Mechanisms of carbapenem resistance in Acinetobacter baumannii

Pripadnici roda Acinetobacter su nefermentativni mikroorganizmi široko rasprostranjeni u vodi i na zemlji. Pojedine vrste unutar roda sastavni su dio fiziološke flore kože i sluznica te su sposobni preživjeti duži vremenski period na suhim i vlažnim površinama. Acinetobacter baumannii je oportunistički uzročnik hospitalnih infekcija, prvenstveno u imunokompromitiranih bolesnika. Sve do 1970-ih godina, većina izolata unutar roda Acinetobacter bila je osjetljiva na široki spektar različitih antibiotika. Razvoj rezistencije na karbapeneme novijeg je datuma i posljedica je stvaranja metalo-β-laktamaza (karbapenemaza), oksacilinaza koje imaju sposobnost hidrolize karbapenema, gubitka proteina u vanjskoj membrani, izbacivanja antibiotika iz stanice ili kombinacije navedenih mehanizama rezistencije. Smatra se da su karbapenemaze i oksacilinaze koje hidroliziraju karbapeneme najznačajni u ekspresiji rezistencije na karbapeneme u kliničkih izolata A. baumannii. Enzimi koji imaju sposobnost hidrolize karbapenema u kliničkim izolatima A. baumannii pripadaju molekularnoj klasi D (OXA enzimi, oksacilinaze) ili molekularnoj klasi B (metaloenzimi iz grupe IMP, VIM i SIM karbapenemaza). Veliko kliničko značenje danas imaju oksacilinaze koje se dijele u četiri filogenetske skupine specifične za izolate A. baumannii: OXA-23 skupina, OXA-40 skupina, OXA-58 skupina i najveća OXA-51 skupina, poznata i kao prirodno kromosomski kodirane oksacilinaze. OXA-51 skupina oksacilinaza uglavnom ima slabu sposobnost hidrolize karbapenema, ali prisustvo insercijske sekvencije ISAba1 smještene neposredno uz blaOXA-51 like gen djeluje kao promotor rezistencije ili smanjene osjetljivosti na karbapeneme. Zabrinjavajući porast rezistencije na karbapeneme zabilježen je posljednjih godina među izolatima A. baumannii u nekoliko bolnica u Hrvatskoj. Molekularna osnova smanjene osjetljivosti na karbapeneme istražena je na velikom broju izolata iz KBC Split, a šesnaest izolata uključeno je i u međunarodni ARPAC (Antibiotic Resistance, Prevention and Control) projekt. Genotipizacija pomoću dvije metode (RAPD i PFGE) potvrdila je pripadnost hrvatskih izolata Europskom klonu I (sekvencijska grupa 2).Organisms of the genus Acinetobacter are ubiquitous and widely distributed in soil and water. They are frequently present on human skin and mucous membranes and are able to survive for long periods on dry and humid surfaces. Acinetobacter baumannii is an opportunistic pathogen that is mostly involved in nosocomial infections in immunocompromised patients. Until the 1970s, most isolates were susceptible to a wide range of antibiotics. Carbapenem resistance results from production of metallo-β-lactamases, carbapenem hydrolyzing oxacillinases, loss of outer membrane proteins, efflux and often combined mechanisms of resistance. These resistance mechanisms pose a serious therapeutic threat, since carbapenems are frequently used to treat otherwise resistant A. baumannii infections. Carbapenemases found in Acinetobacter belong to molecular class D (OXA enzymes) or class B (metalloenzymes of IMP- and VIM-type or SIM-1). The OXA carbapenemases are divided into four phylogenetic subgroups: acquired enzymes OXA-23-like, OXA-40-like and OXA-58-like and OXA-51-like enzymes that are intrinsic to A. baumannii. OXA-51-like enzymes are normally expressed at low levels but can be over expressed as consequence of the insertion of an ISAba1 sequence upstream of their genes. Recently an increase in the prevalence of carbapenem resistant Acinetobacter baumannii isolates was observed in few medical centers in Croatia. The investigation of the background of carbapenem resistance in relevant clinical isolates of A. baumannii from Split University Hospital was performed during last years and sixteen different strains of carbapenem resistant A. baumannii were included in ARPAC project (Antibiotic Resistance, Prevention and Control). The molecular typing by random amplified polymorphic DNAanalysis (RAPD), followed by pulsed-field gel electrophoresis (PFGE) belonged isolates to the same PFGE type as a part of sequence group 2 (European \u27clone I\u27 lineage)

Motivation of Employees 50+

In recent years, employees older than 50 years of age represent a significant work force and companies have become aware of their importance. They have to be managed in a specific way by motivating and encouraging them in achieving extraordinary performance. However, in the literature, there is a lack of empirical research about older employees. Because of that, the aim of this paper is to explore the motivation of employees 50+ This paper is based on the large empirical investigation conducted within the project InCounceling 50+ co-funded by the European Commission through the Erasmus+ Programme. The research in Croatia was conducted in 2017 in 6 Croatian companies. The research instrument was a specially designed questionnaire with 30 questions. The questions relevant for this paper were about employees’ general characteristics, employees’ competencies and motivational factors. These questions were completed by 141 employees. The collected data was analyzed by the usual statistics methods supported by SPSS program. The research results showed that employees 50+ consider that they have sufficient or even higher competencies required for their job position. Regarding motivational factors, good atmosphere at work is the most important motivational factor for employees 50+, followed by the respect and recognition and safety and stability of the employment. Career development is the least important motivational factor for employees 50+. Additionally, research results showed that there are no statistically significant differences in motivational factors of employees 50+ regarding their gender, educational level and job position

