GERMS

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Open AccessErratum

Erratum

by Jayaweera Arachchige Asela Sampath Jayaweera, Senaka Pilapitiya and Widuranga Kumbukgolla

GERMS 2020, 10(3), 279; https://doi.org/10.18683/germs.2020.1219 - 1 Sep 2020

Abstract

Jayaweera JAAS, Pilapitiya S, Kumbukgolla W [...] Full article

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Open AccessCommunication

COVID-19 in Nigeria: Situation Update and Combative Measures Taken by the Government

by Henshaw Uchechi Okoroiwu, Ikenna Kingsley Uchendu, Christopher Ogar Ogar and Ifeyinwa Maryann Okafor

GERMS 2020, 10(3), 274-278; https://doi.org/10.18683/germs.2020.1218 - 1 Sep 2020

Cited by 7

Abstract

Aside the monkey pox and Lassa fever endemicity currently going on in Nigeria, coronavirus disease (COVID-19) has joined the queue [...] Full article

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Open AccessCommunication

Comment on: “The Relationship Between the Exposure to Healthcare Settings and Colonization with Methicillin-Resistant Staphylococcus aureus Among Medical Students”

by Sophie Rainbow and Tenzin Dorji

GERMS 2020, 10(3), 272-273; https://doi.org/10.18683/germs.2020.1217 (registering DOI) - 1 Sep 2020

Abstract

Dear Editor, This article provides crucial insights into the ways in which medical students undergoing clinical placement might pose a risk to patients [...] Full article

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Open AccessCase Report

Hemophagocytic Lymphohistiocytosis Syndrome Associated with Epstein-Barr Infection in an Immunocompetent Patient. A Case Study

by Petros Ioannou, Evangelia Akoumianaki, Konstantinos Alexakis, Athanasia Proklou, Maria Psyllaki, Efthimis Stamatopoulos, Mairi Koulentaki, Eumorfia Kondili and Diamantis P Kofteridis

GERMS 2020, 10(3), 266-271; https://doi.org/10.18683/germs.2020.1216 - 1 Sep 2020

Cited by 3

Abstract

Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening rare disease resulting from the uncontrolled activation of the immune system, leading to unrestrained cytokine release and macrophage activation. It can be either hereditary or acquired due to infections, hematological disease or malignancy. Case report: We [...] Read more.

Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening rare disease resulting from the uncontrolled activation of the immune system, leading to unrestrained cytokine release and macrophage activation. It can be either hereditary or acquired due to infections, hematological disease or malignancy. Case report: We present the case of a 19-year old woman that presented with high fever and acute cholestatic hepatitis. She was initially admitted to the Gastroenterology department and the following days she developed respiratory distress and multiorgan insufficiency that necessitated intubation and support in the Intensive Care Unit. Fever, splenomegaly, hypertriglyceridemia, increased ferritin levels and hemophagocytosis in the bone marrow were found, thus, fulfilling the criteria of hemophagocytic lymphohistiocytosis. Laboratory examination was notable for positive serology (IgM and IgG) and PCR for EBV in the serum. An extensive workup including virology and immunologic workup, blood cultures, a CT of the thorax and the abdomen and a bone marrow biopsy did not reveal any cause of secondary HLH other than the EBV infection. The patient was treated with high dose corticosteroids and intravenous immunoglobulins with slow resolution of her symptoms. Conclusions: In patients with EBV infection who exhibit persistent high fever and unresponsiveness to antibiotics, the possibility of HLH should be considered. Early diagnosis and rapid initiation of appropriate treatment may avert an unfavorable outcome. Full article

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Open AccessCase Report

Severe Scarlet Fever in a Child with Down Syndrome—A Case Report

by Halyna Pavlyshyn, Ivanna Horishna and Iryna Sarapuk

GERMS 2020, 10(3), 260-265; https://doi.org/10.18683/germs.2020.1215 - 1 Sep 2020

Abstract

Introduction: Scarlet fever is an acute infectious disease that is characterized by development of characteristic pin-point exanthema in a patient with signs of streptococcal pharyngitis and tonsillitis. Nowadays, due to effective antibacterial treatment, severe complicated cases of scarlet fever are occasionally rare. Because [...] Read more.

