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  • 1
    Electronic Resource
    Electronic Resource
    Meningococcal meningitis in Italy: 1887–1986 (1991)
    Springer
    European journal of epidemiology 7 (1991), S. 431-433 
    Details
    ISSN: 1573-7284
    Keywords: Meningococcal meningitis ; Morbidity ; Mortality ; Case fatality rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In Italy three epidemic peaks of meningococcal meningitis have occurred reflecting pandemic recrudescence of the disease. The seasonal distribution of the disease is similar in the epidemic or non-epidemic periods. There is no significant difference in the regional distribution of the disease. The disease is more prevalent among young males. The prevalent serogroup of Neisseria meningitidis is C. There has been a decrease in resistance to suphonamides and an increase to rifampin among the isolated strains.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00145010
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    An emerging opportunistic infection in HIV patients: A retrospective analysis of 11 cases of pulmonary aspergillosis (1993)
    Springer
    European journal of epidemiology 9 (1993), S. 638-644 
    Details
    ISSN: 1573-7284
    Keywords: Aspergillosis ; HIV ; Pneumonia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Invasive pulmonary aspergillosis usually occurs in patients with severe granulocytopenia or defects of cell-mediated immunity secondary to cytotoxic chemotherapy or high-dose corticosteroids, but it is an unusual opportunistic infection in patients with AIDS. Eleven cases of Aspergillus pulmonary disease were diagnosed in HIV-infected patients from January 1985 to December 1992, in the Department of Infectious Diseases of the Catholic University. Four patients had invasive pulmonary aspergillosis, six probable pulmonary invasive aspergillosis and one allergic broncopulmonary aspergillosis. Fiberoptic broncoscopy with bronco-alveolar lavage was confirmed to be an useful tool for the diagnosis of pulmonary aspergillosis in AIDS patients. The response of aspergillosis to therapy, either amphotericin B or itraconazole, has usually been poor. It is possible to speculate that the longer survival of AIDS patients and the latter development of other functional immunological abnormalities related to HIV infection may allow the appearance of opportunistic infection, such as pulmonary aspergillosis, different from those more often observed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00211439
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Condyloma acuminatum: Epidemiological, clinical and therapeutic aspects (1987)
    Springer
    European journal of epidemiology 3 (1987), S. 209-215 
    Details
    ISSN: 1573-7284
    Keywords: Condyloma acuminatum ; Epidemiology Clinical ; Therapeutic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Condyloma acuminatum, CA or genital warts, are benign fibro-epithelial tumors with a predilection for moist environments, especially mucosal surfaces. This sexually transmitted disease (STD) is increasing rapidly in incidence. The lesions are associated with a number of human papillomavirus (HPV) types. Some HPV types are closely linked with genital (especially cervical) dysplasia and neoplasia. Treatment consists of such traditional modalities as podophyllin, cryotherapy or surgical excision and, more recently, administration of interferon (IFN).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00149726
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  • 4
    Electronic Resource
    Electronic Resource
    Ten years of brucellosis in Italy (1977–1986) (1988)
    Springer
    European journal of epidemiology 4 (1988), S. 503-505 
    Details
    ISSN: 1573-7284
    Keywords: Brucellosis ; Brucella melitensis ; Epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the decade 1977–1986 the total number of cases of brucellosis recorded in Italy was 25,165. The reported cases probably reflect only a minority of the total number of the effective cases due to lack of reporting. The epidemiological and clinical features of 62 cases of brucellosis, observed by the authors are reported as a sample of the total number of cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00146407
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  • 5
    Electronic Resource
    Electronic Resource
    Central venous catheter-related sepsis in a cohort of 366 hospitalised patients (1997)
    Springer
