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The aim of this study was to determine the prevalence and antibiotic resistance rates of extendedspectrum b-lactamase (ESBL)-producing Proteus mirabilis strains isolated from inpatients at the Split University Hospital (southern Croatia) during a survey performed between 2005 and 2008. A total of 2152 consecutive isolates of P. mirabilis were isolated. The prevalence was 0.5 % in 2005 and increased significantly to 20.9 % by 2008. Strains were most frequently isolated from urine (36.5 %) and bronchial aspirates and wound swabs (11.3 %). ESBL-producing P. mirabilis isolates showed very high resistance rates to the majority of non-b-lactam antibiotics and were susceptible to a b-lactam/b-lactamase inhibitor and carbapenems. The isolates were genotyped and their ESBLs were molecularly characterized. Strains originating from the intensive care unit and the surgery and neurosurgery wards were clonally related. All P. mirabilis isolates produced the TEM-52 type of ESBL. To the best of our knowledge, our work detailed here and summarized in an earlier communication is the first report of such isolates from southern Croatia. Increased monitoring and screening for ESBL production in this species at our hospital is mandatory.

Study Objectives The aim of this study was to investigate differences in dual-energy X-ray absorptiometry (DXA) parameters, trabecular bone score (TBS), bone turnover markers and inactive matrix Gla protein (dp-ucMGP) between patients with obstructive sleep apnea (OSA) and healthy controls. Methods This study enrolled 53 male patients diagnosed with OSA, and 50 age- and body mass index (BMI)-matched control subjects. All participants underwent DXA imaging, TBS assessment and blood sampling for biochemical analysis of bone metabolism markers. Results Mean apnea–hypopnea index (AHI) score of OSA patients was 43.8 ± 18.8 events/h. OSA patients had significantly higher plasma dp-ucMGP levels in comparison to controls (512.7 ± 71.9 vs. 465.8 ± 50.9 pmol/L, p < 0.001). OSA and control group did not significantly differ regarding standard DXA results, while TBS values were significantly lower in the OSA group (1.24 ± 0.17 vs. 1.36 ± 0.15, p < 0.001). AHI score was a significant independent correlate of plasma dp-ucMGP levels (β ± SE, 1.461 ± 0.45, p = 0.002). In addition, TBS retained a significant relationship with dp-ucMGP values (β ± SE, −93.77 ± 38.1, p = 0.001). Conclusions dp-ucMGP levels are significantly higher in patients with OSA and correlate with disease severity. In addition, TBS values in OSA patients are lower in comparison with the control group and decrease with disease severity.

Ganglioside GM3 is particularly abundant in the kidney tissue and is thought to play an important role in the maintenance of the charge-selective filtration barrier of glomeruli. Altered expression of ganglioside GM3 was pathologically related with glomerular hypertrophy occurring in diabetic human and rat kidneys. Considering the role of GM3 ganglioside in kidney function, the aim of this study was to determine the difference in expression of GM3 ganglioside in glomeruli and tubules using immunofluorescence microscopy both in rat models of types 1 and 2 diabetes mellitus. Diabetes was induced with streptozotocin (55 mg/kg for type 1 diabetes and 35 mg/kg for type 2 diabetes) injection to male Sprague-Dawley rats which were fed with normal pellet diet (type 1 diabetes) or high-fat diet (type 2 diabetes). Rats were sacrificed 2 weeks after diabetes induction, frozen renal sections were stained with primary antibody GM3(Neu5Ac) and visualized by secondary antibody coupled with Texas red. In addition, renal gangliosides GM3 were analyzed by high-performance thin-layer chromatography followed by GM3 immunostaining. Immunofluorescent microscopy detected 1.7-fold higher GM3 expression in tubules and 1.25-fold higher GM3 in glomeruli of type 1 diabetes mellitus compared with control group. Type 2 diabetes mellitus rats showed slight GM3 increase in whole kidney, unchanged GM3 in glomeruli, but significant higher GM3 expression in tubules, compared with control animals. Taking into consideration increased tubular GM3 content in both types of diabetes, we could hypothesize the role of GM3 in early pathogenesis of diabetic nephropathy.

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Carbapenem-resistant isolates of Acinetobacter baumannii from intensive care units at Split University Hospital, Split, Croatia, were studied. Most (100 of 106) had ISAba1 inserted upstream of a bla OXA-107 gene, encoding an unusual OXA-51-type oxacillinase. Pulsed-field gel electrophoresis revealed that the isolates formed three clusters belonging to the sequence group 2 (European clone 1) lineage.An increasing trend toward multidrug resistance, including carbapenem resistance, in Acinetobacter baumannii has been observed in the past two decades. Carbapenem resistance mechanisms in A. baumannii include the production of metallo-␤-lactamases (MBLs) and carbapenem-hydrolyzing oxacillinases, efflux mechanisms, and the loss of outer membrane proteins, often in combination (6). These resistance mechanisms pose a serious therapeutic threat, since carbapenems are frequently used to treat otherwise resistant A. baumannii infections.Since 2002, increasing numbers of carbapenem-resistant isolates of A. baumannii have been recovered at Split University Hospital in Split, Croatia. Meropenem is prescribed at this hospital more frequently than imipenem, while ertapenem has only recently been licensed in Croatia. There are few published data concerning carbapenem resistance in multidrug-resistant isolates of A. baumannii from Croatia. The present study investigated the epidemiology and carbapenem resistance mechanisms of multidrug-resistant A. baumannii isolates endemic in this regional teaching hospital.Between 2002 and 2007, 106 nonrepetitive isolates of A. baumannii with an unusual resistance profile were isolated consecutively from two adult surgical intensive care units (ICUs), a pediatric ICU, a neurosurgery ICU, and a general surgery ICU at different locations in Split University Hospital (a 1,651-bed university teaching hospital with facilities at three sites). The hospital serves a pediatric and adult population of ca.500,000 and is also a referral hospital for much of southern Croatia (with a total population of ca. 1 million inhabitants). Isolates were initially recovered on blood agar plates from routine blood cultures, urine samples, wound exudates, catheter tip specimens, and bronchial secretions. Conventional biochemical tests and the API 20NE system (bioMérieux, Marcyl'Etoile, France) were used to presumptively identify the isolates as members of the Acinetobacter calcoaceticus-A. baumannii complex. Isolates were confirmed to be A. baumannii by the identification of an OXA-51-type enzyme (10) (see below) and, for selected isolates, by tRNA spacer fingerprinting (2).Routine susceptibility testing used a disk diffusion method, while MICs were determined by broth microdilution with Mueller-Hinton broth in 96-well microtiter plates (1). Resistance to imipenem and/or meropenem was confirmed using Etests (AB Biodisk, Solna, Sweden). The isolates were also tested for possible MBL production by using MBL Etests. Multidrug resistance was defined as resistance to three or more antimicrobial classes.Crude bacterial DNA t...

Our findings may indicate involvement of CaMKII in transmission of nociceptive input early in DM1, but not in DM2. CaMKII may be a suitable pharmacological target for diabetic neuropathy.