Large Italian University Research Articles

Why are lower socioeconomic background students underrepresented in Erasmus? A focus on the selection into mobility and degree course organization

ABSTRACT Disadvantaged students in higher education are significantly underrepresented in study abroad programs. Existing research has explored this socioeconomic disparity in student mobility, primarily by comparing mobile and non-mobile students. However, these studies often overlook the extensive selection process students undergo to join a mobility program, encompassing application phases, eligibility assessments, and ability evaluations. This study investigates how these selection steps contribute to the unequal uptake of higher education mobility in Europe, focusing on the European Union’s most popular study-abroad program ‘Erasmus’. Additionally, it explores how the program organization at the degree course level is associated with socioeconomic disparities in student mobility. Using administrative population data from a large Italian university, covering 46,000 graduates, the study finds that, on average, 90% of socioeconomic disparities in Erasmus mobility are due to disadvantaged students shying away from the application, while ability selection is only marginally important. Additionally, degree-level characteristics, particularly the social segregation across fields of study, matter. Although the study is based on data from a single university in Italy, it has implications for an international audience in countries with similar institutional settings for international student mobility, as it demonstrates for the first time the impact of the selection process and degree course organization on the socioeconomic gap in study abroad program participation.

The new normal of remote work: exploring individual and organizational factors affecting work-related outcomes and well-being in academia.

Flexible work arrangements have become increasingly popular, driven by the widespread adoption of digital technologies in the workplace because of the pandemic. However, there is a scarcity of studies concerning remote work, especially related to technical-administrative staff (TAS) in academia. Therefore, the current study, adopting the Job Demands-Resources model, aimed to investigate the relationships between remote working self-efficacy, organizational support, techno-complexity, mental well-being, and job performance among TAS during remote working. A total of 373 individuals from TAS of a large Italian university participated in this study by completing a self-report questionnaire. The findings showed positive and significant relationships between remote self-efficacy and job satisfaction as well as between such a perceived efficacy and mental well-being. Perceived support from supervisors acted as a protective factor against techno-complexity. In contrast, perceived support from colleagues emerged as able to promote well-being and job satisfaction. In addition, the latter was positively associated with well-being. Finally, individual job performance was positively affected by job satisfaction and negatively by techno-complexity. This study highlights the need for interventions to support TAS in remote working environments by leveraging employees' self-efficacy as a key factor in reducing stress related to new technologies as well as enhancing well-being, job satisfaction, and, in turn, their performance.

Risk of obstructive sleep apnea among health workers: results of a screening in a large Italian University Hospital.

Obstructive sleep apnea (OSA) is a common respiratory sleep disorder, related to increased mortality, poor quality of life, and higher risk of work accidents and injuries. Studies on the risk of OSA (rOSA) among health workers (HW) are scant. The aims of this study were to investigate this issue in a large University Hospital and to assess the effectiveness of a screening program. The STOP-BANG questionnaire (SBQ) was sent via e-mail to the 5031 HW employed at the University Hospital of Verona. HW who completed the SBQ were classified at low, moderate, and high rOSA. HW at high rOSA were invited to undergo nocturnal polygraphy. The determinants of rOSA were studied by non-parametric Kruskal-Wallis test, Pearson's chi-squared, and multinomial logistic model. Of 5031 HW, 1564 (31.1%) completed the online questionnaire. Responders with low, moderate, and high rOSA were 72.7%, 13.7%, and 13.6%. Male gender, older age, and higher body mass index (BMI) were significant predictors of high rOSA, as expected. Physicians had the lowest probability of being in the high-risk category. Polygraphy was performed in 64 subjects. The positive predictive value of the self-administered SBQ was 68.8% (95%C.I. 55.9-79.8%) but raised to 96.9% (95%C.I. 89.2-99.6%) when re-administered by medical staff. SBQ showed its effectiveness as a screening tool in detecting undiagnosed OSA in HW. Systematic screening for OSA in work settings could allow early diagnosis and treatment, reducing short- and long-term health effects of OSA.

