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Fallucca A, Restivo V, Sgariglia MC, Roveta M, Trucchi C. Hepatitis a Vaccine as Opportunity of Primary Prevention for Food Handlers: A Narrative Review. Vaccines (Basel) 2023; 11:1271. [PMID: 37515087 PMCID: PMC10383099 DOI: 10.3390/vaccines11071271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The hepatitis A virus (HAV) is still a leading cause of viral hepatitis worldwide. After a long incubation period, the clinical manifestations range from asymptomatic infection to acute liver failure. The severity of the disease increases with age and pre-existing liver disease. The transmission is mainly via person-to-person contact or ingestion of contaminated food or water. Food contamination can occur at any step of the food chain, especially when infected people handle not-heated or otherwise-treated food. HAV is endemic in low-income countries because of poor sanitary and sociodemographic conditions. The populations of developed countries are highly susceptible, and large outbreaks occur when HAV is introduced from endemic countries due to globalization, travel, and movement of foodstuffs. HAV prevention includes hygiene practices, immunoglobulins, and vaccination. Safe and effective inactivated and live attenuated vaccines are available and provide long-term protection. The vaccine targets are children and subjects at increased risk of HAV exposure or serious clinical outcomes. This review discusses the critical role of food handlers in the spread of HAV and the opportunity for food industry employers to consider food handler immunization a tool to manage both food safety in compliance with HACCP principles and food operators' biologic risk.
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Affiliation(s)
- Alessandra Fallucca
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Vincenzo Restivo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | | | - Marco Roveta
- Food Hygiene and Nutrition Service, Department of Prevention, Local Health Unit 3, 16142 Genoa, Italy
| | - Cecilia Trucchi
- Food Hygiene and Nutrition Service, Department of Prevention, Local Health Unit 3, 16142 Genoa, Italy
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Calagna G, Granese R, Giallombardo V, Capra G, Perino A, Schiattarella A, Trucchi C, Caridi G. Attitudes of mothers of pre-adolescent girls on HPV vaccine in Italy. Do we need a turning point? Minerva Obstet Gynecol 2022:S2724-606X.22.05153-3. [PMID: 36193834 DOI: 10.23736/s2724-606x.22.05153-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND To investigate the knowledge, awareness and attitude of mothers of preadolescent girls regarding the HPV vaccination and cervical cancer, and to understand how to improve the efficacy of the Italian vaccination campaign through the gathered data. METHODS A questionnaire-based survey was conducted in mothers of unvaccinated 9 to 12-year-old (yo) girls in Italy from November 2018 to July 2019, to evaluate their awareness and the attitude toward HPV, its vaccination and the information sources of the vaccination campaign. The selection of the distribution sites of the questionnaire was performed with randomization of 50 major places of aggregation located throughout the Italian territory. RESULTS Three hundred mothers of unvaccinated girls were included in the study and divided into two groups (191 subjects <45yo, 109 subjects >45yo). Results showed that 79.6% of <45yo knew what HPV is, compared to 60.6% of >45yo (p-value <0.001); only 60.2% (<45yo) and 54.1% (>45yo) showed awareness about the HPV vaccine (p-value 0.03). The percentage of parents against vaccination in pre-adolescent was higher in the >45yo (29.4%); however, most of them appeared favorable to the information campaigns regarding the vaccine (p-value <0.001). CONCLUSIONS Our study showed that mothers of unvaccinated pre-adolescent girls have suboptimal knowledge on the topic. Moreover, the implementation of communication strategies dedicated to the population segment appears as a central aspect. As HPV vaccination keeps being a public health concern, it is fundamental to understand which trigger should be managed by healthcare decision makers in order to boost the vaccination campaigns.
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Affiliation(s)
- Gloria Calagna
- Obstetrics and Gynecology Unit, Villa Sofia Cervello Hospital, University of Palermo, Palermo, Italy -
| | - Roberta Granese
- Obstetrics and Gynecology Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, A.O.U. G. Martino, Messina, Italy
| | - Vincenzo Giallombardo
- Obstetrics and Gynecology Unit, Azienda Sanitaria Provinciale di Palermo, Palermo, Italy
| | - Giuseppina Capra
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) G. D'Alessandro, University of Palermo, Palermo, Italy
| | - Antonino Perino
- IVF Unit, Azienda Sanitaria Provinciale di Palermo, Palermo, Italy
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Cecilia Trucchi
- Food Hygiene and Nutrition, Azienda Sociosanitaria Ligure 3 (A.S.L. 3), Genova, Italy
| | - Giorgio Caridi
- Social Media Marketing, Università E-Campus, Novedrate, Como, Italy
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Restivo V, Minutolo G, Battaglini A, Carli A, Capraro M, Gaeta M, Odone A, Trucchi C, Favaretti C, Vitale F, Casuccio A. Leadership Effectiveness in Healthcare Settings: A Systematic Review and Meta-Analysis of Cross-Sectional and Before-After Studies. Int J Environ Res Public Health 2022; 19:10995. [PMID: 36078706 PMCID: PMC9518077 DOI: 10.3390/ijerph191710995] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/25/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
To work efficiently in healthcare organizations and optimize resources, team members should agree with their leader's decisions critically. However, nowadays, little evidence is available in the literature. This systematic review and meta-analysis has assessed the effectiveness of leadership interventions in improving healthcare outcomes such as performance and guidelines adherence. Overall, the search strategies retrieved 3,155 records, and 21 of them were included in the meta-analysis. Two databases were used for manuscript research: PubMed and Scopus. On 16th December 2019 the researchers searched for articles published in the English language from 2015 to 2019. Considering the study designs, the pooled leadership effectiveness was 14.0% (95%CI 10.0-18.0%) in before-after studies, whereas the correlation coefficient between leadership interventions and healthcare outcomes was 0.22 (95%CI 0.15-0.28) in the cross-sectional studies. The multi-regression analysis in the cross-sectional studies showed a higher leadership effectiveness in South America (β = 0.56; 95%CI 0.13, 0.99), in private hospitals (β = 0.60; 95%CI 0.14, 1.06), and in medical specialty (β = 0.28; 95%CI 0.02, 0.54). These results encourage the improvement of leadership culture to increase performance and guideline adherence in healthcare settings. To reach this purpose, it would be useful to introduce a leadership curriculum following undergraduate medical courses.
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Affiliation(s)
- Vincenzo Restivo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Giuseppa Minutolo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Alberto Battaglini
- Vaccines and Clinical Trials Unit, Department of Health Sciences, University of Genova, Via Antonio Pastore 1, 16132 Genova, Italy
| | - Alberto Carli
- Santa Chiara Hospital, Largo Medaglie d’oro 9, 38122 Trento, Italy
| | - Michele Capraro
- School of Public Health, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Maddalena Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy
| | - Cecilia Trucchi
- Planning, Epidemiology and Prevention Unit, Liguria Health Authority (A.Li.Sa.), IRCCS San Martino Hospital, Largo R. Benzi 10, 16132 Genoa, Italy
| | - Carlo Favaretti
- Centre on Leadership in Medicine, Catholic University of the Sacred Heart, Largo F. Vito 1, 00168 Rome, Italy
| | - Francesco Vitale
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
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4
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Bassetti M, Vena A, Giacobbe DR, Trucchi C, Ansaldi F, Antonelli M, Adamkova V, Alicino C, Almyroudi MP, Atchade E, Azzini AM, Brugnaro P, Carannante N, Peghin M, Berruti M, Carnelutti A, Castaldo N, Corcione S, Cortegiani A, Dimopoulos G, Dubler S, García-Garmendia JL, Girardis M, Cornely OA, Ianniruberto S, Kullberg BJ, Lagrou K, Lebihan C, Luzzati R, Malbrain M, Merelli M, Marques AJ, Martin-Loeches I, Mesini A, Paiva JA, Raineri SM, Rautemaa-Richardson R, Schouten J, Spapen H, Tasioudis P, Timsit JF, Tisa V, Tumbarello M, Van den Berg CHSB, Veber B, Venditti M, Voiriot G, Wauters J, Zappella N, Montravers P. Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study. Infect Dis Ther 2022; 11:827-840. [PMID: 35182353 PMCID: PMC8960530 DOI: 10.1007/s40121-021-00585-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10-30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. METHODS We performed a case-control study in 26 European ICUs during the period January 2015-December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did not develop episodes of IAC during ICU admission. Matching was performed at a ratio of 1:1 according to time at risk (i.e. controls had to have at least the same length of ICU stay as their matched cases prior to IAC onset), ICU ward and period of study. RESULTS During the study period, 101 case patients with a diagnosis of IAC were included in the study. On univariate analysis, severe hepatic failure, prior receipt of antibiotics, prior receipt of parenteral nutrition, abdominal drain, prior bacterial infection, anastomotic leakage, recurrent gastrointestinal perforation, prior receipt of antifungal drugs and higher median number of abdominal surgical interventions were associated with IAC development. On multivariate analysis, recurrent gastrointestinal perforation (OR 13.90; 95% CI 2.65-72.82, p = 0.002), anastomotic leakage (OR 6.61; 95% CI 1.98-21.99, p = 0.002), abdominal drain (OR 6.58; 95% CI 1.73-25.06, p = 0.006), prior receipt of antifungal drugs (OR 4.26; 95% CI 1.04-17.46, p = 0.04) or antibiotics (OR 3.78; 95% CI 1.32-10.52, p = 0.01) were independently associated with IAC. CONCLUSIONS Gastrointestinal perforation, anastomotic leakage, abdominal drain and prior receipt of antifungals or antibiotics may help to identify critically ill patients with higher probability of developing IAC. Prospective studies are needed to identify which patients will benefit from early antifungal treatment.
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Affiliation(s)
- Matteo Bassetti
- Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, L.go R. Benzi 10, 16132, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Antonio Vena
- Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, L.go R. Benzi 10, 16132, Genoa, Italy.
- Department of Health Sciences, University of Genoa, Genoa, Italy.
| | - Daniele R Giacobbe
- Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, L.go R. Benzi 10, 16132, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Cecilia Trucchi
- A.Li.Sa. Liguria Health Authority, Genoa, Italy
- Healthcare Planning Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - Filippo Ansaldi
- A.Li.Sa. Liguria Health Authority, Genoa, Italy
- Healthcare Planning Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - Massimo Antonelli
- Department of Intensive Care Anesthesiology and Emercency Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Istituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Vaclava Adamkova
- Clinical Microbiology and ATB Centre, Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital, Prague, Czech Republic
- Department of Medical Microbiology, Medical Faculty of Palackeho University, Olomouc, Czech Republic
| | - Cristiano Alicino
- Medical Direction, Santa Corona Hospital, ASL 2 Regional Health System of Liguria, Pietra Ligure, Italy
| | | | - Enora Atchade
- Département d'Anesthésie-Réanimation, CHU Bichat-Claude Bernard, HUPNVS, APHP, Paris, France
| | - Anna M Azzini
- Department of Diagnostics and Public Health, Infectious Disease Unit, University of Verona, Verona, Italy
| | | | - Novella Carannante
- First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, Naples, Italy
| | - Maddalena Peghin
- Infectious Diseases Clinic, Santa Maria della Misericordia University Hospital of Udine, ASUFC, Udine, Italy
| | - Marco Berruti
- Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, L.go R. Benzi 10, 16132, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alessia Carnelutti
- Infectious Diseases Clinic, Santa Maria della Misericordia University Hospital of Udine, ASUFC, Udine, Italy
| | - Nadia Castaldo
- Infectious Diseases Clinic, Santa Maria della Misericordia University Hospital of Udine, ASUFC, Udine, Italy
| | - Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy
| | - Andrea Cortegiani
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy
- Department of Anesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy
| | - George Dimopoulos
- Department of Critical Care, University Hospital Attikon, Attikon Medical School, Νational and Kapodistrian University of Athens, Athens, Greece
| | - Simon Dubler
- Department of Anesthesiology and Intensive Care Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - José L García-Garmendia
- Servicio de Cuidados Críticos y Urgencias, Hospital San Juan de Dios del Aljarafe, Bormujos, Seville, Spain
| | - Massimo Girardis
- Department of Anesthesia and Intensive Care, University Hospital of Modena, Modena, Italy
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Stefano Ianniruberto
- Infectious Diseases Unit, Department of Medical and Surgical Science, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Bart Jan Kullberg
- Radboud Umc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katrien Lagrou
- Department of Laboratory Medicine and National Reference Centre for Mycosis, University Hospitals of Leuven, Leuven, Belgium
- Department of Microbiology and Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Clement Lebihan
- APHP; Medical and Infectious Diseases ICU (MI2), Bichat Hospital, 75018, Paris, France
| | - Roberto Luzzati
- Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata Di Trieste, Trieste, Italy
| | - Manu Malbrain
- Department of Intensive Care Medicine, University Hospital Brussels (UZB), 1090, Jette, Belgium
- Faculty of Medicine and Pharmacy, Vrije Unversiteit Brussel (VUB), 1090, Brussels, Belgium
| | - Maria Merelli
- Infectious Diseases Clinic, Santa Maria della Misericordia University Hospital of Udine, ASUFC, Udine, Italy
| | - Ana J Marques
- C.H. Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ignacio Martin-Loeches
- Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, Dublin, Ireland
- Centro de Investigación Biomedica En Red-Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, Respiratory Institute, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi I Sunyer - University of Barcelona, Barcelona, Spain
| | - Alessio Mesini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - José-Artur Paiva
- Department of Emergency and Intensive Care Medicine, Centro Hospitalar Universitário São João, Faculdade de Medicina da Universidade Do Porto E Grupo de Infecção E Sépsis, Porto, Portugal
| | - Santi Maurizio Raineri
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy
- Institute for Biomedical Research and Innovation (IRIB) - National Research Council (CNR), Palermo, Italy
| | - Riina Rautemaa-Richardson
- Faculty of Biology, Medicine and Health, Division of Evolution, Infection and Genomics, University of Manchester, Manchester, UK
- Department of Infectious Diseases, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Jeroen Schouten
- Radboud Umc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Herbert Spapen
- Universitair Ziekenhuis Brussel, VUB University, Brussels, Belgium
| | | | - Jean-François Timsit
- Université Paris Diderot/Hopital Bichat-Réanimation Medicale et Des Maladies Infectieuses, Paris, France
- UMR 1137-IAME Team 5-DeSCID: Decision Sciences in Infectious Diseases, Control and Care, Inserm/Univ Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Valentino Tisa
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Mario Tumbarello
- Institute of Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Benoit Veber
- Pole Anesthésie-Réanimation-SAMU, Rouen University Hospital, Rouen, France
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Guillaume Voiriot
- Service de Réanimation Et USC Médico-Chirurgicale, AP-HP, Hôpitaux Universitaires de L'Est Parisien, Pôle TVAR, Hôpital Tenon, Paris, France
| | - Joost Wauters
- Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, UK
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Astengo M, Paganino C, Amicizia D, Trucchi C, Tassinari F, Sticchi C, Sticchi L, Orsi A, Icardi G, Piazza MF, Di Silverio B, Deb A, Senese F, Prandi GM, Ansaldi F. Economic Burden of Pneumococcal Disease in Individuals Aged 15 Years and Older in the Liguria Region of Italy. Vaccines (Basel) 2021; 9:vaccines9121380. [PMID: 34960127 PMCID: PMC8706914 DOI: 10.3390/vaccines9121380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/11/2021] [Accepted: 11/20/2021] [Indexed: 11/23/2022] Open
Abstract
Despite the availability of vaccines against Streptococcus pneumoniae, the global incidence and economic cost of pneumococcal disease (PD) among adults is still high. This retrospective cohort analysis estimated the cost of emergency department (ED) visits/hospitalizations associated with non-invasive pneumonia and invasive pneumococcal disease among individuals ≥15 years of age in the Liguria region of Italy during 2012–2018. Data from the Liguria Region Administrative Health Databases and the Ligurian Chronic Condition Data Warehouse were used, including hospital admission date, length of stay, discharge date, outpatient visits, and laboratory/imaging procedures. A ≥30-day gap between two events defined a new episode, and patients with ≥1 ED or inpatient claim for PD were identified. The total mean annual number of hospitalizations for PD was 13,450, costing ~€49 million per year. Pneumonia accounted for the majority of hospitalization costs. The median annual cost of hospitalization for all-cause pneumonia was €38,416,440 (per-capita cost: €26.78) and was €30,353,928 (per-capita cost: €20.88) for pneumococcal and unspecified pneumonia. The total number and associated costs of ED visits/hospitalizations generally increased over the study period. PD still incurs high economic costs in adults in the Liguria region of Italy.
