Search

Aim: The aim of our study was to determine the most common bacteria isolated from wound samples and tо compare the frequency of the resistant bacteria isolated over a 3-year period. Material and methods: During a three years period (2017-2019) a total of 11 863 wound samples (wound swabs, punctuates, exudates, tissue, etc.) were obtained from the hospitalized patients in the University Clinics of the ,,Mother Theresa” campus, the City hospital ,,8th September” and the University Clinic for surgical diseases ,,St. Naum Ohridski” in Skopje. All samples were processed at the Institute of Microbiology and Parasitology, Faculty of Medicine, Skopje. They were examined by standard microbiology techniques. Identification and susceptibility of microorganisms were done by both standard methods and automatized Vitek 2 system. Results: Out of a total number of samples, which was 3 463 in 2017, 4 127 in 2018 and 4 273 in 2019, positive were 2 068 (60%), 2 302 (55.8%) and 2 387 (55.9%), respectively. From the total of aerobes/facultative anaerobes (2 758, 2 949 and 3 279 in three consecutive years, 2017, 2018 and 2019, respectively), Staphylococcus aureus was the most predominant isolate (19.5%, 16.6%, 16.9%) followed by Enterococcus spp (16%, 16%, 16.7%), Pseudomonas aeruginosa (12%, 13%, 12.7%) and E. coli (10%, 10.4%, 10.7%). Considering anaerobic bacteria, the percentage of Gram positive anaerobes (Peptostreptococcus) has decreased from 33% to 18% out of a total number of anaerobes, unlike Gram negative anaerobes in which the increasing percentage was mostly observed in bacteria of the genus Bacteroides (from 39% to 45%). The percentage of the resistant strains of MRSA, CNS-MR and VRE was almost the same in that period. In Gram-negatives the percentage of ESBL-positive isolates of E. coli and Enterobacter spp. increased consecutively from 2017 to 2019. The increase in the percentage of resistant strains was more noticeable in ESBL-positive isolates of Klebsiella pneumonia between 2017 and 2018, but in 2019 a percentage decrease can be observed. Considering carbapenem-resistant (CR) Enterobacterales, an increase in the resistance was noticeable in K. pneumonia. The increase in the percentage of resistant strains in Enterobacter spp. between 2017 and 2018, as well as the decrease between 2018 and 2019 was statistically significant. The percentage of CR-isolates of Pseudomonas aeruginosa was from 30% to 38% and for Acinetobacter spp. this percentage was from 81% to 85%. Conclusion: The knowledge of the most commonly isolated bacterial pathogens, especially the presence of resistant bacteria, is crucial and should be continuously monitored in order to understand, construct and update effective treatment algorithms and guidelines., Цел: Цел на студијата е да се детектираат најчестите бактерии изолирани од примероци од рани и да се спореди процентот на резистентни бактерии во тригодишниот период. Материјал и методи: Во период од три години (2017-2019) беа земени вкупно 11 863 примероци од рани (брисеви, пунктати, ексудати, ткиво и др.) од пациенти хоспитализирани во Универзитетските клиники во кампусот ,,Мајка Тереза”, Градската болница ,,8. Септември” Универзитетската клиника за хируршки болести ,,Св. Наум Охридски” во Скопје. Сите примероци беа обработени на Институтот за микробиологија и паразитологија, Медицински факултет, Скопје. За обработка беа користени стандардни микробиолошки техники. Идентификацијата на бактериите, како и одредување на нивната осетливост кон антимикробни средства беше направена со стандардни и автоматизирани методи (Vitek 2- систем). Резултати: Од вкупниот број на примероци кој изнесуваше 3 463 во 2017, 4 127 во 2018 и 4 273 во 2019 год., позитивни беа 2 068 (60%), 2 302 (55,8%) и 2 387 (55,9%), последователно. Од вкупниот број аероби/факултативно анаероби (2 758, 2 949 и 3 279 во три последователни години, 2017, 2018 и 2019 год.), најчесто изолирана беше бактеријата Staphylococcus aureus (19,5%, 16,6% и 16,9%), потоа Enterococcus spp (16%, 16% и 16,7%), Pseudomonas aeruginosa (12%, 13% и 12,7%) и E. coli (10%, 10,4% и 10,7%). Од анаеробните бактерии, беше детектирано намалување на процентот на Грам-позитивните анаероби (Peptostreptococcus) од 33% на 18%, од вкупиот број на анаероби, за разлика од Грам-негативните анаероби каде беше детектирано зголемување на тој процент, особено кај бактериите од родот Bacteroides (од 39% на 45%). Процентот на резистентни соеви (MRSA, CNS-MR и VRE) беше речиси идентичен во испитуваниот период. Кај Грам-негативните бактерии, беше детектирано зголемување на процентот на ESBL-позитивни изолати на E. coli и Enterobacter spp. во периодот од 2017 до 2019, а кај Klebsiella pneumoniaе во периодот од 2017 и 2018 имаше зголемување, а во 2019 намалување на тој процент. Во однос на карбапенем-резистентните (CR) ентеробактерии, кај К. pneumoniae беше детектирано зголемување на процентот на резистентни изолати во сите три години, додека, пак, кај Enterobacter spp. тој процентот беше повисок меѓу 2017 и 2018, а во 2019 год. статистички значајно понизок. Процентот на CR- изолати на Pseudomonas aeruginosa беше помеѓу 30% и 38%, а за Acinetobacter spp. овој процент беше меѓу 81% и 85%. Заклучок: Потребно е континуирано мониторирање на најчесто изолираните бактерии од примероците од рани, особено присуството на резистентни бактерии, со цел примена на соодветни алгоритми и водичи за ефективен третман на инфекциите на рани. &nbsp

