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Research Fellow of Hygiene and Preventive Medicine, MD, Ph.D. at the University of Bari, Italy. Main research activities: health surveillance and promotion, molecular epidemiology, SARS-CoV-2, influenza, HIV, sexually transmitted infections, viral hepatitis infectious disease epidemiology, outbreak investigation, immunizations, epidemiology, antibiotic resistance, vaccine-preventable infections, foodborne diseases, vector-borne disease, effectiveness of vaccines, communication on vaccines and vaccinations. Hospital and laboratory activities - Hygiene Unit, Policlinico Hospital of Bari, Italy.
The SARS-CoV-2 P.1 variant of concern (VOC) was first identified in Brazil and is now spreading in European countries. It is characterized by the E484K mutation in the receptor-binding domain, which could contribute to the evasion from neutralizing antibodies. In Italy, this variant was first identified in January 2021. Here, we report an autochthonous outbreak of SARS-CoV-2 P.1 variant infections in southern Italy in subjects who had not travelled to endemic areas or outside the Apulia region. The outbreak involved seven subjects, three of whom had received a COVID-19 vaccine (one had received two doses and two had received one dose). Four patients had a mild clinical presentation. Laboratory investigations of nasopharyngeal swabs revealed that all strains were S-gene target failure-negative and molecular tests revealed they were the P.1 variant. Whole-genome sequencing confirmed that five subjects were infected with closely related strains classified as the P.1 lineage. The circulation of VOCs highlights the importance of strictly monitoring the spread of SARS-CoV-2 variants through genomic surveillance and of investigating local outbreaks. Furthermore, public health measures including social distancing, screening, and quarantine for travelers are key tools to slow down the viral transmission and to contain and mitigate the impact of VOC diffusion, and rapid scaling-up of vaccination is crucial to avoid a possible new epidemic wave.
Daniela Loconsole; Anna Sallustio; Francesca Centrone; Daniele Casulli; Maurizio Mario Ferrara; Antonio Sanguedolce; Marisa Accogli; Maria Chironna. An Autochthonous Outbreak of the SARS-CoV-2 P.1 Variant of Concern in Southern Italy, April 2021. Tropical Medicine and Infectious Disease 2021, 6, 151 .
AMA StyleDaniela Loconsole, Anna Sallustio, Francesca Centrone, Daniele Casulli, Maurizio Mario Ferrara, Antonio Sanguedolce, Marisa Accogli, Maria Chironna. An Autochthonous Outbreak of the SARS-CoV-2 P.1 Variant of Concern in Southern Italy, April 2021. Tropical Medicine and Infectious Disease. 2021; 6 (3):151.
Chicago/Turabian StyleDaniela Loconsole; Anna Sallustio; Francesca Centrone; Daniele Casulli; Maurizio Mario Ferrara; Antonio Sanguedolce; Marisa Accogli; Maria Chironna. 2021. "An Autochthonous Outbreak of the SARS-CoV-2 P.1 Variant of Concern in Southern Italy, April 2021." Tropical Medicine and Infectious Disease 6, no. 3: 151.
Background: Solid-organ transplant (SOT) recipients are at a high risk of severe COVID-19, and are priority for vaccination. Here, we describe three cases of severe COVID-19 caused by SARS-CoV-2 B.1.1.7 lineage in vaccinated SOT recipients. Methods: Three SOT patients were hospitalized in the Policlinico Hospital of Bari (southern Italy) and underwent nasopharyngeal swabs for molecular detection of SARS-CoV-2 genes and spike protein mutations by real-time PCR. One sample was subjected to whole-genome sequencing. Results: One patient was a heart transplant recipient and two were kidney transplant recipients. All were hospitalized with severe COVID-19 between March and May 2021. Two patients were fully vaccinated and one had received only one dose of the BNT162b2 mRNA vaccine. All the patients showed a high viral load at diagnosis, and molecular typing revealed the presence of B.1.1.7 lineage SARS-CoV-2. In all three cases, prolonged viral shedding was reported. Conclusions: The three cases pose concern about the role of the B.1.1.7 lineage in severe COVID-19 and about the efficacy of COVID-19 vaccination in immunocompromised patients. Protecting immunocompromised patients from COVID-19 is a challenge. SOT recipients show a suboptimal response to standard vaccination, and thus, an additive booster or a combined vaccination strategy with mRNA, protein/subunit, and vector-based vaccines may be necessary. This population should continue to practice strict COVID-19 precautions post-vaccination, until new strategies for protection are available.
Daniela Loconsole; Emma Stea; Anna Sallustio; Giulia Fontò; Virginia Pronzo; Simona Simone; Francesca Centrone; Marisa Accogli; Loreto Gesualdo; Maria Chironna. Severe COVID-19 by SARS-CoV-2 Lineage B.1.1.7 in Vaccinated Solid-Organ Transplant Recipients: New Preventive Strategies Needed to Protect Immunocompromised Patients. Vaccines 2021, 9, 806 .
AMA StyleDaniela Loconsole, Emma Stea, Anna Sallustio, Giulia Fontò, Virginia Pronzo, Simona Simone, Francesca Centrone, Marisa Accogli, Loreto Gesualdo, Maria Chironna. Severe COVID-19 by SARS-CoV-2 Lineage B.1.1.7 in Vaccinated Solid-Organ Transplant Recipients: New Preventive Strategies Needed to Protect Immunocompromised Patients. Vaccines. 2021; 9 (8):806.
Chicago/Turabian StyleDaniela Loconsole; Emma Stea; Anna Sallustio; Giulia Fontò; Virginia Pronzo; Simona Simone; Francesca Centrone; Marisa Accogli; Loreto Gesualdo; Maria Chironna. 2021. "Severe COVID-19 by SARS-CoV-2 Lineage B.1.1.7 in Vaccinated Solid-Organ Transplant Recipients: New Preventive Strategies Needed to Protect Immunocompromised Patients." Vaccines 9, no. 8: 806.
