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Microorganisms
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State-of-the-Art Medical Microbiology in Italy (2023, 2024)
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State-of-the-Art Medical Microbiology in Italy (2023, 2024)

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (15 December 2024) | Viewed by 10871

Special Issue Editor

Prof. Dr. Antonella d'Arminio Monforte

E-Mail Website
Guest Editor
1. Icona Foundation, 20142 Milan, Italy
2. Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy
Interests: liver diseases; HIV infection; HIV prevention; tuberculosis; clinical infectious diseases; infectious disease epidemiology; mycobacterium tuberculosis; viral infection; immunology of infectious diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue aims to provide a comprehensive overview of state-of-the-art Medical Microbiology in Italy. We encourage Italian researchers from related fields to contribute papers highlighting the latest developments in Medical Microbiology or to invite relevant experts and colleagues to do so. The Special Issue will publish full research articles and comprehensive reviews.

Prof. Dr. Antonella d'Arminio Monforte
Guest Editor

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Published Papers (6 papers)

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Research

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10 pages, 472 KiB  
Article
The Role of the OLM CandID Real-Time PCR in the Invasive Candidiasis Diagnostic Surveillance in Intensive Care Unit Patients
by Laura Trovato, Maddalena Calvo, Concetta Ilenia Palermo, Maria Rita Valenti and Guido Scalia
Microorganisms 2025, 13(3), 674; https://doi.org/10.3390/microorganisms13030674 - 18 Mar 2025
Viewed by 508
Abstract
Molecular techniques recently integrated the candidiasis diagnostic workflow, avoiding the culture-based prolonged turn-around time and lack of sensitivity. The present retrospective study evaluated the OLM CandID Real-Time PCR on serum samples in the early and rapid candidaemia diagnosis among ICU patients. The final [...] Read more.
Molecular techniques recently integrated the candidiasis diagnostic workflow, avoiding the culture-based prolonged turn-around time and lack of sensitivity. The present retrospective study evaluated the OLM CandID Real-Time PCR on serum samples in the early and rapid candidaemia diagnosis among ICU patients. The final purpose of the protocol was to demonstrate the effectiveness of a PCR assay in the invasive candidiasis diagnostic workflow due to the high sensitivity rates and species identification possibility. The evaluation screened 60 suitable patients, accounting for 10 probable and 7 proven candidiasis cases. Patients with at least a positive (1→3)-β-D-glucan (BDG) value underwent molecular procedures. A sensitivity of 83.3%, a specificity of 94.3%, a positive predictive value of 87.5%, and a negative predictive value of 91.7% emerged for the PCR assay. As a conclusion, Candida PCR assays may represent useful diagnostic assistance tools when applied together with serological markers and culture-based assays. Full article
(This article belongs to the Special Issue State-of-the-Art Medical Microbiology in Italy (2023, 2024))
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12 pages, 848 KiB  
Article
Infection-Related Stillbirths: A Detailed Examination of a Nine-Year Multidisciplinary Study
by Liliana Gabrielli, Matteo Pavoni, Francesca Monari, Federico Baiesi Pillastrini, Maria Paola Bonasoni, Chiara Locatelli, Maria Bisulli, Alessandra Vancini, Ilaria Cataneo, Margherita Ortalli, Giulia Piccirilli, Alessia Cantiani, Simone Ambretti, Fabio Facchinetti and Tiziana Lazzarotto
Microorganisms 2025, 13(1), 71; https://doi.org/10.3390/microorganisms13010071 - 2 Jan 2025
Cited by 1 | Viewed by 896
Abstract
Background: Although several conditions and specific risk factors have been associated with stillbirth (SB), in most of the cases it is difficult to identify the definitive etiopathology and cause of death. Specifically, the role of infections in SB is still debated. Our aim [...] Read more.
Background: Although several conditions and specific risk factors have been associated with stillbirth (SB), in most of the cases it is difficult to identify the definitive etiopathology and cause of death. Specifically, the role of infections in SB is still debated. Our aim was to study maternal, placental, and fetal tissues in cases of SB in order to define the causative link between infections and fetal death, through a multidisciplinary clinical audit. Methods: Between 2014 and 2022, microbiological investigations on maternal, placental and fetal samples of SB cases were performed according to a standardized protocol including serology, cultures, and molecular biology. Autopsies and placental examination were mandatory in all SB cases. Results: A total of 182 cases of SB were investigated. Bacteria were detected in 22.2% of vaginal swabs, 65% of placental biopsies, 29% of fetal blood, and 14.1% of oropharyngeal swabs. Vaginal and oropharyngeal swabs were positive for urogenital mycoplasmas in 25.2% and 8.6%, respectively. Positive results of microbiological investigations, in association with histological features suggestive of infection, were observed in six cases, indicating that fetal death was likely related to a bacterial infection. In one case, a high SARS-CoV-2 load was found in the placenta of a SB due to placental abruption. Conclusions: Infections were likely associated with fetal death in 3.8% of cases. Thus, in developed countries, an infection, defined when positive microbiological findings are associated with histological evidence of organ damage, is a minor contributory factor in SB. Full article
