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Fifty-five healthy conscious dogs were included in a prospective randomised double-blinded clinical study. The dogs allocated to one of four groups received intravenous bolus followed by infusion of fentanyl (FEN-group), or ketamine (KET-group), or lidocaine (LID-group), or saline (SAL-group). The intraocular pressure (IOP), pupil size (PS), heart rate (HR) and mean arterial pressure (MAP) were measured prior to and at 2, 5, 10, 20 and 30 min after initiation of the drug administration. The data were analysed using an analysis of variance and the Steel-Dwass test. No significant difference in the IOP within or between the groups was detected. In the FEN-group, the PS decreased significantly at all the measured times. In the KET-group, the PS increased significantly at 2, 5 and 10 minutes. The PS was significantly smaller in the FEN-group compared to the KET-group at 2, 5, 10 and 20 min, compared to the SAL-group at 5, 10, 20 and 30 minutes. In the FEN-group the HR significantly decreased compared to the baseline and was significantly lower compared to the KET-group and LID-group. Fentanyl, ketamine or lidocaine administered at the doses studied as a bolus followed by a 30-min infusion seem to cause no effect on the IOP in healthy conscious non-painful dogs without ocular abnormalities. Fentanyl decreased and ketamine transiently increased the PS., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2022 Rauser et al.)

Background: We report the results of INICC surveillance study from 2013 to 2018, in 664 intensive care units (ICUs) in 133 cities, of 45 countries, from Latin-America, Europe, Africa, Eastern-Mediterranean, Southeast-Asia, and Western-Pacific., Methods: Prospective data from patients hospitalized in ICUs were collected through INICC Surveillance Online System. CDC-NHSN definitions for device-associated healthcare-associated infection (DA-HAI) were applied., Results: We collected data from 428,847 patients, for an aggregate of 2,815,402 bed-days, 1,468,216 central line (CL)-days, 1,053,330 mechanical ventilator (MV)-days, 1,740,776 urinary catheter (UC)-days. We found 7,785 CL-associated bloodstream infections (CLAB), 12,085 ventilator-associated events (VAE), and 5,509 UC-associated urinary tract infections (CAUTI). Pooled DA-HAI rates were 5.91% and 9.01 DA-HAIs/1,000 bed-days. Pooled CLAB rate was 5.30/1,000 CL-days; VAE rate was 11.47/1,000 MV-days, and CAUTI rate was 3.16/1,000 UC-days. P aeruginosa was non-susceptible (NS) to imipenem in 52.72% of cases; to colistin in 10.38%; to ceftazidime in 50%; to ciprofloxacin in 40.28%; and to amikacin in 34.05%. Klebsiella spp was NS to imipenem in 49.16%; to ceftazidime in 78.01%; to ciprofloxacin in 66.26%; and to amikacin in 42.45%. coagulase-negative Staphylococci and S aureus were NS to oxacillin in 91.44% and 56.03%, respectively. Enterococcus spp was NS to vancomycin in 42.31% of the cases., Conclusions: DA-HAI rates and bacterial resistance are high and continuous efforts are needed to reduce them., (Copyright © 2021. Published by Elsevier Inc.)

Background: Nasal polyps (NPs) are one of the most common inflammatory mass lesions of the nose, affecting up to 0.5-4% of the population. The pathogenesis of NPs has been studied widely, but it is not clearly understood. A possible role of S. aureus in nasal polyposis has been suggested by numerous studies. This study aimed to map S.aureus colonisation in NP patients in the nose in comparison to healthy controls., Material and Methods: We identified Staphylococcus aureus in nasal mucosal swab, collected from 58 patients with nasal polyposis from the out-patient ENT clinic of the Faculty Hospital in Nitra. We compared them to 50 patients without symptoms of nasal obstruction or NP. Isolated bacterial strains were then further identified., Results: In nasal mucosa membrane, results were not statistically significant. The selected population consisted of 108 patients, of which 58 (54%) had nasal polyps and 50 (46%) didnt. We collected the following information about patients from both groups: age, gender, smoker, presence of asthma, allergy and presence of Staphylococcus aureus by cultivation from nasal mucosa. In addition, for patients with nasal polyposis we have following variables, such as: presence inflammatory diseases, allergy to acylpyrine, cystic fibrosis. Out of 58 patients with nasal polyposis 15% (n=9) were found to have S.aureus in nasal mucosa membrane, compared to the healthy controls where 6% (n=3) of patients had S. aureus., Conclusion: Our results did not show that S. aureus found in nasal mucosa membrane is significantly different in patients with or without NP. However, association of the presence of S. aureus in patients with nasal polyposis with asthma, allergy and inflammation has been shown.

