HIV-1/2 prevalence among MSM (men who have sex with men) in Eastern and Southern Europe: non invasive oral fluid testing as a tool for surveillance among hard-to-reach groups (reference lab for European Project Sialon p.n. 101046).

Introduzione:Si stima che quasi il 40% delle nuove diagnosi di infezione da HIV descritte nel 2008 nei paesi dell\u2019Unione Europea, sia da attribuire agli MSM, dove un costante trend in crescita nel numero di infezioni \ue8 stato registrato nell\u2019ultimo decennio. L\u2019ottenimento di dati sulla prevalenza di HIV in questa popolazione ad alto rischio \ue8 di cruciale importanza per lo sviluppo e la realizzazione di adeguati\ua0 programmi di prevenzione e di controllo. L\u2019utilizzo del fluido orale, a tale scopo appare un\u2019utile strategia alternativa al prelievo ematico per la\ua0 ricerca di anticorpi anti-HIV in ambito epidemiologico. Scopo:Questo studio, a cui hanno preso parte sette paesi dell\u2019Unione Europea, si propone: i) di validare un test immunoenzimatico di terza generazione per l\u2019utilizzo di campioni di fluido orale da pazienti con stato sierologico noto per HIV ii) di stimare la prevalenza dell\u2019infezione da HIV tra gli MSM, provenienti da paesi dell\u2019Sud-Est Europa attraverso un vasto campionamento di fluido orale.Metodi:Nella fase di validazione\ua0 263 campioni di siero e di fluido orale da\ua0 pazienti HIV positivi e 235 campioni da soggetti sieronegativi sono stati analizzati\ua0 con il test Genscreen HIV-1/2 versione 2 (BIO-RAD). La procedura \ue8 stata adattata ai campioni di fluido orale attraverso la determinazione di un valore di cut-off specifico.Abbiamo\ua0 quindi realizzato una survey-multicentrica nel periodo tra Aprile 2008 e Settembre 2009, arruolando 2688 MSM che hanno accettato di fornire campioni di fluido orale per la ricerca di anticorpi anti-HIV.Di tutti i campioni di fluido orale \ue8 stata valutata la concentrazione di IgG totali e 3.5 mg/L sono stati considerati sufficienti per procedere ai tests successivi. Tutti i campioni sono stati analizzati con test EIA e i casi positivi sono stati\ua0 sottoposti a conferma con un test rapido immunocromatografico e/o con Western Blot. Risultati:Lo studio di validazione ha evidenziato una completa concordanza tra i campioni di fluido orale e i rispettivi sieri, eccetto che per 4 campioni provenienti da pazienti sieropositivi. Il test EIA Genscreen eseguito su campioni di fluido orale, ha pertanto dimostrato una sensibilit\ue0 del 98.5% e una specificit\ue0 del 100% rispetto al siero.Il valore di cut-off calcolato sui controlli del fluido orale\ua0 \ue8 risultato coincidente col cut-off dei sieri di controllo (media\ub15DS; 0.2).Ai fini della valutazione statistica di prevalenza della survey, 2535 sono stati i campioni di fluido orale considerati validi. La stima complessiva dell\u2019infezione da HIV tra gli MSM \ue8 stata di 196/2535 (7.7%). In particolare i paesi del Sud Europa hanno mostrato una differenza staticamente significativa nella prevalenza dell\u2019 infezione da HIV rispetto ai paesi dell\u2019Est\ua0 Europa (12.3% vs 4.4%; p<0.001).Conclusioni:I nostri dati dimostrano che EIA Genscreen condotto sul fluido orale \ue8 un test idoneo per la sorveglianza epidemiologica dell\u2019infezione da HIV.L\u2019alta prevalenza di infezione da HIV riscontrata tra gli MSM indica la necessit\ue0 di un potenziamento delle misure preventive e di controllo dell\u2019epidemia.Background:MSM account for nearly 40% of all newly diagnosed HIV infections reported in EU in 2008. Since MSM continue to bear a high burden of HIV infection, surveillance data on HIV prevalence among this high risk population are essential for the development and evaluation of HIV control initiatives. The use of oral fluid (OF) has been suggested as an attractive alternative strategy to HIV blood testing for field collection in outreach settings.Objective:This study, involving the participation of seven European countries, was designed primarily to validate a third generation EIA on OF samples from subjects with known HIV serological status and secondly to conduct a European survey for HIV prevalence estimation among MSM from Southern and Eastern countries by means of non-invasive OF sample collection.Methods:On validation study, matched serum and OF samples were collected from both HIV seropositive patients (n=263) and healthy controls (n=235). All samples were analyzed by using Genscreen HIV-1/2 version 2 (BIO-RAD), and procedure was adapted for OF testing by cut-off calculation. A cross sectional-survey was carried out between April 2008 and September 2009, among 2688 MSM accepting to provide OF specimens for HIV antibody testing. A\ua0 total IgG quantification test was also performed to ensure that the OF found negative after testing was taken properly.All OF samples were examined using EIA testing and those recording positive EIA results were analyzed for confirmation by a rapid immunocromatographic assay and/or Western Blot.\ua0Results: On validation study, all OF sample from HIV positive patients except for 4 samples were positively concordant with serum, whereas a total concordance was found among negative volunteers. This resulted in a sensitivity of 98.5% and a specificity of 100%, when EIA Genscreen was performed on OF samples. We found that cut-off values based on the control sera were also suitable for OF testing (mean\ub15SD; 0.2).\ua0In the multicenter survey, 2535 OF specimens were considered valid for the data analysis. Overall prevalence of antibody to HIV among MSM was 196/2535 (7.7%). A statistically significant difference in HIV prevalence was found between Southern and Eastern European countries (12.3% vs 4.4%; p<0.001).Conclusion: This data indicates that oral fluid based testing is a reliable tool for epidemiological surveillance of HIV infection. High HIV prevalence found among MSM suggests the need for implementation in prevention strategies to control epidemic

