Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population.

Background Infective endocarditis (IE) is an uncommon disease with an involved interplay of clinical and surgical team management. We aimed to define diagnosis parameters and delineate in-hospital management in patients with IE admitted in a tertiary hospital of Southern Italian. Materials and methods Fifty-six consecutive patients (42 males, 14 females; age range: 34-85 years) admitted for IE in the Infectious Diseases, Cardiac Surgery, and Cardiology units, between January 2011 and August 2017, were enrolled. Demographic data, mortality, comorbidities, specimen type, microscopy results, special histological staining performed, and antimicrobial therapy were collected and analyzed. Any com…

Behavioral and clinical characteristics of people receiving medical care for HIV infection in an outpatient facility in Sicily, Italy

Paola Di Carlo,1 Giuliana Guadagnino,1 Palmira Immordino,1 Giovanni Mazzola,2 Pietro Colletti,2 Ilenia Alongi,1 Lucia Adamoli,1 Francesco Vitale,1 Alessandra Casuccio1 1Department of Sciences for Health Promotion and Mother-Child Care “G D’Alessandro”, University of Palermo, 2Department of Medicinal Clinics and Emerging Diseases, “Paolo Giaccone” Polyclinic University Hospital, Palermo, Italy Aim: The authors examined a cohort of HIV-positive outpatients at the AIDS Center of Palermo University in Italy in order to identify factors related to the frequency of their visits to the outpatient facility for health care services.Methods: Two hundr…

Colonizzazione da gram negativi multiresistenti produttori di beta-lattamasi ad ampio spettro (ESBL) in una UTIN.

Two cases of monomicrobial intraabdominal abscesses due to KPC - 3 Klebsiella pneumoniaeST258 clone

Abstract Background Knowledge of the etiology of pyogenic liver and pancreatic abscesses is an important factor in determining the success of combined surgical and antibiotic treatment. Literature shows geographical variations in the prevalence and distribution of causative organisms, and the spread of Klebsiella pneumoniae carbapenemase-producing bacteria is an emerging cause of abdominal infections. Case presentation We herein describe two cases of intra-abdominal abscesses due to monomicrobial infection by Klebsiella pneumoniae Sequence Type 258 producing K. pneumoniae carbapenemase 3 (KPC-Kp). In case 1, a 50-year-old HIV-negative Italian woman with chronic pancreatitis showed infection…

Socio-Demographic Characteristics and Sexual Behavioral Factors of Patients with Sexually Transmitted Infections Attending a Hospital in Southern Italy

Sexually transmitted infections (STIs) are a serious global health problem. In Italy, data describing the vulnerability to STIs of specific sexual minorities and the influence of sociodemographic and behavioral determinants are limited, as most infections are not subject to mandatory notification. This retrospective study describes the sociodemographic profile and main sexual behaviors of patients attending a hospital in Palermo (Sicily, Italy) from January 2018 to March 2019 as predictors of STI risk. Patients were divided in subgroups: men-who-have-sex-with-men (MSM), men-who-have-sex-with-women (MSW), bisexual men and females. Data were obtained through an anonymous questionnaire. Patien…

Bone Mineral Status in HIV infected Patients in Mediterranean Region: Preliminary Data

Diagnosis of congenital toxoplasmosis: pre-and post-natal evaluation in Sicilian (Italy) epidemiological area. Preliminary data.

Acalculous cholecystitis in a patient with plasmodium falciparum malaria and cytomegalovirus infection

Acalculous cholecystitis is a syndrome of gallbladder inflammation without gallstones, recognized within the setting of critically ill patients. Acalculous cholecystitis associated with infectious agents is reported in the literature to be rare. Herein we describe a case of acalculous cholecystitis in a patient with malaria caused by Plasmodium falciparum and apparent cytomegalovirus infection, and discuss the possible role of CMV in the pathogenesis of acalculous cholecystitis in patients with malaria.

Un caso di infezione da Geotrichum capitatum

Tuberculosis evolution and climate change: How much work is ahead?

Impact of Mycobacterium tuberculosis Infection on Human B Cell Compartment and Antibody Responses

Tuberculosis (TB) remains one of the most important health challenges worldwide. Control of the TB epidemic has not yet been achieved because of the lack of an effective vaccine and rapid and sensitive diagnostic approaches, as well as the emergence of drug-resistant forms of M. tuberculosis. Cellular immunity has a pivotal role against M. tuberculosis infection, but the role of humoral immunity is still controversial. We analyzed the frequency, absolute counts, and phenotypic and functional subsets of B lymphocytes in the peripheral blood of patients with active TB and subjects with latent infection compared to healthy donors. Moreover, we analyzed serum levels of total Ig and their IgA, I…

Caratteristiche epidemiologiche dell’Infezione da virus respiratorio sinciziale in Sicilia: dati preliminari su una casistica di infettivologia pediatrica

Preliminary evaluation of renal function in HIV naïve patients

Valutazione del ruolo della cross-trasmissione nella colonizzazione endemica da Gram negativi multiresistenti in una Unità di Terapia Intensiva Neonatale; IX Conferenza Nazionale di Sanità Pubblica, Parma, 13-15 ottobre 2005;

Neuroimmaging in childhood central nervous system tuberculosis

Spread of a new MBL-producing strain of Pseudomonas aeruginosa in NICU during microbiological surbeillance in 2003

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…

Multimodal surgical and medical treatment for extensive rhinocerebral mucormycosis in an elderly diabetic patient: a case report and literature review

Diabetes is a well-known risk factor for invasive mucormycosis with rhinocerebral involvement. Acute necrosis of the maxilla is seldom seen and extensive facial bone involvement is rare in patients with rhino-orbital-cerebral mucormycosis. An aggressive surgical approach combined with antifungal therapy is usually necessary. In this report, we describe the successful, personalized medical and surgical management of extensive periorbital mucormycosis in an elderly diabetic, HIV-negative woman. Mono- or combination therapy with liposomal amphotericin B (L-AmB) and posaconazole (PSO) and withheld debridement is discussed. The role of aesthetic plastic surgery to preserve the patient’s physical…

Diffusion modeling of COVID-19 under lockdown

Viral immune evasion by sequence variation is a significant barrier to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine design and coronavirus disease-2019 diffusion under lockdown are unpredictable with subsequent waves. Our group has developed a computational model rooted in physics to address this challenge, aiming to predict the fitness landscape of SARS-CoV-2 diffusion using a variant of the bidimensional Ising model (2DIMV) connected seasonally. The 2DIMV works in a closed system composed of limited interaction subjects and conditioned by only temperature changes. Markov chain Monte Carlo method shows that an increase in temperature implicates reduced virus diffusi…

Histopathologic diagnosis in the era of new and old yeast infections in critical ill surgical patients

Several antifungals are currently available for management of invasive fungal infections (IFI), but this exacerbating infectious disease still presents difficulties, especially in the case of opportunistic infection occurring in individuals with seriously impaired defense mechanisms or in multimorbid patients. Patients who undergo complex surgical procedures with or without immunosuppressive therapy are at increased risk for invasive fungal infections. Supplemental procedures for diagnosis, such as indirect monitoring of pathophysiology of the infection, have become a more important and practical way for management of the disease. In this regard, histopathologic and/or cytopathologic examin…

Occult Hepatitis B Infection (OBI)in HIV-Infected Patients in Palermo: Preliminary data

T-Cell Subsets (TCM, TEM, TEMRA) and Poly-Functional Immune Response in Patients with Human Immunodeficiency Virus (HIV) Infection and Different T-CD4 Cell Response

OBJECTIVE: Dynamic changes of cytotoxic T cell responses against Human Immunodeficiency Virus 1 (HIV-1) infection have been the subject of an innovative investigation using antiretroviral therapy (ART). Currently, human CD8 naïve central memory (TCM), effector memory (TEM), and effector memory cells re-expressing CD45RA (TEMRA) T-cells have been thoroughly studied with ART. CD45RA is a marker usually found on naïve T-cells. MATERIALS AND METHODS: We performed a longitudinal study of mono-/polyfunctional T-cells in the peripheral blood while targeting three functionally distinct cell populations of CD4+ and CD8+ T-cells (single IL2 and IFN-γ, dual IL2/IFN-γ) in 50 HIV-1 patients. These patie…

Selective depression of interferon-γ and granulysin production with increase of proliferative response by Vγ9/Vδ2 T cells in children with tuberculosis

Vgamma9/Vdelta2 T cells can contribute to protective immune response against Mycobacterium tuberculosis, although the extent to which and mechanisms by which they could actually protect against human tuberculosis remain unclear. We have previously reported that Vgamma9/Vdelta2 T cells from tuberculin purified protein derivative (PPD)-positive children, either healthy or affected by different clinical forms of tuberculosis, strongly proliferate to different phosphoantigens in vitro, whereas Vgamma9/Vdelta2 T cells from PPD-negative healthy subjects proliferate very poorly. We report here that Vgamma9/Vdelta2 T cells from tuberculous children have an increased proliferative activity, but decr…

Pustular lesions and itching in a couple of young migrants

Two teenage illegal migrants from Bangladesh coming from a Libyan port arrived at Lampedusa Island-Italy. The health authorities, having noticed the presence of pustules on the limbs and genitals, suspecting a monkeypox virus infection, have urgently transferred them to the University Hospital of Palermo. They mentioned itching and prior sexual contact. On inspection, itching lesions and pustular lesions with central crusted umbilication and erythematous bases were detected. One of them had also fever and increased c-reactive protein. A real-time polymerase chain reaction assay on vesicle swabs to research monkeypoxvirus DNA and HIV serology was performed for both patients.

