GERMS

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Open AccessCommunication

Anxiety and Burnout Among Healthcare Workers During the COVID-19 Circuit Breaker in a Women’s and Children’s Hospital in Singapore

by Komal Tewani, Akshita Agarwal, Wei Han Melvin Wong, Irene Teo, Hiang Khoon Tan, Wai Loong Wong and Kee Chong Ng

GERMS 2022, 12(1), 137-141; https://doi.org/10.18683/germs.2022.1317 - 31 Mar 2022

Abstract

Healthcare workers (HCWs) are at the epicenter in times of a calamity and are pivotal in the overall response during outbreaks [...] Full article

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Open AccessCase Report

Unexpected Clinical Case of Pasteurella multocida Infectious Endocarditis in a Patient with IV Drug Abuse: Why Epidemiological History Matters

by Svetlana A. Rachina, Nadezhda V. Mukhina, Natalia A. Cherkasova, Irina S. Komarova, Olga E. Ushakova, Suman M. Nasrulloeva, Elena N. Burmistrova and Natali V. Ivanchik

GERMS 2022, 12(1), 130-136; https://doi.org/10.18683/germs.2022.1316 - 31 Mar 2022

Cited by 1

Abstract

Introduction: Right-sided lesions caused by staphylococci are the most common clinical entity of infectious endocarditis (IE) among iv drug abusers. But some aspects of the epidemiological history are critical in terms of early detection of uncommon pathogens. Case report: We describe a clinical [...] Read more.

Introduction: Right-sided lesions caused by staphylococci are the most common clinical entity of infectious endocarditis (IE) among iv drug abusers. But some aspects of the epidemiological history are critical in terms of early detection of uncommon pathogens. Case report: We describe a clinical observation of native aortic valve IE caused by Pasteurella multocida in a 37-year-old female with a history of heroin addiction, alcohol abuse and liver cirrhosis. She presented herself at our hospital with acute fever, chills, subconjunctival petechial hemorrhages, traces of scratches on the hands, splenomegaly, peripheral edema, elevated WBC and inflammatory serum markers. Initial transthoracic echocardiography was negative, but the patient was put on oxacillin for suspected right-sided IE. The transesophageal echocardiography revealed vegetation on noncoronary leaflet of aortic valve. Blood culture was positive with the growth of P. multocida in 4/4 samples. On detailed questioning, a close domestic contact with cats was revealed. Oxacillin was switched to meropenem and tigecycline with a prompt clinical response. The P. multocida isolate was found to be susceptible to penicillins, so the patient was discharged after 3 weeks with recommendations to take amoxicillin for up to 4 weeks. At 3 and 6 months follow-up there were no signs of IE relapse revealed. Conclusions: P. multocida is a rare causative agent of IE. In our case, this pathogen was identified in a patient with injection drug use, where such etiology is not usually assumed. The close contact with cats was not taken into account, which caused late diagnosis and delayed therapy. Full article

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Open AccessCase Report

Fatal Septic Shock Caused by Capnocytophaga canimorsus Diagnosed by 16S rRNA Gene Sequencing

by Ludovic Bergon, Maud Foissac, Brigitte Rivière, Marie Isabelle Steinbach, Bob Catala, Sarah Khatibi, Aubin Souche, Laure Pirovano, Pauline Condom, Gilles Salama and Jacques Gilquin

GERMS 2022, 12(1), 124-129; https://doi.org/10.18683/germs.2022.1315 - 31 Mar 2022

Abstract

Introduction: Capnocytophaga canimorsus is a commensal bacterium found in the saliva of dogs and cats. In most cases C. canimorsus causes local infection resulting from bite-wounds, scratches or licks but severe forms can occur. The following case describes a severe and rapidly fatal [...] Read more.

