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Traveler's diarrhea (TD) is a major public health problem affecting the activities of the individual, as well as through the possibility of spreading the disease in the population. This pathology has most commonly bacterial etiology, such as Enterotoxigen Escherichia coli, Enteroaggregative Escherichia coli, Campylobacter jejuni, Shigella spp. and Salmonella spp. Parasites involved in traveler's diarrhea are Giardia lamblia, Entamoeba histolytica and Cryptosporidium spp., and in terms of viruses, most commonly are the Noroviruses. Depending on epidemiological data, patient's symptoms and onset of the disease, the clinical suspicion of the diagnosis can turn towards one of the three etiologies, and just in specific cases will move toward additional appropriate microbiological diagnostic methods in order to establish a more accurate diagnose and to recommend the appropriate therapy. In most of the cases of TD, diagnose should be based on clinical data and treatment recommendations should be empiric (specific and nonspecific). Nevertheless, it is mandatory that each practitioner be aware and well informed that only through judicial epidemiologic and fundamental microbiologic analyses (taking into consideration their limits) there have been developed nowadays, simplified methods for diagnosing and treating TD, but very well adapted to each high risk region. [ABSTRACT FROM AUTHOR]

Chronic venous leg ulcers (CVLU) account for the final outcome of a far wider disease spectrum referred to as chronic venous disease. Physiological wound healing involves a three-stage process, with the coagulation/ inflammatory, granulation and epithelialization phases occurring successively. In the case of chronic wounds, such as CVLUs, the tissue damage and repair are misbalanced, resulting in the ulcer's lodging in a particular wound stage - the inflammation or granulation stage -, consequently impairing progression towards wound healing. Failure to rebuild the skin integrity may be due to a large number of factors, either endogenous - host factors determining or maintaining breaches in the protective barrier of the skin -, or exogenous, such as microbial biofilm infections. The future research should focus upon the study of wound microenvironment. The detection of specific biomarkers of chronic wound healing, as well as the discovery of therapeutic agents that target molecules involved in the pathogenic cascade would change the course of the disease. [ABSTRACT FROM AUTHOR]

Although controlled by vaccination long ago, diphtheria may become a re-emergent disease as a result of at least two factors: the circulation of toxigenic strains in endemic areas (countries of former CSI, some of them neighbouring countries of Romania) and the lack of interest of the local health institutions for surveillance of this very low incidence disease. The aim of this study was to evaluate the carriage of potentially toxigenic Corynebacterium strains in healthy people in Romania. In this study, 1120 biological samples were analysed consisting of swabs, nasal exudates and conjunctival secretions collected from 730 healthy individuals from eight different geographic regions of the country, in order to establish carriage of potentially toxigenic strains belonging to the Corynebacterium genus. 129 strains of the Corynebacterium species were isolated and identified by phenotypic and molecular methods: Corynebacterium pseudodiphtheriticum (n = 76), C. propinquum (n = 34), C. striatum (n = 9), C. macginleyi (n = 2), C. glucuronolyticum/seminale (n = 2), C. group F1(n = 6). These species are saprophytic species for the upper respiratory tract, some of them being an opportunistic pathogen especially in immunocompromised hosts. The present data require the attention of clinicians, epidemiologists and microbiologists since diphtheria is an infectious disease that could re-emerge. [ABSTRACT FROM AUTHOR]

About one-third of the world population is estimated to be infected with tuberculosis (TB), but the global incidence of TB appears to be declining slowly, with regional differences. Specific control measures are required and have been proposed to obtain a substantial reduction in the global TB burden. The advantages achieved so far are currently threatened by the emergence of highly drug-resistant forms of TB, the high prevalence of human immunodeficiency virus infection and the persisting global poverty. Socioeconomic development, but also access and quality of health services appear to be important in lowering the risk factors for TB. [ABSTRACT FROM AUTHOR]

