Tiziana D’Inzeo

Università Cattolica del Sacro Cuore

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Maurizio Sanguinetti

Università Cattolica del Sacro Cuore

Teresa Spanu

Istituti di Ricovero e Cura a Carattere Scientifico

Barbara Fiori

Università Cattolica del Sacro Cuore

Brunella Posteraro

Agostino Gemelli University Polyclinic

Giulia Menchinelli

Agostino Gemelli University Polyclinic

Giulia De Angelis

Istituti di Ricovero e Cura a Carattere Scientifico

Flora Marzia Liotti

Università Cattolica del Sacro Cuore

Giovanni Fadda

University of Sassari

Mario Tumbarello

University of Siena

Flavio De Maio

Agostino Gemelli University Polyclinic

Cooperative Institutions

Università Cattolica del Sacro Cuore

157

Agostino Gemelli University Polyclinic

133

Istituti di Ricovero e Cura a Carattere Scientifico

125

Catholic University of America

University of the Sacred Heart

Sapienza University of Rome

Czech Academy of Sciences, Institute of Microbiology

University of Siena

Pontifícia Universidade Católica de São Paulo

University of Padua

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Performance of Two Resin-Containing Blood Culture Media in Detection of Bloodstream Infections and in Direct Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry (MALDI-TOF MS) Broth Assays for Isolate Identification: Clinical Comparison of the BacT/Alert Plus and Bactec Plus Systems

Journal of Clinical Microbiology (2014)

Barbara Fiori Tiziana D’Inzeo Viviana Di Florio Flavio De Maio Giulia De Angelis

ABSTRACT We compared the clinical performances of the BacT/Alert Plus (bioMérieux) and Bactec Plus (Becton Dickinson) aerobic and anaerobic blood culture (BC) media with adsorbent polymeric beads. Patients ≥16 years old with suspected bloodstream infections (BSIs) were enrolled in intensive care units and infectious disease wards. A single 40-ml blood sample was collected from each and used to inoculate (10 ml/bottle) one set of BacT/Alert Plus cultures and one set of Bactec Plus cultures, each set consisting of one aerobic and one anaerobic bottle. Cultures were incubated ≤5 days in the BacT/Alert 3D and Bactec FX instruments, respectively. A total of 128 unique BSI episodes were identified based on the recovery of clinically significant growth in 212 aerobic cultures (106 BacT/Alert and 106 Bactec) and 151 anaerobic cultures (82 BacT/Alert and 69 Bactec). The BacT/Alert aerobic medium had higher recovery rates for Gram-positive cocci ( P = 0.024), whereas the Bactec aerobic medium was superior for recovery of Gram-negative bacilli ( P = 0.006). BacT/Alert anaerobic medium recovery rates exceeded those of the Bactec anaerobic medium for total organisms ( P = 0.003), Gram-positive cocci ( P = 0.013), and Escherichia coli ( P = 0.030). In terms of capacity for diagnosing the 128 septic episodes, the BacT/Alert and Bactec sets were comparable, although the former sets diagnosed more BSIs caused by Gram-positive cocci ( P = 0.008). They also allowed earlier identification of coagulase-negative staphylococcal growth (mean, 2.8 h; P = 0.003) and growth in samples from patients not on antimicrobial therapy that yielded positive results (mean, 1.3 h; P < 0.001). Similarly high percentages of microorganisms in BacT/Alert and Bactec cultures (93.8% and 93.3%, respectively) were identified by direct matrix-assisted laser desorption ionization–time of flight mass spectrometry assay of BC broths. The BacT/Alert Plus media line appears to be a reliable, timesaving tool for routine detection of BSIs in the population we studied, although further studies are needed to evaluate their performance in other settings.

Bacteremia

Blood Culture

Gram-Positive Cocci

Enterococcus faecalis

10.1128/jcm.01171-14

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Citations (54)

Chip-Based Molecular Evaluation of a DNA Extraction Protocol for Candida Species from Positive Blood Cultures

Microorganisms (2023)

Vittorio Ivagnes Giulia Menchinelli Flora Marzia Liotti Elena De Carolis Riccardo Torelli

The diagnosis of

Negative control

10.3390/microorganisms12010081

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Citations (1)

Simulated Pediatric Blood Cultures to Assess the Inactivation of Clinically Relevant Antimicrobial Drug Concentrations in Resin-Containing Bottles

Frontiers in Cellular and Infection Microbiology (2021)

Liliana Giordano Flora Marzia Liotti Giulia Menchinelli Giulia De Angelis Tiziana D’Inzeo

