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1. Vaccination coverage in healthcare workers: a multicenter cross-sectional study in Italy

Author

Genovese C., Picerno I. A. M., Trimarchi G., Cannavo G., Egitto G., Cosenza B., Merlina V., Icardi G., Panatto D., Amicizia D., Orsi A., Colosio C., Marsili C., Lari C., Palamara M. A. R., Vitale F., Casuccio A., Costantino C., Azara A., Castiglia P., Bianco A., Curra A., Gabutti G., Stefanati A., Sandri F., Florescu C., Marranzano M., Giorgianni G., Fiore V., Platania A., Torre I., Cappuccio A., Guillari A., Fabiani L., Giuliani A. R., Appetiti A., La Fauci V., Squeri A., Ragusa R., Squeri R., Genovese, C., Picerno, I. A. M., Trimarchi, G., Cannavo, G., Egitto, G., Cosenza, B., Merlina, V., Icardi, G., Panatto, D., Amicizia, D., Orsi, A., Colosio, C., Marsili, C., Lari, C., Palamara, M. A. R., Vitale, F., Casuccio, A., Costantino, C., Azara, A., Castiglia, P., Bianco, A., Curra, A., Gabutti, G., Stefanati, A., Sandri, F., Florescu, C., Marranzano, M., Giorgianni, G., Fiore, V., Platania, A., Torre, I., Cappuccio, Antonella, Guillari, A., Fabiani, L., Giuliani, A. R., Appetiti, A., La Fauci, V., Squeri, A., Ragusa, R., Squeri, R., Genovese C., Picerno I.A.M., Trimarchi G., Cannavo G., Egitto G., Cosenza B., Merlina V., Icardi G., Panatto D., Amicizia D., Orsi A., Colosio C., Marsili C., Lari C., Palamara M.A.R., Vitale F., Casuccio A., Costantino C., Azara A., Castiglia P., Bianco A., Curra A., Gabutti G., Stefanati A., Sandri F., Florescu C., Marranzano M., Giorgianni G., Fiore V., Platania A., Torre I., Cappuccio A., Guillari A., Fabiani L., Giuliani A.R., Appetiti A., La Fauci V., Squeri A., Ragusa R., and Squeri R.

Subjects
Adult, Male, 0303 health sciences, Vaccines, 030306 microbiology, Health Personnel, education, Nurses, Middle Aged, Infectious Disease Transmission, Professional-to-Patient, NO, 03 medical and health sciences, Healthcare workers, Vaccination coverage, Cross-Sectional Studies, Healthcare workers, Vaccination coverage, Vaccines, Italy, Physicians, Healthcare worker, Humans, Original Article, Female
Abstract

Introduction In recent years, a phenomenon known as "vaccine hesitancy" has spread throughout the world, even among health workers, determining a reduction in vaccination coverage (VC). A study aimed at evaluating VC among healthcare workers (HCWs) in 10 Italian cities (L'Aquila, Genoa, Milan, Palermo, Sassari, Catanzaro, Ferrara, Catania, Naples, Messina) was performed. Materials and methods Annex 3 of the Presidential Decree n. 445 of 28 December 2000 was used to collect information on the vaccination status of HCWs. The mean and standard deviation (SD) were calculated with regard to the quantitative variable (age), while absolute and relative frequencies were obtained for categorical data (sex, professional profile, working sector, vaccination status). The connection between VC and the categorical variables was evaluated by chi-square method (statistical significance at p, Journal of Preventive Medicine and Hygiene, Vol 60, No 1 (2019): 2019601

Published
2019

2. Evaluation of Vaccination Coverages in the Health Care Workers of a University Hospital in Southern Italy

Author

Squeri, R, La Fauci, V, Picerno, I A M, Trimarchi, G, Cannavò, G, Egitto, G, Cosenza, B, Merlina, V, and Genovese, C

Subjects
Adult, Immunity, Herd, Male, Coverage, Vaccination Coverage, Health Personnel, Nursing Staff, Hospital, Hospitals, University, Young Adult, Age Distribution, Vaccination Refusal, Surveys and Questionnaires, Medical Staff, Hospital, Healthcare workers, Humans, Pediatricians, Sex Distribution, Vaccine hesitancy, Aged, Chi-Square Distribution, Vaccine, Middle Aged, Logistic Models, Italy, Female
Abstract