PREVALENCE OF HEPATIC STEATOSIS AND ITS RELATIONSHIP WITH CARDIOVASCULAR RISK IN HIV-PATIENTS WITH OR WITHOUT HCV CO-INFECTION

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...

Anti-16-kilodalton mycobacterial protein immunoglobulin M levels in healthy but purified protein derivative-reactive children decrease after chemoprophylaxis.

ABSTRACT Serum responses against Mycobacterium tuberculosis HSP16 were determined for children with tuberculosis (TB) and for healthy purified protein derivative (PPD)-positive and PPD-negative children. Immunoglobulin G (IgG) and IgM responses were higher for TB patients than for other groups. After chemotherapy, IgM and IgG responses decreased for TB patients and PPD-positive subjects. Monitoring of anti- M. tuberculosis HSP16 responses could assist in the management of pediatric TB.

Assunzione di calcio e fattori di rischio comportamentali per la perdita di massa ossea in soggetti con o senza infezione da HIV residenti in un'area del Mediterraneo

Steatosi epatica (SE) e rischio cardiovascolare in una popolazione di pazienti HIV-positivi

Epidemiology and Pattern of Resistance of Gram-Negative Bacteria Isolated from Blood Samples in Hospitalized Patients: A Single Center Retrospective Analysis from Southern Italy

Background: Blood culturing remains the mainstream tool to inform an appropriate treatment in hospital-acquired bloodstream infections and to diagnose any bacteremia. Methods: A retrospective investigation on the prevalence of Gram-negative bacteria (GNB) and their resistance in hospitalized patients by age, sex, and units from blood cultures (BCs) was conducted from January 2018 to April 2020 at Sant’Elia hospital, Caltanissetta, southern Italy. We divided the patient age range into four equal intervals. Results: Multivariate demographic and microbiological variables did not show an association between bacteria distributions and gender and age. The distribution by units showed a higher pre…

Visceral leishmaniasis, hypertriglyceridemia and secondary hemophagocytic lymphohistiocytosis

cytokines, an upregulation of adhesion molecules and MHC I and II molecules on mono/macrophages, and an expansion of inflammatory monocytes. This exaggerated inflammatory response is responsible for necrosis and organ failure and results in uncontrolled proliferation and phagocytic activity of histiocytes [2]. Hypertriglyceridemia (fasting, greater than or equal to 265 mg/100 ml) is one of the current diagnostic criteria for HLH [2]. Several studies link hypertriglyceridemia to inhibition of lipoprotein lipase (LPL) by tumor necrosis factor-α (TNF-α), and TNF-α is a powerful autocrine and paracrine regulator of adipose tissue [3]. Indeed, many different sources of intense and prolonged T-ly…

Human CD8 T lymphocytes recognize Mycobacterium tuberculosis antigens presented by HLA-E during active tuberculosis and express type 2 cytokines

CD8 T cells contribute to protective immunity against Mycobacterium tuberculosis. In humans, M. tuberculosis reactive CD8 T cells typically recognize peptides associated to classical MHC class Ia molecules, but little information is available on CD8 T cells recognizing M. tuberculosis Ags presented by nonclassical MHC class Ib molecules. We show here that CD8 T cells from tuberculosis (TB) patients recognize HLA-E-binding M. tuberculosis peptides in a CD3/TCR αβ mediated and CD8-dependent manner, and represent an additional type of effector cells playing a role in immune response to M. tuberculosis during active infection. HLA-E-restricted recognition of M. tuberculosis peptides is detectab…

Chancre of the eyelid as manifestation of primary syphilis, and precocious chorioretinitis and uveitis in an HIV-infected patient: a case report

Abstract Background Ocular syphilis is often difficult to diagnose because of the wide variation in clinical features. HIV co-infection may further complicate the picture. Case presentation Herein the authors report an unusual primary syphilitic ocular lesion in a 45-year-old Italian HIV-infected bisexual man who presented with a unilateral eyelid lesion. Associated precocious signs and symptoms in the posterior segment of both eyes, bilateral chorioretinitis and uveitis, are described. Intravenous penicillin and steroid treatment produced a rapid improvement in clinical status and complete resolution. Conclusions Careful questioning about sexual behavior is crucial for unmasking unusual fe…

Liver disease severity and low bone mineral density in HIV mono-infected and HIV/HCV co-infected patients

Background: In this study we assess: prevalence of osteopenia, osteoporosis and reduced bone mineral density in HIV infection and HIV / HCV co-infection;risk factors associated with reduced bone mineral density(BMD); relationship between bone mineral density and reduced liver fibrosis (FE) measured as "liver stiffness" (LS), by FibroScan ® in patients co-infected with HIV / HCV; relationship between reduced bone mineral density and cardiovascular risk assessed with the 10-year Framingham risk score (FRS) in HIV / HCV co-infected Patients And Methods: One hundred and ninety-four HIV-infected subjects (121 males =62% and 73 females = 38 %): 129 HIV-infected ( 66.5 % ) and 65 HIV / HCV co-infe…

Cystic hydatidosis: a rare case of spine localization.

Children, parents and Respiratory Syncytial Virus in Palermo, Italy: prevention is primary.

A study was conducted to describe the characteristics of the Respiratory Syncytial Virus (RSV) infection cases occurring in the season 2006—7 in Palermo, Italy, and to evaluate the parents’ knowledge and behaviours concerning prevention and control of acute respiratory infections (ARIs). All children aged between 0 and 2 years, admitted for a lower respiratory tract infection (LRTI) between October 2006 and May 2007, were enrolled in the study. Data were collected about demographic and household characteristics. Furthermore, their parents were asked to compile a structured questionnaire on transmission, prevention and management of ARIs in children. A total of 198 children with a diagnosis…

Quantitative and qualitative profiles of circulating monocytes may help identifying tuberculosis infection and disease stages

Tuberculosis (TB) is one of the most important cause of morbidity and death among infectious diseases, and continuous efforts are needed to improve diagnostic tools and therapy. Previous published studies showed that the absolute cells number of monocytes or lymphocytes in peripheral blood or yet the ratio of monocytes to lymphocytes displayed the ability to predict the risk of active TB. In the present study we evaluated the ratio of monocytes to lymphocytes variation and we also analyzed the ex-vivo expression of CD64 on monocytes as tools to identify biomarkers for discriminating TB stages. Significant differences were found when the average ratio of monocytes to lymphocytes of active TB…

An overview of the role of T cells in controlling tuberculosis infection in a pediatric population

The most significant immunological studies of tuberculosis (TB) infection have involved adult patients. Few studies about the immune repertoire have been conducted in children. The purpose of this paper is to focus on cellular immune response to Mycobacterium tuberculosis by reviewing our studies conducted on children with different forms of TB infection between 1998 and 2006. Although the gold standard of TB diagnosis remains isolation of TB bacillus that also allows estimation of pattern of resistance of M. tuberculosis, the study of immune response can be useful for the early diagnosis and therapeutic follow-up of pediatric TB.

Materno-fetal Toxoplasma gondii infection: critical review of available diagnotic methods

Epidemiological assessment of Respiratory Syncytial Virus infection in hospitalized infants, during the season 2005–2006 in Palermo, Italy

Abstract Objectives Respiratory Syncytial Virus (RSV) is the leading cause of hospitalization for lower respiratory tract infections (LRTI) in young children worldwide. We evaluate the epidemiological and clinical patterns of RSV infection in infants hospitalized for LRTI in in Palermo, South Italy, Sicily. Methods We collected the demographic details of infants hospitalized to G. Di Cristina Children's Hospital in Palermo for LRTI between November 2005 and May 2006. We also included all cases occurred in newborns hospitalized in the Neonatal Intensive Care Unit (NICU) Of Palermo. Results During the studied period, 335/705 hospitalized infants for LRTI were enrolled in the study. The trend …

Applicazione della PFGE nella sorveglianza da gram negativi multiresistenti in UTIN”, I Congresso Nazionale SIMPIOS; Bergamo, 20-22 maggio 2004

Candida parapsilosis Infection:A Multilocus Microsatellite Genotyping-Based Survey Demonstrating an Outbreak in Hospitalized Patients

Microsatellite analysis identifies specific genotypes and the genetic relationship between strains. Our objective was to analyze the genotypes of C. parapsilosis strains isolated on different wards of aTertiary- Referral University Center. We evaluated 70 C. parapsilosis strains in total, isolated from samples of patients admitted to five different wards over two years (January 2015-December 2016). Eight microsatellite markers were selected, and two multiplex PCR assays were set up for microsatellite analysis. The 70 strains, examined at eight microsatellite loci, showed 46 different multilocus genotypes profiles. A total of 74 alleles were detected, with an average of 9.25 alleles per locu…

Prevalence and risk factors for advanced liver fibrosis in HIV/HCV-coinfected individuals

Tuberculosis of the central nervous system in children: 32 years survey.

