Guidance to post-mortem collection and storage of biological specimens for the diagnosis of Covid-19 infection

The following document is based on the current knowledge of SARS-CoV-2 and the related disease (COVID-19). The Italian Institute of Health (ISS) is monitoring the virus spread throughout the country through daily reports sent by individual regions and regional reference laboratories. The diagnosis of infection is based on the use of standardized and validated molecular tests for the search for viral RNA in different sets of biological samples, from patients suspected of having contracted the infection. This document provides a specific guidance for the collection and storage of biological samples from deceased persons. It also provides recommendations on safety practices to be adopted during both collection and handling of specimens, and during autopsy procedures. With regard autopsy, it is recommended to follow the procedures for the execution of diagnostic findings in patients died with SARS-CoV-2 infection issued by ISS Working Group on Causes of Death from COVID-19, published on March 27, 2020

Presepsin (Soluble CD14 Subtype): Reference Ranges of a New Sepsis Marker in Term and Preterm Neonates.

OBJECTIVE:Presepsin (soluble CD14 subtype) has been shown to be beneficial as a sepsis marker in adults. Nevertheless, very few data are available in neonates. The aim of the present study was to determine reference ranges of presepsin in term and preterm neonates. METHODS:Healthy term neonates and preterm neonates without clinical signs of infection admitted to the Neonatal Unit were consecutively enrolled. Presepsin concentrations in whole blood were measured using a point-of-care assay system located in the Unit. Demographic data, antenatal and perinatal variables commonly affecting C-reactive protein and procalcitonin values were considered. RESULTS:Of the 684 neonates enrolled in the study, 484 (70.8%) were born at term and 200 (29.2%) were preterm (24-36 weeks' gestation). In term infants, presepsin median value was 603.5 pg/mL (interquartile range: 466.5-791 pg/mL; 5th and 95th centiles: 315 and 1178 pg/mL respectively). In preterm infants, presepsin median value was slightly higher, equal to 620 pg/mL (interquartile range: 503-864 pg/mL; 5th and 95th centiles: 352 and 1370 pg/mL respectively). The reference ranges of presepsin we determined were much higher than those seen in healthy adults. No correlation between presepsin levels and postnatal age was observed, as well as no significant difference was demonstrated in preterm neonates at different gestational ages. None of the variables analyzed affected presepsin levels at a clinical significant extent. CONCLUSION:For the first time, this study provides reference ranges of presepsin in term and preterm neonates. Having reliable reference values is crucial for obtaining an adequate diagnostic accuracy. Based on our results, most variables commonly affecting C-reactive protein and procalcitonin values do not affect presepsin levels, which suggests that presepsin could be an effective sepsis marker. Further investigations in large groups of neonates with sepsis are needed to determine the diagnostic and prognostic value of this biomarker

Mycoplasma hominis Induces Mediastinitis after a Tonsillar Abscess

Mycoplasma hominis is commonly involved in genitourinary tract infections. We report a 59-year-old man who developed a M. hominis-associated mediastinitis following acute tonsillar infection

Case Report Mycoplasma hominis Induces Mediastinitis after a Tonsillar Abscess

Mycoplasma hominis is commonly involved in genitourinary tract infections. We report a 59-year-old man who developed a M. hominis-associated mediastinitis following acute tonsillar infection

Epidemiologia delle batteriemie nosocomiali in Lombardia nel triennio 1999-2001

We analyzed bloodstream infection(BI) performed in eight hospitals in Region Lombardia in the period 1999- 2001 following criteria and methods as in the study performed in the year 1997.Data were evaluated from 434.000 hospital patients (one third of hospital patients annualy recovered in Lombardia Region each year). Of these 56.3 positive blood coltures /1000 patients were observed. Data were similar as 1997. In total 3063 episodes of bacteriemia were observed (6.98 BI / 1000 hospital patients).53% of cases correlated to hospital infection. Organism identification of causative organisms resulted 22.5% for E.coli and 10.6% for KES; 17.7% S.aureus,4.5% Yeast .Anaerobic bacteria resulted involved in 3.4%.Among the frequency of isolates difference was noted in different wards In intensive care unit E.coli was pathogenic in 5.9% of patients, but KES in 25.5% of cases. Differences were noted if nosocomial or comunity infections were involved. It was concluded that epidemiological data of BI from all the hospital of Region Lombardia could support the knowledge of bacteriemic episodes in different wards as useful method of surveillance particularly in order to control economic aspects and efficacy of prevention

Presepsin levels (pg/mL) in term neonates classified by the variables under study, singly considered (means ± standard errors).

<p>Presepsin levels (pg/mL) in term neonates classified by the variables under study, singly considered (means ± standard errors).</p

FilmArray™ GI panel performance for the diagnosis of acute gastroenteritis or hemorragic diarrhea

Abstract Background Acute gastroenteritis is a common cause of morbidity and mortality in humans worldwide. The rapid and specific identification of infectious agents is crucial for correct patient management. However, diagnosis of acute gastroenteritis is usually performed with diagnostic panels that include only a few pathogens. In the present bicentric study, the diagnostic value of FilmArray™ GI panels was assessed in unformed stool samples of patients with acute gastroenteritis and in a series of samples collected from pediatric patients with heamorragic diarrhea. The clinical performance of the FilmArray™ gastrointestinal (GI) panel was assessed in 168 stool samples collected from patients with either acute gastroenteritis or hemorragic diarrhea. Samples showing discordant results between FilmArray and routine methods were further analyzed with an additional assay. Results Overall, the FilmArray™ GI panel detected at least one potential pathogen in 92/168 (54.8%) specimens. In 66/92 (71.8%) samples, only one pathogen was detected, while in 26/92 (28.2%) multiple pathogens were detected. The most frequent pathogens were rotavirus 13.9% (22/168), Campylobacter 10.7% (18/168), Clostridium difficile 9.5% (16/168), and norovirus 8.9% (15/168). Clostridium difficile was identified only in patients with acute gastroenteritis (p < 0.01), while STEC was detected exclusively in patients with hemorragic diarrhea (p < 0.01). In addition, Campylobacter spp., Salmonella spp., EPEC and E. coli producing Shiga-like toxin were more frequently detected in patients with hemorragic diarrhea (p < 0.05). The overall percent agreement calculated in samples was 73.8% and 65.5%, while 34.5% were discordant. After additional confirmatory analyses, the proportion of discordant samples decreased to 7.7%. Rotavirus and astrovirus were the most frequently unconfirmed pathogens. Conclusion In conclusion, the FilmArray™ GI panel has proved to be a valuable new diagnostic tool for improving the diagnostic efficiency of GI pathogens

Centiles of the distribution of presepsin levels (pg/mL) in term and preterm neonates.

<p>Centiles of the distribution of presepsin levels (pg/mL) in term and preterm neonates.</p