Publications by authors named "Seminari E"

Introduction: Infections significantly impact morbidity and mortality in lung transplant (LuTx) recipients. This survey focused on documenting current practices regarding the prevention and management of infections in LuTx in Italy.

Methods: A 52-question survey was administered online in the period from December 1, 2023, to January 31, 2024, assessing center characteristics, Tx team organization, microbiological investigations, infection prevention, and management.

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Background: Daptomycin pharmacokinetics and pharmacodynamics data relative to higher doses in patients are necessary for clinical practice.

Objectives: A monocentric, prospective study that enrolled patients with a diagnosis of spp. infective endocarditis treated with daptomycin according to clinical practice, to evaluate the pharmacokinetics/pharmacodynamics of different daptomycin daily doses (group A: 8-10 and group B: 11-12 mg/kg).

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Article Synopsis
  • *This report presents a case of successful valve-in-valve transcatheter aortic valve replacement (TAVR) in a patient with a degenerated bioconduit resulting from previously healed infectious endocarditis.
  • *The case emphasizes the importance of personalized long-term follow-up and the potential use of imaging techniques, like 18F-FDG PET/CT, to assess risks in patients unable to have surgical replacement due to their medical history.
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Background: Infection by SARS-CoV2 has become a challenge, especially for immunocompromised patients who show a weaker humoral response to COVID-19 vaccine. Tixagevimab+cilgavimab (Evusheld) is a combination of human monoclonal antibodies that can be used for pre-exposure prophylaxis to prevent infection or disease by SARS-CoV2.

Objectives: Our study aimed to investigate the effectiveness of Evusheld by comparing an Exposed and an Unexposed group.

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  • Daptomycin is an antibiotic effective against serious infections like endocarditis caused by Staphylococcus aureus, and its effectiveness is best measured by the AUC 0-24 to minimum inhibitory concentration ratio.
  • The study involved calculating AUC 0-24 values in 50 White patients over at least five days, using a high-performance liquid chromatography method to analyze plasma concentrations.
  • The results showed that measuring daptomycin levels prior to and two hours after dosing provides a reliable estimation of AUC 0-24, facilitating personalized dosing strategies, particularly for patients at higher risk of treatment failure.
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  • Intravenous drug users (IVDUs) are at a higher risk for serious gram-positive bacterial infections like MRSA, and current antibiotic dosing strategies may not be effective for them.
  • This review analyzes how common antibiotics (like daptomycin and vancomycin) behave differently in IVDUs, indicating that their treatment needs to be more personalized.
  • The study highlights the impact of factors like opioid substitution therapy and malnutrition on drug effectiveness, stressing the need for doctors to adjust antibiotic doses for better patient outcomes in IVDUs.
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In this study, we present two cases of , one KPC-33- and one NDM-1-producing, showing resistance to cefiderocol and ceftazidime/avibactam, collected in the intensive care unit of a hospital in Northern Italy from two patients who had recently undergone lung transplantation. Whole-genome sequencing was performed to investigate the molecular features of these strains.

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Introduction: long term suppressive antibiotic treatment may be the only feasible option for patients with infective endocarditis (IE) not suitable for surgery.

Case Reports: we present three cases of prosthetic valve endocarditis (PVE) caused by and which could not undergo surgical intervention due to high risk. Despite this, patients were successfully managed only by medical approach.

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We aimed to compare the efficacy of ceftazidime-avibactam (CAZ-AVI) versus the best available therapy (BAT) in solid organ transplant (SOT) recipients with bloodstream infection caused by carbapenemase-producing Klebsiella pneumoniae (CPKP-BSI). A retrospective (2016-2021) observational cohort study was performed in 14 INCREMENT-SOT centers (ClinicalTrials.gov identifier: NCT02852902; Impact of Specific Antimicrobials and MIC Values on the Outcome of Bloodstream Infections Due to ESBL- or Carbapenemase-producing Enterobacterales in Solid Organ Transplantation: an Observational Multinational Study).

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The emergency room (ER) is the first gateway for patients with sepsis to inpatient units, and identifying best practices and benchmarks to be applied in this setting might crucially result in better patient's outcomes. In this study, we want to evaluate the results in terms of decreased the in-hospital mortality of patients with sepsis of a Sepsis Project developed in the ER. All patients admitted to the ER of our Hospital from the 1st January, 2016 to the 31stJuly 2019 with suspect of sepsis (MEWS score ≥ of 3) and positive blood culture upon ER admission were included in this retrospective observational study.

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Background: The use of steroid therapy in potentially life-threatening neuroinvasive forms of West Nile infection (WNND) is controversial. The aim of this study is to assess the efficacy of steroid therapy in reducing intrahospital mortality, length of stay, and neurological sequelae at discharge.

