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Maltezou HC, Tseroni M, Drositis I, Gamaletsou MN, Koukou DM, Bolikas E, Peskelidou E, Daflos C, Panagiotaki E, Ledda C, Pavli A, Moussas N, Kontogianni S, Svarna E, Ploumidis M, Spyrou A, Chini M, Adamis G, Lourida A, Hatzigeorgiou D, Gargalianos P, Syrogiannopoulos G, Sipsas NV. Vaccination coverage rates and attitudes towards mandatory vaccinations among healthcare personnel in tertiary-care hospitals in Greece. Expert Rev Vaccines 2022; 21:853-859. [PMID: 35382665 DOI: 10.1080/14760584.2022.2063118] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES : Our aim was to estimate vaccination and susceptibility rates against vaccine-preventable diseases among healthcare personnel (HCP) in eight hospitals. METHODS This study was a cross-sectional survey. RESULTS A total of 1284 HCP participated (physicians: 31.3%, nursing personnel: 36.6%, paramedical personnel: 11.1%, administrative personnel: 13.2%, supportive personnel: 7.3%). Vaccination rates were 32.9% against measles and mumps, 38.1% against rubella, 5.7% against varicella, 9.2% against hepatitis A, 65.8% against hepatitis B, 31.8% against tetanus-diphtheria, 7.1% against pertussis, 60.2% against influenza, and 80.1% against COVID-19. Susceptibility rates were: 27.8% for measles, 39.6% for mumps, 33.4% for rubella, 22.2% for varicella, 86.3% for hepatitis A, 34.2% for hepatitis B, 68.2% for tetanus-diphtheria, and 92.9% for pertussis. Older HCP had higher susceptibility rates against mumps, rubella, varicella, hepatitis A, hepatitis B, tetanus-diphtheria, and pertussis (p-values <0.001 for all). Mandatory vaccinations were supported by 81.85% of HCP. CONCLUSIONS Although most HCP supported mandatory vaccinations, significant vaccination gaps and susceptibility rates were recorded. The proportion of susceptible HCP to measles, mumps, rubella, and varicella increased the past decade, mostly because of reduction of acquired cases of natural illness. Vaccination programs for HCP should be developed. A national registry to follow HCP' vaccination rates is urgently needed.
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Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies, and Documentation, National Public Health Organization, Athens, Greece
| | - Maria Tseroni
- Directorate of Epidemiological Surveillance of Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Ioannis Drositis
- Medical Oncology Department, Venizeleio-Pananeio General Hospital, Heraklion, Greece
| | - Maria N Gamaletsou
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, and General Hospital of Athens Laiko, Athens, Greece
| | - Dimitra Maria Koukou
- First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Emmanouil Bolikas
- Infection Control Committee, Venizeleio-Pananeio General Hospital, Heraklion, Greece
| | - Emmanuela Peskelidou
- COVID-19 Intensive Care Unit, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece
| | - Charalambos Daflos
- Infection Control Committee, Korgialeneio-Benakeio Red Cross General Hospital, Athens, Greece
| | | | - Caterina Ledda
- Occupational Medicine Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Androula Pavli
- Department for Travel Medicine, National Public Health Organization, Athens, Greece
| | - Nikolaos Moussas
- Internal Medicine and Infectious Diseases Clinic, Iatriko Athinon General Hospital, Athens, Greece
| | | | - Eftychia Svarna
