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Summary We are reporting the case of a nine-month-old Pakistani female with complaint of growth retardation who presented multiple intestinal parasitic infections. Probably because of contamination with fecal matter, the initial microscopic examination of the urinary sample revealed the presence of eggs of Enterobius vermicularis, cysts of Entamoeba coli, and an organism similar to mites. Stool samples were obtained after two weeks and microscopic investigation confirmed the presence of Enterobius vermicularis eggs, cysts of Entamoeba coli, and hookworm eggs. The patient was immediately subjected to mebendazole therapy associated with trimethoprim-sulfamethoxazole, to which she responded well. Follow-up stool re-examinations performed 15 and 30 days after the treatment tested negative for all parasitic ova and cysts. This study reflects the importance of considering multiple parasitic infestations in low socio-economic populations and highlights the need of improving poor hygienic conditions to prevent such infections, in particular in children.

The correlation of clinical, radiological and laboratory findings of patients at admission in the Emergency Department (ED) with clinical severity and risk of mortality was investigated. Adult coronavirus disease 2019 (COVID-19) patients hospitalized in March 2020 in Desio Hospital, Lombardy, were retrospectively included in the study, and categorized in terms of disease severity and adverse outcome. Out of the 175 patients enrolled, 79% presented one or more comorbidities, with cardiovascular disease being the most frequent (62%). More than half of the patients showed lymphocytopenia and 20% thrombocytopenia. The patients in the severe group presented higher absolute neutrophil count (ANC), C-reactive protein (CRP), AST, LDH, procalcitonin (PCT) and BUN values compared to the non-severe group (p 106.08 µmol/L (OR = 2.87; 95% CI 1.04–7.92) and creatine kinase > 2.90 µkat/L (OR = 3.80; 95% CI 1.31–10.9) were observed on admission (p

Highlights • We conducted a retrospective study on 61 patients admitted to the ICU • We investigated the relationship among SARS-CoV-2 and bacterial/fungal colonization • Among positive bronchial aspirates, 80 % were colonized by fungi or P. aeruginosa • No multidrug-resistant bacteria or fungi were isolated • The failure in the regulation of defenses against pathogens other than SARS-CoV-2

The infrequency of urinary tract and blood stream infections caused by Aerococcus urinae is most probably due to the difficulties in the identification of this bacterium using standard microbiological methods. With the introduction of more sensitive and accurate techniques in clinical microbiology, such as genetic approaches and Matrix-Assisted Laser Desorption/Ionization-Time Of Flight (MALDI-TOF) mass spectrometry (MS), the incidence of infections due to A. urinae increased. Herein, we described a case of urinary tract and bloodstream infection caused by A. urinae, which occurred in an 86-year-old Caucasian man with a previous history of prostate cancer. The identification of A. urinae was performed by MALDI-TOF MS, since this microorganism cannot be identified by biochemical reactions. In this report, we highlight the need to consider MALDI-TOF MS as technique of choice for A. urinae identification in the presence of subjects with predisposing factors, such as old age, male gender, and genitourinary tract pathologies.

Bacterial vaginosis (BV) is one of the most frequent causes of vaginal discharge in women during reproductive age worldwide. This disease is characterized by the replacement of the normal vaginal flora with an overgrowth of anaerobic bacteria most of them producing sialidase enzyme. BV is associated with an increased risk of adverse outcomes in pregnancy and susceptibility to several sexually transmitted diseases. In the present study, we evaluated the detection of sialidase activity by OSOM BVBlue test in association with routine microbial cultures and Nugent’s score, considered as the gold standard, for the diagnosis of bacterial vaginosis. Three vaginal swabs were collected from 352 women older than 12 years in age. A swab collected into Amies transport medium was employed for standard microbial cultures, a FLOQSwab for Gram stain, and a second FLOQSwab for the BVBlue test. According to Nugent’s score, BV frequency was 16.5 % (58 samples). The sensitivity of microbial culture and BVBlue test, when compared with Nugent’s score, was 69.8 % and 39.6 %, respectively. However, BVBlue test detected five cases with no bacterial growth in culture, whereas 14 samples with bacterial cultures positive for Gardnerella vaginalis showed a BVBlue test negative. The combination of microbial culture and BVBlue test increased the sensitivity to 75 % compared with Nugent’s score. In conclusion, BVBlue test alone appears not to be an efficient screening test, but, when associated with microbial cultures, can improve the diagnosis of BV

