GERMS

144 KB

Open AccessCommunication

Iraq Faces New Outbreak of Cholera, 2022

by Amal Talib Al Sa’ady

GERMS 2023, 13(1), 90-91; https://doi.org/10.18683/germs.2023.1372 - 31 Mar 2023

Cited by 1

1During the twenty-first century, Iraq faced several outbreaks of cholera, most recently in 2015 and 2017 [...] Full article

259 KB

Open AccessCase Report

Adult Tetanus Is Not Gone Yet, but Could Be Ready to Leave: A Case-Series from Central India

by Mahadev Meena, Vaibhav Yadav, Manish M Yadav, Rajnish Joshi, Prachi Singh, Rajesh Panda and Saurabh Saigal

GERMS 2023, 13(1), 86-89; https://doi.org/10.18683/germs.2023.1371 - 31 Mar 2023

Cited by 2

Abstract

Introduction Adult tetanus is a neurotoxin mediated infectious disease, that continues to be seen despite availability of a highly efficacious vaccine. In India population-based burden estimates for adult tetanus are not available. Elimination of neonatal and maternal tetanus from India was achieved in [...] Read more.

Introduction Adult tetanus is a neurotoxin mediated infectious disease, that continues to be seen despite availability of a highly efficacious vaccine. In India population-based burden estimates for adult tetanus are not available. Elimination of neonatal and maternal tetanus from India was achieved in 2015 with DPT (diphtheria, pertusis, and tetanus) vaccine during childhood and tetanus toxoid (TT) during antenatal care. Vaccine coverage in adults is uneven. While pregnant women receive the vaccine as part of ante-natal care, booster dose coverage in all other non-pregnant women and men is poor. Case report We describe four cases of adult tetanus that presented to our tertiary care hospital in central India. Out of four cases, two were homemakers, one was a farmer, another was a student. Three of them were not aware regarding primary tetanus vaccination and none of the four received any booster dosages of tetanus vaccine. Conclusions These cases highlight complexity of disease management and reinforce the need for adult booster immunization against tetanus. Full article

203 KB

Open AccessCase Report

A Rare Presentation of Infectious Mononucleosis: Cholestatic Hepatitis with Hyperbilirubinemia

by Aldin Jerome, Vatsal Khanna, Elisa Akagi and Ashish Bhargava

GERMS 2023, 13(1), 80-85; https://doi.org/10.18683/germs.2023.1370 - 31 Mar 2023

Cited by 2

Abstract

Introduction Epstein-Barr virus infection with mononucleosis is the most common presentation in young adults. Most infections are self-limited, although in a few cases complications can include serious conditions such as lymphoproliferative disorders or in less severe cases, mild hepatitis. Case report We present [...] Read more.

Introduction Epstein-Barr virus infection with mononucleosis is the most common presentation in young adults. Most infections are self-limited, although in a few cases complications can include serious conditions such as lymphoproliferative disorders or in less severe cases, mild hepatitis. Case report We present an unusual case of a young male with no liver disease, who presented with markedly elevated cholestatic pattern hyperbilirubinemia, as well as hepatitis. The patient responded well to symptomatic treatments, with spontaneous improvement of the hyperbilirubinemia and transaminitis. Conclusions Epstein-Barr virus mononucleosis can frequently present with mild elevation of transaminases, but very rarely can have marked elevation of bilirubin, which may make clinicians doubt that the infection is the sole culprit of the process. Full article

267 KB

Open AccessCase Report

Brevundimonas spp. Infection in Immunocompromised Children: Two Case Reports

by Andreé Altamirano-Beltrán, Christian Chiara-Chilet, José W. López, Maria J. Pons and Julio Maquera-Afaray

GERMS 2023, 13(1), 72-79; https://doi.org/10.18683/germs.2023.1369 - 31 Mar 2023

Cited by 3

Abstract

Introduction Brevundimonas spp. are rare and opportunistic pathogens which may cause infections in patients who are immunocompromised or have underlying disease. Case report Two cases with a microbiological diagnosis of Brevundimonas aurantiaca and Brevundimonas spp. are presented. Both occurred in immunocompromised patients [...] Read more.

