Iako je razvoj molekularnih metoda omogućio učinkovitu dijagnostiku infekcije uzrokovane bakterijom Mycoplasma genitalium (M. genitalium), podaci o infekcijama uzrokovanih ovom bakterijom u Hrvatskoj ...su nedostatni, budući je dijagnostika vrlo zahtjevna te još uvijek nije rutinska metoda u mikrobiološkim laboratorijima. Cilj ovog rada bio je utvrditi učestalost M. genitalium u obriscima cerviksa i obriscima uretre muškaraca zaprimljenih u Službi za kliničku mikrobiologiju Nastavnog zavoda za javno zdravstvo "Dr. Andrija Štampar" radi testiranja na C. trachomatis. Istraživanje je provedeno u razdoblju od sedam mjeseci. Od ukupno 5057 zaprimljenih obrisaka cerviksa koji su bili testirani na C. trachomatis, 195 uzoraka je testirano na M. genitalium (99 C. trachomatis pozitivnih i 96 C. trachomatis negativnih). Testirano je i 52 obrisaka uretre muškaraca s negonokoknim uretritisom (18 C. trachomatis pozitivnih i 34 C. trachomatis negativnih). M. genitalium i C. trachomatis dokazivane su real-time PCR metodama, dok je gonokokna infekcija isključena pregledom izravnog mikroskopskog preparata. U obriscima cerviksa učestalost infekcije uzrokovane C. trachomatis iznosila je 2,04% (103/5057). Od 195 testiranih obrisaka cerviksa, M. genitalium je dokazana u 6 uzoraka (3,08%). Svi obrisci cerviksa pozitivni na M. genitalium bili su istodobno pozitivni i na C. trachomatis (6/99) dok niti jedan C. trachomatis negativan uzorak nije bio pozitivan na M. genitalium (0/96; P < 0,05). U obriscima uretre muškaraca s negonokoknim uretritisom M. genitalium je dokazana u jednom uzorku koji je bio C. trachomatis negativan. M. genitalium je važan, ali u našoj sredini nedovoljno prepoznat i nedovoljno dijagnosticiran uzročnik spolno prenosivih bolesti. Sukladno rezultatima ove studije testiranje na M. genitalium opravdano je izvoditi u sklopu rutinskog testiranja na spolno prenosive bolesti u obriscima cerviksa žena kod kojih je dokazana C. trachomatis infekcija.
Genital Mycoplasmas Ljubin‐Sternak, Suncanica
Diagnostics to Pathogenomics of Sexually Transmitted Infections,
11/2018
Book Chapter
Mycoplasmas are the smallest bacteria that are capable of living and replication outside the host cell. Genital mycoplasmas comprise those that primarily colonize genitourinary tract. Mycoplasmas are ...contained by a triple‐layered cell membrane and do not possess a cell wall. The genital mycoplasmas are parasites or commensals residing the genital tract of humans. Attachment of genital mycoplasmas to the host cells in the genitourinary tract of humans is a first step in a process of colonization and infection. Genital mycoplasmas can be transmitted by direct contact between hosts, most commonly through genital‐genital or oral‐genital contact. Genital mycoplasmas can cause disease of lower and upper urogenital tract both in men and women, and rarely extragenital clinical manifestation. Since genital mycoplasmas are primarily transmitted by sexual contact, standard precaution measures for safe sexual intercourse (i.e. condom use) will prevent the colonization/infection.
The aim of the present study was to show the virologic and epidemiological characteristics of non-polio enterovirus (NPEV) infection over a ten-year period in Croatia.
During the 2000-2009 period, ...the Laboratory for Enteroviruses, Croatian Public Health Institute analyzed 2754 clinical samples collected from 1880 patients with a clinical picture of enteroviral infection. The diagnosis of enteroviral infection was confirmed by virus isolation in cell culture. Viruses were typed using indirect immunofluorescence and/or neutralization assay.
