo, Seminerio, Antonello, Stefanini, Paolo, Sticca, Giovanna, Taddei, Stefania, Tessari, Lorella, Tetamo, Romano, Ticca, Mariantonietta, Tribastoni, Salvatore, Vallorani, Sarah, Venturoni, Federica, Vitagliano, Emilia, Vitali, Pietro, Zappone, Assunta, Zei, Ettore, Zeoli, Maria Prudenzia, Agodi A., Barchitta M., Auxilia F., Brusaferro S., D'Errico M.M., Montagna M.T., Pasquarella C., Tardivo S., Arrigoni C., Fabiani L., Laurenti P., Mattaliano A.R., Orsi G.B., Squeri R., Torregrossa M.V., Mura I., Aiello M.R., Alliani C., Amatucci M.R., Antoci M., Antonelli M., Astuto M., Arnoldo L., Arru B., Baccari G., Barbadoro P., Barbara A., Barilaro C., Battaglia P., Bellocchi P., Bernasconi M.O., Bianco A., Bissolo E., Bocchi A., Bruno A., Brusaferro M., Buccheri M., Campanella F., Canino R., Cannistra A., Carini S.A., Catalano S., Castellani P., Castiglione G., Coniglio S., Consolante C., Conte C., Contrisciani R., Corallini R., Crollari P., Damiani G., Denaro C., De Remigis S., Diana F., Di Bartolo R., Di Benedetto A., Di Fabio G., Di Falco C., Digeronimo V., Di Gregorio P., Distefano R., Egitto G., Falciani E., Farruggia P., Fenaroli S., Ferlazzo G., Garofalo G., Girardis M., Giovanelli L., Giubbini G., Graceffa A., Guadagna A., Gregu G., Ingala F., Innocenzi L., La Camera G., La Rosa M.C., Lesa L., Longhitano A.M., Luppino G., Maida C.M., Manta G., Marino G., Masia M.D., Maviglia R., Mazzetti M., Maugeri A., Megna M.T., Mella L.M., Milazzo M., Milia M., Minari C., Minerva M., Mordacci M., Murgia P., Oliveri P., Olori M.P., Pagliarulo R., Palermo R., Pandiani I., Pappalardo F., Papetti C., Partenza A., Pascu D., Pasculli M., Pavia M., Pavone M.L., Pellegrino M.G., Pelligra F., Pillon D., Pintaudi S., Pitzoi L., Pinto A., Piotti P., Pupo S., Quattrocchi R., Righi E., Rigo A., Romeo A., Rosa E., Rutigliano S., Sarchi P., Scimonello G., Seminerio A., Stefanini P., Sticca G., Taddei S., Tessari L., Tetamo R., Ticca M., Tribastoni S., Vallorani S., Venturoni F., Vitagliano E., Vitali P., Zappone A., Zei E., Zeoli M.P., Agodi, A., Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, P., Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, M. R., Alliani, C., Amatucci, M. R., Antoci, M., Antonelli, M., Astuto, M., Arnoldo, L., Arru, B., Baccari, G., Barbadoro, P., Barbara, A., Barilaro, C., Battaglia, P., Bellocchi, P., Bernasconi, M. O., Bianco, A., Bissolo, E., Bocchi, A., Bruno, A., Brusaferro, M., Buccheri, M., Campanella, F., Canino, R., Cannistra, A., Carini, S. A., Catalano, S., Castellani, P., Castiglione, G., Coniglio, S., Consolante, C., Conte, C., Contrisciani, R., Corallini, R., Crollari, P., Damiani, G., Denaro, C., De Remigis, S., Diana, F., Di Bartolo, R., Di Benedetto, A., Di Fabio, G., Di Falco, C., Digeronimo, V., Di Gregorio, P., Distefano, R., Egitto, G., Falciani, E., Farruggia, P., Fenaroli, S., Ferlazzo, G., Garofalo, G., Girardis, M., Giovanelli, L., Giubbini, G., Graceffa, A., Guadagna, A., Gregu, G., Ingala, F., Innocenzi, L., La Camera, G., La Rosa, M. C., Lesa, L., Longhitano, A. M., Luppino, G., Maida, C. M., Manta, G., Marino, G., Masia, M. D., Maviglia, R., Mazzetti, M., Maugeri, A., Megna, M. T., Mella, L. M., Milazzo, M., Milia, M., Minari, C., Minerva, M., Mordacci, M., Murgia, P., Oliveri, P., Olori, M. P., Pagliarulo, R., Palermo, R., Pandiani, I., Pappalardo, F., Papetti, C., Partenza, A., Pascu, D., Pasculli, M., Pavia, M., Pavone, M. L., Pellegrino, M. G., Pelligra, F., Pillon, D., Pintaudi, S., Pitzoi, L., Pinto, A., Piotti, P., Pupo, S., Quattrocchi, R., Righi, E., Rigo, A., Romeo, A., Rosa, E., Rutigliano, S., Sarchi, P., Scimonello, G., Seminerio, A., Stefanini, P., Sticca, G., Taddei, S., Tessari, L., Tetamo, R., Ticca, M., Tribastoni, S., Vallorani, S., Venturoni, F., Vitagliano, E., Vitali, P., Zappone, A., Zei, E., and Zeoli, M. P.