- Department of Pediatrics, University of Thessaly, Larissa, Greece
| | - Michalis Ploumidis
- First Department of Internal Medicine - Infectious Diseases Unit, Gennimatas General Hospital, Athens, Greece
| | - Andronikos Spyrou
- First Department of Internal Medicine - Infectious Diseases Unit, Gennimatas General Hospital, Athens, Greece
| | - Maria Chini
- Third Department of Internal Medicine and Infectious Diseases Unit, Korgialeneio-Benakeio Red Cross Hospital, Athens, Greece
| | - Georgios Adamis
- First Department of Internal Medicine - Infectious Diseases Unit, Gennimatas General Hospital, Athens, Greece
| | - Athanasia Lourida
- Infection Prevention and Control Committee, Aghia Sofia Children's Hospital, Athens, Greece
| | | | - Panagiotis Gargalianos
- Internal Medicine and Infectious Diseases Clinic, Iatriko Athinon General Hospital, Athens, Greece
| | | | - Nikolaos V Sipsas
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, and General Hospital of Athens Laiko, Athens, Greece
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Maltezou HC, Krumbholz B, Mavrouli M, Tseroni M, Gamaletsou MN, Botsa E, Anastassopoulou C, Gikas A, Fournarakou E, Kavieri M, Koureli A, Mandilara D, Marinopoulou A, Theodorikakou A, Tsiahris P, Zarzali A, Pournaras S, Lourida A, Elefsiniotis I, Vrioni G, Sipsas NV, Tsakris A. A study of the evolution of the third COVID-19 pandemic wave in the Athens metropolitan area, Greece, through two cross-sectional seroepidemiological surveys: March, June 2021. J Med Virol 2021; 94:1465-1472. [PMID: 34812522 PMCID: PMC9011894 DOI: 10.1002/jmv.27465] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 12/22/2022]
Abstract
We studied the third coronavirus disease 2019 (COVID‐19) pandemic wave in Athens metropolitan area (3 738 901 inhabitants) through two seroepidemiological surveys. Persons presenting in 12 healthcare facilities across Athens in March and June 2021 were studied (764 and 901, respectively). Immunoglobulin G antibodies against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) spike protein were measured by a chemiluminescent microparticle immunoassay. In March the seroprevalence rate was 11.6%, meaning that 435 208 residents of Athens had evidence of immunity. The respective values in June were 55.7% and 2 082 568 residents. The highest seroprevalence rates attributed to SARS‐CoV‐2 infection were recorded in persons <18 years (16.3% in March and 31.6% in June), while immunity was mainly vaccine‐induced in persons 18–64 years and >65 years. Infection‐attributed immunity also increased in older‐age groups. Wide ranges in seroprevalence rates were noted across areas in March and June. The highest seroprevalence rates were recorded in Piraeus (47.2%) and West Attica (37.5%). However, the highest increase (>5 times) occurred in Piraeus and the South Section of Athens, which are among the most densely populated areas in Athens. In both study periods, history of COVID‐19 or febrile episode, and having a cohabitant with COVID‐19 were associated with increased risk for seropositivity among unvaccinated persons (p values <0.001 for all). Residing in Piraeus, the South Section or West Attica was associated with increased risk for seropositivity in June (p values <0.001). Wide heterogeneity in seroprevalence rates was found across areas in Athens, which is mainly attributed to population density. The impact of population mobility and socioeconomic status should be explored.
