GERMS

274 KB

Open AccessCase Report

Use of High-Dose Ciprofloxacin for Recurrent Biofilm-Forming Multidrug-Resistant Klebsiella pneumoniae Bacteremia

by Jayaweera Arachchige Asela Sampath Jayaweera and Mahen Kothalawala

GERMS 2021, 11(3), 449-453; https://doi.org/10.18683/germs.2021.1282 - 29 Sep 2021

Cited by 2

Introduction: Klebsiella pneumoniae is a significant nosocomial pathogen. We aimed to assess the clinical success following high-dose ciprofloxacin for recurrent bacteremia from biofilm-forming multidrug resistant Klebsiella pneumoniae in a liver transplanted patient. Case report: A 55-year-old male had undergone liver transplantation [...] Read more.

Introduction: Klebsiella pneumoniae is a significant nosocomial pathogen. We aimed to assess the clinical success following high-dose ciprofloxacin for recurrent bacteremia from biofilm-forming multidrug resistant Klebsiella pneumoniae in a liver transplanted patient. Case report: A 55-year-old male had undergone liver transplantation and at day 10 he developed fever and dysuria. Two blood cultures became positive and were identified by Vitek2 (BioMérieux, USA) as K. pneumoniae. From his urine K. pneumoniae was isolated. Based on antimicrobial susceptibility (AST) panel (Vitek2), i.v. meropenem 1 g 8 hourly and i.v. amikacin 15 mg/kg/daily (5 days) were started (the isolate was ciprofloxacin-resistant). Following 14 days of meropenem he was discharged and 3 days later he was readmitted with fever and dysuria. Since the blood and urine isolate was K. pneumoniae, based on AST 21 days of meropenem were given, the patient was discharged and 3 days later he was readmitted with fever and dysuria. Since this was the 3rd episode with K. pneumoniae bacteremia, to exclude the focus of infection contrast-enhanced computed tomography and ¹⁸F-fluorodeoxyglucose-positron emission tomography were done but both were normal. Based on multilocus sequence typing (MLST) and microtiter plate assay, biofilm forming magA(K1)-positive (+) K. pneumoniae CC23 was found. The patient was having continuous asymptomatic bacteriuria with similar (magA(K1)-positive (+) K. pneumoniae CC23) isolate; we opted for high dose oral ciprofloxacin (800 mg, 8 hourly) for 7 days. Conclusions: Following a high dose of oral ciprofloxacin, we were able to achieve urinary microbial clearance and a permanent cure following (magA(K1)-positive (+) K. pneumoniae CC23) bacteremia. This could be a promising therapy to achieve microbial clearance from biofilm-forming multidrug-resistant K. pneumoniae. Full article

395 KB

Open AccessReview

Candida auris and Other Phylogenetically Related Species – A Mini-Review of the Literature

by Cristina Nicoleta Ciurea, Anca Delia Mare, Irina-Bianca Kosovski, Felicia Toma, Camelia Vintilă and Adrian Man

GERMS 2021, 11(3), 441-448; https://doi.org/10.18683/germs.2021.1281 - 29 Sep 2021

Cited by 7

Abstract

The lesser-known non-albicans Candida species are often overlooked and difficult to diagnose in most microbiology laboratories. Candida auris, a relatively newly discovered species, is responsible for outbreaks in various geographical regions. Because of its increased resistance to antifungal drugs, C. auris [...] Read more.

The lesser-known non-albicans Candida species are often overlooked and difficult to diagnose in most microbiology laboratories. Candida auris, a relatively newly discovered species, is responsible for outbreaks in various geographical regions. Because of its increased resistance to antifungal drugs, C. auris is responsible for hard-to-treat infections and its pathogenicity is still incompletely elucidated. Non-albicans species phylogenetically related to C. auris, like the C. haemulonii complex might also play a role in human pathology. The current summary of the literature presents the emergence, virulence, laboratory identification, and molecular mechanisms responsible for antifungal resistance of emergent rare non-albicans Candida species. Full article

412 KB

Open AccessReview

The Challenges to a Successful COVID-19 Vaccination Programme in Africa

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

GERMS 2021, 11(3), 427-440; https://doi.org/10.18683/germs.2021.1280 - 29 Sep 2021

Cited by 52

Abstract

The COVID-19 vaccination campaign is an ongoing worldwide effort to vaccinate large numbers of people against COVID-19 in order to ensure protection from the disease, control the rate of infection, reduce severe outcomes, and get back to normal life. Most African countries had [...] Read more.

