Athanassios Tsakris

University of Thessaly, Iolcus, Thessaly, Greece

Are you Athanassios Tsakris?

Claim your profile

Publications (283)1031.36 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The study examines the pathological circumstances related to Byron's death, the primary issue being malaria. Lord Byron died during the Greek War of Independence against the Ottoman Empire, in Messolonghi on 19 April 1824. Byron's medical profile consists of recurrent onsets of fever, which gave rise to the issue of malaria relapses. According to Byron's letters he reported crises of fever in Greece (1810), Malta (1811), Italy (1817-1819) and England. Evidence from Byron's autopsy, specifically the absence of hepatosplenomegaly, does not support a hypothetical diagnosis of malaria. Nonetheless, the relapsing fevers cannot be ignored and the same applies to the possibility of malaria relapse or re-infection in line with the endemic nature of the Messolonghi area. Our research on the chronologies of Byron's reported fevers found that new attacks occurred at intervals of 540 days on average. Moreover, the most outstanding feature of Plasmodium vivax and Plasmodium ovale is their ability to form dormant forms of hypnozoites in the liver which, when reactivated (110-777 days), cause true relapses of clinical disease. Of course, an ex post facto diagnosis is under debate, because the diagnosis is not clinical but microscopic. Byron's example raises alarm over a current medical problem, i.e. the diagnosis of unexplained fevers, and the need for a detailed travel or immigration history, which will include malaria in the differential diagnosis.
    Le infezioni in medicina: rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive 09/2015; 23(3):288-195.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The mec and bla systems, among other genetic factors, are critical in regulating the expression of methicillin resistance in Staphylococcus aureus. We examined by WGS a naturally occurring oxacillin-susceptible mecA-positive S. aureus isolate to identify the mechanism conferring oxacillin susceptibility. The mecA-positive oxacillin-susceptible S. aureus isolate GR2 (penicillin and oxacillin MICs 0.094 and 1 mg/L, respectively), belonging to clonal complex 80, was characterized. DNA fragment libraries were sequenced on Roche 454 and Illumina MiSeq sequencers and de novo assembly of the genome was generated using SeqMan NGen software. Plasmid curing was conducted by SDS treatment. Expression of mecA was quantified without/with β-lactam pressure. The genome of GR2 consisted of a 2 792 802 bp chromosome and plasmids pGR2A (28 895 bp) and pGR2B (2473 bp). GR2 carried SCCmec type IV, with a truncated/non-functional mecR1 gene and no mecI. A single copy of the bla system, with an organization unique for S. aureus, was found, harboured by plasmid pGR2A. Particularly, the blaZ gene was orientated like its regulatory genes, blaI and blaR1, and a gene encoding transposase IS66 was integrated between blaZ and the regulatory genes deleting the 5'-end of blaR1; blaI, encoding blaZ/mecA repressor, was intact. After plasmid loss, GR2 became penicillin and oxacillin resistant (MICs 0.5 and 6 mg/L, respectively). We can conclude that after exposure to β-lactams, the non-functional BlaR1 does not cleave the mecA repressor BlaI, derepression does not occur and mecA is not efficiently expressed. Removal of the bla system after curing of pGR2A allows constitutive expression of mecA, resulting in oxacillin and penicillin resistance. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail:
    Journal of Antimicrobial Chemotherapy 07/2015; DOI:10.1093/jac/dkv210 · 5.31 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of unclear etiology. The role of bacteria in the pathogenesis of disease remains controversial. Materials and Methods: Specimens were obtained from 22 HS patients by direct percutaneous needle aspiration. The collected material was cultured in aerobic and anaerobic conditions, and sensitivity tests were performed. Results: Of the 22 patients, 32% were culture negative and 68% were culture positive. A total of 16 isolates was obtained, 14 aerobic and 2 anaerobic. Aerobic bacteria were present in 86% of the specimens, whereas only anaerobic bacteria were isolated in 7%. The predominant aerobic species were Proteus mirabilis, Staphylococcus haemolyticus and Staphylococcus lugdunensis. The isolated anaerobic bacteria were Dermacoccus nishinomiyaensis and Propionibacteriumgranulosum. Conclusion: A variety of aerobic and anaerobic bacteria was isolated from the HS lesions of our patients. In contrast to previous studies, fewer patients were found to be culture positive, and Staphylococcus aureus was isolated in only 1 of them. More studies are necessary to elucidate the controversial role of bacteria in the pathogenesis of HS.
