C Viscoli

Publications (118)416.86 Total impact

• Article: Candidaemia in internal medicine departments: the burden of a rising problem.

  M Bassetti, M P Molinari, M Mussap, C Viscoli, E Righi
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  ABSTRACT: Although internal medicine wards (IMWs) represent a significant reservoir of patients with candidemia, few investigators have specifically addressed the epidemiological aspects of candidaemia in this population. Of all patients hospitalized during the study period with candidaemia, 133/348 (38%) were admitted to IMWs. Variables associated with IMWs included: antibiotic therapy prior to hospitalization, urinary or central venous catheter, parenteral nutrition, tumour and age >75 years. Overall, 30-day mortality in IMWs was significantly higher than that in other wards (51.1% vs. 38.2%, p <0.02). Multiple logistic regression analysis identified the administration of antifungal treatment 48 h after having the first positive BC as an independent determinant of hospital mortality. Patients with candidaemia in IMWs account for a substantial proportion of patients with candidaemia and have higher mortality compared with patients in other wards.
  Clinical Microbiology and Infection 01/2013; · 4.54 Impact Factor
• Article: Impact on bone mineral density of tenofovir-containing HAART in HIV-1 infected children and adolescents: a report from 5 years of clinical experience

  R Rosso, A Di Biagio, A Parodi, C Torrisi, F Ginocchio, F De Terlizzi, M Vignolo, C Viscoli
  Journal of the International AIDS Society 04/2012; 11:1-2. · 3.26 Impact Factor
• Article: Piperacillin/tazobactam (Tazocin™) seems to be no longer responsible for false-positive results of the galactomannan assay.

  M Mikulska, E Furfaro, V Del Bono, A M Raiola, S Ratto, A Bacigalupo, C Viscoli
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  ABSTRACT: Galactomannan (GM) testing is extremely useful for diagnosing invasive aspergillosis in high-risk patients, but false-positive results have been reported in patients treated with piperacillin/tazobactam. The aims of this study are to test if the recent piperacillin/tazobactam (Tazocin™; Pfizer) preparation still contains GM, and if serum GM positivity in haematopoietic stem cell transplant (HSCT) recipients receiving piperacillin/tazobactam can be attributed to this treatment. Serum samples obtained from 1 October 2009 to 31 October 2010 from HSCT recipients for GM testing were analysed. The difference in the rate of positive results (defined as GM ≥ 0.5) in patients receiving and not receiving piperacillin/tazobactam was evaluated. Piperacillin/tazobactam vials from randomly selected batches were tested. Of 1606 samples drawn in the absence of piperacillin/tazobactam therapy, 25 (1.6%) tested positive for GM versus 10 of 394 samples (2.5%) drawn while on piperacillin/tazobactam (P = 0.18). The median GM result of samples drawn on piperacillin/tazobactam was slightly higher than that of samples drawn in the absence of piperacillin/tazobactam (0.141 versus 0.122; P < 0.001). All 90 piperacillin/tazobactam vials from 30 randomly selected batches tested negative for GM, with a median GM value of 0.057 (range: 0.011-0.320). Although some residual GM might still be present in piperacillin/tazobactam, currently available brand piperacillin/tazobactam preparations seem no longer responsible for false-positive GM results.
  Journal of Antimicrobial Chemotherapy 04/2012; 67(7):1746-8. · 5.07 Impact Factor
• Article: Galactomannan: testing the same sample twice?

  E Furfaro, M Mikulska, F Miletich, C Viscoli
  Transplant Infectious Disease 04/2012; 14(4):E38-9. · 2.22 Impact Factor
• Article: Mortality after bloodstream infections in allogeneic haematopoietic stem cell transplant (HSCT) recipients.

