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Staphylococcus aureus, a prevalent human pathogen and a leading cause of hospital-acquired infections, is increasingly evolving antibiotic-resistant strains, increasing mortality and morbidity rates. Anti-staphylococcal vaccine research for prevention and treatment has become a priority. Antibodies against specific S. aureus components, toxins, and polysaccharides have demonstrated encouraging results in animal studies regarding protection against colonization or infection. However, human immunization trials have yielded less optimistic outcomes, with no anti-staphylococcal having passed clinical trials up to now. Although multiple formulation attempts triggered strong antibody responses, the vaccines could not effectively prevent S. aureus infections. This article delves into the results of immunotherapeutic strategies against S. aureus in both animal and human studies, discussing the feasibility of adequate immunization approaches against S. aureus in humans. [ABSTRACT FROM AUTHOR]

Diarrhoea represents a significant public health concern worldwide and is responsible for an increase in mortality and morbidity, especially among children but also among adults. Cryptosporidium, one of the most common intestinal protozoan parasites, is the etiological agent of cryptosporidiosis, an acute infection with self-limiting evolution, but that can evolve into severe diarrhoea in children and immunosuppressed hosts. The main species that cause human cryptosporidiosis are C. parvum and C. hominis. Despite the progress made in order to control and monitor cryptosporidiosis at the global level, numerous outbreaks have been reported with the source of infection being food or water. Using Promedmail.org we have performed a review of Cryptosporidium related outbreaks reported in the last 10 years over the world. [ABSTRACT FROM AUTHOR]

Predecessors in the Romanian School of Microbiology established several golden guidelines for the clinical integration of the microbiology laboratory, the clinical rationale behind the infectious disease patients, and the antibiotic administration. However, without a determined mind to continue, strengthen, and nurture the work they have undertaken, professors Ion Cantacuzino, Victor Babes, and Matei Bals' expertise would have vanished [1-3]. Professor Angelescu proved to be the ideal individual right when he was most needed, determined to carry on their legacy, to further advance antibiotic knowledge, and a patient, father-like figure to his younger colleagues. He answered the invitation to become a leading authority at a time when advances in the science of antibiotics had doctors puzzled. The "Angelescu's Guide" was intended to be a lifeline for what would soon become one of the major challenges of the twenty-first century: antibiotic resistance in delicate clinical settings. Actual, achievable strategies for the care of an infectious illness patient are provided below, as are pertinent research recommendations for younger and fresher medical minds. [ABSTRACT FROM AUTHOR]

Despite the global economic development, diarrhoea remains an important health concern worldwide. The epidemiological importance of Shigella spp. infections is very high, being the leading cause of bacterial diarrhoea. Clinically, shigellosis can manifest as watery diarrhoea or dysentery, with bloody stool, accompanied by fever and abdominal pain. Children and the elderly are most susceptible to developing severe forms. In this review, we highlight the rise of antibiotic-resistant Shigella spp. strains and provide an overview of recent shigellosis outbreaks. Shigellosis is an infectious disease that should not be neglected, as evidenced by the many outbreaks reported throughout the world. [ABSTRACT FROM AUTHOR]

Malaria is a serious and, in some unfortunate cases, fatal disease caused by a parasite of the Plasmodium genus. It predominantly occurs in tropical areas where it is transmitted through the bite of an infected Anopheles mosquito. The pathogenesis of malaria is complex and incompletely elucidated. During blood-stage infection, in response to the presence of the parasite, the host's immune system produces proinflammatory cytokines including IL-6, IL-8, IFN-γ, and TNF, cytokines which play a pivotal role in controlling the growth of the parasite and its elimination. Regulatory cytokines such as transforming growth factor- (TGF-) β and IL-10 maintain the balance between the proinflammatory and anti-inflammatory responses. However, in many cases, cytokines have a double role. On the one hand, they contribute to parasitic clearance, and on the other, they are responsible for pathological changes encountered in malaria. Cytokine-modulating strategies may represent a promising modern approach in disease management. In this review, we discuss the host immune response in malaria, analyzing the latest studies on the roles of pro- and anti-inflammatory cytokines. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) poses a medical, social, and economic problem. In Romania since 2002, the prevention of HIV transmission and the care for HIV-positive people have been overseen by Governmental Law. HIV infection in Romania has some particularities, such as the high number of HIVinfected patients under treatment and the high percentage of long-term survivors. Romania reported its first case of AIDS to the World Health Organization in 1985, and its first case in the pediatric population in 1989. A year later, a new case definition, based on local possibilities was formulated together with the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC, Atlanta, GA). According to the latest report of the Compartment for Monitoring and Evaluation of HIV/AIDS in Romania, the cumulative number of HIV cases registered between 1985-2021 was 26,171, while the number of people living with HIV at the end of December 2021 was 17,271. [ABSTRACT FROM AUTHOR]

