Alessandro Russo - Academia.edu (original) (raw)

Papers by Alessandro Russo

Diabetes Research and Clinical Practice, 2013

Our study aimed to observe, in patients with recent onset type 2 diabetes, the activity of the au... more Our study aimed to observe, in patients with recent onset type 2 diabetes, the activity of the autonomic nervous system evaluated by heart rate variability (HRV) analysis during 24-h ECG recording and glucose metabolic impairment, measured by continuous glucose monitoring. The data indicate hyperactivity of the sympathetic component with loss of circadian rhythm and minimal changes in glucose values. The role of glycemia appeared to be less important than that of insulin resistance.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Jan 3, 2016

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Jan 2, 2016

The aim of this study is to identify factors associated with mortality in ICU patients with KPC-K... more The aim of this study is to identify factors associated with mortality in ICU patients with KPC-Kp septic shock. A retrospective analysis of ICU patients with KPC-Kp infection and septic shock observed in a large teaching hospital from November 2010 to December 2014 was performed. A total of 111 patients were included in the study. The most frequent source of infection was unknown focus bacteremia in 53 (47.7%) patients. The rate of resistance to colistin was 51.3%; 30-day mortality was reported for 44 (39.6%) patients. Surviving patients were more frequently treated with an initial therapy (within 24 hours) including ≥2 antibiotics displaying in vitro activity against the isolated KPC-Kp strain (41.8% Vs 18.1%, p=0.01), and were also more likely to receive a definitive therapy including ≥2 in vitro active antibiotics (85.1% Vs 15.9%, p<0.001). Cox regression analysis revealed that a colistin-containing antibiotic regimen (Hazard ratio [HR] 0.21, CI 95% 0.05-0.72, p<0.001), us...

Infectious Disease Reports, 2015

Intensive Care Medicine, 2015

Infectious disease reports, Jan 11, 2015

Gram-positive cocci are emerging causes of spontaneous bacterial peritonitis (SBP), especially in... more Gram-positive cocci are emerging causes of spontaneous bacterial peritonitis (SBP), especially in patients with healthcare-associated infections. We report the case of a 68-year-old man with hepatitis C virus and alcohol-related cirrhosis who developed SBP due to methicillin-resistant Staphylococcus aureus treated with daptomycin. We discuss the potential role of daptomycin in this setting with a review of the literature about the use of daptomycin in primary or secondary bacterial peritonitis.

Antimicrobial agents and chemotherapy, Jan 19, 2015

To determine the incidence, risk factors, and outcomes of bloodstream infections (BSI) subsequent... more To determine the incidence, risk factors, and outcomes of bloodstream infections (BSI) subsequent to Clostridium difficile infection (CDI). Retrospective study of all patients with definite diagnosis of CDI admitted from January 2014 to December 2014 in two large Hospitals in Rome. Two groups of patients were analyzed: those with CDI and subsequent BSI (CDI/BSI+), and those with CDI and no evidence of primary BSI (CDI/BSI-). Data about clinical features, microbiology, treatments and mortality were obtained. Overall, 393 cases of CDI were included in the final analysis: 72 developed a primary nosocomial BSI while 321 had CDI without microbiological and clinical evidence of BSI. Etiologic agents of BSI were Candida species (47.3%), Enterobacteriaceae (19.4%), enterococci (13.9%), and mixed infections (19.4%). In multivariate analysis ribotype 027 (odds ratio [OR] 6.5), CDI recurrence (OR 5.5), severe CDI infection (OR 8.3), and oral vancomycin >500 mg/day (OR 3.1) were recognized a...

Internal and Emergency Medicine

About 90% of TB-infected individuals develop a latent tuberculosis (TB) infection, which means th... more About 90% of TB-infected individuals develop a latent tuberculosis (TB) infection, which means the infecting bacteria are alive in the body but inactive. The assessment of latent infection relies on the measurement of host immune responses as a surrogate for the presence of viable bacteria. Although these carriers do not have TB symptoms and cannot spread the infection to others, they are at risk of developing an active infection that is both symptomatic and contagious. Given the risks of drug resistance and of treatment failure if patients with unsuspected active tuberculosis treated with a single-drug regimen, careful evaluation for active disease must precede initiation of treatment for latent infection. Clinicians should be aware that nowadays TB occurs in sites other than the lungs and that these sites account for an increasing proportion of cases of TB. A high clinical suspicion is required in the elderly, since symptoms may be masked by generalized debility.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Jan 14, 2015