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Affiliation(s)
- Matteo Astengo
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (C.P.); (D.A.); (C.T.); (F.T.); (C.S.); (M.F.P.); (B.D.S.); (F.A.)
- Correspondence: ; Tel.: +39-0105488257
| | - Chiara Paganino
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (C.P.); (D.A.); (C.T.); (F.T.); (C.S.); (M.F.P.); (B.D.S.); (F.A.)
| | - Daniela Amicizia
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (C.P.); (D.A.); (C.T.); (F.T.); (C.S.); (M.F.P.); (B.D.S.); (F.A.)
| | - Cecilia Trucchi
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (C.P.); (D.A.); (C.T.); (F.T.); (C.S.); (M.F.P.); (B.D.S.); (F.A.)
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy; (L.S.); (A.O.); (G.I.)
| | - Federico Tassinari
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (C.P.); (D.A.); (C.T.); (F.T.); (C.S.); (M.F.P.); (B.D.S.); (F.A.)
| | - Camilla Sticchi
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (C.P.); (D.A.); (C.T.); (F.T.); (C.S.); (M.F.P.); (B.D.S.); (F.A.)
| | - Laura Sticchi
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy; (L.S.); (A.O.); (G.I.)
| | - Andrea Orsi
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy; (L.S.); (A.O.); (G.I.)
| | - Giancarlo Icardi
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy; (L.S.); (A.O.); (G.I.)
| | - Maria Francesca Piazza
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (C.P.); (D.A.); (C.T.); (F.T.); (C.S.); (M.F.P.); (B.D.S.); (F.A.)
| | - Bruno Di Silverio
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (C.P.); (D.A.); (C.T.); (F.T.); (C.S.); (M.F.P.); (B.D.S.); (F.A.)
| | - Arijita Deb
- Merck & Co., Inc., Kenilworth, NJ 07033, USA;
| | | | | | - Filippo Ansaldi
- Regional Health Agency of Liguria (ALiSa), 16121 Genoa, Italy; (C.P.); (D.A.); (C.T.); (F.T.); (C.S.); (M.F.P.); (B.D.S.); (F.A.)
- Department of Health Sciences (DiSSal), University of Genoa, 16132 Genoa, Italy; (L.S.); (A.O.); (G.I.)
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6
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Ponzio M, Tacchino A, Amicizia D, Piazza MF, Paganino C, Trucchi C, Astengo M, Simonetti S, Gallo D, Sansone A, Brichetto G, Battaglia MA, Ansaldi F. Prevalence of multiple sclerosis in Liguria region, Italy: an estimate using the capture-recapture method. Neurol Sci 2021; 43:3239-3245. [PMID: 34817728 PMCID: PMC9018629 DOI: 10.1007/s10072-021-05718-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/30/2021] [Indexed: 11/21/2022]
Affiliation(s)
- M Ponzio
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy.
| | - A Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - D Amicizia
- A.Li.Sa, Liguria Health Authority, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M F Piazza
- A.Li.Sa, Liguria Health Authority, Genoa, Italy
| | - C Paganino
- A.Li.Sa, Liguria Health Authority, Genoa, Italy
| | - C Trucchi
- A.Li.Sa, Liguria Health Authority, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M Astengo
- A.Li.Sa, Liguria Health Authority, Genoa, Italy
| | | | - D Gallo
- A.Li.Sa, Liguria Health Authority, Genoa, Italy
| | - A Sansone
- AISM Rehabilitation Centre Liguria, Italian Multiple Sclerosis Society, Genoa, Italy
| | - G Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy.,AISM Rehabilitation Centre Liguria, Italian Multiple Sclerosis Society, Genoa, Italy
| | - M A Battaglia
- Department of Life Sciences, University of Siena, Siena, Italy
| | - F Ansaldi
- A.Li.Sa, Liguria Health Authority, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
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7
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Ponzio M, Amicizia D, Brichetto G, Tacchino A, Piazza MF, Paganino C, Trucchi C, Astengo M, Battaglia MA, Ansaldi F. The Prevalence of Multiple Sclerosis in Liguria region, Italy, using the capture–recapture method. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In recent years, there has been a growing interest in developing methods based on health administrative databases to estimate prevalence of chronic diseases, hoping that this would lead to more precise and reliable estimates. The capture-recapture method can be used to improve the prevalence of a disease reducing the bias of case underestimation.
Objective
To assess the prevalence of multiple sclerosis (MS) in the Liguria region in Italy using routinely collected healthcare data.
Methods
Data from three sources collected in Liguria Health Authority (A.Li.Sa.) databases - hospital discharge records, drug-dispensing records, disease-specific payment exemptions from copayment to health care - and a capture-recapture method with log-linear models were used to estimate the prevalence of MS. The accuracy of the case-finding algorithm was tested using a sample of people residents in Liguria Region with a definite diagnosis of MS extracted from clinical records of Liguria AISM Rehabilitation Service as reference standard.
Results
The case-finding algorithm to capture people with MS from routinely collected healthcare data used in our study found an observed crude prevalence of MS in Liguria region on 31 December 2017, of 202.4 cases per 100,000 inhabitants (95% CI: 195.3-209.5). After linkage to clinical data, the algorithm showed a sensitivity of 82.7%, with 22.1% of MS cases undetected on capture-recapture models. Consequently, the capture-recapture method prevalence estimate of 259.7 per 100,000 inhabitants (95% CI: 251.7-267.8) suggest that this region constitutes a high-risk area for MS.
Conclusions
Our initial study of crude MS prevalence showed an overall regional prevalence of MS of 202.4 cases per 100,000, capture-recapture analysis would add another 20%, to those figures. This method could be considered a good alternative to the population-based study design for estimating the prevalence of MS.
Key messages
Studies based on routinely collected healthcare data could help estimate the prevalence of chronic disease. To reduce the bias of case underestimation, the capture–recapture method can be useful.
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Affiliation(s)
- M Ponzio
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - D Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - G Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
- AISM Rehabilitation Service, Italian Multiple Sclerosis Society, Genoa, Italy
| | - A Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
| | - MF Piazza
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - C Paganino
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - C Trucchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - M Astengo
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
| | - MA Battaglia
- Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy
- Department of Life Sciences, University of Siena, Siena, Italy
| | - F Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- A.Li.Sa., Liguria Health Authority, Genoa, Italy
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8
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Trucchi C, D'Amelio M, Amicizia D, Orsi A, Loiacono I, Tosatto R, Piazza MF, Paganino C, Pitrelli A, Icardi G, Ansaldi F. Lowering the recommended age for the free and active offer of influenza vaccination in Italy: clinical and economic impact analysis in the Liguria region. Hum Vaccin Immunother 2021; 17:1387-1395. [PMID: 33121342 PMCID: PMC8078656 DOI: 10.1080/21645515.2020.1810494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective we estimated the epidemiological and budget impact of lowering the recommended age for influenza immunization with quadrivalent vaccine actively offered and administered free of charge to persons over 50 years old by public immunization services. Methods a multi-cohort, deterministic, static Markov model was populated by real-world data on the clinical and economic impact of Influenza-Like Illness and Lower Respiratory Tract Infection over 1 year. Four scenarios featuring different vaccine coverage rates were compared with the base case; coverage rates in subjects with and without risk factors were considered separately. Results compared with the base case, adopting scenarios 1–4 would reduce the annual number of influenza cases by 6.5%, 10.8%, 13.8% and 3.4%, Emergency Department accesses by 10.7%, 9.1%, 15.4% and 4.6%, complications by 8.9%, 9.9%, 14.7% and 4.1%, and the hospitalization of complicated cases by 11%, 9.1%, 15.4% and 4.5%, respectively. The four scenarios would require an additional investment (vaccine purchase and administration) of €316,996, €529,174, €677,539, and €168,633, respectively, in comparison with the base case. Scenario 1 proved to be cost-saving in the 60–64-year age-group. The incremental costs of implementing the other hypothetical scenarios ranged from 2.7% (scenario 4) to 13.2% (scenario 3). Conclusions lowering the recommended age for influenza vaccination to 60 years would allow a high proportion of subjects at risk for severe influenza to be reached and would save money.
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Affiliation(s)
- Cecilia Trucchi
- Planning, Epidemiology and Prevention Unit, A.Li.Sa. Liguria Health Authority, Genoa, Italy.,IRCCS San Martino Hospital, Genoa, Italy
| | | | - Daniela Amicizia
- Planning, Epidemiology and Prevention Unit, A.Li.Sa. Liguria Health Authority, Genoa, Italy.,IRCCS San Martino Hospital, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Andrea Orsi
- IRCCS San Martino Hospital, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | | | - Maria Francesca Piazza
- Planning, Epidemiology and Prevention Unit, A.Li.Sa. Liguria Health Authority, Genoa, Italy
| | - Chiara Paganino
- Planning, Epidemiology and Prevention Unit, A.Li.Sa. Liguria Health Authority, Genoa, Italy
| | | | - Giancarlo Icardi
- IRCCS San Martino Hospital, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Filippo Ansaldi
- Planning, Epidemiology and Prevention Unit, A.Li.Sa. Liguria Health Authority, Genoa, Italy.,IRCCS San Martino Hospital, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
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9
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Icardi G, Costantino C, Guido M, Zizza A, Restivo V, Amicizia D, Tassinari F, Piazza MF, Paganino C, Casuccio A, Vitale F, Ansaldi F, Trucchi C. Burden and Prevention of HPV. Knowledge, Practices and Attitude Assessment Among Pre-Adolescents and their Parents in Italy. Curr Pharm Des 2020; 26:326-342. [PMID: 31942852 PMCID: PMC7527545 DOI: 10.2174/1381612826666200114100553] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 01/08/2020] [Indexed: 12/24/2022]
Abstract
Despite infections due to HPV nowadays represent the most common sexually transmitted diseases worldwide with recognized effective and safe preventive strategies, knowledge, attitudes; however, awareness on HPV is considerably low. The present study has two main objectives: 1. To conduct a literature review to analyze the evolution of preventive tools, the complexity of the vaccine choice process, and the challenges posed by HPV vaccine hesitancy and refusal among pre-adolescents and their parents; 2. To assess knowledge, practices and attitudes toward HPV infection and vaccination in a sample of Italian pre-adolescents and their parents. The observational study was carried out through the use of two anonymous and self-administered pre- and post-intervention questionnaires dedicated to the target populations. Between the administrations of the pre- and post-intervention questionnaires, an educational intervention on HPV infection and related diseases, and prevention strategies was conducted. All participants demonstrated suboptimal knowledge and positive attitudes in the pre-intervention questionnaire. Higher levels of knowledge and attitudes were observed among pre-adolescents thatused social networks and had heard of sexually transmitted diseases at home/school/physician and from parents and also who had heard of HPV from General Practitioners, Gynecologists, family members and newspapers. A significant increase in HPV vaccination awareness was observed among pre-adolescents after the educational sessions. Health education programs aimed at increasing knowledge, attitudes and awareness on HPV are needed to implement the outcomes of HPV immunization programs, especially if supported by the physicians involved in counselling and recommendation processes.
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Affiliation(s)
- Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,IRCCS San Martino Policlinic Hospital, Genoa, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE), University of Palermo, Italy
| | - Marcello Guido
- Department of Biological and Environmental Sciences and Technologies, Laboratory of Hygiene, University of the Salento, Lecce, Italy.,Inter-University Centre for Research of Influenza and other Transmissible Infections (C.I.R.I.- I.T.), Genova Italy
| | - Antonella Zizza
- National Research Council, Institute of Clinical Physiology, Campus Ecotekne, Lecce, Italy
| | - Vincenzo Restivo
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE), University of Palermo, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy.,IRCCS San Martino Policlinic Hospital, Genoa, Italy.,Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Liguria Region, Genova, Italy
| | | | - Maria Francesca Piazza
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Liguria Region, Genova, Italy
| | - Chiara Paganino
- Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Liguria Region, Genova, Italy
| | - Alessandra Casuccio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE), University of Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties (PROMISE), University of Palermo, Italy
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,IRCCS San Martino Policlinic Hospital, Genoa, Italy.,Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Liguria Region, Genova, Italy
| | - Cecilia Trucchi
- IRCCS San Martino Policlinic Hospital, Genoa, Italy.,Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Liguria Region, Genova, Italy
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10
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Giovanazzi G, Barbara A, Parente P, Restivo V, Selle V, Siddu A, Silenzi A, Trucchi C, Voglino G, gualano MR. Leadership in Public Health: an Italian learning experience. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The “Public Health Leadership” Working Group of Italian Society of Public Health (S.It.I.) organized a two-days Workshop in Verona in January 2020. Leadership is linked to capacity of inspiring people to craft and achieve vision and goals, to provide mentoring, coaching and recognition and to encouragement empowerment, allowing other leaders to emerge and high quality of care. As in others country, in Italy investing in new generations is fundamental and far-sighted to create Leadership culture in tomorrow's professionals.
