Intranasal octenidine, an antiseptic alternative to mupirocin, can be used for methicillin-resistant Staphylococcus aureus (MRSA) decolonisation in the prevention of nosocomial transmission. A controlled before-after study was conducted in three extended-care hospitals in Singapore. All inpatients with >48 h stay were screened for MRSA colonisation in mid-2015(pre-intervention) and mid-2016(post-intervention). Hospital A: universal daily chlorhexidine bathing throughout 2015 and 2016, with intranasal octenidine for MRSA-colonisers in 2016. Hospital B: universal daily octenidine bathing and intranasal octenidine for MRSA-colonisers in 2016. Hospital C: no intervention. In 2015, MRSA prevalence was similar among the hospitals (Hospital A: 38.5%, Hospital B: 48.1%, Hospital C: 43.4%, P = 0.288). From 2015 to 2016, MRSA prevalence reduced by 58% in Hospital A (Adj OR 0.42, 95% CI 0.20-0.89) and 43% in Hospital B (Adj OR 0.57, 95% CI 0.39-0.84), but remained similar in Hospital C (Adj OR 1.19, 95% CI 0.60-2.33), after adjusting for age, gender, comorbidities, prior MRSA carriage, prior antibiotics exposure and length of hospital stay. Compared with the change in MRSA prevalence from 2015 to 2016 in Hospital C, MRSA prevalence declined substantially in Hospital A (Adj OR 0.35, 95% CI 0.13-0.97) and Hospital B (Adj OR 0.48, 95% CI 0.22-1.03). Topical intranasal octenidine, coupled with universal daily antiseptic bathing, can reduce MRSA colonisation in extended-care facilities.

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Background: Well structured and adequacy influenza surveillance system of Severe Acute Respiratory Infections (SARI) provide to determine a qualitative judgment on the severity of a current influenza epidemic or pandemic in comparison to past epidemics and pandemics. The aim of this study is to provide a research of sentinel surveillance of SARI in Serbia in 2018-2019 influenza season with matching between SARI hospitalizations and the percentage of influenza positive samples in order to testing the adequacy of SARI surveillance.Methods and materials: Sentinel SARI surveillance is performed from week 40 to 20 of the following year. Both epidemiological and virological data were collected on a weekly basis in 25 districts during the period of surveillance. For laboratory confirmation of influenza, Real time polymerase chain reaction (RT-PCR) was used. 10 sentinel hospitals in 4 cities participated in SARI surveillance system. Intensive care units (ICUs), infectious disease, pediatric and respiratory disease wards were all represented.Results: Start of influenza season was registered in week 52/2018. Influenza activity peaked between weeks 3/2019 and 9/2019, with the positivity rate higher than 50%. A total of 1117 SARI cases were reported with 100% recorded age. Of these, 13% were 0-4 years old, 6% were 5-14, 49% were 15-64 years old and 32% were 15-64 years old. Among these cases, 684 (61%) respiratory specimens were collected. The number of positive samples was 356 (52%).The highest proportion of laboratory-confirmed influenza cases was 69% in week 7/2019. Two influenza viruses were confirmed: A(H1)pdm09 and A(H3). A(H1)pdm09 viruses predominated, accounting for 90% of all sentinel SARI detections. The majority of cases with A (H1)pdm09 were registered <60 years of age.Among hospitalized influenza virus-infected patients with acute respiratory distress syndrome (ARDS) admitted to ICU wards (20% of all SARI reported cases), 100% were infected with type A viruses, and of those sub typed, 90% were A(H1)pdm09. Conclusion:Existing the high match between SARI hospitalizations and the percentage of influenza positive samples indicates the adequacy of sentinel SARI surveillance in Serbia. Integration epidemiological with laboratory surveillance highlights the importance of maintaining and improving national influenza surveillance capacity especially in the frame of International Health Regulations.

treat MDRGNB infections. This finding pointed that strict antibiotic policies were required to work out the issue of emerging MDR-GNB infections.

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