210 results on '"Moro, Ml"'
Search Results
2. Casi di infezione/colonizzazione da Candida auris in Emilia- Romagna: un aggiornamento del quadro epidemiologico
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Ferrari, E, Vecchi, E, Mattei, G, Diegoli, G, Gagliotti, C, Ricchizzi, E, Moro, Ml, Palandri, L, and Righi, E
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- 2022
3. Fuzzy branch‐and‐bound algorithm with owa operators in the case of consumer decision making
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Vizuete‐luciano, E, Boria‐reverter, S, Merigó‐lindahl, JM, Gil‐lafuente, AM, and Solé‐moro, ML
- Abstract
The ordered weighted averaging (OWA) operator is one of the most used techniques in the operator’s aggregation procedure. This paper proposes a new assignment algorithm by using the OWA operator and different extensions of it in the Branch‐and‐bound algorithm. The process is based on the use of the ordered weighted average distance operator (OWAD) and the induced OWAD operator (IOWAD). We present it as the Branch‐and‐bound algorithm with the OWAD operator (BBAOWAD) and the Branch‐and‐bound algorithm with the IOWAD operator (BBAIOWAD). The main advantage of this approach is that we can obtain more detailed information by obtaining a parameterized family of aggregation operators. The application of the new algorithm is developed in a consumer decision‐making model in the city of Barcelona regarding the selection of groceries by districts that best suit their needs. We rely on the opinion of local commerce experts in the city. The key advantage of this approach is that we can consider different sources of information independent of each other.
- Published
- 2021
4. Healthcare-associated infections and antimicrobial use in long-term care facilities (HALT3): an overview of the Italian situation
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Furmenti, Mf, Rossello, P, Bianco, S, Olivero, E, Thomas, R, Emelurumonye, In, Zotti, Cm, Moro, Ml, Brusaferro, S, Sticchi, C, Chadenier, Gm, D'Errico, M, Ripabelli, G, Prato, R, Mura, Ii, Agodi, A, Collini, F, Torri, E, Novati, R, Fedeli, U, and HALT3 Italian Collaborating Group
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Male ,Microbiology (medical) ,Healthcare associated infections ,Healthcare Associated Infections ,Long-Term Care Facility ,Point-Prevalence Survey ,medicine.medical_specialty ,Population ,Healthcare-associated infections ,030501 epidemiology ,Antimicrobial Stewardship ,03 medical and health sciences ,Antibiotic resistance ,Anti-Infective Agents ,Surveys and Questionnaires ,80 and over ,Prevalence ,medicine ,Humans ,Antimicrobial stewardship ,Infection control ,Point prevalence survey ,education ,Aged ,Aged, 80 and over ,Cross Infection ,Infection Control ,0303 health sciences ,education.field_of_study ,030306 microbiology ,business.industry ,General Medicine ,Antimicrobial ,Long-Term Care ,Drug Utilization ,Long-term care ,Infectious Diseases ,Antimicrobial use ,Italy ,Family medicine ,Female ,Long-term care facility ,0305 other medical science ,business - Abstract
Summary Background Awareness of healthcare-associated infections (HAIs) and antimicrobial use in long-term care facilities (LTCFs) is increasing. In 2017, the third national point prevalence survey (PPS) was conducted in Italy as part of the third ‘Healthcare-Associated Infections in European Long-Term Care Facilities’ (HALT3) study. Aim To report the results of HALT3 and analyse the resident population of LTCFs, implementation of good practices, prevalence of infections and antimicrobial use. Methods The survey was designed as a PPS, carried out from April to June 2017. All residents who lived full-time in the institution were included. All facilities were asked to complete an institutional questionnaire, a ward list for all residents, and a resident questionnaire for those residents presenting with signs/symptoms of active infection and/or receiving an antimicrobial agent. Findings In total, 418 facilities took part in the study; 24,132 residents were eligible, and most were aged >85 years, disoriented and incontinent. The prevalence of HAIs was 3.9%, and 50% of the institutions reported that they had a professional trained in infection control on their staff. Only 26.4% of infections were confirmed by a microbiological sample, and 26.9% of the isolated micro-organisms were resistant to at least one antimicrobial class. In total, 1022 residents received at least one antimicrobial agent, and cephalosporins were prescribed most commonly. Conclusion The number of infection control and antimicrobial stewardship measures implemented was found to be considerably higher in this study compared with previous studies. This could lead to a reduction in the prevalence of HAIs, antimicrobial use and antimicrobial resistance. Further studies are needed to monitor these aspects.
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- 2019
5. Healthcare associated infections (HAI) in long-term care facilities in Europe
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Moro ML, Jans B, Latour K, Ricchizzi E, Cookson B, MacKenzie D, Van de Mortel M, and Fabry J
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Medicine ,Science - Published
- 2011
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6. The concordance of European and US definitions for healthcare-associated infections (HAI)
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Hansen S, Sohr D, Geffers C, Astagneau P, Blacky A, Koller W, Morales I, Moro ML, Palomar M, Szilagyi E, Suetens C, and Gastmeier P
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Medicine ,Science - Published
- 2011
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7. Increasing trends of Acinetobacter Baumannii infections in Emilia-Romagna, Italy
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Gagliotti C, Pan A, Buttazzi R, Capatti C, Carretto E, Pedna F, Sarti M, Venturelli C, and Moro ML
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Medicine ,Science - Published
- 2011
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8. Antimicrobial stewardship programs in Emilia-Romagna, Italy
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Pan A, Gagliotti C, Arlotti M, Bassi P, Bertozzi L, Borsari M, Cancellieri C, Carletti R, Giordani S, Libanore M, Magnani G, Marchegiano P, Mazzini E, Mezzadri S, Minghetti M, Nola S, Puggioli C, Ragni P, Ratti G, Sisti M, Vandelli C, Viale P, Vitali P, and Moro ML
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Medicine ,Science - Published
- 2011
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- View/download PDF
9. Tuberculosis among children and young adults in Emilia-Romagna Region (Northern Italy): surveillance system and integration with socioeconomic data [La tubercolosi nei bambini e nei giovani adulti in Emilia-Romagna: sistema di sorveglianza e integrazione con dati socioeconomici]
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Morandi, M, DI GIROLAMO, Chiara, Caranci, Nicola, Mattivi, A, Marchi, Massimiliano, Borrini, Bm, Moro, Ml, Morandi, M, Di Girolamo, C, Caranci, N, Mattivi, A, Marchi, M, Borrini, BM, and Moro, ML
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deprivation index ,tuberculosis ,geocoding ,children ,young people ,tuberculosis, geocoding, deprivation index, children, young people - Abstract
OBJECTIVES: to characterise the cases of tuberculosis (TB) aged 0-24 years reported in Emilia-Romagna (Northern Italy) Region between 2001 and 2010 through an ecological approach and from a sociodemographic perspective. DESIGN: observational study on notified TB cases, with data integration and subsequent location through geocoding and ecological deprivation index. SETTING AND PARTICIPANTS: notification records of TB cases identified by the current surveillance system. Cases were geocoded where address details were available and, through spatial intersection with census block polygons, the related deprivation index (DI) was attributed to them. MAIN OUTCOME MEASURES: deprivation index distribution of the observed cases. RESULTS: in the considered decade, 686 cases of tuberculosis in the age group 0-24 years were reported, 14.5% of the overall number of cases in the Emilia-Romagna Region. The DI was attributed to the 90.4% of cases. Notified TB cases were more frequently located in the most deprived areas. CONCLUSIONS: as other TB international surveillance systems, this study shows that it is possible to locate TB cases, to link them with census data and, therefore, to characterise with socioeconomic information. Looking ahead, the extension of the analysis to all age classes, the updating of socioeconomic data and the use of qualitative methodologies can integrate surveillance system data to better describe the social disadvantage among TB cases.
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- 2015
10. Building a continuous multicenter infection surveillance system in the intensive care unit: findings from the initial data set of 9,493 patients from 71 Italian intensive care units
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MALACARNE P, LANGER M, NASCIMBEN E, MORO ML, GIUDICI D, LAMPATI L, BERTOLINI G, ITALIAN GROUP FOR THE EVALUATION OF INTERVENTIONS IN INTENSIVE CARE MEDICINE, GIARRATANO, Antonino, Malacarne, P., Langer, M., Nascimben, E., Moro, Ml, Giudici, D, Lampati, L, Bertolini, G, Italian Group for the Evaluation of Interventions in Intensive Care, Medicine, Ferraro, Fausto, MALACARNE P, LANGER M, NASCIMBEN E, MORO ML, GIUDICI D, LAMPATI L, BERTOLINI G, GIARRATANO A, and ITALIAN GROUP FOR THE EVALUATION OF INTERVENTIONS IN INTENSIVE CARE MEDICINE
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Resuscitation ,medicine.medical_specialty ,Medical Records Systems, Computerized ,Quality Assurance, Health Care ,health care facilities, manpower, and services ,critically ill ,Critical Care and Intensive Care Medicine ,Infections ,law.invention ,critical care medicine sepsis infectious disease ,law ,Risk Factors ,Intensive care ,Epidemiology ,medicine ,Infection control ,Humans ,Hospital Mortality ,Prospective Studies ,Intensive care medicine ,Infection surveillance ,business.industry ,Septic shock ,Incidence ,Length of Stay ,Middle Aged ,medicine.disease ,Prognosis ,Intensive care unit ,infection control ,infection ,Icu admission ,severe sepsis ,Survival Rate ,Intensive Care Units ,infection control control ,Logistic Models ,Italy ,Population Surveillance ,septic shock ,business ,intensive care units, critically ill, infection, infection control, severe sepsis, septic shock - Abstract
OBJECTIVE: To describe the epidemiology of infections in intensive care units (ICUs), whether present at admission or acquired during the stay. METHODS: Prospective data collection lasting 6 months in 71 Italian adult ICUs. Patients were screened for infections and risk factors at ICU admission and daily during their stay. MAIN RESULTS: Out of 9,493 consecutive patients admitted to the 71 ICUs, 11.6% had a community-acquired infection, 7.4% a hospital-acquired infection, and 11.4% an ICU-acquired infection. The risk curve of acquiring infection in the ICU was higher in patients who entered without infection than in those already infected (log-rank test, p < .0001; at 15 days, 44.0% vs. 34.6%). Hospital mortality (27.8% overall) was higher in patients admitted with infection than in those who acquired infection in the ICU (45.0% vs. 32.4%, p < .0001). Although the presence of infection per se did not influence mortality, the conditions of severe sepsis and septic shock were strong prognostic factors (odds ratio, 2.3 and 4.8, respectively). Apart from ICU-acquired peritonitis, no other site of infection reached statistical significance as an independent prognostic factor for hospital mortality. CONCLUSIONS: Adding specific data on infections and risk factors to a well-established electronic data collection system is a reliable basis for a continuous multicenter infection surveillance program in the ICU. Given the well-established importance of infection prevention programs, our data suggest that the improvement of the treatment of severe sepsis and septic shock is the key to lower infection-related mortality in the ICU. This calls for closer attention to severe infections in surveillance programs. intensive care units; critically ill; infection; infection control; severe sepsis; septic shock.