Objectives
The Workshop aim was to immerse Public Health residents into Health Leadership. Two types of practical/interactive experiences (Design thinking and Barometer strategy) and three speakers' interventions aroused curiosity, suggesting innovative ways to manage emerging local and global healthcare problems. Are residents interested in Leadership? Do they think Leadership could influence, motivate and enable to contribute to organization effectiveness?
Results
100 residents (Male 52, Female 48), from 72% of Public Health Schools (26), attended Workshop: 46 of 1st, 23 of 2nd, 18 of 3rd and 13 of residency program last year. Satisfaction questionnaire was completed by 58 residents (7 points Likert scale from 1 [dissatisfied/not useful] to 7 [satisfied/useful]). 5.91 pts result in interventions satisfaction, increasing from 1st (5.84) to last year (6.00); interventions topics deepening results in 5.38 pts, decreasing from 1st (5.52) to last year (5.00). Overall satisfaction on practical/interactive activities was 5.89 and 5.83 pts results in these methodologies usefulness.
Conclusions
Health Leadership is a hot topic for residents; during residency program Leadership in not a main theme and residents want to improve non-technical skills to realise organization high quality of care. The practical/interactive activities were a winning choice to capture attention and cultivate mutual trust. This experience could be adapted in other countries.
Key messages
Teaching Leadership in Public Health is a main topic that needs to be strengthened in Public Health agenda. Italian Public Health residents are very interested in Health Leadership improvement during their trainings.
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Affiliation(s)
- G Giovanazzi
- School of Specialization in Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - A Barbara
- School of Specialization in Hygiene and Preventive Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - P Parente
- WHO Collaborating Centre for Leadership, Governance and HP, Catholic University of the Sacred Heart, Rome, Italy
| | - V Restivo
- Department of Health Promotion Sciences, University of Palermo, Palermo, Italy
| | - V Selle
- Unit of Hygiene and Public Health, AULSS 3 Serenissima, Venice, Italy
| | - A Siddu
- National Institute of Health, Rome, Italy
| | - A Silenzi
- Centre for Leadership in Medicine Research and Studies, Catholic University of the Sacred Heart, Rome, Italy
- Strategic Directorate, Brescia Agency for Health Protection, Brescia, Italy
| | - C Trucchi
- A.Li.Sa. Liguria Health Authority, Genoa, Italy
| | - G Voglino
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - M R gualano
- Department of Public Health Sciences, University of Turin, Turin, Italy
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11
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Restivo V, Gaeta M, Odone A, Trucchi C, Battaglini A, Carli A, Capraro M, Minutolo G, Casuccio A, Favaretti C. The effectiveness of leadership: meta-analysis of trial, cross-sectional, and before after studies. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The clinical and surgical procedures are often based on scientifical evidence but 30-40% of patients do not receive treatment according to evidence based medicine. The main aim of this review and meta-analysis is to assess the effectiveness of leadership in healthcare setting.
Methods
It was conducted a literature research on MEDLINE, Pubmed and Scopus with publication year between 2015 and 2019. The inclusion criteria were studies involving healthcare workers that evaluated effectiveness of opinion leaders in improving behaviour of healthcare workers, according to clinical or patient related outcomes. The quality of studies were assesed with the NHLBI for before after studies and the NOS for other study designs. The effect of leadership was assessed as risk difference for all studies with the exception of cross sectional studies. For the last it was evaluated correlation between leadership level and outcome measurment.
Results
A total of 3,155 articles were screened and 284 were fully assessed including 22 of them in the final database: 1 randomized trial, 9 cross sectional and 12 before after studies. For the cross-sectional studies there was a correlation of 0.22 (95% CI 0.15-0.28) between leadership level and outcome measurment. In the metaregression analysis the only factor that increased the correlation was private setting (meta regression coefficent =0.52, p = 0.022). The pooled efficacy was 24% (95% CI 10%-17%) for before after studies. Furthermore, a higher effectiveness was revealed in studies conducted on multi professional (24%) than single professional (9%) healthcare workers.
Conclusions
According to results, the guidelines adherence and task performance increased in a setting with leadership implementation. The leadership effectiveness appears comparable to other strategies as audit and feedback used to implement evidence-based practice in worldwide healthcare.
Key messages
The translation of evidence into clinical practice is often difficult but this study suggests that leaderhip can had higher effectiveness in multiprofessional healthcare workers and private setting. The effectiveness of leadership in this review suggests that it can be of help in order to make aware healthcare professionals about effectiveness of comply with evidence-based practice.
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Affiliation(s)
- V Restivo
- Department PROMISE, University of Palermo, Palermo, Italy
| | - M Gaeta
- Department of Public Health, Experimental and Forensic Medic, University of Pavia, Pavia, Italy
| | - A Odone
- School of Public Health, University Vita-Salute San Raffaele, Milan, Italy
| | - C Trucchi
- Department of Health Sciences, University of Genoa and IRCSS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Battaglini
- Department of Health Sciences, University of Genoa and IRCSS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Carli
- Department of Medical Direction, Maggiore della Carità University Hospital of Novara, Novara, Italy
| | - M Capraro
- School of Public Health, University Vita-Salute San Raffaele, Milan, Italy
| | - G Minutolo
- Department PROMISE, University of Palermo, Palermo, Italy
| | - A Casuccio
- Department PROMISE, University of Palermo, Palermo, Italy
| | - C Favaretti
- Centre for Leadership in Medicine, Catholic University of the Sacred Heart, Rome, Italy
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12
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Costantino C, Restivo V, Trucchi C, Vella C, Sannasardo CE, Caracci F, Scarpitta F, Icardi G, Casuccio A, Vitale F. Pre-post school educational intervention assessment on HPV vaccination attitudes and willingness. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In Italy, vaccination coverage against human Papilloma Virus (HPV) showed a decreasing trend during last years. Different reasons could lead to a decrease in HPV vaccination confidence, such as not taking part to school seminars on HPV infection and vaccination. A pre-post intervention study was conducted in order to assess the improvement of knowledge, attitudes and behavior on HPV-related diseases and willingness on HPV vaccination among secondary school students.
Methods
Two anonymous pre-post intervention questionnaires made up of 25 and 8 items, respectively, were administered to a representative sample of students attending secondary schools of Palermo, Italy. Between the two questionnaire administration, an educational intervention on HPV-related diseases and HPV vaccination, conducted by Public Health medical residents at the University of Palermo, was carried out.
Results
During 2017/2018 and 2018/2019 school years, a sample of 1702 students, attending 18 first-grade secondary schools of the Province of Palermo, was enrolled. Evaluating a 10-scale likert question on the willingness of the children regarding vaccination against HPV, a significant increase of the average score from 8.50 (SD ± 1.79) to 9.01 (SD ± 1.50) (p value <0.001) was observed after intervention. At the multivariate analysis, male students (adjOR 1.76; 95% CI 1.28-2.42) and students attending schools in areas with a high deprivation index (adjOR 1.25; CI 95 % 1.01-1.55), showed a lower increase in HPV vaccination willingness after the educational intervention. In addition, 188 children from 5 schools of more deprived areas, not yet immunized, were vaccinated against HPV.
Conclusions
Standardized educational interventions in the school environment could increase confidence towards HPV and other vaccinations among students. Furthermore, vaccination offer at schools could represent a fundamental strategy to increase vaccination coverage, especially in more deprived areas.
Key messages
The research confirms the effectiveness of school educational interventions in increasing HPV vaccination confidence. Vaccination offer at schools could represent a fundamental strategy to increase vaccination coverage especially in more deprived areas.
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Affiliation(s)
- C Costantino
- Department of Health Promotion, University of Palermo, Palermo, Italy
| | - V Restivo
- Department of Health Promotion, University of Palermo, Palermo, Italy
| | - C Trucchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - C Vella
- Department of Health Promotion, University of Palermo, Palermo, Italy
| | - C E Sannasardo
- Department of Health Promotion, University of Palermo, Palermo, Italy
| | - F Caracci
- Department of Health Promotion, University of Palermo, Palermo, Italy
| | - F Scarpitta
- Department of Health Promotion, University of Palermo, Palermo, Italy
| | - G Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - A Casuccio
- Department of Health Promotion, University of Palermo, Palermo, Italy
| | - F Vitale
- Department of Health Promotion, University of Palermo, Palermo, Italy
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13
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Bassetti M, Ansaldi F, Icardi G, Pelosi P, Robba C, Taramasso L, Trucchi C, Vena A, Giacobbe DR. COVID-19: Some clinical questions after the first 4 months. Eur J Clin Invest 2020; 50:e13326. [PMID: 32562550 PMCID: PMC7323159 DOI: 10.1111/eci.13326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/12/2020] [Accepted: 06/13/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Matteo Bassetti
- Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Health Planning Unit, Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Genoa, Italy.,Health Planning Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Hygiene Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - Paolo Pelosi
- Anaesthesia and Intensive Care, Ospedale Policlinico San Martino - IRCCS for Oncology and Neuroscience, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Chiara Robba
- Anaesthesia and Intensive Care, Ospedale Policlinico San Martino - IRCCS for Oncology and Neuroscience, Genoa, Italy
| | - Lucia Taramasso
- Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - Cecilia Trucchi
- Health Planning Unit, Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Genoa, Italy.,Health Planning Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
| | - Antonio Vena
- Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
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14
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Ballarino P, Cervellin G, Trucchi C, Altomonte F, Bertini A, Bonfanti L, Bressan MA, Carpinteri G, Noto P, Gavelli F, Molinari L, Patrucco F, Sainaghi PP, Caristia S, Cavazza M, Gallitelli M, Longo S, Cremonesi P, Orsi A, Ansaldi F, Marino R, Di Somma S, Castello LM, Moscatelli P, Avanzi GC. An Italian registry of chest pain patients in the emergency department: clinical predictors of acute coronary syndrome. Minerva Med 2020; 111:120-132. [PMID: 32338841 DOI: 10.23736/s0026-4806.20.06472-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The aim of this study was to describe the population of patients arriving in several Italian Emergency Departments (EDs) complaining of chest pain suggestive of acute coronary syndrome (ACS) in order to evaluate the incidence of ACS in this cohort and the association between ACS and different clinical parameters and risk factors. METHODS This is an observational prospective study, conducted from the 1st January to the 31st December 2014 in 11 EDs in Italy. Patients presenting to ED with chest pain, suggestive of ACS, were consecutively enrolled. RESULTS Patients with a diagnosis of ACS (N.=1800) resulted to be statistically significant older than those without ACS (NO ACS; N.=4630) (median age: 70 vs. 59, P<0.001), and with a higher prevalence of males (66.1% in ACS vs. 57.5% in NO ACS, P<0.001). ECG evaluation, obtained at ED admission, showed new onset alterations in 6.2% of NO ACS and 67.4% of ACS patients. Multiple logistic regression analysis showed that the following parameters were predictive for ACS: age, gender, to be on therapy for cardio-vascular disease (CVD), current smoke, hypertension, hypercholesterolemia, heart rate, ECG alterations, increased BMI, reduced SaO2. CONCLUSIONS Results from this observational study strengthen the importance of the role of the EDs in ruling in and out chest pain patients for the diagnosis of ACS. The analysis put in light important clinical and risk factors that, if promptly recognized, can help Emergency Physicians to identify patients who are more likely to be suffering from ACS.
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Affiliation(s)
- Paola Ballarino
- Emergency Department, San Martino University Hospital, Genoa, Italy
| | | | - Cecilia Trucchi
- Department of Health Science, University of Genoa, Genoa, Italy
| | | | | | - Laura Bonfanti
- Emergency Department, Parma University Hospital, Parma, Italy
| | - Maria A Bressan
- Emergency Department, San Matteo University Hospital, Pavia, Italy
| | | | - Paola Noto
- Emergency Department, Vittorio Emanuele University Hospital, Catania, Italy
| | - Francesco Gavelli
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Emergency Department, Maggiore della Carità University Hospital, Novara, Italy
| | - Luca Molinari
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Emergency Department, Maggiore della Carità University Hospital, Novara, Italy
| | - Filippo Patrucco
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Emergency Department, Maggiore della Carità University Hospital, Novara, Italy
| | - Pier Paolo Sainaghi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Emergency Department, Maggiore della Carità University Hospital, Novara, Italy
| | - Silvia Caristia
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Emergency Department, Maggiore della Carità University Hospital, Novara, Italy
| | - Mario Cavazza
- Emergency Department, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Mauro Gallitelli
- Emergency Department, SS Giovanni e Paolo Hospital, Venice, Italy
| | - Stefania Longo
- Internal Medicine and Emergency Department, Bari University Hospital, Bari, Italy
| | | | - Andrea Orsi
- Department of Health Science, University of Genoa, Genoa, Italy
| | - Filippo Ansaldi
- Department of Health Science, University of Genoa, Genoa, Italy
| | - Rossella Marino
- Department of Medical-Surgery Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Salvatore Di Somma
- Department of Medical-Surgery Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Luigi M Castello
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy - .,Emergency Department, Maggiore della Carità University Hospital, Novara, Italy
| | - Paolo Moscatelli
- Emergency Department, San Martino University Hospital, Genoa, Italy
| | - Gian Carlo Avanzi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Emergency Department, Maggiore della Carità University Hospital, Novara, Italy
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Trucchi C, Paganino C, Orsi A, Amicizia D, Tisa V, Piazza MF, Gallo D, Simonetti S, Buonopane B, Icardi G, Ansaldi F. Hospital and economic burden of influenza-like illness and lower respiratory tract infection in adults ≥50 years-old. BMC Health Serv Res 2019; 19:585. [PMID: 31426795 PMCID: PMC6700791 DOI: 10.1186/s12913-019-4412-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/08/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Influenza-like illnesses (ILIs) and lower respiratory tract infections (LRTIs) cause substantial morbidity and mortality worldwide. The study assessed the health and economic burden of ILI and LRTI according to age and comorbidities, since available evidence is limited and heterogeneous. METHOD The prevalence of comorbidities, the seasonal incidence rates and the mean and per capita direct costs of ED accesses for ILI/LRTI, whether followed by hospitalization or not, recorded in adults aged ≥50 years over the last 6 years, in the referral hospitals located in the Genoese metropolitan area (Liguria, Italy) where the syndromic surveillance system is active, were evaluated through a retrospective observational study. Comorbidities were estimated through the Chronic Condition Data Warehouse that integrates multiple Medicare data sources. A comparison with the administrative healthcare International Classification of Diseases-9th revision-Clinical Modification (ICD-9-CM)-based data was also conducted. RESULTS The prevalence of subjects with ≥1 comorbidity ranged from 23.49 to 59.92%. The most prevalent all-age comorbidities were cardiovascular diseases and cancer. The overall ILI/LRTI incidence rate was 6.73/1000 person-years, almost double the value derived from routine data, and increased with age. The highest rates were observed in patients with renal failure and bronchopneumopathies. The mean cost of ED accesses/hospitalization for ILI/LRTI was €3353 and was almost twice as high in the ≥85 years as in the youngest age-group. The highest mean costs were observed in patients with renal failure and cancer. The per capita costs increased from €4 to €71 with age, and were highest in patients with renal failure and bronchopneumopathy. CONCLUSION The burden of ILIs/LRTIs in terms of ED accesses and hospitalizations in adults aged ≥50 years is heavy, and is related to increasing age and, especially, to specific comorbidities. These results could contribute to revising age- and risk-based anti-influenza and -pneumococcus immunization strategies.