Introduction: Scarlet fever is an acute infectious disease that is characterized by development of characteristic pin-point exanthema in a patient with signs of streptococcal pharyngitis and tonsillitis. Nowadays, due to effective antibacterial treatment, severe complicated cases of scarlet fever are occasionally rare. Because of immunity particularities, patients with Down syndrome are predisposed to bacterial respiratory diseases (and scarlet fever among them), that usually have prolonged complicated course. Case report: A clinical case of scarlet fever in a patient with Down syndrome was analyzed. The disease had a severe course with a specific skin syndrome and was complicated by pneumonia. Hospitalization and adequate treatment of the patient led to his complete recovery despite late initiation of antibacterial medicine. Discussion: A long severe complicated course of the disease in the presented case was caused by combination of the late initiation of antibacterial treatment and the patient’s personal particularities of reactivity. Conclusions: Patients with Down syndrome should be adequately monitored by family doctors in case of pharyngitis with early testing for group A hemolytic Streptococcus infection and administration of the correct antibacterial treatment, if the test is positive. Full article

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Open AccessCase Report

Candida parapsilosis Endocarditis. Report of Cases and Review of the Literature

by Petros Ioannou, Maria Volosyraki, Vasiliki Mavrikaki, Ioanna Papakitsou, Anna Mathioudaki, George Samonis and Diamantis P Kofteridis

GERMS 2020, 10(3), 254-259; https://doi.org/10.18683/germs.2020.1214 (registering DOI) - 1 Sep 2020

Cited by 10

Abstract

Introduction: Infective endocarditis (IE) due to Candida species is a rare disease representing about 1-2% of all IE cases and carries a high mortality rate. Given the rarity of the disease, there are no clear guidelines on the type and duration of antifungal [...] Read more.

Introduction: Infective endocarditis (IE) due to Candida species is a rare disease representing about 1-2% of all IE cases and carries a high mortality rate. Given the rarity of the disease, there are no clear guidelines on the type and duration of antifungal therapy. Thus, long-term or even life-long antifungal treatment is commonly used. Case report: We report two patients with prosthetic valve C. parapsilosis IE and persistent candidemia that failed conservative treatment and ultimately developed heart failure. They underwent prosthetic valve replacement and prolonged antifungal treatment with favorable outcome. Discussion: Candida IE commonly occurs in the setting of underlying malignancy, chronic liver disease, previous endocarditis, previous antimicrobial exposure, previous abdominal surgery, intravenous drug use, presence of a central venous catheter, and previous cardiac surgery. Both present patients had undergone a cardiac surgery and had a prosthetic heart valve, while one patient had an underlying autoimmune disease that could be associated with higher risk of IE. In both patients transthoracic ultrasound failed to diagnose IE. In our patients, conservative treatment alone was not enough to control the infection, thus, both patients underwent valve replacement and were subsequently treated with antifungals for 6 weeks. Furthermore, both patients were put on long-term antifungal suppression treatment. Conclusions: Given the absence of controlled randomized trials, the treatment of Candida endocarditis mostly relies on experts’ opinion, and, thus, future studies focusing on the type and duration of antifungal treatment are required. Full article

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Open AccessCase Report

Purulent Pericarditis in a Patient with Community-Acquired Methicillin-Resistant Staphylococcus aureus: A Case Report with Mini-Review

by Durga Shankar Meena, Deepak Kumar, Maya Gopalakrishnan, Gopal Krishana Bohra, Naresh Midha, Parag Vijayvargiya and Sarbesh Tiwari

GERMS 2020, 10(3), 249-253; https://doi.org/10.18683/germs.2020.1212 - 1 Sep 2020

Cited by 2

Abstract

Introduction: The etiopathogenesis of purulent pericarditis has changed significantly in modern antibiotic era with the emergence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in the last few decades. Pericarditis due to MRSA is rarely reported in the literature without risk factors like immunosuppression, thoracic [...] Read more.

