Changes in the Use of Antibiotics for Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Children: A 5-Year Retrospective, Single Center Study.

Monitoring antibiotic use in the pediatric population is a challenge, especially when determining a relationship between specific pathogens, infections, and antibiotic use. We retrospectively analyzed the consumption of anti-methicillin-resistant Staphylococcus aureus (MRSA) drugs from 2017 to 2021 at Istituto Giannina Gaslini by means of defined daily dose (DDD) adopted for adults by World Health Organization. We observed a statistically significant increase in the use of daptomycin and ceftaroline, combined with a decrease in the use of vancomycin. In the same period, we observed an increase in the proportion of bloodstream infections due to MRSA with vancomycin minimally inhibitory concentration (MIC mg/L) = 1, that represented the 100% of cases in 2021. This aspect was combined with the observation that in the 59% of cases, where vancomycin plasma concentrations were evaluated, it was not possible to achieve a ratio of the 24-h area under the concentration-time curve and MIC (AUC0-24/MIC) of vancomycin ≥ 400 mg/L. This study confirms that DDD can be used in pediatrics to monitor antibiotic consumption in relationship with infections epidemiology. Moreover, it describes the presence of vancomycin MIC creep for MRSA also in pediatrics and the difficulties in obtaining effective vancomycin plasma concentrations in children.

How has the SARS-CoV-2 pandemic changed the epidemiology and management of acute bronchiolitis?

OBJECTIVE: SARS-COV-2 pandemic profoundly impacted acute bronchiolitis epidemiology worldwide, especially respiratory syncytial virus (RSV) diffusion and the burden of disease, with remarkable implications on the management of health resources. We aimed to study the epidemiology and clinical course of bronchiolitis in the past 5 years in our region and to assess the trends that occurred during and after the SARS-COV-2 pandemic. METHODS: We conducted an observational study including all children aged 0-2 years with bronchiolitis admitted to a tertiary children's hospital during the last 5 years. Demographic, clinical, and microbiological data were collected. Comparisons between patient subgroups were carried out. RESULTS: A total of 647 patients admitted for bronchiolitis were included (median age 78 days). Molecular diagnostic tests were performed in 617 patients (95.4%) with RSV detected in 51.5% of patients in prepandemic years and 74.5% in pandemic years. Through the study period, we observed a progressive increase in the number of children requiring respiratory support, RSV infections, and children with a history of prematurity. Conversely, this was not true for mechanical ventilation, duration of respiratory support, intensive care unit admission, and length of stay. CONCLUSIONS: Clinical course and epidemiology of bronchiolitis showed a significant change through the study years with a heavy impact during the 2021-2022 season. The increase in the number of patients requiring respiratory support, although not associated with an increase in mechanical ventilation, may be explained by the higher prevalence of RSV. The change in epidemiology highlights the importance of surveillance systems to monitor RSV circulation, to plan prophylactic strategies, and prepare healthcare systems.

Protection against MIS-C outweighs the risk of myocarditis after Covid-19 vaccination in children.

From March 2020 to July 2022, in Liguria region (North-West Italy) incidence of MIS-C among pediatric patients infected by SARS-CoV-2 was 38.7/100.000, which is higher than that of myocarditis after COVID-19 vaccination. In our opinion severity of MIS-C-related cardiac disease outweigh the risk of myocarditis after COVID-19 vaccine.

Residents’ perceptions of environmental certification, environmental impacts and support for the world expo 2015: the moderating effect of place attachment

PurposeBased on social exchange theory (SET) and signaling theory (ST), this study aims to evaluate how an event’s perceived environmental certification (PEC) by residents, affect their evaluations of environmental impacts and subsequent event support (ES). The moderating role of place attachment (PA) on some of these relationships is also evaluated.Design/methodology/approachUsing partial least square structural equation modeling (PLS-SEM), a theoretical model is tested on a sample of 450 residents who attended the 2015 Milan World Expo.FindingsPEC positively affects evaluations of positive environmental impacts (PEI) but negatively affects evaluations of negative environmental impacts (NEI). PEC positively affects ES while the relationship between PEC and NEI is moderated by PA.Research limitations/implicationsItems used to measure PEC, PEI and NEI are not exhaustive. SET has its own limitations in explaining residents’ ES, which the authors have attempted to attenuate by using ST.Practical implicationsUsing environmental certification as a communication tool must demonstrate to residents how it reduces negative externalities, rather than focusing only on its positive community benefits. Less well-educated residents had the lowest ES, suggesting the need to use social media to increase ES.Originality/valueThis study contributes to understandings of the perceptions of the benefits of event certification by residents, and how this affects their ES. PA moderates the relationship between PEC and NEI.

Unmasking the other face of flexible working practices: A systematic literature review

Flexible working practice (FWP) has been acclaimed as the practice of the 21st century, and it is likely to continue as humans engage with new technologies in the world of work. Studies have signaled caution in the adoption of FWP, drawing attention to its many downsides. In this paper, we undertake an approximately 11-year systematic review (2011–mid-2021) of scholarship that has examined FWPs. We focus on the downsides and unintended consequences regarding this concept. Following the rapid growth in remote working arrangements in the digital era, we map out the intellectual structure of these studies and uncover the hidden costs of FWP as well as its implication for employees, managers of technological platforms, organizations, and society. We identify the gaps in understanding these pitfalls and propose a holistic approach with health, legal, and spatial dimensions while indicating directions for future research.

