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1. Genomic surveillance as a scalable framework for precision phage therapy against antibiotic-resistant pathogens

Author

Koncz, Mihály, Stirling, Tamás, Hadj Mehdi, Hiba, Méhi, Orsolya, Eszenyi, Bálint, Asbóth, András, Apjok, Gábor, Tóth, Ákos, Orosz, László, Vásárhelyi, Bálint Márk, Ari, Eszter, Daruka, Lejla, Polgár, Tamás Ferenc, Schneider, György, Zalokh, Sif Aldin, Számel, Mónika, Fekete, Gergely, Bohár, Balázs, Nagy Varga, Karolina, Visnyovszki, Ádám, Székely, Edit, Licker, Monica-Sorina, Izmendi, Oana, Costache, Carmen, Gajic, Ina, Lukovic, Bojana, Molnár, Szabolcs, Szőcs-Gazdi, Uzonka Orsolya, Bozai, Csilla, Indreas, Marina, Kristóf, Katalin, Van der Henst, Charles, Breine, Anke, Pál, Csaba, Papp, Balázs, and Kintses, Bálint

Published
2024
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2. Understanding the pathogenesis, clinical, laboratory diagnosis and treatment of the recent monkeypox virus outbreak

Author

Goia Aneta-Rada, Muntean Delia, Musta Virgil, Herlo Alexandra, Vulpie Silvana, Izmendi Oana, Jumanca Romanita, and Licker Monica

Subjects
mpox, orthopox virus, diagnosis, laboratory-based diagnosis, treatment, Medicine
Abstract

Human mpox is a zoonotic disease, caused by the mpox virus (MPXV), that can spread either between animals and humans or humans and humans. In 1970 the first human case of mpox was reported in Zaire, Democratic Republic of the Congo (DRC). Other notable human mpox outbreaks in non-endemic countries were identified in June 2003 in the United States, in July 2021 in Dallas (USA), and the most recent one in May 2022 in Europe in the United Kingdom (UK). During the 2022 outbreak, sexual intercourse was observed to be the most prevalent transmission method, although other means should not be ignored, such as the involvement of respiratory droplets, exposure to surfaces and skin suspected of contamination. In the context of the current mpox outbreak, we consider it important and necessary to correctly identify the virus, use the proper laboratory testing for a correct diagnosis of mpox, understand the means of prophylaxis, and apply the correct treatment, highlighting these facts being the aim of this study.

Published
2024
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3. Enterobacterales carrying chromosomal AmpC β-lactamases in Europe (EuESCPM): Epidemiology and antimicrobial resistance burden from a cohort of 27 hospitals, 2020–2022

Author

Boattini, Matteo, Bianco, Gabriele, Llorente, Laura Iglesias, Acero, Laura Alonso, Nunes, Daniel, Seruca, Miguel, Mendes, Vasco Santos, Almeida, André, Bastos, Paulo, Rodríguez-Villodres, Ángel, Gascón, Adelina Gimeno, Halperin, Ana Verónica, Cantón, Rafael, Escartín, Maria Nieves Larrosa, González-López, Juan José, Floch, Pauline, Massip, Clémence, Chainier, Delphine, Barraud, Olivier, Dortet, Laurent, Cuzon, Gaëlle, Zancanaro, Clément, Mizrahi, Assaf, Schade, Rogier, Rasmussen, Asger Nellemann, Schønning, Kristian, Hamprecht, Axel, Schaffarczyk, Lukas, Glöckner, Stefan, Rödel, Jürgen, Kristóf, Katalin, Balonyi, Ágnes, Mancini, Stefano, Quiblier, Chantal, Fasciana, Teresa, Giammanco, Anna, Paglietti, Bianca, Rubino, Salvatore, Budimir, Ana, Bedenić, Branka, Rubic, Zana, Marinović, Jelena, Gartzonika, Konstantina, Christaki, Eirini, Mavromanolaki, Viktoria Eirini, Maraki, Sofia, Yalçın, Tuğba Yanık, Azap, Özlem Kurt, Licker, Monica, Musuroi, Corina, Talapan, Daniela, Vrancianu, Corneliu Ovidiu, Comini, Sara, Zalas-Więcek, Patrycja, Michalska, Anna, Cavallo, Rossana, Melo Cristino, José, and Costa, Cristina

Published
2024
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4. Characteristics of Urinary Tract Infections in Patients with Diabetes from Timișoara, Romania: Prevalence, Etiology, and Antimicrobial Resistance of Uropathogens.

Author

Sorescu, Teodora, Licker, Monica, Timar, Romulus, Musuroi, Corina, Muntean, Delia, Voinescu, Adela, Vulcanescu, Dan Dumitru, Cosnita, Andrei, Musuroi, Silvia-Ioana, and Timar, Bogdan

Subjects
TYPE 2 diabetes, ESCHERICHIA coli, URINARY tract infections, GLOMERULAR filtration rate, ANTIBIOTIC overuse, BODY mass index
Abstract

Background and Objectives: Diabetic patients are more likely to develop infections compared to the general population, especially urinary tract infections (UTIs). The aim of this study was to assess the prevalence of UTIs in a population of patients with diabetes (DM) from Romania, to identify the most common uropathogens and their antimicrobial resistance (AMR) patterns, as well as to determine the correlations between resistance behavior and particularities of patients with UTIs according to DM type. Materials and Methods: The hospital records of 1282 type 1 (T1D) and type 2 DM (T2D) adult inpatients who were ordered urine cultures during hospitalization were reviewed, and all 241 patients who presented a positive urine culture were included in the present study analysis. Results: The prevalence of UTIs in diabetic patients was 18.8% and higher in patients with T2D vs. T1D. Patients with UTIs and T2D had a significantly older age, longer duration of DM, higher waist circumference and body mass index, lower levels of estimated glomerular filtration rate, and more frequent chronic complications of DM than patients with T1D. E. coli was the most frequently isolated uropathogen (56.4%), with a significantly higher incidence for T2D, followed by K. pneumoniae (12.9%) and Enterococcus spp. (9.5%). Although the acquired resistance phenotypes were more frequently isolated in T2D patients (over 90% of the multidrug-resistant and extended-spectrum beta-lactamase-producing isolates, respectively, and 75% of the total carbapenem-resistant organisms), no statistically significant correlation was found regarding the distribution of AMR patterns in the two types of DM. Conclusions: The present study brings new data regarding the prevalence of UTIs in diabetic patients from Western Romania. By identifying the spectrum of uropathogens and their AMR pattern, this paper may contribute to improving UTI management in diabetic patients, thus reducing antibiotic overuse and preventing recurrent UTIs. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Prevalence and Antibiotic Resistance of Streptococcus agalactiae in Women of Childbearing Age Presenting Urinary Tract Infections from Western Romania.

Author

Marc, Constantin Catalin, Susan, Monica, Sprintar, Sergiu Adrian, Licker, Monica, Oatis, Daniela Adriana, Marti, Daniela Teodora, Susan, Razvan, Nicolescu, Laura Corina, Mihu, Alin Gabriel, Olariu, Tudor Rares, and Muntean, Delia

Subjects
MICROBIAL sensitivity tests, URINARY tract infections, CHILDBEARING age, STREPTOCOCCUS agalactiae, NEONATAL infections
Abstract

Urinary tract infections (UTIs) are a common bacterial infection in women of childbearing age. Streptococcus agalactiae (Group B Streptococcus—GBS), a rare causative pathogen of UTIs in this population, is particularly important due to the potential risk during pregnancy, when it can lead to life-threatening neonatal infections. The current study analyzed 17,273 urine samples collected from consecutive women aged 18–45 years from Arad County, Western Romania. A total of 2772 samples tested positive for UTIs. In 130 cases, GBS was identified as the causative agent. Univariate logistic regression analysis revealed that women aged 25–34 years were more likely to test positive for GBS than those aged 18–24 years (cOR = 1.91, 95% CI: 1.07–3.43, p = 0.03). Antibiotic sensitivity testing revealed that all GBS strains were fully sensitive to penicillin, ampicillin, and vancomycin. High resistance was observed for clindamycin (77.34%) and tetracycline (88.46%). While GBS was found to be a rare pathogen in UTIs, our results underscore the importance of monitoring GBS in women of childbearing age, especially due to its risks during pregnancy, and emphasize the need for appropriate antibiotic management. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Profiles of multidrug-resistant organisms among patients with bacteremia in intensive care units: an international ID-IRI survey

Author

El-Sokkary, Rehab, Uysal, Serhat, Erdem, Hakan, Kullar, Ravina, Pekok, Abdullah Umut, Amer, Fatma, Grgić, Svjetlana, Carevic, Biljana, El-Kholy, Amani, Liskova, Anna, Özdemir, Mehmet, Khan, Ejaz Ahmed, Uygun-Kizmaz, Yesim, Pandak, Nenad, Pandya, Nirav, Arapović, Jurica, Karaali, Rıdvan, Oztoprak, Nefise, Petrov, Michael M., Alabadla, Rami, Alay, Handan, Kholy, Jehan Ali El, Landelle, Caroline, Khedr, Reham, Mamtora, Dhruv, Dragovac, Gorana, Fernandez, Ricardo, Evren, Emine Unal, Raka, Lul, Cascio, Antonio, Dauby, Nicolas, Oncul, Ahsen, Balin, Safak Ozer, Cag, Yasemin, Dirani, Natalia, Dogan, Mustafa, Dumitru, Irina Magdalena, Gad, Maha Ali, Darazam, Ilad Alavi, Naghili, Behrouz, Del Vecchio, Rosa Fontana, Licker, Monica, Marino, Andrea, Akhtar, Nasim, Kamal, Mostafa, Angioni, Goffredo, Medić, Deana, Esmaoğlu, Aliye, Gergely, Szabo Balint, Silva-Pinto, André, Santos, Lurdes, Miftode, Ionela Larisa, Tekin, Recep, Wongsurakiat, Phunsup, Khan, Mumtaz Ali, Kurekci, Yesim, Pilli, Hema Prakash, Grozdanovski, Krsto, Miftode, Egidia, Baljic, Rusmir, Vahabolgu, Haluk, and Rello, Jordi

Published
2021
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7. The Profile of Bacterial Infections in a Burn Unit during and after the COVID-19 Pandemic Period.

