SAMBA: Structure-Learning of Aquaculture Microbiomes Using a Bayesian Approach.

Gut microbiomes of fish species consist of thousands of bacterial taxa that interact among each other, their environment, and the host. These complex networks of interactions are regulated by a diverse range of factors, yet little is known about the hierarchy of these interactions. Here, we introduce SAMBA (Structure-Learning of Aquaculture Microbiomes using a Bayesian Approach), a computational tool that uses a unified Bayesian network approach to model the network structure of fish gut microbiomes and their interactions with biotic and abiotic variables associated with typical aquaculture systems. SAMBA accepts input data on microbial abundance from 16S rRNA amplicons as well as continuous and categorical information from distinct farming conditions. From this, SAMBA can create and train a network model scenario that can be used to (i) infer information of how specific farming conditions influence the diversity of the gut microbiome or pan-microbiome, and (ii) predict how the diversity and functional profile of that microbiome would change under other variable conditions. SAMBA also allows the user to visualize, manage, edit, and export the acyclic graph of the modelled network. Our study presents examples and test results of Bayesian network scenarios created by SAMBA using data from a microbial synthetic community, and the pan-microbiome of gilthead sea bream (Sparus aurata) in different feeding trials. It is worth noting that the usage of SAMBA is not limited to aquaculture systems as it can be used for modelling microbiome-host network relationships of any vertebrate organism, including humans, in any system and/or ecosystem.

Intensive care antibiotic consumption and resistance patterns: a cross-correlation analysis.

BACKGROUND: Over recent decades, a dramatic increase in infections caused by multidrug-resistant pathogens has been observed worldwide. The aim of the present study was to investigate the relationship between local resistance bacterial patterns and antibiotic consumption in an intensive care unit in a Romanian university hospital. METHODS: A prospective study was conducted between 1st January 2012 and 31st December 2013. Data covering the consumption of antibacterial drugs and the incidence density for the main resistance phenotypes was collected on a monthly basis, and this data was aggregated quarterly. The relationship between the antibiotic consumption and resistance was investigated using cross-correlation, and four regression models were constructed, using the SPSS version 20.0 (IBM, Chicago, IL) and the R version 3.2.3 packages. RESULTS: During the period studied, the incidence of combined-resistant and carbapenem-resistant P. aeruginosa strains increased significantly [(gradient = 0.78, R2 = 0.707, p = 0.009) (gradient = 0.74, R2 = 0.666, p = 0.013) respectively], mirroring the increase in consumption of ß-lactam antibiotics with ß-lactamase inhibitors (piperacillin/tazobactam) and carbapenems (meropenem) [(gradient = 10.91, R2 = 0.698, p = 0.010) and (gradient = 14.63, R2 = 0.753, p = 0.005) respectively]. The highest cross-correlation coefficients for zero time lags were found between combined-resistant vs. penicillins consumption and carbapenem-resistant P. aeruginosa strains vs. carbapenems consumption (0.876 and 0.928, respectively). The best model describing the relation between combined-resistant P. aeruginosa strains and penicillins consumption during a given quarter incorporates both the consumption and the incidence of combined-resistant strains in the hospital department during the previous quarter (multiple R2 = 0.953, p = 0.017). The best model for explaining the carbapenem resistance of P. aeruginosa strains based on meropenem consumption during a given quarter proved to be the adjusted model which takes into consideration both previous consumption and incidence density of strains during the previous quarter (Multiple R2 = 0.921, p = 0.037). CONCLUSIONS: The cross-correlation coefficients and the fitted regression models provide additional evidence that resistance during the a given quarter depends not only on the consumption of antibacterial chemotherapeutic drugs in both that quarter and the previous one, but also on the incidence of resistant strains circulating during the previous quarter.

Antimicrobial consumption, costs and resistance patterns: a two year prospective study in a Romanian intensive care unit.

