Simona Birsanu, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu
{"title":"Antiviral medication to prevent fetal transmission of maternal CMV during pregnancy","authors":"Simona Birsanu, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2022.2.1","DOIUrl":"https://doi.org/10.37897/rjid.2022.2.1","url":null,"abstract":"Background. Cytomegalovirus infection represents the most frequent congenital viral infection, with serious consequences on newborns. Neurosensorial hearing loss is the principal outcome, but also, the infection can cause other central nervous system’s anomalies. Although CMV infection can have a major impact on fetal development, there are not clear directions to follow yet, to prevent or treat this condition. Therefore, our purpose with this paper is to update the knowledge regarding the treatment options in order to prevent fetal transmission of maternal CMV infection, based on the latest data from the specialized literature in this field. Methods. Electronic research and analysis of the relevant articles published mainly in the last 5 years were performed, consulting the web platforms PubMed, ScienceDirect, Mendeley and ClinicalTrials.gov. Results and conclusions. To date, there is not enough evidence to reach a consensus on therapeutic methods to prevent or to treat fetal CMV infections and, as a consequence, antenatal screening is not justified. Many pharmaceutical companies work on vaccines to prevent CMV infection, but the results are only from studies’ second phase. Information on efficiency of hyperimmunoglobulin is mixt and it is necessary to clarify the dosage. Among antiviral agents, valaciclovir, which was studied in recent clinical trials, seems to have the best efficiency to prevent fetal transmission of maternal CMV infection and the best safety profile. Valganciclovir has possible embryotoxic effects, but higher potency and information on it are available only from case reports. The interest of scientific community on this topic is high, thus many studies are underway to bring new clarifications.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47676425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current and future approaches in Clostridioides difficile management","authors":"G. Gherlan","doi":"10.37897/rjid.2022.2.6","DOIUrl":"https://doi.org/10.37897/rjid.2022.2.6","url":null,"abstract":"Clostridioides difficile is considered one of the main causes of the healthcare associated infections worldwide and the main cause of antibiotic-associated diarrhea, with forms of clinical disease ranging from mild to deadly. Both 2021 IDSA and ESCMID guidelines recommend that for the first episode of CDI Fidaxomicin should be considered as the preferred regimen of treatment and Vancomycin becomes 2nd Standard of Care (SOC) line, an alternative to fidaxomicin. Monoclonal antibodies, fecal microbiota transplantation and surgery remain other recommendations in the guidelines. New means of management of Clostridioides difficile infection are under development, these including prevention measures (vaccination, population with non-toxigenic strains of the colon, standardized fecal microbiota products) and new antibiotics.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47899175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nóra Evelin Jiva-Chiril, L. Meliț, Tudor Fleșeriu, O. Marginean
{"title":"Diagnostic and therapeutic challenges in SARS-CoV-2 and Rotavirus coinfection","authors":"Nóra Evelin Jiva-Chiril, L. Meliț, Tudor Fleșeriu, O. Marginean","doi":"10.37897/rjid.2022.2.2","DOIUrl":"https://doi.org/10.37897/rjid.2022.2.2","url":null,"abstract":"The SARS-CoV-2 infection in children associates multiple challenges related especially to the diagnosis due to the lack of symptoms or due to the polymorph clinical picture that might occur in these children, and which can often mimic a wider spectrum of pathologies. The Rotavirus infection is one of the most common etiologies of acute gastroenteritis in children which might result in increased mortality rates in small ages or in patients at risk. We report the case of a 2-month-old male infant, without significant personal history admitted to the Pediatrics Clinic 1, COVID Compartment, Targu-Mures, for vomiting, loss of appetite, and diarrhea. The family history revealed that the paternal grandfather was confirmed with SARS-CoV-2 infection. Based on the patient’s symptoms and anamnesis, he was tested and confirmed with SARS-CoV-2 by RT-PCR. The stool viral antigens confirmed also Rotavirus infection. The clinical exam at the time of admission pointed out influenced general status, diminished cutaneous turgor, abdominal tenderness at palpation and accelerated bowel movements. The laboratory tests revealed severe dehydration associated with positive inflammatory biomarkers. Taking into account the small age, the presence of coinfection and the severe dehydration, we initiated supportive treatment with rehydration solutions by vein, antibiotics, anticoagulant and symptomatic treatment. The patient’s evolution was favorable with the previously mentioned treatment. The early diagnosis of a possible coinfection in pediatric ages represents the cornerstone in preventing potential complications.