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- 2008
11. Progress in infection prevention and control in Italy: a nationwide survey
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Moro, Ml, Marchi, M, Buttazzi, R, Nascetti, S, Collaborators: Pompa MG, INF OSS Project G. r. o. u. p., Salcuni, P, Scassa, E, Scudieri, M, Cauzillo, G, Locuratolo, F, Barone, R, Pizzuti, R, Sarnelli, B, Simon, G, Turello, D, Trevisan, R, Puro, V, Martini, L, Mandolini, D, Vizio, M, Nannini, M, Pavan, A, Bernieri, F, D'Errico, M, Prospero, E, Zotti, Carla Maria, Dipietrantonj, C, Prato, R, Villone, G, Balducci, Mt, Mura, M, Mura, I, Maniaci, L, Cantaro, Sp, Poli, A, Privitera, G, Porretta, A, Fiorio, M, Montedori, A, Sacco, R, Mastaglia, M, Spolaore, P, Fedeli, U, Santa, Pj, Fabbri, L, and Piccini, G.
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Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,Community service ,Nationwide survey ,prevention ,medicine ,Humans ,Infection control ,survey ,Clinical risk management ,Healthcare related Infection ,Response rate (survey) ,Cross Infection ,Infection Control ,business.industry ,Public health ,Health services research ,General Medicine ,Infectious Diseases ,Italy ,Respondent ,Health Services Research ,business ,Demography - Abstract
A national survey was conducted to describe the coverage and characteristics of infection prevention and control (IC) programmes in Italy and to evaluate progress during recent years. All regions, with one small exception, participated and the response rate was 88%. Nearly all 278 respondent public health trusts reported having an IC committee, 80% of the 615 respondent hospitals to have instituted an IC team, and 79% to have an IC nurse. However, when the presence of truly operating IC bodies was considered, the pattern was different: only 27% of IC teams met at least monthly, and variation by region was extremely large [coefficient of variation (CV): 1.06]. The IC programme characteristics with the greatest variation by region included: availability of qualified nurses and IC doctors (CV: 1.55 and 1.39 respectively); integration of IC activities and clinical risk management (CV: 1.05); IC programmes also involving community services (CV: 0.98); training of personnel at induction (CV: 0.82); and availability of written policies for the control of multidrug-resistant organisms (CV: 1.08). A relevant and statistically significant North-South gradient showed Southern Regions averaging 23 points less than Northern Regions on the IC score. Compared with a similar survey conducted in 2000, the distribution of several activities by region had improved significantly. Despite the noteworthy improvement observed over time, the situation in Italy is still unsatisfactory, due to significant variation in the development of IC organisations and initiatives by region and by type of hospital.
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- 2011
12. Il profilo di salute per il nuovo Piano della Prevenzione della Regione Emilia-Romagna, 2014-2018
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Angelini, P, Bal, M, Baldacchini, F, Ballarini, A, Ballotari, P, Balsamo, A, Baronciani, D, Baronio, F, Bedeschi, E, Bertozzi, N, Bolognesi, L, Borciani, E, Borrini, Bm, Botarelli, L, Broccoli, S, Busciolano, S, Buttazzi, R, I Cagarelli R, Cacciapuoti, Caranci, N, Carrozzi, G, Cassio, A, Colacci, Am, Collarile, P, Collini, G, De Palma, R, Diegoli, G, Falaschi, L, Falcini, F, Fedruzzi, G, Ferrari, D, Ferretti, S, Ferri, M, Finarelli, Ac, Finelli, A, Frasca, G, Fridel, M, Gagliotti, C, Galletti, G, Giannini, S, Giorgi Rossi, P, Giuliani, O, Goldoni, Ca, Gualanduzzi, C, Guastarobaa, P, Luberto, F, Mangone, L, Manicardi, V, Marchesi, C, Massaro, S, Massimiliani, E, Mattivi, A, Mazzocchetti, A, Michiara, M, Miraglia, V, Moro, Ml, Moschella, L, Naldoni, C, Natali, M, Natalini, S, L Nocera L, Nobilio, Pacelli, B, Padovani, A, Paladini, M, Palazzi, M, Paolucci, C, Marenti, M, Parmagnani, F, Pascucci, Mg, Rangoni, R, Ranzi, A, Ravaioli, A, Ricchizzi, E, Righetti, F, Romanelli, A, Sampaolo, L, Santi, A, Saponaro, A, Sardonini, L, Sassoli de'Bianchi, P, Scaroni, I, Stivanello, E, Tamba, M, Tortorici, D, Rondinini, Az, and Zauli Sajani, S
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Socio-culturale - Published
- 2015
13. Chikungunya virus in North-Eastern Italy: a seroprevalence survey
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Moro ML, Gagliotti C, Silvi G, Angelini R, Sambri V, Rezza G, Massimiliani E, Mattivi A, Grilli E, Finarelli AC, Spataro N, Pierro AM, Seyler T, Macini P, Chikungunya Study Group., Moro ML, Gagliotti C, Silvi G, Angelini R, Sambri V, Rezza G, Massimiliani E, Mattivi A, Grilli E, Finarelli AC, Spataro N, Pierro AM, Seyler T, Macini P, and Chikungunya Study Group.
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.disease_cause ,Antibodies, Viral ,Asymptomatic ,Serology ,Disease Outbreaks ,CHIKUNGUNYA ,Young Adult ,Blood serum ,Seroepidemiologic Studies ,Virology ,Environmental health ,Epidemiology ,medicine ,Seroprevalence ,Humans ,EPIDEMIOLOGY ,Chikungunya ,RISK ASSESSMENT ,Alphavirus infection ,Child ,Aged ,Aged, 80 and over ,business.industry ,Alphavirus Infections ,SEROLOGY ,Infant, Newborn ,Outbreak ,Infant ,Articles ,Middle Aged ,medicine.disease ,Infectious Diseases ,Italy ,Child, Preschool ,Parasitology ,Female ,medicine.symptom ,business ,Chikungunya virus - Abstract
After an outbreak of Chikungunya infection in Emilia-Romagna Region (North-eastern Italy), a survey was performed to estimate the seroprevalence of antibody to Chikungunya virus and the proportion of asymptomatic infections, to identify factors associated with infection, and evaluate the performance of the surveillance system. The method used was a survey on a random sample of residents of the village with the largest number of reported cases. The prevalence was 10.2% (33 of 325), being higher in older people and males, and lower when window screens and insect repellents were used. Only 18% of infected persons were fully asymptomatic, 85% of the 27 symptomatic confirmed cases satisfied the surveillance case definition, and 63% of the persons meeting the criteria for suspect case were identified by the active surveillance system. This study provides basic parameters for modeling the transmission potential of outbreaks and planning control measures for Chikungunya infection in temperate settings.
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- 2010
14. Sorveglianza epidemiologica della tubercolosi pediatrica in Emilia Romagna: 1996-2006
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Odone A, Riccò M, Boccuni C, Borrini BM, Moro ML, Pasquarella C, Signorelli C., Odone, A, Riccò, M, Boccuni, C, Borrini, Bm, Moro, Ml, Pasquarella, C, and Signorelli, C.
