Publications by authors named "Isabella Marchesi"

23 Publications

  • Page 1 of 1

virucidal efficacy of a dry steam disinfection system against Human Coronavirus, Human Influenza Virus, and Echovirus.

J Occup Environ Hyg 2021 Oct 20:1-6. Epub 2021 Oct 20.

Department of Surgery Medicine Dentistry and Morphological Sciences with an Interest in Transplant Oncology, University of Modena and Reggio Emilia, Modena, Italy.

This study was aimed to assess the efficacy of dry steam in inactivating Human Coronavirus OC43 (HCoV-OC43) as surrogate of SARS-CoV-2, Human Influenza Virus A/H1N1/WSN/33 and Echovirus 7 on stainless steel, polypropylene, and cotton. The virus models were chosen on the basis of their transmission route and environmental resistance. Tests were carried out under a laminar flow cabinet, where two panels of each material were contaminated with a viral suspension. The inocula were left to dry and then the virus on untreated panel (control) was collected by swabbing in order to determine the initial titer. The other panel was treated using a professional vacuum cleaner equipped with a dry steam generator. Dry steam is generated in a boiler where tap water is heated up to 155 °C at 5.5 bar pressure and then during the passage along the flexible hose the temperature decreases to a value between 100 °C and 110 °C at the output. The dry steam was applied for four sec with a window wiper on metal and plastic panels or a brush covered by a microfiber cap on cotton, simulating the steam application during routine cleaning. After the treatment, infectious virus possibly remained on the surface was collected following the same swabbing procedure applied for controls. HCoV-OC43 and Echovirus 7 were titrated by end-point method on HCT-8 line cells and Vero cells, respectively, while Human Influenza Virus was quantified by plaque reduction assay on MDCK cells. Dry steam resulted effective against the three viruses on all tested materials, achieving a mean Log reduction factor ≥4 in viral titer of treated samples compared with controls according to UNI EN 14476:2019. Thus, dry steam may be proposed as an ease to use, effective, fast, and nontoxic alternative to chemicals for surface disinfection without damaging materials. Therefore, this device could be employed not only in healthcare facilities but also in occupational, domestic, and community settings, with advantages for environment and human health.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/15459624.2021.1989442DOI Listing
October 2021

Seroprevalence of anti-SARS-CoV-2 antibodies in the Northern Italy population before the COVID-19 second wave.

Int J Occup Med Environ Health 2021 Aug 27. Epub 2021 Aug 27.

University of Modena and Reggio Emilia, Modena, Italy (Department of Biomedical, Metabolic and Neural Sciences).

Objectives: The COVID-19 pandemic is due to SARS-CoV-2 coronavirus infections. It swept across the world in the spring of 2020, and so far it has caused a huge number of hospitalizations and deaths. In the present study, the authors investigated serum anti-SARS-CoV-2 antibody prevalence in the period of June 1-September 25, 2020, in 7561 subjects in Modena, Northern Italy.

Material And Methods: The study population included 5454 workers referred to testing by their companies, and 2107 residents in the Modena area who accessed testing through self-referral.

Results: The authors found the overall seroprevalence to be 4.7% (95% confidence interval [CI] 4.2-5.2%), which was higher in women (5.4%, 95% CI: 4.5-6.2%) than in men (4.3%, 95% CI: 3.7-4.9%), and in the oldest age groups (7.3%, 95% CI: 5.2-9.3% for persons aged 60-69 years, and 11.8%, 95% CI: 8.6-15.1%, for persons aged ≥70 years). Among the occupational categories, the highest seroprevalence was found in healthcare workers (8.8%, 95% CI: 7.0-10.5%), dealers and vehicle repairers (5.2%, 95% CI: 2.9-7.6%), and workers in the sports sector (4.0%, 95% CI: 1.8-6.1%), while there was little or no such evidence for those employed in sectors such as transport and storage, accommodation and restaurant services, and the school system.

Conclusions: These results have allowed, for the first time, to assess population seroprevalence in this area of Italy severely hit by the epidemic, while at the same time identifying the subgroups at a higher risk of exposure to SARS-CoV-2.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.13075/ijomeh.1896.01826DOI Listing
August 2021

Assessing Undergraduates' Perception of Risks Related to Body Art in Italy: The SUPeRBA Multicenter Cross-Sectional Study.

