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  1. Article ; Online: Pharyngeal and cutaneous diphtheria: a tail of a refugee.

    Galfo, Valentina / Riccardi, Niccolò / Leonildi, Alessandro / Falcone, Marco / Barnini, Simona

    Infection

    2023  Volume 51, Issue 5, Page(s) 1599–1600

    MeSH term(s) Humans ; Diphtheria/diagnosis ; Refugees
    Language English
    Publishing date 2023-01-31
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 185104-4
    ISSN 1439-0973 ; 0300-8126 ; 0173-2129
    ISSN (online) 1439-0973
    ISSN 0300-8126 ; 0173-2129
    DOI 10.1007/s15010-023-01990-4
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    Zs.A 881: Show issues Location:
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    Zs.MO 528: Show issues

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  2. Article ; Online: Meropenem/vaborbactam plus aztreonam for the treatment of New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae infections.

    Tiseo, Giusy / Suardi, Lorenzo Roberto / Leonildi, Alessandro / Giordano, Cesira / Barnini, Simona / Falcone, Marco

    The Journal of antimicrobial chemotherapy

    2023  Volume 78, Issue 9, Page(s) 2377–2379

    MeSH term(s) Humans ; Meropenem/therapeutic use ; Aztreonam/pharmacology ; Aztreonam/therapeutic use ; Klebsiella pneumoniae ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; beta-Lactamases ; Drug Combinations ; Microbial Sensitivity Tests ; Klebsiella Infections/drug therapy
    Chemical Substances Meropenem (FV9J3JU8B1) ; Aztreonam (G2B4VE5GH8) ; beta-lactamase NDM-1 (EC 3.5.2.6) ; vaborbactam (1C75676F8V) ; Anti-Bacterial Agents ; beta-Lactamases (EC 3.5.2.6) ; Drug Combinations
    Language English
    Publishing date 2023-07-18
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 191709-2
    ISSN 1460-2091 ; 0305-7453
    ISSN (online) 1460-2091
    ISSN 0305-7453
    DOI 10.1093/jac/dkad206
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    Zs.A 1197: Show issues Location:
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    Zs.MO 124: Show issues

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  3. Article ; Online: Real-world experience with meropenem/vaborbactam for the treatment of infections caused by ESBL-producing Enterobacterales and carbapenem-resistant Klebsiella pneumoniae.

    Tiseo, Giusy / Galfo, Valentina / Riccardi, Niccolò / Suardi, Lorenzo Roberto / Pogliaghi, Manuela / Giordano, Cesira / Leonildi, Alessandro / Barnini, Simona / Falcone, Marco

    European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology

    2024  

    Abstract: Purpose: Real-world experience with meropenem/vaborbactam (M/V) is limited. Our aim is to report a clinical experience of M/V in the treatment of resistant Gram-negative bacilli.: Methods: This is a prospective observational study including patients ... ...

    Abstract Purpose: Real-world experience with meropenem/vaborbactam (M/V) is limited. Our aim is to report a clinical experience of M/V in the treatment of resistant Gram-negative bacilli.
    Methods: This is a prospective observational study including patients hospitalized in the University Hospital of Pisa (March 2021-Jan 2023) with infections by both extended-spectrum β-lactamases (ESBL)-producing Enterobacterales and carbapenem-resistant Klebsiella pneumoniae (Kp) treated with M/V. The primary outcome measure was clinical success, defined as a composite of survival, resolution of signs and symptoms and absence of microbiological failure at day 30 from infection onset. A multivariable regression analysis was performed to identify factors associated with clinical failure. Odds ratio (OR) with 95% confidence intervals (CI) was calculated.
    Results: A total of 104 patients who received M/V were included: 24/104 (23.1%) infections were caused by ESBL non-hypervirulent Enterobacterales, 17/104 (16.3%) by ESBL-producing hypervirulent Klebsiella pneumoniae (hvKp) and 63/104 (60.6%) by CRE. The most common infections were bloodstream infections, followed by urinary tract infections, hospital-acquired pneumonia, intra-abdominal infections and others. Septic shock occurred in 16/104 (15.4%) patients. Clinical success was achieved in 77% of patients, and 30-day mortality rate was 15.4%. In patients with KPC-producing Kp infections, clinical success and 30-day mortality rates were 82% and 11.5%, respectively. On multivariable analysis, SOFA score (OR 1.32, 95% CI 1.02-1.7, p=0.032) was independently associated with clinical failure, while source control (OR 0.16, 95% CI 0.03-0.89, p=0.036) was protective.
    Conclusions: M/V is a promising therapeutic option against infections caused by difficult-to-treat ESBL-producing Enterobacterales and CR-Kp.
    Language English
    Publishing date 2024-02-20
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 603155-9
    ISSN 1435-4373 ; 0934-9723 ; 0722-2211
    ISSN (online) 1435-4373
    ISSN 0934-9723 ; 0722-2211
    DOI 10.1007/s10096-024-04758-2
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    Zs.A 1732: Show issues Location:
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  4. Article ; Online: Trends in hospital acquired New Delhi metallo-beta-lactamase-producing Enterobacterales in Tuscany (Italy) from 2019 to 2021: impact of the COVID-19 pandemic.

