Outbreak of ST395 KPC-Producing Klebsiella pneumoniae in a Neonatal Intensive Care Unit in Palermo, Italy

Virulence genotypes of Helicobacter pylori in Palermo, Italy

HBV-DNA suppression and disease course in HBV cirrhosis patients on long-term lamivudine therapy

In hepatitis B virus (HBV) cirrhosis patients on long-term lamivudine (LAM), the relationships between HBV suppression, development of viral resistance and disease outcome are unclear. We analysed the dynamic of serum HBV-DNA and its relationship with the clinical course of 59 patients (52 males, mean age 51.4 ±8.4 years, 12 HBeAg positive and 47 HBeAg negative, and 57 genotype D and two genotype A) with cirrhosis (45 in Child-Turcotte-Pugh class A) and high levels of serum HBV-DNA (median 14.7x107 genomes/ml) treated with LAM [median (range): 44 (15–78) months]. A total of 50 patients (84.7%) achieved a virological response (serum HBV-DNA negative by PCR) during the first 6 months of ther…

A case of spotted fever rickettsiosis in a human immunodeficiency virus-positive patient.

Methicillin-resistant Staphylococcus pseudintermedius as causative agent of dairy cow mastitis.

Staphylococcus pseudintermedius is a coagulase-positive specie similar to Staphylococcus intermedius , frequently associated with pyoderma, otitis and urinary tract infections of dogs and cats (van Duijkeren and others 2011). No information about bovine mastitis caused by S pseudintermedius is available in the literature. Antimicrobial resistance among S pseudintermedius strains is increasing: in the past, susceptibility to most antibiotics was common (Bond and Loeffler 2012), but in the last few years methicillin-resistant S pseudintermedius (MRSP) strains have emerged as a significant animal health problem in veterinary medicine (Schwarz and others 2008, van Duijkeren and others 2008, Wee…

TYPING OF LEGIONELLA PNEUMOPHILA SEROGROUP 1 BY SBT, MLVA AND SPOLIGOTYPING

Introduction: The current typing method of Legionella pneumophila recommended by the European EWGLI Consortium is a multi locus sequence typing (MLST)-like protocol called sequence-based typing (SBT).This approach is highly portable and widely used to perform epidemiological surveys and outbreak investigation. Recent studies have demonstrated the values of using the multiple-locus variable-number tandem repeat (VNTR) analysis (MLVA) and the diversity of clustered regularly interspaced short palindromic repeat (CRISPR)-based typing technique (Spoligotyping) as genotyping markers. In this study we used these three methods for typing the L. pneumpophila isolates and for investigating the origi…

Profilo patogenetico e sensibilità ai farmaci di stipiti di S.aureus meticillino-resistente SCCMEC tipo IVa isolati in quattro ospedali palermitani

Successful control of an outbreak of colonization by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae sequence type 258 in a neonatal intensive care unit, Italy

This article reports an outbreak of colonization by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) sequence type (ST) 258 in a neonatal intensive care unit (NICU) in Palermo, Italy. KPC-Kp ST258 was detected by an active surveillance culture programme. Between 18th September and 14th November 2012, KPC-Kp was isolated from 10 out of 54 neonates admitted in the outbreak period. No cases of infection were recorded. Male sex was associated with colonization, whereas administration of ampicilline-sulbactam plus gentamicin was protective. Infection control interventions interrupted the spread of KPC-Kp without the need to close the NICU to new admissions. (C) 2013 The Healt…

Staphylococcal cassette chromosome mec typing and mecA sequencing in methicillin-resistant staphylococci from Algeria: a highly diversified element with new mutations in mecA.

Genetic mechanisms of methicillin resistance are still relevant in staphylococci. The aims of this study are to assess the possible exchanges of staphylococcal cassette chromosome mec (SCCmec) among isolates of methicillin-resistant staphylococci (MRS) and to check for known or new mutations in mecA DNA. A total of 35 MRS non-repetitive isolates were recovered, including 20 Staphylococcus haemolyticus, 7 Staphylococcus aureus, 4 Staphylococcus sciuri, 2 Staphylococcus saprophyticus and 1 isolate each of Staphylococcus xylosus and Staphylococcus lentus. Only 16 of the 35 strains were assigned to known SCCmec types: 7 SCCmec VII, 6 SCCmec IV and 3 SCCmec III, with possible horizontal transfer…

Extraintestinal pathogenic Escherichia coli sequence type 131 H30-R and H30-Rx subclones in retail chicken meat, Italy

Extraintestinal pathogenic Escherichia coli sequence type 131 (ST131), typically fluoroquinolone-resistant (FQ-R) and/or extended-spectrum β-lactamase (ESBL)-producing, has emerged globally. Among clinical isolates, ST131, primarily its H30-R and H30-Rx subclones, accounts for most antimicrobial-resistant E. coli and is the dominant E. coli strain worldwide. We assessed its prevalence and characteristics among raw chicken meat samples on sale in Palermo, Italy. A collection of 237 fluoroquinolone resistant and ESBL/AmpC producing E. coli isolates, which had been isolated from processed retail chicken meat in the period May 2013-April 2015, was analyzed. Established polymerase chain reaction…

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

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

Outbreak of colonizations by extended-spectrum β-lactamase-producing Escherichia coli sequence type 131 in a neonatal intensive care unit, Italy

Abstract Background Extended spectrum β-lactamases (ESBLs) often associated with resistance to aminoglycosides and fluoroquinolones have recently emerged in community-associated Escherichia coli. The worldwide clonal dissemination of E. coli sequence type (ST)131 is playing a prominent role. We describe an outbreak of colonizations by ESBL-producing E. coli (ESBL-E. coli) in the neonatal intensive care unit (NICU) of the University Hospital, Palermo, Italy. Methods An epidemiological investigation was conducted with the support of molecular typing. All children admitted to the NICU and colonized by ESBL-E. coli between January and June 2012, were included in the study. Cases were defined as…

Italian males recovering from mild COVID-19 show no evidence of SARS-CoV-2 in semen despite prolonged nasopharyngeal swab positivity.

Analisi genotipica di Helicobacter pylori in campioni bioptici

Daptomycin non-susceptible, vancomycin intermediate methicillin-resistant Staphylococcus aureus ST398 from a chronic leg ulcer, Italy

To the Editor,Human infections caused by methicillin-resistant Staphylococcus aureus (MRSA) sequence type 398 (ST398) have been emerging in recent y in Europe [1–3]. Most studies have shown a stron...

