INTRODUCTION:The problem of detecting legionella after a case of legionellosis from the source of environmental contamination has been known since a long time ago. Legionella is a bacterium present in various natural and artificial habitats and especially in surface fresh waters. It is found in greater concentration in warm waters, at temperatures between 20 °C and 42 °C. The greatest risk factor for humans is represented by the presence of Legionella in water distribution systems in hospitals, medical equipment (e.g. respirators, dialyzers, inhalers, humidifiers, water, massage equipment used in balneotherapy) and turbines used in dental practices, especially for hospitalized individuals. In the EU directive 2020/2184, issued by the European parliament on 16/12/2020, the concentration of Legionella was added to the parameters to be determined in assessing the quality of drinking water intended for human consumption. The objectives were to improve the quality standard of drinking water, reduce the consumption of bottled water and consequently reduce plastic waste. The WHO notes that Legionella causes the greatest burden from a health point of view and it is included among the parameters that require careful monitoring with a limit of less than 1000 CFU/L. The aim of this report was to evaluate the new EU directive 2020/2184 on the light of our laboratory experience. MATERIALS AND METHODS:A total of 459 samples were processed at our Hygiene of food Laboratory - Department of Medical Sciences and Public Health. All statistical analyses were conducted using the SPSS statistical package (version 23 for Windows. SPSS, Inc. Chicago, Ill). RESULTS AND DISCUSSION:Of the 67 structures examined where the cases occurred, 35 showed samples with at least one over-threshold value considering the reference value of 100 CFU/L, whereas using the new limit of 1000 CFU/L, only 25 structures resulted as having at least one sample above the threshold. In our experience as a regional reference laboratory for Legionella research, the increase from 100 CFU/L to 1,000 CFU/L could lead to a lower alert level. In fact, in the period between October 2017 and October 2021, the median value of CFU/L in presence of a case was 0 (0-100). Despite the large amount of studies on Legionella only a few relate the withdrawals and the consequent CFU/L with the confirmed cases of legionellosis, as in our analysis. The 75° percentile values of the Legionella concentration equal to 100 CFU/L in all samples associated with cases and clusters leads us to hypothesize that the limit equal to 1000 CFU/L that will be introduced for environmental monitoring as per recent European regulations may not be sufficiently protective for minimizing risk in the population, especially in healthcare facilities where fragile patients are assisted.

Pleurotus eryngii is an edible mushroom that suffers significant losses due to fungal contamination and bacteriosis. The Pseudomonadaceae family represents one of the most frequent etiologic agents. Grapefruit seed extract (GSE) is a plant extract that contains different bioactive components, such as naringin, and exhibits a strong antibacterial and antioxidant activity. Over the last decade, GSE use as an alternative to chemical treatments in the food sector has been tested. However, to our knowledge, its application on mushroom crops has never been investigated. This study focuses on evaluating GSE efficacy in preventing P. eryngii yellowing. GSE antibiotic activity, inhibitory and bactericidal concentrations, and antibiofilm activity against several microorganisms were tested with the Kirby–Bauer disk diffusion assay, the broth microdilution susceptibility test, and the Crystal violet assay, respectively. In vitro, the extract exhibited antimicrobial and antibiofilm activity against Staphylococcus aureus 6538 and MRSA (wild type), Escherichia coli ATCC 8739, and Pseudomonas spp. (Pseudomonas aeruginosa 9027, P. fluorescens (wild type)). GSE application in vivo, in pre- and post-sprouting stages, effectively prevented bacterial infections and subsequent degradation in the mushroom crops: none of the P. eryngii treated manifested bacteriosis. Our findings support the use of GSE as an eco-friendly and sustainable alternative to chemical treatments for protecting P. eryngii crops from bacterial contamination, consequently ensuring food safety and preventing financial losses due to spoilage. Furthermore, GSE’s potential health benefits due to its content in naringin and other bioactive components present new possibilities for its use as a nutraceutical in food fortification and supplementation.

