The current spectrum and prevalence of intestinal parasitosis in Campania (region of southern Italy) and their relationship with migration from endemic countries

Background: In Italy, the current clinical–epidemiological features of intestinal parasitosis and the impact of recent massive migration flows from endemic areas on their distribution are not very well known. Methods: An analysis was carried out involving 1766 patients (720 natives and 1046 immigrants) observed during the period 2009–2010 (the 'current group') and 771 native patients observed during the period 1996–1997 (the 'historical group'), a time at which immigration in the area was minimal. Patients were analyzed for intestinal parasitosis at four healthcare centres in Campania. Results: A wide variety of intestinal parasites was detected in the study subjects. Immigrants had a significantly higher prevalence of parasitosis and multiple simultaneous infections than natives in both groups. In both study groups of natives, the detection of at least one parasite was significantly associated with a history of travel to endemic areas. Among immigrants, we found an inverse correlation between the frequency of parasite detection and the amount of time spent in Italy. No circulation of parasites was found among contacts of parasitized patients. Conclusions: Intestinal parasites are still a cause of intestinal infection in Campania. Although immigrants have a significantly higher prevalence of parasitosis than natives, this does not increase the risk of infection for that population. This is likely due to the lack of suitable biological conditions in our area

Drug-resistant tuberculosis in Naples, 2008-2013

Background. Drug-resistant tuberculosis (TB) is an important threat in industrialized countries, but low information is known from Southern Italy. Here, we present the results of a retrospective study on TB cases diagnosed in 2008-2013 in Naples, the biggest city in the South of Italy. Methods. Six hundred ninety Mycobacterium tuberculosis strains were isolated at the Ospedali dei Colli of Naples, and resistance to first-line and second-line drugs was determined. Results. Multidrug-resistant (MDR) TB increased from 2008 to 2013, with most strains being isolated from migrants arriving from 41 countries. Overall MDR-TB rate was 4.5%: Italian-born persons, 2.2%; Romania, 7.5%; Former Soviet Union countries (Ukraine, Russia, Armenia, Georgia), 22.4%; all other foreign countries, 2.0%. Resistance of MDR strains to second-line drugs was high against kanamycin, ofloxacin, capreomycin. Conclusions. MDR-TB increased in 2008-13 and was mostly observed in migrants, indicating the need to intensify diagnosis and treatment of these populations in Naples

Evaluation of antibiotic resistance and microorganisms “Alert” recorded in 2008 at the A.O.R.N.V. Monaldi (Naples)

The risk of infection is higher in intensive care units than in the other hospital department because of multiple factors contributing. In particular, it is estimated that the frequency of nosocomial infections is much higher in the patients hospitalized in the ICU than in patients hospitalized in other wards, with an incidence equal to 34%. In this study,we have assessed the grade of dangerous antibiotic resistance in intensive care units in our local reality.We have retrospectively analyzed the results for the microbiological test performed in 2003 and 2008 in the intensive care unit of A.O.R.N.V. Monaldi (Naples). The bacterial strains, once isolated from cultures, were identified microscopic analytical methods, biochemical methods and other manual and automated way. With regard to the Gram positive bacteria belonging to the Staphylococcus genus, it was evaluated carefully methicillin resistance and the MIC to vancomycin, confirmed by E-test in case of VISA strains. Besides it has been assessed and confirmed by test the vancomycin resistance of the Enterococcus, in case of VRE strains, and its resistance to high levels of gentamicin.With regard to the Gram negative bacteria, instead, it was evaluated the production of ESBL in the Enterobacteriaceae and the resistance to carbapenems of the Pseudomonas aeruginosa

