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5. Risk factors for nosocomial rectal colonization with carbapenem-resistant Acinetobacter baumannii in hospital: a matched case-control study

Author

Meschiari, M., Kaleci, S., Orlando, G., Selmi, S., Santoro, A., Bacca, E., Menozzi, M., Franceschini, E., Puzzolante, C., Bedini, A., Sarti, M., Venturelli, C., Vecchi, E., and Mussini, C.

Subjects
Acinetobacter baumannii, Adult, Male, Adolescent, Endemic hospital, lcsh:Infectious and parasitic diseases, Tertiary Care Centers, Young Adult, Risk Factors, Drug Resistance, Multiple, Bacterial, Humans, lcsh:RC109-216, Hospital Mortality, Rectal colonization, Aged, Retrospective Studies, Aged, 80 and over, Cross Infection, Surveillance, Carbapenem-resistant Acinetobacter baumannii, Risk factors, Research, Rectum, Middle Aged, Carbapenems, Italy, Case-Control Studies, Multivariate Analysis, Female, Acinetobacter Infections
Abstract

Background During the last decade carbapenem-resistant Acinetobacter baumannii (CRAB) became hyper-endemic in hospitals due to difficult to control spreading. Our aim is to identify risk factors for nosocomial rectal CRAB colonization in an endemic hospital. Methods A retrospective matched case–control study (ratio 1:2) with a prospective inclusion of cases and concurrent selection of controls was conducted from January 2017 to December 2018 in a tertiary-care hospital. Universal active surveillance for CRAB was implemented. Univariate and multivariate logistic regression was carried out using a stepwise selection method to compare prognostic factors between cases and controls. A sub-analysis was carried out according to the type of department. Results Forty-five cases with nosocomial rectal CRAB colonization and 90 controls were included. One hundred and two (75%) patients were hospitalized in medical departments. At multivariable analysis significant risk factors associated with CRAB colonization were: use of permanent devices (OR 10.15, 95% CI 2.27–45.39; P = 0.002), mechanical ventilation (OR 40.01, 95% CI 4.05–395.1; P = 0.002), urinary catheters (OR 4.9, 95% CI 1.52–16.19; P = 0.008), McCabe score (OR 5.45, 95% CI 1.87–15.89; P = 0.002), length of stay (OR 1.03, 95% CI 1.01–1.05; P = 0.002), carbapenem use (OR 5.39, 95% CI 1.14–25.44; P = 0.033). The sub-analysis showed that patients admitted to different departments had different risk factors. In geriatric department a fatal disease and a longer hospital stay represented significant risk factors both in univariate and multivariate analysis, while in internal medicine department the use of permanent devices, current antibiotic therapy and antibiotic polytherapy represented significant risk factors for CRAB at the univariate analysis, also confirmed in multivariate analysis. Conclusions Our data suggest that active surveillance for rectal CRAB colonization should be addressed to patients with an unfavourable prognosis, longer hospitalizations and carriers of multiple devices. To counter CRAB spreading in endemic settings, clinicians must limit the use of carbapenems, and reinforce interventions aimed at proper use of devices.

Published
2021

7. SICI-GISE/SIN Consensus document: Contrast-induced acute kidney injury in interventional cardiology

Author

Ronco F., Azzalini L., Briguori C., Cosmai L., D'Amico M., Di Luca M., Esposito G., Granatelli A., Maddestra N., De Marco F., La Manna A., Maioli M., Musumeci G., Tarantino F., Venturelli C., Brunori G., Tarantini G., Ronco, F., Azzalini, L., Briguori, C., Cosmai, L., D'Amico, M., Di Luca, M., Esposito, G., Granatelli, A., Maddestra, N., De Marco, F., La Manna, A., Maioli, M., Musumeci, G., Tarantino, F., Venturelli, C., Brunori, G., and Tarantini, G.

Published
2019

9. Epidemiology and Risk Factors Associated With Mortality in Consecutive Patients With Bacterial Bloodstream Infection: Impact of MDR and XDR Bacteria

Author

Santoro, A., Franceschini, E., Meschiari, M., Menozzi, M., Zona, S., Venturelli, C., Digaetano, M., Rogati, C., Guaraldi, G., Paul, M., Gyssens, I.C.J., Mussini, C., Santoro, A., Franceschini, E., Meschiari, M., Menozzi, M., Zona, S., Venturelli, C., Digaetano, M., Rogati, C., Guaraldi, G., Paul, M., Gyssens, I.C.J., and Mussini, C.

Abstract

Contains fulltext : 229596.pdf (publisher's version ) (Open Access), BACKGROUND: Mortality related to bloodstream infections (BSIs) is high. The epidemiology of BSIs is changing due to the increase in multidrug resistance, and it is unclear whether the presence of multidrug-resistant (MDR) organisms, per se, is an independent risk factor for mortality. Our objectives were, first, to describe the epidemiology and outcome of BSIs and, second, to determine the risk factors associated with mortality among patients with BSI. METHODS: This research used a single-center retrospective observational study design. Patients were identified through microbiological reports. Data on medical history, clinical condition, bacteria, antimicrobial therapy, and mortality were collected. The primary outcome was crude mortality at 30 days. The relationships between mortality and demographic, clinical, and microbiological variables were analyzed by multivariate analysis. RESULTS: A total of 1049 inpatients were included. MDR bacteria were isolated in 27.83% of patients, where 2.14% corresponded to an extremely drug-resistant (XDR) isolate. The crude mortality rates at days 7, 30, and 90 were 12.11%, 25.17%, and 36.13%, respectively. Pitt score >2, lung and abdomen as site of infection, and XDR Pseudomonas aeruginosa were independent risk factors for 7-, 30-, and 90-day mortality. Charlson score >4, carbapenem-resistant Klebsiella pneumoniae, and XDR Acinetobacter baumannii were independent risk factors for 30- and 90-day mortality. Infection by XDR gram-negative bacteria, Charlson score >4, and immunosuppression were independent risk factors for mortality in patients who were stable at the time of BSI. CONCLUSIONS: BSI is an event with an extreme impact on mortality. Patients with severe clinical condition are at higher risk of death. The presence of XDR gram-negative bacteria in blood is strongly and independently associated with patient death.

