Editorial

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Editorial

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Liječenje COVID-19: pravo vrijeme za program upravljanja antimikrobnom terapijom

Last several months, the World is witnessing Coronavirus disease 2019 (COVID-19) pandemic caused by the newly identified Coronavirus. Due to the fast and easy disease spread as well as its severity, currently this pandemic is dominating every aspect of the global healthcare systems but also it outstandingly influences every side of our lives including the global economy. Almost all COVID-19 treatment guidelines advocate the rational use of antibiotics, but if we analyse the reports published so far, it is evident that about 70% up to even 100% of patients are treated with antibiotics. This antibiotic misuse highlights the urgent need for launching the Antimicrobial Stewardship Program in order to monitor the appropriate use of antibiotics. In this article, the authors suggest the postulates for implementing the antibiotic stewardship in COVID-19 patients.Posljednjih nekoliko mjeseci svijet je svjedok pandemije COVID-19 izazvane novootkrivenim koronavirusom. Zbog brzog i lakog širenja bolesti, kao i njezine ozbiljnosti, trenutno ova pandemija dominira svim aspektima globalnih zdravstvenih sustava, ali također iznimno utječe na sve aspekte našeg života, uključujući globalno gospodarstvo. Gotovo sve smjernice liječenja COVID-19 zagovaraju racionalnu uporabu antibiotika, ali ako analiziramo do sada objavljena izvješća, očito je da se oko 70% pa čak i do 100% bolesnika liječi antibioticima. Ova zlouporaba antibiotika naglašava hitnu potrebu za pokretanjem programa upravljanja antimikrobnim lijekovima radi praćenja odgovarajuće uporabe antibiotika. U ovom članku autori predlažu postulate za primjenu programa upravljanja antibioticima u bolesnika s COVID-19

Liječenje COVID-19: pravo vrijeme za program upravljanja antimikrobnom terapijom

Last several months, the World is witnessing Coronavirus disease 2019 (COVID-19) pandemic caused by the newly identified Coronavirus. Due to the fast and easy disease spread as well as its severity, currently this pandemic is dominating every aspect of the global healthcare systems but also it outstandingly influences every side of our lives including the global economy. Almost all COVID-19 treatment guidelines advocate the rational use of antibiotics, but if we analyse the reports published so far, it is evident that about 70% up to even 100% of patients are treated with antibiotics. This antibiotic misuse highlights the urgent need for launching the Antimicrobial Stewardship Program in order to monitor the appropriate use of antibiotics. In this article, the authors suggest the postulates for implementing the antibiotic stewardship in COVID-19 patients.Posljednjih nekoliko mjeseci svijet je svjedok pandemije COVID-19 izazvane novootkrivenim koronavirusom. Zbog brzog i lakog širenja bolesti, kao i njezine ozbiljnosti, trenutno ova pandemija dominira svim aspektima globalnih zdravstvenih sustava, ali također iznimno utječe na sve aspekte našeg života, uključujući globalno gospodarstvo. Gotovo sve smjernice liječenja COVID-19 zagovaraju racionalnu uporabu antibiotika, ali ako analiziramo do sada objavljena izvješća, očito je da se oko 70% pa čak i do 100% bolesnika liječi antibioticima. Ova zlouporaba antibiotika naglašava hitnu potrebu za pokretanjem programa upravljanja antimikrobnim lijekovima radi praćenja odgovarajuće uporabe antibiotika. U ovom članku autori predlažu postulate za primjenu programa upravljanja antibioticima u bolesnika s COVID-19

Trichinelosis in Brodsko-posavska country

Autori su ovim radom željeli prikazati kliničke i epidemiološke osobitosti trihineloze na području županije brodsko-posavske. Obradili su sve bolesnike koji su liječeni ili na bolničkom odjelu ili u specijalističkoj ambulanti Službe za infektivne bolesti Opče bolnice u Slavonskom Brodu, tijekom perioda 1991-1996. godine. U svih bolesnika su pratili postotak eozinofila u perifernoj krvi, kao i kreatin kinazu i laktat dehidrogenazu u serumu. Od ukupnog broja liječenih bolesnika, najviše ih je bilo tijekom zime 1995/96. godine. Bolest je u najvećem broju bila laka ili, čak, asimptomatska. Od simptoma koji su se najčešće javljali, bili su povišena temperatura, bolovi u mišićima, periorbitalni edem i injekcija konjuktiva. Postotak eozinofila u perifernoj krvi je u ispitivanih bolesnika bio dobar pokazatelj težine kliničke slike. Enzimi koji su određivani u serumu bolesnika, adekvatni su indikatori afekcije poprečno-prugaste muskulature. Iz rezultata se vidi da je trihineloza na području županije u porastu te da se u njenoj prevenciji mora biti aktivniji.In this paper the authors would like to present clinical and epidemiological characteristics of trichinelosis in the area of Brodsko posavska County. They researched all the patients who were treated ambulatory or hospitalized at the Department for Infectious Diseases of the General Hospital in Slavonski Brod, in the period 1991-1996. The percentage of eosinophils in blood as well as creatine kinase and lactate dehydrogenase in serum samples were determined in all patients. Out of the total number of patients, most cases occurred during the winter of 1995/96. The disease was predominantly mild or even asymptomatic. The most frequently seen symptoms were: fever, muscle pain, periorbital edema and conjuctival injection. The percentage of eosinophils in patients ’ blood was a good indicator of the severity of illness . The enzyms determined in serum samples were adequate indicators of cseletal muscle affection. The results of the study indicate that the occurrence of trichinellosis is increasing, requiring a most active approach in its prevention