Introduction: The etiopathogenesis of purulent pericarditis has changed significantly in modern antibiotic era with the emergence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in the last few decades. Pericarditis due to MRSA is rarely reported in the literature without risk factors like immunosuppression, thoracic surgery, chest trauma or pre-existing pericardial diseases. Case report: We describe an 18-year-old male who presented with 5 days history of fever, chest pain and shortness of breath. Echocardiogram and thorax CT showed significant pericardial effusion. The patient underwent pericardiocentesis, MRSA was isolated from blood and pericardial fluid. The patient improved with intravenous antibiotics (linezolid). Follow-up echocardiography at 3 months was unremarkable, without any residual fluid or features of constrictive pericarditis. Discussion: In the absence of known risk factors, MRSA is an extremely rare cause of pericarditis in modern antibiotics era. The possibility of MRSA pericarditis should be sought in every case of pericarditis to achieve prompt diagnosis and treatment. Conclusions: Our case highlights the role of aggressive pericardiocentesis and appropriate antibiotic therapy in purulent pericarditis. Full article

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Open AccessCase Report

Parvovirus B19 Infection Mimicking Systemic Lupus Erythematosus, Successfully Treated with Intravenous Immune Globulin

by Sare Gülfem Özlü, Başak Alan, Aysegül Şahiner, Büşra Bulut, Gülsüm İclal Bayhan and Sonay İncesoy Özdemir

GERMS 2020, 10(3), 244-248; https://doi.org/10.18683/germs.2020.1211 - 1 Sep 2020

Cited by 2

Abstract

Introduction: Parvovirus B19 infection generally presents as a transient viral illness in children but rarely shows systemic lupus erythematosus-like symptoms. Case report: Here we present a 7-year-old girl with parvovirus B19 infection who had prolonged fever, rash, pancytopenia and hypocomplementemia making it difficult [...] Read more.

Introduction: Parvovirus B19 infection generally presents as a transient viral illness in children but rarely shows systemic lupus erythematosus-like symptoms. Case report: Here we present a 7-year-old girl with parvovirus B19 infection who had prolonged fever, rash, pancytopenia and hypocomplementemia making it difficult do differentiate from the first episode of systemic lupus erythematosus. Because she had severe progressive pancytopenia she was administered intravenous immune globulin treatment and her clinical course was dramatically improved. Discussion: Parvovirus B19 infection can mimic systemic lupus erythematosus and it may be difficult to differentiate a recent parvovirus B19 infection and the first presentation of systemic lupus erythematosus. Absence of discoid lesions, alopecia, Raynaud phenomenon and autoimmune hemolytic anemia may help to distinguish parvovirus B19 infection from systemic lupus erythematosus. Conclusions: Parvovirus B19 infection may cause a severe clinical picture resembling systemic lupus erythematosus even in otherwise healthy children. Intravenous immune globulin treatment might be considered in cases resistant to supportive management. Full article

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Open AccessOpinion

Impact of COVID-19 on Medical Students in the United Kingdom

by Sophie Rainbow and Tenzin Dorji

GERMS 2020, 10(3), 240-243; https://doi.org/10.18683/germs.2020.1210 - 1 Sep 2020

Cited by 29

Abstract

Medical student training in the United Kingdom has undoubtedly been impacted by the COVID-19 pandemic. Most notably, there have been disruptions to teaching, cancellation of exams and clinical electives and the abandonment of research projects. In response, medical education has been reshaped to [...] Read more.

Medical student training in the United Kingdom has undoubtedly been impacted by the COVID-19 pandemic. Most notably, there have been disruptions to teaching, cancellation of exams and clinical electives and the abandonment of research projects. In response, medical education has been reshaped to facilitate the continuation of studies, such as the online deliverance of course material, digital examinations and implementing welfare and financial support systems. There has also been a surge in student volunteers, often playing critical roles in primary and secondary care to support National Health Service (NHS) staff working on the frontlines. This opinion piece will aim to address the effects of COVID-19 on medical students and their training, and further evaluate how well medical schools responded to the challenges presented by the pandemic. This should highlight aspects requiring improvement and will allow medical schools to be better prepared to tackle similar dilemmas in the future. Full article

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Open AccessReview

Infective Endocarditis by Proteus Species: A Systematic Review

by Petros Ioannou and Georgios Vougiouklakis

GERMS 2020, 10(3), 229-239; https://doi.org/10.18683/germs.2020.1209 - 1 Sep 2020

Cited by 22

Abstract

Proteus spp. are members of the Enterobacteriaceae family and are Gram-negative, rod-shaped bacteria known to mainly cause urinary tract infections (UTIs) in humans. However, even though scarce evidence exists suggesting their potential to cause infective endocarditis (IE), a study summarizing the existing evidence [...] Read more.

