Parasitic intestinal infections in humans between 2006 and 2007

Between 2006-07 faecal specimens of 2.132 subjects (1.508 adults and 624 children) were examined for ova & parasites, using direct and after formalin-ethylacetate concentration microscopy, and permanent specific stains. 380 bubjects (17.8 %) were infected: 313 adults (20.8 %) and 67 children (10.7 %). 331 cases (15.5 %) were infected by pathogens, 275 adults (18.2 %) and 56 children (9.0 %). 389 pathogenic or not pathogenic protozoa (18.2 %) and 60 helminths (2.8 %) were identified, more among adults than children (21.0 % vs 11.5 % and 3.2 % vs 1.8 % respectively).Among protozoa, D. fragilis was in all observed in 145 cases (6.8 %), G. duodenalis in 74 cases (3.5 %), other were very rare.Among helminths nematodes were more frequent than trematodes and cestodes, with S. stercoralis (14 cases) and E. vermicularis (13 cases) the most frequent ones. 2.302 subjects (1.505 adults and 797 children) were examined for microbiological tests because affected by acute or prolonged diarrhoea. 82 cases (3.6 %) of protozoal infections were observed, 70 among adults (4.7 %) and 12 among children (1.5 %). D. fragilis was in all prevalent (2.0 %) in respect of G. duodenalis (1.0 %) or other ones (0.6 %). For S. stercoralis specific investigation, modified Baermann method / larvae colture were performed: 20/189 cases (10.6 %) od strongyloidiasis was diagnosed in adults. For E. vermicularis investigation, scotch test was performer: 43/179 cases (24.0%) of enterobiasis was diagnosed. The Authors underline the application of standard operative procedures for O & P with permanent specific stains in subject affected by enterites too, and the analysis of more specimens for each subjects for good diagnostical performances

Diagnostic considerations about visceral leishmaniasis. Two case report

Two cases of visceral leishmaniasis (VL) in immunocompetent patients have been described. Both patients lived in endemicic areas for leishmaniasis in the south of Italy, tested positive for anti-Leishmania antibodies. A definitive diagnosis of VL was delayed by false negative microscopic examinations. Both patients were treated successfully with liposomal amphotericin B

QuantiFERON-TB and tuberculin skin test in patients with active tuberculosis: the experience of a single medium-sized Italian University Hospital

Interferon-γ releasing assays (IGRAs) are currently widely employed in the initial work up of Mycobacterium tuberculosis infection, as well as in suspected tuberculosis (TB). These assays are commonly utilized over the Tuberculin Skin Test (TST) in high resource and low TB burden settings, despite the unclear benefits shown in such contexts. The debate on the use of TST and IGRAs is of current interest also in Italy due to the increasing presence of immigrants from countries with a high incidence of TB and the rising attention of health care institutions to economic costs. The aim of this study was to compare QuantiFERON-TB (QFT) and TST results in active TB. We evaluated QFT results and TST reactions from 245 consecutive patients having both tests, registered among 411 patients admitted for TB at the Infectious Disease Clinic, Department of Medicine of the University of Perugia (Italy). We compared the rates of positive QFT and TST tests and noted no statistically significant differences overall or in relation to age, gender, HIV status and TB localization. Among foreign-born patients with confirmed TB, we observed a lower rate of positive TST results. The results of our study indicated that both QFT and TST can be used in the work up of TB having special attention when evaluating foreign-born patients

Acute gastroenteritis due to Vibrio cholerae biovar albensis infection: A case report

Vibrio cholerae represents diverse species and includes pathogenic and non-pathogenic variants. Particularly serogroups O1 and O139 are related to cholera epidemics, while non-O1/O139 serogroups (NOVC) in general are non-pathogenic or asymptomatic colonizers in humans, but also can cause different diseases. Vibrio albensis, a non-O1/non-O-139 serogroup, is rarely implicated in human infections. Only a few cases of human pathology related to this species are described in the literature. We present the menagement of V. albensis gastroenteritis in a a 47-year-old woman and discuss clinical presentation, diagnosis and treatement

Bactericidal activity of oxacillin and glycopeptides against <it>Staphylococcus aureus </it>in patients with endocarditis: Looking for a relationship between tolerance and outcome

Abstract Background There is no clear relationship between in vitro bactericidal activity tests and clinical outcome. We studied bactericidal activity of oxacillin, vancomycin and teicoplanin against Staphylococcus aureus isolates in patients with endocarditis and then we sought to determine if there was a relationship between in vitro bactericidal activity and clinical outcome. Methods Minimal bacteriostatic and minimal bactericidal concentrations were determined for Staphylococcus aureus strains isolated from patients with endocarditis following standardized methods. Medical records were reviewed retrospectively to collect data on antimicrobial susceptibility at admission, antimicrobial therapy, need for surgery, embolic events and outcome. Results and Discussion Sixty-two Staphylococcus aureus strains were studied in 62 patients with endocarditis. Overall, 91.9% definite, 21% methicillin resistant and 72.6% cured. Surgery was performed in 32.3% and embolic events were documented in 64.5%. Tolerance to oxacillin and teicoplanin was more common than vancomycin tolerance among methicillin susceptible Staphylococcus aureus. Among methicillin resistant Staphylococcus aureus teicoplanin was shown to have a higher rate of tolerance than vancomycin. No statistically significant differences on clinical outcome between oxacillin tolerant and oxacillin non tolerant Staphylococcus aureus infections were observed. Tolerance to oxacillin did not adversely affect clinical outcomes of patients with methicillin susceptible Staphylococcus aureus endocarditis treated with a combination of antimicrobials including oxacillin. The cure rate was significantly lower among patients with methicillin resistant Staphylococcus aureus endocarditis. Conclusions In vitro bactericidal test results were not valid predictors of clinical outcome. Physicians need to use additional parameters when treating patients with staphylococcal endocarditis.</p

People living with undiagnosed HIV infection and a low CD4 count: Estimates from surveillance data, Italy, 2012 to 2014

Background and aims: Late HIV diagnosis is associated with onward HIV transmission, higher morbidity, mortality and healthcare costs. In Italy, more than half of people living with HIV were diagnosed late during the last decade, with a CD4 count < 350 cells/mm3 at diagnosis. We aimed to determine the number and characteristics of people living with undiagnosed HIV infection and low CD4 counts in Italy. Methods: Data on newly reported HIV diagnoses from 2012 \u20132014 were obtained from the national HIV surveillance system. We used the European Centre for Disease Prevention and Control HIV modelling tool to calculate the undiagnosed prevalence and yearly diagnosed fraction (YDF) in people with low CD4 count. Results: The estimated annual number undiagnosed HIV infections with low CD4 count was on average 6,028 (95% confidence interval (CI): 4,954\u20138,043) from 2012\u20132014. In 2014, most of the undiagnosed people with low CD4 count were men (82.8%), a third acquired HIV through sex between men (MSM) (35.0%), and heterosexual transmission (33.4%), respectively. The prevalence of undiagnosed HIV infection was 11.3 (95% CI: 9.3\u201314.9) per 100,000 residents ranging from 0.7 to 20.8 between Italian regions. Nationally the prevalence rate was 280.4 (95% CI: 173.3\u2013450.2) per 100,000 MSM, 8.3 (95% CI: 4.9\u201313.6) per 100,000 heterosexual men, and 3.0 (95% CI: 1.4\u20135.6) per 100,000 women. The YDF was highest among heterosexual women (27.1%; 95% CI: 16.9\u201345.2%). Conclusions: These findings highlight the importance of improving efforts to identify undiagnosed HIV infections primarily among men, both MSM and heterosexual men