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Plant essential oils have been reported to possess antimicrobial properties and therefore have potential usage as natural antimicrobials of food. The aim of the study was to examined the antimicrobial effect of sweet basil and thyme essential oils against growth and reproduction of Salmonella enteritidis reference strain ATCC 13076 (S. enteritidis RS) and Salmonella enteritidis epidemical strain (S. enteritidis ES) cultivated on plate. Therefore, the samples were prepared as a dip application from different concentrations of sweet basil and thyme essential oils (1%; 2.5% and 5%) with initial concentration of bacteria from 109 CFU/mL and were cultivated on plate. The control samples were prepared as dip application of bacteria without added essential oils. All samples were exposed at 37°C and 46°C. The growth of S. enteritidis RS and S. enteritidis ES was observed only in the control samples without added sweet basil and thyme essential oils. There was not any growth of both Salmonella еnteritidis strains in the samples dipped in the 1%; 2.5% and 5% sweet basil and thyme essential oils. The results from the ANOVA indicate that the utilized essential oils in combination with temperature regime was significantly (p

BACKGROUND: Global tuberculosis (TB) epidemic is being driven to an increasing extent by the emergence and spread of drug-resistant strains of Mycobacterium tuberculosis complex (MTBC). We present a case of primary multidrug-resistant tuberculosis (MDR-TB), highlighting Macedonian MDR-TB management issues.CASE REPORT: A 39-year old previously healthy Caucasian male, with no previous history of TB or close contact to TB, was admitted in referral TB-hospital due to respiratory bleeding. Chest X-ray revealed opacity with cavernous lesions in the right upper lobe. Sputum samples showed no presence of acid-fast bacilli (AFB) on fluorescence microscopy, but molecular tests (real-time PCR-based assay and multiplex PCR-based reverse hybridisation Line Probe Assay) confirmed the presence of MTBC, also revealing rifampicin and isoniazid resistance and absence of resistance to second-line anti-tubercular drugs. The strain was considered multidrug-resistant, lately confirmed by conventional methods in liquid and solid culture. Following the protocol of the World Health Organization, we started the longer treatment of MDR-TB comprised of at least five effective anti-tubercular drugs. Due to patient’s extreme non-adherence, we had to delay and modify the regimen (i.e. omitting parenteral aminoglycoside) and to discharge him from the hospital a month after directly observed therapy (DOT) in negative pressure room. As there is no legal remedy in our country regarding involuntary isolation, our patient continued the regimen under ambulatory control of referral TB-hospital. Ignoring the risk of additional acquisition of drug resistance and prolonged exposure of the community to MDR-TB strain - for which he was repeatedly advised - he decided to cease the therapy six months after beginning.CONCLUSION: The benefit of molecular tests in the early diagnosis of TB and drug resistance is unequivocal for adequate treatment of resistant forms of TB. Whole genome sequencing ensures additional knowledge of circulating strains and their resistance patterns. These are essentials of effective TB control programs and can provide evidence to medical and legal authorities for more active policies of screening, involuntary confinement and compliance with therapy, and alternative modalities for successful treatment, as a part of infection control.

