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State-of-the-Art Parasitic and Bacterial Infections in Romania

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A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Public Health Microbiology".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 15419

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Dr. Zsuzsa Kalmár

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Guest Editor

Department of Parasitology and Parasitic Diseases, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 3-5 Calea Mănăştur Street, 400372 Cluj-Napoca, Romania
Interests: parasites infection
Special Issues, Collections and Topics in MDPI journals

Dr. Ioana Adriana Matei

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Co-Guest Editor

Department of Microbiology, Immunology, Epidemiology, Universitatea de Stiinte Agricole si Medicina Veterinara, Calea Mănăștur 3-5, 400372 Cluj-Napoca, Romania
Interests: antimicrobial resistance; natural products with antimicrobial potential; antimicrobial compounds identification and testing
Special Issues, Collections and Topics in MDPI journals

Dr. Lupșe Mihaela

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Co-Guest Editor

Department of Infection Diseases, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
Interests: infectious diseases;bacteria; pathogens
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Parasitic infections, caused by several organisms (protozoa, helminths) transmitted by vectors or involved intermediate hosts and bacterial infections caused by diverse microorganisms, are both associated with animal and human diseases that have a great social, economic and environmental impacts. The findings presented in the studies published within this Special Issue may give an overall picture of the epidemiology, including the exposure to the parasitic and bacterial infections in Romania.

This Special Issue aims to provide new insights into the relationship between parasites, bacteria and host, also focuses on the pathogenicity, epidemiology, infection process and diagnosis of pathogenic microorganisms associated with animal and human diseases in Romania. The scope of this Special Issue is to collect original research and review papers concerning any aspects related to parasitology, microbiology and infection diseases in Romania in the context of veterinary and medical sciences. Studies on the epidemiology of antimicrobial resistance in pathogenic bacteria are also within the scope of this Special Issue. In this Special Issue, original research articles and reviews are welcome. Short reports/communications or case studies with significant originality are welcomed as well. Research areas may include (but not limited to) the following: parasites, bacterial infection, tick–pathogen relationships, host–parasite interactions, antimicrobial resistance in the context of medical, veterinary and biological sciences.

We look forward to receiving your contributions.

Dr. Zsuzsa Kalmár
Dr. Ioana Adriana Matei
Dr. Lupșe Mihaela
Guest Editor

Manuscript Submission Information

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Keywords

parasitic and bacterial infections
host–parasite interactions
bacterial pathogens
antimicrobial resistance

Published Papers (10 papers)

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Research

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12 pages, 305 KiB

Open AccessArticle

Antimicrobial Resistance Profile of Group B Streptococci Colonization in a Sample Population of Pregnant Women from Romania

by Aida Petca, Florica Șandru, Silvius Negoiță, Mihai Cristian Dumitrașcu, Daiana Anne-Marie Dimcea, Tiberiu Nedelcu, Claudia Mehedințu, Marinela Magdalena Filipov and Răzvan-Cosmin Petca

Microorganisms 2024, 12(2), 414; https://doi.org/10.3390/microorganisms12020414 - 19 Feb 2024

Viewed by 845

Abstract

Group B Streptococcus (GBS) represents one of the leading causes of life-threatening invasive disease in pregnant women and neonates. Rates of GBS colonization vary by region, but studies on maternal GBS status are limited in Romania. This study aims to identify the prevalence of colonization with GBS and whether the obstetrical characteristics are statistically associated with the study group’s antimicrobial susceptibility patterns of tested GBS strains. This observational study was conducted between 1 May and 31 December 2021 at The Department of Obstetrics and Gynecology at Elias University Emergency Hospital (EUEH) in Bucharest, Romania. A total of 152 samples were positive for GBS and included in the study according to the inclusion criteria. As a result, the prevalence of colonized patients with GBS was 17.3%. GBS isolated in this population had the highest resistance to erythromycin (n = 38; 25%), followed by clindamycin (n = 36; 23.7%). Regarding the susceptibility patterns of tested strains to penicillin, the 152 susceptible strains had MIC breakpoints less than 0.06 μg/μL. The susceptibility patterns of tested strains to linezolid indicated three resistant strains with low levels of resistance (MICs ranging between 2 and 3 μg/μL). Multidrug resistance (at least three antibiotic classes) was not observed. In conclusion, although GBS naturally displays sensitivity to penicillin, the exact bacterial susceptibility testing should be performed in all cases where second-line therapy is taken into consideration for treatment. We acknowledge the need for future actions to limit multidrug-resistant bacteria. Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

