E. Pariani

F. Ruggeri

G. Ianiro

L. Bubba

L. Pellegrinelli

M. Monini

S. Binda

V. Primache

AIR Universita degli studi di Milano

88 Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
determine associations between the preferred feeding choices and
the factors affecting the decisions.
Results: The ﬁndings revealed good knowledge (60%) of the
infant feeding options among the respondents. About 42.9% of the
women felt the counsellors were not convinced to certain limit
which method was best, hence they not conﬁdently guide them
on the correct options. The adoption of infant feeding options as
recommended by WHO was not optimal. Reasons included deter-
rents like ﬁnancial limitations in 36.9% of respondents which was
statistically signiﬁcant at the bivariate (p= <0.001) andmultivariate
(p=0.013, odds ratio = 32.779) levels. This showed that respondents
with ﬁnancial constraints were 32 times less likely to practice the
ideal feeding options than women who are not ﬁnancially con-
strained. Also, sociocultural norms and beliefs in 40%, and the
knowledge of risks associated with some feeding practices (38.5%)
statistically signiﬁcant (p=0.022 and 0.023 at bivariate and multi-
variate levels respectively). In the course of feeding their children,
the respondents had challenges of insufﬁcient breast milk, stigma
and discrimination, among others.
Conclusion: High proportions of respondents know the rec-
ommended infant feeding options, though the adoption of, and
adherence to the ideal methods is not practiced. Sociocultural
norms, fear of stigma, discrimination, and ﬁnancial constraints
affect their ability to do so. It is recommended that effective coun-
selling services should be made available to HIV positive women in
the hospital by trained hospital personnel to guide such women on
making correct choices.
http://dx.doi.org/10.1016/j.ijid.2016.11.221
19.184
Seroepidemiological study to assess visceral
leishmaniasis in Armenia, 2015
L. Paronyana,∗, H. Apresyanb, G. Avetisyanc, K.
Gevorgyana, L. Babayana, A. Vanyana
a National Center for Disease Control and Prevention,
Ministry of Health, Republic of Armenia, Yerevan/AM
b Nork” Infection Clinical Hospital, Infectious
Diseases, Yerevan/AM
c Republican veterinarian-sanitarian and
phytosanitarian center of laboratory services, SSFS,
RA Ministry of Agriculture, Yerevan/AM
Purpose: Leishmaniasis is a vector-bornedisease causedbypro-
tozoan parasites of the Leishmania genus which is transmitted by
Phlebotomine sandﬂies. The ﬁrst case of visceral leishmaniasis (VL)
in Armenia was registered in 1913. From 1926-1969, 919 cases of
VL were reported at different altitudes with the main focus being
Yerevan where more than 80% of the cases were situated. A 1970
survey of dogs showed an infection rate of 7.3%. No VL cases were
reported between 1969 and 1999. However, since 1999, 99 indige-
nous human cases of VL have been reported,mainly in Yerevan and
in the Syunik, Lori and Tavush regions. The incidence rate is 0.03-
0.6 per 100000. As most VL cases are asymptomatic, the objective
of the study was to identify the real prevalence of VL in Armenia.
Methods & Materials: A systematic random sampling, pulled
from the medical facilities’ registry of children less than six years
of age, was conducted. Dogs living within a 1500 meter radius of a
human case residence were sampled. Leishmanial antibodies were
tasted using immune-chromatographic rapid tests rK 39. A stan-
dardized questionnairewas developed that contained 28 questions
on demographic, epidemiological and clinical characteristics and
on knowledge, attitude and practice questions regarding leishman-
iasis and its prevention.
Results: Four of the 1238 children tested were positive (0.3%)
including 2/91 in Syunik (2.2%) 1/100 in Tavush (1.0%) and 1/200
in Lori (0.5%). In these regions, 146 dogs were tested with eight
positives (5.5%): four in Syunik (9.3%), two in Tavush (8.0%), one
in Lori (5.6%), and one dog out of 50 tested in Yerevan (2%). The
vast majority of parents (93.5%) had not heard of leishmaniasis.
The highest levels of disease awareness were observed in Syunik
(21%) and the lowest levels in Lori (2%).
Conclusion: Visceral leishmaniasis is a re-emerging problem
in Armenia, with a high epidemic potential because of its canine
reservoir. It is recommended that intersectional collaboration be
strengthened including dog registration and vaccination against