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- 2010
15. Training infection control and hospital hygiene professionals in Europe, 2010: Agreed core competencies among 33 European countries
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Brusaferro, S, Cookson, B, Kalenic, S, Cooper, T, Fabry, J, Gallagher, R, Hartemann, P, Mannerquist, K, Popp, W, Privitera, G, Ruef, C, Viale, P, Coiz, F, Fabbro, E, Suetens, C, Varela Santos, C, Blacky, A, Simon, A, Vatcheva-Dobrevska, R, Budimir, A, Stavroulla, S, Sturma, J, Holt, J, Lemetsar, A, Lyytikäinen, O, Astagneau, P, Mielke, M, Ftika, L, Hajdu, A, Donlon, S, Moro, ML, Nikiforova, R, Gailiene, G, Heisbourg, E, Borg, M, Ummels, L, Sorknes, Nina, Stefanof, P, Costa, C, Pitigoi, D, Kristufkova, Z, Kolman, J, Pareja-Bezares, A, CetinkayaSardan, Y, Sheridan, E, Mills, A, Scottish, Faser C, and Gauci, T
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VDP::Medisinske fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806 ,VDP::Midical sciences: 700::Health sciences: 800::Health service and health administration research: 806 - Published
- 2014
16. Cosa c’è di nuovo sulle infezioni correlate all’assistenza ed uso di antibiotici nelle strutture residenziali per anziani in Italia? I risultati del progetto europeo HALT2
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Ricchizzi, E, Moro, Ml, Agodi, ANTONELLA PAOLA, Arnoldo, L, Barchitta, Martina, Brusaferro, S, Cocconi, R, Cunsolo, R, D’Errico, M, Fedeli, U, Ferraro, F, Murolo, G, Palmieri, D, Parruti, G, Puro, V, Ruscitti, L, Schievano, E, Stillo, M, Torregrossa, V, and Zotti, C. M.
- Published
- 2014
17. The Italian national surgical site infection surveillance programme and its positive impact, 2009 to 2011
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Marchi, M, Pan, A, Gagliotti, C, Morsillo, F, Parenti, M, Resi, D, Moro, Ml, Sorveglianza Nazionale Infezioni in Chirurgia Study Group, Agodi, ANTONELLA PAOLA, D' Errico, M, Fabbri, L, Mana, F, Martini, L, Mastaglia, M, Novati, R, Pizzuti, R, Poli, A, Privitera, G, Puro, V, Santa, Pj, Sarnelli, B, and Zotti, C.
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Program evaluation ,Adult ,medicine.medical_specialty ,Multivariate analysis ,Time Factors ,Epidemiology ,MEDLINE ,Aged ,Cross Infection ,Data Collection ,Female ,Health Care Surveys ,Humans ,Infection Control ,Italy ,Length of Stay ,Middle Aged ,Multivariate Analysis ,Patient Discharge ,Population Surveillance ,Postoperative Care ,Program Evaluation ,Risk Factors ,Socioeconomic Factors ,Surgical Wound Infection ,Lower risk ,Virology ,medicine ,Infection control ,Intervention Duration ,surgical site infections, Italy, national surveillance ,business.industry ,Public Health, Environmental and Occupational Health ,surgical site infections ,Surgery ,Increased risk ,Emergency medicine ,national surveillance ,business ,Surgical site infection - Abstract
Programmes surveying surgical site infection (SSI) have been implemented throughout the world and are associated with a reduction in SSI rates. We report data on non-prosthetic surgery from the Italian SSI surveillance programme for the period 2009 to 2011. Participation in the programme was voluntary. We evaluated the occurrence of SSI, based on protocols from the European Centre for Disease Prevention and Control, within 30 days of surgery. Demographic data, risk factors, type of surgery and presence of SSI were recorded. The National Coordinating Centre analysed the pooled data. On 355 surgical wards 60,460 operations were recorded, with the number of surveyed intervention doubling over the study period. SSI was observed in 1,628 cases (2,6%) and 60% of SSI were diagnosed through 30-days post discharge surveillance. Operations performed in hospitals with at least two years of surveillance showed a 29% lower risk of SSI. Longer intervention duration, American Society of Anesthesiologists’ (ASA) score of at least three, and pre-surgery hospital stay of at least two days were associated with increased risk of SSI, while videoscopic procedures had reduced SSI rates. Implementation of a national surveillance programme was helpful in reducing SSI rates and should be prioritised in all healthcare systems.
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- 2014
18. Lo Studio di prevalenza europeo su infezioni correlate all’assistenza e uso di antibiotici negli ospedali per acuti: i risultati dell’esperienza Italiana 2011
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Ricchizzi, E, Moro, Ml, Novati, R, Zotti, Cm, Sticchi, C, Lorusso, C, Gramegna, M, Santa, Pj, Fabbri, L, Fedeli, U, Brusaferro, S, Poli, A, Privitera, G, D’Errico, M, Giaimo, Md, Puro, V, Martini, L, Pizzuti, R, Sarnelli, B, Prato, R, Murolo, G, Torregrossa, V, Cunsolo, R, Agodi, ANTONELLA PAOLA, and Mura, I.
- Published
- 2014
19. Il sistema nazionale di sorveglianza delle infezioni in terapia intensiva - SITIN: 2009-2012
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Morsillo, F, Pan, A, Agodi, ANTONELLA PAOLA, Bertolini, G, Cappelli, V, Morandi, M, Ricchizzi, E, Moro, Ml, Giviti, and Spin, Uti
- Published
- 2014
20. Surveillance of anti-tuberculosis drug resistance: Results of the 1998/1999 proficiency testing in Italy
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Migliori GB, Ambrosetti M, Fattorini L, Penati V, Vaccarino P, Besozzi G, Ortona L, Saltini C, Orefici G, Moro ML, Iona E, Cassone A, De Santis A, Giorgio V, Vinciguerra P, Angarano G, Petrozzi L, Costa D, Gozzellino F, Perboni A, Marchetti D, Pascali A, Falcone F, Mariano V, Rizza F, Pretto P, Turano A, Matteelli A, Carosi GP, Tedoldi S, Pinsi G, Farris AG, Ligia GP, Orani G, Farris B, Foschi C, Trucco G, Aiolfi S, Ceruti T, Parpanesi M, Calabro S, Felisatti G, Tortoli E, Nutini S, Montini G, Fiorentini F, D'Ambrosio V, Ceraminiello A, Bernorio S, Buono L, Montesano P, Vinci E, Sabato E, Gamba S, Crepaldi P, Bertoli G, Rupianesi F, Losi M, Richeldi L, Ferrara G, Muccio E, Napolitano G, Molinari GL, Saini L, Garzone A, Vertuccio C, Marcias, Menozzi, Marone P, Peona, Nascimbene, Pasi, Cascina, Casali, Monaco, Penza, Pasticci, M.B., Bistoni, Sposini, Colorizio, Confalonieri M, Bottrighi P, Orsi, Schiavi, Macor, Moretti, Fatigante, Barbaro, Agati, Zacarra, Viola, Le Donne, Farinelli, Mancini, Ermeti, Migliori, Gb, Ambrosetti, M, Fattorini, L, Penati, V, Vaccarino, P, Besozzi, G, Ortona, L, Saltini, C, Orefici, G, Moro, Ml, Iona, E, Cassone, A, De Santis, A, Giorgio, V, Vinciguerra, P, Angarano, G, Petrozzi, L, Costa, D, Gozzellino, F, Perboni, A, Marchetti, D, Pascali, A, Falcone, F, Mariano, V, Rizza, F, Pretto, P, Turano, A, Matteelli, A, Carosi, Gp, Tedoldi, S, Pinsi, G, Farris, Ag, Ligia, Gp, Orani, G, Farris, B, Foschi, C, Trucco, G, Aiolfi, S, Ceruti, T, Parpanesi, M, Calabro, S, Felisatti, G, Tortoli, E, Nutini, S, Montini, G, Fiorentini, F, D'Ambrosio, V, Ceraminiello, A, Bernorio, S, Buono, L, Montesano, P, Vinci, E, Sabato, E, Gamba, S, Crepaldi, P, Bertoli, G, Rupianesi, F, Losi, M, Richeldi, L, Ferrara, G, Muccio, E, Napolitano, G, Molinari, Gl, Saini, L, Garzone, A, Vertuccio, C, Marcias, Menozzi, Marone, P, Peona, Nascimbene, Pasi, Cascina, Casali, Monaco, Penza, Pasticci, M., B., Bistoni, Sposini, Colorizio, Confalonieri, M, Bottrighi, P, Orsi, Schiavi, Macor, Moretti, Fatigante, Barbaro, Agati, Zacarra, Viola, Le, Donne, Farinelli, Mancini, and Ermeti
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Tuberculosi ,Drug susceptibility testing ,Proficiency testing - Published
- 2000
21. Perioperative antibiotic prophylaxis in adults. Outline of the principal recommendations. National reference guidelines
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Calise, F, Capussotti, L, Caterino, S, Delitala, A, Terrazzi, P, Francucci, M, Gaspari, A, Langer, M, Marata, Am, Martelli, C, Moro, Ml, Pantosti, A, Passali, Desiderio, Petrosillo, N, Polastri, R, Rossolini, GIAN MARIA, Santaniello, W, Scaglione, F, and Ziparo, V.
