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4. Accuracy of Pancreatic Stone Protein for diagnosis of sepsis in children admitted to pediatric intensive care or high-dependency care: a pilot study

Author

Bottari, Gabriella, Caruso, Mariangela, Paionni, Emanuel, De Luca, Maia, Romani, Lorenza, Pisani, Mara, Grandin, Annalisa, Gargiullo, Livia, Zampini, Giorgio, Gagliardi, Chiara, Fegatelli, Danilo Alunni, Vestri, Annarita, Lancella, Laura, Porzio, Ottavia, Muda, Andrea Onetti, Villani, Alberto, Atti, Marta Ciofi Degli, Raponi, Massimiliano, and Cecchetti, Corrado

Published
2023
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8. Italian intersociety consensus on management of long covid in children

Author

Esposito, Susanna, Principi, Nicola, Azzari, Chiara, Cardinale, Fabio, Di Mauro, Giuseppe, Galli, Luisa, Gattinara, Guido Castelli, Fainardi, Valentina, Guarino, Alfredo, Lancella, Laura, Licari, Amelia, Mancino, Enrica, Marseglia, Gian Luigi, Leonardi, Salvatore, Nenna, Raffaella, Zampogna, Stefania, Zona, Stefano, Staiano, Annamaria, and Midulla, Fabio

Published
2022
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9. Tuberculosis disease in immunocompromised children and adolescents: a pTBnet multi-centre case-control study

Author

Rodríguez-Molino, Paula, primary, Tebruegge, Marc, additional, Noguera-Julian, Antoni, additional, Neth, Olaf, additional, Fidler, Katy, additional, Brinkmann, Folke, additional, Sainz, Talia, additional, Ivaskeviciene, Inga, additional, Ritz, Nicole, additional, Brito, Maria Joao, additional, Milheiro Silva, Tiago, additional, Chechenieva, Vira, additional, Serdiuk, Maryna, additional, Lancella, Laura, additional, Russo, Cristina, additional, Soler-García, Aleix, additional, Navarro, Maria Luisa, additional, Krueger, Renate, additional, Feiterna-Sperling, Cornelia, additional, Starshinova, Anna, additional, Hiteva, Antonina, additional, Hoffmann, Anna, additional, Kalibatas, Paulius, additional, Lo Vecchio, Andrea, additional, Scarano, Sara Maria, additional, Bustillo, Matilde, additional, Blázquez Gamero, Daniel, additional, Espiau, María, additional, Buonsenso, Danilo, additional, Falcón, Lola, additional, Turnbull, Louise, additional, Colino, Elena, additional, Rueda, Santiago, additional, Buxbaum, Charlotte, additional, Carazo, Begoña, additional, Alvarez, Cristina, additional, Dapena, Marta, additional, Piqueras, Anabel, additional, Velizarova, Svetlana, additional, Ozere, Iveta, additional, Götzinger, Florian, additional, Pareja, Marta, additional, Garrote Llanos, Maria Isabel, additional, Soto, Beatriz, additional, Rodríguez Martín, Sonia, additional, Korta, Jose Javier, additional, Pérez-Gorricho, Beatriz, additional, Herranz, Mercedes, additional, Hernández-Bartolomé, Ángel, additional, Díaz-Almirón, Mariana, additional, Kohns Vasconcelos, Malte, additional, Ferreras-Antolín, Laura, additional, and Santiago-García, Begoña, additional

Published
2024
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10. The Thousand Faces of Invasive Group A Streptococcal Infections: Update on Epidemiology, Symptoms, and Therapy

Author

Mercadante, Stefania, primary, Ficari, Andrea, additional, Romani, Lorenza, additional, De Luca, Maia, additional, Tripiciano, Costanza, additional, Chiurchiù, Sara, additional, Calo Carducci, Francesca Ippolita, additional, Cursi, Laura, additional, Di Giuseppe, Martina, additional, Krzysztofiak, Andrzej, additional, Bernardi, Stefania, additional, and Lancella, Laura, additional

Published
2024
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12. Tuberculosis Disease in Immunocompromised Children and Adolescents: A Pediatric Tuberculosis Network European Trials Group Multicenter Case-control Study.

Author

Rodríguez-Molino, Paula, Tebruegge, Marc, Noguera-Julian, Antoni, Neth, Olaf, Fidler, Katy, Brinkmann, Folke, Sainz, Talia, Ivaskeviciene, Inga, Ritz, Nicole, Brito, Maria Joao, Silva, Tiago Milheiro, Chechenieva, Vira, Serdiuk, Maryna, Lancella, Laura, Russo, Cristina, Soler-García, Aleix, Navarro, Maria Luisa, Krueger, Renate, Feiterna-Sperling, Cornelia, and Starshinova, Anna

Subjects
TUBERCULOSIS diagnosis, PREVENTION of communicable diseases, TUBERCULOSIS epidemiology, HIV infection complications, RISK assessment, DISEASE duration, RESEARCH funding, IMMUNOCOMPROMISED patients, TREATMENT effectiveness, DESCRIPTIVE statistics, ANTITUBERCULAR agents, PEDIATRICS, ODDS ratio, RESEARCH, CASE-control method, TUBERCULIN test, CONFIDENCE intervals, TUBERCULOSIS, IMMUNOSUPPRESSION, ADOLESCENCE, CHILDREN
Abstract