Proteus spp. are members of the Enterobacteriaceae family and are Gram-negative, rod-shaped bacteria known to mainly cause urinary tract infections (UTIs) in humans. However, even though scarce evidence exists suggesting their potential to cause infective endocarditis (IE), a study summarizing the existing evidence is lacking. The purpose of this study was to systemically review all published cases of IE by Proteus species in the literature. A systematic review of PubMed, Scopus and Cochrane Library (through 5^th May 2020) for studies providing epidemiological, clinical and microbiological data as well as data on treatment and outcomes of IE by Proteus species was performed. A total of 16 studies, containing data of 16 patients, were included. A prosthetic valve was present in 25%, while the most common causative pathogen was P. mirabilis. Aortic valve was the most common infected site in 33.3%, followed by mitral valve in 26.7%. Diagnosis was set with transesophageal echocardiography in 37.5%, and transthoracic echocardiography in 25%, while the diagnosis was set at autopsy in 25%. Fever and sepsis were present in 100% and 84.6%, respectively. Aminoglycosides and cephalosporins were the most common antimicrobials used for treatment. Clinical cure was noted in 62.5%, while overall mortality was 43.8%. This systematic review describes IE by Proteus species in detail and provides information on epidemiology, clinical presentation, treatment and outcomes.

Full article

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Open AccessReview

COVID-19 (SARS-CoV-2) Pandemic: Fears, Facts and Preventive Measures

by Israel Oluwasegun Ayenigbara, Olasunkanmi Rowland Adeleke, George Omoniyi Ayenigbara, Joseph Sunday Adegboro and Oluwaseyi Oye Olofintuyi

GERMS 2020, 10(3), 218-228; https://doi.org/10.18683/germs.2020.1208 - 1 Sep 2020

Cited by 28

Abstract

The aim of this review is to give a synopsis on the coronavirus disease 2019 (COVID-19) pandemic, with major focus on the preventive measures. Ever since the influenza pandemic of 1918, and the second world war of (1939–1945), the world has not been [...] Read more.

The aim of this review is to give a synopsis on the coronavirus disease 2019 (COVID-19) pandemic, with major focus on the preventive measures. Ever since the influenza pandemic of 1918, and the second world war of (1939–1945), the world has not been faced with a common problem in recent memory like the COVID-19 pandemic. The unprecedented COVID-19 pandemic is caused by infection with a viral pathogen, the nascent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and is characterized by respiratory failure in severe cases. The communicability period of COVID-19 varies, but it is usually between 2–14 days, and the major signs and symptoms of COVID-19 are high temperature (fever), severe and consistent cough, and serious breathing problems in severe cases, however, complications result in the serious inflammation of the lungs, and organ malfunction occurs in patients with comorbidities and health conditions especially diabetes, heart disease and obesity. With high virulence and contagious nature of SARS-CoV-2, over 11.4 million confirmed cases and over 533,780 deaths have occurred as a result of COVID-19 globally, with over 6.1 million recoveries as of 6^th July 2020. Presently, there is no known cure for COVID-19, however, remdesivir has been approved for emergency use for the treatment of COVID-19 patients by the Food and Drug Administration, a United States federal regulatory body (FDA), while various clinical trial treatments and vaccines are being tried globally. The world is faced with containing the spread of the infection, and this review revealed that thorough hand washing with antiseptic soap and running water and usage of alcohol hand sanitizer, frequent surfaces cleaning, strict adherence to social distancing, regular respiratory hygiene, wearing of protective face masks, frequent testing, self-isolation, quarantine and rigorous contact tracing will help to prevent further spread, and control the transmission of the viral pathogen. It is however strongly recommended that only the strict compliance to the mitigative and preventive measures provided above will yield the desired results in the prevention, management and control of the COVID-19 pandemic. Full article

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Open AccessReview

From Food to Hospital: We Need to Talk About Acinetobacter spp.

by Rogerio Caldeira Rodrigues Malta, Gustavo Luis de Paiva Anciens Ramos and Janaína dos Santos Nascimento

GERMS 2020, 10(3), 210-217; https://doi.org/10.18683/germs.2020.1207 - 1 Sep 2020

Cited by 22

Abstract

Some species of the genus Acinetobacter are admittedly important hospital pathogens. Additionally, various animal and plant foods have been linked to the presence of Acinetobacter, including resistant strains. However, due to isolation difficulties and the lack of official standard methods, there is [...] Read more.