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Settore MED/18 - Chirurgia Generale - Published
- 2009
22. Il ruolo della programmazione regionale: l’esperienza dell’Emilia Romagna nella lotta alla sepsi
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Girardis, Massimo, Donno, L., Rinaldi, L., Marietta, M., Codeluppi, M., Pmarchegiano, Baricchi, R., Caramelli, F., D’Errico, A., Giovannitti, A., Melotti, R., Peghetti, A., Pinelli, G., Resi, D., Sangiorgi, G., Tumietto, F., Zanello, M., and Moro, Ml
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sepsi ,programma regionale - Published
- 2007
23. Nosocomial infections in HIV infected/AIDS patients: national multicenter incidence study
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Petrosillo N, Girardi E, Ippolito G, Ortona L, Moro ML, Carosi G, Pugliese G, Gobbi M, Angarano G, Maggi P, Petrosillo, N, Girardi, E, Ippolito, G, Ortona, L, Moro, Ml, Carosi, G, Pugliese, G, Gobbi, M, Angarano, G, and Maggi, P
- Published
- 1996
24. Infezioni ospedaliere
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Boccia, Antonio, Derrico, Mm, Marzuillo, Carolina, Moro, Ml, and Villari, Paolo
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- 2005
25. Surveillance of anti-tuberculosis drug resistance: Results of the 1998/1999 proficiency testing in Italy
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Migliori, Gb, Ambrosetti, M, Fattorini, L, Penati, V, Vaccarino, P, Besozzi, G, Ortona, L, Saltini, C, Orefici, G, Moro, Ml, Iona, E, Cassone, A, De Santis, A, Giorgio, V, Vinciguerra, P, Angarano, G, Petrozzi, L, Costa, D, Gozzellino, F, Perboni, A, Marchetti, D, Pascali, A, Falcone, F, Mariano, V, Rizza, F, Pretto, P, Turano, A, Matteelli, A, Carosi, Gp, Tedoldi, S, Pinsi, G, Farris, Ag, Ligia, Gp, Orani, G, Farris, B, Foschi, C, Trucco, G, Aiolfi, S, Ceruti, T, Parpanesi, M, Calabro, S, Felisatti, G, Tortoli, E, Nutini, S, Montini, G, Fiorentini, F, D'Ambrosio, V, Ceraminiello, A, Bernorio, S, Buono, L, Montesano, P, Vinci, E, Sabato, E, Gamba, S, Crepaldi, P, Bertoli, G, Rupianesi, F, Losi, M, Richeldi, L, Ferrara, G, Muccio, E, Napolitano, G, Molinari, Gl, Saini, L, Garzone, A, Vertuccio, C, Marcias, Menozzi, Marone, P, Peona, Nascimbene, Pasi, Cascina, Casali, Monaco, Penza, Pasticci, M. B., Bistoni, Sposini, Colorizio, Confalonieri, M, Bottrighi, P, Orsi, Schiavi, Macor, Moretti, Fatigante, Barbaro, Agati, Zacarra, Viola, Donne, Le, Farinelli, Mancini, and Ermeti
- Subjects
Drug susceptibility testing ,Tuberculosis ,Proficiency testing - Published
- 2000
26. Comparison of two HIV testing strategies in primary care centres: indicator-condition-guided testingvs. testing of those with non-indicator conditions
- Author
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Menacho, I, primary, Sequeira, E, additional, Muns, M, additional, Barba, O, additional, Leal, L, additional, Clusa, T, additional, Fernandez, E, additional, Moreno, L, additional, Raben, D, additional, Lundgren, J, additional, Gatell, JM, additional, Garcia, F, additional, Cayuelas, L, additional, Aragunde, V, additional, Vergara, M, additional, Catalan, M, additional, Moreno, MA, additional, Hormigo, G, additional, Siso, A, additional, Herreras, Z, additional, Sebastian, L, additional, Benito, L, additional, Picas, A, additional, Hoyo, J, additional, Giner, MJ, additional, Cararach, D, additional, Moles, E, additional, Moro, ML, additional, Arrabal, P, additional, Roca, D, additional, Prego, S, additional, Ferrer, X, additional, Egido, A, additional, Ventosa, C, additional, Garcia, S, additional, Muñoz, S, additional, Massana, A, additional, Sole, J, additional, Curiel, M, additional, Heras, F, additional, and Leon, A, additional
- Published
- 2013
- Full Text
- View/download PDF
27. P212: Antimicrobial resistance and healthcare associated infections: one and only battle
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Moro, ML, primary, Gagliotti, C, additional, Marchi, M, additional, Buttazzi, R, additional, Cappelli, V, additional, Morandi, M, additional, Morsillo, F, additional, Pan, A, additional, Parenti, M, additional, and Ricchizzi, E, additional
- Published
- 2013
- Full Text
- View/download PDF
28. P033: Incidence estimate of Clostridium difficile infection in Emilia-Romagna Region by linkage of administrative and laboratory data
- Author
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Morandi, M, primary, Buttazzi, R, additional, Marchi, M, additional, Morsillo, F, additional, Gagliotti, C, additional, and Moro, ML, additional
- Published
- 2013
- Full Text
- View/download PDF
29. Risk factors for early onset pneumonia in traume patients
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Antonelli, Massimo, Moro, Ml, Cappelli, O, DE BLASI, Roberto Alberto, D'Errico, Rr, Conti, Giorgio, Bufi, Maurizio, and Gasparetto, Alessandro
- Published
- 1994
30. Validation of the surveillance system for new cases of tuberculosis in a province of northern Italy. Varese Tuberculosis Study Group
- Author
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Migliori, GB, primary, Spanevello, A, additional, Ballardini, L, additional, Neri, M, additional, Gambarini, C, additional, Moro, ML, additional, Trnka, L, additional, and Raviglione, MC, additional
- Published
- 1995
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31. Interleukin 18 gene polymorphisms predict risk and outcome of Alzheimer's disease.
- Author
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Bossù P, Ciaramella A, Moro ML, Bellincampi L, Bernardini S, Federici G, Trequattrini A, Macciardi F, Spoletini I, Di Iulio F, Caltagirone C, Spalletta G, Bossù, Paola, Ciaramella, Antonio, Moro, Maria Luisa, Bellincampi, Lorenza, Bernardini, Sergio, Federici, Giorgio, Trequattrini, Alberto, and Macciardi, Fabio
- Abstract
Background and Aim: Inflammation has been extensively implicated in the pathogenesis of Alzheimer's disease (AD). Although there is evidence of a key role for cytokines in neuroinflammation processes, so far the proinflammatory cytokine interleukin (IL)-18 has not been associated with AD. The aim of this study was to investigate the impact of two polymorphisms of the human IL-18 gene promoter at positions -607 (C/A) and -137 (G/C) on both susceptibility to and progression of AD.Results: The results revealed that the genotype distribution of the -607 (C/A) polymorphism was different between patients with AD and control subjects (chi2 = 7.99, df = 2, p = 0.0184). In particular, carriers of the CC genotype were at increased risk of developing AD (OR 2.33; 95% CI 1.29 to 4.22; p = 0.0052). The observed genotypes were in Hardy-Weinberg equilibrium, as for the -607 polymorphism, whereas the -137 polymorphism appeared in Hardy-Weinberg disequilibrium only in the patient group (p = 0.0061). Finally, in a 2 year follow-up study, the -137 CC genotype was strongly and specifically associated with a faster cognitive decline (F = 4.024; df = 4,192; p = 0.0037 for time by IL-18 -137 G/C group interaction) with no interaction effect with the apolipoprotein E epsilon4/non-epsilon4 allele presence.Conclusion: As IL-18 cytokine promoter gene polymorphisms have been previously described to have functional consequences on IL-18 expression, it is possible that individuals with a prevalent IL-18 gene variant have a dysregulated immune response, suggesting that IL-18 mediated immune mechanisms may play a crucial role in AD. [ABSTRACT FROM AUTHOR]- Published
- 2007
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32. Antibiotic treatments for children ages 0-23 months in a northern Italy region: a cohort study.
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Gagliotti C, Morsillo F, Resi D, Milandri M, and Moro ML
- Abstract
BACKGROUND: This study aims to describe the pattern of antibiotic treatments in the community for children ages 0-23 months in Emilia-Romagna (a northern Italy region) pointing out possible changes of prescribed agents when first treatments in the life of each children are compared to successive ones. MATERIALS AND METHODS: The Regional Drug Prescription and the Resident Population databases were used as data sources to study the cohort of children born between January 1 and December 31, 2000 and resident in Emilia-Romagna. RESULTS: The cumulative incidences of children with at least one treatment were 22%, 55% and 82% at 6, 12 and 24 months of age, respectively. Broad spectrum penicillins were the most prescribed antibiotic class for children at their first treatment while cephalosporins were the most prescribed class for successive treatments and when pooling all treatments. CONCLUSION: Cephalosporins and other second line antibiotics are frequently prescribed to 0 to 23-month-old residents in Emilia-Romagna even when only first treatments are considered; further research is needed to quantify inappropriateness of antibiotic prescription. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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33. T-dependent immunity in aged humans. I. Evaluation of T-cell subpopulations before and after short term administration of a thymic extract
- Author
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Isabella Quinti, Moro Ml, Fernando Aiuti, Massimo Fiorilli, Franco Pandolfi, and Silvana Zolla
- Subjects
Male ,medicine.medical_specialty ,Aging ,business.industry ,T cell ,T-Lymphocytes ,T lymphocyte ,Thymus Extracts ,Rosette (botany) ,Endocrinology ,Immune system ,medicine.anatomical_structure ,Antigen ,Ageing ,Immunity ,Delayed hypersensitivity ,Internal medicine ,Immunology ,Medicine ,Humans ,Female ,business ,Immunologic Memory ,Aged ,Skin Tests - Abstract
T lymphocytes, T lymphocyte subpopulations and delayed hypersensitivity reactions to recall antigens were studied in 20 aged subjects clinically unaffected by disorders of the immune system. T-cells evaluated by the sheep rosette test and absolute T-cell number were within normal range. T-cell subsets were studied by the high affinity rosetting test and by the sheep rosette test after pre-incubation with theophylline; such methods have been shown by others to discriminate between T-cells with helper or suppressor activity. We did not observe an imbalance of such subpopulations. Skin reactivity to recall antigens (Candida and SK-SD) was depressed in several cases. Since a decline in serum levels of thymic hormones has been reported in the ageing and it is suggested that this could account for the T-dependent immunity defect, we treated these patients with a bovine thymic extract (thymostimulin, TP-1) 1 mg/kg/day for three consecutive days. Immunological tests were performed again after this therapy but no modifications were observed. We may conclude that the aged subjects studied in this paper present normal relative and absolute number of T-cells and T subpopulations, whereas the function of T-cells, as assessed by skin reactivity to recall antigens is often depressed. Short term therapy with TP-1 at the above mentioned dosage was ineffective in modifying the parameters analysed.