The alterations occurring in the intestinal flora during Clostridium difficile infection (CDI) ma... more The alterations occurring in the intestinal flora during Clostridium difficile infection (CDI) may promote the translocation of Candida to the blood and the development of candidaemia. The aim of our study was to analyse clinical findings of these patients to determine the risk factors associated with the development of candidaemia subsequent to CDI. We compared 35 patients with candidaemia subsequent to CDI with 105 patients with CDI. Patients with candidaemia showed more severe infections and higher mortality. The ribotype 027 strain and vancomycin treatment at ≥1000 mg/day were prevalent in patients developing candidaemia. CDI may predispose to the translocation of Candida.

Journal of Chemotherapy, 2010

Candida species are the most common causes of invasive fungal infections in humans, producing inf... more Candida species are the most common causes of invasive fungal infections in humans, producing infections that range from mucocutaneous disorders to invasive disease that can involve any organ. Here we present our clinical experience with anidulafungin for the treatment of documented nosocomial candidaemia. from february 2009 through January 2010 all patients with documented candidemia treated with anidulafungin in three medical centers in italy were reviewed. Demographics, clinical and microbiological data, and outcome were collected for each patient. twenty-four patients were included in the study. most patients had a central venous catheter (CVC) or a port-a-cath (100%), had a history of recent surgery (87.5%), or were receiving total parenteral nutrition (79%), broad spectrum antibiotics (83%), steroids or chemotherapy (45.8%). C. albicans (54%) was the most commonly isolated pathogen. CVC was the source of candidemia in 79% of cases. Six patients (25%) developed severe sepsis or septic shock, and five patients had unfavorable outcomes, with an overall mortality rate of 20%. No patients experienced side effects related to anidulafungin therapy. Anidulafungin was effective in the treatment of patients with documented candidemia arising from different sites, and no significant side effects were observed.

Journal of Chemotherapy, 2011

Clinical Infectious Diseases, 2014

Clinical Infectious Diseases, 2013

Background. Higher daptomycin doses are advocated for select methicillin-resistant Staphylococcus... more Background. Higher daptomycin doses are advocated for select methicillin-resistant Staphylococcus aureus (MRSA)-related infections, but the probabilities of target attainment (PTA) and toxicity of these doses have not been characterized in critically ill patients.

The American Journal of Cardiology, 2015

in collaboration with the SIXTUS Study Group † Community-acquired pneumonia (CAP) is complicated ... more in collaboration with the SIXTUS Study Group † Community-acquired pneumonia (CAP) is complicated by cardiac events in the early phase of the disease. Aim of this study was to assess if these intrahospital cardiac complications may account for overall mortality and cardiovascular events occurring during a long-term followup. Three hundred one consecutive patients admitted to the University-Hospital, Policlinico Umberto I, with community-acquired pneumonia were prospectively recruited and followed up for a median of 17.4 months. Primary end point was the occurrence of death for any cause, and secondary end point was the occurrence of cardiovascular events (cardiovascular death, nonfatal myocardial infarction [MI], and stroke). During the intrahospital stay, 55 patients (18%) experienced a cardiac complication. Of these, 32 had an MI (29 noneST-elevation MI and 3 ST-elevation MI) and 30 had a new episode of atrial fibrillation (7 nonmutually exclusive events). During the follow-up, 89 patients died (51% of patients with an intrahospital cardiac complication and 26% of patients without, p <0.001) and 73 experienced a cardiovascular event (47% of patients with and 19% of patients without an intrahospital cardiac complication, p <0.001). A Cox regression analysis showed that intrahospital cardiac complications, age, and Pneumonia Severity Index were significantly associated with overall mortality, whereas intrahospital cardiac complications, age, hypertension, and diabetes were significantly associated with cardiovascular events during the follow-up. In conclusion, this prospective study shows that intrahospital cardiac complications in the early phase of pneumonia are associated with an enhanced risk of death and cardiovascular events during long-term followup. Ó 2015 Elsevier Inc. All rights reserved. (Am J Cardiol 2015;116:647e651)

