Italy's biggest hospital was at the centre of a hygiene and mismanagement scandal on Friday after an Italian magazine printed the shocking findings of a journalist who worked undercover as a cleaner at the clinic.
Journalist Fabrizio Gatti who writes for the weekly L'Espresso spent a month pretending to be a cleaner at the Umberto I hospital in Rome.
His subsequent report painted a picture of filth and negligence which put patients' health at risk.
Using a small hidden camera, Gatti photographed and filmed dirty floors and corridors, hazardous refuse that had been abandoned inside the hospital, staff smoking outside the children's intensive care unit and cleaning mops and brooms that were old and soiled.
The latest edition of L'Espresso carried Gatti's expose' while its on-line version added the short films shot by the reporter inside the hospital.
The immediate effect was the arrival of the Carabinieri police's health and hygiene unit Nas at Umberto I, which is under the management of Rome's La Sapienza University.
Nas officers swooped on the hospital on Friday morning on magistrates' orders, carrying out inspections and checks throughout the sprawling structure.
Health Minister Livia Turco subsequently said she wanted an investigation of hygiene standards in all Italian hospitals.
She said the probe would begin next week after she had had talks with the governments of Italy's 20 regions, who are responsible for local health care.
The minister expressed particular concern about the possible impact of poor hygiene on hospital infection levels.
According to figures cited by L'Espresso, between 4,500-7,000 patients die each year because of infections contracted while in hospital.
It said hospital infections were a factor in 21,000 other patient deaths per year while up to 700,000 patients contracted non-fatal infections.
In 2005, 6.7% of all hospital patients were hit by infections which in at least 30% of cases could have been avoided, the weekly said.
Piero Marrazzo, who heads the regional government of Lazio of which Rome is the capital, said he was "shocked and dismayed" by the L'Espresso article.
"It's unbelievable that such basic hygiene and safety norms could be breached in such a way in a hospital," he said.
Marrazzo also said he wanted a thorough review of the hospital's cleaning contracts, warning the outside contractors that they could see their deals revoked or suffer penalties if they were found to be at fault in any way.
In his article, Gatti reported that the four floors of Umberto I's eye care unit were cleaned by two people hired by the contractor Pultra.
He said that during his month at the hospital, one of the cleaners was off sick and so the other had to do all the work single-handedly and without the aid of any industrial cleaning machines.
"There are no vacuum cleaners or other machines because in order to earn more, the contractors hire at the lowest wage level and only specialised workers can operate such equipment.
"The result is that in these wards and others, the same mops and cloths cover kilometers every day without ever being changed or washed between one room and the next or one ward and the next," Gatti said.
He noted that the 2005 contract for Pultra's services had cost the hospital 8.687 million euros.
Gatti himself was not officially hired as a cleaner but simply slipped into the hospital last month disguised as one. No-one stopped him to ask his identity or carry out a security check for the entire four weeks he was there.
He said he discovered areas of the hospital which were being used as rubbish tips with piled-up waste that included material labelled as "dangerous and infective".
He said patients, some of them in a critical condition, were wheeled through abandoned, filthy corridors that were being used as short cuts between wards.
Gatti also said the filth was then transported through the hospital on the footwear of staff and the wheels of wheelchairs and trolleys.
At one point, Gatti came across some dog excrement in one of the corridors which he said remained there for three days.
Other episodes highlighted by the reporter included the abandonment of thousands of confidential patient files in a corridor and the lack of security measures on the infectious disease and radiology wards, which he said anyone could walk into.
Umberto I has in the past been at the centre of a series of health scares related to poor hygiene standards.
In 1999, four patients lost their sight after undergoing routine cataract operations while more than a dozen babies subsequently came down down with mysterious intestinal infections so severe that two of them had to have part of their intestines removed.
Gatti is one of Italy's top investigative reporters.
Last year, he posed as an illegal immigrant tomato picker to expose conditions for such workers on farms in the southern region of Puglia.
In 2005, he triggered a storm with a similar report about conditions at an immigrant holding centre on the Sicilian island of Lampedusa.