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43846935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simona Daniela Savu (Popescu), Alina Marin, D. Codreanu, R. Vlădăreanu
{"title":"Human papillomavirus infection and associated risk of preterm birth","authors":"Simona Daniela Savu (Popescu), Alina Marin, D. Codreanu, R. Vlădăreanu","doi":"10.37897/rjid.2022.2.3","DOIUrl":"https://doi.org/10.37897/rjid.2022.2.3","url":null,"abstract":"Introduction. The human papilloma virus (HPV) is a virus usually transmitted through mucocutaneous contact directly with the infected organs, resulting in a sexually transmitted infection that exposes particularly young women to a high risk of developing neoplasia of cervical, anogenital, respectively oropharyngeal origin if the virus persists for more than 1-2 years. Our study aimed to detect the correlation between HPV infection and spontaneous preterm labor. Materials and methods. We conducted an observational comparative case-control study in the Department of Neonatology/Obstetrics and Gynaecology of Elias Emergency University Hospital on women diagnosed with HPV infection to assess the risk of preterm labour associated with this infection. Results. The overall group of patients was divided into two groups (confirmed and unconfirmed (or negative) with HPV infection). We observed that, among positive patients, there was a higher incidence of patients infected with a single HPV strain (n=36), followed by patients infected with 2 strains (n=7). Our study revealed the fact that only 4 cases (22.2%) had a history of preterm birth, as opposed to 77.8% (14 cases) who had no associated preterm birth history in the case of HPV genotype 16 positive patients. The data obtained showed no statistical significance (p=0.977). Conclusions. Preterm birth remains one of the leading causes of perinatal mortality and lifetime morbidity worldwide. HPV is a frequently diagnosed viral infection, but clinical studies have observed mixed results regarding the association of HPV 16 and the risk of preterm birth.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47096441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marius-Costin Chitu, T. Salmen, B. Mihai, Vlad Dima, Claudia-Gabriela Potcovaru, D. Cinteză, R. Bohîlțea, Paula-Roxana Raducanu, D. Marcu, D. Mischianu
{"title":"Diagnostic challenges in neuroinfections: case report and literature review","authors":"Marius-Costin Chitu, T. Salmen, B. Mihai, Vlad Dima, Claudia-Gabriela Potcovaru, D. Cinteză, R. Bohîlțea, Paula-Roxana Raducanu, D. Marcu, D. Mischianu","doi":"10.37897/rjid.2022.2.4","DOIUrl":"https://doi.org/10.37897/rjid.2022.2.4","url":null,"abstract":"Meningitis and encephalitis are a group of neuroinfectious diseases that require both correct and early diagnosis and etiopathogenic treatment, because their potential for severe evolution, is often being associated with sequelae. In addition to the detailed anamnesis and clinical examination, it is important to know the specific neurological manifestations at the beginning in order to decide properly the indication to perform the lumbar puncture for identifying an etiopathogenic agent in order to administer a targeted treatment. We present the approach both in terms of diagnosis and treatment, in case of an elderly patient with a favourable evolution, towards healing, without associating neurological sequelae. At the same time, we present a synthesis of the novelties of diagnostic and treatment methods in infectious meningitis and encephalitis.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46241522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Talbi, W. Ferjaoui, S. Omrani, M. Hajri, S. Baccouche, Nizar Cherni, L. Gharbi, Nefaa Arfaa, H. Mestiri, R. Bayar
