Antibiotic Resistance in Paediatric Febrile Urinary Tract Infections

: Febrile urinary tract infection (UTI) is currently considered the most frequent cause of serious bacterial illness in children in the first 2 years of life. UTI in paediatrics can irreversibly damage the renal parenchyma and lead to chronic renal insufficiency and related problems. To avoid this risk, an early effective antibiotic treatment is essential. Moreover, prompt treatment is mandatory to improve the clinical condition of the patient, prevent bacteraemia, and avoid the risk of bacterial localization in other body sites. However, antibiotic resistance for UTI-related bacterial pathogens continuously increases, making recommendations rapidly outdated and the definition of the best empiric antibiotic therapy more difficult. Variation in pathogen susceptibility to antibiotics is essential for the choice of an effective therapy. Moreover, proper identification of cases at increased risk of difficult-to-treat UTIs can reduce the risk of ineffective therapy. In this review, the problem of emerging antibiotic resistance among pathogens associated with the development of paediatric febrile UTIs and the best potential solutions to ensure the most effective therapy are discussed. Literature analysis showed that the emergence of antibiotic resistance is an unavoidable phenomenon closely correlated with the use of antibiotics themselves. To limit the emergence of resistance, every effort to reduce and rationalise antibiotic consumption must be made. An increased use of antibiotic stewardship can be greatly effective in this regard

Epidemiology, Clinical Features and Prognostic Factors of Pediatric SARS-CoV-2 Infection: Results From an Italian Multicenter Study

Background: Many aspects of SARS-CoV-2 infection in children and adolescents remain unclear and optimal treatment is debated. The objective of our study was to investigate epidemiological, clinical and therapeutic characteristics of pediatric SARS-CoV-2 infection, focusing on risk factors for complicated and critical disease. Methods: The present multicenter Italian study was promoted by the Italian Society of Pediatric Infectious Diseases, involving both pediatric hospitals and general pediatricians/family doctors. All subjects under 18 years of age with documented SARS-CoV-2 infection and referred to the coordinating center were enrolled from March 2020. Results: As of 15 September 2020, 759 children were enrolled (median age 7.2 years, IQR 1.4; 12.4). Among the 688 symptomatic children, fever was the most common symptom (81.9%). Barely 47% of children were hospitalized for COVID-19. Age was inversely related to hospital admission (p < 0.01) and linearly to length of stay (p = 0.014). One hundred forty-nine children (19.6%) developed complications. Comorbidities were risk factors for complications (p < 0.001). Viral coinfections, underlying clinical conditions, age 5\u20139 years and lymphopenia were statistically related to ICU admission (p < 0.05). Garazzino et al. SARS-CoV-2 in Children and Adolescents Conclusions: Complications of COVID-19 in children are related to comorbidities and increase with age. Viral co-infections are additional risk factors for disease progression and multisystem inflammatory syndrome temporarily related to COVID-19 (MIS-C) for ICU admission

Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day-17.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered

Determinazione di composti organostannici in campioni ambientali mediante cromatografia liquida accoppiata a spettrometria di massa al plasma accoppiato induttivamente

I composti organostannici (OTC), in particolar modo il tributilstagno (TBT), sono stati utilizzati, a partire dagli anni ’50, principalmente come fungicidi, conservanti del legno ed additivi nelle vernici antivegetative. L’estensivo uso in diverse applicazioni ha determinato la loro diffusa presenza negli ambienti acquatici, principalmente marino-costieri e lagunari. Nonostante le numerose iniziative legislative, emanate a livello comunitario e internazionale, volte a contrastare la contaminazione marina da TBT, sostanza prioritaria pericolosa, rimane oggi l’urgenza di monitorare i composti organostannici negli ambienti acquatici, data l’elevata persistenza e la loro biomagnificazione lungo la catena alimentare. Lo standard di qualità ambientale (SQA) stabilito per i composti di TBT nei sedimenti marini è 5 µg/kg ss. Pertanto, si richiedono tecniche analitiche sensibili e selettive, conformi ai requisiti normativi, per poter rilevare questi composti in matrici complesse come quelle ambientali. L'attuale metodica (GC/MS) adottata dalle agenzie di protezione nazionali e internazionali prevede una laboriosa e complessa procedura di preparazione del campione, che può risultare in basse rese di estrazione e perdita di analiti, quindi ad una sottovalutazione del contenuto di OTC nei campioni ambientali. Lo scopo di questo studio è stato lo sviluppo di un metodo per la speciazione del TBT e dei suoi prodotti di degradazione, dibutilstagno (DBT) e monobutilstagno (MTB), mediante cromatografia liquida accoppiata a spettrometria di massa al plasma accoppiato induttivamente (HPLC-ICP-MS). La separazione è stata ottenuta in meno di 9 minuti utilizzando una colonna con fase stazionaria octadecilsilica (C18) e fase mobile Metanolo: Acqua : Acido Acetico : Tropolone (60%:35%:5%:0.02%). Questa tecnica consente di semplificare in modo significativo la fase di preparazione dei campioni, rendendo non necessario lo step di derivatizzazione, e di raggiungere elevata sensibilità