Author

Musuroi, Corina, Musuroi, Silvia-Ioana, Baditoiu, Luminita, Crainiceanu, Zorin, Muntean, Delia, Voinescu, Adela, Izmendi, Oana, Sirmon, Alexandra, and Licker, Monica

Subjects
COVID-19 pandemic, DRUG resistance in bacteria, DRUG resistance in microorganisms, BURN patients, GRAM-negative bacteria, KLEBSIELLA pneumoniae
Abstract

Infections represent a major complication for burn-injured patients. The aim of this study was to highlight the changes in the incidence and antimicrobial resistance of bacterial strains isolated from burn patients, at the end of the COVID-19 pandemic, in relation to the antibiotics used during the pandemic. A comparative analysis of the demographic data and the microorganisms identified in the clinical samples of two groups of burn patients admitted to a university hospital in Romania was carried out. The first group consisted of 48 patients and the second of 69 patients, hospitalized in January–August 2020 and 2023, respectively. The bacterial species with the highest incidence were S. aureus, A. baumannii, Pseudomonas spp. The significant changes between 2023 and 2020 are reflected in the increase in the frequency of non-fermentative Gram-negative bacteria, especially S. maltophilia, and the increase in antimicrobial resistance of Pseudomonas and Klebsiella spp. Klebsiella spp. did not change in frequency (7%), but there was a significant increase in the incidence of K. pneumoniae strains with pan-drug resistant behaviour to antibiotics (40%), including colistin. The phenomenon can be explained by the selection of specimens carrying multiple resistance genes, as a result of antibiotic treatment during the COVID-19 period. The post-pandemic antimicrobial resistance detected in burn patients indicates the need for permanent surveillance of the resistance trends, primarily due to the limited therapeutic options available for these patients. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Bacterial Resistances and Sensibilities in a Tertiary Care Hospital in Romania—A Retrospective Analysis.

Author

Chisavu, Lazar, Chisavu, Flavia, Marc, Luciana, Mihaescu, Adelina, Bob, Flaviu, Licker, Monica, Ivan, Viviana, and Schiller, Adalbert

Subjects
DRUG resistance in bacteria, BURDEN of care, STAPHYLOCOCCUS aureus, ESCHERICHIA coli, ACINETOBACTER
Abstract

The increase in bacterial resistance is currently a global burden for the health care system. In order to evaluate the resistance rates of several bacteria from the most encountered cultures in clinical practice, we performed a retrospective analysis of all of the positive cultures from the year 2021 in a tertiary care hospital in Romania. Our analysis captured 3299 positive cultures. The median age of the patients was 62 years (IQR: 41–71 years old) with a slight predominance among females (53.1%). Overall, the most common cultures were urocultures, wound secretion cultures and blood cultures, and the most common identified bacteria were Escherichia coli, Staphylococcus aureus and Klebsiella spp. Positive cultures with the highest resistance rates were found in the bronchial aspirate cultures, catheter tip cultures, urocultures and blood cultures. Escherichia coli (n = 996) had the highest resistance to ampicillin (19.8%) and trimetoprim-sulfametoxazole (16.4%), while Staphylococcus aureus (n = 698) presented the highest resistance rates to clindamycin (27.4%) and oxaciline (19.7%). Klebsiella (n = 481) presented the highest resistance rates to piperaciline-tazobactam (25.2%) and ampicillin (20.4%), whereas Acinetobacter baumanii (n = 123) presented a resistance rate of more than 50% to carbapenems, gentamicin, ciprofloxacin and ceftazidime. The aim of our study was to identify bacterial resistance rates in order to provide updated clinical data to guide physicians in choosing the best empirical antibiotic treatment, especially in the west part of Romania. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Difficult to Treat Proteeae strains in high risk Romanian hospital departments

Author

Musuroi Corina, Licker Monica, Rus Maria, Seclaman Edward, Muntean Delia, Vulpie Silvana, and Baditoiu Luminita

Subjects
fatality, providencia stuartii, antibiotical resistance, Medicine
Abstract

Introduction: Resistance to first-line antibiotics of the Proteeae strains within the difficult-to-treat (DTR) phenotype is a cause of limitation of therapeutic options. The study aimed to characterize these strains, to identify the factors that influence their acquisition and the predictive factors for the patient’s evolution.

Published
2021
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10. A Comprehensive Review of Microbial Biofilms on Contact Lenses: Challenges and Solutions.

Author

Voinescu, Adela, Licker, Monica, Muntean, Delia, Musuroi, Corina, Musuroi, Silvia Ioana, Izmendi, Oana, Vulpie, Silvana, Jumanca, Romanita, Munteanu, Mihnea, and Cosnita, Andrei

Subjects
MICROBIAL adhesion, TECHNOLOGICAL innovations, EYE care, CONTACT lenses, CONFOCAL microscopy
Abstract

Contact lenses (CL) have become an immensely popular means of vision correction, offering comfort to millions worldwide. However, the persistent issue of biofilm formation on lenses raises significant problems, leading to various ocular complications and discomfort. The aim of this review is to develop safer and more effective strategies for preventing and managing microbial biofilms on CL, improving the eye health and comfort of wearers. Taking these into consideration, the present study investigates the intricate mechanisms of biofilm formation, by exploring the interplay between microbial adhesion, the production of extracellular polymeric substances, and the properties of the lens material itself. Moreover, it emphasizes the diverse range of microorganisms involved, encompassing bacteria, fungi, and other opportunistic pathogens, elucidating their implications within lenses and other medical device-related infections and inflammatory responses. Going beyond the challenges posed by biofilms on CL, this work explores the advancements in biofilm detection techniques and their clinical relevance. It discusses diagnostic tools like confocal microscopy, genetic assays, and emerging technologies, assessing their capacity to identify and quantify biofilm-related infections. Finally, the paper delves into contemporary strategies and innovative approaches for managing and preventing biofilms development on CL. In Conclusion, this review provides insights for eye care practitioners, lens manufacturers, and microbiology researchers. It highlights the intricate interactions between biofilms and CL, serving as a foundation for the development of effective preventive measures and innovative solutions to enhance CL safety, comfort, and overall ocular health. Research into microbial biofilms on CL is continuously evolving, with several future directions being explored to address challenges and improve eye health outcomes as far as CL wearers are concerned. [ABSTRACT FROM AUTHOR]

Published
2024
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12. The Challenges of The Diagnostic and Therapeutic Approach of Patients with Infectious Pathology in Emergency Medicine.

Author

Musuroi, Silvia Ioana, Voinescu, Adela, Musuroi, Corina, Baditoiu, Luminita Mirela, Muntean, Delia, Izmendi, Oana, Jumanca, Romanita, and Licker, Monica

Subjects
EMERGENCY medicine, THERAPEUTICS, ESCHERICHIA coli, GRAM-negative bacteria, MICROBIAL sensitivity tests, URINARY tract infections
Abstract

The emergency department (ED) represents an important setting for addressing inappropriate antimicrobial prescribing practices because of the time constraints and the duration of microbiological diagnosis. The purpose of this study is to evaluate the etiology and antimicrobial resistance (AMR) pattern of the community-acquired pathogens, as well as the epidemiological characteristics of patients admitted through the ED, in order to guide appropriate antibiotic therapy. Methods: A retrospective observational study was performed on 657 patients, from whom clinical samples (urine, purulent secretions, blood cultures, etc.) were collected for microbiological diagnosis in the first 3 days after presentation in the ED. The identification of pathogens and the antimicrobial susceptibility testing with minimum inhibitory concentration determination were carried out according to the laboratory protocols. Results: From the 767 biological samples analyzed, 903 microbial isolates were identified. E. coli was most frequently isolated (24.25%), followed by Klebsiella spp., S. aureus (SA), and non-fermentative Gram-negative bacilli. E. coli strains maintained their natural susceptibility to most antibiotics tested. In the case of Pseudomonas spp. and Acinetobacter spp., increased rates of AMR were identified. Also, 32.3% of SA strains were community-acquired MRSA. Conclusions: The introduction of rapid microbiological diagnostic methods in emergency medicine is imperative in order to timely identify AMR strains and improve therapeutic protocols. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Microbial biofilm in human health - an updated theoretical and practical insight

Author

Licker Monica, Moldovan Roxana, Hogea Elena, Muntean Delia, Horhat Florin, Baditoiu Luminița, Rogobete Alexandru Florin, Tîrziu Emil, and Zambori Csilla

Subjects
biofilm, medical devices, microscopy, Medicine
Abstract

The term biofilm designates an aggregate of microorganisms belonging to one or more species which adhere to various surfaces but also to each another. These microbial communities are included and interconnected within an organic structure known as slime, composed of protein substances, polysaccharides, and DNA.

Published
2017
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14. COVID-19 Biomarkers Comparison: Children, Adults and Elders

Author

Capraru, Ionut Dragos, primary, Vulcanescu, Dan Dumitru, additional, Bagiu, Iulia Cristina, additional, Horhat, Florin George, additional, Popescu, Irina Maria, additional, Baditoiu, Luminita Mirela, additional, Muntean, Delia, additional, Licker, Monica, additional, Radulescu, Matilda, additional, Mot, Ion Cristian, additional, Diaconu, Mircea Mihai, additional, and Marian, Catalin, additional

Published
2023
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18. Bacterial and Fungal Superinfections in COVID-19 Patients Hospitalized in an Intensive Care Unit from Timișoara, Romania

Author

Novacescu,Alexandru Noris, Buzzi,Bettina, Bedreag,Ovidiu, Papurica,Marius, Rogobete,Alexandru Florin, Sandesc,Dorel, Sorescu,Teodora, Baditoiu,Luminita, Musuroi,Corina, Vlad,Daliborca, and Licker,Monica

