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The rapid and accurate detection of SARS-CoV-2 in environmental settings is crucial for effective public health management during the COVID-19 pandemic. This study compares the performance of the Reverse Transcription quantitative polymerase chain reaction (RT-qPCR) and the Reverse Transcription loop-mediated isothermal amplification (RT-LAMP) for SARS-CoV-2 detection from 100 surface samples collected in healthcare environments. The reference method, RT-qPCR, identified a percentage of 25% of positive samples, while RT-LAMP detected a percentage of 27% of positive surfaces. Our findings reveal a sensitivity of 32% and specificity of 75% for RT-LAMP, with a positive predictive value of 30% and a negative predictive value of 77%. The overall accuracy and concordance with RT-qPCR was 64% for both methods. Despite its lower sensitivity compared to RT-qPCR, RT-LAMP had an advantage due to its rapid screening and environmental surveillance, which is particularly useful for confirming negative results. These results underscore the potential of RT-LAMP not only as a valuable method in the environmental monitoring of SARS-CoV-2 but also as a system to control the sanitation process in ordinary and emergency conditions, providing further optimization and validation for its reliability in routine surveillance and outbreak response efforts. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) recommends the introduction of a water safety plan (WSP) approach on drinking water, in all types of settings. This study represents the first WSP developed on the Neptune Fountain, in Bologna (Italy), based on an interdisciplinary approach, integrating hydraulic and microbiological features, in a Building Information Modeling (BIM). The aim was to develop a dynamic and digital platform to update and share the maintenance program, promoting collaboration among microbiologists, engineers, and municipal staff. Water samples were collected along fountain water distribution systems (WDS) from 2016 to 2021 to monitor water quality through the heterotrophic bacteria at 22 °C and 37 °C, as well as to conduct an Enterococci, Coliform bacteria, Escherichia coli, Pseudomonas aeruginosa, Clostridium perfringens, and Staphylococcus aureus assessment. Simultaneously, hydraulic measures were performed, and advanced geomatics techniques were used to detect the WDS structural components, with a focus on the water treatment system (WTS). The WTS consisted of 10 modules corresponding to specific treatments: descaling, carbon–sand filtration, reverse osmosis, and ultraviolet disinfection. Fecal indicators, heterotrophic bacteria, and P. aeruginosa exceeded the reference limits in most of the modules. Several disinfections and washing treatments, other than changing the maintenance procedure scheduling, were performed, improving the WTS and controlling the contamination. The developed microbiological results, hydraulic measurements, and maintenance procedures were integrated in the BIM model to optimize the data storage, updating procedures and the real-time data sharing. This approach improved the fountain management, operation, and material conservation, ultimately preserving the health of daily visitors. [ABSTRACT FROM AUTHOR]

Two Legionella-like isolates, 8cVS16T and 9fVS26, were isolated from a water distribution system (WDS) in a healthcare facility. Cells were Gram- and Ziehl Neelsen-stain-negative, rod-shaped, motile, and exhibited a blue-white fluorescence under Wood's lamp at 365 nm. The strains grew in a range of 32–37 °C on BCYE with L-cysteine (Cys+), GVPC, and MWY agar medium, with a positive reaction for oxidase, catalase, and gelatinase. The dominant fatty acids were summed features 3 (C16:1ω7c/C16:1ω6c) (27.7%), C16:0 iso (17.5%), and C16:0 (16.3%), and Q13 as the major ubiquinone. The mip and rpoB gene sequences showed a similarity of 96.7% and 92.4%, with L. anisa (ATCC 35292T). The whole genomes sequencing (WGS) performed displayed a GC content of 38.21 mol% for both. The digital DNA-DNA hybridization (dDDH) analysis demonstrated the separation of the two strains from the phylogenetically most related L. anisa (ATCC 35292T), with ≤43% DNA-DNA relatedness. The Average Nucleotide Identity (ANI) between the two strains and L. anisa (ATCC 35292T) was 90.74%, confirming that the two isolates represent a novel species of the genus Legionella. The name proposed for this species is Legionella resiliens sp. nov., with 8cVS16T (=DSM 114356T = CCUG 76627T) as the type strain. [ABSTRACT FROM AUTHOR]