Published
2020

19. Stewardship antimicrobica nel neonato e nel piccolo lattante: Perché e come praticarla

Author

Berardi, Alberto, Ficara, Monica, Pietrella, Elisa, Boncompagni, Alessandra, Toffoli, Carlotta, Bianchini, Anastasia, Della Casa, Elisa, Spada, Caterina, Spaggiari, Eugenio, Ciccia, Matilde, Gargano, Giancarlo, Rizzo, Vittoria, Azzalli, Milena, Biasucci, Giacomo, Gambini, Lucia, Bolognesi, Serenella, Ferrari, Fabrizio, Memo, L., Nicolini, G., Ciccia, M., Sandri, F., Capretti, M. G., Dondi, A., Pasini, L., Ragni, L., Albarelli, A., Fiorini, V., Giugno, C., Lanzoni, P., Di Grande, E., Polese, A., China, M. C., Rizzo, V., Stella, M., Zucchini, A., Malaguti, L., Azzalli, M., Garani, G., Nasi, S., Bacchini, P., Fragni, G., Baldassarri, P., Pulvirenti, R. M., Valletta, E., Bidetti, M. L., Incerti, S. Storchi, Di Carlo, C., Lanzoni, A., Serra, L., Silvestrini, D., Berardi, A., Ferrari, F., Lugli, L., Venturelli, C., Sarti, M., Volta, A., Dodi, I., Magnani, C., Guidi, B., Biasucci, G., Chiarabini, R., De Paulis, N., Padrini, D., Riboni, S., Pedna, M. F., Casadio, L., Marchetti, F., Muratori, C., Piccinini, G., Renzelli, C., Amarri, S., Baroni, L., Carretto, E., Gargano, G., Pedori, S., Riva, M., Zuelli, C., Ancona, G., Bolognesi, S., Vergine, G., Viola, L., Chiossi, C., Pagano, R., Zanacca, C., Palmieri, R., PICCININI, GIANCARLO, BASTELLI, ANNALISA, AMBRETTI, SIMONE, CORVAGLIA, LUIGI TOMMASO, LANARI, MARCELLO, LAMA, CARLA, VENTUROLI, VINCENZO, ALESSANDRINI, CATERINA, FACCHINETTI, FABRIZIO, GAMBINI, LUIGI, BERTELLI, MICHELE, SAMBRI, VITTORIO, FORNACIARI, SILVIA, PAPA, IRENE, RIVI, CLAUDIA, BONVICINI, CARLOTTA, Berardi, Alberto, Ficara, Monica, Pietrella, Elisa, Boncompagni, Alessandra, Toffoli, Carlotta, Bianchini, Anastasia, Della Casa, Elisa, Spada, Caterina, Spaggiari, Eugenio, Ciccia, Matilde, Gargano, Giancarlo, Rizzo, Vittoria, Azzalli, Milena, Biasucci, Giacomo, Gambini, Lucia, Bolognesi, Serenella, Piccinini, Giancarlo, Ferrari, Fabrizio, Memo, L., Nicolini, G., Ciccia, M., Bastelli, A., Sandri, F., Ambretti, S., Capretti, M. G., Corvaglia, L., Dondi, A., Lanari, M., Pasini, L., Ragni, L., Albarelli, A., Fiorini, V., Giugno, C., Lanzoni, P., Di Grande, E., Polese, A., China, M. C., Rizzo, V., Stella, M., Zucchini, A., Malaguti, L., Azzalli, M., Garani, G., Lama, C., Nasi, S., Bacchini, P., Fragni, G., Baldassarri, P., Pulvirenti, R. M., Valletta, E., Venturoli, V., Alessandrini, C., Bidetti, M. L., Incerti, S. Storchi, Di Carlo, C., Lanzoni, A., Serra, L., Silvestrini, D., Berardi, A., Facchinetti, F., Ferrari, F., Lugli, L., Venturelli, C., Sarti, M., Volta, A., Dodi, I., Gambini, L., Magnani, C., Guidi, B., Bertelli, M., Biasucci, G., Chiarabini, R., De Paulis, N., Padrini, D., Riboni, S., Pedna, M. F., Sambri, V., Casadio, L., Marchetti, F., Muratori, C., Piccinini, G., Renzelli, C., Amarri, S., Baroni, L., Carretto, E., Fornaciari, S., Gargano, G., Pedori, S., Riva, M., Zuelli, C., Ancona, G., Bolognesi, S., Papa, I., Vergine, G., Viola, L., Chiossi, C., Pagano, R., Rivi, C., Zanacca, C., Bonvicini, C., and Palmieri, R.

Subjects
Sepsi, Pediatrics, Perinatology and Child Health, Antibiotic, Antimicrobial stewardship, Prophylaxi, Infection, Newborn
Abstract

Antimicrobial resistances are increasing worldwide, due to the misuse of antibiotic therapies in humans as well as in animals. It is expected that within a few decades multi-resistant pathogens will become the leading cause of death worldwide. The misuse of antibiotics in the neonatal period depends on the lack of predictive diagnostic tests and the peculiarity of symptoms of sepsis, which frequently are vague and unspecific at the time of presentation. Policies to prevent the emergence of antimicrobial resistances rely on a judicious use of antibiotics, on protocols and additional measures shared by health care providers. This document summarizes recent indications issued in the Emilia-Romagna subsequent to a review of the literature.

