45 research outputs found
A comprehensive UHPLC-MS/MS screening method for the analysis of 98 New Psychoactive Substances and related compounds in human hair
Full text linkIn this study, a rapid liquid chromatography-tandem mass spectrometry (LC-MS/MS) method has been developed and validated for the targeted analysis of 98 New Psychoactive Substances (NPS) from the hair matrix. The monitored compounds included various chemical classes (7 phenethylamines, 10 tryptamines, 18 cathinones, 24 synthetic opioids, and 38 synthetic cannabinoids) with emphasis given to newly emerged NPS. The method employed a direct extraction process through the incubation of hair samples (25 mg) and internal standards with M3® reagent at 100 °C for 60 min, followed by extract purification through acid and basic liquid-liquid micro-extraction (LLME). Extracted compounds were analyzed through LC-MS/MS system operating in multiple reaction monitoring mode. NPS were separated in 9.5 min with a Poroshell 120 EC-C18 column (2.7 μm, 4.6 × 50 mm) using a gradient eluting mobile phase composed of water and acetonitrile/water (95:5) both containing 0.1 % of formic acid. The developed and validated method shows a good precision (≤ 15 %), linearity (R2 between 0.993 and 0.999), selectivity, and sensitivity (LOD: 0.6-10.3 pg mg-1 and LOQ: 2.1-34.4 pg mg-1). The method showed also reduced matrix effect and acceptable recovery for most of the targeted compounds. Our results showed that this method is suitable for quantifying NPS in hair matrix and could be employed in the context of routine analyses in analytical laboratories
Differences between Community - and Hospital - acquired urinary tract infections in a tertiary care hospital
No full textThe aim of this retrospective study was to highlight the differences in antibiotic resistance between Hospital-acquired and Community-acquired urinary tract infections (UTIs). Antimicrobial UTIs resistance data were collected from March 2011 to March 2018. Uropathogens were identified from 41,715 patients using routine laboratory methods. Differences in antibiotic resistance between Hospital and Community (non-hospitalized) patients were statistically validated. Odds ratio (OR) and p-values was used to determine whether a particular exposure (hospitalization) was a risk factor for a particular outcome (higher antibiotic resistance). We reported a general increase of unnecessary urine cultures in both community and hospital patients. The most representative microorganism isolated from Community (58.2%) and Hospital (47.6%) was E. coli. UTIs causative bacteria in hospitalized patients was more than twice as resistant to Trimetoprim/sulphamethoxazole (OR 2.26) and Imipenem (OR 2.56), for Gram-positive and Gram-negative, respectively, than in Community patients. Nitrofurantoin was the only agent without differences in resistance rate between community and hospital UTIs. Therefore, physicians could use it as a definitive therapy for uncomplicated cystitis and as a prophylactic agent for recurrent uncomplicated cystitis. With this work we provided a general protocol applicable by physicians to select the most suitable, if necessary, UTIs empiric treatment
Analysis of humoral and cellular immune activation up to 21 months after heterologous and homologous COVID-19 vaccination
Full text link: To address the COVID-19 pandemic, diverse vaccination strategies, including homologous and heterologous schedules, were employed to enhance immune protection. This study evaluates the long-term humoral and cellular immune responses in individuals vaccinated with homologous (ChAdOx1-S/ChAdOx1-S [ChAd/ChAd]) and heterologous (ChAdOx1-S/BNT162b2 [ChAd/BNT]) schedules, followed by a third-dose mRNA booster (BNT162b2 [BNT] or mRNA-1273). Anti-Spike IgG titers were measured at 9-, 12-, and 21-months post-primary vaccination (corresponding to 3-, 6-, and 15-months post-booster), while SARS-CoV-2-specific B- and T-cell responses were assessed at 21-months post-booster. Antibody titers declined by 12-months post-primary vaccination, regardless of the third dose administered, and increased significantly by 21-months, potentially due to a fourth dose (BNT or mRNA-1273) or natural SARS-CoV-2 infection. The heterologous ChAd/BNT schedule elicited a stronger and more durable immune response than the homologous ChAd/ChAd, as evidenced by higher anti-Spike IgG titers, increased IgM-/IgG+ memory B-cell activation, and enhanced cytotoxic CD8+ T-cell cytokine expression in infected individuals. SARS-CoV-2 infection further boosted humoral and cellular responses, with infected individuals showing higher anti-Spike IgG titers and greater CD8+ T-cell activation compared to uninfected individuals. These findings highlight the benefits of heterologous vaccination schedules and the role of infection-driven immune activation, providing valuable insights for optimizing vaccination strategies to improve long-term immunity against SARS-CoV-2
Retrospective analysis of nosocomial infections in an Italian tertiary care hospital
Full text linkNosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients. Studies of their prevalence in single institutions can reveal trends over time and help to identify risk factors. The aim of this study was to investigate the nosocomial infections trend and identify the prevalence of predominant bacterial microorganisms and their drug resistance patterns in an Italian tertiary care hospital. Infections were classified according to the Centres for Disease Control and Prevention definitions. A retrospective study was carried out from March 2011 to June 2014, based on the bacterial isolate reports of a hospital located in Central Italy. During the 40-month study period, a total of 1547 isolates were obtained from 1046 hospitalized patients and tested for their antibiotic sensitivity. The most common isolates belonged to the Enterobacteriaceae family (61.7%), followed by Enterococcus species (12.4%), Pseudomonas species (10.7%) and S. aureus (10.0%). The incidence density rate of nosocomial infections was 7.4 per 1000 patient days, with a significant difference among the 3 annual infection rates (P<0.001). The highest infection prevalence rate was found in Internal Medicine Unit (41.3%), followed by Intensive Care Units (12.4%), Surgical Units (9.0%,) and Cardiology (7.1%)
A three-year study entailing molecular characterization and epidemiology of Clostridium difficile in an Italian tertiary care hospital
Full text linkIn Italy, there are limited studies on the molecular epidemiology of Clostridium difficile, possibly due to insufficient laboratory diagnostic capacity, low awareness and lack of high-quality surveillance systems. The aim of this study was to evaluate the diffusion of C. difficile in a tertiary care hospital and to genotype all the collected strains in order for hospital staff to take corrective action. All specimens were subjected to a CDI diagnostic algorithm. This included highly specific toxin PCRs and multilocus sequence typing (MLST) to obtain clear, unequivocal genotypization. During a three-year study period, as part of routine C. difficile testing, 711 stool samples were collected from 522 patients to detect the presence of toxigenic genes. After testing, 106 different samples were identified as toxigenic. The proportions of non-toxigenic and toxigenic isolates were respectively 8.7% (62/711) and 14.9% (106/711). The most infection findings in wards for toxigenic strains were in Internal Medicine (56), followed by Neurology (11) and Gastroenterology (11). Three novel sequence types (STs) were found. The two most prevalent STs in wards were clade 1 ST-378 (40) and clade 1 ST-379 (33). Other healthcare-acquired strains were clade 4 ST-37 (11) and clade 5 ST-11 (7). Two STs, namely clade 3 ST-5 (10) and clade 1 ST-380 (5), were isolated among external patients. To prevent an increase in outbreak probability, an active surveillance programme combined with proper hand hygiene, environmental cleaning and contact precautions should be implemented
Which ones, when and why should renin-angiotensin system inhibitors work against COVID-19?
