2015/16 seasonal vaccine effectiveness against hospitalisation with influenza a(H1N1)pdm09 and B among elderly people in Europe: Results from the I-MOVE+ project

We conducted a multicentre test-negative caseâ\u80\u93control study in 27 hospitals of 11 European countries to measure 2015/16 influenza vaccine effectiveness (IVE) against hospitalised influenza A(H1N1)pdm09 and B among people aged â\u89¥ 65 years. Patients swabbed within 7 days after onset of symptoms compatible with severe acute respiratory infection were included. Information on demographics, vaccination and underlying conditions was collected. Using logistic regression, we measured IVE adjusted for potential confounders. We included 355 influenza A(H1N1)pdm09 cases, 110 influenza B cases, and 1,274 controls. Adjusted IVE against influenza A(H1N1)pdm09 was 42% (95% confidence interval (CI): 22 to 57). It was 59% (95% CI: 23 to 78), 48% (95% CI: 5 to 71), 43% (95% CI: 8 to 65) and 39% (95% CI: 7 to 60) in patients with diabetes mellitus, cancer, lung and heart disease, respectively. Adjusted IVE against influenza B was 52% (95% CI: 24 to 70). It was 62% (95% CI: 5 to 85), 60% (95% CI: 18 to 80) and 36% (95% CI: -23 to 67) in patients with diabetes mellitus, lung and heart disease, respectively. 2015/16 IVE estimates against hospitalised influenza in elderly people was moderate against influenza A(H1N1)pdm09 and B, including among those with diabetes mellitus, cancer, lung or heart diseases

Oral Systemic Infection – Endocardial Involvement

The aim of the present study is to investigate oral systemic infections and their complications, with a closer look to the endocardial involvement. Material and methods The present study was performed on 31 patients diagnosed with oral sepsis between 2004-2010, in “Sf. Cuv. Parascheva” Infectious Diseases Hospital from Iasi. The link between dental intervention and bacterial endocarditis was anamnestic documented. The organic damages or dysfunctions occurred in sepsis were followed, and the aetiology and clinical response to the applied antibiotherapy were analysed. Results Patients included in this study, most men coming from rural areas, and having most affected group aged between 40 and 60 years, had presented in association predisposing conditions for the basic damage (oral sepsis). Other patients were accused of an oral hygiene lack and incomplete dental treatment for initial conditions. After interdisciplinary clinical examination and intraoperative assessment in Surgery Clinics (Oro-maxillo-facial Surgery, Ophthalmology) the diagnose of patients oriented to specific damages and then they were transferred to the Infectious Diseases Hospital and diagnosed with oral sepsis, on prone land to this pathology (valvular, implanted cardiac devices, diabetes, liver diseases, cancer, tuberculosis, pancytopenia). At 4 patients, the transthoracic echocardiography detected vegetation on mitral valve (specific for endocarditis) and prosthetic valve dehiscence in mitral position to a patient from rural areas, with periapical abscess and multiple root debris. Echocardiographic diagnosis of infectious endocarditis subsequently confirmed by positive blood cultures (Enterococcus faecalis, anaerobic gram-negative bacilli) was found at patients with valvular heart diseases and a history of tooth extraction without prophylaxis. Regarding the therapy of these infections were used antibiotics as beta-lactams in association with quinolones and/or chloramphenicol in order to cover the specific polimicrobian spectrum, applying the de-escalation techniques, with an evolution and favourable prognosis in more than half cases. Conclusions Literature and guidelines for prevention and management of odontogenic bacteraemia were in constant review, regarding prophylactic antibiotics and invasive procedures with dental visa, expressing different opinions. Diagnosis of infective endocarditis (5 cases) on patients with valvular heart disease and a history of tooth extraction without prophylaxis, unfortunately indicate a low level of compliance of some practitioners to the specific recommendations, and non-recognition of the situations when the prophylaxis is absolutely necessary

