The Genetic Origin of Daunians and the Pan-Mediterranean Southern Italian Iron Age Context.

The geographical location and shape of Apulia, a narrow land stretching out in the sea at the South of Italy, made this region a Mediterranean crossroads connecting Western Europe and the Balkans. Such movements culminated at the beginning of the Iron Age with the Iapygian civilization which consisted of three cultures: Peucetians, Messapians, and Daunians. Among them, the Daunians left a peculiar cultural heritage, with one-of-a-kind stelae and pottery, but, despite the extensive archaeological literature, their origin has been lost to time. In order to shed light on this and to provide a genetic picture of Iron Age Southern Italy, we collected and sequenced human remains from three archaeological sites geographically located in Northern Apulia (the area historically inhabited by Daunians) and radiocarbon dated between 1157 and 275 calBCE. We find that Iron Age Apulian samples are still distant from the genetic variability of modern-day Apulians, they show a degree of genetic heterogeneity comparable with the cosmopolitan Republican and Imperial Roman civilization, even though a few kilometers and centuries separate them, and they are well inserted into the Iron Age Pan-Mediterranean genetic landscape. Our study provides for the first time a window on the genetic make-up of pre-Roman Apulia, whose increasing connectivity within the Mediterranean landscape, would have contributed to laying the foundation for modern genetic variability. In this light, the genetic profile of Daunians may be compatible with an at least partial autochthonous origin, with plausible contributions from the Balkan peninsula.

Epidemiological and molecular updates on hookworm species in dogs from southern Italy.

BACKGROUND: The zoonotic hookworms Ancylostoma caninum and Uncinaria stenocephala are widespread soil-transmitted helminths in dogs in Europe. Given the veterinary and public health importance of hookworms in dogs and the recent changes in the molecular epidemiology of some species, there is a need to continuously monitor the epidemiological and molecular prevalence of these parasites also at the "local" level. The present study aimed to update the epidemiological scenario of hookworm infections in both owned and stray dogs in southern Italy and to discriminate between different hookworm species (A. caninum and U. stenocephala) through molecular analyses. For this purpose, a retrospective analysis was performed over 10 years (2011-2021), including a total of 7008 owned dogs and 5642 stray dogs referred to our laboratory for copromicroscopic examinations. Moreover, 72 faecal samples, from dogs naturally infected by hookworms, were used to discriminate between A. caninum and U. stenocephala using two PCR protocols. Prior to molecular analyses, a subsample of 40/72 positive faecal samples was used for morphometric investigations on hookworm eggs. RESULTS: The results of the ten-year retrospective analysis (2011-2021) showed an overall prevalence of hookworm infection of 9.16%, specifically 5.1% in owned dogs and 14.2% in stray dogs. Logistic regression showed a significant association between positivity to hookworms and the variable "puppies" both in stray (13.84%; OR = 2.4) and owned (7.07%; OR = 2.2) dogs. The results of molecular analyses showed that positivity was confirmed only in 21/72 samples, specifically, 6 samples using protocol A and 19 with protocol B. Sequencing revealed 15 samples positive to U. stenocephala and 6 to A. caninum. CONCLUSIONS: The findings of this study showed a high prevalence of hookworm infections in dogs in southern Italy, updating the epidemiological scenario of the last decade. Moreover, the results of the study revealed the first identification of hookworm species in dogs in Italy by molecular studies, highlighting that U. stenocephala is more prevalent than A. caninum.

Management of differentiated thyroid cancer through nuclear medicine facilities during Covid-19 emergency: the telemedicine challenge.

PURPOSE: To investigate whether a telemedicine service (TMS) carried out during the Covid-19 pandemic impacted on management of patients with differentiated thyroid cancer (DTC). METHODS: We retrospectively reviewed the number and the findings of outpatient visits in DTC subjects referred between March 11, 2020, and May 31, 2020, during the Covid-19 pandemic at the Radiometabolic Unit of the University of Naples Federico II. Office visits scheduled in March and May 2020 were converted in teleconsultation reaching all patients planned for an in-ward access to advise them to use the TMS for all clinical necessity. The number and the findings of DTC patients evaluated by in-ward access in the corresponding period of 2019 were also assessed for direct comparison. RESULTS: The number of outpatient visits performed by TMS during the pandemic (n = 445) and by in-ward access in the corresponding period of 2019 (n = 525) was comparable with only 15% of outpatient evaluations missed. CONCLUSIONS: Our findings demonstrate the utility of telemedicine tools to avoid the potential negative impact of interruption or postponement of diagnostic and/or therapeutic procedures. Therefore, investments in medical network system development, including the implementation of telehealth approaches, should be encouraged at national and international levels.

