Evaluation of a commercially available reverse transcription-PCR enzyme immunoassay (Enterovirus Consensus kit) for the diagnosis of enterovirus central nervous system infections

ABSTRACTA commercial reverse transcription (RT)-PCR amplification method was compared with culture for the diagnosis of enterovirus meningitis. In total, 99 cerebrospinal fluid (CSF) specimens were examined with the Enterovirus Consensus kit and shell vial culture. RT-PCR allowed the amplification of enterovirus cDNA and its detection in a microtitre plate by hybridisation. Clinical information and CSF analysis were used to resolve the discrepancy in results. The detection limit of the RT-PCR assay was determined with the Third European Union Concerted Action Enterovirus Proficiency Panel. There were 34 truepositive CSF specimens. Of these, RT-PCR detected 33 (sensitivity 97%), while culture detected 19 (sensitivity 54.5%). RT-PCR failed to detect one culture-positive specimen that contained inhibitors. When samples from the Third European Union Concerted Action Enterovirus Proficiency Panel were tested, the RT-PCR method gave identical results to those expected. The Enterovirus Consensus kit was rapid and statistically more sensitive than culture (p < 0.01) for the detection of enteroviruses in CSF, and may offer considerable benefits in the clinical management of patients with enterovirus meningitis

Spinal Infections: An Update

Spinal infection poses a demanding diagnostic and treatment problem for which a multidisciplinary approach with spine surgeons, radiologists, and infectious disease specialists is required. Infections are usually caused by bacterial microorganisms, although fungal infections can also occur. The most common route for spinal infection is through hematogenous spread of the microorganism from a distant infected area. Most patients with spinal infections diagnosed in early stages can be successfully managed conservatively with antibiotics, bed rest, and spinal braces. In cases of gross or pending instability, progressive neurological deficits, failure of conservative treatment, spinal abscess formation, severe symptoms indicating sepsis, and failure of previous conservative treatment, surgical treatment is required. In either case, close monitoring of the patients with spinal infection with serial neurological examinations and imaging studies is necessary

PrEP (Pre-Exposure Prophylaxis) as an innovative HIV prevention strategy

&lt;p&gt;PrEP (Pre-Exposure Prophylaxis) is an innovative HIV prevention strategy, which, although widely used in several countries, only constituted a pilot project in Greece. PrEP is defined as the administration of antiretroviral agents recommended for HIV-negative individuals who have a high risk of HIV infection. The aim of the present review is to highlight PrEP as a prevention treatment strategy that acts complementary to other risk reduction strategies. Specifically, clinical trial data from studies conducted during the last decade is presented and analyzed. PrEP, in all subpopulation studied and with all regimens used, significantly lowers the risk of HIV infection compared to placebo used in each study, in the 90% of the cases. No serious side effects were reported, while it was established that with adherence to the prescribed dose, the chances of prevention are greater.&lt;/p&gt

The Impact of Antibiotic Stewardship Programs in Combating Quinolone Resistance: A Systematic Review and Recommendations for More Efficient Interventions

Quinolones are among the most commonly prescribed antibiotics worldwide. A clear relationship has been demonstrated between excessive quinolone use and the steady increase in the incidence of quinolone-resistant bacterial pathogens, both in hospital and community sites. In addition, exposure to quinolones has been associated with colonization and infection with healthcare-associated pathogens such as methicillin-resistant Staphylococcus aureus and Clostridium difficile in hospitalized patients. Therefore, the management of quinolone prescribing in hospitals through antibiotic stewardship programs is considered crucial. Although suggestions have been made by previous studies on the positive impact of stewardship programs concerning the emergence and spread of multidrug-resistant bacteria at hospital level, the association of quinolone-targeted interventions with reduction of quinolone resistance is vague. The purpose of this article was to evaluate the impact of stewardship interventions on quinolone resistance rates and healthcare-associated infections, through a literature review using systematic methods to identify and select the appropriate studies. Recommendations for improvements in quinolone-targeted stewardship programs are also proposed. Efforts in battling quinolone resistance should combine various interventions such as restriction formulary policies, prospective audits with feedback to prescribers, infection prevention and control measures, prompt detection of low-level resistance, educational programs, and guidelines for optimal quinolone usage. However, the effectiveness of such strategies should be assessed by properly designed and conducted clinical trials. Finally, novel approaches in diagnostic stewardship for rapidly detecting bacterial resistance, including PCR-based techniques, mass spectrometry, microarrays, and whole-genome sequencing as well as the prompt investigation on the clonality of quinolone-resistant strains, will strengthen our ability to personalize quinolone prescribing to individual patients. © 2017, Springer Healthcare

A comprehensive review of monkeypox (mpox) on the occasion of the ongoing multicountry outbreak of the disease

&lt;p&gt;The ongoing recent outbreak of mpox, extending to both endemic and non endemic regions, has emerged as a growing international public health threat. The purpose of this review is to highlight the basics of the disease. Mpox is a zoonotic infectious disease, caused by MPV, a DNA virus in the genus Orthopoxvirus. There are two possible means of mpox transmission: animal-to-human and human-to-human transmission. In this epidemic, mpox is predominantly affecting men who have sex with men. The early symptoms and signs of mpox are nonspecific but the subsequent evolution of the skin lesions is characteristic. The preferred diagnostic method for mpox is Polymerase Chain Reaction (PCR) testing of samples from skin lesions. The management of mpox includes supportive care and pain relief medication. There is no treatment approved specifically for mpox. However, there is evidence that antiviral agents that are effective against variola virus are also effective against MPV. There are several simple precautions in order to avoid mpox, including vaccination.&lt;/p&gt

Lessons from a historic example of diving safety rules violation: The case of Greek sponge divers

This study presents a historical example of systematic safety rules violations by professional sponge divers in Greece during the early 20th century. In light of absolute unaccountability in favour of economic competition and in the absence of state oversight, the profession of sponge diving had developed into a deadly undertaking. The study is based on a report compiled by Professor of Hygiene and Microbiology Konstantinos Savvas, which was addressed to the Ministry of Marine Affairs. Savvas&apos; report rested on data concerning hospitalised divers derived from the medical records of warship &apos;Kriti&apos; (Crete), which escorted groups of Greek fishing vessels to four of their expedition in the Mediterranean over the period 1900-1903. Although the events explored herein took place at a time much different from the modern era with its numerous advancements in hyperbaric medicine, enhanced divers&apos; professionalism and the establishment of labour rights and strict safety regulations, we should not overlook the human factor of professional exploitation that leads to the violation of safety rules. On the other hand, supervisory authorities entrusted with the responsibility of overseeing professional activities ought to be vigilant on a constant basis, especially in times of economic crisis that may lead to lax state functioning. © 2020 PSMTTM