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Epidemiology
of infectious diseases
Antibody
responses to BNT162b2 SARS-CoV-2 mRNA vaccine among healthcare workers
and residents of long-term care facilities: A cohort study in Northern
Italy. Costanza Vicentini, Carla Maria Zotti, Alessandro
Roberto Cornio, Jacopo Garlasco, Noemi Marengo, Davide Meddis, Savina
Ditommaso, Monica Giacomuzzi, Gabriele Memoli, Valerio Bordino,
Maria Michela Gianino, the Collaborating Group. Health
Science Reports, February 2023.
Long-term
care facilities (LTCFs) have been severely impacted by COVID-19,
with a disproportionate amount of SARS-CoV-2 infections and related
deaths occurring among residents. This study is part of an ongoing
multicenter, prospective cohort study conducted among healthcare
workers (HCWs) and residents of 13 LTCFs in Northern Italy designed
to evaluate SARS-CoV-2 specific immunoglobulin class G (IgG) titers
before and following vaccination with Pfizer/BNT162b2 SARS-CoV-2
mRNA vaccine (two doses of vaccine, 21 days apart). Serum samples
were obtained from participants (t0) before vaccination, and (t1)
2 weeks after and analyzed to determine anti-S1 IgG antibodies.
Five hundred and thirty-four participants were enrolled (404 subjects
participated in both blood draws). Seropositivity was 50.19% at
t0 and 99% at t1, with a significant difference in IgG titers. A
higher proportion of residents were seropositive at t0 compared
with HCWs, with significantly higher IgG titers among residents
at both t0 and t1. Pre-existing immunity also had a significant
effect on postvaccination IgG titers. However, a significant difference
in titers at t1 between HCWs and residents considering only participants
seropositive at t0 was found, with higher median titers among previously
seropositive residents. Findings of this study provide scientific
evidence endorsing the policy of universal vaccination in LTCFs.
Serological
Responses up to 9 Months following COVID-19 mRNA Vaccination in
Residents and Health-Care Workers of Long-Term Care Facilities:
A Multicenter Prospective Cohort Study in Northern Italy. Costanza
Vicentini, Carla Maria Zotti, Alessandro Roberto Cornio, Jacopo
Garlasco, Noemi Marengo, Davide Meddis , Savina Ditommaso, Monica
Giacomuzzi, Gabriele Memoli, Valerio Bordino, Maria Michela Gianino
and on behalf of the Collaborating Group. Vaccines
2022, 10(12), 2183;
Long-term
care facilities (LTCFs) were severely affected by COVID-19, in particular
in Northern Italy. We aimed to assess antibody responses among residents
and healthcare workers (HCWs) of 13 LTCFs through serum samples
collected at three time points: prior to, two weeks, and 9 months
after receiving Pfizer/BNT162b2 SARS-CoV-2 mRNA vaccine (respectively
t0, t1, and t2). IgG antibodies targeted towards the S1 domain of
the spike protein were measured, and results were expressed in binding
antibody units (BAU/mL). Friedman’s average rank test was
performed to compare antibody titres between the three time points.
Two logistic regression models were built to identify independent
predictors of (1) developing and (2) maintaining a significant antibody
response to vaccination, using a previously identified threshold.
In total, 534 subjects were enrolled (371 HCWs and 163 residents).
The antibody titres at t1 were the highest; at t2, the IgG titres
significantly decreased, remaining however 10 times higher compared
to titres at t0. Previous infection was the only significant predictor
of developing and maintaining a response over threshold in both
models. Results of this study provided further insights on the humoral
response elicited by vaccination, and on host factors determining
variations in its magnitude and kinetics.
Seroprevalence
of infection-induced SARS-CoV-2 antibodies among healthcare users
of Northern Italy – results from two serosurveys (October-November
2019 – September-October 2021). Costanza
Vicentini, Valerio Bordino, Alessandro Roberto Cornio, Davide Meddis,
Noemi Marengo, Savina Ditommaso, Monica Giacomuzzi, Gabriele Memoli,
Gabriella Furfaro, Giulio Mengozzi, Valentina Ricucci, Giancarlo
Icardi, Carla Maria Zotti. Journal of Infectious Diseases
(2022).
Objective:
To estimate the seroprevalence of SARS-CoV-2 in autumn 2019 (before
case zero was identified in Italy) and 2021 among residual sera
samples of healthcare users of Piedmont, Northwestern Italy.
