Aim: During the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many countries reported a significant decrease in the prevalence of influenza virus cases. The study aimed to characterize the flu seasons from 2018 to 2023 in Sarajevo Canton, Bosnia and Herzegovina (B&H), and to assess the possible impact of the SARS-CoV-2 pandemic on the influenza A and B virus circulation. Methods: The CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panels were used for the detection of influenza virus A and B, and subtyping of influenza virus A (H1pdm09 virus and H3). The data for this regis-try-based retrospective study were collected at the Clinical Centre of the University of Sarajevo, Unit for Clinical Microbiology (the laboratory that acts as a referral for the detection and characterization of influenza virus and SARS-CoV-2 in Federation B&H). Results: In the 2018/2019 and 2019/2020, an equal percentage of positive cases was recorded (148/410; 36%, and 182/504; 36%, respectively). The absence of the influenza virus was observed in 2020/2021. During 2021/2022, influenza virus was detected among 19/104 (18%) patients and slightly increased in 2022/2023 (45/269; 17%). The switch of the influenza B virus lineage was observed. Conclusion: The SARS-CoV-2 virus had an impact on the prevalence of influenza virus infection among the population of the Sarajevo Canton, B&H. Since the interactions between these two viruses are not entirely clear, awareness of a possible threat to public health is crucial.
Klebsiella pneumoniae, a member of the Enterobacteriaceae family, demonstrates an increasing trend of resistance to carbapenems and is a common cause of both hospital- and community-acquired infections. The current study provides insights into the genetic characterization of carbapenem-resistant K. pneumoniae (CRKP) isolates circulating during 2022 in a Sarajevo tertiary hospital. Among the 87 CRKP strains analyzed, real-time polymerase chain reaction (rtPCR) results showed that 85 (97.7%) tested positive for the carbapenem resistance gene. The oxacillinase-48 (OXA-48) gene was detected in 83 (95.4%) isolates, while the K. pneumoniae carbapenemase (KPC) and the New Delhi metallo-beta-lactamase (NDM) genes were detected in one isolate each. No Verona integron-encoded-metallo-beta-lactamase (VIM) or imipenemase-metallo-beta-lactamase 1 (IMP-1) genes were found in any of the tested isolates. The multilocus sequence typing (MLST) analysis of sequence types (STs) revealed that ST101, an emerging high-risk clone exhibiting extensive drug resistance, was the most prevalent, whereas ST307 was detected in only one isolate. Phylogenetic analysis of the ten CRKP isolates indicated the presence of three clusters that could constitute an outbreak. A comparison of the results of the utilized phenotypic test (the combined-disk test [CDT]) and rtPCR showed high concordance, suggesting that the phenotypic assay may be useful for the early detection of resistance mechanisms as part of routine susceptibility testing. With the increased affordability of next-generation sequencing (NGS), its application in hospital settings has proven highly beneficial, aiding in the implementation of infection control and prevention measures. Given the significant resistance demonstrated by the CRKP isolates to most tested antibiotics, it is imperative to establish effective methods to restrict the spread of these isolates, as well as to carefully monitor the use of carbapenems in clinical practice.
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