Adipokines, and not vitamin D, associate with antibody immune responses following dual BNT162b2 vaccination within individuals younger than 60 years.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) led to a global health outbreak known as the COVID-19 pandemic which has been lasting since March 2020. Vaccine became accessible to people only at the beginning of 2021 which greatly helped reducing the mortality rate and severity of COVID-19 infection afterwards. The efficacy of vaccines was not fully known and studies documenting the immune responses following vaccination are continuing to emerge. Recent evidence indicate that natural infection prior vaccination may improve the antibody and cellular immune responses, while little is known about the factors influencing those processes. Here we investigated the antibody responses following BNT162b2 vaccination in relation to previous-infection status and age, and searched for possible biomarkers associated with the observed changes in immune responses. We found that the previous-infection status caused at least 8-times increase in the antibody titres, effect that was weaker in people over 60 years old and unaltered by the vitamin D serum levels. Furthermore, we identified adiponectin to positively associate with antibody responses and negatively correlate with pro-inflammatory molecules (MCP-1, factor D, CRP, PAI-1), especially in previously-infected individuals.

Emergence of a new group CTX-M enzyme in Romania and risk factors for extended spectrum beta-lactamase producing E. coli infections.

Antibiotic resistance rates in E. coli are rapidly rising, with worrisome aspects especially regarding community--acquired resistance to third- and fourth-generation cephalosporins and fluoroquinolones. The objectives of this prospective cohort study was to determine the resistance profile of E. coli for two categories of patients (< 49 years and > or = 50 years), risk factors for ESBL positivity and to investigate the molecular epidemiology of ESBL type CTX-M enzymes. A total of 885 strains of E. coli were isolated in the Infectious Diseases Hospital laboratory between June 2008 and June 2011 and E. coli resistance due to ESBL production was noted in 17% of cases. We found that previous therapy with cephalosporins, hospitalization and urinary catheter were risk factors for ESBL positivity. We noted significant differences concerning resistance rate between patients under 49 years and aged more than 50 years for ciprofloxacin (19% and 38%, respectively, p = 0,0001), for gentamicin (15% and 23%, p = 0,008), ceftazidime (15% and 24%, p = 0,001) and ESBL positivity (14% and 20%, p = 0.009). This study highlights the predominance of CTX-M producing strains (92.5% of ESBLs-positive E. coli harboured bla CTX-M genes); CTX-M-15 producing isolates were the most common, accounting for 96% of isolates. Only 4% were belonging to CTX-M group-9, an emerging ESBL group which is newly described in Romania.

Triplex real-time pcr for detection of methicillin-resistant staphylococcus aureus and Panton-Valentine leukocidin in North-East Romania.

UNLABELLED: The aim of the present study was to investigate S. aureus isolates for the presence of methicillin-resistance and Panton-Valentine leukocidin (PVL) genes and to further characterize positive strains by means of antibiotic resistance patterns. MATERIAL AND METHODS: We used a triplex Real-Time PCR method for simultaneous detection of nuc, mecA and pvl genes in clinical isolates from 188 patients admitted to "Sf. Parascheva" Infectious Diseases Hospital lasi, during a 3 year period (2008-2010). RESULTS: The study revealed a relatively high rate of PVL-producing strains (23.93%), mainly community-associated (CA-MRSA) (51.11%). Most pvl-positive CA-MRSA isolates were resistant to erythromycin (91.3%), but none was resistant to clindamycin, fluoroquinolones, rifampicin, chloramphenicol or fusidic acid. CONCLUSIONS: Antibiotic susceptibility testing showed a high rate of multidug-resistance among strains classified as CA-MRSA (54.83%), but not among PVL-producers (4.44%). Although resistance to fusidic acid was previously proposed as a marker for PVL-producing CA-MRSA, our data suggest that we cannot rely on resistance to fusidic'acid to screen for PVL-producing CA-MRSA in our setting.

[Carbapenem resistance in Klebsiella pneumoniae clinical isolates from urinary tract infections]. / Emergenta rezistentei la carbapeneme la tulpini de Klebsiella pneumoniae izolate din infectii ale tractusului urinar.

