New Insights into Clostridium difficile infection

Maria Chasampalioti1, Georgia Kagalou2, Melina Kachrimanidou1
1.Department of Microbiology, Medical School, Aristotelian University of Thessaloniki
2.Department of Microbiology, AXEPA University Hospital

Clostridium difficile is one of the most important causes of healthcare associated diarrhea. The
spectrum of the disease can range from mild, self-limited diarrhea to severe, life-threatening colitis.
The main virulence factors of the microorganism are the two large clostridial toxins A and B.
C. difficile associated disease can arise if the normal flora has disrupted by antibiotic therapy.
Major risk factors for C. difficile infection are previous exposure to antimicrobial agents, hospitalization
and advanced age. The diagnosis of CDI is established by a combination of clinical suspicion
and laboratory confirmation. Treatment depends on the severity of infection. Prevention
of C. difficile infection can be achieved by avoiding acquire the organism and by controlling the
transmission of C. difficile and its spores in a hospital environment. Over the past decade, there
was an increased research interest that focused on new virulence factors, developing new treatment
regimens and prevention strategies. This review summarizes the recent changes that have
occurred in the epidemiology of C. difficile infection and focuses on the diagnosis, management
and prevention of CDI.

Key words
Diarrhea, Clostridium difficile, epidemiology, diagnosis,treatment, prevention

Biochemical analysis of seminal plasma

George Antonakos1, Georgia Vrioni2
1.Department of Clinical Biochemistry, General University Hospital “Attikon”, Haidari, Attiki, Greece
2.Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece

Biochemical analyses of the seminal fluid would provide valuable information on the function
of the accessory genital glands under normal and pathologic conditions, especially in case of infertility.
This review presents several biochemical markers, like pH of the semen, as well as biochemical
parameters of the secretion of prostate, epididymis and seminal vesicles, their role,
methods of measure, and their reference values.

Key words
seminal plasma, biochemical parameters

IL28B polymorphisms in patients with HBeAg negative chronic HBV infection genotype D.

Emilia Hadziyannis1, Andreas Laras1, Eleni Panopoulou1, Alexandros Gryparis2,
Stephanos J. Hadziyannis1
1.Academic Department of Medicine at Hippokration Hospital, National and Kapodistrian University of Athens,
Athens Greece,
2.Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens,
Athens Greece.

Aim of the study: Evaluation of possible associations of single nucleotide polymorphisms upstream
the interferon-lambda 3 (IL28B) gene with the phases of HBeAg-negative chronic hepatitis
B virus (HBV) genotype D infection and with patient outcomes in a Caucasian population.
Materials and methodology: The IL-28B rs12979860 polymorphisms were evaluated in 400 Greek
patients with HBeAg-negative chronic HBV infection genotype D (n=311 with chronic hepatitis B,
n=89 inactive HBsAg carriers) and a control group of 222 healthy adults of the same race and ethnicity.
Associations with the phase of the infection, response to interferon and/or nucleos(t)ide
analogue (NA) therapy, development of hepatocellular carcinoma (HCC) and spontaneous HBsAg
clearance were investigated.
Results: The distribution of IL28B genotypes and C and T allele frequency among the overall cohort
of patients with chronic HBV infection was not statistically different from the general population.
In males inactive HBsAg carriers the CC genotype (59%) and C allele (74.5%) were statistically significantly
more prevalent compared to chronic hepatitis B patients (37.7%, p= 0.028 and 59.5%,
p=0.005, respectively) and the general population (31.4 %, p=0.018 and 58%, p=0.005, respectively).
There was no association between IL28B polymorphisms and allele frequencies with spontaneous
HBsAg clearance, response to treatment or development of HCC.
Conclusions: IL28B polymorphisms at rs12979860 alone do not appear to play any role in the
spontaneous or treatment related outcomes of HBeAg-negative genotype D infection in Caucasians,
but the possibility that CC genotype and C allele favor the development of the inactive
HBsAg carrier state in males should be further investigated.

Key words
genotype D, HBV, IL28B, natural history, treatment

The great epidemics of the 19th century and the birth of Microbiology in Greece

Effie Poulakou-Rebelakou1, Georgia Vrioni2, Evangelos Vogiatzakis3, Athanassios Tsakris2
1.Department of History of Medicine, Medical School, National and Kapodistrian University of Athens, Greece
2.Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Greece
3.Department of Microbiology, General Chest Hospital “Sotiria”, Athens, Greece

The aim of this study is to present the nosological spectrum of infectious diseases in Europe and
especially in Greece during the 19th century. Sources of information have been the scientific
works of the pioneers; the lectures of the Athens Medical Society during the period 1835-1900,
including microbiology-related issues, the biographies of the first microbiologists and the historical
references of the same period. The analysis of the above data reveals that Greece was affected
by the same infections as Europe. The significant discoveries in the field of microbiology
were soon and successfully transplanted in Greece as Greek scientists were educated at the famous
European laboratories. The activities of the pioneers and the establishment of the first
Chair of Microbiology at the University of Athens contributed much to the achieved progress.

Key words
Epidemics, Greece, History of Microbiology, Konstantinos Savvas, Public Health

Measles virus infection: a snapshot from N. Greece in 2017

Angeliki Melidou, Georgia Gioula, Maria Exindari
Microbiology Department, Medical School, Aristotle University of Thessaloniki, Greece

Measles is an infectious disease that still represents an existing health issue of concern in
Europe. While the World Health Organization (WHO) target for the elimination of measles virus
has been postponed until year 2020, in 2016 measles outbreaks were seen in a number of
EU/EEA countries and an increase in the number of cases is still observed in 2017, some linked
to the large ongoing outbreak in Romania. Since 2010, there has been no report from outbreaks
in Greece. However, sporadic cases are reported and genotyping of a recent case with no
known travel history, revealed a B3 genotype, similarly to other parts of the WHO European region,
Austria, Belgium, Germany, Ireland, Italy, Portugal, Sweden, UK and also Romania. National
policies need to assure increased routine vaccination uptake of hard-to-reach groups, especially
taking under consideration the large immigrant wave in the region. It is essential to continue
epidemiological and virological surveillance of measles in Greece to monitor the transmission
pattern of the virus and the effectiveness of measles immunization, which will eventually lead
to the achievement of the goal for elimination.

Key words

Measles, Greece, genotyping, virological surveillance

Saprochaete capitata (former name of Geotrichum capitatum) fungemia in a patient with chronic neurological
and hematological disease

Georgia Vrioni1, Genovefa Chronopoulou2, Christina Vossou2, Kalliopi Theodoridou1,
Constantinos Tsiamis1, Helen Karachaliou1, Anastasia Kouki2, Athanassios Tsakris1
1.Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
2.Biopathology Laboratories, Euroclinic Hospital, Athens, Greece

The filamentous or arthrosporic fungi Saprochaete capitata (previously named Geotrichum capitatum)
is a genus of fungi widely distributed in nature as a component of the soil, water and plants.
Also it is often isolated as a colonizer of the respiratory and gastrointestinal tract in 30% of the
healthy population. Fungemias caused by S. capitata are extremely rare. In fact, invasive infections
due to S. capitata have been reported almost exclusively in neutropenic, oncohematological patients.
In this report, we describe a case of fungemia caused by S. capitata in a patient with chronic
hematological and neurological disease, hospitalized for a long period in an Intensive Care Unit.
The prompt identification of S. capitata is extremely important because of its intrinsic resistance
to echinocandins.

Key words
Saprochaete capitata, fungal infection, fungemia