Risk Assessment of Legionellosis in Cardiology Units.

Infective Endocarditis (IE) is a disease with high morbidity and mortality. Nowadays, in addition to classic pathogens were isolated exigent Gram negative bacteria as A. baumannii, A. lwoffii, C. burnetii, Bartonella, Chlamydia and Legionella. We present our experience of Legionella isolations in environmental sample (water and air) collected from the Cardiology units belonging a two hospitals in Messina (Italy). Sample size  has been established in function of hospital beds. A total of 80 samples were carried out. 30 and 50, respectively in the first and in the second structure: 55 of water and 25 of aerosol.The positivity of 30% of the water samples analyzed  and 15% of those aerosol strengthens the conviction of the need for greater environmental monitoring, especially in the wards at high risk.

Cardiology Rehabilitation wards: Isolation of Staphylococcus capitis. A risk of infection to be kept under control

Odděleni kardiovaskularni rehabilitace se specializuji na rehabilitaci nemocných po kardiochirurgickem výkonu nebo po akutnim infarktu myokardu. Nemocnicni infekce jsou velmi castou a zavažnou komplikaci provaděne lecby. V poslednich dvou desetiletich se nicmeně ukazalo, že hlavni přicinou připadů infekce a sepse na jednotkach kardiologicke pece jsou koagulaza-negativni stafylokoky (CoNS), mezi nimiž významne misto zaujima bakterie Staphylococcus capitis. Popisujeme nase zkusenosti z izolaty S. capitis od pacienta, který byl hospitalizovan s kardiovaskularnim onemocněnim a s bercovými vředy. © 2019, CKS

Legionella risk assessment in cruise ships and ferries.

Introduction The increasing development of marine traffic has led to a rise in the incidence of legionellosis among travellers. It occurs in similar environments, especially closed and crowded, and aboard ships Legionella survives and multiplies easily in water pipes, spreading into the environment through air conditioning systems and water distribution points. Although in recent years in the construction of cruise ships preventive measures aimed at curbing the proliferation of Legionella (design, materials, focus on the operation and maintenance of the water system), have been taken account, little or no attention has been paid to small ships which, in many cases, are old and not well maintained. Objective The aim of the study was to evaluate the frequency and severity of Legionella contamination in ferries and cruise ships in order to adopt more specific control measures. Material and Methods A prevalence study was carried out on 10 ferries and 6 cruise ships docking or in transit across the port of Messina (Sicily, Italy). Water and air samples collected from many critical points were tested for qualitative and quantitative identification of Legionella. Results and conclusions Legionella pneumophila sg 1 was isolated from the samples of shower and tap water in 7 (70%) of the 10 ferries examined, and in 3 (33%) of the 6 cruise ships examined, and L. pneumophila sg 2–14 in 8 (80%) and 1 (16.7%) of these ships, respectively. No Legionella contamination was found in whirlpool baths, air and ice samples. In conclusion, the data obtained confirm higher levels of Legionella contamination in local ferries and cruise ships, underlining the need to adopt corrective actions more specific for these smaller vessels

Health education intervention to improve vaccination knowledge and attitudes in a cohort of Obstetrics students.

Introduction. To improve the vaccination coverage in pregnant women it is important to increase their knowledge of vaccines and related preventable diseases. Midwifes can play an important role because they are often the first contact for woman during her pregnancy. This study aimed to explore the vaccination knowledge and attitudes in a cohort of Obstetrics students in Italy and improve their knowledge through an informative health education intervention. Methods. The study consisted in the administration of a first questionnaire followed by a health education intervention concerning all aspects of vaccinations. Then, a second questionnaire to evaluate the efficacy of the educational program was administered. Results. From the pre-intervention questionnaire resulted that almost the whole sample (97.1%) were favorable to vaccines in general. Moreover, 65.7% of the participants declared a sufficient level of vaccination knowledge but 62.9% found herself unprepared to answer questions and provide information about vaccinations. Concerning the answers about vaccination in pregnancy, the correct answers went from 17.1%, to 68.6% respectively before and after educational intervention. The training intervention obtained a total consensus (100%). The most part of the students (85.7%) declared that the received information changed some of their beliefs and the entire sample (100%) stated that it improved their preparation. Conclusions. Our results revealed some critical issues in the preparation of midwifes about vaccinations and confirm the necessity to carry out health intervention campaigns to these health professionals that, for the role they play, they must necessarily be well prepared

