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  1. Article: Superior vena cava Candida krusei septic thrombophlebitis in an ARDS patient on ECMO, with an unusual late complication.

    Iskandar, Elizabeth / Cavanna, Caterina / Mollaschi, Eva Maria Giada / Trani, Ruben Mattia / Mojoli, Francesco / Amatu, Alessandro

    The new microbiologica

    2023  Volume 46, Issue 1, Page(s) 90–94

    Abstract: Candida-related bloodstream infections (BSIs) represent a severe condition associated with health care in the critical patient, with an increasing incidence of Candida non-albicans species. These infections could lead to several and unusual complications ...

    Abstract Candida-related bloodstream infections (BSIs) represent a severe condition associated with health care in the critical patient, with an increasing incidence of Candida non-albicans species. These infections could lead to several and unusual complications in high-risk patients due to various factors, including a prolonged hospital stay and invasive medical interventions. Here we report a case of a Candida krusei septic thrombophlebitis in an ARDS patient admitted to the ICU, complicated by a late onset prostatic abscess. To our knowledge, our patient represents the first reported case of a prostatic abscess due to Candida krusei treated with pharmacological therapy alone.
    MeSH term(s) Humans ; Abscess ; Extracorporeal Membrane Oxygenation ; Vena Cava, Superior ; Candida albicans ; Candidiasis/complications ; Candidiasis/drug therapy ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy
    Language English
    Publishing date 2023-02-09
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 756168-4
    ISSN 1121-7138 ; 0391-5352
    ISSN 1121-7138 ; 0391-5352
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  2. Article: The Prognostic Role of Diagnostic Criteria for COVID-19-Associated Pulmonary Aspergillosis: A Cross-Sectional Retrospective Study.

    Asperges, Erika / Pesare, Rebecca / Bassoli, Cecilia / Calia, Matteo / Lerta, Sonia / Citiolo, Francesco / Albi, Giuseppe / Cavanna, Caterina / Sacchi, Paolo / Bruno, Raffaele

    Antibiotics (Basel, Switzerland)

    2024  Volume 13, Issue 2

    Abstract: Several criteria exist to diagnose pulmonary aspergillosis with varying degrees of certainty in specific populations, including oncohaematological patients (EORTC/MSG), ICU patients (mAspICU) and COVID-19 patients (ECMM). At the beginning of the pandemic, ...

    Abstract Several criteria exist to diagnose pulmonary aspergillosis with varying degrees of certainty in specific populations, including oncohaematological patients (EORTC/MSG), ICU patients (mAspICU) and COVID-19 patients (ECMM). At the beginning of the pandemic, however, the diagnosis of COVID-19-Associated Pulmonary Aspergillosis (CAPA) could not be performed easily, and the decision to treat (DTT) was empirical. In this cross-sectional retrospective study including patients with SARS-CoV-2 infection and suspicion of CAPA, we studied the concordance between the DTT and the three diagnostic criteria using Cohen's coefficient, and then we identified the factors associated with the DTT and corrected them by treatment to study the influence of the diagnostic criteria on survival. We showed good concordance of the DTT and mAspICU and ECMM criteria, with "compatible signs", "positive culture" and "positive galactomannan" influencing the DTT. Treatment also showed a positive effect on survival once corrected for a putative, possible or probable diagnosis of CAPA using mAspICU and ECMM criteria. We conclude that EORTC/MSGERC are not considered applicable in clinical practice due to the lack of inclusion of signs and symptoms and do not lead to improved survival. mAspICU and ECMM criteria showed a good degree of agreement with the DTT and a positive correlation with patient recovery.
    Language English
    Publishing date 2024-02-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics13020150
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  3. Article ; Online: A Case Report of Disseminated Histoplasmosis in AIDS Diagnosed Through Peripheral Blood Smear.

    Asperges, Erika / Cavanna, Caterina / Mollaschi, Eva M G / Seminari, Elena M

    Current HIV research

    2021  Volume 19, Issue 5, Page(s) 457–459

    Abstract: Background: Histoplasma capsulatum is an environmental fungus that causes opportunistic infections in AIDS patients in endemic areas but is uncommon in Europe. It shares clinical features with other opportunistic infections and lymphoproliferative ... ...