Published
2017

20. Strategies for preventing group B streptococcal infections in newborns: A nation-wide survey of Italian policies

Author

Tzialla, C, berardi, A, farina, C, clerici, P, borghesi, A, viora, E, scollo, P, stronati, M, Task Force for group B streptococcal infections for the Italian Society of Neonatology including Stival, G, barbaglia, Ma, guala, A, giunta, E, parola, L, grossignani, Mr, perri, P, tubaldi, L, alletto, G, daidone, S, flacco, V, dani, C, sterpa, A, rapisardi, G, elicio, Mr, faldella, G, capretti, Mg, messner, H, bandiera, M, achille, C, azzali, A, montrasio, G, mariani, S, galvagno, G, giacosa, E, de Angelis, F, spandrio, M, serra, A, garofalo, F, perona, A, porcelli, F, ferrero, F, De Franco, S, paollilo, P, picone, S, besana, R, varisco, T, farina, M, memo, L, nicolini, G, lietti, D, Di Chiara, G, rottoli, A, Bonabitacola, T, Cortis, E, Neri, E, Martinelli, S, Ilardi, L, Rondanini, Gf, Calzi, P, Gatta, A, Quntadamo, Pa, Ivaldi, M, Terenzani, L, Di Lascio, N, Travaglio, Md, Vetrano, G, Furcolo, G, Vitacco, V, Intini, C, Frigerio, M, Stroppiana, P, Policicchio, G, Mesirca, P, Gianino, P, Audenio, E, Paludetto, R, Raimondi, F, Pugliese, A, Valentino, L, Nosari, N, Marchesano, G, Chirico, G, Bellù, R, Menchini, M, Poletti, A, E T, Vacchiano, Pinto, L, E D, Perri, Coppola, R, Perini, R, Vetrella, A, De Luca, G, Lista, G, Cavigioli, F, Bettinelli, A, Massironi, E, Franco, C, Bernardo, L, Poli, S, Palladini, M, Tota, V, Spadavecchia, F, Zuccotti, Gv, Pogliani, L, Bracaglia, G, Mancini, Al, Zocco, F, Iozzia, G, Auriemma, A, Teani, M, Mangilli, G, Tempra, Am, Di Terlizi, L, Bottino, R, Salvi, C, Fortunato, V, Musaico, R, Gargantini, G, Carrera, G, Magaldi, R, Taurino, L, D'Onofrio, Am, Buffone, E, Tempera, A, Agosti, M, Garzia, P, Mosca, F, Pugni, L, Tagliabue, P, Colombo, C, Demi, M, Picco, G, Carlucci, A, Zorzi, G, Padula, D, Cardone, Ml, Buonocore, G, Muraca, Mc, Boldrini, A, Ciantelli, M, Lanari, M, Serra, L, Felici, L, Banderalli, G, Brambilla, C, Dall'Agnola, A, Viviani, E, Zonca, Mc, Licardi, G, Chiara, A, Ancora, G, Papa, I, Gancia, P, Pomero, G, Deloglu, A, Villani, P, Mussini, P, Canidio, E, Migliavacca, D, Di Fabio, S, Cipollone, I, Biasucci, G, Rubbi, P, Piepoli, M, Guastaferro, N, Infriccioli, F, Bertino, E, Perathoner, C, Parmigiani, S, Suriano, G, Ianniello, C, Biasini, A, Azzalli, M, Timpani, G, Barresi, S, Caoci, G, Ciccotti, R, De Curtis, M, Natale, F, Finocchi, M, Haass, C, Milillo, F, Lucieri, S, Guercio, E, Canepa, Sa, Scozia, G, Antonucci, R, Limongelli, O, Macciò, S, Mongelli, F, Colonna, F, Dragovic, D, Calipa, Mt, Cohen, A, Moresco, L, Italian Society of Obstetricians and Gynecologists including La Spina, R, Ruggeri, R, Luehwink, A, Brattoli, M, Fedi, A, Lacchi, L, Ettore, G, Pappalardo, E, Conoscenti, G, Zeni, B, Spellecchia, D, Favretti, L, Spagna, L, Zaglio, S, Bresciani, D, Bandini, A, Mancini, R, Mustoni, P, Dodero, D, Grimaldi, M, Di Mario, M, Migliorini, P, Kemeny, A, Anastasio, Ps, Riccardi, T, Maggino, T, Cerri, G, Puggina, P, Marconi, Am, Morgia, S, Bellia, G, D'Anna, Mr, Catania, M, Bacchi Modena, A, Franchi, L, Calonaci, N, Schettini, S, Paradiso, R, Saccucci, P, Ioppi, M, Zorzi, M, Stellin, G, Patacchiola, F, Carrata, L, Bassini, D, San Marco, L, Todros, T, Tibadi, C, Liborio, M, Italian Association of Clinical Microbiologists including Laricchia, R, Tauro, L, Ferrara, F, Nuara, C, Ghiraldi, E, Molinari, F, Comessatti, A, Rocchetti, A, Di Matteo, L, Miconi, V, Calvi, P, Pernigotti, A, Fabozzi, F, Micca, G, Monticone, G, Sarti, M, Da Rin, G, Zoppelletto, M, Modolo, E, Landini, Mp, Furlini, G, Galluppi, E, Pagani, E, Aschbacher, R, Innocenti, P, Bresolin, N, Raggi, Me, Bonfanti, C, De Francesco, M, Santer, P, Griessmaier, A, De Francesco, D, Pirali, A, Prasciolu, C, Usai, F, Cuzzone, G, Scutellà, M, Tramacere, P, Fossati, D, Piaserico, G, Bordignon, G, Sciacca, A, Di Vincenzo, F, Imbriani, A, Melotti, D, Catanoso, G, Rivetti, I, Neri, G, Bruno, R, Bacelle, L, Sartore, P, Giana, G, Sala, E, Giraldi, C, Cavalcanti, P, Perugini, M, Perugini, A, Ginardi, C, Maritano, D, Ferrini, A, Bonettini, A, Avanzini, A, Gasperoni, S, Pieretti, B, Montanari, E, Carillo, C, Rossi, Mr, Laureti, A, Baldoni, Ml, Serra, D, Melioli, G, Bandettini, R, Oneto, F, Colla, R, Storchi Incerti, S, Lanzini, F, Pauri, P, Tili, E, Leone, Ra, Verdastro, G, Megha, M, Luzzaro, F, Conti, A, Busulini, L, Mirri, P, Diodati, R, Vettori, C, Pittalis, S, Anesi, A, Fiore, A, Goglia, L, Vitullo, E, Sinno, A, Platzgummer, S, Spitaler, C, Trabucchi, Mc, Besozzi, M, Cesana, E, Inghilleri, G, Grosso, S, D'Angelo, R, Fogato, E, Lavarda, F, Ortisi, G, Clementi, M, Cichero, P, Rumpianesi, F, Venturelli, C, Mortillaro, F, Daffara, S, Catania, Mr, Iula, D, Andreoni, S, Politi, A, Agostinelli, C, Paparella, C, Capozzi, D, Notaris, P, Bistoni, F, Mencacci, A, Valentini, M, Filippetti, A, Confalonieri, M, Novarese, O, Bonini, F, Salamone, D, Camporese, A, De Rosa, R, Casprini, P, Degl'Innocenti, R, Giordano, R, Allù, Mt, Zanella, D, Malandrino, M, Tronci, M, Valmarin, M, Leonetti, G, Falco, S, Meledandri, M, Ballardini, M, Spanò, A, Cava, Mc, Mascellino, Mt, Schinella, M, Gualdi, P, Casari, E, Scattolo, N, Motta, C, Perfetti, C, Bassano, M, Cera, G, Iafisco, P, Mura, I, Palmieri, A, Migliardi, M, Ferlini, M, Grandi, G, Giardini, F, Albano, F, Latino, M, Ferrero, Mp, Bellizia, L, Russolo, M, Russolo, S, Pesenti, A, Fasano, Ma, Previato, S, Radillo, O, Busetti, M, Ferrari, P, Siderini, V, Puzzolante, L, Scarparo, C, Arzese, A, Cappuccia, N, Lodolo, L, Delledonne, L, Gramoni, A, Maiolo, V, Gheller, A, Spadaro, S, Balzaretti, M, Tzialla, C., Berardi, A., Farina, C., Clerici, P., Borghesi, A., Viora, E., Scollo, P., Stronati, M., Stival, G., Barbaglia, M. A., Guala, A., Giunta, E., Parola, L., Grossignani, M. R., Perri, P., Tubaldi, L., Alletto, G., Daidone, S., Flacco, V., Dani, C., Sterpa, A., Rapisardi, G., Elicio, M. R., Faldella, G., Capretti, M. G., Messner, H., Bandiera, M., Achille, C., Azzali, A., Montrasio, G., Mariani, S., Galvagno, G., Giacosa, E., de Angelis, F., Spandrio, M., Serra, A., Garofalo, F., Perona, A., Porcelli, F., Ferrero, F., De Franco, S., Paollilo, P., Picone, S., Besana, R., Varisco, T., Farina, M., Memo, L., Nicolini, G., Lietti, D., Di Chiara, G., Rottoli, A., Bonabitacola, T., Cortis, E., Neri, E., Martinelli, S., Ilardi, L., Rondanini, G. F., Calzi, P., Gatta, A., Quntadamo, P. A., Ivaldi, M., Terenzani, L., Di Lascio, N., Travaglio, M. D., Vetrano, G., Furcolo, G., Vitacco, V., Intini, C., Frigerio, M., Stroppiana, P., Policicchio, G., Mesirca, P., Gianino, P., Audenio, E., Paludetto, R., Raimondi, F., Pugliese, A., Valentino, L., Nosari, N., Marchesano, G., Chirico, G., Bell(`u), R., Menchini, M., Poletti, A., Vacchiano, T., Pinto, L., Perri, D., Coppola, R., Perini, R., Vetrella, A., De Luca, G., Lista, G., Cavigioli, F., Bettinelli, A., Massironi, E., Franco, C., Bernardo, L., Poli, S., Palladini, M., Tota, V., Spadavecchia, F., Zuccotti, G. V., Pogliani, L., Bracaglia, G., Mancini, A. L., Zocco, F., Iozzia, G., Auriemma, A., Teani, M., Mangilli, G., Tempra, A. M., Di Terlizi, L., Bottino, R., Salvi, C., Fortunato, V., Musaico, R., Gargantini, G., Carrera, G., Magaldi, R., Taurino, L., D?onofrio, A. M., Buffone, E., Tempera, A., Agosti, M., Garzia, P., Mosca, F., Pugni, L., Tagliabue, P., Colombo, C., Demi, M., Picco, G., Carlucci, A., Zorzi, G., Padula, D., Cardone, M. L., Buonocore, G., Muraca, M. C., Boldrini, A., Ciantelli, M., Lanari, M., Serra, L., Felici, L., Banderalli, G., Brambilla, C., Dall?agnola, A., Viviani, E., Zonca, M. C., Licardi, G., Chiara, A., Ancora, G., Papa, I., Gancia, P., Pomero, G., Deloglu, A., Villani, P., Mussini, P., Canidio, E., Migliavacca, D., Di Fabio, S., Cipollone, I., Biasucci, G., Rubbi, P., Piepoli, M., Guastaferro, N., Infriccioli, F., Bertino, E., Perathoner, C., Parmigiani, S., Suriano, G., Ianniello, C., Biasini, A., Azzalli, M., Timpani, G., Barresi, S., Caoci, G., Ciccotti, R., De Curtis, M., Natale, F., Finocchi, M., Haass, C., Milillo, F., Lucieri, S., Guercio, E., Canepa, S. A., Scozia, G., Antonucci, R., Limongelli, O., Macci(`o), S., Mongelli, F., Colonna, F., Dragovic, D., Calipa, M. T., Cohen, A., Moresco, L., La Spina, R., Ruggeri, R., Luehwink, A., Brattoli, M., Fedi, A., Lacchi, L., Ettore, G., Pappalardo, E., Conoscenti, G., Zeni, B., Spellecchia, D., Favretti, L., Spagna, L., Zaglio, S., Bresciani, D., Bandini, A., Mancini, R., Mustoni, P., Dodero, D., Grimaldi, M., Di Mario, M., Migliorini, P., Kemeny, A., Anastasio, P. S., Riccardi, T., Maggino, T., Cerri, G., Puggina, P., Marconi, A. M., Morgia, S., Bellia, G., D?anna, M. R., Catania, M., Bacchi Modena, A., Franchi, L., Calonaci, N., Schettini, S., Paradiso, R., Saccucci, P., Ioppi, M., Zorzi, M., Stellin, G., Patacchiola, F., Carrata, L., Bassini, D., San Marco, L., Todros, T., Tibadi, C., Liborio, M., Laricchia, R., Tauro, L., Ferrara, F., Nuara, C., Ghiraldi, E., Molinari, F., Comessatti, A., Rocchetti, A., Di Matteo, L., Miconi, V., Calvi, P., Pernigotti, A., Fabozzi, F., Micca, G., Monticone, G., Sarti, M., Da Rin, G., Zoppelletto, M., Modolo, E., Landini, M. P., Furlini, G., Galluppi, E., Pagani, E., Aschbacher, R., Innocenti, P., Bresolin, N., Raggi, M. E., Bonfanti, C., De Francesco, M., Santer, P., Griessmaier, A., De Francesco, D., Pirali, A., Prasciolu, C., Usai, F., Cuzzone, G., Scutell(`a), M., Tramacere, P., Fossati, D., Piaserico, G., Bordignon, G., Sciacca, A., Di Vincenzo, F., Imbriani, A., Melotti, D., Catanoso, G., Rivetti, I., Neri, G., Bruno, R., Bacelle, L., Sartore, P., Giana, G., Sala, E., Giraldi, C., Cavalcanti, P., Perugini, M., Perugini, A., Ginardi, C., Maritano, D., Ferrini, A., Bonettini, A., Avanzini, A., Gasperoni, S., Pieretti, B., Montanari, E., Carillo, C., Rossi, M. R., Laureti, A., Baldoni, M. L., Serra, D., Melioli, G., Bandettini, R., Oneto, F., Colla, R., Storchi Incerti, S., Lanzini, F., Pauri, P., Tili, E., Leone, R. A., Verdastro, G., Megha, M., Luzzaro, F., Conti, A., Busulini, L., Mirri, P., Diodati, R., Vettori, C., Pittalis, S., Anesi, A., Fiore, A., Goglia, L., Vitullo, E., Sinno, A., Platzgummer, S., Spitaler, C., Trabucchi, M. C., Besozzi, M., Cesana, E., Inghilleri, G., Grosso, S., D?angelo, R., Fogato, E., Lavarda, F., Ortisi, G., Clementi, M., Cichero, P., Rumpianesi, F., Venturelli, C., Mortillaro, F., Daffara, S., Catania, M. R., Iula, D., Andreoni, S., Politi, A., Agostinelli, C., Paparella, C., Capozzi, D., Notaris, P., Bistoni, F., Mencacci, A., Valentini, M., Filippetti, A., Confalonieri, M., Novarese, O., Bonini, F., Salamone, D., Camporese, A., De Rosa, R., Casprini, P., Degl?innocenti, R., Giordano, R., All(`u), M. T., Zanella, D., Malandrino, M., Tronci, M., Valmarin, M., Leonetti, G., Falco, S., Meledandri, M., Ballardini, M., Span(`o), A., Cava, M. C., Mascellino, M. T., Schinella, M., Gualdi, P., Casari, E., Scattolo, N., Motta, C., Perfetti, C., Bassano, M., Cera, G., Iafisco, P., Mura, I., Palmieri, A., Migliardi, M., Ferlini, M., Grandi, G., Giardini, F., Albano, F., Latino, M., Ferrero, M. P., Bellizia, L., Russolo, M., Russolo, S., Pesenti, A., Fasano, M. A., Previato, S., Radillo, O., Busetti, M., Ferrari, P., Siderini, V., Puzzolante, L., Scarparo, C., Arzese, A., Cappuccia, N., Lodolo, L., Delledonne, L., Gramoni, A., Maiolo, V., Gheller, A., Spadaro, S., Balzaretti, M., Tzialla, Chryssoula, Berardi, Alberto, Farina, Claudio, Clerici, Pierangelo, Borghesi, Alessandro, Viora, Elsa, Scollo, Paolo, Stronati, Mauro, [.., Lanari, Marcello, Faldella, Giacomo, and ]