MICROECONOMIC ASPECTS OF WATER PRICES

Voda kao specifi čna roba i vodoopskrba kao specifi čna djelatnost nude veoma zanimljivo područje za mikroekonomsku analizu. Polazeći od činjenice da se u tržišnoj ekonomiji većina mikroekonomskih kategorija i relacija vrti oko cijene, u ovome se radu pokušalo provesti jednu svestranu analizu ključnih mikroekonomskih determinanti cijena vode. Konstatirajući da u vodoopskrbi djeluje monopolističko tržište, analizirani su odnosi između ponude i potražnje na takvom tržištu, elastičnost potražnje, odnos ukupnog prihoda vodoopskrbljivača i cijene vode, značaj i ponašanje troškova u vodoopskrbi, odnos prihoda, troškova i profita vodoopskrbljivača, veza poslovnog rezultata vodoopskrbljivača i količine plasirane vode, osnove i modeli diskriminacije cijena vode, odnos kapaciteta, ponude i potražnje i specifičnosti ponašanja mikroekonomskih parametara u kratkom roku. U radu se zaključuje da u djelatnosti vodoopskrbe monopolistička situacija, s jedne strane ima pozitivne efekte u ograničavanju neracionalnog i ekološki neprihvatljivog rasta potrošnje, a sa druge strane zahtijeva određeni oblik eksterne kontrole, pa i intervencije, da bi se potrošači zaštitili od monopolističkog podizanja cijena i limitiranja pristupa marginalnih potrošača. No, ta eksterna intervencija ne smije biti takva da ugrožava ekonomsku racionalnost poslovanja vodoopskrbnog poduzeća, jer bi to također, na dugi rok, ugrozilo stabilnost i kvalitetu vodoopskrbe.Water as a specific commodity, and water supply as a specific industry, represent a very interesting field for microeconomic analysis. Starting from the fact that in the market economy most of microeconomic categories and relations are turning around the price, this paper is attempting to give a comprehensive analysis of key microeconomic determinants of water prices. Establishing that the water market is a monopolistic one, relations between supply and demand have been analyzed, as well as demand elasticity, relations between water supplier revenue and water price, importance and behavior of costs in water supply industry, relations between revenue, costs and profit of water supplier, relation between water supplier’s business results and quantity of water produced/sold, foundations and models of price discrimination, relations between capacities, supply and demand, and peculiarities of the behavior of basic microeconomic parameters in the short run. The conclusions of this paper are that monopolistic situation in the water supply industry brings positive effects by limiting irrational and ecologically unacceptable growth of consumption, while, in the other hand, it requires some kind of external control or even intervention in order to protect consumers from monopolistic rise of prices and limitation of access for marginal consumers. However, that external regulation should not be such to endanger economic rationality of business making of the water supplier, because that could jeopardize stability and quality of water supply itself

Smanjena osjetljivost na dezinficijense bakterije Acinetobacter baumannii u obliku biofilma na staklu i keramici

The aim of this study was to determine the susceptibility of hospital and environmental Acinetobacter baumannii isolate biofilms on ceramics and glass to common disinfectants benzalkonium chloride and chlorhexidine. For this purpose wedeveloped a new method for biofilm cultivation and quantification on ceramics. The biofilm bacteria were more resistant to disinfectants than the planktonic populations, as more than 50 % of the biofilm population and none of the planktonic population survived 5-minute exposure. Furthermore, biofilm populations on ceramic tiles were significantly more resistant than those on glass coverslips, even though the amount of biofilm was practically the same on ceramics and glass. The reason for reduced susceptibility of A. baumannii biofilms on ceramics may be related to surface/disinfection interactions. Our findings suggest that biofilms on ceramic surfaces can be an important source of A. baumannii infection in hospital environmentsVrsta Acinetobacter baumannii prepoznata je kao trenutačno vodeći uzročnik bolničkih infekcija sa smrtnim ishodom. Trajna prisutnost A. baumannii u bolnicama posljedica je ponajviše otpornosti na antibiotike te sposobnosti ove bakterije da stvara biofilm. U radu je testirana osjetljivost biofilma kliničkih i okolišnih izolata vrste A. baumannii na najčešće korištene dezinficijense, benzalkonijev klorid i klorheksidin. Predložena je nova metoda za uzgoj biofilma na keramičkim pločicama te su rezultati uspoređeni s biofilmom koji je nastao na staklu. Bakterije unutar biofilma bile su otporne na dezinficijense; pri koncentraciji dezinficijensa koja je potpuno uništila planktonske bakterije, unutar biofilma preživjelo je više od 50 % populacije, čak i nakon petominutnog izlaganja dezinficijensima. Značajno je opažanje da su bakterije u obliku biofilma na keramici znatno otpornije na dezinficijense od bakterija u obliku biofilma na staklu, iako je brojnost bakterija bila podjednaka. Navedeni rezultati upućuju na zaključak da je međudjelovanje materijala i dezinficijensa važan čimbenik koji određuje učinkovitost dezinfekcije. Sposobnost stvaranja biofilma na keramičkim površinama moguće je ishodište i značajno stanište bakterija A. baumannii u bolničkom okružju