This study describes a case of SARS-CoV-2 reinfection confirmed by whole-genome sequencing in a healthy physician who had been working in a COVID-19 hospital in Italy since the beginning of the pandemic. Nasopharyngeal swabs were obtained from the patient at each presentation as part of routine surveillance. Nucleic acid amplification testing was performed on the two samples to confirm SARS-CoV-2 infection, and serological tests were used to detect SARS-CoV-2 IgG antibodies. Comparative genome analysis with whole-genome sequencing was performed on nasopharyngeal swabs collected during the two episodes of COVID-19. The first COVID-19 episode was in March 2020, and the second was in January 2021. Both SARS-CoV-2 infections presented with mild symptoms, and seroconversion for SARS-CoV-2 IgG was documented. Genomic analysis showed that the viral genome from the first infection belonged to the lineage B.1.1.74, while that from the second infection to the lineage B.1.177. Epidemiological, clinical, serological, and genomic analyses confirmed that the second episode of SARS-CoV-2 infection in the healthcare worker met the qualifications for “best evidence” for reinfection. Further studies are urgently needed to assess the frequency of such a worrisome occurrence, particularly in the light of the recent diffusion of SARS-CoV-2 variants of concern.
Daniela Loconsole; Anna Sallustio; Marisa Accogli; Francesca Centrone; Daniele Casulli; Antonino Madaro; Ersilia Tedeschi; Antonio Parisi; Maria Chironna. Symptomatic SARS-CoV-2 Reinfection in a Healthy Healthcare Worker in Italy Confirmed by Whole-Genome Sequencing. Viruses 2021, 13, 899 .
AMA StyleDaniela Loconsole, Anna Sallustio, Marisa Accogli, Francesca Centrone, Daniele Casulli, Antonino Madaro, Ersilia Tedeschi, Antonio Parisi, Maria Chironna. Symptomatic SARS-CoV-2 Reinfection in a Healthy Healthcare Worker in Italy Confirmed by Whole-Genome Sequencing. Viruses. 2021; 13 (5):899.
Chicago/Turabian StyleDaniela Loconsole; Anna Sallustio; Marisa Accogli; Francesca Centrone; Daniele Casulli; Antonino Madaro; Ersilia Tedeschi; Antonio Parisi; Maria Chironna. 2021. "Symptomatic SARS-CoV-2 Reinfection in a Healthy Healthcare Worker in Italy Confirmed by Whole-Genome Sequencing." Viruses 13, no. 5: 899.
Epidemiological and virological studies have revealed that SARS-CoV-2 variants of concern (VOCs) are emerging globally, including in Europe. The aim of this study was to evaluate the spread of B.1.1.7-lineage SARS-CoV-2 in southern Italy from December 2020–March 2021 through the detection of the S gene target failure (SGTF), which could be considered a robust proxy of VOC B.1.1.7. SGTF was assessed on 3075 samples from week 52/2020 to week 10/2021. A subset of positive samples identified in the Apulia region during the study period was subjected to whole-genome sequencing (WGS). A descriptive and statistical analysis of the demographic and clinical characteristics of cases according to SGTF status was performed. Overall, 20.2% of samples showed SGTF; 155 strains were confirmed as VOC 202012/01 by WGS. The proportion of SGTF-positive samples rapidly increased over time, reaching 69.2% in week 10/2021. SGTF-positive cases were more likely to be symptomatic and to result in hospitalization (p < 0.0001). Despite the implementation of large-scale non-pharmaceutical interventions (NPIs), such as the closure of schools and local lockdowns, a rapid spread of VOC 202012/01 was observed in southern Italy. Strengthened NPIs and rapid vaccine deployment, first among priority groups and then among the general population, are crucial both to contain the spread of VOC 202012/01 and to flatten the curve of the third wave.
Daniela Loconsole; Francesca Centrone; Caterina Morcavallo; Silvia Campanella; Anna Sallustio; Marisa Accogli; Francesca Fortunato; Antonio Parisi; Maria Chironna. Rapid Spread of the SARS-CoV-2 Variant of Concern 202012/01 in Southern Italy (December 2020–March 2021). International Journal of Environmental Research and Public Health 2021, 18, 4766 .
AMA StyleDaniela Loconsole, Francesca Centrone, Caterina Morcavallo, Silvia Campanella, Anna Sallustio, Marisa Accogli, Francesca Fortunato, Antonio Parisi, Maria Chironna. Rapid Spread of the SARS-CoV-2 Variant of Concern 202012/01 in Southern Italy (December 2020–March 2021). International Journal of Environmental Research and Public Health. 2021; 18 (9):4766.
Chicago/Turabian StyleDaniela Loconsole; Francesca Centrone; Caterina Morcavallo; Silvia Campanella; Anna Sallustio; Marisa Accogli; Francesca Fortunato; Antonio Parisi; Maria Chironna. 2021. "Rapid Spread of the SARS-CoV-2 Variant of Concern 202012/01 in Southern Italy (December 2020–March 2021)." International Journal of Environmental Research and Public Health 18, no. 9: 4766.
The coronavirus disease 2019 (COVID-19) pandemic now represents a major threat to public health. Health care workers (HCW) are exposed to biological risk. Little is currently known about the risk of HCW operating in pediatric wards for SARS-CoV-2 infection. The aim is to assess the prevalence of SARS-CoV-2 infection in HCW in a third-level children’s hospital in Southern Italy. An observational cohort study of all asymptomatic HCW (physician, technicians, nurses, and logistic and support operators) was conducted. HCW were screened, on a voluntary basis, for SARS-CoV-2 by RT-PCR on nasopharyngeal swab performed during the first wave of COVID-19. The study was then repeated, with the same modalities, at a 7-month interval, during the “second wave” of the COVID-19 pandemic. At the initial screening between 7 and 24 April 2020, 525 HCW were tested. None of them tested positive. At the repeated screening, conducted between 9 and 20 November 2020, 627 HCW were tested, including 61 additional ones resulting from COVID-emergency recruitment. At this second screening, eight subjects (1.3%) tested positive, thus being diagnosed as asymptomatic carriers of SARS-CoV-2. They were one physician, five nurses, and two HCW from the logistic/support services. They were employed in eight different wards/services. In all cases, the epidemiological investigation showed convincing evidence that the infection was acquired through social contacts. The study revealed a very low circulation of SARS-CoV-2 infection in HCW tested with RT-PCR. All the infections documented in the second wave of epidemic of SARS-CoV-2 were acquired outside of the workplace, confirming that in a pediatric hospital setting, HCW education, correct use of personal protective equipment, and separation of the COVID-patient pathway and staff flow may minimize the risk derived from occupational exposure.
Désirée Caselli; Daniela Loconsole; Rita Dario; Maria Chironna; Maurizio Aricò. Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children’s Hospital in Southern Italy. Pediatric Reports 2021, 13, 118 -124.
