Six-month psychophysical evaluation of olfactory dysfunction in patients with COVID-19

This study prospectively assessed the six-month prevalence of self-reported and psychophysically measured olfactory dysfunction in subjects with mild-to-moderate COVID-19. Self-reported smell or taste impairment was prospectively evaluated by SNOT-22 at diagnosis, 4-week, 8-week, and 6-month. At 6 months from the diagnosis, psychophysical evaluation of olfactory function was also performed using the 34-item culturally adapted University of Pennsylvania Smell Identification Test (CA-UPSIT). 145 completed both the 6-month subjective and psychophysical olfactory evaluation. According to CA-UPSIT, 87 subjects (60.0%) exhibited some smell dysfunction, with 10 patients being anosmic (6.9%) and 7 being severely microsmic (4.8%). At the time CA-UPSIT was administered, a weak correlation was observed between the self-reported alteration of sense of smell or taste and olfactory test scores (Spearman's r=-0.26). Among 112 patients who self-reported normal sense of smell at last follow-up, CA-UPSIT revealed normal smell in 46 (41.1%), mild microsmia in 46 (41.1%), moderate microsmia in 11 (9.8%), severe microsmia in 3 (2.3%), and anosmia in 6 (5.4%) patients; however, of those patients self-reporting normal smell but who were found to have hypofunction on testing, 62 out of 66 had self-reported reduction in sense of smell or taste at an earlier time point. Despite most patients report a subjectively normal sense of smell, we observed a high percentage of persistent smell dysfunction at 6 months from the diagnosis of SARS-CoV-2 infection, with 11.7% of patients being anosmic or severely microsmic. These data highlight a significant long-term rate of smell alteration in patients with previous SARS-COV-2 infection

Antifungal susceptibility of invasive yeast isolates in Italy: the GISIA3 study in critically ill patients

<p>Abstract</p> <p>Background</p> <p>Yeasts are a common cause of invasive fungal infections in critically ill patients. Antifungal susceptibility testing results of clinically significant fungal strains are of interest to physicians, enabling them to adopt appropriate strategies for empiric and prophylactic therapies. We investigated the antifungal susceptibility of yeasts isolated over a 2-year period from hospitalised patients with invasive yeast infections.</p> <p>Methods</p> <p>638 yeasts were isolated from the blood, central venous catheters and sterile fluids of 578 patients on general and surgical intensive care units and surgical wards. Etest strips and Sensititre panels were used to test the susceptibility of the isolates to amphotericin B, anidulafungin, caspofungin, fluconazole, itraconazole, posaconazole and voriconazole in 13 laboratories centres (LC) and two co-ordinating centres (CC). The Clinical and Laboratory Standards Institute (CLSI) reference broth microdilution method was used at the CCs for comparison.</p> <p>Results</p> <p>Etest and Sensititre (LC/CC) MIC₉₀values were, respectively: amphotericin B 0.5/0.38, 1/1 mg/L; anidulafungin 2/1.5 and 1/1 mg/L; caspofungin 1/0.75 and 0.5/0.5 mg/L; fluconazole 12/8 and 16/16 mg/L; itraconazole 1/1.5, 0.5/0.5 mg/L; posaconazole 0.5 mg/L and voriconazole 0.25 mg/L for all. The overall MIC₉₀values were influenced by the reduced susceptibility of <it>Candida parapsilosis </it>isolates to echinocandins and a reduced or lack of susceptibility of <it>Candida glabrata </it>and <it>Candida krusei </it>to azoles, in particular fluconazole and itraconazole. Comparison of the LC and CC results showed good Essential Agreement (90.3% for Etest and 92.9% for Sensititre), and even higher Categorical Agreement (93.9% for Etest and 96% for Sensititre); differences were observed according to the species, method, and antifungal drug. No cross-resistance between echinocandins and triazoles was detected.</p> <p>Conclusions</p> <p>Our data confirm the different antifungal susceptibility patterns among species, and highlight the need to perform antifungal susceptibility testing of clinically relevant yeasts. With the exception of a few species (e.g. <it>C. glabrata </it>for azoles and <it>C. parapsilosis </it>for echinocandins), the findings of our study suggest that two of the most widely used commercial methods (Etest and Sensititre) provide valid and reproducible results.</p

Evaluation of allograft contamination and decontamination at the Treviso Tissue Bank Foundation: A retrospective study of 11,129 tissues.

Microbiological contamination of retrieved tissues has become a very important topic and a critical aspect in the safety of allografts. We have analysed contamination in 11,129 tissues with a longitudinal contamination profile for each individual tissue. More specifically, 10,035 musculoskeletal tissues and 1,094 cardiovascular tissues were retrieved from a total of 763 multi-tissue donors, of whom 105 were heart-beating donors as well as organ donors, while the remaining 658 were non-heart beating donors and tissue donors only. All tissues were decontaminated twice, the first time immediately after retrieval and the second time after processing. Each tissue was submitted to microbiological culture three times, i.e., upon retrieval (Time 1), after the first decontamination (Time 2) and after the second decontamination (Time 3). The contamination rate for musculoskeletal tissues was 52%, 16.2% and 0.5% at Time 1, 2 and 3, respectively. The contamination rate for cardiovascular tissues was 84%, 42% and 6%. More than one strain was simultaneously present in 10.8% of musculoskeletal tissues and 44.6% of cardiovascular tissues. Out of 8,560 non-heart-beating donor musculoskeletal tissues, 4,689 (54.8%), 1,383 (16.2%) and 42 (0.5%) were contaminated at Time 1, Time 2 and Time 3, respectively. Out of 1,475 heart-beating donor musculoskeletal tissues, 522 (35.4%) 113 (7.7%) and 2 (0.1%) tissues were found to be contaminated at Time 1, 2 and 3, respectively. Out of 984 non-heart beating donor cardiovascular tissues, 869 (88.3%), 449 (45.6%) and 69 (7%) proved positive at Time 1, 2 and 3 respectively, while 50 (45.5%) and 10 (9.1%) heart-beating donor cardiovascular tissues were contaminated at Time 1 and 2. No tissue was contaminated at Time 3. Based on our methods, the two-step decontamination approach is mandatory in order to drastically reduce the number of tissues found to be positive at the end of the process

