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Pennisi F, Lo Presti T, Ricciardi GE, Dalla Valle Z, Minerva M, Privitera G, Signorelli C. Training and career opportunities for residencies in Hygiene and Preventive Medicine: results of a survey on 39 Italian schools. Ig Sanita Pubbl 2023; 80:94-100. [PMID: 37782813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
INTRODUCTION The Italian National Health Service (SSN) is currently grappling. with a complex situation, characterized by a persistent shortage of medical personnel and the divergent aspirations of young medical graduates. Additionally, recent regulatory developments concerning specialist training further contribute to the intricacies of the landscape, calling for a comprehensive analysis of the challenges and opportunities within the sector. This study aims to provide an updated overview of the current placement of medical graduates, residents and specialists in the specific hygiene and preventive medicine (Public Health) field. METHODS Data on admissions, withdrawals and resignations were obtained from the Ministries of Universities and Health and from the archives of the "Associazione Liberi Specializzandi" (ALS). Information regarding the professional prospects for specialists and residents in the field of Public Health was gathered through a tailored survey conducted by the "Consulta dei Medici in Formazione Specialistica" (Council of Medical Residents) of the Italian Society of Hygiene (SItI). RESULTS In 2022, a total of 483 specialization contracts were granted, indicating a decrease of 37% compared to the previous year. Notably, 85 positions (17.6%) remained unallocated or resulted in dropouts. Six months after completing their residency, 1.5% of hygiene residents were still actively seeking employment. On a positive note, 75.4% of fourth-year residents secured contracts under the "Decreto Calabria". Career opportunities within the Italian SSN have witnessed growth, with a significant proportion of placements in territorial services and hospital medical directorates. DISCUSSION AND CONCLUSIONS The updating of training programs provided by residency schools and the exploration of innovative approaches are of paramount importance to address the urgent need for high-quality training and to cater to the requirements of the national health system.
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Affiliation(s)
- F Pennisi
- School of Public Health, Vita-Salute San Raffaele University (Milan, Italy)
| | - T Lo Presti
- School of Public Health, University of Udine (Udine, Italy)
| | - G E Ricciardi
- School of Public Health, Vita-Salute San Raffaele University (Milan, Italy)
| | - Z Dalla Valle
- School of Public Health, Vita-Salute San Raffaele University (Milan, Italy)
| | - M Minerva
- School of Public Health, Vita-Salute San Raffaele University (Milan, Italy)
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa (Pisa, Italy)
| | - C Signorelli
- School of Public Health, Vita-Salute San Raffaele University (Milan, Italy)
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Scardina G, Ceccarelli L, Casigliani V, Mazzilli S, Padovan M, Petillo A, Tavoschi L, Foddis R, Privitera G, Baggiani A. Flu vaccination coverage in healthcare workers during a 3-year period in the context of the pandemic. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs and maintain essential healthcare services during influenza epidemics. With the present study we aimed to evaluate the efficacy of measures implemented during the three flu campaigns of 2018/19, 2019/20 and 2020/21 in a university hospital in Pisa, Italy, through the assessment of vaccination coverage (VC) in HCWs and to assess attitudes toward flu vaccination.
Methods
Flu VC was stratified according to sex, age, job and vaccination status for each season and the association between each variable and vaccination status was explored. In 2020, a survey collecting data on knowledge and attitudes on flu vaccination was distributed.
Results
Starting from the 2018/19 campaign, an increasing flu VC rate was registered: contained in 2019/20 (from 11.6% to 14.3%, Δ%=23.1) and significant (VC = 39.6%, Δ%=177.6) in 2020/21 as compared with the previous year. Physicians were the professionals most willing to get vaccinated during all seasons. Considering age the situation changed greatly over the study period, with VC rising in 2020/21 in those age groups marked by low VC in previous years (<30 and 41-50 years old, Δ%=293). Having been vaccinated in the previous year represented the most important variable to predict likelihood of accepting flu jab. However, while previously vaccinated HCWs were 13 times more likely to get the flu jab in 2019/20 compared with the others; in 2020/21 they were only 3 times. Only half of HCWS considered themselves at higher risk of contracting influenza compared to the general population, while 71% totally agreed that receiving the flu jab in 2020/21 was more important than the previous years due to COVID.
Conclusions
A significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years, due to the COVID pandemic that positively influenced vaccination uptake.
Key messages
• This study evaluates the impact of subsequent flu vaccination campaigns implemented in a large university hospital in Italy through the assessment of flu VC among HCWs.
• A significant increase in flu VC among HCWs was observed in 2020/21, especially in those categories characterized by lower VC rates in the previous years, more likely due to the COVID-19 pandemic.
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Affiliation(s)
- G Scardina
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | - L Ceccarelli
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | - V Casigliani
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | | | - M Padovan
- Occupational and Preventive Medicine, University of Pisa , Pisa, Italy
| | - A Petillo
- Occupational and Preventive Medicine, University of Pisa , Pisa, Italy
| | - L Tavoschi
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | - R Foddis
- Occupational and Preventive Medicine, University of Pisa , Pisa, Italy
| | - G Privitera
- Translational Research in Medicine, University of Pisa , Pisa, Italy
| | - A Baggiani
- Translational Research in Medicine, University of Pisa , Pisa, Italy
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Mazaccara A, Privitera G, Di Pucchio A, Barbina D, Bertinato L, Mistretta A, Simonelli M, Caminada S, Arzilli G, Brusaferro S. Need for a competency-based approach for the Public Health Workforce training: the ISS proposal. Eur J Public Health 2022. [PMCID: PMC9594438 DOI: 10.1093/eurpub/ckac131.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Issue The COVID-19 pandemic acted as a catalyst for a reconsidering health care professional workforce (HCPW) competency needed to face future public health challenges, in line with the recent WHO “Global Competency and Outcomes Framework for UHC” document. In this context, in the Italian G20 Presidency framework, the Italian National Institute of Health (ISS), launched a program named “Laboratorium” - recognised in the G20 Declarations of Ministers of Health and Leaders - aimed to the development of training tools suitable for distance learning in whatever context they are placed. Description of the problem Common competencies and needs of the HCPW have to be fulfilled through cross-sectional and multilevel training, to overcome the current emergency and be able to face future challenges. The aim is to provide a modular educational approach that is finalized to actively involve the participant: health professionals step in their training pathway according to their knowledge gaps, identify their specific learning objectives and, through a problem-based learning approach, acquire the proper skills for their function and tasks. Results We propose a two-tiered approach to training: the development of competence based courses oriented to active learning. A pilot course on Epidemic Intelligence design according to this model is ready to be released. At the same time, a repository of everything available on the web systematically selected from authorised sources by a scientific committee was created to support the training objective. It is characterised by a detailed multilevel tagging that allows an effective modularisation to reach only the content useful for its user. Lessons Accessibility to health-related training materials is a required necessity at every level of HCPW. Profiles within healthcare are increasingly heterogeneous and there is a need to focus on disseminating tools that can provide knowledge to address different healthcare scenarios and common purposes. Key messages • Future public health challenges underline a need for a competencies-based learning approach in Healthcare Workforce training. • Italian National Institute of Health propose two methods within the ‘Laboratorium’ project to enable this type of learning: specifically designed courses and a structured document repository.
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Affiliation(s)
- A Mazaccara
- Training Office, National Institute of Health , Rome, Italy
| | - G Privitera
- Training Office, National Institute of Health , Rome, Italy
| | - A Di Pucchio
- Training Office, National Institute of Health , Rome, Italy
| | - D Barbina
- Training Office, National Institute of Health , Rome, Italy
| | - L Bertinato
- Scientific Secretariat to the President Head, National Institute of Health , Rome, Italy
| | - A Mistretta
- National Institute of Health Scientific Communication Unit, , Rome, Italy
| | - M Simonelli
- National Center for Global Health, National Institute of Health , Rome, Italy
| | - S Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - G Arzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Pisa, Italy
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Papini F, Privitera G. Commentary to the paper V.D. Tran, D.T. Pham, T.T.N. Cao, M. Bahlol, R.S. Dewey, M.H. Le, V.A. Nguyen. Perspectives on COVID-19 prevention and treatment using herbal medicine in Vietnam: a cross-sectional study (Ann Ig. 2022 Sept-Oct; 34(5): 515-531. doi: 10.7416/ai.2021.2484. E-pub Dec 9). Ann Ig 2022; 34:532-533. [PMID: 34882167 DOI: 10.7416/ai.2021.2487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- F Papini
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Hygiene, Uni-versity of Pisa
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, Section of Hygiene, Uni-versity of Pisa
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Arzilli G, Scardina G, Menicagli D, Lucaccini E, Sironi D, Papini F, Tavoschi L, Lopalco PL, Privitera G. Digital devices to assess vaccine hesitancy and promote pertussis vaccination during pregnancy. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Vaccination against pertussis in pregnancy is the main strategy to prevent the disease in the first trimester of life of new-borns. Effective communication is essential to successfully engage pregnant women. The use of digital devices within the outpatient setting may be helpful to engage patients before and during the consultation. The aim of this study was to develop and test an e-health tool to assess vaccine hesitancy and to deliver tailored information and education interventions to raise awareness and promote vaccine acceptance.
Methods
One-hundred-and-five participants were recruited in 4 ob-gyn clinics. Participants were invited to complete a self-administered psychometric questionnaire to assess vaccine hesitancy, disease beliefs and self-efficacy perception on health behaviours on a tablet. Participants were randomly allocated to three communication-format types providing equivalent content: 1)a single video simulating a patient-doctor conversation on the topic; 2)an interactive platform with five infographics videos; 3)a paper leaflet followed by a brief consultation with the physician. The intention to get vaccinated during pregnancy was assessed through a specific question before and after the intervention.
