GERMS

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Open AccessCommunication

SARS-CoV-2 in Romania – Analysis of the First Confirmed Case and Evolution of the Pandemic in Romania in the First Three Months

by Adrian Streinu-Cercel, Cătălin Apostolescu, Oana Săndulescu, Dan Oţelea, Anca Streinu-Cercel, Ovidiu Vlaicu, Simona Paraschiv, Otilia Elisabeta Benea, Rodica Bacruban, Maria Niţescu, Alexandru Rafila, Amalia Şerban, Adriana Pistol and Daniela Piţigoi

GERMS 2020, 10(2), 132-134; https://doi.org/10.18683/germs.2020.1198 - 2 Jun 2020

Cited by 17

Abstract

On 26 February 2020, Romania reported the first confirmed case of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) – a 25-year-old man from Gorj county, Romania [...] Full article

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Open AccessCommunication

Coronavirus Disease (COVID-19) in Morocco: Situation Update and Proposed Remedial Measures

by Rahal El Kahkahi, Meryama Moustaine, Majida Hafidi, Rachid Zouhair and Rafik Errakhi

GERMS 2020, 10(2), 129-131; https://doi.org/10.18683/germs.2020.1197 - 2 Jun 2020

Cited by 8

Abstract

Coronavirus disease (COVID-19) is an emerging infectious contagious disease caused by a strain of coronavirus called SARS-CoV-2 [...] Full article

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Open AccessCommunication

Standardized Risk Assessment and Management of Exposure Amongst Healthcare Workers to Coronavirus Disease 2019

by Saurabh RamBihariLal Shrivastava and Prateek Saurabh Shrivastava

GERMS 2020, 10(2), 126-128; https://doi.org/10.18683/germs.2020.1196 - 2 Jun 2020

Cited by 2

Abstract

The ongoing coronavirus disease-2019 (COVID-19) pandemic continues to affect the lives of millions and has eventually brought everything to a standstill [...] Full article

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Open AccessCommunication

Native Mitral Valve Endocarditis Due to Neisseria elongata Following an Untreated Dental Abscess

by Maud Foissac, Ludovic Bergon, Morgane Mourguet, Laurent Prudhomme and Sarah Khatibi

GERMS 2020, 10(2), 123-125; https://doi.org/10.18683/germs.2020.1195 - 2 Jun 2020

Cited by 3

Abstract

Dear Editor, we report a new case of Neisseria elongata endocarditis to educate clinicians about this rare but serious disease [...] Full article

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Open AccessCommunication

Ensuring Optimal Utilization of Personal Protective Equipment in the Coronavirus Disease-2019 Pandemic

by Saurabh RamBihariLal Shrivastava and Prateek Saurabh Shrivastava

GERMS 2020, 10(2), 120-122; https://doi.org/10.18683/germs.2020.1194 - 2 Jun 2020

Cited by 1

Abstract

The Coronavirus Disease-2019 (COVID-19) pandemic [...] Full article

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Open AccessCase Report

A Case Report of Acute Disseminated Encephalomyelitis Following Severe Dengue in a Child

by Nutan Kamath, Kamineni Mounica, Jayashree Kanthila, Sowmini P Kamath and Suchetha S Rao

GERMS 2020, 10(2), 115-119; https://doi.org/10.18683/germs.2020.1193 - 2 Jun 2020

Cited by 1

Abstract

Introduction: Acute disseminated encephalomyelitis (ADEM) is a rare neurological complication seen in association with severe dengue infection. Here we report a case of a six-year-old male child with ADEM following dengue fever. Case report: A six-year-old boy was admitted with fever, hematuria, and [...] Read more.