Caratterizzazione molecolare di stipiti di Mycobacterium tuberculosis isolati a palermo

Evaluation of the diagnostic performances of two commercially available assays for the detection of enteric adenovirus antigens

The performance of 2 antigenic commercial assays for enteric adenovirus (AdV) infection, bioNexia Rota-Adeno ImmunoChromatographic Tests (ICT) and LIAISON® Adenovirus ChemiLuminescence Immuno Assays (CLIA), was evaluated on 321 stools from children hospitalized for acute gastroenteritis in Palermo, Italy, using a Real time-PCR (Rt-PCR) as reference method. The CLIA showed higher sensitivity (77% vs 60%), accuracy (94.4 vs 90.9) and concordance (k: 0.81 vs 0.67) with respect to ICT, despite equivalent specificity (98.8%). Using the Ct values of the Rt-PCR as a proxy of the fecal viral load, similar Ct values (mean 9.32 vs 9.89) were observed among the true positive samples, whilst a signific…

Farmaco-resistenza in stipiti di Helicobacter pylori isolati da pazienti afferenti a strutture ospedaliere della Sicilia centro-occidentale.

Recombinant GII.P16 genotype challenges RT-PCR-based typing in region A of norovirus genome

Abstract Objectives In latest years GII.4[P16] and GII.2[P16] noroviruses have become predominant in some temporal/geographical settings. In parallel with the emergence of the GII.P16 polymerase type, norovirus surveillance activity in Italy experienced increasing difficulties in generating sequence data on the RNA polymerase genomic region A, using the widely adopted JV12A/JV13B primer set. Two sets of modified primers (Deg1 and Deg2) were tested in order to improve amplification and typing of the polymerase gene. Methods Amplification and typing performance of region A primers was assessed in RT-PCR on 452 GII norovirus positive samples obtained from 2194 stool samples collected in 2016–2…

MOLECULAR CHARACTERIZATION OF MULTIDRUG-RESISTANT E. COLI ISOLATED FROM BACTEREMIA PATIENTS

Background: Extraintestinal pathogenic Escherichia coli (ExPEC) bacteria have the ability to cause diverse and serious diseases, such as urinary tract infections (UTIs) and bacteremia; incidence of bacteremia is increasing globally. The emergence of multidrug resistance in E. coli is also becoming a global concern, with particular emphasis on E. coli sequence type (ST) 131, which is being increasingly reported in UTIs. Drug resistance is mediated by extended- spectrum β-lactamases (ESBLs), mainly of the CTX-M family, particularly CTX-M-15, and less frequently of the SHV and OXA families. Few studies are available regarding the characterization of E. coli strains causing bacteremia. Methods:…

High prevalence to resistance of clarithromycin in Helicobacter pylori strains isolated in Sicily .

Splenic tuberculosis in a patient with Crohn's disease on infliximab: Case report

Resistenza alla rifampicina di stipiti di Mycobacterium tuberculosis isolati a Palermo

Caratterizzazione molecolare di stipiti di Helicobacter pylori isolati da soggetti con patologia gastrica

Resistance to clarithromycin and genotypes in Helicobacter pylori strains isolated in Sicily

The resistance of Helicobacter pylori strains to clarithromycin is increasing in several developed countries and their association with a genetic pattern circulation has been variously explained as related to different geographical areas. In this study we have reported: the prevalence of the resistance of H. pylori, isolated in Sicily, to clarithromycin; the principal point of mutation associated with this resistance; and the more frequent association between resistance to clarithromycin and cagA, the EPIYA motif, and the vacA and oipA genes. Resistance to clarithromycin was detected in 25 % of cases, the main genetic mutation involved being A2143G. The cagA gene was present in 48 % of case…

Induction of IL-8 production by Helicobacter pylori strains with different cagA genotype and oipA functional status.

MOLECULAR EPIDEMIOLOGY OF MYCOBACTERIUM TUBERCULOSIS COMPLEX IN PALERMO, ITALY

Background: We aimed to investigate the molecular epidemiology of Mycobacterium tuberculosis complex (MTBC) in the province of Palermo, Italy, by characterizing 183 isolates identified in the years 2004-2012. A comparison with 104 MTBC strains identified in the same geographic area in the years 1994-2000 was also carried out. Methods: MTBC isolates were analyzed by spoligotyping and the 24 mycobacterial interspersed repetitive unit (MIRU)-variablenumber tandem-repeat (VNTR) method typing. Susceptibility testing to streptomycin, isoniazid, rifampin and ethambutol was also carried out. Furthermore, the spoligotyping dataset obtained from 104 MTBC isolates identified in the years 1994-2000 in …

HELICOBACTER PYLORI E GENOTIPI DELLE CITOCHINE IL-1B, IL-1RA, IL-10 in pazienti con carcinoma gastrico

Tipizzazione molecolare di stipiti di Legionella pneumophila sierogruppo 1 isolati da campioni clinici ed ambientali

Diversity, virulence, and antimicrobial resistance of the KPC-producing Klebsiella pneumoniae ST307 clone

ABSTRACT : The global spread of Klebsiella pneumoniae producing Klebsiella pneumoniae carbapenemase (KPC) has been mainly associated with the dissemination of high-risk clones. In the last decade, hospital outbreaks involving KPC-producing K. pneumoniae have been predominantly attributed to isolates belonging to clonal group (CG) 258. However, results of recent epidemiological analysis indicate that KPC-producing sequence type (ST) 307, is emerging in different parts of the world and is a candidate to become a prevalent high-risk clone in the near future. Here we show that the ST307 genome encodes genetic features that may provide an advantage in adaptation to the hospital environment and t…

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

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of infections outside of health care settings. We carried out a survey to determine the prevalence and characteristics of MRSA isolates (CA-MRSA, HA-MRSA) identified among in- and outpatients by the clinical microbiology laboratories of four general hospitals in Palermo, Italy during the period February-January 2010. Methods: Participating laboratories performed isolation, confirmed methicillin-resistance by their routine method and weekly sent their strains to the coordinating laboratory at the Department of Sciences for Health Promotion “G. D’Alessandro”, University of Palermo, Italy. The isolates were tes…

OXA-163-Producing Klebsiella pneumoniae in Cairo, Egypt, in 2009 and 2010

ABSTRACT Two genetically unrelated OXA-163-carrying Klebsiella pneumoniae strains were identified from two infection cases in June 2009 and May 2010 in Cairo, Egypt. OXA-163-producing Enterobacteriaceae had been previously reported in Argentina only. Both patients had no history of travel abroad. The emergence of this newly recognized OXA-48-related β-lactamase able to hydrolyze cephalosporins and carbapenems is especially worrying in a geographic area where OXA-48 is endemic and effective surveillance for antibiotic resistance is largely unaffordable.