Effects of the COVID-19 pandemic on myocardial perfusion imaging for ischemic heart disease.

PURPOSE: We assessed the effects of the COVID-19 pandemic on myocardial perfusion imaging (MPI) for ischemic heart disease during the lockdown imposed by the Italian Government. METHODS: We retrospectively reviewed the number and the findings of stress single-photon emission computed tomography (SPECT)-MPI performed between February and May 2020 during the COVID-19 pandemic at the University of Napoli Federico II. The number and the findings of stress SPECT-MPI studies acquired in the corresponding months of the years 2017, 2018, and 2019 were also evaluated for direct comparison. RESULTS: The number of stress SPECT-MPI studies performed during the COVID-19 pandemic (n = 123) was significantly lower (P < 0.0001) compared with the mean yearly number of procedures performed in the corresponding months of the years 2017, 2018, and 2019 (n = 413). Yet, the percentage of abnormal stress SPECT-MPI studies was similar (P = 0.65) during the pandemic (36%) compared with the mean percentage value of the corresponding period of the years 2017, 2018, and 2019 (34%). CONCLUSION: The number of stress SPECT-MPI studies was significantly reduced during the COVID-19 pandemic compared with the corresponding months of the previous 3 years. The lack of difference in the prevalence of abnormal SPECT-MPI studies between the two study periods strongly suggests that many patients with potentially abnormal imaging test have been missed during the pandemic.

Hepatitis C virus infection and risk of liver-related and non-liver-related deaths: a population-based cohort study in Naples, southern Italy.

BACKGROUND: Hepatitis C virus (HCV) infection represents a global health issue with severe implications on morbidity and mortality. This study aimed to evaluate the impact of HCV infection on all-cause, liver-related, and non-liver-related mortality in a population living in an area with a high prevalence of HCV infection before the advent of Direct-Acting Antiviral (DAA) therapies, and to identify factors associated with cause-specific mortality among HCV-infected individuals. METHODS: We conducted a cohort study on 4492 individuals enrolled between 2003 and 2006 in a population-based seroprevalence survey on viral hepatitis infections in the province of Naples, southern Italy. Study participants provided serum for antibodies to HCV (anti-HCV) and HCV RNA testing. Information on vital status to December 2017 and cause of death were retrieved through record-linkage with the mortality database. Hazard ratios (HRs) for cause-specific mortality and 95% confidence intervals (CIs) were estimated using Fine-Grey regression models. RESULTS: Out of 626 deceased people, 20 (3.2%) died from non-natural causes, 56 (8.9%) from liver-related conditions, 550 (87.9%) from non-liver-related causes. Anti-HCV positive people were at higher risk of death from all causes (HR = 1.38, 95% CI: 1.12-1.70) and liver-related causes (HR = 5.90, 95% CI: 3.00-11.59) than anti-HCV negative ones. Individuals with chronic HCV infection reported an elevated risk of death due to liver-related conditions (HR = 6.61, 95% CI: 3.29-13.27) and to any cause (HR = 1.51, 95% CI: 1.18-1.94). The death risk of anti-HCV seropositive people with negative HCV RNA was similar to that of anti-HCV seronegative ones. Among anti-HCV positive people, liver-related mortality was associated with a high FIB-4 index score (HR = 39.96, 95% CI: 4.73-337.54). CONCLUSIONS: These findings show the detrimental impact of HCV infection on all-cause mortality and, particularly, liver-related mortality. This effect emerged among individuals with chronic infection while those with cleared infection had the same risk of uninfected ones. These results underline the need to identify through screening all people with chronic HCV infection notably in areas with a high prevalence of HCV infection, and promptly provide them with DAAs treatment to achieve progressive HCV elimination and reduce HCV-related mortality.