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Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies, and Documentation, National Public Health Organization, Athens, Greece
| | | | - Maria Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Tseroni
- Directorate of Epidemiological Surveillance of Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Maria N Gamaletsou
- Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, and General Hospital of Athens Laiko, Athens, Greece
| | - Evanthia Botsa
- First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | | | - Dionysia Mandilara
- Academic Department of Internal Medicine, General Oncology Hospital of Kifisia "Agioi Anargyroi", National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | | | - Spyridon Pournaras
- Laboratory of Clinical Microbiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasia Lourida
- Infection Control Committee, Aghia Sophia Children's Hospital, Athens, Greece
| | - Ioannis Elefsiniotis
- Academic Department of Internal Medicine, General Oncology Hospital of Kifisia "Agioi Anargyroi", National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Vrioni
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos V Sipsas
- Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, and General Hospital of Athens Laiko, Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Maltezou HC, Tseroni M, Daflos C, Anastassopoulou C, Vasilogiannakopoulos A, Daligarou O, Panagiotou M, Botsa E, Spanakis N, Lourida A, Tsakris A. Environmental testing for SARS-CoV-2 in three tertiary-care hospitals during the peak of the third COVID-19 wave. Am J Infect Control 2021; 49:1435-1437. [PMID: 34455029 PMCID: PMC8388137 DOI: 10.1016/j.ajic.2021.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 11/21/2022]
Abstract
Contamination of surfaces has been implicated in transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We tested by real-time PCR for SARS-CoV-2 contamination environmental samples from three hospitals during the peak of the third pandemic wave. Overall, 19 of 463 (4.1%) samples tested positive: 12 of 173 (6.9%) samples from a COVID-19 hospital, 3 of 177 (1.7%) samples from a non-COVID-19 hospital, and 4 of 113 (3.5%) samples from a pediatric hospital with dedicated COVID-19 clinics. Most positive samples originated from emergency departments (EDs) (47.3%) and the intensive care units (ICUs) (26.3%) of the COVID-19 hospital. Positive samples belonged almost exclusively (18/19) to the highly transmissible B.1.1.7 cluster, that might explain environmental contamination at this stage of the pandemic. The frequency and efficiency of disinfection in high-risk patient areas, such as EDs and ICUs, should be reinforced, especially during this period where highly transmissible variants of concern are widespread.
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Maltezou HC, Pavli A, Dedoukou X, Georgakopoulou T, Raftopoulos V, Drositis I, Bolikas E, Ledda C, Adamis G, Spyrou A, Karantoni E, Gamaletsou MN, Koukou DM, Lourida A, Moussas N, Petrakis V, Panagopoulos P, Hatzigeorgiou D, Theodoridou M, Lazanas M, Gargalianos P, Sipsas NV. Determinants of intention to get vaccinated against COVID-19 among healthcare personnel in hospitals in Greece. Infect Dis Health 2021; 26:189-197. [PMID: 33906828 PMCID: PMC8011642 DOI: 10.1016/j.idh.2021.03.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/19/2021] [Accepted: 03/25/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND To investigate intention rates to get vaccinated against COVID-19 among healthcare personnel (HCP) in Greece. METHODS Cross-sectional survey. RESULTS The response rate was 14.5%. Of 1521 HCP with a known profession, 607 (39.9%) were nursing personnel, 480 (31.6%) physicians, 171 (11.2%) paramedical personnel, 72 (4.7%) supportive personnel, and 191 (12.6%) administrative personnel. Overall, 803 of 1571 HCP (51.1%) stated their intention to get vaccinated while 768 (48.9%) stated their intention to decline vaccination. Most HCP (71.3%) who reported intent to get vaccinated noted contributing to the control of the pandemic and protecting their families and themselves as their reasons, while the most common reason for reporting intent to decline vaccination was inadequate information about the vaccines (74.9%), followed by concerns about vaccine safety (36.2%). Logistic regression analysis revealed that the probability of intending to get vaccinated increased with male gender, being a physician, history of complete vaccination against hepatitis B, history of vaccination against pandemic A (H1N1) in 2009-2010, belief that COVID-19 vaccination should be mandatory for HCP, and increased confidence in vaccines in general during the COVID-19 pandemic. The following factors were associated with a lower intention to get vaccinated: no vaccination against influenza the past season, no intention to get vaccinated against influenza in 2020-2021, and no intention to recommend COVID-19 vaccination to high-risk patients. CONCLUSION There is an urgent need to built safety perception towards COVID-19 vaccines and raise vaccine uptake rates by HCP, and thus to protect the healthcare workforce and the healthcare services.
