Citomegalovirus nei pazienti trapiantati d\u2019organo

aim of the work Calprotectin (CalP) and myeloperoxidase (MPO) are biochemical markers in the gingival crevicular fluid (GCF). Their increased concentration indicates the onset of an inflammatory process. The aim of this study was to valuate the correlation between the levels of calprotectin and myeloperoxidase detected in the crevicular fluid (GCF) at different probing depth (PPD). Materials and methods In a total of 11 subjects with chronic periodontitis, non smokers enjoying good health and who had not undergone periodontal nor antibiotic therapy in the 6 months prior the study, 60 sites were randomly selected and bleeding on probing (BOP), PPD, quantity of GCF and concentration of MPO and CalP were recorded. The volume of GCF was assessed through inserting PerioCol paper strips in the periodontal pockets for 10 seconds, then analyzed with a micro-moisture meter electronic instrument (Periotrom 6000, Siemens). The determination of the CalP was performed by enzyme immunoassay. The determination of MPO in the crevicular fluid was performed using the spectrophotometric reading of optical density. The results were statistically analyzed (SPSS16). Results PPD 5 mm (GCF=0,72 \u3bcg/\u3bcl; CalP=10,06 \u3bcg/\u3bcl; MPO=3,69 \u3bcg/\u3bcl); PPD 6 mm (GCF=0,78 \u3bcg/\u3bcl; CalP=10,64 \u3bcg/\u3bcl; MPO=5,45 \u3bcg/\u3bcl); PPD 657 mm (GCF=1,32 \u3bcg/\u3bcl; CalP=7,20 \u3bcg/\u3bcl; MPO=5,55 \u3bcg/\u3bcl). There were no statistically significant differences in the concentrations of MPO and CalP in the deeper periodontal pocket. Conclusion The concentration ofmyeloperoxidase seems significantly related to the increased presence of neutrophils into the deepest pockets

Aseptic central nervous system infections in adults: what predictor for unknown etiological diagnosis?

Despite the availability of nucleic acid amplification tests (NAATs), most of aseptic acute meningitides, encephalitides, and meningoencephalitides (AAMEMs) in adults remain of unknown etiology so far. To shed light on such topic, we aimed to evaluate potential predictors for AAMEMs of unknown origin. We collected retrospectively data from all consecutive cases of AAMEMs in adults discharged from an Italian referral hospital, from January 2004 to December 2016. Laboratory analysis included common immunometric methods and NAATs. Potential predictors for unknown etiology (age, seasonality, serum C-reactive protein value, antibiotic use before lumbar puncture, immunodeficiency conditions, clinical symptoms and signs) were evaluated by a logistic regression analysis model. A p value 64\u20090.05 was considered to indicate statistical significance. The study included 92 patients (median age 39 years; 54.3% males) affected by meningitis (n\u2009=\u200957), encephalitis (n\u2009=\u200925), and meningoencephalitis (n\u2009=\u200910). The identified agents that cause AAMEMs were herpesviruses (20.7%), enteroviruses (5.4%), tick-borne encephalitis virus (3.3%), influenza virus A (2.2%), West Nile virus (1.1%), and parvovirus B19 (1.1%), while 66.3% of cases were of unknown etiology. No predictor was found to be significantly associated with AAMEMs of unknown etiology. We suggest that potential infectious agents causing undiagnosed cases should be investigated among non-bacterial, non-opportunistic, and non-seasonal organisms

Sylvatic rabies in the North Est of Italy: monitoring and evaluation of the effectiveness of prophylaxis in workers at risk and travelers

Rabies is a zoonotic viral encephalitis almost invariably fatal in both humans and animals. Rabies virus infects mammals through infected saliva via bites or scratches, although atypical exposures have been documented. In late 2008, wildlife rabies re emerged in Northeastern Italy. Since then, 287 animal cases have been documented with the last one diagnosed in a red fox in February 2011. No human cases have been reported linked to the recent epidemic and Italy has been declared as free from rabies in February 2013. Several oral fox vaccination campaigns and extensive monitoring of territories subject to the epidemic have been implemented together with education and preventive vaccination of workers at risk of viral exposure as forestry and wildlife workers, veterinarians, shelters \u2018operators and laboratory personnel. We have evaluated the level and persistence of serological response in workers at risk and travelers vaccinated following different immunization schedules. In 113 cases post exposure prophylaxis has been administered, five or four doses, with Rabipur (Novartis), Verorab (Sanofi Pasteur) vaccine. Serum samples from about 300 vaccinated volunteers at risk and travelers were collected from the Northeastern territories recently subject to the epidemic. All sera have been tested using an ELISA (Enzyme Linked Immunosorbent Assay) and a neutralising test, namely FAVN (Fluorescent Antibody Virus Neutralisation). The results of the ongoing analysis will be reported

Challenges and opportunities by bridging human and animal surveillance to tackle antimicrobial resistance

Introduction: Antimicrobial resistance (AMR) requires a global and multidisciplinary approach to improve awareness, understand dynamics and find preventive solutions. In this framework we set up a one-health tailored pilot surveillance network to monitor occurrence of Escherichia coli ESBL in humans and food producing animals FPA, to investigate on dissemination paths of ESBL resistant E. coli in human healthcare units and to plan and develop educational modules for prudent use of antimicrobials in human and animals. With the project network in place we could promptly investigate on the emergence of the plasmid-mediated colistin resistance gene mcr-1 that has been recently reported in E. coli of both animal and human origin. Materials and Methods: According to objectives: i) we set up a cross-sectional study (2016-2017) by collecting representative E. coli ESBL+ isolates from human communities and FPA industrial holdings in six Italian Regions; ii) we searched for available data sources for descriptors and parameters to develop dynamic mathematical models to describe E. coli ESBL+ dissemination paths between health care units and iii) we explored the learning needs to tackle AMR so to identify knowledge gaps to be addressed by specific educational proposals. In this frame, colistin resistance was investigated among E. coli ESBL+ isolates from both animal and human sources. MIC was determined by broth microdilution method and interpreted according to EUCAST breakpoints. mcr-1 gene was detected by PCR and sequencing. Results: Halfway through the project 827 E. coli ESBL+ isolates (277 were from FPA) were collected. A post graduate course and a distance learning courses were identified to fulfill learning needs of clinicians, veterinarians and microbiologists. Few E. coli ESBL+ of human origin were tested for colistin resistance so far and found all susceptible. On the contrary among colistin resistant E. coli ESBL+ isolates of animal origin mcr-1 was detected in 5% of poultry and 10% of bovines and of swine isolates. Data from antimicrobial susceptibility test (AMS) of patients from a high geographical coverage and statistics from health care units is feeding and providing parameters for mathematic dynamic models. Conclusions: A challenge in a one-health-based surveillance of opportunistic bacteria is the different reference population that require a wide animal sample to detect the targeted human pathogens. So far, our experience recommends to stick on strong case definitions of both clinical cases and isolates to be included in the study. Although the data herein reported is preliminary the proportions of mcr-1 carriers E. coli ESBL+ detected in FPA represents a serious public health threat that requires strict surveillance

Detection of mcr-1 carrying ESBL resistant E. coli isolates from humans with extraintestinal infections and food producing animals, in Italy (2016 - 2017)

The proportions of mcr-1-carrying isolates detected in ESBL-producing E. coli from FPAs represents a serious public health threat that requires strict surveillance. Although no evidence of transmission of mcr-1-carrying isolates from animals to humans has been herein demonstrated, the occurrence of a mcr -1 ST131 isolate from poultry is of concer