  M Mikulska, V Del Bono, P Bruzzi, A M Raiola, F Gualandi, M T Van Lint, A Bacigalupo, C Viscoli
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  ABSTRACT: Bloodstream infections (BSIs) are frequent after allogeneic haematopoietic stem cell transplantation (HSCT). The aim of this study was to identify predictors of mortality after BSI in patients who undergo HSCT. Patients who underwent HSCT between 1 January 2004 and 31 January 2008 and developed BSI during the first year post-transplantation were included. Variables influencing overall mortality at 7 and 30 days after BSI were analysed. BSIs developed in 149 patients, within a median of 9 days after undergoing HSCT. Early and late mortality were 15 and 27%, respectively. Of the BSI, 54% were due to Gram-positive microorganisms, 33% were due to Gram-negative microogranisms, 10% were polymicrobial and 3% were fungal. The associated 7-and 30-day mortality was respectively 10 and 24% (Gram positive), 22 and 31% (Gram negative; Pseudomonas aeruginosa mortality 67%, all within 7 days), 13 and 27% (polymicrobial) and 40% (fungal, all within 7 days). Early mortality was higher in relapsed disease at HSCT (25.9%, p = 0.01), but lower in early (i.e. within 20 days of HSCT) BSI (11.7%, p = 0.03) and BSI due to Gram-positive infective agents (10%, p = 0.05). Multivariate analysis confirmed a higher mortality in late BSI [odds ratio (OR) 3.29, p = 0.03] and relapsed disease at HSCT (OR 2.2, p = 0.04). Late mortality was associated with the type of underlying disease (OR 0.44 for diseases other than acute leukaemia, p = 0.05) and its status (OR 6.04 for relapse at HSCT, p = 0.001). Appropriate empirical therapy was associated with lower early and late mortality in single Gram-negative BSI (16 vs. 45% for 7-day mortality, p = 0.09; 21 vs. 64% for 30-day mortality, p = 0.02). BSIs are frequent during the first year after HSCT and are associated with a high mortality rate. The aetiology influenced early mortality, while the type and phase of the underlying disease played a pivotal role in late mortality. Appropriate empirical therapy is crucial in BSI due to Gram-negative infective agents.
  Infection 12/2011; 40(3):271-8. · 2.66 Impact Factor
• Article: ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients.

  O Marchetti, F Lamoth, M Mikulska, C Viscoli, P Verweij, S Bretagne
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  ABSTRACT: As culture-based methods for the diagnosis of invasive fungal diseases (IFD) in leukemia and hematopoietic SCT patients have limited performance, non-culture methods are increasingly being used. The third European Conference on Infections in Leukemia (ECIL-3) meeting aimed at establishing evidence-based recommendations for the use of biological tests in adult patients, based on the grading system of the Infectious Diseases Society of America. The following biomarkers were investigated as screening tests: galactomannan (GM) for invasive aspergillosis (IA); β-glucan (BG) for invasive candidiasis (IC) and IA; Cryptococcus Ag for cryptococcosis; mannan (Mn) Ag/anti-mannan (A-Mn) Ab for IC, and PCR for IA. Testing for GM, Cryptococcus Ag and BG are included in the revised EORTC/MSG (European Organization for Research and Treatment of Cancer/Mycoses Study Group) consensus definitions for IFD. Strong evidence supports the use of GM in serum (A II), and Cryptococcus Ag in serum and cerebrospinal fluid (CSF) (A II). Evidence is moderate for BG detection in serum (B II), and the combined Mn/A-Mn testing in serum for hepatosplenic candidiasis (B III) and candidemia (C II). No recommendations were formulated for the use of PCR owing to a lack of standardization and clinical validation. Clinical utility of these markers for the early management of IFD should be further assessed in prospective randomized interventional studies.
  Bone marrow transplantation 09/2011; 47(6):846-54. · 3.00 Impact Factor
• Article: Risk factors and mortality of healthcare-associated and community-acquired Staphylococcus aureus bacteraemia.