An adequate immunization of the health care workers is essential for infection prevention and control, to avoid consequences not only for them, but for all patients that the health care workers could infect causing serious damage and / or death. Unfortunately, to date, despite the presence of international and national guidelines (Law Decree 119/2017), the vaccination coverage was low, also because of the "vaccine hesitancy" spread among the same health care workers. In light of the above, the aim of our study was to investigate the vaccination coverage of healthcare workers of all the operational units present in our hospital and to evaluate differences between sex, age, professional profile and area of work.A study was conducted from March to June 2018 to investigate the vaccination coverage of healthcare workers at the University hospital "G. Martino" of Messina; data were collected using a self-completion questionnaire based on Attachment 3 of Ministerial Circular 25233 of 18 August 2017. We verified any possible association between physicians and pediatricians and between age classes by the chi square method. Also, a logistic regression was used for each vaccination, considering the vaccination as the variable and the following covariates: type of operative unit, sex, age and area) in order to predict the probability of vaccination.We analyzed a sample of 822 health care workers (324 males and 498 females with an age of 49.5 ± 10.5 SD). The sample was made up of physicians (36%), nurses (21%) and other professional categories (43%). Analyzing the data we obtained vaccination coverages lower than the target required to guarantee "herd immunity"; higher vaccination coverages were found for females, physicians and the clinical area and - for influenza vaccination - in the older age groups and - for all the other vaccinations - in the younger groups.Data analysis revealed a lax attitude towards vaccinations by health care workers and the need for measures aimed at increasing vaccination their coverage to prevent them from becoming a source of dangerous outbreaks.

