Sepsis is a life-threatening condition frequently associated with gut dysbiosis and bacterial colonization by multidrug-resistant organisms. However, the interplay between gut microbiota, colonization patterns, and sepsis onset remains poorly defined. The authors analyzed longitudinal gut microbiota profiles from 132 hospitalized patients enrolled in the SURVEIL study. Rectal swabs were collected at three time points (baseline, sepsis onset, and discharge). Bacterial colonization status and MDR strains were determined through culture-based methods, while microbiota composition was assessed via 16S rDNA sequencing. Diversity indices, taxonomic and functional profiles, and differential abundance analyses (LEfSe) were integrated with clinical metadata, including age and sepsis status. At baseline, colonized patients-particularly those harboring Gram-positive taxa-exhibited significantly reduced alpha diversity compared to non-colonized individuals. Aging further modulated diversity and beta diversity patterns independently. Sepsis was associated with profound dysbiosis, characterized by enrichment in opportunistic genera (e.g., Finegoldia sp., Anaerococcus sp., Parabacteroides sp.), reduced microbial diversity, and distinct beta diversity trajectories. Functional predictions revealed enhanced representation of anaerobic metabolism, nitrogen/sulfur cycling, and host-adaptive traits in colonized states. MDR strains partially overlapped with bloodstream pathogens in septic patients, suggesting a possible link between intestinal colonization and bloodstream infection that warrants mechanistic validation. Our findings demonstrate that bacterial colonization and sepsis are strongly associated with compositional and functional shifts in the gut microbiota. Age and MDR carriage further shape microbiota dynamics. Early microbial signatures, such as Finegoldia sp. enrichment in colonized non-septic patients, may represent early markers of microbial destabilization and sepsis risk.

OBJECTIVES:The rise of antimicrobial resistance poses a major challenge for both clinicians and clinical microbiologists. There is an increasing need for user-friendly and reliable methods to assess the activity of antibiotics against multidrug-resistant (MDR) strains. Although synergy testing provides valuable insights, conventional methods such as checkerboard assays and time-kill studies are labour-intensive, technically demanding, and difficult to standardize. This study evaluated the MTS™ SAS (MIC Test Strip - Synergy Application System, Liofilchem, Italy), a commercial gradient diffusion assay developed for antibiotic synergy testing. METHODS:The performance of MTS™ SAS was evaluated in comparison with the checkerboard microdilution method, used as the reference standard. Nine antibiotic combinations were tested against ten different bacterial strains across 11 Italian hospitals. Inter-laboratory reproducibility and agreement with the reference method were analysed. RESULTS:The concordance between MIC test strips and the broth microdilution (BMD) method was 98.4%, with 1.6% showing discordant results - all within a 3-dilution range. Among 996 synergy determinations, MTS™ SAS demonstrated high reproducibility across all centers (96.7%), while only 3.3% of tests showed discordant synergy classifications (e.g., synergy vs. indifference). Comparison with the checkerboard method demonstrated an overall concordance of 96.2%, despite the absence of specific operator training at each site. CONCLUSION:These findings support MTS™ SAS as a practical and reliable alternative to conventional synergy testing methods, particularly suitable for routine clinical settings and laboratories lacking advanced microbiological expertise.

Background and Aims: patients suffering from systemic mycobacterial spread are at high risk of unfavorable clinical outcomes. Rapid microbiological diagnosis, however, is complicated due to the very slow cultural growth of mycobacteria. To facilitate the diagnostic workflow, we assessed a workflow allowing mass spectrometry-based identification and molecular resistance testing of mycobacteria directly from blood culture pellets. Materials and Methods: for this study, 50 blood cultures spiked with n=10 Mycobacterium tuberculosis (MTC) isolates and n=40 isolates belonging to 12 other species of non-tuberculous mycobacteria (n=13 M. abscessus complex, n=5 M. avium, n=3 M. chimaera, n=5 M. fortuitum, n=5 M. intracellulare, n=2 M. lentiflavum and n=2 M. mucogenicum, n=1 for each one of the species M. elephantis, M. hassiacum, M. marseillense, M. nebraskense and M. parascrofulaceum) were used next to two clinical cases of a disseminated infection in HIV patients. Results: the application of the MBT Sepsityper® kit allowed the correct species level identification by applying mass spectrometry as well as correct molecular resistance testing results as compared to the diagnostic reference approach applied with mycobacterial culture material. Conclusions: in conclusion, the results provide a proof-of-principle of the suitability of the assessed potential workflow in order to achieve a shortened time-to-result for the diagnosis of systemic mycobacterial infections. Future studies in high endemicity settings are desirable to assess the clinical applicability and impact of such a shortened workflow.

