Infezioni in Medicina最新文献

{"title":"MIS-C related to SARS-CoV-2 infection: a narrative review of presentation, differential diagnosis, and management.","authors":"Salika Gadiwala,&nbsp;Ayushi Mistry,&nbsp;Sejal Patel,&nbsp;Avanthika Chaithanya,&nbsp;Stuti Pathak,&nbsp;Travis Satnarine,&nbsp;Daria Bekina-Sreenivasan,&nbsp;Abdul Akim Bakarr,&nbsp;Bibhuti Bhusan Das,&nbsp;Raja Chandra Chakinala,&nbsp;Saurabhkumar Patel,&nbsp;Sathya Areti","doi":"10.53854/liim-3003-3","DOIUrl":"https://doi.org/10.53854/liim-3003-3","url":null,"abstract":"<p><p>Multisystem Inflammatory Syndrome in Children (MIS-C), a rare condition, has been reported approximately 2-4 weeks after the onset of COVID-19 in children and adolescents, causing inflammation in multiple systems, including cardiovascular and respiratory, digestive, and central nervous systems. This condition is also known as hyperinflammatory shock, Kawasaki-like disease, and Pediatric Inflammatory Multisystem Syndrome (PIMS). The signs and symptoms include but are not limited to fever, rash, peripheral edema, gastrointestinal symptoms, conjunctivitis, and shock. Thirty-eight studies met our criteria, with a total of 5822 patients. The most affected population was between 5-18 years of age. We noted that MIS-C presented with a wide range of signs and symptoms that overlap with Kawasaki Disease, including high fever, sore throat, malaise, tachypnea, tachycardia, conjunctival injection, mucosal edema, cardiac involvement, and gastrointestinal symptoms. It causes an increase in IL-17A, IL-6, and arterial damage, a distinct difference from Kawasaki disease. The laboratory findings in MIS-C showed an increase in inflammatory markers like CRP, ESR, ferritin, leukocytes, and TNF-α. WHO stated that 23% of affected children with MIS-C had underlying conditions like chronic lung diseases, cardiovascular disease, and immunosuppression. In most affected children, aspirin and IVIG were successful, which resulted in a decrease in the inflammatory markers. We find that MIS-C is a rare, but potentially fatal pediatric complication, after COVID-19 infection. The aim of this article is to study the emerging relationship between COVID-19 and MIS-C in children and adolescents affected by this condition, to discuss the immunological mechanisms, and explore potential therapies.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"30 3","pages":"344-352"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448305/pdf/1124-9390_30_3_2022_344-352.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33479277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment of pan-drug resistant <i>Acinetobacter baumannii</i> nosocomial meningitis/ventriculitis by combined intravenous and intrathecal colistin-tigecycline administration: a case series.","authors":"Andreas Theofanopoulos,&nbsp;Dionysia Fermeli,&nbsp;Dionysios Vekios,&nbsp;Aristeidis Bizos,&nbsp;Markos Marangos,&nbsp;Constantine Constantoyannis,&nbsp;Vasileios Panagiotopoulos,&nbsp;Stelios F Assimakopoulos","doi":"10.53854/liim-3101-14","DOIUrl":"https://doi.org/10.53854/liim-3101-14","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the efficacy of combined intraventricular and intravenous co-administration of colistin and tigecycline in the management of pan-drug resistant <i>Acinetobacter baumannii</i> meningitis/ventriculitis.</p><p><strong>Methods: </strong>In this case series we report 3 patients with healthcare-associated ventriculitis/meningitis caused by pan-drug resistant <i>Acinetobacter baumannii</i> that were treated with combined colistin and tigecycline administration through both intraventricular and intravenous routes.</p><p><strong>Results: </strong>All patients were administered colistin intraventricularly at a dose of 250.000 IU q.d. and intravenously at 9 million IU loading dose, followed after 12 hours by maintenance dose of 4.5 million IU every 12 hours and tigecycline intraventricularly at a dose of 10 mg b.i.d. and intravenously at 200 mg loading dose followed after 12 hours by 100 mg every 12 hours. In patients with a calculated creatinine clearance of less than 60 ml/min, according to the Cockcroft-Gault formula, the maintenance dose of colistin was reduced based on a modified formula. All patients had a favourable clinical and microbiological response with evidence of CSF sterilization.</p><p><strong>Conclusions: </strong>Taking advantage of the synergistic action of combined colistin and tigecycline through administration both intraventricularly and intravenously may be a promising salvage option for critically ill patients with pan-drug resistant <i>A. baumannii</i> CNS infection.