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1. 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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2. Prevalence, Outcome, and Prevention of Congenital Cytomegalovirus Infection in Neonates Born to Women With Preconception Immunity (CHILd Study)

Author

Lilleri, D., Tassis, B., Pugni, L., Ronchi, A., Pietrasanta, C., Spinillo, A., Arossa, A., Achille, C., Vergani, P., Ornaghi, S., Riboni, S., Cavoretto, P., Candiani, M., Gaeta, G., Prefumo, F., Fratelli, N., Fichera, A., Vignali, M., Prun, A.B.D., Fabbri, E., Cetin, I., Locatelli, A., Consonni, S., Rutolo, S., Miotto, E., Savasi, V., Di Giminiani, M., Cromi, A., Binda, S., Fiorina, L., Furione, M., Cassinelli, G., Klersy, C., Lilleri, D, Tassis, B, Pugni, L, Ronchi, A, Pietrasanta, C, Spinillo, A, Arossa, A, Achille, C, Vergani, P, Ornaghi, S, Riboni, S, Cavoretto, P, Candiani, M, Gaeta, G, Prefumo, F, Fratelli, N, Fichera, A, Vignali, M, Prun, A, Fabbri, E, Cetin, I, Locatelli, A, Consonni, S, Rutolo, S, Miotto, E, Savasi, V, Di Giminiani, M, Cromi, A, Binda, S, Fiorina, L, Furione, M, Cassinelli, G, and Klersy, C

Subjects
Microbiology (medical), Human cytomegalovirus, congenital infection, non-primary infection, pre-conception immunity, Settore MED/17 - Malattie Infettive, preconception immunity, Settore MED/07 - Microbiologia e Microbiologia Clinica, Infectious Diseases, nonprimary infection, human cytomegalovirus, Settore MED/40 - Ginecologia e Ostetricia, human cytomegaloviru
Abstract

Background Human cytomegalovirus (HCMV) is the leading infectious cause of congenital disabilities. We designed a prospective study to investigate the rate, outcome, and risk factors of congenital CMV (cCMV) infection in neonates born to immune women, and the potential need and effectiveness of hygiene recommendations in this population. Methods The study was composed of 2 sequential parts: an epidemiology (part 1) and a prevention (part 2) study. Performance of part 2 depended upon a cCMV rate >0.4%. Women enrolled in part 1 did not receive hygiene recommendations. Newborns were screened by HCMV DNA testing in saliva and cCMV was confirmed by urine testing. Results Saliva swabs were positive for HCMV DNA in 45/9661 newborns and cCMV was confirmed in 18 cases. The rate of cCMV was .19% (95% confidence interval [CI]: .11–.29%), and 3 out of 18 infants with cCMV had symptoms of CMV at birth. Age, nationality, occupation, and contact with children were similar between mothers of infected and noninfected newborns. Twin pregnancy (odds ratio [OR]: 7.2; 95% CI: 1.7–32.2; P = .037) and maternal medical conditions (OR: 3.9; 95% CI: 1.5–10.1; P = .003) appeared associated with cCMV. Given the rate of cCMV was lower than expected, the prevention part of the study was cancelled. Conclusions Newborns from women with preconception immunity have a low rate of cCMV, which appears to be mostly due to reactivation of the latent virus. Therefore, serological screening in childbearing age would be pivotal to identify HCMV-seropositive women, whose newborns have a low risk of cCMV. Clinical trials registration www.clinicaltrials.gov (NCT03973359).

Published
2023

3. Prevalence, Outcome, and Prevention of Congenital Cytomegalovirus Infection in Neonates Born to Women With Preconception Immunity (CHILd Study)

Author

Lilleri, D, Tassis, B, Pugni, L, Ronchi, A, Pietrasanta, C, Spinillo, A, Arossa, A, Achille, C, Vergani, P, Ornaghi, S, Riboni, S, Cavoretto, P, Candiani, M, Gaeta, G, Prefumo, F, Fratelli, N, Fichera, A, Vignali, M, Prun, A, Fabbri, E, Cetin, I, Locatelli, A, Consonni, S, Rutolo, S, Miotto, E, Savasi, V, Di Giminiani, M, Cromi, A, Binda, S, Fiorina, L, Furione, M, Cassinelli, G, Klersy, C, Lilleri, Daniele, Tassis, Beatrice, Pugni, Lorenza, Ronchi, Andrea, Pietrasanta, Carlo, Spinillo, Arsenio, Arossa, Alessia, Achille, Cristian, Vergani, Patrizia, Ornaghi, Sara, Riboni, Silvia, Cavoretto, Paolo, Candiani, Massimo, Gaeta, Gerarda, Prefumo, Federico, Fratelli, Nicola, Fichera, Anna, Vignali, Michele, Prun, Allegra Barbasetti Di, Fabbri, Elisa, Cetin, Irene, Locatelli, Anna, Consonni, Sara, Rutolo, Simona, Miotto, Elena, Savasi, Valeria, Di Giminiani, Maria, Cromi, Antonella, Binda, Sandro, Fiorina, Loretta, Furione, Milena, Cassinelli, Gabriela, Klersy, Catherine, Lilleri, D, Tassis, B, Pugni, L, Ronchi, A, Pietrasanta, C, Spinillo, A, Arossa, A, Achille, C, Vergani, P, Ornaghi, S, Riboni, S, Cavoretto, P, Candiani, M, Gaeta, G, Prefumo, F, Fratelli, N, Fichera, A, Vignali, M, Prun, A, Fabbri, E, Cetin, I, Locatelli, A, Consonni, S, Rutolo, S, Miotto, E, Savasi, V, Di Giminiani, M, Cromi, A, Binda, S, Fiorina, L, Furione, M, Cassinelli, G, Klersy, C, Lilleri, Daniele, Tassis, Beatrice, Pugni, Lorenza, Ronchi, Andrea, Pietrasanta, Carlo, Spinillo, Arsenio, Arossa, Alessia, Achille, Cristian, Vergani, Patrizia, Ornaghi, Sara, Riboni, Silvia, Cavoretto, Paolo, Candiani, Massimo, Gaeta, Gerarda, Prefumo, Federico, Fratelli, Nicola, Fichera, Anna, Vignali, Michele, Prun, Allegra Barbasetti Di, Fabbri, Elisa, Cetin, Irene, Locatelli, Anna, Consonni, Sara, Rutolo, Simona, Miotto, Elena, Savasi, Valeria, Di Giminiani, Maria, Cromi, Antonella, Binda, Sandro, Fiorina, Loretta, Furione, Milena, Cassinelli, Gabriela, and Klersy, Catherine

Abstract

BACKGROUND: Human cytomegalovirus (HCMV) is the leading infectious cause of congenital disabilities. We designed a prospective study to investigate the rate, outcome, and risk factors of congenital CMV (cCMV) infection in neonates born to immune women, and the potential need and effectiveness of hygiene recommendations in this population. METHODS: The study was composed of 2 sequential parts: an epidemiology (part 1) and a prevention (part 2) study. Performance of part 2 depended upon a cCMV rate >0.4%. Women enrolled in part 1 did not receive hygiene recommendations. Newborns were screened by HCMV DNA testing in saliva and cCMV was confirmed by urine testing. RESULTS: Saliva swabs were positive for HCMV DNA in 45/9661 newborns and cCMV was confirmed in 18 cases. The rate of cCMV was .19% (95% confidence interval [CI]: .11-.29%), and 3 out of 18 infants with cCMV had symptoms of CMV at birth. Age, nationality, occupation, and contact with children were similar between mothers of infected and noninfected newborns. Twin pregnancy (odds ratio [OR]: 7.2; 95% CI: 1.7-32.2; P = .037) and maternal medical conditions (OR: 3.9; 95% CI: 1.5-10.1; P = .003) appeared associated with cCMV. Given the rate of cCMV was lower than expected, the prevention part of the study was cancelled. CONCLUSIONS: Newborns from women with preconception immunity have a low rate of cCMV, which appears to be mostly due to reactivation of the latent virus. Therefore, serological screening in childbearing age would be pivotal to identify HCMV-seropositive women, whose newborns have a low risk of cCMV. CLINICAL TRIALS REGISTRATION: www.clinicaltrials.gov (NCT03973359).

