#Risk #factors, #awareness of disease and use of #medications in a deprived population: differences between #indigent natives and undocumented #migrants in #Italy (J Pub Health, abstract)

[Source: Journal of Public Health, full page: (LINK). Abstract, edited.]

Risk factors, awareness of disease and use of medications in a deprived population: differences between indigent natives and undocumented migrants in Italy

Gianfrancesco Fiorini, Cesare Cerri, Flavia Magri, Luca Chiovato, Laura Croce, Antonello E Rigamonti, Alessandro Sartorio, Silvano G Cella

Journal of Public Health, fdz123, https://doi.org/10.1093/pubmed/fdz123

Published: 08 November 2019

 

Abstract

Background

Undocumented migrants experience many health problems; a comparison with a suitable control group of natives living in the same socio-economic conditions is still lacking.

Methods

Demographic data and data on risk factors, chronic conditions and dietary habits were obtained for 6933 adults (2950 Italians and 3983 undocumented migrants) receiving medical assistance from 40 non-governmental organizations all over the country.

Results

Attributed to the fact that these were unselected groups, differences were found in their demographic features, the main ones being their marital status (singles: 50.5% among Italians and 42.8% among migrants; P < 0.001). Smokers were more frequent among Italians (45.3% versus 42.7% P = 0.03); the same happened with hypertension (40.5% versus 34.5% P < 0.001). Migrants were more often overweight (44.1% versus 40.5% P < 0.001) and reporting a chronic condition (20.2% versus 14.4% P < 0.001). Among those on medications (n = 1354), Italians were fewer (n = 425) and on different medications. Differences emerged also in dietary habits.

Conclusions

Differences in health conditions exist between native-borns and undocumented migrants, not because of a bias related to socio-economic conditions. Further studies are needed to design sustainable health policies and tailored prevention plans.

chronic diseases, dispensation of medications, poverty, undocumented migrants

Topic: hypertension – diet – adult – chronic disease – demography – habits – health policy – italy – marital status – medical assistance – single person – socioeconomic factors – poverty – overweight – prevention – nongovernmental organizations – smokers

Issue Section: Original Article

© The Author(s) 2019. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Public Health; Society; Poverty; Migrants; Italy.

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#Bloodstream #infections caused by #Escherichia coli in #onco-haematological patients: #Risk #factors and #mortality in an #Italian prospective survey (PLOS One, abstract)

[Source: PLOS One, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Bloodstream infections caused by Escherichia coli in onco-haematological patients: Risk factors and mortality in an Italian prospective survey

Enrico Maria Trecarichi , Gabriele Giuliano, Chiara Cattaneo, Stelvio Ballanti, Marianna Criscuolo, Anna Candoni, Francesco Marchesi, Marica Laurino, Michelina Dargenio, Rosa Fanci, Mariagiovanna Cefalo, Mario Delia, Angelica Spolzino,  [ … ], for the Haematologic Malignancies Associated Bloodstream Infections Surveillance (HEMABIS) registry–Sorveglianza Epidemiologica Infezioni Fungine in Emopatie Maligne (SEIFEM) group, Italy

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Published: October 29, 2019 / DOI: https://doi.org/10.1371/journal.pone.0224465

 

Abstract

Bloodstream infections (BSIs) remain life-threatening complications in the clinical course of patients with haematological malignancies (HM) and Escherichia coli represent one of the most frequent cause of such infections. In this study, we aimed to describe risk factors for resistance to third generation cephalosporins and prognostic factors, including the impact of third generation cephalosporins resistance, in patients with HM and BSIs caused by E. coli. Three hundred forty-two cases of E. coli BSIs were collected during the study period (from January 2016 to December 2017). The percentage of resistance to third generation cephalosporins was 25.7%. In multivariate analysis, the variables recent endoscopic procedures, culture-positive surveillance rectal swabs for multidrug-resistant bacteria, antibiotic prophylaxis with fluoroquinolones, and prolonged neutropenia were independently associated with bloodstream infections caused by a third generation cephalosporins resistant E. coli. The overall 30-day mortality rate was 7.1%. Cox regression revealed that significant predictors of mortality were acute hepatic failure, septic shock, male sex, refractory/relapsed HM, and third generation cephalosporins resistance by E. coli isolate. In conclusion, resistance to third generation cephalosporins adversely affected the outcomes of bloodstream infections caused by E. coli in our cohort of HM patients. We also found a significant correlation between prophylaxis with fluoroquinolones and resistance to third generation cephalosporins by E. coli isolates.

