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2. Nationwide survey on the management of pediatric pharyngitis in Italian emergency units

Author

Milani, G, Rosa, C, Tuzger, N, Alberti, I, Ghizzi, C, Zampogna, S, Amigoni, A, Agostoni, C, Peroni, D, Marchisio, P, Chiappini, E, Tappi, E, Rabbone, I, Salvini, F, Cozzi, G, Silvagni, D, Pitea, M, Manieri, S, Crisalfi, A, Vaccaro, A, Plebani, A, Falorni, S, Martelli, L, Lanari, M, Di Stefano, G, De Martinis, M, Bulciolu, P, Iughetti, L, Fabiani, E, Greco, R, Cardinale, F, Boera, R, Arrighini, A, Chiaretti, A, Nunziata, F, Salvo, R, Banderali, G, Fasoli, S, Baracchia, G, Antonucci, R, Biondi, A, Tenci, A, Mirri, G, Battisti, L, Bellettato, M, Ruffini, E, Cogo, P, Dragovic, D, Da Dalt, L, Bruni, P, Caloiero, M, Varisco, T, Palmieri, M, Picciotti, E, Cualbu, A, Pradal, U, Grosso, S, Pogliani, L, Selicorni, A, Soffiati, M, Bene, P, Guala, A, Bertolozzi, G, Tommasi, P, Campanozzi, A, Cella, A, Ghitti, C, Groff, P, Bondone, C, Vitale, A, Capalbo, P, Dall'Amico, R, Sisto, A, Livio, E, Tato, E, Flora, M, Raiola, G, Suppiej, A, Clemente, C, Lizzoli, F, Chiarelli, F, Podesta, A, Forte, F, Vasarri, P, Pennoni, G, Parrinello, F, Fornaro, M, Casa, R, Zaglia, F, Tipo, V, Morandi, F, Cecinati, V, Calabro, G, Messini, B, Marseglia, G, Arrigoni, S, Gaggiano, S, Cavalli, C, Gramaglia, G, Serra, L, Valletta, E, Militerno, G, Chiossi, M, Camellino, G, Masi, S, Marchetti, F, Traina, G, Maccarrone, R, Milani G. P., Rosa C., Tuzger N., Alberti I., Ghizzi C., Zampogna S., Amigoni A., Agostoni C., Peroni D., Marchisio P., Chiappini E., Tappi E., Rabbone I., Salvini F. M., Cozzi G., Silvagni D., Pitea M., Manieri S., Crisalfi A., Vaccaro A., Plebani A. M., Falorni S., Martelli L., Lanari M., Di Stefano G., De Martinis M., Bulciolu P., Iughetti L., Fabiani E., Greco R., Cardinale F., Boera R., Arrighini A., Chiaretti A., Nunziata F., Salvo R., Banderali G., Fasoli S., Baracchia G., Antonucci R., Biondi A., Tenci A., Mirri G., Battisti L., Bellettato M., Ruffini E., Cogo P., Dragovic D., Da Dalt L., Bruni P., Caloiero M., Varisco T., Palmieri M., Picciotti E., Cualbu A., Pradal U., Grosso S., Pogliani L. M., Selicorni A., Soffiati M., Bene P., Guala A., Bertolozzi G., Tommasi P., Campanozzi A., Cella A., Ghitti C., Groff P., Bondone C., Vitale A., Capalbo P. T., Dall'Amico R., Sisto A., Livio E. L., Tato E., Flora M., Raiola G., Suppiej A., Clemente C., Lizzoli F., Chiarelli F., Podesta A., Forte F. R., Vasarri P., Pennoni G., Parrinello F., Fornaro M., Casa R., Zaglia F., Tipo V., Morandi F., Cecinati V., Calabro G., Messini B., Marseglia G. L., Arrigoni S., Gaggiano S., Cavalli C., Gramaglia G., Serra L., Valletta E., Militerno G., Chiossi