Potrošnja antibiotika u bolnicama i stopa otpornosti bakterija Klebsiella pneumoniae i Escherichia coli u Crnoj Gori

Inappropriate use of antibiotics leads to an increase in antibiotic resistance. Infections caused by antibiotic-resistant gram-negative bacteria are a serious threat to public health. This study aimed to compare data on inpatient antibiotic consumption with antimicrobial resistance (AMR) rate of Klebsiella pneumoniae and Escherichia coli invasive strains in Montenegro and provide targets for improving antibiotic use. We used the national data on antibiotic consumption from 2009 to 2015, Point Prevalence Survey data on inpatient antibiotic consumption from 2015, and national AMR data on 79 Klebsiella pneumoniae and 68 Escherichia coli isolates collected from 8 hospitals from 2016 to 2018. The most commonly used antibiotics were third-generation cephalosporins with a median annual consumption of 0.66 DDD/1000/day. Ceftriaxone was the most frequently prescribed antibiotic in the treatment of community/hospital acquired infections and surgical/medical prophylaxis. The highest resistance rates were recorded for Klebsiella pneumoniae to ceftriaxone, ceftazidime and gentamicin (93.59%, 90.79% and 89.87%, respectively), and Escherichia coli to aminopenicillins, ceftriaxone and ceftazidime (89.06%, 70.15% and 61.54%, respectively). High consumption of broadspectrum antibiotics in Montenegro is accompanied by the high rate of resistance of Klebsiella pneumoniae and Escherichia coli to these agents. Antibiotic misuse demands the introduction of an antimicrobial stewardship program in Montenegrin hospitals.Neodgovarajuća upotreba antibiotika dovodi do povećanja otpornosti na antibiotike. Infekcije uzrokovane gram-negativnim bakterijama otpornima na antibiotike ozbiljna su prijetnja javnom zdravlju. Ovo istraživanje imalo je za cilj usporediti podatke o potrošnji antibiotika u bolnicama sa stopom antimikrobne rezistentnosti (AMR) invazivnih sojeva Klebsiella pneumoniae i Escherichia coli u Crnoj Gori i osigurati ciljeve za poboljšanje upotrebe antibiotika. Rabili smo nacionalne podatke o potrošnji antibiotika od 2009. do 2015. godine, podatke iz studije presjeka o potrošnji antibiotika u bolnicama u 2015. godini i nacionalne podatke AMR za 79 izolata Klebsiella pneumoniae i 68 izolata Escherichia coli prikupljena iz 8 bolnica od 2016. do 2018. godine. Najčešće primijenjeni antibiotici bili su cefalosporini treće generacije s medijanom godišnje potrošnje od 0,66 DDD/1000/dan. Ceftriakson je najčešće propisivani antibiotik u liječenju izvanbolničkih i bolničkih infekcija te u kirurškoj/medicinskoj profilaksi. Stopa otpornosti Klebsiella pneumoniae bila je najviša na ceftriakson, ceftazidim i gentamicin (93,59%, 90,79% odnosno 89,87%), a Escherichia coli na aminopeniciline, ceftriakson i ceftazidim (89,06%, 70,15% odnosno 61,54%). Visoka potrošnja antibiotika širokog spektra u Crnoj Gori praćena je visokom stopom otpornosti Klebsiella pneumoniae i Escherichia coli na njih. Zlouporaba antibiotika zahtijeva uvođenje programa antimikrobnog upravljanja u crnogorskim bolnicama

Antibiotic susceptibility of Salmonella spp.: a comparison of two surveys with a 5 years interval

Salmonella infections are one of the major global public health problems. During the last decade, antibiotic resistance and multiresistance of Salmonella spp. have increased a great deal, especially in developing countries with an increased and indiscriminate use of antibiotics in the treatment of humans and animals. This study aims to investigate and compare antimicrobial susceptibility patterns of Salmonella during 2005 and 2010.A total of 186 Salmonella strain during 2005 and 140 Salmonella strain during 2010 were isolated from stool specimens using standard methods. The isolates were confirmed as Salmonella by using a battery of biochemical reactions. Specific antisera were used for serologic characterization of Salmonella strain. Antimicrobial susceptibility testing was performed by standard disk diffusion method using ampicillin, trimethoprim-sulfamethoxasole, ceftriaxon, chloramphenicol, nalidixic acid and ciprofloxacin.One hundred eighty (96.8%) of 186 isolated Salmonella strains in 2005, and 133 (95%) of 140 isolated Salmonella strain in 2010 are recognized as Salmonella Enteritidis. Sensitivity of Salmonella isolates during 2005 and 2010 were 91.9% and 92.9% to ampicillin, 95.7% and 97.1% to trimethoprim-sulfamethoxasole, 99.5% and 100% to chloramphenicol, 99.5% and 100% to ciprofloxacin, 98.9% and 97.1% to ceftriaxon, 73.1% and 95.7% to nalidixic acid, respectively.Sensitivity of Salmonella isolates to all tested antimicrobial agents except to ceftriaxon was been slightly improved over testing period. Resistance rate to ceftriaxon was higher in 2010 than in 2005, and this fact deserves attention. Significantly increase susceptibility rate to nalidixic acid was observed between the two survey

