Sposobnost adherencije bakterija na biotičke i abiotičke površine,funkcioniranje kao zajednica, te međusobna komunikacija bakterijskihstanica, od posebne su važnosti u nastanku kroničnih ...infektivnihbolesti. Sesilna zajednica mikroorganizama, danas poznatakao biofilm, povezuje se s brojnim bakterijskim infekcijama.Ključne karakteristike biofilm-infekcija jesu perzistencija infekcije,te rezistencija na antimikrobne lijekove i obranu imunološkogsustava domaćina. Napretkom tehnologije i primjenom novih mikroskopskihi molekularnih metoda u proučavanju ultrastrukture ifunkcionalnim odnosima unutar biofilma, nastoji se pronaći noviterapijski pristup u kontroli biofilm-infekcija, koje su jedan odnajvećih izazova 21. stoljeća.
To determine the prevalence and antibiotic susceptibility of Haemophilus influenzae and H. parainfluenzae isolated from the urinary and genital tracts.
Identification of strains bacteria Haemophilus ...spp. was carried out by using API NH identification system, and antibiotic susceptibility was performed by Kirby-Bauer disk diffusion method.
A total number of 50 (0.03%) H. influenzae and 14 (0.01%) H. parainfluenzae (out of 180, 415 samples) were isolated from genitourinary tract. From urine samples of the girls under 15 years of age these bacteria were isolated in 13 (0.88%) and two (0.13%) cases, respectively, and only in one case (0.11%) of the UTI in boys (H. influenzae). In persons of fertile age, it was only H. influenzae bacteria that was found in urine samples of the five women (0.04%) and in three men (0.22%). As a cause of vulvovaginitis, H. influenzae was isolated in four (5.63%), and H. parainfluenzae in two (2.82%) girls. In persons of fertile age, H. influenzae was isolated from 10 (0.49%) smears of the cervix, and in nine (1.74%) male samples. H. parainfluenzae was isolated from seven (1.36%) male samples. (p < 0.01). Susceptibility testing ofH. influenzae and H. parainfluenzae revealed that both pathogens were significantly resistant to cotrimoxasol only (26.0% and 42.9%, respectively).
In the etiology of genitourinary infections of girls during childhood, genital infections of women in fertile age (especially in pregnant women), and men with cases of epididimytis and/or orchitis, it is important to think about this rare and demanding bacteria in terms of cultivation.
Human papillomavirus (HPV) infection is the most common sexually transmitted infection, especially among young, sexually active individuals. As persistent infection with oncogenic types may lead to ...cervical cancer, HPV testing is a useful tool to screen for women at risk for subsequent development of cervical cancer. The aim of the study was to determine the prevalence of high-risk HPV (hrHPV) infection in different age groups of cytologically selected women from the Zagreb region, and to evaluate the frequency and results of repeat hrHPV testing. During a one-year study period (November 2005 to November 2006), a total of 3,440 cervical samples from women attending gynecological services of public and private health care systems were received. They were tested for 13 hrHPV genotypes by the polymerase chain reaction based AMPLICOR HPV test (Roche Molecular Systems). The overall prevalence of hrHPV was 34.6%. Most samples were obtained from women aged 21-30 years (44.2%), followed by the 31-40 (27.6%), 41-50 (15.7%), 51-60 (5.3%) and 261 (2.4%) age groups. Out of 3,227 cervical samples obtained from women of known age, 4.9% were obtained from the group of girls younger than 21, in which the highest prevalence of hrHPV (49.4%) was found. A similar prevalence was observed in women aged 21-30 (45.1%). The prevalence gradually decreased with age. During the study period, repeat hrHPV testing was performed in samples from 66 women at different intervals. Out of 28 women that were hrHPV negative on initial testing, only five women turned positive on repeat testing. Out of 38 women that were positive on initial testing, in one-third hrHPV could not be detected on repeat testing. As expected, hrHPV infection was highly prevalent in female adolescents and young women. Further investigation on repeat hrHPV testing is needed to assess virus clearance and rate of newly acquired infection.
Molecular characterization of ESBL-producing K. pneumoniae strains isolated from urine of outpatients in Zagreb region during the last five years.
