BackgroundTo inform prevention and control of sexually transmitted infections (STIs), we need reliable prevalence estimates.AimOne objective of the Slovenian National Survey of Sexual Lifestyles, ...Attitudes and Health was to estimate the prevalence of STIs with
,
,
and
.MethodsData were collected between October 2016 and July 2017 in a probability sample of the general population aged 18-49 years. Computer-assisted face-to-face interviewing and self-completion of questionnaires were used. Respondents were invited to provide urine samples to be tested for STIs.ResultsOf 1,929 survey participants, 1,087 individuals provided urine samples which were tested confidentially for
and a subset (n = 1,023) were tested anonymously for the other STIs. The prevalence of
was 0.5% (95% confidence interval (CI): 0.1-1.8) in men and 1.7% (95% CI: 0.9-3.2) in women. Age-specific prevalence was the highest among individuals aged 18-24 years, 2.8% (95% CI: 0.7-10.6) in men and 4.7% (95% CI: 1.7-12.3) in women.
was not detected. Prevalence of
was 0.5% (95% CI: 0.1-2.2) in men and 0.3% (95% CI: 0.1-1.1) in women; the highest prevalence was among men aged 25-34 years (1.1%; 95% CI: 0.2-7.5) and women aged 35-49 years (0.5%; 95% CI: 0.1-2.0).
was detected in the sample from one woman (0.2%; 95% CI: 0.1-1.2).ConclusionThe substantial prevalence of
among young adults suggests gaps in testing, diagnosis and treatment.
Background: Acute uncomplicated cystitis in women is a common reason for antibiotic treatment in the outpatient clinic of family doctors. Microbiological diagnostics is not indicated; treatment is ...generally empirical and based on guidelines and recommendations. Therefore, we do not have representative data on the incidence and sensitivity of pathogens from regular laboratory work. Special targeted research is needed.
Methods: We present the results of the prospective research conducted in four regional laboratories of the Centre for Medical Microbiology NLZOH between 15 September 2017 and 31 December 2019. We included 110 female patients with suspected acute uncomplicated cystitis who completed a questionnaire and submitted urine samples for microbiological examination.
Results: The result of urine examination was positive in 79 patients (71.8%). Among all isolates, the most common bacterium was Escherichia coli (74%), followed by Staphylococcus saprophyticus (10%), and others. The susceptibility of E. coli to trimethoprim with sulfamethoxazole was 85.5%, to nitrofurantoin 98.4%, and to fosfomycin 100%. S. saprophyticus isolates were susceptible to the tested antibiotics except for fosfomycin, against which the bacterium is intrinsically resistant. The total susceptibility of all isolates was 85.8% - 88.2% for trimethoprim with sulfamethoxazole, 88.1% - 95.2% for nitrofurantoin, 73.8% - 80.8% for fosfomycin, 72.6% for ampicillin and amoxicillin, 97.7% for cefadroxil, and 98.9% for amoxicillin with clavulanate acid. A comparison with the results of monitoring bacterial resistance as part of the regular work of microbiological laboratories shows significant differences for most of the tested antibiotics.
Conclusion: The research results show a relatively good susceptibility of the causative agents of acute uncomplicated cystitis to oral antibiotics, the only exception being amoxicillin.
•In Slovenia macrolide consumption decreased by 42.4% in the period 1997 to 2017.•The macrolide resistance of invasive pneumococci increased from 5.8% to 12.8%.•Spread of a clone explains the ...increased macrolide resistance among invasive pneumococci.•Reduced consumption of antibiotics is not enough to reverse microbial resistance.
The objective of this study was to investigate the correlation between decreased national consumption of macrolides and resistance of invasive Streptococcus pneumoniae isolates in Slovenia during 1997–2017.
A total of 4241 invasive S. pneumoniae isolates were collected in Slovenia from 1997 to 2017. The presence of erm(B), mef(E), mef(A) and erm(TR) genes was determined by PCR in 612 erythromycin-resistant isolates. Selected isolates carrying the mef(A) gene were further examined by pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) was performed for 161 erythromycin-resistant isolates from 2004 to 2009.
