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Introduction. The aim of this study is to describe a proactive surveillance system of food, water and environmental surfaces, in order to avoid Healthcare-Associated Infections (HAIs) from hospital environment. Methods. It is a retrospective descriptive study. The surveillance system consists of two integrated phases: pre-analytic and post-analytic. The activities are distinguished in ordinary control activities, performed after scheduled and shared surveys, and compliance activities, performed when it is necessary to establish the adequacy of the destination use, for example opening a new ward. Results. A total of 1,470 Samples were collected and 539 Reports were generated across the five-year study period. Water for human consumption procedure: a statistically significant trend was found only in the total number of Samples collected (p < 0.001). Legionella spp. infection water risk procedure: all Samples and Reports, with the exception of Compliance Report Samples, showed a statistically significant trend (p < 0.001). Pseudomonas aeruginosa water risk procedure: only Ordinary Reports and Compliance Report Samples trend were statistically significant (p = 0.002 and p = 0.028 respectively). Effectiveness of surface sanitization procedure: no trend was statistically significant (p < 0.05). Hospital catering and food surfaces procedure: Samples and Reports yearly number was constant, no trend analysis was performed. HAIs prevalence was never over 5% in the hospital under study. Conclusions. This surveillance system of water, food and environmental surfaces represents an innovative way of approaching hospital safety for patients and personnel because it overcomes the limitations due to a classic approach limited to a laboratory analytic phase only, according to the best available scientific evidence.

The Authors present their two-year experience regarding an evaluation of the hygienic quality of ready-to-eat foods in a hospital foodservice, both for patients' meals and hospital staff, prepared by using the Cook Chill system. According to the microbiological parameters provided by International Guidelines, 23 of 27 food samples that were collected and analyzed were found to be satisfactory, one was acceptable and only three were unsatisfactory (two for aerobic colony count and one both for aerobic colony count and hygienic procedure). Escherchia coli, Staphylococcus aureus, Salmonella, Listeria monocytogenes, and Clostridium perfringens were absent in all of the analyzed products, The study results are encouraging and confirm the need to always verify that the different phases of production of hospital meals are correctly implemented, even when the foodservice is out-sourced. This has always been considered a priority in the study hospital, where the Health Department is at the forefront both in control and verification of food safety practices and in offering training activities, especially in view of the increased susceptibility of hospitalized patients.

Foodborne diseases and antibiotic resistance are serious widespread health problems in the contemporary world. In this study, we compared the microbiological quality of ready-to-eat (RTE) foods found in community canteens versus hospital canteens in Rome, Italy, focusing on detection and quantification of Enterobacteriaceae and the antibiotic resistance of these bacteria. Our findings show a remarkable difference in Enterobacteriaceae contamination between RTE foods distributed in community canteens (33.5% of samples) and those distributed in hospital canteens (5.3% of samples). This result highlights greater attention to good manufacturing practices and good hygiene practices by the food operators in hospitals compared with food operators in community canteens. As expected, a higher percentage of cold food samples (70.9%) than of hot food samples (10.8%) were positive for these bacteria. Excluding the intrinsic resistance of each bacterial strain, 92.3% of the isolated strains were resistant to at least one antibiotic, and about half of the isolated strains were classified as multidrug resistant. The prevalence of multidrug-resistant strains was 50% in the community samples and 33.3% in hospital canteens. Our results indicate that approximately 38% of RTE foods provided in community canteens is not compliant with microbiological food safety criteria and could be a special risk for consumers through spread of antibiotic-resistant strains. Hygienic processing and handling of foods is necessary for both hospital and community canteens.

Background The surveillance data on antimicrobial resistance, collected by the European Antimicrobial Resistance Surveillance Network, show the rise and spread of antibiotic resistance in Europe as an important public health concern. Currently, one of the main routes of transmission of resistant pathogens is represented by ready to eat foods, animal and vegetable, whose raw materials are occasionally treated with antibiotics in order to preserve their characteristics. The aim of this study was comparing the differences in antibiotic resistance in Enterobacteriaceae from community and hospital canteens in Rome, Italy and analyzing the potential implications. Methods All food samples were analyzed according to the ISO 21528-1. The genus, species and the corresponding susceptibility testing were performed using ID32ETM Automated System and ATBTM strips read by mini API . Univariate analysis was performed to assess the associations between antibiotic resistance and the two kind of environment. Results A total of 325 food samples (238 from community and 87 from hospital) were analyzed, 94 (29%) of those were positive for Enterobacteriaceae. The prevalence of positivity in community canteens was 33.2% (N = 79) while the prevalence of positivity in hospital canteens was 17.2% (N = 15). Resistance to cephalothin was observed in 80.9% of cases, followed by ticarcillin in 64.9%, cefotaxime in 56.4% and cefuroxime in 53.2%. Concerning the differences between the two scenarios, the prevalence of strains resistant to piperacillin (p = 0.01), ticarcillin (p = 0.01), cefotaxime (p = 0.03) and cefuroxime (p = 0.03) in the community samples was higher than in the hospital ones. Although the differences were not significant, even for the other antibiotics, the prevalence of resistance in the community samples was greater than in the hospital ones. Conclusions This significant higher prevalence of strains resistant to several antibiotics in the community samples allows deducing that t

