Distribuzione e frequenza di isolamento di miceti in una piscina pubblica della Città di Palermo

Outbreak of ST395 KPC-Producing Klebsiella pneumoniae in a Neonatal Intensive Care Unit in Palermo, Italy

ATTIVITA’ IN VITRO DI ANIDULAFUNGINA, CASPOFUNGINA, VORICONAZOLO, ITRACONAZOLO E FLUCONAZOLO NEI CONFRONTI DI ISOLATI CLINICI DI CANDIDA SPP.

Presenza di Giardia e Cryptosporidium in reflui civili e in campioni d'acqua superficiale e profonda del territorio palermitano

This paper reports the investigation carried out on the occurrence of Cryptosporidium and Giardia (oo)cysts in water samples of two municipal treatment plants, and in surface water and ground water wells of the province of Palermo. The wastewater samples taken before and after treatment process were assayed over the course of one year Giardia cysts were detected in all samples throught the year at higher concentration levels than Cryptosporidium oocysts, with a peak observed in spring. The overall removal efficiency of (oo)cysts in the treatment plants was about of 90%. Their presence were also searched in surface waters (three artificial lakes and one river); (oo)cysts were detected in one…

Epidemiology of intensive care unit-acquired sepsis in Italy: Results of the SPIN-UTI network

Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to…

Investigation and control of a Norovirus outbreak of probable waterborne transmission through a municipal groundwater system

During March 2011 an outbreak of gastroenteritis occurred in Santo Stefano di Quisquina, Agrigento, Sicily, Italy. Within two weeks 156 cases were identified among the 4,965 people living in the municipality. An epidemiological investigation was conducted to characterize the outbreak and target the control measures. A case was defined as a person developing diarrhea or vomiting during February 27–March 13, 2011. Stool specimens were collected from 12 cases. Norovirus (NoV) genotype GII.4 variant New Orleans 2009 was identified in stool samples from 11 of 12 cases tested (91.7%). Epidemiological investigations suggested a possible association with municipal drinking water consumption. Water …

Occurrence of illicit drugs in two wastewater treatment plants in the South of Italy

In this study the occurrence and the behavior of illicit drugs and their metabolites have been investigated for two wastewater treatment plants (WWTPs) (namely, WWTP-1 and WWTP-2) located in Sicily (island of Italy). Samples were analyzed for methamphetamine, cocaine (COC), 3,4-methylenedioxymethamphetamine (MDMA), methadone (METH), 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), 3,4-methylenedioxy amphetamine (MDA); 3,4-methylenedioxy ethylamphetamine (MDEA), 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH) and Benzoylecgonine (BEG). The BEG, COC, MOR and THC-COOH were found at the highest concentration in both WWTPs. The Wastewater-based epidemiology calculation for BEG, COC…

Synthesis and antimicrobial activity of new 1-R-3-(2-Piridyl)-4-nitroso-5 carboxiethyl-1H-Pyrazoles

SYNTHESIS AND ANTIMICROBIAL ACTIVITY OF NEW 1-R-3-(2-PIRIDYL)- 4-NITROSO- 5-CARBOXIETHYL-1H-PYRAZOLES. Stefania Aielloa , Carmelo Massimo Maidab, Fabio Venturellab, Diego Planetac Marco Giammancod, M.Milicib a Dipartimento di Scienze e Tecnologie Molecolari e Biomolecolari, Università degli Studi di Palermo bDipartimento di Scienze per la Promozione della Salute G. D’ Alessandro, Università degli Studi di Palermo cDipartimento dei Sistemi Agro-Abientali,Università degli Studi di Palermo d Dipartimednto di Studi Giuridici, Economici, Biomedici e Psicosociopedagogici delle Scienze Motorie e Sportive, Università degli Studi di Palermo Corresponding author: Stefania Aiello, Dipartimento di Scie…

Dynamics and molecular evolution of HIV-1 strains in Sicily among antiretroviral naïve patients.

Abstract HIV-1 subtype B is the most frequent strain in Sicily. To date, there is no available data about the genetic diversity of HIV-1 viral strains circulating in Sicily among antiretroviral (ARV) naive subjects and the role of immigration as potential determinant of evolutionary dynamics of HIV-1 molecular epidemiology. For this purpose, HIV-1 polymerase (pol) sequences obtained from 155 ARV naive individuals from 2004 to 2009 were phylogenetically analysed. The overall rate of HIV-1 non-B infections was 31.0% (n = 48/155), increasing from 7.8% in 2004–2006 to 40.9% in 2009, and about one-third were identified as unique recombinant forms. CRF02_AG was the prevalent non-B clade (n = 28/4…

Estimating the burden of hospitalization for pneumococcal pneumonia in a general population aged 50 years or older and implications for vaccination strategies

Streptococcus pneumoniae is a major cause of human infectious diseases worldwide. Despite this documented evidence, data on pneumococcal disease rates among general populations are scant because of the frequent lack of cultural identification. In this study we propose a model for estimating the burden of pneumococcal pneumonia on hospitalizations. The study was performed by analyzing administrative and clinical data of patients aged 50 years or older, resident in Sicily, and hospitalized, from 2005 to 2012. Demographic information, admission/discharge dates, discharge status, and up to 6 discharge diagnoses coded according to ICD-9 CM were collected for each hospitalized patient. During the…

First case of monkeypox virus, SARS-CoV-2 and HIV co-infection

PRODUZIONE DI RIFIUTI A RISCHIO INFETTIVO E INDICI DI COMPLESSITÀ IN UN “CENTRO TRAPIANTI”

Questo studio analizza la produzione di rifiuti a rischio infettivo in una grande struttura ospedaliera specializzata per le attività di trapianto: Ismett (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), che si trova a Palermo. Sono state determinate le relazioni fra la quantità e la composizione dei rifiuti, da una parte; la complessità della struttura e la natura delle cure erogate, dall’altra. In letteratura si trovano regolarmente i risultati di ricerche sulla produzione di rifiuti a rischio infettivo nei più diversi Paesi del mondo; i dati pubblicati provengono quasi esclusivamente da Ospedali Generali, anche complessi e di Alta Specializzazione. Tali dati po…

Ciprofloxacin releasing gellan gum/polydopamine based hydrogels with near infrared activated photothermal properties.