Introduction. Blood borne infections have a decisive role in the evolution of the liver transplant patient. Detecting these infections remains an absolute priority. Objectives. To compare the ability of two automated microbiological screening systems (VersaTREK versus BACTEC 9050) in detecting the bacterial and fungal etiology of hemocultures in the curable-phases of infection in liver transplant patients, in order to apply the timely and guided antibiotic and antifungal treatment. Material and method. The microbiological study was performed on 60 liver transplant patients (38 men and 22 women) at the "Dan Setlacec" General Surgery and Liver Transplantation Centre from Fundeni Clinical Institute. This study was performed from February to November 2013, in patients with at least 2-3 episodes of transient bacteremia and / or in postoperative sepsis, with 1 to 30 CFU / ml blood the limit of detection. 480 blood cultures from both systems were collected, 240 aerobic and 240 anaerobic. VersaTREK bottles (Redox 1/40 ml, Redox 2/40 ml) were compared with aerobic and anaerobic standard BACTEC/F. By comparing these systems, we detected isolated bacteria and fungi from positive blood cultures. Results. The time to growth detection from the moment of incubation was 18 hours for all organisms on the VersaTREK system, with detection sensitivity of fewer than 20 CFU / ml, as compared to the BACTEC system where growth was detected at 24 hours. We isolated a percent of 30% Gramnegative bacilli (non-fermenters and fermenters), 21.6% MRSA and 6.6% Candida albicans. False positive results were detected - 16.6% for VersaTREK and 25% on BACTEC. Contaminations were particularly present when blood was drawn from an indwelling catheter and less often when a percutaneous venipuncture was performed. For the VersaTREK system, an inoculum of 0.1 ml yielded detection and isolation of germs after only 3 hours after incubation. Conclusions. Both systems were effective in detection of bacteria and fungi in liver transplant patients, but in the case of the VersaTREK system germs were detected and isolated from 0.1 ml inoculum at >3 hours from incubation [ABSTRACT FROM AUTHOR]

Introduction. Blood borne infections have a decisive role in the evolution of the liver transplant patient. Detecting these infections remains an absolute priority. Objectives. To compare the ability of two automated microbiological screening systems (VersaTREK versus BACTEC 9050) in detecting the bacterial and fungal etiology of hemocultures in the curable-phases of infection in liver transplant patients, in order to apply the timely and guided antibiotic and antifungal treatment. Material and method. The microbiological study was performed on 60 liver transplant patients (38 men and 22 women) at the "Dan Setlacec" General Surgery and Liver Transplantation Centre from Fundeni Clinical Institute. This study was performed from February to November 2013, in patients with at least 2-3 episodes of transient bacteremia and / or in postoperative sepsis, with 1 to 30 CFU / ml blood the limit of detection. 480 blood cultures from both systems were collected, 240 aerobic and 240 anaerobic. VersaTREK bottles (Redox 1/40 ml, Redox 2/40 ml) were compared with aerobic and anaerobic standard BACTEC/F. By comparing these systems, we detected isolated bacteria and fungi from positive blood cultures. Results. The time to growth detection from the moment of incubation was 18 hours for all organisms on the VersaTREK system, with detection sensitivity of fewer than 20 CFU / ml, as compared to the BACTEC system where growth was detected at 24 hours. We isolated a percent of 30% Gramnegative bacilli (non-fermenters and fermenters), 21.6% MRSA and 6.6% Candida albicans. False positive results were detected - 16.6% for VersaTREK and 25% on BACTEC. Contaminations were particularly present when blood was drawn from an indwelling catheter and less often when a percutaneous venipuncture was performed. For the VersaTREK system, an inoculum of 0.1 ml yielded detection and isolation of germs after only 3 hours after incubation. Conclusions. Both systems were effective in detection of bacteria and fungi in liver transplant patients, but in the case of the VersaTREK system germs were detected and isolated from 0.1 ml inoculum at >3 hours from incubation [ABSTRACT FROM AUTHOR]

