ACTA Microbiologica Hellenica (Volume 66, Issue 2-3)

An overview of microbiological diagnostic methods in SARS-CoV-2 infection

Panagiotis Toumasis, Georgia Vrioni

Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece

Since 2020, humanity is facing the pandemic of COVID-19 disease, with the scientific community
looking for reliable ways to diagnose SARS-CoV-2 infection. The quiver of diagnostic methods
includes three types of tests. In order to document acute SARS-CoV-2 virus infection,
techniques for detecting the genetic material of the virus are used either by the reverse transcriptase
polymerase chain reaction (rRT-PCR) method or by isothermal reaction techniques
as well as antigens detection tests. Diagnostic tests aimed at detecting either specific binding
or specific neutralizing antibodies to the SARS-CoV-2 virus are primarily used to detect previous
COVID-19 infection, helping to assess the cumulative impact of infection or vaccination
in a community. Each test has advantages and disadvantages and should be used according
to specific clinical situations.

Key words: SARS-CoV-2, COVID-19, microbiological diagnosis

Hashimoto Thyroiditis in Coexistence with Papillary Thyroid Cancer

Eleftherios Zisopoulos

International Hellenic University, Thessaloniki, School of Health Sciences, Department of Biomedical Science

Hashimoto’s thyroiditis and papillary thyroid carcinoma consist two commonly observed disorders
of the thyroid gland, while the incidence of their comorbidity is continuously increasing
the recent years. Since the middle of the last century, the existence of a correlation between
these two nosological entities has been proposed, which seem to present common clinicopathological
characteristics. The present review aims to introduce the most recent clinical studies
that examine the epidemiological, molecular and immunological aspects of this association.
According to the available data so far, it has been concluded that although Hashimoto’s thyroiditis
seems to predispose patients to the development of papillary thyroid cancer, it exerts
at the same time some kind of protective action when it coexists with it, delaying its progression
and offering better prognosis. The enhanced immune activity seems to have a major role,
with the inflammation being discussed as “the golden section” between the two pathologies.
Nonetheless, the high variability of the results of numerous studies makes some scientists
question the existence of a connection, thus not allowing its definitive establishment. This
issue remains an active area of research and discussion, as researchers are facing the challenge
of limiting systematic errors that have occurred in past years, in order to clarify the mechanisms
of interaction that possibly exist between these two diseases.

Key words: Thyroid Gland, Hashimoto Thyroiditis, Papillary Thyroid Cancer, Autoimmunity

Co-occurrence of bap gene among multi-drug resistant strains of Acinetobacter baumannii from India

V.T. Thamarai Selvi1, Smiline Girija A.S.2, Vijayashree Priyadharsini J.3

1. Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical
Sciences [SIMATS], Saveetha University, P.H.Road, Chennai, Tamilnadu – 600077, India
2. Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and
Technical Sciences [SIMATS], Saveetha University, P.H.Road, Chennai, Tamilnadu – 600077, India
3. Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical
Sciences [SIMATS], Saveetha University, P.H.Road, Chennai, Tamilnadu – 600077, India