Campylobacter is a frequent cause of enteric infections with common antimicrobial resistance issues. The most recent reports of campylobacteriosis in Italy include data from 2013 to 2016. We aimed to provide national epidemiological and microbiological data on human Campylobacter infections in Italy during the period 2017–2021. Data was collected from 19 Hospitals in 13 Italian Regions. Bacterial identification was performed by mass spectrometry. Antibiograms were determined with Etest or Kirby-Bauer (EUCAST criteria). In total, 5419 isolations of Campylobacter spp. were performed. The most common species were C. jejuni (n = 4535, 83.7

Previous studies reported that the hepatitis C virus (HCV) could help disseminate the hepatitis D virus (HDV) in vivo through the unrelated hepatitis B virus (HBV), but with essentially inconclusive results. To try to shed light on this still-debated topic, 146 anti-HCV-positive subjects (of whom 91 HCV/HIV co-infected, and 43 with prior HCV eradication) were screened for anti-HDV antibodies (anti-HD), after careful selection for negativity to any serologic or virologic marker of current or past HBV infection. One single HCV/HIV co-infected patient (0.7%) tested highly positive for anti-HD, but with no positive HDV-RNA. Her husband, in turn, was a HCV/HIV co-infected subject with a previous contact with HBV. While conducting a thorough review of the relevant literature, the authors attempted to exhaustively describe the medical history of both the anti-HD-positive patient and her partner, believing it to be the key to dissecting the possible complex mechanisms of HDV transmission from one subject to another, and speculating that in the present case, it may have been HCV itself that behaved as an HDV helper virus. In conclusion, this preliminary research, while needing further validation in large prospective studies, provided some further evidence of a role of HCV in HDV dissemination in humans.

In this study the activity of Isavuconazole, Voriconazole, Amphotericin B, and Caspofungin against 224 clinical isolates of Aspergillus spp. originating from seven Italian hospitals, was comparatively evaluated with two commercial antifungal susceptibility tests (AST): SensititreTM YeastOneTM (SYO) and MIC Test Strip. More attention was focused on Isavuconazole activity, given the new introduction of the drug in widely distributed antifungal susceptibilities methods in the clinical microbiology lab. The minimum inhibitory concentrations of antifungal drug that can inhibit the growth of pathogen by 90% (MIC90) for Isavuconazole detected by SYO were 0.5, 1, 0.25, and 2 mu g/mL for Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus, and Aspergillus niger, respectively, whilst they were 0.25, 0.25, 0.5, and 0.75 mu g/mL by MIC Test Strip. Essential agreement between the two tested methods for Isavuconazole is 70% for all the species tested, 75.7% for A. fumigatus, 45.2% for A. flavus, 90.6% for A. terreus, and 40% for A. niger. Although the tested strains do not express any phenotypic resistance, MIC results were quite different if tested with microdilution broth or gradient agar method. This is the first Italian multicenter report on Isavuconazole MIC obtained employing the widely used SensititreTM Yeast OneTM (SYO) and MIC Test Strip on clinical isolates of Aspergillus.

JDDG: Journal der Deutschen Dermatologischen GesellschaftVolume 19, Issue 1 p. 133-139 DiagnosequizFree to Read In Island erworbene Hautinfektion Laura Cristina Gironi, Corresponding Author gironi.laura@gmail.com Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy Korrespondenzanschrift Laura Cristina Gironi, MD Department of Health Sciences A. Avogadro University of Eastern Piedmont Corso Mazzini 18 28100 Novara, Italy E-Mail: gironi.laura@gmail.comSearch for more papers by this authorEdoardo Cammarata, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorAnna Camaggi, Laboratory of Microbiology and Virology, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorDiego Brustia, Infectious Diseases Department, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorAngela Giacalone, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorStefano Andreoni, Laboratory of Microbiology and Virology, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorRoberto Giorgione, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorPaolo Boggio, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorStefano Astolfi, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorRossana Tiberio, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorPaola Savoia, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this author Laura Cristina Gironi, Corresponding Author gironi.laura@gmail.com Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy Korrespondenzanschrift Laura Cristina Gironi, MD Department of Health Sciences A. Avogadro University of Eastern Piedmont Corso Mazzini 18 28100 Novara, Italy E-Mail: gironi.laura@gmail.comSearch for more papers by this authorEdoardo Cammarata, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorAnna Camaggi, Laboratory of Microbiology and Virology, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorDiego Brustia, Infectious Diseases Department, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorAngela Giacalone, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorStefano Andreoni, Laboratory of Microbiology and Virology, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorRoberto Giorgione, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorPaolo Boggio, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorStefano Astolfi, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorRossana Tiberio, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorPaola Savoia, Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this author First published: 25 January 2021 https://doi.org/10.1111/ddg.14178_gAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Volume19, Issue1January 2021Pages 133-139 RelatedInformation