Environmental assessment of interventions to restrain the impact of industrial pollution using a quasi-experimental design: limitations of the interventions and recommendations for public health policy.

BACKGROUND: In an industrial area, the asymmetry between the weights of the economic interests compared to the public-health needs can determine which interests are represented in decision-making processes. This might lead to partial interventions, whose impacts are not always evaluated. This study focuses on two interventions implemented in Taranto, Italy, a city hosting one of the largest steel plants in Europe. The first intervention deals with measures industrial plants must implement by law to reduce emissions during so called "wind days" in order to reduce PM10 and benzo [a] pyrene concentrations. The second one is a warning to the population with recommendations to aerate indoor spaces from 12 pm to 6 pm, when pollutant concentrations are believed to be lower. METHODS: To analyse the impact of the first intervention, we analysed monthly PM10 data in the period 2009-2016 from two monitoring stations and conducted an interrupted-time-series analysis. Coefficients of time-based covariates are estimated in the regression model. To minimise potential confounding, monthly concentrations of PM10 in a neighbourhood 13 km away from the steel plant were used as a control series. To evaluate the second intervention, hourly concentrations of PM10, SO2 and polycyclic-aromatic-hydrocarbons (PAHs) were analysed. RESULTS: PM10 concentrations in the intervention neighbourhood showed a peak just a few months before the introduction of the law. When compared to the control series, PM10 concentrations were constantly higher throughout the entire study period. After the intervention, there was a reduction in the difference between the two time-series (- 25.6%). During "wind days" results suggested no reduction in concentrations of air pollutants from 12 pm to 18 pm. CONCLUSION: Results of our study suggest revising the warning to the population. Furthermore, they evidence that in complex highly industrialised areas, air quality interventions cannot focus on only a single pollutant, but rather should consider the complex relationships between the different contaminants. Environmental interventions should be reviewed periodically, particularly when they have implications for social constraints. While the results of our study can be related only to the specific situation reported in the article, the methodology applied might be useful for the environmental management in industrial areas with similar features.

FDG-PET/CT imaging during the Covid-19 emergency: a southern Italian perspective.

PURPOSE: To assess the impact of the Covid-19 pandemic on FDG-PET/CT work volume and to evaluate the occurrence of abnormal imaging findings suspicious or potentially diagnostic for interstitial pneumonia by Covid-19 infection in south Italy. METHODS: We retrospectively reviewed the number and the findings of FDG-PET/CT studies acquired between February and April 2020 during the Covid-19 pandemic at the University of Napoli Federico II. The number and the findings of FDG-PET/CT studies acquired in the corresponding period of 2019 were also assessed for direct comparison. RESULTS: The number of FDG-PET/CT studies performed during the pandemic (n = 299) and in the corresponding period of 2019 (n = 335) were comparable. The percentage of abnormal FDG-PET/CT findings, suspicious for interstitial pneumonia by Covid-19 infection, was significantly higher during the pandemic (9%) compared with that found in the corresponding period of 2019 (4%) (χ2 5.45, P = 0.02). No significant differences were observed in the distribution of Covid-19 reporting and data system (CO-RADS) classification and in the maximum standardized uptake value between the pandemic (2.6 ± 2.2) and the corresponding period of 2019 (3.2 ± 1.4). Of note, patients with abnormal imaging findings during the pandemic time had clinical data and/or laboratory tests negative for Covid-19 infection. CONCLUSION: Despite the restrictive medical measures for the emergency, the number of FDG-PET/CT studies was unchanged during the pandemic compared with the previous year. Our findings also indicate that Covid-19 infection was contained in our series of patients from southern Italy.

Prevalence, molecular epidemiology, and antimicrobial resistance of methicillin-resistant Staphylococcus aureus from swine in southern Italy.