M., Camellino G., Masi S., Marchetti F., Traina G., Maccarrone R. M., Milani, G, Rosa, C, Tuzger, N, Alberti, I, Ghizzi, C, Zampogna, S, Amigoni, A, Agostoni, C, Peroni, D, Marchisio, P, Chiappini, E, Tappi, E, Rabbone, I, Salvini, F, Cozzi, G, Silvagni, D, Pitea, M, Manieri, S, Crisalfi, A, Vaccaro, A, Plebani, A, Falorni, S, Martelli, L, Lanari, M, Di Stefano, G, De Martinis, M, Bulciolu, P, Iughetti, L, Fabiani, E, Greco, R, Cardinale, F, Boera, R, Arrighini, A, Chiaretti, A, Nunziata, F, Salvo, R, Banderali, G, Fasoli, S, Baracchia, G, Antonucci, R, Biondi, A, Tenci, A, Mirri, G, Battisti, L, Bellettato, M, Ruffini, E, Cogo, P, Dragovic, D, Da Dalt, L, Bruni, P, Caloiero, M, Varisco, T, Palmieri, M, Picciotti, E, Cualbu, A, Pradal, U, Grosso, S, Pogliani, L, Selicorni, A, Soffiati, M, Bene, P, Guala, A, Bertolozzi, G, Tommasi, P, Campanozzi, A, Cella, A, Ghitti, C, Groff, P, Bondone, C, Vitale, A, Capalbo, P, Dall'Amico, R, Sisto, A, Livio, E, Tato, E, Flora, M, Raiola, G, Suppiej, A, Clemente, C, Lizzoli, F, Chiarelli, F, Podesta, A, Forte, F, Vasarri, P, Pennoni, G, Parrinello, F, Fornaro, M, Casa, R, Zaglia, F, Tipo, V, Morandi, F, Cecinati, V, Calabro, G, Messini, B, Marseglia, G, Arrigoni, S, Gaggiano, S, Cavalli, C, Gramaglia, G, Serra, L, Valletta, E, Militerno, G, Chiossi, M, Camellino, G, Masi, S, Marchetti, F, Traina, G, Maccarrone, R, Milani G. P., Rosa C., Tuzger N., Alberti I., Ghizzi C., Zampogna S., Amigoni A., Agostoni C., Peroni D., Marchisio P., Chiappini E., Tappi E., Rabbone I., Salvini F. M., Cozzi G., Silvagni D., Pitea M., Manieri S., Crisalfi A., Vaccaro A., Plebani A. M., Falorni S., Martelli L., Lanari M., Di Stefano G., De Martinis M., Bulciolu P., Iughetti L., Fabiani E., Greco R., Cardinale F., Boera R., Arrighini A., Chiaretti A., Nunziata F., Salvo R., Banderali G., Fasoli S., Baracchia G., Antonucci R., Biondi A., Tenci A., Mirri G., Battisti L., Bellettato M., Ruffini E., Cogo P., Dragovic D., Da Dalt L., Bruni P., Caloiero M., Varisco T., Palmieri M., Picciotti E., Cualbu A., Pradal U., Grosso S., Pogliani L. M., Selicorni A., Soffiati M., Bene P., Guala A., Bertolozzi G., Tommasi P., Campanozzi A., Cella A., Ghitti C., Groff P., Bondone C., Vitale A., Capalbo P. T., Dall'Amico R., Sisto A., Livio E. L., Tato E., Flora M., Raiola G., Suppiej A., Clemente C., Lizzoli F., Chiarelli F., Podesta A., Forte F. R., Vasarri P., Pennoni G., Parrinello F., Fornaro M., Casa R., Zaglia F., Tipo V., Morandi F., Cecinati V., Calabro G., Messini B., Marseglia G. L., Arrigoni S., Gaggiano S., Cavalli C., Gramaglia G., Serra L., Valletta E., Militerno G., Chiossi M., Camellino G., Masi S., Marchetti F., Traina G., and Maccarrone R. M.

