Occurrence of a case of influenza A(H1N1)pdm09 and B co-infection during the epidemic season 2012–2013

We report the detection of one case of co-infection with influenza A(H1N1)pdm09 and B, occurred during the 2012–2013 influenza season in Sicily. The dual infection was identified in a 18-year-old boy, who was not covered by specific vaccination and who had no other pre-existing risk factors. He presented classical symptoms of influenza-like illness developing no respiratory complications. A(H1N1)pdm09 viral concen- tration was initially about 10-fold higher than B virus, whereas its clearance was more rapidly achieved than in the case of B virus infection. Although influenza co-infection appears to be a rare event, a contin- ued influenza surveillance activity is recommended, in order to evaluate diversity and evolution, but also to support public health prevention measures

Prevalence of Occult Hepatitis B Virus Infection in a Cohort of HIV-Positive Patients Resident in Sicily, Italy

Occult hepatitis B virus (OBI) in HIV-infected groups is still debated, as well as the associated risk-factors and clinical significance. In this paper, we examined a total of 405 HBsAg-negative/HIV-infected patients enrolled from January 2007 to December 2009. Overall, the prevalence of OBI was 5.9% (95% confidence interval (CI95%): 3.8–8.7%); it was more frequently associated with “anti- HBc alone” serological marker (11.3%; adjusted odds ratio = 3.7, CI95%: 1.4–9.8), although it was also detected in the absence of any HBV serological marker (4.9%; CI95%: 2.3–9.1%). A low prevalence of anti-HCV-positive patients with OBI was found (3.1%; CI95%: 0.6–8.7%). HIV RNA plasma levels or other immunological/clinical characteristics were not significantly associated with OBI. All but one occult HBV infections were sustained by genotype D viral strains. OBI is relatively frequent in HIV-infected patients, although it does not seem to exert a relevant clinical impact. Viral genotypes in occult HBV infections reflect those circulating in the Mediterranean area

Estimating the burden of hospitalization for pneumococcal pneumonia in a general population aged 50 years or older and implications for vaccination strategies

Streptococcus pneumoniae is a major cause of human infectious diseases worldwide. Despite this documented evidence, data on pneumococcal disease rates among general populations are scant because of the frequent lack of cultural identification. In this study we propose a model for estimating the burden of pneumococcal pneumonia on hospitalizations. The study was performed by analyzing administrative and clinical data of patients aged 50 years or older, resident in Sicily, and hospitalized, from 2005 to 2012. Demographic information, admission/discharge dates, discharge status, and up to 6 discharge diagnoses coded according to ICD-9 CM were collected for each hospitalized patient. During the 8-year study period, a total of 72 372 hospitalizations with at least one ICD-9 CM diagnosis code suggestive of all-cause pneumonia were recorded. Of these, 1943 (2.7%) hospitalizations had specific ICD-9 CM diagnosis codes for pneumococcal pneumonia. According to the proposed model, 16 541 (22.9%) pneumonia out of all-cause pneumonia was estimated to be attributable to S. pneumoniae. Pneumococcal pneumonia and model-estimated pneumococcal pneumonia had mean hospitalization rates of 13.4 and 113.3/100 000, respectively, with a decreasing temporal trend. The risk of hospitalization for pneumococcal pneumonia was strongly correlated with age (P<0.001). Our model provides data usable to construct suitable decisional models for the decision-makers and could allow to the responsibles of healthcare facilities to assess the budget impact if they hypothesize to offer vaccination for pneumococcal disease to certain cohorts of subjects aged 50 years or older. In our area, the high estimated hospitalization rates among adults aged ≥65 years suggest the need to implement effective preventive strategies (e.g., vaccination) tailored for these groups

A self-sterilizing fluorescent Nanocomposite as versatile material with broad-spectrum Antibiofilm features

