Professional Realization and Label Market Problems – Nursing Program Student Survey

Given the shortage of nurses in Bulgaria, there stands at the forefront need of attracting of well-trained health care professionals to take care of the patients.It is beneficial for employers to be informed about student attitudes when choosing a job. Objective: The aim of the study was to explore the preconceptions of students in "Nurse" in the fourth course on professional realization and to give recommendations to the users of the staff.Methods: An anonymous survey was conducted amongst fourth year student nurses. Respondents were (52 students, aged 20 – 36).Results: The opinion of the students about sector, the therapeutic unit, the age group of patients with whom they would like to work, the preferences for work shifts, and their motivation to improve their qualification were investigated.The analysis of the results showed strong motivation and willingness to practice the profession - (94.23%) and improvement of competences through courses, specializations, etc. - (80.76%) and continuing education in a Master's degree (57.69%). The majority of the respondents (82.69%) pointed out as motivation for work the remuneration for the work done adequately.The analysis of the results revealed some worrying trends - the most preferred countries for practicing the profession are: Germany - (59.61%), USA - (17.30%), UK - (15.38).It was found that 15.38% of the respondents stated willingness for Continuing education abroad.Conclusion: In view of the increasing migration in countries in and outside the European Union, there are still reserves to improve the recruitment of staff in Bulgaria. It is extremely important to "rejuvenate" the aging population of nurses.The specificity of work and delicacy in serving sick people is a challenge for newly-educated nurses looking for better pay for their work and satisfaction with practicing the profession

Correlation of methicillin resistance and virulence genes of Staphylococcus aureus with infection types and mode of acquisition in Sofia, Bulgaria

Background: Infections due to methicillin resistant Staphylococcus aureus (MRSA) which is the most virulent species among the staphylococci have become a global health challenge. The aim of this study was to assess the correlation of genes encoding virulence and methicillin resistance in invasive and non-invasive isolates from inpatients/outpatients with staphylococcal infections in Sofia, Bulgaria.Materials and methods: Non-duplicate S. aureus isolates were recovered from clinical samples obtained from a total of 368 in-patients with healthcare-associated infections and outpatients with community acquired infections, following overnight cultures of samples on Columbia agar with 5% sheep blood at 35°C. The isolates were presumptively identified by colony and Gram stain morphology, positive catalase reaction and plasma-coagulase test. Isolates were screened for methicillin resistance by the cefoxitin disk method according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) protocol. The mecA and mecC, and 12 staphylococcal virulence genes were detected by a combination of monoplex and multiplex polymerase chain reaction (PCR) assays.Results: The prevalence of MRSA based on carriage of mecA gene was 12%; 7.7% for outpatients and 16.2% for inpatients (p<0.05). The frequency of toxin genes detection in the staphylococcal isolates were as follows; sei (72.6%), seb (59.8%), seh (41.3%), sec (38.3%), seg (37.5%), sej (32.3%), sea (26.6%), sed (10.3%), tst (6.5%), and see (4.3%). The virulence genes, tst, sea, seb, sec, seg, seh and sei were more frequently associated with MRSA than methicillin sensitive (MSSA) strains (p<0.05). About one-third of the clinical S. aureus isolates harbored seven virulence genes; sea, seb, sec, see, seg, seh and sei, that were detected significantly more among the invasive isolates (p<0.05).Conclusions: This study shows the occurrence of highly virulent staphylococcal isolates in our geographical region.Keywords: Staphylococcus aureus, virulence, methicillin resistanc

Historical Review And Analysis Of Contemporary Aspects In The Treatment Of Acute And Chronic Form Of Q-Fever

Световно разпространената зооноза Ку-треска се причинява от вътреклетъчния микроорганизъм Coxiella burnetii. Заболяването е ендемично за нашата страна и има две форми на протичане - остра и хронична. Поради неспецифичната симптоматика на Ку-треската поставянето на точна диагноза и правилно лечение са затруднени. В исторически план лечението на заболяването е претърпяло много промени, свързани с различни in vitro модели за проучване на чувствителността на Coxiella burnetii към антибиотични комбинации. За съвременното лечение на острата форма на Q-треската (Ку-треската) при възрастни се използва 100 mg доксициклин два пъти дневно за 14 дена, a при бременни се препоръчва ко-тримоксазол (триметоприм/сулфаметоксазол: 160 mg / 800 mg) два пъти дневно до последните шест седмици на бременността. Aктуалната терапия на хроничната форма на заболяването включва 100 mg доксициклин два пъти дневно, комбинирани с хидроксихлорохин три пъти дневно при 200 mg на доза в продължение на най-малко 18 месеца.Worldwide spread Q-fever zoonosis is caused by the intracellular microorganism Coxiella burnetii. The disease is endemic to our country and has both acute and chronic forms. Due to the non-specific symptoms of Q-fever, accurate diagnosis and proper treatment are difficult. Historically, the treatment of the disease has undergone many changes associated with various in vitro models for studying the sensitivity of Coxiella burnetii to antibiotic combinations. For acute treatment of the acute form of Q-fever in adults, 100 mg doxycycline is used twice daily for 14 days, and co-trimoxazole (trimethoprim/sulfamethoxazole: 160mg/800mg) twice daily during pregnancy is recommended up to the last six weeks of pregnancy. Current chronic disease therapy includes 100 mg doxycycline twice daily combined with hydroxychloroquine three times a day at 200 mg per dose for at least 18 months