Published
2023

7. Strategies for preventing group B streptococcal infections in newborns: A nation-wide survey of Italian policies

Author

Tzialla, C, berardi, A, farina, C, clerici, P, borghesi, A, viora, E, scollo, P, stronati, M, Task Force for group B streptococcal infections for the Italian Society of Neonatology including Stival, G, barbaglia, Ma, guala, A, giunta, E, parola, L, grossignani, Mr, perri, P, tubaldi, L, alletto, G, daidone, S, flacco, V, dani, C, sterpa, A, rapisardi, G, elicio, Mr, faldella, G, capretti, Mg, messner, H, bandiera, M, achille, C, azzali, A, montrasio, G, mariani, S, galvagno, G, giacosa, E, de Angelis, F, spandrio, M, serra, A, garofalo, F, perona, A, porcelli, F, ferrero, F, De Franco, S, paollilo, P, picone, S, besana, R, varisco, T, farina, M, memo, L, nicolini, G, lietti, D, Di Chiara, G, rottoli, A, Bonabitacola, T, Cortis, E, Neri, E, Martinelli, S, Ilardi, L, Rondanini, Gf, Calzi, P, Gatta, A, Quntadamo, Pa, Ivaldi, M, Terenzani, L, Di Lascio, N, Travaglio, Md, Vetrano, G, Furcolo, G, Vitacco, V, Intini, C, Frigerio, M, Stroppiana, P, Policicchio, G, Mesirca, P, Gianino, P, Audenio, E, Paludetto, R, Raimondi, F, Pugliese, A, Valentino, L, Nosari, N, Marchesano, G, Chirico, G, Bellù, R, Menchini, M, Poletti, A, E T, Vacchiano, Pinto, L, E D, Perri, Coppola, R, Perini, R, Vetrella, A, De Luca, G, Lista, G, Cavigioli, F, Bettinelli, A, Massironi, E, Franco, C, Bernardo, L, Poli, S, Palladini, M, Tota, V, Spadavecchia, F, Zuccotti, Gv, Pogliani, L, Bracaglia, G, Mancini, Al, Zocco, F, Iozzia, G, Auriemma, A, Teani, M, Mangilli, G, Tempra, Am, Di Terlizi, L, Bottino, R, Salvi, C, Fortunato, V, Musaico, R, Gargantini, G, Carrera, G, Magaldi, R, Taurino, L, D'Onofrio, Am, Buffone, E, Tempera, A, Agosti, M, Garzia, P, Mosca, F, Pugni, L, Tagliabue, P, Colombo, C, Demi, M, Picco, G, Carlucci, A, Zorzi, G, Padula, D, Cardone, Ml, Buonocore, G, Muraca, Mc, Boldrini, A, Ciantelli, M, Lanari, M, Serra, L, Felici, L, Banderalli, G, Brambilla, C, Dall'Agnola, A, Viviani, E, Zonca, Mc, Licardi, G, Chiara, A, Ancora, G, Papa, I, Gancia, P, Pomero, G, Deloglu, A, Villani, P, Mussini, P, Canidio, E, Migliavacca, D, Di Fabio, S, Cipollone, I, Biasucci, G, Rubbi, P, Piepoli, M, Guastaferro, N, Infriccioli, F, Bertino, E, Perathoner, C, Parmigiani, S, Suriano, G, Ianniello, C, Biasini, A, Azzalli, M, Timpani, G, Barresi, S, Caoci, G, Ciccotti, R, De Curtis, M, Natale, F, Finocchi, M, Haass, C, Milillo, F, Lucieri, S, Guercio, E, Canepa, Sa, Scozia, G, Antonucci, R, Limongelli, O, Macciò, S, Mongelli, F, Colonna, F, Dragovic, D, Calipa, Mt, Cohen, A, Moresco, L, Italian Society of Obstetricians and Gynecologists including La Spina, R, Ruggeri, R, Luehwink, A, Brattoli, M, Fedi, A, Lacchi, L, Ettore, G, Pappalardo, E, Conoscenti, G, Zeni, B, Spellecchia, D, Favretti, L, Spagna, L, Zaglio, S, Bresciani, D, Bandini, A, Mancini, R, Mustoni, P, Dodero, D, Grimaldi, M, Di Mario, M, Migliorini, P, Kemeny, A, Anastasio, Ps, Riccardi, T, Maggino, T, Cerri, G, Puggina, P, Marconi, Am, Morgia, S, Bellia, G, D'Anna, Mr, Catania, M, Bacchi Modena, A, Franchi, L, Calonaci, N, Schettini, S, Paradiso, R, Saccucci, P, Ioppi, M, Zorzi, M, Stellin, G, Patacchiola, F, Carrata, L, Bassini, D, San Marco, L, Todros, T, Tibadi, C, Liborio, M, Italian Association of Clinical Microbiologists including Laricchia, R, Tauro, L, Ferrara, F, Nuara, C, Ghiraldi, E, Molinari, F, Comessatti, A, Rocchetti, A, Di Matteo, L, Miconi, V, Calvi, P, Pernigotti, A, Fabozzi, F, Micca, G, Monticone, G, Sarti, M, Da Rin, G, Zoppelletto, M, Modolo, E, Landini, Mp, Furlini, G, Galluppi, E, Pagani, E, Aschbacher, R, Innocenti, P, Bresolin, N, Raggi, Me, Bonfanti, C, De Francesco, M, Santer, P, Griessmaier, A, De Francesco, D, Pirali, A, Prasciolu, C, Usai, F, Cuzzone, G, Scutellà, M, Tramacere, P, Fossati, D, Piaserico, G, Bordignon, G, Sciacca, A, Di Vincenzo, F, Imbriani, A, Melotti, D, Catanoso, G, Rivetti, I, Neri, G, Bruno, R, Bacelle, L, Sartore, P, Giana, G, Sala, E, Giraldi, C, Cavalcanti, P, Perugini, M, Perugini, A, Ginardi, C, Maritano, D, Ferrini, A, Bonettini, A, Avanzini, A, Gasperoni, S, Pieretti, B, Montanari, E, Carillo, C, Rossi, Mr, Laureti, A, Baldoni, Ml, Serra, D, Melioli, G, Bandettini, R, Oneto, F, Colla, R, Storchi Incerti, S, Lanzini, F, Pauri, P, Tili, E, Leone, Ra, Verdastro, G, Megha, M, Luzzaro, F, Conti, A, Busulini, L, Mirri, P, Diodati, R, Vettori, C, Pittalis, S, Anesi, A, Fiore, A, Goglia, L, Vitullo, E, Sinno, A, Platzgummer, S, Spitaler, C, Trabucchi, Mc, Besozzi, M, Cesana, E, Inghilleri, G, Grosso, S, D'Angelo, R, Fogato, E, Lavarda, F, Ortisi, G, Clementi, M, Cichero, P, Rumpianesi, F, Venturelli, C, Mortillaro, F, Daffara, S, Catania, Mr, Iula, D, Andreoni, S, Politi, A, Agostinelli, C, Paparella, C, Capozzi, D, Notaris, P, Bistoni, F, Mencacci, A, Valentini, M, Filippetti, A, Confalonieri, M, Novarese, O, Bonini, F, Salamone, D, Camporese, A, De Rosa, R, Casprini, P, Degl'Innocenti, R, Giordano, R, Allù, Mt, Zanella, D, Malandrino, M, Tronci, M, Valmarin, M, Leonetti, G, Falco, S, Meledandri, M, Ballardini, M, Spanò, A, Cava, Mc, Mascellino, Mt, Schinella, M, Gualdi, P, Casari, E, Scattolo, N, Motta, C, Perfetti, C, Bassano, M, Cera, G, Iafisco, P, Mura, I, Palmieri, A, Migliardi, M, Ferlini, M, Grandi, G, Giardini, F, Albano, F, Latino, M, Ferrero, Mp, Bellizia, L, Russolo, M, Russolo, S, Pesenti, A, Fasano, Ma, Previato, S, Radillo, O, Busetti, M, Ferrari, P, Siderini, V, Puzzolante, L, Scarparo, C, Arzese, A, Cappuccia, N, Lodolo, L, Delledonne, L, Gramoni, A, Maiolo, V, Gheller, A, Spadaro, S, Balzaretti, M, Tzialla, C., Berardi, A., Farina, C., Clerici, P., Borghesi, A., Viora, E., Scollo, P., Stronati, M., Stival, G., Barbaglia, M. A., Guala, A., Giunta, E., Parola, L., Grossignani, M. R., Perri, P., Tubaldi, L., Alletto, G., Daidone, S., Flacco, V., Dani, C., Sterpa, A., Rapisardi, G., Elicio, M. R., Faldella, G., Capretti, M. G., Messner, H., Bandiera, M., Achille, C., Azzali, A., Montrasio, G., Mariani, S., Galvagno, G., Giacosa, E., de Angelis, F., Spandrio, M., Serra, A., Garofalo, F., Perona, A., Porcelli, F., Ferrero, F., De Franco, S., Paollilo, P., Picone, S., Besana, R., Varisco, T., Farina, M., Memo, L., Nicolini, G., Lietti, D., Di Chiara, G., Rottoli, A., Bonabitacola, T., Cortis, E., Neri, E., Martinelli, S., Ilardi, L., Rondanini, G. F., Calzi, P., Gatta, A., Quntadamo, P. A., Ivaldi, M., Terenzani, L., Di Lascio, N., Travaglio, M. D., Vetrano, G., Furcolo, G., Vitacco, V., Intini, C., Frigerio, M., Stroppiana, P., Policicchio, G., Mesirca, P., Gianino, P., Audenio, E., Paludetto, R., Raimondi, F., Pugliese, A., Valentino, L., Nosari, N., Marchesano, G., Chirico, G., Bell(`u), R., Menchini, M., Poletti, A., Vacchiano, T., Pinto, L., Perri, D., Coppola, R., Perini, R., Vetrella, A., De Luca, G., Lista, G., Cavigioli, F., Bettinelli, A., Massironi, E., Franco, C., Bernardo, L., Poli, S., Palladini, M., Tota, V., Spadavecchia, F., Zuccotti, G. V., Pogliani, L., Bracaglia, G., Mancini, A. L., Zocco, F., Iozzia, G., Auriemma, A., Teani, M., Mangilli, G., Tempra, A. M., Di Terlizi, L., Bottino, R., Salvi, C., Fortunato, V., Musaico, R., Gargantini, G., Carrera, G., Magaldi, R., Taurino, L., D?onofrio, A. M., Buffone, E., Tempera, A., Agosti, M., Garzia, P., Mosca, F., Pugni, L., Tagliabue, P., Colombo, C., Demi, M., Picco, G., Carlucci, A., Zorzi, G., Padula, D., Cardone, M. L., Buonocore, G., Muraca, M. C., Boldrini, A., Ciantelli, M., Lanari, M., Serra, L., Felici, L., Banderalli, G., Brambilla, C., Dall?agnola, A., Viviani, E., Zonca, M. C., Licardi, G., Chiara, A., Ancora, G., Papa, I., Gancia, P., Pomero, G., Deloglu, A., Villani, P., Mussini, P., Canidio, E., Migliavacca, D., Di Fabio, S., Cipollone, I., Biasucci, G., Rubbi, P., Piepoli, M., Guastaferro, N., Infriccioli, F., Bertino, E., Perathoner, C., Parmigiani, S., Suriano, G., Ianniello, C., Biasini, A., Azzalli, M., Timpani, G., Barresi, S., Caoci, G., Ciccotti, R., De Curtis, M., Natale, F., Finocchi, M., Haass, C., Milillo, F., Lucieri, S., Guercio, E., Canepa, S. A., Scozia, G., Antonucci, R., Limongelli, O., Macci(`o), S., Mongelli, F., Colonna, F., Dragovic, D., Calipa, M. T., Cohen, A., Moresco, L., La Spina, R., Ruggeri, R., Luehwink, A., Brattoli, M., Fedi, A., Lacchi, L., Ettore, G., Pappalardo, E., Conoscenti, G., Zeni, B., Spellecchia, D., Favretti, L., Spagna, L., Zaglio, S., Bresciani, D., Bandini, A., Mancini, R., Mustoni, P., Dodero, D., Grimaldi, M., Di Mario, M., Migliorini, P., Kemeny, A., Anastasio, P. S., Riccardi, T., Maggino, T., Cerri, G., Puggina, P., Marconi, A. M., Morgia, S., Bellia, G., D?anna, M. R., Catania, M., Bacchi Modena, A., Franchi, L., Calonaci, N., Schettini, S., Paradiso, R., Saccucci, P., Ioppi, M., Zorzi, M., Stellin, G., Patacchiola, F., Carrata, L., Bassini, D., San Marco, L., Todros, T., Tibadi, C., Liborio, M., Laricchia, R., Tauro, L., Ferrara, F., Nuara, C., Ghiraldi, E., Molinari, F., Comessatti, A., Rocchetti, A., Di Matteo, L., Miconi, V., Calvi, P., Pernigotti, A., Fabozzi, F., Micca, G., Monticone, G., Sarti, M., Da Rin, G., Zoppelletto, M., Modolo, E., Landini, M. P., Furlini, G., Galluppi, E., Pagani, E., Aschbacher, R., Innocenti, P., Bresolin, N., Raggi, M. E., Bonfanti, C., De Francesco, M., Santer, P., Griessmaier, A., De Francesco, D., Pirali, A., Prasciolu, C., Usai, F., Cuzzone, G., Scutell(`a), M., Tramacere, P., Fossati, D., Piaserico, G., Bordignon, G., Sciacca, A., Di Vincenzo, F., Imbriani, A., Melotti, D., Catanoso, G., Rivetti, I., Neri, G., Bruno, R., Bacelle, L., Sartore, P., Giana, G., Sala, E., Giraldi, C., Cavalcanti, P., Perugini, M., Perugini, A., Ginardi, C., Maritano, D., Ferrini, A., Bonettini, A., Avanzini, A., Gasperoni, S., Pieretti, B., Montanari, E., Carillo, C., Rossi, M. R., Laureti, A., Baldoni, M. L., Serra, D., Melioli, G., Bandettini, R., Oneto, F., Colla, R., Storchi Incerti, S., Lanzini, F., Pauri, P., Tili, E., Leone, R. A., Verdastro, G., Megha, M., Luzzaro, F., Conti, A., Busulini, L., Mirri, P., Diodati, R., Vettori, C., Pittalis, S., Anesi, A., Fiore, A., Goglia, L., Vitullo, E., Sinno, A., Platzgummer, S., Spitaler, C., Trabucchi, M. C., Besozzi, M., Cesana, E., Inghilleri, G., Grosso, S., D?angelo, R., Fogato, E., Lavarda, F., Ortisi, G., Clementi, M., Cichero, P., Rumpianesi, F., Venturelli, C., Mortillaro, F., Daffara, S., Catania, M. R., Iula, D., Andreoni, S., Politi, A., Agostinelli, C., Paparella, C., Capozzi, D., Notaris, P., Bistoni, F., Mencacci, A., Valentini, M., Filippetti, A., Confalonieri, M., Novarese, O., Bonini, F., Salamone, D., Camporese, A., De Rosa, R., Casprini, P., Degl?innocenti, R., Giordano, R., All(`u), M. T., Zanella, D., Malandrino, M., Tronci, M., Valmarin, M., Leonetti, G., Falco, S., Meledandri, M., Ballardini, M., Span(`o), A., Cava, M. C., Mascellino, M. T., Schinella, M., Gualdi, P., Casari, E., Scattolo, N., Motta, C., Perfetti, C., Bassano, M., Cera, G., Iafisco, P., Mura, I., Palmieri, A., Migliardi, M., Ferlini, M., Grandi, G., Giardini, F., Albano, F., Latino, M., Ferrero, M. P., Bellizia, L., Russolo, M., Russolo, S., Pesenti, A., Fasano, M. A., Previato, S., Radillo, O., Busetti, M., Ferrari, P., Siderini, V., Puzzolante, L., Scarparo, C., Arzese, A., Cappuccia, N., Lodolo, L., Delledonne, L., Gramoni, A., Maiolo, V., Gheller, A., Spadaro, S., Balzaretti, M., Tzialla, Chryssoula, Berardi, Alberto, Farina, Claudio, Clerici, Pierangelo, Borghesi, Alessandro, Viora, Elsa, Scollo, Paolo, Stronati, Mauro, [.., Lanari, Marcello, Faldella, Giacomo, and ]