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Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies, and Documentation, National Public Health Organization, Athens, 11523, Greece.
| | - Androula Pavli
- Department for Travel Medicine, National Public Health Organization, Athens, 11523, Greece
| | | | - Theano Georgakopoulou
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, 11523, Greece
| | - Vasilios Raftopoulos
- HIV Surveillance Department, National Public Health Organization, Athens, 11523, Greece
| | - Ioannis Drositis
- Medical Oncology Department, Venizeleio-Pananeio General Hospital, Heraklion, 71409, Greece
| | - Emmanouil Bolikas
- Infection Control Committee, Venizeleio-Pananeio General Hospital, Heraklion, 71409, Greece
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, 95124, Italy
| | - Georgios Adamis
- First Department of Internal Medicine, Infectious Diseases Unit, Gennimatas General Hospital, Athens, 11527, Greece
| | - Andronikos Spyrou
- First Department of Internal Medicine, Infectious Diseases Unit, Gennimatas General Hospital, Athens, 11527, Greece
| | - Eleni Karantoni
- Medical Directorate, Hellenic Air Force General Staff, Athens, 11525, Greece
| | - Maria N Gamaletsou
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, 11527, Greece
| | - Dimitra Maria Koukou
- First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, 11527, Greece
| | - Athanasia Lourida
- Infection Prevention and Control Committee, Aghia Sofia Children's Hospital, Athens, 11527, Greece
| | - Nikolaos Moussas
- Internal Medicine and Infectious Diseases Clinic, Iatriko Athinon General Hospital, Athens, 11523, Greece
| | - Vasilios Petrakis
- Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | - Periklis Panagopoulos
- Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | | | - Maria Theodoridou
- First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, 11527, Greece
| | - Marios Lazanas
- Internal Medicine and Infectious Diseases Department, Iaso Maternity Hospital, Athens, 11523, Greece
| | - Panagiotis Gargalianos
- Internal Medicine and Infectious Diseases Clinic, Iatriko Athinon General Hospital, Athens, 11523, Greece
| | - Nikolaos V Sipsas
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, 11527, Greece
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Kopsidas I, Tsopela GC, Maroudi-Manta S, Kourkouni E, Charalampopoulos D, Sirogianni A, Collins ME, Lourida A, Kourlaba G, Zaoutis TE, Coffin SE. Increasing healthcare workers' uptake of seasonal influenza vaccination in a tertiary-care pediatric hospital in Greece with a low-cost, tailor-made, multifaceted strategy. Vaccine 2020; 38:4609-4615. [PMID: 32430148 DOI: 10.1016/j.vaccine.2020.05.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/06/2020] [Accepted: 05/04/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Healthcare workers' (HCW) seasonal influenza vaccination (SIV) is critical to prevent nosocomial influenza. However, HCW vaccination rates remain unacceptably low in many European institutions. A two-year three-step initiative was implemented at a tertiary-care pediatric hospital with 750 beds in Athens, Greece with the aim of increasing SIV among HCW. METHODS Α cross-sectional anonymous survey of HCWs was conducted during the 2015-16 influenza season with the aim to evaluate attitudes, knowledge, and specific barriers and facilitators for SIV. Stratified analysis was used to identify factors associated with no prior history of influenza vaccination. Multifaceted interventions were implemented in the 2016-2017 season. These included 1) education around influenza disease and SIV, and 2) communication of availability and opportunity (time and place) of SIV. Interventions were designed to target HCWs with the lowest SIV rates in the previous three years. RESULTS We achieved a 67% response rate, with 363 respondents (106 doctors, 145 nurses, 101 other hospital staff; 11 did not provide their profession). Most (64%) had not been vaccinated in the previous three years; only 14% received the vaccine annually. Non-vaccination rates were significantly higher among nurses (76%) and cleaning and food-service workers (73%) compared to doctors (40%) (P < 0.001). Protection of self, family, patients and colleagues were the most common motivations. Concerns about the safety and effectiveness of the vaccine, the belief that one does not belong to a high-risk group were the most common barriers. The interventions led to an increase in SIV uptake by the HCWs in the hospital, from 19% to 31%. CONCLUSIONS In a country with very low reported rates of vaccination among HCWs, a simple, low-cost, tailor-made intervention strategy can lead to an increase in SIV uptake. Stratifying data according to vaccination history may reveal a diversity of targets for improvement that might otherwise be missed.
