Special Issue "Old and New Epidemiological Alerts: Prevention and Control of COVID-19, Candida auris, Measels, MDR and Other Infectious Diseases"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 28 February 2021.

Special Issue Editors

Dr. Jadwiga Wojkowska-Mach
Website
Guest Editor
Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
Interests: infection prevention and control; surveillance of healthcare-associated infection; surveillance of antimicrobial resistance; surveillance of antimicrobial use
Special Issues and Collections in MDPI journals
Dr. Maria Luisa Moro
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Guest Editor
Agenzia Sanitaria e Sociale Regione Emilia-Romagna, Bologna, Italy
Interests: epidemiology; hygiene and public health; infection prevention in long term-care facilities; antibiotics consumption
Dr. Monika Chlebowicz
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Guest Editor
Faculty of Medical Sciences, University of Groningen, Groningen, The Netherlands
Interests: molecular diagnostics of infectious diseases; microbiology; genomics; next generation sequencing; genotyping
Dr. Anna Różańska
Website
Guest Editor
Jagiellonian University Medical College, Krakow, Poland
Interests: infection prevention and epidemiology; multidrug resistant organisms; public health

Special Issue Information

Dear Colleagues,

Medicine, rapidly developing in all its branches, certainly has contributed to a longer and more pleasant human life. Having solved many major health problems, we still have to face some, and are discovering new ones. By this I mean, for instance, new aetiological factors of infectious diseases, such as the COVID-19, the Zika virus, Candida auris, or multidrug-resistant (MDR) microorganisms.

Some of the old problems are still recurring. The only infectious disease that has been successfully eradicated is smallpox, whereas other such diseases still pose a threat, which is well illustrated by the epidemic of measles in Europe since 2017. According to a report by the ECDC, large outbreaks with fatalities are ongoing in countries that had previously eliminated or interrupted endemic transmission. As we can see, even the diseases we thought we knew well can surprise us.

MDR microorganisms and healthcare-associated infections (HAIs) remain significant challenges, both in hospitals and in long-term care facilities. They may cause patients or residents to suffer from additional ailments, and sometimes result in death. The existing problem of MDR microorganisms and HAIs shows us that, in order to properly follow the primum non nocere principle in healthcare, we should take into account all of the epidemiological, biological, organizational, and social aspects of healthcare.

We need to better understand the vital role that infection prevention and control play in improving healthcare systems. That is why this Special Issue of the International Journal of Environmental Research and Public Health will be devoted to Old and New Epidemiological Alerts: COVID-19, Candida Auris, Measels, MDR, Epidemiology, and Prevention. You are most welcome to join the discussion.

Dr. Jadwiga Wojkowska-Mach
Dr. Maria Luisa Moro
Dr. Monika Chlebowicz
Dr. Anna Różańska
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • infection prevention and control
  • surveillance of infections
  • epidemiology of infections
  • health policy
  • public health
  • COVID-19
  • candida auris
  • multidrug-resistant microorganisms
  • Healthcare-associated infections

Published Papers (4 papers)