A case of spotted fever rickettsiosis in a HIV-positive patient

Detection of CagA EPIYA motifs in H.pylori DNA extracted from recently collected, frozen, or deparaffinized biopsies and clinical samples

CagA is a major virulence factor of Helicobacter pylori that, once injected into the epithelial cells and phosphorylated on specific bacterial tyrosine residues within repeating EPIYA-A,-B,-C, and -D motifs, localizes to the plasma membrane and interacts with a number of intracellular effectors suggested to play an important role in Helicobacter pylori pathogenesis. EPIYA-D (in East Asian CagA) and EPIYA-C motifs (in Western CagA) are the main sites of CagA phosphorylation and the presence both of EPIYA-D or an increasing number of EPIYA-C motifs, rather than the general CagA positivity, has been associated with more severe gastroduodenal disease. With the aim to analyze EPIYA motifs in 24 …

Characterization of Acinetobacter baumannii from intensive care units and home care patients in Palermo, Italy.

AbstractIn this study 45 isolates of Acinetobacter baumannii identified from patients in intensive care units of three different hospitals and from pressure ulcers in home care patients in Palermo, Italy, during a 3-month period in 2010, were characterized. All isolates were resistant to at least three classes of antibiotics, but susceptible to colistin and tygecycline. Forty isolates were non-susceptible to carbapenems. Eighteen and two isolates, respectively, carried the blaOXA-23-like and the blaOXA-58-like genes. One strain carried the VIM-4 gene. Six major rep-PCR subtype clusters were defined, including isolates from different hospitals or home care patients. The sequence type/pulsed …

Are hepatitis G virus and TT virus involved in cryptogenic chronic liver disease?

Abstract Background . Hepatitis G virus can cause chronic infection in man but the role of this agent in chronic liver disease is poorly understood. Little is known about the relation of another newly discovered agent, the TT virus, with chronic liver disease. Aim . To investigate the rate of infection with hepatitis G virus and TT virus in patients with cryptogenic chronic liver disease. Patients . A total of 23 subjects with chronically raised alanine transaminase and a liver biopsy in whom all known causes of liver disease had been excluded, and 4D subjects with hepatitis C virus-related chronic liver disease. Methods . Evaluation of anti-hepatitis G virus by enzyme immunoassay. Hepatiti…

Molecular epidemiology of Acinetobacter baumannii in Iran: endemic and epidemic spread of multiresistant isolates

Objectives We examined the molecular epidemiology of Acinetobacter baumannii clinical isolates from two cities (Tehran and Tabriz) of Iran. Methods DiversiLab repetitive extragenic palindromic PCR (rep-PCR), multilocus sequence typing and sequence group multiplex PCR were performed. The presence of resistance mechanisms including metallo-β-lactamases, extended-spectrum β-lactamases, OXA carbapenemases, aminoglycoside-modifying enzymes and RNA methylases was also investigated. Results DiversiLab rep-PCR identified 11 clusters and 11 singleton isolates. Twelve sequence types (STs), including six novel types, were identified. Sequence groups (SGs) 1-3 as well as five additional banding pattern…

Ventilator-associated Pneumonia and MRSA ST398, Italy

To the Editor: Methicillin-resistant Staphylococcus aureus (MRSA) sequence type (ST)398 has become increasingly common in livestock, particularly pigs, in some countries in Europe, such as Spain and Germany (1). In Italy, prevalences as high as 14% and 21.6% in pig-breeding facilities and meat-processing sites, respectively, have been recently reported (1). Possible association of MRSA in animals with infection in humans has been investigated. One study showed a strong relationship between contact with pigs or calves and carriage by persons having direct contact with animals and families of persons who handle animals (2). Moreover, an MRSA prevalence >11.9% has been described by de Boer et …

Emergence in 2017-2019 of novel reassortant equine-like G3 rotavirus strains in Palermo, Sicily.

Rotavirus A (RVA) is a major etiologic agent of gastroenteritis in children worldwide. Hospital-based surveillance of viral gastroenteritis in paediatric population in Palermo (Italy) from 2017 onwards revealed a sharp increase in G3P[8] RVAs, accounting for 71% of all the RVAs detected in 2019. This pattern had not been observed before in Italy, with G3 RVA usually being detected at rates lower than 3%. In order to investigate this unique epidemiological pattern, the genetic diversity of G3 RVAs identified during a 16-year long surveillance (2004-2019) was explored by systematic sequencing of the VP7 and VP4 genes and by whole genome sequencing of selected G3 strains, representative of the…

A Snapshot on MRSA Epidemiology in a Neonatal Intensive Care Unit Network, Palermo, Italy

Objectives. We performed a one-year prospective surveillance study on MRSA colonization within the five NICUs of the metropolitan area of Palermo, Italy. The purpose of the study was to assess epidemiology of MRSA in NICU from a network perspective. Methods. Transfer of patients between NICUs during 2014 was traced based on the annual hospital discharge records. In the period February 2014 – January 2015, in the NICU B, at the University teaching hospital, nasal swabs from all infants were collected weekly, whereas in the other four NICUs (A, C, D, E) at four week-intervals of time. MRSA isolates were submitted to antibiotic susceptibility testing, SCCmec typing, PCR to detect lukS-PV and l…

Caratterizzazione di stipiti di Staphylococcus aureus meticillino-resistenti con SCCmec di tipo IVa isolati in ospedali palermitani

Cephalosporin resistant Escherichia coli from cancer patients in Cairo, Egypt.

Cephalosporin-resistant Escherichia coli has been increasingly reported worldwide. In this study, 32 cephalosporin resistant E. coli isolates identified from cancer patients in Cairo, Egypt in 2009-2010 were analyzed. Twenty-three were of phylogenetic group D, seven A and one each B1 and B2. By rep-PCR 15 phylogroup D isolates were grouped in four clusters, one with sequence type (ST) 405 and three ST68. Seventeen isolates showed single patterns. blaCTX-M-15 and aac(6')-Ib-cr were the most common resistance determinants. blaOXA-48 and blaVIM were also detected. Multidrug resistant E. coli seriously affects healthcare, especially in immunocompromised hosts, such as cancer patients.

