Direct use of eazyplex\uae SuperBug CRE assay from positive blood cultures in conjunction with inpatient infectious disease consulting for timely appropriate antimicrobial therapy in Escherichia coli and Klebsiella pneumoniae bloodstream infections

Objectives: To describe a rapid workflow based on the direct detection of Escherichia coli (Ec) and Klebsiella pneumoniae (Kp) producing CTX-M extended-spectrum \u3b2-lactamase (ESBL) and/or carbapenemases (eg, KPC, VIM) from blood cultures (BCs) and the infectious disease (ID) consulting for timely appropriate antimicrobial therapy. Methods: This observational, retrospective study included adult patients with a first episode of Ec or Kp bloodstream infection (BSI) in a large Italian university hospital, where an inpatient ID consultation team (IDCT) has been operational. Results from the BCs tested for detecting bla CTX-M, bla KPC, bla NDM, bla OXA-48-like, and bla VIM genes by the eazyplex\uae SuperBug CRE assay in Ec and Kp organisms had been notified for antimicrobial therapy consulting. Results: In 321 BSI episodes studied, we found that 151 (47.0%) of Ec or Kp organisms harbored bla CTX-M and/or bla KPC and/or bla VIM (meantime from BC collection: 18.5 h). Empirical antimicrobial treatment was appropriate in 21.8% (33/151) of BSIs, namely 5.9% (3/51) of BSIs caused by KPC/VIM producers and 30.0% (30/100) of BSIs caused by CTX-M producers. After notification of results, the IDCT modified antimicrobial therapy (mean time from BC collection: 20 h) such that the proportion of appropriate treatments increased to 84.8% (128/151) of BSIs, namely 70.6% (36/51) of BSIs caused by KPC/VIM producers and 92.0% (92/100) of BSIs caused by CTX-M producers. Conclusion: Our study shows that a rapid diagnostic-driven clinical strategy allowed for early prescription of potentially effective antimicrobial therapy in BSIs caused by CTX-M ESBL- and/or KPC/VIM carbapenemase-producing Ec and Kp organism

UAV SYSTEM DEVELOPMENT FOR THE MONITORING AND STUDY VOLCANIC AND NATURAL HAZARD EVENTS.

During a natural hazard as volcano eruption the aircraft or helicopter reconnaissance flight require human operators. This implies a high risk level which depends on the environmental conditions. The Unmanned Air Vehicles (UAV) allows to operate a monitoring and surveillance in safety. An experiment of a radio controlled UAV has been carried out on Stromboli volcano on 2004. From this experience a UAV system, (automated controlled), devoted to volcanoes monitoring is under development at the DIEM Department of the University of Bologna. The projected UAV will be furnished of Visible camera will also lodge an IR camera and will experiment a new micro-interferometer based on MOEMS technology, (developed by IMM Institute of CNR), suitable to perform DOAS Fourier spectroscopy, to detect atmospheric trace gases. The uses of the IR camera are relevant in monitoring, during pre-crisis, for thermal anomalies detection and, during crisis, for lava temperatures measurements. These parameters, jointly to the spectral measurements performed by MOEMS interferometer, are useful for the theoretical model improvement. We report the state of art of the system that, thanks to its modularity and restricted dimensions, may be disassembled, sent where the emergency occur, and reassembled in a very short time