Molecular epidemiology of Bordetella pertussis in Greece, 2010-2015.

PURPOSE: To determine the predominant strains of Bordetella pertussis in Greece during 2010-2015. METHODOLOGY: Infants and children (n=1150) (15 days to 14 years) of Greek, Roma and immigrant origin with different vaccination statuses were hospitalized in Athens, Greece with suspected pertussis infection. IS481/IS1001 real-time PCR confirmed Bordetella spp./B. pertussis infection in 300 samples. A subset of samples (n=153) were analysed by multi-locus variable number tandem repeat analysis (MLVA) and (n=25) by sequence-based typing of the toxin promotor region (ptxP) on DNA extracted from clinical specimens.Results/Key findings. A complete MLVA profile was determined in 66 out of 153 samples; the B. pertussis MLVA type 27 (n=55) was the dominant genotype and all tested samples (n=25) expressed the ptxP3 genotype. The vaccine coverage in the Greek population was 90 %; however, the study population expressed complete coverage in 2 out of 264 infants (0-11 months) and in 20 out of 36 children (1-14 years). Roma and immigrant minorities represent 7 % of the Greek population, but make up 50 % of the study population, indicating a low vaccine coverage among these groups. CONCLUSIONS: The B. pertussis MT27 and ptxP3 genotype is dominant in Greek, Roma and immigrant infants and children hospitalized in Greece. Thus, the predominant MLVA genotype in Greece is similar to other countries using acellular vaccines.

Membranous nephritis associated with acquired cytomegalovirus infection in a 19-month-old baby.

Membranous nephritis (MN) is a rare form of glomerulonephritis in childhood, with an incidence of 0.8 to 6.7% based on renal biopsy specimens. Although the disease is considered to be idiopathic in the majority of cases, especially in adults, MN has been associated with various infectious agents, such as hepatitis Beta virus. The natural history of MN in childhood remains unknown because of its rarity, and to the best of our knowledge, no case of MN linked to cytomegalovirus (CMV) infection in an immunocompetent child has been described to date. We report here a 19-month-old female infant who presented with a maculopapular rash, fever, and nephritic-nephrotic syndrome. Virology tests for infectious diseases revealed a recent CMV infection. The renal biopsy findings were compatible with MN, while PCR analysis of the renal tissue specimen was positive for CMV DNA. Antiviral treatment (ganciclovir) resulted in full remission of proteinuria and hematuria. Two years after the initial diagnosis, the child remains well and asymptomatic without clinical or laboratory evidence of the disease.