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2. Incidence and risk factors of bacterial sepsis and invasive fungal infection in neonates and infants requiring major surgery: an Italian multicentre prospective study

Author

Auriti, C., De Rose, D.U., Santisi, A., Martini, L., Ronchetti, M.P., Ravà, L., Antenucci, V., Bernaschi, P., Serafini, L., Catarzi, S., Fiorini, P., Betta, P., Scuderi, M.G., Di Benedetto, V., Ferrari, S., Maino, M., Cavigioli, F., Cocchi, I., Giuffré, M., Bonanno, E., Tzialla, C., Bua, J., Pugni, L., Della Torre, B., Nardella, G., Mazzeo, D., Manzoni, P., Capolupo, I., Ciofi degli Atti, M., Dotta, A., Stronati, M., Raponi, M., Mosca, F., and Bagolan, P.

Published
2022
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3. Editorial: Congenital and perinatal infections: How to prevent sequelaes in neonates and children

Author

De Rose D. U., Ronchetti M. P., Tzialla C., Giuffre M., Auriti C., De Rose D.U., Ronchetti M.P., Tzialla C., Giuffre M., and Auriti C.

Subjects
Pediatrics, Perinatology and Child Health, newborn, infection, sequelae
Abstract

The current severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has overwhelmingly absorbed attention and health resources for 2 years, allowing us to reflect that infections are a permanent health and social problem, causing morbidity and mortality. They require organization, important prevention measures, and containment. This is particularly true in the neonatal age, where infections remain a complex problem with serious consequences.

Published
2023
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5. Effective Rapid Diagnosis of Bacterial and Fungal Bloodstream Infections by T2 Magnetic Resonance Technology in the Pediatric Population

Author

Lucignano, B., Cento, V., Agosta, M., Ambrogi, F., Albitar-Nehme, S., Mancinelli, L., Mattana, G., Onori, M., Galaverna, F., Di Chiara, L., Fragasso, T., Bianchi, R., Tortora, F., Auriti, C., Dotta, A., Cecchetti, C., Perdichizzi, S., Raponi, M., Muda, A. O., Molteni, S. N., Villani, A., Locatelli, Franco, Perno, C. F., Bernaschi, P., Locatelli F. (ORCID:0000-0002-7976-3654), Lucignano, B., Cento, V., Agosta, M., Ambrogi, F., Albitar-Nehme, S., Mancinelli, L., Mattana, G., Onori, M., Galaverna, F., Di Chiara, L., Fragasso, T., Bianchi, R., Tortora, F., Auriti, C., Dotta, A., Cecchetti, C., Perdichizzi, S., Raponi, M., Muda, A. O., Molteni, S. N., Villani, A., Locatelli, Franco, Perno, C. F., Bernaschi, P., and Locatelli F. (ORCID:0000-0002-7976-3654)

Abstract

Children are prone to bloodstream infections (BSIs), the rapid and accurate diagnosis of which is an unmet clinical need. The T2MR technology is a direct molecular assay for identification of BSI pathogens, which can help to overcome the limits of blood culture (BC) such as diagnostic accuracy, blood volumes required, and turnaround time. We analyzed results obtained with the T2Bacteria (648) and T2Candida (106) panels in pediatric patients of the Bambino Gesù Children's Hospital between May 2018 and September 2020 in order to evaluate the performance of the T2Dx instrument with respect to BC. T2Bacteria and T2Candida panels showed 84.2% and 100% sensitivity with 85.9% and 94.1% specificity, respectively. The sensitivity and specificity of the T2Bacteria panel increased to 94.9% and 98.7%, respectively, when BC was negative but other laboratory data supported the molecular result. T2Bacteria sensitivity was 100% with blood volumes ,2 mL in neonates and infants. T2Bacteria and T2Candida provided definitive microorganism identification in a mean time of 4.4 and 3.7 h, respectively, versus 65.7 and 125.5 h for BCs (P , 0.001). T2 panels rapidly and accurately enable a diagnosis of a pediatric BSI, even in children under 1 year of age and for very small blood volumes. These findings support their clinical use in life-threatening pediatric infections, where the time to diagnosis is of utmost importance, in order to improve survival and minimize the long-term sequalae of sepsis. The T2 technology could be further developed to include more bacteria and fungi species that are involved in the etiology of sepsis.