Abstract In this work, with the aim to obtain a wound dressing hydrogel, an amine derivative of gellan gum was crosslinked in the presence of 4arm-polyethylenglycole-vinylsulfone. Through this easy and reproducible chemical procedure, a hydrogel with advanced elastic properties and hydrolytic resistance under physiological conditions was obtained. The incorporation of different quantities of polydopamine in the gelling solutions allows to obtain different hydrogels with marked photothermal properties when irradiated with a laser in the near infrared at 810 nm. The organic nanoparticles, reacting with the amino groups of the polysaccharide derivative, contribute to increase the storage modul…

Surveillance Data for Eight Consecutive Influenza Seasons in Sicily, Italy

Influenza A and B outbreaks occur each year with different activity and molecular patterns. To date, knowledge of seasonal epidemiology remains a prerequisite not only to put in place the most effective immunization strategy against influenza but also to identify population groups at higher risk of developing serious complications. A retrospective analysis of influenza surveillance data from 2010 to 2018 aimed to explore the epidemiology of influenza in Sicily, at the primary care and hospital level. Overall, 6,740 patients with acute respiratory infection were tested, of which 3,032 (45.0%) were positive for influenza. The relative proportion of type A and B viruses markedly varied across …

Nutrient recovery from wastewater treatment by ultrafiltration membrane for water reuse in view of a circular economy perspective

The study aims to recover nitrogen from wastewater by employing ultrafiltration membrane in water reuse for agriculture purpose. To such aim, a new reclaimed water quality index (RWQI) is proposed and applied including an innovative protocol for its assessment. Specifically, the influence of filtration and backwashing times for an ultrafiltration system aimed to nutrient recovery has been analyzed. The final goal was to pin down the trade-off between operation costs and effluent quality. Results show that backwashing time play a crucial role in reducing the operation costs; indeed, low values (i.e., 0.5 min) lead to an increase in the number of required chemical cleanings and consequently o…

Colonizzazione pneumococcica in bambini in eta' scolare e possibile trasmissione intrafamiliare: l'esperienza dello studio "BINOCOLO" in Sicilia.

INTRODUZIONE La colonizzazione orofaringea da pneumococco interessa il 90% dei bambini nel primo anno di vita ed i contatti familiari possono giocare un ruolo cruciale nella stessa. Per analizzare i fattori associati alla colonizzazione da pneumococco e alla possibile trasmissione intra-familiare, è stato realizzato il progetto BINOCOLO: "Bambini Insieme ai NOnni COntro LO Pneumococco" su una popolazione studentesca e relativi familiari co- residenti. METODI Per l'arruolamento dei partecipanti allo studio, sono state identificate due scuole primarie del Comune di Palermo. Per ogni soggetto reclutato, un questionario e un tampone orofaringeo sono stati raccolti attraverso un team opportuname…

Urban air pollution and emergency room admissions for respiratory symptoms: a case-crossover study in Palermo, Italy

Abstract Background Air pollution from vehicular traffic has been associated with respiratory diseases. In Palermo, the largest metropolitan area in Sicily, urban air pollution is mainly addressed to traffic-related pollution because of lack of industrial settlements, and the presence of a temperate climate that contribute to the limited use of domestic heating plants. This study aimed to investigate the association between traffic-related air pollution and emergency room admissions for acute respiratory symptoms. Methods From January 2004 through December 2007, air pollutant concentrations and emergency room visits were collected for a case-crossover study conducted in Palermo, Sicily. Ris…

Posaconazole against Candida glabrata Isolates with Various Susceptibilities to Fluconazole

ABSTRACT We investigated the in vitro activities of posaconazole (POS), fluconazole (FLC), amphotericin B (AMB), and caspofungin (CAS) against four clinical isolates of Candida glabrata with various susceptibilities to FLC (FLC MICs ranging from 1.0 to >64 μg/ml). POS MICs ranged from ≤0.03 to 0.5 μg/ml; AMB MICs ranged from 0.25 to 2.0 μg/ml, while CAS MICs ranged from 0.03 to 0.25 μg/ml. When FLC MICs increased, so did POS MICs, although we did not observe any isolate with a POS MIC greater than 0.5 μg/ml. Time-kill experiments showed that POS, FLC, and CAS were fungistatic against all isolates, while AMB at eight times the MIC was fungicidal against three out of four isolates of C. gl…

Wastewater-based epidemiology for early warning of SARS-COV-2 circulation: A pilot study conducted in Sicily, Italy

There is increasing evidence of the use of wastewater-based epidemiology to integrate conventional monitoring assessing disease symptoms and signs of viruses in a specific territory. We present the results of SARS-CoV-2 environmental surveillance activity in wastewater samples collected between September 2020 and July 2021 in 9 wastewater treatment plants (WTPs) located in central and western Sicily, serving over 570,000 residents. The presence of SARS-CoV-2, determined in 206 wastewater samples using RT-qPCR assays, was correlated with the notified and geo-referenced cases on the areas served by the WTPs in the same study period. Overall, 51% of wastewater samples were positive. Samples we…

Gestione delle acque marine e Sanità Pubblica tra normative, criticità e prospettive.

Il mare copre il nostro pianeta per circa il 71% della superficie terrestre e gioca un ruolo fondamentale nella vita dell’uomo. Le acque marine sono connesse con la Sanità Pubblica a vari livelli, infatti sia lo stato di salute e benessere individuale che di popolazione risulta influenzato dalle condizioni del mare e delle sue risorse in maniera positiva o negativa. Milioni di individui ogni anno in Italia, per attività balneare ricreativa, si concentrano per periodi relativamente ristretti in litorali più o meno estesi spesso ubicati in diretta continuità con le realtà urbane e metropolitane di fatto determinando un potenziale ambito di contatto tra le attività antropiche e lo smaltimento …

La metodica wastewater based epidemiology come proxy di quantificazione del consumo di sostanze stupefacenti nella popolazione: l’esperienza della città di Palermo.