AMA StyleDésirée Caselli, Daniela Loconsole, Rita Dario, Maria Chironna, Maurizio Aricò. Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children’s Hospital in Southern Italy. Pediatric Reports. 2021; 13 (1):118-124.
Chicago/Turabian StyleDésirée Caselli; Daniela Loconsole; Rita Dario; Maria Chironna; Maurizio Aricò. 2021. "Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children’s Hospital in Southern Italy." Pediatric Reports 13, no. 1: 118-124.
Background Real-time polymerase chain reaction (RT-PCR) testing for the identification of viral nucleic acid is the current standard for the diagnosis of SARS-CoV-2 infection, but technical issues limit its utilization for large-scale screening. Serological immunoglobulin M (IgM)/IgG testing has been proposed as a useful tool for detecting SARS-CoV-2 exposure. Objective The objective of our study was to compare the results of the rapid serological VivaDiag test for SARS-CoV-2–related IgM/IgG detection with those of the standard RT-PCR laboratory test for identifying SARS-CoV-2 nucleic acid. Methods We simultaneously performed both serological and molecular tests with a consecutive series of 191 symptomatic patients. The results provided by a new rapid serological colorimetric test for analyzing IgM/IgG expression were compared with those of RT-PCR testing for SARS-CoV-2 detection. Results Of the 191 subjects, 70 (36.6%) tested positive for SARS-CoV-2 based on RT-PCR results, while 34 (17.3%) tested positive based on serological IgM/IgG expression. Additionally, 13 (6.8%) subjects tested positive based on serological test results, but also tested negative based on RT-PCR results. The rapid serological test had a sensitivity of 30% and a specificity of 89% compared to the standard RT-PCR assay. Interestingly, the performance of both assays improved 8 days after symptom appearance. After 10 days had passed since symptom appearance, the predictive value of the rapid serological test was higher than that of the standard molecular assay (proportion of positive results: 40% vs 20%). Multivariate analysis showed that age >58 years (P<.01) and period of >15 days after symptom onset (P<.02) were significant and independent factors associated with serological test positivity. Conclusions The rapid serological test analyzed in this study seems limited in terms of usefulness when diagnosing SARS-CoV-2 infection. However, it may be useful for providing relevant information on people’s immunoreaction to COVID-19 exposure.
Angelo Virgilio Paradiso; Simona De Summa; Daniela Loconsole; Vito Procacci; Anna Sallustio; Francesca Centrone; Nicola Silvestris; Vito Cafagna; Giuseppe De Palma; Antonio Tufaro; Vito Michele Garrisi; Maria Chironna. Rapid Serological Assays and SARS-CoV-2 Real-Time Polymerase Chain Reaction Assays for the Detection of SARS-CoV-2: Comparative Study. Journal of Medical Internet Research 2020, 22, e19152 .
AMA StyleAngelo Virgilio Paradiso, Simona De Summa, Daniela Loconsole, Vito Procacci, Anna Sallustio, Francesca Centrone, Nicola Silvestris, Vito Cafagna, Giuseppe De Palma, Antonio Tufaro, Vito Michele Garrisi, Maria Chironna. Rapid Serological Assays and SARS-CoV-2 Real-Time Polymerase Chain Reaction Assays for the Detection of SARS-CoV-2: Comparative Study. Journal of Medical Internet Research. 2020; 22 (10):e19152.
Chicago/Turabian StyleAngelo Virgilio Paradiso; Simona De Summa; Daniela Loconsole; Vito Procacci; Anna Sallustio; Francesca Centrone; Nicola Silvestris; Vito Cafagna; Giuseppe De Palma; Antonio Tufaro; Vito Michele Garrisi; Maria Chironna. 2020. "Rapid Serological Assays and SARS-CoV-2 Real-Time Polymerase Chain Reaction Assays for the Detection of SARS-CoV-2: Comparative Study." Journal of Medical Internet Research 22, no. 10: e19152.
A critical point in the management of the SARS-CoV-2 pandemic is the need to promptly identify the greatest number of infected people and to implement strict public health measures. In this study, the performance of a rapid serological test in a clinical setting was evaluated. Samples from 819 consecutive patients (with or without respiratory symptoms) admitted to a large Emergency Department were tested between 23 March and 21 April 2020. Patient samples were tested in a real-time PCR assay and a serological assay. In total, 148/819 patients (18.1%) tested positive for SARS-CoV-2 by real-time PCR. The serological test revealed that 70/819 patients (8.5%) had anti-SARS-CoV-2 IgM and/or IgG. The prevalence of anti-SARS-CoV-2 antibodies was significantly higher in patients with respiratory symptoms lasting for >7 days than in those with respiratory symptoms lasting for 0–7 days (p < 0.001). The serological assay had an overall sensitivity of 35.1% and an overall specificity of 97.3%. A high negative predictive value (96.7%) was reported for patients without respiratory symptoms. The results confirm that rapid serological assays alone are not sufficient for diagnosis of SARS-CoV-2 infection but can be incorporated into large-scale screening programs during periods in which the virus circulation is low.
Daniela Loconsole; Francesca Centrone; Caterina Morcavallo; Silvia Campanella; Anna Sallustio; Michele Quarto; Vito Procacci; Maria Chironna. The Light and Shadow of Rapid Serological Tests for SARS-CoV-2 Infection: Results from a Study in a Large Emergency Department. International Journal of Environmental Research and Public Health 2020, 17, 6493 .
AMA StyleDaniela Loconsole, Francesca Centrone, Caterina Morcavallo, Silvia Campanella, Anna Sallustio, Michele Quarto, Vito Procacci, Maria Chironna. The Light and Shadow of Rapid Serological Tests for SARS-CoV-2 Infection: Results from a Study in a Large Emergency Department. International Journal of Environmental Research and Public Health. 2020; 17 (18):6493.
Chicago/Turabian StyleDaniela Loconsole; Francesca Centrone; Caterina Morcavallo; Silvia Campanella; Anna Sallustio; Michele Quarto; Vito Procacci; Maria Chironna. 2020. "The Light and Shadow of Rapid Serological Tests for SARS-CoV-2 Infection: Results from a Study in a Large Emergency Department." International Journal of Environmental Research and Public Health 17, no. 18: 6493.
