The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) (NEW MICROBIOL)

Publications in this journal

• Article: Viral vectors: a look back and ahead on gene transfer technology.

  Laura Vannucci, Michele Lai, Flavia Chiuppesi, Luca Ceccherini-Nelli, Mauro Pistello
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  ABSTRACT: No matter what their origin, strain and family, viruses have evolved exquisite strategies to reach and penetrate specific target cells where they hijack the cellular machinery to express viral genes and produce progeny particles. The ability to deliver and express genetic information to cells is the basis for exploiting viruses as "Trojan horses" to genetically modify the natural cell target or, upon manipulation of the viral receptor to retarget the virus, to genetically engineer different cell types. This process, known as transduction, is accomplished using viral vectors derived from parental wild type viruses whose viral genes, essential for replication and virulence, have been replaced with the heterologous gene(s) required for cell manipulation. Rearrangement of the viral genome to impede replication or generation of infectious virions but maintaining the ability to deliver nucleic acids has been the object of intense research since the early 1980s. Technological advances and the ever-growing knowledge of molecular virology and virus-host cell relationships have constantly improved the safety profile of viral vectors that are now used in vitro and in vivo to study cellular gene function, correct genetic defects (gene therapy), express therapeutic proteins, vaccinate against infectious agents and tumors, produce experimental animal models, and for other purposes. This review illustrates the strategies used to generate some of the most used viral vectors, and their advantages, limitations and principal applications.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):1-22.
• Article: Migration patterns of HIV-1 subtype B virus in Northern Italy.

  Alessandra Lo Presti, Massimo Ciccozzi, Eleonora Cella, Marta Giovanetti, Gianguglielmo Zehender, Daniela Valenti, Nathalie Iannotti, Emanuele Malfatto, Claudia Bernardini, Franco Maggiolo, Annapaola Callegaro
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  ABSTRACT: Gene flow analysis is used to identify the migration patterns of viruses within a geographical area and /or in different populations. 883 HIV-1 B subtype pol gene sequences were analyzed. The gene analysis among different geographical areas of the Bergamo district and from different transmission risk groups showed 25% of the observed gene flow was from people living in the north valleys to lowland and 40.5% from a heterosexual risk group to injecting drug users. Injecting drug users seem to be the central link, mercenary sex being the common route of transmission (and gene flow) between this group and both heterosexual and homosexual individuals.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):75-9.
• Article: Detection of serum IgA to HSV1 and its diagnostic role in sudden hearing loss.

  Guido Scalia, Concetta Ilenia Palermo, Luigi Maiolino, Carmela Maria Costanzo, Domenica Zappal, Caterina Grillo, Anna Maria Martines, Salvatore Cocuzza, Raffaela Russo, Agostino Serra
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  ABSTRACT: A viral etiology of sudden hearing loss has been hypothesized by many authors. HSV1 neurotropism and its involvement in sudden hearing loss has implicated HSV1 as one of the most accredited etiological agents. A non-invasive method such as the titration of HSV1-specific IgA was evaluated to determine the role of HSV1 as a possible cause sudden hearing loss. A prospective study was carried out by titration of serum IgA to HSV1 in 93 patients and in a control group of 50 healthy subjects and 35 subjects suffering from recent herpes labialis reactivation. Statistical analysis of the results disclosed that IgA titers to HSV1 higher than 1:80 are suggestive for the association of HSV1 infection and sudden hearing loss. Moreover, acyclovir therapy was effective in 81% of patients who showed high specific IgA titers. Overall, the titration of specific serum IgA to HSV1 can be a useful tool to determine the viral etiology of certain cases of sudden hearing loss. This method is simple to perform and minimally invasive. It can lead to a rapid presumptive diagnosis and to prompt specific therapy, reducing the need for corticosteroids.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):41-7.
• Article: Methicillin-resistant Staphylococcus aureus clones in Brazil.

  Marcelo J Mimica
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):107.
• Article: Multifocal diffusion of a KPC-3 producing ST512 K. pneumoniae clone in Northern Italy.

  Roberta Migliavacca, Elisabetta Nucleo, Sara Asticcioli, Erminia Casari, Silvia Bracco, Maria C Sironi
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  ABSTRACT: Sequence Type 258 (ST258) together with its allelic single- and double-locus variants have mostly been associated with the dissemination of KPC-producing Klebsiella pneumoniae in Europe. A total of 56 nonreplicate K. pneumoniae isolates with decreased carbapenem-susceptibility, collected at 7 different hospitals located in Northern Italy were investigated for the occurrence of blaKPC-type genes. PCR and sequencing results highlighted the presence of blaKPC2 or blaKPC-3 determinants in 10/56 and 5/56 cases respectively. Here we describe the intra- and inter-hospital spread in Northern Italy of a K. pneumoniae ST512 clone harboring the blaKPC-3 gene.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):109-10.
• Article: When phylogenetic analysis complements the epidemiological investigation: a case of HIV-2 infection, Italy.

