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Montella E, Iodice S, Bernardo C, Frangiosa A, Pascarella G, Santalucia I, Triassi M. Integrated System for the Proactive Analysis on Infection Risk at a University Health Care Establishment Servicing a Large Area in the South of Italy. J Patient Saf 2023; 19:313-322. [PMID: 37366611 PMCID: PMC10373839 DOI: 10.1097/pts.0000000000001141] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVES Our study proposes the use of a proactive system to manage risk combining the new Risk Identification Framework by the World Health Organization, the Lean method, and the hospital's Procedure Analysis.The system was tested for the prevention of surgical site infections in the University Hospital of Naples "Federico II" on the surgical paths, where they were usually applied individually. METHODS We conducted a retrospective observational study from March 18, 2019, to June 30, 2019, at the University Hospital "Federico II" of Naples, Italy (Europe).The study is structured in 3 phases: phase 1, application of each proactive risk management tool (March 18-April 15, 2019); phase 2, analysis and integration of the results, and elaboration of an overview of critical and control points (April 15-20, 2019); and phase 3, evaluation of the outcomes as variation of surgical site infection's incidence between the 3-month period of the 2019 and the same period of the 2018, when each tool was implemented separately (April 30-June 30, 2019). RESULTS (1) The application of the single tool has detected different criticalities; (2) the combined system allowed us to draw a risk map and identify "improving" macroareas; and (3) the infection rate, with the application of this system, was equal to 1.9%; in the same period of the previous year, it was equal to 4%. CONCLUSIONS Our study demonstrates that "integrated system" has been more effective to proactively identify surgical route risks compared with the application of each single instrument.
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Affiliation(s)
- Emma Montella
- From the Department of Public Health, University of Naples “Federico II”
| | - Sabrina Iodice
- From the Department of Public Health, University of Naples “Federico II”
| | - Carlo Bernardo
- From the Department of Public Health, University of Naples “Federico II”
| | | | | | - Ida Santalucia
- From the Department of Public Health, University of Naples “Federico II”
| | - Maria Triassi
- Department of Public Health and Interdepartmental Centre for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II,” Naples, Italy
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Balato G, Palladino R, Montella E, Diana L, Coviello A, Festa E, Iervolino A, Rubba F, Mariconda M, Triassi M. A training ground Lay out improves rehabilitation after trauma surgery: A Fast Track Policy. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.011] [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: 11/14/2022] Open
Abstract
Abstract
Fracture patients are frail and have high mortality. We investigated whether introducing a fast-track strategy during post-surgery care and including early rehabilitation protocols may shorten the length of hospital stay (LOS) while improving the overall clinical effectiveness. A training ground was built inside the inpatient area dedicated to trauma settings. Usual postoperative care consists of immobilization during the first day, but patients may start rehabilitation earlier, 24 hours after the surgical procedure, with a fast-track strategy. In general, gait speed, step length, and self-assessment in terms of mobility improve significantly in the first six postoperative weeks in fracture patients. As delayed postoperative mobility during hospitalization was observed, the established training ground may help with this concern. The expert physiotherapist may contribute to ameliorating the indicators showing great potential in postoperative rehabilitation regardless of fracture pattern. The primary outcome was postoperative physical functioning. Secondary outcomes included the patient’s assessment of therapeutic effect (overall improvement), perceived pain intensity, health services utilization, treatment side effects, and adverse events. Data were analyzed by univariate analysis and binary logistic regression showing a reduction of LOS of almost three days. Further, the optimized hip fracture program reduced the rate of in-hospital postoperative complications and mortality. Adding to the schedule, some PROMPTS (Patient-reported outcome measures) could further integrate the patient empowerment perspective into the quality set of values. For this reason, ‘fast track’ may define a crucial policy able to guarantee rapid rehabilitation, becoming a key factor to achieving a good clinical effect. Fast-track rehabilitation facilitates a shortened hospital stay and cost-saving and can be used to optimize the patient’s condition before admission to a rehabilitation facility
Key messages
• Early rehabilitation protocols may shorten the length of hospital stay (LOS) while improving the overall clinical effectiveness.
• Human factors and patients empowerments may help.
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Affiliation(s)
- G Balato
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - R Palladino
- Public Health Department, AOU Federico II , Naples, Italy
| | - E Montella
- Public Health Department, AOU Federico II , Naples, Italy
| | - L Diana
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - A Coviello
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - E Festa
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - A Iervolino
- University Hospital, AOU Federico II , Naples, Italy
| | - F Rubba
- Public Health Department, AOU Federico II , Naples, Italy
| | - M Mariconda
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - M Triassi
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
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3
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Montella E, Iodice S, Bellopede S, Frangiosa A, Giovagnoli A, Mazia G, Triassi M. Integrated system for the proactive analisys of risk infection in patient’s surgical route. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.417] [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: 11/14/2022] Open
Abstract
Abstract
Background
The most common hospital safety incidents are Hospital-Acquired-Infections (HAI) and among these Surgical Site Infections (SSIs). Our study proposes the use of a proactive system to manage risk combining the new Risk Identification Framework by WHO (IPCAF), the Lean method and the hospital’s Procedure Analysis. Each of the methods has pros and cons, and there is no existing literature that researches the concurrent use of all three methods. We focused on analysing patients’ surgical route to demonstrate that using an integrated system for preventing SSIs delivers enhanced results and significantly contibutes to a reduction in occurence of SSIs.
Methods
We conducted a retrospective observational study from 18 March 2019 to 20 April 2019 at Azienda Ospedaliera Universitaria Federico II di Napoli, Italia (Europa). The study is structured in 3 phases:
Phase 1- application of proactive risk management tools (18 March- 15 April 2019);
Phase 2-integration of results with the elaboration of a single system for proactive risk management (15-20 April 2019);
Phase 3- collection of epidemiologic data concerning SSI. We used the incidence of surgical site as efficiency indicator (1-10 March 2022).
The endpoints identified were:
Primary Endpoint: a reduction of infection occurrence in surgical sites
Secondary Endpoint: identification of critical points and control points within the surgical process with relevant corrective measures
Results
The rate of incidence of SSIs was selected as the efficacy indicator for the system. Our study recorded a 2.40% incidence rate for SSIs in 2020, compared to an incidence rate of 3.80% in 2018 and of 3.5% in 2017.
Conclusions
Considering the economic impact of the infections, along with the increased incidence of mortality and morbidity, employing all available tools to try and reduce SSIs incidence becomes paramount. A small reduction can produce significant cost savings that can be invested in other prevention programs.
Key messages
• Integrated system in proactively and promptly identifying risks related to patients’ surgical routes is effectiveness.
• The system can be adapted to different healthcare settings, to prevent adverse incidents by employing a risk management strategy, and to further enhance existing strategies.
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Affiliation(s)
- E Montella
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - S Iodice
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - S Bellopede
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - A Frangiosa
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - A Giovagnoli
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - G Mazia
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - M Triassi
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
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Nolasco A, Squillante J, Esposito F, Velotto S, Romano R, Aponte M, Giarra A, Toscanesi M, Montella E, Cirillo T. Coffee Silverskin: Chemical and Biological Risk Assessment and Health Profile for Its Potential Use in Functional Foods. Foods 2022; 11:foods11182834. [PMID: 36140962 PMCID: PMC9498437 DOI: 10.3390/foods11182834] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/23/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
The coffee supply chain is characterized by a complex network with many critical and unsustainable points producing a huge amount of waste products. Among these, coffee silverskin (CS), the only by-product of the coffee roasting phase, has an interesting chemical profile that suggests potential use as a food ingredient. However, few data on its safety are available. For this reason, the purpose of the study was to assess the occurrence of chemical and biological contaminants in CS, and the resulting risk due to its potential consumption. Essential, toxic, and rare earth elements, polycyclic aromatic hydrocarbons (PAHs), process contaminants, ochratoxin A (OTA), and pesticides residues were analyzed in three classes of samples (Coffea arabica CS, Coffea robusta CS, and their blend). Furthermore, total mesophilic bacteria count (TMBC) at 30 °C, Enterobacteriaceae, yeasts, and molds was evaluated. The risk assessment was based upon the hazard index (HI) and lifetime cancer risk (LTCR). In all varieties and blends, rare earth elements, pesticides, process contaminants, OTA, and PAHs were not detected except for chrysene, phenanthrene, and fluoranthene, which were reported at low concentrations only in the arabica CS sample. Among essential and toxic elements, As was usually the most representative in all samples. Microorganisms reported a low load, although arabica and robusta CS showed lower contamination than mixed CS. Instead, the risk assessment based on the potential consumption of CS as a food ingredient did not show either non-carcinogenic or carcinogenic risk. Overall, this study provides adequate evidence to support the safety of this by-product for its potential use in functional foods.