At the beginning of the coronavirus-2019 (COVID-19) pandemic, Italy was one of the most affected countries in Europe. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is less frequent and less severe in children than in adults. This study analyzed the frequency of SARS-CoV-2 infection among all children aged <18 years in the Apulia region of southern Italy and the characteristics of the infected children. Clinical and demographic data were collected through the national platform for COVID-19 surveillance. Of the 166 infected children in the Apulia region, 104 (62.6%) were asymptomatic, 37 (22.3%) had mild infections, 22 (13.3%) had moderate infections, and 3 (1.8%) had severe infections. Only ten children (6.0%) were hospitalized, but none required intensive care support and none died. SARS-CoV-2 infection was transmitted mainly from parents or relatives to children. Because of school closure during the lockdown, infection was unlikely to have been transmitted among children. It is unclear whether school reopening would enhance virus spread, leading the Italian government to develop guidelines for safe school reopening. The actual role of children in virus transmission remains unclear. A sensitive surveillance system, prompt identification of cases, testing, and contact tracing will be key to reducing the further spread of infection.
Daniela Loconsole; Desirèe Caselli; Francesca Centrone; Caterina Morcavallo; Silvia Campanella; Maurizio Aricò; Maria Chironna. SARS-CoV-2 Infection in Children in Southern Italy: A Descriptive Case Series. International Journal of Environmental Research and Public Health 2020, 17, 6080 .
AMA StyleDaniela Loconsole, Desirèe Caselli, Francesca Centrone, Caterina Morcavallo, Silvia Campanella, Maurizio Aricò, Maria Chironna. SARS-CoV-2 Infection in Children in Southern Italy: A Descriptive Case Series. International Journal of Environmental Research and Public Health. 2020; 17 (17):6080.
Chicago/Turabian StyleDaniela Loconsole; Desirèe Caselli; Francesca Centrone; Caterina Morcavallo; Silvia Campanella; Maurizio Aricò; Maria Chironna. 2020. "SARS-CoV-2 Infection in Children in Southern Italy: A Descriptive Case Series." International Journal of Environmental Research and Public Health 17, no. 17: 6080.
Every season, circulating influenza viruses change; therefore, vaccines must be reformulated each year. We aimed to estimate vaccine effectiveness (VE) against severe influenza infection for the 2018/19 season in Italy. We conducted a test-negative design case-control study at five Italian hospitals. We estimated influenza VE against severe acute respiratory infection (SARI) requiring hospitalisation overall, and by virus subtype, vaccine brand, and age. The 2018/19 season was characterised by A(H1N1)pmd09 and A(H3N2) influenza viruses. Vaccine coverage among <18 years recruited SARI cases was very low (3.2%). Seasonal vaccines were moderately effective against type A influenza overall (adjusted VE = 40.5%; 95% confidence interval (CI) = 18.7–56.4%) and subtype A(H1N1)pmd09 viruses (adjusted VE = 55%; 95% CI = 34.5–69.1%), but ineffective against subtype A(H3N2) viruses (adjusted VE = 2.5%; 95% CI = −50.0–36.7%). Both Fluad and Fluarix Tetra vaccines were effective against type A influenza overall and subtype A(H1N1)pdm09 viruses. VE appeared to be similar across age groups (0–64 years, ≥65 years). Seasonal influenza vaccines in the 2018/19 season were moderately effective in preventing SARI caused by A(H1N1)pdm09 influenza but ineffective against A(H3N2).
Caterina Rizzo; Francesco Gesualdo; Daniela Loconsole; Elisabetta Pandolfi; Antonino Bella; Andrea Orsi; Giulia Guarona; Donatella Panatto; Giancarlo Icardi; Christian Napoli; Giovanni Battista Orsi; Ilaria Manini; Emanuele Montomoli; Ilaria Campagna; Luisa Russo; Valeria Alfonsi; Simona Puzelli; Antonino Reale; Umberto Raucci; Livia Piccioni; Carlo Concato; Marta Luisa Ciofi Degli Ciofi Degli Atti; Alberto Villani; Maria Chironna; Alberto Eugenio Tozzi. Moderate Vaccine Effectiveness against Severe Acute Respiratory Infection Caused by A(H1N1)pdm09 Influenza Virus and No Effectiveness against A(H3N2) Influenza Virus in the 2018/2019 Season in Italy. Vaccines 2020, 8, 427 .
AMA StyleCaterina Rizzo, Francesco Gesualdo, Daniela Loconsole, Elisabetta Pandolfi, Antonino Bella, Andrea Orsi, Giulia Guarona, Donatella Panatto, Giancarlo Icardi, Christian Napoli, Giovanni Battista Orsi, Ilaria Manini, Emanuele Montomoli, Ilaria Campagna, Luisa Russo, Valeria Alfonsi, Simona Puzelli, Antonino Reale, Umberto Raucci, Livia Piccioni, Carlo Concato, Marta Luisa Ciofi Degli Ciofi Degli Atti, Alberto Villani, Maria Chironna, Alberto Eugenio Tozzi. Moderate Vaccine Effectiveness against Severe Acute Respiratory Infection Caused by A(H1N1)pdm09 Influenza Virus and No Effectiveness against A(H3N2) Influenza Virus in the 2018/2019 Season in Italy. Vaccines. 2020; 8 (3):427.
Chicago/Turabian StyleCaterina Rizzo; Francesco Gesualdo; Daniela Loconsole; Elisabetta Pandolfi; Antonino Bella; Andrea Orsi; Giulia Guarona; Donatella Panatto; Giancarlo Icardi; Christian Napoli; Giovanni Battista Orsi; Ilaria Manini; Emanuele Montomoli; Ilaria Campagna; Luisa Russo; Valeria Alfonsi; Simona Puzelli; Antonino Reale; Umberto Raucci; Livia Piccioni; Carlo Concato; Marta Luisa Ciofi Degli Ciofi Degli Atti; Alberto Villani; Maria Chironna; Alberto Eugenio Tozzi. 2020. "Moderate Vaccine Effectiveness against Severe Acute Respiratory Infection Caused by A(H1N1)pdm09 Influenza Virus and No Effectiveness against A(H3N2) Influenza Virus in the 2018/2019 Season in Italy." Vaccines 8, no. 3: 427.
A recent serological study describes a high level of susceptibility to measles virus (MV) in the province of Bari (Apulia, southern Italy). In this paper we describe the recent outbreak occurred in the province of Lecce (Apulia), where a high level of susceptibility can be hypothesized same as the province of Bari, with regard to the molecular epidemiology of MV. This article is protected by copyright. All rights reserved.