The COVID-19 vaccination campaign is an ongoing worldwide effort to vaccinate large numbers of people against COVID-19 in order to ensure protection from the disease, control the rate of infection, reduce severe outcomes, and get back to normal life. Most African countries had a delay in the initiation of their COVID-19 vaccine national rollout compared to other regions in the world, and the goal of the immunization exercise in the continent is to vaccinate over 60% of the African population to attain herd immunity. Over the years, vaccination programmes are usually faced with challenges in Africa because of numerous factors. So far, some of the major challenges threatening the success of the COVID-19 vaccination rollout in most African countries includes the slow onset of the vaccination exercise, limited funds, concerns around vaccine safety and uncertainties, storage requirements and regulatory hurdles for vaccines, limited shelf life of COVID-19 vaccines, inability to access vulnerable communities in a timely fashion, problems around the use of different vaccines, and wars and conflicts. The solutions and other imperative recommendations to these challenges were provided so as to optimize the vaccination programme and to achieve an appreciable success in the COVID-19 vaccination programme on the continent. In conclusion, a holistic and timely planning, fast execution of plans, rigorous community involvement, and a robust multi-sectoral partnership will ensure a successful COVID-19 vaccination campaign in Africa. Full article

317 KB

Open AccessReview

Parasitic Zoonoses in the Roma Population

by Lucija Bajkovec, Tatjana Vilibic-Cavlek, Ljubo Barbic and Anna Mrzljak

GERMS 2021, 11(3), 418-426; https://doi.org/10.18683/germs.2021.1279 - 29 Sep 2021

Cited by 3

Abstract

Roma people are the largest minority group in Europe. The vast majority live in substandard conditions in segregated settlements, overcrowded with people and animals that predispose them to various, especially zoonotic diseases. Parasitic zoonotic diseases remain a challenge in this vulnerable population group, [...] Read more.

Roma people are the largest minority group in Europe. The vast majority live in substandard conditions in segregated settlements, overcrowded with people and animals that predispose them to various, especially zoonotic diseases. Parasitic zoonotic diseases remain a challenge in this vulnerable population group, especially among Roma children. PubMed was searched using the keywords Roma with combination of names of different parasites to get all available studies on prevalence of parasitic zoonoses among European Roma, published between years 2000 and 2020. After application of exclusion criteria, data were extracted from the studies that made the final sample. Parasitic zoonoses are common among Roma. Cryptosporidium, Toxoplasma gondii, soil-transmitted helminths and Giardia spp. are more common in Roma children compared to non-Roma children, and Toxoplasma gondii and soil-transmitted helminths are also more common in Roma adults compared to non-Roma adults. Data on prevalence of trichinellosis, echinococcosis, and taeniasis among Roma show that they do not affect Roma more often compared to the general population. Roma people, particularly children, are more susceptible to parasitic zoonoses. Substandard sanitary conditions and close contact with infected animals are important risk factors in this population and should be aimed with preventive measures. Full article

590 KB

Open AccessReview

Alcohol-Based Hand Sanitizer—Composition, Proper Use and Precaution

by Tushar Saha, Prakash Khadka and Shyamal C. Das

GERMS 2021, 11(3), 408-417; https://doi.org/10.18683/germs.2021.1278 - 29 Sep 2021

Cited by 26

Abstract

During the COVID-19 pandemic, the use of alcohol-based hand sanitizers (ABHS) increased worldwide among the public as well as the health care workers in pursuit to prevent the spread of SARS-CoV-2, the causative virus of COVID-19. Hand hygiene is one of the primary [...] Read more.