Subjects
Male, Pediatrics, Group B, 0302 clinical medicine, Neonate, Pregnancy, Surveys and Questionnaires, Prevalence, Mass Screening, Blood culture, 030212 general & internal medicine, Antibiotic prophylaxis, Survey, GBS, Group B streptococcus, Infection, Newborn infant, Adult, Antibiotic Prophylaxis, Female, Health Surveys, Humans, Infant, Newborn, Italy, Neonatal Screening, Pregnancy Complications, Infectious, Prenatal Care, Primary Prevention, Risk Assessment, Streptococcal Infections, Streptococcus agalactiae, reproductive and urinary physiology, Group B streptococcu, medicine.diagnostic_test, lcsh:RJ1-570, Infectious, Perinatology and Child Health, Pediatrics, Perinatology and Child Health, medicine.medical_specialty, Antibiotic sensitivity, Group B Streptococcal Infection, Prenatal care, 03 medical and health sciences, 030225 pediatrics, medicine, Intensive care medicine, Mass screening, business.industry, Public health, Infant, lcsh:Pediatrics, Newborn, Pregnancy Complications, business
Abstract

Background There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. Methods Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility. Results All respondent obstetrical units used the culture-based screening approach to identify women who should receive intrapartum antibiotic prophylaxis, and more than half of the microbiological laboratories (58%) reported using specimen processing consistent with CDC guidelines. Most neonatal units (89 out of 107, 82%) reported using protocols for preventing GBS early-onset sepsis consistent with CDC guidelines. Conclusions The screening-based strategy is largely prevalent in Italy, and most protocols for preventing GBS early-onset sepsis are consistent with CDC guidelines. However, we found discrepancies in practices among centers that may reflect the lack of Italian guidelines issued by public health organizations.

Published
2017

21. ACTIVATION OF THE NLRP3 INFLAMMASOME PROMOTES INFLAMMATION IN SKELETAL MUSCLE OF PATIENTS WITH CKD

Author

Milanesi, (Milanesi, S, 1 ), Samantha), Verzola, Daniela, (Verzola, D, 1 ), Daniela), Barisione, (Barisione, C, 1 ), Chiara), Garibaldi, (Garibaldi, S, 1 ), Silvano), Saio, Michela, (Saio, M, 1 ), Michela), Picciotto, (Picciotto, D, Murugavel, Abitha, (Murugavel, A, 1 ), Abitha), Costigliolo, (Costigliolo, F, 1 ), Francesca), Gianetta, Ezio, (Gianetta, E, Ezio)(, 2, Brunori, 3, (Brunori, G, 4 ), Giuliano), Venturelli, (Venturelli, C, 4 ), Chiara), Garibotto, (Garibotto, G, and Giacomo

Published
2018

22. WASTING IN PATIENTS WITH CKD AND DIABETES: THE ROLE OF MYOSTATIN

Author

Picciotto, Daniela, Milanesi, Samantha), Saio, Michela, (Saio, M, 1 ), Michela), Frascio, Marco, (Frascio, M, 2 ), Marco), Brunori, (Brunori, G, 3 ), Giuliano), Venturelli, (Venturelli, C, 3 ), Chiara), Garibotto, Giacomo, (Garibotto, G, 1 ), Giacomo), Verzola, Daniela, (Verzola, D, and 1 ), Daniela)

Published
2018

24. Group B Streptococcus Late-Onset Disease: 2003–2010

Author

Berardi A, Rossi C, Lugli L, Creti R, LANARI, MARCELLO, Memo L, Pedna MF, Venturelli C, Ciccia M, Piepoli M, Contiero R, Ferrari F, GBS Prevention Working Group Emilia Romagna, BACCHI REGGIANI, MARIA LETIZIA, PERRONE, ENRICA, TRIDAPALLI, ELISABETTA, Berardi A, Rossi C, Lugli L, Creti R, Bacchi Reggiani ML, Lanari M, Memo L, Pedna MF, Venturelli C, Perrone E, Ciccia M, Tridapalli E, Piepoli M, Contiero R, Ferrari F, and GBS Prevention Working Group Emilia-Romagna

Subjects
Male, Pediatrics, Diseases, Infant, Premature, Diseases, Group B, Cohort Studies, 0302 clinical medicine, Pregnancy, Risk Factors, STREPTOCOCCUS, Medicine, Prospective Studies, 030212 general & internal medicine, Group B streptococcus, Infant, Intrapartum chemoprophylaxis, Late-onset disease, Sepsis, Age of Onset, Antibiotic Prophylaxis, Carrier State, Community-Acquired Infections, Cross Infection, Cross-Sectional Studies, Female, Humans, Incidence, Infant, Newborn, Italy, Milk, Human, Rectum, Streptococcal Infections, Vagina, Streptococcus agalactiae, Pediatrics, Perinatology and Child Health, Arts and Humanities (miscellaneous), Prospective cohort study, education.field_of_study, Incidence (epidemiology), Perinatology and Child Health, 3. Good health, Milk, Meningitis, Human, medicine.medical_specialty, Population, 03 medical and health sciences, 030225 pediatrics, education, Premature, SEPSIS, business.industry, Intrapartum chemoprophylaxi, Odds ratio, Newborn, medicine.disease, Mastitis, business
Abstract

BACKGROUND:There is insufficient population-based data on group B streptococcus (GBS) late-onset disease (LOD). Risk factors and routes of GBS transmission are poorly understood.METHODS:A prospective, cohort study was conducted to collect incidence data on LOD and evaluate GBS infections over an 8-year period (2003–2010). Starting from January 2007, maternal rectovaginal and breast milk cultures were routinely collected on confirmation of the LOD diagnosis to assess maternal GBS culture status.RESULTS:The incidence rate of LOD was 0.32 per 1000 live births (1.4 and 0.24 per 1000 live births for preterm and term newborns, respectively). The registered cases of LOD (n = 100) were classified as sepsis (n = 57), meningitis (n = 36), or focal infection (n = 7). Thirty neonates were preterm (2 had recurrent infection); 68 were term. Four infants died (3 early preterm, 1 term). At the time the LOD diagnosis was confirmed, 3 (6%) of 53 mothers had GBS mastitis, and 30 (64%) of 47 carried GBS at the rectovaginal site. Early (7–30 days) LOD presentation was associated with neonatal brain lesions or death (odds ratio: 0.96 [95% confidence interval: 0.93–0.99]). Intrapartum antibiotic exposure was significantly associated with mild (12 of 22) rather than severe (11 of 45; P = .03) LOD.CONCLUSIONS:Preterm neonates had the highest rates of LOD and mortality. Most mothers carried GBS at the time of the LOD diagnosis, whereas 6% had mastitis. Intrapartum antibiotics were associated both with delayed presentation of symptoms and milder LOD.