Published
2019

4. Epidemiology of intensive care unit-acquired sepsis in Italy: Results of the SPIN-UTI network

Author

Agodi, A., Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, Patrizia, Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, M. R., Alliani, C., Amatucci, M. R., Antoci, M., Antonelli, Massimo, Astuto, M., Arnoldo, L., Arru, B., Baccari, G., Barbadoro, P., Barbara, A., Barilaro, Cynthia, Battaglia, P., Bellocchi, Paolo, Bernasconi, M. O., Bianco, Assunta, Bissolo, E., Bocchi, A., Bruno, A., Brusaferro, M., Buccheri, M., Campanella, F., Canino, R., Cannistra, A., Carini, S. A., Catalano, S., Castellani, P., Castiglione, G., Coniglio, S., Consolante, C., Conte, Caterina, Contrisciani, R., Corallini, R., Crollari, P., Damiani, Gianfranco, Denaro, C., De Remigis, S., Diana, F., Di Bartolo, R., Di Benedetto, A., Di Fabio, G., Di Falco, C., Digeronimo, V., Di Gregorio, P., Distefano, R., Egitto, G., Falciani, E., Farruggia, P., Fenaroli, S., Ferlazzo, G., Garofalo, G., Girardis, M., Giovanelli, Laura, Giubbini, Gabriele, Graceffa, A., Guadagna, A., Gregu, G., Ingala, F., Innocenzi, L., La Camera, G., La Rosa, M. C., Lesa, L., Longhitano, A. M., Luppino, G., Maida, C. M., Manta, G., Marino, G., Masia, M. D., Maviglia, Riccardo, Mazzetti, M., Maugeri, A., Megna, M. T., Mella, L. M., Milazzo, M., Milia, M., Minari, C., Minerva, M., Mordacci, M., Murgia, P., Oliveri, P., Olori, M. P., Pagliarulo, R., Palermo, R., Pandiani, I., Pappalardo, F., Papetti, C., Partenza, A., Pascu, D., Pasculli, M., Pavia, M., Pavone, M. L., Pellegrino, Maria Gabriella, Pelligra, F., Pillon, D., Pintaudi, S., Pitzoi, L., Pinto, A., Piotti, P., Pupo, S., Quattrocchi, R., Righi, E., Rigo, A., Romeo, A., Rosa, Enrico, Rutigliano, S., Sarchi, P., Scimonello, G., Seminerio, A., Stefanini, P., Sticca, G., Taddei, S., Tessari, L., Tetamo, R., Ticca, M., Tribastoni, S., Vallorani, S., Venturoni, F., Vitagliano, E., Vitali, P., Zappone, Assunta, Zei, E., Zeoli, M. P., Laurenti P. (ORCID:0000-0002-8532-0593), Antonelli M. (ORCID:0000-0003-3007-1670), Barilaro C. (ORCID:0000-0002-6576-8921), Bellocchi P., Bianco A., Conte C., Damiani G. (ORCID:0000-0003-3028-6188), Giovanelli L. (ORCID:0009-0007-8931-6253), Giubbini G., Maviglia R., Pellegrino M. G., Rosa E., Zappone A., Agodi, A., Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, Patrizia, Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, M. R., Alliani, C., Amatucci, M. R., Antoci, M., Antonelli, Massimo, Astuto, M., Arnoldo, L., Arru, B., Baccari, G., Barbadoro, P., Barbara, A., Barilaro, Cynthia, Battaglia, P., Bellocchi, Paolo, Bernasconi, M. O., Bianco, Assunta, Bissolo, E., Bocchi, A., Bruno, A., Brusaferro, M., Buccheri, M., Campanella, F., Canino, R., Cannistra, A., Carini, S. A., Catalano, S., Castellani, P., Castiglione, G., Coniglio, S., Consolante, C., Conte, Caterina, Contrisciani, R., Corallini, R., Crollari, P., Damiani, Gianfranco, Denaro, C., De Remigis, S., Diana, F., Di Bartolo, R., Di Benedetto, A., Di Fabio, G., Di Falco, C., Digeronimo, V., Di Gregorio, P., Distefano, R., Egitto, G., Falciani, E., Farruggia, P., Fenaroli, S., Ferlazzo, G., Garofalo, G., Girardis, M., Giovanelli, Laura, Giubbini, Gabriele, Graceffa, A., Guadagna, A., Gregu, G., Ingala, F., Innocenzi, L., La Camera, G., La Rosa, M. C., Lesa, L., Longhitano, A. M., Luppino, G., Maida, C. M., Manta, G., Marino, G., Masia, M. D., Maviglia, Riccardo, Mazzetti, M., Maugeri, A., Megna, M. T., Mella, L. M., Milazzo, M., Milia, M., Minari, C., Minerva, M., Mordacci, M., Murgia, P., Oliveri, P., Olori, M. P., Pagliarulo, R., Palermo, R., Pandiani, I., Pappalardo, F., Papetti, C., Partenza, A., Pascu, D., Pasculli, M., Pavia, M., Pavone, M. L., Pellegrino, Maria Gabriella, Pelligra, F., Pillon, D., Pintaudi, S., Pitzoi, L., Pinto, A., Piotti, P., Pupo, S., Quattrocchi, R., Righi, E., Rigo, A., Romeo, A., Rosa, Enrico, Rutigliano, S., Sarchi, P., Scimonello, G., Seminerio, A., Stefanini, P., Sticca, G., Taddei, S., Tessari, L., Tetamo, R., Ticca, M., Tribastoni, S., Vallorani, S., Venturoni, F., Vitagliano, E., Vitali, P., Zappone, Assunta, Zei, E., Zeoli, M. P., Laurenti P. (ORCID:0000-0002-8532-0593), Antonelli M. (ORCID:0000-0003-3007-1670), Barilaro C. (ORCID:0000-0002-6576-8921), Bellocchi P., Bianco A., Conte C., Damiani G. (ORCID:0000-0003-3028-6188), Giovanelli L. (ORCID:0009-0007-8931-6253), Giubbini G., Maviglia R., Pellegrino M. G., Rosa E., and Zappone A.

Abstract

Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. Conclusions. Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients.