Background In high-resource settings, the survival of children with immunocompromise (IC) has increased and immunosuppressive therapies are increasingly being used. This study aimed to determine the clinical characteristics, performance of diagnostic tools, and outcome of IC children with tuberculosis (TB) in Europe. Methods Multicenter, matched case-control study within the Pediatric Tuberculosis Network European Trials Group, capturing TB cases <18 years diagnosed 2000–2020. Results A total of 417 TB cases were included, comprising 139 children who are IC (human immunodeficiency virus, inborn errors of immunity, drug-induced immunosuppression, and other immunocompromising conditions) and 278 non-IC children as controls. Nonrespiratory TB was more frequent among cases than controls (32.4% vs 21.2%; P =.013). Patients with IC had an increased likelihood of presenting with severe disease (57.6% vs 38.5%; P <.001; odds ratio [95% confidence interval], 2.073 [1.37–3.13]). Children with IC had higher rates of false-negative tuberculin skin test (31.9% vs 6.0%; P <.001) and QuantiFERON-TB Gold assay (30.0% vs 7.3%; P <.001) results at diagnosis. Overall, the microbiological confirmation rate was similar in IC and non-IC cases (58.3% vs 49.3%; P =.083). Although the mortality in children with IC was <1%, the rate of long-term sequelae was significantly higher than in non-IC cases (14.8% vs 6.1%; P =.004). Conclusions Children with IC and TB in Europe have increased rates of nonrespiratory TB, severe disease, and long-term sequelae. Immune-based TB tests have poor sensitivity in those children. Future research should focus on developing improved immunological TB tests that perform better in patients with IC, and determining the reasons for the increased risk of long-term sequelae, with the aim to design preventive management strategies. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Monocyte‐to‐lymphocyte, neutrophil‐to‐lymphocyte and neutrophil‐to‐monocyte plus lymphocyte ratios in children with active tuberculosis: A multicentre study

Author

Cursi, Laura, primary, Lancella, Laura, additional, Mariani, Francesco, additional, Martino, Laura, additional, Leccese, Bianca, additional, Di Giuseppe, Martina, additional, Venuti, Francesco, additional, Cristina, Russo, additional, Gentile, Leonarda, additional, Sali, Michela, additional, Delogu, Giovanni, additional, Valentini, Piero, additional, and Buonsenso, Danilo, additional

Published
2023
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18. Accuracy of Pancreatic Stone Protein for diagnosis of sepsis in children admitted to pediatric intensive care or high-dependency care: a pilot study

Author

Bottari, Gabriella, primary, Caruso, Mariangela, additional, Paionni, Emanuel, additional, De Luca, Maia, additional, Romani, Lorenza, additional, Pisani, Mara, additional, Grandin, Annalisa, additional, Gargiullo, Livia, additional, Zampini, Giorgio, additional, Gagliardi, Chiara, additional, Fegatelli, Danilo Alunni, additional, Vestri, Annarita, additional, Lancella, Laura, additional, Porzio, Ottavia, additional, Muda, Andrea Onetti, additional, Villani, Alberto, additional, Atti, Marta Ciofi Degli, additional, Raponi, Massimiliano, additional, and Cecchetti, Corrado, additional

Published
2023
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20. Pediatric COVID-TB: A Clinical Perspective Based on the Analysis of Three Cases

Author

Leone, Fabrizio, primary, Di Giuseppe, Martina, additional, De Luca, Maia, additional, Cursi, Laura, additional, Calo Carducci, Francesca Ippolita, additional, Krzysztofiak, Andrzej, additional, Chiurchiù, Sara, additional, Romani, Lorenza, additional, Russo, Cristina, additional, Lancella, Laura, additional, and Bernardi, Stefania, additional

Published
2023
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21. The Use of Cefiderocol as Salvage Therapy in an Infant Receiving ECMO and Continuous Renal Replacement Therapy.

Author

Mercadante, Stefania, Tripiciano, Costanza, Romani, Lorenza, Di Nardo, Matteo, Bottari, Gabriella, Goffredo, Bianca Maria, Simeoli, Raffaele, Guzzo, Isabella, Lancella, Laura, Antachopoulos, Charalampos, and De Luca, Maia

Subjects
RENAL replacement therapy, SALVAGE therapy, CHILD patients, INTENSIVE care units, INFANTS
Abstract

Background: Infections caused by antimicrobial-resistant (AMR) pathogens are increasing worldwide, representing a serious global public health issue with high morbidity and mortality rates The treatment of Pseudomonas aeruginosa (PA) infections has become a significant challenge due to its ability to develop resistance to many of the currently available antibiotics, especially in intensive care unit (ICU) settings. Among the very few therapeutic lines available against extensively drug-resistant (XDR)-PA and/or with difficult-to-treat resistance (DTR)-PA, cefiderocol is an injectable siderophore cephalosporin not licensed for use in pediatric patients. There are only a few case reports and two ongoing trials describing the administration of this cephalosporin in infants. Case presentation: This report describes the case of a critically ill 8-month-old girl affected by ventilator-associated pneumonia (VAP) infection complicated by bloodstream infection (BSI) sustained by VIM-producing PA. She was treated with cefiderocol as a salvage therapy during ECMO and CRRT support. Conclusions: In healthcare settings, treating multidrug-resistant, Gram-negative bacteria poses a serious challenge, especially in pediatric patients. Our findings suggest that cefiderocol can be considered as an off-label rescue therapy in selected pediatric cases. [ABSTRACT FROM AUTHOR]

Published
2024
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23. The Prevalence of Carbapenemase-Producing Microorganisms and Use of Novel Cephalosporins for the Treatment of Severe Infections Caused by Carbapenem-Resistant Gram-Negative Bacteria in a Pediatric Cardiac Intensive Care Unit