BACKGROUND: Colonization by livestock-associated MRSA (LA-MRSA) has increasingly been reported in the swine population worldwide. The aim of this study was to assess the prevalence of MRSA nasal carriage in healthy pigs, including the black (Calabrese) breed, from farms in the Calabria Region (Southern Italy). Between January and March 2018, a total of 475 healthy pigs reared in 32 farms were sampled by nasal swabbing. MRSA isolates were characterized by spa, MLST and SCCmec typing, and susceptibility testing to 17 antimicrobials. RESULTS: 22 of 32 (66.8%) pig farms resulted positive for MRSA. The prevalence of MRSA was 46.1% (219 MRSA culture-positive out of 475 samples). MRSA colonization was significantly higher in intensive farms and in pigs with a recent or ongoing antimicrobial treatment. All 219 MRSA isolates were assigned to ST398. The most common spa types were t011 (37.0%), t034 (22.4%) and t899 (15.1%). A novel spa type (t18290) was detected in one isolate. An insertion of IS256 in the ST398-specific A07 fragment of the SAPIG2195 gene was detected in 10 out of 81 t011 isolates. Nearly all isolates carried the SCCmec type V element, except 11 isolates that carried the SCCmec type IVc. None of the isolates was positive for the Panton-Valentine leukocidin. All isolates were resistant to tetracycline. High resistance rates were also found for clindamycin (93.1%), trimethoprim/sulfamethoxazole (68.4%), fluoroquinolones (47.9-65.3%) and erythromycin (46.1%). None of the isolates was resistant to vancomycin and fusidic acid. Overall, a multidrug resistant phenotype was observed in 88.6% of isolates. CONCLUSIONS: We report a high prevalence of MRSA among healthy swine in Southern Italy farms, with higher isolation frequency associated with intensive farming. The epidemiological types identified in our study reflect those reported in other European countries. Our findings underscore the importance of monitoring the evolution of LA-MRSA in pig farms in order to implement control measures and reduce the risk of spread in the animal population.

Asbestos exposure and malignant mesothelioma of the tunica vaginalis testis: a systematic review and the experience of the Apulia (southern Italy) mesothelioma register.

BACKGROUND: Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is a rare disease with a poor prognosis. The diagnosis and management of these lesions are often difficult for pathologists, surgeons, oncologists and occupational physicians. A preoperative diagnosis of malignancy is rarely made, and there is no established effective therapy except orchidectomy. METHODS: A systematic literature review was conducted among the articles published in the English literature on primary MMTVT. Moreover four cases from the Apulia mesothelioma register are reported here. RESULTS: Two hundred eighty-nine cases of MMTVT have been reported from 1943 to 2018. Overall asbestos exposure has been investigated only for 58% of all cases reported in this review, while in 41.8% this data are not available. Noteworthy is the fact that in many reports there is not an anamnestic reconstruction of any asbestos exposure. A history of direct occupational, environmental or familial asbestos exposure is found in 27.6% of the cases. The four cases from the Apulia mesothelioma register are all with ascertained occupational exposure to asbestos. CONCLUSIONS: The true incidence of asbestos exposure in MMTVT is underestimated because of insufficient information reported in older literature. To establish a broad consensus on the causal relationship between asbestos and MMTVT in the scientific community its necessary to analyze the same variables in the epidemiological studies. In general it should be recommended that a positive history of exposure to asbestos or to asbestos-containing materials are at risk for the development of a MMTVT and should be monitored.

Population history of southern Italy during Greek colonization inferred from dental remains.

OBJECTIVES: We are testing competing scenarios regarding the population history of the ancient Greek colonization of southern Italy using dental phenotypic evidence. MATERIALS AND METHODS: We collected dental metric and nonmetric trait data for 481 human skeletons from six archaeological sites along the Gulf of Taranto, dating to pre-colonial (900-700 BC) and post-colonial periods (700-200 BC). We are evaluating scenarios through an individual-level biodistance analysis using a three-pronged approach: (a) by analyzing levels of mobility in pre- and post-colonial periods under a model of isolation-by-distance; (b) by quantifying differences in group means and variances in pre- and post-colonial periods utilizing permutational multivariate analysis of variance and Betadisper analyses; and (c) by identifying ancestries of post-colonial individuals using naïve Bayes classification. RESULTS: Southern Italy during pre-colonial times was characterized by low levels of mobility and marked differences in group means and variances. During post-colonial times, mobility increased and there were no differences in group means and variances. About 18% of the people in post-colonial times were of Greek ancestry and lived equally distributed across Greek colonies and indigenous villages. Nevertheless, the overall biological composition and variability of southern Italy remained relatively unchanged across pre- and post-colonial periods. DISCUSSION: Our results support a scenario in which only few Greek colonists migrated to southern Italy and lived in smaller numbers alongside indigenous people in Greek colonies as well as in indigenous villages. Our results contradict a scenario in which large numbers of Greek invaders founded biologically isolated and substantially homogeneous colonial enclaves within conquered territories.

