Public Health Institute of Sarajevo Canton

of Sarajevo Canton, Bosnia and Herzegovina

Public Health Institute of Sarajevo Canton

of Sarajevo Canton, Bosnia and Herzegovina
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PubMed | Institute for Public Health and Food Safety, University of Zagreb and Public Health Institute of Sarajevo Canton
Type: Journal Article | Journal: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina | Year: 2016

Aim To investigate prevalence, antimicrobial susceptibility, molecular characteristics, and genetic relationship of AmpC- and/or extended spectrum beta lactamase (ESBL)- producing Proteus spp. clinical isolates in Zenica-Doboj Canton, Bosnia and Herzegovina. Methods Antibiotic susceptibility was determined by disc diffusion and broth microdilution methods according to CLSI guidelines. Double-disk synergy test was performed in order to screen for ESBLs, and combined disk test with phenylboronic acid to detect AmpC -lactamases. PCR was used to detect blaESBL/blacarb genes. Genetic relatedness of the strains was determined by pulsed-fieldgel-electrophoresis (PFGE). Results Eleven ESBL-producing isolates were included in the study (six inpatients and five outpatients). Susceptibility rate to amoxicillin-clavulanic acid, imipenem and meropenem was 100%. Resistance rate to cefuroxime was 100%, gentamicine 90.9%, piperacillin/tazobactam 81.8%, cefotaxim, ceftriaxone and ceftazidime 72.7%, cefoxitine and ciprofloxacine 63.6% and to cefepime 45.5%. In five (out of 11) isolates multi-drug resistance (MDR) to cephalosporins, cefamicines, amynocligosides and fluoroquinolones was detected. Besides TEM-1 which was detected in all isolates, CTX-M+OXA-1 -lactamases were detected in seven (out of 11; 63.6%) isolates (five blaCTX-M-1 and two blaCTX-M-15 genes), and CMY-2 -lactamase in two isolates. PFGE showed no genetic relatedness. Conclusion Because of high prevalence of MDR strains in epidemiologically unrelated patients with AmpC- and/or ESBL producing Proteus spp. infection, further surveillance is needed. Molecular characterization and strain typing, or at least phenotypic test for AmpC/ESBL production is important for appropriate therapy and the detection of sources and modes of spread, which is the main step in order to design targeted infection control strategies.

Hamzic S.,University of Sarajevo | Hamzic S.,Public Health Institute of Sarajevo Canton | Beslagic E.,University of Sarajevo | Beslagic E.,Public Health Institute of Sarajevo Canton | And 4 more authors.
HealthMED | Year: 2011

Introduction: Amoebiasis is an acute or chronic disease characterized by a clinical range of asymptomatic to symptomatic extraintestinal lesions of distant organs and tissues, caused by the protozoa Entamoeba histolytica. It is primarily localized in colon (intestinal amoebiasis), and secondarily, it is localized in other organs (extracolonial amoebiasis) - in lungs, liver (amoebic hepatitis), brains, spleen, skin. Amoebiasis is one of the most frequent protozoan infections, which mostly occurs in areas characterized by poor sanitary circumstances. It occurs as a consequence of reduced natural resistance of organism, since protozoa exist as commensals in colon lumen, or they are transmitted by fecal-oral route or by contamination of hands, food and water. It has been debated for years that protozoa include two genetically and biologically distinct species; a pathogenic one, E. Histolytica, and the other, nonpathogenic species, E. dispar. The first one is pathogenic, causing both intestinal and extraintestinal defects (mostly in liver), while the other one is a commensal in human organism and does not cause any kind of defects or symptoms. Material and methods: Results of parasitological examination of 304 stool samples collected from 234 individuals in the period 01/01/2008 - 12/31/2008 at the Microbiological Laboratory of the Public Health Institute in Sarajevo Canton are presented in this paper. Results: Cystic form was found in a total of 166 (54.6%) of microscopically examined samples. Vegetative form was found in a total of 234 microscopically examined stool samples. Vegetative form of E. histolytica was found in 161 (68.8%) samples, while vegetative form of E. histolytica with ingested erythrocytes was found in 73 (31.2%) samples. Conclusions: Results confirm the existence of cyst-bearing E. histolytica and indicate the importance of preventive actions that imply improvement of sanitary conditions of living and nutrition, in order to thus reduce the possibility of cysts transmitting as infective forms of E. histolytica.