12 pages, 646 KiB

Open AccessArticle

Seroprevalence of Anti-Cytomegalovirus Antibodies in Pregnant Women from South-West Romania

by Cristiana Luiza Radoi, Ovidiu Zlatian, Maria Balasoiu, Tiberiu-Liviu Dragomir, Madalina Ioana Sorop, Iulia Cristina Bagiu, Estera Boeriu, Monica Susan, Bogdan Sorop, Licinia Andrada Oprisoni and Dominic Gabriel Iliescu

Microorganisms 2024, 12(2), 268; https://doi.org/10.3390/microorganisms12020268 - 26 Jan 2024

Viewed by 773

Abstract

Cytomegalovirus (CMV), in addition to other agents, is part of the TORCH complex (Toxoplasma gondii, Rubella virus, Cytomegalovirus, Herpes simplex viruses, and other agents). CMV infection is the most frequent cause of congenital malformations. This study aimed to establish the variation of prevalence of anti-CMV antibodies in pregnant women from the South-West region of Romania, according to demographic factors, such as age and area of residence, in two separate time periods (2013–2016 and 2019–2022). We collected from the hospital records the age, place of residence, and anti-CMV antibody test results using immune electrochemiluminescence and chemiluminescence. This study found that the seroprevalence of anti-CMV IgM antibodies increased slightly from 2013–2016 to 2019–2022, from 1.92% to 2.26%, and for IgG antibodies from 93.68% to 94.96%. In both groups was observed a descending trend of anti-CMV IgM seroprevalence with an increase in age, showing a decrease in seroprevalence from 3.57% to 1.09% in pregnant women from rural areas in the 31–35 years age group, while in urban areas, we observed a decrease in seroprevalence from 11.11% to 3.06% in the <20 years age group. The IgG seroprevalence showed an increase both in rural areas (from 93.97% to 95.52%) and urban areas (from 93.52% to 94.27%). In both groups, seroprevalence was higher in rural areas compared to urban regions. These results show a high rate of immunization against CMV in pregnant women in South-West Romania, which led to a low risk of acquiring the primary infection during pregnancy. However, the increase in the rate of primary CMV infections in pregnancy suggests the need for prioritizing screening programs and improving the existing protocols to enhance maternal and child healthcare. Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

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12 pages, 278 KiB

Open AccessArticle

Prevalence of Toxoplasma gondii IgG Antibodies and Associated Risk Factors in Psychiatric Patients from Western Romania: A Cross-Sectional Study

by Sebastian Grada, Alin Gabriel Mihu, Daniela Adriana Oatis, Monica Susan, Maria Alina Lupu and Tudor Rares Olariu

Microorganisms 2024, 12(1), 172; https://doi.org/10.3390/microorganisms12010172 - 15 Jan 2024

Cited by 1 | Viewed by 977

Abstract

Infection with the coccidian parasite Toxoplasma gondii was associated with an increased risk of several mental disorders. We conducted a case–control study of 464 consecutive psychiatric patients and assessed the prevalence of IgG antibodies against T. gondii and the potential risk factors associated with infection. T. gondii-specific antibodies were determined using a chemiluminescence assay. A questionnaire was utilized to assess the potential correlation between risk factors and Toxoplasma gondii seropositivity. IgG antibodies were found in 325 (70.04%) of the patients. We observed a higher likelihood of positive IgG antibodies against Toxoplasma gondii in older individuals, patients residing in rural areas, and females. We also noted associations between Toxoplasma gondii infection and certain risk factors, like activities that involve contact with soil, low-income levels, and limited educational attainment. Our findings indicate a high prevalence of T. gondii infection among psychiatric patients from Western Romania and provide new information regarding the potential risk factors associated with T. gondii in this population group. This study may serve as a foundation for future research and the development of preventive strategies. Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

16 pages, 1763 KiB

Open AccessArticle

Linkage between Airborne Particulate Matter and Viral Pandemic COVID-19 in Bucharest

by Maria Zoran, Roxana Savastru, Dan Savastru, Marina Tautan and Daniel Tenciu

Microorganisms 2023, 11(10), 2531; https://doi.org/10.3390/microorganisms11102531 - 10 Oct 2023

