Browsing by Author "Pavić, Sladjana (6603595864)"

Clostridium (Clostridioides) difficile infections (CDIs) are among the most frequent healthcare-associated infections in Serbia. In 2013, Serbia participated in the European Clostridium difficile Infection Surveillance Network (ECDIS-Net) who launched a pilot study to enhance laboratory capacity and standardize surveillance for CDI. Two clinics of Clinical Center of Serbia [Clinic for Infectious and Tropical Diseases (CITD) and Clinic of Orthopedic Surgery and Traumatology (COT)] from Belgrade and one general hospital from another metropolitan area of Serbia, Užice, participated. During a period of 3 months in 2013, all patients with diagnosed CDI were included. The CDI incidence rates in CITD, COT, and General Hospital Užice were 19.0, 12.2, and 3.9 per 10,000 patient-days, respectively. In total, 49 patients were enrolled in the study with average age of 72 years. A complicated course of CDI was found in 14.3% of all patients. Six (12.2%) of 49 patients died, but not attributable to CDI. Of 39 C. difficile isolates, available for ribotyping, 78.9% belonged to ribotype 027; other PCR ribotypes were 001, 015, 002, 005, 010, 014, and 276. Antimicrobial susceptibility testing revealed low levels of MIC50 and MIC90 for metronidazole (0.5 μg/ml both) and vancomycin (0.25 and 0.5 μg/ml), while 28 strains of ribotype 027 were resistant to moxifloxacin with MIC ≥4 μg/ml. National surveillance is important to obtain more insight in the epidemiology of CDI and to compare the results with other European countries. This study by ECDIS-Net gives bases for a national surveillance of CDI in Serbia. © 2019 Akadémiai Kiadó, Budapest.

Clostridium (Clostridioides) difficile infections (CDIs) are among the most frequent healthcare-associated infections in Serbia. In 2013, Serbia participated in the European Clostridium difficile Infection Surveillance Network (ECDIS-Net) who launched a pilot study to enhance laboratory capacity and standardize surveillance for CDI. Two clinics of Clinical Center of Serbia [Clinic for Infectious and Tropical Diseases (CITD) and Clinic of Orthopedic Surgery and Traumatology (COT)] from Belgrade and one general hospital from another metropolitan area of Serbia, Užice, participated. During a period of 3 months in 2013, all patients with diagnosed CDI were included. The CDI incidence rates in CITD, COT, and General Hospital Užice were 19.0, 12.2, and 3.9 per 10,000 patient-days, respectively. In total, 49 patients were enrolled in the study with average age of 72 years. A complicated course of CDI was found in 14.3% of all patients. Six (12.2%) of 49 patients died, but not attributable to CDI. Of 39 C. difficile isolates, available for ribotyping, 78.9% belonged to ribotype 027; other PCR ribotypes were 001, 015, 002, 005, 010, 014, and 276. Antimicrobial susceptibility testing revealed low levels of MIC50 and MIC90 for metronidazole (0.5 μg/ml both) and vancomycin (0.25 and 0.5 μg/ml), while 28 strains of ribotype 027 were resistant to moxifloxacin with MIC ≥4 μg/ml. National surveillance is important to obtain more insight in the epidemiology of CDI and to compare the results with other European countries. This study by ECDIS-Net gives bases for a national surveillance of CDI in Serbia. © 2019 Akadémiai Kiadó, Budapest.

Background: Primary hepatocellular carcinoma (HCC) is the most common liver malignancy. Aim: To identify the clinical characteristics of patients with HCC and the factors for its occurrence. Methods: A total of 110 hospitalized patients with HCC was investigated. Histological diagnosis of underlying liver disease was done in 93 patients. Biochemical and hematological parameters were obtained by routine biochemical and hematological techniques. Serum markers for hepatitis B and C viruses and autoantibodies were determined. SPSS version 17.0 was used for statistical analyses and p<0.05 was considered significant. Results: Patients were aged from 48 to 82 years (65,8 ± 7). Males dominated (74 pts). Solitary HCC pattern was observed in 87 patients. Viral etiology was proven in 61 patients while alcoholic liver disease was detected in 21 patients. Increased AFP values (≥ 20 ng/ml) were obtained in 88 pts; values ≥200 ng/ml in 71 pts, and values ≥400 ng/ ml in 57 pts. The clinical presentation was dominated by fatigue, gynecomastia, and bone aches. The most common comorbidities were diabetes mellitus type 2 (53 pts), chronic cardiomyopathy/arterial hypertension (48 pts), and obesity (29 pts). Comparison of patients with and without cirrhosis (66/110) showed no difference in age, gender, tumor pattern, and AFP values ≥20 ng/ml. Those from the first group had higher AFP, larger solitary tumors, greater liver damage and more pronounced clinical symptoms. Conclusions: HCC is mostly detected in liver cirrhosis. Other risk factors include hepatitis B and C viruses, heavy alcohol abuse, older age, male gender, metabolic and chronic cardiovascular diseases. © 2024 by Acta Medica Saliniana.

