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Article ; Online: Doxycycline Post-exposure Prophylaxis and Sexually Transmitted Infections in Italy, 2023.

Calcagno, Andrea / Tutone, Marco / Del Re, Simonetta / Delmonte, Sergio / Agosta, Daniele / Ghisetti, Valeria / Lucchini, Anna

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

2024

Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciae219
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Article: Concurrent and Subsequent Co-Infections of Clostridioides difficile Colitis in the Era of Gut Microbiota and Expanding Treatment Options

Trunfio, Mattia / Scabini, Silvia / Rugge, Walter / Bonora, Stefano / Di Perri, Giovanni / Calcagno, Andrea

Microorganisms. 2022 June 23, v. 10, no. 7

2022

Abstract: We narratively reviewed the physiopathology, epidemiology, and management of co-infections in Clostridioides difficile colitis (CDI) by searching the following keywords in Embase, MedLine, and PubMed: “Clostridium/Clostridioides difficile”, “co-infection” ...

Abstract	We narratively reviewed the physiopathology, epidemiology, and management of co-infections in Clostridioides difficile colitis (CDI) by searching the following keywords in Embase, MedLine, and PubMed: “Clostridium/Clostridioides difficile”, “co-infection”, “blood-stream infection” (BSI), “fungemia”, “Candida”, “Cytomegalovirus”, “probiotics”, “microbial translocation” (MT). Bacterial BSIs (mainly by Enterobacteriaceae and Enterococcus) and fungemia (mainly by Candida albicans) may occur in up to 20% and 9% of CDI, increasing mortality and length of hospitalization. Up to 68% of the isolates are multi-drug-resistant bacteria. A pivotal role is played by gut dysbiosis, intestinal barrier leakage, and MT. Specific risk factors are represented by CDI-inducing broad-spectrum antibiotics, oral vancomycin use, and CDI severity. Probiotics administration (mainly Saccharomyces and Lactobacillus) during moderate/severe CDI may favor probiotics superinfection. Other co-infections (such as Cytomegalovirus or protozoa) can complicate limited and specific cases. There is mounting evidence that fidaxomicin, bezlotoxumab, and fecal microbiota transplantation can significantly reduce the rate of co-infections compared to historical therapies by interrupting the vicious circle between CDI, treatments, and MT. Bacterial BSIs and candidemia represent the most common co-infections in CDI. Physicians should be aware of this complication to promptly diagnose and treat it and enforce preventive strategies that include a more comprehensive consideration of newer treatment options.
Keywords	Candida albicans ; Clostridium difficile ; Cytomegalovirus ; Enterobacteriaceae ; Enterococcus ; Lactobacillus ; Protozoa ; Saccharomyces ; candidemia ; colitis ; dysbiosis ; epidemiology ; intestinal microorganisms ; intestines ; mixed infection ; mortality ; multiple drug resistance ; pathophysiology ; probiotics ; superinfection ; vancomycin
Language	English
Dates of publication	2022-0623
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms10071275
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: I have got you under my skin.

Lupia, Tommaso / Scabini, Silvia / Stroffolini, Giacomo / Calcagno, Andrea

Infection

2020 Volume 48, Issue 2, Page(s) 315–316

MeSH term(s)	Aged ; Animals ; Dirofilaria repens/isolation & purification ; Dirofilariasis/diagnosis ; Ethiopia ; Forearm/parasitology ; Forearm/pathology ; Humans ; Male ; Pruritus/parasitology ; Skin/parasitology ; Skin/pathology ; Travel
Language	English
Publishing date	2020-01-09
Publishing country	Germany
Document type	Case Reports ; 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/s15010-020-01389-5
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Article: Clinical Treatment Options and Randomized Clinical Trials for Neurocognitive Complications of HIV Infection: Combination Antiretroviral Therapy, Central Nervous System Penetration Effectiveness, and Adjuvants.

Lin, Shih-Ping / Calcagno, Andrea / Letendre, Scott L / Ma, Qing

Current topics in behavioral neurosciences

2021 Volume 50, Page(s) 517–545

Abstract: The etiology and pathogenesis of human immunodeficiency virus type-I (HIV)-associated neurocognitive disorders (HAND) remain undetermined and are likely the produce of multiple mechanisms. This can mainly include neuronal injury from HIV, inflammatory ... ...