Cited by 1 | Viewed by 1202

Abstract

The long-distance spreading and transport of airborne particulate matter (PM) of biogenic or chemical compounds, which are thought to be possible carriers of SARS-CoV-2 virions, can have a negative impact on the incidence and severity of COVID-19 viral disease. Considering the total Aerosol Optical Depth at 550 nm (AOD) as an atmospheric aerosol loading variable, inhalable fine PM with a diameter ≤2.5 µm (PM2.5) or coarse PM with a diameter ≤10 µm (PM10) during 26 February 2020–31 March 2022, and COVID-19’s five waves in Romania, the current study investigates the impact of outdoor PM on the COVID-19 pandemic in Bucharest city. Through descriptive statistics analysis applied to average daily time series in situ and satellite data of PM2.5, PM10, and climate parameters, this study found decreased trends of PM2.5 and PM10 concentrations of 24.58% and 18.9%, respectively compared to the pre-pandemic period (2015–2019). Exposure to high levels of PM2.5 and PM10 particles was positively correlated with COVID-19 incidence and mortality. The derived average PM2.5/PM10 ratios during the entire pandemic period are relatively low (<0.44), indicating a dominance of coarse traffic-related particles’ fraction. Significant reductions of the averaged AOD levels over Bucharest were recorded during the first and third waves of COVID-19 pandemic and their associated lockdowns (~28.2% and ~16.4%, respectively) compared to pre-pandemic period (2015–2019) average AOD levels. The findings of this research are important for decision-makers implementing COVID-19 safety controls and health measures during viral infections. Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

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14 pages, 1260 KiB

Open AccessArticle

Antimicrobial Resistance of Actinobacillus pleuropneumoniae, Streptococcus suis, and Pasteurella multocida Isolated from Romanian Swine Farms

by Madalina Iulia Siteavu, Roxana Ionela Drugea, Elena Pitoiu and Emilia Ciobotaru-Pirvu

Microorganisms 2023, 11(10), 2410; https://doi.org/10.3390/microorganisms11102410 - 27 Sep 2023

Cited by 1 | Viewed by 1516

Abstract

Antimicrobial resistance is an important health issue in human and veterinary medicine. The aim of this study was to monitor the antimicrobial resistance of three of the most important bacteria involved in porcine respiratory disease. A total of 465 isolates were tested during the 2017–2022 period for antimicrobial susceptibility for Actinobacillus pleuropneumoniae (n = 137), Streptococcus suis (n = 207), and Pasteurella multocida (n = 121) by disk diffusion method. The results were interpreted by CLSI breakpoints, where available. High rates of susceptibility (from 90 to >99%) were observed for cefquinome, ceftiofur, amoxicillin + clavulanic acid, amoxicillin, penicillin, ampicillin, florfenicol, enrofloxacin, marbofloxacin, and trimethoprim–sulfamethoxazole. A. pleuropneumoniae isolates showed high resistance to streptomycin (77%), gentamycin (45%), tilmicosin (39%) erythromycin (33%), oxytetracycline (19%), and tetracycline (18%). For S. suis, the highest rates of resistance were observed for streptomycin (98%), tetracycline (75%), oxytetracycline (72%), doxycycline (52%), and erythromycin (51%). P. multocida presented a high rate of resistance for streptomycin (63%), tilmicosin (29%), oxytetracycline (13%), and tetracycline (14%). Bacteria isolates maintained high susceptibility against antimicrobial agents usually used against the mainly respiratory tract pathogens of swine. Resistance for streptomycin, tetracycline, oxytetracycline, and tilmicosin was high for all the tested pathogens Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

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14 pages, 1143 KiB

Open AccessArticle

Cystic Echinococcosis in Hospitalized Adult Patients from Western Romania: 2007–2022

by Ana Alexandra Paduraru, Maria Alina Lupu, Laurentiu Sima, Gabriel Veniamin Cozma, Sorin Dan Olariu, Sorin Dan Chiriac, Bogdan Dan Totolici, Catalin Alexandru Pirvu, Fulger Lazar, Alexandru Nesiu, Alin Gabriel Mihu, Alin Adrian Cumpanas, Octavian Marius Cretu and Tudor Rares Olariu

Microorganisms 2023, 11(10), 2388; https://doi.org/10.3390/microorganisms11102388 - 25 Sep 2023