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Affiliation(s)
| | | | - Andrea Orsi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Hygiene Unit, San Martino Polyclinic Hospital, Genoa, Italy
| | - Daniela Amicizia
- Azienda Ligure Sanitaria (A.Li.Sa.), Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Valentino Tisa
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Maria Francesca Piazza
- Azienda Ligure Sanitaria (A.Li.Sa.), Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | | | | | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Hygiene Unit, San Martino Polyclinic Hospital, Genoa, Italy
| | - Filippo Ansaldi
- Azienda Ligure Sanitaria (A.Li.Sa.), Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
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16
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Bassetti M, Giacobbe DR, Vena A, Trucchi C, Ansaldi F, Antonelli M, Adamkova V, Alicino C, Almyroudi MP, Atchade E, Azzini AM, Carannante N, Carnelutti A, Corcione S, Cortegiani A, Dimopoulos G, Dubler S, García-Garmendia JL, Girardis M, Cornely OA, Ianniruberto S, Kullberg BJ, Lagrou K, Le Bihan C, Luzzati R, Malbrain MLNG, Merelli M, Marques AJ, Martin-Loeches I, Mesini A, Paiva JA, Peghin M, Raineri SM, Rautemaa-Richardson R, Schouten J, Brugnaro P, Spapen H, Tasioudis P, Timsit JF, Tisa V, Tumbarello M, van den Berg CHSB, Veber B, Venditti M, Voiriot G, Wauters J, Montravers P. Incidence and outcome of invasive candidiasis in intensive care units (ICUs) in Europe: results of the EUCANDICU project. Crit Care 2019; 23:219. [PMID: 31200780 PMCID: PMC6567430 DOI: 10.1186/s13054-019-2497-3] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 05/28/2019] [Indexed: 01/26/2023]
Abstract
Background The objective of this study was to assess the cumulative incidence of invasive candidiasis (IC) in intensive care units (ICUs) in Europe. Methods A multinational, multicenter, retrospective study was conducted in 23 ICUs in 9 European countries, representing the first phase of the candidemia/intra-abdominal candidiasis in European ICU project (EUCANDICU). Results During the study period, 570 episodes of ICU-acquired IC were observed, with a cumulative incidence of 7.07 episodes per 1000 ICU admissions, with important between-center variability. Separated, non-mutually exclusive cumulative incidences of candidemia and IAC were 5.52 and 1.84 episodes per 1000 ICU admissions, respectively. Crude 30-day mortality was 42%. Age (odds ratio [OR] 1.04 per year, 95% CI 1.02–1.06, p < 0.001), severe hepatic failure (OR 3.25, 95% 1.31–8.08, p 0.011), SOFA score at the onset of IC (OR 1.11 per point, 95% CI 1.04–1.17, p 0.001), and septic shock (OR 2.12, 95% CI 1.24–3.63, p 0.006) were associated with increased 30-day mortality in a secondary, exploratory analysis. Conclusions The cumulative incidence of IC in 23 European ICUs was 7.07 episodes per 1000 ICU admissions. Future in-depth analyses will allow explaining part of the observed between-center variability, with the ultimate aim of helping to improve local infection control and antifungal stewardship projects and interventions.
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Affiliation(s)
- Matteo Bassetti
- Infectious Diseases Clinic, Department of Medicine University of Udine and Santa Maria Misericordia Hospital, Piazzale Santa Maria della Misericordia 15, 33100, Udine, Italy. .,Department of Health Sciences, University of Genoa, Genoa, Italy.
| | | | - Antonio Vena
- Infectious Diseases Clinic, Department of Medicine University of Udine and Santa Maria Misericordia Hospital, Piazzale Santa Maria della Misericordia 15, 33100, Udine, Italy
| | - Cecilia Trucchi
- Health Planning unit, Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Liguria Region, Italy.,Health Planning unit, Policlinic San Martino Hospital - IRCCS, Genoa, Italy
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Health Planning unit, Azienda Ligure Sanitaria della Regione Liguria (A.Li.Sa.), Liguria Region, Italy.,Health Planning unit, Policlinic San Martino Hospital - IRCCS, Genoa, Italy
| | - Massimo Antonelli
- Department of Intensive Care and Anesthesiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Vaclava Adamkova
- Clinical Microbiology and ATB Centre, Institute of Medical Biochemistry and Laboratory Diagnostics, General University Hospital, Prague, Czech Republic.,Department of Medical Microbiology, Medical Faculty of Palackeho University, Olomouc, Czech Republic
| | - Cristiano Alicino
- Department of Health Sciences, University of Genoa, Genoa, Italy.,Medical Direction, Santa Corona Hospital, ASL 2 Regional Health System of Liguria, Pietra Ligure, Italy
| | - Maria-Panagiota Almyroudi
- Department of Critical Care, University Hospital Attikon, Medical School, University of Athens, Athens, Greece
| | - Enora Atchade
- Département d'Anesthésie-Réanimation, CHU Bichat-Claude Bernard, HUPNVS, APHP, Paris, France
| | - Anna M Azzini
- Department of Diagnostics and Public Health, Infectious Disease Unit, University of Verona, Verona, Italy
| | | | - Alessia Carnelutti
- Infectious Diseases Clinic, Department of Medicine University of Udine and Santa Maria Misericordia Hospital, Piazzale Santa Maria della Misericordia 15, 33100, Udine, Italy
| | - Silvia Corcione
- Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy
| | - Andrea Cortegiani
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy
| | - George Dimopoulos
- Department of Critical Care, University Hospital Attikon, Medical School, University of Athens, Athens, Greece
| | - Simon Dubler
- Department of Anesthesiology and Intensive Care Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - José L García-Garmendia
- Servicio de Cuidados Críticos y Urgencias, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, Spain
| | - Massimo Girardis
- Department of Anesthesia and Intensive Care, University Hospital of Modena, Modena, Italy
| | - Oliver A Cornely
- Department I of Internal Medicine, University Hospital of Cologne and Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Stefano Ianniruberto
- Infectious Diseases Unit, Department of Medical and Surgical Science, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Bart Jan Kullberg
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katrien Lagrou
- Department of Laboratory Medicine and National Reference Centre for Mycosis, University Hospitals of Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Clement Le Bihan
- Bichat-Réanimation médicale et des maladies infectieuses, Medical ICU, Paris, France
| | - Roberto Luzzati
- Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Manu L N G Malbrain
- Department of Intensive Care Medicine, University Hospital Brussels (UZB), Jette, Belgium and Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maria Merelli
- Infectious Diseases Clinic, Department of Medicine University of Udine and Santa Maria Misericordia Hospital, Piazzale Santa Maria della Misericordia 15, 33100, Udine, Italy
| | - Ana J Marques
- C.H. Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ignacio Martin-Loeches
- Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James's Hospital, Dublin, Ireland.,Hospital Clinic, IDIBAPS,CIBERes, universidad de Barcelona, Barcelona, Spain
| | - Alessio Mesini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - José-Artur Paiva
- Department of Emergency and Intensive Care Medicine, Centro Hospitalar Universitário São João, Faculdade de Medicina da Universidade do Porto e Grupo de Infecção e Sépsis, Porto, Portugal
| | - Maddalena Peghin
- Infectious Diseases Clinic, Department of Medicine University of Udine and Santa Maria Misericordia Hospital, Piazzale Santa Maria della Misericordia 15, 33100, Udine, Italy
| | - Santi Maurizio Raineri
- Department of Biopathology and Medical Biotechnologies, Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico P. Giaccone, University of Palermo, Palermo, Italy
| | - Riina Rautemaa-Richardson
- Department of Infectious Diseases, Manchester University NHS Foundation Trust, Wythenshawe Hospital; and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jeroen Schouten
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Pierluigi Brugnaro
- Infectious Diseases Department, Ospedale Civile SS. Giovanni e Paolo, Venice, Italy
| | - Herbert Spapen
- Intensive Care Department, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | | | - Jean-François Timsit
- Université Paris Diderot/Hopital Bichat-Réanimation Medicale et Des Maladies Infectieuses, Paris, France.,UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases, Control and Care, Inserm/Univ Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Valentino Tisa
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Mario Tumbarello
- Institute of Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Benoit Veber
- Pole Anesthésie-Réanimation-SAMU, Rouen University Hospital, Rouen, France
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Guillaume Voiriot
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de réanimation médico-chirurgicale, Hôpital Tenon, 75020, Paris, France
| | - Joost Wauters
- Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Philippe Montravers
- Département d'Anesthésie-Réanimation, CHU Bichat-Claude Bernard, HUPNVS, APHP, Paris, France.,Université de Paris, INSERM UMR 1152, Paris, France
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Trucchi C, Paganino C, Amicizia D, Orsi A, Tisa V, Piazza MF, Icardi G, Ansaldi F. Universal influenza virus vaccines: what needs to happen next? Expert Opin Biol Ther 2019; 19:671-683. [PMID: 30957589 DOI: 10.1080/14712598.2019.1604671] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Influenza occurs worldwide and causes significant disease burden in terms of morbidity, associated complications, hospitalizations, and deaths. Vaccination constitutes the primary approach for controlling influenza. Current influenza vaccines elicit a strain-specific response yet occasionally exhibit suboptimal effectiveness. This review describes the limits of available immunization tools and the future prospects and potentiality of universal influenza vaccines. AREAS COVERED New 'universal' vaccines, which are presently under development, are expected to overcome the problems related to the high variability of influenza viruses, such as the need for seasonal vaccine updates and re-vaccination. Here, we explore vaccines based on the highly conserved epitopes of the HA, NA, or extracellular domain of the influenza M2 protein, along with those based on the internal proteins such as NP and M1. EXPERT OPINION The development of a universal influenza vaccine that confers protection against homologous, drifted, and shifted influenza virus strains could obviate the need for annual reformulation and mitigate disease burden. The scientific community has long been awaiting the advent of universal influenza vaccines; these are currently under development in laboratories worldwide. If such vaccines are immunogenic, efficacious, and able to confer long-lasting immunity, they might be integrated with or supplant traditional influenza vaccines.
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Affiliation(s)
- Cecilia Trucchi
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy.,b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy
| | - Chiara Paganino
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy
| | - Daniela Amicizia
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy.,b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Andrea Orsi
- b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Valentino Tisa
- c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Maria Francesca Piazza
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Giancarlo Icardi
- b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Filippo Ansaldi
- a Health Planning Unit , Liguria Health Authority (A.Li.Sa) , Genoa , Italy.,b Hygiene Unit , Ospedale Policlinico San Martino IRCCS teaching hospital , Genoa , Italy.,c Department of Health Sciences , University of Genoa , Genoa , Italy
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18
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Restivo V, Orsi A, Ciampini S, Messano GA, Trucchi C, Ventura G, Casuccio A, Vitale F. How should vaccination services be planned, organized, and managed? Results from a survey on the Italian vaccination services. Ann Ig 2019; 31:45-53. [PMID: 30994163 DOI: 10.7416/ai.2019.2276] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Quality improvement is an increasingly recognized approach to maximize service effectiveness and minimize costs in public health. However, the Italian law never provided for the institutional accreditation of vaccination services. Furthermore, a recently approved law added six more compulsory vaccinations to the original four, which has led to a considerable increase in vaccination efforts, without any previous resources evaluation. The aim of the study was to investigate structural, organizational and managerial characteristics of the Italian vaccination services, in order to suggest the adoption of adequate quality standards. STUDY DESIGN A survey involving the representatives of the Italian Regions and Autonomous Provinces was performed between September 2017 and September 2018. METHODS An online questionnaire, including 26 items, designed to evaluate the structural, organizational and managerial characteristics of vaccination services was administered. The correlation between the number of vaccination centres and the coverage for each region was used to evaluate the performance of the vaccination services. RESULTS Respondents from seven Regions, totaling >15,000,000 inhabitants, answered the questionnaire. Overall, each vaccination service was potentially accessed by an average of 519 children aged zero to 24 months, with a β-coefficient of -0.87 (p = 0.01) for infant vaccination coverage in 2016. Eighty-five percent of vaccination services were provided with architectural features to accommodate the disabled but only 49% provided reserved parking lots. An average of 0.4 physicians and 0.6 other healthcare workers per 10,000 inhabitants were employed in vaccination services, with complete computerization in 74% of them. CONCLUSION The inverse relation between vaccination services' spatial accessibility and vaccination coverage suggests that distance and accessibility of vaccination services should be considered in planning. This survey constitutes a baseline data for Italian vaccination services that could be useful for decision makers in establishing minimum requirements to provide high-quality preventive healthcare service.