Hematogenous spread of infections from colonized central intravenous catheters or central lines is a long-recognized problem with infection rates of 2 and 6.8 per 1000 days, respectively. Besides, removal of severe microbial colonization of implanted biomaterials is still a challenge and usually requires invasive operations. Hence, on demand self-sterilizing materials are required to avoid explant of colonized biomaterials and improve patient compliance. Moreover, photoluminescence is needed to make trackable biomaterials, which can be easily monitored upon implanting them in the body. Here, we propose the incorporation of near infrared (NIR) sensitive red-emitting carbon nanodot (CDs) into a polymeric matrix to give rise to innovative biomaterials with self-tracking and photothermal antimicrobial abilities. We obtain a material which can be processed to obtain medical devices using different techniques, among which, for instance, electrospinning. Herein, a proof-of-concept preparation of electrospun scaffolds is reported as it is highly desired in biomedical applications. Beside to confer imaging properties to the scaffold, that would allow an easy control over the in vivo positioning of implanted biomaterials as well as its degradation state and grade of integration with the surrounding native tissues, thanks to the capability to convert NIR light into local heat CDs can be exploited to exert broad-spectrum antimicrobial effect toward several pathogens. The rise in temperature can be easily modulated by controlling the irradiation time to achieve both an in vitro self-sterilization of the device and eventually in vivo destabilization of the microbial colonization. This innovative biomaterial could successfully inhibits biofilm formation and might be used as a powerful tool to treat antibiotic-resistant nature of biofilm-related infections in implanted medical devices

Mid-Term Estimates of Influenza Vaccine Effectiveness against the A(H1N1)pdm09 Prevalent Circulating Subtype in the 2023/24 Season: Data from the Sicilian RespiVirNet Surveillance System

The current influenza season started in Italy in October 2023, approaching the epidemic peak in late December (52nd week of the year). We aimed to explore the mid-term virologic surveillance data of the 2023/2024 influenza season (from 16 October 2023 to 7 January 2024) in Sicily, the fourth most populous Italian region. A test-negative design was used to estimate the effectiveness of seasonal influenza vaccine (VE) against A(H1N1)pdm09 virus, the predominant subtype in Sicily (96.2% of laboratory-confirmed influenza cases). Overall, 29.2% (n = 359/1230) of oropharyngeal swabs collected from patients with influenza-like illness (ILI) were positive for influenza. Among the laboratory-confirmed influenza cases, 12.5% (n = 45/359) were vaccinated against influenza, with higher prevalence of laboratory-confirmed diagnosis of influenza A among subjects vaccinated with quadrivalent inactivated standard dose (29.4%), live attenuated intranasal (25.1%), and quadrivalent inactivated high-dose (23.8%) influenza vaccines. Comparing influenza vaccination status for the 2023/2024 season among laboratory-confirmed influenza-positive and -negative samples, higher vaccination rates in influenza-negative samples (vs. positive) were observed in all age groups, except for 45-64 years old, regardless of sex and comorbidities. The overall adjusted VE (adj-VE) was 41.4% [95%CI: 10.5-61.6%], whereas the adj-VE was 37.9% [95%CI: -0.7-61.7%] among children 7 months-14 years old and 52.7% [95%CI: -38.0-83.8%] among the elderly (&gt;= 65 years old)

Diagnosis of Influenza: Only a Problem of Coding?

Objective: To evaluate the characteristics of hospital discharge diagnoses of influenza measured by using specific International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) codes. Subjects and Methods: The study was conducted for the 3 years 2007, 2008 and 2011. The database included (1) administrative and clinical data on Sicilian patients admitted to acute care hospitals and (2) data from the influenza virological surveillance of 10 European countries (FluNet database). All Sicilian patients diagnosed with at least 1 ICD-9 CM code for influenza (487.0, 487.1 and 487.9) were considered influenza cases. Results: Overall, 2,880 patients with an ICD-9 CM code attributable to influenza were hospitalized in Sicily: 2,119 (73.6%) were admitted from November to April, whereas 761 (26.4%) were admitted from May to October. In the 3 years studied, the analyzed European influenza surveillance systems recorded a peak of laboratory-confirmed influenza activity from November to April with 36,753 (99.7%) influenza cases, whereas only 124 cases (0.3%) were observed from May to October. Conclusions: In Sicily, more than one quarter of all hospital admissions with an ICD-9 CM code for influenza were observed in the months with a negligible circulation of influenza viruses. Our findings show that several hospital discharge records included ICD-9 CM codes for influenza with low levels of sensitivity, specificity and/or appropriateness for clinical information and support the need for improving medical education on the epidemiology and hospital management of influenza cases