Melissa Baggieri; Anna Morea; Antonella Marchi; Paola Bucci; Daniela Loconsole; Maria Chironna; Fabio Magurano. Measles outbreak in Apulia, southern Italy. Journal of Medical Virology 2020, 92, 2897 -2899.
AMA StyleMelissa Baggieri, Anna Morea, Antonella Marchi, Paola Bucci, Daniela Loconsole, Maria Chironna, Fabio Magurano. Measles outbreak in Apulia, southern Italy. Journal of Medical Virology. 2020; 92 (12):2897-2899.
Chicago/Turabian StyleMelissa Baggieri; Anna Morea; Antonella Marchi; Paola Bucci; Daniela Loconsole; Maria Chironna; Fabio Magurano. 2020. "Measles outbreak in Apulia, southern Italy." Journal of Medical Virology 92, no. 12: 2897-2899.
Shiga toxin-producing Escherichia coli (STEC) infections result in a significant public health impact because of the severity of the disease that, in young children especially, can lead to hemolytic–uremic syndrome (HUS). A rise in the number of HUS cases was observed in the Apulia region of Italy from 2013 to 2017, and so, in 2018, a symptom-based surveillance system for children with bloody diarrhea (BD) was initiated in order to detect and manage STEC infections. The objective of the study was to describe the epidemiology of STEC infections in children from June 2018 to August 2019. Children stx1, stx2, eae) and serogroup identification tests were performed on stool samples/rectal swabs of cases. STEC infection was detected in 87 (10.6%) BD cases. The median age of STEC cases was 2.7 years, and 60 (68.9%) were stx1, stx2, and eae. Five cases (5.7%) caused by O26 (n = 2), O111 (n = 2), and O45 (n = 1) developed into HUS. A risk-oriented approach based on the testing of children with BD during the summer may represent a potentially beneficial option to improve the sensitivity of STEC surveillance, not only in Italy but also in the context of Europe as a whole.
Daniela Loconsole; Mario Giordano; Francesca Centrone; Marisa Accogli; Daniele Casulli; Anna De Robertis; Anna Morea; Michele Quarto; Antonio Parisi; Gaia Scavia; Maria Chironna; on behalf of the Bloody Diarrhea Apulia Working Group. Epidemiology of Shiga Toxin-Producing Escherichia coli Infections in Southern Italy after Implementation of Symptom-Based Surveillance of Bloody Diarrhea in the Pediatric Population. International Journal of Environmental Research and Public Health 2020, 17, 5137 .
AMA StyleDaniela Loconsole, Mario Giordano, Francesca Centrone, Marisa Accogli, Daniele Casulli, Anna De Robertis, Anna Morea, Michele Quarto, Antonio Parisi, Gaia Scavia, Maria Chironna, on behalf of the Bloody Diarrhea Apulia Working Group. Epidemiology of Shiga Toxin-Producing Escherichia coli Infections in Southern Italy after Implementation of Symptom-Based Surveillance of Bloody Diarrhea in the Pediatric Population. International Journal of Environmental Research and Public Health. 2020; 17 (14):5137.
Chicago/Turabian StyleDaniela Loconsole; Mario Giordano; Francesca Centrone; Marisa Accogli; Daniele Casulli; Anna De Robertis; Anna Morea; Michele Quarto; Antonio Parisi; Gaia Scavia; Maria Chironna; on behalf of the Bloody Diarrhea Apulia Working Group. 2020. "Epidemiology of Shiga Toxin-Producing Escherichia coli Infections in Southern Italy after Implementation of Symptom-Based Surveillance of Bloody Diarrhea in the Pediatric Population." International Journal of Environmental Research and Public Health 17, no. 14: 5137.
Despite its aggressive clinical course, leading to 6.4% fatality rate as of May 25, 2020 (https://qap.ecdc.europa.eu/public/extensions/COVID-19/COVID-19.html), COVID‐19 turned out to be only marginally aggressive in children. In a report from Lombardy, 18/88 COVID‐19 hospitalized adults (20%) had developed cutaneous manifestations: erythematous rash, widespread urticarial, and chickenpox‐like vesicles. Trunk was the main involved region. Itching was low or absent and usually lesions healed in few days. An unexpected outbreak of acute pseudochilblain skin lesions is being reported from different countries and related to COVID‐19.
D. Caselli; M. Chironna; Daniela Loconsole; L. Nigri; F. Mazzotta; D. Bonamonte; M. Aricò. No evidence of SARS‐CoV‐2 infection by polymerase chain reaction or serology in children with pseudo‐chilblain. British Journal of Dermatology 2020, 183, 784 -785.
AMA StyleD. Caselli, M. Chironna, Daniela Loconsole, L. Nigri, F. Mazzotta, D. Bonamonte, M. Aricò. No evidence of SARS‐CoV‐2 infection by polymerase chain reaction or serology in children with pseudo‐chilblain. British Journal of Dermatology. 2020; 183 (4):784-785.
Chicago/Turabian StyleD. Caselli; M. Chironna; Daniela Loconsole; L. Nigri; F. Mazzotta; D. Bonamonte; M. Aricò. 2020. "No evidence of SARS‐CoV‐2 infection by polymerase chain reaction or serology in children with pseudo‐chilblain." British Journal of Dermatology 183, no. 4: 784-785.
Background Carbapenem-resistant Klebsiella pneumoniae (CR-KP) is an urgent public health issue in Italy. This pattern of resistance is due mainly to dissemination of carbapenemase genes. Molecular characterization of carbapenem-resistant Klebsiella pneumoniae (CR-KP) strains was performed over a three-year period. In-depth analysis was performed on a subset of emerging CR-KP ST101 and ST307 clones. Methods A prospective study was performed on 691 patients with CR-KP bloodstream infections hospitalized in 19 hospitals located in three large provinces in Southern Italy. Carbapenemase genes were identified via genotyping methods. Multi-locus sequence typing (MLST) and Whole Genome Sequencing (WGS) were carried out on ST101 and ST307 isolates. Results Among the CR-KP isolates, bla KPC was found in 95.6%, bla VIM was found in 3.5%, bla NDM was found in 0.1% and bla OXA-48 was found in 0.1%. The bla KPC-3 variant was identified in all 104 characterized KPC-KP isolates. MLST of 231 representative isolates revealed ST512 in 45.5%, ST101 in 20.3% and ST307 in 18.2% of the isolates. cgMLST of ST307 and ST101 isolates revealed presence of more than one beta-lactam resistance gene. Amino acid substitution in the chromosomal colistin-resistance gene pmrB was found in two ST101 isolates. Conclusions ST512 is widespread in Southern Italy, but ST101 and ST307 are emerging since they were found in a significant proportion of cases. Aggressive infection control measures and a continuous monitoring of these high-risk clones are necessary to avoid rapid spread of CR-KP, especially in hospital settings.