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Citation: Trecarichi EM, Giuliano G, Cattaneo C, Ballanti S, Criscuolo M, Candoni A, et al. (2019) Bloodstream infections caused by Escherichia coli in onco-haematological patients: Risk factors and mortality in an Italian prospective survey. PLoS ONE 14(10): e0224465. https://doi.org/10.1371/journal.pone.0224465

Editor: Peter Gyarmati, University of Illinois College of Medicine, UNITED STATES

Received: June 3, 2019; Accepted: October 14, 2019; Published: October 29, 2019

Copyright: © 2019 Trecarichi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data cannot be made publicly available due to ethical restrictions imposed by Italian legislation and ethic committees of the study coordinating center and of any other participating centers. For additional information, please contact the corresponding author, Professor Enrico M Trecarichi (em.trecarichi@unicz.it) or the ethic committee of the study coordinating center (Fondazione Policlinico Universitario Agostino Gemelli IRCCS – Università Cattolica del Sacro Cuore; E-mail: comitato.etico@policlinicogemelli.it).

Funding: The author(s) received no specific funding for this work.

Competing interests: EMT has been a speaker at accredited educational courses funded by unrestricted grants from Pfizer and Mattioli 1885. MT has been a scientific advisor/consultant for Angelini, Gilead, MSD, Nordic Pharma, and Roche, and speaker/chairman at accredited educational courses funded by unrestricted grants from Astellas, Gilead, MSD, and Pfizer. LP received honoraria for Advisory Board from Gilead Sciences, MSD, Pfizer, Jazz, Janssen, Menarini and Cidara, and has been speaker for Gilead Sciences, MSD, Pfizer, Celgine, Novartis, Astellas Pharma. MD received honoraria for Advisory Board from Honoraria from MSD, Gilead, and Pfizer. AB received honoraria for Advisory Board from Gilead, Pfizer, MSD, and Jazz. None of the other authors has any conflicts of interest to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Keywords: Antibiotics; Drugs Resistance; E. Coli; Fluoroquinolones; Cephalosporins; Cancer; Italy.

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#Antibiotic #prescriptions in #Italian hospitalised #children after serial point prevalence surveys (or pointless prevalence surveys): has anything actually changed over the years? (Ital J Pediatr., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Ital J Pediatr. 2019 Oct 17;45(1):127. doi: 10.1186/s13052-019-0722-y.

Antibiotic prescriptions in Italian hospitalised children after serial point prevalence surveys (or pointless prevalence surveys): has anything actually changed over the years?

Tersigni C1,2,3, Montagnani C4, D’Argenio P5, Duse M6, Esposito S7, Hsia Y8, Sharland M8, Galli L4.

Author information: 1 Institute for Infection and Immunity, Paediatric Infectious Disease Research Group, St. George’s, University of London, London, England. chia88.te@gmail.com. 2 Post graduate school of Paediatrics, University of Florence, Florence, Italy. chia88.te@gmail.com. 3 Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Viale Pieraccini 24, 50139, Florence, Italy. chia88.te@gmail.com. 4 Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Viale Pieraccini 24, 50139, Florence, Italy. 5 Unit of Immune and Infectious Diseases, Academic Department of Pediatrics, Children’s Hospital Bambino Gesù, Rome, Italy. 6 Department of Pediatrics, La Sapienza University of Rome, Rome, Italy. 7 Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy. 8 Institute for Infection and Immunity, Paediatric Infectious Disease Research Group, St. George’s, University of London, London, England.

