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  1. Article ; Online: Clinical outcomes in elderly patients with infections caused by NDM-producing Klebsiella pneumoniae: results from a real-life retrospective single center study in an endemic area.

    Mura, Maddalena / Longo, Benedetta / Andreini, Roberto / Sbrana, Francesco / Ripoli, Andrea / Andreoli, Elisabetta / Sani, Spartaco / Tumbarello, Mario / Meini, Simone

    Internal and emergency medicine

    2023  Volume 18, Issue 8, Page(s) 2261–2269

    Abstract: Real-life outcomes data for elderly patients with infections caused by Klebsiella pneumoniae producing New Delhi metallo-beta-lactamase (NDM-Kp) are lacking. We conducted a retrospective cohort study enrolling 33 consecutive adult patients (mean age 77.4  ...

    Abstract Real-life outcomes data for elderly patients with infections caused by Klebsiella pneumoniae producing New Delhi metallo-beta-lactamase (NDM-Kp) are lacking. We conducted a retrospective cohort study enrolling 33 consecutive adult patients (mean age 77.4 years; 48.5% males; mean Charlson Comorbidity Index-CCI 5.9) hospitalized for NDM-Kp infections during a 24-month period in an Italian highly endemic area. 78.8% were admitted to Internal Medicine ward. 45.4% of patients had bloodstream infections (BSI), 39.4% urinary tract infections (UTI) without BSI, 9.1% respiratory tract infections and 6.1% intra-abdominal infections. 93.9% had rectal colonization.Adequate definitive antibiotic therapy (mainly represented by aztreonam plus ceftazidime/avibactam) was provided to 36.4% of cases. Mean age and CCI of patients adequately treated were significantly lower than those inadequately treated (71.2 vs 80.9 years, p = 0.041, and 4.6 vs 6.7, p = 0.040, respectively). Patients adequately treated had a mean hospitalization length significantly higher (28 vs 15 days, p = 0.016). The overall 30-day survival rate of patients adequately and inadequately treated was 83.3% and 57.1%, respectively: this difference was not statistically significant. Mean age and CCI of 22 patients who survived at 30 days were lower than those of 11 patients who died (73.7 vs 84.8 years, p = 0.003, and 5.3 vs 7.2, p = 0.049, respectively). Twelve survivors received an inadequate therapy: 8/12 had UTI. Six of nine patients inadequately treated who died within 30 days, died before microbiological diagnosis. Our study provides real-life data on outcomes of elderly and multimorbid patients hospitalized for infections caused by NDM-Kp. Further studies with larger sample size are warranted.
    MeSH term(s) Adult ; Male ; Humans ; Aged ; Female ; Retrospective Studies ; Klebsiella pneumoniae ; Klebsiella Infections/drug therapy ; Klebsiella Infections/epidemiology ; Klebsiella Infections/microbiology ; Anti-Bacterial Agents/therapeutic use ; Aztreonam ; Urinary Tract Infections/drug therapy ; Microbial Sensitivity Tests
    Chemical Substances Anti-Bacterial Agents ; Aztreonam (G2B4VE5GH8)
    Language English
    Publishing date 2023-09-12
    Publishing country Italy
    Document type Journal Article ; Comment
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-023-03416-3
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  2. Article ; Online: Validity of "Sepsis-3" criteria in identifying patients with community-onset sepsis in Internal Medicine wards; a prospective, multicenter study.

    Fortini, Alberto / Faraone, Antonio / Meini, Simone / Bettucchi, Michael / Longo, Benedetta / Valoriani, Beatrice / Forni, Silvia

    European journal of internal medicine

    2021  Volume 85, Page(s) 92–97

    Abstract: Background: Few data are available on the validity of "Sepsis-3" criteria in identifying patients with sepsis in internal medicine wards (IMWs). Real-life data about this topic and on the prevalence of sepsis in IMWs could be useful for improving ... ...

