Serena Carovillano

Non-fermentative gram-negative bacteria in hospital tap water and water used for haemodialysis and bronchoscope flushing: Prevalence and distribution of antibiotic resistant strains

This study provides a detailed description of the distribution of non-fermentative gram-negative bacteria (NFGNB) collected in water sources (tap water and water used for haemodialysis and bronchoscope flushing) from different wards of a tertiary care hospital. The aim is to identify risk practices for patients or to alert clinicians to the possible contamination of environment and medical devices. The resistance profile of NFGNB environmental isolates has shown that more than half (55.56%) of the strains isolated were resistant to one or more antibiotics tested in different antimicrobial categories. In particular, 38.89% of these strains were multidrug resistant (MDR) and 16.67% were extensively drug resistant (XDR). The most prevalent bacterial species recovered in water samples were Pseudomonas aeruginosa, Pseudomonas fluorescens, Ralstonia pickettii and Stenotrophomonas maltophilia. Analysis of antibiotic resistance rates has shown remarkable differences between Pseudomonadaceae (P. aeruginosa and P. fluorescens) and emerging pathogens, such as S. maltophilia and R. pickettii. Multidrug resistance can be relatively common among nosocomial isolates of P. aeruginosa, which represent the large majority of clinical isolates; moreover, our findings highlight that the emergent antibiotic resistant opportunistic pathogens, such as R. pickettii and S. maltophilia, isolated from hospital environments could be potentially more dangerous than other more known waterborne pathogens, if not subjected to surveillance to direct the decontamination procedures.

Health inequalities: an analysis of hospitalizations with respect to migrant status, gender and geographical area

BackgroundThe quality of care includes several aspects which may be influenced by social-economic status.This study analyzes hospitalizations for several conditions, such as chronic diseases, cancer and appendectomy, in Italians and immigrant people living in Italy with the aim to evaluate possible inequalities in the quality of health care services due to migrant status, gender and geographical macro-areas (Northern, Central, Southern Italy).MethodsThe data source of hospital discharges for stroke, myocardial infarction, chronic liver disease, cervical cancer, mastectomy and appendectomy was the Ministry of Health. ICD 9 codes were used for data collection. Crude and standardized hospitalization rates per 100.000 were calculated. Italian resident population and an estimate of immigrants living in Italy were used as denominators while standardization was done with respect to the European population. The data we used covers the 2006–2008 period.ResultsImmigrants showed significantly higher hospitalization rates for stroke, cervical cancer and appendectomy and significantly lower hospitalization rates for chronic liver diseases and mastectomy. Males showed significantly higher hospitalization rates than females for myocardial infarction, chronic liver diseases and appendectomy. Notwithstanding, differences related to migrant status and gender varied according to geographical macro-area. With respect to that, Southern Italy showed significantly higher hospitalization rates for stroke, myocardial infarction and chronic liver diseases and significantly lower hospitalization rates for mastectomy and appendectomy.ConclusionsThe results of this study may reflect inequalities in the quality of health care, in particular in primary and secondary prevention, access to specialized care and inappropriateness, due to migrant status and gender. Also, differences between macro-areas suggest heterogeneities in the integration policies and the promotion of immigrants’ health. Research should be endorsed in this field in order to further describe inequalities and their reasons and in the light of supporting policies development.

The role of the Student’s involvement in GlobalHealth Medical Education: the results of a surveyconducted in four Medical Schools in Rome

2010 as reached universal salt iodization (USI). After this time, researches on iodine deficiency at the national level were not held in Kazakhstan. Objectives: The evaluation of the situation on iodine intake at the national level by urine iodine excretion, revelation of salt iodization quality and the awareness level of the population on iodine deficiency, comparison of indicators overtime in RK. Methods A cross-sectional survey of 2011 included 64 clusters on 22 women in each cluster. The women of reproductive age (15-49 years) were interviewed and 1145 salt samples were collected from their households for quantitative determination of iodine, and 1296 their urine samples were analyzed on content of iodine by ammonium persulfate digestion method, based on the Sandell-Kolthoff reaction. It was conducted a comparative analysis of the results with data from national studies before adopting USI strategy (1999) and MICS (2006). Results The urinary iodine median at women in 2011 was 181.1 mg/l, in 2006 235.9 mg/l, in 1999 93.9 mg/l. The prevalence of iodine deficiency of women was 22.8% in 2011, it was 15.9% in 2006, and 54.2% in 1999. In 2011 the percentages of salt samples with adequately iodized salt (?15 ppm) were 95.9%, in 2006 91.4 %, in 1999 29%. In 2011 among interviewed women 92.7%, n = 1303 knew that salt is iodized, in 2004 these were 93,3%, n = 1 500, and only 58.6% were aware of the need to use iodized salt, n = 4800 in 1999. Conclusions Since the adoption of the Law on mandatory salt iodization consumption percentage of adequately iodized salt has increased, which in turn affected the rising of urinary iodine levels at the population. After 8 years of USI median of urinary iodine excretion decreased slightly comparing with 2006, but remained in the normal range on the Background of adequately iodized salt coverage more than 90%. It indicates the necessity of periodic biological monitoring and continuing communication activity among population on long-term and constantly basis. Key message After 8 years of USI median of urinary iodine excretion decreased slightly comparing with 2006, but remained in the normal range.