Subjects
Male, Pediatrics, Group B, 0302 clinical medicine, Neonate, Pregnancy, Surveys and Questionnaires, Prevalence, Mass Screening, Blood culture, 030212 general & internal medicine, Antibiotic prophylaxis, Survey, GBS, Group B streptococcus, Infection, Newborn infant, Adult, Antibiotic Prophylaxis, Female, Health Surveys, Humans, Infant, Newborn, Italy, Neonatal Screening, Pregnancy Complications, Infectious, Prenatal Care, Primary Prevention, Risk Assessment, Streptococcal Infections, Streptococcus agalactiae, reproductive and urinary physiology, Group B streptococcu, medicine.diagnostic_test, lcsh:RJ1-570, Infectious, Perinatology and Child Health, Pediatrics, Perinatology and Child Health, medicine.medical_specialty, Antibiotic sensitivity, Group B Streptococcal Infection, Prenatal care, 03 medical and health sciences, 030225 pediatrics, medicine, Intensive care medicine, Mass screening, business.industry, Public health, Infant, lcsh:Pediatrics, Newborn, Pregnancy Complications, business
Abstract

Background There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. Methods Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility. Results All respondent obstetrical units used the culture-based screening approach to identify women who should receive intrapartum antibiotic prophylaxis, and more than half of the microbiological laboratories (58%) reported using specimen processing consistent with CDC guidelines. Most neonatal units (89 out of 107, 82%) reported using protocols for preventing GBS early-onset sepsis consistent with CDC guidelines. Conclusions The screening-based strategy is largely prevalent in Italy, and most protocols for preventing GBS early-onset sepsis are consistent with CDC guidelines. However, we found discrepancies in practices among centers that may reflect the lack of Italian guidelines issued by public health organizations.

