GERMS

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Open AccessCommunication

Visitor Behavior During Hospital Inpatient Visitation

by Gulsum Iclal Bayhan, Rukiye Can, Sinem Elçi, Fatma Kamiş, Kaan Saritaş, Sümeyye Yetim, Zeynep Ömerbeyoğlu, Hacer Su Haciibrahimoğlu, Aysuna Galandarova, Ezgi Ruken Demir, Merve Can and İlayda Meletli

GERMS 2022, 12(4), 554-560; https://doi.org/10.18683/germs.2022.1360 - 31 Dec 2022

Cited by 1 | Viewed by 40

Abstract

Introduction The common target audience of the current guidelines for the prevention of healthcare-associated infections is represented by healthcare workers. Behavioral protocols for visitors and caregivers that aim to prevent healthcare-associated infections are still not available. The aim of this study was to [...] Read more.

Introduction The common target audience of the current guidelines for the prevention of healthcare-associated infections is represented by healthcare workers. Behavioral protocols for visitors and caregivers that aim to prevent healthcare-associated infections are still not available. The aim of this study was to determine the behavior of the visitors and to determine possible behavior that would contribute to the transmission of pathogenic microorganisms, in order to provide suggestions for visitors in the post-pandemic period. Methods A survey about visitor behavior was administered to 621 visitors. The survey consisted of questions regarding the demographic features and the behavior of the patient visitors. Results Seventy-seven visitors (12.4%) had at least one infection-related symptoms. Overall, 426 (68.6%) visitors stated that they would cancel their visit if they had any infection-related symptoms. The location of the hand washbasin to wash or sanitize the hands at the patient’s unit was not known by 142 (22.9%) visitors. The number of visitors performing all hand hygiene steps was 351 (56.5%). Compliance with hand hygiene was not affected by age, gender, living in the same house as the visited patient, or visiting an adult or pediatric patient. Conclusions The visitors should be queried about symptoms of infectious disease at the entrance of the hospital. The knowledge level of the visitors about hand hygiene is not sufficient. Clear recommendations about when and how often visitors should practice hand hygiene and providing information at the entrance of the hospital will improve the hand hygiene compliance of the visitors. Full article

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Open AccessCase Report

The Key Role of the Ophthalmologist in Diagnosing Botulism: Two Case Reports

by Larisa Cujba, Ovidiu Samoila, Silvina Ilut, Vitalie Vacaras and Cristina Stan

GERMS 2022, 12(4), 548-553; https://doi.org/10.18683/germs.2022.1359 - 31 Dec 2022

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Abstract

Introduction Botulinum toxin, the strongest known neurotoxin, is the cause of a rare fatal neuroparalytic disease characterized by the so-called “four Ds”: diplopia, dysarthria, dysphagia, dry mouth. If left untreated, botulism may cause paralysis of the respiratory muscles, impairing the respiratory function which [...] Read more.

Introduction Botulinum toxin, the strongest known neurotoxin, is the cause of a rare fatal neuroparalytic disease characterized by the so-called “four Ds”: diplopia, dysarthria, dysphagia, dry mouth. If left untreated, botulism may cause paralysis of the respiratory muscles, impairing the respiratory function which can ultimately lead to death. Case report We describe the cases of two patients who presented, two years apart, with similar ocular symptoms such as blurred vision due to accommodation palsy, diplopia, accompanied by xerostomia and swallowing disorders, which were further confirmed as botulism. Both cases had a similar clinical presentation of the intoxication and a positive response to treatment with botulinum antitoxin, while only the first case had a laboratory confirmation of the disease. Conclusions The key to diagnose botulism correctly is based on high clinical suspicion and requires a medical multidisciplinary approach and urgent specific treatment. Ophthalmology specialists must be aware of the disease, especially in cases in which ophthalmic manifestation appear at the onset. Full article

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Open AccessReview

Arbovirus and Its Potential to Lead the Next Global Pandemic from Sub-Saharan Africa: What Lessons Have We Learned from COVID-19?