Introduction: Capnocytophaga canimorsus is a commensal bacterium found in the saliva of dogs and cats. In most cases C. canimorsus causes local infection resulting from bite-wounds, scratches or licks but severe forms can occur. The following case describes a severe and rapidly fatal sepsis and disseminated intravascular coagulation with no evidence of bite in a patient without obvious cause of immunosuppression, diagnosed by polymerase chain reaction and 16S rRNA gene sequencing. Case report: Herein we present a rare case of a 39-year-old man who was taken care of by the emergency medical service for faintness, fever and chills associated with generalized mottling. Despite critical care management and broad-spectrum antibiotherapy, the patient presented an irrepressible shock with disseminated intravascular coagulation and multiple organ failure. He died during the night. The initial etiological assessment was negative but rod-shaped inclusions could be observed in his blood. A pan-bacterial polymerase chain reaction targeting part of the gene encoding 16S ribosomal ribonucleic acid (rRNA) was carried out directly on blood cultures; the sequencing identified Capnocytophaga canimorsus. Conclusions: This observation illustrates the potential severity of C. canimorsus infection even in a patient without neither obvious causes of immunosuppression nor evidence of bite. The presence of intracellular bacillary forms on the blood smear is an important information which should lead to performing a polymerase chain reaction and 16S rRNA gene sequencing. Full article

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Open AccessCase Report

Double Atypical Co-Infection in Ecthyma Gangrenosum: A Peculiar Case Report

by Paulus Mario Christopher, Erna Kristiani and Cucunawangsih

GERMS 2022, 12(1), 118-123; https://doi.org/10.18683/germs.2022.1314 - 31 Mar 2022

Abstract

Introduction: Ecthyma gangrenosum (EG) is a rare cutaneous manifestation commonly associated with Pseudomonas aeruginosa infection in immunocompromised individuals. Additionally, different bacterial and fungal pathogens have also been identified. However, co-infection on EG lesions has never been reported before. Case report: We present the [...] Read more.

Introduction: Ecthyma gangrenosum (EG) is a rare cutaneous manifestation commonly associated with Pseudomonas aeruginosa infection in immunocompromised individuals. Additionally, different bacterial and fungal pathogens have also been identified. However, co-infection on EG lesions has never been reported before. Case report: We present the case of a seven-year-old female Asian patient who initially was diagnosed with febrile neutropenia. Initially, on the sixth day of admission, dermatological status revealed multiple painless erythematous macules on the face and arms together with persistent fever followed by evolution to multiple black, deep-seated, and large central eschars and early identification of Pseudomonas aeruginosa in the blood culture. Further evaluation revealed the development of EG with XDR Acinetobacter baumannii and Aspergillus spp. isolated from the samples harvested intraoperatively. Conclusions: Specific identification of etiological agents will serve its importance for early diagnosis, aggressive antibiotic treatment, and/or surgical intervention to improve the prognosis. Full article

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Open AccessCase Report

Cardiac Tamponade—An Unexpected “Long COVID-19” Complication

by Cristian Cobilinschi, Oana Maria Melente, Cristina Bologa, Ana-Maria Cotae, Laura Constantinescu, Sonia Bacruban and Ioana Marina Grinţescu

GERMS 2022, 12(1), 112-117; https://doi.org/10.18683/germs.2022.1313 - 31 Mar 2022

Cited by 1

Abstract

Introduction: Year 2020 has been a cornerstone in medical research due to the COVID-19 pandemic outbreak. The process of understanding the condition brought to light certain organ involvement like pulmonary or kidney damage or endocrine disbalances, while connection to other types of organ [...] Read more.

