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148 results on '"Brigante, G."'

2. Multicenter prospective study on the prevalence of colistin resistance in Escherichia coli: relevance of mcr-1-positive clinical isolates in Lombardy, Northern Italy

Author

Principe L, Piazza A, Mauri C, Anesi A, Bracco S, Brigante G, Casari E, Agrappi C, Caltagirone M, Novazzi F, Migliavacca R, Pagani L, and Luzzaro F

Subjects
MCR-1, colistin, Escherichia coli, prevalence, surveillance, epidemiology, Infectious and parasitic diseases, RC109-216
Abstract

Luigi Principe,1 Aurora Piazza,2,3 Carola Mauri,1 Adriano Anesi,4 Silvia Bracco,5 Gioconda Brigante,6 Erminia Casari,7 Carlo Agrappi,8 Mariasofia Caltagirone,2 Federica Novazzi,2 Roberta Migliavacca,2 Laura Pagani,2 Francesco Luzzaro1 1Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy; 2Clinical-Surgical, Diagnostic and Pediatric Sciences Department, Unit of Microbiology and Clinical Microbiology, University of Pavia, Pavia, Italy; 3Romeo and Enrica Invernizzi Pediatric Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; 4Clinical Pathology Laboratory, ASST Lodi, Lodi, Italy; 5Clinical Pathology Laboratory, ASST Vimercate, Vimercate, Italy; 6Clinical Pathology Laboratory, ASST Valle Olona, Busto Arsizio, Italy; 7Clinical Pathology Laboratory, IRCCS “Humanitas,” Rozzano, Italy; 8Microbiology and Virology Unit, ASST Ovest Milanese, Legnano, Italy Background: The emergence of the plasmid-mediated colistin resistance mechanism in Escherichia coli has raised concern among public health experts as colistin is a last-line antimicrobial resort. The primary aim of the study was to investigate the prevalence of this resistance trait in E. coli isolates circulating in the Lombardy region, Northern Italy. The presence of mcr-type genes and their genetic relationship were also studied.Materials and methods: A prospective study was performed during a 4-month period (May to August, 2016) in six acute care Hospitals. Consecutive nonduplicate clinical isolates of E. coli from any type of clinical specimen, with the exception of rectal swabs, were included in the study. Isolates that exhibited MIC values for colistin >2 mg/L were further investigated. Bacterial identification was obtained by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Amplification of mcr-type genes (−1 to −5 variants) and microarray analysis were accomplished. Repetitive sequence-based PCR (Rep-PCR) and multilocus sequence typing (MLST) analysis were used for genotyping.Results: Overall, 3,902 consecutive E. coli isolates (2,342 from outpatients, 1,560 from inpatients) were evaluated during the study period. Of them, 18/3,902 (0.5%), collected from 4/6 centers, showed resistance to colistin. These isolates were mostly obtained from urine of both outpatients (n=12) and inpatients (n=6). Colistin MIC values ranged from 4 to 8 mg/L. The mcr-1 gene was detected in 10/18 isolates (7 from outpatients, 3 from inpatients). Rep-PCR and MLST analysis revealed the presence of nine different clusters. Further mcr-type genes were not detected.Conclusion: Resistance to colistin in E. coli clinical isolates appears low in our geographic area. With regard to mcr-1-positive isolates, they accounted for approximately 50% of colistin-resistant E. coli isolates, thus representing a relevant resistance mechanism in this context. Although overall limited, the presence of mcr-1 determinant in our region should not be ignored and great concern should be given to the continuous surveillance. Keywords: MCR-1, colistin, Escherichia coli, prevalence, surveillance, epidemiology

Published
2018

8. Diagnosis and management of infections caused by multidrug-resistant bacteria: guideline endorsed by the Italian Society of Infection and Tropical Diseases (SIMIT), the Italian Society of Anti-Infective Therapy (SITA), the Italian Group for Antimicrobial Stewardship (GISA), the Italian Association of Clinical Microbiologists (AMCLI) and the Italian Society of Microbiology (SIM)

Author

Tiseo, G., Brigante, G., Giacobbe, D. R., Maraolo, A. E., Gona, F., Falcone, Marco, Giannella, M., Grossi, Paolo, Pea, Federico, Rossolini, G. M., Sanguinetti, Maurizio, Sarti, Daniela Maria, Scarparo, C., Tumbarello, Mario, Venditti, Mario, Viale, P., Bassetti, M., Luzzaro, F., Menichetti, F., Stefani, S., Tinelli, M., Falcone M., Grossi P., Pea F., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sarti M., Tumbarello M. (ORCID:0000-0002-9519-8552), Venditti M., Tiseo, G., Brigante, G., Giacobbe, D. R., Maraolo, A. E., Gona, F., Falcone, Marco, Giannella, M., Grossi, Paolo, Pea, Federico, Rossolini, G. M., Sanguinetti, Maurizio, Sarti, Daniela Maria, Scarparo, C., Tumbarello, Mario, Venditti, Mario, Viale, P., Bassetti, M., Luzzaro, F., Menichetti, F., Stefani, S., Tinelli, M., Falcone M., Grossi P., Pea F., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sarti M., Tumbarello M. (ORCID:0000-0002-9519-8552), and Venditti M.