Differing kinetics of anti-spike protein IgGs and neutralizing antibodies against SARS-CoV-2 after Comirnaty (BNT162b2) immunization

Abstract Aims Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has had a serious worldwide impact on human health. On December 2020, an immunization campaign with a COVID-19 mRNA vaccine (Comirnaty-BNT162b2 Pfizer-BioNTech) was started in Italy, first targeting healthcare workers (HCWs). This study aims to investigate the antibodies that are response against SARS-CoV-2 vaccine. Methods and Results The kinetics and the persistence of both anti-S1/S2 IgGs and neutralizing antibodies (Nt-Abs) were investigated in 76 HCWs through a 4-month follow-up with multiple testing points starting at the first dose. Temporal analysis of SARS-CoV-2 Abs titre kinetics showed three diff…

VALUTAZIONE MOLECOLARE DELLA RESISTENZA A RIFAMPICINA ED ISONIAZIDE IN STIPITI PALERMITANI DI MYCOBACTERIUM TUBERCULOSIS

Prevalence of virulence-associated genotypes of Helicobacter pylori and correlation with severity of gastric pathology in patients from western Sicily, Italy

In a bacterium like Helicobacter pylori, which is characterized by a recombinant population structure, the associated presence of genes encoding virulence factors might be considered an expression of a selective advantage conferred to strains with certain genotypes and, therefore, a potentially useful tool for predicting the clinical outcome of infections. However, differences in the geographical and ethnic prevalence of the H. pylori virulence-associated genotypes can affect their clinical predictive value and need to be considered in advance. In this study we carried out such an evaluation in a group of patients living in Sicily, the largest and most populous island in the Mediterranean S…

Multiclonal emergence of carbapenem-resistant Klebsiella pneumoniae in Tuscany, Italy

Erratum to: Enhanced surveillance of invasive listeriosis in the Lombardy region, Italy, in the years 2006-2010 reveals major clones and an increase in serotype 1/2a [BMC Infect Dis., 13, (2013), 152.]

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

Objectives: This investigation was conducted to study co-colonization by carbapenem-resistant Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) and Acinetobacter baumannii (CRAB) in intensive care unit (ICU) patients in Palermo, Sicily, a geographic area where both organisms are endemic in the healthcare setting. Risk factors at admission and during ICU stay and outcomes were also evaluated. Methods: All patients colonized by KPC-Kp, or CRAB, or both in 2 ICUs of a large general hospital during the period October 2011 – March 2012 were enrolled. Demographics and clinical data were collected. Resistance determinants and clonality of the 2 organisms were characterized by mo…

Resistenza alla rifampicina in stipiti di Mycobacterium tuberculosis isolati a Palermo

Sequence type 101 (ST101) as the predominant carbapenem-non-susceptible Klebsiella pneumoniae clone in an acute general hospital in Italy.

Klebsiella pneumoniae is one of the most common multidrug-resistant (MDR) Gram-negative organisms worldwide, responsible for high morbidity and mortality both in hospitals and alternative healthcare settings. Recently, increasing use of carbapenems has promoted the emergence and dissemination of carbapenem-non-susceptible MDR K. pneumoniae strains. All of the CNSKP strains isolated between January 2009 and December 2011 in the General Hospital of Prato (Prato, Italy) were studied. Our findings indicate that, unlike previously reported by other authors from different regions of Italy, K. pneumoniae producing KPC-2 and belonging to ST101 have been established in the area of Prato, Tuscany, It…

Double copies of blaKPC-3::Tn4401a on an IncX3 plasmid in Klebsiella pneumoniae successful clone ST512 from Italy

ABSTRACT A carbapenem-resistant sequence type 512 (ST512) Klebsiella pneumoniae carbapenemase 3 (KPC-3)-producing K. pneumoniae strain showing a novel variant plasmid content was isolated in Palermo, Italy, in 2014. ST512 is a worldwide successful clone associated with the spread of bla KPC genes located on the IncFIIk pKpQIL plasmid. In our ST512 strain, the bla KPC-3 gene was unusually located on an IncX3 plasmid, whose complete sequence was determined. Two copies of bla KPC-3 ::Tn 4401a caused by intramolecular transposition events were detected in the plasmid.

Impact of Vaccination on Rotavirus Genotype Diversity: A Nearly Two-Decade-Long Epidemiological Study before and after Rotavirus Vaccine Introduction in Sicily, Italy

Sicily was the first Italian region to introduce rotavirus (RV) vaccination with the monovalent G1P[8] vaccine Rotarix® in May 2012. In this study, the seasonal distribution and molecular characterization of RV strains detected over 19 years were compared to understand the effect of Rotarix® on the evolutionary dynamics of human RVs. A total of 7846 stool samples collected from children < 5 years of age, hospitalized with acute gastroenteritis, were tested for RV detection and genotyping. Since 2013, vaccine coverage has progressively increased, while the RV prevalence decreased from 36.1% to 13.3% with a loss of seasonality. The local distribution of RV genotypes changed over th…

Healthcare associated pathogens in a changing world

In developed countries about 10% of the hospitalizations are complicated by a healthcare-associated infection [1]. Up to 75% of these infections are due to multidrug-resistant organisms (MDROs) [1]. Antimicrobial resistant bacterial infections are associated to higher morbidity, mortality and healthcare costs than those caused by susceptible organisms [1]. The findings of the point prevalence survey in European acute care hospitals published in 2013 by the European Centre for Disease Control and Prevention (ECDC) show large variations between countries and between different regions of the same country, with Italy being allocated within the high-endemic areas for both MRSA and MDROs [2]. Des…

Successful treatment of KPC-3 Klebsiella Pneumoniae ST258 clone with a combination of high-dose tigecycline and colistin in ICU: a case series report.

INFECTIONS CAUSED BY KLEBSIELLA PNEUMONIAE SEQUENCE TYPE 258 PRODUCING K. PNEUMONIAE CARBAPENEMASE 3 (KPC-Kp)HAVE WIDELY EMERGED AND BOTH INDIVIDUAL CASES AND OUTBREAKS OF COLONIZATION OR INFECTION HAVE BEEN REPORTED IN PALERMO, ITALY.OBIETTIVO: THIS IS A RETROSPECTIVE CASE SERIES THAT DESCRIBES THE CLINICAL AND MICROBIOLOGIC OUTCOMES OF 16 PATIENTS WHO RECEIVED A COMBINATION OF HIGH-DOSE TIGECYCLINE AND COLISTIN FOR TREATMENT OF VAP (4 CASES) AND SEVERE BACTERAEMIA (12 CASES) DURING THE YEARS 2009-2011. 11 OUT OF THE 16 CASES WERE POST SURGICAL PATIENTS WITH INTRABDOMINAL ABSCESSES DUE TO KPC-Kp. IN 5 CASES COMBINED KPC-Kp AND CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII INFECTION WAS ALSO…

Uso combinato di SBT e PFGE quali metodi molecolari per la tipizzazione di stipiti di Legionella pneumophila sierogruppo 1

Long-term course of interferon-treated chronic hepatitis C

Abstract Background/Aims: To evaluate whether sustained response to α-interferon improves clinical outcome in patients with chronic hepatitis C. Methods: A cohort of 410 consecutive patients (65% with chronic hepatitis, 35% with cirrhosis) were treated with α-interferon in two trials (mean follow-up 62.1 months, range 7–109 months). All were serum HCV RNA positive before therapy and received first 10 then 5 million units of α-2b or α-n1 interferon three times weekly for 6 to 12 months. Sustained response was defined as normal aminotransferases 12 months after stopping interferon. Results: Sixty-two patients (15.1%: 54 with chronic hepatitis, eight with cirrhosis) were sustained responders. …

