Epidemiology of skin and soft tissue pathogens circulating in Liguria in 2011

This study was conduced during March-May 2011 with the collaboration of 4 clinical microbiology laboratories evenly distibuited across the Ligurian area to identify the most frequent pahogens isolates from skin and soft tissue infections and to evaluate their antibiotic susceptibility patterns. Overall, 213 consecutive, non duplicate strains were collected and sent to the coordinating laboratory.The most rappresented pathogens were: S. aureus (35.7%), P. aeruginosa (14%), E. coli (12.7%), Staphylococcus coaugulase negative (6.6%) and Enterococcus spp. (4.7%). The data indicate an increase of Gram negative compared to previous years, S. aureus remains the most common pathogen.The methicillin resistance in S. aureus was 43.4% and no one Enterococcus spp. resistant to vancomicin was found

Epidemiological study of pathogens isolated from blood in Liguria during 2011

Objectives. An epidemiological study addressed to identify the most represented pathogens isolated from blood and to evaluate their antibiotic susceptibility patterns, was conducted. Methods. Five clinical microbiology laboratories, homogenously distributed in Liguria, were required to collected all consecutive non-duplicates strains isolated from blood cultures during March 2011 to May 2011. the strains were sent to the reference laboratory (Section of Microbiology, DISC, University of Genoa, Italy). Results. A total of 159 microorganisms were enrolled, including 81 Gram positive, 69 Gram negative and 9 fungi.The most represented pathogens were: Escherichia coli (35), Staphylococcus aureus (26), S. epidermidis (20), S. hominis (10). Samples were collected mainly from medicine (59 isolates).Among the staphylococci, the most active molecules were: vancomycin (100% of susceptible strains), teicoplanin (93.4%), trimethoprim-sulfamethoxazole (83.8%) and tobramycin (61.6%). Enterococci showed rates of resistance to vancomycin of 25%. Enterobacteriaceae exhibited resistance to ampicillin (76.9%), ceftriaxone (44.4%), ciprofloxacin (43.3%), trimethoprim-sulfamethoxazole (36.6%) and ceftazidime (32.2%). Conclusions. The data show a higher incidence of Gram positive (51%) in comparison to Gram negative (43.4%). Gram-positive strains showed a high resistance level to fluoroquinolones (92.3%) while Gram-negative resulted resistant to ceftriaxone (44.4%) and fluoroquinolone (43.3%)

Epidemiological study of pathogens isolated from blood in Liguria (January-April 2010)

Objectives. An epidemiological study to identify the most represented pathogens isolated from blood and to evaluate their antibiotic susceptibility patterns, was conducted. Methods. Seven clinical microbiology laboratories, homogeneously distributed in the Ligurian area,were required to collected all consecutive non-duplicates strains isolated froom blood cultures during January 2010 to April 2010. The strains were sent to the reference laboratory (Sezione di Microbiologia del DISC, University of Genoa, Italy). Results. A total of 277 microorganisms were enrolled, including 155 Gram positive and 122 Gram negative.The most represented pathogens were: Escherichia coli (68), Staphylococcus aureus (57), Staphylococcus epidermidis (32), Staphylococcus hominis (17), Pseudomonas aeruginosa (15), Klebsiella pneumoniae (15), Enterococcus faecalis (11). Samples were collected mainly from medicine (66, 33.3%, of this number was determined by E. coli), intensive care units (33, 18.2% of this number consisted of S. epidermidis), surgery (24, 33.3% consisted of E. coli) and infectious diseases (20, of which S. aureus, E. coli and S. epidermidis equally represented 20.0%).Among the Staphylococci the most active molecules were: vancomycin and teicoplanin (100% of susceptible strains), chloramphenicol (92.3%) and trimethoprim-sulfamethoxazole (89.8%). Among the OXA-R Staphylococci (81/123, 65.9%) the most active molecules were: vancomycin and teicoplanin (100% of susceptible strains), chloramphenicol (93.8%) and trimethoprim-sulfamethoxazole (84.8%). Enterococci showed rates of resistance to vancomycin of 5.9%. Enterobacteriaceae exhibited resistance to ampicillin (77.5%), trimethoprim-sulfamethoxazole (42.6%), ciprofloxacin (41.2%), ceftriaxone (37.5%), ceftazidime (28.2%), cefepime (26.7%), cefoxitin (22.1%), piperacillintazobactam (20.4%), imipenem (4.7%) and amikacin (2.9%). The Gram negative non-Enterobacteriaceae showed rates of resistance of 100% to ceftriaxone, 81.3% to trimethoprim-sulfamethoxazole, 42.1% to ciprofloxacin and piperacillin-tazobactam, 33.3% to ceftazidime, 31.6% to cefepime, 27.8% to imipenem, 26.3 % to amikacin. Conclusions. The data show a higher incidence of Gram positive (56%) in comparison to Gram negative (44%).This confirms the high incidence of oxacillino-resistance in Staphylococci in our geographic area.Against Enterobacteriaceae rates of resistance were observed in excess of 20% for all drugs tested except imipenem (4.7%) and amikacin (2.9%). The proportion of imipenem-resistant isolates was constituted of strains of K. pneumoniae carbapenemase producers