Author

Tripiciano, Costanza, primary, Romani, Lorenza, additional, Mercadante, Stefania, additional, Cursi, Laura, additional, Di Giuseppe, Martina, additional, Calo Carducci, Francesca Ippolita, additional, Fragasso, Tiziana, additional, Di Chiara, Luca, additional, Garisto, Cristiana, additional, Sisto, Annamaria, additional, Vallesi, Leonardo, additional, Costabile, Valentino, additional, Lancella, Laura, additional, Bernaschi, Paola, additional, and De Luca, Maia, additional

Published
2023
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27. Neonatal osteomyelitis: an Italian multicentre report of 22 cases and comparison with the inherent literature

Author

Roversi, Marco, Chiappini, Elena, Toniolo, Renato Maria, Cirillo, Marco, Natale, Fabio, Deriu, Daniele, Grandin, Annalisa, Lancella, Laura, Galli, Luisa, Villani, Alberto, and Krzysztofiak, Andrzej

Abstract

Objective: The primary objective of this study is to report and compare our data with the most relevant literature of the past decade about neonatal osteomyelitis. Study design: We retrospectively review the data of 22 subjects aged 35 days or less who were admitted to three different sites in Italy with a radiological diagnosis of osteomyelitis. The inherent literature was searched and reviewed: five studies were considered for comparison with our data. Results: All the neonates, except three (two pre-term and one post-term), were born at term. The male to female ratio was 1.75 (14 males and 8 females). The mean age at presentation was 19.5 days. The most common presenting signs of the infection were local swelling and reduced mobility of the affected segment. The most common sites of infection were the femur, humerus, and tibia. The mean duration of intravenous antibiotic therapy was 29.5 days. In most neonates the diagnosis was prompt and the antibiotic treatment immediate. A low rate of sequelae was reported. All infants survived through follow up. The data from the inherent literature showed a wide variability, probably owing to the setting and the historical period of the different studies. Conclusion: Neonatal osteomyelitis is an alarming yet poorly understood disease. Nonetheless, our report suggests that a quick diagnosis and treatment can be easily achieved, with good outcome on the remarkably plastic structure of neonatal bones.

Published
2024
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28. Prevention of Surgical Site Infections in Neonates and Children: Non-Pharmacological Measures of Prevention

Author

Meoli, Aniello, Ciavola, Lorenzo, Rahman, Sofia, Masetti, Marco, Toschetti, Tommaso, Morini, Riccardo, Dal Canto, Giulia, Auriti, Cinzia, Caminiti, Caterina, Castagnola, Elio, Conti, Giorgio, Donà, Daniele, Galli, Luisa, La Grutta, Stefania, Lancella, Laura, Lima, Mario, Lo Vecchio, Andrea, Pelizzo, Gloria, Petrosillo, Nicola, Simonini, Alessandro, Venturini, Elisabetta, Caramelli, Fabio, Gargiulo, Gaetano Domenico, Sesenna, Enrico, Sgarzani, Rossella, Vicini, Claudio, Zucchelli, Mino, Mosca, Fabio, Staiano, Annamaria, Principi, Nicola, Esposito, Susanna, On Behalf Of The Peri-Operative Prophylaxis In Neonatal And Paediatric Age Pop-NeoPed Study Group, null, Meoli, Aniello, Ciavola, Lorenzo, Rahman, Sofia, Masetti, Marco, Toschetti, Tommaso, Morini, Riccardo, Dal Canto, Giulia, Auriti, Cinzia, Caminiti, Caterina, Castagnola, Elio, Conti, Giorgio, Donà, Daniele, Galli, Luisa, La Grutta, Stefania, Lancella, Laura, Lima, Mario, Lo Vecchio, Andrea, Pelizzo, Gloria, Petrosillo, Nicola, Simonini, Alessandro, Venturini, Elisabetta, Caramelli, Fabio, Gargiulo, Gaetano Domenico, Sesenna, Enrico, Sgarzani, Rossella, Vicini, Claudio, Zucchelli, Mino, Mosca, Fabio, Staiano, Annamaria, Principi, Nicola, Esposito, Susanna, and On Behalf Of The Peri-Operative Prophylaxis In Neonatal And Paediatric Age Pop-NeoPed Study Group, Null

Subjects
Microbiology (medical), Settore MED/38 - Pediatria Generale e Specialistica, Settore MED/17 - Malattie Infettive, surgical site infection, Biochemistry, Microbiology, Keywords: neonatal infection, pediatric infectious disease, Infectious Diseases, prevention, neonatal infection, pediatric infectious diseases, pediatric surgery, Settore MED/41 - ANESTESIOLOGIA, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics
Abstract

A surgical site infection (SSI) is an infection that occurs in the incision created by an invasive surgical procedure. Although most infections are treatable with antibiotics, SSIs remain a significant cause of morbidity and mortality after surgery and have a significant economic impact on health systems. Preventive measures are essential to decrease the incidence of SSIs and antibiotic abuse, but data in the literature regarding risk factors for SSIs in the pediatric age group are scarce, and current guidelines for the prevention of the risk of developing SSIs are mainly focused on the adult population. This document describes the current knowledge on risk factors for SSIs in neonates and children undergoing surgery and has the purpose of providing guidance to health care professionals for the prevention of SSIs in this population. Our aim is to consider the possible non-pharmacological measures that can be adopted to prevent SSIs. To our knowledge, this is the first study to provide recommendations based on a careful review of the available scientific evidence for the non-pharmacological prevention of SSIs in neonates and children. The specific scenarios developed are intended to guide the healthcare professional in practice to ensure standardized management of the neonatal and pediatric patients, decrease the incidence of SSIs and reduce antibiotic abuse.

