Use of WHONET-SaTScan system for simulated real-time detection of antimicrobial resistance clusters in a hospital in Italy, 2012 to 2014.

Resistant pathogens infections cause in healthcare settings, higher patient mortality, longer hospitalisation times and higher costs for treatments. Strengthening and coordinating local, national and international surveillance systems is the cornerstone for the control of antimicrobial resistance (AMR). In this study, the WHONET-SaTScan software was applied in a hospital in Italy to identify potential outbreaks of AMR. Data from San Filippo Neri Hospital in Rome between 2012 and 2014 were extracted from the national surveillance system for antimicrobial resistance (AR-ISS) and analysed using the simulated prospective analysis for real-time cluster detection included in the WHONET-SaTScan software. Results were compared with the hospital infection prevention and control system. The WHONET-SaTScan identified 71 statistically significant clusters, some involving pathogens carrying multiple resistance phenotypes. Of these 71, three were also detected by the hospital system, while a further 15, detected by WHONET-SaTScan only, were considered of relevant importance and worth further investigation by the hospital infection control team. In this study, the WHONET-SaTScan system was applied for the first time to the surveillance of AMR in Italy as a tool to strengthen this surveillance to allow more timely intervention strategies both at local and national level, using data regularly collected by the Italian national surveillance system

Infant immunization coverage in Italy (2000-2016)

BackgroundIn Italy, national-level immunization polices are included in the National Immunization Prevention Plan (PNPV), whose latest edition - 2017-2019 PNPV- was approved in February 2017. Immunization coverage is a key measure of immunization system performance; it can inform and support national and regional immunization polices’ implementation monitoring, as well as measure the impact of interventions aimed at increase vaccine uptake. MethodsWe collected, analysed and critically interpreted 2000-2015 Italian national infant immunization coverage trends, by different vaccine, target population, and by Region. Data were provided by the Directorate General for Prevention of the Italian Ministry of Health.ResultsIn 2015, none of mandatory or recommended vaccines reached the 95% national coverage target set in the PNPV. Weighted average national coverage for mandatory vaccines (against polio, tetanus, diphtheria, hepatitis B) and other antigens included in the hexavalent vaccine (pertussis, and Haemophilus influenzae type b) in 2015 was 93.3%; it was lower for measles, mumps and rubella vaccines (85.2%), pneumococcal (88.7%) and meningococcal C conjugate vaccines (76.6%), with a high degree of heterogeneity by Region. Both hexavalent and MMR vaccines coverage rates have been decreasing since 2012, with an annual decrease of, respectively 1% and 1.5%.DiscussionFurther efforts are needed to increase vaccine uptake in Italy, to improve data collection and reporting, as well as to fight the growing phenomenon of the vaccine hesitancy so that PNPV objectives and target can be met in the near future.Ep

Emergence of fox rabies in north-eastern Italy.

Italy has been classified as rabies-free since 1997. In October 2008, two foxes have been diagnosed with rabies in the Province of Udine, north-east Italy. One case of human exposure caused by a bite from one of the foxes has occurred and was properly treated

Twelve years of activity of the International Trichinella Reference Centre.

The ITRC is the official reference laboratory of both the International Commission on Trichinellosis (since 1988) and the International Office of Epizootics (since 1992). The ITRC was created as a repository for Trichinella strains and as a source of materials and information for international research in 1988. To date, about 900 isolates of human and animal origin from throughout the world have been examined and identified by new procedures developed at the ITRC or in collaboration with other institutions. Using material from this collection, the ITRC has provided a complete revision of the systematics of the genus Trichinella. The ITRC database can be consulted by accessing the web-site: www.simi.iss.it/trichinella/index.htm

Surveillance of invasive diseases caused by Streptococcus pneumoniae in Italy: evolution of serotypes and antibiotic resistance in different age groups before and after implementation of PCV7

Background: PCV7 has been available in Italy since 2001, however only in 2005 national recommendations were issued and vaccination was implemented with different modalities by the Regions. Objectives: Aim of this study was to describe changes in serotype distribution and antibiotic susceptibility of S. pneumoniae from invasive pneumococcal diseases (IPD) in the last decade. Study Design: S. pneumoniae isolates from IPD, collected through a national surveillance system, were serotyped and antibiotic susceptibility was determined by E-test. Data were analyzed according to age groups (5 years, >5-64 years, 65 years) and to 3 time periods: prior, during and after PCV7 implementation (2001- 2003, 2006-2008 and 2009-2011). Results: The percentage of PCV7 serotypes (vaccine serotypes, VS) decreased over the years not only in children (from 60% to 26%) but also in the other age groups. Penicillin resistance was rather low in 2001-2003 (7-12%), but peaked in children in 2006-2008 (24%), and decreased in 2009-2011, while erythromycin resistance slightly decreased over the 3 periods. Conclusions: PCV7 use has largely impacted the epidemiology of S. pneumoniae in Italy, with a decrease in VS in all age groups.The impact of PCV 13, available in Italy since the end of 2010, requires future evaluations

