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  1. Article ; Online: Epidemiology of respiratory syncytial virus in a large pediatric hospital in Central Italy and development of a forecasting model to predict the seasonal peak.

    Cutrera, Renato / Ciofi Degli Atti, Marta Luisa / Dotta, Andrea / D'Amore, Carmen / Ravà, Lucilla / Perno, Carlo Federico / Villani, Alberto

    Italian journal of pediatrics

    2024  Volume 50, Issue 1, Page(s) 65

    Abstract: Background: Respiratory Syncytial Virus (RSV) is responsible for the majority of acute lower respiratory infections in infants and can affect also older age groups. Restrictions linked to the emergence of the SARS-CoV-2 pandemic and their subsequent ... ...

    Abstract Background: Respiratory Syncytial Virus (RSV) is responsible for the majority of acute lower respiratory infections in infants and can affect also older age groups. Restrictions linked to the emergence of the SARS-CoV-2 pandemic and their subsequent lifting caused a change in the dynamics of RSV circulation. It is therefore fundamental to monitor RSV seasonal trends and to be able to predict its seasonal peak to be prepared to the next RSV epidemics.
    Methods: We performed a retrospective descriptive study on laboratory-confirmed RSV infections from Bambino Gesù Children's Hospital in Rome from 1st January 2018 to 31st December 2022. Data on RSV-positive respiratory samples (n = 3,536) and RSV-confirmed hospitalizations (n = 1,895) on patients aged 0-18 years were analyzed. In addition to this, a SARIMA (Seasonal AutoRegressive Integrated Moving Average) forecasting model was developed to predict the next peak of RSV.
    Results: Findings show that, after the 2020 SARS-CoV-2 pandemic season, where RSV circulation was almost absent, RSV infections presented with an increased and anticipated peak compared to pre-pandemic seasons. While mostly targeting infants below 1 year of age, there was a proportional increase in RSV infections and hospitalizations in older age groups in the post-pandemic period. A forecasting model built using RSV weekly data from 2018 to 2022 predicted the RSV peaks of 2023, showing a reasonable level of accuracy (MAPE 33%). Additional analysis indicated that the peak of RSV cases is expected to be reached after 4-5 weeks from case doubling.
    Conclusion: Our study provides epidemiological evidence on the dynamics of RSV circulation before and after the COVID-19 pandemic. Our findings highlight the potential of combining surveillance and forecasting to promote preparedness for the next RSV epidemics.
    MeSH term(s) Infant ; Child ; Humans ; Aged ; Respiratory Syncytial Virus Infections/epidemiology ; Seasons ; Retrospective Studies ; Pandemics ; Hospitals, Pediatric ; Respiratory Syncytial Virus, Human ; Italy/epidemiology
    Language English
    Publishing date 2024-04-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2088556-8
    ISSN 1824-7288 ; 1720-8424
    ISSN (online) 1824-7288
    ISSN 1720-8424
    DOI 10.1186/s13052-024-01624-x
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  2. Article ; Online: Influenza viruses circulation in a tertiary care children hospital in Rome: a comparison between 2022 and the previous 5 years.

    Ranno, Stefania / Coltella, Luana / Linardos, Giulia / Di Maio, Velia Chiara / Colagrossi, Luna / Gentile, Leonarda / Galeno, Eugenia / Ciofi Degli Atti, Marta Luisa / Cristaldi, Sebastian / Villani, Alberto / Raponi, Massimiliano / Perno, Carlo Federico / Russo, Cristina

    Italian journal of pediatrics

    2023  Volume 49, Issue 1, Page(s) 121

    Abstract: Background: Influenza surveillance aims to determine onset, duration and intensity of the seasonal Influence-like Illness (ILI); data collection begins in the week 42 of a year and ends in the week 17 of the following year. In this observational study, ... ...