Some species of the genus Acinetobacter are admittedly important hospital pathogens. Additionally, various animal and plant foods have been linked to the presence of Acinetobacter, including resistant strains. However, due to isolation difficulties and the lack of official standard methods, there is a dearth of work and epidemiological data on foodborne diseases caused by this microorganism. Considering that Acinetobacter spp. may represent a serious public health problem, especially because of their resistance to carbapenems and colistin, and because of the fact that these pathogens may transfer resistance genes to other bacteria, studies are needed to evaluate the pathogenicity of both food and clinical isolates and to search for them using control strategies, such as the adoption of more efficient disinfection measures and use of antimicrobial substances (AMS). In contrast, AMS production by strains of the genus Acinetobacter has already been described, and its potential for application against other Gram-negative food or clinical pathogens, reveals a new field to be explored. Full article

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Open AccessArticle

Burden of Influenza in Romania. A Retrospective Analysis of 2014/15–2018/19 Seasons in Romania

by Adrian Pană, Adriana Pistol, Adrian Streinu-Cercel and Bogdan-Vasile Ileanu

GERMS 2020, 10(3), 201-209; https://doi.org/10.18683/germs.2020.1206 - 1 Sep 2020

Cited by 4

Abstract

Introduction: Influenza is a seasonal epidemic with a heavy negative impact both on population health, and healthcare system utilization; until now, there are only two burden of disease studies in the Romanian context. This study aims to quantify the burden of influenza for [...] Read more.

Introduction: Influenza is a seasonal epidemic with a heavy negative impact both on population health, and healthcare system utilization; until now, there are only two burden of disease studies in the Romanian context. This study aims to quantify the burden of influenza for the Romanian population for the seasons 2014/15 to 2018/19, using health administrative databases. Methods: Incidence, hospitalization and mortality rates attributable to influenza as well as total number of influenza cases and deaths were estimated, for each season in the analyzed period, by combining the new cases reported by General Practitioners, Emergency Department presentations, hospitalizations, number of deaths, positivity rate of influenza, and probability to be consulted by a physician. Years of life lost due to premature death attributable to influenza complications were also computed. Results: On average, 591,151 cases/season attributable to influenza were estimated during the period 2014/15–2018/19. The highest rates for incidence, hospitalization and presentation to emergency department were found in the age groups 0–4 years and 65 years and above. Influenza mortality rate was estimated at 3 per 100,000 persons and the 65 and above age group had the highest rate. Conclusions: About 3% of the total Romanian population is estimated to develop an influenza attributable disease in a non-pandemic season. An overall increasing trend of the mortality rate attributable to influenza may be also underlined. On average, a person loses 12 years due to premature death caused by complications of influenza. Full article

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Open AccessArticle

Occurrence of Cryptococcus neoformans and Other Yeast-like Fungi in Environmental Sources in Bonaire (Dutch Caribbean)

by Harish C Gugnani, Ferry Hagen, Jacques F Meis and Arunaloke Chakrabarti

GERMS 2020, 10(3), 195-200; https://doi.org/10.18683/germs.2020.1205 - 1 Sep 2020

Cited by 6

Abstract

Introduction: We report here the presence of Cryptococcus neoformans, and other potentially pathogenic yeasts and yeast-like fungi in environmental sources in Bonaire. Methods: Seventy environmental samples comprising 40 samples of old pigeon droppings, 18 of woody debris from hollows of living trees [...] Read more.

