Point prevalence study of antimicrobial usage in acute care hospitals in the Slovak Republic.

BACKGROUND: Antimicrobial use and resultant resistance is still increasing worldwide. Close monitoring and strict implementation of policies are important to tackle this issue. AIM: To assess the use of antimicrobials in acute care hospitals in the Slovak Republic. METHODS: Antimicrobial use was monitored as part of a point prevalence survey (PPS) of healthcare-associated infections. Surveillance was performed in 40 hospitals in the Slovak Republic according to the standardized methodology developed by the European Centre for Disease Prevention and Control. Data were collected according to a standard protocol. FINDINGS: In total, 8397 patients in 40 Slovak hospitals were surveyed. Of these, 30.7% were receiving antibiotics at the time of the survey. In 630 cases, patients were receiving more than one antimicrobial agent. The prevalence of antimicrobial use was highest in intensive care units (54.3%). Antimicrobials were prescribed most frequently for treatment of community-acquired infections (48.1%) and healthcare-associated infections (11.4%). Surgical prophylaxis was the indication for 22.2% of all prescribed antimicrobials, and exceeded 24h in 81.5% of cases. The antimicrobials used most often were fluoroquinolones (20.9%), especially for non-surgical prophylaxis (26.8%) and treatment (21.9%). The antimicrobials prescribed most frequently for surgical prophylaxis were first-generation cephalosporins (23.0%), fluoroquinolones (14.7%) and second-generation cephalosporins (11.4%). The use of antimicrobials was higher in patients with invasive medical devices. CONCLUSION: This study found excessive use of broad-spectrum antibiotics, prolonged surgical prophylaxis, frequent use of parenteral antibiotics and inadequate documentation of the indication for prescription. These findings present opportunities for improving the management of antimicrobials in Slovak hospitals.

Rotavirus type profile in nosocomial and community infections in Western Slovakia.

The surveillance study of rotavirus gastroenteritis at the University Teaching Hospital Trencín area, Slovakia, during 2006-2011 confirmed that the genotype profile of circulating rotaviruses was not stable. While G1P[8] dominating genotype dropped from 75 to 7.3 % in the period 2009-2011, genotype G2P[4] that was not detected in 2009 raised to 45.1 % in 2011. Vaccination coverage rose from 4.4 to 22.1 % in the period 2008-2011. Among the community and hospital cases, we observed that the average age of patients with nosocomial infections was significantly less (10.6 months) than in the cases of community rotavirus gastroenteritis (RVGE) cases. Compared to the nosocomial infection cases, the duration of the disease and the duration of hospitalization among the community cases were significantly longer by 0.22 and 3.63 days, respectively, during 2006-2011. Though the vaccination coverage was found to correlate with changes in the type of the circulating rotaviruses, the natural circulation in rotavirus genotypes may not be excluded as important factor contributing to the emergence of G2P[4] strain during the survey period.

[A point prevalence survey of healthcare-associated infections in the Slovak Republic - a part of the EU project]. / Bodové prevalencné sledovanie nozokomiálnych nákaz na Slovensku - súcast projektu Európskej únie.

AIM: The aim of this survey was to estimate the prevalence of healthcare-associated infections (HAI) in the Slovak Republic (SR), distribution of causative pathogens, and risk factors. METHODS: The point prevalence survey (PPS) of HAI in the SR was carried out in 40 acute care hospitals, according to a standardized methodology developed by the European Centre for Disease Prevention and Control (ECDC). Data were collected according to the standard protocol at the country, hospital, and patient levels. RESULTS: Of 8 397 patients included in the survey in the SR, 298 (3.5%) had HAI. The highest prevalence of HAI (12.4%) was found in the intensive care units (ICU) and Anaesthesiology and Intensive Care Medicine Units (AICMU). Nevertheless, intensive care medicine patients only represented 6.5% of all patients. The following six most common types of HAI accounted for 87.3% of all HAI: urinary tract infection (26.2%), pneumonia and other lower respiratory tract infections (22.0%), surgical site infection (15.7%), bloodstream infection (9.9%), infection of the eye, ear, and upper respiratory tract (8.3%), and skin and soft tissue infection (5.2%). The most often isolated pathogens were Escherichia coli (15.0%), Klebsiella spp. (12.5%), and Pseudomonas aeruginosa (10.8%). Of 8 397 surveyed patients, 60.5% had a medical device inserted: central vascular catheter (CVC)(3.4%), peripheral vascular catheter (PVC)(40.8%), urinary catheter (14.1%), or endotracheal tube (2.1%). The prevalence of HAI was higher in patients with than without a medical device inserted. CONCLUSION: By participating in the PPS, the SR has collected the most recent data on HAI and antimicrobial use in acute care hospitals. The adherence to the standard methods, standard definitions of HAI, and PPS protocol allows to repeat the survey, to analyse the HAI prevalence trend, and to take effective interventions.

[Exotic pets as a potential source of Salmonella]. / Exotickí domáci milácikovia ako potenciálny zdroj salmonel.

STUDY AIM: To clarify the source of infection with the exotic serovar Salmonella Urbana and the route of transmission in a 2-year-old child. MATERIAL AND METHODS: To identify the source of infection and the route of transmission, we used epidemiological investigation of the case of salmonellosis and microbiological methods for the detection of Salmonella from biological specimens, epidemiologically suspected food, turtle tank water and feed, and serotyping of isolated strains of Salmonella. RESULTS: Salmonella Urbana was confirmed in a rectal swab of the infected child and in a sample of turtle tank water. Laboratory analyses of farm eggs eaten by the investigated family, of rectal swabs of the other family members and of a turtle feed sample did not reveal the presence of salmonellae. CONCLUSION: The confirmed source of Salmonella infection caused by the exotic serovar Salmonella Urbana in a two-year-old child were pet water turtles. In the case of the isolation of exotic serovars of Salmonella, the epidemiological and laboratory investigation needs to be aimed at the contact with pet animals, especially reptiles. It is desirable to raise the awareness of both the public and health professionals of this issue.