Effects of ibogaine per os application on redox homeostasis in rat liver and erythrocytes

Ibogaine, administered as a single oral dose (1-25 mg/kg body weight), has been used as an addiction-interrupting agent. Its effects persist for up to 72 h. Ex vivo results showed that ibogaine induced cellular energy consumption and restitution, followed by increased reactive oxygen species production and antioxidant activity. Therefore, the aim of this work was to explore the effect of a single oral dose of ibogaine (1 or 20 mg/kg body weight) on antioxidative defenses in rat liver and erythrocytes. Six and 24 h after ibogaine administration, histological examination showed glycogenolytic activity in hepatocytes, which was highest after 24 h in animals that received 20 mg/kg ibogaine. There were no changes in the activities of superoxide dismutases, catalase, glutathione peroxidase, glutathione reductase and glutathione-S-transferase in the liver and erythrocytes after ibogaine treatment, regardless of the dose. Hepatic xanthine oxidase activity was elevated in rats that received 20 mg/kg compared to the controls (p<0.01), suggesting faster adenosine turnover. TBARS concentration was elevated in the group treated with 1 mg/kg after 24 h compared to the controls (p<0.01), suggesting mild oxidative stress. Our results show that ibogaine treatment influenced hepatic redox homeostasis, but not sufficiently to remodel antioxidant enzyme activities at 6 and 24 h post-ibogaine application

Potrošnja antibiotika u bolnicama i stopa otpornosti bakterija Klebsiella pneumoniae i Escherichia coli u Crnoj Gori

Inappropriate use of antibiotics leads to an increase in antibiotic resistance. Infections caused by antibiotic-resistant gram-negative bacteria are a serious threat to public health. This study aimed to compare data on inpatient antibiotic consumption with antimicrobial resistance (AMR) rate of Klebsiella pneumoniae and Escherichia coli invasive strains in Montenegro and provide targets for improving antibiotic use. We used the national data on antibiotic consumption from 2009 to 2015, Point Prevalence Survey data on inpatient antibiotic consumption from 2015, and national AMR data on 79 Klebsiella pneumoniae and 68 Escherichia coli isolates collected from 8 hospitals from 2016 to 2018. The most commonly used antibiotics were third-generation cephalosporins with a median annual consumption of 0.66 DDD/1000/day. Ceftriaxone was the most frequently prescribed antibiotic in the treatment of community/hospital acquired infections and surgical/medical prophylaxis. The highest resistance rates were recorded for Klebsiella pneumoniae to ceftriaxone, ceftazidime and gentamicin (93.59%, 90.79% and 89.87%, respectively), and Escherichia coli to aminopenicillins, ceftriaxone and ceftazidime (89.06%, 70.15% and 61.54%, respectively). High consumption of broadspectrum antibiotics in Montenegro is accompanied by the high rate of resistance of Klebsiella pneumoniae and Escherichia coli to these agents. Antibiotic misuse demands the introduction of an antimicrobial stewardship program in Montenegrin hospitals.Neodgovarajuća upotreba antibiotika dovodi do povećanja otpornosti na antibiotike. Infekcije uzrokovane gram-negativnim bakterijama otpornima na antibiotike ozbiljna su prijetnja javnom zdravlju. Ovo istraživanje imalo je za cilj usporediti podatke o potrošnji antibiotika u bolnicama sa stopom antimikrobne rezistentnosti (AMR) invazivnih sojeva Klebsiella pneumoniae i Escherichia coli u Crnoj Gori i osigurati ciljeve za poboljšanje upotrebe antibiotika. Rabili smo nacionalne podatke o potrošnji antibiotika od 2009. do 2015. godine, podatke iz studije presjeka o potrošnji antibiotika u bolnicama u 2015. godini i nacionalne podatke AMR za 79 izolata Klebsiella pneumoniae i 68 izolata Escherichia coli prikupljena iz 8 bolnica od 2016. do 2018. godine. Najčešće primijenjeni antibiotici bili su cefalosporini treće generacije s medijanom godišnje potrošnje od 0,66 DDD/1000/dan. Ceftriakson je najčešće propisivani antibiotik u liječenju izvanbolničkih i bolničkih infekcija te u kirurškoj/medicinskoj profilaksi. Stopa otpornosti Klebsiella pneumoniae bila je najviša na ceftriakson, ceftazidim i gentamicin (93,59%, 90,79% odnosno 89,87%), a Escherichia coli na aminopeniciline, ceftriakson i ceftazidim (89,06%, 70,15% odnosno 61,54%). Visoka potrošnja antibiotika širokog spektra u Crnoj Gori praćena je visokom stopom otpornosti Klebsiella pneumoniae i Escherichia coli na njih. Zlouporaba antibiotika zahtijeva uvođenje programa antimikrobnog upravljanja u crnogorskim bolnicama

