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Article: Antibiotics and Infectious Respiratory Diseases.

Di Gennaro, Francesco / Gualano, Gina / Palmieri, Fabrizio

2022 Volume 11, Issue 7

Abstract: Respiratory infectious diseases (rIDs) remain among the most significant causes of morbidity and mortality worldwide, and, in the era of COVID-19, they have come into major focus in the scientific world and global health approaches [ ... ]. ...

Abstract	Respiratory infectious diseases (rIDs) remain among the most significant causes of morbidity and mortality worldwide, and, in the era of COVID-19, they have come into major focus in the scientific world and global health approaches [...].
Language	English
Publishing date	2022-06-27
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics11070859
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Article ; Online: Update of drug-resistant tuberculosis treatment guidelines: A turning point.

Vanino, Elisa / Granozzi, Bianca / Akkerman, Onno W / Munoz-Torrico, Marcela / Palmieri, Fabrizio / Seaworth, Barbara / Tiberi, Simon / Tadolini, Marina

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2023 Volume 130 Suppl 1, Page(s) S12–S15

Abstract: In December 2022 World Health Organization released a new treatment for multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) guideline. The main novelty of this update is two new recommendations (i) a 6-month treatment regimen composed of ... ...

Abstract	In December 2022 World Health Organization released a new treatment for multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) guideline. The main novelty of this update is two new recommendations (i) a 6-month treatment regimen composed of bedaquiline, pretomanid, linezolid (600 mg), and moxifloxacin (BPaLM) is recommended in place of the 9-month or longer (18-month) regimens in MDR/RR-TB patients, now including extensive pulmonary TB and extrapulmonary TB (except TB involving central nervous system, miliary TB and osteoarticular TB); (ii) the use of the 9-month all-oral regimen rather than longer (18-months) regimen is suggested in patients with MDR/RR-TB and in whom resistance to fluoroquinolones has been excluded. Longer (18-month) treatments remain a valid option in all cases in which shorter regimens cannot be implemented due to intolerance, drug-drug interactions, extensively drug-resistant tuberculosis, extensive forms of extrapulmonary TB, or previous failure. The new guidelines represent a milestone in MDR/RR-TB treatment landscape, setting the basis for a shorter, all-oral, more acceptable, equitable, and patient-centered model for MDR/RR-TB management. However, some challenges remain to be addressed to allow full implementation of the new recommendations.
MeSH term(s)	Humans ; Antitubercular Agents/pharmacology ; Extensively Drug-Resistant Tuberculosis/drug therapy ; Rifampin/pharmacology ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Pulmonary/drug therapy
Chemical Substances	Antitubercular Agents ; Rifampin (VJT6J7R4TR)
Language	English
Publishing date	2023-03-12
Publishing country	Canada
Document type	Journal Article ; Review
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2023.03.013
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Article: Implementation of Whole Genome Sequencing of Tuberculosis Isolates in a Referral Center in Rome: Six Years' Experience in Characterizing Drug-Resistant TB and Disease Transmission.

Cannas, Angela / Butera, Ornella / Mazzarelli, Antonio / Messina, Francesco / Vulcano, Antonella / Parracino, Mario Pasquale / Gualano, Gina / Palmieri, Fabrizio / Di Caro, Antonino / Nisii, Carla / Fontana, Carla / Girardi, Enrico

Antibiotics (Basel, Switzerland)

2024 Volume 13, Issue 2

Abstract: Over the past years, Tuberculosis (TB) control strategies have been effective in reducing drug-resistant (DR) TB globally; however, a wider implementation of new diagnostic strategies, such as Whole genome sequencing (WGS), would be critical for further ... ...

Abstract	Over the past years, Tuberculosis (TB) control strategies have been effective in reducing drug-resistant (DR) TB globally; however, a wider implementation of new diagnostic strategies, such as Whole genome sequencing (WGS), would be critical for further improvement. The aim of this study, based on WGS of
Language	English
Publishing date	2024-01-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics13020134
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Article ; Online: Detection of Mycobacterium tuberculosis DNA in CD34

Repele, Federica / Alonzi, Tonino / Navarra, Assunta / Farroni, Chiara / Salmi, Andrea / Cuzzi, Gilda / Delogu, Giovanni / Gualano, Gina / Puro, Vincenzo / De Carli, Gabriella / Girardi, Enrico / Palmieri, Fabrizio / Martineau, Adrian R / Goletti, Delia

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2024 Volume 141S, Page(s) 106999

Abstract: Objectives: To investigate whether Mycobacterium tuberculosis (Mtb) DNA is detected in peripheral blood mononuclear cells (PBMC) of subjects with tuberculosis (TB) or TB infection (TBI) living in a low-burden country.: Methods: We prospectively ... ...

