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Article ; Online: The Elephant in the Room: Secondary Infections and Antimicrobial Use in Patients With COVID-19.

Ripa, Marco / Mastrangelo, Andrea

2021 Volume 160, Issue 2, Page(s) 387–388

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents/therapeutic use ; COVID-19 ; Coinfection/drug therapy ; Humans ; SARS-CoV-2
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2021-08-09
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2021.04.053
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Article: Invasive fungal infections in patients with COVID-19: a review on pathogenesis, epidemiology, clinical features, treatment, and outcomes.

Chiurlo, Matteo / Mastrangelo, Andrea / Ripa, Marco / Scarpellini, Paolo

The new microbiologica

2021 Volume 44, Issue 2, Page(s) 71–83

Abstract: COVID-19 is frequently associated with the onset of secondary infections, especially in severe cases treated in the intensive care unit. While bacterial pathogens are the most frequently encountered causative agents, several factors put SARS-CoV-2 ... ...

Abstract	COVID-19 is frequently associated with the onset of secondary infections, especially in severe cases treated in the intensive care unit. While bacterial pathogens are the most frequently encountered causative agents, several factors put SARS-CoV-2 infected patients at a heightened risk of invasive fungal infections, which have been recognized as a substantial cause of morbidity and mortality in this population. Moreover, the frequent occurrence of these complications in severely ill subjects and the absence of pathognomonic features, together with the emergence of fungal species with reduced susceptibility to first-line treatments and the difficult to manage safety profile of several antifungal drugs, demand an additional focus on these rare but challenging complications. In this review, we will summarize the currently available literature on fungal superinfections in COVID-19 patients, exploring the pathogenesis, epidemiology, clinical features, treatment, and outcomes.
Language	English
Publishing date	2021-07-09
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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Article: Post-neurosurgical Nocardia meningoventriculitis: a case report and review of the literature.

Ponta, Giacomo / Bradanini, Lucia / Morena, Valentina / Mauri, Carola / Ripa, Marco / Uberti Foppa, Caterina / Castagna, Antonella / Luzzaro, Francesco / Piconi, Stefania

The new microbiologica

2023 Volume 46, Issue 1, Page(s) 75–80

Abstract: The genus Nocardia consists of a group of gram-positive environmental bacteria. They typically cause lung and brain infections in immunocompromised patients, even though one out of three infected patients have a normally functioning immune system. Being ... ...

Abstract	The genus Nocardia consists of a group of gram-positive environmental bacteria. They typically cause lung and brain infections in immunocompromised patients, even though one out of three infected patients have a normally functioning immune system. Being a ubiquitous microorganism, in some cases Nocardia has been associated with nosocomial acquired infections and surgical procedures. A review of the literature in this field follows the case report. A 47-year-old woman underwent an endoscopic third ventriculostomy and a left retro-sigmoid craniotomy for a schwannoma removal. Meningeal symptoms began a week later, in association with C reactive protein rise and leukocytosis. Cerebrospinal fluid (CSF) examination was clear with hypoglycorrhachia, hyperprotidorrachia and polymorphonuclear cells. Cultural exam was negative. At the brain magnetic resonance imaging (MRI) purulent material was described in the occipital ventricular horns. Empirical broad spectrum antibiotic therapy was given for 31 days until the brain MRI showed a resolution of the infection. Ten days later, the patient was admitted to the hospital because of new meningeal symptoms. Cerebrospinal fluid culture and Polymerase-chain reaction (PCR) Multiplex for the most important meningitis viruses and bacteria tested negative. A broad-spectrum antibiotic therapy was started with no benefit; thus, a broad-spectrum antifungal therapy was added with little success on clinical status. Meanwhile, a 16s and 18s rRNA PCR was executed on a previous Cerebrospinal fluid with negative results, excluding bacterial and fungal infections. For this reason, all the therapies were stopped. After a few days, high fever and meningeal signs reappeared. The brain MRI showed a meningoventriculitis. An Ommaya catheter with reservoir was inserted and the drawn CSF resulted in the growth of Nocardia farcinica. Antibiogram-based antibiotic therapy was started with intravenous imipenem and trimethoprim-sulfamethoxazole, showing clinical benefit. The patient was sent home with oral linezolid and amoxicillin/clavulanate for a total of 12 months of therapy. Nocardia rarely causes post-neurosurgical complication in a nosocomial setting. This case shows the difficulty in detecting Nocardia and the importance of the correct microbiological sample and antibiogram-based antibiotic therapy to achieve successful treatment.
MeSH term(s)	Animals ; Female ; Humans ; Middle Aged ; Amoxicillin-Potassium Clavulanate Combination ; Cross Infection ; Anti-Bacterial Agents/therapeutic use
Chemical Substances	Amoxicillin-Potassium Clavulanate Combination (74469-00-4) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-02-09
Publishing country	Italy
Document type	Review ; Case Reports ; Journal Article
ZDB-ID	756168-4
ISSN	1121-7138 ; 0391-5352
ISSN	1121-7138 ; 0391-5352
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Article ; Online: Trends of Antimicrobial Susceptibility of Neisseria gonorrhoeae isolates between 2012 and 2023: results from an open Italian cohort.