Published
2023

3. Diagnosis and management of urinary tract infections in children aged 2 months to 3 years in the Italian emergency units: the ItaUTI study

Author

Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., Bellettato M., Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., and Bellettato M.

Abstract

Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% (n = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis. Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques.What is Known:• Several guidelines are published on the management of children with suspected or confirmed urinary tract infection.• No data are available on the management of pediatric urinary tract infections in the emergency setting.What is New:• Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture.• Diagnostic

Published
2022

5. Potential serotype coverage of three pneumococcal conjugate vaccines against invasive pneumococcal infection in Italian children

Author

Azzari, Chiara, Moriondo, Maria, Cortimiglia, Martina, Valleriani, C, Canessa, C, Indolfi, G, Ricci, S, De Martino, Maurizio, Resti, M, Collaborators: Agostiniani R, Italian group for the study of Invasive Pneumococcal D. i. s. e. a. s. e., Allievi, P, Allù, G, Amigoni, A, Bernardi, P, Bernardini, R, Biban, P, Bigi, M, Boldrini, A, Bossi, G, Bottone, U, Cardinale, A, Cardona, A, Castronari, R, Celandroni, A, Chiossi, M, Colleselli, P, Correra, A, D'Ascola, G, D'Aquino, A, De Benedictis FM, Dini, E, Dollfus, L, Domenici, R, Flacco, V, Furbetta, M, Gaetti, Mt, Gagliardi, L, Giani, I, Giglio, P, Guala, A, Lanari, M, Lippi, F, Lizzoli, C, Lombardi, E, Macchia, Pa, Magnini, M, Memmini, G, Mesirca, P, Micheletti, E, Migliozzi, L, Nunziata, F, Pecile, P, Pepe, G, Perferi, G, Peris, A, Perri, Pf, Pescollderungg, L, Pezzati, M, Poggi, Giovanni Maria, Prato, R, Principi, N, Rapisardi, G, Regoli, M, Riva, A, Rizzo, L, Roman, B, Toffolo, A, Strano, M, Trapani, Sandra, Vasarri, P, Vascotto, M, Vecchi, V, Ventura, A, Verini, M, Zorzi, C., Azzari, Chiara, Moriondo, Maria, Cortimiglia, Martina, Valleriani, Claudia, Canessa, Clementina, Indolfi, Giuseppe, Ricci, Silvia, Nieddu, Francesco, de Martino, Maurizio, Resti, Massimo, Italian group for the study of Invasive Pneumococcal Disease [, Lanari, Marcello, and ]

Subjects
Pneumococcal Vaccine, Male, Serotype, medicine.medical_specialty, Adolescent, Sepsi, Vaccination schedule, Longitudinal Studie, Bacteremia, Real-Time Polymerase Chain Reaction, medicine.disease_cause, Pneumococcal Vaccines, Sepsis, Internal medicine, Streptococcus pneumoniae, medicine, Humans, Longitudinal Studies, Serotyping, Child, Vaccines, Conjugate, Bacterial disease, General Veterinary, General Immunology and Microbiology, Meningitis, Pneumococcal, business.industry, Public Health, Environmental and Occupational Health, Infant, medicine.disease, Pneumonia, Infectious Diseases, Italy, Child, Preschool, Pneumococcal pneumonia, Immunology, Molecular Medicine, Female, business, Meningitis, Human
Abstract

Background and aim of the work Since the introduction of the 7-valent vaccine, invasive pneumococcal disease have greatly decreased; however, changes in the distribution of pneumococcal serotypes have recently highlighted the need for vaccines with wider coverage. The aim of the work was to assess the potential serotype coverage of three pneumococcal conjugate vaccines (7-, 10- and 13-valent) against bacteremic pneumococcal pneumonia and meningitis/sepsis in Italian children. Patients and methods We determined pneumococcal serotypes in immunocompetent patients who had been admitted to hospital with suspicion of invasive bacterial disease and had confirmed bacteremic pneumococcal pneumonia or meningitis/sepsis determined by molecular detection of Streptococcus pneumoniae in a normally sterile site. Positive samples were serotyped using Realtime-PCR. Results Between April 2008 and March 2011, a total of 144 patients (age median 4.1 years; Interquartile range 1.8–5.6) with pneumococcal meningitis/sepsis (n = 43) or pneumonia (n = 101) from 83 participating centers located in 19 of 20 Italian regions were serotyped. The 10 most prevalent serotypes were 1 (29.9%), 3 (16.0%), 19A (13.2%), 7F (8.3%), 5 (4.2%), 14 (4.2%), 6A (3.5%), 6B (3.5%), 18C (3.5%), 19F (3.5%). Overall, serotype coverage for PCV-7, -10 and -13 were respectively 19.4%, 61.8% and 94.4% with no statistical difference between pneumonia and meningitis/sepsis. Potential coverage was similar for children 0–2 or 2–5 years of age. Cultures resulted positive in 35/99 (35.4%) samples simultaneously obtained for both culture and RT-PCR. Conclusion These findings indicate that increasing the potential serotype coverage by introducing PCV13 in the vaccination schedule for infancy could provide substantial added benefit for protection from pneumococcal pneumonia or meningitis/sepsis in Italy in children below 2 years as well in older children. The importance of molecular methods for diagnosis and serotyping of invasive pneumococcal disease was confirmed.