Results
In the pre-intervention phase there was no difference observed between groups in terms of the variable “intention” to get vaccinated. After the intervention, participants of groups 1 and 3 showed a higher intention to get vaccinated than group 2 at the Kruskal-Wallis test (H(2)=6.008, p < 0.05). Post-intervention intention to vaccinate correlated with Individual Self-Efficacy (rs(105)=0.30, p < 0.001) and was inversely associated with vaccine hesitancy (rs(105)=0.34, p < 0.001).
Conclusions
We implemented and assessed the impact of different communication strategies to promote vaccine uptake among pregnant women. Our results suggest comparable effect may be obtained using simulated versus live patient-physician communication.
Key messages
The use of digital devices allows an effective and manageable communication about vaccination to pregnant women. In the present study, the implementation of digital forms of communication allowed a comparison with standard procedures of information towards vaccination, demonstrating their equivalence.
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Affiliation(s)
- G Arzilli
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie, Università di Pisa, Pisa, Italy
| | - G Scardina
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie, Università di Pisa, Pisa, Italy
| | - D Menicagli
- MOMILab, Scuola IMT Alti Studi Lucca, Lucca, Italy
| | - E Lucaccini
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - D Sironi
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie, Università di Pisa, Pisa, Italy
| | - F Papini
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie, Università di Pisa, Pisa, Italy
| | - L Tavoschi
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie, Università di Pisa, Pisa, Italy
| | - PL Lopalco
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie, Università di Pisa, Pisa, Italy
| | - G Privitera
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie, Università di Pisa, Pisa, Italy
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Napolitano D, Privitera G, Schiavoni E, Turchini L, Amatucci V, Pugliese D, Gasbarrini A, Scaldaferri F, Armuzzi A. The educational role of IBD nurses in Italy in vaccinations: do not miss the moment for COVID-19. Eur Rev Med Pharmacol Sci 2021; 25:5542-5546. [PMID: 34533804 DOI: 10.26355/eurrev_202109_26666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The role of nurses has great educational-scientific potential in COVID-19 vaccination. The aim of this work is to clarify whether the educational role of IBD nurses in vaccination is perceived by IBD patients. MATERIALS AND METHODS A cross-sectional study was carried out, through a questionnaire, to evaluate how many IBD patients received health education about vaccinations from the dedicated nurses (IBD nurses). RESULTS There were four hundred questionnaires, 310 patients (77.5%) answered all questions. The nurse does not appear to help educate patients on influenza vaccination (66.1%) or pneumococcal vaccination (81.6%). Disclosed patients have many doubts about the new COVID-19 vaccination (74.4%) and many seek information (74.8%) and think that the nurse can provide the necessary information (70%). CONCLUSIONS IBD nurses do not seem very active in the vaccination education role, and they do not meet patients' expectations, which are conversely very high.
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Affiliation(s)
- D Napolitano
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
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Tuvo B, Cristina ML, Spagnolo AM, Totaro M, Baggiani A, Privitera G, Casini B. Microbiological surveillance in reducing potential infection risk. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Failure in reprocessing of endoscopes has been reported as one of the top ten most important threats to patient health.
Materials/Methods
The study was conducted in two digestive endoscopy centres of a teaching hospital (29,000 endoscopies/year, of which 550 endoscopic retrograde cholangiopancreatography (ERCP). Following two cases of bacteremia due to KPC-producing Klebsiella pneumoniae temporally related to ERCP and 89% of non-compliance detected on endoscopes subjected to microbiological surveillance, the reprocessing activities were audited and implemented to ensure guideline compliance. Clinical and microbiological surveillance were reinforced and all responsibilities for each phase identified according to UNI/TR11662. Microbiological surveillance was performed according to the 'Duodenoscope Surveillance Sampling and Culturing Protocols' protocol, CDC, 2018.
Results
In the 11 months of surveillance, 47 endoscopes were sampled (13 colonoscopes, 9 gastroscopes, 23 duodenoscopes and 2 echoendoscopes), 19 washer-disinfector machines and 9 medical cabinets. 36% (17/47) of endoscope internal channels resulted non-compliant, 17% (4/23) in duodenoscopes. NDM-producing K. pneumoniae was isolated in 2 gastroscopes always associated with the use on a colonized patient. The inlet and final rinsing water of washer-disinfectors and medical cabinets resulted always conformed. Non-conformities were managed immediately in order to avoid infectious risks for patients.
Conclusions
Microbiological surveillance of endoscopes after reprocessing allowed to prevent infections in patients undergoing endoscopic procedures.
Key messages
Training of health workers followed by strict adherence to guidelines is the most appropriate tool in preventing and controlling infections related to the use of endoscopes. Endoscopy and reprocessing staff should follow a formal recognized endoscopy reprocessing training program, followed by regular practice and periodically updated training to maintain competency.
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Affiliation(s)
- B Tuvo
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - M L Cristina
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - A M Spagnolo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M Totaro
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - A Baggiani
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - G Privitera
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - B Casini
- Department of Translational Research, University of Pisa, Pisa, Italy
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De Nard F, Battaglini A, De Vita E, Barbara A, Corradi A, Quattrone F, Bonaccorsi G, Damiani G, Privitera G. Core competencies for public health medicine: protocol for an Italian inter-society Delphi consensus. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Developing core competencies is crucial for the quality of educational curricula in Public Health Medicine (PHM). The postgraduate medical School of Public Health of the University of Pisa developed a core curriculum for PHM specialists (CCV0), adapted from the list of core competencies promoted by the Association of Schools in Public Health of the European Region (ASPHER).
Objectives
We will apply the Garavalia method, a three-round step-wise Delphi consensus, for adapting the CCV0 to the Italian context. Participants will be enrolled through purposive sampling among the members of the Italian Society of Hygiene, Public Health and Preventive Medicine, aiming at the best possible balance between geographical distribution and professional profiles (PHM residents, academics, and Public Health operators). A sample of representatives of other PHM-related Italian Societies will also be included.
Results
We will invite 139 participants through e-mail invitations. During round zero, we will collect additional suggested competencies through an open-ended question. We will analyze data qualitatively and integrate the most relevant suggestions with the CCV0, resulting in the CCV1. A subgroup of 64 experts (among PHM residents, academics, and representatives of the included Societies) will participate in the following rounds. The first round will use Likert scales to measure agreement on the appropriateness of the CCV1 competencies. Consensus and agreement will be computed using the RAND/UCLA criteria. The final round will reach out for consensus repeating the same ratings for competencies classified as uncertain, with the help of quali-quantitave summaries of the answers of the first round. The final document (CC2) will report competencies classified as consensus or uncertain, with the corresponding level of consent.
Conclusions
The CC2 will enable current courses to be assessed and inform the design of future educational programs for Italian PHM residents.
Key messages
The Delphi method ensures anonymity and a balanced involvement of all stakeholders –including medical residents- in the development of a core curriculum for Public Health Medicine specialists. A consensus on core competencies in Public Health Medicine will enable the evaluation of current training curricula and the development of future educational programs.
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Affiliation(s)
- F De Nard
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Training working group, Committee of Medical residents, Italian Society of Hygiene, Public Health and Preventive Medicine, Rome, Italy
| | - A Battaglini
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Training working group, Committee of Medical residents, Italian Society of Hygiene, Public Health and Preventive Medicine, Rome, Italy
| | - E De Vita
- Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
- Training working group, Committee of Medical residents, Italian Society of Hygiene, Public Health and Preventive Medicine, Rome, Italy
| | - A Barbara
- Università Cattolica del Sacro Cuore, Rome, Italy
- Training working group, Committee of Medical residents, Italian Society of Hygiene, Public Health and Preventive Medicine, Rome, Italy
| | - A Corradi
- Department of Public Health Sciences, University of Turin, Turin, Italy
- Training working group, Committee of Medical residents, Italian Society of Hygiene, Public Health and Preventive Medicine, Rome, Italy
| | - F Quattrone
- Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
- Training working group, Committee of Medical residents, Italian Society of Hygiene, Public Health and Preventive Medicine, Rome, Italy
| | - G Bonaccorsi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - G Damiani
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Privitera
- Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
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Casini B, Tuvo B, Totaro M, Baggiani A, Privitera G. Surveillance and control of M. chimaera infections in the Tuscany Region, Italy. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Disseminated M. chimaera infections among patients who underwent open-chest surgery with cardiopulmonary bypass have been associated with the contamination of heater-cooler devices (HCDs). The Tuscany region in the Decree 3822/2019 issued recommendations for the surveillance and control of M. chimaera infections.
Methods
In three Tuscan cardiac surgery centers, the case finding was carried out through evaluation and testing of patients with a history of HCD exposure (past 6 years) was performed. Water and aerosol samples were analyzed from each HCDs to determine the microbiological parameters required by the Directive 98/83/CE and to assess the presence of non-tuberculous mycobacteria (NTMs), according to the regional protocol.
Results
M. chimaera infection was not found in any patient and all clinical specimens tested negative. 22 HCDs were sampled (n.12 LivaNova, n.1 Terumo and n.9 Maquet) for a total of 114 samples (45, 8, 2 and 59 respectively). All the microbiological parameters were compliant, excepted for total microbial count at 36 °C that exceeded 100 CFU/ml in 50% (57/114) of samples and for the presence of P.aeruginosa in 10% (12/114). NTMs were detected in 16% (18/114) of HCDs: M. chimaera was identified in 11% (13/114) of samples and in 4% (5/114) M. gordonae. All aerosol samples were negative for NTMs, but in the HCDs Maquet, B.cereus were detected in 7% (4/59) of the samples, K.oxytoca in 2% (1/59), B.ursincola in 2% (1/59) and S. paucimobilis in 3% (2/59). Only S. paucimobilis was isolated also in the same HCD water sample.
Conclusions
The implementation of maintenance and disinfection procedures of HCDs was able to reduce the risk of contamination and aerosolization by NTMs but not of other microorganisms.
Key messages
Further strategies should be put in place for the cases finding. Moreover, reliable decontamination and identification of agents that can disrupt biofilms and increase chlorine susceptibility of mycobacteria are required.
