Among Enterococcus spp, only the virulence gene harboring strains of Enterococcus faecalis and E. faecium are associated with human infections, including urinary tract infections (UTI), pelvic, blood, intraabdominal, and skin and soft tissue infections (SSTI). Over the past decades, enterococcal antimicrobial resistance has escalated in many regions of the world, leading to ominous outcomes. The rising incidence of Healthcare-Associated Infections (HCAIs) secondary to Vancomycin-resistant strain (VRE) resulted in high morbidity and mortality, as well as substantial challenges in control, prevention, and management). The aim of this study is to examine the antimicrobial resistance of E. faecalis and E. faecium species in different human samples. The study included 184 clinical samples over a period of 6 months. E. faecalis was identified in 95.65% and E. faecium in 4.35% of cases. E. faecalis isolates showed resistance to gentamicin in 40.9% of cases and to ampicillin in 1.7% of cases. Resistance to nitrofurantoin and ciprofloxacin was observed in 6.1% and 35.7% of E. faecalis isolates. VRE was isolated in 1.1% of E. faecalis isolates tested for this antibiotic. Resistance of E. faecium isolates to ampicillin and gentamicin was observed in 87.5% of cases in both antibiotics. All urinary isolates of E. faecium were resistant to ciprofloxacin. All E. faecium isolates were sensitive to vancomycin. Based on the results of our study, the growing importance of Enterococcus spp. as a causative agent of hospital infections and infections in the general population, and its antimicrobial resistance to various drugs were observed.

Introduction: Ascaris lumbricoides is a widely spread helminthic infection, predominantly affecting children, making them the most commonly infected population group. The objective of this study is to assess the prevalence of Ascaris lumbricoides infestation in two municipalities, Tešanj and Maglaj, and to investigate the occurrence of Ascaris lumbricoides infections in the pediatric population, focusing particularly on preschool children. Materials and Methods: The study involved the collection of 1409 fecal samples from the Tešanj and Maglaj areas, gathered over a 6-month period, spanning from September 2018 to February 2019. The processing of these samples was conducted in the Microbiology Laboratory of Tešanj General Hospital. Results: Out of the total 1409 samples, 129 (9.16%) tested positive for Ascaris lumbricoides infestation. In Tešanj, where 1198 samples were collected, 106 (8.85%) tested positive, while in Maglaj, 211 samples were collected, with 23 (10.9%) testing positive. Notably, the majority of positive cases in both Tešanj and Maglaj were preschool-age children, accounting for 88.68% and 86.96%, respectively. The study did not identify any statistically significant correlation between age and gender distribution among those with positive test results in either Tešanj or Maglaj. Conclusion: Based on the study results, which have highlighted the infestation of preschool children with Ascaris lumbricoides in two municipalities in our country, it is imperative to implement preventive measures aimed at reducing the incidence of infection.

Cottage cheese is the largest segment of the dairy market and is most often consumed as a fresh food. The microbiological quality of domestic cottage cheese can pose a problem for public health. Cottage cheese belongs to a group of foods having a potential public health risk. The aim of this study was to conduct microbiological research to determine the level of sanitary safety of cottage cheese types acquired from the most frequents markets of Sarajevo Canton (Bosnia and Herzegovina). Of the total (n=40) analysed cheese types, 22 samples (55%) proved to be meet sanitary requirements, while 18 samples (45%) did not meet microbiological quality, pursuant to the microbiological criteria for cheese stipulated by the National Regulation of Microbiological Criteria B&H and Guidelines for Microbiological Food Criteria B&H. The study included 24 samples of pasteurised and 16 samples of unpasteurised milk. However, five cheese samples (20.8%) from pasteurised milk, and 13 samples (81.3%) from unpasteurised milk were non-compliant. Microbiological analysis was conducted for compulsory and several recommended microorganisms: Salmonella spp., Listeria monocytogenes, coagulase positive staphylococci and other species (Staphylococcus aureus), Escherichia coli, and yeasts and moulds. Our findings confirm that the most common bacteria were S. aureus and E. coli. Also, yeasts and moulds were detected but were within the permissible concentrations. Salmonella spp. and L. monocytogenes were not detected in any of the examined samples.