Cited by 1 | Viewed by 1206

Abstract

Cystic echinococcosis (CE) is a neglected parasitic disease caused by the tapeworm Echinococcus granulosus. The aim of this study was to assess the epidemiological features of human cystic echinococcosis in patients from Western Romania. We retrospectively investigated the medical records of patients hospitalized with CE between 1 January 2007 and 1 September 2022. A total of 366 patients (range 18–90 years) were recorded. The number of hospitalized individuals was higher in patients aged 50–59 years (83/366, 22.7%), in females (194/366, 53%), and in residents of rural areas (225/366, 61.5%). The liver was the most common localization of the cysts (302/366, 82.5%). Ninety-eight patients (26.8%) presented complications, including biliary fistula, allergies, and infection of the cyst. Patients with complications had a longer mean hospital stay (15.7 ± 8.3 days) compared to patients without complications (11.5 ± 7.3 days) (p < 0.001). The results of this study revealed that patients diagnosed with CE required hospitalization and extended medical care, indicating that this zoonotic disease remains a significant public health problem in Western Romania. Public health authorities should enhance CE surveillance by implementing control programs and mandatory notification of new cases. Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

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15 pages, 1544 KiB

Open AccessArticle

Toxoplasmosis Screening during Pregnancy in a Romanian Infectious Diseases Tertiary Center: Results of a 15 Years Follow-Up Program

by Violeta Briciu, Angela Monica Ionică, Mirela Flonta, Ariana Almaș, Monica Muntean, Adriana Topan, Melinda Horvat, Liviu Ungureanu and Mihaela Lupșe

Microorganisms 2023, 11(9), 2189; https://doi.org/10.3390/microorganisms11092189 - 30 Aug 2023

Cited by 2 | Viewed by 1314

Abstract

Maternal infection with Toxoplasma gondii during pregnancy may have serious consequences for the fetus. In Romania, screening for toxoplasmosis is included in the first antenatal visit. A retrospective study was performed on all toxoplasmosis antenatal screening patients between May 2008 and February 2023. Twenty-seven thousand one hundred sixty-nine (27,169) pregnant women presented for prenatal screening once (22,858) or several times: during the same pregnancy (209) or during multiple pregnancies (4102). Thirty-one thousand six hundred fifty-eight (31,658) tests for IgM and IgG antibodies were performed. Nine thousand eighty-three (9083) tests (28.69%), corresponding to 7911 women (29.12%), were positive for IgG antibodies. The seroprevalence increased with patients’ age, decreased in time intervals, and was more frequently associated with rural residence. At risk for acquiring the infection during the pregnancy were women with negative anti-Toxoplasma IgG antibodies (70.88%), but only 0.9% of them presented for rescreening during the same pregnancy. Acute Toxoplasma infection (ATI) was suspected in 44 patients (0.16%) due to IgG seroconversion and/or low or borderline IgG avidity. A questionnaire follow-up interview was performed, and no congenital toxoplasmosis was identified in children born from mothers with probable ATI. Our study demonstrates poor compliance with the screening program in the Romanian population. Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

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Review

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9 pages, 578 KiB

Open AccessReview

Boutonneuse Fever in Southeastern Romania

by Simona Claudia Cambrea, Diana Badiu, Constantin Ionescu, Roxana Penciu, Loredana Pazara, Cristina Maria Mihai, Mara Andreea Cambrea and Larisia Mihai

Microorganisms 2023, 11(11), 2734; https://doi.org/10.3390/microorganisms11112734 - 9 Nov 2023

Viewed by 820

Abstract

Boutonneuse fever (BF) is an eruptive disease and is classified as a spotted fever, which is endemic in the Mediterranean basin (i.e., Marseille fever or Mediterranean spotted fever) and the Black Sea, caused by Rickettsia conorii, with dog ticks being a vector (i.e., Rhipicephalus sanguineus). In Romania, although the first reported outbreak of BF occurred during the summer of 1931 in Constanta, the disease was discovered in 1910. Although the disease has occurred most frequently in the two counties of the Dobruja region (Constanta and Tulcea), a region of the Balkan Peninsula, during the last few years, other counties in southeastern Romania have started to report BF cases. In a period of 9 years, 533 cases were registered in Constanta county, while in a period of 11 years, 339 cases were registered in Bucharest county. In this review, we describe the bacterial tick-borne disease caused by R. conorii in southeastern Romania, focusing on its history and epidemiology, pathophysiology, clinical aspects, diagnosis, treatment and preventive measures in the context of climate changes. Although R. conorii is the principal etiologic agent of BF in southeastern Romania, we should take into consideration that other Rickettsia spp. could be present and involved in disease transmission. Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

