The emerging spread of carbapenemase-producing Enterobacterales (CPE) strains, in particular, Klebsiella pneumoniae and Escherichia coli, has become a significant threat to hospitalized patients. Carbapenemase genes are frequently located on plasmids than can be exchanged among clonal strains, increasing the antibiotic resistance rate. The aim of this study was to determine the prevalence of CPE in patients upon their admission and to analyze selected associated factors. An investigation of the antibiotic resistance and genetic features of circulating CPE was carried out. Phenotypic tests and molecular typing were performed on 48 carbapenemase-producing strains of K. pneumoniae and E. coli collected from rectal swabs of adult patients. Carbapenem-resistance was confirmed by PCR detection of resistance genes. All strains were analyzed by PCR-based replicon typing (PBRT) and multilocus sequence typing (MLST) was performed on a representative isolate of each PBRT profile. More than 50% of the strains were found to be multidrug-resistant, and the blaKPC gene was detected in all the isolates with the exception of an E. coli strain. A multireplicon status was observed, and the most prevalent profile was FIIK, FIB KQ (33%). MLST analysis revealed the prevalence of sequence type 512 (ST512). This study highlights the importance of screening patients upon their admission to limit the spread of CRE in hospitals.
Background
Symptoms of obsessive-compulsive disorder (OCD) have been reported to increase during the COVID-19 lockdowns because of the hygiene requirements related to the pandemic. Patients with adjustment disorder (AD) may, in turn, represent a vulnerable population for identifiable stressors. In this study, we aimed at assessing potential symptoms changes in OCD patients during the lockdown in comparison with AD patients as well as versus healthy controls (HC).
Methods
During the COVID-related lockdown, we enrolled 65 patients and 29 HC. Participants were tested with four clinical rating scales (Yale–Brown obsessive-compulsive scale and Brown Assessment of Beliefs Scale for OCD patients; Beck Depression Inventory-II and State–Trait Anxiety Inventory-Y for each group) that had been also administered just before the Italian lockdown.
Results
Our results showed that during the lockdown: (i) the symptoms of depression and anxiety increased in all groups, but this increase was most pronounced in HC (p < 0.001); (ii) OCD symptoms severity did not increase, but the insight worsened (p = 0.028); (iii) the proportion of OCD patients showing hygiene-related symptoms increased (p = 0.031 for obsessions of contamination), whereas that of patients with checking-related symptoms decreased.
Conclusions
The lockdown-induced psychological distress apparently changed the characteristics and the pattern of OCD symptoms expression but not their overall severity. This evidence confirms the heterogeneity and changing nature of OCD symptoms, strongly depending on the environmental circumstances.
Antimicrobial resistance (AMR) arises mostly because of the use and abuse of antibiotics in both the human and veterinary sectors. Furthermore, antibiotic residues can be discharged into the environment, promoting the spread of AMR as well as becoming a potential ecotoxicological risk. Aquaculture is one such source of environmental pollution. In the present work, we evaluated the correlation between antibiotic consumption in 11 selected aquafarms located along the Nera River, and the detection of their residues in surface water and sediment samples gathered monthly from the same stream. Antibiotic consumption was calculated using the ESVAC defined daily doses for animals (DDDvet) method, and a chemical analysis was conducted using a multiclass method. Therefore, the ecological risk of antibiotics being detected in surface waters was established based on the risk quotient (RQ). A strong positive correlation was identified between the concentrations detected in surface waters and the consumption of flumequine (r = 72%, p-value = 0.0085) and florfenicol (r = 83%, p-value = 0.0008). The RQ, however, was low for all the detected antibiotics in surface waters. Therefore, we proved that the antibiotics used in aquaculture can reach the near aquatic environment, but, in this work, they did not represent a toxicological risk to the surrounding ecosystem.
A polycentric mortality study was performed in five Italian harbours: Savona, Marina di Carrara, Livorno, Civitavecchia, and Ravenna. The cohort included active and retired workers (longshoremen), who had been employed between 1960 and 1981. Causes of death were ascertained from death certificates; expected numbers of deaths were generated from age, sex, calendar year, and cause-specific national mortality rates. A low overall mortality was found, which is in agreement with procedures of health selection, typical of physically demanding jobs; an excess of lung cancer was, however, found in four out of five harbours.
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