The most common isolates from pleural infections.

Isolation and identification of the pathogens are important for appropriate treatment of pleural infections. Distribution of the most frequent causative agents varies throughout the world and may change in time.The objective of the study is to analyze the bacteriological isolates of pleural fluids in order to identify the most frequent infectious agents and assess their variability in time.The retrospective study included 272 patients with positive pleural fluid samples analyzed in 5-year period. The samples were examined using the conventional microbiological technique.Of 315 bacterial isolates the most common were streptococcal species, 105 (33%), of which 55 (17.3%) represented the Streptococcus milleri group. Gram-positive anaerobic cocci were detected in 56 (17.6%) isolates. Enterobacteriaceae family included 27 (8.5%) isolates and Pseudomonas aeruginosa was registered in 13 (4.1%). No statistically significant difference was registered in pathogen distribution in the examined period (p = 0.288).The most common agents of community-acquired pleural infections are the Streptococcus milleri group and anaerobic Gram-positive cocci. They differ from the most common pathogens of pneumonia. Among the hospital-acquired pleural infections, Pseudomonas species, Staphylococcus aureus and enterobacteria prevail. The distribution of bacterial agents isolated in the 5-year period exhibits no significant differences.

Use of immunochromatographic assay for rapid identification of Mycobacterium tuberculosis complex from liquid culture.

A new, simple immunochromatographic assay for rapid identification of Mycobacterium tuberculosis complex in liquid cultures has been developed. The principle of the assay is binding of the Mycobacterium tuberculosis complex specific antigen to the monoclonal antibody conjugated on the test strip. The aim of this study is evaluation of the performance of immunochromatographic assay in identification of Mycobacterium tuberculosis complex in primary positive liquid cultures of BacT/Alert automated system. A total of 159 primary positive liquid cultures were tested using the immunochromatographic assay (BD MGIT TBc ID) and the conventional subculture, followed by identification using biochemical tests.Of 159 positive liquid cultures, using the conventional method, Mycobacterium tuberculosis was identified in 119 (74.8%), nontuberculous mycobacteria were found in 4 (2.5%), 14 (8.8%) cultures were contaminated and 22 (13.8%) cultures were found to be negative. Using the immunochromatographic assay, Mycobacterium tuberculosis complex was detected in 118 (74.2%) liquid cultures, and 41 (25.8%) tests were negative. Sensitivity, specificity, positive and negative predictive values of the test were 98.3%; 97.5%; 99.15% i 95.12%, respectively. The value of kappa test was 0.950, and McNemar test was 1.00. The immunochromatographic assay is a simple and rapid test which represents a suitable alternative to the conventional subculture method for the primary identification of Mycobacterium tuberculosis complex in liquid cultures of BacT/Alert automated system.

Adult human case of toxocariasis with pulmonary migratory infiltrate and eosinophilia.

INTRODUCTION: Toxocariasis is a zoonosis which is in Serbia characterized with a very high infection rate of dogs and excessive contamination of the soil with the eggs of Toxocara canis, the agent of the disease. Toxocara-induced infections have in recent years been established in a few hundreds of children, but toxocariasis has rather rarely been diagnosed in adults. CASE REPORT: We reported toxocariasis (visceral larva migrans) in an adult, manifested by migratory pulmonary infiltrates and positive serological test finding to Toxocara. CONCLUSION: Human toxocariasis is a rare disease in adults, therefore it should be considered in adult patients presented with eosinophilia and migratory pulmonary infiltrates.

[Treatment effects of co-amoxiclav (Amoxiclav 2x) in acute exacerbation of severe chronic obstructive pulmonary disease: clinical evaluation].

INTRODUCTION: The exacerbation of chronic obstructive pulmonary disease is most often induced by an infection of bacterial origin in over 50% of the cases (or mixed bacterial and viral infection). This study was aimed at evaluating clinical effects of antibiotics co-amoxiclav. Amoxiicillin with clavulanic acid in the treatment of patients with severe chronic obstructive pulmonary disease exacerbation. MATERIAL AND METHODS: The investigation included 38 patients with severe chronic obstructive pulmonary disease exacerbation hospitalized at the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica. The patients were randomly selected for the antibiotic treatment with Amoxiclav twice a day in 12 hour intervals. The clinical effects of the applied treatment were evaluated by analyzing certain laboratory findings, microbiological sputum findings and improvement of subjective symptoms. RESULTS: Of the examined subjects, 65% were males and 35% were females, their mean age being 66.4 +/- 8.86, and who were mostly smokers (73%). After the completion Of Applied antibiotic treatment, a significant reduction and normalization of all inflammation markers were recorded, as well as a significant improvement of the patients' subjective symptoms. The positive microbiological sputum findings (Haemophilus influenzae, Pseudomonas aeruginosa and Streptococcus pneumoniae) were recorded in 13.58% of the patients. The bacterial agent was eradicated on the third day of the applied treatment. The mean length of the treatment was 7.07 +/- 0.91 days, with no undesirable treatment side effects observed CONCLUSION The antibiotic therapy is justifiable as the initial treatment regimen of severe chronic obstructive pulmonary disease exacerbation and amoxicillin with clavulanic acid is reported as the first-line antibiotic drug in most pharmacotherapy guidelines.