Aim. In order to study the impact of clinical and diagnostic parameters on the clinical outcome of children with central nervous system tuberculosis (CNS-TB), we retrospectively reviewed all cases of CNS-TB diagnosed over a 32-year period at the Children's Hospital of Palermo, Italy. Methods. Data were collected with regard to the clinical, laboratory and demographic characteristics of patients, as well as the results of radiological investigations and data on clinical outcome. In relation to the date of introduction of new diagnostic methods (indirect as well direct) and to the change of treatment periods, the authors compared the clinical outcome of patients admitted prior and after 1984.…

Determinants of patient and health-care system delay in the diagnosis of tuberculosis in Sicily

tuberculosis, health-care system, diagnosis

DETECTION OF A NEW VIM TYPE METALLO-BETA-LACTAMASE (VIM 11) IN A PSEUDOMONAS AERUGINOSA CLINICAL ISOLATE FROM ITALY

Lymphocyte apoptosis in children with central nervous system tuberculosis: a case control study

Abstract Background Studies of the apoptosis mechanisms involved in the pathogenesis of tuberculosis have suggested that Mycobacterium tuberculosis can actively interfere with the apoptosis of infected cells. In vivo studies have been performed in adult populations but have not focused on this process in children. In the present study, we analyzed spontaneous T lymphocyte (PBT) apoptosis in the peripheral blood of children with central nervous system tuberculosis (CNS TB), before and after chemotherapy, and compared the results with healthy controls. Methods A case-control study was conducted from January 2002 to June 2009. It included 18 children with CNS TB and 17 healthy controls. Sponta…

Determinants of HIV outpatient service utilization according to HIV parameters

Introduction : The increased life expectancy of HIV patients in the era of highly active antiretroviral therapy has had profound consequences for the healthcare systems that provide their care. It is useful to assess whether healthcare resources need to be adapted to the different stages of HIV infection or to patient characteristics [1]. To study how patient features influence utilization of out patient services, we retrospectively analyzed the electronic health record of HIV-positive patients who had followed day-care programs at the AIDS Center of the University of Palermo, Italy. Materials and Methods : 223 HIV-infected subjects were recruited and divided into two groups according to CD…

HLA-E-Restricted CD8+ T Lymphocytes Efficiently Control Mycobacterium tuberculosis and HIV-1 Co-Infection

We investigated the contribution of human leukocyte antigen A2 (HLA-A2) and HLA-E-restricted CD8+ T cells in patients with Mycobacterium tuberculosis and human immunodeficiency virus 1 (HIV-1) coinfection. HIV-1 downregulates HLA-A, -B, and -C molecules in infected cells, thus influencing recognition by HLA class I-restricted CD8+ T cells but not by HLA-E-restricted CD8+ T cells, owing to the inability of the virus to downmodulate their expression. Therefore, antigen-specific HLA-E-restricted CD8+ T cells could play a protective role in Mycobacterium tuberculosis and HIV-1 coinfection. HLA-E- and HLA-A2-restricted Mycobacterium tuberculosis-specific CD8+ T cells were tested in vitro for cyt…

Pulmonary tuberculosis in Italian children by age at presentation

Biliary microbiota in pancreatic cancer

The most common microorganisms were Pseudomonas spp. (P < 0.0001) and E. coli (P < 0.0001), which were negatively correlated to PDAC and positively correlated to cholangiocarcinoma by both univariate and multivariate analysis. Gram-negative bacteria are linked to a tumor-associated inflammatory status

La granulisina nella malattia tubercolare: considerazioni su una casistica pediatrica.

Infezione materno-fetale da toxoplasma gondii: analisi critica della diagnosi pre e post-natale

Un caso di linfoma cardiaco primitivo in paziente HIV-NAIVE

Climate change engenders a better Early Warning System development across Sub-Saharan Africa: The malaria case

It is expected that diseases are likely to spread to newer areas, and high-income countries may experience some illnesses that may have been restricted to low or middle-income countries. In addition, following the Intergovernmental Panel on Climate Change, the present study noted that climate change is likely to have many effects on the spatial and temporal distribution of malaria in many Sub-Saharan African countries. This study examines climate change effects on the geographical distribution of malaria occurrence and how extreme climatic events may perhaps be determining factors in the range of vectors for human diseases in SSA in the nearest future. Here, the study appraisals the symbiot…

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…

INFEZIONE POLMONARE DA BLASTOSCHIZOMICES CAPITATUS

Geotrichum capitatum, now known as Blastoschizomyces capitatus, can be responsible for several opportunistic infections (systemic infection or localized at lungs, liver, kidney, encephalitis or meningitis) in an immunocompromised host, especially in those patients affected by leukaemia or under immunosuppressive therapies. A 66-year-old woman with polimyosite under steroid and immunosuppressant therapy was hospitalized in ICU for an acute respiratory distress with moderate hypoxaemia and normocapnia. Pulmonary X-ray revealed a bilateral pneumonia. Hypoxaemia became severe 48 hours later and the patient underwent mechanical ventilation and empirical antibiotic therapy. Blood cultures, urine …

KPC-3 Klebsiella pneumoniae ST258 clone infection in postoperative abdominal surgery patients in an intensive care setting: analysis of a case series of 30 patients

Objective: We studied the clinical course, Intensive Care Unit (ICU) and hospital outcomes of 30 postoperative abdominal surgery patients who showed severe infections caused by Klebsiella pneumoniae Sequence Type 258 producing K. pneumoniae carbapenemase 3 (KPC-Kp). Methods: Patients with at least two positive blood cultures for KPC-Kp after admission to the ICU were recruited for a 12-month period and treated with a combination regimen of colistin plus tigecycline. They were started on a high-dose (initial dose of 200 mg then 100 q12) of tigecycline combined with colistin, taking into account intra-abdominal abscess severity and MCIs for tigecycline. Results: The average age of the patient…

KPC - 3 Klebsiella pneumoniae ST258 clone infection in postoperative abdominal surgery patients in an intensive care setting: analysis of a case series of 30 patients.

Background: Abdominal surgery carries significant morbidity and mortality, which is in turn associated with an enormous use of healthcare resources. We describe the clinical course of 30 Intensive Care Unit (ICU) patients who underwent abdominal surgery and showed severe infections caused by Klebsiella pneumoniae sequence type (ST) 258 producing K. pneumoniae carbapenemase (KPC-Kp). The aim was to evaluate risk factors for mortality and the impact of a combination therapy of colistin plus recommended regimen or higher dosage of tigecycline. Methods: A prospective assessment of severe monomicrobial KPC-Kp infections occurring after open abdominal surgery carried out from August 2011 to Augus…

Low bone mineral density in HIV-positive young Italians and migrants.

Background Human immunodeficiency virus (HIV) infected individuals may have osteoporosis. We aimed to evaluate the bone mineral density (BMD) in naïve antiretroviral (ARV) treated HIV positive patients comparing native Italian group (ItG) to a Migrants group (MiG) upon arrival in Italy. Methods We conducted a cross-sectional study on 83 HIV patients less than 50 years old. We used the dual-energy X-ray absorptiometry (DXA) within six months from the HIV diagnosis. Participants were categorized as having low BMD if the femoral neck or total lumbar spine Z-score was– 2 or less. Results MiG showed low BMD more often than ItG (37.5% vs.13.6%), especially for the female gender (16.7% vs. 0.0%). …

When Climate Turns Nasty, What Are Recent and Future Implications? Ecological and Human Health Review of Climate Change Impacts

Purpose of Review: The impacts of climate change on biodiversity in the last three decades have increasingly assumed from significant to threatening proportions and this causes major global concerns. This study aims at examining the recent and future impacts of global climate change on both ecological resources and human well-being. This review study is based on the general concept of ecological resilience: that coping with climate change stresses and disturbances depends on social resilience, political and environmental strategies accessible in a community. The study assessed over 300 peer-reviewed publications, both articles and books, which linked climate change impacts on ecosystems to …

REVISITING ANTHROPOZOONOSES IN THE MEDITERRANEAN BASIN. A SINGLE-CENTRE PERSPECTIVE. A SOUTHERN ITALIAN EXPERIENCE

Zoonoses, often better defined with the term anthropozoonoses, are diseases that can be transmitted to humans either by direct contact with animals or through arthropod vector intervention. Microbial interaction between humans and animals constitutes an important public health challenge, particularly in the Mediterranean basin. The main reasons this challenge is still relevant today include the phenomenon of migration, of both humans and animals, and climate change, which tend to alter the geographical distribution of zoonosis or the zoonotic agent, as well as the distribution range of potential vectors. The Mediterranean area seems to be affected by plentiful and widely distributed zoonose…

Mycobacterium tuberculosis Drives Expansion of Low-Density Neutrophils Equipped With Regulatory Activities

In human tuberculosis (TB) neutrophils represent the most commonly infected phagocyte but their role in protection and pathology is highly contradictory. Moreover, a subset of low-density neutrophils (LDNs) has been identified in TB, but their functions remain unclear. Here, we have analyzed total neutrophils and their low-density and normal-density (NDNs) subsets in patients with active TB disease, in terms of frequency, phenotype, functional features, and gene expression signature. Full-blood counts from Healthy Donors (H.D.), Latent TB infected, active TB, and cured TB patients were performed. Frequency, phenotype, burst activity, and suppressor T cell activity of the two different subse…

Post-bronchoscopy fatal endobronchial hemorrhage in a woman with bronchopulmonary mucormycosis: a case report

Abstract Introduction During infection, Mucorales fungi invade major blood vessels, leading to extensive necrosis, and in cases of extensive pulmonary disease, bleeding into the lungs may occur. Case presentation We report an unexpected event of post-bronchoscopy fatal endobronchial hemorrhage in a 62-year-old HIV-negative Italian woman with well controlled diabetes mellitus who presented with diffuse cavitated pulmonary lesions. Fiberoptic bronchoscopy revealed bilateral obstruction of the segmental bronchi. Fatal massive bleeding occurred after standard biopsy procedures. Histologic examination showed that the hyphae were more deeply colored by hematoxylin-eosin (H&E) than by other stains…

Follow-up post natale in nati da madre con infezione certa da Toxoplasma gondii considerazioni sul management prenatale.

