Repeated Leftover Serosurvey of SARS-CoV-2 IgG Antibodies in Greece, May to August 2020.

A serosurvey of IgG antibodies against SARS-CoV-2 was conducted in Greece between May and August 2020. It was designed as a cross-sectional survey and was repeated at monthly intervals. The leftover sampling methodology was used and a geographically stratified sampling plan was applied. Of 20,110 serum samples collected, 89 (0.44%) were found to be positive for anti-SARS-CoV-2 antibodies, with higher seroprevalence (0.35%) observed in May 2020. The highest seroprevalence was primarily observed in the "30-49" year age group. Females presented higher seroprevalence compared to males in May 2020 (females: 0.58% VS males: 0.10%). This difference reversed during the study period and males presented a higher proportion in August 2020 (females: 0.12% VS males: 0.58%). Differences in the rate of seropositivity between urban areas and the rest of the country were also observed during the study period. The four-month infection fatality rate (IFR) was estimated to be 0.47%, while the respective case fatality rate (CFR) was at 1.89%. Our findings confirm low seroprevalence of COVID-19 in Greece during the study period. The young adults are presented as the most affected age group. The loss of the cumulative effect of seropositivity in a proportion of previous SARS-CoV-2 infections was indicated.

Combination of conventional culture, vial culture, and broad-range PCR of sonication fluid for the diagnosis of prosthetic joint infection.

We assessed the value of conventional culture, vial culture, and broad-range PCR of the sonication fluid (SF), individually or in combinations, for the diagnosis of prosthetic joint infection (PJI). We studied 114 consecutive patients (median age:72.5 years, males: 28.07%) undergoing removal of a total knee or hip prosthesis. By non-microbiologic criteria, 87 patients had aseptic failure, and 27 PJI. All patients had periprosthetic tissue culture, sonication of prosthesis, and study of SF by conventional and vial culture, and PCR. Compared to tissue culture, each test was significantly more sensitive and less specific. If only one test was positive, the sensitivity was 88.46% and specificity 64.29%. If all three SF tests were positive, sensitivity, and NPV were decreasing (34.6% and 80.23%), but specificity and PPV were increasing up to 98.57% and 90.9%, respectively, outperforming tissue culture. A triple negative test practically excluded PJI.

Sonication assisted microbiological diagnosis of implant-related infection caused by Prevotella disiens and Staphylococcus epidermidis in a patient with cranioplasty.

BACKGROUND: Infections present a major complication of cranioplasty procedures and in many cases removal of the implant material becomes a necessity. Sonication of the artificial implant material has been used during the last years, in order to facilitate better diagnosis of these infections, nevertheless its use in cranial implant infections is still limited. CASE PRESENTATION: A case of a 63-year-old Caucasian male patient who underwent a decompressive craniectomy, due to intracranial hemorrhage, and a consequent cranioplasty using an autogenic bone flap fixed by titanium clamps, is reported. After three unsuccessful cranioplasty efforts to repair a persistent skin defect, removing the bone flap and the titanium clamps was a necessity. Tissue and bone cultures were unable to reveal any microorganism whilst sonication of the removed titanium clamps and consequent culture of the resulting sonication liquid yielded Prevotella disiens and Staphylococcus epidermidis. The patient was treated with daptomycin and metronidazole until discharge and the skin defect was successfully repaired. CONCLUSION: The present case report indicates that the use of the sonication procedure assisted the microbiological diagnosis. This is the first known neurosurgical case of the implementation of the sonication procedure.