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Article ; Online: Safety of probiotics used for hospital environmental sanitation.

Caselli, E / Antonioli, P / Mazzacane, S

2016 Volume 94, Issue 2, Page(s) 193–194

MeSH term(s)	Bacillus/pathogenicity ; Bacterial Infections/microbiology ; Environmental Microbiology ; Hospitals ; Humans ; Infection Control/methods ; Patient Safety ; Probiotics/adverse effects ; Sanitation/methods ; Surface Properties
Language	English
Publishing date	2016-10
Publishing country	England
Document type	Letter
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2016.06.021
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Article ; Online: SARS-CoV-2 RNA contamination on surfaces of a COVID-19 ward in a hospital of Northern Italy: what risk of transmission?

D'accolti, M / Soffritti, I / Passaro, A / Zuliani, G / Antonioli, P / Mazzacane, S / Manfredini, R / Caselli, E

European review for medical and pharmacological sciences

2020 Volume 24, Issue 17, Page(s) 9202–9207

Abstract: Objective: SARS-CoV-2 can reportedly exist on inanimate surfaces for a long duration, but there is limited data available from Italian COVID-19 hospital wards, especially for non-intensive care units hosting patients that do not require mechanical ... ...

Abstract	Objective: SARS-CoV-2 can reportedly exist on inanimate surfaces for a long duration, but there is limited data available from Italian COVID-19 hospital wards, especially for non-intensive care units hosting patients that do not require mechanical ventilation. Identification of the extent of environmental contamination can help in understanding possible virus transmission routes, limit hospital infections and protect healthcare workers. Thus, we investigated virus contamination on surfaces of the acute COVID-19 ward of an Italian hospital. Materials and methods: Ward surfaces, including four points inside and six points outside the patients' rooms were sampled by swabs, seven hours after routine sanitation. To minimize the risk of underestimation of virus detection, two different sensitive molecular methods were used comparatively, and specific internal controls were added to enhance the efficiency of all the analysis steps. Results: SARS-CoV-2 contamination was detected in only three out of all the collected samples, i.e., on two floors and one-bathroom sink, likely reflecting aerosol and saliva contamination, respectively. The overall level of contamination was low, and the floors exhibited a very low level of SARS-CoV-2 presence, evidenced by only one of the two methods used. Conclusions: The existence of SARS-CoV-2 on hospital surfaces may be limited, although it was reported to persist for a longer duration on surfaces under controlled laboratory conditions. Thus, effective transmission of SARS-CoV-2 by surfaces/fomites within the hospital ward may be a rare event. However, the results highlight the importance of assessing method sensitivity and including controls when investigating low-level virus contamination so as to avoid the risk of underestimation of virus presence.
MeSH term(s)	Betacoronavirus/genetics ; Betacoronavirus/isolation & purification ; COVID-19 ; Coronavirus Infections/prevention & control ; Coronavirus Infections/virology ; Disinfection ; Environmental Microbiology ; Equipment Contamination ; Hospitals ; Humans ; Italy ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/virology ; RNA, Viral/analysis ; RNA, Viral/metabolism ; Real-Time Polymerase Chain Reaction ; Risk ; SARS-CoV-2
Chemical Substances	RNA, Viral
Keywords	covid19
Language	English
Publishing date	2020-09-23
Publishing country	Italy
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605550-3
ISSN	2284-0729 ; 1128-3602 ; 0392-291X
ISSN (online)	2284-0729
ISSN	1128-3602 ; 0392-291X
DOI	10.26355/eurrev_202009_22872
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Article ; Online: Potential Use of a Combined Bacteriophage-Probiotic Sanitation System to Control Microbial Contamination and AMR in Healthcare Settings: A Pre-Post Intervention Study.

D'Accolti, Maria / Soffritti, Irene / Bini, Francesca / Mazziga, Eleonora / Arnoldo, Luca / Volta, Antonella / Bisi, Matteo / Antonioli, Paola / Laurenti, Patrizia / Ricciardi, Walter / Vincenti, Sara / Mazzacane, Sante / Caselli, Elisabetta

International journal of molecular sciences

2023 Volume 24, Issue 7

Abstract: Microbial contamination in the hospital environment is a major concern for public health, since it significantly contributes to the onset of healthcare-associated infections (HAIs), which are further complicated by the alarming level of antimicrobial ... ...