UNLABELLED: Resistance to carbapenems by KPC (Klebsiella pneumoniae carbapenemase) production in Klebsiella pneumoniae clinical isolates was first described ten years ago in the U.S.A. and recently reported in other countries. This enzyme inactivates all beta-lactam antibiotics and is associated with fluoroquinolone and aminoglycoside resistance. MATERIAL AND METHODS: We investigated the carbapenem resistance in 498 Escherichia coli and Klebsiella pneumoniae strains isolated from urinary tract infections during 2009 in the lasi "Dr. C. I. Parhon" Clinical Hospital. Antimicrobial susceptibility testing was performed according to CLSI guidelines. To detect ESBL (extended spectrum beta-lactamase) and KPC production we used phenotypic tests and molecular biology methods (PCR). RESULTS: From all tested strains, only two K. pneumoniae strains showed modified susceptibility to carbapenems. The modified Hodge test was positive for the strain resistant to ertapenem, meropenem, imipenem (KA) and negative for the strain resistant only to ertapenem (K(B)). Both KA and K(B) isolates were negative for blaKPC and blaTEM genes, but harbored blaSHV and bla(CTX-M) genes, respectively. CONCLUSIONS: We report the first carbapenem resistant K. pneumoniae strains from Northeast Romania. The resistance is not mediated by KPC-carbapenemase; the possibility of dual mechanisms through cefalosporinases production and porins loss is suggested.

[Metallo-beta-lactamase-mediated resistance among carbapenem-resistant Pseudomonas aeruginosa clinical isolates]. / Rezistenta prin metalo-beta-lactamaze la izolate clinice de Pseudomonas aeruginosa rezistente la carbapeneme.

UNLABELLED: The aim of our study was to evaluate the antimicrobial susceptibility profile and the presence of metallo-beta-lactamases (MBLs) among carbapenem-resistant Pseudomonas aeruginosa clinical isolates. MATERIAL AND METHODS: A total of 84 P. aeruginosa clinical isolates collected between January 2007- February 2011 from four university hospitals in Iasi (North-East region of Romania) were randomly selected. Antimicrobial susceptibility testing was performed according to CLSI 2010 (Clinical and Laboratory Standards Institute) guidelines. The isolates were tested for MBLs using EPI (EDTA-phenanthroline-imipenem) phenotypic test and polymerase chain reaction (PCR) for bla(VIM) and bla(IMP). RESULTS: Fifty-eight carbapenem resistant strains were identified, from which 24 (41,3%) were positive for VIM-type MBLs. No IMP - type MBL was detected. All MBL-producing isolates displayed a MDR (multidrug resistant) phenotype, two of them were XDR (extensively drug-resistant). Colistin remained the most effective antibiotic. CONCLUSIONS: The high proportion of MBL producing P. aeruginosa clinical isolates urges the need for a better use of antibiotics and for efficient infection control measures to prevent dissemination of MBL producers. This is the first report of VIM-like enzymes in P. aeruginosa isolates from the Iasi area.

[Detection of metallo-beta-lactamases in gram-negative bacilli isolated in hospitals from Romania--research fellowship report]. / Depistarea producerii de metalo-beta-lactamaze la bacili gram-negativi izolati în spitale din România.

The emergence of carbapenem resistance in Gram-negative bacilli has become a global concern since these beta-lactams are often the only effective treatment left against many multiresistant strains. Metallo-beta-lactamase-producing isolates are now widespread worldwide, and especially in Europe where they have been responsible for rather large outbreaks. Our study proposes to investigate the presence of such isolates in Romania and to characterize them at the molecular level. A total of 28 clinical isolates clinical isolates of Pseudomonas aeruginosa and Acinetobacter baumannii were collected between 2003 and 2007 from 5 hospitals in 3 cities in north-east of Romania (Iasi, Bacau, Galati). Antimicrobial susceptibility testing was performed according to CLSI guidelines. MBL detection was performed using the EPI phenotypic test and PCR, that was confirmed by hydrolysis test. The structure of MBL-encoding class 1 integron was determined by PCR mapping and sequencing. Genotyping was performed by RAPD. Only 2 strains showed a positive EPI test. PCR and sequencing revealed the presence of bla(VIM-2) and bla(IMP-13) genes, in strains 16GL Pa and 247Pa, respectively. RAPD showed clonal relatedness between the Pa247 and an Italian IMP-13 producing strain. Despite the infrequent occurrence of metallo-beta-lactamases in our settings, both VIM- and IMP-types are present in Romanian Pseudomonas aeruginosa clinical isolates.

Disseminated infection due to Candida guilliermondii in a patient with AML(M4). Case study.