Tegument mycoses are classified into three groups: 1) Superficial skin mycoses or superficial mycoses: infections sustained by fungi limited to the skin horny layer or the hair extrafollicular portion, without a significant inflammatory response in the host. 2) Skin mycoses (dermatophytosis) sensu stricto: fungal infections in which skin and its annexes, at the level of the keratinized layers, are involved with an evident immune response by the host 3) Mycosis of the subcutaneous tissue: fungal infections that mainly affect the subcutaneous tissue and secondarily, by contiguity, skin, bones and other tissues, with a strong immune response by the host [...].

JDDG: Journal der Deutschen Dermatologischen GesellschaftVolume 19, Issue 1 p. 133-139 Case for Diagnosis Granulomatous skin infection from Iceland Laura Cristina Gironi, Corresponding Author Laura Cristina Gironi gironi.laura@gmail.com Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy Correspondence to Laura Cristina Gironi, MD Department of Health Sciences A. Avogadro University of Eastern Piedmont Corso Mazzini 18 28100 Novara, Italy E-mail: gironi.laura@gmail.comSearch for more papers by this authorEdoardo Cammarata, Edoardo Cammarata Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorAnna Camaggi, Anna Camaggi Laboratory of Microbiology and Virology, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorDiego Brustia, Diego Brustia Infectious Diseases Department, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorAngela Giacalone, Angela Giacalone Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorStefano Andreoni, Stefano Andreoni Laboratory of Microbiology and Virology, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorRoberto Giorgione, Roberto Giorgione Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorPaolo Boggio, Paolo Boggio Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorStefano Astolfi, Stefano Astolfi Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorRossana Tiberio, Rossana Tiberio Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorPaola Savoia, Paola Savoia Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this author Laura Cristina Gironi, Corresponding Author Laura Cristina Gironi gironi.laura@gmail.com Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy Correspondence to Laura Cristina Gironi, MD Department of Health Sciences A. Avogadro University of Eastern Piedmont Corso Mazzini 18 28100 Novara, Italy E-mail: gironi.laura@gmail.comSearch for more papers by this authorEdoardo Cammarata, Edoardo Cammarata Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorAnna Camaggi, Anna Camaggi Laboratory of Microbiology and Virology, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorDiego Brustia, Diego Brustia Infectious Diseases Department, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorAngela Giacalone, Angela Giacalone Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorStefano Andreoni, Stefano Andreoni Laboratory of Microbiology and Virology, University Hospital “Maggiore della Carità”, Novara, ItalySearch for more papers by this authorRoberto Giorgione, Roberto Giorgione Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorPaolo Boggio, Paolo Boggio Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorStefano Astolfi, Stefano Astolfi Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorRossana Tiberio, Rossana Tiberio Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this authorPaola Savoia, Paola Savoia Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, ItalySearch for more papers by this author First published: 02 August 2020 https://doi.org/10.1111/ddg.14178AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume19, Issue1January 2021Pages 133-139 RelatedInformation

JDDG: Journal der Deutschen Dermatologischen GesellschaftVolume 18, Issue 2 p. 153-156 Case for Diagnosis Disseminated ulcers with sporotrichoid distribution Federica Veronese, Corresponding Author Federica Veronese federica.veronese@med.uniupo.it Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, Italy Correspondence to Federica Veronese, MD Dermatologic Clinic AOU Maggiore della Carità Hospital 28100 Novara E-mail: federica.veronese@med.uniupo.itSearch for more papers by this authorRossella Molinari, Rossella Molinari Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorStefano Astolfi, Stefano Astolfi Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorLuigia Saini, Luigia Saini Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorRoberta Nicali, Roberta Nicali Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorAnna Camaggi, Anna Camaggi Microbiology and Virology Laboratory, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorStefano Andreoni, Stefano Andreoni Microbiology and Virology Laboratory, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorPiero Emilio Balbo, Piero Emilio Balbo Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorPaola Savoia, Paola Savoia Dermatologic Clinic, Department of Health Science University of Eastern Piedmont, Novara, ItalySearch for more papers by this author Federica Veronese, Corresponding Author Federica Veronese federica.veronese@med.uniupo.it Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, Italy Correspondence to Federica Veronese, MD Dermatologic Clinic AOU Maggiore della Carità Hospital 28100 Novara E-mail: federica.veronese@med.uniupo.itSearch for more papers by this authorRossella Molinari, Rossella Molinari Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorStefano Astolfi, Stefano Astolfi Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorLuigia Saini, Luigia Saini Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorRoberta Nicali, Roberta Nicali Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorAnna Camaggi, Anna Camaggi Microbiology and Virology Laboratory, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorStefano Andreoni, Stefano Andreoni Microbiology and Virology Laboratory, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorPiero Emilio Balbo, Piero Emilio Balbo Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorPaola Savoia, Paola Savoia Dermatologic Clinic, Department of Health Science University of Eastern Piedmont, Novara, ItalySearch for more papers by this author First published: 06 February 2020 https://doi.org/10.1111/ddg.14028AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume18, Issue2February 2020Pages 153-156 RelatedInformation