Int J Environ Res Public Health 2021 09 1;18(17). Epub 2021 Sep 1.

Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", 80133 Naples, Italy.

Tattooing and piercing may lead to health complications. The present multicenter cross-sectional study aimed to assess awareness and knowledge of health risks related to body art and to identify their possible determinants among a large sample of undergraduates in Italy. A web-based questionnaire collecting information on socio-demographic characteristics, awareness, knowledge, and some potential predictors was administered to undergraduates attending twelve Italian universities. The level of knowledge was expressed as the number of correct answers (0-11 for tattooing, 0-14 for piercing). A total of 2985 participants (mean age 23.15 ± 3.99, 73.9% F) participated in the study. Although 95.4% of the respondents were aware of possible health consequences of body art, a low level of specific knowledge was registered for both tattooing (mean number of correct answers 5.38 ± 2.39) and piercing (5.93 ± 3.12) consequences. Lower knowledge was associated with the attendance of non-life science course and with lower duration of academic education for both tattoo and piercing. Lower knowledge of tattooing risks was related with commuter status, while lower knowledge of piercing risks was associated with lower father's education. These findings highlight the need to enhance information campaigns targeted to youths to increase their awareness of possible health risk of body art.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph18179233DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8431427PMC
September 2021

Frequency of Anti-SARS-CoV-2 Antibodies in Various Occupational Sectors in an Industrialized Area of Northern Italy from May to October 2020.

Int J Environ Res Public Health 2021 07 27;18(15). Epub 2021 Jul 27.

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy.

The results of a voluntary screening campaign for the presence of anti-SARS-CoV-2 serum antibodies are presented, performed on workers in the highly industrialized province of Modena in northern Italy in the period 18 May-5 October 2020. The employment activities of the subjects that tested positive for anti-SARS-CoV-2 IgM and/or IgG antibodies were determined and classified using the International Standard Industrial Classification of All Economic Activities (ISIC). The distribution across different sectors was compared to the proportion of workers employed in the same sectors in the province of Modena as a whole. Workers with anti-SARS-CoV-2 serum antibodies were mainly employed in manufacturing (60%), trade (12%), transportation (9%), scientific and technical activities (5%), and arts, entertainment and recreation activities (4.5%). Within the manufacturing sector, a cluster of workers with positive serological tests was observed in the meat processing sector, confirming recent data showing a possible increased risk of SARS-CoV-2 infection in these workers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph18157948DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345498PMC
July 2021

Physical and Sedentary Activities and Childhood Overweight/Obesity: A Cross-Sectional Study among First-Year Children of Primary Schools in Modena, Italy.

Int J Environ Res Public Health 2021 03 20;18(6). Epub 2021 Mar 20.

Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy.

Children obesity is a serious public health issue. This study aimed to investigate physical/sedentary activities of first-year primary schools children in Modena, and their association with overweight/obesity and dietary habits of children and family characteristics to identify the risk factors for unhealthy lifestyles. Child physical/sedentary activities were gathered through an anonymous questionnaire administered to parents, as well as family characteristics and weight/height of child and parents. Logistic regression models, eventually adjusted for parents' sociodemographic characteristics, were used to analyze data. Questionnaires were delivered by 660 families (74.2%), of which 72 without anthropometric data were excluded. Three out of four children spent in physical activities less than 7 h/week, while 63.9% dedicated to sedentary activities two or more hours/day. From multivariate analysis, the habit significantly affecting children's overweight/obesity was spending time on tablets/Personal Computers/mobile phones/videogames. Higher parental education level resulted in a protective factor for implementing unhealthy lifestyles in terms of time dedicated to physical/sedentary activities. Our results suggest the need of interventions to increase time for physical activity and to promote a responsible use of digital media involving the entire families to reach all parents regardless of their education and nationality with a possible relapse on other family members.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph18063221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003752PMC
March 2021

Safety and Effectiveness of Monochloramine Treatment for Disinfecting Hospital Water Networks.

Int J Environ Res Public Health 2020 08 22;17(17). Epub 2020 Aug 22.

Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.