Hasan, M. Shahnaz/0000-0002-7493-7416; Abouqal, Redouane/0000-0002-6117-4341; Altindis, Mustafa/0000-0003-0411-9669; Masjedi, Mansoor/0000-0001-6175-9289; Popescu, Roxana/0000-0002-9387-1141; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; Meco, Basak Ceyda/0000-0003-2951-9634; Kumar, Perikala Vijayananda/0000-0001-8315-7000; Zand, Farid/0000-0003-3489-3372; Maghsoudi, Behzad/0000-0002-1279-8799; KAMARUL ZAMAN, MAZUIN/0000-0002-7920-6399; Gan, Chin Seng/0000-0002-6758-4798; Horoz, Ozden Ozgur/0000-0001-7590-650X; Medeiros, Eduardo A/0000-0002-6205-259X; Sabetian, Golnar/0000-0001-8764-2150; UNAL, SERHAT/0000-0003-1184-4711; Gan, Chin Seng/0000-0002-6758-4798; Delia, Muntean/0000-0001-9100-4530; Yalcin, Ata Nevzat/0000-0002-7243-7354; Leblebicioglu, Hakan/0000-0002-6033-8543; Horhat, Florin George/0000-0001-6133-0204; Yousef, Reham H. A./0000-0003-4004-3008; Delgado Aguirre, Hector Alberto/0000-0001-5448-7975; El Kholy, Amani/0000-0002-0645-7664; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Sanaei Dashti, Anahita/0000-0002-2827-3575; KARABAY, OGUZ/0000-0003-1514-1685; Barahona G., Nayide/0000-0003-3559-6900; Stagnaro, Juan Pablo/0000-0003-3836-9957; Alexandru Florin, Rogobete/0000-0003-1286-4431; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Jayatilleke, Kushlani/0000-0002-3931-6630; Unal, Necmettin/0000-0002-9440-7893; Duszynska, Wieslawa/0000-0002-5880-4904; Ngo, Quy Chau/0000-0002-6787-2757; Elmanakhly, Arwa/0000-0001-8557-0536; yildizdas, dincer/0000-0003-0739-5108; Kanj, Souha/0000-0001-6413-3396; Gupta, Umesh/0000-0001-7717-1404 WOS: 000392626300014 PubMed: 27742143 Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DAHAI), we collected prospective data from861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central lineassociated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheterassociated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. VDR; Foundation to Fight against Nosocomial Infections The funding for design, development, maintenance, technical support, data validation, and report generation of the Surveillance Online System, and the activities carried out at International Nosocomial Infection Control Consortium headquarters, were provided by VDR and the Foundation to Fight against Nosocomial Infections.

Introduction. Although blood culture is considered a gold standard in diagnosis of invasive infections, it is still not reliable and fast enough for diagnosis of candidemia. Determination of serum (1,3)-⃞-D-glucan is a highly sensitive and specific test for invasive mycosis, and could probably be of benefit to patients with high risk for invasive infections with Candida species. Aim. The aim of this study was to prospectively evaluate the diagnostic performance of serum (1.3)-⃞-Dglucan BDG (Fungitell) assay, in comparison with blood culture, for diagnosis of invasive infections with Candida species. Methods. Blood and sera from 120 patients divided in 4 groups, hospitalized at the University clinics in Skopje, during a 2-year period, were investigated for invasive Candida infections. Blood was examined with conventional methods (automated BacT/Alert system, Gram stain and culture on fungal media). Identification of Candida species was performed with VITEK-2 system. Serum (1,3)-⃞-D-glucan was determined by means of Fungitell assay. Results. Positive blood culture was registered in 23.33%, 43.33%, 23.8% and in 3.33% of samples only in groups I, II, III and IV, respectively. Positive findings with (1,3)-⃞-D-glucan Fungitell assay at the same time with blood culture were detected in 83.33%, 76.67%, 30% and 26.67% in groups I, II, III and IV, respectively. The average concentration of BDG was highest in group I, followed by group II, group IV and group III. Conclusion. Our results suggest that a positive (1,3)-⃞-D-glucan assay could be a superior test in addition to the blood culture for diagnosis of candidemia and highlights the value of this test as a diagnostic adjunct in the serodiagnosis of an invasive candidiasis.

Candida species are opportunistic yeasts that can be a serious threat for immunocompromised and critically ill patients, and a cause for increased morbidity and mortality in hospitalized patients. The aim of this study was to determine the frequency and distribution of different Candida species in clinical specimens in patients with increased risk for fungal infections, and to determine the antifungal susceptibility profile of invasive Candida species to antifungal agents. During a two year period, clinical specimens from 120 patients divided into 4 groups were analysed at the Institute of microbiology and parasitology, Faculty of Medicine, Skopje, Republic of Macedonia. Each of these 4 groups consisted of specimens from 30 patients, with primary immune deficiency, critically ill patients treated in the intensive care units (ICU), patients with mucosal candidiasis only, and patients with cystic fibrosis. All specimens were investigated with conventional mycological methods. Identification of Candida species was performed with VITEK-2 system (bioMérieux, France). E-test strips of fluconazole, voriconazole, amphotericin B and caspofungin (AB bioMerieux, France) were used for determination of the antifungal susceptibility profile. In this study, a total of 115 isolates of Candida species were confirmed in different clinical specimens (91 isolates from mucosal surfaces and 24 isolates from blood culture). Colonisation of mucosal membranes of gastrointestinal, respiratory and/or urinary tracts was registered in 56.67% (17/30), 56.67% (17/30), 90% (27/30) and 100% (30/30) of the specimens in the first, second, third and fourth group respectively. In all four groups of patients, the following Candida species were confirmed: C. albicans - 55%, C. glabrata - 17.6%, C. parapsilosis - 7.7%, C. tropicalis - 6.6%, unidentified Candida species - 4.4%, C. dubliniensis - 3.3%, C. kefyr - 2.2%, and one isolate of C. rugosa, C. pelliculosa and C. krusei each. Positive blood culture was registered in 23.33% specimens from the first group, 43.33% in the second group, 23.08% of the third group, and in one specimen of the fourth group. The most frequent isolates from blood culture were C. tropicalis and C. krusei, followed by C. albicans, C. parapsilosis and C. tropicalis, and in the second group C. albicans and C. pelliculosa were equally distributed, followed by C. parapsilosis and C. glabrata. All invasive isolates of Candida species were susceptible to amphotericin B, voriconazole and caspofungin. Resistance to fluconazole was registered in 8.3% (2/24) of all confirmed Candida species. Dose-dependent susceptibility to fluconazole was confirmed in 46% (11/24) of the isolates. Our study confirms high prevalence of colonisation and candidemia with non-albicans Candida species. Resistance to antifungal agents was registered only in two isolates of C. krusei. An epidemiological study is necessary for surveillance of dynamics of candidemia and antifungal susceptibility profile of invasive isolates of Candida species in our patients.