Prevention of infections by vaccines and immune modulators

Откриването и внедряването на ваксините и имуномодулаторите в медицинската практика е огромна крачка напред в предотвратяване на инфекциозните заболявания, някои от които са завършвали фатално при миналите векове. С прогреса в медицинската наука непрекъснато се усъвършенства имунопрофилактиката, като се разработват по-модерни технологии за по-безопасни и ефективни ваксини, което повишава здравния статус на обществото, изчезват смъртните и инвалидизиращи тежко протичащи случаи, намаляват разходите за лечение. Цел на тази разработка е да представи класификацията на видовете ваксини и имуномодулатори, както и съвременното състояние на ефекта от приложението им за превенция на инфекциозни заболявания. Материал и методи: Събрана е актуална информация от научни източници на информация по темата ваксинопрофилактика и имуномодулатори. Тя е анализирана, систематично представена и илюстрирана с подходящи графики. Резултати и обсъждане: Показано е значението на ваксините и имуномодулаторите за ограничаване на редица опасни вирусни и бактериални инфекции, напр. успешната ерадикация на вариола. Представена е съвременна класификация на тези средства за имунопрофилактика. Изброени са използваните понастоящем в България ваксини и имуномодулатори, разгледан е актуалният към момента на проучването имунизационен календар. Обективно са разгледани както полезните ефекти от приложението им, така и някои нежелани, странични ефекти. Проследени са тенденции за бъдещото развитие на имунопрофилактиката в България и в света. Изводи: Ефектът от прилагането на ваксини и имуномодулиращи средства не само за профилактика, но и при терапия на някои инфекциозни заболявания през последните две столетия е доказан в медицинската наука и в практиката. Силно ограничени и облекчени по протичане са инфекции, причинени от силно патогенни вируси и бактерии. Наблюдава се ефект и срещу някои туморни образувания. За повишаване на ефективността от прилагането им, в световен мащаб, се изискват планирани и координирани усилия на здравните институции в отделните страни, a това се постига благодарение на обединяващата дейност на СЗО.Introduction: The discovery and implementation of vaccines and immune modulators in medical practice is a huge step forward towards the prevention of infectious diseases, some of which have lead to a fatal outcome during the past centuries. Immune prophylaxis has been continuously improving along with the progress in medical sciences by developing more advanced technologies for safer and more effective vaccines, which increases the health status of the population of our society. The deaths and severely debilitating cases have disappeared and the cost of treatment has been reduced. Aim: The aim of this work is to present the classification of vaccines and immune modulators, as well as the current state of the effect of their application on the prevention of infectious diseases. Materials and Methods: Current information from scientific sources on the prevention by vaccines and immune modulators has been accumulated. It has been analyzed, systematically presented and illustrated by appropriate graphics. Results and Discussion: The importance of vaccines and immune modulators for limiting a number of dangerous viral and bacterial infections, such as successful eradication of smallpox, is shown. Contemporary classification of these agents for immune prophylaxis is presented. The vaccines and immune modulators used nowadays in Bulgaria are listed, the up-to-date immunization calendar is considered. Both the beneficial effects of their application and some undesirable side effects are objectively presented. Trends for the future development of immune prevention in Bulgaria and in the world are traced.Conclusions: The effect of application of vaccines and immune modulating agents in medical science and practice has been proved to be useful not only for prophylaxis but also for therapy of some infectious diseases during the last two centuries. Very limited and relieved are infections caused by strong pathogenic viruses and bacteria. Also, an effect against some tumor formations has been established. To increase the effectiveness of their implementation worldwide, planned and coordinated efforts of healthcare institutions in all the countries are required, and this is achieved thanks to the unifying activity of WHO

Marin Vassilev and the Study of Books

The text is dedicated to the 100th anniversary of Marin Vassilev (1907-1983) - one of the founders of library education in Bulgaria. After 1952, as Professor of knigoznanie (the study of books) at St. Kliment Ohridski University of Sofia, he followed the traditions in the field established by well-known scholars such as Stilian Kutinchev (1872-1934), Nikola Nachov (1859-1940), Stoian Argirov (1870-1939), and Todor Borov (1901-1993). His textbooks - Istoria i technika na knigata, 1955 (History and technique of the book); Obshto i prolozhno knigoznanie, 1963, 1970 (General and applied study of books), and Knigoznanie, 1971 (The study of books), the last one coauthored with Vl. Vatrachki – present the basic concepts of knigoznanie; the history of the European and Bulgarian book; and the technological aspects of book production. Vassilev’s publications insist that knigoznanie is fundamental for understanding of the past, present and future of the book and of the contemporary cultural politics.Доклад от научната конференция "Строители на съвременното библиотечно-информационно образование в България", проведена на 8 февруари 2007 г. в София