    Abstract Background: Influenza surveillance aims to determine onset, duration and intensity of the seasonal Influence-like Illness (ILI); data collection begins in the week 42 of a year and ends in the week 17 of the following year. In this observational study, we report the experience of a tertiary care children hospital in Rome about Influenza viruses circulation during the calendar year 2022 (January-December) in comparison with the previous five years (2017-2021), with a special focus on the weeks 18-41, usually not under surveillance.
    Methods: This retrospective study involved 36782 respiratory samples referred to 21354 patients (pts), median age 2.63 years, admitted with respiratory symptoms at Bambino Gesù Children's Hospital in the years 2017-2022. Respiratory viruses were detected by molecular Allplex™ Respiratory Panel Assays (Seegene, Korea).
    Results: Regarding the pre pandemic years, 2017-2019, distribution of Flu positive patients focused in the first weeks of the year (weeks 1-17). During the pandemic period, Flu was not detected. In 2022, 239 Flu viruses were identified: 37 FluA (weeks 1-17), 29 FluA (weeks 18-41) and 168 FluA and 5 FluB (weeks 42-52). For the year 2022, during the non-epidemic period, the number of Flu viruses detected corresponded to 12.1% of total Flu detected, respect to 0-1.7% for the previous five years (p < 0.001).
    Conclusions: When compared with pre SARS-CoV-2 pandemic years, our data show a significant increase in Influenza cases during weeks 18-41/2022 and reveal an unexpected summer circulation of these viruses: just weeks 26-30 showed to be influenza virus free. A national year-round Flu surveillance could be useful to understand if changing in influenza epidemiology is transitional or likely to persist in the following years.
    MeSH term(s) Humans ; Child ; Child, Preschool ; Influenza, Human/epidemiology ; Retrospective Studies ; Rome/epidemiology ; Tertiary Healthcare ; COVID-19 ; SARS-CoV-2 ; Hospitals, Pediatric ; Orthomyxoviridae
    Language English
    Publishing date 2023-09-13
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2088556-8
    ISSN 1824-7288 ; 1720-8424
    ISSN (online) 1824-7288
    ISSN 1720-8424
    DOI 10.1186/s13052-023-01519-3
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  3. Article ; Online: Developing a Surgical Site Infection Surveillance System Based on Hospital Unstructured Clinical Notes and Text Mining.

    Ciofi Degli Atti, Marta Luisa / Pecoraro, Fabrizio / Piga, Simone / Luzi, Daniela / Raponi, Massimiliano

    Surgical infections

    2020  Volume 21, Issue 8, Page(s) 716–721

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Adolescent ; Algorithms ; Child ; Child, Preschool ; Data Mining/methods ; Electronic Health Records/organization & administration ; Emergency Service, Hospital ; Female ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Male ; Patient Discharge ; Sentinel Surveillance ; Severity of Illness Index ; Surgical Wound Infection/epidemiology
    Language English
    Publishing date 2020-02-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1440120-4
    ISSN 1557-8674 ; 1096-2964
    ISSN (online) 1557-8674
    ISSN 1096-2964
    DOI 10.1089/sur.2019.238
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    In stock of ZB MED Cologne/Königswinter

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  4. Article ; Online: Pre-COVID-19-pandemic RSV epidemiology and clinical burden in pediatric primary care in Italy: a comparative analysis across two regions for the 2019/2020 season.

    Pandolfi, Elisabetta / Loconsole, Daniela / Chironna, Maria / van Summeren, Jojanneke / Paget, John / Raponi, Massimiliano / Russo, Luisa / Campagna, Ilaria / Croci, Ileana / Concato, Carlo / Perno, Carlo Federico / Tozzi, Alberto Eugenio / Linardos, Giulia / Bartolucci, Veronica / Ciampini, Sara / Muda, Andrea Onetti / De Angelis, Luigi / Ciofi Degli Atti, Marta Luisa / Rizzo, Caterina

    BMC infectious diseases

    2024  Volume 24, Issue 1, Page(s) 388

    Abstract: Background: Respiratory syncytial virus (RSV) infection in children under 5 years have a significant clinical burden, also in primary care settings. This study investigates the epidemiology and burden of RSV in Italian children during the 2019/20 pre- ... ...

