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This study provides a detailed description of the distribution of non-fermentative gram-negative bacteria (NFGNB) collected in water sources (tap water and water used for haemodialysis and bronchoscope flushing) from different wards of a tertiary care hospital. The aim is to identify risk practices for patients or to alert clinicians to the possible contamination of environment and medical devices. The resistance profile of NFGNB environmental isolates has shown that more than half (55.56%) of the strains isolated were resistant to one or more antibiotics tested in different antimicrobial categories. In particular, 38.89% of these strains were multidrug resistant (MDR) and 16.67% were extensively drug resistant (XDR). The most prevalent bacterial species recovered in water samples were Pseudomonas aeruginosa, Pseudomonas fluorescens, Ralstonia pickettii and Stenotrophomonas maltophilia. Analysis of antibiotic resistance rates has shown remarkable differences between Pseudomonadaceae (P. aeruginosa and P. fluorescens) and emerging pathogens, such as S. maltophilia and R. pickettii. Multidrug resistance can be relatively common among nosocomial isolates of P. aeruginosa, which represent the large majority of clinical isolates; moreover, our findings highlight that the emergent antibiotic resistant opportunistic pathogens, such as R. pickettii and S. maltophilia, isolated from hospital environments could be potentially more dangerous than other more known waterborne pathogens, if not subjected to surveillance to direct the decontamination procedures.

Background The quality of care includes several aspects which may be influenced by social-economic status. This study analyzes hospitalizations for several conditions, such as chronic diseases, cancer and appendectomy, in Italians and immigrant people living in Italy with the aim to evaluate possible inequalities in the quality of health care services due to migrant status, gender and geographical macro-areas (Northern, Central, Southern Italy). Methods The data source of hospital discharges for stroke, myocardial infarction, chronic liver disease, cervical cancer, mastectomy and appendectomy was the Ministry of Health. ICD 9 codes were used for data collection. Crude and standardized hospitalization rates per 100.000 were calculated. Italian resident population and an estimate of immigrants living in Italy were used as denominators while standardization was done with respect to the European population. The data we used covers the 2006–2008 period. Results Immigrants showed significantly higher hospitalization rates for stroke, cervical cancer and appendectomy and significantly lower hospitalization rates for chronic liver diseases and mastectomy. Males showed significantly higher hospitalization rates than females for myocardial infarction, chronic liver diseases and appendectomy. Notwithstanding, differences related to migrant status and gender varied according to geographical macro-area. With respect to that, Southern Italy showed significantly higher hospitalization rates for stroke, myocardial infarction and chronic liver diseases and significantly lower hospitalization rates for mastectomy and appendectomy. Conclusions The results of this study may reflect inequalities in the quality of health care, in particular in primary and secondary prevention, access to specialized care and inappropriateness, due to migrant status and gender. Also, differences between macro-areas suggest heterogeneities in the integration policies and the promotion of immigrants’ health. Research should be endorsed in this field in order to further describe inequalities and their reasons and in the light of supporting policies development. Electronic supplementary material The online version of this article (doi:10.1186/s12914-014-0032-9) contains supplementary material, which is available to authorized users.

Background Immigrant population has different access to health services in comparison to natives. This study is a time series analysis of hospitalization rates of immigrant and Italian populations and is aimed to support health planning and interventions. Methods An ecological study was performed from 2001 to 2008. Hospitalization rates for myocardial infarction, stroke, chronic hepatitis/cirrhosis, cervical cancer and mastectomy were chosen as a proxy of lifestyles and access to primary health care. Hospitalizations were requested to …

The environment is a broad reservoir of antibiotic resistant organisms. Bacteria in natural environments likely serve as a reservoir of resistance genes that can be transmitted to human pathogens. Antibiotic resistance in hospital environment is growing concern, especially among non fermenting Gram-negative bacteria (NFGNB), being the most widespread cause of nosocomial infections. Our study provides detailed description of the distribution of NFGNB collected in water sources from different wards of a tertiary …

Background The health status of a population closely depends also on the presence of socially disadvantaged groups, such as immigrants. The aim of this study is to analyze the access to health services of Italian and immigrant people living in Italy, with particular attention to the hospitalizations for two groups of diseases with similar risk factors: heart attack and stroke, chronic liver disease and liver cancer. Methods The data source on …