INTRODUZIONE Le istituzioni europee e la comunità scientifica hanno, recentemente, definito un nuovo modello di sorveglianza attiva della potenziale diffusione delle droghe nella collettività, la Wastewater Based Epidemiology (WBE), attraverso la ricerca analitica delle molecole e dei loro metaboliti nelle acque reflue cittadine. Lo scopo di questo lavoro è stato la valutazione di una preliminare applicazione di METODIca WBE nella città di Palermo, poco studiata in precedenti analisi a livello nazionale e internazionale. METODI Sono stati prelevati 28 campioni (2 litri cad) di refluo medio delle 24 ore in ingresso ai due depuratori di Palermo (WP1=45.000 ab. eq.; WP2=330.000 ab. eq.) in un …

Varicella vaccination as useful strategy for reducing the risk of varicella-related hospitalizations in both vaccinated and unvaccinated cohorts (Italy, 2003-2018).

The present study summarizes evidences of the impact that varicella vaccination (VV) introduction and coverage can have on varicella attributable hospitalization rates.A retrospective observational study was carried out by considering hospital discharge records and VV coverage at 24 months collected from 2003 to 2018 by the Italian Ministry of Health. All hospitalizations records reporting an ICD-9 CM 052.X code as the principal diagnosis or any of the five secondary diagnoses were considered as related to varicella. The hospitalization rate reduction was evaluated by calculating average annual percent change (AAPC) through joint-point analysis.Hospitalization rates showed a decreasing tren…

Candida SPP. Colonization in NICU: A 2-Year Surveillance Study

Introduction: Fungal infections are an important cause of increased morbidity and mortality in infants admitted to neonatal intensive care units (NICUs). In VLBW infants, Candida (C.) albicans is the third most common cause of neonatal late onset sepsis (LOS). The overall incidence of candidemia in NICU is increasing because of the longer survival and the invasive procedures related with the intensive care of extremely preterm infants. Prevention of candidemia in neonates is supported by the identification and adequate management of specific risk factors, including low birth weight, use of invasive devices, prolonged hospitalization and use of broad-spectrum antimicrobial agents. Effective …

Valutazione metodologica della contaminazione microbica dell’aria in sala operatoria: campionamento attivo e campionamento passivo

OBIETTIVI: Valutazione della qualità microbiologica dell’aria nelle sale operatorie dell’A.O.U.P. “P. Giaccone” di Palermo mediante metodi di campionamento attivo e passivo. MATERIALI: Nel secondo semestre del 2009 sono stati effettuati campionamenti di aria in 20 sale operatorie (10 a flusso laminare e 10 a flusso turbolento) sia in condizioni di attività sia in condizioni di riposo. I punti di prelievo per il campionamento attivo sono stati: 1) il centro stanza 2) il VCCC; per il campionamento passivo 1) centro stanza 2) fondo stanza. Sono stati monitorati i seguenti parametri: carica batterica totale (CBT), carica micetica totale (CMT), Staphilococcus aureus ed Indice Microbico Aria (IMA…

Immunization Status against Measles of Health-Care Workers Operating at Three Sicilian University Hospitals: An Observational Study

Measles is a highly contagious vaccine-preventable disease (VPD) that also commonly affects health-care workers (HCWs). Measles immunization of HCWs was strongly recommended by international health authorities, in order to limit the spreading of the illness to susceptible patients and colleagues. An observational study, evaluating the immunization and vaccination status against measles of HCWs working at three Sicilian university hospitals, was conducted. All subjects not completely immune (vaccinated with only one dose in their lifetime), not immune (not vaccinated or not naturally immunized), and with an unknown immunization status were considered not immunized. Among HCWs operating in th…

LA VALUTAZIONE IN VITRO DELLA SENSIBILITÀ DI LIEVITI DI ISOLAMENTO CLINICO AI COMUNI AGENTI ANTIMICOTICI

Serological pattern of Hepatitis B, C, and HIV infections among immigrants in Sicily: epidemiological aspects and implication on public health.

The objective of this study was to describe the prevalence of Hepatitis B virus (HBV), Hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections in a cohort of immigrants living in Palermo, Sicily. The study was carried out in the period May 2006-June 2010 and recruited a total of 393 patients (59.8% males-median age of 32.6 years). All patients were tested for serological markers of HBV, HCV, and HIV infection. One-hundred thirty-eight (35.1%) individuals did not show any HBV/HCV/HIV serological marker, while 186 (47.3%) were indicative of past or current HBV infection. A total of 42 (10.7%) subjects were HBsAg positive, 59 (15.0%) showed the serological profile "anti-HBc …

Gestione degli impianti ad uso natatorio. Monitoraggio chimico-microbiologico ed analisi comparativa dei dati delle piscine comunali di Palermo e del territorio dell’A.S.L. n.2 di Lucca.

Metodo di diffusione in agar per la valutazione della sensibilità di Candida spp. alla caspofungina

Occurrence of a case of influenza A(H1N1)pdm09 and B co-infection during the epidemic season 2012–2013

Abstract We report the detection of one case of co-infection with influenza A(H1N1)pdm09 and B, occurred during the 2012–2013 influenza season in Sicily. The dual infection was identified in a 18-year-old boy, who was not covered by specific vaccination and who had no other pre-existing risk factors. He presented classical symptoms of influenza-like illness developing no respiratory complications. A(H1N1)pdm09 viral concentration was initially about 10-fold higher than B virus, whereas its clearance was more rapidly achieved than in the case of B virus infection. Although influenza co-infection appears to be a rare event, a continued influenza surveillance activity is recommended, in order …

Schools opening and Covid-19 diffusion: Evidence from geolocalized microdata

Are schools triggering the diffusion of the Covid-19? This question is at the core of an extensive debate about the social and long-run costs of stopping the economic activity and human capital accumulation from reducing the contagion. In principle, many confounding factors, such as climate, health system treatment, and other forms of restrictions, may impede disentangling the link between schooling and Covid-19 cases when focusing on a country or regional-level data. This work sheds light on the potential impact of school opening on the upsurge of contagion by combining a weekly panel of geocoded Covid-19 cases in Sicilian census areas with a unique set of school data. The identification o…

Occult Hepatitis B Infection in the Immigrant Population of Sicily, Italy.

