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Tansarli GS, Skalidis T, Legakis NJ, Falagas ME. Abnormal vaginal flora in symptomatic non-pregnant and pregnant women in a Greek hospital: a prospective study. Eur J Clin Microbiol Infect Dis 2016; 36:227-232. [PMID: 27738857 DOI: 10.1007/s10096-016-2787-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 09/07/2016] [Indexed: 10/20/2022]
Abstract
Bacterial vaginosis (BV), candidiasis, and trichomoniasis were the three established types of vaginal conditions until aerobic vaginitis (AV) was defined in the early 2000s. We sought to study the prevalence of abnormal vaginal flora (AVF) with inflammation in our hospital and to correlate it with AV. We prospectively collected vaginal smear specimens originated from symptomatic women who were examined at Iaso Obstetrics, Gynecology and Children's Hospital of Athens from April 2014 until September 2015. Amsel's criteria were used for the diagnosis of BV. The presence of leukocytes and lactobacillary grade were evaluated to classify a condition as AVF with inflammation; subsequently, bacterial cultures were performed. A total of 761 women were included. Five hundred and seventy-nine women were diagnosed with candidiasis, BV, trichomoniasis, or other types of vaginitis in which no pathogenic bacterial growth occurred in cultures. One hundred and eighty-two women (23.9 %) were diagnosed with AVF with inflammation (116 non-pregnant, 66 pregnant). Escherichia coli was the most common pathogen among these women (non-pregnant: 45.7 %, pregnant: 34.8 %). Other common pathogens were Group-B-Streptococcus (non-pregnant: 20.7 %, pregnant: 22.7 % respectively), Enterococcus faecalis (14.7 %, 18.2 %), and Klebsiella pneumoniae (6.9 %, 12.1 %). The prevalence of AVF with inflammation may be high. Since inflammation criteria were applied, most cases of BV were eliminated and the majority of cases of AVF are AV. Therefore, clinicians should include AV in the differential diagnosis of vaginitis, while microbiologists should take into account the growth of aerobic bacteria in vaginal cultures originating from women with microscopic findings of AV.
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Affiliation(s)
- G S Tansarli
- Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece
| | - T Skalidis
- Central Laboratories, Iaso Obstetrics, Gynecology and Children's Hospital, Iaso Group, Athens, Greece
| | - N J Legakis
- Central Laboratories, Iaso Obstetrics, Gynecology and Children's Hospital, Iaso Group, Athens, Greece
| | - M E Falagas
- Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece. .,Department of Internal Medicine - Infectious Diseases, Iaso General Hospital, Iaso Group, Athens, Greece. .,Department of Medicine, Tufts University School of Medicine, Boston, MA, USA.
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Kordinas V, Tsirpanlis G, Nicolaou C, Zoga M, Ioannidis A, Ioannidou V, Bersimis S, Petrihou C, Savva L, Legakis NJ, Chatzipanagiotou S. Is there a connection between inflammation, telomerase activity and the transcriptional status of telomerase reverse transcriptase in renal failure? Cell Mol Biol Lett 2016. [PMID: 26204404 DOI: 10.1515/cmble-2015-0016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Telomerase is involved in the elongation of telomeres. It remains active in very few types of cell in mature organisms. One such cell type is the lymphocytes. In this study, we investigated the activity and expression of telomerase in lymphocytes from renal failure patients and compared it to that for normal controls. Inflammation status was determined at the same time. The enzyme activity was measured using PCR-ELISA with peripheral blood mononuclear cells (PBMCs) from three groups: 53 healthy individuals, 50 patients with chronic kidney disease (CKD) and 50 dialysis patients. In the same cell populations, the expression of the reverse transcriptase of the human telomerase gene (hTERT) was measured via real-time PCR. The inflammationstatus of these individuals was determined by calculating the interleukin 6 (IL-6), IL-10, C-reactive protein (CRP) and tumor necrosis factor alpha (TNF-a) serum concentrations via ELISA. The lowest levels of telomerase activity were detected in CKD, and this group had the highest IL-6 and CRP values and the lowest hTERT expression. The dialysis group showed significant differences in comparison to the normal subjects and to the CKD patients. Further studies are warranted in order to explore the way inflammation influences telomerase activity and hTERT expression.
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Zioga A, Miriagou V, Tzelepi E, Douzinas E, Tsakiri M, Legakis NJ, Daikos GL, Tzouvelekis LS. The ongoing challenge of acquired carbapenemases: a hospital outbreak of Klebsiella pneumoniae simultaneously producing VIM-1 and KPC-2. Int J Antimicrob Agents 2010; 36:190-1. [PMID: 20510588 DOI: 10.1016/j.ijantimicag.2010.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 03/30/2010] [Accepted: 04/01/2010] [Indexed: 12/23/2022]
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4
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Miriagou V, Douzinas EE, Papagiannitsis CC, Piperaki E, Legakis NJ, Tzouvelekis LS. Emergence of Serratia liquefaciens and Klebsiella oxytoca with metallo-beta-lactamase-encoding IncW plasmids: further spread of the blaVIM-1-carrying integron In-e541. Int J Antimicrob Agents 2008; 32:540-1. [PMID: 18786812 DOI: 10.1016/j.ijantimicag.2008.06.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 06/07/2008] [Accepted: 06/16/2008] [Indexed: 10/21/2022]
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Papastathopoulou A, Bezirtzoglou E, Legakis NJ. Bacterioides fragilis: production and sensitivity to bacteriocins. Anaerobe 2007; 3:203-6. [PMID: 16887591 DOI: 10.1006/anae.1997.0106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/1996] [Accepted: 05/22/1997] [Indexed: 11/22/2022]
Abstract
Bacteriocin production and sensitivity to bacteriocins have been successfully applied as an epidemiological tool in several species of bacteria. However, little work has been carried out on the bacteriocins produced by Bacteroides fragilis, which is the most frequently isolated anaerobe species from clinical specimens. Thirty two clinical isolates of B. fragilis grown anaerobically on a 0.22 microm membrane filter spotted on an agar plate, were tested for bacteriocin production and used in a screen for bacteriocin sensitivity. Sensitivity to at least one bacteriocin was found in 94% of the strains, 62.5% were sensitive to two bacteriocins, whereas 34.4% were sensitive to three or more and finally one strain was found sensitive to 17 bacteriocins. Of the strains studied, 94% inhibited at least one strain, 66% inhibited two strains, and 30% inhibited at least three strains or more. Finally, one strain was extremely active by inhibiting the growth of 17 strains. Bacteriocin types are characterised by geographic variation, and their epidemiological investigation by a simple method could be promoted.
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Affiliation(s)
- A Papastathopoulou
- Microbiology Laboratory, Agia Sophia Children's Hospital, Goudi Athens, Greece
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6
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Mavrouli MD, Spanakis N, Levidiotou S, Politi C, Alexiou S, Tseliou P, Hatzitaki M, Foundouli K, Tsakris A, Legakis NJ, Routsias JG. Serologic prevalence of coxsackievirus group B in Greece. Viral Immunol 2007; 20:11-8. [PMID: 17425417 DOI: 10.1089/vim.2006.0085] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Coxsackieviruses are human enteroviruses, which have been associated with myocarditis/pericarditis and sudden death. In one investigation (Spanakis N, Manolis EN, Tsakris A, Tsiodras S, Panagiotopoulos T, Saroglou G, and Legakis NJ: J Clin Pathol 2005;58:357-360), a cluster of cases of fatal myocarditis in Greece was linked to coxsackievirus B3. The information from this investigation prompted us to study serologically the prevalence of coxsackieviruses B throughout Greece. Sera were obtained from 506 healthy blood donors from various transfusion centers, covering the entire country. All sera were tested for the presence of IgG and IgM antibodies, using ELISAs with various antigenic specificities: (1) heat-denatured coxsackievirus type B1 and B5 virions, (2) a synthetic peptide from the N terminus of the VP1 protein of coxsackievirus B3, and (3) a synthetic peptide from the N terminus of the VP1 protein of coxsackievirus B4. Sera positive for IgG antibodies against coxsackieviruses B1/B5, B3, and B4 were detected in 6.7 to 21.6% of the individuals tested in the various regions of Greece. Statistical analysis revealed that the highest prevalence of IgG antibodies against coxsackieviruses B1/B5 was found in blood donors from Crete (p = 0.025), whereas the highest prevalence against coxsackievirus B4 was detected in blood donors from Athens (p = 0.01). IgM antibodies against coxsackievirus B were detected at low percentage, less than 5%, with no significant viral preference for particular geographic regions. The preference of anti-coxsackievirus IgG antibodies for particular geographic regions could be potentially related to the previously reported clustering of cases of insulin-dependent diabetes mellitus and myocarditis in Athens and Crete, respectively.