Journal of Infection and Chemotherapy, 2013

Journal of Chemotherapy, 2012

Background: Daptomycin pharmacokinetics has not been extensively studied in patients undergoing c... more Background: Daptomycin pharmacokinetics has not been extensively studied in patients undergoing continuous renal replacement therapy (CRRT). Methods: The aim of the study was to collect pharmacokinetics and clinical data of patients undergoing CRRT and receiving daptomycin therapy. Daptomycin was measured using an isocratic high-performance liquid chromatography technique. Results: Three patients with bloodstream infection underwent CVVHD and three CVVHDF. CVVHDF patients had significantly lower mean AUC 0224 and C max values. A significant decrease in plasma levels was observed in a CVVHDF patient using 'high cut-off' hemofilters. Conclusion: Increasing doses of daptomycin should be considered in critical patients, especially those undergoing CVVHDF.

Clinical Infectious Diseases, 2013

JR et al. Clostridium difficile Toxin B causes epithelial cell necrosis through an autoprocessing... more JR et al. Clostridium difficile Toxin B causes epithelial cell necrosis through an autoprocessing-independent mechanism. PLoS Pathog. 2012; 8(12). 10. Brito GA, Sullivan GW, Ciesla WP Jr, Carper HT, Mandell GL, Guerrant RL. Clostridium difficile toxin A alters in vitro-adherent neutrophil morphology and function.

PloS one, 2015

The diffusion of multidrug-resistant (MDR) bacteria has created the need to identify risk factors... more The diffusion of multidrug-resistant (MDR) bacteria has created the need to identify risk factors for acquiring resistant pathogens in patients living in the community. To analyze clinical features of patients with community-onset pneumonia due to MDR pathogens, to evaluate performance of existing scoring tools and to develop a bedside risk score for an early identification of these patients in the Emergency Department. This was an open, observational, prospective study of consecutive patients with pneumonia, coming from the community, from January 2011 to January 2013. The new score was validated on an external cohort of 929 patients with pneumonia admitted in internal medicine departments participating at a multicenter prospective study in Spain. A total of 900 patients were included in the study. The final logistic regression model consisted of four variables: 1) one risk factor for HCAP, 2) bilateral pulmonary infiltration, 3) the presence of pleural effusion, and 4) the severit...

Diabetes Research and Clinical Practice, 2013

Our study aimed to observe, in patients with recent onset type 2 diabetes, the activity of the au... more Our study aimed to observe, in patients with recent onset type 2 diabetes, the activity of the autonomic nervous system evaluated by heart rate variability (HRV) analysis during 24-h ECG recording and glucose metabolic impairment, measured by continuous glucose monitoring. The data indicate hyperactivity of the sympathetic component with loss of circadian rhythm and minimal changes in glucose values. The role of glycemia appeared to be less important than that of insulin resistance.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Jan 3, 2016

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Jan 2, 2016

The aim of this study is to identify factors associated with mortality in ICU patients with KPC-K... more The aim of this study is to identify factors associated with mortality in ICU patients with KPC-Kp septic shock. A retrospective analysis of ICU patients with KPC-Kp infection and septic shock observed in a large teaching hospital from November 2010 to December 2014 was performed. A total of 111 patients were included in the study. The most frequent source of infection was unknown focus bacteremia in 53 (47.7%) patients. The rate of resistance to colistin was 51.3%; 30-day mortality was reported for 44 (39.6%) patients. Surviving patients were more frequently treated with an initial therapy (within 24 hours) including ≥2 antibiotics displaying in vitro activity against the isolated KPC-Kp strain (41.8% Vs 18.1%, p=0.01), and were also more likely to receive a definitive therapy including ≥2 in vitro active antibiotics (85.1% Vs 15.9%, p<0.001). Cox regression analysis revealed that a colistin-containing antibiotic regimen (Hazard ratio [HR] 0.21, CI 95% 0.05-0.72, p<0.001), us...

Infectious Disease Reports, 2015

Intensive Care Medicine, 2015

Infectious disease reports, Jan 11, 2015

Gram-positive cocci are emerging causes of spontaneous bacterial peritonitis (SBP), especially in... more Gram-positive cocci are emerging causes of spontaneous bacterial peritonitis (SBP), especially in patients with healthcare-associated infections. We report the case of a 68-year-old man with hepatitis C virus and alcohol-related cirrhosis who developed SBP due to methicillin-resistant Staphylococcus aureus treated with daptomycin. We discuss the potential role of daptomycin in this setting with a review of the literature about the use of daptomycin in primary or secondary bacterial peritonitis.