Introduction: We report here the presence of Cryptococcus neoformans, and other potentially pathogenic yeasts and yeast-like fungi in environmental sources in Bonaire. Methods: Seventy environmental samples comprising 40 samples of old pigeon droppings, 18 of woody debris from hollows of living trees of Caesalpinia (‘Divi Divi’), Ziziphus jujuba (Red Indian date), Tamarindus indica (Tamarind), Terminalia catappa (Tropical almond), Azadirachta indica (Neem) and 3 of other unidentified species of trees, 3 of latex from a rubber tree and 6 of coral dust were processed for isolation of pathogenic Cryptococcus spp. and other potentially pathogenic yeasts and yeast-like fungi. A variety of mycological media were employed. Identification of the isolates was done with conventional techniques and species identification was done by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Results: Three of the 40 samples from old pigeon droppings yielded Cryptococcus neoformans, constituting the first record of environmental occurrence of this important pathogenic yeast in the Dutch Caribbean. Other potentially pathogenic yeasts and yeast-like fungi recovered from these environmental samples included 6 isolates each of Candida albicans, 8 of Candida parapsilosis, 4 each of Candida metapsilosis and Candida orthopsilosis, 2 each of Candida carpophila, Candida famata, Candida fabianii and Candida pelliculosa, 7 of Candida spp., 5 of Trichosporon spp. and 2 of Sporobolomyces spp. Conclusions: This study has demonstrated for the first time the occurrence of C. neoformans in a natural habitat in the Dutch Caribbean. The recovery of many species of potentially pathogenic yeast-like fungi and yeasts from environmental sources is remarkable. Full article

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Open AccessArticle

Human Papillomavirus Vaccine Acceptability Among Healthcare Workers, Parents, and Adolescent Pupils: A Pilot Study in Public Health Centers of Bali, Indonesia

by Tantut Susanto, Erwin Nur Rif’ah, Latifa Aini Susumaningrum, Ira Rahmawati, Rismawan Adi Yunanto, Ni Luh Putu Evayanti and Putu Ayu Sani Utami

GERMS 2020, 10(3), 184-194; https://doi.org/10.18683/germs.2020.1204 - 1 Sep 2020

Cited by 7

Abstract

Introduction: Knowledge and acceptability of HPV vaccination should be identified for supporting the HPV vaccine program in public health centers. Qualitative research approach is one approach that can be developed for increasing the acceptance and use of HPV vaccines in the community. Perceptions [...] Read more.

Introduction: Knowledge and acceptability of HPV vaccination should be identified for supporting the HPV vaccine program in public health centers. Qualitative research approach is one approach that can be developed for increasing the acceptance and use of HPV vaccines in the community. Perceptions of health workers, parents, teachers, and adolescents related to HPV immunization can be explored in depth. This study was performed to explore the perception and meaning of the HPV vaccine acceptability among healthcare professionals, parents, and adolescent pupils in Bali, Indonesia. Methods: A mixed method study was conducted among 176 elementary school children. In-depth interviews were performed with five of the parents and eight of the teachers. Then, four focus group discussions among 19 health professionals were performed for supporting data. A self-administered questionnaire was used to measure knowledge of HPV and acceptability of HPV vaccine among participants. An interview of standard guidelines was performed to identify the perception of the HPV vaccine. Results: The study identified that perception about HPV knowledge and HPV vaccine was low among adolescents and teachers for all of the questions. However, knowledge on HPV and HPV vaccine among parents and healthcare professionals were higher. Meanwhile, the acceptability of the HPV vaccine and the personal experience of women were more positive for the healthcare professionals. Conclusions: Knowledge and perception regarding HPV and HPV vaccination among adolescents and teachers in Indonesia, particularly in Denpasar, Bali, are still insufficient. However, the perception of vaccine administration is acceptance for parents and healthcare professionals. Therefore, socialization of HPV vaccine programs in school and community are needed to improve health promotion about the importance of the HPV vaccine. Full article

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Open AccessArticle

Identification of HIV-1 Subtypes and Drug Resistance Mutations Among HIV-1-Infected Individuals Residing in Pontianak, Indonesia

by Siti Qamariyah Khairunisa, Ni Luh Ayu Megasari, Dwi Wahyu Indriati, Tomohiro Kotaki, Diana Natalia, Nasronudin and Masanori Kameoka

GERMS 2020, 10(3), 174-183; https://doi.org/10.18683/germs.2020.1203 - 1 Sep 2020

Cited by 9

Abstract

Introduction: The present study investigated the HIV-1 subtype classification in addition to prevalence of drug resistance mutations (DRMs) in antiretroviral therapy (ART)-experienced and ART-naïve residents of Pontianak, West Kalimantan, Indonesia. Methods: Whole blood samples collected from 30 HIV-1-infected individuals, comprising 19 ART-experienced and [...] Read more.