Subjects
Infection and Drug Resistance
Abstract

Alexandru Noris Novacescu,1,2,&ast; Bettina Buzzi,3 Ovidiu Bedreag,3,4 Marius Papurica,3,4 Alexandru Florin Rogobete,3,4 Dorel Sandesc,3,4 Teodora Sorescu,5,6 Luminita Baditoiu,7,8,&ast; Corina Musuroi,9,10 Daliborca Vlad,10,11 Monica Licker8– 10,&ast; 1Doctoral School, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania; 2Compartment of Anesthesia and Intensive Care, ‘Dr. Victor Babes’ Infectious Diseases and Pulmonology Clinical Hospital, Timisoara, Romania; 3Clinic of Anesthesia and Intensive Care, ‘Pius Brînzeu’ Emergency Clinical County Hospital, Timisoara, Romania; 4Department of Anaesthesia and Intensive Care, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania; 5Department of Diabetes, Nutrition and Metabolic Diseases, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania; 6Clinic of Diabetes, Nutrition and Metabolic Diseases, ‘Pius Brînzeu’ Emergency Clinical County Hospital, Timisoara, Romania; 7Department of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 8Multidisciplinary Research Center on Antimicrobial Resistance, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania; 9Department of Microbiology, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania; 10Clinical Laboratory, ‘Pius Brînzeu’ Emergency Clinical County Hospital, Timisoara, Romania; 11Department of Pharmacology, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania&ast;These authors contributed equally to this workCorrespondence: Teodora Sorescu, Department of Diabetes, Nutrition and Metabolic Diseases, ‘Victor Babes’ University of Medicine and Pharmacy, 2 Eftimie Murgu Square, Timisoara, Romania, Tel +40724515424, Email sorescu.teodora@umft.roPurpose: Critically ill patients hospitalized in the intensive care unit (ICU) have an increased infection risk. The aim of this study was to determine the bacterial and fungal superinfections rate in Coronavirus disease 2019 (COVID-19) patients stationed in the ICU, identify risk factors associated with their development and to determine whether superinfection plays a role in patients’ outcome in this population.Patients and Methods: In this retrospective, non-interventional, single centre, cohort study, medical records of 302 consecutive patients with SARS-COV-2 pneumonia admitted into the COVID-19 ICU of the largest university hospital from Western Romania between October 2020 and May 2021, were reviewed, of whom 236 patients met the inclusion criteria.Results: One hundred and nineteen patients developed a superinfection ≥ 48 h after being admitted to the hospital. Superinfection rate in the ICU was 50.42%. Coagulase-negative Staphylococci (CoNS) and Enterococcus spp. were predominantly isolated from blood cultures, while Acinetobacter baumannii, Staphylococcus aureus and Candida spp. from tracheobronchial aspirates. Significant independent risk factors regarding bacterial/fungal superinfection in COVID-19 patients were obtained for the following variables: number of days of central venous catheter (HR = 1.13 [1.07– 1.20], p < 0.001) and prior administration of corticosteroids (HR = 2.80 [1.33– 5.93], p = 0.007). Four independent predictive risk factors were associated with unfavorable outcome: age (HR = 1.07 [95% CI 1.03– 1.12], p = 0.001); Carmeli Score (HR = 6.09 [1.18– 31.50], p = 0.031); body mass index (HR = 1.11 [1.02– 1.21], p = 0.011) and the presence of a central venous catheter (HR = 6.49 [1.93– 21.89], p = 0.003).Conclusion: The superinfection rate in COVID-19 patients was high in this study group. Exogenous risk factors were associated with superinfection more than endogenous factors. Only a small percentage of uninfected COVID-19 patients were not prescribed antibiotics during their hospitalization, raising serious concerns regarding the judicious prescribing of antibiotics in viral infections.Keywords: COVID-19, viral pandemic, ICU, bacteria, fungi, superinfection