Published
2018

8. Epidemiology of intensive care unit-acquired sepsis in Italy: Results of the SPIN-UTI network

Author

Agodi, Antonella, Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, P., Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, Mary Rose, Alliani, Cristina, Amatucci, Maria Rita, Antoci, Manuela, Antonelli, Massimo, Astuto, Marinella, Arnoldo, Luca, Arru, Benedetto, Baccari, Giorgio, Barbadoro, Pamela, Barbara, Andrea, Barilaro, Cynthia, Battaglia, Pietro, Bellocchi, Patrizia, Bernasconi, Mara Olga, Bianco, Aida, Bissolo, Emanuela, Bocchi, Anna, Bruno, Anna, Brusaferro, Marco, Buccheri, Margherita, Campanella, Francesca, Canino, Rosario, Cannistrà, Antonino, Carini, Santa Adele, Catalano, Sebastiano, Castellani, Paola, Castiglione, Giacomo, Coniglio, Salvatore, Consolante, Ciriaco, Conte, Carmela, Contrisciani, Roberta, Corallini, Rosy, Crollari, Patricia, Damiani, Gianfranco, Denaro, Carmelo, De Remigis, Santa, Diana, Francesca, Di Bartolo, Rosario, Di Benedetto, Antonino, Di Fabio, Gianna, Di Falco, Carlo, Digeronimo, Vito, Di Gregorio, Pietro, Distefano, Roberta, Egitto, Giovanni, Falciani, Elena, Farruggia, Patrizia, Fenaroli, Salesia, Ferlazzo, Giuseppe, Garofalo, Giuseppe, Girardis, Massimo, Giovanelli, Linda, Giubbini, Gabriele, Graceffa, Adriana, Guadagna, Antonina, Gregu, Giovanna, Ingala, Franco, Innocenzi, Ludovico, La Camera, Giuseppa, La Rosa, Maria Clara, Lesa, Lucia, Longhitano, Anna Maria, Luppino, Giuseppe, Maida, Carmelo Massimo, Manta, Giuseppe, Marino, Giovanni, Masia, Maria Dolores, Maviglia, Riccardo, Mazzetti, Magda, Maugeri, Andrea, Megna, Maria Teresa, Mella, Laura Maria, Milazzo, Marina, Milia, Mario, Minari, Caterina, Minerva, Massimo, Mordacci, Marco, Murgia, Paola, Oliveri, Pietro, Olori, Maria Patrizia, Pagliarulo, Riccardo, Palermo, Rosanna, Pandiani, Irene, Pappalardo, Federico, Papetti, Cristina, Partenza, Adolfo, Pascu, Diana, Pasculli, Marcello, Pavia, Maria, Pavone, Maria Luisa, Pellegrino, Maria Giovanna, Pelligra, Fabrizio, Pillon, Danila, Pintaudi, Sergio, Pitzoi, Lucia, Pinto, Andrea, Piotti, Paola, Pupo, Simona, Quattrocchi, Rosalba, Righi, Elena, Rigo, Alberto, Rigo, Annalisa, Romeo, Antonina, Rosa, Emilio, Rutigliano, Serafina, Sarchi, Pierangelo, Scimonello, Guglielmo, Seminerio, Antonello, Stefanini, Paolo, Sticca, Giovanna, Taddei, Stefania, Tessari, Lorella, Tetamo, Romano, Ticca, Mariantonietta, Tribastoni, Salvatore, Vallorani, Sarah, Venturoni, Federica, Vitagliano, Emilia, Vitali, Pietro, Zappone, Assunta, Zei, Ettore, Zeoli, Maria Prudenzia, Agodi A., Barchitta M., Auxilia F., Brusaferro S., D'Errico M.M., Montagna M.T., Pasquarella C., Tardivo S., Arrigoni C., Fabiani L., Laurenti P., Mattaliano A.R., Orsi G.B., Squeri R., Torregrossa M.V., Mura I., Aiello M.R., Alliani C., Amatucci M.R., Antoci M., Antonelli M., Astuto M., Arnoldo L., Arru B., Baccari G., Barbadoro P., Barbara A., Barilaro C., Battaglia P., Bellocchi P., Bernasconi M.O., Bianco A., Bissolo E., Bocchi A., Bruno A., Brusaferro M., Buccheri M., Campanella F., Canino R., Cannistra A., Carini S.A., Catalano S., Castellani