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Affiliation(s)
- Agata Nolasco
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, Portici, 100-80055 Naples, Italy
| | - Jonathan Squillante
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, Portici, 100-80055 Naples, Italy
| | - Francesco Esposito
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini, 5-80131 Naples, Italy
- Correspondence:
| | - Salvatore Velotto
- Department of Promotion of Human Sciences and the Quality of Life, University of Study of Roma “San Raffaele”, Via di Val Cannuta, 247-00166 Roma, Italy
| | - Raffaele Romano
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, Portici, 100-80055 Naples, Italy
| | - Maria Aponte
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, Portici, 100-80055 Naples, Italy
| | - Antonella Giarra
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cintia, 21-80126 Naples, Italy
| | - Maria Toscanesi
- Department of Chemical Sciences, University of Naples “Federico II”, Via Cintia, 21-80126 Naples, Italy
| | - Emma Montella
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini, 5-80131 Naples, Italy
| | - Teresa Cirillo
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, Portici, 100-80055 Naples, Italy
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Valdecantos RL, Palladino R, Lo Vecchio A, Montella E, Triassi M, Nardone A. Organisational and Structural Drivers of Childhood Immunisation in the European Region: A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10091390. [PMID: 36146467 PMCID: PMC9505321 DOI: 10.3390/vaccines10091390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022] Open
Abstract
Despite the implementation of widespread vaccination programs, the European Health Systems continue to experience care challenges attributable to organizational and structural issues. This study aimed to review the available data on aspects within the organizational and structural domains that might impact vaccination coverage. We searched a comprehensive range of databases from 1 January 2007 to 6 July 2021 for studies that reported quantitative or qualitative research on interventions to raise childhood vaccine coverage. Outcome assessments comprised organizational and structural factors that contribute to vaccine concern among pediatric parents, as well as data reported influencing the willingness to vaccinate. To analyze the risk of bias, the Ottawa, JBI’s (Joanna Briggs Institute) critical appraisal tool, and Amstar quality assessment were used accordingly. The inclusion criteria were met by 205 studies across 21 articles. The majority of the studies were conducted in the United Kingdom (6), the European Union (3), and Italy (3). A range of interventions studied in primary healthcare settings has been revealed to improve vaccination coverage rates including parental engagement and personalization, mandatory vaccination policies, program redesign, supply chain design, administering multiple/combination vaccines, improved vaccination timing and intervals, parental education and reminders, surveillance tools and Supplemental Immunisation Activity (SIA), and information model.
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Affiliation(s)
- Ronan Lemwel Valdecantos
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
- Global Health Workforce Network (GHWN) Youth Hub, World Health Organization, 1211 Geneva, Switzerland
- Correspondence: (R.L.V.); (R.P.)
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80138 Napoli, Italy
- Department of Primary Care and Public Health, Imperial College, London SW7 2BX, UK
- Correspondence: (R.L.V.); (R.P.)
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Section of Pediatrics, University “Federico II” of Naples, 80138 Napoli, Italy
| | - Emma Montella
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80138 Napoli, Italy
| | - Antonio Nardone
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
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Cossiga V, La Civita E, Bruzzese D, Guarino M, Fiorentino A, Sorrentino R, Pontillo G, Vallefuoco L, Brusa S, Montella E, Terracciano D, Morisco F, Portella G. Enhanced liver fibrosis score as a noninvasive biomarker in hepatitis C virus patients after direct-acting antiviral agents. Front Pharmacol 2022; 13:891398. [PMID: 36059971 PMCID: PMC9428144 DOI: 10.3389/fphar.2022.891398] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background: In more than 90% of chronic viral hepatitis C (HCV) patients treated with direct-acting antiviral agents (DAAs), a sustained viral response (SVR) was observed. Unfortunately, there are subgroups of subjects who display enduring liver fibrosis and are at high risk of developing hepatocellular carcinoma (HCC). Thus, liver fibrosis evaluation during the follow-up of these patients plays a pivotal role. The gold standard to evaluate hepatic fibrosis is liver biopsy, which is an invasive procedure. Imaging techniques and serum biomarkers have been proposed as safer and cheaper procedures. Objectives: In this study, we evaluated the concordance of transient elastography (TE) with ELF score ( enhanced liver fibrosis) in a cohort of patients with HCV before and after direct-acting antiviral (DAAs) treatment. ELF score has been validated in other chronic liver diseases; the evidence is not available in HCV patients treated with DAAs. Study design: We prospectively recruited all consecutive HCV patient candidates for DAAs therapy at the University of Naples “Federico II” between April 2015 and July 2016. TE and ELF scores were assessed at baseline, at SVR24, and at SVR48. Results: One-hundred-nineteen patients were treated with DAAs, and 94.1% of them reached SVR. A total of 55.5% of patients were males with a mean age of 64.7 ± 9.6 years. TE results revealed that 12 patients (10%) had F1-2 mild/moderate fibrosis, and 107 (90%) had F3-4 advanced fibrosis. At baseline, SVR24, and SVR48, the concordance between ELF test and TE was poor: 0.11 (p = 0.086), 0.15 (p = 0.124), and 0.034 (p = 0.002), respectively. However, at SVR24 and SVR48, both methods showed a significant amelioration of liver fibrosis compared to baseline (p < 0.001). In addition, both ELF index and TE were significantly associated with portal hypertension at baseline, but not with varices and ascites. Conclusions: Our findings suggested that ELF test could predict changes in liver fibrosis, independently of TE. In case of TE unavailability, ELF score could represent an appropriate tool. Notably, in the context of the COVID-19 pandemic, ELF testing should be encouraged to reduce unnecessary access to the hospital and prolonged physical contact.
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Affiliation(s)
- Valentina Cossiga
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- *Correspondence: Daniela Terracciano, ; Valentina Cossiga,
| | - Evelina La Civita
- Department of Translational Medical Science, University of Naples “Federico II”, Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Maria Guarino
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Andrea Fiorentino
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Rosanna Sorrentino
- Department of Translational Medical Science, University of Naples “Federico II”, Naples, Italy
| | - Giuseppina Pontillo
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Luca Vallefuoco
- Department of Translational Medical Science, University of Naples “Federico II”, Naples, Italy
| | - Stefano Brusa
- Department of Translational Medical Science, University of Naples “Federico II”, Naples, Italy
| | - Emma Montella
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Daniela Terracciano
- Department of Translational Medical Science, University of Naples “Federico II”, Naples, Italy
- *Correspondence: Daniela Terracciano, ; Valentina Cossiga,
| | - Filomena Morisco
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Giuseppe Portella
- Department of Translational Medical Science, University of Naples “Federico II”, Naples, Italy
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Palladino R, Mercogliano M, Fiorilla C, Frangiosa A, Iodice S, Sanduzzi Zamparelli S, Montella E, Triassi M, Sanduzzi Zamparelli A. Association between COVID-19 and Sick Leave for Healthcare Workers in a Large Academic Hospital in Southern Italy: An Observational Study. Int J Environ Res Public Health 2022; 19:9670. [PMID: 35955042 PMCID: PMC9368056 DOI: 10.3390/ijerph19159670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/26/2022] [Revised: 07/26/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
Studies have shown that the pandemic has led to an increase in sick leave periods among healthcare workers (HCWs); however, this might have changed over time considering increase in vaccination coverage and change in COVID-19 variant predominance. Therefore, we conducted an observational study to evaluate whether the type of symptoms and the duration of sick leave period for healthcare workers working in a large university hospital in the South of Italy changed between January 2021 and January 2022; 398 cases of COVID-19 were identified for a total of 382 subjects involved. A total of 191 subjects answered the questionnaire about symptoms; of these, 79 had COVID-19 during the period from March 2020 until February 2022. The results showed a decrease of about 1.2 days in sick leave period for each quarter without finding significant differences in the perception of symptoms. It is possible to hypothesize a contribution from the Omicron variant to the decrease in sick leave period in the last quarter, from vaccination coverage, from optimization of COVID-19 management, and from change in the regulations for the assessment of positivity.
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Affiliation(s)
- Raffaele Palladino
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
- Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
| | | | - Claudio Fiorilla
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Alessandro Frangiosa
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Sabrina Iodice
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | | | - Emma Montella
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
| | - Alessandro Sanduzzi Zamparelli
- Department of Clinical Medicine and Surgery, Section of Respiratory Diseases, University “Federico II”, Azienda Ospedaliera dei Colli-Monaldi Hospital, 80131 Naples, Italy
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De Luca C, Gragnano G, Conticelli F, Cennamo M, Pisapia P, Terracciano D, Malapelle U, Montella E, Triassi M, Troncone G, Portella G. Evaluation of a fully closed real time PCR platform for the detection of SARS-CoV-2 in nasopharyngeal swabs: a pilot study. J Clin Pathol 2022; 75:551-554. [PMID: 33837109 PMCID: PMC8042579 DOI: 10.1136/jclinpath-2021-207516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/01/2021] [Revised: 03/21/2021] [Accepted: 03/24/2021] [Indexed: 12/14/2022]
Abstract
AIMS To date, reverse transcriptase PCR (RT-PCR) on nasopharyngeal swabs is the 'gold standard' approach for the diagnosis of COVID-19. The need to develop easy to use, rapid, robust and with minimal hands-on time approaches are warranted. In this setting, the Idylla SARS-CoV-2 Test may be a valuable option. The aim of our study is to evaluate the analytical and clinical performance of this assay on previously tested SARS-CoV-2 people by conventional RT-PCR based approach in different settings, including initial diagnosis and clinical follow-up. METHODS To evaluate the sensitivity and specificity of the Idylla SARS-CoV-2 Test, we retrieved 55 nasopharyngeal swabs, previously analysed by a fully validated assay, from symptomatic patients or from people who have been in close contact with COVID-19 positive cases. Discordant or high discrepant cases were further analysed by a third technique. In addition, a second subset of 14 nasopharyngeal swab samples with uncertain results (cycle threshold between 37 and 40), by using the fully validated assay, from patients with viral infection beyond day 21, were retrieved. RESULTS Overall, Idylla showed a sensitivity of 93.9% and a specificity of 100.0%. In addition, in the additional 14 nasopharyngeal swab samples, only five (35.7%) featured a positive result by the Idylla SARS-CoV-2 Test. CONCLUSIONS We demonstrated that the Idylla SARS-CoV-2 Test may represent a valid, fast, highly sensitive and specific RT-PCR test for the identification of SARS-CoV-2 infection.
