MULTIDRUG RESISTANT INFECTIONS IN INTENSIVE CARE UNITS

Background: Intensive care units (ICU) are often the epicentre of development of infections caused by multidrug resistant (MDR) organisms. Purpose: The aim of our study was to determine the prevalence and types of ICU-acquired infections, pathogens associated with such infections and to determine the antibiotic resistance pattern of the presented pathogens. Material and methods: In the study were included 130 patients hospitalized into the surgical ICU of the University Clinic for Anesthesiology and Intensive Care in Skopje in period of 2 months, April -Jun, 2017. who developed infection after at least 72 hours of their hospitalization. In all of them the pathogens and their antibiotic resistance pattern were identified. Results: Twenty of 130 (15.4%) patients developed ICU-acquired infection. Most common infections were pneumonia (50%) and surgical site (30%) infections.Gram-negative organisms were more common isolated than Gram-positive organisms (83% vs.17%). The most common isolated bacteria were Acinetobacter species (30, 41.7%) and Pseudomonas aeruginosa (15, 20.8%). All isolated species were MDR organisms resistant to the most used antibiotics like Cephalosporins, Gentamicin, Ciprofloxacin and Clindamycin. Pseudomonas aeruginosa and Acinetobacter species were sensitive to Colistin, Methicillin-resistant Staphylococcus aureus (MRSA) to Vancomycin and Linezolid and Enterococcus only to Linezolid. Klebsiella pneumoniae and Proteus mirabilis showed low resistance only to Amikacin and Carbapenems. Conclusions: Our study obtained local data about the prevalence and types of ICU-acquired infections, types of pathogens and their antibiotic resistance pattern.Based on this knowledge, clinicians can choose appropriate antibiotics, avoiding antibacterial drug overuse and MDR bacteria development

Testicular infection in brucellosis: Report of 34 cases

Background/Purpose: To present clinical and laboratory features, treatment options, and outcome in patients with brucellar testicular infection and to compare them with analogous in brucellar patients without testicular involvement. Methods: Thirty four brucellar patients with testicular infection treated in two general hospitals in the Republic of Macedonia, during the period 1998–2009, were retrospectively analyzed. Their clinical and laboratory characteristics were compared with analogous in 364 male brucellar patients without testicular infection, who were treated at the same hospitals during the same time period. Results: Brucellar testicular infection was evident in 34 (8.5%) out of 398 male patients with brucellosis. The median age of the patients was 46.5 years. In all patients testicular involvement was presented as an acute form with a median duration of 5 days (range, 2–14 days) prior to diagnosis. Twenty-three of the patients had at least one other simultaneous focal infection. After starting with the treatment testicular infection lasted a median 10 days, range 7–21 days. Brucellar patients with testicular infection when compared with other brucellar patients more frequently manifested fever (97% vs. 61%), concomitant spondylitis (32% vs. 16%), and urinary system involvement (12% vs. 2%). Also, the relapse rate in patients with testicular involvement was significantly higher (24% vs. 9%). Conclusion: In endemic regions brucellosis should be taken into consideration in any patient with testicular infection. Brucellar testicular involvement is usually characterized with a severe acute clinical presentation and a high percentage of relapses which entails the need of timely recognition and proper treatment duration of at least 60 days

Медицинска микробиологија и паразитологија, Специјален дел

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