P., Castiglione G., Coniglio S., Consolante C., Conte C., Contrisciani R., Corallini R., Crollari P., Damiani G., Denaro C., De Remigis S., Diana F., Di Bartolo R., Di Benedetto A., Di Fabio G., Di Falco C., Digeronimo V., Di Gregorio P., Distefano R., Egitto G., Falciani E., Farruggia P., Fenaroli S., Ferlazzo G., Garofalo G., Girardis M., Giovanelli L., Giubbini G., Graceffa A., Guadagna A., Gregu G., Ingala F., Innocenzi L., La Camera G., La Rosa M.C., Lesa L., Longhitano A.M., Luppino G., Maida C.M., Manta G., Marino G., Masia M.D., Maviglia R., Mazzetti M., Maugeri A., Megna M.T., Mella L.M., Milazzo M., Milia M., Minari C., Minerva M., Mordacci M., Murgia P., Oliveri P., Olori M.P., Pagliarulo R., Palermo R., Pandiani I., Pappalardo F., Papetti C., Partenza A., Pascu D., Pasculli M., Pavia M., Pavone M.L., Pellegrino M.G., Pelligra F., Pillon D., Pintaudi S., Pitzoi L., Pinto A., Piotti P., Pupo S., Quattrocchi R., Righi E., Rigo A., Romeo A., Rosa E., Rutigliano S., Sarchi P., Scimonello G., Seminerio A., Stefanini P., Sticca G., Taddei S., Tessari L., Tetamo R., Ticca M., Tribastoni S., Vallorani S., Venturoni F., Vitagliano E., Vitali P., Zappone A., Zei E., Zeoli M.P., Agodi, A., Barchitta, M., Auxilia, F., Brusaferro, S., D'Errico, M. M., Montagna, M. T., Pasquarella, C., Tardivo, S., Arrigoni, C., Fabiani, L., Laurenti, P., Mattaliano, A. R., Orsi, G. B., Squeri, R., Torregrossa, M. V., Mura, I., Aiello, M. R., Alliani, C., Amatucci, M. R., Antoci, M., Antonelli, M., Astuto, M., Arnoldo, L., Arru, B., Baccari, G., Barbadoro, P., Barbara, A., Barilaro, C., Battaglia, P., Bellocchi, P., Bernasconi, M. O., Bianco, A., Bissolo, E., Bocchi, A., Bruno, A., Brusaferro, M., Buccheri, M., Campanella, F., Canino, R., Cannistra, A., Carini, S. A., Catalano, S., Castellani, P., Castiglione, G., Coniglio, S., Consolante, C., Conte, C., Contrisciani, R., Corallini, R., Crollari, P., Damiani, G., Denaro, C., De Remigis, S., Diana, F., Di Bartolo, R., Di Benedetto, A., Di Fabio, G., Di Falco, C., Digeronimo, V., Di Gregorio, P., Distefano, R., Egitto, G., Falciani, E., Farruggia, P., Fenaroli, S., Ferlazzo, G., Garofalo, G., Girardis, M., Giovanelli, L., Giubbini, G., Graceffa, A., Guadagna, A., Gregu, G., Ingala, F., Innocenzi, L., La Camera, G., La Rosa, M. C., Lesa, L., Longhitano, A. M., Luppino, G., Maida, C. M., Manta, G., Marino, G., Masia, M. D., Maviglia, R., Mazzetti, M., Maugeri, A., Megna, M. T., Mella, L. M., Milazzo, M., Milia, M., Minari, C., Minerva, M., Mordacci, M., Murgia, P., Oliveri, P., Olori, M. P., Pagliarulo, R., Palermo, R., Pandiani, I., Pappalardo, F., Papetti, C., Partenza, A., Pascu, D., Pasculli, M., Pavia, M., Pavone, M. L., Pellegrino, M. G., Pelligra, F., Pillon, D., Pintaudi, S., Pitzoi, L., Pinto, A., Piotti, P., Pupo, S., Quattrocchi, R., Righi, E., Rigo, A., Romeo, A., Rosa, E., Rutigliano, S., Sarchi, P., Scimonello, G., Seminerio, A., Stefanini, P., Sticca, G., Taddei, S., Tessari, L., Tetamo, R., Ticca, M., Tribastoni, S., Vallorani, S., Venturoni, F., Vitagliano, E., Vitali, P., Zappone, A., Zei, E., and Zeoli, M. P.