There are many known essential oils of which only are commercially important for different types of industry Antimicrobials are used in food for two main reasons to control natural spoilage processes and to prevent control growth of micro organisms including pathogenic microorganisms The aim of this review was to investigate antibacterial effects of rosemary essential oils EOs on some Gram positive and Gram negative bacteria Staphylococcus aureus Bacillus subtilis Escherichia coli Proteus vulgaris Pseudomonas aeruginosa Listeria monocytogenes Salmonella enteritidis Salmonella typhimurium Rosmarinus officinalis essential oil is very important for its medicinal uses and its powerful antibacterial cytotoxic anti mutagenic antioxidant anti phlogistic and chemopreventive properties The antimicrobial and other biological activities of rosemary essential oil are directly correlated with the presence of bioactive volatile components To this end one possibility has been the use of rosemary essential oils EOs and the compounds found there in as alternative antimicrobial food preservatives The future will see investigation of food applications of the naturally occurring antimicrobials especially the effectiveness of rosemary EOs individually and in combination with other parts of plant extract other effective EOs and other food processing techniques

The specific aims of this study were to select the favorable prebiotic for L casei-01 as well as the suitable inoculum of the probiotic for fermented soy with ACE-inhibitory potential. For that purpose the metabolic activity of L casei-01 in soymilk supplemented with (1.5% w/v) prebiotics Fructooligosaccharide (FOS) or oligofructose enriched inulin (Synergy 1) was assessed. The evaluated parameters were: pH, viable cell counts, proteolysis, organic acid production and inhibition of angiotensine converting enzyme activity (IACE). The cell growth of L casei-01 reached the recommended therapeutic level of 9.58 ± 0.035 log cfu mL-1 for low inoculum samples (0.005 and 0.01%w/v) and 11.543 ± 0.13 log cfu mL-1 for high inoculum samples (0.075 and 0.1%w/v) regardless of the prebiotic used. The lower pH during fermentation, faster cell growth and superior proteolysis in Synergy 1 samples indicated better utilization of that prebiotic vs. FOS. The hydrolysis depended on the prebiotic used, showing higher values in Synergy 1 samples. The faster proteolysis was confirmed by SDSPAG electrophoresis. The Mw of polypeptides in the synbiotic end-products were lower than 30kD. The observed values for inhibition of ACE activity were app. 71, 74, 77 and 78% for inoculum rates of 0.005, 0.01, 0.075 and 0.1% w/v, respectively. Based on the results obtained in our study, the prebiotic Synergy 1 (1.5% w/v) and L. casei-01 at inoculum of 0.01% w/v for low dose and 0.075% w/v for high dose were considered more favorable for the production of synbiotic soy drink with antihypertensive potential.

