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The objective of this study was to determine some features of cystic echinococcosis among children and adolescents, such as epidemiology, diagnosis, organ localization, treatment, and social and environmental factors favoring transmission of the disease. The 18-year study period (1996-2013) includes officially registered primary cases treated surgically, and/or with drug therapy, and/or with the puncture, aspiration, injection, reaspiration technique. Organ localization of the cysts and the most common diagnostic procedures were studied from the patients' medical records. Groups of diseased and healthy children were surveyed to outline some of the environmental and social factors influencing morbidity. From 1996 to 2013, the average annual incidence of cystic echinococcosis in the country was 6.7 per 100,000, but with significant variations in the incidence between different age groups. The hydatid cysts in children aged 0 to 9 years may most frequently be found in the lungs, in contrast to patients from other age groups. Almost 90% of the affected children had sustained contact with dogs. At present, among the countries of the European Union, Bulgaria holds the highest incidence and prevalence of cystic echinococcosis. Childhood echinococcosis remains a serious health problem for the country. Therefore, the study of cystic echinococcosis in children has important epidemiological significance concerning the intensity of transmission.

This report describes the first identification of OXA-24 carbapenemase-producing Acinetobacter baumannii isolates from Bulgaria. According to national surveillance data A. baumannii along with Pseudomonas aeruginosa are the most troublesome microorganisms in hospital environment with high rates of acquired carbapenem resistance. In the present study real-time multiplex PCR was performed to identify the most common carbapenemase genes in 15 non-duplicate carbapenem-resistant A. baumannii isolates collected in 2012. The results showed lack of KPC, GES, VIM, IMP-type enzymes. Four A. baumannii isolates tested positive by PCR for the acquired OXA-24 together with the intrinsic OXA-51 carbapenemase. OXA-24 and OXA-23 were determined as co-existent in one isolate. Two isolates were identified with OXA-23 in addition to the OXA-51 carbapenemase.

The purpose of this investigation was to review the clinical cases diagnosed as systemic or extraintestinal salmonellosis between 2005 and 2010 in Bulgaria, to determine the antimicrobial resistance of the causative salmonellae, and to analyze the pulsed field gel electrophoresis (PFGE) profiles of extraintestinal Salmonella Corvallis isolates. Culture, biochemical tests, and serotyping were performed. Resistance to 12 antimicrobial agents was studied with the Bauer-Kirby disk diffusion method. The double-disk synergy method was used for the screening of the presence of extended-spectrum beta-lactamases (ESBLs). PFGE typing and analysis of the dendrogram was performed for the comparative investigation of Salmonella Corvallis isolates. Between 2005 and 2010, 2,227 human non-typhoid Salmonella isolates were investigated at the National Reference Laboratory of Enteric Pathogens, Sofia, Bulgaria. Thirty-three strains (1.48 %) from nine national regions were isolated from patients with systemic and extraintestinal forms of salmonellosis. The serotype distribution was as follows: S. enteritidis (n = 21), S. choleraesuis (diphasic n = 3; monophasic n = 3), S. typhimurium (n = 2), Salmonella Corvallis (n = 2), Salmonella Montevideo (n = 1), and S. javiana (n = 1). Eight patients developed severe forms of infections: sepsis (n = 2), septic shock (n = 1 with fatal outcome), meningitis (n = 3), and acute renal failure (n = 2). Twenty-two percent of isolates were resistant to ampicillin and gentamicin, 17.64 % to tetracycline, 14.28 % to nalidixic acid, and 10 % to chloramphenicol. All isolates were susceptible to ciprofloxacin. One Salmonella Corvallis isolate recovered from a patient with chronic hemolytic anemia produced an ESBL and its PFGE profile demonstrated less than 96 % similarity to fecal and wound Salmonella Corvallis with susceptible phenotypes. S. enteritidis was the most common cause of systemic and extraintestinal forms of human salmonellosis in Bulgaria. Resistance to ampicillin and gentamicin were the predominant profiles, although one Salmonella Corvallis isolate produced an ESBL. The ESBL-producing Salmonella Corvallis isolate clustered separately from the susceptible Salmonella Corvallis isolates.

In 2006, Salmonella enterica serovar I 9,12:l,v:- emerged in Bulgaria. The aim of this study was to characterize Salmonella serovar I 9,12:l,v:- isolates from Bulgaria, Denmark, and the United States. We compared isolates of Salmonella I 9,12:l,v:- and diphasic serovars with similar antigenic formulas by pulsed-field gel electrophoresis (PFGE) and antimicrobial susceptibility. The phase 2 flagellin gene (fljB) was also sequenced for selected isolates. By PFGE, the Salmonella I 9,12:l,v:- isolates from Bulgaria were indistinguishable from the isolate from the United States and distinct from isolates from Denmark; furthermore, several Salmonella I 9,12:l,v:- were indistinguishable from an isolate of Salmonella serovar Goettingen. Sequence analysis showed 100% sequence identity with known H:e,n,z15 sequences of Salmonella Goettingen, which has the antigenic formula I 9,12:l,v:e,n,z15. The study indicated that Salmonella I 9,12:l,v:- is a monophasic variant of Salmonella Goettingen and is present in different countries and on different continents.