CAMPYLOBACTER: FROM MICROBIOLOGY TO PREVENTION

In last years, Campylobacter spp has become one of the most important foodborne pathogens even in high-income countries. Particularly, in Europe, Campylobacteriosis is, since 2005, the foodborne disease most frequently notified and the second in USA, preceded by the infection due to Salmonella spp. Campylobacter spp is a commensal microorganism of the gastrointestinal tract of many wild animals (birds such as ducks and gulls), farm animals (cattle and pigs) and companion animals (such as dogs and cats) and it is responsible for zoonoses. The transmission occurs via the fecal-oral route through ingestion of contaminated food and water. The disease varied from a watery diarrhea to a severe inflammatory diarrhea with abdominal pain and fever and can be burdened by some complications. The main recognized sequelae are Guillain-Barré Syndrome (GBS), the Reactive Arthritis (REA) and irritable bowel syndrome (IBS). Recently, many cases of Campylobacter spp isolated from human infections, showed an important resistance to various antibiotics such as tetracyclines and fluoroquinolones. For these reasons, the prevention of this infection plays an essential role. Many preventive measures exist to limit the transmission of the pathogens and the subsequent disease such as the health surveillance, the vaccination of the poultry and the correct food hygiene throughout the entire production chain. A global surveillance of Campylobacteriosis is desirable and should include data from all countries, including notifications of cases and the microbiological data typing of strains isolated from both human and animal cases

Epidemiological HIV infection surveillance among subjects with risk behaviours in the city of Messina (Sicily) from 1992 to 2015.

Introduction. Epidemiological studies are a key element to know the evolution and spread of HIV infection among the world population. The knowledge of the epidemiological dynamics improves the strategies of prevention and monitoring.Methods. We examined 2,272 subjects who voluntarily underwent to HIV testing from January 1992 to December 2015. For each subject, an anonymous form was filled to get information on personal data, sexual habits and exposure to risk factors.Results. The number of subjects who underwent to the screening test has increased over the years and the average age of the tested subjects has decreased over time. The main motivation to undergo HIV testing was unprotected sex. Even if the heterosexual subjects who carried out the test were more numerous of homosexuals, it is highlighted, during the years, an increase in the latter.Conclusions. Although the number of performed tests has increased over the years, the persistence of unprotected sex shows an inadequate perception of risk. Therefore, it is necessary to implement programs to increase the general awareness of HIV infection. It is also essential to constantly monitor behaviour, risk perception and the application of the screening test via surveillance systems in order to implement effective and efficient prevention

legionella spp amoebae and not fermenting gram negative bacteria in an italian university hospital water system

Introduction. In hospital and other health care facilities, contamination of water systems by potentially infectious microorganisms, such as bacteria, viruses and protozoa, is a source of nosocomial infections, which may originate from colonization of water pipes, cooling towers, spa pools, taps, showers and water supplies. Objective. The study focuses on the occurrence of Legionella spp., free-living amoebae and non-fermenting Gram-negative microorganisms in a University hospital water system located in the town of Messina (Sicily, Italy), which had never been examined previously. Materials and Methods. From January 2008 – March 2009, hot tap water samples were collected from 10 wards. Legionella spp. recovered on selective culture medium were identified by microagglutination latex test; free-living amoebae were cultured using Escherichia coli as a food source. Non-fermenting Gram negative microorganisms were identified by API 20 NE strips. Results. Legionella spp. were found in 33.33% of the samples. L. pneumophila serogroup 1 was recovered from the Laboratory Diagnostic and Anaesthesia-Neurology Wards, with a peak of 3.5 × 10 4 cfu/L in May 2008. L. pneumophila serogroups 2–14 were found in the Othorhinolaryngology, Pathologic Anatomy, Paediatrics and Surgery Wards, and peaked (4 × 10 4 cfu/L) in April 2008. Pseudomonadaceae and Hyphomycetes were also detected. Legionella spp. were recovered from samples positive for non-pathogenic amoebae Hartmannella spp. Conclusion. This first study of a Messina hospital water system suggested potential health risks related to the detection of Hartmannella spp., as reservoirs for Legionella spp., and Pseudomonas aeruginosa, a Gram negative non-fermenting bacterium frequently causing nosocomial pneumonia. The urgent need for monitoring programmes and prevention measures to ensure hospital water safety is stressed

A novel promising laccase from the psychrotolerant and halotolerant Antarctic marine Halomonas sp. M68 strain