Paul Rasse, Le théâtre dans l’espace public : Avignon Off

Ce n’est pas tant le théâtre dans l’espace public (comme dit le titre de l’ouvrage), que le théâtre comme espace public que l’ouvrage de P. Rasse parcourt. Le festival Off d’Avignon fait même figure d’idéal-type d’un espace public régénéré : pour l’auteur, là s’invente un nouveau théâtre où les médiations traditionnelles s’effacent, où les artistes sont confrontés – en prise directe – au jugement esthétique du public et des professionnels, où le spectateur est actif de bout en bout, acteur cu..

Epidemiology and resistance of clinical isolates of Acinetobacter baumannii in Croatia over a ten-year period – what has changed?

Acinetobacter baumannii zauzima posebno mjesto unutar skupine uzročnika teških infekcija, poznatije kao “ESKAPE” mikroorganizmi. Ovaj mikroorganizam postao je vodeći uzročnik hospitalnih infekcija u 21. stoljeću, te su brojna istraživanja usmjerena na epidemiologiju, rezistenciju i nadzor nad ovim patogenom. Epidemiologija i molekularna osnova rezistencije kliničkih izolata Acinetobacter baumannii u Hrvatskoj tijekom posljednja dva desetljeća bitno se promijenila u većini zdravstvenih ustanova, uz visoki postotak rezistencije na karbapeneme, kinolone i aminoglikozide, te prisutnost multiplo-rezistentnih izolata. U ovom pregledu naglasak je stavljen na rezultate istraživanja epidemiologije i rezistencije kliničkih izolata iz Hrvatske.Among the „ESKAPE“ group of serious pathogens Acinetobacter baumannii is under a great concern worldwide. This microorganism has become a leading nosocomial pathogen of the 21th century, and numerous studies are focused on the epidemiology, resistance and control measures of this pathogen in the hospital setting. The epidemiology and molecular basis of resistance of clinical isolates of Acinetobacter baumannii in Croatia over the last two decades has changed significantly in most health institutions, with a high percentage of resistance to carbapenems, quinolones and aminoglycosides, and the presence of multi-resistant isolates. In this review, emphasis was placed on the results of research on epidemiology and resistance of clinical isolates from Croatia

The Impact of Croatian Accession to the European Union on Exports

Izvoz je važna komponenta u ukupnom gospodarskom rastu i realizaciji konkurentskih prednosti te se iz tog razloga u istraživanju obrađuje utjecaj ulaska Republike Hrvatske u Europsku uniju na izvoz. Kako ulazak u Europsku uniju podrazumijeva ulazak na jedinstveno tržište zemalja članica EU, pretpostavlja se da je navedeni događaj utjecao na izvozna kretanja u RH. Međutim, primjenom F-testa nije dokazana statistički značajna veza između ulaska Republike Hrvatske u EU i vrijednosti izvoza. Istraživanjem je dokazano kako se hrvatska izvozna kretanja nisu statistički značajno povećala nakon ulaska u EU iz razloga što Hrvatska nije učinkovito iskoristila mogućnosti sufinanciranja putem bespovratnih sredstava iz fondova EU. Bespovratna sredstva usmjerena su na gospodarski oporavak i razvoj konkurentnosti te poticanje izvoza, a Hrvatska je po stopi iskorištenosti sredstava iz EU fondova na posljednjem mjestu u usporedbi s ostalim članicama EU. Preporuka je, dakle, sustavno osnaživati resursne temelje za učinkovitije iskorištavanje alociranih sredstava iz EU fondova, a to se osobito odnosi na edukaciju ljudskih resursa i učinkovitiju alokaciju financijskih sredstava potrebnih za vlastiti udio u financiranju projekata iz EU.Export is an important component in the overall economic growth and the realization of competitive advantages and for this reason the research deals with the impact of Croatian accession to the European Union on export. As Croatia has entered the single market of EU member states, it has been assumed that it affected the export rates in Croatia. However, the F-test has not been proven statistically significant relationship between the Croatian accession into the EU and the value of exports. The research proved that the Croatian export trends were not statistically significantly increased after joining the EU because Croatia has not effectively used the possibility of co-financing through grants from EU funds. Grants are focused on economic recovery and development of competitiveness and stimulate exports. Croatia is on the last place in comparison with other EU member states measured by utilization rate of EU funds. The recommendation is to systematically strengthen resource foundation for a more efficient use of allocated funds from the EU, and this applies particularly to the education of human resources and a more efficient allocation of financial resources needed for Croatia´s own share in the financing of EU projects