In Italy, about 7 % of the resident population is represented by immigrants originating from geographic regions at high endemicity for hepatitis B virus infection. This study aims to assess the prevalence of occult HBV infection (OBI) including the identification of HBV-genotypes in a population of immigrants serologically negative for hepatitis B surface antigen (HBsAg). Between May 2006 and May 2010, 339 immigrants were tested for markers of HBV, hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections. HBV-DNA was tested by using nested-PCR assays on three different genetic region. HBV-DNA was detected in plasma samples of 11/339 (3.2 %) patients. Most of them had no ser…

STERILIZZAZIONE CON MICROONDE DI RIFIUTI SANITARI: DETERMINAZIONE DIRETTA DELL’EFFICACIA DEL PROCESSO

In the sterilization of those Health Care Waste that are marked as possibly infectious, microwaves (MW) have long been proposed as an alternative means to steam. The effectiveness of the operation is assessed determining the fraction that has survived to the sterilizing agent of a known starting population of micro-organisms. Customarily, this population is introduced into the waste mass in the form of one or more sealed vials. These make up an artificial environment which is completely under control; but onto it the sterilizing agent could a priori behave with higher or lower effectiveness, compared with the loose mass which is directly exposed to it. As far as the traditional steam steril…

Genomic Analysis and Lineage Identification of SARS-CoV-2 Strains in Migrants Accessing Europe Through the Libyan Route

Many African countries, representing the origin of the majority of refugees, asylum-seekers, and other migrants, toward regions bordering on the Mediterranean area, are experiencing sustained local transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sicily is one of the main entry gates of migrants crossing into Europe. We conducted a pilot study, based on the full-genome sequencing of SARS-CoV-2 strains isolated from migrants coming to Sicily by crossing the Mediterranean Sea, with the aim to investigate the viral genome polymorphism and to describe their genetic variations and the phylogenetic relationships. On June 21, a nongovernmental organization vessel rescu…

SARS-CoV-2 Viral Load, IFNλ Polymorphisms and the Course of COVID-19: An Observational Study

The course of SARS-CoV-2 infection ranges from asymptomatic to a multiorgan disease. In this observational study, we investigated SARS-CoV-2 infected subjects with defined outcomes, evaluating the relationship between viral load and single nucleotide polymorphisms of genes codifying for IFN&lambda

In vitro activity of fluconazole, voriconazole and caspofungin against clinical yeast isolates.

Predicting the clinical outcome of a systemic mycosis is often a difficult task, especially when microbiological resistance is one of the factors contributing to therapeutic failure. Some of these factors are host-related--e.g. immune state, site and severity of infection, poor compliance to therapy--while others are associated with the drug's characteristics--e.g. dosage, type of compound (fungistatic/fungicidal), pharmacokinetic properties and drug-drug interactions. In the last few years, clinicians have been confronted with the problem of selecting the most appropriate antifungal therapy for systemic infections and have highlighted the need for a reliable method to assay the in vitro su…

VALUTAZIONE IN VITRO DELLA SENSIBILITÀ DI LIEVITI DI ISOLAMENTO CLINICO AI COMUNI AGENTI ANTIMICOTICI

Human papilloma virus infection and vaccination: Pre-post intervention analysis on knowledge, attitudes and willingness to vaccinate among preadolescents attending secondary schools of palermo, sicily

In recent years, vaccination coverage rates against Human Papilloma Virus (HPV) in Europe have shown a decreasing trend and remain below the required standard. The present study aims to assess knowledge and attitudes regarding HPV infection and vaccination among a representative sample of preadolescents of Palermo, Italy. A survey was carried out throughout two questionnaires, before and after carrying out an educational intervention scheduled during school hours. A total of 1702 students attending first-grade secondary schools of the province of Palermo were enrolled (response rate 68.9%). Students attending third classes (adj OR = 1.18

Branched High Molecular Weight Glycopolypeptide With Broad-Spectrum Antimicrobial Activity for the Treatment of Biofilm Related Infections.

There are few therapeutic options to simultaneously tackle Staphylococcus aureus and Pseudomonas aeruginosa, two of the most relevant nosocomial and antibiotic-resistant pathogens responsible for implant, catheters and wound severe infections. The design and synthesis of polymers with inherent antimicrobial activity have gained increasing attention as a safe strategy to treat multi-drug-resistant microbes. Here, we tested the activity of a new polymeric derivative with glycopolypeptide architecture (PAA-VC) bearing l-arginine, vancomycin, and colistin as side chains acting against multiple targets, which give rise to a broad spectrum antimicrobial activity favorably combining specific and n…

Knowledge, attitudes and risk of HIV, HBV and HCV infections in hairdressers of Palermo city (South Italy)

Background: The hairdressing trade may potentially expose its practitioners and their customers to blood-borne infections. Methods: Knowledge, attitudes and behaviours towards occupational risk of HIV, HBV and HCV infections were evaluated in a cross-sectional survey, conducted during spring 2008, in 105 out of 112 randomly selected hairdressers of Palermo. Participants were queried by answering to an anonymous questionnaire. Results: Most of hairdressers (93.3%) knew that HIV and hepatitis are transmitted through parenteral route and could also be transmitted by razors. The availability of gloves was inadequate, up to 30% of the participants never used them and up to 50% usually reused the…

Il destino dei microinquinanti negli impianti di depurazione e nei corpi idrici.

