Rajica Stosovic
@med.bg.ac.rs
Assistant professor at Allergology and Clinical Immunology Department, Medical faculty University of Belgrade
Medical faculty University of Belgrade
RESEARCH, TEACHING, or OTHER INTERESTS
Immunology, Pulmonary and Respiratory Medicine
Scopus Publications
Scopus Publications
Milica Jovanović, Branko Velebit, Tanja Tošić, Gina Maki, Sladjana Pavić, Snežana Jovanović, Rajica Stošović, and Marcus J Zervos
SAGE Publications
Objectives: In humans, enterococci are among the most important opportunistic pathogens. This study aims to compare invasive isolates obtained from blood cultures of patients with sepsis and endocarditis with colonizing isolates obtained from healthy donors’ stool samples. Methods: A case-by-case assessment was conducted on invasive infection cases to determine whether enterococci were involved in their pathogenesis. They were tested for the presence of virulence factor genes, β-hemolysis on agars supplemented with human and sheep blood, and biofilm forming capacity. Results: Three species of enterococci were identified among invasive isolates: Enterococcus faecalis, Enterococcus faecium, and Enterococcus durans. All endocarditis isolates were biofilm producers. Genes esp, gelE, asa1, ace, hyl, cylB, and cylA were present in 7 (41.2%), 11 (64.7%), 11 (64.7%), 13 (76.5%), 0, 3 (17.6%), and 1 (5.9%) invasive isolate, but none of them could be linked to a particular infection (sepsis or endocarditis). Colonizing isolates proved to have had more virulence factor genes, but the differences were not statistically significant. Members of that group produced a greater amount of biofilm when the ace gene was absent ( p = 0.047). The production of β-hemolysis by noninvasive strains was detected more frequently when agar was supplemented with human blood ( p = 0.021). In general, the presence of either cyl gene on that specific agar was in direct connection with the production of β-hemolysis: cylA ( p = 0.047) or cylB ( p = 0.020). Conclusion: We have been unable to establish any correlation between invasive isolates and any virulence gene carriage and biofilm formation. β-hemolysis was produced significantly more often by colonizing strains when agar had been supplemented with human blood.
Rajica Stosovic and Vesna Tomic-Spiric
National Library of Serbia
Local allergic rhinitis is a new rhinitis phenotype characterized by symptoms similar to allergic rhinitis, in non-atopic patients with a positive nasal allergen provocation test (NAPT). The disease is diagnosed in over 25% of non-atopic patients with rhinitis, marked as non-atopic rhinitis. It most often has perennial and severe symptoms and a progressive course. It is often associated with conjunctivitis and/or asthma. It is necessary to consider local allergic rhinitis in patients with non-atopic rhinitis. The gold standard for diagnosis is a positive NAPT. Pharmacological therapy fails to stop the natural progression and development of comorbidities. Allergen immunotherapy reduces the symptoms, consumption of medicines and increases the tolerance to allergens responsible for local allergic rhinitis. New studies are needed to confirm the curative effects and evaluate the preventive effects of allergen immunotherapy.
Milica Jovanović, Mitra Drakulović, Tanja Tošić, Rajica Stošović, and Snežana Jovanović
Elsevier BV
Milica Jovanović, Tanja Tošić, Snežana Jovanović, Rajica Stošović, Goran Stevanović, Branko Velebit, and Marcus John Zervos
Elsevier BV
Aleksandra Barac, Goran Stevanovic, Marina Pekmezovic, Zoran Rakocevic, Rajica Stosovic, Boban Erovic, and Vesna Tomic Spiric
Oxford University Press (OUP)
&NA; Dysbiosis of the microbiome on the airway mucosa leads to the development of chronic inflammatory and allergic disorders. The aim of this study was to consider the potential diagnostic criteria for allergic fungal rhinosinusitis (AFRS) and nonallergic fungal rhinosinusitis (FRS), and the role of fungal presence in an environment for the development of AFRS. In this study, 136 patients were divided into two groups: patients with positive specific immunoglobulin E (sIgE) and fungal finding (AFRS group), and patients with negative sIgE and positive fungal finding (FRS group). The study design included: anamnesis data, sIgE, eosinophil count and skin‐prick test, rhinology and computerized tomography (CT) observation and mycological finding. Our results showed: (i) the prevalence in Serbia is: AFRS 1.3%, FRS 2.8%; (ii) 30.4% patients with sIgE+ had more often severe and recurrent chronic rhinosinusitis (CRS) (P = .005) and the presence of polyps (P = .025); (iii) 46.4% patients with sIgE+ had positive fungi on the sinonasal mucosa and were considered as AFRS; (iv) patients with AFRS had more frequent asthma (P = .024) and chronicity of CRS >10 years (P = .000). The persistent fungal presence and prolonged duration of CRS could be a silent threat for the progression of inflammation and development of FRS. Lavage with hypertonic‐NaCl should be included in the everyday hygiene routine in an effort to decrease fungal load and antigenic exposure. The presence of allergological parameters and better response to corticosteroid therapy in AFRS patients should be considered as crucial diagnostic criteria for AFRS.