Abstract	The etiology and pathogenesis of human immunodeficiency virus type-I (HIV)-associated neurocognitive disorders (HAND) remain undetermined and are likely the produce of multiple mechanisms. This can mainly include neuronal injury from HIV, inflammatory processes, and mental health issues. As a result, a variety of treatment options have been tested including NeuroHIV-targeted regimens based on the central nervous system (CNS) penetration effectiveness (CPE) of antiretroviral therapy (ART) and adjuvant therapies for HAND. NeuroHIV-targeted ART regimens have produced consistent and statistically significant HIV suppression in the CNS, but this is not the case for cognitive and functional domains. Most adjuvant therapies such as minocycline, memantine, and selegiline have negligible benefit in the improvement of cognitive function of people living with HIV (PLWH) with mild to moderate neurocognitive impairment. Newer experimental treatments have been proposed to target cognitive and functional symptoms of HAND as well as potential underlying pathogenesis. This review aims to provide an analytical overview of the clinical treatment options and clinical trials for HAND by focusing on NeuroHIV-targeted ART regimen development, CPE, and adjuvant therapies.
MeSH term(s)	Central Nervous System ; Cognition ; HIV Infections/complications ; HIV Infections/drug therapy ; Humans ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2021-02-19
Publishing country	Germany
Document type	Journal Article ; Review
ISSN	1866-3370
ISSN	1866-3370
DOI	10.1007/7854_2020_186
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Article ; Online: Lowering SARS-CoV-2 viral load might affect transmission but not disease severity in secondary cases.

Trunfio, Mattia / Calcagno, Andrea / Bonora, Stefano / Di Perri, Giovanni

The Lancet. Infectious diseases

2021 Volume 21, Issue 7, Page(s) 914–915

MeSH term(s)	COVID-19 ; Humans ; RNA, Viral ; SARS-CoV-2 ; Severity of Illness Index ; Viral Load
Chemical Substances	RNA, Viral
Language	English
Publishing date	2021-04-14
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(21)00205-X
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Article: Concurrent and Subsequent Co-Infections of

Trunfio, Mattia / Scabini, Silvia / Rugge, Walter / Bonora, Stefano / Di Perri, Giovanni / Calcagno, Andrea

Microorganisms

2022 Volume 10, Issue 7

Abstract: We narratively reviewed the physiopathology, epidemiology, and management of co-infections ... ...

Abstract	We narratively reviewed the physiopathology, epidemiology, and management of co-infections in
Language	English
Publishing date	2022-06-23
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms10071275
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Article ; Online: Cerebrospinal Fluid CXCL13 as Candidate Biomarker of Intrathecal Immune Activation, IgG Synthesis and Neurocognitive Impairment in People with HIV.

Trunfio, Mattia / Mighetto, Lorenzo / Napoli, Laura / Atzori, Cristiana / Nigra, Marco / Guastamacchia, Giulia / Bonora, Stefano / Di Perri, Giovanni / Calcagno, Andrea

Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology

2023 Volume 18, Issue 1-2, Page(s) 169–182

Abstract: Plasma C-X-C-motif chemokine ligand-13 (CXCL13) has been linked to disease progression and mortality in people living with HIV (PLWH) and is a candidate target for immune-based strategies for HIV cure. Its role in central nervous system (CNS) of PLWH has ...