Metabolical changes in HBV/ HIV coinfections

The aim of this study was to evaluate the main metabolic changes in the case of hepatitis B virus (HBV) / human imunodeficiency virus (HIV) coinfection. A retrospective study, on 482 HIV infected patients was assesed, at Iasi Regional HIV-AIDS Center Iasi, between 2000-2014. Subjects were divided into 2 groups, according to the presence or absence of HBV coinfection. HIV prevalence was higher in the 20-29 years aged group (86.5%), parenteral routes being the predominant mode of HIV transmission (61.5% vs 58.5%). Mean ALT levels were significantly higher (p<0.001) in the HBV group (49.92 IU/L vs 32.93 IU/L). Average total cholesterol levels were significantly higher (p<0.001) in the HBV group( 182.58 vs 167.59 mg%). The average levels of serum triglycerides in the HBV group were significantly lower (p<0.001) than those recorded in the nonHBV group (130.72 vs. 164.59 mg%). Dyslipidemia was common in the HIV/HBV coinfected group (107 vs. 82). Hepatitis B virus infection induced a 2-fold higher relative risk for the occurence of hepatic cytolysis syndrome

ACUTE RENAL FAILURE – CLINICAL PRESENTING FORM OF NON-HODGKIN’S LYMPHOMA IN A HIV-POSITIVE YOUNG PATIENT

We present the case of a woman born in 1987, identified as a HIV-seropositive at age of 11 years and classified from the beginning in AIDS-B3. She was treated with three antiretroviral regimens, her attitude being characterized by non-adherence. In 2013 she is diagnosed with diffuse large B-cell non-Hodgkin's lymphoma (plasmablastic type) and concomitantly, she presented acute renal failure with applying of hemodialysis. The patient could be affected by a wide variety of disease processes that might involve the kidney. It is difficult to distinguish an HIV-associated nephropathy accelerated by non-adherence at antiretrovirals, from an infiltrative process due to malignancy or some HAART-related renal side effects

Epidemiological data and antifungal susceptibility in invasive fungal infections - a Romanian infectious diseases tertiary hospital’s experience. Preliminary report

Introduction: Invasive fungal infections have stood as an important research subject for the past 20 years, being considered as a crucial effect of advancing healthcare services. Low identification rates of invasive fungal infections in blood cultures and low sensibility of biomarkers determine empiric treatments which lead to a change in epidemiological data and antifungal susceptibility. The aim: The epidemiological evaluation of invasive fungal infections and the assessment of antifungal resistance related to this condition. Methods and material: An “antifungal stewardship” retrospective study was developed between January 2010 and April 2016. An epidemiological analysis was performed on 79 cases with proven invasive fungal infections in bloodstream, catheter, and cerebrospinal fluid. We considered: age, gender, HIV status, place of residence, and first option in medical practice of antifungal treatment. The laboratory analysis was performed by the Microbiology Laboratory at “Prof. Dr. Matei Bals” National Institute for Infectious Diseases, Bucharest. Minimum inhibitory concentrations (MIC’s) of 15 isolates were identified using colorimetric micro broth dilution panel YEASTONE ®YO10 and compared with susceptibilities obtained by VITEK2®C system. Candida parapsilosis ATCC 22019 was used as reference. Results: The incidence of invasive fungal infections was 3.7 on 1000 hospitalized patients. The age of the study population ranged between 12 and 83 years, and most were male (59%). The majority of subjects were from an urban area (84%), and 27% of them were HIV positive. The results obtained in VITEK2C® were similar with those from YEASTONE® YO10 for fluconazole, voriconazole, amphotericin B (100%), without any minor, major or very major errors. The fluconazole was the first option of treatment, followed by voriconazole, caspofungin, anidulafungin. In 37% of cases the first treatment option was replaced with a secondary antifungal therapy accordingly with antifungal breakpoints obtained by Vitek ®. Conclusions: No rates of resistance to fluconazole, amphotericin B, voriconazole were obtained. Fluconazole was the major first line antifungal therapy. Conclusions: No rates of resistance to fluconazole, amphotericin B, voriconazole were obtained. Fluconazole was the major first line antifungal therapy