INTRODUCTION:Invasive fungal infections (IFI) are a group of life-threatening diseases associated with significant morbidity, mortality and high healthcare costs. Some modern management programs known as AFS (antifungal stewardship programs) have now been developed. The purpose of this systematic review is to evaluate the different declinations of antifungal stewardship programs (AFPs). METHODS:Articles were systematically reviewed using the PRISMA checklist 2020. EMBASE and MEDLINE/PubMED were searched using the term "antifungal stewardship" (2012-2022 data) on 2 January 2023. Eligible studies were those that described an AFS and included an intervention, performance evaluation and outcome measures. RESULTS:A total of 22/796 studies were included. Approximately two-thirds (16) were published between 2018 and 2022. 16 (72.7%) stated a minimal complete AFS team. 12 (54.5%) adopted a non-compulsory AFS approach, 6(27.3%) had an Educational AFS and 4(18.2%) a compulsory AFS. Cost analyses of 12 studies showed a decrease for 7 (31.8%) compared to an increase for 5 (22.7%). In terms of outcomes, 18 studies showed a lower (10;45.5%) or the same (8;36.4%) pre-post intervention mortality rate. CONCLUSION:AFS programs seem to be related to lower costs and better outcomes and should thus be implemented in tandem with antimicrobial stewardship programs.

Travel-associated Legionnaires’ disease is a significant public health concern worldwide. A high number of cases are reported every year among travellers who stay at guest houses, hotels, and spas. Indeed, hot water systems, showers, and air-conditioning systems can be contaminated by Legionella, which grows at 25–42 °C. Studies have shown that in Sardinia, especially during the summer months, the water circulation in the hotels’ pipes is exposed to extremely high temperatures. As a result, this study was conducted to assess the colonization of hotel water systems by Legionella in Sardinia, concerning a recent EU directive 2020/2184 for drinking water with a limit of 1000 CFU /L. Methods. A total of 112 accommodation facilities were analyzed, of which 61.3% were found to be colonized with Legionella, and out of a total of 807 samples, 32.5% were positive for Legionella presence. The results showed a higher number of positive samples in the summer season. This was also associated with the higher concentration presence of >1000 CFU/L in the samples. Consequently, this study confirms that local hotel operators should improve their water safety and prevention plans, especially in spring and summer.

BACKGROUND:The monitoring of antibiotic prescriptions is of fundamental importance in the hospital setting. Inappropriate prescriptions could cause an unjustified exposure of patients to the risk of ADR (adverse drug reactions) and increase the risk of spreading the ecological resistance of hospital microorganisms. The use of IT media is essential in antimicrobial stewardship programs.OBJECTIVE:The purpose of this work was to evaluate the variation in the exposure index to antibiotics following the adoption of electronic pharmacist-controlled prescriptions in 2015.METHODS:Electronic Personalised Prescription Software (EPPS) was introduced in our University Hospital in 2015. The exposure index to antibiotics was expressed per WHO methodology in DDD (defined daily dose)/100 patient days (DPD). The changes in DPDs over the 2015-2020 period were calculated as percentages and through linear regressions. The analysis was performed using SPSS® (IBM).RESULTS:Following the introduction of EPPS, there was a progressive decline in DPDs during the 2015-2020 period from 98.9 to 65.1 (R2 = 0.687, p = 0.041). This could mainly be linked to the decreased use of ATC class J01CR - penicillin association, including beta-lactamase inhibitors (DPD 2015 39.9; DPD 2020 11.5; variation -71.1%). Expenditure progressively decreased from € 427,000 in 2015 to € 269,000 in 2020.CONCLUSION:The use of EPPS was shown to be useful for pharmacists in implementing proper antibiotic dispensing practices; the avoidance of inappropriate prescriptions leads to a better monitoring of DPDs and the related expenditure which is the main goal of antibiotic stewardship programs.