The bacteremia level as well as the administration of antibiotics before blood collection may significantly affect the recovery of bacterial pathogens from pediatric blood cultures in BacT/Alert Virtuo or Bactec FX BC systems, which remain the common techniques to diagnose bacteremia in pediatric patients. We simulated pediatric blood cultures with low or intermediate bacteremia level to evaluate BacT/Alert PF Plus and Bactec Peds Plus blood culture bottles for resin-based inactivation of 16 antibiotic–bacterium combinations. Overall, 105/192 (54.7%) of BacT/Alert PF Plus bottles and 69/192 (36.0%) of Bactec Peds Plus bottles allowed organisms to grow when exposed to antibiotics. In particular, both BacT/Alert PF Plus and Bactec Peds Plus bottles proved to be effective with piperacillin/tazobactam and Pseudomonas aeruginosa or with oxacillin and methicillin-susceptible Staphylococcus aureus (100% growth), whereas no effectiveness was apparent with ceftriaxone and Escherichia coli , Streptococcus agalactiae , or Streptococcus pneumoniae or with cefepime and E. coli (0% growth). In some relevant instances ( e.g. , with vancomycin and methicillin-resistant S. aureus or Streptococcus pneumoniae ), BacT/Alert PF Plus bottles were superior to Bactec Peds Plus bottles. Together, these findings underscore the potentiality of resin-containing bottles to enhance diagnosis of bacteremia in pediatric patients on antimicrobial therapy. This is particularly true with one of the evaluated BC systems and with simulated intermediate bacteremia level only.

Bacteremia

Cefepime

Blood Culture

10.3389/fcimb.2021.649769

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Citations (4)

Comparing BioFire FilmArray BCID2 and BCID Panels for Direct Detection of Bacterial Pathogens and Antimicrobial Resistance Genes from Positive Blood Cultures

Journal of Clinical Microbiology (2021)

Venere Cortazzo Tiziana D’Inzeo Liliana Giordano Giulia Menchinelli Flora Marzia Liotti

A mong molecular assays currently developed for detection and identification of pathogens (and their antimicrobial resistance genes) in positive blood cultures (BCs) (1), the BioFire FilmArray blood culture identification (BCID) panel (bioMérieux, Marcy l'Etoile, France), a multiplex PCR assay with ,2 min of hands-on time and an ;1-h turnaround time, allows for syndromic diagnosis of bloodstream infection (BSI) (2, 3).Previously, the panel could identify 24 etiological agents of BSI (11 Gram-negative bacteria, 8 Gram-positive bacteria, and 5 yeast species), as well as three antimicrobial resistance genes (mecA, vanA/B, and bla KPC , which encodes Klebsiella pneumoniae carbapenemase).Now, the BioFire FilmArray BCID2 panel encompasses 43 molecular targets associated with BSI, including 15 Gram-negative bacteria, 11 Gram-positive bacteria, 7 yeast species, and 10 antimicrobial resistance genes (https://www.biomerieux-diagnostics.com/biofire-bcid-panel).The last targets include genes encoding carbapenemases (IMP, KPC, OXA-48-like, NDM, and VIM), colistin resistance (mcr-1), extendedspectrum b-lactamase (ESBL) (CTX-M), methicillin resistance (mecA/C and, specifically for methicillin-resistant Staphylococcus aureus [MRSA], mecA/C and MREJ [mec right-extremity junction]), or vancomycin resistance (vanA/B).Unlike BCID, no published studies to date reported on BCID2 performance.This study evaluated and compared the accuracy of BCID2 with that of BCID to identify bacterial species and relative antimicrobial resistance genes directly from positive BCs.We used archived samples from positive BCs (1.5 ml thereof mixed with 100 ml of dimethyl sulfoxide and stored at 280°C), which had prospectively been processed with the BD Bactec 9240 (BD Diagnostic Systems, Sparks, MD), BacTAlert 3D (bioMérieux), or BacTAlert Virtuo (bioMérieux) system at two hospital microbiology laboratories from January 2018 to August 2020.For BCID2 testing, samples were thawed and allowed to reach room temperature, and a 200-ml aliquot was lysed and processed following the manufacturer's instructions.We compared BCID2 results with those of conventional identification or detection (i.e., MALDI BioTyper analysis and, relative to antimicrobial resistance genes, PCR sequencing, both performed on microbial isolates subcultured from positive BC samples), which was considered the reference method in this evaluation, or with those of the BCID.

10.1128/jcm.03163-20

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Citations (46)

Empyema Caused by Prevotella bivia Complicating an Unusual Case of Spontaneous Chylothorax

Journal of Clinical Microbiology (2014)

Alessandro Di Marco Berardino Riccardo Inchingolo Andrea Smargiassi Antonina Re Riccardo Torelli

Spontaneous chylothorax is rare in adults. We present an unusual case that was complicated by Prevotella bivia empyema. Full recovery was achieved with chest tube drainage and prompt treatment with intravenous clindamycin.