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Affiliation(s)
- M D Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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7
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Paraskakis I, Kafetzis DA, Chrisakis A, Papavasilliou H, Kirikou H, Pangalis A, Tzouvelekis LS, Athanasiou T, Legakis NJ. Serotypes and antimicrobial susceptibilities of 1033 pneumococci isolated from children in Greece during 2001–2004. Clin Microbiol Infect 2006; 12:490-3. [PMID: 16643530 DOI: 10.1111/j.1469-0691.2006.01383.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Pneumococci (n = 1033) isolated in the major paediatric hospitals of Athens during 2001-2004 from children with invasive infections (n = 186), non-invasive infections (n = 641) and healthy carriers (n = 206) were studied. The most prevalent serotypes were serotypes 14 (44.6%), 19F (43.5%) and 6B (22.8%) in invasive, non-invasive and carriage isolates, respectively. Among invasive isolates, the potential coverage by the seven-valent conjugate vaccine was 75.3%. Resistance rates to penicillin, amoxycillin, cefotaxime, erythromycin, co-trimoxazole, clindamycin, tetracycline and chloramphenicol were 44.6%, 2.7%, 1.2%, 43.6%, 43.5%, 12.4%, 34.7% and 5.9%, respectively. The M-phenotype accounted for 68.0% of the erythromycin-resistant isolates. All isolates were susceptible to ofloxacin.
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Affiliation(s)
- I Paraskakis
- Clinical Microbiology Department of P. & A. Kyriakou (Annexe), Medical School, University of Athens, Aristofanous 56-58, Athens 152 32, Greece.
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8
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Pournaras S, Markogiannakis A, Ikonomidis A, Kondyli L, Bethimouti K, Maniatis AN, Legakis NJ, Tsakris A. Outbreak of multiple clones of imipenem-resistant Acinetobacter baumannii isolates expressing OXA-58 carbapenemase in an intensive care unit. J Antimicrob Chemother 2006; 57:557-61. [PMID: 16431857 DOI: 10.1093/jac/dkl004] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To investigate the resistance mechanisms and the genetic relationship of imipenem-resistant Acinetobacter baumannii isolates recovered in the intensive care unit (ICU) of a tertiary care hospital. METHODS Imipenem-resistant A. baumannii clinical and environmental isolates were collected in the ICU of the Red Cross General Hospital, Athens, Greece between March and October 2002. The isolates were tested by Etest MBL, PCR, RT-PCR and sequencing for carbapenemase-encoding genes, PFGE and synergy experiments using meropenem and the efflux pump inhibitor carbonyl cyanide chlorophenylhydrazone. RESULTS During the study period, 15 clinical and two environmental imipenem-resistant (MIC 8 to >128 mg/L) A. baumannii isolates were recovered. PFGE showed six different clones that included both clinical and environmental isolates. All 17 isolates were negative by Etest MBL and PCR for genes bla(IMP), bla(VIM), bla(SPM), bla(OXA-23-like) and bla(OXA-24-like). Genes bla(OXA-51-like) and bla(OXA-58-like) were amplified from 15 and 14 isolates, respectively. Sequencing of bla(OXA-51-like) amplicons identified bla(OXA-66) (nine cases) and bla(OXA-69) (six cases), whereas bla(OXA-58-like) sequences were classical bla(OXA-58). Reverse transcriptase-PCR showed that bla(OXA-51-like) genes were expressed in 12 and bla(OXA-58) in 10 isolates; in these isolates, inhibition of OXA enzymes by 200 mM of NaCl reduced carbapenem MICs by up to 4-fold. Overexpression of proton-gradient dependent efflux pumps did not contribute to carbapenem resistance in any isolate. Similarly, although AmpC expression was demonstrated in eight isolates, inhibition of AmpC with cloxacillin did not reduce the MICs of carbapenems significantly. CONCLUSIONS These findings indicate wide dissemination of OXA-58 carbapenemase, which contributes, at least partially, to the imipenem resistance of unrelated A. baumannii isolates in our ICU.
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Affiliation(s)
- S Pournaras
- Department of Microbiology, Medical School, University of Thessaly, Mezourlo, Larissa, Greece
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9
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Papaparaskevas J, Pantazatou A, Katsandri A, Legakis NJ, Avlamis A. Multicentre survey of the in-vitro activity of seven antimicrobial agents, including ertapenem, against recently isolated Gram-negative anaerobic bacteria in Greece. Clin Microbiol Infect 2005; 11:820-4. [PMID: 16153256 DOI: 10.1111/j.1469-0691.2005.01233.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The in-vitro activities of penicillin, ticarcillin-clavulanic acid, cefoxitin, imipenem, ertapenem, metronidazole and clindamycin were evaluated against 138 Gram-negative anaerobic isolates (82 Bacteroides fragilis group, 17 non-fragilis Bacteroides spp., 31 Prevotella spp., four Fusobacterium spp., two Veillonella spp., one Porphyromonas sp. and one Tissierella praeacuta) collected from six general hospitals in Athens, Greece. Overall rates of non-susceptibility (both resistant and intermediately-resistant) to penicillin and ticarcillin-clavulanic acid were 81.8% and 2.3%, respectively. The rates of non-susceptibility to cefoxitin and clindamycin were 30.3% and 31.1%, respectively, and that for metronidazole was 4.3% (four Prevotella spp. isolates, one Porphyromonas sp. isolate and one B. fragilis isolate). Only the single B. fragilis isolate was nim-positive by PCR. Only one B. fragilis isolate was resistant to both carbapenems tested, while six more Bacteroides spp. isolates were imipenem-susceptible and ertapenem-non-susceptible. The MIC range, MIC(50) and MIC(90) values were comparable for imipenem and ertapenem, although ertapenem MIC(90)s were one or two two-fold dilutions higher.
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Affiliation(s)
- J Papaparaskevas
- Department of Microbiology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
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10
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Politi L, Tassios PT, Lambiri M, Kansouzidou A, Pasiotou M, Vatopoulos AC, Mellou K, Legakis NJ, Tzouvelekis LS. Repeated occurrence of diverse extended-spectrum beta-lactamases in minor serotypes of food-borne Salmonella enterica subsp. enterica. J Clin Microbiol 2005; 43:3453-6. [PMID: 16000476 PMCID: PMC1169103 DOI: 10.1128/jcm.43.7.3453-3456.2005] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Screening of Greek nontyphoid salmonellae from 2000 to 2002 yielded three extended-spectrum beta-lactamase (ESBL)-producing human isolates. Salmonella enterica serotype Brandenburg harbored a multiresistant SHV-5 gene-carrying plasmid. S. enterica serotype Blockley and S. enterica serotype Hadar harbored a TEM-52 gene-carrying plasmid. An S. enterica serotype Virchow strain producing plasmid-mediated CTX-M-32 was isolated twice from poultry end products. All ESBL plasmids were self-transferable and carried by clones currently common in Greece.