Isolation of Staphylococcus aureus is quite common in both the general population and hospital environment. The heterogeneity of the disease and the unique ability of S. aureus to develop resistance to the most recently discovered antibacterial drugs points to its ability to adapt and survive in different conditions. CA-MRSA is different from hospital strains of MRSA by its epidemiological, phenotypic and genotypic characteristics. The emergence of MRSA in the community suggests the need for a new approach to managing the indications and the certification of staphylococcal infections, with special emphasis on the selection of empiric antibiotic therapy. In the study, we analised of MRSA from 4341 samples taken from patients from the general population of Sarajevo Canton in the six-month period of follow-up processed at the Public Health Institute of Sarajevo Canton. We determined the epidemiological characteristics of the isolated strains. Methicillin resistance was determined by phenotypic methods. The following molecular methods were used for the confirmation of methicillin resistance: determination of the mecA gene, PFGE profile, genetic type of MRSA being determined by spa typing, the distribution of SCCmec types being examined, and the detected gene for PVL. The study stresses the need for national monitoring of spreading of the existing epidemic strains, as well as the monitoring of emergence of new strains which would enable the inclusion of our country in the international network of monitoring bacterial resistance.

OBJECTIVES Staphylococcus aureus (SA) represents one of the most important microorganism that is part of the normal microflora of humans, but in certain conditions can cause very serious infections. Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for a wide spectrum of nosocomial and community associated infections worldwide. The aim of this study was to determine community acquired MRSA (CA-MRSA), as well as the frequency of Panton-Valentine leukocidin (PVL) genes and staphylococcal cassette chromosome mec (SCCmec) types in isolates obtained from outpatients in the region of 700,000 people (Canton Sarajevo, Bosnia and Herzegovina) Methods: Our investigation included phenotypic and genotypic markers such as antimicrobial resistance, pulsed-field gel electrophoresis (PFGE), SCC typing, and PVL detection. RESULTS Antimicrobial susceptibility: all MRSA isolates were resistant to the β-lactam antibiotics tested, and all isolates were susceptible to trimethoprim sulphamethoxazole, rifampicin, fusidic acid, linezolid, and vancomycin. After the PFGE analysis, the isolates were grouped into five similarity groups: A-E. The largest number of isolates belonged to one of two groups: C - 60% and D - 27%. In both groups C and D, SCCmec type IV was predominant (60% and 88.8%, respectively). A total of 24% of the isolates had positive expression of PVL genes, while 76% showed a statistically significantly greater negative expression of PVL genes. CONCLUSIONS Using combination techniques, we were able to investigate the origin and genetic background of the strains. PFGE analysis revealed two large, genetically related groups of strains consisting of 87 isolates. Our results suggest failure to apply the screening policy, and a lack of knowledge about multiresistant MRSA strains. This study showed the local epidemiological situation which should be the basis of antimicrobial empiric therapy for non-hospitalized patients.

Background: Latent tuberculosis infection (LTBI) is a state of persist immune response to Mycobacterium tuberculosis ( M. tuberculosis ) antigens without any clinical evidence of active tuberculosis. A new progress and inovation in diagnostics of latent tuberculosis, more specific and susceptible than tuberculin skin test, are Interferon Gamma Release Assay, Quanti FERON-TB test, in vitro blood tests used to detect immune response to TB proteins, by measuring interferon gamma (IFN-γ( in whole blood from persons infected with M. tuberculosis . The aim of this retrospective study was to determinate the role of QuantiFERON-TB Gold Plus (QFT – Plus test) test in diagnostics of LTBI evaluating the results from inpatients and outpatiens. Methods: This was a retrospective study where blood samples were collected from 1 st of January to 31 st of December 2016 in the Microbiological Laboratory of General Hospital Tesanj. Samples were performed from inpatients and outpatients in Zenica-Doboj Canton. Full blood from patients aged from 1 to 95 years was collected in four, special QFT plus blood test tubes and tested with QFT – Plus test. Results: The study involved 159 patients who were tested with QFT-Plus test. Gender distribution of positive data (30.82 %) showed prevalence of males (59.18 %). The most common diagnosis of positive data was infiltratio pulmonum (49 %). Sensitivity of QFT – Plus test was 91.67 % and test showed specificity of 73.79 %. Conclusion: Our research showed that QFT – Plus test can be helpful, as a supplement, but it can not be the main parameter in diagnostics of tuberculosis. If the test is positive, it is necessary to observe all other clinical findings to complete the diagnosis.

