In vitro antifungal activities of amphotericin B, 5-fluorocytosine, fluconazole and itraconazole against Cryptococcus neoformans isolated from cerebrospinal fluid and blood from patients in Serbia.

Recently, geographic variations in resistance to agents commonly used in the treatment of cryptococcosis have been reported. Therefore, the antifungal susceptibilities of 31 clinical isolates of Cryptococcus neoformans, collected in Serbia during 10-year period, were investigated. Strains were isolated from cerebrospinal fluid (n=28) and blood (n=3), from patients with AIDS (n=26), lymphoma (n=4) and kidney transplant recipient (n=1). The minimal inhibitory concentrations (MICs) of amphotericin B, 5-fluorocytosine, fluconazole and itraconazole were determined by the E-test(®) method. The isolates were highly susceptible to amphotericin B (100% susceptibility at MIC<0.5 µg/mL) and 5-fluorocytosine (87.1% susceptibility at MIC ≤ 4 µg/mL). Geometric mean MIC of amphotericin B and 5-fluorocytosine were 0.102 µg/mL and 0.396 µg/mL, respectively. Fluconazole exhibited the lowest activity in vitro (48.4% susceptibility at MIC ≤ 8 µg/mL) with a significant resistance rate. The activity of itraconazole was also decreased (48.4% susceptibility at MIC ≤ 0.25 µg/mL). The geometric mean MIC of fluconazole stood at 15.14 µg/mL and of itraconazole was 0.144 µg/mL. Cross-resistance among azoles was not common (3.2%), but the parallel increase in fluconazole and itraconazole MIC has been observed (P<0.01). The low rate of susceptibility to fluconazole stresses the need for active antifungal surveillance of C. neoformans and of the corresponding data from different geographic regions.

Risk factors associated with anemia among Serbian school-age children 7-14 years old: results of the first national health survey.

BACKGROUND: Anemia in school-age children is an important public health problem and available data of its prevalence and existing risk factors are essential for planning preventive strategies. The purpose of the current study was to assess the prevalence of and the risk factors associated with anemia among the school-age children 7-14 years years old in Serbia. METHODS: In the 2000 National Health Survey, a cross-sectional, multistage cluster survey, performed in 1688 private and refugee campuses households across the territory of Serbia a total of 525 cases were recruited. Socioeconomic, nutritional, physical activities and lifestyle data have been collected and hemoglobin levels were determined. RESULTS: The overall prevalence of anemia was 18% (94/525) [95% CI 15-21]. Age of 12-14 yrs (odds ratio 3.56 [95% CI 2.17-5.85], p=0.000), male gender (3.22 [1.92-5.42], p=0.000), refugee campuses residence (1.98 [1.22- 3.23], p=0.000), lunch skipping (3.43 [1.40-8.33], p=0.007), defective poultry intake (1.65 [1.01-2.62], p=0.047), lack of fish consumption (1.84 [1.07-3.18], p=0.028), disagreement that sport contributes protecting health (3.80 [2.02-6.95], p=0.000), absence of learning (1.80 [1.12-2.90], p=0.016) and defective book reading in free time (2.18 [1.03-4.61], p=0.04), were independent risk factors of anemia. The frequency of anemia was highest in schoolaged of male gender adolescent males 12-14 years old (46/105, 44%); in 12-14 years aged participants living in refugee campuses' households (22/63, 35%); in refugees of 7-14 yrs old male gender (32/101, 32%); in subjects with defective fish and poultry intake (35/118, 30%) and in participants who escaped reading and learning as lifestyle practices in free time (53/204, 26%). CONCLUSIONS: Socioeconomic, nutritional, physical and lifestyle risk factors could be considered by introducing preventive strategies of anemia in school-age children in Serbia.