Readiness to Change and Change Recipients’ Reactions. An Investigation of the Beneficial Effects of Change Cynicism

ABSTRACT During M&A (mergers and acquisitions), a frequent outcome is the negative reactions of workers, who demonstrate psychological distress and resistance to change. This paper presents an empirical research study carried out in a large Italian university hospital during an organizational restructuring, which led to the merger of several organizational units. The research involved a sample of healthcare operators as change recipients (N = 130), and investigated the relationship between Readiness to Change and change recipients’ reactions. By adopting a Structural Equation Model approach, this study suggests that the relationship between Readiness To Change and Change Cynicism, Change Anxiety and Intention To Quit, is complex and not always direct and linear. Furthermore, this paper shows the role that Change Cynicism plays in mediating the relationship between Readiness To Change and Change Anxiety and between Readiness To Change and Intention To Quit. This study highlights the importance of investigating and systemically addressing the relationship between these factors. MAD statement This article sets out to Make A Difference (MAD) through analysing the mechanisms underlying the affective and emotional reactions of change recipients. It provides an important practical contribution for practitioners, as it suggests how to manage the variables that intervene in a process of radical organizational change in an appropriate manner. This article has significant consequences, also at a societal level. It highlights the factors that should be managed to avoid undesired, negative organizational and corporate consequences such as states of change anxiety and the Intention To Quit.

To Work or Not to Work Remotely? Work-to-family Interface Before and During the COVID-19 Pandemic.

This paper provides a brief, evidence-based reflection on the differences between 'old-normal' remote working and mandatory work-from-home during the Covid-19 pandemic. From the perspective of applied psychology in the field of work and organizations, we used self-report instruments to assess variations in work-family conflict and enrichment, frequency of information and communication technologies use, and recovery in two longitudinal studies. The first study involved 148 individuals from the technical-administrative staff of a large Italian University, during an experimentation of remote working (one day per week) in 2019. The second study, conducted during the first lockdown in 2020, involved 144 individuals (occasional sample, heterogeneous by profession). All participants completed a self-report online questionnaire two times six months apart. Although the two studies are not directly comparable, the results showed two different situations: in the condition of experimental remote working (one day per week), participants reported a decrease in work-family conflict and an improvement in recovery experiences, while in the emergency remote working condition, a deterioration in work-family enrichment was found. These findings highlighted that some differences exist between a planned remote working condition and a mandatory one in an emergency. We briefly discuss these aspects to inform future organizational decisions and actions for the 'new normal'.

Infection Control among Healthcare Workers and Management of a Scabies Outbreak in a Large Italian University Hospital.

This retrospective observational study describes the results of an ad-hoc designated prevention protocol aimed at containing the spread of the scabies infestation among healthcare workers (HCWs) of a large University Hospital in Italy. The outbreak started on October 2022 and a preventive protocol was set up thanks to a multidisciplinary approach. HCWs at high scabies risk were defined as subjects working in Operative Units with a scabies prevalence higher than 2%, close contacts of a confirmed case of scabies, or HCWs with signs and symptoms of the disease. All cases at high scabies risk underwent a dermatological examination, and the infested HCWs were suspended from work until definitive healing. Mass drug administration was established for all HCWs working in Operative Units with a scabies prevalence higher than 2%. Until March 2023, out of 183 screening dermatological examinations, 21 (11.5%) were diagnostic for scabies. Between 11 October 2022 (date of the first diagnosed scabies case) and 6 March 2023 (the end of incubation period related to the last case detected), the frequency of scabies was 0.35% (21 scabies cases/6000 HCWs). The duration of the outbreak in our hospital was 14.7 weeks. Statistical analysis shows a significant association between scabies and being a nurse and having an allergy to dust mites. We obtained a low frequency of scabies infection, limiting the duration of the outbreak and the related economic burden.

Analysis of Medico-Legal Complaint Data: A Retrospective Study of Three Large Italian University Hospitals.

(1) Background: Identifying hospital-related critical, and excellent, areas represents the main goal of this paper, in both a national and local setting. Information was collected and organized for an internal company's reports, regarding civil litigation that has been affecting the hospital, to relate the obtained results with the phenomenon of medical malpractice on a national scale. This is for the development of targeted improvement strategies, and for investing available resources in a proficient way. (2) Methods: In the present study, data from claims management in Umberto I General Hospital, Agostino Gemelli University Hospital Foundation and Campus Bio-Medico University Hospital Foundation, from 2013 to 2020 were collected. A total of 2098 files were examined, and a set of 13 outcome indicators in the assessment of "quality of care" was proposed. (3) Results: From the total number, only 779 records (37.1%) were attributable to the categories indexable for the present analysis. This data highlights how, following a correct and rigorous categorization of hospital events, it is possible to analyze these medico-legal aspects using a small number of indicators. Furthermore, it is important to consider how a consistent percentage of remaining events was difficult to index, and was also of poor scientific interest. (4) Conclusions: The proposed indicators do not require standards to be compared to, but provide a useful instrument for comparative purposes. In fact, in addition to comparative assessment between different business realities distributed throughout the territory, the use of outcome indicators allows for a longitudinal analysis evaluating the performance of an individual structure over time.