Prevalence of Helicobacter pylori is still high among symptomatic Bulgarian children

Helicobacter pylori positivity was assessed among 656 symptomatic children in 2010–2017. Overall infection prevalence was 24.5% and a significantly higher rate was detected in girls (28.5%) compared to boys (20.0%). Moreover, in children with duodenal ulcer, H. pylori prevalence was higher (47.4%) compared with the rest (23.9%). On the contrary, the infection was detected 1.9-fold less frequently in patients with GERD (14.5%) compared with the other (27.0%) patients and 2.1-fold less often in the presence of duodenogastric reflux (bile) reflux (13.0%) compared with the absence of the reflux (27.0%). No significant difference was observed between the younger (aged ≤7 years, 20.0%) and the older (aged 8–18 years, 25.5%) patients. H. pylori infection rate in Bulgarian pediatric patients between 2010 and 2017 was 2.5-fold lower than that in 1996–2006. In conclusion, H. pylori infection is still an important concern for Bulgarian children, although having decreased by about 1.8%/yearly over 21 years. This study reveals the importance of H. pylori diagnostics even in the youngest symptomatic children and demonstrates an inverse association between either GERD or bile reflux and H. pylori infection

Molecular epidemiology, virulence and antimicrobial resistance of Bulgarian methicillin resistant Staphylococcus aureus isolates

Background: Severe infections of virulent methicillin-resistant Staphylococcus aureus (MRSA) are a serious health problem. The present study aimed to investigate clonal spread, virulence and antimi-crobial resistance rates of Bulgarian MRSA isolates in 2016-2020. Methods: Molecular identification and mecA gene detection were performed with PCR. Clonal relatedness was evaluated by RAPD PCR and MLST. MRSA epidemiology, virulence and resistance patterns were investigated by PCR. Results: All 27 isolates were identified as S. aureus and were mecA positive, and all were susceptible to linezolid, tigecycline and vancomycin. The toxin genes hlg (in 92.6% of isolates), seb (77.8%), sei (77.8%), seh (59.3%), sej (55.6%), and seg (48.1%), were frequently found among the isolates. Epidemiological typing by RAPD identified 4 clones (16 isolates) and 11 were with a unique profile. MLST analysis of the same MRSA isolates showed five MLST clonal complexes and 11 ST types, including CC5 (33.3%) (ST5, ST221, ST4776), CC8 (22.2%) (ST8, ST239, ST72), CC15 (ST582), CC22 (14.8%) (ST217, ST5417), CC30 (ST30) CC398 (ST398), and CC59 (ST59). The isolates from CC5 showed higher virulence po-tential and almost all were macrolide resistant (ermB or ermC positive). CC8 isolates showed higher level of resistance. Conclusion: To the best of our knowledge, this study is the first describing the clonal spreading of Bulgarian MRSA and the association with their virulence and resistance determinants. Monitoring of MRSA epidemiology, resistance and virulence profile can lead to better prevention and faster therapeutic choice in cases of severe infections

Investigation of multidrug-resistant Helicobacter pylori in pediatric patients: A Bulgarian study and literature data

Antibiotic resistance of Helicobacter pylori strains from 106 symptomatic children was evaluated according to EUCAST breakpoints and rate of multidrug resistance (MDR) was analyzed. Overall resistance rates were amoxicillin 7.5%, metronidazole 25.5%, clarithromycin 34.0% and ciprofloxacin 14.1%. There were no significant differences in resistance rates according to patients' age (2-6 and 7-18 years) and sex. Combined resistance rate was 19.8%, including double, triple, and quadruple resistance in 13.2% (14 strains), 5.7% (6) and 0.9% (1) of the strains, respectively. MDR was found in 5.9% (5/84) of the children with gastritis and in two of the four children with celiac disease. The MDR was present in three children aged 4-6 years and in four children aged 10-17 years. The total MDR rate (6.6%) in Bulgarian children in 2012-2021 was higher than those in other studies based on EUCAST breakpoints such as those in pediatric patients in Slovenia in 2011-2014 (3.8%), Lithuania in 2013-2015 (0%) and Spain in 2014-2019 (0%), although being lower than those (20.7% in the untreated and 47.0% in the treated children) in China in 2019. In brief, it is of concern that MDR can strongly limit the choice of H. pylori therapy of one out of fifteen Bulgarian children and that overall resistance to both metro-nidazole and clarithromycin can hinder the treatment of 15.1% of the pediatric patients. Susceptibility-guided tailored eradication therapy of H. pylori infection should be more frequently implemented in the symptomatic children to avoid risks of both the infection itself and multiple antibiotic treatments