 

Abstract

BACKGROUND:

Point prevalence surveys have been used in several studies to provide immediate and easily comparable information about antibiotic use and showed that about one third of hospitalised children had on ongoing antimicrobial prescription during their hospital admission. The aim of this study, as part of the Global Antimicrobial Resistance, Prescribing and Efficacy in Neonates and Children project, is to describe antimicrobial prescriptions among hospitalised children in four tertiary care hospitals in Italy to show if something has changed over the years.

METHODS:

Four tertiary care Italian’s hospitals joined three Point Prevalence Surveys (PPSs) in three different period of the year. All children under 18 years of age with an ongoing antimicrobial prescription, admitted on the participating wards at 8 o’clock in the morning of the selecting day were enrolled.

RESULTS:

A total of 1412 patients (475 neonates and 937 children) were admitted in the days of three PPSs. Overall, among the total admitted patients, 565 patients (40%) had an ongoing antimicrobial prescription in the days of the survey A total of 718 antibiotics were administered in the 485 admitted children and 133 in neonates. The most common indications for antibiotic therapy in children was Lower respiratory tract infections (244/718, 34%), while in neonates were prophylaxis for medical problems (35/133, 26.3%), newborn prophylaxis for newborn risk factors (29/133, 21.8%) and prophylaxis for surgical disease (15/133, 11.3%).

CONCLUSIONS:

Based on our results, it appears that nothing has changed since the last PPS and that the quality improved targets, underlyined in previous studies, are always the same. Serial PPSs can be part of AMS strategies but they are not sufficient alone to produce changes in clinical practice.

KEYWORDS: Antimicrobial stewardship; Antimicrobials; Children; Point prevalence surveys

PMID: 31623633 DOI: 10.1186/s13052-019-0722-y

Keywords: Antibiotics; Pediatrics; Italy.

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#Antimicrobial #resistance genotypes and phenotypes of #Campylobacter jejuni isolated in #Italy from #humans, #birds from wild and urban #habitats, and #poultry (PLoS ONE, abstract)

[Source: PLoS One, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Antimicrobial resistance genotypes and phenotypes of Campylobacter jejuni isolated in Italy from humans, birds from wild and urban habitats, and poultry

Francesca Marotta  , Giuliano Garofolo , Lisa di Marcantonio , Gabriella Di Serafino , Diana Neri , Romina Romantini , Lorena Sacchini , Alessandra Alessiani , Guido Di Donato , Roberta Nuvoloni , Anna Janowicz , Elisabetta Di Giannatale

Published: October 11, 2019 / DOI: https://doi.org/10.1371/journal.pone.0223804

 

Abstract

Campylobacter jejuni, a common foodborne zoonotic pathogen, causes gastroenteritis worldwide and is increasingly resistant to antibiotics. We aimed to investigate the antimicrobial resistance (AMR) genotypes of C. jejuni isolated from humans, poultry and birds from wild and urban Italian habitats to identify correlations between phenotypic and genotypic AMR in the isolates. Altogether, 644 C. jejuni isolates from humans (51), poultry (526) and wild- and urban-habitat birds (67) were analysed. The resistance phenotypes of the isolates were determined using the microdilution method with EUCAST breakpoints, and AMR-associated genes and single nucleotide polymorphisms were obtained from a publicly available database. Antimicrobial susceptibility testing showed that C. jejuni isolates from poultry and humans were highly resistant to ciprofloxacin (85.55% and 76.47%, respectively), nalidixic acid (75.48% and 74.51%, respectively) and tetracycline (67.87% and 49.02%, respectively). Fewer isolates from the wild- and urban-habitat birds were resistant to tetracycline (19.40%), fluoroquinolones (13.43%), and quinolone and streptomycin (10.45%). We retrieved seven AMR genes (tet (O), cmeA, cmeB, cmeC, cmeR, blaOXA-61 and blaOXA-184) and gyrA-associated point mutations. Two major B-lactam genes called blaOXA-61 and blaOXA-184 were prevalent at 62.93% and 82.08% in the poultry and the other bird groups, respectively. Strong correlations between genotypic and phenotypic resistance were found for fluoroquinolones and tetracycline. Compared with the farmed chickens, the incidence of AMR in the C. jejuni isolates from the other bird groups was low, confirming that the food-production birds are much more exposed to antimicrobials. The improper and overuse of antibiotics in the human population and in animal husbandry has resulted in an increase in antibiotic-resistant infections, particularly fluoroquinolone resistant ones. Better understanding of the AMR mechanisms in C. jejuni is necessary to develop new strategies for improving AMR programs and provide the most appropriate therapies to human and veterinary populations.

