Current take on systemic sclerosis patients’ vaccination recommendations

Systemic sclerosis (SSc) is a rare autoimmune inflammatory rheumatic disease. The prevalence of SSc ranges from 7 to 700 cases per million worldwide. Due to multiple organ involvement and constant inflammatory state, this group of patients presents an increased risk of infectious diseases. This paper aimed to gather the up-to-date evidence on vaccination strategies for patients with SSc and to be a useful tool for the prevention and management of infectious diseases. The authors conducted a scoping review in which each paragraph presents data on a specific vaccine’s safety, immuno-genicity, and efficacy. The work deals with the following topics: SARS-CoV-2, seasonal influenza, S. pneumoniae, HAV, HBV, HZV, N. meningitidis, H. influenzae, HPV, and diphtheria-tetanus-pertussis

Isolation of Candida auris from invasive and noninvasive samples of a patient suffering from vascular disease, Italy, July 2019

We recently isolated Candida auris from a blood culture and cutaneous swabs of a patient in her mid-70s. Our routine phenotypic methods failed to identify the microorganism, but it was identified by molecular tests and MALDI-TOF MS analysis. Our report, the first from Italy, further underlines the geographically wide distribution of C. auris and the need to confirm species identification of any suspicious colony as soon as possible to stop its spread

Current Take on Systemic Sclerosis Patients' Vaccination Recommendations

Systemic sclerosis (SSc) is a rare autoimmune inflammatory rheumatic disease. The prevalence of SSc ranges from 7 to 700 cases per million worldwide. Due to multiple organ involvement and constant inflammatory state, this group of patients presents an increased risk of infectious diseases. This paper aimed to gather the up-to-date evidence on vaccination strategies for patients with SSc and to be a useful tool for the prevention and management of infectious diseases. The authors conducted a scoping review in which each paragraph presents data on a specific vaccine's safety, immunogenicity, and efficacy. The work deals with the following topics: SARS-CoV-2, seasonal influenza, S. pneumoniae, HAV, HBV, HZV, N. meningitidis, H. influenzae, HPV, and diphtheria-tetanus-pertussis

Current take on systemic sclerosis patients’ vaccination recommendations

none17noSystemic sclerosis (SSc) is a rare autoimmune inflammatory rheumatic disease. The prevalence of SSc ranges from 7 to 700 cases per million worldwide. Due to multiple organ involvement and constant inflammatory state, this group of patients presents an increased risk of infectious diseases. This paper aimed to gather the up-to-date evidence on vaccination strategies for patients with SSc and to be a useful tool for the prevention and management of infectious diseases. The authors conducted a scoping review in which each paragraph presents data on a specific vaccine’s safety, immuno-genicity, and efficacy. The work deals with the following topics: SARS-CoV-2, seasonal influenza, S. pneumoniae, HAV, HBV, HZV, N. meningitidis, H. influenzae, HPV, and diphtheria-tetanus-pertussis.openMurdaca G.; Noberasco G.; Olobardi D.; Lunardi C.; Maule M.; Delfino L.; Triggiani M.; Cardamone C.; Benfaremo D.; Moroncini G.; Vacca A.; Susca N.; Gangemi S.; Quattrocchi P.; Sticchi L.; Icardi G.; Orsi A.Murdaca, G.; Noberasco, G.; Olobardi, D.; Lunardi, C.; Maule, M.; Delfino, L.; Triggiani, M.; Cardamone, C.; Benfaremo, D.; Moroncini, G.; Vacca, A.; Susca, N.; Gangemi, S.; Quattrocchi, P.; Sticchi, L.; Icardi, G.; Orsi, A

CATETERES VENOSOS CENTRAIS DE INSERÇÃO PERIFÉRICA E SUA UTILIZAÇÃO NA UNIDADE DE TERAPIA INTENSIVA NEONATAL

<p>O objetivo deste trabalho foi realizar um levantamento das principais vantagens da  utilização dos cateteres venosos centrais na unidade de terapia intensiva neonatal e  pediátrica considerando suas vantagens de uso para o paciente e instituição. O estudo  se faz necessário pois conforme dados publicados pelo ministério da Saúde no ano  de 2018 houveram cerca de três milhões de nascimentos no Brasil onde 11% foram  prematuros, estando dentre os 10 países com maior índice de nascimentos  prematuros. Assim temos a necessidade de avaliar a necessidade e relevância de  estudos que contribuam para melhoria contínua dos processos assistenciais,  promovendo uma assistência qualificada e segura ao paciente baseado em estudos  bibliográficos e artigos científicos. O método utilizado foi por revisão bibliográfica,  manuais e artigos científicos publicados. Por meio dos levantamentos e estudos  conclui-se que atualmente a melhor opção em cateter venoso para terapia intravenosa  nas unidades de terapia intensiva são os cateteres venosos centrais de inserção  periférica (PICC) visto que apresenta maior segurança, conforto, mobilidade ao  paciente, economia para instituição, redução dos índices de infecção desde que  inserido de forma asséptica e realizado manutenção rigorosa, preserva a rede venosa  reduzindo a necessidade de punções, evita o risco de lesões por extravasamento de  líquidos irritantes e vesicantes, previne o stress desnecessário ao paciente como dor  e otimiza o tempo de trabalho da equipe assistencial. Dentre outros benefícios que  estaremos descrevendo no presente estudo.</p&gt