Introduction: Year 2020 has been a cornerstone in medical research due to the COVID-19 pandemic outbreak. The process of understanding the condition brought to light certain organ involvement like pulmonary or kidney damage or endocrine disbalances, while connection to other types of organ impairment remain unclear. SARS-CoV-2 has previously been incriminated in cardiac involvement, ranging from mild symptoms to more severe occurrences such as myocarditis, arrythmias or heart failure, thus complicating the acute-phase management and worsening patients’ prognosis. Despite being reported as an acute manifestation in critical COVID-19, cardiac tamponade seems to also occur as a “long- COVID19” complication. The latter is a distinct yet unclear entity associated with remanent fatigue or cough, but more severe sequelae like vasculitis or polyneuropathy can occsur. Case report: We report the case of a 42-year-old patient admitted in the intensive care unit for severe respiratory and renal dysfunction one month after an initial mild episode of COVID-19. RT-PCR for SARS-CoV-2 on admission was negative. Initial imaging through CT and heart ultrasound revealed the presence of pericardial effusion but no signs of tamponade were initially obvious. Twelve hours later, the patient’s state deteriorated with cardiocirculatory failure and signs of obstructive shock. Agents responsible for severe acute respiratory infection (SARI) such as influenza A and B, adenovirus, Bordetella pertussis, Mycoplasma pneumoniae, coxsackie virus, Chlamydia pneumoniae or parainfluenza viruses were ruled out. Surprisingly, RT-PCR testing for SARS-CoV-2 came back positive, although the initial test was negative. Repeated imaging confirmed massive circumferential pericardial effusion for which emergency pericardiocentesis was performed. Fluid was an exudate and histopathology reported chronic inflammation. RT-PCR testing for Mycoplasma tuberculosis in the pericardial tissue came back negative. Conclusions: The case is to our knowledge among the first to report cardiac tamponade one month after mild COVID-19 infection. The aim of this case report is to raise awareness in the medical community on the possibility of severe complications targeting major organs in the long-COVID-19 phase. Full article

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Open AccessCase Report

Association of Hiccup and SARS-CoV-2 Infection with the Administration of Dexamethasone: A Case Report

by Victoria Bîrluţiu and Ciprian Radu Şofariu

GERMS 2022, 12(1), 107-111; https://doi.org/10.18683/germs.2022.1312 - 31 Mar 2022

Cited by 3

Abstract

Introduction: Among the less common symptoms associated with the SARS-CoV-2 infection the attention is drawn by a persistent hiccup that was recently quoted in the literature. Case report: We present the case of a 46-year-old Caucasian male patient hospitalized in the Infectious Diseases [...] Read more.

Introduction: Among the less common symptoms associated with the SARS-CoV-2 infection the attention is drawn by a persistent hiccup that was recently quoted in the literature. Case report: We present the case of a 46-year-old Caucasian male patient hospitalized in the Infectious Diseases Clinic of the Academic Emergency Hospital Sibiu, Romania with laboratory confirmation of SARS-CoV-2 infection with a positive result of real-time reverse transcriptase–polymerase chain reaction (RT-PCR) assay from nasopharyngeal swabs, that during the disease course developed persistent hiccup associated with the administration of cortisone therapy, dexamethasone. A decision to stop the treatment with cortisone preparations was made, with the disappearance of the hiccup after 36 h. Conclusions: From our experience, other cases of SARS-CoV-2 infection that we managed during these months of the pandemic, with mild or severe forms of the disease, showed hiccup under treatment with dexamethasone, an event also described in other medical conditions under the same treatment and improved at its cessation or when replaced by methylprednisolone. Full article

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Open AccessCase Report

A Case of Undisclosed Prior Exposure to Antiretroviral Therapy (ART) and Early Virologic Failure That Improved on a Pre-Emptive Third-Line ART Regimen

by Mireille A Mpalang Kakubu, Tarisai Bikinesi, Emma Sepiso Liswaniso and Patrick Dmc Katoto

GERMS 2022, 12(1), 102-106; https://doi.org/10.18683/germs.2022.1311 - 31 Mar 2022

Abstract

Introduction: The test and treat strategy recommends starting ART on the same day of diagnosis; yet, in Namibia neither baseline viral load (VL) nor genotypic resistance testing (GRT) are recommended prior to ART initiation. However, some clients return to care having defaulted ART [...] Read more.

