Epidemiology, management, and outcome of carbapenem-resistant Klebsiella pneumoniae bloodstream infections in hospitals within the same endemic metropolitan area

In the last decade, carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become endemic in several countries, including Italy. In the present study, we assessed the differences in epidemiology, management, and mortality of CR-Kp bloodstream infection (BSI) in the three main adult acute-care hospitals of the metropolitan area of Genoa, Italy.From January 2013 to December 2014, all patients with CR-Kp BSI were identified through the computerized microbiology laboratory databases of the three hospitals. The primary endpoints of the study were incidence and characteristics of CR-Kp BSI in hospitals within the same endemic metropolitan area. Secondary endpoints were characteristics of CR-Kp BSI in hospitals with and without internal infectious diseases consultants (IDCs) and 15-day mortality.During the study period, the incidence of healthcare-associated CR-Kp BSI in the entire study population was 1.35 episodes per 10,000 patient-days, with substantial differences between the three hospitals. Patients admitted to the two hospital with internal IDCs were more likely to receive post-susceptibility test combined therapy including carbapenems (77% vs. 26%, p <. 0.001), adequate post-susceptibility test therapies (86% vs. 52%, p <. 0.001), and post-susceptibility therapies prescribed by an infectious diseases specialist (84% vs. 14%, p <. 0.001). Overall, the crude 15-days mortality was 26%. In the final multivariable model, only septic shock at BSI presentation was unfavorably and independently associated with 15-days mortality (odds ratio [OR] 6.7, 95% confidence intervals [CI] 2.6-17.6, p <. 0.001), while a protective effect was observed for post-susceptibility test combined therapies including a carbapenem (OR 0.11, 95% CI 0.03-0.43, p = 0.002).Mortality of CR-Kp remains high. Differences in the incidence of CR-Kp BSI were detected between acute-care centers within the same endemic metropolitan area. Efforts should be made to improve the collaboration and coordination between centers, to prevent further diffusion of CR-Kp

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Vaccine-preventable infections in Systemic Lupus Erythematosus

restricted8noSystemic Lupus Erythematosus (SLE) is characterized by abnormal autoantibody production and clearance. Infections are among the most important causes of morbidity and mortality in SLE patients; they have an increased frequency of severe bacterial and viral infections possibly due to inherited genetic and immunologic defects and to immunosuppressive therapies. In addition, infectious agents can switch on lupus disease expression and activity. Among the strategies to reduce the risk of infection, vaccination can be considered the most reliable option. Most vaccines are effective and safe in SLE patients, although in certain cases immunogenicity may be sub-optimal and vaccination can trigger a flare. Although these issues are currently unresolved, the risk benefit balance is in favor for vaccination to reduce the risk of infection in SLE patients. In the present review we discuss the preventive strategies currently recommended to reduce bacterial and viral infections in SLE.restrictedMurdaca, Giuseppe; Orsi, Andrea; Spanò, Francesca; Faccio, Valeria; Puppo, Francesco; Durando, Paolo; Icardi, Giancarlo; Ansaldi, FilippoMurdaca, Giuseppe; Orsi, Andrea; Spano', Francesca; Faccio, Valeria; Puppo, Francesco; Durando, Paolo; Icardi, Giancarlo; Ansaldi, Filipp

Assessing Ebola-related web search behaviour: Insights and implications from an analytical study of Google Trends-based query volumes

BACKGROUND: The 2014 Ebola epidemic in West Africa has attracted public interest worldwide, leading to millions of Ebola-related Internet searches being performed during the period of the epidemic. This study aimed to evaluate and interpret Google search queries for terms related to the Ebola outbreak both at the global level and in all countries where primary cases of Ebola occurred. The study also endeavoured to look at the correlation between the number of overall and weekly web searches and the number of overall and weekly new cases of Ebola. METHODS: Google Trends (GT) was used to explore Internet activity related to Ebola. The study period was from 29 December 2013 to 14 June 2015. Pearson's correlation was performed to correlate Ebola-related relative search volumes (RSVs) with the number of weekly and overall Ebola cases. Multivariate regression was performed using Ebola-related RSV as a dependent variable, and the overall number of Ebola cases and the Human Development Index were used as predictor variables. RESULTS: The greatest RSV was registered in the three West African countries mainly affected by the Ebola epidemic. The queries varied in the different countries. Both quantitative and qualitative differences between the affected African countries and other Western countries with primary cases were noted, in relation to the different flux volumes and different time courses. In the affected African countries, web query search volumes were mostly concentrated in the capital areas. However, in Western countries, web queries were uniformly distributed over the national territory. In terms of the three countries mainly affected by the Ebola epidemic, the correlation between the number of new weekly cases of Ebola and the weekly GT index varied from weak to moderate. The correlation between the number of Ebola cases registered in all countries during the study period and the GT index was very high. CONCLUSION: Google Trends showed a coarse-grained nature, strongly correlating with global epidemiological data, but was weaker at country level, as it was prone to distortions induced by unbalanced media coverage and the digital divide. Global and local health agencies could usefully exploit GT data to identify disease-related information needs and plan proper communication strategies, particularly in the case of health-threatening events

Arbuscular Mycorrhizal Fungi Modulate the Crop Performance and Metabolic Profile of Saffron in Soilless Cultivation

