What do CF patients and their parents tell about infection control?

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Serratia marcescens outbreak in a neonatal intensive care unit: crucial role of implementing hand hygiene among external consultants.

BACKGROUND: Serratia marcescens represents an important pathogen involved in hospital acquired infections. Outbreaks are frequently reported and are difficult to eradicate. The aim of this study is to describe an outbreak of Serratia marcescens occurred from May to November 2012 in a neonatal intensive care unit, to discuss the control measures adopted, addressing the role of molecular biology in routine investigations during the outbreak. METHODS: After an outbreak of Serratia marcescens involving 14 neonates, all admitted patients were screened for rectal and ocular carriage every two weeks. Extensive environmental sampling procedure and hand sampling of the staff were performed. Antimicrobial susceptibility pattern and molecular analysis of isolates were carried out. Effective hand hygiene measures involving all the external consultants has been implemented. Colonized and infected babies were cohorted. Dedicated staff was established to care for the colonized or infected babies. RESULTS: During the surveillance, 65 newborns were sampled obtaining 297 ocular and rectal swabs in five times. Thirty-four Serratia marcescens isolates were collected: 11 out of 34 strains were isolated from eyes, being the remaining 23 isolated from rectal swabs. Two patients presented symptomatic conjunctivitis. Environmental and hand sampling resulted negative. During the fifth sampling procedure no colonized or infected patients have been identified. Two different clones have been identified. CONCLUSIONS: Ocular and rectal colonization played an important role in spread of infections. Implementation of infection control measures, involving also external specialists, allowed to control a serious Serratia marcescens outbreak in a neonatal intensive care unit

Morphological and biochemical effects on the skeletal muscle of ovariectomized old female rats submitted to the intake of diets with vegetable or animal protein and resistance training

Introduction. Sarcopenia is a process characterized by reduction in protein mass and muscle strength with increasing age, especially in the postmenopausal period, resulting in functional limitations and with great impact on the physical autonomy of the elderly. Objective. To evaluate the effects of diets with vegetable proteins (VP) or animal proteins (AP) associated with resistance training (RT) on the structural and biochemical parameters of the medial gastrocnemius muscle in Wistar rats with sarcopenia. Methods. An experimental model with ovariectomized rats was used to induce sarcopenia and resistance training. The histochemical technique was used for the typing of muscle fibers, the cross-sectional area of myocytes, and volume densities of myocytes and interstitiumthe technique of Picrosirius stain was used to highlight the collagen fibers. Results. The VP diet was not able to minimize the effects of sarcopenia in the medial gastrocnemius of sedentary animals and when associated with RT, it promoted maintenance of the CSA, attenuating the atrophy of type IIB fibers in the medial gastrocnemius. The AP diet in sedentary animals protected the type I fibers. When combined with RT, the AP promoted muscle remodeling, with reduction in volume density of type I and IIA fibers, and increase of IIB fibers, together with an increase in collagen volume density. Conclusion. The data suggest a tendency to better results of hypertrophy in animal groups that consumed the AP diet, even the sedentary animals, although more evident in those trained.Laboratory of Morphological and Immunohistochemical Studies, Universidade São Judas Tadeu, BrazilPostgraduate Program (Stricto Sensu), Ph.D. Course in Physical Education, Universidade São Judas Tadeu, BrazilBiological Sciences Department, Federal University of São Paulo, Diadema, SP, BrazilLaboratory of Clinical Analysis, ABC Medical School, Santo André, SP, BrazilBiological Sciences Department, Federal University of São Paulo, Diadema, SP, BrazilWeb of Scienc

Mortality rate of patients with cystic fibrosis on the waiting list and within one year after lung transplantation : a survey of Italian CF centers

Background: Cystic Fibrosis (CF) Centers are involved in the decisions regarding the eligibility of CF patients with end-stage lung disease and timing for inclusion on waiting lists (WL) for lung transplantation (LT). There are currently no data on the mortality rates of Italian CF patients on WL and during the first year after LT and we aimed to assess these outcomes by surveying the CF Centers. Methods: A survey was sent to Italian CF Centers which were requested to report the age at which all CF subjects included on the WL between 2010 and 2014 were included on the list, admitted to either standard or urgent LT, or had died either while on the WL or within the first 3 and 12 months after LT. All outcomes were recorded by December 31, 2015. Results: Two hundred fifty-nine CF subjects were included on the WL during the 5-year study period. The mortality rate during the WL was 19.3% and was not associated with sex, age at inclusion on the WL or standard or urgent access to LT. 159 (61.4%) subjects underwent LT, 46 (28.9%) with urgent procedure. Deaths within the first 3 and 12 months after LT were significantly more prevalent in individuals who underwent urgent LT compared to those with standard LT (p < 0.01). Conclusions: The mortality of Italian CF patients, included in our survey, was about twice that reported by the National Transplant Center for all LT indications, including CF, during the same time period and despite the introduction of urgent LT. The latter was associated with an unfavorable early outcome compared to standard LT

Molecular epidemiology of meticillin-resistant Staphylococcus aureus in Italian cystic fibrosis patients: A national overview

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Donne immigrate e screening cervicale nel Veneto

According to the literature, women coming from countries with strong migratory pressure are at a greater risk of cancer of the cervix with respect to Italian women. This is connected with the fact that women born outside Italy are less likely to undergo a cervical smear. In the Veneto Region the official immigrant population is equivalent to approximately 10% of the total population. This article analyzes the utilization of cervical smear from immigrant women in the Veneto Region, taking into account the smears performed both inside and outside organized screening programmes. Data have been gathered both from the archives of the screening programmes of the Local Health Authorities and from PASSI, a national surveillance system based on a standardized questionnaire administered through telephone interviews. The screening crude participation rate among foreign women was 45.3%, only slightly lower than the one of Italian women. The participation is lower in women from Asia and in women above 50 years. The percentage of positive smear tests was 2.7% among Italian women and 4.0% among foreign women. Compliance to colposcopy has been 89.9% for Italian women and 88.1% for foreign women. The detection rate of cervical intraepithelial neoplasia grade II or worse (CIN II+ diagnoses) in foreign women has been twofold the one detected in Italian women. If we consider the number of smear tests carried out in the last three years and outside the context of screening programmes, the number of women who have undergone a pap smear is much higher among Italian women, women 39-45 years old and women with a high level of education and without particular economic difficulties. The opposite is true for the organized screening programmes, where the differences according to age, level of education, economic difficulties and citizenship are reduced. These data confirm that women coming from countries with strong migratory pressure are at a greater risk of cancer of the cervix with respect to Italian women. A decrease in inequalities (in terms of education level, socio-economical status and nationality) is shown when considering the access to the screening programs