Subjects
Sleep Initiation and Maintenance Disorder, Male, Time Factors, Healthcare-associated infections, Mortality, Sepsis, Surveillance, Public Health, Environmental and Occupational Health, Infectious Diseases, Diet, Mediterranean, Coffee, Health Statu, Mortality Parole chiave: Infezioni correlate all'assistenza, Mortalità, Sepsi, Sorveglianza, Academic Performance, Prevalence, Surveys and Questionnaire, Hospital Mortality, Prospective Studies, Cross Infection, Incidence, Smoking, Tryptophan, Shock, Middle Aged, Shock, Septic, Intensive Care Units, Italy, Population Surveillance, Female, Public Health, Human, Adult, Employment, Alcohol Drinking, Intensive Care Unit, Regression Analysi, Young Adult, Age Distribution, Learning, Humans, Healthcare-associated infection, Exercise, Life Style, Settore MED/42 - IGIENE GENERALE E APPLICATA, Aged, Cross-Sectional Studie, Septic, Environmental and Occupational Health, Body Weight, Length of Stay, Body Height, Prospective Studie, Quality of Life, Students, Nursing
Abstract

Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. Conclusions. Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients.

Published
2018

9. Vaccination coverage in healthcare workers: a multicenter cross-sectional study in Italy.

Author

Genovese C, Picerno IAM, Trimarchi G, Cannavò G, Egitto G, Cosenza B, Merlina V, Icardi G, Panatto D, Amicizia D, Orsi A, Colosio C, Marsili C, Lari C, Palamara MAR, Vitale F, Casuccio A, Costantino C, Azara A, Castiglia P, Bianco A, Currà A, Gabutti G, Stefanati A, Sandri F, Florescu C, Marranzano M, Giorgianni G, Fiore V, Platania A, Torre I, Cappuccio A, Guillari A, Fabiani L, Giuliani AR, Appetiti A, Fauci V, Squeri A, Ragusa R, and Squeri R

Subjects
Adult, Cross-Sectional Studies, Female, Health Personnel statistics & numerical data, Humans, Infectious Disease Transmission, Professional-to-Patient, Italy, Male, Middle Aged, Nurses statistics & numerical data, Physicians statistics & numerical data, Vaccination Coverage statistics & numerical data
Abstract

Introduction: In recent years, a phenomenon known as "vaccine hesitancy" has spread throughout the world, even among health workers, determining a reduction in vaccination coverage (VC).A study aimed at evaluating VC among healthcare workers (HCWs) in 10 Italian cities (L'Aquila, Genoa, Milan, Palermo, Sassari, Catanzaro, Ferrara, Catania, Naples, Messina) was performed., Materials and Methods: Annex 3 of the Presidential Decree n. 445 of 28 December 2000 was used to collect information on the vaccination status of HCWs. The mean and standard deviation (SD) were calculated with regard to the quantitative variable (age), while absolute and relative frequencies were obtained for categorical data (sex, professional profile, working sector, vaccination status). The connection between VC and the categorical variables was evaluated by chi-square method (statistical significance at p < 0.05). The statistical analyses were performed by SPSS and Stata software., Results: A total of 3,454 HCWs participated in the project: 1,236 males and 2,218 females.The sample comprised: physicians (26.9%), trainee physicians (16.1%), nurses (17.2%) and other professional categories (9.8%). Low VC was generally recorded. Higher VC was found with regard to polio, hepatitis B, tetanus and diphtheria, while coverage was very low for measles, mumps, rubella, pertussis, chickenpox and influenza (20-30%)., Conclusions: This study revealed low VC rates among HCWs for all the vaccinations. Measures to increase VC are therefore necessary in order to prevent HCWs from becoming a source of transmission of infections with high morbidity and/or mortality both within hospitals and outside.

Published
2019
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10. Mucinous histology of colon cancer predicts poor outcomes with FOLFOX regimen in metastatic colon cancer.