Abstract

Management of patients with infections caused by multidrug-resistant organisms is challenging and requires a multidisciplinary approach to achieve successful clinical outcomes. The aim of this paper is to provide recommendations for the diagnosis and optimal management of these infections, with a focus on targeted antibiotic therapy. The document was produced by a panel of experts nominated by the five endorsing Italian societies, namely the Italian Association of Clinical Microbiologists (AMCLI), the Italian Group for Antimicrobial Stewardship (GISA), the Italian Society of Microbiology (SIM), the Italian Society of Infectious and Tropical Diseases (SIMIT) and the Italian Society of Anti-Infective Therapy (SITA). Population, Intervention, Comparison and Outcomes (PICO) questions about microbiological diagnosis, pharmacological strategies and targeted antibiotic therapy were addressed for the following pathogens: carbapenem-resistant Enterobacterales; carbapenem-resistant Pseudomonas aeruginosa; carbapenem-resistant Acinetobacter baumannii; and methicillin-resistant Staphylococcus aureus. A systematic review of the literature published from January 2011 to November 2020 was guided by the PICO strategy. As data from randomised controlled trials (RCTs) were expected to be limited, observational studies were also reviewed. The certainty of evidence was classified using the GRADE approach. Recommendations were classified as strong or conditional. Detailed recommendations were formulated for each pathogen. The majority of available RCTs have serious risk of bias, and many observational studies have several limitations, including small sample size, retrospective design and presence of confounders. Thus, some recommendations are based on low or very-low certainty of evidence. Importantly, these recommendations should be continually updated to reflect emerging evidence from clinical studies and real-world experience.

Published
2022

12. The Added Value of Operator's Judgement in Thyroid Nodule Ultrasound Classification Arising From Histologically Based Comparison of Different Risk Stratification Systems

Author

Madeo, B., Brigante, G., Ansaloni, A., Taliani, E., Kaleci, S., Monzani, M. L., Simoni, M., and Rochira, V.

Subjects
Male, Observer Variation, ultrasound, thyroid nodules, Cytodiagnosis, Thyroid Gland, classifications, US operator experience, Middle Aged, malignancy risk, Risk Assessment, ultrasound, thyroid nodules, classifications, malignancy risk, histology, histology, Diagnosis, Differential, Endocrinology, Humans, Female, Prospective Studies, Thyroid Neoplasms, Thyroid Nodule, Original Research, Retrospective Studies, Ultrasonography
Abstract

Objective: Several ultrasound classifications for thyroid nodules were proposed but their accuracy is still debated, since mainly estimated on cytology and not on histology. The aim of this study was to test the diagnostic accuracy and the inter-classification agreement of AACE/ACE-AME, American Thyroid Association (ATA), British Thyroid Association (BTA), and Modena Ultrasound Thyroid Classification (MUT) that stratifies malignancy risk considering also the clinician subjective impression. Methods: A prospective study collecting thyroid nodule features at ultrasound and histological diagnosis was conducted. Ultrasound features were collected following a preformed checklist in candidates for surgery because of indeterminate, suspicious, or malignant cytology. All the nodules, besides the cytologically suspicious one, were blinded analyzed. MUT score was applied prospectively, and the others retrospectively. Sensitivity, specificity, diagnostic cut-off value, and accuracy of each classification were calculated. The overall agreement between classifications was tested by Bland-Altman, and agreement between single nodule analysis by different classifications by Weighted Cohen's Kappa. Results: In classifying a total of 457 nodules, MUT has the highest accuracy (AUC 0.808) and specificity (89%), followed by ATA and BTA, and finally by AACE/ACE-AME. ATA, BTA, and MUT are highly interchangeable. Considering agreement between single nodule analyses, ATA and BTA had the best (κ = 0.723); AACE/ACE-AME showed slight agreement with BTA (κ = 0.177) and MUT (κ = 0.183), and fair agreement with ATA (κ = 0.282); MUT had fair agreement with both ATA (κ = 0.291) and BTA (κ = 0.271). Conclusion: Classifications have an acceptable overall diagnostic accuracy, improved using a less rigid system that takes into consideration operator subjective impression.