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Open AccessArticle
Characteristics of and Public Health Emergency Responses to COVID-19 and H1N1 Outbreaks: A Case-Comparison Study
Int. J. Environ. Res. Public Health 2020, 17(12), 4409; https://doi.org/10.3390/ijerph17124409 - 19 Jun 2020
Abstract
Background: Recently, the novel coronavirus disease (COVID-19) has already spread rapidly as a global pandemic, just like the H1N1 swine influenza in 2009. Evidences have indicated that the efficiency of emergency response was considered crucial to curb the spread of the emerging infectious [...] Read more.
Background: Recently, the novel coronavirus disease (COVID-19) has already spread rapidly as a global pandemic, just like the H1N1 swine influenza in 2009. Evidences have indicated that the efficiency of emergency response was considered crucial to curb the spread of the emerging infectious disease. However, studies of COVID-19 on this topic are relatively few. Methods: A qualitative comparative study was conducted to compare the timeline of emergency responses to H1N1 (2009) and COVID-19, by using a set of six key time nodes selected from international literature. Besides, we also explored the spread speed and peak time of COVID-19 and H1N1 swine influenza by comparing the confirmed cases in the same time interval. Results: The government’s entire emergency responses to the epidemic, H1N1 swine influenza (2009) completed in 28 days, and COVID-19 (2019) completed in 46 days. Emergency responses speed for H1N1 was 18 days faster. As for the epidemic spread speed, the peak time of H1N1 came about 4 weeks later than that of COVID-19, and the H1N1 curve in America was flatter than COVID-19 in China within the first four months after the disease emerged. Conclusions: The speed of the emergency responses to H1N1 was faster than COVID-19, which might be an important influential factor for slowing down the arrival of the peak time at the beginning of the epidemic. Although COVID-19 in China is coming to an end, the government should improve the public health emergency system, in order to control the spread of the epidemic and lessen the adverse social effects in possible future outbreaks. Full article
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Open AccessArticle
Epidemiology of Surgical Site Infections Considering the NHSN Standardized Infection Ratio in Hip and Knee Arthroplasties
Int. J. Environ. Res. Public Health 2020, 17(9), 3167; https://doi.org/10.3390/ijerph17093167 - 02 May 2020
Abstract
Introduction Surgical site infections (SSIs) are a predominant form of hospital-acquired infections in surgical wards. The objective of the study was analysis of the incidence of SSI in, both primary and revision, hip and knee arthroplasties. Material and methods: The study was conducted [...] Read more.
Introduction Surgical site infections (SSIs) are a predominant form of hospital-acquired infections in surgical wards. The objective of the study was analysis of the incidence of SSI in, both primary and revision, hip and knee arthroplasties. Material and methods: The study was conducted in 2012–2018 in a Trauma and Orthopedics Ward in Tarnów according to the methodology of the Healthcare-Associated Infections Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC). Results: The surveillance comprised 2340 surgery patients, including: 1756 Hip Arthroplasties (HPRO) and 584 Knee Arthroplasties (KPRO). In the group of patients under study, 37 cases of SSI were detected, including: 26 cases of SSI after HPRO and 11 cases in KPRO. The average incidence of SSI amounted to 1.6% (1.5% HPRO and 1.9% KPRO) and in-hospital incidence density rates were 1.23 and 1.53 per 1000 patient-days, respectively. Median age of surgical patients in both HPRO and KPRO was 70 years. Women were undergoing arthroplasty surgery more often than men, HPRO (p < 0.05) and KPRO (p < 0.001). Patients with SSI stayed in the ward longer (SSI-HPRO, p < 0.001) (SSI-KPRO p < 0.01). In KPRO operations, the incidence of SSI was higher than expected, calculated according to the Standardized Infection Ratio (SIR). The most common etiologic agents isolated from SSIs in both HPRO and KPRO were coagulase-negative staphylococci. Conclusions: Establishing a thorough surveillance of hospital-acquired infections that takes into consideration epidemiological indicators is indispensable to properly assess the epidemiological situation in the ward. The optimal solution is to carry out long-term and multi-center surveillance in the framework of a uniform program, however, even results of single-center studies provide valuable data indicating challenges and needs in improving patient safety. Full article
Open AccessArticle
Development of an Assessment Method for Investigating the Impact of Climate and Urban Parameters in Confirmed Cases of COVID-19: A New Challenge in Sustainable Development
Int. J. Environ. Res. Public Health 2020, 17(8), 2801; https://doi.org/10.3390/ijerph17082801 - 18 Apr 2020
Cited by 3
Abstract
Sustainable development has been a controversial global topic, and as a complex concept in recent years, it plays a key role in creating a favorable future for societies. Meanwhile, there are several problems in the process of implementing this approach, like epidemic diseases. [...] Read more.
Sustainable development has been a controversial global topic, and as a complex concept in recent years, it plays a key role in creating a favorable future for societies. Meanwhile, there are several problems in the process of implementing this approach, like epidemic diseases. Hence, in this study, the impact of climate and urban factors on confirmed cases of COVID-19 (a new type of coronavirus) with the trend and multivariate linear regression (MLR) has been investigated to propose a more accurate prediction model. For this propose, some important climate parameters, including daily average temperature, relative humidity, and wind speed, in addition to urban parameters such as population density, were considered, and their impacts on confirmed cases of COVID-19 were analyzed. The analysis was performed for three case studies in Italy, and the application of the proposed method has been investigated. The impacts of parameters have been considered with a delay time from one to nine days to find out the most suitable combination. The result of the analysis demonstrates the effectiveness of the proposed model and the impact of climate parameters on the trend of confirmed cases. The research hypothesis approved by the MLR model and the present assessment method could be applied by considering several variables that exhibit the exact delay of them to new confirmed cases of COVID-19. Full article
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Open AccessBrief Report
COVID-19 Pandemic and the Crisis of Health Systems: The Experience of the Apulia Cancer Network and of the Comprehensive Cancer Center Istituto Tumori “Giovanni Paolo II” of Bari
Int. J. Environ. Res. Public Health 2020, 17(8), 2763; https://doi.org/10.3390/ijerph17082763 - 16 Apr 2020
Abstract
On 11 March 2020, the World Health Organization declared a new disease caused by a novel virus characterized by rapid human-to-human transmission and named severe acute respiratory syndrome coronoavirus-2 (SARS-CoV-2) a pandemic. In terms of this ongoing international scenario, we report the situation [...] Read more.
On 11 March 2020, the World Health Organization declared a new disease caused by a novel virus characterized by rapid human-to-human transmission and named severe acute respiratory syndrome coronoavirus-2 (SARS-CoV-2) a pandemic. In terms of this ongoing international scenario, we report the situation in Apulia, a region of southern Italy that, as of April 2, has not yet been overwhelmed by this health emergency. In particular, we consider the care models that have been adopted, especially those that manage the requests of cancer patients. Full article

