101,957 research outputs found
Le infezioni da Virus A(H1N1): update ad un anno dalla emergenza
No full textDuring 2009 influenza A(H1N1) pandemic, 925.861 cases of influenza-like syndromes (ILI) and 7.202.014 cases of acute respiratory infections (ARI) have been reported by European Influenza Surveillance Network (EISN). Whilst the site of initial infection is likely to be the upper airway, in certain hosts with unrecognized predisposing factors or for possible variants of 2009 A(H1N1) virus strains, the primary site of active viral replication may be the lower respiratory tract. Pandemic 2009 influenza A(H1N1) virus infection has been shown to affect lower airways causing serious illness and death in patients with underlying medical conditions such as asthma, obesity, heart, lung and neurological diseases and pregnancy. Similar outcomes have been reported in previously healthy individuals although predictive factors for severe disease in this patient group have not been identified.Nell’intero periodo della pandemia da virus A(H1N1) 925.861 casi di sindromi influenzali (ILI) e 7.202.014 casi di infezioni respiratorie acute (ARI) sono state riportate dalla rete europea di sorveglianza dell’influenza (EISN). Mentre il sito di infezione iniziale del virus pandemico A(H1N1) è rappresentato dalle vie aeree superiori in una parte della popolazione per fattori predisponesti non conosciuti o per possibili varianti del virus pandemico A(H1N1) il sito primario di replicazione è rappresentato dalle basse vie respiratorie. Forme gravi di infezioni e decessi sono state associate ad una serie di condizioni mediche preesistenti quali asma, obesità malattie Respiratorie cardiache e neurologiche, gravidanza. Tuttavia decorso clinico grave ed eventi fatali sono stati riscontrati anche in giovani individui sani; i possibili fattori di rischio in tale popolazione di pazienti non sono stati identificati
Molecular epidemiological insights into colistin-resistant and carbapenemases-producing clinical Klebsiella pneumoniae isolates
No full textPurpose: Carbapenemases-producing Klebsiella pneumoniae are challenging antimicrobial therapy of hospitalised patients, which is further complicated by colistin resistance. This study describes molecular epidemiological insights into colistin-resistant and carbapenemases- producing clinical K. pneumoniae. Patients and methods: Cultures collected from 26 hospitalised patients during 2014–2017 in the main hospital in Molise Region, central Italy, were characterized. The minimum inhibitory concentration for 19 antibiotics was determined, including carbapenems and colistin. Prevalence of resistance-associated genes was investigated through PCR, detecting blaKPC, blaGES, blaVIM, blaIMP, blaNDM, blaOXA-48, blaCTX-M, blaTEM, blaSHV, and mcr- 1,2,3,4,5,6,7,8. The mgrB gene was also analysed in colistin-resistant strains by PCR and sequencing assays. K. pneumoniae were typed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Results: Twenty out of 26 K. pneumoniae were phenotypically resistant to carbapenems and 19 were resistant to colistin. All isolates harbored blaKPC, and blaSHV, blaTEM and blaVIM were further the most common resistance-associated genes. In colistin-resistant strains, mcr- 1,2,3,4,5,6,7,8 variants were not detected, while mutations and insertion elements in mgrB were observed in 68.4% (n=13) in 31.6% (n=6) isolates, respectively. PFGE revealed 12 clusters and 18 pulsotypes at 85% and 95% cut-off, while the Sequence Types ST512 (n=13, 50%), ST101 (n=10, 38.5%), ST307 (n=2, 7.7%) plus a novel ST were detected using MLST. Conclusion: All K. pneumoniae showed a multidrug-resistant phenotype, particularly to carbapenems and colistin. According to national data, blaKPC was the prevailing carbapenemase, followed by blaVIM, while blaTEM and blaSHV were among the most frequent betalactamases. Consistent with previous reports in Italy, ST512 was the most common clone, particularly during 2014–15, whilst ST101 became dominant in 2016–17. Colistin resistance was mainly associated with deleterious mutations and transposon in the mgrB gene. Improvements of surveillance, compliance with infection prevention procedures and antimicrobial stewardship are essential to limit the spread of resistant K. pneumoniae
A single-arm study to evaluate skin tolerance, effectiveness and adherence to use of an alcohol-based hand rub solution among hospital nurses
No full textBackground: Hand hygiene is considered as the most important strategy for preventing healthcare infections. Objective: In this single-arm study, skin tolerance, effectiveness and prolonged efficacy, and adherence to use an alcohol-based hand rub (ABHR) solution among hospital nurses was evaluated. Methods: Nurses were recruited in the main hospital of Molise Region, Central Italy. Skin reactions during 12-week follow-up were self-reported by nurses and, when occurring examined by hospital dermatologist. Samples were collected from palms and fingertips before and after ABHR, also at random times during work. Results: Dermatological reactions were not reported by 20 nurses (15 female and 5 male, aged 30–59 years) after product use. Microbial counts decreased by 99% (2Log10) in 75%, with higher reduction in palm than fingertips (99% vs 70% respectively). Analysis of six randomly collected samples after 10–20 and 30–40 min from the last use showed a satisfactory prolonged efficacy. Discussion: Beyond high effectiveness to reduce transient microbiota, no skin reactions were observed, likely due to the camomile, thyme and eucalyptus extracts contained within the gel. This study, addressing technical questions of a commercialised product, provides useful information for public health authorities faced with a choice of hand disinfectants, evaluating cost-effectiveness and cost-benefit in the light of the huge amount of these products needed at hospital level
