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

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

Management and treatment of Magnusiomyces capitatus (Geotrichum capitatum) pleural infection in a non-neutropenic patient with posaconazole. A new therapeutic opportunity?

Magnusiomyces capitatus may cause uncommon yet severe infections, especially in patients with haematologic disorders. Diagnosis may be difficult and time-consuming and newer approaches are required including the MALDI-TOF technique implemented with the detection of fungal antigens in the body fluids. The recommended treatment includes amphotericin B alone or in combination with flucytosine. We describe a case of a non-neutropenic patient with M. capitatus pleural infection, as identified by MALDI-TOF, positivity for galactomannan antigen in the BAL fluid, and successfully treated with oral posaconazole in single therapy

Fast and reliable diagnosis of XDR Acinetobacter baumannii meningitis by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry

Bacterial meningitis is a medical emergency needing quick and timely diagnosis. Even though meningitis caused by Acinetobacter baumannii is relatively rare, it is associated with high mortality rates especially in neurosurgery patients and represents a serious therapeutic problem due to the limited penetration of effective antibiotics into the cerebrospinal fluid. Recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) has been effectively used as a rapid method for microbial identification. In this case report we identified A. baumanni by MALDI-TOF technique directly from the CSF drawn from the external ventricular drainage of a patient with severe confusional state and signs of meningism. Simultaneously the antibiotic susceptibility test was performed by automated method from the pellet of the broth-enriched sample. The MALDI-TOF technique allowed microbial identification in less than 30 minutes, and the susceptibility test result was available in eight hours, thus allowing a fast diagnosis ready for prompt and targeted antimicrobial therapy

Adult ADHD: a study on evaluation and treatment pathways in Italian Mental Health Services. A black hole in the National System and the European Health System

Attention Deficit and Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that often persists into adult-hood. The Italian situation regarding the clinical management of childhood ADHD shows some criticalities, despite the high preva-lence rate: diagnostic assessments are often inaccurate, protocols for transition from childcare services are almost non-existent and theItalian National Registry for ADHD in childhood was drawn up only in 2007, hence the first specialized services were created laterthan the rest of Europe. On the basis of these issues, we investigated the Italian situation with regard to disorders in adulthood, com-paring the different European operational models, assuming that these critical issues are reflected in the clinical management of thedisorder in adulthood. In fact, unlike other European countries, there are no official guidelines governing the clinical management ofthe disorder in adulthood and evidence-based pharmacotherapies, available in most European countries, are off-label or not allowedin Italy. The aim of the study is to evaluate the current state of knowledge and working method in relation to adult ADHD in the Ital-ian background and to identify the main evaluation and treatment pathways in Italian Mental Health Services. The study is also an at-tempt to clarify which services are operational on the Italian territory, with the aim of improving the quality of interventions for theclinical population. Three hundred thirty-eight services have been identified in all Italian Regions and Autonomous Provinces, includ-ing Mental Health Centres (CSM), Pathological Addition Services (SERD), Psychiatric Diagnosis and Treatment Services (SPDC). Anad-hoc survey with closed-ended questions was administered by telephone to each selected centre and the results were compared withthe European literature