Stenotrophomonas maltophilia, a non-fermentative, ubiquitous, gram-negative aerobic bacterium, is associated with high mortality rates, particularly in immunocompromised or debilitated patients. The prevalence rate of ICU-acquired pneumonia episodes caused by this microorganism has been found to be 2%. S. maltophilia has been identified as one of the top 10 microorganisms responsible for such infections in EU/EEA countries. This study describes an outbreak of S. maltophilia in an intensive care unit of a hospital in northern Italy. This includes an epidemiological investigation of the cases, the environmental microbiological controls carried out, a comparison of the strains by multilocus sequence typing (MLST), and the measures taken to prevent and control the outbreak. Among the seven clinical isolates of S. maltophilia analyzed herein, six demonstrated susceptibilities to trimethoprim–sulfamethoxazole. Conversely, one isolate of S. maltophilia exhibited resistance to first-line antibiotics. ST was found to be identical for six patients (ST 4), as well as in the environmental feedback on the trolley of Box 2. The analysis of the temporal and spatial progression of the outbreak has suggested that the transmission of S. maltophilia may have occurred through cross-transmission during care practices.

In several settings, the COVID-19 pandemic determined a negative impact on the occurrence of healthcare-associated infection, particularly for on central lines associated bloodstream infections (CLABSI). In our setting, we observed a significant increase in CLABSI in our intensive care unit (ICU) during 2020 and 2021 vs. 2018 to 2019. A refresher training activity on central venous catheter (CVC) management bundles was carried out in September–October 2021 for the ICU health staff. We assessed the impact of bundle implementation by means of standardized indicators, such as the Device Utilization Ratio (DUR), in this case, the Central Line Utilization Ratio, the Standardized Utilization Ratio (SUR), and the device Standardized Infection Ratio (dSIR). Standardized ratios for device use and infection ratio were computed using data from 2018 and 2019 as expectation data. After bundle implementation, we observed a significant reduction of dSIR (p < 0.001), which dropped from 3.23 and 2.99 in the 2020–2021 biennium to 1.11 in 2022 (CLABSI in the first quarter only); no more CLABSI were observed afterwards. Standardized ratios proved helpful in identify increasing trends of CLABSI in the ICU and monitoring the impact of a simple effective tool, i.e., training on and implementation of a bundle for CVC management.

Liguria is a northwestern region of Italy that, since the WHO has declared COVID-19 as a pandemic (11 March 2020), presented 108 patients hospitalized, 34 of which were in the intensive care unit. Due to this serious epidemiological emergency, the transformation of a long-distance ferry ship into a hospital ship for COVID-19 patients who were still positive after the acute phase of the illness was carried out to free up hospital beds for patients in the acute phase. The ship was moored in the port of Genoa, the capital of Liguria. The conversion was localized to a single deck, where designated healthcare areas were identified. From 23 March to 18 June 2020, 191 patients were admitted onto the ship; they were provided with high-level healthcare guaranteed by the multi-disciplinary nature of clinical competencies available. Patients had a favorable outcome in all cases, confirmed by their recovery and negative swab results. Moreover, no cases of voluntary discharge were recorded. To the best of our knowledge, this is the only example in the world in which a passenger ship was transformed into a ship hospital for COVID patients.

Background: Staphylococcus aureus bloodstream infections cause substantial hospital mortality (20–50%). Surveillance programs primarily focus on methicillin-resistant S. aureus (MRSA) as a quality indicator, while comprehensive data comparing MRSA and methicillin-susceptible S. aureus (MSSA) hospital-onset bacteremia remain limited outside the UK, the USA, and Canada. This study aims to evaluate incidence trends of all hospital-onset S. aureus bloodstream infections (HO-SABSIs, defined as positive blood cultures ≥ 48 h post-admission) from 2013 onwards, comparing MRSA and MSSA incidence patterns and their associated mortality rates in an Italian tertiary-care hospital through surveillance data. Methods: Retrospective cohort study of all HO-SABSIs from January 2013 to December 2023 at a 458-bed Italian tertiary hospital. Primary outcome was incidence density (cases per 1000 patient-days) stratified by methicillin resistance. Standardized Infection Ratios (SIRs) were calculated using 2013–2015 and 2013–2019 as baseline periods. Temporal trends were analyzed using negative binomial regression. Results: Among 414 HO-SABSI cases, 183 (44.2%) were MRSA and 231 (55.8%) MSSA. MRSA incidence decreased significantly (−6.5% annually; IRR 0.935, 95%CI 0.883–0.991; p = 0.023) from 0.198 to 0.111 per 1000 patient-days. MSSA increased non-significantly (+4.9% annually; IRR 1.049, 95%CI 0.999–1.103; p = 0.056) from 0.103 to 0.239, surpassing MRSA after 2016 and peaking during COVID-19 (2021: SIR 2.41, 95%CI 1.33–4.37). MRSA cases had higher mortality than MSSA (40.6% vs. 27.5%; p = 0.005). Conclusions: MSSA has replaced MRSA as the predominant hospital-onset S. aureus bacteremia pathogen since 2016, with sustained elevation during and after the COVID-19 pandemic. Current MRSA-focused surveillance misses the majority of preventable staphylococcal bacteremias. Comprehensive hospital-onset S. aureus surveillance encompassing both phenotypes is essential for accurate epidemiological assessment and infection prevention.

Background: Healthcare-associated infections (HAIs) remain a major patient safety issue, and hand hygiene (HH) is a key preventive measure. Technologies providing immediate visual feedback may support HH training by allowing objective assessment of hand-rubbing technique. Methods: A multicenter quality improvement project was conducted in three hospitals in northern Italy to assess scanner-measured HH performance over time after a standardized HH training program supported by an automated visual feedback scanner, the Semmelweis Hand Hygiene System^®. Nurses and nurse aides performed scanner assessments before training (T0) and up to 6–9 months after training (T1–T4). Data included demographic variables, baseline HH knowledge, ring detection, and scanner pass/fail outcomes. Longitudinal changes were analyzed using adjusted generalized estimating equation (GEE) logistic regression models. Results: A total of 292 healthcare professionals participated in the project (69.2% nurses; mean age 42 years; 81.1% female). At baseline, 44.2% failed the scanner assessment, with dorsum areas being the most frequently insufficiently covered, and 36.0% wore rings. Across 2422 scanner assessments, pass rates improved over time. In adjusted GEE models, each additional scheduled month from baseline was associated with higher odds of passing the scanner assessment (OR = 1.18, 95% CI 1.13–1.24, p < 0.001). This association remained significant in the first-scan-only sensitivity analysis (OR = 1.16, 95% CI 1.11–1.21, p < 0.001). The association was also confirmed in a completers-only sensitivity analysis. Ring detection was associated with lower odds of passing, whereas baseline HH knowledge was not independently associated with scanner performance. Conclusions: Scanner-based immediate feedback was associated with improved scanner-measured HH technique over time. However, the quality improvement design, absence of a control group, use of the scanner as both feedback tool and outcome measure, and declining retention across follow-up assessments limit causal interpretation. Scanner-supported feedback may represent a useful adjunct to traditional HH education, but further controlled studies are needed to assess sustainability and real-world HH compliance.