Profesionalna izloženost krvi i tjelesnim tekućinama zdravstvenih radnika u općim bolnicama u Srbiji

The risk of occupational bloodborne infections (HBV, HCV, and HIV) among healthcare workers remains a serious issue in developing countries. The aim of this study was to estimate occupational exposure to bloodborne infections among general hospital workers in Serbia. This cross-sectional study was conducted in the spring of 2013 and included 5,247 healthcare workers from 17 general hospitals. The questionnaire was anonymous, self-completed, and included sociodemographic information with details of blood and bodily fluid exposure over the career and in the previous year (2012). Significant predictors of sharps injuries were determined with multiple logistic regressions. The distribution of accidents in 2012 was equal between the genders (39 %), but in entire career it was more prevalent in women (67 %). The most vulnerable group were nurses. Most medical doctors, nurses, and laboratory technicians reported stabs or skin contact with patients’ blood/other bodily fluid/tissue as their last accident. Healthcare workers from the north/west part of the country reported a significantly lower number of accidents over the entire career than the rest of the country (p<0.001). The south of Serbia stood out as the most accident-prone in 2012 (p=0.042).Rizik od profesionalnih krvnoprenosivih bolesti (HBV, HCV, HIV) među zdravstvenim radnicima i dalje je ozbiljan problem u zemljama u razvoju. Cilj presječnoga ispitivanja, koje je provedeno u proljeće 2013. i u kojem je sudjelovalo 5.247 ispitanika iz 17 općih bolnica, bio je procijeniti profesionalnu izloženost zdravstvenih radnika u Srbiji krvnoprenosivim bolestima. Upitnik je bio anoniman i sadržavao je opće podatke i podatke o prethodnoj izloženosti krvi i tjelesnim tekućinama. Korištena je analiza multiple logističke regresije za određivanje značajnih prediktivnih čimbenika ubodnih incidenata. U prethodnoj godini broj ozljeda bio je jednak i u muškoj i u ženskoj populaciji (39 %), a tijekom cijelog radnog staža prevalencija je bila viša u ženskoj populaciji (67 %). Najveći broj ozljeda imale su medicinske sestre/tehničari. Najveći broj liječnika, medicinskih sestara i laboratorijskih radnika kao posljednji incident navode ubod ili kontakt kože s krvlju pacijenta, drugim tjelesnim tekućinama ili tkivima. Razlike među regijama bile su značajne u sjevernom/zapadnom području Srbije, gdje je rizik od incidenata bio niži tijekom cijelog radnog staža (p<0,001), i na jugu, gdje je rizik tijekom prethodne godine bio povišen (p=0,042)

The first outbreak of brucellosis in the region of Šabac

Background/Aim. In Serbia brucellosis is a primary disease of the animals in the southern parts of the country. The aim of this study was to describe the first outbreak of human and animal brucellosis in the region of Šabac, Serbia. Methods. An epidemiological investigation was conducted to identify a source of outbreak and the ways of transmission of brucellosis infection in human population. A descriptive and analytical epidemiological methods (cohort study) were used. Additional data included monthly reports of the infectious diseases from the Institutes of Public Health and data from the Veterinary Specialistic Institute in Šabac. The serological tests for human brucellosis cases were performed in the Laboratory of the Military Medical Academy; laboratory confirmation of animal brucellosis cases was obtained from the reference laboratory of the Faculty of Veterinary Medicine, Belgrade. Results. Twelve cases of brucellosis were recorded from February 9 to September 1, 2004. Total attack rate was 8.1% (7.5% of males, 14.2% of females). Relative risk (RR) of milk consumption was 8.9 (95% confidence interval: 1.63-13.38), and RR for direct contact with animals was 14 (95% confidence interval: 3.5-55.6). The prevalence of seropositive animals in 33 villages of the Mačva region accounted for 0.8%. Regarding animal species, sheep were predominant - 264 (95.7%). Out of a total number of seropositive animals, ELISA results were positive in 228 (88.7%) of them. Conclusion. As contact epidemics generally last longer, it is probable that the implemented measures of outbreak control did reduce the length of their duration