    Abstract Background: Histoplasma capsulatum is an environmental fungus that causes opportunistic infections in AIDS patients in endemic areas but is uncommon in Europe. It shares clinical features with other opportunistic infections and lymphoproliferative disorders common in AIDS patients. The World Health Organization included Histoplasma antigen tests on the Lists of Essential In Vitro Diagnostics, however, they are not routinely available in non-endemic countries. Consequently, mycoses can be a great challenge for clinicians in non-endemic countries.
    Case presentation: We report the case of a 42-year-old Colombian woman admitted to an Italian university hospital with diarrhea, acute renal failure, psychomotor impairment and fever. When a screening HIV test came back positive, she was screened for opportunistic infections with no results. Given the severity of her clinical condition a broad spectrum antibacterial and antifungal therapy was started in addition to HAART. A blood smear documented leucocytes inclusions, identified as capsular structures. On suspicion of Histoplasma capsulatum the patient was started on empiric amphotericin B. The diagnosis was confirmed by positive serology. Despite therapy, the patient died shortly after. In the following days, the mycology laboratory managed to grow Histoplasma capsulatum, thus confirming the diagnosis of invasive histoplasmosis in AIDS.
    Conclusion: The case highlights the need for a high index of suspicion for the diagnosis of endemic mycosis outside of endemic areas, and the necessity of expanding access to tests. Even if antigen/ antibody tests are not available, however, blood smear has worldwide feasibility and allows a rapid diagnosis.
    MeSH term(s) AIDS-Related Opportunistic Infections/diagnosis ; AIDS-Related Opportunistic Infections/drug therapy ; AIDS-Related Opportunistic Infections/epidemiology ; Acquired Immunodeficiency Syndrome/complications ; Adult ; Female ; HIV Infections/complications ; Histoplasma ; Histoplasmosis/diagnosis ; Histoplasmosis/drug therapy ; Humans
    Language English
    Publishing date 2021-06-10
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2192348-6
    ISSN 1873-4251 ; 1570-162X
    ISSN (online) 1873-4251
    ISSN 1570-162X
    DOI 10.2174/1570162X19666210607120404
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  4. Article: Catheter-related blood stream infection caused by Millerozyma farinosa in an immunocompetent patient: a case report and a brief review of the literature.

    Mollaschi, Eva Maria Giada / Iskandar, Elizabeth Nagy / Esposto, Maria Carmela / Prigitano, Anna / Rigano, Giovanni / Rotola, Giorgio / Caneva, Giacomo / Cavanna, Caterina

    The new microbiologica

    2022  Volume 45, Issue 2, Page(s) 142–147

    Abstract: Millerozyma farinose is a halotolerant yeast that has recently been described as an emerging human pathogen, especially in immunocompromised patients. Both the diagnostic process and treatment options are still unclear. Here, we report a case of an ... ...

    Abstract Millerozyma farinose is a halotolerant yeast that has recently been described as an emerging human pathogen, especially in immunocompromised patients. Both the diagnostic process and treatment options are still unclear. Here, we report a case of an immunocompetent oncological patient who developed a catheter-related bloodstream infection (CRBSI) with a concomitant respiratory tract infection caused by M. farinosa. In this report, we discuss how prompt microbiological identification and attentive evaluation of the patient's clinical status can play a significant role in the appropriate management of infections caused by uncommon fungi. MALDI-TOF technology has also substantially improved the timely diagnosis of rare fungi. Furthermore, our diagnosis was subsequently confirmed by 5.8S rRNA sequencing. In our patient, the rapid diagnosis of fungaemia was crucial, together with catheter removal and the initiation of antifungal treatment, for the patient's clinical improvement.
    MeSH term(s) Antifungal Agents/therapeutic use ; Bacteremia/drug therapy ; Catheter-Related Infections/diagnosis ; Catheter-Related Infections/drug therapy ; Catheters ; Fungi ; Humans ; Saccharomycetales/genetics
    Chemical Substances Antifungal Agents
    Language English
    Publishing date 2022-06-14
    Publishing country Italy
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 756168-4
    ISSN 1121-7138 ; 0391-5352
    ISSN 1121-7138 ; 0391-5352
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  5. Article ; Online: Outbreak of Candida parapsilosis fungemia in an intensive care unit during a COVID surge: an epidemic within a pandemic.

