Trajkovska dokich, Elena
Preferred name
Trajkovska dokich, Elena
Official Name
Trajkovska dokich, Elena
Main Affiliation
Email
elena.dokic@medf.ukim.edu.mk
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Item type:Publication, Distribution of Clostridioides difficile ribotypes isolated from patients in North Macedonia - Update(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2023); ; As one of the major hospital pathogens Clostridioides difficile strains are constantly a subject of typing. PCR ribotyping is the standard molecular typing method for this bacteriumin Europe.The aim of this study wasto determine the distribution of C.difficileribotypes isolated from patients in North Macedonia.Eighty isolatesof C.difficile, isolated from the same number of patients`fecalsamples being sent to the Institute of Microbiology and Parasitology in Skopjein the periodfrom 2016to 2020in order to diagnose C.difficileinfection, were included.PCR ribotyping was performed by using primers and protocolsdescribed by Bidet. The final determination of the ribotypes was done by using the software BioNumerics.We determinedthe presence of 20 ribotypes. The most commonribotype was 001/072 represented with 32 (40%) isolates,followed by 014/020 represented with 10 (12,5%) isolates and ribotypes 002, 017 and 027 represented by 5 (6,2%) isolates each. All other ribotypes were represented by less than 4 isolates. Allribotype 001/072isolatesoriginated from patients of the “Mother Teresa”Clinical Center. Unlike in most of the European countries where the hypervirulent ribotype 027 is the dominant one, for a prolonged period of time001/072 has beenthe dominantC. difficileribotype isolated from patients in our country.Considering that most of the isolates of this ribotype hadoriginated from Surgicaland Internal DiseasesClinics in the “Mother Teresa” Clinical Center, we might assume that it is the endemic C. difficile strain there. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Distribution of Clostridium Difficile Ribotypes in Macedonian Patients and their Antimicrobial Susceptibility(Scientific Foundation Spiroski, 2019); ; BACKGROUND:Clostridium difficileis a major nosocomial pathogen. In Europe, this bacterium is mostly characterised by PCR ribotyping. Most of the Clostridium difficileinfections (CDI) are treated with vancomycin or metronidazole, although prolonged antibiotic use is considered as one ofthe main risk factors for CDI.AIM: This study aimedto detect the presence of various C. difficileribotypes in hospitalised patients and to investigate their toxigenicity and antibiotic susceptibility.MATERIAL AND METHODS:All stool samples obtained from each patient were inoculated on Columbia blood agar and cycloserine cefoxitine fructose agar (CCFA) for isolation of C. difficile. Glutamate dehydrogenase and toxins A and B were investigated by immunochromatographic tests. Final confirmation of the isolates was performed by Vitek 2 and MALDI-TOF. A total of 21 isolates were collected for further investigation. PCR ribotyping was performed as described by Janezic and Rupnik. PCR ribotype profiles were analysed using software (Bionumerics, Applied Maths).Antibiotic susceptibility was determined by E-tests for metronidazole, vancomycin, tetracycline, clindamycin, erythromycin, imipenem, ciprofloxacin and moxifloxacin.RESULTS:About 48% of C. difficileisolates belonged to ribotype 001/072. So, this ribotype was the most common ribotype in this study. The remaining 52% of C. difficileisolates consisted of 10 different ribotypes: 017, SLO 160, SLO 187, SLO 120, 255/258, 014/020, 046, 002, 070 and 027. Furthermore, 20 (95.2 %) out of 21 isolates of C. difficilewere toxigenic. Toxins A and B were detected simultaneously in 90.5 % of C. difficileisolates. Two isolates from the ribotype 017 were toxin B positive only. Treatments with any of the following antimicrobials: clindamycin, erythromycin, ciprofloxacin and moxifloxacin (as well as many other antibiotics), could be a risk factor for CDI due to the high resistance of the strains in this study. About 90% of the strains from the most common ribotype 001/072 have MICs for clindamycin and erythromycin >256 μg/ml. CONCLUSION: All strains isolated are highly resistant to ciprofloxacin. All strains were susceptible to vancomycin (median MIC was 0.63 μg/ml) and metronidazole (median MIC was 0.084 μg/ml), so these two antimicrobials remain optimal treatmentoption for CDI - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of BAL PCR for diagnosis of aspergillosis(Department of Anaesthesia and Reanimation Faculty of Medicine, “Ss. Cyril and Methodius” University Skopje, R.N.Macedonia, 2022); ; ; ;