Introduction: The test and treat strategy recommends starting ART on the same day of diagnosis; yet, in Namibia neither baseline viral load (VL) nor genotypic resistance testing (GRT) are recommended prior to ART initiation. However, some clients return to care having defaulted ART and undergo HIV testing as “new” clients without disclosing their previous exposure, which predisposes them to primary virologic failure. Case report: A 53-year-old man tested HIV positive in 2019 without disclosing his prior exposure to ART from 2010–2015 and who stopped medication from 2015–2019 due to religious advice. He was thus initiated of first-line ART on the same day of his new diagnosis with a nadir CD4 count of 102 cells/mm³. He had a negative cryptococcal serum antigen, a normal creatinine clearance but with hepatitis B coinfection. He presented later with a primary virologic failure (VL > 1000 copies/mL) and severe immunosuppression. The in-depth discussion revealed previous exposure to ART. He consequently benefited from a presumptive third-line ART that suppressed his VL while a GRT was being processed which later confirmed ART resistance. Conclusions: In poor resource settings where GRT is not performed regularly, undisclosed exposure to ART might lead to subtherapeutic treatment and primary virologic failure. In such patients where primary virologic failure is suspected despite good adherence, presumptive third-line ART can be considered in severely immunocompromised patients while waiting for GRT. Full article

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Open AccessOpinion

Reassessment of the Blood-Brain Barrier: A Potential Target for Viral Entry Into the Immune-Privileged Brain

by George B. Stefano, Pascal Büttiker and Richard M. Kream

GERMS 2022, 12(1), 99-101; https://doi.org/10.18683/germs.2022.1310 - 31 Mar 2022

Cited by 6

Abstract

Significant alteration of cognitive and affective behaviors mediated by neural pathways in the central nervous system (CNS), currently referred to as “brain fog”, is a major long-term complication following recovery from an acute infectious event [...] Full article

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Open AccessArticle

Nasal Colonization by Potential Bacterial Pathogens in Healthy Kindergarten Children of Nepal: A Prevalence Study

by Govinda Paudel, Neetu Amatya, Bhuvan Saud, Sunita Wagle, Vikram Shrestha and Bibhav Adhikari

GERMS 2022, 12(1), 86-98; https://doi.org/10.18683/germs.2022.1309 - 31 Mar 2022

Cited by 5

Abstract

Introduction: In low- and middle-income countries including Nepal, respiratory tract infection (RTI) is considered as one of the most prominent public health problems in children. Multiple carriage of respiratory pathogens is common in children, especially in preschoolers as they are easily transmitted through [...] Read more.

Introduction: In low- and middle-income countries including Nepal, respiratory tract infection (RTI) is considered as one of the most prominent public health problems in children. Multiple carriage of respiratory pathogens is common in children, especially in preschoolers as they are easily transmitted through close contact and poor hygienic condition. Thus, this research is based on the study of prevalence, co-existence, associated factors and antibiogram of nasal isolates among healthy preschoolers. Methods: The study was conducted in four randomly selected kindergarten schools (two government run and two private run) of Bhaktapur Municipality. Out of a total 140 students, 136 eligible participants of age group 2–5 years old were involved in the study. Nasal swab was collected for the isolation of five target isolates (Staphylococcus aureus, Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae and Haemophilus parainfluenzae) and their antibiotic resistance determination. Results: Of 136 participants involved, 128 (94.5%) were positive for carriage of at least one of the target bacteria. The most common isolate was M. catarrhalis 62.5% (80/128) followed by S. aureus 43.0% (55/128). There was a significant difference in bacterial carriage with respect to type of school (p value < 0.05, OR = 0.50, CI = 0.20–0.90). Regarding bacterial co-existence, the most common co-existence was of S. aureus and M. catarrhalis & S. pneumoniae and M. catarrhalis 48.8%. Multiple logistic regression analysis showed that S. aureus was negatively associated with S. pneumoniae, M. catarrhalis and H. influenzae and S. pneumoniae was positively associated with M. catarrhalis and H. influenzae. Multidrug resistance was seen in 63 isolates (29.4%). Conclusions: Nepalese kindergarten children are at a high risk of respiratory tract infection by multidrug resistant bacteria. Full article