  Massimo Ciccozzi, Annapaola Callegaro, Alessandra Lo Presti, Eleonora Cella, Marta Giovanetti, Romina Salpini, Muhammed Babakir-Mina, Claudio Farina, Franco Maggiolo, Carlo Federico Perno, Marco Ciotti
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  ABSTRACT: Human immunodeficiency virus type 2 (HIV-2) infection is geographically restricted, affecting West African countries such as Guinea- Bissau and Cape Verde. We describe a recent case of HIV-2 infection in an Italian patient. Phylogenetic analysis of the V3 region of HIV-2 indicated that the Italian patient was infected by HIV-2 subtype A2. The sequence obtained from the Italian patient clustered significantly with a sequence isolated from Senegal. A phylogenetic doubt may arise from a Guinea Bissau sequence because it was in a major clade with the Italian and Senegal sequences, but was not statistically significant. The discovery of another Italian case over a short time frame stresses the importance of strengthening the surveillance system for HIV-2 because of the increase in migration from endemic areas to Italy.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):93-6.
• Article: Management of HIV infection after triple class failure.

  Francesca Cossarini, Vincenzo Spagnuolo, Nicola Gianotti, Alessia Carbone, Adriano Lazzarin, Antonella Castagna
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  ABSTRACT: Resistance of Human Immunodeficiency Virus (HIV) to antiretrovirals is a clinically important issue despite the availability of five antiretroviral drug classes. Although the incidence of HIV resistance might have stabilized or even decreased in patients starting their first Highly Active Antiretroviral Therapy (HAART) regimen in recent years, the prevalence of failure to the three original antiretroviral classes is estimated to range from 2.1% to 16% after HAART initiation. International guidelines recommend the use of at least two active drugs in constructing a new antiretroviral regimen to obtain virologic success, and adding a compound with a different mechanism of action often increases the chances of virologic response. With the introduction of new drug classes and new-generation compounds of older classes in the antiretroviral armamentarium, the chances of achieving virologic success in patients with resistance to all three original antiretroviral classes are certainly higher than in the past. Patients who experience virologic failure and show resistance to new antiretrovirals are, however, described both in randomized trials and clinical settings. Although HAART regimens using various associations of the newest antiretrovirals led to very high rates of virologic success in patients with previous failure to all three original drug classes, there are circumstances in which patients cannot benefit from two fully active drugs, especially after prior exposure to several suboptimal therapies or functional monotherapies. These patients often need a holding regimen while awaiting new and effective antiretrovirals. This article reviews strategies that might be effective options to obtain virologic success in patients with triple class failure, and treatment strategies for patients who do not have two active drugs to construct a new effective antiretroviral regimen after virologic failure.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):23-39.
• Article: Real-time polymerase chain reaction with melting analysis of positive blood culture specimens in bloodstream infections: diagnostic value and turnaround time.

  Silvia Angeletti, Giovanni Gherardi, Lucia De Florio, Alessandra Avola, Francesca Crea, Elisabetta Riva, Massimiliano Andrea Vitali, Sara Galluzzo, Giordano Dicuonzo
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  ABSTRACT: A Real-time polymerase chain reaction (PCR) with melting analysis was devised to target bacterial and fungal genes together with the most prevalent antimicrobial resistance genes in 250 positive blood culture broths. This method allowed the blood culture cultivated pathogens to be classified into clinically relevant groups such as Enterobacteriaceae, oxidase-positive bacilli, oxidase-positive coccobacilli, S. aureus and yeast. Enterococci and streptococci could be distinguished from CoNS only by the Gram stain. Gram-positive bacilli were discriminated from Gram-positive cocci by Gram stain. Furthermore, the most important antimicrobial resistant genes such as mecA, vanA, bla TEM , bla SHV and bla CTX-M could be identified. All results were obtained with a turnaround time of three hours from the moment of blood culture positivity compared to 24-72 hours for phenotypic methods. In conclusion, the proposed approach can allow the clinician to implement proper early management of sepsis patients.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):65-74.
• Article: Detection of Simkania negevensis in cell culture by using a monoclonal antibody.

  Manuela Donati, Maria Di Paolo, Simone Avanzi, Antonietta Di Francesco, Natascia Fiani, Alison Favaroni, Martina Caracciolo, Roberto Cevenini
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  ABSTRACT: In the present study, a monoclonal antibody (mAb), D5-14, raised in our laboratory against Chlamydia trachomatis LGV2 serotype, stained Simkania negevensis inclusions in S. negevensis-infected cells by using the immunofluorescence test. D5-14 mAb, reacting in immunoblot with an approximately 64-66-kDa protein of C. trachomatis LGV2 serotype, recognized a protein with the same molecular mass when tested with S. negevensis elementary bodies.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):85-8.
• Article: Seroprevalence of West Nile virus antibodies in blood donors living in the metropolitan area of Milan, Italy, 2009-2011.