An Update of the Evolving Epidemic of blaKPC Carrying Klebsiella pneumoniae in Sicily, Italy, 2014: Emergence of Multiple Non-ST258 Clones

Background: In Italy, Klebsiella pneumoniae carbapenemase producing K. pneumoniae (KPC-Kp) strains are highly endemic and KPC producing CC258 is reported as the widely predominating clone. In Palermo, Italy, previous reports have confirmed this pattern. However, recent preliminary findings suggest that an epidemiological change is likely ongoing towards a polyclonal KPC-Kp spread. Here we present the results of molecular typing of 94 carbapenem non susceptible K. pneumoniae isolates detected during 2014 in the three different hospitals in Palermo, Italy. Methods and Results: Ninety-four consecutive, non replicate carbapenem non susceptible isolates were identified in the three largest acute…

Role of environmental and genetic factor interaction in age-related disease development: the gastric cancer paradigm.

The association of Helicobacter pylori (Hp) infection with gastric cancer is well known and might be considered a paradigmatic example of the role that interaction among environmental factors and individual background might play in inducing age-associated disease. To evaluate the role of interaction of Hp infection with genetic background, gastric cancer and chronic gastritis patients as well as random selected controls were typed for five inflammation-related polymorphisms of IL-1 and IL-10 cytokine genes. No association among IL-10 or IL-1 variants with an increased risk of gastric cancer was found, whereas an Hp-independent association of IL-1beta -511T positive genotypes to an increased…

Assessing the burden of viral co-infections in acute gastroenteritis in children: An eleven-year-long investigation.

Abstract Background Acute gastroenteritis is an important cause of childhood morbidity and mortality worldwide. A number of pathogens are responsible for human acute gastroenteritis. The recent introduction of syndromic assays for the diagnosis of enteric infections, including a wide panel of enteric pathogens, has unveiled the frequency of mixed infections. This study was carried out to assess the burden of viral co-infections and the genetic diversity of the viruses detected in children hospitalized with acute gastroenteritis in Italy. Methods A total of 4161 stool samples collected from diarrheic children over 11 years, from January 2008 to December 2018, were investigated for the presen…

A combined molecular typing approach does not discriminate Legionella pneumophila serogroup 1 strains of a predominant sequence-based type in Palermo, Italy

Summary: The sequence-based type 1,4,3,1,1,1 of Legionella pneumophila sg.1 is predominant in the Palermo city environment since several years. In this study, extended sequence-based typing and pulsed field gel electrophoresis were used in a combined approach in the aim to enhance discriminatory power of the molecular typing procedures. However, probably due to a common environmental reservoir and genetic stability, most of the strains circulating in the geographic area under study belong to the same clone and are, consequently, indistinguishable by molecular typing. Investigations of clinical cases and tracing to their environmental source require caution and support from sound epidemiolog…

Circolazione di MRSA in età pediatrica in ambiente ospedaliero e in comunità

Introduzione. Negli ultimi anni si è assistito ad un generale incremento e ad una sempre più estesa diffusione, sia in ambito ospedaliero che comunitario, di microrganismi multiresistenti. In assenza ed in attesa di trattamenti farmacologici efficaci maggiore attenzione deve essere impiegata alla realizzazione di strategie di sorveglianza mirate. Il primo isolamento di un ceppo di Staphylococcus aureus meticillinoresistente (MRSA) risale al 1961 e fu seguito da una repentina diffusione negli ospedali di tutto il mondo. Ad oggi MRSA è riconosciuto come uno dei principali agenti responsabili delle infezioni nosocomiali e le percentuali di isolamento variano da Paese in Paese in maniera notevo…

A severe case of Israeli spotted fever with pleural effusion in Italy

Abstract Background The most common Italian rickettsiosis is Mediterranean Spotted Fever (MSF). MSF is commonly associated with a symptom triad consisting of fever, cutaneous rash, and inoculation eschar. The rash is usually maculopapular but, especially in severe presentations, may be petechial. Other typical findings are arthromyalgia and headache. Herein, we describe for the first time an unusual case of Israeli spotted fever (ISF) associated with interstitial pneumonia and pleural effusion in which R. conorii subsp. israelensis was identified by molecular methods in the blood, as well as in the pleural fluid. Case presentation A 72-year-old male presented with a 10-day history of remitt…

Molecular epidemiology of tuberculosis in Sicily, Italy: what has changed after a decade?

Background We aimed to investigate the molecular epidemiology of Mycobacterium tuberculosis complex (MTBC) isolates in the province of Palermo, Sicily, Italy, by characterizing 183 isolates identified in the years 2004-2012. A comparison with 104 MTBC strains identified in the same geographic area in the years 1994-2000 was also carried out. Methods One hundred eighty-three MTBC isolates identified in Palermo, Italy, in the years 2004-2012 were analyzed by spoligotyping and the 24 mycobacterial interspersed repetitive unit (MIRU)-variable-number tandem-repeat (VNTR) method typing. Susceptibility testing to streptomycin, isoniazid, rifampin and ethambutol was also performed. Furthermore, the…

Isolamento di Mycobacterium bolletii e Mycobacterium porcinum da pazienti immuno-compromessi

Role of environmental and genetic factor interaction in the aging related disease development: The gastric cancer paradigm.

Assessment of hepatitis C virus-RNA clearance under combination therapy for hepatitis C virus genotype 1: performance of transcription-mediated amplification assay

Monitoring of HCV-RNA in blood during antiviral therapy is performed mostly by commercially available reverse transcription polymerase chain reaction-based (RT-PCR) assays, with a lower detection limit of 30-50 IU/mL of HCV-RNA. Use of different tests in the pivotal trials of combination therapy has generated some discordance, in terms of predictive value of the early virological response (EVR). To evaluate whether the use of a more sensitive test, as a qualitative assay based on transcription mediated amplification (TMA) with a lower detection limit of 5-10 IU/mL of HCV-RNA, may obtain a better prediction of EVR and of the ultimate virological outcome, we retrospectively evaluated serial s…

A Fatal Bloodstream Infection byStaphylococcus pettenkoferiin an Intensive Care Unit Patient

Coagulase negative staphylococci are increasingly recognized as leading pathogens in bacteremia, with incidence peaking in intensive care units. Interpretation of blood cultures that are positive for CoNS is often doubtful. We describe a fatal case of bacteremia by a newly recognized species of CoNS,Staphylococcus pettenkoferi, in an ICU patient.

Is the monoclonal spread of the ST258, KPC-3-producing clone being replaced in southern Italy by the dissemination of multiple clones of carbapenem-nonsusceptible, KPC-3-producing Klebsiella pneumoniae?

