43 research outputs found
Impact of Hepatitis B Exposure on Sustained Virological Response Rates of Highly Viremic Chronic Hepatitis C Patients
Aim. To evaluate the impact of hepatitis B core antibody (anti-HBc) seropositivity in sustained virological response (SVR) rates in treatment-naïve, chronic hepatitis C (CHC) patients with high pretreatment viral load (>800000 IU/mL). Methods. 185 consecutive CHC patients (14.4% cirrhotics, 70.2% prior intravenous drug users) treated with pegylated interferon-a2b plus ribavirin, for 24 or 48 weeks based on viral genotype, were retrospectively analyzed. SVR was confirmed by undetectable serum HCV-RNA six months after the end of treatment schedule.
Results. Thirty percent of CHC/HBsAg-negative patients were anti-HBc-positive. Anti-HBc positivity was more prevalent in cirrhotic, compared to noncirrhotic patients (76.9% versus 19.5%, P < .05). Serum HBV-DNA was detected in the minority of anti-HBc-positive patients (1.97%). Overall, 62.1% of patients exhibited SVR, while 28.6% did not; 71.4% of non-SVRs were infected with genotype 1. In the univariate analysis, the anti-HBc positivity was negatively associated with treatment outcome (P = .065). In the multivariate model, only the advanced stage of liver disease (P = .015) and genotype-1 HCV infection (P = .003), but not anti-HBc-status (P = .726), proved to be independent predictors of non-SVR.
Conclusion. Serum anti-HBc positivity does not affect the SVR rates in treatment-naïve CHC patients with high pretreatment viral load, receiving the currently approved combination treatment
Prevalence of HPV infection among Greek women attending a gynecological outpatient clinic
Background: Human papillomavirus (HPV) infection is a causative factor for cervical cancer. Early detection of high risk HPV types might help to identify women at high risk of cervical cancer. The aim of the present study was to examine the HPV prevalence and distribution in cervical smears in a sample of Greek women attending a gynecological outpatient clinic and to explore the determinants of the infection.Methods: A total of 225 women were studied. All women underwent a regular gynecological control. 35 HPV types were studied; 6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 54, 56, 58, 59, 61, 62, 66, 68, 70, 71, 72, 73, 81, 82, 83, 84, 85 and 89. Also, basic demographic information, sociodemographic characteristics and sexual behavior were recorded.Results: HPV was detected in 22.7% of the study population. The percentage of the newly diagnosed women with HPV infection was 17.3%. HPV-16 was the most common type detected (5.3%) followed by HPV-53 (4.9%). 66.2% of the study participants had a Pap test during the last year without any abnormalities. HPV infection was related positively with alcohol consumption (OR: 2.19, 95% CI: 1.04-4.63, P = 0.04) and number of sexual partners (OR: 2.16, 95% CI: 1.44-3.25, P < 0.001), and negatively with age (OR: 0.93, 95% CI: 0.87-0.99, P = 0.03), and monthly income (OR: 0.63, 95% CI: 0.44-0.89, P = 0.01).Conclusion: The prevalence of HPV in women attending an outpatient clinic is high. Number of sexual partners and alcohol consumption were the most significant risk factors for HPV infection, followed by young age and lower income
Fungal Septic Knee Arthritis Caused by Aspergillus fumigatus following Anterior Cruciate Ligament Reconstruction
Postoperative infections after arthroscopic anterior cruciate ligament (ACL) reconstruction (ACLR) represent a rare but severe complication. An extremely rare case of Aspergillus septic arthritis in a 27-year-old patient following arthroscopic ACLR is reported. The patient presented with signs of knee infection 14 days after ACLR. Two consecutive arthroscopic debridements were performed, while eventually histopathology, cultures and multiplex PCR test revealed Aspergillus identified as A. fumigatus by mass spectrometry. The patient commenced long-term treatment with voriconazole. Fungal arthritis or osteomyelitis following ACLR has a mild local and general inflammatory reaction when compared to the bacterial ones. Nevertheless, such infections may lead to aggressive osseous destruction and necrosis. A high index of suspicion is of utmost importance for early detection, while microscopic, histological examination and multiplex PCR may be more helpful for the diagnosis than cultures since cultures are more time-consuming and may vary depending on different factors
Fungal Septic Knee Arthritis Caused by Aspergillus fumigatus following Anterior Cruciate Ligament Reconstruction
Postoperative infections after arthroscopic anterior cruciate ligament
(ACL) reconstruction (ACLR) represent a rare but severe complication. An
extremely rare case of Aspergillus septic arthritis in a 27-year-old
patient following arthroscopic ACLR is reported. The patient presented
with signs of knee infection 14 days after ACLR. Two consecutive
arthroscopic debridements were performed, while eventually
histopathology, cultures and multiplex PCR test revealed Aspergillus
identified as A. fumigatus by mass spectrometry. The patient commenced
long-term treatment with voriconazole. Fungal arthritis or osteomyelitis
following ACLR has a mild local and general inflammatory reaction when
compared to the bacterial ones. Nevertheless, such infections may lead
to aggressive osseous destruction and necrosis. A high index of
suspicion is of utmost importance for early detection, while
microscopic, histological examination and multiplex PCR may be more
helpful for the diagnosis than cultures since cultures are more
time-consuming and may vary depending on different factors
Comparison of microbial colonization rates between central venous catheters and peripherally inserted central catheters