Published
2020

13. EUCAST rapid antimicrobial susceptibility testing of blood cultures positive for Escherichia coli or Klebsiella pneumoniae: experience of three laboratories in Italy

Author

Cortazzo, Venere, Giordano, Liliana, D'Inzeo, Tiziana, Fiori, B., Brigante, G., Luzzaro, F., Liotti, Flora Marzia, Menchinelli, Giulia, Sanguinetti, Maurizio, Spanu, Teresa, Posteraro, Brunella, Cortazzo V., Giordano L., D'Inzeo T. (ORCID:0000-0003-1508-3518), Liotti F. M., Menchinelli G., Sanguinetti M. (ORCID:0000-0002-9780-7059), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Cortazzo, Venere, Giordano, Liliana, D'Inzeo, Tiziana, Fiori, B., Brigante, G., Luzzaro, F., Liotti, Flora Marzia, Menchinelli, Giulia, Sanguinetti, Maurizio, Spanu, Teresa, Posteraro, Brunella, Cortazzo V., Giordano L., D'Inzeo T. (ORCID:0000-0003-1508-3518), Liotti F. M., Menchinelli G., Sanguinetti M. (ORCID:0000-0002-9780-7059), Spanu T. (ORCID:0000-0003-1864-5184), and Posteraro B. (ORCID:0000-0002-1663-7546)

Abstract

Sir, Recently, EUCAST developed a rapid antimicrobial susceptibility testing (RAST) method for direct use on positive blood culture (BC) samples, which relies on EUCAST standard disc diffusion (DD) methodology and allows inhibition zone reading within 4–8 h of BC positivity.We herein report on EUCAST RAST results for BCs consecutively collected between June 2019 and December 2019 that contained E. coli (n = 134)or K. pneumoniae (n = 66) isolates.

Published
2021

19. Membrane Estrogen Receptor (GPER) and Follicle-Stimulating Hormone Receptor (FSHR) Heteromeric Complexes Promote Human Ovarian Follicle Survival

Author

Casarini, L, Lazzaretti, C, Paradiso, E, Limoncella, S, Riccetti, L, Sperduti, S, Melli, B, Marcozzi, S, Anzivino, C, Sayers, Ns, Czapinski, J, Brigante, G, Poti, F, La Marca, A, De Pascali, F, Reiter, E, Falbo, A, Daolio, J, Villani, Mt, Lispi, M, Orlando, G, Klinger, Fg, Fanelli, F, Rivero-Muller, A, Hanyaloglu, Ac, Simoni, M, Biotechnology and Biological Sciences Research Council (BBSRC), Genesis Research Trust, Università degli Studi di Modena e Reggio Emilia (UNIMORE), University of Rome 'Tor Vergeta', Imperial College London, Medical University of Lublin, University of Parma = Università degli studi di Parma [Parme, Italie], Physiologie de la reproduction et des comportements [Nouzilly] (PRC), Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Dynamiques de populations multi-échelles pour des systèmes physiologiques (MUSCA), Inria Saclay - Ile de France, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Physiologie de la reproduction et des comportements [Nouzilly] (PRC), Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Mathématiques et Informatique Appliquées du Génome à l'Environnement [Jouy-En-Josas] (MaIAGE), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Merck Research Laboratories, Università degli Studi di Roma Tor Vergata [Roma], Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Mathématiques et Informatique Appliquées du Génome à l'Environnement [Jouy-En-Josas] (MaIAGE), Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE), Università degli studi di Parma = University of Parma (UNIPR), Institut Français du Cheval et de l'Equitation [Saumur] (IFCE)-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Institut Français du Cheval et de l'Equitation [Saumur] (IFCE)-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Français du Cheval et de l'Equitation [Saumur] (IFCE)-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Mathématiques et Informatique Appliquées du Génome à l'Environnement [Jouy-En-Josas] (MaIAGE)

Subjects
endocrine system, Settore BIO/17, Endocrine Regulation, Female Reproductive Endocrinology, [SDV]Life Sciences [q-bio], lcsh:Q, Molecular Biology, lcsh:Science, Article
Abstract