The clinical management of perinatal toxoplasmosis involves a gynaecologist during pregnancy and a neonatologist after delivery. Then, in the absence of a uniform approach, early evaluation of infected infants requires a thorough long-term follow-up also in asymptomatic children, who have to be observed for at least one year due to unpredictable sequelae in later life. We retrospectively analyzed pregnancy management of 54 women with certain infection from Toxoplasma gondii (TG) and prospectively enrolled their infants to compare prenatal management with postnatal clinical outcome. All mothers with seroconversion for TG infection were from the Palermo area and were retrospectively analyzed,…

The Burden of Respiratory Syncytial Virus Disease in Pre-Term Infants

This mini-review summarises the risk factors for acquiring Respiratory Syncitial Virus (RSV) infection, and describes the harmful effects of the infection in pre-term infants. Moreover, theoretical considerations are discussed for the prevention of RSV infection in high-risk infant categories, such as pre-term infants. Background: Neonates positive for RSV are more prone to severe infection than neonates infected with other common respiratory viruses. Despite RSV infection being more common in late neonates than in early ones, pre-term infants ≤ 35 wk gestational age (GA) are at high risk for developing severe RSV disease. Efforts to prevent infection include case management, vaccination an…

Draft genome sequence and biofilm production of a carbapenemase-producing Klebsiella pneumoniae (KpR405) sequence type 405 strain isolated in Italy

Rapid identification and characterization of multidrug-resistant Klebsiella pneumoniae strains is essential to diagnose severe infections in patients. In clinical routine practice, K. pneumoniae is frequently identified and characterized for outbreak investigation. Pulsed-field gel electrophoresis or multilocus sequence typing could be used, but, unfortunately, these methods are time-consuming, laborious, expensive, and do not provide any information about the presence of resistance and virulence genes. In recent years, the decreasing cost of next-generation sequencing and its easy use have led to it being considered a useful method, not only for outbreak surveillance but also for rapid ide…

Murine Typhus and Hemophagocytic Syndrome

No Abstract

Helicobacter pylori: Infection and New Perspective for the Treatment

The alarming phenomenon of antibiotic resistance in Helicobacter pylori suggests to pay close attention in the treatment. In particular, the clarithromycin resistance in H. pylori was designed by the World Health Organization (WHO) as high priority for antibiotic research in 2017 [1]. In Italy, the overall primary resistance to clarithromycin can be detected in 35.2% of cases; in France, it can be detected in 26% of cases, while in Spain, clarithromycin resistance is present in 27.2% of strains [2–4]. Natural/innovative strategies, as well as novel potentiators to restore the antibiotic susceptibility in resistant strains, could be used to improve the efficacy of H. pylori eradication, and …

ENDOCRINE, AUXOLOGICAL AND CLINICAL FOLLOW UP IN CONNATAL HIV-INFECTED CHILDREN: PERSONAL EXPERIENCE

Surgical pathology and the diagnosis of invasive visceral yeast infection: two case reports and literature review

Invasive mycoses are life-threatening opportunistic infections that have recently emerged as a cause of morbidity and mortality following general and gastrointestinal surgery. Candida species are the main fungal strains of gut flora. Gastrointestinal tract surgery might lead to mucosal disruption and cause Candida spp. to disseminate in the bloodstream. Here we report and discuss the peculiar clinical and morphological presentation of two cases of gastrointestinal Candida albicans lesions in patients who underwent abdominal surgery. Although in the majority of cases reported in the literature, diagnosis was made on the basis of microbiological criteria, we suggest that morphological feature…

Prurigo nodularis due to Mycobacterium tuberculosis

Prurigo nodularis (PN) is a rare chronic skin disorder of unknown origin. Here we describe what is believed to be the first case of PN associated with tuberculosis. For the first time, culture and PCR analysis of skin biopsy confirmed the presence of Mycobacterium tuberculosis complex in PN skin lesions. The pruritus and skin lesions resolved following antitubercular therapy. Our case provides further evidence in favour of a link between PN and mycobacterial infection.

Leishmania infection in psoriasis

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

Occult Hepatitis B Infection in the Immigrant Population of Sicily, Italy.

In Italy, about 7 % of the resident population is represented by immigrants originating from geographic regions at high endemicity for hepatitis B virus infection. This study aims to assess the prevalence of occult HBV infection (OBI) including the identification of HBV-genotypes in a population of immigrants serologically negative for hepatitis B surface antigen (HBsAg). Between May 2006 and May 2010, 339 immigrants were tested for markers of HBV, hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections. HBV-DNA was tested by using nested-PCR assays on three different genetic region. HBV-DNA was detected in plasma samples of 11/339 (3.2 %) patients. Most of them had no ser…

Analysis of Mycobacterium tuberculosis-Specific CD8 T-Cells in Patients with Active Tuberculosis and in Individuals with Latent Infection

CD8 T-cells contribute to control of Mycobacterium tuberculosis infection, but little is known about the quality of the CD8 T-cell response in subjects with latent infection and in patients with active tuberculosis disease. CD8 T-cells recognizing epitopes from 6 different proteins of Mycobacterium tuberculosis were detected by tetramer staining. Intracellular cytokines staining for specific production of IFN-gamma and IL-2 was performed, complemented by phenotyping of memory markers on antigen-specific CD8 T-cells. The ex-vivo frequencies of tetramer-specific CD8 T-cells in tuberculous patients before therapy were lower than in subjects with latent infection, but increased at four months a…

Surveillance of multidrug-resistant gram-negative bacilli in a neonatal intensive care unit: prominent role of cross transmission

Background Multidrug-resistant gram-negative bacilli (MDRGN) are an important cause of nosocomial infections in neonatal intensive care units (NICUs). We conducted a 1-year prospective surveillance study in an NICU to assess the epidemiology of MDRGN among newborns and the relative importance of acquisition routes. Methods Neonates admitted at the NICU of the Dipartimento Materno-Infantile, University Hospital, Palermo, Italy, from January 7, 2003, to January 6, 2004, were included in the study. Colonization of patients with MDRGN was assessed by cultures of rectal swabs sampled twice a week. Pulsed-field gel electrophoresis was used to determine relatedness among MDRGN isolates. Extended-s…

Direct-acting antivirals and visceral leishmaniasis: a case report

Abstract Background Visceral leishmaniasis is a vector-borne parasitic disease caused by protozoa belonging to the genus Leishmania. The clinical presentation of visceral leishmaniasis strictly depends on the host immunocompetency, whereas depressive conditions of the immune system impair the capability to resolve the infection and allow reactivation from sites of latency of the parasite. Case presentation We describe a case of visceral leishmaniasis (VL) that occurred in a patient with chronic hepatitis C treated with direct-acting antiviral drugs (DAA). The hypothesized mechanism is the alteration of protective inflammation mechanisms secondary to DAA therapy. Downregulation of type II an…

Multifunctional CD4(+) T cells correlate with active Mycobacterium tuberculosis infection.

Th1 CD4(+) T cells and their derived cytokines are crucial for protection against Mycobacterium tuberculosis. Using multiparametic flow cytometry, we have evaluated the distribution of seven distinct functional states (IFN-gamma/IL-2/TNF-alpha triple expressors, IFN-gamma/IL-2, IFN-gamma/TNF-alpha or TNF-alpha/IL-2 double expressors or IFN-gamma, IL-2 or TNF-alpha single expressors) of CD4(+) T cells in individuals with latent M. tuberculosis infection (LTBI) and active tuberculosis (TB). We found that triple expressors, while detectable in 85-90%TB patients, were only present in 10-15% of LTBI subjects. On the contrary, LTBI subjects had significantly higher (12- to 15-fold) proportions of…

Cluster of Legionnaires’ Disease in an Italian Prison

Background: Legionella pneumophila (Lp) is the most common etiologic agent causing Legionnaires&rsquo

Neuroimaging nelle meningiti tubercolari in età pediatrica.

Latent Tuberculosis Infection among Healthcare Students and Postgraduates in a Mediterranean Italian Area: What Correlation with Work Exposure?