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28 pages, 3040 KiB

Open AccessReview

Seroprevalence of Infections with TORCH Agents in Romania: A Systematic Review

by Cristiana Luiza Radoi, Ovidiu Zlatian, Maria Balasoiu, Lucian Giubelan, Andreea Cristina Stoian, Livia Dragonu, Alexandru Neacsu and Dominic Gabriel Iliescu

Microorganisms 2023, 11(8), 2120; https://doi.org/10.3390/microorganisms11082120 - 20 Aug 2023

Cited by 1 | Viewed by 1566

Abstract

Maternal–fetal infectious pathology—notably the TORCH panel (Toxoplasma gondii, rubella, Cytomegalovirus, and herpes simplex viruses)—critically impacts maternal and neonatal health. This review collates data on the seroprevalence of IgG and IgM antibodies against TORCH agents in Romanian women, aiming to discern regional and population differences and identify risk factors. Twenty studies were included in the review, revealing variable seroprevalence rates across the country. Regions such as Moldavia and Banat showed higher anti-T. gondii IgG seroprevalence rates than Bihor, with notable declines in Banat. Rural, older, and multiparous women showed elevated T. gondii IgG rates. Anti-rubella vaccine introduction significantly reduced the prevalence of anti-rubella IgG antibodies, but recent vaccination coverage decreases raise concerns. CMV and HSV seroprevalence varied geographically, with rural areas generally showing higher CMV rates and HSV influenced by factors like education level and number of sexual partners. Concurrent seroprevalence of multiple TORCH components in some cases underscores potential common risk factors. This study highlights the importance of continuous monitoring and preventive measures such as vaccinations and awareness campaigns to mitigate the health impact on the pregnant population. Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

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Other

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8 pages, 2061 KiB

Open AccessCase Report

Lelliottia amnigena and Pseudomonas putida Coinfection Associated with a Critical SARS-CoV-2 Infection: A Case Report

by Victoria Birlutiu, Rares-Mircea Birlutiu and Elena Simona Dobritoiu

Microorganisms 2023, 11(9), 2143; https://doi.org/10.3390/microorganisms11092143 - 24 Aug 2023

Viewed by 2795

Abstract

Lelliottia amnigena is a Gram-negative facultative anaerobic bacillus identified from water sources and later from food (onions, cream, unpasteurized milk, and Spanish pork sausages), which, under certain circumstances, can cause infections in humans, especially in immunocompromised patients. Few cases of human infections have been reported in the literature, such as endophthalmitis, urinary tract infection, pyonephrosis, and sepsis. We describe the case of a 69-year-old Caucasian male patient who lives in an urban environment and presents himself to the emergency department with chills, fever, myalgias, marked physical asthenia, dry cough, dyspnea, symptoms for which he is tested and confirmed with SARS-CoV-2 infection using real-time reverse transcriptase–polymerase chain reaction (RT-PCR) from nasal and pharyngeal swabs, after being admitted the same day (25 May 2023) to the Infectious Diseases Clinic from the County Clinical Emergency Hospital Sibiu, Romania. At the time of admission, a pulmonary computerized tomography (CT) scan was performed, which revealed a severity score of 10 out of 25. In the second week of the disease, the patient presents with hemoptysis, from which bacteriological examinations are carried out, and Pseudomonas putida and Lelliottia amnigena are identified. The evolution was slowly favorable under antiviral treatment, corticotherapy, antibiotic therapy (in the absence of the identified etiology, initially meropenem was administered in association with linezolid, and then ceftazidime-avibactam), voriconazole, anakinra, salbutamol inhaler, inhalation corticosteroids, with slow reduction in oxygen requirement, the patient continued oxygen therapy at home after discharge with a flow rate of 5 L/minute. During the third harvesting of sputum samples, P. putida was isolated along with L. amnigena, both strains of low-virulence species, and maintained susceptibility to antibiotics. In the context of an immunosuppressed patient with previous pulmonary surgery for actinomycosis, chronic obstructive pulmonary disease, and bronchiectasis, all these conditions are favorable for biofilm formation. L. amnigena remains a pathogen rarely isolated in human pathology, but we should pay more attention, especially in the immunosuppressed patient, where it can be responsible for an extremely serious clinical picture. Full article

(This article belongs to the Special Issue State-of-the-Art Parasitic and Bacterial Infections in Romania)

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