    Amatu, Alessandro / Trani, Ruben M / Voltini, Marta / Tavazzi, Guido / Capra Marzani, Federico / Cavanna, Caterina / Cambieri, Patrizia / Corbella, Marta / Muzzi, Alba / Baldanti, Fausto / Mojoli, Francesco

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

    2023  Volume 42, Issue 11, Page(s) 1347–1353

    Abstract: We sought to investigate epidemiology, risk factors, clinical features, and outcome of the C. parapsilosis blood stream infection (BSI) outbreaks observed during the first surges of COVID-19 pandemic in our population. Retrospective, monocentric ... ...

    Abstract We sought to investigate epidemiology, risk factors, clinical features, and outcome of the C. parapsilosis blood stream infection (BSI) outbreaks observed during the first surges of COVID-19 pandemic in our population. Retrospective, monocentric observational study in the 24 bed intensive care unit (ICU) of a tertiary care medical center in northern Italy, from 2019 to 2021 first 5 months. 2030 patients were enrolled, of whom 239 were COVID-19 positive. The total incidence of Candida-BSI was 41.9 per 1000 admissions, with two outbreaks during 2020 spring and winter's COVID surges. The total numbers of C. parapsilosis BSI cases are 94, of which 21 during the first outbreak and 20 during the second. In our population, COVID-19 was strongly associated with C. parapsilosis BSI (OR 4.71, p < 0.001), as well as continuous renal replacement therapy (CRRT) (OR 3.44, p = 0.001), prolonged antibiotic therapy (OR 3.19, p = 0.004), and delayed infusion sets replacements (OR 2.76, p = 0.015). No statistically significant association was found between Candida-BSI episodes and mortality, when adjusted for other known outcome risk factors. COVID surges undermined the infectious control measures in our ICU, leading to two outbreak of C. parapsilosis BSI. A stricter, thorough management of intravascular devices and infusion set is crucial in prevention of catheter related BSI, and awareness must be kept high, especially in emergencies circumstances, such as the ongoing COVID-19 pandemic.
    Language English
    Publishing date 2023-09-30
    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/s10096-023-04670-1
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  6. Article ; Online: Yeast Bloodstream Infections in the COVID-19 Patient: A Multicenter Italian Study (FiCoV Study).

    Prigitano, Anna / Blasi, Elisabetta / Calabrò, Maria / Cavanna, Caterina / Cornetta, Maria / Farina, Claudio / Grancini, Anna / Innocenti, Patrizia / Lo Cascio, Giuliana / Nicola, Lucia / Trovato, Laura / Cogliati, Massimo / Esposto, Maria Carmela / Tortorano, Anna Maria / Romanò, Luisa / On Behalf Of The FiCoV Study Group

    Journal of fungi (Basel, Switzerland)

    2023  Volume 9, Issue 2

    Abstract: Fungemia is a co-infection contributing to the worsening of the critically ill COVID-19 patient. The multicenter Italian observational study FiCoV aims to estimate the frequency of yeast bloodstream infections (BSIs), to describe the factors associated ... ...

    Abstract Fungemia is a co-infection contributing to the worsening of the critically ill COVID-19 patient. The multicenter Italian observational study FiCoV aims to estimate the frequency of yeast bloodstream infections (BSIs), to describe the factors associated with yeast BSIs in COVID-19 patients hospitalized in 10 hospitals, and to analyze the antifungal susceptibility profiles of the yeasts isolated from blood cultures. The study included all hospitalized adult COVID-19 patients with a yeast BSI; anonymous data was collected from each patient and data about antifungal susceptibility was collected. Yeast BSI occurred in 1.06% of patients, from 0.14% to 3.39% among the 10 participating centers. Patients were mainly admitted to intensive or sub-intensive care units (68.6%), over 60 years of age (73%), with a mean and median time from the hospitalization to fungemia of 29 and 22 days, respectively. Regarding risk factors for fungemia, most patients received corticosteroid therapy during hospitalization (61.8%) and had a comorbidity (25.3% diabetes, 11.5% chronic respiratory disorder, 9.5% cancer, 6% haematological malignancies, 1.4% organ transplantation). Antifungal therapy was administered to 75.6% of patients, mostly echinocandins (64.5%). The fatality rate observed in COVID-19 patients with yeast BSI was significantly higher than that of COVID-19 patients without yeast BSI (45.5% versus 30.5%).
    Language English
    Publishing date 2023-02-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2784229-0
    ISSN 2309-608X ; 2309-608X
    ISSN (online) 2309-608X
    ISSN 2309-608X
    DOI 10.3390/jof9020277
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  7. Article: Cryptococcosis in an HIV-negative, HCV positive, immunosenescent patient: a case report.