{"title":"Hydatid cysts of the liver opening in the biliary tracts: about 120 cases comparative study between radical and conservative treatment","authors":"G. Talbi, W. Ferjaoui, S. Omrani, M. Hajri, S. Baccouche, Nizar Cherni, L. Gharbi, Nefaa Arfaa, H. Mestiri, R. Bayar","doi":"10.37897/rjid.2022.1.5","DOIUrl":"https://doi.org/10.37897/rjid.2022.1.5","url":null,"abstract":"Background. Hepatic hydatid disease is still common in Tunisia, is deemed benign disease but concerns its complications; the most frequent is the rupture in biliary ducts. The aim of the work was to study the results of surgical treatment of hydatid cysts of the open liver in the bile ducts and to deduce the predictive factors of postoperative complications. Methods. This was a retrospective study, done in the department of general surgery of Mongi Slim hospital, over a period of 11 years (from January 2000 to December 2013) and collecting 115 patients. Judging criteria were specific morbidity, length of postoperative stay and recurrence. Results. The median age was 43 years (62 women and 53 men). The clinic consisted of typical cholangitis episodes (6.95%), 6.95% of patients were asymptomatic. 50 radical interventions and 65 conservative interventions were performed, supplemented by treatment of the fistula as follows: Fistula blindness (43.47%), trans-fistulo-oddian drainage (3.4%), bipolar drainage (2.6%), PERDOMO (6.95%). The overall mortality was zero. The overall morbidity was 27.69% with an overall specific morality of 14.7% mainly represented by the suppuration of the CR and the external biliary fistulas. The median postoperative stay was 6 days; the recurrence rate was 1.7% with a delay of 30 months. The predictive factors of postoperative complications in bi variance were: The size of the cyst (p = 0.02), The location of a cyst in the hepatic dome (p = 0.002), Surgical treatment: radical or conservative (p = 0.02), The sex factor (p = 0.015). The multivariate study who found a significant association between sex only and postoperative complications. Conclusion. Advances in hepatobiliary surgery and anesthesia are changing the surgical attitude in favor of radical procedures with favorable consequences in terms of morbidity, length of stay and recurrence. It is believed that the surgeon’s experience is the most important factor in the success of surgical treatment. This helps to prevent complications.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46786407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Sorokman, P. Moldovan, I. Sokolnyk, D.I. Koliesnik, N. Popelyuk
{"title":"Concentration of alpha-defensins in the blood plasma of children with Helicobacter pylori – associated peptic ulcer of the duodenum","authors":"T. Sorokman, P. Moldovan, I. Sokolnyk, D.I. Koliesnik, N. Popelyuk","doi":"10.37897/rjid.2022.1.4","DOIUrl":"https://doi.org/10.37897/rjid.2022.1.4","url":null,"abstract":"Introduction. Various gastrointestinal and extragastric diseases are associated with H. pylori in children and adolescents, but the strongest testing and treatment guidelines are only for children and adolescents with peptic ulcer. The most promising developments now are the study of the antibacterial effect of endogenous antimicrobial peptides (AP), among which the most important are defenses 1-3 (human neutrophil peptides, HNPs1-3). Objective. To investigate the concentration of HNPs 1-3 in children with H. pylori-associated peptic ulcer of the duodenum (DU). Methods. A study of 65 children with DU (47 children with H. pylori-associated DU, 18 children with H. pylori-negative DU) and 25 healthy children aged 7-18 years with the determination of HNPs 1-3 levels in plasma. Results. More common was H. pylori in the group of children with III grade of inflammation than in the group of children with II grade (χ2:p<0.0001). A significant association was found between mucosal inflammation activity and the presence of H. pylori (r=0.66, p<0.0001). The mean level of HNP1-3 in healthy children was 13.67±0.96 ng/ml, in children with DU it was probably higher and was 104.88±11.5 ng/ml (p=0.005). There is a direct correlation between the level of HNP1-3 and the severity of DU in children (r=0.67, p>0.05), as well as between HNP1-3 and the activity of the inflammatory process (r=0.73, p>0.01). In children with H. pylori-associated DU, HNP1-3 values were significantly higher (107.34±16.18 [98.45-119.22]) ng/ml than those in children with DU not associated with H. pylori infection (66.70±11.31 [59.54-73.29]) ng/ml and in healthy children (13.67±0.96 [7.27-18.91] ng/ml). Conclusion. Elevated plasma HNP1-3 levels in children with DU in the presence of H. pylori are likely to be a protective response to limit infection that can be used as a potential biomarker of adverse events.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43840038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Cioroba, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu
{"title":"HIV medication to prevent fetal infection during pregnancy","authors":"T. Cioroba, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2022.1.2","DOIUrl":"https://doi.org/10.37897/rjid.2022.1.2","url":null,"abstract":"When it has been declared a global epidemic, HIV infection became a challenge for medical world. Even if there is only one healed case cited in literature, treatment for HIV-infection have evolved during time leading to very good results in disease control and limitation of virus transmission. When it comes for viral transmission, an essential research topic became the prevention of mother to fetal transmission. In the long run, many discovered antiretroviral drugs proved to be efficient in controlling HIV infection during pregnancy and thereby in reducing the risk of viral transmission to the fetus. But along with use of the HIV-treatment in pregnancy, many questions have appeared. Are the drugs safe for the fetus, or are there any adverse pregnancy outcomes? Should the treatment be adjusted for the desired results in pregnancy, or should the initial treatment be changed when the pregnancy is diagnosed? Many retrospective or prospective observational studies and comparative studies have been conducted in order to answer those questions and to analyze the efficacy and the safety of mostly used antiretroviral drugs in pregnancy. This article reviews the existing studies, guidelines and recommendations regarding the combined antiretroviral HIV treatment during pregnancy for fetal infection prevention.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46693730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Menstrual cycle abnormalities in women vaccinated against COVID-19","authors":"Ioana Zechiu","doi":"10.37897/rjid.2022.1.3","DOIUrl":"https://doi.org/10.37897/rjid.2022.1.3","url":null,"abstract":"As more reports of menstrual cycle abnormalities after COVID-19 vaccine inoculation are emerging in media and in clinical practice as well, it was deemed necessary to investigate these claims. This review aims to gather current scientific evidence on COVID vaccination’s effect on menstrual cycle. Further and extensive research is undeniably needed to fully understand these phenomena, but current studies have demonstrated an undeniable link between some menstrual cycle abnormalities (especially heavy menstrual flow and variations in cycle length) and breakthrough bleeding in non-menstruating population and vaccination against SARS-CoV-2. Up to this point, these disturbances seem to be temporary, not lasting for more than a few cycles. The reported menstrual changes have appeared after inoculations of all brands of vaccines, and no particular technology (mRNA or adenovirus-vectored) was particularly associated with them. The greatest concerns raised were those regarding fertility. However, until now, there is no evidence of any of the COVID vaccines affecting fertility when comparing vaccinated and unvaccinated populations.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43137797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miliana Cretu, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu
{"title":"Uptake of the COVID-19 vaccine in pregnancy","authors":"Miliana Cretu, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2022.1.1","DOIUrl":"https://doi.org/10.37897/rjid.2022.1.1","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic with a devastating morbidity and mortality. Pregnant women seem to be at increased susceptibility to have a severe disease and suffer adverse pregnancy outcomes. The only solution to mitigate this pandemic is prophylaxis by mass vaccination. We report a review based on current literature about the evidence available on efficacy and safety of anti-COVID-19 vaccines in pregnancy to aid women decide whether to vaccinate or not, while being pregnant or lactating. Studies so far did not find concerning maternal or fetal outcomes and show a similar efficiency of mRNA vaccines as in non-pregnant population. Moreover, anti-SARS-CoV-2 antibodies resulted from the vaccination seem to be transferred to the newborn through the placenta or the breastmilk building up the neonatal immunity. However, the exclusion from clinical trials created a great deficiency of evidence regarding the vaccination in this high-risk population resulting in their reluctance.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49450369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}