Published
2017

10. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context.

Author

Pietrasanta, C., Pugni, L., Ronchi, A., Schena, F., Davanzo, R., Gargantini, G., Ferrazzi, E., and Mosca, F.

Subjects
*SARS-CoV-2, *COVID-19, *HOSPITAL maternity services, *DYADS, *INFECTION
Abstract

In the context of SARS-CoV-2 pandemic, the hospital management of mother-infant pairs poses to obstetricians and neonatologists previously unmet challenges. In Lombardy, Northern Italy, 59 maternity wards networked to organise the medical assistance of mothers and neonates with suspected or confirmed SARS-CoV-2 infection. Six "COVID-19 maternity centres" were identified, the architecture and activity of obstetric and neonatal wards of each centre was reorganised, and common assistance protocols for the management of suspected and proven cases were formulated. Here, we present the key features of this reorganization effort, and our current management of the mother-infant dyad before and after birth, including our approach to rooming-in practice, breastfeeding and neonatal follow-up, based on the currently available scientific evidence. Considered the rapid diffusion of COVID-19 all over the world, we believe that preparedness is fundamental to assist mother-infant dyads, minimising the risk of propagation of the infection through maternity and neonatal wards. [ABSTRACT FROM AUTHOR]

Published
2020
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11. Lactoferrin and prevention of late-onset sepsis in the pre-term neonates

Author

Manzoni, P, Decembrino, L, Stolfi, I, Pugni, L, Rinaldi, M, Cattani, Sara, Romeo, Mg, Messner, H, Laforgia, N, Vagnarelli, F, Memo, L, Bordignon, L, Saia, Os, Maule, MILENA MARIA, Gallo, E, Mostert, Michael Martin, Magnani, Silvia Carla, Quercia, M, Bollani, Luigi, Pedicino, R, Renzullo, L, Betta, P, Ferrari, F, Magaldi, R, Mosca, F, Stronati, M, Farina, Davide, Italian, Task Force for the Study, Prevention of Neonatal Fungal Infections, and Italian Society of, Neonatology

Subjects
Infant, Premature, Diseases, Sepsis, chemistry.chemical_compound, Anti-Infective Agents, Lactoferricin, Intensive care, medicine, Animals, Humans, Age of Onset, biology, Lactoferrin, business.industry, Infant, Newborn, Obstetrics and Gynecology, medicine.disease, Antimicrobial, Lactoferrin and prevention of late-onset sepsis, Low birth weight, chemistry, Pediatrics, Perinatology and Child Health, Immunology, biology.protein, Premature Birth, Colostrum, Cattle, medicine.symptom, business, Infant, Premature, Fluconazole, medicine.drug
Abstract

Late-onset sepsis (LOS) affects a large proportion of pre-term neonates in neonatal intensive care units (NICUs) worldwide, with high morbidity and related mortality, and frequent occurrence of severe late neurodevelopmental impairment. Due to the frequency, severity and difficulties in early diagnosis and prompt therapy, prevention is crucial for decreasing the burden of infection-related complications in NICUs. It is well known that feeding with fresh maternal milk, hygiene measures and the cautious use of H2-blockers are related with a decreased risk of developing sepsis. However, evidence from randomised clinical trials exists only for fluconazole in the prevention of fungal infections in the NICU. Lactoferrin is the main whey protein in mammalian milk, and is involved in innate immune host defences. Notably, human lactoferrin can be found at increased concentrations in colostrum and in milk from mothers of premature neonates. Human (hLF) and bovine lactoferrin (bLF) share a high (77%) amino-acid homology, and the same N-terminal peptide responsible for antimicrobial activity, called lactoferricin. In vitro, bLF shows potent direct antimicrobial activity against all types of pathogens, which occurs via anti-cell wall actions and leads to disintegration of the micro-organism's membranes. bLF is also synergistic with many antimicrobials and antifungals, and promotes growth and differentiation of the immature gut. Based on this background data, a randomised clinical trial was recently conducted in very low birth weight pre-term neonates given bLF alone or with the probiotic Lactobacillus GG. The aim of the trial was to assess the ability of bLF to prevent late-onset sepsis of any origin in the studied infants during their stay in the NICU. This article discusses the preliminary data from this study, along with the proposed mechanisms of action of bLF in pre-term infants.

Published
2010
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13. Human milk feeding prevents retinopathy of prematurity (ROP) in preterm VLBW neonates

Author

Manzoni, P, Stolfi, I, Pedicino, R, Vagnarelli, F, Mosca, F, Pugni, L, Bollani, L, Pozzi, M, Gomez, K, Tzialla, C, Borghesi, A, Decembrino, L, Mostert, M, Latino, Ma, Priolo, C, Galletto, P, Gallo, E, Rizzollo, S, Tavella, E, Luparia, M, Corona, G, Barberi, Ignazio, Tridapalli, E, Faldella, G, Vetrano, G, Memo, L, Saia, Os, Bordignon, L, Messner, H, Cattani, S, Casa, Ed, Laforgia, N, Quercia, M, Romeo, M, Betta, Pm, Rinaldi, M, Magaldi, R, Maule, M, Stronati, M, Farina, D, Italian Task Force for the study, prevention of Neonatal Fungal Infections, and the Italian Society of Neonatology

Subjects
Male, Pediatrics, medicine.medical_specialty, Birth weight, Gestational Age, law.invention, Sepsis, Randomized controlled trial, law, Intensive Care Units, Neonatal, medicine, Humans, Infant, Very Low Birth Weight, Retinopathy of Prematurity, Human milk, Preterm neonates, Retinopathy of prematurity, Prevention, Univariate analysis, Milk, Human, business.industry, Incidence (epidemiology), Confounding, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Infant, retinopathy of prematurity, medicine.disease, Infant Formula, Italy, Pediatrics, Perinatology and Child Health, Female, business, Infant, Premature
Abstract

Retinopathy of prematurity (ROP) is a multifactorial disease, but little is known about its relationships with neonatal nutritional policies. Human, maternal milk is the best possible nutritional option for all premature infants, including those at high risk for severe complications of prematurity, such as ROP.This is a secondary analysis of data collected during two multicenter RCTs performed consecutively (years 2004 through 2008) by a network of eleven tertiary NICUs in Italy. The two trials aimed at assessing effectiveness of fluconazole prophylaxis (Manzoni et al., N Engl J Med 2007 Jun 14;356(24):2483-95), and of bovine lactoferrin supplementation (Manzoni et al., JAMA 2009 Oct 7;302(13):1421-8), in prevention of invasive fungal infection, and of late-onset sepsis in VLBW infants, respectively. We tested the hypothesis that exclusive feeding with fresh maternal milk may prevent ROP of any stage - as defined by the ETROP study - in VLBW neonates, compared to formula feeding.We analyzed the database from both trials. Systematic screening for detection of ROP was part of the protocol of both studies. The definition of threshold ROP was as defined by the ETROP study. Univariate analysis was performed to look for significant associations between ROP and several possible associated factors, and among them, the type of milk feeding (maternal milk or formula for preterms). When an association was indicated by p0.05, multiple logistic regression was used to determine the factors significantly associated with ROP.In both trials combined, 314 infants received exclusively human maternal milk (group A), and 184 a preterm formula because their mothers were not expected to breastfeed. The clinical, demographical and management characteristics of the neonates did not differ between the two groups, particularly related to the presence of the known risk factors for ROP. Overall, ROP incidence (any stage) was significantly lower in infants fed maternal milk (11 of 314; 3.5%) as compared to formula-fed neonates (29 of 184; 15.8%) (RR 0.14; 95% CI 0.12-0.62; p = 0.004). The same occurred for threshold ROP (1.3% vs. 12.3%, respectively; RR 0.19; 95% CI 0.05-0.69; p = 0.009). At multivariate logistic regression controlling for potentially confounding factors that were significantly associated to ROP (any stage) at univariate analysis (birth weight, gestational age, days on supplemental oxygen, systemic fungal infection, outborn, hyperglycaemia), type of milk feeding retained significance, human maternal milk being protective with p = 0.01.Exclusive human, maternal milk feeding since birth may prevent ROP of any stage in VLBW infants in the NICU.

