Publications by authors named "Piconi S"
A Delphi consensus-seeking procedure was conducted to validate a list of ICD-9-CM codes that could help identify hospital admissions in which antimicrobials are more likely to be prescribed. The panel agreed to include 2967 codes out of 16229 (18.28%).
View Article and Find Full Text PDFOnly toxigenic serogroups O1 and O139 Vibrio cholerae have been associated with widespread cholera epidemics. Other serogroups (non-O1/non-O139 Vibrio cholerae or NOVC) most often cause sporadic gastrointestinal manifestations. Rarely, NOVC can result in severe extraintestinal manifestations in immunocompromised hosts.
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- The study evaluated how smoking affects major clinical events (MCEs) in people with HIV in Italy over nearly a decade.
- Researchers tracked 983 individuals, finding notable rates of cardiovascular events, cancers, and deaths, with a total MCE incidence rate of 17.6 per 1000 person-years.
- Key risk factors for increased MCEs included older age, higher nicotine dependence, low CD4+ counts, previous cancers, and using injection drugs, highlighting the serious impact of smoking on health in this population.
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- Patients with severe COVID-19 pneumonia have limited treatment options, and opaganib is an oral medication being researched to help those hospitalized.
- A clinical trial conducted in 57 locations from August 2020 to July 2021 compared opaganib to a placebo over 14 days, focusing on whether patients could stop needing supplemental oxygen by day 14.
- Although the primary results showed no significant general benefit, post-hoc analysis indicated that patients with low oxygen levels at baseline may experience better outcomes with opaganib, including reduced intubation rates and lower mortality, suggesting the need for further studies in this specific group.
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- A multicenter observational study named CONDIVIDIAMO analyzed the effectiveness of monoclonal antibodies (mAbs) in reducing COVID-19 hospitalizations among outpatients with risk factors for severe disease.
- The study enrolled 1,534 participants and tracked outcomes over 28 days, recording hospitalizations and deaths, with results showing a 5.6% incidence of hospitalization or death after mAbs treatment.
- Key risk factors identified for increased hospitalization included older age and immunodeficiency, highlighting the importance of targeting vulnerable populations for mAb treatment.
Hospital-acquired pneumonia (HAP) and ventilation-associated pneumonia (VAP) are challenging clinical conditions due to the challenging tissue penetrability of the lung. This study aims to evaluate the potential role of fosfomycin (FOS) associated with ceftazidime/avibactam (CZA) in improving the outcome in this setting. We performed a retrospective study including people with HAP or VAP treated with CZA or CZA+FOS for at least 72 h.
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- - Rezafungin, an echinocandin, has a long elimination half-life enabling weekly dosing and is now approved for treating candidemia.
- - Limited information exists regarding its long-term use and effectiveness against deep infections such as endocarditis and osteomyelitis.
- - This report outlines its successful prolonged use in two cases of azole-resistant infections: one involving sacral osteomyelitis and another with prosthetic valve endocarditis linked to a thoracic aneurysm repair.
Long-term outcomes of bictegravir/emtricitabine/tenofovir alafenamide as first-line therapy and as switch strategy in virologically suppressed persons with HIV: data from the ICONA cohort.
J Antimicrob Chemother
June 2024
Objectives: To assess the effectiveness of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) among people poorly represented in clinical trials and potentially at higher risk of suboptimal response to ART.
Methods: Observational cohort study on persons with HIV (PWH) enrolled in ICONA who started BIC/FTC/TAF as initial therapy or as switching regimen while virologically suppressed. Primary endpoint was time to treatment failure (TF): new AIDS/death or virological failure (VF) or discontinuation for toxicity/failure.
Background: Our aim was to estimate the rates of not achieving a robust/above-average humoral response to the COVID-19 mRNA vaccine in people living with HIV (PLWH) who received ≥2 doses and to investigate the role of the CD4 and CD4/CD8 ratio in predicting the humoral response.
Methods: We evaluated the humoral anti-SARS-CoV-2 response 1-month after the second and third doses of COVID-19 mRNA vaccine as a proportion of not achieving a robust/above-average response using two criteria: (i) a humoral threshold identified as a correlate of protection against SARS-CoV-2 (<90% vaccine efficacy): anti-RBD < 775 BAU/mL or anti-S < 298 BAU/mL, (ii) threshold of binding antibodies equivalent to average neutralization activity from the levels of binding (nAb titer < 1:40): anti-RBD < 870 BAU/mL or anti-S < 1591 BAU/mL. PLWH were stratified according to the CD4 count and CD4/CD8 ratio at first dose.
Introduction: Integrase strand transfer inhibitors (INSTI) are one of the most prescribed drug classes for the treatment of HIV infection worldwide. Emtricitabine/Tenofovir Alafenamide/ Bictegravir (FTC/TAF/BIC) has been evaluated in randomized clinical trials; few studies have verified tolerability and safety in clinical practice. Our aim was to investigate the metabolic and hepatic safety in a real-life setting of FTC/TAF/BIC.