The effects of climate elements on the incidence of leptospirosis in Brod – Posavina County

Leptospiroza je jedna od globalno najraširenijih zoonoza uzrokovana spirohetom Leptospira spp. Hrvatska je na 13. mjestu u svijetu, ali i na 1. mjestu u Europi po prijavljenom broju oboljelih sa 17,3 bolesnika na 1000000 stanovnika. Brodsko-posavska županija (BP županija) je prema svom geografskom položaju i prirodnom okruženju svrstana u endemsko područje za leptospirozu. Cilj. Ispitati utjecaj količine oborina, vlažnosti zraka i temperature zraka na pojavnost leptospiroze. Materijali i metode. Prema podacima Državnog hidrometeorološkog zavoda, analizirane su količine oborina, vlažnost i temperature zraka u razdoblju od 2010. do 2015. godine, prema tromjesečnim razdobljima tj. godišnjim dobima. Također smo analizirali i broj oboljelih od leptospiroze na području BP županije, koji su liječeni u istom vremenskom razdoblju na Odjelu za infektivne bolesti u Slavonskom Brodu. Rezultati. U razdoblju od 2010. do 2015. godine hospitalizirano je 58 bolesnika zbog suspektne leptospiroze. Od ukupno 58 bolesnika, u 39 bolesnika (67%), serološki je potvrđen porast protutijela u značajnom titru za endemska područja (≥1: 500). Oboljeli su bili najčešće muškog spola (86%). Bolesnici su češće živjeli u ruralnim područjima ili predgrađu (72%). Najčešće su oboljevali ljudi u skupini srednje životne dobi od 31 do 65 godine (59%) u odnosu na bolesnike koji su bili mlađi od 30 godina (13%) i stariji od 65 godina (11%). Najmlađi bolesnik je imao 16 godina, a najstariji 78 godina. Bolest je bila vrlo teška kod 31 bolesnika (53%), a umrla su 2 bolesnika (3%). Najveća količina oborina je bila 2010. godine (974,5 mm), u proljeće tj. u razdoblju od 4. - 6. mjeseca. U 2014. godini ukupna je količina oborina bila veća od godišnjeg prosjeka (962,9 mm), što je uzrokovalo veliku poplavu. Iste godine, nakon poplave u proljeće, veća količina oborina od godišnjeg prosjeka bila je u ljeto tj. u razdoblju od 7. - 9. mjeseca, kada se bilježi najveći broj oboljelih od leptospiroze. Zaključak. Količina oborina utječe na veću pojavnost leptospiroze u ljudi, ali samo ukoliko više padalina ima tijekom ljetne sezone. Poplava i povećana količina oborina tijekom ljeta mogu dovesti do epidemije leptospiroze. Nije dokazan utjecaj srednje temperature zraka i vlažnosti zraka na pojavnost leptospiroze kod ljudi.Leptospirosis is one of the world\u27s most widespread zoonosis caused by the spirochete Leptospira spp. Croatia is 13th in the world but also the first in Europe with 17.3 registered patients among 1000000 inhabitants. Brod –Posavina County (BP County) according to its geographical position and natural environment is classified as an endemic area for leptospirosis. Aim. To examine the impact of rainfall, humidity and air temperature on the incidence of leptospirosis. Methods. Data from the state Meteorological and Hydrological Service about rainfall, humidity and air temperature during the period from 2010 to 2015 were analyzed according to the quarterly season periods. The number of patients with leptospirosis who were treated in the same period at the General Hospital, Department for Infectious Diseases in Slavonski Brod were also analyzed. Results. In the period from 2010 to 2015, 58 patients were hospitalized because of suspected leptospirosis. From the total of 58 patients, in 39 patients (67%) serological tests confirmed a significant increase in antibody titer in endemic areas (≥1: 500). Patients were mostly male (86%) and were more likely to live in rural areas or the suburbia (72%) than in urban environment. The most common were the patients with mean age of 31–65 years (59%) compared to patients who were younger than 30 years (13%) and over 65 (11%). The youngest patient was 16 and the oldest was 78. The disease was very severe in 31 patients (53%), and 2 patients (3%) died. The highest amount of rainfall was recorded in 2010 (974.5 mm), during spring time period from April to June. In 2014, the total amount of rainfall was higher than the annual average (962.9 mm), which caused a great flood. That same year, after the floods in the spring, greater rainfall than the yearly average was recorded in the summer period from July to September, when the highest number of leptospirosis cases was recorded. Conclusion. Rainfall affects the higher incidence of leptospirosis in humans, but only if greater amount of rainfall happens during the summer season. Floods and increased rainfall during the summer can lead to an epidemic of leptospirosis. It is not proven that the mean air temperature and humidity have an effect on the incidence of leptospirosis in humans