Lucente, Maria Francesca / Raccagni, Angelo Roberto / Galli, Laura / Lolatto, Riccardo / Ranzenigo, Martina / Ripa, Marco / Ponta, Giacomo / Monardo, Roberta / Gona, Floriana / Clementi, Nicola / Burioni, Roberto / Carletti, Silvia / Castagna, Antonella / Nozza, Silvia

Sexually transmitted diseases

2024

Abstract: Background: Neisseria gonorrhoeae (Ng) is a public health priority due to the rapid evolution of antimicrobial resistance, the emergence of antibiotic resistance and the absence of a vaccine against Ng. The aim of this study was to investigate trends in ...

Abstract	Background: Neisseria gonorrhoeae (Ng) is a public health priority due to the rapid evolution of antimicrobial resistance, the emergence of antibiotic resistance and the absence of a vaccine against Ng. The aim of this study was to investigate trends in the minimum inhibitory concentration (MIC) and resistance (R) or reduced susceptibility (DS) of Ng cases to ceftriaxone (CRO), azithromycin (AZM), tetracycline (TET), benzylpenicillin (PenG), ciprofloxacin (CIP) over a 10-year period. Methods: Retrospective analysis on an open cohort of Ng cases diagnosed on rectal, urethral and pharyngeal samples at San Raffaele Scientific Institute, between September 2012-February 2023. MICs of antibiotics were determined by gradient-test strips. Bivariate linear regression models, applied on logarithmic MICs values; Cochran-Armitage test was used to determine a linear trend in the proportions of resistant strains. Results: 436 Ng isolates from 352 individuals were analyzed. MICs of CRO and PenG reduced over time (p < 0.001, p = 0.030), AZM increased (p = 0.001), CIP and TET did not change (p = 0.473, p = 0.272). The percentages of resistant strains were: PenG 89.9%, TET 90.8%, CIP 48.2%, AZM 4.4%; CRO-DS strains were 8.7%, only one CRO-R. The proportion of resistant strains increased over time for AZM (p = 0.007), TET (p = 0.001), CIP (p < 0.001), whereas decreased for PenG (p < 0.001) and CRO-DS/R strains (p < 0.001). Conclusions: Ng strains showed high susceptibility to CRO, although we identified cases of DS/R and observed high levels of susceptibility to AZM. Overall, the recommended primary regimen for Ng treatment confirmed to be effective.
Language	English
Publishing date	2024-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000001981
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Article ; Online: Disseminated Mycobacterium chimaera infection favoring the development of Kaposi's sarcoma: a case report.

Clemente, Tommaso / Spagnuolo, Vincenzo / Bottanelli, Martina / Ripa, Marco / Del Forno, Benedetto / Busnardo, Elena / Di Lucca, Giuseppe / Castagna, Antonella / Danise, Anna

Annals of clinical microbiology and antimicrobials

2022 Volume 21, Issue 1, Page(s) 57

Abstract: Background: Disseminated Mycobacterium chimaera infection is an emerging disease in people undergone to cardiothoracic surgery, which need to be suspected also with atypical presentations.: Case presentation: We report the case of a 74-year-old man ... ...

Abstract	Background: Disseminated Mycobacterium chimaera infection is an emerging disease in people undergone to cardiothoracic surgery, which need to be suspected also with atypical presentations. Case presentation: We report the case of a 74-year-old man with fever of unknown origin, purple nodules on both feet and a history of open-heart surgery. Imaging investigations showed an abscess near aortic bioprosthesis but screening for endocarditis resulted negative and pyrexia did not respond to antibiotic therapy. A biopsy of cutaneous lesions showed HHV8-related Kaposi's sarcoma, so bone marrow biopsy was executed with evidence of HHV8 localization. Bone marrow and urine mycobacterial cultures resulted positive for M. chimaera and a specific antimicrobial therapy was started, with apyrexia after 7 weeks. Conclusions: M. chimaera infection should be always investigated as a possible etiology of fever of unknow origin in people with a history of open-heart surgical intervention, even with negative mycobacterial blood cultures. The possible role of disseminated infection in inducing immunodepression with the occurrence of other opportunistic diseases (such as Kaposi's sarcoma) cannot be excluded.
Language	English
Publishing date	2022-12-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2097873-X
ISSN	1476-0711 ; 1476-0711
ISSN (online)	1476-0711
ISSN	1476-0711
DOI	10.1186/s12941-022-00547-x
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Article: High-Risk Neutropenic Fever and Invasive Fungal Diseases in Patients with Hematological Malignancies.

