Chrysobacterium gleum is a nonmotile, oxidase positive, non-fermentative unsporulate Gram-negative bacillus, bacteria belonging to the genus Chrysobacterium. Infections caused by Chrysobacterium spp are usually health care associated and the most frequent in immunocompromised patients and neonates. In this report we present a case of a 35-yearold female patient admitted to the hospital for extreme malnutrition and a hepatic lesion. Chrysobacterium gleum was isolated from tracheal aspirate and blood culture. The strain was identified with Microflex MALDI Biotyper (Bruker Daltonik, Fremont, CA). The patient was successfully treated with piperacillin/tazobactam. Empirical therapy is difficult due to intrinsic resistance to most antimicrobials which are usually effective against Gram-negative bacteria.

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The rapid detection of KPC-producing K. pneumoniae and vigorous implementation of infection control measures were necessary to successfully control the outbreak.

Pediatric infections caused by clonal spread of MRSA and beta-lactamase-producing Gram-negative bacteria are of major concern. Proper infection control measures should be implemented in order to avoid the transmission and major outbreaks.

Background: Some of the genes belonging to cag pathogenicity island (cagPAI) in Helicobacter pylori were found to be associated with an increased severity of gastric mucosal inflammation that might lead to the development of gastroduodenal disease. Aim: The aim of our study was to define a group of patients based on the frequency of virulence genes of cagPAI island and comparison with pathohistological alterations of gastric mucosa who need to be subjected to further eradication therapy after previous unsuccessful eradication therapy and in spite of benign endoscopic findings.Material and methods: In total 103 H. pylori isolates were analysed. Genes encoding virulence factors were detected by PCR with primers for 10 loci in cagPAI: Apcag (cagA promotor region), cagA1, cagA2, cagA3, cagM, cagT, cagE, LEC, tnpA and tnpB. The patients who provided isolates were classified into three clinical categories: non-ulcer dyspepsia (n=69), erosio/ulcus ventriculi (n=22) and erosio/ulcus duodeni (n=12 (5)(6). On the contrary, some of the authors did not find correlation between cagPAI and gastroduodenal disease (7). CagPAI encodes multiple structural components of bacterial type IV secretion system (T4SS). T4SS translocates cagA protein directly to the cytosol of the gastric epitelium where it gets tyrosin phosphorylated by Src-family kinases and becomes able to alter the host cell functions leading to malignant transformation (2). CagA gene is located in the region I of cagPAI and is considered to be the marker of this region. CagA positive isolates are associated with more severe clinical features in many studies. However, there are contradictory results in the references regarding these studies.CagE is also located in the region I and is necessary to induce production of interleukin IL-8. Some authors consider cagE gene to be better marker of cagPAI region compared to cagA and more useful in monitoring the progress of H. pylori induced gastric disease. CagT gene is a marker of cagII region and some studies connect it with more severe clinical disease (8). LEC (left terminal end of cagII) is not necessary for translocation of cagA into the host cell or induction of interleukin IL8. It is associated with peptic ulcer and adenocarcinoma. Some of the study found connection of tnpA gene with peptic ulcer (9).There are no published studies on the presence of H. pylori virulence genes in Croatia. Considering quite large number of patients with multiple unsuccessful eradication therapy, in spite of lack of clinical symptoms and benign endoscopic result, there is a question to pose whether to insist on eradication or not.The aim of our study was to detect virulence genes of H. pylori just in these patients as a possible predictors of future severe gastroduodenal diseases, by comparing it with clinical and pathohistological results. MATERIAL AND METHODS PatientsThe study analysed gastroscopic test results and bioptic specimens of gastric mucosa with positive H. pylori culture in 103 patients examined during routine, clini...