leishmaniasis, vector-control and host-reservoir treatment pro-
grams. Programs that raise public awareness are required.
http://dx.doi.org/10.1016/j.ijid.2016.11.222
19.185
First report of G12P[8] group A Rotavirus
introduction in northern Italy, 2016
L. Pellegrinelli a,∗, G. Ianirob, L. Bubbaa, M.
Moninib, V. Primachea, E. Pariania, F.M. Ruggerib,
S. Bindaa
a University of Milan, Department of Biomedical
Sciences for Health, Milan/IT
b Istituto Superiore di Sanità, Department of
Veterinary Public Health and Food Safety, Rome/IT
Purpose: As the regional reference laboratory for Lombardy
(a region of Northern Italy) we participate to the RotaNet-Italy
Study Group, in the framework of the EuroRotaNet surveillance
network. In this study, group A rotaviruses (RVA) from cases of
acute gastroenteritis (AGE) were investigated with the aim of eval-
uating the co-circulation of different strains and the emergence
of uncommon or unusual rotavirus genotypes. Although most of
RVA infections are supported by common genotypes G1–G4, and
G9 associated with either P[8] or P[4], an unexpected spreading of
uncommon genotypes could occur, suggesting gene reassortment
events between strains of different origin.
Methods & Materials: During the ﬁrst part of 2015-2016
rotavirus season, 38 positive-RVA stool samples were collected
from as many children (median age: 27 months; IQR: 38.9 months)
with AGE admitted to ‘ASST-CREMONA’ hospital in Cremona, a
city of Lombardy region accounting for nearly 71,000 inhabitants.
Molecular characterization of RVA, based on EuroRotaNet methods
andalgorithms,wasperformedby the regional reference laboratory
located at the University of Milan in collaboration with the Istituto
Superiore di Sanità, which coordinates the project at national level.
Results: A single rotavirus infection was recorded in 97.4%
(38/39) of AGE and a double rotavirus infection was detected in
one out 38 children (2.6%). According to G/P-type RVA character-
ization, the most predominant combination was the uncommon
G12P[8] strain, being present in 39.5% (15/38) of children. G1P[8]
was detected in 26.3% (10/38) of samples and G9P[8] and G4P[8]
were identiﬁed at the same extent (6/38:15.8%); one (1/38:2.6%)
RVA was G2P[4] and no G3P[8] combination was detected during
the study period.
Conclusion: This study reports for the ﬁrst time a predomi-
nant and overwhelming introduction of the uncommon genotype
G12P[8] RVA in children hospitalized for AGE in a small area
of Northern Italy. Continuation of RVA monitoring activities by
the RotaNet-Italy can help deﬁning a baseline of circulating RVA
Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163 89
genotypes before mass vaccination and assess possible genotype
replacement once rotavirus vaccination will be introduced.
http://dx.doi.org/10.1016/j.ijid.2016.11.223
19.187
Horizon scanning through media mining to
identify medical products of human prigin -
associated infectious risks: A pilot NOTIFY
Project study
E. Petrisli a,∗, L. Noelb, J. Schnitzler c, J.R. Nunezc,
D. Fehilyd, M. Kuehnerte, D. Domanovic f, D.M.
Strongg, I. Ushiro-Lumbh, A. Nanni Costaa
a Italian National Transplant Centre, Rome/IT
b NOTIFY Steering Committee, Annecy/FR
c World Health Organization, Geneva/CH
d European Commission, Brussels/BE
e CDC, Atlanta, GA/US
f European Centre For Disease Prevention And
Control, Solna/SE
g NOTIFY Steering Committee, Edmonds,WA/US
h NHSBT Blood and Transplant, London/UK
Purpose: Accomplishments in medical science have led to the
therapeutic use of a wide range of medical products of human ori-
gin (MPHO) that, however, have a shared exposure to risks, such
as donor to recipient transmission of pathogens. The goal of the
NOTIFY Project is to promote and maximize the use of vigilance
and surveillance (V&S) from procurement to clinical application of
MPHO at a global level.
We have performed a systematic review of informal and formal
reports resulting from media mining in order to identify common
and (re)emerging infections that feature possible threats to MPHO
safety, initiate a core global network of public health specialists
in MPHO-associated risk and keep the NOTIFY Library of adverse
occurrences in transplantation, transfusion and assisted reproduc-
tion updated.
Methods & Materials: A 24/7 horizon scanning strategy for
infectious risk associated with MPHO was designed in collabora-
tion with the department of Global Preparedness, Surveillance and