Published
2012
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6. Distribution of invasive meningococcal B disease in Italian pediatric population: implications for vaccination timing

Author

Azzari, Chiara, Canessa, Clementina, Lippi, Francesca, Moriondo, Maria, Indolfi, Giuseppe, Nieddu, Francesco, Martini, Marco, de Martino, Maurizio, Castiglia, Paolo, Baldo, Vincenzo, Resti, Massimo, Agostiniani, R., Allievi, P., Allù, G., Amigoni, A., Bartolini, E., Bernardi, Francesco, Bernardini, SOFIA ROBERTA, Biban, P., Bigi, M., Bossi, G., Bottone, U., Cardinale, A., Cardona, A., Castronari, R., Celandroni, A., Chiossi, M., Colleselli, P., Correra, A., Cortimiglia, M., D'Ascola, G., De Benedictis, F. M., de Martino, M., Dini, E., Dollfus, L., Domenici, R., Flacco, V., Verrotti, A., Gaetti, M. T., Gagliardi, L., Galli, Lorenzo, Giglio, P., Guala, A., Lanari, M., Lasagni, D., Lizzoli, C., Lombardi, E., Magnini, M., Mattei, R., Memmini, G., Mesirca, P., Gragnani, S., Migliozzi, L., Nunziata, F., Pecile, P., Pepe, G., Perferi, G., Peris, A., Perri, P. F., Pescollderungg, L., Pezzati, M., Poggi, G. M., Poggiolesi, C., Rapisardi, G., Ratta, L., Ricci, S., Ridi, F., Riva, MARCO ANDREA, Rizzo, L., Roman, B., Romano, F., Toffolo, A., Strano, M., Trapani, S., Valleriani, C., Vasarri, P., Vascotto, M., Vergine, G., Verini, M., Zorzi, C., Azzari, Chiara, Canessa, Clementina, Lippi, Francesca, Moriondo, Maria, Indolfi, Giuseppe, Nieddu, Francesco, Martini, Marco, de Martino, Maurizio, Castiglia, Paolo, Baldo, Vincenzo, Resti, Massimo, Italian Group for the Study of Invasive Bacterial Disease [, Lanari M., and ]

Subjects
Pediatrics, Children, Incidence, Neisseria meningitidis group B, Realtime PCR, Sensitivity, Vaccine, Adolescent, Age Distribution, Child, Child, Preschool, Hospitals, Pediatric, Humans, Immunization Schedule, Infant, Infant, Newborn, Italy, Meningitis, Meningococcal, Meningococcal Vaccines, Real-Time Polymerase Chain Reaction, Retrospective Studies, Sepsis, Neisseria meningitidis, Serogroup B, Molecular Medicine, Immunology and Microbiology (all), Veterinary (all), Public Health, Environmental and Occupational Health, Infectious Diseases, Disease, Neisseria meningitidis, medicine.disease_cause, Group B, Epidemiology, Medicine, Pediatric, Meningococcal, Incidence (epidemiology), Hospitals, Vaccination, Public Health, Meningitis, medicine.medical_specialty, Serogroup B, Immunology and Microbiology(all), MED/42 Igiene generale e applicata, Preschool, General Veterinary, General Immunology and Microbiology, business.industry, Environmental and Occupational Health, medicine.disease, Newborn, veterinary(all), business
Abstract