The formation of potentially carcinogenic N-nitrosamines, associated with monochloramine, requires further research due to the growing interest in using this biocide for the secondary disinfection of water in public and private buildings. The aim of our study was to evaluate the possible formation of N-nitrosamines and other toxic disinfection by-products (DBPs) in hospital hot water networks treated with monochloramine. The effectiveness of this biocide in controlling spp. contamination was also verified. For this purpose, four different monochloramine-treated networks, in terms of the duration of treatment and method of biocide injection, were investigated. Untreated hot water, municipal cold water and, limited to N-nitrosamines analysis, hot water treated with chlorine dioxide were analyzed for comparison. spp. contamination was successfully controlled without any formation of N-nitrosamines. No nitrification or formation of the regulated DBPs, such as chlorites and trihalomethanes, occurred in monochloramine-treated water networks. However, a stable formulation of hypochlorite, its frequent replacement with a fresh product, and the routine monitoring of free ammonia are recommended to ensure a proper disinfection. Our study confirms that monochloramine may be proposed as an effective and safe strategy for the continuous disinfection of building plumbing systems, preventing vulnerable individuals from being exposed to legionellae and dangerous DBPs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17176116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503937PMC
August 2020

Characterisation of Microbial Community Associated with Different Disinfection Treatments in Hospital hot Water Networks.

Int J Environ Res Public Health 2020 03 24;17(6). Epub 2020 Mar 24.

Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy.

Many disinfection treatments can be adopted for controlling opportunistic pathogens in hospital water networks in order to reduce infection risk for immunocompromised patients. Each method has limits and strengths and it could determine modifications on bacterial community. The aim of our investigation was to study under real-life conditions the microbial community associated with different chemical (monochloramine, hydrogen peroxide, chlorine dioxide) and non-chemical (hyperthermia) treatments, continuously applied since many years in four hot water networks of the same hospital. Municipal cold water, untreated secondary, and treated hot water were analysed for microbiome characterization by 16S amplicon sequencing. Cold waters had a common microbial profile at genera level. The hot water bacterial profiles differed according to treatment. Our results confirm the effectiveness of disinfection strategies in our hospital for controlling potential pathogens such as , as the investigated genera containing opportunistic pathogens were absent or had relative abundances ≤1%, except for non-tuberculous mycobacteria, , and . Monitoring the microbial complexity of healthcare water networks through 16S amplicon sequencing is an innovative and effective approach useful for Public Health purpose in order to verify possible modifications of microbiota associated with disinfection treatments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17062158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143765PMC
March 2020

The relevance of molecular genotyping to allocate cases in a suspected outbreak of Legionella pneumonia in patients with prolonged immunosuppressive therapy.

Int J Infect Dis 2020 Feb 7;91:174-176. Epub 2019 Nov 7.

Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy.

Three cases of pneumonia caused by Legionella pneumophila serogroup 1 (Lp1) in immunosuppressed patients with repeated hospitalization were suspected as a healthcare-associated cluster. The environmental investigation did not reveal the presence of legionellae in the hospital patient rooms. Water samples collected from the homes of two patients were also negative for Legionella spp. In the absence of environmental strains potentially involved in the infections, we proceeded to genotype environmental Lp1 strains isolated in the hospital during routine water sampling during the decade 2009-2019 and recovered after long-term storage at -20°C. These 'historical' strains exhibited a high grade of similarity and stability over time, regardless of the disinfection systems. The different molecular profiles shown among the clinical and environmental strains excluded a nosocomial outbreak. The study suggests that the application of molecular typing may be a useful tool to discriminate hospital vs community-acquired cases, mostly for severely immunosuppressed patients in whom the symptomatology could be insidious and the incubation period could be prolonged. Moreover, the genotyping allowed us to exclude any link between the cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijid.2019.11.002DOI Listing
February 2020

Trace elements in starter infant formula: dietary intake and safety assessment.

Environ Sci Pollut Res Int 2018 Jan 28;25(3):2035-2044. Epub 2016 Dec 28.

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, I-41125, Modena, Italy.