Microorganisms

2024 Volume 12, Issue 1

Abstract: Invasive fungal diseases (IFDs) still represent a relevant cause of mortality in patients affected by hematological malignancies, especially acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) undergoing remission induction chemotherapy, and ...

Abstract	Invasive fungal diseases (IFDs) still represent a relevant cause of mortality in patients affected by hematological malignancies, especially acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) undergoing remission induction chemotherapy, and in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Mold-active antifungal prophylaxis (MAP) has been established as a standard of care. However, breakthrough IFDs (b-IFDs) have emerged as a significant issue, particularly invasive aspergillosis and non-
Language	English
Publishing date	2024-01-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms12010117
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Article ; Online: Immunosenescence and hurdles in the clinical management of older HIV-patients.

Ripa, Marco / Chiappetta, Stefania / Tambussi, Giuseppe

Virulence

2017 Volume 8, Issue 5, Page(s) 508–528

Abstract: People living with HIV (PLWH) who are treated with effective highly active antiretroviral therapy (HAART) have a similar life expectancy to the general population. Moreover, an increasing proportion of new HIV diagnoses are made in people older than 50 y. ...

Abstract	People living with HIV (PLWH) who are treated with effective highly active antiretroviral therapy (HAART) have a similar life expectancy to the general population. Moreover, an increasing proportion of new HIV diagnoses are made in people older than 50 y. The number of older HIV-infected patients is thus constantly growing and it is expected that by 2030 around 70% of PLWH will be more than 50 y old. On the other hand, HIV infection itself is responsible for accelerated immunosenescence, a progressive decline of immune system function in both the adaptive and the innate arm, which impairs the ability of an individual to respond to infections and to give rise to long-term immunity; furthermore, older patients tend to have a worse immunological response to HAART. In this review we focus on the pathogenesis of HIV-induced immunosenescence and on the clinical management of older HIV-infected patients.
Language	English
Publishing date	2017-07-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2657572-3
ISSN	2150-5608 ; 2150-5594
ISSN (online)	2150-5608
ISSN	2150-5594
DOI	10.1080/21505594.2017.1292197
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Article: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses.

Ramirez, Giuseppe A / Ripa, Marco / Burastero, Samuele / Benanti, Giovanni / Bagnasco, Diego / Nannipieri, Serena / Monardo, Roberta / Ponta, Giacomo / Asperti, Chiara / Cilona, Maria Bernadette / Castagna, Antonella / Dagna, Lorenzo / Yacoub, Mona-Rita

Microorganisms

2023 Volume 11, Issue 2

Abstract: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a heterogeneous, multiorgan and potentially life-threatening drug-hypersensitivity reaction (DHR) that occurs several days or weeks after drug initiation or discontinuation. DHRs constitute ...

Abstract	Drug reaction with eosinophilia and systemic symptoms (DRESS) is a heterogeneous, multiorgan and potentially life-threatening drug-hypersensitivity reaction (DHR) that occurs several days or weeks after drug initiation or discontinuation. DHRs constitute an emerging issue for public health, due to population aging, growing multi-organ morbidity, and subsequent enhanced drug prescriptions. DRESS has more consistently been associated with anticonvulsants, allopurinol and antibiotics, such as sulphonamides and vancomycin, although new drugs are increasingly reported as culprit agents. Reactivation of latent infectious agents such as viruses (especially Herpesviridae) plays a key role in prompting and sustaining aberrant T-cell and eosinophil responses to drugs and pathogens, ultimately causing organ damage. However, the boundaries of the impact of viral agents in the pathophysiology of DRESS are still ill-defined. Along with growing awareness of the multifaceted aspects of immune perturbation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing SARS-CoV-2-related disease (COVID-19) pandemic, novel interest has been sparked towards DRESS and the potential interactions among antiviral and anti-drug inflammatory responses. In this review, we summarised the most recent evidence on pathophysiological mechanisms, diagnostic approaches, and clinical management of DRESS with the aim of increasing awareness on this syndrome and possibly suggesting clues for future research in this field.
Language	English
Publishing date	2023-01-30
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms11020346
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Article ; Online: Real-life experience with remdesivir for treatment of COVID-19 among older adults: a multicentre retrospective study.

