Accident Triggered by Electrical Failures in Seveso Sites

Electrical maintenance is important for appropriate of Major Accident Prevention Policy MAPP at Seveso sites. At Seveso sites, many accidents include in the causes an electrical failure, due usually to a poor maintenance. Power outages, in particular, originate cascade effects, leading to a possible loss of hazardous materials. The repository of the minor incidents and near misses recorded at Seveso sites is a valuable source for investigating electrical failures, causes, effects and possible prevention and mitigation measures. The present paper discusses a number of incident records, gathered at Seveso establishments, during the mandatory inspections, required by the Seveso Directive. Gathered documents cover different types of plant, including refineries, oil terminal, LPG depots and chemical plants. They have been analysed, using advanced method, including machine learning. The results of this analysis have been exploited to provide the establishments’ operator with a few recommendations, essential to improve electrical safety and prevent major accidents

Clinical and therapeutic aspects of candidemia: A five year single centre study

B ackground Candida is an important cause of bloodstream infections (BSI) in nosocomial settings causing significant mortality and morbidity. This study was performed to evaluate contemporary epidemiology, species distribution, antifungal susceptibility and outcome of candida BSI in an Italian hospital. Methods All consecutive patients who developed candidemia at Santa Maria della Misericordia University Hospital (Italy) between January 2009 and June 2014 were enrolled in the study. Results A total of 204 episodes of candidemia were identified during the study period with an incidence of 0.79 episodes/1000 admissions. C. albicans was isolated in 60.3% of cases, followed by C. parapsilosis (16.7%), C. glabrata (11.8%) and C. tropicalis (6.4%). Of all Candida BSI, 124 (60.8 %) occurred in patients admitted to IMW, 31/204 (15.2 %) in ICUs, 33/204 (16.2%) in surgical units and 16/204 (7.8%) in Hematology/Oncology wards. Overall, 47% of patients died within 30 days from the onset of candidemia. C. parapsilosis and C. glabrata candidemia were associated with the lowest mortality rate (36%), while patients with C. tropicalis BSI had the highest mortality rate (58.3%). Lower mortality rates were detected in patients receiving therapy within 48 hours from the time of execution of the blood cultures (57,1% vs 38,9%, P <0.05). At multivariate analysis, steroids treatment (OR= 0.27, p=0.005) and CVC removal (OR=3.77, p=0.014) were independently associated with lower and higher survival probability, respectively. Candidemia in patients with peripherally inserted central catheters (PICC) showed to be associated with higher mortality in comparison with central venous catheters (CVC, Short catheters and Portacath) and no CVC use. For each point increase of APACHE III score, survival probability decreased of 2%. Caspofungin (OR=3.45, p=0.015) and Amphothericin B lipid formulation (OR=15.26, p=0.033) were independently associated with higher survival probability compared with no treatment

Measles in Italy, July 2009 to September 2010.

Outbreaks of measles continue to occur in Italy, as in other European countries. We present here details of cases reported through the Italian enhanced measles surveillance system from July 2009 to September 2010. In total, 2,151 cases were reported, 42% (n=895) of which were laboratory confirmed. The median age of cases was 18 years and 1,709 of 1,856 cases (92%) were unvaccinated. Many cases with complications were reported (n=305), including three with encephalitis. A total of 652 of 1,822 cases (36%) were hospitalised. Molecular characterisation revealed circulation of a limited number of measles virus genotypes (D4, D8 and B3), which is consistent with the current epidemiology of the disease in Italy. A national measles elimination plan was approved in 2003 with the aim of interrupting endemic measles transmission by 2007. Since elimination was not achieved, the target date was recently moved to 2015. The emphasis of the new elimination plan, approved in March 2011, is on strengthening surveillance, implementing evidence based-interventions to increase measles-mumps-rubella vaccine uptake in children, adolescents and young adults, and implementing communication activities related to the vaccine. The strategies proposed by the plan should be implemented fully and appropriately by all regions in order to meet the elimination goal by 2015