BACKGROUND: Squamous cell carcinoma (SCC) of the lower lip is a relatively rare carcinoma, with the incidence of 1 to 2%, but it is the most common carcinoma in the oral cavity accounting for 25-30% of all malignant oral tumours. AIM: This study aimed to determine the role of neovascularisation in the process of tumour progression. METHODS: We analysed the surgical specimens obtained from 60 patients with squamous cell carcinoma (SCC) of the lower lip. The examined group consisted of 45 specimens of patients without metastasis and 15 specimens of patients with metastasis in the regional lymph nodes. Histopathological slides were immunohistochemically stained with an antibody against CD34 and by hematoxylin & eosin staining for routine histopathological examination. RESULTS: The results obtained showed a statistically significant difference in the density of neovascularisation between groups of the SCC with different grade of differentiation (Kruskal-Wallis test: H (2, N = 60) = 30.0943, p = 0.00001). Statistical analysis also showed a significant difference in the density of vascularisation of lower lip SCC between patients without metastasis and patients with neck metastasis (Mann-Whitney U test, p = 0.000198). Applying Pearson’s chi-square test, we found a highly significant statistical difference in grade of SCC differentiation in patients with and without neck metastasis (p = 0.0000). CONCLUSION: In conclusion, the density of neoangiogenesis is increased in tumours with poorer differentiation and in patients with neck metastasis. So, the density of neovascularisation of the primary lip SCC may predict the tumour progression.

BACKGROUND: In the past several decades, the increasing frequency of overweight and obese children and adolescents in the world has become a public health problem. It has contributed significantly to the already high tide of diabetes, cardiovascular and cerebrovascular diseases.AIM: To investigate the frequency of insulin resistance and to evaluate the metabolic profile of insulin resistant and non-insulin resistant obese children and adolescents.SUBJECTS AND METHODS: The study included 96 (45 boys, 51 girls) obese children and adolescents aged 4-17 years old (10.50 ± 2.87 years). Only participants with Body Mass Index ≥ 95 percentile were included. We analysed sera for fasting insulin levels (FI), fasting serum triglycerides (TG), total serum cholesterol (TC), fasting plasma glucose (FPG) and plasma glucose 2 hours after the performance of the oral glucose tolerance test (2-h G). Homeostatic model assessment for insulin resistance (HOMA-IR) index was calculated as fasting insulin concentration (microunits per millilitre) x fasting glucose concentration (millimolar)/22.5. The value of HOMA-IR above 3.16 was used as a cut-off value for both genders.RESULTS: Insulin resistance was determined in 58.33% of study participants. Insulin resistant participants had significantly higher level of 2-h G (p = 0.02), FI level (p = 0.000) as well as TG levels (p = 0.01), compared to non-insulin resistant group. Strikingly, 70.73% of the pubertal adolescents were insulin resistant in comparison to 49.09% of the preadolescents (p = 0.03). Significantly higher percentage of insulin-resistant participants were girls (p = 0.009). Moreover, a higher percentage of the girls (70.59%) than boys (44.44%) had HOMA-IR above 3.16 and had elevated FI levels (70.59% vs 48.89%). The difference in the frequency of insulin resistance among obese versus severely obese children and adolescents was not significant (p = 0.73, p > 0.05). Our study results also showed positive, but weak, correlation of HOMA-IR with age, FPG, TG and BMI of the participants (p < 0.05).CONCLUSION: Higher percentage of insulin-resistant participants was of female gender and was adolescents. In general, insulin resistant obese children and adolescents tend to have a worse metabolic profile in comparison to individuals without insulin resistance. It is of note that the highest insulin resistance was also linked with the highest concentrations of triglycerides.