Neisseria meningitidis group B (MenB) is a leading cause of meningitis and sepsis. A new vaccine has been recently licensed. The aim of the present study was to evaluate the epidemiology of MenB disease in pediatric age and define the optimal age for vaccination. All patients aged 0–18 years admitted with a diagnosis of meningitis or sepsis to the 83 participating Italian pediatric hospitals were included in the study. Blood and/or cerebrospinal fluid (CSF) samples were tested by Realtime-PCR and/or culture. One hundred and thirty-six cases (mean age 5.0 years, median 2.7) of MenB disease were found. Among these, 96/136 (70.6%) were between 0 and 5 years, 61/136 (44.9%) were between 0 and 2 years. Among the latter, 39/61 (63.9%) occurred during the first year of life with highest incidence between 4 and 8 months. A case-fatality rate of 13.2% was found, with 27.8% cases below 12 months. Sepsis lethality was 24.4%. RT-PCR was significantly more sensitive than culture: 82 patients were tested at the same time by both methods, either in blood or in CSF; MenB was found by RT-PCR in blood or CSF in 81/82 cases (98.8%), culture identified 27/82 (32.9%) infections (Cohen's Kappa 0.3; McNemar's: p < 10−5). The study shows that the highest incidence of disease occurs in the first year of age, with a peak between 4 and 8 months of life; 30% of deaths occur before 12 months. The results suggest that the greatest prevention could be obtained starting MenB vaccination in the first months of life; a catch-up strategy up to the fifth year of life could be considered. Our results also confirm that Realtime PCR is significantly more sensitive than culture. In those countries where only isolate positive infections are counted as cases, the incidence of MenB infection results highly underestimated.

Published
2013

7. Community‐acquired bacteremic pneumococcal pneumonia in children: diagnosis and serotyping by real‐time polymerase chain reaction using blood samples

Author

Resti, M., Moriondo, M., Cortimiglia, M., Indolfi, G., Canessa, C., Becciolini, L., Bartolini, E., De Benedictis, F. M., De Martino, M., Azzari, C., Agostiniani, R, Allievi, P, Allù, G, Amigoni, A, Baldo, E, Barlocco, G, Bernardi, P, Bernardini, R, Biban, P, Bossi, G, Bottone, U, Cardinale, A, Cardona, A, Castelli Gattinara, G, Celandroni, A, Chiossi, M, Colleselli, P, Correra, A, D'Ascola, G, D'Aquino, A, Dollfus, L, Domenici, R, Flacco, V, Furbetta, M, Gaetti, Mt, Gagliardi, L, Ghiori, F, Giani, I, Giglio, P, Guala, A, Icardi, G, Lanari, M, Lippi, F, Lizzoli, C, Lombardi, E, Macchia, Pa, Magnini, M, Memmini, G, Mesirca, P, Micheletti, E, Migliozzi, L, Nunziata, F, Osimani, P, Paravati, D, Pecile, P, Pepe, G, Peris, A, Perri, Pf, Pescollderungg, L, Pezzati, M, Poggi, Gm, Poggiolesi, C, Prato, R, Principi, N, Rapisardi, G, Ridi, F, Riva, A, Rizzo, L, Roman, B, Toffolo, A, Strano, M, Trapani, S, Vasarri, P, Vascotto, M, Vecchi, V, Ventura, A, Verini, M, Zorzi, C., Resti, Massimo, Moriondo, Maria, Cortimiglia, Martina, Indolfi, Giuseppe, Canessa, Clementina, Becciolini, Laura, Bartolini, Elisa, de Benedictis, Fernando Maria, de Martino, Maurizio, Azzari, Chiara, Italian Group for the, Study of Invasive Pneumococcal Disease, and Lanari, M.

