GERMS

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Open AccessCommunication

Extending Mental Health Support to the Survivors of Ebola Virus Disease by Overcoming Challenges

by Saurabh RamBihariLal Shrivastava and Prateek Sudhakar Bobhate

GERMS 2025, 15(1), 83-87; https://doi.org/10.18683/germs.2025.1458 - 31 Mar 2025

Ebola virus disease (EVD) is a rare infectious tropical disease, which is a serious illness among humans, and is often fatal [...] Full article

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Open AccessCase Report

Acute Chlamydia pneumoniae Infection in a Child, Complicated by Retrobulbar Optic Neuritis

by Gheorghiţă Jugulete, Bianca Borcoş and Mădălina Maria Merişescu

GERMS 2025, 15(1), 77-82; https://doi.org/10.18683/germs.2025.1457 - 31 Mar 2025

Abstract

Introduction: This case highlights a rare and significant complication of Chlamydia pneumoniae infection: optic neuritis (ON). Acute Chlamydia pneumoniae infection in children typically presents with respiratory tract symptoms and may occasionally lead to complications or sequelae. ON is a condition most commonly associated [...] Read more.

Introduction: This case highlights a rare and significant complication of Chlamydia pneumoniae infection: optic neuritis (ON). Acute Chlamydia pneumoniae infection in children typically presents with respiratory tract symptoms and may occasionally lead to complications or sequelae. ON is a condition most commonly associated with viral infections or other demyelinating diseases. Case report: The patient, a 10-year-old girl, initially presented with the typical systemic symptoms of Chlamydia pneumoniae infection, including fever, chills, and headache, in addition to an atypical symptom—chromatic deficit, or visual disturbances. This prompted further investigation into potential neurological complications, ultimately leading to a diagnosis of ON. The case underscores the importance of a comprehensive diagnostic workup, including serological testing (IgM ELISA) and PCR analysis of nasopharyngeal specimens, to confirm the underlying infection. Additionally, imaging studies (CT, MRI) and consultations with specialists in neurology and ophthalmology were critical for excluding other potential causes and assessing the extent of complications. The rapid and favorable response to treatment highlights the importance of early diagnosis and appropriate management. Conclusions: Although ON is a rare complication of Chlamydia pneumoniae infection, it should be considered in pediatric patients with unexplained visual symptoms, particularly when the clinical course does not improve or worsens despite treatment for the primary infection. This case further emphasizes the importance of interdisciplinary collaboration in managing complex cases and the need for vigilant monitoring of potential neurological complications in children with respiratory infections. Full article

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Open AccessCase Report

Rare Cutaneous Fungal Infection Due to Nigrograna chromolaenae in a Heart Transplant Recipient

by Maud Foissac, Lucas Balloy, Guillaume Wartel, Anne-Gaёlle Leroy and Marie-Pierre Moiton

GERMS 2025, 15(1), 71-76; https://doi.org/10.18683/germs.2025.1456 - 31 Mar 2025

Abstract

Introduction: Solid organ transplant recipients are particularly prone to infections, and many germs can be involved, including opportunistic pathogens. Regarding catheter-related infections however, the number of causative microorganisms is most often limited to germs of the skin flora, rare enterobacteria and Pseudomonas aeruginosa [...] Read more.

Introduction: Solid organ transplant recipients are particularly prone to infections, and many germs can be involved, including opportunistic pathogens. Regarding catheter-related infections however, the number of causative microorganisms is most often limited to germs of the skin flora, rare enterobacteria and Pseudomonas aeruginosa. Case report: We present here a case of venous catheter-related cutaneous infection in a man with immunosuppression, which was surprisingly caused by a rare environmental fungus, named Nigrograna chromolaenae. The therapeutic strategy combining posaconazole and removal surgery appears to have been effective, with no relapse more than 2 months after surgery. Conclusions: Due to advances in molecular biology techniques, it is possible that infections with Nigrograna spp. will be increasingly described. At the moment the reported cases are few in number, and the treatment is not yet standardized, which is why we thought this new case could support the literature about these opportunistic pathogens. Full article