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"31 1","pages":"103-107"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994833/pdf/1124-9390_31_1_2023_103-107.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gingival presentation of mucormycosis post infection with COVID-19: series of 3 cases.","authors":"Shruti Tandon,&nbsp;Anju Rana,&nbsp;Arundeep Kaur,&nbsp;Farrukh Faraz,&nbsp;Kamal Agarwal","doi":"10.53854/liim-3101-12","DOIUrl":"https://doi.org/10.53854/liim-3101-12","url":null,"abstract":"<p><p>Through the evolution of this global pandemic, it became increasingly clear that patients with pre-existing conditions such as diabetes mellitus, chronic kidney diseases (CKD), chronic cardiovascular disease, underlying malignancies, organ transplant recipients, and chronic liver disease are at increased risk for developing severe post COVID-19 complications. One such complication seen after COVID-19 is mucormycosis. Oral mucormycosis is a rare but highly fatal disease. Early diagnosis and timely treatment of rhinomaxillary mucormycosis are necessary to limit the spread of infection, which otherwise can lead to high morbidity and mortality. Dental healthcare practitioners should be familiar with its initial presentation, which if left undiagnosed or ignored can rapidly spread to the orbital and cerebral region leading to death. The case series describes the gingival clinical presentation in its initial stage, relevant basic clinical investigations, treatment, and the importance of an inter-professional team approach in the early management of patients with mucormycosis after post covid-19 infection.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"31 1","pages":"86-92"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994826/pdf/1124-9390_31_1_2023_086-092.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-existing chronic kidney disease (CDK) was not associated with a severe clinical outcome of hospitalized COVID-19: results of a case-control study in Southern Italy.","authors":"Federica Calò,&nbsp;Antonio Russo,&nbsp;Mariagrazia Palamone,&nbsp;Paolo Maggi,&nbsp;Enrico Allegorico,&nbsp;Ivan Gentile,&nbsp;Vincenzo Sangiovanni,&nbsp;Annamaria Russomando,&nbsp;Valeria Gentile,&nbsp;Giosuele Calabria,&nbsp;Raffaella Pisapia,&nbsp;Angelo Salomone Megna,&nbsp;Alfonso Masullo,&nbsp;Valentina Iodice,&nbsp;Grazia Russo,&nbsp;Roberto Parrella,&nbsp;Giuseppina Dell'Aquila,&nbsp;Michele Gambardella,&nbsp;Antonio Ponticiello,&nbsp;Mariantonietta Pisaturo,&nbsp;Nicola Coppola,&nbsp;On Behalf Of CoviCam Group","doi":"10.53854/liim-3004-8","DOIUrl":"https://doi.org/10.53854/liim-3004-8","url":null,"abstract":"<p><p>The presence of co-morbidities is associated with a poor outcome in patients with COVID-19. The aim of the present study was to investigate the outcomes of patients with SARS-CoV-2 infection and chronic kidney disease (CKD) in order to assess its impact on mortality and severity of disease. We performed a multicenter, observational, 1:2 matched case-control study involving seventeen COVID-19 Units in southern Italy. All the adults hospitalized for SARS-CoV-2 infection and with pre-existing CKD were included (Cases). For each Case, two patients without CKD pair matched for gender, age (+5 years), and number of co-morbidities (excluding CKD) were enrolled (Controls). Of the 2,005 patients with SARS-CoV-2 infection followed during the study period, 146 patients with CKD and 292 patients without were enrolled in the case and control groups, respectively. Between the Case and Control groups, there were no statistically significant differences in the prevalence of moderate (17.1% vs 17.8%, p=0.27) or severe (18.8% and 13.7%, p=0.27) clinical presentation of COVID-19 or deaths (20.9% vs 28.1%, p=0.27). In the Case group, the patients dead during hospitalization were statistically higher in the 89 patients with CKD stage 4-5 compared to 45 patients with stages 1-3 CKD (30.3% vs 13.3%, p=0.03). Our data suggests that only CKD stage 4-5 on admission was associated with an increased risk of in-hospital death.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"30 4","pages":"539-546"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714999/pdf/1124-9390_30_4_2022_539-546.