Impatto della pertosse nella popolazione e strategie di prevenzione vaccinale

L'impatto epidemiologico della pertosse ha subito variazioni rilevanti soprattutto in et\ue0 pedia-trica, in seguito alla disponibilit\ue0 di vaccini cellulari altamente efficaci e alla successiva dif-fusione di preparati acellulari, caratterizzati da un migliore profilo di tollerabilit\ue0 e formulati in combinazione con altre componenti antigeniche. Cionondimeno, la pertosse rappresenta tutt\u2019oggi un\u2019importante causa di morbosit\ue0 e mortalit\ue0 nei neonati non ancora vaccinati o che non hanno completato il ciclo primario, e che possono essere infettati dai contatti suscettibili. Le coperture vaccinali sub-ottimali, la progressiva riduzione della protezione immunitaria conferita sia dall\u2019infezione naturale sia dalla vaccinazione e la mancata effettuazione dei richiami vaccinali contribuiscono, infatti, a rendere gli adolescenti e gli adulti le fonti princi-pali di trasmissione dell'infezione ai neonati. Strategie di prevenzione integrate e indirizzate a tutti i target coinvolti nella trasmissione dell'infezione (i.e. soggetti in et\ue0 pediatrica, ado-lescente e adulta, le donne in gravidanza, e gli operatori sanitari) rappresentano, pertanto, uno strumento chiave per il controllo della pertosse

Weight of risk factors for mortality and short-term mortality displacement during the COVID-19 pandemic.

Background: We conducted a population-based cohort study to estimate mortality before, during and after the COVID-19 peak and to compare mortality in 2020 with rates reported in previous years, with a view to helping decision makers to apply containment measures for high-risk groups. Methods: All deaths were collected between 2015 and 2020 from municipal registry database. In 2020, weeks 1-26 were stratified in three periods: before, during and after the COVID mortality peak. The Poisson Generalized Linear regression Model showed the “harvesting effect”. Three logistic regressions for 8 dependent variables (age and comorbidities) and a t-test of &nbsp;differences described all-cause mortality risk factors in 2019 and 2020 and differences between COVID and non-COVID patients. Results: A total of 47,876 deaths were collected. All-cause deaths increased by 38.5% during the COVID peak and decreased by 18% during the post-peak period in comparison with the average registered during the control period (2015-19), with significant mortality displacement in 2020. Except for chronic renal injuries in subjects aged 45-64 years, diabetes and chronic cardiovascular diseases in those aged 65-84 years, and neuropathies in those aged &gt;84 years, the weight of comorbidities in deaths was similar or lower in COVID subjects than in non-COVID subjects. Discussions: Surprisingly, the weight of comorbidities in death, compared to weight in non-COVID subjects allows you to highlight some surprising results such as COPD, IBD and Cancer. The excess mortality that we observed in the entire period were modest in comparison with initial estimates during the peak, owing to the mild influenza season and the harvesting effect starting from the second half of May. &nbsp; &nbsp

Is first-line antimicrobial therapy still adequate to treat MRSA in the ICU? A report from a highly endemic country

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Burden and prevention of HPV. Knowledge, Practices and Attitude Assessment Among Pre-adolescents and their Parents in Italy