Published
2022

19. International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

Author

Maurizi, Diego Marcelo, Montanini, Adriana, Spadaro, Maria Laura, Marcos, Lorenzo Santiago, Botta, Priscila, Jerez, Florencia Maria, Chavez, Maria Constanza, Ramasco, Lucia, Colqui, Maria Isabel, Olivieri, Maria Silvia, Rearte, Ana Silvia, Correa, Gladys Edith, Juarez, Paola Deolinda, Gallardo, Paola Fabiana, Brito, Miriam Patricia, Mendez, Gabriel Horacio, Valdez, Julia Rosa, Cardena, Lorena Paola, Harystoy, Jose Maria, Chaparro, Gustavo Jorge, Rodriguez, Claudia Gabriela, Toomey, Rodolfo, Caridi, Maria, Viegas, Monica, Bernan, Marisa Liliana, Romani, Adriana, Dominguez, Claudia Beatriz, Davalos, Luis Kushner, Richtmann, Rosana, Silva, Camila Almeida, Rodrigues, Tatiane T., Filho, Amaury Mielle, Seerig Palme, Ernandi Dagoberto, Besen, Aline, Lazzarini, Caroline, Cardoso, Caroline Batista, Azevedo, Francisco Kennedy, Pinheiro, Ana Paula Fontes, Camacho, Aparecida, De Carvalho, Braulio Matias, De Assis, Maria Jose Monteiro, Carneiro, Ana Paula Vasconcelos, Canuto, Maria Lilian Maciel, Pinto Coelho, Keyla Harten, Moreira, Tamiris, Oliveira, Agamenon Alves, Sousa Colares, Marcela Maria, De Paula Bessa, Marcia Maria, Gomes Bandeira, Tereza De Jesus Pinheiro, De Moraes, Renata Amaral, Campos, Danilo Amâncio, De Barros Araújo, Tânia Mara Lima, Freitas Tenório, Maria Tereza, Amorim, Simone, Amaral, Manuela, Da Luz Lima, Julianne, Pino Da Silva Neta, Lindalva, Batista, Caphiane, De Lima Silva, Fabio Jorge, Ferreira De Souza, Maria C., Arruda Guimaraes, Katia, Marcia Maluf Lopes, Julia, Nogueira Napoles, Karina M., Neto Avelar, Lorena Luiza Silva, Vieira, Lilian Aguiar, Gustavo De Oliveira Cardo, Luis, Takeda, Christianne F.V., Ponte, Glaydson A., Eduardo Aguiar Leitão, Fco, De Souza Kuchenbecker, Ricardo, Pires Dos Santos, Rodrigo, Maria Onzi Siliprandi, Erci, Fernando Baqueiro Freitas, Luiz, Martins, Ianick Souto, Casi, Daiane, Maretti Da Silva, Maria Angela, Blecher, Sergio, Villins, Margarete, Salomao, Reinaldo, Oliveira Castro, Solange Regina, Da Silva Escudero, Daniela V., Andrade Oliveira Reis, Mariana, Mendonca, Marcelo, Furlan, Valter, Claudio do Amaral Baruzzi, Antonio, Sanchez, Tarquino Eristidesg, Moreira, Marina, Vasconcelos de Freitas, Wania, Passos de Souza, Leonardo, Velinova, Velmira Angelova, Hadjieva, Nassya, Petrov, Michael M., Karadimov, Dimitar Georgiev, Kostadinov, Emil D., Dicheva, Violeta Jivkova, Wang, Chaohua, Guo, Xiuqin, Geng, Xihua, Wang, Shufang, Zhang, Jinzhi, Zhu, Ling, Zhuo, Shufang, Guo, Chunli, Lili, Tao, Ruisheng, Li, Kun, Liu, Yang, Xuesong, Yimin, Li, Pu, Mao, Changan, Li, Shumei, Yiang, Kangxiong, Wu, Meiyi, Lin, Ye, Guxiang, Ziqin, Xu, Yao, Suo, Liqiang, Song, Marino Cañas Giraldo, Luis, Margarita Trujillo Ramirez, Elsa, Rios, Paola Andrea, Carlos Torres Millan, Juan, Giovanny Chapeta Parada, Edwin, Eduardo Mindiola Rochel, Andres, Corchuelo Martinez, Andres H., Marãa Perez Fernandez, Ana, Guzman, Nayide Barahona, Guzman, Alfredo Lagares, Ferrer, Marena Rodriguez, Vega, Yazmin Leon, Munoz, Heidi Johanna, Moreno, Germán Camacho, Romero Torres, Sandra Liliana, Hernandez, Herlidia Taboada, Valderrama MarquezClaudia Linares, Ismael A., Valencia, Monica Espinosa, Corrales, Lusayda Sanchez, Bonilla, Sandra Milena, Ivan Marin Uribe, Jorge, Gomez, David Yepes, Martinez, Javier Ospina, Dary Burgos Florez, Luz, Osorio, Johanna, Santofimio, Dagoberto, Cortes, Lorena Matta, Villamil-Gomez, Wilmer, Gutierrez, Gabriel Munoz, Ruiz, Adela Arguello, Fuentes, Carlos Gonzalez, Chinchilla, Antonio Solano, Hernandez, Ivar Calvo, Ugalde, Olber Chavarria, Garcell, Humberto Guanche, Perez, Clara Morales, Bardak, Selin, Ozkan, Sumru, Mejia, Nepomuceno, Puello Guerrero Glenny Mirabal, Adrian M., Delgado, Margarita, Severino, Ramona, Lacerda, Eliesel, Tolari, Gilda, Bovera, María Marcela, Pinto, Diego Barahona, González, Pedro Fernández, Santacruz, Gasdali, Alquinga, Nelly, Zaruma, Celso, Remache, Nelson, Morocho, Diego, Arboleda, Mario, Zapata, Mario Cadena, Garcia, Maria Fernanda, Picoita, Fabricio, Velez, Jorge, Valle, Marcia, Yepez, Estuardo Salgado, Tutillo, Diego Morocho, Mora, Ricardo Arteaga, Padilla, Andrea Peña, Chango, Mayra, Cabezas, Karina, Tenorio López, Shirley, Lucía Bonilla Escudero, Ana, Sánchez, Gladys Tatiana, Alberto Gonzalez Flores, Hugo, Ghazi, Islam Abdullorziz, Hassan, Mohamed, Ismail, Ghada A., Hamed, Reham, Abdel-Halim, Mona Mohiedden, El-Fattah, May Abd, Abdel-Aziz, Doaa, Seliem, Zeinab Salah, Elsherif, Rasha Hamed, Dewdar, Reham Ali, Mohmed, Abeer Ahmed, Abdel-Fatteh Ahmed, Lamiaa, De Jesus Machuca, Lilian, Bran De Casares, Concepcion, Kithreotis, Prokopis, Daganou, Maria, Veldekis, Dimitrios, Kartsonaki, Maria, Gikas, Achilleas, Luque Torres, Marco Tulio, Padgett, Denis, Rivera, Doris Maribel, Jaggi, Namita, Rodrigues, Camilla, Shah, Bhagyesh, Parikh, Keyur, Patel, Jigar, Thakkar, Riya, Chakravarthy, Murali, Gokul, B.N., Sukanya, R., Pushparaj, Leema, Vini, Thejas, Rangaswamy, Sukanya, Patnaik, Saroj Kumar, Venkateshwar, Vempati, John, Biju, Dalal, Shamsher, Sahu, Suneeta, Sahu, Samir, Ray, Banambar, Misra, Sudhiranjan, Mohanty, Nisith, Mishra, Biraj Mohan, Sahoo, Prafulla, Parmar, Naresh, Mishra, Sanghamitra, Pati, Basanta Kumar, Singh, Santosh, Pati, Bhabani Shankar, Panda, Aparajita, Banergee, Swarna, Padhihari, Dipankar, Samal, Soumya, Varma, Karthikeya, Suresh Kumar, Velu Pandi, Gopalakrishnan, Ram, Ramakrishnan, Nagarajan, Abraham, Babu Kuruvilla, Rajagopal, Senthilkumar, Venkatraman, Ramesh, Mani, Ashwin Kumar, Devaprasad, Dedeepiya, Ranganathan, Lakshmi, Francis, Thara, Cherain, Kotturathu Mammen, Ramachandran, Bala, Krupanandan, Ravikumar, Muralidharan, S., Karpagam, Murali, Padmini, Baby, Saranya, S., Kumar, Siva, Pandya, Nirav, Kakkar, Rajesh, Zompa, Tenzin, Saini, Narinder, Samavedam, Srinivas, Jagathkar, Ganshyam, Nirkhiwale, Suhas, Gehlot, G.S., Bhattacharya, Shefali, Sood, Sanjeev, Singh, Suman, Singh, Sanjeev, Todi, Subhash Kumar, Bhattacharyya, Mahuya, Bhakta, Arpita, Basu, Susmita, Agarwal, Anuradha, Agarwal, Manoj, Kharbanda, Mohit, Sengupta, Sankar, Karmakar, Anirban, Gupta, Debkishore, Sarkar, Ajoy Krishna, Dey, Rimita, Bhattacharya, Chandramouli, Chandy, Mammen, Ramanan, V.R., Mahajan, Aseem, Roy, Manas, Bhattacharya, Sanjay, Sinha, Saswati, Roy, Indranil, Gupta, Umesh, Mukherjee, Sujoy, Bej, Mrinmoy, Mukherjee, Purnima, Baidya, Sumana, Azim, Afzal, Sakle, Asmita Sagar, Sorabjee, Jehangir Soli, Potdar, Mrunalini Subhash, Subhedar, Vaibhavi R., Udwadia, F.E., Francis, Hena, Dwivedy, Arpita, Binu, Sheena, Shetty, Suvin, Nair, Pravin Kumar, Khanna, Devendra K., Chacko, Felcy, Blessymole, Seelas, Mehta, Preeti Rajeev, Singhal, Tanu, Shah, Sweta, Kothari, Vatsal, Naik, Reshma, Patel, Mayur Harshadrai, Aggarwal, Deepesh Gokulchand, Jawadwala, Burhanuddin Qutbuddin, Pawar, Niketa Kaul, Kardekar, Shoeb Nizamuddin, Manked, Abizer Nuruddin, Myatra, S.N., Divatia, J.V., Kelkar, R., Biswas, S.K., Raut, V., Sampat, S., Thool, Alka, Karlekar, Anil, Nandwani, Sumi, Gupta, Sudhir, Singhal, Sanjay, Gupta, Madhu, Mathur, Purva, Kumar, Subodh, Sandhu, Kavita, Dasgupta, Arnab, Raha, Abhijeet, Raman, Padmalatha, Wadhera, Ashoo, Badyal, Binesh, Juneja, Sarika, Mishra, Bikas, Sharma, Sunil, Mehrotra, Megha, Shelgaonkar, Jayant, Padbidri, Vikram, Dhawale, Rohini, Sibin, Sheena Mary, Mane, Dileep, Sale, Hanamant Kashinath, Mukhit Abdul Gaffar Kazi, Mohammad, Chabukswar, Supriya, Mathew, Anju, Gaikwad, Dipti, Harshe, Amol, Nadimpalli, Gita, Bhamare, Sunil, Thorat, Soniya, Sarda, Omnarayan, Nadimpalli, Pattabhiramarao, Mendonca, Angelina, Malik, Sujata, Kamble, Asmita, Kumari, Nilakshi, Arora, Sohini, Munshi, Nita, Divekar, Deepa Ganesh, Kavathekar, Maithili Satish, Kulkarni, Anuja Kedar, Suryawanshi, Madhupriya Vijay, Bommala, Madhavi Latha, Bilolikar, Anil, Joshi, Kashmira Limaye, Pamnani, Charulata, Wasan, Harvinder, Khamkar, Sonali, Steephen, Leena, Rajalakshmi, Arjun, Thair, Anzar, Mubarak, Aisha, Sathish, Swathy, Kumar, Suresh, Sunil, H., Sujith, Sujith, Dinesh, Sen, Nagamani, Shinde, Nitin, Alebouyeh, Masoud, Jahani-Sherafat, Somayeh, Zali, Mohammad Reza, Sarbazi, Mohammad Reza, Mansouri, Nahid, Tajeddin, Elahe, Razaghi, Maryam, Seyedjavadi, Simasadat, Rashidan, Marjan, Masjedi, Mansoor, Maghsudi, Behzad, Sabetian, Golnar, Sanaei, Anahita, Yousefipour, Atefeh, Assiri, Abdullah Mufareh, Furukawa-Cinquini, Elaine Mari, Alshehri, Areej Dhafer, Giani, Alysia Faye, Demaisip, Nadia Lynette, Cortez, Elizabeth Laungayan, Cabato, Analen Fabros, Gonzales Celiz, Jerlie Mae, Al-Zaydani Asiri, Ibrahim A.M., Mohammed, Yassir Khidir, Abdullah Al Raey, Mohammed, Omer Abdul Aziz, Ali, Ali Al Darani, Saeed, Aziz, Misbah Rehman, Basri, Roaa Hasan, Al-Awadi, Duaa Khalil, Bukhari, Syed Zahid, Aromin, Rosita Gasmin, Ubalde, Evangelina Balon, Molano, Apsia Musa, Abdullah Al Enizy, Hessa, Baldonado, Celia Flores, Al Adwani, Fatima Mohammad, Marie Casuyon Pahilanga, Arlu, Tan, Avigail M., Joseph, Sonia, Nair, Deepa Sasidharan, Al-Abdullah, Nabeela Abdullah, Sindayen, Grace, Malificio, Annalyn Amor, Mohammed, Diaa Abdullah, Mesfer Al Ghamdi, Hanan, Silo, Ameurfina Curioso, Valisto, Marianina Brenda V., Foteinakis, Nektarios, Ghazal, Sameeh Salem, Joseph, Mercy V., Hakawi, Ahmed, Hasani, Antigona, Jusufi, Ismet, Spahija, Gazmend, Baftiu, Nehat, Gecaj-Gashi, Agreta, Aly, Nasser Yehia, El-Dossoky Noweir, Mohammad, Varghese, Suga Thomas, Ramapurath, Ruby Jose, Mohamed, Amna Mostafa, George, Sneha Mary, Kurian, Anu, Sayed, Amani Fouad, Salama, Mona Foda, Omar, Abeer Aly, Rebello, Flavie Maria, Narciso, Dennis Malungcot, Zahreddine, Nada Kara, Kanafani, Zeina, Kardas, Tala, Molaeb, Bassel, Jurdi, Lamia, Al Souheil, Anwar, Ftouni, Mohamad, Ayash, Hasan, Mahfouz, Tahsine, Kondratas, Tomas, Grinkeviciute, Dovile, Kevalas, Rimantas, Gailiene, Greta, Dagys, Algirdas, Petrovska, Milena, Popovska, Katja, Bogoevska-Miteva, Zaneta, Jankovska, Katerina, Guroska, Snezana Tufekcievska, Anguseva, Tanja, Wan Yusoff, Wan Nurbayah, Shiham Zainal Abidin, Anis, Gan, Chin Seng, Zainol, Hasimah, Rai, Vineya, Kwong, Wong Kang, Hasan, Mohd Shahnaz, Sri La Sri Ponnampala, Sasheela, Veerakumaran, Jeyaganesh, Assadian, Ojan, Phuong, Doan Mai, Binh, Nguyen Gia, Kaur, Kerinjeet, Lim, Joelene, Tan, Lian-Huat, Manikavasagam, Jegathesan, Cheong, Yuet-Meng, Magaña, Hilario Coronado, Cesar Mijangos Méndez, Julio, Jiménez, Federico Corona, Esparza-Ahumada, Sergio, Morfin-Otero, Rayo, Rodriguez-Noriega, Eduardo, Gutierrez-Martinez, Susana, Perez-Gomez, Hector Raul, León-Garnica, Gerardo, Mendoza-Mujica, Christian, Cecilia Culebro Burguet, Martha, Portillo-Gallo, Jorge Horacio, Almazán, Fernando Aguilera, Miramontes, Gaspar Iglesias, Olivas, Maria del Rosario Vázquez, Aguilar Angel, Lucio Alberto, Vargas, Marisol Sanchez, Orlando Flores Alvarado, Angel, Carlos Mares Morales, Roberto, Carlos Fernandez Alvarez, Luis, Armando Rincon Leon, Hector, Navarro Fuentes, Karla Reyna, Mariela Perez Hernandez, Yuri, Falcon, Gabriela Martinez, Vargas, Angel Gonzalez, Trujillo Juarez, Marco A., Mulia, Antonio Martinez, Alma Ulloa Camacho, Paulina, Martinez-Marroquin, Martha Y., Garcia, Marco Montell, Martinez, Araceli Martinez, Sanchez, Elena Leon, Flores, Guadalupe Gomez, Martínez, Marisela del Rocío González, Alfonso Galindo Olmeda, Jesús, Olivarez, Georgina, Rodriguez, Enrique Barbachano, Magdalena Gutierrez Castillo, María, Guadalupe Villa González, María, Beatriz Sauceda Castañeda, Isaura, Rodriguez, Jaime Martínez, Baatar, Otgon, Batkhuu, Byambadorj, Meryem, Kabiri, Amina, Barkat, Abouqal, Rédouane, Zeggwagh, Amine Ali, Dendane, Tarek, Abidi, Khalid, Madani, Naoufel, Mahmood, Syed Faisal, Memon, Badaruddin A., Bhutto, Gul Hassan, Paul, Nadeem, Parveen, Azra, Raza, Aun, Mahboob, Amjad, Nizamuddin, Summiya, Sultan, Faisal, Nazeer, Hammad, Khan, Ashraf Ali, Hafeez, Arifa, Lara, Lydia, Mapp, Trudell, Alvarez, Balkys, Rojas-Bonilla, Magda Ivonne, Castano, Elizabeth, De Moros, Daisy A., Atarama, Roberto Espinoza, Calisto Pazos, Maria Elena, Paucar, Alfredo, Ramos, Marlene Tasayco, Jurado, Jenny, Moreno, Dafne, Cruz Saldarriaga, Marãa E., Ramirez, Eliza, La Hoz Vergara, Carlos Enrique, Enrique Prudencio Leon, Walter, Isidro Castillo Bravo, Luis, Fernanda Aibar Yaranga, Katya, Pichilingue Chagray, Janet E., Marquez Mondalgo, Vanessa A., Zegarra, Socorro Torres, Astete, Nazario Silva, Guevara, Francisco Campos, Pastrana, Javier Soto, Linares Calderon, Carlos F., Jesus Mayorga Espichan, Manuel, Martin Santivanez Monge, Luis, Changano Rodriguez, Maria V., Rosa Diaz Tavera, Zoila, Martin Ramirez Wong, Fernando, Chavez, Selene Manga, Atencio-Espinoza, Teodora, Villanueva, Victoria D., Blanco-Abuy, Maria Teresa, Tamayo, Arnefelina S., Bergosa, Lailane D., Llames, Cristina Mari Jean P., Trajano, Marilou F., Bunsay, Suzette A., Amor, Jessica C., Berba, Regina, Sg Buenaflor, Maria Carmen, Labro, Ever, Mendoza, Myrna T., Javellana, Ofelia P., Salvio, Lilibeth G., Rayco, Rhoda Gay, Bermudez, Vanessa, Kubler, Andrzej, Zielinska, Marzena, Kosmider-Zurawska, Magdalena, Barteczko-Grajek, Barbara, Szewczyk, Ewa, Dragan, Barbara, Mikaszewska-Sokolewicz, Malgorzata Anna, Lazowski, Tomasz, Cancel, Elsie, Licker, Monica Sorina, Dragomirescu, Liliana Alina, Dumitrascu, Victor, Sandesc, Dorel, Bedreag, Ovidiu, Papurica, Marius, Muntean, Delia, Kotkov, Igor, Kretov, Vladimir, Shalapuda, Vladimir, Molkov, Alexander, Puzanov, Sergey, Utkin, Ivan, Tchekulaev, Alexander, Tulupova, Valentina, Nikolic, Ljubica, Ristic, Goran, Eremija, Jelena, Kojovic, Jelena, Lekic, Dragana, Vasiljevic, Sladjana, Lesnakova, Anna, Marcekova, Alzbeta, Furova, Katarina, Gamar Elanbya, May Osman, Ali, Malik Abdo, Kadankunnel, Shobhana Kumari, Somabutr, Suwara, Pimathai, Rungratchanee, Wanitanukool, Suthinee, Luxsuwong, Montri, Supa, Namphon, Prasan, Pornpheth, Thamlikitkul, Visanu, Jamulitrat, Silom, Suwalak, Nonglak, Phainuphong, Parichart, Asma, Bouziri, Aida, Borgi, Sarra, Bel Hadj, Ammar, Khaldi, Ertem, Gunay Tuncer, Bulut, Cemal, Hatipoglu, Cigdem Ataman, Erdinc, Fatma Sebnem, Demiroz, Ali Pekcan, Ozcelik, Menekse, Meco, Basak Ceyda, Oral, Mehmet, Unal, Necmettin, Guclu, Cigdem Yildirim, Kendirli, Tanıl, İnce, Erdal, Çiftçi, Ergin, Yaman, Ayhan, Ödek, Çağlar, Karbuz, Adem, Kocabaş, Bilge Aldemir, Altın, Nilgün, Cesur, Salih, Atasay, Begum, Erdeve, Omer, Akduman, Hasan, Kahvecioglu, Dilek, Cakir, Ufuk, Yildiz, Duran, Kilic, Atila, Arsan, Saadet, Arman, Dilek, Unal, Serhat, Gelebek, Yasemin, Zengin, Humeyra, Sen, Suha, Cabadak, Hatice, Erbay, Ayse, Yalcin, Ata Nevzat, Turhan, Ozge, Cengiz, Melike, Dursun, Oguz, Gunasan, Perihan, Kaya, Sehnaz, Ramazanoglu, Atilla, Ustun, Cemal, Yasayacak, Aliye, Akdeniz, Hayrettin, Sirmatel, Fatma, Otkun, Ali Metin, Sacar, Suzan, Sener, Alper, Turgut, Huseyn, Sungurtekin, Hulya, Ugurcan, Dogaç, Necan, Ceyda, Yilmaz, Cansu, Ozdemir, Davut, Geyik, Mehmet Faruk, Ince, Nevin, Danis, Ayse, Erdogan, Selvi Yener, Erben, Nurettin, Usluer, Gaye, Ozgunes, Ilhan, Uzun, Cengiz, Oncul, Oral, Gorenek, Levent, Erdem, Hakan, Baylan, Orhan, Ozgultekin, Asu, Inan, Asuman, Bolukcu, Sibel, Senol, Gunes, Ozdemir, Halil, Gokmen, Zeynel, Ozdemir, Sonay Incesoy, Kaya, Ali, Ersoz, Gulden, Kuyucu, Necdet, Karacorlu, Sevim, Kaya, Zeynep, Guclu, Ertugrul, Kaya, Gulsume, Karabay, Oguz, Esen, Saban, Aygun, Canan, Ulger, Fatma, Dilek, Ahmet, Yilmaz, Hava, Sunbul, Mustafa, Engin, Aynur, Bakir, Mehmet, Elaldi, Nazif, Koksal, Iftihar, Yildizdas, Dincer, Horoz, Ozden Ozgur, Willke, Ayşe, Koç, Meliha Meriç, Azak, Emel, Elahi, Naheed, Annamma, Philip, El Houfi, Ashraf, Pirez Garcia, Maria Catalina, Vidal, Hector, Perez, Fernando, Empaire, Gabriel D., Ruiz, Yvis, Hernandez, Dulce, Aponte, Dayana, Salinas, Evelyn, Diaz, Claudia, Guzmán Siritt, María Eugenia, Gil De Añez, Zenaida Durán, Bravo, Luis Montes, Orozco, Nelva, Mejías, Eugenia, Hung, Nguyen Viet, Anh, Nguyen Quoc, Chau, Ngo Quy, Thu, Truong Anh, Thi Diem Tuyet, Le, Thi Van Trang, Dang, Hong Thoa, Vo Thi, Tien, Nguyen Phuc, Anh Thu, Le Thi, Hang, Phan Thi, My Hanh, Tran Thi, Thuy Hang, Tran Thi, Phuong Anh, Dinh Pham, Rosenthal, Víctor Daniel, Maki, Dennis George, Mehta, Yatin, Leblebicioglu, Hakan, Memish, Ziad Ahmed, Al-Mousa, Haifaa Hassan, Balkhy, Hanan, Hu, Bijie, Alvarez-Moreno, Carlos, Medeiros, Eduardo Alexandrino, Apisarnthanarak, Anucha, Raka, Lul, Cuellar, Luis E., Ahmed, Altaf, Navoa-Ng, Josephine Anne, El-Kholy, Amani Ali, Kanj, Souha Sami, Bat-Erdene, Ider, Duszynska, Wieslawa, Van Truong, Nguyen, Pazmino, Leonardo N., See-Lum, Lucy Chai, Fernández-Hidalgo, Rosalia, Di-Silvestre, Gabriela, Zand, Farid, Hlinkova, Sona, Belskiy, Vladislav, Al-Rahma, Hussain, Luque-Torres, Marco Tulio, Bayraktar, Nesil, Mitrev, Zan, Gurskis, Vaidotas, Fisher, Dale, Abu-Khader, Ilham Bulos, Berechid, Kamal, Rodríguez-Sánchez, Arnaldo, Horhat, Florin George, Requejo-Pino, Osiel, Ben-Jaballah, Nejla, García-Mayorca, Elías, Kushner-Dávalos, Luis, Pasic, Srdjan, Pedrozo-Ortiz, Luis E., Apostolopoulou, Eleni, Mejía, Nepomuceno, Gamar-Elanbya, May Osman, Jayatilleke, Kushlani, de Lourdes-Dueñas, Miriam, and Aguirre-Avalos, Guadalupe