Introduction: The present study investigated the HIV-1 subtype classification in addition to prevalence of drug resistance mutations (DRMs) in antiretroviral therapy (ART)-experienced and ART-naïve residents of Pontianak, West Kalimantan, Indonesia. Methods: Whole blood samples collected from 30 HIV-1-infected individuals, comprising 19 ART-experienced and 11 ART-naïve individuals, were subjected to RNA and DNA extraction, followed by HIV-1 genes amplification and sequencing analysis. HIV-1 subtyping was classified on viral pol genes encoding reverse transcriptase (RT gene) and protease (PR gene) accompanied by the env and gag genes. DRMs in the RT and PR genes were also analyzed. Results: CRF01_AE was identified as the predominant circulating recombinant form (CRF) of HIV-1 in both ART-experienced and ART-naïve individuals. In addition, CRF02_AG, subtype B, recombinant virus expressing CRF01_AE and subtype B viral genomic fragments, also recombinant virus containing CRF01_AE and CRF02_AG genomic fragments were also identified. Acquired drug resistance (ADR) was identified in 28.5% of ART-experienced individuals, while no transmitted drug resistance was identified in ART-naïve individuals. Conclusions: This study identified CRF01_AE as the most predominant HIV-1 CRF distributing in Pontianak, Indonesia. The prevalence of ADR is considered to be high; thus, further surveillance is needed in this region. Full article

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Open AccessArticle

Molecular Study of Human Astrovirus in Egyptian Children with Acute Gastroenteritis

by Maysaa El Sayed Zaki, Ghada El-Saeed Mashaly, Mona Abdel Latif Alsayed and Manal Mahmoud Nomir

GERMS 2020, 10(3), 167-173; https://doi.org/10.18683/germs.2020.1202 - 1 Sep 2020

Cited by 8

Abstract

Introduction: Human astrovirus (HAstV) has been increasingly identified as an important cause of acute gastroenteritis in young children. Limited information is available about the prevalence and genotype distribution of classic HAstV causing acute gastroenteritis in Egyptian children. Methods: Stool samples were collected from [...] Read more.

Introduction: Human astrovirus (HAstV) has been increasingly identified as an important cause of acute gastroenteritis in young children. Limited information is available about the prevalence and genotype distribution of classic HAstV causing acute gastroenteritis in Egyptian children. Methods: Stool samples were collected from 100 infants and children attending the gastroenterology outpatient clinic in Mansoura University Children Hospital and suffering from acute gastroenteritis during the period extending from January 2018 to January 2019. Samples were tested for HAstV using reverse transcription PCR. Genotyping was performed using type‐specific reverse transcription nested PCR. Results: Among 100 children included in this study, the detection rate of HAstV was 11% (11 patients). There was a significant difference regarding age between cases positive and negative for HAstV (p = 0.005). There was a higher prevalence of HAstV in children aged one year or younger. Significant association was detected between HAstV positive cases and rural residence (p = 0.002), summer season (p = 0.025) and fever (p = 0.017). The HAstV genotypes detected were HAstV-8 (8/11, 72.7%), HAstV-3 (2/11, 18.2%) and HAstV-2 (1/11, 9.1%). Conclusions: This study suggests that HAstV is a common pathogen causing gastroenteritis in Egyptian children especially in rural areas. The most frequent HAstV genotype in our study was HAstV-8. Full article

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Open AccessArticle

A Retrospective Cross-Sectional Study of Urinary Tract Infections and Prevalence of Antibiotic Resistant Pathogens in Patients with Diabetes Mellitus from a Public Hospital in Surabaya, Indonesia

by Norafika, Novita Arbianti, Septiyani Prihatiningsih and Dwi Wahyu Indriati

GERMS 2020, 10(3), 157-166; https://doi.org/10.18683/germs.2020.1201 - 1 Sep 2020

Cited by 10

Abstract

Introduction: Diabetes mellitus (DM) is a metabolic disease that can cause many complications. The occurrence of urinary tract infection is also considered to be the cause of complications in patients with DM. This study aimed to evaluate the prevalence of urinary tract infection [...] Read more.