Consumption of macrolides decreased by 42.5% between 1997 and 2017, and by 57.0% from the highest consumption during 1999 to 2017. Resistance of S. pneumoniae increased by 120.7% in the same period, from 5.8% in 1997 to 12.8% in 2017. The most prevalent serotypes among macrolide-resistant isolates were 14 (54.9%), 19A (9.0%), 19F (8.3%), 6B (7.2%), 6A (5.2%) and 9V (19; 3.0%). The most prevalent determinant of macrolide resistance in the observed period was erm(B) (43.0%; 263/612), followed by mef(A) (36.3%; 222/612) and mef(E) (14.9%; 91/612). During the study period, an increasing trend in serotype 14, mef(A)-carrying isolates was observed, with a peak in 2011 (P<0.001); 63/71 isolates (88.7%) with the mef(A) gene were clonally related and were related to the international England14-9 clonal cluster.
The reason for the observed increase in macrolide resistance among invasive S. pneumoniae in Slovenia despite decreased macrolide consumption was spread of the England14-9 clonal cluster.
BackgroundTo inform sexually transmitted infections (STIs) prevention and control, objective of the second National Survey of Sexual Lifestyles, Attitudes and Health was to estimate the prevalence of ...Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis infections.MethodsA survey of the general population aged 18–49 was conducted in 2016–2017. We used stratified two-stage probability sampling from the Central Population Registry. Survey respondents were invited to contribute first void urine specimens for testing for C. trachomatis and unlinked anonymous testing for other STIs to obtain population prevalence estimates. Specimens were tested for C. trachomatis with specific real time PCR targeting both cryptic plasmid and bacterial chromosome. Positive results were confirmed by Sanger sequencing of the amplicon. Other STIs were detected by a commercially available multiplex PCR (FTD Urethritis plus, fast-track Diagnostics). To avoid false negative results, the human house keeping gene was amplified in all tested samples.ResultsUrine specimens from 452 men and 635 women (56.4% of all survey respondents) were tested for chlamydia. Overall weighted prevalence was 0.5% (95% CI 0.1% to 1.4%) in men and 1.7% (95% CI 0.9% to 3.1%) in women. Age-specific prevalence was the highest among 18–24 years old (men: 2.8%; 95%CI 0.9% to 8.5%; women: 4.7%; 95%CI 1.6% to 10.7%). Urine specimens from 430 men and 593 women (53.0% of all survey respondents), were tested for other STIs. No infections with N. gonorrhoeae were found. Weighted prevalence estimate for M. genitalium was 0.5% (95% CI 0.2% to 1.5%) in men and 0.3% (95% CI 0.0% to 0.9%) in women. Parasite T. vaginalis was detected in one woman only. Corresponding weighted prevalence was 0.2% (95% CI 0.0%–0.9%).ConclusionThe prevalence of C. trachomatis infection in the general population of Slovenians aged 18–24 was substantial. The other three STIs were relatively rare.DisclosureNo significant relationships.
Background
SARS-CoV-2 infection does not confer long immunity. However, studies suggest that prior infection is associated with lower risk of reinfection and milder outcomes of recurrent infections. ...The aims of this retrospective observational case-control study were to describe the clinical and molecular characteristics of genetically confirmed Delta reinfection cases and to assess the potential protective role of preceding infection on the severity of reinfection.
Methods
We used next generation sequencing (NGS) to explore if cases with two positive real time RT-PCR tests > 90 days apart were infected with a different SARS-CoV-2 variant. Cases with confirmed reinfection between August 1st and October 31st, 2021 (the Delta wave) in Slovenia were matched 1:4 by age, sex and timeframe (week of positive test) with individuals with primary infection. Sociodemographic and epidemiologic data, vaccination status, and data on hospitalization and outcome of infection were retrieved from several centralized and standardized national databases. Additional epidemiologic surveys were performed on a limited number of cases and controls.
Results
We identified 628 cases of genetically confirmed reinfection during the study period and matched them with 2,512 control subjects with Delta primary infection. Primary infections in individuals with reinfection were mainly caused by B.1.258.17 (51.1%), followed by B.1.1.7 (15.1%) and reinfection was detected on average 271 days after primary infection (range 101–477 days). Our results show a substantially lower probability of hospitalization in cases with reinfection compared with controls (OR: 0.21,
p
= 0.017), but no significant difference was observed in intensive care unit admission and deaths. We observed a significantly lower proportion of vaccinated individuals among cases compared to controls (4.5% vs. 28.2%), suggesting that hybrid immunity leads to lower probability of reinfection. Detailed analysis of the temporal distribution of variants, responsible for reinfections, showed no significant differences in reinfection potential.
