National Institute Of Infectious Diseases Prof Dr Matei Bals

Bucharest, Romania

National Institute Of Infectious Diseases Prof Dr Matei Bals

Bucharest, Romania

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PubMed | University of Brighton, World Health Organization, Public Health Agency of Sweden, University of Verona and 9 more.
Type: | Journal: BMC public health | Year: 2016

Globally, the HIV epidemic continues to represent a pressing public health issue in Europe and elsewhere. There is an emerging and progressively urgent need to harmonise HIV and STI behavioural surveillance among MSM across European countries through the adoption of common indicators, as well as the development of trend analysis in order to monitor the HIV-STI epidemic over time. The Sialon II project protocols have been elaborated for the purpose of implementing a large-scale bio-behavioural survey among MSM in Europe in line with a Second Generation Surveillance System (SGSS) approach.Sialon II is a multi-centre biological and behavioural cross-sectional survey carried out across 13 European countries (Belgium, Bulgaria, Germany, Italy, Lithuania, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the UK) in community settings. A total of 4,966 MSM were enrolled in the study (3,661 participants in the TLS survey, 1,305 participants in the RDS survey). Three distinct components are foreseen in the study protocols: first, a preliminary formative research in each participating country. Second, collection of primary data using two sampling methods designed specifically for hard-to-reach populations, namely Time Location Sampling (TLS) and Respondent Driven Sampling (RDS). Third, implementation of a targeted HIV/STI prevention campaign in the broader context of the data collection.Through the implementation of combined and targeted prevention complemented by meaningful surveillance among MSM, Sialon II represents a unique opportunity to pilot a bio-behavioural survey in community settings in line with the SGSS approach in a large number of EU countries. Data generated through this survey will not only provide a valuable snapshot of the HIV epidemic in MSM but will also offer an important trend analysis of the epidemiology of HIV and other STIs over time across Europe. Therefore, the Sialon II protocol and findings are likely to contribute significantly to increasing the comparability of data in EU countries through the use of common indicators and in contributing to the development of effective public health strategies and policies in areas of high need.


Revell A.D.,The HIV Resistance Response Database Initiative RDI | Wang D.,The HIV Resistance Response Database Initiative RDI | Wood R.,Desmond Tutu Center | Morrow C.,Desmond Tutu Center | And 11 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2013

Objectives: Genotypic HIV drug-resistance testing is typically 60%-65% predictive of response to combination antiretroviral therapy (ART) and is valuable for guiding treatment changes. Genotyping is unavailable in many resource-limited settings (RLSs). We aimed to develop models that can predict response to ART without a genotype and evaluated their potential as a treatment support tool in RLSs. Methods: Random forest models were trained to predict the probability of response to ART (≤400 copies HIV RNA/mL) using the following data from 14891 treatment change episodes (TCEs) after virological failure, from well-resourced countries: viral load and CD4 count prior to treatment change, treatment history, drugs in the new regimen, time to follow-up and follow-up viral load. Models were assessed by cross-validation during development, with an independent set of 800 cases fromwell-resourced countries, plus 231 cases fromSouthern Africa, 206 from India and 375 from Romania. The area under the receiver operating characteristic curve (AUC) was the main outcome measure. Results: Themodels achieved an AUC of 0.74-0.81 during cross-validation and 0.76-0.77 with the 800 test TCEs. They achievedAUCs of 0.58-0.65 (Southern Africa), 0.63 (India) and 0.70 (Romania).Modelsweremore accurate for data fromthewell-resourced countries than for cases fromSouthern Africa and India (P<0.001), but not Romania. The models identified alternative, available drug regimens predicted to result in virological response for 94% of virological failures in Southern Africa, 99% of those in India and 93% of those in Romania. Conclusions: We developed computational models that predict virological response to ART without a genotype with comparable accuracy to genotyping with rule-based interpretation. These models have the potential to help optimize antiretroviral therapy for patients in RLSs where genotyping is not generally available ©The Author 2013.