Subjects
Microbiology (medical), Male, medicine.medical_specialty, Adolescent, Bacteremia, medicine.disease_cause, Polymerase Chain Reaction, Parapneumonic effusion, Community-acquired pneumonia, Bacterial Typing Technique, Internal medicine, Streptococcus pneumoniae, medicine, Humans, Community-Acquired Infection, Serotyping, Preschool, Child, business.industry, Bacterial pneumonia, Infant, Newborn, Infant, Odds ratio, Pneumonia, Pneumonia, Pneumococcal, medicine.disease, Newborn, Bacterial Typing Techniques, Community-Acquired Infections, Infectious Diseases, Blood, Italy, Child, Preschool, Pneumococcal pneumonia, Immunology, Pneumococcal, Female, business, Human
Abstract

Background. The aim of this study was to use real-time polymerase chain reaction (RT-PCR) on blood samples to diagnose and serotype pneumococcal infection in a large cohort of Italian children hospitalized for community-acquired pneumonia. Methods. We conducted an observational study from April 2007 through June 2009 of children aged 0-16 years with a diagnosis of community-acquired pneumonia admitted to 83 pediatric hospitals in Italy. Results. Seven hundred fifty-three children were studied. RT-PCR found pneumococcal infection in 80 (10.6%) of 753 patients. In 292 patients, culture and RT-PCR were simultaneously performed. Streptococcus pneumoniae was identified in 47 of 292 patients; 45 (15.4%) tested positive by RT-PCR and 11 (3.8%) tested positive by culture. RT-PCR was significantly more sensitive than culture in revealing bacteremic pneumonia (odds ratio, 30.6; 95% confidence interval, 5.8-97.5; P < .001). Complicated pneumonia was found in 162 (21.5%) of 753 children; 152 (93.8%) of these 162 had parapneumonic effusion, and 51 (33.6%) had empyema. Children with complicated pneumonia were significantly older. Pneumococcal bacteremia was found by RT-PCR to occur significantly more frequently in children with complications (38 [23.5%] of 162) than in children with uncomplicated pneumonia (44 [7.4%] of 591; odds ratio, 3.8; 95% confidence interval, 2.30-6.30; P

Published
2010

9. Evidence for the BUAS-test ability to diagnose lumbar radicular pain

Author

Samolsky Dekel, Boaz Gedaliahu, Sorella, Maria Cristina, Vasarri, Alessio, and Melotti, Rita Maria

Abstract

Background: Differential diagnosis of low back pain (LBP) is complex and a prominent issue at all health-care levels; guidance may come from patients’ history cues and clinical examination signs. Human and animal studies report that diagnosis of lumbar radicular pain (LRP) may come from evaluating subjective responses of injured lumbar nerves to a strain applied at the buttock. The Buttock Applied Strain (BUAS-test) test may guide the differential diagnosis of LBP. Following an ex-adiuvantibuscriterion, clinical improvement of LRP, diagnosed with the BUAS-test and congruently treated, may support this test diagnostic ability.Methods: Among 258 LRP patients, who, upon first visit (V1), tested positive on the BUAS-test (with/without positive Straight Leg Raising Test, SLRT), the effect of gabapentin prescription on painDETECT (PD) questionnaire and Brief Pain Inventory (BPI) outcomes was quantified in the follow-up visit (V2). To support BUAS-test diagnostic ability, we hypothesized that, at V2, >50% of the sample would present negative PD outcome, significant (t-test) and ⩾2 points V2-V1 differences for each of the BPI-item’s score. We used multinomial logistic regression (MLR) and χ2analyses to evaluate the PD-V2 outcomes’ dependence upon independent variables.Results: Of the sample, 77% reported a negative PD-V2 outcome. V2-V1 differences of all BPI items were significant and >2 points. PD-V2 outcomes showed significant associations with SLRT-V1 and PD-V1, respectively, but not with gender, age group or pain site. MLR showed a significant relationship between SLRT-V1 and PD-V2 outcomes.Conclusion: Among LRP patients, diagnosed by the BUAS-test and treated with gabapentin, all prespecified endpoints were reached. These results may be considered a piece of ex-adiuvantibusevidence for the BUAS-test ability to diagnose LRP. While positive BUAS-test implies potential LRP, the co-presence with positive SLRT may imply a severer LRP condition. Further prospective research, in different settings and direct clinical measures, is needed.