Despite infections due to HPV nowadays represent the most common sexually transmitted diseases worldwide with recognized effective and safe preventive strategies, knowledge, attitudes; however, awareness on HPV is considerably low. The present study has two main objectives: 1. To conduct a literature review to analyze the evolution of preventive tools, the complexity of the vaccine choice process, and the challenges posed by HPV vaccine hesitancy and refusal among pre-adolescents and their parents; 2. To assess knowledge, practices and attitudes toward HPV infection and vaccination in a sample of Italian pre-adolescents and their parents. The observational study was carried out through the use of two anonymous and self-administered pre- and post-intervention questionnaires dedicated to the target populations. Between the administrations of the pre- and post-intervention questionnaires, an educational intervention on ITV infection and related diseases, and prevention strategies was conducted. All participants demonstrated suboptimal knowledge and positive attitudes in the pre-intervention questionnaire. Higher levels of knowledge and attitudes were observed among pre-adolescents thatused social networks and had heard of sexually transmitted diseases at home/school/physician and from parents and also who had heard of HPV from General Practitioners, Gynecologists, family members and newspapers. A significant increase in HPV vaccination awareness was observed among pre-adolescents after the educational sessions. Health education programs aimed at increasing knowledge, attitudes and awareness on HPV are needed to implement the outcomes of HPV immunization programs, especially if supported by the physicians involved in counselling and recommendation processes

Genotyping of circulating measles strains in Italy in 2010

Introduction. The European Regional Office of the World Health Organization developed a strategic approach to stop the indigenous transmission of measles in its 53 Member States by 2015. In Italy, laboratory surveillance activity is implemented by the National Reference Laboratory for Measles and Rubella at the Italian National Institute of Health (Istituto Superiore di Sanità, Rome). The role of the National Reference Laboratory is to strengthen surveillance systems through rigorous case investigation and laboratory confirmation of suspected sporadic cases and outbreaks. Genetic characterization of wild-type measles virus is an essential component of the laboratory-based surveillance. This study describes the molecular characterization of measles virus strains isolated during 2010. Methods. Dried blood spots, urine and oral fluid samples were collected from patients with a suspected measles infection. Serological tests were performed on capillary blood, and viral detection was performed on urine and oral fluid samples through molecular assay. Positive samples were sequenced and phylogenetically analysed.Results and discussion. The phylogenetic analysis showed a co-circulation of genotypes D4 and D8, and sporadic cases associated to genotypes D9 and B3. Then, molecular epidemiology of measles cases permitted to establish that D4 and D8 were the endemic genotypes in Italy during 2010

Aportes en la elucidación de la respuesta promovida por Gluconacetobacter diazotrophicus como biocontrolador de Ralstonia solanacearum GMI1000