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Affiliation(s)
| | | | | | - Michele Cennamo
- Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Daniela Terracciano
- Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Emma Montella
- Public Health, University of Naples Federico II, Naples, Italy
| | - Maria Triassi
- Public Health, University of Naples Federico II, Naples, Italy
| | | | - Giuseppe Portella
- Translational Medical Sciences, University of Naples Federico II, Naples, Italy
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9
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Montella E, Ferraro A, Sperlì G, Triassi M, Santini S, Improta G. Predictive Analysis of Healthcare-Associated Blood Stream Infections in the Neonatal Intensive Care Unit Using Artificial Intelligence: A Single Center Study. Int J Environ Res Public Health 2022; 19:ijerph19052498. [PMID: 35270190 PMCID: PMC8909182 DOI: 10.3390/ijerph19052498] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/22/2022]
Abstract
Background: Neonatal infections represent one of the six main types of healthcare-associated infections and have resulted in increasing mortality rates in recent years due to preterm births or problems arising from childbirth. Although advances in obstetrics and technologies have minimized the number of deaths related to birth, different challenges have emerged in identifying the main factors affecting mortality and morbidity. Dataset characterization: We investigated healthcare-associated infections in a cohort of 1203 patients at the level III Neonatal Intensive Care Unit (ICU) of the “Federico II” University Hospital in Naples from 2016 to 2020 (60 months). Methods: The present paper used statistical analyses and logistic regression to identify an association between healthcare-associated blood stream infection (HABSIs) and the available risk factors in neonates and prevent their spread. We designed a supervised approach to predict whether a patient suffered from HABSI using seven different artificial intelligence models. Results: We analyzed a cohort of 1203 patients and found that birthweight and central line catheterization days were the most important predictors of suffering from HABSI. Conclusions: Our statistical analyses showed that birthweight and central line catheterization days were significant predictors of suffering from HABSI. Patients suffering from HABSI had lower gestational age and birthweight, which led to longer hospitalization and umbilical and central line catheterization days than non-HABSI neonates. The predictive analysis achieved the highest Area Under Curve (AUC), accuracy and F1-macro score in the prediction of HABSIs using Logistic Regression (LR) and Multi-layer Perceptron (MLP) models, which better resolved the imbalanced dataset (65 infected and 1038 healthy).
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Affiliation(s)
- Emma Montella
- Department of Public Health, University of Naples “Federico”, 80125 Naples, Italy; (E.M.); (M.T.); (G.I.)
| | - Antonino Ferraro
- Department of Information Technology and Electrical Engineering, University of Naples “Federico”, Via Claudio 21, 80125 Naples, Italy; (A.F.); (S.S.)
| | - Giancarlo Sperlì
- Department of Information Technology and Electrical Engineering, University of Naples “Federico”, Via Claudio 21, 80125 Naples, Italy; (A.F.); (S.S.)
- CINI-ITEM National Lab, Complesso Universitario di Monte S. Angelo Via Cinthia Edificio Centri Comuni, 80126 Naples, Italy
- Correspondence:
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico”, 80125 Naples, Italy; (E.M.); (M.T.); (G.I.)
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico”, 80131 Naples, Italy
| | - Stefania Santini
- Department of Information Technology and Electrical Engineering, University of Naples “Federico”, Via Claudio 21, 80125 Naples, Italy; (A.F.); (S.S.)
- CINI-ITEM National Lab, Complesso Universitario di Monte S. Angelo Via Cinthia Edificio Centri Comuni, 80126 Naples, Italy
| | - Giovanni Improta
- Department of Public Health, University of Naples “Federico”, 80125 Naples, Italy; (E.M.); (M.T.); (G.I.)
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico”, 80131 Naples, Italy
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10
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Capasso N, Palladino R, Montella E, Pennino F, Lanzillo R, Carotenuto A, Petracca M, Iodice R, Iovino A, Aruta F, Pastore V, Buonomo AR, Zappulo E, Gentile I, Triassi M, Morra VB, Moccia M. Prevalence of SARS-CoV-2 antibodies in multiple sclerosis: The hidden part of the iceberg. J Neurol Sci 2021. [PMCID: PMC8498489 DOI: 10.1016/j.jns.2021.118116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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11
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Moccia M, Affinito G, Capacchione A, Lanzillo R, Carotenuto A, Montella E, Triassi M, Morra VB, Palladino R. Interferon beta for the treatment of multiple sclerosis in the Campania Region of Italy: Merging the real-life to routinely collected healthcare data. PLoS One 2021; 16:e0258017. [PMID: 34587188 PMCID: PMC8480611 DOI: 10.1371/journal.pone.0258017] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 09/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background We aim to overcome limitations of previous clinical and population-based studies by merging a clinical registry to routinely-collected healthcare data, and to specifically describe differences in clinical outcomes, healthcare resource utilization and costs between interferon beta formulations for multiple sclerosis (MS). Methods We included 850 patients with MS treated with interferon beta formulations, from 2015 to 2019, seen at the MS Clinical Care and Research Centre (Federico II University of Naples, Italy) and with linkage to routinely-collected healthcare data (prescription data, hospital admissions, outpatient services). We extracted and computed clinical outcomes (relapses, 6-month EDSS progression using a roving EDSS as reference), persistence (time spent on a specific interferon beta formulation), adherence (medication possession ratio (MPR)), healthcare resource utilization and costs (annualized hospitalization rate (AHR), costs for hospital admissions and DMTs). To evaluate differences between interferon beta formulations, we used linear regression (adherence), Poisson regression (AHR), mixed-effect regression (costs), and Cox-regression models (time varying variables); covariates were age, sex, treatment duration, baseline EDSS and adherence. Results Looking at clinical outcomes, rates of relapses and EDSS progression were lower than studies run on previous cohorts; there was no differences in relapse risk between interferon beta formulations. Risk of discontinuation was higher for Betaferon®/Extavia® (HR = 3.28; 95%CI = 2.11, 5.12; p<0.01). Adherence was lower for Betaferon®/Extavia® (Coeff = -0.05; 95%CI = -0.10, -0.01; p = 0.02), and Avonex® (Coeff = -0.06; 95%CI = -0.11, -0.02; p<0.01), when compared with Rebif® and Plegridy® (Coeff = 0.08; 95%CI = 0.01, 0.16; p = 0.02). AHR and costs for MS hospital admissions were higher for Betaferon®/Extavia® (IRR = 2.38; 95%CI = 1.01, 5.55; p = 0.04; Coeff = 14.95; 95%CI = 1.39, 28.51; p = 0.03). Conclusions We have showed the feasibility of merging routinely-collected healthcare data to a clinical registry for future MS research, and have confirmed interferon beta formulations play an important role in the management of MS, with positive clinical outcomes. Differences between interferon beta formulations are mostly driven by adherence and healthcare resource utilization.