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Affiliation(s)
- V Restivo
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Specialties of Excellence "G. D'Alessandro", University of Palermo, Italy
| | - A Orsi
- Department of Health Sciences, University of Genoa, "Ospedale Policlinico San Martino IRCCS" Teaching Hospital, Genoa, Ital
| | | | - G A Messano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Ital
| | - C Trucchi
- Department of Health Sciences, University of Genoa, "Ospedale Policlinico San Martino IRCCS" Teaching Hospital, Genoa, Ital
| | - G Ventura
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Specialties of Excellence "G. D'Alessandro", University of Palermo, Italy
| | - A Casuccio
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Specialties of Excellence "G. D'Alessandro", University of Palermo, Italy
| | - F Vitale
- Department of Health Promotion, Mother-Child Care, Internal Medicine and Specialties of Excellence "G. D'Alessandro", University of Palermo, Italy
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19
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Bassetti M, Righi E, Del Giacomo P, Sartor A, Ansaldi F, Trucchi C, Alicino C, Trecarichi EM, Spanu T, Paganino C, Tumbarello M, Carnelutti A. Predictors of Mortality with Staphylococcus aureus Bacteremia in Elderly Adults. J Am Geriatr Soc 2018; 66:1284-1289. [PMID: 29664994 DOI: 10.1111/jgs.15391] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To analyze risk factors for early and late mortality in individuals aged 75 and older with Staphylococcus aureus bacteremia (SAB) in Italy. DESIGN Four-year retrospective observational study (January 2011-December 2014). SETTING Two tertiary care university hospitals in Italy (Santa Maria Misericordia Hospital in Udine, Policlinico Universitario Agostino Gemelli in Rome). PARTICIPANTS All adults consecutively admitted with SAB. MEASUREMENTS Clinical presentation, infection characteristics, and clinical outcomes of individuals aged 75 and older were compared with those of individuals younger than 75. RESULTS Three hundred thirty-seven cases of SAB were diagnosed during the study period, 118 of which (35%) occurred in those aged 75 and older. Seven- (20.3% vs 9.2%) and 30-day (35.7% vs 20.7%) mortality were significantly higher in elderly than younger adults. Clinical presentation with septic shock, adequacy of empiric antibiotic treatment, and liver cirrhosis were found to be predictors of 7-day mortality in elderly adults with SAB. Risk factors independently associated with 30-day mortality included isolation of methicillin-resistant Staphylococcus aureus (MRSA) and not receiving an infectious disease consultation. CONCLUSION Mortality is significantly higher in elderly than in younger adults with SAB, particularly in those presenting with septic shock, liver cirrhosis, or SAB due to MRSA. Additional risk factors for mortality included inappropriate empiric antibiotic treatment and not receiving an infectious disease consultation.
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Affiliation(s)
- Matteo Bassetti
- Santa Maria Misericordia Hospital and University of Udine, Udine, Italy
| | - Elda Righi
- Santa Maria Misericordia Hospital and University of Udine, Udine, Italy
| | - Paola Del Giacomo
- Institute of Infectious Diseases, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Assunta Sartor
- Santa Maria Misericordia Hospital and University of Udine, Udine, Italy
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Cecilia Trucchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Enrico Maria Trecarichi
- Institute of Infectious Diseases, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Teresa Spanu
- Institute of Microbiology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Chiara Paganino
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Mario Tumbarello
- Institute of Infectious Diseases, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
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Orsi A, Colomba GME, Pojero F, Calamusa G, Alicino C, Trucchi C, Canepa P, Ansaldi F, Vitale F, Tramuto F. Trends of influenza B during the 2010-2016 seasons in 2 regions of north and south Italy: The impact of the vaccine mismatch on influenza immunisation strategy. Hum Vaccin Immunother 2018; 14:523-531. [PMID: 28708953 PMCID: PMC5861802 DOI: 10.1080/21645515.2017.1342907] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/22/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022] Open
Abstract
Influenza A and B viruses are responsible for respiratory infections, representing globally seasonal threats to human health. The 2 viral types often co-circulate and influenza B plays an important role in the spread of infection. A 6-year retrospective surveillance study was conducted between 2010 and 2016 in 2 large administrative regions of Italy, located in the north (Liguria) and in the south (Sicily) of the country, to describe the burden and epidemiology of both B/Victoria and B/Yamagata lineages in different healthcare settings. Influenza B viruses were detected in 5 of 6 seasonal outbreaks, exceeding influenza A during the season 2012-2013. Most of influenza B infections were found in children aged ≤ 14 y and significant differences were observed in the age-groups infected by the different lineages. B/Victoria strains prevailed in younger population than B/Yamagata, but also were more frequently found in the community setting. Conversely, B/Yamagata viruses were prevalent among hospitalized cases suggesting their potential role in the development of more severe disease. The relative proportions of viral lineages varied from year to year, resulting in different lineage-level mismatch for the B component of trivalent influenza vaccine. Our findings confirmed the need for continuous virological surveillance of seasonal epidemics and bring attention to the adoption of universal influenza immunization program in the childhood. The use of tetravalent vaccine formulations may be useful to improve the prevention and control of the influenza burden in general population.
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Affiliation(s)
- Andrea Orsi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS University Hospital “San Martino” - IST National Institute for Cancer Research, Genoa, Italy
| | - Giuseppina Maria Elena Colomba
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
| | - Fanny Pojero
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
| | - Giuseppe Calamusa
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
| | | | - Cecilia Trucchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Paola Canepa
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit, IRCCS University Hospital “San Martino” - IST National Institute for Cancer Research, Genoa, Italy
| | - Francesco Vitale
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
- Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, Palermo, Italy
| | - Fabio Tramuto
- Department of Health Promotion Sciences and Mother-Child Care “G. D'Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
- Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, Palermo, Italy
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Alicino C, Paganino C, Orsi A, Astengo M, Trucchi C, Icardi G, Ansaldi F. The impact of 10-valent and 13-valent pneumococcal conjugate vaccines on hospitalization for pneumonia in children: A systematic review and meta-analysis. Vaccine 2017; 35:5776-5785. [DOI: 10.1016/j.vaccine.2017.09.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 08/28/2017] [Accepted: 09/01/2017] [Indexed: 10/18/2022]
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Bragazzi NL, Alicino C, Trucchi C, Paganino C, Barberis I, Martini M, Sticchi L, Trinka E, Brigo F, Ansaldi F, Icardi G, Orsi A. Global reaction to the recent outbreaks of Zika virus: Insights from a Big Data analysis. PLoS One 2017; 12:e0185263. [PMID: 28934352 PMCID: PMC5608413 DOI: 10.1371/journal.pone.0185263] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 09/08/2017] [Indexed: 01/08/2023] Open
Abstract
Objective The recent spreading of Zika virus represents an emerging global health threat. As such, it is attracting public interest worldwide, generating a great amount of related Internet searches and social media interactions. The aim of this research was to understand Zika-related digital behavior throughout the epidemic spreading and to assess its consistence with real-world epidemiological data, using a behavioral informatics and analytics approach. Methods In this study, the global web-interest and reaction to the recently occurred outbreaks of the Zika Virus were analyzed in terms of tweets and Google Trends (GT), Google News, YouTube, and Wikipedia search queries. These data streams were mined from 1st January 2004 to 31st October 2016, with a focus on the period November 2015—October 2016. This analysis was complemented with the use of epidemiological data. Spearman’s correlation was performed to correlate all Zika-related data. Moreover, a multivariate regression was performed using Zika-related search queries as a dependent variable, and epidemiological data, number of inhabitants in 2015 and Human Development Index as predictor variables. Results Overall 3,864,395 tweets, 284,903 accesses to Wikipedia pages dedicated to the Zika virus were analyzed during the study period. All web-data sources showed that the main spike of researches and interactions occurred in February 2016 with a second peak in August 2016. All novel data streams-related activities increased markedly during the epidemic period with respect to pre-epidemic period when no web activity was detected. Correlations between data from all these web platforms resulted very high and statistically significant. The countries in which web searches were particularly concentrated are mainly from Central and South Americas. The majority of queries concerned the symptoms of the Zika virus, its vector of transmission, and its possible effect to babies, including microcephaly. No statistically significant correlation was found between novel data streams and global real-world epidemiological data. At country level, a correlation between the digital interest towards the Zika virus and Zika incidence rate or microcephaly cases has been detected. Conclusions An increasing public interest and reaction to the current Zika virus outbreak was documented by all web-data sources and a similar pattern of web reactions has been detected. The public opinion seems to be particularly worried by the alert of teratogenicity of the Zika virus. Stakeholders and health authorities could usefully exploited these internet tools for collecting the concerns of public opinion and reply to them, disseminating key information.
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Affiliation(s)
| | - Cristiano Alicino
- Department of Health Sciences, University of Genoa, Genoa, Italy
- * E-mail:
| | - Cecilia Trucchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Chiara Paganino
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Ilaria Barberis
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Mariano Martini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Laura Sticchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit,”Ospedale Policlinico San Martino IRCCS” teaching hospital, Genoa, Italy
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Center for Cognitive Neuroscience, Salzburg, Austria
- Department of Public Health Technology Assessment, UMIT—University for Health Sciences, Medical Informatics and Technology, Hall i.T., Innsbruck, Austria
| | - Francesco Brigo
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy
- Department of Neurological, Biomedical, and Movement Sciences, University of Verona, Verona, Italy
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit,”Ospedale Policlinico San Martino IRCCS” teaching hospital, Genoa, Italy
| | - Andrea Orsi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Hygiene Unit,”Ospedale Policlinico San Martino IRCCS” teaching hospital, Genoa, Italy
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Tin Tin Htar M, Stuurman AL, Ferreira G, Alicino C, Bollaerts K, Paganino C, Reinert RR, Schmitt HJ, Trucchi C, Vestraeten T, Ansaldi F. Effectiveness of pneumococcal vaccines in preventing pneumonia in adults, a systematic review and meta-analyses of observational studies. PLoS One 2017; 12:e0177985. [PMID: 28542347 PMCID: PMC5441633 DOI: 10.1371/journal.pone.0177985] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 05/05/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION S. pneumoniae can cause a wide spectrum of diseases, including invasive pneumococcal disease and pneumonia. Two types of pneumococcal vaccines are indicated for use in adults: 23-valent pneumococcal polysaccharide vaccines (PPV23) and a 13-valent pneumococcal conjugate vaccine (PCV13). OBJECTIVE To systematically review the literature assessing pneumococcal vaccine effectiveness (VE) against community-acquired pneumonia (CAP) in adults among the general population, the immunocompromised and subjects with underlying risk factors in real-world settings. METHODS We searched for peer-reviewed observational studies published between 1980 and 2015 in Pubmed, SciELO or LILACS, with pneumococcal VE estimates against CAP, pneumococcal CAP or nonbacteremic pneumococcal CAP. Meta-analyses and meta-regression for VE against CAP requiring hospitalization in the general population was performed. RESULTS 1159 unique articles were retrieved of which 33 were included. No studies evaluating PCV13 effectiveness were found. Wide ranges in PPV23 effectiveness estimates for any-CAP were observed among adults ≥65 years (-143% to 60%). The meta-analyzed VE estimate for any-CAP requiring hospitalization in the general population was 10.2% (95%CI: -12.6; 33.0). The meta-regression indicates that VE against any-CAP requiring hospitalization is significantly lower in studies with a maximum time since vaccination ≥60 months vs. <60 months and in countries with the pediatric PCV vaccine available on the private market. However, these results should be interpreted cautiously due to the high influence of two studies. The VE estimates for pneumococcal CAP hospitalization ranged from 32% (95%CI: -18; 61) to 51% (95%CI: 16; 71) in the general population. CONCLUSIONS Wide ranges in PPV23 effectiveness estimates for any-CAP were observed, likely due to a great diversity of study populations, circulation of S. pneumoniae serotypes, coverage of pediatric pneumococcal vaccination, case definition and time since vaccination. Despite some evidence for short-term protection, effectiveness of PPV23 against CAP was not consistent in the general population, the immunocompromised and subjects with underlying risk factors.
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Affiliation(s)
| | - Anke L. Stuurman
- P95 Epidemiology and Pharmacovigilance Consulting and Services, P95, Leuven, Belgium
| | - Germano Ferreira
- P95 Epidemiology and Pharmacovigilance Consulting and Services, P95, Leuven, Belgium
| | - Cristiano Alicino
- Department of Health Sciences (DiSSal), University of Genoa, Genoa, Italy
| | - Kaatje Bollaerts
- P95 Epidemiology and Pharmacovigilance Consulting and Services, P95, Leuven, Belgium
| | - Chiara Paganino
- Department of Health Sciences (DiSSal), University of Genoa, Genoa, Italy
| | - Ralf René Reinert
- Pfizer: Vaccines Medical Development and Scientific Clinical Affairs, Pfizer Inc, Paris, France
| | - Heinz-Josef Schmitt
- Pfizer: Vaccines Medical Development and Scientific Clinical Affairs, Pfizer Inc, Paris, France
| | - Cecilia Trucchi
- Department of Health Sciences (DiSSal), University of Genoa, Genoa, Italy
| | - Thomas Vestraeten
- P95 Epidemiology and Pharmacovigilance Consulting and Services, P95, Leuven, Belgium
| | - Filippo Ansaldi
- Department of Health Sciences (DiSSal), University of Genoa, Genoa, Italy
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Bassetti M, Peghin M, Carnelutti A, Righi E, Merelli M, Ansaldi F, Trucchi C, Alicino C, Sartor A, Toniutto P, Wauters J, Laleman W, Tascini C, Menichetti F, Luzzati R, Brugnaro P, Mesini A, Raviolo S, De Rosa FG, Lagunes L, Rello J, Dimopoulos G, Colombo AL, Nucci M, Vena A, Bouza E, Muñoz P, Tumbarello M, Losito R, Martin-Loeches I, Viscoli C. Clinical characteristics and predictors of mortality in cirrhotic patients with candidemia and intra-abdominal candidiasis: a multicenter study. Intensive Care Med 2017; 43:509-518. [DOI: 10.1007/s00134-017-4717-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/07/2017] [Indexed: 12/23/2022]
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25
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Bassetti M, Peghin M, Trecarichi EM, Carnelutti A, Righi E, Del Giacomo P, Ansaldi F, Trucchi C, Alicino C, Cauda R, Sartor A, Spanu T, Scarparo C, Tumbarello M. Characteristics of Staphylococcus aureus Bacteraemia and Predictors of Early and Late Mortality. PLoS One 2017; 12:e0170236. [PMID: 28152067 PMCID: PMC5289427 DOI: 10.1371/journal.pone.0170236] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 01/01/2017] [Indexed: 12/03/2022] Open
Abstract
We aimed to describe the characteristics of patients with Staphylococcus aureus bacteremia and to evaluate the risk factors associated with early (7-day) and late (30-day) mortality. We performed an observational study including all consecutive episodes of Staphylococcus aureus bacteremia diagnosed at two Italian university hospitals during 2010–2014. A total of 337 patients were included. Mean age was 69 years (range, 57–78) and 65% were males. Methicillin-resistant S. aureus (MRSA) was identified in 132/337 (39%)cases. Overall 7- and 30-day mortality were 13% and 26%, respectively. Early mortality was associated with increased Charlson scores (OR 1.3, 95% CI 1.1–1.5), MRSA bacteremia (OR 3.2, 95% CI 1.4–8.1), presentation with septic shock (OR 13.5, 95% CI 5.4–36.4), and occurrence of endocarditis (OR 4.5, 95%CI 1.4–14.6). Similar risk factors were identified for late mortality, including increased Charlson scores (OR 1.2, 95% CI 1.1–1.4), MRSA bacteremia (OR 2.1, 95% CI 1.2–3.9), presentation with septic shock (OR 4, 95%CI 1.7–9.7), occurrence of endocarditis (OR 3.8, 95% CI 1.4–10.2) as well as Child C cirrhosis (OR 3.9, 95% CI 1.1–14.4) and primary bacteremia (OR 2.5, 95%CI 1.3–5). Infectious disease consultation resulted in better outcomes both at 7 (OR 0.1, 95% CI 0.05–0.4) and at 30 days (OR 0.4, 95% CI 0.2–0.7). In conclusion, our study highlighted high rates of MRSA infection in nosocomial Staphylococcus aureus bacteremia. Multiple comorbidities, disease severity and methicillin-resistance are key factors for early and late mortality in this group. In patients with Staphylococcus aureus bacteremia, infectious disease consultation remains a valuable tool to improve clinical outcome.
