Now showing 1 - 10 of 10
  • Publication
    The impact of seasonal influenza vaccination uptake on COVID-19 vaccination attitudes in a rural area in Greece
    (Elsevier Ltd, 2023) ; ;
    Andria Papazachariou
    ;
    Onoufrios Malikides
    ;
    Maria Stamatelatou
    ;
    Nektaria Vasilaki
    ;
    Athanasia Milioni
    ;
    Maria Dasenaki
    ;
    Nikolaos Spernovasilis
    Introduction: Promoting vaccination for coronavirus disease 2019 (COVID-19), especially for high-risk groups such as the elderly and persons with comorbidities, is important for reducing the incidence of severe disease and death. Methods: Retrospective cross-sectional study of factors associated with COVID-19 vaccination, including previous influenza vaccination, among all persons who received medical services in a rural area in Crete, Greece, between October 2020-May 2021. Results: Among 3129 participants, receipt of influenza vaccination in 2020–21 was strongly associated with COVID-19 vaccination, as was influenza vaccination in 2019–20, albeit to a lesser extent. In addition, persons older than 59 years (with exception of those 90 + years old) and those who lived closer to the hospital/health center, were more likely to vaccinate for COVID-19. Persons younger than 40 years of age, females, persons with mental illness or neurologic disease, were also less likely to vaccinate for COVID-19 (all p < 0.001). Conclusions: COVID-19 vaccination was more likely among those who were vaccinated for influenza before and during the pandemic. Access to healthcare services and specific comorbidities, were important influencers for vaccination, underlying the importance of tailored interventions to enforce vaccination in high-risk groups.
  • Publication
    Lomentospora prolificans Disseminated Infections: A Systematic Review of Reported Cases
    (MDPI, 2023-01) ;
    Afroditi Konsoula
    ;
    Aris P. Agouridis
    ;
    Lamprini Markaki
    ;
    Nikolaos Spernovasilis
    Background: Lomentospora prolificans, a rare, highly virulent filamentous fungus with high rates of intrinsic resistance to antifungals, has been associated with different types of infections in immunocompromised as well as immunocompetent individuals. Objective: To systematically address all relevant evidence regarding L. prolificans disseminated infections in the literature. Methods: We searched Medline via PubMed and Scopus databases through July 2022. We performed a qualitative synthesis of published articles reporting disseminated infections from L. prolificans in humans. Results: A total of 87 studies describing 142 cases were included in our systematic review. The pathogen was most frequently reported in disseminated infections in Spain (n = 47), Australia (n = 33), the USA (n = 21), and Germany (n = 10). Among 142 reported cases, 48.5% were males. Underlying conditions identified for the majority of patients included malignancy (72.5%), hemopoietic stem cell transplantation (23.2%), solid organ transplantation (16%), and AIDS (2%). Lungs, central nervous system, skin, eyes, heart and bones/joints were the most commonly affected organs. Neutropenia was recorded in 52% of patients. The mortality rate was as high as 87.3%. Conclusions: To the best of our knowledge, this is the first systematic review conducted on disseminated infections due to this rare microorganism. Physicians should be aware that L. prolificans can cause a diversity of infections with high mortality and primarily affects immunocompromised and neutropenic patients.
  • Publication
    Endophthalmitis caused by Enterococcus casseliflavus: a systematic review of literature
    (European Academy of HIV/AIDS and Infectious Diseases, 2023)
    Stylianos A Kandarakis
    ;
    Nikolaos Spernovasilis
    ;
    Ilias Georgalas
    ;
    Michalis Mendris
    ;
    Aris P Agouridis
    ;
    Introduction Enterococcus casseliflavus is a rare pathogen in human infections, despite being widely distributed in natural environments. This systematic review aims to evaluate the evidence related to endophthalmitis caused by E. casseliflavus. Methods A thorough search of PubMed, PubMed Central, and Scopus databases was conducted, covering the period up to October 2022. Results A total of 53 records were identified, with 8 studies reporting a total of 21 cases meeting the inclusion criteria. Among these studies, 7 described isolated case reports, while 1 study described 14 cases. The overall quality of the reports was good, as all articles were determined to have low risk of bias. Vancomycin susceptibility was reported in only one case of isolated case reports, while the remaining cases were all vancomycin resistant. With regard to management, in most cases intravenous ampicillin and linezolid were administered, while only one study reported administration of vancomycin. Conclusions Ophthalmologists should be aware of the potential for E. casseliflavus to cause endophthalmitis infections and the challenges associated with its intrinsic resistance to vancomycin.