Abstract	Microbial contamination in the hospital environment is a major concern for public health, since it significantly contributes to the onset of healthcare-associated infections (HAIs), which are further complicated by the alarming level of antimicrobial resistance (AMR) of HAI-associated pathogens. Chemical disinfection to control bioburden has a temporary effect and can favor the selection of resistant pathogens, as observed during the COVID-19 pandemic. Instead, probiotic-based sanitation (probiotic cleaning hygiene system, PCHS) was reported to stably abate pathogens, AMR, and HAIs. PCHS action is not rapid nor specific, being based on competitive exclusion, but the addition of lytic bacteriophages that quickly and specifically kill selected bacteria was shown to improve PCHS effectiveness. This study aimed to investigate the effect of such combined probiotic-phage sanitation (PCHSφ) in two Italian hospitals, targeting staphylococcal contamination. The results showed that PCHSφ could provide a significantly higher removal of staphylococci, including resistant strains, compared with disinfectants (-76%,
MeSH term(s)	Humans ; Sanitation/methods ; Bacteriophages ; Chlorine ; Pandemics ; COVID-19 ; Cross Infection/prevention & control ; Cross Infection/microbiology ; Staphylococcus ; Delivery of Health Care ; Probiotics/therapeutic use
Chemical Substances	Chlorine (4R7X1O2820)
Language	English
Publishing date	2023-03-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24076535
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Article ; Online: Hospital discharge in patients at risk of surgical site infection: antimicrobial stewardship at Ferrara University Hospital, Italy.

Antonioli, P / Formaglio, A / Gamberoni, D / Bertoni, L / Perrone, P / Stefanati, A / Libanore, M / Cultrera, R / Gabutti, G

Journal of preventive medicine and hygiene

2018 Volume 59, Issue 2, Page(s) E139–E144

Abstract: Introduction: The appropriate use of antibiotics is a global priority in order to avoid antibiotic resistance. Up to 50% of antibiotics usage in hospital is inappropriate (e.g. prolonged surgical prophylaxis, "defensive medicine" approach). In 2015, at ... ...

Abstract	Introduction: The appropriate use of antibiotics is a global priority in order to avoid antibiotic resistance. Up to 50% of antibiotics usage in hospital is inappropriate (e.g. prolonged surgical prophylaxis, "defensive medicine" approach). In 2015, at the Ferrara University Hospital, an antimicrobial stewardship intervention to reduce antimicrobial prescription at the time of hospital discharge in patients at risk of surgical site infection was implemented. This programme included: update meetings for health professionals, focused meetings for critical wards, reviews of some surgical prophylaxis protocols, recommendations to reduce broad-spectrum antimicrobials use, and planning of an audit. The purpose of this study has been to evaluate the effect of this antimicrobial stewardship programme. Methods: To evaluate the effect of this intervention, a study has been carried out including inpatients in surveillance for surgical site infection who had surgery during the last quarter of 2014 (pre-intervention group; 461 patients) and of 2015 (post-intervention group; 532 patients). Results: The proportion of patients with prescription of at least one antimicrobial at discharge decreased from 33% to 24.4% (p = 0.002). The most prescribed categories of antimicrobials in both groups were the combination of penicillins with beta-lactamase inhibitors (with prescription rate reduced from 21.9% to 18%; p = 0.13) and fluoroquinolones (from 8.2% to 3.2%; p < 0.001). Conclusions: This statistically significant reduction in antimicrobial prescription after the intervention was registered without a change in surgical site infections rate (from 3.5% to 3.2%; p = 0.08). Therefore, this intervention was effective in reducing the antimicrobial prescription at discharge, without affecting patients' safety.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/administration & dosage ; Antimicrobial Stewardship ; Drug Resistance, Microbial ; Female ; Hospitals, University ; Humans ; Italy ; Male ; Middle Aged ; Patient Discharge ; Population Surveillance ; Registries ; Surgical Wound Infection/prevention & control
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2018-06-01
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1102926-2
ISSN	2421-4248 ; 1121-2233
ISSN (online)	2421-4248
ISSN	1121-2233
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Article: SARS-CoV-2 RNA contamination on surfaces of a COVID-19 ward in a hospital of Northern Italy: what risk of transmission?

D039, / accolti, M / Soffritti, I / Passaro, A / Zuliani, G / Antonioli, P / Mazzacane, S / Manfredini, R / Caselli, E

Eur Rev Med Pharmacol Sci

Abstract: OBJECTIVE: SARS-CoV-2 can reportedly exist on inanimate surfaces for a long duration, but there is limited data available from Italian COVID-19 hospital wards, especially for non-intensive care units hosting patients that do not require mechanical ... ...

