Italian National Surveillance of Alcohol-Based Hand Rub Consumption in a Healthcare Setting-A Three-Year Analysis: 2020-2022.

Background/Objectives: Hand hygiene (HH) is pivotal in mitigating infectious disease transmission and enhancing public health outcomes. This study focuses on detailing the national surveillance system for alcohol-based hand rub (ABHR) consumption in healthcare facilities across Italy, presenting results from a comprehensive three-year evaluation period, from 2020 to 2022. It aims to delineate this surveillance system and report on ABHR consumption trends in various Regions/Autonomous Provinces (Rs/APs). Methods: ABHR consumption data, collected through the ABHR Italian national surveillance system, coordinated by the Istituto Superiore di Sanità (ISS), were analyzed. Statistical methods, e.g., the Mann-Whitney test, were used to assess trends in ABHR consumption, expressed in liters per 1000 patient days (L/1000PD). Results: The results show significant variation in ABHR consumption across Rs/APs and over the years studied. National median ABHR consumption decreased from 2020 to 2022, with a significant reduction from a median of 24.5 L/1000PD in 2020 to 20.4 L/1000PD in 2021 and 15.6 L/1000PD in 2022. Conclusions: The decline in ABHR consumption raises concerns about the ongoing adherence to HH practices in Italian healthcare settings. This underscores the essential role that systematic ABHR monitoring and improved surveillance play in enhancing HH compliance, suggesting that sustained and strategic efforts are fundamental to uphold high standards of hygiene and to effectively respond to fluctuating ABHR usage trends over time. Further research is needed to explore barriers to effective ABHR use and to develop targeted strategies to improve HH practices.

Sustainable Development Goals and 2030 Agenda: Awareness, Knowledge and Attitudes in Nine Italian Universities, 2019.

Sustainable Development Goals (SDGs) and 2030 Agenda represent global development programs. Education can widen the acknowledgement of their relevance and their applications. This survey aims to assess awareness, knowledge and attitudes towards SDGs and sustainability among first-year students in nine Italian Universities. A Likert scale-based online questionnaire of 70 items was compiled by students from March to July 2019. It examined knowledge and expectations referred to sustainable development concepts, indicators and documents/models accounting for sociodemographic variables. Statistical analyses performed were Chi-square test, Fisher's Exact test, Kendall's W correlation coefficient, univariate and multivariate analysis. The questionnaire was completed by 1676 students. A low percentage referred a good knowledge of SDGs and 2030 Agenda, most of them had never attended related educational activities previously. Better knowledge of SDGs and 2030 Agenda was observed in case of previous specific educational activities (p < 0.001). The expectation towards university guaranteeing an education on SDGs was high, both for personal wisdom and for usefulness in future professional context. A significant difference (p < 0.001) in such expectations was found, as healthcare students were less interested than colleagues of other areas. The results showed low knowledge but interest towards sustainable development. A scheduled implementation of academic initiatives should be considered.

Postoperative acute kidney injury in lung transplant recipients.

OBJECTIVES: Acute kidney injury (AKI) is a common postoperative complication after lung transplantation. The aim of the present study was to evaluate the incidence of AKI in lung transplant patients and its effect on patients and graft outcome in relation to degree of severity. METHODS: Data from 135 patients who underwent lung transplant in the same Italian institution were recorded retrospectively and analysed (69 unilateral and 66 bilateral lung transplants, age 51.2 ± 12.2 years, 84 males). RESULTS: One-third of our population developed AKI in the early postoperative period. Male sex and severe arterial hypotension with haemodynamic decompensation were significantly associated with an increased risk of AKI (P = 0.025 and P = 0.002, respectively). Induction therapy with basiliximab and the use of tacrolimus instead of cyclosporine proved to be protective against AKI (P = 0.047 and P = 0.004, respectively). Patients with AKI were sicker and showed a worse respiratory outcome with longer invasive mechanical ventilation (P = 0.002), higher prevalence of tracheostomy (P = 0.003) and need for postoperative extracorporeal membrane oxygenation (P = 0.01) and required administration of vasoactive amine for a longer period (P = 0.008). Patients with AKI showed a significantly lower survival rate than those who did not develop AKI (P = 0.001). Patients with stage 3 AKI requiring renal replacement therapy had a worse survival rate (P < 0.0001). CONCLUSIONS: Our study confirms the importance of AKI in patients undergoing lung transplant that can significantly affect outcome. The pathogenesis of AKI is heterogeneous, and prerenal causes have a great impact. Particular attention must be paid to the haemodynamics, which proved to be strongly associated with the onset of AKI. Severe renal impairment is associated with respiratory impairment and reduced survival.