[THE ROLE OF ANTISEPTICS AND STRATEGY OF BIOFILM REMOVAL IN CHRONIC WOUND].

Chronic wound does not heal within the expected time frame because it remains in the inflammation phase of healing. The reason for this is the presence of necrotic tissue and a large number of microorganisms, primarily bacteria that secrete the biofilm, along with ischemia, hypoxia and edema. Biofilm is present in 90% of chronic wounds and 6% of the acute ones.

[Recognition and treatment of chronic wound infection].

Recognition and treatment of a chronic wound infection is an extraordinarily complex task that requires team work and purposeful and graduate resolving of the problem. Chronic wound infection is the most risky complication because it may have fatal outcome for the patient. The principles of best clinical practice include thorough examination of the patient with respect to endogenous diseases and risk factors, defining the locality of infection and wound characteristics, along with clinical symptoms of infection.

[Prevention of chronic wound infection].

An integral follow-up of the patient starting with medical history, present status and the wound itself will lead us to decide which plan of prevention, care and treatment will be efficient. The interaction of host immune abnormalities and growth of the microbial population invading the wound have a significant impact on the clinical presentation and direction of the development of the wound. Infection of a chronic wound is a consequence of a large number and composition of microbe populations in the tissue, along with the presence of virulence factors depending on the type and representation in the biofilm as a factor of greatest importance, the synergy of various microbial communities of aerobes-anaerobes in various combinations, and the host immune response.

[Atypical agents of wound infection and targeted samples].

All open wounds are primarily contaminated and subsequently colonized by microorganisms, predominantly bacteria. Only about 30% of chronic wounds are also infected. Factors which favor the development of infection are the following: large quantity of bacteria, presence of virulence factors, their quantity and number, predominantly the synergy of aerobic and anaerobic bacteria, and formation of biofilm.

An intrauterine device as a possible cause of change in the microbial flora of the female genital system.

Aim: An intrauterine device (IUD), used by millions of women worldwide, is one of the most efficient methods of contraception. The goal of our study was to compare a group of women using the IUD to a control group.

Material & Methods: The survey included 236 women of fertile age from gynaecological practices in the area of Split and Dalmatia County, Croatia.

[Can introduction of guidelines for use of an intrauterine device reduce changes in microbial flora of female genital system in IUD-users?].

The intrauterine device (IUD), one of the most effective and most common methods of reversible contraception, is used by millions of women worldwide. Although various studies indicate the benefits of its use as a contraceptive method, the greatest concern regarding IUDs is the potential risk for infection. The presence of the IUD gives a solid surface for bacterial attachment and biofilm formation.

The importance of P-glycoprotein multidrug transporter activity measurement in patients with Helicobacter pylori infection.

P-glycoprotein is important in local antibiotic resistance. Aim was to evaluate the role of P-glycoprotein in local antibiotic resistance in patients with antral gastritis during antibiotic therapy to Helicobacter pylori infection. In the group of 53 patients with pathohistologically verified gastritis and microbiologically confirmed H.

[Necrotizing soft tissue infection of upper extremity complicated with toxic shock syndrome--clinical presentation and treatment options].

Necrotizing soft tissue infections (NSTI) are uncommon infections associated with considerable morbidity and mortality (20%-40%). They are characterized by rapidly progressive necrosis of soft tissue that primarily involves subcutaneous fat and fascia with variable involvement of the overlying skin and muscle. Extensive soft tissue necrosis is often accompanied by systemic toxicity.

[Characteristics of war wound infection].

War wounds are the most complex type of non-targeted injuries due to uncontrolled tissue damage of varied and multifold localizations, exposing sterile body areas to contamination with a huge amount of bacteria. Wound contamination is caused by both the host microflora and exogenous agents from the environment (bullets, cloth fragments, dust, dirt, water) due to destruction of the host protective barriers. War wounds are the consequence of destructive effects of various types of projectiles, which result in massive tissue devitalization, hematomas, and compromised circulation with tissue ischemia or anoxia.

Increased activity of Pgp multidrug transporter in patients with Helicobacter pylori infection.

Aim: To determine whether local antibiotic resistance involves P-glycoprotein (Pgp)-mediated active drug out-pumping during Helicobacter pylori (H pylori) infection treatment with classic antibiotic therapy.

Methods: Pgp activity was determined in gastric mucosa biopsy specimens obtained from 53 patients with pathohistologically verified gastritis and microbiologically confirmed H pylori infection, and compared with the Pgp activity in 12 control subjects with normal endoscopic findings. The H pylori positive patients were treated with short-term 7-d therapy consisting of two antibiotics (amoxicillin and azithromycin/metronidazole and clarithromycin) and a proton pump inhibitor.

[Coagulation tests in septic surgical patients].

Aim: To determine whether sequential change in coagulation parameters such as activated partial thromboplastin time (aPTT), prothrombin time (PT), platelets count and fibrinogen level may predict the outcome of patients in sepsis.

Study Design: Cohort longitudinal study.

Patients And Methods: Patients with positive two or more clinical criteria for sepsis were eligible for the study.

[Pseudomonas aeruginosa--a significant hospital pathogen and resistance to carbapenem].

Pseudomonas aeruginosa (P. aeruginosa) is an etiologic agent of nosocomial infections of various localizations. The frequency of infections is a consequence of an increased number of immunocompromised patients, large surgical interventions, long-term hospital care and virulence factors of the bacterium.

[Is the methicillin-resistant Staphylococcus aureus heteroresistant to vancomycin in Croatia?].

Introduction: Staphylococcus (S.) aureus with reduced susceptibility to vancomycin has attracted much attention all over the world since the first report of Staphylococcus aureus isolate intermediarily resistant to vancomycin (VISA) in Japan 1997. Other authors from different parts of the world have also described VISA isolates in patients with treatment failures after prolonged vancomycin therapy.

Ilizarov technique in the treatment of chronic osteomyelitis caused by Vibrio alginolyticus.

We present a case of 26-year-old woman with posttraumatic chronic osteomyelitis caused by Vibrio alginolyticus, contracted after contamination of a tibial fracture with seawater. The patient underwent bone resection and bifocal osteosynthesis according to Ilizarov and was treated with a combination of ciprofloxacin and tetracycline. The patient responded in the same way to distraction osteogenesis as any other patient with chronic osteomyelitis with large defects.