D. M. Geraci, C. Bonura, M. Giuffre, L. Saporito, G. Graziano, A. Aleo, T. Fasciana, F. Di Bernardo, T. Stampone, D. M. Palma and C. Mammina 1) Department of Sciences for Health Promotion and Mother-Child Care ‘G. D’Alessandro’, University of Palermo, 2) Postgraduate Specialty School in Hygiene and Preventive Medicine, University of Palermo, 3) Laboratory of Microbiology, General Hospital ARNAS ‘Civico, Di Cristina & Benfratelli’, 4) Laboratory of Microbiology, General Hospital Azienda Ospedaliera ‘Villa Sofia-V, Cervello’ and 5) II Intensive Care Unit, General Hospital ARNAS ‘Civico, Di Cristina & Benfratelli’, Palermo, Italy

Tipizzazione molecolare di stipiti di Legionella pneumophila sierogruppo 1 isolati a Palermo

Descriptive epidemiology of nasal carriage of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus among patients admitted to two healthcare facilities in Algeria.

Aim: To evaluate nasal carriage rate and variables associated with Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted in two healthcare facilities. Results: S. aureus was isolated from 159 (26%) of the enrolled patients. Methicillin-susceptible S. aureus was isolated from 150 (24.5%) patients, and MRSA was isolated from 9 (1.5%). Cancer and previous hospitalization were associated with a significantly higher frequency of nasal S. aureus carriage among the patients admitted to the general hospital and the nephrology department, respectively. MRSA isolates were heterogeneous with respect to their staphylococcal cassette chromosome mec element (SC…

Polyclonal non multiresistant Staphylococcus aureus isolates from clinical cases of infection occurring in Palermo, Italy, during a one-year surveillance period.

BACKGROUND: The evolving epidemiology of methicillin resistant Staphylococcus aureus (MRSA) is characterized by the emergence of infections caused by non multiresistant MRSA carrying staphylococcal chromosomal cassette (SCC)mec IV or V in the healthcare settings. A molecular epidemiological analysis of non multiresistant MRSA isolates from four acute general hospitals was performed in Palermo, Italy, during a one year period. METHODS: For the purpose of the study, MRSA isolates were defined as non multiresistant when they were susceptible to at least three classes of non beta-lactam antibiotics. Seventy-five isolates were submitted to antimicrobial susceptibility testing, multilocus sequenc…

Enhanced surveillance of invasive listeriosis in the Lombardy region, Italy, in the years 2006-2010 reveals major clones and an increase in serotype 1/2a

Background Invasive listeriosis is a rare, life-threatening foodborne disease. Lombardy, an Italian region accounting for 16% of the total population, reported 55% of all listeriosis cases in the years 2006-2010. The aim of our study was to provide a snapshot of listeriosis epidemiology in this region after the implementation of a voluntary laboratory-based surveillance system. Methods We characterized by serotyping, pulsed-field gel electrophoresis, multilocus sequence typing and detection of epidemic clone markers, 134 isolates from 132 listeriosis cases, including 15 pregnancy-related cases, occurring in the years 2006-2010 in Lombardy. Demographic and clinical characteristics of cases h…

Probable disseminated Mycobacterium abscessus subspecies bolletii infection in a patient with idiopathic CD4+ T lymphocytopenia: a case report.

Abstract Introduction Rapidly growing mycobacteria are opportunistic pathogens in patients with underlying risk factors. Mycobacterium abscessus subsp. bolletii is a newly recognized member of rapidly growing mycobacteria, isolated from respiratory tract and cutaneous infections. Case presentation We describe a case of chronic disseminated infection caused by M. abscessus subsp. bolletii in a 38-year-old Sri Lankan man with idiopathic CD4+ T lymphocytopenia. Idiopathic CD4+ T lymphocytopenia is a rare cause of immunodysfunction that, similar to human immunodeficiency virus infection, causes a depletion of CD4+ T lymphocytes. M. abscessus subsp. bolletii infection was diagnosed by culture is…

MOLECULAR TYPING OF CLINICAL AND ENVIRONMENTAL LEGIONELLA PNEUMOPHILA SEROGROUP 1 ISOLATES IN PALERMO

Sequence-Based-Typing (SBT) ed Amplified Fragment Lenght Polymorphism (AFLP) quali metodi di tipizzazione molecolare di stipiti di Legionella pneumophila sierogruppo 1

Valuation of Human,B-defensin 2 and 3 in sera of Helicobacter pylori infected patients

In recent years, anti-microbial peptides have emerged as a critical component of host innate defense. These peptides are gene-encoded natural antibiotics expressed by immune and non-immune cell types including epithelia. Human beta defensin are disulphide linked, low molecular weight cationic peptides that are known to be a major components of innate immune defense mechanisms at mucosal surfaces. Their expression level differs between those that are constitutively expressed and those that are induced upon challenge with inflammatory or pathogen-derived stimuli. To date six members of the human-β-defensins (hBD1-6) family have been identified. Helicobacter pylori (H. pylori), a pathogenic bu…

High dose of trimethoprim-sulfamethoxazole and daptomycin as a therapeutic option for MRSA endocarditis with large vegetation complicated by embolic stroke: a case report and literature review.

CARATTERIZZAZIONE MOLECOLARE DI STIPITI DI H.PYLORI isolati da soggetti con patologia gastrica

Methicillin-resistant Staphylococcus aureus nasal colonization in a level III neonatal intensive care unit: Incidence and risk factors

Objective: To describe epidemiologic features and identify risk factors for methicillin-resistant Staphylococcus aureus (MRSA) acquisition in a level III neonatal intensive care unit (NICU). Setting: A prospective, cohort study in a university-affiliated NICU with an infection control program including weekly nasal cultures of all neonates. Methods: Demographic, clinical, and microbiologic data were prospectively collected between June 2009 and June 2013. Molecular characterization of MRSA isolates was done by multilocus variable number tandem repeat fingerprinting, staphylococcal cassette chromosome mec typing, and on representative isolates by multilocus sequence typing and s. pa typing. …

In vitro activities of tetracyclines against different clones of multidrug-resistant Acinetobacter baumannii isolates from two Iranian hospitals.

Acinetobacter baumannii has emerged as one of the most challenging healthcare-related pathogens and its occurrence has increased worldwide, especially in patients admitted to intensive care units. A. baumannii isolates are frequently resistant to multiple antimicrobial agents and there are recent reports of isolates resistant to virtually all clinically relevant drugs. In the present study, the in vitro activities of tigecycline, minocycline and doxycycline against 67 MDR-AB isolates recovered from 29 burn and 38 non-burn Iranian patients hospitalised in Tehran and Tabriz, respectively, were studied. Tigecycline and minocycline may be still considered effective therapeutic options for MDR-A…

Methicillin-resistant Staphylococcus aureus colonization: a three-year prospective study in a neonatal intensive care unit in Italy.

