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2 results on '"Alba Muzzi"'

1. Implementation of an antimicrobial stewardship program in the Vascular Surgery ward of a university tertiary care hospital in Pavia, Northern Italy

Author

Marco Vecchia, Marta Colaneri, Paolo Sacchi, Lea Nadia Marvulli, Andrea Salvaderi, Jessica Lanza, Stefano Boschini, Franco Ragni, Piero Marone, Sara Cutti, Alba Muzzi, Carlo Marena, Monica Calvi, Luigia Scudeller, Enrico Maria Marone, and Raffaele Bruno

Subjects
Vascular surgery, Antimicrobial stewardship program, Multidisciplinary team, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Purpose The commitment of multidisciplinary teams in antimicrobial stewardship programs (ASPs) is often inadequately considered, especially in surgical wards. We wanted to evaluate clinical, microbiological, and pharmacological outcomes before and after the implementation of an ASP in the Vascular Surgery ward of Fondazione IRCCS Policlinico San Matteo, a tertiary care hospital in Pavia, Italy. Methods This was a quasi-experimental quality-improvement study. The antimicrobial stewardship activity was conducted twice a week for 12 months and consisted of both prospective audit and feedback of all the ongoing antimicrobial prescriptions by the infectious diseases’ consultants and educational meetings for the healthcare workers of the Vascular Surgery ward. For comparison between the study periods, Student t test (Mann–Whitney test for skewed distributions) was used for quantitative variables (ANOVA or Kruskall-Wallis for > 2 groups respectively), and Pearson’s chi-squared test (Fisher exact test where appropriate) for categorical variables. 2-tailed tests were used. P-value significance cut-off was 0.05. Results During the 12-month intervention period, among a total number of 698 patients, 186 prescriptions were revised, mostly leading to de-escalating an ongoing antimicrobial therapy (39, 20.97%). A statistically significant reduction in isolates of carbapenem-resistant Pseudomonas aeruginosa (p-value 0.003) and the absence of Clostridioides difficile infections were reported. No statistically significant changes were observed in terms of length of stay and all-cause in-hospital mortality. A significant decrease in the administration of carbapenems (p-value 0.01), daptomycin (p-value

Published
2023
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2. Post-exposure rate of tuberculosis infection among health care workers measured with tuberculin skin test conversion after unprotected exposure to patients with pulmonary tuberculosis: 6-year experience in an Italian teaching hospital

Author

Elena Seminari, Carlo Marena, Piero Marone, Carmine Tinelli, Alba Muzzi, Luigia Scudeller, Lorenzo Minoli, M. Strosselli, P. Mangiarotti, and Tiziana Feletti

Subjects
Adult, Male, medicine.medical_specialty, Tuberculosis, Adolescent, health care facilities, manpower, and services, Health Personnel, education, Infection control, Young Adult, Medical microbiology, Pulmonary tuberculosis, Occupational Exposure, Health care, Occupational TB, Medicine, Humans, Young adult, Hospitals, Teaching, Tuberculosis, Pulmonary, Aged, Tuberculin skin test conversion, business.industry, Tuberculin Test, virus diseases, Middle Aged, bacterial infections and mycoses, medicine.disease, Surgery, Infectious Diseases, Italy, Emergency medicine, Tropical medicine, Female, business, Research Article
Abstract

Background This study assesses the risk of LTBI at our Hospital among HCWs who have been exposed to TB patients with a delayed diagnosis and respiratory protection measures were not implemented. Methods All HCWs exposed to a patient with cultural confirmed pulmonary TB and respiratory protection measures were not implemented were included. Data on TST results performed in the past (defined as T0) were recorded. TST was performed twice: first, immediately after exposure to an index patient (T1) and three months later (T2). The period of time between T0 and T1 was used to calculate he annual rate of tuberculosis infection (ARTI), while le period of time between T1 and T2 was used to calculate the post exposure annual rate of tuberculosis infection (PEARTI). Results Fourteen index patients were admitted; sputum smear was positive in 7 (58.3%), 4 (28.6%) were non-Italian born patients. 388 HCWs were exposed to index patients, a median of 27 (12-39) HCW per each index patient. One hundred eighty (46.4%) HCWs received BCG in the past. One hundred twenty two HCWs (31%) were TST positive at a previous routine screening and not evaluated in this subset. Among the remaining 255 HCWs with negative TST test in the past, TST at T1 was positive in 11 (4.3%). ARTI was 1.6 (95% CI 0.9-2.9) per 100 PY. TST at T2 was positive in 9 (3.7%) HCWs, that were TST negative at T1. PEARTI was 26 (95% CI 13.6-50) per 100 PY. At univariate analysis, older age was associated with post exposure latent tuberculosis infection (HR 1.12; 95% CI 1.03-1.22, p=0.01). Conclusions PEARTI was considerably higher among HCWs exposed to index patients than ARTI. These data underscore the overwhelming importance of performing a rapid diagnosis, as well as implementing adequate respiratory protection measures when TB is suspected.

Published
2014

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