Abstract	OBJECTIVE: SARS-CoV-2 can reportedly exist on inanimate surfaces for a long duration, but there is limited data available from Italian COVID-19 hospital wards, especially for non-intensive care units hosting patients that do not require mechanical ventilation. Identification of the extent of environmental contamination can help in understanding possible virus transmission routes, limit hospital infections and protect healthcare workers. Thus, we investigated virus contamination on surfaces of the acute COVID-19 ward of an Italian hospital. MATERIALS AND METHODS: Ward surfaces, including four points inside and six points outside the patients' rooms were sampled by swabs, seven hours after routine sanitation. To minimize the risk of underestimation of virus detection, two different sensitive molecular methods were used comparatively, and specific internal controls were added to enhance the efficiency of all the analysis steps. RESULTS: SARS-CoV-2 contamination was detected in only three out of all the collected samples, i.e., on two floors and one-bathroom sink, likely reflecting aerosol and saliva contamination, respectively. The overall level of contamination was low, and the floors exhibited a very low level of SARS-CoV-2 presence, evidenced by only one of the two methods used. CONCLUSIONS: The existence of SARS-CoV-2 on hospital surfaces may be limited, although it was reported to persist for a longer duration on surfaces under controlled laboratory conditions. Thus, effective transmission of SARS-CoV-2 by surfaces/fomites within the hospital ward may be a rare event. However, the results highlight the importance of assessing method sensitivity and including controls when investigating low-level virus contamination so as to avoid the risk of underestimation of virus presence.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #790183
Database	COVID19

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Article ; Online: SARS-CoV-2 RNA contamination on surfaces of a COVID-19 ward in a hospital of Northern Italy

D'Accolti, M. / Soffritti, I. / Passaro, A. / Zuliani, G. / Antonioli, P. / Mazzacane, S. / Manfredini, R. / Caselli, E.

What risk of transmission?

2020

Abstract	OBJECTIVE: SARS-CoV-2 can reportedly exist on inanimate surfaces for a long duration, but there is limited data available from Italian COVID-19 hospital wards, especially for non-intensive care units hosting patients that do not require mechanical ventilation. Identification of the extent of environmental contamination can help in understanding possible virus transmission routes, limit hospital infections and protect healthcare workers. Thus, we investigated virus contamination on surfaces of the acute COVID-19 ward of an Italian hospital. MATERIALS AND METHODS: Ward surfaces, including four points inside and six points outside the patients' rooms were sampled by swabs, seven hours after routine sanitation. To minimize the risk of underestimation of virus detection, two different sensitive molecular methods were used comparatively, and specific internal controls were added to enhance the efficiency of all the analysis steps. RESULTS: SARS-CoV-2 contamination was detected in only three out of all the collected samples, i.e., on two floors and one-bathroom sink, likely reflecting aerosol and saliva contamination, respectively. The overall level of contamination was low, and the floors exhibited a very low level of SARS-CoV-2 presence, evidenced by only one of the two methods used. CONCLUSIONS: The existence of SARS-CoV-2 on hospital surfaces may be limited, although it was reported to persist for a longer duration on surfaces under controlled laboratory conditions. Thus, effective transmission of SARS-CoV-2 by surfaces/fomites within the hospital ward may be a rare event. However, the results highlight the importance of assessing method sensitivity and including controls when investigating low-level virus contamination so as to avoid the risk of underestimation of virus presence.
Keywords	COVID -19 ; covid19
Subject code	360
Language	English
Publishing country	it
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Use of terminal filters to prevent Legionnaires' disease.

De Lorenzi, S / Salvatorelli, G / Antonioli, P M

The Journal of hospital infection

2016 Volume 92, Issue 3, Page(s) 301–302

MeSH term(s)	Bacterial Load ; Filtration/methods ; Humans ; Infection Control/methods ; Legionella pneumophila/isolation & purification ; Legionnaires' Disease/prevention & control ; Water Microbiology ; Water Purification/methods
Language	English
Publishing date	2016-03
Publishing country	England
Document type	Letter
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2015.09.015
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Article ; Online: A 2-year point-prevalence surveillance of healthcare-associated infections and antimicrobial use in Ferrara University Hospital, Italy.

Antonioli, Paola / Bolognesi, Niccolò / Valpiani, Giorgia / Morotti, Chiara / Bernardini, Daniele / Bravi, Francesca / Di Ruscio, Eugenio / Stefanati, Armando / Gabutti, Giovanni

BMC infectious diseases

2020 Volume 20, Issue 1, Page(s) 75

Abstract: Background: Healthcare-Associated Infections (HAIs) represent one of the leading issues to patient safety as well as a significant economic burden. Similarly, Antimicrobial Use (AMU) and Resistance (AMR) represent a growing threat to global public ... ...