Author

Maisano R, Azzarello D, Maisano M, Mafodda A, Bottari M, Egitto G, and Nardi M

Subjects
Activities of Daily Living, Adenocarcinoma, Mucinous diagnosis, Adenocarcinoma, Mucinous secondary, Adult, Aged, Antineoplastic Agents administration & dosage, Antineoplastic Agents therapeutic use, Colonic Neoplasms diagnosis, Drug Resistance, Neoplasm, Female, Fluorouracil therapeutic use, Follow-Up Studies, Humans, Leucovorin therapeutic use, Liver Neoplasms diagnosis, Liver Neoplasms drug therapy, Liver Neoplasms pathology, Liver Neoplasms secondary, Male, Middle Aged, Organoplatinum Compounds administration & dosage, Organoplatinum Compounds therapeutic use, Oxaliplatin, Peritoneal Neoplasms drug therapy, Peritoneal Neoplasms pathology, Peritoneal Neoplasms secondary, Prognosis, Remission Induction, Retrospective Studies, Survival Analysis, Adenocarcinoma, Mucinous drug therapy, Adenocarcinoma, Mucinous pathology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Colonic Neoplasms drug therapy, Colonic Neoplasms pathology
Abstract

Mucinous adenocarcinoma (MA) of colorectal cancer seems associated with reduced responsiveness to chemotherapy. The overexpression of markers of resistance to fluorouracil and oxaliplatin has recently been demonstrated. We revised the outcomes of metastatic MA of the colon treated with FOLFOX. From January 2002 to December 2009, we treated 198 patients with metastatic colon cancer, of which 21 (10.6%) had diagnosis of MA and were compared with 42 control patients with non-mucinous adenocarcinoma (NMA). In MA group, three patients [14%; inhibitory concentration 95: ± 7.5%] reached partial response, and in NMA group, two patients obtained complete response and 16 obtained partial response with an overall response rate of 43% (inhibitory concentration 95: ± 7.6%) with a significant statistical difference (P = 0.027). Median progression-free survival for MA group was 4 months with respect to 8 months for NMA (P = 0.0001); regarding overall survival, we registered a median of 8 months with respect to 18 months for MA and NMA (P = 0.001). In multivariate analysis, MA histology, Eastern Cooperative Oncology Group performance status 2, more than two metastatic sites, and peritoneal metastatic involvement resulted in negative independent prognostic factors. Also in our study, MA is connected to poor prognosis and reduced activity of chemotherapy. In the absence of randomised studies, it may be convenient to analyse this subgroup of patients within the large trials carried out on colorectal cancer.

Published
2012
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11. Alkaline phosphatase levels as a prognostic factor in metastatic colorectal cancer treated with the FOLFOX 4 regimen: a monoinstitutional retrospective study.

Author

Maisano R, Azzarello D, Del Medico P, Maisano M, Bottari M, Egitto G, and Nardi M

Subjects
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols adverse effects, Chemotherapy, Adjuvant, Colorectal Neoplasms drug therapy, Female, Fluorouracil adverse effects, Fluorouracil therapeutic use, Humans, Leucovorin adverse effects, Leucovorin therapeutic use, Male, Middle Aged, Organoplatinum Compounds adverse effects, Organoplatinum Compounds therapeutic use, Predictive Value of Tests, Prognosis, Retrospective Studies, Survival Analysis, Treatment Outcome, Alkaline Phosphatase blood, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biomarkers, Tumor blood, Colorectal Neoplasms enzymology, Colorectal Neoplasms pathology
Abstract

Aims and Background: Metastatic colorectal cancer has a heterogeneous behavior, and a set of patients will have minimal response and rapid disease progression. To understand this heterogeneity, studies have evaluated biological and clinical prognostic factors. Alkaline phosphatase seems to be a key prognostic factor, so we have reviewed the outcomes of our patients with respect to alkaline phosphatase levels., Methods and Study Design: Between January 2003 and December 2008, we treated with the FOLFOX 4 regimen 103 consecutive patients with metastatic colorectal cancer. Thirty-two patients had alkaline phosphatase > or =300 U/l., Results: Median time to progression was 4 months for patients with high alkaline phosphatase levels and 8 months for those with low alkaline phosphatase levels. Median overall survival was 8 and 17.5 months, respectively. Only 3 patients in the high alkaline phosphatase group obtained partial response (9.4%) compared to 3 complete responses and 24 partial responses (41.5%) in low alkaline phosphatase group. Toxicity was substantially different, with more grade 3-4 neutropenia, diarrhea and oral mucositis in the high than low alkaline phosphatase group., Conclusions: Alkaline phosphatase is an uncomplicated and potent prognostic factor. Patients with high alkaline phosphatase levels had a poor prognosis.

Published
2011
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