Micobatteriological control of diagnostic instrumentation

Introduction: In addition to sterility testings for common bacteria, from 2006 on we have introduced in our laboratory sterility tests for mycobacteria on surgical instruments such as bronchoscope and lava-endoscope fluid used for their sterilization as well. Methods: Bronchology and Pneumology SUN departments, doing bronchoscopies, regularly send to our laboratory bronchoscopes washing fluids. Bronchology department also sends liquids used in lavaendoscopes. Our standard protocol consists of liquids inoculation directly on Lowenstein - Jensen (LJ) solid ground and on Middlebrook 7H9 liquid medium into Mgit test tubes, both produced by Becton Dickinson, within 42 days (1, 5, 6). Results: When growth of acid-alcohol resistant bacilli was detected, they were identified through probes or Accuprobe bioMérieux Inno- LIPA Mycobacteria by Innogenetics. All positivite results were related to M. Gordonae. As for the liquids examined, we found one positivite result in liquid medium in 2006 and none in 2007. On the contrary, in 2008 and the first 6 months of 2009, we have identified the following positive results: 2008 - 2009 (6m) LJ pos TOT 20 C. Lavaendoscope 8 V. 12 FBS We linked the positive findings on equipment with positivity for M. gordonae observed in patients undergoing bronchoscopy. Conclusions: Data analysis indicates within the period 2008-2009 we observed a recurring positivity for M. gordonae on equipment and therefore in some patients. On a careful evaluation, they showed no signs of clinical infection, also considering that this mycobacteria is usually a saprophyte (2, 3, 4). However, the protocol we adopted allowed us to recognize equipment contamination at birth and to urge fellow users to review sterilization protocols

Utilization of CHROMagar MRSA in the supervision of the methicillin-resistent Staphylococcus aureus

Methicillin-resistent Staphylococcus aureus (MRSA) is one of the most common pathogen responsible for nosocomial infections. Laboratory diagnosis and assays of antimicrobial susceptibility are basic in controlling and preventing infection by MRSA. Our study was conducted for one year (May 2008-April 2009) on patients hospitalized to monitor the eventual colonization by MRSA.The use of chromogenic agar MRSA allowed us to identify pink-mauve colonies of MRSA within 24 hours and to make a timely e careful diagnosis

Distribution of HCV genotypes in the metropolitan area of Naples

The Hepatitis C virus is characterized by high genomic variability that leads to the identification of six different genotypes and many subtypes. In this work, we show the prevalence of genotypes in patients living in the metropolitan area of Naples collected in one year, analyzing differences in the distribution depending on sex and age groups

Subacute bacterial endocarditis (SBE) due to Streptococcus gordonii

Endocarditis is an inflammatory state of the endothelium that promotes thrombus formation and tissue damage on the surface of heart valves. Recent studies have reported endocarditis mortality rates ranging from 12% to 46% (2008). The Streptococcus gordonii is a normal inhabitant of the human oral cavity. It is a component of the microbial communities responsible of plaque formation, associated with dental caries and also regarded as the main causative agent in the development of subacute bacterial endocarditis (SBE)

Distribution of HCV genotypes in the metropolitan area of Naples

The Hepatitis C virus is characterized by high genomic variability that leads to the identification of six different genotypes and many subtypes. In this work, we show the prevalence of genotypes in patients living in the metropolitan area of Naples collected in one year, analyzing differences in the distribution depending on sex and age groups

Presenza della glutatione perossidasi plasmatica (plGPX) in pazienti affetti da epatite C

In the past decade it became accepted that reactive oxygen metabolites (ROM’s) play a role in various tissues damages, thus in certain liver deseases as well hepatitis C. Hepatic cells, utilize the enzymatic system constituted by the glutathione peroxidase/glutathione reductase enzymes (GPX/GR), to reduce oxidative damages. In fact, the GPX enzyme utilizes GSH to reduce ROM’s. Interferon alpha (IFN) might be useful to reducing the oxidative stress, probably through an increase of reduced glutatione (GSH). Recent findings demonstrate that hepatitis C virus (HCV) encodes a GPX gene in a reading frame overlapping a known non structural gene, NS4b, of unidentified function.The HCV GPX sequence has features of both the plasma and cellular GPX types. Aim of our study was to demonstrate the presence of the plGPX in sera of patients with C hepatitis and with a various viremia level. Our results show the presence of plGPX in all the sera examinated. Particularly, there is a remarkable increase in the sera with an high viremia as respect the sera without a viral replication. Moreover, it is very interesting to observe that some of the sera without viral replication possess an high plGPX level. In the other side, some of the sera with an high viral replication have low plGPX levels. Starting from these results, it will be foundamental to evaluate whether the patients examinated are, or not, in terapeutic treatment. Moreover, since GPX is a target of the tumor suppressor protein p53, that activates the apoptotic process in mammalian cells, it will be very interesting to establish wether the plGPX detected in the sera is of viral source or is the plGPX present in the hepatocytes. In fact, the understandig of these cellular mechanisms might play an important role in the evolution of hepatic cirrosis to hepato carcinoma in patients with C hepatitis