Abstract Food sector operators are responsible for monitoring the production cycle in order to offer a safe product from a sanitary point of view for marketing and consumption. The main goal of the work was to evaluate the degree of contamination of various surfaces in different production companies and therefore the effectiveness of the sanitization procedures performed at critical points in the aforesaid process (CCPs). As a result of this initial analysis, suggestions are then made on how to strengthen the prevention and reduce the risk of microbial contamination of the entire workflow and also on how to prevent foodborne infectious diseases and drug resistance. The analytical investigation activity was carried out in our province in the period between 2011–2020 and involved commercial catering environments, large-scale distribution, small retail centers and small producers. Significant differences emerged from the results regarding the contamination of surfaces in the operational situations considered (contamination with Enterobacteriaceae spp. was more frequent in retail centers than in the other food sectors (16.3% vs 33.0%; p < 0.001) whilst a higher possibility of finding a positive sample was more probable for large-scale distribution equipment (24.3% vs 40.4%; p = 0.005). It was also observed how the collecting technique performed by contact plate gave more positive results than collecting samples with a swab (10.1% vs 5.7%; p = 0.002) and how some types of surfaces require more attention. In conclusion, from a risk prevention perspective, the results were satisfactory but could be further implemented through better sanitization practices that were recommended in the event of positive sampling.

This study was conducted to acquire knowledge on the epidemiology and ecology of some zoonotic agents in snails. Chemical and microbiological analysis was carried out on 46 samples of snails belonging to the species of Helix aspersa and Helix (Eobania) vermiculata. The association between heavy metals and wild snails, a native consumer product in the Region of Sardinia, was determined. The molecular characterisation of Listeria monocytogenes virulence genes has shown a genetic profile that deserves more attention for the improvement of surveillance and risk prevention. Specimens of H. vermiculata showed higher concentrations of cadmium (M=0.80±0.56 mg/kg) than H. aspersa (M=0.61±0.17 mg /kg). A further objective was to determine whether the samples showed significant differences from the point of view of secretion characterisation, in terms of protein content, and to identify species-specific correlations and possible relationships with the environment. The presence of Salmonella enterica sub.sp houtenae (6,14: z4, z23) and Salmonella enterica subsp diarizonae (47: k: e, n, z15) (1 sample), Listeria monocytogenes (2 samples) with Molecular characterization of virulence genes together with the measurement of heavy metals in samples of wild snails has shown a health and hygiene profile that would deserve greater attention for the improvement of the surveillance and prevention of microbiological and chemical risk in such products which currently show a tendency towards increase in consumption.

Bifidobacteria colonize the human gastrointestinal tract early on in life, their interaction with the host starting soon after birth. The health benefits are strain specific and could be due to the produced polysaccharides. The consumption of probiotics may prevent obesity, irritable bowel syndrome, eczema or atopic dermatitis, and asthma. Non-replicative strains of Bifidobacterium longum (NCC3001 and NCC2705) promote the differentiation of normal human epidermal keratinocytes (NHEKs), inducing a high expression of differentiation markers (keratin —KRT1—, and transglutaminase —TGM1—) and pro-regeneration markers (cathepsins), including β-defensin-1, which plays an important role in modulating the cutaneous immune response. Strains belonging to the genera Bifidobacterium and Lactobacillus can increase tight-junction proteins in NHEKs and enhance barrier function. Bifidobacteria and lactobacilli may be used as prophylactic or therapeutic agents towards enteric pathogens, antibiotic-associated diarrhea, lactose intolerance, ulcerative colitis, irritable bowel syndrome, colorectal cancer, cholesterol reduction, and control of obesity and metabolic disorders. Bifidobacterium bifidum showed an in vitro capability of lowering cholesterol levels thanks to its absorption into the bacterial membrane. Several strains of the species Lactobacillus acidophilus, L. delbrueckii subsp. bulgaricus, L. casei, and L. gasseri led to a reduced amount of serum cholesterol due to their ability to assimilate cholesterol (in vitro). Lactococcus lactis KF147 and Lactobacillus plantarum Lp81 have also been shown to reduce cholesterol levels by 12%. Clarifying the specific health mechanisms of Bifidobacterium and Lactobacillus strains in preventing high-cost pathologies could be useful for delineating effective guidelines for the treatment of infants and adults.