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Epidemiology of surgical site infections considering the NHSN Standardized Infection Ratio in hip and knee arthroplasties
Authors: Róża Słowik; Małgorzata Kołpa; Marta WAŁASZEK; Anna Różańska; Barbara Jagiencarz-Starzec; Witold Zieńczuk; Łukasz Kawik; Zdzisław Wolak; Jadwiga Wójkowska-Mach
Affiliation: Jagiellonian University Medical College
Abstract: INTRODUCTION Surgical site infections (SSIs) are a predominant form of hospital-acquired infections in surgical wards. MATERIAL AND METHODS The study was conducted in 2012–2018 in a Trauma and Orthopedics Ward in Tarnów. Testing comprised 2,340 surgery patients, including: 1,756 Hip Prosthesis (HPRO) and 584 Knee Prosthesis (KPRO) operations. The study was conducted according to the methodology of the Healthcare-Associated Infections Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC). The objective of the study was analysis of SSI incidence in hip and knee arthroplasties. RESULTS In the group of patients under study, 37 cases of SSI were detected, including: 26 cases of SSI after HPRO and 11 cases in KPRO. The average incidence of SSI amounted to 1.6% per 100 operations (1.5% HPRO and 1.9% KPRO). The median age of surgery patients in both HPRO and KPRO was 70 years. Women were undergoing endoprosthesis surgery more often than men, HPRO (p<0.05) and KPRO (p<0.001). Patients with SSI stayed in the ward longer (SSI-HPRO, p<0.001) (SSI-KPRO p<0.01). In KPRO operations, the incidence of SSI was higher than expected, calculated according to the Standardized Infection Ratio (SIR). The most common etiologic agents isolated from patients with SSI in both HPRO and KPRO were coagulase-negative staphylococci. CONCLUSIONS Establishing a thorough surveillance of hospital-acquired infections that takes into consideration epidemiological indicators is indispensable to properly assess the epidemiological situation in the ward. The optimal solution is to carry out long-term and multi-center surveillance in the framework of a uniform program, however, even results of single-center studies provide valuable data indicating challenges and needs in improving patient safety. In Polish hospitals, the healthcare system conditioning is probably a significant factor affecting epidemiological coefficients.

Title: Characteristics of and public health emergency responces to COVID-19 and H1N1 outbreak: a case-comparison study
Authors: Qian Wang; Tiantian Zhang; Huanhuan Zhu; Ying Wang; Xin Liu; Ge Bai; Ruiming Dai; Ping Zhou; Li Luo
Affiliation: School of Public Health, Fudan University
Abstract: Background: In 2019, the novel coronavirus disease (COVID-19) emerged in China and now spread rapidly as a globle pandemic. In view of the disaster the last global pandemic (2009 H1N1) caused, we explored the government’s emergency responses to COVID-19 in comparison with H1N1, in order to draw a lesson from the past, and provide suggestions to policy makers. Methods: A qualitative comparative study was conducted in the study, by using a set of 6 key time nodes selected from international literature to compare the emergency responses of H1N1 (2009) and COVID-19. Besides, we also explored the spread speed and peak time of COVID-19 and H1N1 swine influenza by comparing the confirmed cases in the same time interval.Results: (1) The government’s entire emergency responses of the epidemic, H1N1 swine influenza (2009) completed in 28 days, and COVID-19 (2019) completed in 46 days. Emergency responses speed for H1N1 was 18 days faster. (2) As for the epidemic spread speed, the peak time of H1N1 came about 4 weeks later than that of COVID-19, and the H1N1 curve in America was more flat than COVID-19 within the first four months after the disease emerged. Conclusions: The emergency responses to H1N1 was faster than that of COVID-19, which might be an important influential factor for slowing down the arrival of the peak time at the begginning of the epidemic. While the strict follow-up measures for COVID-19 in China help to constain the further spread of epidemic effectively in a short time.