Introduction Brevundimonas spp. are rare and opportunistic pathogens which may cause infections in patients who are immunocompromised or have underlying disease. Case report Two cases with a microbiological diagnosis of Brevundimonas aurantiaca and Brevundimonas spp. are presented. Both occurred in immunocompromised patients with post-chemotherapy febrile neutropenia for B-type acute lymphoblastic leukemia and hepatoblastoma. Antibiogram findings showed resistance to quinolones, ceftazidime, and intermediate resistance to cefepime, being susceptible to carbapenems and aminoglycosides. The cases responded favorably to the administration of carbapenem. Conclusions The identification of the species and antimicrobial susceptibility profile favor response to infection, denoting the importance of species identification and the performance of an antibiogram to determine the different susceptibility profiles described in the literature on this emerging pathogen. Full article

415 KB

Open AccessCase Report

Facial Palsy at the Onset of SARS-CoV-2 Infection. A Case Report

by Victoria Bîrluţiu, Rareş Mircea Bîrluţiu, Alin Iulian Feiereisz and Elena Simona Dobriţoiu

GERMS 2023, 13(1), 65-71; https://doi.org/10.18683/germs.2023.1368 - 31 Mar 2023

Cited by 2

Abstract

Introduction SARS-CoV-2 infection has been associated with an increased number of deaths, due to severe respiratory damage, cardiovascular impairment, acute renal failure, and also neurological injury, including stroke, which is most commonly responsible for death. These are elements that determine patients to seek [...] Read more.

Introduction SARS-CoV-2 infection has been associated with an increased number of deaths, due to severe respiratory damage, cardiovascular impairment, acute renal failure, and also neurological injury, including stroke, which is most commonly responsible for death. These are elements that determine patients to seek medical advice. Case report This is a case report of a female Caucasian patient, aged 65 years, with type 2 diabetes mellitus on metformin 1000 mg twice/day, and hypertension, who presented to the emergency department with one day history of left orbital hyperlacrimation and chewing and swallowing difficulty. On physical examination there was a decreased blink reflex, flattened nasolabial fold, and drooping left corner of the mouth, with left conjunctival hyperemia, and a present corneal reflex. Motion limited head CT and MRI revealed no pathological changes suggestive for the appearance of paresis. The patient was transferred to the Department of Infectious Diseases after laboratory confirmation of SARS-CoV-2 infection. Under treatment, improvement of paresis after three days was observed, with minimal asymmetry left five days after admission. A reassessment one month after discharge revealed complete recovery of the paresis, physical asthenia, and headache, in the context of long-COVID syndrome. Conclusions The appearance of paresis may be a consequence of the direct action of the virus on the nervous system, of hypercoagulability, or, later, of an immune mechanism. The case presented is judged as an early, direct action of the virus on the central nervous system, the respiratory symptoms were minimized by the patient at the time of presentation. Full article

210 KB

Open AccessCase Report

Facial Nerve Palsy: An Early Sign of COVID-19

by Michael Somero, Elisa Akagi and Ashish Bhargava

GERMS 2023, 13(1), 60-64; https://doi.org/10.18683/germs.2023.1367 - 31 Mar 2023

Cited by 3

Abstract

Introduction Bell’s palsy is a peripheral lower motor neuron (LMN) facial nerve palsy, characterized by the acute onset (72 hours or less) of unilateral peripheral facial paresis without other neurologic signs. Bell’s palsy has been described at three clinical junctures of COVID-19 infection: [...] Read more.

Introduction Bell’s palsy is a peripheral lower motor neuron (LMN) facial nerve palsy, characterized by the acute onset (72 hours or less) of unilateral peripheral facial paresis without other neurologic signs. Bell’s palsy has been described at three clinical junctures of COVID-19 infection: as the unique initial signal of COVID-19, as an accompanying feature during the acute phase of COVID-19 when respiratory and systemic symptoms predominate, or during the recuperative phase beginning 2-3 weeks after resolution of respiratory and systemic covid symptoms. Case report We present a unique case of a COVID-19-related facial nerve palsy that occurred 3 weeks prior to the onset of pneumonia caused by COVID-19. Conclusions This case report suggests an association between early COVID-19 presenting as facial nerve palsy and alerts physicians about the ways in which COVID-19 may cause this phenomenon. Full article