Introduction: Acute disseminated encephalomyelitis (ADEM) is a rare neurological complication seen in association with severe dengue infection. Here we report a case of a six-year-old male child with ADEM following dengue fever. Case report: A six-year-old boy was admitted with fever, hematuria, and melena of five days duration. On evaluation, the child had shock and features of coagulopathy. Dengue NS 1 antigen and IgM ELISA were positive. The child received treatment as per the 2009 WHO dengue protocol. On day seven of illness, he developed neurological symptoms. Magnetic resonance imaging (MRI) done on day eight of illness showed T2/FLAIR hyperintensities in bilateral frontoparietal subcortical deep white matter, occipital periventricular white matter, pons and cerebellar hemispheres, diagnostic of ADEM. He responded to intravenous methylprednisolone. He was discharged 2 weeks after hospitalization. His neurological examination was normal at follow up after a month. Conclusions: Early recognition and prompt treatment of ADEM in dengue can lead to a successful outcome without neurological deficits. Full article

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Open AccessOpinion

Iranian Healthcare System Against COVID-19

by Milad Dodangeh and Masoud Dodangeh

GERMS 2020, 10(2), 112-114; https://doi.org/10.18683/germs.2020.1192 - 2 Jun 2020

Cited by 9

Abstract

Viruses are one of the major causes of morbidity and mortality worldwide [...] Full article

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Open AccessArticle

Molecular Surveillance of Methicillin-Susceptible Staphylococcus aureus (MSSA) Isolated over a One-Year Period from a Malaysian Teaching Hospital

by Hassriana Fazilla Sapri, Mohd Azrul Hisham Ismail, Nurul Azirah Mohamad Sani, Ainihayati Noordin, Toh Leong Tan, Salasawati Hussin and Hui-Min Neoh

GERMS 2020, 10(2), 104-111; https://doi.org/10.18683/germs.2020.1191 - 2 Jun 2020

Cited by 2

Abstract

Introduction: We report the results of a molecular surveillance study carried out on methicillin-susceptible Staphylococcus aureus (MSSA) isolated in a one-year duration from Hospital Canselor Tuanku Muhriz (HCTM), a tertiary hospital located in Kuala Lumpur, Malaysia. Methods: The first strain isolated from each [...] Read more.

Introduction: We report the results of a molecular surveillance study carried out on methicillin-susceptible Staphylococcus aureus (MSSA) isolated in a one-year duration from Hospital Canselor Tuanku Muhriz (HCTM), a tertiary hospital located in Kuala Lumpur, Malaysia. Methods: The first strain isolated from each MSSA infection in HCTM during the year 2009 was included into the study. Antimicrobial susceptibility testing and agr group typing were carried out for all strains; virulence gene (cna, seh, TSST-1 and PVL) typing results of the strains were obtained from a previous study. Pulsed-field gel electrophoresis (PFGE) was done on selected strains from the orthopedic ward. Relationship(s) between different typing methods used in the study was investigated, where a p value of <0.05 indicated significant association between typing methods. Results: A total of 880 MSSA strains were included into the study. The strains were generally susceptible to most antibiotics, with most of them carrying cna and agr-I (51.6%, n = 454; 39.8%, n = 350, respectively). A total of 17 PFGE pulsotypes were identified using an 80% similarity cut-off value, where the main pulsotype (pulsotype E) consisted of 24 isolates (23.5%). agr-III strains were found to be usually positive for both cna and seh (p < 0.05). In addition, some PFGE pulsotypes were also characteristic of certain virulence genes or agr groups. Conclusions: We did not identify a dominant MSSA clone circulating in HCTM in 2009. Nevertheless, results from this molecular surveillance will provide good baseline data for the hospital’s second S. aureus surveillance planned for the year 2020. Full article

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Open AccessArticle

Carbapenemase-Producing Enterobacteriaceae in a Portuguese Hospital – A Five-Year Retrospective Study

by Ana Gorgulho, Ana Maria Grilo, Manuel de Figueiredo and Joana Selada

GERMS 2020, 10(2), 95-103; https://doi.org/10.18683/germs.2020.1190 - 2 Jun 2020

Cited by 10

Abstract

Background: Our hospital experienced an outbreak of OXA-48-producing Enterobacteriaceae, triggering this study. We aimed to describe the population with carbapenemase-producing Enterobacteriaceae (CPE) in our hospital from 2014 to 2018, the phenotypic and genotypic characteristics of isolates, and strategies to stop the outbreak. Methods: [...] Read more.

