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.

Objectives: Anaerobic bacteria may cause numerous infections in different locations through human body. Those infections can be life-threatening with significant mortality. Wounds represent a suitable habitat for colonization of anaerobic bacteria. Their proliferation contributes to moist and warm environment, hypoxic and necrotic tissue.Methods:A retrospective study was conducted at the Clinical Centre University of Sarajevo from 2015-2017. The study involved wound swab samples, sampled from hospitalized patients. The anaerobic bacteria were isolated using standard procedures.Results: During the period from 01.01.2015. to 31.12.2017, 8386 samples were analyzed on anaerobic bacteria and 872 (10.4%) of specimen were positive. In 2015, 332 (15%) specimens were positive, while during 2016 and 2017, 244 (7,8%) and 296 (9.9%) respectively. Bacteroides spp. was the most common isolate during three year period: 2015-227 (55.5%); 2016-139 (48%); 2017-161 (42,5%). It was followed by Peptococcus spp.: 2015-70 (17.1%); 2016-40 (13.9%); 2017-66 (17.4%), Clostridium spp.: 2015 – 32 (7.8%); 2016-21 (7.3%); 2017- 35 (9.2%), Fusobacterium spp.: 2015 – 49 (11.9%); 2016-32 (11.1%); 2017- 45 (11.9%).VITEK 2 Compact has identified to the level of species 48 isolates which were in pure culture.The largest number of anaerobic bacteria were isolated from the samples received from the Abdominal surgery. The overview of antimicrobial sensitivity showed highest sensitivity to metronidazole (99,9%) and carbapenems (99,9%), respectively.Conclusions The most commonly isolated anaerobic bacteria was Bacteroides spp.Highest number of positive isolates was from abdominal surgery since intra-abdominal infections reflect the microflora of the resected organ. Metronidazole remains the antibiotic of choice in the treatment of anaerobic infections.

AIM Recently increased attention and interest for Acinetobacterbaumannii are the result of the occurrence of multidrug resistant (MDR), extensive drug resistant (XDR) and pandrug resistant (PDR) isolates around the world. The aim of this study was to examine the resistance of A. baumannii isolates to antimicrobials in Clinical Centre University of Sarajevo, Bosnia and Herzegovina. METHODS Two hundred and fifty-seven A.baumannii isolates were collected between July 2011 and June 2012 in different wards and from different clinical samples. Multidrug resistant, XDR and PDR were defined according to international expert proposal for interim standard definitions for acquired resistance. RESULTS A total of 257 A. baumannii isolates showed eleven different patterns of resistance, of which ten patterns corresponded to MDR and one corresponded to XDR (sensitive only to colistin). Multidrug resistant and XDR strains were the most common at Intensive Care Units and surgical departments. The largest numbers of isolates were found in wound swabs, blood and bronchial aspirate. CONCLUSION This is the first report of XDR A. baumannii in the 2000-bed Clinical Centre University of Sarajevo, Bosnia-Herzegovina. Although XDR strains have been detected, the resistance to colistin has not. The elevated prevalence of these strains indicates that local antibiotic prescription policies should be revised and infection prevention and control should be improved.