We knew Fernando D’Ostilio well and we will write about his death in the hospital in Teramo (ten doctors investigated for manslaughter with the autopsy underlining the death due to an alleged infection that arose following some surgical operations) only after the possible indictment. However, we need to raise attention on hospital deaths in Abruzzo and above all in our nation.
Italy boasts a negative record in Europe. First place for deaths linked to infections caused by germs multi-resistant to antibiotics: 11 thousand deaths a year, a third of all deaths. Antibiotic resistance and healthcare-related infections (HAI) have a burden on the NHS, with 2.7 million beds occupied per year. The income statement includes direct costs amounting to approximately 2.4 billion euros. About 8% of hospitalized patients contract an infection of this type. The solution to reduce the impact by at least 30%?
There are two projects presented by Massimo Andreoni, Scientific Director of Simit, the Society of Infectious and Tropical Diseases.
1) Together.
The professor Cristina Mussinivice president of SIMIT summarizes
to make the strategies to combat HAI operational, coordination is needed between institutions, health departments and clinicians; as well as inclusion in national projects; continuous monitoring and a permanent system, since these are constantly evolving phenomena. From these needs was born “Insieme”, a project with which SIMIT proposes itself as an operational arm in the application of the PNCAR, standardizing hospital infection control policies at a national level. Precisely to avoid heterogeneous applications we have set up a group of experts who can promote training, organize checks in hospitals and audits that identify critical issues.”
2) RESISTIM
The RESISTIMIT project (from the portmanteau between RESISTenza and sIMIT) is developed with the aim of creating a network dedicated to monitoring and fighting multi-resistant microorganisms, be they bacteria, fungi or viruses, throughout the Italian territory.
It is conducted under the patronage of the Italian Society of Infectious and Tropical Diseases (SIMIT) and is coordinated by the RESISTIMIT study group of which Prof. Falcone is National Secretary. It also uses data from the ALARICO network (Advancing knowLedge on Antimicrobial Resistant Infections Collaboration Network).
The project was born with the aim of creating a network committed to the fight and understanding of antimicrobial resistance, in particular it is developed as a National Platform involving more than 100 infectious disease specialists for a total of ten pilot centers (Bari, Foggia, Modena , Naples, Padua, Palermo, Perugia, Pisa, Rome, Varese) and then progressively extended to all Italian infectious disease centers.
The spread of multi-resistant pathogens, the onset of new and increasingly complex resistances and the continuous development of new therapeutic molecules requires a multicentric-national approach, which allows us to understand and manage this phenomenon on a large scale.
The RESISTIMIT project is a twenty-year project with the aim of creating a national, dynamic and continuously updated register that allows monitoring the spread of antibiotic resistance at a local, regional and national level and the microbiological and clinical characteristics of these pathogens. Furthermore, it constitutes the basis for the harmonious study at a national level of new antimicrobial drugs, with the aim of obtaining real-life data for a better therapeutic choice that can be used by decision-making bodies (e.g. AIFA).
All centres, beyond the ten pilot centres, who wish to participate in the project can request participation in the project using the following form.
All participating centers can, through our platform:
- Make analysis proposals for specific objectives and possible subpopulations;
- Participate in online and in-person meetings, with a view to better understanding epidemiology and microbiology at a local and national level, as well as contributing to the implementation of the project, taking into account the evidence that will emerge over time.
- Share scientific evidence and benefit from the digital material developed by the project managers and the various participants
The RESISTIMIT group has the role of evaluating the proposals of the Participating Centers and evaluating the feasibility of the proposed analysis. This group is made up of young researchers in Infectious Diseases coming from different Italian epidemiological realities, with established experience in the condition of multicenter observational clinical studies on Italian and international territory and which was established by SIMIT. This group will have the role of coordinating and managing the activities and data analyzes promoted by the group itself.
What is the main prevention tool for hospital infections?
Among the key measures we remember the correct hand washing (which remains one of the most important and effective), the reduction of unnecessary diagnostic and therapeutic procedures, the correct use of antibiotics and disinfectants, the sterilization of devices, compliance with asepsis in invasive procedures, control of the risk of infection environmental, the protection of patients with appropriate use of antibiotic prophylaxis and the administration of recommended vaccinations (when possible with adequate advance to allow a good immune response), the vaccination of healthcare workers, infection surveillance activities, identification and timely control of epidemics, possible isolation from other patients, reinforcement of the measures that must already normally be adopted to avoid transmission between patients. In order to ensure continuous and uniform operations on the national territory regarding hospital infections, 2 circulars from the Ministry of Health have been published in Italy:
- ministerial circular 52/1985 – Fight against hospital infections which recommends the launch of an infection control program in each hospital, which includes the establishment of a multidisciplinary committee, the establishment of an operational group, the provision of dedicated nursing staff. The Regions are entrusted with the task of coordinating activities and strengthening professional training programs
- ministerial circular 8/1988 – Fight against hospital infections: surveillance in which the standardized criteria for the definition and diagnosis of the different sites of hospital infections and the surveillance methods are defined. It recommends using, in addition to laboratory data, “active” surveillance systems.
What is the most common cause of hospital infection?
L’infection nosocomial more frequent And that of the urinary tract, followed by infections of the surgical wound, theinfection of venous access (point where the needle is inserted to administer intravenous therapies), pneumonia (WHO 2012).
Source and Photo Ministry of Health, Quotidiano della Salute, https://www.simit.org/simit/progetto-resistimit