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Affiliation(s)
- B Casini
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
| | - B Tuvo
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
| | - M Totaro
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
| | - A Baggiani
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
| | - G Privitera
- University of Pisa, Department of Translational Research on New Technologies in Medicine and Surgery, Pisa, Italy
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Canale A, Giardi F, Gandolfo S, Lorenzi V, Corda V, Farneti S, Taddeucci M, Maielli M, Privitera G, Mencaroni S. “Nudge” in Lucca’s Hospital: separate waste collection improvement and cigarettes dumping reduction. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Positive behaviour and user's collaboration improved by using choices orientation techniques; in Lucca's Hospital (North-West Tuscany Sanitary Authority) this approach has improved separate waste collection execution and has decreased cigarettes dumping in commons areas.
Objectives
Phase 1 (May 2019): amendment of choices architecture recyclable waste bins in commons areas and into the wards were boosted, with “islands” clearly visible from any point of common paths; in the transit areas were installed exclusively multi-material and paper bins, equipped with signs that clearly indicate which products deliver; residual waste bins were allowed exclusively in certain points.ashtrays at the hospital entrances were eliminated and replaced with signage indicating smoking cessation benefits and the presence of areas “put your cigarette out” along the structure approach routes.
Phase 2 (scheduled for May 2020): “nudge” action
Spreading in community (using press and social-media) and locally (using poster) of the slogan “In San Luca we are taking a step forward: don't lag behind!”. This message stimulate the perception of an ongoing change to join.
Results
A decrease in residual waste collection and in instances of non-compliance in separate waste collection was detected. Decorum in the outdoor environments improved, with a reduction of user's reports and extra-cleaning interventions.
Conclusions
The described actions have improved user's collaboration, management efficiency of waste disposal and cleaning service, perceived quality and cost.
Key messages
Imitating a social model appears to be successful motivator of virtuous behaviours. Choices architecture and “nudge” techniques may improve citizens’ care pathways governance.
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Affiliation(s)
- A Canale
- Department of Translational Research and NTMS, University of Pisa, Pisa, Italy
| | - F Giardi
- Department of Translational Research and NTMS, University of Pisa, Pisa, Italy
| | - S Gandolfo
- Department of Translational Research and NTMS, University of Pisa, Pisa, Italy
| | - V Lorenzi
- San Luca Hospital Medical Direction, North-West Tuscany Sanitary Authority, Lucca, Italy
| | - V Corda
- San Luca Hospital Medical Direction, North-West Tuscany Sanitary Authority, Lucca, Italy
| | - S Farneti
- San Luca Hospital Medical Direction, North-West Tuscany Sanitary Authority, Lucca, Italy
| | - M Taddeucci
- San Luca Hospital Medical Direction, North-West Tuscany Sanitary Authority, Lucca, Italy
| | - M Maielli
- San Luca Hospital Medical Direction, North-West Tuscany Sanitary Authority, Lucca, Italy
| | - G Privitera
- Department of Translational Research and NTMS, University of Pisa, Pisa, Italy
| | - S Mencaroni
- San Luca Hospital Medical Direction, North-West Tuscany Sanitary Authority, Lucca, Italy
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Spatola C, Privitera G, Milazzotto R, Liardo R, Salamone V, Raffaele L, Foti P, Basile A, Palmucci S, Licata A, Cataldo AD, Amico A, Acquaviva G, Destri GL. P-25 Single-institution experience of total neoadjuvant therapy for locally advanced rectal cancer: Long-term results. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Monali R, De Vita E, Mariottini F, Privitera G, Lopalco PL, Tavoschi L. Impact of vaccination on invasive pneumococcal disease in Italy 2007-2017: surveillance challenges and epidemiological changes. Epidemiol Infect 2020; 148:e187. [PMID: 32418558 PMCID: PMC7482190 DOI: 10.1017/s0950268820001077] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/10/2020] [Accepted: 03/09/2020] [Indexed: 01/20/2023] Open
Abstract
Surveillance of new cases of invasive pneumococcal disease (IPD) in Italy was started in 2007 by the Ministry of Health (MoH). In 2012, pneumococcal childhood vaccination was introduced at the national level and, in 2017, for citizens aged 65 years and over. We describe here IPD epidemiology in Italy over the past 10 years investigating the impact of the vaccine programme on disease burden. Reports of IPD cases, data on serotype and vaccination coverage (VC) data were obtained from MoH annual reports, for the period 2007-2017. IPD notification rate and proportion by year, region, age and serotype were calculated. In 2007, 525 cases were reported (rate 0.88/100 000), rising to 1703 cases (rate 2.82/100 000) in 2017. The distribution of IPD cases by age group over time registered the largest share among individuals aged 65 years and over. A decreasing trend in notification rate was observed among those aged 0-4 years. During the same period, the 24-month VC increased, ranging from 80.9% to 96.7% in 2017. Molecular data indicated re-emergence of PPSV23-specific serotypes and non-vaccine serotypes. We observed an increase in IPD notifications during 2007-2017, likely due to an improved surveillance system, at least in some regions, with the relative quota of IPD notifications decreasing among vaccinated children cohorts. Further strengthening of IPD surveillance system, including molecular and vaccine coverage data, would be needed to assess and inform pneumococcal vaccination strategies in Italy.
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Affiliation(s)
- R. Monali
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - E. De Vita
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - F. Mariottini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - G. Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - P. L. Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - L. Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Tardivo S, Moretti F, Agodi A, Appignanesi R, Baldovin T, Barchitta M, Brusaferro S, Canino R, Carli A, D'Errico MM, Giuliani G, Moro M, Mura I, Nobile M, Novati R, Pasquarella C, Privitera G, Rossini A, Sodano L, Torregrossa MV, Torri E, Auxilia F. Essential strategies in HAI prevention and control: performance assessment through the implementation of the HAI-CoSIP tool of the GISIO-SItI group. A pilot study in a sample of Italian Organizations. Ann Ig 2019; 30:502-508. [PMID: 30374513 DOI: 10.7416/ai.2018.225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Healthcare-Associated Infections are a great concern for worldwide healthcare systems and represent a considerable threat to patient safety, leading to adverse clinical outcomes. A defined panel of indicators represents a key element to guide Healthcare Organizations towards identification of main gaps, implementation of effective actions and continuous improvements on Healthcare-Associated Infections prevention and control activities. A review on accreditation systems conducted by the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene Preventive Medicine and Public Health revealed a substantial heterogeneity of implemented standards and led to the development of a core set of indicators and requirements for Healthcare-Associated Infections' prevention and control within the hospital setting. The main aim of the study was to test the feasibility of the Healthcare-Associated Infections' prevention and control within the hospital setting tool to calculate performance scores on a sample of Italian Healthcare Organizations and to identify major critical issues. The potential benefits of the possibility of future implementation of the tool within Institutional Accreditation Programs is discussed. STUDY DESIGN Cross sectional pilot survey. METHODS The Healthcare-Associated Infections' prevention and control within the hospital setting included 96 criteria and 20 key areas including an area for outcomes indicators. For applicable criteria, standards fulfilment was evaluated according to a 4 point Likert scale. A composite score was calculated for each Healthcare Organization and five performance levels were identified. Data were further analysed by computing performance scores at the level of each area and requirement. RESULTS 20 Healthcare Organizations agreed to take part in this pilot study including two rehabilitative Healthcare Organizations. Among the whole sample a mean of 12.20% of requirements resulted not fulfilled, leaving space for further improvements. Critical areas were easily identified and the instrument was able to capture substantial differences between Healthcare Organizations. Only a few number of standards resulted "Not Applicable" (Mean = 4.71%) and most of them regarded Rehabilitative Healthcare Organizations. Mean composite performance index resulted 74.06% (SD = 16.96, range 36.30 - 94.27%); area of outcome indicators obtained a mean score of 56.17. CONCLUSION The Healthcare-Associated Infections' prevention and control within the hospital setting resulted an useful tool to assess Healthcare Organizations' performance in the field of Healthcare-Associated Infections prevention and control and to identify necessary actions for further improvements. The distribution of total scores by Healthcare Organizations showed a high heterogeneity. Implementation of the Healthcare-Associated Infections' prevention and control within the hospital setting tool as an institutional accreditation tool may help to drive the required harmonization at a national level of Healthcare-Associated Infections management and control strategies and overcome current substantial regional differences.