Published
2021
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10. Medical Evidence Influence on Inpatients and Nurses Pain Ratings Agreement

Author

Gedaliahu Samolsky Dekel, Boaz, Gori, Alberto, Vasarri, Alessio, Cristina Sorella, Maria, Di Nino, Gianfranco, and Maria Melotti, Rita

Abstract

Biased pain evaluation due to automated heuristics driven by symptom uncertainty may undermine pain treatment; medical evidence moderators are thought to play a role in such circumstances. We explored, in this cross-sectional survey, the effect of such moderators (e.g., nurse awareness of patients’ pain experience and treatment) on the agreement between n=862 inpatients’ self-reported pain and n=115 nurses’ pain ratings using a numerical rating scale. We assessed the mean of absolute difference, agreement (κ-statistics), and correlation (Spearman rank) of inpatients and nurses’ pain ratings and analyzed congruence categories’ (CCs: underestimation, congruence, and overestimation) proportions and dependence upon pain categories for each medical evidence moderator (χ2 analysis). Pain ratings agreement and correlation were limited; the CCs proportions were further modulated by the studied moderators. Medical evidence promoted in nurses overestimation of low and underestimation of high inpatients’ self-reported pain. Knowledge of the negative influence of automated heuristics driven by symptoms uncertainty and medical-evidence moderators on pain evaluation may render pain assessment more accurate.

Published
2016
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11. Diagnosis and management of urinary tract infections in children aged 2 months to 3 years in the Italian emergency units: the ItaUTI study

Author

Francesca, Cenzato, Milani, Gregorio P., Angela, Amigoni, Francesca, Sperotto, Bianchetti, Mario G., Carlo, Agostoni, Giovanni, Montini, Farello, Giovanni, Francesco, Chiarelli, Greco, Rita, Franco Di Lollo, Fabio Rocco Forte, Sergio, Manieri, Luigi, Carpino, Mimma, Caloiero, Anastasia, Cirisano, Salvatore, Bragh(`(o)), Roberto Della Casa, Felice, Nunziata, Carmine, Pecoraro, Rosario, Pacifico, Marcello, Lanari, Chiara, Ghizzi, Laura, Serra, Marcello, Stella, Giuseppe, Maggiore, Roberto, Fiorini, Icilio, Dodi, Andrea, Morelli, Lorenzo, Lughetti, Andrea, Cella, Gianluca, Vergine, Alessandro De Fanti, Danica, Dragovic, Daniele, Santori, Giorgio, Cozzi, Paola, Cogo, Marilena, Raponi, Riccardo, Lubrano, Mauro de Martinis, Antonio, Gatto, Maria Antonietta Barbieri, Antonino, Reale, Giorgio, Bracaglia, Emanuela, Piccotti, Riccardo, Borea, Alberto, Gaiero, Laura, Martelli, Alberto, Arrighini, Paola, Cianci, Claudio, Cavalli, Leonardina De Santis, Benedetta Chiara Pietra, Andrea, Biondi, Marco, Sala, Pogliani, Laura M., Simonetta, Cherubini, Marta, Bellini, Paola, Bruni, Giovanni, Traina, Paola, Tommasi, Paolo Del Barba, Sergio, Arrigoni, Salvini, Filippo M., Luca, Bernardo, Giuseppe, Bertolozzi, Silvia, Fasoli, Gian Luigi Marseglia, Emilio, Palumbo, Annalisa, Bosco, Gianpaolo, Mirri, Elisabetta, Fabiani, Ermanno, Ruffini, Luisa, Pieragostini, Martina, Fornaro, Gabriele, Ripanti, Donnina, Pannoni, Felici, Enrico, Anna, Perona, Eleonora, Tappi, Oscar Nis Haitink, Ivana, Rabbone, Pina Teresa Capalbo, Antonio, Urbino, Andrea, Guala, Gianluca, Cosi, Maria Gabriella Barracchia, Baldassarre, Martire, Fabio, Cardinale, Fulvio, Moramarco, Carmelo, Perrone, Angelo, Campanozzi, Valerio, Cecinati, Alessandro, Canetto, Ciro, Clemente, Antonio, Cualbu, Fabio, Narducci, Giuseppina, Mula, Pasquale, Bulciolu, Roberto, Antonucci, Giuseppe, Gramaglia, Giuseppe, Cavaleri, Carmelo, Salpietro, Giovanni, Corsello, Rosario, Salvo, Marcello, Palmeri, Maria Assunta Vitale, Ambra, Morgano, Susanna, Falorni, Diego, Peroni, Stefano, Masi, Alessio, Bertini, Angelina, Vaccaro, Pierluigi, Vasarri, Petra, Reinstadler, Massimo, Soffiati, Maurizio, Stefanelli, VERROTTI di PIANELLA, Alberto, Catherine, Bertone, Stefano, Marzini, Liviana Da Dalt, Simone, Rugolotto, Floriana, Scozzola, Luca Ecclesio Livio, Mauro, Cinquetti, Davide, Silvagni, Massimo Bellettato and, Cenzato F., Milani G.P., Amigoni A., Sperotto F., Bianchetti M.G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M.A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B.C., Biondi A., Sala M., Pogliani L.M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F.M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G.L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P.T., Urbino A., Guala A., Cosi G., Barracchia M.G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M.A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., and Bellettato M.