Published
2022

31. Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis: a multicentre PTBNET study

Author

Buonsenso, Danilo, primary, Noguera-Julian, Antoni, additional, Moroni, Rossana, additional, Hernández-Bartolomé, Angel, additional, Fritschi, Nora, additional, Lancella, Laura, additional, Cursi, Laura, additional, Soler-Garcia, Aleix, additional, Krüger, Renate, additional, Feiterna-Sperling, Cornelia, additional, Sali, Michela, additional, Lo Vecchio, Andrea, additional, Scarano, Sara, additional, Hernanz Lobo, Alicia, additional, Espiau, Maria, additional, Soriano-Arandes, Antonio, additional, Cetin, Benhur Sirvan, additional, Brinkmann, Folke, additional, Ozere, Iveta, additional, Baquero-Artigao, Fernando, additional, Tsolia, Maria, additional, Milheiro Silva, Tiago, additional, Bustillo-Alonso, Matilde, additional, Martín Nalda, Andrea, additional, Mancini, Margherita, additional, Starshinova, Anna, additional, Ritz, Nicole, additional, Velizarova, Svetlana, additional, Ferreras-Antolín, Laura, additional, Götzinger, Florian, additional, Bilogortseva, Olga, additional, Chechenyeva, Vira, additional, Tebruegge, Marc, additional, and Santiago-García, Begoña, additional

Published
2022
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32. Severe viral respiratory infections in the pre‐COVID era: A 5‐year experience in two pediatric intensive care units in Italy

Author

De Luca, Maia, primary, D'Amore, Carmen, additional, Romani, Lorenza, additional, Tripiciano, Costanza, additional, Clemente, Vitangelo, additional, Mercadante, Stefania, additional, Perrotta, Daniela, additional, Nunziata, Joseph, additional, Cecchetti, Corrado, additional, Rossetti, Emanuele, additional, Bianchi, Roberto, additional, Perno, Carlo Federico, additional, Bernaschi, Paola, additional, Russo, Cristina, additional, Lancella, Laura, additional, Raponi, Massimiliano, additional, and Ciofi degli Atti, Marta Luisa, additional

Published
2022
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33. Case report: Microcirculatory leukocytes in a pediatric patient with severe SARS-CoV-2 pneumonia. Findings of leukocytes trafficking beyond the lungs

Author

Bottari, Gabriella, primary, Ince, Can, additional, Confalone, Valerio, additional, Perdichizzi, Salvatore, additional, Casamento Tumeo, Chiara, additional, Nunziata, Joseph, additional, Bernardi, Stefania, additional, Calò Carducci, Francesca, additional, Lancella, Laura, additional, Bernaschi, Paola, additional, Russo, Cristina, additional, Perno, Carlo Federico, additional, Cecchetti, Corrado, additional, and Villani, Alberto, additional

Published
2022
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34. Surgical Antimicrobial Prophylaxis in Abdominal Surgery for Neonates and Paediatrics: A RAND/UCLA Appropriateness Method Consensus Study

Author

Bianchini, Sonia, Rigotti, Erika, Monaco, Sara, Nicoletti, Laura, Auriti, Cinzia, Castagnola, Elio, Conti, Giorgio, Galli, Luisa, Giuffrè, Mario, La Grutta, Stefania, Lancella, Laura, Lo Vecchio, Andrea, Maglietta, Giuseppe, Petrosillo, Nicola, Pietrasanta, Carlo, Principi, Nicola, Tesoro, Simonetta, Venturini, Elisabetta, Piacentini, Giorgio, Lima, Mario, Staiano, Annamaria, Esposito, Susanna, The Peri-Operative Prophylaxis In Neonatal And Paediatric Age Pop-NeoPed Study Group, null, Bianchini S., Rigotti E., Monaco S., Nicoletti L., Auriti C., Castagnola E., Conti G., Galli L., Giuffre M., La Grutta S., Lancella L., Lo Vecchio A., Maglietta G., Petrosillo N., Pietrasanta C., Principi N., Tesoro S., Venturini E., Piacentini G., Lima M., Staiano A., Esposito S., Bianchini, Sonia, Rigotti, Erika, Monaco, Sara, Nicoletti, Laura, Auriti, Cinzia, Castagnola, Elio, Conti, Giorgio, Galli, Luisa, Giuffrè, Mario, La Grutta, Stefania, Lancella, Laura, Lo Vecchio, Andrea, Maglietta, Giuseppe, Petrosillo, Nicola, Pietrasanta, Carlo, Principi, Nicola, Tesoro, Simonetta, Venturini, Elisabetta, Piacentini, Giorgio, Lima, Mario, Staiano, Annamaria, Esposito, Susanna, and The Peri-Operative Prophylaxis In Neonatal And Paediatric Age Pop-NeoPed Study Group, Null

Subjects
Microbiology (medical), Infectious Diseases, pancreas surgery, Settore MED/41 - ANESTESIOLOGIA, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics, abdominal surgery, gastrointestinal endoscopy, Biochemistry, Microbiology, appendectomy, liver surgery
Abstract