Providential personalities have been writing history since the beginning of times - personalities that could be found within and across Romania's borders [1]. In medicine, such brilliant figures have healed patients through diligence, dedication, and professionalism, but have also passed significant teachings to the next generations. They have rigorously respected an authentic professor's definition, a figure that teaches and prepares specialists for the future. The great medical personalities, Ion Cantacuzino and Victor Babeș, have been mentored by famous professors, have also become famous professors on their own, and they have educated doctors and professors who have carried on their research and medical teaching legacies. Through study, through diligence, and an impressive personal development, their students have also become proficient figures in medicine [1-2]. They have trained personalities in the medical field that could have reached higher peaks, were it not for the political and social climate of their country. Among those, now we shall bring into discussion professor Matei Balș, a remarkable man and teacher, whose contribution focused the necessity of employing strict and correct means of practice, tying together in an organic way the clinical and the laboratory work, a dogma which he has passed on to his students. He has funded the "School of Infectious Diseases" at Colentina Hospital and has formulated teachings that stand the test of time; his working approach is still appropriate and praised today. The current generation as well as future ones not only have the obligation to recognise the exceptional achievements of our ancestors in history, but to also keep them alive and develop upon them, in the interest of the Romanian people, Romania itself, but also for the public health system at an international level [1]. [ABSTRACT FROM AUTHOR]

Providential personalities are an essential, unifying, element across cultures, omnipresent in the world's history [1]. Professor Victor Babeș, a distinguished figure in pathology, microbiology and virology, attended high school in Budapest and pursued his higher medical education in Budapest and Wien. He lectures at the pathology department of the University of Budapest at only 18 years of age. In 1885, he co-authored the first Bacteriology Treaty in Paris alongside Cornil. In 1887, he went on to establish the pathology and bacteriology departments at the Faculty of Medicine, in Bucharest. He contributed to the medical world literature with over 1000 papers, written in different languages. Professor Victor Babeș studied bacteria, viruses, parasites and influenced preventive medicine. Overall, he discovered more than 50 new microbes. An entire book may be devoted just to his pathological discoveries (cancer, leprosy, tuberculosis, diphtheria, actinomycosis, anthrax, syphilis, plague, rabies, etc.). In 1912 he published (in Paris) a vast treaty on rabies; he dedicated 90 of his best works to rabies. Victor Babeș National Institute of Research and Development in Pathology and Biomedical Sciences has been founded on the 28th of April 1887 by Professor Victor Babeș. Initially constituted as a "Bacteriology and Pathology Institute", it was able to comply with one of the most demanding medical needs of the time and it has contributed to finding realistic solutions regarding medical organization. In terms of importance and activity, the institute represented a prefiguration of the future Ministry of Health [2]. Professor Babeș's life should be remembered for his works that marked the opening of new horizons and for a personality whose genius echoes to this day. [ABSTRACT FROM AUTHOR]

Acute diarrheal disease remains a major public health issue. Salmonella spp. infection is one of the leading causes of acute diarrheal disease despite the preventive measures implemented. The clinical picture of salmonellosis varies from a common gastroenteritis to enteric fevers which are life-threatening diseases requiring a prompt and correct antibiotic treatment. In this review we present recent salmonellosis outbreaks and point out that Salmonella infections continue to be an important health issue. Numerous outbreaks of Salmonella spp. have been reported worldwide in recent years, indicating that prevention and control programs need to be improved as well as the infectious diseases surveillance, all over the world. [ABSTRACT FROM AUTHOR]