Gluconacetobacter diazotrophicus (Gd) es una bacteria endófita promotora del crecimiento vegetal (PGPBEs). La asociación planta-PGPBE beneficia a la planta hospedadora mediante la fitoestimulación, biofertilización y protección contra patógenos. Ralstonia solanacearum (Rso) es la bacteria responsable de la marchitez bacteriana en tomate, y causa enormes pérdidas económicas. El objetivo de este trabajo fue estudiar la acción de Gd PAL5 como agente de biocontrol evaluando los mecanismos antagónicos de esta bacteria durante el estrés biótico producido por Rso GMI1000. La motilidad bacteriana es de importancia en el proceso de colonización de la planta por parte del endófito, por eso se ensayaron las motilidades tipo swimming, swarmming y twiching en placas de Petri con medio LGI-P con concentraciones diferentes de agar y se observó la migración de las bacterias y la morfología de los bordes de las colonias. Los ensayos de biocontrol se realizaron mediante estudios in vivo e in vitro. Plantas de Arabidopsis thaliana Col0 se inocularon con 10^6 UFC/mL de Gd, luego de 3 semanas, se inocularon por raíz con 10^6 UFC/mL de Rso. Luego de 12 días: I- Las plantas se esterilizaron superficialmente y extractos de los distintos órganos se sembraron en medios selectivos para cada bacteria. II- Se tomaron muestras a distintos días post inoculación con Gd y Rso, se fijaron en FAA, cortaron y tiñeron con safranina-fast green y azul de toluidina (1%). III- Se cuantificó colorimétricamente el contenido de clorofila a y clorofila b en hojas de plantas sometidas a distintos tratamientos. Además, se buscaron posibles compuestos antimicrobianos mediante experimentos in vitro ensayando la actividad antibacteriana de fracciones de cultivo de la bacteria endófita (medio extracelular, contenido celular y cultivo bacteriano), con la técnica de superposición con soft agar. Bajo las condiciones ensayadas Gd presentó motilidad tipo swarming, que le permite una migración rápida y coordinada, que junto a la producción de exopolisacáridos juegan un rol sustancial en la interacción con la planta. Los ensayos de biocontrol in vivo muestran: a) estructuras anatómicas del tallo más conservadas en plantas con Gd evidenciándose aumento de xilema, mayor lignificación y mayor cantidad de tejido esclerosado entre los haces vasculares; b) técnicas histoanatómicas y los resultados de recuentos bacterianos revelaron mayor proliferación del fitopatógeno en plantas no tratadas con Gd; c) A su vez, se observó una concentración menor de pigmentos en plantas no inoculadas con Gd. En los ensayos in vitro se evidenció actividad antagonista de la fracción celular del cultivo de Gd contra Rso. Los resultados del presente trabajo muestran que Gd coloniza las plantas de A. thaliana ejerciendo un rol protector frente a Rso.Fil: Srebot, Maria Sol. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Ciencias Biológicas. Cátedra de Botánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Rodriguez, María Victoria. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Ciencias Biológicas. Cátedra de Botánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ansaldi, Nazarena. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Ciencias Biológicas. Cátedra de Botánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Tano, María Josefina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Carrau, Analía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Fernandez, Armando Eduardo. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Ciencias Biológicas. Cátedra de Botánica; ArgentinaFil: Martinez, María Laura. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Ciencias Biológicas. Cátedra de Botánica; ArgentinaFil: Cortadi, Adriana Amalia. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Departamento de Ciencias Biológicas. Cátedra de Botánica; ArgentinaFil: Orellano, Elena Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaXV Congreso Argentino de Microbiología; V Congreso Argentino de Microbiología de Alimentos: V Congreso Latinoamericano de Microbiología de Medicamentos y Cosméticos y XIV Congreso Argentino de Microbiología GeneralCiudad de Buenos AiresArgentinaSociedad Argentina de Microbiología Genera

A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality

Abstract Purpose: Clinical data on patients with intra-abdominal candidiasis (IAC) is still scarce. Methods: We collected data from 13 hospitals in Italy, Spain, Brazil, and Greece over a 3-year period (2011\u20132013) including patients from ICU, medical, and surgical wards. Results: A total of 481 patients were included in the study. Of these, 27 % were hospitalized in ICU. Mean age was 63 years and 57 % of patients were male. IAC mainly consisted of secondary peritonitis (41 %) and abdominal abscesses (30 %); 68 (14 %) cases were also candidemic and 331 (69 %) hadconcomitant bacterial infections. The most commonly isolated Candida species were C. albicans (n = 308 isolates, 64 %) and C. glabrata (n = 76, 16 %). Antifungal treatment included echinocandins (64 %), azoles (32 %), and amphotericin B (4 %). Septic shock was documented in 40.5 % of patients. Overall 30-day hospital mortality was 27 % with 38.9 % mortality in ICU. Multivariate logistic regression showed that age (OR 1.05, 95 % CI 1.03\u20131.07, P\0.001), increments in 1-point APACHE II scores (OR 1.05, 95 % CI 1.01\u20131.08, P = 0.028), secondary peritonitis (OR 1.72, 95 % CI 1.02\u20132.89, P = 0.019), septic shock (OR 3.29, 95 % CI 1.88\u20135.86, P\0.001), and absence of adequate abdominal source control (OR 3.35, 95 % CI 2.01\u20135.63, P\0.001) wereassociated with mortality. In patients with septic shock, absence of source control correlated with mortality rates above 60 % irrespective of administration of an adequate antifungal therapy. Conclusions: Low percentages of concomitant candidemia and high mortality rates are documented in IAC. In patients presenting with septic shock, source control is fundamental