Background: Tuberculosis screening is part of the standard protocol for evaluating the risk of infection in healthcare workers. The aim of this study was to evaluate the prevalence of latent tuberculosis infection (LTBI) among students attending various healthcare profession degree courses and postgraduate medical courses at the School of Medicine of the University of Palermo, Italy, and assess the possible professional origin of infection. Methods: In total, 2946 students (2082 undergraduates and 864 postgraduates) took part in a screening program for LTBI between January 2014 to April 2019 using the tuberculin skin test (TST). Students with a positive TST result underwent a Quantiferon-TB…

VIRULENCE FACTORS AND ANTIMICROBIAL RESISTANCE OF ESCHERICHIA COLI ST131 IN COMMUNITY-ONSET HEALTHCARE-ASSOCIATED INFECTIONS IN SICILY, ITALY

Escherichia coli ST131 is an emerging resistant agent recently called “superbug” in England. This strain is responsible of community-acquired urinary tract infections and nowadays showing increasing resistance to antibiotics like fluoroquinolones and cephalosporins. Survey of virulent bacterial clone is relevant to control its spreading in community. We aim to assess the circulation of resistant clones Escherichia coli ST131 outside of the hospital to prompt control of outbreak in our geographical area. We selected 105 E. coli resistant isolates from community-acquired urinary infections and performed a multiplex PCR to evaluate if they belonged to the ST131 type. We investigated their set …

Circolazione di Gram-negativi produttori di ESBL in una unità di terapia intensiva neonatale.

Colonizzazione da gram negativi multiresistenti produttori di ESBL in una UTIN”, I Congresso Nazionale SIMPIOS; Bergamo, 20-22 maggio 2004;

TTAS a New Stilbene Derivative that Induces Apoptosis in Leishmania Infantum

Leishmania parasites are able to undergo apoptosis (programmed cell death), similarly to mammalian cells. Recently it was demonstrated in vitro the anti-leishmanial effect of some natural and synthetic stilbenoids including resveratrol and piceatannol. In this study we evaluated the Leishmanicidal activity of a pool of stilbene derivatives which had previously shown high apoptotic efficacy against neoplastic cells. All the compounds tested were capable to decrease the parasite viability in a dose-dependent manner. Trans-stilbenes proved to be markedly more effective than cis-isomers. This was different from that observed in tumor cells in which cis-stilbenes were more potent cytotoxic agent…

Candida spp. infections after abdominal urgent surgery: comparative analysis of histologic data for which microbiological results were positive for Candida spp.

EV0515 ePoster Viewing Diagnostic/laboratory methods other than molecular Candida spp. infections after abdominal urgent surgery: comparative analysis of histologic data for which microbiological results were positive for Candida spp. V. Rodolico1, G. Gulotta1, L. Montana1, G. Salamone1, D.C. Paola1 1Department of Sciences for Health Promotion and Mother Child Care, Palermo, Italy Objectives: Microbiological identification is justified when the yeast is isolated from a sterile site, the potential clinical impact of identified isolates from non sterile sites such as intra- abdominal organs don’t help the clinicians to determine whether the strain isolate represents contamination, colonizatio…

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…

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

Abstract 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 β-lactam antibiotics. Seventy-five isolates were submitted to antimicrobial susceptibility testing, multilocus seq…

Unusual MRI findings in an immunocompetent patient with EBV encephalitis: a case report.

Abstract Blackground It is well-known that Epstein-Barr virus (EBV) can affect the central nervous system (CNS). Case presentation Herein the authors report unusual timely Magnetic Resonance Imaging (MRI) brain scan findings in an immunocompetent patient with EBV encephalitis. Diffusion weighted MRI sequence performed during the acute phase of the disease was normal, whereas the Fast Relaxation Fast Spin Echo T2 image showed diffuse signal intensity changes in white matter. The enhancement pattern suggested an inflammatory response restricted to the brain microcirculation. Acyclovir and corticosteroid therapy was administered. After three weeks, all signal intensities returned to normal and…

Investigation and management of Toxoplasma gondii infection in pregnancy and infancy: a prospective study.

Aim:Toxoplasma gondii infection during pregnancy poses a serious risk to the fetus, therefore timely and accurate diagnosis is essential. The aim of this study was to estimate the frequency of congenital infection via evaluating mother's immunological status and the possibility to improving the diagnostic and therapeutic approaches.Methods:Eighty five mothers with Toxoplasma seroconversion and their offspring were enrolled (among them, 2 spontaneous abortions were documented in the first trimester). Prenatal PCR diagnosis was carried out on 50 patients (60%), with 7 positive cases (14%). Morphological ultrasound scanning revealed anomalies in one fetus. Long-term follow-up included general …

A novel ELISA system for detecting serum granulysin in tuberculosis patients

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

Vitamin D and Osteoporosis in HIV/HCV Coinfected Patients: A Literature Review

Vitamin D deficiency further increases the risk of osteoporosis in HIV-positive patients coinfected with hepatitis C virus (HCV); however, it is still unclear whether HCV-related increased fracture risk is a function of the severity of liver disease. The aim of this review was to identify studies on associative vitamin D deficiency patterns in high-risk populations such as HIV/HCV coinfected patients. We did this by searching MEDLINE and EMBASE databases, from inception to August 2014, and included bibliographies. The final 12 articles selected are homogeneous in terms of age but heterogeneous in terms of sample size, participant recruitment, and data source. Most of the HIV/HCV coinfected …

Management of Intra-abdominal Infections due to Carbapenemase-Producing Organisms.

The prevalence of bacterial resistance to carbapenem antibiotics continues to increase because of bacteria producing metallo-β-lactamases (MBL), called carbapenemase-producing organisms (CPO). Enterobacteriaceae, which can be a common cause of intra-abdominal infections (IAIs), have become carbapenem-resistant Enterobacteriaceae (CRE). Updated international guidelines for the treatment of both IAIs and IAIs due to CRE have been published. Given the multifaceted nature of these infections, these recommendations have been jointly reviewed and endorsed by the Surgical Society and the Association of Medical Microbiology and Infectious Disease. The aims of this review are to summarize the genera…

Colonizzazione da Gram negativi multiresistenti produttori di ESBL in una UTIN.

Prevalence of Occult Hepatitis B Virus Infection in a Cohort of HIV-Positive Patients Resident in Sicily, Italy

Occult hepatitis B virus (OBI) in HIV-infected groups is still debated, as well as the associated risk-factors and clinical significance. In this paper, we examined a total of 405 HBsAg-negative/HIV-infected patients enrolled from January 2007 to December 2009. Overall, the prevalence of OBI was 5.9% (95% confidence interval (CI95%): 3.8–8.7%); it was more frequently associated with “anti-HBc alone” serological marker (11.3%; adjusted odds ratio = 3.7, CI95%: 1.4–9.8), although it was also detected in the absence of any HBV serological marker (4.9%; CI95%: 2.3–9.1%). A low prevalence of anti-HCV-positive patients with OBI was found (3.1%; CI95%: 0.6–8.7%). HIV RNA plasma levels or other imm…

Stipiti di Pseudomonas aeruginosa MBL produttori in Unità di Terapia Intensiva Neonatale (UTIN)

Non-invasive assessment of liver steatosis and fibrosis in HIV/HCV- and HCV- infected patients

BACKGROUND: Conflicting data have been reported on the prevalence of liver steatosis, its risk factors and its relationship with fibrosis in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection or with HCV mono-infection. AIM: The study aims were to assess steatosis prevalence and its risk factors in both HCV groups. We also evaluated whether steatosis was linked with advanced fibrosis. Sixty-eight HIV/HCV co-infected and 69 HCV mono-infected patients were consecutively enrolled. They underwent liver ultrasonography and transient elastography. Bright liver echo-pattern was used to diagnose steatosis; advanced fibrosis was defined as liver stiffness ≥ 9.5 kPa…

Permanent Loss of Human Leukocyte Antigen E–restricted CD8+ T Stem Memory Cells in Human Tuberculosis

Nosocomial colonization due to imipenem-resistant Pseudomonas aeruginosa epidemiologically linked to breast milk feeding in a neonatal intensive care unit.

Aim: We describe a one-year investigation of colonization by imipenemresistant, metallo-β-lactamase (MBL) producing Pseudomonas aeruginosa in a neonatal intensive care unit (NICU) of the University Hospital of Palermo, Italy. Methods: A prospective epidemiological investigation was conducted in the period 2003 January to 2004 January. Rectal swabs were collected twice a week from all neonates throughout their NICU stay. MBL production by imipenem-resistant strains of P aeruginosa was detected by phenotypic and molecular methods. Pulsed field gel electrophoresis (PFGE) was carried out on all isolates of P aeruginosa. The association between risk factors and colonization by imipenem-resistant…

Early warning climate indices for malaria and meningitis in tropical ecological zones

AbstractThis study aims at assessing the impacts of climate indices on the spatiotemporal distribution of malaria and meningitis in Nigeria. The primary focus of the research is to develop an Early Warning System (EWS) for assessing climate variability implications on malaria and meningitis spread in the study area. Both climate and health data were used in the study to determine the relationship between climate variability and the occurrence of malaria and meningitis. The assessment was based on variations in different ecological zones in Nigeria. Two specific sample locations were randomly selected in each ecological zone for the analysis. The climatic data used in this study are dekadal …

Poly-functional immune response in HIV infection: a correlation between immunological and clinical status