Speciation of organotin compounds in environmental samples

Organotin compounds (OTCs) are well known global pollutants. Depending on the nature and the number of the organic groups bound to the Sn cation, some organotins show specific toxic effects to different organisms, even at very low concentration levels. They are considered endocrine disruptors, as responsible for genetic, reproductive and metabolic disorders[1] and because of their persistence, OTCs presence and bioaccumulation in living organisms is still a current issue[2]. The Ministerial Decree n°260/2010 sets the environmental quality standard EQS for TBT compounds in marine sediments at 5µg/kg dw. Therefore, analytical methods in compliance with the EQS proposed to protect the aquatic environment and human beings are needed. The current methodology adopted by national and international protection agencies consists in different sequential steps, after sample lyophilization and homogenization, such as extraction, derivatisation with Grignard reagent, clean up and, finally, GC/MS determination. Since low yields of derivatization and losses of analytes can easily occur during all this complex sample preparation procedure, leading to an underestimation of OTCs content in environmental samples, more accurate and sensitive analytical methods need to be improved in order to be able to detect these compounds in complex matrices such as sediments and biota. HPLC-inductively coupled plasma mass spectrometer (HPLC-ICP-MS) is a promising technique to satisfy these requirements. In addition, methods based on HPLC-ICP-MS can significantly simplify sample preparation step avoiding derivatization, moreover they allow for speciation of organotin compounds. Therefore, the aim of this study was the development of a hyphenated method to determine organotin compounds (tributyltin TBT, dibutyltin DBT, monobutyltin MTB), applicable to the analysis of biotic and abiotic marine samples. In order to evaluate the performance of HPLC-ICP-MS method, the results have been compared to those obtained from standard methodology adopted by protection agencies

Occurance of heavy metals in sediments and biota in Northern Adriatic Sea

Due to the low depth and the modest water exchange, Adriatic Sea is considered a fragile area. In particular, the Northern area receives fresh water input from a series of sources; the most important one is the Po River which drains intensely cultivated and industrialized hinterland areas and releases into the sea great amounts of dissolved and particulate materials, including anthropogenic contaminants. The aim of this study was to monitor heavy metals concentrations, in biotic and abiotic samples. Heavy metals, especially mercury, are often present in industrial and municipal effluents and are ubiquitary pollutants frequently detected in the environment that can cause long-term effects on marine ecosystems. In particular, samples of sediments, fishes and filter-feeding organisms, collected in the North-Est area of Adriatic Sea were analyzed. The samples were homogenized and digested with nitric acid and hydrogen peroxide by using microwave-oven technique. The analyses were performed by graphite furnace absorption spectrometry (Cd and As), atomic emission spectrometry (ICP-AES) (Ba, Cr, Fe, Mn, Ni, Pb, Cu and Zn) and cold vapour atomic absorption spectrometry after amalgamation traps on gold for the preconcentration of mercury in order to lower the detection limit of the analyte

Adsorption of L-lysine on zeolites: effect of different framework topology and different Si/Al ratio

