Purpose. The routine diagnosis of enterobiasis consists of a microscopic examination of perianal imprints on a transparent scotch tape for the presence of parasitic eggs. However, this method has low sensitivity when the number of eggs is small. The development of highly sensitive and specific methods, such as PCR, will increase the possibilities of detecting the parasite and will enable its genetic characterization. Material/Methods. The study was conducted from May 2022 to September 2022 and comprised 24 patients infected with Enterobius vermicularis. DNA was extracted from parasite eggs/adult worms using PureLink Genomic DNA Mini Kit (INVITROGEN), according to the manufacturer's instructions. Nested polymerase chain reaction (PCR) for detection of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was applied with two sets of primers. Results. The developed and described method for genetic determination of Enterobius vermicularis in samples from infected individuals is suitable and applicable to improve the diagnosis of the disease, as well as for further phylogenetic research of the parasite, which is of great importance for its successful treatment and control. Conclusions. Regardless of existing morphological diagnostic methods, genotyping studies concerning Enterobius vermicularis need to be deepened. Molecular-biological analyses increase diagnostic sensitivity, provide valuable knowledge about the geographic distribution and diversity of helminths, and allow the monitoring of therapy.

A 3-month-old female infant with meningo-encephalitis caused by Salmonella enterica Paratyphi B var. Java is described. The aetiological agent was confirmed in six CSF samples; however, none of the blood or faecal samples was positive for the same pathogen. The presence of the bacteria was confirmed in the CSF by culture, serology and Multiplex PCR assay. The infant developed dilated subarachnoid spaces and right-sided hemiparesis associated with the persistent bacterial meningo-encephalitis. She was re-admitted 2 weeks after recovery and initial discharge from hospital owing to recurrence of S. enterica Paratyphi B bacteria in the CSF and the development of large bilateral subdural effusions in the brain. Computed tomography and the clinical course confirmed dynamically progressive meningo-encephalitis. Following further parenteral antibiotics and symptomatic treatment, the child’s condition improved. After a total of 24 days in the PICU, she was sufficiently improved to be discharged with a residual right-sided hemiparesis. However, sadly she died a week after discharge. Abbreviation: ALT: alanine aminotransferase; API: analytical profile index 20 E-test; AST: aspartate aminotransferase; CRP: C-reactive protein; CSF: cerebrospinal fluid; CT: computed tomography; EUCAST: European Committee on Antimicrobial Susceptibility Testing; MDCT: multi-detector computed tomography; PCR: polymerase chain reaction; PICU: paediatric intensive care unit; RBC: red blood cells; VITEK: automated instrument for identification/antimicrobial susceptibility testing; WBC: white blood cells.

Yersinia enterocolitica is a foodborne pathogen, mainly associated with disorders involving the gastrointestinal tract, including diarrhea, ileitis, and mesenteric lymphadenitis. Extraintestinal presentation is uncommon in healthy individuals, but bacteremia is reported in immunocompromised hosts. We present a 74-year-old male with Y. enterocolitica serogroup O:3 bacteremia who complicated to rupture of an abdominal aortic aneurysm. With the current case report, we aimed to emphasize the association of Y. enterocolitica bacteremia with abdominal aortic aneurysm rupture. Better surveillance is needed, not only to reduce morbidity and mortality but also to update current epidemiological data on the incidence of such associations.

Introduction. The incidence of salmonellosis among people in Bulgaria in recent years has remained relatively high, despite the annual fluctuations. With this work, we aim to clarify the dynamics in the spread of human infections for 2017 -2023 in Bulgaria. Materials and Methods. Data from annual analyses of 3208 Salmonella cultures from patients and contacts of the NRL Enteric Infections, Pathogenic Cocci and Diphtheria" and primary microbiological laboratories in the country were used. Also, data on reported cases of salmonellosis from all 28 Regional Health Administrations, data from the National Centre for Public Health and Analysis and the end annual analyses of communicable diseases in Bulgaria prepared by the Epidemiology Department of the National Centre for Infectious and Parasitic. Results and Discussion. During the study period, a total of 3208 human salmonellosis cases were laboratory confirmed by bacterial culture isolation, of which 1847 were from patients with enterocolitis syndrome and 1361 from infectious carriers. These cultures represent two species of Salmonella enterica and S. bongori, 4 subtypes- enterica; salame; arizonae and diarizonae and 66 Salmonella serotypes. Salmonella Enteritidis was the leading etiological agent in the patients, with a relative share of 47%, followed by Salmonella Typhimurium- 32.8%, 40.5%- monophasic. The third place is held by Salmonella Infantis - 4,85%. The following serotypes were isolated for the first time in our country: Brazzavile; Larochelle; Ndolo; Kuoka; Jerusalem; Vejle and the unique for the world, new serotype- Salmonella 11: z41: enz15. In carriers, in contrast to patients, other serotypes come to the fore- Muenster; Bazenheid; Dublin, etc. The data obtained from the analysis again confirm that the group most affected by Salmonella infections is the group of infants and young children. Salmonella outbreaks in the country have been decreasing dramatically since 2020, in contrast to sporadic cases. In 2018, an outbreak of a serotype rare in the country- London was recorded. Conclusion. From the above data, it is evident that Salmonella infections continue to be a complex public health problem, making it imperative that in the fight to contain them, their aetiological structure is well understood and monitored dynamically.

Campylobacter infection is a serious health problem worldwide. There is still insufficient information in Bulgaria about the spread and course of the infection. Data on campylobacteriosis in adults are particularly scarce. In our study, we performed a comparative analysis in patients in different age groups, including the resistance of isolated strains. In the period 2018-2020, a total of 1,120 patients hospitalised with acute diarrhoea syndrome, aged 0-97 years, were studied, and a total of 1,120 faecal samples were examined by culture techniques and multiplex polymerase chain reaction (PCR). The antimicrobial resistance of some of the isolates was determined. A total of 385 (34.37%) isolates belonged to Campylobacter spp.: 340 (88.31%) to Campylobacter jejuni and 45 (11.68%) C. coli, respectively. The highest incidence was observed in the youngest (< 5 years of age) and the oldest (≥ 65 years of age) patients. Elderly adults are most likely to present with poor and non-specific symptoms despite the severe course of the infection. We observed severe antimicrobial resistance to tetracycline in both young children and older adults (about 40%). In older adults, we observed high resistance to ciprofloxacin. Regarding the C. jejuni strains, the resistance was 19.07% in the youngest, but it reached 59.15% in older adults. The mimicry of the symptoms in older adults can be misleading for the clinician with regard both to the diagnosis and the severity of the infection.

Aim. The aim of this report is to present the case of a 44-year-old male tourist from Belgium with type 1 diabetes who developed necrotizing fasciitis and sepsis caused by Vibrio vulnificus during his stay at the Bulgarian Black Sea Coast. Material and methods. Data was collected from the patient's examination records. V. vulnificus was isolated by culture on blood agar and identified with biochemical tests. Results. During the initial hospitalisation the patient left the clinic without leave and returned 24 hours later. He was surgically treated and supported with intensive care. However, the patient developed severe sepsis which resulted in fatal outcome. Conclusion. It is important to highlight the need for sufficient awareness among patients with diabetes and other serious chronic diseases of the potential threat posed by V. vulnificus infections.