BACKGROUND: Due to the vulnerable nature of its patients, the wide use of invasive devices and broad-spectrum antimicrobials used, the intensive care unit (ICU) is often called the epicentre of infections. In the present study, we quantified the burden of hospital acquired pathology in a Romanian university hospital ICU, represented by antimicrobial agents consumption, costs and local resistance patterns, in order to identify multimodal interventional strategies. METHODS: Between 1st January 2012 and 31st December 2013, a prospective study was conducted in the largest ICU of Western Romania. The study group was divided into four sub-samples: patients who only received prophylactic antibiotherapy, those with community-acquired infections, patients who developed hospital acquired infections and patients with community acquired infections complicated by hospital-acquired infections. The statistical analysis was performed using the EpiInfo version 3.5.4 and SPSS version 20. RESULTS: A total of 1596 subjects were enrolled in the study and the recorded consumption of antimicrobial agents was 1172.40 DDD/ 1000 patient-days. The presence of hospital acquired infections doubled the length of stay (6.70 days for patients with community-acquired infections versus 16.06/14.08 days for those with hospital-acquired infections), the number of antimicrobial treatment days (5.47 in sub-sample II versus 11.18/12.13 in sub-samples III/IV) and they increased by 4 times compared to uninfected patients. The perioperative prophylactic antibiotic treatment had an average length duration of 2.78 while the empirical antimicrobial therapy was 3.96 days in sample II and 4.75/4.85 days for the patients with hospital-acquired infections. The incidence density of resistant strains was 8.27/1000 patient-days for methicilin resistant Staphylococcus aureus, 7.88 for extended spectrum ß-lactamase producing Klebsiella pneumoniae and 4.68/1000 patient-days for multidrug resistant Acinetobacter baumannii. CONCLUSIONS: Some of the most important circumstances collectively contributing to increasing the consumption of antimicrobials and high incidence densities of multidrug-resistant bacteria in the studied ICU, are represented by prolonged chemoprophylaxis and empirical treatment and also by not applying the definitive antimicrobial therapy, especially in patients with favourable evolution under empirical antibiotic treatment. The present data should represent convincing evidence for policy changes in the antibiotic therapy.

Urinary tract infections in Romanian patients with diabetes: prevalence, etiology, and risk factors.

AIM: Patients with diabetes mellitus (DM) have an increased risk of infections, especially urinary tract infections (UTIs). The aim of this study was to assess the prevalence and etiology of UTIs and identify the risk factors for their development in patients with DM. PATIENTS AND METHODS: In this retrospective, noninterventional study, the medical records of 2,465 adult patients with DM who were hospitalized in a Diabetes Clinic were reviewed. Data regarding the presence of UTI and possible associated risk factors were collected and their possible relation was analyzed. The study protocol and procedures were approved by the Ethics Committee of Timișoara Emergency Hospital. All data were collected and analyzed using SPSS v.17 statistical software. RESULTS: The prevalence of UTIs in patients with DM was 12.0% (297 cases), being higher in females than in males and higher in patients with type 2 DM compared with patients with type 1 DM. In univariate logistic regression analysis, risk factors associated with UTIs were female gender, age, type 2 DM, longer duration of DM, and the presence of chronic kidney disease and coronary artery disease. Multivariate analysis identified age, duration of DM, and metabolic control (hemoglobin A1c levels) as independent risk factors for UTIs. The gram-negative bacilli from the Enterobacteriaceae family were predominant, with Escherichia coli being the most frequent of them (70.4%). CONCLUSION: UTIs are a frequent condition associated with DM. It is necessary to improve the care and the screening of UTIs in patients with DM to prevent the occurrence of possible associated severe renal complications.

Cystic echinococcosis in Arad County, Romania.