A two years cross-sectional longitudinal survey was carried out for determination of udder pathogens prevalence and their antimicrobial profile in one commercial dairy farm. Dairy cows were selected in relation to date of calving and period of early lactation in order to minimize environmental impact.A udder quarters milk samples were obtained from totally 211 black-white dairy cows. The quarter milk-samples were screening using the California Mastitis Test (CMT) for detection of abnormal milk secretion (AMS) and from quarters with AMS were obtained milk-samples for microbiological examination in order to detect intramammary infections (IMI). The milk-samples were obtained in two periods: period from beginning of lactation until 21st day in lactation and period from 22nd to 42nd day in lactation. The prevalence of IMI in period from beginning of lactation until 21st day in lactation and period from 22nd to 42nd day in lactation was 4.03% and 4.38%, respectively. Based on CMT, there was found totally 162 udder quarters with AMS. From these quarters, the overall proportion of microbiological negative quarters was 56.17% and mastitis pathogens were isolated from 43.83% of udder quarters, from which the dominant mastitis pathogens were: Streptococcus agalactiae (19.14%), Enterococcus spp. (8.02%), Candida non-albicans (6.79%), Staphylococcus aureus (6.17%), Escherichia coli(1.85%), Aspergilus niger (1.23%) and Pseudomonas aeruginosa (0.62%). The results indicated that contagious pathogens were the most common patogens of IMI in early lactation. There was significant difference in the prevalence of intramammary infection (χ2=35.136, df=1, p

Aim: To establish a review in the current literature and to analyze the relation Legionnaires’ disease – TNF-α inhibitors, in order to estimate the real indications for such connection.Material and Methods: The electronic data for PubMed and Google Scholar have been searched, according to the vocabulary: legionellosis, epidemiology, outbreak, diagnosis, pathogenesis, therapy, TNF-α inhibitors, indications, side effects, risk of infection. The obtained studies have been selected in English, according to the relevance by the topic.Results: Selected papers, consisted of ten studies and eight case reports, yielded 35 cases of Legionnaires' disease associated with the use of TNF- α inhibitor treatment.Discussion: There is a prevailing conclusion for increased risk of serious infections while using TNF-α inhibitors and also a deficiency of studies for an association of Legionnaires’ disease with the use of TNF-α inhibitors. Sub-diagnosing and no-existence of screening before the anti-TNF-α therapy blur the factual profile for the researched relation. The possibility for latent infection has not been sufficiently researched.Conclusion: There are indications that Legionnaires’ disease in the therapy with TNF-α inhibitors is indeed a forthcoming problem. Additional target researches are required in order to establish the position of Legionnaires’ disease in the mosaic of anti - TNF-α therapy.

Background: Chronic infections in CHD are due to one or both of the organisms Chlamydia pneumoniae and Helicobacter pylori. Aim: To examine the association between serum markers of Chlamydia pneumoniae and Helicobacter pylori infection and markers of myocardial damage. in patients with acute coronary syndrome (ACS), with chronic coronary artery disease (CAD) and in–control group. Material and methods: Sera were taken from a total of 153 subjects. Subjects were divided in three groups: 64 patients with ACS; 53 patients with CAD and a group of 35 conditionally healthy individuals. Analysis of patients’ sera for IgG antibodies to H. pylori and markers for myocardial damage was done on the Immulite system.. The presence of specific IgG and IgA antibodies to C. pneumoniae was determined with MIF, Sero FIA (Savyon Diagnostics, Israel). Statistical analysis of data was done using the statistical program SPSS (Statistical Package for Social Sciences), version 13. Results and discussion: There was a high significant difference in troponin levels between the three groups of subjects (p=0.0000). Levels of creatine kinase isoenzyme (CK-MB) were highest in the ACS group (500.0 ng/mL). There was a statistically significant difference between CG subjects and ACS patients due to more frequent detection of antichlamydial IgA antibodies in patients with acute coronary syndrome. Positive serum immune response for Helicobacter pylori was 17 (53.1%) and 29 (80.6%), respectively. Conclusion: Increased IgA antibody titers for C. Pneumoniae, increased CRP values as well as classic markers of myocardial damage are risk factors for coronary events.

A 48-year-old man with retrosternal chest pain and upper abdominal pain with propagation to the back, with clinical signs of nausea, dyspnea and dysphagia was referred to the Clinics of thoracic surgery. After esophagography, operative treatment was indicated. Left thoracotomy with mediastinothomy were performed. During the operation, a sample of pus was taken and sent for a microbiological examination at the Institute of Microbiology and Parasitology, Medical Faculty in Skopje. Standard microbiological procedures were used. The sample was cultured anaerobically on Schaedler agar and incubated for 48 hours at 37oC. Oval, smooth colonies were observed. Gram stained smear revealed short branching Gram-positive filaments suspected for genus Actinomyces . For a definitive diagnosis and differentiation of the Actinomyces species, an automated VITEK system was used. Two weeks after treatment by ceftriaxon, metronidazol and analgetics, all clinical signs improved and patient was released in good physical condition.