Daniela Loconsole; Marisa Accogli; Anna Lisa De Robertis; Loredana Capozzi; Angelica Bianco; Anna Morea; Rosanna Mallamaci; Michele Quarto; Antonio Parisi; Maria Chironna. Emerging high-risk ST101 and ST307 carbapenem-resistant Klebsiella pneumoniae clones from bloodstream infections in Southern Italy. Annals of Clinical Microbiology and Antimicrobials 2020, 19, 1 -10.
AMA StyleDaniela Loconsole, Marisa Accogli, Anna Lisa De Robertis, Loredana Capozzi, Angelica Bianco, Anna Morea, Rosanna Mallamaci, Michele Quarto, Antonio Parisi, Maria Chironna. Emerging high-risk ST101 and ST307 carbapenem-resistant Klebsiella pneumoniae clones from bloodstream infections in Southern Italy. Annals of Clinical Microbiology and Antimicrobials. 2020; 19 (1):1-10.
Chicago/Turabian StyleDaniela Loconsole; Marisa Accogli; Anna Lisa De Robertis; Loredana Capozzi; Angelica Bianco; Anna Morea; Rosanna Mallamaci; Michele Quarto; Antonio Parisi; Maria Chironna. 2020. "Emerging high-risk ST101 and ST307 carbapenem-resistant Klebsiella pneumoniae clones from bloodstream infections in Southern Italy." Annals of Clinical Microbiology and Antimicrobials 19, no. 1: 1-10.
Background Pseudomonas aeruginosa (PA) is one of the most common and serious causes of healthcare-associated bacteremia. The emergence and dissemination of multidrug-resistant (MDR) and extensively drug-resistant (XDR) PA strains pose a major clinical concern. ST235-PA is a high-risk clone which shows a high capacity to acquire antibiotic resistance. Here we describe the first autochthonous New Delhi metallo-β-lactamase (NDM)-producing Pseudomonas aeruginosa ST235 identified in Italy. Case presentation In October 2019, a patient residing in an elderly health care and rehabilitation facility, was hospitalized and died from sepsis caused by an XDR-PA. The strain belonged to the high-risk clone sequence type ST235. Whole genome sequencing (WGS) revealed the presence of genes encoding NDM-1 and multiple β-lactamases, many clinically significant multidrug efflux pump complexes and also the virulence gene ExoU, which is associated with a high cytotoxic phenotype. Conclusions Few strains of NDM-1-PA have been identified worldwide, all belonging to ST235. The combination of ST235 and ExoU is a predictor of highly unfavorable prognosis. The potential spread of these high-risk clones in healthcare settings is worrisome because treatment options are limited. Early identification of high-risk clones could help in outbreaks investigation and infections control.
Daniela Loconsole; Marisa Accogli; Monica Monaco; Maria Del Grosso; Anna Lisa De Robertis; Anna Morea; Loredana Capozzi; Laura Del Sambro; Annarosa Simone; Vincenzo De Letteriis; Michele Quarto; Antonio Parisi; Maria Chironna. First detection of autochthonous extensively drug-resistant NDM-1 Pseudomonas aeruginosa ST235 from a patient with bloodstream infection in Italy, October 2019. Antimicrobial Resistance & Infection Control 2020, 9, 1 -5.
AMA StyleDaniela Loconsole, Marisa Accogli, Monica Monaco, Maria Del Grosso, Anna Lisa De Robertis, Anna Morea, Loredana Capozzi, Laura Del Sambro, Annarosa Simone, Vincenzo De Letteriis, Michele Quarto, Antonio Parisi, Maria Chironna. First detection of autochthonous extensively drug-resistant NDM-1 Pseudomonas aeruginosa ST235 from a patient with bloodstream infection in Italy, October 2019. Antimicrobial Resistance & Infection Control. 2020; 9 (1):1-5.
Chicago/Turabian StyleDaniela Loconsole; Marisa Accogli; Monica Monaco; Maria Del Grosso; Anna Lisa De Robertis; Anna Morea; Loredana Capozzi; Laura Del Sambro; Annarosa Simone; Vincenzo De Letteriis; Michele Quarto; Antonio Parisi; Maria Chironna. 2020. "First detection of autochthonous extensively drug-resistant NDM-1 Pseudomonas aeruginosa ST235 from a patient with bloodstream infection in Italy, October 2019." Antimicrobial Resistance & Infection Control 9, no. 1: 1-5.
Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020. https://doi.org/10.1002/jmv.25748[Epub ahead of print]. Article PubMed PubMed Central Google Scholar Chen D, Xu W, Lei Z, et al. Recurrence of positive SARS-CoV-2 RNA in COVID-19: a case report. Int J Infect Dis. 2020;93:297–9. https://doi.org/10.1016/j.ijid.2020.03.003. CAS Article PubMed PubMed Central Google Scholar Ye G, Pan Z, Pan Y, et al. Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation. J Infect. 2020;80:e14–e1717. https://doi.org/10.1016/j.jinf.2020.03.001. CAS Article PubMed PubMed Central Google Scholar Lombardi A, Bozzi G, Mangioni D, et al. Duration of quarantine in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a question needing an answer. J Hosp Infect. 2020. https://doi.org/10.1016/j.jhin.2020.03.003. Article PubMed PubMed Central Google Scholar Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med. 2020;382:970–1. https://doi.org/10.1056/NEJMc2001468. Article PubMed PubMed Central Google Scholar Long Q, Liu B, Deng H, et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med. 2020. https://doi.org/10.1038/s41591-020-0897-1. Article PubMed Google Scholar Download references Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, “Aldo Moro”, Piazza G. Cesare 11, 70124, Bari, Italy Daniela Loconsole, Francesca Centrone & Maria Chironna Department of Biomedical Sciences and Human Oncology-Clinica Medica “A. Murri”, University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy Francesca Passerini, Vincenzo Ostilio Palmieri, Stefania Pugliese, Lucia Donatella Grimaldi & Piero Portincasa Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Piazza G. Cesare 11, 70124, Bari, Italy Anna Sallustio You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar Correspondence to Maria Chironna. The authors declare that they have no conflict of interest. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Reprints and Permissions Loconsole, D., Passerini, F., Palmieri, V.O. et al. Recurrence of COVID-19 after recovery: a case report from Italy. Infection (2020). https://doi.org/10.1007/s15010-020-01444-1 Download citation Received: 07 May 2020 Accepted: 09 May 2020 Published: 16 May 2020 DOI: https://doi.org/10.1007/s15010-020-01444-1
Daniela Loconsole; Francesca Passerini; Vincenzo Ostilio Palmieri; Francesca Centrone; Anna Sallustio; Stefania Pugliese; Lucia Donatella Grimaldi; Piero Portincasa; Maria Chironna. Recurrence of COVID-19 after recovery: a case report from Italy. Infection 2020, 48, 965 -967.