Methods:
Two serosurveys were conducted. Samples were tested for the detection
of IgG antibodies against the S1 domain of the spike protein, using
a semi-quantitative method. Positive samples from the 2019 survey
were independently re-tested using a multiplex panel for the detection
of IgG antibodies against the receptor-binding domain, S1 and S2,
and nucleocapsid (N). Positive samples from the 2021 survey underwent
repeat testing with ELISA for the detection of IgG anti-N antibodies.
Prevalence rates according to gender and age groups, together with
their respective 95% CIs, were calculated.
Results:
Overall, the proportion of positive samples was 2/353 in 2019 and
22/363 in 2021, with an estimated seroprevalence of 0.27% (95% CI
0 – 1.86) and 6.21% (95% CI 3.9 – 9.31), in 2019 and
2021 respectively.
Conclusion:
Results
of this study support the hypothesis that the virus was circulating
in Italy as early as autumn 2019. The role of these early cases
in broader transmission dynamics remains to be determined.
A
cross-sectional study of SARS-CoV-2 seropositivity among healthcare
workers and residents of long-term facilities in Italy, January
2021. Valerio
Bordino, Noemi Marengo, Jacopo Garlasco, Alessandro Roberto Cornio,
Davide Meddis, Savina Ditommaso, Monica Giacomuzzi, Gabriele Memoli,
Maria Michela Gianino, Costanza Vicentini, Carla Maria Zott, Collaborating
group.J Med Virol. 2022 Jul;94(7):3054-3062.
Long-term
care facilities (LTCFs) are high-risk settings for SARS-CoV-2 infection.
This study aimed to describe SARS-CoV-2 seropositivity among residents
of LTCFs and health-care workers (HCWs). Subjects were recruited
in January 2021 among unvaccinated HCWs of LTCFs and hospitals and
residents of LTCFs in Northern Italy. Information concerning previous
SARS-CoV-2 infections and a sample of peripheral blood were collected.
Anti-S SARS-CoV-2 IgG antibodies were measured using the EUROIMMUN
Anti-SARS-CoV-2 QuantiVac ELISA kit (EUROIMMUN Medizinische Labordiagnostika
AG). For subjects with previous COVID-19 infection, gender, age,
type of subject (HCW or resident), and time between last positive
swab and blood draw were considered as possible determinants of
two outcomes: the probability to obtain a positive serological result
and antibody titer. Six hundred and fifty-eight subjects were enrolled.
56.1% of all subjects and 65% of residents presented positive results
(overall median antibody titer: 31.0 RU/ml). Multivariable models
identified a statistically significant 4% decrease in the estimated
antibody level for each 30-day increase from the last positive swab.
HCWs were associated with significant odds for seroreversion over
time (OR: 0.926 for every 30 days, 95% CI: 0.860-0.998), contrary
to residents (OR: 1.059, 95% CI: 0.919-1.22). Age and gender were
not factors predicting seropositivity over time. Residents could
have a higher probability of maintaining a seropositive status over
time compared to HCWs.
Pertussis
(whooping cough) is a highly infectious disease caused by Bordetella
pertussis. Mothers lacking adequate immunity and contracting the
disease represent the biggest risk of transmission to new-borns,
for which the disease is often a threat. The aim of the study was
to estimate the frequency of pertussis susceptibility among pregnant
women, in order to point out the need for a vaccine recall during
pregnancy, and to evaluate the antibody response in already vaccinated
women. A cross-sectional observational study was conducted in the
blood test centre of "St. Anna" Obstetrics and Gynaecology
Hospital in Turin (Piedmont, Italy). Eligibility criteria included
pregnant women coming to the centre for any blood test, aged 18
or above and with gestational age between 33 and 37 weeks at the
moment of the blood draw. The data collection was carried out from
May 2019 to January 2020 and the concentration of anti-Pertussis
Toxin (anti-PT) IgG was measured through the Enzyme-Linked Immunosorbent
Assay (ELISA) technique. Two-hundred women (median age 35) were
enrolled: 132 (66%) had received at least one dose of pertussis
vaccine, 82 of which during pregnancy. Recently vaccinated women
had significantly higher antibody titres (even 12-15 times as high)
compared to those vaccinated more than 5 years before or never vaccinated
at all (p < 0.0001). Moreover, 95.1% of recently vaccinated women
had anti-PT IgG levels above 10 IU/ml, and 85.4% above 20 IU/ml,
while the same proportions were as low as 37% and 21% (respectively)
in the group of women not vaccinated in pregnancy. This study confirmed
that the vaccination is greatly effective in ensuring high antibody
titres in the first months after the booster vaccine, with considerable
differences in anti-PT IgG compared to women vaccinated earlier
or never vaccinated at all, and therefore vaccinating pregnant women
against pertussis still represents a valuable strategy.