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Affiliation(s)
- Matteo Bassetti
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
- * E-mail:
| | - Maddalena Peghin
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | | | - Alessia Carnelutti
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Elda Righi
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Paola Del Giacomo
- Institute of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - Filippo Ansaldi
- IRCCS AOU San Martino IST, Department of Health Sciences, University of Genoa; Genoa, Italy
| | - Cecilia Trucchi
- IRCCS AOU San Martino IST, Department of Health Sciences, University of Genoa; Genoa, Italy
| | - Cristiano Alicino
- IRCCS AOU San Martino IST, Department of Health Sciences, University of Genoa; Genoa, Italy
| | - Roberto Cauda
- Institute of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - Assunta Sartor
- Microbiology Unit, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Teresa Spanu
- Institute of Microbiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Claudio Scarparo
- Microbiology Unit, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Mario Tumbarello
- Institute of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
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Trucchi C, Alicino C, Orsi A, Paganino C, Barberis I, Grammatico F, Canepa P, Rappazzo E, Bruzzone B, Sticchi L, Ansaldi F. Fifteen years of epidemiologic, virologic and syndromic influenza surveillance: A focus on type B virus and the effects of vaccine mismatch in Liguria region, Italy. Hum Vaccin Immunother 2016; 13:456-463. [PMID: 27924684 PMCID: PMC5328239 DOI: 10.1080/21645515.2017.1264779] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In order to estimate the burden of influenza and to describe the genetic evolutionary pattern and antigenic variability of type B viral strains, data deriving from 3 surveillance systems active in Liguria region, Northern Italy, were described. Since the re-emergence of the Victoria lineage in 2001, the clinical-epidemiological and syndromic surveillances demonstrated the heavy burden of influenza like illness (ILI) syndrome. Focusing on type B influenza virus, it predominated or played a relevant epidemic role in the 50% of the evaluated influenza seasons. Furthermore, the virologic surveillance demonstrated the frequent co-circulation of both lineages an heterogeneous circulation of different influenza B strains, determining a partial or complete mismatch in at least 6 influenza seasons. The undemonstrated cross-reactivity between lineages and the unpredictability of predominant lineage arose the scientific debate about the opportunity to include the quadrivalent influenza vaccine among the preventive tools to improve the protection against type B viruses. The integration of different surveillance systems highly contribute to estimate the poorly evaluated burden of type B influenza virus and help to find variants to include in the vaccine formulation.
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Affiliation(s)
- Cecilia Trucchi
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Cristiano Alicino
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Andrea Orsi
- a Department of Health Sciences , University of Genoa , Genoa , Italy.,b O.U. Hygiene, IRCCS AOU San Martino - IST , Genoa , Italy
| | - Chiara Paganino
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Ilaria Barberis
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | | | - Paola Canepa
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Emanuela Rappazzo
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | | | - Laura Sticchi
- a Department of Health Sciences , University of Genoa , Genoa , Italy.,c O.U. Clinical Governance and Hospital Organization, IRCCS AOU San Martino - IST , Genoa , Italy
| | - Filippo Ansaldi
- a Department of Health Sciences , University of Genoa , Genoa , Italy.,c O.U. Clinical Governance and Hospital Organization, IRCCS AOU San Martino - IST , Genoa , Italy
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Alicino C, Trucchi C, Paganino C, Barberis I, Boccalini S, Martinelli D, Pellizzari B, Bechini A, Orsi A, Bonanni P, Prato R, Iannazzo S, Icardi G. Incidence of herpes zoster and post-herpetic neuralgia in Italy: Results from a 3-years population-based study. Hum Vaccin Immunother 2016; 13:399-404. [PMID: 27925843 PMCID: PMC5328218 DOI: 10.1080/21645515.2017.1264834] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Herpes Zoster (HZ) and its main complication, post-herpetic neuralgia (PHN), represent important public health issues because of their relevant burden among older adults. However, data on the epidemiology of HZ and PHN in Italy are very limited. A population-based study was performed by seeking for cases of HZ and PHN, occurred in the period 2013-2015, in the clinical charts of 56 General Practitioners working in 4 Italian Regions (Liguria, Puglia, Toscana and Veneto). The main objective of the study was to estimate the incidence of HZ and the proportion of PHN (at 1 and 3 mo from the onset of HZ; PHN1 and PHN3) among people aged ≥ 50 y. Overall, 598 cases of HZ were identified over 93,146 person-years of observation, thus corresponding to an overall incidence of 6.42 (IC95%: 5.93 – 6.95) HZ cases per 1,000 person-years. The incidence of HZ increased with age and was higher in female than in male. In total, 22.7%, 12.7%, and 2.4% of HZ cases suffered PHN at 1 and 3 mo and 1 y from the onset of acute episode. The proportions of these complications significantly increased with age, with the peak occurring in people aged ≥ 85 y. Four per cent of patients suffered ophthalmic zoster. The study provided an update of the epidemiological burden of HZ and PHN in Italy, confirming the relevant burden of the disease in the elderly population. The study was funded by the Italian Ministry of Health, Center for Disease Prevention and Control (CCM) in 2013.
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Affiliation(s)
- Cristiano Alicino
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Cecilia Trucchi
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Chiara Paganino
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Ilaria Barberis
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Sara Boccalini
- b Department of Health Sciences , University of Florence , Florence , Italy
| | - Domenico Martinelli
- c Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | - Barbara Pellizzari
- d Regional Center for Disease Prevention and Control , Veneto Region , Italy
| | - Angela Bechini
- b Department of Health Sciences , University of Florence , Florence , Italy
| | - Andrea Orsi
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Paolo Bonanni
- b Department of Health Sciences , University of Florence , Florence , Italy
| | - Rosa Prato
- c Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | | | - Giancarlo Icardi
- a Department of Health Sciences , University of Genoa , Genoa , Italy
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Bassetti M, Righi E, Peghin M, Carnelutti A, Ansaldi F, Trucchi C, Alicino C, Tricarichi EM, Del Giacomo P, Tumbarello M. Is first-line antimicrobial therapy still adequate to treat MRSA in the ICU? A report from a highly endemic country. Crit Care 2016; 20:246. [PMID: 27566537 PMCID: PMC5002169 DOI: 10.1186/s13054-016-1430-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Matteo Bassetti
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy. .,Clinica Malattie Infettive, Azienda Ospedaliero-Universitaria "Santa Maria della Misericordia", Piazzale S. Maria della Misericordia, n. 15, 33100, Udine, Italy.
| | - Elda Righi
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Maddalena Peghin
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Alessia Carnelutti
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy
| | - Filippo Ansaldi
- IRCCS AOU San Martino IST, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Cecilia Trucchi
- IRCCS AOU San Martino IST, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Cristiano Alicino
- IRCCS AOU San Martino IST, Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Paola Del Giacomo
- Institute of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - Mario Tumbarello
- Institute of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
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Contini P, Negrini S, Bodini G, Trucchi C, Ubezio G, Strada P, Savarino V, Ghio M. Granulocytes and monocytes apheresis induces upregulation of TGFβ 1 in patients with active ulcerative colitis: A possible involvement of soluble HLA-I. J Clin Apher 2016; 32:49-55. [PMID: 27080173 DOI: 10.1002/jca.21466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/22/2016] [Accepted: 03/28/2016] [Indexed: 12/20/2022]
Abstract
Granulocyte and monocyte apheresis has been used in different immune-mediated disorders, mainly inflammatory bowel diseases. The removal of activated leukocytes and several additional immunomodulatory mechanisms have been so far suggested to explain the anti-inflammatory effects of the treatment. Recent data indicate that, during centrifugation based apheresis, sHLA-I adsorbed to plastic circuits is able to induce TGFβ1 production in activated leukocytes. On these bases, the present study was aimed at analyzing if this model could be applied to a noncentrifugation based apheresis, such as granulocyte and monocyte apheresis. Ten patients with ulcerative colitis were enrolled. Every patient received 5 weekly apheresis treatments. Cellulose acetate beads removed from the column post-GMA were stained by fluorescent anticlass I mAb and examined by fluorescent microscope. Moreover, sFasL plasma concentration, TGFβ1 plasma levels, and the percentage of TGFβ1 positive neutrophils were evaluated before and immediately after each single apheresis. Immunofluorescent images revealed a homogeneous layer of a sHLA-I adsorbed to the surface of the beads recovered following the procedure. sFasL plasma concentration progressively increased both following the procedures and during inter-procedure periods. Consistently, also TGFβ1 plasma levels and the percentage of TGFβ1 positive neutrophils increased during the procedures with a meaningful relationship with sFasL plasma levels. Taken together, these findings suggest that the immunosuppressive effects attributed to granulocyte and monocyte apheresis might depend, at least in part, on the sensitivity of activated leucocytes to the bioactivity of sHLA-I molecules. J. Clin. Apheresis 32:49-55, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Paola Contini
- Department of Internal Medicine, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Simone Negrini
- Department of Internal Medicine, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Giorgia Bodini
- Department of Internal Medicine, Gastroenterology Unit I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Cecilia Trucchi
- Department of Health Sciences, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Gianluca Ubezio
- Immunohematology and Transfusion Centre, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Paolo Strada
- Immunohematology and Transfusion Centre, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Vincenzo Savarino
- Department of Internal Medicine, Gastroenterology Unit I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
| | - Massimo Ghio
- Department of Internal Medicine, I.R.C.C.S. "a.O.U. San Martino-IST" and University of Genoa, Genova, Italy
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Tramuto F, Orsi A, Maida CM, Costantino C, Trucchi C, Alicino C, Vitale F, Ansaldi F. The Molecular Epidemiology and Evolutionary Dynamics of Influenza B Virus in Two Italian Regions during 2010-2015: The Experience of Sicily and Liguria. Int J Mol Sci 2016; 17:549. [PMID: 27089319 PMCID: PMC4849005 DOI: 10.3390/ijms17040549] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/31/2016] [Accepted: 04/07/2016] [Indexed: 11/24/2022] Open
Abstract
Molecular epidemiology of influenza B virus remained poorly studied in Italy, despite representing a major contributor to seasonal epidemics. This study aimed to reconstruct the phylogenetic relationships and genetic diversity of the hemagglutinin gene sequences of 197 influenza B strains circulating in both Southern (Sicily) and Northern (Liguria) Italy between 2010 and 2015. Upper respiratory tract specimens of patients displaying symptoms of influenza-like illness were screened by real-time RT-PCR assay for the presence of influenza B virus. PCR-positive influenza B samples were further analyzed by sequencing. Neighbor-joining phylogenetic trees were constructed and the amino-acid alignments were analyzed. Phylogenetic analysis showed clusters in B/Victoria clade 1A/1B (n = 29, 14.7%), and B/Yamagata clades 2 (n = 112, 56.8%) and 3 (n = 56, 28.4%). Both influenza B lineages were found to co-circulate during the study period, although a lineage swap from B/Victoria to B/Yamagata occurred in Italy between January 2011 and January 2013. The most represented amino-acid substitutions were N116K in the 120-loop (83.9% of B/Yamagata clade 3 strains) and I146V in the 150-loop (89.6% of B/Victoria clade 1 strains). D197N in 190-helix was found in almost all viruses collected. Our findings provide further evidence to support the adoption of quadrivalent influenza vaccines in our country.
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Affiliation(s)
- Fabio Tramuto
- Department of Health Promotion Sciences and Mother-Child Care "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo 90127, Italy.
- Clinical Epidemiology Unit, University Hospital "Paolo Giaccone", Palermo 90127, Italy.
| | - Andrea Orsi
- Department of Health Sciences, University of Genoa, Genoa 16132, Italy.
- Hygiene Unit, IRCCS University Hospital "San Martino"-IST National Institute for Cancer Research, Genoa 16132, Italy.
| | - Carmelo Massimo Maida
- Department of Health Promotion Sciences and Mother-Child Care "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo 90127, Italy.
| | - Claudio Costantino
- Department of Health Promotion Sciences and Mother-Child Care "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo 90127, Italy.
| | - Cecilia Trucchi
- Department of Health Sciences, University of Genoa, Genoa 16132, Italy.
| | - Cristiano Alicino
- Department of Health Sciences, University of Genoa, Genoa 16132, Italy.
| | - Francesco Vitale
- Department of Health Promotion Sciences and Mother-Child Care "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo 90127, Italy.
- Clinical Epidemiology Unit, University Hospital "Paolo Giaccone", Palermo 90127, Italy.
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa 16132, Italy.
- Hygiene Unit, IRCCS University Hospital "San Martino"-IST National Institute for Cancer Research, Genoa 16132, Italy.
