Plasmid-mediated multiple antibiotic resistance of Escherichia coli in crude and treated wastewater used in agriculture.

A total of 273 Escherichia coli isolates from raw and treated municipal wastewaters were investigated to evaluate the frequency and persistence of antibiotic resistance and to detect the occurrence of conjugative R plasmids and integrons. The highest resistance rates were against ampicillin (22.71%), tetracycline (19.41%), sulfamethoxazole (16.84%) and streptomycin (14.28%). Multiple antibiotic resistance was present in 24.17% of the isolates. Several multiple antibiotic-resistant isolates proved to be able to transfer en bloc their resistance patterns by conjugative R plasmids with different molecular sizes and restriction profiles. Class 1 integrons of 1 or 1.5 kbp were found in 5 out of 24 representative multiresistant E. coli isolates. Although wastewater treatments proved to be effective in eliminating Salmonella spp. and in reaching WHO microbiological standards for safe use of wastewater in agriculture, they were ineffective in reducing significantly the frequency of plasmid-mediated multiple antibiotic resistance in surviving E. coli. Since multiple antibiotic-resistant bacteria carrying integrons and conjugative R plasmids can constitute a reservoir of antibiotic-resistance genes in wastewater reclaimed for irrigation, risks for public health should be considered. Bacterial strains carrying R plasmids and integrons could contaminate crops irrigated with reclaimed wastewater and transfer their resistances to the consumers' intestinal bacteria

I bisogni di salute dei giovani e la prevenzione dell'età evolutiva

Nel corso degli ultimi cinquanta anni il quadro demografico ed epidemiologico della popolazione italiana è profondamente cambiato. In particolare, si sono drasticamente ridotte la mortalità generale e la mortalità infantile, sono scomparse le malattie da carenze alimentari, mentre gli agenti microbici che mietevano vittime nell'infanzia e nell'adolescenza sono stati eradicati o sono sotto controllo, tanto che attualmente il numero di morti per malattie infettive nelle classi d'età tra 0 e 24 anni assomma a meno di 80 in un anno contro le diecine di migliaia del passato. In questo quadro indubbiamente positivo emergono, però, nuovi bisogni di salute che non sono ancora percepiti in tutta la loro importanza e complessità perché rientrano in problematiche in parte nuove. Le principali problematiche sanitarie nell'età evolutiva riguardano: gli incidenti stradali, che causano circa 2.000 decessi l'anno tra i giovani di 15-24 anni, quasi la metà di tutti quelli che occorrono in questa fascia d'età; la malnutrizione per eccesso, che è responsabile di soprappeso ed obesità in circa il 30% della popolazione e costituisce un importante fattore di rischio per le malattie cronico-degenerative; i disturbi dell'alimentazione, che si manifestano sempre più frequentemente nelle adolescenti con comportamenti anoressici e bulimici; il fumo di sigaretta ed il consumo eccessivo di alcol; il consumo di droghe illegali; le gravidanze indesiderate a seguito di rapporti sessuali precoci. La maggior parte dei fattori che inducono perdita di salute è insito nell'attuale stile di vita che ostacola la piena realizzazione della persona in un armonico sviluppo fisico, psichico e sociale. Pertanto, la prevenzione e la promozione della salute nell'età evolutiva devono essere basate sulla scelta di uno stile di vita esente dai condizionamenti negativi dell'attuale società dei consumi. In questo senso, la scuola dell'obbligo, fin dalle prime classi, può svolgere un ruolo decisivo in stretta collaborazione con le famiglie. The demographic age profile and epidemiological profile of the Italian population have greatly changed over the last fifty years. In particular, figures for general and infant mortality have dramatically dropped, diseases caused by malnutrition have disappeared and microbic agents responsible for large numbers of deaths in infancy and adolescence have been eradicated or are under control. At the moment the number of deaths from infectious diseases in subjects between 0 and 24 years is less than 80 per year, in contrast with the tens of thousands in the past. Within this undoubtedly positive picture, emerge new health needs, whose importance and complexity have yet to be fully realized as they sometimes form part of new problematic issues. The main health problems in the developmental age regard: road accidents, which cause the death of about 2000 young people between the ages of 15 and 24 and account for almost half the accidents involving this age group; hyper-nutrition, responsible for excess weight and obesity in about 30% of the population, one of the main risk factors for chronic and degenerative diseases; eating disorders, which are increasingly frequent in teenage girls, such as anorexia and bulimia; health hazards caused by cigarette smoke and excessive alcohol consumption; illegal drug use and unwanted pregnancies resulting from early sexual intercourse. Most of the factors leading to loss of health are inherent in the present lifestyle, hindering full and harmonious physical, psychic and social development. Therefore, prevention of diseases and promotion of health in the developmental age must be based on a lifestyle free from the negative conditioning of the modern consumer society. To this end, a decisive role can be played by schools, from the very first classes, in close co-operation with pupils' families

Carbohydrate assimilation profiles of the first italian Candida dubliniensis clinical isolates recovered from an HIV-infected individual

A total of six Candida dubliniensis isolates were obtained during 1 year of monitoring by monthly swabs from the oral cavity of an asymptomatic human immunodeficiency virus-infected individual in Catania, Italy. To the authors' knowledge, this constitutes the first recovery of C. dubliniensis from a human in Italy. Our identification procedure was based on colony color on CHROMagar Candida and carbohydrate assimilation profiles obtained by two commercial systems: API ID 32C and API 20C AUX. Karyotyping by pulsed-field gel electrophoresis confirmed the phenotypic identification. The biocodes obtained with API 20C AUX and with API ID 32C were 6172134 and 7142140015, respectively, for all six isolates. Both biocodes corresponded to those described in the literature as being produced by most C. dubliniensis isolates with each of the two identification systems. Our results confirm that both API 20C AUX and API ID 32C are able to rapidly and accurately differentiate C. dubliniensis from C. albicans. © 2000 Éditions scientifiques et médicales Elsevier SAS

Knowledge, beliefs and attitudes of Italian female undergraduate students towards HIV infection and risky sexual behaviour. Do female medical students make good peer educators?