Results. During one year period, 212 strains of E. coli and 103 strains of K. pneumoniae were isolated. Of these, the ESBL production was observed in 26 (11.8%) isolates of E. coli and 25 (24.3%) isolates of K. pneumoniae. ESBLproducing E. coli isolates were commonly recovered from the respiratory tract (21.4%) and urine (7.2%). ESBL-positive K. pneumoniae was commonly recovered from urine (38.5%) and respiratory tract (18.7%). ESBL-positive E. coli isolates were more susceptible to AMC (76%) and SXT (50%), than were the isolates of ESBLpositive K. pneumoniae (40% and 32%). Considering aminoglycosides, 92% of ESBL-positive E. coli and 60% of ESBL-positive K. pneumoniae were susceptible to amikacin vs. 23% and 40% of ESBL-positive E. coli and K. pneumoniae strains to gentamicin. ESBL-positive K. pneumoniae strains were more susceptible to ciprofloxacin (84%) than ESBL-positive strains of E. coli (38%). Cefepime shows the best in vitro activity of tested cephalosporins (58% for E. coli and 72% for K. pneumoniae). All isolates were susceptible to imipenem.

Background. According to immunological deficit the period after hematopoietic stem cell transplantation (HSCT) can be divided in three phases: aplastic phase, phase of acute GVHD, and phase of chronic GVHD. Fungal infections are predominant in first, aplastic phase. Deep neutropenia and implantation of central venous catheter are two major risk factors contributing to infection. Aim. To retrospectively analyze fungal infections, fungal isolates and to compare success of different antifungal strategies during the first 30 days after HSCT. Material and methods. During a 7 year period (2000-2007), we have performed 128 HSCT in 120 patients with different hematological diseases. Male: 62 Female: 58. Median age: 34 years. Patients were treated in sterile room, conditioned with HEPA filters, and low microbes diet. Antifungal prophylaxis with Fluconazole 200mg, Itraconazole 200mg, or combination Fluconazole200/Itraconazole 200 (in high-risk patients) was administered from day 0 until day +100. Results. Patients treated with combination of Fluconazole200/Itraconazol200 have had only few oropharyngeal candidiasis, without signs of invasive fungal infection. There is no statistically significant difference between the prophylaxis with Fluconazole and Itraconazole, (p=0,302). Non-Albicans Candida is predominantly isolated funga (Non-Albicans Candida vs. Candida Albicans: 54% vs. 46%). There is no isolation of Aspergillus during the first phase after HSCT in our group of patients. Concluson. The rising incidence of invasive fungal infections and the currently problematic early diagnosis call for an intensive exploration of new drugs and further developments in diagnosis and treatment of invasive fungal infection.

Viability of L. casei during fermentation in soymilk and freeze-dried soymilk; effect of cryoprotectant, rehydration and storage temperature The aim of the work was to investigate the behaviour of L. casei and the effect of sorbitol on its viability during fermentation in soymilk drink. Values for pH, ranging from 6.82 to 3.42 in the soymilk drink without sorbitol and from 6.74 to 3.41 in the drink with sorbitol were noted during 72 h of fermentation at 25oC. The corresponding values for titratable acidity ranged from 0.071% to 0.758% and from 0.073% to 0.761%, respectively. Soymilk was found to support the growth of L. casei with improvement in viability for 0.24 log at the end of fermentation when sorbitol was added. Survival of L. casei and the effectiveness of sorbitol in improving viability during freeze-drying, subsequent rehydration and during a 5-week period of storage under different temperatures were also investigated. After freeze-drying, L. casei exhibited a survival percent of approximately 46%. Sorbitol improved the viability of L. casei by 0.51 log immediately after freeze-drying and by 1.30 log and 0.47 log during five weeks of storage at 25oC and 4oC, respectively. Further study revealed that the freeze-dried fermented soymilk rehydrated at 45oC was optimum for the recovery of L. casei with improvement in recovery for 0.68 log when sorbitol was added. A higher percent of survival was noted when the dried soymilk was stored at 4oC than at 25oC with improved viability at the end of 5 weeks storage for approximately 6 log for drinks with and without sorbitol. Fermented dried soymilk with sorbitol afforded significant tolerance of L. casei to acid stress. Generally, a stable probiotic diary product was prepared in which the concentration of L. casei remained above therapeutic level of 107 cfu/ml.