    European journal of clinical microbiology & infectious diseases 16 (1997), S. 203-209 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Five hundred two central venous catheters inserted in 366 patients were evaluated prospectively over a one-year period to determine the frequency and risk factors associated with catheter-related sepsis. For study purposes, in cases in which catheter infection was suspected but the initial blood cultures were negative, the catheters were replaced by guidewire technique; otherwise, the catheters were routinely changed after 21 days by guidewire technique. A catheter-related infection was suspected in 190 cases (190/502, 38%). A diagnosis of catheter-related sepsis was established in 50 patients, which represents 10% of the total number of lines (502). Over a total of 6428 days of catheter use, the infection rate was 0.8 cases of sepsis per 100 catheter-days.Staphylococcus epidermidis, Staphylococcus aureus, andCandida spp. were the most frequently isolated aetiological agents of sepsis. On univariate analysis, six variables affecting the rate of catheter-related sepsis were identified: neutropenia for more than eight days (p〈0.001); AIDS (p〈0.001); haematological malignancy (p〈0.001); administration of total parenteral nutrition (p=0.001); duration of site use (p=0.04); and high APACHE II score (p=0.04). The logistic regression analysis revealed that AIDS and haematological malignancies were independent risk factors of catheter-related sepsis. Catheter replacement over a guidewire was no more likely to be associated with sepsis than was percutaneous catheter insertion. In conclusion, although the incidence of established catheter infection is much lower than the incidence of suspected infection, in most cases of suspected infection it is wise to change the catheter with the guidewire technique and wait for culture of the tip, rather than to remove the catheter immediately. Such a policy may help reduce the number of unnecessary catheter removals.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709582
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  • 6
    Electronic Resource
    Electronic Resource
    Candidemia in HIV-Infected Subjects (1999)
    Springer
    European journal of clinical microbiology & infectious diseases 18 (1999), S. 478-483 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The epidemiological features of 37 episodes of candidemia in HIV-infected subjects were analysed in a retrospective matched case-control study conducted over an 8-year period (1990–1997). Univariate analysis identified eight risk factors that were significantly associated with candidemia (P〈0.05): i) use of central venous catheters; ii) administration of total parenteral nutrition; iii) previous antifungal therapy; iv) previous therapy with glycopeptides; v) presence of oral/esophageal candidiasis; vi) concomitant bacterial infections; vii) neutropenia; and viii) concomitant AIDS dementia complex. Stepwise logistic regression analysis revealed that the only independent risk factor for developing candidemia was the use of central venous catheters (P=0.0001). Candida albicans was the most frequently isolated pathogen, accounting for 18 (48%) episodes of candidemia, followed by Candida tropicalis (19%) and Candida glabrata (11%). The crude mortality rate was 62%. On univariate analysis concomitant opportunistic infections, presence of non-Candida albicans species of Candida and neutropenia were shown to be predictive of death. Multivariate analysis revealed that the presence of non-Candida albicans strains of Candida was the only significant factor associated with a worse prognosis (P=0.001). In conclusion, candidemia appears to be more common in patients with advanced HIV disease. Of the factors which influenced the onset of candidemia, use of central venous catheters seemed to be the most important one.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100960050327
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  • 7
    Electronic Resource
    Electronic Resource
    Possible predictive parameters for the outcome of bacterial meningitis (1994)
    Springer
    Neurological sciences 15 (1994), S. 438-439 
    Details
    ISSN: 1590-3478
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02339909
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  • 8
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    Multidrug-Resistant Proteus mirabilis Bloodstream Infections: Risk Factors and Outcomes [Clinical Therapeutics] (2012)
    The American Society for Microbiology (ASM)
    Details
    Publication Date: 2012-05-30