Contact tracing, use of surgical masks, hand hygiene and social distancing represent a bundle of effective measures to control SARS-CoV-2 spreading among healthcare workers in a paediatric hospital.

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the causative agent of pandemic coronavirus disease 2019 (COVID 19) Protection from virus exposure in children's hospital is a pivotal aspect of SARS-COV-2 pandemic control. Healthcare workers (HCW) could play an important role in viral infection in-hospital spread. Infection control measures were thus implemented to protect fragile patients and healthcare workers.We retrospectively described a HCW infectionscase-series due to SARS-CoV-2 from February 24th to July 31stat the IRCCS Istituto Giannina Gaslini. Seven separate cases of SARS-CoV-2 infection were observed among healthcare workers, with a total of 395 contacts, and 23 (6%) secondary case. A program of contact tracing and quarantine of SARS-CoV-2 positive HCW, screening of asymptomatic HCW, use of surgical masks, hand hygiene, social distancing and use of PPE in COVID-19 cases assistance prevented the spread of the virus to patients and blocked the diffusion within the hospital.

Customers’ evaluation of mechanical artificial intelligence in hospitality services: a study using online reviews analytics

PurposeThis paper aims to analyze if and to what extent mechanical artificial intelligence (AI)-embedded in hotel service robots-influences customers’ evaluation of AI-enabled hotel service interactions. This study deploys online reviews (ORs) analytics to understand if the presence of mechanical AI-related text in ORs influences customers’ OR valence across 19 leading international hotels that have integrated mechanical AI – in the guise of service robots – into their operations.Design/methodology/approachFirst, the authors identified the 19 leading hotels across three continents that have pioneered the adoption of service robots. Second, by deploying big data techniques, the authors gathered the entire population of ORs hosted on TripAdvisor (almost 50,000 ORs) and generated OR analytics. Subsequently, the authors used ordered logistic regressions analyses to understand if and to what extent AI-enabled hospitality service interactions are evaluated by service customers.FindingsThe presence of mechanical AI-related text (text related to service robots) in ORs influences positively electronic word-of-mouth (e-WOM) valence. Hotel guests writing ORs explicitly mentioning their interactions with the service robots are more prone to associate high online ratings to their ORs. The presence of the robot’s proper name (e.g., Alina, Wally) in the OR moderates positively the positive effect of mechanical AI-related text on ORs ratings.Research limitations/implicationsHospitality practitioners should evaluate the possibility to introduce service robots into their operations and develop tailored strategies to name their robots (such as using human-like and short names). Moreover, hotel managers should communicate more explicitly their initiatives and investments in AI, monitor AI-related e-WOM and invest in educating their non-tech-savvy customers to understand and appreciate AI technology. Platform developers might create a robotic tag to be attached to ORs mentioning service robots to signal the presence of this specific element and might design and develop an additional service attribute that might be tentatively named “service robots.”Originality/valueThe current study represents the first attempt to understand if and to what extent mechanical AI in the guise of hotel service robots influences customers’ evaluation of AI-enabled hospitality service interactions.

First Case of Candida auris Colonization in a Preterm, Extremely Low-Birth-Weight Newborn after Vaginal Delivery.

Candida auris is a multidrug-resistant, difficult-to-eradicate pathogen that can colonize patients and health-care environments and cause severe infections and nosocomial outbreaks, especially in intensive care units. We observed an extremely low-birth-weight (800 g), preterm neonate born from vaginal delivery from a C. auris colonized mother, who was colonized by C. auris within a few hours after birth. We could not discriminate whether the colonization route was the birth canal or the intensive care unit environment. The infant died on her third day of life because of complications related to prematurity, without signs or symptoms of infections. In contexts with high rates of C.auris colonization, antifungal prophylaxis in low-birth-weight, preterm neonates with micafungin should be considered over fluconazole due to the C. auris resistance profile, at least until its presence is excluded.

Antibodies against Receptor Binding Domain of SARS-CoV-2 spike protein induced by BNT162b2 vaccine: results from a pragmatic, real-life study.

BACKGROUND: As part of the fight against SARS CoV2 infection, vaccination program for health workers at Giannina Gaslini pediatric hospital (IGG) in Genoa, Italy, started on December 2020. We evaluated the anti-Spike protein response in healthcare workers after a complete vaccination scheme of 2 doses spaced by 3 weeks. METHODS: Immunoglobulin class G (IgG) against SARS-CoV-2 spike RBD were detected by means of a chemiluminescence immunoassay for quantitative IgG antibodies using Maglumi SARS-CoV-2-S-RBD IgG kit during the 3rd week after vaccination completion. RESULTS: IgG anti SARS-CoV-2 spike protein were detected in 99.88% of 1765 healthcare workers 3 weeks after 2nd dose of BNT162b2. Higher median IgG values were observed in younger subjects (807 UA/mL in under 30 vs 429 UA/mL in over 60; p < 0.001) and those with previous COVID-19 (1284 vs 574 UA/mL; p < 0.001). CONCLUSION: BNT162b2 is effective in inducing anti SARS-CoV-2 antibodies even in real-life setting. The higher antibody title observed in workers with a previous documented SARS CoV2 infection confirms the possibility to carry out only one dose of BNT162b2 in a context of vaccines shortage.