Oana Streinu-Cercel

Neurocognitive impairment screening in Romanian HCV infected patients

Background Neurocognitive impairment can occur in HCV infected patients. A series of studies have shown that patients with HCV may experience diminished attention and concentration, or suffer from severe cognitive deficits, such as disorientation and fluctuating consciousness. We performed a study to determine if there are neurocognitive differences or dissimilarities in the quality of life between a control group and a group of HCV infected patients.

Breast Ecology Assessment in the Study of Local Microflora

A number of articles published in this and other renowned journals mention the existence of an endogenous breast flora1–3 and its role in the formation of a prosthetic implant biofilm that contributes to capsular contracture.1,4 For example, Wixtrom et al1 showed bacteria-filled breast parenchyma in Figure 4A,B of their article published in Aesthetic Surgery Journal . This depiction comes as somewhat of a surprise, particularly since, to our knowledge, there is no official description of such resident flora of the …

BReast Ecology Assessment in the STudy of local MicroFlora - Study Protocol

INTRODUCTION Recent articles have described an endogenous breast flora, particularly in the nipple ducts, with potential implications in the outcome of aesthetic breast surgery. To characterize the ecology of the breast, we designed a study to assess the microbial species identified on the breast skin and parenchyma in patients undergoing breast surgical interventions. METHODS AFTER OBTAINING INFORMED CONSENT AND BACKGROUND DATA ON CONCURRENT DISEASES, PREVIOUS CONTACT WITH THE HOSPITAL SYSTEM AND PRIOR USE OF ANTIBIOTICS, SAMPLES ARE COLLECTED PREOPERATIVELY FROM THREE AREAS OF THE BREAST SKIN, BILATERALLY: the inframammary fold, the areola and the axilla, prior to decontamination. These samples will serve as positive controls and will aid in characterizing the normal breast skin flora. After preoperative decontamination, samples are again collected, to check for any residual bacterial flora and the nipple is sealed with Tegaderm (3M, USA) and betadine ointment, to reduce any putative bacterial load. Intraoperatively, samples are collected from: a) the incision line (dermal level): 1. superficially, 2. medium depth in the breast parenchyma, 3. deep parenchyma, and b) axillary parenchyma (where possible), together with a bioptic fragment. Postoperatively, a second nipple sample is collected. For secondary breast augmentation surgeries, capsular biopsy is also performed (where relevant), and the implants undergo sonication, to allow biofilm identification. In the laboratory, all samples are cultured on blood agar incubated with CO2, cystine lactose electrolyte deficient medium and Sabouraud gentamicin-chloramphenicol agar. For positive culture samples, the number of colonies and their morphologic characteristics are reported. Identification will be carried out with MALDI-TOF and VITEK (bioMérieux, France), yielding automated antibiotic sensitivity profiles. For all germs with sensitivity profiles differing from the wild-type strain, E-tests will be performed. Follow-up information on the postoperative evolution will be collected and analyzed for potential factors predictive of good evolution. DISCUSSION This study will provide important information about the microflora of the breast skin, its sensitivity profile, and the degree of contamination of the nipple ducts and parenchyma, if any, addressing a scientific hypothesis insufficiently explored so far.

Prevalence of nasal carriage of S aureus in children.

Asymptomatic carriage of Staphylococcus aureus is common, particularly in the anterior part of the nasal cavity. Apart from nasal and nasopharyngeal carriage, another frequent site for S aureus colonization is the skin, particularly the inguinal fold, rectum and axilla. The general prevalence of S aureus carriage is around 20-30% as reported by relevant studies in field literature. In children, data on nasal carriage appears to be somewhat similar to the prevalence reported in adults, ranging from 18.12 to 38.5 percent, but there are certain particularities and a wide variability between results from different countries and different studies. To determine the real prevalence of S aureus and MRSA strains, studies should adjust for confounding factors, as described in this article.

The role of sonication in the microbiological diagnosis of implant-associated infections – the experience of the National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest

The role of sonication in the microbiological diagnosis of implant-associated infections – the experience of the National Institute for Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest Raluca Mihăilescu, Daniela Tălăpan, Olga Dorobăț, Alexandru Rafila, Emilia Capraru, Daniela Munteanu, Anca Streinu-Cercel, Oana Streinu-Cercel, Vlad Predescu, Florian Purghel, Cătălin Cârstoiu, Razvan Ene, Dana Mihaela Jianu, Cristina Popescu, Victoria Aramă, Adrian Streinu-Cercel

Entecavir as specific antiviral therapy in selected cases of severe acute hepatitis B.

The role of specific antiviral treatment in severe acute hepatitis B has been subject to debate during the past few years. We present clinical findings in a series of three cases of severe acute hepatitis B and one case of acute hepatitis B treated with entecavir during 2007-2009, with interesting evolution. Entecavir appeared to improve the clinical evolution in the reported cases. Two of the patients displayed HBsAg to HBsAb seroconversion while another patient went into an inactive HBsAg carrier state. In the case of mild acute hepatitis B, the liver enzymes had returned to normal, symptomatology had receded but HBsAg had remained positive. Without data on viral load, we were unable to determine whether the patient had entered an inactive HBsAg carrier state or had continued into the services of another medical unit, for treatment of chronic HBV infection. We also discuss into detail a case which displayed transient initial HBe seroconversion at 1 week, followed by seroreversion to positive HBeAg and negative HBeAb at week 3, and a new seroconversion at week 7. We assess the possible roles of precore mutations, antibody-dependent cellular cytotoxicity, coinfection with Epstein Barr virus and the function of Kupffer cells.

Molecular determinants of resistance in Escherichia coli-ST131 isolated blood stream infections

Background During the past years an E coli clonal lineage ST131 has emerged explosively, causing predominantly communityonset antimicrobial resistant infections. E coli ST131 has been shown to harbor a number of virulence and resistance genes and is now recognized for its ability to cause potentially severe infections in many parts of the developing world, implying public health measures in attempt to control infection.

Nasopharyngeal bacterial colonization in children – study hypothesis

Background With monthly reports of decreased bacterial susceptibility to antibiotics and the soaring incidence of invasive infections, it becomes increasingly important to assess bacterial colonization, as this can easily constitute a reservoir for infection. Entering the community for kindergarten and school training is an important step for children, particularly since this may be associated with a change in the microbiota.

Correlations between noninvasive tests as predictors of liver fibrosis and of viral response in chronic hepatitis C patients.

Background The noninvasive assessment of liver fibrosis in chronic hepatitis C patients is very important as it dictates the disease prognosis and the indication for therapy, narrowing down the use of the liver biopsy. Standardized scores (FibroTest, FibroMax) and imaging techniques (FibroScan) have been validated in this respect. As for the noninvasive prediction of the sustained viral response (SVR), GenoFibroTest and Prometheus are two indexes that may be used. This study’s aim is to compare several biological scores with these standardized scores for evaluating fibrosis and the two indexes for prediction of SVR.

Antiviral treatment in severe acute hepatitis B

We aimed to evaluate the clinical, biological and virological impact of antiviral therapy in severe acute hepatitis B. [1]