West Nile virus state of the art report of MALWEST Project.

During the last three years Greece is experiencing the emergence of West Nile virus (WNV) epidemics. Within this framework, an integrated surveillance and control programme (MALWEST project) with thirteen associate partners was launched aiming to investigate the disease and suggest appropriate interventions. One out of seven work packages of the project is dedicated to the State of the Art report for WNV. Three expert working groups on humans, animals and mosquitoes were established. Medical databases (PubMed, Scopus) were searched together with websites: e.g., WHO, CDC, ECDC. In total, 1,092 relevant articles were initially identified and 258 of them were finally included as references regarding the current knowledge about WNV, along with 36 additional sources (conference papers, reports, book chapters). The review is divided in three sections according to the fields of interest: (1) WNV in humans (epidemiology, molecular characteristics, transmission, diagnosis, treatment, prevention, surveillance); (2) WNV in animals (epidemiological and transmission characteristics concerning birds, horses, reptiles and other animal species) and (3) WNV in mosquitoes (control, surveillance). Finally, some examples of integrated surveillance programmes are presented. The introduction and establishment of the disease in Greece and other European countries further emphasizes the need for thorough research and broadening of our knowledge on this viral pathogen.

Characterization of Enterobius vermicularis in a human population, employing a molecular-based method from adhesive tape samples.

Human infection with the parasitic nematode Enterobius vermicularis occurs worldwide, particularly in children. Although its prevalence may exceed 35% in some parts of the world, molecular studies of E. vermicularis in humans are limited. The aim of the present study was to investigate the genetic variation within E. vermicularis in a human population. For this purpose, 77 adhesive tape samples taken from Greek children infested with E. vermicularis were tested. New primers were designed to amplify a segment of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene of E. vermicularis from adhesive tape samples. Thirty-six amplicons were sequenced and eleven different haplotypes were identified. All sequences clustered within the type previously characterized (type B), only reported to date from captive chimpanzees. To the best of our knowledge, this is the first study of E. vermicularis genotypes from a human population.

Streptococcus agalactiae infections in non-pregnant adults: single center experience of a growing clinical problem.

BACKGROUND: Group B beta-hemolytic streptococcus (Streptococcus agalactiae) has been traditionally considered a major pathogen in neonates and pregnant women. However, there is accumulating concern about its significance in non-pregnant adults too. MATERIAL/METHODS: To study Streptococcus agalactiae infections in non-pregnant adults in a 354-bed general tertiary center in Athens, Greece, we analyzed retrospectively collected data from patients with Streptococcus agalactiae isolates during a 5-year period. RESULTS: Sixty-nine strains were isolated from specimens of 65 non-pregnant adults (42 women and 23 men). Thirty-four of them were managed as inpatients and 31 as outpatients. Mean age of the 34 inpatients was 57.7 (range 18-84) years. Nineteen (17 women and 2 men) of the 34 inpatients had the organism isolated from urine. Thirteen of these 19 (68.4%) patients had clinical evidence of urinary tract infection (UTI). Streptococcus agalactiae infections were diagnosed in 26 of 34 inpatients. Besides the 13 inpatients with an UTI, 2 had bacteremia of unknown origin, 2 pneumonia, 2 erysipelas, 1 spondylodiscitis, 1 peritonitis, 2 prostatitis, 1 perirectal abscess, 1 testicular abscess, and 1 diabetic foot infection. Underlying conditions of the 26 inpatients possibly predisposing to infections were neoplasia, diabetes mellitus, heart disease, splenectomy, and corticosteroid treatment. CONCLUSIONS: In keeping with results from other recent studies Streptococcus agalactiae was isolated more frequently than previously believed from non-pregnant adults in our study. In addition, our data suggest that Streptococcus agalactiae may be an underestimated cause of UTI in non-pregnant women.

Molecular and morphological characterization of Aedes albopictus in northwestern Greece and differentiation from Aedes cretinus and Aedes aegypti.

The presence of Aedes albopictus (Skuse) was recently confirmed for the first time in northwestern Greece. This location is within the distribution range of a morphologically similar species, Aedes cretinus Edwards, and is a potentially favorable region for the reintroduction of Aedes aegypti (L.). It was thus compelling to use methods in addition to morphology-based keys to correctly identify specimens badly damaged, rubbed, or otherwise altered in their external characteristics. It was decided to use molecular techniques as a novel and reliable method for differentiating the three Stegomyia species. The nuclear internal transcribed spacer 2 (ITS2) fragments from morphologically identified Ae. albopictus and Ae. cretinus specimens were amplified, and their sequences were compared with those in GenBank for Ae. albopictus, Ae. cretinus, and Ae. aegypti. Also, mitochondrial cytochrome oxidase I (COI) fragments were amplified for Ae. albopictus and Ae. cretinus (so far not available in GenBank) and compared with Ae. aegypti fragments. ITS2 and COI sequences generated in our study were deposited in GenBank and could be useful in future studies of mosquitoes by other research workers.

The 500-base-pair fragment of the putative gene RvD1-Rv2031c is also present in the genome of Mycobacterium tuberculosis.

BACKGROUND: It has been proposed that differentiation between M. bovis and M. tuberculosis is possible by using a PCR assay for the 500bp fragment present only in the M. bovis genome. MATERIALS AND METHODS: Forty clinical samples and 16 clinical isolates from the Department of Microbiology, as well as 4 clinical isolates obtained from another laboratory, were tested for the purpose of this study. As controls we tested 2 M. bovis (M. bovis BCG Pasteur TMC1011 and M. bovis BCG Copenhagen), 1 H37Rv M. tuberculosis strain, 2 M. avium (ATCC15765 and ATCC1975, respectively) and 1 M. paratuberculosis (ATCC19698) strains. RESULTS: None of the mtp40- negative clinical isolates amplified the 500bp fragment, whereas 4 out of 17 mtp40-positive clinical isolates scored positive for the 500bp fragment. All clinical isolates scored positive for IS6110, mtp40, the pncA and oxyR PCR's. All but one of the clinical isolates amplified the 500bp fragment. Sequence analysis of the pncA and oxyR PCR products revealed the presence of nucleotide C at position 169 and G at position 285 respectively, suggesting M. tuberculosis as the causative agent. CONCLUSION: Our data suggest that the 500bp PCR fragment is present not only in M. bovis but also in M. tuberculosis.

Strongyloides hyperinfection in a patient with sarcoidosis.

A 51-year-old-woman presented with chronic eosinophilia, a diffuse interstitial lung pattern on CT and splenomegaly with hypodense lesions. A diagnosis of sarcoidosis was determined from a lung biopsy. Hyperinfection with strongyloides following treatment with systemic steroids explains the presence of eosinophilia and splenic involvement.