Published
2013

25. Clinical performance of a commercial real-time PCR assay for Aspergillus DNA detection in serum samples from high-risk patients: comparison with a galactomannan enzyme immunoassay

Author

Pini, P, Bettua, C, Orsi, C, Venturelli, C, Faglioni, L, Forghieri, F, Bigliardi, S, Luppi, F, Girardis, M, Blasi, E, Pini, P., Bettua, C., Orsi, C. F., Venturelli, C., Faglioni, L., Forghieri, F., Bigliardi, S., Luppi, F., Girardis, M., Blasi, E., Pini, P, Bettua, C, Orsi, C, Venturelli, C, Faglioni, L, Forghieri, F, Bigliardi, S, Luppi, F, Girardis, M, Blasi, E, Pini, P., Bettua, C., Orsi, C. F., Venturelli, C., Faglioni, L., Forghieri, F., Bigliardi, S., Luppi, F., Girardis, M., and Blasi, E.

Abstract

We investigated the clinical performance of a polymerase chain reaction (PCR)-based commercial platform, the Myconostica MycAssayTM Aspergillus (MAP), for fungal DNA detection in the serum of patients at risk of invasive aspergillosis (IA). Sixty-four hospitalized patients were prospectively enrolled and a total of 71 different episodes were investigated (30 episodes were clinically/microbiologically classified as IA and 41 as control episodes). When MAP was compared to the galactomannan (GM) assay, no significant differences were found in terms of sensitivity (46.7 % vs. 50.0 %), specificity (97.6 % vs. 95.1 %), positive predictive value (PPV) (93.3 % vs. 88.2 %), and negative predictive value (NPV) (71.4 % vs. 72.2 %). The corresponding areas under the curve (AUC) of the receiver operating characteristic (ROC) curves were also superimposable. Overall, because of the good agreement between the two assays and considering the high specificity and PPV of the MAP, we suggest the use of this PCR-based platform as a second-level examination for the evaluation of clinically undefined cases where culture or GM have provided positive results.

Published
2015

26. Evolving beta-lactamase epidemiology in Enterobacteriaceae from Italian nationwide surveillance, October 2013: KPC-carbapenemase spreading among outpatients

Author

Giani, T., Antonelli, A., Caltagirone, M., Mauri, C., Nicchi, J., Arena, F., Nucleo, E., Bracco, S., Pantosti, A., Vismara, C., Pini, B., Andreoni, S., Dusi, P. A., Aschbacher, R., Scarparo, C., Sarti, M., Venturelli, C., Pecile, P., Manso, E., Spanu, T., Labonia, M., Buonopane, G., Giraldi, C., Luzzaro, F., Pagani, L., and Rossolini, Gian Maria

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, Epidemiology, medicine.drug_class, Klebsiella pneumoniae, medicine.medical_treatment, 030106 microbiology, Cephalosporin, Class C beta-lactamases, ESBL, Enterobacteriaceae, carbapenemase, epidemiology, outpatients, Public Health, Environmental and Occupational Health, Virology, Microbial Sensitivity Tests, beta-Lactamases, Microbiology, 03 medical and health sciences, Bacterial Proteins, Outpatients, Escherichia coli, medicine, Humans, Proteus mirabilis, Escherichia coli Infections, Molecular Epidemiology, biology, Enterobacteriaceae Infections, biology.organism_classification, Anti-Bacterial Agents, Cephalosporins, 3. Good health, Cross-Sectional Studies, Italy, Beta-lactamase, Female, Erratum, Proteus Infections
Abstract

Extended-spectrum beta-lactamases (ESBLs), AmpC-type beta-lactamases (ACBLs) and carbapenemases are among the most important resistance mechanisms in Enterobacteriaceae. This study investigated the presence of these resistance mechanisms in consecutive non-replicate isolates of Escherichia coli (n = 2,352), Klebsiella pneumoniae (n = 697), and Proteus mirabilis (n = 275) from an Italian nationwide cross-sectional survey carried out in October 2013. Overall, 15.3% of isolates were non-susceptible to extended-spectrum cephalosporins but susceptible to carbapenems (ESCR-carbaS), while 4.3% were also non-susceptible to carbapenems (ESCR-carbaR). ESCR-carbaS isolates were contributed by all three species, with higher proportions among isolates from inpatients (20.3%) but remarkable proportions also among those from outpatients (11.1%). Most ESCR-carbaS isolates were ESBL-positive (90.5%), and most of them were contributed by E. coli carrying bla CTX-M group 1 genes. Acquired ACBLs were less common and mostly detected in P. mirabilis. ESCR-carbaR isolates were mostly contributed by K. pneumoniae (25.1% and 7.7% among K. pneumoniae isolates from inpatients and outpatients, respectively), with bla KPC as the most common carbapenemase gene. Results showed an increasing trend for both ESBL and carbapenemase producers in comparison with previous Italian surveys, also among outpatients.

Published
2017

28. Questa terra è la mia terra. Educazione alla cittadinanza e civiltà planetaria

Author

Fellin E., Lichene C., Odini L., Marinoni M., Vischi A., Malavasi L., Piccioli M., Galletti F., Guerra E., Venturelli C., Bortolotti A., Trezza D., Giordano M., Albarano A., Del Vecchio M., Ferrante G., Gattullo V., D’Onofrio A., Rea G., Rioda M., Infantino A., Moretti L., Onida M., Fellin Emanuela, Vischi, Alessandra, Vischi (ORCID:0000-0002-7259-8756), Fellin E., Lichene C., Odini L., Marinoni M., Vischi A., Malavasi L., Piccioli M., Galletti F., Guerra E., Venturelli C., Bortolotti A., Trezza D., Giordano M., Albarano A., Del Vecchio M., Ferrante G., Gattullo V., D’Onofrio A., Rea G., Rioda M., Infantino A., Moretti L., Onida M., Fellin Emanuela, Vischi, Alessandra, and Vischi (ORCID:0000-0002-7259-8756)

Abstract

La riflessione pedagogica, nell’indagare le possibilità educative lungo tutto l’arco della vita, richiama alla necessità di analizzare in modo multidisciplinare le questioni attuali per addivenire a progettualità formative di sviluppo efficaci e orientate alla “ecologia integrale”. La rilevanza etico-educativa della nozione di sostenibilità si pone come luogo ermeneutico per provocare la consapevolezza critica della pedagogia. La progettazione pedagogica si confronta con diversi saperi in uno scenario, mutevole come quello attuale, in cui le città rappresentano una prospettiva emblematica di formazione e di confronto nel rispetto dei diritti umani e della custodia del creato. Tra i modelli talora contrapposti di riforma dell’istruzione e divergenti politiche per l’ambiente e per il lavoro, la riflessione sull’educazione è impegnata a prefigurare la trasformazione della società nel tempo futuro e a favorire nelle coscienze individuali quella sensibilità ecologica capace di muovere comportamenti sostenibili e responsabili. Aziende, imprese sociali e nuove professionalità rappresentano ambiti emblematici per dare vita a Human Grids alleanze sul piano della progettazione educativa e di sviluppo. Promuovere un’economia civile implica educare in modo intenzionale a comportamenti non-strumentali ma espressivi di virtù civili, per un futuro contrassegnato da una “crescita umana” durevole, connotata da “cura, attenzione, riguardo e rispetto per l’ambiente.