    05/2015; 1(2):55-59. DOI:10.1159/000381959
  • [Show abstract] [Hide abstract]
    ABSTRACT: Group A streptococcus (GAS) is an important cause of morbidity and mortality worldwide. Surveillance of emm types have important implications as they can serve as baseline information for possible implementation of vaccination. A total of 1349 GAS pediatric isolates were collected during a 7-year period (2007-2013). emm typing was completed in 1282 pharyngeal (84%) or non-pharyngeal (16%) isolates and emm-clusters and temporal changes were analyzed. Thirty five different emm types including 14 sub-types were identified. The most prevalent emm types identified were 1(16.7%), 12(13.6%), 77(10.9%), 4(10.8%), 28(10.4%), 6(6.8%) 3(6.6%) and 89(6.6%) accounting for 82.3% of total isolates. Rheumatogenic emm types comprised 16.3% of total isolates. emm types 12, 4 and 77 were more prevalent among pharyngeal isolates and emm1, 89, 6, 75 and 11 among non-pharyngeal. The emm types identified belong to 13 emm-clusters and the 8 most prevalent clusters comprise 97% of all isolates. There was statistically significant decrease in prevalence of emm types 12, 4, 5 and 61 and increase in emm89, 75 and 11 comparing with the period 2001-2006. Proposed 30-valent GAS vaccine, currently in preclinical studies, encompasses 97.2% of emm types detected in our study and 97.4% of erythromycin resistant strains. In addition, it includes 93.3% of emm types involved in bacteremia. A much greater diversity of GAS emm types was identified in our area than previously described. Seasonal fluctuations and introduction of new emm types was observed. Continuous surveillance of emm types is needed in order to evaluate the possible benefit of an M protein based GAS vaccine. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
    Journal of clinical microbiology 04/2015; 53(7). DOI:10.1128/JCM.00301-15 · 3.99 Impact Factor
  • K. Theodoridou · V. Kapsimali · A. Tsakris
    [Show abstract] [Hide abstract]
    ABSTRACT: HIV infection has been a major problem for public health since the first report of the disease in 1982. The scientific knowledge about the infection was limited and the size of the problem unknown, while fear and prejudice were predominant. The transmission of HIV virus was related with sexual contact, contaminated blood or blood products and through perinatal transmission. The infection through transfusions of blood or blood products was particularly important for our country with the cohorts of multi-transfused persons and ended in 1985 with the implementation of PCR method in blood banks. The 1994 Pediatric AIDS Clinical Trials Group (PACTG) protocol 076 demonstrated that Zidovudine (ZVD) therapy administered to selected HIV-infected pregnant women and their newborn infants reduced the rate of perinatal HIV transmission from 25% to 8% and was the first major prevention breakthrough in the HIV epidemic. The rapid implementation of the guidelines for the use of ZDV has resulted in a dramatic decrease in perinatal HIV transmission. Nowadays, with combination therapy of pregnant women and administration two or three antiretroviral drugs to the newborn the transmission rate has decreased to <2%. In Greece the rate of HIV infected pregnant women is low (0,001) but enhanced perinatal surveillance is needed. Today HIV infection is characterized as a chronic infectious disease. Treatment advances with combination therapies have increased survival of HIV infected children. As a result, more children are living with HIV infection that needs treatment, care and services. Perinatally infected children are aging into adolescence. The expectations for the future are the achievements of treating HIV infection to reach the developing countries and an effective vaccine for prevention to be invented. © 2015, Greek Society of Microbiology Ascent Ltd. All rights reserved.
    Acta Microbiologica Hellenica 04/2015; 60(2):101-109.