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Tisa V, Barberis I, Faccio V, Paganino C, Trucchi C, Martini M, Ansaldi F. Quadrivalent influenza vaccine: a new opportunity to reduce the influenza burden. J Prev Med Hyg 2016; 57:E28-33. [PMID: 27346937 PMCID: PMC4910440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Influenza illness is caused by influenza A and influenza B strains. Although influenza A viruses are perceived to carry greater risk because they account for the majority of influenza cases in most seasons and have been responsible for influenza pandemics, influenza B viruses also impose a substantial public health burden, particularly among children and at-risk subjects. Furthermore, since the 2001-2002 influenza season, both influenza B lineages, B/Victoria-like viruses and B/Yamagata-like viruses have co-circulated in Europe. The conventional trivalent influenza vaccines have shown a limited ability to induce effective protection when major or minor mismatches between the influenza B vaccine component and circulating strains occur. For this reason, the inclusion of a second B strain in influenza vaccines may help to overcome the well-known difficulties of predicting the circulating B lineage and choosing the influenza B vaccine component. Two quadrivalent influenza vaccines, a live-attenuated quadrivalent influenza vaccine (Q/LAIV) and a split inactivated quadrivalent influenza vaccine (I/QIV), were first licensed in the US in 2012. Since their introduction, models simulating the inclusion of QIV in influenza immunization programs have demonstrated the substantial health benefits, in terms of reducing the number of influenza cases, their complications and mortality. In the near future, evaluations from simulation models should be confirmed by effectiveness studies in the field, and more costeffectiveness analyses should be conducted in order to verify the expected benefits.
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Affiliation(s)
- V. Tisa
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - I. Barberis
- Department of Health Sciences, University of Genoa, Genoa, Italy;,Ilaria Barberis, Department of Health Sciences, University of Genoa, via A. Pastore 1, 16132 Genoa, Italy - Tel. +39 010 3538123 - Fax +39 010 505618 E-mail: ilaria.barberis@ fastwebnet.it
| | - V. Faccio
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - C. Paganino
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - C. Trucchi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M. Martini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - F. Ansaldi
- Department of Health Sciences, University of Genoa, Genoa, Italy;,IRCCS AOU S. Martino, IST Genoa, Italy
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Alicino C, Giacobbe DR, Orsi A, Tassinari F, Trucchi C, Sarteschi G, Copello F, Del Bono V, Viscoli C, Icardi G. Trends in the annual incidence of carbapenem-resistant Klebsiella pneumoniae bloodstream infections: a 8-year retrospective study in a large teaching hospital in northern Italy. BMC Infect Dis 2015; 15:415. [PMID: 26464061 PMCID: PMC4605101 DOI: 10.1186/s12879-015-1152-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 09/28/2015] [Indexed: 11/26/2022] Open
Abstract
Background Bloodstream infections (BSI) due to carbapenem-resistant (C-R) Klebsiella pneumoniae (Kp) are of global concern from both clinical and public health standpoints. This retrospective study aimed to describe C-R Kp BSI epidemiology in a large teaching hospital in northern Italy. Methods Between 1 January 2007 and 31 December 2014, annual incidences both of C-R Kp BSI and of carbapenem-susceptible (C-S) Kp BSI were calculated as the number of events per 10,000 patient-days. A Chi square test for linear trend was used to assess the change in the incidence of C-R Kp BSI and C-S Kp BSI over the study period. Crude 30-day mortality rates were provided both for C-R Kp BSI and for C-S Kp BSI. Results From 2007 to 2014, we observed 511 episodes of Kp BSI, 349 of which were caused by C-R Kp (68.3 %). The incidence of C-R Kp BSI considerably increased from 0.04/10,000 patient-days in 2007 to 1.77/10,000 patient-days in 2014 (Chi square for trend p < 0.001). The highest incidence of C-R Kp BSI was observed in intensive care units (ICUs), with a peak of 22.01 C-R Kp BSI/10,000 patient-days in 2012. A less marked but significant increase of C-S Kp BSI was also observed (Chi square for trend p = 0.004). Crude 30-day mortality was 36.1 % in patients with C-R Kp BSI and 23.5 % in those with C-S Kp BSI. Conclusions During the study period, we observed a dramatic increase in the incidence of C-R Kp BSI in our hospital. More concerted infection-control efforts are needed to contain this alarming C-R Kp diffusion.
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Affiliation(s)
- Cristiano Alicino
- Department of Health Sciences, University of Genoa and Hygiene and Infection Control Unit, IRCCS AOU San Martino-IST teaching Hospital, Genoa, Italy.
| | - Daniele Roberto Giacobbe
- Department of Health Sciences, University of Genoa and Infectious Diseases Unit, IRCCS AOU San Martino-IST teaching Hospital, L.go R. Benzi, 10-16132, Genoa, Italy.
| | - Andrea Orsi
- Department of Health Sciences, University of Genoa and Hygiene and Infection Control Unit, IRCCS AOU San Martino-IST teaching Hospital, Genoa, Italy.
| | - Federico Tassinari
- Department of Health Sciences, University of Genoa and Hygiene and Infection Control Unit, IRCCS AOU San Martino-IST teaching Hospital, Genoa, Italy.
| | - Cecilia Trucchi
- Department of Health Sciences, University of Genoa and Hygiene and Infection Control Unit, IRCCS AOU San Martino-IST teaching Hospital, Genoa, Italy.
| | - Giovanni Sarteschi
- Department of Health Sciences, University of Genoa and Infectious Diseases Unit, IRCCS AOU San Martino-IST teaching Hospital, L.go R. Benzi, 10-16132, Genoa, Italy.
| | - Francesco Copello
- Occupational Medicine Unit, IRCCS AOU San Martino-IST teaching Hospital, Genoa, Italy.
| | - Valerio Del Bono
- Department of Health Sciences, University of Genoa and Infectious Diseases Unit, IRCCS AOU San Martino-IST teaching Hospital, L.go R. Benzi, 10-16132, Genoa, Italy.
| | - Claudio Viscoli
- Department of Health Sciences, University of Genoa and Infectious Diseases Unit, IRCCS AOU San Martino-IST teaching Hospital, L.go R. Benzi, 10-16132, Genoa, Italy.
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa and Hygiene and Infection Control Unit, IRCCS AOU San Martino-IST teaching Hospital, Genoa, Italy.
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Alicino C, Bragazzi NL, Faccio V, Trucchi C, Paganino C, Amicizia D, Panatto D, Gasparini R, Icardi GC. Searching for 2014 Ebola epidemics: a global analytical study of Google Trends-based query volumes. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Trucchi C, Paganino C, Orsi A, Canepa P, Faccio V, Rappazzo E, Battistini A, Podestà F, Moscatelli P, Morando A, Ansaldi F. Respiratory Syndromes Surveillance System to monitor Emergency Department crowding in Genoa, Italy. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ansaldi F, Orsi A, Durando P, Alicino C, De Florentiis D, Trucchi C, Paganino C, Zacconi M, Albanese E, Barberis I, Turello V, Schiaffino S, Icardi G. First Italian Experience of Elderly Immunization with Pneumococcal Conjugate Vaccine. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Trucchi C, Gabutti G, Cristina Rota M, Bella A. Burden of varicella in Italy, 2001-2010: analysis of data from multiple sources and assessment of universal vaccination impact in three pilot regions. J Med Microbiol 2015; 64:1387-1394. [PMID: 25813818 DOI: 10.1099/jmm.0.000061] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Varicella represents the most widespread vaccine-preventable childhood infectious disease in Italy. The purpose of this retrospective study was to assess the burden of varicella in Italy and in three regions that first implemented universal varicella vaccination. Four data sources were analysed: statutory notification data, the National Hospital Discharge Database, mortality data, and the vaccination coverage reached in Sicilia, Veneto and Apulia. The incidence rates per 100,000 population were calculated using the Italian resident population provided by the Italian Institute of Statistics in 2001-2010. In 2001-2010, the mean annual incidence of notifications of varicella was 150.7 cases per 100,000 population, reaching 948.6 cases per 100,000 population in the paediatric age group. The annual incidence declined to 102.6 per 100,000 population in 2010. During the period considered, 20,295 hospitalizations for varicella were observed. The mean annual incidence was 3.4 per 100,000 population, reaching a minimum of 2.5 per 100,000 in 2009 and 2010. Of the hospitalizations, 68.4% occurred in the paediatric age group. The median length of hospital stay was 4 days. During 2001-2003 and 2006-2010, 33 deaths were reported. In the three regions considered, vaccination coverage increased steadily, reaching 81.5% in Sicily, 79.4% in Veneto and 75.6% in Apulia in 2010. During the same period, hospitalization and notification rates decreased significantly. This study demonstrated that varicella continues to represent a relevant health problem in Italy, especially in the paediatric age group. Data obtained from the three Italian regions that first introduced universal vaccination demonstrated that vaccination reduces the incidence of varicella and hospitalization rates.
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Affiliation(s)
- Cecilia Trucchi
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Giovanni Gabutti
- Department of Medical Sciences, Section of Hygiene, University of Ferrara, Via Fossato di Mortara 64b, 44121 Ferrara, Italy
| | - Maria Cristina Rota
- Infectious Diseases Epidemiology Unit, National Center for Epidemiology Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Antonino Bella
- Infectious Diseases Epidemiology Unit, National Center for Epidemiology Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Ansaldi F, Orsi A, Trucchi C, De Florentiis D, Ceravolo A, Coppelli M, Schiaffino S, Turello V, Rosselli R, Carloni R, Icardi G, Study Group LP, Canepa P, Sticchi L, Zanetti R, Cremonesi I, Brasesco P, Moscatelli P. Potential effect of PCV13 introduction on Emergency Department accesses for lower respiratory tract infections in elderly and at risk adults. Hum Vaccin Immunother 2014; 11:166-71. [PMID: 25483530 DOI: 10.4161/hv.34419] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Liguria, an administrative region in northern Italy characterized by a decade of high PCV coverage in paediatric age group, has issued new PCV13 recommendations for free active immunization in adults with risk factors and subjects aged ≥ 70 years old. Main aims of this study are: (1) a descriptive epidemiology of the clinical burden of lower respiratory tract infections (LRTI) in adults ≥18 years of age; and (2) a crossover evaluation of the effect of introduction of PCV13 vaccination in adults aged ≥70 years old, in terms of ED accesses for LRTI, obtained by a Syndrome Surveillance System (SSS). The ED access, chief complaint based SSS will allow an active surveillance of a population cohort of >430 000 individuals resident in Genoa metropolitan area, aged ≥18 years old, for a period of 60 months. During pre-PCV period, annual cumulative incidence of ED accesses for LRTI was equal to 7/1000 and 2% in ≥65 and ≥85 year adults, respectively. In ≥65 years adults, more than 70% of subjects identified by the SSS has at least one risk condition, with a peak of 87% in ≥85 year cohort. New Ligurian PCV13 recommendations can potentially reach more than 75% of ED accesses for LRTI. Data highlights the heavy impact of LRTI in terms of ED accesses, especially in the elderly and subjects with chronic conditions and the usefulness of SSS tool for monitoring PCV vaccination effect.
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Affiliation(s)
- Filippo Ansaldi
- a Department of Health sciences (DiSSal); University of Genoa; Genoa, Italy
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Durando P, Rosselli R, Cremonesi I, Orsi A, Albanese E, Barberis I, Paganino C, Trucchi C, Martini M, Marensi L, Turello V, Study Group TLP, Bregante A, Cacciani R, Iudici R, La Marca D, Pedano L, Petrucci AF, Santolini M, Sbisà V, Zacconi M. Safety and tolerability of 13-valent pneumococcal conjugate vaccine in the elderly. Hum Vaccin Immunother 2014; 11:172-7. [PMID: 25483531 DOI: 10.4161/hv.34420] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In September 2011 the European Medical Agency authorized the use of 13-valent pneumococcal conjugate vaccine (PCV13) in adults aged ≥50 years. The same occurred in the US in December 2011 when the Food and Drug Administration approved the use of PCV13 in the same target age-group with indication for the prevention of invasive pneumococcal diseases and community acquired pneumonia sustained by the serotypes contained in the vaccine. The Liguria Region, in Italy, implemented in 2013 an active and free of charge immunization strategy with PCV13 among adults affected by specific risk conditions and the elderly aged ≥70 years. METHODS An observational study was performed in order to assess the safety and tolerability of PCV13 among elderly dwelling in the metropolitan area of Genoa, the capital city of Liguria Region. Eligible subjects, who received PCV13 following the public health immunization campaign at the Local Health Unit 3 of Genoa, provided a written informed consent to take part in the study. Eight-hundred-seventy-one subjects were enrolled between October 2013 and May 2014: all were monitored by qualified healthcare personnel for at least 30 min after vaccination at the outpatient clinics, in order to assess any possible sudden reaction. The occurrence of a series of local and systemic solicited reactions and of any unsolicited Adverse Events (AEs) was monitored using a self-administered clinical diary and by regular phone contacts up to 14 and 21 d following immunization, respectively. Moreover, a 6-months follow-up following vaccination was planned in order to monitor Severe Adverse Events (SAEs). RESULTS No sudden reaction occurred in vaccinees at the outpatient clinics. Pain (27.4%) was the most frequent reaction reported by subjects at the injection site, while new muscle pain (13.6%), fatigue (10.7%), and headache (9.9%) resulted the most common systemic reactions. Rates of the main reactions reported in this on-field study resulted generally lower than those registered in clinical trials performed in the elderly. The incidence of fever (2.2%) following vaccination was low at values superimposable to that reported in previous studies. CONCLUSION This observational study showed a good safety and tolerability of PCV13 among the elderly in routine clinical practice further confirming the evidence coming from clinical trials in the same age-group.