Análise da porcentagem de pacientes com infarto agudo do miocárdio que não são submetidos à trombolítico e são encaminhados para cinecoronariografia na fase hospitalar

Introdução: As doenças cardiovasculares representam um grande problema da saúde pública brasileira. Com o advento das Unidades Terapêuticas e o controle das arritmias a mortalidade diminuiu porem elas ainda se encontram como principal causa de morte da população. Dentre as doenças, a que possui maior índice é o Infarto Agudo do Miocárdio (IAM), que com o advento do tratamento por fibrinolíticos precoce, alem de ter melhorado o prognostico dos pacientes, reduziu efetivamente o óbito. Objetivos: Quantificar a porcentagem de pacientes encaminhados ao serviço de hemodinâmica do Hospital Santa Lucinda, em Sorocaba-SP, sem receberem o tratamento de re-vascularização precoce. Métodos: Nesse trabalho associamos o uso do trombolítico na fase pré-hospitalar com a necessidade da cinecoronariografia, já que no serviço, os pacientes são encaminhados sem receber o medicamento em questão. Para tal, foi aplicado um questionário nos pacientes internados, portadores de IAM com supra-desnivelamento do segmento ST. Nesse questionário foram abordados tópicos como: sexo, idade, gênero, tempo decorrente do inicio do sintoma, procura do serviço de emergência, necessidade de angioplastia e evolução dos pacientes. Resultados: Distribuição dos pacientes quanto a idade: 14% menos de 45 anos e 86% com 45 anos ou mais, sendo que 77% do total são do sexo masculino. Caracterizando melhores esses pacientes, 83% deles estavam na classificação Killip I, 14% Killip II e 3% Killip IV, 68% da amostra tinham troponina positiva e 79% CKMB positiva. Os pacientes apresentaram em sua maioria (56%) Infarto Agudo do Miocárdio acometendo o seguimento anterior, seguido por 36% de parede inferior e 3% de parede lateral. Dos pacientes que não receberam o trombolítico: 65% dos pacientes não possuíam contra-indicações, 10% não souberam informar, 20% apresentaram o atendimento fora do tempo adequado para a realização da trombólise, 3% estavam com a pressão muito alta na hora do atendimento e os outros 3% tiveram um episódio de sangramento recente nos últimos 3 meses. Evolução desses pacientes: 71% retornaram ao hospital de origem, 11% receberam alta hospitalar, 11% tiveram intervenção cirúrgica, 5% foram internados e 3% foram a óbito, sendo que dentro desse grupo, em 43% dos pacientes foi feita a colocação do stent na artéria predominantemente culpada. Evolução dos pacientes que receberam o trombolítico: 57% não necessitou a colocação do stent e 87% desses pacientes retornaram ao hospital de origem, 9% receberam alta e 4% foram encaminhados para a realização da cirurgia cardíaca. Conclusão: O reconhecimento dos sinais e sintomas do IAM por parte do paciente é fundamental para o diagnostico rápido e preciso e determinante no tratamento e evolução do paciente

A 5-year survey of antimicrobial susceptibility profiles of methicillin-resistant staphylococcus aureus (MRSA) isolated from patients with bloodstream infections in Northeast Italy

A 5-year survey (2009-2013) of antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) isolated from patients with bloodstream infections was carried out in Northeast Italy. No upward creep of glycopeptides MICs was documented among 582 nonduplicate MRSA blood isolates, which were tested in accordance with broth microdilution and interpreted in accordance with EUCAST recommendations. Teicoplanin showed stably a lower MIC50 in comparison with vancomycin (0.25-0.5 versus 1 mg/L). The activities of newer anti-MRSA antibacterials stratified by glycopeptides MICs showed similar trends in MICs of either vancomycin or teicoplanin with those of daptomycin, linezolid, and tigecycline. We hypothesize that in centers with different distribution of glycopeptides MICs, downward for teicoplanin and upward for vancomycin, teicoplanin could be a more effective alternative to vancomycin for empirical treatment of MRSA-related bacteremia

Percentage of contamination and bacteria found at Times 1, 2 and 3 in CVT.

<p>Percentage of contamination and bacteria found at Times 1, 2 and 3 in CVT.</p

N° of tissues contaminated and contamination rate in MST of HBD and NHBD at Times 1, 2 and 3.

<p>N° of tissues contaminated and contamination rate in MST of HBD and NHBD at Times 1, 2 and 3.</p

Percentage of contamination and bacteria found at Times 1, 2 and 3 in MST.

<p>Percentage of contamination and bacteria found at Times 1, 2 and 3 in MST.</p

Number and percentage of bacterial isolates per tissue in CVT of HBD and NHBD at Times 1, 2 and 3.

<p>Number and percentage of bacterial isolates per tissue in CVT of HBD and NHBD at Times 1, 2 and 3.</p