Peracetic Acid (PAA) Disinfection: Inactivation of Microbial Indicators and Pathogenic Bacteria in a Municipal Wastewater Plant.

Several studies have noted that treated and untreated wastewaters are primary contributors of a variety of pathogenic microorganisms to the aquatic ecosystem. Conventional wastewater treatment may not be sufficient to achieve microbiologically safe effluent to be discharged into natural waters or reused, thus requiring wastewater effluents to be disinfected. In recent years, peracetic acid (PAA) has been adopted as a disinfectant for wastewater effluents. The aim of this study was to evaluate the disinfection efficiency of PAA at low doses (range 0.99–2.10 mg/L) against microbial indicators and pathogenic bacteria in a municipal wastewater plant. Samples of untreated sewage and effluents before and after PAA treatment were collected seasonally for 1 year and were analysed for pathogenic Campylobacter, Salmonella spp., E. coli O157:H7 and E. coli virulence genes using molecular methods; moreover, the detection of specific microbial indicators (E. coli, faecal coliforms, enterococci, C. perfringens) and Salmonella spp. were carried out using culturing methods. Salmonella spp. DNA was found in all untreated sewage and effluent before PAA treatment, whereas it was recovered in 50% of the samples collected after PAA treatment. Although E. coli O157:H7 was never identified, the occurrence of Shiga-like toxin I amplicons was identified in 75% of the untreated sewage samples, in 50% of the effluents assayed before PAA treatment, and in 25% of the effluents assayed after PAA treatment, whereas the stx2 gene was never found. Campylobacter coli was only detected in one effluent sample before PAA treatment. In the effluents after PAA treatment, a lower load of indicator bacteria was observed compared to the effluents before treatment. The results of this study highlight that the use of low doses of PAA seems to lead to an improvement of the microbiological quality of the effluent, although it is not sufficient to guarantee its suitability for irrigation. These results underscore the need for additional studies to further assess the efficiency of PAA disinfection in municipal wastewater plants

A pilot study employing hepatic intra-arterial irinotecan injection of drug-eluting beads as salvage therapy in liver metastatic colorectal cancer patients without extrahepatic involvement: The first southern Italy experience

Background: The main aim of this prospective study was to evaluate the efficacy of drug-eluting beads with irinotecan (DEBIRI) for liver metastases from colorectal cancer. Secondary aims were to evaluate survival and toxicity. Methods: Twenty-five patients with metastases in <50% of the liver and without extrahepatic involvement were enrolled. Treatment response assessment was performed by multidetector contrast enhancement computed tomography (MDCT) with evaluation of the enhancement pattern of the target lesion and tumor response rates according to modified Response Evaluation Criteria in Solid Tumors (mRECIST, Version 1.1). All adverse events were recorded by the Cancer Therapy Evaluation Program Common Terminology Criteria for Adverse Events, Version 3.0. Associations of tumor response and variables were calculated using the chi-squared test. Overall survival (OS) was calculated using the Kaplan–Meier method. Comparisons were made using the log-rank test. Results: According to mRECIST, complete response (CR) was observed in 21.8% of patients, partial response (PR) in 13%, stable disease (SD) in 52.2% and progressive disease (PD) in 13% of patients. Response rate (RR = CR + PR) was 34.8%. No associations between treatment response and variables such as Dukes’ classification, grading and Kras status were found (P>0.05). The median OS was 37 months (95% CI: 13.881 to 60.119). Cox regression model showed that neither site, Dukes’ classification, grading, Kras status nor number of chemotherapy treatments pre-DEBIRI influenced the OS. The log-rank test showed no statistically significant difference in OS among patients who underwent 1, 2 or 3 DEBIRI treatments (χ2=2.831, P=0.09). In our study, the main toxicities included postembolization syndrome (PES), hypertransaminasemia and fever. Conclusion: The favorable tumor response and the favorable toxicity profile make DEBIRI treatment a potential third-line therapy. Although further larger studies are needed to confirm these data, we can state that DEBIRI is an attractive emerging treatment in these patients