Efthymia Petinaki

This study aimed to investigate the marked increase in bla_NDM-1-positive Acinetobacter baumannii isolates (20% of all CRAB isolates) observed in a tertiary-care hospital in Central Greece during 2025. Thirty bla_NDM-1-producing carbapenem-resistant A. baumannii (CRAB) isolates were selected and subjected to whole-genome sequencing for molecular typing and characterization of antimicrobial resistance determinants and virulence-associated genes. The majority of the isolates (22/30) belonged to ST2^Pasteur (18 strains), ST85^Pasteur (2 strains) and ST2493^Pasteur (2 strains), all previously identified in 2023. The remaining eight strains belonged to newly detected STs, such as ST1^Pasteur (six strains) and ST2806^Pasteur (two strains). All strains carried the bla_NDM-1 gene on the Tn7382. The high prevalence of bla_NDM-1-positive CRAB represents not only a local threat but also a national concern, as patients from our hospital are frequently transferred to other healthcare facilities or long-term care centers across the country, creating a substantial risk for further dissemination of these strains. Routine molecular screening for bla_NDM-1-positive CRAB may represent a valuable strategy for limiting further dissemination.

Background: Measles remains a significant occupational hazard in healthcare settings. In the context of the 2017–2018 measles outbreak in Greece and amid an outbreak at the study hospital, this seroprevalence study aimed to identify gaps in measles serologic status among healthcare workers in a tertiary hospital in central Greece. Methods: We conducted a seroprevalence study among hospital employees between February and December 2017. Blood samples and data on sociodemographic and work-related characteristics were collected from a convenience sample of participants. Measles IgG and IgM antibodies were measured using the ELISA method to determine seropositivity. The 95% CIs for measles IgG seronegativity proportions were calculated using the Clopper–Pearson exact method. Associations between participant characteristics and measles antibody status were assessed using Firth’s penalized logistic regression models. Results: A total of 336 healthcare workers participated in the study (response rate: 24.9%). Overall, 5.4% (95% CI: 3.2–8.3) tested negative for measles IgG antibodies. No significant associations were observed between participants’ characteristics and measles IgG antibody status. Male participants had 15.8 times higher adjusted odds of testing positive for measles IgM antibodies compared with female participants (aOR: 15.8; 95% CI: 2.33–107.54; p = 0.005). Conclusions: Our results indicate a low—but not negligible—proportion of IgG measles seronegativity among participants. The detection of seronegative individuals born prior to 1970 challenges the assumption of universal natural immunity based solely on year of birth. Given the recent rise in measles outbreaks and the limited seroprevalence data among healthcare workers in Greece, these findings provide valuable data to support ongoing efforts to achieve full vaccination coverage in this group. Further research is warranted to investigate the observed sex differences in susceptibility to measles infection.

Helicobacter pylori (Hp), a widespread gastric pathogen, has long been studied for its role in upper gastrointestinal disorders. While its involvement in gastritis, peptic ulcer disease, and gastric cancer is well established, its impact on esophageal diseases remains an area of ongoing investigation. Nevertheless, some data indicate that Hp may be involved in the pathogenesis of gastroesophageal reflux disease–Barrett’s esophagus–esophageal adenocarcinoma sequence. Similarly, the Hp-related mast cell activation—an essential immunological event—may also play a crucial role in the progression from gastroesophageal reflux disease to Barrett’s esophagus and esophageal adenocarcinoma. The underlying mechanisms include immune modulation, cytokine cascades, and microbial interactions that collectively shape the esophageal microenvironment. This review provides an in-depth analysis of these pathways, highlighting the potential role of Hp-induced, mast cell-driven inflammation in esophageal disease progression and discussing emerging therapeutic strategies.