The aim of this study was to investigate the concentrations of five essential (Fe, Mn, Zn, Cu and Se) and four non-essential/toxic elements (Cr, Cd, Ni and Pb) in 35 different starter infant formulas (0-6 months) sold in Italy. In addition, a safety assessment of these trace elements was carried out, by comparing the estimated daily intake (EDI) with the adequate intake (AI) and the provisional tolerable daily intake (PTDI), with a view to provide information on the metal distribution patterns and health risk to infants arising from the consumption of these products. The concentrations were determined by using inductively coupled plasma mass spectrometry after microwave digestion. The concentrations expressed in geometric mean ± geometric standard deviation of Fe (6.17 ± 1.61 mg/L), Zn (6.21 ± 1.31 mg/L), Cu (416.4 ± 1.21 μg/L), Mn (121.5 ± 1.85 μg/L) and Se (13.27 ± 1.67 μg/L) were within legal limits. In spite of this, the mean EDIs of Fe (4.81 mg/day) and Mn (94.75 μg/day) were many times higher than the recommended AI, especially for Mn. Chromium, Ni, Cd and Pb concentrations were not detectable in 11, 37, 57 and 66% of the samples, respectively. Considering the overall sample, the GM ± GSD of these elements were 4.80 ± 5.35 μg/L for Cr, 1.02 ± 11.65 μg/L for Ni, 0.21 ± 14.83 μg/L for Cd and 0.14 ± 17.13 μg/L for Pb. The mean EDIs were far below the respective PTDI. When the safety assessment was based on the 75° percentile level of each elements, all EDIs remained well below the PTDI, with the exception of Cd, whose EDI approached (74.7%), albeit remaining below the PTDI. In conclusion, our results and the increased awareness on the potential risks of excessive Mn and Fe for infants support that an urgent scientific-based definition of the appropriated levels of fortification in formulas is required. Moreover, regular monitoring of all the stages of production of infant formulas is essential in order to limit toxic metal contamination.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11356-016-8290-9DOI Listing
January 2018

Control of Legionella Contamination and Risk of Corrosion in Hospital Water Networks following Various Disinfection Procedures.

Appl Environ Microbiol 2016 05 2;82(10):2959-2965. Epub 2016 May 2.

University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neurosciences, Section of Public Health, Modena, Italy.

Physical and chemical disinfection methods have been proposed with the aim of controlling Legionella water contamination. To date, the most effective procedures for reducing bacterial contamination have not yet been defined. The aim of this study was to assess the long-term effectiveness of various disinfection procedures in order to reduce both culturable and nonculturable (NC) legionellae in different hospital water networks treated with heat, chlorine dioxide, monochloramine, and hydrogen peroxide. The temperature levels and biocide concentrations that proved to give reliable results were analyzed. In order to study the possible effects on the water pipes, we verified the extent of corrosion on experimental coupons after applying each method for 6 months. The percentage of positive points was at its lowest after treatment with monochloramine, followed by chlorine dioxide, hydrogen peroxide, and hyperthermia. Different selections of Legionella spp. were observed, as networks treated with chlorine-based disinfectants were contaminated mainly by Legionella pneumophila serogroup 1, hyperthermia was associated with serogroups 2 to 14, and hydrogen peroxide treatment was associated mainly with non-pneumophila species. NC cells were detected only in heat-treated waters, and also when the temperature was approximately 60°C. The corrosion rates of the coupons were within a satisfactory limit for water networks, but the morphologies differed. We confirm here that chemical disinfection controls Legionella colonization more effectively than hyperthermia does. Monochloramine was the most effective treatment, while hydrogen peroxide may be a promising alternative to chlorine-based disinfectants due to its ability to select for other, less virulent or nonpathogenic species.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1128/AEM.03873-15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959080PMC
May 2016

Aetiology, source and prevention of waterborne healthcare-associated infections: a review.

J Med Microbiol 2014 Oct 7;63(Pt 10):1247-1259. Epub 2014 Aug 7.

Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.