Providential personalities are an essential, unifying, element across cultures, omnipresent in the world's history. They are one of a kind, born every century or even more than a hundred years apart, and their emergence is conditioned by specific factors and even circumstances. Among Romania's historical personalities, Professor Cantacuzino's name and achievements could not be contained within the country's borders. His genius has left its mark not only on the Romanian public health system, or even the nearby Balkan area, but has echoed way further than Europe at that time. The conscious effort he made to offer more than he had previously received stemmed from his exceptional personal development work. A multifaceted persona like few have been, he has managed to acquire great insights into many subjects and, more importantly, he had the character and strength to establish a Healthcare Legacy and an Institute that will soon celebrate 100 years of existence. The current generation and the ones to come should learn their history and praise the achievements of their ancestors, while also preserving and further cultivating them, for the good of Romanian citizens, Romania and the global health system. [ABSTRACT FROM AUTHOR]

Difficult-to-treat infections produced by Pseudomonas aeruginosa have a long evolution with a great impact not only in regard to the patient's health, but also to his well-being, the public health and economy. Considering that not only the antimicrobial resistance, but other characteristics of these strains may be involved in the longue and difficult evolution of this infections; we evaluated the ability to produce biofilm on inert substrate through a microdilution method. We evaluated 25 strains of P. aeruginosa isolated from infections with a longue evolution. Most of the strains produced an important biofilm, especially at 48 hours, presenting an interesting architecture, suggesting the ability to persist. These findings highlight the impact of biofilm production in P. aeruginosa, and underline the importance of finding alternative therapies and a personalised approach. [ABSTRACT FROM AUTHOR]

Retroviral infections have been an important cause of preoccupation of research and medical systems in the past decades. The discovery of human immunodeficiency virus (HIV) as the etivological factor of acquired immunodeficiency syndrome (AIDS) marked a turning point in the conceptual framework and medical management. Retrospective diagnosis has permitted the discovery of infections after 20- 30 years from the date of death. The transmission chains are still undefined and are still under study. Given that, the United Nations HIV/AIDS (UNAIDS) targets for 2020 and 2030 are ambitious. To reach these goals, in spite of the overwhelming material costs to healthcare and socio-medical systems, and different kinds of “psychological pressure”, attention and support to combat HIV/AIDS infection need to remain a first‑line problem for governments and contemporary society. We propose a review of the defining moments in the natural history and their impact on the global medical systems of HIV/AIDS in the 1981-1990 period and to underline the most important information up to 2017 in our country. [ABSTRACT FROM AUTHOR]

Natural medicines and in specially herbs spices and extracts for treatment of various diseases were the first medicines used from immemorial times. In treatment of fungal infection the traditional medicine provide a lot of possible extracts from plants with proved effects to cure superficial infections. This work reviews shortly the main remedies from alternative medicine used in different traditional and modern medicine from all over the world and new researches on the efficiency of the old methods of treatment against Candida infections. One of the targets of this paper is to describe the most interesting and active plant extracts in order to be use as alternatives to chemical antifungal products, in treatments against Candida species infections. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) remains one of the most important public health challanges all over the world. World Health Organization (WHO) estimates that almost one third of the world's population is infected with Mycobacterium tuberculosis (M. tuberculosis). Early diagnosis, an adequate therapy, and preventions measures of disease spread are essential for an efficient control of TB. Problems that arise are related to the clinical management and prevention of dissemination of the disease in the general population. In terms of diagnosis, of great importance is the early detection of M. tuberculosis and the detection of susceptibility to antituberculous drugs in the mycobacteriology laboratory. The advent of new and modern methods of molecular diagnosis has considerable shortened the time in which the bacteriological diagnosis and susceptibility tests to antituberculous drugs are established. Such a test is GenoTypeMDRTBplus. Studying the 234 pathological prelevates positive to microscopy from the period October - December 2013, we have revealed that 161 strains were sensitive to rifampicin and isoniazid, and 54 strains were resistant. Others results of the study will be presented in this article. [ABSTRACT FROM AUTHOR]

Enterococci are one of the important causes of urinary tract infections and are inherently resistant to many antimicrobials, including penicillin, clindamycin, trimethoprimsulfamethoxazole and low levels of aminoglycosides. Moreover, they are poorly responsive to cephalosporins in vivo. The study was carried out in “Cantacuzino” National Research Institute on samples received from community. In order to detect resistance in Enterococcus species, a total of 102 Enterococcus species samples were included in the study. Although Enterococcus faecalis (98.03%) was one of the most common species associated with urinary tract infections, we also identified Enterococcus faecium (1.97%), showing the necessity of species level identification in laboratory settings. There were also isolated enterococci from mixture of two or three bacteria. E. faecalis was sensitive to vancomycin (94.10%), ampicillin (50.98%), penicillin (50.98%), linezolid (97.06%), nitrofurantoin (96.07%), levofloxacin (62.74%), ciprofloxacin (62.74%), chloramphenicol (89.22%) and tetracycline (17.65%), and resistant to gentamycin - high level resistance (25%). [ABSTRACT FROM AUTHOR]