Subjects
Sleep Initiation and Maintenance Disorder, Male, Time Factors, Healthcare-associated infections, Mortality, Sepsis, Surveillance, Public Health, Environmental and Occupational Health, Infectious Diseases, Diet, Mediterranean, Coffee, Health Statu, Mortality Parole chiave: Infezioni correlate all'assistenza, Mortalità, Sepsi, Sorveglianza, Academic Performance, Prevalence, Surveys and Questionnaire, Hospital Mortality, Prospective Studies, Cross Infection, Incidence, Smoking, Tryptophan, Shock, Middle Aged, Shock, Septic, Intensive Care Units, Italy, Population Surveillance, Female, Public Health, Human, Adult, Employment, Alcohol Drinking, Intensive Care Unit, Regression Analysi, Young Adult, Age Distribution, Learning, Humans, Healthcare-associated infection, Exercise, Life Style, Settore MED/42 - IGIENE GENERALE E APPLICATA, Aged, Cross-Sectional Studie, Septic, Environmental and Occupational Health, Body Weight, Length of Stay, Body Height, Prospective Studie, Quality of Life, Students, Nursing
Abstract

Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. Conclusions. Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients.

Published
2018

20. Cluster analysis identifies patients at risk of catheter-associated urinary tract infections in intensive care units: findings from the SPIN-UTI Network

Author

Francesca Moretti, Giovanni Battista Orsi, Antonella Agodi, Marina Milazzo, Riccardo Pagliarulo, Cristina Arrigoni, Raffaele Squeri, Anna Maria Longhitano, Ida Mura, MC La Rosa, Emanuela Bissolo, Salvatore Coniglio, Paola Piotti, Salesia Fenaroli, Elena Righi, Cesare Vittori, Giovanni Gallo, Massimo Girardis, Alberto Rigo, Marcello Pasculli, Franco Marinangeli, Leila Fabiani, Aida Bianco, Ennio Sicoli, Marinella Astuto, Maria Pavia, Ignazio Dei, Paolo Marco Riela, Sergio Pintaudi, Giuseppe Manta, Giacomo Castiglione, Marcello Mario D’Errico, Massimo Minerva, Stefano Tardivo, Patrizia Laurenti, Patrizia Bellocchi, Marco Brusaferro, Romano Tetamo, Abele Donati, Albino Borracino, Pierangelo Sarchi, Luca Arnoldo, R Magnano San Lio, Giorgio Scrofani, Antonino Cannistrà, Maria Carmela Riggio, Antonino Di Benedetto, Salvatore Tribastoni, Maria Concetta Monea, Maria Teresa Montagna, Martina Barchitta, A R Mattaliano, Patrizia Farruggia, Irene Pandiani, Paolo Stefanini, Franco Ingala, Silvio Brusaferro, Andrea Maugeri, C La Mastra, Rosario Massimo Di Bartolo, Alberto Carli, Giuliana Favara, Barchitta, M., Maugeri, A., Favara, G., Riela, P. M., La Mastra, C., La Rosa, M. C., Magnano San Lio, R., Gallo, G., Mura, I., Agodi, A., Salesia, F., Ennio, S., Montagna, M. T., Squeri, R., Di Bartolo, R. M., Salvatore, T., Mattaliano, A. R., Bellocchi, P., Castiglione, G., Astuto, M., Longhitano, A. M., Monea, M. C., Scrofani, G., Di Benedetto, A., Carmela, R. M., Manta, G., Tetamo, R., Dei, I., Pandiani, I., Antonino, C., Piotti, P., Girardis, M., Righi, E., Pierangelo, S., Arnoldo, L., Brusaferro, S., Coniglio, S., Albino, B., Pintaudi, S., Minerva, M., Milazzo, M., Bissolo, E., Rigo, A., Fabiani, L., Marinangeli, F., Stefanini, P., D'Errico, M. M., Donati, A., Tardivo, S., Moretti, F., Carli, A., Pagliarulo, R., Bianco, A., Pavia, M., Pasculli, M., Vittori, C., Orsi, G. B., Arrigoni, C., Laurenti, P., Ingala, F., and Farruggia, P.

