GERMS

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Open AccessCase Report

Spondylodiscitis and Bacteremia Due to Staphylococcus hyicus in an Immunocompetent Man

by Maud Foissac, Maria Lekaditi, Bouchra Loutfi, Agnès Ehrhart and Frédéric-Antoine Dauchy

GERMS 2016, 6(3), 106-110; https://doi.org/10.11599/germs.2016.1097 - 1 Sep 2016

Cited by 7

Introduction: Staphylococcus hyicus is a coagulase-variable Staphylococcusspp. well-known by veterinarians since it is the major agent of a severe cutaneous infection in piglets called exudative epidermitis. In other species the symptoms of infection are quite different. Human cases are uncommon but seem to occur more frequently after repeated contacts with farm animals. Case report: We report the case of a 58-year-old man suffering from debilitating subacute lumbar pain, in whom diagnosis of infectious spondylodiscitis was based on spine MRI and positive microbiological results. A strain of S. hyicus was surprisingly isolated from blood cultures and bone biopsy. Identification was confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS, Bruker, USA), and the patient was successfully cured with a six-week course of anti-staphylococcal antibiotic regimen. Conclusion: The prevalence of S. hyicus in human clinical samples is very low, but may be underestimated. This pathogen may enter the bloodstream through a skin injury, and then induce various pyogenic manifestations in people working with farm animals. S. hyicus exfoliative toxins, responsible for dermatological lesions in piglets, seem unable to damage the human epidermis, explaining the absence of cutaneous blisters in the previously reported cases. Precise data about its pathogenicity in humans and the adequate therapy are lacking. Full article

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Open AccessArticle

Rotavirus Gastroenteritis in Children Less than Five Years of Age in Primary Care Settings in Bulgaria: An Observational Study

by Mayda Tiholova, Kusuma Gopala, Magda Berberova, Margarita Strokova-Stoilova and Monica Tafalla

GERMS 2016, 6(3), 97-105; https://doi.org/10.11599/germs.2016.1095 - 1 Sep 2016

Cited by 3

Abstract

Background: Rotavirus (RV) causes a high proportion of acute gastroenteritis (AGE) cases, especially among children under the age of five years old. This surveillance study was undertaken to study the incidence and severity of rotavirus gastroenteritis (RVGE) in primary care settings in Bulgaria over a one-year period. Methods: In this prospective, observational study of AGE cases in children under five years of age presenting in the primary care setting over a one year period, stool samples were collected and tested for RV using a rapid visual immunochromatographic test kit. After the first visit, parents monitored their child for about two weeks and reported the symptoms experienced by the child during the follow-up period to the physician in a follow-up phone call. The percentage of RVGE cases among AGE was calculated and the severity of AGE (according to the 20-point Vesikari scale) was assessed by the physician based on the symptoms reported by the parents. The seasonality of RVGE was also studied. Results: The proportion of RVGE among the 624 AGE cases examined was 25.5%. Severe AGE was experienced by 81.8% RV-positive and 54.6% RV-negative children (p-value < 0.001) and a third of all severe AGE cases occurred in RV-positive patients. A multivariate logistic regression analysis of the determinants of hospitalization indicated that severity of disease and RV-positivity were the statistically significant variables explaining hospitalization of AGE cases; even controlling for severity, RV-positive patients were more often hospitalized than RV-negative ones. RVGE cases occurred throughout the year, with peaks during August and September. Conclusion: Our study emphasizes that RV is an important cause of AGE in children under five presenting in primary care settings in Bulgaria and a disproportionately high proportion of severe AGE cases may be attributed to RV infections. Trial registration number: NCT01733849 Full article

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Open AccessArticle

Prevalence, Virulence and Antimicrobial Resistance Patterns of Aeromonas spp. Isolated from Children with Diarrhea

by Mohammad Mehdi Soltan Dallal, Ramin Mazaheri Nezhad Fard, Morteza Kavan Talkhabi, Leyla Aghaiyan and Zohre Salehipour