Subjects
Catheter, Urinary tract, Emergency department, Pediatrics, Perinatology and Child Health, Guidelines, Infants, Infection, Survey, Urine, Infant, Guideline
Abstract

Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% (n = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis. Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques. What is Known:• Several guidelines are published on the management of children with suspected or confirmed urinary tract infection.• No data are available on the management of pediatric urinary tract infections in the emergency setting. What is New:• Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture.• Diagnostic CFU thresholds largely vary among centers.

Published
2022

12. Isolated Radial Nerve Palsy in a Newborn Due to a Congenital Myofibroma: A Rare Case of Peripheral Nerve Injury.

Author

Chiellino S, Fortini V, Castellani C, and Vasarri P

Abstract

Isolated musculoskeletal infantile myofibroma is a rare tumor of pediatric age. The majority of cases are seen in children under two years old, but it can occur at any age as a painless enlarging mass that involves bone, skin, or soft tissue, typically accompanied by compression symptoms. Perineural involvement is extremely rare in myofibromas. Neurological impairment can occur during infancy but isolated nerve palsy, particularly in peripheral nerves within the upper extremity, is very uncommon. Neonatal radial nerve palsy is a rare entity caused by different conditions. Among these, we mention local tumors affecting peripheral nerves, such as myofibroma. There are few cases described in the literature, which mainly concern adult patients. The authors present a case of congenital isolated radial nerve palsy in a newborn with MF of the right elbow, which resulted in impairment of the wrist and finger extension. Following a six-month monitoring period, the patient underwent surgical treatment to restore function to his right wrist and hand. This involved excising the infiltrated radial nerve segment associated with palliative surgery. Despite the benignity of this lesion, severe nerve damage and perineural involvement may require surgical treatment with nerve resection and reconstruction.

Published
2024
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13. Case report: vertical transmission of Plesiomonas shigelloides. Is it time to strengthen information on safety concerns for raw seafood dietary exposure in pregnancy?

Author

Cavaliere AF, Perelli F, Mattei A, Dal Poggetto P, Marchi L, Vidiri A, Turrini I, Aquilini D, Brunelli T, Scambia G, Straface G, Orfeo L, and Vasarri P

Subjects
Infant, Newborn, Animals, Humans, Female, Pregnancy, Dietary Exposure, Seafood adverse effects, Plesiomonas, Sepsis, Meningitis
Abstract

The consumption of raw seafood, generally considered to be a healthy food, has greatly increased worldwide. Pathogens of fish can cause foodborne illnesses in humans, especially following the consumption of raw seafood from contaminated water.Foodborne illness in pregnant women is seldom the cause of neonatal infection, but, as in the reported cases, it has been associated with a high degree of morbidity and mortality.We present the case of a newborn with septicemia and meningitis caused by Plesiomonas shigelloides acquired via the transplacental route. There was a maternal history of ingestion of raw seafood 1 week prior to delivery. A few similar cases are described in the existing literature, which reports 7 neonatal deaths.Therefore, the primary objective of this paper is to highlight the fact that the popularity of raw seafood such as sushi, sashimi, and oysters, requires an improvement in dietary advice regarding unsafe choices in pregnancy in order to avoid preventable foodborne diseases, sometimes fatal for the newborn.

Published
2023
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