Rare viral infections in children receiving hemopoietic stem cell transplant.

Viral infections are a rare complication in autologous hemopoietic stem cell transplant (HSCT) recipients but represent a frequent cause of disease after allogeneic HSCT. In the last years, there has been an increase in the number of viral diseases observed in these patients. This fact may be at least partially due to an improvement in diagnostic facilities, but the increasing number of transplant procedures and the more severe immunosuppression may also have played an important role.

Acyclovir plus CMV immunoglobulin prophylaxis and early therapy with ganciclovir are effective and safe in CMV high-risk renal transplant pediatric recipients.

Cytomegalovirus (CMV) infection is still a major cause of morbidity in high-risk renal transplant recipients. In the present report, we have reviewed our records of renal transplant pediatric recipients (RTPR; mean age 14.1 +/- 4.9 years) since 1991, when we started a policy of CMV prophylaxis constituting high-dose oral acyclovir plus CMV hyperimmune immunoglobulins (HIg) followed by early i.v. ganciclovir therapy in high-risk patients (i.e., CMV donor+/recipient-). Four patients received a kidney from a living relative (LR), 2 patients had one previous transplant, and 1 had a combined liver-kidney transplant. Thirty-three patients who were negative for CMV antibodies (ab) before transplantation received a kidney from CMV ab positive donors. The immunosuppressive regimen included cyclosporine A and steroids, with the addition of azathioprine in the 4 patients who received an LR kidney. Serial assessments for CMV antigenemia (pp 65) were routinely performed for 6 months after transplantation to define CMV infection. Among the 33 CMV seronegative recipients (R-) who received the graft from a CMV seropositive donor (D+), 18 (54.5%) experienced CMV infection, whereas among the 28 CMV R+, who received a graft from a CMV D+, 11 (39.3%) experienced CMV infection. With regard to CMV- related symptoms, only 2 patients suffered from a CMV syndrome (fever and leukopenia in 1 patient, fever and arthralgia in the other). In no case did the spectrum of CMV disease occur; only minor symptoms were present in 7 of the remaining CMV-infected patients (fever in 6 and leukopenia in 1). Rejection episodes and renal function did not differ between CMV-infected and non-CMV-infected patients. Our experiences support the use of prophylactic acyclovir plus CMV HIg followed by early therapy with i.v. ganciclovir to combat the risk of increased morbidity in high risk RTPR.

[Evaluation of the fungicidal-fungistatic activity of various preparations for the cure and prevention of seborrheic dermatitis]. / Valutazione dell'attività fungistatica-fungicida di alcuni preparati per la cura e la prevenzione della dermatite seborroica.

Fungistatic and fungicide activity of 4 preparations available on the market for the prevention and treatment of infection due to P. ovale has been defined. P. ovale is a microorganism which complicates phlogosis of seborrhoeic dermatitis. The advantages of the presence of a limited antifungal activity are considered.

In-vitro activity of quinolones against different species of staphylococci of recent clinical isolation.

We considered 256 strains of S. aureus (SA) and S. non-aureus (SnA) of recent clinical isolation. Their susceptibility (S) or resistance (R) to pefloxacin, ciprofloxacin, enoxacin, ofloxacin (which have been used in therapy for several years) and to timentin as well, has been tested, in relation with methicillin susceptibility (MS) and methicillin resistance (MR). To date, the activity of quinolones against all staphylococci remains relatively high, notwithstanding the appearance of resistant strains, in particular among MR SnA. Of the four quinolones examined, ofloxacin showed to be the most active, i.e. effective against 100% of the staphylococci, either SA or SnA.

[Agglutinating antibodies against Listeria monocytogenes in healthy adult subjects]. / Anticorpi agglutinanti Listeria monocytogenes in soggetti adulti sani.

The prevalence of antibodies to L. monocytogenes, type 1 and type 4b, in 334 healthy adults of Liguria land was determined by serological agglutination test. Agglutinins at low titer to L. monocytogenes are present in 22.45% of cases; in 88% of these the titer is 1:40. On the whole, the incidence of antibodies to L. monocytogenes type 1 increases with age and is higher (53.33%) than to 4b (22.66%). The incidence of agglutinins to O-antigens of L. monocytogenes is higher than to H-antigens.

[Listeria monocytogenes agglutinating antibodies in children]. / Anticorpi agglutinanti Listeria monocytogenes in soggetti di eta' pediatrica.

The AA. relate the results of a serological study on the spreading of listeria infection over the pediatric population of Liguria. The research of agglutinating antibodies for types 1 and 4b of L. monocytogenes in 367 sera gave the following results: -- 195 sera (53,13%) resulted positive, although at low titer (1/40) as a general rule; -- on the whole, agglutinins toward type 1 had considerably higher incidence than toward type 4b ones (57,43% and 5,12% respectively); -- O - antibodies had higher incidence (44,95%) than H - antibodies (22,34%).

[Status of tetanus immunity in a group of children in Liguria]. / Stato dell'immunita' antitetanica in un gruppo di bambini della Liguria.

By means of the passive hemagglutination test the antitetanus immunity in a group of 380 children, aged between 0 and 14 years, of various Italian regions, was ascertained. On the whole, 62.9% of the subjects showed a titer equal to, or higher than 1024, equivalent to 0.1 I.U./ml of antitoxin. In subjects younger than 2 years, this ratio is only 42.2%, thus showing a scanty protection in this age period. As far as the origin of the subjects is concerned, it turns out that, for the group of the Center-South the percentage of the children immunized in the younger ages is higher, unlike what occurs subsequently beyond 10 years when the highest ratio of unprotected subjects can be detected. The opportunity to immunize the mothers and to anticipate the age of the primovaccination for tetanus is set forth.

[Serological studies of the diffusion of toxoplasmosis in a sample of the population of northern Italy]. / Indagine sierologica sulla diffusione della toxoplasmosi in un campione di popolazione del nord Italia.

The prevalence of toxoplasmosis as results by serologic tests (agglutination test = Fulton test and indirect emoagglutination test) of 904 subjects of North Italy was determined. Serologic signs of toxoplasmosis were present by only one or by both two tests in 66.4% and respectively in 64.1% of these subjects. The prevalence increased highly from the first 5 years of life, reach c.a. 40% at 20th year and 60% in the group of subjects of 20-24 years. The results of Fulton test and indirect hemoagglutination test correlate very well. 96.6% of the levels of Fulton test were from 1:16 to 1:128 and 76.9% of those of passive hemoagglutination test were from 1:64 to 1:512.

[Staphylococci in children's pathology (author's transl)]. / Stafilococchi implicati in patologia infantile.

In this paper we report and make short comments on data concerning 237 strains of Staphylococci isolated from 8820 samples of various pathologic material we tested when normal working in the Laboratory of our pediatric Institute. We noticed that 34.1% of cases were St. epidermidis or St. saprophyticus and we think that the frequency of such a results is related to the special conditions of subjects, all children or newborn children, so that also so called saprophytic Staphylococci may have etiological meaning.

[Results and consideration on blood cultures activity in a great children Hospital (author's transl)]. / Risultati e considerazioni sulla attivita' emocolturale in un istituto pediatrico.

This paper reports the results of blood cultures of a great children Hospital during the last three years. It regards 2164 blood cultures, 140 of which positive, and analyses the reasons that probably determinate the detected deficencies and defects.