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Background: Italy was significantly affected by the COVID-19 pandemic, experiencing multiple waves of infection following the sequential emergence of new variants. Understanding the transmission patterns and evolution of SARS-CoV-2 is vital for future preparedness. Methods: We conducted an analysis of viral genome sequences, integrating epidemiological and phylodynamic approaches, to characterize how SARS-CoV-2 variants have spread within the country. Results: Our findings indicate bidirectional international transmission, with Italy transitioning between importing and exporting the virus. Italy experienced four distinct epidemic waves, each associated with a significant reduction in fatalities from 2021 to 2023. These waves were primarily driven by the emergence of VOCs such as Alpha, Delta, and Omicron, which were reflected in observed transmission dynamics and effectiveness of public health measures. Conclusions: The changing patterns of viral spread and variant prevalence throughout Italy's pandemic response underscore the continued importance of flexible public health strategies and genomic surveillance, both of which are crucial for tracking the evolution of variants and adapting control measures effectively to ensure preparedness for future outbreaks.

Summary: COVID-19 vaccines elicit a strong anti-S antibodies response. We aim to describe antibody titers in peri-vaccination SARS-CoV-2 infections. This is a retrospective longitudinal single-cohort study. Serological tests were performed at the time of the first SARS-CoV-2 vaccine dose (T0) and 60 (T1), 120 (T2), and 240 (T3) days after.The study included 4,682 subjects. Group A had the infection without an anti-S Ig response. Group B and C seroconverted for anti-N Ig between T0 and T1 and between T1 and T2, respectively. Group D was persistently anti-N Ig negative. Group B showed an initial sub-optimal response, reaching the highest titer at T3. Those who received the second dose 120 days after the infection had higher titers compared to those who received it 21 days after the first dose. The immune response depends on the number and the timing of vaccine doses, highlighting the need for a more personalized approach to vaccination.

Summary: Patients undergoing haemodialysis are exposed to a great volume of dialysis water and therefore its microbial analysis is important for patient safety. Furthermore, microbial surveillance is reported in several guidelines as a necessary means to identify contamination of gastrointestinal endoscopes in order to reduce the potential of infection risk.Here we evaluated the Uro4 HB&L™ automated system to detect microbial contamination in dialysis water and gastrointestinal endoscopes. A total of 222 samples were collected during a six month period. Dialysis water and gastrointestinal endoscopes were evaluated both with the reference culture methods and the Uro4 HB&LTM system. Bacterial identification was performed using a matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS).The results show that the Uro4 HB&LTM system has high specificity but a lesser sensitivity than traditional culture method, even if it might allow the identification of more exigent bacteria in terms of nutrition.The Uro4 HB&LTM system gives positive results in less time than culture method but the possibility to generate false negative results imposes that it should be associated with a traditional 48 h agar culture.

Capnocytophaga canimorsus infection was recently recognized as a zoonosis. We report the first case of fulminant septic shock in Italy caused by this pathogen. The patient, with a history of splenectomy, died at the main hospital in Brescia with a presumptive diagnosis of sepsis. PCR and sequencing on post mortem samples confirmed C. canimorsus as a causative organism. Our purpose is to alert medical professionals to the virulence of C. canimorsus in asplenic and immunocompromised patients. Keywords: Capnocytophaga canimorsus, septic shock, PCR, sequencing