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Affiliation(s)
- L Politi
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, M. Asias 75, Athens 11527, Greece
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11
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Pournaras S, Maniati M, Spanakis N, Ikonomidis A, Tassios PT, Tsakris A, Legakis NJ, Maniatis AN. Spread of efflux pump-overexpressing, non-metallo-β-lactamase-producing, meropenem-resistant but ceftazidime-susceptible Pseudomonas aeruginosa in a region with blaVIM endemicity. J Antimicrob Chemother 2005; 56:761-4. [PMID: 16115825 DOI: 10.1093/jac/dki296] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To investigate the resistance mechanisms of meropenem-resistant, ceftazidime-susceptible Pseudomonas aeruginosa isolates, in a clinical setting where VIM-2 or VIM-4 metallo-beta-lactamase (MBL)-producing pseudomonads are common. METHODS During May to December 2003, 13 consecutive meropenem-resistant, ceftazidime-susceptible P. aeruginosa isolates were recovered from separate patients at the University Hospital of Larissa, Thessaly, Greece. The isolates were studied by Etest MBL, PCR for blaVIM, blaIMP and blaSPM genes and PFGE. Experiments were performed to detect synergy between meropenem or other antimicrobials and the efflux pump inhibitor carbonyl cyanide-m-chlorophenylhydrazone (CCCP). The isolates were also tested by PCR and RT-PCR for the expression of the genes mexB and mexY, which encode the efflux pumps MexAB-OprM and MexXY-OprM. RESULTS Twelve of the isolates, belonging to six distinct PFGE types, gave negative results in the MBL Etest and lacked genes encoding MBLs but exhibited synergy between meropenem and CCCP, indicating that efflux pump activity contributed to the meropenem resistance. All 12 isolates were positive for mexB and 11 were also positive for mexY genes. RT-PCR showed that 10 and five isolates over-expressed mexB and mexY, respectively. One isolate was blaVIM-2-positive and did not show synergy with CCCP, or harbour mexB or mexY. CONCLUSIONS In our hospital, where MBL-producing P. aeruginosa were previously prevalent, meropenem resistance due to the overexpression of efflux pumps has also now emerged. Early recognition of this resistance mechanism should allow the use of alternative beta-lactams, such as ceftazidime, which would be inactive even against phenotypically susceptible MBL producers.
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Affiliation(s)
- S Pournaras
- Department of Microbiology, Medical School, University of Thessaly, Mezourlo, Larissa, Greece
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12
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Spanakis N, Manolis EN, Tsakris A, Tsiodras S, Panagiotopoulos T, Saroglou G, Legakis NJ. Coxsackievirus B3 sequences in the myocardium of fatal cases in a cluster of acute myocarditis in Greece. J Clin Pathol 2005; 58:357-60. [PMID: 15790697 PMCID: PMC1770614 DOI: 10.1136/jcp.2004.020099] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM The investigation of three fatal cases during a nationwide cluster of cases of an upper respiratory tract infection (URTI) associated with myocarditis and/or pericarditis in Greece in 2002. METHODS In the three women who died, necropsies were performed and tissue sections were taken for histological examination, antigen detection by immunohistochemistry and indirect immunofluorescence assay (IFA), amplification of viral genomes by nested reverse transcription polymerase chain reaction (RT-PCR), and sequence analysis. RESULTS All samples showed histological signs of active myocarditis. Immunohistochemistry revealed the presence of the enterovirus VP1 family of proteins and IFA revealed the presence of coxsackievirus B3 antigen. Nested RT-PCR amplified enteroviral alleles of the 5'-untranslated region which were identical to each other and to the coxsackievirus B3 sequences. CONCLUSIONS This study provides pathological evidence of enteroviral infection among fatal myocarditis cases in a nationwide URTI cluster of cases associated with myocarditis and/or pericarditis.
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Affiliation(s)
- N Spanakis
- Department of Microbiology, Medical School, University of Athens, 115 27 Athens, Greece
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13
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Chatzipanagiotou S, Michalopoulou M, Marinou I, Boufidou F, Papavasileiou E, Trikka-Graphakos E, Kabouri E, Nicolaou C, Legakis NJ. Investigation of possible cytokine induction in peripheral blood mononuclear cells by heat-stable serotypes of Campylobacter jejuni. Clin Microbiol Infect 2005; 11:63-5. [PMID: 15649306 DOI: 10.1111/j.1469-0691.2004.01038.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Several Campylobacter jejuni heat-stable (HS) serotypes have been associated with the autoimmune Guillain-Barre neurological syndrome (GBS). In order to examine the possible involvement of cytokines in this phenomenon, the levels of three pro-inflammatory cytokines (interleukin (IL)-2sRa, IL-6 and interferon (IFN)-gamma) and one anti-inflammatory cytokine (IL-10) were measured in peripheral blood mononuclear cells after induction by different C. jejuni serotypes. No differences were found for IL-6, IFN-gamma and IL-10, but the non-sialylated serotype HS:3 was associated with decreased production of IL-2sRa. The results raise the possibility that absence of sialylation might be associated with the inability to induce inflammatory factors such as cytokines.
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Affiliation(s)
- S Chatzipanagiotou
- Athens Medical School, Department of Clinical Microbiology, Aeginition Hospital, Athens, Greece.
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14
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Levidiotou S, Vrioni G, Papadogeorgaki H, Avdeliodi K, Kada H, Kaparos G, Kouskouni E, Fragouli E, Legakis NJ. Chlamydia trachomatis infections in Greece: first prevalence study using nucleic acid amplification tests. Eur J Clin Microbiol Infect Dis 2005; 24:207-13. [PMID: 15776253 DOI: 10.1007/s10096-005-1296-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present retrospective study was initiated to determine the prevalence of Chlamydia trachomatis and to assess the risk factors for infection in adult women and men presenting to general practitioners, gynecologists, dermatologists, and family-planning centers in Greece. The study was carried out in four different Greek hospital centers using highly sensitive nucleic acid amplification techniques. Altogether, 16,834 women and 1,035 men were enrolled from October 1998 to April 2004. Two types of specimens were collected from each patient: cervical swabs from women, urethral swabs from men, and first-catch urine from women and men. All specimens were examined with the Cobas Amplicor C. trachomatis polymerase chain reaction assay (Roche Molecular Systems, Branchburg, NJ, USA) or the LC x C. trachomatis ligase chain reaction assay (Abbott Laboratories, Abbott Park, IL, USA). Demographic and behavioral data were collected by clinicians using a standardized questionnaire. A total of 704 (3.9%) patients were infected with C. trachomatis. The prevalence among female patients was 3.5% and that among male patients 11.2%. Among infected patients, 88% were under 30 years of age, 71% reported more than one sexual partner, and 91% reported a new sexual partner within the last year. In conclusion, the prevalence of C. trachomatis infection in Greece is low. Young age and new and multiple sexual partners within the last year were factors consistently associated with an increased risk of chlamydial infection.
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Affiliation(s)
- S Levidiotou
- Department of Microbiology, Medical School, University of Ioannina, 45110, Ioannina, Greece.
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15
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Giakkoupi P, Tzouvelekis LS, Daikos GL, Miriagou V, Petrikkos G, Legakis NJ, Vatopoulos AC. Discrepancies and interpretation problems in susceptibility testing of VIM-1-producing Klebsiella pneumoniae isolates. J Clin Microbiol 2005; 43:494-6. [PMID: 15635025 PMCID: PMC540174 DOI: 10.1128/jcm.43.1.494-496.2005] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Susceptibilities to beta-lactam antibiotics of five VIM-1-producing Klebsiella pneumoniae isolates were determined by broth microdilution, Etest, disk diffusion, and the automated systems Vitek 2, Phoenix, and MicroScan. Significant discrepancies were observed in the determination of susceptibility to imipenem and meropenem. Interpretation problems by the automated systems were also noted.
