A pilot sentinel surveillance system to monitor treatment and treatment outcomes of chronic hepatitis B and C infections in clinical centres in three European countries, 2019.

BackgroundThe World Health Organization European Action Plan 2020 targets for the elimination of viral hepatitis are that > 75% of eligible individuals with chronic hepatitis B (HBV) or hepatitis C (HCV) are treated, of whom > 90% achieve viral suppression.AimTo report the results from a pilot sentinel surveillance to monitor chronic HBV and HCV treatment uptake and outcomes in 2019.MethodsWe undertook retrospective enhanced data collection on patients with a confirmed chronic HBV or HCV infection presenting at one of seven clinics in three countries (Croatia, Romania and Spain) for the first time between 1 January 2019 and 30 June 2019. Clinical records were reviewed from date of first attendance to 31 December 2019 and data on sociodemographics, clinical history, laboratory results, treatment and treatment outcomes were collected. Treatment eligibility, uptake and case outcome were assessed.ResultsOf 229 individuals with chronic HBV infection, treatment status was reported for 203 (89%). Of the 80 individuals reported as eligible for treatment, 51% (41/80) were treated of whom 89% (33/37) had achieved viral suppression. Of 240 individuals with chronic HCV infection, treatment status was reported for 231 (96%). Of 231 eligible individuals, 77% (179/231) were treated, the majority of whom had received direct acting antivirals (99%, 174/176) and had achieved sustained virological response (98%, 165/169).ConclusionTreatment targets for global elimination were missed for HBV but not for HCV. A wider European implementation of sentinel surveillance with a representative sample of sites could help monitor progress towards achieving hepatitis control targets.

Adenosin triiphosphat Bioluminiscence Hospital Cleaning--A Method to Influence Invasive Fungal Infections.

Invasive fungal infections are infections determinate by fungal invasion and can be endogenous from patient mycobiome or through horizontal transmission from medical workers' hands and from patients hospital environment especially candidemia with C. parapsilosis. Candidemia is one of leading bloodstream infections associated with healthcare situated on fourth position and USA with high mortality rates especially for immunosuppressed patients. Demonstrating the level of cleaning using adenosine triphosphate bioluminescence technique we can improve the cleaning and hand hygiene and can influence decreasing of invasive fungal infections transmitted by hands. Material and methods: We have evaluated 200 samples from hands and patient environment on 2 hospitals with pneumology and infectious diseases profile (I and II) using bioluminescence to establish the status of hygiene and to determine measures of cleaning. Results: Regarding hand hygiene the level of relative light units over the values recommended by producer (FAIL) was 66% (6 of 9) in unit I and 75% in unit II (3 from 4). Regarding the level of cleaning in other places in direct contact with patients like toilets, bed bar, commodes the results were FAIL over 60%. Conclusions: In this moment in hospitals the hygiene is evaluated visually and no objective method was implemented beside the sanitation tests in Romania. ATP Bioluminescence evaluates in 15 seconds the level of cleaning in comparison with other methods and generates input in cleaning process, influencing indirectly decreasing hospital acquired infections including invasive fungal infections, together with other measures like education, antibiotic stewardship, increasing patient safety. In hospitals evaluated cleaning of hands and surfaces need improvement and investment in cleaning products and processes monitoring.

Two case reports on visceral leishmaniasis diagnosed in Romania.

Two cases of visceral leishmaniasis with a species from Leishmania donovani complex were detected in the Fundeni Clinical Institute. In one case, two infection sources were possible: one from Italy, where the patient worked three years, the other from the Southwest of Romania (Dolj County), where he was resident and where few human and canine leishmaniasis cases were registered in the past. In the second case, the patient lived in the Northeast of Romania (Iasi County), but worked in the same southwest zone. In both cases, a local transmission should be considered, situation that could amplify and extend in the future, supposing that increased temperatures will persist, favoring the persistence and multiplication of autochthonous and allochthonous Phlebotomus vector species.

The antitoxoplasma gondii antibodies incidence to the different ocular diseases patients cases of human ocular toxoplasmosis infections in Romania.

Toxoplasmosis is an anthropo-zoonosis widely spread around the earth, whose ocular complications are very frequent and are often a first sign of infestation. This is a retrospective statistic research based on the clinical survey and periodic control of a lot of 135 patients with toxoplasmosis, out of which 90 presented ocular toxoplasmosis.

Antimicrobial susceptibility of Staphylococcus aureus isolated from colonized hospital personnel.

The present study was performed to investigate the in vitro activity of oxacillin and other antimicrobial agents against S. aureus strains obtained from nursing personnel. We tested 127 S. aureus colonizing nasal mucous and hand skin and isolated from nursing personnel of University Hospital Department of Infectious Diseases, Iasi, during June 2005 period. Minimum inhibitory concentrations (MICs) were determined by the dilution method in Mueller-Hinton agar. Most of the S. aureus strains were susceptible to tested agents excepted erythromycin and azithromycin. Erythromycin and azithromycin resistance was observed among 29.1% respectively 22% of S. aureus strains. Vancomycin was active against all isolates. Teicoplanin was active against against all MRSA excepted one of the strain, with an reduced susceptibility. Linezolid has very good in vitro activity against staphylococci, with an MIC 90 of 2 mcg/ml and only 0.8% resistance. The MIC values range was between 0.5-2 mcg/ml. In conclusion, the usually hygienic methods (disposable gowns, hygienic hand disinfection after each patients contact, masks use when is a risk of aerosolization of MRSA) are indicate for significantly reducing of these strains.