Source patterns and contamination level of polycyclic aromatic hydrocarbons (PAHs) in urban and rural areas of Southern Italian soils.

Polycyclic aromatic hydrocarbons (PAHs) are a group of persistent organic pollutants. They have been identified as a type of carcinogenic substance and are relatively widespread in environment media such as air, water and soils, constituting a significant hazard for human health. In many parts of the world, PAHs are still found in high concentrations despite improved legislation and monitoring, and it is therefore vital defining their profiles, and assessing their potential sources. This study focused on a large region of the south of Italy, where concentration levels, profiles, possible sources and toxicity equivalent quantity (TEQ) level of sixteen PAHs were investigated. The survey included soils from five large regions of the south of Italy: 80 soil samples (0-20 cm top layer) from urban and rural locations were collected and analysed by gas chromatography-mass spectrometry. Total PAHs and individual molecular compounds from the US Environmental Protection Agency priority pollutants list were identified and measured. Results showed that 16 PAHs varied significantly in urban and rural areas, and different regions presented discordant characteristics. Urban areas presented concentrations ranging from 7.62 to 755 ng g-1 (mean = 84.85 ng g-1), whilst rural areas presented ranges from 1.87 to 11,353 ng g-1 (mean = 333 ng g-1). Large urban areas, such as Rome, Naples and Palermo, exhibited high PAHs total concentration, but high values were also found in rural areas of Campania region. Different PAHs molecular ratios were used as diagnostic fingerprinting for source identification: LWMPAHs/HWMPAHs, Fluo/(Fluo + Pyr), BaA/(BaA + Chr), Ant/(Ant + Phe) and IcdP/(IcdP + BghiP). These ratios indicated that PAHs sources in the study area were mainly of pyrogenic origin, i.e. mostly related to biomass combustion and vehicular emission. On the other hand, values in Sicilian soils seemed to indicate a petrogenic origin, possibly linked to emissions from crude oil combustion and refineries present in the region. Finally, results allowed to calculate the toxicity equivalent quantity (TEQBAP) levels for the various locations sampled, highlighting that the highest values were found in the Campania region, with 661 and 54.20 ng g-1, in rural and urban areas, respectively. These findings, which could be linked to the presence of a large solid waste incinerator plant, but also to well-documented illegal waste disposal and burning, suggest that exposure to PAH may be posing an increased risk to human health in some of the studied areas.

Conservation and genetic characterisation of common bean landraces from Cilento region (southern Italy): high differentiation in spite of low genetic diversity.

Since its introduction from Central-South America to Italy almost 500 years ago, the common bean (Phaseolus vulgaris L.) was largely cultivated across the peninsula in hundreds of different landraces. However, globalisation and technological modernisation of agricultural practices in the last decades promoted the cultivation of few varieties at the expense of traditional and local agro-ecotypes, which have been confined to local markets or have completely disappeared. The aim of this study was to evaluate the genetic diversity and differentiation in 12 common bean landraces once largely cultivated in the Cilento region (Campania region, southern Italy), and now the object of a recovery program to save them from extinction. The analysis conducted using 13 nuclear microsatellite loci in 140 individuals revealed a high degree of homozygosity within each landrace and a strong genetic differentiation that was reflected in the success in assigning individuals to the source landrace. On the contrary, internal transcribed spacers 1 and 2, analysed in one individual per landrace, were highly similar among common bean landraces but allowed the identification of a cowpea variety (Vigna unguiculata Walp.), a crop largely cultivated in the Old World before the arrival of common bean from Americas. In conclusion, our study highlighted that conservation of landraces is important not only for the cultural and socio-economic value that they have for local communities, but also because the time and conditions in which they have been selected have led to that genetic distinctiveness that is at the basis of many potential agronomical applications and dietary benefits.

