rubrica

Sistemi di sorveglianza

  • Antonia Stazi1

  1. Istituto superiore di sanità, Roma

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Ricerca bibliografica periodo 2 giugno 2011 –2 agosto 2011

Per leggere le caratteristiche di questa ROUTINE di ricerca clicca qui

Database: Pubmed/MEDline
Stringa: (Sentinel Surveillance [MESH] or Behavioral Risk Factor Surveillance System [MESH] or Population Surveillance [MESH]) or "surveillance system*" (tuutti I campi) or "surveillance program*" (tutti I campi) AND Italy (tutti i campi).

Di ogni articolo è disponibile l'abstract. Per visualizzarlo basta cliccare sul titolo.

Donnarumma F, Indorato C, Mastromei G, Goti E, Nicoletti P, Pecile P, Fanci R, Bosi A, Casalone E.
Molecular analysis of population structure and antibiotic resistance of Klebsiella isolates from a three-year surveillance program in Florence hospitals, Italy.
Eur J Clin Microbiol Infect Dis. 2011 Jul 9. [Epub ahead of print]
CIBIACI and Department of Evolutionary Biology, University of Florence, Via Romana 17/19, 50125, Florence, Italy.

Abstract

We report the results of a three-year surveillance program of Klebsiella spp. in six hospitals in Florence (Italy). A total of 172 Klebsiella isolates were identified and typed by AFLP: 122 were K. pneumoniae and 50 were K. oxytoca. Most K. pneumoniae (80%) and K. oxytoca (93%) showed unrelated AFLP profiles. Beside this heterogeneous population structure, we found five small epidemic clonal groups of K. pneumoniae. Four of these groups were involved in outbreak events, three of which occurred in neonatal ICUs. The fifth clonal group spread in three different wards of two hospitals. Only one non-epidemic clonal group of K. oxytoca was detected. The frequencies of isolates with multiple antibiotic resistances increased with time; at the end of the study period, most K. pneumoniae were resistant to all the antibiotics tested. A PCR analysis of seven ertapenem resistant isolates was unable to detect any of the major genes known to underlie carbapenem resistance in K. pneumoniae.

2. Marinaccio A, Binazzi A, Marzio DD, Scarselli A, Verardo M, Mirabelli D, Gennaro V, Mensi C, Riboldi L, Merler E, De Zotti R, Romanelli A, Chellini E, Silvestri S, Pascucci C, Romeo E, Menegozzo S, Musti M, Cavone D, Cauzillo G, Tumino R, Nicita C, Melis M, Iavicoli S; ReNaM Working Group.
Pleural malignant mesothelioma epidemic. Incidence, modalities of asbestos exposure and occupations involved from the italian national register.
Int J Cancer. 2011 Jun 6. doi: 10.1002/ijc.26229. [Epub ahead of print]
Workers Compensation Authority (INAIL), Research area ex ISPESL, Occupational Medicine Department, Epidemiology Unit, Rome, Italy. alessandro.marinaccio@ispesl.it.

Abstract
Due to the large scale use of asbestos (more than 3.5 million tons produced or imported until its definitive banning in 1992) a specific national surveillance system of mesothelioma incident cases is active in Italy, with direct and individual anamnestic etiological investigation. In the period between 1993 and 2004 a case-list of 8,868 pleural MM was recorded by the Italian National Register (ReNaM) and the modalities of exposure to asbestos fibres have been investigated for 6,603 of them. Standardised incidence rates are 3.49 (per 100,000 inhabitants) for men and 1.25 for women, with a wide regional variability. Occupational asbestos exposure was in 69.3% of interviewed subjects (N = 4,577 cases), while 4.4% was due to cohabitation with someone (generally the husband) occupationally exposed, 4.7% by environmental exposure from living near a contamination source and 1.6% during a leisure activity. In the male group 81.5% of interviewed subjects exhibit an occupational exposure. In the exposed workers the median year of first exposure was 1957 and mean latency was 43.7 years. The analysis of exposures by industrial sector focuses on a decreasing trend for those traditionally signalled as "at risk" (asbestos-cement industry, shipbuilding and repair, railway carriages maintenance) and an increasing trend for the building construction sector. The systematic mesothelioma surveillance system is relevant for the prevention of the disease and for supporting an efficient compensation system. The existing experience on all-too-predictable asbestos effects should be transferred to developing countries where asbestos use is spreading.

Breve commento a cura di Antonia Stazi
Solamente in Italia, Francia e Australia esiste un sistema di sorveglianza attivo sui mesoteliomi in cui è previsto che la storia occupazionale di ogni caso sia individualmente rilevata tramite intervista. L’articolo di Marinaccio e collaboratori, oltre a riportare le incidenze nazionali e regionali per il mesotelioma pleurico stimate dal Registro Nazionale (ReNaM) considerando gli 8.868 casi censiti tra il 1993 e il 2004, focalizza l’attenzione proprio sulle esposizioni lavorative e i relativi settori economici coinvolti, così come rilevati dalle intervista dirette o indirette effettuate in oltre il 90% dei casi con accertata esposizione alle fibre di asbesto. Risulta che in totale il 69% dei casi ha avuto una esposizione di tipo occupazionale e tale percentuale sale all’81% negli uomini. Circa un 20% dei casi con esposizione professionale non ne era consapevole. Dal momento che nel nostro paese l’unica forma di risarcimento passa attraverso l’INAIL, c’è da chiedersi se non sia il caso di tutelare, in principio, anche il restate 31% (77% nelle donne) dei casi di mesotelioma pleurico (e di altra sede) non occupazionale, istituendo un fondo per tutte le vittime da asbesto come quello vigente in Francia dal 2000 che non discrimina sul tipo di esposizione. In principio, perché sono solo circa 400 i casi di mesotelioma che hanno avuto un riconoscimento dall’INAIL nel periodo 1994-2006.

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