PubMed Health⌕ Search

Biomedical subjects

M M D'Errico

Publications and source records attributed to M M D'Errico.

At least 19 recordsLinked to original sources
PubMed2006

Surveillance for surgical site infection after hospital discharge: a surgical procedure-specific perspective.

OBJECTIVE: To estimate the rate of surgical site infection (SSI) occurring after hospital discharge, to evaluate whether limiting surveillance to inpatients underestimates the true rate of SSI, and to select surgical procedures that should be included in a postdischarge surveillance program. DESIGN: Prospective surveillance study. SETTING: A surgical ward at a university teaching hospital in Italy. PATIENTS: A total of 264 surgical patients were included in the study. RESULTS: The global SSI rate was 10.6% (28 patients); 17 (60.2%) of patients with an SSI developed the infection after hospital discharge. The overall mean length of postoperative stay (+/-SD) for patients who acquired a postdischarge SSI was 4.9+/-3.7 days, and SSI was diagnosed a mean duration (+/-SD) of 11.5+/-4.5 days after surgery. Among procedures with postdischarge SSIs, those classified by the National Nosocomial Infections Surveillance system (NNIS) as herniorrhaphy, mastectomy, other endocrine system, and other integumentary system were associated with a mean postoperative stay that was less than the mean time between the operation and the onset of SSI. Four (36%) of in-hospital SSIs occurred after procedures with an NNIS risk index of 0, and 7 (64%) occurred after procedures with an NNIS risk index of 1 or higher. Of the 17 SSIs diagnosed after discharge, 14 procedures (82%) had an NNIS risk index of 0, compared with 3 procedures (18%) with an NNIS risk index of 1 or higher. CONCLUSIONS: Our results revealed an increased risk of postdischarge SSI after some types of surgical procedures and suggest that there is an important need to change from generalized to NNIS operative category-directed postdischarge surveillance, at least for procedures locally considered to be high-risk.

Aged↗
PubMed2000

Combination studies between polycationic peptides and clinically used antibiotics against Gram-positive and Gram-negative bacteria.

The in vitro interaction between five polycationic peptides, buforin II, cecropin P1, indolicidin, magainin II, and ranalexin, and several clinically used antimicrobial agents was evaluated against several clinical isolates of Gram-positive and Gram-negative aerobic bacteria, using the microbroth dilution method. The combination studies showed synergy between ranalexin and polymyxin E, doxycycline and clarithromycin. In addition, magainin II was shown to be synergic with betalactam antibiotics.

Amino Acid Sequence↗
PubMed2000

Evaluation of a transit first-aid station providing emergency care to former Yugoslavian war victims evacuated in Ancona, Italy.

BACKGROUND: A first-aid station was implemented in Falconara Marittima airport (Ancona, Italy). It provided medical emergency care to war victims evacuated from former Yugoslavia in transit for further treatment. MATERIALS AND METHODS: A descriptive analysis of the displaced population arriving at the first-aid station was performed using three independent datasets for administrative information, of which one included medical information. The implemented resources were also evaluated. RESULTS: From August 1993 to March 1995, 2272 displaced persons were registered at the first-aid station, out of which 54.2% were accompanying family members. Among those needing medical intervention (45.8% of total), most frequent diagnoses were traumatisms and burns (59.8%), neoplasms (15.6%), and congenital malformations (13.2%). The medical care provided at the first-aid station was most often basic: a medical examination alone was performed on 77.0% of the patients, and a minor dressing on 17.3%. Median length of stay was 1 day. Patients were sent to 30 different countries and 8% were forwarded to the local regional hospital. Deployed logistical resources exceeded by far actual needs but a lack of psychological assistance was observed, mainly for children. The agencies involved did not coordinate data sharing and follow-up information. CONCLUSIONS: The medical assistance to the war victims was efficient regarding provided care and timeliness. Effectiveness of such a programme could be improved by a better coordination between partners, allowing more adequate logistics according to appropriate epidemiological information.

Adolescent↗
PubMed2000

Environmental and serological evidence for the presence of toxocariasis in the urban area of Ancona, Italy.

