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 Klebsiella 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 Klebsiella 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.

Continuous progress in the nursing profession has a significant impact on the quality in the process of clinical care, which brings about new challenges and tasks for nurses to invest in new knowledge and skills. The healthcare process requires a systematic team approach in the design of evidence-based tasks, good clinical practice and clinical guidelines, documented standardized phenomena and evaluated measurements and tests. Measurement instruments and statistical tests of treatment effectiveness are used to assess the quality of health care provided. For a successful measurement and analysis of the quality of clinical care, it is necessary to have standardized healthcare documentation that allows treatment and outcomes monitoring. Qualitative and safety indicators are used to assess the quality of clinical health care, which represent a means of measurement, screening or warning. Monitoring Quality and Safety Indicators in Health Care Services is used as a guide to monitoring, evaluating and improving the quality of health care, and supporting services and organizational functions. In the field of health care, we measure the total treatment, outcome of the healthcare process, patient satisfaction, unwanted events,quality of life, etc.

Introduction: Intensive unit microflora mainly consists of organism capable of surviving in moist media, such as gram-negative bacteria, skin-colonizing microorganisms, those with the ability to adhere to medical devices, and microorganisms resistant to conventional antibiotics. Therefore, cleansing and disinfection of intensive care units is of great importance in the prevention and control of hospital infections.Material and Methods: The use of the device was demonstrated in the isolation room of the intensive care unit after a patient colonized with hospital bacterial strains was discharged. The first sampling was carried out immediately after the patient was discharged, the second after the standard medical cleansing of the equipment and space, and the third after the disinfection with the “SterisafePro”. The analysis of the smears was performed at the OU Clinical Microbiology. Quantitative method analyses was performed according to standard operative procedure (SOP). The results of the analysis are calculated according to the formula and expressed in the values of CFU / cm2.Results: After the patient was discharged and the area cleaned mechanically, the Acinetobacter baumanii was isolated in three samples, coagulase negative staphylococci in one, while two smears remained sterile. Acinetobacter baumanii and coagulase negative staphylococci were isolated in three samples. After using the disinfecting device, all swabs were sterile.Conclusion: Disinfection of the hospital with the “Sterisafe”Pro” device has proved to be very successful. The advantages of using the “Sterisafe”Pro” device are that is uses no chemicals, has a low labor and usage costs, is harmless to the patients and staff, and is very easy to use. 

Continuous progress in the nursing profession has a significant impact on the quality in the process of clinical care, which brings about new challenges and tasks for nurses to invest in new knowledge and skills. The healthcare process requires a systematic team approach in the design of evidence-based tasks, good clinical practice and clinical guidelines, documented standardized phenomena and evaluated measurements and tests. Measurement instruments and statistical tests of treatment effectiveness are used to assess the quality of health care provided. For a successful measurement and analysis of the quality of clinical care, it is necessary to have standardized healthcare documentation that allows treatment and outcomes monitoring. Qualitative and safety indicators are used to assess the quality of clinical health care, which represent a means of measurement, screening or warning. Monitoring Quality and Safety Indicators in Health Care Services is used as a guide to monitoring, evaluating and improving the quality of health care, and supporting services and organizational functions. In the field of health care, we measure the total treatment, outcome of the healthcare process, patient satisfaction, unwanted events, quality of life, etc.

Introduction: Intensive unit microflora mainly consists of organism capable of surviving in moist media, such as gram-negative bacteria, skin-colonizing microorganisms, those with the ability to adhere to medical devices, and microorganisms resistant to conventional antibiotics. Therefore, cleansing and disinfection of intensive care units is of great importance in the prevention and control of hospital infections. Material and Methods: The use of the device was demonstrated in the isolation room of the intensive care unit after a patient colonized with hospital bacterial strains was discharged. The first sampling was carried out immediately after the patient was discharged, the second after the standard medical cleansing of the equipment and space, and the third after the disinfection with the “SterisafePro”. The analysis of the smears was performed at the OU Clinical Microbiology. Quantitative method analyses was performed according to standard operative procedure (SOP). The results of the analysis are calculated according to the formula and expressed in the values of CFU / cm2. Results: After the patient was discharged and the area cleaned mechanically, the Acinetobacter baumanii was isolated in three samples, coagulase negative staphylococci in one, while two smears remained sterile. Acinetobacter baumanii and coagulase negative staphylococci were isolated in three samples. After using the disinfecting device, all swabs were sterile. Conclusion: Disinfection of the hospital with the “Sterisafe”Pro” device has proved to be very successful. The advantages of using the “Sterisafe”Pro” device are that is uses no chemicals, has a low labor and usage costs, is harmless to the patients and staff, and is very easy to use.