Dientamoebiasis is globally distributed and detected in a large number of subjects with diarrhea, abdominal discomfort, flatulence, fatigue and loss of appetite. The life cycle and transmission of Dientamoeba fragilis are poorly understood. Microscopic examination of permanent stained smears is traditionally employed to diagnose the infection. However, this approach is time-consuming and the success in detecting D. fragilis depends on the microscopist’s experience. Hence, only a few laboratories routinely carry out tests for D. fragilis. Consequently, the prevalence of D. fragilis infection is probably underestimated. Although novel, rapid and more sensitive diagnostic tests are becoming available for detecting intestinal parasites, they also possess some limitations. The aim of this study was to emphasize the importance of performing microscopic examination of permanent stained smears from at least one fresh stool specimen after sample arrival at the laboratory, as a mandatory practice for the diagnosis of dientamoebiasis, particulary where it is not possible to perform molecular assays.

OBJECTIVE: The analysis of the protein pattern of Klebsiella pneumoniae carbapenemase (KPC)-producing strains by Bruker Matrix-Assisted Laser Desorption Ionization (MALDI) Biotyper system has revealed the presence, in the majority of cases, of an 11.109 m/z peak. The peak corresponds to the gene product named p019 of the bla(KPC)-bearing plasmids and has been suggested as a candidate for a biomarker that is able to distinguish KPC-producers from non-KPC-producers. The aim of this study was to evaluate the rapid detection of the 11.109 m/z peak of KPC-producer strains in the clinical laboratory routine by Matrix-Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF) technique, using the Vitek(®) Research-User-Only (RUO) Mass Spectrometry (MS) system without changing the instrument parameters. MATERIALS AND METHODS: Globally, 373 K. pneumoniae isolates were investigated and identified by MALDI-TOF MS analysis. KPC-producers were distinguished from non-KPC-producers by Antimicrobial Susceptibility Testing (AST) and phenotypic carbapenemase resistance assays. RESULTS: The MALDI-TOF Vitek MS RUO detected the 11.109 m/z peak in 95.7% of KPC-producers with 100% specificity before traditional test results became available. CONCLUSION: Our approach is appropriate as a first screening step for the rapid identification of KPC isolates, which will help to improve infection control in clinical practice and prevent the outbreak and dissemination of resistant bacteria.

Fungal peritonitis is a rare but serious complication of peritoneal dialysis. This infection has been reported to be mostly caused by Candida species, and less frequently by a variety of other yeasts and moulds, such as Aspergillus, Penicillium, and Fusarium spp. are commonly isolated from soil, plants and environmental surfaces, and rarely from non-immunosuppressed subjects. In this report, author describe a case of infection caused by Fusarium solani in a 59-year-old man undergoing continuous ambulatory peritoneal dialysis. The fungus was recovered from cultures of peritoneal dialysate and the pathogen identification was carried out by mass spectrometry. The patient's outcome was favorable without complications after liposomal amphotericin B treatment along with peritoneal dialysis catheter removal.

Bacillus pumilus is commonly isolated from a wide variety of soils, plants and environmental surfaces, but rarely from human specimens. In this report, we describe a case of infection caused by B. pumilus in a healthy 10-years-old child. The microorganism was recovered from a severe wound of the left knee after three days from trauma. Pathogen identification was carried out by mass spectrometry. The patient's outcome was positive following an ampicillin/sulbactam treatment without complications.

Background Environmental toxicants are allegedly involved in decreasing semen quality in recent decades; however, definitive proof is not yet available. In 1976 an accident exposed residents in Seveso, Italy, to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Objective The purpose of this study was to investigate reproductive hormones and sperm quality in exposed males. Methods We studied 135 males exposed to TCDD at three age groups, infancy/prepuberty (1–9 years), puberty (10–17 years), and adulthood (18–26 years), and 184 healthy male comparisons using 1976 serum TCDD levels and semen quality and reproductive hormones from samples collected 22 years later. Results Relative to comparisons, 71 men (mean age at exposure, 6.2 years; median serum TCDD, 210 ppt) at 22–31 years of age showed reductions in sperm concentration (53.6 vs. 72.5 million/mL; p = 0.025); percent progressive motility (33.2% vs. 40.8%; p < 0.001); total motile sperm count (44.2 vs. 77.5 × 106; p = 0.018); estradiol (76.2 vs. 95.9 pmol/L; p = 0.001); and an increase in follicle-stimulating hormone (FSH; 3.58 vs. 2.98 IU/L; p = 0.055). Forty-four men (mean age at exposure, 13.2 years; median serum TCDD, 164 ppt) at 32–39 years of age showed increased total sperm count (272 vs. 191.9 × 106; p = 0.042), total motile sperm count (105 vs. 64.9 ×106; p = 0.036), FSH (4.1 vs. 3.2 UI/L; p = 0.038), and reduced estradiol (74.4 vs. 92.9 pmol/L; p < 0.001). No effects were observed in 20 men, 40–47 years of age, who were exposed to TCDD (median, 123 ppt) as adults (mean age at exposure, 21.5 years). Conclusions Exposure to TCDD in infancy reduces sperm concentration and motility, and an opposite effect is seen with exposure during puberty. Exposure in either period leads to permanent reduction of estradiol and increased FSH. These effects are permanent and occur at TCDD concentrations < 68 ppt, which is within one order of magnitude of those in the industrialized world in the 1970s and 1980s and may be responsible at least in part for the reported decrease in sperm quality, especially in younger men.