In the context of excessive, often abusive use of antibiotics and chemotherapeutic agents, further studies are needed to elucidate to what extent this problem is present in our country, followed by the development of a program to prevent and control the extension of this damaging, worrisome phenomenon, damaging both for the patient and for public health and healthcare system in general. There are recommendations on how these therapeutic resources should be properly utilized. However, noting that recommendations are rarely respected and given the fact that replacing drugs that can be "lost" due to the increase in microbial resistance requires on average two decades of study, we support the view of personalities in the field regarding a possible solution: avoiding errors most commonly encountered in the practice of antibiotic therapy. We presented some suggestive examples in this regard and we recommend the study of the bibliographic resources on the bases of which we wrote this material and that the concepts be applied in everyday practice. [ABSTRACT FROM AUTHOR]

Dermatological disorders are common in patients infected with HIV (Human Immunodeficiency Virus), being present in all stages of progression. Skin manifestations provide useful clues to diagnose the infection. Moreover, these pathologies may reveal the presence of an associated systemic disease or may suggest the progression of immunosuppression. Dermatological manifestations are more severe in these patients compared to the general population and do not respond to conventional therapies, relapses being frequent. These lesions have an important psychological impact on patients, representing a real stigma, affecting the quality of life. The clinical picture of HIV patients varies significantly, depending upon the geographic region or upon the different groups of risk. In this article I attempted to highlight the most common skin manifestations of HIV-infected patients and to describe their main features, as pointed out in recent scientific papers. [ABSTRACT FROM AUTHOR]

Introduction: Staphyloccocus aureus is a conditionally pathogenic bacterium and represents a common cause of skin infections, such as abscesses or respiratory and intestinal infections. An estimated 20% of the human population carries S. aureus for long term. Case presentation: We present the case of a 54-year-old woman who presented to the gynecological examination for menstruation associated with skin rash. Genital clinical and ultrasound examinations were normal. The abdominal and axillary skin examination revealed disseminated tumors with a diameter between 1 and 5 cm with celsiene signs and spontaneous exteriorization of a gray-white creamy liquid and other tumors containing chocolatte-like creamy. The presumed diagnosis was a Staphylococcus skin infection and a possible cutaneous endometriosis. There was collected biological product from the pustules and Staphylococcus aureus was isolated. It was developed the autovaccine for the patient. One month after the administration of the vaccine the pustules were in almost complete remission. Conclusions: Staphylococcus aureus skin infection may have different clinical presentations. In the current situation it was manifested as a papular rash with relapses and spontaneous remissions correlated to the menstrual cycle phases. Thus, the appearance of lesions and the patient history made possible the differential diagnosis with cutaneous endometriosis. [ABSTRACT FROM AUTHOR]

The pathogenesis of chronic wounds (CW) involves a multifaceted interplay of biochemical, immunological, hematological, and microbiological interactions. Biofilm development is a significant virulence trait which enhances microbial survival and pathogenicity and has various implications on the development and management of CW. Biofilms induce a prolonged suboptimal inflammation in the wound microenvironment, associated with delayed healing. The composition of wound fluid (WF) adds more complexity to the subject, with proven pro-inflammatory properties and an intricate crosstalk among cytokines, chemokines, microRNAs, proteases, growth factors, and ECM components. One approach to achieve information on the mechanisms of disease progression and therapeutic response is the use of multiple high-throughput 'OMIC' modalities (genomic, proteomic, lipidomic, metabolomic assays), facilitating the discovery of potential biomarkers for wound healing, which may represent a breakthrough in this field and a major help in addressing delayed wound healing. In this review article, we aim to summarize the current progress achieved in host–microbiome crosstalk in the spectrum of CW healing and highlight future innovative strategies to boost the host immune response against infections, focusing on the interaction between pathogens and their hosts (for instance, by harnessing microorganisms like probiotics), which may serve as the prospective advancement of vaccines and treatments against infections. [ABSTRACT FROM AUTHOR]