Title: COVID-19 pandemia and the crisis of health systems: the experience of the Apulia Cancer Network and of the Comprehensive Cancer Center Istituto Tumori “Giovanni Paolo II” of Bari
Authors: Nicola Silvestris; Antonio Moschetta; Angelo Paradiso; Antonio Delvino
Affiliation: Department of Biomedical Sciences and Human Oncology, Unit of Internal Medicine “Guido Baccelli”, University of Bari Medical School, Bari, Italy; IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
Abstract: Nothing will be like before; or at least nothing should remain as before. The storm triggered by COVID-19 pandemia has placed each of us in front of the fear of unknown life-threatening danger with the health systems in crisis even in the most advanced countries. In this international scenario, we report the situation in Apulia, a region of southern Italy that on April 2 has not yet been overwhelmed by this health emergency. In particular, we consider care models that have been adopted, especially in order to manage the requests of cancer patients.

Title: Development of an Assessment Method for Investigating the Impact of Climate and Urban Parameters in Confirmed Cases of COVID-19: A New Challenge in Sustainable Development
Authors: Behrouz Pirouz; Sina Shaffiee Haghshenas; Behzad Pirouz; Sami Shaffiee Haghshenas; Patrizia Piro
Affiliation: Department of Computer Engineering, Modelling, Electronics and Systems Engineering, University of Calabria, Rende
Abstract: Sustainable development has been a controversial global topic and counting as a complex concept in recent years, which plays a key role in creating a favorable future for societies. Meanwhile, there are several problems in the process of implementing this approach, like epidemic diseases. Hence, in this study, the impact of climate and urban factors on confirmed cases of COVID-19 (a new type of coronavirus) with the trend and multivariate linear regression (MLR) has been investigated to propose a more accurate prediction model. For this propose, some important climate parameters, including daily average temperature, relative humidity, and wind speed besides urban parameter such as population density were considered, and their impacts on confirmed cases of COVID-19 was analyzed. The analysis conducted for three case studies in Italy and the application of the proposed method have been investigated. In this regard, the impacts of parameters have been considered with a delay time from one to nine days to find out the most suitable combination. The result of the analysis demonstrated the effectiveness of the proposed model and the impact of climate parameters on the trend of confirmed cases.

Title: Epidemiology of Shiga toxin-producing Escherichia coli infections in Southern Italy after implementation of symptom-based surveillance of bloody diarrhea in the pediatric population
Authors: Daniela Loconsole; Mario Giordano; Francesca Centrone; Marisa Accogli; Daniele Casulli; Anna Lisa De Robertis; Anna Morea; Michele Quarto; Antonio Parisi; Gaia Scavia; Maria Chironna
Affiliation: Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy
Abstract: Shiga toxin-producing Escherichia coli (STEC) infections result in a significant public health impact because of the severity of the disease that, in young children especially, can lead to Hemolytic-Uremic Syndrome (HUS). A rise in the number of HUS cases was observed in the Apulia region of Italy from 2013 to 2017 and so, in 2018, a symptom-based surveillance system for children with bloody diarrhea (BD) was initiated to detect and manage STEC infections. The objective of the study was to describe the epidemiology of STEC infections in children from June 2018 to August 2019. Children <15 years were hospitalized with BD and tested for STEC. Real-time PCR for virulence genes (stx1, stx2, eae) and serogroup identification tests were performed on stool samples/rectal swabs of cases. STEC infection was detected in 87 (10.6%) BD cases. The median age of STEC cases was 2.7 years, and 60 (68.9%) were <4. Of these 87 cases, 12 (13.8%) came from households with diarrhea. The reporting rate was 14.2/100,000, with the highest incidence in cases from the province of Bari (24.2/100,000). Serogroups O26 and O111 were both detected in 22/87 (25.3%) cases. Co-infections occurred in 12.6% of cases (11/87). Twenty-nine STEC were stx1+, stx2+, and eae+. Five cases (5.7%) caused by O26 (n=2), O111 (n=2), and O45 (n=1) developed into HUS. A risk-oriented approach based on testing of children with BD during the summer may represent a potentially beneficial option to improve the sensitivity of STEC surveillance, not only in Italy but also in the European context.

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