Subject(s)
Exophiala , Mycoses , Peritoneal Dialysis, Continuous Ambulatory , Peritonitis/microbiology , Female , Humans , Middle AgedABSTRACT
A case of subconjunctival infection with a zoonotic species of Onchocerca is described, in a 16-year-old Albanian man who had immigrated to Greece. This is the first report of human infection with Onchocerca in this tissue location and only the eighth report of zoonotic Onchocerca in man.
Subject(s)
Conjunctival Diseases/pathology , Onchocerciasis, Ocular/pathology , Adolescent , Animals , Conjunctival Diseases/parasitology , Humans , Male , Onchocerciasis, Ocular/parasitology , Zoonoses/parasitologyABSTRACT
OBJECTIVES: To evaluate the clinical and laboratory findings of Streptococcus pneumoniae acute otitis media in children during a 1 year period. METHODS: From October 1995 to September 1996, 113 children aged 2 months to 14 years (median 18 months), with S. pneumoniae acute otitis media were studied. Susceptibility testing was performed by the Kirby-Bauer method and the E-test, and serotyping by the Quellung reaction. RESULTS: E-test assays detected five isolates (4.4%) to be highly resistant to penicillin and 13 (11.5%) that had intermediate resistance. All isolates were found to be susceptible to vancomycin, rifampicin and cefotaxime. In total, 25 isolates (22.1%) were resistant to one or more drugs. Fifty per cent of the penicillin-resistant or intermediately resistant S. pneumoniae isolates were resistant to multiple drugs, whereas only 2.1% of the penicillin-susceptible isolates were resistant to multiple drugs. The predominating serogroups of the isolates with reduced susceptibility to penicillin were the 19 (61.1%), 9 (16.7%), 23 (11.1%), 6 (5.5%) and 14 (5.5%) whereas those of the susceptible isolates were the 19 (26.3%), 14 (13.7%), 3 (11.6%), 6 (11.6%), 9 (8.4%), 1 (5.3%) and 12 (5.3%). CONCLUSIONS: Streptococcus pneumoniae isolates from children with acute otitis media were penicillin-insensitive in 15.9%. The multiresistant S. pneumoniae isolates belonged to serogroups: 19 (45.4%), 9 (27.3%), 6 (18.2%) and 23 (9.1%).
Subject(s)
Disease Susceptibility , Drug Resistance, Microbial , Otitis Media/microbiology , Streptococcal Infections/microbiology , Streptococcus pneumoniae/isolation & purification , Acute Disease , Adolescent , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Drug Resistance, Multiple , Ear, Middle/microbiology , Ear, Middle/pathology , Female , Humans , Infant , Infant, Newborn , Male , Microbial Sensitivity Tests , Otitis Media/diagnosis , Otitis Media/drug therapy , Serotyping , Streptococcal Infections/drug therapy , Streptococcus pneumoniae/classification , Streptococcus pneumoniae/pathogenicitySubject(s)
Immunocompromised Host , Lung Diseases/etiology , Nocardia Infections/etiology , Nocardia asteroides , Respiratory Tract Infections/etiology , Anemia, Hemolytic, Autoimmune/drug therapy , Child , Fatal Outcome , Female , Greece , Humans , Immunosuppressive Agents/therapeutic use , Syndrome , Thrombocytopenia/drug therapySubject(s)
Ampicillin/pharmacology , Anti-Bacterial Agents/pharmacology , Bacteremia/microbiology , Enterococcus faecium/drug effects , Glycopeptides , Penicillins/pharmacology , Aged , Bacteremia/drug therapy , Bacteremia/metabolism , Bacterial Proteins/metabolism , Carbon-Oxygen Ligases/metabolism , Enterococcus faecium/isolation & purification , Enterococcus faecium/metabolism , Gram-Positive Bacterial Infections/metabolism , Gram-Positive Bacterial Infections/microbiology , Greece , Humans , Male , Microbial Sensitivity Tests , Penicillin Resistance , Vancomycin ResistanceSubject(s)
Anti-Bacterial Agents/pharmacology , Erythromycin/pharmacology , Streptococcus/classification , Streptococcus/drug effects , Child , Child, Preschool , Clarithromycin/pharmacology , Clindamycin/pharmacology , Drug Resistance, Microbial , Greece , Hospitals, Pediatric , Humans , Infant , Infant, Newborn , Microbial Sensitivity Tests , PhenotypeABSTRACT
A total of 140 non-replicate Streptococcus pneumoniae community isolates from Greek children collected during the period 1995-1997 were studied. Combined intermediate and high penicillin resistance rates were 23% in 1995, 29% in 1996, and 27% in 1997. The proportion of highly resistant isolates steadily increased from 2% in 1995 to 12% in 1997. There was no significant difference in penicillin resistance rates among colonizing and infecting isolates (23 and 27%, respectively). Over the study period, a clear shift towards higher penicillin MIC was observed among both the susceptible and resistant groups. Thus, penicillin resistance rates were equally high among colonizing and infecting isolates and resistance levels appeared to be gradually increasing throughout the entire S. pneumoniae population.
