Publications by authors named "Spanu T"

Background: Carbapenem-Resistant Gram-Negative Bacteria, including Carbapenem-Resistant Enterobacterales (CRE) and Carbapenem-Resistant Pseudomonas aeruginosa (CRPA), are common causes of infections in intensive care units (ICUs) in Italy.

Objective: This prospective observational study evaluated the epidemiology, management, microbiological characterization, and outcomes of hospital-acquired CRE or CRPA infections treated in selected ICUs in Italy.

Methods: The study included patients with hospital-acquired infections due to CRE and CRPA treated in 20 ICUs from June 2021 to February 2023.

View Article and Find Full Text PDF

Metallo-β-lactamases (MBLs) in and other Gram-negative organisms pose significant public health threats due to their association with multidrug resistance (MDR). Although aztreonam (AZT) can target MBL-producing organisms, its efficacy is compromised in organisms expressing additional β-lactamases that inactivate it. Combining AZT with the β-lactamase inhibitor avibactam (AVI) may restore its activity against MBL-producing isolates.

View Article and Find Full Text PDF

Objective: To assess whether 48-h negative blood culture (BC) bottles are still negative at the classic 120-h incubation endpoint and whether 48 h might be the time to make antimicrobial therapy decisions.

Methods: Data from the first collected bottles from bloodstream infection (BSI) episodes of single patients were retrospectively analyzed. Probabilities of bottles being negative at the classic endpoint were calculated from 0 to 120 h of incubation.

View Article and Find Full Text PDF

Bloodstream infection (BSI) caused by carbapenem-resistant (KP) poses significant challenges, particularly when the infecting isolate carries multiple antimicrobial resistance (AMR) genes/determinants. This study, employing short- and long-read whole-genome sequencing, characterizes six New Delhi metallo-β-lactamase (NDM) 1 and KP carbapenemase (KPC) 3 co-producing KP isolates, the largest cohort investigated in Europe to date. Five [sequence type (ST) 512] and one (ST11) isolates were recovered from patients who developed BSI from February to August 2022 or February 2023 at two different hospitals in Rome, Italy.

View Article and Find Full Text PDF

The identification of microorganisms at the species level has always constituted a diagnostic challenge for clinical microbiology laboratories. The aim of the present study has been the evaluation in a real-time assay of the performance of Autobio in comparison with the Bruker mass spectrometry system for the identification of bacteria and yeasts. A total of 535 bacteria and yeast were tested in parallel with the two systems by direct smear or fast formic acid extraction for bacteria and yeasts, respectively.

View Article and Find Full Text PDF

Objective: To evaluate whether acute histologic chorioamnionitis (HCA) diagnosed in the placenta may be associated with an increased occurrence of bronchopulmonary dysplasia (BPD) or death among extremely low gestational age neonates (ELGAN).

Methods: This Italian single-center case-control retrospective study involved ELGAN admitted to the neonatal intensive care unit between January 2019 and June 2022. Infants born from pregnant women with acute and severe HCA, identified as stage ≥2 and grade 2 HCA, (HCA-infants) were compared with infants of pregnant women without chorioamnionitis or with stage 1, grade 1 chorioamnionitis (no-HCA-infants).

View Article and Find Full Text PDF

The growing phenomenon of antibiotic resistance and the presence of limited data concerning the pediatric area prompted us to focus on infection in this study, its antibiotic resistance profile, and the therapeutic management of affected children. We conducted a retrospective study by collecting clinical data on infants and children with antibiogram-associated infection. We enrolled 1210 patients with a mean age of 0.

View Article and Find Full Text PDF
Article Synopsis
  • Candida auris and other Candida species are significant causes of bloodstream infections, requiring prompt antifungal treatment; however, the presence of antifungal agents can hinder the effectiveness of blood cultures used for diagnosis and monitoring.
  • A study compared different blood culture media to determine their effectiveness in identifying Candida species in the presence of high concentrations of antifungal drugs; findings showed that certain media (FAP and PAF) were better at fostering the growth of C. auris and C. glabrata even with antifungal presence.
  • The research highlights challenges in treating bloodstream infections from resistant Candida species, primarily C. auris and C. glabrata, especially when using echinocandins
View Article and Find Full Text PDF

Objective: The purpose of this study was to assess the rate and type of infections in gynecological cancer patients. We also performed an economic analysis to provide an overview of costs related to healthcare associated infections.

Methods: We retrospectively collected data from culture samples at the site of infection from patients undergoing surgery or chemotherapy, admitted to the Gynecologic Oncology Unit, Fondazione Policlinico Agostino Gemelli IRCCS, from January 2017 to December 2018.

View Article and Find Full Text PDF

Background And Aim: Antibiotic resistance represents one of the major public health issues, due to the potential future ineffectiveness of available antibiotics. However, epidemiological studies on E. coli antibiotic resistance patterns in the pediatric population are limited.

View Article and Find Full Text PDF
Article Synopsis
  • - The study investigates the impact of maternal colonization of specific species during pregnancy on the neurodevelopment of preterm infants born before 30 weeks of gestation.
  • - In a cohort of 254 preterm infants, only 12.6% were exposed to maternal colonization, showing no significant difference in overall developmental scores at 24 months but poorer locomotor abilities in the exposed group.
  • - Despite similar rates of cognitive and motor impairments between the two groups, the exposed infants had lower scores specifically in locomotor skills, indicating potential negative effects of maternal colonization on movement development.
View Article and Find Full Text PDF

This study aimed to assess the comparability of in vitro susceptibility testing methods to ceftazidime-avibactam (CZA) and ceftolozane-tazobactam (C/T). Meropenem-resistant and/or carbapenemase-producing clinical isolates of () and were tested by both bioMérieux ETEST and VITEK-2 AST-N397 card and compared with a Micronaut AST-system broth microdilution (BMD) method. CZA and C/T MICs were interpreted using EUCAST breakpoints.