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Open AccessArticle

Mycoplasma pneumoniae and Chlamydia pneumoniae Community-Acquired Pneumonia in Young Adults from a Family Medicine Practice

by Ana-Maria Slănină, Adorata Elena Coman, Antoneta-Dacia Petroaie, Carmen Liliana Barbacariu, Otilia Novac, Elena Popa, Mihaela Manole, Agnes Iacinta Bacuşcă and Adriana Cosmescu

GERMS 2025, 15(1), 64-70; https://doi.org/10.18683/germs.2025.1455 - 31 Mar 2025

Cited by 1

Abstract

Introduction: A major area of pathology in primary care practice is represented by respiratory infections, from common colds to severe lower respiratory tract illness. Our aim was to evaluate the incidence of Mycoplasma pneumoniae and Chlamydia pneumoniae pneumonia among the patients with suspected [...] Read more.

Introduction: A major area of pathology in primary care practice is represented by respiratory infections, from common colds to severe lower respiratory tract illness. Our aim was to evaluate the incidence of Mycoplasma pneumoniae and Chlamydia pneumoniae pneumonia among the patients with suspected atypical pneumonia from a family medicine urban setting in Iaşi, Romania, to study serological retrospective diagnosis, the therapeutic outcome and the modified immunologic parameters in a subgroup of patients. Methods: We enrolled 93 patients with suspected atypical community-acquired pneumonia (CAP); enzyme-linked immunosorbent assay (ELISA) testing for Mycoplasma pneumoniae and Chlamydia pneumoniae was performed, both immunoglobulins M and G being determined. Considering the systemic inflammation associated to atypical germs infections, in a subgroup of 13 patients, with positive results for Mycoplasma and Chlamydia pneumoniae, interleukin 5, interleukin 8, tumor necrosis factor α and interferon γ levels were determined, using chemiluminescence method (EI-CLA). Results: Positive IgM serology for atypical germs was recorded in 25.8% of patients. Mycoplasma pneumoniae infection was confirmed in 10.8% of patients, Chlamydia pneumoniae infection in 6.5% of patients, and co-infection (both Mycoplasma pneumoniae and Chlamydia pneumoniae) in 8.6% of patients. A number of 41 patients (44.0%) presented chronic cough/bronchial hyperreactivity despite the treatment. Modified values were recorded for all immunological parameters tested, confirming the role in chronic airway inflammation. Conclusions: Mycoplasma and Chlamydia pneumoniae CAP, frequent among young adults, is successfully treated with macrolides, still, the residual symptoms and the modified immunologic parameters need further studies regarding chronic inflammation. Full article

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Open AccessArticle

A Clinical Analysis of the 2024 Pertussis Outbreak Among Pediatric Patients in an Infectious Diseases Hospital in Bucharest, Romania

by Mădălina Maria Merişescu, Gheorghiţă Jugulete, Irina Dijmărescu, Andreea Mihaela Băluţă and Anca Oana Dragomirescu

GERMS 2025, 15(1), 56-63; https://doi.org/10.18683/germs.2025.1454 - 31 Mar 2025

Abstract

Introduction: The objective of this study was to identify and analyze cases of pertussis hospitalized in 2024 that met the clinical criteria, epidemiological context, and laboratory confirmation through polymerase chain reaction (PCR) or serological testing for Bordetella pertussis. This study aimed to assess [...] Read more.