Corrigendum to "A fatal case of COVID-19 due to metabolic acidosis following dysregulate inflammatory response (cytokine storm)" [ID Cases 21 (2020) e00829]

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The effects of climate elements on the incidence of leptospirosis in Brod – Posavina County

Leptospiroza je jedna od globalno najraširenijih zoonoza uzrokovana spirohetom Leptospira spp. Hrvatska je na 13. mjestu u svijetu, ali i na 1. mjestu u Europi po prijavljenom broju oboljelih sa 17,3 bolesnika na 1000000 stanovnika. Brodsko-posavska županija (BP županija) je prema svom geografskom položaju i prirodnom okruženju svrstana u endemsko područje za leptospirozu. Cilj. Ispitati utjecaj količine oborina, vlažnosti zraka i temperature zraka na pojavnost leptospiroze. Materijali i metode. Prema podacima Državnog hidrometeorološkog zavoda, analizirane su količine oborina, vlažnost i temperature zraka u razdoblju od 2010. do 2015. godine, prema tromjesečnim razdobljima tj. godišnjim dobima. Također smo analizirali i broj oboljelih od leptospiroze na području BP županije, koji su liječeni u istom vremenskom razdoblju na Odjelu za infektivne bolesti u Slavonskom Brodu. Rezultati. U razdoblju od 2010. do 2015. godine hospitalizirano je 58 bolesnika zbog suspektne leptospiroze. Od ukupno 58 bolesnika, u 39 bolesnika (67%), serološki je potvrđen porast protutijela u značajnom titru za endemska područja (≥1: 500). Oboljeli su bili najčešće muškog spola (86%). Bolesnici su češće živjeli u ruralnim područjima ili predgrađu (72%). Najčešće su oboljevali ljudi u skupini srednje životne dobi od 31 do 65 godine (59%) u odnosu na bolesnike koji su bili mlađi od 30 godina (13%) i stariji od 65 godina (11%). Najmlađi bolesnik je imao 16 godina, a najstariji 78 godina. Bolest je bila vrlo teška kod 31 bolesnika (53%), a umrla su 2 bolesnika (3%). Najveća količina oborina je bila 2010. godine (974,5 mm), u proljeće tj. u razdoblju od 4. - 6. mjeseca. U 2014. godini ukupna je količina oborina bila veća od godišnjeg prosjeka (962,9 mm), što je uzrokovalo veliku poplavu. Iste godine, nakon poplave u proljeće, veća količina oborina od godišnjeg prosjeka bila je u ljeto tj. u razdoblju od 7. - 9. mjeseca, kada se bilježi najveći broj oboljelih od leptospiroze. Zaključak. Količina oborina utječe na veću pojavnost leptospiroze u ljudi, ali samo ukoliko više padalina ima tijekom ljetne sezone. Poplava i povećana količina oborina tijekom ljeta mogu dovesti do epidemije leptospiroze. Nije dokazan utjecaj srednje temperature zraka i vlažnosti zraka na pojavnost leptospiroze kod ljudi.Leptospirosis is one of the world\u27s most widespread zoonosis caused by the spirochete Leptospira spp. Croatia is 13th in the world but also the first in Europe with 17.3 registered patients among 1000000 inhabitants. Brod –Posavina County (BP County) according to its geographical position and natural environment is classified as an endemic area for leptospirosis. Aim. To examine the impact of rainfall, humidity and air temperature on the incidence of leptospirosis. Methods. Data from the state Meteorological and Hydrological Service about rainfall, humidity and air temperature during the period from 2010 to 2015 were analyzed according to the quarterly season periods. The number of patients with leptospirosis who were treated in the same period at the General Hospital, Department for Infectious Diseases in Slavonski Brod were also analyzed. Results. In the period from 2010 to 2015, 58 patients were hospitalized because of suspected leptospirosis. From the total of 58 patients, in 39 patients (67%) serological tests confirmed a significant increase in antibody titer in endemic areas (≥1: 500). Patients were mostly male (86%) and were more likely to live in rural areas or the suburbia (72%) than in urban environment. The most common were the patients with mean age of 31–65 years (59%) compared to patients who were younger than 30 years (13%) and over 65 (11%). The youngest patient was 16 and the oldest was 78. The disease was very severe in 31 patients (53%), and 2 patients (3%) died. The highest amount of rainfall was recorded in 2010 (974.5 mm), during spring time period from April to June. In 2014, the total amount of rainfall was higher than the annual average (962.9 mm), which caused a great flood. That same year, after the floods in the spring, greater rainfall than the yearly average was recorded in the summer period from July to September, when the highest number of leptospirosis cases was recorded. Conclusion. Rainfall affects the higher incidence of leptospirosis in humans, but only if greater amount of rainfall happens during the summer season. Floods and increased rainfall during the summer can lead to an epidemic of leptospirosis. It is not proven that the mean air temperature and humidity have an effect on the incidence of leptospirosis in humans