Background: Methicillin resistant Staphylococcus aureus (MRSA) is a major etiological agent of infection in neonatal intensive care units (NICUs). Routes of entry of this organism can be different and the transmission pathway complex. Colonized neonates are the main endogenous reservoir. Methods and Results: We conducted a prospective three-year study on MRSA colonization recruiting 722 neonates admitted between 2009 and 2012. Nasal swabs were cultured weekly and MRSA isolates were submitted to molecular typing. The annual incidence density of acquisition of MRSA ranged from a maximum of 20.2 cases for 1000 patient-days during the first year to a minimum of 8.8 cases in the second one to ra…

Helicobacter pylori e genotipi delle citochine IL-1β, IL-1Ra, IL-10 in pazienti con carcinoma gastrico

Cephalosporin resistantEscherichia colifrom cancer patients in Cairo, Egypt

Cephalosporin-resistant Escherichia coli has been increasingly reported worldwide. In this study, 32 cephalosporin resistant E. coli isolates identified from cancer patients in Cairo, Egypt in 2009–2010 were analyzed. Twenty-three were of phylogenetic group D, seven A and one each B1 and B2. By rep-PCR 15 phylogroup D isolates were grouped in four clusters, one with sequence type (ST) 405 and three ST68. Seventeen isolates showed single patterns. blaCTX-M-15 and aac(6')-Ib-cr were the most common resistance determinants. blaOXA-48 and blaVIM were also detected. Multidrug resistant E. coli seriously affects healthcare, especially in immunocompromised hosts, such as cancer patients.

Israeli Spotted Fever in Sicily. Description of two cases and minireview

Mediterranean spotted fever (MSF) is endemic in Italy, where Rickettsia conorii subsp. conorii was thought to be the only pathogenic rickettsia and Rhipicephalus sanguineus the vector and main reservoir. R. conorii subsp. israelensis, which belongs to the R. conorii complex, is the agent of Israeli spotted fever (ISF); apart from Israel, it has also been found in Italy (Sicily and Sardinia) and in different regions of Portugal. We describe here two severe cases of ISF which occurred in otherwise healthy Italian adults. Their characteristics are analyzed and discussed in the light of other 91 cases found through a systematic review of international literature.

tst1-positive ST22-MRSA-IVa in healthy Italian preschool children

A survey was performed in May 2013 to assess methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization in healthy children attending 26 municipal daycare centres in Palermo, Italy. Of the 500 children, ten (2 %) tested positive. Eight MRSA isolates were tst1-positive ST22-MRSA-IVa, spa t223; the other two isolates were identified as ST1-IVa and ST398-V, respectively. tst1-positive ST22-MRSA, spa t223 has been previously identified only in the Middle Eastern area.

LEVELS OF HBD2 AND HBD3 IN PATIENTS INFECTED AND NON-INFECTED BY HELICOBACTER PYLORI

Introduction: Infection with Helicobacter pylori (H. pylori) evokes inflammatory and immune responses of the host, which most likely determine the clinical outcome of H. pylori infection. In the gastric epithelium, expression of human alpha-defensins, beta-defensins (hBD)-1, -2 and -3 has been detected in vivo. In particularly hBD3 as well hBD2 is known to be induced in gastric epithelial cells infection by the H. pylori and may be involved in the pathogenesis of H pylori-associated gastritis, possibly through its function as immune and inflammatory mediator. However, during prolonged infection, hBD3 was subsequently downregulated by the H. pylori virulence determinant CagA. Materials and M…

Stipiti di Klebsiella pneumoniae resistenti ai carbapenemi circolanti in differenti reparti dell'A.O.U.P. "P. Giaccone" di Palermo

Caratterizzazione molecolare di stipiti di H.pylori isolati a Palermo mediante analisi dei motivi EPIYA di CagA

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

We describe polyclonal spread of colistin-resistant Klebsiella pneumoniae in an acute general hospital in Italy. Between June and December 2011, 58 colistin-resistant K. pneumoniae isolates were recovered from 28 patients admitted to different wards, but mainly in the intensive care units. All isolates were tested for drug susceptibility and the presence of beta-lactamase (bla) genes. Clonality was investigated by repetitive extragenic palindromic (rep)-PCR and multilocus sequence typing (MLST). Fifty-two isolates had minimum inhibitory concentrations (MICs) for colistin of 6-128 mg/L, carried blaKPC3 and were attributed to sequence type ST258. The remaining six isolates were susceptible to…

Complete Genome Sequence of KPC-3- and CTX-M-15-Producing Klebsiella pneumoniae Sequence Type 307.

ABSTRACT Klebsiella pneumoniae sequence type (ST) 307, carrying bla KPC-3 , bla CTX-M-15 , bla OXA-1 , aac(6′)-Ib-cr , and qnrB 1 genes, is replacing the predominant hyperepidemic ST258 clone in Italy. Whole-genome and complete plasmid sequencing of one ST307 strain was performed and new features were identified.

Induction of IL-8 production by H.pylori strains with different cagA genotype and oipA functional status

TIPIZZAZIONE MOLECOLARE DI STIPITI DI L.pneumophila SIEROGRUPPO 1 ISOLATI DA CAMPIONI CLINICI ED AMBIENTALI

Analisi dei motivi EPIYA di CagA in campioni bioptici di soggetti con patologia gastrica H.pylori-correlata

Epidemic spread of ST1-MRSA-IVa in a neonatal intensive care unit, Italy

Abstract Background Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has recently emerged as an important pathogen in neonatal intensive care units (NICUs). The purposes of this study were to characterize methicillin-resistant isolates from an outbreak in a NICU, to examine the genetic traits and clonality of CA-MRSA, and to review the characteristics and outcomes of the neonatal cases and investigate the routes of entry and transmission of the MRSA outbreak strain in the NICU under study. Methods The study NICU practiced an active surveillance program for multidrug-resistant organisms, including weekly cultures for detection of MRSA from nasal swabs among all the …

NDM-1 and OXA-163 producing Klebsiella pneumoniae isolates in Cairo, Egypt, 2012

Here we describe carbapenem resistance determinants in two Klebsiella pneumoniae isolates recovered from two hospitalised patients in the same intensive care unit of a cancer hospital in Cairo, Egypt. PCR and sequencing were used to detect and characterise β-lactamase genes. Clonal relationships between the isolates were analysed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). The first K. pneumoniae isolate carried the blaNDM-1 gene and the second isolate carried the blaOXA-163 gene. Both isolates co-expressed the extended-spectrum β-lactamase CTX-M-15. The two isolates belonged to different sequence types (STs), ST11 and ST16, respectively. No history of …

