High #incidence of #MDR and #XDR #Pseudomonas aeruginosa isolates obtained from #patients with #ventilator-associated #pneumonia in #Greece, #Italy and #Spain as part of the MagicBullet clinical trial (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

High incidence of MDR and XDR Pseudomonas aeruginosa isolates obtained from patients with ventilator-associated pneumonia in Greece, Italy and Spain as part of the MagicBullet clinical trial

Astrid Pérez, Eva Gato, José Pérez-Llarena, Felipe Fernández-Cuenca, María José Gude, Marina Oviaño, María Eugenia Pachón, José Garnacho, Verónica González, Álvaro Pascual, José Miguel Cisneros, Germán Bou

Journal of Antimicrobial Chemotherapy, dkz030, https://doi.org/10.1093/jac/dkz030

Published: 08 February 2019




To characterize the antimicrobial susceptibility, molecular epidemiology and carbapenem resistance mechanisms in Pseudomonas aeruginosa isolates recovered from respiratory tract samples from patients with ventilator-associated pneumonia enrolled in the MagicBullet clinical trial.


Isolates were collected from 53 patients from 12 hospitals in Spain, Italy and Greece. Susceptibility was determined using broth microdilution and Etest. MALDI-TOF MS was used to detect carbapenemase activity and carbapenemases were identified by PCR and sequencing. Molecular epidemiology was investigated using PFGE and MLST.


Of the 53 isolates, 2 (3.8%) were considered pandrug resistant (PDR), 19 (35.8%) were XDR and 16 (30.2%) were MDR. Most (88.9%) of the isolates from Greece were MDR, XDR or PDR, whereas fewer of the isolates from Spain (33.3%) and Italy (43.5%) showed antibiotic resistance. Three Greek isolates were resistant to colistin. Overall, the rates of resistance of P. aeruginosa isolates to imipenem, ciprofloxacin, ceftolozane/tazobactam and ceftazidime/avibactam were 64.1%, 54.7%, 22.6% and 24.5%, respectively. All isolates resistant to ceftolozane/tazobactam and ceftazidime/avibactam (Greece, n = 10; and Italy, n = 2) carried blaVIM-2. Spanish isolates were susceptible to the new drug combinations. Forty-eight restriction patterns and 27 STs were documented. Sixty percent of isolates belonged to six STs, including the high-risk clones ST-111, ST-175 and ST-235.


MDR/XDR isolates were highly prevalent, particularly in Greece. The most effective antibiotic against P. aeruginosa was colistin, followed by ceftolozane/tazobactam and ceftazidime/avibactam. blaVIM-2 is associated with resistance to ceftolozane/tazobactam and ceftazidime/avibactam, and related to highly resistant phenotypes. ST-111 was the most frequent and disseminated clone and the clonal diversity was lower in XDR and PDR strains.

Topic: antibiotics – phenotype – polymerase chain reaction – pseudomonas aeruginosa – antibiotic resistance, bacterial – colistin – ciprofloxacin – ceftazidime – clone cells – drug combinations – electrophoresis, gel, pulsed-field – epidemiology, molecular – greece – ichthyosis, x-linked – imipenem – italy – respiratory system – sequence tagged sites – spain – spectrometry, mass, matrix-assisted laser desorption-ionization – sodium thiosulfate – antimicrobial susceptibility – tazobactam – ventilator-associated pneumonia – ceftolozane – avibactam – carbapenem resistance

Issue Section:


© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Pseudomonas aeruginosa; Pneumonia; Italy; Spain; Greece; Colistin; Ciprofloxacin; Ceftazidime; Iminpenem; Tazobactam; Ceftolozane; Avibactam.



Cocirculation of #Hajj and non-Hajj #strains among serogroup W #meningococci in #Italy, 2000 to 2016 (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Cocirculation of Hajj and non-Hajj strains among serogroup W meningococci in Italy, 2000 to 2016

Cecilia Fazio1, Arianna Neri1, Paola Vacca1, Andrea Ciammaruconi2, Milena Arghittu3, Anna Maria Barbui4,Caterina Vocale5, Paola Bernaschi6, Patrizia Isola7, Irene Alessandra Galanti8, Antonella Mencacci9, Rosella De Nittis10, Maria Chironna11,Anna Giammanco12, Elisabetta Pagani13, Alessandro Bisbano14, Paola Stefanelli1