Predictors of Vancomycin-Resistant Enterococcus spp. Intestinal Carriage among High-Risk Patients in University Hospitals in Serbia

The predictors of intestinal carriage of vancomycin-resistant Enterococcus spp. (VRE) among high-risk patients in the counties of the Southeast Europe Region are insufficiently investigated, yet they could be of key importance in infection control. The aim of the study was to identify risk factors associated with fecal VRE colonization among high-risk inpatients in university hospitals in Serbia. The study comprised 268 inpatients from three university hospitals. Data on patient demographics and clinical characteristics, length of hospital stay, therapy, and procedures were obtained from medical records. Chi-squared tests and univariate and multivariate logistic regressions were performed. Compared to the hemodialysis departments, stay in the geriatric departments, ICUs, and haemato-oncology departments increased the risk for VRE colonization 7.6, 5.4, and 5.5 times, respectively. Compared to inpatients who were hospitalized 48 h before stool sampling for VRE isolation, inpatients hospitalized 3–7, 8–15, and longer than 16 days before sampling had 5.0-, 4.7-, and 6.6-fold higher risk for VRE colonization, respectively. The use of cephalosporins and fluoroquinolones increased the risk for VRE colonization by 2.2 and 1.9 times, respectively. The age ≥ 65 years increased the risk for VRE colonization 2.3 times. In comparison to the University Clinical Centre of Serbia, the hospital stays at Zemun and Zvezdara University Medical Centres were identified as a protector factors. The obtained results could be valuable in predicting the fecal VRE colonization status at patient admission and consequent implementation of infection control measures targeting at-risk inpatients where VRE screening is not routinely performed

Epidemiology of Toxoplasmosis in SERBIA: A Cross-Sectional Study on Blood Donors

Toxoplasmosis is a globally distributed parasitic zoonosis, affecting approximately one third of the human population. Epidemiological studies on toxoplasmosis conducted in Serbia so far have been focused on women of childbearing age, without a clear insight into the prevalence in the general population. We conducted a cross-sectional study in a representative sample of the healthy adult population consisting of 1095 blood donors of both genders to establish the prevalence and risk factors for Toxoplasma gondii infection. Data on the demographic and clinical characteristics of all study participants, as well as on their lifestyle habits, were collected by means of a questionnaire. The overall prevalence of infection was 20.5% (224/1095) and the avidity of the specific IgG antibodies detected was high in a vast majority of the seropositive donors (98.2%). Interestingly, the remaining 1.8% of the specific IgG positive samples were of borderline avidity (4/224), in complete absence of specific IgM. The multivariate logistic regression analysis showed that independent risk factors included age (from OR (95% CI) 1.9 (1.13–3.28) in the 30–39 age group, to 6.8 (3.27–14.24) in the age group of >60 years), suburban living (OR (95% CI) 2.2 (1.43–3.34)) and contact with soil (OR (95% CI) 1.4 (1.01–1.94)). This first large-scale study on toxoplasmosis in the general population in Serbia shows the lowest prevalence ever reported in this country. Moreover, the novel perspective on risk factors provides an updated basis for future prevention programs

Factors Associated with Toxoplasma gondii Seroprevalence in Pregnant Women: A Cross-Sectional Study in Belgrade, Serbia

Toxoplasmosis, caused by the cosmopolitan protozoan Toxoplasma gondii, has particular implications during pregnancy due to the possible transmission of infection to the fetus. Very few studies have assessed seroprevalence and the risk factors for toxoplasmosis in healthy pregnant women. The aim of this study was to examine the seroprevalence of T. gondii infection in healthy pregnant women and to identify the associated risk factors for toxoplasmosis. The cross-sectional study involved 300 healthy pregnant women who came to the Institute for Blood Transfusion in Belgrade between November 2018 and February 2019 for routine blood group and Rh factor testing before delivery, who were also tested using serological screening for the presence of specific antibodies. Positives were further examined using enzyme immunoassay. Of the total sera of participants analyzed, 38 were positive for specific IgG, resulting in a seroprevalence rate of 12.7% (95% Confidence Interval (CI) 9.1–17.0%). All pregnant women presented negative anti-T. gondii IgM antibodies. The multivariate logistic regression analysis revealed that living in a house with a garden was independently associated with the risk of T. gondii infections, while eating chicken meat was connected with a lower risk compared to eating other types of meat with an odds ratio (OR) of 2.5 (95% CI 1.21–5.02) and an OR of 0.3 (95% CI 0.09–0.83), respectively. Although the prevalence of anti-T. gondii IgG antibodies is relatively low, it is essential to maintain and adapt evidence-based preventive measures for toxoplasmosis continually