Indoor Radon Concentration Levels in Healthcare Settings: The Results of an Environmental Monitoring in a Large Italian University Hospital.

The aim of the study is to determine the radon concentrations in the University Hospital of Bari, Apulia Region, Southern Italy. The monitoring took place from 2017 to 2018 for a total of 402 days and included 3492 premises. Radon environmental sampling was performed with passive dosimeters of the CR-39 type. The highest mean concentration was found in basement rooms (118.9 Bq/m3), followed by ground-floor rooms (88.2 Bq/m3), first-floor rooms (78.1 Bq/m3), second-floor rooms (66.7 Bq/m3), and third-floor rooms (68.9 Bq/m3). An average radon concentration lower than the WHO recommended level of 100 Bq/m3 was detected in 73.5% of monitored environments, while only 0.9% exceeded the reference level of 300 Bq/m3 set by the national law (Legislative Decree 101/2020). The frequency of environments in which radon concentrations exceed 300 Bq/m3 is significantly higher in the basement (p-value < 0.001). As for a previous preliminary investigation in the same hospital conducted on a much smaller number of premises (n = 401), most of the monitored environments had radon concentrations lower than the reference levels set by the new national law, and the risk to the healthcare workers' health derived from occupational exposure to radon could be considered acceptable.

The Mediating Role of Sleep Quality in the Relationship between Negative Emotional States and Health-Related Quality of Life among Italian Medical Students.

Sleep problems have been shown to be related to adverse outcomes concerning physical and mental well-being. Furthermore, mental health issues and sleep problems were reported to be highly prevalent among medical students and physicians, and were found to be associated with worse academic and clinical performance in these populations. This study aims to investigate the prevalence of poor sleep to examine the associations between sleep quality and health-related quality of life (HRQoL), and to explore the possible mediating role of sleep in the relationship between psychological distress and HRQoL itself in a sample of medical and dental students attending a large Italian university. Participants (n = 407, mean age: 24.2 ± 2.4) answered an online questionnaire comprising the 21-item Depression Anxiety Stress Scale, the Pittsburgh Sleep Quality Index, and the Short Form-12 health survey. Up to 62% of the participants reported poor sleep quality. Controlling for psychological distress, sleep quality components were found to be associated with physical and mental HRQoL. Mediation analysis showed that overall sleep quality mediated all the single associations between anxiety, depression, and stress and HRQoL. These preliminary findings suggest that the quality of sleep is important for the well-being of medical students and that targeting sleep issues in this academic population may be beneficial.

Validation of the Italian version of the Camouflaging Autistic Traits Questionnaire (CAT-Q) in a University population

The Camouflaging Autistic Traits Questionnaire (CAT-Q) is an instrument recently developed and validated in English for measuring social camouflaging. While increasing research is focusing on camouflaging behaviours often used for masking autistic traits in social contexts, the CAT-Q remains the only self-report instrument in this field. We aimed to validate the Italian version of the CAT-Q, further testing its validity and reliability in a large Italian University population (N = 2439). We employed the Adult Autism Subthreshold Spectrum (AdAS Spectrum) for assessing autism spectrum conditions. The CAT-Q demonstrated excellent internal consistency and test-retest reliability, as well as strong correlations with the AdAS Spectrum. Our results confirm that the CAT-Q is a valuable instrument for evaluating social camouflaging.

Candidemia in intensive care units over nine years at a large Italian university hospital: Comparison with other wards.

