Bosnian Journal of Basic Medical Sciences, Aug 4, 2015
Staphylococcus aureus is a major cause of hospital-acquired infections worldwide. Increased frequ... more Staphylococcus aureus is a major cause of hospital-acquired infections worldwide. Increased frequency of methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients and possibility of vancomycin resistance requires rapid and reliable characterization of isolates and control of MRSA spread in hospitals. Typing of isolates helps to understand the route of a hospital pathogen spread. The aim of this study was to investigate and compare genotypic and phenotypic characteristics of MRSA samples on three different geography locations. In addition, our aim was to evaluate three different methods of MRSA typing: spa-typing, agr-typing and GenoType MRSA. We included 104 samples of MRSA, isolated in 3 different geographical locations in clinical hospitals in Zagreb, Mostar, and Heidelberg, during the period of six months. Genotyping and phenotyping were done by spa-typing, agr-typing and dipstick assay GenoType MRSA. We failed to type all our samples by spa-typing. The most common spa-type in clinical hospital Zagreb was t041, in Mostar t001, and in Heidelberg t003.We analyzed 102/104 of our samples by agr-typing method. We did not find any agr-type IV in our locations. We analyzed all our samples by the dipstick assay GenoType MRSA. All isolates in our study were MRSA strains. In Zagreb there were no positive strains to PVL gene. In Mostar we have found 5/25 positive strains to PVL gene, in Heidelberg there was 1/49. PVL positive isolates were associated with spa-type t008 and agr-type I, thus, genetically, they were community-associated MRSA (CA-MRSA). Dipstick assay GenoType MRSA has demonstrated sufficient specificity, sensibility, simple performance and low cost, so we could introduce it to work in smaller laboratories. Using this method may expedite MRSA screening, thus preventing its spread in hospitals.
Aim This cross-sectional study of a group of women with abnormal cytology and high-risk human pap... more Aim This cross-sectional study of a group of women with abnormal cytology and high-risk human papillomavirus (hrHPV) infection compared genotyping HPV DNA and mRNA assays according to two age categories of women (S1: ≤30 and S2: >30 years). Methods The hrHPV DNA positive results of 105 cervical samples of women were pooled and those harbouring HPV-16, 18, 31, 33 and/or 45 DNA were tested for the type specific HPV oncogene E6/E7 overexpression (mRNA). Results Although HPV DNA testing showed a higher proportion of women infected by any of five hrHPVs in S1 group, total agreement of hrHPV DNA and mRNA positive results was higher in S2 group of women (75.8% v. 83.9%). The most prevalent type in both age groups was HPV-16. A 100% agreement of positivity of both tests was noted for HPV-18 and 33 in S1 group, and for HPV-18 in S2 group. Increasing concordance of HPV-16 and 31 DNA and mRNA positive results with the severity of cervical cytology was observed in S1 group of women. Absolute matching (100.0%) of positivity of both diagnostic tests was recorded in S2ASCUS group (for HPV-16, 18 and 33), in S1HSIL (for HPV-16, 18, 31 and 33), in S1LSIL category (for HPV-18 and 33) and in S2HSIL group (for HPV-18). Conclusion The results indicate the possibility of predicting the risk of persistent infection only by HPV DNA typing test, with no need for additional RNA testing in categories of infected women showing a high (absolute) agreement of positivity of both tests.
Aim: To analyze the frequency and antimicrobial resistance of Acinetobacter baumannii isolated fr... more Aim: To analyze the frequency and antimicrobial resistance of Acinetobacter baumannii isolated from blood cultures. Methods: Blood cultures of all consecutive patients hospitalized in different departments of the University Clinical Centre of Sarajevo from January 2003 to December 2010 were processed by "BACTEC 9120" system. The isolates were identified by conventional methods. Susceptibility testing was performed by disc-diffusion method following guidelines from the Clinical Laboratory Standards Institute (CLSI). Results: A total of 93,215 blood cultures were examined, 6,338 (6.8%) were positive. Acinetobacter baumannii was isolated in 283 (4.5%) cases. Overall yearly resistance rates to antibiotics had an increasing trend during the eight year period: amicacin from 45.3% to 71.4%; gentamycin from 70.6% to 83.2%; ciprofloxacin from 60.6% to 85.8%; carbapenems (imipenem and meropenem) from 0% to 52.8%. Carbapenem-resistant Acinetobacter baumannii (CRAB) emerged in 2009 and was rapidly disseminated in intensive care units. Resistance to tobramycin and colistin was not detected. Conclusion: High resistance rates and an increase of Acinetobacter baumannii to all antimicrobials, especially to carbapenems, were noted. The dissemination of carbapenem-resistant isolate may indicate the appearance of untreatable infection by this organism. It points out the rationality in prescribing antimicrobial drugs.
