[Trends in resistant bacteria isolated from a tube smear in intubated patients in intensive care]. / Kretanje rezistencije bakterija izoliranih brisom tubusa kod intubiranih pacijenata na intenzivnoj njezi.

Long standing antibiotics therapy has resulted in growing bacteria resistance. We took a tube smear and prepared culture with antibiogram from the fifty intubated patients in the Intensive care unit in the war period. Gram-negative germs were the dominant ones in total sum, and among them the Acinetobacter calcoaceticus (No 21), Pseudomonas aeruginosa (No 18), Klebsiella pneumoniae (No 18), were isolated most frequently. Pseudomonas aeruginosa showed high resistance to Gentamicin (64%), Amikacin (35%), Trimethoprim (66%), Pefloxacin (20%), Ofloxacin (25%), Ciprofloxacin (25%). Klebsiella pneumoniae is resistant to Gentamicin (68%), Amikacin (22%), Cephalosporin (100%), Trimethoprim (31%), but it showed no resistance to chinolones. Acinetobacter calcoaceticus is resistant to Gentamicin (73%), Amikacin (36%), Cephalosporin (100%), Trimethoprim (63%), Pefloxacin (33%), Ofloxacin (67%), Ciprofloxacin (46%). Staphylococcus aureus was the most frequent among Gram-positive germs and it was resistant to Penicillin (100%), Gentamicin (40%), Lincocin (18%), Trimethoprim (5%), Pefloxacin (13%), Methicillin (21%), Cephalosporin (8%). The appearance of resistance on the antibiotics demands attentive follow-up aiming to influence the empirical application of antibiotics schemes depending on resistance.

[Serologic verification of epidemic hemorrhagic fever during the lifting of the blockade in Sarajevo]. / Seroloska potvrda epidemije hemoragicne groznice u toku deblokade Sarajeva.

OBJECTIVES: After four years of Sarajevo siege, the deblocade started on July 1995. Many soldiers involved in the deblocade developed a clinical symptoms of hemorrhagic fever indicating a possible epidemic. METHODS: Suspected patients were treated in the war hospital Igman-Fojnica. Blood samples of all the patients were processed on IgM and IgG antibodies with ELISA test, using "the double sandwich" technique. RESULTS: IgM and IgG were performed on Puumala (PVV), Hantaan (HTN) and Dobrava antigens. 38 out of 45 treated serums had high antibody titres. Sera of 28 patients had high titres of specific IgM antibodies on Hantaan antigen (12,800). A ten patients had a same titre level for specific antibodies of Puumala antigen. A 20 patients had specific IgG antibodies on Dobrava antigen with the titre 400. Our results confirmed the epidemic for which were responsible two serotypes of HFRS-PVV and HTN. They also proved the existence of a new serotypes appearing for the first time in Sarajevo region. This epidemic confirms that BiH especially Sarajevo region are among the biggest epidemic areas of HFRS in Europa.

[Pefloxacin in the treatment of septicemia, purulent meningitis and salmonellosis]. / Pefloksacin u lijecenju septikemija, purulentnih meningitisa i salmoneloza.

Thirty two patients (16 female and 16 male), ranging in age from 13 to 80 years, were treated with pefloxacin (Abactal) at The Clinic of Infectious Diseases and Febrile Conditions. Pefloxacin was applied parenterally in 21 patients with serious infections. 15 of the cases had the signs of verified septicemia, i. e. bacteriemia; 5 patients developed purulent meningitis, i. e. meningoencephalitis; and in one patient bronchopneumonia occurred. Isolated causative agents (Staphylococcus aureus, S. epidermis and Gram-negative aerobic bacteria), were sensitive to pefloxacin. In 11 patients with enterocolitis Abactal was also included in the treatment because of the increasing occurrence of the resistance of Salmonella spp. to various chemotherapeutics and excellent "in vitro" effects of pefloxacin to those multiple-resistant species. Salmonella virchow was isolated from the stools of 6 patients. Salmonella enteritidis from 3 patients, Shigella sonnei from one, and in one case the causative agent was not identified. Pefloxacin was applied per os or parenterally in the dosage of 800-1200 mg in the period from 5-9 days. In all the patients (100%) eradication of the causative agents found in stools was done as early as the third or fourth day of the therapy. There were no adverse effects.

[C-reactive protein values]. / Vrijednost C-reaktivnog proteina.

According to our research, C-reactive protein is powerful separator between bacterial and viral infections. For this case the best discriminative value is 40 mg/l. A more serious bacterial infections are usually followed by a higher concentration of CRP in serum, but its serial determination presents truly the improvement of bacterial infect, otherwise it is happening spontaneously or under the influence of adequate therapeutica.