Published
2013

14. Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial

Author

Manzoni, P, Rinaldi, M, Cattani, S, Pugni, L, Romeo, Mg, Messner, H, Stolfi, I, Decembrino, L, Laforgia, N, Vagnarelli, F, Memo, L, Bordignon, L, Saia, Os, Maule, M, Gallo, E, Mostert, M, Magnani, C, Quercia, M, Bollani, L, Pedicino, R, Renzullo, L, Betta, P, Mosca, F, Ferrari, Fabrizio, Magaldi, R, Stronati, M, Farina, D, Italian Task Force for the Study, and Prevention of Neonatal Fungal Infections Italian Society of Neonatology

Subjects
bovine lactoferrin
Published
2009

15. A multicenter, randomized trial of prophylactic fluconazole in preterm neonates

Author

Manzoni, P, Stolfi, I, Pugni, L, Decembrino, L, Magnani, Silvia Carla, Vetrano, G, Tridapalli, E, Corona, Gabriella, Giovannozzi, Chiara, Farina, Davide, Arisio, R, Merletti, Franco, Maule, MILENA MARIA, Mosca, F, Pedicino, R, Stronati, M, Mostert, Michael Martin, Gomirato, G, Italian, Task Force for the Study, Prevention of Neonatal Fungal Infections, and Italian Society of, Neonatology

Published
2007

16. The Milan Project: a newborn hearing screening programme

Author

Pastorino G., Sergi P., Mastrangelo M., Ravazzani P., Tognola G., Parazzini M., Mosca F., Pugni L., and Grandori F.

Subjects
otorhinolaryngologic diseases, otoacoustic emissions, ABR, newborn hearing screening
Abstract

Aim: Since 1997 a newborn hearing screening programme has been implemented by the U.O. Neurologia-Neurofisiopatologia and Dipartimento di Neonatologia of the Istituti Clinici di Perfezionamento ICP in Milan for both babies with no risk and those at risk of hearing impairment. This programme was named the Milan Project. Methods: The protocol for norisk babies consisted of three stages: in the first two stages, newborns were tested with transient click-evoked otoacoustic emissions (TEOAE), in the third one with conventional auditory brainstem responses (ABR). The first TEOAE test was performed by 36 h of age, before discharge, the second one after 15-30 d in case of referral, and the third one, by ABR, for those babies who failed the second TEOAE stage. Newborns at audiological risk were submitted to conventional ABR before the third month of corrected age. Some of this latter population was also submitted to the TEOAE test. The entire tested population (no-risk babies and newborns at audiological risk) consisted of 19 777 babies: 19 290 without risk ("no risk") and 487 at risk ("at risk"). Results: During the course of the Milan Project, hearing impairment (ABR threshold equal to or greater than 40 dB nHL) was identified in 63 newborns (19 from the no-risk and 44 from the at-risk population), with a prevalence of 0.32%. Bilateral hearing impairment (BHI) was found in 33 newborns (10 from the no-risk and 23 from the at-risk population), corresponding to 0.17%. Among infants with bilateral hearing impairment, 30.3% had no risk factors. The prevalence of hearing impairment was determined on days 15-30 after birth. Conclusions: The results show that the implementation of a hospital-based, universal neonatal hearing screening programme for babies with and without audiological risk is feasible and effective. The effectiveness of the programme has increased as a function of the years since its inception, with a strong decrease in the referral rate. Further improvement is obtained if the TEOAE measurements are repeated in cases of referral scoring before discharge.

Published
2005
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20. Herpesviruses and breast milk

Author

Pietrasanta, C., primary, Ghirardi, B., additional, Manca, M.F., additional, Uccella, S., additional, Gualdi, C., additional, Tota, E., additional, Pugni, L., additional, and Mosca, F., additional

Published
2014
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24. Clinical characteristics and response to prophylactic fluconazole of preterm VLBW neonates with baseline and acquired fungal colonisation in NICU: data from a multicentre RCT

Author

Manzoni, P., primary, Mostert, M., additional, Latino, M.A., additional, Pugni, L., additional, Stolfi, I., additional, Decembrino, L., additional, Vagnarelli, F., additional, Corona, G., additional, Tridapalli, E., additional, Vetrano, G., additional, Memo, L., additional, Priolo, C., additional, Galletto, P., additional, Giovannozzi, C., additional, Gallo, E., additional, Pedicino, R., additional, Barberi, I., additional, Faldella, G., additional, Mosca, F., additional, Saia, O.S., additional, Bollani, L., additional, Maragliano, R., additional, Ruffinazzi, G., additional, Tzialla, C., additional, Stronati, M., additional, Rizzollo, S., additional, Farina, D., additional, Benjamin, D.K., additional, Smith, P.B., additional, Jacqz-Aigrain, E., additional, Kaguelidou, F., additional, and Cohen-Wolkowiez, M., additional

Published
2012
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25. A3 Bovine lactoferrin supplementation for prevention of necrotising enterocolitis in preterm very-low-birth-weight neonates: a randomised trial

Author

Rinaldi, M., primary, Manzoni, P., additional, Meyer, M., additional, Casa, E. Della, additional, Pugni, L., additional, Mosca, F., additional, Stolfi, I., additional, Messner, H., additional, Memo, L., additional, Laforgia, N., additional, Decembrino, L., additional, Pasqua, M. Betta, additional, Vagnarelli, F., additional, Stronati, M., additional, and Farina, D., additional

Published
2012
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26. Use of linezolid in infants and children: a retrospective multicentre study of the Italian Society for Paediatric Infectious Diseases

Author

Garazzino, S., primary, Krzysztofiak, A., additional, Esposito, S., additional, Castagnola, E., additional, Plebani, A., additional, Galli, L., additional, Cellini, M., additional, Lipreri, R., additional, Scolfaro, C., additional, Bertaina, C., additional, Calitri, C., additional, Bozzola, E., additional, Lancella, L., additional, Quondamcarlo, A., additional, Bosis, S., additional, Pugni, L., additional, Losurdo, G., additional, Soresina, A., additional, De Gaudio, M., additional, Mariotti, I., additional, Mancini, L., additional, Gabiano, C., additional, and Tovo, P.-A., additional

Published
2011
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31. Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial.

Author

Manzoni P, Rinaldi M, Cattani S, Pugni L, Romeo MG, Messner H, Stolfi I, Decembrino L, Laforgia N, Vagnarelli F, Memo L, Bordignon L, Saia OS, Maule M, Gallo E, Mostert M, Magnani C, Quercia M, Bollani L, and Pedicino R

Abstract

Context: Sepsis is a common and severe complication in premature neonates, particularly those with very low birth weight (VLBW) (<1500 g). Whether lactoferrin, a mammalian milk glycoprotein involved in innate immune host defenses, can reduce the incidence of sepsis is unknown. In animal models, the probiotic Lactobacillus rhamnosus GG (LGG) enhances the activity of lactoferrin but has not been studied in human infants.Objective: To establish whether bovine lactoferrin (BLF), alone or in combination with LGG, reduces the incidence of late-onset sepsis in VLBW neonates.Design, Setting, and Patients: Prospective, multicenter, double-blind, placebo-controlled, randomized trial conducted in 11 Italian tertiary neonatal intensive care units. Patients were 472 VLBW infants enrolled from October 1, 2007, through July 31, 2008, and assessed until discharge for development of sepsis.Intervention: Infants were randomly assigned to receive orally administered BLF (100 mg/d) alone (n = 153), BLF plus LGG (6 x 10(9) colony-forming units/d) (n = 151), or placebo (n = 168) from birth until day 30 of life (day 45 for neonates <1000 g at birth).Main Outcome Measure: First episode of late-onset sepsis, ie, sepsis occurring more than 72 hours after birth with isolation of any pathogen from blood or from peritoneal or cerebrospinal fluid.Results: Demographic, clinical, and management characteristics of the 3 groups were similar, including type of feeding and intake of maternal milk. Incidence of late-onset sepsis was significantly lower in the BLF and BLF plus LGG groups (9/153 [5.9%] and 7/151 [4.6%], respectively) than in the control group receiving placebo (29/168 [17.3%]) (risk ratio, 0.34; 95% confidence interval, 0.17-0.70; P = .002 for BLF vs control and risk ratio, 0.27; 95% confidence interval, 0.12-0.60; P < .001 for BLF plus LGG vs control). The decrease occurred for both bacterial and fungal sepsis. No adverse effects or intolerances to treatment occurred.Conclusion: Compared with placebo, BLF supplementation alone or in combination with LGG reduced the incidence of a first episode of late-onset sepsis in VLBW neonates.Trial Registration: isrctn.org Identifier: ISRCTN53107700. [ABSTRACT FROM AUTHOR]

Published
2009
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32. Hydrolysed proteins in preterm formula: influence on plasma aminoacids, blood fatty acids and insulinaemia.

