Publications by authors named "Oltolini C"

Article Synopsis
  • Invasive fungal infections (IFIs) are a significant health issue for patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), and Isavuconazole (ISA) is a safe antifungal treatment option being studied in combination with sirolimus.
  • This retrospective analysis looked at 51 allo-HSCT patients treated with both ISA and sirolimus over about five years, focusing on the effectiveness, safety, and monitoring of drug levels.
  • Results showed that ISA was effective in treating IFIs, with a 68% response rate after 90 days, and no significant drug interaction toxicities were reported when both drugs were administered at therapeutic levels.
View Article and Find Full Text PDF

Purpose: Cardiac implantable electronic device (CIED) infections are increasingly common. Gram-positive bacteria such as coagulase negative staphylococci and Staphylococcus aureus are the most commonly involved pathogens. The aim of this study was to describe the characteristics and outcome of patients with CIED infections who underwent device removal and were empirically treated with high dose (8-12 mg/kg daily) daptomycin (DAP) in combination with ceftriaxone (CRO).

View Article and Find Full Text PDF

Background: Disseminated non-tuberculous mycobacteria (dNTM) infections are mostly reported among individuals with an underlying congenital or acquired immunodeficiency or receiving immunosuppressive treatment, but are rarely documented in otherwise healthy subjects.

Case Presentation: We describe a case of recurrent disseminated mycobacterial infection in an apparently immunocompetent Chinese woman. Mycobacterium szulgai and Mycobacterium avium-complex were identified in distinct episodes.

View Article and Find Full Text PDF
Article Synopsis
  • - Cefiderocol, a new antibiotic, is effective against carbapenem-resistant Gram-negative bacteria but lacks real-world usage data concerning therapy types and patient demographics.
  • - A study of 200 cases found that cefiderocol was primarily used as targeted therapy (72.5%) rather than empirical (27.5%) and was administered equally as monotherapy (50.5%) and in combination (49.5%).
  • - The findings highlight that specific patient histories, like previous infections and conditions, influence the choice between monotherapy and combination therapy, emphasizing the need for better guidelines and further studies on treatment efficacy.
View Article and Find Full Text PDF
Article Synopsis
  • - Bruton tyrosine kinase inhibitors (BTKi) and venetoclax have notably improved outcomes for chronic lymphocytic leukemia (CLL) patients, but the impact of these treatments on infection rates needs more exploration.
  • - Infections classified as grade ≥3 were seen in 11.4%-30% of treatment-naive and relapsed/refractory CLL patients receiving BTKi, while those on venetoclax-based therapy had varied rates peaking around 20%.
  • - Although severe or fatal infections were rare, understanding the factors that contribute to increased infection risk in CLL patients may guide better prevention strategies.
View Article and Find Full Text PDF

Central nervous system (CNS) lesions, especially invasive fungal diseases (IFDs), in immunocompromised patients pose a great challenge in diagnosis and treatment. We report the case of a 48-year-old man with acute myeloid leukaemia and probable pulmonary aspergillosis, who developed hyposthenia of the left upper limb, after achieving leukaemia remission and while on voriconazole. Magnetic resonance imaging (MRI) showed oedematous CNS lesions with a haemorrhagic component in the right hemisphere with lepto-meningitis.

View Article and Find Full Text PDF

This large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs.

View Article and Find Full Text PDF

CLL is associated with an increased risk of infectious complications. Treatment with BTK or BCL-2 inhibitors does not seem to increase significantly the risk of opportunistic infections, but the role of combination therapies including BTK and/or BCL-2 inhibitors remains to be established. Various infectious complications can be successfully prevented with appropriate risk management strategies.

View Article and Find Full Text PDF

Letermovir prophylaxis revolutionized the approach to Cytomegalovirus infection in adult hematopoietic stem cell transplant (HCT), while data in pediatric setting are still lacking. We retrospectively analyzed 87 HCT children transplanted in 11 AIEOP centers receiving letermovir as off-label indication between January 2020 and November 2022. Letermovir was used as primary, secondary prophylaxis or CMV treatment in 39, 26 and 22 cases, respectively; no discontinuation due to toxicity was reported.