During the COVID-19 pandemic, the use of alcohol-based hand sanitizers (ABHS) increased worldwide among the public as well as the health care workers in pursuit to prevent the spread of SARS-CoV-2, the causative virus of COVID-19. Hand hygiene is one of the primary preventive measures to prevent the spread of harmful germs. Although ABHS are effective hand hygiene products and help reduce the transmission of pathogenic microorganisms, appropriate use of such products is necessary to ensure the maximum killing of pathogens and to prevent hazards associated with ABHS. The effectiveness of ABHS against different microorganisms, including SARS-CoV-2 is also documented, but proper knowledge on hand hygiene techniques, selection of appropriate hand sanitizer product, and safe handling of ABHS are required to avoid their adverse effects such as allergies, skin irritation, lung injury, fire hazards, and toxicities. The effectiveness of ABHS is dependent on several factors including its appropriate usage, manufacturing methods, the choice of active agents, and the appropriateness of the agent on the target pathogen. This article highlights the importance of proper usage, handling, and appropriate ABHS selection for maximum efficacy against intended pathogens and safe use of ABHS. User awareness can help promote the appropriate usage of ABHS and prevent its hazards, which ultimately can help in preventing the transmission of pathogenic microorganisms. Full article

275 KB

Open AccessArticle

Surveillance for Hepatitis B Virus Seroprevalence Nearly 30 Years After the Implementation of a National Vaccination Program

by Tanita Suttichaimongkol, Chitchai Rattananukrom, Arthit Wongsaensook, Kittisak Sawanyawisuth and Wattana Sukeepaisarnjaroen

GERMS 2021, 11(3), 403-407; https://doi.org/10.18683/germs.2021.1277 - 29 Sep 2021

Cited by 1

Abstract

Introduction: Hepatitis B virus (HBV) infection is associated with cirrhosis and hepatocellular carcinoma. Vaccination is one aspect of public health policy aimed at eliminating HBV infection. After the implementation of an HBV vaccination program for newborns in Thailand, the estimated residual infection rate [...] Read more.

Introduction: Hepatitis B virus (HBV) infection is associated with cirrhosis and hepatocellular carcinoma. Vaccination is one aspect of public health policy aimed at eliminating HBV infection. After the implementation of an HBV vaccination program for newborns in Thailand, the estimated residual infection rate was 3.5%. However, that study was conducted in only 5964 participants in seven provinces and only 22 years after the start of the campaign. This study aimed to evaluate the HBV seroprevalence rate in Thailand in larger sample size and a longer duration after program implementation using HBV surveillance. Methods: This was a surveillance study conducted in 20 provinces in northeast Thailand. The study period was between July 2010 and November 2019. Rates of HBV seroprevalence in each province and overall were calculated. Participants were divided into two groups: those vaccinated under the national campaign and those who were not. Participants aged 0–20 years were used as references, while other age groups (intervals of 10 years) were comparators. Residual HBV seroprevalence after the vaccination program was calculated with odds ratio for HBV seroprevalence in each age group. Results: There were 31,855 subjects who participated in the project. Of those, 1805 (5.7%) had HBV. The HBV seroprevalence rate in the national HBV vaccination group was significantly lower than that in those not vaccinated under the national program (1.0% vs 5.9%; p < 0.001). Seroprevalence was 1.0% in participants ≤20 years of age. Participants 31–40 years of age had the highest odds ratio (10.41), followed those 21–30 years of age (7.42). Conclusions: This real-world surveillance study showed that residual HBV infection was 1.0% after nearly 30 years of nationwide HBV vaccination. Full article

761 KB

Open AccessArticle

COVID-19 in Nigeria: Account of Epidemiological Events, Response, Management, Preventions and Lessons Learned

by Henshaw Uchechi Okoroiwu, Christopher Ogar Ogar, Glory Mbe Egom Nja, Dennis Akongfe Abunimye and Regina Idu Ejemot-Nwadiaro

GERMS 2021, 11(3), 391-402; https://doi.org/10.18683/germs.2021.1276 - 29 Sep 2021

Cited by 15

Abstract

Introduction: After the World Health Organization declared COVID-19 a pandemic, a hand full of cases and deaths have been recorded globally, Nigeria inclusive. Methods: A retrospective analysis of the COVID-19 weekly disease update report by the Nigeria Centre for Disease Control (NCDC) covering [...] Read more.