Published
2014
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21. Self-reported antibiotic stewardship and infection control measures from 57 intensive care units: An international ID-IRI survey

Author

El-Sokkary, Rehab, primary, Erdem, Hakan, additional, Kullar, Ravina, additional, Pekok, Abdullah Umut, additional, Amer, Fatma, additional, Grgić, Svjetlana, additional, Carevic, Biljana, additional, El-Kholy, Amani, additional, Liskova, Anna, additional, Özdemir, Mehmet, additional, Khan, Ejaz Ahmed, additional, Kizmaz, Yesim Uygun, additional, Pandak, Nenad, additional, Pandya, Nirav, additional, Arapović, Jurica, additional, Karaali, Rıdvan, additional, Oztoprak, Nefise, additional, Petrov, Michael M., additional, Alabadla, Rami, additional, Alay, Handan, additional, El Kholy, Jehan Ali, additional, Landelle, Caroline, additional, Khedr, Reham, additional, Mamtora, Dhruv, additional, Dragovac, Gorana, additional, Fernandez, Ricardo, additional, Evren, Emine Unal, additional, Raka, Lul, additional, Cascio, Antonio, additional, Dauby, Nicolas, additional, Oncul, Ahsen, additional, Balin, Safak Ozer, additional, Cag, Yasemin, additional, Dirani, Natalia, additional, Dogan, Mustafa, additional, Dumitru, Irina Magdalena, additional, Gad, Maha Ali, additional, Darazam, Ilad Alavi, additional, Naghili, Behrouz, additional, Del Vecchio, Rosa Fontana, additional, Licker, Monica, additional, Marino, Andrea, additional, Akhtar, Nasim, additional, Kamal, Mostafa, additional, Angioni, Goffredo, additional, Medić, Deana, additional, Esmaoğlu, Aliye, additional, Gergely, Szabo Balint, additional, Silva-Pinto, André, additional, Santos, Lurdes, additional, Miftode, Ionela Larisa, additional, Tekin, Recep, additional, Wongsurakiat, Phunsup, additional, Khan, Mumtaz Ali, additional, Kurekci, Yesim, additional, Pilli, Hema Prakash, additional, Grozdanovski, Krsto, additional, Miftode, Egidia, additional, Baljic, Rusmir, additional, Uysal, Serhat, additional, Vahabolgu, Haluk, additional, and Rello, Jordi, additional