Introduction: Acinetobacter species is associated with health care associated infections especially in patients on respiratory therapy equipment and indwelling catheters. They are becoming increasingly drug resistant. The knowledge of the prevalence and pattern of antimicrobial susceptibility pattern of Acinetobacter spp. is important. Aims The study is undertaken to estimate the prevalence rate, risk factors and antimicrobial resistance pattern of isolates. in Acinetobacter spp. from various clinical samples. Material and Methods: The isolates of Acinetobacter species obtained from various clinical specimen. Specimens were processed by standard microbiological techniques. Antimicrobial sensitivity tests of the Acinetobacter isolates were done by modified Kirby-Bauer disc diffusion method. Results Out of 622 isolates, 399 isolates were from inpatients (62,18%) and 223 were from outpatients (37,82%). More than 90% of isolates displayed resistance to ampicillin, amoxicillin-clavulanic acid, ceftazidime, caftriaxon and amikacin. Resistance to gentamicin, co-trimoxazole and ciprofloxacin were also common. Least resistance was seen to piperacillin-tazobactam and imipenem. A total of 125 Acinetobacter isolates were analyzed, out of which 78.4 % were multi-drug resistant (MDR). Of these MDR isolates, 17.24% were pan-resistant. A. baumannii was the most common species responsible for wound infection (84,8%), pneumonia(96,15%), abscess (72.7%), urinary tract infection (85,7%) and septicemia(89,5%). Conclusion: Multi-drug resistant Acinetobacter has emerged as an important nosocomial pathogen. Antibiotic susceptibility testing is critical in the treatment of infections caused by Acinetobacter. Continued surveillance of prevalent organisms in ICUs, combined with preventive measures remains absolutely essential in efforts to prevent or limit the spread of Acinetobacter infection.

Background Tumor development and growth are driven in many cases by inflammatory cells, which can produce cytokines and other factors that can stimulate the development of the malignant process. The aim of this study was to evaluate interleukin-6 (IL-6), C-reactive protein (CRP), matrix metalloproteinase-9 (MMP-9), serum levels in patients with colorectal cancer (CRC), and their association with the stage of CRC. Methods IL-6, MMP-9, and CRP serum levels were measured in 75 patients with CRC just before surgical treatment, as well as in 20 healthy individuals as controls. Surgically obtained tissue material was subjected to pathological analysis. Results Significant increase in CRP and IL-6 serum concentration is associated with increasing stage of CRC (p <0.05), where MMP-9 serum level was significantly higher in stages III and IV compared to the stage II CRC. Significant correlation was found between IL-6 and MMP-9 serum levels (rho=0.478; p <0.001) as well as between IL-6 and CRP serum levels (rho=0.720; p <0.001) and between MMP-9 and CRP serum levels (rho=0.379; p <0.001). Serum levels of MMP-9 and CRP have been shown to be independent predictors of the CRC stage. Conclusion Combined quantification of IL-6, MMP-9, and CRP serum levels seems to be a reliable index of inflammation-related processes during colorectal carcinogenesis.

Introduction: Neonatal or newborn period includes the first 28 days after the birth of a child. The immune sistem of a newborn is not fully developed and can not be completely effective oppose to pathogens which the infant can be exposed perinatally or in the period just before birth and seven days after. Goal : The aim of this study was to identify the most common causative agents of neonatal infections and the movement of infections through the observed period. Material and methods : This retrospective analytical study recruited 160 patients admitted to the Neonatology Department of the Cantonal Hospital „Dr Irfan Ljubijankic“ in Bihac, in the period from January 2013 to December 2014 on suspicion of neonatal infection. Results : Of 160 neonates suspected on neonatal infections in 123 (76,9%) was confirmed. Most neonates were admitted in the period from October to December 2013 (n=31, 19,4%). Most neonates with confirmed neonatal infection were admitted in the period from January to March 2013 (n=25, 20.3%). The most common diagnosis was Infectio perinatalis (n=57, 28,5%). Of the 87 isolated pathogens 65% (n=57) were Gram-positive, from which the most common were Staphylococcus aureus and MRSA 82,5% (n=47). Conclusion : Of the total number of neonates admitted on suspicion of neonatal infection, healing was result in 75% (n=120), neurological deficit in 18,1% (n=29), and the death in 6,9% (n=11) neonates. Keywords : neonates, Infectio perinatalis , Staphylococcus aureus , neurological deficit