The objectives of the present work were as follows: (i) the detection of cathelicidin biomolecules in the milk of individual goats during the early stages of mastitis and their potential use for the diagnosis of mastitis at its early stage and (ii) the evaluation of the presence of cathelicidin proteins in the bulk-tank milk from goat and sheep farms. In an experimental study, after inoculation of Staphylococcus simulans into a mammary gland of goats, bacteriological and cytological examinations of milk samples, as well as proteomics examinations [two-dimensional gel electrophoresis analysis (2-DE) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometer (MALDI-TOF MS) analysis] were performed sequentially, from 4 to 48 h post-challenge. Cathelicidin-1 and cathelicidin-2 were detected consistently in milk samples obtained throughout the study, and spot optical densities obtained from PDQuest v.8.0 were recorded. Associations were calculated between the presence of mastitis in a mammary gland at a given timepoint and the detection of cathelicidin proteins in the respective milk sample. All inoculated mammary glands developed mastitis, confirmed by the consistent bacterial isolation from milk samples and the increased somatic cell content therein. Spot optical density of cathelicidin proteins was higher than in samples from contralateral mammary glands. There was a significant association between the presence of mastitis in a mammary gland and the detection of cathelicidin biomolecules in the respective milk sample; the overall accuracy was 81.8% (95% confidence interval: 70.4–90.2%). In a field investigation, the presence of cathelicidin proteins was evaluated in the bulk-tank milk of 32 dairy goat and 57 dairy sheep farms. In this part of the work, no cathelicidin proteins were detected in any bulk-tank milk sample of goat, 0.0% (95% confidence interval: 0.0–10.7%), or sheep, 0.0% (95% confidence interval: 0.0–6.3%), farms.

Background/Objectives: Endovascular aneurysm repair (EVAR) of the aorta may trigger an inflammatory response that affects coagulation. In the EVAR of para-renal and thoraco-abdominal aortic aneurysms, the implants are more complex and the duration of surgery is longer. However, the exact pathophysiological mechanisms of coagulation activation are not yet well understood. The primary aim of this study is to investigate the effects of complex EVAR of para-renal and thoraco-abdominal aortic aneurysms on the coagulation status of patients. Methods: This prospective observational study (STROBE), approved and registered by the Ethics Committee of the University Hospital of Larissa (UHL) (NCT06432387), will enroll consecutive patients undergoing elective EVAR of para-renal and thoraco-abdominal aortic aneurysms. Exclusion criteria: Refusal to participate, previous surgery within 3 months, American Society of Anesthesiologists physical status (ASA PS) > 3, known history of thrombophilia or functional platelet dysfunction. Perioperative laboratory tests will be performed according to institutional guidelines. These include a complete blood count, conventional coagulation tests, and kidney and liver function tests. In addition, the following parameters will be determined: von Willebrand factor, factors VIII and XI, D-dimers, fibrinogen, Adamts-13, anti-Xa, platelet activation (multiplate), and high-sensitivity troponin. Blood samples will be taken pre-operatively before induction of anesthesia (01), on postoperative day 1 (02), and on postoperative day 3–4 (03). During hospitalization, myocardial injury after non-cardiac surgery (MINS), major adverse cardiovascular events after non-cardiac surgery (MACE), acute kidney injury (AKI), post-implantation syndrome (PIS), and death from any cause will be recorded. In addition, our patients will be reviewed at 30 days, 3, 6, and 12 months for MACE, implant failure, or death from any cause. All enrolled patients will be treated by the same medical team at UHL according to the indications. According to our power analysis, for a cohort of patients with three consecutive measurements, 58 patients should be included in the study. To compensate for possible dropouts, the sample size was increased to 65 patients. Conclusions: The results of the present study could help physicians to better understand the effects of complex EVAR of para-renal and thoraco-abdominal aortic aneurysms on blood coagulation and platelet activation.