INTRODUCTION:Ensuring the microbiological quality of textiles is an important requirement for health care facilities. The present study examines the way transport times and temperatures influence microbial growth in textiles. Therefore, the effectiveness of washing and disinfection processes has also been studied. METHODS:Microbial Challenge Tests were set up through the artificial contamination of different dry and wet textiles which were stored at different temperatures. The bacterial concentration was evaluated in well-defined time phases aimed at simulating the time it took for the textiles to be transported from the hospital facilities to the reconditioning unit. Three times were therefore considered from T = 0 inoculation moment to T = 72 h post inoculation. At the end of each time, the increase in bacterial concentration was assessed by means of microbiological cultures, using selective media for the enumeration of each type of inoculated microorganism. RESULTS:In all the contaminated textiles the bacterial concentration remained unchanged at a temperature of 4 °C, while at 22 °C and 37 °C there was a significant increase (p < 0.05) starting from 8 h of storage. In these textiles, the microorganism that showed the greatest growth capacity was P. aeruginosa with average initial concentration values of 104 CFU/cm2 and a final concentration of 1.5 × 105 CFU/cm2 at 22 °C and 1 × 105 CFU/cm2 at 37 °C 72 h after inoculum. CONCLUSION:The data highlights the fact that the degree of contamination in textiles does not undergo an increase when transport takes place at a controlled temperature. Refrigerated transport of hospital textiles is thus a desirable preventive measure to keep microbiological risk under control.

Microbiological monitoring of air and surfaces is a valuable tool for assessing the level of environmental contamination by bacteria and fungi in hospitals, especially in high-risk wards. The presence of these microorganisms requires strict control in view of their role as opportunistic pathogens. As regard yeasts, Candida albicans is one of the main opportunistic pathogens. However, in recent years, many other “non-Albicans” species have been identified that are implicated in the onset of both localised infections in immunocompetent patients and systemic infections in immunocompromised patients. The aim of the work was to evaluate the frequency of isolation of Rhodotorula spp. in environmental samples of hospital origin in order to highlight how its presence may represent an increased risk for hospitalised patients. The samples were taken in at-risk wards, divided into six types of environments, in three hospitals in southern Sardinia between 2016 and 2019. The presence of moulds and yeasts was higher in the air (55.7%) than on surfaces (44.3%) in the hospital environments (p < 0.001). Similarly, the isolation frequency of Rhodotorula spp. was found to be greater (p < 0.001) in the air (14.2%) than on surfaces (9.2%). This study made it possible to evaluate the presence of pathogenic fungi in hospital environments, paying particular attention to Rhodotorula spp. since it is an emerging opportunistic yeast. It also highlights the importance of control measures especially in those where immunocompromised patients are present.

Introduction: An amendment incorporated into the 2007 AHA and 2009 ESC guidelines on infective endocarditis led to a substantial restriction in indications for the administration of antibiotic prophylaxis. This may have resulted in a subsequent steady increase in the number of cases of infective endocarditis worldwide. Methods: It has been hypothesised that susceptibility to infective endocarditis, together with effectiveness of antibiotic prophylaxis, may be linked to fluctuations of the immune system. Throughout a person's lifetime, individual susceptibility to infective endocarditis may vary in an identical situation of risk. As a consequence, a personalised targeted approach should be adopted when prescribing antibiotic prophylaxis to prevent onset of endocarditis, taking into account a series of factors including age, comorbidities, cortisol levels, and ethnicity. Children affected by bicuspid aortic valve and injection drug users are amongst the newly-emerging higher risk populations. Conclusion: This up-to-dated narrative review summarizes all the available scientific evidence concerning the variable influence of the immune system on susceptibility to infective endocarditis.