    Colaneri, Marta / Cavanna, Caterina / Mussa, Marco / Morea, Alessandra / Manciulli, Tommaso / Brunetti, Enrico / Di Matteo, Angela / Lallitto, Fabiola

    The new microbiologica

    2020  Volume 43, Issue 2, Page(s) 99–102

    Abstract: Cryptococcus species is still a very common opportunistic infection in AIDS patients. However, it is increasingly responsible for disease in otherwise immunocompromised individuals, such as transplant recipients and the heterogeneous group of patients ... ...

    Abstract Cryptococcus species is still a very common opportunistic infection in AIDS patients. However, it is increasingly responsible for disease in otherwise immunocompromised individuals, such as transplant recipients and the heterogeneous group of patients with underlying immunologic diseases, hematologic disorders and organ failure syndromes. Clinical presentation, prognosis, and outcomes are difficult to define given these varied host groups, and tailoring treatments to fit the necessities of each patient is likewise challenging. Our patient was on treatment with steroids and direct-acting antiviral agents (DAAs) for a chronic HCV-related hepatitis, worsened by cryoglobulinemia, membranoproliferative glomerulonephritis and a lowgrade B cells lymphoma. We report a case of systemic cryptococcal infection in an immunosenescent, HIV-negative patient.
    MeSH term(s) Antiviral Agents ; Cryptococcosis/diagnosis ; Cryptococcosis/virology ; HIV Seronegativity ; Hepatitis/virology ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/microbiology ; Humans ; Immunosenescence
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2020-06-07
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 756168-4
    ISSN 1121-7138 ; 0391-5352
    ISSN 1121-7138 ; 0391-5352
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  8. Article ; Online: Presence of L701 M mutation in the FKS1 gene of echinocandin-susceptible Candida krusei isolates.

    Lallitto, Fabiola / Prigitano, Anna / Mangione, Francesca / Piralla, Antonio / Tamarozzi, Francesca / Marone, Piero / Cavanna, Caterina

    Diagnostic microbiology and infectious disease

    2018  Volume 92, Issue 4, Page(s) 311–314

    Abstract: Resistance of Candida krusei isolates to echinocandins, the recommended drugs to treat candidemia, has been associated with mutations in hot spot (HS) regions of the FKS1 gene or L701 M mutation in a region between HS1 and HS3 of FKS1. However, the role ... ...

    Abstract Resistance of Candida krusei isolates to echinocandins, the recommended drugs to treat candidemia, has been associated with mutations in hot spot (HS) regions of the FKS1 gene or L701 M mutation in a region between HS1 and HS3 of FKS1. However, the role of L701 M mutation alone in causing reduced echinocandins susceptibility is still unclear. We analyzed a region between HS1 and HS3 of FKS1 of 25 C. krusei isolates from clinical samples. Susceptibility to echinocandins was determined by a commercial broth microdilution assay and by the microdilution method according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). The L701 M mutation was detected in 22/25 (88%) C. krusei isolates with low MIC values in the absence of other HS mutations. The presence of isolated L701 M mutation in C. krusei clinical isolates susceptible to echinocandins suggests that this mutation may be just associated to polymorphism in the C. krusei population.
    MeSH term(s) Amino Acid Substitution ; Antifungal Agents/pharmacology ; Candida/classification ; Candida/drug effects ; Candida/genetics ; Candida/isolation & purification ; Candidemia/microbiology ; Drug Resistance, Fungal ; Echinocandins/pharmacology ; Fungal Proteins/genetics ; Glucosyltransferases/genetics ; Humans ; Microbial Sensitivity Tests ; Mutation ; Polymerase Chain Reaction ; Sequence Analysis, DNA
    Chemical Substances Antifungal Agents ; Echinocandins ; Fungal Proteins ; Glucosyltransferases (EC 2.4.1.-)
    Language English
    Publishing date 2018-07-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604920-5
    ISSN 1879-0070 ; 0732-8893
    ISSN (online) 1879-0070
    ISSN 0732-8893
    DOI 10.1016/j.diagmicrobio.2018.07.005
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  9. Article: Cryptococcosis in an HIV-negative, HCV positive, immunosenescent patient: a case report.