- Published
- 1981
34. Persistence of anti–chikungunya virus–specific antibodies in a cohort of patients followed from the acute phase of infection after the 2007 outbreak in Italy
- Author
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Maria Luisa Moro, P. Gaibani, Maria Paola Landini, Anna Pierro, Giada Rossini, A C Finarelli, Vittorio Sambri, Pierro, A, Rossini, G, Gaibani, P, Finarelli, Ac, Moro, Ml, Landini, Mp, and Sambri, V.
- Subjects
serological follow-up ,medicine.disease_cause ,Microbiology ,Virus ,Persistence (computer science) ,lcsh:Infectious and parasitic diseases ,infected patients ,medicine ,New Microbes in Humans ,lcsh:RC109-216 ,Chikungunya ,chikungunya virus ,biology ,business.industry ,Outbreak ,Virology ,Chikungunya, antibodies persistance, IgG, IgM ,Titer ,Infectious Diseases ,Antibody response ,Italy ,Immunology ,Cohort ,biology.protein ,Antibody ,business - Abstract
Chikungunya is a mosquito-borne infection of humans, and its diffusion has increased worldwide. In 2007 an outbreak occurred in Italy. In this study, the antibody response of 133 patients followed up starting from the acute phase of infection was investigated. Antibody titres were periodically scored up to 1 year since the infection: 82.7% of the IgM antibody disappeared within 12 months, and the IgG response lasted longer than 12 months. Nevertheless, the IgG mean titre was lower in 95.5% of patients at the end of follow-up, thus suggesting a decrease within a relatively short period.
- Published
- 2015
35. Outbreak of Citrobacter freundii carrying VIM-1 in an Italian Hospital, identified during the carbapenemases screening actions, June 2012
- Author
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Maria Paola Landini, Carlo Gagliotti, Greta Roncarati, Ciro Tenace, Magda Mazzetti, Luca Guerra, Simone Ambretti, Miriam Cordovana, Andrea Berlingeri, Vittorio Sambri, Paolo Gaibani, Patrizia Farruggia, Gloria Bua, M. V. Tamburini, Maria Luisa Moro, Gaibani P, Ambretti S, Farruggia P, Bua G, Berlingeri A, Tamburini MV, Cordovana M, Guerra L, Mazzetti M, Roncarati G, Tenace C, Moro ML, Gagliotti C, Landini MP, and Sambri V
- Subjects
Male ,Microbiology (medical) ,Klebsiella pneumoniae ,Microbial Sensitivity Tests ,beta-Lactamases ,Disease Outbreaks ,Microbiology ,MLST ANALYSIS ,Genotype ,polycyclic compounds ,medicine ,Humans ,Phylogeny ,Aged ,Aged, 80 and over ,Cross Infection ,biology ,Enterobacteriaceae Infections ,Outbreak ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,biology.organism_classification ,Enterobacteriaceae ,Virology ,Hospitals ,Anti-Bacterial Agents ,Citrobacter freundii ,Multiple drug resistance ,Diarrhea ,Infectious Diseases ,Italy ,bacteria ,Multilocus sequence typing ,Female ,VIM-1 ,medicine.symptom ,Multilocus Sequence Typing ,MLST - Abstract
Summary Objective The identification of patients colonized or infected with carbapenemase-producing Enterobacteriaceae (CPE), in order to control and prevent the global spread of multidrug-resistant (MDR) pathogens. Methods From June 1 to June 15, 2012, eight Citrobacter freundii strains with reduced susceptibility to carbapenems were isolated from rectal swabs of hospitalized patients during active screening following the detection of a Klebsiella pneumoniae carbapenemase (KPC) -positive patient on the ward. All isolates were analyzed phenotypically and molecularly by PCR and sequencing. Genotype clustering was performed by multilocus sequence typing (MLST) analysis. Results The isolates showed high rates of multidrug resistance profile. A phenotypic assay for carbapenemase production suggested the presence of metallo-β-lactamase (MBL). The blaVIM-1 gene was detected in all imipenem-resistant C. freundii isolates. MLST showed that the C. freundii isolates shared the same sequence type (ST). Phylogenetic analysis revealed a strict relationship with an ST5 C. freundii isolate from a diarrhea patient in China. Conclusions Our findings showed that the active surveillance program for CPE was useful, not only for the detection of KPC-producers, but also to identify and control the spread of other MDR pathogens that could expand the spectrum of circulating MDR pathogens.
- Published
- 2013
36. Molecular epidemiology of KPC-producing Klebsiella pneumoniae from invasive infections in Italy: Increasing diversity with predominance of the ST512 clade II sublineage
- Author
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Conte, Viola, Monaco, Monica, Giani, Tommaso, D'Ancona, Fortunato, Moro, Maria Luisa, Arena, Fabio, D'Andrea, Marco Maria, Rossolini, Gian Maria, Pantosti, Annalisa, Bianchi, E., Catania, M. R., Cavalcanti, P., De Nittis, R., Dusi, P. A., Grandesso, S., Gualdi, P., Imbriani, A., Pini, B., Vincenzi, C., Meledandri, M., Agrappi, C., Parisi, G., Pollini, S., Restelli, A., Rocchetti, A., Vailati, F., Aschbacher, R., Barbaro, A., Bona, R., Chirillo, M., Corradini, S., Cuccurullo, S., De Bernochi, A., Dodi, C., Giammanco, A., Mencacci, Antonella, Milano, F., Miragliotta, G., Mungiguerra, M., Pedna, M. F., Piana, Francesca, Porcheddu, G. M., Rossi, M. R., Santino, I., Sartor, A., Sartore, P., Conte V., Monaco M., Giani T., D'Ancona F., Moro M.L., Arena F., D'Andrea M.M., Rossolini G.M., Pantosti A., Bianchi E., Catania M.R., Cavalcanti P., De Nittis R., Dusi P.A., Grandesso S., Gualdi P., Imbriani A., Pini B., Vincenzi C., Meledandri M., Agrappi C., Parisi G., Pollini S., Restelli A., Rocchetti A., Vailati F., Aschbacher R., Barbaro A., Bona R., Chirillo M., Corradini S., Cuccurullo S., De Bernochi A., Dodi C., Giammanco A., Mencacci A., Milano F., Miragliotta G., Mungiguerra M., Pedna M.F., Piana F., Porcheddu G.M., Rossi M.R., Santino I., Sartor A., Sartore P., Conte, V, Monaco, M, Giani, T, D'Ancona, F, Moro, Ml, Arena, F, D'Andrea, Mm, Rossolini, Gm, Pantosti, A, AR-ISS Study Group on Carbapenemase-Producing K., pneumoniae: Bianchi E, Catania, Mr, Cavalcanti, P, De Nittis, R, Dusi, Pa, Grandesso, S, Gualdi, P, Imbriani, A, Pini, B, Vincenzi, C, Meledandri, Alessio, Agrappi, C, Parisi, G, Pollini, S, Restelli, Ugo, Rocchetti, Romualdo, Vailati, F, Aschbacher, R, Barbaro, A, Bona, R, Chirillo, M, Corradini, S, Cuccurullo, S, De Bernochi, A, Dodi, C, Giammanco, Anna, Mencacci, A, Milano, F, Miragliotta, Giuseppe, Mungiguerra, M, Pedna, Mf, Piana, Daniela, Porcheddu, Gm, Rossi, Mr, Santino, I, Sartor, A, and Sartore, P.
- Subjects
0301 basic medicine ,Microbiology (medical) ,gel ,Klebsiella pneumoniae ,genotype ,030106 microbiology ,Population ,cross-sectional studies ,pulsed-field ,multilocus sequence typing ,electrophoresis, gel, pulsed-field ,humans ,italy ,klebsiella infections ,klebsiella pneumoniae ,molecular epidemiology ,serogroup ,beta-lactamases ,genetic variation ,Settore BIO/19 - Microbiologia Generale ,Cross-Sectional Studies ,Electrophoresis, Gel, Pulsed-Field ,Humans ,Italy ,Klebsiella Infections ,Molecular Epidemiology ,Multilocus Sequence Typing ,Serogroup ,beta-Lactamases ,Genetic Variation ,Genotype ,Pharmacology ,Pharmacology (medical) ,Infectious Diseases ,law.invention ,Microbiology ,beta-Lactamase ,03 medical and health sciences ,law ,Pulsed-field gel electrophoresis ,Typing ,education ,Polymerase chain reaction ,Cross-Sectional Studie ,education.field_of_study ,biology ,Molecular epidemiology ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,Settore MED/07 - Microbiologia e Microbiologia Clinica ,bacterial infections and mycoses ,Virology ,electrophoresis ,Multilocus sequence typing ,Human ,Klebsiella Infection - Abstract
Objectives The spread of carbapenem-resistant Enterobacteriaceae (CRE) represents one of the most worrisome problems for clinical medicine worldwide. In Italy, the Antibiotic-Resistance-Istituto Superiore di Sanita surveillance network, in collaboration with the Committee for Antimicrobial Agents of the Italian Society of Clinical Microbiologists, promoted a study to investigate the carbapenem-resistance mechanisms, clonal relatedness and capsular typing of a recent collection of carbapenem-resistant Klebsiella pneumoniae (CR-KP). Methods A total of 17 laboratories distributed across Italy collected all consecutive non-replicate CR-KP isolated from invasive infections during two different study periods (2011-12 and 2013). Carbapenemase genes were searched for by filter hybridization and confirmed by PCR and sequencing. KPC-producing K. pneumoniae (KPC-KP) were typed by PFGE and MLST. Capsular types were identified by wzi gene typing. Results Of the collected K. pneumoniae isolates (n = 461), the overall proportion of CR-KP was 36.2% (n = 167). The majority (97%) of the CR-KP were positive for the blaKPC gene. Among the KPC-KP population, nine different STs were detected with the majority of isolates (94%) belonging to the clonal group (CG) 258. A subpopulation that belonged to ST512 and showed an identical PFGE profile represented the majority (57%) of KPC-KP strains, with a countrywide distribution. Capsular characterization showed the predominance of the wzi154, cps-2 capsular type (88.8% of all CG258 strains). ST258 strains were associated with both cps-1 and cps-2 capsular types, while ST512 was associated with cps-2 only. Conclusions Although a trend to a polyclonal evolution of the Italian KPC-KP was noted, this study showed that the KPC-KP population remained largely oligoclonal with the wide diffusion of an ST512 lineage carrying cps-2 capsular type and producing the KPC-3 enzyme.