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Affiliation(s)
- Marcello Moccia
- Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University of Naples, Naples, Italy
- * E-mail: ,
| | - Giuseppina Affinito
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Antonio Capacchione
- Merck Serono S.p.A (an affiliate of Merck KGaA, Darmstadt, Germany), Rome, Italy
| | - Roberta Lanzillo
- Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University of Naples, Naples, Italy
| | - Antonio Carotenuto
- Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University of Naples, Naples, Italy
| | - Emma Montella
- Health Management Office, Federico II University Hospital of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Vincenzo Brescia Morra
- Department of Neuroscience, Reproductive Science and Odontostomatology, Multiple Sclerosis Clinical Care and Research Centre, Federico II University of Naples, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, Federico II University of Naples, Naples, Italy
- Department of Primary Care and Public Health, Imperial College, London, United Kingdom
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12
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Pascarella G, Rossi M, Montella E, Capasso A, De Feo G, Botti G, Nardone A, Montuori P, Triassi M, D'Auria S, Morabito A. Risk Analysis in Healthcare Organizations: Methodological Framework and Critical Variables. Risk Manag Healthc Policy 2021; 14:2897-2911. [PMID: 34267567 PMCID: PMC8275831 DOI: 10.2147/rmhp.s309098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/01/2021] [Accepted: 05/10/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose A risk assessment matrix is a widely used tool for analyzing, assessing and setting priorities in risk management in many fields. This paper overviews critical variables, advantages, disadvantages, strengths and weaknesses of this tool, according to the ISO 31000 risk management framework. Results Risk assessment is one of the key stages in the Risk Management Process and involves specific steps: identifying hazards, analyzing and evaluating all possible risks. Several methods are developed to assess risks in the literature. A risk matrix method, also called “decision matrix risk assessment (DMRA) technique”, is a systematic approach used to determine the risk level and to compare different risks and define which threats need to be controlled first. The actors involved in risk assessment are called on to manage different issues related to the choice of the most appropriate methodological approach, the assessment of the adequacy of the existing control measures, the articulation of risk consequence domains, the definition of the impact-consequences, the explanation of risk likelihood scales and the development of a risk matrix. Conclusion We highlighted a number of recommendations in order to address these issues, especially useful when healthcare organizations provide insufficient guidance on how to use risk matrices as well as what to do in response to the existing criticisms on their use.
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Affiliation(s)
- Giacomo Pascarella
- Scientific Directorate, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Napoli, Italy
| | - Matteo Rossi
- Wroclaw School of Banking Wyższa Szkoła Bankowa, Wrocalw, Poland
| | - Emma Montella
- Department of Public Health, Università Federico II, Napoli, Italy
| | - Arturo Capasso
- Wroclaw School of Banking Wyższa Szkoła Bankowa, Wrocalw, Poland
| | - Gianfranco De Feo
- Scientific Directorate, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Napoli, Italy
| | - Gerardo Botti
- Scientific Directorate, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Napoli, Italy
| | - Antonio Nardone
- Department of Public Health, Università Federico II, Napoli, Italy
| | - Paolo Montuori
- Department of Public Health, Università Federico II, Napoli, Italy
| | - Maria Triassi
- Department of Public Health, Università Federico II, Napoli, Italy
| | - Stefania D'Auria
- Department of Health Management, Istituto Nazionale Tumori, "Fondazione G. Pascale", IRCCS, Napoli, Italy
| | - Alessandro Morabito
- Thoracic Department, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Napoli, Italy
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13
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Bousquet J, Agache I, Blain H, Jutel M, Ventura MT, Worm M, Del Giacco S, Benetos A, Bilo MB, Czarlewski W, Abdul Latiff AH, Al-Ahmad M, Angier E, Annesi-Maesano I, Atanaskovic-Markovic M, Bachert C, Barbaud A, Bedbrook A, Bennoor KS, Berghea EC, Bindslev-Jensen C, Bonini S, Bosnic-Anticevich S, Brockow K, Brussino L, Camargos P, Canonica GW, Cardona V, Carreiro-Martins P, Carriazo A, Casale T, Caubet JC, Cecchi L, Cherubini A, Christoff G, Chu DK, Cruz AA, Dokic D, El-Gamal Y, Ebisawa M, Eberlein B, Farrell J, Fernandez-Rivas M, Fokkens WJ, Fonseca JA, Gao Y, Gavazzi G, Gawlik R, Gelincik A, Gemicioğlu B, Gotua M, Guérin O, Haahtela T, Hoffmann-Sommergruber K, Hoffmann HJ, Hofmann M, Hrubisko M, lenaIllario M, Irani C, Ispayeva Z, Ivancevich JC, Julge K, Kaidashev I, Khaitov M, Knol E, Kraxner H, Kuna P, Kvedariene V, Lauerma A, Le LT, Le Moing V, Levin M, Louis R, Lourenco O, Mahler V, Martin FC, Matucci A, Milenkovic B, Miot S, Montella E, Morais-Almeida M, Mortz CG, Mullol J, Namazova-Baranova L, Neffen H, Nekam K, Niedoszytko M, Odemyr M, O'Hehir RE, Okamoto Y, Ollert M, Palomares O, Papadopoulos NG, Panzner P, Passalacqua G, Patella V, Petrovic M, Pfaar O, Pham-Thi N, Plavec D, Popov TA, Recto MT, Regateiro FS, Reynes J, Roller-Winsberger RE, Rolland Y, Romano A, Rondon C, Rottem M, Rouadi PW, Salles N, Samolinski B, Santos AF, Serpa FS, Sastre J, Schols JMGA, Scichilone N, Sediva A, Shamji MH, Sheikh A, Skypala I, Smolinska S, Sokolowska M, Sousa-Pinto B, Sova M, Stelmach R, Sturm G, Suppli Ulrik C, Todo-Bom AM, Toppila-Salmi S, Tsiligianni I, Torres M, Untersmayr E, Urrutia Pereira M, Valiulis A, Vitte J, Vultaggio A, Wallace D, Walusiak-Skorupa J, Wang DY, Waserman S, Yorgancioglu A, Yusuf OM, Zernotti M, Zidarn M, Chivato T, Akdis CA, Zuberbier T, Klimek L. Management of anaphylaxis due to COVID-19 vaccines in the elderly. Allergy 2021; 76:2952-2964. [PMID: 33811358 PMCID: PMC8251336 DOI: 10.1111/all.14838] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 11/30/2022]
Abstract
Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID‐19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID‐19 vaccines due to high risk of death. In very rare instances, the COVID‐19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA‐EAACI‐EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID‐19 vaccines. Anaphylaxis to COVID‐19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.
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Affiliation(s)
- Jean Bousquet
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany.,University Hospital Montpellier, France.,MACVIA-France, Montpellier, France
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Hubert Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, and ALL-MED Medical Research Institute, Wrocław, Poland
| | - Maria Teresa Ventura
- University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy
| | - Margitta Worm
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
| | - Athanasios Benetos
- Department of Geriatrics, CHRU de Nancy and Inserm DCAC, Université de Lorraine, Nancy, France
| | - M Beatrice Bilo
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche - Allergy Unit - Department of Internal Medicine, University Hospital, Ospedali Riuniti di Ancona, Ancona, Italy
| | | | - Amir Hamzah Abdul Latiff
- Allergy & Immunology Centre, Pantai Hospital, Department of Pediatrics, Universiti Putra Malaysia Teaching Hospital,, Kuala Lumpur, Malaysia
| | - Mona Al-Ahmad
- Microbiology Department, Faculty of Medicine, Kuwait University and Department of Allergy, Al-Rashed Allergy Center, Kuwait
| | - Elizabeth Angier
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Isabella Annesi-Maesano
- Institut Desbrest d'Epidémiologie et Santé Publique (IDESP), INSERM et Université de Montpellier, Montpellier, France
| | | | - Claus Bachert
- Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium.,Sun Yat-sen University, International Airway Research Center, First Affiliated Hospital Guangzou, China.,Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm and Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Annick Barbaud
- Division of Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France & Division of Equipe PEPITES, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Anna Bedbrook
- Allergy & Immunology Centre, Pantai Hospital, Department of Pediatrics, Universiti Putra Malaysia Teaching Hospital,, Kuala Lumpur, Malaysia
| | - Kazi S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - Elena Camelia Berghea
- Allergology and Clinical Immunology, Carol Davila University of Medicine and Pharmacy, Bucharest, and Clinical Emergency Hospital for Children MS Curie, Bucharest, Romania
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - Sergio Bonini
- Institute of Translational Pharmacology, Italian National Research Council, Rome, Italy
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany
| | - Luisa Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - Paulo Camargos
- Federal University of Minas Gerais, Medical School, Department of Pediatrics, Belo Horizonte, Brazil
| | - G Walter Canonica
- Personalized Medicine Asthma, & Allergy Clinic-Humanitas University & Research Hospital, IRCCS-Milano, Italy
| | - Victoria Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL research network, Barcelona, Spain
| | - Pedro Carreiro-Martins
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Lisbon, Portugal
| | - Ana Carriazo
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - Thomas Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, Fl, USA
| | - Jean-Christoph Caubet
- Pediatric Allergy Unit, Department of Child and Adolescent, Geneva University Hospital, Geneva, Switzerland
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | | | - Derek K Chu
- Department of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alvaro A Cruz
- Fundação ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - Dejan Dokic
- University Clinic of Pulmology and Allergy, Medical Faculty Skopje, Republic of Macedonia
| | - Yehia El-Gamal
- Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Japan
| | - Bernadette Eberlein
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany
| | - John Farrell
- LANUA International Healthcare Consultancy, Down, UK
| | | | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centers, AMC, Amsterdam, The Netherland, and EUFOREA, Brussels, Belgium
| | - Joao A Fonseca
- CINTESIS, Center for Health Technology and Services Research, Faculdade de Medicina, Universidade do Porto, Porto, Portugal ; Allergy Unit, CUF Porto, Porto, Portugal
| | - Yadong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Gaëtan Gavazzi
- Service Gériatrie Clinique, Centre Hospitalo-Universitaire Grenoble-Alpes, GREPI (TIMC-IMAG, CNRS 5525), Université Grenoble-Alpes, Grenoble, France
| | - Radolslaw Gawlik
- Dept of Internal Medicine, Allergy and Clin Immunology, Silesian University of Medicine, Katowice, Poland
| | - Asli Gelincik
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Bilun Gemicioğlu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Maia Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
| | | | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki University, Helsinki, Finland
| | - Karin Hoffmann-Sommergruber
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Hans Jürgen Hoffmann
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus & Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Maja Hofmann
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