Published
2022
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23. Current State of Knowledge Regarding WHO Critical Priority Pathogens: Mechanisms of Resistance and Proposed Solutions through Candidates Such as Essential Oils

Author

Badescu, Bianca, primary, Buda, Valentina, additional, Romanescu, Mirabela, additional, Lombrea, Adelina, additional, Danciu, Corina, additional, Dalleur, Olivia, additional, Dohou, Angele Modupe, additional, Dumitrascu, Victor, additional, Cretu, Octavian, additional, Licker, Monica, additional, and Muntean, Delia, additional

Published
2022
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24. Severe Thrombocytopenic Purpura Associated with COVID-19 in a Pediatric Patient

Author

Marinescu,Adelina Raluca, Lazureanu,Voichita Elena, Musta,Virgil Filaret, Nicolescu,Narcisa Daniela, Mocanu,Alexandra, Cut,Talida Georgiana, Muresan,Camelia Oana, Tudoran,Cristina, Licker,Monica, and Laza,Ruxandra

Subjects
Infection and Drug Resistance
Abstract

Adelina Raluca Marinescu,1– 3 Voichita Elena Lazureanu,1,2 Virgil Filaret Musta,1,2 Narcisa Daniela Nicolescu,1,2 Alexandra Mocanu,1– 3 Talida Georgiana Cut,1– 4 Camelia Oana Muresan,4,5 Cristina Tudoran,6,7 Monica Licker,8,9 Ruxandra Laza1,2 1Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 2Victor Babes Clinical Hospital of Infectious Diseases and Pneumophtisiology, Timisoara, Romania; 3Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 4Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 5Discipline of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 6Discipline of Internal Medicine II, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 7Center of Molecular Research in Nephrology and Vascular Disease, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 8Discipline of Microbiology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 9Multidisciplinary Research Centre on Antimicrobial Resistance, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, RomaniaCorrespondence: Talida Georgiana Cut, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania, Tel +4 0755690250, Email talida.cut@umft.roPurpose: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to cause a diverse spectrum of clinical manifestations ranging from mild, flu-like symptoms to severe progressive pneumonia, acute respiratory distress syndrome with or without other extrapulmonary impairment. Hematological changes such as lymphopenia, neutrophilia, and anemia as the disease progresses, are frequently found in COVID-19. Thrombocytopenia may be drug-induced or can occur secondary to sepsis, disseminated intravascular coagulation or bone marrow suppression. Immune thrombocytopenic purpura (ITP) is frequently observed in children aged 2– 5 years and in 60% of cases may proceed an upper respiratory tract infection. The present paper aimed to raise awareness of ITP as a possible pediatric presentation of coronavirus disease.Patients and Methods: We present the case of previously healthy, eight-year-old female patient, who developed an immune thrombocytopenia flare, also known as immune thrombocytopenic purpura (ITP), in the context of COVID-19, with diffuse petechiae and ecchymosis on her body, face and oral mucosa, and a nadir platelet count of 0× 103/μL.Results: Platelet count recovery was observed after seven days of combined treatment with intravenous immunoglobulin (IVIG) and corticosteroids.Conclusion: The growing body of literature regarding the clinical and laboratory manifestations of COVID-19 infection in children, has reported thrombocytopenia in relation to unfavorable disease progression or multisystem inflammatory syndrome (MIS-C). Clinicians must be aware that ITP may appear both in mild and severe COVID-19, at any time during its course, and can be associated with a higher bleeding risk, thus its diagnostic may be critical.Keywords: SARS-CoV-2 infection, immune thrombocytopenia, bleeding risk, intravenous immunoglobulin

Published
2022

25. Current State of Knowledge Regarding WHO Critical Priority Pathogens: Mechanisms of Resistance and Proposed Solutions through Candidates Such as Essential Oils

Author

UCL - SSS/LDRI - Louvain Drug Research Institute, UCL - (SLuc) Département de pharmacie, Badescu, Bianca, Buda, Valentina, Romanescu, Mirabela, Lombrea, Adelina, Danciu, Corina, Dalleur, Olivia, Dohou, Angele Modupe, Dumitrascu, Victor, Cretu, Octavian, Licker, Monica, Muntean, Delia, UCL - SSS/LDRI - Louvain Drug Research Institute, UCL - (SLuc) Département de pharmacie, Badescu, Bianca, Buda, Valentina, Romanescu, Mirabela, Lombrea, Adelina, Danciu, Corina, Dalleur, Olivia, Dohou, Angele Modupe, Dumitrascu, Victor, Cretu, Octavian, Licker, Monica, and Muntean, Delia

Abstract

The rise of multidrug-resistant (MDR) pathogens has become a global health threat and an economic burden in providing adequate and effective treatment for many infections. This large-scale concern has emerged mainly due to mishandling of antibiotics (ABs) and has resulted in the rapid expansion of antimicrobial resistance (AMR). Nowadays, there is an urgent need for more potent, non-toxic and effective antimicrobial agents against MDR strains. In this regard, clinicians, pharmacists, microbiologists and the entire scientific community are encouraged to find alternative solutions in treating infectious diseases cause by these strains. In its "10 global issues to track in 2021", the World Health Organization (WHO) has made fighting drug resistance a priority. It has also issued a list of bacteria that are in urgent need for new ABs. Despite all available resources, researchers are unable to keep the pace of finding novel ABs in the face of emerging MDR strains. Traditional methods are increasingly becoming ineffective, so new approaches need to be considered. In this regard, the general tendency of turning towards natural alternatives has reinforced the interest in essential oils (EOs) as potent antimicrobial agents. Our present article aims to first review the main pathogens classified by WHO as critical in terms of current AMR. The next objective is to summarize the most important and up-to-date aspects of resistance mechanisms to classical antibiotic therapy and to compare them with the latest findings regarding the efficacy of alternative essential oil therapy.

Published
2022

26. Listeria Monocytogenes Meningitis in an Immunocompetent Patient

Author

Magiar,Oana, Vulpie,Silvana, Musuroi,Corina, Iosif,Marincu, Murariu,Alina, Turaiche,Mirela, Musuroi,Silvia Ioana, Muntean,Delia, Licker,Monica, Magiar,Oana, Vulpie,Silvana, Musuroi,Corina, Iosif,Marincu, Murariu,Alina, Turaiche,Mirela, Musuroi,Silvia Ioana, Muntean,Delia, and Licker,Monica

Abstract

Oana Magiar,1 Silvana Vulpie,1,2 Corina Musuroi,1,3 Iosif Marincu,4,5 Alina Murariu,6 Mirela Turaiche,4,5 Silvia Ioana Musuroi,7 Delia Muntean,1,3,8 Monica Licker1,3,8 1Clinical Laboratory, “Pius Brînzeu” County Clinical Emergency Hospital Timisoara, Timis, Romania; 2Doctoral School, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Timis, Romania; 3Microbiology Department, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Timis, Romania; 4”Victor Babeș” Clinical Hospital of Infectious Diseases, Methodological and Infectious Diseases Research Centre Timisoara, Timis, Romania; 5Infectious Diseases Department, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Timis, Romania; 6Neurology II Department, “Pius Brînzeu” County Clinical Emergency Hospital Timisoara, Timis, Romania; 7Internal Medicine Department, Clinical Emergency Municipal Hospital, Timisoara, Romania; 8Multidisciplinary Research Centre for Antibiotic Resistance, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Timis, RomaniaCorrespondence: Silvana Vulpie, Clinical Laboratory, “Pius Brînzeu” County Clinical Emergency Hospital Timisoara, Liviu Rebreanu, No. 156, Timișoara, Timis, 300723, Romania, Tel +40 727248701, Email vulpie.silvana@umft.comAbstract: Listeria monocytogenes (LM), one of the most important foodborne pathogens, is an intracellular bacterium found in food and the environment. It causes listeriosis, a potentially severe disease, particularly for pregnant women, the elderly and immunocompromised patients, but in rare cases, it can cause invasive disease in immunocompetent adults and children. Community-acquired bacterial meningitis caused by LM is rare and difficult to diagnose. It carries a high mortality rate; therefore, it is essential to start appropriate antibiotic treatment as soon as possible. The first case of LM meningitis identified in our hospital over the last 10 years is that of a previously

Published
2022

27. Self-reported antibiotic stewardship and infection control measures from 57 intensive care units: An international ID-IRI survey

Author

El-Sokkary, Rehab, Erdem, Hakan, Kullar, Ravina, Pekok, Abdullah Umut, Amer, Fatma, Grgić, Svjetlana, Carevic, Biljana, El-Kholy, Amani, Liskova, Anna, Özdemir, Mehmet, Khan, Ejaz Ahmed, Kizmaz, Yesim Uygun, Pandak, Nenad, Pandya, Nirav, Arapović, Jurica, Karaali, Rıdvan, Oztoprak, Nefise, Petrov, Michael M., Alabadla, Rami, Alay, Handan, El Kholy, Jehan Ali, Landelle, Caroline, Khedr, Reham, Mamtora, Dhruv, Dragovac, Gorana, Fernandez, Ricardo, Evren, Emine Unal, Raka, Lul, Cascio, Antonio, Dauby, Nicolas, Oncul, Ahsen, Balin, Safak Ozer, Cag, Yasemin, Dirani, Natalia, Dogan, Mustafa, Dumitru, Irina Magdalena, Gad, Maha Ali, Darazam, Ilad Alavi, Naghili, Behrouz, Del Vecchio, Rosa Fontana, Licker, Monica, Marino, Andrea, Akhtar, Nasim, Kamal, Mostafa, Angioni, Goffredo, Medić, Deana, Esmaoğlu, Aliye, Gergely, Szabo Balint, Silva-Pinto, André, Santos, Lurdes, Miftode, Ionela Larisa, Tekin, Recep, Wongsurakiat, Phunsup, Khan, Mumtaz Ali, Kurekci, Yesim, Pilli, Hema Prakash, Grozdanovski, Krsto, Miftode, Egidia, Baljic, Rusmir, Uysal, Serhat, Vahabolgu, Haluk, Rello, Jordi, El-Sokkary, Rehab, Erdem, Hakan, Kullar, Ravina, Pekok, Abdullah Umut, Amer, Fatma, Grgić, Svjetlana, Carevic, Biljana, El-Kholy, Amani, Liskova, Anna, Özdemir, Mehmet, Khan, Ejaz Ahmed, Kizmaz, Yesim Uygun, Pandak, Nenad, Pandya, Nirav, Arapović, Jurica, Karaali, Rıdvan, Oztoprak, Nefise, Petrov, Michael M., Alabadla, Rami, Alay, Handan, El Kholy, Jehan Ali, Landelle, Caroline, Khedr, Reham, Mamtora, Dhruv, Dragovac, Gorana, Fernandez, Ricardo, Evren, Emine Unal, Raka, Lul, Cascio, Antonio, Dauby, Nicolas, Oncul, Ahsen, Balin, Safak Ozer, Cag, Yasemin, Dirani, Natalia, Dogan, Mustafa, Dumitru, Irina Magdalena, Gad, Maha Ali, Darazam, Ilad Alavi, Naghili, Behrouz, Del Vecchio, Rosa Fontana, Licker, Monica, Marino, Andrea, Akhtar, Nasim, Kamal, Mostafa, Angioni, Goffredo, Medić, Deana, Esmaoğlu, Aliye, Gergely, Szabo Balint, Silva-Pinto, André, Santos, Lurdes, Miftode, Ionela Larisa, Tekin, Recep, Wongsurakiat, Phunsup, Khan, Mumtaz Ali, Kurekci, Yesim, Pilli, Hema Prakash, Grozdanovski, Krsto, Miftode, Egidia, Baljic, Rusmir, Uysal, Serhat, Vahabolgu, Haluk, and Rello, Jordi

