Molecular epidemiology of Acinetobacter baumannii in central intensive care unit in Kosova teaching hospital

Infections caused by bacteria of genus Acinetobacter pose a significant health care challenge worldwide. Information on molecular epidemiological investigation of outbreaks caused by Acinetobacter species in Kosova is lacking. The present investigation was carried out to enlight molecular epidemiology of Acinetobacterbaumannii in the Central Intensive Care Unit (CICU) of a University hospital in Kosova using pulse field gel electrophoresis (PFGE). During March - July 2006, A. baumannii was isolated from 30 patients, of whom 22 were infected and 8 were colonised. Twenty patients had ventilator-associated pneumonia, one patient had meningitis, and two had coinfection with bloodstream infection and surgical site infection. The most common diagnoses upon admission to the ICU were politrauma and cerebral hemorrhage. Bacterial isolates were most frequently recovered from endotracheal aspirate (86.7 percent). First isolation occurred, on average, on day 8 following admission (range 1-26 days). Genotype analysis of A. baumannii isolates identified nine distinct PFGE patterns, with predominance of PFGE clone E represented by isolates from 9 patients. Eight strains were resistant to carbapenems. The genetic relatedness of Acinetobacter baumannii was high, indicating cross-transmission within the ICU setting. These results emphasize the need for measures to prevent nosocomial transmission of A. baumannii in ICU.

Risk factors for esophageal cancer in Serbia.

AIM: To establish the role of specified risk factors in the etiology of squamous cell carcinoma of esophagus in Serbia. METHODS: The hospital based case-control study included 102 newly diagnosed patients with squamous cell esophageal cancer and the same number of age and sex matched hospital controls. In the analysis of data conditional univariate and multivariate logistic regressions were applied. RESULTS: The factors significantly related to cancer of esophagus were: smoking (OR=2.0, 95%CI 1.0-4.2), daily consumption of hard liquor (OR=7.5, 95%CI 2.8-20.0), low educational level (OR=4.7, 95%CI 2.2-10.0), occupational exposure to chemicals (OR=3.7, 95%CI 1.6-9.0), malignant tumors in family history (OR=3.6, 95%CI 1.6-9.0), consumption of wine (OR=0.1, 95%CI 0.1-0.3,) and non-carbonated beverages (OR=0.3, 95%CI 0.2-0.7). CONCLUSIONS: Hard liquor and tobacco appear to be the important risk factors for development of squamous cell esophageal cancer in Serbia, whereas wine and non-carbonated beverages may play a protective role.

Evaluación del Programa de Educación para la Salud en el tratamiento estomatológico de mujeres embarazadas en la ciudad de Nis, Serbia / Evaluation of the Health Education Program for the dental treatment of pregnant women in the Nis city, Serbia

Introducción: Para mantener y mejorar la salud oral en pacientes embarazadas es necesario implementar programas de educación para la salud. El presente estudio trata de evaluar los resultados obtenidos en un programa de educación para la salud bucal en mujeres durante el segundo trimestre de embarazo. Objetivo: Evaluar los efectos de la implementación de un programa de educación para la salud bucal en mujeres embarazadas. Material y métodos: El estudio fue realizado en el Centro de Salud del Distrito de Nis-Serbia, en pacientes embarazadas durante el segundo trimestre de embarazo. Se formaron 3 grupos de estudio; 1 grupo experimental y 2 grupos control. Resultados: El programa demostró resultados estadísticamente significativos en cuanto a prevención y actividades educativas. Las pacientes cambiaron su conducta, hábitos y actitudes en relación a nutrición, higiene oral, prevención de caries y visitas al odontólogo. Conclusión: Los programas de educación para la salud pueden lograr cambios no sólo en las mujeres embarazadas en cuanto a comportamiento, hábitos y actitudes sino también en sus descendientes.

Introduction: In order to maintain and improve oral health in pregnant woman it is needed to implement health educational programs. This study evaluates obtained results of an educational program for oral health in pregnant woman in their second trimester of their gestational period. Purpose. To evaluate the effect of the educational oral health program in pregnant woman: Material and methods: the study was carried out at the Nis Health Centre, Serbia, in pregnant woman in their second trimester of their gestational period. Three study groups of 60 each were assigned one experimental and two control groups. Results: The obtained data was statistically significant in respect to prevention and educational activities. The participants changed their behavior, habits and attitude towards nutrition, oral hygiene, caries prevention and dental visits. Conclusion: Health educational programs can achieve change not only in pregnant women behavior, habits, and attitude but also are benefical to their offspring.

Epidemiology of diseases caused by Streptococcus pyogenes in Serbia during a nine-year period (1991-1999).