by Elizabeth N. Mbim, Uwem Okon Edet, Henshaw Uchechi Okoroiwu, Francisca O. Nwaokorie, Asanga Effiong Edet, Ayo Owolabi and Mboto Clement I

GERMS 2022, 12(4), 538-547; https://doi.org/10.18683/germs.2022.1358 - 31 Dec 2022

Cited by 5 | Viewed by 42

Abstract

Risk and predisposing factors for viral zoonoses abound in the sub-Saharan Africa (SSA) region with significant public health implications. For several decades, there have been several reports on the emergence and re-emergence of arbovirus infections. The lifetime burden of arboviral diseases in developing [...] Read more.

Risk and predisposing factors for viral zoonoses abound in the sub-Saharan Africa (SSA) region with significant public health implications. For several decades, there have been several reports on the emergence and re-emergence of arbovirus infections. The lifetime burden of arboviral diseases in developing countries is still poorly understood. Studies indicate significant healthcare disruptions and economic losses attributed to the viruses in resource-poor communities marked by impairment in the performance of daily activities. Arboviruses have reportedly evolved survival strategies to aid their proliferation in favorable niches, further magnifying their public health relevance. However, there is poor knowledge about the viruses in the region. Thus, this review presents a survey of zoonotic arboviruses in SSA, the burden associated with their diseases, management of diseases as well as their prevention and control, mobility and determinants of infections, their vectors, and co-infection with various microorganisms. Lessons learned from the ongoing coronavirus disease 2019 (COVID-19) pandemic coupled with routine surveillance of zoonotic hosts for these viruses will improve our understanding of their evolution, their potential to cause a pandemic, control and prevention measures, and vaccine development. Full article

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Open AccessReview

The Zika Virus: An Opportunity to Revisit Reproductive Health Needs and Disparities

by Richard A. Stein, Alexis Grayon, Adi Katz and Frank A. Chervenak

GERMS 2022, 12(4), 519-537; https://doi.org/10.18683/germs.2022.1357 - 31 Dec 2022

Cited by 1 | Viewed by 41

Abstract

First isolated in 1947, the Zika virus was initially connected only to limited or sporadic human infections. In late 2015, the temporal clustering of a Zika outbreak and microcephaly in newborn babies from northeastern Brazil, and the identification of a causal link between [...] Read more.

First isolated in 1947, the Zika virus was initially connected only to limited or sporadic human infections. In late 2015, the temporal clustering of a Zika outbreak and microcephaly in newborn babies from northeastern Brazil, and the identification of a causal link between the two, led to the characterization of the congenital Zika syndrome. In the wake of the epidemic, several countries from Latin America advised women to postpone pregnancies for periods ranging from six months to two years. These recommendations initiated critical conversations about the challenges of implementing them in societies with limited access to contraception, widespread socioeconomic inequalities, and high rates of unplanned and adolescent pregnancies. The messaging targeted exclusively women, despite a high prevalence of imbalances in the relationship power, and addressed all women as a group, failing to recognize that the decision to postpone pregnancies will impact different women in different ways, depending on their age at the time. Finally, in several countries affected by the Zika epidemic, due to restrictive reproductive policies, legally terminating a pregnancy is no longer an option even at the earliest time when brain malformations as part of the congenital Zika syndrome can be detected by ultrasonography. The virus continued to circulate after 2016 in several countries. Climate change models predict an expansion of the geographical area where local Zika transmission may occur, indicating that the interface between the virus, teratogenesis, and reproductive rights is a topic of considerable interest for medicine, social sciences, and public health for years to come. Full article

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Open AccessArticle

Monitoring SARS CoV-2 Antibodies Positivity in Healthcare Workers After Inactivated CoronaVac^® Vaccine

by Melek Demir, Ahmet Çalışkan, İlknur Kaleli, Büşra Dönmez, Hatice Er and Çağrı Ergin

GERMS 2022, 12(4), 507-518; https://doi.org/10.18683/germs.2022.1356 - 31 Dec 2022

Cited by 1 | Viewed by 39

Abstract

Introduction: In this study, we aimed to monitor anti-spike and anti-nucleocapsid antibodies positivity in healthcare workers (HCWs) vaccinated with two doses of inactivated CoronaVac^® (Sinovac, China) vaccine. Methods: Overall, 242 volunteer HCWs were included. Of the participants, 193 were HCWs without history [...] Read more.