The purpose of this review is to discuss the scientific literature on waterborne healthcare-associated infections (HCAIs) published from 1990 to 2012. The review focuses on aquatic bacteria and describes both outbreaks and single cases in relation to patient characteristics, the settings and contaminated sources. An overview of diagnostic methods and environmental investigations is summarized in order to provide guidance for future case investigations. Lastly, on the basis of the prevention and control measures adopted, information and recommendations are given. A total of 125 reports were included, 41 describing hospitalized children. All cases were sustained by opportunistic pathogens, mainly Legionellaceae, Pseudomonadaceae and Burkholderiaceae. Hot-water distribution systems were the primary source of legionnaires' disease, bottled water was mainly colonized by Pseudomonaceae, and Burkholderiaceae were the leading cause of distilled and sterile water contamination. The intensive care unit was the most frequently involved setting, but patient characteristics were the main risk factor, independent of the ward. As it is difficult to avoid water contamination by microbes and disinfection treatments may be insufficient to control the risk of infection, a proactive preventive plan should be put in place. Nursing staff should pay special attention to children and immunosuppressed patients in terms of tap-water exposure and also their personal hygiene, and should regularly use sterile water for rinsing/cleaning devices.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1099/jmm.0.075713-0DOI Listing
October 2014

Monochloramine and chlorine dioxide for controlling Legionella pneumophila contamination: biocide levels and disinfection by-product formation in hospital water networks.

J Water Health 2013 Dec;11(4):738-47

Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Via Campi 287, I-41125 Modena, Italy E-mail:

Legionella colonization in hospital hot water distribution networks was evaluated following 36 months of continuous treatment with monochloramine and compared with chlorine dioxide. Nitrite, nitrate, chlorite, chlorate, bromide, trihalomethanes and haloacetic acids as well as the biocide concentration at sampled points were measured. Only 8/84 samples treated with monochloramine were found contaminated and after the first 8 months of treatment no Legionella was isolated. Chlorine dioxide was associated with a strong reduction in Legionella contamination compared to pre-treatment, but differences according to the device were observed. Monochloramine between 2 and 3 mg l(-1) and chlorine dioxide between 0.50 and 0.70 mg l(-1) were needed to control Legionella colonization. Comparing no- and post-flush samples, a higher frequency of no-flush positive samples was noted using chlorine dioxide, suggesting an increased risk for patients when they open the tap. No increase in chlorite levels and no water nitrification occurred by using monochloramine. Chlorite at levels exceeding the limit requested for drinking water was measured when chlorine dioxide was applied. In conclusion, we highlight that continuous injection of monochloramine should be considered as an effective alternative to chlorine dioxide in controlling legionellae contamination inside hospital water distribution systems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2166/wh.2013.079DOI Listing
December 2013

A culture-proven case of community-acquired legionella pneumonia apparently classified as nosocomial: diagnostic and public health implications.

Case Rep Med 2013 11;2013:303712. Epub 2013 Feb 11.

Department of Clinical, Diagnostic and Public Health Medicine, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.

We report a case of Legionella pneumonia in a 78-year-old patient affected by cerebellar haemangioblastoma continuously hospitalised for 24 days prior to the onset of overt symptoms. According to the established case definition, this woman should have been definitely classified as a nosocomial case (patient spending all of the ten days in hospital before onset of symptoms). Water samples from the oncology ward were negative, notably the patient's room and the oxygen bubbler, and the revision of the case history induced us to verify possible contamination in water samples collected at home. We found that the clinical strain had identical rep-PCR fingerprint of L. pneumophila serogroup 1 isolated at home. The description of this culture-proven case of Legionnaires' disease has major clinical, legal, and public health consequences as the complexity of hospitalised patients poses limitations to the rule-of-thumb surveillance definition of nosocomial pneumonia based on 2-10-day incubation period.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2013/303712DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3582109PMC
March 2013

[Hand hygiene of medical and nursing students during clinica rotations: a pilot study on knowledge, attitudes and impact on bacterial contamination].

Assist Inferm Ric 2012 Jul-Sep;31(3):123-30

Dipartimento di Scienze di Sanitá Pubblica, Università degli Studi di Mondena e Reggio Emilia.

Unlabelled: Hand hygiene in nursing and medical students during training: a pilot study on knowledge, practices and impact on bacterial contamination.

Introduction: Despite exhaustive guidelines on hand hygiene (HH), compliance in health care professionals is reported to be low. In order to improve adherence with HH, interventions on students' education should be effective.

Aim: To describe the knowledge, behavior and hand hygiene (HH) practices in nursing and medical students. The results of the pilot study are presented.

Methods: A questionnaire designed to investigate knowledge on HH and its practical implementation was administered to a sample of 50 nursing and 50 medical students. Data collected were associated with hand contamination measured at the beginning and at the end of the training shift.

