BackgroundThe objective of this study was to investigate independent risk factors (RFs) connected with healthcare-associated (HA) Clostridium difficile infection (CDI) in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital.MethodsRisk factors for the infection were prospectively assessed among surgical patients with laboratory confirmed HA CDI and compared with a control group without HA CDI.ResultsThe overall incidence rate of HA CDI was 2.6 per 10000 patient-days. Significant independent RFs for HA CDI were the use of carbapenems (P = 0.007, OR: 10.62, 95% CI: 1.93–58.4), the admission to intensive care unit (P = 0.004, OR:3.00, 95% CI:1.41–6.40), and the administration of 3rd generation cephalosporins (P = 0.014, OR:2.27, 95% CI:1.18–4.39). Patients with HA CDI had significantly higher in–hospital mortality compared to controls (P: 0.007; OR: 8.95; 95% CI: 1.84–43.43).ConclusionsCDI is an important HA infection in population of surgical patients and this study emphasizes the importance of the wise use of antibiotics, and other infection control strategies in order to prevent HA CDI, and to decrease the incidence and in-hospital mortality rate.

Introduction: Clostridioides difficile (C. difficile) infection (CDI) is one of the most common healthcare-associated (HA) infections in contemporary medicine. The risk factors (RFs) for HA CDI in medical and surgical patients are poorly investigated in countries with a limited resource healthcare system. Therefore, the aim of the study was to investigate differences in patients' characteristics, factors related to healthcare and outcomes associated with HA CDI in surgical and medical patients in tertiary healthcare centre in Serbia. Materials and Methods: A prospective cohort study was conducted including adult patients diagnosed with initial episode of HA CDI, first recurrence of disease, readmission to hospital, while deaths within 30 days of CDI diagnosis and in-hospital mortality were also recorded. Patients hospitalized for any non-surgical illness, who developed initial HA CDI were assigned to medical group, whereas those who developed initial HA CDI after surgical procedures were in surgical group. The data on patients' characteristics and factors related to healthcare were collected, too. Results: During 7-year period, from 553 patients undergoing in-hospital treatment and diagnosed with CDI, 268 (48.5%) and 285 (51.5%) were surgical and medical patients, respectively. Age ≥ 65 years, use of proton pump inhibitors, chemotherapy and fluoroquinolones were positively associated with being in medical group, whereas admission to intensive care unit and use of second-and third-generation cephalosporins were positively associated with being in surgical group. Conclusions: Based on obtained results, including significant differences in 30-day mortality and in-hospital mortality, it can be concluded that medical patient were more endangered with HA CDI than surgical ones.

Изучавање војне психологије у Србији старо је дуже од једног века. Вероватно је први официр у Краљевини Србији који је покушао да се на компетентан начин бави питањима и проблемима ове психолошке дисциплине био Тодор Павловић, кога је погибија у Првом светском рату спречила да остави дубљи траг у нашој науци (Kajtez, Starčević, 2021). Павловић је у краткој паузи између Другог балканског рата и Првог светског рата написао и објавио књигу под насловом Из психологије борбе (Pavlović, 1914). У тој књизи овај официр с докторатом стеченим на Сорбони и редовни професор војне педагогије на Војној академији у Београду изучавао је појаве страха и панике, мотивацију за борбу и утицај уверења у победу на исход битке. Ипак, из сагледавања развоја војне психологије у Срба види се да је снага тог развоја пулсирала. Велики замах војне психологије из времена СФР Југославије, видљив по великом броју истраживања, научних чланака и књига, био је заустављен у распаду државе и грађанском рату, с пратећим сужавањем могућности за финансирање истраживања и смањивањем броја психолога запосених у војсци. Узгред, војна психологија доминантно и јесте била изучавана у војним академијама, па је, сасвим логично, свођењем на једну војну академију, без посебне катедре за војну психологију, битно умањен и научни потенцијал за бављење овом примењеном граном психологије.