Healthy children in urban areas have a high prevalence of fecal carriage of drug-resistant E. coli.

We report a case of Zika virus infection imported in Florence, Italy ex-Thailand, leading to a secondary autochthonous case, probably through sexual transmission. The two cases occurred in May 2014 but were retrospectively diagnosed in 2016 on the basis of serological tests (plaque reduction neutralisation) performed on stored serum samples. Our report provides further evidence that sexual transmission of Zika virus is possible. Case reportsAt the beginning of May 2014, an Italian man is his early 30s (patient 1) returned to Florence, Italy, after a 10-day holiday in Thailand. On the day after his arrival, he developed a confluent maculopapular rash, on the face, trunk, arms, and legs, with fever (maximum temperature 38 °C), conjunctivitis, and frontal headache with retroocular pain.Four days later, patient 1 was admitted to the Infectious and Tropical Diseases Unit of the Florence Careggi University Hospital. Blood tests revealed leucopenia (3,000 cells/µL; reference: 4,000-10,000/µL) while creatinine, platelet count and transaminases were normal. Serological investigation two days after (i.e. 6 days after symptoms onset), showed past exposure to measles and parvovirus, negative results for human immunodeficiency virus (HIV) 1-2 Ab/Ag and chikungunya IgM, a positive result for dengue virus (DENV) IgM, and negative results for DENV IgG, as well as DENV NS1 Ag (Table).The symptoms subsequently rapidly resolved (total duration of fever and rash: 6 days) and he was discharged nine days after admission with a probable diagnosis of DENV infection.Perifocal vector control activities (including spraying adult mosquitoes and destruction of larval breeding sites) were implemented the day after the availability of DENV IgM positive results, around the patient's residence and workplace, even though the period of activity of Aedes albopictus in Italy is usually considered to start in June and end in October [1]. A second and third blood test using enzyme-linked immunosorbent assay (ELISA), performed 38 and 109 days after symptoms onset, showed DENV IgG seroconversion and IgM negativisation in the third sample.Nineteen days after the onset of symptoms in patient 1, his girlfriend (patient 2), who was in her late 20s developed diffuse pain, associated to both wrists and oedema on fingers of each hand, maculopapular rash on the trunk, arms, and legs, without fever. Four days later she was evaluated at the outpatient facility of the same hospital. Patient 2 had not travelled to tropical areas during the previous year. Blood tests performed on the next day (5 days after her symptoms started) showed normal white blood cells and platelet count, normal C-reactive protein, creatinine, transaminases, and undetectable beta-human chorionic gonadotropin (HCG). The patient had IgG antibodies against cytomegalovirus, Epstein-Barr virus, parvovirus and rubella, while she was seronegative for coxsackie A, coxsackie B, echovirus and DENV (IgG, IgM and NS1 Ag). Serological tests were repeated 39 and 93 days after symptoms onset, respectively,...

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Screening for active tuberculosis (TB) and latent TB infection (LTBI) is mandatory prior to the initiation of tumour necrosis factor-a inhibitor therapy. However, no agreement exists on the best strategy for detecting LTBI in this population. The aim of the present study was to analyse the performance of the tuberculin skin test (TST) and QuantiFERON1-TB Gold in-tube (QFT-GIT) on LTBI detection in subjects with immunomediated inflammatory diseases (IMID).The TST and QFT-GIT were prospectively performed in 398 consecutive IMID subjects, 310 (78%) on immunosuppressive therapy and only 16 (4%) had been bacillus Calmette-Guérin (BCG) vaccinated.Indeterminate results to QFT-GIT were found in five (1.2%) subjects. Overall, 74 (19%) out of 393 subjects were TST-positive and 52 (13%) were QFT-GIT-positive. Concordance between TST and QFT-GIT results was good (87.7%): 13 were QFT-GIT-positive/TST-negative and 35 QFT-GITnegative/TST-positive. By multivariate analysis both tests were significantly associated with older age. Only the TST was associated with BCG vaccination and radiological lesions of past TB. Use of immunosuppressive drugs differently modulated QFT-GIT or TST scoring.Use of the QuantiFERON1-TB Gold in-tube, as a screening tool for latent tuberculosis among immunomediated inflammatory disease subjects, is feasible. Until further data will elucidate discordant tuberculin skin test/QuantiFERON1-TB Gold in-tube results, a strategy of simultaneous tuberculin skin and QuantiFERON1-TB Gold in-tube testing in a low prevalence bacillus CalmetteGuérin vaccinated population, should maximise potentials of latent tuberculosis diagnosis.