    Abstract Background: Few data are available on the validity of "Sepsis-3" criteria in identifying patients with sepsis in internal medicine wards (IMWs). Real-life data about this topic and on the prevalence of sepsis in IMWs could be useful for improving hospital organization.
    Objectives: To assess the validity of "Sepsis-3" criteria in identifying patients with community-onset sepsis in IMWs. Secondary objectives: to evaluate the prevalence of these patients in IMWs and to compare "Sepsis-3" and "Sepsis-1" criteria.
    Methods: Multicenter, prospective, observational, cohort study, carried out in 22 IMWs of Tuscany (Italy). All patients admitted to each of the study centers over a period of 21-31 days were evaluated within 48 hours; those with clinical signs of infection were enrolled. The main outcome was in-hospital mortality.
    Results: 2,839 patients were evaluated and 938 (33%) met the inclusion criteria. Patients with sepsis diagnosed according to "Sepsis-3" were 522, representing 55.6% of patients with infection and 18.4% of all patients hospitalized; they were older than those without sepsis (79.4±12.5 vs 74.6±15.2 years, p<0.001). In-hospital mortality was significantly higher in patients with sepsis compared to others (13.8% vs 4.6%; p<0.001). "Sepsis-3" criteria showed greater predictive validity for in-hospital mortality than "Sepsis-1" criteria (AUROC=0.71; 95%CI, 0.66-0.77 vs 0.60; 95%CI 0.54-0.66; p=0.0038).
    Conclusions: "Sepsis-3" criteria are able to identify patients with community-onset sepsis in IMWs, whose prevalence and in-hospital mortality are remarkably high. Medical departments should adapt their organization to the needs for care of these complex patients.
    MeSH term(s) Cohort Studies ; Hospital Mortality ; Hospitals ; Humans ; Italy/epidemiology ; Prospective Studies ; Retrospective Studies ; Sepsis/diagnosis ; Sepsis/epidemiology
    Language English
    Publishing date 2021-01-12
    Publishing country Netherlands
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2020.12.025
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  3. Article ; Online: Reinfection of SARS-CoV-2 - analysis of 23 cases from the literature.

    Roberts, Anna Teresa / Piani, Fiorella / Longo, Benedetta / Andreini, Roberto / Meini, Simone

    Infectious diseases (London, England)

    2021  Volume 53, Issue 7, Page(s) 479–485

    Abstract: Introduction: The duration of immunity after infection from SARS-CoV-2 conferring protection from subsequent COVID-19 episodes is not yet fully understood. We reviewed the literature for cases of documented reinfection.: Materials and methods: A ... ...

    Abstract Introduction: The duration of immunity after infection from SARS-CoV-2 conferring protection from subsequent COVID-19 episodes is not yet fully understood. We reviewed the literature for cases of documented reinfection.
    Materials and methods: A comprehensive computerized search in PubMed, through 15 December 2020, using the following terms in combination:
    Results: We identified 23 cases globally, for which viral genome analysis was performed in 10 cases and serology in 19 cases. The mean interval between the two episodes was 15 weeks. Mean age of cases was 44.5 years, and 10 (43.5%) were women. In 17/23 cases, no comorbidity was observed. In 10 cases, the first episode was more severe than the ensuing episode, whereas in seven cases the ensuing episode was more severe. In four cases, there was no difference in severity and in two cases both episodes were asymptomatic.
    Conclusions: From this sample of 23 cases, a clear pattern of the second episode being less or more severe did not emerge. A better understanding of immunity to SARS-CoV-2, necessary to assess the probability of a second infection and the durability of protection conferred by vaccination, is warranted.
    MeSH term(s) Adult ; COVID-19 ; Comorbidity ; Female ; Humans ; Male ; Recurrence ; Reinfection ; SARS-CoV-2
    Language English
    Publishing date 2021-04-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2839775-7
    ISSN 2374-4243 ; 2374-4235
    ISSN (online) 2374-4243
    ISSN 2374-4235
    DOI 10.1080/23744235.2021.1905174
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  4. Article: Role of Lopinavir/Ritonavir in the Treatment of Covid-19: A Review of Current Evidence, Guideline Recommendations, and Perspectives.

