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Sadeta Hamzić

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D. Junuzović, M. Hasanbegović, S. Zvizdić, S. Hamzić, Lejla Zunic

Introduction: Endoscopic surgery and endourological procedures imply the use of special instruments that are introduced into the urinary system through the urethra and percutaneous techniques that allow ante grade access to the urinary tract. The risk of urinary tract infection after endourological procedures and the use of antibiotic prophylaxis for these procedures is a question about which there is no unique opinion. Goal: The objective of this study was to determine the connection between endourological procedures and occurrence of urinary infections and to analyze the risk factors of urinary infection for patients who were hospitalized at the Urology Clinic of the Clinical Center University of Sarajevo (CCUS). Material and methods: The research was conducted as a prospective study on a sample of 208 patients of both genders, who were hospitalized at the Urology Clinic of the CCUS and to whom one of endourological procedures was indicated either for diagnostic or therapeutic purposes. All patients were clinically examined prior to endoscopic procedures and after the treatment attention was focused on the symptoms of urinary tract infections. Results: Analysis of the presence of postoperative bacteriuria shows that it has been more common in men or in 48 cases (28.1%) compared to women with 8 cases (21.6%) (p>0.05). Preoperative catheterization was statistically significantly more present in patients who have had a postoperative bacteriuria (16 or 28.6%) compared to those without bacteriuria (8 or 5.3%) (p<0.05). Analysis of the average duration of postoperative catheterization shows that patients with postoperative bacteriuria had longer duration of postoperative cauterization of 1.97±0.14 days (range 1-20 days) compared to those without postoperative bacteriuria with 1.4±0.4 days (range 0-5 days) and with a statistically significant difference (p<0.05). Antibiotic prophylaxis in relation to the occurrence of postoperative bacteriuria did not show a statistically significant difference (p> 0.05). Analysis of the correlation coefficient indicates that a statistically significant effect on the occurrence of postoperative bacteriuria have preoperative bacteriuria, duration of postoperative catheterization and duration of hospital stay, as well as the total duration of hospitalization before and after endourological treatment (p<0.05). Conclusion: It is important to emphasize that the endourological procedures are safe procedures in terms of urinary tract infections. This study should lay pathway to establishment of guidelines for the application of antibiotic prophylaxis in endourological procedures. This would standardize the perioperative use of antibiotics, taking into account the local prevalence of pathogens and antibiotic resistance, but keeping the individual approach to each patient, considering all risk factors for the development of urinary infection after endourological procedures..

Senad Ljuca, S. Zvizdić, S. Hamzić, Merlina Kalajdžija, Asmira Ljuca

Antibacterial resistance is generally regarded as a public health problem, not only in local terms, but also worldwide. The objective of this research work would be to analyze inpatient's and outpatient's antimicrobial resistance to a set of various agents. The patients have been medically treated in the region of Ze-do canton since 2005 until today. Total number of 164 patients was included in our research. Regarding the place of medical treatment, our patients were divided into two groups: a total number of 111 inpatients and a total number of 53 outpatients. 56 of them were males, rest females. Apart from the sex affiliation, the exeminees were divided into two groups, depending on the presence of the Foley's catheter (inpatients only). We were obliged to determine the antimicrobial sensitivity of the isolated bacteria to certain representatives of antimicrobials. During the conducted testing, it has been proved that the phenomenon of polymicrobic infection found while testing inpatients is in immediate correlation to the catheterization. The inpatients urine tract infections are duo to the most commonest agent--E. coli that is in terms of percentage 38.5%, followed closely by Proteus spp.--19.3%, Pseudomonas spp.--13.6%, Klebsiella pneumoniae, 12.5%, et cetera. The outpatients urine tract infections are due to the most common agent E. coli percentage is 81%, as well as to Klebsiella pneumoniae, 19.0%. During the testing of the antimicrobial sensitivity of the isolated bacteria, it has been determined that the urine tract infection agents (starting with E. coli and Klebsiella pneumoniae) isolated from the inpatients urine specimens are proved to have higher resistance to tested antimicrobials compared to the same agents isolated from the outpatient's urine specimens. The differences refferring to resistance rates are ranging from 0.2% (trimetoprim-sulphametoksazol) to 25.9% (cephazolin) for E. coli, since the difference refferring resistance to Klebsiella pneumoniae is more noticeable and ranging from 0.8% (amoxicillin- clavulonic acid) to 65.0% (gentamicin).