Conclusion
Reinfection with the SARS-CoV-2 Delta variant resulted in fewer hospitalizations compared to the primary Delta infection, suggesting that primary infection may, to some extent, produce at least short lasting protective immunity. This study provides additional insight into the reinfection dynamics that may allow appropriate public health measures to be taken in subsequent waves of the COVID-19 pandemic.
Surveillance schemes for methicillin-resistant
(MRSA) are widely established at the national and international levels. Due to the simple standardization of the protocol, mainly isolates from ...bloodstream infections are used. However, the limitations of this simple surveillance system are well described. We conducted a comprehensive analysis of MRSA isolates in a large Slovenian region over 5 years to identify the optimal sample group for assessing the overall MRSA diversity. At the same time, this study provides to date non-available molecular characterization of Slovenian MRSA isolates. A total of 306 MRSA isolates from various sources were sequenced and phenotypically tested for resistance. The isolates exhibited significant molecular diversity, encompassing 30 multi locus sequence type (MLST) sequence types (STs), 39 ST-SCC
genetic lineages, 49
types, and 29 antibiotic resistance profiles. Furthermore, the isolate pool comprised 57 resistance genes, representing 22 resistance mechanisms, and 96 virulence genes. While bloodstream isolates, commonly used in surveillance, provided insights into frequently detected clones, they overlooked majority of clones and important virulence and resistance genes. Blood culture isolates detected 21.3%
types, 24.1% resistance phenotypes, and 28.2% MLST-SCC
profiles. In contrast, strains from soft tissues demonstrated superior genomic diversity capture, with 65.3%
types, 58.6% resistance phenotypes, and 71.8% MLST-SCC
profiles. These strains also encompassed 100.0% of virulence and 82.5% of resistance genes, making them better candidates for inclusion in surveillance programs. This study highlights the limitations of relying solely on bloodstream isolates in MRSA surveillance and suggests incorporating strains from soft tissues to obtain a more comprehensive understanding of the epidemiology of MRSA.IMPORTANCEIn this study, we investigated the diversity of methicillin-resistant
(MRSA), a bacterium that can cause infections that are difficult to treat due to its resistance to antimicrobial agents. Currently, surveillance programs for MRSA mainly rely on isolates from bloodstream infections, employing a standardized protocol. However, this study highlights the limitations of this approach and introduces a more comprehensive method. The main goal was to determine which group of samples is best suited to understand the overall diversity of MRSA and to provide, for the first time, molecular characterization of Slovenian MRSA isolates. Our results suggest that including MRSA strains from soft tissue infections rather than just blood infections provides a more accurate and comprehensive view of bacterial diversity and characteristics. This insight is valuable for improving the effectiveness of surveillance programs and for developing strategies to better manage MRSA infections.
BackgroundSequencing of SARS-CoV-2 PCR-positive samples was introduced in Slovenia in January 2021. Our surveillance programme comprised three complementary schemes: (A) non-targeted sequencing of at ...least 10% of samples, (B) sequencing of samples positive after PCR screening for variants of concern (VOC) and (C) sequencing as per epidemiological indication.AimWe present the analysis of cumulative data of the non-targeted surveillance of SARS-CoV-2 and variant-dependent growth kinetics for the five most common variants in Slovenia for the first 9 months of 2021.MethodsSARS-CoV-2 PCR-positive samples, from January to September 2021, were selected for sequencing according to the national surveillance plan. Growth kinetics studies were done on Vero E6 cells.ResultsAltogether 15,175 genomes were sequenced and 64 variants were detected, of which three successively prevailed. Variant B.1.258.17 was detected in ca 80% of samples in January and was replaced, within 9 weeks, by the Alpha variant. The number of cases decreased substantially during the summer of 2021. However, the introduction of the Delta variant caused a fourth wave and completely outcompeted other variants. Other VOC were only detected in small numbers. Infection of Vero E6 cells showed higher replication rates for the variants Alpha and Delta, compared with B.1.258.17, B.1.258, and B.1.1.70, which dominated in Slovenia before the introduction of the Alpha and Delta variants.ConclusionInformation on SARS-CoV-2 variant diversity provided context to the epidemiological data of PCR-positive cases, contributed to control of the initial spread of known VOC and influenced epidemiological measures.
Salmonella is an important zoonotic pathogen in animals and humans. In the European Union, Salmonella enterica subspecies enterica serovar Enteritidis (serovar Enteritidis) is one of the serovars ...most frequently associated with human illness. The most important food vehicles responsible for the infection are eggs and egg products. We describe two serovar Enteritidis outbreaks on account of consump
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