  Paolo Gaibani, Anna Pierro, Giovanna Lunghi, Claudio Farina, Vincenzo Toschi, Caterina Matinato, Anna Orlandi, Antonella Zoccoli, Daniela Almini, Maria Paola Landini, Erminio Torresani, Vittorio Sambri
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  ABSTRACT: A seroprevalence study for anti-West Nile virus-specific antibodies was carried out in healthy blood donors resident in the metropolitan area of Milan in two different years, 2009 and 2011. In 2009 no positive sera were found, whereas 5 positive sera were found in 2011, revealing viral circulation in this naive area. The seroprevalence rate identified in 2011 was 0.57%, suggesting that the area of WNV circulation in Italy is larger than that previously identified.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):81-3.
• Article: Comparative analysis of different methods to detect Clostridium difficile infection.

  Adriana Calderaro, Mirko Buttrini, Monica Martinelli, Chiara Gorrini, Sara Montecchini, Maria Cristina Medici, Maria Cristina Arcangeletti, Flora De Conto, Silvia Covan, Carlo Chezzi
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  ABSTRACT: The increased incidence and severity of Clostridium difficile infection, particularly in North America and Europe, have brought renewed focus on the most appropriate method to detect C. difficile and/or its toxins in stools. This prospective study evaluated the usefulness of the Illumigene TM C. difficile assay in diagnostic practice for the detection of toxigenic C. difficile DNA in clinical samples. A total of 88 out of 306 stool samples analysed were positive both by Illumigene and the combination of toxigenic C. difficile culture (TC) and immunochromatographic assay (IC) with a concordance of 100%. Of the 218 samples negative by the combination of TC and IC, 204 were negative also by Illumigene with a concordance of 93.57%. In our experience, compared to conventional assays Illumigene assay proved to be easy to perform, accurate and prompt giving results within 1 hour at a cost of 28 euro per sample.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):57-63.
• Article: Acute pancreatitis in children and rotavirus infection. Description of a case and minireview.

  Salvatore Giordano, Gregorio Serra, Piera Dones, Maria Di Gangi, Maria Concetta Failla, Chiara Iaria, Filippo Ricciardi, Lucia Maria Pernice, Dario Pantaleo, Antonio Cascio
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  ABSTRACT: This report describes a case of acute pancreatitis in a 2-year-old boy following rotavirus gastroenteritis. Its characteristics are analyzed and discussed in the light of another 4 cases of pancreatitis associated with rotavirus infection found through a systematic review of the international literature. None of the five children underwent surgery or was referred to an intensive care unit and all 5 children recovered with normalization of pancreatic enzymes within 5-10 days. The pathogenesis of this rare complication remains unsettled, and its actual incidence may be higher than reported. Although acute pancreatitis associated with rotavirus gastroenteritis seems to be a mild disease, attention must be paid by the pediatrician fearing possible complications. Rotavirus infection should be amended to the differential diagnosis panel of pancreatitis in toddlers.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):97-101.
• Article: Immune reconstitution inflammatory syndrome involving the central nervous system in a patient with HIV infection: a case report and review of literature.

  Lorenzo Zaffiri, Rajanshu Verma, Kevin Struzzieri, Joanne Monterroso, Donald H Batts, Mark E Loehrke
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  ABSTRACT: IRIS is described as a paradoxical deterioration of clinical status upon initiation of combined anti-retroviral therapy (cART) in patients with HIV infection. Immune reconstitution inflammatory syndrome (CNS-IRIS) involving the central nervous system is rarely reported. We describe the case of 57-year-old man who developed a fatal case of CNS- IRIS. A rapid deterioration of neurological status was associated with progression of patchy T2-weighted hyperintensities involving different vascular territories on brain MRI. Diagnosis of CNS-IRIS is based of laboratory and radiologic findings, however brain biopsy is supportive. Despite immune restoration being involved in clinical deterioration, discontinuation of cART is not recommended. The use of corticosteroids is highly controversial. Prompt recognition of CNS-IRIS is crucial for preventing neurological complications and ensuing sequelae.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):89-92.
• Article: Imported hantavirus cardiopulmonary syndrome in an Italian traveller returning from Cuba.

  Francesca Rovida, Elena Percivalle, Antonella Sarasini, Guido Chichino, Fausto Baldanti
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  ABSTRACT: Hantavirus hemorrhagic fever with renal syndrome is endemic in Europe and Asia, while hantavirus cardiopulmonary syndrome (HCPS) is endemic in Northern, Central and Southern America. The first case of imported HCPS involving an Italian traveller returning from Cuba is reported.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 01/2013; 36(1):103-5.
• Article: HIV-1 Non-B subtypes in Italy: a growing trend.