Subjects
Microbiology (medical), medicine.medical_specialty, Catheters, Urinary system, medicine.medical_treatment, Catheter-associated urinary tract infection, 030501 epidemiology, Urinary catheterization, law.invention, 03 medical and health sciences, Cluster analysis, Interquartile range, law, Internal medicine, Intensive care, Sepsis, Intensive care unit, Risk factor, Cluster Analysis, Humans, Intensive Care Units, Italy, Catheter-Related Infections, Cross Infection, Urinary Tract Infections, medicine, Cluster analysi, Settore MED/42 - IGIENE GENERALE E APPLICATA, 0303 health sciences, 030306 microbiology, business.industry, Incidence (epidemiology), General Medicine, Catheter, Infectious Diseases, 0305 other medical science, business
Abstract

Background: Although preventive strategies have been proposed against catheter-associated urinary tract infections (CAUTIs) in intensive care units (ICUs), more efforts are needed to control the incidence rate. Aim: To distinguish patients according to their characteristics at ICU admission, and to identify clusters of patients at higher risk for CAUTIs. Methods: A two-step cluster analysis was conducted on 9656 patients from the Italian Nosocomial Infections Surveillance in Intensive Care Units project. Findings: Three clusters of patients were identified. Type of admission, patient origin and administration of antibiotics had the greatest weight on the clustering model. Cluster 1 comprised more patients with a medical type of ICU admission who came from the community. Cluster 2 comprised patients who were more likely to come from other wards/hospitals, and to report administration of antibiotics 48 h before or after ICU admission. Cluster 3 was similar to Cluster 2 but was characterized by a lower percentage of patients with administration of antibiotics 48 h before or after ICU admission. Patients in Clusters 1 and 2 had a longer duration of urinary catheterization [median 7 days, interquartile range (IQR) 12 days for Cluster 1; median 7 days, IQR 11 days for Cluster 2] than patients in Cluster 3 (median 6 days, IQR 8 days; P

Published
2021

21. Co-colonization with carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii in intensive care unit patients

Author

Anna Rita Vivoli, Laura Saporito, Maria Antonietta Saporito, Pier Giorgio Fabbri, Daniela Maria Palma, Francesca Di Bernardo, Romano Tetamo, Concetta Sodano, Andrea Neville Cracchiolo, Celestino Bonura, Caterina Mammina, Maria Stella Verde, Mammina, C, Bonura, C, Vivoli, AR, Di Bernardo, F, Sodano, C, Saporito, MA, Verde, MS, Saporito, L, Cracchiolo, AN, Fabbri, PG, Tetamo, R, and Palma, DM

Subjects
Acinetobacter baumannii, Adult, Male, Microbiology (medical), medicine.medical_specialty, Pediatrics, Younger age, Genotype, Carbapenem resistant Klebsiella pneumoniae, Klebsiella pneumoniae, Critical Illness, Settore MED/42 - Igiene Generale E Applicata, Hospitals, General, beta-Lactamases, law.invention, Bacterial Proteins, Risk Factors, law, Internal medicine, Drug Resistance, Bacterial, medicine, Humans, General hospital, Sicily, Aged, Aged, 80 and over, General Immunology and Microbiology, biology, Coinfection, business.industry, Major trauma, General Medicine, Middle Aged, biology.organism_classification, medicine.disease, Intensive care unit, Carbapenem resistance, co-colonization, intensive care unit, risk factors, Klebsiella Infections, Molecular Typing, Intensive Care Units, Infectious Diseases, Female, Co colonization, business, Acinetobacter Infections
Abstract

Objectives: This investigation was conducted to study co-colonization by carbapenem-resistant Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) and Acinetobacter baumannii (CRAB) in intensive care unit (ICU) patients in Palermo, Sicily, a geographic area where both organisms are endemic in the healthcare setting. Risk factors at admission and during ICU stay and outcomes were also evaluated. Methods: All patients colonized by KPC-Kp, or CRAB, or both in 2 ICUs of a large general hospital during the period October 2011 – March 2012 were enrolled. Demographics and clinical data were collected. Resistance determinants and clonality of the 2 organisms were characterized by molecular methods. Results: Seventy-fi ve of 391 patients (19.2%) proved to be colonized by KPC-Kp, CRAB, or both: 30 (40%) were co-colonized and 44 (58.7%) were mono-colonized by CRAB and 1 by KPC-Kp. Younger age, major trauma, and length of stay were positively associated with co-colonization. However, no signifi cant differences were detected between co-colonized and non co-colonized patients in infection and ICU mortality rates and length of stay after the fi rst isolation. Both organisms proved to be circulating in a clonal way. Conclusions: In our setting, co-colonization by KPC-Kp and CRAB disproportionately affected young trauma patients with those with a prolonged ICU stay.

Published
2013

22. Ongoing spread of colistin-resistant Klebsiella pneumoniae in different wards of an acute general hospital, Italy, June to December 2011

Author

Daniela Maria Palma, Caterina Mammina, Maria Antonietta Saporito, Aurora Aleo, Concetta Sodano, F. Di Bernardo, Teresa Fasciana, Romano Tetamo, Celestino Bonura, Maria Stella Verde, Mammina, C., Bonura, C., Di Bernardo, F., Aleo, A., Fasciana, T., Sodano, C., Saporito, M., Verde, M., Tetamo, R., and Palma, D.

