MICROBIOLOGICAL MONITORING OF HOSPITAL ENVIRONMENT IN REGION VARNA

The hospital environment is widely contaminated with opportunistic and pathogenic microorganisms and is considered as a source of outbreaks of nosocomial infections which are a worldwide phenomenon. Thus, it is clear that monitoring of the hospital environment is an essential element in the control of nosocomial infections. The purpose is to isolate and identify the microbes from hospital environment samples of different hospitals and healthcare services in the Region Varna and to analyze the risk that hospital environment poses in the region. This study was conducted over a period of 5 years from January 2012 to December 2016. A total of 12,673 different types of samples were collected and delivered quickly to the Laboratory of Microbiology of Regional Health Inspectorate Varna, where analyses were performed. We found bacteria in 816 of the tested objects and isolated a total of 29 bacterial species. The results show predominant Gram positive flora (71.81%), while Gram negatives represented only 28.19%. Prevention of nosocomial infections is a responsibility of all health-care workers. Microbiology laboratories should play a significant role in the attempts to minimize the occurrence of nosocomial infection through accurate identification of responsible organisms, timely reporting of laboratory data and participation in hospital infection control

YEAST PRION PROTEIN Ure2p – A USEFUL MODEL FOR HUMAN PRION DISEASES.

Mammalian transmissible spongiform encephalopathies are uncommon and irreversible diseases caused by prions. Prions lack nucleic acid and can self-propagate by converting normal cell protein to isomeric prion form. In the pathogenesis of these diseases a long variable incubation period occurs, followed by progressive appearance of severe clinical symptoms and death. A major knowledge in the field of prions comes from studies on a functionally unrelated protein of yeast Saccharomyces cerevisiae – [URE3], which in normal state (Ure2p) possesses a variety of regulatory and enzymatic functions. Ure2p is a cytoplasmic homodimeric protein with structural homology to glutathione S-transferases and crucial role in nitrogen metabolism, oxidant protection and heavy metal resistance in yeast. In this work, we discuss the role of Ure2p to provide valuable information about protein infectivity, prion structure and functions

MEDICO-LABORATORY SERVICES IN OUTPATIENT CARE IN NORTHEASTERN BULGARIA – STATE AND PROSPECTS

Aim: The aim of this article is to study the satisfaction of patients with laboratory services in outpatient care in Northeastern Bulgaria regarding access and quality of service. Study design: Prospective cohort study Material and methods: The survey was carried out on the territory of Northeastern Bulgaria and covered the districts of Varna, Dobrich and Shumen and thirty municipalities. The following methods were applied in the study: sociological method by applied direct anonymous questionnaire, documentary method and statistical methods for analysis and interpretation of the data in order to reveal the nature of the observed phenomena and their interrelations. Results: The research data show that 24,4% of the respondents live at a distance of more than ten kilometres from the nearest medico-diagnostic laboratory. The larger share of these patients are residents of small settlements in Northeastern Bulgaria. More than half (55%) of the respondents are not satisfied with their provision of laboratory services, but the majority of patients claim that the location of the selected laboratory is accessible (69,4%) and the quality of the laboratory service is high (83,7%). Conclusion: The main problems in outpatient care are related to the poor provision of medico-laboratory services and specialized outpatient care in the smaller settlements in Northeastern Bulgaria

Epidemiological Study of Hepatitis A Infection in Eastern Bulgaria

Background: Hepatitis A virus (HAV) infection is an acute, self-limited liver disease transmitted usually through the faecal-oral route via person-to-person contact. Bulgaria has intermediate HAV endemicity with higher susceptibility among adults and recurrent outbreaks

EFFECTIVENESS OF MRSA DETECTION METHODS IN THE LABORATORY PRACTICE – A BRIEF REVIEW

Methicillin-resistant Staphylococcus aureus (MRSA) are bacteria, responsible for severe and hard-to-manage infections in human. They are resistant to beta-lactam antibiotics – penicillins (methicillin, dicloxacillin, nafcillin, and oxacillin), cephalosporins and carbapenems, but can also be resistant to the new-generation MRSA-active cephalosporins (such as ceftaroline) or other groups of antibiotics, including aminoglycosides, macrolides, clindamycin, amphenicols, quinolones and tetracyclines. MRSA bacteria are pandemic and are often isolated in medical practice and nosocomial infections. The MRSA detection is a challenge to any clinical microbiology laboratory and demands implementation of strict protocols for active screening. While more expensive molecular techniques have the potential of offering highly sensitive and rapid results, the cultural methods require longer time but can achieve a comparable sensitivity for lower price

PEDIATRIC URINARY INFECTIONS, CAUSED BY EXTENDED-SPECTRUM BETA-LACTAMASE - PRODUCING MICROORGANISMS IN VARNA, BULGARIA

Background: Extended-spectrum beta-lactamase (ESBLs) producing bacteria are microorganisms which have the ability to hydrolyze β-lactame ring of a large part of the antibiotics, commonly used to treat bacterial infections including urinary tract infections. Purpose: The aim of this study is present the epidemiology of childhood urinary tract infections caused by ESBL-producing strains in Varna, Bulgaria. Material/methods: A total of 3895 urine samples of children patients (aged 0 to 18 years) were examined during the period 2010-2012 for presence of ESBL-producing bacteria. Results: Six percent of the tested urinary samples were positive for ESBL production. All of the isolates were resistant to ampicillin, piperacillin, cephalothin, cefprozil, cefuroxime, ceftriaxone, ceftazidime, levofloxacin, cefaclor, but were were sensitive to meropenem and imipenem. Conclusions: Cephalosporins and penicillins are the most used antibiotics in Bulgaria, but they should be very precisely prescribed in medical practice, because otherwise preconditions for maintaining high share of ESBLs are created

KETOGENIC DIET – FROM THE IMPLEMENTATION IN CLINICAL PRACTICE TO NOWADAYS

Introduction: The ketogenic diet (KGD) is a high-fat, adequate-protein, low-carbohydrate diet. In 1920`s the diet was developed to treat difficult-to-control epilepsy in children. Nowadays its efficacy has been proven in many other diseases, such as metabolic disorders, brain tumours, autism, Rett syndrome, and in other areas, it has been actively studied. Aim: The aim of this article is to represent the historical review of the therapeutic implication of KGD, as well as to reveal the contemporary clinical trends in which it is being used. Material and Methods: A literature review of 96 scientific reports in English has been made. Results and Discussion: The KGD was developed in the early 1920s. In the period 1970-1990, the therapeutic use of the diet was discontinued, due to the breakthrough of the new anticonvulsants for epilepsy. The interest in KGD was recovered after a meeting of the “American Epilepsy Society” in 1996. The diet demonstrates anticonvulsant efficacy in epilepsy therapy. According to a survey in 2013, the incidence of seizures among half of the number of children was reduced by at least a half, and 15% of them were completely discontinued. The diet is also used in the treatment of metabolic diseases, such as GLUT 1-deficiency syndrome, reducing the incidence of seizures, improving muscle coordination and concentration. It is also effective in pyruvate dehydrogenase deficiency syndrome by replacing the major energy source - glucose with ketones. Along with these, it is also used in patients with autism (in approximately 60% of patients it improves learning ability and social skills), Rett syndrome, Alzheimer's disease, Parkinson's disease, and others. Its mechanism of action is not fully clarified, as well as its degree of effectiveness in some areas. Conclusion: The ketogenic diet is widely implemented worldwide. It comprises a tremendous therapeutic potential that has been growing considerably during the past decades