Epidemiology of tuberculosis in a low-incidence Italian region with high immigration rates: differences between not Italy-born and Italy-born TB cases

<p>Abstract</p> <p>Background</p> <p>Emilia Romagna, a northern Italian region, has a population of 4.27 million, of which 9.7% are immigrants. The objective of this study was to investigate the epidemiology of tuberculosis (TB) during the period 1996-2006 in not Italy-born compared to Italy-born cases.</p> <p>Methods</p> <p>Data was obtained from the Regional TB surveillance system, from where personal data, clinical features and risk factors of all notified TB cases were extracted.</p> <p>Results</p> <p>5377 TB cases were reported. The proportion of immigrants with TB, over the total number of TB cases had progressively increased over the years, from 19.1% to 53.3%. In the not Italy-born population, TB incidence was higher than in Italians (in 2006: 100.7 cases per 100 000 registered not Italy-born subjects and 83.9/100 000 adding 20% of estimated irregular presences to the denominators. TB incidence among Italians was 6.5/100 000 Italians). A progressive rise in the not Italy-born incident cases was observed but associated with a decline in TB incidence. Not Italy-born cases were younger compared to the Italy-born cases, and more frequently classified as "new cases" (OR 2.0 95%CI 1.61-2.49 for age group 20-39); 60.7% had pulmonary TB, 31.6% extra pulmonary and 7.6% disseminated TB. Risk factors for TB in this population group were connected to lower income status (homeless: OR 149.9 95%CI 20.7-1083.3 for age group 40-59).</p> <p>Conclusions</p> <p>In low-incidence regions, prevention and control of TB among sub-groups at risk such as the foreign-born population is a matter of public health concern. In addition, increasing immigration rates may affect TB epidemiology. TB among immigrants is characterized by particular clinical features and risk factors, which should be analyzed in order to plan effective action.</p

Monitoraggio microbiologico ambientale nei musei: conservazione preventiva delle collezioni grafiche