    Colaneri, Marta / Cavanna, Caterina / Mussa, Marco / Morea, Alessandra / Manciulli, Tommaso / Brunetti, Enrico / Di Matteo, Angela / Lallitto, Fabiola

    The new microbiologica

    2019  Volume 43, Issue 1

    Abstract: Cryptococcus species is still a very common opportunistic infection in AIDS patients. However, it is increasingly responsible for disease in otherwise immunocompromised individuals, such as transplant recipients and the heterogeneous group of patients ... ...

    Abstract Cryptococcus species is still a very common opportunistic infection in AIDS patients. However, it is increasingly responsible for disease in otherwise immunocompromised individuals, such as transplant recipients and the heterogeneous group of patients with underlying immunologic diseases, hematologic disorders and organ failure syndromes. Clinical presentation, prognosis, and outcomes are difficult to define given these varied host groups, and tailoring treatments to fit the necessities of each patient is likewise challenging. Our patient was on treatment with steroids and direct-acting antiviral agents (DAAs) for a chronic HCV-related hepatitis, worsened by cryoglobulinemia, membranoproliferative glomerulonephritis and a low-grade B cells lymphoma. We report a case of systemic cryptococcal infection in an immunosenescent, HIV-negative patient.
    Language English
    Publishing date 2019-12-13
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 756168-4
    ISSN 1121-7138 ; 0391-5352
    ISSN 1121-7138 ; 0391-5352
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  10. Article ; Online: Azole resistance in Aspergillus isolates by different types of patients and correlation with environment - An Italian prospective multicentre study (ARiA study).

    Prigitano, Anna / Esposto, Maria C / Grancini, Anna / Biffi, Arianna / Innocenti, Patrizia / Cavanna, Caterina / Lallitto, Fabiola / Mollaschi, Eva Maria Giada / Bandettini, Roberto / Oltolini, Chiara / Passera, Marco / De Lorenzis, Gabriella / Sargolzaei, Maryam / Crespan, Manna / Cogliati, Massimo / Tortorano, Anna Maria / Romanò, Luisa

    Mycoses

    2021  Volume 64, Issue 5, Page(s) 528–536

    Abstract: Background: A wide range of frequency of azole-resistance in A fumigatus in different patient populations worldwide was observed threatening to reduce therapeutic options.: Objectives: Estimate the prevalence of azole-resistance, investigate the ... ...

    Abstract Background: A wide range of frequency of azole-resistance in A fumigatus in different patient populations worldwide was observed threatening to reduce therapeutic options.
    Objectives: Estimate the prevalence of azole-resistance, investigate the molecular mechanisms of resistance, compare the genotypes of resistant clinical isolates with those from the surrounding environment.
    Methods: Aspergillus isolates were collected by seven Italian hospital microbiology laboratories. Strains were isolated from different clinical samples from unselected patients. The azole-resistance was evaluated using screening test and microdilution EUCAST method. The molecular mechanism of resistance was performed sequencing the cyp51A gene. Resistant isolates were genotyped by microsatellite analysis and their profiles compared with those of azole-resistant isolates from previous Italian studies.
    Results: 425 Aspergillus isolates from 367 patients were analysed. The azole-resistance rates were 4.9% and 6.6% considering all Aspergillus spp. isolates and the A fumigatus sensu stricto, respectively. All resistant isolates except one were from a single hospital. Two rare azole-resistant species were identified: A thermomutatus and A lentulus. The predominant resistance mechanism was TR
    Conclusions: This study confirms the trend of azole-resistance rate in Italy, showing a geographical difference. Data reinforce the importance of surveillance programmes to monitor the local epidemiological situation.
    Language English
    Publishing date 2021-01-28
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 392487-7
    ISSN 1439-0507 ; 0933-7407
    ISSN (online) 1439-0507
    ISSN 0933-7407
    DOI 10.1111/myc.13241
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