NPEV was proven in 394 (21%) of 1880 patients. Males were more commonly infected than females, at a ratio of 1.8:1, while the number of infected cases was highest among preschoolers and schoolchildren. Patients with isolated NPEV were most frequently diagnosed with aseptic meningitis (234/394; 59.4%). Infections were most commonly caused by echoviruses (218/394; 55.3%), followed by Coxsackie B (126/394; 32.0%) and Coxsackie A (31/394; 7.9%) viruses, rarely by echovirus 22 - parechovirus 1 (16/394; 4.1%) and enterovirus 71 (3/394; 0.8%). In most cases, echoviruses of the following serotypes were proven: 6, 9, 11, 13, 14, 18 and 30 (45/218, 21%; 14/218, 6.4%; 18/218, 8.3%; 15/218, 6.9%; 11/218, 5.0%; 55/218, 25.2% and 42/218, 19.3%), while serotypes 2, 3, 4, 5, 7, 12, 20, 21,25 and 26 were evidenced in a minority of patients or individual cases. Coxsackie B5 was the predominant serotype among Coxsackie B viruses (50/126, 40%), while Coxsackie A9 was most common Coxsackie A virus (26/31, 84%). Coxsackie B5 and B4 viruses were continually detected during the study period and appeared more frequently every four to five years. The most common echovirus isolate was echovirus 18, detected continually between 2000 and the outbreak year of 2006. Echovirus 6 and echovirus 30 were also isolated continually with peaks in 2002 and 2008, or 2002, 2006 and 2008.
The results of this study pointed to a specific pattern of the occurrence of certain NPEV serotypes in Croatia. The epidemic pattern (echovirus 18 and Coxsackie 81) was characterized by peaks with an elevated number of isolations in given years. Contrary to this, endemic viruses were isolated in similar counts every year (Coxsackie B3), or manifested milder epidemic peaks every few years (echoviruses 30 and 6, Coxsackie B4 and B5). Data on NPEV infections, given their serotype and specific pattern of occurrence, contribute significantly to prompt diagnostic, clinical and epidemiological response to NPEV infections.
ERADIKACIJA POLIOMIJELITISA - KORAK DO CILJA LJUBIN-STERNAK, SUNČANICA; KAIĆ, BERNARD; VILIBIĆ-ČAVLEK, TATJANA ...
Acta medica Croatica,
07/2015, Volume:
68, Issue:
4-5
Web Resource
Open access
Dječja paraliza - bolest uzrokovana poliovirusom - poznata je od davnina. S pojavom epidemija u dvadesetom stoljeću poliomijelitis
postaje globalni javno zdravstveni problem. Svjetska zdravstvena ...organizacija (SZO) 1988. godine započinje kampanju s ciljem
eradikacije poliomijelitisa te je do danas broj slučajeva smanjen za više od 99 %. U Hrvatskoj je cijepljenje protiv dječje paralize
započelo već 1961. godine i dovelo do dramatičnog smanjenja obolijevanja. Eradikacija poliomijelitisa u Hrvatskoj proglašena
je 2002. godine istodobno s eradikacijom ove bolesti u Europi. Ipak, krajnji cilj - polio-free world još nije postignut. Stoga,
radna skupina globalne inicijative za eradikaciju poliomijelitisa donosi „Završni strateški plan 2013-2018“ u kojem su razrađeni
postupci s ciljem rješavanja: a) trajnog prijenosa divljeg soja u endemskim zemljama, b) reinfekcije područja bez poliomijelitisa
i c) epidemija dječje paralize uzrokovanih cirkulirajućim sojevima proizašlim iz cjepiva (cVDPV, engl. vaccine derived poliovirus).
Slijedi povlačenje oralnog, atenuiranog poliovirusnog cjepiva (OPV) i uvođenje inaktiviranog cjepiva (IPV) na globalnoj razini.