Aim: We analysed patient immunological status and serum cytokine profile to establish immune-activation state and afterwards the obtained data were correlated to viral activity and ARV therapy. Materials and Methods: 50 HIV-1 mono-infected patients (pt) were recruited: 5 naïve, 5 virologic controllers, 10 virologic non controllers (ARV drug-untreated pt with HIV viremia above 10,000 copies/ml), 20 virologic responders (ARV drug-treated pt with undetectable HIV viremia) and 10 virologic non responders patients (ARV drug-treated pt with HIV viremia ≥ 400 copies/ml). IFN- production and plasmatic cytokine pattern levels (IL-1β, IL-2, IL-6, TNF-β, IL-4, IL-10, IL-13, IP-10, IL-8, MIP-1 α, MIP-…

Vancomycin resistant Enterococcus faecium (VRE) vertebral osteomyelitis after uneventful spinal surgery: A case report and literature review

Abstract Objective Case report and literature review. Background Enterococcus faecium is an emerging pathogen responsible for post procedural infections in patients who have undergone spinal decompression surgery. In this case report, the authors discuss and review recent literature on approaches to post-operative spinal infection. Case report We herein report the case of a 55-year-old HIV-negative Caucasian Italian woman who showed vertebral osteomyelitis with abscesses around the interbody cage caused by an Enterococcus faecium vancomycin resistant gen-Van A, following a Transforaminal Lumbar Interbody Fusion (TLIF). The same strain was detected in disc biopsy, urine culture and rectal sw…

The role of visiting friends and relatives (VFRS) in imported malaria

With the integration of immigrants in their host countries, a new, special group of travellers - Visiting Friends and Relatives (VFRs) - has emerged over time. The term VFRs refers in particular to immigrants who move to high-income countries from countries where socio-economic status is low, and regularly return to their country of origin, sometimes for fairly long periods of time, to visit their friends and relatives or, where women are concerned, also to give birth and spend the post-partum period with their family. Precisely because they are “special tourists”, VFRs are considered to be at higher risk than other regular travellers of contracting diseases like tuberculosis, HIV and malar…

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…

Circulating Endothelial Cell Levels Correlate with Treatment Outcomes of Splanchnic Vein Thrombosis in Patients with Chronic Myeloproliferative Neoplasms

Circulating endothelial cells (CECs) are viable, apoptotic or necrotic cells, identified by CD 146 surface antigen expression, considered a biomarker of thrombotic risk, given their active role in inflammatory, procoagulant and immune processes of the vascular compartment. Growing evidence establishes that CECs are also involved in the pathogenesis of several hematological and solid malignancies. The primary aim of this study was to verify if CEC levels could predict both the course and treatment responses of splanchnic vein thrombosis (SVT), either in patients affected by myeloproliferative neoplasms (MPNs) or liver disease. Thus, a retrospective multicenter study was performed; fifteen pa…

Diagnosis of congenital toxoplasmosis: pre e post natal evaluation in a sicilian (Italy) epidemiological area

Follow-up diagnostico di bambini con sospetta toxoplasmosi connatale: valutazioni preliminari

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…

Rickettsia typhi and Haemophagocytic Syndrome

Appropriate therapy (dexamethasone, cyclosporin, and etoposide) could save the patient in those cases in which the pathogen-direct therapy has not been sufficient by itself to control the disease.

Toxoplasmosi: il western blot nella diagnosi dell'infezione materno-fetale. Dati preliminari

LIODetect®TB-ST: Evaluation of novel blood test for a rapid diagnosis of active pulmonary and extra-pulmonary tuberculosis in IGRA confirmed patients

Abstract Because of the current limits of immunological tests in the diagnosis of tuberculosis there is a need to identify new and rapid tests that can be carried out on a large scale in endemic countries and useful in the identification of infected subjects, but also able to discriminate those with latent infection from subjects with active. We have taken into consideration and analysed the LIODetect®TB-ST Tuberculosis Rapid Test, a membrane test for the qualitative detection of specific IgG, IgA, and IgM antibodies against Mycobacterium tuberculosis, performed on serum, plasma, or whole blood.85 samples positive to QuantiFERON TB-GOLD PLUS test were processed using this test and the resul…

A systematic review on omics data (metagenomics, metatranscriptomics, and metabolomics) in the role of microbiome in gallbladder disease

Microbiotas are the range of microorganisms (mainly bacteria and fungi) colonizing multicellular, macroscopic organisms. They are crucial for several metabolic functions affecting the health of the host. However, difficulties hamper the investigation of microbiota composition in cultivating microorganisms in standard growth media. For this reason, our knowledge of microbiota can benefit from the analysis of microbial macromolecules (DNA, transcripts, proteins, or by-products) present in various samples collected from the host. Various omics technologies are used to obtain different data. Metagenomics provides a taxonomical profile of the sample. It can also be used to obtain potential funct…

Intra-abdominal Candida spp infection in acute abdomen in a quality assurance (QA)-certified academic setting

AimsTo evaluate the contribution of light microscopy to detecting Candida spp infection in patients with complicated intra-abdominal infections (IAIs) admitted for acute abdomen to a quality assurance (QA)-certified surgical emergency ward.MethodsWe conducted a retrospective study (2008–2012) of 809 abdominal intraoperative or biopsy tissue specimens obtained from patients admitted with acute abdomen and microbiological samples positive for Candida spp. Demographic data, mortality, comorbidities, specimen type, microscopy results, special histological staining performed, antimicrobial therapy were collected and analysed. Any comments at the multidisciplinary team meeting was recorded in min…

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.

Platelets accumulate in lung lesions of tuberculosis patients and inhibit T-cell responses and Mycobacterium tuberculosis replication in macrophages

: Platelets regulate human inflammatory responses that lead to disease. However, the role of platelets in tuberculosis (TB) pathogenesis is still unclear. Here, we show that patients with active TB have a high number of platelets in peripheral blood and a low number of lymphocytes leading to a high platelets to lymphocytes ratio (PL ratio). Moreover, the serum concentration of different mediators promoting platelet differentiation or associated with platelet activation is increased in active TB. Immunohistochemistry analysis shows that platelets localise around the lung granuloma lesions in close contact with T lymphocytes and macrophages. Transcriptomic analysis of caseous tissue of human …

Endocrine, auxological and clinical follow up of connatally HIV-infected children: personal experience

Tumore della palpebra come manifestazione primaria di sifilide e corioretinite precoce con uveite in un paziente HIV positivo

SPREAD OF A NEW MBL-PRODUCING STRAIN OF PSEUDOMONAS AERUGINOSA IN NICU DURING MICROBIOLGICAL SURVEILLANCE IN 2003

Circulating varicella-zoster virus strains in european chickenpox outbreacks and its implications regarding a universal vaccination policy.

Fatal Pulmonary Hemorrhage Through Fiberoptic Broncoscopy in a Well Controlled Diabetic Female With Mucormycosis

A rare case of invasive pulmonary mucormycosis complicated by fatal massive haemoptysis through bronchoscopy in a patient with a well controlled diabetes is reported. Histological features of infection are reported and the characteristic aspects of the staining are discussed. Fiberoptic bronchoscopy revealed bilateral obstruction of the segmental bronchi and fatal massive bleeding occurring because of biopsy sampling. Caution is warranted in the use of bronchoscopy sampling in patients with radiological features of cavitated lesions of fungal origins. Better preventive and early therapeutic antifungal treatments are needed to avoid this serious complication.

Bactibilia in women affected with diseases of the biliary tract and pancreas. A STROBE guidelines-adherent cross-sectional study in Southern Italy.

Abstract Purpose. Bile is a hepatobiliary lipid-rich sterile solution, and its colonization by microorganisms defines the condition of bactibilia. In this study, we aimed to assess the bile microbiological flora and its potential link with comorbidity in women. Methodology. We performed a microbiologic investigation on 53 female patients with biliopancreatic diseases who granted consent, and we analysed the data using a MATLAB platform. Results. We found that the most frequent disease associated with bactibilia was pancreas head carcinoma (PHC) (P=0.0015), while the least frequent disease was gall bladder carcinoma (GBC) (P=0.0002). The most common microorganisms were Pseudomonas spp. (P&lt…

Decreased serum granulysin levels in childhood tuberculosis which reverse after therapy

Abstract Granulysin is a cytolytic protein of natural killer (NK) cells and cytotoxic T lymphocytes (CTLs). Serum levels of granulysin are related to host cellular immunity. We used an ELISA to quantify granulysin serum levels in children with tuberculosis (TB), before and after chemotherapy. The study involved children affected by different clinical forms of TB (n=72) and healthy control children (n=150) from the same geographical area and of similar socio-economic background. Serum granulysin levels before the initiation of TB therapy were significantly lower in children with TB compared to controls, with the lowest levels being found in TB patients who were PPD skin test negative. No sta…

Hormonal, auxological and clinical follow-up in children with connatal HIV infection: personal records

Auxological and endocrinological complications frequently occur in children with connatal HIV infection. These complications seem to be related both to the infection itself and the antiretroviral therapy. Many children consequently show height-weight and pubertal retardation without any evidence of hormonal deficit. We studied 10 children with connatal HIV infection who were enrolled in this analysis and followed up for 7 years in order to evaluate their height-weight growth, pubertal maturation, bone age progression and hormonal pattern [basal Growth hormone (GH) and GH after Clonidine or Insulin stimulation, Insulin-like Growth Factor 1 (IGF-1), Insulin-like Growth Factor Binding Protein …

