Four hundred forty-eight patients with 929 Echinococcus granulosus hydatid cysts received 3- to 6-month continuous cycles of mebendazole or albendazole treatment and underwent prolonged follow-up by clinical visits and imaging studies (range, 1-14 years) to assess the long-term outcome of treatment. Degenerative changes and relapse were assessed by imaging techniques. At the end of therapy, 74.1% of the hydatid cysts showed degenerative changes. These were more frequent in albendazole-treated than in mebendazole-treated cysts (82.2% vs. 56.1%; P < .001). During long-term follow-up, 104 cysts (22%) had degenerative changes that progressed, whereas 163 cysts (approximately 25%) relapsed. The percentages of relapses in the two drug-treated groups were almost the same. Relapses occurred more frequently in type II cysts of the liver. Cysts recurred most often (78.5%; P < .001) within the first 2 years after treatment ended. Further chemotherapy cycles induced degenerative changes in >90% of relapsed cysts without inducing more frequent or more severe side effects than those observed during the initial cycles.

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The immunological reactivity of Echinococcus granulosus antigen B was evaluated in 30 hydatid patients. Antigen B was purified from sheep hydatid cyst fluid by electroelution from a non-reducing SDS-PAGE gel (AgB). In ELISA and immunoblotting (IB), determining antibody production in sera from patients with hydatid disease and with other parasitic infections, purified AgB showed higher specificity than a partially purified antigen named pH5PPT (100% vs 83% in pH5PPT-ELISA and 58% in pH5PPT-IB). AgB-IB achieved higher sensitivity than AgB-ELISA (80% vs 63%). All AgB-IB positive sera recognized the 12 kDa subunit. Qualitative AgB-IB assessment of IgG isotype responses identified IgG4 as the predominant isotype (87%). The other isotypes showed a lower percentage of positive reactions: IgG1, 33%; IgG2, 21%; and IgG3, 17%. PBMC proliferative assay revealed a cellular response to AgB in 100% of patients' PBMC. These findings confirm antigen B, especially its smallest subunit, as a good diagnostic molecule.

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Here we report for the first time, a detailed characterization of a variant of the SCCmec element, in a methicillin-resistant Staphylococcus intermedius human isolate. S. intermedius is a coagulase-positive zoonotic microrganism, recently classified as a separate species. In routine clinical laboratory practice, the coagulase production is used as criterion of pathogenicity related to S. aureus, but S. intermedius is frequently misidentified-being mistaken for S. aureus-and consequently its real incidence underestimated. S. intermedius have been found only occasionally in human beings, and methicillin-resistance is very rare for this organism. Even if the genetic element responsible for methicillin-resistance--the mecA gene carried by diverse staphylococcal chromosomal cassettes--has been described in various staphylococcal species, the current literature doesn't report any case of S. intermedius isolate carrying SCCmec-like elements. Our study could be useful to explain the mechanism and routes of transfer of the chromosomal cassette carrying the mec complex, among staphylococci.

Heart rhythm disorders are increasingly reported during coronavirus virus disease 2019 and the presence of relative bradycardia (RB), known as an inappropriate low heart rate (HR) in response to an increased body temperature (BT), has been reported only occasionally [1]. However, its definition varied widely among studies and little is known regarding its role in predicting clinical outcomes [1,2]. We evaluated the prevalence and clinical significance of RB at hospital admission in patients with COVID-19. From March to September 2020, we performed a retrospective singlecentre study including all adult patients hospitalized at Policlinico Umberto I-Sapienza University (Rome) with confirmed COVID-19 (SARS-CoV-2 RNA detected by real-time PCR on nasopharyngeal swab). Exclusion criteria were treatment with HR-lowering agents and non-sinus rhythm at ECG. RB was defined as HR < 90 bpm and