Epidemiology and risk factors for hepatitis C virus genotypes in a high prevalence region in Italy.

Hepatitis C virus (HCV) is globally widespread. Southern Italy is a high prevalence region where the distribution of the HCV genotypes (GTs) is changing. Intravenous drug abuse is the only risk factor associated with a specific HCV GT (GT3). The aim of this study was to evaluate the distribution and the risk factors for specific HCV GTs. A total of 682 patients with measurable serum HCV-RNA were enrolled between January and March 2017. We recorded clinical information and the presence of risk factors for HCV. GT1b was the prevalent genotype in our patients (59.8%). HCV GT1a and GT3 infections were more frequent among patients aged ≤60 years (14.9% vs 2.2%, p<0.01 and 13.6% vs 0.8%, p<0.01, respectively). At multivariate analysis, intravenous drug abuse and age ≤60 years were associated with GT1a infection (OR: 4.79; 95% CI: 2.43-9.47, p <0.001 and OR: 5.07; 95CI: 2.25-11.40, p<0.001, respectively), while age ≤60 years was the only risk factor for GT3 (OR: 15.81; 95CI: 4.76-52.54, p <0.001). In the Campania region, we observed an increase in GT1a and GT3 rates compared with those observed in previous years. Age ≤60 was an independent risk factor for GT1a and GT3 infection. Intravenous drug use was independently associated with GT1a infection.

Cryptococcus neoformans in the respiratory tract of squirrels, Callosciurus finlaysonii (Rodentia, Sciuridae).

Cryptococcosis is a fungal disease acquired from the environment, for which animals may serve as sentinels for human exposure. The occurrence of Cryptococcus spp. in the respiratory tract of 125 squirrels, Callosciurus finlaysonii, trapped in Southern Italy, was assessed. Upon examination of nasal swabs and lung tissue from each individual, a total of 13 (10.4%) animals scored positive for yeasts, 7 for Cryptococcus neoformans (C.n.) (5.6%) and 6 for other yeasts (4.8%). C.n. was isolated from the nostrils and lungs, with a high population size in nostrils. Two C.n. molecular types, VNI and VNIV, were identified, with C.n. var. grubii VNI the most prevalent. Phylogenetic analyses of ITS+ and URA5 sequences revealed that C.n. isolates were genetically similar to isolates from a range of geographical areas and hosts. Results suggest that C.n. can colonize or infect the respiratory tract of C. finlaysonii. The high occurrence and level of colonization of nasal cavities might be an indicator of environmental exposure to high levels of airborne microorganism. The close phylogenetic relationship of C.n. strains from squirrels with those from human and other animal hosts suggests a potential role for these animals as "sentinels" for human exposure.

Off-label and unlicensed drug use among neonatal intensive care units in Southern Italy.

BACKGROUND: Many drugs used for neonates are unlicensed or off-label. An increased risk of medication errors and unexpected adverse drug reactions is associated with their use. This risk is even higher in preterm newborns, because of their physiological immaturity and the exposure to many different medicines. The objective of this study was to evaluate the use of unlicensed or off-label drugs in eight tertiary-level neonatal intensive care units (NICU) from two different southern Italian regions. METHODS: All drugs prescribed to newborns admitted to each NICU, during 1 month of observation, were recorded and classified as licensed, unlicensed or off-label, according, respectively, first, to their license status and, then, their indications, dose, treatment route, and duration of treatment specified in each specific marketing authorization. RESULTS: A total of 126 newborns were treated with at least one drug during the observation period. A total of 483 prescriptions referred to 87 different drugs, classified as licensed, unlicensed or off-label. Each newborn was exposed to three (median) different drugs; 88.6% were licensed and 11.4% unlicensed (range, according to different NICU, 1.9-26.7%). Among licensed drugs, 37.4% were used as off-label (range, 27.3-53.4%). CONCLUSIONS: The use of unlicensed or off-label drugs use is common practice in NICU, with wide variation in local policies and newborn characteristics. Well-designed and -conducted pharmaceutical studies in newborns are needed to increase the number of licensed drugs, thereby reducing any risk for patients due to over- or under-treatment, and also legal issues for clinicians.

