Publications by authors named "Carlo Chezzi"

Matrix-Assisted Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) in the last decade has revealed itself as a valid support in the workflow in the clinical microbiology laboratory for the identification of bacteria and fungi, demonstrating high reliability and effectiveness in this application. Its use has reduced, by 24 h, the time to obtain a microbiological diagnosis compared to conventional biochemical automatic systems. MALDI-TOF MS application to the detection of pathogens directly in clinical samples was proposed but requires a deeper investigation, whereas its application to positive blood cultures for the identification of microorganisms and the detection of antimicrobial resistance are now the most useful applications.

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Even if malaria is rare in Europe, it is a medical emergency and programs for its control should ensure both an early diagnosis and a prompt treatment within 24-48 h from the onset of the symptoms. The increasing number of imported malaria cases as well as the risk of the reintroduction of autochthonous cases encouraged laboratories in non-endemic countries to adopt diagnostic methods/algorithms. Microscopy remains the gold standard, but with limitations.

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Respiratory tract infections (RTIs) are the focus of developments in public health, given their widespread distribution and the high morbidity and mortality rates reported worldwide. The clinical spectrum ranges from asymptomatic or mild infection to severe or fatal disease. Rapidity is required in diagnostics to provide adequate and prompt management of patients.

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  • The study investigates a Clostridioides difficile infection (CDI) outbreak in a Long-term Care Unit from February to March 2022, highlighting the emergence of clinically significant C. difficile strains.
  • A total of 143 fecal samples were analyzed, revealing C. difficile DNA in 51 samples from 46 patients, with 29 isolates identified, including three distinct clusters via a specialized typing method called T-MALDI.
  • The prevalent epidemic strain was characterized by susceptibility to vancomycin and metronidazole but resistance to moxifloxacin, producing specific toxins, marking the first documented outbreak of this unique toxin profile.
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We report the first Italian case of SARS-CoV-2 and influenza A virus super-infection. Laboratory diagnosis revealed the presence of both agents' RNA specific sequences by molecular methods and infectious influenza A virus by cell culture methods.

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  • The study examines the occurrence and prevalence of a protozoan called Dientamoeba fragilis over a 10-year period (2011-2020) in a tertiary-care hospital in Northern Italy, noting an increasing trend in cases.
  • Out of 16,275 suspected intestinal parasite cases, 606 were identified as Dientamoeba fragilis, accounting for a prevalence of 3.7% and showing a rise in the last five years.
  • The parasite was more commonly found in foreigners from developing countries and in children, with anal pruritus being the only significant clinical sign associated with it, emphasizing the need to include this protozoan in the differential diagnosis of gastrointestinal diseases.
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  • - The study investigates isolated anti-HBV core antigen antibody (anti-HBcAg) in subjects with persistent HBV infection but without detectable HBV surface antigen (HBsAg), highlighting underlying risks of liver disease.
  • - Among 33,048 participants tested at a virology unit in Italy, the prevalence of isolated anti-HBcAg was found to be 3.1%, with higher rates in males and Italians, particularly in outpatients.
  • - The findings suggest that those with isolated anti-HBcAg may have occult HBV infections or co-infections, emphasizing the need for further analysis and raising awareness of increasing HBV prevalence linked to migration from endemic regions.
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  • Acute gastroenteritis (AGE) poses significant health risks in children, with a study conducted in Parma, Italy, revealing that 56.2% of 2,066 children had identifiable pathogens in their stool samples between 2018 and 2020.
  • The most common pathogens identified were Enteropathogenic E. coli (EPEC), Clostridioides difficile, Norovirus, and Campylobacter, with infants and toddlers (0-5 years) being the most affected age group.
  • Notably, the incidence of detected pathogens declined significantly from 2018 to 2020, likely due to public health measures related to the COVID-19 pandemic.
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Accurate, prompt, and reliable tools for the diagnosis of malaria are crucial for tracking the successes or drawbacks of control and elimination efforts, and for future programs aimed at global malaria eradication. Although microscopy remains the gold standard method, the number of imported malaria cases and the risk of reappearance of autochthonous cases stimulated several laboratories located in European countries to evaluate methods and algorithms suited to non-endemic settings, where skilled microscopists are not always available. In this review, an overview of the field evaluation and a comparison of the methods used for the diagnosis of malaria by European laboratories is reported, showing that the development of numerous innovations is continuous.

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Colistin resistance is one of the major threats for global public health, requiring reliable and rapid susceptibility testing methods. The aim of this study was the evaluation of a MALDI-TOF mass spectrometry (MS) peak-based assay to distinguish colistin resistant (colR) from susceptible (colS) strains. To this end, a classifying algorithm model (CAM) was developed, testing three different algorithms: Genetic Algorithm (GA), Supervised Neural Network (SNN) and Quick Classifier (QC).

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  • * Out of nearly 23,000 patients monitored, 5% had CPKP-positive rectal swabs, and 3.1% had actual CPKP infections, with most infections found in those also carrying the bacteria.
  • * The findings highlighted a significant number of asymptomatic carriers, underscoring the need for ongoing surveillance, contact precautions, and appropriate antibiotic treatment to manage CPKP risks effectively.
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Typing methods are needed for epidemiological tracking of new emerging and hypervirulent strains because of the growing incidence, severity and mortality of infections (CDI). The aim of this study was the evaluation of a typing Matrix-Assisted Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS (T-MALDI)) method for the rapid classification of the circulating strains in comparison with polymerase chain reaction (PCR)-ribotyping results. Among 95 strains, 10 ribotypes (PR1-PR10) were identified by PCR-ribotyping.