Obiective. Acest studiu și-a propus să efectueze o revizuire sistematică a literaturii existente pentru a evalua efectele COVID-19 la femeile însărcinate și la nou-născuții acestora, estimând, în același timp, posibilitatea transmiterii verticale. Materiale şi metode. Am efectuat o cercetare sistematică a literaturii folosind Pubmed și Google Scholar, acoperind perioada decembrie 2019-noiembrie 2020. Revizuirea a fost efectuată în conformitate cu ghidurile PRISMA. Rezultate. Am inclus 16 studii - recenzii sistematice și metaanalize publicate între mai 2020 și noiembrie 2020 - care s-au concentrat pe rezultatele perinatale ale femeilor însărcinate cu COVID-19 și 7 prezentări de cazuri ale nou-născuților cu transmitere verticală a COVID-19. În general, rata cazurilor de COVID-19 la nou-născuții din mame COVID-19 pozitive a fost de 3% cu CI 95% [1,86, 4,24]). Rata nașterii premature a fost de 16,4%, cu CI 95% [10,5, 22,3], iar rata mortalității și a deceselor fetale a fost de 1,4% (11 studii, 0 până la 4,8%). Dintre cei 7 nou-născuți cu transmitere verticală dovedită, majoritatea s-au născut prematuri, cu greutate bună la naștere și scor APGAR, iar manifestările clinice au fost heterogene; 4 au dezvoltat simptome severe. Evoluțiile atât pentru mamă, cât și pentru nou-născuţi au fost bune în 85% dintre cazuri. Concluzii. În ceea ce privește rata prematurității și rata mortalității la femeile cu COVID-19, rezultatul este similar cu populația generală. Transmiterea verticală este posibilă și pare să aibă loc în aproximativ 3% dintre cazuri. Prognosticul matern și perinatal este favorabil, iar prezentarea clinică a transmiterii în uter a SARS-CoV-2 la nou-născuți este heterogenă. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to perform a systematic review of existing literature to assess the outcomes of pregnancy in women with COVID-19 infection and their newborns while estimating the possibility of vertical transmission. Materials and methods. We conducted a systematic literature research using Pubmed and Google Scholar covering the period from December 2019 to 20th of November 2020. The review was conducted in accordance with PRISMA guidelines. Outcomes. We included 16 studies - systematic reviews and meta-analyses published between May 2020 and November 2020 - which focused on perinatal outcomes of pregnant women with COVID-19 and 7 case reports of neonates with congenital transmission of COVID-19. Overall, the rate of COVID-19 cases in neonates of COVID-19 positive mothers was 3% with 95% CI [1.86, 4.24]). The preterm birth rate was 16.4% with 95% CI [10.5, 22.3] and the rate of stillbirths and foetal deaths was 1.4% (11 studies, 0 to 4.8%). From the 7 newborns with proved vertical transmission, majority were born preterm, with good birth weight and APGAR score and heterogenous symptoms; 4 developed severe symptoms. Overall progress and evolution for both mother and newborn was good. Conclusions. COVID-19 impact on pregnancy outcome is similar to general population in regard to preterm rate and stillbirth rate. Vertical transmission is possible and it seems to occur in about 3% of cases. Overall maternal and perinatal outcome is favourable and clinical presentation of in utero transmission of SARSCoV-2 in newborns is heterogenous. [ABSTRACT FROM AUTHOR]

Introduction: Risk reduction of TORCH congenital infections mainly involves prevention of infection prepregnancy and during pregnancy by educating the target population. We developed and tested a support system for women who would like to conceive and for pregnant women. Objectives: We assesed the usability of www.torch.ro website and MAMI smartphone application in a group of adult women of fertile age (18-49 years old). Our second aim was to asses the knowledge gain following their use in a group of pregnant women. Methods: We evaluated the usability, credibility, loyalty and appearance using Standardized User Experience Percentile Rank Questionnaire (SUPR-Q) which was completed online by 171 women of childbearing age. For knowledge evaluation, we developed a test-questionnaire and distributed to 61 pregnant women. Results: The participants had a good experience, as reflected by SUPR-Q of 4.47 out of 5. 74% of users have qualified as promoters, which imply that they are likely to recommend the website/app; the best scoring categories were trust, credibility and loyalty - score of 4.49/5. Majority (59.6%, n = 102) answered that they will definitely apply the measures of prevention of TORCH infections acquired in case of a next/future pregnancy and 28.7% (n = 49) said they will probably do so. There was an increase in the number of correct answers for almost all the questions, with a maximum increment of 21.3% for individual questions. Overall, there was a difference of plus 86 correct answers after exposure which represents 16% increase compared to initial number of correct answers of 535. Conclusion: End-user experience of website and smartphone app MAMI was evaluated as positive by the participants. The tools are trustworthy, credible and women who have used them are very likely to recommend them hence increasing the awareness about TORCH infections prevention. [ABSTRACT FROM AUTHOR]