Antimicrobial agents and chemotherapy, Jan 19, 2015

To determine the incidence, risk factors, and outcomes of bloodstream infections (BSI) subsequent... more To determine the incidence, risk factors, and outcomes of bloodstream infections (BSI) subsequent to Clostridium difficile infection (CDI). Retrospective study of all patients with definite diagnosis of CDI admitted from January 2014 to December 2014 in two large Hospitals in Rome. Two groups of patients were analyzed: those with CDI and subsequent BSI (CDI/BSI+), and those with CDI and no evidence of primary BSI (CDI/BSI-). Data about clinical features, microbiology, treatments and mortality were obtained. Overall, 393 cases of CDI were included in the final analysis: 72 developed a primary nosocomial BSI while 321 had CDI without microbiological and clinical evidence of BSI. Etiologic agents of BSI were Candida species (47.3%), Enterobacteriaceae (19.4%), enterococci (13.9%), and mixed infections (19.4%). In multivariate analysis ribotype 027 (odds ratio [OR] 6.5), CDI recurrence (OR 5.5), severe CDI infection (OR 8.3), and oral vancomycin >500 mg/day (OR 3.1) were recognized a...

Internal and Emergency Medicine

About 90% of TB-infected individuals develop a latent tuberculosis (TB) infection, which means th... more About 90% of TB-infected individuals develop a latent tuberculosis (TB) infection, which means the infecting bacteria are alive in the body but inactive. The assessment of latent infection relies on the measurement of host immune responses as a surrogate for the presence of viable bacteria. Although these carriers do not have TB symptoms and cannot spread the infection to others, they are at risk of developing an active infection that is both symptomatic and contagious. Given the risks of drug resistance and of treatment failure if patients with unsuspected active tuberculosis treated with a single-drug regimen, careful evaluation for active disease must precede initiation of treatment for latent infection. Clinicians should be aware that nowadays TB occurs in sites other than the lungs and that these sites account for an increasing proportion of cases of TB. A high clinical suspicion is required in the elderly, since symptoms may be masked by generalized debility.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Jan 14, 2015

The alterations occurring in the intestinal flora during Clostridium difficile infection (CDI) ma... more The alterations occurring in the intestinal flora during Clostridium difficile infection (CDI) may promote the translocation of Candida to the blood and the development of candidaemia. The aim of our study was to analyse clinical findings of these patients to determine the risk factors associated with the development of candidaemia subsequent to CDI. We compared 35 patients with candidaemia subsequent to CDI with 105 patients with CDI. Patients with candidaemia showed more severe infections and higher mortality. The ribotype 027 strain and vancomycin treatment at ≥1000 mg/day were prevalent in patients developing candidaemia. CDI may predispose to the translocation of Candida.

Journal of Chemotherapy, 2010

Candida species are the most common causes of invasive fungal infections in humans, producing inf... more Candida species are the most common causes of invasive fungal infections in humans, producing infections that range from mucocutaneous disorders to invasive disease that can involve any organ. Here we present our clinical experience with anidulafungin for the treatment of documented nosocomial candidaemia. from february 2009 through January 2010 all patients with documented candidemia treated with anidulafungin in three medical centers in italy were reviewed. Demographics, clinical and microbiological data, and outcome were collected for each patient. twenty-four patients were included in the study. most patients had a central venous catheter (CVC) or a port-a-cath (100%), had a history of recent surgery (87.5%), or were receiving total parenteral nutrition (79%), broad spectrum antibiotics (83%), steroids or chemotherapy (45.8%). C. albicans (54%) was the most commonly isolated pathogen. CVC was the source of candidemia in 79% of cases. Six patients (25%) developed severe sepsis or septic shock, and five patients had unfavorable outcomes, with an overall mortality rate of 20%. No patients experienced side effects related to anidulafungin therapy. Anidulafungin was effective in the treatment of patients with documented candidemia arising from different sites, and no significant side effects were observed.

