Publications by authors named "Chironna Maria"

Article Synopsis
  • Respiratory syncytial virus (RSV) significantly affects adults over 65, leading to hospitalizations and complications, prompting a study in Italy to evaluate its impact in primary care settings.
  • The study involved 152 older patients with acute respiratory infections, finding that 21.7% tested positive for RSV, with a median illness duration of 14 days and a high rate of further healthcare consultations.
  • The results underline the importance of an RSV surveillance system for older adults to improve vaccination strategies and inform public health planning, showcasing the need for cost-effectiveness evaluations in managing healthcare resources.
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  • An emerging yeast species poses a significant threat to global health, with the first case of candidemia reported in Southern Italy.
  • Whole genome sequencing (WGS) was used to analyze two strains from infected patients, revealing high genetic similarity to strains found in Lebanon.
  • Environmental sampling in an ICU showed a concerning 46.1% positivity rate for this yeast, emphasizing the urgent need for enhanced infection control measures.
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  • Respiratory Syncytial Virus (RSV) primarily affects young children, especially those under 24 months old, causing severe respiratory infections, and is a global health concern according to the WHO; Nirsevimab, a long-acting monoclonal antibody, has been approved to prevent RSV in infants.
  • A narrative review compiled effectiveness data on Nirsevimab, assessing the strengths and limitations of existing studies while focusing on its potential for disease prevention.
  • The findings from the studies indicate that Nirsevimab is effective in real-world settings, significantly lowering hospitalizations and ICU admissions for RSV, though challenges related to supply and study variability remain; ongoing research is essential to evaluate its long-term effectiveness and
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Background: Influenza B/Yamagata viruses exhibited weak antigenic selection in recent years, reducing their prevalence over time and requiring no update of the vaccine component since 2015. To date, no B/Yamagata viruses have been isolated or sequenced since March 2020.

Methods: The antibody prevalence against the current B/Yamagata vaccine strain in Italy was investigated: For each influenza season from 2012/2013 to 2021/2022, 100 human serum samples were tested by haemagglutination inhibition (HAI) assay against the vaccine strain B/Phuket/3073/2013.

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RSV infection causes severe respiratory illness and mortality in the elderly, especially in the presence of comorbidities. Early identification of infection would result in appropriate clinical-therapeutic management, avoiding hospitalizations, the risk of healthcare-associated infections, and inappropriate antibiotic prescriptions, thus reducing healthcare costs and fighting antimicrobial resistance. The aim of this study was to assess RSV hospitalizations in subjects >64 years hospitalized in a large tertiary care hospital in Southern Italy, in order to assess their usefulness as a proxy for targeting a potential vaccination strategy.

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Objectives: A new variant of echovirus 11 (E11) infection is a major health concern in neonates. Here, we describe the clinical and virological characteristics of enterovirus (EV) infections in children hospitalized with acute respiratory infection in Southern Italy.

Methods: Between July 2022 and August 2023, 173 EV infections were identified.

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Introduction: Human respiratory syncytial virus (RSV) is one of the most frequent causes of respiratory infections in children under 5 years of age, but its socioeconomic impact and burden in primary care settings is still little studied.

Methods: During the 2022/2023 winter season, 55 pediatricians from five Italian regions participated in our community-based study. They collected a nasal swab for RSV molecular test from 650 patients under the age of 5 with acute respiratory infections (ARIs) and performed a baseline questionnaire.

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Background: Respiratory syncytial virus (RSV) infection in children under 5 years have a significant clinical burden, also in primary care settings. This study investigates the epidemiology and burden of RSV in Italian children during the 2019/20 pre-pandemic winter season.

Methods: A prospective cohort study was conducted in two Italian regions.

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Background: The question of whether influenza vaccine effectiveness (VE) wanes over the winter season is still open and some contradictory findings have been reported. This study investigated the possible decline in protection provided by the available influenza vaccines.

Research Design And Methods: An individual-level pooled analysis of six test-negative case-control studies conducted in Italy between the 2018/2019 and 2022/2023 seasons was performed.

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Article Synopsis
  • A study investigated an outbreak of extensively drug-resistant Klebsiella pneumoniae (NDM-KP) in Southern Italy from 2020 to 2022, focusing on genomic surveillance of the bacteria.
  • Out of 459 carbapenem-resistant isolates tested, 22.6% carried the NDM gene, with high genetic similarity found in a subgroup of 27 isolates, all showing resistance to first-line antibiotics.
  • The findings highlight the urgent need for genomic surveillance and infection control measures in healthcare settings to manage the risks posed by these hypervirulent strains.
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West Nile virus (WNV) is a public health concern in Europe. Rising temperatures and the migration of potential vectors promote the spread of viruses to previously unaffected areas. In 2023, the Apulia region of Southern Italy experienced an unexpected increase in West Nile neuroinvasive disease (WNND); no such cases had been reported in the previous 10 years.

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Background: The gastrointestinal (GI) tract represents one of the main targets of typical hemolytic uremic syndrome (HUS) in children. In this observational study, we tried to establish (1) the main features of GI complications during STEC-HUS and (2) the relationship between Escherichia coli serotypes and Shiga toxin (Stx) variants with hepatopancreatic involvement.