Introduction: In this study, we aimed to monitor anti-spike and anti-nucleocapsid antibodies positivity in healthcare workers (HCWs) vaccinated with two doses of inactivated CoronaVac^® (Sinovac, China) vaccine. Methods: Overall, 242 volunteer HCWs were included. Of the participants, 193 were HCWs without history of prior documented COVID-19 (Group 1), while 49 had history of prior documented COVID-19 before vaccination (Group 2). The participants were followed up for SARS-CoV-2 antibodies positivity at four different blood sampling time points (immediately before the second vaccine dose and at the 1st, 3rd months and 141-150 days after the second dose). We investigated the serum IgG class antibodies against SARS-CoV-2 RBD region and IgG class antibodies against SARS-CoV-2 nucleocapsid antigen by chemiluminescent microparticle immunoassay (CMIA) method using commercial kits. Results: We found positive serum anti-RBD IgG antibody in 76.4% of the participants (71% in Group 1; 98% in Group 2) 28 days after the first dose. When the antibody levels of the groups were compared at the four blood sampling time points, Group 2 anti-RBD IgG levels were found to be significantly higher than those in Group 1 at all follow-up time points. Although anti-RBD IgG positivity persisted in 95.6% of all participants in the last blood sampling time point, a significant decrease was observed in antibody levels compared to the previous blood sampling time point. Anti-nucleocapsid IgG antibody was positive in 12 (6.2%) of participants in Group 1 and 32 (65.3%) in Group 2 at day 28 after the first dose. At the fourth blood sampling time point, anti-nucleocapsid antibodies were found to be positive in a total of 20 (9.7%) subjects, 10 (6.1%) in Group 1 and 10 (23.8%) in Group 2. Conclusions: In this study, it was determined that serum antibody levels decreased in both groups after the third month after the second dose in HCWs vaccinated with CoronaVac^® vaccine. Full article

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Open AccessArticle

Investigating the Antimicrobial Activity of Essential Oils Against Pathogens Isolated from Sewage Sludge of Southern Lebanese Villages

by Malak Mezher, Rana El Hajj and Mahmoud Khalil

GERMS 2022, 12(4), 488-506; https://doi.org/10.18683/germs.2022.1355 - 31 Dec 2022

Cited by 12 | Viewed by 48

Abstract

Introduction: Due to the high load of pathogens in sewage, seeking for effective treatments became a priority. In this regard, testing the sensitivity of microorganisms isolated from sewage against essential oils (EOs) is suggested. In Lebanon, little evidence supports bacteria isolated from sewage [...] Read more.

Introduction: Due to the high load of pathogens in sewage, seeking for effective treatments became a priority. In this regard, testing the sensitivity of microorganisms isolated from sewage against essential oils (EOs) is suggested. In Lebanon, little evidence supports bacteria isolated from sewage reveals a sensitivity to EOs. Due to this fact, the present investigation aims at determining the sensitivity of microbes isolated from sewage sludge to three EOs: lettuce, coconut, and almond. Methods: Bacterial isolates were identified by VITEK screening. Yeast was identified by germ tube assay. The chemical components of the oils were identified by gas chromatography – mass spectrometry (GC-MS). Susceptibility of the microbial isolates was assessed by the agar well diffusion assay. Bacteriostatic and bactericidal effects of EOs were detected by minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) broth microdilution assay. The activity of EOs on biofilms was detected by antibiofilm screening. Results: The identified microorganisms include Gram-negative isolates (Escherichia coli, Citrobacter freundii, Citrobacter braakii, Leclercia adecarboxylata, and Stenotrophomonas maltophilia), Gram-positive isolates (Enterococcus faecium, Streptococcus intermedius, Staphylococcus aureus, Staphylococcus capitis, and Staphylococcus haemolyticus), and Candida albicans. Thirty oils’ chemical components were identified. Among the antibiotics, doxycycline exhibited the best inhibitory effect. The three EOs were effective against bacterial isolates and yeast at concentrations ranging between 3.125% and 50%. They exhibited a bacteriostatic activity. Lettuce and coconut oils were effective against biofilm formation and the three oils were effective on pre-formed biofilms. Conclusions: The results reflected the significant antimicrobial and antibiofilm activities of the oils, thus suggesting their potential antimicrobial applications. Full article