Introduction: After the World Health Organization declared COVID-19 a pandemic, a hand full of cases and deaths have been recorded globally, Nigeria inclusive. Methods: A retrospective analysis of the COVID-19 weekly disease update report by the Nigeria Centre for Disease Control (NCDC) covering February 29, 2020 (Week 9) and March 28, 2021 (Week 12) was adopted for this study. Data were curated from the NCDC database. Results: As of March 28, 2021, Nigeria is the 5th most affected African country and the 77th most affected country globally with 162,593 COVID-19 cases and 2,048 COVID-19 related deaths. COVID-19 has been reported in all 36 States and the Federal Capital Territory. However, Lagos has remained the epicenter of the pandemic accounting for 35.4% of the pandemic in Nigeria while Kogi State is the least affected State (0.003%). The trend showed male predilection while the age bracket 35-39 years was the most affected. The attack rate was found to be 78.8 per 100,000 of the population while the cumulative death per 100,000 of the population was found to be 1.0. The case fatality rate was found to be 1.30. Approximately 1,778,105 COVID-19 tests have been performed while 923,623 doses of vaccine have been administered. Conclusions: COVID-19 has been reported in all states in Nigeria as well as the Federal Capital Territory with many of the cases involving males. The case trend showed a bimodal form indicating a second wave occurrence. Nigeria government has initiated some combative measures as well as vaccine initiation. Full article

483 KB

Open AccessArticle

Impact of a Comprehensive Care Bundle Educational Program on Device-Associated Infections in an Emergency Intensive Care Unit

by Essamedin M. Negm, Howaydah A. Othman, Mohamed M. Tawfeek, Marwa M. Zalat, Rehab H. El-Sokkary and Khaled M. Alanwer

GERMS 2021, 11(3), 381-390; https://doi.org/10.18683/germs.2021.1275 - 29 Sep 2021

Cited by 7

Abstract

Introduction: Implementation of care bundles was shown to reduce the incidence of device-associated infections (DAIs). Substantial improvements in the rate of infection have been achieved by applying educational programs for infection control. Objectives: To demonstrate the impact of a comprehensive care bundle educational [...] Read more.

Introduction: Implementation of care bundles was shown to reduce the incidence of device-associated infections (DAIs). Substantial improvements in the rate of infection have been achieved by applying educational programs for infection control. Objectives: To demonstrate the impact of a comprehensive care bundle educational program (CCBEP) on DAIs, mortality rates in an emergency Intensive Care Unit (ICU), and improving healthcare workers (HCWs') knowledge, compliance to care bundle, and infection control practice. Methods: A quasi-experimental study was carried out in an 15-beds emergency ICU, from May 2017 to October 2018. A comprehensive care bundle educational program was implemented. It covers items regarding device care bundle and infection control. Results: Device care bundle compliance was variable between different bundle items. There was a significant improvement in HCWs' knowledge after the educational program intervention especially in hand hygiene, catheter-associated urinary tract infection (CAUTI) bundle, and total knowledge. There was a higher risk of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and CAUTI in the pre-intervention phase compared to post-intervention (RR: 1.4, 1.4, and 1.9 respectively). The total mortality rate decreased from 24.2/100 to 16.7/100 patients after intervention. Conclusions: There was a statistically significant improvement in compliance with device care bundles with a decrease in the incidence of DAIs. Full article