The
purpose of the present study was to determine possible cross-reactivity
between different serogroups or between different species by
means of bacterial smears of individual L. pneumophila serogroups
and several non-pneumophila Legionella spp. Using BIOCHIP slide
we found a considerable frequency of cross-reactions with L.
pneumophila serogroup 12 (88.4%) therefore BIOCHIP slide proved
as useful method for identification of cross-reactivity between
members of the Legionnellaceae.
Prevalence
of anti-legionella antibodies among Italian hospital workers.
P Borella, A Bargellini, I Marchesi, S Rovesti, G Stancanelli,
S Scaltriti, M Moro, M T Montagna, D Tatò, C Napoli, M Triassi,
S Montegrosso, F Pennino, C M Zotti, S Ditommaso, M Giacomuzzi.
J Hosp Infect. 2008 Jun;69(2):148-55.
This
study evaluated the prevalence of anti-legionella antibodies in
workers at hospitals with a long-term history of legionella contamination.
The hospitals are located in Milan and Turin, northern Italy, and
in Naples and Bari, southern Italy. Antibody prevalence and titres
of healthcare workers, medical and dental students and blood donors
were assessed. In total 28.5% of subjects were antibody positive,
most frequently to L. pneumophila serogroups 7-14. Major differences
were observed in seroprevalence and type of legionella antibody
in persons from different geographic areas. Healthcare workers had
a significantly higher frequency of antibodies compared with blood
donors in Milan (35.4 vs 15.9%, P<0.001), whereas in Naples both
groups exhibited high antibody frequency (48.8 vs 44.0%) and had
a higher proportion of antibodies to legionella serogroups 1-6.
Dental workers had a higher seroprevalence than office staff in
Bari, but not in Turin, where daily disinfecting procedures had
been adopted to avoid contamination of dental unit water. No association
was found between the presence of antibodies and the presence of
risk factors for legionellosis, nor with the occurrence of pneumonia
and/or flu-like symptoms. In conclusion, the presence of legionella
antibodies may be associated with occupational exposure in the hospital
environment, but there was no evidence of any association with disease.
Colonization
of a water system by Legionella organisms and nosocomial legionellosis:
a 5-year report from a large Italian hospital. S
Ditommaso, C Biasin, M Giacomuzzi, C M Zotti, R Arione, E Guglielmi,
S Barbaro, A Di Leo, R Serra, G Marchiaro, A Ruggenini Moiraghi.
Infect Control Hosp Epidemiol. 2006 May;27(5):532-5.
Legionella
pneumophila in a hospital in Torino, Italy. A retrospective one-year
study. A Moiraghi Ruggenini, M Castellani Pastoris,
P J Dennis, C Barral, A Sciacovelli, F Carle, M Bolgiani, G Passarino,
M G Mingrone, C Passi, et al. Epidemiol Infect. 1989
Feb;102(1):21-9.
Legionella
pneumophila serogroup 1 was isolated from post mortem specimens
from 13 out of 58 patients with pneumonia diagnosed at autopsy.
The results of a study undertaken in the hospital environment showed
that the water plumbing system was colonized with L. pneumophila
serogroup 1 which could also be isolated from respiratory devices
filled with tap water. Control measures instituted are described.
In
1 year 12 of 48 patients who developed fatal pneumonia following admission
with non-respiratory disorders to the Hospital Molinette, Torino,
yielded Legionella pneumophila serogroup 1 from lung at autopsy. Patients
were hospitalized on seven different wards for different conditions;
only two of the wards had air conditioning but legionellas were not
isolated from these. All patients were in poor health or immunocompromised.
Some patients had inhaled humidified oxygen from piped supplies and
three had undergone surgery. Legionella pneumophila serogroup 1 was
detected in the water of oxygen bubble humidifiers and an underwater
chest drain. The contaminated devices had been filled with tap or
distilled water and the hospital water supply was found to be contaminated
with L. pneumophila serogroup 1. Our findings suggest that filling
bubble humidifiers or underwater chest drains with tap water is a
potential hazard and should be avoided.
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