    Meini, Simone / Pagotto, Alberto / Longo, Benedetta / Vendramin, Igor / Pecori, Davide / Tascini, Carlo

    Journal of clinical medicine

    2020  Volume 9, Issue 7

    Abstract: A life-threatening respiratory illness (COVID-19) due to severe acute respiratory syndrome (SARS)-CoV-2 coronavirus was first described in December 2019 in Wuhan (China), rapidly evolving into a pandemic. In the first phase, when the viral replication ... ...

    Abstract A life-threatening respiratory illness (COVID-19) due to severe acute respiratory syndrome (SARS)-CoV-2 coronavirus was first described in December 2019 in Wuhan (China), rapidly evolving into a pandemic. In the first phase, when the viral replication plays a pivotal pathogenetic role, antiviral drugs could be crucial in limiting viral-induced organ damage. Unfortunately, there are no specific antivirals of proven efficacy for COVID-19, and several drugs have been repurposed to face this dramatic pandemic. In this paper we review the studies evaluating lopinavir/ritonavir association (LPV/r) use in COVID-19, and previously in SARS and Middle East respiratory syndrome (MERS). We searched PubMed to identify all relevant clinical and laboratory studies published up to 15 May 2020; the guidelines on the use of LPV/r in COVID-19 were further directly searched on the website of the main international scientific societies and agencies. Available evidence is currently scarce and of low quality. The recommendations issued for COVID-19 vary from positions clearly against the use of LPV/r to other positions that are more favorable. In our opinion, despite the controversial results of an important randomized clinical trial, and some recommendations, clinicians should not abandon the use of LPV/r for the treatment of COVID-19, possibly using this drug inside a prospective randomized trial, waiting for the results of the numerous ongoing trials evaluating its efficacy.
    Keywords covid19
    Language English
    Publishing date 2020-06-30
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm9072050
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  5. Article ; Online: Primary septic arthritis of the knee caused by Neisseria meningitidis serogroup B in an elderly patient. Case report and review of the literature.

    Longo, Benedetta / Fazio, Cecilia / Meini, Simone / Neri, Arianna / Andreoli, Elisabetta / Vacca, Paola / Salamone, Domenico / Sani, Spartaco / Mura, Maddalena / Bracalente, Irene / Venturini, Luigi / Andreini, Roberto / Ambrosio, Luigina / Carannante, Anna / Stefanelli, Paola

    Infection

    2022  Volume 51, Issue 2, Page(s) 499–506

    Abstract: Purpose: Primary meningococcal arthritis (PMA) represents an uncommon clinical presentation of meningococcal infection, mainly reported among young people. Herein, a case of PMA of the knee in an elderly patient is described.: Case presentation: On ... ...

    Abstract Purpose: Primary meningococcal arthritis (PMA) represents an uncommon clinical presentation of meningococcal infection, mainly reported among young people. Herein, a case of PMA of the knee in an elderly patient is described.
    Case presentation: On January 2022, an 87-year-old patient arrived at hospital with continuous fever persisting for three days and a picture of pain, swelling, redness, and warmth of her left knee. An arthrocentesis was promptly performed and the inoculated synovial fluid turned positive with numerous Gram-negative diplococci at the microscopic examination. The identification of bacteria was done in 48 h using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF) MS systems (VITEK
    Review of the literature: A total of 41 cases of PMA caused by N. meningitidis was reported in the literature, but only four occurred in elderly. To our knowledgements, no cases of PMA caused by MenB were previously reported among patients of more than 65 years of age.
    MeSH term(s) Humans ; Female ; Aged ; Adolescent ; Aged, 80 and over ; Serogroup ; Neisseria meningitidis ; Meningococcal Infections/diagnosis ; Meningococcal Infections/drug therapy ; Meningococcal Infections/microbiology ; Knee Joint ; Arthritis, Infectious/diagnosis ; Arthritis, Infectious/drug therapy ; Arthritis, Infectious/microbiology
    Language English
    Publishing date 2022-10-01
    Publishing country Germany
    Document type Review ; 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/s15010-022-01928-2
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  6. Article: Role of lopinavir/ritonavir in the treatment of covid-19: A review of current evidence, guideline recommendations, and perspectives