The role of a monthly active surveillance programme for multidrug-resistant Gram-negative bacteria in a neonatal intensive care unit: impact evaluation of preventive measures

Background: Antimicrobial resistance is a public health threat. Neonatal Intensive Care Unit (NICU) patients are particularly at risk, due to the large use of invasive devices and antimicrobial treatment. Since 2014 an active surveillance program of multidrug-resistant organisms is in place in the five NICUs of Palermo, Italy. High prevalence of multidrug-resistant Gram-negative bacteria (MDR-GNB) carriage observed in one NICU suggested the need of a long-lasting approach to achieve effective control of MDR-GNB circulation. Materials/methods: Rectal swabs were obtained every month from each hospitalized new-born. Samples were enriched in liquid cultures, plated in McConkey Agar with three a…

Sorveglianza della nuova influenza H1N1 in Sicilia

The Increasing Challenge of Multidrug-Resistant Gram-Negative Bacilli: Results of a 5-Year Active Surveillance Program in a Neonatal Intensive Care Unit

Colonization and infection by multidrug-resistant gram-negative bacilli (MDR GNB) in neonatal intensive care units (NICUs) are increasingly reported.We conducted a 5-year prospective cohort surveillance study in a tertiary NICU of the hospital "Paolo Giaccone," Palermo, Italy. Our objectives were to describe incidence and trends of MDR GNB colonization and the characteristics of the most prevalent organisms and to identify the risk factors for colonization. Demographic, clinical, and microbiological data were prospectively collected. Active surveillance cultures (ASCs) were obtained weekly. Clusters of colonization by extended spectrum β-lactamase (ESBL) producing Escherichia coli and Klebs…

OXA-48-producing Klebsiella pneumoniae in a neonatal intensive care unit in Palermo, Italy

Objectives Surveillance cultures are of great importance to detect the emergence of multidrug resistant (MDR) bacteria in high-risk settings and prevent the occurrence of colonization and clinical infection cases. We report the isolation of OXA-48-harbouring Klebsiella pneumoniae sequence type (ST) 530 in a Neonatal Intensive Care Unit (NICU) in Palermo, Italy. Methods Since June 2009, a routine surveillance protocol is in place in the NICU of the University Hospital of Palermo, including nasal and rectal swabs obtained on a weekly basis to monitor the prevalence of colonization by methicillin- resistant Staphylococcus aureus, MDR Gram-negatives and glycopeptide-resistant enterococci. Enter…

Tipizzazione molecolare di stipiti di L.pneumophila sierogruppo1 isolati a Palermo

Efficacy of a coordinated strategy for containment of multidrug-resistant Gram-negative bacteria carriage in a Neonatal Intensive Care Unit in the context of an active surveillance program

AbstractBackgroundAntimicrobial resistance in neonatal intensive care unit (NICU) patients is a threat, due to the frequent use of antimicrobial treatment and invasive devices in fragile babies. Since 2014 an active surveillance program of multidrug-resistant Gram-negative bacteria (MDR-GNB) carriage has been in place in the five NICUs of Palermo, Italy. In 2017 an increase in the prevalence of MDR-GNB, and in particular of extended-spectrum β-lactamases-producingKlebsiella pneumoniae(ESBL-KP), was observed in “Civico” hospital NICU.AimTo assess the impact of a coordinated intervention strategy in achieving long-lasting reduction of MDR-GNB prevalence in the NICU.MethodsRectal swabs were ob…

Isolamento e tipizzazione di stipiti di Dipodascus capitatus: patogeno opportunista emergente

L’incidenza delle infezioni micotiche ha subito negli ultimi decenni un incremento rilevante, sia in ambito ospedaliero che comunitario. In ambiente ospedaliero il problema sta assumendo dimensioni preoccupanti poiché, sebbene Candida spp. si debba considerare il principale responsabile di infezioni correlate ai miceti, emergono altre specie il cui ruolo deve essere accertato. In particolare Dipodascus capitatus, forma teleomorfica di Geotrichum capitatum, microrganismo che può risiedere nel suolo, sulla pelle e nel tratto respiratorio e gastroenterico, nel passato considerato un contaminate o un innocuo colonizzatore, da qualche anno è stato associato ad infezioni soprattutto nei pazienti …

Colonizzazione da Staphylococcus Aureus Meticillino-Resistente (MRSA) in epoca di vita neonatale nell’U.O. Neonatologia e TIN dell’AOUP “P.Giaccone” di Palermo nel periodo 2009 - 2015

Colonizzazione, MRSA, UTIN

Characterization of MRSA from Palermo, Italy, and description of prevalent clones

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

Abstract Background Multidrug-resistant Acinetobacter baumannii, initially considered as having a poor clinical relevance, is frequently isolated from infection cases in intensive care units. We describe the epidemiology of carbapenem resistant A. baumannii (CRAB) in a general ICU in Palermo, Italy, from October 2010 to March 2011. Findings 58 of 61 isolates exhibited MICs for meropenem or imipenem ≥16 mg/L. Forty-nine carried blaOXA-23 and two blaOXA-58 genes. Five subtype clusters were detected by rep-PCR. Clusters D and E included 10 isolates that tested negative for the carbapenem resistance genes. MLST attributed all isolates, but two, with sequence type (ST)2, whereas the two remainin…

MRSA infection in the neonatal intensive care unit

Methicillin-resistant Staphylococcus aureus (MRSA) is well known as one of the most frequent etiological agents of healthcare-associated infections. The epidemiology of MRSA is evolving with emergence of community-associated MRSA, the clonal spread of some successful clones, their spillover into healthcare settings and acquisition of antibacterial drug resistances. Neonatal intensive care unit (NICU) patients are at an especially high risk of acquiring colonization and infection by MRSA. Epidemiology of MRSA in NICU can be very complex because outbreaks can overlap endemic circulation and make it difficult to trace transmission routes. Moreover, increasing prevalence of community-associated…

Colonization of pressure ulcers by multidrug-resistant microorganisms in patients receiving home care

Colonization and/or infection with multidrug-resistant microorganisms (MDRO) of pressure ulcers in patients receiving care at home have seldom been investigated. The objective of this study was to assess the prevalence of MDRO colonization in pressure ulcers of patients receiving home care in Palermo, Italy. Vancomycin-resistant Enterococcus (VRE), methicillinresistant Staphylococcus aureus (MRSA), and multidrug-resistant Gram-negative bacilli (MDRGN) were isolated, identifi ed, and characterized from pressure ulcers and selected home environment surfaces. Thirty-two patients were enrolled, of whom 12 were under antimicrobial therapy. Five patients had been admitted to hospital in the prece…