Enterobacteriaceae Antibiotic Resistance in Ready-to-Eat Foods Collected from Hospital and Community Canteens: Analysis of Prevalence

Foodborne diseases and antibiotic resistance are serious widespread health problems in the contemporary world. In this study, we compared the microbiological quality of ready-to-eat (RTE) foods found in community canteens versus hospital canteens in Rome, Italy, focusing on detection and quantification of Enterobacteriaceae and the antibiotic resistance of these bacteria. Our findings show a remarkable difference in Enterobacteriaceae contamination between RTE foods distributed in community canteens (33.5% of samples) and those distributed in hospital canteens (5.3% of samples). This result highlights greater attention to good manufacturing practices and good hygiene practices by the food operators in hospitals compared with food operators in community canteens. As expected, a higher percentage of cold food samples (70.9%) than of hot food samples (10.8%) were positive for these bacteria. Excluding the intrinsic resistance of each bacterial strain, 92.3% of the isolated strains were resistant to at least one antibiotic, and about half of the isolated strains were classified as multidrug resistant. The prevalence of multidrug-resistant strains was 50% in the community samples and 33.3% in hospital canteens. Our results indicate that approximately 38% of RTE foods provided in community canteens is not compliant with microbiological food safety criteria and could be a special risk for consumers through spread of antibiotic-resistant strains. Hygienic processing and handling of foods is necessary for both hospital and community canteens

Prevalence of Rome IV Pediatric Diagnostic Questionnaire-Assessed Disorder of Gut–Brain Interaction, Psychopathological Comorbidities and Consumption of Ultra-Processed Food in Pediatric Anorexia Nervosa

anorexia nervosa (AN) is a severe eating disorder primarily affecting children and adolescents. disorders of the gut-brain interaction (DGBIs) have gained recognition as significant symptoms in individuals with AN. however, limited studies have explored GI symptoms in pediatric populations with AN using age-specific diagnostic tools. this study aims to investigate the prevalence of DGBIs, their associated psychopathological aspects and their potential correlations with ultra-processed food (UPF) consumption among pediatric AN patients. the study included AN patients who were under the care of a specialized multidisciplinary team. we assessed DGBI-related symptoms using the rome IV pediatric diagnostic questionnaire on functional gastrointestinal disorders (R4PDQ) and conducted psychological evaluations. dietary intake and UPF consumption were evaluated. among 56 AN patients, we observed a lower prevalence of DGBIs (functional constipation: 61%; functional dyspepsia: 54%; irritable bowel syndrome: 25%) compared to the existing literature. the psychological assessments revealed high rates of depression (72%) and anxiety (70%). UPF consumption was inversely related to depression levels (p = 0.01) but positively correlated with functional constipation (p = 0.046). this study highlights the importance of using age-specific diagnostic tools and emphasizes the crucial role of a specialized multidisciplinary team in the treatment of AN

Risk factors for carbapenem-resistant Acinetobacter baumannii (crab) bloodstream infections and related mortality in critically ill patients with (crab) colonization

Background: Among MDR bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) is a major concern due to the limited therapeutic options. During the COVID-19 pandemic, a worrying increase in the spread of CRAB infections was reported. Objectives: The study assessed the risk factors for CRAB bloodstream infection (BSI) in patients admitted to the ICU with CRAB colonization, and the related mortality risk factors. Methods: We conducted a single-centre, observational, prospective study; all consecutive patients with CRAB colonization admitted to the ICU of a tertiary hospital in Rome from January 2021 to September 2022 were included in the study. Univariate and multivariate analyses were performed to investigate BSI and mortality risk factors. Results: Overall, 129 patients were included in the study; 57 (44%) out of these developed BSI. In our study population, at the multivariable analysis the Charlson comorbidity index (CCI) (P = 0.026), COVID-19 (P < 0.001), multisite colonization (P = 0.016) and the need for mechanical ventilation (P = 0.024) were risk factors independently associated with BSI development. Furthermore, age (P = 0.026), CCI (P < 0.001), septic shock (P = 0.001) and Pitt score (P < 0.001) were independently associated with mortality in the BSI patients. Instead, early appropriate therapy (P = 0.002) and clinical improvement within 72 h (P = 0.011) were shown to be protective factors. Conclusions: In critically ill patients colonized by CRAB, higher CCI, multisite colonization and the need for mechanical ventilation were identified as risk factors for BSI onset. These predictors could be useful to identify patients at highest risk of BSI

