Control of multi-drug resistant infectious agents

Tipologia: Malattie Infettive

Principal Investigator: Prof. Bruno Raffaele

The research group focuses on four interconnected areas: antimicrobial resistance and stewardship, hospital-acquired infections and sepsis, infectious complications in solid organ transplantation, and the role of chronic bacterial infection in non-infectious disease pathogenesis.
In the field of antimicrobial resistance, current work addresses the risk of bloodstream infection in patients with rectal colonisation by multidrug-resistant organisms (KPC, NDM, VRE, CRAB); optimal antibiotic duration for resistant bloodstream infections; real-world outcomes of novel agents including cefiderocol; and antimicrobial susceptibility dynamics in Clostridioides difficile infection. In the area of sepsis, the group has implemented and evaluated fast-track 24/7 blood culture diagnostic pathways and sepsis bundle programmes across hospital and obstetric settings in the Lombardy region. Research on infective endocarditis — including prosthetic valve endocarditis, double-valve disease, and the bacterial hypothesis in calcific aortic valve disease — is conducted within a multidisciplinary cardiology and cardiac surgery team. Transplant infectious diseases constitute a further pillar, encompassing post-cardiac transplant ICU infections, donor-derived bloodstream infections in solid organ transplant recipients, and CMV antiviral resistance. The group also investigates the application of machine learning and artificial intelligence to complex infectious disease phenotypes.

Colaneri M., Giordani P., Milanesi S., Lerta S., Tosca E.M., Sangani A., Villano V.A., Rettani M., Muzzi A., Corbella M., Cambieri P., Gori A., De Nicolao G., Bruno R. From Colonisation to Infection: Assessing the BSI Potential in Patients with KPC, NDM, VRE and CRAB Rectal Colonisation. Infectious Diseases and Therapy, 2025; 14:2359–2372. DOI 10.1007/s40121-025-01222-2
Zuccaro V., Asperges E., Marvulli L.N., Valsecchi P., Pagani E., Sacchi P., Bruno R. Seven versus fourteen days for resistant bloodstream infections: what do we actually know? A scoping review. Infection, 2026. DOI 10.1007/s15010-026-02821-y
Forlino A., Giordani P., Merla C., Roda S., Besio R., Ahmed A.A.Q., Kuka A., Mileto I., Petazzoni G., Corbella M., Cambieri P., Baldanti F., De Silvestri A., Totaro P., Amoroso F., Pelenghi S., Arbustini E., Bruno R., Seminari E. Infectious seeds of valve calcification: Exploring the bacterial hypothesis in the pathogenesis of calcific aortic valve disease. European Journal of Clinical Investigation, 2026; 56:e70188. DOI 10.1111/eci.70188
Minucci R., De Silvestri A., Cambieri P., Corbella M., Pellegrini C., Roda S., Dezza C., Pelenghi S., Bruno R., Belliato M., Seminari E. The Challenge of Bacterial Infections During Intensive Care Unit Stay After Heart Transplantation. Transplant Infectious Disease, 2025; 27:e70031. DOI 10.1111/tid.70031
Seminari E., Colaneri M., Corbella M., De Silvestri A., Muzzi A., Perlini S., Martino I.F., Marvulli L.N., Arcuri A., Maffezzoni M., Minucci R., Bono E., Cambieri P., Marone P., Bruno R. Reduction of BSI associated mortality after a sepsis project implementation in the ER of a tertiary referral hospital. Scientific Reports, 2023; 13:5142. DOI 10.1038/s41598-023-31219-1

•    One Health Basic and Translational Research Actions Addressing Unmet Needs on Emerging Infectious Diseases - Fondazione INF-ACT (PNRR)
•    Comparison of immunoblotting bands pattern in patients with treated versus untreated inactive echinococcal cysts of the liver.
•    Radiomic Analysis for DIagnosis Of Invasive Pulmonary Aspergilllosis in Hematologic patients (RADIOPAH)
•    San Matteo Endocarditis Registry (STEADY)

•    One Health Basic and Translational Research Actions Addressing Unmet Needs on Emerging Infectious Diseases - Fondazione INF-ACT (PNRR)
•    4CE Consortium / SMACORE - Consortium for Clinical Characterization of COVID-19 by EHR, coordinated by Harvard University
•    Hospital networking in the Lombardy Region: control of healthcare-associated infections and antibiotic resistance through an advanced IT platform for microbial genomics and big data integration (H. Sacco – H. Niguarda - San Matteo - UniMi)
•    European AIDS Clinical Society (EACS) - Panel membership, Hepatitis Guidelines Working Group
•    Regional sepsis network, Lombardy - Fight Against Sepsis in Obstetrics (SOS Study)
•    We are a clinical hub for CeReMi (Regional Center for the Prevention and Management of Infectious Diseases), which serves as the Lombardy Region’s strategic center for epidemiological surveillance and the management of infectious disease emergencies.