Spatial distribution of the Barbary Partridge (Alectoris barbara) in Sardinia explained by land use and climate

More than half of the European population of the Barbary Partridge is in Sardinia; nonetheless, the researches concerning this species are very scarce, and its conservation status is not defined because of a deficiency of data. This research aimed to analyse the habitat selection and the factors affecting the abundance and the density of the Barbary Partridge in Sardinia. We used the data collected over 8 years (between 2004 and 2013) by spring call counts in 67 study sites spread on the whole island. We used GLMM to define the relationships between the environment (topography, land use, climate) both the occurrence and the abundance of the species. Moreover, we estimated population densities by distance sampling. The Barbary Partridge occurred in areas at low altitude with garrigue and pastures, avoiding woodlands and sparsely vegetated areas. We found a strong relationship between the occurrence probability and the climate, in particular, a positive relation with temperature and a negative effect of precipitation, especially in April–May, during brood rearing. Furthermore, dry crops positively affected the abundance of the species. We estimated a density of 14.1 partridges per km2, similar to other known estimates. Our findings are important both because they increase the knowledge concerning this species, which is considered data deficient in Italy, and because they are useful to plan management actions aimed to maintain viable populations if necessary

An outbreak of sepsis due to extensively drug- resistant originating from an environmental source in an Italian haematologic unit

Background: Multidrug-resistant (MDR) or extensively-drug-resistant (XDR) Pseudomonas aeruginosa (PSA) strains infections are a major concern in nosocomial environments being associated both with worse outcomes and with high mortality rates especially in oncologic and haematogic settings. In the Trieste University hospital, we experienced an outbreak of XDR-PSA bacteremia in the haematology unit probably caused by a reservoir in the toilets faucets. Materials/methods: The haematology unit in Trieste hospital has twelve double-bed rooms and a protected area with three single-bed rooms reserved to patients undergoing marrow transplants and severe neutropenia (neutrophils <0.5 x103/\u3bcL). From August until September 2017 we found 5 patients with sepsis or septic-shock due to an XDR-PSA. The bacterial identification was performed by Vitek-2 (bioM\ue9rieux). Minimal inhibitory concentrations (MICs) were determined by a micro-dilution method (Sensititre Diagnostic System, Trek), and interpreted according to the EUCAST criteria. MIC for ceftolozane/tazobactam was determined by e-test. Genotyping to determine genetic relatedness between isolates was performed by analysis of pulsed-field gel electrophoresis (PFGE) profiles of chromosomal DNA digested with SpeI. Results: All 5 consecutive strains of PSA from blood culture were resistant to piperacillin/tazobactam, ceftazidime, cefepime, ciprofloxacin, gentamicin, imipenem, meropenem and ceftolozane/tazobactam and susceptible to colistin and amikacin. None of these patients had any apparent source of bacteremia. Four out of five patients occupied the three isolation rooms. Two out of five patients had CVC-related sepsis and two died because of the XDR-PSA bacteremia (40% in-hospital mortality). No culture from rectal swabs and samples from ventilation filters was found positive for XDR-PSA which was instead found in the faucets of the toilets in the protected area. Pulse field analysis demonstrated that the strains both from blood cultures and from the toilets tabs were highly related suggesting that the outbreak was due to a single clone, probably originating from the tap water. The environmental disinfection of the ward succeeded in clearing the XDR-PSA strain and allowed to resume the regular transplant activity. Conclusions: The investigation of this dramatic outbreak of XDR PSA highlights the potential role of environmental sources acting as a reservoir of MDR/XDR nosocomial pathogens

A staging system for renal outcome and early markers of renal response to chemotherapy in AL amyloidosis

The kidney is involved in 70% of patients with immunoglobulin light-chain (AL) amyloidosis, but little is known on progression or reversibility of renal involvement, and criteria for renal response have never been validated. Newly diagnosed patients from the Pavia (n = 461, testing cohort) and Heidelberg (n = 271, validation cohort) centers were included. Proteinuria >5 g/24 h and estimated glomerular filtration rate (eGFR) <50 mL/min predicted progression to dialysis best. Proteinuria below and eGFR above the thresholds indicated low risk (0 and 4% at 3 years in the testing and validation cohorts, respectively). High proteinuria and low eGFR indicated high risk (60% and 85% at 3 years). At 6 months, a ≥25% eGFR decrease predicted poor renal survival in both cohorts and was adopted as criterion for renal progression. A decrease in proteinuria by ≥30% or below 0.5 g/24 h without renal progression was the criterion for renal response, being associated with longer renal survival in the testing and validation populations. Hematologic very good partial or complete remission at 6 months improved renal outcome in both populations. We identified and validated a staging system for renal involvement and criteria for early assessment of renal response and progression in AL amyloidosis that should be used in clinical practice and trial design