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Affiliation(s)
- P Giakkoupi
- Department of Microbiology, National School of Public Health, 196 Alexandras Ave., Athens 11521, Greece
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16
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Chatzipanagiotou S, Kyriazi Z, Ioannidis A, Trikka-Graphakos E, Nicolaou C, Legakis NJ. Detection of chromosomal- and plasmid-encoded virulence-associated epidemiological markers in Yersinia enterocolitica strains isolated from clinical cases: a comparative study. ACTA ACUST UNITED AC 2004; 8:131-2. [PMID: 15527328 DOI: 10.1007/bf03260056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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17
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Tseliou PM, Spiliotakara A, Politis C, Spanakis N, Legakis NJ, Tsakris A. Prevalence of human T-cell lymphotropic virus-I/II-indeterminate reactivities in a Greek blood bank population. Transfus Med 2004; 14:253-4. [PMID: 15180821 DOI: 10.1111/j.0958-7578.2004.00509.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Expanded-spectrum cephalosporins (ESCs) such as ceftriaxone, together with fluorinated quinolones, are the choice antibiotics in the treatment of invasive salmonella infections. Resistance to ESCs among non-typhoid salmonella has been recognised since the late 1980s. Currently, ESC-resistant salmonella strains are reported world-wide and in some areas their incidence is significant. Resistance is mainly due to acquisition of multi-resistant plasmids encoding a variety of extended-spectrum and AmpC-type beta-lactamases. The origins of ESC-resistant salmonellae are diverse. Exchange of resistance determinants between salmonellae and nosocomial enterobacteria seems to be frequent, at least in developing countries. Also, the use of newer beta-lactams in animal husbandry and veterinary medicine may have facilitated the spread of ESC-resistant salmonella strains in livestock.
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Affiliation(s)
- V Miriagou
- Laboratory of Bacteriology, Hellenic Pasteur Institute, Athens, Greece
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Tsakris A, Tassios PT, Polydorou F, Papa A, Malaka E, Antoniadis A, Legakis NJ. Infrequent detection of acquired metallo-beta-lactamases among carbapenem-resistant Pseudomonas isolates in a Greek hospital. Clin Microbiol Infect 2004; 9:846-51. [PMID: 14616706 DOI: 10.1046/j.1469-0691.2003.00642.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study the possible distribution of metallo-beta-lactamases among nosocomial Pseudomonas isolates in a Greek hospital with a recent high prevalence of carbapenem-resistant Pseudomonas isolates. METHODS All carbapenem-resistant (imipenem- and/or meropenem-resistant) (MICs > 8 mg/L) Pseudomonas non-replicate isolates recovered from clinical infections in the Microbiology Laboratory of Saint Demetrios Hospital, Thessaloniki, Greece, from April 1998 to November 2000 were studied for the presence of metallo-beta-lactamases. They were tested by a disk diffusion test, PCR analysis, and nucleotide sequencing. DNA fingerprints were obtained by pulsed-field gel electrophoresis (PFGE) of XbaI-digested chromosomal DNA. RESULTS In total, 24 carbapenem-resistant isolates (23 P. aeruginosa and one P. putida) were recovered. The serotypes observed among the P. aeruginosa isolates were, in order of decreasing frequency, O:11 (52%), O:3 and O:12 (17% each), and O:6 (13%). PFGE grouped 17 of the P. aeruginosa isolates into four clusters, each containing from two to seven isolates, while the remaining isolates exhibited unique genotypes. blaVIM-2 was detected in the P. putida isolate and a P. aeruginosa serotype O:3 isolate. The latter strain was genotypically distinct from other contemporaneous or older carbapenem-resistant P. aeruginosa Greek isolates. CONCLUSION These findings suggest that, although the prevalence of metallo-beta-lactamases is low, the integron-associated blaVIM genes can spread to P. aeruginosa serotypes that have not been previously associated with carbapenem resistance in our region, as well as to other pseudomonal species.
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Affiliation(s)
- A Tsakris
- First Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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20
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Horianopoulou M, Kanellopoulou M, Paraskevopoulos I, Kyriakidis A, Legakis NJ, Lambropoulos S. Use of inhaled ampicillin–sulbactam against multiresistant Acinetobacter baumannii in bronchial secretions of intensive care unit patients. Clin Microbiol Infect 2004; 10:85-6. [PMID: 14706094 DOI: 10.1111/j.1469-0691.2004.00806.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Fotopoulou N, Tassios PT, Beste DV, Ioannidou S, Efstratiou A, Lawrence ER, Papaparaskevas J, George RC, Legakis NJ. A common clone of erythromycin-resistant Streptococcus pneumoniae in Greece and the UK. Clin Microbiol Infect 2003; 9:924-9. [PMID: 14616680 DOI: 10.1046/j.1469-0691.2003.00689.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the possible genetic relationship among erythromycin-resistant Streptococcus pneumoniae strains isolated in Greece and the UK. METHODS During 1995-97, 140 S. pneumoniae strains were isolated from clinical specimens submitted to the microbiology departments of the two main children's hospital in Athens. All erythromycin-resistant strains were further studied with respect to the presence of genes encoding for the two major mechanisms of macrolide resistance, their serotypes, and pulsed-field gel electrophoresis (PFGE) types, in comparison to a previously characterized UK erythromycin-resistant clone. RESULTS Eleven of the 140 isolates (7.9%) were resistant to erythromycin; nine of these were susceptible to penicillin. Serotyping allocated seven, three and one isolates to serotypes 14, 19F and serogroup 6, respectively. The mefA gene was detected in seven isolates (five serotype 14 and two serotype 19F), ermB in two (one serotype 19F and the serogroup 6 isolate), whilst in the remaining two isolates no resistance gene could be detected by polymerase chain reaction (PCR). Pulsed-field gel electrophoresis of genomic DNA showed that five Greek serotype 14 isolates belonged to the same chromosomal type as the serotype 14 erythromycin-resistant UK clone. CONCLUSIONS The present study showed that erythromycin resistance among the S. pneumoniae isolates was mostly owing to the efflux mechanism and suggested a possible clonal spread of serotype 14 erythromycin-resistant S. pneumoniae strains between Greece and the UK.
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Affiliation(s)
- N Fotopoulou
- Microbiology Department, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, GR 115 27 Athens, Greece
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22
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Vourli S, Tzouvelekis LS, Tzelepi E, Lebessi E, Legakis NJ, Miriagou V. Characterization of In111, a class 1 integron that carries the extended-spectrum beta-lactamase gene blaIBC-1. FEMS Microbiol Lett 2003; 225:149-53. [PMID: 12900034 DOI: 10.1016/s0378-1097(03)00510-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A class 1 integron, In111, carried by a self-transferable plasmid from an Escherichia coli clinical strain was characterized. The variable region of In111 constituted an array of gene cassettes encoding the extended-spectrum beta-lactamase IBC-1, the aminoglycoside-modifying enzymes AAC(6')-Ib and ANT(3")-Ia, dihydrofolate reductase I and a putative polypeptide (SMR-2) sharing similarity with the Qac transporters. Transcription of the gene cassettes was driven by a hybrid-type P1 promoter located in a typical 5' conserved segment (CS). The 3'CS included sulI, qacEDelta1, orf5 and orf6. In111 was bounded on the right by an inversely oriented IRt. The 5'CS was preceded by an intact IS26 element followed by an aphA1 gene.