- Published
- 2016
37. Le infezioni in odontostomatologia
- Author
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LAURITANO, DORINA, CARINI, FABRIZIO, MADDALONE, MARCELLO, BALDONI, MARCO GIOVANNI, Rondanelli, EG, Moro, ML, Grossi, P, Marone, P, Lauritano, D, Carini, F, Maddalone, M, and Baldoni, M
- Subjects
MED/28 - MALATTIE ODONTOSTOMATOLOGICHE ,DENTISTRY, INFECTIONS, MICROBIOLOGY - Published
- 2010
38. Use of Azithromycin Attributable to Acute SARS-CoV-2 Infection.
- Author
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Gagliotti C, Banchelli F, Buttazzi R, Ricchizzi E, Canziani LM, Rolli M, Tacconelli E, Moro ML, and Berti E
- Subjects
- Humans, Retrospective Studies, Female, Male, Middle Aged, Italy epidemiology, Aged, Adult, SARS-CoV-2, Young Adult, Aged, 80 and over, Adolescent, Acute Disease, Practice Patterns, Physicians' statistics & numerical data, Cohort Studies, Azithromycin therapeutic use, Anti-Bacterial Agents therapeutic use, COVID-19 Drug Treatment, COVID-19 epidemiology
- Abstract
Purpose: In the early stages of the COVID-19 pandemic, preliminary results that later proved to be incorrect suggested the possible efficacy of anti-infective drugs such as azithromycin for the treatment of SARS-CoV-2 infection. These preliminary data may have influenced the prescription of azithromycin. However, no individual-level data linking the use of this antibiotic to acute SARS-CoV-2 infection are available. The present analysis aims to fill this gap., Methods: A retrospective population-based cohort design was used including patients diagnosed with SARS-CoV-2 infection in the period ranging from February 2020 to February 2022. The data source for antibiotic consumption was the drug database of outpatient prescriptions of Emilia-Romagna Region (Italy). Antibiotics were classified according to the Anatomical Therapeutic Chemical (ATC) classification system. Consumption rates and percentages of azithromycin DDDs (defined daily doses) during the acute phase of the infection were compared with a previous control period and with the post-acute phase. Analyses were stratified by four groups according to the prevalent virus variant at time of diagnosis., Results: Comparing the previous control period with the acute phase of infections, the rates of azithromycin consumption (DDD per 1000 individuals per day) increased from 1.17 to 23.11, from 0.80 to 33.03, from 0.81 to 21.01, and from 1.02 to 9.76, in the pre-Alpha, Alpha, Delta, and Omicron periods, respectively. Similarly, the percentages of individuals receiving azithromycin, and the azithromycin DDDs percentages over total systemic antibiotics DDDs increased in acute phases of infection compared with control periods. The consumption rates and percentages returned to preinfection levels in the post-acute phase. In the study period, 12.9% of the use of azithromycin in the entire adult population of Emilia-Romagna was attributable to acute SARS-CoV-2 infection., Conclusions: Considering the low likelihood of bacterial coinfections, the increased azithromycin consumption in the acute phase of SARS-CoV-2 infection suggests inappropriate prescribing of this antibiotic., (© 2024 The Author(s). Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.)
- Published
- 2024
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39. Maternal Vitamin D Deficiency Impairs the Development of β Cells in Offspring Rats in a Sex-Dependent Manner.
- Author
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Schavinski AZ, Reis NG, Morgan HJN, Assis AP, Moro ML, Valentim RR, Seni-Silva AC, Ramos ES, Kettelhut IC, and Navegantes LCC
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- Animals, Female, Male, Rats, Pregnancy, Prenatal Exposure Delayed Effects metabolism, Prenatal Exposure Delayed Effects etiology, Sex Factors, Insulin Secretion, Insulin-Secreting Cells metabolism, Vitamin D Deficiency metabolism, Rats, Wistar, Insulin blood, Insulin metabolism
- Abstract
Recent studies have shown that maternal vitamin D deficiency (VDD) causes long-term metabolic changes in offspring. However, little is known about the impact of maternal VDD on offspring endocrine pancreas development and insulin secretion in the adult life of male and female animals. Female rats (Wistar Hannover) were fed either control (1000 IU Vitamin D3/kg), VDD (0 IU Vitamin D3/kg), or a Ca
2+ -enriched VDD diet (0 IU Vitamin D3/kg + Ca2+ and P/kg) for 6 weeks and during gestation and lactation. At weaning, VDD status was confirmed based on low serum calcidiol levels in dams and pups. Next, male and female offspring were randomly separated and fed a standard diet for up to 90 days. At this age, serum calcidiol levels were restored to normal levels in all groups, but serum insulin levels were decreased in VDD males without affecting glucagon levels, glycemia, or glucose tolerance. Islets isolated from VDD males showed lower insulin secretion in response to different glucose concentrations, but this effect was not observed in VDD females. Furthermore, VDD males, but not females, showed a smaller total pancreatic islet area and lower β cell mass, an effect that was accompanied by reduced gene expression of Ins1 , Ins2 , Pdx1 , and SLC2A2 . The decrease in Pdx1 expression was not related to the methylation profile of the promoter region of this gene. Most of these effects were observed in the male VDD+Ca2+ group, indicating that the effects were not due to alterations in Ca2+ metabolism. These data show that maternal VDD selectively impairs the morphology and function of β cells in adult male offspring rats and that female offspring are fully protected from these deleterious effects.- Published
- 2024
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40. Mortality and healthcare assessment among patients with chronic disease over 2 years of COVID-19: a population-based study in a large hard-hit Italian region.
- Author
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Fortuna D, Caselli L, Berti E, and Moro ML
- Subjects
- Adult, Humans, Retrospective Studies, Communicable Disease Control, Inpatients, Health Priorities, Chronic Disease, Italy epidemiology, Mortality, COVID-19 epidemiology
- Abstract
Objectives: We aimed to provide a region-wide comprehensive account of the indirect effects of COVID-19 on patients with chronic disease, in terms of non-COVID-19 mortality, and access to both inpatient and outpatient health services over a 2-year pandemic period., Design: Population-based retrospective study., Setting: Adult patients, affected by at least 1 of 32 prevalent chronic conditions, residing in the Emilia-Romagna Region in Italy, during the years 2020 (N=1 791 189, 47.7% of the overall adult regional population) and 2021 (N=1 801 071, 47.8%)., Results: Overall, non-COVID-19 mortality among patients with chronic disease during the pandemic (2.7%) did not differ substantially from the expected mortality (2.5%), based on a 3 years prepandemic period (2017-2019) and adjusting for the demographic and clinical characteristics of the population under study. Indeed, while the first pandemic wave was characterised by a significant non-COVID-19 excess mortality (March: +35%), the subsequent phases did not show such disruptive variations in non-COVID-19 deaths, which remained around or even below the excess mortality threshold. End-of-life care of patients with chronic disease, especially for non-COVID-19 cases, significantly shifted from hospitalisations (-19%), to homecare (ADI: +7%; w/o ADI: +9%). Overall, healthcare of patients without COVID-19 chronic disease decreased, with similar negative trends in hospitalisations (-15.5%), major procedures (-19.6%) and ER accesses (-23.7%). Homecare was the least affected by the pandemic, with an overall reduction of -9.8%. COVID-19 outbreak also impacted on different types of outpatient care. Rehabilitation therapies, specialist visits, diagnostic and lab tests were considerably reduced during the first pandemic wave and consequent lockdown, with access rates of patients without COVID-19 chronic disease below -60%., Conclusions: This work thoroughly describes how a large and well-defined population of patients without COVID-19 chronic disease has been affected by the changes and reorganisation in the healthcare system during 2 years of the pandemic, highlighting health priorities and challenges in chronic disease management under conditions of limited resources., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2023
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41. Direct impact of 2 years of COVID-19 on chronic disease patients: a population-based study in a large hard-hit Italian region.