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Affiliation(s)
- Ioannis Kopsidas
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece.
| | | | | | - Eleni Kourkouni
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece
| | | | | | - Madeline E Collins
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece
| | - Athanasia Lourida
- Infection Control Committee, Aghia Sophia Children's Hospital, Athens, Greece
| | - Georgia Kourlaba
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece
| | - Theoklis E Zaoutis
- Centre for Clinical Epidemiology and Outcomes Research(CLEO), Athens, Greece; Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Susan E Coffin
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Koukou D, Chatzichristou P, Trimis G, Siahanidou T, Skiathitou AV, Koutouzis EI, Syrogiannopoulos GA, Lourida A, Michos AG, Syriopoulou VP. Rotavirus Gastroenteritis in a Neonatal Unit of a Greek Tertiary Hospital: Clinical Characteristics and Genotypes. PLoS One 2015. [PMID: 26214830 PMCID: PMC4516237 DOI: 10.1371/journal.pone.0133891] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Rotavirus (RV) infection in neonatal age can be mild or even asymptomatic. Several studies have reported that RV is responsible for 31%-87% of pediatric nosocomial diarrhea and causes gastroenteritis outbreaks in pediatric and neonatal units. OBJECTIVES Study clinical characteristics, genotypes and risk factors of RV infection in neonatal age. METHODS A prospective study was conducted from April 2009 till April 2013 in the neonatal special care unit of the largest tertiary pediatric hospital of Greece. Fecal samples and epidemiological data were collected from each neonate with gastrointestinal symptoms. RV antigen was detected with a rapid immunochromatography test. RV positive samples were further genotyped with RT PCR and sequencing using specific VP7 and VP4 primers. RESULTS Positive for RV were 126/415 samples (30.4%). Mean age of onset was 18 days. Seventy four cases (58%) were hospital acquired. Seasonality of RV infection did not differ significantly throughout the year with the exception of 4 outbreaks. Genotypes found during the study period were G4P[8] (58.7%), G1P[8] (14.7%), G12P[8] (9.3%), G3P[8] (9.3%), G12P[6] (5.3%), G9P[8] (1.3%) and G2P[4] (1.3%). RV cases presented with: diarrhea (81%), vomiting (26.2%), fever (34.9%), dehydration (28.6%), feeding intolerance (39.7%), weight loss (54%), whilst 19% of cases were asymptomatic. Comparing community with hospital acquired cases differences in clinical manifestations were found. CONCLUSIONS Significant incidence of nosocomially transmitted RV infection in neonatal age including asymptomatic illness exists. Genotypes causing nosocomial outbreaks are not different from community strains. Circulating vaccines can be effective in prevention of nosocomial RV infection through herd immunity.