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10433779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors for mortality in COVID-19 patients during the first wave of the COVID-19 pandemic in Rome, Italy: a single-center retrospective study.","authors":"Emanuele Rando,&nbsp;Alessandra Oliva,&nbsp;Francesca Cancelli,&nbsp;Claudia D'Agostino,&nbsp;Giulia Savelloni,&nbsp;Maria Rosa Ciardi,&nbsp;Camilla Ajassa,&nbsp;Guido Siccardi,&nbsp;Gioacchino Galardo,&nbsp;Claudio M Mastroianni","doi":"10.53854/liim-3101-7","DOIUrl":"https://doi.org/10.53854/liim-3101-7","url":null,"abstract":"<p><strong>Background: </strong>Since the beginning of 2020, the SARS-CoV-2 pandemic has become a serious public health problem. Numerous studies have highlighted the main clinical features of COVID-19, mainly the huge heterogeneity of the clinical manifestations that can vary from asymptomatic infection to serious viral pneumonia with a high mortality rate. The aim of this study was to analyze retrospectively the clinical characteristics and assess the risk factors for mortality in an Italian cohort of patients with COVID-19.</p><p><strong>Methods: </strong>Retrospective analysis including patients with COVID-19 admitted to the Infectious Diseases wards of Azienda Ospedaliera Universitaria Policlinico \"Umberto 1\", Rome, from March 2020 to May 2020. The data were part of an electronic anonymous web-based database processed by SIMIT (Italian Society of Infectious and Tropical Diseases).</p><p><strong>Results: </strong>258 patients were included in the analysis, and 34 (13.2%) died. The median age was 62 (IQR, 52-74), 106 (40%) were women, and 152 (60%) were males, 172 (66.7%) had at least one co-morbidity. The most common signs and symptoms were: fever [221 (85.6%)], cough [135 (52.3%)], and dyspnea [133 (51.5%)]. The PaO2/FiO2 ratio was often altered [352 (IQR, 308-424)]. Lymphopenia [lymphocyte counts, 875/μL (IQR, 640-1250)] and high levels of D-dimer [mg/dL, 874 (IQR, 484-1518)] were found. Non-survivors were older than survivors [median age, 74 (IQR, 67-85)] vs. 61 (QR, 51-72)], mostly men [25 (73.5%)] and more frequently with more than 2 comorbidities [21 (61.8%) vs. 94 (42.1%)]. In the multiple logistic regression model, the variables associated with in-hospital mortality were age [OR, 3.65 (95% CI, 1.22-10.89)], male gender [OR, 2.99 (95% CI, 1.18-7.54)], blood urea [OR, 2.76 (95% CI, 1.20-6.35)] and a low PaO2/FiO2 ratio [OR, 0.28 (95% CI, 0.12-0.62)].</p><p><strong>Conclusion: </strong>The mortality rate in COVID-19 was 13,2%. The risk factors associated with in-hospital mortality were advanced age, male sex, increased blood urea, and the PaO2/FiO2 ratio reduction.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"31 1","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994829/pdf/1124-9390_31_1_2023_049-054.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9095030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Aspergillus fumigatus</i> causing vertebral osteomyelitis in an immunocompetent patient: a case report and literature review.","authors":"Thomas A N Reed,&nbsp;Anan Shtaya,&nbsp;Kate Beard,&nbsp;Kordo Saeed,&nbsp;Sarah Glover,&nbsp;Mark Fabian,&nbsp;Mohammad Baraka,&nbsp;Stephen McGillion","doi":"10.53854/liim-3101-15","DOIUrl":"https://doi.org/10.53854/liim-3101-15","url":null,"abstract":"<p><p><i>Aspergillus</i> vertebral osteomyelitis causing deformity in immunocompetent patients is uncommon. We describe a previously healthy 68-year-old male who was referred after 2 years of lower thoracic back pain and gibbus. His inflammatory markers and HIV test were normal. Imaging demonstrated bony destruction of T12/L1 and L2 with vertebral collapse. Following inconclusive CT-guided biopsy, he underwent reconstructive spinal surgery. Histopathology showed fungi and <i>Aspergillus fumigatus</i> was cultured. He was treated with isavuconazole 200 mg once daily for 12 months with a satisfactory clinical outcome. We present a summary of recently published cases of atraumatic Aspergillus vertebral osteomyelitis in immunocompetent patients without risk factors. Fungal infection should be considered in culture-negative spondylodiscitis, even in the absence of risk factors.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"31 1","pages":"108-112"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994825/pdf/1124-9390_31_1_2023_108-112.