  • [Show abstract] [Hide abstract]
    ABSTRACT: In recent years, Kingella kingae is increasingly recognized as an invasive pathogen in young children, mainly causing osteoarticular infections, bacteremia and endocarditis. A case of K. kingae bacteremia in an otherwise healthy infant is described. An 8-month old female infant presented with fever, cough and nasal congestion. Six hours after admission the clinical picture deteriorated with the development of tachypnea, tachycardia and high grade fever. WBC count, C-reactive protein and erythrocyte sedimentation rate rapidly increased. Empirical IV ceftriaxone therapy was initiated. Parenteral fluids, oral corticosteroids and bronchodilators were additionally administered. K. kingae was detected in blood cultures, by using the BACTEC (BD, USA) automated system. Laboratory diagnosis was based on typical culture characteristics of the bacterium, on Phoenix automated system (BD, USA) and was confirmed by sequencing of 16S r-RNA gene. The transesophangeal ultrasound was normal. The infection resolved completely after 10-days treatment, without any complication. In conclusion, upper respiratory tract infections often coincide with K. kingae disease. Clinical Microbiologists should be aware of the difficulties in recovery and identification of the bacterium. Potential serious complications necessitate prompt initiation of antibiotic therapy and close monitoring of patients with K. kingae infections. © 2015, Greek Society of Microbiology Ascent Ltd. All rights reserved.
    Acta Microbiologica Hellenica 04/2015; 60(2):125-130.
  • [Show abstract] [Hide abstract]
    ABSTRACT: As MRSA are considered Staphylococcus aureus isolates with oxacillin minimum inhibitory concentration (MIC) of ≥4 mg/L or harboring the mecA gene. However, the presence of mecA does not necessarily lead to oxacillin resistance and mecA gene-carrying isolates may have oxacillin MIC within the susceptible range (≤2 mg/L). During the last few years it has become apparent that oxacillin-susceptible (OS) mecA-positive S. aureus isolates (commonly called OS-MRSA) are rather commonly detected worldwide and may remain undiagnosed using phenotypic susceptibility testing methods. This review will summarize the current reports on OS-MRSA isolations and the underlying mechanisms regulating the expression of oxacillin resistance and also oxacillin susceptibility in mecA-positive S. aureus isolates. As MRSA commonly cause severe infections against which effective therapies are limited, understanding of these mechanisms could enable the identification of new targets for the treatment or reversion of the MRSA phenotype.
    Current pharmaceutical design 03/2015; 21(16). DOI:10.2174/1381612821666150310103754 · 3.45 Impact Factor
  • Source
  • Source
  • [Show abstract] [Hide abstract]
    ABSTRACT: Here we describe an outbreak caused by a pandrug-resistant Providencia stuartii strain involving 15 critically ill patients in a Greek intensive care unit (ICU) during September-November 2011. All isolates harboured the blaVIM-1 gene and a class 1 integron structure of 1913 bp as well as blaSHV-5 and blaTEM-1. Pulsed-field gel electrophoresis (PFGE) demonstrated that isolates from all 15 patients belonged to a single P. stuartii clonal type. As all of the infected patients were hospitalised during overlapping time periods, horizontal intra-ICU transmission was considered as the main route for the dissemination of the outbreak strain. The outbreak ended following reinforcement of infection control measures, including implementation of additional barrier precautions for infected patients. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
    International Journal of Antimicrobial Agents 02/2015; 45(5). DOI:10.1016/j.ijantimicag.2014.12.030 · 4.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The current phenotypic methods for detecting carbapenemase-producing Enterobacteriaceae (CPE) allow differentiation between class A and B carbapenemases but they cannot confirm in a single test class D OXA-48 carbapenemase producers. In this study we evaluated a new phenotypic test, the OXA-48 disk test, which is based on an imipenem disk and two blank disks loaded with the tested strain and impregnated with EDTA and EDTA plus phenyl boronic acid (PBA), respectively. The evaluation of the OXA-48 disk test was performed with 81 genotypically confirmed OXA-48-producing Enterobacteriaceae (41 ESBL producers, 3 AmpC producers and 37 non-ESBL, non-AmpC producers). To measure the specificity of the test, 173 genotypically confirmed OXA-48-negative Enterobacteriaceae isolates (57 KPC producers, 34 VIM producers, 23 KPC/VIM producers, 22 NDM producers, 37 AmpC or ESBL producers and porin deficient) that were non-susceptible to at least one carbapenem were chosen for testing. Using imipenem disk and the distortion of the inhibition halo around both blank disks containing EDTA and EDTA/PBA, the test differentiated all but three of the 81 OXA-48 producers (sensitivity 96.3%). The test was negative for OXA-48 production in all but four of the 173 carbapenem-non-susceptible isolates producing other carbapenemases, AmpCs or ESBLs (specificity 97.7%). This evaluation shows that OXA-48 disk test is a useful phenotypic method for the accurate differentiation of OXA-48-producing Enterobacteriaceae. Its use along with combined-disk tests employing inhibitor-supplemented carbapenem disks could allow the differentiation of the currently known carbapenemase types in Enterobacteriaceae species and provide important infection control information. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
    Journal of Clinical Microbiology 02/2015; 53(4). DOI:10.1128/JCM.03318-14 · 3.99 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Rhodococcus equi infection in humans was first reported in 1967. Since the advent of the AIDS epidemic, the reported cases of human infection increased dramatically and Rhodococcus equi has become an important opportunistic pathogen in immunocompromised patients. The presented case is a necrotizing pneumonia in a 45-year-old HIV-positive man who responded well to clarythromycin and rifampicin / isoniazid. The aim of this report is to increase physician awareness so as to suspect a Rhodococcus equi infection and to render the microbiologists more vigilant.