The consumption of fresh or RTE fruits is increasing every year and Listeria monocytogenes has been identified on raw or minimally processed fruits. A food product can become contaminated with L. monocytogenes anywhere along the pathway of food production during planting, harvesting, packaging, distribution and serving. The aim of this work was to assess the microbiological risks associated with consumption of ready- to- eat fruit such as melon, pineapple, coconut and fruit salad. The presence of Escherichia coli, Salmonella spp. and L. monocytogenes was also evaluated. Microbiological challenge tests were carried out for the evaluation of the L. monocytogenes growth potential in RTE fruit stored at 4 and 8°C. E. coli counts resulted under the detection limit of 10 CFU g-1, Salmonella and L. monocytogenes were not detected (absence in 25g). The growth potential values in coconut and melon (δ>0.5) showed the growth capacity of Listeria at the temperatures considered. A low initial load, also derived from good hygiene practices, and correct storage temperatures are essential to reduce bacterial growth in RTE fruit. The challenge test showed how each type of RTE fruit has a different commercial life based on its specific growth potential and that food should be stored at temperatures not higher than 4°C for a short period.

Preclinical and clinical studies have shown that the Trk receptors of neurotrophic factors play an important role in regulating the biological properties and the clinical evolution of neuroblastoma, the most frequent extracranial solid tumor in childhood. We have recently reported that treatment of retinoic acid (RA)‐differentiated human neuroblastoma cells with valproic acid (VPA) and other histone deacetylase (HDAC) inhibitors downregulates the expression and signaling of the BDNF receptor TrkB, a marker of unfavorable and aggressive neuroblastoma. In the present study we report that VPA, at therapeutically relevant concentrations, upregulates the expression of the neurotrophin 3 receptor TrkC in undifferentiated and RA‐differentiated SH‐SY5Y neuroblastoma cells. The exposure to VPA markedly increased the TrkC mRNA and the levels of the full length and truncated forms of TrkC protein. This change was associated with enhanced expression of TrkC at the plasma membrane, as indicated by cell surface biotinylation experiments and immunofluorescence assays in non permeabilized cells. The upregulation of TrkC was time‐dependent, being evident after 24 h of drug addition, and was accompanied by the emergence of apoptotic cell death. VPA increased the levels of the transcription factor RUNX3, a positive regulator of the NTRK3 gene encoding TrkC, and inhibition of this response by siRNA treatment attenuated the upregulation of TrkC. Moreover, pharmacological blockade of either ERK1/2 or JNK, but not p38MAPK, signaling pathways reduced VPA‐induced TrkC expression. VPA was found to induce TrkC also in MYCN‐amplified BE(2)C, NB‐1 and Kelly neuroblastoma cells and its effect was mimicked by other HDAC inhibitors, such as romidepsin and entinostat. These data indicate that VPA upregulates TrkC by activating a transcriptional programme involving epigenetic changes and MAPK signaling. As the expression of TrkC has been associated with a favorable outcome in neuroblastoma, the upregulation of this neurotrophin receptor may constitute an important component of the antineuroblastoma activity of VPA.Support or Funding InformationSardegna Ricerche‐Progetto IBERNAT‐NBL P.O.R. Sardegna 2014–2020, CUP F21B17000730005.

Besides inhibiting monoamine reuptake, antidepressants have been shown to affect a number of neurotransmitter receptor systems, at which they most often act as antagonists. We have previously shown that in neuronal and non‐neuronal cells different antidepressants, predominantly belonging to the tricyclic and tetracyclic classes, activate the LPA1 lysophosphatidic acid (LPA) receptor to induce proliferative and prosurvival signaling. In the present study we further characterize this unique agonist activity of antidepressants by examining their ability to activate two additional members of the LPA receptor family, LPA2 and LPA3, which display high sequence similarity to LPA1. The human LPA receptors were stably transfected in HEK293 cells (HEK293‐LPA1–3 cells), and their activation was monitored by measuring the phosphorylation/activation of ERK1/2 by Western blot. Exposure to LPA caused a concentration‐dependent increase of phospho‐ERK1/2 levels with EC50 values of 145, 210 and 45 nM in HEK293‐LPA1, ‐LPA2 and ‐LPA3 cells, respectively. As previously observed in other cell types endogenously expressing LPA receptors, amitriptyline, imipramine, clomipramine, desipramine, mianserin and mirtazapine effectively increased ERK1/2 phosphorylation in HEK293‐LPA1 cells. In HEK293 cells stably transfected with a LPA1 mutant (Q3.29A), which was unresponsive to LPA, the stimulatory effects of amitriptyline, clomipramine and mianserin were greatly suppressed, indicating the dependence on receptor structural integrity. Tricyclic antidepressants failed to stimulate ERK1/2 phosphorylation in HEK293‐LPA2 cells, whereas the tetracyclic compounds mianserin and mirtazapine displayed agonist activity, although with relative efficacies lower than those showed in HEK293‐LPA1 cells. Conversely, both tricyclic and tetracyclic antidepressants induced ERK1/2 activation in HEK293‐LPA3 cells. These data demonstrate that some classes of antidepressants can exert agonist activity at more than one LPA receptor, thus extending their spectrum of pharmacological activity. In particular, the present finding that antidepressants can activate LPA3, which is expressed in human hippocampus, amygdala, frontal cortex and in different peripheral tissues, suggests that this receptor can be a potential target for the therapeutic and adverse effects of these drugs.Support or Funding InformationUniversity of Cagliari FIR 2019

