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2.
Molecules ; 26(19)2021 Oct 06.
Article in English | MEDLINE | ID: covidwho-1463769

ABSTRACT

Pristine high-density bulk disks of MgB2 with added hexagonal BN (10 wt.%) were prepared using spark plasma sintering. The BN-added samples are machinable by chipping them into desired geometries. Complex shapes of different sizes can also be obtained by the 3D printing of polylactic acid filaments embedded with MgB2 powder particles (10 wt.%). Our present work aims to assess antimicrobial activity quantified as viable cells (CFU/mL) vs. time of sintered and 3D-printed materials. In vitro antimicrobial tests were performed against the bacterial strains Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Staphylococcus aureus ATCC 25923, Enterococcus faecium DSM 13590, and Enterococcus faecalis ATCC 29212; and the yeast strain Candida parapsilosis ATCC 22019. The antimicrobial effects were found to depend on the tested samples and microbes, with E. faecium being the most resistant and E. coli the most susceptible.


Subject(s)
Anti-Infective Agents/pharmacology , Bacteria/drug effects , Boron Compounds/pharmacology , Fungi/drug effects , Magnesium Compounds/pharmacology , Candida parapsilosis/drug effects , Enterococcus faecalis/drug effects , Enterococcus faecium/drug effects , Escherichia coli/drug effects , Microbial Sensitivity Tests , Polyesters/pharmacology , Printing, Three-Dimensional , Pseudomonas aeruginosa/drug effects , Staphylococcus aureus/drug effects
3.
Ann Med ; 53(1): 1779-1786, 2021 12.
Article in English | MEDLINE | ID: covidwho-1462157

ABSTRACT

BACKGROUND: An unexpected high prevalence of enterococcal bloodstream infection (BSI) has been observed in critically ill patients with COVID-19 in the intensive care unit (ICU). MATERIALS AND METHODS: The primary objective was to describe the characteristics of ICU-acquired enterococcal BSI in critically ill patients with COVID-19. A secondary objective was to exploratorily assess the predictors of 30-day mortality in critically ill COVID-19 patients with ICU-acquired enterococcal BSI. RESULTS: During the study period, 223 patients with COVID-19 were admitted to COVID-19-dedicated ICUs in our centre. Overall, 51 episodes of enterococcal BSI, occurring in 43 patients, were registered. 29 (56.9%) and 22 (43.1%) BSI were caused by Enterococcus faecalis and Enterococcus faecium, respectively. The cumulative incidence of ICU-acquired enterococcal BSI was of 229 episodes per 1000 ICU admissions (95% mid-p confidence interval [CI] 172-298). Most patients received an empirical therapy with at least one agent showing in vitro activity against the blood isolate (38/43, 88%). The crude 30-day mortality was 42% (18/43) and 57% (4/7) in the entire series and in patients with vancomycin-resistant E. faecium BSI, respectively. The sequential organ failure assessment (SOFA) score showed an independent association with increased mortality (odds ratio 1.32 per one-point increase, with 95% confidence interval 1.04-1.66, p = .021). CONCLUSIONS: The cumulative incidence of enterococcal BSI is high in critically ill patients with COVID-19. Our results suggest a crucial role of the severity of the acute clinical conditions, to which both the underlying viral pneumonia and the enterococcal BSI may contribute, in majorly influencing the outcome.KEY MESSAGESThe cumulative incidence of enterococcal BSI is high in critically ill patients with COVID-19.The crude 30-day mortality of enterococcal BSI in critically ill patients with COVID-19 may be higher than 40%.There could be a crucial role of the severity of the acute clinical conditions, to which both the underlying viral pneumonia and the enterococcal BSI may contribute, in majorly influencing the outcome.


Subject(s)
Bacteremia/epidemiology , COVID-19/epidemiology , Cross Infection/epidemiology , Enterococcus faecalis , Enterococcus faecium , Gram-Positive Bacterial Infections/epidemiology , Mortality , Vancomycin-Resistant Enterococci , Aged , Bacteremia/microbiology , Critical Illness , Female , Gram-Positive Bacterial Infections/microbiology , Humans , Intensive Care Units , Male , Microbial Sensitivity Tests , Middle Aged , Organ Dysfunction Scores , Retrospective Studies , SARS-CoV-2
4.
Cell Rep Med ; 2(4): 100229, 2021 04 20.
Article in English | MEDLINE | ID: covidwho-1129218

ABSTRACT

The impact of secondary bacterial infections (superinfections) in coronavirus disease 2019 (COVID-19) is not well understood. In this prospective, monocentric cohort study, we aim to investigate the impact of superinfections in COVID-19 patients with acute respiratory distress syndrome. Patients are assessed for concomitant microbial infections by longitudinal analysis of tracheobronchial secretions, bronchoalveolar lavages, and blood cultures. In 45 critically ill patients, we identify 19 patients with superinfections (42.2%). Superinfections are detected on day 10 after intensive care admission. The proportion of participants alive and off invasive mechanical ventilation at study day 28 (ventilator-free days [VFDs] at 28 days) is substantially lower in patients with superinfection (subhazard ratio 0.37; 95% confidence interval [CI] 0.15-0.90; p = 0.028). Patients with pulmonary superinfections have a higher incidence of bacteremia, virus reactivations, yeast colonization, and required intensive care treatment for a longer time. Superinfections are frequent and associated with reduced VFDs at 28 days despite a high rate of empirical antibiotic therapy.