Author

M.Agosti, Pugni, L., Ramenghi, L.A., Mosca, F., and Marini, A.

Subjects
*PROTEIN hydrolysates, *AMINO acids, *INSULIN, *PREMATURE infants
Abstract

The data from the present investigation differ from those of the previous study. The new version of hydrolysed protein formula did not induce changes in insulinaemia or in the insulinaemia/glycaemia ratio in pre- and postprandial samples when compared with the intact protein formula. The investigation also confirmed that branch chain aminoacids regulate insulin secretion and that the length of chain is insulinotropic for fatty acids, while the degree of unsaturation is not able to reduce insulin secretion in the newborn baby. This could be caused by stimulation of insulin output activated by the C20:5 n 3; the effects of fatty acids are probably related more to the variable composition of cell membrane than to the fatty acids circulating levels. [ABSTRACT FROM AUTHOR]

Published
2003
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36. Bovine Lactoferrin Supplementation for Prevention of Late-Onset Sepsis in Very Low-Birth-Weight Neonates A Randomized Trial

Author

Manzoni, P, Rinaldi, M, Cattani, Sara, Pugni, L, Romeo, Mg, Messner, H, Stolfi, I, Decembrino, L, Laforgia, N, Vagnarelli, F, Memo, L, Bordignon, L, Saia, Os, Maule, MILENA MARIA, Gallo, E, Mostert, Michael Martin, Magnani, Silvia Carla, Quercia, M, Bollani, Luigi, Pedicino, R, Renzullo, L, Betta, P, Mosca, F, Ferrari, F, Magaldi, R, Stronati, M, Farina, Davide, Italian, Task Force for the Study, Prevention of Neonatal Fungal Infections, and Italian Society of, Neonatology

Subjects
Very Low Birth Weight, Infant, Premature, Diseases

37. [Cerebral oxygenation and near-infrared rays spectrophotometry]

Author

Mosca F, Fumagalli M, Bray M, Barbarini M, Luigi Gagliardi, Colnaghi M, and Pugni L

Subjects
Spectroscopy, Near-Infrared, Umbilicus, Indomethacin, Hemodynamics, Infant, Newborn, Brain, Ibuprofen, Pulmonary Surfactants, Suction, Catheterization, Oxygen, Phlebotomy, Cerebrovascular Circulation, Humans, Blood Transfusion
Abstract

Near infrared spectroscopy (NIRS) is a new technique which allows non invasive bedside monitoring of cerebral oxygenation and hemodynamics by measuring relative changes in cerebral oxy- and deoxyhaemoglobin and cytochrome aa3. We have applied this technique to evaluate the possible effects on cerebral oxygenation and hemodynamics of clinical procedures usually performed on preterm infants:--endotracheal suctioning, and we have demonstrated that the magnitude and the duration of the negative effects of open system are significantly reduced using closed endotracheal suctioning system;--withdrawal and infusion through umbilical vein and artery cause significant changes in cerebral hemodynamics: these effects are significantly reduced after administration of ibuprofen;--treatment of patent ductus arteriosus with ibuprofen does not significantly reduce cerebral perfusion and oxygen availability compared to indomethacin and ibuprofen administration also does not affect cerebral vasoreactivity to arterial carbon dioxide tension;--administration of different types and doses of natural surfactant causes different changes in cerebral hemodynamics and these effects seem to be dose-related. Therefore NIRS is an useful device to investigate cerebral oxygenation state of preterm infants and new possibilities could derive from the introduction of a new NIRS method which allows to measure the tissue oxygenation index.

41. A multicenter, randomized trial of prophylactic fluconazole in preterm neonates.

Author

Manzoni P, Stolfi I, Pugni L, Decembrino L, Magnani C, Vetrano G, Tridapalli E, Corona G, Giovannozzi C, Farina D, Arisio R, Merletti F, Maule M, Mosca F, Pedicino R, Stronati M, Mostert M, Gomirato G, Italian Task Force for the Study and Prevention of Neonatal Fungal Infections, and Italian Society of Neonatology

Published
2007

42. CXCR5‐CXCL13 axis markers in full‐term and preterm human neonates in the first weeks of life

Author

Alessandro Aiuti, Andrea Ronchi, Carlo Pietrasanta, Fabio Mosca, Lorenza Pugni, Tatiana Jofra, Pasqualina De Leo, Maria Pia Cicalese, Georgia Fousteri, Pietrasanta, C., De Leo, P., Jofra, T., Ronchi, A., Pugni, L., Mosca, F., Aiuti, A., Cicalese, M. P., and Fousteri, G.

Subjects
Receptors, CXCR5, 0301 basic medicine, Term Birth, Vaccine response, Immunology, Biology, CXCR5, Immunophenotyping, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Text mining, medicine, Humans, Immunology and Allergy, CXCL13, Full Term, business.industry, Infant, Newborn, Germinal center, T-Lymphocytes, Helper-Inducer, medicine.disease, Chemokine CXCL13, Phenotype, 030104 developmental biology, Premature Birth, Disease Susceptibility, business, Biomarkers, 030215 immunology
Abstract

Term and preterm neonates have very few circulating Tfh-like cells (cTfh), and no circulating Tfr-like cells. Neonatal cTfh are CXCR5lo PD-1lo CD45RAhi , suggestive of a naive, possibly recently activated phenotype. CXCL13 is high at birth, but decreases rapidly in the first weeks of life. Overall, signs of GC activity in human neonates are weak, even in those born prematurely or after sepsis. Term and preterm neonates have very few circulating Tfh-like cells (cTfh), and no circulating Tfr-like cells. Neonatal cTfh are CXCR5(lo)PD-1(lo)CD45RA(hi), suggestive of a naive, possibly recently activated phenotype. CXCL13 is high at birth, but decreases rapidly in the first weeks of life. Overall, signs of GC activity in human neonates are weak, even in those born prematurely or after sepsis. (dagger)

Published
2021
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43. incidence and risk factors of bacterial sepsis and invasive fungal infection in neonates and infants requiring major surgery: an Italian multicentre prospective study

Author

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

Subjects
Microbiology (medical), Settore MED/38 - Pediatria Generale e Specialistica, Fungal infection, Antifungal Agents, Incidence, Infant, Newborn, Infant, General Medicine, Candida, Fungal colonization, Neonatal sepsis, Surgery, Infectious Diseases, Mycoses, Risk Factors, Sepsis, Humans, Prospective Studies, Neonatal sepsi, fungal infection Fungal colonization Neonatal sepsis Surgery Candida, Invasive Fungal Infections
Abstract

Background: Limited data are currently available on the incidence rates and risk factors for bacterial sepsis and invasive fungal infections (IFIs) among neonates and infants undergoing major surgery. Aim: To assess the incidence of bacterial sepsis and IFI, fungal colonization, risk factors for sepsis, and mortality in neonates and infants aged

Published
2022

44. Invasive candida infections in neonates after major surgery: Current evidence and new directions

Author

Domenico Umberto De Rose, Alessandra Santisi, Maria Paola Ronchetti, Ludovica Martini, Lisa Serafini, Pasqua Betta, Marzia Maino, Francesco Cavigioli, Ilaria Cocchi, Lorenza Pugni, Elvira Bonanno, Chryssoula Tzialla, Mario Giuffrè, Jenny Bua, Benedetta Della Torre, Giovanna Nardella, Danila Mazzeo, Paolo Manzoni, Andrea Dotta, Pietro Bagolan, Cinzia Auriti, on behalf of Study Group of Neonatal Infectious Diseases, De Rose D.U., Santisi A., Ronchetti M.P., Martini L., Serafini L., Betta P., Maino M., Cavigioli F., Cocchi I., Pugni L., Bonanno E., Tzialla C., Giuffre M., Bua J., Della Torre B., Nardella G., Mazzeo D., Manzoni P., Dotta A., Bagolan P., and Auriti C.