Results: All nursing students performed HH with a significantly higher frequency compared to medical students. At the end of training, total bacterial counts were significantly reduced in both groups, but more in nursing students. Total bacterial count increased in absence of hygienic practices and the most effective procedure was the alternate use of conventional hand washing and alcohol-based hands rubs. The knowledge of both groups was adequate, although some differences were observed.

Conclusions: At the beginning of their course, nursing students are educated to correct practices that implement during practical training. Medical students receive information on HH later in their education and pay less attention to these aspects, also due to the limited number of physical contacts with patients. Thus, the contents on HH should be anticipated before the start of the training activity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1702/1176.13038DOI Listing
January 2013

Protozoa and human macrophages infection by Legionella pneumophila environmental strains belonging to different serogroups.

Arch Microbiol 2013 Feb 8;195(2):89-96. Epub 2012 Nov 8.

Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.

Three Legionella pneumophila strains isolated from municipal hot tap water during a multicentric Italian survey and belonging to serogroups 1, 6, 9 and the reference strain Philadelphia-1 were studied to determine the intracellular replication capability and the cytopathogenicity in human monocyte cell line U937 and in an Acanthamoeba polyphaga strain. Our results show that both serogroups 1 and Philadelphia-1 were able to multiply into macrophages inducing cytopathogenicity, while serogroup 6 and ever more serogroup 9 were less efficient in leading to death of the infected macrophages. Both serogroups 1 and 6 displayed a quite good capability of intracellular replication in A. polyphaga, although serogroup 1 was less cytopathogenic than serogroup 6. Serogroup 9, like Philadelphia-1 strain, showed a reduced efficiency of infection and replication and a low cytopathogenicity towards the protozoan. Our study suggests that bacterial pathogenesis is linked to the difference in the virulence expression of L. pneumophila serogroups in both hosts, as demonstrated by the fact that only L. pneumophila serogroup 1 shows the contextual expression of the two virulence traits. Serogroup 6 proves to be a good candidate as pathogen since it shows a good capacity for intracellular replication in protozoan.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00203-012-0851-9DOI Listing
February 2013

Control of Legionella contamination in a hospital water distribution system by monochloramine.

Am J Infect Control 2012 Apr 8;40(3):279-81. Epub 2011 Jul 8.

Department of Public Health Sciences, University of Modena and Reggio Emilia, Italy.

Background: We report the results of 1-year application of monochloramine to control Legionella pneumophila contamination in a hospital hot water distribution system.

Methods: In the main building of the hospital, a device continuously distributing monochloramine was installed. Legionella pneumophila and Pseudomonas spp contamination was followed in comparison with 2 other water networks in the same building using chlorine dioxide.

Results: Monochloramine significantly reduced the number of contaminated sites compared with baseline (from 97.0% to 13.3%, respectively), chlorine dioxide device I (from 100% to 56.7%, respectively), and device II (from 100% to 60.8%, respectively). No positive sample exceeded 10(4) colony-forming units/L versus 59.4% at baseline.

Conclusion: Monochloramine could represent a good alternative to chlorine dioxide in controlling legionellae contamination in public and private buildings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajic.2011.03.008DOI Listing
April 2012

Parameters predictive of Legionella contamination in hot water systems: association with trace elements and heterotrophic plate counts.

Water Res 2011 Mar 20;45(6):2315-21. Epub 2011 Jan 20.

Department of Public Health Sciences, University of Modena and Reggio Emilia, Via Campi 287, I-41125 Modena, Italy.

The contamination of hot water samples with Legionella spp. was studied in relation to temperature, total hardness, trace element concentrations (iron, zinc, manganese, and copper) and heterotrophic plate counts (HPC) at both 22 and 37 °C. Factor analysis and receiver operating characteristic (ROC) curves were used to establish the cut-off of water parameters as predictors for Legionella contamination. Legionella spp. was isolated in 194 out of 408 samples (47.5%), with Legionella pneumophila being the most common (92.8%). After multiple logistic regression analysis, the risk for legionellae colonisation was positively associated with Mn levels >6 μg l(-1), HPC at 22 °C >27 CFU l(-1), and negatively with temperature >55 °C and Cu levels >50 μg l(-1). Multiple regression analysis revealed that Legionella spp. counts were positively associated with Mn, HPC at 37 °C and Zn and negatively associated with temperature. Only 1 out of the 97 samples (1%) having a Mn concentration, an HPC at 22 °C and an HPC at 37 °C below the respective median values exhibited a Legionella spp. concentration exceeding 10(4) CFU l(-1)vs. 41 out of the 89 samples (46.1%) with the three parameters above the medians. Our results show a qualitative and quantitative relationship between Legionella spp., the Mn concentration and heterotrophic plate counts in hot water samples from different buildings, suggesting that these parameters should be included in a water safety plan. The role of manganese in biofilm formation and its possible involvement in the mechanisms favouring Legionella survival and growth in water niches should be investigated further.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.watres.2011.01.009DOI Listing
March 2011