Affiliations: 1 Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; 2 Molecular Biology Section, Army Medical and Veterinary Research Center, Rome, Italy; 3 Microbiology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy; 4 Microbiology and Virology Laboratory, Molinette Hospital, Turin, Italy; 5 Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, St. Orsola Malpighi University Hospital, Bologna, Italy; 6 Microbiology Laboratory, Bambino Gesù Hospital, Rome, Italy; 7 Clinical Pathology Department, Azienda USL 6, Livorno, Italy; 8 Microbiology Laboratory, Azienda USL Toscana sud est, Arezzo, Italy; 9 Medical Microbiology Section, Dept. of Medicine, University of Perugia, Perugia, Italy; 10 Clinical Pathology Department, University Hospital, Foggia, Italy; 11 Biomedical Sciences and Human Oncology Department – Hygiene Section, University Hospital, Bari, Italy; 12 Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy; 13 Microbiology and Virology Laboratory, Azienda Sanitaria dell’Alto Adige, Bolzano, Italy; 14 Epidemiology Unit ASP Crotone, Italy

Correspondence:  Paola Stefanelli

Citation style for this article: Fazio Cecilia, Neri Arianna, Vacca Paola, Ciammaruconi Andrea, Arghittu Milena, Barbui Anna Maria, Vocale Caterina, Bernaschi Paola,Isola Patrizia, Galanti Irene Alessandra, Mencacci Antonella, De Nittis Rosella, Chironna Maria, Giammanco Anna, Pagani Elisabetta, Bisbano Alessandro, Stefanelli Paola. Cocirculation of Hajj and non-Hajj strains among serogroup W meningococci in Italy, 2000 to 2016. Euro Surveill. 2019;24(4):pii=1800183. https://doi.org/10.2807/1560-7917.ES.2019.24.4.1800183

Received: 11 Apr 2018;   Accepted: 23 Oct 2018



In Italy, B and C are the predominant serogroups among meningococci causing invasive diseases. Nevertheless, in the period from 2013 to 2016, an increase in serogroup W Neisseria meningitidis (MenW) was observed. This study intends to define the main characteristics of 63 MenW isolates responsible of invasive meningococcal disease (IMD) in Italy from 2000 to 2016. We performed whole genome sequencing on bacterial isolates or single gene sequencing on culture-negative samples to evaluate molecular heterogeneity. Our main finding was the cocirculation of the Hajj and the South American sublineages belonging to MenW/clonal complex (cc)11, which gradually surpassed the MenW/cc22 in Italy. All MenW/cc11 isolates were fully susceptible to cefotaxime, ceftriaxone, ciprofloxacin, penicillin G and rifampicin. We identified the full-length NadA protein variant 2/3, present in all the MenW/cc11. We also identified the fHbp variant 1, which we found exclusively in the MenW/cc11/Hajj sublineage. Concern about the epidemic potential of MenW/cc11 has increased worldwide since the year 2000. Continued surveillance, supported by genomic characterisation, allows high-resolution tracking of pathogen dissemination and the detection of epidemic-associated strains.

©  This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Neisseria meningitidis sg W; Italy.


#Incidence study of #GBS in the province of #Ferrara, Northern #Italy, between 2003 and 2017. A 40-year follow-up (Neurol Sci., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Neurol Sci. 2019 Jan 7. doi: 10.1007/s10072-018-3688-4. [Epub ahead of print]

Incidence study of Guillain-Barré syndrome in the province of Ferrara, Northern Italy, between 2003 and 2017. A 40-year follow-up.

Granieri E1, Andreasi NG2, De Martin P2, Govoni V2, Castellazzi M2, Cesnik E2, Pugliatti M2, Casetta I2.

Author information: 1 Department of Biomedical and Specialty-Surgical Sciences, Section of Neurology, Psychology and Psychiatry, University of Ferrara, Via Aldo Moro 8, 44124, Cona, Ferrara, Italy. enrico.granieri@unife.it. 2 Department of Biomedical and Specialty-Surgical Sciences, Section of Neurology, Psychology and Psychiatry, University of Ferrara, Via Aldo Moro 8, 44124, Cona, Ferrara, Italy.




Guillain-Barré syndrome (GBS) is an acute/subacute autoimmune inflammatory polyradiculoneuropathy. Previous epidemiological studies carried out in the province of Ferrara, Italy, from 1981 to 2002 indicated that GBS incidence had tendency of increase in the period considered.


We aimed at updating the epidemiology of GBS in the years 2003-2017 and carrying on the work started in the 1980s.