Background: Infective endocarditis (IE) is still a significant cause of mortality in European hospitals, despite of the fact, that large nationwide studies were performed in last twenty years and pathogens are well known. The aim of the study was to assess risk factors, mortality, etiology and proportion of elderly patients within a longitudinal nation wide survey of infectious endocarditis in Slovakia., Patients and Methods: Etiology, risk factors and outcome of 1003 cases of infective endocarditis (IE) in Slovakia over the last 33 years have been assessed., Results: The majority of IE were caused by Staphylococci (28.3%), 15.6% were due to Viridans streptococci, 10% due to Enterococci, 8.2% by gram-negative bacteria, Acinetobacter baumannii and Pseudomonas aeruginosa, 3.7% by other organisms and 31.0% of all cases were culture negative. The following risk factors were recorded: age > 65 (36.8%), rheumatic fever (15.3%), dental surgery (8.7%), previous non-cardiological surgery (8.2 %), neoplasia (8.1%), diabetes (7.8%), any endoscopy (8.5%) and dialysis (4.6%). All patients were treated with antimicrobials, 507 (51%) also with surgery. Survival rate at day 60 after diagnosis was 88.1% (n=883). Only age >65 (34.3% vs. 49.5%, p=0.045) and persistent bacteremia (with three or more positive blood cultures 15.7% vs. 34.5%, p=0,001) were significantly associated with higher attributable mortality. Concerning risk factors, etiology and therapeutic strategies, rheumatic fever and neoplasia showed decrease in tendency. Dental surgery and tonsillitis were less frequent as well (26.7% vs. 2%, p<0,001 and 16% vs. 1%, p<0.001). There was a significant shift in etiology after 1997: culture-negative endocarditis was surprisingly more frequently observed in the 2007-2017 period than before and represented 10.7% of all cases in 1984-1990 in comparison to 25.1-25.6% in 2007-2010 and 2011-2017. Staphylococci decreased from 48% to 29.6% (2007-2017), but are still major pathogens. Persistent bacteremia (3 or more positive blood cultures 5.3% vs. 24.7%, p<0,001) was less commonly observed within the 1st period (1984-1990) in comparison to 2007-2010. More patients in the 1st period (1984-1990) had embolization complications of IE than in the fifth and sixth period (2007-2017) (76 vs. 16.3% p<0.001). CNS embolization decreased from 14% to less than 5% (p<0.003). Attributable mortality was lower too (26.7% vs. 9.5%, p<0.001) because of increased proportion of cardiac surgery in the treatment of IE in 2007-2017 in comparison to 1984-1990., Conclusions: Study has showed significant shifts in etiology, risk factors and complications over the observed time periods in Slovakia.

Analysing 101 cases of nosocomial meningitis due to staphylococci other than S. aureus within last 15 years, coagulase negative staphylococci represented the commonest pathogen. Major risk factor for staphylococcal meningitis was prior neurosurgery, mainly ventriculoperitoneal shunt insertion. Ten of 101 cases were caused by glycopeptide intermediate resistant strains in patients pretreated with multiple combination of antibiotics including vancomycin and shunt exchanges: 76% of strains were also oxacillin resistant.

Risk factors, mortality and antimicrobial susceptibility of Pseudomonas aeruginosa bacteremias isolated from 148 patients from all University Hospitals in Slovakia were analyzed. Only 1.2% of 169 strains of P. aeruginosa were resistant to meropenem, 4.1% to piperacillin/tazobactam, 7.7% to ceftazidime as well as cefepime and 12% to amikacin. More than 30% of P. aeruginosa were resistant to ciprofloxacin. Our analysis of risk factors for antimicrobial resistance to the particular antimicrobials, indicated no difference in risk factors and outcome in cases infected with P. aeruginosa bacteremias resistant to amikacin, piperacillin/tazobactam or ceftazidime in comparison to episodes caused by P. aeruginosa due to susceptible isolates. When comparing risk factors for P. aeruginosa bacteremia in children vs. adults, cancer vs. non-cancer patients, several differences in risk factors were observed. Neither antimicrobial resistance to amikacin, ceftazidime or piperacillin/tazobactam, nor appropriateness of therapy according to two separate analyses were associated with better outcome.

Objectives: The aims of this study were to evaluate risk factors, clinical presentation, outcome and antimicrobial susceptibility in patients with Escherichia coli bacteremia occurring over seven years in a single cancer hospital., Methods: Sixty five episodes of bacteremia from E. coli appearing over seven years from 12,301 admissions in a single cancer institution were retrospectively analyzed., Results: The proportion of bacteremia caused by E. coli among Gram-negative bacteremia was 20.8% (the second most common organism after Pseudomonas aeruginosa), and infection-associated mortality was 17%. The incidence in 1989-1995 varied from 14.3 to 24.7%. The most common risk factors were: solid tumors as the underlying disease (70.7%); central venous catheter insertion (32.3%); prior surgery (46.2%), and prior chemotherapy within 48 h (44.4%). Neutropenia and urinary catheters did not place patients at high risk in any of the subgroups. When we compared the two subgroups of 61 cases of bacteremia - monomicrobial and polymicrobial (when E. coli was isolated from blood culture with another microorganism) - we found that acute leukemia and breakthrough (recurrence while receiving antibiotics) bacteremia were more frequently associated with polymicrobial E. coli bacteremia. There was also a difference in infection-associated mortality: monomicrobial bacteremia due to E. coli only had a significantly lower mortality in comparison with polymicrobial E. coli bacteremia (8.9 vs 35.0%, respectively; P<0.03)., Conclusion: The susceptibility of 115 E. coli strains isolated from 65 episodes of bacteremia was stable. Only two episodes caused by quinolone-resistant strains occurred, both in 1995, after six years of using ofloxacin for prophylaxis in neutropenic patients in our hospital. We found that 85.2-91.3% of all strains were susceptible to aminoglycosides, 97.8% to quinolones, and 90-100% to third generation cephalosporins and imipenems. The patients most commonly infected had solid tumors and the mortality was only 17%.

The serological diagnostics of suspicions of measles is of ever growing importance with adequately decreasing morbidity. The utilization of the complement binding reaction is compared with results of the haemagglutination test, the IgG enzyme immunoassay, the IgG and IgM immunofluorescence technique and the haemadsorption immunosorbent test for IgM prove of measles. The virus-specific methods of evidence prove to be favourable ones. The present possibilities of the decentralized routine diagnostics in district laboratories make the complement binding reaction a reliable method.