Abstract

We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases–International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (~5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%−90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs’ implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2022

30. Therapeutic plasma exchange followed by convalescent plasma transfusion in severe and critically ill COVID‑19 patients: A single centre non‑randomized controlled trial

Author

Novacescu, Alexandru, primary, Duma, Georgiana, additional, Buzzi, Bettina, additional, Baditoiu, Luminita, additional, Bedreag, Ovidiu, additional, Papurica, Marius, additional, Sandesc, Dorel, additional, Sorescu, Teodora, additional, Vlad, Daliborca, additional, and Licker, Monica, additional

Published
2021
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32. Clostridium Difficile and COVID-19: General Data, Ribotype, Clinical Form, Treatment-Our Experience from the Largest Infectious Diseases Hospital in Western Romania

Author

Marinescu, Adelina Raluca, primary, Laza, Ruxandra, additional, Musta, Virgil Filaret, additional, Cut, Talida Georgiana, additional, Dumache, Raluca, additional, Tudor, Anca, additional, Porosnicu, Mirela, additional, Lazureanu, Voichita Elena, additional, and Licker, Monica, additional

Published
2021
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35. Detection of extended-spectrum β-lactamase and carbapenemase activity in Gram-negative bacilli using liquid chromatography - tandem mass spectrometry

Author

Serafim, Vlad, Shah, Ajit J., Licker, Monica, Horhat, Florin George, Vulpie, Silvana, Musuroi, Corina, and Muntean, Delia

Abstract

PURPOSE: Several mass spectrometry-based methods for antimicrobial sensitivity testing have been described in recent years. They offer an alternative to commercially available testing systems which were considered to have disadvantages in terms of cost- and time-efficiency. The aim of this study was to develop a LC-MS/MS-based antibiotic hydrolysis assay for evaluating antimicrobial resistance of Gram-negative bacteria.\ud \ud METHODS: Four species of Gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Providencia stuartii and Acinetobacter baumannii) were tested against six antibiotics from three different classes: ampicillin, meropenem, imipenem, ceftazidime, ceftriaxone and cefepime. Bacterial suspensions from each species were incubated with a mixture of the six antibiotics. Any remaining antibiotic following incubation were measured using LC-MS/MS. The results were interpreted using measurements obtained for an E. coli strain sensitive to all antibiotics and expressed as percentage of hydrolyzed antibiotic. These were subsequently compared to commercially-available system for the bacteria identification and susceptibility testing. \ud \ud RESULTS: Overall, LC-MS/MS assay and commercial antimicrobial susceptibility platform results showed good agreement in terms of an organism being resistant/sensitive to an antibiotic. The time required to complete the LC-MS/MS-based hydrolysis test was under 5 h, significantly shorter that commercially available susceptibility testing platforms. \ud \ud CONCLUSION: By using a sensitive strain for results interpretation and simultaneous use of multiple antibiotics, the proposed protocol offers improved robustness and multiplexing over previously described methods for antibiotic sensitivity testing. Nevertheless, further research is needed before routine assimilation of the method, especially for strains with intermediate resistance.

Published
2020

36. Distribution of NDM1 Carbapenemase-Producing Proteeae Strains on High-Risk Hospital Wards

Author

Rus,Maria, Licker,Monica, Musuroi,Corina, Seclaman,Edward, Muntean,Delia, Cirlea,Natalia, Tamas,Alina, Vulpie,Silvana, Horhat,Florin George, Baditoiu,Luminita, Rus,Maria, Licker,Monica, Musuroi,Corina, Seclaman,Edward, Muntean,Delia, Cirlea,Natalia, Tamas,Alina, Vulpie,Silvana, Horhat,Florin George, and Baditoiu,Luminita

Abstract

Maria Rus,1,2 Monica Licker,1– 3 Corina Musuroi,2 Edward Seclaman,4 Delia Muntean,1– 3 Natalia Cirlea,2 Alina Tamas,2 Silvana Vulpie,2 Florin George Horhat,1,3 Luminita Baditoiu3,5 1Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2“Pius Brinzeu” County Clinical Emergency Hospital, Timisoara, Romania; 3Multidisciplinary Research Center on Antimicrobial Resistance, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 4Department of Biochemistry, “Victor BabeÅŸ” University of Medicine and Pharmacy, TimiÅŸoara, Romania; 5Department of Epidemiology, “Victor BabeÅŸ” University of Medicine and Pharmacy, TimiÅŸoara, RomaniaCorrespondence: Monica LickerDepartment of Microbiology, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu, Timisoara 300041, RomaniaTel +40 0256-707513Email licker.monica@umft.roCorina MusuroiPius Brinzeu” County Clinical Emergency Hospital, No. 156 L.Rebreanu, Timisoara 300723, RomaniaTel +40745050232Email cormus1@yahoo.comBackground: Carbapenem-resistant Proteeae (CRP) is a group of multidrug-resistant (MDR) microorganisms that raise special treatment problems due to their intrinsic resistance to colistin. In this study, our aim is to provide a phenotypic and molecular characterization of the carbapenemases secreted by CRP strains isolated from inpatients from an intensive care unit (ICU) and surgical wards, as well as the identification of the risk factors involved in their acquisition.Methods: An observational, cross-sectional study was performed which included all Proteeae strains isolated in samples from inpatients on high-risk wards of the largest university hospital in Western Romania, from July 2017 to April 2019. Meropenem-resistant strains (N=65) with MIC ≥ 16 μg/mL were subjected to a singleplex PCR

Published
2020

37. Detection of Extended-Spectrum β-Lactamase and Carbapenemase Activity in Gram-Negative Bacilli Using Liquid Chromatography – Tandem Mass Spectrometry

Author

Serafim,Vlad, Shah,Ajit, Licker,Monica, Horhat,Florin George, Vulpie,Silvana, Musuroi,Corina, Muntean,Delia, Serafim,Vlad, Shah,Ajit, Licker,Monica, Horhat,Florin George, Vulpie,Silvana, Musuroi,Corina, and Muntean,Delia

Abstract

Vlad Serafim,1,2 Ajit J Shah,3 Monica Licker,4,5 Florin George Horhat,4 Silvana Vulpie,5 Corina Musuroi,4,5 Delia Muntean4,5 1Genetics Discipline, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, Romania; 2The National Institute of Research and Development for Biological Sciences, Bucharest 060031, Romania; 3Department of Natural Sciences, Middlesex University, London NW4 4BT, UK; 4Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, Romania; 5“Pius Brînzeu” Emergency Clinical County Hospital, TimiÈ™oara 300723, RomaniaCorrespondence: Monica LickerDepartment of Microbiology, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu, Timisoara 300041, RomaniaTel +40 0256-707513Email licker.monica@umft.roPurpose: Several mass spectrometry-based methods for antimicrobial sensitivity testing have been described in recent years. They offer an alternative to commercially available testing systems which were considered to have disadvantages in terms of cost- and time-efficiency. The aim of this study was to develop an LC-MS/MS-based antibiotic hydrolysis assay for evaluating antimicrobial resistance (AMR) of Gram-negative bacteria.Materials and Methods: Four species of Gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Providencia stuartii and Acinetobacter baumannii) were tested against six antibiotics from three different classes: ampicillin, meropenem, imipenem, ceftazidime, ceftriaxone and cefepime. Bacterial suspensions from each species were incubated with a mixture of the six antibiotics. Any remaining antibiotic following incubation was measured using LC-MS/MS. The results were interpreted using measurements obtained for an E. coli strain sensitive to all antibiotics and expressed as percentage of hydrolyzed antibiotic. These were subsequently compared to commercially-available system for the b

Published
2020

38. Extensively drug-resistant Myroides odoratimimus – a case series of urinary tract infections in immunocompromised patients

Author

Licker, Monica, Sorescu, Teodora, Rus, Maria, Cirlea, Natalia, Horhat, Florin, Jurescu, Cristiana, Botoca, Mircea, Cumpănaş, Alin, Timar, Romulus, and Muntean, Delia

Subjects
resistance, outbreak, Myroides odoratimimus, urinary tract infection, Original Research
Abstract

Purpose We report an outbreak of urinary tract infections (UTIs) caused by Myroides odoratimimus, which occurred in the largest clinical hospital in western Romania. Patients and methods From June to August 2017, four strains of M. odoratimimus were isolated from the urine samples of patients hospitalized in the urology, diabetes, and surgery departments. Hospital records of all patients whose urine cultures were positive for M. odoratimimus were reviewed retrospectively. We also reviewed the cases reported in the literature. Results All UTIs, except one, were hospital-acquired infections. All patients with M. odoratimimus UTIs were immunocompromised. Three patients underwent urinary catheterization with a Foley’s catheter upon admission in the emergency department and one presented for replacement of ureterostomy tubes. All Myroides isolates were resistant to almost all the tested antibiotics. Two patients were successfully treated with tigecycline and one was receiving antimicrobial treatment for another infection at the time of isolation of the microorganism. Conclusion Although M. odoratimimus is an uncommon pathogen, clinicians should be aware of its ability to cause UTI outbreaks, especially in the immunocompromised population. Due to its multi-drug resistance, it is important to rapidly identify Myroides spp. in order to choose the best treatment regimen.