Published
2017

29. The burden of early-onset sepsis in Emilia-Romagna (Italy): a 4-year, population-based study

Author

Berardi, Alberto, Baroni, Lorenza, Bacchi Reggiani, Maria Letizia, Ambretti, Simone, Biasucci, Giacomo, Bolognesi, Serenella, Capretti, Maria Grazia, Carretto, Edoardo, Ciccia, Matilde, Fiorini, Valentina, Fortini, Cinzia, Gargano, Giancarlo, Pedna, Maria Federica, Rizzo, Vittoria, Creti, Roberta, Ferrari, Fabrizio, Memo, L., Nicolini, G., Campanile, A., Tridapalli, E., Ciccia, M., Bastelli, A., Sandri, F., Ambretti, S., Capretti, M. G., Gentili, A., Ragni, L., Albarelli, A., Piscina, A., Borghi, A., Simoni, A., Fiorini, V., Grande, E. D., Polese, A., Biasini, A., China, M. C., Rizzo, V., Zucchini, A., Malaguti, L., Contiero, R., Fortini, C., Garani, G., Rossi, M. R., Nasi, S., Bacchini, P., Baldassarri, P., Pulvirenti, R. M., Vaienti, F., Venturoli, V., Bidetti, M. L., Colla, R., Toniato, M., Carlo, C. D., Lanari, M., Serra, L., Silvestrini, D., Facchinetti, F., Ferrari, F., Lugli, L., Venturelli, C., Sarti, M., Volta, A., Dodi, I., Gambini, L., Guidi, B., Bertelli, M., Biasucci, G., Chiarabini, R., Padrini, D., Piepoli, M., Riboni, S., Rubbi, P., Pedna, M. F., Sambri, V., Perrone, A., Preti, P., Marchetti, F., Piccinini, G. C., Amarri, S., Carretto, E., Gargano, G., Pedori, S., Riva, M., Rossi, C., Zuelli, C., Bolognesi, S., Papa, I., Vergine, G., Viola, L., Chiossi, C., Pagano, R., Zanacca, C., Palmieri, R., Berardi, Alberto, Baroni, Lorenza, Bacchi Reggiani, Maria Letizia, Ambretti, Simone, Biasucci, Giacomo, Bolognesi, Serenella, Capretti, Maria Grazia, Carretto, Edoardo, Ciccia, Matilde, Fiorini, Valentina, Fortini, Cinzia, Gargano, Giancarlo, Pedna, Maria Federica, Rizzo, Vittoria, Creti, Roberta, Ferrari, Fabrizio, and GBS Prevention Working Group Emilia-Romagna [,Lanari, Marcello,]

Subjects
Pediatrics, Antibiotics, group B streptococcu, Logistic regression, medicine.disease_cause, Severity of Illness Index, Group B, 0302 clinical medicine, Risk Factors, Medicine, Birth Weight, 030212 general & internal medicine, Escherichia coli Infections, Streptococcus, Gestational age, meningitis, Obstetrics and Gynecology, Drug Resistance, Microbial, intrapartum chemoprophylaxi, Perinatology and Child Health, meningiti, Anti-Bacterial Agents, Italy, Regression Analysis, Neonatal Sepsis, Meningitis, Early-onset sepsis, group B streptococcus, intrapartum chemoprophylaxis, newborn infant, Pediatrics, Perinatology and Child Health, Infant, Premature, Cohort study, medicine.medical_specialty, medicine.drug_class, Statistics, Nonparametric, Streptococcus agalactiae, Sepsis, 03 medical and health sciences, 030225 pediatrics, Streptococcal Infections, Escherichia coli, Humans, Retrospective Studies, business.industry, Infant, Newborn, Infant, medicine.disease, Early-onset sepsi, Ampicillin, Gentamicins, business
Abstract

Objective: To provide the first Italian data on pathogens causing early-onset sepsis (EOS) and their antimicrobial susceptibility, after the successfully prevention of Group B streptococcus (GBS) EOS. Methods: Retrospective area-based cohort study from Emilia-Romagna (Italy). Cases of EOS registered (from 2009 to 2012) in all gestational age neonates were reviewed. Results: Live births (LB) numbered 146 682. Ninety neonates had EOS and 12 died (incidence rates of 0.61 and 0.08/1000 LB, respectively). EOS and mortality were the highest among neonates with a birth weight n = 27, 0.18/1000 LB) and Escherichia coli (n = 19, 0.13/1000 LB). Most infants affected by E. coli EOS were born preterm (n = 13), had complications (n = 4) or died (n = 7). Among 90 isolates tested, only 3 were resistant to both first line empirical antibiotics. Multivariate logistic regression analysis showed that low gestational age, caesarean section and low platelet count at presentation were significantly associated with death or brain lesions (area under ROC curve = 0.939, H-L = 0.944, sensitivity 76.0%, specificity 90.7%). Conclusions: GBS slightly exceeds E. coli as a cause of EOS. However, E. coli is the prominent cause of death, complications and in most cases affects preterm neonates. Empirical antimicrobial therapy of EOS seems appropriate.

Published
2015

30. Pediatric tuberculosis in Italian children: Epidemiological and clinical data from the Italian register of pediatric tuberculosis

Author

Galli, Lavinia Maddalena, Lancella, L., Tersigni, Chiara, Venturini, Elena, Chiappini, Elisabetta, Bergamini, B., Codifava, M., Venturelli, Chiara, Tosetti, Giovanni, Marabotto, C., Cursi, L., Boccuzzi, E., Garazzino, S., Tovo, P., Pinon, M., Serre, D., Castiglioni, L., Vecchio, A., Guarino, A., Bruzzese, E., Losurdo, G., Castagnola, E., Bossi, Giuliana, Marseglia, G., Esposito, S., Bosis, S., Grandolfo, R., Fiorito, V., Valentini, Piero, Buonsenso, Danilo, Domenici, R., Montesanti, M., Salvini, F., Riva, E., Dodi, I., Maschio, F., Abbagnato, L., Fiumana, E., Fornabaio, C., Ballista, P., Portelli, V., Bottone, G., Palladino, N., Valenzise, M., Vecchi, B., Gangi, M., Lupi, C., Villani, Andrea, De Martino, M., Galli L., Tersigni C., Venturini E., Chiappini E. (ORCID:0000-0002-9782-0712), Venturelli C., Tosetti G., Bossi G., Valentini P. (ORCID:0000-0001-6095-9510), Buonsenso D., Villani A., Galli, Lavinia Maddalena, Lancella, L., Tersigni, Chiara, Venturini, Elena, Chiappini, Elisabetta, Bergamini, B., Codifava, M., Venturelli, Chiara, Tosetti, Giovanni, Marabotto, C., Cursi, L., Boccuzzi, E., Garazzino, S., Tovo, P., Pinon, M., Serre, D., Castiglioni, L., Vecchio, A., Guarino, A., Bruzzese, E., Losurdo, G., Castagnola, E., Bossi, Giuliana, Marseglia, G., Esposito, S., Bosis, S., Grandolfo, R., Fiorito, V., Valentini, Piero, Buonsenso, Danilo, Domenici, R., Montesanti, M., Salvini, F., Riva, E., Dodi, I., Maschio, F., Abbagnato, L., Fiumana, E., Fornabaio, C., Ballista, P., Portelli, V., Bottone, G., Palladino, N., Valenzise, M., Vecchi, B., Gangi, M., Lupi, C., Villani, Andrea, De Martino, M., Galli L., Tersigni C., Venturini E., Chiappini E. (ORCID:0000-0002-9782-0712), Venturelli C., Tosetti G., Bossi G., Valentini P. (ORCID:0000-0001-6095-9510), Buonsenso D., and Villani A.

Abstract

Tuberculosis (TB) is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1%) children had active TB, 594 (14.0%) latent TB and 3086 (72.9%) were uninfected. Among children with active TB, 481 (86.8%) patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534) of the cases. Overall, 210 (39.3%) out of these 534 children were treated with three and 216 (40.4%) with four first-line drugs. Second-line drugs where used in 87 (16.3%) children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7%) children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries.

Published
2016

31. Diagnosis of latent tuberculosis in children immigrants from countries with high tuberculosis prevalence

Author

Bergamini, BM, Losi, M, Del Giovane, C, Meacci, M, Luppi, F, Venturelli, C, D’Amico, R, Spagnolo, P, Meccugni, B, Cerri, S, Codifava, M, Rumpianesi, F, Paolucci, P, Fabbri, LM, Richeldi, L, Bergamini, B, Losi, M, Del Giovane, C, Meacci, M, Luppi, F, Venturelli, C, D’Amico, R, Spagnolo, P, Meccugni, B, Cerri, S, Codifava, M, Rumpianesi, F, Paolucci, P, Fabbri, L, and Richeldi, L

Subjects
Latent tuberculosis infection, children immigrants
Published
2010

32. Surveillance on vector-borne diseases in Emilia-Romagna Region, Italy

Author

Venturi L., Angelini P., Bellini R., Calzolari M., Borrini B. M., Dottori M., Rugna G., Venturelli C., Martini E., Tamba M., BALDELLI, RAFFAELLA, POGLAYEN, GIOVANNI, Venturi L., Angelini P., Baldelli R., Bellini R., Calzolari M., Borrini B.M., Dottori M., Poglayen G., Rugna G., Venturelli C., Martini E., and Tamba M.