Simple Summary: In this study, we assessed changes in bone mineral density at disease onset and at the end of therapy in follicular lymphoma patients treated with R-CHOP and R-Bendamustine regimens. Another aim was to assess whether low bone mineral density at the onset of the disease is an unfavorable prognostic index. We also evaluated changes in other radiomic parameters, such as the musculoskeletal index, visceral adipose tissue, and subcutaneous adipose tissue in patients treated with R-Bendamustine and R-CHOP, with the latter containing high doses of steroids, which we know are associated with negative bone balance, a loss of muscle mass, and metabolic and cardiovascular issues. This is particularly relevant in elderly patients, in whom these changes could have an important impact on outcomes and the quality of life. As R-CHOP and R-Bendamustine are two effective treatment regimens in follicular lymphoma, this study, together with other clinical-laboratory parameters, could help in the choice of therapy. In patients with follicular lymphoma (FL), therapeutic advances have led to improved survival, and within this framework, it is important to identify treatment strategies offering a better quality of life. Using (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT), in patients treated with R-CHOP-like or R-Bendamustine regimens, we assessed changes in the bone mineral density (BMD), musculoskeletal index (SMI), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) at disease onset and at the end of therapy. We evaluated whether the high-steroid regimen could lead to more significant radiological changes than those induced by the steroid-free regimen and whether a low BMD at disease onset is an unfavorable prognostic index. Seventy-nine patients between 60 and 80 years old with a new diagnosis of FL were included in the study. Evaluation of Delta values (pre- and post-therapy mean values) in the two immunochemotherapy regimens showed differences in radiomic parameters within the two patient cohorts. The R-CHOP-like regimen was associated with a significant reduction in BMD, an increase in SAT and VAT, and a reduction in skeletal muscle density (SMD) and SMI. Moreover, patients with high FLIPI showed a BMD below the cut-off value. This study represents the first study demonstrating a prognostic correlation between FLIPI and low BMD. [ABSTRACT FROM AUTHOR]

Simple Summary: The reported incidence of thrombotic events (TE) in non-promyelocytic acute myeloid leukemia (AML) patients varies in the literature from 2% to 13%. The aim of our retrospective study was to assess the incidence of TE in a real-word population of AML patients to determine the impact of TE on survival and to recognize risk factors for early venous thromboembolism (VTE). We observed a TE incidence of 14.6% among 300 patients with newly diagnosed AML. Arterial TE but not VTE was associated with a poorer OS. Furthermore, we observed a higher relapse rate among patients experiencing a VTE. We recognized platelets count >50 × 109/L, presence of comorbidities and a previous history of TE as risk factors for early VTE development. Accordingly, we proposed a score combining these factors that may help in implementing strategies to manage patients at higher risk of early thrombotic complications. Information regarding the incidence and the prognostic impact of thrombotic events (TE) in non-promyelocytic acute myeloid leukemia (AML) is sparse. Although several risk factors associated with an increased risk of TE development have been recognized, we still lack universally approved guidelines for identification and management of these complications. We retrospectively analyzed 300 consecutive patients with newly diagnosed AML. Reporting the incidence of venous TE (VTE) and arterial TE (ATE) was the primary endpoint. Secondarily, we evaluated baseline patient- and disease-related characteristics with a possible influence of VTE-occurrence probability. Finally, we evaluated the impact of TE on survival. Overall, the VTE incidence was 12.3% and ATE incidence was 2.3%. We identified three independent predictors associated with early-VTE: comorbidities (p = 0.006), platelets count >50 × 109/L (p = 0.006), and a previous history of VTE (p = 0.003). Assigning 1 point to each variable, we observed an overall cumulative incidence of VTE of 18.4% in the high-risk group (≥2 points) versus 6.4% in the low-risk group (0–1 point), log-rank = 0.002. Overall, ATE, but not VTE, was associated with poor prognosis (p < 0.001). In conclusion, TE incidence in AML patients is not negligible. We proposed an early-VTE risk score that could be useful for a proper management of VTE prophylaxis. [ABSTRACT FROM AUTHOR]

Hypofibrinogenemia (HF) in adult acute lymphoblastic leukemia (ALL) of B lineage is uncommon and mostly associated with asparaginase (ASP) delivery. Since we noticed a significant reduction in fibrinogen (FBG) plasma levels even before the first ASP dose, we aim to assess the levels of FBG during induction treatment and explore if the FBG fall correlated with therapies other than asparaginase and/or specific leukemia biological features. We retrospectively analyzed FBG levels in 115 patients with B-ALL. In 74 (64%) out of 115 patients FBG decline occurred during the steroid prephase. In univariate analysis, such a steroid-related HF was significantly associated with BCR-ABL1 rearrangement (p = 0.00158). None of those experiencing HF had significant modifications of liver function tests during induction treatment. Our retrospective study suggests that in B-ALL, steroid therapy can also induce HF and that such an event is preferentially observed in patients carrying BCR-ABL1 rearrangements. The pathogenesis of this phenomenon is still unclear. We attempt to explain it by applying the International Society of Thrombosis and Hemostasis-Disseminated Intravascular Coagulation score (ISTH-DIC score); nonetheless additional studies are needed to clarify further the mechanisms of HF in this subset of patients. [ABSTRACT FROM AUTHOR]