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Citation: Marotta F, Garofolo G, di Marcantonio L, Di Serafino G, Neri D, Romantini R, et al. (2019) Antimicrobial resistance genotypes and phenotypes of Campylobacter jejuni isolated in Italy from humans, birds from wild and urban habitats, and poultry. PLoS ONE 14(10): e0223804. https://doi.org/10.1371/journal.pone.0223804

Editor: Grzegorz Woźniakowski, Panstwowy Instytut Weterynaryjny – Panstwowy Instytut Badawczy w Pulawach, POLAND

Received: July 12, 2019; Accepted: September 27, 2019; Published: October 11, 2019

Copyright: © 2019 Marotta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: We have uploaded our study’s minimal underlying data set as Supporting Information file S1 Table.

Funding: This work was supported by the Italian Ministry of Health, grant number: MSRCTE0717. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Antibiotics; Drugs Resistance; Campylobacter jejuni; Human; Poultry; Wildlife; Italy.

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Long-term #immunogenicity of #Measles #vaccine: an #Italian retrospective cohort study (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Long-term immunogenicity of Measles vaccine: an Italian retrospective cohort study

Francesco Paolo Bianchi, Pasquale Stefanizzi, Sara De Nitto, Angela Maria Vittoria Larocca, Cinzia Germinario, Silvio Tafuri

The Journal of Infectious Diseases, jiz508, https://doi.org/10.1093/infdis/jiz508

Published:  03 October 2019

 

Abstract

Background

Levels of antibodies induced by the Measles virus containing vaccine have been shown to decline over time, but actually there is not a formal recommendation about the opportunity of testing immunized subjects (in particular, HCWs) to investigate the persistence of Measles IgG.

Methods

This study aims to evaluate the long-time immunogenicity of Measles vaccine in a sample of medical students and residents of the University of Bari who attended the Hygiene Department for the biological risk assessment (April 2014-June 2018).

Results

2,000 immunized (2 doses of MMR vaccine) students and residents have been tested. 305/2,000 (15%) subjects didn’t show protective anti-Measles IgG. This proportion was higher among vaccinated at ≤15 months (20%) than in vaccinated at 16-23 months (17%) and at ≥24 months (10%; p<0.0001). After an MMR vaccine booster dose, we noted a seroconversion of 74% of seronegative HCWs. The overall seroconversion rate after a second dose booster was of 93%. No serious adverse events were noted after the booster doses.

Conclusions

An important proportion of subjects immunized for Measles don’t show a protective IgG titer in the 10 years after the vaccination. Our management strategy seems consistent with the purpose of evidencing immunological memory.

healthcare workers, booster dose, duration of immunization

This content is only available as a PDF.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Keywords: Measles; Vaccines.

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Secondary #Autochthonous #Outbreak of #Chikungunya, Southern #Italy, 2017 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 11—November 2019 / Dispatch

Secondary Autochthonous Outbreak of Chikungunya, Southern Italy, 2017

Flavia Riccardo1  , Giulietta Venturi1, Marco Di Luca1, Martina Del Manso, Francesco Severini, Xanthi Andrianou, Claudia Fortuna, Maria Elena Remoli, Eleonora Benedetti, Maria Grazia Caporali, Francesca Fratto, Anna Domenica Mignuoli, Liliana Rizzo, Giuseppe De Vito, Vincenzo De Giorgio, Lorenzo Surace, Francesco Vairo, Paola Angelini, Maria Carla Re, Antonello Amendola, Cristiano Fiorentini, Giulia Marsili, Luciano Toma, Daniela Boccolini, Roberto Romi, Patrizio Pezzotti, Giovanni Rezza, and Caterina Rizzo