• Monitoraggio di droghe in quattro impianti di depurazione siciliani e in un corpo idrico ricettore. • Elevata presenza nei reflui influenti a tutti gli impianti monitorati di THC-COOH e BEG, metaboliti rispettivamente della cannabis e della cocaina. • Fenomeni di degradazione naturale ad opera del biota e/o di accumulo nei sedimenti del corpo idrico ricettore comportano la riduzione delle concentrazione di THC-COOH.

Diagnosis of Influenza: Only a Problem of Coding?

<b><i>Objective:</i></b> To evaluate the characteristics of hospital discharge diagnoses of influenza measured by using specific International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) codes. <b><i>Subjects and Methods:</i></b> The study was conducted for the 3 years 2007, 2008 and 2011. The database included (1) administrative and clinical data on Sicilian patients admitted to acute care hospitals and (2) data from the influenza virological surveillance of 10 European countries (FluNet database). All Sicilian patients diagnosed with at least 1 ICD-9 CM code for influenza (487.0, 487.1 and 487.9) were considere…

DISTRIBUZIONE E FREQUENZA DI ISOLAMENTO DI MICETI IN UNA PISCINA PUBBLICA DELLA CITTA' DI PALERMO

Direct RNA nanopore sequencing of SARS-CoV-2 extracted from critical material from swabs

ABSTRACTBackgroundIn consideration of the increasing prevalence of COVID-19 cases in several countries and the resulting demand for unbiased sequencing approaches, we performed a direct RNA sequencing experiment using critical oropharyngeal swab samples collected from Italian patients infected with SARS-CoV-2 from the Palermo region in Sicily.MethodsHere, we identified the sequences SARS-CoV-2 directly in RNA extracted from critical samples using the Oxford Nanopore MinION technology without prior cDNA retro-transcription.ResultsUsing an appropriate bioinformatics pipeline, we could identify mutations in the nucleocapisid (N) gene, which have been reported previously in studies conducted in…

Posaconazole Activity against Candida glabrata after Exposure to Caspofungin or Amphotericin B

ABSTRACT We evaluated the effects of sequential therapy with caspofungin (CAS) or amphotericin B (AMB) followed by posaconazole (POS) against Candida glabrata . The susceptibilities to POS of yeast cells pre-exposed to CAS or AMB were identical to those of untreated cells as shown by standard Clinical and Laboratory Standards Institute broth dilution, cell viability, and disk diffusion methods. We then investigated the activity of sequential regimens in an experimental model of disseminated candidiasis. CAS given at 1 mg/kg/day for 2 days followed by POS at either 15 or 30 mg/kg/day significantly reduced the counts compared to the controls, but this treatment was not superior to the use of …

First detection of SARS-CoV-2 A.23.1 sub-lineage in migrants arriving to Italy via the Mediterranean Sea and public health implications

Prevalence of Occult Hepatitis B Virus Infection in a Cohort of HIV-Positive Patients Resident in Sicily, Italy

Occult hepatitis B virus (OBI) in HIV-infected groups is still debated, as well as the associated risk-factors and clinical significance. In this paper, we examined a total of 405 HBsAg-negative/HIV-infected patients enrolled from January 2007 to December 2009. Overall, the prevalence of OBI was 5.9% (95% confidence interval (CI95%): 3.8–8.7%); it was more frequently associated with “anti-HBc alone” serological marker (11.3%; adjusted odds ratio = 3.7, CI95%: 1.4–9.8), although it was also detected in the absence of any HBV serological marker (4.9%; CI95%: 2.3–9.1%). A low prevalence of anti-HCV-positive patients with OBI was found (3.1%; CI95%: 0.6–8.7%). HIV RNA plasma levels or other imm…

Coverage rates against vaccine-preventable diseases among healthcare workers in Sicily (Italy)

Abstract Background Vaccination of healthcare workers (HCWs) reduces the risk of occupational vaccine-preventable diseases (VPDs), prevents their nosocomial transmission and preserves healthcare delivery during outbreaks. Extensive implementation of vaccination programmes for HCWs allowed the elimination or control of several VPDs within healthcare facilities; despite these, the vaccine adherence rates among HCWs are persistently suboptimal. Methods A questionnaire was self-administered by HCWs to assess their vaccination rates against several VPDs and self-reported immunity in two university hospitals of Southern Italy (Catania and Palermo). Results A total of 2586 questionnaires were anal…

Illicit drugs consumption evaluation by wastewater-based epidemiology in the urban area of Palermo city (Italy)

Introduction. A wastewater-based epidemiology approach was performed to estimate the drug consumption in Palermo city, the fifth largest city of Italy with a population of 671 696 inhabitants, and to investigate the monthly variability of drug loads in wastewater from different areas of the city. A seven-months detection campaign was conducted at the two wastewater treatment plants of the city. Methods. Following a pre-treatment, 32 samples of wastewater were analyzed by liquid chromatography-tandem mass spectrometry. Results. We estimated a mean cocaine use in Palermo of 0.19 g/day/1000 people, corresponding to 1.90 doses/1000 people and cannabinoids use of 2.85 g/day/1000 people, correspo…

Sorveglianza Igienico-Sanitaria Di Una Piscina Di Uso Pubblico Della Città Di Palermo (Italia) [Surveillance of the sanitary conditions of a public swimming pool in the city of Palermo (Italy)]

In a previous study we evaluated the microbiological quality of water of seven pools in the city of Palermo through evaluation of bacterial indicators of faecal contamination and of protozoa (Giardia and Cryptosporidium). In this study we also searched for the presence of fungi in two swimming pools of a public swimming facility in the same city. Samples were collected from both pools, their filtration systems and floor surfaces of the facility. Chemical-physical and microbiological examination of water of the two pools have shown that quality of water depends on the concentration of residual free chlorine and on the number of bathers in the pool. The values of four microbiological paramete…

Induzione sperimentale di resistenza a fluconazolo in C. albicans

Clinical Severity in Different Waves of SARS-CoV-2 Infection in Sicily: A Model of Smith’s “Law of Declining Virulence” from Real-World Data