| | - Martin Hrubisko
- Department of Clinical Immunology and Allergy, Oncology Institute of St Elisabeth, Heydukova, Bratislava, Slovakia
| | - Madda lenaIllario
- Federico II University & Hospital, Department of Public Health and Research and Development Unit Naples, Italy
| | - Carla Irani
- Department of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Zhanat Ispayeva
- President of Kazakhstan Association of Allergology and Clinical Immunology, Department of Allergology and clinical immunology of the Kazakh National Medical University, Kazakhstan
| | | | - Kaja Julge
- Tartu University Institute of Clinical Medicine, Children's Clinic, Tartu, Estonia
| | - Igor Kaidashev
- Ukrainina Medical Stomatological Academy, Poltava, Ukraine
| | - Musa Khaitov
- National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular Immunology, Moscow, Russia
| | - Edward Knol
- Departments of Immunology and Dermatology/Allergology, University Medical Center Utrecht, The Netherlands
| | - Helga Kraxner
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Poland
| | - Violeta Kvedariene
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University and Institute of Clinical Medicine, Clinic of Chest diseases and Allergology, faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Antti Lauerma
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University, Meilahdentie Helsinki, Finland
| | - Lan Tt Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - Vincent Le Moing
- Department of Infectiology, Montpellier University Hospital, France
| | - Michael Levin
- Division Paediatric Allergology, University of Cape Town, Cape Town, South Africa
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 research group, Liege, Belgium
| | - Olga Lourenco
- Faculty of Health Sciences and CICS - UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | | | - Finbarr C Martin
- Emeritus Geriatrician and Professor of Medical Gerontology Population Health Sciences I, King's College London, UK
| | - Andrea Matucci
- Immunoallergology Unit, Careggi University Hospital, Florence, Italy
| | - Branislava Milenkovic
- Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - Stéphanie Miot
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France
| | - Emma Montella
- Federico II University & Hospital, Department of Public Health and Research and Development Unit, Naples, Italy
| | | | - Charlotte G Mortz
- Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona,, Spain
| | - Leyla Namazova-Baranova
- Pediatrics and Child Health Research Institute, Central Clinical Hospital of the Russian Academy of Sciences, Russian National Research Medical University, Moscow, Russia
| | - Hugo Neffen
- Director of Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina
| | - Kristof Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - Marek Niedoszytko
- Medical University of Gdańsk, Department of Allergology, Gdańsk, Poland
| | - Mikaëla Odemyr
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Robyn E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, Monash University, and Alfred Health, Melbourne, Victoria, Australia
| | - Yoshitaka Okamoto
- Dept of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg & Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis,, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou, University of Athens, Athens, Greece
| | - Petr Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Gianni Passalacqua
- Allergy and Respiratory Diseases, Ospedale Policlino San Martino -University of Genoa, Genoa, Italy
| | - Vincenzo Patella
- Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, "Santa Maria della Speranza" Hospital, Battipaglia Salerno, Italy
| | - Mirko Petrovic
- Department of Internal Medicine and Paediatrics, Section of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Nhân Pham-Thi
- Ecole polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France
| | - Davor Plavec
- Children's Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - Todor A Popov
- University Hospital 'Sv Ivan Rilski'", Sofia, Bulgaria
| | | | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra and Institute of Immunology, Faculty of Medicine, University of Coimbra, and ICBR - Coimbra Institute for Clinical and Biomedical Research, CIBB, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Jacques Reynes
- Department of Infectiology, Montpellier University Hospital, France
| | | | - Yves Rolland
- Gérontopôle de Toulouse, INSERM 1027, Toulouse, France
| | - Antonino Romano
- Oasi Research Institute-IRCCS, Troina, Italy; bFondazione Mediterranea GB Morgagni, Catania, Italy
| | - Carmen Rondon
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga, & Allergy Research Group, Instituto de Investigación Biomedica de Malaga-IBIMA and ARADyAL, Malaga, Spain
| | - Menachem Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Philip W Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
| | - Nathalie Salles
- Société Française de Gériatrie et Gérontologie, Paris, France
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Poland
| | - Alexandra F Santos
- Department of Women and Children's Health (Paediatric Allergy, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London and Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London,and Children's Allergy Service, Evelina London Children's Hospital Guy'sand St Thomas' Hospital, London, Asthma UK Centre for Allergic Mechanisms in Asthma, London, UK
| | - Faradiba Sarquis Serpa
- Asthma Reference Center - School of Medicine of Santa Casa de Misericórdia of Vitória, Espírito Santo, Brazil
| | - Joaquin Sastre
- Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Spain
| | - Jos M G A Schols
- Department of Health Services Research and Department of Family Medicine Caphri - Care and Public Health Research Institute, Maastricht University, Maastrich, Netherlands
| | | | - Anna Sediva
- Department of Immunology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Mohamed H Shamji
- Immunomodulation and Tolerance Group, Imperial College London, and Allergy and Clinical Immunology, Imperial College London, London, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Isabel Skypala
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Sylwia Smolinska
- Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, & "ALL-MED" Medical Research Institute, Wroclaw, Poland
| | - Milena Sokolowska
- Christine Kühne - Center for Allergy Research and Education (CK-CARE, Davos, Switzerland
| | - Bernardo Sousa-Pinto
- CINTESIS, Center for Health Technology and Services Research, Faculdade de Medicina, Universidade do Porto, Porto, Portugal ; Allergy Unit, CUF Porto, Porto, Portugal.,MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Portugal
| | - Milan Sova
- Department of Respiratory Medicine, University Hospital Olomouc, Czech Republic
| | - Rafael Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Gunter Sturm
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria Outpatient Allergy Clinic Reumannplatz, Vienna, Austria
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, and Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - Ana Maria Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Portugal
| | - Sanna Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki University, Helsinki, Finland
| | - Ioanna Tsiligianni
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece and International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland
| | - Maria Torres
- Allergy Unit, Málaga Regional University Hospital-IBIMA, Málaga, Spain
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | | | - Arunas Valiulis
- Vilnius University, Faculty of Medicine, Institute of Clinical Medicine & Institute of Health Sciences, Vilnius, Lithuania; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - Joana Vitte
- Aix-Marseille University, IRD, APHM, MEPHI, Marseille& IHU Méditerranée Infection, Marseille and IDESP, INSERM, University of Montpellier,, Montpellier, France
| | | | - Dana Wallace
- Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - De-Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Susan Waserman
- Department of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Osman M Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - Mario Zernotti
- Universidad Católica de Córdoba, Universidad Nacional de Villa Maria, Villa Maria, Argentina
| | - Mihaela Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - Tomas Chivato
- School of Medicine, University CEU San Pablo, Madrid, Spain
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Torsten Zuberbier
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, and Center for Rhinology and Allergology, Wiesbaden, Germany
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14
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Bertolino L, Patauner F, Gagliardi M, D'Amico F, Crivaro V, Bernardo M, Scherillo I, Bellitti F, Cusano C, Greco R, Panetta V, Durante A, Di Caterino A, Frieri A, Cioffi G, Nappo M, Corrado M, Lanzieri M, Sabatini P, Bettelli R, Dello Russo R, Taddeo ML, Petrone R, Di Sevo MG, Iannuzzo M, Iervolino M, Buonocore R, D'Agostino F, Gambardella M, De Martino A, Spagnuolo S, Savarese M, Sole S, Russo C, Agozzino E, Galdiero M, Martino R, Calemma R, Sciambra A, Aprea C, Colaccio D, Di Guida P, Venditti M, Montella E, Guerriero F, Perrotta R, Di Filippo U, Pizza A, Di Fronzo A, Lombardi A, Capuano L, De Stefano A, Mastropietro A, Mastro M, Loffreda R, Maccarone L, Di Tora A, Oto S, Tammaro C, Mondelli AC, Ruocco M, Ferraro B, Petrosino A, Presta SSA, Durante Mangoni E. Diagnostic and infection control strategies for Clostridioides difficile infections in a setting of high antimicrobial resistance prevalence. Infez Med 2021; 29:70-78. [PMID: 33664175] [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: 06/12/2023]
Abstract
Clostridioides difficile (CD) is a major nosocomial pathogen and the leading cause of antibiotic-associated diarrhoea. In light of the strong association between antimicrobial use and CD infections (CDI), it may be hypothesised that areas at higher prevalence of antimicrobial resistance, like the region of Campania in southern Italy, could also have a higher rate of CDI. In this multicentre, region-based, prospective study, we analysed such issues, exploiting CDI incidence data collected from local hospitals. In 2016, the Italian National Centre for Disease Control supported a project involving three Italian regions: Friuli Venezia Giulia, Lazio and Campania. In Campania, a network of 49 hospitals willing to participate in the project was created. The project consisted of two phases: a survey on practice patterns concerning CDI and an epidemiological surveillance study. We identified a stringent need to improve awareness about CDI among the regional health-care community, as a widespread lack of surveillance programmes for CDI control was observed (existing in only 40% of participating facilities). Moreover, almost half of the participating hospitals (n=16, 43%) had no standardised procedures or protocols to control and prevent CDI. In the second phase of the study, we collected data of CDI cases during a six-month surveillance programme. In all, 87 CDI cases were observed, for a total of 903,334 patient bed-days and 122,988 admissions. According to the above data, CDI incidence was 0.96 cases/10000 patient bed-days, much lower than expected based on prior studies conducted elsewhere. The results of our study suggest CDI remains a rather neglected clinical issue in Campania. Despite a high burden of antimicrobial resistance and antimicrobial use in our geographic setting, we observed a very low incidence of CDI. Such a low incidence could be explained by underdiagnosis, but could also be related to actual diet, the lower patient age or the specific genetic background. However, further studies are warranted to either confirm or rebut the above hypotheses.