  • Publication
    Not surprising: a rebound in antibacterial consumption in Europe, with Cyprus and Greece on the podium
    (Oxford University Press, 2024-05-01)
    Nikolaos Spernovasilis
    ;
    Recent European-wide data place Cyprus and Greece in the highest positions of total antimicrobial consumption. While this level of consumption might be partly attributed to the high rates of infections due to MDR bacteria in these countries, several other reasons should be sought to help apply local measures, to decrease inappropriate and excess antimicrobial use. The present viewpoint aims to provide a roadmap for interventions, by briefly discussing the various factors that underlie antimicrobial use and prescribing practices in Greece and Cyprus.
  • Publication
    In vitro study on the transmission of multidrug-resistant bacteria from textiles to pig skin
    (Baishideng Publishing Group Inc, 2023-12) ; ;
    Pavlina Lena
    ;
    Spyridon Karageorgos
    ;
    Maria Liatsou
    ;
    Aris P Agouridis
    ;
    Nikolaos Spernovasilis
    ;
    Demetris Lamnisos
    BACKGROUND The survival of microorganisms on textiles and specifically on healthcare professionals’ (HCP) attire has been demonstrated in several studies. The ability of microorganisms to adhere and remain on textiles for up to hours or days raises questions as to their possible role in transmission from textile to skin via HCP to patients. AIM To evaluate the presence, survival and transmission of different multidrug-resistant bacteria (MDRB) from HCP attire onto skin. METHODS Three MDRB [methicillin-resistant Staphylococcus aureus (MRSA); vancomycin-resistant Enterococcus faecium (VRE); carbapenem-resistant Klebsiella pneumoniae, CRKP)] were inoculated on textiles from scrubs (60% cotton-40% polyester) and white coat (100% cotton) at concentrations of 108 colony-forming units (CFU), 105 CFU, and 103 CFU per mL. The inoculation of swatches was divided in time intervals of 1 min, 5 min, 15 min, 30 min, 1 h, 2 h, 3 h, 4 h, 5 h, and 6 h. At the end of each period, textiles were imprinted onto pig skins and each skin square was inverted onto three different selective chromogenic media. Growth from the pig skin squares was recorded for the 3 MDRB at the three above concentrations, for the whole length of the 6-h experiment. RESULTS MRSA was recovered from pig skins at all concentrations for the whole duration of the 6-h study. VRE was recovered from the concentration of 108 CFU/mL for 6 h and from 105 CFU/mL for up to 3 h, while showing no growth at 103 CFU/mL. CRKP was recovered from 108 CFU/mL for 6 h, up to 30 min from 105 CFU/mL and for 1 min from the concentration of 103 CFU/mL. CONCLUSION Evidence from the current study shows that MRSA can persist on textiles and transmit to skin for 6 h even at low concentrations. The fact that all MDRB can be sustained and transferred to skin even at lower concentrations, supports that textiles are implicated as vectors of bacterial spread. ©The Author(s)
  • Publication
    Oral Molnupiravir and Nirmatrelvir/Ritonavir for the Treatment of COVID-19: A Literature Review with a Focus on Real-World Evidence
    (Multidisciplinary Digital Publishing Institute (MDPI), 2023-12)
    Ioannis Karniadakis
    ;
    Nikolaos Mazonakis
    ;
    Michail Papadakis
    ;
    Ioulia Markaki
    ;
    Nikolaos Spernovasilis
    ;
    Vaccines remain the cornerstone of medical prevention and are highly effective in reducing the risk of severe disease and death due to coronavirus disease 2019 (COVID-19). In the context of expanding the therapeutic armamentarium against COVID-19, molnupiravir (Lagevrio) and ritonavir-boosted nirmatrelvir (Paxlovid) were developed, constituting the first effective oral treatments against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this narrative review, we retrospectively inquired into the clinical trials and real-world studies investigating the efficacy of these agents. Overall, clinical trials and real-world studies have demonstrated the efficacy of both agents in reducing hospitalization and death rates in COVID-19 patients. As per current recommendations, their use is suggested in patients with mild to moderate symptoms who are at high risk of developing severe disease. Nevertheless, limited data exist regarding their efficacy in specific subpopulations, such as immunocompromised patients, those with severe kidney disease, pregnant women, and children.