The SIALON Project: Report on HIV Prevalence and Risk Behaviour Among MSM in Six European Cities

Data from 23 European countries show that the annual number of HIV diagnoses in men who have sex with men (MSM) increased by 86% between 2000 and 2006. This paper reports the main preliminary results of a bio-behavioural survey in MSM with a specific focus on HIV prevalence and use of United Nations General Assembly Special Session (UNGASS) indicators in six cities in Southern and Eastern Europe. Time-location sampling (TLS) was used. A total number of 2,356 questionnaires and 2,241 oral fluid samples were collected (invalid samples 4.1%). The data show different socio-demographic patterns across countries regarding age, level of education, living conditions, living area and self-identity. Southern European cities had the highest percentage of people who had tested for HIV and collected the result. More than 50% of respondents in the sample from Barcelona reported having used a condom last time they had anal sex (57.2%), whilst in all other cities this proportion was below 50%. The cities with the highest HIV prevalence in MSM were Barcelona (17.0%) and Verona (11.8%) whilst lower percentages were reported in Bratislava (6.1%), Bucharest (4.6%), Ljubljana (5.1%) and Prague (2.6%). The low prevalence in Eastern European cities is encouraging. However, with the level of high-risk sexual behaviour documented and the lower frequency of HIV test seeking behaviour, there is a clear risk of an increase in HIV transmission

Evaluation of allograft contamination and decontamination at the Treviso Tissue Bank Foundation: A retrospective study of 11,129 tissues.