  M Bassetti, E M Trecarichi, A Mesini, T Spanu, D R Giacobbe, M Rossi, E Shenone, G D Pascale, M P Molinari, R Cauda, C Viscoli, M Tumbarello
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  ABSTRACT: Staphylococcus aureus bacteraemia (SAB) is a leading cause of mortality and morbidity in both nosocomial and community settings. The objective of the study is to explore epidemiological characteristics and predisposing risk factors associated with healthcare-associated (HCA) and community-acquired (CA) SAB, and to evaluate any differences in mortality and efficacy of initial antimicrobial therapy on treatment outcome. We conducted a two-part analysis. First, a triple case-control study in which groups of HCA SAB with onset ≥ 48 h after hospital admission (HCA ≥ 48 h), HCA SAB with onset <48 h of hospital admission (HCA <48 h), and CA SAB were compared with controls. Second, a cohort study including all patients with SAB was performed to identify factors associated with in-hospital mortality. SAB was diagnosed in 165 patients over the study period (January 2007 to December 2007). Five variables were independently associated with HCA ≥ 48 h SAB: presence of central venous catheter, solid tumour, chronic renal failure, previous hospitalization and previous antibiotic therapy. Significant risk factors for HCA <48 h SAB were: Charlson Comorbidity Index ≥ 3, previous hospitalization, living in long-term care facilities and corticosteroid therapy. Factors independently associated with CA SAB were: diabetes mellitus, HIV infection and chronic live disease. Patients with HCA <48 h SAB were significantly more likely to receive initial inadequate antimicrobial treatment than patients with CA or HCA ≥ 48 h SAB (44.8% versus 33.3% and 31.5%, respectively). Logistic-regression analysis identified three variables as independent predictors of mortality: presentation with septic shock, infection with methicillin-resistant S. aureus, and initial inadequate antimicrobial treatment. More than half of patients with SAB have MRSA strains and presentation with septic shock, and inappropriate empirical therapy was associated with increased mortality.
  Clinical Microbiology and Infection 09/2011; 18(9):862-9. · 4.54 Impact Factor
• Article: Sequential outbreaks of multidrug-resistant Acinetobacter baumannii in intensive care units of a tertiary referral hospital in Italy: combined molecular approach for epidemiological investigation.

  F Ansaldi, P Canepa, M Bassetti, M Zancolli, M P Molinari, A Talamini, F Ginocchio, P Durando, M Mussap, G Orengo, C Viscoli, G Icardi
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  ABSTRACT: A laboratory-based surveillance study was conducted from January 2007 to May 2010 in San Martino Tertiary Referral Hospital in Genoa, Italy in which the molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the five intensive care units (ICUs). A total of 53 A. baumannii strains were isolated from patients admitted to ICUs (69.8%) and to other epidemiologically linked hospital wards (30.2%) and were genotyped by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), multilocus sequence typing (MLST) and adeB sequence typing. REP-PCR fingerprinting analysis, MLST and adeB typing results were well correlated and allowed us to classify strains causing epidemic events into three major epidemic clones: A (REP-I/ST4, adeB-STII genotype) isolated for the first time in May 2007, B (REP-IV/ST95, adeB-STI genotype) from November 2007 to May 2009 and C (REP-VII/ST118, adeB-STII genotype) from July 2008 to May 2010. MLST results demonstrated that epidemic clones A and C were related as they were members of the widespread clonal complex CC92. The genetic determinants of carbapenem resistance were investigated and resistance associated with the presence of the bla(OxA-58-like) gene with ISAba2 and ISAba3 elements flanking it in clone A, and with the bla(OxA-23-like) gene flanked by ISAba1 in clones B and C. A molecular approach allowed the prompt introduction of infection control measures and the evaluation of data in a global epidemiological context.
  The Journal of hospital infection 08/2011; 79(2):134-40. · 3.01 Impact Factor
• Article: Low dosage liposomal amphotericin B in the treatment of Candida infections in critically ill patients.

  M Bassetti, E Blasi, A Giarratano, F G DE Rosa, L Balzano, C Viscoli
  Journal of chemotherapy (Florence, Italy) 07/2011; 23(4):242. · 1.08 Impact Factor
• Article: Risk factors for chronic kidney disease among human immunodeficiency virus-infected patients: A European case control study.