Obradovic Z.,Public Health Institute of Sarajevo Canton | Obradovic Z.,University of Sarajevo | Velic R.,University of Sarajevo
Croatian Medical Journal | Year: 2010

Aim: To analyze the frequency and distribution of human brucellosis in the Federation of Bosnia and Herzegovina in the period 2001-2008, and measures and activities undertaken for prevention and control of the disease. Method In this descriptive, retrospective study, we used official reports on infectious diseases from public health institutes at the federal and cantonal level, as well as epidemiological surveys. For comparison with animal brucellosis cases, we used the distribution data from veterinary surveillance. Results: Since 2001, the number of infected people has rapidly increased and brucellosis has become a very important public health problem. In the period 2001-2008, there were 1639 human brucellosis cases and the number of cases increased every year. The morbidity rate over the study period ranged from 3.8 to 33.4 per 100 000 inhabitants. According to epidemiological surveys, in villages human brucellosis was transmitted mostly by contact with infected animals and their products, and in cities by consumption of dairy products made from contaminated, unpasteurized milk. When test-and-slaughter control approach was used, the prevalence of seropositive livestock was 4.6% and approximately 70 000 animals were slaughtered after testing between 2001 and 2008. From 1 June 2009, this approach was replaced with mass vaccination of sheep and goats. Conclusion: The large number of human brucellosis cases and seropositive livestock poses a very serious problem for Bosnia and Herzegovina. The solution may be the introduction of mass vaccination.

Hamzic S.,University of Sarajevo | Hamzic S.,Public Health Institute of Sarajevo Canton | Beslagic E.,University of Sarajevo | Beslagic E.,Public Health Institute of Sarajevo Canton | And 10 more authors.
Technics Technologies Education Management | Year: 2011

Introduction: Amoebiasis has been infecting humans since ancient history and the disease could not have been differentiated from other intestinal diseases that manifest in diarrhea until the causal agent has been identified. Humans are the main reservoir of histolytic amoebas and asymptomatic parasite-bearers are the main source of infection. Excreted cysts can survive in outer environment for weeks, even for months in humid environment. Infection is transmitted by fecal-oral route, mostly by food, usually vegetables that are not boiled (salad) or water contaminated by feces, and rarely by direct contact in poor sanitary conditions. Epidemic occurrences are rare and they are usually related to highly contaminated drinking water. Entamoeba histolytica occurs in two forms: vegetative form (trophozoit) and cystic form. It is found in colon, where it exists as a commensal, not causing pathological changes; however, when immune powers of organism are reduced, it becomes an invasive form, leading to numerous ulcerations and lesions and causing blood-mucous diarrhea. Clinical features can be presented as colonial (intestinal) and extraintestinal amoebiasis. Asymptomatic cyst-bearing is a consequence of infections with histolytic amoeba in 90-99% of infected individuals. Beside the epidemiological importance, it is also significant for bearers, since cyst-bearing can be transformed into the invasive disease under certain conditions. Material and methods: The study involved 40 samples of fruit and vegetable lavates, as well as 17 water samples, examined in the period 01/01/2009 - 12/31/2009. The samples were examined at the Microbiological Laboratory of the Public Health Institute of Sarajevo Canton; direct preparation was examined for Entamoeba histolytica, after the first, second or the third passage. Results: Out of a total of 32 vegetable lavate samples examined on direct preparation by microscopic method, cystic form of E. histolytica was found in 15.6% of samples. All examined fruit lavate samples remained negative. Results of microscopic examination of direct preparation made of 17 different water samples suggest that cystic form of E. histolytica was found in 5.9%. Conclusions: Transformation of asymptomatic infection into the invasive disease, as well as possible contamination of environment, is a problem that requires obligatory reporting and controlling of Entamoeba histolytica from epidemiological aspect of spreading, distribution and intensity of infection.

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