Cystic echinococcosis (CE) is a major parasitosis in Romania, a country where in the past at least one person from 45.5% of its localities underwent surgery for this disease. This survey aimed to provide new epidemiological and clinical data regarding human cases of CE in a western Romanian county. We have retrospectively investigated the medical records of the patients with CE hospitalized during the period of 2004-2010 in the surgical sections of Arad County. A total of 79 patients aged 5-88 years (mean age: 35.9±20.1 years) were diagnosed with CE during the study period. The average yearly incidence was 2.4 cases per 100,000 inhabitants, and the majority of the patients (29.1%) were aged 0-19 years. Most of the adult cases (≥18 years) were people with limited formal education (laborers) (45.6%). The analysis for trend showed an overall decrease in the affected persons over the study period (R(2)=0.66, p=0.026). Hepatic localizations of the hydatid cysts predominated within the study group (73.4%). Only 21.5% of the diseased presented complications and the mean length of hospital stay was 16.2±10.9 days. Eosinophilia of at least 10% of the leukocyte value occurred in 14% of cases and leukocytosis was noticed in 24.1% of patients. Although the rates of CE cases have decreased in Arad County (Romania), this parasitic disease continues to be a concern for public health services and requires the implementation of more stringent prophylactic measures.

The roots of evil: the amazing history of trichinellosis and Trichinella parasites.

This review aims to investigate, from a historical point of view, the roots of the Trichinella pathogens and the disease they produce, beginning from the times first recorded in the Bible and continuing until the scientific mysteries of the pathogen were finally unveiled. Our journey sheds light on "strange" epidemics developing before the discovery of the parasite and bearing a clinical similitude to trichinellosis; it follows the controversies that erupted after the nineteenth century discovery of the parasite and the subsequent official outbreaks, and then examines the pioneering methods used for its visualization. Finally, it tries to reveal the possible relationship of trichinellosis with the arts. Furthermore, it seems that the saga of the helminth, "destined to remain with us, both in nature and in the laboratory," will continue to haunt and fascinate scientists from both developing and developed countries, as they try to answer new questions about the parasite's "evil" nature.

Human cystic echinococcosis in two south-western and central-western Romanian counties: a 7-year epidemiological and clinical overview.

PURPOSE: To analyze the epidemiological and clinical characteristics of human cystic echinococcosis (CE) in two Romanian counties, of which one is known from a previous survey as hyperendemic, whereas in the other no extensive studies have been undertaken so far. METHODS: Retrospective investigation of the medical records of the patients diagnosed with this condition and hospitalized during 2004-2010 in Caras-Severin and Hunedoara counties. RESULTS: A total of 190 patients aged 5-88 years (44.3±21.8 years old) were diagnosed with CE. More than one fifth of cases (21.1%) were younger than 19 years old, indicating active transmission of the disease. The yearly average incidence was 3.3 cases/100,000 inhabitants. The highest incidence was registered in patients aged 60-69 years (6.2 cases/100,000 inhabitants), regardless of their gender. Liver involvement occurred in 84.7% of patients. One fifth of the cases (20%) presented complications. Normal values of the eosinophil counts and leukocyte counts predominated within the study group. The length of the hospital stay varied between 1 and 65 days with a mean of 13.1±9.5 days. CONCLUSIONS: CE has a significant burden in this part of Romania, and continues to be a public health concern. Consequently, better implementation of preventive measures and extensive informative campaigns for the population are mandatory.

Foodborne nematodal infections in hospitalized patients from a southwestern Romanian county.

OBJECTIVES: Caras-Severin County presented the highest incidence of human trichinellosis (108.5 cases per 100,000 inhabitants) throughout Romania in 1993. This study aimed at providing an overview of the epidemiological and clinical characteristics of persons from this county hospitalized with nematodal infections between 1996 and 2008. PATIENTS AND METHODS: Data were collected from the medical records of 269 patients admitted to two infectious diseases hospitals and found to have nematode helminthic infections. RESULTS: Of the study group, 250 patients (92.9%) presented with trichinellosis, 10 (3.7%) with ascariasis, 7 (2.6%) with trichuriasis, and 2 (0.8%) with ascariasis and trichuriasis coinfections. Geohelminthic infections prevailed in children (68.4%). Giardiasis, a protozoan parasitic disease, was also found in 21 patients (7.8%). CONCLUSIONS: Although trichinellosis cases decreased in this county, public health authorities must remain aware because new outbreaks may occur at any time as it happened in the neighboring counties. Regarding geohelminthiasis, parents must be aware of the potential risk of acquiring these infections and the major complications that may follow.