In the literature, there are few publications which present data related to the infections of the urinary tract infections (UTI) of the patients who suffer from HiV/AIDS, although they represent an important cause which causes the death of these patients. The prevalence of the etiological agents differs according to the studied area. The urological complications in the case of HIV/ AIDS patients are often the result of a bacterial, parasitic, viral or fungal infections. The antiretroviral therapy increases the life span but, at the same time, it represents a favourable factor for infections, for exam pie, through the urolithiasis which they can produce. We set ourselves to review aspects related to UTI at this group of patients, having as a future objective the evaluation of this correlation in Romania. [ABSTRACT FROM AUTHOR]

The purpose of this review is to carry out an overall evaluation of the scientific literature on the selection of the best candidate as an animal translation model. We used the PubMed/MEDLINE, Web of Science Core Collection and medRxiv/BioRxiv (preprint materials) databases for original research published in English to September 2020. Review research was conducted in accordance with the preferred reporting elements for systematic reviews and meta-analysis (PRISMA). The inclusion criteria were: establishing animal models (mouse, ferret, dog, cat, primates, etc.) for SARSCoV-2, prophylaxis, therapy and vaccines. The exclusion criteria were: books, guidelines and protocols, population genetics. This review highlights the distinct advantages and limitations of each animal model, which should be taken into account in the design of studies, the interpretation of pathogenic mechanisms or extrapolation of the results of therapy or vaccines in humans. In order to generate results that are consistent, reproducible and comparable between studies, it is necessary to harmonize the protocols for experimentation on animal models. [ABSTRACT FROM AUTHOR]

In the context of increasing resistance to antimicrobials, therapeutic alternatives must be developed, one of which may be the administration of autologous bacterial vaccine. There are few studies in the literature reporting the immune and clinical response to autologous vaccine administration. In this study we tried to evaluate the clinical effect of the administration of the autologous bacterial vaccine to people with dermatological diseases for which the classical therapy did not bring the desired results. [ABSTRACT FROM AUTHOR]

The ongoing coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic by the World Health organization in early March 2020. The disease typically presents with viral respiratory symptoms that could progress to acute respiratory distress syndrome. Emerging evidence suggests different possible dermatologic manifestations of COVID-19, including: acral lesions (pernio-like, pseudo-chillblain), vesicular eruptions, macular and papular exanthema, urticaria, livedoid, purpuric and petechial rashes. However, specific skin manifestations of the COVID-19 disease have not yet been clearly established and the relationship between the appearance of skin lesions and SARS-CoV-2 infection is still unclear. These highly variable skin changes could represent a direct consequence of the viral infection, an immunological response to viral nucleotides, adverse reactions to drugs frequently used for the treatment of COVID-19, or other disorders. In a global effort to comprehend the exact cutaneous features of COVID-19, several international dermatological societies have initiated nationwide studies to analyze COVID-19 cutaneous manifestations during this pandemic. This paper represents a literature review of the scientific data available on the clinical characteristics and symptoms of the cutaneous manifestations associated with COVID-19. Such findings are extremely useful in establishing if dermatological manifestations in COVID-19 patients could harbor a diagnostic significance and subsequently be used as prognostic factors for outcomes of COVID-19. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis is an often-overlooked condition that otherwise negatively impacts both the individual and the community, prompting major public health concerns. Early diagnosis and treatment, as well as collaboration between specialties including surgery and parasitology, are essential for avoiding complications and disease relapse. To better illustrate this, we present the case of an elderly person with a rare localization of the disease at the muscular level. The patient underwent numerous surgical interventions, and received multiple courses of antiparasitic treatment over the course of 40 years as a result of the multivisceral dissemination of the parasite. [ABSTRACT FROM AUTHOR]