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Affiliation(s)
- S Vourli
- Laboratory of Bacteriology, Hellenic Pasteur Institute, Vas. Sofias 127, Athens 11521, Greece
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23
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Giakkoupi P, Xanthaki A, Kanelopoulou M, Vlahaki A, Miriagou V, Kontou S, Papafraggas E, Malamou-Lada H, Tzouvelekis LS, Legakis NJ, Vatopoulos AC. VIM-1 Metallo-beta-lactamase-producing Klebsiella pneumoniae strains in Greek hospitals. J Clin Microbiol 2003; 41:3893-6. [PMID: 12904412 PMCID: PMC179807 DOI: 10.1128/jcm.41.8.3893-3896.2003] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Seventeen Klebsiella pneumoniae clinical isolates carrying the bla(VIM-1) metallo-beta-lactamase gene were collected in the intensive care units of three hospitals in Athens, Greece, in 2002. They exhibited various carbapenem resistance levels (Etest MICs of imipenem ranged from 4 to 32 microg/ml). All isolates gave positive results by the imipenem-EDTA synergy Etest. The isolates were classified into four main types by pulsed-field gel electrophoresis; the majority of the isolates (5 and 10 isolates) belonged to two types. The bla(VIM-1) gene cassette was part of the variable region of a class 1 integron that also included aac6, dhfrI, and aadA. This structure was carried by transferable plasmids.
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Affiliation(s)
- P Giakkoupi
- Departments of Hygiene and Epidemiology. Microbiology, Medical School, University of Athens, Athens, Greece
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Balis E, Boufas A, Iliopoulos I, Legakis NJ, Zerva L. Severe community-acquired pneumonia with acute hypoxemic respiratory failure due to primary infection with Chlamydia pneumoniae in a previously healthy adult. Clin Infect Dis 2003; 36:e155-7. [PMID: 12802780 DOI: 10.1086/375063] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2002] [Accepted: 01/10/2003] [Indexed: 11/03/2022] Open
Abstract
Community-acquired pneumonia due to Chlamydia pneumoniae is associated with a benign clinical course. Severe, life-threatening pneumonia is rare and occurs only in immunocompromised hosts. We report a case of severe pneumonia complicated by acute hypoxemic respiratory failure due to primary infection with C. pneumoniae in a previously healthy 46-year-old woman.
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Affiliation(s)
- Evangelos Balis
- Ninth Pulmonary Clinic, General Thoracic Hospital Sotiria, Athens, Greece
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25
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Pournaras S, Maniati M, Petinaki E, Tzouvelekis LS, Tsakris A, Legakis NJ, Maniatis AN. Hospital outbreak of multiple clones of Pseudomonas aeruginosa carrying the unrelated metallo-beta-lactamase gene variants blaVIM-2 and blaVIM-4. J Antimicrob Chemother 2003; 51:1409-14. [PMID: 12716773 DOI: 10.1093/jac/dkg239] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The possible contribution of metallo-beta-lactamases in the frequent detection of carbapenem-resistant Pseudomonas aeruginosa isolates in a tertiary Greek hospital in Central Greece was investigated. MATERIALS AND METHODS All carbapenem-resistant (imipenem- and/or meropenem-resistant) P. aeruginosa isolates recovered from separate patients during a 1 year period in the Clinical Microbiology Laboratory at the University Hospital of Thessaly, Larissa, Greece, were studied for metallo-beta-lactamases. They were tested by Etest MBL, PCR analysis and nucleotide sequencing. DNA fingerprints were obtained by pulsed-field gel electrophoresis (PFGE) of XbaI-digested chromosomal DNA. RESULTS A blaVIM gene was detected in 47 of the 53 (88.7%) carbapenem-resistant P. aeruginosa isolates. PFGE grouped the blaVIM-positive isolates in six unrelated genotypes; one type included two subtypes. Nucleotide sequencing of the PCR amplicons of a randomly selected isolate from each one of the seven subtypes, detected the variant sequences blaVIM-2 in four and blaVIM-4 in three cases, respectively. They were carried as single gene cassettes or along with an aminoglycoside resistance gene (aacA29a) in class 1 integrons. CONCLUSIONS These findings suggest that different strains of P. aeruginosa carrying unrelated metallo-beta-lactamase gene variants predominate in our hospital environment.
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Affiliation(s)
- S Pournaras
- Department of Microbiology, University Hospital of Thessaly, Mezourlo, Larissa 412 22, Greece.
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26
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Abstract
One hundred and twenty-one clinical isolates of Acinetobacter baumannii recovered from the intensive care units (ICUs) of nine tertiary-care hospitals in Athens, Greece were studied in order to determine whether the increasing appearance of resistant acinetobacters is due to the spread of epidemic strains. The majority of the isolates exhibited resistance to ampicillin-sulbactam, and the most common antibiotic resistance profiles comprised resistance to nine and eight of the 11 potentially active antibiotics tested, respectively. Pulsed-field gel electrophoresis showed that 68% of the isolates, recovered from all ICUs, belonged to two clonal groups, indicating inter-hospital dissemination of multiresistant A. baumannii in our region.
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Affiliation(s)
- A N Maniatis
- Department of Microbiology, School of Medicine, University of Thessaly, 22 Papakyriazi Str., 41222 Larissa, Greece.
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27
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Zachariadou L, Papaparaskevas J, Paraskakis I, Efstratiou A, Pangalis A, Legakis NJ, Tassios PT. Predominance of two M-types among erythromycin-resistant group A Streptococci from Greek children. Clin Microbiol Infect 2003; 9:310-4. [PMID: 12667242 DOI: 10.1046/j.1469-0691.2003.00493.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In order to investigate the potential relationship between erythromycin resistance and specific M-serotypes among clinical isolates of Streptococcus pyogenes from children in Greece, we randomly selected a total of 49 erythromycin-resistant (EryR) and 21 erythromycin-susceptible (EryS) isolates from the 1158 S. pyogenes isolates from the two main children's hospitals of Athens during the period October 1997 to October 1998. The isolates were further characterized by M-serotyping, examined for their susceptibility to penicillin, vancomycin and clindamycin, and categorized into resistance phenotypes. A total of 248 (21%) S. pyogenes isolates in the two main children's hospitals of Athens during the study period were resistant to erythromycin. All 49 EryR and 21 EryS isolates were susceptible to penicillin and vancomycin. With respect to erythromycin and clindamycin resistance, phenotypes M and IR MLSB dominated, with 30 and 17 isolates, respectively, two isolates belonged to the CR MLSB phenotype. Among the erythromycin resistant isolates, two M serotypes were dominant: M22 (30%) and M84 (41%). More specifically, M22 and M84 were most prevalent in resistance phenotypes IR MLSB (65%) and M (63%), respectively. In the susceptible group, no isolate belonged to these two M-serotypes, nor was a predominant serotype found. In contrast to susceptible isolates, two distinct M-serotypes were highly represented among EryR S. pyogenes isolates and predominantly associated with two distinct phenotypes.
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Affiliation(s)
- L Zachariadou
- Microbiology Department, 'Aghia Sophia' Children's Hospital, Athens, Greece
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28
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Tzelepi E, Magana C, Platsouka E, Sofianou D, Paniara O, Legakis NJ, Vatopoulos AC, Tzouvelekis LS. Extended-spectrum beta-lactamase types in Klebsiella pneumoniae and Escherichia coli in two Greek hospitals. Int J Antimicrob Agents 2003; 21:285-8. [PMID: 12636993 DOI: 10.1016/s0924-8579(02)00361-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Seventy-nine Klebsiella pneumoniae and 124 Escherichia coli clinical strains, isolated consecutively during August-October 2001 in two Greek hospitals, were examined for production of extended-spectrum beta-lactamases (ESBLs). Seventy-one (35%) isolates (46 K. pneumoniae and 25 E. coli) were ESBL-positive by phenotypic methods. Isoelectric focusing of beta-lactamases and PCR assays for bla genes showed that SHV-5-type ESBLs were the most frequent (45 isolates, 22%) followed by CTX-M (24 isolates, 12%) and IBC (three isolates, 1.5%). The latter two ESBL types may have been established recently in this setting.