The use of Microfiltered Water Dispensers (MWDs) is increasing in offices, companies, or commercial facilities, as a response to plastic pollution. Despite their widespread use, poor data are available about the water quality and pathogens developed. Starting from a high contamination found in MWDs, a Water Safety Plan (WSP) was implemented on 57 MWDs to improve the water quality. To assess the effectiveness of WSP during the period 2017–2021, the environmental monitoring of heterotrophic plate counts (HPCs) at 36 °C and 22 °C, Enterococcus spp., Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, and Clostridium perfringens, as prescribed by Italian regulation for drinking water, was conducted. A high level of HPCs at both temperatures was observed, over the regulation limit; contrarily, the pathogenic bacteria were absent. The contamination found was studied with respect to the temperature threshold of 25 °C, suggested by directives. No significant differences were found between samples above and below the threshold, while a significant decrease over the years was observed for HPCs at 36 °C (p = 0.0000000001) and 22 °C (p = 0.000006). The WSP implementation resulted in a 43.09% decrease for HPCs at 36 °C and a 24.26% decrease for HPCs at 22 °C. Moreover, during the SARS-CoV-2 pandemic, the WSP contributed to limit the microbial contamination, preserving the MWDs' functionality and hygienic conditions and the drinking water quality. [ABSTRACT FROM AUTHOR]

Legionella species distribution in the Emilia-Romagna region, involving hospital (H) and community (C) environments, was conducted. Legionella culture, agglutination test, and mip-gene sequencing were applied on 240 isolates. The analysis showed a higher prevalence of non-Legionellapneumophila (n-Lp) species (84.1%) compared with L. pneumophila (Lp) (15.9%), with a higher frequency of n-Lp with respect to Lp species in both environments (77.6% and 96.4%, in H and C, respectively). The Shannon index showed a significant difference in Legionella distribution (p = 0.00017), with a significant abundance of Lp in the H compared with C environment (p = 0.00028). The continuous disinfection treatment in H could contribute to adaptive survival of the Lp species. Phylogenetic analysis revealed a conservative clade distribution between H and C: L. feeleii clade with three subclades in C and the Lp clade with five subclades in H and two in C, respectively. Our findings suggest the importance of Legionella surveillance both in H and C, with a focus on n-Lp species less connected to human disease. The Legionella prevalence and diversity found here indicate that geographical and temporal isolate evolution should be considered during surveillance, particularly in the light of global warming and changes in population risk factors. [ABSTRACT FROM AUTHOR]

University wastewater is a type of wastewater with higher pollutants load and flow rate variability than typical domestic wastewater. Constructed wetlands (CW) could be used for university wastewater treatment and consequently for wastewater reuse. A hybrid CW pilot plant, at the University of Bologna (Italy), was monitored to assess its potential to be used at the university. Its treatment performance was monitored for one year and public acceptance explored through a survey. The pilot plant had two treatment lines, (1) a vertical flow CW (VFCW) and a planted horizontal flow CW (HFCW), and (2) the same VFCW and an unplanted horizontal flow filter (HFF). The HFCW achieved higher removals than the HFF, but it was also found to be prone to higher water losses. However, both treatment lines met the Italian limits for discharge in natural water bodies and some of the limits for wastewater reuse in Italy and the EU. The VFCW alone was not able to meet the same limits, demonstrating the advantages of hybrid over single stage CWs. A positive attitude towards CWs and wastewater reuse was found among the survey participants. Therefore, hybrid CWs (planted and unplanted) are considered a feasible technology for application at universities. [ABSTRACT FROM AUTHOR]

Surgical handwashing is a mandatory practice to protect both surgeons and patients in order to control Healthcare-Associated Infections (HAIs). The study is focused on Legionella and Pseudomonas aeruginosa contamination in Surgical Handwashing Outlets (SHWOs) provided by sensor-activated faucets with Thermostatic Mixer Valves (TMVs), as correlated to temperature, technologies, and disinfection used. Samples were analyzed by standard culture techniques, comparing hot- and cold-water samples. Legionella isolates were typed by an agglutination test and by mip sequencing. Legionella contamination showed the same distribution between hot and cold samples concerning positive samples and mean concentration: 44.5% and 1.94 Log10 cfu/L vs. 42.6% and 1.81 Log10 cfu/L, respectively. Regarding the distribution of isolates (Legionella pneumophila vs. Legionella non-pneumophila species), significant differences were found between hot- and cold-positive samples. The contamination found in relation to ranges of temperature showed the main positive samples (47.1%) between 45.1–49.6 °C, corresponding to high Legionella concentrations (2.17 Log10 cfu/L). In contrast, an increase of temperature (>49.6 °C) led to a decrease in positive samples (23.2%) and mean concentration (1.64 Log10 cfu/L). A low level of Pseudomonas aeruginosa was found. For SHWOs located in critical areas, lack of consideration of technologies used and uncorrected disinfection protocols may lead to the development of a high-risk environment for both patients and surgeons. [ABSTRACT FROM AUTHOR]