transmitted drug resistance mutations and trends of hiv 1 subtypes in treatment naive patients a single centre experience

Abstract Background Transmitted drug resistances (TDRs) and HIV-1 diversity could affect treatment efficacy and clinical outcomes. Here we describe the circulating viral subtypes and estimate the prevalence of resistance among drug naive patients attending Sapienza University Hospital in Rome from 2006-2017. Methods Genotypic resistance test (GRT) was performed on 668 ART-naive patients. GRT were conducted in integrase (n = 52), protease and reverse transcriptase (n = 668) sequences. Results Twenty-one different subtypes and Circulating Recombinant Forms (CRFs) were identified. Subtype B was the most common (67%), followed by CRF02_AG (8.3%), subtypes C and F (6%). We found a significantly increased overtime in the proportion of non-B strains and in the rates of non-Italian patients (p  Minor or accessory INSTI mutations were detected in 17.3% of patients. No significant decrease of TDR prevalence was documented overtime. Conclusion The significant increase of non-B subtypes suggests that the molecular epidemiology of HIV-1 is changing. The detection of a major INSTI mutation in two naive patients highlights the importance of performing GRT before commencing treatment. This finding and the lack of a significant reduction of TDR underline the importance of a continuous surveillance of resistance mutations

Full-length genome sequence of a dengue serotype 1 virus isolate from a traveler returning from Democratic Republic of Congo to Italy, July 2019.

Abstract We report the full-genome sequence of a Dengue serotype-1 virus (DENV-1) isolated from a traveller returning in July 2019 to Italy from Democratic Republic of Congo (DRC), which is currently affected by Ebola and measles outbreaks. The sequence shows high similarity with two 2013 strains isolated in Angola and China

Association between Staphylococcus aureus nasal carriage and disease phenotype in patients affected by systemic lupus erythematosus

Staphylococcus aureus (SA) is a commensal bacterium representing one of the most important components of the skin microbiome, mostly isolated in the anterior nares. A higher rate of SA nasal colonization in patients affected by Wegener's granulomatosis and rheumatoid arthritis compared with healthy subjects (HS) has been described. No studies focusing on systemic lupus erythematosus (SLE) are available. We aimed at analyzing the prevalence of SA nasal carriers in an SLE cohort and evaluating correlation between nasal colonization and clinical, laboratory and therapeutic features. METHODS: We enrolled 84 patients with SLE (number of male/female patients 6/78; mean age 41.3 ± 12.2 years, mean disease duration 142.1 ± 103.8 months) and 154 HS blood donors. Patients with SLE underwent a physical examination and the clinical/laboratory data were collected. All the patients with SLE and the HS received a nasal swab for SA isolation and identification. RESULTS: SA nasal colonization prevalence was 21.4 % in patients with SLE and 28.6 % in HS (P not significant). We analyzed patients with SLE according to the presence (n = 18, SA-positive SLE) or the absence (n = 66, SA-negative SLE) of nasal colonization. Renal involvement was significantly more frequent in SA-positive SLE (11.6 % vs 3.0 %; P = 0.0009). Moreover, the presence of anti-dsDNA, anti-Sm, anti-SSA, anti-SSB, anti-RNP antibodies was significantly higher in SA-positive SLE (P < 0.0001, P = 0.01, P = 0.008, P = 0.03, P = 0.03, respectively). CONCLUSION: SA colonization is a relatively frequent condition in patients with SLE, with a frequency similar to HS. The presence of SA seems associated with a peculiar SLE phenotype characterized by renal manifestations and autoantibody positivity, confirming the role of the microbiome in disease phenotype

Capitolo 7.2. Artriti da agenti infettivi.

Le artriti da agenti infettivi sono causate dall’azione nel microambiente articolare di un agente infettivo, sia esso un batterio, un virus, un micete o un parassita che si moltiplica attivamente nel cavo articolare provocando un’intensa risposta infiammatoria. Le forme acute sono generalmente provocate da batteri piogeni o virus, mentre le artriti da funghi e micobatteri sono più subdole e tendono a cronicizzare

Capitolo 7.8 Artriti da agenti infettivi

Le artriti da agenti infettivi sono causate dall’azione nel microambiente articolare di un agente infettivo, sia esso un batterio, un virus, un micete o un parassita che si moltiplica attivamente nel cavo articolare provocando un’intensa risposta infiammatoria. Le forme acute sono generalmente provocate da batteri piogeni o virus, mentre le artriti da funghi e micobatteri sono più subdole e tendono a cronicizzare

Spontaneous Spinal Infections: Diagnostic and Therapeutic Management. The experience of Neurosurgery department of University of Rome “Sapienza”

Spinal infectious disease has an incidence ranging from 0.5 to 5% [1]. The spondylodiscitis or, more generally, osteomyelitis, represents the most common spinal infection. This is an inflammatory process that may involve the vertebral body, the posterior elements, the intersomatic space, the epidural space, the paraspinal soft tissues and secondly the meninges or spinal cord. These structures can be involved individually or together in the same patient. These nosological entities, if not properly and early treated, can lead to significant and dramatic consequences such as permanent paralysis or other neurological sequelae and spinal deformity. With the advent of antibiotics, with the improvement of management techniques and especially with early identification of the disease, the mortality associated with spinal infections decreased significantly, with a mortality rate of less than 5% in developing countries [34]

Clinical Application of Antibacterial Hydrogel and Coating in Orthopaedic and Traumatology Surgery

Implant related infection is one of the most frequent complications in orthopaedic and trauma surgery. Local antibiotic treatment strategies are becoming part of the prevention and treatment methodology for this fearful complication. To date, there are two coatings available on the market, both with a polylactic acid base. Current evidence supports the use of these types of coatings in the prophylaxis of periprosthetic infections and fracture-related infections. However, their therapeutic use has been less investigated. The purpose of this article is to summarise recent evidence relating to the clinical application of antibacterial hydrogels and coatings in orthopaedic and traumatology surgery and indicating which future applications may benefit from it

Mesenteric adenitis caused by Yersinia pseudotubercolosis in a patient subsequently diagnosed with Crohn's disease of the terminal ileum.

Although the association between inflammatory bowel disease and gastrointestinal infections has been suggested, the mechanisms involved in the pathogenesis of Crohn's disease (CD) are still undetermined. We report the case of a man, who presented with mesenteric adenitis initially due to a Yersinia pseudotubercolosis infection, who was later diagnosed with Crohn's disease. This case is in keeping with recent evidence in the literature which suggests that CD is a disease linked to abnormal immune responses to enteric bacteria in genetically susceptible individuals

Multidisciplinary management of Spontaneous Spinal Infections: there is a correlation between timing, type of treatment and outcome? A multivariate analysis of an observational cohort study

Spontaneous Spinal Infections SSI represent a rare and serious pathological entity. We've tried to study a correlation between type of treatment, timing of treatment and clinical outcome through a multivariate analysis of an observational cohort study with the aim to define what is the optimal clinico-therapeutic management