bapAb-associated biofilm formation in Acinetobacter baumannii enhances the virulence properties
and highly influences the pattern of drug susceptibility among hospitalized patients.
This study thus aims to molecularly characterize bapAb gene and to evaluate its co-occurrence
among the multidrug-resistant (MDR) strains of A. baumannii. Semi-quantitative adherent
bioassay was performed to detect the biofilm formation by 73 MDR strains of A. baumannii.
Genomic DNA was further extracted and screened for bapAb by PCR followed by sequencing
of the amplicons from representative strains. Pearson correlation analysis was performed to
check the frequency of its distribution in different groups of drug-resistant strains at a significant
p-value of <0.05. Biofilm assay showed 58.9%, 31.5% and 0.9% as high grade, low grade and negative biofilm formers respectively. bapAb gene was observed in 14 MDR strains (19.17%) of A. baumannii. Co-occurrence of bapAb gene was 100% among the β-lactam/β-lactamase inhibitors-, cephems-, carbapenems- and aminoglycosides-resistant strains followed by 85% among fluroquinolones-, efflux pumps- and folate inhibitors-resistant strains of A. baumannii. The findings of the study suggest the need of periodical monitoring of the frequency of bapAb associated biofilms in MDR strains of A. baumannii, however further studies are needed to monitor its association with varying the drug resistance patterns among these strains. Key words: bapAb; A. baumannii; MDR; virulence [av_button label='PDF' link='manually,' link_target='_blank' size='large' position='center' label_display='' icon_select='no' icon='ue800' font='entypo-fontello' color='theme-color' custom_bg='#444444' custom_font='#ffffff' av_uid='av-49ja7ax' admin_preview_bg=''] [/av_toggle] [av_toggle title='Prevalence and antimicrobial resistance of non-ESKAPE-Ec Enterobacteriales in a IV-level hospital in Lima, Peru' tags='' av_uid='av-29xyw33'] Wilfredo Flores-Paredes1a, Nestor Luque2a, Roger Albornoz2, Nayade Rojas3, Manuel Espinoza4, Joaquim Ruiz5, Maria J. Pons5 1.Servicio de Microbiología, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru; 2. Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Peruana Union (UPeU), Lima, Peru; 3. Ministerio de Salud, Lima, Peru; 4. Instituto Nacional de Salud, Lima, Peru; 5. Laboratorio de Genética Molecular y Bioquímica, Universidad Científica del Sur, Lima, Peru; a These authors equally contributed to this work. The aim of this work was to evaluate the levels and the evolution of antimicrobial resistance of non-ESKAPE-Ec Enterobacteriales (NEEcE, non Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli) from a IV-level Peruvian hospital. NEEcE accounting for >0.5% of total isolates
in 2009-2010 (Period 1) and/or 2012-2014 (Period 2) were included in the study. Bacterial identification
and antimicrobial resistance was performed by automated methods. Additionally,
the presence of extended spectrum beta-lactamases (ESBLs) was investigated in Klebsiella oxytoca.
According to our results, Citrobacter freundii, Klebsiella oxytoca, Morganella morganii, Proteus
mirabilis, Providencia spp. and Serratia marcescens fulfilled inclusion criteria, accounting
for 695/9918 isolates (7.0%); 238/3777 (6.30%) in Period 1 and 447/6141 (7.28%) in Period 2
(p=0.0038). P. mirabiliswas the most frequent with 192 isolates (1.94%), while only 54 Providencia
spp. (0.54%) were recovered. Carbapenems were the most active antibacterial agents. In
general, the microorganisms showed lower or moderate levels of resistance to amikacin and
piperacillin/tazobactam, while resistance levels to the remaining antibacterial agents were
>40%. Multidrug resistance (MDR) levels varied from 36.1% in S. marcescens to 73.9% in P.
mirabilis. Temporal analysis showed that the levels of antibiotic resistance tended to decrease
or not to vary. This finding led to a MDR decrease, except for P. mirabilis and Providencia spp.
The presence of ESBL was associated with significantly higher levels of resistance to noncephalosporin
antibiotics, except imipenem. In conclusion, present results demonstrate the
relevance of NEEcE, highlighting the need to include these Enterobacteriales in routine followup
and also warn about the worrisome panorama of antibiotic resistance in the area.

Key words: antimicrobial resistance Citrobacter freundii; Klebsiella oxytoca; Morganella morganii,
Providencia; Proteus mirabilis; Serratia marcescens

Antifungal susceptibility profile and molecular epidemiology of recurrent vulvovaginal candidiasis in Yasuj, southwestern Iran

Maral Gharaghani1, Mohammad Amin Ghatee2,3, ShahinTaj Aramesh2, Ali Mousavizadeh4,
Gholamreza Shokoohi5, Saham Ansari6, Shahamat Tabansirat2, Vahid Kazemi2, Leila Rajabi1,
Sadegh Nouripour-Sisakht1

1 Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
2 Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
3 Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
4 Department of Biostatistics and Epidemiology, School of Health Social Determinants of Health Research Center,
Yasuj University of Medical Sciences, Yasuj, Iran
5 Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences,
Jahrom, Iran
6 Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences,
Tehran, Iran