Journal of Chemotherapy, 2011

Clinical Infectious Diseases, 2014

Clinical Infectious Diseases, 2013

Background. Higher daptomycin doses are advocated for select methicillin-resistant Staphylococcus... more Background. Higher daptomycin doses are advocated for select methicillin-resistant Staphylococcus aureus (MRSA)-related infections, but the probabilities of target attainment (PTA) and toxicity of these doses have not been characterized in critically ill patients.

The American Journal of Cardiology, 2015

in collaboration with the SIXTUS Study Group † Community-acquired pneumonia (CAP) is complicated ... more in collaboration with the SIXTUS Study Group † Community-acquired pneumonia (CAP) is complicated by cardiac events in the early phase of the disease. Aim of this study was to assess if these intrahospital cardiac complications may account for overall mortality and cardiovascular events occurring during a long-term followup. Three hundred one consecutive patients admitted to the University-Hospital, Policlinico Umberto I, with community-acquired pneumonia were prospectively recruited and followed up for a median of 17.4 months. Primary end point was the occurrence of death for any cause, and secondary end point was the occurrence of cardiovascular events (cardiovascular death, nonfatal myocardial infarction [MI], and stroke). During the intrahospital stay, 55 patients (18%) experienced a cardiac complication. Of these, 32 had an MI (29 noneST-elevation MI and 3 ST-elevation MI) and 30 had a new episode of atrial fibrillation (7 nonmutually exclusive events). During the follow-up, 89 patients died (51% of patients with an intrahospital cardiac complication and 26% of patients without, p <0.001) and 73 experienced a cardiovascular event (47% of patients with and 19% of patients without an intrahospital cardiac complication, p <0.001). A Cox regression analysis showed that intrahospital cardiac complications, age, and Pneumonia Severity Index were significantly associated with overall mortality, whereas intrahospital cardiac complications, age, hypertension, and diabetes were significantly associated with cardiovascular events during the follow-up. In conclusion, this prospective study shows that intrahospital cardiac complications in the early phase of pneumonia are associated with an enhanced risk of death and cardiovascular events during long-term followup. Ó 2015 Elsevier Inc. All rights reserved. (Am J Cardiol 2015;116:647e651)

Journal of Infection and Chemotherapy, 2013

Journal of Chemotherapy, 2012

Background: Daptomycin pharmacokinetics has not been extensively studied in patients undergoing c... more Background: Daptomycin pharmacokinetics has not been extensively studied in patients undergoing continuous renal replacement therapy (CRRT). Methods: The aim of the study was to collect pharmacokinetics and clinical data of patients undergoing CRRT and receiving daptomycin therapy. Daptomycin was measured using an isocratic high-performance liquid chromatography technique. Results: Three patients with bloodstream infection underwent CVVHD and three CVVHDF. CVVHDF patients had significantly lower mean AUC 0224 and C max values. A significant decrease in plasma levels was observed in a CVVHDF patient using 'high cut-off' hemofilters. Conclusion: Increasing doses of daptomycin should be considered in critical patients, especially those undergoing CVVHDF.

Clinical Infectious Diseases, 2013

JR et al. Clostridium difficile Toxin B causes epithelial cell necrosis through an autoprocessing... more JR et al. Clostridium difficile Toxin B causes epithelial cell necrosis through an autoprocessing-independent mechanism. PLoS Pathog. 2012; 8(12). 10. Brito GA, Sullivan GW, Ciesla WP Jr, Carper HT, Mandell GL, Guerrant RL. Clostridium difficile toxin A alters in vitro-adherent neutrophil morphology and function.

PloS one, 2015

The diffusion of multidrug-resistant (MDR) bacteria has created the need to identify risk factors... more The diffusion of multidrug-resistant (MDR) bacteria has created the need to identify risk factors for acquiring resistant pathogens in patients living in the community. To analyze clinical features of patients with community-onset pneumonia due to MDR pathogens, to evaluate performance of existing scoring tools and to develop a bedside risk score for an early identification of these patients in the Emergency Department. This was an open, observational, prospective study of consecutive patients with pneumonia, coming from the community, from January 2011 to January 2013. The new score was validated on an external cohort of 929 patients with pneumonia admitted in internal medicine departments participating at a multicenter prospective study in Spain. A total of 900 patients were included in the study. The final logistic regression model consisted of four variables: 1) one risk factor for HCAP, 2) bilateral pulmonary infiltration, 3) the presence of pleural effusion, and 4) the severit...