S. Zvizdić, S. Hamzić, Ines Rodinis-Pejić, Fadila Avdić-Kamberović, S. Bektaš, Enes Šačić

Fungi from genera Aspergillus, Penicillium, Fusarium, Rhizopus, Alternaria and other are frequent contaminants of cereals, cattle nutrients and other herb products used in animal and human nutrition. Some species of fungi produce mycotoxins (secondary metabolites) that can affect animal and human health by contaminating food. The most significant mycotoxins are: aflatoxin, zearalenone, ochratoxin, trichotecen, fumonisin and palutin. One of their features refers to thermo-stability and resistance in certain medium. They are causal agents of mycotoxicoses of acute or chronic course, affecting the central nervous system, lungs, liver, digestive or cardiovascular systems. Disorders are manifested as poisoning, with special accent on their cumulative, carcinogenic, teratogenic and mycogenic effects. Their economic and trade significance is frequently addressed today. ELISA was used for detection of aflatoxins and ochratoxins in analyzed human food, carried out in accordance with recommendations of producer. The screening method was used to detect the quantity of mycotoxins measured in nanograms. Results are compared to the standards determined in the regulations on concentration limits of mycotoxins in consumed food, which should be harmonized with the norms of certain European countries. The period from October to December 2007 was involved by the research. A total of 300 (150-150) food samples were analyzed. There were 25 (16.6%) samples of flour and flour products, 43 (28.6%) samples of peanut, walnut, hazelnut and various pips, 23 (15.3%) samples of dried fruits, 15 (10.0%) samples of rice, soya and barley, as well as 15 (10.0%) samples of various spices, 12 (8.0%) samples of cocoa and related products, 8 (5.3%) samples of coffee, 5 (3.3%) samples of coconut, 3 (2.0%) samples of children’s food and juices and 1 (0.6%) of stock-feed. Analysis of 150 food samples proved the presence of aflatoxins in higher concentrations than allowed in 28 (18.8%) samples, while the presence of ochratoxins was not detected in any of 150 food samples.

R. Velić, T. Bajrović, S. Zvizdić, L. Velić, S. Hamzić

Serotyping of five rabies virus isolates with monoclonal anti-nucleoprotein antibodies for classical rabies virus and rabies-related viruses and phylogenetic relationships among sequences indicate that viruses circulating in population of animals in Bosnia and Herzegovina belong to the sero-genotype 1 of classical rabies virus. Phylogenetic relationships among sequences of our viruses have shown the presence of two phylogenetic lines, one which is present in the northwestern part and other which is present in the northeastern part of the country. Our viruses are closely related to Westeuropean isolates of rabies virus.

The examination involved the individuals, whose sera were tested in the Laboratory for specific diagnostic of human Q fever, in the Department for Microbiology of the Medical Faculty University of Sarajevo, during the period 2000 – 2004, using the IFA test for detection of human IgM and IgG antibodies for C. burnetti. Human Coxiella burnetti infection was confirmed in 191 (69.7%) men and 83 (30.3%) women, with the most frequent occurrence in the group aged between 31 and 40 (26.7%). Analyzing the values of obtained results of titers of specific IgM and IgG antibodies phase I and phase II C. burnetii antigens in sera of individuals involved, we confirmed the presence of acute disease in 80.3% of cases, as well as chronic, i.e. convalescent disease in 19.7% of cases.

Ibrahim Aličkovič, S. Tandir, Z. Puvacić, S. Zvizdić, S. Hamzić

After the war in Bosnia and Herzegovina there is a sudden increase in number of infected with the Q-fever, which becomes huge public health and economic problem. Although this disease occurred in very different geographic areas of Bosnia and Herzegovina the Zenica-Doboj Canton was among the most affected. Infections of Q-fever at the Zenica-Doboj Canton represent very complex epidemiology problem, because it is in highest incidence rates not only for Bosnia and Herzegovina, but also for Europe. The total number of population affected by Q-fever in Zenica-Doboj Canton since the beginning of 1998 until the end of 2005 was 193, with the average morbidity rate of 48.30 %000. In Zenica-Doboj canton affected by Q-fever was the inhabitants of both genders, all ages and on wide territory, which in majority of cases did not have the contact with domestic animals. Incubation period varies from 14 to 27 days. Actual incidence rate due to asymptomatic occurrence of this disease is for sure higher. Researches of spreading manner for the Q-fever among humans showed that this disease can be spread in epidemic and sporadic manner in Zenica-Doboj Canton, and that there are many risk factors which influence its occurrence.