  A Di Biagio, R Rosso, F Vitale, F Cardinale, M P Sormani, G Secondo, L Di Stefano, C Viscoli
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  ABSTRACT: Renal dysfunction is a common complication in human immunodeficiency virus (HIV)-infected patients and can be attributed to direct viral damage, comorbidities or drug toxicity. The aim of this study was to assess cross-sectional correlates of renal damage in a contemporary European cohort of patients. We performed a case-control study from our cohort of 750 HIV-infected adults over a period of 5 months. We assessed renal damage by either proteinuria (≥+ on urine dipstick), reduced creatinine clearance (< 60 ml/min) or reduced estimated glomerular filtration rate (eGFR) of < 60 ml/ min/1.73 m2. The characteristics of cases and controls were compared in analysis and in multivariate logistic regression models with stepwise selection. Approximately 50% of the screened 106 patients had a qualifying abnormality. Altogether, we identified 55 cases with 110 age- and gender-matched controls. Mean eGFR was 90.7 (4.8) for cases vs. 106.1 (2.3) ml/min/1.73 m2 for controls (p = 0.001). Cases had a longer duration of HIV infection, more complex regimen, longer exposure to antiretroviral therapy and a more frequent diagnosis of acquired immune-deficiency syndrome (AIDS) and hepatitis C virus (HCV) infection. In the logistic multivariate model, renal damage remained significantly associated with longer known duration of HIV infection (OR 2.88, 95% CI: 1.28 - 6.46, p = 0.01), AIDS defining condition (OR 1.09 95% CI: 1.03 - 1.16, p = 0.002) female gender (OR 2.01, 95% CI: 0.96 - 4.18, p = 0.06), and HCV infection (OR 2.12, 95% CI: 0.99 - 4.52, p = 0.05). Duration, antiretroviral regimen and coincidental HCV impacted the frequency of renal abnormalities in our patients.
  Clinical nephrology 06/2011; 75(6):518-23. · 1.17 Impact Factor
• Article: Measles outbreak in adults in Italy.

  Matteo Bassetti, Eva Schenone, Anna Calzi, Marco Camera, Laura Valle, Filippo Ansaldi, Gabriella Pagano, Claudio Viscoli
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  ABSTRACT: Several outbreaks of measles have been reported since 2007 both in Italy and elsewhere in Europe. The objective of this study was to analyze the characteristics of the cases of measles that were hospitalized at San Martino Hospital from January 2008 to April 2009. All suspected cases of measles from January 2008 to April 2009 were analyzed. Laboratory confirmation was attained by determination of measles-specific IgM antibodies with enzyme immunoassay and/or detection of the measles virus genome in throat swab or urine by nested polymerase chain reaction (PCR). In all, 114 patients with clinically suspected measles were observed and laboratory confirmation was obtained in 83 cases: 34 (34/83; 41%) by specific genome PCR; five (5/83; 6%) only by IgM antibodies and 44 (44/83; 53%) by both methods. The median age was 25 years (range 15-66). The vaccination status was known for 80/83 patients, amongst whom the proportion of unvaccinated was 90% (72/80). No severe complications were observed. The most common complications were nausea/vomiting in 28/83 (34%) and radiologically documented interstitial pneumonia in 22/83 (26%) cases. The median length of hospitalization was five days (range 1-9 days). Almost 90% of patients were aged 20 years and older and hence measles cannot be regarded solely as a childhood disease. Thus widespread high vaccination coverage would be required to prevent new outbreaks and hospitalizations in the adult population.
  Le infezioni in medicina: rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive 03/2011; 19(1):16-9.
• Article: Risk factors for severe complications of the novel influenza A (H1N1): analysis of patients hospitalized in Italy.