Background: The COVID-19 epidemic had a rapid spread worldwide with a continuous and fast mutation of the virus, resulting in the emergence of several variants of concern (VOC). The aim of this study was to evaluate the severity of each VOC among SARS-CoV-2 infected subjects by investigating deaths, ICU admissions, intubations, and severe critical symptoms. Methods: An ecological observational study was performed to evaluate mortality rates and clinical characteristics of 321,490 unvaccinated Sicilian SARS-CoV-2 cases observed from 2 March 2020 to 27 March 2022. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by multivariate logistic regression analysis evaluating factors…

Impact of Communicative and Informative Strategies on Influenza Vaccination Adherence and Absenteeism from Work of Health Care Professionals Working at the University Hospital of Palermo, Italy: A Quasi-Experimental Field Trial on Twelve Influenza Seasons

Every year, about 20% of health care workers (HCWs) acquire influenza, continuing to work and encouraging virus spreading. Influenza vaccination coverage rates and absenteeism from work among HCWs of the University Hospital (UH) of Palermo were analyzed before and after the implementation of several initiatives in order to increase HCWs&rsquo

Burden and viral aetiology of influenza-like illness and acute respiratory infection in intensive care units

The purpose of this investigation was to study the viral aetiology of influenza-like illness (ILI) and acute respiratory tract infection (ARTI) among patients requiring intensive care unit admission. A cross-sectional retrospective study was carried out in Sicily over a 4-year period. A total of 233 respiratory samples of patients with ILI/ARTI admitted to intensive care units were molecularly analyzed for the detection of a comprehensive panel of aetiologic agents of viral respiratory infections. About 45% of patients was positive for at least one pathogen. Single aetiology occurred in 75.2% of infected patients, while polymicrobial infection was found in 24.8% of positive subjects. Influe…

Surveillance of hospitalised patients with influenza-like illness during pandemic influenza A(H1N1) season in Sicily, April 2009 - December 2010

This paper describes the epidemiology of hospitalised cases with influenza-like illness (ILI) and laboratory- confirmed influenza A cases in Sicily (Italy) during the 2009 influenza pandemic. The first ILI case diagnosed as infected with pandemic influenza A(H1N1)2009 in Sicily was reported in June 2009 and it rapidly became the dominant circulating strain. In the period from 30 April 2009 through 31 December 2010, a total of 2,636 people in Sicily were hospitalised for ILI and 1,193 were laboratory-confirmed for influenza A. Basic demo- graphic and clinical information for all hospitalised patients was collected and population mortality rates (PMRs) and case fatality ratios (CFRs) were cal…

Respiratory Syncytial Virus: New Challenges for Molecular Epidemiology Surveillance and Vaccination Strategy in Patients with ILI/SARI.

Several respiratory pathogens are responsible for influenza-like illness (ILI) and severe respiratory infections (SARI), among which human respiratory syncytial virus (hRSV) represents one of the most common aetiologies. We analysed the hRSV prevalence among subjects with ILI or SARI during the five influenza seasons before the emergence of SARS-CoV-2 epidemic in Sicily (Italy). Respiratory specimens from ILI outpatients and SARI inpatients were collected in the framework of the Italian Network for the Influenza Surveillance and molecularly tested for hRSV-A and hRSV-B. Overall, 8.1% of patients resulted positive for hRSV. Prevalence peaked in the age-groups &lt

INDAGINI MICROBIOLOGICHE IN ACQUE DI FALDA DEL TERRITORIO PALERMITANO DESTINATE AL CONSUMO UMANO

Surveillance of methicillin-resistant Staphylococcus aureus, multidrug-resistant Gram-negatives and fungi colonization in the Neonatal Intensive Care Units in the city of Palermo.

Introduction Multidrug-resistant organisms are a serious public health problem, particularly in critical hospital wards such as the Neonatal Intensive Care Units (NICUs). Hospitalized neonates are at high risk for healthcare-associated infections leading to higher morbidity and mortality rates, because of their poor immune defences, frequent exposure to antibiotics, invasive procedures and contacts with healthcare-workers. Our study aimed to evaluate the prevalence of colonization by methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Gram-negatives (MDRGNs) and fungi in the five NICUs of the city of Palermo. Methods From February 2014 to January 2015, an active surveill…

Evaluation of the Disk Diffusion Method Compared to the Microdilution Method in Susceptibility Testing of Anidulafungin against Filamentous Fungi

ABSTRACT Susceptibility testing of anidulafungin (AFG) against 32 mold isolates showed an excellent correlation between disk diffusion (DD) and broth microdilution methods. Based on our data, a 2-μg disk of AFG and a 24-h reading time might represent the best parameters for AFG DD testing against filamentous fungi.

GESTIONE DEGLI IMPIANTI AD USO NATATORIO. MONITORAGGIO CHIMICO-MICROBIOLOGICO ED ANALISI COMPARATIVA DEI DATI DELLE PISCINE COMUNALI DI PALERMO E DEL TERRITORIO DELL'AZ. USL 2 DI LUCCA.

Case-based surveillance of measles in Sicily during 2012-2017: The changing molecular epidemiology and implications for vaccine strategies.