(This article belongs to the Special Issue State-of-the-Art Medical Microbiology in Italy (2023, 2024))
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10 pages, 2780 KiB  
Article
Chip-Based Molecular Evaluation of a DNA Extraction Protocol for Candida Species from Positive Blood Cultures
by Vittorio Ivagnes, Giulia Menchinelli, Flora Marzia Liotti, Elena De Carolis, Riccardo Torelli, Desy De Lorenzis, Cinzia Recine, Maurizio Sanguinetti, Tiziana D’Inzeo and Brunella Posteraro
Microorganisms 2024, 12(1), 81; https://doi.org/10.3390/microorganisms12010081 - 31 Dec 2023
Cited by 1 | Viewed by 1810
Abstract
The diagnosis of Candida bloodstream infection (BSI) may rely on a PCR-based analysis of a positive blood culture (PBC) obtained from the patient at the time of BSI. In this study, a yeast DNA extraction protocol for use on PBCs was developed and [...] Read more.
The diagnosis of Candida bloodstream infection (BSI) may rely on a PCR-based analysis of a positive blood culture (PBC) obtained from the patient at the time of BSI. In this study, a yeast DNA extraction protocol for use on PBCs was developed and evaluated with the molecular mouse (MM) yeast blood (YBL) chip-based PCR assay, which allowed us to detect nine medically relevant Candida species. We studied 125 simulated or clinical PBCs for Candida species. A positive correlation between the DNA concentration and colony-forming unit count was found for simulated (Spearman’s ρ = 0.58; p < 0.0001) and clinical (Spearman’s ρ = 0.23, p = 0.09) PBCs. The extracted DNA yielded positive results with the MM YBL chip assay that agreed with the Candida species-level identification results for 63 (100%) of 63 isolates from simulated PBCs and 66 (99.5%) of 67 isolates from clinical PBCs. The false-negative result was for one C. tropicalis isolate that grew together with C. albicans in PBC. None of the 30 (Candida)-negative clinical BCs included as negative controls yielded a positive result with the MM YBL chip assay. Our DNA extraction protocol for the Candida species couples efficiency and simplicity together. Nevertheless, further studies are needed before it can be adopted for use with the MM YBL chip assay. Full article
(This article belongs to the Special Issue State-of-the-Art Medical Microbiology in Italy (2023, 2024))
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10 pages, 754 KiB  
Communication
Intersociety Position Statement on the Prevention of Ophthalmia Neonatorum in Italy
by Chryssoula Tzialla, Cinzia Auriti, Salvatore Aversa, Daniele Merazzi, Stefano Martinelli, Gabriella Araimo, Luca Massenzi, Giacomo Cavallaro, Luigi Gagliardi, Mario Giuffrè, Fabio Mosca, Irene Cetin, Vito Trojano, Herbert Valensise, Nicola Colacurci, Luigi Orfeo, Vito Mondì and on behalf of their respective Scientific Societies
Microorganisms 2024, 12(1), 15; https://doi.org/10.3390/microorganisms12010015 - 21 Dec 2023
Cited by 2 | Viewed by 2507
Abstract
There is currently no worldwide agreement on the real need to administer conjunctival antibiotics to neonates at birth to prevent neonatal conjunctivitis (usually defined as ophthalmia neonatorum) by Chlamydia trachomatis and Neisseria gonorrhoeae. Therefore, there is wide variability in antibiotic administration, conditioned [...] Read more.
There is currently no worldwide agreement on the real need to administer conjunctival antibiotics to neonates at birth to prevent neonatal conjunctivitis (usually defined as ophthalmia neonatorum) by Chlamydia trachomatis and Neisseria gonorrhoeae. Therefore, there is wide variability in antibiotic administration, conditioned mainly by the social and health context. In Italy, a law enacted in 1940 required doctors and midwives to administer ophthalmic prophylaxis with 2% silver nitrate to all newborns at birth. This law was repealed in 1975 and since then there has been no clear guidance on the use of ophthalmia neonatorum prophylaxis at birth. Since neonatal conjunctivitis caused by C. trachomatis and N. gonorrhoeae is not reported, we carried out a nationwide survey of 1,041,384 neonates across all Italian birth centers to evaluate the incidence of ophthalmia neonatorum and the current practice of prophylaxis. After analyzing the results, we formulated an intersociety position statement on the prevention of ophthalmia neonatorum to update and standardize this prevention strategy in Italy. Full article
(This article belongs to the Special Issue State-of-the-Art Medical Microbiology in Italy (2023, 2024))