Published
2022

6. Prevention of Surgical Site Infections in Neonates and Children: Non-Pharmacological Measures of Prevention

Author

Meoli, A., Ciavola, L., Rahman, S., Masetti, M., Toschetti, T., Morini, R., Dal Canto, G., Auriti, C., Caminiti, C., Castagnola, E., Conti, Giorgio, Dona, D., Galli, Lavinia Maddalena, La Grutta, S., Lancella, L., Lima, M., Lo Vecchio, A., Pelizzo, G., Petrosillo, Nicola, Simonini, A., Venturini, Elena, Caramelli, F., Gargiulo, G. D., Sesenna, E., Sgarzani, R., Vicini, Cinzia, Zucchelli, M., Mosca, F., Staiano, A., Principi, N., Esposito, S., Conti G. (ORCID:0000-0002-8566-9365), Galli L., Petrosillo N., Venturini E., Vicini C., Meoli, A., Ciavola, L., Rahman, S., Masetti, M., Toschetti, T., Morini, R., Dal Canto, G., Auriti, C., Caminiti, C., Castagnola, E., Conti, Giorgio, Dona, D., Galli, Lavinia Maddalena, La Grutta, S., Lancella, L., Lima, M., Lo Vecchio, A., Pelizzo, G., Petrosillo, Nicola, Simonini, A., Venturini, Elena, Caramelli, F., Gargiulo, G. D., Sesenna, E., Sgarzani, R., Vicini, Cinzia, Zucchelli, M., Mosca, F., Staiano, A., Principi, N., Esposito, S., Conti G. (ORCID:0000-0002-8566-9365), Galli L., Petrosillo N., Venturini E., and Vicini C.

Abstract

A surgical site infection (SSI) is an infection that occurs in the incision created by an invasive surgical procedure. Although most infections are treatable with antibiotics, SSIs remain a significant cause of morbidity and mortality after surgery and have a significant economic impact on health systems. Preventive measures are essential to decrease the incidence of SSIs and antibiotic abuse, but data in the literature regarding risk factors for SSIs in the pediatric age group are scarce, and current guidelines for the prevention of the risk of developing SSIs are mainly focused on the adult population. This document describes the current knowledge on risk factors for SSIs in neonates and children undergoing surgery and has the purpose of providing guidance to health care professionals for the prevention of SSIs in this population. Our aim is to consider the possible non-pharmacological measures that can be adopted to prevent SSIs. To our knowledge, this is the first study to provide recommendations based on a careful review of the available scientific evidence for the non-pharmacological prevention of SSIs in neonates and children. The specific scenarios developed are intended to guide the healthcare professional in practice to ensure standardized management of the neonatal and pediatric patients, decrease the incidence of SSIs and reduce antibiotic abuse.

Published
2022

7. Peri-Operative Prophylaxis in Patients of Neonatal and Pediatric Age Subjected to Cardiac and Thoracic Surgery

Author

Bianchini S., Nicoletti L., Monaco S., Rigotti E., Corbelli A., Colombari A., Auriti C., Caminiti C., Conti G., De Luca M., Dona D., Galli L., Garazzino S., Inserra A., La Grutta S., Lancella L., Lima M., Lo Vecchio A., Pelizzo G., Petrosillo N., Piacentini G., Pietrasanta C., Principi N., Puntoni M., Simonini A., Tesoro S., Venturini E., Staiano A., Caramelli F., Gargiulo G.D., and Esposito S.

Subjects
surgical antibiotic prophylaxis, ECMO, thoracic surgery, cardiac surgery, pediatric infectious diseases, antibiotics
Abstract

Surgical site infections (SSIs) represent a potential complication of surgical procedures, with a significant impact on mortality, morbidity, and healthcare costs. Patients undergoing cardiac surgery and thoracic surgery are often considered patients at high risk of developing SSIs. This consensus document aims to provide information on the management of peri-operative antibiotic prophylaxis for the pediatric and neonatal population undergoing cardiac and non-cardiac thoracic surgery. The following scenarios were considered: (1) cardiac surgery for the correction of congenital heart disease and/or valve surgery; (2) cardiac catheterization without the placement of prosthetic material; (3) cardiac catheterization with the placement of prosthetic material; (4) implantable cardiac defibrillator or epicardial pacemaker placement; (5) patients undergoing ExtraCorporal Membrane Oxygenation; (6) cardiac tumors and heart transplantation; (7) non-cardiac thoracic surgery with tho-racotomy; (8) non-cardiac thoracic surgery using video-assisted thoracoscopy; (9) elective chest drain placement in the pediatric patient; (10) elective chest drain placement in the newborn; (11) thoracic drain placement in the trauma setting. This consensus provides clear and shared indications, repre-senting the most complete and up-to-date collection of practice recommendations in pediatric cardiac and thoracic surgery, in order to guide physicians in the management of the patient, standardizing approaches and avoiding the abuse and misuse of antibiotics.