Nosocomial infections at Clinical Centre in Kragujevac: Prevalence study

Introduction Nosocomial infections (NIs) are a serious health problem in hospitals worldwide and are followed by a series of consequences, medical, judicial, ethical and economic. Objective The main aim of this study was to assess the magnitude of NIs at the Clinical Centre in Kragujevac. Methods A prevalence study of nosocomial infections was conducted from 16th till 20th May, 2005, within Second National Prevalence Study of Niš in the Republic of Serbia. Results The study included 866 patients. 40 patients had a NI, thus the prevalence of patients with NIs and prevalence of NIs was the same, 4.6%. Among NIs, the most frequent were urinary infections (45.0%) followed by surgical-site infections (17.5%), skin and soft tissue infections (15%) and pneumonia (12.5%). The rate of NIs was highest at departments of orthopaedics and traumatological surgery (12.0%), followed by intensive care units (8.0%). Overall, 67.5% (27/40) NIs were culture-proved; the leading pathogens were Escherichia coli (40.0%), followed by gram-negative bacteria (Pseudomonas species, Proteus mirabilis, Enterobacteriaceae with equal frequency of 8.0%). Nosocomial infections were significantly more frequent in patients aged ≥65 years (p&lt;0.05), with longer hospitalization ≥8 days (p&lt;0.00), in intensive care patients (p&lt;0.05), patients with an intravenous catheter (p&lt;0.00), urinary catheter (p&lt;0.00), and those under antibiotic therapy (p&lt;0.00). Conclusion This study showed that the prevalence of nosocomial infections in our hospital is similar to the prevalence in the developed countries. The study of prevalence provides a prompt insight into basic epidemiological and ethiological characteristics of nosocomial infections, hence identification of hospital priorities and the need to undertake appropriate prevention measures.

Nosocomial infections prevalence study in a Serbian university hospital

Background/Aim. Nosocomial infections (NI) are a serious health problem resulting in an enormous burden of excess morbidity and mortality rates, and health care costs. The aim of this study was to assess the prevalence of NI and to identify groups of patients at special risk for NI in the University Clinical Center, Kragujevac, Serbia. Methods. A period prevalence study design was used in this study. A survey of NI included all patients hospitalized in all departments in the University Clinical Center, Kragujevac. Results. Among 764 patients surveyed, the global prevalence rate of patients with at least one NI was 6.2% (95%CI = 5.6-6.8), while the prevalence of NI was 7.1%. The most frequent infections were surgical site infections (14.1%; 95%CI = 12.9-15.3), followed by pneumonia (2.3%; 95%CI = 2.1-2.5) in surgical patients. In medical wards, the most common NI were skin and subcutaneous tissue infections (1.6%l 95%CI = 1.4-1.8), and urinary infections (1.4%; 95%CI = 1.3-1.5). Overall, 85.1% NI were culture-proven; the leading pathogens were Pseudomonas species (40.0%), followed by Staphylococcus species (25.0%), Escherichia coli (22.5%), Proteus mirabilis (17.5%) and Klebsiella-Enterobacter (12.5%). Multivariate logistic regression analysis identified 3 risk factors independently associated with NI appearance: hospital stay ≥ 8 days (p = 0.0015), urinary catheter (p = 0.0022) and antibiotic use (p &lt; 0.001). Conclusion. This study showed that NI are a serious health problem in our hospital. The most common infections were surgical site infections, followed by skin and subcutaneous tissue infection and urinary tract infections. Nosocomial infections were most common in patients in urological and orthopedic departments, and then in intensive care units. Prolonged hospital stay, urinary catheter and antibiotic exposure were risk factors independently associated with NI appearance