Etiology and antibiotic susceptibility patterns of bacteria collected from urinary tract infections in the ASL3 in Genoa

An epidemiological study addressed to identify the pathogens collected from urine samples and their antibiotic susceptibility patterns was conducted. From January 2008 to May 2009 56,435 urine samples were processed in the Clinical Microbiological Laboratory of the ASL3 in Genoa. Materials and methods. Urine samples were firstly screened by automated equipment Uroquik (ALIFAX).All urine cultures with microbial ≥105 CFU / ml were seeded on Chromagar Orientation (BD) and incubated at 37 ° C °.The identification of the isolates and the evaluation of their susceptibility to antibiotics were determined by the automated system Vitek 2 (bioMérieux). Results. About 33% (18,543) of the urine samples gave positive results.The number and frequency of the microorganisms collected was: 13,379 (72%) Gram-negative including 9179 (69%) E.coli, 1382 (10%) Klebsiella spp, 1209 (9%) Proteus spp, 445 (3%) Pseudomonas spp, and other species 1164 (9%), 4942 (27%) Gram positive which included 3615 (73%) Enterococcus spp, 821 (17%) Staphylococcus spp, 506 (10% ) Streptococcus spp and 222 (1%) fungi. In E. coli the incidence of susceptible strains ranged between 90-96% for gentamicin, fosfomycin, nitrofurantoin, piperacillin-tazobactam, between 87-89% for the cefepime, cefotaxime, ceftazidime, about 70% for quinolones ciprofloxacin, norfloxacin, and trimethoprim-sulfamethoxazole, 62% for piperacillin, about 50% to ampicillin. For Klebsiella spp and Proteus spp the percentage of susceptible strains ranged from 95-99% to piperacillin-tazobactam, gentamicin, and respectively 93% and between 68-52% for third-generation cephalosporins cefotaxime and ceftazidime and fluoroquinolones ciprofloxacin and norfloxacin. Conclusions. Present findings indicate that among the Enterobacteriaceae, E. coli, cause most of UTI and in vitro resulted susceptible various antibiotics.There was an increased resistance to fluoroquinolones among community-acquired E. coli and Proteus spp.A periodical epidemiological study will be necessary to monitor the evolution toward resistance to antibiotics of the strains collected from urinary tract infections

Incidence of Acinetobacter baumannii and other pathogens isolated from Intensive Care Unit of the Hospital San Carlo, Genoa - Voltri

Acinetobacter baumannii is an emerging pathogen of great impact especially in nosocomial settings due to its complex epidemiology that makes its control very difficult. In this study the strains isolated from the Intensive Care Unite were analysed. Materials and methods. All the patients admitted into intensive care of San Carlo Hospital,Voltri, Genoa, Italy (ASL 3) in the period from May to December 2009 were considered.A total of 63 patients were studied including 31 women and 32 men, with an average of 73 years old.The study considered the following biological samples (N): bronchial aspirate and sputum (84), urine (55), blood (28), and other materials (36).The positive samples were processed for strain identification and evaluations of its antibiotic susceptibility pattern by standard VITEK2 system, following the Clinical and Laboratory Standard Institute Guidelines. Results and Conclusions. From samples taken into account, the prevalent percentage of bacterial species collected was registered by Gram negative (46.3%), followed by Gram positive (36.4%), and fungi (17.3%). Considering Gram negative isolates A. baumannii and Escherichia coli resulted among the prevalent pathogens (23.4 and 24.5% respectively). This microorganism was collected especially from bronchial aspirate (13) followed by urines (4), blood cultures (2) and other materials (3). On the basis of the analysis of the antibiotic susceptibility tests, colistin was active on the totality (100%) of A. baumannii, followed by tigecycline (96.77%).Amikacin resulted also active against a large proportion of these isolates (93.3%). Present findings confirm the great multidrug resistance phenotype of A. baumanii against the main classes of antimicrobial agents and its dangerous diffusion in the Intensive Care Units. For these reasons a continuous surveillance of the evolution of this pathogen toward antibiotic resistance is requested. In this contest it will be important an evaluation of antibiotic susceptibility following the guidelines suggested by EUCAST (European Committee on Antimicrobial Susceptibility Testing)

Raccomandazioni cliniche in odontostomatologia

L’Organizzazione Mondiale della Sanità considera la salute orale come parte integrante, non solo dello stato di salute generale, ma anche della qualità della vita di ciascun individuo. In tale ottica, in accordo e con il sostegno del mondo professionale e della comunità scientifica di questo settore, le raccomandazioni cliniche in odontostomatologia contenute nel presente volume forniscono indicazioni e definiscono standard di intervento per la prevenzione e la cura delle più comuni patologie del cavo orale nonché per l’identificazione di percorsi terapeutici appropriati a supporto degli operatori pubblici e privati. Esse costituiscono, inoltre, uno strumento utile per mantenere alto il livello di qualità delle cure in questo periodo storico, nel quale, se da un lato crescono le opportunità tecniche di cura e la potenziale domanda delle stesse, dall’altro la riduzione delle risorse economiche a disposizione dei cittadini tende a limitare l’accesso all’offerta professionale privata e, al contempo, i processi di razionalizzazione dell’allocazione dei fondi nel SSN rendono più difficile l’accesso alle strutture pubbliche. L’individuazione di raccomandazioni cliniche chiaramente definite e rese pubbliche può facilitare la condivisione degli obiettivi e dei percorsi terapeutici tra odontoiatra e paziente, migliorare la comunicazione e, in ultima analisi, accrescere la fiducia sia nei riguardi del proprio specifico professionista che del “sistema delle cure” più in generale. La revisione delle “Raccomandazioni cliniche in odontostomatologia” si è resa necessaria in considerazione del cambiamento dell’evidenza scientifica, dell’immissione in commercio di nuovi materiali e dell’utilizzo di nuove tecnologie, specie in ambito protesico. Come per la precedente, alla realizzazione di questa edizione ha contribuito un ampio gruppo di docenti ed esperti delle singole branche odontoiatriche insieme alle più importanti e rappresentative Associazioni professionali e ai componenti della Commissione Albo Odontoiatri (CAO) nazionale