JDDG: Journal der Deutschen Dermatologischen GesellschaftVolume 18, Issue 2 p. 153-156 Diagnosequiz Disseminierte Ulzera mit sporotrichoider Ausbreitung Federica Veronese, Corresponding Author Federica Veronese federica.veronese@med.uniupo.it Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, Italy Korrespondenzanschrift Federica Veronese, MD Dermatologic Clinic AOU Maggiore della Carità Hospital 28100 Nsovara E-Mail: federica.veronese@med.uniupo.itSearch for more papers by this authorRossella Molinari, Rossella Molinari Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorStefano Astolfi, Stefano Astolfi Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorLuigia Saini, Luigia Saini Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorRoberta Nicali, Roberta Nicali Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorAnna Camaggi, Anna Camaggi Microbiology and Virology Laboratory, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorStefano Andreoni, Stefano Andreoni Microbiology and Virology Laboratory, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorPiero Emilio Balbo, Piero Emilio Balbo Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorPaola Savoia, Paola Savoia Dermatologic Clinic, Department of Health Science University of Eastern Piedmont, Novara, ItalySearch for more papers by this author Federica Veronese, Corresponding Author Federica Veronese federica.veronese@med.uniupo.it Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, Italy Korrespondenzanschrift Federica Veronese, MD Dermatologic Clinic AOU Maggiore della Carità Hospital 28100 Nsovara E-Mail: federica.veronese@med.uniupo.itSearch for more papers by this authorRossella Molinari, Rossella Molinari Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorStefano Astolfi, Stefano Astolfi Dermatologic Clinic, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorLuigia Saini, Luigia Saini Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorRoberta Nicali, Roberta Nicali Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorAnna Camaggi, Anna Camaggi Microbiology and Virology Laboratory, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorStefano Andreoni, Stefano Andreoni Microbiology and Virology Laboratory, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorPiero Emilio Balbo, Piero Emilio Balbo Medical Department, Division of Respiratory Medicine, University of Eastern Piedmont, AOU Maggiore della Carità Hospital, Novara, ItalySearch for more papers by this authorPaola Savoia, Paola Savoia Dermatologic Clinic, Department of Health Science University of Eastern Piedmont, Novara, ItalySearch for more papers by this author First published: 06 February 2020 https://doi.org/10.1111/ddg.14028_gAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume18, Issue2February 2020Pages 153-156 RelatedInformation

OBJECTIVES:The goal of this study was to assess chest computed tomography (CT) diagnostic accuracy in clinical practice using RT-PCR as standard of reference.METHODS:From March 4th to April 9th 2020, during the peak of the Italian COVID-19 epidemic, we enrolled a series of 773 patients that performed both non-contrast chest CT and RT-PCR with a time interval no longer than a week due to suspected SARS-CoV-2 infection. The diagnostic performance of CT was evaluated according to sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy, considering RT-PCR as the reference standard. An analysis on the patients with discrepant CT scan and RT-PCR result and on the patient with both negative tests was performed.RESULTS:RT-PCR testing showed an overall positive rate of 59.8 %. CT sensitivity, specificity, PPV, NPV, and accuracy for SARS-CoV-2 infection were 90.7 % [95 % IC, 87.7%-93.2%], 78.8 % [95 % IC, 73.8-83.2%], 86.4 % [95 % IC, 76.1 %-88.9 %], 85.1 % [95 % IC, 81.0 %-88.4] and 85.9 % [95 % IC 83.2-88.3%], respectively. Twenty-five/66 (37.6 %) patients with positive CT and negative RT-PCR results and 12/245 (4.9 %) patients with both negative tests were nevertheless judged as positive cases by the clinicians based on clinical and epidemiological criteria and consequently treated.CONCLUSIONS:In our experience, in a context of high pre-test probability, CT scan shows good sensitivity and a consistently higher specificity for the diagnosis of COVID-19 pneumonia than what reported by previous studies, especially when clinical and epidemiological features are taken into account.

