The prevalence of infections in psychiatric institutes in Belgium

The prevalence study of hospital-acquired infections at different surgical departments in Banjaluka

Introduction: Prevalence study is simple, cheap and fast method that provides information about hospital-acquired infections (HAI). Objective: To assess the HAI prevalence at different surgical departments in the Clinical Center of Banjaluka. Method: A point prevalence study design was used. All patients (N = 174) hospitalized on July, 1st, 1999 were included in the study. The study was performed by following the CDC guidelines. All patients with clinically manifested infections on the day of study in all surgical departments were recorded. Infections of more than one site in the same patient were considered separate infections. Results: The overall prevalence of patients with HAI was 16.1% (28/174; 95%CI = 10.4-21.6) and the overall HAI prevalence was 18.4% (32/174). Surgical-site infections were the most prevalent (6.3%) followed by skin/soft tissue infections (4.6%) and urinary tract infections (4.0%). More than two thirds (87.5%) of HAI were microbiologically documented. The most commonly isolated microorganisms were Pseudomonas aeruginosa (29.7%), Enterobacter spp. (24.3%) and Staphylococcus aureus (16.2%). Conclusion: This point prevalence study clearly showed the magnitude of HAI problem at different surgical departments in the Clinical Center of Banjaluka, the most prevalent anatomic localizations of HAI, and the most common causes.

Plasma levels of cytokines and soluble cytokine receptors in psychiatric patients upon hospital admission: effects of confounding factors and diagnosis

It has been hypothesized that the immune system plays a pathogenetic role in psychiatric disorders, in particular in major depression and schizophrenia. This hypothesis is supported by a number of reports on altered circulating levels and in vitro production of cytokines in these disorders. However, the respective evidence is not consistent. This may be in part due to an incomplete control for numerous confounding influences in earlier studies. We investigated the plasma levels of cytokines and soluble cytokine receptors in psychiatric patients (N = 361) upon hospital admission and compared the results to those obtained in healthy controls (N = 64). By multiple regression analysis we found that circulating levels of interleukin-1 receptor antagonist (IL-1Ra), soluble IL-2 receptor (sIL-2R), tumor necrosis factor-alpha (TNF-alpha), soluble TNF receptors (sTNF-R p55, sTNF-R p75) and IL-6 were significantly affected by age, the body mass index (BMI), gender, smoking habits, ongoing or recent infectious diseases, or prior medication. Cytokine or cytokine receptor levels were significantly increased in patients treated with clozapine (sIL-2R, sTNF-R p75), lithium (TNF-alpha, sTNF-R p75, IL-6) or benzodiazepines (TNF-alpha, sTNF-R p75). Taking all these confounding factors into account, we found no evidence for disease-related alterations in the levels of IL-1Ra, sIL-2R, sTNF-R p75 and IL-6, whereas levels of TNF-alpha and sTNF-R p55 in major depression and sTNF-R p55 in schizophrenia were slightly decreased compared to healthy controls. We conclude that, if confounding factors are carefully taken into account, plasma levels of the above mentioned cytokines and cytokine receptors yield little, if any, evidence for immunopathology in schizophrenia or major depression.