•Burkholderia gladioli was identified as a cause of healthcare-associated bacteremia.•The investigation traced to the contaminated multidose vials with saline solution.•Isolates from blood and saline ...showed the same susceptibility patterns.•Pulsed-field gel electrophoresis (PFGE) was used to genotype the strains.•PFGE profile of all B. gladioli isolates demonstrated clonal relatedness.
Burkholderia gladioli has been associated with infections in patients with cystic fibrosis, chronic granulomatous disease, and other immunocompromising conditions. The aim of this study was to better depict the outbreak of healthcare-associated bacteremia caused by B. gladioli due to exposure to contaminated multidose vials with saline solutions.
An environmental and epidemiologic investigation was conducted by the Infection Prevention and Control Team (IPCT) to identify the source of the outbreak in three Croatian hospitals.
During a 3-month period, 13 B. gladioli bacteremia episodes were identified in 10 patients in three Croatian hospitals. At the time of the outbreak, all three hospitals used saline products from the same manufacturer. Two 100-ml multidose vials with saline solutions and needleless dispensing pins were positive for B. gladioli. All 13 bacteremia isolates and two isolates from the saline showed the same antimicrobial susceptibility patterns and pulsed-field gel electrophoresis profile, demonstrating clonal relatedness.
When an environmental pathogen causes an outbreak, contamination of intravenous products must be considered. Close communication between the local IPCT and the National Hospital Infection Control Advisory Committee is essential to conduct a prompt and thorough investigation and find the source of the outbreak.
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In the Balkans, rising concerns about invasive fungal infections over the past decade stem from various factors. Primarily, there has been a notable uptick in immunocompromised individuals, including ...those with chronic illnesses like immunological and hematological diseases. Thus, it is essential to assess the region's laboratory capabilities and the availability of antifungals. This evaluation is vital for gauging the preparedness to diagnose and treat fungal infections effectively, thus minimizing their public health impact.
Data were collected via an online questionnaire targeting healthcare professionals specializing in relevant fields across diverse healthcare settings in Balkan countries. The survey covered various aspects, including diagnostic methods, imaging techniques, and available antifungal armamentarium.
Responses were obtained from 50 institutions across the Balkans. While conventional diagnostic methods like microscopy (96 %) and culture (100 %) diagnostics were widely available, access to newer diagnostic tools such as molecular assays (61 %) were limited, often relying on outsourced services. Imaging modalities like ultrasound (100 %) and CT scans (93 %) were universally accessible. A variety of antifungal drugs were available, including amphotericin B formulations (80 %), echinocandins (79 %), and triazoles (100 %). However, access to newer agents like posaconazole (62 %) and isavuconazole (45 %) was inconsistent. Therapeutic drug monitoring (53 %) services were also limited.
The study underscores the need for equitable access to diagnostic facilities and antifungal treatments across healthcare settings in the Balkan geographic region. Improving access to molecular diagnostic tools and essential antifungal drugs, as well as implementing therapeutic drug monitoring, would optimize the management of fungal infections in the region.
Aim
To identify and investigate a difference between microorganisms present on intensive care unit (ICU) health care workers' (HCW, doctors, nurses or medical technicians) and medical students' ...mobile phones as well as to investigate a difference between the frequency and the way of cleaning mobile phones.
Methods
Fifty swabs were collected from HCWs who work in the ICU (University Hospital Centre Osijek) and 60 swabs from medical students (School of Medicine, University of Osijek). Microorganisms were identified according to standard microbiological methods and biochemical tests to the genus/species level.
Results
Out of 110 processed mobile phones, mobile phones microorganisms were not detected on 25 (22.7%), 15 (25%) students' and 10 (20%) HCW's mobile phones. No statistically significant difference was found between the number of isolated bacteria between the HCW' and students' mobile phones (p>0.05). Statistically significant difference was found between both HCW and students and frequency of cleaning their mobile phones (p<0.001). A significant difference was also obtained with the way of cleaning mobile phones between HCWs and students (p <0.001).
Conclusion
The most common isolated microorganisms in both groups were coagulase-negative staphylococci (CoNS) and Staphylococcus aureus. Most HCWs cleaned their mobile phones at least once a week, 35 (52.0%), and most medical students several times per year, 20 (33.3%). HCW clean their mobile phones with alcohol disinfectant in 26 (40.0%) and medical students with dry cloth in 20 (33.3%) cases.
In the last decade, the incidence of invasive meningococcal disease (IMD) in Croatia remained stable at approximately 1 case per 100 000 inhabitants, affecting mainly children aged ≤5 years. We ...report the molecular characterization of meningococci causing IMD occurring from June 2009 to January 2014 in Croatia. Genomic DNA from 50 clinical isolates was analysed for serogroup, multilocus sequence typing and allele type of the two outer membrane protein genes, porA and the iron-regulated fetA. Furthermore, 22 of them were characterized by using whole-genome sequencing to define the meningococcal vaccine four-component meningococcal serogroup B (4CMenB) antigen genes factor H-binding protein (fHbp), Neisseria heparin-binding antigen (nhba) and Neisseria adhesin A (nadA) and the antimicrobial target resistance genes for penicillin (penicillin binding protein 2, penA), ciprofloxacin (DNA gyrase subunit A, gyrA) and rifampicin (β-subunit of RNA polymerase, rpoB). The Etest was used to phenotypically determine the antimicrobial susceptibility of isolated meningococci. The main serogroup/clonal complex combinations were MenB cc41/44, MenC/cc11, MenW/cc174 and MenY/cc23. PorA P1.7-2, FetA F5-5 and F1-5 were the most represented through the serogroups. Meningococci with decreased susceptibility to penicillin (38.9 %) and one strain resistant to ciprofloxacin were identified. Forty-two percent of MenB showed the presence of at least one of the 4CMenB vaccine antigens (fHbp, NHBA, NadA and PorA). Our findings highlight the genetic variability of meningococci causing IMD in Croatia, especially for the serogroup B. Molecular-based characterization of meningococci is crucial to enhance IMD surveillance and to better plan national immunization programmes.