Introduction: The objective of this study was to identify and analyze cases of pertussis hospitalized in 2024 that met the clinical criteria, epidemiological context, and laboratory confirmation through polymerase chain reaction (PCR) or serological testing for Bordetella pertussis. This study aimed to assess the age distribution of cases, vaccination rates, identify severe cases, and associated complications such as apnea, acute respiratory failure, and acute pneumonia. The findings aim to provide valuable data to enhance diagnostic and therapeutic strategies for managing pertussis in the pediatric population. Methods: We conducted a retrospective study from January to November 2024, involving pediatric patients admitted to the Pediatric Departments of the National Institute of Infectious Diseases “Prof. Dr. Matei Balş,” Bucharest, Romania, diagnosed with pertussis. The diagnosis was established based on epidemiological and clinical criteria and confirmed through laboratory tests, including serology or PCR testing. The selection criteria focused on hospitalized patients presenting clinical signs suggestive of pertussis, with laboratory confirmation. Results: Among the hospitalized patients, a significant proportion, 56.9%, were unvaccinated, while 12.5% had incomplete vaccination status. Common comorbidities contributing to increased hospitalization risk included prematurity, malnutrition, and asthma. Co-infections were identified in 32% of cases, with common pathogens such as measles, SARS-CoV-2, rhinovirus, and adenovirus. Respiratory complications were frequent, with apnea occurring in 51% of cases, pneumonia in 60%, and respiratory failure in 13.2%. Despite these complications, no fatalities were reported. Conclusions: This study highlights significant concerns related to low vaccination coverage in the pediatric population, emphasizing the importance of improving vaccination rates to prevent severe pertussis cases. The study also identifies the frequent occurrence of severe complications, including respiratory failure, apnea, and pneumonia, underlining the need for early intervention and effective management. Co-infections with respiratory pathogens further complicate diagnosis and treatment, underscoring the importance of comprehensive clinical evaluation in suspected cases of pertussis. Full article

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Open AccessArticle

by Gheorghe Gindrovel Dumitra, Carmen-Adriana Dogaru, Sandra Adalgiza Alexiu, Dorica Sănduţu, Cosmina Berbecel, Monica Curelea, Cristina Vasilica Barbu, Anca Deleanu, Adrian Grom, Maria Lup, Ioana Budiu, Mădălina Vesa, Florin Proşa, Daniela Ştefănescu, Roxana Surugiu, Ştefana Oana Popescu, Anca Lăcătuş, Mihaela Adela Iancu and Adina Turcu-Stiolica

GERMS 2025, 15(1), 37-55; https://doi.org/10.18683/germs.2025.1453 - 31 Mar 2025

Abstract

Introduction: Human papilloma virus (HPV) vaccination is a key strategy for preventing HPV-related cancers, yet vaccine hesitancy remains a challenge due to persistent myths and misconceptions. This study aimed to identify the most frequently encountered HPV vaccine-related myths in clinical practice from the [...] Read more.

Introduction: Human papilloma virus (HPV) vaccination is a key strategy for preventing HPV-related cancers, yet vaccine hesitancy remains a challenge due to persistent myths and misconceptions. This study aimed to identify the most frequently encountered HPV vaccine-related myths in clinical practice from the perspective of family doctors and to assess differences in their prevalence between urban and rural populations. Methods: A cross-sectional study was conducted among family doctors in Romania who reported common myths encountered when discussing HPV vaccination with parents and women eligible for catch-up vaccination. The analysis focused on identifying the most prevalent perceived myths and assessing differences between urban and rural settings, age groups and genders, using Kruskal-Wallis test, followed by post-hoc Dunn’s tests with Holm correction to account for multiple comparisons, as well as Chi-square tests. Results: The most frequently reported myths overall were “The HPV vaccine is only for girls” (mean score ± SD, 2.91 ± 1.27), “The HPV vaccine has severe and long-term side effects” (mean score ± SD, 2.83 ± 1.27), and “There are too many new vaccines” (mean score ± SD, 2.77 ± 1.3). Rural respondents reported significantly higher belief in concerns related to vaccine safety, effectiveness, increasing number of vaccines, necessity in monogamous individuals, fear of injections, and concerns about promiscuity, particularly in their perception of parents of adolescent girls. Conclusions: Family doctors consider that persistent myths continue to fuel vaccine hesitancy, especially in rural areas. Strengthening family doctors' communication skills through motivational interviewing and evidence-based counseling is essential. Public health efforts should focus on targeted educational interventions and social prescription tools to improve vaccine acceptance and reduce the burden of HPV-related diseases. Full article

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Open AccessArticle

The Presence of Exotoxin Genes and Biofilm Production in Carbapenem-Resistant Pseudomonas aeruginosa Clinical Isolates

by Amany Gamal Thabit, Magda Nasser Sediek and Mona Sallam Embarek Mohamed

GERMS 2025, 15(1), 26-36; https://doi.org/10.18683/germs.2025.1452 - 31 Mar 2025

Cited by 1

Abstract

Introduction: Pseudomonas aeruginosa produces many exotoxins which are essential for the bacterial pathogenesis. The aim of this study was to identify Pseudomonas aeruginosa from clinical specimens, detect the sensitivity pattern, biofilm production, and the frequency of exogenes. Methods: Pseudomonas aeruginosa clinical isolates were [...] Read more.