Subjects
0301 basic medicine, Microbiology (medical), Antifungal, medicine.medical_specialty, medicine.drug_class, Invasive Candida infections, 030106 microbiology, lcsh:Medicine, Invasive Candida infection, Candida infections, 03 medical and health sciences, Broad spectrum, Neonatal surgery, invasive Candida infections, 0302 clinical medicine, Invasive fungal infection, Invasive fungal infections, Intensive care, Epidemiology, Fungal colonization, Immunology and Allergy, Medicine, Antifungal prophylaxi, 030212 general & internal medicine, Molecular Biology, Newborns, General Immunology and Microbiology, business.industry, lcsh:R, Impaired immune responses, Newborn, Surgery, Infectious Diseases, Settore MED/20, Antifungal prophylaxis, business
Abstract

Infections represent a serious health problem in neonates. Invasive Candida infections (ICIs) are still a leading cause of mortality and morbidity in neonatal intensive care units (NICUs). Infants hospitalized in NICUs are at high risk of ICIs, because of several risk factors: broad spectrum antibiotic treatments, central catheters and other invasive devices, fungal colonization, and impaired immune responses. In this review we summarize 19 published studies which provide the prevalence of previous surgery in neonates with invasive Candida infections. We also provide an overview of risk factors for ICIs after major surgery, fungal colonization, and innate defense mechanisms against fungi, as well as the roles of different Candida spp., the epidemiology and costs of ICIs, diagnosis of ICIs, and antifungal prophylaxis and treatment.

Published
2021

45. Hexavalent vaccines in preterm infants: an update by Italian Society of Pediatric Allergy and Immunology jointly with the Italian Society of Neonatology

Author

Fabio Mosca, Mauro Calvani, Domenico Minasi, Chiara Petrolini, Carlo Caffarelli, Carlo Pietrasanta, Elena Chiappini, Arabella Martelli, Lorenza Pugni, Marzia Duse, G B Pajno, Mariangela Tosca, Sara Manti, Gian Luigi Marseglia, Fabio Cardinale, M. Miraglia Del Giudice, Amelia Licari, Chiappini, E., Petrolini, C., Caffarelli, C., Calvani, M., Cardinale, F., Duse, M., Licari, A., Manti, S., Martelli, A., Minasi, D., Miraglia Del Giudice, M., Pajno, G. B., Pietrasanta, C., Pugni, L., Tosca, M. A., Mosca, F., and Marseglia, G. L.

Subjects
Pediatrics, medicine.medical_specialty, Vaccination schedule, Hexavalent vaccines, Preterm infants, Vaccines, Review, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Humans, Medicine, Age Factor, Hexavalent vaccine, Vaccines, Combined, 030212 general & internal medicine, Neonatology, Adverse effect, Immunization Schedule, Age Factors, Infant, Infant, Newborn, Infant, Premature, Italy, Practice Guidelines as Topic, business.industry, Tetanus, Diphtheria, lcsh:RJ1-570, lcsh:Pediatrics, medicine.disease, Vaccination, Immunization, Preterm infant, Vaccine-preventable diseases, business, Vaccine, Human
Abstract

Hexavalent vaccines, protecting against six diseases (diphtheria, tetanus, pertussis [DTaP], poliovirus, hepatitis B virus [HBV], and Haemophilus influenzae type b [Hib], are routinely the standard of care in Europe. The use of combined vaccines allows the reduction of number of injections and side effects, the reduction of costs, and the increase in adherence of the family to the vaccination schedule both in terms of the number of doses and timing. The safety profile, efficacy and effectiveness of hexavalent vaccines have been extensively documented in infants and children born at term, and data are accumulating in preterm infants. Hexavalent vaccines are particularly important for preterm infants, who are at increased risk for severe forms of vaccine preventable diseases. However, immunization delay has been commonly reported in this age group. All the three hexavalent vaccines currently marketed in Italy can be used in preterm infants, and recent data confirm that hexavalent vaccines have a similar or lower incidence of adverse events in preterm compared to full-term infants; this is likely due to a weaker immune system response and reduced ability to induce an inflammatory response in preterm infants. Apnoea episodes are the adverse events that can occur in the most severe preterm infants and / or with history of respiratory distress. The risk of apnoea after vaccination seems to be related to a lower gestational age and a lower birth weight, supporting the hypothesis that it represents an unspecific response of the preterm infant to different procedures. High seroprotection rates have been reported in preterm infants vaccinated with hexavalent vaccine. However, a lower gestational age seems to be associated with lower antibody titres against some vaccine antigens (e.g. HBV, Hib, poliovirus serotype 1, and pertussis), regardless of the type of hexavalent vaccine used. Waiting for large effectiveness studies, hexavalent vaccines should be administered in preterm infants according to the same schedule recommended for infants born at term, considering their chronological age and providing an adequate monitoring for cardio-respiratory events in the 48–72 h after vaccination, especially for infants at risk of recurrence of apnoea.

Published
2019
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46. Exposure to Gastric Acid Inhibitors Increases the Risk of Infection in Preterm Very Low Birth Weight Infants but Concomitant Administration of Lactoferrin Counteracts This Effect

Author

Paolo Manzoni, Ruben García Sánchez, Michael Meyer, Ilaria Stolfi, Lorenza Pugni, Hubert Messner, Silvia Cattani, Pasqua Maria Betta, Luigi Memo, Lidia Decembrino, Lina Bollani, Matteo Rinaldi, Maria Fioretti, Michele Quercia, Milena Maule, Elena Tavella, Alessandro Mussa, Chryssoula Tzialla, Nicola Laforgia, Fabio Mosca, Rosario Magaldi, Michael Mostert, Daniele Farina, Amelia Di Comite, Alessandro Borghesi, Giovanni Agriesti, Riccardo Arisio, Caterina Franco, Roberta Guardione, Elena Boano, Alessia Catarinella, Cristina Romano, Cesare Monetti, Ugo Sala, Caterina Carbonara, Emmanuele Mastretta, Paola Del Sordo, Claudio Priolo, Paolo Galletto, Francesca Campagnoli, Mauro Vivalda, Giuseppina Bonfante, Giovanna Gomirato, Davide Montin, Roberta Camilla, Alessandro Messina, Marta Pieretto, Domenico Cipolla, Mario Giuffrè, Giovanni Corsello, Fabio Natale, Gennaro Vetrano, Elisabetta Tridapalli, Giacomo Faldella, Maria Grazia Capretti, PierMichele Paolillo, Simonetta Picone, Serafina Lacerenza, Giancarlo Gargano, Cristiana Magnani, Onofrio Sergio Saia, Elena Della Casa, Manzoni, Paolo, García Sánchez, Ruben, Meyer, Michael, Stolfi, Ilaria, Pugni, Lorenza, Messner, Hubert, Cattani, Silvia, Betta, Pasqua Maria, Memo, Luigi, Decembrino, Lidia, Bollani, Lina, Rinaldi, Matteo, Fioretti, Maria, Quercia, Michele, Maule, Milena, Tavella, Elena, Mussa, Alessandro, Tzialla, Chryssoula, Laforgia, Nicola, Mosca, Fabio, Magaldi, Rosario, Mostert, Michael, Farina, Daniele, Giuffrè, Mario, Corsello, Giovanni, Manzoni P, García Sánchez R, Meyer M, Stolfi I, Pugni L, Messner H, Cattani S, Betta PM, Memo L, Decembrino L, Bollani L, Rinaldi M, Fioretti M, Quercia M, Maule M, Tavella E, Mussa A, Tzialla C, Laforgia N, Mosca F, Magaldi R, Mostert M, Farina D, and Di Comite A, Borghesi A, Agriesti G, Arisio R, Franco C, Guardione R, Boano E, Catarinella A, Romano C, Monetti C, Sala U, Carbonara C, Mastretta E, Del Sordo P, Priolo C, Galletto P, Campagnoli F, Vivalda M, Bonfante G, Gomirato G, Montin D, Camilla R, Messina A, Pieretto M, Cipolla D, Giuffrè M, Corsello G, Natale F, Vetrano G, Tridapalli E, Faldella G, Capretti MG, Paolillo P, Picone S, Lacerenza S, Gargano G, Magnani C, Sergio Saia O, Della Casa E