Abstract	Objectives: To investigate whether Mycobacterium tuberculosis (Mtb) DNA is detected in peripheral blood mononuclear cells (PBMC) of subjects with tuberculosis (TB) or TB infection (TBI) living in a low-burden country. Methods: We prospectively enrolled 57 patients with TB, 41 subjects with TBI, and 39 controls in Rome, Italy. PBMC were isolated, cluster of differentiation (CD)34 Results: We detected Mtb DNA at a low copy number in CD34 Conclusions: Mtb DNA was detected at low frequencies and levels in the PBMC of subjects with TBI and donors with TB living in a low-burden country. In particular, Mtb DNA was detected more frequently in CD34
MeSH term(s)	Adult ; Humans ; Latent Tuberculosis ; Leukocytes, Mononuclear ; Mycobacterium tuberculosis/genetics ; Tuberculosis ; DNA, Bacterial
Chemical Substances	DNA, Bacterial
Language	English
Publishing date	2024-03-07
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2024.106999
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Article ; Online: A randomized trial of pamrevlumab in patients with COVID-19 pneumonia.

Sgalla, Giacomo / Leone, Paolo Maria / Gualano, Gina / Simonetti, Jacopo / Comes, Alessia / Verdirosi, Diana / Di Gennaro, Francesco / Larici, Anna Rita / Ianniello, Stefania / Cicchetti, Giuseppe / Fusco, Nicoletta / Pani, Marcello / Palmieri, Fabrizio / Richeldi, Luca

Respirology (Carlton, Vic.)

2023 Volume 28, Issue 10, Page(s) 954–957

MeSH term(s)	Humans ; COVID-19 ; Antibodies, Monoclonal, Humanized/therapeutic use
Chemical Substances	pamrevlumab (QS5F6VTS0O) ; Antibodies, Monoclonal, Humanized
Language	English
Publishing date	2023-08-21
Publishing country	Australia
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1435849-9
ISSN	1440-1843 ; 1323-7799
ISSN (online)	1440-1843
ISSN	1323-7799
DOI	10.1111/resp.14575
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Article ; Online: Recovery from Triple Infection with SARS-CoV-2, RSV and Influenza virus: A case report.

Guido, Giacomo / Lalle, Eleonora / Mosti, Silvia / Mencarini, Paola / Lapa, Daniele / Libertone, Raffaella / Ianniello, Stefania / Ricciuto, Giulio Maria / Vaia, Francesco / Maggi, Fabrizio / Palmieri, Fabrizio

Journal of infection and public health

2023 Volume 16, Issue 7, Page(s) 1045–1047

Abstract: The overall probability of infection with RSV, influenza virus, or SARS-CoV-2 in the general population is assessed as high by the ECDC. A high level of respiratory virus circulation increases hospitalizations and places significant pressure on ... ...

Abstract	The overall probability of infection with RSV, influenza virus, or SARS-CoV-2 in the general population is assessed as high by the ECDC. A high level of respiratory virus circulation increases hospitalizations and places significant pressure on healthcare systems. Here we describe the case of a 52-year-old woman who recovered from pneumonia with a triple infection with SARS-CoV-2, RSV, and Influenza virus. We suggest searching for antigenic or molecular detection of VSR and influenza viruses, together with SARS-CoV-2, in patients with respiratory symptoms during this epidemic period, whereas all three viruses are present right now.
MeSH term(s)	Female ; Humans ; Middle Aged ; SARS-CoV-2 ; COVID-19 ; Epidemics ; Hospitalization ; Orthomyxoviridae ; Influenza, Human/diagnosis ; Respiratory Syncytial Virus, Human ; Respiratory Syncytial Virus Infections/diagnosis
Language	English
Publishing date	2023-05-04
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2023.05.001
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Article: Alternative biomarkers of tuberculosis infection in patients with immune-mediated inflammatory diseases.

Petruccioli, Elisa / Petrone, Linda / Najafi-Fard, Saeid / Navarra, Assunta / Vanini, Valentina / Cuzzi, Gilda / Cantini, Fabrizio / Gualano, Gina / Palmieri, Fabrizio / Goletti, Delia

Frontiers in medicine

2023 Volume 10, Page(s) 1271632

Abstract: Introduction: IFN-γ release assays (IGRAs) are one of the referral tests for diagnosing tuberculosis infection (TBI). To improve IGRAs accuracy, several markers have been investigated. Patients with immune-mediated inflammatory diseases (IMID), taking ... ...