Presence of histopathological premalignant lesions and infection caused by high-risk genotypes of human papillomavirus in patients with suspicious cytological and colposcopy results: A prospective study

Background/Aim. In patients with premalignant cervical lesions, human papillomavirus (HPV) infection, at any moment, may be spontaneously eliminated, or may persist or transform cervical epithelium from a lower to a higher degree. Due to that, it is necessary to wisely select the patients who are at high risk of cancer development. The aim of the study was to establish the interdependence between a suspicious Papanicolaou (Pap) test and colposcopy with the infection caused by high-risk genotypes of human papillomavirus and the presence of premalignant cervical lesions. Methods. This prospective study used cytological, colposcopy, real-time polymerase chain reaction (PCR) of high-risk genotypes of human papillomavirus and histopathological analysis of cervical biopsy specimen. Out of 2,578 female patients sent to cytological analyses in Clinical Center of Montenegro, during 2012, 2013 and 2014, the study included 80 women who had to submit their biopsy specimens due to a suspicious Pap test and atypical colposcopy results. Results. In the group of 80 (3.1%; n = 80/2,578) of the selected female patients with suspicious Pap test and colposcopy, 2/3 or 56 (70%) of them had cervicitis, and 1/3 or 24 (30%) had cervical intraepithelial neoplasia. The most common type in cervical intraepithelial neoplasia was HPV16 in 8 female patients, ie 61.53% out of the number of infected, or 33.33% out of the total number of premalignant lesions. Conclusion. Patients with suspicious Papanicolaou test, colposcopy results and infection which is caused by high-risk HPV infection (HPV 16 in particular) often have premalignant cervical lesions. In these cases, histopathological confirmation of lesions is mandatory, since it serves as a definitive diagnostic procedure

Frequency and risk factors of cervical human papilloma virus infection in women in Montenegro

Cervical human papilloma virus (HPV) infection among women from 17 to 62 years of age in Montenegro was studied using in situ hybridization and cytological testing. Cervical HPV infection was diagnosed in 44.3% of women. The most common HPV genotype was 31/33/51 found in 56.9%. HPV positive samples for types 16/18 were identified in 41% HPV positive samples. The results showed that 57% and 45% of women who had had their first sexual intercourse before and after the age of 18, respectively, had cervical HPV infection. Cytological findings of Papanicolaou (Pap) test class III were significantly more common in women smokers. Cervical HPV infection among women in Montenegro is most commonly caused by HPV genotypes for which a prophylactic vaccine is available, or by phylogenetically related types, thus offering the opportunity of using vaccines to reduce the incidence of HPV infection

Ibogaine has sex-specific plasma bioavailability, histopathological and redox/antioxidant effects in rat liver and kidneys

Ibogaine induces rapid changes in cellular energetics followed by the elevation of antioxidant activities. As shown earlier in male rats, ibogaine treatment with both 1 and 20 mg/kg b.w. per os led to significant glycogenolytic activity in the liver. In this work, female rats treated with the same doses of ibogaine per os displayed lower liver glycogenolytic activity relative to males, dilatation of the central vein and branches of the portal vein, and increased concentration of thiols 6 h after treatment. These changes were followed by increased catalase activity and lipid peroxidation, and decreased xanthine oxidase activity after 24 h. In kidneys, mild histopathological changes were found in all treated animals, accompanied by a decrease of glutathione reductase (after 6 and 24 h at both doses) and an increase of catalase (6 h) and xanthine oxidase activity (6 and 24 h). Ibogaine did not affect antioxidant enzymes activity in erythrocytes. Bioavailability of ibogaine was two to three times higher in females than males, with similar kinetic profiles. Compared to previous results in males, ibogaine showed sex specific effect at the level of antioxidant cellular system. Effects of ibogaine in rats are sex- and tissue-specific, and also dose- and time-dependent