550 KB

Open AccessArticle

Enterobacteriaceae Isolates from Clinical and Household Tap Water Samples: Antibiotic Resistance, Screening for Extended-Spectrum, Metallo- and AmpC-Beta-Lactamases, and Detection of Bla_TEM, Bla_SHV and Bla_CTX-M in Uyo, Nigeria

by Olajide J. Akinjogunla, Adebowale T. Odeyemi, Edinam-Abasi S. Udofia, Oyetayo O. Adefiranye, Clarence S. Yah, Igbagbo Ehinmore and Idongesit U. Etukudo

GERMS 2023, 13(1), 50-59; https://doi.org/10.18683/germs.2023.1366 - 31 Mar 2023

Cited by 5

Abstract

Introduction Infections caused by multidrug-resistant (MDR) bacteria, extended spectrum β-lactamase (ESBL), metallo-β-lactamase (MBL) and AmpC-β-lactamase (AmpC-βL)-producers are increasing globally. This study identified bacteria in clinical and tap water samples and determined the prevalence of MDR, and β-lactamase enzymes and genes. Methods Isolates were [...] Read more.

Introduction Infections caused by multidrug-resistant (MDR) bacteria, extended spectrum β-lactamase (ESBL), metallo-β-lactamase (MBL) and AmpC-β-lactamase (AmpC-βL)-producers are increasing globally. This study identified bacteria in clinical and tap water samples and determined the prevalence of MDR, and β-lactamase enzymes and genes. Methods Isolates were identified by the Vitek 2 (bioMérieux, France) automated system. Antibiotic resistance and screening for β-lactamase enzymes and genes was done using disc diffusion method and Vitek 2 automated system, CHROMagar-ESBL, combined double disc, inhibition-based method and multiplex polymerase chain reaction, respectively. Results The Enterobacteriaceae isolates obtained were Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Salmonella spp., Proteus mirabilis, Enterobacter aerogenes, Shigella sonnei, Proteus vulgaris, Enterobacter sakazakii, Klebsiella oxytoca, Citrobacter diversus, and Serratia liquefaciens. Of the 674 isolates from clinical samples, 36.5%, 28.5%, and 19.9% were ESBL, MBL, and AmpC-βL producers, respectively. A low prevalence of AmpC-βL and MBL producers were obtained, with no significant difference (p < 0.05) between the prevalence of ESBL and non-ESBL producers. Isolates exhibited varied levels of resistance to gentamicin, amoxicillin-clavulanic acid, ciprofloxacin, and tetracycline. The results showed that 54.6% of ESBL producers, 57.9% of MBL producers, and 62.8% of AmpC-βL producers were MDR strains. Of the 141 representative isolates tested, 36.9%, 15.6%, and 20.6% had only bla_TEM, bla_SHV, and bla_CTX-M, respectively; 5.7% possessed both bla_TEM and bla_SHV; 7.1% possessed both bla_TEM and bla_CTX-M and 4.3% had both bla_SHV and bla_CTX-M. Conclusions This study found a high prevalence of β-lactamase producers, indicating the need for further research on the molecular epidemiology of β-lactamase producers and their impacts in the region. Full article

392 KB

Open AccessArticle

Adverse Events Following Immunization (AEFI): COVID-19 Vaccine Dose and Characteristics in Central Java, Indonesia

by Firdaus Wahyudi, Arwinda Nugraheni, Ani Margawati, Dodik Pramono, Dea Amarilisa Adespin, Teddy Wahyu Nugroho and Cipta Pramana

GERMS 2023, 13(1), 40-49; https://doi.org/10.18683/germs.2023.1365 - 31 Mar 2023

Abstract

Introduction Vaccination is an effort to control the COVID-19 pandemic. Although vaccines can be effective prevention, they can have potential side effects, or adverse events following immunization (AEFI). CoronaVac, BBIBP-CorV, BNTb262-BioNTech, mRNA-1273, and ChAdOx1NCoV-19 were vaccines used in Indonesia when this study was [...] Read more.