Malarija je još uvijek najznačajnija parazitarna infekcija na svijetu, značajan uzrok pobola i smrtnosti u endemskim zemljama te predstavlja velik rizik za putnike u te krajeve. Ključan dio u ...globalnoj borbi protiv malarije je mogućnost brze i točne detekcije uzročnika. Tehnološki napredak otvara nove dijagnostičke mogućnosti no, najstarija metoda, konvencionalna mikroskopska dijagnostika malarije i dalje predstavlja zlatni standard. Cilj ovog teksta je pregledati dio relevantne literature o dijagnostičkim metodama za malariju koje se najčešće upotrebljavaju u kliničkoj praksi u endemskim i neendemskim zemljama: mikroskopskoj dijagnostici, brzim antigenskim testovima (BAT), molekularnim metodama i serologiji. Također, iznosimo podatke o nekim od novijih napredaka u dijagnozi malarije.
Uvod: Svrha ovog rada bila je podsjetiti na osnovne karakteristike bakterije iz roda Brucella te prikazati podatke o pacijentima hospitaliziranima u Klinici za infektivne bolesti „Dr. Fran ...Mihaljević“ u razdoblju od 2007. do 2020. godine. Dobiveni su rezultati uspoređeni s dostupnim podacima iz Bosne i Hercegovine i podacima iz elektronske baze Europskog centra za kontrolu bolesti za razdoblje od 2007. do 2019. godine.
Metode: Anamnestički su podaci prikupljeni iz povijesti bolesti pacijenata Klinike za infektivne bolesti „Dr. Fran Mihaljević“. Uspoređeni su podaci prikupljeni iz godišnjih izvještaja za Republiku Hrvatsku te izvještaja Europskog centra za kontrolu i prevenciju bolesti za europske zemlje.
Rezultati: U razdoblju od 2007. do 2020. godine u Klinici za infektivne bolesti „Dr. Fran Mihaljević“, od bruceloze je liječeno 25 pacijenata. Podaci o oboljelima od bruceloze Hrvatskog zavoda za javno zdravstvo i Klinike za infektivne bolesti „Dr. Fran Mihaljević“ ne podudaraju se za 2008., 2014. i 2020. godinu. Bosna i Hercegovina bilježi značajno višu incidenciju bruceloze u usporedbi sa zemljama u regiji. Mediteranske zemlje imaju značajno više slučajeva novooboljelih nego što je to zabilježeno u Hrvatskoj.
Zaključak: Brucelozu u Hrvatskoj karakteriziraju sporadični slučajevi, najčešće importirani iz Bosne i Hercegovine. Potrebna je daljnja provedba, kao i razvitak preventivnih mjera s ciljem održavanja povoljne epidemiološke situacije.
Dirofilariasis is an endemic infestation in tropical and subtropical countries caused by about 40 different species. It rarely occurs in the oral cavity and is mostly presented as mucosal and ...submucosal nodules. Differential diagnoses include lipoma, mucocele, and pleomorphic adenoma. We report a rare case of oral dirofilariasis mimicking mucocele in a 41-year-old male patient from Croatia without an epidemiological history of travelling outside the country. He came in because of non-painful lower lip swelling that had lasted for two months. The parasite was surgically removed from the lesion. This is the first reported case of oral dirofilariasis in Croatia. It is important to point out this rare diagnosis in order to make dentists aware of the possibility of the presence of such an infestation in common lesions of the oral mucosa.
•Incidence of IMD has declined and surveillance is in place in most Eastern European countries.•Predominating serogroups of Nm are B and C, then A; W, Y and X are emerging.•Vaccines are not in ...NIPs/only provided to high-risk groups, in which antibiotic prophylaxis is key.•Use of conjugate vaccines is recommended to interrupt acquisition of carriage.•Monitoring outbreaks, spread of Nm and antibiotic resistance can inform management strategies.
The Global Meningococcal Initiative (GMI) aims to prevent invasive meningococcal disease (IMD) worldwide through education, research and cooperation. In March 2019, a GMI meeting was held with a multidisciplinary group of experts and representatives from countries within Eastern Europe. Across the countries represented, IMD surveillance is largely in place, with incidence declining in recent decades and now generally at <1 case per 100,000 persons per year. Predominating serogroups are B and C, followed by A, and cases attributable to serogroups W, X and Y are emerging. Available vaccines differ between countries, are generally not included in immunization programs and provided to high-risk groups only. Available vaccines include both conjugate and polysaccharide vaccines; however, current data and GMI recommendations advocate the use of conjugate vaccines, where possible, due to the ability to interrupt the acquisition of carriage. Ongoing carriage studies are expected to inform vaccine effectiveness and immunization schedules. Additionally, IMD prevention and control should be guided by monitoring outbreak progression and the emergence and international spread of strains and antibiotic resistance through use of genomic analyses and implementation of World Health Organization initiatives. Protection of high-risk groups (such as those with complement deficiencies, laboratory workers, migrants and refugees) is recommended.
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