    Acta Microbiologica Hellenica 01/2015; 60(1):69-74.
  • A. Kafasi · N. Spanakis · G. Vrioni · A. Tsakris
    [Show abstract] [Hide abstract]
    ABSTRACT: Influenza virus infection can cause serious complications in children who are immunosuppressed concerning their medical treatment against cancer. The increased risk of infection in this group of patients may be due to either the disease itself or to their immunosuppression as a result of chemotherapy. Influenza virus infections present in the form of annual infections and may cause interruption of the cancer treatment for up to several weeks. In patients with cancer, immunization via vaccine has been shown to provide protection against several virus infections at similar levels to those of healthy individuals. This evidence can be translated into reduced duration and severity of the infection and potential improvement in patients' morbidity and mortality. Immune responses depend on the time of the immunization via vaccine, concerning the time that has passed since the last chemotherapy treatment. It has been shown that patients receiving chemotherapy develop weaker immune responses compared with those who have completed chemotherapy, as well as with healthy people. However, few data are available for cancer patients who are in childhood, as the groups of patients are heterogeneous with regard to underlying malignancy, the type of chemotherapy, the dose, the time and the route of administration of influenza vaccine. As for the vaccine's composition, the circulating human influenza viruses are subject to antigenic changes requiring annual adjustment of the composition of the vaccine. We can underline that the vaccine containing inactivated virus strains contains no risk to cause outbreak or secondary complications and is considered safe for administration to immunocompromised individuals, even though these are children.
    Acta Microbiologica Hellenica 01/2015; 60(1):35-44.
  • [Show abstract] [Hide abstract]
    ABSTRACT: West Nile virus (WNV) is a mosquito-borne arbovirus of the Flaviviridae family. Transmission to humans occurs predominantly following a bite from an infected mosquito, principally of the genus Culex, which acquires virus after feeding on avian amplifying hosts. Most people infected with WNV remain asymptomatic, and only 20% of infected individuals develop West Nile fever (WNF), a mild and self-limited flu-like illness of fever. Less than 1% of WNV infections progress to clinical disease associated with severe neurological manifestations, including aseptic meningitis, encephalitis, and acute flaccid paralysis. Since its first isolation in the West Nile district of Uganda in 1937, a geographic expansion and westward spread of the virus has occurred during the last 20 years. Until recently, its medical and veterinary health concern was relatively low; however, the number, frequency and severity of outbreaks with neurological consequences in humans and horses have lately increased in Europe and the Mediterranean basin. Even though great advances have been obtained lately regarding WNV infection, and although efficient equine vaccines are available, no specific treatments or vaccines for human use are on the market. Peak WNV transmission occurs during mosquitoes' active period, usually between midsummer and early autumn. Climatic conditions (temperature and precipitation), landscape features and land-use seem to react on WNV transmission. This review updates the most recent investigations in different aspects of WNV life cycle: molecular virology, host range, transmission dynamics, pathogenesis, clinical manifestations, diagnosis, vaccine development, control, and prevention, and highlights some aspects that require further research.