Well water requires chemical, physical-chemical, and microbiological analysis to ensure that the water used for irrigation or for human consumption presents no specific risks. The aim of the present work was to determine the microbiological risk of samples taken from wells in south-central Sardinia. In this survey, 55 water samples were taken from private wells in the period from 2014 to 2018. Quality was assessed through the detection of the parameters required by national law. The analysis of the data showed that only 36.4% of the samples (20 wells) complied with legal limits for water for human consumption. The most isolated species was P. aeruginosa, present in 29.1%; its high concentration and recorded Coliforms suggest that the disinfection of the wells was insufficient or not performed properly if implemented. Such data suggest the need to pay more attention to the waters used not only for human consumption but also for irrigation, since the cultivated vegetables could become a vehicle for potentially pathogenic microorganisms. National legislation sets contamination limits only for water intended for human consumption and not for irrigation water. However, based on these considerations, it appears necessary to develop reference standards for irrigation water.

INTRODUCTION:Legionella spp. are ubiquitous aquatic organisms found to be associated with community-acquired pneumoniae (CAP) as well as hospital-acquired pneumonia (HAP). Direct inhalation of aerosols from environmental colonisation is typically the source of infection. The aim of this study was to determine the level of colonisation in hospital water supply systems in order to assess the criticality of the water distribution network and strengthen preventive measures.METHODS:From 2009 to 2018, 769 water samples were collected and then analysed according to the standard methods indicated in ISO11731-2:2004 and ISO11731:2017 for Legionella detection.RESULTS:The samples were positive in 37.1% cases (n. 285) and negative in 62.9% cases (n. 484). The threshold of 10,000 CFU/L was exceeded in 15.1% cases and led to decolonisation as indicated by Italian and European ECDC guidelines. In the autumn-winter period SG1 showed a positivity of 41.2% (n. 40) with a decrease in the spring-summer period with 9.6% (n. 18) of positivity. In contrast, SG2-15 showed a positivity of 30.9% (n. 30) in autumn-winter, which tends to increase to 56.9% (n. 112) in spring-summer (p < 0.001).CONCLUSION:Surprisingly, besides showing a seasonal trend already described previously in the literature, the positivity of our sample was not balanced even for serogroups in the two periods. This could be due to genetic differences and ecological niches to be further investigated that could also have links with the greater pathogenicity of SG1. Environmental microbiological surveillance and risk assessment should be performed more frequently and disinfection must be carried out, especially in health facilities where people are more susceptible to infections.