    Arzilli, G / Forni, S / Righi, L / Barnini, S / Petricci, P / Parisio, E M / Pistello, M / Vivani, P / Gemignani, G / Baggiani, A / Bellandi, T / Privitera, G / Gemmi, F / Tavoschi, L / Porretta, A

    The Journal of hospital infection

    2023  Volume 137, Page(s) 44–53

    Abstract: Objectives: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control ... ...

    Abstract Objectives: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control measures successfully reducing transmission. We describe the NDM-CRE epidemiology during the COVID-19 pandemic in Tuscany.
    Methods: Data on NDM-CRE patients hospitalized in five Tuscan hospitals were collected from January 2019 to December 2021. Weekly rates of NDM-CRE cases on hospital days in medical and critical-care wards were calculated. In March-December 2020, NDM-CRE rates were stratified by COVID-19 diagnosis. Multi-variate regression analysis was performed to assess outcomes' differences among two periods analysed and between COVID-19 populations.
    Results: Since March 2020, an increase in NDM-CRE cases was observed, associated with COVID-19 admissions. COVID-19 patients differed significantly from non-COVID-19 ones by several variables, including patient features (age, Charlson index) and clinical history and outcomes (NDM-CRE infection/colonization, intensive care unit stay, length of stay, mortality). During the pandemic, we observed a higher rate of NDM-CRE cases per hospital day in both non-COVID-19 patients (273/100,000) and COVID-19 patients (370/100,00) when compared with pre-pandemic period cases (187/100,00).
    Conclusions: Our data suggest a resurgence in NDM-CRE spread among hospitalized patients in Tuscany during the COVID-19 pandemic, as well as a change in patients' case-mix. The observed increase in hospital transmission of NDM-CRE could be related to changes in infection prevention and control procedures, aimed mainly at COVID-19 management, leading to new challenges in hospital preparedness and crisis management planning.
    MeSH term(s) Humans ; Pandemics ; COVID-19 Testing ; COVID-19/epidemiology ; beta-Lactamases ; Hospitals ; Gammaproteobacteria ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Microbial Sensitivity Tests
    Chemical Substances beta-lactamase NDM-1 (EC 3.5.2.6) ; beta-Lactamases (EC 3.5.2.6) ; Anti-Bacterial Agents
    Language English
    Publishing date 2023-05-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 779366-2
    ISSN 1532-2939 ; 0195-6701
    ISSN (online) 1532-2939
    ISSN 0195-6701
    DOI 10.1016/j.jhin.2023.04.016
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    Zs.A 1586: Show issues Location:
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  5. Article ; Online: Rapid detection of colistin-resistant Klebsiella pneumoniae using MALDI-TOF MS peak-based assay.

    Giordano, Cesira / Barnini, Simona

    Journal of microbiological methods

    2018  Volume 155, Page(s) 27–33

    Abstract: Carbapenemase-producing Klebsiella pneumoniae has become a worldwide recognized cause of nosocomial infections and requires urgent public health attention. The main reason of this concern is the increasing resistance to all the last-resort antibiotics, ... ...