Objectives: In humans, enterococci are among the most important opportunistic pathogens. This study aims to compare invasive isolates obtained from blood cultures of patients with sepsis and endocarditis with colonizing isolates obtained from healthy donors’ stool samples. Methods: A case-by-case assessment was conducted on invasive infection cases to determine whether enterococci were involved in their pathogenesis. They were tested for the presence of virulence factor genes, β-hemolysis on agars supplemented with human and sheep blood, and biofilm forming capacity. Results: Three species of enterococci were identified among invasive isolates: Enterococcus faecalis, Enterococcus faecium, and Enterococcus durans. All endocarditis isolates were biofilm producers. Genes esp, gelE, asa1, ace, hyl, cylB, and cylA were present in 7 (41.2%), 11 (64.7%), 11 (64.7%), 13 (76.5%), 0, 3 (17.6%), and 1 (5.9%) invasive isolate, but none of them could be linked to a particular infection (sepsis or endocarditis). Colonizing isolates proved to have had more virulence factor genes, but the differences were not statistically significant. Members of that group produced a greater amount of biofilm when the ace gene was absent (p = 0.047). The production of β-hemolysis by noninvasive strains was detected more frequently when agar was supplemented with human blood (p = 0.021). In general, the presence of either cyl gene on that specific agar was in direct connection with the production of β-hemolysis: cylA (p = 0.047) or cylB (p = 0.020). Conclusion: We have been unable to establish any correlation between invasive isolates and any virulence gene carriage and biofilm formation. β-hemolysis was produced significantly more often by colonizing strains when agar had been supplemented with human blood. © The Author(s) 2023.

Objectives: In humans, enterococci are among the most important opportunistic pathogens. This study aims to compare invasive isolates obtained from blood cultures of patients with sepsis and endocarditis with colonizing isolates obtained from healthy donors’ stool samples. Methods: A case-by-case assessment was conducted on invasive infection cases to determine whether enterococci were involved in their pathogenesis. They were tested for the presence of virulence factor genes, β-hemolysis on agars supplemented with human and sheep blood, and biofilm forming capacity. Results: Three species of enterococci were identified among invasive isolates: Enterococcus faecalis, Enterococcus faecium, and Enterococcus durans. All endocarditis isolates were biofilm producers. Genes esp, gelE, asa1, ace, hyl, cylB, and cylA were present in 7 (41.2%), 11 (64.7%), 11 (64.7%), 13 (76.5%), 0, 3 (17.6%), and 1 (5.9%) invasive isolate, but none of them could be linked to a particular infection (sepsis or endocarditis). Colonizing isolates proved to have had more virulence factor genes, but the differences were not statistically significant. Members of that group produced a greater amount of biofilm when the ace gene was absent (p = 0.047). The production of β-hemolysis by noninvasive strains was detected more frequently when agar was supplemented with human blood (p = 0.021). In general, the presence of either cyl gene on that specific agar was in direct connection with the production of β-hemolysis: cylA (p = 0.047) or cylB (p = 0.020). Conclusion: We have been unable to establish any correlation between invasive isolates and any virulence gene carriage and biofilm formation. β-hemolysis was produced significantly more often by colonizing strains when agar had been supplemented with human blood. © The Author(s) 2023.

Introduction Pronounced symptoms of depression and disorders of cognitive functions can be observed in patients with chronic hepatitis B. Objective The objective of the study was evaluation of the severity of symptoms and predictive factors for depression and the existence of cognitive disorders in patients with chronic hepatitis B. Methods A total of 150 respondents were included in this prospective study (50 patients with chronic hepatitis B, 50 patients with other chronic liver diseases and 50 healthy persons). The patients with chronic hepatitis B were homogeneous by age compared to healthy subjects (p=0.566) and patients with other chronic liver diseases (p=0.528). Assessment of intensity of depression was determined by the Hamilton Depression Rating Scale (HAMD). A Mini Mental State Examination (MMSE) test was used to investigate the presence of cognitive disorders. Results Significantly expressed depression was observed in patients with chronic hepatitis B compared with healthy persons as well as the occurrence of cognitive dysfunction (p=0.00), while in comparison with the patients with chronic nonviral liver diseases, depression was statistically significantly less markedly expressed (p=0.003). Depression and cognitive dysfunction were more noticeable in patients with chronic hepatitis B in the stage of liver cirrhosis in relation to the early stage of the disease. Multivariate analysis of variables related to the sociodemographic characteristics showed that the most significant positive predictor of depression was more expressed in older age (over 50 years) (B=0.276; SE=0.092; p=0.004). Conclusion Patients with chronic hepatitis B have a higher intensity of depression compared to healthy people, which is intensified with the progression of the disease. The highest expression of depression is expected in the elderly. Patients with chronic hepatitis B have a lower intensity of depression and fewer disorders of cognitive functions than patients with other chronic liver diseases. © 2015 Serbia Medical Society. All rightsreserved.