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Affiliation(s)
- S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - R Appignanesi
- Management Department, Asur Zt 12, San Benedetto del Tronto, Italy
| | - T Baldovin
- Department of Molecular Medicine, Section of Public Health, University of Padova, Padova, Italy
| | - M Barchitta
- Department of Molecular Medicine, Section of Public Health, University of Padova, Padova, Italy
| | - S Brusaferro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - R Canino
- Medical Direction Department, Oglio-Po Hospital, Vicomoscano - Casalmaggiore, Cremona, Italy
| | - A Carli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - M M D'Errico
- Department of Biomedical Science and Public Health, Polytechnic University of Marche, Torrette di Ancona, Ancona, Italy
| | - G Giuliani
- Medical Direction Department, Infections Control Committee, G.Salvini Hospital, Garbagnate Milanese, Milan, Italy
| | - M Moro
- Medical Direction Department, Infections Control Committee, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - I Mura
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M Nobile
- Management Department, G. Pini Orthopedic Institute, University of Milan, Milan, Italy
| | - R Novati
- Medical Direction Department, Aosta Regional Hospital, Aosta, Italy
| | - C Pasquarella
- Department of Hygiene and Public Health, University of Parma, Parma, Italy
| | - G Privitera
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - A Rossini
- Medical Direction Department, IRCCS Santa Lucia Scientific Institute, Rome, Italy
| | - L Sodano
- Medical Direction Department San Camillo Forlanini Hospital, Rome, Italy
| | - M V Torregrossa
- Department of Sciences for Health Promotion "G. D'Alessandro", Hygiene Section, University of Palermo, Palermo, ItalY
| | - E Torri
- Department of Health and Social Policy, P.A. Trento, Trento, Italy
| | - F Auxilia
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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14
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Totaro M, De Vita E, Mariotti T, Bisordi C, Giorgi S, Gallo A, Costa AL, Casini B, Valentini P, Privitera G, Baggiani A. Cost analysis for electron time-flow taps and point of use filters: a comparison of two methods for Legionnaires' disease prevention in hospital water networks. J Hosp Infect 2019; 103:231-232. [PMID: 31310790 DOI: 10.1016/j.jhin.2019.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
Affiliation(s)
- M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - E De Vita
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - T Mariotti
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - C Bisordi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - S Giorgi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Gallo
- Division of Public Health and Nutrition, Area of Pisa, Azienda USL Toscana Nord Ovest, Italy
| | - A L Costa
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
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15
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Totaro M, Avella M, Giorgi S, Casini B, Tulipani A, Costa AL, Frendo L, Valentini P, Lopalco PL, Privitera G, Baggiani A. Survey on Energy Drinks consumption and related lifestyle among students of two Italian high schools. Ann Ig 2019; 30:509-516. [PMID: 30614500 DOI: 10.7416/ai.2018.2251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The European Food Safety Authority (EFSA) has identified some risk factors for the occurrence of side effects linked to energy drinks (EDs) consumption by young people. EDs consumption has been evaluated in a sample of students in Italy together with some aspects of their lifestyle. METHODS The survey was performed in two high schools from September 2016 to June 2017. 583 students between 14 to 18 years were recruited and a standard questionnaire (EFSA checklist) was used to collect information on responders characteristics, beverages consumption, EDs with alcohol, and EDs and sports. RESULTS Despite 350 out of 583 responders (60%) consumed EDs, only 146 out of 583 (25%) were EDs-alcohol consumers. Moreover, 208 out of 379 (55%) of all physically active adolescents reported frequent EDs consumption before sport trainings. CONCLUSIONS Study results highlight the need for primary prevention measures in communication campaigns and training delivered by school to limit potential health threats related to excess of EDs consumption.
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Affiliation(s)
- M Totaro
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - M Avella
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - S Giorgi
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - B Casini
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - A Tulipani
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - A L Costa
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - L Frendo
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - P Valentini
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - P L Lopalco
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - G Privitera
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
| | - A Baggiani
- Department of Translational Research and the new Technologies in Medicine and Surgery, University of Pisa
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16
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Privitera G, Luca T, Castorina S, Passanisi R, Ruberto G, Napoli E. Anticancer activity of Salvia officinalis essential oil and its principal constituents against hormone-dependent tumour cells. Asian Pac J Trop Biomed 2019. [DOI: 10.4103/2221-1691.250266] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Filippetti E, Baggiani A, Privitera G, Lopalco PL. Teaching children hygiene principles using a tailored version of e-Bug. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E Filippetti
- Unit of Hygiene and Epidemiology, Department of Translational Research, New Technologies in Medicine, Pisa, Italy
| | - A Baggiani
- Unit of Hygiene and Epidemiology, Department of Translational Research, New Technologies in Medicine, Pisa, Italy
| | - G Privitera
- Unit of Hygiene and Epidemiology, Department of Translational Research, New Technologies in Medicine, Pisa, Italy
| | - PL Lopalco
- Unit of Hygiene and Epidemiology, Department of Translational Research, New Technologies in Medicine, Pisa, Italy
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18
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Celotto D, Battistella C, D'Angelo M, Agodi A, Baldo V, Icardi G, Privitera G, Siliquini R, Tardivo S, Quattrin R, Brusaferro S. Influenza vaccination knowledge, attitudes and behaviors in dialysis patients: a national survey. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Celotto
- Department of Medicine, University of Udine, Udine, Italy
| | - C Battistella
- Department of Medicine, University of Udine, Udine, Italy
| | | | - A Agodi
- Medical, Surgical and Advanced Technologies, Catania, Italy
| | - V Baldo
- Department of Cardiology, Thoracic and Vascular Sciences, University of Padua, Padova, Italy
| | - G Icardi
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - G Privitera
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - R Siliquini
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - R Quattrin
- Accreditation, Clinical Risk Management and Performance Assessment Unit, Udine Healthcare and University Integrated Trust, Udine, Italy
| | - S Brusaferro
- Accreditation, Clinical Risk Management and Performance Assessment Unit, Udine Healthcare and University Integrated Trust - Department of Medicine, University of Udine, Udine, Italy
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19
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Cristina ML, Valeriani F, Casini B, Agodi A, D'Errico MM, Gianfranceschi G, Laganà P, Liguori G, Liguori R, Mucci N, Mura I, Pasquarella C, Piana A, Sotgiu G, Privitera G, Protano C, Quattrocchi A, Ripabelli G, Rossini A, Scaramucci E, Spagnolo AM, Tamburro M, Tardivo S, Veronesi L, Vitali M, Romano Spica V. Procedures in endoscope reprocessing and monitoring: an Italian survey. Ann Ig 2018; 30:45-63. [PMID: 30374511 DOI: 10.7416/ai.2018.2250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND The high diffusion of endoscopes worldwide and the need for effective reprocessing methods requested the development of guidelines and implementation of surveillance procedures at local level. STUDY DESIGN In order to collect data on everyday's practice and adherence to available guidelines, endoscopy units from different public institutions were surveyed using a dedicated questionnaire. METHODS Between July and November 2015 a survey was carried in 12 main hospitals from 10 different Italian regions, involving 22 endoscopy units. The state of the art of national and international guidelines was investigated to compare the protocols adopted at local level. RESULTS In all the surveyed hospitals, the reprocessing activity is based on pre-established protocols in adherence with principal guidelines. Enzymatic detergents, which are recommended by the international guidelines, are used in 55.6% of units and peracetic acid is currently the most widely used chemical disinfectant. Discrepancies were observed in the application of periodic quality controls. CONCLUSION Updated guidelines are generally applied in reprocessing practice. Quality controls may represent a critical issue to improve effectiveness and surveillance. The whole of acquired data can promote a positive trend towards the application of best practices.
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Affiliation(s)
- M L Cristina
- Department of Health Sciences, University of Genoa - UOS Igiene Ospedaliera E.O. Ospedali Galliera, Genoa, Italy
| | - F Valeriani
- Unit of Public Health, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, Pisa University, Pisa, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - M M D'Errico
- Department of Biomedical Sciences and Public Health, Politechnic University of Marche, Ancona, Italy
| | - G Gianfranceschi
- Unit of Public Health, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - P Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - G Liguori
- Department of Movement and Health Sciences, University "Parthenope," Napoli, Italy
| | - R Liguori
- Department of Science and Technology, University "Parthenope," Napoli, Italy
| | - N Mucci
- Department of Technological Innovations and Safety of Plants, Products and Anthropic Settlements, National Institute for Insurance against Accidents at Work, INAIL, Rome, Italy
| | - I Mura
- Department of Biomedical Science-Hygiene Section, University of Sassari, Sassari, Italy
| | - C Pasquarella
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - A Piana
- Department of Biomedical Science-Hygiene Section, University of Sassari, Sassari, Italy
| | - G Sotgiu
- Department of Biomedical Science-Hygiene Section, University of Sassari, Sassari, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, Pisa University, Pisa, Italy
| | - C Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Quattrocchi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - G Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - A Rossini
- Fondazione Santa Lucia Institute for Research and Health Care, IRCCS, Rome, Italy
| | | | - A M Spagnolo
- Department of Health Sciences, University of Genoa - UOS Igiene Ospedaliera E.O. Ospedali Galliera, Genoa, Italy
| | - M Tamburro
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - L Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - V Romano Spica
- Unit of Public Health, Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Rome, Italy
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20
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Tardivo S, Moretti F, Nobile M, Agodi A, Appignanesi R, Arrigoni C, Baldovin T, Brusaferro S, Canino R, Carli A, Chiesa R, D'Alessandro D, D'Errico MM, Giuliani G, Montagna MT, Moro M, Mura II, Novati R, Orsi GB, Pasquarella C, Privitera G, Ripabelli G, Rossini A, Saia M, Sodano L, Torregrossa MV, Torri E, Zarrilli R, Auxilia F, SItI G. Definition of criteria and indicators for the prevention of Healthcare-Associated Infections (HAIs) in hospitals for the purposes of Italian institutional accreditation and performance monitoring. Ann Ig 2018; 29:529-547. [PMID: 29048451 DOI: 10.7416/ai.2017.2183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) are an important issue in terms of quality of care. HAIs impact patient safety by contributing to higher rates of preventable mortality and prolonged hospitalizations. In Italy, analysis of the currently available accreditation systems shows a substantial heterogeneity of approaches for the prevention and surveillance of HAIs in hospitals. The aim of the present study is to develop and propose the use of a synthetic assessment tool that could be implemented homogenously throughout the nation. METHODS An analysis of nine international and of the 21 Italian regional accreditation systems was conducted in order to identify requirements and indicators implemented for HAI prevention and control. Two relevant reviews on this topic were further analyzed to identify additional evidence-based criteria. The project team evaluated all the requirements and indicators with consensus meeting methodology, then those applicable to the Italian context were grouped into a set of "focus areas". RESULTS The analysis of international systems and Italian regional accreditation manuals led to the identification respectively of 19 and 14 main requirements, with relevant heterogeneity in their application. Additional evidence-based criteria were included from the reviews analysis. From the consensus among the project team members all the standards were compared and 20 different thematic areas were identified, with a total of 96 requirements and indicators for preventing and monitoring HAIs. CONCLUSIONS The study reveals a great heterogeneity in the definition of accreditation criteria between the Italian regions. The introduction of a uniform, synthetic assessment instrument, based on the review of national and international standards, may serve as a self-assessment tool to evaluate the achievement of a minimum standards set for HAIs prevention and control in healthcare facilities. This may be used as an assessment tool by the Italian institutional accreditation system, also useful to reduce regional disparities.