This article consists of a literature review on main actual issues related to Lyme disease / Borreliosis. Lyme disease is produced by Borrelia burgdorferi spirochetes and is transmitted by ticks of the genus Ixodes (tickborne illness) and for instance in the USA is considered to be four times more frequent than another very severe infectious disease: AIDS(1-6). This spirochete cycles between tick and their vectors including reptiles, birds, mamifers (rodents, deer)(3,4,6). The most common simptoms after the tick bite is a skin rash called erythema migrans which may be followed by fatigue, musculoskeletal and/ or neurologic symptoms and/or cardiac abnormalities after a few weeks or months(3-6). In a synthetic overview, the Lyme disease is characterized as "a complex, immune mediated, multisystem disorder, which has infectious origin and inflammatory expression" (7). The neurologic, arthritic and ophthalmologic are the most invalidating conditions among those generated by such a disease and respectively, the cardiological ones are possibly life-threatening. Especially the severe consequent neuro-locomotor disabling sequels often lead, also to family/ work/ social impairments, sometimes with poor possibilities of re-integration - all the more so in times of economic crises - peaking dependent on wheelchairs or bedridden. Lyme disease diagnosis is primarily clinical/ epidemiological, the laboratory tests being useful to confirm/ exclude any infection. Yet, the diagnosis matter is still subject to scientific and practical debates and attempts at improving. The same goes for the pharmacologic treatment against this infection: currently, there is no unanimously accepted antibiotherapy approach in Borreliosis, but there are various therapeutic options among which, doctors may choose. [ABSTRACT FROM AUTHOR]

Background & objectives: Purified protein derivative (PPD) is currently the only available skin test reagent used worldwide for the diagnosis of tuberculosis (TB). The aim of this study was to develop a Mycobacterium tuberculosis specific skin test reagent, without false positive results due to Bacillus Calmette-Guerin (BCG) vaccination using recombinant antigens. Methods: Proteins in PPD IC-65 were analyzed by tandem mass spectrometry and compared to proteins in M. tuberculosis culture filtrate; 54 proteins were found in common. Top candidates MPT64, ESAT 6, and CFP 10 were overexpressed in Escherichia coli expression strains and purified as recombinant proteins. To formulate optimal immunodiagnostic PPD cocktails, the antigens were evaluated by skin testing guinea pigs sensitized with M. tuberculosis H37Rv and BCG. Results: For single antigens and a cocktail mixture of these antigens, best results were obtained using 3 µg/0.1 ml, equivalent to 105 TU (tuberculin units). Each animal was simultaneously tested with PPD IC- 65, 2 TU/0.1 ml, as reference. Reactivity of the multi-antigen cocktail was greater than that of any single antigen. The skin test results were between 34.3 and 76.6 per cent the level of reactivity compared to that of the reference when single antigens were tested and 124 per cent the level of reactivity compared to the reference for the multi-antigen cocktail. Interpretation & conclusions: Our results showed that this specific cocktail could represent a potential candidate for a new skin diagnostic test for TB. [ABSTRACT FROM AUTHOR]

Epidemiology of Bordetella pertussis infection shows an universal re-emerging pattern, independent of the increased rate of vaccination in some countries. Whooping cough can affect people of any age, as it is highly contagious, but unvaccinated infants and children possess a high risk of developing life-threatening complications. Acquiring anti-pertussis antibodies through active immunization, naturally (post-infection) or artificially (post-vaccination), do not confer life-long immunity. The acellular component of pertussis vaccine DTaP (diphtheria-tetanus-acellular pertussis) is commonly used in the vaccination schedules, but new results of research studies show that the vaccine DTwP, which contains a whole-cell pertussis component (wP), provides a better protection against infection and an acceptable rate of adverse events. In addition to this, from the economic point of view, the cost-efficiency of DTwP vaccine is estimated to be higher. Improving the level and quality of immunization at a populational level is the best method of protection against pertussis. Adopting new strategies which contain the whole-cell pertussis component could successfully obtain a decrease in the incidence of infection and confer an appropriate durable immunity. [ABSTRACT FROM AUTHOR]