Bronchial asthma prevalence in the pediatric population in an industrial area of the centre south of Italy: preliminary results
No full textAmplified fragment lenght polymorphism analysis of Listeria monocytogenes by experionTM automated microfluidic electrophoresis
No full textFifty Listeria monocytogenes strains were genotyped by sAFLP and PCR products were separated by agarose gel and automated chip-based microfluidic electrophoresis. A high congruency of results was observed comparing the two techniques, although for some cultures a better separation of sAFLP fragments was achieved with microfluidic system, which proved to be a highly reliable and reproducible tool to improve the molecular typing of L. monocytogenes, requiring lower volumes of samples and reducing significantly analysis time
Tracking multidrug-resistant Klebsiella pneumoniae from an Italian hospital: molecular epidemiology and surveillance by PFGE, RAPD and PCR-based resistance genes prevalence
No full textAntimicrobial-resistant Klebsiella pneumoniae represent a global public health concern. K. pneumoniae strains isolated during 2010 and 2014–2016 within a single hospital of Molise Region, Central Italy, were analyzed testing antimicrobial susceptibility, clonality by pulsed-field gel electrophoresis (PFGE) and random amplified polymorphic DNA (RAPD)-PCR, and prevalence of carbapenem resistance genes by PCR. Forty isolates (23 wild-type in 2010 and 17 non-wild-type in 2014–2016) were collected from hospitalized patients (65.2 ± 18.1 years old, 75% male, 80% from intensive care unit—ICU). K. pneumoniae showed multidrug-resistant profiles and 15 resistotypes were identified (discriminatory power D = 0.88). The 69.6 and 17.4% of isolates in 2010 resulted intermediate and resistant to imipenem, respectively, and 91.3% was sensitive to meropenem, while 88.2% of isolates of 2014–2016 were resistant to both antibiotics. PFGE identified 16 clusters versus 23 by RAPD, 26 pulsotypes versus 33 RAPD patterns (D ≥ 0.97). PFGE separated strains according to isolation period and identified an outbreak occurred in the ICU during December 2014 and January 2015. No strains harbored blaGES, blaIMP, blaNDM−1, and blaOXA−48 genes, as well as AmpC plasmid-mediated beta-lactamases genes. Only K. pneumoniae isolated during 2014–2016 were blaKPC positive. Prevalence of blaVIM was 87 and 76.5% during 2010 and 2014–2016, respectively. No strains colistin-resistant harbored mcr-1 plasmid-mediated resistance gene. The study findings underline an increased circulation of multidrug-resistant K. pneumoniae within the hospital, and the acquisition of carbapenem resistance mechanism. The implementation of surveillance and molecular characterization of isolates are needed to identify outbreaks, reduce the spread of resistance, and guide empirical therapy
Identification of emesis-causing Bacillus cereus strains by polymerase chain reaction: preliminary results
No full textBacillus cereus can give rise to two distinct forms of food borne disease, the diarrehoealand emetic syndromes. The second one is characterized by symptoms of nausea andvomiting which appear within 1–4 h from ingestion of the contaminated food. The emeticsyndrome is believed to be associated with an emetic toxin preformed in the food.Cooked rice and farinaceous foods such as pasta, noodles and cakes are consideredthe most common vehicles (Shinagawa et al., 1996). The emetic toxin is a cyclic dodecadepsipeptidenamed cereulide. It is resistant to pH changes and high temperature, resemblingthe staphylococcal enterotoxins and its activity is evident at low doses(Agata et al., 2002). For the detection of enterotoxic Bacillus cereus strains diagnosticmolecular assays such as PCR–based methods and immunological methods based on thedetection of the Hbl-L2 component (BCET-RPLA) have been performed. On the contrary,are not yet available commercial diagnostic kits for the detection of Bacillus cereusemetic strains (Guinebretiere et al., 2002). Three different methods for identificationof the emetic toxin have been described in recent years: the Hep-2 (larynx carcinoma)cells vacuolation assay, LC-MS analysis and a biological assay based on cereulideinducedinhibition of the motility in boar spermatozoa. According to Andersson et al.(2004), the cereulide producing Bacillus cereus strains are not able to hydrolyze starch.Recently, Ehling-Schulz and coworkers (2004) have identified a genomic DNA fragmentof 635 pb codifying for cereulide, and developed specific primers for the detection ofemetic Bacillus cereus strains.[...