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Affiliation(s)
- S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - M Nobile
- Management Department, G. Pini Orthopedic Institute, University of Milan, Milan, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - R Appignanesi
- Management Department, Asur Zt 12, San Benedetto del Tronto, Italy
| | - C Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - T Baldovin
- Department of Molecular Medicine, Section of Public Health, University of Padova, Padova, Italy
| | - S Brusaferro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - R Canino
- Medical Direction Department, Oglio-Po Hospital, Vicomoscano - Casalmaggiore, Cremona, Italy
| | - A Carli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - R Chiesa
- Programming Acquisition and Control Department, Asl Brescia, Brescia, Italy
| | - D D'Alessandro
- Department of Civil Building and Environmental Engineering, Sapienza University of Rome, Rome, Italy
| | - M M D'Errico
- Department of Biomedical Science and Public Health, Polytechnic University of Marche, Torrette di Ancona, Ancona, Italy
| | - G Giuliani
- Department of Medical Direction, Infections Control Committee, G. Salvini Hospital, Garbagnate Milanese, Milan, Italy
| | - M T Montagna
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - M Moro
- Department of Medical Direction, Infections Control Committee, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - I I Mura
- Department of Biomedical Sciences, Hygiene Unit, University of Sassari, Sassari, Italy
| | - R Novati
- Medical Direction, Aosta Regional Hospital, Aosta, Italy
| | - G B Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Pasquarella
- Department of Hygiene and Public Health, University of Parma, Parma, Italy
| | - G Privitera
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - G Ripabelli
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - A Rossini
- Department of Medical Direction, IRCCS Santa Lucia Scientific Institute, Rome, Italy
| | - M Saia
- Veneto Region Health Directorate, Palazzo Molin San Polo Venice, Italy
| | - L Sodano
- Department of Medical Direction, San Camillo Forlanini Hospital, Rome, Italy
| | - M V Torregrossa
- Department of Sciences for Health Promotion "G. D'Alessandro" - Hygiene Section, University of Palermo, Palermo, Italy
| | - E Torri
- Department of Health and Social Policy, Trento, Italy
| | - R Zarrilli
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - F Auxilia
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Gisio SItI
- Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
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21
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Totaro M, Porretta A, Canale A, Filippetti E, Tulipani A, Quattrone F, Giorgi S, Costa AL, Valentini P, Casini B, Privitera G, Baggiani A. Preliminary study of the air quality in operating rooms: do textiles have a role? J Hosp Infect 2018; 99:306-308. [PMID: 29674114 DOI: 10.1016/j.jhin.2018.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/10/2018] [Indexed: 11/15/2022]
Affiliation(s)
- M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Porretta
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Canale
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - E Filippetti
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Tulipani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - F Quattrone
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - S Giorgi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A L Costa
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
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22
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Casini B, Baggiani A, Totaro M, Mansi A, Costa AL, Aquino F, Miccoli M, Valentini P, Bruschi F, Lopalco PL, Privitera G. Detection of viable but non-culturable legionella in hospital water network following monochloramine disinfection. J Hosp Infect 2017; 98:46-52. [PMID: 28917570 DOI: 10.1016/j.jhin.2017.09.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/04/2017] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Prevention of legionellosis remains a critical issue in healthcare settings where monochloramine (MC) disinfection was recently introduced as an alternative to chlorine dioxide in controlling Legionella spp. contamination of the hospital water network. Continuous treatments with low MC doses in some instances have induced a viable but non-culturable state (VBNC) of Legionella spp. AIM To investigate the occurrence of such dormant cells during a long period of continuous MC treatment. METHODS Between November 2010 and April 2015, 162 water and biofilm samples were collected and Legionella spp. isolated in accordance with standard procedures. In sampling sites where MC was <1.5mg/L, VBNC cells were investigated by ethidium monoazide bromide (EMA)-real-time polymerase chain reaction (qPCR) and 'resuscitation' test into Acanthamoeba polyphaga CCAP 1501/18. According to the Health Protection Agency protocol, free-living protozoa were researched in 60 five-litre water samples. FINDINGS In all, 136 out of 156 (87.2%) of the samples taken from sites previously positive for L. pneumophila ST269 were negative by culture, but only 47 (34.5%) negative by qPCR. Although no positive results were obtained by EMA-qPCR, four out of 22 samples associated with MC concentration of 1.3 ± 0.5mg/L showed VBNC legionella resuscitation. The presence of the amoeba A. polyphaga in the hospital water network was demonstrated. CONCLUSION Our study is the first report evidencing the emergence of VNBC legionella during a long period of continuous MC treatment of a hospital water network, highlighting the importance of keeping an appropriate and uninterrupted MC dosage to ensure the control of legionella colonization in hospital water supplies.
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Affiliation(s)
- B Casini
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy.
| | - A Baggiani
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - M Totaro
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - A Mansi
- INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Monte Porzio Catone (Roma), Roma, Italy
| | - A L Costa
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - F Aquino
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - M Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - P Valentini
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - F Bruschi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - P L Lopalco
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - G Privitera
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
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23
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Ruggieri M, Praticò AD, Serra A, Maiolino L, Cocuzza S, Di Mauro P, Licciardello L, Milone P, Privitera G, Belfiore G, Di Pietro M, Di Raimondo F, Romano A, Chiarenza A, Muglia M, Polizzi A, Evans DG. Childhood neurofibromatosis type 2 (NF2) and related disorders: from bench to bedside and biologically targeted therapies. Acta Otorhinolaryngol Ital 2017; 36:345-367. [PMID: 27958595 PMCID: PMC5225790 DOI: 10.14639/0392-100x-1093] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 04/29/2016] [Indexed: 12/22/2022]
Abstract
Neurofibromatosis type 2 [NF2; MIM # 101000] is an autosomal dominant disorder characterised by the occurrence of vestibular schwannomas (VSs), schwannomas of other cranial, spinal and cutaneous nerves, cranial and spinal meningiomas and/or other central nervous system (CNS) tumours (e.g., ependymomas, astrocytomas). Additional features include early onset cataracts, optic nerve sheath meningiomas, retinal hamartomas, dermal schwannomas (i.e., NF2-plaques), and (few) café-au-lait spots. Clinically, NF2 children fall into two main groups: (1) congenital NF2 - with bilateral VSs detected as early as the first days to months of life, which can be stable/asymptomatic for one-two decades and suddenly progress; and (2) severe pre-pubertal (Wishart type) NF2- with multiple (and rapidly progressive) CNS tumours other-than-VS, which usually present first, years before VSs [vs. the classical adult (Gardner type) NF2, with bilateral VSs presenting in young adulthood, sometimes as the only disease feature]. Some individuals can develop unilateral VS associated with ipsilateral meningiomas or multiple schwannomas localised to one part of the peripheral nervous system [i.e., mosaic NF2] or multiple non-VS, non-intradermal cranial, spinal and peripheral schwannomas (histologically proven) [schwannomatosis]. NF2 is caused by mutations in the NF2 gene at chromosome 22q12.1, which encodes for a protein called merlin or schwannomin, most similar to the exrin-readixin-moesin (ERM) proteins; mosaicNF2 is due to mosaic phenomena for the NF2 gene, whilst schwannomatosis is caused by coupled germ-line and mosaic mutations either in the SMARCB1 gene [SWNTS1; MIM # 162091] or the LZTR1 gene [SWNTS2; MIM # 615670] both falling within the 22q region and the NF2 gene. Data driven from in vitro and animal studies on the merlin pathway [e.g., post-translational and upstream/downstream regulation] allowed biologically targeted treatment strategies [e.g., Lapatinib, Erlotinib, Bevacizumab] aimed to multiple tumour shrinkage and/or regression and tumour arrest of progression with functional improvement.