Introduction: Diabetes mellitus (DM) is a metabolic disease that can cause many complications. The occurrence of urinary tract infection is also considered to be the cause of complications in patients with DM. This study aimed to evaluate the prevalence of urinary tract infection (UTI) and antibiotic-resistant bacteria found in urine culture from patients with DM in Surabaya, Indonesia. Methods: This study was conducted with a retrospective cross-sectional study design, using a database of 1551 patients with DM admitted to Haji Hospital, Surabaya, Indonesia, from January 2017 to December 2018. Data regarding the bacteria isolated from urine and antimicrobial sensitivity were analyzed. Results: The prevalence of UTI was 3.93%—61 patients were confirmed with urine culture for UTI diagnosis. The predominant isolates found were Escherichia coli (24.5%) and Enterococcus faecalis (8%). This study also showed multidrug-resistant organisms (MDRO) found in UTI such as Escherichia coli MDRO (3.3%), Klebsiella pneumoniae MDRO (3.3%), Acinetobacter baumannii MDRO (1.6%), extended-spectrum beta-lactamase (ESBL) Escherichia coli (3.3%). The E. coli were sensitive to fosfomycin (93%), meropenem (93%) and nitrofurantoin (67%). No significant difference in the prevalence of UTI was found among ages, sex, and duration of disease in all patients with DM. Conclusions: The cases of UTI seen in patients with DM show the importance of monitoring UTI occurrence in this patient category to ensure better treatment for these patients. Full article

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Open AccessArticle

Update on Urogenital Tuberculosis in Southern Tunisia: A Review of a 26-Year Period

by Fatma Hammami, Makram Koubaa, Houda Ben Ayed, Khaoula Rekik, Maissa Ben Jemaa, Mariem Ben Hmida, Maroua Trigui, Chakib Marrakchi, Jamel Dammak and Mounir Ben Jemaa

GERMS 2020, 10(3), 150-156; https://doi.org/10.18683/germs.2020.1200 - 1 Sep 2020

Cited by 2

Abstract

Introduction: Tuberculosis affects commonly the lungs, but any other organs can be affected as well. Urogenital tuberculosis is usually misdiagnosed. In this perspective, we aimed to give an update on the epidemiological, clinical and evolutionary features of urogenital tuberculosis in Southern Tunisia. Methods: [...] Read more.

Introduction: Tuberculosis affects commonly the lungs, but any other organs can be affected as well. Urogenital tuberculosis is usually misdiagnosed. In this perspective, we aimed to give an update on the epidemiological, clinical and evolutionary features of urogenital tuberculosis in Southern Tunisia. Methods: We conducted a retrospective study including all patients with extrapulmonary tuberculosis notified during the period from 1992 to 2017 in Southern Tunisia. We specified the particularities of urogenital tuberculosis cases, and we compared them with other extrapulmonary tuberculosis cases. Results: Overall, we analyzed 240 cases with urogenital tuberculosis, among 1702 patients with extrapulmonary tuberculosis (14.1%). There were 121 women (50.4%). The mean age was 49±17 years. Multifocal tuberculosis was noted in 29 cases (12.1%). There were 169 cases with urinary tract tuberculosis (70.4%). Chronological trends analysis showed that the median age at diagnosis increased significantly (Rho = 0.41; p = 0.039) and the number of urogenital tuberculosis declined during the study period, without a statistical significance (Rho = -0.07; p = 0.721). Compared to other extrapulmonary tuberculosis sites, patients aged 60 years and above (OR = 2.7; p < 0.001) and coming from rural areas (OR = 1.4; p = 0.021) were more frequently diagnosed with urogenital tuberculosis. Treatment duration was significantly longer in patients with urogenital tuberculosis (10.13 ± 3.79 vs 9.20 ± 3.77 months; p < 0.001). As for the disease evolution, relapse was significantly more frequent in patients with urogenital tuberculosis (OR = 4.1; p = 0.045). Conclusions: Although decreasing trends over time were noted, the prognosis of urogenital tuberculosis was more severe compared to other extrapulmonary tuberculosis sites. Full article

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Open AccessEditorial

COVID-19 and Cold Season Preparedness

by Oana Săndulescu

GERMS 2020, 10(3), 149; https://doi.org/10.18683/germs.2020.1199 - 1 Sep 2020

Cited by 2

Abstract

If less than one year ago we were talking about pandemic preparedness in general terms, we are now in the midst of a real-life pandemic, and much of our focus has shifted, at least temporarily, to cold season preparedness [...] Full article

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GERMS, Volume 10, Issue 3 (09 2020) – 20 articles

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