The distribution of 3497 Staphylococcus aureus strains according to methicillin resistance, specimens, departmental profession and antibiotic resistance patterns was analysed. The strains were cultured from the patients of the Clinical Center of Skopje, Macedonia, between 1 January 2002 and 31 December 2004. The majority of the isolates was obtained from suppurated wounds (28.5%), nares (21%), intratracheal tubes (13%) and blood cultures (11.8%). Overall 1100 (31.4%) of the isolates was methicillin-resistant with 1 microg oxacillin disc. Of these 35.5%, 30.5% and 10.4% were cultured from wounds, intratracheal tubes and blood samples, respectively. The prevalence of MRSA strains was 78.6%, 75%, 44.2% and 37.3% in specimens of ICU, Coma Center, General Surgery and Haematology patients. There were extremely big differences in the frequency of MRSA between departments with particular specialisation. The 2397 MSSA isolates belonged to practically one antibiotic resistance pattern characterised with penicillin resistance and susceptibility to other antistaphylococcal drugs. The 1100 MRSA isolates distributed to four antibiotic resistance patterns on the basis of their resistance to oxacillin, penicillin, amoxicillin+clavulanic acid, azithromycin, clindamycin, amikacin, gentamicin, ciprofloxacin, trimethoprim+sulphamethoxasole, vancomycin and teicoplanin. All the MRSA isolates were multidrug resistant but sensitive to glycopeptides.

Backgorund: Acinetobacter baumannii is often referred to as the “Gram-negative methicillin-resistant Staphylococcus aureus”, because it is frequently resistant to antibiotics. Clonal outbreaks of carbapenem-resistant and OXA-23–producing A. baumannii have been reported worldwide. Aim: The goal of this study was to promote the phenomenon of disbalance in endemic hospital ECO system which included increase of carbapenemase-resistant Acinetobacter baumanii on account of reduction of MRSA rate in surgical ICU and it’s clonal relatedness as well as the specific precautions. Material nad Methods: Computer database from 1994 – 2012 from surgical ICU patients in the Clinical Center Skopje was used as basic material for this study. Comparative study indicated 2007/8 as a break point period in which almost a twofold decrease of MRSA rates (from over 80% to 45%) versus increased rates of Acinetobacter baumanii (from 29% to 40%) was observed. In 2011 the very first eight strains of carbapenem resistant (resistant to imipenem and meropenem) A. baumannii, were observed. Disc diffusion and VITEK were used for antibiotic susceptibility testing. Resultes: Three distinct strains were detected by PFEGE and were designated as UKIM01AC-1 (5 strains),UKIM01AC-2 (two strains) and 642/2 (one strain). UKIM01AC-1 representatives were PCR positive for bla (OXA-23-like), in addition to the bla (OXA- 51-like) gene which is intrinsic in Acinetobacter baumannii. All isolated strains belonged to European clone II lineage. Conclusion: This clone dispersed very fast in 2012 and achieved the rate of 61.9%. This implicated changes in infection control precautions. Keywords: Acinetobacter, Carbapenem Resistance, Clonal Distribution, Endemic ECO System

