A seroprevalence study of poliovirus antibody in the population of northern Greece

This study assessed immunity to poliomyelitis in a representative sample of 1064 persons living in northern Greece. Antibody prevalences in the individuals tested were 91.1% (95% confidence interval (CI): 89.4-92.8), 92.1% (95% CI: 90.5-93.7) and 83.1% (95% CI: 80.8-85.4) for poliovirus types 1, 2 and 3, respectively. For poliovirus type 3, a gap in immunity was found in individuals aged 10-29 years. Re-vaccination of adolescents living in northern Greece is suggested to ensure herd immunity and to minimise the risk of importation of wild poliovirus from endemic countries.     

Seroprevalence of Toxoplasma gondii in northern Greece during the last 20 years

The seroprevalence of Toxoplasma gondii in the northern Greek population was determined in 1984, 1994 and 2004, and changes during this period were investigated. In total, 1014, 812 and 958 sera from individuals aged 1 day to 70 years were examined in 1984, 1994 and 2004, respectively, for IgG and IgM anti-Toxoplasma antibodies with the standard immunofluorescence assay (IFA) and microparticle enzyme immunoassay (MEIA). In individuals positive for IgM-specific antibodies, primary infection with Toxoplasma was diagnosed on the basis of the Toxoplasma serological profile (IFA, MEIA, conventional IgM and IgA ELISAs, immunosorbent agglutination assay and IgG avidity test). The prevalence of IgG-specific antibodies in the general population was 37%, 29.9% and 24.1% in 1984, 1994 and 2004, respectively, and was 35.6%, 25.6% and 20%, respectively, in women of reproductive age (15-39 years). The incidence of Toxoplasma infection, based on cases of primary infection and the annual seroconversion rate for the general population, was estimated to be 1.25% and 1.1% in 1984, 1.05% and 0.93% in 1994, and 0.85% and 0.8% in 2004. The significant decline in prevalence, and the shift towards an older age group, observed during this period could be explained by the improved socio-economic situation. The high (80%) proportion of women of reproductive age susceptible to Toxoplasma infection, with an estimated 90-200 neonates infected in utero annually, seems to present a potential risk to public health. Education of the public and prophylactic measures may become increasingly important.     

In vitro activity of daptomycin against Gram-positive cocci: the first multicentre study in Greece

A total of 10420 Gram-positive cocci (including staphylococci, enterococci and various groups of streptococci) collected from clinically significant specimens in ten Greek hospitals during 2006--2007 were tested for their susceptibility to daptomycin. The minimum inhibitory concentration (MIC) was determined by the broth microdilution method. Daptomycin demonstrated very high activity against Enterococcus faecalis (MIC at which 50% of the isolates were inhibited (MIC50) = 1mg/L and MIC at which 90% of the isolates were inhibited (MIC90) = 1.36 mg/L), Enterococcus faecium (MIC50 = 1.36 mg/L and MIC90 = 1.90 mg/L), Streptococcus pyogenes (MIC50 = 0.12 mg/L and MIC90 = 0.50mg/L), Streptococcus agalactiae (MIC50 = 0.09 mg/L and MIC90 = 0.12 mg/L), Streptococcus pneumoniae (MIC50 = 0.24 mg/L and MIC90 = 0.5 mg/L) and viridans group streptococci (MIC50 = 0.50 mg/L and MIC90 = 0.89 mg/L). Resistance to linezolid and vancomycin for enterococci and to penicillin for streptococci appears to be independent of reduced susceptibility to daptomycin. On the other hand, daptomycin was also active against meticillin-resistant Staphylococcus aureus (MIC50 = 0.44 mg/L and MIC90 = 0.78 mg/L) and meticillin-resistant coagulase-negative staphylococci (MIC50 = 0.24 mg/L and MIC90 = 0.44 mg/L); however, 0.9% of the staphylococci tested had an MIC > 1mg/L, which is the Clinical and Laboratory Standards Institute breakpoint proposed for susceptibility. For all tested organism groups, resistance to daptomycin was not associated with glycopeptide resistance.     