To evaluate the Toxocara spp. eggs environmental contamination of the soil of the urban or suburban area Ancona (Italy), 22 public playgrounds were selected and several cores of soil were taken from any selected areas. To study the Toxocara seroprevalence in the inhabitants of Ancona, blood samples were collected from selected groups of individuals. One hundred and sixty-three blood samples were tested using an enzyme linked immunosorbent assay (ELISA) technique (Lofarma Lab, Milan, Italy) for the detection of IgG-specific antibodies to T. canis excretory-secretory antigens. Toxocara spp. eggs were found in the soil samples from 14 (63.6%) playgrounds. Toxocara seroprevalence was detected in blood specimens from six (8.1%) out of 74 symptomatic individuals and from one (1.1%) out of 89 asymptomatic controls. Among symptomatic individuals, the association between Toxocara seroprevalence and eosinophilia resulted statistically significant (p = 0.029). The high environmental contamination frequency found make necessary to prompt preventive public health measures, such as control of stray animals, treatment of infected pets and hygiene education of the population.

Adolescent↗
PubMed2000

Epidemiology and microbiology of surgical wound infections.

This study included 676 surgery patients with signs and symptoms indicative of wound infections, who presented over the course of 6 years. Bacterial pathogens were isolated from 614 individuals. A single etiologic agent was identified in 271 patients, multiple agents were found in 343, and no agent was identified in 62. A high preponderance of aerobic bacteria was observed. Among the common pathogens were Staphylococcus aureus (191 patients, 28.2%), Pseudomonas aeruginosa (170 patients, 25.2%), Escherichia coli (53 patients, 7.8%), Staphylococcus epidermidis (48 patients, 7.1%), and Enterococcus faecalis (38 patients, 5.6%).

Anti-Bacterial Agents↗
PubMed1998

Routine preoperative investigation. Results of a multicenter survey in Italy. Collaborator Group.

We conducted a study to acquire information on the current behavior of a sample of Italian surgeons and anesthesiologists about prescribing, interpreting, and using routine preoperative investigations. Consultants in surgery and anesthesiology in 60 hospitals in northern, central, and southern Italy were interviewed. Prescription of these procedures by doctors were driven more by personal experience than by updated scientific knowledge. This practice often led to ineffective and inefficient clinical practice, with healthy patients undergoing useless, time-consuming, costly, and sometimes harmful procedures.

Analysis of Variance↗
PubMed1998

Epidemiology of tetanus in the Marches Region of Italy, 1992-95.

Reported is the incidence of tetanus in the Marches Region of Italy for the period 1992-95. Data were obtained from both the regional public health committee's notification forms for infectious diseases and from hospital clinical records. A total of 36 cases were examined, comprising 7 males (19.4%) and 29 females. The raw annual incidence was 6.3 per million population; the standardized incidence for females was four times greater than that for males (9.2 and 2.4 per million population annually, respectively). The patients' ages varied from 31 years to 88 years (median, 73.5 years). The incidence among subjects older than 65 years was approximately ten times greater than that among younger individuals. Chronic wounds, such as trophic lesions, represented the site of tetanus infection in 14.3% of cases whose infection entry point was identified. Treatment of the 36 cases required a total of 1239 hospital days, of which 58.7% were in intensive care and 29.6% were in infectious diseases departments. The raw annual mortality rate for the period considered was 0.7 per million population; the case-fatality ratio was 11%. The results of our study confirm the limits of the current Italian immunization programmes, which exclude a large portion of the population from antitetanus protection.

Adult↗
PubMed1997

Diphtheria: epidemiological update and review of prevention and control strategies.

The importance of anti-diphtheria immunity in adults through periodic booster doses of vaccine is now increasing after last years diphtheria outbreaks in Newly Independent States (NIS) and Algeria and a few cases found in Europe and USA. Diphtheria cases notified in Italy between 1991-1994 have been reported. In 1995 WHO outlined the need to review vaccination schedules against diphtheria in all countries where gaps occur in the immunity of adults. The main sero-epidemiological studies performed in adults and vaccination schedules against diphtheria in some industrialized countries have been examined. Actual situation and control strategies adopted by WHO in the NIS and implications for other countries have been briefly presented. Finally, guidelines for management, investigation and control of diphtheria have been reported, including CDCs recommendations.