Mihailescu R.,University of Lausanne | Mihailescu R.,National Institute Of Infectious Diseases Prof Dr Matei Bals | Tafin U.F.,University of Lausanne | Corvec S.,University of Lausanne | And 5 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2014

Increasing antimicrobial resistance reduces treatment options for implant-Associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA). We evaluated the activity of fosfomycin alone and in combination with vancomycin, daptomycin, rifampin, and tigecycline against MRSA (ATCC 43300) in a foreign-body (implantable cage) infection model. The MICs of the individual agents were as follows: fosfomycin, 1 μg/ml; daptomycin, 0.125 μg/ml; vancomycin, 1 μg/ml; rifampin, 0.04 μg/ ml; and tigecycline, 0.125 μg/ml. Microcalorimetry showed synergistic activity of fosfomycin and rifampin at subinhibitory concentrations against planktonic and biofilm MRSA. In time-kill curves, fosfomycin exhibited time-dependent activity against MRSA with a reduction of 2.5 log10 CFU/ml at 128the MIC. In the animal model, planktonic bacteria in cage fluid were reduced by>1 log10 CFU/ml with fosfomycin and tigecycline, 1.7 log10 with daptomycin, 2.2 log 10 with fosfomycin-tigecycline and fosfomycin-vancomycin, 3.8 log10 with fosfomycin-daptomycin, and>6.0 log10 with daptomycin-rifampin and fosfomycin-rifampin. Daptomycin-rifampin cured 67% of cage-Associated infections and fosfomycin-rifampin cured 83%, whereas all single drugs (fosfomycin, daptomycin, and tigecycline) and rifampin-free fosfomycin combinations showed no cure of MRSA cageassociated infections. No emergence of fosfomycin resistance was observed in animals; however, a 4-fold increase in fosfomycin MIC (from 2 to 16 μg/ml) occurred in the fosfomycin-vancomycin group. In summary, the highest eradication of MRSA cageassociated infections was achieved with fosfomycin in combination with rifampin (83%). Fosfomycin may be used in combination with rifampin against MRSA implant-Associated infections, but it cannot replace rifampin as an antibiofilm agent.© 2014, American Society for Microbiology.


Carstoiu C.,University of Bucharest | Ene R.,University of Bucharest | Panti Z.,University of Bucharest | Ene P.,University of Bucharest | And 3 more authors.
Key Engineering Materials | Year: 2014

Implant-associated infections in orthopedics represent a major challenge for diagnosis and treatment [1]. Sonication is an alternative method for the diagnosis in prosthetic infections, with a higher sensitivity compared to the conventional periprosthetic cultures. The aim of this paper was to compare the results of conventional culturing and sonication process in per prosthetic joint infections. We studied a group of 34 patients admitted for inflamatory complications related to orthopedic implants, like total hip joint arthroplasty and fracture fixation in the University Emergency Hospital of Bucharest. Local and biopsy cultures were compared with sonication fluid culturing. Our study involved 34 patients with an average age of 63.08 ±10.65SD. In 3 cases the cultures after sonication was negative in 9 cases Methicilin resistant (MR) staphylococcus was isolated, in 1 case Serratia Marcescens and another case with Staphylococcus Warmei. Our study underlines the importance of the etiological diagnosis with the application of sonication. The sonication technique is simple and can be performed in most of microbiological laboratories. Sonication has the benefit of the etiological diagnosis either in mono-microbial and poli-microbial implant-associated infections, with a higher sensitivity than standard culturing. © (2015) Trans Tech Publications, Switzerland.