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9099395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of point of care testing of procalcitonin in paediatric acute assessment.","authors":"Alasdair P S Munro,&nbsp;Charles Hungwe,&nbsp;Pratisksha Patel,&nbsp;Nick Ward,&nbsp;Simon Struthers,&nbsp;Kordo Saeed","doi":"10.53854/liim-3004-14","DOIUrl":"https://doi.org/10.53854/liim-3004-14","url":null,"abstract":"<p><strong>Objective: </strong>Febrile illnesses are a common cause of presentation in acute pediatrics, with biomarkers frequently used to help differentiate mild infections from serious bacterial infections (SBI). We aimed to see if a point of care test for procalcitonin could help to reduce antibiotic use and avoid unnecessary admission.</p><p><strong>Patients and methods: </strong>A point of care procalcitonin machine which produces results within 20 minutes was introduced to two pediatric assessment units across both sites of a secondary-care hospital trust, alongside guidance for when tested would be appropriate. We performed a prospective, observational, pilot service evaluation, of all children tested during the study period of November 2018 to March 2019. We collected data at the time of testing, including the indication for testing and plan prior to testing, then retrospectively collected outcome data for children tested including diagnosis, treatment and whether the child was admitted to hospital.</p><p><strong>Results: </strong>68 tests were performed over 5 months. There are differing denominators due to missing data. Children were predominantly male (40/68, 58.8%) and pre-school age (median age 2.9y, Q1-Q3 1.3-6.7). Severity of illness was low, with 7/54 (11.5%) triggering sepsis tools. The primary indication for testing was febrile illness with no source of infection and some concerning features (31/59, 52.5%). Following testing, 35/67 (52.5%) of patients were admitted and 31/67 (47.1%) had IV antibiotics. A low procalcitonin (<0.5 ng/L) was observed in 46/67 (69.1%) of patients, however 21/46 (45.7%) of these children were admitted and 16/46 (34.8%) were given IV antibiotics. Procalcitonin performed poorly at detecting SBIs in this cohort (result >0.5 ng/L for 1/5 SBIs).</p><p><strong>Conclusion: </strong>There was no clear impact of point of care procalcitonin on admission or antibiotic prescribing in this small pilot study. Clinicians often tested for reasons outside the recommended scenarios and often treated \"low risk\" patients, as determined by low procalcitonin, with antibiotics. These effects may be due to low familiarity with procalcitonin as a biomarker.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"30 4","pages":"587-592"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714994/pdf/1124-9390_30_4_2022_587-592.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10433784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroids use for COVID-19: an overview of systematic reviews.","authors":"Mario Cruciani,&nbsp;Ilaria Pati,&nbsp;Francesca Masiello,&nbsp;Simonetta Pupella,&nbsp;Vincenzo De Angelis","doi":"10.53854/liim-3004-1","DOIUrl":"https://doi.org/10.53854/liim-3004-1","url":null,"abstract":"<p><strong>Purpose: </strong>A reappraisal of the validity of the conclusions of systematic reviews (SRs) and meta-analyses related to corticosteroids use for the treatment of COVID-19.</p><p><strong>Material and methods: </strong>An overview of SRs (umbrella review). The methodological quality of the SRs was assessed using tha AMSTAR-2 checklist; quality of the evidence was appraised following the GRADE approach.</p><p><strong>Results: </strong>35 SRs were included in this overview. Data were from 307 overlapping reports, based on 121 individual primary studies (25 randomized clinical trials (RCTs), 96 non-RCTs. In critically ill patients the use of steroids significantly reduced mortality compared to standard of care in 80% of the SRs, more often with moderate/high level of certainty; however, in patients not requiring oxygen supplementation the use of steroids increased the overall mortality in 2/3 of the comparisons. Clinical progression of diseases (need for mechanical ventilation, or for intensive care admission) was more commonly observed among controls compared to steroids recipients (in 9 out of 14 comparisons; certainty of evidence from very-low to moderate). The occurrence of adverse events was similar among steroids recipients and controls. Other outcomes (<i>i.e</i>., viral clearance, length of hospital stay) or issue related to optimal dose and type of steroids were addressed in a minority of SRs, with a high level of uncertainty, so that no definitive conclusions can be drawn.