- Author
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Fortuna D, Caselli L, Berti E, and Moro ML
- Subjects
- Adult, Humans, Male, Aged, Retrospective Studies, SARS-CoV-2, Italy epidemiology, Chronic Disease, COVID-19 epidemiology
- Abstract
Objectives: We aimed to provide a region-wide comprehensive account of the direct effects of COVID-19 on chronic disease patients, in terms of disease incidence, severity and mortality, over a 2-year pandemic period (2020-2021)., Design: Population-based retrospective study., Setting/participants: Adult patients, affected by at least 1 of 32 prevalent chronic conditions, residing in the Emilia-Romagna Region in Italy, during the years 2020 (N=1 791 189, 47.7% of the overall adult regional population) and 2021 (N=1 801 071, 47.8%)., Results: COVID-19 incidence among chronic disease patients was 4.1% (74 067 cases) in 2020 and 7.3% (126 556 cases) in 2021, varying across pathologies, with obesity and dementia showing the highest incidence. Hospitalisation rate for pneumonia or acute respiratory distress syndrome among SARS-CoV-2-positive patients was 15.4%. COVID-19-related excess mortality, that is, deaths from COVID-19 as either main or contributing (1.5% of the total) cause of death, was observed during the three pandemic waves, with observed/expected death ratios ranging from +38% (March 2020) to +11% (December 2021). Increased risks of both COVID-19-related hospitalisation and death were associated with male gender, elderly age and many pre-existing pathologies, including cardiovascular, cerebrovascular and respiratory diseases, neurological and psychiatric disorders, and metabolic dysfunctions. The higher the number of concomitant pathologies, the greater the risk of COVID-19-related adverse outcomes: the likelihood of hospitalisation and death more than doubled for people with more than two comorbidities, compared with those with one underlying condition., Conclusions: This study presents a thorough and up-to-date quantification of the direct impact of COVID-19 on chronic disease patients. The results obtained are particularly relevant considering that people with pre-existing chronic conditions accounted for almost all cases of COVID-19-related hospitalisation (82.6%) and death (91.5%) in a vast region of Italy, among the hardest hit by the pandemic., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2023
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42. The incidence and risk factors of selected drug prescriptions and outpatient care after SARS-CoV-2 infection in low-risk subjects: a multicenter population-based cohort study.
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Gagliotti C, Banchelli F, De Paoli A, Buttazzi R, Narne E, Ricchizzi E, Schievano E, Bellio S, Pitter G, Tonon M, Canziani LM, Rolli M, Tacconelli E, Berti E, Russo F, and Moro ML
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- Humans, Female, Aged, Adult, Male, SARS-CoV-2, Incidence, Cohort Studies, Retrospective Studies, Risk Factors, Ambulatory Care, Multicenter Studies as Topic, COVID-19 epidemiology
- Abstract
Background: Knowledge about the dynamics of transmission of SARS-CoV-2 and the clinical aspects of COVID-19 has steadily increased over time, although evidence of the determinants of disease severity and duration is still limited and mainly focused on older adult and fragile populations., Methods: The present study was conceived and carried out in the Emilia-Romagna (E-R) and Veneto Regions, Italy, within the context of the EU's Horizon 2020 research project called ORCHESTRA (Connecting European Cohorts to increase common and effective response to SARS-CoV-2 pandemic) (www.orchestra-cohort.eu). The study has a multicenter retrospective population-based cohort design and aimed to investigate the incidence and risk factors of access to specific healthcare services (outpatient visits and diagnostics, drug prescriptions) during the post-acute phase from day-31 to day-365 after SARS-CoV-2 infection, in a healthy population at low risk of severe acute COVID-19. The study made use of previously recorded large-scale healthcare data available in the administrative databases of the two Italian Regions. The statistical analysis made use of methods for competing risks. Risk factors were assessed separately in the two Regions and results were pooled using random effects meta-analysis., Results: There were 35,128 subjects in E-R and 88,881 in Veneto who were included in the data analysis. The outcome (access to selected health services) occurred in a high percentage of subjects in the post-acute phase (25% in E-R and 21% in Veneto). Outpatient care was observed more frequently than drug prescriptions (18% vs. 12% in E-R and 15% vs. 10% in Veneto). Risk factors associated with the outcome were female sex, age greater than 40 years, baseline risk of hospitalization and death, moderate to severe acute COVID-19, and acute extrapulmonary complications., Conclusion: The outcome of interest may be considered as a proxy for long-term effects of COVID-19 needing clinical attention. Our data suggest that this outcome occurs in a substantial percentage of cases, even among a previously healthy population with low or mild severity of acute COVID-19. The study results provide useful insights into planning COVID-19-related services., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gagliotti, Banchelli, De Paoli, Buttazzi, Narne, Ricchizzi, Schievano, Bellio, Pitter, Tonon, Canziani, Rolli, Tacconelli, Berti, Russo and Moro.)
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- 2023
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43. Implementation Strategies for Preventing Healthcare-Associated Infections across the Surgical Pathway: An Italian Multisociety Document.
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Sartelli M, Bartoli S, Borghi F, Busani S, Carsetti A, Catena F, Cillara N, Coccolini F, Cortegiani A, Cortese F, Fabbri E, Foghetti D, Forfori F, Giarratano A, Labricciosa FM, Marini P, Mastroianni C, Pan A, Pasero D, Scatizzi M, Viaggi B, and Moro ML
- Abstract
Healthcare-associated infections (HAIs) result in significant patient morbidity and can prolong the duration of the hospital stay, causing high supplementary costs in addition to those already sustained due to the patient's underlying disease. Moreover, bacteria are becoming increasingly resistant to antibiotics, making HAI prevention even more important nowadays. The public health consequences of antimicrobial resistance should be constrained by prevention and control actions, which must be a priority for all health systems of the world at all levels of care. As many HAIs are preventable, they may be considered an important indicator of the quality of patient care and represent an important patient safety issue in healthcare. To share implementation strategies for preventing HAIs in the surgical setting and in all healthcare facilities, an Italian multi-society document was published online in November 2022. This article represents an evidence-based summary of the document.
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- 2023
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44. Increasing Number of Cases Due to Candida auris in North Italy, July 2019-December 2022.
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Sticchi C, Raso R, Ferrara L, Vecchi E, Ferrero L, Filippi D, Finotto G, Frassinelli E, Silvestre C, Zozzoli S, Ambretti S, Diegoli G, Gagliotti C, Moro ML, Ricchizzi E, Tumietto F, Russo F, Tonon M, Maraglino F, Rezza G, and Sabbatucci M
- Abstract
Candida auris is an emerging fungus that represents a serious health threat globally. In Italy, the first case was detected in July 2019. Then, one case was reported to the Ministry of Health (MoH) on January 2020. Nine months later, a huge number of cases were reported in northern Italy. Overall, 361 cases were detected in 17 healthcare facilities between July 2019 and December 2022 in the Liguria, Piedmont, Emilia-Romagna, and Veneto regions, including 146 (40.4%) deaths. The majority of cases (91.8%) were considered as colonised. Only one had a history of travel abroad. Microbiological data on seven isolates showed that all but one strain (85.7%) were resistant to fluconazole. All the environmental samples tested negative. Weekly screening of contacts was performed by the healthcare facilities. Infection prevention and control (IPC) measures were applied locally. The MoH nominated a National Reference Laboratory to characterise C. auris isolates and store the strains. In 2021, Italy posted two messages through the Epidemic Intelligence Information System (EPIS) to inform on the cases. On February 2022, a rapid risk assessment indicated a high risk for further spread within Italy, but a low risk of spread to other countries.
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- 2023
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45. Effectiveness of community hospital post-acute care on mortality, re-admission, institutionalization, and activation of a home care programme in Emilia-Romagna region, Italy.
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Di Girolamo C, Leucci AC, Sforza S, Moro ML, and Berti E
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- Humans, Cohort Studies, Subacute Care, Institutionalization, Italy epidemiology, Hospitals, Community, Home Care Services
- Abstract
Background: In Italy, there is scant evidence on the impact of Community Hospitals (CHs) on clinical outcomes., Aims: To assess the effectiveness of CHs versus long-term care hospital or inpatient rehabilitation facilities on mortality, re-admission, institutionalization, and activation of a home care programme in the Emilia-Romagna Region (ERR-Italy) after acute hospitalisation., Methods: We implemented a cohort study drawing upon the ERR Administrative Healthcare Database System and including hospital episodes of ERR residents subject ≥ 65 years, discharged from a public or private hospital with a medical diagnosis to a CH or to usual care between 2017 and 2019. To control for confounding, we applied a propensity score matching., Results: Patients transferred to CHs had a significantly lower risk of dying but an increased risk of being readmitted to community or acute hospital within 30/90 days from discharge. The hazard of institutionalisation within 30/90 days was significantly lower in the whole population of the CH exposed group but not among patients with cardiac or respiratory chronic diseases or diabetes. The activation of a home care program within 90 days was slightly higher for those who were transferred to a CH., Discussion: The findings of our study show mixed effects on outcomes of patients transferred to CHs compared to those who followed the post-acute usual care and should be taken with cautious as could be affected by the so-called 'confounding by indication'., Conclusions: The study contributes to the intermediate care available evidence from a region with a well-established care provision through CHs., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
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- 2023
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46. How Many Cancer Patients Need Palliative Care? A Population-Based Study.
