Clostridium difficile Infection Diagnosis by Biological Molecular Methods

In the past 15 years, the incidence of Clostridium difficile infection has emerged especially because of the new highly virulent strains. The classical diagnosis methods used to diagnose C. difficile infection take time and the enzyme immunoassay (EIA) test has demonstrated the lack of sensitivity. Even though new modern molecular methods have become available, the diagnosis of C. difficile in patients or healthy carriers remains a big challenge for both clinicians and laboratory staff. In the present chapter, we will list the main genotyping methods, stressing their advantages and disadvantages, as well. A brief presentation of the most useful kit (principle, sensitivity, specificity, benefits and disadvantages) to assess the impact of molecular methods in comparison with classical methods will offer support for future research in the present context of an increasing prevalence of C. difficile infection that represents worldwide, a real public health problem. To improve the patients’ quality of life, to limit hospital transmission, and to save money, we have tried to identify the best diagnosis algorithm as tool in C. difficile diagnosis and surveillance. This algorithm may differ depending on the capacities of the laboratories and on the socioeconomic level of the countries in question

Spread of VIM-2 metallo-beta-lactamase in Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolates from Iaşi, Romania Răspândirea metalo-beta-lactamazei VIM-2 printre izolate clinice de Pseudomonas aeruginosa şi Acinetobacter baumannii din Iaş

Abstract Our study investigated the type of acquired metallo-β-lactamases (MBLs

HPV prevalence and type distribution in women with or without cervical lesions in the Northeast region of Romania

Abstract Background Cervical cancer is a major public health problem worldwide. While Romania has the highest incidence of cervical cancer in Europe, the prevalence of HPV has not been evaluated. We report the first data on HPV prevalence and type distribution in Northeast Romania. Methods HPV prevalence and genotype distribution was investigated in 514 consecutively women with or without cervical lesions in Northeast Romania. Genotyping was performed with Linear Array Genotyping/Roche kit. Results In our study group, 192/514 (37.4%) patients were positive for HPV (infected with single and with multiple HPV types). Most frequent types were: 16 (10.5%), 53 (5.44%), 51 (5.05%), 52 (4.08%) 18 (2.91%) and 31 (2.73%). Conclusions Infection with high risk types of HPV is common in Northeast Romania. Enhanced and systematic screening for cervical cancer is needed. Our results call for the implementation of a National HPV vaccine program in Romania.</p

METODE DE GENOTIPARE A VIRUSULUI HEPATITIC D

Infecţia cu virusul hepatitic D (VHD) este cunoscută ca fiind una dintre infecţiile care cauzează cele mai severe forme de hepatită, având prognosticul cel mai rezervat, cu rate înalte de hepatită fulminantă şi insuficienţă hepatică. Până în prezent, au fost descrise 8 genotipuri de VHD. Având în vedere implicarea diferitelor genotipuri în evoluţia bolii hepatice, o abordare ideală a pacientului ar trebui să cuprindă şi genotiparea VHD. Acest studiu a avut drept scop identificarea metodelor de genotipare a VHD descrise până în prezent. Obiectivele au constat in: identificarea metodelor folosite în genotiparea VHD, analiza comparativă a metodelor identificate şi aprecierea celei mai fiabile metode pentru utilizarea în practica medicală. Pentru o abordare integrativă a metodelor de genotipare VHD utilizate până în prezent, am efectuat o căutare în principalele baze de date şi am luat în considerare studii originale, peer-reviewed, realizate pe subiecţi umani. Am identificat 4 metode de genotipare descrise în diferite studii de-a lungul anilor: hibridizare, RT-LAMP (Reverse Transcription-Loop-Mediated Isothermal Amplifi-cation), PCR-RFLP (Polymerase Chain Reaction-Restriction Fragment Length Polymorphism) şi PCR urmat de secvenţiere. Studiul poate să reprezinte un punct de plecare în stabilirea metodei standard de genotipare VH

The Need for Cervical Cancer Control in HIV-Positive and HIV-Negative Women from Romania by Primary Prevention and by Early Detection Using Clinically Validated HPV/DNA Tests

<div><p>Background</p><p>In Romania, a country with no organized national surveillance program regarding cervical cancer, the early diagnosis of HPV (Human Papilloma Virus) infections is a major requirement, especially in HIV-infected women. The objective of this study was to determine the HPV prevalence and type distribution in young HIV-positive women and to assess the difference in the risk factors for developing cervical cancer compared to those of HIV-negative women.</p><p>Method</p><p>We conducted one cross-sectional cohort study from June 2013–September 2014, including 1,032 women: 992 HIV- women who were 36.5 years old (limits: 17 ÷ 84) and 40 HIV + women who were 22.9 years old (limits: 17 ÷ 30) with iatrogenic HIV infected. We detected HPV types with the <i>Linear Array HPV Genotyping</i> test (Roche, Romania).</p><p>Results</p><p>DNA/HPV was detected in 18/40 (45%) of the HIV+ patients and in 350/992 (35.2%) of the HIV- patients (OR = 1.5, 95%CI 0.76÷2.96). After age adjustment, the overall HPV prevalence was 51.6% in HIV+ versus 63.2% in HIV- women aged under 25, and 22.2% in HPV+ versus 47.2% in HIV- women aged 25–34. We detect HIV being a risk factor for acquiring multiple HPV type infections (OR = 2.30, 95% CI 0.88÷5.97). The eight most common HPV types (high-risk, and low-risk) for women below age 30, HIV+ / - were: HPV 16, 18, 31, 51, 58, 68, and 6 and 82 respectively. To assess the risk factors of HIV-positive women for acquiring HPV infection, we analyzed the CD4/μL, ARN/HIV copies/μL, the age group, the number of sexual partners, smoking, and the type of HPV infection (single versus multiple infections). We found that the number of sexual partners and smoking are statistically significant risk factors.</p><p>Conclusion</p><p>Even though there are no significant differences regarding the prevalence of HPV infection in HIV + <i>versus</i> HIV – patients, multiple infections were more frequent in the first group. In our study group young HIV-infected patients under HAART therapy, high number of sexual partners (more than 3) and smoking were detected to be risk factors. Future organized screening for HPV infection using sensitive and specific methods are necessary at the national level in Romania.</p></div

The HPV prevalence in HIV-positive women and HIV-negative women, compared by age group.

<p>The HPV prevalence in HIV-positive women and HIV-negative women, compared by age group.</p

The demographic characteristics of the two study groups.

<p>The demographic characteristics of the two study groups.</p

The eight most common HPV types (high-risk or low-risk) for women below age 30, HIV+ /-.

<p>The eight most common HPV types (high-risk or low-risk) for women below age 30, HIV+ /-.</p