Faculty of Medicine
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Item type:Publication, ANTIMICROBIAL RESISTANCE PROFILES OF DIARRHEAL PATHOGENS ISOLATED FROM HOSPITALIZED ADULT PATIENTS WITH ACUTE GASTRO-ENTERITIS,(SHMSHM - AAMD, 2025); ; Background: Acute gastroenteritis is a self-limiting disease, but in high-risk patients for bacteremia like neonates and immunocompromised patients, appropriate antimicrobial treatment is required. Antimicrobial resistance (AMR) has become a global health challenge, particularly in bacterial pathogens causing gastrointestinal infections, thus per protocol treatment is necessary. Material and methods: This retrospective descriptive study included 200 in-patients with acute gastroenteritis, at the University Clinic for Infectious Diseases, Skopje, between July 2022 and August 2024. Stool samples were collected and tested by standard microbiological methods. Antimicrobial resistance profiles of isolates were determined by the disc-diffusion technique according to EUCAST. Results: Among 200 patients analyzed, 53% were confirmed to have an infectious etiology, with Salmonella enteritis group D as the predominant pathogen (36%), followed by Clostridium difficile and Campylobacter jejuni (6%). S. typhimurium was isolated in one patient. Viral etiology like Norovirus and Rotavirus was detected in 4,5% of cases. Resistance to ampicillin was observed in all Salmonella isolates, while C. jejuni showed no resistance to standard antimicrobial therapy. We lack data on C. difficile susceptibility. Conclusions: These findings provide insights in the most commonly found diarrheal pathogens in our setting and the resistance trends, for which reason further and appropriate empirical treatment options in patients with acute gastroenteritis should be explored. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Epidemiological and clinical features of patients with Clostridoides difficile infection(Elsevier BV, 2024-12); ; Georgievska, DajanaAIM Investigation and identification of epidemiological characteristics, risk factors and treatment regimens effectivity in reducing morbidity and mortality. BACKGROUND C.difficile remains the leading cause of health care associated diarrhea, usually as a result of irrational use of antimicrobial therapy. METHODS Retrospective descriptive study (October 2020-january2024) included all patients with clinical symptoms of Clostridoides difficile infection (CDI) admitted at our clinic. Diagnosis is based on isolation with coproculture for C.difficile, toxin confirmation with immunochromatography, small number confirmed with PCR film array. RESULTS 594 inpatients with clinical symptoms of CDI were evaluated and diagnosis was confirmed in 44. Average mean age was 58,5 (29-90)years, approximately with no differencies on sex representation. Comorbidities and previous hospitalisations were noted in two third of them, and 63% had used antimicrobial drugs, while 34% had history of corticosteroid usage and 4,5% imunosupressive therapy. Often used antibiotics cephalosporins, clindamycine, quinolones and macrolides. 68,2% had history of protein pump inhibitors usage. Culture positive were 38%, toxinA/B is confirmed with immunochromatography in 77% of patients, PCR film array confirmed C.difficile toxin A/B in the remaining patients. Treatment is carried out with oral vancomycine in 56% of patients, 15% with metronidazole and the remaining with combination of two drugs. Regarding outcomes 90% of patients were cured while 10% had fatal outcomes and CDI is not considered the main cause of death. CONCLUSION Elderly patients with antibiotic history treatment, previous healthcare exposures and comorbidities were the most affected by CDI infection. Metronidazole and vancomycine has shown good therapeutic results. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Initial empiric antimicrobial treatment of Chlamydia pneumoniae: a study of 54 cases in the Republic of Macedonia(Macedonian Academy of Sciences and Arts, 2006-07-27); ;