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Affiliation(s)
- E Tzelepi
- Laboratory of Bacteriology, Hellenic Pasteur Institute, Athens, Greece
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29
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Lebessi E, Stamos G, Foustoukou M, Vourli S, Legakis NJ, Tzouvelekis LS. Performance of methods for detection of extended-spectrum beta-lactamases applied to clinical enterobacterial strains producing IBC-type beta-lactamases. J Clin Microbiol 2003; 41:912. [PMID: 12574316 PMCID: PMC149728 DOI: 10.1128/jcm.41.2.912.2003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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30
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Giakkoupi P, Petrikkos G, Tzouvelekis LS, Tsonas S, Legakis NJ, Vatopoulos AC. Spread of integron-associated VIM-type metallo-beta-lactamase genes among imipenem-nonsusceptible Pseudomonas aeruginosa strains in Greek hospitals. J Clin Microbiol 2003; 41:822-5. [PMID: 12574292 PMCID: PMC149675 DOI: 10.1128/jcm.41.2.822-825.2003] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Fifty-eight imipenem-nonsusceptible (MIC >or= 8 microg/ml) Pseudomonas aeruginosa strains isolated during May 2001 in 15 Greek hospitals were studied. Thirty-six isolates derived from nine hospitals carried VIM-type metallo-beta-lactamase genes, as found by PCR. In 34 isolates, bla(VIM) was associated with class 1 integrons of various sizes. DNA sequencing indicated the presence of bla(VIM-2) gene cassettes in a variety of integron structures. Random amplified polymorphic DNA typing suggested diversity of the bla(VIM)-positive strains. Synergy between 2-mercaptoacetic acid and imipenem indicated carbapenemase activity in 26 bla(VIM)-positive strains.
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Affiliation(s)
- P Giakkoupi
- Department of Hygiene & Epidemiology, Medical School, Athens University, Greece
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31
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Tzouvelekis LS, Lukova V, Tassios PT, Fluit AC, Jones RN, Legakis NJ. Resistance to beta-lactams among blood isolates of Salmonella spp. in European hospitals: results from the SENTRY Antimicrobial Surveillance Program 1997-98. Clin Microbiol Infect 2003; 9:149-52. [PMID: 12588337 DOI: 10.1046/j.1469-0691.2003.00507.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The susceptibility to beta-lactams and the beta-lactamase content of 110 Salmonella spp. blood isolates collected during 1997-98 in 19 European centers participating in the SENTRY Surveillance Program were studied. Thirty-one isolates (28%) were resistant to penicillins, due to production of TEM-1 (27 isolates), OXA-1 (three isolates) or TEM-1 + OXA-1 (one isolate). All OXA-1 producers and 10 TEM-1-producing isolates were also resistant to penicillin-clavulanic acid combinations. In the latter isolates, this phenotype was associated with increased production of TEM-1. Sixteen TEM-1-producing Salmonella Enteritidis isolates and one OXA-1-producing S. Typhimurium isolate were able to transfer beta-lactam resistance by conjugation.
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Affiliation(s)
- L S Tzouvelekis
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
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32
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Chatzipanagiotou S, Papavasileiou E, Panagea T, Makri A, Paraskaki I, Nicolaou C, Ioannidis A, Legakis NJ. Penicillin resistant Streptococcus pneumoniae isolated from infected children in Athens, Greece: resistance patterns, serotypes and penicillin-binding protein 2B mutation characterization by PCR. Int J Antimicrob Agents 2002; 20:147-9. [PMID: 12297366 DOI: 10.1016/s0924-8579(02)00121-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
An Escherichia coli clinical strain resistant to all beta-lactams except carbapenems was isolated in a Greek hospital. Analysis of beta-lactamase content by isoelectric focusing, PCR assays specific for various bla genes, and DNA sequencing showed that the strain produced TEM-1, a Citrobacter freundii AmpC-related cephalosporinase, and CTX-M-3. The blaCTX.M-3 gene was carried by a 120-kb plasmid that was readily transferable to a susceptible E. coli host.
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Affiliation(s)
- A Mavroidi
- Laboratory of Bacteriology, Hellenic Pasteur Institute, Athens, Greece
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34
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Petinaki E, Miriagou V, Tzouvelekis LS, Hatzi F, Legakis NJ, Maniatis AN. Evaluation of an anti-PBP 2a slide latex agglutination test in coagulase-negative staphylococci isolated in Greek hospitals. Diagn Microbiol Infect Dis 2002; 42:279-82. [PMID: 12007447 DOI: 10.1016/s0732-8893(01)00362-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Oxacillin resistance was examined in 258 coagulase-negative staphylococci from Greek hospitals. mecA DNA was detected in 168 isolates, which were also resistant to oxacillin by agar dilution and disk diffusion, according to the current NCCLS breakpoints. Both methods exhibited a relatively low specificity misclassifying 21 and 19 of the 90 mecA-negative isolates respectively as oxacillin resistant. In contrast, an anti-PBP 2a latex agglutination test, applied after induction by oxacillin, correctly classified 163 mecA-positive (sensitivity 97%) and 88 mecA-negative isolates (specificity 97.7%).
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Affiliation(s)
- E Petinaki
- Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece
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35
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Kanellopoulou M, Horiaropoulou M, Paraskevopoulos I, Lambropoulos S, Legakis NJ, Papafrangas E. Unusual nosocomial infection due to Pseudomonas aeruginosa. J Hosp Infect 2002; 50:239. [PMID: 11886208 DOI: 10.1053/jhin.2001.1183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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36
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Gaitanis G, Velegraki A, Frangoulis E, Mitroussia A, Tsigonia A, Tzimogianni A, Katsambas A, Legakis NJ. Identification of Malassezia species from patient skin scales by PCR-RFLP. Clin Microbiol Infect 2002; 8:162-73. [PMID: 12010171 DOI: 10.1046/j.1469-0691.2002.00383.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study was aimed at the development of a DNA-based procedure directly applicable to pathological skin scales and at the assessment of its value in rapid laboratory confirmation and identification of each of the seven Malassezia species. These lipophilic basidiomycetous yeasts in predisposed individuals are involved in pityriasis versicolor, seborrheic dermatitis, blepharitis, folliculitis, atopic dermatitis and fungemia. Standard identification procedures to species level are available, but so far no system for direct detection and characterization of Malassezia species in clinical specimens is available. METHODS Malassezia DNA was extracted from pathological skin scales by a modified hexadecyltrimethylammonium bromide (CTAB) method and amplified by single and nested polymerase chain reaction (PCR), assays using the general fungal ITS 1/4 and 3/4 primers for amplification of sequences from the Malassezia major ribosomal DNA complex. Restriction fragment length polymorphism (RFLP) analysis of PCR products was used in subsequent species identification. DNA extracted from culture-positive skin scales was also tested by PCR and the RFLP patterns obtained were analyzed. RESULTS A total of 36 isolates were tested. Distinct pure culture and skin-scale ITS 3/4 HinfI and AluI restriction patterns differentially identified M. furfur, M. globosa, M. restricta, M. sympodialis, M. pachydermatis, M. obtusa and M. slooffiae. Malassezia DNA was extracted from pathological skin scales and RFLP identified solitary and multiple Malassezia species in the same specimen. Molecular identification was confirmed by cultures and biochemical tests. Concurrent detection and identification of Candida and Yarrowia species was also feasible from skin scales. CONCLUSION The proposed method, described for the first time, could provide a sensitive and rapid detection and identification system for Malassezia species, which may be applied to epidemiological surveys and routine practice.
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Affiliation(s)
- G Gaitanis
- Department of Microbiology, Mycology Reference Laboratory, Medical School, University of Athens, Greece
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37
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Lebessi E, Dellagrammaticas H, Tassios PT, Tzouvelekis LS, Ioannidou S, Foustoukou M, Legakis NJ. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit in the high-prevalence area of Athens, Greece. J Clin Microbiol 2002; 40:799-804. [PMID: 11880396 PMCID: PMC120254 DOI: 10.1128/jcm.40.3.799-804.2002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (EPKP) strains are frequently implicated in outbreaks in neonatal intensive care units (NICUs). During the period from 1997 to 1998, 21 infections and 23 colonizations with EPKP were recorded in the NICU of a children's hospital in Athens, Greece. Seventeen of the infected and 12 of the colonized neonates had been referred from other hospitals. The remaining infections and colonizations occurred during the current hospitalization. Pulsed-field gel electrophoresis typing showed that the latter cases were due to an outbreak strain that persisted in the unit, while the repeated introduction of EPKP carriers was mostly due to clonal outbreaks in two maternity hospitals.