View Article and Find Full Text PDF
Article Synopsis
  • Invasive fungal diseases (IFDs) are a significant cause of mortality in patients with hematological conditions like AML and MDS, particularly during chemotherapy and after stem cell transplants.
  • Mold-active antifungal prophylaxis (MAP) is the standard care, though breakthrough infections (b-IFDs) like invasive aspergillosis remain a pressing issue.
  • A study of 184 AML/MDS patients showed a 1.7% incidence of b-IFDs while undergoing high-dose chemotherapy with posaconazole, highlighting ongoing challenges in diagnosis and treatment adaptations in a rapidly changing medical landscape.
View Article and Find Full Text PDF

Introduction: The severe acute respiratory syndrome coronavirus-2 pandemic significantly affected clinical practice, also in pediatric oncology units. Cancer patients needed to be treated with an adequate dose density despite the SARS-CoV-2 infection, balancing risks of developing severe COVID-19 disease.

Areas Covered: Although the pandemic spread worldwide, the prevalence of affected children was low.

View Article and Find Full Text PDF
Article Synopsis
  • The study looked at how carbapenem resistance in a type of bacteria called Klebsiella pneumoniae affects how many people survive after getting a blood infection.
  • Out of 426 patients, 25% had a more dangerous version of the bacteria, and those patients had higher death rates compared to those with a less resistant version.
  • The research showed that the type of treatment given didn't really change the survival chances, suggesting that in certain areas, the treatment might be good enough for both types of bacteria.
View Article and Find Full Text PDF

Vaccination with Bacillus Calmette-Guérin (BCG) can be harmful to patients with combined primary immunodeficiencies. We report the outcome of BCG vaccination in a series of twelve patients affected by adenosine deaminase deficiency (ADA-SCID). BCG vaccination resulted in a very high incidence of complications due to uncontrolled replication of the mycobacterium.

View Article and Find Full Text PDF

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) in SARS-CoV-2 positive candidates is usually delayed until the clinical resolution of the infection's symptoms and a negative nasopharyngeal molecular test. However, prolonged SARS-CoV-2 positivity has been frequently observed in haematological malignancies, thus representing a challenge for the timing of transplant procedures. Here, we report on the case of a 34-year-old patient with recent pauci-symptomatic COVID-19 undergoing transplant for high-risk acute B-lymphoblastic leukemia before achieving viral clearance.

View Article and Find Full Text PDF

PTCY has been mainly used in haploidentical transplant (haploHSCT), but its use in matched donors allowed better evaluation of infectious risk conferred separately by PTCY or donor type. PTCY increased the risk of bacterial infections, both in haploidentical and matched donors, mainly pre-engraftment bacteremias. Bacterial infections, particularly due to multidrug-resistant Gram-negatives, were main causes of infection-related deaths.

View Article and Find Full Text PDF

Human herpesvirus 6 (HHV-6) can reactivate after allogeneic hematopoietic stem cell transplant (allo-HSCT) and may lead to severe symptoms. HHV-6-specific immune responses after HSCT are largely unexplored. We conducted a prospective observational study on 208 consecutive adult patients who received allo-HSCT to investigate HHV-6 reactivations and specific immune responses.

View Article and Find Full Text PDF

Weight gain following the initiation or the switch of antiretroviral therapy (ART) is well documented and mainly associated with some of the most recent drugs, such as integrase strand transfer inhibitors and tenofovir alafenamide. However, limited data have been published on weight trends in ART-experienced people living with HIV (PLWH) with a long exposure to HIV infection and antiretroviral drugs. In our study, we assessed changes in weight after switching ART among PLWH who reported weight gain under a previous regimen.

View Article and Find Full Text PDF

Background: We investigated the role of infectious disease consultation (IDC) on therapeutic appropriateness in Gram-negative bloodstream infections (GNBSIs) in a setting with a high proportion of antibiotic resistance. Secondary outcomes were in-hospital mortality and the impact of rapid diagnostic tests (RDTs).

Methods: Retrospective study on hospitalised patients with GNBSIs.

View Article and Find Full Text PDF

Fluoroquinolone prophylaxis's (FQ-P) usefulness in patients with neutropenia is controversial. In recent decades, Italian epidemiological data has shown worrisome rates of FQ resistance. A single-center cohort study on 136 autologous stem cell transplantations (ASCTs) and 223 allogeneic hematopoietic stem cell transplantations (allo-HSCTs) was performed from January 2018 to December 2020.

View Article and Find Full Text PDF

Objectives: To assess the clinical features and outcomes of Pseudomonas aeruginosa bloodstream infection (PA BSI) in neutropenic patients with hematological malignancies (HM) and with solid tumors (ST), and identify the risk factors for 30-day mortality. Methods: We performed a large multicenter, retrospective cohort study including onco-hematological neutropenic patients with PA BSI conducted across 34 centers in 12 countries (January 2006−May 2018). Episodes occurring in hematologic patients were compared to those developing in patients with ST.

View Article and Find Full Text PDF