Evidence of Trichinella spiralis in Timis County, Romania: a report of a winter trichinellosis outbreak in 2008 due to consumption of contaminated pork.

A trichinellosis outbreak occurred in early 2008 in two villages in Timis County, Romania, due to consumption of pork from an infected animal. The infective species, detected by multiplex polymerase chain reaction, was Trichinella spiralis (Isolate Code ISS 1951). This report presents an extensive characterization of the outbreak using the documents of the epidemiological investigation and the medical charts of the hospitalized patients. Fifteen people consumed pork from the same backyard pig, which was slaughtered in the household without veterinary inspection of the meat. Among them, five patients presented clinical forms of the disease and were hospitalized. The analysis within this report includes only the hospitalized cases that were serologically confirmed. The mean age of the patients was 33.4 years. The common symptoms presented by these patients included headache, eyelid and lower limb edema, myalgia, fever, diarrhea, and nausea. Eosinophil counts ranged between 5.5% and 52%. Favorable outcomes were achieved for the patients using antihelminthic therapy. As an important public health concern, trichinellosis outbreaks reinforce the need to urgently implement veterinary and educational programs. Identification of T. spiralis in this case strengthens the supposition that it is one of the most frequently spread species in Romania.

Trichinellosis and poverty in a Romanian industrial area: an epidemiological study and brief review of literature.

OBJECTIVE: Trichinellosis is a foodborne parasitic disease that is acquired by humans through ingestion of raw or inadequately cooked meat containing larvae of different Trichinella species. During a high endemic year, Hunedoara County, part of Transylvania region, was the second most affected Romanian county, with an incidence of 84.8 cases per 100,000 inhabitants. The objective of this study was to bring new epidemiological and clinical data on human trichinellosis from an endemic former industrial area characterized by high rates of poverty and unemployment. PATIENTS AND METHODS: Data have been collected from the medical charts of 492 patients (mean age, 27.6 years) found to have trichinellosis and admitted between 1996 and 2005 in two infectious disease hospitals. A brief review of relevant epidemiological and epizoological information regarding the evolution of the infection in this region was also considered. RESULTS: Women (55.1%, n = 271), townsfolk (77.0%, n = 379), and unemployed (40.1%, n = 126) were the most affected categories. The clinical symptoms included myalgia (64.6%, n = 118), edema (45.3%, n = 223), and headache (38.6%, n = 190). Eosinophilia ranged between 10% and 19.99% in 28.0% (n = 138) of the cases. For 47.8% (n = 235) of the patients, the hospitalization period ranged from 1 to 7 days. Thiabendazole was administered in 72.0% (n = 329) of the cases. CONCLUSIONS: For a long period of time, trichinellosis represented a serious public health and ecological concern because of the favorable social, economic, cultural, and geographic conditions of this territory. Despite rich history, an overall decrease in the number of human trichinellosis cases over the 10-year study period was revealed and the decline might have been favored by the following positive aspects: improvement of sanitary conditions, implementation of a more reliable collaboration between veterinarians and pig breeders/consumers, education of the population, and a more careful supervision of the public health services.

Epidemiology and epizootology of trichinellosis in Romania 1868-2007.

According to the International Commission on Trichinellosis, Romania accounted for the most cases of trichinellosis reported worldwide in 2004. The following report summarizes the evolution of trichinellosis in Romania over a 140-year period (1868-2007). The sylvatic cycle, such as the consumption of meat from wild boar and bear, has been implicated in human cases. However, 95% of human trichinellosis cases originate from specific cultural food practices involving pork consumption. The first report of human and pig trichinellosis in Romania dates back to 1868. After the political changes of 1989, the annual incidence increased from between 0.1 and 4.1 cases per 100,000 inhabitants during the communist period (1963-1989) to 6.2 cases per 100,000 inhabitants, with a range of 2-15.9 per 100,000 between 1990 and 2007. Trichinellosis is a major public health issue in Romania that requires that policies be put forth to advance efficient prevention and control strategies.

Foodborne botulism in southwest Romania during the post-communism period 1990-2007.