    Abstract Carbapenemase-producing Klebsiella pneumoniae has become a worldwide recognized cause of nosocomial infections and requires urgent public health attention. The main reason of this concern is the increasing resistance to all the last-resort antibiotics, including colistin. The ideal methodology for colistin susceptibility testing still remains undefined. However, the emergence of colistin as one of the last-option treatments requires a reliable method to determine the susceptibility profile of resistant isolates. The aim of the present study was to evaluate the impact of detecting colistin resistance in Klebsiella pneumoniae isolates using MALDI-TOF MS in clinical routine practice. For this reason, 139 isolates of K. pneumoniae were collected during 2015-2017 from patients hospitalized at Pisa University Hospital. Colonies suspected to be colistin resistant were identified using MALDI-TOF MS (Bruker Daltonik GmbH, Bremen, Germany) following a protein extraction protocol. Strains were previously wholly genome sequenced. To create a customized database entry and to generate classifying algorithm models, 1.112 mass spectra were collected. In relation to their mass signals and intensities, a two dimensional peak distribution was created. The recognition capability of the algorithm based on two manually selected mass peaks was 91,8%, while cross validation was 87,6%. The proportion of correctly classified colistin-resistant K. pneumoniae was 91% and colistin-susceptible was 73%. The emergence of colistin-resistant Gram-negative organisms has a dramatic impact on patient outcomes. Our study, based on MALDI-TOF MS technology, offers rapid preliminary results on colistin resistance profile coupled with bacteria identification.
    MeSH term(s) Algorithms ; Anti-Bacterial Agents/pharmacology ; Colistin/pharmacology ; Cross Infection/diagnosis ; Cross Infection/microbiology ; Drug Resistance, Bacterial/drug effects ; Drug Resistance, Bacterial/genetics ; Humans ; Klebsiella Infections/diagnosis ; Klebsiella Infections/microbiology ; Klebsiella pneumoniae/drug effects ; Klebsiella pneumoniae/genetics ; Klebsiella pneumoniae/isolation & purification ; Klebsiella pneumoniae/pathogenicity ; Microbial Sensitivity Tests ; Proteome ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods
    Chemical Substances Anti-Bacterial Agents ; Proteome ; Colistin (Z67X93HJG1)
    Language English
    Publishing date 2018-11-12
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 604916-3
    ISSN 1872-8359 ; 0167-7012
    ISSN (online) 1872-8359
    ISSN 0167-7012
    DOI 10.1016/j.mimet.2018.11.008
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    Zs.A 1849: Show issues Location:
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  6. Article ; Online: Salvage therapy with sulbactam/durlobactam against cefiderocol-resistant

    Tiseo, Giusy / Giordano, Cesira / Leonildi, Alessandro / Riccardi, Niccolò / Galfo, Valentina / Limongi, Federica / Nicastro, Manuela / Barnini, Simona / Falcone, Marco

    JAC-antimicrobial resistance

    2023  Volume 5, Issue 3, Page(s) dlad078

    Abstract: Background: Carbapenem-resistant : Methods: We report a case of severe infection by CRAB resistant to both colistin and cefiderocol treated with sulbactam/durlobactam and describe the molecular features of the strain. Susceptibility to cefiderocol ... ...

    Abstract Background: Carbapenem-resistant
    Methods: We report a case of severe infection by CRAB resistant to both colistin and cefiderocol treated with sulbactam/durlobactam and describe the molecular features of the strain. Susceptibility to cefiderocol was detected by disc diffusion according to EUCAST breakpoints. Susceptibility to sulbactam/durlobactam was determined by Etest according to preliminary breakpoints provided by Entasis Therapeutics. Whole Genome Sequencing (WGS) of the CRAB isolate was performed.
    Results: A burn patient with ventilator-associated pneumonia by CRAB resistant to colistin and cefiderocol received sulbactam/durlobactam as compassionate use. She was alive after 30 days from the end of therapy. Complete microbiological eradication of CRAB was achieved. The isolate harboured
    Conclusions: Further treatment options for severe infections by CRAB resistant to all available antibiotics are urgently needed. Sulbactam/durlobactam may be a future option against MDR
    Language English
    Publishing date 2023-06-14
    Publishing country England
    Document type Journal Article
    ISSN 2632-1823
    ISSN (online) 2632-1823
    DOI 10.1093/jacamr/dlad078
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  7. Article ; Online: Clinical Features and Outcomes of Infections Caused by Metallo-β-Lactamase-Producing Enterobacterales: A 3-Year Prospective Study From an Endemic Area.

    Falcone, Marco / Giordano, Cesira / Leonildi, Alessandro / Galfo, Valentina / Lepore, Aurelio / Suardi, Lorenzo Roberto / Riccardi, Niccolò / Barnini, Simona / Tiseo, Giusy

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2023  Volume 78, Issue 5, Page(s) 1111–1119

    Abstract: Background: Metallo-β-lactamase (MBL)-producing Enterobacterales are increasing worldwide. Our aim was to describe clinical features, treatments, and outcomes of infections by MBL-Enterobacterales.: Methods: A prospective observational study ... ...