Chylothorax

Chest tube

Prevotella

10.1128/jcm.03282-13

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Citations (14)

First reported case of intraventricular tigecycline for meningitis from extremely drug-resistant Acinetobacter baumannii

Journal of neurosurgery (2016)

Liverana Lauretti Quintino Giorgio D’Alessandris Massimo Fantoni Tiziana D’Inzeo Eduardo Fernández

The authors report on the first case of the intraventricular administration of tigecycline described in the Western literature. A 22-year-old man developed cerebrospinal fluid infection from an extremely drug-resistant strain of Acinetobacter baumannii as a complication of endoscopic transsphenoidal surgery for the removal of a giant pituitary adenoma. The patient was safely and successfully treated with the prolonged intraventricular administration of tigecycline. Here, the authors provide the schedule details that can be invaluable in treating meningitis from extremely drug-resistant bacterial strains. Intraventricular tigecycline can be a valuable tool against multidrug-resistant central nervous system infections.

Tigecycline

Acinetobacter baumannii

Ventriculitis

10.3171/2016.6.jns16352

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Citations (50)

Simplified Testing Method for Direct Detection of Carbapenemase-Producing Organisms from Positive Blood Cultures Using the NG-Test Carba 5 Assay

Antimicrobial Agents and Chemotherapy (2019)

Liliana Giordano Barbara Fiori Tiziana D’Inzeo Gabriella Parisi Flora Marzia Liotti

We directly tested 484 organisms from clinical ( n = 310) and simulated ( n = 174) positive blood cultures using the NG-Test Carba 5 assay for carbapenemase-producing Enterobacterales detection. The assay identified all but 4 of the KPC (170/171), OXA-48-like (22/22), VIM (19/21), and NDM (14/15) producers with no false positives.

Blood Culture

Enterobacteriaceae Infections

10.1128/aac.00550-19

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Citations (29)

Identification of methicillin-resistant isolates of Staphylococcus aureus and coagulase-negative staphylococci responsible for bloodstream infections with the Phoenix™ system

Diagnostic Microbiology and Infectious Disease (2004)

Teresa Spanu Maurizio Sanguinetti Tiziana D’Inzeo Daniela Ciccaglione Lucio Romano

cons

Coagulase

Bacteremia

SCCmec

Meticillin

10.1016/j.diagmicrobio.2003.11.004

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Citations (30)

Antifungal Susceptibility Profiles of Bloodstream Yeast Isolates by Sensititre YeastOne over Nine Years at a Large Italian Teaching Hospital

Antimicrobial Agents and Chemotherapy (2015)

Brunella Posteraro Teresa Spanu Barbara Fiori Flavio De Maio Elena De Carolis

Sensititre YeastOne (SYO) is an affordable alternative to the Clinical and Laboratory Standards Institute (CLSI) reference method for antifungal susceptibility testing. In this study, the MICs of yeast isolates from 1,214 bloodstream infection episodes, generated by SYO during hospital laboratory activity (January 2005 to December 2013), were reanalyzed using current CLSI clinical breakpoints/epidemiological cutoff values to assign susceptibility (or the wild-type [WT] phenotype) to systemic antifungal agents. Excluding Candida albicans (57.4% of all isolates [n = 1,250]), the most predominant species were Candida parapsilosis complex (20.9%), Candida tropicalis (8.2%), Candida glabrata (6.4%), Candida guilliermondii (1.6%), and Candida krusei (1.3%). Among the non-Candida species (1.9%), 7 were Cryptococcus neoformans and 17 were other species, mainly Rhodotorula species. Over 97% of Candida isolates were susceptible (WT phenotype) to amphotericin B and flucytosine. Rates of susceptibility (WT phenotype) to fluconazole, itraconazole, and voriconazole were 98.7% in C. albicans, 92.3% in the C. parapsilosis complex, 96.1% in C. tropicalis, 92.5% in C. glabrata, 100% in C. guilliermondii, and 100% (excluding fluconazole) in C. krusei. The fluconazole-resistant isolates consisted of 6 C. parapsilosis complex isolates, 3 C. glabrata isolates, 2 C. albicans isolates, 2 C. tropicalis isolates, and 1 Candida lusitaniae isolate. Of the non-Candida isolates, 2 C. neoformans isolates had the non-WT phenotype for susceptibility to fluconazole, whereas Rhodotorula isolates had elevated azole MICs. Overall, 99.7% to 99.8% of Candida isolates were susceptible (WT phenotype) to echinocandins, but 3 isolates were nonsusceptible (either intermediate or resistant) to caspofungin (C. albicans, C. guilliermondii, and C. krusei), anidulafungin (C. albicans and C. guilliermondii), and micafungin (C. albicans). However, when the intrinsically resistant non-Candida isolates were included, the rate of echinocandin nonsusceptibility reached 1.8%. In summary, the SYO method proved to be able to detect yeast species showing antifungal resistance or reduced susceptibility.

Candida parapsilosis

Candida krusei

Candida glabrata

10.1128/aac.00285-15

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Citations (67)

A New Easy-to-Perform Flow Cytometry Assay for Determining Bacterial and Viral Infection-Induced Polymorphonuclear Neutrophil and Monocyte Membrane Marker Modulation in Febrile Patients

Marilena La Sorda Desy De Lorenzis Alessandra Battaglia Barbara Fiori Rosalia Graffeo

pending

Monocyte

10.20944/preprints202410.0590.v1

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Citations (0)