Published
2022
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17. Plasma and CSF pharmacokinetics of meropenem in neonates and young infants: Results from the NeoMero studies

Author

Germovsek, E, Lutsar, I, Kipper, K, Karlsson, Mo, Planche, T, Chazallon, C, Meyer, L, Trafojer, Umt, Metsvaht, T, Fournier, I, Sharland, M, Heath, P, Standing, Jf, Neomero, Consortium, Auriti, C, Esposito, S, Lorenza, P, Ilmoja, Ml, Drazdiene, N, Sarafidis, K, Mitsiakos, G, van der Flier, M, Clarke, P, Collinson, A, Gupta, S, Anthony, M, Thomas, M, Pattnayak, S, Davis, J, Rabe, H, Pilling, E, Bandi, S, and Sinha, A

Subjects
Male, Infant, Newborn, Infant, Meropenem, Anti-Bacterial Agents, Meningitis, Bacterial, Europe, Sepsis, Humans, Female, Neonatal Sepsis, Gram-Negative Bacterial Infections, Infusions, Intravenous, Monte Carlo Method
Abstract

Sepsis and bacterial meningitis are major causes of mortality and morbidity in neonates and infants. Meropenem, a broad-spectrum antibiotic, is not licensed for use in neonates and infants below 3 months of age and sufficient information on its plasma and CSF disposition and dosing in neonates and infants is lacking.To determine plasma and CSF pharmacokinetics of meropenem in neonates and young infants and the link between pharmacokinetics and clinical outcomes in babies with late-onset sepsis (LOS).Data were collected in two recently conducted studies, i.e. NeoMero-1 (neonatal LOS) and NeoMero-2 (neonatal meningitis). Optimally timed plasma samples (n = 401) from 167 patients and opportunistic CSF samples (n = 78) from 56 patients were analysed.A one-compartment model with allometric scaling and fixed maturation gave adequate fit to both plasma and CSF data; the CL and volume (standardized to 70 kg) were 16.7 (95% CI 14.7, 18.9) L/h and 38.6 (95% CI 34.9, 43.4) L, respectively. CSF penetration was low (8%), but rose with increasing CSF protein, with 40% penetration predicted at a protein concentration of 6 g/L. Increased infusion time improved plasma target attainment, but lowered CSF concentrations. For 24 patients with culture-proven Gram-negative LOS, pharmacodynamic target attainment was similar regardless of the test-of-cure visit outcome.Simulations showed that longer infusions increase plasma PTA but decrease CSF PTA. CSF penetration is worsened with long infusions so increasing dose frequency to achieve therapeutic targets should be considered.

