Currently, limited data on maternal and neonatal outcomes of pregnant women with infection and pneumonia related to SARS coronavirus 2 (SARS-CoV-2) are available. Our report aims to describe a case of placental swabs positive for the molecular research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 RNA in an asymptomatic woman with positive rhino-pharyngeal swab for SARS-CoV-2 who underwent an urgent cesarean section in our obstetrics unit. Sample collection, processing, and laboratory testing were conducted in accordance with the World Health Organization (WHO) guidance. In the next months, conclusive data on obstetrical outcomes concerning the gestational age and pregnancy comorbidity as well as the eventual maternal–fetal transmission are needed.

Systemic sclerosis (SSc) is a rare autoimmune inflammatory rheumatic disease. The prevalence of SSc ranges from 7 to 700 cases per million worldwide. Due to multiple organ involvement and constant inflammatory state, this group of patients presents an increased risk of infectious diseases. This paper aimed to gather the up-to-date evidence on vaccination strategies for patients with SSc and to be a useful tool for the prevention and management of infectious diseases. The authors conducted a scoping review in which each paragraph presents data on a specific vaccine’s safety, immunogenicity, and efficacy. The work deals with the following topics: SARS-CoV-2, seasonal influenza, S. pneumoniae, HAV, HBV, HZV, N. meningitidis, H. influenzae, HPV, and diphtheria-tetanus-pertussis.

Systemic sclerosis (SSc) is the connective tissue disease with the highest mortality and patients with chronic inflammatory immune-mediated diseases are at high risk of acquiring infections as they are often treated with immunosuppressive or biological drugs. This study, conducted among the patients followed by our clinical immunology, part of the Internal Medicine Department in the Ospedale Policlinico San Martino, Genoa, northwest Italy, has set itself the primary objective of analyzing the vaccine uptake and the vaccination coverage against both seasonal influenza and S. pneumoniae in a cohort of patients with SSc. We evaluated the influenza and pneumococcal vaccination rate among various subgroups of patients and the source of the recommendation for vaccination. We evaluated the vaccination rate changes between the two years considered in our study. We also calculated a binomial logistic regression between vaccination acceptance and clinical and demographics characteristics of the patients to evaluate the adjusted odds ratio (OR) of each factor on vaccination. The vaccination coverage that resulted was significantly higher than in other similar studies. Age over 65 years old, interstitial lung disease, and ongoing immunosuppressive therapy were significantly related with acceptance to both vaccinations using univariate analyses, but the multivariate logistic regression found a significant correlation only with the age and therapy factors.

Patients with diffused Systemic Sclerosis (dSSc) are more subject to severe respiratory complications with higher rates of intensive care unit (ICU) admission. Vaccination represents the most effective means of prevention and care for frail patients, such as SSc patients, preventing infections, reducing mortality and morbidity, and granting a better quality of life. Both vaccinations against seasonal influenza and Streptococcus pneumoniae are currently recommended by the European League Against Rheumatism (EULAR) guidelines on vaccination. The aim of this study is to give an updated analysis on S. pneumoniae and seasonal influenza vaccination coverage in a cohort of 91 patients with SSc and to investigate demographic and clinical variables significantly related to vaccine acceptance. The correlation between vaccine administration and other factors was investigated using a binomial logistic regression to evaluate the adjusted odds ratio (aOR). The patients followed up in this study reached higher percentages than the general population, passing the 75% target for both influenza and anti-pneumococcal vaccinations and reaching for influenza vaccine coverage rates of 83.8% for subjects undergoing immunosuppressive therapies and 88.9% for elderly subjects. For the latter group, it is important to emphasize the strong correlation between older age groups and vaccination acceptance.

Background: Legionella contamination of hospital water distribution system still remains a critical issue in healthcare settings, despite the disputed relationship between environmental legionella and hospital-acquired legionellosis. We report the experience of our 1200-beds hospital, where a new water safety plan (WSP) has been applied since 2017, and the results obtained with the application of different methods to control Legionella water contamination, especially in critical areas. Methods: Policlinico San Martino is the referral tertiary acute-care university hospital in Liguria region, North-West Italy. It’s made of 21 buildings of different dimensions, 7 of which host high risk patients, according to Italian Guidelines for legionellosis prevention and control. A sampling plan for Legionella detection was implemented in 2017, focusing on the water network critical points. Different secondary disinfection procedures were used, including systemic (chlorine dioxide, monochloramine), focal (point-of-use filtration) and short-term methods (hyperchlorination), the last in case of contamination higher than 10^4 CFU/l. Results: Respectively, during 2017 and 2018 a total of 201 and 119 hot water samples were collected, distributed among the 7 critical buildings of the hospital. Negative samples raised from 69.7% to 74.8%, while positive samples >10^3 CFU/l (recommended cut-off for acute disinfection according to Italian guidelines) lowered from 21.9% to 9.2% of total samples. Out of 55 positive samples, Legionella sg 3 accounted for 98.2% of the total. Conclusions: The new WSP determined a significant reduction of Legionella contamination of water distribution networks in our hospital critical buildings. The continuous surveillance of critical water system points provided evidence to elaborate an effective protocol for routine and extraordinary disinfection interventions, as result of a close collaboration between hospital hygiene unit and engineering and technical services. Key messages: The implementation of an effective water safety plan and different disinfection procedures in hospital critical areas allow us to reduce and control the risk of hospital-acquired Legionella infection. Continuous surveillance cultures of drinking water to detect Legionella are necessary to adapt disinfection methods to local results.