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Open AccessArticle

Evaluation of Hematological Parameters in Patients with Leprosy in Southern Nigeria

by Inyeneobong Ernest Inyang, Iya Eze Bassey and Henshaw Uchechi Okoroiwu

GERMS 2022, 12(4), 478-487; https://doi.org/10.18683/germs.2022.1354 (registering DOI) - 31 Dec 2022

Cited by 2 | Viewed by 38

Abstract

Introduction: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae that mostly result in immunological reactions that affect the skin, peripheral nervous system and mucosa of the upper respiratory tract. This study aimed to evaluate hematological parameters among subjects with leprosy [...] Read more.

Introduction: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae that mostly result in immunological reactions that affect the skin, peripheral nervous system and mucosa of the upper respiratory tract. This study aimed to evaluate hematological parameters among subjects with leprosy and deduce biomarkers for onset of leprosy reaction. Methods: This was a cross-sectional study performed from 1 September 2018 to 1 August 2019. Sixty patients with leprosy (30 on multidrug therapy (MDT) and 30 that had completed MDT) and 30 apparently healthy controls were enrolled. Hematology auto-analyzer (Sysmex KX-21N by Sysmex Corporation Kobe, Japan) was used in sample analysis. ANOVA and Kruskal Wallis were used for mean comparison. Eta squared was used to assess effect size. Sensitivity and specificity were assessed using receiver operator characteristic (ROC) curve. Association was checked using bivariate logistics regression. Results: The majority (68.3%) of the patients with leprosy were males and a larger proportion were either farmers or unemployed. The prevalence of leprosy reaction in the studied population was 40%. The following parameters were significantly (p < 0.05) reduced: red cell count, hemoglobin and hematocrit in patients with leprosy compared to controls. Total white cell count, absolute lymphocyte, neutrophil, monocyte and eosinophil counts were significantly elevated in patients with leprosy compared to controls. The hemoglobin and mean corpuscular volume of patients with leprosy on treatment were significantly higher compared to those who had completed treatment, while the mean corpuscular hemoglobin concentration was significantly reduced. Overall, 65% of patients with leprosy were anemic. Eosinophil count showed good biomarker potential for leprosy reaction onset with AUC 0.709. Sex and absolute eosinophil count were associated with leprosy reaction (OR = 11.194; 95%CI: 1.775–70.586). Conclusions: This study has shown a high frequency of anemia in patients with leprosy, both those on treatment and those that had completed MDT, necessitating incorporation of post treatment plan in the management of leprosy. This study has reported absolute eosinophil as potential biomarker of leprosy reaction. Full article

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Open AccessArticle

Risk Factors Associated with Rabies Incidence in Rabies Endemic Areas in West Kalimantan

by Malik Saepudin, Resky Nanda Pranaka, Huibert Hendrian Umboh and Slamet Wardoyo

GERMS 2022, 12(4), 472-477; https://doi.org/10.18683/germs.2022.1353 - 31 Dec 2022

Cited by 5 | Viewed by 64

Abstract

Introduction: Rabies remains a significant health problem in many parts of the world. The World Health Organization (WHO) states that rabies is a disease neglected in its management and has become a problem, especially in poor areas. It is estimated that 55,000 rabies [...] Read more.