463 KB

Open AccessArticle

Prevalence of Anti-SARS-CoV-2 IgG Antibodies in a Group of Patients, a Control Group, and Healthcare Workers of Thrace Area in Greece, by the Use of Two Distinct Methods

by Theocharis Konstantinidis, Stavroula Zisaki, Ioannis Mitroulis, Dimitrios Cassimos, Ioanna Nanousi, Eftychia G. Kontekaki, Vasilis Petrakis, Kalliopi Parrisi, Eleni Fotiadou, Aikaterini Linardou, Nikolaos Lemonakis, Anastasia Grapsa, Theodora Gioka, Leonidas Lazidis, Charalampos Papagoras, Chistina Tsigalou, Periklis Panagopoulos, Panagiotis Skendros, Georges Martinis and Maria Panopoulou

GERMS 2021, 11(3), 372-380; https://doi.org/10.18683/germs.2021.1274 - 29 Sep 2021

Abstract

Introduction: The aim of this study was to assess the clinical performance of different automated immunoassays available in Europe to detect anti-SARS-CoV-2 antibodies; an ELISA assay and a CLIA. The second goal was to estimate the seroprevalence of SARS-CoV-2 antibodies among healthcare workers [...] Read more.

Introduction: The aim of this study was to assess the clinical performance of different automated immunoassays available in Europe to detect anti-SARS-CoV-2 antibodies; an ELISA assay and a CLIA. The second goal was to estimate the seroprevalence of SARS-CoV-2 antibodies among healthcare workers in Evros area during the first pandemic wave of COVID-19. Methods: The study included serum samples from 101 patients with confirmed COVID-19 by RT-PCR and 208 negative patients. Furthermore, it included 1036 healthcare workers (HWs) of the Evros Region, Northern Greece. The measurement of anti-SARS-CoV-2 antibodies was performed using the Abbott SARS-CoV-2 IgG and anti-SARS-CoV-2 ELISA IgG assay (Epitope Diagnostics, USA). Results: Of 101 confirmed COVID-19 patients, 82 were hospitalized and 19 were outpatients. Hospitalized patients had higher IgG levels in comparison to outpatients (6.46 ± 2.2 vs. 3.52 ± 1.52, p < 0.001). Of 208 non−COVID-19 patients only 1 was positive in both ELISA and CLIA assay. SARS-CoV-2-IgG antibodies were detected in 6 HWs out of 1036 (0.58%) with mean S/CO-value of anti-SARS-CoV-2 IgG 3.12 ± 1.3 (confidence interval 0.95), which was lower than in COVID-19 patients (3.12 vs. 5.9; p = 0.016). The clinical evaluation of two immunoassays showed remarkably high true positivity rates in the confirmed COVID-19 patients. Sensitivities obtained with CLIA and ELISA methods were 99.02% vs. 97.09% and specificities 99.52% vs 99.05% respectively. Conclusions: We found an acceptable accordance between CLIA and ELISA assays in the confirmed COVID-19 patients. In all subjects included in this study in the past medical history, the information that was obtained included details about the presence of autoimmune diseases. Full article

354 KB

Open AccessArticle

Diagnosis and Management of Pharyngitis in Children: A Survey Study in Ukraine

by Oksana Boyarchuk, Oksana Mochulska and Roman Komorovsky

GERMS 2021, 11(3), 363-371; https://doi.org/10.18683/germs.2021.1273 - 29 Sep 2021

Cited by 4

Abstract

Introduction: The purpose of our study was to evaluate the knowledge of pediatricians in diagnosis and management of sore throat in children and to identify further ways to raise their awareness. Methods: We conducted a survey among pediatricians on evaluation of diagnosis and [...] Read more.

