Analysis of the antibiotic resistance profiles in methicillin-sensitive s. Aureus pathotypes isolated on a commercial rabbit farm in Italy

The breeding of meat rabbits is an important sector in the livestock industry in Italy. The focus of this study was to describe the antibiotic resistance profile distribution among the Methicillin-sensitive Staphylococcus aureus isolated in a rabbit farm. From 400 animals of different ages and three farm workers, 96 randomly selected strains isolated from various anatomical sites and lesions were analysed. According to spa typing and the resistance profiles towards veterinary and human antibiotics, 26 pathotypes were identified. The highest resistance was observed against Tetracyclines (92.3%) and Macrolides (80.8%), while almost all were susceptible to Penicillins, according to the limited use of β-lactams on the farm. In total, 92.3% of pathotypes were multidrug resistant (MDRs). Two MDR pathotypes belonging to the t2802 spa type were isolated from both farmers and rabbits. Age categories harboured significantly different pathotypes (p = 0.019), while no association was found between pathotypes and lesions (p = 0.128) or sampling sites (p = 0.491). The antibiotic resistance was observed to increase with the time spent in the farm environment (age category). The selective pressure exerted by antibiotic use acted by giving advantage to more resistant strains rather than by lowering susceptibility to various drug categories within strains

Malpractice claims related to musculoskeletal imaging. Incidence and anatomical location of lesions.

Obiettivo. La mancata osservazione di lesioni dell\u2019apparato muscolo-scheletrico \ue8 una frequente causa di denunce contro i radiologi. Materiali e metodi. Sono state esaminate tutte le denunce assicurative per presunti errori in indagini radiologiche riguardanti l\u2019apparato scheletrico rivolte contro i radiologi italiani in un periodo di 14 anni (1993\u20132006). Risultati. Nel periodo in esame sono state sporte contro i radiologi 416 denunce per presunti errori diagnostici relativi all\u2019apparato scheletrico: di queste, 389 (93,5%) erano relative all\u2019omessa indicazione di fratture e 15 (3,6%) a mancata diagnosi di tumore. Conclusioni. L\u2019errata interpretazione della patologia ossea \ue8 tra le pi\uf9 frequenti cause di contenzioso verso i radiologi; da sola essa rappresenta il 36,4% di tutte le denunce per presunto errore diagnostico pervenute nel periodo di osservazione. La consapevolezza del rischio dovrebbe indurre alla massima prudenza e diligenza.Purpose. Failure to detect lesions of the musculoskeletal system is a frequent cause of malpractice claims against radiologists. Materials and methods. We examined all the malpractice claims related to alleged errors in musculoskeletal imaging filed against Italian radiologists over a period of 14 years (1993\u20132006). Results. During the period considered, a total of 416 claims for alleged diagnostic errors relating to the musculoskeletal system were filed against radiologists; of these, 389 (93.5%) concerned failure to report fractures, and 15 (3.6%) failure to diagnose a tumour. Conclusions. Incorrect interpretation of bone pathology is among the most common causes of litigation against radiologists; alone, it accounts for 36.4% of all malpractice claims filed during the observation period. Awareness of this risk should encourage extreme caution and diligence

Malpractice claims in interventional radiology: frequency, characteristics and protective measures Il contenzioso in radiologia interventistica: frequenza, caratteristiche ed azioni di tutela

interventistica \ue8 sensibilmente aumentato negli ultimi anni; di pari passo si \ue8 notato un incremento del contenzioso medico-legale ad esse associato. Questo studio mira a sottolineare i problemi all\u2019origine delle denunce per malapratica in radiologia interventistica, ed a valutare l\u2019importanza del consenso informato. Materiali e metodi. Sono state esaminate tutte le denunce assicurative causate da presunti errori in radiologia interventistica in un periodo di 14 anni, enuncleandole dal data-base assicurativo dei radiologi iscritti alla Societ\ue0 Italiana di Radiologia Medica (SIRM) dal 01/01/1993 al 31/12/2006. Risultati. Nel periodo in esame sono state sporte 98 denunce contro radiologi che avevano effettuato procedure interventistiche. In 21 casi (21,4%) l\u2019evento aveva causato la morte del paziente. In oltre l\u201980% dei casi l\u2019evento lesivo era occorso in una struttura pubblica. Il rischio di ricevere una denuncia per presunta malapratica per un radiologo che pratichi tecniche interventistiche \ue8 pari al 47 per mille, il che corrisponde ad una denuncia per ogni 21 anni di attivit\ue0. Discussione. La radiologia interventistica, attivit\ue0 sovrapponibile per profilo di rischio biologico alle procedure chirurgiche, espone gli operatori ad un elevato rischio di contenzioso medico-legale sia per problemi intrinseci alle tecniche usate, sia per la necessit\ue0 di operare su soggetti con gravi patologie, e in condizioni cliniche compromesse. Conclusioni. La prevenzione del contenzioso dipende in gran parte da una riduzione della percentuale di errore medico abbinata ad una corretta ed organica informazione del paziente. L\u2019adozione di buone pratiche radiologiche, la scrupolosa revisione delle procedure e dell\u2019efficienza tecnica degli strumenti usati, la verifica delle procedure organizzative e gestionali sono i fattori che riducono la probabilit\ue0 dell\u2019errore. Il miglioramento delle tecniche di comunicazione, nel rispetto dell\u2019autonomia del paziente, passa anche attraverso l\u2019adozione di procedure chiare e rigorose per l\u2019ottenimento del consenso all\u2019atto medico.Purpose. The use of interventional radiology procedures has considerably increased in recent years, as has the number of related medicolegal litigations. This study aimed to highlight the problems underlying malpractice claims in interventional radiology and to assess the importance of the informed consent process. Materials and methods. The authors examined all insurance claims relating to presumed errors in interventional radiology filed by radiologists over a period of 14 years after isolating them from the insurance database of all radiologists registered with the Italian Society of Medical Radiology (SIRM) between 1 January1993 and 31 December 2006. Results. In the period considered, 98 malpractice claims were filed against radiologists who had performed interventional radiology procedures. In 21 cases (21.4%), the event had caused the patient\u2019s death. In >80% of cases, the event occurred in a public facility. The risk of a malpractice claim for a radiologist practising interventional procedures is 47 per 1,000, which corresponds to one malpractice claim for each 231 years of activity. Discussion. Interventional radiology, a discipline with a biological risk profile similar to that of surgery, exposes practitioners to a high risk of medicolegal litigation both because of problems intrinsic to the techniques used and because of the need to operate on severely ill patients with compromised clinical status.Conclusions. Litigation prevention largely depends on both reducing the rate of medical error and providing the patient with correct and coherent information. Adopting good radiological practices, scrupulous review of procedures and efficiency of the instruments used and audit of organisational and management processes are all factors that can help reduce the likelihood of error. Improving communication techniques while safeguarding the patient\u2019s right to autonomy also implies adopting clear and rigorous processes for obtaining the patient\u2019s informed consent to the medical procedure