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Affiliation(s)
- Lorenzo Bertolino
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Fabian Patauner
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Massimo Gagliardi
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Fabiana D'Amico
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | | | | | | | | | | | - Rita Greco
- A.O.U. "Sant'Anna e San Sebastiano", Caserta, Italy
| | | | | | | | - Angelo Frieri
- "Sant'Angelo dei Lombardi" Hospital, Avellino, Italy
| | - Grazia Cioffi
- A.O.U.S. Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Maria Nappo
- A.O.U.S. Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Mariano Corrado
- "Umberto I" Hospital, Nocera, and DEA Nocera-Pagani-Scafati, Italy
| | - Michele Lanzieri
- "Umberto I" Hospital, Nocera, and DEA Nocera-Pagani-Scafati, Italy
| | - Paola Sabatini
- "Umberto I" Hospital, Nocera, and DEA Nocera-Pagani-Scafati, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Erminia Agozzino
- Dipartimento di Medicina Sperimentale, Università della Campania "L. Vanvitelli", AOU della Campania "L. Vanvitelli", Naples, Italy
| | - Massimiliano Galdiero
- Dipartimento di Medicina Sperimentale, Università della Campania "L. Vanvitelli", AOU della Campania "L. Vanvitelli", Naples, Italy
| | - Rosa Martino
- Istituto NazionaleTumori-IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Rosa Calemma
- Istituto NazionaleTumori-IRCCS "Fondazione G. Pascale", Naples, Italy
| | | | | | - Diego Colaccio
- "S. Giuseppe Melorio" Hospital, S. Maria Capua Vetere, Italy
| | | | | | | | | | | | | | | | | | - Anna Lombardi
- "S. Giovanni di Dio" Hospital, Frattamaggiore, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Emanuele Durante Mangoni
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy; Unit of Infectious and Transplant Medicine, AORN Ospedali dei Colli - Monaldi Hospital, Naples, Italy
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15
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Lo Vecchio A, Pierri L, Poeta M, Vassallo E, Varelli M, Montella E, Guarino A, Bruzzese E. Risk of SARS-CoV-2 Transmission in Health Care Personnel Working in a Pediatric COVID-19 Unit. Hosp Pediatr 2020; 11:e42-e47. [PMID: 33361399 DOI: 10.1542/hpeds.2020-003855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The paucity of symptoms and the difficulties in wearing personal protective equipment make children a potential source of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for health care workers (HCWs). Previous experience in pediatric settings reported high rate of intrahospital SARS-CoV-2 transmission in HCWs caring for children. We aimed at investigating the rate and determinants of SARS-CoV-2 infection among HCWs working in a regional reference center in the Southern Italy. METHODS A prospective observational study was conducted to monitor the occurrence of SARS-CoV-2 infections among HCWs and investigate the relation between the infection rate and hours of exposure or number and characteristics of procedures, including nasopharyngeal swab, high-flow oxygen delivery, suctioning of airway secretions, sputum induction, and nebulizer administration. RESULTS After 5 months of monitoring, 425.6 hours of SARS-CoV-2 exposure (18.5 hours per person), and 920 hospital procedures, no case of nosocomial transmission was reported among the 23 HCWs enrolled in the study. CONCLUSIONS The application of stringent preventive measures, also outside the area dedicated to patients' care, can effectively control infection spreading also in pediatric settings.
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Affiliation(s)
- Andrea Lo Vecchio
- Section of Pediatrics, Departments of Translational Medical Science and
| | - Luca Pierri
- Section of Pediatrics, Departments of Translational Medical Science and
| | - Marco Poeta
- Section of Pediatrics, Departments of Translational Medical Science and
| | - Edoardo Vassallo
- Section of Pediatrics, Departments of Translational Medical Science and
| | | | - Emma Montella
- Public Health, University of Naples Federico II, Naples, Italy; and
| | - Alfredo Guarino
- Section of Pediatrics, Departments of Translational Medical Science and
| | - Eugenia Bruzzese
- Section of Pediatrics, Departments of Translational Medical Science and
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16
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Nunziata F, Bruzzese E, Poeta M, Pierri L, Catzola A, Ciccarelli GP, Vassallo E, Montella E, Lo Vecchio A, Guarino A. Health-care organization for the management and surveillance of SARS-CoV-2 infection in children during pandemic in Campania region, Italy. Ital J Pediatr 2020; 46:170. [PMID: 33198780 PMCID: PMC7667478 DOI: 10.1186/s13052-020-00928-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/26/2020] [Indexed: 01/10/2023] Open
Abstract
Background In comparison with adults, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection in children has a milder course. The management of children with suspected or confirmed coronavirus disease (COVID-19) needs to be appropriately targeted. Methods We designed a hub-and-spoke system to provide healthcare indications based on the use of telemedicine and stringent admission criteria, coordinate local stakeholders and disseminate information. Result Between March 24th and September 24th 2020, the Hub Centre managed a total of 208 children (52% males, median age, 5.2, IQR 2–9.6 years) with suspected or confirmed COVID-19. Among them, 174 were managed in cooperation with family pediatricians and 34 with hospital-based physicians. One hundred-four (50%) received a final diagnosis of SARS-CoV-2 infection. Application of stringent criteria for hospital admission based on clinical conditions, risk factors and respect of biocontainment measures, allowed to manage the majority of cases (74, 71.1%) through telemedicine. Thirty children (28%) were hospitalized (median length 10 days, IQR 5–19 days), mainly due to the presence of persistent fever, mild respiratory distress or co-infection occurring in infant or children with underlying conditions. However, the reasons for admission slightly changed over time. Conclusion An hub-and-spoke system is effective in coordinate territorial health-care structures involved in management paediatric COVID-19 cases through telemedicine and the definition of stringent hospital admission criteria. The management of children with COVID-19 should be based on clinical conditions, assessed on a case-by-case critical evaluation, as well as on isolation measures, but may vary according to local epidemiological changes.
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Affiliation(s)
- Francesco Nunziata
- Department of Translational Medical Sciences - Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134, Naples, Italy.
