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Petrelli F, Giannini D, Pucci C, Del Corso I, Rocchi V, Dolcher MP, Pieve G, Pratesi F, Migliorini P, Puxeddu I. Allergy Workup in the Diagnosis of COVID-19 Vaccines-Induced Hypersensitivity Reactions and Its Impact on Vaccination. Int Arch Allergy Immunol 2022; 184:54-62. [PMID: 36265449 PMCID: PMC9747735 DOI: 10.1159/000526764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/17/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Immediate and delayed hypersensitivity reactions (HSR) to COVID-19 vaccines are rare adverse events that need to be prevented, diagnosed, and managed in order to guarantee adherence to the vaccination campaign. The aims of our study were to stratify the risk of HSR to COVID-19 vaccines and propose alternative strategies to complete the vaccination. METHODS 1,640 subjects were screened for vaccinal eligibility, according to national and international recommendations. Among them, we enrolled for allergy workup 152 subjects, 43 with HSR to COVID-19 vaccines and 109 at high risk of HSR to the first dose. In vivo skin tests with drugs and/or vaccines containing PEG/polysorbates were performed in all of them, using skin prick test and, when negative, intradermal tests. In a subgroup of patients resulted negative to the in vivo skin tests, the programmed dose of COVID-19 vaccine (Pfizer/BioNTech) was administered in graded doses regimen, and detection of neutralizing anti-spike antibodies was performed in these patients after 4 weeks from the vaccination, using the SPIA method. RESULTS Skin tests for PEG/polysorbates resulted positive in only 3% (5/152) of patients, including 2 with previous HSR to COVID-19 vaccines and 3 at high risk of HSR to the first dose. Among the 147 patients with negative skin tests, 97% (143/147) were eligible for vaccination and 87% (124/143) of them received safely the programmed COVID-19 vaccine dose. Administration of graded doses of Pfizer/BioNTech vaccine were well tolerated in 17 out of 18 patients evaluated; only 1 developed an HSR during the vaccination, less severe than the previous one, and all developed neutralizing anti-spike antibodies after 4 weeks with values comparable to those subjects who received the vaccine in unfractionated dose. CONCLUSION On the whole, the usefulness of the skin tests for PEG/polysorbates seems limited in the diagnosis of HSR to COVID-19 vaccines. Graded doses regimen (Pfizer/BioNTech) is a safe and effective alternative strategy to complete the vaccinal course.
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Affiliation(s)
- Fiorella Petrelli
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy
| | - Daiana Giannini
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy
| | - Celestino Pucci
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy
| | - Isabella Del Corso
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy
| | - Valeria Rocchi
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy
| | - Maria Pia Dolcher
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy
| | - Giulio Pieve
- UO Direzione Medica di Presidio, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Federico Pratesi
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy
| | - Paola Migliorini
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy
| | - Ilaria Puxeddu
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, Pisa University, Pisa, Italy,*Ilaria Puxeddu,
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Tsioutis C, Birgand G, Bathoorn E, Deptula A, ten Horn L, Castro-Sánchez E, Săndulescu O, Widmer AF, Tsakris A, Pieve G, Tacconelli E, Mutters NT. Education and training programmes for infection prevention and control professionals: mapping the current opportunities and local needs in European countries. Antimicrob Resist Infect Control 2020; 9:183. [PMID: 33168085 PMCID: PMC7652580 DOI: 10.1186/s13756-020-00835-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies have repeatedly highlighted the need for homogenisation of training content and opportunities in infection prevention and control (IPC) across European countries. OBJECTIVES To map current training opportunities for IPC professionals, define local needs and highlight differences, across 11 European countries (Cyprus, France, England, Germany, Greece, Italy, Netherlands, Poland, Romania, Spain, Switzerland). SOURCES From July 2018 to February 2019, IPC experts directly involved in IPC training and education in their countries and/or internationally were invited to complete a prespecified set of questions in order to provide a detailed description of IPC training opportunities and needs in their country. CONCLUSIONS IPC training among nurses and doctors varies greatly across countries, with differences in content and type of training (e.g., standardised curriculum, educational programme, clinical experience) duration, as well as in assessment and recognition/accreditation. The observed heterogeneity in IPC training between European countries can be eliminated through establishment of interdisciplinary region-wide training programmes, with common learning objectives, shared know-how and supported by national and international professional bodies.