The antiepileptic and mood stabilizer agent valproic acid (VPA) has been shown to exert anti-tumour effects and to cause neuronal damage in the developing brain through mechanisms not completely understood. In the present study we show that prolonged exposure of SH-SY5Y and LAN-1 human neuroblastoma cells to clinically relevant concentrations of VPA caused a marked induction of the protein and transcript levels of the common neurotrophin receptor p75NTR and its co-receptor sortilin, two promoters of apoptotic cell death in response to proneurotrophins. VPA induction of p75NTR and sortilin was associated with an increase in plasma membrane expression of the receptor proteins and was mimicked by cell treatment with several histone deacetylase (HDAC) inhibitors. VPA and HDAC1 knockdown decreased the level of EZH2, a core component of the polycomb repressive complex 2, and upregulated the transcription factor CASZ1, a positive regulator of p75NTR. CASZ1 knockdown attenuated VPA-induced p75NTR overexpression. Cell treatment with VPA favoured proNGF-induced p75NTR/sortilin interaction and the exposure to proNGF enhanced JNK activation and apoptotic cell death elicited by VPA. Depletion of p75NTR or addition of the sortilin agonist neurotensin to block proNGF/sortilin interaction reduced the apoptotic response to VPA and proNGF. Exposure of mouse cerebellar granule cells to VPA upregulated p75NTR and sortilin and induced apoptosis which was enhanced by proNGF. These results indicate that VPA upregulates p75NTR apoptotic cell signalling through an epigenetic mechanism involving HDAC inhibition and suggest that this effect may contribute to the anti-neuroblastoma and neurotoxic effects of VPA.

To investigate the link between Human Herpesvirus 8 (HHV8) infection and plasma oxidative stress in patients with diabetes mellitus type 2 (DM2). Blood samples collected from DM2 and control subjects were screened for the presence of antibodies against HHV8 and for biomarkers of oxidative stress. We determined the products of radical damage on the plasma lipid fraction, such as malondialdehyde (MDA), fatty acid hydroperoxides (HP) and 7-ketocholesterol (7-keto), the oxidation products of unsaturated fatty acids (UFA) and cholesterol, respectively. The level of plasma antioxidant α-tocopherol (α-toc) was also assessed. Relevant differences were observed in the redox status in DM2 and either HHV8-positive or -negative control subjects. The level of α-toc significantly decreased in both DM2 and HHV8-positive subjects. Levels of MDA, HP and 7-keto were much higher in HHV8-positive and DM2 subjects, indicating that plasma oxidative stress is a common feature in both DM2 and HHV8-infection. In addition, 7-keto was further increased in HHV8-positive DM2 patients. We hypothesized that the HHV8-infection may contribute to the production of ROS, and hence to the oxidative stress closely related to the pathogenesis and development of DM2.

Oncogenic and latent-persistent viruses belonging to both DNA (herpesviruses) and RNA viruses [hepatitis C virus (HCV), enteroviruses, rubella, human immunodeficiency virus, and dengue virus] are known to cause severe alterations of cell metabolism, which occasionally can lead to diabetes onset. HCV has been claimed to be able to impair cell metabolism by means of a direct modification of insulin cell sensitivity and host innate immune response. Human herpesvirus 8 (HHV8) infection also induces stable modifications in cell metabolism. HHV8 enhances the production of insulin receptors in endothelial cells, favors the concentration of lipid droplets in the cytoplasm of endothelial cells, and induces a general impairment of both triglycerides and cholesterol metabolism. HHV8 is also known to alter humoral response and the production of cytokines, which affects cell oxidative activity (reactive oxygen species activation), with a general impairment of acquired immunity. This review focuses particular attention on the recent findings reported on these two latent-persistent human viruses, namely, HCV and HHV8.

BACKGROUNDVegetables are major components of a healthy and balanced diet. However, 25% of foodborne diseases are linked to the consumption of vegetables.STUDY DESIGNThe aim of this work was to assess the microbiological risks associated with consumption of ready to eat salads (RTE).METHODSMicrobiological challenge tests were carried out for the evaluation of the L. monocytogenes growth potential in RTE salads stored at different temperatures.RESULTSThe results indicate that L.monocytogenes was able to grow (δ ≥ 0.5) in all storage conditions considered at the end of shelf life. In order to evaluate the virulence role of L. monocytogenes, the temperature-dependent transcription of major virulence genes was also investigated by RT-PCR.CONCLUSIONSThe microbiological challenge test allowed us to confirm, as also demonstrated by other authors, that RTE salads are able to support the growth of L. monocytogenes strains (d δ≥ 0.5) stored under different temperatures.