| | - Eugenia Bruzzese
- Department of Translational Medical Sciences - Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134, Naples, Italy
| | - Marco Poeta
- Department of Translational Medical Sciences - Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134, Naples, Italy
| | - Luca Pierri
- Department of Translational Medical Sciences - Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134, Naples, Italy
| | - Andrea Catzola
- Department of Translational Medical Sciences - Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134, Naples, Italy
| | - Gian Paolo Ciccarelli
- Department of Translational Medical Sciences - Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134, Naples, Italy
| | - Edoardo Vassallo
- Department of Translational Medical Sciences - Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134, Naples, Italy
| | - Emma Montella
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences - Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134, Naples, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences - Paediatrics Section, University of Naples Federico II, via Pansini 5, 80134, Naples, Italy
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17
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Montella E, Caputi EM, Del Core M, Guida A, Triassi M. <p>Safety Pathway Design for Patients Not Affected by COVID-19 During the SARS-CoV-2 Pandemic in an Italian University Hospital</p>. Healthc Policy 2020; 13:2621-2626. [PMID: 33235532 PMCID: PMC7678504 DOI: 10.2147/rmhp.s265942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/28/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Emma Montella
- Public Health Department, “Federico II” University of Naples, Naples, Italy
- Correspondence: Emma Montella Public Health Department, “Federico II” University of Naples, Via Sergio Pansini, 5, Naples80131, ItalyTel +393332253185 Email
| | | | - Mariapia Del Core
- Public Health Department, “Federico II” University of Naples, Naples, Italy
| | - Antonella Guida
- Health Management, Local Health Authority (ASL) Caserta, Caserta, Italy
| | - Maria Triassi
- Public Health Department, “Federico II” University of Naples, Naples, Italy
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18
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Arpino G, De Angelis C, De Placido P, Pietroluongo E, Formisano L, Bianco R, Fiore G, Montella E, Forestieri V, Lauria R, Cardalesi C, Vozzella EA, Iervolino A, Giuliano M, De Placido S. Optimising triage procedures for patients with cancer needing active anticancer treatment in the COVID-19 era. ESMO Open 2020; 5:e000885. [PMID: 32958531 PMCID: PMC7507249 DOI: 10.1136/esmoopen-2020-000885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 06/30/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 01/24/2023] Open
Abstract
Background Immunosuppression induced by anticancer therapy in a COVID-19-positive asymptomatic patient with cancer may have a devastating effect and, eventually, be lethal. To identify asymptomatic cases among patients receiving active cancer treatment, the Federico II University Hospital in Naples performs rapid serological tests in addition to hospital standard clinical triage for COVID-19 infection. Methods From 6 to 17 April 2020, all candidates for chemotherapy, radiotherapy or target/immunotherapy, if negative at the standard clinical triage on the day scheduled for anticancer treatment, received a rapid serological test on peripheral blood for COVID-19 IgM and IgG detection. In case of COVID-19 IgM and/or IgG positivity, patients underwent a real-time PCR (RT-PCR) SARS-CoV-2 test to confirm infection, and active cancer treatment was delayed. Results Overall 466 patients, negative for COVID-19 symptoms, underwent serological testing in addition to standard clinical triage. The average age was 61 years (range 25–88 years). Most patients (190, 40.8%) had breast cancer, and chemotherapy with or without immunotherapy was administered in 323 (69.3%) patients. Overall 433 (92.9%) patients were IgG-negative and IgM-negative, and 33 (7.1%) were IgM-positive and/or IgG-positive. Among the latter patients, 18 (3.9%), 11 (2.4%) and 4 (0.9%) were IgM-negative/IgG-positive, IgM-positive/IgG-negative and IgM-positive/IgG-positive, respectively. All 33 patients with a positive serological test, tested negative for RT-PCR SARS-CoV-2 test. No patient in our cohort developed symptoms suggestive of active COVID-19 infection. Conclusion Rapid serological testing at hospital admission failed to detect active asymptomatic COVID-19 infection. Moreover, it entailed additional economic and human resources, delayed therapy administrationand increased hospital accesses.
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Affiliation(s)
- Grazia Arpino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Carmine De Angelis
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Pietro De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Erica Pietroluongo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Luigi Formisano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Roberto Bianco
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Giovanni Fiore
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Emma Montella
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Valeria Forestieri
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Rossella Lauria
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Cinzia Cardalesi
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
| | - Emilia Anna Vozzella
- Direzione Sanitaria, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - Anna Iervolino
- Direzione Generale, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy.
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
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19
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Rubba F, Paparo E, Capuano F, Montella E, Continisio IG, Iervolino A, Magri P, De Angelis C, De Placido S, Triassi M. From 'to cure' to 'to care' in Oncology Toward shared Evidence based practice. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1102] [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
Aims
Oncological disease need a system of care involving hospital staff and informal caregivers. Care-givers are subjected to stressful factors (burden) with repercussions on psycho-physical balance. The project, carried out together with the ONLUS Travel Companions Association and the Multidisciplinary Oncological Groups (GOM) of Brain and Breast Cancers, intends to offer supportive training experiences for care-givers and health workers, offering emotional and practical preparation for the treatments that they will find themselves providing the cancer relative by helping to improve the quality of care and the relationship between the subjects. The professionals participating in the project (doctors, nurses) take part in a training held by professionals from the Association. The care givers, divided into groups, carry out a CBI test (Caregiver Burden Inventory) and training meetings on medical, psychological and social assistance issues. After 3 months from the end of the course, the care-giver carries out the interview with the psychologist and recompiles the CBI. Furthermore, on 30 selected patients of Breast Cancers, GOM, an emotional evaluation questionnaire of their life experience was administered with respect to the stages of the disease pathway.
Results
The answers were then analyzed by the word cloud method and summarized in a synthetic map for each question. The most used words to describe the mood during the illness are 'anger, pain, anguish and worry'; while waiting before the visit they are 'long, exhausting, anxious'; towards the doctor 'availability, humanity, kindness, friendliness, professionalism'; with regard to 'excellent, availability' assistance; about social life during the 'unchanged, serene' illness; towards the return home 'joy'.
Conclusions
The project is a starting point towards a continuous and progressive humanization of the integrated pathways from 'to cure' to 'to care' in oncology.
Key messages
Patients are positively affected from shared initiatives. Word cloud may resume patients moods and thei main issues concerninthe path.
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Affiliation(s)
- F Rubba
- AOU Federico II, Naples, Italy
| | | | - F Capuano
- Travel Companions onlus, Naples, Italy
| | | | | | | | - P Magri
- AOU Federico II, Naples, Italy
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20
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Rubba F, Montella E, Carannante I, Trummolo MC, Simeone A, Vozzella EA, Magri P, Iervolino A, Colao A, Triassi M. Share your rare with care: a patient corner for the European Reference Networks on Rare Disease. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.280] [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: 11/14/2022] Open
Abstract
Abstract
Background
The European Reference Network on Rare Disease (ERN) is focused on providing more equitable care across Europe and creates a network of both medical specialists and patient experts. One relevant objective of the activities planned into the ERNs is to address the economic dimensions of rare diseases in order to develop strategies to improve research and patients' access to orphan drugs (ODs) and highly specialized health technologies. The themes built in these preliminary years were directed toward guidelines and policies concerning reimbursement of ODs and direct provision by the healthcare system.
Methods
to proceed further in humanization of care we establish involvement of patients' associations in decision making and implementation of clinical practice guidelines. We built in Federico II University Hospital where 12 ERN were aligned a front office corner shared between patients association and hospital direction in order to face the patient difficulties along the pathway. The corner is open three times a week on the morning, with a dedicated phone number.
Results
Main issues regarded the understanding of the disease and the diagnosis (ie, lack of familiarity with the rare disease, disease heterogeneity, lack of established diagnostic criteria, misdiagnosis,) the development of effective treatments and the need for efficacy along the path way of care (ie, geographical limitations, disease coding systems, ethical and privacy issues). Fewer concerns were about the equity of access and other social pressures. Conclusions In general, in ERN context, few people declared to work in human and social issues, including research on patient's quality of life, patient's awareness, or methods for social support. Our findings demonstrated that Patients were positively affected from the corner initiative: this may ameliorate the use of infrastructures offering services, also that rarely known as national and international biobanking platforms, registries and networks.
Key messages
Humanization of care issues and strategies are nowadays mandatory in rare diseases. Patients are positively affected from shared initiatives.
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Affiliation(s)
- F Rubba
- AOU Federico II, Naples, Italy
| | | | | | - M C Trummolo
- Rare disease active citizen onlus, Naples, Italy
| | | | | | - P Magri
- AOU Federico II, Naples, Italy
| | | | - A Colao
- AOU Federico II, Naples, Italy
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21
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Buonomo A, Brescia Morra V, Zappulo E, Lanzillo R, Gentile I, Montella E, Triassi M, Palladino R, Moccia M. COVID-19 prevention and multiple sclerosis management: The SAFE pathway for the post-peak. Mult Scler Relat Disord 2020; 44:102282. [PMID: 32554288 PMCID: PMC7283048 DOI: 10.1016/j.msard.2020.102282] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 05/25/2020] [Revised: 05/30/2020] [Accepted: 06/08/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND We hereby report on our experience from Naples (South Italy), where the peak of coronavirus disease 2019 (COVID-19) has already passed. METHODS Assuming that COVID-19 will be circulating until vaccination and/or herd immunity is achieved (possibly not earlier than 2021), we have developed a protocol for the long-term management of multiple sclerosis (MS). RESULTS We have defined a pathway for the access to the MS Centre with logistic, preventative and clinical recommendations, and have also included 14-day self-isolation and COVID-19 testing before some disease modifying treatments. DISCUSSION Overall, we believe our experience could be helpful for MS management in the upcoming months.