Subjects
Colonization, Proton Pump Inhibitor, Neonatal intensive care unit, Administration, Oral, Histamine H2 Antagonist, Probiotic, Gastroenterology, Pediatrics, H2 blocker, 0302 clinical medicine, Risk Factors, Infant, Very Low Birth Weight, 030212 general & internal medicine, Candida, VLBW neonate, Lacticaseibacillus rhamnosus, Gestational age, Perinatology and Child Health, Histamine H2 Antagonists, Italy, Necrotizing enterocolitis, medicine.symptom, Infection, Infant, Premature, Human, medicine.medical_specialty, Birth weight, Gastric Acid, Sepsis, 03 medical and health sciences, Enterocolitis, Necrotizing, Intensive Care Units, Neonatal, 030225 pediatrics, Internal medicine, medicine, H2 blockers, Humans, Dietary Supplement, business.industry, Risk Factor, Probiotics, Infant, Newborn, Proton Pump Inhibitors, medicine.disease, Low birth weight, Lactoferrin, Concomitant, Dietary Supplements, Pediatrics, Perinatology and Child Health, VLBW neonates, Gastric acid, Lactobacillus rhamnosu, business, New Zealand
Abstract

Objective: To investigate whether exposure to inhibitors of gastric acidity, such as H2 blockers or proton pump inhibitors, can independently increase the risk of infections in very low birth weight (VLBW) preterm infants in the neonatal intensive care unit. Study design: This is a secondary analysis of prospectively collected data from a multicenter, randomized controlled trial of bovine lactoferrin (BLF) supplementation (with or without the probiotic Lactobacillus rhamnosus GG) vs placebo in prevention of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants. Inhibitors of gastric acidity were used at the recommended dosages/schedules based on the clinical judgment of attending physicians. The distribution of days of inhibitors of gastric acidity exposure between infants with and without LOS/NEC was assessed. The mutually adjusted effects of birth weight, gestational age, duration of inhibitors of gastric acidity treatment, and exposure to BLF were controlled through multivariable logistic regression. Interaction between inhibitors of gastric acidity and BLF was tested; the effects of any day of inhibitors of gastric acidity exposure were then computed for BLF-treated vs -untreated infants. Results: Two hundred thirty-five of 743 infants underwent treatment with inhibitors of gastric acidity, and 86 LOS episodes occurred. After multivariate analysis, exposure to inhibitors of gastric acidity remained significantly and independently associated with LOS (OR, 1.03; 95% CI, 1.008-1.067; P = .01); each day of inhibitors of gastric acidity exposure conferred an additional 3.7% odds of developing LOS. Risk was significant for Gram-negative (P < .001) and fungal (P = .001) pathogens, but not for Gram-positive pathogens (P = .97). On the test for interaction, 1 additional day of exposure to inhibitors of gastric acidity conferred an additional 7.7% risk for LOS (P = .003) in BLF-untreated infants, compared with 1.2% (P = .58) in BLF-treated infants. Conclusion: Exposure to inhibitors of gastric acidity is significantly associated with the occurrence of LOS in preterm VLBW infants. Concomitant administration of BLF counteracts this selective disadvantage. Trial registration: isrctn.org: ISRCTN53107700.

Published
2018

47. Prenatal antibiotics reduce breast milk IgA and induce dysbiosis in mouse offspring, increasing neonatal susceptibility to bacterial sepsis.

Author

Pietrasanta C, Carlosama C, Lizier M, Fornasa G, Jost TR, Carloni S, Giugliano S, Silvestri A, Brescia P, De Ponte Conti B, Braga D, Mihula M, Morosi L, Bernardinello A, Ronchi A, Martano G, Mosca F, Penna G, Grassi F, Pugni L, and Rescigno M

Subjects
Animals, Mice, Female, Pregnancy, Gastrointestinal Microbiome drug effects, Feces microbiology, Humans, Immunoglobulin A, Secretory, Milk, Human immunology, Mice, Inbred C57BL, Milk, Disease Susceptibility, T-Lymphocytes, Regulatory immunology, T-Lymphocytes, Regulatory drug effects, Apyrase metabolism, Intestinal Mucosa drug effects, Intestinal Mucosa immunology, Intestinal Mucosa microbiology, Animals, Newborn, Anti-Bacterial Agents pharmacology, Dysbiosis microbiology, Immunoglobulin A, Sepsis microbiology, Sepsis immunology
Abstract

Antibiotics (Abx) are administered to 20%-30% of pregnant women, but their effects on neonatal immune development are poorly understood. We show that newborn mice born to Abx-treated dams are more susceptible to late-onset sepsis. This susceptibility is linked to lower maternal breast milk immunoglobulin A (IgA), neonatal fecal IgA, and IgA coating of intestinal bacteria, thus causing the translocation of intestinal pathobionts. Weaned young adults born to Abx-treated mothers had reduced IgA+ plasma cells in the ileum and colon, fecal secretory IgA (SIgA), colonic CD4 + T regulatory lymphocytes and T helper 17-like lymphocytes, and a less diverse fecal microbiome. However, treatment with apyrase, which restores SIgA secretion, prompted IgA production in breast milk and protected pups from sepsis. Additionally, breast milk from untreated mothers rescued the phenotypes of pups born to Abx-treated mothers. Our data highlight the impact of prenatal Abx on breast milk IgA and their long-term influence on intestinal mucosal immune function mediated by breastfeeding., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2024
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48. LINE1 modulate human T cell function by regulating protein synthesis during the life span.

Author

Burattin FV, Vadalà R, Panepuccia M, Ranzani V, Crosti M, Colombo FA, Ruberti C, Erba E, Prati D, Nittoli T, Montini G, Ronchi A, Pugni L, Mosca F, Ricciardi S, Abrignani S, Pietrasanta C, Marasca F, and Bodega B

Subjects
Humans, Heterogeneous-Nuclear Ribonucleoproteins metabolism, Heterogeneous-Nuclear Ribonucleoproteins genetics, Signal Transduction, Adult, T-Lymphocytes metabolism, T-Lymphocytes immunology, Receptors, Antigen, T-Cell metabolism, Lymphocyte Activation, CD4-Positive T-Lymphocytes metabolism, CD4-Positive T-Lymphocytes immunology, Aging metabolism, Gene Expression Regulation, Child, Protein Biosynthesis, Mechanistic Target of Rapamycin Complex 1 metabolism, Long Interspersed Nucleotide Elements, Polypyrimidine Tract-Binding Protein metabolism, Polypyrimidine Tract-Binding Protein genetics
Abstract

The molecular mechanisms responsible for the heightened reactivity of quiescent T cells in human early life remain largely elusive. Our previous research identified that quiescent adult naïve CD4 + T cells express LINE1 (long interspersed nuclear elements 1) spliced in previously unknown isoforms, and their down-regulation marks the transition to activation. Here, we unveil that neonatal naïve T cell quiescence is characterized by enhanced energy production and protein synthesis. This phenotype is associated with the absence of LINE1 expression attributed to tonic T cell receptor/mTOR complex 1 (mTORC1) signaling and (polypyrimidine tract-binding protein 1 (PTBP1)-mediated LINE1 splicing suppression. The absence of LINE1 expression primes these cells for rapid execution of the activation program by directly regulating protein synthesis. LINE1 expression progressively increases in childhood and adults, peaking in elderly individuals, and, by decreasing protein synthesis, contributes to immune senescence in aging. Our study proposes LINE1 as a critical player of human T cell function across the human life span.

Published
2024
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50. Sudden infant death syndrome "Gray Zone" in newborn with pneumonia.

Author

Tomasello T, Paradiso B, Rizzuti T, Gobbo AD, Pugni L, and Ottaviani G

Subjects
Humans, Male, Infant, Newborn, Pneumonia pathology, Autopsy, Lung pathology, Fatal Outcome, Heart Conduction System physiopathology, Heart Conduction System pathology, Cause of Death, Sudden Infant Death pathology, Sudden Infant Death etiology, Sudden Infant Death diagnosis
Abstract

Sudden infant death syndrome (SIDS) "gray zone" or borderline cases are those in which it is challenging to define whether the pathological findings are sufficiently severe to lead to death. We report a case of a 17-day old male newborn who came to our attention for unexplained death. A complete autopsy was performed, including close examination of the cardiac conduction system. Lungs presented diffuse alveolar damage and interstitial inflammation, the cardiac conduction system showed fetal dispersion, resorptive degeneration, junctional tissue islands and cartilaginous hypermetaplasia of the central fibrous body. The final cause of death was a "gray zone" SIDS. This case report will highlight the intersection of SIDS and pneumonia in newborns, exploring the challenges and controversies surrounding the diagnosis and management of this complex condition., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2025
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