OBJECTIVES: This study was a retrospective investigation of botulism cases over a period of 18 years following major political and economic changes, addressing the question of whether this disease is still an important health concern in southwest Romania. METHODS: The medical records of botulism cases were used as the source of data. Patients from five southwest Romanian counties were hospitalized at Victor Babes Hospital of Infectious Diseases in Timisoara during the period 1990-2007. RESULTS: The median annual incidence of botulism cases in southwest Romania decreased from 0.1 per 100 000 persons during 1990-1998, to 0.05 per 100 000 persons during 1999-2007. Most of the cases (18.6%) were diagnosed in 1990, immediately following the communism period. The median age of the patients was 38 years (range 16-73 years); 24 (55.8%) were male; the case fatality rate was 2.3%. A significantly higher incidence rate of 2.7 cases per 100 000 persons occurred in rural areas, even though most of the cases (53.5%) were inhabitants of urban areas. The clinical pattern included: difficulty swallowing (79.1%), double and/or blurred vision (69.8%), dry mouth (60.5%), drooping eyelids (51.2%), vomiting (39.5%), mydriasis (37.2%), constipation (27.9%), abdominal pain (23.3%), and slurred speech (18.6%). All cases were attributed to contaminated food sources, mainly home-prepared traditional pork products. CONCLUSIONS: Although the botulism cases decreased over the study period in southwest Romania, this life-threatening disease continues to be an important concern. A strategy addressing individual behaviors in the home is needed to improve food safety.

Trichinellosis, a threatening and re-emerging disease in a Romanian western county.

INTRODUCTION: Trichinellosis is frequently reported in east European countries like Romania, where the yearly incidence during 1990-1999 was 5.5 cases/100,000 inhabitants. Arad, a western Romanian county, is known as one of the most endemic regions of trichinellosis. A major and unforgettable epidemic of trichinellosis has developed at the beginning of 1973 in this county. The present study focuses on human trichinellosis patients from Arad County, emphasizing on epidemiological, clinical, laboratory, and therapeutic aspects. PATIENTS AND METHODS: Retrospective analysis of the medical records of 335 patients found to have trichinellosis during 1996-2006 and hospitalized in Arad County. The mean age of the trichinellosis patients was 33.6 years, and majority (64.8%) were inhabitants of the rural areas. RESULTS: Winter was the season with the highest number of cases (71.6%). Fever was the most frequent manifestation of the disease (85.4%), followed by myalgia (83%). Eosinophilia ranged predominantly between 20% and 20.99% (19.4%). Albendazole was the specific drug administered in 49.4% of the patients. CONCLUSIONS: Trichinellosis still remains a concern and a major issue of public health in Arad County. Implementation of strict hygienic measures, especially in the rural areas, must be a priority.

Importation of visceral leishmaniasis in returning Romanian workers from Spain.

BACKGROUND: Over the past two decades visceral leishmaniasis cases and foci have increased in Romania, where the disease has also become a medical concern. The following study aimed to provide essential knowledge on early diagnosis and management of visceral leishmaniasis cases in Romania acquired especially by traveling and working in the Mediterranean countries. METHOD: Retrospective analysis of the medical records of the patients diagnosed with imported visceral leishmaniasis in a western Romanian county. RESULTS: Three patients with visceral leishmaniasis imported from Spain were admitted to hospital in Timisoara in 2005. Detailed case histories along with clinical and laboratory features are presented. In all the patients the final laboratory confirmation of the disease was by Giemsa-stained blood smears obtained by bone marrow biopsy. CONCLUSIONS: Since 2004, many Romanian citizens left their homeland looking for a better job in the Mediterranean region. Unaware of the risks of outdoor labor in warm climatic conditions, they accepted to live and work in improper sanitary conditions. Late identification of the disease resulted mainly from failure of the physicians to diagnose and associate the syndrome with travel.

Intestinal schistosomiasis, importation of a neglected tropical disease in Romania. Case report of a traveler to endemic regions.