    Meini, Simone / Pagotto, Alberto / Longo, Benedetta / Vendramin, Igor / Pecori, Davide / Tascini, Carlo

    J. Clin. Med.

    Abstract: A life-threatening respiratory illness (COVID-19) due to severe acute respiratory syndrome (SARS)-CoV-2 coronavirus was first described in December 2019 in Wuhan (China), rapidly evolving into a pandemic. In the first phase, when the viral replication ... ...

    Abstract A life-threatening respiratory illness (COVID-19) due to severe acute respiratory syndrome (SARS)-CoV-2 coronavirus was first described in December 2019 in Wuhan (China), rapidly evolving into a pandemic. In the first phase, when the viral replication plays a pivotal pathogenetic role, antiviral drugs could be crucial in limiting viral-induced organ damage. Unfortunately, there are no specific antivirals of proven efficacy for COVID-19, and several drugs have been repurposed to face this dramatic pandemic. In this paper we review the studies evaluating lopinavir/ritonavir association (LPV/r) use in COVID-19, and previously in SARS and Middle East respiratory syndrome (MERS). We searched PubMed to identify all relevant clinical and laboratory studies published up to 15 May 2020; the guidelines on the use of LPV/r in COVID-19 were further directly searched on the website of the main international scientific societies and agencies. Available evidence is currently scarce and of low quality. The recommendations issued for COVID-19 vary from positions clearly against the use of LPV/r to other positions that are more favorable. In our opinion, despite the controversial results of an important randomized clinical trial, and some recommendations, clinicians should not abandon the use of LPV/r for the treatment of COVID-19, possibly using this drug inside a prospective randomized trial, waiting for the results of the numerous ongoing trials evaluating its efficacy.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #635691
    Database COVID19

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  7. Article ; Online: Community-acquired pneumonia.

    Carbonara, Sergio / Monno, Laura / Longo, Benedetta / Angarano, Gioacchino

    Current opinion in pulmonary medicine

    2009  Volume 15, Issue 3, Page(s) 261–273

    Abstract: Purpose of review: Community-acquired pneumonia (CAP) is a major cause of morbidity, mortality and expenditure of resources. When followed, guidelines for CAP management have been demonstrated to improve clinical outcomes; however, several issues are ... ...