Introduction: Rabies remains a significant health problem in many parts of the world. The World Health Organization (WHO) states that rabies is a disease neglected in its management and has become a problem, especially in poor areas. It is estimated that 55,000 rabies deaths occurred worldwide in 2018. From 2015 to 2019, there were 404,306 cases of rabigenic wounds inflicted by animal bites in Indonesia, with 544 deaths. West Kalimantan Province is one of the areas endemic to rabies and one of the five provinces with the highest number of deaths due to rabies. Methods: This was a case-control study of patients who presented to the health service for potentially-rabigenic wounds inflicted by animal bites and being diagnosed with rabies exposure. The post-mortem examination was carried out to support the diagnosis of exposure to rabies. Cases were defined as those who had experienced dog bites from the health services medical register from 2015 to 2019. Controls were defined as those who lived in the same area as patients from the cases group and were owners of potentially rabigenic animals. The research was performed in Landak and Sanggau Regencies, West Kalimantan. Results: The results showed an association between the following risk factors and the incidence of rabies: animal care (p = 0.033), rabies vaccine (p = 0.006), and behavior (p = 0.011), while other risk factors were knowledge (p = 1.000) and attitude (p = 0.840). Conclusions: The study’s findings inform rabies prevention and eradication, particularly in the province of West Kalimantan, which has experienced issues related to the population power of rabies-transmitting animals, as well as the process of vaccinating rabies-transmitting animals and a lack of public awareness. These factors have a significant impact on the prevalence of rabies, as dogs in the province of West Kalimantan have rabies. Full article

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Open AccessArticle

Distribution of Chlorhexidine Resistance Genes Among Staphylococcus aureus Clinical Isolates: The Challenge of Antiseptic Resistance

by Amira M. Sultan and Mohammad A. Ahmed

GERMS 2022, 12(4), 461-471; https://doi.org/10.18683/germs.2022.1352 - 31 Dec 2022

Cited by 4 | Viewed by 51

Abstract

Introduction: Chlorhexidine is an antiseptic agent which is extensively used to prevent nosocomial infections; however, this could result in reduction of its susceptibility. The aim of this work was to determine chlorhexidine susceptibility among Staphylococcus aureus isolates and to detect qacA/B and smr [...] Read more.

Introduction: Chlorhexidine is an antiseptic agent which is extensively used to prevent nosocomial infections; however, this could result in reduction of its susceptibility. The aim of this work was to determine chlorhexidine susceptibility among Staphylococcus aureus isolates and to detect qacA/B and smr antiseptic resistance genes among these isolates. Furthermore, we aimed to identify possible risk factors for the reduction of chlorhexidine susceptibility among S. aureus isolates. Methods: Various clinical samples were collected from patients with evidence of S. aureus infection. Antimicrobial susceptibilities of identified S. aureus isolates were determined by disk diffusion method. Resistance to methicillin was identified by cefoxitin disk diffusion test besides mecA gene detection by PCR. Chlorhexidine minimum inhibitory concentration (MIC) values were measured by broth microdilution method while qacA/B and smr resistance genes were detected by multiplex PCR. Results: A total percentage of 25.9% of S. aureus isolates showed reduced susceptibility to chlorhexidine. Methicillin resistant S. aureus (MRSA) had a reported percentage of 39.5%, which was significantly higher than the 11.3% reported for methicillin susceptible S. aureus (MSSA), p < 0.001. S. aureus isolates were found to harbor qacA/B and smr genes at 23.2% and 7.7% respectively. Risk factors for reduced susceptibility to chlorhexidine included; ICU setting (OR = 2.02, 95%CI: 0.3–1.6), prolonged ICU stay (OR = 1.7, 95%CI: 0.4–1.1), presence of central vascular catheter (OR = 2.3, 95%CI: 0.2–1.9), mechanical ventilation (OR = 1.88, 95%CI: 0.4–1.7) and acquisition of qacA/B (OR = 15.7, 95%CI: 3.4–12.1) or smr gene (OR = 15.7, 95%CI: 3.4–12.1). Conclusions: Our work highlighted the current challenge of antiseptic resistance in our locality. The frequencies of qacA/B and smr genes were significantly higher among MRSA than MSSA isolates. About two thirds of chlorhexidine tolerant isolates displayed an MDR profile. To maintain chlorhexidine efficiency, biocidal stewardship program and ongoing surveillance are essential. Full article