Cilj: Atipične bakterije česti su uzročnici pneumonija diljem svijeta. Etiologija se raz- likuje ovisno o zemljopisnom području te dobi ispitivane populacije. Cilj je ovog rada ispitati učestalost ...atipičnih bakterija u pacijenata hospitaliziranih s kliničkom slikom pneumonije. Ispitanici i metode: U razdoblju od 2009. do 2012. godine na najčešće uzročnike atipičnih pneumonija metodama ELISA i IFA testirano je ukupno 524 pacijenta hospitaliziranih u dvanaest bolnica u Hrvatskoj. Rezultati: Etiologija je dokazana u 303 (57,8 %) pacijenata. Najčešći dokazani uzročnik bila je Mycoplasma (M.) pneumoniae (145/47,9 %), zatim Chlamydophila (C.) pneumoniae (80/26,4 %), Legionella spp. (56/18,5 %) te Coxiella (C.) burnetii (21/6,9 %). Pneumonija uzrokovana C. trachomatis nađena je u samo jednog četveromjesečnog djeteta (0,3 %), dok C. psittaci nije dokazana niti u jednom slučaju. M. pneumoniae javljala se u svim dobnim skupinama, s najvećom učestalošću u dobnoj skupini od 10 do 19 godina (50,0 %). Prevalencija C. pneumoniae rasla je s dobi, počevši od dobne skupine od 30 do 39 godina. Le gionella spp. uzrokovala je većinom infekcije u osoba starijih od 40 godina, dok se C. burnetii javljala u svim dobnim skupi- nama. Pneumonije uzrokovane M. pneumoniae i C. pneumoniae javljale su se tijekom cijele godine. Legionarska bolest javljala se češće u ljetnim i jesenskim mjesecima. Sporadični slučajevi i manje epidemije Q-groznice zabilježeni su tijekom proljeća i jeseni. Zaključci: Rezultati ovog istraživanja pokaza- li su da su u 57,8 % pacijenata hospitaliziranih s kliničkom slikom pneumonije uzročnici bile atipične bakterije, s najvećom prevalencijom M. pneumoniae (47,9 %) i C. pneumoniae (26,4 %).
The aim of the study was to explore the prevalence of PTSD in refugees from Croatia and investigate the relationship between PTSD and the number of experienced traumas, especially with regard to ...being held in detention camp, as well as the relationship between PTSD and demographic variables. A group of refugees, consisting of 34 men and 54 women, mean age 43, were studied. Trauma Questionnaire and Watson's PTSD Interview were applied. The group experienced three traumas, on average; whereas after two years of life in captivity the prevalence of PTSD was 45.45%. It was established that the total of PTSD symptoms grow with the increasing number of traumas and with the refugee's age, but decrease with the person's higher education.
U razdoblju od 2009. do 2012. godine u Odsjeku za serološku dijagnostiku Hrvatskog zavoda za javno zdravstvo testirana su ukupno 124 uzorka seruma na prisutnost IgM/IgG protutijela na Rickettsia ...typhi i Rickettsia conorii metodom indirektne imunofluorescencije. Ispitanici su bili s područja 12 hrvatskih županija. U 10 (8%) testiranih uzoraka dokazana su IgG protutijela na R. typhi, a u 36 (29%) uzoraka IgG protutijela na R. conorii. Od njih je 5 (4%) bilo seropozitivno na obje rikecije. Seroprevalencija se nije značajno razlikovala između muškaraca i žena kao niti između dobnih skupina. Seropozitivni bolesnici bili su iz četiri županije priobalnog područja (Istarska, Ličko-Senjska, Šibensko-kninska i Dubrovačko-neretvanska županija), tri županije istočne Hrvatske (Požeško-slavonska, Brodsko-posavska i Osječko-baranjska županija) te područja grada Zagreba. Tijekom navedenog razdoblja, akutna infekcija R. typhi nije dokazana niti u jednog bolesnika. Akutna infekcija R. conorii dokazana u 11 bolesnika (pozitivan nalaz IgM/IgG protutijela) uz sezonsku pojavnost, od svibnja do studenog.
To evaluate the value of IgG avidity in diagnosis of congenital cytomegalovirus (CMV) infection in newborns and infants we collected serum samples from 40 infants under 12 months of age with ...suspected congenital CMV infection. Sera were tested for IgM, IgG and IgG avidity. For 25 of them, virus isolation and/or polymerase chain reaction (PCR) on urine specimens were performed. Thirteen (32.5%) patients showed the presence of CMV IgM antibodies, 3 (7.5%) had equivocal IgM result, and 24 (60.0%) patients had IgG antibodies only. Using IgG avidity, CMV infection (low avidity index- AI) was documented in 61.5% IgM positive and 54.2% IgM negative patients. Eight of nine (88.8%) IgM positive patients were positive either on virus isolation or PCR. In IgM negative patients, 46.6% urine cultures were positive for CMV and 66.6% were PCR positive. According to age, IgG avidity demonstrated acute/recent primary CMV infection in 58.8% patients younger than three months compared with 91.7% and 81.8% in 3–6 and 6–12 months old babies, respectively. In conclusion, IgG avidity is useful in diagnosis of CMV infection either in IgM positive or IgM negative children older than 3 months of age. In infants less than 3 months, transplacentally derived maternal IgG antibodies of high avidity influence on the IgG avidity result. In these children, CMV infection should be confirmed by direct virologic methods such as virus isolation or PCR.
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