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Affiliation(s)
- Dimitra Koukou
- First Department of Pediatrics, Athens University, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Panagiota Chatzichristou
- First Department of Pediatrics, Athens University, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | | | - Tania Siahanidou
- First Department of Pediatrics, Athens University, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Anna-Venetia Skiathitou
- First Department of Pediatrics, Athens University, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | | | - George A. Syrogiannopoulos
- Department of Pediatrics, University of Thessaly, General University Hospital of Larissa, Larissa, Greece
| | - Athanasia Lourida
- First Department of Pediatrics, Athens University, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Athanasios G. Michos
- First Department of Pediatrics, Athens University, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Vassiliki P. Syriopoulou
- First Department of Pediatrics, Athens University, “Aghia Sophia” Children’s Hospital, Athens, Greece
- * E-mail:
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Kourlaba G, Kourkouni E, Spyridis N, Gerber JS, Kopsidas J, Mougkou K, Lourida A, Zaoutis TE. Antibiotic prescribing and expenditures in outpatient paediatrics in Greece, 2010-13. J Antimicrob Chemother 2015; 70:2405-8. [PMID: 25881618 DOI: 10.1093/jac/dkv091] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 03/18/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The objectives of this study were to provide a nationally representative analysis of antibiotic prescribing in outpatient paediatrics and to assess overall and class-specific antibiotic costs in Greece. METHODS Data on antibiotic prescriptions for patients aged ≤19 years old between July 2010 and June 2013 in Greece were extracted from the IMS Health Xponent database. Antibiotics were grouped into narrow- and broad-spectrum agents. The number of prescribed antibiotics and census denominators were used to calculate prescribing rates. The total costs associated with prescribed antibiotics were calculated. RESULTS More than 7 million antibiotics were prescribed during the study period, with an annual rate of 1100 antibiotics/1000 persons. Prescribing rates were higher among children aged <10 years old. Acute respiratory tract infections (ARTIs) accounted for 80% of prescribed antibiotics, with acute otitis media (22.3%), acute tonsillitis (19.5%) and acute bronchitis/bronchiolitis (13.9%) being the most common clinical diagnoses. Cephalosporins (32.9%), penicillins (32.3%) and macrolides (32.1%) were the most commonly prescribed antibiotic classes. The majority (90.4%) of antibiotics were broad spectrum. Antibiotic expenditures totalled ∼€50 million. CONCLUSIONS Broad-spectrum antibiotic prescribing is common in outpatient paediatric patients. These data provide important targets to inform the development of an outpatient antimicrobial stewardship programme targeting specific practices, providers and conditions.
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Affiliation(s)
- Georgia Kourlaba
- The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece
| | - Eleni Kourkouni
- The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece
| | - Nikos Spyridis
- Aglaia Kyriakou Children's Hospital, Second Department of Pediatrics, University of Athens School of Medicine, Athens, Greece
| | - Jeffrey S Gerber
- Division of Infectious Diseases, Children's Hospital of Philadelphia, UPENN School of Medicine, Philadelphia, PA, USA
| | - John Kopsidas
- The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece
| | - Katerina Mougkou
- The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece
| | - Athanasia Lourida
- The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece
| | - Theoklis E Zaoutis
- The Stavros Niarchos Foundation - Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens School of Medicine, Athens, Greece Division of Infectious Diseases, Children's Hospital of Philadelphia, UPENN School of Medicine, Philadelphia, PA, USA
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Mougkou K, Kouni S, Kurlaba G, Kitra M, Gkentzi D, Maroudi-Manta S, Lourida A, Coffin S, Zaoutis T. P218: Active surveillance for central line associated bloodstream infections in hospitalized children in Greece. Antimicrob Resist Infect Control 2013. [PMCID: PMC3688088 DOI: 10.1186/2047-2994-2-s1-p218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kouni S, Mougkou K, Kurlaba G, Nteli C, Lourida A, Maroudi-Manta S, Zaoutis T, Coffin S. P130: Assessment of hand hygiene practices at the two children's hospitals in Greece. Antimicrob Resist Infect Control 2013. [PMCID: PMC3687970 DOI: 10.1186/2047-2994-2-s1-p130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Maltezou HC, Katerelos P, Mavrouli M, Lourida A, Routsias JG, Spanakis N, Maragos A, Tedoma A, Bassiakos Y, Koratzanis G, Mantagos S, Metallidis S, Katragkou A, Nikolaidis P, Roilides E, Theodoridou M, Tsakris A. Seroepidemiological study of pandemic influenza H1N1 following the 2009-2010 wave in Greece. Vaccine 2011; 29:6664-9. [PMID: 21762749 DOI: 10.1016/j.vaccine.2011.06.098] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 06/22/2011] [Accepted: 06/25/2011] [Indexed: 10/18/2022]