Introduction Vaccination is an effort to control the COVID-19 pandemic. Although vaccines can be effective prevention, they can have potential side effects, or adverse events following immunization (AEFI). CoronaVac, BBIBP-CorV, BNTb262-BioNTech, mRNA-1273, and ChAdOx1NCoV-19 were vaccines used in Indonesia when this study was conducted. This study aimed to analyze the factors associated with AEFI for the COVID-19 vaccines for each dose in the community. Methods This study used a cross-sectional design. The study was conducted in Central Java Province, Indonesia from August to October 2021. The variables included respondent characteristics, COVID-19 infection history, COVID-19 vaccine AEFI, dose, and type. Data collection was performed through questionnaires and data was analyzed by a logistic regression test. Results The percentage of AEFI was 21.1% after the first dose, 14.1% after the second dose, and 83.9% after the third dose of the vaccine. The factors associated with higher odds of COVID-19 vaccine AEFI were different for each dose, as follows: for the first dose: age group >45 years (p = 0.009; OR = 2.837; 95%CI: 1.301-6.187) and overweight (p = 0.007; OR = 3.323; 95%CI: 1.242-8.689); for the second dose: overweight (p = 0.007; OR=9.118; 95%CI: 1.827-45.5), female sex (p=0.011; OR=2.885; 95%CI: 1.274-6.531), age group >45 years (p=0.017; OR=3.257; 95%CI: 1.24-8.555) and prior episode of COVID-19 (p = 0.044; OR = 2.459; 95%CI: 1.026-5.893); and for the third dose: female sex (p = 0.040; OR = 3.650; 95%CI: 1.062-12.550). Conclusions The factors that were associated with AEFI of COVID-19 vaccine were sex, age, nutritional status and prior history of COVID-19. Full article

244 KB

Open AccessArticle

Assessment of Adherence to Guidelines for Testing and Treatment of Pharyngitis Among Children in Palestine: A Retrospective Review Study

by Shahenaz Najjar, Haya O Sultan, Hiba H Falana, Razan O Ata, Maryam A Manasrah, Mutaz Dreidi, Abdallah D. Abukhalil and Hani Naseef

GERMS 2023, 13(1), 32-39; https://doi.org/10.18683/germs.2023.1364 - 31 Mar 2023

Cited by 2

Abstract

Introduction One of the most common reasons for pediatric outpatient visits is acute pharyngitis, an upper respiratory tract infection. Bacterial pharyngitis is caused by Group A beta-hemolytic Streptococcus (GABHS), also known as Streptococcus pyogenes. This research aimed to assess physicians’ adherence to [...] Read more.

Introduction One of the most common reasons for pediatric outpatient visits is acute pharyngitis, an upper respiratory tract infection. Bacterial pharyngitis is caused by Group A beta-hemolytic Streptococcus (GABHS), also known as Streptococcus pyogenes. This research aimed to assess physicians’ adherence to clinical guidelines for diagnosis, management, and selecting appropriate treatment for children suspected of bacterial pharyngitis. Methods A retrospective, observational study was conducted by reviewing patient charts for childred aged 3 to 13 years old diagnosed with pharyngitis from June 2019 until December 2019 at the Emergency Department of Palestine Medical Complex (PMC). The Modified Centor score, throat swab collections, and assessment of antimicrobial selection were used to assess the extent of physicians’ adherence to clinical guidelines for appropriate diagnosis and management of pharyngitis. SPSS was used for data analysis. Results Out of 290 cases diagnosed with acute pharyngitis, 217 patients (74.8%) had a Modified Centor score of ≥2; 126 received antibiotics, and eight had their throat swabbed to confirm the diagnosis; furthermore, 73 patients (25.2%) had a Modified Centor score of 2, older children, and those presenting with fever. Conclusions Most cases were not appropriately tested to confirm the diagnosis of bacterial pharyngitis and were mostly treated with inappropriate antimicrobial agents such as azithromycin. Nonadherence to clinical guidelines is very evident in this study. Full article

880 KB

Open AccessArticle

Coronin-1A Serves as a Serum Biomarker for Supportive Diagnosis of Mycobacterium tuberculosis Infection

by Supaporn Khamchun and Orathai Pongtussanahem

GERMS 2023, 13(1), 20-31; https://doi.org/10.18683/germs.2023.1363 - 31 Mar 2023

Cited by 3

Abstract

Introduction The severity and spread of tuberculosis, a major burden, can be prevented by more rapid and accurate laboratory diagnosis. The purpose of this study is to systematically explore candidate serum proteins in patients with Mycobacterium tuberculosis infection for further application as novel [...] Read more.