BACKGROUND: Schistosomiasis is the second most common parasitic disease after malaria. Imported cases of schistosomiasis are reported in nonendemic regions due to an increased number of travelers to affected geographical areas. The present case report aimed to emphasize the importance of a correct history of a patient, including information regarding travel history and its consequences, and to overview the evolution of a tropical disease diagnosed rarely in Romania. MATERIALS AND METHODS: Retrospective analysis of a single case of imported schistosomiasis diagnosed in Timisoara, Romania. RESULT: A 25-year old male patient had traveled and worked abroad for a long period of time in tropical areas in Asia and South America (Brazil). The clinical pattern at admission to hospital included fever and diarrhea with multiple liquid stools with mucus. Physical examination was normal. Routine laboratory tests revealed an increased number of leucocytes. CONCLUSIONS: Final diagnosis was established with difficulty in this case. Failure to associate a febrile prolonged syndrome or chronic diarrhea with a history of travel can cause a delayed diagnosis.

Epidemiological and diagnostic findings during a 16-year-long trichinellosis surveillance in Timis County, Romania.

The main source of trichinellosis in Romania is insufficiently cooked pork infected with Trichinella spiralis. Timis, the largest Romanian county, is located in the western part of the country where pork and traditional food prepared from pork are extensively consumed. The objective of the present study was to conduct a retrospective investigation of the incidence of human trichinellosis in Timis County over a period of 16 years (1990-2005). The medical records of 521 patients were used as the source of data. Patients were hospitalized at Victor Babes Hospital of Infectious Diseases from Timisoara during the period 1990-2005. The highest number of cases was recorded in 1994 (16.90%) and most of the patients were in the age group of 20-29 (23.22%). Males and females were almost equally affected by trichinellosis. The clinical pattern was mainly characterised by myalgia (72.55%) and edema (54.12%). Laboratory investigations included mainly elevated eosinophil and leucocyte values. In 52.02% of the patients, the hospitalization period ranged between 8 and 14 days. Most of the patients were from urban areas, but often the source of infection was found in rural areas. Hospitalization of the affected patients required considerable health care resources. The decreasing incidence of trichinellosis in Romania over the last decade has been due to sanitary education programmes for both swine breeders and consumers.

[Risk factors involved in multiresistant infections with strains of Enterobacteriaceae]. / Factorii de risc implicati în infectiile cu tulpini de Enterobacteriaceae multirezistente.

OBJECTIVE: The present study aims to analyse the risk factors involvement in the cross infectious pathology determined by multiresistant Enterobacteriaceae, in hospitalised patients in the Intensive Care Unit at the County Emergency Clinical Hospital in Timisoara. MATERIAL AND METHOD: We carried out a case-control study with 3 groups of adult inpatients--200 patients with no superadded infectious pathology, 100 patients infected with Enterobacteriaceae strains resistant to 3 classes of antibacterial chemotherapeutic agents and 100 infected with multiresistant strains. Identification of bacterial germs was performed using API ID 20 E manual galleries (BioMérieux) and the inclusion in the resistance phenotypes was done using the Osiris Evolution (BioRad) analyser. RESULTS: Subjects infected with multiresistant strains are mostly male, (p=0.020, OR=1.8 [1.06-3.07], RR=1.49, [1.05-2.11]), with the mean age younger than that of the control group (p=0.011). The mean Charlson Comorbidity Index was 3.34 in Group III and 4.06 in Group I (p=0.027). The logistic regression application keeps as well as independent risk factors for multiresistance--the mechanical ventilation, consciousness impairment, prolonged hospitalization and the higher number of days of antibiotherapy. CONCLUSIONS: In this study, the nosocomial factors and basic pathology prevail to the detriment of other intrinsic risk factors.

[Gram-positive cocci isolated from urocultures of ambulatory and hospitalized patients with surgical risk]. / Coci Gram-pozitivi izolati din uroculturi provenite din ambulator si sectii cu risc chirurgical.

