Incidence and Risk of Cytomegalovirus Infection during Pregnancy in an Urban Area of Northern Italy

The fetal consequences of CMV infection make it one of the most serious infections contracted during pregnancy, but the scientific community is divided over the proposed implementation of preventive screening for anti-CMV antibodies. The aim of this study was to assess the incidence and risk of infection during pregnancy in 2817 women who underwent anti-CMV IgG and IgM antibody screening during the period 2005–2007. The prevalence of anti-CMV IgG antibodies was 68.3% (95% CI: 66.6–70.0); the seroconversion rate in the 892 seronegative women was 0.32%; the results of IgG avidity testing revealed an cumulative incidence of 1.4% (95% CI: 0.97–1.83), density incidence of 0.8% (as cases/pregnant woman-trimester) (95% CI: 0.47–1.13), and a risk of infection of 0.5% (95% CI: 0.24–0.76). The screening identified 13 cases of primary infection (84.6% of which occurred in the first trimester of pregnancy). The possibility to identify these cases and consequently to plan appropriate interventions, supports the use of screening during pregnancy, especially in the first trimester when the risk of infection is greater

Search for Anti-EA(D) Antibodies in Subjects with an “Isolated VCA IgG” Pattern

The presence of an “isolated viral capsid antigen (VCA) IgG” pattern in serum is not easy to interpret without the aid of further tests, such as specific immunoblotting or a virus genome search, that often give rise to organisational and economic problems. However, one alternative is to use an enzyme-linked immunosorbent assay (ELISA) to detect anti-early antigen (EA) antibodies, which can be found in about 85% of subjects with acute Epstein-Barr virus (EBV) infections. The purpose of this work was to search for anti-EA(D) antibodies in 130 samples with an isolated VCA IgG pattern at ELISA screening and classified as being indicative of past (102 cases) or acute (28 cases) infection on the basis of the immunoblotting results. Thirty-seven samples (28.5%) were positive for anti-EA(D), of which 25 (89.3%) had been classified by immunoblotting as indicating acute and 12 (11.8%) past EBV infection. This difference was statistically significant (P < .01). The results of our search for anti-EA(D) antibodies correctly identified nearly 90% of acute (presence) or past EBV infections (absence). When other tests are not available, the search for anti-EA antibodies may therefore be helpful in diagnosing patients with an isolated VCA IgG pattern at screening tests

Multicenter prospective study on the prevalence of colistin resistance in escherichia coli: Relevance of mcr-1-positive clinical isolates in Lombardy, Northern Italy

Background: The emergence of the plasmid-mediated colistin resistance mechanism in Escherichia coli has raised concern among public health experts as colistin is a last-line antimicrobial resort. The primary aim of the study was to investigate the prevalence of this resistance trait in E. coli isolates circulating in the Lombardy region, Northern Italy. The presence of mcr-type genes and their genetic relationship were also studied. Materials and methods: A prospective study was performed during a 4-month period (May to August, 2016) in six acute care Hospitals. Consecutive nonduplicate clinical isolates of E. coli from any type of clinical specimen, with the exception of rectal swabs, were included in the study. Isolates that exhibited MIC values for colistin &gt;2 mg/L were further investigated. Bacterial identification was obtained by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Amplification of mcr-type genes (-1 to -5 variants) and microarray analysis were accomplished. Repetitive sequence-based PCR (Rep-PCR) and multilocus sequence typing (MLST) analysis were used for genotyping. Results: Overall, 3,902 consecutive E. coli isolates (2,342 from outpatients, 1,560 from inpatients) were evaluated during the study period. Of them, 18/3,902 (0.5%), collected from 4/6 centers, showed resistance to colistin. These isolates were mostly obtained from urine of both outpatients (n=12) and inpatients (n=6). Colistin MIC values ranged from 4 to 8 mg/L. The mcr-1 gene was detected in 10/18 isolates (7 from outpatients, 3 from inpatients). Rep-PCR and MLST analysis revealed the presence of nine different clusters. Further mcr-type genes were not detected. Conclusion: Resistance to colistin in E. coli clinical isolates appears low in our geographic area. With regard to mcr-1-positive isolates, they accounted for approximately 50% of colistin-resistant E. coli isolates, thus representing a relevant resistance mechanism in this context. Although overall limited, the presence of mcr-1 determinant in our region should not be ignored and great concern should be given to the continuous surveillance

Clerici P. Incidence and risk of cytomegalovirus infection during pregnancy in an urban area of Northern Italy. Infect Dis Obstet Gynecol

The fetal consequences of CMV infection make it one of the most serious infections contracted during pregnancy, but the scientific community is divided over the proposed implementation of preventive screening for anti-CMV antibodies. The aim of this study was to assess the incidence and risk of infection during pregnancy in 2817 women who underwent anti-CMV IgG and IgM antibody screening during the period [2005][2006][2007]. The prevalence of anti-CMV IgG antibodies was 68.3% (95% CI: 66.6-70.0); the seroconversion rate in the 892 seronegative women was 0.32%; the results of IgG avidity testing revealed an cumulative incidence of 1.4% (95% CI: 0.97-1.83), density incidence of 0.8% (as cases/pregnant woman-trimester) (95% CI: 0.47-1.13), and a risk of infection of 0.5% (95% CI: 0.24-0.76). The screening identified 13 cases of primary infection (84.6% of which occurred in the first trimester of pregnancy). The possibility to identify these cases and consequently to plan appropriate interventions, supports the use of screening during pregnancy, especially in the first trimester when the risk of infection is greater

