Identification of a novel HLA-B*15 variant allele, HLA-B*15:276, in an umbilical cord blood donor.

A newly identified allele, named HLA B*15:276, differs from B*15:01:01:01 by the single nucleotide substitution 511T-C at codon 147 (Trp → Arg) in exon 3.

A novel HLA-DRB1 allele, DRB1*01:54, identified by sequence-based typing.

The new HLA DRB1*01:54 differs from DRB1*01:02:01 by one nucleotide at exon 2.

Identification of a novel HLA-DRB1*13 variant allele: DRB1*13:154.

A newly identified allele, named HLA-DRB1*13:154, differs from DRB1*13:13 by the single nucleotide substitution 227T-A at codon 47 in exon 2.

Identification of a novel HLA-DRB1 allele through sequence-based typing of an Italian patient candidate for kidney transplant.

In this report, we describe the identification of the novel HLA-DRB1*13:120 that differs from the closest matching allele HLA-DRB1*13:65 at two nucleotidic position in the exon 2.

A novel HLA-B*51:01:29 allele identified by sequence-based typing.

A novel HLA-B*51:01:29 allele differs from B*51:01:01 at one nucleotidic position in the exon 3.

Identification of a novel HLA-DRB1*11 variant allele, DRB1*1189.

Here, we describe the identification of a novel human leukocyte antigen (HLA)-DRB1 allele, DRB1*1189, that was found in an Italian Caucasian individual. This sequence differs from HLA-DRB1*1134 by three nucleotide exchange at positions 286 (C-->T), 296 (A-->G), and 308 (C-->A) in exon 2.

[Legionellosis in Apulia (Italy): an underevaluated disease]. / Legionellosi in Puglia: una malattia ancora sottovalutata.

The frequent occurrence of Legionnaires' disease outbreaks in many countries, including Italy, highlights the importance of epidemiological investigations on this disease. For this purpose, an active surveillance programme of pneumonia patients was carried out in a large hospital in Apulia (Italy) from March 2001 to December 2003. A total of 612 patients were tested for Legionella pneumophila infection by urinary antigen detection and evaluation of antibodies titre. Culture of respiratory specimens was performed on 117 patients. Thirty-seven patients (6%) tested positive for legionellosis: 10 resulted nosocomial cases and 27 as community-acquired. Only 9 cases di Legionella pneumophila infection were reported from Apulia to the routine surveillance system between 1996 and 2000. The results of our study denote the level of underestimation of this disease in Apulia.

Outbreak of fungemia due to Candida parapsilosis in a pediatric oncology unit.

We report an outbreak of infection due to genotypically identical Candida parapsilosis isolates among patients hospitalized in a pediatric oncology unit. Control cultures showed genetic relatedness between strains isolated from the patients and those isolated from the hands of a health care worker. Our data underline the importance of an effective surveillance program for preventing nosocomial fungal infections.

Direct detection of Clostridium perfringens enterotoxin in patients' stools during an outbreak of food poisoning.

An outbreak of diarrhoea in a hotel affected 25 time keepers attending the 1997 Mediterranean Games. Epidemiological investigation implicated a 'pasta al ragù' consumed at the hotel's restaurant and Clostridium perfringens food poisoning was identified by direct detection of C. perfringens enterotoxin in patients' stools. This report confirms that a careful evaluation of epidemiological features, together with the availability of direct and rapid laboratory methods, may lead to a prompt identification of C. perfringens food poisoning.

Behaviour of Listeria monocytogenes during the maturation of naturally and artificially contaminated salami: effect of lactic-acid bacteria starter cultures.

The antimicrobial activity of a bacteriocin-producing Lactobacillus plantarum MCS strain against Listeria monocytogenes in naturally and artificially contaminated salami was evaluated in comparison with that of other non bacteriocin-producing lactic-acid bacteria (i.e., L. plantarum MCS1 mutant strain and two commercial starter cultures). In salami not inoculated with lactic-acid bacteria, moderate L. monocytogenes growth was observed after 7-14 days. The addition of the starter cultures prevented growth, but not always the survival of Listeria. During the maturation of artificially-contaminated salami, Listeria counts tended to decrease, but no significant differences were observed between samples inoculated with L. plantarum MCS or with the MCS1 bacteriocin-negative mutant strain. However, at the end of the maturation period, in naturally-contaminated salami, differences in the survival of Listeria (recovered by enrichment) were observed in the batches inoculated with the different lactic-acid bacteria: Listeria appeared to be absent only in salami inoculated with the L. plantarum MCS strain.

Evaluation of the thermal resistance of different Salmonella serotypes in pork meat containing curing additives.