Introduction: Pseudomonas aeruginosa produces many exotoxins which are essential for the bacterial pathogenesis. The aim of this study was to identify Pseudomonas aeruginosa from clinical specimens, detect the sensitivity pattern, biofilm production, and the frequency of exogenes. Methods: Pseudomonas aeruginosa clinical isolates were identified by conventional and genotypic methods. Antibiotic susceptibility patterns and biofilm production were performed. Molecular detection of exotoxin genes exoS, exoT, exoU, and exoY in Pseudomonas aeruginosa isolates was performed by PCR. Results: Seventy-five Pseudomonas aeruginosa were identified in 400 clinical specimens. Sixty-six (88%) isolates were carbapenem-resistant. A total of 25 (33.3%) isolates were extensively drug resistant, 18 (24%) were multidrug resistant, and 11 (14.7%) were pandrug resistant. Sixty-three (84%) isolates were biofilm producers. Biofilm formation was detected in 56 (85%) of carbapenem-resistant isolates. Totally, 70 (93.3%) isolates carried exoS, 68 (90.7%) carried exoY, 65 (86.7%) carried exoT, and 28 (37.3%) carried exoU. Exogenes were highly expressed in carbapenem-resistant isolates. Coexistence of more than one gene was detected in nearly all isolates. Conclusions: Pseudomonas aeruginosa clinical isolates were resistant to many anti-pseudomonal antibiotics. Most of isolates were biofilm-producers. The genes exoT, exoS and exoY were identified in almost all P. aeruginosa strains and are considered an inevitable component of P. aeruginosa virulence. Full article

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Open AccessArticle

Bibliometric Analysis of Highly Pathogenic Avian Influenza Research Globally from 2003 to 2023

by Clement Meseko, Uwem Okon Edet, Okoroiwu Henshaw, Nicodemus Mkpuma, Kayode Abraham Olawuyi and Charles Archibong

GERMS 2025, 15(1), 11-25; https://doi.org/10.18683/germs.2025.1451 - 31 Mar 2025

Abstract

Introduction: Despite decades of research on highly pathogenic avian influenza, especially H5N1, an understanding of the impact of research outputs on policy, the impact of funding and policies, collaboration between authors, and other bibliometric measurable indices is elusive. Methods: H5N1 research data were [...] Read more.

Introduction: Despite decades of research on highly pathogenic avian influenza, especially H5N1, an understanding of the impact of research outputs on policy, the impact of funding and policies, collaboration between authors, and other bibliometric measurable indices is elusive. Methods: H5N1 research data were retrieved from the PubMed database using “H5N1”, “highly pathogenic”, and “influenza” as keywords, and combined with the Boolean operator, “OR”. The evaluated growth pattern of H5N1 research was analysed using Microsoft Excel, while the VOS viewer window version 1.6.15 was utilized in analyzing the keywords, authors’ inputs, and collaborations amongst research institutes/universities involved in H5N1 research. Results: A total of 8411 articles published within 2003 and 2023 were retrieved. The trend of the published articles indicates that 2003 to 2004 had the lowest number of articles, while the highest were observed for 2009 and 2010. Since then, there has been a gradual decline. The most dominant article type was original research article (89.80%), followed by reviews with 7.54%. The most productive countries were Japan, the United States of America, China, and Egypt in Africa. The top 15 authors accounted for 12.40% of the total published data. Keywords analysis revealed the emergence of newer keywords such as H5N8, wild birds, mammals, and Nigeria; however, as expected, influenza virus avian H5N1 subtype was the dominant keyword. Research institutes with backgrounds in agriculture and veterinary medicine dominated the top 15 organizations involved in H5N1 research. Conclusions: Our findings suggest that research aimed at developing therapeutics and vaccines, as well as continuous surveillance in high-risk areas is urgently needed. Furthermore, the findings provide baseline data for all the stakeholders involved in H5N1 research, which could inform future research, funding, and policies. Full article

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GERMS, Volume 15, Issue 1 (03 2025) – 8 articles , Pages 11-87

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