Monitoring on chemical and biological pollutants in sea waters of central-northern Sardinia

Introduction. The aims of this study are to assess the quality of the coastal waters of central-northern Sardinia through data from a monitoring network and to outline maps and experimental models of environmental risk correlated to the presence of chemical and microbiological contaminants. The area studied is the coast between Capo Falcone and the mouth of the river Coghinas, in the northwestern part of the island. Methods. In a first phase, 7 sampling stations of sea water and 1sampling station of bivalve molluscs (Mytilus galloprovincialis Lam.) wereidentified. For each transept 3 different collection points at respectively 500, 1000, and 3000 meters from the coast for a total 21 sampling sites were identified. In a second phase, another 7 transepts wereidentified, 2 of which on the island of Asinara. Results. As regards the microbiological monitoring of the sea water, very low concentrations of Total coliforms, Faecal coliforms and Faecal Streptococci were found and no Salmonella were isolated. Chemical analysis of the waters showed a high constant presence of phenols. In the bivalves we found rather high concentrations of Faecal coliforms without any clear seasonal variation, while no Salmonella was isolated in any of the examined samples. Discussion. The results show that the considered area is not affected by serious pollution processes, thus allowing to express a completely satisfactory judgement on its state of health. However, anthropic pressure in the considered territory is testified by the presence in the water of high concentrations of phenols. Conclusions. The results point out to the necessity of targeted and rational preventive action by means of control and protection measures for environmental ecosytems

Synthesis and antimicrobial activity of new 1-R-3-(2-Piridyl)-4-nitroso-5 carboxiethyl-1H-Pyrazoles