Subjects
DNA, Bacterial, Settore MED/07 - Microbiologia E Microbiologia Clinica, Epidemiology, Klebsiella pneumoniae, Microbial Sensitivity Tests, Settore MED/42 - Igiene Generale E Applicata, Hospitals, General, Polymerase Chain Reaction, Klebsiella pneumoniae, carbapenems, colistin resistance, ICU, epidemiology, beta-Lactamases, Microbiology, Disease Outbreaks, Antibiotic resistance, Virology, Intensive care, Drug Resistance, Multiple, Bacterial, Patients' Rooms, Medicine, Humans, colistin-resistance, MLST, General hospital, Cross Infection, biology, business.industry, Colistin, Public Health, Environmental and Occupational Health, Outbreak, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, Anti-Bacterial Agents, Bacterial Typing Techniques, Klebsiella Infections, Intensive Care Units, Carbapenems, Italy, Multilocus sequence typing, business, Horizontal transmission, medicine.drug, Multilocus Sequence Typing
Abstract

We describe polyclonal spread of colistin-resistant Klebsiella pneumoniae in an acute general hospital in Italy. Between June and December 2011, 58 colistin-resistant K. pneumoniae isolates were recovered from 28 patients admitted to different wards, but mainly in the intensive care units. All isolates were tested for drug susceptibility and the presence of beta-lactamase (bla) genes. Clonality was investigated by repetitive extragenic palindromic (rep)-PCR and multilocus sequence typing (MLST). Fifty-two isolates had minimum inhibitory concentrations (MICs) for colistin of 6-128 mg/L, carried blaKPC3 and were attributed to sequence type ST258. The remaining six isolates were susceptible to carbapenems, exhibited MICs for colistin of 3-32 mg/L, and belonged to two different types, ST15 and ST273. Rep-PCR included all isolates in three clusters, one containing all ST258 KPC-3-producing isolates and two containing ST15 and ST273 isolates. Cross-transmission containment measures and intensification of staff and environmental hygiene could not stop the outbreak. Selective pressure and horizontal transmission probably contributed to emergence and spread of three different strains of colistin-resistant K. pneumoniae in the hospital. Strict implementation of the above measures and a wider awareness of the antimicrobial resistance threat are crucial to preserve the last therapeutic options of the multidrug-resistant Gram-negative infections. .

Published
2012

23. Epidemiology and clonality of carbapenem-resistant Acinetobacter baumannii from an intensive care unit in Palermo, Italy

Author

Teresa Fasciana, Maria Antonietta Saporito, Maria Stella Verde, Caterina Mammina, Cinzia Calà, Aurora Aleo, Romano Tetamo, Celestino Bonura, Concetta Sodano, Daniela Maria Palma, Andrea Neville Cracchiolo, Mammina, C, Palma, DM, Bonura, C, Aleo, A, Fasciana, T, Sodano, C, Saporito, MA, Verde, MS, Calà, C, Cracchiolo, AN, and Tetamo, R

Subjects
Male, Acinetobacter baumannii, Imipenem, Settore MED/07 - Microbiologia E Microbiologia Clinica, Time Factors, lcsh:Medicine, Tigecycline, Polymerase Chain Reaction, intensive care unit, law.invention, law, Drug Resistance, Multiple, Bacterial, Epidemiology, polycyclic compounds, Medicine, lcsh:QH301-705.5, Medicine(all), Aged, 80 and over, biology, General Medicine, Middle Aged, Intensive care unit, Intensive Care Units, Italy, Female, Acinetobacter Infections, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Short Report, Microbial Sensitivity Tests, Meropenem, General Biochemistry, Genetics and Molecular Biology, Young Adult, Intensive care, Humans, Intensive care medicine, lcsh:Science (General), Aged, Demography, Biochemistry, Genetics and Molecular Biology(all), business.industry, lcsh:R, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, biology.organism_classification, Clone Cells, Carbapenems, lcsh:Biology (General), bacteria, business, Carbapenem resistant Acinetobacter baumannii, lcsh:Q1-390
Abstract

Background Multidrug-resistant Acinetobacter baumannii, initially considered as having a poor clinical relevance, is frequently isolated from infection cases in intensive care units. We describe the epidemiology of carbapenem resistant A. baumannii (CRAB) in a general ICU in Palermo, Italy, from October 2010 to March 2011. Findings 58 of 61 isolates exhibited MICs for meropenem or imipenem ≥16 mg/L. Forty-nine carried blaOXA-23 and two blaOXA-58 genes. Five subtype clusters were detected by rep-PCR. Clusters D and E included 10 isolates that tested negative for the carbapenem resistance genes. MLST attributed all isolates, but two, with sequence type (ST)2, whereas the two remaining isolates with ST78. The respiratory tract was the most common site of infection (26 out of 36 cases. 72.2%). A high infection related mortality rate was observed (18 out of 35 patients, 51.4%). Nineteen patients tested positive for other multidrug resistant organisms in addition to CRAB. In eight cases isolates belonging to distinct subtype clusters and/or with distinct carbapenemase profiles were identified. Conclusions Carbapenem resistance was prominently driven by the dissemination of CRAB isolates belonging to ST2, carrying the carbapenemase gene blaOXA-23. The colonization/infection of some patients by multiple strains is suggestive of an endemic circulation of CRAB.