<p><strong>Background</strong>: The main purpose of this study was to identify and describe knowledge, beliefs and attitudes towards HIV infection and risky sexual behaviour in female medical freshmen in order to evaluate the possibility of female medical student-based peer education.</p><p><strong>Methods</strong>: Researchers surveyed 560 freshmen: 280 medical students and 280 non medical students at two Italian Universities, collecting the data through anonymous, self administered questionnaires. Data were codified and statistical analysis was computed using Statistica and Openstat 4 software.</p><p><strong>Results</strong>: Female medical freshmen showed higher levels of knowledge and risk perception about HIV infection, and higher levels of self-awareness in preventing infection when compared with non-medical freshmen. Moreover, medical student’s had a lower rate of sexual activity and a higher rate of condom usage.</p><p><strong>Conclusions</strong>: Our data leads to the hypothesis that the involvement of female medical students in developing and providing safe sex education may be an important and effective way of better enhancing young people’s knowledge, attitude and behaviour towards the prevention of HIV and other sexually transmitted infections.</p&gt

Molecular Epidemiology of Ampicillin Resistance in Salmonella spp. and Escherichia coli from Wastewater and Clinical Specimens

International audienceMolecular epidemiology at local scale in Sicily (Italy) of ampicillin resistance in Salmonella spp. isolates from municipal wastewater (n ¼ 64) and clinical specimens (n ¼ 274) is described in comparison with previously examined Escherichia coli isolates (n ¼ 273) from wastewater. High prevalence of antibiotic resistance (28.9%) with highest resistance rates against ampicillin (22.7%) was observed in E. coli isolates. Different resistance rates were observed in Salmonella according to the serovars, with prevalences of the same order in both wastewater and clinical isolates belonging to the same serovar (e.g., 91.7% ampicillin resistance in wastewater isolates vs. 70.8% in clinical isolates of the Salmonella serovar Typhimurium and 0% ampicillin resistance in both wastewater and clinical isolates of the Salmonella serovar Enteritidis). The b-lactam resistance gene bla TEM was present in both wastewater and clinical Salmonella spp. isolates, with the exception of Salmonella enterica serovar Typhimurium isolates with a typical six-drug resistance pattern AmpChlSulTeStrSp that had the bla PSE-1 gene. The bla TEM gene was present in all the E. coli isolates but one had the bla SHV gene. Several E. coli and some Salmonella isolates were positive for class 1 integrons with variable regions of 1.0 or 1.5 kb containing aadA1, dfrA17-aadA5, or dfrA1-aadA1 gene cassettes, whereas Salmonella serovar Typhimurium isolates with the six-drug resistance pattern were positive for both 1.0 and 1.2 kb integrons. Polymerase chain reaction replicon typing demonstrated the presence of multireplicon resistance plasmids in several isolates of E. coli, containing two to four of the replicons IncF, IncI1, IncFIA, and IncFIB, whereas other isolates showed resistance plasmids with only IncF, IncP, or IncK replicons. Replicon IncI1 was detected in one Salmonella isolate, whereas other isolates belonging to different serovars had IncN replicons. Analysis of isolates from wastewater can be a useful epidemiologic tool to monitor the prevalence of antibiotic resistance and genetic elements related to antibiotic resistance in Salmonella clones circulating in the human population

Persistent Endemicity of Salmonella bongori 48:z(35):− in Southern Italy: Molecular Characterization of Human, Animal, and Environmental Isolates

From 1984 to 1999, we collected 31 isolates of the rare serovar Salmonella bongori 48:z(35):− in southern Italy. Twenty-four of the isolates were from cases of acute enteritis in humans. Pulsed-field gel electrophoresis analysis showed that all but one of our isolates were at least 80% similar. Our findings suggest that genetically related S. bongori 48:z(35):− strains are endemically circulating in southern Italy

Characterization of Shiga Toxin-Producing Escherichia coli O157:H7 Isolated in Italy and in France

Twenty-one Escherichia coli O157:H7 strains isolated in northern Italy from sporadic cases of hemolytic-uremic syndrome and from cattle and food were characterized by virulence gene analysis, pulsed-field gel electrophoresis (PFGE) of XbaI-digested DNA, enterobacterial repetitive intergenic consensus (ERIC) sequence-based PCR (ERIC-PCR), and antibiotic resistance patterns and compared to 18 strains isolated in France from human cases of diarrhea, cattle, and the environment. Strains isolated in Sicily (southern Italy) from a local farm (one strain) and from calves just imported from France (11 strains) and Spain (six strains) were also typed. Whereas the eae and hlyA genes were always detected, Shiga toxin gene (stx) analysis showed some differences related to geographic areas. Isolates from northern Italy showed a high frequency of stx(1) and stx(2), while strains isolated in France and from French and Spanish calves imported to Sicily more frequently possessed the stx(2c) gene. The majority of the strains isolated in northern Italy were also resistant to one or more antibiotics, while most of the strains isolated in France and Sicily were fully susceptible. ERIC-PCR analysis was not able to differentiate the strains. PFGE typing after XbaI DNA digestion produced a total of 54 distinct restriction endonuclease digestion profiles (REDPs) among the 57 strains. Phylogenetic analysis was unable to cluster REDPs according to geographic origin. All epidemiologically related isolates showed either identical or ≥91% similar REDPs. Our findings suggest a peculiar circulation of antibiotic-resistant, genetically unrelated strains in northern Italy