Maghsoudi, Behzad/0000-0002-1279-8799; Kritsotakis, Evangelos/0000-0002-9526-3852; Yalcin, Ata Nevzat/0000-0002-7243-7354; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; ALDEMIR KOCABAS, Bilge/0000-0002-6396-5243; Masjedi, Mohammad Reza/0000-0002-6871-382X; Masjedi, Mansoor/0000-0001-6175-9289; Gan, Chin Seng/0000-0002-6758-4798; Oncul, Oral/0000-0002-1681-1866; Sabetian, Golnar/0000-0001-8764-2150; YAMAN, Ayhan/0000-0002-5651-1286; Ozdemir, Halil/0000-0002-7318-1688; Leon, Hector Armando Rincon/0000-0003-0715-200X; Delia, Muntean/0000-0001-9100-4530; Atasay, Fatma Begum/0000-0002-9114-5293; Zand, Farid/0000-0003-3489-3372; Kuchenbecker, Ricardo/0000-0002-4707-3683; Medeiros, Eduardo A/0000-0002-6205-259X; ROMERO LOPEZ-ALBERCA, CRISTINA/0000-0001-5856-8668; Salomao, Reinaldo/0000-0003-1149-4598; ozdemir, sonay incesoy/0000-0003-2863-901X; Meco, Basak Ceyda/0000-0003-2951-9634; Horoz, Ozden Ozgur/0000-0001-7590-650X; Horhat, Florin George/0000-0001-6133-0204; Kazi, Mohammad Mukhit/0000-0003-3824-5540; Ciftci, Ergin/0000-0002-4955-160X; Abouqal, Redouane/0000-0002-6117-4341; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; Kendirli, Tanil/0000-0001-9458-2803; de Souza, Maria Cecilia B V/0000-0003-0318-3087; Sanaei Dashti, Anahita/0000-0002-2827-3575; UNAL, SERHAT/0000-0003-1184-4711; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Barahona G., Nayide/0000-0003-3559-6900; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517; ERDEVE, OMER/0000-0002-3193-0812; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Gikas, Achilleas/0000-0002-8455-9631; Baylan, Orhan/0000-0002-6529-7824; Mitrev, Zan/0000-0001-7859-8821; yildizdas, dincer/0000-0003-0739-5108; Ngo, Quy Chau/0000-0002-6787-2757; Duszynska, Wieslawa/0000-0002-5880-4904; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; Gupta, Umesh/0000-0001-7717-1404; Navarro Fuentes, Karla Reyna/0000-0002-6894-8872; zali, Mohammadreza/0000-0002-9027-4560; Morocho Tutillo, Diego Rolando/0000-0002-4974-7856; El Kholy, Amani/0000-0002-0645-7664; Kanj, Souha/0000-0001-6413-3396; Assiri, Abdullah/0000-0002-5605-2876; Unal, Necmettin/0000-0002-9440-7893; Jayatilleke, Kushlani/0000-0002-3931-6630; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000341307100001 PubMed: 25179325 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U. S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The objective of our research was to determine the presence of Chlamydia trachomatis in the women’s urethra in patients with an infection of cervix but without symptoms for a urinary infection. The study included 74 patients, 46 (62%) of which had subjective symptoms and 28 patients (38%) that didn’t have subjective symptoms for a genital infection. Urethral and cervical swabs were taken from all the patients included in the study. Chlamydia trachomatis was isolated from 18 patients (24.3%). Of these 18 patients, 10 patients had symptoms for a genital infection and 8 patients didn’t have symptoms for a genital infection. Chlamydia trachomatis was detected both in cervix uteri and the urethra in 16 patients, only in cervix uteri in one patient and only in the urethra in one patient. The obtained data shows that there is no significant difference in the presence of Chlamydia trachomatis in the groups of patients with and without symptoms for a genital infection, as well as a high degree of correlation between the presence of Chlamydia trachomatis in the urethra and cervix uteri, which in turn allows the introduction of the method of taking a urethral swab to detect Chlamydia trachomatis as a screening method.

Aim: To determine the most common bacteria isolated from wound specimens and to compare those culture results to Gram stain slides. Material and methods: A total of 1970 specimens from 1788 patients, treated in the University Clinics in Skopje during a one year period were examined by standard microbiology techniques (inoculation onto standard agar media and direct Gram-stained smears). Automatized Vitek system was used for identification of all anaerobes. Results: Out of a total of 1970 specimens, 1094 (55.5 %) were positive by culture. A total of 1462 strains were isolated: 753 Gram positive (Gram+), 661 Gram negative (Gram-) and 48 anaerobic bacteria. The number of specimens yielding one, two or more different strains was 788, 244 and 62, respectively. Gram + bacteria, in 44.7 % of positive samples were a single isolate. The most commonly isolated potential pathogen was Staphylococcus . In 23.7% samples, Gram negative bacteria were a single isolate ( E. coli was the most common isolate). 1094 specimens were positive by culture, 419 (38.3%) were positive by both culture and Gram stain and 675 (61.7%) were negative by Gram stain (leukocytes were present in 276 specimens). 876 specimens were negative by culture, 789 (90%) were negative by both culture and Gram stain (leukocytes were present in 271 specimen) and 87 (9.9%) were positive only by Gram stain. Conclusion: Our study demonstrated only a 38.3 % of microbiological correlation between Gram stain and culture. This data makes the clinical utility of Gram stain for the microbiological analysis of wounds questionable.