Acne vulgaris is a chronic inflammatory skin disease of the pilosebaceous unit. Its pathogenesis is multifactorial and involves the overlap between four main processes: alteration of the keratinization, increased sebum production, colonization with Cutibacterium acnes, and inflammation. The role of oxidative stress (OS) has been intensively studied in inflammatory skin conditions such as psoriasis, vitiligo, or atopic dermatitis. However, the involvement of OS in the pathogenesis of acne is less known. The evidence accumulated over the last decade suggests that in the case of acne patients, there is an imbalance between oxidants and antioxidants. In this review, we analyzed studies that evaluated markers of OS in patients with acne, published in the last ten years, with the aim of providing new insights into the pathogenesis of acne. [ABSTRACT FROM AUTHOR]

Botulism occurs by ingestion of canned food contaminated with Clostridium botulinum. In most cases, the incriminated canned foods are homemade; commercial products only occasionally produce the disease, due to improper handling and storage after purchase. In Romania, the most common sources of food botulism are homemade pork products (ham, bacon, salami, meat and sausages preserved in lard). The disease occurs in small outbreaks. Out of several serotypes of C. botulinum, the predominant serotype in our country is type B. The Laboratory of Anaerobic and Zoonotic Infections in Cantacuzino Institute performs in vivo reference laboratory diagnosis of botulinum food poisoning, using the mouse lethality assay for detection of the toxin in the sample and for toxin typing. Between 2003 and 2017, our laboratory tested 576 biological samples for the diagnosis of botulism: patient blood serum samples (80%), food samples (19.02%) and autopsy fragments from deceased patients (0.8%). Type B botulinum toxin was detected in 50% of the total number of blood serum samples received for testing and a single serum was positive for type E toxin. 5% of the tested food samples were positive for type B toxin. Until 2007, the geographic origin of positive samples that we received for testing showed high incidence of food botulism in the center and west of the country. Starting 2007, we received more samples from several eastern counties, many of them being confirmed as positive. Until mid 2009, we frequently received insufficient amounts of patient serum, and we could not determine the toxin serotype. [ABSTRACT FROM AUTHOR]

Wastewater treatment plants (WWTP) are considered to be an important reservoir of antibiotic resistance genes (ARGs) and antibiotic resistant bacteria (ARB) that may contribute to an increase release of resistance into environment, which menace human and animal health. The resistance selection processes of ARB and ARGs transfer that occurs into WWTP are poorly understood and studies are required to advance our current knowledge in the field and thus optimizing wastewater treatment for the removal of ARB and ARGs. The aim of this paper is to summarize methods used for analyzing the antibiotic resistance in environmental samples, providing information that can be used by professionals to improve the wastewater treatment for the removal of ARB and ARGs. [ABSTRACT FROM AUTHOR]

Most of fungal infections are superficial and relatively easy to treat. Nevertheless, millions of invasive fungal infections have also been reported. Considering that most of the time the presence of this fungus represents colonization, the challenge is to differentiate between colonization and infection. The objective is to summarize the Candida spp. virulence factors and to highlight their clinical relevance. We have selected the most pertinent articles from the recent medical literature regarding this subject using Google Academic and Pubmed databases. The first virulence factors involved in the infection are adhesion proteins (e.g., the fungal protein gpm1 interacts with vibronectin, leading to fungal adhesion to keratinocytes, endothelial cells and monocytes). In order to invade, the fungus penetrates the epithelium/endothelium using hydrolytic enzymes - aspartyl proteases (encoded by SAP genes), phospholipases and lipases. Candida albicans could induce its own endocytosis by the epithelial cells, process governed by Efg1p and Tpk2p proteins. Penetration is favored by the yeast-hyphae conversion, pleomorphism being essential in pathogenicity. It is triggered by various factors including pH and temperature changes, hormonal variations etc. The fungus is very versatile, having the capacity to survive within a wide range of environmental conditions. It can cause co-infections with different bacteria such as Pseudomonas aeruginosa, Klebsiella pneumoniae etc. The virulence factor with the most important clinical significance is the capacity of biofilm formation. A significant role in biofilm formation is played by the adhesion proteins codified by ALS and EAP Candida albicans genes. Biofilm presence on medical instruments leads to antifungal resistance. The study of the Candida spp. virulence factors is a continually developing field. Understanding these mechanisms has a major clinical importance when comes to correct evaluation of a positive Candida spp. sample and correct treatment administration. It could also lead to new therapeutic approaches if we consider the increase of antifungal resistance in the last years. We highlight the importance of collaboration between the clinician and the laboratory physician. [ABSTRACT FROM AUTHOR]

