Lucia Rossi

Saccharomyces cerevisiae fungemia in a neutropenic patient treated with Saccharomyces boulardii

Abstract A case of Saccharomyces fungemia in an 8-month-old baby affected by acute myeloid leukemia while receiving intensive chemotherapy is reported. The patient was receiving prophylaxis treatment with Saccharomyces boulardii capsules (Codex) to prevent diarrhea, which is commonly associated with this type of chemotherapy. Fever spiked just the day after ending the chemotherapy course, and a strain of Saccharomyces cerevisiae was isolated from blood culture although the patient was also receiving antifungal prophylaxis with fluconazole. The patient recovered, though still neutropenic, with amphotericin-B and removal of the central venous catheter. The common biochemical characteristics make it difficult to differentiate between the strain of Saccharomyces cerevisiae and that of Saccharomyces boulardii with routine methods. In other cases, authors demonstrated an identity between the two strains with a more detailed analysis. These reports raise concern about the potential side effects of such biotherapeutic agents.

Measurements of the proton-proton total cross section and small angle elastic scattering at ISR energies

Measurements of the total cross section have been performed at the ISR with c.m. energies between 23.5 GeV and 62.5 GeV. Two independent experimental methods have been applied, a measurement of total interaction rate and of small angle elastic scattering. Both experiments give consistent results showing that the total cross section increases by (11.8±1.5) % over the ISR energy range. This experiment has also measured the slope of the forward diffraction peak in elastic scattering at small momentum transfer. The elastic cross section shows the same relative rise as the total cross section, and the ratio λ of elastic to total cross section approaches a constant value of λ=0.178±0.003.

Leuconostoc Species: A Case-cluster Hospital Infection

Leuconostoc species are members of the Streptococcacae family. They are generally regarded as non-pathogenic culture contaminants and are thought to be an uncommon cause of infection. We present a study of a case-cluster nosocomial infection due to Leuconostoc spp. Three patients were hospitalized at the time of the infection with significant underlying diseases and all had a compromised skin and mucous barriers. Two had received previous antibiotic therapy. This report highlights the importance of Leuconostoc spp. as an emerging pathogen, even though the modes of transmission and reservoirs of Leuconostoc spp. are as yet unknown.

Successful treatment of disseminated fusariosis in a child with acute myelogenous leukaemia with medical and surgical approach

We report a case of disseminated fusariosis in an 8‐year‐old boy with acute myelogenous leukaemia that occurred whilst the patient was severely neutropenic after high‐dose chemotherapy. Lung involvement was associated with recurrent typical skin lesions. Despite a significant clinical and radiological improvement with voriconazole‐based antifungal therapy, granulocyte transfusions (GTXs) and surgical excision of residual lesions were necessary to achieve a complete response before the patient proceeded to allogeneic stem‐cell transplantation from an alternative donor. Voriconazole was continued for 6 months after transplant as secondary prophylaxis. After 15 months of follow‐up, the patient is alive and well, and in complete remission of his underlying disease. Triazoles have the potential for improving the cure rate of Fusarium infections but both surgery and shortening the duration of neutropenia by GTXs are important factors in optimising the results.

Oxybiotest project: microorganisms under pressure. Hyperbaric oxygen (HBO) and simple pressure interaction on selected bacteria

BackgroundHyperBaric Oxygen (HBO) therapy involves exposure to pure oxygen in a pressurized room, and it is an already well-established treatment for various conditions, including those originated by serious infections. Starting from the observation of an increased number of patients who were accessing our HBO units for diseases supported from concomitant multidrug-resistant microorganisms, as well as considering the evident clinical benefit and laboratory final outcome of those patients at the end of the treatment, aim of our study was to measure, or better define at least, if there was any interaction between a hyperbaric environment and some selected microorganisms and if those positive results were due to the increased oxygen partial pressure (pO2) value or just to the increased pressure, regardless of the fraction of inspired oxygen (FiO2) applied (21÷100%).Design and methodsWe applied various increased pO2 values in a hyperbaric environment. Our study design was tailored in four steps to answer four specific questions, ordered in a progressive process: OxyBioTest (OBT)-1,2,3, and 4. Specifically, we chose to investigate possible changes in the Minimum Inhibitory Concentration (MIC) and in the Minimum Bactericidal Concentration (MBC) of multi-resistant microorganisms after a single session of hyperbaric therapy.ResultsOBT-1 and OBT-2 provide a semi-quantitative confirmation of the bacterio-cidal and cytostatic effects of HBO. HBO is cidal only if the total exposure pressure is elevated, and cidal or cytostatic effect are not always dependent on the pO2 applied.OBT-4 has shown the adjuvant effect of HBO and antimicrobial drug against some selected bacteria.DiscussionWe seem allowed to hypothesize that only in case of a good approach to a lesion, permitting smaller bacterial loads thanks to surgical debridement and/or eventual antibiotic therapy for example, You can observe the clear effectiveness of the HyperBaric Oxygen (HBO) exposure as a valid adjuvant therapy, even when that lesion is substained from multidrug-resistant micro-organisms. On the contrary when the bacterial load is very high we observe an unchanged situation or a just a slightly diminishing in the number of cfu/ml.ConclusionsEven if confined in this ‘in vitro’ environment and in a single treatment, just knowing the microorganism strain responsible of the lesion we seem allowed to both weight the possible related effectiveness using HBO Therapy (HBOT) and derive the best pO2 to treat the case. A further possible development of the study highlights a comparison between Acinetobacter baumannii (ACBA) and Pseudomonas aeruginosa (PSAE), and Escherichia coli (ESCO) and Klebsiella pneumoniae (KLPN).

Vibrio cholerae non-O1, non-O139 bacteraemia associated with pneumonia, Italy 2016

This paper describes an elderly male patient, living in the Veneto Region, Italy, who developed Vibrio cholerae bacteraemia and pneumonia. Some days previously, while on holiday in the Lagoon of Venice, he had been collecting clams in seawater, during which he suffered small abrasions of the skin. On admission to hospital, he was confused, had fever and a cough, but neither diarrhoea nor signs of gastroenteritis were found. Both blood and stool cultures grew V. cholerae of non-O1 non-O-139 type, and the patient recovered after prompt administration of intravenous ceftriaxone for 2 weeks. This clinical case emphasises the role of global warming and climate changes in causing increasing numbers of water-borne infections.