Author affiliations: Istituto Superiore di Sanità, Rome, Italy (F. Riccardo, G. Venturi, M. Di Luca, M. Del Manso, F. Severini, X. Andrianou, C. Fortuna, M.E. Remoli, E. Benedetti, M.G. Caporali, A. Amendola, C. Fiorentini, G. Marsili, L. Toma, D. Boccolini, R. Romi, P. Pezzotti, G. Rezza); European Centre for Disease Prevention and Control, Stockholm, Sweden (X. Andrianou); Regione Calabria, Calabria, Italy (F. Fratto, A.D. Mignuoli, L. Rizzo); ASP di Catanzaro, Calabria (G. De Vito, V. De Giorgio, L. Surace); National Institute for Infectious Diseases, Rome (F. Vairo); Emilia-Romagna Region, Bologna, Italy (P. Angelini); University of Bologna, Bologna (M.C. Re); Ospedale Pediatrico Bambino Gesù, Rome (C. Rizzo)

 

Abstract

In 2017, a chikungunya outbreak in central Italy later evolved into a secondary cluster in southern Italy, providing evidence of disease emergence in new areas. Officials have taken action to raise awareness among clinicians and the general population, increase timely case detection, reduce mosquito breeding sites, and promote mosquito bite prevention.

Keywords: Chikungunya fever; Italy.

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#Virological #Surveillance of #Influenza in the eight #epidemic seasons after the 2009 #pandemic in Emilia-Romagna (Northern #Italy) (Acta Biomed., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Acta Biomed. 2019 Sep 13;90(9-S):35-44. doi: 10.23750/abm.v90i9-S.8722.

Virological Surveillance of Influenza in the eight epidemic seasons after the 2009 pandemic in Emilia-Romagna (Northern Italy).

Affanni P1, Colucci ME, Bracchi MT, Capobianco E, Zoni R, Caruso L, Castrucci MR, Puzelli S, Cantarelli A, Veronesi L.

Author information: 1 Department of Medicine and Surgery, University of Parma, Italy. paola.affanni@unipr.it.

 

Abstract

BACKGROUND AND AIM OF THE WORK:

Influenza virological surveillance is essential for monitoring the evolution of influenza viruses (IVs) as well as for annual updating of the vaccine composition. The aim of this study is to analyse IVs circulation in Emilia-Romagna during the eight epidemic seasons after the 2009 pandemic and to evaluate their match with seasonal vaccine strains.

METHODS:

A total of 7882 respiratory specimens from patients with influenza-like illness (ILI), were collected by regional sentinel practitioners and hospital physicians. Viral investigations were conducted by rRT-PCR assay. Genetic characterization was performed for a spatial-temporal representative number of influenza laboratory-confirmed specimens.

RESULTS:

Influenza-positive samples per season ranged between 28.9% (2013-2014) and 66.8% (2012-2013). Co-circulation of IVs type A and type B was observed in all seasons, although with a different intensity. In all seasons, the highest number of positive samples was recorded in younger patients aged 5-14 years with relative frequencies ranging from 40% in the 2013-2014 season and 78% in the 2012-2013 season. Since the 2009 pandemic, A/H1N1pdm09 IVs circulating were closely related to the vaccine strain A/California/7/2009. Antigenic mismatch between vaccine strain and A/H3N2 IVs was observed in the 2011-2012 and 2014-2015 seasons. During 2015-2016, 2016-2017 and 2017-2018 seasons a complete or nearly complete mismatch between the predominant influenza B lineage of IVs type B circulating and vaccine B lineage occurred.

CONCLUSIONS:

This analysis confirms the importance of the virological surveillance and highlights the need of a continuous monitoring of IVs circulation, to improve the most appropriate vaccination strategies. (www.actabiomedica.it).

PMID: 31517888 DOI: 10.23750/abm.v90i9-S.8722

Keywords: Seasonal Influenza; H1N1pdm09; H3N2; Influenza B; Italy.

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