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Open AccessArticle

Febrile Illness of Bacterial Etiology in a Public Fever Hospital in Egypt: High Burden of Multidrug Resistance and WHO Priority Gram Negative Pathogens

by Shimaa H. Mostafa, Sarra E. Saleh, Samira M. Hamed and Khaled M. Aboshanab

GERMS 2022, 12(1), 75-85; https://doi.org/10.18683/germs.2022.1308 - 31 Mar 2022

Cited by 12

Abstract

Introduction: Contemporary emergence of multidrug resistance (MDR) urges regular updates on circulating pathogens and their antimicrobial resistance profiles. We aimed to identify the burden of MDR and World Health Organization (WHO) priority Gram negative pathogens among patients admitted with febrile illness to Abbassia [...] Read more.

Introduction: Contemporary emergence of multidrug resistance (MDR) urges regular updates on circulating pathogens and their antimicrobial resistance profiles. We aimed to identify the burden of MDR and World Health Organization (WHO) priority Gram negative pathogens among patients admitted with febrile illness to Abbassia Fever Hospital, a major Public Fever Hospital in Egypt. The carbapenemase- and extended spectrum beta-lactamases (ESBLs)-encoding genes carried by the isolates were also identified. Methods: A total of 9602 clinical specimens were collected from febrile patients during 2018 and 2019. The recovered bacterial isolates were examined for antimicrobial susceptibility using disk diffusion test. Susceptibility to colistin was tested using E-test. ESBLs production was phenotypically and genotypically analyzed. Results: A total of 790 bacterial isolates (612 Gram negative and 178 Gram positive) were recovered. A percentage of 77.6%, and 62.9% of the Gram negative and positive isolates showed MDR phenotype, respectively. WHO priority pathogens were abundant, including carbapenem-resistant (CR) Enterobacterales (105/187; 56.1%) and CR glucose non-fermenters (82/187; 43.8%) such as: A. baumannii (55; 29.4%), P. aeruginosa (27; 14.4%). Carbapenemase- and ESBLs-encoding genes were detected in 56.1% and 30.8% of Enterobacterales and in 43.8% and 46.3% of glucose non-fermenters, respectively. Antimicrobials such as fosfomycin and chloramphenicol retained good activities against MDR Gram negative pathogens. Conclusions: This study highlights the regional burden of MDR and priority Gram negative pathogens. The obtained data are of relevant medical importance for implementation of evidence-based antimicrobial stewardship programs and for tailoring the existing empirical treatment guidelines. Full article

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Open AccessArticle

Immunization Status of Children 1–5 Years Old Seen at the Emergency Pediatric Unit of a Teaching Hospital in North-Central Nigeria

by Esther S. Yiltok, Jonathan C. Daboer, Edward M. Dachalson, Mathilda E. Banwat, Augustine O. Ebonyi, Helen O. Akhiwu, David D. Shwe and Tolulope O. Afolaranmi

GERMS 2022, 12(1), 63-74; https://doi.org/10.18683/germs.2022.1307 - 31 Mar 2022

Cited by 4

Abstract

Introduction: Advocacy for immunization has been ongoing in various parts of the world to improve immunization uptake amongst children. Annually within the last decade, immunization has been reported to avert over two million deaths globally. This study determined the current immunization status of [...] Read more.

Introduction: Advocacy for immunization has been ongoing in various parts of the world to improve immunization uptake amongst children. Annually within the last decade, immunization has been reported to avert over two million deaths globally. This study determined the current immunization status of children 1–5 years of age, the factors affecting immunization uptake and recommends ways of improving immunization uptake among children presenting at an Emergency Pediatric Unit (EPU). Methods: This was a prospective cross-sectional study conducted from 1 October to 30 November 2019. All eligible children aged 1–5 years old seen within the study period whose mothers/caregivers consented to participate in the study were recruited in the EPU of Jos University Teaching Hospital (JUTH), Plateau State, Nigeria. A systematic sampling technique was employed in the selection of caregiver/mother-child pair while data were obtained using an interviewer-administered questionnaire. Results: A total of 191 (76.4%) children were fully immunized for age. Distance to the health facility, experience of vaccine side effects and health workers’ attitude were significantly associated with immunization status. Distance to health facility was an independent predictor of complete immunization while short messaging service (SMS) was the most preferred 190 (76.0%) way suggested to improve immunization uptake. Conclusions: This study has brought to light a suboptimal level of full immunization status for age, which can be improved by targeting homegrown interventions at improving accessibility to the facility and addressing adverse events following immunization promptly. Full article