Abstract	Introduction: IFN-γ release assays (IGRAs) are one of the referral tests for diagnosing tuberculosis infection (TBI). To improve IGRAs accuracy, several markers have been investigated. Patients with immune-mediated inflammatory diseases (IMID), taking biological drugs, have a higher risk to progress to TB-disease compared to the general population. In several guidelines, annual TBI screening is recommended for patients undergoing biological therapy. Aim of this study was to investigate, within the QuantiFERON-TB-Plus (QFT-Plus) platform, if beside IFN-γ, alternative biomarkers help to diagnose TBI-IMID patients. Methods: We enrolled 146 subjects: 46 with TB disease, 20 HD, 35 with TBI and 45 with TBI and IMID. Thirteen IMID subjects with a QFT-Plus negative result were diagnosed as TBI based on radiological evidence of TBI. We evaluated the IP-10 level in response to TB1 and TB2 peptides of QFT-Plus assay and we compared these results with the standardized assay based on IFN-γ. Multiplex immune assay was performed on plasma from TB1 and TB2 tubes and results were analyzed by a gradient boosting machine (GBM) as learning technique. Results: TBI-IMID showed a significant decreased IP-10 level in response to TB1 and TB2 stimulation compared to TBI-NO IMID ( Discussion: To develop alternative strategies for TBI immune-diagnosis, future studies are needed to evaluate the memory response of TBI defined by radiological tools. These results may help in tuberculosis management of patients taking lifelong immune-suppressive drugs.
Language	English
Publishing date	2023-11-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2023.1271632
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Article ; Online: Characterization of the immune impairment of patients with tuberculosis and COVID-19 coinfection.

Najafi-Fard, Saeid / Aiello, Alessandra / Navarra, Assunta / Cuzzi, Gilda / Vanini, Valentina / Migliori, Giovanni Battista / Gualano, Gina / Cerva, Carlotta / Grifoni, Alba / Sette, Alessandro / Vaia, Francesco / Palmieri, Fabrizio / Goletti, Delia

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2023 Volume 130 Suppl 1, Page(s) S34–S42

Abstract: Objectives: To characterize the plasma immune profile of patients with tuberculosis (TB)-COVID-19 compared with COVID-19, TB, or healthy controls and to evaluate in vitro the specific responses to SARS-CoV-2 and Mycobacterium tuberculosis (Mtb)-antigens. ...

Abstract	Objectives: To characterize the plasma immune profile of patients with tuberculosis (TB)-COVID-19 compared with COVID-19, TB, or healthy controls and to evaluate in vitro the specific responses to SARS-CoV-2 and Mycobacterium tuberculosis (Mtb)-antigens. Methods: We enrolled 119 subjects: 14 TB-COVID-19, 47 COVID-19, 38 TB, and 20 controls. The plasmatic levels of 27 immune factors were measured at baseline using a multiplex assay. The specific response to SARS-CoV-2 and Mtb antigens was evaluated using a home-made whole blood platform and QuantiFERON-Plus tubes, respectively. Results: We found an immune signature (tumor necrosis factor [TNF]-α, macrophage inflammatory protein-1β, and interleukin [IL]-9) associated with TB-COVID-19 coinfection compared with COVID-19 (P <0.05), and TNF-α showed the highest discriminant power. We also found another signature (TNF-α, IL-1β, IL-17A, IL-5, fibroblast growth factor-basic, and granulocyte macrophage colony-stimulating factor [GM-CSF]) in coinfected patients compared with patients with TB (P <0.05), and among them, TNF-α and granulocyte macrophage colony-stimulating factor showed a non-negligible discriminating ability. Moreover, coinfected patients showed a significantly reduced SARS-CoV-2-specific response compared with COVID-19 for several pro-inflammatory cytokines/chemokines, anti-inflammatory cytokines, and growth factors (P ≤0.05). Furthermore, coinfection negatively affected the Mtb-specific response (P ≤0.05). Conclusion: We found immune signatures associated with TB-COVID-19 coinfection and observed a major impairment of SARS-CoV-2-specific and, to a lesser extent, the Mtb-specific immune responses. These findings further advance our knowledge of the immunopathology of TB-COVID-19 coinfection.
MeSH term(s)	Humans ; Tumor Necrosis Factor-alpha ; Coinfection ; Macrophage Colony-Stimulating Factor ; COVID-19/complications ; SARS-CoV-2/metabolism ; Tuberculosis ; Mycobacterium tuberculosis ; Cytokines
Chemical Substances	Tumor Necrosis Factor-alpha ; Macrophage Colony-Stimulating Factor (81627-83-0) ; Cytokines
Language	English
Publishing date	2023-03-21
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2023.03.021
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Article: Diagnosis of Tuberculosis in a Case of Chronic Urticaria following Omalizumab Therapy.