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Affiliation(s)
- Antonio Buonomo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, Federico II University of Naples, Italy
| | - Vincenzo Brescia Morra
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Italy
| | - Emanuela Zappulo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, Federico II University of Naples, Italy
| | - Roberta Lanzillo
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Italy
| | - Ivan Gentile
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, Federico II University of Naples, Italy; UNESCO Chair on Health Education and Sustainable Development, Federico II University of Naples, Italy
| | - Emma Montella
- Department of Hygiene, Preventive and Industrial Medicine, Federico II University Hospital, Naples, Italy
| | - Maria Triassi
- Department of Public Health, Federico II University of Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, Federico II University of Naples, Italy; Department of Primary Care and Public Health, Imperial College London, United Kingdom
| | - Marcello Moccia
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Italy
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Raiola E, Triassi M, Improta G, Di Cicco MV, Montella E, Ferraro A, Cerchione R, Centobelli P. Implementation of lean practices to reduce healthcare associated infections. IJHTM 2020. [DOI: 10.1504/ijhtm.2020.10039887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ferraro A, Centobelli P, Cerchione R, Cicco MVD, Montella E, Raiola E, Triassi M, Improta G. Implementation of lean practices to reduce healthcare associated infections. IJHTM 2020. [DOI: 10.1504/ijhtm.2020.116783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Rubba F, Alfano R, Martello R, Egidio R, Montella E, D'Onofrio G, De Divitiis O, Pacelli R, Marinelli A, Triassi M. Therapeutic and l Diagnostic Path as a tool for handling Cerebral neoplastic disease. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Rubba
- AOU Federico II, Napoli, Italy
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Montella E, Di Cicco MV, Ferraro A, Centobelli P, Raiola E, Triassi M, Improta G. The application of Lean Six Sigma methodology to reduce the risk of healthcare-associated infections in surgery departments. J Eval Clin Pract 2017; 23:530-539. [PMID: 27860065 DOI: 10.1111/jep.12662] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 09/19/2016] [Accepted: 10/05/2016] [Indexed: 01/13/2023]
Abstract
RATIONALE Nowadays, the monitoring and prevention of healthcare-associated infections (HAIs) is a priority for the healthcare sector. AIMS AND OBJECTIVES In this article, we report on the application of the Lean Six Sigma (LSS) methodology to reduce the number of patients affected by sentinel bacterial infections who are at risk of HAI. METHODS The LSS methodology was applied in the general surgery department by using a multidisciplinary team of both physicians and academics. Data on more than 20 000 patients who underwent a wide range of surgical procedures between January 2011 and December 2014 were collected to conduct the study using the departmental information system. The most prevalent sentinel bacteria were determined among the infected patients. The preintervention (January 2011 to December 2012) and postintervention (January 2013 to December 2014) phases were compared to analyze the effects of the methodology implemented. The methodology allowed the identification of variables that influenced the risk of HAIs and the implementation of corrective actions to improve the care process, thereby reducing the percentage of infected patients. RESULTS The improved process resulted in a 20% reduction in the average number of hospitalization days between preintervention and control phases, and a decrease in the mean (SD) number of days of hospitalization amounted to 36 (15.68), with a data distribution around 3 σ. The LSS is a helpful strategy that ensures a significant decrease in the number of HAIs in patients undergoing surgical interventions. The implementation of this intervention in the general surgery departments resulted in a significant reduction in both the number of hospitalization days and the number of patients affected by HAIs. CONCLUSIONS This approach, together with other tools for reducing the risk of infection (surveillance, epidemiological guidelines, and training of healthcare personnel), could be applied to redesign and improve a wide range of healthcare processes.
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Affiliation(s)
- Emma Montella
- Department of Hygiene, Preventive and Industrial Medicine, University Hospital (A.O.U.) "Federico II" of Naples, Naples, Italy
| | | | - Anna Ferraro
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Piera Centobelli
- Department of Industrial Engineering, University "Federico II" of Naples, Naples, Italy
| | - Eliana Raiola
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Giovanni Improta
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
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Montella E, Triassi M, Bellopede R, Reis W, Palladino R, Di Silverio P. Prevalence surveys as part of a strategic plan to prevent healthcare associated infections. The experience of the University Hospital "Federico II" of Naples, Italy. Ann Ig 2014; 26:279-85. [PMID: 24998219 DOI: 10.7416/ai.2014.1986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The care-associated infections (HAI) are the most serious complication associated with medical care. They are the cause of diseases for patients and economic damage to public health. The University "Federico II" of Naples decided to monitor the HAI, repeating the prevalence survey conducted earlier in 2011 in order to analyze the phenomenon of infection and to evaluate the possible correlation with risk factors. METHODS The Survey was conducted according to ECDC criteria. Considered that the study carried out in 2011 was conducted following the same methodology, to compare the results of the year 2012 the prevalence rates of both years were standardized. FINDINGS For the year 2012, the number of patients enrolled in the study and stratification of patients by age and sex were similar to data collected in 2011. It was very interesting to find the prevalence of HAI standardized reduced in 2012 compared to 2011. As a matter of fact, in fact, that the standardized prevalence of HAI for the year 2012 was 3.1%, one percentage point lower than in 2011 (4.4%). CONCLUSIONS The practical training and direct regarded as the most appropriate approach in order to make health professionals aware in the field of health care-associated infections, as well as the system of selfcontrol peripheral for the correct application of the procedures, as well as epidemiological surveillance active, measured through rates of incidence, at the same time allow the monitoring of the phenomenon is infectious and the application of corrective measures that prevent its onset. The choice to make again an epidemiological study of prevalence with the same methodology ensures, in fact, two advantages: the comparability of the data, both at intra-company both at regional, national and international evaluation of the effectiveness of corrective actions.
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Affiliation(s)
- E Montella
- University Hospital "Federico II" - Department of Public Health, Naples, Italy
| | - M Triassi
- University Hospital "Federico II" - Department of Public Health, Naples, Italy
| | - R Bellopede
- University Hospital "Federico II" - Department of Public Health, Naples, Italy
| | - W Reis
- University Hospital "Federico II" - Department of Public Health, Naples, Italy
| | - R Palladino
- University Hospital "Federico II" - Department of Public Health, Naples, Italy
| | - P Di Silverio
- University Hospital "Federico II" - Department of Public Health, Naples, Italy
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Montella E, Schiavone D, Apicella L, Di Silverio P, Gaudiosi M, Ambrosone E, Moscaritolo E, Triassi M. Cost-benefit evaluation of a preventive intervention on the biological risk in health: the accidental puncture during the administration of insulin in the University Hospital "Federico II" of Naples. Ann Ig 2014; 26:272-8. [PMID: 24998218 DOI: 10.7416/ai.2014.1985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The occupational exposure to biological risk is a frequent event that affects millions of workers in the health sector. Operators are exposed to accidental contact with blood and other potentially infectious biological materials with a frequency higher than that observed in the population (occupational exposure). The pathogens most frequently implicated are the human immunodeficiency virus (HIV), hepatitis C (HCV) and hepatitis B (HBV) viruses. The World Health Organization estimates that each year more than 3 million health workers hurt themselves with an object/edge definitely contaminated with at least one HIV (about 170,000 exposures), hepatitis B (approximately 2,000,000 exposures) and hepatitis C (approximately 900,000 exposures). In Italy approximately 100,000 percutaneous exposures/year are estimated to take place. The needlestick injuries in health care workers are, in large part, preventable by adopting measures such as the use of instrumental needlesticks Prevention Devices - NPDs. The adoption of the NPDs is extremely effective in reducing occupational exposure to biological risk (from 63 % to 100 % reduction). METHODS The aim of this study was to evaluate whether the adoption of NPDs for insulin therapy is costeffective in terms of prevention of accidents by Biohazard, compared to administration of insulin with traditional methods (syringe + vial). The estimation is carried out both in the light of current legislation (European Directive 2010/32 and 81/08 Italian Law) and epidemiological data and cost of accidents (according to frequency) and alternative interventions. RESULTS The evaluation of cost-effectiveness included the construction of an economic model that would allow the weighting of the costs of accidents that can occur following the administration of insulin therapy with traditional methods. The economic model was developed taking into account the international literature on the phenomenon of "accidental puncture" and allowed the financial quantification of the event. Then we calculated the cost of insulin therapy using the traditional methodology and the cost has been converted to the cost of insulin therapy when administered by NPDs. The period of the study was the year 2010. CONCLUSIONS The data thus obtained were used to evaluate the benefits of implementing NPDs for insulin therapy, in terms not only of economic advantage but also of preventive efficacy and on the cost of the accident.
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Affiliation(s)
- E Montella
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - D Schiavone
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - L Apicella
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - P Di Silverio
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - M Gaudiosi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - E Ambrosone
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - E Moscaritolo
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - M Triassi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
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Montella E, Reis W, Palladino R, Bellopede R, Cristofanini A, Nardone A, Tucci DG, Triassi M. Prevalence survey of healthcare-associated infections in the University Hospital Federico II of Naples, Italy. Ann Ig 2013; 25:73-81. [PMID: 23435782 DOI: 10.7416/ai.2013.190783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Healthcare Associated Infections (HAI) are the most serious complication associated with health care. They cause diseases for patients and economic damage for Public Health. A prevalence survey at the University Hospital "Federico II" of Naples was conducted according to ECDC criteria in order to analyze the infectious phenomenon of healthcare assistance and assess possible correlations with risk factors as healthcare procedure and clinical condition of patients. METHODS Were enrolled 450 patients. The collected data were then analyzed using univariate and multivariable logistic regression. RESULTS It was found a prevalence rate of infections of 9.3%, with a prevalence rate of HAI of 4.4%. Statistical analysis showed correlation between HAI and ultimately-fatal-disease (P <0.04) and between HAI and the use of invasive devices as CVC (P<0.005), PVC (P<0.004) and intubation (P<0.01). CONCLUSIONS The epidemiological surveillance strategies are part of preventive measures and monitoring of the HAI, implemented to ensure safety and quality of care.
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Affiliation(s)
- E Montella
- Department of Public Health, University Hospital Federico II, Naples, Italy
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