Published
2012

24. Outbreak of infection with Klebsiella pneumoniae sequence type 258 producing Klebsiella pneumoniae Carbapenemase 3 in an intensive care unit in Italy

Author

Daniela Maria Palma, Cinzia Calà, Concetta Sodano, Romano Tetamo, Maria Rosa Anna Plano, Rachele Monastero, Celestino Bonura, Mammina C, Mammina, C, Palma, DM, Bonura, C, Plano, MRA, Monastero, R, Sodano, C, Calà, C, and Tetamo, R

Subjects
Microbiology (medical), Adult, Male, Settore MED/07 - Microbiologia E Microbiologia Clinica, Adolescent, Genotype, Klebsiella pneumoniae, medicine.medical_treatment, Treatment outcome, Microbial Sensitivity Tests, Klebsiella pneumoniae, carbapenem, UTI, outbreak, beta-Lactamases, law.invention, Disease course, Microbiology, Disease Outbreaks, Bacterial protein, Bacterial Proteins, law, polycyclic compounds, Medicine, Humans, Letters to the Editor, Aged, Aged, 80 and over, biology, business.industry, Outbreak, Klebsiella infections, Sequence Analysis, DNA, Middle Aged, bacterial infections and mycoses, biology.organism_classification, Intensive care unit, DNA Fingerprinting, Anti-Bacterial Agents, Bacterial Typing Techniques, Klebsiella Infections, Intensive Care Units, Treatment Outcome, Italy, Beta-lactamase, Female, business
Abstract

Gram-negative pathogens producing carbapenemases represent an alarming clinical threat with serious effects on patient outcomes ([3][1], [7][2]). In 2001, Yigit et al. ([11][3]) reported a novel β-lactamase termed “ K lebsiella pneumoniae carbapenemase” (KPC-1) in North Carolina. KPC-producing

Published
2010

25. Nutrition support for critically ill patients during the COVID-19 pandemic: the Italian SIAARTI survey.

Author

Tetamo R, Fittipaldi C, Buono S, and Umbrello M

Abstract

Background: Critically ill, COVID-19 patients are characterized by a hypermetabolic state and a reduced food intake and are at high risk of malnutrition and lean body mass loss. An appropriate metabolic-nutritional intervention aims to reduce complications and improve the clinical outcomes. We conducted a cross-sectional, multicenter, observational, nationwide online survey involving Italian Intensivists to assess the nutritional practices in critically ill patients with COVID-19., Results: A group of experts in nutrition of the Italian Society of Anaesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) developed a 24-item questionnaire; the 9000 members of the Society were invited to participate through emails and social networks. Data was collected from June 1 to August 1, 2021. A total of 545 responses were collected: 56% in northern, 25% in central, and 20% in southern Italy. Artificial nutrition support is directly handled by intensivists in > 90 of the cases; the nutritional status is assessed as suggested by the guidelines in more than 70% of the cases, and a form of nutrition support is started within the first 48 h from ICU admission by > 90% of the respondents. Nutritional targets are reached in 4-7 days in > 75% of the cases, mainly by the enteral route. Indirect calorimetry, muscle ultrasound, and bioimpedance analysis are used by a limited part of the interviewees. Only about a half of the respondents reported the nutritional issues in the ICU discharge summary., Conclusions: This survey among Italian Intensivists during the COVID-19 epidemic showed how the beginning, progression, and route of nutritional support adhere to international recommendations, while recommendations on the tools to set the target and monitor the efficacy of the metabolic support are less followed., (© 2022. The Author(s).)

Published
2022
Full Text
View/download PDF

28. Medical nutrition therapy and clinical outcomes in critically ill adults: a European multinational, prospective observational cohort study (EuroPN).