OBJECTIVES: We propose a comparative study of sensitivity to antibiotics of Gram-positive germs isolated in urocultures from patients in ambulatory and two wards with surgical risk (urology and obstetrics-gynaecology), and also to establish the resistance phenotypes of these strains. MATERIAL AND METHOD: 124 strains of Gram-positive cocci were studied: 28 S. aureus strains, 24 strains of coagulase-negative staphylococcus (CNS), 23 Streptococcus aglactiae strains, 1 Streptococcus anginosus strain and 48 Enterococcus spp. strains. The isolated strains came from 4398 urocultures (1889--ambulatory, 1871--urology, 629--obstetrics-gynaecology). Testing of antibiotic sensitivity was performed through Kirby-Bauer disk-diffusion method, with automatic phenotyping (Osiris Evolution system). RESULTS: In ambulatory, the wild phenotype was predominant in all isolated strains (33.33% S. aureus, 50% CNS, 100% Streptococcus aglactiae, 60% Enterococcus spp.). In the urology ward, the following multiresistant strains were isolated: 9 MRSA strains (47.36%), 1 MRSE strain (100%), 1 VRE strain (4.34%). In the obstetrics-gynaecology ward, 7 strains showed multiple antibiotic resistance: 4 MRSA strains (66.66%), 2 MRSE strains (50%), 1 VRE strain (6.66%). CONCLUSIONS: Multiresistant strains were isolated in hospital environment, which can be explained by the improper use of antibiotics, the instrumental approach of the urinary tract, and the existence of risk factors in the patients admitted in the above-mentioned wards. Enforcement of efficient nosocomial infection control measures is advisable, as well as a policy for rational antibiotic use.

[Bacterial multiresistance emergence in South-Western Romania]. / Emergenta multirezistentei bacteriene în partea de Sud-Vest a României.

INTRODUCTION: European Centre for Diseases Control (ECDC), involved in the surveillance of nosocomial infections (NI) and resistance to antimicrobials (AMR) in Europe, estimates 4 million IN/year, among whom 37,000 deceased, out of which half are determined by multiresistant germs (MDR). A phenomenon encountered more and more often is that of pan-resistance of germs, without the option for an optimal antibiotherapy. The allarming increase of AMR is a phenomenon which our country also faces in the present. MATERIAL, METHOD, RESULTS: Resistance rate registered in Intensive Care Units in Timisoara during 2005-2007 (when we participated in the Helics European network) situates us among the last places among the European countries that participated--with 50-60% MRSA strains, 24% E. coli BLSE strains, 62,7% K. pneumoniae BLSE strains, 34% P. aeruginosa BLSE. Furthermore, data registered in ambulatory in the South-West part of Romania during 2006-2007 (processed by the greatest private laboratory in the region) are not more optimistic--26% MRSA strains, 4,25% E. coli BLSE, 12,49% K. pneumoniae BLSE, 8,69% P. aeruginosa BLSE. CONCLUSIONS: As the management of MDR produced infections requires huge costs, a better antibiotic policy in the Romanian hospitals and ambulatory is compulsive, being more efficient to spend for control than for the treatment of these infections.

Human trichinellosis in children from Timis County, Romania: epidemiological features from a retrospective study conducted between 1990 and 2006.

Trichinellosis, a parasitic zoonosis caused by the ingestion of inadequately cooked pork containing Trichinella larvae, has been a serious health problem in Timis, the largest of the Romanian counties. The authors conducted a survey on trichinellosis in children from Timis County, emphasising epidemiological aspects. Medical records from 106 children who were hospitalised at the Victor Babes Infectious Diseases Hospital in Timisoara from 1990 to 2006 were investigated. Children affected by trichinellosis were predominantly in the 10- to 14-year-old age group (34.9%). Most patients (59.43%) were inhabitants of urban areas and 59.43% of cases were males. Winter was the season when the number of cases peaked (76.42%). The highest prevalence of disease (18.87%) was recorded in 1994. For 38.68% of the patients, eosinophilia ranged between 10% and 20%. The length of hospitalisation ranged from 8 to 14 days in 50.94% of cases. In recent years, human trichinellosis has decreased in Timis County as a result of an improvement in the implementation of hygiene measures. The highest prevalence of the disease recorded in 1994 can be explained by an economic transition period when national pig farms began to close. Winter was the season with the highest prevalence because people eat a lot of pork during the traditional holidays.