Impact of a mixed educational and semi-restrictive antimicrobial stewardship project in a large teaching hospital in Northern Italy

Background: The overuse of antimicrobials favors the dissemination of antimicrobialresistance, as well as invasive fungal diseases and Clostridium difficile infections (CDI). In this study, we assessed the impact of a mixed educational and semi-restrictive antimicrobial stewardship (AMS) project in a large teaching hospital in Italy. Methods: The AMS project was conducted from May 2014 to April 2016. It consisted of two initiatives in two consecutive periods: (1) educational activities; (2) semi-restrictive control of antimicrobial prescribing through a computerized software. The primary endpoint was consumption of antibacterials and antifungals. Secondary endpoints were incidence of CDI, methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI), carbapenem-resistant Klebsiella pneumoniae (CRKP) BSI, and Candida BSI. Results: During the study period, a statistically significant reduction in consumption was observed for antibacterials (\ue2\u88\u921.45 defined daily doses (DDD)/1000 patient-days monthly, 95% confidence intervals [CI] \ue2\u88\u922.38 to \ue2\u88\u920.52, p 0.004), mainly driven by reductions in the use of fluoroquinolones, third/fourth generation cephalosporins, and carbapenems. No decrease in consumption of antifungals was observed (\ue2\u88\u920.04 DDD/1000 patient-days monthly, 95% CI \ue2\u88\u920.34 to +0.25, p 0.750). A statistically significant trend towards reduction was observed for incidence of CRKP BSI (incidence rate ratio 0.96, 95% CI 0.92\ue2\u80\u930.99, p 0.013). No statistically significant variations in trends were observed for CDI, MRSA BSI, and Candida BSI. Conclusions: The mixed AMS project was effective in reducing the use of major antibacterials and the incidence of CRKP BSI. Further research is needed to assess the extent of long-term benefits of semi-restrictive approaches

Bronchoalveolar lavage fluid characteristics and outcomes of invasively mechanically ventilated patients with COVID-19 pneumonia in Genoa, Italy

BACKGROUND: The primary objective of the study is to describe the cellular characteristics of bronchoalveolar lavage fluid (BALF) of COVID-19 patients requiring invasive mechanical ventilation; the secondary outcome is to describe BALF findings between survivors vs non-survivors.MATERIALS AND METHODS: Patients positive for SARS-CoV-2 RT PCR, admitted to ICU between March and April 2020 were enrolled. At ICU admission, BALF were analyzed by flow cytometry. Univariate, multivariate and Spearman correlation analyses were performed.RESULTS: Sixty-four patients were enrolled, median age of 64years (IQR 58-69). The majority cells in the BALF were neutrophils (70%, IQR 37.5-90.5) and macrophages (27%, IQR 7-49) while a minority were lymphocytes, 1%, TCD3+92% (IQR 82-95). The ICU mortality was 32.8%. Non-survivors had a significantly older age (p=0.033) and peripheral lymphocytes (p=0.012) were lower compared to the survivors. At multivariate analysis the percentage of macrophages in the BALF correlated with poor outcome (OR 1.336, CI95% 1.014-1.759, p=0.039).CONCLUSIONS: In critically ill patients, BALF cellularity is mainly composed of neutrophils and macrophages. The macrophages percentage in the BALF at ICU admittance correlated with higher ICU mortality. The lack of lymphocytes in BALF could partly explain a reduced anti-viral response

Correction to: Impact of a mixed educational and semi-restrictive antimicrobial stewardship project in a large teaching hospital in Northern Italy (Infection, 10.1007/s15010-017-1063-7)

A technical error led to incorrect rendering of the author group in this article. The correct authorship is as follows: Daniele Roberto Giacobbe1, Valerio Del Bono1, Malgorzata Mikulska1, Giulia Gustinetti1, Anna Marchese2, Federica Mina3, Alessio Signori4, Andrea Orsi5, Fulvio Rudello6, Cristiano Alicino5, Beatrice Bonalumi3, Alessandra Morando7, Giancarlo Icardi5, Sabrina Beltramini3, Claudio Viscoli1; On behalf of the San Martino Antimicrobial Stewardship Group