Sars-Cov2 Not Detected in a Pediatric Population With Acute Respiratory Infection in Primary Care in Central and Southern Italy From November 2019 to Early March 2020

Background: In December 2019, a novel coronavirus named SARS-CoV-2 started circulating in China and this led to a major epidemic in Northern Italy between February and May 2020. Young children (aged <5 years) seem to be less affected by this coronavirus disease (COVID-19) compared to adults, although there is very little information on the circulation of this new virus among children in Italy. We retrospectively tested nasopharyngeal swabs for SARS-CoV-2 in samples collected in young children between November, 2019 and March, 2020 in the context of the RSV ComNet study. Methods: Two networks of primary care pediatricians in Lazio (Central Italy) and Puglia (Southern Italy) collected nasopharyngeal swabs from children, aged <5 years, presenting with symptoms for an acute respiratory infection (ARI). The RSV ComNet study is a multicenter study implemented to estimate the burden of RSV in young children (aged <5 years) in the community. Swabs were sent to a central reference laboratory and tested for 14 respiratory viruses through RT-PCR. All collected samples were retrospectively tested for SARS-CoV-2 using RT-PCR (Istituto Superiore di Sanità protocol). Results: A total of 293 children with ARI were identified in the two participating networks. The highest number of cases were recruited in weeks 51/2019 and 3/2020. The majority of patients (57%) came from the Lazio region. All of the 293 samples tested negative for SARS-Cov2. Rhinovirus was the most frequently detected virus (44%), followed by RSV (41%) and influenza viruses (14%). Conclusions: Our study shows that in Lazio (a region of intermediate SARS-COV-2 incidence) and Puglia (a region of low incidence), the SARS-Cov2 virus did not circulate in a sample of ARI pediatric cases consulting primary care pediatricians between November 2019 and March 2020

BNT162B2 mRNA COVID-19 vaccine in heart and lung transplanted young adults: is an alternative SARS-CoV-2 immune response surveillance needed?

[no abstract available

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

STUDIO DELL’IMMUNOFENOTIPO NELLE EMOPATIE: IDENTIFICAZIONE DI TARGETS FENOTIPICI COME POTENZIALI BERSAGLI TERAPEUTICI

Ad oggi, le ragioni dell’importanza dalla caratterizzazione immunofenotipica nel contesto delle patologie onco-ematologiche, risiedono principalmente nel ruolo sempre crescente che essa svolge non solo nella diagnosi e classificazione delle emopatie ma soprattutto nella identificazione, al loro interno, di sottogruppi caratterizzati da prognosi e risposta alla terapia differenti, con la possibilità di individuare importanti bersagli biologici, targets di approcci terapeutici sempre più personalizzati (target therapy). In particolare, la valutazione fenotipica dell’espressione di particolari antigeni sulla superficie cellulare, unitamente alla quantizzazione ed allo studio della modulazione della loro intensità di espressione, oltre che permettere la definizione di fasi distinte del processo differenziativo cellulare, sottolinea l’importanza dell’indagine citofluorimetrica nella identificazione di caratteristiche fenotipiche specifiche che potrebbero indirizzare verso trattamenti che prevedano, ad esempio, l’utilizzo di specifici anticorpi monoclonali, ormai divenuti di largo impiego nella pratica clinica. Accanto a ciò, lo studio immunofenotipico in ambito ematologico permette di identificare la presenza di proteine con ormai riconosciuto valore prognostico e che rappresentano dei veri e propri parametri biologici sulla base dei quali è possibile effettuare una scelta terapeutica specifica per ciascun paziente. Un esempio è rappresentato dalla possibilità, mediante saggio citofluorimetrico, di determinare la presenza della proteina di fusione Bcr-Abl in lisati di campioni di leucemia acuta, o dalla possibilità di valutare, mediante metodiche di immunocitochimica, un accumulo aberrante della proteina p53 in campioni di pazienti affetti da leucemia linfatica cronica. Ultimo, ma non meno importante aspetto da considerare, è il ruolo che un’ampia e dettagliata caratterizzazione fenotipica in fase diagnostica ricopre nelle fasi di valutazione della malattia minima residua permettendo un accurato monitoraggio dei pazienti affetti da patologie ematologiche mediante metodiche citofluorimetriche