Resistance to ceftazidime-avibactam and other new ß-lactams in Pseudomonas aeruginosa clinical isolates: a multi-center surveillance study.

New ß-lactam-ß-lactamase inhibitor combinations represent last-resort antibiotics to treat infections caused by multidrug-resistant Pseudomonas aeruginosa. Carbapenemase gene acquisition can limit their spectrum of activity, and reports of resistance toward these new molecules are increasing. In this multi-center study, we evaluated the prevalence of resistance to ceftazidime-avibactam (CZA) and comparators among P. aeruginosa clinical isolates from bloodstream infections, hospital-acquired or ventilator-associated pneumonia, and urinary tract infections, circulating in Southern Italy. We also investigated the clonality and content of relevant ß-lactam resistance mechanisms of CZA-resistant (CZAR) isolates. A total of 120 P. aeruginosa isolates were collected. CZA was among the most active ß-lactams, retaining susceptibility in the 81.7% of cases, preceded by cefiderocol (95.8%) and followed by ceftolozane-tazobactam (79.2%), meropenem-vaborbactam (76.1%), imipenem-relebactam (75%), and aztreonam (69.6%). Among non-ß-lactams, colistin and amikacin were active against 100% and 85.8% of isolates respectively. In CZAR strains subjected to whole-genome sequencing (n = 18), resistance was mainly due to the expression of metallo-ß-lactamases (66.6% VIM-type and 5.5% FIM-1), followed by PER-1 (16.6%) and GES-1 (5.5%) extended-spectrum ß-lactamases, mostly carried by international high-risk clones (ST111 and ST235). Of note, two strains producing the PER-1 enzyme were resistant to all ß-lactams, including cefiderocol. In conclusion, the CZA resistance rate among P. aeruginosa clinical isolates in Southern Italy remained low. CZAR isolates were mostly metallo-ß-lactamases producers and belonging to ST111 and ST253 epidemic clones. It is important to implement robust surveillance systems to monitor emergence of new resistance mechanisms and to limit the spread of P. aeruginosa high-risk clones. IMPORTANCE: Multidrug-resistant Pseudomonas aeruginosa infections are a growing threat due to the limited therapeutic options available. Ceftazidime-avibactam (CZA) is among the last-resort antibiotics for the treatment of difficult-to-treat P. aeruginosa infections, although resistance due to the acquisition of transferable ß-lactamase genes is increasing. With this work, we report that CZA represents a highly active antipseudomonal ß-lactam compound (after cefiderocol), and that metallo-ß-lactamases (VIM-type) and extended-spectrum ß-lactamases (GES and PER-type) production is the major factor underlying CZA resistance in isolates from Southern Italian hospitals. In addition, we reported that such resistance mechanisms were mainly carried by the international high-risk clones ST111 and ST235.

Respiratory Syncytial Virus (RSV) Hospitalizations in the Elderly in a Tertiary Care Hospital in Southern Italy as a Useful Proxy for Targeting Vaccine Preventive Strategies.

RSV infection causes severe respiratory illness and mortality in the elderly, especially in the presence of comorbidities. Early identification of infection would result in appropriate clinical-therapeutic management, avoiding hospitalizations, the risk of healthcare-associated infections, and inappropriate antibiotic prescriptions, thus reducing healthcare costs and fighting antimicrobial resistance. The aim of this study was to assess RSV hospitalizations in subjects >64 years hospitalized in a large tertiary care hospital in Southern Italy, in order to assess their usefulness as a proxy for targeting a potential vaccination strategy. Fifty-two RSV-positive patients were identified from the 2014-2015 to the 2022-2023 seasons. RSV type B was found in 71.2% of cases. The median age was 78 years (IQR: 72-84) and 40.4% of the subjects had at least one comorbidity; 5.8% needed intensive care. The use of combined rapid tests for SARS-CoV-2/influenza/RSV identification in primary care settings may contribute to an improved definition of the burden of RSV in the elderly. The implementation of an anti-RSV vaccination strategy in the elderly population would reduce direct and indirect infection costs. More robust epidemiological data in Italy are needed for targeted preventive strategies.