  Massimo Ciccozzi, Maria Mercedes Santoro, Marta Giovanetti, Laura Andrissi, Ada Bertoli, Marco Ciotti
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  ABSTRACT: Sequence analysis plays an important role in the management of patients chronically infected with HIV-1. Knowledge of the viral genotype and drug resistance mutations is crucial for the correct management of these patients. From this point of view, the experience of researchers in the HIV-1 field and the introduction of the HIV-1 genotyping resistance test has been fundamental. Several molecular tools are available to assist the provider in interpreting genotypic test results including phylogenetics. However, it should be remembered that antiretroviral drug designs, resistance studies and interpretation systems have been largely based on HIV-1 subtype B, which has been historically the most prevalent subtype in Western countries. Due to increased migration towards Europe, especially from Africa and South- East Asia, the molecular epidemiology of HIV-1 in Western Europe, including Italy, is changing. HIV-1 non-B subtypes have entered Europe and their prevalence has increased over the last years. In Italy, the estimated percentage of infection with non-B subtypes ranges from 2.4 % to 19.4%. However, the true prevalence of HIV-1 non-B subtypes in this country is still not well known and probably underestimated. This may have important clinical and diagnostic implications. A strict molecular epidemiological survey and a reinforced sequencing strategy are required.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 10/2012; 35(4):377-86.
• Article: HAART simplification with lopinavir/ritonavir monotherapy in HIV/HCV co-infected patients starting anti-HCV treatment: a randomised pilot study (KaMon study).

  Hamid Hasson, Laura Galli, Giulia Gallotta, Valentina Neri, Perluigi Blanc, Marco D'Annunzio, Giulia Morsica, Salvatore Sollima, Marco Merli, Adriano Lazzarin, Caterina Uberti-Foppa
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  ABSTRACT: The aim of this randomised, prospective, open-label, multicentre pilot clinical trial was to compare the 48-week toxicity profile of lopinavir/ritonavir (LPV/r) monotherapy with LPV/r�based HAART (KaMon = Kaletra monotherapy) in HIV/HCV patients undergoing HCV treatment. The study involved 30 HIV/HCV co-infected patients na�ve to anti- HCV therapy. One patient in each arm (6.7%) discontinued anti-HCV therapy because of adverse events. There were no significant between-group differences in terms of the proportion of patients experiencing AEs (p=0.999) or the number of grade 3-4 AEs (p=0.146). No HIV failure was observed. The safety profile of LPV/r monotherapy was similar to that of LPV/r�based HAART, thus encouraging HAART simplification in patients receiving anti-HCV treatment.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 10/2012; 35(4):469-74.
• Article: First detection of Brucella canis infections in a breeding kennel in Austria.

  Erwin Hofer, Zolt N Bag, Sandra Revilla-Fern Ndez, Falk Melzer, Herbert Tomaso, Igniacio L Pez-Go I, Gerhard Fasching, Friedrich Schmoll
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  ABSTRACT: Brucella canis occurs almost worldwide and is a potential danger to the health of dogs and humans. The pathogen was detected in the placenta and fetuses of a Standard Poodle by direct culture and immunohistochemistry. Further, Brucellae were also isolated from the blood samples of two asymptomatic female Medium Poodles. The isolates were identified as B. canis by conventional microbiological methods and a novel Bruce-ladder multiplex PCR. Genotyping was performed by multiple locus variable number tandem repeats analysis (MLVA).
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 10/2012; 35(4):507-10.
• Article: Antiretroviral molecules and cardiovascular diseases.

  Davide Gibellini, Marco Borderi, Alberto Clò, Silvia Morini, Anna Miserocchi, Isabella Bon, Maria Carla Re
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  ABSTRACT: Antiretroviral therapy has effectively tackled HIV replication and prevented the development of AIDS-related complications in the majority of HIV-positive patients. This pharmacological approach has dramatically increased the life expectancy of HIV-positive subjects transforming HIV infection into a chronic disease. Notwithstanding this major improvement in HIV disease management, several HIV-positive patients show an earlier and significant onset of agingrelated chronic conditions such as cardiovascular disease, osteoporosis, diabetes and neoplasias with respect to uninfected individuals. In particular, cardiovascular diseases are associated with both HIV infection and antiretroviral treatment, and represent major clinical complications in HIV-positive patients. Here, we discuss the interaction between antiretroviral therapy and cardiovascular system in HIV-positive patients focusing on the antiretroviral-related mechanisms involved in cardiovascular alterations.
  The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 10/2012; 35(4):359-75.