Adolescent↗
PubMed1996

Syphilis and blood donors: comparison of two different diagnostic strategies.

In this study the validity of the methods provided for by Italian law (VDRL or RPR tests) were compared with the diagnostic strategy suggested by WHO (the use of VDRL and TPHA tests in parallel). Sensitivity, specificity and posterior probability of infection after a positive or a negative result were estimated. The application of two tests in parallel produces a statistically significant increase of sensitivity from 47% to 98% while the increase of proportion of false positives is not significant (from 15% to 16%). Probability of infection when the result is negative to the RPR is 0.07% while a negative result to the RPR and the TPHA tests has a probability to be really infected of 0.003%. The use of the two tests (RPR and TPHA) in parallel is able to give the highest degree of sensitivity, indispensable to select possible blood donors, while maintaining a good degree of specificity. The authors concluded that the use of VDRL alone does not exclude infectivity of a blood sample, and in accordance with WHO and international recommendations, the VDRL or RPR and TPHA tests should be used in parallel for syphilis screening.

Blood Donors↗
PubMed1994

Dentists and AIDS: a survey of knowledge, attitudes, and behavior in Italy.

OBJECTIVES: Italy, together with Spain, is second only to France in the total number of AIDS cases in Europe, with over 16,800 as of March 1993. The purpose of this study was to evaluate knowledge, attitudes, and behavior concerning AIDS and infection control among Italian dentists. METHODS: A questionnaire was mailed to 1,000 dentists randomly selected from the Italian Dental and Maxillo-Facial Association's register of dentists. RESULTS: Of the 715 dentists responding, 70.7 percent of dentists knew all the main risk groups able to transmit the infection and that semen is a biologic fluid potentially contaminated by HIV virus. This knowledge was greater if the number of patients per week was not higher than 55 and if the dentist had had a previous contact with an HIV-seropositive patient. Only a few (21.1%) knew all the oral manifestations of AIDS. Over 65 percent of the dentists indicated that they would treat HIV-seropositive patients (71.9%) or those with AIDS (66.8%). Dentists were more willing to care for an HIV-seropositive patient if they were involved in specialties with high blood contact, if they had a previous contact with an HIV patient, as the average number of patients per week increased, and if they did not consider saliva as a possible route of transmission of HIV. A small percentage of dentists who had the opportunity to treat patients at risk for AIDS (12.1%) or HIV seropositive (9.4%) refused to treat them. Willingness to treat was the most significant predictor of actual treatment of an infected patient. Only 24.4 percent routinely used all barrier techniques (gloves, masks, and protective eyewear). Predictors of routine use of all barrier techniques were specialties with high blood contact, considering saliva a possible route of transmission of HIV infection, average number of patients per week fewer than 40, and number of years of practice. CONCLUSIONS: Educational efforts for improving knowledge and finding and implementing ways to motivate dentists to the correct and routine use of infection control procedures are needed.

AIDS-Related Opportunistic Infections↗
PubMed1991

Dental health in a group of drug addicts in Italy.

The caries prevalence, periodontal health, and oral hygiene status were assessed in 124 drug addicts aged 18-34 yr in Mercato San Severino (Salerno), Italy. The years of drug addiction ranged from 1 to 15 yr. The majority used heroin (96%) but all the subjects indicated that they had used more than one drug. The percentage of drug addicts caries free was 6.5%, ranging from no caries free subjects in the group over 29 yr of age, to 11.4% in the group aged 26-29 yr old. Mean DMFT and DMFS scores for all age groups were 12.9 and 36.2, respectively; mean Periodontal Index (PI) and mean Simplified Oral Hygiene Index (OHI-S) scores were 1.37 and 1.71, respectively. The poor dental health in this target group indicates the need for more extensive collaboration between the social and dental health care sectors.

Adolescent↗
PubMed1988

Use of colistin and sorbitol for better isolation of Serratia marcescens in clinical samples.