Author

Matejovic M, Huet O, Dams K, Elke G, Vaquerizo Alonso C, Csomos A, Krzych ŁJ, Tetamo R, Puthucheary Z, Rooyackers O, Tjäder I, Kuechenhoff H, Hartl WH, and Hiesmayr M

Subjects
Adult, Cohort Studies, Energy Intake, Humans, Intensive Care Units, Prospective Studies, Critical Illness therapy, Parenteral Nutrition
Abstract

Background: Medical nutrition therapy may be associated with clinical outcomes in critically ill patients with prolonged intensive care unit (ICU) stay. We wanted to assess nutrition practices in European intensive care units (ICU) and their importance for clinical outcomes., Methods: Prospective multinational cohort study in patients staying in ICU ≥ 5 days with outcome recorded until day 90. Macronutrient intake from enteral and parenteral nutrition and non-nutritional sources during the first 15 days after ICU admission was compared with targets recommended by ESPEN guidelines. We modeled associations between three categories of daily calorie and protein intake (low: < 10 kcal/kg, < 0.8 g/kg; moderate: 10-20 kcal/kg, 0.8-1.2 g/kg, high: > 20 kcal/kg; > 1.2 g/kg) and the time-varying hazard rates of 90-day mortality or successful weaning from invasive mechanical ventilation (IMV)., Results: A total of 1172 patients with median [Q1;Q3] APACHE II score of 18.5 [13.0;26.0] were included, and 24% died within 90 days. Median length of ICU stay was 10.0 [7.0;16.0] days, and 74% of patients could be weaned from invasive mechanical ventilation. Patients reached on average 83% [59;107] and 65% [41;91] of ESPEN calorie and protein recommended targets, respectively. Whereas specific reasons for ICU admission (especially respiratory diseases requiring IMV) were associated with higher intakes (estimate 2.43 [95% CI: 1.60;3.25] for calorie intake, 0.14 [0.09;0.20] for protein intake), a lack of nutrition on the preceding day was associated with lower calorie and protein intakes (- 2.74 [- 3.28; - 2.21] and - 0.12 [- 0.15; - 0.09], respectively). Compared to a lower intake, a daily moderate intake was associated with higher probability of successful weaning (for calories: maximum HR 4.59 [95% CI: 1.5;14.09] on day 12; for protein: maximum HR 2.60 [1.09;6.23] on day 12), and with a lower hazard of death (for calories only: minimum HR 0.15, [0.05;0.39] on day 19). There was no evidence that a high calorie or protein intake was associated with further outcome improvements., Conclusions: Calorie intake was mainly provided according to the targets recommended by the active ESPEN guideline, but protein intake was lower. In patients staying in ICU ≥ 5 days, early moderate daily calorie and protein intakes were associated with improved clinical outcomes. Trial registration NCT04143503 , registered on October 25, 2019., (© 2022. The Author(s).)

Published
2022
Full Text
View/download PDF

29. Clinical features and outcome of patients with descending necrotizing mediastinitis: prospective analysis of 34 cases.

Author

Palma DM, Giuliano S, Cracchiolo AN, Falcone M, Ceccarelli G, Tetamo R, and Venditti M

Subjects
Adult, Aged, Female, Humans, Male, Mediastinitis mortality, Middle Aged, Necrosis mortality, Prospective Studies, Sepsis prevention & control, Sepsis therapy, Survival Analysis, Treatment Outcome, Young Adult, Anti-Infective Agents therapeutic use, Mediastinitis pathology, Mediastinitis therapy, Necrosis pathology, Necrosis therapy, Surgical Procedures, Operative methods
Abstract

Purpose: We aimed to investigate clinical features of patients with descending necrotizing mediastinitis (DNM) in order to improve management and outcome., Methods: We prospectively examined all patients with DNM admitted to the Intensive Care Unit (ICU) during the period from April 2007 to December 2013. Demographics, clinical features, microbiology, medical and surgical treatment data were recorded. Survivor and nonsurvivor groups were analyzed to identify factors associated with mortality., Results: Overall, 34 patients with DNM have been included. The mean age was 46.8 ± 11.2 years (range 24-70). The male/female ratio was 3.25. DNM arose from odontogenic infection in 22 (65%) patients; from peritonsillar abscess in 9 (26%) patients and from paranasal sinus in 3 (9%) patients. Microbiological cultures revealed a high percentage of aerobic/anaerobic coinfection. Nonsurvivors were statistically more likely to have higher SAPS II score (mean difference 19.1, 95% CI 12.3-25.9 P < 0.01) and more severe disease (P < 0.01) than survivors. Positive correlation was found between time to ICU admission after head or neck infection diagnosis and SAPS II score (ρ = 0.5, P = 0.03). The same was true for ICU length of stay and time to ICU admission (ρ = 0.6, P < 0.01) and time to surgery (ρ = 0.5, P = 0.03). Surgical treatments consisted in: transcervical drainage in 14 cases, (42%); irrigation through subxiphoid and cervical incisions of the anterior mediastinum with additional percutaneous thoracic drainage when necessary in ten cases, (29 %); thoracotomy with radical mediastinal surgical debridement, excision of necrotic tissue and decortication in ten cases, (29%). We have found a mortality rate of 12%. Patients with DNM type IIB were admitted to the ICU later than patients with DNM type I and type IIA (mean difference 3.2 days, 95% CI 1.2-5.1, P 0.02)., Conclusions: Prompt ICU admission in order to manage severe sepsis and/or septic shock, along with early and aggressive surgery and adequate antimicrobial therapy, could be key factors in reducing DNM mortality.