AMA StyleDaniela Loconsole, Francesca Passerini, Vincenzo Ostilio Palmieri, Francesca Centrone, Anna Sallustio, Stefania Pugliese, Lucia Donatella Grimaldi, Piero Portincasa, Maria Chironna. Recurrence of COVID-19 after recovery: a case report from Italy. Infection. 2020; 48 (6):965-967.
Chicago/Turabian StyleDaniela Loconsole; Francesca Passerini; Vincenzo Ostilio Palmieri; Francesca Centrone; Anna Sallustio; Stefania Pugliese; Lucia Donatella Grimaldi; Piero Portincasa; Maria Chironna. 2020. "Recurrence of COVID-19 after recovery: a case report from Italy." Infection 48, no. 6: 965-967.
During the coronavirus disease 2019 (COVID-19) pandemic, some healthcare workers (HCWs), directly involved in the care of infectious patients, have chosen to separate temporarily from their families in order to protect their parents or children from the risk of infection. Such separation can be very difficult and expensive. In China, some hospitals provided facilities, including the provision of food and daily living supplies, and help for staff to video record their routines in the hospital to share with their families in order to alleviate the concerns of family members [1Chen Q. Liang M. Li Y. Guo J. Fei D. Wang L. et al.Mental health care for medical staff in China during the COVID-19 outbreak.Lancet Psychiatry. 2020; 7: e15-e16Abstract Full Text Full Text PDF PubMed Scopus (249) Google Scholar]. This article describes our experience in southern Italy.
L. Vimercati; S. Tafuri; M. Chironna; Daniela Loconsole; F.I.M. Fucilli; G. Migliore; L. Gesualdo. The COVID-19 hotel for healthcare workers: an Italian best practice. Journal of Hospital Infection 2020, 105, 387 -388.
AMA StyleL. Vimercati, S. Tafuri, M. Chironna, Daniela Loconsole, F.I.M. Fucilli, G. Migliore, L. Gesualdo. The COVID-19 hotel for healthcare workers: an Italian best practice. Journal of Hospital Infection. 2020; 105 (3):387-388.
Chicago/Turabian StyleL. Vimercati; S. Tafuri; M. Chironna; Daniela Loconsole; F.I.M. Fucilli; G. Migliore; L. Gesualdo. 2020. "The COVID-19 hotel for healthcare workers: an Italian best practice." Journal of Hospital Infection 105, no. 3: 387-388.
BACKGROUND Real-time polymerase chain reaction (RT-PCR) testing for the identification of viral nucleic acid is the current standard for the diagnosis of SARS-CoV-2 infection, but technical issues limit its utilization for large-scale screening. Serological immunoglobulin M (IgM)/IgG testing has been proposed as a useful tool for detecting SARS-CoV-2 exposure. OBJECTIVE The objective of our study was to compare the results of the rapid serological VivaDiag test for SARS-CoV-2–related IgM/IgG detection with those of the standard RT-PCR laboratory test for identifying SARS-CoV-2 nucleic acid. METHODS We simultaneously performed both serological and molecular tests with a consecutive series of 191 symptomatic patients. The results provided by a new rapid serological colorimetric test for analyzing IgM/IgG expression were compared with those of RT-PCR testing for SARS-CoV-2 detection. RESULTS Of the 191 subjects, 70 (36.6%) tested positive for SARS-CoV-2 based on RT-PCR results, while 34 (17.3%) tested positive based on serological IgM/IgG expression. Additionally, 13 (6.8%) subjects tested positive based on serological test results, but also tested negative based on RT-PCR results. The rapid serological test had a sensitivity of 30% and a specificity of 89% compared to the standard RT-PCR assay. Interestingly, the performance of both assays improved 8 days after symptom appearance. After 10 days had passed since symptom appearance, the predictive value of the rapid serological test was higher than that of the standard molecular assay (proportion of positive results: 40% vs 20%). Multivariate analysis showed that age >58 years (P<.01) and period of >15 days after symptom onset (P<.02) were significant and independent factors associated with serological test positivity. CONCLUSIONS The rapid serological test analyzed in this study seems limited in terms of usefulness when diagnosing SARS-CoV-2 infection. However, it may be useful for providing relevant information on people’s immunoreaction to COVID-19 exposure.
Angelo Virgilio Paradiso; Simona De Summa; Daniela Loconsole; Vito Procacci; Anna Sallustio; Francesca Centrone; Nicola Silvestris; Vito Cafagna; Giuseppe De Palma; Antonio Tufaro; Vito Michele Garrisi; Maria Chironna. Rapid Serological Assays and SARS-CoV-2 Real-Time Polymerase Chain Reaction Assays for the Detection of SARS-CoV-2: Comparative Study (Preprint). 2020, 1 .
AMA StyleAngelo Virgilio Paradiso, Simona De Summa, Daniela Loconsole, Vito Procacci, Anna Sallustio, Francesca Centrone, Nicola Silvestris, Vito Cafagna, Giuseppe De Palma, Antonio Tufaro, Vito Michele Garrisi, Maria Chironna. Rapid Serological Assays and SARS-CoV-2 Real-Time Polymerase Chain Reaction Assays for the Detection of SARS-CoV-2: Comparative Study (Preprint). . 2020; ():1.