Methods: This was a multicenter, retrospective, observational study conducted in 5 hospitals in Northern Italy, headed by the Fondazione IRCSS Policlinico San Matteo (Pavia).

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Background: The aim of our survey was to analyze the current attitudes toward antimicrobial prophylaxis in heart transplanting centers worldwide.

Methods: The survey was composed of a total of 50 questions, it consisted of four different sections as follows. The first section collected physicians' personal data and centers' general characteristics, second assessed the approach to patients colonized with multidrug-resistant organisms (MDROs), while the third consisted of the infection risk related to cardiovascular devices, and antimicrobial treatment data, the last focused on donor's colonization.

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SARS-CoV-2 and flu may lead to severe acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO). The aim of the present study is to compare the incidence of bloodstream infections (BSIs) and outcome in patients with flu and SARS-CoV-2 infection hospitalized in ICU and undergoing ECMO. This study is a retrospective analysis of the San Matteo COVID-19 Registry (SMACORE) cohort.

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The immunogenicity of severe acute respiratory syndrome 2 virus (SARS-CoV-2) vaccines in immunocompromised patients remains to be further explored. Here, we evaluated the immunogenicity elicited by complete vaccination with BNT162b2 vaccine in solid organ transplant recipients (SOTRs). A cohort of 110 SOTRs from Northern Italy were vaccinated with two doses of BNT162b2 mRNA vaccine and prospectively monitored at baseline and after 42 days.

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The development and persistence of SARS-CoV-2-specific immune response in immunocompetent (IC) and immunocompromised patients is crucial for long-term protection. Immune response to SARS-CoV-2 infection was analysed in 57 IC and 15 solid organ transplanted (TX) patients. Antibody responses were determined by ELISA and neutralization assay.

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Article Synopsis
  • - The study assessed the effectiveness of ertapenem vs. meropenem in treating bacteremia caused by ESBL-producing bacteria in kidney transplant recipients, using a large cohort from 29 international centers.
  • - Among the 201 patients, clinical cure rates at day 14 were similar: 45% for ertapenem and 50.5% for meropenem, indicating that both treatments are comparable in effectiveness.
  • - Additionally, over 49% of patients treated with ertapenem showed better outcomes when considering factors like hospital stay and cost, suggesting that ertapenem might offer some advantages over meropenem in this context.
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Background And Objective: When administered for severe infections in intravenous drug users (IDUs) at a daily dose of 6 mg/kg, daptomycin displayed abnormal pharmacokinetic parameters compared with those seen in healthy volunteers; specifically, decreased trough and maximum concentrations (C; C) and increased clearance (CL). The objective of this study was to evaluate the pharmacokinetics and pharmacodynamics of daptomycin administered at a daily dosage of 12 mg/kg for Staphylococcus aureus infective endocarditis (IE) in patients concomitantly treated with methadone, and to compare the results with those published in the literature for healthy controls treated with the same daily dose.

Methods: Antibiotic treatment included daptomycin (12 mg/kg daily) in combination with an antistaphylococcal β-lactam (cefazolin 2 g three times a day).

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Background: Histoplasma capsulatum is an environmental fungus that causes opportunistic infections in AIDS patients in endemic areas but is uncommon in Europe. It shares clinical features with other opportunistic infections and lymphoproliferative disorders common in AIDS patients. The World Health Organization included Histoplasma antigen tests on the Lists of Essential In Vitro Diagnostics, however, they are not routinely available in non-endemic countries.

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Nocardia has always been considered a pathogen of the immunocompromised host, but recent evidence has also highlighted its role as a pathogen in the immunocompetent. We aim to assess the role of immunosuppression in the disease. We reviewed all the cases of infections due to Nocardia spp.

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Patients with Corynebacterium striatum endocarditis are usually managed with long-term intravenous antibiotic therapy and hospitalization. Here we describe a case of a 76-year-old woman with hepatitis C virus (HCV) related cirrhosis who developed endocarditis due to Corynebacterium striatum associated with severe aortic regurgitation. To our knowledge, this is the first case to be successfully treated with an early switch to oral linezolid after three weeks of vancomycin.

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Objective: Progressive multifocal leukoencephalopathy (PML) is still burdened by high mortality in a subset of patients, such as those affected by hematological malignancies. The aim of this study was to analyze the safety and carry out preliminary evaluation of the efficacy of polyomavirus JC (JCPyV)-specific T cell therapy in a cohort of hematological patients with PML.

Methods: Between 2014 and 2019, 9 patients with a diagnosis of "definite PML" according to the 2013 consensus who were showing progressive clinical deterioration received JCPyV-specific T cells.

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