    Acta Microbiologica Hellenica 01/2015; 60(1):7-34.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Molecular typing data on antimicrobial-resistant Propionibacterium strains are limited in the literature. We examined antimicrobial resistance profiles and the underlying resistance mechanisms in Propionibacterium spp. isolates recovered from patients with moderate to severe acne vulgaris in Greece. The clonallity of the resistant Propionibacterium acnes isolates was also investigated. Propionibacterium spp. isolates were detected using Tryptone-Yeast Extract-Glucose (TYG) agar plates supplemented with 4% furazolidone. Erythromycin, clindamycin, vancomycin, penicillin, co-trimoxazole, doxycycline, minocycline and ciprofloxacin MICs were determined using the gradient strip method. Erythromycin, clindamycin and tetracycline mechanisms of resistance were determined using PCR and sequencing of the domain V of 23S rRNA and 16S rRNA, as well as the presence of the ermX gene. Typing was performed using the multi locus sequence typing (MLST) methodology. Seventy nine isolates from 76 patients were collected. Twenty-three isolates (29.1%) exhibited resistance to erythromycin and clindamycin, while two additional isolates (2.5%) were resistant only to erythromycin. Resistance to tetracycline was not detected. The underlying molecular mechanisms were point mutations A2059G and A2058G. MLST typing of the P. acnes resistant isolates revealed that lineage type IA1 (ST-1, 3 and 52) prevailed (12/18; 66.7%), whilst lineage type IA2 (ST-2 and 22) accounted for five more isolates (27.8%). Susceptible isolates were more evenly distributed between ST types. Propionibacterium spp. from moderate to severe acne vulgaris in Greece are frequently resistant to erythromycin/clindamycin but not to tetracyclines, mainly due to the point mutations A2059G and A2058G. P. acnes resistant isolates were more clonally related than susceptible ones and belonged to a limited number of MLST types. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Anaerobe 11/2014; 31. DOI:10.1016/j.anaerobe.2014.10.007 · 2.48 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Influenza human infections are considered as a persistent global public health issue. Whereas vaccination is important for prevention, given its limitations, antiviral therapy is at the forefront of treatment, while it also plays a significant role in prevention. Currently, two classes of drugs, adamantanes (M2 blockers) and neuraminidase inhibitors (NAIs), are available for treatment and chemoprophylaxis of influenza infections. Given the resistance patterns of circulating influenza strains, adamantanes are not currently recommended. The current review mainly focuses on the development of resistance to NAIs among A and B subtypes of influenza virus strains over the last 5 years. 'Permissive' drift mutations and reassortment of viral gene segments have resulted in NAI oseltamivir-resistant A/(H1N1) variants that rapidly became predominant worldwide in the period 2007-2009. However, the prevalence of antiviral resistance to NAI zanamivir remains relatively low. In addition, the recently developed NAIs, peramivir and laninamivir, while licensed in certain countries, are still under evaluation and only a few reports have described resistance to peramivir. Although in 2014, the majority of circulating human influenza viruses remains susceptible to all NAIs, the emergence of oseltamivir-resistant influenza variants that could retain viral transmissibility, highlights the necessity for enhanced epidemiological and microbiological surveillance and clinical assessment of antiviral resistance.
    Expert Review of Anti-infective Therapy 11/2014; 12(11):1325-36. DOI:10.1586/14787210.2014.966083 · 2.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: ABSTRACT Aim: The bacterial and atypical etiology of acute exacerbations of chronic obstructive pulmonary disease was investigated and the diagnostic techniques used were compared among 92 hospitalized patients. Sputum specimens were investigated using culture and PCR, serological status evaluation was performed and the inflammatory profile was associated with the microbiological results. The majority of the patients (65.2%) had very severe airway obstruction. The most common bacteria were Haemophilus influenzae and Pseudomonas aeruginosa (23.9 and 14.1%, respectively). Acinetobacter baumannii- and P. aeruginosa-positive cultures were associated with prolonged hospitalization and severe airway obstruction (p = 0.03 and 0.031, respectively). Chlamydia pneumoniae or Mycoplasma pneumoniae infection was diagnosed in four and two patients, respectively. Discrepant results were detected between PCR and serology, especially regarding C. pneumoniae.