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- - The genus Nocardia includes gram-positive bacteria commonly found in the environment that can lead to severe lung and brain infections, especially in immunocompromised patients, but they can also affect those with normal immunity.
- - A case study describes a 47-year-old woman who developed meningitis after brain surgery, initially showing no clear signs of infection, but later tests finally revealed Nocardia farcinica as the culprit after multiple therapies were ineffective.
- - The patient's treatment was successfully adjusted to include specific antibiotics after the bacteria were identified, highlighting the challenges of diagnosing Nocardia infections, especially given the initial negative results for other possible pathogens.
Background: Surgical site infection (SSI) is the major complication in orthotopic liver transplantation (LT). It is of prime importance to assess the incidence of infections in liver transplants and to analyze the risk factors associated with morbidity and mortality.
Methods: Between 2014 and 2019, we performed a retrospective cohort study at the Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Background: SARS-COV-2 infection has been associated to long-lasting neuropsychiatric sequelae, including cognitive deficits, that persist after one year. However, longitudinal monitoring has been scarcely performed. Here, in a sample of COVID-19 patients, we monitor cognitive, psychological and quality of life-related profiles up to 22 months from resolution of respiratory disease.
View Article and Find Full Text PDFThe coronavirus disease 2019 pandemic has represented an individual and collective trauma with an impact on mental health. COVID-19 survivors need to be screened for psychological distress regularly for timely intervention. After March 2020, an outpatients clinic for follow up of discharged COVID-19 patients was set up at Infectious Diseases Department of the Hospital of Lecco, Italy.
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- The SARS-CoV-2 pandemic led to a noticeable decline in antimicrobial stewardship programs (ASPs) and an increase in antibiotic use, particularly in areas with high multidrug-resistant organisms (MDROs).
- A survey conducted in July 2021 revealed that 50% of the 18 infectious disease (ID) units experienced reduced ASP activity, with 38.9% completely suspending their programs during the pandemic.
- Hospitals that had established ASPs as a priority prior to the pandemic were more successful in reviving those programs after the initial COVID-19 waves, indicating that pre-existing commitment to ASPs was crucial for resilience during the crisis.
Importance: Convalescent plasma (CP) has been generally unsuccessful in preventing worsening of respiratory failure or death in hospitalized patients with COVID-19 pneumonia.
Objective: To evaluate the efficacy of CP plus standard therapy (ST) vs ST alone in preventing worsening respiratory failure or death in patients with COVID-19 pneumonia.
Design, Setting, And Participants: This prospective, open-label, randomized clinical trial enrolled (1:1 ratio) hospitalized patients with COVID-19 pneumonia to receive CP plus ST or ST alone between July 15 and December 8, 2020, at 27 clinical sites in Italy.
Objective: To investigate the durability of the first integrase inhibitor-based regimen in a HIV geriatric multicentric prospective cohort and to explore the reasons of regimen discontinuation.
Design: This is an analysis conducted on the Geriatric Patients Living with HIV/AIDS (GEPPO) cohort, an Italian prospective observational multicentre cohort of people living with HIV with 65 years of age or more.
Methods: The analysis was performed using R (version 4.
carbapenemase–producing (KPC) has been endemic in Italy since 2013. In a multicenter cohort study, we investigated various aspects of KPC among patients, including 15-day mortality rates and delays in adequate therapy. Most (77%) KPC strains were sequence type (ST) ST512 or ST307.
View Article and Find Full Text PDFObjective: The aim of this study was to explore weight gain in people with HIV (PWH) at least 65 years of age who switch to a DTG based regimen (DTG-s) vs. remaining INSTI-naive (INSTI-n) on stable ART.
Methods: This was a longitudinal prospective study of PWH from the GEPPO cohort.
The IL-1 receptor antagonist, anakinra, may represent a therapeutic option for acute respiratory distress syndrome (ARDS) associated with coronavirus disease 2019 (COVID-19). In this study, COVID-19 ARDS patients admitted to the Azienda Socio Sanitaria Territoriale of Lecco, Italy, between March 5th to April 15th, 2020, and who had received anakinra off-label were retrospectively evaluated and compared with a cohort of matched controls who did not receive immunomodulatory treatment. The primary end point was survival at day 28.
View Article and Find Full Text PDFCase Report: A 64-year-old woman presented to our emergency department during the outbreak of the covid-19 emergency in Italy with syncope, anosmia, mild dyspnoea and atypical chest and dorsal pain. A chest CT scan showed an acute type B aortic dissection (ATBAD) and bilateral lung involvement with ground-glass opacity, compatible with interstitial pneumonia. Nasopharyngeal swabs resulted positive for SARS-CoV-2.
View Article and Find Full Text PDFPurpose: We evaluated if, during lithotripsy, bacteria may be detected in the irrigation fluid of percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). The concordance between urine culture from stone fragmentation (SFUC), bladder (BUC), renal pelvic (RPUC) and stone (SC) was analyzed. We also assessed the correlation between variables and cultures and their association with systemic inflammatory response syndrome (SIRS) and of a positive SC.
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