Summary In museums, the biological component of indoor air, called bioaerosol or biological aerosol, is a potential biodeteriogen for graphic collections. The biological particles settling on the surface of artworks find favorable nutritional and environmental conditions for their growth, and promote biodeterioration. As is well known, biological attacks depend on microclimatic conditions; for this reason their control is essential to assess contamination and estimate biological risks. This article presents the partial application of a methodological model, in the National Institute of Graphic Arts (Istituto Nazionale per la Grafica-ING), a museum of international importance in Rome, on a collection of ancient drawings in the Fondo Corsini, preserved in repository no.1. This model is based on an integrated system of biological environmental monitoring (air and surfaces) in association with microclimatic monitoring (repository no.1, cabinet no.6, volumes, drawings and outdoor) carried out in an interdisciplinary research project.The values of thermohygrometric parameters were stable enough during the monitored month and had no daily fluctuations. The qualitative and quantitative analysis of air contamination and that on the surfaces of drawings did not show a critical situation.This article describes a pilot study which has focused attention on the biological contamination of the graphic collections and is a contribution to standardizing a system of diagnosis-intervention for preventive conservation of organic cultural heritage preserved in museums and in other indoor environments and the protection of the health of operators and visitors.Riassunto Nei musei la componente biologica dell’aria, chiamata bioaerosol o aerosol biologico, rappresenta un potenziale biodeteriogeno per le collezioni grafiche aventi come supporto la carta. Le particelle biologiche quando si depositano sulla superficie del manufatto e trovano condizioni nutrizionali ed ambientali favorevoli per la loro crescita causano il biodeterioramento. Come è noto gli attacchi biologici sono fortemente condizionati dalle condizioni microclimatiche, per questo il loro controllo è essenziale per la valutazione della contaminazione e la stima del rischio biologico. In questo articolo viene presentata l’applicazione parziale di un modello metodologico presso l’Istituto Nazionale per la Grafica (ING), un organismo museale di rilevanza internazionale con sede a Roma, su una raccolta di disegni antichi appartenenti al Fondo Corsini, conservato nel deposito di conservazione n°1. Tale modello è basato su un sistema integrato di monitoraggio microbiologico (aria e superfici) e monitoraggio microclimatico (interno ed esterno ambiente, opere ed arredi) e realizzato su un progetto di ricerca interdisciplinare. Dai risultati ottenuti emerge che i parametri termoigrometrici non mostrano fluttuazioni durante tutto il mese monitorato e il loro andamento risulta stabile. Dall’analisi qualitativa e quantitativa della contaminazione microbica nell’aria e sulle superfici dei disegni è emersa una situazione di non criticità. Questo lavoro riporta uno studio pilota che ha focalizzato l’attenzione sul rischio biologico per le collezioni grafiche, come contributo alla standardizzazione di un sistema di diagnosi-intervento per la conservazione preventiva del patrimonio culturale di natura organica conservato nei musei e in tutti gli ambienti confinati di conservazione ed esposizione e per la protezione della salute degli operatori e visitatori.Résumé Dans les musées, la composante biologique de l’air, appelée bioaerosol ou aérosol biologique, correspond à une menace potentielle de détérioration biologique pour les collections d’arts graphiques sur support papier. Lorsqu’elles se déposent sur la surface de l’objet, et lorsqu’elles y trouvent des conditions nutritionnelles et environnementales favorables à leur croissance, les particules biologiques en provoquent la biodétérioration. Il est bien connu que les attaques biologiques sont fortement influencées par les conditions microclimatiques. Dès lors, il devient primordial de les contrôler pour évaluer la contamination et pour estimer le risque biologique. Cet article traite de l’application partielle d’un modèle méthodologique chez l’Institut national des arts graphiques (Istituto Nazionale per la Grafica, ING), un organisme muséal d’importance internationale dont le siège est à Rome, notamment sur un recueil de dessins anciens du Fonds Corsini conservés dans le dépôt de conservation n. 1. Ce modèle est fondé sur un système intégré de surveillance microbiologique (air et surfaces) et surveillance microclimatique (environnement interne et externe, oeuvres et éléments de la décoration), qui a été mis en place dans le cadre d’un projet de recherche multidisciplinaire.Les résultats obtenus montrent que les paramètres thermiques et hydrométriques ne fluctuent pas au cours du mois étudié, leur évolution étant stable. L’analyse qualiquantitative de la contamination microbienne de l’air et des surfaces des dessins fait ressortir l’absence de criticités. Ce travail relate les résultats d’une étude pilote qui s’est concentrée tout particulièrement sur le risque biologique pour les collections d’arts graphiques, afin de contribuer à la standardisation d’un système de diagnostic et d’intervention pour la conservation préventive du patrimoine culturel de nature organique des musées et de tous les lieux de conservation et d’exposition confinés, en vue d’assurer aussi la protection de la santé des opérateurs et des visiteurs.Zusammenfassung In den Museen stellt die als Bio-Aerosol oder biologisches Aerosol bezeichnete Komponente der Luft einen potentiellen biologischen Schadfaktor für alle grafischen Sammlungen dar, deren Trägermaterial Papier ist. Wenn biologische Partikel sich auf der Oberfläche