    Future Microbiology 11/2014; 9(11):1251-60. DOI:10.2217/fmb.14.90 · 4.28 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The effects of doxycycline-streptomycin-rifampin versus a standard doxycycline-streptomycin regimen on residual Brucella DNA were compared in 36 acute brucellosis patients. At admission, all patients given triple (n = 22) and double (n = 14) regimens had detectable Brucella DNA with similar mean loads (P = 0.982). At follow-up, 14 to 20 months postpresentation, significantly more patients receiving triple than double regimens had undetectable Brucella DNA (P = 0.026). The doxycycline-streptomycin-rifampin regimen eliminates Brucella DNA more efficiently than doxycycline-streptomycin, which may result in superior long-term clearance of Brucella.
    Antimicrobial Agents and Chemotherapy 09/2014; 58(12). DOI:10.1128/AAC.03841-14 · 4.48 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Serological, molecular and phylogenetic analyses of a recently imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) in Greece are reported. Although MERS-CoV remained detectable in the respiratory tract secretions of the patient until the fourth week of illness, viraemia was last detected 2 days after initiation of triple combination therapy with pegylated interferon, ribavirin and lopinavir/ritonavir, administered from Day 13 of illness. Phylogenetic analysis of the virus showed close similarity with other human MERS-CoVs from the recent Jeddah outbreak in Saudi Arabia. Immunoglobulin G (IgG) titres peaked 3 weeks after the onset of illness, whilst IgM levels remained constantly elevated during the follow-up period (second to fifth week of illness). Serological testing confirmed by virus neutralisation assay detected an additional case that was a close contact of the patient.
    International Journal of Antimicrobial Agents 09/2014; 44(6). DOI:10.1016/j.ijantimicag.2014.07.026 · 4.30 Impact Factor
  • Source
    Immunology Letters 09/2014; 161(1). DOI:10.1016/j.imlet.2014.04.013 · 2.51 Impact Factor

Publication Stats

4k Citations
1,031.36 Total Impact Points


  • 2009–2014
    • University of Thessaly
      • • Μαιευτική και Γυναικολογική Κλινική
      • • School of Medicine
      Iolcus, Thessaly, Greece
  • 2008–2014
    • Harokopion University of Athens
      Athínai, Attica, Greece
  • 2004–2014
    • National and Kapodistrian University of Athens
      • • Department of Medicine
      • • Division of Microbiology
      Athínai, Attica, Greece
  • 2013
    • Κωνσταντοπούλειο νοσοκομείο Νέας Ιωνίας (Η Αγία Όλγα)
      Athínai, Attica, Greece
    • Hellenic Center for Disease Control and Prevention
      Saloníki, Central Macedonia, Greece
  • 2012
    • University of Kragujevac
      Krabujevac, Central Serbia, Serbia
    • Γενικό Νοσοκομείο Σάμου Αγίου Παντελεήμονα
      Vathy, North Aegean, Greece
  • 2011
    • National Technical University of Athens
      Athínai, Attica, Greece
    • Azienda Ospedaliera Cannizzaro
      Catania, Sicily, Italy
    • Tzaneio General Hospital of Piraeus
      Le Pirée, Attica, Greece
  • 2009–2011
    • Γενικό Νοσοκομείο Σερρών
      Seres, Central Macedonia, Greece
  • 2010
    • National Academy of Medical Sciences of Nepal
      Kantipura, Central Region, Nepal
  • 2007
    • Aghia Sophia Children’s Hospital
      Athínai, Attica, Greece
  • 2006
    • Metaxa Cancer Hospital
      Le Pirée, Attica, Greece
    • Hippokration General Hospital, Thessaloniki
      Saloníki, Central Macedonia, Greece
  • 1994–2005
    • AHEPA University Hospital
      Saloníki, Central Macedonia, Greece
  • 1997–2003
    • Aristotle University of Thessaloniki
      • Laboratory of General Microbiology
      Saloníki, Central Macedonia, Greece
  • 1992
    • Hippokration General Hospital, Athens
      Athínai, Attica, Greece
  • 1991
    • North Middlesex University Hospital NHS Trust
      Londinium, England, United Kingdom