Surgical site infections (SSIs), i.e., surgery-related infections that occur within 30 days after surgery without an implant and within one year if an implant is placed, complicate surgical procedures in up to 10% of cases, but an underestimation of the data is possible since about 50% of SSIs occur after the hospital discharge. Gastrointestinal surgical procedures are among the surgical procedures with the highest risk of SSIs, especially when colon surgery is considered. Data that were collected from children seem to indicate that the risk of SSIs can be higher than in adults. This consensus document describes the use of preoperative antibiotic prophylaxis in neonates and children that are undergoing abdominal surgery and has the purpose of providing guidance to healthcare professionals who take care of children to avoid unnecessary and dangerous use of antibiotics in these patients. The following surgical procedures were analyzed: (1) gastrointestinal endoscopy; (2) abdominal surgery with a laparoscopic or laparotomy approach; (3) small bowel surgery; (4) appendectomy; (5) abdominal wall defect correction interventions; (6) ileo-colic perforation; (7) colorectal procedures; (8) biliary tract procedures; and (9) surgery on the liver or pancreas. Thanks to the multidisciplinary contribution of experts belonging to the most important Italian scientific societies that take care of neonates and children, this document presents an invaluable reference tool for perioperative antibiotic prophylaxis in the paediatric and neonatal populations.

Published
2022

35. Secondary cytomegalovirus infections: How much do we still not know? Comparison of children with symptomatic congenital cytomegalovirus born to mothers with primary and secondary infection

Author

Scaramuzzino, Fabiola, Di Pastena, Michela, Chiurchiu, Sara, Romani, Lorenza, De Luca, Maia, Lucignani, Giulia, Amodio, Donato, Seccia, Annalisa, Marsella, Pasquale, Grimaldi Capitello, Teresa, Longo, Daniela, Palma, Paolo, Lancella, Laura, Bernardi, Stefania, Rossi, Paolo, and Calo Carducci, Francesca Ippolita

Subjects
Pediatrics, Perinatology and Child Health
Abstract

Congenital cytomegalovirus (cCMV) infection can follow primary and secondary maternal infection. Growing evidence indicate that secondary maternal infections contribute to a much greater proportion of symptomatic cCMV than was previously thought. We performed a monocentric retrospective study of babies with cCMV evaluated from August 2004 to February 2021; we compared data of symptomatic children born to mothers with primary or secondary infection, both at birth and during follow up. Among the 145 babies with available data about maternal infection, 53 were classified as having symptomatic cCMV and were included in the study: 40 babies were born to mothers with primary infection and 13 babies were born to mothers with secondary infection. Analyzing data at birth, we found no statistical differences in the rate of clinical findings in the two groups, except for unilateral sensorineural hearing loss (SNHL) which was significantly more frequent in patients born to mother with secondary infection than in those born to mother with primary infection (46.2 vs. 17.5%, P = 0.037). During follow up, we found a higher rate of many sequelae (tetraparesis, epilepsy, motor and speech delay, and unilateral SNHL) in the group of children born to mothers with secondary infection, with a statistical difference for tetraparesis and unilateral SNHL. Otherwise, only children born to mothers with primary infection presented bilateral SNHL both at birth and follow up. Our data suggest that the risk of symptomatic cCMV and long-term sequelae is similar in children born to mother with primary and secondary CMV infection; it is important to pay appropriate attention to seropositive mothers in order to prevent reinfection and to detect and possibly treat infected babies.

Published
2022

37. Case report:Microcirculatory leukocytes in a pediatric patient with severe SARS-CoV-2 pneumonia. Findings of leukocytes trafficking beyond the lungs

Author

Bottari, Gabriella, Ince, Can, Confalone, Valerio, Perdichizzi, Salvatore, Casamento Tumeo, Chiara, Nunziata, Joseph, Bernardi, Stefania, Calo Carducci, Francesca, Lancella, Laura, Bernaschi, Paola, Russo, Cristina, Perno, Carlo Federico, Cecchetti, Corrado, Villani, Alberto, Bottari, Gabriella, Ince, Can, Confalone, Valerio, Perdichizzi, Salvatore, Casamento Tumeo, Chiara, Nunziata, Joseph, Bernardi, Stefania, Calo Carducci, Francesca, Lancella, Laura, Bernaschi, Paola, Russo, Cristina, Perno, Carlo Federico, Cecchetti, Corrado, and Villani, Alberto

Abstract

Background SARS-CoV-2 can lead to excessive coagulation and thrombo-inflammation with deposition of microthrombi and microvascular dysfunction. Several studies in human and animal models have already evidenced biomarkers of endothelial injury during SARS-CoV-2 infection. Real-time observation of sublingual microcirculation using an handheld vital microscopy with an Incident Dark Field (IDF) technique could represent a non-invasive way to assess early signs of microvascular dysfunction and endothelial inflammation in patients with severe COVID-19 infection. Clinical case We report for the first time in a pediatric patient with severe SARS-CoV-2 pneumonia findings about microcirculatory leukocytes in the sublingual microcirculation of a 7 month-old patient admitted to our PICU using handheld vital microscopy with IDF technique. Results Sublingual microcirculation analysis revealed the presence of microcirculatory alterations and an extensive presence of leukocytes in the patient's sublingual microcirculation. It's significant to underline how the patient didn't show a contextual significant increase in inflammatory biomarkers or other clinical signs related to an inflammatory response, beyond the presence of severe hypoxic respiratory failure. Conclusion Leukocyte activation in multiple organs can occur at the endothelial lining of the microvasculature where a surge of pro-inflammatory mediators can result in accumulation of activated leukocytes and degradation of the endothelium. The introduction of a method to assess in a non-invasive, real-time manner the extent of inflammation in a patient with COVID19 could lead to potential clinical and therapeutic implications. However, more studies are required to prove that studying leukocytes microcirculation using sublingual microcirculation analysis could be useful as a bedside point of care monitor to predict the presence of systemic inflammation associated with the impact of COVID-19, leadi

