[Prevalence of glycopeptide resistant enterococci in hospitalized patients and in the community in Calabria (Italy)]. / Prevalenza di portatori ospedalieri e comunitari di enterococchi resistenti ai glicopeptidi.

The study evaluated prevalence of glycopeptide (vancomycin and teicoplanin) resistant enterococci (VRE) in hospitalized patients and in the community in Calabria (Italy). Rectal swabs were collected from hospitalized and community subjects. Information was gathered on demographics, ward and duration of hospital stay and antibiotics administered; in community subjects information on previous hospitalizations and antibiotics use in the previous year were also collected. Rectal swabs were plated on Enterococcosel agar alone and with addition of vancomycin (6 mg/l) and incubated aerobically at 37 degrees for 24-48 hours. Typical colonies were tested for Gram stain and catalase production. Enterococci were identified to the species level by biochemical tests. Antimicrobial susceptibility test and E-test were performed by the disk diffusion method to evaluate vancomycin and teicoplanin susceptibility. t-test and chi square test were performed to evaluate difference in means and proportions, respectively. Samples were collected from 211 subjects; 132 (62.6%) from community and 79 (37.4%) from hospitals. Enterococci were isolated from 145 subjects (68.7%), 72.7% and 62% in community and in hospital, respectively. The most frequent isolates were E. faecium (30.4%), followed by E. faecalis and E. durans (25.5%), and, finally, by Leuconostoc (18.6%). Only one E. faecium strain was resistant to both vancomycin and teicoplanin, isolated from a non-hospitalized 45 years old woman (1.3%). The results did not show emergence of VRE in our area, although surveillance to confirm these findings is needed, considering the substantial spread of antibiotics in hospitals and in the community.

Healthcare personnel and hand decontamination in intensive care units: knowledge, attitudes, and behaviour in Italy.

The purpose of this study was to evaluate knowledge, attitudes, and behaviour regarding hand decontamination in personnel of intensive care units (ICUs) in Italy. All ICU physicians and nurses in 19 and five randomly selected hospitals in Campania and Calabria (Italy) were mailed a questionnaire focusing on demographics and practice characteristics; knowledge about prevention of hospital acquired infection; attitudes and behaviour with respect to hand decontamination; and use of gloves. A total of 413 questionnaires were returned giving a response rate of 66.6%. Overall, 53.2% agreed with the correct responses on knowledge related to infection control, and this knowledge was significantly higher in neonatal and medicine-surgery wards and in larger ICUs. A positive attitude was reported by the large majority who agreed that hand decontamination reduces the risk of infection in patients (96.8%) and personnel (86.2%), and the positive attitude was significantly higher among older and female personnel and in those with a higher level of knowledge. Only 60% always decontaminate hands at the start of a shift, and 72.5% before and after a patient contact. Higher compliance is reported for invasive manoeuvres, such as urinary catheters (96.5%) and intravenous lines (77.1%). Routine hand decontamination between each patient was significantly higher in females, and in neonatal and medicine-surgery ICUs. Our results suggest that interventions should not only be focused on predisposing factors (knowledge), but also on enabling (facilitating) and reinforcing (gratifying) factors.