Margalit, Ili / Tiseo, Giusy / Ripa, Marco / Borghi, Vanni / Green, Hefziba / Prendki, Virginie / Riccardi, Niccolò / Perego, Giovanni Battista / Grembiale, Alessandro / Galli, Laura / Tinelli, Marco / Castagna, Antonella / Mussini, Cristina / Falcone, Marco / Yahav, Dafna

The Journal of antimicrobial chemotherapy

2023 Volume 78, Issue 6, Page(s) 1505–1509

Abstract: Introduction: The effect of remdesivir on COVID-19 mortality remains conflicting. Elderly individuals are at risk for poor COVID-19 outcomes. We aimed to assess the effect of remdesivir on COVID-19 mortality among elderly individuals, using real-world ... ...

Abstract	Introduction: The effect of remdesivir on COVID-19 mortality remains conflicting. Elderly individuals are at risk for poor COVID-19 outcomes. We aimed to assess the effect of remdesivir on COVID-19 mortality among elderly individuals, using real-world data. Methods: Retrospective multinational cohort of individuals aged ≥65 years, hospitalized with COVID-19 in six medical centres between January 2020 and May 2021. Associations with in-hospital mortality were evaluated using a multivariable logistic regression model with propensity score adjustment for remdesivir therapy and while implementing generalized estimating equations to control for centre effect. Sensitivity analysis was performed by stratification according to the degree of respiratory support. Results: Of 3010 individuals included, 2788 individuals required either oxygen supplementation or non-invasive/invasive mechanical ventilation, 489 (16%) were treated with remdesivir, and 836 (28%) died. Median age was 77 (IQR 70-84) years and 42% were women. Remdesivir was the only therapeutic intervention associated with decreased mortality [adjusted OR (aOR) 0.49, 95% CI 0.37-0.66, P < 0.001]. This protective effect was shown for individuals requiring oxygen support and non-invasive mechanical ventilation, while no association was found among individuals necessitating invasive mechanical ventilation.Risk factors for mortality included invasive ventilation (aOR 5.18, 95% CI 2.46-10.91, P < 0.001), higher serum creatinine (aOR 1.25, 95% CI 1.09-1.43, P = 0.001) and dyspnoea (aOR 1.40, 95% CI 1.07-1.84, P = 0.015) on presentation, and other non-modifiable factors, such as comorbidities. Conclusions: Among elderly individuals hospitalized with COVID-19, remdesivir carries survival benefit for those with moderate to severe disease. Its role among individuals with critical illness should be further assessed.
MeSH term(s)	Aged ; Humans ; Female ; Male ; COVID-19 ; COVID-19 Drug Treatment ; Retrospective Studies ; Hospital Mortality ; Antiviral Agents/therapeutic use ; Alanine/therapeutic use
Chemical Substances	remdesivir (3QKI37EEHE) ; Antiviral Agents ; Alanine (OF5P57N2ZX)
Language	English
Publishing date	2023-04-05
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	191709-2
ISSN	1460-2091 ; 0305-7453
ISSN (online)	1460-2091
ISSN	0305-7453
DOI	10.1093/jac/dkad118
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Zs.A 1197: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Bowel perforation in a Covid-19 patient: case report.

De Nardi, Paola / Parolini, Danilo C / Ripa, Marco / Racca, Sara / Rosati, Riccardo

International journal of colorectal disease

2020 Volume 35, Issue 9, Page(s) 1797–1800

Abstract: Introduction: Since the outbreak of novel coronavirus (2019-nCoV), it became evident that a proportion of patients may present with gastrointestinal symptoms.: Case: We report the case of a Covid-19-infected patient who, during recovery from the ... ...

Abstract	Introduction: Since the outbreak of novel coronavirus (2019-nCoV), it became evident that a proportion of patients may present with gastrointestinal symptoms. Case: We report the case of a Covid-19-infected patient who, during recovery from the pulmonary pneumonia, had gastrointestinal symptoms followed by a diastasic right colon perforation due to acute over distension of the bowel. Conclusion: This case highlights the importance of paying attention to initial gastrointestinal symptoms in order to prevent possible complications.
MeSH term(s)	Anastomosis, Surgical/methods ; COVID-19 ; Colectomy/methods ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Coronavirus Infections/therapy ; Emergencies ; Follow-Up Studies ; Humans ; Intestinal Perforation/complications ; Intestinal Perforation/diagnostic imaging ; Intestinal Perforation/surgery ; Laparotomy/methods ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/therapy ; Postoperative Care/methods ; Risk Assessment ; Severe Acute Respiratory Syndrome/complications ; Severe Acute Respiratory Syndrome/diagnosis ; Severe Acute Respiratory Syndrome/therapy ; Tomography, X-Ray Computed/methods ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2020-05-27
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-020-03627-6
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