INTRODUZIONE: Legionella è un batterio ubiquitario negli ambienti acquosi. In Europa, circa il 90% delle infezioni causate da questo batterio sono dovute a L. pneumophila con sierogruppo di tipo 1. Il metodo standard utilizzato per la sorveglianza ambientale è la tecnica colturale, sebbene il metodo basato sulla PCR Real-time PCR rappresenti un’attraente alternativa. L’obiettivo di questo studio è l’identificazione del valore soglia, calcolato con la PCR Real-time, che rifletta la maggior concordanza con i valori della tecnica convenzionale microbiologica. MATERIALI E METODI: Dal 2011 al 2013, 77 campioni di acqua sono stati raccolti in bottiglie sterili, contenenti sodio tiosolfato allo 0.01% per neutralizzare i residui di Cloro, e trasportati a temperatura controllata ai laboratori per le successive analisi. Il DNA di L. pneumophila è stato estratto e poi quantificato mediante PCR Real-time utilizzando il kit iQ-Check Screen L. pneumophila (Biorad). RISULTATI: Venti campioni (26%) su 77 analizzati sono risultati positivi alla metodica standard colturale. Le concentrazioni di L. pneumophila, determinate tramite PCR come GU/l, sono risultate maggiori di quelle espresse in CFU/l in 56 campioni (73%), minori in 1 solo campione (1%), ed uguali in 20 campioni (26%). E’ stata riportata una significativa correlazione tra le metodiche (ρ=0.52). CONCLUSIONI: L’elevata sensibilità e il valore predittivo negativo rilevati, rendono la PCR Real-time un metodo di screening ideale per identificare e quantificare L. pneumophila in campioni ambientali di acqua. Se confrontata con i metodi colturali ha il vantaggio di fornire i risultati in meno di 3 ore dopo i passaggi di filtrazione dell’acqua ed estrazione del DNA. La PCR Real-time rappresenta quindi un’interessante tecnica complementare al metodo colturale standard.

BACKGROUND: Legionella pneumophila is increasingly recognised as a significant cause of sporadic and epidemic community-acquired and nosocomial pneumonia. Many studies describe the frequency and severity of Legionella spp. contamination in spa pools, natural pools, hotels and ships, but there is no study analysing the environmental monitoring of Legionella on board trains. The aims of the present study were to conduct periodic and precise environmental surveillance of Legionella spp. in water systems and water tanks that supply the toilet systems on trains, to assess the degree of contamination of such structures and to determine the effectiveness of decontamination. METHODS: A comparative pre-post ecological study was conducted from September 2006 to January 2011. A total of 1,245 water samples were collected from plumbing and toilet water tanks on passenger trains. The prevalence proportion of all positive samples was calculated. The unpaired t-test was performed to evaluate statistically significant differences between the mean load values before and after the decontamination procedures; statistical significance was set at p ≤ 0.05. RESULTS: In the pre-decontamination period, 58% of the water samples were positive for Legionella. Only Legionella pneumophila was identified: 55.84% were serogroup 1, 19.03% were serogroups 2-14 and 25.13% contained both serogroups. The mean bacterial load value was 2.14 × 10(3) CFU/L. During the post-decontamination period, 42.75% of water samples were positive for Legionella spp.; 98.76% were positive for Legionella pneumophila: 74.06% contained serogroup 1, 16.32% contained serogroups 2-14 and 9.62% contained both. The mean bacterial load in the post-decontamination period was 1.72 × 10(3) CFU/L. According to the t-test, there was a statistically significant decrease in total bacterial load until approximately one and a half year after beginning the decontamination programme (p = 0.0097). CONCLUSIONS: This study indicates that sys