Surgical site infections (SSIs) determine an increase in hospitalization time and antibiotic therapy costs. The aim of this study was to identify the germs involved in SSIs in patients from the Clinical Emergency County Hospital of Craiova (SCJUC) and to assess their resistance to antimicrobials, with comparisons between surgical wards and the intensive care unit (ICU). The biological samples were subjected to classical bacteriological diagnostics. Antibiotic resistance was tested by disc diffusion. We used hierarchical clustering as a method to group the isolates based upon the antibiotic resistance profile. The most prevalent bacterial species isolated were Staphylococcus aureus (S. aureus; 50.72%), followed by Escherichia coli (E. coli; 17.22%) and Pseudomonas aeruginosa; 10.05%). In addition, at lower percentages, we isolated glucose-non-fermenting, Gram-negative bacteria and other Enterobacteriaceae. The antibiotic resistance varied greatly between species; the most resistant were the non-fermenting Gram-negative rods. E. coli exhibited lower resistance to third generation cephalosporins, quinolones and carbapenems. By contrast, Klebsiella was resistant to many cephalosporins and penicillins, and to a certain extent to carbapenems due to carbapenemase production. The non-fermenting bacteria were highly resistant to antibiotics, but were generally sensitive to colistin. S. aureus was resistant to ceftriaxone (100%), penicillin (91.36%), amoxicillin/clavulanate (87.50%), amikacin (80.00%) and was sensitive to levofloxacin, doxycycline, gentamycin, tigecycline and teicoplanin. The Enterobacteriaceae resistance was only slightly higher in the ICU, particularly to carbapenems (imipenem, 31.20% in the ICU vs. 14.30% in the surgical wards; risk ratio = 2.182). As regards Staphylococcus species, but for non-fermenting bacteria, even if the median was almost the same, the antibiotic resistance index values were confined to the upper limit in the ICU. The data gathered from this study may help infection control teams to establish effective guidelines for antibiotic therapies in various surgical procedures, in order to minimize the risk of developing SSIs by the efficient application of the anti-infection armamentarium.

Background Nigella sativa is a herb from the Mediterranean region with antidiabetic, bronchodilator, antioxidant, hepatoprotective, lipid lowering, anti-inflammatory and analgesic properties. Purpose This study aimed to reveal the antifungal activity of aqueous, methanolic and chloroform extracts obtained from the plant seeds, compared with the effect of traditional antifungals. Materials and methods Using standard mycological diagnostic methodology The authors isolated and identified 20 strains of Candida albicans from pathological products collected from patients hospitalised in different departments of the Craiova Emergency Hospital. Aqueous, methanolic and chloroform extracts were made from the seeds of Nigella sativa, in decreasing dilutions, in which Wattman filter paper discs were soaked and dried and then used to achieve the antifungal graph by using the Kirby-Bauer diffusion technique. Simultaneously, the testing was repeated using standard antifungal disks (Becton Dickinson) and the two sets of results compared. The antifungal effect was assessed by measuring the diameter of the inhibition zone, noting the concentration per disk. Results The results show that methanolic extracts of Nigella sativa have the strongest antifungal effect followed by the chloroform extracts. Aqueous extracts showed no antifungal activity. Conclusions The research shows treatment with natural products in a good light as an alternative for treating fungal infections. The authors envisage Nigella sativa extract enhancing the effect of conventional therapy.

Background Plant species Robinia pseudoacacia L. (Fabaceae) has been used as a medicinal plant since ancient times, as its infusions and extracts have antacid, antibacterial, purgative and emenagogic properties. The volatile oil of the flowers is also used in perfumery and cosmetics. Purpose Due to its high content of volatile oil phenolic compounds, flavonoids and tannins with antimicrobial properties, the present study proposed to investigate the antibacterial and antifungal effect of the species Robinia pseudoacacia. Materials and methods The dry powdered flowers, leaves, bark and seeds of Robinia pseudoacacia were subjected to extraction in a Soxhlet extractor with 90% ethanol. The alcoholic extract obtained in the concentration of 100 mg / ml, was tested using sterile discs of Whatman No. 1 filter paper, impregnated with 100 mg extract. Antibacterial and antifungal effects was evaluated by the Kirby-Bauer disc diffusion method, in accordance with the NCCLS / CLSI standard, using the following infectious agents isolated from patients and the corresponding reference strains: methicillin-resistant Staphylococcus aureus and methicillin-sensitive haemolytic S. epidermidis, Streptococcus pyogenes, Enterococcus, Enterobacter aerogenes, Escherichia coli, Salmonella choleraesuis, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus, Candida albicans. Results Extracts from various different parts of the plant had different antibacterial activities. Extracts of flowers and seeds are efficient antibacterials for Gram positive cocci. Bark and leaf extracts were active against Escherichia coli, Pseudomonas, Proteus, Salmonella choleraesuis, Candida albicans. Conclusions These results prove the antimicrobial or antifungal properties of certain extracts of Robinia pseudoacacia L., which offers an alternative treatment with a natural product with synergistic effects with conventional antibacterial treatment.

Rationale & Objective: Clinical practice guidelines for dietary intake in hemodialysis focus on individual nutrients. Little is known about associations of dietary patterns with survival. We evaluated the associations of dietary patterns with cardiovascular and all-cause mortality among adults treated by hemodialysis.

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