Published
2016
Full Text
View/download PDF

30. Co-colonization with carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii in intensive care unit patients.

Author

Mammina C, Bonura C, Vivoli AR, Di Bernardo F, Sodano C, Saporito MA, Verde MS, Saporito L, Cracchiolo AN, Fabbri PG, Tetamo R, and Palma DM

Subjects
Acinetobacter Infections microbiology, Acinetobacter baumannii classification, Acinetobacter baumannii drug effects, Acinetobacter baumannii genetics, Acinetobacter baumannii isolation & purification, Adult, Aged, Aged, 80 and over, Bacterial Proteins genetics, Coinfection microbiology, Critical Illness, Drug Resistance, Bacterial, Female, Genotype, Hospitals, General, Humans, Intensive Care Units, Klebsiella Infections microbiology, Klebsiella pneumoniae classification, Klebsiella pneumoniae drug effects, Klebsiella pneumoniae genetics, Klebsiella pneumoniae isolation & purification, Male, Middle Aged, Molecular Typing, Risk Factors, Sicily epidemiology, beta-Lactamases genetics, Acinetobacter Infections epidemiology, Bacterial Proteins metabolism, Coinfection epidemiology, Klebsiella Infections epidemiology, beta-Lactamases metabolism
Abstract

Objectives: This investigation was conducted to study co-colonization by carbapenem-resistant Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) and Acinetobacter baumannii (CRAB) in intensive care unit (ICU) patients in Palermo, Sicily, a geographic area where both organisms are endemic in the healthcare setting. Risk factors at admission and during ICU stay and outcomes were also evaluated., Methods: All patients colonized by KPC-Kp, or CRAB, or both in 2 ICUs of a large general hospital during the period October 2011-March 2012 were enrolled. Demographics and clinical data were collected. Resistance determinants and clonality of the 2 organisms were characterized by molecular methods., Results: Seventy-five of 391 patients (19.2%) proved to be colonized by KPC-Kp, CRAB, or both: 30 (40%) were co-colonized and 44 (58.7%) were mono-colonized by CRAB and 1 by KPC-Kp. Younger age, major trauma, and length of stay were positively associated with co-colonization. However, no significant differences were detected between co-colonized and non co-colonized patients in infection and ICU mortality rates and length of stay after the first isolation. Both organisms proved to be circulating in a clonal way., Conclusions: In our setting, co-colonization by KPC-Kp and CRAB disproportionately affected young trauma patients with those with a prolonged ICU stay.

Published
2013
Full Text
View/download PDF

31. Daptomycin in the treatment of invasive Gram-positive bacterial infections in children: personal experience.

Author

Palma DM, Giordano S, Neville Cracchiolo A, Zangara V, Coffaro G, and Tetamo R

Subjects
Adolescent, Child, Child, Preschool, Cohort Studies, Female, Humans, Infant, Male, Retrospective Studies, Anti-Bacterial Agents therapeutic use, Daptomycin therapeutic use, Gram-Positive Bacterial Infections drug therapy
Abstract

Aim: The emergence and dissemination of antimicrobial resistance among Gram-positive pathogens has become troublesome for pediatric patients. Daptomycin is a first-in-its-class cyclic lipopeptide, which can be useful for treatment of these infections in children, but clinical experience is lacking., Methods: Retrospective review of medical records of seven hospitalized children who received daptomycin for treatment of invasive Gram-positive bacterial infections at Children's Cardiosurgery of AORNAS Civico-Di Cristina-Benfratelli, Palermo (Italy), from December 2009 to September 2010. Six patients had a congenital cardiomyopathy; only one patient had not any underlying comorbid condition. Bacterial isolates were tested for susceptibility to daptomycin by gradient diffusion method (E-test, Biomerieux)., Results: Seven children received daptomycin. All these children had invasive disease and only one of them was not receiving care in our Intensive Care Unit. Organisms isolated were 2 S. aureus methicillin-resistant; 4 S. Epidermidis methicillin-resistant and 1 E. faecium. Six infections were bloodstream infections and one was a complicated skin and soft tissue infection. All these infections had failed standard empirical antimicrobial therapy and had persistently positive blood cultures and/or fever prior to initiation of daptomycin. Outcomes after the initiation of daptomycin included clearance of blood cultures and defervescence within 72 hours. No drug related adverse events were documented., Conclusion: All our patients improved but two patients died of complications of their pre-existing pathology. Further studies are necessary to assess the pharmacological characteristics, safety and effectiveness of daptomycin in children, but it seems to be promising antimicrobial agent in pediatric patients.

Published
2013

32. Epidemiology and clonality of carbapenem-resistant Acinetobacter baumannii from an intensive care unit in Palermo, Italy.