Abstract
Knowledge of seroprevalence rates against 2009 pandemic H1N1 virus will assist vaccination recommendations and the preparation of the health-care system during subsequent years. This study was conducted in Greece during June-August 2010 to estimate the seroprevalence rate against pandemic H1N1 virus. Persons presenting in 29 health-care facilities across the country were studied. Seroprevalence was estimated employing a virus-free ELISA that specifically recognizes 2009 H1N1 virus antibodies in human sera. Sera collected from 2005 to April 2009 were also used to estimate pre-pandemic seroprevalence rates. A total of 954 persons were studied. The overall seroprevalence rate was 28.5% (95% confidence interval=25.6-31.3%). Age-specific rates were 34.2% in persons 0-4 years, 36.3% in persons 5-19 years, 25.0% in persons 20-39 years, 23.4% in persons 40-59 years, and 31.8% in persons ≥ 60 years. The highest rates were recorded in the Regions of Ionian Islands (67%) and Epirus (42.9%), while the lowest (8.4%) in the Region of Thessaly. Age-specific attack rates of infection during 2009-2010 were 28.8% in persons 0-4 years, 32.5% in persons 5-19 years, 14.3% in persons 20-39 years, 19.1% in persons 40-59 years, and 14.4% in persons ≥ 60 years. Multivariate analysis revealed that Region of residence and caring for children <5 years were associated with increased risk for seropositivity. Urbanity, personal and family characteristics, working in a health-care facility or in a school, history of pandemic H1N1 vaccination or history of influenza-like illness during 2009-2010 were not associated with increased risk for seropositivity.
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Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Diseases, Control and Prevention, 3-5 Agrafon Street, Athens 15123, Greece.
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11
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Georgaki-Angelaki E, Kostaridou S, Lourida A, Petraki C, Lagona E. Abrupt and durable remission of Henoch-Schonlein purpura nephritis with cyclosporine A. Clin Kidney J 2008; 1:300-2. [PMID: 25983917 PMCID: PMC4421271 DOI: 10.1093/ndtplus/sfn105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 06/26/2008] [Indexed: 11/12/2022] Open
Abstract
Henoch–Schönlein purpura glomerulonephritis (HSP-GN) is a common form of systemic small vessel vasculitis in children. Although prognosis is usually favourable, the disease is occasionally associated with a risk of renal insufficiency. Various immunosuppressive agents have been used in patients with severe HSP-GN, but none have shown convincing favourable effects. We report a case of biopsy-proven HSP-related GN in a 4-year-old girl that responded remarkably well to cyclosporine A (CsA), following failure to respond to other immunosuppressive agents. At 8 months post-CsA treatment, repeat renal biopsy findings were consistent with histological improvement. We conclude that CsA treatment not only exerts beneficial effects on resistant HSP-related GN but may also arrest progression of the disease.
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Affiliation(s)
| | - Stavroula Kostaridou
- Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens 11527
| | - Athanasia Lourida
- Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens 11527
| | - C. Petraki
- Nephropathology Department, Evangelismos Hospital, Athens, Greece
| | - Evagelia Lagona
- Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens 11527
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12
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Abstract
A 12-year-old girl with chronic otitis media complicated by petrositis and cerebellar abscess is presented. Early surgical intervention, in combination with broad-spectrum antibiotics, provided a good outcome. Life-threatening complications of otitis media, although rare, still occur in developed countries.
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Affiliation(s)
- G Trimis
- 1st Pediatric Clinic of University of Athens, Athens, Greece.
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13
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Nikolaidou P, Charocopos E, Anagnostopoulos G, Lazopoulou D, Kairis M, Lourida A, Tzoumakas K, Tsiligiannis T. Cellular Interstitial Pneumonitis in Children: Response to Hydroxychloroquine Treatment in Two Cases. ACTA ACUST UNITED AC 2003. [DOI: 10.1089/088318703320910106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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