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Ocul Immunol Inflamm ; 28(8): 1290-1292, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-32976055


PURPOSE: To report a case of impending central retinal vein occlusion (iCRVO) in a COVID-19 patient. CASE REPORT: A 54 years old woman with COVID-19 related pneumonia presented to our emergency department complaining of scotomas and decreased vision in her right eye. Funduscopic examination and multimodal imaging revealed rare retinal hemorrhages, retinal whitening, and fern-like hypo-autofluorescent appearance typical of iCRVO. She had no risk factors other than a transient hyper-coagulability status likely related to the ongoing infection. Systemic treatment with steroids normalized her inflammatory and coagulation status and the occlusion completely resolved. CONCLUSIONS: Retinal circulation should be considered as a potential site for thromboembolic complications from COVID-19.

Betacoronavirus , Infecções por Coronavirus/complicações , Angiofluoresceinografia/métodos , Pneumonia Viral/complicações , Retina/patologia , Oclusão da Veia Retiniana/etiologia , Tomografia de Coerência Óptica/métodos , Infecções por Coronavirus/epidemiologia , Feminino , Fundo de Olho , Humanos , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Oclusão da Veia Retiniana/diagnóstico
New Microbiol ; 41(3): 230-231, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30028475


We describe two multi drug-resistant (MDR) carbapenemase-producing Escherichia coli clinical isolates from an acute hospital in Milan. Both strains, isolated from a surgical wound sample and a surveillance rectal swab respectively, were positive for a blaNDM-type gene by Xpert Carba-R test. The whole-genome sequence characterization disclosed several resistance determinants: blaNDM-5, blaCMY-42, blaTEM-198, rmtB, mphA. The two isolates belonged to phylogenetic group A, sequence type (ST) 1702 and serotype O89:H9. PCR-based replicon typing and conjugation assay demonstrated an IncI1 plasmid localization for both blaNDM-5 and blaCMY-42 genes. This is the first report of a ST1702 NDM-5 and CMY-42- producing E. coli clone in Italy.

Escherichia coli/genética , Escherichia coli/isolamento & purificação , Idoso , Antibacterianos/farmacologia , Proteínas de Bactérias , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Regulação Bacteriana da Expressão Gênica , Regulação Enzimológica da Expressão Gênica , Hospitais , Humanos , Itália/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Filogenia , Reto/microbiologia , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/microbiologia , beta-Lactamases
Surg Infect (Larchmt) ; 17(5): 577-82, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27348793


BACKGROUND: In 2015 a new device for the collection of mediastinal fluid from patients with deep sternal wound infection (DSWI) in the presence of negative-pressure wound therapy (NPWT) became available. The present study was designed to evaluate whether changing sample collection devices increased micro-organism detection in patients undergoing NPWT. METHODS: During 2013-2014, 207 samples were collected and cultured from NPWT patients (n = 23) to demonstrate the presence of DSWI using reticulated polyurethane sponge culture, a swab, and blood culture. In 2015, a new collection device was introduced for specimen collection. A total of 357 samples (n = 17) were collected using the ESwab(™) (Copan, Murrieta, CA) for deep and superficial wound sample collection. In addition, blood culture devices were used for collecting mediastinal fluid aspirated directly from the wound and biologic fluid obtained from the NPWT device. Fisher exact test was performed to test the rate of independence rate of micro-organism identification using the NPWT sponge device and taking blood culture results as a reference for micro-organism identification. RESULTS: After the introduction of the new collection device in our hospital, an overall increase in the detection of micro-organisms (46.7%) was reported. During 2013-2014 our traditional microbiologic collection method did not detect a pathogen in 30.4% of patients. During 2015, the new sample collection approach, direct from the NPWT device, improved micro-organism detection by 10.4% and reduced DSWIs with undetected pathogens to 17.6% (p < 0.01). CONCLUSIONS: As a result of proficiency gained in the last year, the most representative specimen in wound infection was represented by mediastinal fluid collected directly from the wound and the NPWT device. Given the correlation between the blood culture of micro-organisms detected using the ESwab device from the wound, mediastinal drainage, and drainage from the NPWT device, we can assume that the NPWT device may replace the other biologic sampling devices.

Tratamento de Ferimentos com Pressão Negativa/instrumentação , Tratamento de Ferimentos com Pressão Negativa/métodos , Manejo de Espécimes/métodos , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Mediastino/cirurgia , Pessoa de Meia-Idade , Tratamento de Ferimentos com Pressão Negativa/estatística & dados numéricos , Esterno/cirurgia , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/microbiologia
J Infect Public Health ; 9(1): 24-33, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26116453


Carbapenem-resistant Klebsiella pneumoniae (CRKP) is emerging as a public health problem worldwide. In Italy, a remarkable increase in CRKP cases has been reported since 2010. In this study, CRKP diffusion, distribution and in-hospital transmission trends were evaluated in a university hospital in Milan, Italy, from January 2012 to December 2013. Isolates from 63 newly detected CRKP-positive patients were genotyped, and possible transmission was determined by combining the molecular results with data concerning the patients' admission and in-hospital transfers. Most of the cases (90.4%) were from general medical and surgery wards, and the remaining 9.6% were from the intensive care unit. Fifteen of the 46 hospital-associated cases (32.6%) were attributable to in-hospital transmission. After the introduction of targeted and hospital-wide control measures, the transmission index significantly decreased from 0.65 to 0.13 (p=0.01). There was also a decrease in the overall nosocomial case incidence, from 0.37 to 0.17 per 1000 person-days (p=0.07). Our findings indicate that the spread of CRKP in Northern Italy hospitals may go far beyond high-risk settings (i.e., intensive care units) and that strict surveillance should be extended to general areas of care.

Antibacterianos/farmacologia , Carbapenêmicos/farmacologia , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecção Hospitalar/transmissão , Feminino , Genótipo , Hospitais Universitários , Humanos , Itália/epidemiologia , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/transmissão , Klebsiella pneumoniae/genética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem