GERMS

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Open AccessBook Review

Entering an Unseen World and the Discoveries of George Palade

by Ioana D. Olaru and Adriana Hristea

GERMS 2017, 7(1), 45-46; https://doi.org/10.18683/germs.2017.1108 - 1 Mar 2017

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“For a scientist, it is a unique experience to live through a period in which his field of endeavor comes to bloom—to be witness to those rare moments when the dawn of understanding finally descends upon what appeared to be confusion only a [...] Read more.

“For a scientist, it is a unique experience to live through a period in which his field of endeavor comes to bloom—to be witness to those rare moments when the dawn of understanding finally descends upon what appeared to be confusion only a while ago—to listen to the sound of darkness crumbling.” [...] Full article

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Open AccessOpinion

Resistance Testing for the Treatment of Chronic Hepatitis C with Direct Acting Antivirals: When and for How Long?

by Ana Belén Pérez, Natalia Chueca and Federico García

GERMS 2017, 7(1), 40-44; https://doi.org/10.18683/germs.2017.1107 - 1 Mar 2017

Cited by 14 | Viewed by 33

Abstract

The need to test for resistance associated substitutions (RAS) has been intensively debated in the past two years. In the absence of pangenotypic combinations, it seems reasonable that, if available, RAS testing in the NS5A gene at baseline for genotypes 1a and 3 [...] Read more.

The need to test for resistance associated substitutions (RAS) has been intensively debated in the past two years. In the absence of pangenotypic combinations, it seems reasonable that, if available, RAS testing in the NS5A gene at baseline for genotypes 1a and 3 may help to avoid overtreatment in terms of ribavirin usage and/or prolonged treatment duration. When patients fail treatment, RAS testing may also be useful to guide the selection of the new regimen, especially for those that need urgent retreatment and that have failed a combination including an NS5A inhibitor. However, there are new drugs in the pipeline that in combination are pangenotypic, very potent and with a high genetic barrier to resistance. In this new scenario, RAS testing may not play such an important role. Full article

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Open AccessReview

Consensus Statement on the Management of Patients with HCV Infection in Romania

by Consensus Statement on HCV Infection in Romania Working Group

GERMS 2017, 7(1), 32-39; https://doi.org/10.18683/germs.2017.1106 - 1 Mar 2017

Cited by 1 | Viewed by 39

Abstract

Background: HCV direct-acting antivirals (DAAs) have made treatment easier for both patients and healthcare practitioners, but have also brought new challenges in terms of patient management and monitoring prior to, during, and after treatment. Methods: To sum up and unify the clinical experience [...] Read more.

Background: HCV direct-acting antivirals (DAAs) have made treatment easier for both patients and healthcare practitioners, but have also brought new challenges in terms of patient management and monitoring prior to, during, and after treatment. Methods: To sum up and unify the clinical experience of Romanian DAA prescribing physicians, we have organized a Consensus Meeting in November 2016 in Bucharest, Romania. Consensus Statement: The Consensus Meeting has provided expert answers to ten significant questions regarding HCV infection, namely: How do we diagnose patients with HCV infection? How do we stage liver disease in patients with HCV infection? How do we monitor patients with HCV infection prior to treatment? Which patients with HCV infection do we treat? When do we start treatment for HCV infection? What regimens do we use for treating HCV infection? How do we monitor patients with HCV infection during treatment? What adverse events should we expect during treatment of HCV infection and how do we prevent/manage them? How do we monitor patients with HCV infection after treatment? How do we expect the landscape of HCV to change in the following years? Full article

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Open AccessCase Report

Enterococcal Meningitis in Association with Strongyloides Hyperinfection Syndrome

by Kalpesh S Sukhwani, Nitin Bansal, Mamta Soni, Anand Ramamurthy and Ram Gopalakrishnan

GERMS 2017, 7(1), 28-31; https://doi.org/10.18683/germs.2017.1105 - 1 Mar 2017

Cited by 5 | Viewed by 44

Abstract

Introduction: Strongyloidiasis can cause hyperinfection or disseminated infection in an immunocompromised host, and is an important factor linked to enterococcal bacteremia and meningitis. Case reports: We report two cases highlighting the importance of suspecting Strongyloides hyperinfection syndrome in patients with enterococcal meningitis. Conclusion: [...] Read more.

Introduction: Strongyloidiasis can cause hyperinfection or disseminated infection in an immunocompromised host, and is an important factor linked to enterococcal bacteremia and meningitis. Case reports: We report two cases highlighting the importance of suspecting Strongyloides hyperinfection syndrome in patients with enterococcal meningitis. Conclusion: Our cases highlight the importance of suspecting Strongyloides hyperinfection syndrome in cases of community acquired enterococcal bacteremia and meningitis. Full article

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Open AccessArticle

Bibliometric Analysis of Literature on Antifungal Triazole Resistance: 1980–2015

by Waleed M. Sweileh, Ansam F. Sawalha, Samah Al-Jabi and Sa’ed H. Zyoud

GERMS 2017, 7(1), 19-27; https://doi.org/10.18683/germs.2017.1104 - 1 Mar 2017

Cited by 24 | Viewed by 28

Abstract

Background: Triazole antifungal agents play an important role in the treatment of a wide range of fungal infections. Little is known about antifungal triazole drug resistance when compared to antibiotic resistance. Therefore, this study was carried out to give a bibliometric overview of [...] Read more.

Background: Triazole antifungal agents play an important role in the treatment of a wide range of fungal infections. Little is known about antifungal triazole drug resistance when compared to antibiotic resistance. Therefore, this study was carried out to give a bibliometric overview of literature on triazole antifungal drug resistance. Methods: Keywords related to triazole drug class and resistance were used in a search query in the Scopus search engine. The time span was set from 1980 to 2015. Data pertaining to growth of publications, the most active countries and institutions, the most cited articles, and mapping of molecular mechanisms of resistance were analyzed. Results: A total of 1648 journal articles were retrieved with an average of 20.46 citations per article. Annual growth of triazole resistance showed an increasing pattern during the study period. The United States of America (n = 446; 27.06%) ranked first in productivity followed by the United Kingdom (UK) (n = 176; 10.68%), and China (n = 133; 8.07%). Radboud University Nijmegen Medical Centre (n = 69, 4.19%) in the Netherlands ranked first in productivity, while the journal Antimicrobial Agents and Chemotherapy ranked first (n = 255; 15.47%) in publishing articles on triazole resistance. Mapping mechanisms of resistance showed that efflux pump and mutations in target enzyme are major mechanisms described in resistance to triazoles. Conclusion: There was a growth of publications on triazole resistance in the past two decades with the bulk of publications on triazole resistance in Candida species. The data presented here will serve as baseline information for future comparative purposes. Full article

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Open AccessArticle

Public Health Relevance of Non-Tuberculous Mycobacteria Among AFB Positive Sputa

by Prabha Desikan, Karuna Tiwari, Nikita Panwalkar, Saima Khaliq, Manju Chourey, Reeta Varathe, Shaina Beg Mirza, Arun Sharma, Sridhar Anand and Manoj Pandey

GERMS 2017, 7(1), 10-18; https://doi.org/10.18683/germs.2017.1103 - 1 Mar 2017

Cited by 10 | Viewed by 33

Abstract

Background: Sputum smear microscopy for acid fast bacilli (AFB) is used by most public health programmes to detect tuberculosis. While most AFB in countries endemic for tuberculosis are Mycobacterium tuberculosis (MTB), some may also be non-tuberculous mycobacteria (NTM). The inability to differentiate NTM [...] Read more.

Background: Sputum smear microscopy for acid fast bacilli (AFB) is used by most public health programmes to detect tuberculosis. While most AFB in countries endemic for tuberculosis are Mycobacterium tuberculosis (MTB), some may also be non-tuberculous mycobacteria (NTM). The inability to differentiate NTM from MTB by sputum smear microscopy may lead to erroneous diagnoses of tuberculosis, leading in turn to inappropriate therapy. Methods: This was a retrospective study of consecutive sputum samples received from November 2013 to March 2015 in the Department of Microbiology, Bhopal Memorial Hospital & Research Centre, Bhopal, India. Samples underwent smear microscopy, line probe assay (LPA) for MTB complex, culture, biochemical tests and LPA for NTM. Results: Of 4095 sputum samples, 2886 were AFB smear positive (70.5%). Of these, MTB complex was detected in 2611 (90.5%) samples by LPA. Of the remaining 275 samples, 47 grew AFB on culture. Nine strains belonged to the MTB complex. The remaining 38 (1.3%) were NTM, and could be speciated in 26 strains; 14 (53.8%) were M. abscessus; 10 (38.4%) M. intracellulare, one (3.8%) M. kansasii and one (3.8%) M. fortuitum. The remaining 12 NTM could not be speciated. Conclusion: NTM were present in at least 1.3% of all smear positive samples. It is important for public health programs to recognize the avoidable burden on logistics, infrastructure and finances caused by this. Detection and quantification of this burden would help design an appropriate strategy for optimal tuberculosis control. Full article

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Open AccessEditorial

CEPI—A Global Partnership

by Richard B. Roberts

GERMS 2017, 7(1), 8-9; https://doi.org/10.18683/germs.2017.1102 - 1 Mar 2017

Cited by 2 | Viewed by 29

Abstract

1For the last two decades, we have witnessed a substantial number of new infectious-disease outbreaks and epidemics that have taken the lives of many individuals [...] Full article

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GERMS, Volume 7, Issue 1 (03 2017) – 7 articles , Pages 8-46

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