Zolezzi, Alberto / Gualano, Gina / Licata, Maria A / Mosti, Silvia / Mencarini, Paola / Papagni, Roberta / Vulcano, Antonella / Cannas, Angela / Villanacci, Alberta / Albarello, Fabrizio / Del Nonno, Franca / Colombo, Daniele / Palmieri, Fabrizio

Antibiotics (Basel, Switzerland)

2023 Volume 12, Issue 12

Abstract: In Italy, tuberculosis (TB) incidence in the last decade has remained constant at under 10 cases/100,000 inhabitants. In the Philippines, TB annual incidence is greater than 500 cases/100,000 inhabitants. Omalizumab is a humanized anti-IgE monoclonal ... ...

Abstract	In Italy, tuberculosis (TB) incidence in the last decade has remained constant at under 10 cases/100,000 inhabitants. In the Philippines, TB annual incidence is greater than 500 cases/100,000 inhabitants. Omalizumab is a humanized anti-IgE monoclonal antibody approved for the treatment of chronic spontaneous urticaria. We report the case of a 32-year-old Filipino woman who suffered from chronic urticaria, treated with topic steroids since June 2022 and systemic steroids for 2 weeks. In November 2022, she started omalizumab therapy at a monthly dose of 300 mg; she was not screened for TB infection. In the same month, a left laterocervical lymphadenopathy arose, which worsened in February 2023 (diameter: 3 cm). The patient recovered in April 2023 in INMI "Lazzaro Spallanzani" in Rome for suspected TB. Chest CT showed a "tree in bud" pattern at the upper-right pulmonary lobe. The patient tested positive for lymph node biopsy molecular tuberculosis. The patient started standard antituberculosis therapy. She discontinued omalizumab. To our knowledge, this is the second diagnosed TB case during omalizumab treatment, which suggests that attention should be paid to the known risk of TB during biotechnological treatments. Even if current guidelines do not recommend screening for TB before starting anti-IgE therapy, further data should be sought to assess the relationship between omalizumab treatment and active TB. Our experience suggests that screening for TB should be carried out in patients from highly tuberculosis-endemic countries before starting omalizumab therapy.
Language	English
Publishing date	2023-11-24
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics12121655
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Article: Utility of Liver Biopsy in the Diagnosis and Management of Possible Drug-Induced Liver Injury in Patients Receiving Antituberculosis Therapy: A Retrospective Study.

Gualano, Gina / Zace, Drieda / Mosti, Silvia / Mencarini, Paola / Musso, Maria / Libertone, Raffaella / Cerva, Carlotta / Goletti, Delia / Rianda, Alessia / Del Nonno, Franca / Falasca, Laura / Palmieri, Fabrizio

Infectious disease reports

2023 Volume 15, Issue 6, Page(s) 735–746

Abstract: Background: Drug-induced liver injury (DILI) secondary to ATT treatment (TB-DILI) is reported in 2-28% of patients. We present here a series of clinical cases of suspected DILI arising during antituberculosis treatment, studied with the aid of liver ... ...

Abstract	Background: Drug-induced liver injury (DILI) secondary to ATT treatment (TB-DILI) is reported in 2-28% of patients. We present here a series of clinical cases of suspected DILI arising during antituberculosis treatment, studied with the aid of liver biopsy. Methods: this was a retrospective descriptive study including 10 tuberculosis patients who underwent liver biopsy for suspected TB-DILI at the "Lazzaro Spallanzani" Institute from 2017 to 2022. Results: Ten patients who underwent LB were extracted from the database and included in the retrospective study cohort. According to the clinical classification, eight patients had hepatocellular liver injury, one patient had cholestatic injury, and another had mixed-type injury. Histopathological diagnosis revealed liver damage due to DILI in 5/10 (50%) cases. In one case, liver biopsy showed necrotizing granulomatous hepatitis. Conclusions: Severe and persistent elevation of hepatic transaminases, hepatic cholestasis despite discontinuation of therapy, and other suspected hepatic conditions are indications for liver biopsy, which remains a valuable tool in the evaluation of selected tuberculosis patients with suspected DILI for many reasons. However, the decision to perform a liver biopsy should be based on clinical judgment, considering the benefits and risks of the procedure.
Language	English
Publishing date	2023-11-28
Publishing country	Switzerland
Document type	Journal Article
ISSN	2036-7430
ISSN	2036-7430
DOI	10.3390/idr15060066
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