PSieroprevalenza dell’infezione da Toxoplasma gondii nella popolazione femminile, italiana e straniera, residente nell’area di Legnano (MI)

Introduction. Anti-Toxoplasma antibodies prevalence varies worldwide, showing to be lower in industrializes countries of Northern Europe, and higher in developing countries. In Europe from the 80s’ to 2000 a progressive lessening of the prevalence within different ages was observed. Aim of our survey is to analyze the prevalence of anti-Toxoplasma antibodies among Italian and foreign women afferent to Legnano Hospital from 2000 till 2005. Method. The IgG antibody level of anti-Toxoplasma was tested in 11246 women, aged between 15 and 44 years, 1230 of which (10.9%) were foreigners. Results. The prevalence of IgG anti-Toxoplasma decreased from the 31.2% in 2000 to the 21.4,% in the 2005 (P&lt;0.01). Foreign women constituted 6.7% of our sample in 2000, growing up to 14.7% in 2005 (p&lt;0.01). Seroprevalence among Italian women shifted from 31.4% in 2000 to 19.5% in 2005 (p&lt;0.01), while among foreign women the seroprevalence remains stable around 30%. Conclusion. According to our data a decrease of immunity to the toxoplasmosis becomes apparent between 2000 and 2005, notwithstanding an increase of foreign women with higher seroprevalence

Evaluation of the TGS TA system for the detection of anti-cytomegalovirus antibodies

<em>Background and aims:</em> The aim of the present study was to evaluate the new Technogenetics TGS TA system for detecting anti-Cytomegalovirus IgG and IgM antibodies and IgG avidity. The TGS TA system was compared with our routinely used system, LIAISON XL, for the detection of IgG and IgM antibodies. Only in positive IgM samples, TGS TA system was compared to an enzyme linked fluorescent assay (ELFA) test (VIDAS, BioMérieux, Marcy-l’Étoile, France) and with LIAISON XL system for the IgG avidity (if possible). <br /><em>Materials and methods:</em> Three hundred sera samples from pregnant women were examined with the TGS TA system and divided in 3 groups according to IgG and IgM screening LIAISON XL tests: 102 were non-immune women (Group 1), 98 were pregnant with past infection (Group 2) and 100 were pregnant with positive or equivocal IgM (95 with positive IgG and 5 with negative IgG) (Group 3). <br /><em>Results:</em> The overall concordance of the IgG results between LIAISON XL and TGS TA was 98.3%: 97.1% in Group 1, 100% in Group 2 and 98.0% in Group 3. The overall concordance of the IgM results between LIAISON XL and TGS TA was 92.1%: 100% in Group 1, 99.0% in Group 2 and 70.1% in Group 3. In Group 3, the concordance between the results of the IgG avidity with the LIAISON XL and TGS TA tests was 87.4%. Comparing the clinical diagnosis obtained with our protocol and that of the TGS TA system, the overall concordance was 94.3%: 97.1% in Group 1, 99.0% in Group 2 and 87.0% in Group 3. <br /><em>Conclusions</em>: In conclusion, the overall clinical concordance between the LIAISON XL/VIDAS protocol and the TGS TA system is excellent. TGA TA system shows to be a valuable tool able to clearly identify non-specific subjects, those with a non-recent infection and classify as either recent or past infection half of the subjects with undetermined infection with our protocol

Management of Toxoplasma gondii screening in pregnancy: light and shade

The aim of our study was to evaluate the performance of screening for toxoplasmosis in pregnancy through comparing the data obtained from Italian and foreign women. 3074 women, 2465 Italians (80.2%) and 609 foreigners (19.8%) had undergone screening for serological detection of anti-Toxoplasma IgG and IgM antibodies in the years 2005-2007. 85.0% of the Italian women and 84.1% of the foreign women had the first blood test in the first trimester of pregnancy (difference not statistically significant).Among anti-Toxoplasma negative women average of blood tests during pregnancy was 3.69 for the Italians and 3.42 for the foreigners (p &lt;0.01). 32.2% of Italian and 28.3% of foreign women were subjected to five or more blood tests (difference not statistically significant). Considering the trimester of pregnancy, the percentage of Italian and foreign women tested at least once in every trimester was respectively 58.0% and 45.2% (p &lt;0.01). In conclusion, our data show that on the one hand the screening is active in controlling women within the first trimester of pregnancy, while on the other it appears weak in fully implementing the follow up, as indicated by the legislation currently in force. In addition, foreign women undergo fewer tests covering all trimesters compare to Italian women. This problem should be taken into account in terms of health policy