UNLABELLED: A 43-year-old patient admitted with acute myelogenous leukemia, developed bronchopneumonia and sepsis during profound neutropenia. Fever and pulmonary infiltrates did not improve by using empiric antibacterial therapy (Cefoperazona-Sulbactam, Trimethoprim-Sulphametoxazol). Blood and sputum culture were performed and patient received Voriconazol. Both cultures, from blood and sputum, yielded Candida guilliermondii after 48 hours of incubations. The isolates have the same biochemical and antimicrobial spectrum and were susceptible to Amphotericin B and Fluconazole. After a few days of therapy with Voriconazol, fever disappeared and the clinical state of patient was improved. A culture from pharyngeal swab, performed after 11 days, yielded the same microorganism. CONCLUSIONS: (1) The emergence of less common, but medically important fungal pathogens, including Candida guilliermondii, contributes to the rate of morbidity and mortality, especially in the increasingly expanding population of immunocompromised patients. (2) We consider that the oropharyngeal colonization with Candida guilliermondii and profound neutropenia predispose our patient to develop bronchopneumonia and candidemia.

[Current trends in the epidemiology of bloodstream infections in patients with hematological malignancies and solid neoplasms]. / Spectrul etiologic al infectiilor sistemice la pacientii cu hemopatii maligne si tumori solide.

OBJECTIVES: to characterize the epidemiological and microbiological spectrum of systemic infections in hematological and oncological patients. METHOD: a prospective study of bloodstream infections was conducted between May 2004-December 2005 in two hospitals from Iasi. RESULTS: We investigated a total of 86 suspected episodes of systemic infections that occurred in 76 selected patients, 40 males and 36 females (average age = 26 years old). There were 39 (45.35%) febrile episodes with positive blood culture and 47 (54.65%) with negative blood culture. The most common microorganisms were gram-positive cocci 12 (30.76%), followed by stable cell-wall deficient forms 9 (23.07%), gram-negative bacteria 7 (17.95%), gram-positive bacteria 5 (12.82%), fungi 4 (10.25%), and anaerobes 2 (5%). From the total of 23 cell-wall deficient form strains (58.97%), 14 returned to their typical morphology (6 gram-positive cocci, 5 gram-positive bacilli, 3 gram-negative bacilli) and 9 were L-stable. CONCLUSIONS: 1) The isolation rate of 45.5% was in accordance with literature reports; similar percentages of gram-positive and gram-negative isolates were found (the shift from predominating gram-negative to a gram-positive etiology was noted). 2) A high proportion of cell wall deficient forms was found, rarely reported in previous studies. 3) Studies reporting local microbiological findings are necessary because they support an initial empiric antibiotic regimens for prophylaxis or therapy more accurately than from other areas. The right treatment protocols remain to be established.

[Disseminated infections due to Scedosporium apiospermum in a patient with anaplastic large cell lymphoma. A case study]. / Infectie diseminata cu Scedosporium apiospermum la un pacient cu limfom anaplastic tip T cu celule mari. Prezentare de caz.

A 42-year-old man was diagnosed with hepatosplenic T-cell lymphoma in November 2003. Remission was incompletely achieved despite 10 courses of chemotherapy. He developed fever (38.5-39 degrees C), chills, cough and morning expectoration after the 61 courses of chemotherapy. During this period, an ultrasound of the abdomen showed multiple hypodense lesions of the liver. Culture of the sputum yielded Scedosporium apiospermum. Fungal cultures from blood remained negative. The patient was treated with voriconazol. After one month from therapy, an ultrasound examination showed decreasing of hypodense lesions of the liver, and no further lesions appeared. Based on significant improvement of liver lesions with voriconazole therapy, we proposed the diagnostic "probable" disseminated infections due to S.apiospermum.

[Screening methods for detection of metallo-beta-lactamase producing gram negative rods]. / Metode de screening al bacililor gram-negativi producatori de metalo-beta-lactamaze.

Modified Hodge test and a method using a disk with imipenem plus 1000 mg of EDTA were used to determine the presence of metallo-beta-lactamase producing gram-negative rods among 166 clinical isolates from hospitals in Iasi and Galati. Of 9 imipenem resistant strains found, only one Pseudomonas aeruginosa gave positive results with both tests and other two P. aeruginosa clinical isolates gave negative results with both tests. The rest of the strains (2 P. aeruginosa, 2 Acinetobacter baumanii, 1 Sphingomonas paucimobilis) did not give conclusive results. These screening methods are useful, simple and accessible to clinical laboratories. PCR is needed to confirm the presence of metallo-beta-lactamase gene in bacteria and to determine the type of the enzymes.