Author

Mammina C, Palma DM, Bonura C, Aleo A, Fasciana T, Sodano C, Saporito MA, Verde MS, Calà C, Cracchiolo AN, and Tetamo R

Subjects
Acinetobacter baumannii genetics, Adolescent, Adult, Aged, Aged, 80 and over, Clone Cells, Demography, Female, Humans, Italy epidemiology, Male, Microbial Sensitivity Tests, Middle Aged, Polymerase Chain Reaction, Time Factors, Young Adult, Acinetobacter Infections epidemiology, Acinetobacter Infections microbiology, Acinetobacter baumannii drug effects, Acinetobacter baumannii isolation & purification, Carbapenems pharmacology, Drug Resistance, Multiple, Bacterial drug effects, Intensive Care Units statistics & numerical data
Abstract

Background: Multidrug-resistant Acinetobacter baumannii, initially considered as having a poor clinical relevance, is frequently isolated from infection cases in intensive care units. We describe the epidemiology of carbapenem resistant A. baumannii (CRAB) in a general ICU in Palermo, Italy, from October 2010 to March 2011., Findings: 58 of 61 isolates exhibited MICs for meropenem or imipenem ≥16 mg/L. Forty-nine carried blaOXA-23 and two blaOXA-58 genes.Five subtype clusters were detected by rep-PCR. Clusters D and E included 10 isolates that tested negative for the carbapenem resistance genes. MLST attributed all isolates, but two, with sequence type (ST)2, whereas the two remaining isolates with ST78.The respiratory tract was the most common site of infection (26 out of 36 cases. 72.2%). A high infection related mortality rate was observed (18 out of 35 patients, 51.4%). Nineteen patients tested positive for other multidrug resistant organisms in addition to CRAB. In eight cases isolates belonging to distinct subtype clusters and/or with distinct carbapenemase profiles were identified., Conclusions: Carbapenem resistance was prominently driven by the dissemination of CRAB isolates belonging to ST2, carrying the carbapenemase gene blaOXA-23. The colonization/infection of some patients by multiple strains is suggestive of an endemic circulation of CRAB.

Published
2012
Full Text
View/download PDF

33. Outbreak of infection with Klebsiella pneumoniae sequence type 258 producing Klebsiella pneumoniae Carbapenemase 3 in an intensive care unit in Italy.

Author

Mammina C, Palma DM, Bonura C, Anna Plano MR, Monastero R, Sodano C, Calà C, and Tetamo R

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Bacterial Typing Techniques, DNA Fingerprinting, Female, Genotype, Humans, Intensive Care Units, Italy, Klebsiella Infections microbiology, Klebsiella pneumoniae classification, Klebsiella pneumoniae genetics, Klebsiella pneumoniae isolation & purification, Male, Microbial Sensitivity Tests, Middle Aged, Sequence Analysis, DNA, Treatment Outcome, Bacterial Proteins biosynthesis, Disease Outbreaks, Klebsiella Infections epidemiology, Klebsiella pneumoniae enzymology, beta-Lactamases biosynthesis
Published
2010
Full Text
View/download PDF

34. [Pulmonary infection caused by Blastoschizomices capitatus].

Author

Romano A, Giordano S, Di Carlo P, Abbagnato L, Sapuppo F, Lazzaro G, Tetamo R, and Titone L

Subjects
Aged, Amphotericin B therapeutic use, Blastomycosis drug therapy, Fatal Outcome, Female, Fluconazole therapeutic use, Humans, Lung Diseases, Fungal drug therapy, Lung Diseases, Fungal microbiology, Myositis drug therapy, Antifungal Agents therapeutic use, Blastomyces isolation & purification, Blastomycosis diagnosis, Immunocompromised Host, Lung Diseases, Fungal diagnosis
Abstract

Geotrichum capitatum, now known as Blastoschizomyces capitatus, can be responsible for several opportunistic infections (systemic infection or localized at lungs, liver, kidney, encephalitis or meningitis) in an immunocompromised host, especially in those patients affected by leukaemia or under immunosuppressive therapies. A 66-year-old woman with polimyosite under steroid and immunosuppressant therapy was hospitalized in ICU for an acute respiratory distress with moderate hypoxaemia and normocapnia. Pulmonary X-ray revealed a bilateral pneumonia. Hypoxaemia became severe 48 hours later and the patient underwent mechanical ventilation and empirical antibiotic therapy. Blood cultures, urine cultures and serological tests were negative, while yeast was identified by Gram's stain of bronchoaspirate. Before identifying the yeasts Fluconazole was added to therapy. At day 5 the clinical conditions remained severe and Candida spp were excluded: so Fluconazole was switched to liposomal Amphotericin B. At day 8 B. capitatus was identified. At day 26 the patient died of refractory respiratory insufficiency. B. capitatus infection is infrequent and its prognosis is severe, with a high mortality rate (>50%). Microbiological diagnosis requires time to characterize the yeast. At present no standard therapy is available although some authors report a good susceptibility to Amphotericin B and Voriconazole (100%), according to NCCLS guidelines.

Published
2005

Catalog

Books, media, physical & digital resources
See catalog results