Published
2018

41. Urinary Microbiota—Are We Ready for Prime Time? A Literature Review of Study Methods’ Critical Steps in Avoiding Contamination and Minimizing Biased Results

Author

Cumpanas, Alin Adrian, primary, Bratu, Ovidiu Gabriel, additional, Bardan, Razvan Tiberiu, additional, Ferician, Ovidiu Catalin, additional, Cumpanas, Andrei Dragos, additional, Horhat, Florin George, additional, Licker, Monica, additional, Pricop, Catalin, additional, and Cretu, Octavian Marius, additional

Published
2020
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42. Evaluation of essential oil obtained from Mentha×piperita L. against multidrug-resistant strains

Author

Muntean,Delia, Licker,Monica, Alexa,Ersilia, Popescu,Iuliana, Jianu,Calin, Buda,Valentina, Dehelean,Cristina Adriana, Ghiulai,Roxana, Horhat,Florin, Horhat,Delia, and Danciu,Corina

Subjects
Infection and Drug Resistance
Abstract

Delia Muntean,1 Monica Licker,1 Ersilia Alexa,2 Iuliana Popescu,2 Calin Jianu,3 Valentina Buda,4 Cristina Adriana Dehelean,5 Roxana Ghiulai,6 Florin Horhat,1 Delia Horhat,7 Corina Danciu8 1Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, Romania; 2Department of Food Control, Faculty of Food Processing Technology, Banat’s University of Agricultural Sciences and Veterinary Medicine “King Michael I of Romania”, Timisoara 300645, Romania; 3Department of Food Tehnologies, Faculty of Food Engineering, Banat’s University of Agricultural Sciences and Veterinary Medicine “King Michael I of Romania”, Timişoara 300645, Romania; 4Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, Romania; 5Department of Toxicology, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, Romania; 6Department of Pharmaceutical Chemistry, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, Romania; 7Department of ENT, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, Romania; 8Department of Pharmacognosy, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, RomaniaCorrespondence: Valentina Buda; Delia Horhat“Victor Babes” University of Medicine and Pharmacy, 2nd EftimieMurgu Square, Timisoara 300041, RomaniaTel +40 25 649 4804Fax +40 25 649 4804Email buda.valentina.oana@gmail.com; horhat.ioana@umft.roBackground: Bacterial multidrug resistance currently poses an increasingly serious threat, with important clinical consequences regarding treatment options. In 2017, the WHO released a global list of resistant bacteria, identifying multidrug-resistant (MDR) Gram-negative bacteria such as carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa or Acinetobacter baumannii, extended-spectrum cephalosporin-resistant Enterobacteriaceae as critical priorities for developing new strategies of treatment.Purpose: The novelty presented in this study refers to the evaluation of the volatile oil obtained from the leaves of Mentha×piperita L., on MDR strains from hospitalized patients.Material and methods: The essential oil was extracted by steam distillation and tested on six reference bacterial strains and also on the MDR strains collected from patients of the “Pius Brînzeu” Emergency Clinical County Hospital Timișoara. The in vitro antibacterial activity was evaluated by agar disk diffusion method and microdilution method.Results: Testing the antibacterial activity of peppermint oil on both reference strains and isolated MDR strains from hospitalized patients demonstrated its bactericidal effect. Minimum inhibitory concentration (MIC) was lower (20 mg/mL) for Staphylococcus aureus, Escherichia coli and Proteus mirabilis and higher (40 mg/mL) for Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii strains. Minimum bactericidal concentration (MBC) was equal to MIC, with the exception of Pseudomonas aeruginosa strains, where MBC was the double of MIC.Conclusion: The present study highlights the bactericidal activity of Mentha×piperita L. essential oil on all tested MDR or extensively drug-resistant Gram-positive and Gram-negative strains of Staphylococcus aureus, Escherichia coli, Klebsiellapneumoniae, Proteus mirabilis, Pseudomonas aeruginosa and Acinetobacter baumannii. This oil may be a therapeutic option in the near future for many infectious diseases produced by MDR bacteria.Keywords: bacterial multidrug resistance, peppermint, essential oil, bactericidal effect

Published
2019

43. Extensively drug-resistant Acinetobacter baumannii and Proteeae association in a Romanian intensive care unit: risk factors for acquisition

Author

Muntean,Delia, Licker,Monica, Horhat,Florin, Dumitrașcu,Victor, Săndesc,Dorel, Bedreag,Ovidiu, Dugăeșescu,Dorina, Coșniță,Dan Andrei, Krasta,Anca, and Bădițoiu,Luminița

Subjects
Infection and Drug Resistance
Abstract

Delia Muntean,1,2 Monica Licker,1,2 Florin Horhat,1 Victor Dumitrașcu,1 Dorel Săndesc,1,2 Ovidiu Bedreag,1,2 Dorina Dugăeșescu,1 Dan A Coșniță,1 Anca Krasta,2 Luminița Bădițoiu1 1Victor Babeș University of Medicine and Pharmacy, Timisoara, Romania; 2Pius Brînzeu Emergency Clinical County Hospital, Timisoara, Romania Purpose: The purpose of this study was to identify risk factors for extensively drug-resistant (XDR) Acinetobacter baumannii (AB) and XDR Proteeae association in the largest intensive care unit (ICU) in Western Romania. Materials and methods: This retrospective case-controlled study was conducted between January 2016 and December 2016 in the ICU of the “Pius Brînzeu” County Emergency Clinical Hospital of Timișoara. Data were collected, in strict confidentiality, from the electronic database of the Microbiology Laboratory and the hospital’s electronic medical records. Risk factors were investigated by logistic regression. Independent variables with P≤0.05 and OR >1 (95% CI >1) in the univariate analysis were entered into multivariate sequenced analysis. Findings: The incidence density of coinfection with XDR AB and XDR Proteeae was 5.31 cases per 1,000 patient-days. Independent risk factors for the association of XDR AB and XDR Proteeae were represented by the presence of tracheostomy and naso-/orogastric nutrition ≥ 8 days. In addition, pressure ulcers were independent predictive factors for infections with all three infection types. Previous antibiotic therapy was an independent risk factor for the acquisition of XDR-AB strains, alone or in association, while the prolonged hospitalization in the ICU, blood transfusion, and hemodialysis appear as independent risk factors for single infections. Conclusion: This association of XDR AB and XDR Proteeae may well not be limited to our hospital or our geographical area. Keywords: extensive drug resistance, ICU, infections, risk factors

Published
2018

44. Genetic Features of mcr-1 Mediated Colistin Resistance in CMY-2-Producing Escherichia coli From Romanian Poultry

Author

Maciuca, Iuliana E., primary, Cummins, Max L., additional, Cozma, Andreea P., additional, Rimbu, Cristina M., additional, Guguianu, Eleonora, additional, Panzaru, Carmen, additional, Licker, Monica, additional, Szekely, Edit, additional, Flonta, Mirela, additional, Djordjevic, Steven P., additional, and Timofte, Dorina, additional

Published
2019
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46. Extensively drug-resistant Myroides odoratimimus – a case series of urinary tract infections in immunocompromised patients

Author

Licker,Monica, Sorescu,Teodora, Rus,Maria, Cirlea,Natalia, Horhat,Florin, Jurescu,Cristiana, Botoca,Mircea, Cumpanas,Alin Adrian, Timar,Romulus, Muntean,Delia, Licker,Monica, Sorescu,Teodora, Rus,Maria, Cirlea,Natalia, Horhat,Florin, Jurescu,Cristiana, Botoca,Mircea, Cumpanas,Alin Adrian, Timar,Romulus, and Muntean,Delia

Abstract

Monica Licker,1,2 Teodora Sorescu,3,4 Maria Rus,5,6 Natalia Cirlea,6 Florin Horhat,1 Cristiana Jurescu,5,6 Mircea Botoca,7,8 Alin Cumpănas,7,8 Romulus Timar,3,4 Delia Muntean1,2 1Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 2Clinical Laboratory, “Pius Brînzeu” Emergency Clinical County Hospital, Timisoara, Romania; 3Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 4Diabetes Clinic, “Pius Brînzeu” Emergency Clinical County Hospital, Timisoara, Romania; 5“Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 6“Pius Brînzeu” Emergency Clinical County Hospital, Timisoara, Romania; 7Department of Orthopaedics – Traumatology, Urology and Medical Imaging, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania; 8Urology Unit, “Pius Brînzeu” Emergency Clinical County Hospital, Timisoara, Romania Purpose: We report an outbreak of urinary tract infections (UTIs) caused by Myroides odoratimimus, which occurred in the largest clinical hospital in western Romania. Patients and methods: From June to August 2017, four strains of M. odoratimimus were isolated from the urine samples of patients hospitalized in the urology, diabetes, and surgery departments. Hospital records of all patients whose urine cultures were positive for M. ­odoratimimus were reviewed retrospectively. We also reviewed the cases reported in the literature. Results: All UTIs, except one, were hospital-acquired infections. All patients with M. odoratimimus UTIs were immunocompromised. Three patients underwent urinary catheterization with a Foley’s catheter upon admission in the emergency department and one presented for replacement of

Published
2018

47. SYMMETRICAL AND ASYMMETRICAL MESO-SUBSTITUTED PORPHYRINS AND Zn-METALLOPORPHYRINS IN GOLD COLLOID ENVIRONMENT. OPTICAL PROPERTIES AND EVALUATION OF ANTIBACTERIAL ACTIVITY.

Author

SALAGEANU, LUMINIȚA, MUNTEAN, DELIA, LICKER, MONICA, LASCU, ANCA, ANGHEL, DIANA, and FAGADAR-COSMA, EUGENIA

Subjects
COLLOIDAL gold, PORPHYRINS, OPTICAL properties, GOLD nanoparticles, ENTEROCOCCUS faecalis
Abstract

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2020
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49. Determining the Biological Sealing Quality of the Implant-abutment Interface Using Streptococcus mutans in Both, Conical and Internal Hex Connections A comparative study

Author

Hajaj, Tareq, primary, Talpos, Serban, additional, Stoian, Caius, additional, Negrutiu, Meda Lavinia, additional, Szuhanek, Camelia, additional, Popa, Malina, additional, Stan, Adrian Tudor, additional, Zaharia, Cristian, additional, Hajaj, Karin Roxana, additional, Licker, Monica, additional, Muntean, Delia, additional, Ianes, Emilia, additional, and Sinescu, Cosmin, additional

Published
2018
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