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Open AccessArticle

The Mycological Efficacy and Safety of Selenium Sulfide 1.8% Versus Ketoconazole 2% Shampoo in Pityriasis Versicolor: A Double-Blind Randomized Controlled Trial

by Lusiana, Lis Surachmiati, Siti Rizny Fitriana Saldi, Trah Lusianingtyas and Kusmarinah Bramono

GERMS 2022, 12(4), 452-460; https://doi.org/10.18683/germs.2022.1351 - 31 Dec 2022

Cited by 1 | Viewed by 299

Abstract

Introduction: Although it has long been used as a topical treatment of pityriasis versicolor (PV), the efficacy of topical selenium disulfide as compared to topical ketoconazole in the treatment of PV remains unclear. This study aims to assess the mycological efficacy and safety [...] Read more.

Introduction: Although it has long been used as a topical treatment of pityriasis versicolor (PV), the efficacy of topical selenium disulfide as compared to topical ketoconazole in the treatment of PV remains unclear. This study aims to assess the mycological efficacy and safety of SeS₂ 1.8% shampoo and ketoconazole 2% shampoo for the treatment of PV. Methods: A double-blind randomized controlled trial was performed in patients with PV during September–December 2018, based on block randomization. Physical examinations, scale provocation test, Wood’s lamp, and potassium hydroxide examination were conducted. Intention to treat analysis was performed to evaluate the mycological efficacy. Results: The mycological efficacy and side effect were not significantly different between the ketoconazole group and the selenium group; 94% vs. 86% (RR = 2.3(95%CI 0.6–8.5), p = 0.182), and 22% versus 8%. Conclusions: SeS₂ 1.8% has the same mycological efficacy and side effect as compared to ketoconazole 2% in the treatment of PV. Full article

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Open AccessArticle

Distribution of Bacterial, Viral and Parasitic Gastroenteritis Agents in Children Under 18 Years of Age in Erzurum, Turkey, 2010–2020

by Bahar Çimen and Osman Aktaş

GERMS 2022, 12(4), 444-451; https://doi.org/10.18683/germs.2022.1350 - 31 Dec 2022

Cited by 8 | Viewed by 41

Abstract

Introduction: Diarrheal diseases have existed since antiquity, resulting in high morbidity and mortality rates, particularly among children in developing countries. To eradicate these diseases, it is crucial to identify the pathogens that cause them and immediately initiate appropriate treatment. This retrospective study aims [...] Read more.

Introduction: Diarrheal diseases have existed since antiquity, resulting in high morbidity and mortality rates, particularly among children in developing countries. To eradicate these diseases, it is crucial to identify the pathogens that cause them and immediately initiate appropriate treatment. This retrospective study aims to investigate the incidence of childhood gastroenteritis and the epidemiological features of its causative agents. Methods: During an 11-year period (2010–2020), as many as 51159 stool samples were obtained from children aged 0–17 years. These samples were examined for the presence of parasitic, bacterial, and/or viral gastroenteritis agents and evaluated retrospectively. The records obtained from the "ENLIL Hospital Information Management System Modules" were used to collect patient-related information. Results: The most frequently observed pathogens were rotavirus (22.4%), adenovirus (2.2), Giardia lamblia (1.6%), and Campylobacter spp. (3.0%), considering the number of samples examined for each organism. The total incidence of viruses was about 25%, parasites 5% and the rate of pathogenic bacteria was 2%. In one-way ANOVA analysis, pathogen positivity was found to be significantly higher in children aged 3-5 years compared to those aged 15–17 and 0–2 [F (5, 51,153, 17,588, p < 0.001)]. The highest demand for the investigation of GE factors from stool samples was made in August, September and July. According to the number of samples examined, the highest pathogen positivity was in February, October, May, December and March, respectively. The most common pathogens involved in coinfections, occurring in 0.04% of the studied cases, were rotavirus and Giardia lamblia. Conclusions: Parasitic, viral, and bacterial gastroenteritis maintain their current status with a high prevalence in children under 18 years of age, especially in children aged 0–4 years in Erzurum, Turkey. Full article

