6 research outputs found
Multi-year prevalence and macrolide resistance of Mycoplasma genitalium in clinical samples from a southern Italian hospital
The use of azithromycin for the treatment of Mycoplasma genitalium infections has led to resistance to macrolides. From July 2014 to July 2020, 7150 samples were analysed for the detection of sexually transmitted infections at the Policlinico of Bari. A total of 67/7150 samples (0.93%) were positive for MG DNA and 47 samples were analysed for the evaluation of six azithromycin resistance-associated mutations. In 5/47 samples, the A2058G mutation was detected (10.63%). Although the cases of positive MG samples and mutations are low in our reality, diagnostic tests to detect azithromycin resistant-associated genes may provide a convenient way to monitor resistance rate
Epidemiological evaluation of human papillomavirus genotypes and their associations in multiple infections
Abstract
The aim of this study was to determine the frequency of multiple type human papillomavirus
(HPV) infections, and whether any types are involved in multiple HPV-type infections
(mHPV) more or less frequently than expected. From January 2012 to February 2018, 2848
cervico-vaginal swabs were analysed in the UOC Microbiology and Virology of Policlinico
of Bari, Italy. HPV DNA detection was performed using initially nested-polymerase chain
reaction (PCR) and subsequently multiplex real-time PCR assay. 1357/2848 samples (47.65%)
were HPV DNA positive and 694/1357 (51.14%) showed mHPVs. The median number of
mHPVs was 2 (interquartile range: 2–3). HPV-types more frequently detected were 42
(9.97%), 16 (8.92%), 53 (7.23%) and 31 (7.16%). Each detected HPV-type was involved in
mHPVs in more than 50% of cases. Statistical analysis showed significant associations for all
HPV-types except for 33, 43, 51, 58 and 82 HPV-types. The major number of significant pairwise
associations were detected for the types 42 and 70. Only positive associations were detected.
Further data are necessary to evaluate the clinical impact of the single combinations
Epidemiological evaluation of human papillomavirus genotypes and their associations in multiple infections
Abstract
The aim of this study was to determine the frequency of multiple type human papillomavirus
(HPV) infections, and whether any types are involved in multiple HPV-type infections
(mHPV) more or less frequently than expected. From January 2012 to February 2018, 2848
cervico-vaginal swabs were analysed in the UOC Microbiology and Virology of Policlinico
of Bari, Italy. HPV DNA detection was performed using initially nested-polymerase chain
reaction (PCR) and subsequently multiplex real-time PCR assay. 1357/2848 samples (47.65%)
were HPV DNA positive and 694/1357 (51.14%) showed mHPVs. The median number of
mHPVs was 2 (interquartile range: 2–3). HPV-types more frequently detected were 42
(9.97%), 16 (8.92%), 53 (7.23%) and 31 (7.16%). Each detected HPV-type was involved in
mHPVs in more than 50% of cases. Statistical analysis showed significant associations for all
HPV-types except for 33, 43, 51, 58 and 82 HPV-types. The major number of significant pairwise
associations were detected for the types 42 and 70. Only positive associations were detected.
Further data are necessary to evaluate the clinical impact of the single combinations
A Retrospective Study about the Impact of Switching from Nested PCR to Multiplex Real-Time PCR on the Distribution of the Human Papillomavirus (HPV) Genotypes
Background and objectives: Human papillomavirus (HPV) is the most prevalent etiological agent of viral sexually-transmitted infection. This study retrospectively evaluated the impact of a switch to a real-time PCR assay in the HPV prevalence and genotypes distribution by a quasi-experimental before-and-after approach. Materials and Methods: In total, 1742 samples collected from 1433 patients were analyzed at the UOC Microbiology and Virology of Policlinico of Bari, Italy. HPV DNA detection was performed using initially nested PCR and subsequently multiplex real-time PCR assay. Results: Statistically significant difference in HPV overall prevalence after the introduction of the real-time assay was not detected (48.97% vs. 50.62%). According to different extraction-DNA amplification methods, differences were observed in the prevalence rates of HPV-45, 68, 40, 42, and 43. The lowest prevalence for HPV-45 was observed in the Magna Pure-Real Time PCR group, while HPV-68, 40, 42, and 43 were less observed in the Qiagen-Real Time PCR group. After, a multivariate logistic regression, an increase in the prevalence of HPV-42 (aOR: 4.08, 95% CI: 1.71–9.73) was associated with the multiplex real-time PCR assay. Conclusions: Although this study is a not a direct comparison between two diagnostic methods because it has a sequential structure, it serves to verify the impact of a new molecular assay on HPV distribution. Moreover, the stability of HPV prevalence over time suggests that the population composition and the behavioral variables did not likely change during the observation period. Our study proposes that the introduction of a molecular test for HPV detection may be related to changes of HPV genotypes distribution
Trends in Klebsiella pneumoniae strains isolated from the bloodstream in a teaching hospital in southern Italy.
