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Infections associated with medical procedures, or hospital-acquired infections (HAIs), occur in all hospitals worldwide. An integrated infection-control program with HAI surveillance as its cornerstone can reduce the incidence of HAIs and contribute to economic benefits. The aim of this paper was to report the prevalence and epidemiological features of HAI in hospitals in Vojvodina, Serbia. The study population examined herein was compromised of all of the patients present in the ward at least 48 hours before the day of surveillance. It also included patients that were scheduled for discharge or transfer, and those temporarily absent from the ward for examinations or diagnostic procedures. Data were collected using uniform questionnaires, created by the scientific board of the study. Data from paper questionnaires were entered into a specially created electronic database and analyzed using standard statistical methods. A total of 2 435 patients were included in the study. The frequency of patients with HAI was 6.6% (95% CI: 5.6%-7.6%), and the prevalence of infection was 7.1% (95% CI: 6.1%-8.1%). HAI prevalence was significantly different depending on the ward, ranging from 1.7% in the gynecology department to 18.1% in intensive care departments. The most common type of HAI was pneumonia, representing 20.9% of all reported HAIs. The second most frequently reported type of HAI was surgical site infection (19.8%), followed by urinary tract infection (17.4%), gastro-intestinal infection (14.5%) and bloodstream infection (11.0%). The most commonly found microorganisms were Enterococcus spp. (14.5%), Klebsiella pneumoniae (14.5%), Acinetobacter spp. (13.7%), coagulase-negative Staphylococcus spp. (12.1%), Pseudomonas aeruginosa (10.5%) and Clostridium difficile (7.3%). The most frequently used antibiotics in therapy were third generation cephalosporins to which most of the isolates showed resistance. Although the consumption of carbapenems in this sample was only 8%, the registered carbapenem resistance in some bacteria indicates more frequent and longer use of carbapenems in hospitals with the side effect of selective pressure.