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Affiliation(s)
- Paolo Durando
- a Department of Health Sciences, Vaccines and Clinical Trials Unit; University of Genoa, Italy; I.R.C.C.S. A.O.U. San Martino - IST of Genoa; Italy and Integrated Group for the Development of Vaccine Sciences (GISVa); Genoa, Italy
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Bassetti M, Righi E, Ansaldi F, Merelli M, Trucchi C, De Pascale G, Diaz-Martin A, Luzzati R, Rosin C, Lagunes L, Trecarichi EM, Sanguinetti M, Posteraro B, Garnacho-Montero J, Sartor A, Rello J, Rocca GD, Antonelli M, Tumbarello M. Erratum to: A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality. Intensive Care Med 2014. [DOI: 10.1007/s00134-014-3387-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Gasparini R, Lai PL, Casabona F, Trucchi C, Boccalini S, Cristina ML, Rossi S, Amicizia D, Panatto D. Do the omeprazole family compounds exert a protective effect against influenza-like illness? BMC Infect Dis 2014; 14:297. [PMID: 24889553 PMCID: PMC4051147 DOI: 10.1186/1471-2334-14-297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 05/28/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Infections by influenza viruses place a heavy burden on public health and economies worldwide. Although vaccines are the best weapons against influenza, antiviral drugs could offer an opportunity to alleviate the burden of influenza. Since omeprazole family compounds block the "proton pump", we hypothesized that they could interfere with the mechanism of fusion of the virus envelope and endosomal membrane, thereby hindering the M2 proton pump mechanism of influenza viruses. METHODS A matched case-control study was performed in 2010-2011 in Italy. Cases were subjects aged over 18 years with a diagnosis of Influenza-like Illness (ILI); 254 case-control pairs were recruited. A multivariable conditional logistic regression analysis was used to assess the association between the prevention of ILI and the administration of omeprazole family compounds. The interaction between omeprazole family compounds and influenza vaccination was also examined. RESULTS After control for potential confounders, subjects treated with omeprazole family compounds displayed a lower risk of catching ILI (ORadj = 0.29, 95% CI: 0.15-0.52). The risk of ILI in unvaccinated non-OFC users was about six times than that in vaccinated OFC users. CONCLUSIONS Although confirmation is necessary, these results suggest that omeprazole family compounds could be profitably used in the prevention of ILI.
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Affiliation(s)
- Roberto Gasparini
- Department of Health Sciences, Genoa University, Genoa, Italy
- Inter-University Centre for Research on Influenza and other Transmitted Infections (CIRI-IT), Genoa, Italy
| | - Piero Luigi Lai
- Department of Health Sciences, Genoa University, Genoa, Italy
- Inter-University Centre for Research on Influenza and other Transmitted Infections (CIRI-IT), Genoa, Italy
| | | | - Cecilia Trucchi
- Department of Health Sciences, Genoa University, Genoa, Italy
| | - Sara Boccalini
- Department of Health Sciences, Florence University, Firenze, Italy
| | | | - Stefania Rossi
- Inter-University Centre for Research on Influenza and other Transmitted Infections (CIRI-IT), Genoa, Italy
- Department of Molecular and Developmental Medicine, Siena University, Siena, Italy
| | - Daniela Amicizia
- Department of Health Sciences, Genoa University, Genoa, Italy
- Inter-University Centre for Research on Influenza and other Transmitted Infections (CIRI-IT), Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences, Genoa University, Genoa, Italy
- Inter-University Centre for Research on Influenza and other Transmitted Infections (CIRI-IT), Genoa, Italy
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Bassetti M, Righi E, Ansaldi F, Merelli M, Trucchi C, Cecilia T, De Pascale G, Diaz-Martin A, Luzzati R, Rosin C, Lagunes L, Trecarichi EM, Sanguinetti M, Posteraro B, Garnacho-Montero J, Sartor A, Rello J, Rocca GD, Antonelli M, Tumbarello M. A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality. Intensive Care Med 2014; 40:839-45. [PMID: 24807083 DOI: 10.1007/s00134-014-3310-z] [Citation(s) in RCA: 184] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 04/15/2014] [Indexed: 12/14/2022]
Abstract
PURPOSE Candida is the most common cause of severe yeast infections worldwide, especially in critically ill patients. In this setting, septic shock attributable to Candida is characterized by high mortality rates. The aim of this multicenter study was to investigate the determinants of outcome in critically ill patients with septic shock due to candidemia. METHODS This was a retrospective study in which patients with septic shock attributable to Candida who were treated during the 3-year study period at one or more of the five participating teaching hospitals in Italy and Spain were eligible for enrolment. Patient characteristics, infection-related variables, and therapy-related features were reviewed. Multiple logistic regression analysis was performed to identify the risk factors significantly associated with 30-day mortality. RESULTS A total of 216 patients (mean age 63.4 ± 18.5 years; 58.3 % males) were included in the study. Of these, 163 (75 %) were admitted to the intensive care unit. Overall 30-day mortality was 54 %. Significantly higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores, dysfunctional organs, and inadequate antifungal therapy were compared in nonsurvivors and survivors. No differences in survivors versus nonsurvivors were found in terms of the time from positive blood culture to initiation of adequate antifungal therapy. Multivariate logistic regression identified inadequate source control, inadequate antifungal therapy, and 1-point increments in the APACHE II score as independent variables associated with a higher 30-day mortality rate.
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Affiliation(s)
- Matteo Bassetti
- Infectious Diseases Division, Santa Maria Misericordia University Hospital, Udine, Italy,
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Panatto D, Amicizia D, Trucchi C, Casabona F, Lai PL, Bonanni P, Boccalini S, Bechini A, Tiscione E, Zotti CM, Coppola RC, Masia G, Meloni A, Castiglia P, Piana A, Gasparini R. Sexual behaviour and risk factors for the acquisition of human papillomavirus infections in young people in Italy: suggestions for future vaccination policies. BMC Public Health 2012; 12:623. [PMID: 22871132 PMCID: PMC3490840 DOI: 10.1186/1471-2458-12-623] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 07/27/2012] [Indexed: 11/10/2022] Open
Abstract
Background Human Papillomavirus (HPV) is the most common sexually transmitted infection. The main risk factors correlated with HPV infection are: early sexual debut, the number of partners, frequency and type of sexual contact and partner’s sexual histories. We surveyed sexual habits among young people in order to provide information that might orient decision-makers in adopting HPV multi-cohort vaccination policies. Methods We administered a questionnaire to students (14–24 years old) in five Italian cities. Results 7298 questionnaires were analyzed (4962 females and 2336 males); 55.3% of females (95% CI 53.9–56.7) and 52.5% of males (95% CI 50.5–54.5) reported regular sexual activity. The mean age at sexual debut was 15.7 ± 1.6 and 15.6 ± 1.6 for females and males, respectively, and the median age was 16 for both sexes. With regard to contraceptive use during the last year, 63.6% of males and 62.8% of females responded affirmatively; 42.6% of males and 42.8% of females used condoms. Conclusion The results reveal precocious sexual activity among respondents, with the mean age at first intercourse declining as age decreases. Condom use proved to be scant. Considering lifestyle-related risk factors, males appear to have a higher probability of acquiring HPV infection than females. These data support the importance of promoting multi-cohort HPV vaccination strategies for females up to 25 years of age. It is essential to improve vaccination coverage through different broad-spectrum strategies, including campaigns to increase awareness of sexually transmitted diseases and their prevention.
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Affiliation(s)
- Donatella Panatto
- Department of Health Sciences, University of Genoa, Via Pastore, 1 16132, Genoa, Italy.
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Zoppi G, Trucchi C. Prevention of invasive diseases: strategies to increase vaccination coverage in children and adolescents. J Prev Med Hyg 2012; 53:125-129. [PMID: 23240175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Vaccines able to prevent invasive bacterial diseases have been introduced into national and/or regional immunization plans through different strategies. We evaluated Haemophilus influenzae type b, Pneumococcus and Meningococcus C vaccination coverage in the 5 Ligurian Local Health Agencies, in the Liguria Region, and in Italy in order to assess the efficacy of current immunisation policies concerning children at the 24th month and adolescents. Furthermore, we considered new strategies for increasing vaccination coverage. MATERIALS AND METHODS We estimated the vaccination coverage of Local Health Agency 4 by means of the "OASIS" software. The regional mean vaccination coverage was calculated from the data provided by the other four Local Health Agencies in Liguria. National data were obtained from the database of the Ministry of Health and from the last report of the ICONA Working Group. We used a questionnaire to evaluate the knowledge of Meningococcus C vaccination among the pediatricians and general practitioners operating in our Local Health Agency. RESULTS The regional vaccination coverage at the 24th month proved to be: > 95% for Haemophilus influenzae type b, 93% for Pneumococcus and 87% for Meningococcus C. The national mean is: > 95% for Haemophilus influenza type b, 55% for Pneumococcus and 37% for Meningococcus C. Meningococcus C vaccination coverage among adolescents is 49% in Liguria, while the national mean is 16%. The questionnaire administered to the physicians was composed of 5 questions, which were answered by 81% of pediatricians and only 22% of general practitioners. Reducing the incidence of invasive meningococcal diseases through large-scale vaccination was deemed very important by 92% of pediatricians and 81% of general practitioners. About 92% of pediatricians and 85% of general practitioners considered the vaccine safe and effective. All (100%) physicians expressed their agreement with the Ligurian immunization strategy. However, while all the pediatricians reported recommending this vaccination, only 76% of general practitioners did so. Finally, all the physicians interviewed stated their willingness to collaborate with the Department of Prevention to increase vaccination coverage. DISCUSSION VC against Hib at the 24th month, in both Liguria and Italy, proved excellent. Compliance with vaccination against Pneumococcus has been very high since its introduction in 2003 in Liguria, while the national mean is suboptimal. The regional vaccination coverage against Meningococcus C at the 24th month is good; the national value, however, is low because some Italian Regions have not yet introduced this vaccination into their immunization plans. Vaccination coverage in adolescents varies widely among the Ligurian Local Health Agencies and needs to be increased; the national figure is very low because few Regions have introduced this vaccination. However, achieving compliance with vaccinations in adolescents is difficult. The questionnaire indicated that general practitioners place less emphasis on vaccinations than pediatricians. Nevertheless, both general practitioners and pediatricians expressed their willingness to collaborate with the Department of Prevention of Local Health Agency 4 in improving the immunization strategies aimed at adolescents. CONCLUSIONS In conclusion, we consider it very important to create a network involving the Department of Prevention, pediatricians and general practitioners, in order to share the best immunization strategies.
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Affiliation(s)
- G Zoppi
- Department of Prevention, Local Health Agency 4 "Chiavarese", Liguria, Italy.
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Trucchi C, Zoppi G. Invasive bacterial diseases: national surveillance in Italy and vaccination coverage in the Local Health Agency 4 "Chiavarese", Liguria region (Italy). J Prev Med Hyg 2012; 53:120-124. [PMID: 23240174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION In 2007 in Italy, the National Institute of Health published a new protocol for the National Surveillance of Invasive Bacterial Diseases, in order to enhance the notification system of these diseases and to improve immunization strategies. Available vaccines to prevent these diseases were introduced for the first time into the 1999-2000 National Immunization Plan (NIP) (vaccination against Haemophilus influenzae type b) and the 2005-2007 NIP (vaccination against Streptococcus pneumoniae and Neisseria meningitidis serogroup C). We evaluated the frequency of invasive diseases, on the basis of the number of notifications, the different immunization strategies in the Italian Regions and the vaccination coverage in Local Health Agency 4 "Chiavarese" (LHA) in the Liguria Region (Italy). MATERIALS AND METHODS We evaluated the number of notifications of invasive diseases collected by the national databank coordinated by the ISS (Informative System of Infectious Diseases, SIMI) from 1994 to 2011. We also examined regional regulations concerning immunization policies. Immunization coverage was calculated by means of the "OASIS" software (version 9.0.0) used in our LHA. RESULTS AND DISCUSSION Available data indicate that the large-scale vaccination policy begun in 1999 in Italy has led to a great reduction in Haemophilus influenzae-related diseases in the pediatric age. Meningococcal diseases have declined to a lesser degree; this is due to the more recent introduction of vaccination against serogroup C (in 2005), the variability of the immunization strategies adopted in the different Italian Regions and the availability of the vaccination against serogroup C only in the pediatric age. The diseases caused by Streptococcus pneumoniae seem to have increased since 2007 because of the implementation of the Surveillance of Invasive Diseases Program and the subsequent notification of all invasive diseases (not only meningitis). Furthermore, the various Italian Regions have adopted different immunization strategies against this disease, too. We evaluated vaccination coverage in LHA 4 from 2003 to 2008. VC levels against Haemophilus influenzae are excellent; the objective indicated in the 2005-2007 NIP (> or = 95%) has therefore been reached. Vaccination coverage levels against Streptococcus pneumoniae and Neisseria meningitidis serogroup C at the 24th month of age are also good. However, we need to implement specific immunization strategies for adolescents, since the vaccination coverage levels are not completely satisfactory. CONCLUSIONS The improvement of the national invasive disease surveillance system has provided better knowledge of the size of the problem and the impact of immunization strategies on the incidence of invasive bacterial diseases. Furthermore, immunization policies in Italy display territorial heterogeneity. Vaccination coverage levels against Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis at the 24th month in LHA 4 are very high. In adolescents (15 year-olds) the immunization coverage are good but needs to be improved through specific strategies, such as raising the awareness of healthcare workers, involving general practitioners and educating the target population.
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Affiliation(s)
- C Trucchi
- Department of Health Sciences, University of Genova, Italy
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Zoppi G, Trucchi C. Investigation on seasonal influenza vaccination among children with high-risk medical conditions who live in the area of Local Health Agency 4 "Chiavarese". J Prev Med Hyg 2011; 52:148-150. [PMID: 22010547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION The Italian Ministry of Health recommends influenza vaccination in patients with chronic diseases associated with an increased risk of influenza complications. We estimated the number of patients aged from 6 months to 14 years with chronic diseases living in the area of Local Health Agency 4 "Chiavarese". MATERIALS AND METHODS In order to estimate the number of children with chronic diseases, we evaluated data from three sources: the Health Charge Exemption Records Office; the "Nocchiero Project", implemented by the Regional Health Agency in 2009, and independent pediatricians. RESULTS The pediatric population in the district of Local Health Agency 4 "Chiavarese" consists of 16,118 subjects. The percentage of children with high-risk medical conditions is 4.14% of the pediatric population according to records of health-charge exemption, 6.36% according to the "Nocchiero Project" data and 3.38% according to the data provided by pediatricians. In the 2010-2011 influenza vaccination campaign, 415 children were vaccinated at Local Health Agency 4 "Chiavarese"; 335 of these had chronic diseases. Vaccination coverage was estimated as 50.07% on the basis of the list of patients exempt from health care charges, as 65.68% by the independent pediatricians and as 31.45% according to the "Nocchiero Project" data. DISCUSSION Our investigation underlines the difficulty of dividing subjects into different risk categories. The data provided by independent pediatricians yielded higher estimates of vaccination coverage in pediatric patients than the data from the other two sources. CONCLUSIONS Estimates of vaccination coverage vary according to the source of data. However, pediatricians seem to be the most reliable source, as they know their patients better. Collaboration between health authorities and independent pediatricians should therefore be improved in order to obtain the best results in terms of influenza prevention in high-risk groups.
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Affiliation(s)
- G Zoppi
- Department of Prevention, Local Health Agency 4 Chiavarese, Liguria, Italy.
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