    Abstract Purpose of review: Community-acquired pneumonia (CAP) is a major cause of morbidity, mortality and expenditure of resources. When followed, guidelines for CAP management have been demonstrated to improve clinical outcomes; however, several issues are still open. This review summarizes the recent advances in this field and the priority needs for future research.
    Recent findings: Recently identified clinical and biochemical tools promise to improve the assessment of CAP severity; however, definition of the most accurate and feasible rule(s) for clinical practice is now necessary. Some empirical antimicrobial regimens are still being debated, such as the need for atypical pathogen coverage in home-treated and nonsevere hospitalized patients and the inclusion of respiratory fluoroquinolones among first-choice molecules. New drugs such as tigecycline and cethromycin appear promising. Pharmacokinetically enhanced amoxicillin/clavulanate is highly effective, even for treating CAP caused by multiple-drug-resistant Streptococcus pneumoniae. Other aspects recently clarified include the inappropriateness of rigid time-to-first-antibiotic-dose rules, the advantages of shorter antibiotic treatments for nonsevere patients and the need of special clinical attention for acute myocardial infarction among patients with severe CAP or clinical failure.
    Summary: Recent developments have significantly contributed to refine the management of CAP patients. However, various hot topics remain undefined as yet and urgently require ad-hoc research in order to optimize the outcomes and the costs of this highly social-impacting disease.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Community-Acquired Infections/diagnosis ; Community-Acquired Infections/drug therapy ; Community-Acquired Infections/epidemiology ; Guideline Adherence ; Humans ; Pneumonia, Bacterial/diagnosis ; Pneumonia, Bacterial/drug therapy ; Pneumonia, Bacterial/epidemiology ; Prognosis ; Risk Factors ; Severity of Illness Index
    Chemical Substances Anti-Bacterial Agents
    Keywords covid19
    Language English
    Publishing date 2009-05
    Publishing country United States
    Document type Editorial ; Review
    ZDB-ID 1285505-4
    ISSN 1531-6971 ; 1070-5287 ; 1078-1641
    ISSN (online) 1531-6971
    ISSN 1070-5287 ; 1078-1641
    DOI 10.1097/MCP.0b013e3283287c3f
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  8. Article ; Online: Increasing proportion of AIDS diagnoses among older adults in Italy.

    Longo, Benedetta / Camoni, Laura / Boros, Stefano / Suligoi, Barbara

    AIDS patient care and STDs

    2008  Volume 22, Issue 5, Page(s) 365–371

    Abstract: We evaluated the impact of AIDS among older persons in Italy and compared these cases with cases among younger persons. The data source was Italy's National AIDS Registry. We considered adults diagnosed with AIDS between 1982 and 2005. Older adults were ... ...

    Abstract We evaluated the impact of AIDS among older persons in Italy and compared these cases with cases among younger persons. The data source was Italy's National AIDS Registry. We considered adults diagnosed with AIDS between 1982 and 2005. Older adults were defined as those aged 50 years or older at diagnosis. Of the total adult cases, 8.8% were among older adults. This proportion increased over time, from 4.9% in 1982-1990 to 15.9% in 2000-2005. Among older adults, the most represented exposure category (80.8%) was sexual intercourse (heterosexual and homosexual). At AIDS diagnosis, older adults, compared to younger adults, had a higher risk of developing AIDS dementia complex or wasting syndrome, and of presenting multiple AIDS-defining illnesses. A significantly lower proportion of older adults were undergoing antiretroviral therapy, compared to younger adults. Among older adults, 67.2% were late testers, compared to 32.8% of younger adults. Most of the older adults acquired the infection through sexual contact; approximately two thirds of them were diagnosed late (i.e., first HIV-positive test 6 months or less before AIDS diagnosis); and only one fourth were undergoing antiretroviral therapy at diagnosis. These observations stress the need to more seriously consider the possibility of HIV infection among older individuals and to collect more detailed information on their sexual behavior.
    MeSH term(s) AIDS-Related Opportunistic Infections/epidemiology ; AIDS-Related Opportunistic Infections/etiology ; Adolescent ; Adult ; Age Factors ; Aged ; Female ; HIV Infections/complications ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Prevalence ; Registries ; Risk Factors ; Sex Distribution
    Language English
    Publishing date 2008-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1326868-5
    ISSN 1557-7449 ; 0893-5068 ; 1087-2914
    ISSN (online) 1557-7449
    ISSN 0893-5068 ; 1087-2914
    DOI 10.1089/apc.2007.0168
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  9. Article: PCR-DGGE differentiation of strains of Saccharomyces sensu stricto.

    Manzano, Marisa / Cocolin, Luca / Longo, Benedetta / Comi, Giuseppe

    Antonie van Leeuwenhoek

    2004  Volume 85, Issue 1, Page(s) 23–27

    Abstract: A quick molecular biology method based on the polymerase chain reaction (PCR) and Denaturing Gradient Gel Electrophoresis (DGGE) was developed for distinguishing strains belonging to the Saccharomyces sensu stricto group. Differentiation was obtained ... ...