Abstract	Plasma C-X-C-motif chemokine ligand-13 (CXCL13) has been linked to disease progression and mortality in people living with HIV (PLWH) and is a candidate target for immune-based strategies for HIV cure. Its role in central nervous system (CNS) of PLWH has not been detailed. We described CSF CXCL13 levels and its potential associations with neurological outcomes. Cross-sectional study enrolling PLWH without confounding for CXCL13 production. Subjects were divided according to CSF HIV-RNA in undetectable (< 20 cp/mL) and viremics. CSF CXCL13, and biomarkers of blood-brain barrier (BBB) impairment, intrathecal synthesis, and immune activation were measured by commercial immunoturbidimetric and ELISA assays. All subjects underwent neurocognitive assessment. Sensitivity analyses were conducted in subjects with intact BBB only. 175 participants were included. Detectable CSF CXCL13 was more common in the viremic (31.4%) compared to the undetectable group (13.5%; OR 2.9 [1.4-6.3], p = 0.006), but median levels did not change (15.8 [8.2-91.0] vs 10.0 [8.1-14.2] pg/mL). In viremics (n = 86), CXCL13 associated with higher CSF HIV-RNA, proteins, neopterin, intrathecal synthesis and BBB permeability. In undetectable participants (n = 89), CXCL13 associated with higher CD4+T-cells count, CD4/CD8 ratio, CSF proteins, neopterin, and intrathecal synthesis. The presence of CXCL13 in the CSF of undetectable participants was associated with increased odds of HIV-associated neurocognitive disorders (58.3% vs 28.6%, p = 0.041). Sensitivity analyses confirmed all these findings. CXCL13 is detectable in the CSF of PLWH that show increased intrathecal IgG synthesis and immune activation. In PLWH with CSF viral suppression, CXCL13 was also associated with neurocognitive impairment.
MeSH term(s)	Humans ; Biomarkers/cerebrospinal fluid ; Chemokine CXCL13/cerebrospinal fluid ; Cross-Sectional Studies ; HIV Infections/cerebrospinal fluid ; HIV Infections/complications ; Immunoglobulin G ; Neopterin/cerebrospinal fluid ; RNA
Chemical Substances	Biomarkers ; Chemokine CXCL13 ; CXCL13 protein, human ; Immunoglobulin G ; Neopterin (670-65-5) ; RNA (63231-63-0)
Language	English
Publishing date	2023-05-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2227405-4
ISSN	1557-1904 ; 1557-1890
ISSN (online)	1557-1904
ISSN	1557-1890
DOI	10.1007/s11481-023-10066-x
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Article ; Online: Extended and Continuous Infusion of Novel Protected β-Lactam Antibiotics: A Narrative Review.

Venuti, Francesco / Trunfio, Mattia / Martson, Anne-Grete / Lipani, Filippo / Audagnotto, Sabrina / Di Perri, Giovanni / Calcagno, Andrea

Drugs

2023 Volume 83, Issue 11, Page(s) 967–983

Abstract: Consolidated data from pharmacokinetic and pharmacodynamic studies support the administration of β-lactam antibiotics in prolonged infusion (i.e., extended or continuous) to optimize therapeutic efficacy by increasing the probability of attaining maximal ...

Abstract	Consolidated data from pharmacokinetic and pharmacodynamic studies support the administration of β-lactam antibiotics in prolonged infusion (i.e., extended or continuous) to optimize therapeutic efficacy by increasing the probability of attaining maximal bactericidal activity. This is the longest possible time during which the free drug concentrations are approximately four-fold the minimum inhibitory concentration between dosing intervals. In the context of antimicrobial stewardship strategies, achieving aggressive pharmacokinetic and pharmacodynamic targets is an important tool in the management of multi-drug resistant (MDR) bacterial infections and in the attainment of mutant preventing concentrations. However, prolonged infusion remains an unexploited resource. Novel β-lactam/β-lactamase inhibitor (βL/βLI) combinations (ceftolozane-tazobactam, ceftazidime-avibactam, meropenem-vaborbactam, and imipenem-cilastatin-relebactam) have been released in recent years to face the emerging challenge of MDR Gram-negative bacteria. Pre-clinical and real-life evidence has confirmed the promising role of prolonged infusion of these molecules in specific settings and clinical populations. In this narrative review we have summarized available pharmacological and clinical data, future perspectives, and current limitations of prolonged infusion of the novel protected β-lactams, their application in hospital settings and in the context of outpatient parenteral antimicrobial therapy.
MeSH term(s)	Humans ; Anti-Bacterial Agents/therapeutic use ; Gram-Negative Bacterial Infections/drug therapy ; beta-Lactamase Inhibitors/therapeutic use ; Drug Combinations ; Monobactams/pharmacology ; Monobactams/therapeutic use ; Drug Resistance, Multiple, Bacterial ; Microbial Sensitivity Tests
Chemical Substances	Anti-Bacterial Agents ; beta-Lactamase Inhibitors ; Drug Combinations ; Monobactams
Language	English
Publishing date	2023-06-14
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	120316-2
ISSN	1179-1950 ; 0012-6667
ISSN (online)	1179-1950
ISSN	0012-6667
DOI	10.1007/s40265-023-01893-6
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Article ; Online: A tinea immune reconstitution inflammatory syndrome in a HIV-positive patient starting combination antiretroviral treatment.