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Affiliation(s)
- Constantinos Tsioutis
- School of Medicine, European University Cyprus, Nicosia, Cyprus
- European Committee On Infection Control (EUCIC), Basel, Switzerland
| | - Gabriel Birgand
- European Committee On Infection Control (EUCIC), Basel, Switzerland
- NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
| | - Erik Bathoorn
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Aleksander Deptula
- Department of Propaedeutics of Medicine and Infection Prevention, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Antimicrobial Stewardship and Infection Control Unit, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | - Lenny ten Horn
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Enrique Castro-Sánchez
- NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
- Imperial College Healthcare NHS Trust, St Mary’s Road, London, UK
| | - Oana Săndulescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Balș”, No. 1 Dr. Calistrat Grozovici Street, 021105 Bucharest, Romania
| | - Andreas F. Widmer
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Athanasios Tsakris
- European Committee On Infection Control (EUCIC), Basel, Switzerland
- Department of Microbiology, Medical School, University of Athens, 11527 Athens, Greece
| | - Giulio Pieve
- Clinical management staff, University Hospital of Pisa, Pisa, Italy
| | - Evelina Tacconelli
- European Committee On Infection Control (EUCIC), Basel, Switzerland
- Infectious Diseases, Department of Diagnostic and Public Health, Verona University Hospital, Verona, Italy
| | - Nico T. Mutters
- European Committee On Infection Control (EUCIC), Basel, Switzerland
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
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Porretta A, Quattrone F, Aquino F, Pieve G, Bruni B, Gemignani G, Vatteroni ML, Pistello M, Privitera GP, Lopalco PL. A nosocomial measles outbreak in Italy, February-April 2017. ACTA ACUST UNITED AC 2018; 22:30597. [PMID: 28840827 PMCID: PMC5572940 DOI: 10.2807/1560-7917.es.2017.22.33.30597] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 08/10/2017] [Indexed: 01/09/2023]
Abstract
We describe a nosocomial outbreak of measles that occurred in an Italian hospital during the first months of 2017, involving 35 persons and including healthcare workers, support personnel working in the hospital, visitors and community contacts. Late diagnosis of the first case, support personnel not being promptly recognised as hospital workers and diffusion of the infection in the emergency department had a major role in sustaining this outbreak.
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Affiliation(s)
- Andrea Porretta
- Hygiene and Epidemiology section, Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Filippo Quattrone
- Hygiene and Epidemiology section, Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Francesco Aquino
- Hygiene and Epidemiology section, Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giulio Pieve
- Hygiene and Epidemiology section, Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Beatrice Bruni
- Hygiene and Epidemiology section, Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giulia Gemignani
- Medical Direction, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Mauro Pistello
- Retrovirus Center and Virology Section, Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Gaetano Pierpaolo Privitera
- Hygiene and Epidemiology section, Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pier Luigi Lopalco
- Hygiene and Epidemiology section, Department of Translational Research, New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Bert F, Giacomelli S, Amprino V, Pieve G, Ceresetti D, Testa M, Zotti CM. The "bundle" approach to reduce the surgical site infection rate. J Eval Clin Pract 2017; 23:642-647. [PMID: 28145067 DOI: 10.1111/jep.12694] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/25/2016] [Accepted: 11/25/2016] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES In Italy, since 2008, the surveillance of surgical site infections (SSIs) has been conducted following ECDC recommendations, according to the protocol of the National System of Surveillance of Surgical Site Infections. In 2009, in Piedmont region, where the study was conducted, it was introduced a survey of a "bundle" for every patient under SSIs surveillance. The bundle includes 5 items: infection risk index calculation, preoperative shower, trichotomy, antibiotic prophylaxis, and body temperature control. The aim of this study is the evaluation of the incidence rate of the SSIs in relation to the implementation of the bundle from January 1st to December 31st, 2012. METHOD This study is an observational study (retrospective cohort). The regional surveillance system collected 3314 surgical operations during the year 2012 from 37 hospitals. The represented surgical categories were hip prosthetic surgery (HPRO: 1992 cases) and colon surgery (COLO: 1322 cases). The bundle was implemented in 1114 and 671 operations, respectively. Univariate and multivariate analysis were conducted stratifying the sample for hip surgery and colorectal surgery, with the purpose to identify an association between the implementation of the bundle and a decrease of the rate of SSIs. RESULTS From the analysis, the bundle resulted as a protective factor for the infection risk in colon surgery (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.38-0.78). The main risk factors were American Society of Anesthesiologists score ≥ 3 (OR, 1.57; 95% CI, 1.10-2.24) and contamination class ≥ 3 (OR, 2.02; 95% CI, 1.37-2.97). In the hip surgery, the application of the bundle was not statistically associated to a decrease of the risk of infection. CONCLUSION The use of surgical bundle seems to reduce significantly the SSIs rate in the colon surgery.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Sebastian Giacomelli
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Viola Amprino
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Giulio Pieve
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Daniela Ceresetti
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Marco Testa
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Carla M Zotti
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
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Gualano MR, Bert F, Camussi E, Pieve G, Voglino G, Siliquini R. Could Animal Assisted Intervention be implemented in public health programs? Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw165.030] [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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Giacomelli S, Pieve G. Implementation of a Bundle to reduce surgical site infections in colon and hip surgery. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.155] [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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