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Open AccessArticle

Ultrasound Markers in Early Diagnosis of Asymptomatic Chronic Hepatitis. A Prospective Study

by Mihai Lazăr, Ecaterina Constanţa Barbu, Cristina Emilia Chiţu, Marius Ştefan and Daniela Adriana Ion

GERMS 2022, 12(1), 54-62; https://doi.org/10.18683/germs.2022.1306 - 31 Mar 2022

Abstract

Introduction: Nowadays, chronic viral hepatitis represents one of the most common pathological entities with over 400 million cases worldwide, with high diagnosis and treatment cost, severe complications in late stages and an annual death-rate around 1 million. The purpose of this study was [...] Read more.

Introduction: Nowadays, chronic viral hepatitis represents one of the most common pathological entities with over 400 million cases worldwide, with high diagnosis and treatment cost, severe complications in late stages and an annual death-rate around 1 million. The purpose of this study was to identify noninvasive ultrasound markers in order to establish an early diagnosis in asymptomatic chronic hepatitis. Methods: We enrolled in a prospective study 111 patients diagnosed with asymptomatic chronic hepatitis: 53 patients with hepatitis B (group A) and 58 patients with hepatitis C (group B). All patients underwent ultrasound exam; we evaluated the dimensions of the left hepatic lobe, right hepatic lobe, caudate lobe, portal vein, liver stiffness, presence of hepatic hilar lymph nodes, number and dimensions of the adenopathies. Results: Increased liver size was found in over 16% of patients in group A and over 20% of patients in group B. We registered an enlarged portal vein in 3.77% of patients in group A and in 3.45% of patients in group B. Adenopathies were found in 64.16% of group A and 82.76% of group B. Using long adenopathic axis as marker, we obtained a NPV over 0.9, PPV of 0.5 in the detection of chronic hepatitis B and a PPV of 0.9 in the detection of chronic hepatitis C in asymptomatic patients, a specificity of 0.98 for both chronic hepatitis B and C, a sensitivity of 0.81 for group B and 0.64 for group A. Conclusions: The presence of hilar liver adenopathies represents an important marker in detecting asymptomatic chronic viral hepatitis. Full article

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Open AccessArticle

Self-Medication in Hospitalized Patients With COVID-19: A Cross-Sectional Study in Northern Peru

by Luis E. Vasquez-Elera, Virgilio E. Failoc-Rojas, Raisa N. Martinez-Rivera, Noelia Morocho-Alburqueque, Mario S. Temoche-Rivas and Mario J. Valladares-Garrido

GERMS 2022, 12(1), 46-53; https://doi.org/10.18683/germs.2022.1305 - 31 Mar 2022

Cited by 20

Abstract

Introduction: This study aimed to identify factors associated with self-medication in patients with COVID-19. Methods: A cross-sectional study was conducted using medical records of patients with COVID-19 who self-medicated before admission to a hospital in Piura, Peru. Prevalence ratios and 95% confidence intervals [...] Read more.