Chicago/Turabian StyleAngelo Virgilio Paradiso; Simona De Summa; Daniela Loconsole; Vito Procacci; Anna Sallustio; Francesca Centrone; Nicola Silvestris; Vito Cafagna; Giuseppe De Palma; Antonio Tufaro; Vito Michele Garrisi; Maria Chironna. 2020. "Rapid Serological Assays and SARS-CoV-2 Real-Time Polymerase Chain Reaction Assays for the Detection of SARS-CoV-2: Comparative Study (Preprint)." , no. : 1.
In the originally published article, the name of the 8th author Michele Quarto was inadvertently omitted during typesetting. Author’s name is now correctly captured above. Also, the collaborators of...
Daniela Loconsole; Bloody Diarrhea Apulia Working Group; Mario Giordano; Nicola Laforgia; Diletta Torres; Luisa Santangelo; Vincenza Carbone; Antonio Parisi; Michele Quarto; Gaia Scavia; Maria Chironna. Correction to: Case-management protocol for bloody diarrhea as a model to reduce the clinical impact of Shiga toxin-producing Escherichia coli infections. Experience from Southern Italy. European Journal of Clinical Microbiology & Infectious Diseases 2019, 39, 549 -549.
AMA StyleDaniela Loconsole, Bloody Diarrhea Apulia Working Group, Mario Giordano, Nicola Laforgia, Diletta Torres, Luisa Santangelo, Vincenza Carbone, Antonio Parisi, Michele Quarto, Gaia Scavia, Maria Chironna. Correction to: Case-management protocol for bloody diarrhea as a model to reduce the clinical impact of Shiga toxin-producing Escherichia coli infections. Experience from Southern Italy. European Journal of Clinical Microbiology & Infectious Diseases. 2019; 39 (3):549-549.
Chicago/Turabian StyleDaniela Loconsole; Bloody Diarrhea Apulia Working Group; Mario Giordano; Nicola Laforgia; Diletta Torres; Luisa Santangelo; Vincenza Carbone; Antonio Parisi; Michele Quarto; Gaia Scavia; Maria Chironna. 2019. "Correction to: Case-management protocol for bloody diarrhea as a model to reduce the clinical impact of Shiga toxin-producing Escherichia coli infections. Experience from Southern Italy." European Journal of Clinical Microbiology & Infectious Diseases 39, no. 3: 549-549.
Gaetano Brindicci; Daniela Loconsole; Danilo Carboni; Roberto Genga; Eleonora Moschini; Giulia Montorzi; Felicetta Viscogliosi; Marco Pompili; Massimo Agostini; Gabriele Ripanti. Incidence of pertussis in the province of Pesaro-Urbino (Italy). 2019, 27, 393 -397.
AMA StyleGaetano Brindicci, Daniela Loconsole, Danilo Carboni, Roberto Genga, Eleonora Moschini, Giulia Montorzi, Felicetta Viscogliosi, Marco Pompili, Massimo Agostini, Gabriele Ripanti. Incidence of pertussis in the province of Pesaro-Urbino (Italy). . 2019; 27 (4):393-397.
Chicago/Turabian StyleGaetano Brindicci; Daniela Loconsole; Danilo Carboni; Roberto Genga; Eleonora Moschini; Giulia Montorzi; Felicetta Viscogliosi; Marco Pompili; Massimo Agostini; Gabriele Ripanti. 2019. "Incidence of pertussis in the province of Pesaro-Urbino (Italy)." 27, no. 4: 393-397.
To describe an operating protocol for bloody diarrhea (BD) in a pediatric population as a rapid response to a public health threat represented by an excess of pediatric HUS cases in the Apulia region (Southern Italy) starting from 2013. The protocol was set up with the goal of correct clinical management of Shiga toxin-producing Escherichia coli (STEC) infections, reductions in subsequent cases of hemolytic uremic syndrome (HUS), and improved short- and long-term disease outcomes. The protocol consisted of rapid hospitalization of children with bloody diarrhea (BD), hematochemical laboratory tests every 12–24 hours, and prompt laboratory diagnosis of STEC. No antibiotics were recommended until diagnosis. Children positive for STEC infections underwent early vigorous volume expansion. In June–December 2018, 438 children with BD were hospitalized, of which 53 (12.1%) had a STEC infection. The most common serogroups were O26 (36.1%), O111 (23.0%), and O157 (14.8%). Thirty-one samples carried the stx2 gene. Four cases evolved into HUS (7.5%), all with favorable outcome despite neurological involvement in two cases. Prompt and accurate laboratory diagnosis of STEC infections is of the utmost importance in patients with BD for correct clinical management. The strict adherence to the protocol could reduce the progression rate of STEC infections to HUS and prevents complications. Enhanced BD surveillance may help reduce cases of pediatric HUS in Southern Italy.
Daniela Loconsole; Bloody Diarrhea Apulia Working Group; Mario Giordano; Nicola Laforgia; Diletta Torres; Luisa Santangelo; Vincenza Carbone; Antonio Parisi; Michele Quarto; Gaia Scavia; Maria Chironna. Case-management protocol for bloody diarrhea as a model to reduce the clinical impact of Shiga toxin-producing Escherichia coli infections. Experience from Southern Italy. European Journal of Clinical Microbiology & Infectious Diseases 2019, 39, 539 -547.
AMA StyleDaniela Loconsole, Bloody Diarrhea Apulia Working Group, Mario Giordano, Nicola Laforgia, Diletta Torres, Luisa Santangelo, Vincenza Carbone, Antonio Parisi, Michele Quarto, Gaia Scavia, Maria Chironna. Case-management protocol for bloody diarrhea as a model to reduce the clinical impact of Shiga toxin-producing Escherichia coli infections. Experience from Southern Italy. European Journal of Clinical Microbiology & Infectious Diseases. 2019; 39 (3):539-547.
Chicago/Turabian StyleDaniela Loconsole; Bloody Diarrhea Apulia Working Group; Mario Giordano; Nicola Laforgia; Diletta Torres; Luisa Santangelo; Vincenza Carbone; Antonio Parisi; Michele Quarto; Gaia Scavia; Maria Chironna. 2019. "Case-management protocol for bloody diarrhea as a model to reduce the clinical impact of Shiga toxin-producing Escherichia coli infections. Experience from Southern Italy." European Journal of Clinical Microbiology & Infectious Diseases 39, no. 3: 539-547.