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Objectives: Pneumonia still remains a problem from the clinical and public health viewpoint because of the relevant epidemiological burden. The etiological diagnosis is important in the light of avoiding unnecessary antibiotic treatment and choosing the most appropriate therapeutical approach. This study is aimed at providing evidence on the proportion of microbiological ascertainment in pneumonia-related hospitalizations in one of the most important teaching hospitals in Rome., Methods: The study relied on the record linkage of two administrative databases of the same hospital: the electronic hospital discharge register and the microbiology laboratory surveillance database., Results: 2819 records were identified, where 46% had a microbiological ascertainment, significantly higher in males than in females (51% vs 40%) and in cases of pneumonia reported in secondary diagnosis instead of primary diagnosis (52% vs 42%). Medical patients had significantly lower proportion of ascertainment compared to surgical patients (43% vs 67%) whereas there were not differences between patients with emergency and elective admission. The overall mortality was 17%. Mortality was significantly higher: in surgical compared to medical patients (27% vs 15%), in ventilated compared to not ventilated patients (41% vs 11%), in cases with secondary diagnosis of pneumonia compared to a primary diagnosis (23% vs 11% ) and in hospitalized in intensive care unit-ICU- rather than in non-ICU (71% vs 12%)., Conclusion: The proportion of microbiological ascertaiment in pneumonia remains less than 50%. Albeit in line with other evidence, this result should call the attention on the impact of unknown etiological diagnosis on antibiotic treatment and resistance.

Objective: To investigate, through a questionnaire, older adults' demographic and socio-economic characteristics, knowledge, attitudes and practices in terms of food safety and healthy diet; and to develop dietary and hygiene indices able to represent participants' nutritional and food safety behaviour, exploring their association with demographic and socio-economic factors., Design: One-year cross-sectional study., Setting: Gemelli Teaching Hospital (Rome, Italy)., Participants: People aged ≥65 years, Italian speaking, accessing the Centre of Ageing Medicine., Results: Mean age of the sample was 74 (sd 7·7) years. Subjective perception of a safe diet was high: 64·2 % of respondents believed they have a balanced diet. Interviewees got informed about proper nutrition mainly from television, magazines, newspapers, Internet (29·9 %) and from health professionals (34·8 %) such as dietitians, whereas 15·4 % from general practitioners. Regarding food safety, 33·8 % of participants reported to consume expired food, even more than once per month; between 80 and 90 % of participants reported to follow food safety practices during preparation and cooking, even though 49·3 % defrosted food at room temperature. Calculated dietary and hygiene indices showed that the elderly participants were far from having optimal nutritional and food safety behaviours., Conclusions: These results suggest it is necessary to increase the awareness of older adults in the matter of healthy diet and food safety. Specific and targeted educational interventions for the elderly and their caregivers could improve the adoption of recommended food safety practices and safe nutritional behaviours among older adults.

The prevention of Legionella colonization of water systems is one of the goals of hospital management. Among chemical disinfection methods, chlorine dioxide (ClO 2 ) has been largely used to control Legionella spp. in water systems. We performed a retrospective study to analyse data deriving from the surveillance plan of the water system in a large academic hospital in Rome (Italy) during the period August 2011 and August 2018. We collected the data deriving from the routine water samples used to monitor Legionella spp. colonization. Data from the water samples collected from 163 selected sampling points (hot water tanks, the return loop and distal outlets) was analysed using a life table analysis in order to investigate the duration of the effectiveness of the ClO 2 method in eradicating Legionella spp. The colonization of the water sample by Legionella spp. was considered as the outcome. Our results show that in 81,59% of the sampling points Legionella spp. were never detected at four years of follow up. Chemical and physical characteristics of the water were also compared between the samples which were positive for Legionella spp. and those which were not. No association was found between these factors. The knowledge of the duration over time of the effectiveness of the ClO 2 disinfection method could support decision-making processes in the framework of Risk Management activities in hospitals. Future studies could also be conducted in hospitals to compare the long-term cost-effectiveness of different Legionella spp. colonization prevention methods., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Introduction: Elderly people are more likely to develop influenza-related complications. However, despite the recommendations, the optimal vaccination coverage is not reached. The use of deprivation indexes can help to identify subgroups with lower vaccination uptake. We analyzed vaccination coverage among elderly subjects living in the city of Rome on the basis of their socioeconomic characteristics by using a local deprivation index., Methods: We focused on the population aged ≥ 65 years living in the city of Rome from 2009 to 2013. Information on vaccination coverage was collected from general practitioners. A combination of multivariate techniques, including multiple linear regression, factor and cluster analysis, was used to construct a composite area-based Index of Socio-Economic and Health Deprivation (SEHDI). The index was calculated for each census tract on the basis of data from the 2001 Italian census., Results: The majority of elderly subjects living in Rome belonged to the medium (40.4%) and medium-high (24%) deprivation groups; only 4.5% of the population was in the low-deprivation group. An inverse relationship was found between influenza vaccination coverage and the deprivation index: elderly subjects in the low-deprivation group displayed lower coverage (55.45%) than those in the high-deprivation group (57.59%). Specifically, vaccination coverage decreased with the increase of replacement index, employment rate and the percentage of: single and divorced individuals; university and high-school graduates; employees, entrepreneurs and freelancers, family assistants, students; foreigners and stateless persons residing in Italy; families consisting of one person., Conclusions: Our results show an inverse relationship between deprivation and vaccination coverage and may help to identify subgroups that could benefit from targeted initiatives to increase vaccination coverage.

The aim of the study was to investigate the association between socio-demographic variables and "at high risk of inappropriateness" of hospital admissions. We used hospital admissions data of Local Health Unit (LHU) Rome H (year 2004). We investigated the relationship between socio-demographic variables (sex, age, job activity, marital status, nationality, place of residence, educational level) and a high risk of inappropriate hospital stay. We computed univariate and multivariate analysis using chi2 test and logistic regression model. Out of 32,233 hospital admissions, 4685 (14.5%) resulted at high risk of inappropriateness. The following variables were associated with high risk of inappropriateness: age (for patients aged 0-15 and 46-65 OR: 1.83 (95% C.I.: 1.57-2.13) and 1.56 (95% C.I.: 1.42-1.72) respectively); job activity (for employed OR: 1.98 (95% C.I.: 1.81-2.17), for students OR: 1.34 (95% C.I.: 1.16-155)); marital status (for unmarried OR: 1.37 (95% C.I.: 1.23-1.51)); place of residence (for patients belonging to LHU Rome H OR:1.09 (95% C.I.: 1.02-1.78)); nationality (for foreign nationals OR: 0.71 (95% C.I.: 0.58-0.87)); educational level (for high school degree and graduated people OR: 0.89 (95% C.I.: 0.81-0.98)). Our study demonstrates that socio-demographic variables are related to the high risk of inappropriate hospital admissions. We believe that these variables could be considered as potential factors to modulate the offer of health services.