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Affiliation(s)
- M Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Italy
| | - A D Praticò
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Italy
| | - A Serra
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - L Maiolino
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - S Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - P Di Mauro
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - L Licciardello
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Otorhinolaryngology, University of Catania, Italy
| | - P Milone
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Radiology, University of Catania, Italy
| | - G Privitera
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Radiology, University of Catania, Italy
| | - G Belfiore
- Unit of Paediatric Radiology, AOU "Policlinico-Vittorio Emanuele", Catania, Italy
| | - M Di Pietro
- Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", Institute of Ophthalmology, University of Catania, Italy
| | - F Di Raimondo
- Division of Hematology, AOU "Policlinico-Vittorio Emanuele", University of Catania, Italy
| | - A Romano
- Division of Hematology, AOU "Policlinico-Vittorio Emanuele", University of Catania, Italy
| | - A Chiarenza
- Division of Hematology, AOU "Policlinico-Vittorio Emanuele", University of Catania, Italy
| | - M Muglia
- Unit of Genetics, Institute of Neurological Sciences, National Research Council, Piano Lago di Mangone, Italy
| | - A Polizzi
- National Centre for Rare Disease, Istituto Superiore di Sanità, Rome, Italy.,Institute of Neurological Sciences, National Research Council, Catania, Italy
| | - D G Evans
- Genomic Medicine, University of Manchester, Manchester Academic Health Science Centre, Institute of Human Development, Central Manchester NHS Foundation Trust, Manchester Royal Infirmary, Manchester, UK
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24
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Mazzei MM, Sindoni A, Santacaterina A, Platania A, Marino L, Umina V, Girlando A, Ricottone N, D'Agostino A, Marletta F, Tamburo M, Acquaviva G, Spatola C, Privitera G, Frosina P, Garufi G, Bonanno S, Rosso A, Barone V, Corallo A, Sansotta G, Delia P, Donato V, Lopes S, Pisana M, Runco R, Risoleti E, Arcudi A, Rifatto C, Arena G, Potami A, Messina G, Parisi S, Marletta D, Pontoriero A, Iatì G, Pergolizzi S. Radiation therapy utilisation in patients with bone metastases secondary to prostate cancer: A multicenter study. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28657212 DOI: 10.1111/ecc.12681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2017] [Indexed: 11/28/2022]
Affiliation(s)
- M M Mazzei
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - A Sindoni
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - A Platania
- Radiotherapy Unit, AOOR Papardo, Piemonte, Messina, Italy
| | - L Marino
- Radiotherapy Unit, REM Center, Catania, Italy
| | - V Umina
- Radiotherapy Unit, REM Center, Catania, Italy
| | - A Girlando
- Radiotherapy Unit, Humanitas, Catania, Italy
| | - N Ricottone
- Radiotherapy Unit, Humanitas, Catania, Italy
| | | | | | | | - G Acquaviva
- Radiotherapy Unit, AOOR Papardo, Piemonte, Messina, Italy
| | - C Spatola
- Radiotherapy Unit, University Hospital of Catania, Catania, Italy
| | - G Privitera
- Radiotherapy Unit, University Hospital of Catania, Catania, Italy
| | - P Frosina
- Radiotherapy Unit, "San Vincenzo" Hospital, Taormina, Italy
| | - G Garufi
- Radiotherapy Unit, "San Vincenzo" Hospital, Taormina, Italy
| | - S Bonanno
- Garibaldi-Nesima Hospital, Catania, Italy
| | - A Rosso
- Garibaldi-Nesima Hospital, Catania, Italy
| | - V Barone
- Paternò Arezzo Hospital, Ragusa, Italy
| | - A Corallo
- Paternò Arezzo Hospital, Ragusa, Italy
| | - G Sansotta
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - P Delia
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - V Donato
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - S Lopes
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - M Pisana
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - R Runco
- University of Messina, Messina, Italy
| | - E Risoleti
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - A Arcudi
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - C Rifatto
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - G Arena
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - A Potami
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - G Messina
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - S Parisi
- University of Messina, Messina, Italy
| | | | - A Pontoriero
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - G Iatì
- Radiotherapy Unit, University Hospital of Messina, Messina, Italy
| | - S Pergolizzi
- Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
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25
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Totaro M, Casini B, Valentini P, Miccoli M, Giorgi S, Porretta A, Privitera G, Lopalco PL, Baggiani A. Evaluation and control of microbial and chemical contamination in dialysis water plants of Italian nephrology wards. J Hosp Infect 2017; 97:169-174. [PMID: 28546028 DOI: 10.1016/j.jhin.2017.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/16/2017] [Indexed: 11/13/2022]
Abstract
BACKGROUND Patients receiving haemodialysis are exposed to a large volume of dialysis fluid. The Italian Society of Nephrology (ISN) has published guidelines and microbial quality standards on dialysis water (DW) and solutions to ensure patient safety. AIM To identify microbial and chemical hazards, and evaluate the quality of disinfection treatment in DW plants. METHODS In 2015 and 2016, water networks and DW plants (closed loop and online monitors) of nine dialysis wards of Italian hospitals, hosting 162 dialysis beds overall, were sampled on a monthly basis to determine the parameters provided by ISN guidelines. Chlorinated drinking water was desalinated by reverse osmosis and distributed to the closed loop which feeds all online monitors. Disinfection with peracetic acid was performed in all DW plants on a monthly basis. FINDINGS Over the 24-month study period, seven out of nine DW plants (78%) recorded negative results for all investigated parameters. Closed loop contamination with Burkholderia cepacia was detected in a DW plant from January 2015 to March 2015. Pseudomonas aeruginosa was isolated from March 2016 to May 2016 in the closed loop of another DW plant. These microbial contaminations were eradicated by shock disinfection with sodium hypochlorite and peracetic acid, followed by water flushing. CONCLUSION These results highlight the importance of chemical and physical methods of DW disinfection. The maintenance of control measures in water plants hosted in dialysis wards ensures a microbial risk reduction for all dialysis patients.
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Affiliation(s)
- M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - M Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Giorgi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A Porretta
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - P L Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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26
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Casini B, Selvi C, Cristina ML, Totaro M, Costa AL, Valentini P, Barnini S, Baggiani A, Tagliaferri E, Privitera G. Evaluation of a modified cleaning procedure in the prevention of carbapenem-resistant Acinetobacter baumannii clonal spread in a burn intensive care unit using a high-sensitivity luminometer. J Hosp Infect 2016; 95:46-52. [PMID: 27939245 DOI: 10.1016/j.jhin.2016.10.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/25/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Enhanced environmental cleaning practices are among the most accepted measures for controlling the spread of carbapenem-resistant Acinetobacter baumannii (CR-Ab). AIM To evaluate the impact of heightened cleaning on an ongoing CR-Ab outbreak in a burn intensive care unit (BICU) of an Italian teaching hospital, where chlorhexidine-60% isopropyl alcohol was applied as a complementary disinfectant on high-touch surfaces. METHODS Compliance with the microbial limit proposed for the BICU by AFNOR-NF-S90-351 (20 colony-forming units/100cm2) was assessed by plate count, and compared with the results obtained with intracellular adenosine triphosphate (ATP) detection. Genotyping was performed using pulsed-field gel electrophoresis. FINDINGS During the standard cleaning regimen, three out of 23 samples (13%) gave results over the AFNOR limit and five (21.7%) showed unacceptable ATP levels with 100 relative light units/100cm2 as the benchmark limit (sensibility 86.4%, specificity 92.2%). Following improvement of the cleaning procedure, only two samples out of 50 (4%) did not satisfy the microbiological criteria and seven (14%) exceeded the ATP limit. In a successive phase, eight of 30 samples collected showed unacceptable results (27%). CONCLUSIONS Adding chlorhexidine-60% isopropyl alcohol as complementary disinfectant proved to be effective for reducing environmental microbial contamination, ATP levels and CR-Ab infection/colonization in patients admitted to the BICU. Real-time monitoring by ATP assay was useful for managing the cleaning schedule and reducing hospital infections, although the calculated values must be interpreted as cleanliness indicators rather than risk indicators.
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Affiliation(s)
- B Casini
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy.
| | - C Selvi
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - M L Cristina
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M Totaro
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - A L Costa
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - P Valentini
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - S Barnini
- Unit of Microbiology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - A Baggiani
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - E Tagliaferri
- Unit of Infectious Diseases, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - G Privitera
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
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27
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Totaro M, Casini B, Costa AL, Valentini P, Petretti F, Giorgi S, Frendo L, Miccoli M, Privitera G, Baggiani A. Evaluation of the relationship between consumers and food labels in Tuscany (Italy). Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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28
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Casini B, Zezza L, Totaro M, Giorgi S, Righi A, Bianchi G, Marini L, Valentini P, Tagliaferri E, Tascini C, Baggiani A, Privitera G. Risk of transmission of KPC-producing Klebsiella pneumoniae in digestive endoscopy. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Baggiani A, Casini B, Totaro M, Aquino F, Valentini P, Bruni B, Porretta A, Casalini F, Miccoli M, Privitera G. Colonization by Legionella spp. of water networks in residential buildings of the Province of Pisa, Italy. Ann Ig 2015; 27:718-25. [PMID: 26661913 DOI: 10.7416/ai.2015.2064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Despite the increase of community acquired cases of legionellosis in Italy over the last years, the Italian guidelines do not give indications for prevention and control of Legionella in the hot water networks (or centralized conditioning systems) of residential buildings. We performed a survey on eight medium sized apartment buildings in the Pisa district to assess the prevalence of Legionella spp. in the water network and the respondance to drinking water requisites at the point of use, according to the Italian norms. METHODS For each building two hot water and three cold water samples (located at water entrance from the aqueduct network into the building pipework, at the exit from pressure autoclave, and at a remote tap) were collected. RESULTS Legionella was detected in 20% of residential buildings, mostly in those with a central hot water production system. CONCLUSIONS The study highlights a condition of potential risk for susceptible population subgroups and supports the need for measures of risk assessment and control.
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Affiliation(s)
- A Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - M Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - F Aquino
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - P Valentini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - B Bruni
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - A Porretta
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - F Casalini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - M Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
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30
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Bagnara V, Castorina S, Nappo SG, Privitera G, Luca T, Caione P. Hypothesis on etiopathogenesis, congenital or acquired, of an imperforate distal ureter: a case report. J Med Case Rep 2015; 9:227. [PMID: 26444977 PMCID: PMC4596491 DOI: 10.1186/s13256-015-0711-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 09/15/2015] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Ureteral atresia is a rare disease usually associated with a non-functioning kidney. Its association with other urinary anomalies is rare. CASE PRESENTATION In this study we discuss the possibility of congenital or acquired etiology of a right imperforate distal ureter. Here we report the case of 11-month-old white boy with a right ureteropelvic junction obstruction. He underwent a right pyeloplasty when he was 11-months old, and 3 weeks after surgery a cystoscopy was performed. Two months after the first operation, he underwent a right ureteral meatoplasty and a new pyeloplasty. CONCLUSIONS To the best of our knowledge, few cases of imperforate distal ureter have been described in the literature. The suspicion of a non-patent terminal ureter, occurring during upper urinary tract surgery, must be intraoperatively clarified to preserve the renal function and to avoid more complex surgical approaches.
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Affiliation(s)
- Vincenzo Bagnara
- Department of Maternal and Infant Medicine and Radiological Sciences, University of Catania, Via S. Sofia, 78, 95123, Catania, Italy. .,"G.B. Morgagni" Mediterranean Foundation, 95125, Catania, Italy.
| | - S Castorina
- "G.B. Morgagni" Mediterranean Foundation, 95125, Catania, Italy. .,Department of Biomedical and Biotechnological Sciences, University of Catania, 95125, Catania, Italy.
| | - S Gerocarni Nappo
- Division of Urology-Andrology, Department of Paediatric Nephrology-Urology, "Bambino Gesu" Children's Hospital, Research Institute, Rome, Italy.
| | - G Privitera
- "G.B. Morgagni" Mediterranean Foundation, 95125, Catania, Italy.
| | - T Luca
- "G.B. Morgagni" Mediterranean Foundation, 95125, Catania, Italy.
| | - P Caione
- Division of Urology-Andrology, Department of Paediatric Nephrology-Urology, "Bambino Gesu" Children's Hospital, Research Institute, Rome, Italy.