The preliminary heat resistance evaluation of 94 Salmonella strains was carried out in culture medium (Trypticase soy broth, TSB). The heat resistance of three S. typhimurium strains (ATCC 14028, 133 and 1116), a strain each of S. derby B4373, S. potsdam 1133, S. menston 179. S. eppendorf 166, and S. kingston I124 was determined also in pork meat containing curing additives. As expected, the eight Salmonella strains showed greater heat resistance in pork meat than in TSB. At the lowest temperature (58 degrees C), the heat resistance increased 1.5-4 times, and it was most pronounced for the strains being most heat sensitive in TSB. S. potsdam 133 was the most resistant strain in pork meat, with D-values at 58 degrees C, 60 degrees C and 63 degrees C of 4.80, 1.57 and 0.30 min, respectively. The most sensitive strain turned out to be S. kingston 1124, with D-values of 2.79. 0.92 and 0.24 min, at the same temperatures. According to collected data, the heating processes, as applied to cured pork meat, providing an internal temperature of 60 degrees C for 9-10 min or of 63 degrees C for 3-4 min can be expected to provide a > or = 7 D kill of Salmonella belonging to the serotypes studied.

Detection of hepatitis A virus in mussels from different sources marketed in Puglia region (South Italy).

Hepatitis A virus (HAV) infection is endemic in Puglia (South Italy). Epidemiological studies indicate that shellfish consumption, particularly mussels, is a major risk factor for HAV infection, since these products are eaten raw or slightly cooked. Nested reverse transcriptase-polymerase chain reaction (RT-PCR) has been shown to be a sensitive technique for the detection of HAV in mussels. The aim of the present study was to detect the presence of HAV in a large sample of mussels by nested RT-PCR and to confirm the presence of infectious viral particles in positive samples by cell culture infection and RT-PCR confirmation. Two hundred and ninety samples of mussels from different sources were collected between December 1999 and January 2000. One hundred samples were collected before being subjected to depuration, 90 after depuration, and 100 were sampled in different seafood markets. HAV-RNA was detected in 20 (20.0%) of non-depurated mussels, in 10 (11.1%) of depurated samples, and in 23 (23.0%) of samples collected in the shellfish markets, without any significant difference in the prevalence of positive samples by collection sources (chi2 = 4.79, p = 0.09). Of the 53 samples found positive by nested RT-PCR, 18 (34.0%) resulted positive by cell culture assay. No relationship between viral contamination and bacterial contamination was found (p = 0.41). This study confirms the usefulness of molecular techniques in detecting HAV in shellfish and, thus, for the screening of a large sample of naturally contaminated mussels. Improved shellfish depuration methods are needed to obtain virus-safe shellfish and reduce the risk for public human health.

Efficacy and safety of cefotetan in the treatment of complicated urinary tract infections: clinical experience in a selective and single study.

A single, selective study was performed in order to evaluate the efficacy and safety of cefotetan in the treatment of complicated urinary tract infections (UTI). Of 34 pre-treatment isolated strains, 60% were pluri-resistant to other antibiotics (ampicillin, carbenicillin, piperacillin, cefalotin, aztreonam) but only 21.2% to cefotetan. Pseudomonas aeruginosa and enterococci were resistant to cefotetan. Escherichia coli was the common strain isolated (50%). Nineteen adult patients, with complicated UTI caused by sensitive organisms, were treated with a 1 g intramuscular (i.m.) daily dose. Duration of treatment ranged from 5-15 days, with a mean of 13.75 days. Within 24-48 h and 30 days post-therapy, the infection was cured in 84% and 52% of patients, respectively. Reinfection, relapse or super-infection occurred in 42% of the cases. In only one patient, the infecting organism did not respond to treatment. The clinical response was evaluated in only seven patients with symptomatic UTI. Six of them (85.7%) were cured after therapy and the cure persisted at follow-up. In most cases, the adverse reactions were local, mild and negligible. In only 15.8% and 10.5% of patients, side-effects (diarrhoea, headache, abdominal pain, tachycardia, chill, pain and erythema in the injection site) were severe and moderate. In these cases, the adverse reactions were reversible when the therapy was discontinued. The relationship between treatment and side-effects was doubtful in two cases. It is concluded that cefotetan, administered at 1 g i.m. daily dose, is effective in treating complicated UTI caused by sensitive organisms, pluri-resistant to other antibiotics.

An outbreak of hepatitis A in Puglia, Italy, 1996.

In the region of Puglia, in the south east of Italy (population: 4 million), the number of notifications of hepatitis A virus (HAV) infection increases in a two yearly cycle. In 1992 a very large outbreak was observed, but no epidemiological investigation

A persisting outbreak of hepatitis A in Puglia, Italy, 1996: epidemiological follow-up.

