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Publications (4)6.05 Total impact

  • E C Repetto, C G Giacomazzi, F Castelli
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    ABSTRACT: Fungi can cause severe infections. Two or more nosocomial unusual fungal infections diagnosed in a short period should be assumed as an outbreak. The review's aim was to collect data to improve their management. The free online worldwide database for nosocomial outbreaks ( http://www.outbreak-database.com ) and the PubMed/MEDLINE database were used to collect the English literature published from 1990 to June 2011. The more common Candida spp. and Aspergillus spp. infections were excluded. For each outbreak, the following data were reviewed: species, duration, source and site of infection, ward, risk factors, number of patients infected, treatment, related mortality, type of epidemiological study and time elapsed between index cases and second cases. Thirty-six reports were considered: yeasts caused the majority of the outbreaks (16 out of 36). The median values for the overall duration, number of infected people per outbreak and infection-related mortality were 5 months, 4 and 20 %, respectively. Eighteen cases were caused by contaminated substances and 13 cases were hypothesised as human-transmitted. Nosocomial outbreaks due to rare fungal pathogens involve few patients but have high related mortality. These results could be explained by the diagnostic delay, the inability of recognising the source of the infections and the challenges of the treatment. More efforts should be concentrated to implement the application of proper hygiene practices to avoid human-human transmission.
    European Journal of Clinical Microbiology 06/2012; 31(11):2897-904. · 3.02 Impact Factor
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    ABSTRACT: A case of septic shock due to Gemella spp in a patient with a probable rhino-pharyngeal cancer-abscess is described. Gemellae have been associated to severe infections such as endocarditis and meningitis but septic shock has been usually considered a rare finding. Well-known risk factors for Gemellae bacteremia are neutropenia, antibiotic prophylaxis and proton pumps inhibitors, but reports in patients with solid cancers are increasing and the presence of a damaged oral mucosa could help their dissemination. The hypothesis that Gemellae may be encountered as opportunistic pathogens in immunocompromised patients and a preventive approach to these infections are suggested.
    J Med Cases. 01/2012; 2012 (3)(3):178-180.
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    ABSTRACT: We describe the greatest Italian human acute opisthorchiasis outbreak acquired from eating raw tenches. Out of 52 people with suspected opisthorchiasis, 45 resulted in being infected. The most frequent symptoms and laboratory findings were fever, abdominal pain and eosinophilia. Seven tri-phasic computed tomography (CT) scans were done, showing multiple hypodense nodules with hyper-enhancement in the arterial phase. All patients took one day of praziquantel 25 mg/kg TID without failures. Reported symptoms suggested a febrile eosinophilic syndrome with cholestasis rather than a hepatitis-like syndrome. It seems common to find hepatic imaging alterations during acute opisthorchiasis: CT scan could be the most suitable imaging examination. Even if stool test remains the diagnostic gold standard, we found earlier positivity with the serum antibody test. Without previous freezing, the consumption of raw freshwater fish should be avoided.
    European Journal of Clinical Microbiology 09/2011; 31(6):1089-93. · 3.02 Impact Factor
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    Ernestina C Repetto, Antonio Traverso, Claudio G Giacomazzi
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    ABSTRACT: Artemisinin-combination therapies (ACTs) are recommended for the treatment of uncomplicated malaria in endemic areas with multidrug resistant Plasmodium falciparum. We report a case of possible artemether-lumefantrine clinical failure in an Italian traveler with uncomplicated P. falciparum malaria imported from Democratic Republic of Congo.
    Mediterranean Journal of Hematology and Infectious Diseases 01/2011; 3(1):e2011041.