Gheorghita V.I.,Central Military Emergency Hospital Dr Carol Davila | Gheorghita V.I.,National Institute of Infectious Diseases Prof Dr Matei Bals | Caruntu F.A.,National Institute of Infectious Diseases Prof Dr Matei Bals | Caruntu F.A.,Carol Davila University of Medicine and Pharmacy | And 7 more authors.
Journal of Gastrointestinal and Liver Diseases | Year: 2013

Background & Aims: The aim of the study was to assess the clinical utility of serum HBsAg quantification as a surrogate biomarker for the prediction of sustained virological response (SVR) in chronic hepatitis B (CHB) patients treated with Pegylated Interferon alfa-2a (Peg-IFN α-2a). Methods: We performed a prospective cohort study which included 57 patients with CHB treated 48 weeks with Peg-IFN α-2a and followed for another 24 weeks. HBsAg was quantified at the baseline, during treatment and at the end of follow-up. SVR was defined as HBV-DNA below 2,000 IU/ml at 24 weeks after the end of therapy. Results: The majority of patients had HBeAg-negative CHB (68%, n=39). Positive predictive factors for SVR at baseline were low levels of HBsAg (3.72 log10 IU/ml, p=0.032) and HBV-DNA (3.96 log10 IU/ml, p=0.035). During treatment, patients who achieved SVR showed a marked decrease in serum HBsAg in comparison with nonresponders (at week 48 mean decrease of 1.06 ± 1.3 log10 IU/ml versus 0.04 ± 0.5 log10 UI/ml, p=0.005). On therapy, HBV-DNA reduction ≥ 2 log10 IU/ml with any decrease of HBsAg level at week 12 had a positive predictive value (PPV) of 80% (95% CI: 51.91-95.43%) for SVR, while HBV-DNA decline < 2 log10 IU/ml without any decline of HBsAg had a negative predictive value (NPV) of 85.71% (95% CI: 42.23-97.63%) for SVR. Conclusions: HBsAg quantification combined with HBV-DNA assessment could become an early useful tool to optimize the management of CHB patients treated with Peg-IFN α-2a, according to response guided therapy.


Berteanu E.,Romanian National Institute for Research and Development for Biological Sciences | Ionita D.,Polytechnic University of Bucharest | Simoiu M.,National Institute Of Infectious Diseases Prof Dr Matei Bals | Paraschiv M.,Romanian National Institute for Research and Development for Biological Sciences | And 2 more authors.
Materiale Plastice | Year: 2016

The paper presents a method for elaboration and characterization some chitosan-gelatine membranes with different collagen-gelatine mass ratio, cross-linked with glutaraldehyde (GA) and coupled with extract plants. The aqueous extracts obtained from these plants were analyzed in terms of biologically active substances content (amino acids, polyphenols and phytosterols). The investigation for all obtained membranes involves: SEM microscopy, porosity, degradation test, contact angles measurement, hemolisys and antibacterian index determination.


Adriana N.,Emergency Universitary Hospital | Cristina O.,National Institute Of Infectious Diseases Prof Dr Matei Bals | Olariu M.,National Institute Of Infectious Diseases Prof Dr Matei Bals | Olteanu D.,Emergency Universitary Hospital
Therapeutics, Pharmacology and Clinical Toxicology | Year: 2012

Less than 25% of asymptomatic adults have elevated levels of transaminases on a first evaluation, one third of these patients have normal values on a retest. From those who have elevated ALT on retest, some prove to suffer from an acute liver disease (with normal ALT in less than 6 months), and the others represent the category of chronic (more than 6 months) elevation of transaminases. The etiology of chronic hypertransaminasemia can be elucidated in 90% of the cases, due to liver disease with occult/ atypical evolution, or extra-hepatic causes of chronic elevation of transaminases. The 10% left represent the category of unexplained (obscure cause) elevation of transaminases. The occult/atypical evolution liver diseases are represented by chronic viral hepatitis (HBV, HCV), alcohol consumption, non-alcoholic steatohepatitis (NASH), congestion liver, drugs and liver toxic substances, autoimmune hepatitis, Wilson's disease, a1 antitrypsin deficiency, parasitic diseases. The extra-hepatic causes that can determinate chronic elevations of transaminases are haemolysis, soft muscle diseases (polymyositis), occult celiac sprue, suprarenal insufficiency, thyroid pathology. There still remains 10% of the patients in witch the etiology can not be explained. Usually these patients are kept under surveillance, periodic reevaluation, and undergo a second liver biopsy; witch may reveal nonspecific lesions, NASH, chronic hepatitis, cirrhosis. There are cases in witch on the surveillance period it was observed a spontaneous normalization of transaminases. Chronic hypertransaminasemia is quite frequent, and has a high addressability to the physician from patients with this type of pathology, being for most of them a discovery by chance on a routine blood check. It is also important to have a clear diagnosis to start the specific treatment for those patients who can benefit out of it as soon as possible. © 2012.