Subject(s)
Drug Resistance, Microbial , Penicillins/pharmacology , Streptococcus pneumoniae/drug effects , Child , Humans , Microbial Sensitivity TestsSubject(s)
Bacteremia/etiology , Catheters, Indwelling/adverse effects , Child, Hospitalized/statistics & numerical data , Cross Infection/etiology , Causality , Child , Child, Preschool , Greece , Hospitals, Pediatric , Humans , Incidence , Infant , Infant, Newborn , Infection Control , Retrospective StudiesABSTRACT
The number of cases of meningococcal disease reported to the Meningitis Reference Laboratory in Athens rose dramatically in 1996-1997. The aims were (1) to determine if the increase was due to introduction of new strains, (2) to assess the geographic and age distribution of the cases, (3) to compare antibiotic sensitivity patterns of the current isolates with strains from the early 1990s. In 1993-1994, 15/19 (74%) of the cases for which information on age was available were in children < or = 5 years; in 1995-1997, 80/179 (45%) of cases were in children < or = 5 years and 99 (55%) in the older age range (P < 0.02). From 593 cases in 1993 1997, 214 (36%) isolates were available for characterisation. Serogroup B was predominant in the early 1990s, but by 1997, serogroup C accounted for 46/72 (64%) of isolates and serogroup B for 25/72 (35%). Serogroup B was predominant in children < or = 5 years (44/78, 56%) but only 19/99 (18%) of older children and adults (P=0.0000005). Sulfonamide resistance decreased from 10/22 (45%) in 1993-1994 to 27/192 (14%) in 1995-1997 (P<0.01). Multilocus enzyme electrophoresis of 70 strains obtained during this period identified the epidemic ET-15 clone in 24 (34.3)%. The profiles of the Greek ET-15 isolates were identical to C:2a:P1.2(P1.5) strains responsible for the epidemic in the Czech Republic which began in 1993. This genotype was not found in Greek strains isolated prior to 1993. We conclude that the increase in meningococcal disease is due to introduction of the epidemic serogroup C:2a:P1.2(P1.5) strain responsible for disease in the Czech Republic and Canada.
Subject(s)
Meningitis, Meningococcal/epidemiology , Meningococcal Infections/epidemiology , Neisseria meningitidis/classification , Adolescent , Adult , Age Distribution , Anti-Bacterial Agents/pharmacology , Bacterial Typing Techniques , Child , Child, Preschool , Greece/epidemiology , Humans , Infant , Infant, Newborn , Meningitis, Meningococcal/microbiology , Meningococcal Infections/microbiology , Microbial Sensitivity Tests , Middle Aged , Neisseria meningitidis/drug effects , Neisseria meningitidis/isolation & purification , SerotypingABSTRACT
The prevalence and patterns of Streptococcus pneumoniae resistance to antibiotics was examined in 146 nasopharyngeal carrier strains obtained during April and May, 1997, from 382 healthy children attending eight day care centers (DCCs) in the area of Athens. Reduced susceptibility to at least one antibiotic was found in 32.6% as follows: penicillin 11.4% (intermediate), cefotaxime 0.8% (intermediate), trimethoprim-sulfamethoxazole 22.7%, erythromycin 13.6%, tetracycline 11.4%, chloramphenicol 8.3%. Most of the nonsusceptible to penicillin isolates belonged to serogroups 23, 9, and 19. Multidrug resistance was detected in 11.4% of S. pneumoniae isolates including five penicillin nonsusceptible serogroup 23 strains. More than half of the multidrug resistant strains were susceptible to penicillin and belonged to serogroups 6 (4), 23 (1), 19 (1), and 1(1). Strains that belonged to the same serogroup/serotype and had identical resistance patterns appeared to cluster in some DCCs. Antibiotic use in the previous month was associated with reduced susceptibility to penicillin (p = 0.007) and multidrug resistance (p = 0.012). In conclusion, a moderate prevalence of reduced susceptibility to penicillin in pneumococcal carrier strains was found in our community. Multidrug resistance was common and was often associated with susceptibility to penicillin. Several distinct patterns of resistance were observed, suggesting the spread of resistant clones to our country.
Subject(s)
Carrier State , Child Day Care Centers , Drug Resistance, Microbial , Streptococcus pneumoniae/drug effects , Anti-Bacterial Agents/administration & dosage , Child , Greece , Humans , Microbial Sensitivity Tests , Nasopharynx/microbiology , Streptococcus pneumoniae/genetics , Streptococcus pneumoniae/isolation & purificationABSTRACT
Usage of antibiotics in southern Europe is less well regulated than in northern countries. The proportion (48%) of meningococci in Spain insensitive to pencillin (MIC greater than or equal to 0.1 mg/l) prompted this investigation of antibiotic sensitivities of isolates from Greek patients with meningitis (31) and carriers (47 school-children and 472 recruits). The agar dilution method was used to determine MIC to penicillin G (PN), sulphamethoxazole (SU), rifampicin (RF), cefaclor (CF) and ciprofloxacin (CP). The proportion of isolates insensitive to PN was 48% for isolates from patients, 19% from school-children and 36.6% from recruits. Resistance to SU (MIC greater than or equal to 16 mg/l) was found in 16% of those from patients, 10.6% from children and 40% from recruits. None of the isolates from patients was resistant to RF (greater than or equal to 1 mg/l) but 6% of those from carriers were. Resistance to CF (greater than or equal to 4 mg/l) was found in 9.2% of patient isolates, 6.4% from children and 23.7% from recruits. All isolates except one were sensitive to CP (MIC range less than 0.0015-0.125 mg/l). Resistances to PN, SU and RF were analysed by serogroup, serotype and subtype of the bacteria. The proportion of resistant isolates showed some variation between different areas of Greece, but it was not statistically significant.