[Clinical and epidemiologic assessment of a group of patients suffering from mumps, hospitalized in a 23 years period]. / Evaluari clinico-epidemiologice asupra unui lot de bolnavi cu parotidita epidemica spitalizati într-o perioada de 23 de ani.

Authors present the results of the evaluation of some epidemiological and clinical parameters, on a sample of 2101 inpatients suffering from mumps, hospitalized in the Clinic of Infectious Diseases Iasi, between 1981-2003. The annual hospitalization average was of 5.7%. Authors highlight a high incidence of mumps in males (68.1%), urban area (67.8%), and winter-spring season (62%). The most affected was the age group of 7-10 (21.5%), followed by 11-14 (17.3%), and 1-6 (16.7%) and inpatients over 20 years old registered 25.1%. The clinical forms were varied: 30.6% cases without the affection of other glands and organs; 26.1% associated meningitis; 15.6% with orchitis; 2.5% with pancreatitis. Meningitis and orchitis were pointed out as primary infection in 3.8% and 3.4% cases, respectively. The clinical manifestation forms were: mild (14.8%); medium (84.5%), and severe (0.5%) and 146 cases (6.9%) were registered as nosocomial infection. The nature of the epidemic foci was established retrospectively: school (5.9%), preschool (1.4%), and familial (92.7%). All these aspects highlight the necessity of the epidemiological surveillance of risk groups and the inclusion of anti-mumps vaccine-prevention in the Extended Immunization Program.

[Pulmonary alveolar proteinosis in AIDS patients]. / Proteinoza alveolara pulmonara la pacientii cu SIDA.

We present 4 patients with pulmonary alveolar proteinosis and AIDS which died in Infectious Disease Hospital Iasi in the interval January 2002-March 2003. The pulmonary tissue from the necropsy exam was stained with H.E., PAS, Alcian blue and Mucicarmine. The macroscopical examination revealed multiple yellow-gray nodular areas (>2 cm) of consolidation. Microscopically, the alveoli were filled with a delicate, granular, acidophil material that was periodic acid Schiff (PAS) positive. The intraalveolar material was Alcian blue and Mucicarmine negative, too.

[Cutaneous and oral manifestations in HIV-infected children and adults--169 cases]. / Manifestari cutaneo-mucoase în infectia HIV/SIDA. Consideratii pe 169 de cazuri.

UNLABELLED: The aim of the study was to evaluate cutaneous and oral manifestations in infected HIV patients. MATERIALS AND METHODS: We retrospectively analyzed 169 cases admitted in Infectiouse Disease Department of Iasi in 2001-2002 period. RESULTS: Cutaneous and oral manifestations were: candidiasis (99 cases), herpes virus infectious (36 cases), scabies and straphylococcal/streptococcal skin disease (26 cases), prurigo nodularis, psoriasis and verruca vulgaris (9 cases). Children of 0-13 year old group was 75.73 percent. Classification of HIV infection was related with CD4 count for 166 cases. Twelve cases with oral pharyngitis candidiasis, scabies and streptococcal skin diseases was 2-3 recurrent episodes of manifestations. Etiotrop treatment was associated with HAART therapy. CONCLUSIONS: Cutaneous and oral manifestations are occurred frequently in HIV infected patients, with a various etiology, but the severity, persistence and its evolution did not evaluate.

HIV type 1 diversity in northeastern Romania in 200-2001 based on phylogenic analysis of pol sequences from patient failing antiretroviral therapy.

Protease and the first half of reverse transcriptase from 71 Romanian patients failing highly active antiretroviral therapy (HAART) have been sequenced and phylogenetically analyzed. These analyses show that 70 patients were infected with subtype F1 and one with subtype C. The pattern of drug resistance mutations in subtype F1-infected patients failing HAART is similar to that described for subtype B strains. These results show that the diversity pattern of HIV type 1 infection in Romania has remained steady over a decade, with subtype F1 remaining the predominant viral form. The circulation of subtype F1 in Romania has the potential to be a source of this HIV-1 subtype in Europe..

[Fungal infection in AIDS patients. Consideration for 10 cases]. / Infectia fungica la bolnavii cu SIDA consideratii pe 10 cazuri.

Clinic, etiologic and therapeutic study of fungic infection in AIDS patients. The retrospective clinical study of the 10 AIDS patients admitted between 01.01.1994 and 31.12.2000 in Infectious Diseases Clinical Hospital of Iasi. The majority of the cases (7) were registered in the last 3 years: 4 children and 6 adults. HIV infection was known only for 4 patients according to their history, and for the other 6 patients this diagnosis was made concomitantly of fungic infection diagnosis. The disease onset was insidious in 7 cases (2 children and 5 adults) being characterized by manifestations of nervous system involvement and consciousness disturbances (6 cases). The etiological diagnosis was established for alive patients by cerebrospinal fluid culture and hemocultures and Cryptococcus neoformans was isolated for 9 patients and Candida to another one. Fungic infection lead to meningeal injuries to 6 patients and the systemic one in for 4 patients. Although, under antifungical and antiretroviral therapy, the disease was lethal for 4 patients. The fungic infection recrudesces in AIDS patients, possessing systemic or/and meningeal manifestation, long evolution that can be lethal for a lot of them.