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Affiliation(s)
- E Lebessi
- Department of Microbiology, Neonatal Intensive Care Unit, P. & A. Kyriakou Children's Hospital, University of Athens, Athens, Greece
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38
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Paraskakis I, Stamos G, Stavrinadis CS, Lebessi E, Kallergi K, Kafetzis DA, Legakis NJ. Clinical microbiological case: facial inflammation in a child with a subnormal serum concentration of IgG2. Clin Microbiol Infect 2002; 8:45-6, 60-1. [PMID: 11906500 DOI: 10.1046/j.1198-743x.2001.00346.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- I Paraskakis
- Department of Microbiology, 'P. & A. Kyriakou' Children's Hospital, Athens, Greece.
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Dimopoulos G, Kostoula O, Logotheti M, Stratis A, Rasidakis A, Legakis N, Velegraki A. Crit Care 2002; 6:P92. [DOI: 10.1186/cc1797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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40
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Maniatis AN, Aqel A, Legakis NJ, Tzouvelekis LS, Maniatis N, Agel A. Mupirocin resistance in Staphylococcus aureus from Greek hospitals. Int J Antimicrob Agents 2001; 18:407-8. [PMID: 11691579 DOI: 10.1016/s0924-8579(01)00429-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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41
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Velegraki A, Kiosses VG, Pitsouni H, Toukas D, Daniilidis VD, Legakis NJ. First report of Cryptococcus neoformans var. gattii serotype B from Greece. Med Mycol 2001; 39:419-22. [PMID: 12054052 DOI: 10.1080/mmy.39.5.419.422] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
A plethora of cases of Cryptococcus neoformans infections have been recorded worldwide in immunocompromised individuals. The number of such cases showed a steady rise before 1981 and increased dramatically thereafter due to the AIDS epidemic. A similar pattern has been seen in Greece but, so far, infections appear to have been caused by C. neoformans var. neoformans. This paper describes for the first time two culture-proven C. n. var. gattii serotype B infections in Greece, one in an AIDS patient and one in a patient with systemic lupus erythematosus.
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Affiliation(s)
- A Velegraki
- Department of Microbiology, Medical School, University of Athens, Greece.
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Velegraki A, Kiosses VG, Kansouzidou A, Smilakou S, Mitroussia-Ziouva A, Legakis NJ. Prospective use of RFLP analysis on amplified Cryptococcus neoformans URA5 gene sequences for rapid identification of varieties and serotypes in clinical samples. Med Mycol 2001; 39:409-17. [PMID: 12054051 DOI: 10.1080/mmy.39.5.409.417] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Clinical isolates of Cryptococcus neoformans, whole blood, cerebrospinal fluid, bronchoalveolar lavage fluid from patients with positive cryptococcal antigen latex-agglutination test, and spiked clinical material from healthy individuals, were tested by polymerase chain reaction (PCR) with primers amplifying C. neoformans URA5 gene sequences. To test compatibility of different DNA extraction protocols with the PCR-restriction fragment length polymorphism (RFLP) assay, a commercial DNA extraction kit (XTRAX; Gull Laboratories, UT, USA) was used alongside with the hexadecyltrimethylammonium bromide (CTAB) method on spiked biological fluids. Both methods extracted DNA from spiked clinical samples containing C. neoformans (8 +/- 2 cells ml(-1)) and generated amplification products suitable for restriction enzyme analysis. Alu I digestion differentiated the two varieties of C. neoformans. Three distinct RFLP patterns were obtained upon restriction with MspI corresponding to serotypes A, AD and B, C and D. URA5 PCR followed by RFLP analysis, coupled with a sensitive in-house or commercially available DNA extraction method from clinical samples, could be successfully incorporated into rapid routine diagnostic strategies. It could also provide an expeditious tool for epidemiology-based population genetics studies.
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Affiliation(s)
- A Velegraki
- Department of Microbiology, Medical School, University of Athens, Greece.
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Nicolatou-Galitis O, Dardoufas K, Markoulatos P, Sotiropoulou-Lontou A, Kyprianou K, Kolitsi G, Pissakas G, Skarleas C, Kouloulias V, Papanicolaou V, Legakis NJ, Velegraki A. Oral pseudomembranous candidiasis, herpes simplex virus-1 infection, and oral mucositis in head and neck cancer patients receiving radiotherapy and granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash. J Oral Pathol Med 2001; 30:471-80. [PMID: 11545238 DOI: 10.1034/j.1600-0714.2001.030008471.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Oral pseudomembranous candidiasis (OPC) was evaluated in 61 patients receiving head and neck radiotherapy (RT). Herpes simplex virus-1 (HSV-1) reactivation was also investigated in 14 patients. According to the agreed protocol, granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash was administered in 46 patients with radiation-induced ulcers. Candidiasis was diagnosed in 31 patients. Candida albicans was the most frequent isolate. Multiple Candida species were isolated from the lesions of four patients. Concurrent candidiasis and radiation-induced ulcers were observed in 17 patients. Viral culture and the polymerase chain reaction disclosed the presence of HSV-1 in five patients. Twenty of the 46 patients, with initial mucositis grade II and grade III, completed RT with mucositis grade I, indicating a beneficial effect of GMCSF mouthwash, although further controlled studies are necessary to verify that. In conclusion, OPC was an important infection in patients undergoing radiotherapy. The role of HSV-1 in oral mucositis during head and neck radiotherapy needs additional study.
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MESH Headings
- Adenocarcinoma/radiotherapy
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Candida/classification
- Candida albicans/classification
- Candidiasis, Oral/drug therapy
- Candidiasis, Oral/etiology
- Carcinoma/radiotherapy
- Carcinoma, Squamous Cell/radiotherapy
- Dose Fractionation, Radiation
- Female
- Granulocyte-Macrophage Colony-Stimulating Factor/administration & dosage
- Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use
- Head and Neck Neoplasms/radiotherapy
- Herpesvirus 1, Human/genetics
- Herpesvirus 1, Human/growth & development
- Humans
- Lymphoma, Non-Hodgkin/radiotherapy
- Male
- Middle Aged
- Mouthwashes/therapeutic use
- Oral Ulcer/drug therapy
- Oral Ulcer/etiology
- Osteosarcoma/radiotherapy
- Pilot Projects
- Polymerase Chain Reaction
- Radiation Injuries/drug therapy
- Radiation Injuries/etiology
- Stomatitis/classification
- Stomatitis/drug therapy
- Stomatitis/etiology
- Stomatitis, Herpetic/drug therapy
- Stomatitis, Herpetic/etiology
- Treatment Outcome
- Virus Activation
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Affiliation(s)
- O Nicolatou-Galitis
- Department of Oral Pathology and Surgery, School of Dentistry, University of Athens, Greece.
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Kanellopoulou M, Stamos G, Petinnelli I, Savala M, Tzimogianni A, Legakis NJ, Foustoukou M, Papafragas E, Velegraki A. Subtyping and antifungal susceptibilities of Candida spp. in the intensive care unit of a Greek general hospital. Int J Antimicrob Agents 2001; 18:179-83. [PMID: 11516942 DOI: 10.1016/s0924-8579(01)00367-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study identified the Candida spp., susceptibility to antifungal agents and the prevailing Candida albicans subtypes responsible for infections or colonization of 42 patients in the ICU over a 6-month period. Most isolates were C. albicans (66.1%) and Candida tropicalis (28.3%) all of which were susceptible in vitro to antifungal agents. Subtypes of the C. albicans isolates were identified by pulsed field gel electrophoresis Sfi I chromosomal digests. Two major C. albicans subtypes were identified, whereas subtype heterogeneity was found among strains of Candida glabrata and C. tropicalis. Sfi I PFGE restriction patterns were able to discriminate between sub-populations of C. albicans isolates, clustering them into distinct, epidemiologically congruous groups.