Parasitological Survey in European Brown Hare (Lepus europaeus Pallas, 1778) Breeding Facilities in Southern Italy.

Parasites are considered important regulating factors of hosts' population dynamics, not only in free-ranging wildlife, but also in captive bred animals. To date, only few studies have been carried out to assess the parasitic communities of the European brown hare in Southern Italy, and only one focused on animals in captivity. The aim of the present survey was to assess the composition of the endoparasite community in game hares bred for restocking purposes. For this purpose, 215 fecal pools collected in eight different breeding facilities were examined by qualitative and quantitative coprological techniques. Parasites characterized by a direct life cycle, including six species of coccidia from the genus Eimeria and the nematode Trichostrongylus retorataeformis, proved to be the most prevalent parasites. Further helminthic infestations by Passalurus ambiguous, Strongylosides papillosus, Cittotenia spp. and Dicrocoelium dendriticum were also detected, but with an overall prevalence lower than 20%. The present study contributes to increasing knowledge on the health status of a poorly investigated species, and is useful for optimizing breeding efforts in captivity.

Carpological Analysis of Two Endemic Italian Species: Pimpinella anisoides and Pimpinella gussonei (Apiaceae).

This study aims to clarify the taxonomic doubts, which have varied over the centuries, on the only two endemic species of the genus Pimpinella growing in Italy: P. anisoides and P. gussonei. For this purpose, the main carpological characters of the two species were examined, analyzing the external morphological traits and their cross-sections. Fourteen morphological traits were identified, obtaining datasets for the two groups using 40 mericarps (20 per species). The obtained measurements were subjected to statistical analysis (MANOVA and PCA). Our results highlight that at least 10 of the 14 morphological traits analyzed support the distinction between P. anisoides and P. gussonei. In particular, the following carpological characters are very significant ways to distinguish between the two species: monocarp width and length (Mw, Ml), monocarp length from base to maximum width (Mm), stylopodium width and length (Sw, Sl), length/width ratio (l/w) and cross-section area (CSa). In particular, the fruit of P. anisoides is larger (Mw 1.61 ± 0.10 mm) than that of P. gussonei (Mw 1.27 ± 0.13 mm), the mericarps of the first species are longer (Ml 3.14 ± 0.32 vs. 2.26 ± 0.18 mm) and the cross-section area (CSa) of P. gussonei is larger (0.92 ± 0.19 mm) than that of P. anisoides (0.69 ± 0.12 mm). The results also highlight the importance of the morphological traits of the carpological structures for the specific discrimination of similar species. The findings of this study contribute to an evaluation of the taxonomic significance of this species within the genus Pimpinella, and also provide valuable information for the conservation of these two endemic species.

A 10-year retrospective analysis (2012-2021) of hospitalizations resulting from dog bites in Southern Italy.

This study aimed to describe the incidence and characteristics of dog-bite injury hospitalizations (DBIH) in the largest administrative region of Italy (Sicily) over the 10-year period: 2012-2021. Four hundred and forty-nine cases were analyzed. Patients were divided into seven age groups: preschoolers (0-5 years), school-age children (6-12 years), teenagers (13-19 years), young adults (20-39 years), middle-aged adults (40-59 years), old adults (60-74 years), and the elderly (≥75 years). Association among categorical variables (age, gender, principal injury location) was evaluated using chi-square tests, and mean differences for normally distributed variables were assessed using one-way analysis of variance. Finally, a Poisson regression general linear model (GLM) analysis was used to model incidence data. The results revealed that the incidence of DBIH per 100,000 population increased from 0.648 in 2012 (95%CI 0.565-0.731) to 1.162 in 2021 (95%CI 1.078-1.247, P < 0.01). Incidence for both male and female victims also increased over the studied period (P < 0.05). We found an increasing trend of incidence in young and middle-aged adults (P < 0.05 and P < 0.005 respectively). Moreover, the most frequently injured age group by dogs was the preschooler group and, whilst we found a lower risk of being injured for males older than 20 years, no difference with females was observed. The location of lesions depended on the age group (P < 0.001). The number of days of DBIH increased significantly with age (P < 0.01). The increase of DBIH represents a public health problem that requires the development of preventive approaches.