Background: The aetiology of lower respiratory tract infections is challenging to investigate.Despite the wide array of diagnostic tools, invasive techniques, such as bronchoalveolar lavage (BAL), are often required to obtain adequate specimens.PneumoniaCheck TM is a new device that collects aerosol particles from cough, allowing microbiological analyses.Up to now it has been tested only for bacteria detection, but no study has investigated its usefulness for virus identification.Methods: In this pilot study we included 12 consecutive patients with pneumonia.After testing cough adequacy via a peak flow meter, a sampling with PneumoniaCheck TM was collected and a BAL was performed in each patient.Microbiological analyses for virus identification were performed on each sample and concordance between the two techniques was tested (sensitivity, specificity and positive/negative predictive values), taking BAL results as reference.Results: BAL was considered adequate in 10 patients.Among them, a viral pathogen was identified by PneumoniaCheck TM 6 times, each on different samples, whereas BAL allowed to detect the presence of a virus on 7 patients (14 positivities).Overall, the specificity for PneumoniaCheck TM to detect a virus was 100%, whereas the sensitivity was 66%.When considering only herpes viruses, PneumoniaCheck TM showed a lower sensitivity, detecting a virus in 1/4 of infected patients (25%).Conclusions: In this pilot study PneumoniaCheck TM showed a good correlation with BAL for non-herpes virologic identification in pneumonia patients, providing excellent specificity.Further studies on larger population are needed to confirm these results and define its place in the panorama of rapid diagnostic tests for lower respiratory tract infections.

This report describes a case of Sphingobacterium hotanense bacteraemia in a patient scratched by a rooster on the right arm. Diagnostic, clinical and therapeutic features are discussed. To the best of our knowledge, this is the first case of Sphingobacterium hotanense bacteremia reported in the medical literature.

Dermatomycoses due to Trichophyton violaceum are described in Mediterranean Countries, North Africa and in the Horn of Africa where T. soudanense is present too, but it was rare until few years ago in Italy. Aim of the present study was to evaluate an Italian multicenter 9 year (2005-2013) experience concerning these re-emerging pathogens. Fifty three fungal strains were sent from clinical laboratories to the Medical Mycology Committee (CoSM)--Italian Association of Clinical Microbiology (AMCLI) for mycological confirmation. Strains were identified as T. violaceum (23) and T. soudanense (30) by phenotypic and genotypic methods. These dermatophytes present epidemiological (high rate of inter-human transmission, high risk among adopted children coming from countries of either the Horn of Africa or Sub-Saharan Africa also in outbreaks of tinea capitis) and clinical peculiarities (reduced alopecia, presence of exudative lesions) confirming the originality of these "imported" dermatophyte infections.

To date, only 11 cases of infection by Arthrographis kalrae have been described. According to the literature, we report a second case of arthritis caused by this mycete after a penetrating wound successfully treated with voriconazole before arthroscopic knee washout for six weeks.

Infection is an important cause of morbidity and mortality among patients with end stage renal disease. Stenotrophomonas maltophilia is an unusual yet emerging pathogen in dialysis units. We performed a systematic PubMed/Medline and Scopus review of peer-reviewed English papers on S. maltophilia infections among patients undergoing chronic dialysis, with regard to vascular accesses, systemic infections and environment contaminations. Moreover, we suggest a treatment algorithm to preserve the patient and the permanent dialysis catheters.

The emergence of drug resistance in fungal pathogens has a profound impact on human health given limited number of antifungal drugs. Antifungal resistance in Aspergillus spp. infection can be encountered in the antifungal drug-exposed patient due to selection of intrinsically resistant species or isolates with acquired resistance belonging to species that are normally susceptible. Resistance to triazoles is not common in Aspergillus spp., however, triazole resistance in A. fumigatus appears to be increasing in several European countries in recent years and can be clinically relevant. The Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing have developed breakpoints and epidemiological cutoff values that are now established for Aspergillus spp. Clinical microbiology laboratories will be employed commercial susceptibility assays, rather than reference broth microdilution methods and comparative studies are particularly important.