Introduction The severity and spread of tuberculosis, a major burden, can be prevented by more rapid and accurate laboratory diagnosis. The purpose of this study is to systematically explore candidate serum proteins in patients with Mycobacterium tuberculosis infection for further application as novel biomarkers. Methods Our study was performed in two major steps: screening of the literature for potential biomarkers, and then validation of their levels in patients and controls. Many serum/plasma proteins previously reported to be abnormally expressed in patients with tuberculosis between 2012 and 2021 were comprehensively assembled. The biological role in tuberculosis was also predicted for each using the bioinformatics tool STRING. Candidate proteins found to have the same expression in other related diseases were excluded. Subsequently, the serum level of the candidate serum/plasma protein that met the aforementioned criteria was validated by sandwich ELISA; diagnostic performance was analysed by the area under the curve (AUC) of the receiver operating characteristic (ROC). Results From 103 collected serum/plasma proteins, coronin-1A was found to have abnormal expression only in patients with tuberculosis and was associated with tuberculosis. In addition, the validation of coronin-1A in the serum of patients with pulmonary tuberculosis revealed a higher level than in that of healthy individuals. Furthermore, the area under the ROC curve for diagnostic power of coronin-1A was 0.866, with high sensitivity and specificity at a cut-point of approximately 52.7 ng/mL. Conclusions We concluded that the level of serum coronin-1A might serve as a novel biomarker for alternative laboratory examination to effectively distinguish patients with tuberculosis from those with other related diseases and healthy individuals. Full article

377 KB

Open AccessArticle

Associated Factors for Bacterial Colonization in Patients Admitted to the Intensive Care Unit of the Clinical Hospital of Infectious Diseases

by Nicoleta-Dorina Vlad, Septimiu Voidăzan, Andreea Căpâlnă, Roxana-Carmen Cernat, Sorina-Dalia Carp, Romelia Mitan, Andrei Dumitru, Sorin Rugină, Codruţa Nemet and Irina Magdalena Dumitru

GERMS 2023, 13(1), 10-19; https://doi.org/10.18683/germs.2023.1362 - 31 Mar 2023

Cited by 1

Abstract

Introduction This study aimed to identify isolates from colonization and assess the risk factors for bacterial colonization and the risk of death in patients admitted to the intensive care unit (ICU) of the Constanţa County Infectious Diseases Hospital between September 2017 and September [...] Read more.

Introduction This study aimed to identify isolates from colonization and assess the risk factors for bacterial colonization and the risk of death in patients admitted to the intensive care unit (ICU) of the Constanţa County Infectious Diseases Hospital between September 2017 and September 2019. Methods This was a retrospective case-control study in a single center that included all patients admitted to the ICU in Constanţa, Romania, who underwent bacteriological screening upon admission and 7 days after admission, between September 2017 and September 2019. In total, 253 patients were included in this study. The nasal exudate, pharyngeal exudate, and rectal swab samples were screened. Results In this study, 253 patients were screened bacteriologically, of which 53 had bacterial colonization and 200 did not. Among the bacterial strains, Klebsiella spp. (43.39%) was the most frequently isolated. The predominant resistance mechanism detected in the bacterial isolates was extended-spectrum β-lactamase (ESBL). Multivariate analysis identified a Carmeli score of 3 as an independent risk factor for acquiring bacterial colonization in the ICU. The mortality rate of patients with bacterial colonization was 11.32% and 6% for the patients without colonization (p > 0.05). Conclusions Our study revealed an increased prevalence of Enterobacterales colonization in the ICU. Risk factors for acquiring bacterial colonization differed depending on the type of bacterial colonization, such as ESBL, carbapenemases, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). An independent risk factor for acquiring bacterial colonization was the Carmeli score of 3. Full article

157 KB

Open AccessPerspective

Oral Biofilms–Pivotal Role in Understanding Microbes and Their Relevance to the Human Host

by Oana Săndulescu and Mihai Săndulescu

GERMS 2023, 13(1), 7-9; https://doi.org/10.18683/germs.2023.1361 - 31 Mar 2023

Cited by 5

Abstract

1In 1675 Antony van Leeuwenhoek used a self-made microscope to provide the first written description of protozoa¹ as “living creatures in rain water which had flood but few days in a new earthen pot” [...] Full article

Journal Menu

Journal Browser

GERMS, Volume 13, Issue 1 (03 2023) – 12 articles , Pages 7-91

Further Information

Guidelines

MDPI Initiatives

Follow MDPI