Nosocomial, and community-acquired infections are surveillance terms that have stood, essentially unaltered, for almost two decades, yet the health care system has been anything but static during this period. Nosocomial is considered an infection occurring in patients hospitalized 48 hours or longer, community-acquired an infection in a patient with no discernible recent contact with the health-care system. This distinction seems to be outdated because some nosocomial multidrug-resistant organisms (MDROs) are spreading in the community and, vice-versa, community acquired methicillin- resistant Staphylococcus aureus strains have been isolated in patients in healthcare institutions, blurring the definition of community and hospital-acquired infection.
The second AMIT Congress has been organized in different Scientific Sessions, selected by the Organizing Committee, in order to consider and discuss some of the most important emerging topics related to the microbiology, epidemiology, treatment and prevention of infections. The Clostridium difficile worldwide spreading epidemic and the rapidly increasing prevalence of infections in long-term care facilities (LTCFs) are new challenges to face. The risk of infection in LTCFs, is increasing for different reasons: the greater circulation of MDROs, patients transferred from the acute care to the LTCF setting, structural factors related to facilities, low-technology, understaffing and overcrowding.
The infections caused by MDROs and the currently available therapeutic armamentarium are very important and useful topics for the clinician in the routine practice; in particular: the new model for antibiotic treatment, monotherapy versus combination, antifungal treatment, antibiotic empirical therapy in the intensive care units (ICU), PK and PD of new antibacterial agents. How to treat and to prevent the infections associated with intravascular devices and in solid organ transplant recipients have also been focused as topics of main interest to discuss during the Congress. As far as prevention strategies for the different surveillance and control models of healthcare infections, current policies used in France and in four Italian regions will be compared. A Session will be also devoted to the increasingly frequent legal claims in Italy related to responsibilities and risks of the healthcare professionals in order to reduce conflicts opposing doctors to patients.
In particular, the medico-legal aspects in case of endemic and epidemic infections and the new models for the management of health-care acquired infections, will be discussed. The relationships between molecules with immunotherapeutic effects in HIV-positive patients and the use of new pharmacogenetic methods in clinical practice will be the topics of the last Congress Session. The hope of the second AMIT Congress is to contribute, not only to improve the scientific knowledge of the Specialists in Internal Medicine, Infectious Diseases and Clinical Microbiology through the presentations of renowned International and Italian experts, but also to propose legislative changes in this field.