Alfredo Chiarini

Università degli studi di Palermo, Palermo, Sicily, Italy

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Publications (5)8.93 Total impact

  • Article: A combined molecular typing approach does not discriminate Legionella pneumophila serogroup 1 strains of a predominant sequence-based type in Palermo, Italy.
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    ABSTRACT: The sequence-based type 1,4,3,1,1,1 of Legionella pneumophila sg.1 is predominant in the Palermo city environment since several years. In this study, extended sequence-based typing and pulsed field gel electrophoresis were used in a combined approach in the aim to enhance discriminatory power of the molecular typing procedures. However, probably due to a common environmental reservoir and genetic stability, most of the strains circulating in the geographic area under study belong to the same clone and are, consequently, indistinguishable by molecular typing. Investigations of clinical cases and tracing to their environmental source require caution and support from sound epidemiological data.
    Journal of infection and public health. 01/2009; 2(4):184-8.
  • Article: Detection of bacterial and yeast species with the Bactec 9120 automated system with routine use of aerobic, anaerobic, and fungal media.
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    ABSTRACT: During the period 2006 and 2007, all blood cultures required by four units at high infective risk and most of those required by other units of the University Hospital of Palermo, Palermo, Italy were performed using a Bactec 9120 automated blood culture system with a complete set of Plus Aerobic/F, Plus Anaerobic/F, and Mycosis IC/F bottles. The aim of the study was to enable the authors to gain firsthand experience of the culture potentialities of the three different media, to obtain information regarding the overall and specific recovery of bacteria and yeasts from blood cultures in the hospital, and to reach a decision as to whether and when to utilize anaerobic and fungal bottles. Although very few bloodstream infections (1.8%) were associated with obligate anaerobes, the traditional routine use of anaerobic bottles was confirmed because of their usefulness, not only in the detection of anaerobes, but also in that of gram-positive cocci and fermentative gram-negative bacilli. In this study, Mycosis IC/F bottles detected 77.4% of all the yeast isolates, 87.0% of yeasts belonging to the species Candida albicans, and 45.7% of nonfermentative gram-negative bacilli resistant to chloramphenicol and tobramycin. In order to improve the diagnosis of fungemia in high-risk patients, the additional routine use of fungal bottles was suggested when, as occurred in the intensive-care unit and in the hematology unit of the University Hospital of Palermo, high percentages of bloodstream infections are associated with yeasts, and/or antibiotic-resistant bacteria and/or multiple bacterial isolates capable of inhibiting yeast growth in aerobic bottles.
    Journal of clinical microbiology 11/2008; 46(12):4029-33. · 4.16 Impact Factor
  • Article: European Sero-Epidemiology Network 2: standardisation of immunoassay results for pertussis requires homogeneity in the antigenic preparations.
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    ABSTRACT: A standardisation process, already developed during the earlier European Sero-Epidemiology Network (ESEN) project, was employed with a more robust algorithm to harmonise results of pertussis serological assays performed in 12 European and non-European countries. Initially, results from each country's own assay were compared with those obtained at the reference laboratory by means of an in-house pertussis toxin (PT)-based ELISA: seven countries used in-house or commercial PT-ELISAs; the other countries used assays based on Bordetella pertussis whole cell extracts (WCE) (three countries) or on combined PT-FHA (filamentous haemagglutinin) antigenic preparations (two countries). The WCE assays, although admitted for diagnostic purposes, confirmed their low correlation with the PT-ELISAs and their results could not be used for standardisation; the PT-FHA ELISAs gave results that were suitable for standardisation in one country but unsatisfactory in the other; the use of purified PT in serological assays confirmed its better reliability than other preparations and all PT-ELISAs results could be calibrated against those of the reference centre. In the standardisation process two high-titre cut-offs indicative of likelihood of recent infection (from within 4 weeks of disease onset up to 1 year after) were included for evaluations as they are suggested to be more useful, for the sero-epidemiological assays of immunity to pertussis, than the cut-off of protection, commonly employed, but still not defined for pertussis. Providing PT-ELISAs are used, standardisation of pertussis assay results is always possible and, when standardisation is performed, evaluation and comparison of the impact of different interventions can be also allowed, by measuring at the distribution of high antibody titres in the populations.
    Vaccine 08/2008; 26(35):4486-93. · 3.77 Impact Factor
  • Article: Genotyping of Legionella pneumophila serogroup 1 strains isolated in Northern Sicily, Italy.
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    ABSTRACT: During a three-year period, from April 2002 to May 2005, one hundred-forty-seven samples, taken from technical systems of water distribution at point of use, were repeatedly collected at six different sites in Northern Sicily and assayed for the presence of Legionella pneumophila serogroup 1 and serogroups 2 to 14. At the first samplings, the water distribution systems of all the sites were heavily contaminated, and disinfection treatments by the superheat and flush method were therefore performed. Treatments were always successful against L. pneumophila sg.1, but only in a few cases against all other serogroups. Eighty-six strains of L. pneumophila sg. 1, isolated from 26 of these samples, were characterized by amplified fragment length polymorphism (AFLP) analysis and sequence-based typing (SBT) procedure. Perfectly overlapping results were obtained by both the procedures and four genotypes were identified, accounting for all the isolates. The easy transferability of the SBT data through a web-based database made it possible to identify the presence in Northern Sicily of the two SBT types most commonly circulating in Europe.
    The new microbiologica: official journal of the Italian Society for Medical, Odontoiatric, and Clinical Microbiology (SIMMOC) 05/2008; 31(2):217-28. · 1.00 Impact Factor
  • Article: Immunity to diphtheria in the 3–19 year age group in Italy
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    ABSTRACT: In Italy, immunization with diphtheria toxoid has been compulsory for all newborns since 1939. The last two clinical cases of diphtheria were reported in 1987. During the period 1987–1989, immunity against diphtheria was assessed by neutralization test in a random sample of 1740 healthy subjects 3–19 years old, from five geographical areas of Italy. Of the total population, 76.5% showed antibody levels considered to be protective (⩾0.1 IU ml−1), 17.2% had a relative degree of protection (0.01–0.09 IU ml−1), and 6.3% lacked immunity (<0.01 IU ml−1). The percentage of unprotected subjects increased from 6.1% in the age group of 3–5 years to 11.4% in the age group of 18–19 years (p < 0.01). A smaller proportion of males (5.3%) than of females (7.2%) was unprotected, but this difference was not statistically significant. Subjects residing in the south and the islands were more likely to be unprotected than those residing in the north (7.4 versus 4.1%, p < 0.01). No association was found between lack of protective antibodies and family size (odds ratio 1.35, confidence interval 95% = 0.77–2.36). However, paternal education of less than 12 years was associated with a higher prevalence of non-responders. In order to maintain a high degree of immunity in the adult population, a routine adult booster dose of diphtheria toxoid is advisable.
    Vaccine.