  M Bassetti, A Parisini, A Calzi, F M Bobbio Pallavicini, G Cassola, S Artioli, M Anselmo, G Pagano, G Rezza, C Viscoli
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  ABSTRACT: Eighty-one patients affected by the novel influenza A (H1N1), hospitalized in North-western Italy, were studied. The median age was 32 years (range 1-81 years). Fifty-six (69%) had an underlying medical condition, including lung disorders (asthma or chronic obstructive pulmonary disease) in 34% and obesity in 25%. Fifty percent of them had pneumonia, 12% were admitted to the intensive care unit and 3% died. Antiviral treatment was initiated in 75% of patients started within 48 h. Older age and lung and neurocognitive disorders were associated with severe disease and death.
  Clinical Microbiology and Infection 02/2011; 17(2):247-50. · 4.54 Impact Factor
• Article: Persistence of a positive (1,3)-beta-D-glucan test after clearance of candidemia in hematopoietic stem cell transplant recipients.

  M Mikulska, E Furfaro, V Del Bono, F Gualandi, M T Van Lint, F Miletich, A Bacigalupo, C Viscoli
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  ABSTRACT: In 6 hematopoietic stem cell transplant (HSCT) recipients with candidemia, the (1,3)-β-d-glucan (BG) test was positive a median of 2.5 days after a positive blood culture. Only in 1 patient did BG positivity precede positive blood cultures. BG concentrations decreased in patients with clinical response, but positive BG results persisted long after blood cultures became sterile (median, 48 days).
  Clinical and vaccine immunology: CVI 01/2011; 18(3):518-9. · 2.37 Impact Factor
• Article: Multidrug-resistant Pseudomonas aeruginosa bloodstream infections: risk factors and mortality.

  M Tumbarello, E Repetto, E M Trecarichi, C Bernardini, G De Pascale, A Parisini, M Rossi, M P Molinari, T Spanu, C Viscoli, R Cauda, M Bassetti
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  ABSTRACT: We retrospectively studied patients diagnosed with P. aeruginosa bloodstream infections (BSIs) in two Italian university hospitals. Risk factors for the isolation of multidrug-resistant (MDR) or non-MDR P. aeruginosa in blood cultures were identified by a case-case-control study, and a cohort study evaluated the clinical outcomes of such infections. We identified 106 patients with P. aeruginosa BSI over the 2-year study period; 40 cases with MDR P. aeruginosa and 66 cases with non-MDR P. aeruginosa were compared to 212 controls. Independent risk factors for the isolation of MDR P. aeruginosa were: presence of central venous catheter (CVC), previous antibiotic therapy, and corticosteroid therapy. Independent risk factors for non-MDR P. aeruginosa were: previous BSI, neutrophil count <500/mm3, urinary catheterization, and presence of CVC. The 21-day mortality rate of all patients was 33·9%. The variables independently associated with 21-day mortality were presentation with septic shock, infection due to MDR P. aeruginosa, and inadequate initial antimicrobial therapy.
  Epidemiology and Infection 01/2011; 139(11):1740-9. · 2.84 Impact Factor
• Article: Pulmonary cryptococcosis with severe eosinophilia in an immunocompetent patient.

  M Bassetti, M Mikulska, E Nicco, C Viscoli
  Journal of chemotherapy (Florence, Italy) 10/2010; 22(5):366-7. · 1.08 Impact Factor
• Source

  Available from: Floriana Campanile

  Article: Community associated methicillin resistant staphylococcus aureus (CA-MRSA) infective endocarditis in Italy.

  M Bassetti, E Nicco, M Malgorzata, C Viscoli, A Valbusa, D Bongiorno, F Campanile, S Stefani
  The Journal of infection 10/2010; 61(4):353-5. · 4.13 Impact Factor
• Article: Risk factors for enterococcal bacteremia in allogeneic hematopoietic stem cell transplant recipients.