Bactibilia in diseases of the biliary tract and pancreatic gland in patients older than 80 years: a STROBE-retrospective cohort study in a teaching hospital in Italy

Bile is a lipid-rich sterile solution produced in the liver that can be infected resulting in bactibilia. A higher incidence of postoperative infectious complications has been seen in patients with bactibilia. Recently, gram-negative bacteria have been linked to a tumor-associated inflammatory status. This study is a retrospective cohort study of 39 patients, who are over 80 years of age only (53.85% males and 46.15% females), hospitalized with diseases of the biliopancreatic system in one teaching hospital in Italy from January 2011 to December 2012 with a follow-up of 5 years. The most common biliary diseases after surgery were pancreatic head cancer (p < 0.0001) and gallbladder cancer (p…

Dairy calcium intake and lifestyle risk factors for bone loss in hiv-infected and uninfected mediterranean subjects

Abstract Background Despite the reported high prevalence of osteoporosis in the human immunodeficiency virus (HIV)-population, there have been no previous studies examining dairy calcium intake and bone mineral density (BMD) in HIV-subjects. We assessed the prevalence of low BMD in HIV-infected and uninfected subjects and analyzed the effects of calcium intake, lifestyle and HIV-related risk factors on BMD. Methods One hundred and twelve HIV-infected subjects were consecutively enrolled. Seventy- six HIV-uninfected subjects matched for age and sex were enrolled as the control group. The HIV-subjects were interviewed about lifestyle habits and completed a weekly food-frequency questionnaire …

Valutazione del ruolo della cross-trasmissione nella colonizzazione endemica da Gram negativi multiresistenti in un'Unità di Terapia Intensiva Neonatale

Longitudinal investigation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in older patients in the province of Palermo (Southern Italy) during the early wave of the pandemic.

IntroductionClinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in old adults from Southern Italy is little known. This study aims to investigate the mortality risk related to risk factors, therapy and clinical course and to suggest prognostic indicators based on day-to-day follow-up of clinical and laboratory findings.Material and methodsIt was designed as a retrospective longitudinal cohort study of adult SARS-CoV-2 patients admitted at Partinico COVID Hospital in Palermo, Southern Italy. Patients were recruited between 4 March and 25 April and followed up until 31 May 2020, day-to-day until death or hospital discharge. Clinical data, laboratory…

Continuity correction of pearson’s chi-square test in 2x2 contingency tables: A mini-review on recent development

The Pearson’s chi-square test represents a nonparametric test more used in Biomedicine and Social Sciences, but it introduces an error for 2 x 2 contingency tables, when a discrete probability distribution is approximated with a continuous distribution. The first author to introduce the continuity correction of Pearson’s chi-square test has been Yates F. (1934). Unfortunately, Yates’s correction may tend to overcorrect of p-value, this can implicate an overly conservative result. Therefore many authors have introduced variants Pearson’s chi-square statistic, as alternative continuity correction to Yates’s correction. The goal of this paper is to describe the most recent continuity correctio…

MRSA ST22-IVa (EMRSA-15 clone) in Palermo, Italy

Summary: Epidemic spread of methicillin-resistant Staphylococcus aureus (MRSA) strains carrying the Staphylococcal Chromosomal Cassettes (SCC) mec type IV is being increasingly reported in many geographical areas. A survey to determine the prevalence and characteristics of MRSA SCCmec IV isolates identified in four general hospitals in Palermo, Italy, was carried out. During the period February–June 2009, SCCmec type IVa has been found in 12 out of 94 isolates. Nine isolates from all hospitals and all strains from a NICU outbreak occurring in the same period were attributed with the ST22-IVa (EMRSA-15) clone. In our setting, due to the changing MRSA epidemiology, detection of SCCmec IV coul…

Successful management of a cerebral abscess secondary to chronic cholesteatoma caused by Prevotella melaninogenica and Peptococcus anaerobius – A case report and literature review

Abstract Cerebral abscess following cholesteatomatous otomastoiditis is a life-threatening complication and poses diagnostic and therapeutic challenges. We report a case of life-threatening cerebritis and cerebral abscess due to a collection of pus from an aerobic super infections occurring months after the apparent resolution of an otogenic brain abscess in a 67-year-old immunocompetent Italian female. Two gram-positive anaerobic pathogens were isolated during secondary neurosurgical procedures and antibiotic treatment was adopted to resolve the complications. Another objective of this study was to review the literature on gram-positive anaerobic pathogens and brain abscess complications i…

Identification of plasma biomarkers for discrimination between tuberculosis infection/disease and pulmonary non tuberculosis disease.

We used the Luminex Bead Array Multiplex Immunoassay to measure cytokines, chemokines and growth factors responses to the same antigens used for RD1-based Interferon γ Release Assay (IGRA) test. Seventy-nine individuals, 27 active TB, 32 latent infection subsets, 20 individuals derivative purified protein (PPD) negative (subjects that do not have any indurative cutaneous reaction after 72 hrs of intradermal injection of PPD) and with other pulmonary disease were retrospectively studied. Forty-eight analytes were evaluated by Luminex Assay in plasma obtained from whole blood stimulated cells. The diagnostic accuracies of the markers detected were evaluated by ROC curve analysis and by the co…

Leg ulcer and osteomyelitis due to methicillin-susceptible Staphylococcus aureus infection after fracture repair treatment: a case highlighting the potential role of prostaglandin E₁ vasodilator.

Prostaglandins appear to reduce biofilm formation and chronicization of infections, and stimulate a rapid and effective clearance of infecting micro-organisms. We report a case of recovery from methicillin-susceptible Staphylococcus aureus (MSSA) osteomyelitis after multidisciplinary management with antibiotics, anti-thrombotics and prostaglandin E1 (PGE1) vasodilator, in a patient with tibial plateau fracture repaired with internal fixation devices. A 47-year-old HIV-negative male with chronic ulcer on the proximal third of the left leg was admitted to the Orthopaedic Unit of the Orestano Clinic in Palermo, Italy, for suspected osteomyelitis. A biopsy of the skin ulcer and blood cultures w…

Perdita di Massa ossea e severità della fibrosi epatica in una coorte di pazienti HIV/HCV co-infetti

Helicobacter pylori and Epstein–Barr Virus Infection in Gastric Diseases: Correlation with IL-10 and IL1RN Polymorphism

Introduction. Helicobacter pylori and Epstein–Barr virus (EBV) infection have recently been shown to be associated with gastric diseases. Polymorphisms in genes encoding cytokines such as interleukin 10 (IL-10) and interleukin 1 Receptor (IL-1RN) influence cytokine secretion levels and appear to contribute to the risk of developing gastroduodenal diseases. To our knowledge, this is the first preliminary study to address the association of coinfection with H. pylori and EBV and their correlation with genetic predisposition in the development of gastric diseases. Methods. Gastric biopsy samples of 96 patients with different gastric diseases were used. Results. Our results showed that the rate…

Epidemiology of severe RSV infection in Palermo, a sicilian pediatric population: identifying risk factors, epidemic wave and severity

Sorveglianza delle colonizzazioni da microrganismi multi resistenti e da miceti e delle infezioni acquisite in ambiente nosocomiale in pazienti sottoposti ad interventi chirurgici in urgenza ed in elezione presso l’AOUP “Paolo Giaccone” di Palermo – risultati preliminari

Epidemiologia dell'infezione da VRS a Palermo: 2 anni di esperienza

Transient elastography: A non-invasive tool for assessing liver fibrosis in HIV/HCV patients

AIM: To assess the prevalence of advanced liver fibrosis (ALF) in human immunodeficiency virus (HIV), hepatitis C virus (HCV) and HIV/HCV patients using transient elastography, and to identify factors associated with ALF. METHODS: Between September 2008 and October 2009, 71 HIV mono-infected, 57 HIV/HCV co-infected and 53 HCV mono-infected patients on regular follow-up at our Center were enrolled in this study. Alcohol intake, the main parameters of liver function, presence of HCV-RNA, HIV-RNA, duration of highly active anti-retroviral therapy (HAART) and CD4 cell count were recorded. ALF was defined as liver stiffness (LS) ≥ 9.5 kPa. To estimate liver fibrosis (LF) a further 2 reliable bio…

Clinical and biological data on the use of hydroxychloroquine against SARS-CoV-2 could support the role of the NLRP3 inflammasome in the pathogenesis of respiratory disease

The use of hydroxychloroquine (HCL) has been very common in countries with a rapid spread of coronavirus disease 2019 (COVID-19), although controversial and the subject of heated scientific discussions with implications for the whole society. This article is protected by copyright. All rights reserved.

