ABSTRACT
In Italy, cervical cancer represents the fifth most prevalent cancer in women under 50 years of age and is one of the most commonly detected lesions globally. Given the developing burden of the disease and the availability of both primary and secondary prevention measures, their accurate surveillance is of paramount importance. The aim of this study was to evaluate the trends in cervical cancer screening adherence in the period between 2020 and 2022, as well as to evaluate positive tests, identifying the most frequently associated genotypes and the vaccination coverage. The study sample was made up of 6880 women from the health district of Messina. We highlighted that there was a high proportion of positive results in the investigated period, with a high prevalence of HSIL. Moreover, HPV vaccination coverage was clearly inadequate, as was adherence to screening, both far away from WHO goals. This finding is probably linked to inadequate communication and awareness of the issue in the population and to the lack of data relating to tests carried out privately. In accordance with existing data in the literature, the introduction of the HPV-DNA test in Sicily made it possible to identify women positive for the genotypes most frequently involved in the etiopathogenesis of neoplastic lesions (genotypes 16 and 18), as well as for those in the "others" category, which should be investigated because some of them could have an impact on carcinogenicity and, for this reason, a future vaccine including them could represent a new prevention weapon.
ABSTRACT
BACKGROUND: The WHO recognized antimicrobial resistance as a growing global health threat with a wide variability across Europe: in Italy these rates are higher than in other countries. The aim of our study was to detect antimicrobial resistance on the hands of healthcare workers and on surfaces around the patient, to assess the variability between levels of bacterial contamination on these surfaces and to compare the results with those achieved six years ago. MATERIAL AND METHODS: The study was conducted from June 2017 to May 2018 using contact slides for surfaces and active sampling for air. We used automated biochemical methods to identify microorganisms; antibiograms were performed in compliance with the EUCAST expert rules. RESULTS: We analyzed 3,760 samples, 16.17% were found positive and 34 % of these were antimicrobial-resistant. On analyzing the isolated Staphylococci, 39% were multidrug-resistant and 5% extensively drug-resistant. A 30% of the Enterococcus faecalis isolates were resistant to gentamycin and vancomycin. We found Klebsiella pneumoniae isolates resistant to ceftriaxone, cefoxitin, mecillinam and imipenem. A 7% and 8% of the Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively, were resistant to gentamicin, imipenem, and ceftazidime. CONCLUSIONS: These findings are in line with the international literature, confirming that antimicrobial resistance is also steadily growing in Italy with rates varied for the different pathogens
INTRODUCCIÓN: La OMS reconoce la resistencia a los antimicrobianos como una creciente amenaza para la salud mundial con una amplia variabilidad en toda Europa: en Italia estas tasas son más altas que en otros países. El objetivo de nuestro estudio fue detectar la resistencia a los antimicrobianos en las manos de trabajadores sanitarios y en las superficies alrededor del paciente así como evaluar la variabilidad entre los niveles de contaminación bacteriana en estas superficies y los resultados obtenidos hace seis años. MATERIAL Y MÉTODOS: El estudio se realizó entre junio de 2017 y mayo de 2018 utilizando dispositivos de contacto para superficies y muestreo activo de aire. Se empleó métodos bioquímicos automatizados para identificar microorganismos y la sensibilidad antimicrobiana fue realizada de acuerdo con las normas del EUCAST. RESULTADOS: Se analizaron 3.760 muestras, de las cuales el 16,17% fueron positivas y el 34% de ellas fueron resistentes a antibióticos. Al analizar los estafilococos, el 39% fueron multirresistentes y el 5% extremadamente resistentes. Un 30% de las cepas de Enterococcus faecalis fueron resistentes a gentamicina y vancomicina. Se aislaron cepas de Klebsiella pneumoniae resistentes a ceftrixona, cefoxitina, mecillinam e imipenem. Un 7% de las cepas de Acinetobacter baumannii y un 8% de las cepas de Pseudomonas aeruginosa fueron resistentes a gentamicina, imipenem y ceftazidima. CONCLUSIONES: Estos hallazgos están en línea con los estudios publicados en otros países, lo que confirma que la resistencia a los antibióticos también está creciendo constantemente en Italia con tasas variadas para los diferentes patógenos