  M Mikulska, V Del Bono, R Prinapori, L Boni, A M Raiola, F Gualandi, M T Van Lint, A Dominietto, T Lamparelli, P Cappellano, A Bacigalupo, C Viscoli
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  ABSTRACT: Bacteremia is a well known cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients and enterococci are among the most frequently isolated pathogens. The aim of this study was to identify risk factors for enterococcal bacteremia during the first 30 days after allogeneic HSCT. A retrospective case-control study was performed; for each case, 3 controls were randomly selected among 306 patients transplanted during the study period (January 1, 2004 to December 31, 2007). Odds ratios (OR) with 95% confidence intervals (CI) were calculated for variables influencing the risk for bacteremia. Overall, 33 patients developed enterococcal bacteremia, within a median of 9 days after HSCT (range, 2-24). The cumulative incidence was 10.8%. Multivariate analysis identified the following variables as risk factors for enterococcal bacteremia: donor and transplant type (greater risk for mismatched related or cord blood) (OR=8.98, 95% CI, 1.65-48.99 and OR=7.52, 95% CI, 1.56-36.31, respectively, P=0.047); severe (grades 3-4) mucositis (OR=9.04, 95% CI, 1.97-41.52, P=0.018); pharyngeal enterococcal colonization (OR=4.48, 95% CI, 1.11-18.03, P=0.035); and previous empirical therapy with cephalosporins (OR=4.16, 95% CI, 0.93-18.66 for 1-7 days of therapy, and OR=7.31, 95% CI, 1.78-30.12 for 8-23 days, P=0.018). Higher Karnofsky score (≥50) and previous empirical therapy with glycopeptides were associated with a decreased risk (OR=0.25, 95% CI, 0.06-0.97, P=0.045 and OR=0.11, 95% CI, 0.02-0.59, P=0.010, respectively). The crude mortality at 7 and 30 days was 12% (4/33) and 24% (8/33), respectively. Enterococcal bacteremia is frequent after allogeneic HSCT. The factors associated with this infection are type of transplant, pharyngeal colonization, severe mucositis, and use of cephalosporins. Good general conditions and the use of vancomycin were associated with lower risk of enterococcal bacteremia.
  Transplant Infectious Disease 07/2010; 12(6):505-12. · 2.22 Impact Factor
• Source

  Available from: Hamdi Akan

  Article: Caspofungin first-line therapy for invasive aspergillosis in allogeneic hematopoietic stem cell transplant patients: an European Organisation for Research and Treatment of Cancer study.

  R Herbrecht, J Maertens, L Baila, M Aoun, W Heinz, R Martino, S Schwartz, A J Ullmann, L Meert, M Paesmans, O Marchetti, H Akan, L Ameye, M Shivaprakash, C Viscoli
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  ABSTRACT: Caspofungin at standard dose was evaluated as first-line monotherapy of mycologically documented probable/proven invasive aspergillosis (IA) (unmodified European Organisation for Research and Treatment of Cancer/Mycosis Study Group criteria) in allogeneic hematopoietic SCT patients. The primary efficacy end point was complete or partial response at end of caspofungin treatment. Response at week 12, survival and safety were additional end points. Enrollment was stopped prematurely because of low accrual, with 42 enrolled and 24 eligible, giving the study a power of 85%. Transplant was from unrelated donors in 16 patients; acute or chronic GVHD was present in 15. In all, 12 patients were neutropenic (<500/microl) at baseline, 10 received steroids and 16 calcineurin inhibitors or sirolimus. Median duration of caspofungin treatment was 24 days. At the end of caspofungin therapy, 10 (42%) patients had complete or partial response (95% confidence interval: 22-63%); 1 (4%) and 12 (50%) had stable and progressing disease, respectively; one was not evaluable. At week 12, eight patients (33%) had complete or partial response. Survival rates at week 6 and 12 were 79 and 50%, respectively. No patient had a drug-related serious adverse event or discontinued because of toxicity. Caspofungin first-line therapy was effective and well tolerated in allogeneic hematopoietic SCT patients with mycologically documented IA.
  Bone marrow transplantation 07/2010; 45(7):1227-33. · 3.00 Impact Factor
• Article: Hospital-acquired infections and leading pathogens detected in a regional university adult acute-care hospital in Genoa, Liguria, Italy: results from a prevalence study.

