Dermatophytoses are of worldwide distribution. Epidemiological studies concerning dermatophyte infections have been performed in many countries and differences in the incidence and the aetiological agents have been reported in different geographical locations. This study was undertaken to investigate the prevailing species of dermatophytes in the island of Crete, Greece, and their pattern of infection during a 7-year period (1997-2003). A total of 5544 samples obtained from 3751 patients with clinically suspected dermatomycoses were examined mycologically in the laboratory of Clinical Microbiology at the University Hospital of Crete, Greece. Skin, hair and nail specimens were subjected to direct microscopy and culture. Dermatophytes were isolated from 520 patients (13.9%). Trichophyton rubrum was the most frequently isolated dermatophyte accounting for 48% of the infections, followed by Microsporum canis (17.9%), Trichophyton mentagrophytes var. interdigitale (14.2%) and Epidermophyton floccosum (6%). Tinea unguium, tinea pedis, tinea corporis, tinea capitis, tinea cruris, tinea manuum and tinea facei were the clinical types of dermatophytoses in decreasing order of frequency. Trichophyton rubrum is the predominant dermatophyte in our area. As the epidemiology of dermatophytoses is changing over time it is important to review periodically the incidence of dermatophytes and their distribution.
Summary Vulvovaginal candidiasis (VVC) is a common infection of the genital tract affecting millions of women worldwide. Data on epidemiological trends of VVC in Greece are scarce. This study was undertaken to evaluate the prevalence of VVC among symptomatic women in Crete, Greece, identify the Candida species involved and determine their susceptibility to antifungals. Over a 6‐year period (2012‐2017), 10 256 symptomatic women with vaginitis were evaluated. Isolation of yeasts was performed on Sabouraud dextrose agar with chloramphenicol, and the isolates were identified using the API 20 C AUX and/or the Vitek 2 YST card. Susceptibility of the isolates to amphotericin, fluconazole, voriconazole and flucytosine was determined by the Vitek 2 automated system. The results were interpreted according to Clinical and Laboratory Standards criteria. Vaginal swab cultures of 1217 (11.9%) women yielded Candida species. Recurrent VVC was documented in 62 (5.1%) of them. Candida albicans was the most frequently isolated species (75.6%), followed by Candida glabrata (13.6%). Overall, resistance rates to amphotericin B, fluconazole, voriconazole and flucytosine were 0.2%, 6.6%, 1.4% and 2.1%, respectively. Fluconazole resistance of C. albicans significantly increased in the second period of the study (2015‐2017) (P = 0.031). This study demonstrated that VVC is a common infection among women in our region, with C. albicans being the predominant species involved. Although resistance to antifungals was infrequent, resistance to fluconazole among C. albicans isolates was found to significantly increase with time. Continued surveillance of changes in species distribution and susceptibility to antifungals are necessary to guide treatment.
During a 5-y period (2003 - 2007), nocardial infections were diagnosed in 15 patients admitted to the University Hospital of Heraklion, Crete, Greece. Nine patients (60%) had 1 or more underlying conditions predisposing to nocardiosis. The skin was involved in 10 cases, followed by the lung in 4. One patient had disseminated disease. Five different species were identified: N. brasiliensis (n =7), N. otitidiscaviarum (n=4), N. abscessus (n=2), N. transvalensis (n=1), and N. farcinica (n=1). The most common species was N. brasiliensis. All isolates were sensitive to linezolid, moxifloxacin, and tigecycline, and 80% of them to trimethoprim-sulfamethoxazole. Antibiotics were given to all 15 patients. A clinical response was observed in 14 of them, while 1 died of nocardiosis. Nocardiosis is a rare but sometimes life-threatening infection, complicating immunosuppression. Early diagnosis and timely administration of appropriate treatment result in a favourable outcome.
The aim of the present study was to determine the serotype distribution and the evolution of antimicrobial resistance among Salmonella enterica strains isolated from patients with diarrhea in Crete, Greece, during a 5-year period (2000-2004). Among the 401 S. enterica isolates recovered, serotype Enteritidis was the most prevalent (66.6%), followed by serotype Typhimurium (14.2%). The rates of resistance to ampicillin, amoxicillin-clavulanic acid, gentamicin, chloramphenicol, tetracycline, nalidixic acid and trimethoprim-sulfamethoxazole were 8.5, 7, 0.7, 5.4, 14.2, 2.7 and 2.7%, respectively. A marked decrease in resistance was observed during the study period. Resistance and multidrug resistance was most common in serotype Typhimurium. The extended-spectrum beta-lactamase production observed in one strain of S. enterica serotype Virchow and the reduced ciprofloxacin susceptibility detected in 2.7% of the isolates studied are causes of concern.
Mycoplasma hominis and Ureaplasma species are opportunistic pathogens associated with urogenital infections, complications during pregnancy and postpartum infections. Appropriate empirical antimicrobial treatment is necessary to achieve an optimal therapeutic outcome. This study evaluated the prevalence and the antimicrobial susceptibility of Mycoplasma hominis and Ureaplasma spp. isolated from 1,008 endocervical samples of outpatients in Crete, Greece, during a five-year period (2012-2016), using the commercially available Mycoview kit (Zeakon diagnostics, France). Ureaplasma spp. was isolated from 116 patients (11.5%), M. hominis from 6 (0.6%), while coinfection with both mycoplasmas was demonstrated in 17 (1.7%). All Ureaplasma strains were susceptible to josamycin and doxycycline. Doxycycline, minocycline and ofloxacin were the most potent antibiotics against M. hominis. Docycycline was proved the most active and is still the drug of choice for the treatment of genital mycoplasma infections. Local surveillance to monitor changes in antimicrobial susceptibilities is necessary to guide treatment strategies.
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