Microbial communities inhabiting the Antarctic Ocean show psychrophilic and halophilic adaptations conferring interesting properties to the enzymes they produce, which could be exploited in biotechnology and bioremediation processes. Use of cold- and salt-tolerant enzymes allows to limit costs, reduce contaminations, and minimize pretreatment steps. Here, we report on the screening of 186 morphologically diverse microorganisms isolated from marine biofilms and water samples collected in Terra Nova Bay (Ross Sea, Antarctica) for the identification of new laccase activities. After primary screening, 13.4 and 10.8% of the isolates were identified for the ability to oxidize 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and the dye azure B, respectively. Amongst them, the marine Halomonas sp. strain M68 showed the highest activity. Production of its laccase-like activity increased six-fold when copper was added to culture medium. Enzymatic activity-guided separation coupled with mass spectrometry identified this intracellular laccase-like protein (named Ant laccase) as belonging to the copper resistance system multicopper oxidase family. Ant laccase oxidized ABTS and 2,6-dimethoxy phenol, working better at acidic pHs The enzyme showed a good thermostability, with optimal temperature in the 40–50°C range and maintaining more than 40% of its maximal activity even at 10°C. Furthermore, Ant laccase was salt- and organic solvent-tolerant, paving the way for its use in harsh conditions. To our knowledge, this is the first report concerning the characterization of a thermo- and halo-tolerant laccase isolated from a marine Antarctic bacterium

Geostatistics – a tool applied to the distribution of Legionella pneumophila in a hospital water system

[b]Introduction.[/b] Legionnaires' disease is normally acquired by inhalation of legionellae from a contaminated environmental source. Water systems of large buildings, such as hospitals, are often contaminated with legionellae and therefore represent a potential risk for the hospital population. The aim of this study was to evaluate the potential contamination of [i]Legionella pneumophila[/i] (LP) in a large hospital in Italy through georeferential statistical analysis to assess the possible sources of dispersion and, consequently, the risk of exposure for both health care staff and patients. [b]Materials and Method. [/b]LP serogroups 1 and 2–14 distribution was considered in the wards housed on two consecutive floors of the hospital building. On the basis of information provided by 53 bacteriological analysis, a 'random' grid of points was chosen and spatial geostatistics or [i]FAIk Kriging[/i] was applied and compared with the results of classical statistical analysis. [b]Results[/b]. Over 50% of the examined samples were positive for [i]Legionella pneumophila[/i]. LP 1 was isolated in 69% of samples from the ground floor and in 60% of sample from the first floor; LP 2–14 in 36% of sample from the ground floor and 24% from the first. The iso-estimation maps show clearly the most contaminated pipe and the difference in the diffusion of the different [i]L. pneumophila[/i] serogroups. [b]Conclusion.[/b] Experimental work has demonstrated that geostatistical methods applied to the microbiological analysis of water matrices allows a better modeling of the phenomenon under study, a greater potential for risk management and a greater choice of methods of prevention and environmental recovery to be put in place with respect to the classical statistical analysis

Evaluation of Legionella Air Contamination in Healthcare Facilities by Different Sampling Methods: An Italian Multicenter Study

Healthcare facilities (HF) represent an at-risk environment for legionellosis transmission occurring after inhalation of contaminated aerosols. In general, the control of water is preferred to that of air because, to date, there are no standardized sampling protocols. Legionella air contamination was investigated in the bathrooms of 11 HF by active sampling (Surface Air System and Coriolis®μ) and passive sampling using settling plates. During the 8-hour sampling, hot tap water was sampled three times. All air samples were evaluated using culture-based methods, whereas liquid samples collected using the Coriolis®μ were also analyzed by real-time PCR. Legionella presence in the air and water was then compared by sequence-based typing (SBT) methods. Air contamination was found in four HF (36.4%) by at least one of the culturable methods. The culturable investigation by Coriolis®μ did not yield Legionella in any enrolled HF. However, molecular investigation using Coriolis®μ resulted in eight HF testing positive for Legionella in the air. Comparison of Legionella air and water contamination indicated that Legionella water concentration could be predictive of its presence in the air. Furthermore, a molecular study of 12 L. pneumophila strains confirmed a match between the Legionella strains from air and water samples by SBT for three out of four HF that tested positive for Legionella by at least one of the culturable methods. Overall, our study shows that Legionella air detection cannot replace water sampling because the absence of microorganisms from the air does not necessarily represent their absence from water; nevertheless, air sampling may provide useful information for risk assessment. The liquid impingement technique appears to have the greatest capacity for collecting airborne Legionella if combined with molecular investigation