Subject(s)
COVID-19/pathology , Respiration, Artificial , Superinfection/diagnosis , Aged , Bronchoalveolar Lavage Fluid/microbiology , COVID-19/complications , COVID-19/virology , Cohort Studies , Critical Illness , Enterococcus faecalis/isolation & purification , Female , Humans , Incidence , Intensive Care Units , Length of Stay , Male , Middle Aged , Pseudomonas aeruginosa/isolation & purification , SARS-CoV-2/isolation & purification , Superinfection/complications , Superinfection/epidemiology , Time Factors
5.
ACS Nano ; 15(1): 1167-1178, 2021 01 26.
Article in English | MEDLINE | ID: covidwho-1014984

ABSTRACT

Existing methods for RNA diagnostics, such as reverse transcription PCR (RT-PCR), mainly rely on nucleic acid amplification (NAA) and RT processes, which are known to introduce substantial issues, including amplification bias, cross-contamination, and sample loss. To address these problems, we introduce a confinement effect-inspired Cas13a assay for single-molecule RNA diagnostics, eliminating the need for NAA and RT. This assay involves confining the RNA-triggered Cas13a catalysis system in cell-like-sized reactors to enhance local concentrations of target and reporter simultaneously, via droplet microfluidics. It achieves >10 000-fold enhancement in sensitivity when compared to the bulk Cas13a assay and enables absolute digital single-molecule RNA quantitation. We experimentally demonstrate its broad applicability for precisely counting microRNAs, 16S rRNAs, and SARS-CoV-2 RNA from synthetic sequences to clinical samples with excellent accuracy. Notably, this direct RNA diagnostic technology enables detecting a wide range of RNA molecules at the single-molecule level. Moreover, its simplicity, universality, and excellent quantification capability might render it to be a dominant rival to RT-qPCR.


Subject(s)
CRISPR-Cas Systems , Microfluidics , RNA/analysis , Cell Line, Tumor , Enterococcus faecalis , Escherichia coli , Humans , Klebsiella pneumoniae , MCF-7 Cells , MicroRNAs/analysis , Pseudomonas aeruginosa , RNA, Ribosomal, 16S/analysis , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , Staphylococcus aureus
6.
Eur J Clin Invest ; 50(10): e13319, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-597897

ABSTRACT

BACKGROUND: Little is known about the incidence and risk of intensive care unit (ICU)-acquired bloodstream infections (BSI) in critically ill patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: This retrospective, single-centre study was conducted in Northern Italy. The primary study objectives were as follows: (a) to assess the incidence rate of ICU-acquired BSI and (b) to assess the cumulative risk of developing ICU-acquired BSI. RESULTS: Overall, 78 critically ill patients with COVID-19 were included in the study. Forty-five episodes of ICU-acquired BSI were registered in 31 patients, with an incidence rate of 47 episodes (95% confidence interval [CI] 35-63) per 1000 patient-days at risk. The estimated cumulative risk of developing at least one BSI episode was of almost 25% after 15 days at risk and possibly surpassing 50% after 30 days at risk. In multivariable analysis, anti-inflammatory treatment was independently associated with the development of BSI (cause-specific hazard ratio [csHR] 1.07 with 95% CI 0.38-3.04 for tocilizumab, csHR 3.95 with 95% CI 1.20-13.03 for methylprednisolone and csHR 10.69 with 95% CI 2.71-42.17 for methylprednisolone plus tocilizumab, with no anti-inflammatory treatment as the reference group; overall P for the dummy variable = 0.003). CONCLUSIONS: The incidence rate of BSI was high, and the cumulative risk of developing BSI increased with ICU stay. Further study will clarify if the increased risk of BSI we detected in COVID-19 patients treated with anti-inflammatory drugs is outweighed by the benefits of reducing any possible pro-inflammatory dysregulation induced by SARS-CoV-2.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Bacteremia/epidemiology , Candidemia/epidemiology , Coronavirus Infections/drug therapy , Cross Infection/epidemiology , Methylprednisolone/therapeutic use , Pneumonia, Viral/drug therapy , Aged , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Critical Illness , Enterobacter aerogenes , Enterobacteriaceae Infections/epidemiology , Enterococcus faecalis , Enterococcus faecium , Female , Gram-Positive Bacterial Infections/epidemiology , Humans , Incidence , Intensive Care Units , Italy/epidemiology , Male , Middle Aged , Pandemics , Pneumococcal Infections/epidemiology , Pneumonia, Viral/epidemiology , Proportional Hazards Models , Pseudomonas Infections/epidemiology , Pseudomonas aeruginosa , Retrospective Studies , Risk Factors , SARS-CoV-2 , Staphylococcal Infections/epidemiology , Staphylococcus aureus , Streptococcus pneumoniae
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