The Global Meningococcal Initiative (GMI) aims to prevent invasive meningococcal disease (IMD) worldwide through education, research and cooperation. In March 2019, a GMI meeting was held with a multidisciplinary group of experts and representatives from countries within Eastern Europe. Across the countries represented, IMD surveillance is largely in place, with incidence declining in recent decades and now generally at < 1 case per 10 0,0 0 0 persons per year. Predominating serogroups are B and C, followed by A, and cases attributable to serogroups W, X and Y are emerging. Available vaccines differ between countries, are generally not included in immunization programs and provided to high-risk groups only. Available vaccines include both conjugate and polysaccharide vaccines; however, current data and GMI recommendations advocate the use of conjugate vaccines, where possible, due to the ability to interrupt the acquisition of carriage. Ongoing carriage studies are expected to inform vaccine effectiveness and immunization schedules. Additionally, IMD prevention and control should be guided by monitoring outbreak progression and the emergence and international spread of strains and antibiotic resistance through use of genomic analyses and implementation of World Health Organization initiatives. Protection of high-risk * Corresponding author.

Candida bloodstream infections (BSI) are a significant cause of mortality in intensive care units (ICU), hereof the prospective 12-months (2014-2015) hospital- and laboratory-based survey was performed at the Serbian National Reference Medical Mycology Laboratory (NRMML). Candida identification was done by a matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry and a susceptibility test, according to the Clinical and Laboratory Standards Institute methodology. Among nine centres (265 beds; 10 820 patient admissions), four neonatal/paediatric (NICU/PICUs) and five adult centres (ICUs) participated, representing 89 beds and 3446 patient admissions, 166 beds and 7347 patient admissions respectively. The NRMML received 43 isolates, 17 from NICU/PICUs and 26 from adult ICUs. C. albicans dominated highly in NICU/PICUs (~71%), whereas C. albicans and C. parapsilosis were equally distributed within adults (46%, each), both accounting for ~90% of received isolates. The resistance to itraconazole and flucytosine were 25% and 2.4% respectively. In addition, the 2 C. albicans were azole cross-resistant (4.6%). The overall incidence of CandidaBSI was ~3.97 cases/1000 patient admissions (4.93 in NICU/PICU and 3.53 in adult ICU). The 30-day mortality was ~37%, most associated with C. tropicalis and C. glabrataBSI. Data from this national survey may contribute to improving the Balkan and Mediterranean region epidemiology of CandidaBSI within ICUs.

The aim of this study was to present the epidemiology of invasive diseases caused by Neisseria meningitidis and Streptococcus pneumoniae in the pre-vaccine period, and Haemophilus influenzae in the post-vaccine period in a pediatric population from Serbia. Among the meningococci, serogroup B dominated (83%), followed by serogroup C (11.3%). High antigenic diversity was found, with fine type P1.5-1,10-4 being the most frequent. Moderate susceptibility to penicillin was common (55%). Within pneumococci, serotypes 19F, 14, 6B, 6A, 18C, 23F, 3, and 7F prevailed, while 19A was rare (3.6%). The coverages of PCV10 and PCV13 were 68% and 84%, respectively. Major sequence types were ST320, ST15, ST273, ST271, and ST81. Non-susceptibility to penicillin (66.7%), cefotaxime (37%), and macrolides (55%) was predominantly detected in vaccine-related serotypes. Among the 11 invasive H. influenzae isolates collected, there were six Hib, three non-type b, and two non-typeable strains (ntHi) that were antibiotic susceptible. These results imply a potential benefit of future Men-B vaccine implementations. For pneumococci, as PCV10 was recently introduced, a significant reduction of morbidity and antibiotic resistance might be expected. The efficiency of Hib vaccination is evident, but a shift towards non-type b and ntHi strains may be anticipated.

This case is presented to emphasize the negative outcome of empirical treatment when Listeria monocytogenes is not taken into consideration. Furthermore, the administration of ampicillin and gentamicin combination for treatment should be considered as the best therapeutic option in Listeria monocytogenes meningoencephalitis.

The COVID-19 pandemic has shaken the majority of health systems around the world, pointing out that it is necessary to invest in the modern equipment for molecular diagnostics, as well as to provide an adequate space within microbiological laboratories for this form of diagnostics, according to the standards that are required for such procedures. It is also necessary to increase the number of specialists within the field of medical microbiology, especially in those laboratories where the lack of experts is at an alarming level. Investing in the diagnostic branches of medicine (and microbiology, as well) provides the optimal health protection: fast and correct diagnosis, the application of the adequate antimicrobial therapy as soon as possible, resulting in greater chances for curing. Furthermore, this leads to fewer hospital days and fewer deathly outcomes, while for infirmary patients this means a faster diagnostic procedure and a decrease in the number of specialist examinations, which are sometimes unnecessary. During the Covid-19 pandemic, The Section of Microbiologists of the Serbian Medical Society as well as the Institute for Microbiology and Immunology of the Faculty of Medicine of Belgrade University, have made themselves available to the Ministry of Health of The Republic of Serbia for the identification of potential laboratory capacities and for conducting necessary experts training, for doctors specialists and for laboratory technicians, as well. Although new technologies develop fast and the laboratory work becomes automated, in theory and in practice as well, an educated expert in medical microbiology still presents the main pillar that stands up for a precise, modern, quick and high-quality diagnosis of infective pathogens, especially those with pandemic potential.