Ageism: Does it Exist Among Children?

Ageism is stereotyping and prejudice against individuals or groups because of their age. Robert Butler first used it in 1969, to express a systematic stereotyping and discrimination against elderly people. Available data appears to confirm that attitudes of children to the old age differ from that of adults. The study population consisted of 162 subjects (56 school children, 48 nurses and 58 elderly patients). Each subject in the survey was asked to respond to the following three questions: Question #1: “Is the old age unattractive ?”; Question #2: “How old is an old man? Question #3: “What should you do to have a long life (what is good for longevity)? The majority of polled children (33) gave positive statements about ageing in their responses to the first item, while most of the nurses gave condition answers, like: “It is not unattractive if you are healthy”. Elderly subjects made up a group with the majority of negative responses (in percentage), as only 33% of them answered that old age is not unattractive. All three groups of subjects demonstrated a good knowledge of what is considered good for longevity, and had a generally positive health attitude. Our results indicate that majority of children have positive perception and attitude about old age, which leads us to conclusion that ageism is adopted later in life

Attitudes of medical students in Belgrade, Yugoslavia, toward preventive medicine and epidemiology

Medical students in Belgrade were interviewed regarding their opinions about the teaching of preventive medicine, with particular emphasis on epidemiology, at the beginning and at the end of the course. Results indicated that the course provoked no interest whatsoever in the disciplines of preventive medicine. A part of social factors influencing the motivation of students, the didactic approach to teaching and the strict division between preventive and clinical medicine were implicated as the main reasons for this lack of enthusiasm. The absence in this country of clear and generally accepted ideas regarding what a graduate student should know in order to meet optimally the health needs of the community has been assessed as the factor which obscures definition of the aims of teaching and, accordingly, the creation of purposeful syllabuses.

Distribution and antibiotic susceptibility of pathogens isolated from adults with hospital-acquired and ventilator-associated pneumonia in intensive care unit

Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are the most common hospital infections with the highest prevalence in intensive care units (ICU). The aim of this study was to investigate prevalence of bacterial pathogens isolated from ICU patients with HAP/VAP and reveal their susceptibility rates in order to establish a basis for empirical antibiotic therapy. Prospective cohort study was conducted in central ICU of Clinical Centre Kragujevac, Serbia, from January 2009 to December 2015, enrolling 620 patients with documented HAP (38.2%) or VAP (61.8%).Gram-negative agents were isolated in 95.2%. Generally, the most common pathogens were Acinetobacter spp. and Pseudomonas aeruginosa, accounting for over 60% of isolates. The isolates of Acinetobacter spp. in HAP and VAP had low susceptibility to the 3rd generation cephalosporins, aminoglycosides, fluoroquinolones (0–10%). The rate of susceptibility to piperacillin-tazobactam was below 15%, whereas for carbapenems and 4th generation cephalosporins it was about 15–20%. Isolates of P. aeruginosa from HAP and VAP showed low susceptibility to ciprofloxacin and gentamicin (below 10%), followed by amikacin (25%), while the rate of susceptibility to carbapenems and 4th generation cephalosporin was 30–35%. Furthermore, 86% of isolates of P. aeruginosa non-susceptible to carbapenems were also non-susceptible to ciprofloxacin. The highest level of susceptibility from both groups was retained toward piperacilin-tazobactam. In ICU within our settings, with predominance and high resistance rates of Gram-negative pathogens, patients with HAP or VAP should be initially treated with combination of carbapenem or piperacillin-tazobactam with an anti-pseudomonal fluoroquinolone or aminoglycoside. Colistin should be used instead if Acinetobacter spp. is suspected. Vancomycin, teicoplanin or linezolide should be added only in patients with risk factors for MRSA infections. Keywords: Hospital-acquired pneumonia, Ventilator-associated pneumonia, Microbiology, Resistance rat

Previous Antibiotic Exposure and Antimicrobial Resistance Patterns of Acinetobacter spp. and Pseudomonas aeruginosa Isolated from Patients with Nosocomial Infections

Background: The alarming spread of antibiotic-resistant bacteria causing healthcare-associated infections has been extensively reported in recent medical literature. Aims: To compare trends in antimicrobial consumption and development of resistance among isolates of Acinetobacter spp. and Pseudomonas aeruginosa that cause hospital infections. Study Design: Cross-sectional study. Methods: A study was conducted in a tertiary healthcare institution in central Serbia, during the 7-year period between January 2009 and December 2015. The incidence rate of infections caused by Acinetobacter or Pseudomonas, as well as their resistance density to commonly used antibiotics, were calculated. Utilization of antibiotics was expressed as the number of defined daily doses per 1000 patient-days. Results: A statistically significant increase in resistance density in 2015 compared to the first year of observation was noted for Acinetobacter, but not for Pseudomonas, to third-generation cephalosporins (p=0.008), aminoglycosides (p=0.005), carbapenems (p=0.003), piperacillin/tazobactam (p=0.025), ampicillin/sulbactam (p=0.009) and tigecycline (p=0.048). Conclusion: Our study showed that there is an association between the resistance density of Acinetobacter spp. and utilization of carbapenems, tigecycline and aminoglycosides. A multifaceted intervention is needed to decrease the incidence rate of Acinetobacter and Pseudomonas hospital infections, as well as their resistance density to available antibiotic

Risk factors of nosocomial infections caused by piperacillin-tazobactam resistant Pseudomonas aeruginosa

Introduction Pseudomonas aeruginosa is a common cause of serious infections in hospitalized patients and is associated with high rates of hospital morbidity and mortality. Objective The aim of this study was to identify the risk factors of nosocomial infections caused by piperacillin-tazobactam-resistant P. aeruginosa (PT-RPA). Methods A case-control study was conducted in the Clinical Centre Kragujevac from January 2010 to December 2011. Results In the observed period, 79 (38.16%) patients had PTRPA infections, while 128 (61.84%) patients had infections caused by piperacillin-tazobactam-sensitive P. aeruginosa (PT-SPA). Pneumonia was more frequently found in the PT-RPA group (55.70%) (p<0.05), whereas urinary tract infections were more frequent in the group of patients with PT-SPA infections (26.56%) (p<0.01). Multivariate analysis was used to identify an injury on admission (OR=3.089; 95%CI=1.438-6.635; p=0.004), administration of imipenem (OR=15.027; 95%CI=1.778-127.021; p=0.013), meropenem (OR=2.618; 95%CI=1.030-6.653; p=0.043), ciprofloxacin (OR=3.380; 95%CI=1.412-8.090; p=0.006), vancomycin (OR=4.294; 95%CI=1.477-12.479; p=0.007), piperacillin-tazobactam (OR=4.047; 95%CI=1.395-11.742; p=0. 010) as independent risk factors associated with PT-RPA infection. Conclusion In hospitalized patients, the risk of PT-RPA infec tions is associated with previous administration of imipenem, meropenem, ciprofloxacin, vancomycin, piperacillin-tazobac tam, and the presence of injury on admission

Hospital-Acquired Pneumonia in Newborns with Birth Weight Less Than 1500 Grams: Risk Factors and Causes

Low birth weight newborns (≤1500 grams) are at a high risk of acquiring hospital infections due to the immaturity of the immune system, lack of efficient structural barriers, and an incomplete development of endogenous microbial flora