Molecular epidemiology of Echovirus 6 in Greece

The objective was to investigate the genetic relationships among Echovirus 6 (E6) strains circulating in Greece and to compare them with the respective strains from other geographic regions. Cerebrospinal fluid samples collected during the period 2006–2007 from 84 patients with aseptic meningitis or encephalitis were tested for a probable enteroviral infection. Two RT-PCRs amplifying overlapping regions of the VP1 gene were performed, while isolation procedures were applied in one third of cases. All PCR products were sequenced, and further phylogenetic analysis was performed for E6 strains. Enteroviruses were detected in 27 out of 84 cases (32.14%) and E6 was the predominant serotype (11 out of 27, 40.74%). Three distinct clades of Greek E6 sequences were seen in the phylogenetic tree: sequences of the present study were placed in clades A and B, while sequences of a former study in Greece were clustered in clade C. Sequences of clades A and C presented high genetic homology (>95%) with sequences from other countries, while sequences of clade B were unique, differing by more than 15% from all known E6 sequences. The most prevalent enterovirus in Greece during the period 2006–2007 was E6, and was associated with aseptic meningitis. A high degree of heterogeneity was observed among Greek E6 strains.     

Serological survey on the immunity to diphtheria of the northern Greek population

The recent outbreak of diphtheria in the Newly Independent States (NIS) of the former USSR and the immigration from these high risk areas to Greece prompted us to determine the diphtheria antitoxin levels by enzyme-linked immunosorbent assays (ELISA) in 509 healthy individuals (307 males and 202 females) from northern Greece. The population under study was divided in ten age groups from 1 day to > 60 years old. Diphtheria antitoxin levels of 0.1 IU/ml were considered as protective ones. 44.6% of the examined people were found susceptible. The children up to their twenties seem to be immune to diphtheria in a high proportion (86–88.4%). The diphtheria antitoxin levels declined sharply above this age (17.6% in the age group 21–30 years old). The level of protection in adults appeared to be higher in the oldest group (49%). According to these results, the adults are not properly protected. Booster doses of vaccine for them are recommended to improve the resistance of the northern Greek population from possible infection by toxigenic stains of Corynebacterium diphtheriae, imported or endogenous.     

Specific detection of blaVIM and blaIMP metallo-β-lactamase genes in a single real-time PCR

This study describes the development of a real-time PCR protocol for rapid detection of the most common bla(VIM) (bla(VIM-1), bla(VIM-2), bla(VIM-3), bla(VIM-4), bla(VIM-5), bla(VIM-6), bla(VIM-10), bla(VIM-11), bla(VIM-12)) and bla(IMP) (bla(IMP-1), bla(IMP-2), bla(IMP-6), bla(IMP-8), bla(IMP-10), bla(IMP-15), bla(IMP-19), bla(IMP-20)) genes in a single reaction. The genes were specifically detected and clearly differentiated into four groups, i.e., (i) bla(VIM-1)-like (bla(VIM-1), bla(VIM-4), bla(VIM-5), bla(VIM-12)); (ii) bla(VIM-2)-like (bla(VIM-2), bla(VIM-3), bla(VIM-6), bla(VIM-10), bla(VIM-11)); (iii) bla(IMP-1)-like (bla(IMP-1), bla(IMP-6), bla(IMP-10)); and (iv) bla(IMP-2)-like (bla(IMP-2), bla(IMP-8), bla(IMP-15), bla(IMP-19), bla(IMP-20)), by melting curve analysis of the real-time PCR products. The protocol was used to screen positive bla(VIM-1), bla(VIM-2) and bla(IMP-1) control strains, 70 Gram-negative isolates resistant to carbapenems, and 30 Gram-negative isolates susceptible to carbapenems (negative controls).     

Echovirus 15 and autumn meningitis outbreak among children, Patras, Greece, 2005.