Abstract	Background: Healthcare-Associated Infections (HAIs) represent one of the leading issues to patient safety as well as a significant economic burden. Similarly, Antimicrobial Use (AMU) and Resistance (AMR) represent a growing threat to global public health and the sustainability of healthcare services. Methods: A Point Prevalence Survey (PPS) following the 2016 ECDC protocol for HAI prevalence and AMU was conducted at Ferrara University Hospital (FUH). Data were collected by a team of trained independent surveyors in 2016 and 2018. Risk factors independently associated with HAI were assessed by a multivariate logistic regression model. Results: Of the 1102 patients surveyed, 115 (10.4%) had an active HAI and 487 (44.2%) were on at least 1 systemic antimicrobial agent. Factors independently associated with increased HAI risk were a "Rapidly Fatal" McCabe score (expected fatal outcome within 1 year), presence of medical devices (PVC, CVC, indwelling urinary catheter or mechanically assisted ventilation) and a length of hospital stay of at least 1 week. The most frequent types of HAI were pneumonia, bloodstream infections, and urinary tract infections. Antimicrobial resistance to third-generation cephalosporins was observed in about 60% of Enterobacteriaceae. Conclusions: The survey reports a high prevalence of HAI and AMU in FUH. Repeated PPSs are useful to control HAIs and AMU in large acute-care hospitals, highlighting the main problematic factors and allowing planning for improvement actions.
MeSH term(s)	Adolescent ; Adult ; Aged ; Anti-Infective Agents/therapeutic use ; Bacteremia/drug therapy ; Bacteremia/epidemiology ; Cross Infection/drug therapy ; Cross Infection/epidemiology ; Enterobacteriaceae/isolation & purification ; Female ; Hospitals, University ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Pneumonia/drug therapy ; Pneumonia/epidemiology ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Urinary Catheters/microbiology ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/epidemiology ; Young Adult
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2020-01-23
Publishing country	England
Document type	Journal Article
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-020-4791-8
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Article: Temporal trends of healthcare associated infections and antimicrobial use in 2011-2013, observed with annual point prevalence surveys in Ferrara University Hospital, Italy.

Antonioli, P / Manzalini, M C / Stefanati, A / Bonato, B / Verzola, A / Formaglio, A / Gabutti, G

Journal of preventive medicine and hygiene

2016 Volume 57, Issue 3, Page(s) E135–E141

Abstract: Introduction: Healthcare associated infections (HAIs) and misuse of antimicrobials (AMs) represent a growing public health problem. The Point Prevalence Surveys (PPSs) find available information to be used for specific targeted interventions and ... ...

Abstract	Introduction: Healthcare associated infections (HAIs) and misuse of antimicrobials (AMs) represent a growing public health problem. The Point Prevalence Surveys (PPSs) find available information to be used for specific targeted interventions and evaluate their effects. The objective of this study was to estimate the prevalence of HAIs and AM use, to describe types of infections, causative pathogens and to compare data collected through three PPSs in Ferrara University Hospital (FUH), repeated in 3 different years (2011-2013). The population-based sample consists of all patients admitted to every acute care and rehabilitation Department in a single day. Methods: ECDC Protocol and Form for PPS of HAI and AM use, Version 4.2, July 2011. Risk factor analysis was performed using logistic regression. Results: 1,239 patients were observed. Overall, HAI prevalence was 9.6%; prevalence was higher in Intensive Care Units; urinary tract infections were the most common HAIs in all 3 surveys; E.coli was the most common pathogen; AM use prevalence was 51.1%; AMs most frequently administered were fluoroquinolones, combinations of penicillins and third-generation cephalosporins. According to the regression model, urinary catheter (OR: 2.5) and invasive respiratory device (OR: 2.3) are significantly associated risk factors for HAIs (p < 0.05). Conclusions: PPSs are a sensitive and effective method of analysis. Yearly repetition is a useful way to maintain focus on the topic of HAIs and AM use, highlighting how changes in practices impact on the outcome of care and providing useful information to implement intervention programs targeted on specific issues.
MeSH term(s)	Anti-Infective Agents/therapeutic use ; Cross Infection/epidemiology ; Hospitals, University ; Humans ; Italy/epidemiology ; Prevalence ; Surveys and Questionnaires
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2016-12-13
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	1102926-2
ISSN	1121-2233
ISSN	1121-2233
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Article: The Italian Regulatory Guidelines for the implementation of Patient Blood Management.

Vaglio, Stefania / Gentili, Sara / Marano, Giuseppe / Pupella, Simonetta / Rafanelli, Daniela / Biancofiore, Gianni / Antonioli, Paola / Velati, Claudio / Liumbruno, Giancarlo M

Blood transfusion = Trasfusione del sangue

2017 Volume 15, Issue 4, Page(s) 325–328

MeSH term(s)	Blood Transfusion/legislation & jurisprudence ; Blood Transfusion/standards ; Female ; Guideline Adherence ; Humans ; Italy ; Male ; Practice Guidelines as Topic
Language	English
Publishing date	2017
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2135732-8
ISSN	1723-2007 ; 0041-1787
ISSN	1723-2007 ; 0041-1787
DOI	10.2450/2017.0060-17
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