Introduction: This study aimed to identify factors associated with self-medication in patients with COVID-19. Methods: A cross-sectional study was conducted using medical records of patients with COVID-19 who self-medicated before admission to a hospital in Piura, Peru. Prevalence ratios and 95% confidence intervals were estimated using generalized linear models with Poisson distribution family, log link function, and robust variance. Results: Out of 301 patients, 165 (54.8%) self-medicated before hospital admission, being more frequent self-medication with ivermectin (85.5%) and azithromycin (71.5%). The frequency of self-medication in those aged between 30–59 years was 2.53-fold higher than in those between 18–29 years. Male patients, dyslipidemia, smoking, and hepatic steatosis were associated with self-medication. Clinical characteristics associated with self-medication were fever, cough, headache, anosmia, dysgeusia, nausea/vomiting, and gastroesophageal reflux. Conclusions: A high frequency of self-medication before hospital admission was observed in Peruvian patients with COVID-19, mainly of drugs without proven efficacy. Full article

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Open AccessArticle

Human Cytomegalovirus and Isocitrate Dehydrogenase Status in Glioma: Association and Prognosis Value in Moroccan Population

by Coumba Fall, Mohammed Chaoui El Faiz, Nawal Hammass, Hinde El Fatemi, Khalid Hassouni, Laila Bouguenouch, Samira El Fakir and Bahia Bennani

GERMS 2022, 12(1), 32-45; https://doi.org/10.18683/germs.2022.1304 - 31 Mar 2022

Abstract

Introduction: Human cytomegalovirus (HCMV) and isocitrate dehydrogenase (IDH) have been separately associated to gliomas. IDH is a molecular marker considered in the histo-molecular classification of gliomas as well as in their management and prognosis. However, even if oncomodulatory properties were attributed to HCMV, [...] Read more.

Introduction: Human cytomegalovirus (HCMV) and isocitrate dehydrogenase (IDH) have been separately associated to gliomas. IDH is a molecular marker considered in the histo-molecular classification of gliomas as well as in their management and prognosis. However, even if oncomodulatory properties were attributed to HCMV, its association to gliomas remains a controversy. Most of the studies that investigated this association used the histological classification of gliomas; nevertheless, in 2016, the World Health Organization recommended the introduction of molecular characteristics to refine this classification. The aims of this study were to determine the prevalence of HCMV in glioma patients, the association between HCMV and IDH with gliomas and subsequently their associations with survival of patients in a Moroccan cohort. Methods: A series of 102 gliomas and 32 controls were analyzed by nested PCR (nPCR) to determine the HCMV status. PCR and sequencing were used to determine the IDH subtypes in tumors samples. IDH mutation and HCMV status were correlated to the characteristics of the tumors using SPSS, whereas the survival curves were obtained by the Kaplan-Meier method and the log rank test. Results: HCMV shows significant association with gliomas with a detection rate of 30.4% and no case in the control group. The IDH mutation was identified in 40.9–50% of grade II–III gliomas and in 10.9% of grade IV gliomas. A significant association was obtained between survival in patients with glioblastomas and IDH/HCMV status. Glioblastoma patients with HCMV+ and IDHwt had a poor prognostic. Conclusions: HCMV was detected exclusively in tumor cases and was significantly associated with poor prognosis in patients with gliomas and particularly with glioblastomas. The worst overall survival was significantly seen in patients with gliomas HCMV+/IDHwt. So, it will be of interest to consider HCMV and IDH status in gliomas management strategies. Full article

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Open AccessArticle

Clinical Manifestations, Associated Diseases, Diagnosis, and Treatment of Human Infections Caused by Erysipelothrix rhusiopathiae: A Systematic Review

by Mosayeb Rostamian, Donya Rahmati and Alisha Akya

GERMS 2022, 12(1), 16-31; https://doi.org/10.18683/germs.2022.1303 - 31 Mar 2022

Cited by 12

Abstract

Introduction: Erysipelothrix rhusiopathiae is a bacillus that can cause cutaneous and systemic diseases in humans. Studies on the infection caused by this bacterium have been mostly done as case reports. This study aimed to systematically review E. rhusiopathiae infection cases published over the [...] Read more.