The tattooed population in Italy: a national survey on demography, characteristics and perception of health risks

Background. In recent years, Italy has seen a constant upward trend in the practice of tattooing. The Italian National Health Institute has conducted a national survey to determine the prevalence of tattooed people in Italy and to study related features of the phenomenon. Aim. Establish the prevalence and characteristics of the tattooed population and evaluate awareness of the risks associated with tattoos, which can contribute to consumer health protection. Methods. Computer-assisted telephone interviews and computer-assisted web interviews were completed by a sample of the general population; 7608 people aged between 12 and 75+. Results. The prevalence of tattooed people was 12.8% of the general population in Italy (95% CI: 12.05%-13.55%), equivalent to an estimated 6 900 000 tattooed individuals. Tattoos were more prevalent among women, at 13.8%, while tattooed men accounted for 11.8%. The vast majority of tattooed subjects had decorative tattoos of small dimensions, with a higher prevalence of monochromatic tattoos. Only a minority of tattooed participants reported having cosmetic tattoos (3.0%) or medical tattoos (0.5%). According to the data, 3.3% of tattooed subjects claimed complications or reactions; of these, only 21.3% consulted a dermatologist/general practitioner; more than half (51.3%) did not consult anyone. In general, only 58.2% of the sample were aware of health risks. The Italian survey showed that 36.7% of all tattoos had been performed in the last five years prior to the interview. Conclusions. The estimated prevalence of tattoos in Italy is in agreement with the statistics of the European Union. The prevalence in the age group 35-44 years is almost double that of the Italian population and it is higher in women than in men. Tattooing is relevant to public health. The high number of tattooed Italians, the potential long-term effects on health and the reported complications call for the awareness of health authorities. Appropriate intervention should ensure safer tattooing by reinforcing the training of tattooists, by improving surveillance and by providing information to raise public awareness of the risks and contraindications of tattooing.

The Italian national survey on coronavirus disease 2019 epidemic spread in nursing homes

Introduction: Residents in facilities such as nursing homes (NHs) are particularly vulnerable to Coronavirus disease 2019 (COVID-19). A national survey was carried out to collect information on the spreading and impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in nursing homes, and on how suspected and/or confirmed cases were managed. We carried out a survey between 25 March 2020 and 5 May 2020. Materials and methods: All Italian nursing homes either public or providing services both privately and within the NHS were included in the study. An on-line questionnaire was sent to 3292 nursing homes across all Italian regions. Nursing homes were also contacted by telephone to provide assistance in completing the questionnaire. Results: A total of 1356 nursing homes voluntarily participated to the survey, hosting a total of 100,806 residents. Overall, 9154 residents died due to any cause from February 1 to the time when the questionnaire was completed (from March 25 to May 5). Of these, 7.4% had COVID-19 and 33.8% had flu-like symptoms, corresponding to a cumulative incidence of 0.7 and 3.1, respectively. Lack of personnel, difficulty in transferring patients to hospital or other facility, isolating residents with COVID-19, number of beds and geographical area were the main factor positively associated to the presence of COVID-19 in nursing homes. Discussion: This survey showed the dissemination and impact of SARS-CoV-2 infection in Italian nursing homes and on how older and potentially chronically ill people residing in these long-term care facilities were managed

Increased incidence of invasive meningococcal disease of serogroup C / clonal complex 11, Tuscany, Italy, 2015 to 2016

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Initial impact of SARS-Cov-2 vaccination on healthcare workers in Italy- Update on the 28th of March 2021

In Italy, the COVID-19 vaccination campaign started in December 2020 with the vaccination of healthcare workers (HCW). To analyse the real-life impact that vaccination is having on this population group, we measured the association between week of diagnosis and HCW status using log-binomial regression. By the week 22-28 March, we observed a 74% reduction (PPR 0.26; 95% CI 0.22-0.29) in the proportion of cases reported as HCW and 81% reduction in the proportion of symptomatic cases reported as HCW, compared with the week with the lowest proportion of cases among HCWs prior to the vaccination campaign (31 August-7 September). The reduction, both in relative and absolute terms, of COVID-19 cases in HCWs that started around 30 days after the start of the vaccination campaign suggest that COVID-19 vaccines are being effective in preventing infection in this group