    Abstract Background: Respiratory syncytial virus (RSV) infection in children under 5 years have a significant clinical burden, also in primary care settings. This study investigates the epidemiology and burden of RSV in Italian children during the 2019/20 pre-pandemic winter season.
    Methods: A prospective cohort study was conducted in two Italian regions. Children with Acute Respiratory Infection (ARI) visiting pediatricians were eligible. Nasopharyngeal swabs were collected and analyzed via multiplex PCR for RSV detection. A follow-up questionnaire after 14 days assessed disease burden, encompassing healthcare utilization and illness duration. Statistical analyses, including regression models, explored associations between variables such as RSV subtype and regional variations.
    Results: Of 293 children with ARI, 41% (119) tested positive for RSV. Median illness duration for RSV-positive cases was 7 days; 6% required hospitalization (median stay: 7 days). Medication was prescribed to 95% (110/116) of RSV cases, with 31% (34/116) receiving antibiotics. RSV subtype B and regional factors predicted increased healthcare utilization. Children with shortness of breath experienced a 36% longer illness duration.
    Conclusions: This study highlights a significant clinical burden and healthcare utilization associated with RSV in pre-pandemic Italian primary care settings. Identified predictors, including RSV subtype and symptomatology, indicate the need for targeted interventions and resource allocation strategies. RSV epidemiology can guide public health strategies for the implementation of preventive measures.
    MeSH term(s) Child ; Humans ; Infant ; Child, Preschool ; Respiratory Syncytial Virus, Human/genetics ; Hospitalization ; Seasons ; Prospective Studies ; Pandemics ; COVID-19/epidemiology ; Respiratory Syncytial Virus Infections/epidemiology ; Respiratory Tract Infections/epidemiology ; Italy/epidemiology ; Primary Health Care
    Language English
    Publishing date 2024-04-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041550-3
    ISSN 1471-2334 ; 1471-2334
    ISSN (online) 1471-2334
    ISSN 1471-2334
    DOI 10.1186/s12879-024-09229-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Clonal Spread of Hospital-Acquired NDM-1-Producing

    Agosta, Marilena / Bencardino, Daniela / Argentieri, Marta / Pansani, Laura / Sisto, Annamaria / Ciofi Degli Atti, Marta Luisa / D'Amore, Carmen / Bagolan, Pietro / Iacobelli, Barbara Daniela / Magnani, Mauro / Raponi, Massimiliano / Perno, Carlo Federico / Andreoni, Francesca / Bernaschi, Paola

    Antibiotics (Basel, Switzerland)

    2023  Volume 12, Issue 4

    Abstract: This article reports a rapid and unexpected spread of colonization cases of NDM-1 carbapenemase- ... ...

    Abstract This article reports a rapid and unexpected spread of colonization cases of NDM-1 carbapenemase-producing
    Language English
    Publishing date 2023-03-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics12040642
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  6. Article ; Online: Health-related quality of life in Italian children and adolescents with congenital heart diseases.

    Amodeo, Giulia / Ragni, Benedetta / Calcagni, Giulio / Piga, Simone / Giannico, Salvatore / Yammine, Marie Laure / Drago, Fabrizio / Ciofi Degli Atti, Marta Luisa / Rossi, Angela / De Stasio, Simona / Grimaldi Capitello, Teresa

    BMC cardiovascular disorders

    2022  Volume 22, Issue 1, Page(s) 173

    Abstract: Background: Congenital heart disease (CHD) is the most common congenital anomaly at birth, affecting approximately 1% of live births. In recent decades great medical and surgical advances have significantly increased life expectancy, shifting healthcare ...