Following the indication of the World Health Organization, a national plan for the elimination of measles was approved in Italy and this included the improvement of the molecular surveil- lance of measles viruses and the interruption of indigenous transmission of the disease. Nevertheless, large outbreaks continue to occur in almost all regions of the country, includ- ing Sicily. Here we describe the epidemiology and molecular dynamics of measles viruses as a result of the measles surveillance activity carried out by the “Reference Laboratory for Measles and Rubella” in Sicily over a 5-year period. Biological samples of 259 suspected measles cases were tested for viral RNA detection and a t…

Socio-Demographic Factors Involved in a Low-Incidence Phase of SARS-CoV-2 Spread in Sicily, Italy

Background: The present study analysed SARS-CoV-2 cases observed in Sicily and investigated social determinants that could have an impact on the virus spread. Methods: SARS-CoV-2 cases observed among Sicilian residents between the 1 February 2020 and 15 October 2020 have been included in the analyses. Age, sex, date of infection detection, residency, clinical outcomes, and exposure route have been evaluated. Each case has been linked to the census section of residency and its socio-demographic data. Results: A total of 10,114 patients (202.3 cases per 100,000 residents

An Ecological Study to Investigate Links Between Atmospheric Pollutants From Farming and SARS-CoV-2 Mortality

AbstractExposure to atmospheric particulate matter and nitrogen dioxide has been linked to SARS-CoV-2 infection and death. We hypothesized that an interaction between SARS-CoV-2 infection and exposure to farming-related atmospheric pollutants worsens the effect of SARS-CoV-2 on mortality. Our objective was investigate this hypothesis by performing an ecological study in five Italian Regions (Piedmont, Lombardy, Veneto, Emilia-Romagna and Sicily) linking all-cause mortality, by province (administrative entities within regions), to atmospheric particulate matter (PM2.5and PM10) nitrous oxide (N2O), ammonia (NH3) and methane (CH4) mainly produced by agricultural activities. Study outcome was c…

Igiene dell'ambiente: inquinamento atmosferico, gestione dei rifiuti e gestione delle acque

The molecular epidemiology and evolutionary dynamics of influenza B virus in two Italian regions during 2010-2015: The experience of Sicily and Liguria

Molecular epidemiology of influenza B virus remained poorly studied in Italy, despite representing a major contributor to seasonal epidemics. This study aimed to reconstruct the phylogenetic relationships and genetic diversity of the hemagglutinin gene sequences of 197 influenza B strains circulating in both Southern (Sicily) and Northern (Liguria) Italy between 2010 and 2015. Upper respiratory tract specimens of patients displaying symptoms of influenza-like illness were screened by real-time RT-PCR assay for the presence of influenza B virus. PCR-positive influenza B samples were further analyzed by sequencing. Neighbor-joining phylogenetic trees were constructed and the amino-acid alignm…

Sorveglianza delle colonizzazioni da microrganismi multi resistenti e da miceti e delle infezioni acquisite in ambiente nosocomiale in pazienti sottoposti ad interventi chirurgici in urgenza ed in elezione presso l’AOUP “Paolo Giaccone” di Palermo – risultati preliminari

SARS-CoV-2 Infection in Healthcare Professionals and General Population During “First Wave” of COVID-19 Pandemic: A Cross-Sectional Study Conducted in Sicily, Italy

On December 31, 2019, an outbreak of lower respiratory infections was documented in Wuhan caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the beginning, SARS-CoV-2 has caused many infections among healthcare workers (HCWs) worldwide. Aims of this study were: a. to compare the distribution among the HCWs and the general population of SARS-CoV-2 infections in Western Sicily and Italy; b. to describe the characteristics of HCWs infected with SARS-CoV-2 in the western Sicilian healthcare context during the first wave of the epidemic diffusion in Italy. Incidence and mean age of HCWs infected with SARS-CoV-2 were comparable in Western Sicily and in the whole Ita…

The role of a monthly active surveillance programme for multidrug-resistant Gram-negative bacteria in a neonatal intensive care unit: impact evaluation of preventive measures

Background: Antimicrobial resistance is a public health threat. Neonatal Intensive Care Unit (NICU) patients are particularly at risk, due to the large use of invasive devices and antimicrobial treatment. Since 2014 an active surveillance program of multidrug-resistant organisms is in place in the five NICUs of Palermo, Italy. High prevalence of multidrug-resistant Gram-negative bacteria (MDR-GNB) carriage observed in one NICU suggested the need of a long-lasting approach to achieve effective control of MDR-GNB circulation. Materials/methods: Rectal swabs were obtained every month from each hospitalized new-born. Samples were enriched in liquid cultures, plated in McConkey Agar with three a…

Sorveglianza della nuova influenza H1N1 in Sicilia

Sorveglianza delle colonizzazioni e delle infezioni fungine acquisite in ambiente nosocomiale in pazienti sottoposti ad interventi chirurgici in urgenza ed in elezione presso l’AOUP “Paolo Giaccone” di Palermo.

INDAGINI SULLA STAGIONALITÀ DI GIARDIA E CRYPTOSPORIDIUM NEL FIUME ORETO DI PALERMO.

Wastewater-Based Epidemiology as a Tool to Detect SARS-CoV-2 Circulation at the Community Level: Findings from a One-Year Wastewater Investigation Conducted in Sicily, Italy

Wastewater-based epidemiology is a well-established tool for detecting and monitoring the spread of enteric pathogens and the use of illegal drugs in communities in real time. Since only a few studies in Italy have investigated the correlation between SARS-CoV-2 in wastewater and the prevalence of COVID-19 cases from clinical testing, we conducted a one-year wastewater surveillance study in Sicily to correlate the load of SARS-CoV-2 RNA in wastewater and the reported cumulative prevalence of COVID-19 in 14 cities from October 2021 to September 2022. Furthermore, we investigated the role of SARS-CoV-2 variants and subvariants in the increase in the number of SARS CoV-2 infections. Our findin…

Efficacy of a coordinated strategy for containment of multidrug-resistant Gram-negative bacteria carriage in a Neonatal Intensive Care Unit in the context of an active surveillance program

AbstractBackgroundAntimicrobial resistance in neonatal intensive care unit (NICU) patients is a threat, due to the frequent use of antimicrobial treatment and invasive devices in fragile babies. Since 2014 an active surveillance program of multidrug-resistant Gram-negative bacteria (MDR-GNB) carriage has been in place in the five NICUs of Palermo, Italy. In 2017 an increase in the prevalence of MDR-GNB, and in particular of extended-spectrum β-lactamases-producingKlebsiella pneumoniae(ESBL-KP), was observed in “Civico” hospital NICU.AimTo assess the impact of a coordinated intervention strategy in achieving long-lasting reduction of MDR-GNB prevalence in the NICU.MethodsRectal swabs were ob…

A self-sterilizing fluorescent Nanocomposite as versatile material with broad-spectrum Antibiofilm features

Abstract Hematogenous spread of infections from colonized central intravenous catheters or central lines is a long-recognized problem with infection rates of 2 and 6.8 per 1000 days, respectively. Besides, removal of severe microbial colonization of implanted biomaterials is still a challenge and usually requires invasive operations. Hence, on demand self-sterilizing materials are required to avoid explant of colonized biomaterials and improve patient compliance. Moreover, photoluminescence is needed to make trackable biomaterials, which can be easily monitored upon implanting them in the body. Here, we propose the incorporation of near infrared (NIR) sensitive red-emitting carbon nanodot (…

Indagine sulla presenza di Giardia e Cryptosporidium in campioni di reflui civili, di acque superficiali e sotterranee della provincia di Palermo.