S. Zvizdić, S. Hamzić, S. Tandir

Rotaviruses belong to the family Reoviridae, genus Rotavirus with several types that are important for human and animal medicine. Rotavirus genome is consisted of 11 segments of double-stranded RNA, which code the synthesis of structural (VP) and non-structural proteins (NSP). The virus genome is enclosed in the three-layer capsid. Protein of the middle layer (VP6) is responsible for group specificity, and two proteins of the external capsid layer (VP7 and VP4) are responsible for belonging of rotaviruses group A to different sero/genotypes, in further text G and P. These two important antigen proteins stimulate an organism to produce specific neutralizing antibodies. Today, there are overall 15 G and 23 P serotypes of rotaviruses known and discovered so far. It infects humans, with 10 G and 11 P serotypes of rotaviruses discovered, with the most frequent presence of group A of serotypes G1 to G4, and serotypes P4 and P8, respectively. The most frequently found serotype among them is G1. According to recent reports, rotaviruses are still one of the most important causes of acute gastroenteritis in the population of young children, with endemic distribution in all geographic regions. Annually, around 50,000 of rotavirus-infected individuals are hospitalized in USA and around 80,000 in Europe. Compared to other pathogens, rotaviruses are present in causing of acute diarrheas in children in 30-40 % of cases. In children younger than 5, around 136 millions of gastroenteritis cases with rotavirus etiology are registered annually. Out of this number, 111 millions are treated at homes, 25 millions ask for medical consultations, 2 millions are hospitalized, and around 440,000 die.

S. Tandir, S. Zvizdić, S. Hamzić, Ibrahim Aličkovič

Viral hepatitis A is an endemic disease with periodic epidemics, or sporadic cases within endemic areas. It is present in a majority of world countries, more often in undeveloped ones. In our country it occurs occasionally, so it still cannot be considered as solved problem. This is because Bosnia and Herzegovina until 1990 was in the group of countries with the largest hepatitis A morbidity in Europe, and municipality Zenica within B&H with the largest morbidity in the period from 1987 until 1996. By studying the occurrence of the viral hepatitis A according to age groups, we can notice that the largest number of patients is at the age between 7 and 18 years (school children and youth) with 68.86% of baseline, than follows patients up to 6 years of age with 15.34%. In analysis of occurrence season, it is noticed that disease have a season features with the peak occurrence during November and December. Regarding the area of living, it is noticed that the disease occurs significantly less frequently among urban than rural and suburban population (78%). Among total number of patients within the period of epidemic we have registered 82.0% of patients, and only 18.0% was occasional cases. In majority of cases virus spreads by contact, which is the consequence of poor hygiene and sanitation that was, or still are present in the rural areas, because of inadequate infrastructure and lack of sufficient quantity of clean drinking water, or to say low level of health knowledge among rural population.

Abstract:  Q fever is a zoonotic disease with worldwide distribution. It occurs in different geographic regions and climate zones. From 1990 till the end of 1997, only three infected individuals were registered in Bosnia and Herzegovina, during the year 1991, with the incidence of 0.05% 000. From 1996 onward, there was a sudden aggravation of epizoological and epidemiological situation in particular regions of Bosnia and Herzegovina. We performed serotesting during the 4‐year period from 2000 to 2003. We tested serum samples from 708 individuals from different regions of Bosnia and Herzegovina. Q fever was serologically diagnosed in 249 individuals. The overall seroprevalence was 35.2%. The acute disease form was confirmed in 79.9% of the whole seropositive sample. Most of the Q seropositive individuals were from Kakanj (17.3%), Mostar (15.3%), Sarajevo (12.5%), Bihać (9.6%), Zenica (9.2%), Gornji Vakuf (8.9%), Tešanj (4.4%), Visoko (2.8%), and Travnik (2.4%). The number and distribution of seropositive individuals suggests that Q fever is endemic in Bosnia and Herzegovina.

E. Beslagić, S. Hamzić, O. Beslagić, S. Zvizdić

Abstract:  Zoonoses are animal and human diseases. Q fever is primarily a zoonosis—an animal disease that can be transmitted to humans under certain conditions. Recent epidemiological studies suggest that Q fever should be considered as a public health problem in many countries where it is present, but unrecognizable due to inadequate disease controls. Through specific serological diagnosis of clinically suspected human Q fever cases, we are trying to determine a level of general Coxiella burnetii (C. burnetii) exposition among populations in different regions of Bosnia and Herzegovina. This would be a contribution in controlling the present and the future disease outbreaks, as well as its prevention, which is one of the prime objectives of public health. During the period from January to June 2004, in the Laboratory of the Department for Microbiology in the Medical Faculty of the University of Sarajevo, of 58 tested sera from 48 clinically suspected individuals, we confirmed the presence of specific anti‐C. burnetii antibodies in 30 sera (51.7%), from 25 seropositive individuals (52.0%), by means of indirect immunofluorescent antibody (IFA) testing. Urgent steps must be taken in public education to help decrease the risk of C. burnetii infection among at‐risk populations in regions of Bosnia and Herzegovina.

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