Caggiano G

SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients.

PurposeWe compared the risk factors, the diagnostic tools and the outcome of filamentous fungal infections (FFIs) in hematological patients (HAEs) and non-hematological patients (non-HAEs).MethodsProspective surveillance (2009–2011) of proven and probable FFIs was implemented in 23 Italian hospitals.ResultsOut of 232 FFIs, 113 occurred in HAEs and 119 in non-HAEs. The most frequent infection was invasive aspergillosis (76.1xa0% for HAEs, 56.3xa0% for non-HAEs), and the localization was principally pulmonary (83.2xa0% for HAEs, 74.8xa0% for non-HAEs). Neutropenia was a risk factor for 89.4xa0% HAEs; the main underlying condition was corticosteroid treatment (52.9xa0%) for non-HAEs. The distribution of proven and probable FFIs was different in the two groups: proven FFIs occurred more frequently in non-HAEs, whereas probable FFIs were correlated with the HAEs. The sensitivity of the galactomannan assay was higher for HAEs than for non-HAEs (95.3 vs. 48.1xa0%). The overall mortality rate was 44.2xa0% among the HAEs and 35.3xa0% among the non-HAEs. The etiology influenced the patient outcomes: mucormycosis was associated with a high mortality rate (57.1xa0% for HAEs, 77.8xa0% for non-HAEs).ConclusionsThe epidemiological and clinical data for FFIs were not identical in the HAEs and non-HAEs. The differences should be considered to improve the management of FFIs according to the patients’ setting.

Cavernicolous habitats harbouring Cryptococcus neoformans: results of a speleological survey in Apulia, Italy, 1999–2000

Twenty-five caves of speleological and palaeontological interest were investigated for the presence of Cryptococcus spp. within the Apulia region of Italy. Five hundred and forty-five specimens of soil, mud, animal faeces, water and decayed animal and plant remains were examined. Faecal specimens from bats, pigeons and foxes in three caves yielded Cryptococcus neoformans var. neoformans and C. laurentii, C. neoformans var. neoformans and C. albidus were isolated from two soil specimens. Only three caves were positive for the presence of C. neoformans, but the survey documents the finding of a possible natural reservoir in Apulia. It is the first record of occurrence of this yeast in association with cavernicolous habitats, and indicates the potential role of caves in exposing speleologists to life-threatening fungal infections.

Prevalence and characterization of methicillin-resistant Staphylococcus aureus isolates in food industry workers.

BACKGROUNDnMethicillin-resistant S. aureus (MRSA) is a pathogen spread not only in the hospital environment but also in the community and amongst livestock (LA-MRSA). LA-MRSA can be transmitted to humans that live in close contact with MRSA-colonized animals, and human colonization and/or infection has been reported worldwide, particularly among those involved with livestock farming. In this study the authors evaluated the prevalence of S. aureus and MRSA among healthy carriers who worked in the food industry in Apulia, Southern Italy.nnnMETHODSnNasal swabs were taken from pasta and pork industry workers. All swab samples were subjected to tests for the isolation, identification and typing of S. aureus and MRSA strains. The identification of the strains was confirmed by molecular assessment using multiplex-PCR for the amplification of the nuc and mecA genes. The strains identified as MRSA were then subjected to a PCR protocol for the characterization of sequence type ST398.nnnRESULTSnIn total 26.3% of examined nasal swabs were positive for S. aureus, 8.2% of them were methicillin resistant strains and 28.5% of MRSA isolates were characterized as ST398. The MRSA prevalence among pork factory workers was 3% , whereas among the pasta operators the prevalence was 11.5.nnnCONCLUSIONnThe presence of S. aureus and MRSA among food workers represents a public health risk. Further, considering the dissemination of S. aureus and MRSA among non-nosocomial environments, including communities and livestock, careful surveillance and continuous monitoring of the emergence of MRSA is fundamental for safeguarding public health.

Alternaria is an Infrequent Cause of Keratitis: A Case Report and Review of the Literature

Objective: To report a case of fungal keratitis caused by Alternaria in a 49-year-old female who developed an acute onset of eye infection after ocular trauma caused by an olive leaf. Methods: The clinical presentation, microbiological diagnosis, and therapeutic approaches are reported. Results: The patient was referred to our university hospital clinic with corneal abscess in her left eye. Before the start of an empirical antibacterial therapy (both topical and systemic), a swab of the cornea was obtained which at microscopic examination revealed a few fragments of hyphal elements, probably for the paucity of material collected. After one week, the corneal abscess had increased in size, and the corneal stroma was filled with filamentous structures similar to fungal hyphae. Oral and topical voriconazole was administered because of the clinical picture and the response of microbiological laboratory whose examination of the material removed from the anterior chamber showed numerous hyphal fragments identified by culture as Alternaria spp. The corneal abscess healed in two weeks, but the patient now has a corneal scar and is awaiting a corneal transplant. Conclusions: Ophthalmologists and microbiologists must take fungi into greater consideration as a possible cause of keratitis as they are emerging as the cause of this infectious disease in many countries. Voriconazole spreads well in the eye and is effective in the cure of fungal keratitis including those caused by Alternaria.

Food labelling: Regulations and Public Health implications

Legislators have implemented policies to improve food labelling to protect consumers and to make the presentation of ingredients and nutritional information more transparent. Proper food labelling allows consumers who may suffer from food allergies or intolerances to know exactly what ingredients a product contains, and it also helps them make more informed health and nutrition choices. This paper deals with the most current European and Italian legislation on food labelling, actions taken in non-EU countries to increase health choices, and the expected impact on Public Health.

The aquifer recharge: an overview of the legislative and planning aspect

In most regions of the world, safeguarding groundwater resources is a serious issue, particularly in coastal areas where groundwater is the main water source for drinking, irrigation and industry. Water availability depends on climate, topography and geology. The aim of this paper is to evaluate aquifer recharge as a possible strategy to relieve water resource scarcity. Natural aquifer recharge is defined as the downward flow of water reaching the water table, increasing the groundwater reservoir. Hydro-meteorological factors (rainfall, evapotranspiration and runoff) may alter natural recharge processes. Artificial aquifer recharge is a process by which surface water is introduced with artificial systems underground to fill an aquifer. As a consequence of global warming that has increased the frequency and severity of natural disasters like the drought, the impacts of climate change and seasonality, the artificial recharge has been considered as a viable option. Different direct and indirect techniques can be used, and the choice depends on the hydrologic characteristics of a specific area. In Italy, Legislative Decree no. 152/06 plans artificial aquifer recharge as an additional measure in water management, and Decree no. 100/2016 establishes quantitative and qualitative conditions for recharge. Many projects examine aquifer recharge, such us WADIS-MAR in the southern Mediterranean region, WARBO in Italy and municipal wastewater treatment project in Apulia, a southern Italian region. However, aside from groundwater recharge, the community must foster a spirit of cooperation to manage groundwater as a sustainable resource.