Published
2022

38. Peri-Operative Prophylaxis in Patients of Neonatal and Pediatric Age Subjected to Cardiac and Thoracic Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Author

Bianchini, Sonia, Nicoletti, Laura, Monaco, Sara, Rigotti, Erika, Corbelli, Agnese, Colombari, Annamaria, Auriti, Cinzia, Caminiti, Caterina, Conti, Giorgio, De Luca, Maia, Donà, Daniele, Galli, Luisa, Garazzino, Silvia, Inserra, Alessandro, La Grutta, Stefania, Lancella, Laura, Lima, Mario, Lo Vecchio, Andrea, Pelizzo, Gloria, Petrosillo, Nicola, Piacentini, Giorgio, Pietrasanta, Carlo, Principi, Nicola, Puntoni, Matteo, Simonini, Alessandro, Tesoro, Simonetta, Venturini, Elisabetta, Staiano, Annamaria, Caramelli, Fabio, Domenico Gargiulo, Gaetano, Esposito, Susanna, Giorgio Conti (ORCID:0000-0002-8566-9365), Nicola Petrosillo, Bianchini, Sonia, Nicoletti, Laura, Monaco, Sara, Rigotti, Erika, Corbelli, Agnese, Colombari, Annamaria, Auriti, Cinzia, Caminiti, Caterina, Conti, Giorgio, De Luca, Maia, Donà, Daniele, Galli, Luisa, Garazzino, Silvia, Inserra, Alessandro, La Grutta, Stefania, Lancella, Laura, Lima, Mario, Lo Vecchio, Andrea, Pelizzo, Gloria, Petrosillo, Nicola, Piacentini, Giorgio, Pietrasanta, Carlo, Principi, Nicola, Puntoni, Matteo, Simonini, Alessandro, Tesoro, Simonetta, Venturini, Elisabetta, Staiano, Annamaria, Caramelli, Fabio, Domenico Gargiulo, Gaetano, Esposito, Susanna, Giorgio Conti (ORCID:0000-0002-8566-9365), and Nicola Petrosillo

Published
2022

39. Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Subjected to Eye Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Author

Bianchini, Sonia, Morini, Chiara, Nicoletti, Laura, Monaco, Sara, Rigotti, Erika, Caminiti, Caterina, Conti, Giorgio, De Luca, Maia, Donà, Daniele, Maglietta, Giuseppe, Lancella, Laura, Lo Vecchio, Andrea, Marchini, Giorgio, Pietrasanta, Carlo, Principi, Nicola, Simonini, Alessandro, Venturini, Elisabetta, Longo, Anita Rosa, Gusson, Elena, Boccuzzi, Domenico, Vigo, Luca, Mosca, Fabio, Staiano, Annamaria, Esposito, Susanna, Giorgio Conti (ORCID:0000-0002-8566-9365), Rosa Longo, Bianchini, Sonia, Morini, Chiara, Nicoletti, Laura, Monaco, Sara, Rigotti, Erika, Caminiti, Caterina, Conti, Giorgio, De Luca, Maia, Donà, Daniele, Maglietta, Giuseppe, Lancella, Laura, Lo Vecchio, Andrea, Marchini, Giorgio, Pietrasanta, Carlo, Principi, Nicola, Simonini, Alessandro, Venturini, Elisabetta, Longo, Anita Rosa, Gusson, Elena, Boccuzzi, Domenico, Vigo, Luca, Mosca, Fabio, Staiano, Annamaria, Esposito, Susanna, Giorgio Conti (ORCID:0000-0002-8566-9365), and Rosa Longo

Abstract

Ocular surgery encompasses a wide range of procedures, including surgery of the tear ducts, eyelid, cornea and conjunctiva, lens, ocular muscle, and vitreoretinal and iris surgery. Operations are also performed for the removal of tumors, repairs of ocular trauma and, finally, corneal transplantation. Antibiotic prophylaxis for the prevention of surgical site infections (SSIs) in ocular surgery is a complex field in which shared lines of action are absent. In light of the scarcity of shared evidence in the use of ocular antimicrobial prophylaxis for the pediatric population, this consensus document aims to provide clinicians with a series of recommendations on antimicrobial prophylaxis for patients of neonatal and pediatric age undergoing eye surgery. The following scenarios are considered: (1) intraocular surgery; (2) extraocular surgery; (3) ocular trauma; (4) ocular neoplasm; (5) ocular surface transplantations; (6) corneal grafts. This work has been made possible by the multidisciplinary contribution of experts belonging to the most important Italian scientific societies and represents, in our opinion, the most complete and up-to-date collection of recommendations regarding clinical actions in the peri-operative environment in eye surgery. The application of uniform and shared protocols aims to improve surgical practice, through the standardization of procedures, with a consequent reduction of SSIs, also limiting the phenomenon of antimicrobial resistance.

Published
2022

40. Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis: a multicentre PTBNET study.