Response of WHO using the Hazard Detection and Risk Assess-
ment System(HDRAS), that integrates a largenumberofdistributed
electronic resources. To make our search more speciﬁc, we have
included the NOTIFY Library’s MPHO and pathogen comprehen-
sive taxonomyas additional screening parameters. Once the results
started to appear, we were able to rate the signiﬁcant items (TR
topic related: RE relevant, HR highly relevant).
Results: A total number of 136 notiﬁcations were captured
during the one month study period. Speciﬁcally, 39 notiﬁcations
were MPHO-related (TR, 28.7%), 27 of which MPHO-safety related
(RE) and 12MPHO-derived infection transmissions (HR). Themean
number of notiﬁcations per day was 4.6 (min 0, max 12). Outcomes
have been discussed with US-CDC and E-CDC on weekly basis tele-
conferences.
Conclusion: A real time horizon scanning strategy through
mediamining could be a newV&S tool to supportMPHO safety and
contribute to the improvement of individual and public health. The
initial results of this innovative approach justify further assessment
over a longer period to search for possible reﬁnements of its use
and explore potentials in collaboration with national authorities in
charge of MPHO safety at a global level.
http://dx.doi.org/10.1016/j.ijid.2016.11.224
19.188
Infections and antimicrobial use in Hungarian
long-term care facilities in 2015: A
questionnaire-based survey to evaluate
initiatives and future developments
R. Szabóa, I. Prantnerb,∗, A. Kurczc
a National Centre for Epidemiology, Department of
Hospital Epidemiology, Budapest/HU
b National Center for Epidemiology, Budapest/HU
c National Center for Epidemiology, Department of
Hospital Epidemiology and Hygiene, Budapest/HU
Purpose: Due to the aging population of Europe there is a
growing need for long-term care facilities (LTCF). Elderly are at
higher risk of impaired immune system due to multiple under-
lying, chronic diseases, malnutrition, dehydration, and/or use of
immunosuppressant medication. Therefore, healthcare-associated
infections (HAI) and antimicrobial use can be signiﬁcant among
residents in these settings. This can contribute to the growing
problem of antimicrobial resistance in LTCFs, including multidrug-
resistant organisms. Due to the lack of national data, our purpose
was to establish baseline rates and to identify priorities for
improvement.
Methods & Materials: All LTCFs were invited to participate in
our questionnaire-based survey between January and December
2015. The assessment covered infection prevention-related top-
ics including: facility demographics, infection prevention practices
(e.g. presence of written guidelines, hand hygiene), the most com-
mon types of infections and antimicrobial use. Descriptive statistics
were used to present the data.
Results: A total of 546 LTCFs (43% of all authorized facilities
in the country) participated in the survey covering 40,562 beds.
The median number of available beds per facility was 74 (range:
10-720). A minority of LTCFs (2%) had assigned an infection con-
trol practitioner. Overall, there was a high availability of protocols
for hand hygiene, for prevention and management of MRSA infec-
tion/colonization and for the prevention of bloodborne pathogen
transmission. 70% of LTCFs reported that their residents acquired
infections in the preceding year. The most common were respira-
tory (88%), urinary (76%) and skin/soft tissue (28%) infections. 66%
of LTCFs used antimicrobials. Most frequently used antibacterials
were beta-lactams, penicillins (ATC J01C) (34%), quinolones (ATC
J01 M) (29%), and macrolides, lincosamides and streptogramins
(ATC J01F) (13%).
Conclusion:Our results indicate thatHAIs andantimicrobial use
constitute a relevant public health problem in LTCFs in Hungary.
We have an urgent need for a national recommendation for good
practice in LTCFs inorder topreventHAIs and inappropriate antimi-
crobial therapy leading to the risk of multidrug resistant pathogen
development. In addition, limitation of antibiotic use and con-
tinuing education of prescribers on antimicrobial treatment are
essential.
http://dx.doi.org/10.1016/j.ijid.2016.11.225


First report of G12P[8] group a rotavirus introduction in northern Italy, 2016

https://air.unimi.it/retrieve/handle/2434/467234/765927/1-s2.0-S1201971216314412-main.pdf

First report of G12P[8] group a rotavirus introduction in northern Italy, 2016

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