During the five-year study period a total of 2, 651 ...K. pneumoniae strains were isolated from urine of nonhospitalized patients with significant bacteriuria. ESBL production was detected by double-disk diffusion technique and by > or = 3-dilution reduction in the minimal inhibitory concentration of ceftazidime in the presence of clavulanate. A total of 441 ESBL-producing K. pneumoniae strains (15.5%) were collected and 17 strains were further characterised. Double-disk synergy test was used to detect ESBLs. Minimum inhibitory concentrations (MICs) were determined by broth microdilution method according to CLSI. The transferability of cefotaxime resistance was tested by conjugation (broth mating method). PCR was used to detect alleles encoding ESBL enzymes. The genotypes of the strains were compared by pulsed-field gel electrophoresis (PFGE) of Xba I-digested genomic DNA.
A significant difference in frequencies of ESBL isolates was observed. In the first year of study only 4.9% of isolated strains were ESBL producers, while in the second year 17.% ESBL-positive strains were detected (p < 0.01), and the frequency remained stabile within following years. All strains yielded an amplicon with primers specific for SHV beta-lactamases and CTX-M beta-lactamases. Based on sequencing of bla(CTX-M) genes enzymes of nine strains were identified as CTX-M 15 beta -lactamase and three as CTX-M-14. Isolates were not clonally related.
The study demonstrated community-associated emergence of CTX-M 1 beta-lactamase-producing K. pneumoniae strains.
Aim Molecular characterization of ESBL-producing K. pneumoniaestrains isolated from urine of outpatients in Zagreb regionduring the last five years. Methods During the five-year study period a total ...of 2, 651 K.pneumoniae strains were isolated from urine of nonhospitalized patients with significant bacteriuria. ESBL production was detected by double-disk diffusion technique and by ≥3-dilution reduction in the minimal inhibitory concentration of ceftazidime in the presence of clavulanate. A total of 441 ESBL producing K. pneumoniae strains (15.5%) were collected and 17 strains were further characterised. Double-disk synergy test was used to detect ESBLs. Minimum inhibitory concentrations (MICs) were determined by broth microdilution method according to CLSI. The transferability of cefotaxime resistance was tested by conjugation (broth mating method).PCR was used to detect alleles encoding ESBL enzymes.The genotypes of the strains were compared by pulsed-field gel electrophoresis (PFGE) of Xba I-digested genomic DNA. Results A significant difference in frequencies of ESBL isolates was observed. In the first year of study only 4.9% of isolated strains were ESBL producers, while in the second year 17.3% ESBL-positive strains were detected (p<0.01), and the frequency remained stabile within following years. All strains yielded an amplicon with primers specific for SHV β-lactamases and CTX-M β-lactamases. Based on sequencing of blaCTX-M genes enzymes of nine strains were identified as CTX-M 15 β –lactamase and three as CTX-M-14. Isolates were not clonally related. Conclusion The study demonstrated community associated emergence of CTX-M 1 β-lactamase–producing K. pneumoniae strains.
Razvoj stimulacije atrija za prevenciju atrijske fibrilacije refraktorne na lijekove predstavlja logičan slijed u liječenju ove aritmije. Elektrofiziološka svrsishodnost stimulacije atrija temelji se ...na smanjenju ukupnih i lokalnih vremena atrijske aktivacije tijekom stimulacije, što dovodi do smanjene disperzije atrijske refraktornosti i smanjenog kašnjenja interatrijskog provođenja. Međutim, primjenu stimulacije atrija treba razmotriti kod različitih populacija s atrijskom fibrilacijom. Danas ima dosta dokaza da je jednostruka stimulacija atrija korisna u prevenciji atrijske fibrilacije u bolesnika sa sindromom bolesnog sinusnog čvora. Dvostruka stimulacija desnog atrija ili septalna stimulacija atrija djelotvornije su od jednostruke i mogu se primijeniti u izabranih bolesnika sa simptomatskom atrijskom fibrilacijom, osobito kod onih koji imaju produženo interatrijsko provođenje. Djelotvornost biatrijske stimulacije još nije dokazana, a tehnički je povezana s čestim dislokacijama elektrode u koronarnom sinusu. Potrebne su buduće studije s višestrukom stimulacijom atrija i/ili novim algoritmima za prevenciju atrijske fibrilacije, vjerojatno u kombinaciji s lijekovima ili ablacijom, koje bi trebale proširiti primjenu atrijske stimulacije u liječenju simptomatske atrijske fibrilacije.
