Trends in hospital acquired New Delhi metallo-beta-lactamase-producing Enterobacterales in Tuscany (Italy) from 2019 to 2021: impact of the COVID-19 pandemic.

OBJECTIVES: In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control measures successfully reducing transmission. We describe the NDM-CRE epidemiology during the COVID-19 pandemic in Tuscany. METHODS: Data on NDM-CRE patients hospitalized in five Tuscan hospitals were collected from January 2019 to December 2021. Weekly rates of NDM-CRE cases on hospital days in medical and critical-care wards were calculated. In March-December 2020, NDM-CRE rates were stratified by COVID-19 diagnosis. Multi-variate regression analysis was performed to assess outcomes' differences among two periods analysed and between COVID-19 populations. RESULTS: Since March 2020, an increase in NDM-CRE cases was observed, associated with COVID-19 admissions. COVID-19 patients differed significantly from non-COVID-19 ones by several variables, including patient features (age, Charlson index) and clinical history and outcomes (NDM-CRE infection/colonization, intensive care unit stay, length of stay, mortality). During the pandemic, we observed a higher rate of NDM-CRE cases per hospital day in both non-COVID-19 patients (273/100,000) and COVID-19 patients (370/100,00) when compared with pre-pandemic period cases (187/100,00). CONCLUSIONS: Our data suggest a resurgence in NDM-CRE spread among hospitalized patients in Tuscany during the COVID-19 pandemic, as well as a change in patients' case-mix. The observed increase in hospital transmission of NDM-CRE could be related to changes in infection prevention and control procedures, aimed mainly at COVID-19 management, leading to new challenges in hospital preparedness and crisis management planning.

Case report of Candida parapsilosis sepsis detected in peripheral blood smear

Introduction During long periods of hospitalization, debilitated and immunosuppressed patients are prone to contracting nosocomial fungal infections, such as Candida parapsilosis, which can cause sepsis. Candida parapsilosis, indeed, is able to form firm and persistent biofilms in central venous catheters (CVC) in addition to other medical devices, thus threatening patients undergoing invasive medical procedures [1]. We report a case of Candida parapsilosis sepsis detected in the peripheral blood smear and by the change of the cytograms of the hematology analyzer before to blood culture positivization. Case presentation An 89-year-old woman, positive for the Sars-Cov2 virus, was admitted at the San Donato hospital (Arezzo) for 40 days for Covid symptoms. Laboratory tests show an increase in C reactive protein (10.6 mg/dL), gamma GT (76 U/L), total bilirubin (2.31 mg/dL) and direct (1.46 mg/ dL), creatinine (1.00 mg/dL ) and reduction of glomerular filtrate (50.4 mL/min /1.73 mq). In addition, at the CBC anemia is detected with hemoglobin of 102 (g/L) and thrombocytopenia (32 x 10

(INVITED)Quantitative detection of SARS-CoV-2 virions in aqueous mediums by IoT optical fiber sensors

The COVID-19 pandemic has emphasized the need for portable, small-size, low-cost, simple to use, and highly sensitive sensors able to measure a specific substance, with the capability of the transmission over the Internet of statistical data, such as in this specific case on the spread of the SARS-CoV-2 virions. Moreover, to resolve the COVID-19 emergency, the possibility of making selective SARS-CoV-2 measurements in different aqueous matrices could be advantageous. Thus, the realization of rapid and innovative point-of-care diagnostics tests has become a global priority. In response to the current need for quick, highly sensitive and on-site detection of the SARS-CoV-2 virions in different aqueous solutions, two different nanolayer biorecognition systems separately combined with an adaptable optical fiber sensor have been reported in this work. More specifically, two SARS-CoV-2 sensors have been developed and tested by exploiting a plasmonic plastic optical fiber (POF) sensor coupled with two different receptors, both designed for the specific recognition of the SARS-CoV-2 Spike protein;one is aptamer-based and the other one Molecular Imprinted Polymer-based. The preliminary tests on SARS-CoV-2 virions, performed on samples of nasopharyngeal (NP) swabs in universal transport medium (UTM), were compared with data obtained using reverse-transcription polymerase chain reaction (RT-PCR). According to these preliminary experimental results obtained exploiting both receptors, the sensitivity of the proposed SARS-CoV-2 optical fiber sensors proved to be high enough to detect virions. Furthermore, a relatively fast response time (a few minutes) to detect virions was obtained without additional reagents, with the capability to transmit the data via the Internet automatically. © 2021 The Authors