Introduction. Although influenza is longest and most studied infectious disease, to date, not much has been achieved in preventing and combating this disease. Many infectious diseases are now eliminated or significantly reduced, but only influenza remained epidemic and pandemic character. Influenza epidemics occur every year. Increase in number of patients occurs in early winter. Pandemics occur over long intervals of time and are caused by new subtypes of the influenza virus. Objective. To analyze the epidemiological characteristics of influenza through surveillance of influenza during 3 seasons of monitoring. Method. Data for the analysis were gathered from epidemiological surveillance of influenza through sentinel surveillance, virological surveillance and control of severe acute respiratory distress syndrome. Sentinel physician network consisted of doctors from the public sector, general practitioners, pediatricians, and specialists of emergency medicine and pulmonologists from intensive care units. Supervisors were experts from the Institute of Public Health of Vojvodina, Novi Sad. Samples from the patients (nasopharyngeal swabs) were tested by PCR in National Reference Laboratories (Institute of Virology, Vaccines and Sera 'Torlak' in Belgrade) and in Institute of Public Health of Vojvodina). Results. During the pandemic season, based on the recorded incidence or intensity of clinical activity, incidence rate of the influenza virus infections was above the intermediate threshold (246.3) for the territory of Vojvodina in the period from 45th to 52nd week of surveillance with the peak incidence at 50th week (1090.3 / 100,000). In the next two seasons of sentinel surveillance intensity of virus activity threshold was above the average over the period of 4 to 10 weeks (season 2010/11) and of 11 to 13 weeks of surveillance (season 2011/12). The largest number of patients was registered in the age group of 5-14 years, and the lowest number of patients was in age group over 65. Summarized results of virological surveillance of influenza show that during the pandemic season the most frequent isolate was the virus influenza A (H1N1). The largest number (24) of confirmed cases was registered in 51st week of surveillance, which coincided with the highest activity of the virus influenza during sentinel surveillance of ILI. Within virological surveillance in the season 2010/11 out of total of 213 tested samples of patient material, infection was confirmed in 112 samples: influenza A (H1N1) was confirmed in 90% (101/112), type B in 6.3% (7/112) and influenza A (H3N2) in 3.6% (4/112) samples. During the last season dominant infection was influenza A (H3N2) with a share of 96.5% (55/57) of all confirmed cases of sentinel and non-sentinel specimens tested. The average age of the 38 patients with fatal outcome during the seasons 2009/10 and 2010/11 was 47.1 (range: 12 to 76 years), and all were confirmed to infection with influenza virus A (H1N1). Obesity had the largest share as a factor of comorbidity, and was registered in 36.8% (14/38) patients with fatal outcome. Conclusion. The influenza virus is constantly present in a population with different intensity from year to year. Disease is the most often registered in the preschool and school children, but fatalities due to influenza are usually registered among the working population. Uvod. Iako je influenca najduže i najviše izučavana zarazna bolest, do danas se nije mnogo postiglo u sprečavanju i suzbijanju ovog oboljenja. Mnoge zarazne bolesti su danas eliminisane ili je njihovo javljanje značajno smanjeno, ali je influenca zadržala epidemijski i pandemijski karakter. Epidemije influence se javljaju svake godine. U zemljama severne hemisfere epidemije imaju sezonski karakter. Porast broja obolelih je superponiran, odnosno poklapa se sa početkom zimskog perioda. Pandemije se javljaju u dužim vremenskim intervalima i uzrokovane su novim podtipovima virusa. Cilj rada. Analizirati epidemiološke karakteristike influence kroz nadzor nad gripom tokom tri sezone praćenja. Metod. Podaci za analizu potiču iz epidemiološkog nadzora nad gripom kroz predostrožni (sentinel) nadzor, virusološki nadzor i nadzor nad teškim akutnim respiratornim distres sindromom. Mrežu sentinel lekara činili su lekari iz državnog sektora, lekari opšte medicine i pedijatri, a u jedinicima intenzivne terapije specijalisti urgentne medicine i pulmolozi. Koordinatori nadzora su bili stručnjaci Instituta za javno zdravlje Vojvodine, Novi Sad. Rezultati. U AP Vojvodini, tokom pandemijske godine nadzora nad gripom, stopa incidencije je iznad srednjeg praga intenziteta u periodu od 45. nedelje tekuće godine do 1. nedelje naredne godine, dok su u postpandemijskom periodu vrednosti stopa incidencije iznad praga srednjeg intenziteta u periodu od 1. do 11. nedelje (sezona 2010/2011), odnosno od 11. do 14. nedelje (sezona 2011/2012) nadzora. Tokom pandemijske i naredne godine u uzorcima bolesničkog materijala (bris grla/nosa) dominira infekcija virusom gripa tip A podtip H1N1, a u sezoni 2011/2012 infekcija virusom gripa tip A podtip H3N2. Tokom pandemijske godine ukupan broj umrlih je 32, a tokom naredne sezone 6, dok u poslednjoj sezoni nadzora nisu registrovani smrtni ishodi od gripa. Najveće procentualno učešće umrlih je u uzrastu od 40 do 59 godina i iznosi 55,3% (21/38). Zaključak. Virus influence je konstantno prisutan u populaciji, s različitim intenzitetom aktivnosti od godine do godine. Oboljenje se najčešće registruje u predškolskom i školskom uzrastu, ali su smrtni ishodi zbog gripa najčešće registrovani među radno aktivnim stanovništvom.

Hospital environments provide a special setting for the interaction of microbiological agents of infection and a host of patients and healthcare workers. Although the basic tenets about the spread of infections in hospital have not changed, new issues have emerged that make infection control more problematic. The aim of this paper was to provide the epidemiological characteristics of nosocomial infections and pathogens among patients in an intensive care unit (ICU), the department with the highest risk of the infections associated with medical devices and healthcare.

Due to the atypical symptoms and signs of Q fever, the high incidence of mild infections and the fact that in our region the appearance of this anthropozoonosis is linked to the lambing season (the end of winter and beginning of spring), when the greatest frequency of respiratory infections is manifested, Q fever is not recognized very often. The possible lethal complications, the fact that Coxiella burnetii can survive for years in the environment and be transferred by airstream in great breathing spaces, the small infectious dose necessary to cause the disease and speculation as to its possible use in bioterrorism, make it a significant public health problem. The aim of our study was to give some data on Q fever in the Autonomous Province of Vojvodina, Serbia, an area with a high degree of agricultural activity.

WOS: 000345825900004, PubMed ID: 24849547, We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon- release assay (Quantiferon TB gold in tube) 90.2%, automated culture systems (ACS) 81.8%, Lowenstein Jensen medium (L-J) 72.7%, adenosine deaminase (ADA) 29.9% and EZNs 27.3%. CSF-ACS was superior to CSF L-J culture and CSF-PCR (p