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In this study, we investigated the involvement of keratin 8 during human influenza A/NWS/33 virus (H1N1) infection in semi-permissive rhesus monkey-kidney (LLC-MK2) and permissive human type II alveolar epithelial (A549) cells. In A549 cells, keratin 8 showed major expression and phosphorylation levels. Influenza A/NWS/33 virus was able to subvert keratin 8 structural organization at late stages of infection in both cell models, promoting keratin 8 phosphorylation in A549 cells at early phases of infection.

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  • * Out of 154 patients, 90 tested positive for SARS-CoV-2, with fungal infections more common in these patients compared to those who were SARS-CoV-2 negative.
  • * The overall mortality rate was 40.4%, with higher deaths among SARS-CoV-2 positives; the study noted differing patterns of infections between the two groups, possibly influenced by treatment approaches and ICU duration.
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  • The study aimed to identify the prevalence of respiratory virus infections, including SARS-CoV-2, from December 2019 to March 2020 in Parma, Northern Italy, using samples from a hospital.
  • Out of 906 samples, 52.3% tested positive for at least one virus, with respiratory syncytial virus and rhinovirus being the most common, while SARS-CoV-2 was detected in 82 samples starting late February 2020.
  • The research highlighted a contrasting pattern where common respiratory viruses predominantly affected children, while SARS-CoV-2 infections were mainly seen in adult males.
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Systemic sclerosis (SSc) is a severe autoimmune disorder characterized by vasculopathy and multi-organ fibrosis; its etiology and pathogenesis are still largely unknown. Herpesvirus infections, particularly by human cytomegalovirus (HCMV) and human herpesvirus 6 (HHV-6), have been suggested among triggers of the disease based on virological and immunological observations. However, the direct impact of HCMV and/or HHV-6 infection on cell fibrosis and apoptosis at the cell microenvironment level has not yet been clarified.

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SARS-CoV-2 emerged in China in December 2019 and has now been declared a pandemic by the World Health Organization. This paper described the case of a 7-week-old suckling baby from Italy who was SARS-CoV-2-positive only by the cell culture method, with no clinical suspicion of and/or risk factors for SARS-CoV-2 infection. The baby was referred to hospital, with signs and symptoms of upper respiratory tract infection, before the virus had spread to the province.

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The Accelerate Pheno™ System (APS), a new platform that combines rapid identification (ID) of bacteria and yeasts and phenotypic antimicrobial susceptibility testing (AST) in a single assay, has been evaluated directly from positive blood cultures in comparison to routine laboratory methods. The APS ID results showed an overall sensitivity and specificity of 92.6% and 99.

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Acute respiratory tract infections (ARTIs) are among the leading causes of morbidity and mortality in children. The viral etiology of ARTIs was investigated over 3 years (October 2012-September 2015) in 2575 children in Parma, Italy, using indirect immunofluorescent staining of respiratory samples for viral antigens, cell culture, and molecular assays. Respiratory viruses were detected in 1299 cases (50.

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Human cytomegalovirus (HCMV) is a highly prevalent opportunistic agent in the world population, which persists as a latent virus after a primary infection. Besides the well-established role of this agent causing severe diseases in immunocompromised individuals, more recently, HCMV has been evoked as a possible factor contributing to the pathogenesis of autoimmune diseases such as systemic sclerosis (SSc). The interplay between HCMV and immune surveillance is supposed to become unbalanced in SSc patients with expanded anti-HCMV immune responses, which are likely involved in the exacerbation of inflammatory processes.

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This study represents a 2-year picture of the epidemiology of enteric pathogens in children suffering from gastroenteritis using the FilmArray® Gastrointestinal Panel (FA-GP), a multiplex molecular assay that allows to simultaneously detect a large panel of pathogens independently of the etiological suspicion and to evaluate its potential contribution to the diagnosis compared to the conventional methods. A total of 1716 stool samples, collected from children with clinical suspicion of bacterial and/or viral gastroenteritis attending the University Hospital of Parma, was submitted to the FA-GP and, when an adequate aliquot was available, to electron microscopy (n = 1163) for virus detection and to an enterovirus-targeting real-time PCR (n = 1703). Specimens with positive results for Salmonella, Yersinia enterocolitica, Vibrio, diarrheagenic Escherichia coli/Shigella, Campylobacter, Plesiomonas shigelloides and/or parasites by the FA-GP were also submitted to conventional diagnostic methods.

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Background: Malaria is no longer endemic in Italy since 1970 when the World Health Organization declared Italy malaria-free, but it is now the most commonly imported disease. The aim of the study was to analyse the trend of imported malaria cases in Parma, Italy, during January 2013-June 2017, reporting also the treatment and the outcome of cases, exploring the comparison of the three diagnostic tests used for malaria diagnosis: microscopy, immunochromatographic assay (ICT) (BinaxNOW) and Real-time PCR assays detecting Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale curtisi, Plasmodium ovale wallikeri, and Plasmodium knowlesi.

Results: Of the 288 patients with suspected malaria, 87 were positive by microscopy: 73 P.

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Background: In this study for the first time, a Dientamoeba fragilis protein profile by MALDI-TOF MS was created in order to identify specific markers for the application of this technology in the laboratory diagnosis of dientamoebiasis. In particular, one D. fragilis reference strain was used to create a reference spectrum and 14 clinical isolates to verify the reliability of the obtained results.

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Viruses depend on cellular machinery to efficiently replicate. The host cytoskeleton is one of the first cellular systems hijacked by viruses in order to ensure their intracellular transport and promote the development of infection. Our previous results demonstrated that stable microfilaments and microtubules interfered with human influenza A/NWS/33 virus (H1N1) infection in semi-permissive LLC-MK2 cells.

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