The importance of active surveillance in the intensive care unit of Galliera Hospital in Genoa. Analysis of bacterial strains isolated in 2006-2007

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Epidemiological study of pathogens collected from blood for a period of a year (2008-2009)

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Erysipelothrix rhusiopathiae intra-abdominal abscess

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The importance of active surveillance in the intensive care unit of Galliera Hospital in Genoa. Analysis of bacterial strains isolated in 2006-2007

Introduction. The risk of infection is higher in intensive care units than in other hospital departments for a number of reasons: the often serious condition of the patients, the invasive diagnostic and therapeutic procedures performed, the indiscriminate use of broad-spectrum antibiotics and the administration of immunosuppressive drugs. Aims. The present study aimed, on the one hand, to assess the importance of surveillance in the intensive care unit as a means of evaluating healthcare and management procedures and detecting epidemics and “sentinel” microorganisms, and, on the other, to gather up-to-date information on resistance to antibiotics in order to guide proper empirical therapy. Materials and methods.We conducted a retrospective analysis of the microbiological examinations carried out in the period 2006-2007 in the intensive care unit of Galliera Hospital in Genoa. Microbiological surveillance reports and those with antibiograms were picked out.The microorganisms most frequently isolated in the total of samples were listed and then subdivided according to the sample type (respiratory or blood) from which they were isolated. The antibiotic resistance of these microorganisms was subsequently evaluated. Results. Data analysis revealed that S. aureus was the microorganism most frequently isolated in the total of samples (15.6%), followed by S. epidermidis (11.6%) and E. coli (11.1%).With regard to the respiratory samples, S. aureus again proved to be the most frequently isolated strain (18.7%), while S. epidermidis was isolated from a higher percentage of blood cultures (36.7%). Conclusions. The results obtained confirm the utility of infection surveillance procedures in departments at risk, such as intensive care units

Incidence and surveillance of infections from Clostridium difficile: the experience at the Galliera of Genoa in the three-year period 2004-2006

Introduction Clostridium difficile is a Gram-positive bacillus, anaerobic, sporogenous ,with oro-faecal transmission.The formation of the spores can persist in a long time, encouraging the transmission. Use of broad-spectrum antibiotics, age, alteration of intestinal flora are the most common risk factors that expose the subject to any subsequent colonization and infection. The hospital staff is the main vehicle of transmission and the probability of contracting an infection is proportional to the duration of hospitalization in patients infected with cohabitation. Objectives The infections surveillance of C. difficile is a instrument to monitor procedures for the control of hospital infections, and may be useful to highlight and point out shortcomings in the system. Materials and Methods The data are the results of tests for the detection of toxins on stools during the period 2004-2006, distributed quarterly to study the seasonal, divided by individual UO the hospital and later for area hospital. Results and conclusions The incidence of infection from C. difficile in the last three years has been in constant increase (from 7 to 12.5 case/1000 admissions). Much of increase is attributable to community infections 3 case/1000 admissions (2004) up to about 6 case/1000 admissions (2006). Substantially increasing content of hospital infections (5-6 case/1000 admissions)

<i>Stenotrophomonas maltophilia</i> Outbreak in an ICU: Investigation of Possible Routes of Transmission and Implementation of Infection Control Measures

Stenotrophomonas maltophilia, a non-fermentative, ubiquitous, gram-negative aerobic bacterium, is associated with high mortality rates, particularly in immunocompromised or debilitated patients. The prevalence rate of ICU-acquired pneumonia episodes caused by this microorganism has been found to be 2%. S. maltophilia has been identified as one of the top 10 microorganisms responsible for such infections in EU/EEA countries. This study describes an outbreak of S. maltophilia in an intensive care unit of a hospital in northern Italy. This includes an epidemiological investigation of the cases, the environmental microbiological controls carried out, a comparison of the strains by multilocus sequence typing (MLST), and the measures taken to prevent and control the outbreak. Among the seven clinical isolates of S. maltophilia analyzed herein, six demonstrated susceptibilities to trimethoprim–sulfamethoxazole. Conversely, one isolate of S. maltophilia exhibited resistance to first-line antibiotics. ST was found to be identical for six patients (ST 4), as well as in the environmental feedback on the trolley of Box 2. The analysis of the temporal and spatial progression of the outbreak has suggested that the transmission of S. maltophilia may have occurred through cross-transmission during care practices