    Abstract Background: Congenital heart disease (CHD) is the most common congenital anomaly at birth, affecting approximately 1% of live births. In recent decades great medical and surgical advances have significantly increased life expectancy, shifting healthcare professionals' and researchers' interests in patients' Quality of Life (QoL). The main aims of our study were to evaluate generic and condition-specific QoL in a group of Italian children and adolescents with CHD and their parents and examine the level of agreement and directional disagreement between child/adolescent and parents reports on generic and condition-specific QoL.
    Methods: A cross-sectional study was designed with CHD children and adolescents and their parents referred to the Cardiology Department of "Bambino Gesù" Children's Hospital. The PedsQL scale was used, including generic (PedsQL 4.0) and cardiac-specific modules (PedsQL 3.0) were administered to patients and caregivers. A Kruskal-Wallis test was used to compare generic and cardiac module scores between patients with different ages, CHD diagnoses, and between patients who underwent surgery interventions and/or are currently taking cardiac medications.
    Results: 498 families were enrolled in this study. On average, patients reported a good level of generic and condition-specific QoL, as well as their mothers and fathers. Children aged between 5-7 years old reported lower generic and cardiac-specific total QoL levels than children aged 8-12 years and adolescents (13-18 years). With regard to the agreement, patient-parent agreement on condition-specific QoL ranged from 25 to 75% while on generic QoL, it ranged from 19 to 76%. The highest percentage of disagreement between parents and children was found in patients aged 5-7 years old, both for condition-specific and generic QoL rates.
    Conclusions: Our study contributed to the growing body of knowledge on QoL in CHD, emphasizing the need for these families to receive support from multidisciplinary standardized care, including psychological consultations and support.
    MeSH term(s) Adolescent ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Heart Defects, Congenital/diagnosis ; Heart Defects, Congenital/surgery ; Humans ; Infant, Newborn ; Italy ; Parents/psychology ; Quality of Life/psychology ; Surveys and Questionnaires
    Language English
    Publishing date 2022-04-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059859-2
    ISSN 1471-2261 ; 1471-2261
    ISSN (online) 1471-2261
    ISSN 1471-2261
    DOI 10.1186/s12872-022-02611-y
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  7. Article ; Online: Escalation of care in children at high risk of clinical deterioration in a tertiary care children's hospital using the Bedside Pediatric Early Warning System.

    Gawronski, Orsola / Latour, Jos Maria / Cecchetti, Corrado / Iula, Angela / Ravà, Lucilla / Ciofi Degli Atti, Marta Luisa / Dall'Oglio, Immacolata / Tiozzo, Emanuela / Raponi, Massimiliano / Parshuram, Christopher S

    BMC pediatrics

    2022  Volume 22, Issue 1, Page(s) 530

    Abstract: Background: Escalation and de-escalation are a routine part of high-quality care that should be matched with clinical needs. The aim of this study was to describe escalation of care in relation to the occurrence and timing of Pediatric Intensive Care ... ...