We conducted an incidence study, by adopting a complete enumeration approach. Cases were identified from administrative, medical records, and database of the Ferrara Hospital and other provincial structures of the study area. Case ascertainment and definition are analogous to those adopted in previous surveys.


In the period 1 January 2003 to 31 December 2017, 73 patients living in the province of Ferrara (mean population 353,142) were found to be new cases of GBS fulfilling the NINCDS criteria. Male/female ratio 1.15. The mean incidence rate was 1.38 per 100,000 (95% CI 1.08-1.74), 1.54 per 100,000 for men and 1.23 per 100,000 for women, a nonsignificant difference. During the period considered, the rates had slow increase or mild decrease, without nonsignificant difference. The highest rates were observed for the age groups 70-79 years for both sexes. A half of patients reported infectious events in the weeks before the onset of symptoms.


In line with many epidemiological data, in the whole period 2003-2017, we observed a trend towards increase or decrease in incidence and periods of relative stability. Similar temporal heterogeneity with the comparison to our previous works was found.

KEYWORDS: Epidemiology; Ferrara; Guillain-Barré syndrome; Incidence; Italy

PMID: 30617450 DOI: 10.1007/s10072-018-3688-4

Keywords: GBS; Neurology; Italy.


Expanding #Usutu virus #circulation in #Italy: detection in the Lazio region, central Italy, 2017 to 2018 (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Expanding Usutu virus circulation in Italy: detection in the Lazio region, central Italy, 2017 to 2018

Fabrizio Carletti1, Francesca Colavita1, Francesca Rovida2, Elena Percivalle2, Fausto Baldanti2,3, Ida Ricci4, Claudio De Liberato4, Francesca Rosone4, Francesco Messina1, Eleonora Lalle1, Licia Bordi1, Francesco Vairo5, Maria Rosaria Capobianchi1, Giuseppe Ippolito6, Giuseppina Cappiello7, Alberto Spanò7, Silvia Meschi1, Concetta Castilletti1

Affiliations: 1 Laboratory of Virology, National Institute for Infectious Diseases ‘Lazzaro Spallanzani’ IRCCS, Rome, Italy; 2 Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 3 Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy; 4 Istituto Zooprofilattico Sperimentale delle regioni Lazio e Toscana, Rome, Italy; 5 Regional Service for Surveillance and Control of Infectious Diseases (SERESMI)-Lazio Region, National Institute for Infectious Diseases ‘Lazzaro Spallanzani’ IRCCS, Rome, Italy; 6 Scientific Direction, National Institute for Infectious Diseases ‘Lazzaro Spallanzani’ IRCCS, Rome, Italy; 7 Unit of Microbiology, Sandro Pertini Hospital, Rome, Italy

Correspondence: Silvia Meschisilvia.meschiinmi.it

Citation style for this article: Carletti Fabrizio, Colavita Francesca, Rovida Francesca, Percivalle Elena, Baldanti Fausto, Ricci Ida, De Liberato Claudio, Rosone Francesca, Messina Francesco, Lalle Eleonora, Bordi Licia, Vairo Francesco, Capobianchi Maria Rosaria, Ippolito Giuseppe, Cappiello Giuseppina, Spanò Alberto, Meschi Silvia, Castilletti Concetta. Expanding Usutu virus circulation in Italy: detection in the Lazio region, central Italy, 2017 to 2018. Euro Surveill. 2019;24(3):pii=1800649. https://doi.org/10.2807/1560-7917.ES.2019.24.3.1800649

Received: 03 Dec 2018;   Accepted: 16 Jan 2019



Blood donation screening for West Nile virus (WNV) was mandatory in the Lazio region in 2017 and 2018 (June-November) according to the national surveillance plan. In these years, all five donations reactive in WNV nucleic acid amplification tests harboured instead Usutu virus (USUV). Clade ‘Europe 2’ was identified in four blood donations and a 2018 mosquito pool. The cocirculation of WNV and USUV in Lazio warrants increased laboratory support and awareness of possible virus misidentification.

©  This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Arbovirus; Usutu Virus; WNV; Italy.