Objectives: The main objective of the study was to identify the most frequent isolates from female outpatients with urinary tract infection. Material and methods: The retrospective study was performed at the Department of Microbiology, Parasitology and Virology Faculty of Medicine, University of Sarajevo in period of 2015. The most frequent isolates were determined in 405 first urine samples from female outpatients of Hrasno community in Sarajevo, B&H. Identification of isolates was performed by the standard microbiological testing and the standard methods of descriptive statistics as well. Results: E. coli was identified with the frequency of (67.21%), followed by Proteus spp. (9.83%), Enterococcus faecalis (7.37%) and Enterobacter (5.73%). Pseudomonas aeruginosa and Pseudomonas spp. were found in (2.45%), while the frequency of Klebsiella spp., Streptococcus spp. and Acinetobacter spp. was lower (1.63%). Conclusions: The isolated strains of E. coli pointed the highest frequency among female outpatients of Hrasno community.

Objectives: The aim of this study was to examine the presence of antimicrobial resistance / susceptibility strains of Escherichia coli in inpatients and outpatients. Materials and methods: It is a retrospective study carried out at the Department of Microbiology, Parasitology and Virology Faculty of Medicine, University of Sarajevo. In cooperation with the Microbiological laboratory of the Cantonal Hospital Zenica and the Microbiological laboratory of the General Hospital Tesanj, 3863 urine samples were processed in the period from March 1st to March 31st 2016. Results: Our study showed that E. coli had the highest antimicrobial resistance to trimethoprim / sulfamethoxazole (38.61%), followed by amoxicillin / clavulanic acid (19.62%), ciprofloxacin (9.49%), gentamicin (8.86%), cephalexin (8.23%), nitrofurantoin (8.23%), cefuroxime (7.52%), ceftazidime (6.33%), cefuroxime (89.87%), amikacin (4.43%). Conclusions: The isolated strains of E. coli showed the highest resistance to trimethoprim / sulfamethoxazole and amoxicillin / clavulanic acid. The isolated strains of E. coli showed the greatest susceptibility to amikacin and ceftazidime. Gender distribution of positive E. coli isolates showed statistically significant differences in favor of females.

Background: Methicillin resistant Staphylococcus aureus (MRSA) is responsible for a wide spectrum of nosocomial and community associated infections worldwide. The aim of this study was to analyze MRSA strains from the general population in Canton Sarajevo, B&H. Methods: Our investigation including either phenotypic and genotypic markers such as antimicrobial resistance, pulsed-field gel electrophoresis (PFGE), SCC typing, and Panton-Valentine leukocidin (PVL) detection. Results: Antimicrobial susceptibility: all MRSA isolates were resistant to the β-lactam antibiotics tested, and all isolates were susceptible trimethoprim sulphamethoxazole, rifampicin, fusidic acid, linezolid and vancomycin. Sixty-eight per cent of the MRSA isolates were resistant to erythromycin, 5% to clindamycin, 5% to gentamicin and 4% to ciprofloxacin. After the PFGE analysis, the isolates were grouped into five similarity groups: A-E. The largest number of isolates belonged to one of two groups: C: 60 (60%) and D: 27 (27%). In both groups C and D, SCCmec type IV was predominant (60% and 88, 8%, respectively). A total of 24% of the isolates had positive expression of PVL genes, while 76% showed a statistically significantly greater negative expression of PVL genes. Conclusion: SCCmec type IV, together with the susceptibility profile and PFGE grouping, is considered to be typical of CA-MRSA