    Description: Our aims were to identify (i) risk factors associated with the acquisition of multidrug-resistant (MDR, to 3 or more classes of antimicrobials) Proteus mirabilis isolates responsible for bloodstream infections (BSIs) and (ii) the impact on mortality of such infections. Risk factors for acquiring MDR P. mirabilis BSIs were investigated in a case-case-control study; those associated with mortality were assessed by comparing survivors and nonsurvivors in a cohort study. The population consisted of 99 adult inpatients with P. mirabilis BSIs identified by our laboratory over an 11-year period (1999 to 2009), 36 (33.3%) of which were caused by MDR strains, and the overall 21-day mortality rate was 30.3%. Acquisition of an MDR strain was independently associated with admission from a long-term care facility (odds ratio [OR], 9.78; 95% confidence interval [CI], 1.94 to 49.16), previous therapy with fluoroquinolones (OR, 5.52; 95% CI, 1.30 to 23.43) or oxyimino-cephalosporins (OR, 4.72; 95% CI, 1.31 to 16.99), urinary catheterization (OR, 3.89; 95% CI, 1.50 to 10.09), and previous hospitalization (OR, 2.68; 95% CI, 10.4 to 6.89). Patients with MDR P. mirabilis BSIs received inadequate initial antimicrobial therapy (IIAT, i.e., treatment with drugs to which the isolate displayed in vitro resistance) more frequently than those with non-MDR infections; they also had increased mortality and (for survivors) longer post-BSI-onset hospital stays. In multivariate regression analysis, 21-day mortality was associated with septic shock at BSI onset (OR, 12.97; 95% CI, 32.2 to 52.23), P. mirabilis isolates that were MDR (OR, 6.62; 95% CI, 16.4 to 26.68), and IIAT (OR, 9.85; 95% CI, 26.7 to 36.25), the only modifiable risk factor of the 3. These findings can potentially improve clinicians' ability to identify P. mirabilis BSIs likely to be MDR, thereby reducing the risk of IIAT—a major risk factor for mortality in these cases—and facilitating the prompt implementation of appropriate infection control measures.
    Print ISSN: 0066-4804
    Electronic ISSN: 1098-6596
    Topics: Biology , Medicine
    Published by The American Society for Microbiology (ASM)
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  • 9
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    Predictive Models for Identification of Hospitalized Patients Harboring KPC-Producing Klebsiella pneumoniae [Epidemiology and Surveillance] (2014)
    The American Society for Microbiology (ASM)
    Details
    Publication Date: 2014-05-15
    Description: The production of Klebsiella pneumoniae carbapenemases (KPCs) by Enterobacteriaceae has become a significant problem in recent years. To identify factors that could predict isolation of KPC-producing K. pneumoniae (KPCKP) in clinical samples from hospitalized patients, we conducted a retrospective, matched (1:2) case-control study in five large Italian hospitals. The case cohort consisted of adult inpatients whose hospital stay included at least one documented isolation of a KPCKP strain from a clinical specimen. For each case enrolled, we randomly selected two matched controls with no KPCKP-positive cultures of any type during their hospitalization. Matching involved hospital, ward, and month/year of admission, as well as time at risk for KPCKP isolation. A subgroup analysis was also carried out to identify risk factors specifically associated with true KPCKP infection. During the study period, KPCKP was isolated from clinical samples of 657 patients; 426 of these cases appeared to be true infections. Independent predictors of KPCKP isolation were recent admission to an intensive care unit (ICU), indwelling urinary catheter, central venous catheter (CVC), and/or surgical drain, ≥2 recent hospitalizations, hematological cancer, and recent fluoroquinolone and/or carbapenem therapy. A Charlson index of ≥3, indwelling CVC, recent surgery, neutropenia, ≥2 recent hospitalizations, and recent fluoroquinolone and/or carbapenem therapy were independent risk factors for KPCKP infection. Models developed to predict KPCKP isolation and KPCKP infection displayed good predictive power, with the areas under the receiver-operating characteristic curves of 0.82 (95% confidence interval [CI], 0.80 to 0.84) and 0.82 (95% CI, 0.80 to 0.85), respectively. This study provides novel information which might be useful for the clinical management of patients harboring KPCKP and for controlling the spread of this organism.
    Print ISSN: 0066-4804
    Electronic ISSN: 1098-6596
    Topics: Biology , Medicine
    Published by The American Society for Microbiology (ASM)
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