Introduction: Erysipelothrix rhusiopathiae is a bacillus that can cause cutaneous and systemic diseases in humans. Studies on the infection caused by this bacterium have been mostly done as case reports. This study aimed to systematically review E. rhusiopathiae infection cases published over the last 20 years. Methods: Science Direct, PubMed, Scopus, Google Scholar, and Web of Science were searched using appropriate keywords to find relevant studies. After assessment of the studies, 57 case reports which surveyed 62 patients were included and their data were collected and analyzed. Results: The majority of cases were adult men living in high-income countries with an animal-related job and/or a history of animal contacts. The number of cases has increased in recent years. The main underlying diseases that were associated with E. rhusiopathiae infections include hypertension, diabetes, and alcoholism. The most frequent presentations were fever, pain, local skin lesions, and heart failure/endocarditis. Two patients died, while 60 patients were recovered following antibiotic therapy, mainly with penicillin and ceftriaxone. Conclusions: Altogether, the results indicated that E. rhusiopathiae usually infects people who come into contact with animals and causes mild to severe local or systemic infections, especially in those who have underlying diseases. Therefore, accurate and early diagnosis of E. rhusiopathiae infections by setting up appropriate laboratory tests is required. Full article

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Open AccessArticle

COVID-19 Infection Characteristics and Outcomes in a Predominantly Latino Community Hospital

by Daniel Colon Hidalgo, Manasa Jasti, Natalie Tapaskar, Christine Junia, Akshata Chaugule, Fanny Giron Galeano, Daniel C. Alcantar, Maria Jose Zabala Ramirez, Jose L. Zabala Genovez, Gabino Maza Rodas, Diana Espinoza Barrera, Raul Rodriguez and Fritzie Albarillo

GERMS 2022, 12(1), 10-15; https://doi.org/10.18683/germs.2022.1302 - 31 Mar 2022

Cited by 2

Abstract

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread worldwide and claimed millions of lives. Several studies have attempted to understand the relationship between COVID-19 infection and health disparities. The aim of the current work was to evaluate the pre-admission health characteristics, [...] Read more.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread worldwide and claimed millions of lives. Several studies have attempted to understand the relationship between COVID-19 infection and health disparities. The aim of the current work was to evaluate the pre-admission health characteristics, symptomatology, diagnostic abnormalities, treatment measures and clinical outcomes of the community served by our institution, with a sub-analysis of our Hispanic community. Methods: This is a single-center, cross-sectional cohort study of patients with COVID-19 admitted from 15 March 2020 to 30 April 2020 to MacNeal Hospital. A retrospective chart review was performed including patients >18 years and a positive nasopharyngeal SARS-CoV-2 PCR. Demographical data, comorbidities, clinical data, treatment regimen, and patient outcomes were collected. Results: A total of 257 patients were included in the study of which 60.4% were identified as Hispanic. The median age at admission of Hispanic patients was significantly lower compared to non-Hispanic patients (56.6 vs. 65.7 years, p10 mg/dL (OR 4.53, 95%CI 1.49–13.38) and D-dimer >1.5 mcg/mL (OR 3.63, 95%CI 1.31–10.05). An oxygen saturation of >90% on room air on presentation was a protective factor when predicting intubation (OR 0.11, 95%CI 0.03–0.33). The overall 30-day mortality rate was 17.1% (n = 44); 11.9% in the Hispanic group vs 26.3% in the non-Hispanic group (p < 0.003). Conclusions: Our review of consecutive patients admitted with COVID-19 demonstrated that over half of patients were of Hispanic descent. Interestingly enough, despite being significantly younger and healthier, the need for mechanical ventilation in the Hispanic group was not significantly different compared to the non-Hispanic group. However, the Hispanic group had a lower mortality rate. Full article

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Open AccessEditorial

The Renewed Threat of Vaccine-Preventable Diseases in the War-Struck European Continent

by Oana Săndulescu

GERMS 2022, 12(1), 7-9; https://doi.org/10.18683/germs.2022.1301 - 31 Mar 2022

Cited by 3

Abstract

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GERMS, Volume 12, Issue 1 (03 2022) – 17 articles , Pages 7-141

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