Published
2018

22. Congenital syphilis in Italy: a multicentre study

Author

Tridapalli, E., Capretti, M. G., Reggiani, M. L. B., Stronati, M., Faldella, G., Auriti, C., Balata, A., Barera, G., Bennato, E., Berardi, A., Bolognesi, S., Bonomi, A., Boulos, F., Brambilla, C., Branchi, M., Cabiati, G., Caddia, V., Calzetti, G., Campanile, A., Cataldo, P., Cavagna, R., Chiarolini, A., Ciccia, M., Ciccotti, R., Ciofalo, A., Contiero, R., Corona, G., Corso, G., Costa, L., Coviello, C., Cristofori, G., Crivellaro, C., Cucchi, G., Danese, G., Da Riol, R., Decembrino, L., Delogu, A., Del Vecchio, A., De Sanctis, L., Di Chiara, G., Di Comite, A., Di Grande, E. C., D'Onofrio, A. M., Faccia, P., Ferrari, D., Fortunati, P., Gabriella, T. L., Galimberti, D., Garzia, P., Giorgino, M., Gragnani, S., Gurrido, R., Lacaita, G., Leone, G., Lipari, A., Lorenzini, C., Lo Sciotto, P., Malagutti, L., Maschio, F., Matteucci, L., Migliozzi, L., Mileti, F., Murgia, M. R., Navone, M., Nosari, N., Notarmuzi, M. L., Pagliani, L., Paino, D., Papa, I., Papili, F., Parisi, G., Perocchi, F., Perona, A., Pirrami, R., Pitassi, I., Priore, Raponi, S., Rizzo, V., Robieux, I., Rossi, A., Ruffini, E., Russo, R., Salvi, G., Serra, L., Sferlazzo, S., Solimano, T., Spadaro, V., Stramare, D., Stroppiana, P., Tarquini, E., Taurino, L., Tedoldi, S., Tessariol, D., Travaglio, M. D., Vagnarelli, F., Valente, A., Valentini, P., Volta, A., Zaffaroni, M., Tridapalli E, Capretti MG, Reggiani ML, Stronati M, Faldella G, and Italian Neonatal Task Force of Congenital Syphilis for The Italian Society of Neonatology – Collaborative Group.

Subjects
medicine.medical_specialty, Pediatrics, Adolescent, Reproductive medicine, Infant, Premature, Diseases, Prenatal care, Young Adult, Foreign born, Pregnancy, Risk Factors, Seroepidemiologic Studies, Age Factors, Birth Weight, Female, Humans, Infant, Newborn, Infant, Premature, Italy, Maternal Age, Pregnancy Complications, Infectious, Prenatal Care, Prospective Studies, Syphilis, Syphilis, Congenital, medicine, CONGENITAL SYPHILIS, Seroprevalence, Reproductive health, business.industry, Obstetrics and Gynecology, General Medicine, medicine.disease, Congenital syphilis, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Pediatrics, Perinatology and Child Health, MULTICENTER STUDY, business
Abstract

OBJECTIVE: To study the prevalence of congenital syphilis and its risk factors in Italy. STUDY DESIGN: Prospective study from 1 July 2006 to 30 June 2007. Data on mother-child pairs were collected for every syphilis seropositive mother. RESULTS: Maternal syphilis seroprevalence at delivery was 0.17%. 207 infants were born to 203 syphilis seropositive mothers. In 25 newborns it was possible to diagnose congenital syphilis (20/100,000 live births). Maternal risk factors included age

Published
2010
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38. 15 Determinants of Nosocomial Infection (NI) in Six Italian Neonatal Intensive Care Units (NICUs).

Author

Auriti, C, primary, Pezzotti, P, additional, Ronchetti, M P, additional, Marrocco, G, additional, Quondamcarlo, A, additional, Arioni, C, additional, Serra, G, additional, Bacolla, G, additional, Ravà, L, additional, Bagnoli, F, additional, Buonocore, G, additional, De Felice, C, additional, Mastropasqua, S, additional, Mari, G, additional, Corchia, C, additional, Seganti, G, additional, Di Lallo, D, additional, and Orzalesi, M, additional

Published
2005
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40. Cocaine abuse in pregnancy: Its evaluation through hair analysis of pathological new-borns

Author

Strano Rossi, Sabina, Chiarotti, Marcello, Fiori, A, Auriti, C, Seganti, G., Strano Rossi, Sabina (ORCID:0000-0001-7530-2968), Strano Rossi, Sabina, Chiarotti, Marcello, Fiori, A, Auriti, C, Seganti, G., and Strano Rossi, Sabina (ORCID:0000-0001-7530-2968)

Abstract

Cocaine abuse in pregnancy has been evaluated through toxicological analysis of hair from 123 pathological new-barns admitted in an intensive care division. The newborns were affected with malformations, low gestational age, low birth weight, respiratory distress. A control group of 39 healthy new-boms was also analysed. Hair samples (about 50 mg) were enzymatically digested and directly analysed by RIA. Samples positive to the preliminary screening were extracted by SPE columns and injected in GCNS. Results obtained showed 3 positive samples (2.4%). All cocaine babies had low gestational age, low birth weight, two of them showed heart malformation, one kidney malformation and one genital malformation. None of the control new-born resulted positive for cocaine. These results show a worrying trend of cocaine diffusion in the Italian population.

Published
1996

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