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Affiliation(s)
- M Kanellopoulou
- Department of Microbiology, Sismanoglion District General Hospital, Greece
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Abstract
Human brucellosis poses a significant public health problem in many developing countries and requires fast and accurate diagnosis. A PCR assay amplifying part of the 31-kDa Brucella abortus antigenic protein gene sequence was developed and applied to whole-blood and serum samples from 31 brucellosis patients and 45 healthy individuals. All patients except one had detectable Brucella DNA in either whole blood or serum (combined sensitivity, 97%), but the assay sensitivity was higher with serum samples (94%) than with whole-blood samples (61%). The assay specificity was excellent (100%). A confirmatory PCR assay targeting another Brucella gene region (omp-2) was also developed but lacked sensitivity. Serum is the optimal specimen for the diagnosis of brucellosis by PCR, a choice that leads to assay simplification and shortens turnaround time.
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Affiliation(s)
- L Zerva
- Department of Microbiology, Medical School, National University of Athens, Athens, Greece.
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Ioannidou S, Tassios PT, Kotsovili-Tseleni A, Foustoukou M, Legakis NJ, Vatopoulos A. Antibiotic resistance rates and macrolide resistance phenotypes of viridans group streptococci from the oropharynx of healthy Greek children. Int J Antimicrob Agents 2001; 17:195-201. [PMID: 11282264 DOI: 10.1016/s0924-8579(00)00338-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A total of 200 isolates of viridans group streptococci isolated from the oropharynx of healthy Greek children were studied. Vancomycin, rifampicin, fluoroquinolones and dalfopristin/quinupristin were active against all tested isolates. High level resistance to gentamicin was not seen. Intermediate and high-level penicillin resistance was present in 28.5 and 14.5% isolates, respectively, with 41.3% of the latter group, being also resistant to cefotaxime. Resistance rates to other antimicrobials were as follows - erythromycin 38.5%, clarithromycin 33.5%, clindamycin 7.5% and tetracycline 23%. Penicillin resistance occurred more frequently in Streptococcus mitis isolates, while macrolide resistance was more frequent in S. oralis. MLSB resistance phenotype M was dominant (74%) among erythromycin resistant isolates, with phenotypes IR and CR being represented by 6 and 20% of isolates, respectively.
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Affiliation(s)
- S Ioannidou
- Department of Clinical Microbiology, P and A Kyriakou Childrens' Hospital, Thivon and Levadias 115 27, Athens, Greece.
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Kouppari G, Papadaki H, Arida C, Sakellariou J, Legakis NJ, Papaparaskevas J. First report of ampicillin and glycopeptide resistant Enterococcus faecium VanA bacteraemia in Greece. Int J Antimicrob Agents 2000; 16:254-6. [PMID: 11185546 DOI: 10.1016/s0924-8579(00)00228-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Deplano A, Schuermans A, Van Eldere J, Witte W, Meugnier H, Etienne J, Grundmann H, Jonas D, Noordhoek GT, Dijkstra J, van Belkum A, van Leeuwen W, Tassios PT, Legakis NJ, van der Zee A, Bergmans A, Blanc DS, Tenover FC, Cookson BC, O'Neil G, Struelens MJ. Multicenter evaluation of epidemiological typing of methicillin-resistant Staphylococcus aureus strains by repetitive-element PCR analysis. The European Study Group on Epidemiological Markers of the ESCMID. J Clin Microbiol 2000; 38:3527-33. [PMID: 11015358 PMCID: PMC87431 DOI: 10.1128/jcm.38.10.3527-3533.2000] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2000] [Accepted: 06/30/2000] [Indexed: 11/20/2022] Open
Abstract
Rapid and efficient epidemiologic typing systems would be useful to monitor transmission of methicillin-resistant Staphylococcus aureus (MRSA) at both local and interregional levels. To evaluate the intralaboratory performance and interlaboratory reproducibility of three recently developed repeat-element PCR (rep-PCR) methods for the typing of MRSA, 50 MRSA strains characterized by pulsed-field gel electrophoresis (PFGE) (SmaI) analysis and epidemiological data were blindly typed by inter-IS256, 16S-23S ribosomal DNA (rDNA), and MP3 PCR in 12 laboratories in eight countries using standard reagents and protocols. Performance of typing was defined by reproducibility (R), discriminatory power (D), and agreement with PFGE analysis. Interlaboratory reproducibility of pattern and type classification was assessed visually and using gel analysis software. Each typing method showed a different performance level in each center. In the center performing best with each method, inter-IS256 PCR typing achieved R = 100% and D = 100%; 16S-23S rDNA PCR, R = 100% and D = 82%; and MP3 PCR, R = 80% and D = 83%. Concordance between rep-PCR type and PFGE type ranged by center: 70 to 90% for inter-IS256 PCR, 44 to 57% for 16S-23S rDNA PCR, and 53 to 54% for MP3 PCR analysis. In conclusion, the performance of inter-IS256 PCR typing was similar to that of PFGE analysis in some but not all centers, whereas other rep-PCR protocols showed lower discrimination and intralaboratory reproducibility. None of these assays, however, was sufficiently reproducible for interlaboratory exchange of data.
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Affiliation(s)
- A Deplano
- Reference Laboratory for Staphylococci, Université Libre de Bruxelles, Hôpital Erasme, 1070 Brussels, Belgium
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Kyriakopoulos AM, Matsiota-Bernard P, Marinis E, Legakis NJ, Tassios PT. Comparison of Mycobacterium avium isolates from Greek AIDS and human immunodeficiency virus-negative patients by pulsed-field gel electrophoresis. Clin Microbiol Infect 2000; 6:490-5. [PMID: 11168183 DOI: 10.1046/j.1469-0691.2000.00131.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the chromosomal types of Mycobacterium avium strains infecting HIV-negative and AIDS patients in Greece. METHODS In total, 41 Mycobacterium avium isolates, 23 from AIDS and 18 from HIV-negative patients, were compared by pulsed-field gel electrophoresis of genomic DNA after XbaI digestion. The majority (87%) of AIDS isolates were from disseminated infection, while the majority (61%) of HIV-negative isolates were from children with cervical lymphadenitis. RESULTS Pulsed-field gel electrophoresis classified strains whose electrophoretic patterns were at least 85% similar into three clusters, A (four isolates), B (12 isolates), and C (15), while 10 isolates remained outside of these clusters. There was no statistically significant correlation of any PFGE cluster with a specific patient group. Within each patient group, no significant correlation of PFGE type with time, place of residence or, in the case of AIDS patients, hospital attended was observed. CONCLUSIONS Genotypic similarities between isolates responsible for disseminated infection in AIDS patients and lymphadenitis in HIV-negative children suggest that related strains, possibly from an environmental source, cause both types of infections.
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Abstract
The recent data concerning antibiotic resistance of the enterobacteria isolated in Greek hospitals are reviewed. A variety of mechanisms of resistance, clustered in most of the cases, was observed. Epidemics of plasmids were responsible for dissemination of third-generation cephalosporins, aminoglycosides, and trimethoprim resistance among Klebsiella pneumoniae and, to a lesser extent, Escherichia coli isolates. Stable depression of the expression of chromosomal cephalosporinase is the main cause of resistance to third-generation cephalosporins observed at high frequencies in Enterobacter spp. strains.
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Affiliation(s)
- N J Legakis
- Department of Microbiology, Medical School, University of Athens, Greece
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