  • Publication
    Statins in Children with Neurofibromatosis Type 1: A Systematic Review of Randomized Controlled Trials
    (Multidisciplinary Digital Publishing Institute (MDPI), 2023-09) ;
    Aris P. Agouridis
    ;
    Nikoletta Palli
    ;
    Vasiliki-Eirini Karagiorga
    ;
    Afroditi Konsoula
    ;
    Lamprini Markaki
    ;
    Nikolaos Spernovasilis
    Background: Statins, apart from their plasma-cholesterol-lowering ability, exert several pleiotropic effects, making them a potential treatment for other diseases. Animal studies have showed that statins, through the inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase, can affect the Ras/MAPK pathway, thus providing impetus to examine the efficacy of statins in the pediatric population with neurofibromatosis type 1 (NF1). We aimed to systematically address all relevant evidence of statin treatment in children with NF1. Methods: We searched PubMed and Cochrane Library resources up to 2 June 2023 for randomized controlled trials (RCTs) written in English and evaluating statins versus placebo in children with NF1 (PROSPERO registration number: CRD42023439424). Results: Seven RCTs were suitable to be included in this qualitative synthesis, with a total participation of 336 children with NF1. The duration of the studies ranged from 12 to 52 weeks. The mean age of the pediatric population was 10.9 years old. Three studies investigated the role of simvastatin, while four studies examined lovastatin. According to our analysis, neither simvastatin nor lovastatin improved cognitive function, full-scale intelligence, school performance, attention problems, or internalizing behavioral problems when compared with placebo in children with NF1. Statins were well tolerated in all included RCTs. Conclusion: Although safe, current evidence demonstrates that statins exert no beneficial effect in cognitive function and behavioral problems in children with NF1.
  • Publication
    Assessing the knowledge, attitudes and perceptions of junior doctors on antimicrobial use and antimicrobial resistance in Greece
    (Elsevier Ltd, 2020-06) ;
    Nikolaos Spernovasilis
    ;
    Despo Ierodiakonou
    ;
    Athanasia Milioni
    ;
    Lamprini Markaki
    ;
    Diamantis P. Kofteridis
    Objectives: Understanding antimicrobial prescribing attitudes and perceptions, especially in the early stages of medical training, is an important driver for appropriate interventions. This study examined junior doctors’ knowledge, attitudes and perceptions regarding antimicrobial use and antimicrobial resistance in Greece. Methods: A self-administered, internet-based questionnaire survey was completed by trainees and residents of all primary care centres and hospitals in Crete, Greece. Results: From the 313 invited junior doctors, 214 (68.4%) fully completed the questionnaire. The mean correct knowledge score (four items) was 60%. The highest confidence rates with prescribing were recorded in accurately diagnosing an infection that needs antimicrobial treatment, selecting an appropriate administration route, and selecting the appropriate dosage. The lowest confidence rates were recorded in modifying antimicrobial treatment based on clinical and/or microbiological evidence, prescribing antimicrobial combinations and not prescribing an antimicrobial in a febrile patient without severity criteria and uncertain diagnosis of infection. Use of guidelines and expert consultation were perceived as the most important factors influencing antimicrobial prescribing practices. Most participants were aware of the antimicrobial resistance problem in Greece, and considered excessive prescribing of antimicrobials and broad-spectrum antimicrobials to be the most important causes. Availability of local and national guidelines and antimicrobial resistance data, senior consultation and infectious diseases specialist consultation were the preferred interventions to improve antimicrobial prescribing. Conclusions: The findings of this study will contribute to the design of appropriate interventions, based on local evidence, for the establishment of antimicrobial stewardship programs in a country characterised by excessive use of antimicrobials and high resistance rates.
  • Publication
    Fever of unknown origin caused by infectious diseases in the era of migrant and refugee crisis
    (Elsevier USA, 2020-02) ;
    Nikolaos Spernovasilis
    ;
    Lamprini Markaki
    ;
    Maria Zafeiri
    ;
    Stella Soundoulounaki
    ;
    Achilleas Gikas
    Concern exists in Europe about the possibility of importation of infectious diseases due to the recent influx of migrants and refugees after 2011. In this retrospective 6-year study, we examined the epidemiology of fever of unknown origin (FUO) in Greece over the past years. Forty-eight patients with classical FUO were included. The proportion of infectious causes of FUO (29.2%) was similar to previous studies in Greece and all infections were endemic to the area. Disease-related mortality was 12.5% and no deaths due to infection were recorded. In conclusion, none of the diagnosed infectious causes of FUO raised concerns about the possibility of imported diseases or pathogens. These results re-inforce the perception that migrants and refugees are not carriers of communicable diseases that can cause public health problems to European countries.