Selenium interactions with essential and toxic elements in egg yolk from commercial and fortified eggs.

J Trace Elem Med Biol 2008 5;22(3):234-41. Epub 2008 Jun 5.

Department of Public Health Sciences, University of Modena and Reggio Emilia, Modena, Italy.

The main objective of this work was to evaluate the interaction between selenium concentration in both commercial and Se-enriched eggs and other essential/toxic elements (Ca, Mg, Fe, Zn, Pb, and Cd), taking into account a possible synergic action of iodine. Commercial eggs were purchased from several sale points or directly from the producers (farmyard eggs). Fortified eggs were obtained by supplementing chickenfeed for 6 weeks with Se as sodium selenite (1.0 microg/g Se) or Se plus iodine (1.0 microg/g Se+3.7 microg/g I). Se in experimental egg yolks significantly increased over the basic value by 39% in the Se group and 61% in the Se+I group, suggesting that I addition may enhance Se absorption. Levels of Se in commercial yolks were identical in free-range, barn or battery eggs, but significantly lower in farmyard and higher in organic eggs where the Se content approximated that found in Se fortified eggs. A significant reduction in Cd was observed in Se+I treated yolks compared to both control and Se alone diet, thus suggesting a high sensitivity of Cd to the detoxifying effect of Se combined with I. Furthermore, Se+I supplementation was associated with a significant Zn reduction, a finding which needs clarification to avoid attempts to maximize one component affecting the levels of other essential elements.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jtemb.2008.03.004DOI Listing
February 2009

Epidemiological investigation on a suggestive case of Legionella pneumonia and public health implications.

Scand J Infect Dis 2006 ;38(8):725-8

Department of Public Health Sciences, University of Modena and Reggio E, Modena, Italy.

We report a case of Legionella pneumonia in a patient with psoriasis. The clinical strain had an identical PFGE pattern of 1 subtype of L. pneumophila serogroup 1 isolated at low concentration in a sporting club bath. Diagnostic, clinical and epidemiological aspects are discussed for their relevant public health implications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/00365540500488881DOI Listing
October 2006

Water ecology of Legionella and protozoan: environmental and public health perspectives.

Biotechnol Annu Rev 2005 ;11:355-80

Department of Hygiene and Microbiology, University of Modena and Reggio Emilia, Via Campi 287, 41100 Modena, Italy.

Ecological studies on Legionella spp. are essential to better understand their sources in the natural environments, the mechanism of their entry into man-made water systems and the factors enabling their survival and growth in aquatic habitats. Legionella spp. exhibits peculiar and multiple strategies to adapt to stressful environment conditions which normally impair other germ survival. These strategies include the ability to enter in a viable but non-cultivable (VBNC) state, to multiply intracellularly within a variety of protozoa, such as amoebae, to survive as free organisms within biofilms and to be enhanced/inhibited by the presence of other aquatic bacteria. The host-parasite interaction has been shown to be central in the pathogenesis and ecology of L. pneumophila. The bacterial-protozoan interaction contributes to the amplification of Legionella population in water systems, represents a shelter against unfavourable environmental conditions, acts as a reservoir of infection and contributes to virulence by priming the pathogen to infect human cells. Legionella is able to survive as free organism for long periods within biofilms which are widespread in man-made water systems. Biofilm provides shelter and nutrients, exhibits a remarkable resistance to biocide compounds and chlorination, thus representing ecological niches for legionella persistence in such environments. Further knowledge on biofilm-associated legionellae may lead to effective control measures to prevent legionellosis. Lastly, new perspectives in controlling legionella contamination can arise from investigations on aquatic bacteria able to inhibit legionella growth in natural and artificial water systems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S1387-2656(05)11011-4DOI Listing
July 2006

Legionella contamination in hot water of Italian hotels.