Human papillomavirus (HPV) infection is the most common sexually transmitted infection, especially among young,
sexually active individuals. As persistent infection with oncogenic types may lead to ...cervical cancer, HPV testing is a useful
tool to screen for women at risk for subsequent development of cervical cancer. The aim of the study was to determine
the prevalence of high-risk HPV (hrHPV) infection in different age groups of cytologically selected women from the
Zagreb region, and to evaluate the frequency and results of repeat hrHPV testing. During a one-year study period (November
2005 to November 2006), a total of 3,440 cervical samples from women attending gynecological services of public
and private health care systems were received. They were tested for 13 hrHPV genotypes by the polymerase chain reaction
based AMPLICOR HPV test (Roche Molecular Systems). The overall prevalence of hrHPV was 34.6%.Most samples were
obtained from women aged 21–30 years (44.2%), followed by the 31–40 (27.6%), 41–50 (15.7%), 51–60 (5.3%) and ³61
(2.4%) age groups. Out of 3,227 cervical samples obtained from women of known age, 4.9% were obtained from the group
of girls younger than 21, in which the highest prevalence of hrHPV (49.4%) was found. A similar prevalence was observed
in women aged 21–30 (45.1%). The prevalence gradually decreased with age. During the study period, repeat
hrHPV testing was performed in samples from 66 women at different intervals. Out of 28 women that were hrHPV negative
on initial testing, only five women turned positive on repeat testing. Out of 38 women that were positive on initial
testing, in one-third hrHPV could not be detected on repeat testing. As expected, hrHPV infection was highly prevalent in
female adolescents and young women. Further investigation on repeat hrHPV testing is needed to assess virus clearance
and rate of newly acquired infection.
Darovano humano mlijeko je najbolja zamjena za majčino mlijeko u okolnostima kad ona ne može hraniti svoje dijete. Sigurno i kvalitetno darovano humano mlijeko osiguravaju banke humanog mlijeka. S ...tim ciljem u Hrvatskoj banci tkiva i stanica Kliničkog bolničkog centra Zagreb osnovana je Banka humanog mlijeka u siječnju 2020. Rad Banke u skladu je sa Zakonom o primjeni ljudskih tkiva i stanica. U ovom radu prikazujemo rezultate njenog rada od otvaranja do lipnja 2020. godine. Iz logističkih razloga uzrokovanih epidemijom COVID-19 i potresom u Zagrebu Banka humanog mlijeka nije prikupljala mlijeko 43 dana. Mlijeko je darovala 31 majka. Medijan dobi bio je 31 godina a 81% ih je bilo visokoobrazovanih. U 52% slučajeva majke su počele darivati mlijeko tri mjeseca nakon porođaja. Najviše darivateljica darovalo je mlijeko samo jedan put (45%). Medijan razdoblja darivanja bio je 46 dana. Većina (52%) darivateljica rodilo je prvi put, u očekivanom terminu porođaja (94%), djecu porođajne mase >2 500 gr. Samo troje od njihove djece (9%) bilo je na intenzivnom liječenju. Ukupno je prikupljeno 175,5 L mlijeka (prosječno 5,7 L/darivateljici), od kojih je 151,5 L zadovoljilo zahtjeve ulazne kontrole kakvoće, a 141 L je bila i pasterizirana. Kritičan broj vijabilnih, aerobnih i fakultativnih bakterija imalo je 32,6% mješavina mlijeka pripremljenih za pasterizaciju, a nakon nje 8,9%. Za kliničku primjenu izdano je 78,7 L u tri jedinice intenzivnog liječenja novorođenčadi. Već u prvim mjesecima rada Banka humanog mlijeka pokazala je važnost svog djelovanja. Kako bi mogli zadovoljiti potrebe za darovanim humanim mlijekom na nacionalnoj razini, potrebno je trajno podučavati/educirati majke o važnosti humanog mlijeka i promicati njegovo darivanje.