Background: In recent decades, young men in some industrialized areas have reportedly experienced a decrease in semen quality. Objective: We examined effects of perinatal dioxin exposure on sperm quality and reproductive hormones. Methods: We investigated sperm quality and hormone concentrations in 39 sons (mean age, 22.5 years) born between 1977 and 1984 to mothers exposed to dioxin after the accident in Seveso, Italy (1976), and 58 comparisons (mean age, 24.6 years) born to mothers exposed only to background dioxin. Maternal dioxin levels at conception were extrapolated from the concentrations measured in 1976 serum samples. R esults: The 21 breast-fed sons whose exposed mothers had a median serum dioxin concentration as low as 19 ppt at conception had lower sperm concentration (36.3 vs. 86.3 million/mL; p = 0.002), total count (116.9 vs. 231.1; p = 0.02), progressive motility (35.8 vs. 44.2%; p = 0.03), and total motile count (38.7 vs. 98 million; p = 0.01) than did the 36 breast-fed comparisons. The 18 formula-fed exposed and the 22 formula-fed and 36 breast-fed comparisons (maternal dioxin background 10 ppt at conception) had no sperm-related differences. Follicle stimulating hormone was higher in the breast-fed exposed group than in the breast-fed comparisons (4.1 vs. 2.63 IU/L; p = 0.03) or the formula-fed exposed (4.1 vs. 2.6 IU/L; p = 0.04), and inhibin B was lower (breast-fed exposed group, 70.2; breast-fed comparisons, 101.8 pg/mL, p = 0.01; formula-fed exposed, 99.9 pg/mL, p = 0.02). C onclusions: In utero and lactational exposure of children to relatively low dioxin doses can permanently reduce sperm quality

Caveolin-1 and flotillin-1 belong to plasma membrane microdomains. They are characterized by peculiar lipid and protein composition and are involved in fundamental cellular events such as: signal transduction, cell adhesion, lipid/protein sorting, and human cancer. We addressed caveolin-1 and flotillin-1 expression in 30 human renal cell carcinoma (RCC) and adjacent normal kidney (ANK) samples by SDS-PAGE and immunoblotting with specific antibodies. Significant caveolin-1 and flotillin-1 over-expression was found in RCC tissues compared to ANK, and was confirmed by immunohistochemistry. Caveolin-1 and flotillin-1 protein levels were found by 1-D, 2-DE, and MS to be increased also in RCC microdomain-enriched subcellular fractions purified from paired RCC and ANK samples.

Renal cell carcinoma (RCC) tissue is composed of a mixture of neoplastic and normal cells, which complicate proteome analysis. The aim of our study was to investigate whether it is feasible to establish primary cell cultures of RCC and of renal cortex maintaining the tissue phenotype along with a more homogeneous and enriched cytological material. Fourteen (82.3%) primary cultures from 17 surgical cases were established and characterized by morphology, growth rate, immunocytochemistry, and molecular analysis performed by Real-time PCR, Western blotting, two-dimensional electrophoresis (2-DE), and mass spectrometry. Cultures showed >90% cytokeratine-positive epithelial cells. In primary tumor cultures, the molecular phenotype of manganese superoxide dismutase and heat shock protein 27 was the same as that found in tumor tissues with overexpression and increased number of isoforms. Moreover, 27 out 28 specific proteins and their isoforms, present in spots excised from 2-DE gel of cortex or RCC cultures, corresponded to those identified on the 2-DE tissue cortex reference map, suggesting that these primary cultures retain the proteomic profile of the corresponding tissues.