Saffron (Crocus sativus L.) is cultivated worldwide. Its stigmas represent the highest-priced spice and contain bioactive compounds beneficial for human health. Saffron cultivation commonly occurs in open field, and spice yield can vary greatly, from 0.15 to 1.5 g m−2, based on several agronomic and climatic factors. In this study, we evaluated saffron cultivation in soilless systems, where plants can benefit from a wealth of nutrients without competition with pathogens or stresses related to nutrient-soil interaction. In addition, as plant nutrient and water uptake can be enhanced by the symbiosis with arbuscular mycorrhizal fungi (AMF), we also tested two inocula: a single species (Rhizophagus intraradices) or a mixture of R. intraradices and Funneliformis mosseae. After one cultivation cycle, we evaluated the spice yield, quality (ISO category), antioxidant activity, and bioactive compound contents of saffron produced in soilless systems and the effect of the applied AMF inocula. Spice yield in soilless systems (0.55 g m−2) was on average with that produced in open field, while presented a superior content of several health-promoting compounds, such as polyphenols, anthocyanins, vitamin C, and elevated antioxidant activity. The AMF symbiosis with saffron roots was verified by light and transmission electron microscopy. Inoculated corms showed larger replacement corms (+50% ca.). Corms inoculated with R. intraradices performed better than those inoculated with the mix in terms of spice quality (+90% ca.) and antioxidant activity (+88% ca.). Conversely, the mixture of R. intraradices and F. mosseae increased the polyphenol content (+343% ca.). Thus, soilless systems appeared as an effective alternative cultivation strategy for the production of high quality saffron. Further benefits can be obtained by the application of targeted AMF-based biostimulants

DFT study of methanol adsorption on PtCo(111)

Methanol adsorption on PtCo(111) surface at low coverage is studied using Density Functional Theory (DFT) calculations without and with van der Waals corrections. We investigated the PtCo FCT alloy surface with a uniform distribution. The most favorable site for CH3OH adsorption is on top of a Co atom, with an adsorption energy of −0.92 eV. Methanol attachs to the surface by the O atom, with a distance of 2.24 Å. The molecule presents a small distortion after adsorption. The C–O–Co bond angle is 142°. The C–H bonds are strengthened whereas the C–O and O–H bonds are weakened. A charge transfer from C atom to O atom occurs upon adsorption, and then further transfer occurs to the Co atom on the surface. The calculated vibrational frequencies for adsorbed methanol present a red-shift displacement compared to gas-phase, confirming the adsorption process.Fil: Orazi, Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; ArgentinaFil: Bechthold, Pablo Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; ArgentinaFil: Jasen, Paula Verónica. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; ArgentinaFil: Faccio Sgiorovello, Ricardo Juan. Universidad de la República; UruguayFil: Pronsato, Maria Estela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; ArgentinaFil: Gonzalez, Estela Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; Argentin

Effects of Native Vacancies on Nb-Doped MgH 2 Using Density Functional Theory Calculations

In the present work, we considered the effect of Nb and charged vacancies on the properties of magnesium hydride. We performed spin-polarized ab initio calculations substituting an Mg atom by an Nb impurity. Then, some charged vacancies were included in the MgH 2 + Nb system (V H , V Mg , or V Mg-H ). In each case, three possible charge states were considered (+1, 0, or -1). We computed cohesion and formation energies, band gap, and magnetic moment. We also calculated the transition level energy value and the density of states. Nb states are located in the gap, and a magnetic moment is induced. In the case of the system with charged vacancies, we found that V H + and V H 0 are the more probable vacancies formed, and the states near the Fermi level (E F ) are filled, thus getting an important reduction in the band gap.Fil: Gaztañaga, Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Eléctrica y de Computadoras; ArgentinaFil: Luna, Carla Romina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Eléctrica y de Computadoras; ArgentinaFil: Orazi, Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Eléctrica y de Computadoras; ArgentinaFil: Gonzalez, Estela Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Eléctrica y de Computadoras; ArgentinaFil: Faccio, Ricardo. Universidad de la República; UruguayFil: Jasen, Paula Verónica. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; Argentina. Universidad Nacional del Sur. Departamento de Ingeniería Eléctrica y de Computadoras; Argentin

La vaccinazione nel paziente con infezione da HIV: attuali raccomandazioni e strategie multidisciplinari per il raggiungimento dei soggetti suscettibili. L\u2019esperienza della Liguria

Even in the era of highly active antiretroviral therapy (HAART), HIV-infected subjects are at higher risk of complications from vaccine-preventable diseases than those uninfected. Despite the current national and international guidelines strongly recommend that these patients should been immunized, the available data indicate sub-optimal coverage rates, partially due to the difficulty in identifying those susceptible to preventable infections. In order to reach these subjects, the LIgurian Vaccination in HIV Program (LIV in HIV) aimed at proactive screening, identification and immunization of HIV-infected individuals. This program is based on a network of primary care/public health providers and specialists working together to ensure the timely administration of recommended vaccines. The Ligurian HIV Network web platform allows to identify the susceptible individuals, to monitor immunization coverage and to manage failures and defaulting, using a connection with regional immunization registry system. The aim of this study is to describe the experience of the referral outpatient clinics of Infectious Disease (San Martino-IST hospital and Galliera hospital) and Hygiene Unit (San Martino-IST hospital) in Genoa metropolitan area, in order to evaluate the acceptability of vaccination in HIV-infected patients

Additional file 2: S1. of Assessing Ebola-related web search behaviour: insights and implications from an analytical study of Google Trends-based query volumes

Dataset of raw weekly GT data and weekly new cases of Ebola as according to the WHO patient database and situation report at the global level (Sheet 1); in the three main affected West African Ebola countries (Guinea – Sheet 2, Sierra Leone – Sheet 3 and Liberia – Sheet 4); raw weekly GT data in all countries where primary cases of Ebola were registered and Pearson’s correlations (Sheet 5); total GT RSV and the total number of Ebola cases per country (Sheet 6). (XLSX 44 kb