Background: Our hospital experienced an outbreak of OXA-48-producing Enterobacteriaceae, triggering this study. We aimed to describe the population with carbapenemase-producing Enterobacteriaceae (CPE) in our hospital from 2014 to 2018, the phenotypic and genotypic characteristics of isolates, and strategies to stop the outbreak. Methods: We performed a retrospective study, including every patient with CPE species in a clinical sample. Epidemiology, risk factors, treatment and outcomes were gathered from medical records. Results: A total 113 patients were included, ranging from 5 in 2015 to 83 in 2018. In 2018 the number of CPE went from 4 in May to 20 in July. With the implemented measures, propagation stopped. Implantable devices were present in 36% of patients and open wounds in 34%. Antibiotics had been prescribed to 71% of patients in the prior 30 days and most of the patients had been hospitalized for more than 5 days prior to sample collection or had a hospital stay in the previous year. Klebsiella pneumoniae was the most common species (87%). OXA-48 (62%) and Klebsiella pneumoniae-carbapenemase (KPC) (15%) were the most common carbapenemases, with OXA-48 being implicated in the 2018 outbreak. The case fatality rate at 30 days was 32%. Combination therapy resulted in less mortality. Conclusions: While KPC is the most common carbapenemase in Europe and Portugal, we experienced an important OXA-48 outbreak. Surveillance should be in place as these isolates are probably spreading. Effective communication, multidisciplinary team work and proper infection control measures are some of the best strategies during outbreaks. Full article

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Open AccessArticle

Prevalence of Hepatitis E Virus in Children with Acute Hepatitis: One Egyptian Center Study

by Maysaa El Sayed Zaki, Mona Abdel Latif Alsayed, Hoda Ramadan Ryad Abbas, Doaa Mabrouk Ahmed and Amany Yusif El Ashry

GERMS 2020, 10(2), 88-94; https://doi.org/10.18683/germs.2020.1189 - 2 Jun 2020

Cited by 7

Abstract

Introduction: The objective of the present study was to evaluate the prevalence of hepatitis E virus in acute hepatitis in pediatric patients. Methods: This was a cross-sectional study including 180 children with acute hepatitis. Blood samples were obtained and subjected to study the [...] Read more.

Introduction: The objective of the present study was to evaluate the prevalence of hepatitis E virus in acute hepatitis in pediatric patients. Methods: This was a cross-sectional study including 180 children with acute hepatitis. Blood samples were obtained and subjected to study the serological markers of hepatitis B surface antigen (HBsAg), hepatitis B core IgM (HBc IgM), hepatitis C IgG (HCV IgG) and hepatitis A IgM (HAV IgM), hepatitis E IgM and IgG, cytomegalovirus IgM (CMV IgM) and specific antibodies IgM for Epstein Barr virus by ELISA. Also ELISA attempted the laboratory diagnosis of autoantibodies by performing assay of antinuclear and anti-smooth muscle antibodies. Real time PCR was used for determination of HEV-RNA in samples positive for HEV serological markers. Results: From a total of 180 children with acute jaundice 69.4% were males and 39.6% were females with mean age ± standard deviation 5.8 ± 3.5 years. Positive HEV markers were found in 47 patients (26.1%). A comparison between demographic, clinical and laboratory findings in children with positive HEV markers and children negative for HEV markers, revealed significant association with contact of animals (p = 0.001), rural residence (p = 0.001), presence of positive autoantibodies (p = 0.001) and positive HAV IgM (p = 0.001). The markers of hepatitis E virus showed significantly higher prevalence in children below age of 6 years (p = 0.04). Conclusions: HEV infection is more common in preschool age. There is a significant association between contact with animals, rural residence and other hepatitis affection like autoimmune hepatitis and other viral hepatitis viruses such as hepatitis A. Full article

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Open AccessArticle

Utility of Smear Microscopy and GeneXpert for the Detection of Mycobacterium tuberculosis in Clinical Samples

by Disha Arora and Biranthabail Dhanashree

GERMS 2020, 10(2), 81-87; https://doi.org/10.18683/germs.2020.1188 - 2 Jun 2020

Cited by 24

Abstract

Introduction: Rapid identification of Mycobacterium tuberculosis (MTB), its resistance to rifampicin and differentiation of MTB from nontuberculous mycobacteria (NTM) is necessary in the management of mycobacterial diseases. Culture, the "gold standard" for the detection of MTB, is time consuming. In spite of its [...] Read more.