Abstract

In recent years an increase in vector-borne disease activity has been recorded in different regions. The epidemiology of such diseases is conditioned by complex interactions among environment, parasite, vector, man and eventually animal – either domestic or wild – reservoir. Global warming together with the increase of transport of goods, animals and people travels are impacting the risk that exotic species, both of insects and parasites, enter and establish in new territories. For these reasons a regional surveillance program focused on vectored diseases was implemented in Emilia-Romagna. The aim of the project is to create a regional surveillance and risk assessment system based on a multidisciplinary network, with the capability of collecting data about both vector populations dynamics, and possible presence of pathogens in vectors, men and animals. It has therefore been constituted a working group, coordinated by the General Direction for Health and Social Policy of the Emilia-Romagna Region, composed by physicians, veterinarians and entomologists. Activities have been addressed to the activation of an entomological monitoring system for key vectors, to the development of diagnostic procedures of selected zoonosis, to the predisposition of a training program. Because it is endemic in Emilia-Romagna Region, Leishmaniasis has been selected to test the system. After only two months from its constitution, the working group had to manage the Chikungunya epidemic occurred in Ravenna and Cervia municipalities during summer of 2007. After only 15 days from the reporting of the first human cases, it has been possible to perform the diagnosis, isolating the virus from the vector (Aedes albopictus), to define a reporting system of clinical suspects and diagnostic procedures in man. In the same time an intensive vector control program was carried out in infected areas. The timing organization of a multidisciplinary network focused on vector diseases surveillance and control is producing important positive output in terms of managing capacity of epidemic situation and risk assessment

Published
2009

33. Sviluppo di un piano di sorveglianza sulle malattie trasmesse da vettori nella regione Emilia-Romagna

Author

Tamba M., Venturi L., Angelini P., Bellini R., Borrini B.M., Dottori M., Rugna G.L., Venturelli C., Martini E., BALDELLI, RAFFAELLA, POGLAYEN, GIOVANNI, AA.VV., G. SCAVIA, S. BABSA, M. SALA, Tamba M., Venturi L., Angelini P., Baldelli R., Bellini R., Borrini BM., Dottori M., Poglayen G., Rugna GL., Venturelli C., and Martini E.

Subjects
VETTORI, EMILIA-ROMAGNA, SORVEGLIANZA, MALATTIE TRASMISSIBILI
Abstract

Negli ultimi anni si è assistito ad un aumento degli episodi e degli allarmi connessi a malattie trasmesse da artropodi vettori, tra le quali infezioni virali (West Nile Disease, Bluetongue) e patologie protozoarie (Leishmaniosi), che rivestono un particolare interesse per la sanità pubblica. I cambiamenti climatici ed il contemporaneo aumento della movimentazione di merci, animali e degli spostamenti di persone, hanno incrementato la possibilità che specie esotiche di insetti e agenti patogeni entrino e si stabiliscano nel nostro territorio. Per tale motivo si è ritenuto necessario progettare e sviluppare un sistema regionale di sorveglianza in grado di rispondere adeguatamente a problematiche presenti e potenziali. Obiettivo del progetto è quello di creare un sistema regionale di sorveglianza tramite una rete interdisciplinare che fornisca, da un lato, informazioni sulle popolazioni (presenza e dinamica di popolazione) dei vettori potenziali e riconosciuti di agenti patogeni e dall’altro controlli, attraverso opportune indagini di laboratorio, la presenza di agenti patogeni nella popolazione dei vettori, degli animali domestici e umana. E’ stato quindi costituito un gruppo di lavoro, coordinato dalla DG Sanità e Politiche Sociali della Regione Emilia-Romagna, composto da medici, veterinari ed entomologi operanti sia sul territorio, sia in strutture di ricerca e sperimentazione. Le attività sono state indirizzate all’attivazione di un sistema di sorveglianza entomologica per alcuni vettori; allo sviluppo di metodiche diagnostiche per la rilevazione di arbovirus agenti di zoonosi; alla predisposizione di un percorso formativo, indispensabile alla costituzione di una rete di operatori sanitari addestrati alla gestione di un sistema di sorveglianza. E’ stata inoltre selezionata la leishmaniosi come item per lo sviluppo di sistema pilota. Disporre in loco di una rete di competenze multidisciplinare ha permesso, a solo due mesi dall’avvio del progetto, di gestire con successo l’epidemia di Chikungunya che si è verificata in Romagna durante l’estate 2007. A soli 15 giorni dalla segnalazione dei primi casi umani è stato possibile eseguire la diagnosi, isolando il virus dall’insetto vettore (Aedes albopictus), predisporre un sistema di segnalazione dei sospetti clinici e di conferma diagnostica dei casi umani, effettuare programmi di disinfestazione localizzati alle aree infette che hanno permesso di controllare ed estinguere in tempi relativamente rapidi l’epidemia.

Published
2008

34. Detection of Pneumocystis jirovecii and Aspergillus spp. DNA in bronchoalveolar lavage fluids by commercial real-time PCR assays: Comparison with conventional diagnostic tests

Author

Orsi, C, Bettua, C, Pini, P, Venturelli, C, La Regina, A, Morace, G, Luppi, M, Forghieri, F, Bigliardi, S, Luppi, F, Codeluppi, M, Girardis, M, Blasi, E, Orsi, CF, Orsi, C, Bettua, C, Pini, P, Venturelli, C, La Regina, A, Morace, G, Luppi, M, Forghieri, F, Bigliardi, S, Luppi, F, Codeluppi, M, Girardis, M, Blasi, E, and Orsi, CF

Abstract

The present study employed two commercial real-time PCR kits, MycAssayTM Pneumocystis (PJ-PCR) and MycAssayTM Aspergillus (ASP-PCR), for the search of fungal DNA on 44 bronchoalveolar lavage (BAL) fluids from patients at risk of invasive fungal disease. Operationally, on the basis of clinical diagnosis and according to the European Organization for Research and Treatment Cancer/Mycoses Study Group (EORTC/MSG) criteria, patients were clustered in 3 groups: a P. jirovecii pneumonia (PCP) group, an invasive aspergillosis (IA) group and a control (CTRL) group, consisting of 8, 10 and 24 patients, respectively. The results were compared to those obtained with conventional diagnostic assays, including BAL culture, galactomannan-ELISA (GM) and immunofluorescence (IF). The PJ-PCR assay returned a sensitivity and specificity of 100% and 94.4%, respectively. The ASP-PCR assay showed a sensitivity and specificity of 80% and 97.1%. When compared to the culture assay, the ASP-PCR showed enhanced sensitivity, and a good level of agreement (kappa = 0.63) was observed between ASP-PCR and GM assays. Overall, our data emphasize the diagnostic usefulness of the two commercial real-time PCR assays, especially in high-risk patients where timing is critical and a low fungal burden may hamper correct and prompt diagnosis by conventional tests.

Published
2015

35. Looking for Candida nivariensis and C. bracarensis among a large Italian collection of C. glabrata isolates: Results of the FIMUA working group

Author

Esposto, M. C, Prigitano, A, Romeo, O, Criseo, G, Trovato, L, Tullio, V, Fadda, M. E, Tortorano, A. M, FIMUA Working Group, Ossi, C, Grancini, A, Grandesso, S, Sanguinetti, M, Montagna, Mt, Manso, E, Deiana, Ml, Pitzurra, L, Mazzoli, S, Tavanti, A, Venturelli, C, LO CASCIO, Giuliana, and Innocenti, P.

