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Sandulescu O.,Carol Davila University of Medicine and Pharmacy | Sandulescu O.,National Institute for Infectious Diseases Prof Dr Matei Bals
GERMS | Year: 2014

Ample resources have been dedicated to studying bacterial resistance, biofilm formation, and genetic encoding of resistance, metabolism or fitness mutations. However, less is known about bacterial persister cells that display multidrug tolerance, latency or adaptation. © GERMS 2014.


Najar H.,Carol Davila University of Medicine and Pharmacy | Streinu-Cercel A.,Carol Davila University of Medicine and Pharmacy | Streinu-Cercel A.,National Institute for Infectious Diseases Prof Dr Matei Bals
GERMS | Year: 2012

Introduction Transmission of rabies to humans occurs rarely in Europe but in the absence of vaccination, it almost invariably leads to a fatal disease. In 2007, Romania implemented a program for rabies eradication in foxes. Methods We performed a descriptive study evaluating the trend of rabies disease in Romania, both in animals and in humans, between 2008-2012. Results In the past years, a large number of adults have presented to the Antirabic Center of the National Institute for Infectious Diseases "Prof.Dr. Matei Balş", Bucharest, Romania. The major bite-inflicting animals were cats and dogs, particularly stray dogs (more than two thirds of the cases). Most cases of animal rabies were recorded in 2008 (1089 cases), with a subsequent decline in the following years: 516 in 2009, 469 in 2010, and 195 in 2011. Six cases of human rabies have been reported in Romania from 2008 to 2012, two of which were located in the Bacǎu district. Four of the cases occurred in females, and two in males; half were children and half adults. The animals inflicting the bites were domestic cats and stray dogs in half of the cases. Discussion Domestic animals, particularly cats, appear to be a major cause of rabies transmission to humans. Therefore, vaccination after cat bites should be taken into account. There is stringent need for specific measures to increase the awareness regarding the problem. People should be educated that cats in rural areas or in the vicinity of forests pose the same level of risk as dogs or wild animals. Conclusion There is need for a new strategy regarding the prevention of animal rabies and its transmission to humans. Proper surveillance systems and continuous monitoring for the disease in wildlife and cities is of utmost importance and should be continued, together with the programs for vaccination of stray dogs and foxes in order to eliminate rabies infection. © GERMS 2012.


Gheorghe L.,Fundeni Clinical Institute of Digestive Diseases and Liver Transplantation | Pascu O.,3rd Medical Clinic | Ceausu E.,Victor Babes Hospital for Infectious Diseases | Csiki I.E.,Institute of Public Health | And 4 more authors.
Journal of Gastrointestinal and Liver Diseases | Year: 2010

Background: An overall prevalence rate of HCV infection in Romanian adult population was recently estimated to be 3.23%. The proportion of treated patients with chronic hepatitis C in our country has never been assessed. Aims: 1) to analyze the quality and quantity of antiviral therapy delivery; 2) to determine the proportion of patients being annually and ever treated with antiviral therapy in Romania and 3) to identify barriers against treatment of HCV infected-population in Romania. Results: The number of annually treated patients remained relatively stable between 2002 and 2007 (1,813 patients treated with pegylated interferon and ribavirin in 2002 and 2,446 in 2007). There was a doubled increase in reimbursed treatment in 2008 and 2009 (4,503 and respectively 4,701 treated patients) due to a special campaign organized to increase awareness and prevention of HCV transmission. The median time to therapy approval varies from county to county; overall it is 10.23 months. A total number of 25,318 patients with chronic C hepatitis were treated between 2002-2009, corresponding to a cumulative proportion of 4.1% of the prevalent cases of HCV infection treated in Romania until 1st January 2010. The main limiting factor of access to antiviral therapy for hepatitis C in Romania remains the lack of funds. Conclusions: This is the first analysis of the nationwide practice for treatment of hepatitis C in Romania. Increased public health efforts are required to improve access to antiviral therapy for hepatitis C in Romania.


Rafila A.,Carol Davila University of Medicine and Pharmacy | Rafila A.,National Institute for Infectious Diseases Prof Dr Matei Bals | Pitigoi D.,National Institute for Infectious Diseases Prof Dr Matei Bals
NATO Science for Peace and Security Series A: Chemistry and Biology | Year: 2013

Countering bioterrorism, as other health threats caused by infectious agents, requires good preparedness, and early warning and response, which can be achieved by an efficient epidemiological surveillance system. In 1990, Romania inherited a functional and quite efficient epidemiological surveillance system from the former communist regime, based on pyramidal and autocratic principles where the state control was absolute. In 2001, the assessment conducted by WHO/Europe showed many unsatisfactory elements of the remaining epidemiological surveillance system for communicable diseases, with a lack of procedures, poor microbiology laboratory capacities, and overlapping responsibilities. The lack of a coordinating body was evident, especially during bioterrorist threats following 9/11 attacks in New York. In 2003 and 2004, the PHARE Project offered an important opportunity for Romania to improve the Romanian System of Epidemiological Surveillance and Control of Communicable Diseases. At the end of this project many of the technical capacities had been improved, specialized trainings of epidemiologists and microbiologists were carried out, and a coordinating body of the epidemiological surveillance network was established [1]. Furthermore, a National Plan of Action was approved by the Minister of Health with the declared objective to improve the system in order to comply with EU standards. At present, the National Institute of Public Health hosts the National Center for Communicable Diseases Surveillance and Control which coordinates the epidemiological network and serves as the Romanian focal point for international institutions such as WHO and ECDC. Each year, comprehensive reports regarding surveillance in Romania of many communicable diseases are published, including diseases potentially related to bioterrorism. Until now, no evidence of a bioterrorism event has been registered in Romania. © 2013 Springer Science+Business Media Dordrecht.


Hristea A.,National Institute for Infectious Diseases Prof Dr Matei Bals | Hristea A.,Carol Davila University of Medicine and Pharmacy | Olaru I.D.,National Institute for Infectious Diseases Prof Dr Matei Bals | Olaru I.D.,Research Center Borstel | And 2 more authors.
Infectious Diseases | Year: 2015

Background: Our objective was to describe the distribution of extended-spectrum beta-lactamase (ESBL) genes found in Escherichia coli and Klebsiella pneumoniae isolates from hospital-acquired or community-onset bloodstream infections (BSIs) in Bucharest, Romania. Methods: E. coli and K. pneumoniae isolates, resistant to at least one antimicrobial drug family, were analyzed for genes encoding ESBL by PCR and sequencing. The E. coli isolates were screened by an ST131 clone allele-specific PCR for the pab B gene. Results: ESBL genes were found in 30 (35%) of 85 drug-resistant E. coli and 19 (70%) of 27 drug-resistant K. pneumoniae. Twenty-nine (97%) E. coli carried bla CTX-M-15 . Nineteen (63%) E. coli carrying an ESBL gene belonged to the ST131 clonal group. The blaCTX-M-15 gene was found in 15 (79%) and blaSHV-12 in 12 (63%) K. pneumoniae isolates. Conclusion: In Bucharest CTX-M15 was the most frequently encountered ESBL in both E. coli and K. pneumoniae BSI isolates regardless of the setting of infections. © 2014 Informa Healthcare.

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