    Abstract A quick molecular biology method based on the polymerase chain reaction (PCR) and Denaturing Gradient Gel Electrophoresis (DGGE) was developed for distinguishing strains belonging to the Saccharomyces sensu stricto group. Differentiation was obtained between S. cerevisiae, S. paradoxus and S. bayanus / S. pastorianus although no distinction was possible between S. bayanus and S. pastorianus using the amplification of the ITS regions. The ability to distinguish between different strains of the Saccharomyces sensu stricto group could allow for a better understanding of the ecology of these species on grapes as well as in musts and wines and the method developed can be useful for the quick identification of Saccharomyces sensu stricto strains from numerous isolates.
    MeSH term(s) Base Sequence ; DNA Primers ; Electrophoresis, Polyacrylamide Gel/methods ; Polymerase Chain Reaction/methods ; Saccharomyces/classification ; Saccharomyces/genetics ; Saccharomyces/isolation & purification ; Saccharomyces cerevisiae/classification ; Saccharomyces cerevisiae/genetics ; Saccharomyces cerevisiae/isolation & purification
    Chemical Substances DNA Primers
    Language English
    Publishing date 2004-01
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 214861-4
    ISSN 1572-9699 ; 0003-6072
    ISSN (online) 1572-9699
    ISSN 0003-6072
    DOI 10.1023/B:ANTO.0000020270.44019.39
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  10. Article: Changes over time in post-seroconversion CD4 cell counts in the Italian HIV-Seroconversion Study: 1985-2002.

    Dorrucci, Maria / Phillips, Andrew N / Longo, Benedetta / Rezza, Giovanni

    AIDS (London, England)

    2005  Volume 19, Issue 3, Page(s) 331–335

    Abstract: Objective: To determine whether there has been a tendency for early post-seroconversion CD4 cell counts to change over calendar time.: Design: A prospective cohort study of individuals with well-estimated dates of seroconversion.: Methods: We ... ...

    Abstract Objective: To determine whether there has been a tendency for early post-seroconversion CD4 cell counts to change over calendar time.
    Design: A prospective cohort study of individuals with well-estimated dates of seroconversion.
    Methods: We studied 1251 individuals who seroconverted to HIV in Italy between 1985 and 2002, and for whom the first CD4 count was measured within 2 years of seroconversion and before any use of antiretrovirals. Linear regression models were used to assess evidence for a trend in post-seroconversion CD4 cell count over time.
    Results: The median post-seroconversion CD4 cell count was 674 x 10 cells/l in those seroconverting between 1985 and 1990, 588 x 10 cells/l for 1991 to 1994, 559 x 10 cells/l for 1995 to 1998 and 494 x 10 cells/l for 1999 to 2002. The post-seroconversion CD4 cell count decreased by an average of 8.4 x 10 cells/l per year (95% confidence interval, 4.0-12.9; P < 0.001), after adjustment for potential confounders, including interval between HIV-negative and HIV-positive tests, lag time for first CD4 cell count measurement, age at seroconversion, gender, HIV-transmission group, and clinical centre. The finding was consistent in sensitivity analyses restricted to those with information on acute infection.
    Conclusion: These data suggest a possible decreasing trend in CD4 cell count immediately following seroconversion in Italy which requires further investigation.
    MeSH term(s) AIDS-Related Opportunistic Infections/immunology ; Acute Disease ; Adolescent ; Adult ; Aged ; CD4 Lymphocyte Count ; Epidemiologic Methods ; Female ; HIV Seropositivity/immunology ; HIV-1/immunology ; Humans ; Male ; Middle Aged
    Language English
    Publishing date 2005-02-18
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 639076-6
    ISSN 1473-5571 ; 0269-9370 ; 1350-2840
    ISSN (online) 1473-5571
    ISSN 0269-9370 ; 1350-2840
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