STUDIO DELL’IMMUNOFENOTIPO NELLE EMOPATIE: IDENTIFICAZIONE DI TARGETS FENOTIPICI COME POTENZIALI BERSAGLI TERAPEUTICI

Ad oggi, le ragioni dell’importanza dalla caratterizzazione immunofenotipica nel contesto delle patologie onco-ematologiche, risiedono principalmente nel ruolo sempre crescente che essa svolge non solo nella diagnosi e classificazione delle emopatie ma soprattutto nella identificazione, al loro interno, di sottogruppi caratterizzati da prognosi e risposta alla terapia differenti, con la possibilità di individuare importanti bersagli biologici, targets di approcci terapeutici sempre più personalizzati (target therapy). In particolare, la valutazione fenotipica dell’espressione di particolari antigeni sulla superficie cellulare, unitamente alla quantizzazione ed allo studio della modulazione della loro intensità di espressione, oltre che permettere la definizione di fasi distinte del processo differenziativo cellulare, sottolinea l’importanza dell’indagine citofluorimetrica nella identificazione di caratteristiche fenotipiche specifiche che potrebbero indirizzare verso trattamenti che prevedano, ad esempio, l’utilizzo di specifici anticorpi monoclonali, ormai divenuti di largo impiego nella pratica clinica. Accanto a ciò, lo studio immunofenotipico in ambito ematologico permette di identificare la presenza di proteine con ormai riconosciuto valore prognostico e che rappresentano dei veri e propri parametri biologici sulla base dei quali è possibile effettuare una scelta terapeutica specifica per ciascun paziente. Un esempio è rappresentato dalla possibilità, mediante saggio citofluorimetrico, di determinare la presenza della proteina di fusione Bcr-Abl in lisati di campioni di leucemia acuta, o dalla possibilità di valutare, mediante metodiche di immunocitochimica, un accumulo aberrante della proteina p53 in campioni di pazienti affetti da leucemia linfatica cronica. Ultimo, ma non meno importante aspetto da considerare, è il ruolo che un’ampia e dettagliata caratterizzazione fenotipica in fase diagnostica ricopre nelle fasi di valutazione della malattia minima residua permettendo un accurato monitoraggio dei pazienti affetti da patologie ematologiche mediante metodiche citofluorimetriche

Candida gut colonization, yeast species distribution, and biofilm production in Clostridioides difficile infected patients. A comparison between three populations in two different time periods

Candida gut colonization and yeast biofilm production capacity were investigated, by means of XTT reduction assay, in Clostridioides difficile infected (CDI) patients, in non-CDI diarrheic patients, and in healthy donors in two different time periods (2013–2015 and 2018–2019 respectively). Candida gut colonization was significantly (p &lt; 0.001) associated to C. difficile infection, and to patients infected with hypervirulent C. difficile strains bearing the tcdC deletion at nucleotide 117 (p = 0.0003). Although there was not a prevalent yeast species in CDI patients, C. albicans was the species significantly (p &lt; 0.001) associated to both the infections sustained by the non-hypervirulent C. difficile strains and those caused by the hypervirulent strain (p = 0.001). The biofilm production by the yeasts isolated from the CDI patients and from non-CDI diarrheic patients did not differ significantly. However, a significantly (p = 0.007) higher biofilm production was observed in the Candida strains, particularly C. albicans, isolated from healthy donors compared to that of the yeasts cultured from CDI patients. Seasonal occurrence was observed in the isolation rate of CDI and non-CDI diarrheic cases (p = 0.0019), peaking in winter for CDI patients and in spring for non-CDI diarrheic patients. Furthermore, seasonality emerged in the gut colonization by Candida of CDI patients in the winter. It seems, therefore, that the reduced capacity of biofilm production by Candida strains isolated from CDI patients might have a role in the development of C. difficile infection, probably facilitating the spread of the bacteria into the gut thus amplifying their pathogenic action