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15 pages, 587 KiB  
Article
Epidemiological and Molecular Investigation of the Heater–Cooler Unit (HCU)-Related Outbreak of Invasive Mycobacterium chimaera Infection Occurred in Italy
by Angela Cannas, Antonella Campanale, Daniela Minella, Francesco Messina, Ornella Butera, Carla Nisii, Antonio Mazzarelli, Carla Fontana, Lucia Lispi, Francesco Maraglino, Antonino Di Caro and Michela Sabbatucci
Microorganisms 2023, 11(9), 2251; https://doi.org/10.3390/microorganisms11092251 - 7 Sep 2023
Cited by 8 | Viewed by 2142
Abstract
Background: From 2013 onwards, a large outbreak of Mycobacterium chimaera (MC) invasive infection, which was correlated with the use of contaminated heater–cooler units (HCUs) during open chest surgery, was reported from all over the world. Here, we report the results of the epidemiological [...] Read more.
Background: From 2013 onwards, a large outbreak of Mycobacterium chimaera (MC) invasive infection, which was correlated with the use of contaminated heater–cooler units (HCUs) during open chest surgery, was reported from all over the world. Here, we report the results of the epidemiological and molecular investigations conducted in Italy after the alarm raised about this epidemic event. Methods: MC strains isolated from patients or from HCU devices were characterized by genomic sequencing and molecular epidemiological analysis. Results: Through retrospective epidemiological analysis conducted between January 2010 and December 2022, 40 possible cases of patients infected with MC were identified. Thirty-six strains isolated from these patients were analysed by whole genome sequencing (WGS) and were found to belong to the genotypes 1.1 or 1.8, which are the genotypes correlated with the outbreak. Most of the cases presented with prosthetic valve endocarditis, vascular graft infection or disseminated infection. Among the cases found, there were 21 deaths. The same analysis was carried out on HCU devices. A total of 251 HCUs were found to be contaminated by MC; genotypes 1.1 or 1.8 were identified in 28 of those HCUs. Conclusions: To ensure patients’ safety and adequate follow-up, clinicians and general practitioners were made aware of the results and public health measures, and recommendations were issued to prevent further cases in the healthcare settings. The Italian Society of Cardiac Surgery performed a national survey to assess the incidence of HCU-related MC prosthetic infections in cardiac surgery. No cases were reported after HCU replacement or structural modification and disinfection and possibly safe allocation outside surgical rooms. Full article
(This article belongs to the Special Issue State-of-the-Art Medical Microbiology in Italy (2023, 2024))
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32 pages, 2048 KiB  
Systematic Review
Antimicrobial Lock Therapy in Clinical Practice: A Scoping Review
by Aniello Alfieri, Sveva Di Franco, Maria Beatrice Passavanti, Maria Caterina Pace, Vittorio Simeon, Paolo Chiodini, Sebastiano Leone and Marco Fiore
Microorganisms 2025, 13(2), 406; https://doi.org/10.3390/microorganisms13020406 - 13 Feb 2025
Cited by 1 | Viewed by 1651
Abstract
Antimicrobial lock therapy (ALT) prevents microbial colonization in central vein catheters and treats existing catheter-related bloodstream infections (CRBSIs); the ALT assessment involves several key considerations. First, identifying which patients are suitable candidates is crucial. Additionally, understanding the clinical contexts in which is utilised [...] Read more.
Antimicrobial lock therapy (ALT) prevents microbial colonization in central vein catheters and treats existing catheter-related bloodstream infections (CRBSIs); the ALT assessment involves several key considerations. First, identifying which patients are suitable candidates is crucial. Additionally, understanding the clinical contexts in which is utilised provides insight into its applications. Examining when ALT has been employed and analyzing trends in its use over time can highlight its evolving role in patient care. Equally important is understanding how ALT is administered, including the specific agents used. Lastly, determining whether there is sufficient existing literature is essential to evaluate the feasibility of conducting future systematic reviews. This study is a scoping review adhered to the PRISMA-ScR guidelines and followed a five-stage methodological framework. Of the 1024 studies identified, 336 were included in the analysis. Findings highlight the widespread use of ethanol and taurolidine for CRBSIs prevention and the concurrent use of ALT with systemic antimicrobials to treat CRBSIs without catheter removal. ALT improves clinical outcomes, including post-infection survival and catheter retention. From our analysis, we have concluded that both an umbrella review of systematic reviews and a network meta-analysis comparing lock solutions can provide clearer guidance for clinical practice. Full article
(This article belongs to the Special Issue State-of-the-Art Medical Microbiology in Italy (2023, 2024))
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