The risk of transmission and the death rate of vaccinepreventable diseases require constant review of national immunization programs' efficacy, in order to increase the compliance of the general population. Last year, in Spain, a child died following an infection with Corynebacterium diphtheriae and this case produced a “state of alert” about the importance of international vaccination coverage for preventable diseases and also about the the need for the existence of diphtheria antitoxin (DAT) as national supplies. The National Reference Centre from Belgium confirmed a case of diphtheria on the 15th of March, 2016 in a 3‑year‑old child, in the city of Antwerp (Anvers). It should be mentioned that she was not vaccinated against diphtheria. She has been hospitalized on the 11th of March, in an intensive care unit, with symptoms for the last five days. In the absence of national production of diphtheria antitoxin (DAT), which is the treatment of choice for diphtheria, the Scientific Institute of Public Health asked the European Centre for Disease Prevention and Control (ECDC) on the 16th of March. ECDC facilitated the immediate supplementation of DAT from the Netherlands. Despite the antitoxin administration on the 16th of March, the child died the next day. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is an important public health issue, in terms of incidence and mortality, with approximately 1.8 million new cases reported worldwide in 2018. Advancements in understanding pathophysiological key steps in CRC tumorigenesis have led to the development of new targeted therapies such as those based on epidermal growth factor receptor inhibitors (EGFR inhibitors). The cutaneous adverse reactions induced by EGFR inhibitors, particularly papulopustular rash, often require long-term antibiotic treatment with tetracycline agents (mostly minocycline and doxycycline). However, this raises several issues of concern: possible occurrence of gut dysbiosis in already vulnerable CRC patients, selection of highly antibiotic resistant and/or virulent clones, development of adverse reactions related to tetracyclines, interference of antibiotics with the response to oncologic therapy, with a negative impact on disease prognosis etc. In the context of scarce information regarding these issues and controversial opinions regarding the role of tetracyclines in patients under EGFR inhibitors, our aim was to perform a thorough literature review and discuss the main challenges raised by long-term use of tetracyclines in advanced CRC patients receiving this targeted therapy. [ABSTRACT FROM AUTHOR]

Introduction: Bacterial growth in liquid growth medium, in the absence of cell agitation subjects the microorganisms to different oxygenation regimes, due to limitation in oxygen diffusion rate. When oxygen itself is limited, microorganisms will grow in anaerobic and microaerophilic conditions. The goal of this paper is to present the differences in bacterial growth associated with variations in residual oxygen inside the microcalorimetric cells. Materials and Methods: The bacterial strain chosen for this investigation was Escherichia coli (ATCC 25922). The studied inoculum represents a hundred fold dilution of a 0.1 McFarland units suspension, subjected to stationary growth, lacking homogenization, at 37°C in a differential scanning Setaram microDSC III microcalorimeter. To explore the metabolism in the context of limited oxygen supply, the bacterial suspension was cultivated in Hastelloy cells, hermetically sealed with silicon o-rings, provided by the manufacturer. The total efficient volume of the cell is 0.94ml. The volume of residual air (and implicitly, of oxygen) in the headspace of the cell was adjusted by addition to the bacterial suspension of Physiological Saline (PS). Results: The comparison the growth curves obtained by recording the growth of 0.6 ml of suspension with those of 0.3 ml and 0.3 ml with addition of 0.3 ml PS shows the differences in bacterial metabolism when oxygen and nutritive medium are in different volumes. Reducing of the bacterial suspension by half resulted in decrease in the intensity of the first peak, while at the same time leading to increase in the second peak. The addition of PS maintained roughly the same first peak intensity, while bringing the second peak intensity to its original level. Discussions: Published studies of microbial microcalorimetry do not present data of base processes that lead to generation of the microcalorimetric curve. This first experimental analysis of bacterial growth helps in understanding the processes of growth under limited oxygen conditions. We propose that differences in remaining oxygen inside the microcalorimetric cells would, in part, be responsible for the variability seen in the specialty literature. [ABSTRACT FROM AUTHOR]