Summary Classically, follicle-stimulating hormone receptor (FSHR)-driven cAMP-mediated signaling boosts human ovarian follicle growth and oocyte maturation. However, contradicting in vitro data suggest a different view on physiological significance of FSHR-mediated cAMP signaling. We found that the G-protein-coupled estrogen receptor (GPER) heteromerizes with FSHR, reprogramming cAMP/death signals into proliferative stimuli fundamental for sustaining oocyte survival. In human granulosa cells, survival signals are missing at high FSHR:GPER ratio, which negatively impacts follicle maturation and strongly correlates with preferential Gαs protein/cAMP-pathway coupling and FSH responsiveness of patients undergoing controlled ovarian stimulation. In contrast, FSHR/GPER heteromers triggered anti-apoptotic/proliferative FSH signaling delivered via the Gβγ dimer, whereas impairment of heteromer formation or GPER knockdown enhanced the FSH-dependent cell death and steroidogenesis. Therefore, our findings indicate how oocyte maturation depends on the capability of GPER to shape FSHR selective signals, indicating hormone receptor heteromers may be a marker of cell proliferation., Graphical Abstract, Highlights • G-protein-coupled estrogen receptor (GPER) interacts with FSH receptor (FSHR) • FSHR/GPER heteromers reprogram FSH-induced death signals to proliferative stimuli • Anti-apoptotic signaling of heteromers is via a GPER-Gαs inhibitory complex and Gβγ • Heteromer formation impacts follicle maturation and FSH responses of IVF patients, Molecular Biology; Female Reproductive Endocrinology; Endocrine Regulation

Published
2020
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20. Polygenic Susceptibility to Papillary Thyroid Cancer in Italian Subjects

Author

Brigante, G., Lazzaretti, C., Paradiso, E., Foersti, A., Hemminki, K., Elisei, R., Romei, C., Rochira, V., Simoni, M., Landi, S., and Casarini, L.

Subjects
thyroid cancer, papillary thyroid cancer, genetic, polygenicity, thyroid cancer, genetic, polygenicity, papillary thyroid cancer
Published
2020

25. Ultrasound Changes of Healthy Thyroides over Six Years in Adults

Author

Brigante, G., Monzani, M. L., Locaso, M., Gnarini, V. L., Graziadei, L., Kaleci, S., De Santis, M. C., Tagliavini, S., Simoni, M., Rochira, V., and Madeo, B.

Subjects
US, Thyroid ultrasound, Screening, Healthy Subjects, Thyroid ultrasound, healthy subjects, thyroid nodules, US, thyroid nodules, Screening, Healthy Subjects, Thyroid ultrasound
Published
2019

28. Thyroid Ultrasound Pitfalls: Esophageal Fibrovascular Polyp Mimicking Thyroid Nodule

Author

Ansaloni, Anna, Brigante, G., and Madeo, B.

Subjects
Article Subject
Abstract

Background. Ultrasound (US) is the most accurate tool in the diagnosis of thyroid nodules if performed by expert physician. Misdiagnosis due to extrathyroidal lesions mimicking thyroid nodules is reported in literature. We describe the first case of an esophageal fibrovascular polyp misdiagnosed as a thyroid nodule on US examination. Patient Findings. A 54-year-old woman presented to emergency department for headache and underwent carotid Doppler extended to neck ultrasound with incidental finding of a nodule in the posterior side of the left thyroid lobe. A following thyroid US performed by an endocrinologist allowed the characterization of the lesion as an esophageal pathology, considering the extrathyroidal position, the typical peripheral hyperechoic spots and hypoechoic rim, the connection to the esophagus, and the swallowing connected movement. The patient was addressed to further investigations and finally to anterior pharyngotomy with histological diagnosis of esophageal fibrovascular polyp. Summary. Differential diagnosis between thyroid nodules and other neck lesions is important to prevent an unnecessary fine needle aspiration biopsy and to treat the extrathyroidal pathology. In this case, an US performed by an expert endocrinologist allowed detecting an esophageal fibrovascular polyp requiring surgical removal. In conclusion, the possibility of an esophageal pathology, and even fibrovascular polyp, should be considered during US thyroid examination.

Published
2016
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46. Identification of coagulase-negative staphylococci by using the BD phoenix system in the low-inoculum mode

Author

Brigante, G., Menozzi, M. G., Pini, B., Porta, Rosaria, Somenzi, P., Sciacca, A., Spanu, Teresa, Stefani, Stefania, Spanu, Teresa (ORCID:0000-0003-1864-5184), Brigante, G., Menozzi, M. G., Pini, B., Porta, Rosaria, Somenzi, P., Sciacca, A., Spanu, Teresa, Stefani, Stefania, and Spanu, Teresa (ORCID:0000-0003-1864-5184)

Abstract

The new "low-inoculum" mode of the Phoenix system was evaluated to identify clinical coagulase-negative staphylococci. API ID32 Staph panels were used as comparators, and discrepancies were resolved by 16S rRNA and tuf gene analysis. The system correctly identified 90.5% of isolates, with a mean time of 10.2 h. Accuracy was satisfactory for Staphylococcus epidermidis, S. saprophyticus, and S. haemolyticus.

Published
2008

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