Background/Objective: Late-onset sepsis (LOS), a systemic infection occurring after 72 h of life, is a significant issue of morbidity and mortality in preterm neonates. Nevertheless, in this population, cultures frequently remain negative, even in the presence of typical clinical signs of sepsis. Materials and Methods: This single-center, retrospective study included preterm infants with a birth weight (BW) < 1500 g and/or a gestational age (GA) ≤ 32 weeks, diagnosed with culture-negative LOS (CNLOS) and culture-proven LOS (CPLOS). The study aimed to determine the incidence of these conditions, describe the frequency of isolated pathogens, and compare clinical profiles, antibiotic usage, morbidity, and mortality between these two groups as well as a no-sepsis group. Results: Among 277 infants, 30 (10.8%) had CPLOS, 83 (30%) had CNLOS, and 164 (59.2%) had no sepsis. Significant differences were found between the groups regarding BW, GA, hospitalization duration, morbidity, and mortality (p < 0.001). CNLOS and CPLOS did not differ in terms of mechanical ventilation or central line use. However, CPLOS infants had a higher rate of thrombocytopenia (p < 0.001), inotrope use (p = 0.006), and mortality (p < 0.001) compared to CNLOS infants. The duration of antibiotic treatment was similar between groups [median DOT (IQR): 20 (14–33) vs. 20 (14–35), p = 0.935]. In the CPLOS group, Gram-negative pathogens were isolated in 42.4% of infants, with Klebsiella oxytoca being the most common; Gram-positive organisms in 36.3%; and fungi in 21.2%. Conclusions: LOS, whether culture-proven or not, was associated with neonatal morbidity and mortality. CPLOS was linked to a worse prognosis, while CNLOS was also frequently diagnosed and associated with increased antibiotic use in Neonatal Intensive Care Units (NICUs).

Background: Deep neck infections represent a common but heterogeneous medical condition, as clinical manifestations and outcomes vary, depending, among others, on the infection site. The pharyngeal mucosal space (PMS) represents the most superficial neck space, confined between the pharyngeal mucosa and the pharyngeal constrictor muscles. The collection of pus in the PMS (pharyngeal mucosal abscess (PMA)) is considered rare and is rarely reported in the literature. This study focuses on infections of the pharyngeal mucosal space, aiming to provide an elaborate description of the clinical behavior of this category and reporting its differences from other categories of deep neck infections (DNIs). Methods: A retrospective study of 743 cases of deep neck infections was conducted in a single tertiary center. Cases of abscesses, confined in the pharyngomucosal space (PMAs), were studied, reporting demographics, clinical features, imaging, bacteriology, and treatment data, and comparisons with other DNIs were made. Results: A total of 106 cases of pharyngomucosal space abscesses (PMAs) were reported, representing 14.3% of deep neck infections (DNIs). Dysphagia, odynophagia, and fever were the most common symptoms. Hospitalization with non-surgical drainage was the treatment of choice, resulting in complete recovery with no complications. Conclusions: In conclusion, the frequency of PMAs in our series suggests that they may not be as rare as they are considered to be. Symptoms and clinical findings can be similar to those of other DNIs, especially parapharyngeal abscesses, but, overall, PMAs seem to have a milder clinical behavior, highlighting the need for diagnosis and reporting as a separate, recognizable category.

The objectives of this work were as follows: (i) the evaluation of the prevalence of detection of genetic material of Coxiella burnetii in the bulk tank milk of sheep and goat farms in Greece and (ii) the investigation of variables related to the management applied in farms as possible predictors for this. The presence of C. burnetii genetic material was studied in the bulk tank milk of 325 sheep and 119 goat farms throughout the country. For qualitative and quantitative identification of the genetic material of the pathogen, a commercially available real-time PCR was used. In total, 45 parameters were assessed for potential association with the detection of the pathogen: these referred to the management system, infrastructure, health management, animals, production characteristics, and human resources on the farms. Genetic material of the pathogen was detected in bulk tank milk samples from nine sheep (2.8%) and six goat (5.0%) farms. Genetic material was at significantly higher median concentrations in samples from goat farms than from sheep farms, 1,078,096 (min: 181,121, max: 2,331,386) versus 15,728 (min: 507, max: 505,852) GE mL⁻¹, respectively. For sheep farms, the intensive or semi-intensive management system applied in farms (p = 0.003), and for goat farms, the intensive or semi-intensive management system applied in farms (p = 0.0007) and the smaller number of annual veterinary visits to farms (p = 0.044) emerged as significant predictors. Among sheep farms managed under the intensive or semi-intensive system, the lack of accessory barns on farms (p = 0.024) emerged as a significant predictor; no significant predictor could be found among goat farms under such management systems. There was no significant difference in production outcomes between farms in which C. burnetii was or was not detected in the bulk tank milk; also, there was no association between the detection of C. burnetii and the annual incidence rate of cases of abortion on the farms. The results suggest that the risk of transfer of C. burnetii to dairy products from sheep and goat milk appears to be small, but not negligible, which indicates that the pasteurization of milk from small ruminants must be carried out consistently and correctly to ensure the safety of the product.