Ilie A.,National Institute Of Infectious Diseases Prof Dr Matei Bals
Therapeutics, Pharmacology and Clinical Toxicology | Year: 2011

The author presents case of an infected HIV patient, late presenter and antiretroviral treatment management using Raltegravir as first line therapy. The patient associated in 2008 chronic hepatitis C with sustained viral response. © reserved 2011.


Iacob S.A.,National Institute Of Infectious Diseases Prof Dr Matei Bals | Iacob D.G.,Carol Davila University of Medicine and Pharmacy
Protein and Peptide Letters | Year: 2014

The human cathelicidin-18 is an antimicrobial, immunomodulatory and tissue repair peptide. The LL-37 fragment of this peptide which is in fact the active domain of the cathelicidin-18 is critical for the human antibacterial defense and epithelial integrity. It's activity against resistant pathogens, the potential of epithelial healing after microbial injury and the neutralization of bacterial endotoxin underlie the most important benefits of this peptide. However, there are still a number of questions that remain to be answered regarding the precise interactions of cathelicidin-18 within the immune system, the exact tissue concentrations or its possible pro-tumoral activity. In this respect, the therapeutic potential of cathelicidin-18 in various infections has been proved by in vitro experiments, but additional detailed clinical studies are still required to ascertain its antimicrobial role in vivo. We present a short review on the antibacterial activity of human cathelicidin-18 (LL-37) according to in vitro experiments while discussing its potential use in the clinical practice. © 2014 Bentham Science Publishers.


PubMed | National Institute Of Infectious Diseases Prof Dr Matei Bals
Type: Journal Article | Journal: Journal of the International AIDS Society | Year: 2014

Late presentation is associated with increased healthcare costs, rates of HIV transmission and poor outcome. In Romania, in 2012, one third of individuals with new HIV diagnosis were late presenters (LP).The aim of the study was to evaluate the epidemiological and clinical characteristics associated with late presentation.We retrospectively studied patients over 18 years old, notified in our institution between January 2012 and December 2013, including 499 out of 727 newly diagnosed patients in Bucharest. LP were defined as patients presenting with CD4 T-cell count below 350 cells/mm(3) or with an AIDS defining event. Patients with advanced HIV disease (AHD) were defined as persons with a CD4 T-cell count below 200 cells/mm(3). Differences between groups were analyzed using the Mann-Whitney U test for continuous variables and the chi-square test for dichotomous variables. Multivariable analysis was performed using binary logistic regression.Out of 499 patients included, 362 (72%) were male. The median age was 30 (IQR 26-36). A total of 302 (61%) were LP and 184 (37%) were patients with AHD. A total of 170 (34%) were asymptomatic and 114 (23%) presented with an AIDS-defining event. The median CD4 count was 293 cells/mm(3) (IQR 125-471) and the median HIV viral load was 100,191 copies/mL (IQR 34,560-272,936). Characteristics of LP compared with non-LP are shown in Table 1. Stage C disease has been shown by multivariable analysis to be associated with LP (p<0.001, OR=11.56, 95% CI 4.94-27.03).More than half of newly HIV diagnosed patients in Bucharest were LP. The proportion of LP was highest among heterosexually acquired cases. Although most our patients were young, late presentation was associated with age over 35 years. The lower proportion of LP among IVDU compared with those heterosexually infected could be explained by a higher proportion of HIV screening tests among IVDU.

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