    Abstract Background: Escalation and de-escalation are a routine part of high-quality care that should be matched with clinical needs. The aim of this study was to describe escalation of care in relation to the occurrence and timing of Pediatric Intensive Care Unit (PICU) admission in a cohort of pediatric inpatients with acute worsening of their clinical condition.
    Methods: A monocentric, observational cohort study was performed from January to December 2018. Eligible patients were children: 1) admitted to one of the inpatient wards other than ICU; 2) under the age of 18 years at the time of admission; 3) with two or more Bedside-Paediatric-Early-Warning-System (BedsidePEWS) scores ≥ 7 recorded at a distance of at least one hour and for a period of 4 h during admission. The main outcome -the 24-h disposition - was defined as admission to PICU within 24-h of enrolment or staying in the inpatient ward. Escalation of care was measured using an eight-point scale-the Escalation Index (EI), developed by the authors. The EI was calculated every 6 h, starting from the moment the patient was considered eligible. Analyses used multivariate quantile and logistic regression models.
    Results: The 228 episodes included 574 EI calculated scores. The 24-h disposition was the ward in 129 (57%) and the PICU in 99 (43%) episodes. Patients who were admitted to PICU within 24-h had higher top EI scores [median (IQR) 6 (5-7) vs 4 (3-5), p < 0.001]; higher initial BedsidePEWS scores [median (IQR) 10(8-13) vs. 9 (8-11), p = 0.02], were less likely to have a chronic disease [n = 62 (63%) vs. n = 127 (98%), p < 0.0001], and were rated by physicians as being at a higher risk of having a cardiac arrest (p = 0.01) than patients remaining on the ward. The EI increased over 24 h before urgent admission to PICU or cardiac arrest by 0.53 every 6-h interval (CI 0.37-0.70, p < 0.001), while it decreased by 0.25 every 6-h interval (CI -0.36-0.15, p < 0.001) in patients who stayed on the wards.
    Conclusion: Escalation of care was related to temporal changes in severity of illness, patient background and environmental factors. The EI index can improve responses to evolving critical illness.
    MeSH term(s) Adolescent ; Child ; Clinical Deterioration ; Heart Arrest ; Hospitals ; Humans ; Retrospective Studies ; Tertiary Healthcare
    Language English
    Publishing date 2022-09-07
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2041342-7
    ISSN 1471-2431 ; 1471-2431
    ISSN (online) 1471-2431
    ISSN 1471-2431
    DOI 10.1186/s12887-022-03555-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Alert sign and symptoms for the early diagnosis of pulmonary tuberculosis: analysis of patients followed by a tertiary pediatric hospital.

    Farina, Elisa / D'Amore, Carmen / Lancella, Laura / Boccuzzi, Elena / Ciofi Degli Atti, Marta Luisa / Reale, Antonino / Rossi, Paolo / Villani, Alberto / Raponi, Massimiliano / Raucci, Umberto

    Italian journal of pediatrics

    2022  Volume 48, Issue 1, Page(s) 90

    Abstract: Background: Intercepting earlier suspected TB (Tuberculosis) cases clinically is necessary to reduce TB incidence, so we described signs and symptoms of retrospective cases of pulmonary TB and tried to evaluate which could be early warning signs.: ... ...

    Abstract Background: Intercepting earlier suspected TB (Tuberculosis) cases clinically is necessary to reduce TB incidence, so we described signs and symptoms of retrospective cases of pulmonary TB and tried to evaluate which could be early warning signs.
    Methods: We conducted a retrospective descriptive study of pulmonary TB cases in children in years 2005-2017; in years 2018-2020 we conducted a cohort prospective study enrolling patients < 18 years accessed to Emergency Department (ED) with signs/symptoms suggestive of pulmonary TB.
    Results: In the retrospective analysis, 226 patients with pulmonary TB were studied. The most frequently described items were contact history (53.5%) and having parents from countries at risk (60.2%). Cough was referred in 49.5% of patients at onset, fever in 46%; these symptoms were persistent (lasting ≥ 10 days) in about 20%. Lymphadenopathy is described in 15.9%. The prospective study enrolled 85 patients of whom 14 (16.5%) were confirmed to be TB patients and 71 (83.5%) were non-TB cases. Lymphadenopathy and contact history were the most correlated variables. Fever and cough lasting ≥ 10 days were less frequently described in TB cases compared to non-TB patients (p < 0.05).
    Conclusions: In low TB endemic countries, pulmonary TB at onset is characterized by different symptoms, i.e. persistent fever and cough are less described, while more relevant are contact history and lymphadenopathy. It was not possible to create a score because signs/symptoms usually suggestive of pulmonary TB (considered in the questionnaire) were not significant risk factors in our reality, a low TB country.
    MeSH term(s) Child ; Cough/etiology ; Early Diagnosis ; Fever/diagnosis ; Hospitals, Pediatric ; Humans ; Lymphadenopathy/complications ; Prospective Studies ; Retrospective Studies ; Tuberculosis, Pulmonary/complications ; Tuberculosis, Pulmonary/diagnosis ; Tuberculosis, Pulmonary/epidemiology
    Language English
    Publishing date 2022-06-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2088556-8
    ISSN 1824-7288 ; 1720-8424
    ISSN (online) 1824-7288
    ISSN 1720-8424
    DOI 10.1186/s13052-022-01288-5
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  9. Article ; Online: Hypoventilation and sleep hypercapnia in a case of congenital variant-like Rett syndrome.