Asthma prevalence and risk factors among children and adolescents living around an industrial area: a cross-sectional study.
No full textBACKGROUND: The exposure to air pollution has negative effects on human health, increasing the risk of respiratory diseases, such as asthma. Few data are yet available on the epidemiology of childhood asthma in some areas of Italy. The aim of the study was to estimate asthma prevalence and related risk factors in children and adolescents residents around the industrial area of Termoli, Molise region, Central-South Italy.
METHODS: Prevalence was assessed through the administration of modified ISAAC questionnaires filled out by parents of 89 children and adolescents for the identification of confirmed and probable cases, and by analyzing pediatricians' databases on drug prescriptions for symptoms control and treatment of assisted population in the study area (n = 1,004), compared to a control area (n = 920) with lower industrialization. The association of asthma with risk factors was evaluated by univariate (Chi-square or Fisher's Exact test) and regression logistic analysis.
RESULTS: A total of 22 (24.7%) asthmatics were identified, including both confirmed (n = 7; 7.9%) and probable cases (n = 15; 16.8%), most of them (n = 17; 77.3%) resident of Termoli town. All asthma cases were georeferenced based on the residence, however clusters were not found. Using drug prescriptions analysis, a higher prevalence (n = 138; 13.7%) of diagnosed cases was found. Lifetime history of both atopic dermatitis and bronchitis were significantly relateds to asthma cases, as well as an elevated body mass index, whose association is consistent with prevalence data of overweight/obese children living in the study area. Moreover, being resident of the town of Termoli was associated to the occurrence of cases.
CONCLUSIONS: Although our data indicated a prevalence concordance with previous national studies in pediatric population, a definitive correlation with environmental industrial factors present in the study area was not established. However, asthma outcome was significantly associated to individuals living in the town of Termoli that, despite the industrial/manufacturing activities, is also subjected to a higher environmental pressure due to the presence of toll road, state highway, railroad, and seaport which may cause air pollution from motor vehicle traffic and increase asthma induction. This study provides hitherto unavailable data on asthma in childhood population living in an industrialized area which was never investigated before, could be part of a systematic review or meta-analysis procedure, might suggest significant findings for larger observational studies, and contribute to complete the frame of disease epidemiology in Italy
High prevalence of human papillomavirus type 58 in HIV infected men who have sex with men: A preliminary report in Central Italy
No full textHuman papillomavirus (HPV) infection and type-specific prevalence at anal, oral, coronal sulcus, and urethral mucosa in fifty HIV positive men having sex with men (MSM) were evaluated; patients were enrolled in a non-metropolitan area of Central Italy. Clinical and socio-demographic information, drug, and sexual behaviors were obtained for each participant. HPV was detected by PCR from an overall of 200 specimens, and genotyping was performed by both Restriction Fragment Length Polymorphism analysis and sequencing. HPV DNA was found in 60.0% (n = 30) of HIV positive MSM, and prevalence was higher at anal canal (n = 28, 56.0%) compared to all the other anatomical sites (χ(2) test P < 0.01) of coronal sulcus (n = 11, 22.0%), oral (n = 8, 16.0%), and urethral mucosa (n = 5, 10.0%). We found 63.3% (n = 19) of MSM with at least one high-risk genotype, and HPV-58 was more frequently detected (n = 9, 47.4%) respect to HPV-16 (n = 6, 31.6%). This is the first report on HPV detected at four anatomical sites involved in sexual practices in HIV positive MSM. We found an unusual distribution of oncogenic genotypes with an exceeding prevalence of HPV-58 respect to HPV-16. Hence, the recently licensed nonavalent vaccine should be suitable to prevent a larger number of infections caused by potentially emerging high-risk genotypes. J. Med. Virol. © 2015 Wiley Periodicals, Inc
Prevalenza di geni codificanti per tossina emetica ed enterotossine in ceppi di Bacillus cereus isolati da alimenti
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