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Health Minister Livia Turco promised swift action, but insisted that Italians could still trust their health system, noting the problems affected a minority of the country's hospitals.

Special health units from the Carabinieri paramilitary police inspected 321 of Italy's 672 public medical centers this week, reporting shocking instances of poor hygiene, officials said at a news conference at the Health Ministry.

Some 17 percent of hospitals, mostly in southern and central Italy, had problems serious enough to recommend possible judicial investigations against 111 people, the Health Ministry said. Thirty-six percent of hospitals were found to have administrative violations.

The investigation was ordered after a magazine report on one of Rome's largest hospitals showed images of corridors soiled with dog feces and garbage, unguarded radioactive material, abandoned medical records and workers smoking next to patients.

The police inspection found hundreds of expired drugs and reactants for lab tests across Italy. In Calabria, some nurses were unlicensed, while some hospital workers in Sicily used friends or family to punch them in while they moonlighted at other jobs, said Gen. Saverio Cotticelli, head of the unit that made the inspections.

Italian newspapers also reported that police found a colony of stray cats in the basement of Milan's San Carlo hospital, while rats were found in a Naples hospital, where bulldozers had to be called in to remove piles of garbage and medical refuse left in underground corridors.

Cotticelli confirmed the reports but declined to give details. He insisted the problems were limited and didn't affect patient care.

"The problem of stray animals is one that returns periodically, you exterminate and after a month they are back," he said. "We found disorder and lack of maintenance ... there are some modest changes to be made, often it's simply an issue of mentality."

In the report last week by L'Espresso weekly, a journalist roamed freely around Rome's Umberto I Polyclinic for a month using a blue cleaner's uniform. The report denounced poor hygiene that exposed patients to an increased risk of hospital infections.

Turco, the health minister, noted that hospital infections affect between 4.5 and 7 percent of those treated in Italian medical centers, in line with European Union averages.

A 2000 report by the World Health Organization ranked Italy's health system as second-best after France. The United States came in 37th out of 191 countries ranked by performance.

"Citizens can trust the Italian health system, there are cases of negligence that must be dealt with firmly, there are problems of neglect that must be solved, but there is a lot of good health work being done," Turco said at the presentation of the inspection's results.