Subjects
Adult, Male, Adolescent, Genes, Fungal, Candida bracarensis, Candida glabrata, Young Adult, 80 and over, 5.8S, Humans, Child, Preschool, Mycological Typing Techniques, Candida nivariensis, Aged, Aged, 80 and over, Candida, Candidiasis, Child, Preschool, Female, Infant, Infant, Newborn, Italy, Middle Aged, Phenotype, RNA, Fungal, RNA, Ribosomal, 5.8S, 2708, Infectious Diseases, Ribosomal, Newborn, Fungal, Genes, RNA
Abstract

Two recently described pathogenic Candida species, C. nivariensis and C. bracarensis, share many phenotypic characteristics with C. glabrata and are easily misidentified as such. The aim of this study was to determine the occurrence of these cryptic species in Italy. One thousand yeast isolates collected in 14 Italian regions and identified as C. glabrata by phenotypic and biochemical methods were included in this study: 928 were screened on CHROMagar and 72 were analysed by a multiplex PCR. None of these cryptic species was identified despite the nationwide distribution and the variety of biological origin of the isolates.

Published
2013

36. Serratia marcescens in a neonatal intensive care unit: two long-term multiclone outbreaks in a 10-year observational study

Author

Casolari, C., Pecorari, M., Della Casa, E., Cattani, S., Venturelli, C., Fabio, G., Tagliazucchi, S., Serpini, G. F., Mario Migaldi, Marchegiano, P., Rumpianesi, F., and Ferrari, F.

Subjects
Male, Cross Infection, Infant, Newborn, Infant, Disease Outbreaks, Serratia Infections, Italy, Case-Control Studies, Female, Humans, Intensive Care Units, Neonatal, Retrospective Studies, Serratia marcescens
Abstract

We investigated two consecutive Serratia marcescens (S. marcescens) outbreaks which occurred in a neonatal intensive care unit (NICU) of a tertiary level hospital in North Italy in a period of 10 years (January 2003-December 2012). Risk factors associated with S. marcescens acquisition were evaluated by a retrospective case-control study. A total of 21,011 clinical samples was examined: S. marcescens occurred in 127 neonates: 43 developed infection and 3 died. Seven clusters were recorded due to 12 unrelated clones which persisted for years in the ward, although no environmental source was found. The main epidemic clone A sustaining the first cluster in 2003 reappeared in 2010 as an extended spectrum ?-lactamase (ESBL)-producing strain and supporting the second epidemic. Birth weight, gestational age, use of invasive devices and length of stay in the ward were significantly related to S. marcescens acquisition. The opening of a new ward for non-intensive care-requiring neonates, strict adherence to alcoholic hand disinfection, the timely identification and isolation of infected and colonized neonates assisted in containing the epidemics. Genotyping was effective in tracing the evolution and dynamics of the clones demonstrating their long-term persistence in the ward.

Published
2013

37. Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011

Author

Giani, T, Pini, B, Arena, F, Conte, V, Bracco, S, Migliavacca, R, Pantosti, A, Pagani, L, Luzzaro, F, M Rossolini, G, Vismara, C, Colombo, A, Serra, R, Kroumova, V, Mori, M, A Dusi, P, Mazzariol, A, Pagani, E, Gargiulo, R, Venturelli, C, Pecile, P, Mencacci, A, Manso, E, Tronci, M, Fazii, P, Labonia, M, Pizzolante, M, Amato, G, Buonopane, G, Cavalcanti, P, G Conaldi, P, Stefani, S, and F Di Vincenzo

Subjects
Infection Control, KPC carbapenemase, Colony Count, Microbial, Microbial Sensitivity Tests, Laboratories, Hospital, beta-Lactamases, Klebsiella Infections, Specimen Handling, Klebsiella pneumoniae, Cross-Sectional Studies, Bacterial Proteins, Carbapenems, Italy, Drug Resistance, Multiple, Bacterial, Humans
Abstract

Carbapenem-resistant Enterobacteriaceae (CRE) are emerging as a public health problem in various settings. In Italy, a rapid and remarkable increase of carbapenem-non-susceptible Klebsiella pneumoniae has been reported since 2010. Here we report on the results of a countrywide cross-sectional survey, carried out from 15 May to 30 June 2011 to investigate the diffusion of CRE in Italy and to characterise the most prevalent resistance mechanisms and their dissemination patterns. CRE were reported from most (23 of 25) participating laboratories, with an overall proportion of 3.5% and 0.3% among consecutive non-duplicate clinical isolates of Enterobacteriaceae from inpatients (n=7,154) and outpatients (n=6,595), respectively. K. pneumoniae was the most frequent species (proportion of carbapenem-non-susceptible isolates: 11.9%), while a minority of CRE of other species were detected. Carbapenemase production was detected in the majority (85%) of CRE. KPC-type enzymes were by far the most common (89.5% of carbapenemase producers), followed by VIM-1 (9.2%) and OXA-48 (1.3%). KPC-producing K. pneumoniae (KPC-KP) were detected in most centres and contributed majorly to the epidemic dissemination of CRE recently observed in our country. Dissemination of KPC-KP was mostly sustained by strains of clonal complex 258 (ST-258 producing KPC-2 or KPC-3, and ST-512 producing KPC-3), while a minority belonged to ST-101.

Published
2013

38. Performance of two commercial real-time PCR assays for the detection of Aspergillus and Pneumocystis DNA in bronchoalveolar lavage fluid samples from critical care patients

Author

Orsi, C. F., Gennari, W., Venturelli, C., La Regina, A., Pecorari, M., Righi, E., Machetti, M., and Blasi, E.

Subjects
BAL, Adult, Male, Critical Care, Pneumocystis, Aspergillus, Fungal DNA, Real-time PCR, Aged, Aspergillosis, Bronchoalveolar Lavage Fluid, DNA, Fungal, Female, Humans, Middle Aged, Molecular Typing, Pneumonia, Pneumocystis, Predictive Value of Tests, ROC Curve, Real-Time Polymerase Chain Reaction, Retrospective Studies, DNA, Pneumonia, Fungal
Published
2012

39. Tuberculosis infection in foreign-born children: a screening survey based on skin and blood testing

Author

Losi, M., Bergamini, Barbara Maria, Venturelli, C., DEL GIOVANE, Cinzia, Sighinolfi, G., Rumpianesi, F., and Richeldi, Luca

Subjects
Adult, interferon-gamma assays, active tuberculosis, Adolescent, Tuberculin Test, latent tuberculosis infection, Emigrants and Immigrants, Infant, Mycobacterium tuberculosis, foreign-born children, Interferon-gamma, Young Adult, Italy, Child, Preschool, Humans, Mass Screening, Tuberculosis, Child, Interferon-gamma Release Tests
Abstract

This study, carried out in a low tuberculosis (TB) prevalence country with high immigration rates from high TB prevalence countries, deals with the interferon-gamma release assay, QuantiFERON®-TB Gold In-Tube, for the diagnosis of latent TB infection (LTBI) in foreign-born children. The results of our study highlight the potential advantages and concerns of using a blood test for diagnosing LTBI in a 'two-step' strategy in foreign-born children.

Published
2011

45. Evaluation of serum (1 → 3)-β-d-glucan clinical performance: kinetic assessment, comparison with galactomannan and evaluation of confounding factors

Author

Pini, P., primary, Bettua, C., additional, Orsi, C. F., additional, Venturelli, C., additional, Forghieri, F., additional, Bigliardi, S., additional, Faglioni, L., additional, Luppi, F., additional, Serio, L., additional, Codeluppi, M., additional, Luppi, M., additional, Mussini, C., additional, Girardis, M., additional, and Blasi, Elisabetta, additional

Published
2015
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46. Accuracy of automated and manual systems for susceptibility testing of Pseudomonas aeruginosa to piperacillin and piperacillin-tazobactam

Author

Gagliotti, C., Sarti, M., Sabia, C., Gargiulo, R., Rossolini, G. M., Carillo, C., Cassani, C., Cipolloni, A. P., Pedna, F., Rossi, M. R., Incerti, S. S., Testa, G., Venturelli, C., and Maria Luisa Moro

Subjects
Piperacillin, Bacteriological Techniques, antibiotic resistance, Piperacillin, Tazobactam Drug Combination, Predictive Value of Tests, Pseudomonas aeruginosa, pseudomonas. automated system, Humans, Penicillanic Acid, Pseudomonas Infections, Microbial Sensitivity Tests, Anti-Bacterial Agents
Abstract

This study aimed to evaluate the accuracy of routine systems (Vitek2 cards AST-N022 and AST-N026; Kirby Bauer; Etest) for susceptibility testing of Pseudomonas aeruginosa to piperacillin and piperacillin-tazobactam. Vitek2 (card AST-N022) showed the worst performance; the other three methods (Vitek2 card AST-N026, Kirby-Bauer and E-test) performed comparably but never fulfilled the minimal standard proposed by FDA.

Published
2010

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