    Ghirardo, Sergio / Sabatini, Letizia / Onofri, Alessandro / Testa, Maria Beatrice Chiarini / Paglietti, Maria Giovanna / Diodato, Daria / Travaglini, Lorena / Stregapede, Fabrizia / Ciofi Degli Atti, Marta Luisa / Cherchi, Claudio / Cutrera, Renato

    Italian journal of pediatrics

    2022  Volume 48, Issue 1, Page(s) 167

    Abstract: Background: Breathing disturbances are often a primary clinical concern especially during wakefulness of the classic form of Rett syndrome, but data for atypical forms are lacking.: Case presentation: We report the case of a 20-month-old female ... ...

    Abstract Background: Breathing disturbances are often a primary clinical concern especially during wakefulness of the classic form of Rett syndrome, but data for atypical forms are lacking.
    Case presentation: We report the case of a 20-month-old female affected by Rett syndrome with congenital variant-like onset, characterized by severe hypotonia and neurodevelopment impairment. She presented hypoventilation, persistent periodic breathing, and sustained desaturation during sleep, without obstructive or mixed events. Pulse oximetry and capnography during wakefulness were strictly normal. To the best of our knowledge, this is the first case of a patient affected by a congenital variant of Rett syndrome presenting sleep hypercapnia. Hypotonia may play a major role in the genesis of hypoventilation and hypoxemia in our patient. Non-invasive ventilation led to quality-of-life improvements.
    Conclusions: Thus, we suggest screening patients with congenital-like Rett syndrome through transcutaneous bedtime carbon dioxide and oxygen monitoring. Moreover, assisted control mode was a breakthrough to achieve adequate ventilation in our case.
    MeSH term(s) Female ; Humans ; Hypercapnia/diagnosis ; Hypercapnia/etiology ; Hypercapnia/therapy ; Hypoventilation/diagnosis ; Hypoventilation/therapy ; Infant ; Muscle Hypotonia ; Rett Syndrome/complications ; Rett Syndrome/diagnosis ; Rett Syndrome/therapy ; Sleep
    Language English
    Publishing date 2022-09-07
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2088556-8
    ISSN 1824-7288 ; 1720-8424
    ISSN (online) 1824-7288
    ISSN 1720-8424
    DOI 10.1186/s13052-022-01359-7
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  10. Article: Management of Enteral Nutrition in the Pediatric Intensive Care Unit: Prokinetic Effects of Amoxicillin/Clavulanate in Real Life Conditions.

    Chiusolo, Fabrizio / Capriati, Teresa / Erba, Ilaria / Bianchi, Roberto / Ciofi Degli Atti, Marta Luisa / Picardo, Sergio / Diamanti, Antonella

    Pediatric gastroenterology, hepatology & nutrition

    2020  Volume 23, Issue 6, Page(s) 521–530

    Abstract: Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess ... ...

    Abstract Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance.
    Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily.
    Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement,
    Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.
    Language English
    Publishing date 2020-11-05
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 3032413-0
    ISSN 2234-8840 ; 2234-8646
    ISSN (online) 2234-8840
    ISSN 2234-8646
    DOI 10.5223/pghn.2020.23.6.521
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