Milica Jovanovic, Tanja Tosic, Snezana Jovanovic, Goran Stevanovic, Mitra Drakulovic, Rajica Stosovic, and Marcus Zervos
Journal of Infection in Developing Countries
Introduction: In an intensive care unit (ICU) of the Emergency Center in the Clinical Center of Serbia, four species of vancomycin resistant enterococci (VRE) were isolated in a 17-month period mostly from blood cultures, including E. faecalis, E. faecium, E. raffinosus and E.gallinarum.
 Methodology: The relationship between isolates from each species was investigated by PFGE, and PCR experiments for detection of pathogenicity factor genes and van genes to determine the nature of each clone. A PCR-based method, using 10 primer pairs (p1/2-p19/20), was used to investigate the presence of the Tn1546-like structure.
 Results: PFGE indicated the presence of two different E. faecium clones, while the three other enterococcal species belonged to one clone each. Transposon typing revealed that isolates of E. raffinosus (4), E. gallinarum (4) and E. faecalis (3) yielded gene sequences identical to 10 primer pairs (p1/2-p19/20), suggesting the possibility of identical transposon-like structure in these species.
 Conclusions: The results of the study indicate probable horizontal spread of Tn1546-like structure in three species of VRE obtained from the same ICU.
Valentina Arsic-Arsenijevic, Aleksandra Barac, Marina Pekmezovic, Rajica Stosovic, and Ivica Pendjer
National Library of Serbia
Allergic fungal sinusitis (AFS) is a chronic non?invasive disease. Hypersensitive immune response is usually initiated by allergens of filamentous fungi Aspergillus, Penicillium, Cladosporium, Fusarium, Bipolaris, Curvularia and Alternaria. AFS is a clinical and immune analogue of the allergic bronchopulmonary aspergillosis (ABPA) as the sinus exudate resembles that of the bronchoalveolar lavage (BAL) in ABPA. Patients with AFS are usually immunocompetent, atopic and males. The most common symptoms are headache, fullness in the paranasal sinuses, and difficult breathing through the nose. Clinically, there is a chronic mucosal inflammation and histopathologic finding shows allergic mucin and eosinophils. Specific staining methods, Gomori?s Methenamine Silver (GMS) or periodic acid?Schiff (PAS), are used for microscopic visualisation of hyphae, which are, in addition to the isolated fungi, most reliable evidence of AFS. Computerized tomography (CT) of paranasal sinuses shows the areas of hyperdensity. In cases where AFS is complicated by the erosion of bone tissue, discontinuation of the sinus bone wall can be seen. Significant laboratory finding, which correlate highly with the AFS, are high immunoglobulin E (IgE) antibodies specific for fungi, detected by the skin prick test or in serum. Treatment is often surgical, and after removal of the allergic mucin, therapy involves oral and nasal corticosteroids, immunotherapy and locally applied antimycotics (with verified fungal etiology). During treatment, the total/specific IgE is monitored - concentration increases with the development of AFS, and decreases during the improvement process. Knowledge of the pathophysiological mechanisms of AFS is scarce, and represents the focus of further research in order to define an optimal diagnostic and therapeutic approach.
J. Bolpacic, M. Bogic, J. Tadic, V. Tomic-Spiric, A. Peric-Popadic, J. Sojic-Rajcic, S. Arandjelovic, R. Stosovic, S. Raskovic, and L. Stefanovic
Dustri-Verlgag Dr. Karl Feistle
Background: Association between the allergic rhinitis and allergic bronchial asthma has been clinically observed long time ago. The aim of our study was to determine the possible presence of inflammation of the lower airway mucosal tissue in patients with allergic rhinitis who were symptom-free in the lower airways. Methods: A total of 87 patients with allergic rhinitis, 25 patients with allergic bronchial asthma without allergic rhinitis and 25 healthy controls were examined. Based on the results of the non-specific and specific bronchoprovocation tests (NBPT and SBPT), the patients with allergic rhinitis were divided into 4 subgroups: the patients with negative results of both tests (subgroup 1), patients only with positive NBPT results (subgroup 2), patients only with positive SBPT (subgroup 3) and patients with positive results of both tests (subgroup 4). Results: The results of the cytological analysis of the induced sputum from the subgroups of patients with allergic rhinitis were compared to those obtained from the patients with allergic bronchial asthma and healthy controls and confirmed presence of the allergic inflammation in subgroups 3 and 4 of the patients. Conclusions: Absence of lower airway complaints in subgroup 4 patients with allergic rhinitis may be explained by still insufficient degree of the allergic inflammation in comparison to the one in patients with allergic bronchial asthma.