Klebsiella pneumoniae is a common nosocomial pathogen
involved in many infectious diseases such as bacteraemia,
urinary and respiratory tract infections. It is
responsible for the rise in morbidity and mortality rates
since most clinical isolates exhibit resistance to several
antibiotics. Moreover, the epidemiology of these nosocomial
infections is variable across countries and regions.
From January 2015 to December 2017 we retrospectively
analysed the bloodstream infections caused by K. pneumoniae
strains in hospitalised patients with the aim of
studying the temporal trends of wild type (WT), multi-
drug resistant (MDR), extended drug resistant (XDR),
pan-drug resistant (PDR) and carbapenem-resistant
(CR) strains. In all, 439 K. pneumoniae isolates from 356
patients were collected from all units of the Policlinico
of Bari. The majority of clinical isolates were collected
from the intensive care unit (125, 28.47%), haematology
(34, 7.74%), rehabilitation (27, 6.15%) and cardiac
surgery wards (25, 5.69%). Moreover, the majority of
SUMMARY
the isolates were classified as CR (325, 74.03%, 95%CI:
69.61-78.19) and XDR (255, 58.09%, 95%CI: 53.31-62.72).
Annual prevalence rates and monthly counts were analysed
using the Chi Squared test for trends and the
Poisson regression with multiple p-value correction
according to Benjamini and Hochberg’s procedure. The
annual relative frequencies of the XDR and CR K. pneumoniae
isolates decreased significantly from 63.37% to
48.44% and from 78.48% to 63.28% respectively, while
WT K. pneumoniae significantly increased from 13.95%
to 23.44%. Poisson regression analysis confirmed the
presence of a decreasing monthly trend for the XDR and
CR K. pneumoniae count series. In order to control the
spread of antibiotic resistance, more inclusive surveillance
data will be needed to either confirm these results
or improve antibiotic stewardship measures
Trends in the antibiotic resistance of S. aureus clinical isolates: a 4 years retrospective study in a teaching hospital in South Italy.
Staphylococcus aureus is responsible for life-threatening
conditions, while in the meantime it has rapidly
acquired resistance to several antibiotic classes. In the
context of an effective empirical antibiotic therapy, an
accurate evaluation of the resistance rates of S. aureus
may be critical. The aim of this study was to determine
the resistance rates of S. aureus in the years 2015-2018
and to assess the impact of specimen stratification on
the resistance rates.
We have retrospectively analysed S. aureus strains isolated
from blood, bronchial aspirate, pus, sputum and
urine collected from hospitalized and ambulatory care
patients. The comparison between resistance rates from
2015 to 2018 and among different specimens was assessed
by Fisher’s exact test followed by Benjamini and
Hochberg’s correction of the p-values.
Higher resistance rates were detected for penicillin
followed by oxacillin, levofloxacin, erythromycin
and clindamycin. Differences in the annual resist-
SUMMARY
ance rates were not statistically significant after the
BH’s correction. The comparison between cumulative
S. aureus resistance rates stratified by specimens
showed some statistically relevant differences among
the five specimen types. In particular, p-values were
statistically significant for clindamycin, erythromycin,
gentamicin, levofloxacin, oxacillin, penicillin and
vancomycin.
Annual resistance rates of S. aureus clinical isolates
remained constant over the course of time. Moreover,
the stratification of the data by specimen may significantly
impact on the evaluation of the resistance rates,
at least for some antibiotics. Therefore, if the number
of data is high, stratification by specimens may be recommendable
to better approach an empirical antibiotic
therapy