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Open AccessArticle

Prevalence of Multidrug-Resistant Gram-Negative Bacteria From Blood Cultures and Rapid Detection of Beta-Lactamase-Encoding Genes by Multiplex PCR Assay

by Sanja Zornic, Bojana Lukovic, Ivana Petrovic and Aleksandra Jencic

GERMS 2022, 12(4), 434-443; https://doi.org/10.18683/germs.2022.1349 - 31 Dec 2022

Cited by 1 | Viewed by 34

Abstract

Introduction: This study aimed to determine the prevalence of multidrug-resistant Gram-negative bacteria (GNB) from blood cultures in a tertiary-care hospital and the multiplex PCR assay’s ability to detect resistance genes. Methods: A total of 388 GNB isolates obtained from hospitalized patients between November [...] Read more.

Introduction: This study aimed to determine the prevalence of multidrug-resistant Gram-negative bacteria (GNB) from blood cultures in a tertiary-care hospital and the multiplex PCR assay’s ability to detect resistance genes. Methods: A total of 388 GNB isolates obtained from hospitalized patients between November 2019 and November 2021 were included in the study. Antimicrobial susceptibility testing was done by VITEK 2 system and broth microdilution method. Beta-lactamase-encoding genes were detected by multiplex PCR assays, BioFire-Blood Culture Identification 2 (BCID2) panel (bioMérieux, France). Extended-spectrum beta-lactamases (ESBLs) were detected phenotypically with VITEK AST-GN71 card (bioMérieux, France). The isolates of GNB were classified into multidrug-resistant, extensively-drug-resistant, and pandrug-resistant categories, and their prevalence and distribution in different wards, including coronavirus diseases 2019 (COVID-19) intensive care units (ICU), were calculated. Results: Results revealed that all isolates of Acinetobacter baumannii and Pseudomonas aeruginosa were multidrug-resistant as well as 91.6% of Enterobacter cloacae, 80.6% of Proteus mirabilis, and 76.1% of Klebsiella pneumoniae, respectively. In fermentative bacteria, bla_OXA-48-like (58.1%), bla_NDM (16.1%), bla_KPC (9.7%) and bla_VIM (6.5%) genes were detected. More than half of Enterobacter cloacae (58.3%) and Klebsiella pneumoniae (53.7%) produced ESBLs. Among non-fermenters, the bla_NDM gene was carried by 55% of Pseudomonas aeruginosa and 19.5% of Acinetobacter baumannii. In the COVID-19 ICU, Acinetobacter baumannii was the most common isolate (86.1%). Conclusions: This study revealed high proportions of multidrug-resistant blood isolates and various underlying resistance genes in Gram-negative strains. The BCID2 panel seems to be helpful for the detection of the most prevalent resistance genes of fermentative bacteria. Full article

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Open AccessPerspective

Peri-Implantitis, Biofilm Contamination and Peri-Implant Bone Loss

by Mihai Săndulescu

GERMS 2022, 12(4), 432-433; https://doi.org/10.18683/germs.2022.1348 - 31 Dec 2022

Cited by 2 | Viewed by 26

Abstract

Dental implants have been successfully used to treat all types of edentulism for many decades [...] Full article

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GERMS, Volume 12, Issue 4 (12 2022) – 13 articles , Pages 432-560

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