View Article and Find Full Text PDF

Objectives: To explore the real-life performance of meropenem/vaborbactam for treating serious KPC-producing infections, including those resistant to ceftazidime/avibactam.

Methods: A retrospective observational cohort study was conducted in 12 Italian hospitals. Enrolled patients had carbapenemase (KPC)-producing (KPC-) infections (59.

View Article and Find Full Text PDF

Objective: The study aimed to report a novel coronavirus disease 2019 (COVID-19)-associated multisystem inflammatory syndrome in children (MIS-C) in a neonate found to have an atypical diffuse thickening in coronary artery walls whose diagnosis required a multi-imaging approach.

Study Design: A neonate presented at birth with multiple organ involvement and coronary artery anomalies. A diagnosis of MIS-C associated with COVID-19 was supported by maternal severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection during pregnancy, and by the presence of both immunoglobulin (Ig)-G against SARS-CoV-2 and spike-specific memory B-cells response in the neonatal blood.

View Article and Find Full Text PDF

Bacterial pneumonia is a challenging coronavirus disease 2019 (COVID-19) complication for intensive care unit (ICU) clinicians. Upon its implementation, the FilmArray pneumonia plus (FA-PP) panel's practicability for both the diagnosis and antimicrobial therapy management of bacterial pneumonia was assessed in ICU patients with COVID-19. Respiratory samples were collected from patients who were mechanically ventilated at the time bacterial etiology and antimicrobial resistance were determined using both standard-of-care (culture and antimicrobial susceptibility testing [AST]) and FA-PP panel testing methods.

View Article and Find Full Text PDF

Background/objectives: We investigated whether behavioral precautions adopted during Coronavirus disease (COVID-19) pandemic also influenced the spreading and multidrug resistance (MDR) of ESKAPEEc (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii [AB], Pseudomonas aeruginosa, Enterobacter spp and Escherichia Coli, [EC]) among Intensive Care Unit (ICU) patients.

Subjects/methods: We performed a single-center retrospective study in adult patients admitted to our COVID-19-free surgical ICU. Only patients staying in ICU for more than 48 hours were included.

View Article and Find Full Text PDF

To support the clinical laboratory diagnosis of () pneumonia (PCP), an invasive fungal infection mainly occurring in HIV-negative patients, in-house or commercial -specific real-time quantitative PCR (qPCR) assays are todays' reliable options. The performance of these assays depends on the type of gene (multi-copy mitochondrial versus single-copy nuclear) targeted by the assay. We described the development of a -PCR assay targeting the dihydrofolate reductase (DHFR)-encoding gene.

View Article and Find Full Text PDF

Objective And Design: Our prospective study assesses the role of detailed lung ultrasound (LUS) features to discriminate the etiological diagnosis of acute lower respiratory tract infection (ALRTI) in children.

Methodology: We analyzed patients aged from 1 month to 17 years admitted between March 2018 and April 2020 who were hospitalized for ALRTI. For all patients, history, clinical parameters, microbiological data, and lung ultrasound data were collected.

View Article and Find Full Text PDF

The coronavirus disease 2019 causes a wide degree of organ dysfunction and is associated with bacterial secondary infections. We reported lung microbiota dynamics in a critically ill patient with coronavirus disease 2019, who developed severe Hafnia alvei ventilator-associated pneumonia and required extracorporeal membrane oxygenation support.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to analyze COVID-19 patients who experienced bloodstream infections (BSI) and identify factors linked to in-hospital mortality.
  • A total of 293 patients were examined, with 46 (15.7%) developing clinically relevant hospital-acquired BSIs, and a significant portion of these patients had multidrug-resistant organisms.
  • Key risk factors for death included being over 75 years old, experiencing septic shock, and having BSI onset within the first three days of hospitalization, highlighting the need for awareness and targeted interventions in these high-risk patients.
View Article and Find Full Text PDF

The bacteremia level as well as the administration of antibiotics before blood collection may significantly affect the recovery of bacterial pathogens from pediatric blood cultures in BacT/Alert Virtuo or Bactec FX BC systems, which remain the common techniques to diagnose bacteremia in pediatric patients. We simulated pediatric blood cultures with low or intermediate bacteremia level to evaluate BacT/Alert PF Plus and Bactec Peds Plus blood culture bottles for resin-based inactivation of 16 antibiotic-bacterium combinations. Overall, 105/192 (54.

View Article and Find Full Text PDF
Article Synopsis
  • Ceftazidime-avibactam (CAZ-AVI) has shown promise in treating infections caused by carbapenem-resistant bacteria, specifically Klebsiella pneumoniae, based on a review of patient data.
  • In a study of 577 adults with severe infections, the overall 30-day mortality rate was 25%, with no significant difference in outcomes between those treated with CAZ-AVI alone and those using it in combination with other antibiotics.
  • Factors like septic shock, neutropenia, and certain types of infections increased mortality risk, while longer infusion times of CAZ-AVI were associated with better outcomes, highlighting the need for further research on treatment protocols.
View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the use of C-reactive protein (CRP) and the time to positivity (TTP) of blood cultures in deciding whether to continue or discontinue empirical antibiotics for suspected neonatal early-onset sepsis (EOS).
  • Researchers analyzed data from 103 infants admitted for suspected EOS, finding that 80% of pathogenic organisms had a TTP of less than 12 hours, and 100% were positive within 48 hours.
  • The findings suggest that stopping antibiotics in asymptomatic infants 48 hours after starting treatment could reduce unnecessary antibiotic use by 31.1%, highlighting the potential for safer management of suspected EOS.
View Article and Find Full Text PDF