[Detection of laboratory biomarkes in haematological and pulmonology patients at high risk for aspergillosis].

INTRODUCTION: During the past decades a dramatic increase in the incidence of invasive fungal diseases, especially invasive aspergillosis has been observed. Undiagnosed and diagnosed late invasive aspergillosis is followed by lethality of up to 90%. Detection of early laboratory biomarkers (galactomannan and anti-Aspergillus antibodies) contributes to early diagnosis and is used for screening, as well as for monitoring therapy of aspergillosis. OBJECTIVE: The aim was to evaluate usefulness of "non-culture" methods (galactomannan and anti-Aspergillus antibodies IgA, IgM and IgG) for early diagnosis of aspergillosis in high-risk patients. METHODS: Prospective two-year study involved 262 high-risk patients for aspergillosis. In pulmonology and haematology patients (adults and children) blood samples were tested on galactomannan and anti-Aspergillus antibodies. RESULTS: Early laboratory biomarkers were statistically significantly higher in pulmonology patients (p = 0.00033). However, in haematological patients galactomannan was a more frequently positive finding, while in pulmonology patients it was the finding of anti-Aspergillus antibodies. It is interesting that, despite the possible immunosuppression, in about 1/3 of haematological patients anti-Aspergillus antibodies were confirmed. CONCLUSION: Early diagnosis and treatment of aspergillosis represent both clinical and laboratory problem. Nowadays, the application of new "non-culture" methods is of particular importance for the outcome of aspergillosis. Clinical features, laboratory findings of biomarkers and their correct interpretation significantly increase the possibility of timely implementation of appropriate therapy. In this regard, the new organization of reference laboratory for medical mycology has significantly improved the outcome of aspergillosis in high-risk patients in our country. However, further investigations, implementation of European standards and introduction of new diagnostic methods are necessary in this field.

[Antimycotics susceptibility testing of dermatophytes].

Dermatophytes are moulds that produce infections of the skin, hair and nails of humans and animals. The most common forms among these infections are onychomycosis and tinea pedis affecting 20% of world population. These infections are usually chronic. The treatment of dermatophytoses tends to be prolonged partly because available treatments are not very effective. Antifungal drug consumption and public health expenditure are high worldwide, as well as in Serbia. For adequate therapy, it is necessary to prove infection by isolation of dermatophytes and to test the antifungal susceptibility of isolates. Susceptibility testing is important for the resistance monitoring, epidemiological research and to compare in vitro activities of new antifungal agents. The diffusion and dilution methods of susceptibility tests are used, and technical issues of importance for the proper performance and interpretation of test results are published in the document E.DEF 9.1 (EUCAST) and M38-A2 (CLSI). The aim of our paper is to promptly inform the public about technical achievements in this area, as well as the new organization of laboratory for medical mycology in our country. The formation of laboratory networks coordinated by the National Reference Laboratory for the cause of mycosis need to enable interlaboratory studies and further standardization of methods for antifungal susceptibility testing of dermatophytes, reproducibility of tests and clinical correlation monitoring (MIK values and clinical outcome of dermatophytosis). The importance of the new organization is expected efficient improvement in the dermatophytosis therapy at home, better quality of patient's life and the reduction of the cost of treatment.

[Shigellosis--epidemiological situation in Montenegro in period 1996-2005].

UNLABELLED: INTRODUCTION Shigellosis is the most common cause of diarrhoea in the world. It is estimated to cause 165 million cases per a year, and two third of all diseases and most of the deaths are among children under 10 years of age. The aim of this descriptive epidemiologic study was to analyze the incidence of shigellosis in Montenegro during the period 1996-2005 and to find out which species of Shigella were dominant in this region. MATERIAL AND METHODS: In the analysis of the data we used crude, age-specific and standardized incidence rates calculated by direct method using world population by Segi as standard. RESULTS: During the study period the average participation of shigellosis among all cases of intestinal diseases expressed in percentage was 1.2%. The average standardized incidence rate for shigellosis was 7.18/100.000 in male population and 6.3/100.000 in female population. During the period 1996-2005 the number of Shigella cases decreased both in male and female population. Most of the cases were among children aged 0-14, and then in the age group 15-24 years. The most common species were S. sonnei (46.1%), then S. flexnery (25.4%), S. boydi (10.9%) and S. dysenteriae (3.6%). DISCUSSION: Today shigellosis is still a big health problem in most countries because of high mortality rate among children, the presence of multi-resistant species to antibiotics, easy transmission from one person to another and lack of preventive measures, especially vaccine. CONCLUSION: In order to decrease the incidence of shigellosis it is necessary to apply appropriate preventive measures as well as to improve vaccine against this disease.