INTRODUCTION Among the most important causes of diarrhea in modern hospitals is Clostridium difficile (C. difficile). A wide spectrum of diseases caused by this bacterium is now known as C. difficile associated disease (CDAD). The development of CDAD is usually preceded by the administration of antimicrobial therapy and fecal-oral infections with C. difficile. Over the last years epidemiology of CDAD has significantly changed. Recently, a hypervirulent BI/NAP1/027 strain, the cause of severe epidemics in North America and Western Europe, has been identified. OBJECTIVE The aim of this study was to identify risk factors for CDAD in patients operated on at the Military Medical Academy (MMA). METHODS The study included all patients who underwent surgery at the MMA during 2010. Nested case-control study design was used. The subjects were divided into groups of operated patients with and without CDAD. The patients were under prospective follow-up, while their data were collected using a questionnaire during a routine epidemiological control. RESULTS During 2010 the incidence rate of CDAD was 3.3 per 10,000 hospital days. Univariate regression analysis showed that the length of administration of one or two antibiotics, as well as concurrent administration of two antibiotics, were far more frequently observed in the patients with than in the patients without CDAD. Independent risk factor for the development of CDAD was the length of the administration of one antibiotic. CONCLUSION Reduction in the incidence rate of CDAD can be achieved by using reliable measures of prevention and control; the rational use of antibiotics, early diagnosis and therapy of infected patients, contact isolation of infected persons, proper disinfection, and continued education of medical and nonmedical personnel.

Bo`ana MIKLAU[I] 1,*), dr. med., specijalizant infektologije Davorka DU[EK 2), dr. med., specijalist infektologije Rok ̂ IVLJAK 2,3), prim., dr. med., specijalist infektologije i pedijatrijske infektologije Marina OLJA^A PRIBANI] 2), dr. med., specijalist infektologije Miljena COPOIS2), dr. med., specijalizant infektologije Sini{a SKO^IBU[I] 4,5,*), mr. sc., dr. med., specijalist infektologije Ljiljana @MAK 3,6), dr. sc., dr. med., specijalist medicinske mikrobiologije s parazitologijom Vera KATALINI]-JANKOVI] 6), prim., dr. med., specijalist medicinske mikrobiologije s parazitologijom Bruno BAR[I] 2,3), prof. dr. sc., dr. med., specijalist infektologije

The aim of the study was to analyze stroke in young adults in Tuzla Canton, Bosnia and Herzegovina. From January 2001 to December 2005, 3864 patients with first-ever stroke were admitted at the Department of Neurology Tuzla. A retrospective analysis of risk factors, stroke types, severity and one month outcome in all young adults (18-45 years of age) with first-ever stroke was carried out. Out of total, there were 154 (4%) young adults with stroke. Mean age was 38.8 +/- 5.7 years and 47% were women. The leading risk factors were smoking (56%) and hypertension (45%). Subarachnoid hemorrhage (SAH) was more frequent in young adults compared with older patients (> 45 years of age) (22% vs. 3.5%, p < 0.0001), intracerebral hemorrhage (ICH) was similar in both groups (16.9% vs. 15.8%, p = 0.7), but ischemic stroke (IS) was predominant stroke type in the older group (61% vs. 74%, p = 0.0004). Young adults had more frequent lacunar stroke (26.6% vs. 16.1%, p = 0.01) and stroke due to other etiology (8.5% vs. 1.8%, p = 0.0004) than stroke patients over 45 years of age. Stroke severity at admission was lower in young adults than in older patients (p < 0.0001), as well as mortality at one month (11% vs. 30%, p < 0.0001). Favorable outcome (modified Rankin Scale < or = 2) had 71% of young adults compared with only 53% of patients in the older group (p = 0.0003). Stroke in young adults in Tuzla Canton is rare. Risk factors profile, stroke types, severity and outcome at one month in young adults are different from those in older patients.

SummaryTh e aim of this paper is to determined dynamics and vertical distribution of nutrients and microbial communities in calcocambisol and terra rossa in natural lawns in Mostar district (Bosnia and Herzegovina). Th e main research was focused on total number of bacteria, actinomycetes, fungi, free-living nitrogen fi xers, ammonifi ers and Azotobacter sp., as well as on the chemical properties of soils. Microbiological and chemical properties of soils were determined during the 2011 in diff erent depths using the standard methodology. Chemical analyses of the examinated soil showed the acid pH value, poor to moderate humus content, as well as total N and available P and K. Results of research confi rm the strong infl uence of season of sampling, soils depth and their interaction on microbial activity. Number of microorganisms was controlled by pH value, humus and total nitrogen content, soil moisture and temperature. In both soil types, total bacterial number was the highest in spring, while number of fungi and actinomycetes was the highest in autumn.