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Totaro M, Carnesecchi E, Valentini P, Porretta A, Bruni B, Privitera G, Casini B, Baggiani A. Presence of Legionella in water networks of italian residential buildings. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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Casini B, Carnesecchi E, Totaro M, Privitera G, Baggiani A. Diffusion model applied to assessment of children health impact. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv172.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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33
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Moroni M, Pagano A, Lazzarin A, Privitera G, Parravicini CL. Opportunistic infections in AIDS patients in Milan. Antibiot Chemother (1971) 2015; 38:174-9. [PMID: 3662469 DOI: 10.1159/000414232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- M Moroni
- Clinica di Malattie Infettive, Universitá di Milano, Italia
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Privitera G, Luca T, Musso N, Vancheri C, Crimi N, Barresi V, Condorelli D, Castorina S. In vitro antiproliferative effect of trastuzumab (Herceptin(®)) combined with cetuximab (Erbitux(®)) in a model of human non-small cell lung cancer expressing EGFR and HER2. Clin Exp Med 2015; 16:161-8. [PMID: 25716471 DOI: 10.1007/s10238-015-0343-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 02/16/2015] [Indexed: 11/26/2022]
Abstract
Lung cancer is the leading cause of cancer death. For this reason, new therapies are needed for the treatment of this devastating disease. In this study, we investigated the effects of combining cetuximab and the trastuzumab on the growth of a model of human non-small cell lung carcinoma cell line (A549). The results were compared with those obtained from a human lung squamous carcinoma cell line (NCI-H226). Both cell lines were treated with cetuximab and trastuzumab, alone or in combination, at various concentrations, for 24, 48 and 72 h. Cell proliferation was measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. EGFR and HER-2 mRNA expression was detected by reverse transcription polymerase chain reaction, and the gene amplification status of receptors was evaluated by fluorescence in situ hybridisation. The colorimetric proliferation assay showed that trastuzumab combined with cetuximab significantly inhibited A549 cells at a dose of 40 μg/ml after 72 h of treatment (p < 0.05), while no time-dose dependent inhibition was observed in NCI-H226 cells. The combined treatment influenced both levels of EGFR and HER-2 mRNA in A549 cells and only EGFR mRNA levels in NCI-H226 cells. Fluorescence in situ hybridisation showed that both cell lines were aneuploid for the two genes with equally increased EGFR and CEN7 signals, as well as HER-2 and CEN17 signals, indicating a condition of polysomy without amplification. The preliminary results of this study encourage further investigations to elucidate the downstream events involved and to understand how these mechanisms influence non-small cell lung cancers growth.
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Affiliation(s)
- G Privitera
- Fondazione Mediterranea "G.B. Morgagni", Via del Bosco, 105, 95125, Catania, Italy.
| | - T Luca
- Fondazione Mediterranea "G.B. Morgagni", Via del Bosco, 105, 95125, Catania, Italy
| | - N Musso
- Department of Bio-Medical Sciences, University of Catania, Catania, Italy
| | - C Vancheri
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - N Crimi
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - V Barresi
- Department of Bio-Medical Sciences, University of Catania, Catania, Italy
| | - D Condorelli
- Department of Bio-Medical Sciences, University of Catania, Catania, Italy
| | - S Castorina
- Department of Bio-Medical Sciences, University of Catania, Catania, Italy
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Brusaferro S, Arnoldo L, Cattani G, Fabbro E, Cookson B, Gallagher R, Hartemann P, Holt J, Kalenic S, Popp W, Privitera G, Prikazsky V, Velasco C, Suetens C, Varela Santos C. Harmonizing and supporting infection control training in Europe. J Hosp Infect 2015; 89:351-6. [PMID: 25777079 DOI: 10.1016/j.jhin.2014.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 12/16/2014] [Indexed: 11/18/2022]
Abstract
Healthcare-associated infection (HCAI), patient safety, and the harmonization of related policies and programmes are the focus of increasing attention and activity in Europe. Infection control training for healthcare workers (HCWs) is a cornerstone of all patient safety and HCAI prevention and control programmes. In 2009 the European Centre for Disease Prevention and Control (ECDC) commissioned an assessment of needs for training in infection control in Europe (TRICE), which showed a substantial increase in commitment to HCAI prevention. On the other hand, it also identified obstacles to the harmonization and promotion of training in infection control and hospital hygiene (IC/HH), mostly due to differences between countries in: (i) the required qualifications of HCWs, particularly nurses; (ii) the available resources; and (iii) the sustainability of IC/HH programmes. In 2013, ECDC published core competencies for infection control and hospital hygiene professionals in the European Union and a new project was launched ['Implementation of a training strategy for infection control in the European Union' (TRICE-IS)] that aimed to: define an agreed methodology and standards for the evaluation of IC/HH courses and training programmes; develop a flexible IC/HH taxonomy; and implement an easily accessible web tool in 'Wiki' format for IC/HH professionals. This paper reviews several aspects of the TRICE and the TRICE-IS projects.
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Affiliation(s)
- S Brusaferro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
| | - L Arnoldo
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - G Cattani
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - E Fabbro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - B Cookson
- Division of Infection and Immunity, University College London, London, UK
| | - R Gallagher
- Infection Prevention and Control, Royal College of Nursing, London, UK
| | - P Hartemann
- Service d'Hygiène Hospitalière, C.H.U. de Nancy & DESP-SERES, Faculté de Médicine, Vandoeuvre‒Nancy, France
| | - J Holt
- National Center for Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - S Kalenic
- Department of Medical Microbiology, University of Zagreb, Zagreb, Croatia
| | - W Popp
- Hospital Hygiene, University Clinics Essen, Essen, Germany
| | - G Privitera
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, University of Pisa, Pisa, Italy
| | - V Prikazsky
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - C Velasco
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - C Suetens
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - C Varela Santos
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Brusaferro S, Cookson B, Kalenic S, Cooper T, Fabry J, Gallagher R, Hartemann P, Mannerquist K, Popp W, Privitera G, Ruef C, Viale P, Coiz F, Fabbro E, Suetens C, Varela Santos C. Training infection control and hospital hygiene professionals in Europe, 2010: agreed core competencies among 33 European countries. ACTA ACUST UNITED AC 2014; 19. [PMID: 25523973 DOI: 10.2807/1560-7917.es2014.19.49.20985] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The harmonisation of training programmes for infection control and hospital hygiene (IC/HH) professionals in Europe is a requirement of the Council recommendation on patient safety. The European Centre for Disease Prevention and Control commissioned the 'Training Infection Control in Europe' project to develop a consensus on core competencies for IC/HH professionals in the European Union (EU). Core competencies were drafted on the basis of the Improving Patient Safety in Europe (IPSE) project's core curriculum (CC), evaluated by questionnaire and approved by National Representatives (NRs) for IC/HH training. NRs also re-assessed the status of IC/HH training in European countries in 2010 in comparison with the situation before the IPSE CC in 2006. The IPSE CC had been used to develop or update 28 of 51 IC/HH courses. Only 10 of 33 countries offered training and qualification for IC/HH doctors and nurses. The proposed core competencies are structured in four areas and 16 professional tasks at junior and senior level. They form a reference for standardisation of IC/HH professional competencies and support recognition of training initiatives.
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Affiliation(s)
- S Brusaferro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
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Brusaferro S, Cookson B, Gallagher R, Hartemann P, Holt J, Kalenic S, Popp W, Privitera G, Arnoldo L, Cattani G, Fabbro E, Varela Santos C, Suetens C. A model for validation of European Professional Infection Control/Hospital Hygiene training courses. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku161.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Luca T, Barresi V, Privitera G, Musso N, Caruso M, Condorelli DF, Castorina S. In vitro combined treatment with cetuximab and trastuzumab inhibits growth of colon cancer cells. Cell Prolif 2014; 47:435-47. [PMID: 25131935 DOI: 10.1111/cpr.12125] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/20/2014] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Overexpression or constitutive activation of epidermal growth factor receptors (EGFR) is involved in growth of human cancers. We investigated effects of EGFR and HER-2 blockade in colon cancer cell lines using cetuximab and trastuzumab, with the aim of developing novel approaches to cancer therapy. MATERIALS AND METHODS We studied effects of treatment on cell growth, cell cycle distribution, induction of apoptosis, changes in EGFR and HER-2 mRNA-protein expression and EGFR and HER-2 gene copy number in Caco-2, HT-29 and HCT-116 cells. RESULTS Treatment of cells resulted in no effect in one of the three cell lines and in inhibition of cell proliferation in a time- and dose-dependent manner in the other two, with modulation of EGFR and HER-2 mRNA and protein levels. Differences in sensitivity to cetuximab and trastuzumab were observed. Treatment induced specific changes in cell cycle distribution in both cell lines affected, while apoptosis was not increased. Fluorescence in situ hybridization analysis revealed abnormal copy number of two genes resulting from aneuploidy; this was not responsible for different sensitivity to combination between the two cell lines. CONCLUSIONS Targeting EGFR and HER-2 simultaneously could have useful applications in colorectal cancer treatment. To improve pharmacological efficacy of cetuximab and trastuzumab combination, molecular mechanisms involved in their activity need to be elucidated.