Methods: A total of 79 STEC-HUS patients were admitted to our pediatric nephrology department between January 2012 and June 2021.

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Article Synopsis
  • Elderly patients with severe COVID-19 showed reduced T-cell diversity and weaker immune responses compared to younger patients, highlighting age-related vulnerabilities in fighting the virus.
  • The study used advanced sequencing techniques to analyze T-cell responses in both COVID-19 patients and individuals with inborn errors of immunity who received an mRNA vaccine, revealing specific genetic associations affecting these responses.
  • Findings indicated that mRNA vaccines successfully enhanced the T-cell responses in individuals with immune deficiencies, suggesting their effectiveness even in populations that struggle to develop strong immune responses on their own.
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Background: The impact of seasonal influenza vaccination (SIV) on mortality is still controversial; some studies have claimed that increasing vaccination coverage rates is beneficial, while others have found no significant association. This study aimed to construct a granular longitudinal dataset of local VCRs and assess their effect on pneumonia- and influenza-related (P&I) mortality among Italian adults aged ≥ 65 years.

Methods: NUTS-3 (nomenclature of territorial units for statistics) level data on SIV coverage were collected via a survey of local data holders.

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Evidence-based, standard antibiotic therapy for ventilator-associated pneumonia (VAP) caused by carbapenem-resistant (CRAB) is a relevant unmet clinical need in the intensive care unit (ICU). We aimed to evaluate the effectiveness of first-line therapy with old and novel CRAB active antibiotics in monomicrobial VAP caused by CRAB. A prospective, observational study was performed in a mixed non-COVID-19 ICU.

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Article Synopsis
  • Bronchiolitis is a leading cause of hospitalizations in infants, largely due to RSV, with this study focused on infants in the Apulia region of Italy in 2021.
  • Data was collected from 349 infants aged 0-12 months, finding that a significant majority were under 3 months old and required oxygen support, with high hospitalization rates peaking in November.
  • The study highlighted that younger infants faced worse outcomes, including higher rates of needing intensive care and longer hospital stays, underscoring the severity of bronchiolitis in this age group.
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Multisystem inflammatory syndrome in children (MIS-C) is a pediatric hyperinflammatory syndrome related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection whose epidemiology is not very well known at present. The objective of the study was to better understand the incidence of MIS-C in the Apulia region in southern Italy. Our primary goal was to estimate the incidence of newly identified cases of MIS-C in children aged 0-18 years, during a period of six months, encompassing the second pandemic wave.

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Background & Aims: Hepatitis A virus (HAV) infections are considered not to trigger innate immunity in vivo, in contrast to hepatitis C virus (HCV). This lack of induction has been imputed to strong interference by HAV proteases 3CD and 3ABC. We aimed to elucidate the mechanisms of immune activation and counteraction by HAV and HCV in vivo and in vitro.

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Global mitigation strategies to tackle the threat posed by SARS-CoV-2 have produced a significant decrease of the severity of 2020/21 seasonal influenza, which might result in a reduced population natural immunity for the upcoming 2021/22 influenza season. To predict the spread of influenza virus in Italy and the impact of prevention and control measures, we present an age-structured Susceptible-Exposed-Infectious-Removed (SEIR) model including the role of social mixing patterns and the impact of age-stratified vaccination strategies and Non-Pharmaceutical Interventions (NPIs) such as school closures, partial lockdown, as well as the adoption of personal protective equipment and the practice of hand hygiene. We find that vaccination campaigns with standard coverage would produce a remarkable mitigation of the spread of the disease in moderate influenza seasons, making the adoption of NPIs unnecessary.

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Objective: Oral lesions received increased attention as likely new signs or secondary manifestations of COVID-19. Therefore, we clinically examined oral cavity of patients with COVID-19 and investigated oral lesions and patient comorbidities as possible risk factors of COVID-19 disease outcome.

Methods: From January to March 2022, a prospective study was conducted by recruiting all COVID-19 patients admitted to the Intensive Care Unit and Respiratory Intensive Care Unit of Maxi-Emergencies Hospital in Bari, Italy.

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Following an extremely low incidence of influenza during the first waves of the ongoing COVID-19 pandemic, the 2021/22 Northern Hemisphere winter season saw a resurgence of influenza virus circulation. The aim of this study was to describe epidemiology of severe acute respiratory infections (SARIs) among Italian adults and estimate the 2021/22 season influenza vaccine effectiveness. For this purpose, a test-negative case-control study was conducted in a geographically representative sample of Italian hospitals.

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Article Synopsis
  • - The monkeypox virus has surged as a public health concern since May 2022, leading to cases in areas where it’s not typically found.
  • - A unique case during this outbreak involved a patient who developed paraphimosis—a painful condition affecting the penis—due to lesions from the monkeypox virus.
  • - The patient was treated successfully with a surgical procedure without needing antiviral medication, highlighting the importance of a collaborative medical approach for managing unusual monkeypox cases.
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