SYNTHESIS AND ANTIMICROBIAL ACTIVITY OF NEW 1-R-3-(2-PIRIDYL)- 4-NITROSO- 5-CARBOXIETHYL-1H-PYRAZOLES. Stefania Aielloa , Carmelo Massimo Maidab, Fabio Venturellab, Diego Planetac Marco Giammancod, M.Milicib a Dipartimento di Scienze e Tecnologie Molecolari e Biomolecolari, Università degli Studi di Palermo bDipartimento di Scienze per la Promozione della Salute G. D’ Alessandro, Università degli Studi di Palermo cDipartimento dei Sistemi Agro-Abientali,Università degli Studi di Palermo d Dipartimednto di Studi Giuridici, Economici, Biomedici e Psicosociopedagogici delle Scienze Motorie e Sportive, Università degli Studi di Palermo Corresponding author: Stefania Aiello, Dipartimento di Scienze e Tecnologie Molecolari e Biomolecolari, Università degli Studi di Palermo, Via Archirafi 32, 90123 Palermo, Italy; tel:+39.091 23896802; email: [email protected] In recent years, epidemiological studies confirm the significant impact on human health by infections caused by pathogenic fungi. In fact, although the Candida genus is commensal and a constituent of the normal gut flora, it is responsible for opportunistic infections and can become pathogenic secondary to predisposing factors related to the host, like a comprimised immune system (AIDS, anti-cancer therapy, transplants), excessive prophylaxis with antimicrobial agents, and use of invasive catheters. Large-scale surveillance for fungal infections has demonstrated an increasing incidence of drug-resistant fungal pathogens. As a matter of fact, a significant number of fungi species (especially Candida glabrata and Candida krusei) exhibited primary resistance to Fluconazole or were less susceptible to Amphotericin B. Furthermore, as a consequence of the toxicity of the currently used polyene antifungal drugs, which leads to interrupt the therapy, and the emergence of Candida species resistance to azole-based agents, there is an urgent need for developing alternative drug therapies. In our previous study we have disclosed the synthesis and antifungal activity of a series of 4-nitrosopyrazoles that mainly displayed in vitro potent antifungal activity at no cytotoxic concentrations and that some of these compounds were 4 times more potent than Amphotericine B and Fluconazole respectively against Cryptococcus neoformans and Candida Krusei [1-4] As part of our Structure Activity Relationships studies, we were interested in learning the influence of the steric and electronic effects of the substituent in position 5 of the 4-nitrosopyrazoles which had already showed powerful antimycotic activity. Therefore, we synthetized title compounds and evaluated their antimycotic activity (fig1). NNNCOOC2H5ONR R: a=H, b= CH3, c=C2H5 Fig 1. Synthetized compounds The 5-carboxiethylester group has made the antimycotic actity dramatically decay, confirming the necessity, for a good antimicotic activity, of derivatives in which the position 5 is free or substituted with little groups as a methyl shown the best antifungal activity. [1] E. Aiello, S. Aiello, F. Mingoia, A. Bacchi, G. Pelizzi, C. Musiu, M. G. Setzu, A. Pani, P. La Colla and M. E. Marongiu. Synthesis and Antimicrobial activity of New 3-(1-R -3-methyl-4-nitroso-1H-5-pyrazolyl)-5-methylisoxazole derivatives, Bioorganic and Medicinal Chemistry, 2000, 8, 2719-2728 [2] Stefania Aiello; Enrico Aiello, Marica Orioli, Marina Carini, 3-(1-R-3-methyl-4-nitroso-1H-5-pyrazolyl)-5-methylisoxazoles: a new class of antifungal compounds. In vitro metabolism by rat liver:LC and LC-MS studies. Convegno Nazionale, Sorrento 18-22 Settembre 2002. [3] S. Aiello, E. Aiello and M. Milici: “Synthesis and Antifungal Activity of new 3(5)-methyl-5(3)-(2-thiophenyl) and -(2-quinolyl)-1H-1-R-4-nitrosopyrazoles.Part V”. Polish-Austrian-German-Hungarian-Italian Joint Meeting on Medicinal Chemistry, Krakow, October 15-18, 2003 [4] Stefania Aiello, Antonio Macchiarulo, Maria Milici and Enrico Aiello, Sintesi e studi QSAR di nuovi derivati 3(5)-(2-X)-1R-1H-4-nitrosopirazoli: una classe di composti con potente attività antifungina in vitro. Parte VI XVII Convegno Nazionale della Divisione di Chimica Farmaceutica della SCI, Pisa 6-10 settembre 2004

The molecular epidemiology and evolutionary dynamics of influenza B virus in two Italian regions during 2010-2015: The experience of Sicily and Liguria

Molecular epidemiology of influenza B virus remained poorly studied in Italy, despite representing a major contributor to seasonal epidemics. This study aimed to reconstruct the phylogenetic relationships and genetic diversity of the hemagglutinin gene sequences of 197 influenza B strains circulating in both Southern (Sicily) and Northern (Liguria) Italy between 2010 and 2015. Upper respiratory tract specimens of patients displaying symptoms of influenza-like illness were screened by real-time RT-PCR assay for the presence of influenza B virus. PCR-positive influenza B samples were further analyzed by sequencing. Neighbor-joining phylogenetic trees were constructed and the amino-acid alignments were analyzed. Phylogenetic analysis showed clusters in B/Victoria clade 1A/1B (n = 29, 14.7%), and B/Yamagata clades 2 (n = 112, 56.8%) and 3 (n = 56, 28.4%). Both influenza B lineages were found to co-circulate during the study period, although a lineage swap from B/Victoria to B/Yamagata occurred in Italy between January 2011 and January 2013. The most represented amino-acid substitutions were N116K in the 120-loop (83.9% of B/Yamagata clade 3 strains) and I146V in the 150-loop (89.6% of B/Victoria clade 1 strains). D197N in 190-helix was found in almost all viruses collected. Our findings provide further evidence to support the adoption of quadrivalent influenza vaccines in our country