In early 1996, an increase in the notifications of hepatitis A cases was identified in the region of Puglia, in the south east of Italy. An outbreak investigation conducted in May 1996 showed a strong association between illness and consumption of raw sea

A simple method to detect HIV-1 protein specificity of IgG intrathecal synthesis in HIV-1 infection.

There is currently no simple method to detect the antigen specificity of anti-HIV-1 IgG intrathecal synthesis (IS). Fifty-seven pairs of serum and corresponding CSF from 29 HIV-1 seropositive patients were adjusted to an identical concentration of total IgG and tested by a commercial HIV-1 Western Blot (WB) assay. IgG IS to a given HIV-1 protein was demonstrated when the corresponding band was present in CSF but absent or significantly less represented in serum. A total anti-HIV-1 IS was defined as the presence of an IS to one or more HIV-1 antigens. Our WB analysis of CSF and serum, compared with conventional mathematical formulas, showed a higher sensitivity in demonstrating anti-HIV-1 IgG IS. Moreover, the method disclosed which HIV-1 proteins represent the target of IgG IS. This procedure is easy to perform and therefore may represent a valuable tool to study central nervous system (CNS) involvement by HIV-1 during different stages of infection.

Assessment of disinfectant topical agents in keratinocyte cell culture grafting technique in severely burned patients.

On the basis of previous experiences and of international literature data the authors emphasize the importance of making a "targeted" choice of the topical disinfectant in the therapy of burn wound infections. The objective of the investigation is to reach the highest rate of take of the autologous keratinocyte cultures in burn wounds.

[Epidemiologic study and cost analysis of an Slamonella enteritidis epidemic]. / Indagine epidemiologica ed analisi dei costi di un'epidemia da Salmonella enteritidis.

Salmonellosis is one of the most common forms of foodborne infection. An outbreak of gastroenteritidis associated with a wedding party was investigated, even to value the costs falling on individuals, the health services and society as a whole. One hundred and fifty nine wedding guests were interviewed by phone. Multivariate analysis was used to assess which food were significantly associated with infection. One hundred and thirteen cases were identified; ten stool samples were culture positive for Salmonella enteritidis. Handmade ice-cream and babà (a typical Italian pastry) were significantly associated with infection. The cost of a case was estimated to be between US $ 74 (for non hospitalised patients) and US $ 1,896 (for hospitalised patients). The outbreak was caused by a strain of Salmonella enteritidis and the vehicle of infection were unpasteurised eggs used to prepare the ice-cream. The economic impact of this outbreak was considerable and mainly due to the hospitalisation.

[Carriers of Neisseria meningitidis among teen-agers in Apulia (Italy)]. / Indagine sui portatori sani di Neisseria meningitidis tra gli adolescenti di alcune aree pugliesi.

An investigation about N. meningitidis carriers was carried out in Apulia (Italy) among teen-agers. 85 healthy carriers were identified (1.4%): the 81.2% of isolates resulted polyagglutinable, 3.5% autoagglutinable and 1.2% were not classifiable with antisera. The other strains belonged to serogroup B (9.4%), W135 (2.3%), Y (1.2%) and 29E (1.2%). Some Authors report that non-groupable strains are usually isolated from healthy carriers pharynx. The most recent molecular methods permit to subdivide these bacteria in serotype and serosubtype by membrane protein antigens, too. So, today the only identification as serogroup is not able to study N. meningitidis epidemiology.

Environmental surveillance of poliovirus in Italy: pilot study.

A pilot study on environmental surveillance of poliovirus included one hundred ninety-six samples (drinking water, surface water, seawater and sewage), collected between 1996 and 1998 in different regions of Italy. Samples were screened for the presence of poliovirus and other enteric viruses. Twelve polioviruses, 35 non polio enteroviruses (NPE) and 51 enteric non entero (NE) viruses were isolated. All poliovirus isolates, namely four type 1, four type 2 and four type 3, were characterised as Sabin-like strains. Thirty-one Coxsackie B and 4 Echo viruses were also detected. The presence of Sabin-like polioviruses in the environment is not unexpected since immunization with only oral poliovirus vaccine was performed in Italy until May 1999, when a sequential schedule consisting of two doses of inactivated polio vaccine (IPV) and two of oral polio vaccine (OPV) was adopted; in July 2002 a schedule consisting of four doses of IPV was adopted. Although this is only a pilot study and the number of samples analysed is limited, so far data from this study so far supports once again evidence of lack of circulating wild poliovirus and is in line with results from AFP surveillance in Italy and stool survey on healthy children.