Author

Buonsenso, Danilo, Noguera-Julian, Antoni, Moroni, Rossana, Hernández-Bartolomé, Angel, Fritschi, Nora, Lancella, Laura, Cursi, Laura, Soler-Garcia, Aleix, Krüger, Renate, Feiterna-Sperling, Cornelia, Sali, Michela, Lo Vecchio, Andrea, Scarano, Sara, Hernanz Lobo, Alicia, Espiau, Maria, Soriano-Arandes, Antonio, Sirvan Cetin, Benhur, Brinkmann, Folke, Ozere, Iveta, and Baquero-Artigao, Fernando

Subjects
TUBERCULOUS meningitis, LATENT tuberculosis, TUBERCULOSIS, HIV infections, JUVENILE diseases
Abstract

Rationale: In 2016, a new interferon-gamma release assay (IGRA) was introduced, QuantiFERON-TB Gold Plus (QFT-Plus), claimed to have improved sensitivity in active tuberculosis (TB).Objectives: This study aimed to determine the performance of QFT-Plus, compared with previous generation IGRAs and the tuberculin skin test (TST), in children with TB in Europe.Methods: Multicentre, ambispective cohort study within the Paediatric Tuberculosis Network European Trials Group (ptbnet), a dedicated paediatric TB research network comprising >300 members, capturing TB cases <18 years-of-age diagnosed between January 2009 and December 2019.Measurements and Main Results: 1001 TB cases from 16 countries were included (mean age (IQR) 5.6 (2.4-12.1) years). QFT-Plus was performed in 358, QFT Gold in-Tube (QFT-GIT) in 600, T-SPOT.TB in 58 and TST in 636 cases. The overall test sensitivities were: QFT-Plus 83.8% (95% CI 80.2% to 87.8%), QFT-GIT 85.5% (95% CI 82.7% to 88.3%), T-SPOT.TB 77.6% (95% CI 66.9% to 88.3%) and TST (cut-off ≥10 mm) 83.3% (95% CI 83.3% to 86.2%). There was a trend for tests to have lower sensitivity in patients with miliary and/or central nervous system (CNS) TB (73.1%, 70.9%, 63.6% and 43.5%, respectively), and in immunocompromised patients (75.0%, 59.6%, 45.5% and 59.1%, respectively).Conclusions: The results indicate that the latest generation IGRA assay, QFT-Plus, does not perform better than previous generation IGRAs or the TST in children with TB disease. Overall, tests performed worse in CNS and miliary TB, and in immunocompromised children. None of the tests evaluated had sufficiently high sensitivity to be used as a rule-out test in children with suspected TB. [ABSTRACT FROM AUTHOR]

Published
2023
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41. Clostridioides difficile Infection in Children: A 5-Year Multicenter Retrospective Study

Author

Buonsenso, Danilo, primary, Graffeo, Rosalia, additional, Pata, Davide, additional, Valentini, Piero, additional, Palumbo, Carla, additional, Masucci, Luca, additional, Ruggiero, Antonio, additional, Attinà, Giorgio, additional, Onori, Manuela, additional, Lancella, Laura, additional, Lucignano, Barbara, additional, Giuseppe, Martina Di, additional, Bernaschi, Paola, additional, and Cursi, Laura, additional

Published
2022
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42. Safety of Monoclonal Antibodies in Children Affected by SARS-CoV-2 Infection

Author

Romani, Lorenza, primary, Calò Carducci, Francesca Ippolita, additional, Chiurchiù, Sara, additional, Cursi, Laura, additional, De Luca, Maia, additional, Di Giuseppe, Martina, additional, Krzysztofiak, Andrzej, additional, Lancella, Laura, additional, Palma, Paolo, additional, Vallesi, Leonardo, additional, Corsetti, Tiziana, additional, Campana, Andrea, additional, Nicastri, Emanuele, additional, Rossi, Paolo, additional, and Bernardi, Stefania, additional

Published
2022
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43. Additional file 1 of Italian intersociety consensus on management of long covid in children

Author

Esposito, Susanna, Principi, Nicola, Azzari, Chiara, Cardinale, Fabio, Di Mauro, Giuseppe, Galli, Luisa, Gattinara, Guido Castelli, Fainardi, Valentina, Guarino, Alfredo, Lancella, Laura, Licari, Amelia, Mancino, Enrica, Marseglia, Gian Luigi, Leonardi, Salvatore, Nenna, Raffaella, Zampogna, Stefania, Zona, Stefano, Staiano, Annamaria, and Midulla, Fabio

Abstract

Additional file 1: Supplementary Table 1. Questionnaire for the evaluation of long COVID in pediatric age.

Published
2022
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45. Surgical Antimicrobial Prophylaxis in Neonates and Children with Special High-Risk Conditions: A RAND/UCLA Appropriateness Method Consensus Study

Author

Bianchini, Sonia, Rigotti, Erika, Nicoletti, Laura, Monaco, Sara, Auriti, Cinzia, Castagnola, Elio, Castelli Gattinara, Guido, De Luca, Maia, Galli, Luisa, Garazzino, Silvia, La Grutta, Stefania, Lancella, Laura, Lo Vecchio, Andrea, Maglietta, Giuseppe, Montagnani, Carlotta, Petrosillo, Nicola, Pietrasanta, Carlo, Principi, Nicola, Simonini, Alessandra, Tesoro, Simonetta, Venturini, Elisabetta, Piacentini, Giorgio, Lima, Mario, Staiano, Annamaria, Esposito, Susanna, On Behalf Of The Peri-Operative Prophylaxis In Neonatal And Paediatric Age Pop-NeoPed Study Group, Null, Bianchini, Sonia, Rigotti, Erika, Nicoletti, Laura, Monaco, Sara, Auriti, Cinzia, Castagnola, Elio, Castelli Gattinara, Guido, De Luca, Maia, Galli, Luisa, Garazzino, Silvia, La Grutta, Stefania, Lancella, Laura, Lo Vecchio, Andrea, Maglietta, Giuseppe, Montagnani, Carlotta, Petrosillo, Nicola, Pietrasanta, Carlo, Principi, Nicola, Simonini, Alessandra, Tesoro, Simonetta, Venturini, Elisabetta, Piacentini, Giorgio, Lima, Mario, Staiano, Annamaria, Esposito, Susanna, and On Behalf Of The Peri-Operative Prophylaxis In Neonatal And Paediatric Age Pop-NeoPed Study Group, Null