PurposeCandidemia is an alarming problem in critically ill patients including those admitted in intensive care units (ICUs). We aimed to describe the clinical and microbiological characteristics of bloodstream infections (BSIs) due to Candida spp. in patients admitted to ICUs of an italian tertiary referral university hospital over nine years.MethodsA retrospective observational study of all cases of candidemia in adult patients was carried out from January 1, 2010 to December 31, 2018 at a 980-bedded University Hospital in Ancona, Italy, counting five ICUs. The incidence, demographics, clinical and microbiologic characteristics, therapeutic approaches and outcomes of ICU-patients with candidemia were collected. Non-ICU patients with candidemia hospitalized during the same time period were considered for comparison purposes. Early (7 days from the occurrence of the episode of Candida BSI) and late (30 days) mortality rates were calculated.ResultsDuring the study period, 188/505 (36%) episodes of candidemia occurred in ICU patients. Cumulative incidence was 9.9/1000 ICU admission and it showed to be stable over time. Candida albicans accounted for 52% of the cases, followed by C. parapsilosis (24%), and C. glabrata (14%). There was not a significant difference in species distribution between ICU and non-ICU patients. With the exception of isolates of C. tropicalis which showed to be fluconazole resistant in 25% of the cases, resistance to antifungals was not of concern in our patients. Early and late mortality rates, were 19% and 41% respectively, the latter being significantly higher than that observed in non-ICU patients. At multivariate analysis, factors associated with increased risk of death were septic shock, acute kidney failure, pulmonary embolism and lack of antifungal therapy. The type of antifungal therapy did not influence the outcome. Mortality did not increased significantly over time.ConclusionNeither cumulative incidence nor crude mortality of candidemia in ICU patients increased over time at our institution. However, mortality rate remained high and significantly associated with specific host-related factors in the majority of cases.

Influenza and pneumococcal vaccinations are not associated to COVID-19 outcomes among patients admitted to a university hospital

In order to reduce the burden on healthcare systems and to support differential diagnosis with COVID-19, influenza and pneumococcal vaccinations were strongly recommended during the COVID-19 pandemic, especially in vulnerable groups. However, no univocal and conclusive evidence on the relationship between influenza and pneumococcal vaccinations and COVID‐19 outcomes exists. We evaluated the association between such vaccinations, COVID-19 hospitalization, intensive care unit admissions and deaths in a cohort (N = 741) of COVID-19 patients who had access to the emergency room of a large Italian University hospital between March 1, 2020 and June 1, 2020. Results show that influenza and pneumococcal vaccinations did not affect hospitalization, intensive care unit admission and deaths in COVID-19 patients in the overall sample and in those ≥65 years. The same pattern of results was confirmed considering timing of influenza vaccine administration, vaccination type, and number of uptakes in the last five vaccination campaigns. In conclusion, our study does not support an impact of influenza and pneumococcal vaccinations on COVID-19 outcomes.

Successful SARS-CoV-2 vaccine allergy risk-management: The experience of a large Italian University Hospital

BackgroundNovel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines have been approved recently, and public concern regarding the risk of anaphylactic reactions arose after a few cases during the first days of mass vaccination. Polyethylene glycol (PEG) has been suggested as the most probable culprit agent for allergic reactions. ObjectiveWe describe the allergy work-up protocol implemented for the vaccination campaign in our Center, aiming to allow the greatest number of people to be vaccinated safely. MethodsThe protocol included the self-report of a history of suspected drug or vaccine allergies, and subsequent teleconsultation and allergometric tests for PEG and Polysorbate 80 (PS80). A desensitizing protocol of vaccine administration was applied to patients sensitized only to PS80, and to those with a suspect allergic reaction after the first vaccine dose. Results10.2% (414 out of 4042) of the entire vaccine population have been screened: only one patient resulted allergic to PEG and therefore excluded from the vaccination. Another patient was sensitized to PS80 only and safely vaccinated applying the desensitizing protocol. Seven subjects without a previous history of allergic disease experienced suspect hypersensitivity reactions to the first administered dose: one of them resulted allergic to PEG and was excluded from the second dose, while the others safely completed the vaccination with the desensitizing protocol. ConclusionA careful allergological risk-assessment protocol significantly reduces the number of patients who would have avoided SARS-CoV-2 vaccination for their allergies and to effectively identify and manage those rare patients with sensitization to PEGs and/or PS80.

Utility of ultrasound-guided fine needle aspiration cytology in assessing malignancy in head and neck pathology.

Fine needle aspiration cytology (FNAC) is a well-established diagnostic procedure for head and neck masses not clearly originating from mucosal or cutaneous surfaces. We analysed head and neck masses evaluated over a 2-year period, to assess the reliability of FNAC for the evaluation of malignancy. We enrolled all patients undergoing FNAC, from April 2013 to July 2015, in a single service of a large Italian university hospital. Relevant clinical data and ultrasonographic parameters of the lesions were recorded. We performed both conventional and thin-prep smears. Clinical presentation, ultrasonographic features and final cytology diagnoses were analysed and correlated with histology. The series included 301 lesions in 285 patients, with a single (94.4%) or two (5.6%) lesions. Only eight samples were considered non-diagnostic/inadequate (2.6%). Among the cases, 139 FNAC (46.1%) underwent surgery. Cytological-histological correspondence was found in 89% of the cases. Concerning malignancy, we documented less than 4% false positives and less than 2.5% false negatives, with 92.7% sensitivity and 94.6% specificity. FNAC diagnosis can be highly specific. Most importantly, it is highly reliable in assessing malignancy, thus defining the priority and guiding the management procedures.