  P Durando, M Bassetti, G Orengo, P Crimi, A Battistini, G Tiberio, D Bellina, A Talamini, F Dodi, F Ansaldi, C Alicino, R Iudici, L Sticchi, D De Florentiis, C Viscoli, G Icardi
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  ABSTRACT: A prevalence study aimed to update the epidemiological scenario of Hospital-Acquired Infections (HAI) was performed at the San Martino University Hospital of Genoa, the Regional Reference Adult-care Center in Liguria, Italy, with more than 1300 beds. The investigation was performed in all the wards, except the Psychiatric Units, between 19th March and 6Ih April, 2007, using a one-day monitoring system for each ward. International standardized criteria and definitions for the surveillance of HAI were used for the collection of data, which were recorded in specific software for subsequent consolidation, analysis and quality control. The hospital infection control staff actively monitored 912 inpatients: a total of 84 HAI among 72 patients were diagnosed, with an overall prevalence of infections and affected cases of 9.2% (95% CI: 7.3-11.1) and 7.9% (95% CI: 6.1-9.7), respectively. Urinary Tract Infections (UTI) (30.9%), Respiratory Tract Infections (RTI) (28.6%) and Blood Stream Infections (BSI) (21.4%) were found to be the most frequent infections. As expected, both specific prevalence and localization of HAI varied considerably between wards, with the highest values recorded in Intensive Care Units (ICU) and in Functional Rehabilitation wards. RTI (26.3%) and BSI (13.2%) were found primarily represented in ICU, while the highest values of UTI (13.3%) were registered in Functional Rehabilitation Units. Enterococcus spp. (16.8%), Candida spp. (14%), Pseudomonas spp. (12.2), Staphylococcus aureus (10.7%), Escherichia coli (10.3%) and Coagulase-negative staphylococci (CNS) (9.3%) were the most frequent pathogens isolated. The overall rate of administration of antibiotics was 55.3% and penicillin (26.7%), cephalosporins (22.8%) and fluoroquinolones (17.9%) were found to be the leading antibacterial administered. Results of the present study have been, and are currently, used for orientating surveillance and control hospital policies, planning activities according to a rational and evidence-based approach.
  Journal of preventive medicine and hygiene 06/2010; 51(2):80-6.
• Source

  Available from: Maura Faraci

  Article: Performance of the galactomannan antigen detection test in the diagnosis of invasive aspergillosis in children with cancer or undergoing haemopoietic stem cell transplantation.

  E Castagnola, E Furfaro, I Caviglia, M Licciardello, M Faraci, F Fioredda, P Tomà, R Bandettini, M Machetti, C Viscoli
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  ABSTRACT: Serum galactomannan (GM) antigen detection is not recommended for defining invasive aspergillosis (IA) in children undergoing aggressive chemotherapy or allogeneic haemopoietic stem cell transplantation (HSCT). The ability of the GM test to identify IA in children was retrospectively evaluated in a cohort of children. Test performance was evaluated on samples that were collected during 195 periods at risk of IA. Proven IA was diagnosed in seven periods, all with positive GM test results (true positives, 4%), and possible IA was diagnosed in 15 periods, all with negative GM test results (false negatives, 8%). The test result was positive with negative microbiological, histological and clinical features in three periods (false positives, 1%), and in 170 periods it was negative with negative microbiological, histological and clinical features (true negatives, 87%). The sensitivity was 0.32 and the specificity was 0.98; the positive predictive value was 0.70 and the negative predictive value was 0.92. The efficiency of the test was 0.91, the positive likelihood ratio was 18.3, and the negative likelihood ratio was 1.4. The probability of missing an IA because of a negative test result was 0.03. Test performance proved to be better during at-risk periods following chemotherapy than in periods following allogeneic HSCT. The GM assay is useful for identifying periods of IA in children undergoing aggressive chemotherapy or allogeneic HSCT.
  Clinical Microbiology and Infection 02/2010; 16(8):1197-203. · 4.54 Impact Factor