BACKGROUND: Enteroviruses are the most common cause of aseptic meningitis, presenting in epidemic or endemic form. OBJECTIVES: To determine the causative agent of an aseptic meningitis outbreak in autumn, 2005 in Patras, Greece. STUDY DESIGN: Cerebrospinal fluid (CSF) samples taken during May 2005-February 2006 from children admitted to the Children Hospital of Patras with signs of aseptic meningitis were tested for the presence of enteroviral RNA. Typing was performed by nucleotide analysis. RESULTS: Enteroviruses were detected in 11 (57.9%) of 19 tested CSF samples. In a 12-day period (27 October-7 November 2005) five aseptic meningitis cases were observed. Echovirus 15 was detected in all five cases, and differed from the prototype strain by 27.6%. Enteroviruses before and after this cluster of cases were of different serotypes (Echovirus 9, Echovirus 6). All patients with Echovirus 15 infection were male with a mean age of 7.7 years (2 months-13 years), all recovered successfully. CONCLUSIONS: This is the first report of a cluster of aseptic meningitis cases caused by Echovirus 15. The causative agent was a new variant of Echovirus 15.     

Aseptic meningitis and encephalitis because of herpesviruses and enteroviruses in an immunocompetent adult population

Background and aim:  Human herpesviruses (HHVs) and enteroviruses (EVs) are the major causative agents of CNS viral infections. The aim of the study was to identify the etiology and determine the frequency of aseptic meningitis and encephalitis due to HHVs and EVs in an immunocompetent adult population.
Methods:  Eighty-one patients (ages ≥15) with aseptic meningitis or encephalitis treated in the Infectious Diseases Hospital of Thessaloniki, Greece, during 2003–2006, were included in the study. Polymerase chain reaction for detection of herpes- and enterovirus genome direct in cerebrospinal fluid samples was performed.
Results:  Based on clinical and laboratory data, 36/81 patients had meningitis and 45/81 had encephalitis. Etiology was defined in 11 patients (31%) with aseptic meningitis. EVs were the major causative agents (8/36, 22%), followed by varicella zoster virus (2/36, 5%) and herpes simplex virus-2 (HSV-2) (1/36, 3%). Etiology was identified in 8 of 45 (18%) patients with encephalitis, EV (4/45, 9%) and HSV-1 (4/45, 9%) being the most common pathogens.
Conclusion:  Enteroviruses are the most common cause of adult aseptic meningitis and together with HSV-1 the main causes of encephalitis.     

Molecular epidemiology of adenovirus strains isolated from patients with ocular disease in the area of Thessaloniki, Greece (1998-2002)

Thirty strains of adenovirus (Ads) associated with ocular disease have been isolated over a period of 4 years in Thessaloniki, Northern Greece. Eleven strains were isolated from sporadic patients with conjunctivitis or keratoconjunctivitis in Thessaloniki city between 1998 and 2000. Nineteen strains were isolated from patients with keratoconjunctivitis during an outbreak of Ads in the area of Thessaloniki (Thessaloniki and Serres cities) in 2002. PCR-sequence method using primers targeted against the hypervariable regions (HVRs) of hexon gene, as well as the neutralization test were used for typing the Ad isolates and assessing a possible relation among these strains, and their genetic variability. Ad4 with very close homology to variant Z-G 95-873 was the most frequent genotype causing sporadic conjunctivitis over a period of 4 years. Two other strains, one Ad2, and one Ad3 were similar to the prototype ones, and a third one shows close homology to the variant of prototype Ad15, the Morrison strain. The genome typing of twenty two Ad8 isolates showed very close homology in their amino acid and nucleotide sequences to the variant of Ad8, strain 1127 (accession no. X74663). Four were isolated from patients with keratoconjunctivitis in 1998, 1999, 2000 and 18 during the outbreak in 2002. As far as strain 1127 is concerned, all the Ad8 isolates showed the same changes in the HVR 1 and HVR 2 except one isolate in 1998, which showed some changes outside the HVRs. During the outbreak of Ad8 keratoconjunctivitis, it was not possible to identify the exact source of infection (nosocomial or/and outpatients). Finally, Ad4 variant Z-G 95-873 and Ad8 which is closely related to the strain 1127, were found to be the predominant adenoviruses circulating in Northern Greece during 1998-2002.