Subjects
Microbiology (medical), immunosuppression, multidrug resistant bacteria, antibiotic allergy, comorbidity, MRSA, MSSA, splenectomy, surgical antibiotic prophylaxis, Keywords: antibiotic allergy, Biochemistry, Microbiology, Infectious Diseases, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics, surgical antibiotic prophylaxis 1. Introduction
Abstract

Surgical site infections (SSIs), which are a potential complications in surgical procedures, are associated with prolonged hospital stays and increased postoperative mortality rates, and they also have a significant economic impact on health systems. Data in literature regarding risk factors for SSIs in pediatric age are scarce, with consequent difficulties in the management of SSI prophylaxis and with antibiotic prescribing attitudes in the various surgical procedures that often tend to follow individual opinions. The lack of pediatric studies is even more evident when we consider surgeries performed in subjects with underlying conditions that may pose an increased risk of complications. In order to respond to this shortcoming, we developed a consensus document to define optimal surgical antimicrobial prophylaxis (SAP) in neonates and children with specific high-risk conditions. These included the following: (1) colonization by methicillin-resistant Staphylococcus aureus (MRSA) and by multidrug resistant (MDR) bacteria other than MRSA; (2) allergy to first-line antibiotics; (3) immunosuppression; (4) splenectomy; (5) comorbidity; (6) ongoing antibiotic therapy or prophylaxis; (7) coexisting infection at another site; (8) previous surgery in the last month; and (9) presurgery hospitalization lasting more than 2 weeks. This work, made possible by the multidisciplinary contribution of experts belonging to the most important Italian scientific societies, represents, in our opinion, the most up-to-date and comprehensive collection of recommendations relating to behaviors to be undertaken in a perioperative site in the presence of specific categories of patients at high-risk of complications during surgery. The application of uniform and shared protocols in these high-risk categories will improve surgical practice with a reduction in SSIs and consequent rationalization of resources and costs, as well as being able to limit the phenomenon of antimicrobial resistance.

Published
2022

46. Severe COVID-19 Complicated by Cerebral Venous Thrombosis in a Newborn Successfully Treated with Remdesivir, Glucocorticoids, and Hyperimmune Plasma

Author

Cursi, Laura, primary, Calo Carducci, Francesca Ippolita, additional, Chiurchiu, Sara, additional, Romani, Lorenza, additional, Stoppa, Francesca, additional, Lucignani, Giulia, additional, Russo, Cristina, additional, Longo, Daniela, additional, Perno, Carlo Federico, additional, Cecchetti, Corrado, additional, Lombardi, Mary Haywood, additional, D’Argenio, Patrizia, additional, Lancella, Laura, additional, Bernardi, Stefania, additional, and Rossi, Paolo, additional

Published
2021
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48. Severe viral respiratory infections in the pre‐COVID era: A 5‐year experience in two pediatric intensive care units in Italy.

Author

De Luca, Maia, D'Amore, Carmen, Romani, Lorenza, Tripiciano, Costanza, Clemente, Vitangelo, Mercadante, Stefania, Perrotta, Daniela, Nunziata, Joseph, Cecchetti, Corrado, Rossetti, Emanuele, Bianchi, Roberto, Perno, Carlo Federico, Bernaschi, Paola, Russo, Cristina, Lancella, Laura, Raponi, Massimiliano, and Ciofi degli Atti, Marta Luisa

Subjects
INTENSIVE care units, PEDIATRIC intensive care, POSITIVE pressure ventilation, VIRUS diseases, RESPIRATORY infections, COVID-19, CHILDREN'S hospitals, PLANT viruses
Abstract

Background: Viral respiratory infections are one of the main causes of hospitalization in children. Even if mortality rate is low, 2% to 3% of the hospitalized children need mechanical ventilation. Risk factors for admission to the pediatric intensive care unit (PICU) are well known, while few studies have described risk factors for invasive ventilator support and prolonged hospitalization. Methods: A retrospective study including all patients aged between 2 and 18 months with a confirmed viral respiratory infection, requiring admission to PICU from September to March between 2015 and 2019, was conducted at Bambino Gesù Children's Hospital in Rome, Italy. Results: One hundred ninety patients were enrolled, with a median age of 2.7 months; 32.1% had at least one comorbidity, mainly prematurity. The most frequent isolated viruses were RSV‐B, rhinovirus, and RSV‐A; 38.4% needed mechanical ventilation. This subgroup of patients had lower median birth weight compared with patients not requiring mechanical ventilation (2800 g vs. 3180 g, p = 0.02); moreover, comorbidities were present in 43.8% of intubated patients and in 24.8% of patients treated with non‐invasive ventilation (p = 0.006). Viral coinfection did not result to be a risk factor for mechanical support, while virus–bacteria coinfection was significantly associated with mechanical ventilation (p < 0.001). Similar risk factors were identified for prolonged hospitalization. Conclusions: Early identification of patients who could have a sudden respiratory deterioration and need of mechanical ventilation is crucial to reduce complications due to orotracheal intubation and prolonged hospitalization in PICU. Further studies are needed to define high‐risk group of patients and to design targeted interventions. [ABSTRACT FROM AUTHOR]

Published
2023
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