Lupia, Tommaso / Costa, Cecilia / Forni, Nicola / Calcagno, Andrea

Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia

2019 Volume 155, Issue 5, Page(s) 695–697

MeSH term(s)	Anti-Retroviral Agents/administration & dosage ; Drug Combinations ; HIV Seropositivity/complications ; HIV Seropositivity/drug therapy ; Humans ; Immune Reconstitution Inflammatory Syndrome/etiology ; Male ; Middle Aged ; Tinea/immunology
Chemical Substances	Anti-Retroviral Agents ; Drug Combinations
Language	English
Publishing date	2019-01-09
Publishing country	Italy
Document type	Case Reports ; Letter
ZDB-ID	604114-0
ISSN	1827-1820 ; 0026-4741 ; 0392-0488
ISSN (online)	1827-1820
ISSN	0026-4741 ; 0392-0488
DOI	10.23736/S0392-0488.18.06097-2
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Article ; Online: Host Single Nucleotide Polymorphisms and Biomarkers of Neuronal Damage and Inflammation in People Living with HIV.

Cusato, Jessica / Manca, Alessandra / Palermiti, Alice / Mula, Jacopo / Avataneo, Valeria / Antonucci, Miriam / Marinaro, Letizia / Bonora, Stefano / Trunfio, Mattia / Perri, Giovanni Di / D'Avolio, Antonio / Calcagno, Andrea

International journal of antimicrobial agents

2024 , Page(s) 107137

Abstract: Background: Blood brain barrier impairment is frequent in people living with HIV (PLWH), affecting the penetration of target cells and antiretrovirals into the central nervous system, through transporters (e.g. ABCB1), leading to neuroinflammation.: ... ...

Abstract	Background: Blood brain barrier impairment is frequent in people living with HIV (PLWH), affecting the penetration of target cells and antiretrovirals into the central nervous system, through transporters (e.g. ABCB1), leading to neuroinflammation. Objectives: The aim of this study was to identify variants of genes encoding transporters able to predict neuroinflammation biomarker levels. Materials and methods: Cerebrospinal fluid (CSF) and plasma samples were obtained from PLWH. CSF biomarkers were quantified by commercial assays. Genetic variants were evaluated through real-time polymerase chain reaction (PCR). Results: 107 PLWH (163 samples) were included in the study: 79% were male, median age was 48.5 years, CD4% was 25%, HIV-associated neurolocognitive disorder (HAND) was observed in 17.8% of patients. ABCB1 2677G>T genetic variant showed a different allelic distribution according to the clinical group (p=0.026). In linear regression analyses, HIV-related central nervous system disorders, ABCG2 1194+928CC genotype, log viral load, CSAR, β-1,42 levels and CSF proteins were retained in the final model as factors independently associated with CSF neopterin levels; CSF proteins and integrase inhibitors use were associated with CSF tau level in the multivariate model. Phospho-tau regression analysis reported ABCB1 2677GT/TT genotype and CSF proteins as predictors in the final model; gender and protease inhibitors, neopterin, ABCB1 2677 GT/ TT genotype resulted predictors in the multivariate regression for β-1,42. Conclusions: For the first time, pharmacogenetic and clinical features were predictors of neuro-inflammation biomarkers.
Language	English
Publishing date	2024-03-18
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1093977-5
ISSN	1872-7913 ; 0924-8579
ISSN (online)	1872-7913
ISSN	0924-8579
DOI	10.1016/j.ijantimicag.2024.107137
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