Appl Environ Microbiol 2005 Oct;71(10):5805-13

Department of Hygiene and Microbiology, Via Campi, 287, I-41100 Modena, Italy.

A cross-sectional multicenter survey of Italian hotels was conducted to investigate Legionella spp. contamination of hot water. Chemical parameters (hardness, free chlorine concentration, and trace element concentrations), water systems, and building characteristics were evaluated to study risk factors for colonization. The hot water systems of Italian hotels were strongly colonized by Legionella; 75% of the buildings examined and 60% of the water samples were contaminated, mainly at levels of > or =10(3) CFU liter(-1), and Legionella pneumophila was the most frequently isolated species (87%). L. pneumophila serogroup 1 was isolated from 45.8% of the contaminated sites and from 32.5% of the hotels examined. When a multivariate logistic model was used, only hotel age was associated with contamination, but the risk factors differed depending on the contaminating species and serogroup. Soft water with higher chlorine levels and higher temperatures were associated with L. pneumophila serogroup 1 colonization, whereas the opposite was observed for serogroups 2 to 14. In conclusion, Italian hotels, particularly those located in old buildings, represent a major source of risk for Legionnaires' disease due to the high frequency of Legionella contamination, high germ concentration, and major L. pneumophila serogroup 1 colonization. The possible role of chlorine in favoring the survival of Legionella species is discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1128/AEM.71.10.5805-5813.2005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1265926PMC
October 2005

Legionella infection risk from domestic hot water.

Emerg Infect Dis 2004 Mar;10(3):457-64

Dipartamento di Scienze Igienistiche, Microbiologiche e Biostatistiche, University of Modena and Reggio E., Via Campi 287, I-41100 Modena, Italy.

We investigated Legionella and Pseudomonas contamination of hot water in a cross-sectional multicentric survey in Italy. Chemical parameters (hardness, free chlorine, and trace elements) were determined. Legionella spp. were detected in 33 (22.6%) and Pseudomonas spp. in 56 (38.4%) of 146 samples. Some factors associated with Legionella contamination were heater type, tank distance and capacity, water plant age, and mineral content. Pseudomonas presence was influenced by water source, hardness, free chlorine, and temperature. Legionella contamination was associated with a centralized heater, distance from the heater point >10 m, and a water plant >10 years old. Furthermore, zinc levels of <100 microg/L and copper levels of >50 microg/L appeared to be protective against Legionella colonization [corrected]. Legionella species and serogroups were differently distributed according to heater type, water temperature, and free chlorine, suggesting that Legionella strains may have a different sensibility and resistance to environmental factors and different ecologic niches.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322798PMC
http://dx.doi.org/10.3201/eid1003.020707DOI Listing
March 2004

Relationship between mineral content of domestic hot water and microbial contamination.

J Trace Elem Med Biol 2003 ;17 Suppl 1:37-43

Department of Hygiene, Microbiology and Biostatistics, University of Modena, Modena, Italy.

The relationship between Legionella and Pseudomonas spp contamination and mineral content of domestic hot waters was investigated in a cross-sectional Italian survey. Pseudomonas spp contamination was associated with elevated Ca, but lower Fe and free chlorine content in the water. Waters with Cu concentrations > 50 microg/L prevented Legionella spp colonisation (OR = 0.14, 95% CI = 0.02-1.13), whereas the risk of legionellae occurrence increased in waters with Mn levels > 3 microg/L (OR = 2.37, 95% CI = 1.06-5.30). Furthermore, Mn was positively associated with the risk of colonisation by eterotrophic bacteria growing at either 22 and 36 degrees C. Legionella species and serogroups were differently distributed according to Cu and Mn concentrations, suggesting that Legionella strains may have a different sensibility/resistance to trace elements. A specific action of Cu as decontamination factor is suggested and the consideration of Mn as a risk indicator for bacterial colonisation and biofilm presence is proposed.
View Article and Find Full Text PDF

Download full-text PDF

Source
July 2004
-->