Introduction: Rapid identification of Mycobacterium tuberculosis (MTB), its resistance to rifampicin and differentiation of MTB from nontuberculous mycobacteria (NTM) is necessary in the management of mycobacterial diseases. Culture, the "gold standard" for the detection of MTB, is time consuming. In spite of its rapidity and low cost, smear microscopy has poor sensitivity for the detection of acid-fast bacilli (AFB). A real-time PCR based rapid diagnostic method like GeneXpert MTB/RIF assay can simultaneously detect M. tuberculosis and rifampicin (RIF) resistance. Hence, we aim to compare the performance of GeneXpert MTB/RIF assay with smear microscopy and culture. Methods: In this descriptive cross-sectional study, we compared the performance of GeneXpert in pulmonary (N = 127) and extrapulmonary (N = 48) clinical specimens with other diagnostic methods like culture, Auramine O (AO), and Ziehl Neelsen (ZN) staining. Rifampicin resistance was detected only by GeneXpert. Demographic data and clinical history of the subjects were collected from the patient’s hospital records. Results: AO and ZN staining when compared with mycobacterial growth indicator (MGIT) culture showed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 68.6, 95.7, 80, 92.4, 90.3% and 65.7, 95.7, 79.3, 91.8, 89.7%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of GeneXpert was 88.6, 93.6, 77.5, 97.0 and 92.6%, respectively. Conclusions: GeneXpert is the best available rapid diagnostic method as it can detect MTB and rifampicin resistance gene simultaneously. Accuracy and negative predictive value of GeneXpert was found to be better than AFB staining. Thus, a negative GeneXpert test can rule out TB. Further, a negative GeneXpert and a positive smear microscopy results indicate the presence of NTM. However, GeneXpert is expensive and needs sophisticated instrument when compared to smear microscopy. Full article

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Open AccessArticle

Prevalence, Characterization and Antimicrobial Resistance of Listeria monocytogenes Isolated from Beef Meat in Meknes City, Morocco

by Meryem Boukili, Fouzia Rhazi Filali, Nada Lafkih, Aziz Bouymajane, Majida Sefiani and Mohieddine Moumni

GERMS 2020, 10(2), 74-80; https://doi.org/10.18683/germs.2020.1180 - 2 Jun 2020

Cited by 7

Abstract

Introduction: Listeria monocytogenes is one of the most pathogenic bacteria related to the consumption of contaminated food. This study aims to determine the prevalence of L. monocytogenes in raw beef meat in Meknes city of Morocco, to evaluate its pathogenicity and resistance to [...] Read more.

Introduction: Listeria monocytogenes is one of the most pathogenic bacteria related to the consumption of contaminated food. This study aims to determine the prevalence of L. monocytogenes in raw beef meat in Meknes city of Morocco, to evaluate its pathogenicity and resistance to antimicrobials. Methods: During four seasons, a total of 140 samples were collected from supermarkets, butcheries and Souk (weekly traditional market). The PCR method was used to examine the presence of specific and virulence genes in the isolated strains, and also to identify their serotypes. The antimicrobial resistance was determined. Results: The results show a prevalence of 7.14% which depends on retail sites and also on the season’s variation. The majority of the strains were detected in butcheries (6 strains), and supermarkets (4 strains). Moreover, the majority of strains were detected during summer (50%). Concerning virulence genes, the seven researched genes were detected in 100% of isolated strains. The majority of strains were of the (1/2a, 1/2c, 3a and 3c) serogroup (70%), while two of them were of the (1/2b, 3b, 4b and 4d) serogroup (20%). All isolates were resistant to at least one antimicrobial, while three strains were resistant to nine tested antimicrobials. However, they were highly susceptible to amikacin, imipenem, gentamicin, sulfamethoxazole and chloramphenicol. Conclusions: According to results, isolated L. monocytogenes from analyzed beef meat shows a high level of pathogenicity and resistance to the most used antimicrobials in listeriosis therapy, which calls for the severe application of quality systems at the slaughterhouses and retail sites level. Full article

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Open AccessEditorial

SARS-CoV-2 and Dental Treatments

by Mihai Săndulescu

GERMS 2020, 10(2), 72-73; https://doi.org/10.18683/germs.2020.1187 - 2 Jun 2020

Cited by 1

Abstract

In recent years, dental care has become more than a necessity treatment [...] Full article

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GERMS, Volume 10, Issue 2 (06 2020) – 13 articles

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