Abstract Background Central venous catheters (CVCs) and peripherally inserted central catheters (PICCs), have been widely used as intravascular devices in critically ill patients. However, they might evoke complications, such as catheter colonization that has been considered as predisposing factor for central line-associated bloodstream infections (CLABSIs). Although numerous studies have compared the risk of bloodstream infections between PICCs and CVCs, comparative studies on their colonization rates are limited. Objectives The episodes of catheter colonization in critically ill patients with CVCs or PICCs were retrospectively analysed during a two-year period in a Greek tertiary care hospital and colonization rates, microbial profiles and antimicrobial susceptibility patterns were compared. Methods Clinical and laboratory data of consecutive hospitalized critically-ill patients who underwent PICC and CVC placement between May 2017–May 2019 were analysed. All catheters were examined by the semiquantitative culture technique for bacterial pathogens, either as a routine process after catheter removal or after suspicion of infection. Species identification and antimicrobial resistance patterns were determined by the Vitek2 automated system. Results During the survey period a total of 122/1187 (10.28%) catheter colonization cases were identified among CVCs and 19/639 (2.97%) cases among PICCs (p = 0.001). The colonization rate was 12.48/1000 catheter-days for the CVC group and 1.71/1000 catheter-days for the PICC group (p < 0.001). The colonization rate per 1000 catheter-days due to multidrug-resistant organisms (MDROs) was 3.85 in all study cases, 7.26 (71/122) in the CVC group and 0.63 (7/19) in the PICC group (p < 0.001). Within the CVC group, the most common microorganism isolated was MDR Acinetobacter baumannii (n = 38, 31.1%) followed by MDR Klebsiella pneumoniae (n = 20, 16.4%). In the PICC group, the predominant microorganism isolated was Candida spp. (n = 5, 23.8%) followed by MDR K. pneumoniae and MDR A. baumannii in equal numbers (n = 3, 14.2%). Conclusion PICC lines were associated with significantly lower colonization rates comparing to the CVC ones. In addition, patterns of microbial colonization revealed a trend over the predominance of MDR gram-negatives in CVCs suggesting that PICCs might be a safer alternative for prolonged inpatient intravascular access. Prevention programs directed by local microbial ecology may diminish catheter colonization rates and CLABSIs
Emerging infectious diseases
The field of infectious disease is vast, complex and rapidly expanding. New advances in
diagnostic testing, the development of new antimicrobial therapies and even the emergence of novel
infectious diseases require diligent study by medical practitioners to remain current. International
travelling can pose various risks to health, depending on the characteristics of both the traveller and
the travel. Travellers may encounter sudden and significant changes in altitude, humidity, microbes
and temperature, which can result in ill-health. In addition, serious health risks may arise in areas
where accommodation is of poor quality, hygiene and sanitation are inadequate, medical services
are not well developed and clean water is unavailable. The purpose of this paper is to highlight the
details and impact of 4 significant diseases that pose a threat to public health. Specifically issues
are such as the cause, transmission, geographical distribution, nature of disease and precautions of
SARS, influenza, chikungunya and avian flu
The Impact of Antibiotic Stewardship Programs in Combating Quinolone Resistance: A Systematic Review and Recommendations for More Efficient Interventions
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Serological and virological profile of chronic HBV infected women at reproductive age in Greece - A two-year single center study
Objective: Seroprevalence of HBsAg in 26,746 women at reproductive age
in Greece and evaluation of HBeAg/anti-HBe serological status as well as
serum HBV-DNA levels in a subgroup of HBsAg(+) women at labor.
Study design: Serological markers were detected using enzyme
immunoassays. Serum HBV-DNA was calculated using a sensitive
quantitative PCR assay, with a lower limit of quantification of 200
copies/ml.
Results: Overall, 1.53% of women were HBsAg(+) and the majority of them
(64.96%) were Albanian. Among Albanian women the mean prevalence of
HBsAg was 4.9%, 5.57% among Asian women, and 1.29% among women from
Eastern European countries. The prevalence of HBsAg among African
(0.29%) and Greek women (0.57%) was very low and significantly lower
in comparison with the mean value of the studied population. Only 2.67%
of HBsAg(+) women were HBeAg(+). Of a subgroup of women in labor with
available serum samples 28.6% had undetectable levels of viremia (<200
copies/ml) and 15.9% had extremely low levels of viral replication
(<400 copies/ml). Only 12.7% of pregnant women evaluated at labor
exhibited extremely high serum HBV-DNA levels (>10,000,000 copies/ml)
whereas 42.8% of them exhibited HBV-DNA levels between 1500 and 40,000
copies/ml.
Conclusions: The overall prevalence of HBsAg is relatively low among
women at reproductive age in Greece but is higher among specific ethnic
populations (Asian, Albanian). The HBeAg(-)/antiHBe(+) serological
status is a finding observed in the vast majority of HBsAg(+) women of
our study population, and a significant percentage of them
(approximately 44.5%) exhibit extremely low or even undetectable levels
of viral replication at labor, suggesting possibly that only a
proportion of HBsAg(+) women in Greece exhibit an extremely high risk of
vertical transmission of the infection. (C) 2006 Elsevier Ireland Ltd.
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