No full textThe article describes the possible pathophysiological origin of COVID-19 and the crucial role of renin-angiotensin system (RAS), providing several "converging" evidence in support of this hypothesis. SARS-CoV-2 has been shown to initially upregulate ACE2 systemic activity (early phase), which can subsequently induce compensatory responses leading to upregulation of both arms of the RAS (late phase) and consequently to critical, advanced and untreatable stages of COVID-19 disease. The main and initial actors of the process are ACE2 and ADAM17 zinc-metalloproteases, which, initially triggered by SARS-CoV-2 spike proteins, work together in increasing circulating Ang 1-7 and Ang 1-9 peptides and downstream (Mas and Angiotensin type 2 receptors) pathways with anti-inflammatory, hypotensive and antithrombotic activities. During the late phase of severe COVID-19, compensatory secretion of renin and ACE enzymes are subsequently upregulated, leading to inflammation, hypertension and thrombosis, which further sustain ACE2 and ADAM17 upregulation. Based on this hypothesis, COVID-19-phase-specific inhibition of different RAS enzymes is proposed as a pharmacological strategy against COVID-19 and vaccine-induced adverse effects. The aim is to prevent the establishment of positive feedback-loops, which can sustain hyperactivity of both arms of the RAS independently of viral trigger and, in some cases, may lead to Long-COVID syndrome
A Real-World Setting Study: Which Glucose Meter Could Be the Best for POCT Use? An Easy and Applicable Protocol During the Hospital Routine
No full textThe aim of this retrospective study is to evaluate the reliability and robustness of six glucose meters for point-of-care testing in our wards using a brand-new protocol. During a 30-days study period a total of 50 diabetes patients were subjected to venous blood sampling and glucose meter blood analysis. The results of six glucose meters were compared with our laboratory reference assay. GlucoMen Plus (Menarini) with the 82% of acceptable results was the most robust glucose meter. Even if the Passing-Bablok analysis demonstrates the presence of constant systematic errors and the Bland-Altman test highlighted a possible overestimation, the surveillance error grid analysis showed that this glucose meter can be used safely. We proved that portable glucose meters are not always reliable in routinely clinical settings
A clone of linezolid-resistant Staphylococcus epidermidis bearing the G2576T mutation is endemic in an Italian hospital
No full textCirculating ACE2 level and zinc/albumin ratio as potential biomarkers for a precision medicine approach to COVID-19
Full text linkHighly mutable influenza is successfully countered based on individual susceptibility and similar
precision-like medicine approach should be effective against SARS-COV-2. Among predictive
markers to bring precision medicine to COVID-19, circulating ACE2 has potential features being
upregulated in both severe COVID-19 and predisposing comorbidities. Spike SARS-CoVs were
shown to induce ADAM17-mediated shedding of enzymatic active ACE2, thus accounting for its
increased activity that has also been suggested to induce positive feedback loops leading to
COVID-19-like manifestations. For this reason, pre-existing ACE2 activity and inhibition of
ACE2/ADAM17 zinc-metalloproteases through zinc chelating agents have been proposed to predict COVID-19 outcome before infection and to protect from COVID-19, respectively. Since most diagnostic laboratories are not equipped for enzymatic activity determination, other potential predictive markers of disease progression exploitable by diagnostic laboratories were explored. Concentrations of circulating albumin, zinc, ACE2 protein and its activity were investigated in healthy, diabetic (COVID-19-susceptible) and SARS-CoV-2-negative COVID-19 individuals. ACE2 both protein levels and activity significantly increased in COVID-19 and diabetic patients. Abnormal high levels of ACE2 characterised a subgroup (16–19%) of diabetics, while COVID-19 patients were characterised by significantly higher zinc/albumin ratios, pointing to a relative increase of albumin-unbound zinc species, such as free zinc ones.
Data on circulating ACE2 levels are in line with the hypothesis that they can drive susceptibility
to COVID-19 and elevated zinc/albumin ratios support the therapeutic use of zinc chelating inhibitors of ACE2/ADAM17 zinc-metalloproteases in a targeted therapy for COVID-19
