Postoperative wound infections represent about 16% of hospital-acquired infections. Staphylococcus aureus is the most common cause of nosocomial wound infections. Increased frequency of Methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients and possibility of vancomycin resistance requires permanent control of MRSA spread in the hospital.The purpose of this study was to analyse the frequency of Methicillin-resistant Staphylococcus aureus (MRSA) in the swabs taken from the surgical wounds, the presence of MRSA infection in surgical departments and to examine antimicrobial susceptibility of MRSA isolates. Wound swabs were examined from January 2006 to December 2008. The isolates were identified by conventional methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc-diffusion method as per NCCLS guidelines.A total of 5755 wound swabs were examined: 938 (16,3%) swabs were sterile and 4817 (83,7%) were positive. Staphylococcus aureus was isolated in 1050 (22,0%) swabs and it was the most common cause of wound infections. MRSA was isolated from 12,4% samples in 2006, from 6,7% samples in 2007 and from 3,7% samples during 2008. Wound infections caused by MRSA dominated in the department of plastic surgery (24,4%) and in the department of orthopaedic surgery (24,1%). Antimicrobial susceptibility testing showed that 73% of MRSA isolates were with the same antibiotic sensitivity pattern (antibiotyp)-sensitive only to vancomycin, tetracycline, fucid acid and trimethoprim/sulfamethoxasole. Our results show decreasing of MRSA infection in the surgical wards. These results appear to be maintained with strategies for preventing nosocomial infection: permanent education, strong application of protocols and urging the implementation of strict infection control policy.
Brucellosis is an important public health problem in Bosnia and Herzegovina. The diagnosis of brucellosis in the country without any experiences with this kind of infection may be very difficult. The aim of this study was to evaluate diagnostic methods: Rose Bengal test, blood cultures and ELISA IgM and IgG in the patients with brucellosis. The study included 91 brucellosis patients in the period 2004 to 2007. All the patients were treated at the Clinic for Infectious Diseases, University of Sarajevo Clinics Centre. Blood cultures were positive in 28/91 (30, 8%) patients. This method often needs a long period of incubation and specimens need to be obtained early. These limitations make serology the most useful tool for the laboratory diagnosis of Brucella infection. Rose Bengal is a rapid plate agglutination test, very sensitive irrespective of the stage of the disease. In our study, Rose Bengal test was positive in all patients 91/91 (100, 0%). Brucella IgM antibodies with ELISA were positive in 59/91 (64, 8%). Brucella IgG antibodies with ELISA were positive in 51/91 (56%). In order to determine the diagnostic value of the different tests, we compared the sensitivity among test-methods: Rose Bengal test-100.0%, blood culture-30.8%, ELISA IgM-64.8% and ELISA IgG-56.1%. Sensitivity of test methods was different in the different stages of illness. It is necessary to use combination of different tests such are blood culture, Rose Bengal test and ELISA in order to ensure the diagnosis. Rose Bengal test is excellent for the screening. Blood culture is a method of choice for the diagnosis acute infection. ELISA is a very good method for the diagnostic chronic disease and relapse.
This study showed the diagnostic value and importance of detection of matrix metalloproteinases in human brucellosis. MMPs are a useful serum biomarker for assessment of disease activity.
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