    Abstract Background: Metallo-β-lactamase (MBL)-producing Enterobacterales are increasing worldwide. Our aim was to describe clinical features, treatments, and outcomes of infections by MBL-Enterobacterales.
    Methods: A prospective observational study conducted in the Pisa University Hospital (January 2019 to October 2022) included patients with MBL-producing Enterobacterales infections. The primary outcome measure was the 30-day mortality rate. Multivariable Cox regression analysis was performed to identify factors associated with that mortality rate, and adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated.
    Results: The study's 343 patients included 15 with Verona integron-encoded MBL (VIM)- and 328 with New Delhi MBL (NDM)-producing Enterobacterales infections; there were 199 patients (58%) with bloodstream infections, 60 (17.5%) with hospital-acquired or ventilator-associated pneumonia, 60 (17.5%) with complicated urinary tract infections, 13 (3.8%) with intra-abdominal infections, and 11 (3.2%) with skin and soft-tissue infections. The 30-day mortality rate was 29.7%. Of 343 patients, 32 did not receive in vitro active antibiotic therapy, 215 (62.7%) received ceftazidime-avibactam plus aztreonam, 33 (9.6%) received cefiderocol-containing regimens, 26 (7.6%) received colistin-containing regimens, and 37 (10.8%) received other active antibiotics. On multivariable analysis, septic shock (aHR, 3.57 [95% CI, 2.05-6.23]; P < .001) and age (1.05 [1.03-1.08]; P < .001) were independently associated with the 30-day mortality rate, while in vitro active antibiotic therapy within 48 hours after infection (0.48 [.26-.8]; P = .007) and source control (0.43 [.26-.72]; P = .001) were protective factors. Sensitivity analysis showed that ceftazidime-avibactam plus aztreonam, compared with colistin, was independently associated with a reduced 30-day mortality rate (aHR, 0.39 [95% CI, .18-.86]; P = .02). Propensity score analyses confirmed these findings.
    Conclusions: MBL-producing carbapenem-resistant Enterobacterales infections are associated with high 30-day mortality rates. Patients with MBL-producing Enterobacterales infections should receive early active antibiotic therapy.
    MeSH term(s) Humans ; beta-Lactamases/metabolism ; Male ; Prospective Studies ; Female ; Middle Aged ; Enterobacteriaceae Infections/drug therapy ; Enterobacteriaceae Infections/mortality ; Enterobacteriaceae Infections/microbiology ; Enterobacteriaceae Infections/epidemiology ; Aged ; Anti-Bacterial Agents/therapeutic use ; Anti-Bacterial Agents/pharmacology ; Enterobacteriaceae/drug effects ; Enterobacteriaceae/enzymology ; Adult ; Ceftazidime/therapeutic use ; Ceftazidime/pharmacology ; Aged, 80 and over ; Microbial Sensitivity Tests ; Drug Resistance, Multiple, Bacterial ; Endemic Diseases ; Drug Combinations
    Language English
    Publishing date 2023-12-13
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciad725
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    Zs.A 1505: Show issues Location:
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    Zs.MO 480: Show issues

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  8. Article ; Online: A Prospective Evaluation of Two Rapid Phenotypical Antimicrobial Susceptibility Technologies for the Diagnostic Stewardship of Sepsis.

    Giordano, Cesira / Piccoli, Elena / Brucculeri, Veronica / Barnini, Simona

    BioMed research international

    2018  Volume 2018, Page(s) 6976923

    Abstract: Rapid identification of bloodstream pathogens by MALDI-TOF MS and the recently introduced rapid antimicrobial susceptibility testing (rAST) directly from positive blood cultures allow clinicians to promptly achieve a targeted therapy, especially for ... ...

    Abstract Rapid identification of bloodstream pathogens by MALDI-TOF MS and the recently introduced rapid antimicrobial susceptibility testing (rAST) directly from positive blood cultures allow clinicians to promptly achieve a targeted therapy, especially for multidrug resistant microorganisms. In the present study, we propose a comparison between phenotypical rASTs performed in light-scattering technology (Alfred 60AST, Alifax®) and fluorescence
    MeSH term(s) Bacterial Typing Techniques/methods ; Gram-Negative Anaerobic Bacteria/classification ; Gram-Negative Bacterial Infections/blood ; Gram-Negative Bacterial Infections/microbiology ; Gram-Positive Bacteria/classification ; Gram-Positive Bacterial Infections/blood ; Gram-Positive Bacterial Infections/microbiology ; Humans ; Microbial Sensitivity Tests/methods ; Prospective Studies ; Sepsis/blood ; Sepsis/diagnosis ; Sepsis/microbiology
    Language English
    Publishing date 2018-05-10
    Publishing country United States
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 2698540-8
    ISSN 2314-6141 ; 2314-6133
    ISSN (online) 2314-6141
    ISSN 2314-6133
    DOI 10.1155/2018/6976923
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  9. Article ; Online: Cefiderocol- Compared to Colistin-Based Regimens for the Treatment of Severe Infections Caused by Carbapenem-Resistant Acinetobacter baumannii.