Carbapenems are last resort antibiotics used in infections caused by multidrug-resistant bacteria. Carbapenem-resistant Enterobacteriaceae infections are an increasingly global threat, especially because carbapenemase production is more frequent than other resistance mechanisms and is encoded by genes located on transferable genetic structures. The production of classes A (KPC), B (IMP, VIM, NDM) and D (OXA-48 and its variants) of carbapenemases has important clinical consequences and is a constant pool of resistance. This review tries to show the diversity of carbapenemases and to underline their importance. [ABSTRACT FROM AUTHOR]

Neisseria meningitidis (Nm) is the pathogen carried asymptomatically in the nasopharynx but which under certain conditions can produce meningitis or even multi-organ failure. Experimental induction of meningitis in an animal model is necessary for testing new nanopharmaceutical products. Thus, the aim of the study was to establish the concentration of Nm capable of inducing the disease. We carried out 2 studies where we tested different concentrations of Nm obtained by the nephelometric and spectrophotometric methods. In the first study we included 20 BALB/c mice, and in the second 24. Local and general clinical signs, complete with body temperature values, body weight, hematological, microbiological and histopathological examination were important indicators for the assessment of the establishment of meningitis. The clinical results have pronounced depression in the first 2 days after inoculation, then the general condition will appear. The microbiological and histopathological examination indicated the presence of bacteria at the brain level and specific meningeal lesions only in the case of the second attempt, but the early mortality, requires additional testing of the bacterial concentration that induces meningites in a stable and persistent way so that treatment against the condition can be tested later. [ABSTRACT FROM AUTHOR]

Background: Romania is one of the European countries reporting very high antimicrobial resistance (AMR) rates and consumption of antimicrobials. We aimed to characterize the AMR profiles and clonality of 304 multi-drug resistant (MDR) Acinetobacter baumannii (Ab) and Pseudomonas aeruginosa (Pa) strains isolated during two consecutive years (2018 and 2019) from hospital settings, hospital collecting sewage tanks and the receiving wastewater treatment plants (WWTPs) located in the main geographical regions of Romania. Methods: The strains were isolated on chromogenic media and identified by MALDI-TOF-MS. Antibiotic susceptibility testing and confirmation of ESBL- and CP- producing phenotypes and genotypes were performed. The genetic characterization also included horizontal gene transfer experiments, whole-genome sequencing (WGS), assembling, annotation and characterization. Results: Both clinical and aquatic isolates exhibited high MDR rates, especially the Ab strains isolated from nosocomial infections and hospital effluents. The phenotypic resistance profiles and MDR rates have largely varied by sampling point and geographic location. The highest MDR rates in the aquatic isolates were recorded in Galați WWTP, followed by Bucharest. The Ab strains harbored mostly blaOXA-23, blaOXA-24, blaSHV, blaTEM and blaGES, while Pa strains blaIMP, blaVIM, blaNDM, blaVEB, blaGES and blaTEM, with high variations depending on the geographical zone and the sampling point. The WGS analysis revealed the presence of antibiotic resistance genes (ARGs) to other antibiotic classes, such as aminoglycosides, tetracyclines, sulphonamides, fosfomycin, phenicols, trimethoprim-sulfamethoxazole as well as class 1 integrons. The molecular analyses highlighted: (i) The presence of epidemic clones such as ST2 for Ab and ST233 and ST357 for Pa; (ii) The relatedness between clinical and hospital wastewater strains and (iii) The possible dissemination of clinical Ab belonging to ST2 (also proved in the conjugation assays for blaOXA-23 or blaOXA-72 genes), ST79 and ST492 and of Pa strains belonging to ST357, ST640 and ST621 in the wastewaters. Conclusion: Our study reveals the presence of CP-producing Ab and Pa in all sampling points and the clonal dissemination of clinical Ab ST2 strains in the wastewaters. The prevalent clones were correlated with the presence of class 1 integrons, suggesting that these isolates could be a significant reservoir of ARGs, being able to persist in the environment. [ABSTRACT FROM AUTHOR]