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Fortuna D, Caselli L, Banchelli F, Moro ML, and Costantini M
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- Humans, Palliative Care, Retrospective Studies, Hospice and Palliative Care Nursing, Neoplasms epidemiology, Neoplasms therapy, Terminal Care
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Background: The number of cancer patients potentially amenable to palliative care is conventionally estimated from cancer deaths, as reported in the death certificates. However, a more representative population should also include cancer patients who die from causes other than cancer, as they may develop other life-limiting chronic conditions leading to terminal prognosis., Aim: This study aimed at refining the assessment of the number of cancer patients potentially in need of palliative care, by linked hospital and death data., Design: Retrospective study., Setting/participants: Residents in the Emilia Romagna Region in Italy, who died between 2009 and 2017., Results: We identified a potential palliative care population of 157,547 cancer patients. The use of different administrative data sources enhanced the sensitivity of our selection. Starting from a standard estimate of 129,212 patients based on cancer as the primary cause of death, we showed that the additional use of hospital records identified a further 11.4% of possible palliative care patients 14,687. Also considering cancer as secondary cause of death, the estimate further increased by 10.6% (13,648 new cases). Notably, the proportion of cancer patients selected by the additional data sources were characterized by more advanced age and higher prevalence of comorbidity., Conclusion: Healthcare services addressing the issue of estimating palliative care needs of cancer patients at a population level should consider that relying on the death certificate alone may lead to underestimating these needs of about 22%., (Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)
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- 2022
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47. SPiNCAR: A systematic model to evaluate and guide actions for tackling AMR.
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Bravo G, Cattani G, Malacarne F, Tricarico P, Arnoldo L, Brunelli L, Zotti C, Moro ML, Diegoli G, Pezzotti P, Bella A, Pantosti A, Punzo O, Grossi A, Barchitta M, Agodi A, Castellini G, Marrazzo M, Auxilia F, Cavallaro G, Alborali GL, Mazzolini E, and Brusaferro S
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- Delivery of Health Care, Humans, Italy, Pilot Projects, Anti-Infective Agents, Cross Infection prevention & control
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Background: Italy records very alarming levels antimicrobial resistance (AMR), so a National Action Plan on Antimicrobial resistance (PNCAR) was developed, adopting the AMR European Union's recommendations based on the results of the ECDC site visit of January 2017. For achieving PNCAR objectives, it is necessary to support and harmonize the implementation of recommendations in all the different healthcare levels (regional authorities and local trusts), so the SPiNCAR project was launched to create a tool for reaching this goal., Methods: We developed a framework based on a scientific literature and national and international guidelines. Firstly, we identified the major intervention areas for tackling AMR, then, for each area, we built a set of standards, both for regional authorities than for local trusts. Every standard is composed by a set of essential and additional criteria, which refer to a minimum or supplemental performance level respectively. The contents were firstly discussed by the project's team during face-to-face kick-off meetings, then confirmed with Delphi methodology and finally validated through a pilot study., Results: The final framework consists of seven different areas that reflect the PNCAR structure: Governance, Surveillance and Monitoring, Appropriate Use of antimicrobials, Healthcare-associated Infections (HAIs) control and prevention, Education and Training, Alliance among Stakeholders, Implementation. The total number of standards for the regional framework was 34 with 264 criteria and for the local version 36 criteria with 279 standards., Conclusion: The ongoing use of this tool, developed on international evidences and recommendations that were tailored on the Italian specific context, allows monitoring the improvement achieved over time and plan the next steps., Competing Interests: The authors have declared that no competing interests exist.
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- 2022
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48. General and COVID-19-Related Mortality by Pre-Existing Chronic Conditions and Care Setting during 2020 in Emilia-Romagna Region, Italy.
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Caranci N, Di Girolamo C, Bartolini L, Fortuna D, Berti E, Sforza S, Giorgi Rossi P, and Moro ML
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- Cross-Sectional Studies, Female, Humans, Italy epidemiology, Male, Mortality, Pandemics, SARS-CoV-2, COVID-19
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In 2020, the number of deaths increased in Italy, mainly because of the COVID-19 pandemic; mortality was among the highest in Europe, with a clear heterogeneity among regions and socio-demographic strata. The present work aims to describe trends in mortality and to quantify excess mortality variability over time and in relation to demographics, pre-existent chronic conditions and care setting of the Emilia-Romagna region (Northern Italy). This is a registry-based cross-sectional study comparing the 2020 observed mortality with figures of the previous five years by age, sex, month, place of death, and chronicity. It includes 300,094 deaths in those 18 years of age and above resident in the Emilia-Romagna region. Excess deaths were higher during the first pandemic wave, particularly among men and in March. Age-adjusted risk was similar among both men and women (Mortality Rate Ratio 1.15; IC95% 1.14-1.16). It was higher among females aged 75+ years and varied between sub-periods. Excluding COVID-19 related deaths, differences in the risk of dying estimates tended to disappear. Metabolic and neuropsychiatric diseases were more prevalent among those that deceased in 2020 compared to the deaths that occurred in 2015-2019 and therefore can be confirmed as elements of increased frailty, such as being in long-term care facilities or private homes as the place of death. Understanding the impact of the pandemic on mortality considering frailties is relevant in a changing scenario.
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- 2021
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49. Reduction trend of mcr-1 circulation in Emilia-Romagna Region, Italy.
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Gagliotti C, Bolzoni L, Carretto E, Sarti M, Ricchizzi E, Ambretti S, Barozzi A, Bracchi C, Confalonieri M, Menozzi I, Morganti M, Pedna MF, Sambri V, Scaltriti E, Schiavo R, Soliani L, Tambassi M, Venturelli C, Biagetti C, Buttazzi R, Calderaro A, Casadio C, Meschiari M, Tumietto F, Diegoli G, Pongolini S, and Moro ML
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- Anti-Bacterial Agents pharmacology, Bacterial Proteins genetics, Drug Resistance, Bacterial, Enterobacteriaceae classification, Enterobacteriaceae drug effects, Enterobacteriaceae genetics, Enterobacteriaceae Infections epidemiology, Ethanolaminephosphotransferase genetics, Humans, Italy epidemiology, Microbial Sensitivity Tests, Phylogeny, Retrospective Studies, Bacterial Proteins metabolism, Enterobacteriaceae enzymology, Enterobacteriaceae Infections microbiology, Ethanolaminephosphotransferase metabolism
- Abstract
This study aims to describe trends of mcr-positive Enterobacterales in humans based on laboratory surveillance with a defined catchment population. The data source is the Micro-RER surveillance system, established in Emilia-Romagna region (Italy), to monitor the trend of mcr resistance. Enterobacterales isolates from human clinical samples with minimum inhibitory concentration (MIC) ≥ 2 mg/L for colistin were sent to the study reference laboratory for the detection of mcr genes. Isolates prospectively collected in the period 2018-2020 were considered for the assessment of population rates and trends; further analyses were carried out for the evaluation of clonality and horizontal mcr gene transfer. Previous isolates from local laboratory collection were also described. In the period 2018-2020, 1164 isolates were sent to the reference laboratory, and 51 (4.4%) were confirmed as mcr-positive: 50 mcr-1 (42 Escherichia coli, 6 Klebsiella pneumoniae, 2 Salmonella enterica) and 1 mcr-4 (Enterobacter cloacae). The number of mcr-positive isolates dropped from 24 in the first half of 2018 to 3 in the whole of 2020 (trend p value < 0.001). Genomic analyses showed the predominant role of the horizontal transfer of mcr genes through plasmids or dissemination of transposable elements compared to clonal dissemination of mcr-positive microorganisms. The study results demonstrate a substantial decrease in the circulation of mcr-1 plasmid genes in Emilia-Romagna Region., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2021
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50. Reducing antibiotic prescriptions in children is not associated with higher rate of complications.
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Di Mario S, Gagliotti C, Buttazzi R, Marchetti F, Dodi I, Barbieri L, and Moro ML
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- Acute Disease, Anti-Bacterial Agents therapeutic use, Child, Humans, Infant, Italy epidemiology, Prescriptions, Otitis Media drug therapy, Otitis Media epidemiology, Pharyngitis
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Acute otitis media (AOM) and sore throat are common reasons for antibiotic prescription in children. Starting from 2007, evidence-based guidelines and other multifaceted improvement activities (ProBA project) were implemented in Emilia-Romagna, a northern Italian region. Antibiotic prescription rate in the region decreased with time (37% relative reduction from 2005 to 2019). Within the ProBA project, this retrospective observational study, including all hospitals of the region, aims to assess if lower rate of antibiotic prescription was associated with an increased rate of acute mastoiditis and acute rheumatic fever (ARF). Hospital admission rates for acute mastoiditis and ARF from 2005 to 2019 were calculated using ICD-9 codes. Hospital intervention rates for myringotomy, incision of mastoid, and mastoidectomy were also assessed. A comparison with antibiotic prescription rate in the pediatric population was performed. Data were gathered using administrative databases and trends were calculated using Poisson regression. During the study period, rate of mastoiditis and similar diagnosis declined from 54.1 to 33.6 per 100.000 (β coefficient = - 0.047, p value < 0.001) and rate of surgical treatment from 134.6 to 89.6 per 100.000 (β coefficient = - 0.036, p value < 0.001), whereas rate of ARF remained stable at around 4.4-4.8 per 100.000 (β coefficient = - 0.009, p value = 0.472).Conclusion: ProBA project implementation-recommending 5 days of amoxicillin for AOM when needed and 6 days of amoxicillin when streptococcal pharyngitis is detected-was associated with a reduced antibiotic use without an increase of complications. What is Known: • Acute otitis media (AOM) and streptococcal pharyngitis are common pediatric infections and frequent cause of antibiotics prescription. • Fear of rare complications like mastoiditis and acute rheumatic fever can hinder health professionals' compliance with evidence-based guideline. What is New: • Guidelines recommending a short course of antibiotics for AOM and streptococcal pharyngitis are associated with reduced antibiotic prescriptions and no increase of complications. • Analysis based on administrative databases is useful for monitoring projects and supporting health professionals in complying with guidelines.
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- 2021
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