GERMS 2016, 6(3), 91-96; https://doi.org/10.11599/germs.2016.1094 - 1 Sep 2016

Cited by 36

Abstract

Background: Aeromonas spp. cause various intestinal and extraintestinal diseases. These bacteria are usually isolated from fecal samples, especially in children under five years old. The aim of this study was to assess the prevalence of Aeromonas spp. and their antimicrobial resistance profile in children with diarrhea referred to the Children Medical Center in Tehran, between 2013 and 2014. Methods: A total number of 391 stool samples were collected from children with ages between 1 day and 14 years old, with diarrhea (acute or chronic), referred to the Children Hospital, Tehran, Iran, between 2013 and 2014. Samples were enriched in alkaline peptone water broth for 24 hours at 37 °C and then cultured. Suspicious colonies were analyzed through biochemical tests. Furthermore, antimicrobial susceptibility tests were carried out for the isolates. Isolates were further studied for act, ast, alt, aerA and hlyA virulence genes using polymerase chain reaction. Results: In total, 12 isolates (3.1%) were identified as Aeromonas spp.; all were confirmed using the API-20E test. Of these isolates, five A. caviae (42%), four A. veronii (33%) and three A. hydrophila (25%) were identified in cases with gastroenteritis. Second to ampicillin (which was included in the growth medium used), the highest rate of antimicrobial resistance was seen against nalidixic acid and trimethoprim-sulfamethoxazole (5 isolates each, 41.6%) and the lowest rate of antimicrobial resistance was seen against gentamicin, amikacin and cefepime (none of the isolates). Results included 76.4% act, 64.7% ast, 71.5% alt, 83.3% aerA and 11.7% hlyA genes. Conclusion: Aeromonas spp. are important due to their role in diarrhea in children; therefore, isolation and identification of these fecal pathogens should seriously be considered in medical laboratories. Since virulence genes play a significant role in gastroenteritis symptoms caused by these bacteria, Aeromonas species that include virulence genes are potentially suspected to cause severe infections. Moreover, bacterial antimicrobial resistance is increasing, especially against trimethoprim-sulfamethoxazole and nalidixic acid. Full article

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Open AccessArticle

Syphilis on the Rise: A Prolonged Syphilis Outbreak Among HIV-Infected Patients in Northern Greece

by Olga Tsachouridou, Lemonia Skoura, Eirini Christaki, Panagiotis Kollaras, Eleni Sidiropoulou, Pantelis Zebekakis, Efstratios Vakirlis, Apostolia Margariti and Symeon Metallidis

GERMS 2016, 6(3), 83-90; https://doi.org/10.11599/germs.2016.1093 - 1 Sep 2016

Cited by 10

Abstract

Introduction: Sexually transmitted diseases (STDs) are a major public health issue in Europe. Numerous outbreaks of syphilis have been described recently and an increased prevalence of high-risk sexual practices has raised concern about the transmission of HIV and other STDs. Similarly, an increase in sexually transmitted infections has been recorded in Northern Greece. Methods: This report describes a recent outbreak of syphilis in people living with HIV. The demographic, clinical, and serologic data of HIV patients diagnosed with syphilis were recorded and analyzed. Data on syphilis incidence from the general population was also compared to HIV patients’ data. Results: Fifty-eight HIV-patients of the Infectious Diseases Unit of a tertiary hospital (5.2%) were diagnosed with syphilis during a three-year period (2008-2010). Highly active antiretroviral therapy (HAART) and coexistence of other STDs were independent predictors of syphilis (OR: 2.4, 95CI%: 1.26, 4.63, p = 0.008; OR: 9.4, 95%CI: 4.49, 19.64, p < 0.001, respectively). Origin from a country other than Greece (p = 0.005), and homosexual contact (p = 0.003), were separate risk factors for syphilis in the general population in the same area. Conclusion: Diagnosis of a sexually transmitted disease in an HIV patient is a crucial clinical event that should trigger the clinician’s suspicion for high-risk sexual behavior. Sexual health assessments should be a routine process for HIV patients. Full article

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Open AccessEditorial

The Transition from Co-Morbidities to Geriatric Syndromes in HIV

by Giovanni Guaraldi

GERMS 2016, 6(3), 79-81; https://doi.org/10.11599/germs.2016.1092 - 1 Sep 2016

Cited by 5

Abstract

Several recent cohort studies have suggested that life expectancy of HIV-infected individuals is currently comparable to that of the general population, particularly when antiretroviral therapy (ART) was initiated at earlier disease stages [...] Full article

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GERMS, Volume 6, Issue 3 (09 2016) – 5 articles , Pages 79-110

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