ABSTRACT
The prevalence of anti-human herpesvirus 8 (HHV-8) antibodies was retrospectively assessed in a cohort of 248 consecutive HIV-1-positive patients followed up in an academic unit in Greece during a 14-year period and in 46 highly exposed, persistently HIV-seronegative (HEPS) individuals. The impact of the initial anti-HHV-8 status on tumorgenesis and mortality was studied. The first available serum sample from the department's pool was tested. Demographics and data regarding history of sexually transmitted diseases, Hepatitis B surface antigen (HbsAg) and hepatitis C (HCV) status were collected. Patients who developed either HHV-8-related or non-HHV-8-related neoplasms during long-term follow-up were also identified. Forty-eight percent of the HIV-1-positive patients and 56% of the HEPS subjects were found anti-HHV-8-positive. No difference was observed regarding the development of HHV-8-related or non-HHV-8-related neoplasia and mortality on grounds of initial anti- HHV-8 status. Mortality was positively associated with the presence of HBsAg. HCV infection showed a trend to be more common in anti-HHV-8-positive patients. In summary, the seroprevalence of HHV-8 among HIV-1-positive patients is higher than the one reported in the Western world. The initial anti-HHV-8 status is not a prognostic factor in HIV-1-positive individuals. The high seroprevalence in HEPS individuals possibly reflects their risk-prone lifestyle. HbsAg-positive status is a long-term negative prognostic factor in HIV infection.
Subject(s)
HIV Infections/epidemiology , HIV-1/isolation & purification , Herpesviridae Infections/epidemiology , Herpesvirus 8, Human/isolation & purification , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Analysis of Variance , Cohort Studies , Comorbidity , Confidence Intervals , Female , Greece/epidemiology , HIV Infections/diagnosis , HIV Seronegativity , HIV Seropositivity , Herpesviridae Infections/diagnosis , Herpesvirus 8, Human/immunology , Humans , Incidence , Logistic Models , Male , Middle Aged , Probability , Retrospective Studies , Risk Factors , Sarcoma, Kaposi/diagnosis , Sarcoma, Kaposi/epidemiology , Seroepidemiologic Studies , Sex Distribution , Survival AnalysisABSTRACT
This study estimated the clinical effectiveness of five different antibiotic regimens (doxycycline, chloramphenicol, ciprofloxacin, doxycycline plus chloramphenicol, and doxycycline plus ciprofloxacin) administered for infection with Rickettsia typhi in terms of the duration of the fever. Eighty-seven patients with endemic typhus were hospitalized between 1993 and 1998 at the General Hospital of Chania in Chania, Crete, Greece. The mean time to defervescence was 2.9 days for doxycycline, 4.0 days for chloramphenicol, and 4.2 days for ciprofloxacin. In patients receiving combinations of doxycycline plus chloramphenicol and doxycycline plus ciprofloxacin, fever subsided in 3.4 and 4.0 days, respectively. The outcome was favorable in all patients, and no deaths or relapses were observed within two months.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Typhus, Endemic Flea-Borne/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Drug Therapy, Combination/therapeutic use , Female , Humans , Male , Middle Aged , Time FactorsABSTRACT
OBJECTIVE: To determine the frequency and type of nosocomial infections (NIs) (especially surgical-site infections [SSIs]), risk factors, and the type and duration of antibiotic use among surgical patients in Greek hospitals. DESIGN: Two point-prevalence studies. SETTING: Fourteen Greek hospitals. PATIENTS: Those in the hospitals during two prevalence surveys undergoing surgery during their stay. RESULTS: In the 1999 survey, 129 of 1,037 surgical patients had developed 148 NIs (14.3%). A total of 1,093 operations were registered, and 49 SSIs (4.5%) were found. In the 2000 survey, 82 of 868 surgical patients had developed 88 NIs (10.1%). A total of 902 operations were registered, and 38 SSIs were detected (4.2%). The median length of stay (LOS) for surgical patients without SSI was 10.0 days (range, 1-19 days); for patients who developed SSI it was 30 days (range, 1-52 days; P < .001). The median LOS prior to surgery for patients without SSI was 1 day (range, 0-4 days); for patients who developed SSI it was 3 days (range, 0-7.5 days; P < .001). Among 30 possible risk factors studied, wound class, LOS prior to surgery, and central venous catheterization were independent predictors of SSI. Median durations of prophylactic antibiotic therapy were 4 days (range, 1-14 days) and 6 days (range, 1-16 days) in the 1999 and 2000 surveys, respectively. CONCLUSION: Surgical patients in Greek hospitals suffered higher rates of SSI than did surgical patients in other developed countries while prophylactic antibiotics were used excessively.
Subject(s)
Cross Infection/epidemiology , Surgical Wound Infection/epidemiology , Antibiotic Prophylaxis , Data Collection , Female , Greece/epidemiology , Humans , Length of Stay , Male , Prevalence , Risk Factors , Surgical Wound Infection/prevention & controlABSTRACT
Over a period of 5 years (1993-97), 83 cases of murine typhus were identified and studied in the city of Chania, on the island of Crete. Of these cases, 4.8% were registered in 1993, 19.3% in 1994, 47.0% in 1995, 10.8% in 1996, and 18.1% in 1997. The greatest incidence of the disease occurred during the third trimester of the year. Direct contact with rats was noted in 45 (54.2%) of 83 patients. Two strains of Rickettsia typhi were isolated in cell cultures. The predominant clinical manifestations were: fever (100%), headache (88%), chills (86.7%), and rash (79.5%). In 4 of the patients (4.8%), the disease was complicated by acute renal failure, and in 4 other patients (4.8%), by pulmonary consolidations. The outcome under appropriate treatment was favourable for all patients.