#Dolphin #Morbillivirus in Eurasian #Otters, #Italy (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 2—February 2019 / Research Letter

Dolphin Morbillivirus in Eurasian Otters, Italy

Iolanda Padalino, Giovanni Di Guardo  , Antonio Carbone, Pasquale Troiano, Antonio Parisi, Domenico Galante, Maria Assunta Cafiero, Marta Caruso, Lucia Palazzo, Laura Guarino, Laura De Riso, Cinzia Centelleghe, Sandro Mazzariol, and Antonio Petrella

Author affiliations: Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Foggia, Italy (I. Padalino, A. Carbone, P. Troiano, A. Parisi, D. Galante, M.A. Cafiero, A. Petrella); University of Teramo, Teramo, Italy (G. Di Guardo); Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Matera, Italy (M. Caruso); Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Potenza, Italy (L. Palazzo); Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Taranto, Italy (L. Guarino); Ente Parco Nazionale del Cilento, Salerno, Italy (L. De Riso); University of Padua, Padua, Italy (C. Centelleghe, S. Mazzariol)



We report biomolecular evidence of dolphin morbillivirus in 4 wild Eurasian otters (Lutra lutra) from southern Italy; 2 animals showed simultaneous immunohistochemical reactivity against morbilliviral antigen. These cases add further concern and support to the progressively expanding host range of dolphin morbillivirus in the western Mediterranean Sea.

Keywords: Dolphin Morbillivirus; Wildlife; Italy.


Integration of #genetic and #epidemiological data to infer #H5N8 HPAI virus #transmission dynamics during the 2016-2017 #epidemic in #Italy (Sci Rep., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Sci Rep. 2018 Dec 21;8(1):18037. doi: 10.1038/s41598-018-36892-1.

Integration of genetic and epidemiological data to infer H5N8 HPAI virus transmission dynamics during the 2016-2017 epidemic in Italy.

Mulatti P1, Fusaro A2, Scolamacchia F2, Zecchin B2, Azzolini A2, Zamperin G2, Terregino C2, Cunial G2, Monne I2, Marangon S2.

Author information: 1 Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, (Padua), Italy. pmulatti@izsvenezie.it. 2 Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, (Padua), Italy.



Between October 2016 and December 2017, several European Countries had been involved in a massive Highly Pathogenic Avian Influenza (HPAI) epidemic sustained by H5N8 subtype virus. Starting on December 2016, also Italy was affected by H5N8 HPAI virus, with cases occurring in two epidemic waves: the first between December 2016 and May 2017, and the second in July-December 2017. Eighty-three outbreaks were recorded in poultry, 67 of which (80.72%) occurring in the second wave. A total of 14 cases were reported in wild birds. Epidemiological information and genetic analyses were conjointly used to get insight on the spread dynamics. Analyses indicated multiple introductions from wild birds to the poultry sector in the first epidemic wave, and noteworthy lateral spread from October 2017 in a limited geographical area with high poultry densities. Turkeys, layers and backyards were the mainly affected types of poultry production. Two genetic sub-groups were detected in the second wave in non-overlapping geographical areas, leading to speculate on the involvement of different wild bird populations. The integration of epidemiological data and genetic analyses allowed to unravel the transmission dynamics of H5N8 virus in Italy, and could be exploited to timely support in implementing tailored control measures.

PMID: 30575785 DOI: 10.1038/s41598-018-36892-1

Keywords: Avian Influenza; H5N8; Poultry; Wild Birds; Italy.


#Spanishflu in #Italy: new #data, new questions (Infez Med., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Infez Med. 2018 Mar 1;26(1):97-106.

Spanish flu in Italy: new data, new questions.

Fornasin A1, Breschi M2, Manfredini M3.

Author information: 1 Department of Economics and Statistics, University of Udine, Italy. 2 Department of Economics and Business, University of Sassari, Italy. 3 Department of Life Sciences, University of Parma, Italy.



This paper proposes a new estimate for the number of victims of Spanish flu in Italy and highlights some aspects of mortality closely linked to the First World War. The sources used are official death statistics and the Albo d’oro, a roll of honor of the Italians fallen in the First World War. The new estimate of deaths from the flu is 410,000 for 1918, which should be raised to 466,000 when the numbers are taken up to 1920. Deaths from Spanish flu among the military were about 70,000. The time sequence of deaths recognizes two distinct peaks, one in October and one in November 1918. Between these two peaks, the lowest number of deaths falls in the week of the armistice between Italy and Austria-Hungary (signed 4 November 1918). This suggests links between Spanish flu and WWI that cannot be merely explained in terms of movement of people and contagion.

PMID: 29525806[Indexed for MEDLINE] Free full text

Keywords: Pandemic Influenza; Spanish Flu; H1N1; Italy; Society; Wars.