eines Manufakts ablagern und dort für ihr Wachstum günstige Ernährungs und Umgebungsbedingungen vorfinden, verursachen sie eine biologische Schädigung. Wie bekannt, sind biologische Angriffe stark von den mikroklimatischen Bedingungen abhängig. Deshalb ist deren Kontrolle eine wesentliche Voraussetzung für die Beurteilung der Kontamination und die Einschätzung des biologischen Risikos.In diesem Artikel präsentieren wir die partielle Anwendung einer Modellmethode beim Istituto Nazionale per la Grafica (ING), einer Museums-Organisation von internationaler Bedeutung mit Sitz in Rom. Diese Anwendung betrifft eine Sammlung antiker Zeichnungen aus dem Besitz des Fondo Corsini, die im Konservierungslager Nr. 1 verwahrt ist. Das genannte Modell basiert auf einem integrierten (Luft und Flächen) mikrobiologischen und mikroklimatischen Überwachungssystem (Umgebung innen und außen, Werke und Einrichtung) und wurde aufgrund eines interdisziplinären Forschungsprojekts realisiert. Aus den Ergebnissen zeigt sich, dass die Wärmeund Feuchtigkeitsparameter während des gesamten Überwachungsmonats keine Schwankungen aufweisen und der Verlauf der Werte gleichbleibend ist. Aus der Qualitäts- und Mengenanalyse der bakteriellen Kontamination der Luft und der Oberflächen der Zeichnungen ergibt sich eine nicht kritische Situation. Das vorliegende Schriftstück berichtet über eine Pilotstudie, deren Brennpunkt das biologische Risiko für graphische  Sammlungen war. Sie soll zur Standardisierung eines Diagnose- und Maßnahmensystems zur vorbeugenden Konservierung des Kulturbestands aus organischem Material beitragen, der in den Museen bzw. in geschlossenen Aufbewahrungs- und Ausstellungsräumen verwahrt ist, sowie zum Schutz der Gesundheit von Beschäftigten und Besuchern.Resumen En los museos, el componente biológico del aire, llamado bioaerosol o aerosol biológico, es un potencial agente biológico deteriorante de las colecciones gráficas realizadas sobre papel. Cuando las partículas biológicas se depositan sobre la superficie del objeto y encuentran condiciones nutricionales y ambientales favorables para su crecimiento provocan el deterioro biológico. Se sabe que los ataques biológicos están estrechamente vinculados a las condiciones del microclima. Por ello resulta fundamental controlarlas con miras a evaluar la contaminación y valorar el riesgo biológico.En este artículo se presenta la aplicación parcial de un modelo metodológico en el Istituto Nazionale per la Grafica (ING), organismo museológico de relevancia internacional sito en Roma, a una colección de dibujos antiguos pertenecientes al Fondo Corsini, guardado en el depósito de conservación nº 1. Dicho modelo se basa en un sistema integrado de seguimiento microbiológico (aire y superficies) y monitorización del microclima (ambiente interior y exterior, obras y decoraciones) aplicado en el marco de un proyecto de investigación interdisciplinario. De los resultados obtenidos se desprende que los parámetros térmicos e higrométricos no han mostrado fluctuaciones durante la totalidad del mes monitorizado y su evolución resulta ser estable. El análisis cualitativo y cuantitativo de la contaminación microbiana del aire y las superficies de los dibujos revela una situación no crítica. Este trabajo presenta un estudio piloto que centra su atención en el riesgo biológico al que están expuestas las colecciones gráficas y constituye una contribución para la creación de un sistema estándar de diagnostico-intervención con el fin de conservar de manera preventiva el patrimonio cultural de tipo orgánico que se guarda en los museos y en todos los lugares destinados a la conservación y la exposición, así como para proteger la salud de operadores y visitantes.简介 博物馆中空气中的生物组成成份，被称为有机气溶胶，是以纸张形式书画藏品一个潜在的生物腐蚀威胁。当生物颗粒附着于工艺品上，并获得营养物供给以及合适的繁殖环境，它们就会造成生物腐蚀问题。众所周知，微环境条件决定了微生物的破坏性，因此微环境的控制对污染评估及生物危害评估尤为重要。这篇文章介绍了国家书画协会（ING）所使用的部分应用，该协会位于罗马，是具有国际影响力的博物馆型组织，其中收藏了一系列归属于Corsini基金会的一级古老书绘画藏品。该应用模型基于一套完备的微生物监控（空气及表面）和微环境监控（内外部环境，作品及装饰），并融合多学科研究为一体。根据检测结果得出，在检测月期间，温度-湿参数无波动，走向平稳。由空气、绘画表面微生物污染的质、量分析得出无危险性。这项报告引发了新研究，将注意力指向了书画藏品所面对的生物威胁，如针对博物馆或其它保存、展览环境中的天然成分文化遗产的预防性保存，提供了一个标准化诊断-干预系统，并为工作人员及游客的身体健康提供保护。Резюме Биологические компоненты воздуха, т.н. биоаэрозоль или биологический аэ-розоль, является потенциальным биовредителем для графических коллекций на бумажном носителе в музеях. При оседании на поверхности артефакта и в присутствии благоприятных для их развития условий питания и окружающей среды биологические частицы наносят ущерб. Как известно, биологическая атака сильно зависит от микроклиматических условий, поэтому, их контроль играет фундаментальную роль в оценке загрязнения и биологического риска. В этой статье представлено частичное применение методологической модели в Национальном институте графики (ING) - римском музее международного значения, на собрании старинных рисунков из фонда Корсини, хранящегося в фондохранилище № 1. Эта модель основана на интегрированной системе микробиологического мониторинга (воздуха и поверхностей) и микроклиматического мониторинга (внутри и вне помещения, произведений и мебели) и была создана в результате междисципли-нарного исследовательского проекта. Полученные результаты показывают, что термо-гигрометрические параметры не претерпели колебаний в течение месяца, когда велось наблюдение, и их уровень является стабильным. Качественный и количественный анализ микробного загрязнения воздуха и поверхности рисунков обнаружил некритическое состояние. В этой работе представлено пилотное ис-следование, сфокусированное на биологическом риске для графических коллек-ций, вносящее вклад в стандартизацию системы диагноза и вмешательства для профилактической консервации объектов культурного достояния органического происхождения, хранящихся в музеях и других закрытых средах для хранения и экспозиции, а также для охраны здоровья работников и посетителей