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Affiliation(s)
- T Luca
- Fondazione Mediterranea "G.B. Morgagni", 95125, Catania, Italy
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Casini B, Verani M, Tascini C, Privitera G, Carducci A. Airborne antibiotic resistant bacteria in a solid waste recycling plant: a crucial area for public health actions. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Brusaferro S, Cookson B, Gallagher R, Hartemann P, Holt J, Kalenic S, Popp W, Privitera G, Varela Santos C, Suetens C, Arnoldo L, Cattani G, Fabbro E. Promoting european infection control / hospital hygiene core competencies: a need for training professionals in Europe. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tricarico P, Cambieri A, Campo A, Cantaro P, Costa A, Fiore S, Marazzi L, Marcolongo A, Monturano M, Mura I, Pascu D, Privitera G, Rinaldi O, Romano G, Sotgiu G, Tardivo S, Zanardo D, Zerman T, Brusaferro S. Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA). Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt124.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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42
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Moro ML, Ricchizzi E, Morsillo F, Marchi M, Puro V, Zotti CM, Prato R, Privitera G, Poli A, Mura I, Fedeli U. Infections and antimicrobial resistance in long term care facilities: a national prevalence study. Ann Ig 2013; 25:109-18. [PMID: 23471448 DOI: 10.7416/ai.2013.1912] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND A point prevalence survey (PPS) was conducted in Italy in 2010, as part of the first European PPS in Long Term Care Facilities (LTCFs), conducted within the HALT Project. METHODS The PPS was aimed at estimating the prevalence of infections, antimicrobial resistance, and antibiotic use and to assess the status of infections control programs in this setting. RESULTS Ninety two LTCFs, located in 11 different Italian regions, participated to the study: 9391 residents were enrolled, 9285 of whom were eligible according to the study criteria. The prevalence of residents with signs/symptoms of infection was 6.5% (606 residents); 438 residents were on antimicrobial treatment (4.7%) and 526 had signs/symptoms (5.7%) but in 324 residents only (3.5/100 residents) the infection satisfied the modified McGeer criteria and was considered confirmed. The most frequent infection site was the respiratory tract (1.27/100 residents). Mostly of the antibiotics were prescribed for respiratory tract infections (42.8% of the antibiotics) and for urinary tract infections (26.6%). The most frequently prescribed classes were quinolones, followed by penicillin plus beta-lactamase inhibitor and 3rd generation cephalosporins. Few infection had a microbiological confirmation, but among the 143 isolated microorganisms 24% were multidrug resistant. CONCLUSIONS The burden of infections and antimicrobial resistance in LTCFs is significant and infection control and surveillance program are urgently needed.
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Affiliation(s)
- M L Moro
- Infectious Disease Risk Unit, Healthcare and Social Agency Emilia Romagna Region, Bologna, Italy
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Idolo A, Serio F, Lugoli F, Grassi T, Bagordo F, Guido M, Privitera G, Lobreglio G, De Donno A. Identification of HEV in symptom-free migrants and environmental samples in Italy. J Viral Hepat 2013; 20:438-43. [PMID: 23647961 DOI: 10.1111/jvh.12038] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 10/15/2012] [Indexed: 12/22/2022]
Abstract
Hepatitis E virus (HEV) is considered an emerging pathogen in industrialized countries. The occurrence of HEV genotypes in samples of faeces from asymptomatic migrants arriving on the coasts of South Italy and environmental samples was investigated. Analyses of sequences were used to compare human and environmental genotypes. A total of 40 stool specimens, 12 samples of untreated urban sewage, 12 samples of treated urban sewage and 12 samples of surface water were analysed. Viruses were concentrated from water samples by the tangential flow ultrafiltration technique. The presence of HEV RNA was detected by nested RT-PCR. Viral isolates were sequenced and phylogenetically characterized. Two (5%) of the 40 faecal samples tested were found to be positive for HEV RNA (G1 and G3 genotypes). The virus was detected in 25% (3/12) of the untreated sewage samples and 25% (3/12) of the surface water samples: all isolates belonged to G3 genotype. None of the treated sewage samples were found to be HEV RNA positive. The virus was detected in the faeces of two asymptomatic subjects, suggesting a potential role for symptom-free HEV carriers as a human reservoir. G3 HEV strains were detected in the untreated sewage, as observed in similar studies conducted in other European countries but differing from another study conducted in Italy recently. Moreover, our results show the first case of HEV isolated from fresh surface waters.
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Affiliation(s)
- A Idolo
- Department of Biological and Environmental Science and Technology Di.STe.B.A., University of the Salento, 73100- Lecce, Italy
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Casini B, Minacori MG, Buzzigoli A, Valentini P, Morici P, Barnini S, Tascini C, Menichetti F, Rossolini GM, Privitera G. Is multi-drugs resistant Acinetobacter baumannii epidemic spread related to reduced susceptibility to biocides? BMC Proc 2011. [PMCID: PMC3239734 DOI: 10.1186/1753-6561-5-s6-p300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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45
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Casini B, Buzzigoli A, Valentini P, Vecchione A, Torracca F, Baggiani A, Privitera G. Best practice approach to the risk management of Legionella infection in health care facilities. BMC Proc 2011. [PMCID: PMC3239739 DOI: 10.1186/1753-6561-5-s6-p305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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46
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Cassani E, Privitera G, Pezzoli G, Pusani C, Madio C, Iorio L, Barichella M. Use of probiotics for the treatment of constipation in Parkinson's disease patients. MINERVA GASTROENTERO 2011; 57:117-121. [PMID: 21587143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM The aim of this paper was to assess the effects of milk fermented with the probiotic strain Lactobacillus casei Shirota on constipation in Parkinson's disease patients. Constipation is a common secondary symptom in patients suffering from Parkinson's Disease (PD), generally treated with dietary therapy, soluble fiber supplements and macrogol laxatives without sodium sulfate. There are no studies on the use of probiotics in the treatment of constipation in these patients. The effects of the administration of Lactobacillus casei Shirota on gastrointestinal symptoms have been assessed in two randomized controlled trials on patients suffering from chronic constipation. METHODS Forty PD patients suffering from constipation according to Rome III criteria were recruited. We compared the characteristic of intestinal function during two periods with different treatments: in the first week the patients treated constipation only with dietetic therapy; in the following 5 weeks the patients treated constipation not only with dietetic therapy, but also taking a 65 mL fermented milk drink containing 6.5×109 CFU of Lactobacilus casei Shirota daily.They completed a daily diary for 6 weeks, recording details related to their intestinal function. RESULTS After probiotic intake we observed a statistically significant increase in the number of days per week in which stools were of normal consistency (P<0.01) and significant reductions in the number of days per week in which patients felt bloated (P<0.01), experienced abdominal pain (P<0.01) and sensation of incomplete emptying (P<0.01). CONCLUSION This pilot study showed that a regular intake of probiotics can significantly improve stool consistency and bowel habits in Parkinson's disease patients.
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Affiliation(s)
- E Cassani
- Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy.
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Carducci A, Verani M, Lombardi R, Casini B, Privitera G. Environmental survey to assess viral contamination of air and surfaces in hospital settings. J Hosp Infect 2011; 77:242-7. [PMID: 21277649 PMCID: PMC7124363 DOI: 10.1016/j.jhin.2010.10.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 10/29/2010] [Indexed: 11/04/2022]
Abstract
The presence of pathogenic viruses in healthcare settings represents a serious risk for both staff and patients. Direct viral detection in the environment poses significant technical problems and the indirect indicators currently in use suffer from serious limitations. The aim of this study was to monitor surfaces and air in hospital settings to reveal the presence of hepatitis C virus, human adenovirus, norovirus, human rotavirus and torque teno virus by nucleic acid assays, in parallel with measurements of total bacterial count and haemoglobin presence. In total, 114 surface and 62 air samples were collected. Bacterial contamination was very low (<1 cfu/cm2) on surfaces, whereas the ‘medium’ detected value in air was 282 cfu/m3. Overall, 19 (16.7%) surface samples tested positive for viral nucleic acids: one for norovirus, one for human adenovirus and 17 (14.9%) for torque teno virus (TTV). Only this latter virus was directly detected in 10 air samples (16.1%). Haemoglobin was found on two surfaces. No relationship was found between viral, biochemical or bacterial indicators. The data obtained confirm the difficulty of assessing viral contamination using bacterial indicators. The frequent detection of TTV suggests its possible use as an indicator for general viral contamination of the environment.
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Affiliation(s)
- A Carducci
- Department of Biology, University of Pisa, Italy.
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Casini B, Valentini P, Baggiani A, Torracca F, Frateschi S, Nelli LC, Privitera G. Molecular epidemiology of Legionella pneumophila serogroup 1 isolates following long-term chlorine dioxide treatment in a university hospital water system. J Hosp Infect 2008; 69:141-7. [DOI: 10.1016/j.jhin.2008.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Accepted: 03/06/2008] [Indexed: 11/26/2022]
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Vigneri PG, Banna GL, Novello G, Restuccia N, Salomone E, Privitera G, Gangi S, Ferraù F, Buscarino C. Short course dose-dense (dd) epirubicin (E) and cyclophosphamide (C) as neo-adjuvant chemotherapy for stage II-IIIA breast cancer (BC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.11543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Castorina S, Mignosa C, Degno S, Bianca I, Salvo D, Tolaro S, Luca T, Privitera G, Riccioli V. Demonstration of an anomalous connection between the left coronary artery and the pulmonary artery using a multislice CT 64. Clin Anat 2008; 21:319-24. [PMID: 18428987 DOI: 10.1002/ca.20618] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this article, we describe two cases of anomalous connection of the left coronary artery. The first case is an infant of 4 years with an anomalous origin of the left anterior descending (LAD) artery and the diagonal branches and a circumflex artery which originated from the pulmonary artery. The second case is an adult of 50 years with the coronary artery originating from the pulmonary artery. Anomalous origin of the left coronary artery from the pulmonary artery is an uncommon congenital cardiac anomaly with an incidence of 0.25% among all congenital heart defects (Parale and Pawar [2006], J Assoc Physicians India 54:397-399). The originality of this communication consists in the use of a multislice CT scanner as a support for the angiography. The result is an original image with three dimensional details; in the case of the infant, it was determinant in the choice of the surgical approach.
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Affiliation(s)
- S Castorina
- Department of Human Anatomy GF Ingrassia, University of Catania, Italy.
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