ABSTRACT
BACKGROUND: Nursing students can be exposed to patients with hepatitis A virus (HAV) and can represent a vehicle of transmission both for health personnel, patients and relatives. OBJECTIVES: The aim of this study was to assess the risk of HAV infection in nursing students during their internship. PATIENTS AND METHODS: A seroprevalence survey on HAV infection was performed on nursing students at the Cagliari university-hospital, together with the assessment of the compliance to preventive measures to decrease the risk of infection during their internship. Blood specimens were obtained from 253 students. All serum samples were tested for anti-HAV antibodies (IgG) by the enzyme-linked immunosorbent assay (ELISA). Compliance to preventive measures was recorded by trained personnel. RESULTS: Overall HAV seropositivity in nursing students (mean age 24, range 17 - 45 years) was 3%. Compliance to preventive measures was not uniform (6% - 76%) and extremely low in some specific measures targeted to decrease the oral-fecal transmission. CONCLUSIONS: The high proportion of susceptible nursing students can contribute to an increase in the risk of nosocomial transmission, especially when specific preventive measures are not completely applied. Nursing education packages, before starting medical internship, should be implemented in order to increase their compliance to preventive measures, especially in wards at higher risk. Vaccination should be considered in wards at higher risk.
ABSTRACT
BACKGROUND: Human papillomavirus (HPV) infection is the most common sexually transmitted infection and high-risk HPV types are a necessary cause for the development of cervical cancer. The present study investigated the HPV-type specific prevalence in 650 women, aged 15-76 years, with cytological abnormalities and the association between HPV infection and cervical disease in a subset of 160 women for whom cytological results for Pap-Test were available, during the period 2008-2011 in Cagliari (Southern Italy). DESIGN AND METHODS: HPV-DNA extraction was performed by lysis and digestion with proteinase K and it was typed by using the INNOLiPA HPV Genotyping Assay. RESULTS: Overall the HPV prevalence was 52.6%; high-risk genotypes were found in 68.9% of women and multiple-type infection in 36.1% of HPV-positive women. The commonest types were HPV-52 (23.4%), HPV-53 (15.7%), HPV-16 (15.4%) and HPV-6 (12.4%). Among the women with cytological diagnosis, any-type of HPV DNA was found in 49.4% of the samples and out of these 93.7% were high-risk genotypes. Genotype HPV 53 was the commonest type among women affected by ASCUS lesions (21.4%), genotype 52 in positive L-SIL cases (22.5%), genotype 16 H-SIL (27.3%). CONCLUSIONS: This study confirmed the high prevalence of HPV infection and high-risk genotypes among women with cervical abnormalities while, unlike previously published data, genotype HPV-52 was the most common type in our series. These data may contribute to increase the knowledge of HPV epidemiology and designing adequate vaccination strategies. Significance for public healthHuman papillomavirus (HPV) is the most common sexually-transmitted agent, which can cause cervical lesions and cancer in females. Efforts to reduce the burden of cervical cancer with cytology screening in the last years have had limited success. HPV infection and disease imposes a substantial burden of direct costs on the Italian National Health Service that have never been fully quantified. Monitoring HPV prevalence could represent a tool to follow the evolution of the infection in the vaccination and post-vaccination era, to understand the impact of HPV types in cervical diseases in Italy. Our survey shows an high frequency of infections sustained by HPV 52. Given the recent implementation of a widespread immunization program with vaccines not containing HPV 52, it has been relevant to prove the high prevalence of this HPV genotype from the beginning of the vaccination campaign, to avoid ascribing to the vaccination program a possible selection effect and the importance of non-vaccine HPV types in the burden of cervical disease, in order to assess the opportunity to realize new vaccine including other types.