BACKGROUND & OBJECTIVES: Streptococcus pyogenes (group A Streptococcus - GAS) is an important human pathogen which causes a variety of diseases, including tonsillopharyngitis, scarlet fever and rheumatic fever. It is important to understand the changes in epidemiology of the diseases caused by the pathogen for improved control of such infections. Hence, the aim of the present study was to carry out an epidemiological analysis of GAS infections in Serbia in a 9-yr period (1991-1999) and evaluation of susceptibility of GAS isolates obtained during the same period to penicillin and erythromycin. METHODS: Occurrence of tonsillopharyngitis, scarlatina and rheumatic fever was analyzed and GAS carrier status in healthy children was examined over a 9-yr period from 1991 to 1999. Susceptibility to penicillin and erythromycin was determined for 1657 GAS isolates obtained from patients diagnosed with pharyngitis or scarlet fever and 512 isolates from healthy carriers. M-type antigen was also determined in these isolates. RESULTS: The average incidences of tonsillopharyngitis and scarlet fever were 76.2 and 30.8 per cent respectively. A total of 166 cases of rheumatic fever were registered. Per cent of carriers varied from 5.5 to 11.4 per cent over the study period. Predominating M serotypes among GAS isolates tested were M1, M3, M4, M6, M11, M12 and M18, depending on the source of clinical material and period of isolation. Antimicrobial susceptibility testing showed susceptibility to penicillin in all isolates tested and resistance to erythromycin in 2.41 per cent of the isolates. INTERPRETATION & CONCLUSION: Although the fluctuations in incidence were noted during the nine-year period, the incidence of streptococcal tonsillopharyngitis is low but with a steady raise in Serbia. No significant changes in the incidence of scarlet fever and rheumatic fever were noted. Susceptibility to penicillin remained unchanged, but the number or erythromycin resistant strains have increased.

Epidemiology of swine trichinellosis in Yugoslavia.

Intensive epidemiological and seroepidemiological studies of Trichinella spiralis infection in swine have been carried out in the borough of Kladovo, one of the four regions in Yugoslavia where trichinellosis is endemic. A high prevalence (4.7%) of trichinellosis was discovered in three neighboring parishes adjoining the bank of the river Danube. Both geographically and epidemiologically these three parishes constitute a very unique condition that is very vulnerable to T. spiralis infection. Studies of 7,409 swine showed that the ELISA test for the detection of specific antibodies to T. spiralis in swine was highly reliable.

Epidemiology and diagnosis of sarcocystosis.

The studies included a total of 788 swine, of which 395 animals were raised on state farms and 393 on privately owned farms. Using artificial digestion (by trypsin) of diaphragm muscles, cystozoites were detected in 193 swine; 24.49% out of 788 animals examined. Among the 395 swine raised on state farms, the presence of cystozoites was demonstrated in 63 (15.95%) of the animals, while in 393 swine from privately-owned farms, cystozoites were found in 130 (33.07%) of those examined. By histological methods cystozoites were detected in 43 swine (18.14%) of the tested animals.

Detection of Trichinella by various methods in Yugoslavia.

From studies performed on experimentally infected pigs, it was possible to conclude that enzymatic digestion methods are superior to trichinoscopy for inspection of pork for the presence of Trichinella spiralis. The analyses included comparative examination of samples taken from five different parts of diaphragm tissue.

Epidemiological survey of trichinellosis in Yugoslavia.

In a long term epidemiological survey that included different hosts for Trichinella spiralis among wild and domestic animals, the parasitological and serological screening revealed a high number of positive animals. The incidence of T. spiralis in grazing pigs was high, 21.76% (170 examined) but most of positive animals were lightly infected (0.016-0.02 l/g). While out of 2,394 pigs raised in small private farms, 1.67% were positive with high infection rates, none of the pigs raised on a modern breeding and fattening farm were seropositive. A repeated survey in grazing pigs performed five years later and in the same area, showed the prevalence of seropositive pigs to be still high (22% of 100 examined pigs). The same data were confirmed by detection of specific anti-Trichinella antibodies in Western blotting procedure. One of 2,031 serologically (IgG-ELISA) examined horses from Croatia reacted positively with very high OD values. Different characteristics of biological patterns (RCI, female fecundity, capsule formation, isoenzyme analysis) were found between two well distinguished groups of isolates. The first group consisted of well defined T1 isolates with patterns described by the Reference Centre for Trichinellosis, Rome, Italy. The data obtained by isoenzyme analysis of the representative sylvatic isolate were comparable to T3 characteristics of isolates from foxes in Italy.