Fusariosis in a Patient with Acute Myeloid Leukemia: A Case Report and Review of the Literature

Fusarium spp. causes infections mostly in patients with prolonged neutropenia. We describe the case of a disseminated Fusariumsolani infection in a patient with acute myeloid leukemia which never reached complete remission during its clinical course. The patient had profound neutropenia and developed skin nodules and pneumonia in spite of posaconazole prophylaxis. F. solani was isolated from blood and skin biopsy, being identified from its morphology and by molecular methods. By broth dilution method, the strain was resistant to azoles, including voriconazole and posaconazole, and to echinocandins. MIC to amphotericin B was 4 mg/L. The patient initially seemed to benefit from therapy with voriconazole and amphotericin B, but, neutropenia perduring, his clinical condition deteriorated with fatal outcome. All efforts should be made to determine the correct diagnosis as soon as possible in a neutropenic patient and to treat this infection in a timely way, assuming pathogen susceptibility while tests of antimicrobial susceptibility are pending. A review of the most recent literature on invasive fungal infections is reported

Susceptibility of Helicobacter pylori to Antibiotics Including Tigecycline

Abstract Background: H. pylori antibiotic resistance is an important factor in the treatment failure, therefore is important to know the local pattern of this resistance. Material and Methods: A total of 111 patients were studied. Ninety- one H. pylori strains isolated from patients, including 12 from children, having previous repeated treatment failure and 20 strains were isolated from naïve patients, were studied. Antibiotic susceptibility including those to tigecycline, was determinated by E-Test. Results: In treated adult and children patients the resistance rates were respectively 81% and 91.6% for clarithromycin; 27.8% and 41% for amoxicillin; 67.1% and 16.7% for metronidazole; 38% and 8.3% for levofloxacin; 5.1% and 0% for tetracycline. Primary resistance, in naïve adult patients was 50% for clarithromycin, 10% for amoxicillin, 20% for metronidazole, 30% for levofloxacin and 0% for tetracycline. Tigecycline has shown good activity, in vitro, against H. pylori (MIC90 = 0.064 mg/L). Conclusion: The resistance rates found in H. pylori, in our area, are very high both in naïve and treated patients. Few papers have reported the tigecycline susceptibility in H. pylori. The good activity and the lack of resistance to tigecycline found in our study, may consider this antibiotic a “rescue” therapy, saving the use of other antibiotics such as rifabutin, a drug used for the treatment of tuberculosis

Paecilomyces lilacinus Keratitis in a Soft Contact Lens Wearer

ABSTRACT:: We describe a case of keratitis caused by Paecilomyces lilacinus in a contact lens wearer with a history of diabetes

Prevalence of urinary schistosomiasis in migrants in Apulia, a region of southern Italy, in the years 2006-2016

Schistosomiasis is the most prevalent tropical disease in the world after malaria. According to the World Health Organization, the disease afflicts more than 240 million people in about 80 countries. Recently, an epidemiological surveillance study performed between 1997 and 2010 by the European Network for Tropical Medicine and Health Travel regarding schistosomiasis between immigrants and travelers has been published. No data are available in the literature regarding the situation in South Italy. Herein, we report the prevalence of urinary schistosomiasis in a population of migrants in Apulia referring to our outpatient clinic for immigrant diseases in the period 2006-2016. Since all cases of schistosomiasis were related to the last three years of observation, the demographic and clinical characteristics of the study population were compared before and after 2014. Nearly 51% of all patients visited (1762) were from high/moderate endemic countries for schistosomiasis, and nine cases of urinary schistosomiasis were diagnosed. Prevalence was 1% among migrants from endemic areas and 10% in those from Mali and Senegal. Our findings confirm that schistosomiasis is a widespread infection among immigrants, even if it is often underdiagnosed because of the multifaceted clinical presentation. Changes in migratory dynamics can affect clinical observations very quickly

Isolation and molecular characterization of free-living amoebae from different water sources in Italy

Free-living amoebae (FLA) are protozoa ubiquitous in Nature, isolated from a variety of environments worldwide. In addition to their natural distribution, some species have been found to be pathogenic to humans. In the present study a survey was conducted in order to evaluate the presence and to characterize at molecular level the isolates of amoebic organisms collected from different water sources in Italy. A total of 160 water samples were analyzed by culture and microscopic examination. FLA were found in 46 (28.7%) of the investigated water samples. Groundwater, well waters, and ornamental fountain waters were the sources with higher prevalence rates (85.7%, 50.0%, and 45.9%, respectively). Identification of FLA species/genotypes, based on the 18S rDNA regions, allowed to identify 18 (39.1%) Acanthamoeba isolates (genotypes T4 and T15) and 21 (45.6%) Vermamoeba vermiformis isolates. Other FLA species, including Vahlkampfia sp. and Naegleria spp., previously reported in Italy, were not recovered. The occurrence of potentially pathogenic free-living amoebae in habitats related to human population, as reported in the present study, supports the relevance of FLA as a potential health threat to humans

Diffusion and Persistence of Multidrug Resistant Salmonella Typhimurium Strains Phage Type DT120 in Southern Italy

Sixty-two multidrug resistant Salmonella enterica serovar Typhimurium strains isolated from 255 clinical strains collected in Southern Italy in 2006–2008 were characterised for antimicrobial resistance genes, pulsotype, and phage type. Most strains (83.9%) were resistant to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, and tetracycline (ACSSuT) encoded in 88.5% by the Salmonella genomic island (SGI1) and in 11.5% by the InH-like integron (blaOXA-30–aadA1) and catA1, sul1, and tet(B) genes. STYMXB.0061 (75%) and DT120 (84.6%) were the prevalent pulsotype and phage type identified in these strains, respectively. Five other resistance patterns were found either in single or in a low number of isolates. The pandemic clone DT104 (ACSSuT encoded by SGI1) has been identified in Italy since 1992, while strains DT120 (ACSSuT encoded by SGI1) have never been previously reported in Italy. In Europe, clinical strains DT120 have been reported from sporadic outbreaks linked to the consumption of pork products. However, none of these strains were STYMXB.0061 and SGI1 positive. The prevalent identification and persistence of DT120 isolates would suggest, in Southern Italy, a phage type shifting of the pandemic DT104 clone pulsotype STYMXB.0061. Additionally, these findings raise epidemiological concern about the potential diffusion of these emerging multidrug resistant (SGI linked) DT120 strains