Lyme disease (LD) is a natural focal zoonotic disease caused by Borrelia burgdorferi, which is mainly transmitted through infected Ixodes ricinus tick bites. The presence and abundance of ticks in various habitats, the infectivity rate, as well as prolonged human exposure to ticks are factors that may affect the infection risk as well as the incidence of LD. In recent years, 20% to 25% of ticks infected with different borrelial species, as well as about 5,300 citizens with LD, have been registered in the Belgrade area. Many of the patients reported tick bites in city’s grassy areas. The aim of this study was to assess the seroprevalence of B. burgdorferi in high-risk groups (forestry workers and soldiers) in the Belgrade area, and to compare the results with healthy blood donors. A two-step algorithm consisting of ELISA and Western blot tests was used in the study. Immunoreactivity profiles were also compared between the groups. The results obtained showed the seroprevalence to be 11.76% in the group of forestry workers, 17.14% in the group of soldiers infected by tick bites and 8.57% in the population of healthy blood donors. The highest IgM reactivity was detected against the OspC protein, while IgG antibodies showed high reactivity against VlsE, p19, p41, OspC, OspA and p17. Further investigations in this field are necessary in humans and animals in order to improve protective and preventive measures against LD.
BackgroundThe objective of this study was to investigate independent risk factors (RFs) connected with healthcare-associated (HA) Clostridium difficile infection (CDI) in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital.MethodsRisk factors for the infection were prospectively assessed among surgical patients with laboratory confirmed HA CDI and compared with a control group without HA CDI.ResultsThe overall incidence rate of HA CDI was 2.6 per 10000 patient-days. Significant independent RFs for HA CDI were the use of carbapenems (P = 0.007, OR: 10.62, 95% CI: 1.93–58.4), the admission to intensive care unit (P = 0.004, OR:3.00, 95% CI:1.41–6.40), and the administration of 3rd generation cephalosporins (P = 0.014, OR:2.27, 95% CI:1.18–4.39). Patients with HA CDI had significantly higher in–hospital mortality compared to controls (P: 0.007; OR: 8.95; 95% CI: 1.84–43.43).ConclusionsCDI is an important HA infection in population of surgical patients and this study emphasizes the importance of the wise use of antibiotics, and other infection control strategies in order to prevent HA CDI, and to decrease the incidence and in-hospital mortality rate.
The present study was conducted in order to evaluate the efficiency of personal body microclimate cooling systems based on a phase change materials and its effects on physiological strain in soldiers during exertional heat stress in hot environment. The results are obtained in the experiment conducted in the climatic chamber in the Institute of Hygiene, Military Medical Academy in Belgrade. Ten male soldiers were voluntarily subjected to exertional heat stress tests consisted of walking on treadmill (5.5 km/h) in hot conditions (40°C) in climatic chamber. The subjects performed first test while wearing a field camouflage uniform without any cooling system (CONTROL group) and in second test they used additional microclimate cooling system with paraffin wax consist of n-hexadecane (C 16 H 34 ), in a form of cooling packs (COOL group). As indicators of thermal strain, mean skin (T sk ) and tympanic (T ty ) temperature were determined. Simultaneously, thermal effects of phase change materials were measured by thermal imaging camera. The exercise in hot conditions induced a physiological response to heat stress, manifested through increased body core and skin temperatures. The results confirmed that the cooling vest worn over the field uniform was able to attenuate the physiological strain during exercise, compared to the identical exposure in the "control" group. The results of thermal imaging also indicate that heat generated inside the body is the main factor that will affect the phase change material melting time.
Background: Serratia marcescens (SM) is a Gram-negative pathogen discovered by Italian pharmacist, Bizio, in 1819. According to the literature, S. marcescens is resistant to a wide range of antibiotics, including penicillin, cephalosporin, tetracycline, macrolide, nitrofurantoin, and colistin. We conducted a systematic review of published reports, determined what invasive infections could cause SM, and established the most appropriate antibiotic therapy. Methods: We registered this systematic review on the PROSPERO registry of systematic reviews–meta-analyses before we started our research (registration number CRD42022323159). The online searches of published studies were implemented via MEDLINE, the Cochrane Central Register of Controlled Trials, EBSCO, Scopus, Google Scholar, SCIndex, and the registry of clinical studies of human participants (ClinicalTrials.gov). Results: Our study included 32 published articles (9 case series and 23 case reports). There were 57 individual cases, respectively. The oldest patient was 97 years and the youngest patient was a newborn. S. marcescens was, in most cases, isolated from blood followed by urine and cerebrospinal fluid. In most cases, sensitivity was tested to cotrimoxazole (from 27 isolates, 10 showed resistance) followed by gentamicin (from 26 isolates, 3 showed resistance) as well as amikacin (from 21 isolates, none showed resistance). Patients died from an infection in 21 cases (31%). Conclusions: Treatment of SM infections should include carbapenems or aminoglycosides in combination with third-generation (and eventually fourth-generation) cephalosporin. Cotrimoxazole should be considered in cases of uncomplicated urinary infections.
Using a body cooling system based on PCM in the form of vest under NBC protective clothes during physical activity in hot conditions, reduces sweating and alleviates heat stress manifested by increased core and skin temperatures and heart rate values. These effects directly improve heat tolerance, hydration state, decrease in the risk of heat illness, and extends the duration of soldiers' exposure to extreme conditions.
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