    Falcone, Marco / Tiseo, Giusy / Leonildi, Alessandro / Della Sala, Leonardo / Vecchione, Alessandra / Barnini, Simona / Farcomeni, Alessio / Menichetti, Francesco

    Antimicrobial agents and chemotherapy

    2022  Volume 66, Issue 5, Page(s) e0214221

    Abstract: Cefiderocol may represent a therapeutic option for carbapenem-resistant Acinetobacter baumannii (CRAB) infections, but clinical data are limited. This is an observational retrospective study conducted in the University Hospital of Pisa including ... ...

    Abstract Cefiderocol may represent a therapeutic option for carbapenem-resistant Acinetobacter baumannii (CRAB) infections, but clinical data are limited. This is an observational retrospective study conducted in the University Hospital of Pisa including consecutive patients with CRAB infections (January 2020 to August 2021). Patients were divided in two study groups according to the antibiotic treatment received: cefiderocol- and colistin-containing regimens. The primary outcome was the 30-day mortality. A Cox regression analysis was performed to identify factors independently associated with 30-day mortality. A propensity score analysis using inverse probability of treatment weighting (IPTW) was also performed. A total of 124 patients were included: 47 (37.9%) received cefiderocol, while 77 (62.1%) colistin-containing regimens. Overall, 79 (63.7%) patients had a bloodstream infection (BSI), 35 (28.5%) a ventilator-associated pneumonia (VAP) and 10 (8.1%) other infections. Thirty-day mortality was higher in patients receiving colistin- compared to those who received cefiderocol-containing regimens (55.8% versus 34%,
    MeSH term(s) Acinetobacter baumannii ; Anti-Bacterial Agents/therapeutic use ; Carbapenems/therapeutic use ; Cephalosporins ; Colistin/therapeutic use ; Humans ; Pneumonia, Ventilator-Associated/drug therapy ; Retrospective Studies ; Sepsis/drug therapy ; Cefiderocol
    Chemical Substances Anti-Bacterial Agents ; Carbapenems ; Cephalosporins ; Colistin (Z67X93HJG1)
    Language English
    Publishing date 2022-03-21
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Observational Study
    ZDB-ID 217602-6
    ISSN 1098-6596 ; 0066-4804
    ISSN (online) 1098-6596
    ISSN 0066-4804
    DOI 10.1128/aac.02142-21
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    Zs.A 809: Show issues Location:
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    Einzelsignatur: Show issues

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  10. Article: Investigating Resistance to Carbapenems in Enterobacterales: A Descriptive Epidemiological Study of 2021 Screening in an Italian Teaching Hospital.

    De Vita, Erica / De Angelis, Luigi / Arzilli, Guglielmo / Baglivo, Francesco / Barnini, Simona / Vecchione, Alessandra / Baggiani, Angelo / Rizzo, Caterina / Porretta, Andrea Davide / Teams Aid

    Pathogens (Basel, Switzerland)

    2023  Volume 12, Issue 9

    Abstract: Antimicrobial resistance (AMR) presents a growing threat to global healthcare. This descriptive epidemiological study investigates the prevalence and characteristics of Enterobacterales with AMR factors in a tertiary teaching hospital in Italy over the ... ...

    Abstract Antimicrobial resistance (AMR) presents a growing threat to global healthcare. This descriptive epidemiological study investigates the prevalence and characteristics of Enterobacterales with AMR factors in a tertiary teaching hospital in Italy over the course of the year 2021. In 2021, the prevalence of colonisation by Enterobacterales with AMR factors in patients was 1.08%. During the observation period, a total of 8834 rectal swabs were performed, with 1453 testing positive. A total of 5639 rectal swabs were performed according to a hospital procedure for the active screening of MDRO colonisation at the time of admission. Of these, 679 were positive for microorganisms under surveillance, and 74 patients were colonised with Enterobacterales, predominantly
    Language English
    Publishing date 2023-09-06
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2695572-6
    ISSN 2076-0817
    ISSN 2076-0817
    DOI 10.3390/pathogens12091140
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