Spread of a new MBL-producing strani of Pseudomonas Aeruginosa in NICU during microbiological surveillance in 2003

Isolamento in alimenti di Enterococcus spp resistenti ai glicopeptidi (GRE)

Magnetic resonance and computed tomography findings in childhood central nervous system tuberculosis

Spread of a new MBL-producing strain of pseudomanas aeruginosa in NICU during microbiological surveillance in 2003

Intestinal Involvement in Kawasaki Disease

Objectives To describe a case of Kawasaki disease with intestinal involvement and to analyze other published reports to define clinical characteristics, diagnostic issues, and therapeutic approaches of gastrointestinal involvement in Kawasaki disease. Study design A computerized search without language restriction was conducted using PubMed and SCOPUS. An article was considered eligible for inclusion in the systematic review if it reported data on patient(s) with intestinal involvement in Kawasaki disease. Our case was also included in the analysis. Results Thirty-three articles reporting 48 cases of Kawasaki disease with intestinal involvement were considered. Fever, abdominal pain, and vo…

MONOCYTES MACROPHAGES EXPRESSION OF Ml OR M2 PHENOTYPES IN LATENT TUBERCULOSIS, ACTIVE DISEASES AND UNINFECTED MIGRANTS AND SICILIAN PATIENTS

The high grade ofphenotype plasticity of monocytes macrophages, is resumed in two different cell subsets named M1 or M2. Several studies of microbial infections in vitro and in vivo, showed that, during the early stage of infection, macrophages are polarized toward Ml phenotype that should be protective against pathogen, while during the chronic phase of infection/disease macrophages polarize toward M2 phenotype to avoid damages from a prolonged Ml type activation.Obiettivo: In order to investigate if Mycobacterium tuberculosis infection can drive circulating monocytes toward the expression of Ml or M2 phenotypes, we have analyzed by flow cytometry monocytes obtained from patients with acti…

&lt;p&gt;The microbiota of the bilio-pancreatic system: a cohort, STROBE-compliant study&lt;/p&gt;

Background: The gut microbiota play an essential role in protecting the host against pathogenic microorganisms by modulating immunity and regulating metabolic processes. In response to environmental factors, microbes can hugely alter their metabolism. These factors can substantially impact the host and have potential pathologic implications. Particularly pathogenic microorganisms colonizing pancreas and biliary tract tissues may be involved in chronic inflammation and cancer evolution. Purpose: To evaluate the effect of bile microbiota on survival in patients with pancreas and biliary tract disease (PBD). Patients and Methods: We investigated 152 Italian patients with cholelithiasis (CHL), …

Monocyte to lymphocyte blood ratio in tuberculosis and HIV patients: Comparative analysis, preliminary data

Recent data confirmed the hypothesis suggested by historical studies that the ratio of peripheral blood monocytes to lymphocytes (M/L) is associated with the risk of tuberculosis (TB) disease. We retrospectively analyzed the electronic health records of tuberculosis and HIV-positive patients who had followed day-care programs at the AIDS Center of the University of Palermo, Italy. 261 patients were recruited and divided into 6 groups as follows: healthy control group (HCG: 47 pts), latent HIV negative infected TB group (LIG, 43 pts), active HIV negative tuberculosis (TAG: 61 pts), treated tuberculosis HIV negative (TTG: 44 pts), HIV drug-naive patients tested TST and QFT-IT-negative with ne…

RISOLUZIONE DI UN’ENDOCARDITE DA MRSA CON VEGETAZIONE LARGA, MOBILE E COMPLICATA DA STROKE EMBOLICO TRATTATA CON SOLA TERAPIA ANTIBIOTICA COMBINATA

Prospective evaluation of hepatic steatosis in HIV-infected patients with or without hepatitis C virus co-infection

Background: Limited data are available on hepatic steatosis (HS) in HIV patients who are not infected with hepatitis C virus (HCV). The aims of this study were to assess the prevalence of HS and its risk factors in HIV patients with and without HCV infection, and to evaluate whether HS correlates with advanced liver fibrosis and/or cardiovascular disease risk. Methods: Fifty-seven HIV mono-infected and 61 HIV/HCV co-infected patients were enrolled consecutively. All patients underwent liver ultrasound and transient elastography. The main parameters of liver function, HIV and HCV viral loads, CD4+ cell counts, and data on highly active antiretroviral therapy (HAART) were recorded. Cardiovasc…

Descrizione del primo caso clinico di rapida guarigione di un ulcera cutanea in soggetto con osteomielite da Staphylococcus aureus dopo trattamento che include PGE1 vasodilatatore

Background: L'osteomielite è uno delle complicanze infettive più gravi del paziente sottoposto a riduzione della fratture mediante mezzi di sintesi. Alcuni pazienti hanno manifestazioni sistemiche di infezione ma alcuni anche se non diabetici e immunocompetenti possono avere solo sintomi locali come ulcerazione cutanea da fistola ossea. Recentemente alcuni lavori dimostrano come l’utilizzo delle prostaglandine ad azione vasodilatatoria come PGE1, PGE2 in associazione alla terapia antibiotica possano contribuire alla più rapida guarigione della osteomielite senza intervento chirurgico ortopedico poiché le prostaglandine sembrano ridurre la formazione del biofilm e la cronicizzazione dell’inf…

Madura foot: An imported case of a non-common diagnosis

Mycetoma (or "madura foot") is characterized by deformation, cutaneous lesions, infection of tissues extending from the cutaneous layer to the underlying fascia, and an indolent course. A number of fungal or bacterial agents that are introduced through traumatic inoculation can be responsible for the disease, but Actinomadura madurae is among the most common agents of mycetoma occurring worldwide. We report a case of madura foot caused by A. madurae in an immunocompetent young Somali man who was admitted with a diagnosis of skin and soft tissue infection of the left foot with osteomyelitis. The present report emphasizes the importance of the knowledge of this infection, which is sporadic bu…

[Epidemiology of paediatric tuberculosis today].

Tuberculosis (TB) kills 2 million people each year in the world, of which 250,000 are children. In Italy, paediatric TB is 3.5% of total cases with a steady trend in the last ten years. Childhood tuberculosis remains a disease of great concern because its occurrence always indicates recent transmission and is a pivotal indicator of effectiveness of TB control efforts. The epidemiological study, including DNA fingerprinting, of 71 children affected by TB - 62 pulmonary, 9 meningitis, 2 renal-shows that the source case is frequently a parent or household member. Sensitivity to anti-tubercular drugs was tested for 18/20 isolates obtained from the children and 21/44 isolates obtained from infec…

Human bile microbiota: A retrospective study focusing on age and gender

Aims: The emerging biliary colonization of microorganisms in patients with biliary diseases may be devastating. Recent evidence suggests that age and gender may influence changes in the microbial composition of gut microbiota. To study the relationship between these parameters on bile microbiota, we retrospectively reviewed positive bile cultures following an endoscopic retrograde cholangiopancreatography (ERCP) in a QA-certified academic surgical unit of a single institution. Methods: 449 positive bile cultures from 172 Italian patients with diseases of the biliopancreatic system hospitalized from 2006 through 2017 were investigated for aerobic, anaerobic, and fungal organisms. The patient…

INVASIVE FUNGAL INFECTIONS IN INTENSIVE CARE UNIT

Invasive fungal infections (IFI) is associated with a high mortality rate, specially in patients with delayed beginning of antifungal treatment...

Respiratory syncytial virus infection in a Sicilian pediatric population: Risk factors, epidemiology, and severity

Respiratory syncytial virus (RSV) is the leading cause of hospitalization for lower respiratory tract infections (LRTIs) in young children worldwide. This study evaluated the epidemiological and clinical patterns of RSV infection in infants hospitalized for LRTIs in Sicily. Over a 7-month period (October 1, 2005 to April 30, 2006), all children 6 months old, with a gestational age (GA) of >36 weeks, with a birth weight of >2.50 g, with previous hospitalizations due to LRTI, with smokers in the household, and with a history of breast-feeding (p < 0.05 for each). RSV infection was associated with a higher likelihood to be admitted to neonatal intensive care units and to longer hospitalization…

Cryptic Leishmania infantum infection in Italian HIV infected patients.

Abstract Background Visceral leishmaniasis (VL) is a protozoan diseases caused in Europe by Leishmania (L.) infantum. Asymptomatic Leishmania infection is more frequent than clinically apparent disease. Among HIV infected patients the risk of clinical VL is increased due to immunosuppression, which can reactivate a latent infection. The aims of our study were to assess the prevalence of asymptomatic L. infantum infection in HIV infected patients and to study a possible correlation between Leishmania parasitemia and HIV infection markers. Methods One hundred and forty-five HIV infected patients were screened for the presence of anti-Leishmania antibodies and L. infantum DNA in peripheral blo…

Applicazione della PFGE nella sorveglianza delle colonizzazioni da gram negativi multiresistenti in UTIN

Clostridium difficile Induced Inflammasome Activation and Coagulation Derangements

C. difficile enterocolitis (CDAC) is the most common hospital infection, burdened by an increased incidence of coagulation-related complications such as deep vein thrombosis (DVT) and disseminated intravascular coagulation (DIC) as well as a significant sepsis-related mortality. In this review, we analyzed the available data concerning the correlation between coagulation complications related to C. difficile infection (CDI) and inflammasome activation, in particular the pyrin-dependent one. The little but solid available preclinical and clinical evidence shows that inflammasome activation increases the risk of venous thromboembolism (VTE). As proof of this, it has been observed that in vitr…

Cratterizzazione feno-genotipica di stipiti di Enteococcus spp. resistente ai glicopeptidi (GRE) da fonte umana ed alimentare

Evoluzione del quadro neurostrumentale in tre bambini con infezione congenita da toxoplasma gondii (TG):follow-up gravidico e post natale

Infezione primaria da Toxoplasma gondii in gravidanza: considerazioni su un campione di 58 coppie madre-bambino.