Introduction. Shigellosis causes around 165 million infections and around 1 million deaths in the world every year. Two thirds of both infections and deaths are among children younger than 10. Shigellosis mainly spreads by direct or indirect contact, but water- and food-borne outbreaks are not rare. Material and methods. A descriptive epidemiological method was used to analyse characteristics of shigellosis outbreaks in the AP of Vojvodina in the period 1979-2005. Results. During this period 9.083 shigellosis infections were registered, 51,9% of them in 202 shigellosis outbreaks. The leading way of transmission was contact, but water- and food-borne outbreaks were also detected. The average number of infections in contact outbreaks of shigellosis was small - 6.3 infections. The highest average is in water-borne outbreaks - 55.1. Most of the outbreaks were those occurring in families (47.5%) and most of them were registered in august. Discussion. Shigellosis has been mandatory reported in the AP of Vojvodina since 1945 and results of outbreak investigation of this disease were analyzed since 1979. In the first half of this period water was the most common way of agent transmission in shigellosis outbreaks, but in recent 15 years the contact became the leading one. In the last 5 years there was no water-borne shigellosis outbreaks. Almost one third of all outbreaks were imported from Montenegro and Croatia by tourists coming back from those countries. Most of the outbreaks are small outbreaks occurring in families, primarily transmitted by contact. Outbreaks in facilities for care of disabled children and elders are also important. Sh. sonnei and Sh. flexneri are the two serotypes identified, the former in 57.4% and the latter in 40.1% outbreaks. Conclusion. Shigellosis is a disease occurring in the AP of Vojvodina primarily in small outbreaks inside families, transmitted by contact, most often in August and more often caused by Sh. sonnei. Health promotion and strict use of general measures of disease control and prevention are important.

Introduction. The goal is to investigate epidemiological characteristics of outbreaks of health-care-associated infections in health care institutions such as hospitals, nursing homes and ambulatory care settings. Material and methods. Relevant data associated with outbreaks in health-care settings in the period from 1980 to 2004 were retrospectively collected from epidemiological annual reports of infectious diseases in Vojvodina. Descriptive statistics were applied to the data. Results. The mean number of outbreaks is 7 per year (ranging from 0 to 13 outbreaks) involving 22 cases per outbreak (ranging from 2 to 74 cases). The most frequently involved settings (51%) were nursing homes and most (31%) of the patients were more than 60 years old. This surveillance documented that wards for children less than 12 months of age were the most frequently (57.5%) associated with nosocomial outbreaks in hospitals. The leading diseases were gastrointestinal tract infections with case fatality rale of 1.8%, that is 10-100 fold higher than rales in general population. The leading transmission route in 70% of outbreaks was contact, demonstrating the association between infections and poor general and hand-hygiene policies. Conclusion. The proportion of nosocomial outbreaks in total number of out?breaks is 9%. The most frequent are gastrointestinal outbreaks transmited in long-term-care facilities by contact route, involving elderly patients. Introducing proper environmental and hand hygiene policies in health-care settings with strict imple?mentation of procedures may significantly decrease the number of nosocomial infections and prevent nosocomial outbreaks. .

Introduction. With the widespread use of active immunization, significant results have been achieved in the control and prevention of numerous communicable diseases. The Expanded Programme on Immunization of the World Health Organization is intended to strengthen national programs for the reduction in the incidence and mortality rates and global elimination or eradication of communicable diseases. The aim of this paper is to analyze results of the immunization program in Vojvodina. Material and methods. The results of the immunization program were analyzed on the basis of the incidence rates, since the introduction of the mandatory reporting system, till 2006. The analysis included immunization coverage against diphtheria, tetanus, pertussis, poliomyelitis and measles as well as reported cases of missed opportunities in the period from 1997 to 2006. Results. Poliomyelitis has not been reported in Vojvodina since 1963, diphtheria since 1978 and measles in the period from 2001 to 2006. Sporadic cases of pertussis have been reported in unimmunized children of the youngest age, and tetanus in unimmunized elderly population. Vaccination coverage against poliomyelitis, diphtheria, tetanus and pertussis was above 96%. Vaccination coverage against measles was lower (95% vaccination, 87% revaccination). The highest proportion of missed opportunities was caused by not responding to immunization calls (46.6%). Conclusion. These results can be maintained by up-to-date (UTD) immunization and high vaccination coverage without territorial and population differences. Data on the total number of children without up-to-date vaccination cannot be obtained on the basis of administrative coverage follow-up. It is necessary to establish follow-up mechanisms for UTD immunization, which would reveal the number of children at risk from vaccine preventable diseases and characteristics of unimmunized population.

An outbreak of measles is ongoing in northern Serbia. The first cases were in January 2007 in the area of Novi Sad in the autonomous province of Vojvodina. As of 12 March 2007, 121 suspected cases had been reported to the regional Institute of Public Health.