Microbiological contamination of retrieved tissues has become a very important topic and a critical aspect in the safety of allografts. We have analysed contamination in 11,129 tissues with a longitudinal contamination profile for each individual tissue. More specifically, 10,035 musculoskeletal tissues and 1,094 cardiovascular tissues were retrieved from a total of 763 multi-tissue donors, of whom 105 were heart-beating donors as well as organ donors, while the remaining 658 were non-heart beating donors and tissue donors only. All tissues were decontaminated twice, the first time immediately after retrieval and the second time after processing. Each tissue was submitted to microbiological culture three times, i.e., upon retrieval (Time 1), after the first decontamination (Time 2) and after the second decontamination (Time 3). The contamination rate for musculoskeletal tissues was 52%, 16.2% and 0.5% at Time 1, 2 and 3, respectively. The contamination rate for cardiovascular tissues was 84%, 42% and 6%. More than one strain was simultaneously present in 10.8% of musculoskeletal tissues and 44.6% of cardiovascular tissues. Out of 8,560 non-heart-beating donor musculoskeletal tissues, 4,689 (54.8%), 1,383 (16.2%) and 42 (0.5%) were contaminated at Time 1, Time 2 and Time 3, respectively. Out of 1,475 heart-beating donor musculoskeletal tissues, 522 (35.4%) 113 (7.7%) and 2 (0.1%) tissues were found to be contaminated at Time 1, 2 and 3, respectively. Out of 984 non-heart beating donor cardiovascular tissues, 869 (88.3%), 449 (45.6%) and 69 (7%) proved positive at Time 1, 2 and 3 respectively, while 50 (45.5%) and 10 (9.1%) heart-beating donor cardiovascular tissues were contaminated at Time 1 and 2. No tissue was contaminated at Time 3. Based on our methods, the two-step decontamination approach is mandatory in order to drastically reduce the number of tissues found to be positive at the end of the process

A 5-year survey of antimicrobial susceptibility profiles of methicillin-resistant staphylococcus aureus (MRSA) isolated from patients with bloodstream infections in Northeast Italy

A 5-year survey (2009-2013) of antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) isolated from patients with bloodstream infections was carried out in Northeast Italy. No upward creep of glycopeptides MICs was documented among 582 nonduplicate MRSA blood isolates, which were tested in accordance with broth microdilution and interpreted in accordance with EUCAST recommendations. Teicoplanin showed stably a lower MIC50 in comparison with vancomycin (0.25-0.5 versus 1 mg/L). The activities of newer anti-MRSA antibacterials stratified by glycopeptides MICs showed similar trends in MICs of either vancomycin or teicoplanin with those of daptomycin, linezolid, and tigecycline. We hypothesize that in centers with different distribution of glycopeptides MICs, downward for teicoplanin and upward for vancomycin, teicoplanin could be a more effective alternative to vancomycin for empirical treatment of MRSA-related bacteremia

Number and percentage of bacterial isolates per tissue in MST of HB and NHBD at Times 1, 2 and 3.

<p>Number and percentage of bacterial isolates per tissue in MST of HB and NHBD at Times 1, 2 and 3.</p

N° of tissues contaminated and contamination rate in MST of HBD and NHBD at Times 1, 2 and 3.

<p>N° of tissues contaminated and contamination rate in MST of HBD and NHBD at Times 1, 2 and 3.</p

Percentage of contamination and bacteria found at Times 1, 2 and 3 in MST.

<p>Percentage of contamination and bacteria found at Times 1, 2 and 3 in MST.</p

Number and percentage of bacterial isolates per tissue in CVT of HBD and NHBD at Times 1, 2 and 3.

<p>Number and percentage of bacterial isolates per tissue in CVT of HBD and NHBD at Times 1, 2 and 3.</p

Percentage of contamination and bacteria found at Times 1, 2 and 3 in CVT.

<p>Percentage of contamination and bacteria found at Times 1, 2 and 3 in CVT.</p

Number of bacterial isolates/number of tissues in CVT of HBD and NHBD at Times 1, 2 and 3.

<p>Number of bacterial isolates/number of tissues in CVT of HBD and NHBD at Times 1, 2 and 3.</p