Candidal vaginitis is a common infection causing various clinical presentations that can also
emerge as recurrent vulvovaginal candidiasis (RVVC) in many patients. Candida albicans is
the most common causative agent of RVVC. Since there is no definitive guideline for RVVC
treatment, it is important to consider the species and susceptibility profile of the isolate to
use the appropriate antifungals. The present study was conducted to determine the prevalence
of RVVC, the etiological agents, and their antifungal susceptibility among clinically suspected
patients in the yasuj region, southwest Iran. The isolated yeasts were identified based
on the morphological and molecular methods followed by antifungal susceptibility testing.
Overall, 65 Candida strains were isolated from RVVC samples. Candida albicans (95.4%) were
the main causative agents, followed by C. glabrata (3.1%), and C. krusei (1.53%). According to
our findings, 20.7% and 22.4% of Candida isolates were resistant to fluconazole (MIC≥8
μg/mL) and clotrimazole (MIC≥1 μg/mL), receptively. Although C. albicans was still the main
causative agent of RVVC incidence, the importance of accurate identification of Candida
strains and determination of antifungal susceptibility are emphasized. Moreover, in this study,
low drug-resistance was found among isolated Candida species in Yasuj.

Key words: Recurrent vulvovaginal candidiasis, antifungal susceptibility, fluconazole, clotrimazole

Evaluation of the seroprevalence of syphilis infection among voluntary blood donors from northern Greece. Retrospective study from 2015 to 2020

Magdalini Pape1, Vasiliki Bakaloudi1, Parthena Lazaridou1, Ioannis Moschos2, Chrisa Pargiana2,
Vasilis Zevgolis3, Maria Chatzikyrkou1

1. Blood Centre, AHEPA University General Hospital of Thessaloniki
2. Department of Microbiology, G.H.T. HIPPOCRATIO – Hospital of Skin and Veneral Diseases of Thessaloniki
3. National Blood Center, Athens, Greece

Blood donation is an important procedure that saves millions of lives. However, unsafe transfusion
practices carry the risk of transfusion-transmissible infections (TTIs). Screening for
syphilis is mandatory for routine blood transfusions. The purpose of our study was to investigate
syphilis seroprevalence in voluntary blood donors from Northern Greece. Data from
blood donors were analyzed, including first-time and repeat donors, all apparently healthy,
who gave blood the last six years (2015-2020). Routine blood donation data and demographics
were extracted. Also the variation of the annual syphilis seroprevalence was evaluated.
Serological testing was performed using the reverse algorithm, which initiates the
screening with a highly sensitive treponemal test. A total of 127.413 donations were tested.
Among screen positive test results, 87 (0,07%) tested positive by at least one confirmatory
test. Confirmed positivity was positively associated with men of middle age (31-50 years)
and blood donations from sporadic blood donors. Seroprevalence of syphilis infection did
not change significantly per year. Syphilis is a disease with a low prevalence in the blood
donation population of Northern Greece. Blood Centers should implement new methods
and updated algorithms for detecting infections. Through syphilis screening control, they
offer transfusion safety, significant benefit for public health and ongoing infectious disease

Key words: syphilis, blood donors, reverse algorithm, surveillance

A rare case report of brain abscess due to Nocardia paucivorans in an immunocompromised patient

Aikaterini Michelaki1, Maria Kamperogianni1, Maria Orfanidou1, Eleni Petrou1, Aggeliki Tsolaki1,
Vasileios Valadakis2, Eleni Papadogeorgaki3, Eleni Vagiakou1

1. Laboratory of Microbiology, General Hospital “G. Gennimatas”, Athens Greece
2. Neurosurgery Department, General Hospital “G. Gennimatas”, Athens Greece
3. Central Laboratories, Hygeia General Hospital, Athens Greece

Nocardia species are aerobic, Gram positive, filamentous, weakly acid-fast rods that are ubiquitous
in the environment. Nocardiosis has been referred to as an opportunistic infection which
may be localized or disseminated depending on the host immunity. Diagnosis of Nocardia
species may be challenging but both early identification and adapted antimicrobial therapy
are critical for a favorable outcome. We report a rare case of an immunocompromised patient
with N. paucivorans brain abscess.

Key words: Nocardia paucivorans, brain abscess, antimicrobial treatment