Introduction: The purpose of our study was to evaluate the knowledge of pediatricians in diagnosis and management of sore throat in children and to identify further ways to raise their awareness. Methods: We conducted a survey among pediatricians on evaluation of diagnosis and management of pharyngitis in children. The study involved pediatricians of Ternopil region, Ukraine. Overall, 112 pediatricians participated in the study. Among the participants 79 (70.5%) were primary care physicians and 33 (29.5%) worked in the secondary and tertiary care hospitals. Results: Overall, 70.5% of pediatricians prescribed a throat swab for patients with pharyngitis in selected cases. However, they rarely (20 %) used Centor or McIsaak criteria to choose management strategy of sore throat. Amoxicillin as a first-line antibiotic for streptococcal pharyngitis was chosen by 66.1% of respondents and primary care pediatricians prescribed it more often than pediatricians in hospitals (p < 0.001), but antibiotic therapy was prescribed for 10 days only by 52.7% of respondents. Less than half of the correct answers were to the questions related to prescription of antibacterial therapy in healthy children, in which GAS is detected in throat swab (39.3%) and in cases of positive antistreptolysin O (ASL-O—25.9%). Conclusions: The study showed a wide range of knowledge of pediatricians about the diagnosis and management of GAS pharyngitis—from satisfactory responses concerning prescription of antibiotic therapy to low level of knowledge about the diagnosis and determination of strategies in healthy carriers. These data emphasize the need to improve knowledge about the strategies of GAS pharyngitis control. Full article

440 KB

Open AccessArticle

Antibiotic Resistance of Non-Fermenting Gram-Negative Bacilli Isolated at a Large Infectious Diseases Hospital in North-Eastern Romania, During an 11-Year Period

by Elena Roxana Buzilă, Eduard Vasile Năstase, Cătălina Luncă, Aida Bădescu, Egidia Miftode and Luminiţa Smaranda Iancu

GERMS 2021, 11(3), 354-362; https://doi.org/10.18683/germs.2021.1272 - 29 Sep 2021

Cited by 8

Abstract

Introduction: Increased antibiotic resistance of non-fermenting Gram-negative bacilli (NFGNB) associated with increased morbidity and mortality makes the infections they produce a major public health problem. This study aims to assess the evolution of antibiotic susceptibility and the level of NFGNB antibiotic resistance. Methods: [...] Read more.

Introduction: Increased antibiotic resistance of non-fermenting Gram-negative bacilli (NFGNB) associated with increased morbidity and mortality makes the infections they produce a major public health problem. This study aims to assess the evolution of antibiotic susceptibility and the level of NFGNB antibiotic resistance. Methods: We carried out a retrospective study on 994 NFGNB strains which had been isolated in the Clinical Laboratory of the "Sf. Parascheva” Clinical Hospital of Infectious Diseases, Iași, during a period of 11 years (2008–2018). Results: Of the 994 NFGNB analyzed, 322 were Acinetobacter spp. and 672 Pseudomonas aeruginosa. Also, 882 NFGNB were isolated from non-sterile sites, in which there was a higher burden of P. aeruginosa strains (n = 617). Acinetobacter spp. presented over 70% resistance to the majority of antibiotics. Three pandrug-resistant P. aeruginosa strains were identified. The rate of colistin resistance was 2.91% for P. aeruginosa and 3.33% for Acinetobacter spp. A comparative analysis of the antibiotic susceptibility of strains isolated from non-sterile sites versus sterile sites revealed statistically significant differences only for Acinetobacter spp. The percentage of resistant strains was significantly higher in tracheobronchial aspirate compared to sputum. Conclusions: The results show that Acinetobacter spp. is substantially more resistant to antibiotics compared to P. aeruginosa and that the use of medical devices can favor the occurrence of infections with multidrug-resistant strains. Full article

233 KB

Open AccessEditorial

“Red Throat” or Acute Pharyngitis—Challenges in Real Life Clinical Practice

by Victor Daniel Miron and Mihai Craiu

GERMS 2021, 11(3), 351-353; https://doi.org/10.18683/germs.2021.1271 - 29 Sep 2021

Cited by 6

Abstract

An interesting article by Oksana Boyarchuk et al. has just been published in the current issue of Germs—“Diagnosis and management of pharyngitis in children: a survey study in Ukraine” [...] Full article

Journal Menu

Journal Browser

GERMS, Volume 11, Issue 3 (09 2021) – 12 articles , Pages 351-453

Further Information

Guidelines

MDPI Initiatives

Follow MDPI