The study of the ability of zeolites to adsorb amino acids is significant to improve the knowledge of the interactions between these molecules and solid surfaces. This is of fundamental importance to increase the level of understanding of much more complex systems and to select adsorbent materials able to selectively capture amino acids from aqueous solutions.[1] Zeolites are aluminosilicate materials characterized by regular crystalline structure with microporous cavities which confer a high superficial area. The physico-chemical proprieties of zeolites depend on the composition of their framework that consist of tetrahedral units of SiO4 and AlO4 and, in particular, their ratio (SAR) characterizes the hydrophilic/hydrophobic behavior of the material. Moreover, the different conformation and dimension of the internal channels and cages influence the adsorption selectivity towards host molecules.[2] The ability of zeolites to adsorb biologically active biomolecules such as amino acids is of particular interest in industrial biotechnology[3] due to the fact that these adsorbent materials could be used as solid solvents to stabilize the different charged forms of the amino acids. In this study we tested the different adsorption capacity of zeolites L and ZSM-5 towards the amino acid L-lysine. These zeolites were chosen since they present different framework, with 2D and 3D channels structures, and different pore dimensions. Moreover, for the zeolite ZSM-5, two materials having different SAR were selected to study the effect of zeolite chemical composition on the adsorption capacity. Kinetic and isothermal experiments were carried out at different L-lysine initial concentrations to study the adsorption processes. The results show high capacity towards the adsorption of L-lysine for every zeolite investigated. We found a higher capacity for zeolite L with respect to ZSM-5. Moreover, zeolite ZSM-5 with greater SAR has shown less adsorption, probably a cause of different surface charge. [1][4] Moreover, the results obtained by thermal analyses (TGDTG- DTA) showed different interactions within the amino acid-zeolite adduct and different stability, depending on the peculiarities of the zeolites studied. Further investigation of the refinements of X ray powder diffraction patterns showed the adsorption sites, the orientation and the interactions of the amino acid molecules within the zeolite channels. This work allowed to improve the understanding of the formation and interactions of the adducts that originate from the adsorption of amino acids on zeolites. The information obtained are useful for separation of amino acids from complex mixtures. [1] G. Beltrami, A. Martucci, L. Pasti, T. Chenet, M. Ardit, L. Gigli, M. Cescon, E. Suard, ChemistryOpen 2020, 9(10), 978–982. [2] A. Martucci, L. Pasti, N. Marchetti, A. Cavazzini, F. Dondi, A. Alberti, Micropor. Mesopor. Mat. 2012, 148(1), 174-183. [3] K. Stückenschneider, J. Merz, and G. Schembecker, J. Phys. Chem. 2014, 118, 5810-5819. [4] T. Chenet, A. Martucci, M. Cescon, G. Vergine, G. Beltrami, L. Gigli, M. Ardit, M. Migliori, E. Catizzone, G. Giordano, L. Pasti, Micropor. Mesopor. Mat., 2021, 323, 111183

Contamination of organotin compounds in the Northern Adriatic Sea

The aim of this study was to monitor organotin compounds (tributyltin TBT, dibutyltin DBT, monobutyltin MTB) concentrations, in biotic and abiotic marine samples. In particular, samples of sediments, fishes and filter-feeding organisms, collected in the North-Est area of Adriatic Sea were analysed. The Ministerial Decree n°260/2010 sets the environmental quality standard EQS for TBT compounds in marine sediments at 5μg/kg dw. Therefore, analytical methods in compliance with the EQS proposed to protect the aquatic environment and human beings are needed. HPLC-inductively coupled plasma mass spectrometer (HPLC-ICP-MS) is a promising technique to satisfy these requirements. In addition, methods based on HPLC-ICP-MS can significantly simplify sample preparation step avoiding derivatization, moreover they allow for speciation of organotin compounds. In order to evaluate the performance of HPLC-ICP-MS method, the results have to be compared to those obtained from current methodology adopted by national and international protection agencies. In this study, after sample lyophilization and homogenization, the analytical procedure consisted in different sequential steps, such as extraction, derivatisation, clean up and, finally, GC/MS determination

Speciation analysis of organotin compounds by capillary electrophoresis with direct ultraviolet absorbance detection

Organotin compounds (OTCs), particularly tributyltin, have been widely used as biocides in antifouling paints. These pollutants have been detected in many aquatic ecosystems, with highest concentrations in the marine coastal and lagoon environments; their widespread diffusion is due to their use in many activity sectors and their chemical characteristics. OTC are extremely toxic to a wide range of organisms, including humans; they are considered endocrine disruptors, as responsible for genetic, reproductive and metabolic disorders. Because of their persistence, there is increasing concern over their presence in the environment. The most commonly used separation techniques are liquid chromatography LC and gas chromatography GC, despite the need for derivatization of organotin compounds to more volatile species, one of the most critical steps in organotin analysis. Capillary electrophoresis (CE) could be an alternative technique of great potential because the organotin species can be separated without changing the actual chemical form of the species. In addition, CE has the advantages of high speed, high efficiency, relatively low cost and requires much smaller sample. Therefore, the aim of this study was the development of a CE method for the inexpensive and quick determination of organotin compounds (tributyltin TBT, dibutyltin DBT, monobutyltin MTB) using direct ultraviolet absorbance detection, although their lack of chromophore, by proper selection of acetate buffer, pH adjustment and organic modifier addition to the background electrolyte. Future studies will concern the improvement of sensitivity and the development of a preconcentration step, using new materials such as zeolite, in order to evaluate the applicability of the method to real environmental samples