A comparison was made of different culture media and procedures for detection of Serratia marcescens from faecal, pharyngeal and ocular swabs collected from 213 neonates. MacConkey agar and MacConkey agar with sorbitol (1%) and/or colistin (200 i.u./ml) were used both for primary isolation and after enrichment using Mossel Enterobacteriaceae broth with colistin (200 i.u./ml). The use of MacConkey agar supplemented with colistin for primary isolation improved considerably the isolation rate of S. marcescens from faecal swabs but not from pharyngeal swabs; the number of ocular isolations were insufficient to demonstrate differences between procedures. Moreover the enrichment procedures consistently increased the number of S. marcescens isolates especially from pharyngeal and ocular swabs. Use of sorbitol made detection of S. marcescens from clinical specimens easier and time- and cost-efficient.

Colistin↗
PubMed1988

[Comparison of anti-influenza vaccines: whole adsorbed trivalent, trivalent subunit and tetravalent subunit].

Two different sub-unit polyvalent vaccines have been compared with the trivalent whole virus adsorbed vaccine, in two different groups of people, including both sexes, aging between 20 and 60 yrs. and between 65 and 85 yrs. respectively. Our findings show that all the three vaccines induced high seroconversion rates against the subtypes A/Mississippi/1/85 and A/Chile/1/83. As to the strain B/Ann Arbor/1/86 the sub-unit vaccine induced significantly higher seroconversion rates then the whole virus vaccine; the geometric mean titer has been higher in the groups given the vaccine than in the remaining group; in the latter group the GMTs of antibody against the A strains were consistently above the protective level, whereas the GMT of antibody against the B strain was fairly low. The authors consider useless including into the vaccine the strains A/Mississippi/1/85 and A/Chile/1/83, whereas it seems to be essential the incorporation of the strains A/Singapore/1/86 like and B/Ann Arbor/1/86. Moreover it turns out that the sub-unit vaccines, because of their better effectiveness, should substitute the whole virus adsorbed vaccine.

Adult↗
PubMedDate not supplied

[Evaluation of microbial air contamination in dental areas].

The Authors carried out a survey in dental wards in order to evaluate the qualitative and quantitative microbial contamination level of the air, which is considered a crucial habitat for the transmission of many infectious diseases. A high microbial counts were found in all of the environments tested; the microorganisms isolated belonged to pathogenous species such as Staphylococcus aureus, Staphylococcus haemoliticus, Pseudomonas aeruginosa, Acinetobacter calcoaceticus var. lwoffi. It seems necessary, therefore, to carry out preventive interventions directed to the protection of the personnel of dental care and, in particular, of the patients.

Acinetobacter↗
PubMedDate not supplied

[Evaluation of the effectiveness of disinfectants used in several Neapolitan hospitals].

Among the various and complex aspects concerning the etiology of nosocomial infections, a relevant role is played by the indiscriminate and incorrect use of disinfectants: they may change paradoxically from devices used for nosocomial infection prevention into carriers of infections. Critical situations are: a) inadequate cleaning of the container; b) inaccurate concentrations set up; c) use of unsterilized water as a diluent; d) introduction of gauze or cotton flocks into the container; e) disinfectant contact with inactivating substances such as soaps, detergents, and organic substances; f) solution stability; etc.. Therefore, in the light of the experience we acquired in the field of nosocomial infections, we believed interesting to carry out a study in order to detect contamination of disinfectants used in various hospitals in Naples as well as their usage. In the period from January to May 1988, 243 disinfecting solutions routinely used in surgical departments of the 2nd School of Medicine and of three large neapolitan hospitals were tested for microbiological contamination. The analysis was carried out according to Kelsey and Maurer. 13 disinfectants were contaminated. The bacterial count exceeded the value of 5000 col/ml in 6 cases, while for he other disinfectants there were levels between 2500 and 4500 col/ml. 64% of the microorganisms isolated belonged to Pseudomonas spp. (cepacia, aeruginosa, fluorescens, maltophilia), while Acinetobacter calcoaceticus and Staphylococcus epidermidis were found in 21% and 15% of specimens respectively. A major consideration arising out from our study is the little attention played to health problems related to disinfection by hospital staff, together with a lack of knowledge about the proper way of using disinfectants.(ABSTRACT TRUNCATED AT 250 WORDS)

Disinfectants↗