ATTIVITA' IN VITRO DI FLUCONAZOLO, VORICONAZOLO E CASPOFUNGINA NEI CONFRONTI DI LIEVITI DI ISOLAMENTO CLINICO

PNPLA3 and TLL-1 Polymorphisms as Potential Predictors of Disease Severity in Patients With COVID-19

Albeit the pathogenesis of COVID-19 remains unclear, host’s genetic polymorphisms in genes involved in infection and reinfection, inflammation, or immune stimulation could play a role in determining the course and outcome. We studied in the early phase of pandemic consecutive patients (N = 383) with SARS-CoV-2 infection, whose subsequent clinical course was classified as mild or severe, the latter being characterized by admission to intensive therapy unit or death. Five host gene polymorphisms (MERTK rs4374383, PNPLA3 rs738409, TLL-1 rs17047200, IFNL3 rs1297860, and INFL4 rs368234815) were assessed by using whole nucleic acids extracted from nasopharyngeal swabs. Specific protease cleavage …

Wastewater surveillance of SARS-CoV-2 variants in October-November 2022 in Italy: detection of XBB.1, BA.2.75 and rapid spread of the BQ.1 lineage

This study adds insight regarding the occurrence and spread of SARS-CoV-2 Variants of Concern (VOCs) and Var-iants of Interest (VOIs) in Italy in October and November 2022, by testing urban wastewater collected through-out the country. A total of 332 wastewater samples were collected from 20 Italian Regions/Autonomous Provinces (APs) within the framework of national SARS-CoV-2 environmental surveillance. Of these, 164 were collected in the first week of October and 168 in the first week of November. A similar to 1600 bp fragment of the spike protein was sequenced by Sanger (for individual samples) and long-read nanopore sequencing (for pooled Region/AP samples).In October, mutations charact…

Proposal for an Alliance Between Healthcare and Legal Area Professionals for Shared Public Health and Preventive Strategies in Italy and Europe

Following the implementation of the new Italian legislation on responsibility of healthcare workers, a multi-professional framework, involving representatives of the Italian public health professionals and legal professionals expert in the field, drafted a proposal of the actionable recommendations to be implemented in the management of civil and penal disputes arising from the practice of public health interventions. In order to prevent legal disputes concerning some public health fields such as vaccinations, cancer screening, environmental health surveillance, and hospital management, it should be primary taken into account to update guidelines in supporting decision-making processes, in …

Human bile microbiota: A retrospective study focusing on age and gender

Aims: The emerging biliary colonization of microorganisms in patients with biliary diseases may be devastating. Recent evidence suggests that age and gender may influence changes in the microbial composition of gut microbiota. To study the relationship between these parameters on bile microbiota, we retrospectively reviewed positive bile cultures following an endoscopic retrograde cholangiopancreatography (ERCP) in a QA-certified academic surgical unit of a single institution. Methods: 449 positive bile cultures from 172 Italian patients with diseases of the biliopancreatic system hospitalized from 2006 through 2017 were investigated for aerobic, anaerobic, and fungal organisms. The patient…

Aspetti di micologia nelle acque ricreazionali della piscina comunale di Palermo

Physical dispersion and disappearance of bacteria in the Golfo di Palermo: the results of two surveys.

This paper reports on some results of two surveys at sea carried out in the surroundings of a urban wastewater discharge on the coast of the Golfo di Palermo, western Sicily (Italy). At the time of the surveys (year 2005) the stretch of water lying before the central part of the capital town received the untreated wastewater originating from about 200 000 inhabitants, which was discharged on-shore without any prior treatment by the free-surface outfall of “Porta Felice main sewer”. This outfall has crucial importance in the water quality; indeed, the Municipality is steadily implementing a plan featuring an intercepting main sewer along the coast and some pumping stations to connect all the…

Il ruolo dell’immigrazione nelle dinamiche dell’epidemiologia molecolare del virus HIV-1: analisi filo-geografica di varianti virali non-B in individui nativi italiani e migranti in Sicilia.

Obiettivi Sebbene il subtipo B di HIV-1 sia prevalente in Europa Occidentale, virus ascrivibili ai genotipi non-B stanno rapidamente diffondendosi in questa area geografica, specialmente a causa dai flussi immigratori da regioni endemiche. La Sicilia, vista la sua posizione centrale nel bacino del Mediterraneo, rappresenta una delle principali porte di ingresso per i migranti in Europa, in particolare dall’Europa orientale, dall’Africa e dal sud-est asiatico. L’obiettivo del presente studio è stato valutare la prevalenza, le caratteristiche molecolari e le dinamiche geografiche di varianti virali di HIV-1 non ascrivibili al subtipo B in una coorte di individui infetti non sottoposti a terap…

Isolation of Giardia and Cryptosporidium in raw and treated water in Palermo

INDAGINE SULLA STAGIONALITÀ DI GIARDIA E CRYPTOSPORIDIUM NEL FIUME ORETO DI PALERMO

INDAGINI SULLA STAGIONALITÀ DI GIARDIA E CRYPTOSPORIDIUM NEL FIUME ORETO DI PALERMO