Request of hospital care dropped for TIA but remained stable for stroke during COVID-19 pandemic at a large Italian university hospital

Reduced incidence of stroke during COVID-19 pandemic was sometimes reported. While decrease in stroke incidence and fear of patients to go to the hospitals were sometimes invoked to explain this decrease, reduction in urban pollution was also hypothesized as a possible cause. We investigated statistically the incidence of ischemic and hemorrhagic stroke, and of transient ischemic attacks, at a large Italian tertiary stroke center during the pandemic. We analyzed statistically the number of transient ischemic attacks (TIA), ischemic strokes (IS) and hemorrhagic strokes (HS) between March 8 and May 2, 2020, the peak of the COVID-19 epidemic in Italy, and compared them with the identical period of 2019. We also analyzed the concentration of small particulate matter (PM10) in 2019 and 2020, to see if it could account for modified incidence of strokes or TIA. We found a large, significant drop in TIA (− 51%) during the pandemic compared to the same period of 2019. By contrast, the number of HS was identical, and IS showed a not significant − 24% decrease. PM10 concentration, already low in 2019, did not further decrease in 2020. Patients kept seeking hospital care when experiencing permanent neurological symptoms (stroke), but they tended not go to the hospital when their symptoms were transient (TIA). The fact that we did not observe a significant decrease in strokes may be explained by the fact that in our city the concentration of small particulate matter did not change compared to 2019.

Silence is golden: the role of team coordination in health operations

PurposeThis study investigates the relationships between team dynamics and performance in healthcare operations. Specifically, it explores, through wearable sensors, how team coordination mechanisms can influence the likelihood of surgical glitches during routine surgery.Design/methodology/approachBreast surgeries of a large Italian university hospital were monitored using Sociometric Badges – wearable sensors developed at MIT Media Lab – for collecting objective and systematic measures of individual and group behaviors in real time. Data retrieved were used to analyze team coordination mechanisms, as it evolved in the real settings, and finally to test the research hypotheses.FindingsFindings highlight that a relevant portion of glitches in routine surgery is caused by improper team coordination practices. In particular, results show that the likelihood of glitches decreases when practitioners adopt implicit coordination mechanisms rather than explicit ones. In addition, team cohesion appears to be positively related with the surgical performance.Originality/valueFor the first time, direct, objective and real time measurements of team behaviors have enabled an in-depth evaluation of the team coordination mechanisms in surgery and the impact on surgical glitches. From a methodological perspective, this research also represents an early attempt to investigate coordination behaviors in dynamic and complex operating environments using wearable sensor tools.

The interplay between work engagement, workaholism, emotional exhaustion and job satisfaction in academics: A person‐centred approach to the study of occupational well‐being and its relations with job hindrances and job challenges in an Italian university

AbstractThe aim of this study was to analyse the occupational well‐being of academics by using a person‐centred approach. Data was collected by an online self‐report questionnaire involving the academic population of a large Italian university. Cluster analysis showed the presence of four significantly different clusters, that were labelled engaged‐satisfied, engaged‐workaholic, exhausted‐workaholic and detached. Multivariate analysis of variances showed significant differences between clusters regarding well‐being dimensions, and the perception of work demand on academics as sources of hindrance or challenge. The findings of this study suggested, for the first time, the existence of a well‐being typology within the academic context, considering aspects, such as workaholism, that have been rarely taken into account. Moreover, it has been shown that the well‐being profile can influence the way in which academics perceived academic work demands, highlighting the potentialities of analysing well‐being profile in order to identify employees who are more or less at risk.

Candida blood stream infections observed between 2011 and 2016 in a large Italian University Hospital: A time-based retrospective analysis on epidemiology, biofilm production, antifungal agents consumption and drug-susceptibility.