Monitoring COVID-19 transmission risks by quantitative real-time PCR tracing of droplets in hospital and living environments

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination occurs through droplets and biological fluids released in the surroundings from patients or asymptomatic carriers. Surfaces and objects contaminated by saliva or nose secretions represent a risk for indirect transmission of coronavirus disease 2019 (COVID-19). We assayed surfaces from hospital and living spaces to identify the presence of viral RNA and the spread of fomites in the environment. Anthropic contamination by droplets and biological fluids was monitored by detecting the microbiota signature using multiplex quantitative real-time PCR (qPCR) on selected species and massive sequencing on 16S amplicons. A total of 92 samples (flocked swabs) were collected from critical areas during the pandemic, including indoor (three hospitals and three public buildings) and outdoor surfaces exposed to anthropic contamination (handles and handrails, playgrounds). Traces of biological fluids were frequently detected in spaces open to the public and on objects that are touched with the hands (.80%). However, viral RNA was not detected in hospital wards or other indoor and outdoor surfaces either in the air system of a COVID hospital but only in the surroundings of an infected patient, in consistent association with droplet traces and fomites. Handled objects accumulated the highest level of multiple contaminations by saliva, nose secretions, and fecal traces, further supporting the priority role of handwashing in prevention. In conclusion, anthropic contamination by droplets and biological fluids is widespread in spaces open to the public and can be traced by qPCR. Monitoring fomites can support evaluation of indirect transmission risks for coronavirus or other flu-like viruses in the environment

Air microbial contamination in dental clinics: comparison between active and passive methods

The aim of this study was to evaluate the correlation between the microbial air contamination values obtained by active sampling (colony-forming units per cubic metre, CFU/m3) and by passive sampling (Index of microbial air contamination, IMA) and to calculate the corresponding equations. Air sampling was performed in ten dental clinics (DC), before (T0), during (T1) and after (T2) the clinical activity, for five consecutive days, once a month for a period of three months, for a total of 450 air samplings. The correlation was evaluated using the Spearman test, and a p value below 0.05 was considered statistically significant. A statistically significant correlation was found considering both the results obtained from the total observations and from the single sampling times, T0, T1 and T2. Different correlation patterns were observed stratifying by DC. Both methods were able to evaluate the microbial air quality and highlight critical situations; therefore, both can be used with this aim. However, in particular during the activity, passive sampling resulted more sensitive, and for its simplicity, economy and standardization by IMA, as suggested by several authors, can be suggested for routine monitoring