Outbreak of Salmonella infantis gastroenteritis among people who had eaten at a hash house in southern Italy.

OBJECTIVES: To describe an outbreak of acute gastroenteritis in people who had eaten at a hash house in southern Italy. STUDY DESIGN: Case-control study. METHODS: A clinical case of gastroenteritis was defined as a person who had eaten at the hash house from 29 August to 4 September 2011 and who experienced defined gastrointestinal symptoms within 72 hours, or a person with a laboratory-confirmed salmonella infection without symptoms. A convenience sample was enrolled as the control group. Environmental and human samples were collected, and Salmonella infantis was identified by polymerase chain reaction. Univariate analysis was performed for each food type, and multivariate analysis was performed for each food type and demographic variable (gender, age). RESULTS: Twenty-three cases of gastroenteritis were notified between 1 and 4 September 2011, two of which were admitted to the local hospital. Multivariate analysis showed that porchetta [odds ratio (OR) 22.0, 95% confidence interval (CI) 3.2-152.6, z = 3.13, P = 0.002] and roasted meat (OR 14.4, 95% CI 1.7-122.0, z = 2.45, P = 0.014) were associated with gastrointestinal symptoms. Environmental and human isolates exhibited the same sequence type (ST 32). CONCLUSIONS: This experience highlighted that, in the control of a foodborne outbreak, integrated epidemiological and laboratory surveillance enables rapid identification of the source of infection, thus reducing the risk of an epidemic.

Surveillance of new HIV infections/diagnoses in Puglia region (south Italy), years 2007-2011.

BACKGROUND: The aim of the study is to describe temporal trend, distribution and characteristics of new HIV infections detected in Puglia Region in years 2007-2011. METHODS: Case surveillance data for all individuals newly diagnosed with HIV infection in these years were analysed. Risk factors associated with late presentation at diagnosis were analysed by multivariate logistic analysis. RESULTS: In the years 2007-2011 a total of 632 new diagnoses of HIV infection were notified. 573 (90,7%) of all cases were residents (83,8% Italians, 16,2% migrants). Among residents, 76,8% were males (median age 36 years), 23,2% females (median age 30 years). On the whole, 58,3% were late presenters (LP) and 40,8% were subjects with advanced HIV disease (AHD). At multivariate analysis, older age and being a migrant were risk factors significantly associated with late presentation at diagnosis. CONCLUSIONS: Clinical-epidemiological analysis of new HIV diagnosis/infections in Puglia shows a high proportion of LP and AHD. The results of the study strongly suggest the need to promote access to counselling and screening services of subjects at high risk of late presentation for a better targeting of information campaigns.

Prevalence of HPV infection and genotype distribution in women from Africa seeking asylum in Puglia, Italy.

HPV type-specific distribution was evaluated in genital samples collected from 151 women from West Africa and Horn of Africa, living in the Asylum Seeker Center in Bari Palese (Italy), undergoing voluntary screening correlated with cytological abnormalities. HPV-DNA was assayed by Linear Array HPV genotyping test. HPV DNA was detected in 39.1 % of the women, 42.5 % of which had multiple infection and 69.5 % had high-risk HPV infection. Age-prevalence rates evidenced a peak of HPV infection in women ≤ 20 years of age (53.1 %). HPV 53 and 16 were the most common viral types (13.5 and 12.0 % respectively). Abnormal Pap test results were found in 4.4 % of women with known cytological result. Although a prevalence of HPV positive women higher in African than in European women was expected, the differing rate between residents and migrants African women must be investigated in future studies.

Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children.

OBJECTIVES: Mycoplasma pneumoniae is a frequent cause of human lower respiratory tract infections (LRTIs) for which macrolides are the treatment of choice. The aim of this study was to determine the rate of macrolide resistance and to subtype M. pneumoniae strains in Italy. PATIENTS AND METHODS: During an outbreak of M. pneumoniae infections in southern Italy in 2010, 48 clinical specimens from 43 paediatric patients hospitalized for LRTIs were analysed for macrolide resistance. The mutations associated with resistance (A2063G and A2064G) and M. pneumoniae subtypes were detected by sequencing the targeted domain V region of the 23S rRNA gene and a region in the MPN528a gene, respectively. RESULTS: Macrolide resistance genotypes were detected in 11 (26%) of the 43 M. pneumoniae-positive children. The A2063G mutation was identified in seven patients and the A2064G mutation was identified in the remaining four. Upon admission, the isolates from three patients showed a susceptible genotype but subsequently acquired the A2063G mutation. Genotyping revealed M. pneumoniae subtype 1 in 33 of 40 sequenced strains and subtype 2 in the remaining 7. There was no association between macrolide resistance or susceptibility and the M. pneumoniae subtypes. CONCLUSIONS: This is the first report of macrolide resistance among M. pneumoniae strains in Italy. Our findings indicate an unexpected high prevalence of macrolide resistance genotypes in children, and so macrolide resistance should be carefully considered in patients who do not respond appropriately to antibiotic treatment. The epidemiological monitoring of macrolide resistance has become necessary in Italy and in the rest of Europe.

Case report: fulminant pneumococcal sepsis in an unvaccinated asplenic patient in Italy.

We report a fatal case of overwhelming pneumococcal infection in an asplenic young adult not vaccinated against Streptococcus pneumoniae (S. pneumoniae).

Frequency of human papillomavirus infection and genotype distribution among women with known cytological diagnosis in a Southern Italian region.

INTRODUCTION: In the Puglia region (South Italy) about 200 new hospitalizations for cervical cancer are registered every year. The study investigated the frequency of Human Papillomavirus (HPV) infection and the genotype distribution of HPV in a sample of women with known cytology attending the outpatient clinics of four Gynecological Departments of the University of Bari over a four-year period (2005-2008). METHODS: Cervical samples from 1,168 women were analyzed for the presence of HPV-DNA through Polymerase Chain Reaction (PCR) in L1 region and reverse hybridization. The cytological results were associated with HPV positivity and type-specific prevalence. RESULTS: Overall, HPV infection was found in 355 (30.4%) women. HPV-DNA was found in 34.4% of women with a cytological diagnosis of ASCUS, in 46.8% of women with Low-grade Squamous Intraepithelial Lesion (LSIL) and in 87.0% of women with High-grade Squamous Intraepithelial Lesion (HSIL)/carcinoma. Also 16.0% of women with normal Pap smear were found to be HPV-DNA positive. The most common HPVgenotype was type 16 found in 27.3% of positives, followed by type 53 (11.5%), type 66 (9.2%) and type 31 (9.0%). HPV genotype 18 was found in 6.4% of positives. Types 16 or 18 were detected in about 34% (120/355) of all infected women, in about 33% of LSIL and in 60% of HSIL/ carcinoma HPV-positive women. Among low risk (LR) genotypes, type 61 was found in 10.7% of HPV positive women, type 62 in 8.4%, type 42 in 8.1% and type CP6108 in 7.8%. DISCUSSION AND CONCLUSIONS: The findings of the study give evidence that HPV infection is frequent in the studied cohort of women. The most widespread genotypes found were 16 and 53. These data may represent a benchmark for future evaluation after the recent introduction of vaccination against HPV in 12-year-old girls.

An impression procedure for the severely atrophied mandible.

A procedure is described for the final impression of the severely atrophied mandible. The final impression is developed by use of open- and closed-mouth procedures. The objective is to develop a physiologic impression with maximum support of both hard and soft tissues.