Candida bloodstream infection (BSI) represents a growing infective problem frequently associated to biofilm production due to the utilization of intravascular devices. Candida species distribution (n = 612 strains), their biofilm production and hospital antifungal drug consumption were evaluated in different wards of a tertiary care academic hospital in Italy during the years 2011–2016. In the considered time window, an increasing number of Candida BSI (p = 0.005) and of biofilm producing strains were observed (p<0.0001). Although C. albicans was the species more frequently isolated in BSI with a major biofilm production, an increased involvement of non-albicans species was reported, particularly of C. parapsilosis that displayed a high frequency in catheter infections, and lower biofilm production compared to C. albicans. Although trends of biofilm production were substantially stable in time, a decreasing biofilm production by C. parapsilosis in the Intensive Care Unit (ICU) was observed (p = 0.0041). Principal component analysis displayed a change in antifungal drugs consumption driven by two mutually independent temporal trends, i.e. voriconazole use in the general medicine wards initially, and fluconazole use mainly in the ICU; these factors explain 68.9% and 25.7% of total variance respectively. Moreover, a significant trend (p = 0.003) in fluconazole use during the whole time period considered emerged, particularly in the ICU (p = 0.017), but also in the general medicine wards (p = 0.03). These trends paralleled with significant increase MIC90 of fluconazole (p = 0.05), particularly for C. parapsilosis in the ICU (p = 0.04), with a general and significant decreased trend of the MIC90 values of caspofungin (p = 0.04), and with significant increased MIC50 values for amphotericin B (p = 0.01) over the study period. In conclusion, drug utilization in our hospital turned out to be a putative influencing factor on the ecology of the species, on the increase in time of the biofilm producing strains and on the Candida antifungal susceptibility profile, thus influencing clinical management.

A Multiple-Indicator Latent Growth Mixture Model to Track Courses with Low-Quality Teaching

This paper describes a multi-indicator latent growth mixture model built on the data collected by a large Italian university to track students’ satisfaction over time. The analysis of the data involves two steps: first, a pre-processing of data selects the items to be part of the synthetic indicator that measures students’ satisfaction; the second step then retrieves heterogeneity that allows the identification of a clustering structure with a group of university courses (outliers) which underperform in terms of students’ satisfaction over time. Regression components of the model identify courses in need of further improvement and that are prone to receiving low classifications from students. Results show that it is possible to identify a large group of didactic activities with a high satisfaction level that stays constant over time; there is also a small group of problematic didactic activities with low satisfaction that decreases over the period under analysis.

Direct use of eazyplex® SuperBug CRE assay from positive blood cultures in conjunction with inpatient infectious disease consulting for timely appropriate antimicrobial therapy in Escherichia coli and Klebsiella pneumoniae bloodstream infections.

Objectives: To describe a rapid workflow based on the direct detection of Escherichia coli (Ec) and Klebsiella pneumoniae (Kp) producing CTX-M extended-spectrum β-lactamase (ESBL) and/or carbapenemases (eg, KPC, VIM) from blood cultures (BCs) and the infectious disease (ID) consulting for timely appropriate antimicrobial therapy.Methods: This observational, retrospective study included adult patients with a first episode of Ec or Kp bloodstream infection (BSI) in a large Italian university hospital, where an inpatient ID consultation team (IDCT) has been operational. Results from the BCs tested for detecting blaCTX-M, blaKPC, blaNDM, blaOXA-48-like, and blaVIM genes by the eazyplex® SuperBug CRE assay in Ec and Kp organisms had been notified for antimicrobial therapy consulting.Results: In 321 BSI episodes studied, we found that 151 (47.0%) of Ec or Kp organisms harbored blaCTX-M and/or blaKPC and/or blaVIM (meantime from BC collection: 18.5 h). Empirical antimicrobial treatment was appropriate in 21.8% (33/151) of BSIs, namely 5.9% (3/51) of BSIs caused by KPC/VIM producers and 30.0% (30/100) of BSIs caused by CTX-M producers. After notification of results, the IDCT modified antimicrobial therapy (mean time from BC collection: 20 h) such that the proportion of appropriate treatments increased to 84.8% (128/151) of BSIs, namely 70.6% (36/51) of BSIs caused by KPC/VIM producers and 92.0% (92/100) of BSIs caused by CTX-M producers.Conclusion: Our study shows that a rapid diagnostic-driven clinical strategy allowed for early prescription of potentially effective antimicrobial therapy in BSIs caused by CTX-M ESBL- and/or KPC/VIM carbapenemase-producing Ec and Kp organisms.