</p><p><strong>Conclusions: </strong>There is moderate certainty of evidence that corticosteroids reduce mortality and progression of disease in critically ill COVID-19 patients compared to standard of care, without increasing the occurrence of adverse events.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"30 4","pages":"469-479"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714993/pdf/1124-9390_30_4_2022_469-479.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10433786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic evaluation of <i>Acinetobacter baumannii</i> ventilator-associated pneumonia in COVID-19.","authors":"Ilaria De Benedetto,&nbsp;Tommaso Lupia,&nbsp;Nour Shbaklo,&nbsp;Alessandro Bianchi,&nbsp;Erika Concialdi,&nbsp;Maurizio Penna,&nbsp;Silvia Corcione,&nbsp;Francesco Giuseppe De Rosa","doi":"10.53854/liim-3004-12","DOIUrl":"https://doi.org/10.53854/liim-3004-12","url":null,"abstract":"<p><strong>Background: </strong>Since the emergence of the pandemic of SARS-CoV-2, a high reported incidence of VAP in COVID-19 sustained by carbapenem resistant <i>Acinetobacter baumannii</i> (CRAB) has been observed, but data are scarce to date.</p><p><strong>Materials and methods: </strong>We retrospectively collected COVID-19 patients who developed CRAB-VAP - defined according to Center for Diseases Control (CDC) 2020 criteria and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) or Infectious Diseases Society of America (IDSA) guidelines - to describe characteristics and outcome.</p><p><strong>Results: </strong>Among 21 patients with CRAB-VAP in COVID-19, median age was 66 years (IQR 41-80). Median time of VAP-onset was 7 days (IQR 0-28 days) from ICU - admission and 76.2% had septic shock. Treatment regimens were all colistin-based, in 28% (n=6) including ampicillin/sulbactam and rifampicin. In three cases, cefiderocol was started as rescue. Survival rate at 28-days was 35% (n=7).</p><p><strong>Conclusion: </strong>Non-fermenting Gram-negative bacteria are an emerging aetiology of VAP in COVID-19 patients. This underscores the urgent need for proper microbiological identification to address therapies and infection control protocols.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"30 4","pages":"570-576"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715004/pdf/1124-9390_30_4_2022_570-576.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10373181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emergence of SARS-CoV-2 Omicron subvariants: current situation and future trends.","authors":"Ramadan Abdelmoez Farahat,&nbsp;Abdelaziz Abdelaal,&nbsp;Tungki Pratama Umar,&nbsp;Amro A El-Sakka,&nbsp;Amira Yasmine Benmelouka,&nbsp;Khaled Albakri,&nbsp;Iftikhar Ali,&nbsp;Tareq Al-Ahdal,&nbsp;Basel Abdelazeem,&nbsp;Ranjit Sah,&nbsp;Alfonso J Rodriguez-Morales","doi":"10.53854/liim-3004-2","DOIUrl":"https://doi.org/10.53854/liim-3004-2","url":null,"abstract":"<p><p>The SARS-CoV-2 Omicron variant (B.1.1.529) has been the most recent variant of concern (VOC) established by the World Health Organization (WHO). Because of its greater infectivity and immune evasion, this variant quickly became the dominant type of circulating SARS-CoV-2 worldwide. Our literature review thoroughly explains the current state of Omicron emergence, particularly by comparing different omicron subvariants, including BA.2, BA.1, and BA.3. Such elaboration would be based on structural variations, mutations, clinical manifestation, transmissibility, pathogenicity, and vaccination effectiveness. The most notable difference between the three subvariants is the insufficiency of deletion (Δ69-70) in the spike protein, which results in a lower detection rate of the spike (S) gene target known as (S) gene target failure (SGTF). Furthermore, BA.2 had a stronger affinity to the human Angiotensin-converting Enzyme (hACE2) receptor than other Omicron sub-lineages. Regarding the number of mutations, BA.1.1 has the most (40), followed by BA.1, BA.3, and BA.3 with 39, 34, and 31 mutations, respectively. In addition, BA.2 and BA.3 have greater transmissibility than other sub-lineages (BA.1 and BA.1.1). These characteristics are primarily responsible for Omicron's vast geographical spread and high contagiousness rates, particularly BA.2 sub-lineages.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":"30 4","pages":"480-494"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714996/pdf/1124-9390_30_4_2022_480-494.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10373182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}