Introduction: The prevalence of MRSA (Methicillin Resistant Staphylococcus Aureus) in haemodialys... more Introduction: The prevalence of MRSA (Methicillin Resistant Staphylococcus Aureus) in haemodialysis patients has increased dramatically during recent years. The aim of our study is to determine the prevalence of MRSA colonization among haemodialysis patients and medical staff. Material and methods: This prospective study included 235 patients undergoing haemodialysis therapy and 60 medical staff members, in the Center for Haemodialysis Sarajevo. Nasal and throat samples were taken (identification of MRSA was performed using standard microbiological methods). A total of 474 nasal and throat cultures from patients' samples and 120 cultures from medical staff samples were obtained. Results and discussion: The total number of sampled patients was 235 and colonies were found in 36 of the samples (15.3%). Among medical staff nasal carriage rate of MRSA was 11.6% (7/60). The mean age of haemodialysis patients with MRSA was 52.94:1:5.3. The patients aged between 55 and 64 had the highest prevalence of MRSA (11/36, 30.55%). Those aged 45-54 had the next highest prevalence of nasal carriage (10/36, 27.77%). Patients aged 65 years had middle prevalence of MRSA (6/36, 8.33%). Patients aged 25-34 had the lowest prevalence of nasal carriage. We did not have possibilities to isolate MRSA positive dialysis patients, and we used intensive antibacterial prophylaxis. We treated our patients with mupirocin ointment (three times a day for 5-14 days) and gained decolonization in 34 patients (94.4%). In the treatment period, positive medical staff did not come to work. Conclusion: The overall prevalence of MRSA colonization in our dialysis patients was higher (15.3%). Implementation of adequate strategies for prevention of MRSA with application of mupirocin among carriers, reduced prevalence of MRSA in our dialysis units.
Aim: To determine the occurrence of colonization and subsequent infection with multidrug-resistan... more Aim: To determine the occurrence of colonization and subsequent infection with multidrug-resistant organisms (MDROs) among patients in the neonatal intensive care unit and to assess the yield of surveillance cultures. Methods: Cultures of nose, throat and stool were obtained from 196 neonates admitted to the Neonatal Intensive Care Unit (NICU) at the Clinical Center of the University of Sarajevo in the six-month period upon admission and once a week if the length of stay was more than seven days. At the same time clinical relevant samples (blood, urine, CSF, wounds swabs, tracheal aspirates) were examined for presence of MDROs. Identification and antibiotic sensitivity pattern of organisms were determined according to the CLSI. Results: A total of 126 (64.3%) patients were identified as colonized and 50 (25.5%) as infected with MDROs. 44.4% (56) of patients were colonized on admission. Fecal carriage was most common with extended-spectrum beta lactamase (ESBL)-producing Klebsiella pneumonia, and nose/throat with Acinetobacter baumannii. The patients become colonized more often during the first week of hospitalization (31.7%; p less .001). The infection is more observed in patients who had previously been colonized than those who had not (78% vs. 22%; p less 0.05). The most common infection was the blood infection (bacteremia). The median length of stay in neonates with an infection was 3.5 weeks and without infection 1 week (p less than 0.001). Conclusion: An infection was more frequently observed in patients who had been previously colonized than those who had not. Microbial surveillance is necessary to detect colonized neonates when multidrug-resistant organisms become epidemic.
Bosnian Journal of Basic Medical Sciences, Feb 20, 2010
Pregnancy represents a risk factor in the occurrence of vaginal candidosis. e objectives of our s... more Pregnancy represents a risk factor in the occurrence of vaginal candidosis. e objectives of our study were: to make determination of the microscopic fi ndings of vaginal swab, frequency of Candida species in the culture of pregnant women and patients who are not pregnant, determine the Candida species in all cultures, and to determine the frequency and diff erences in the frequency of C. albicans and other non-albicans species. In one year study performed during year, we tested patients of Gynaecology and Obstetrics clinic of the Clinical Centre in Sarajevo and Gynaecology department of the General hospital in Sarajevo. woman included in the study were separated in two groups: pregnant (in the last trimester of pregnancy), and non-pregnant woman in period of fertility. Each vaginal swab was examined microscopically. e yeast, number of colonies, and the species of Candida were determined on Sabouraud dextrose agar with presence of antibiotics. For determination of Candida species, we used germ tube test for detection of C. albicans, and cultivation on the selective medium and assimilation tests for detection of non-albicans species. e results indicated positive microscopic fi ndings in the test group (,), as well as greater number of positive cultures (,). e most commonly detected species for both groups was C. albicans (test group . and control group ,). e most commonly detected non-albicans species for the test group were C. glabrata (, ) and C. krusei (,), and for the control group were C. glabrata (,) and C. parapsilosis (,). e microscopic fi ndings correlated with the number of colonies in positive cultures. In the test group, we found an increased number of yeasts (,), and the pseudopyphae and blastopores by microscopic examination as an indication of infection. In the control group, we found a small number of yeasts (,) , in the form of blastopores, as an indication of the candida colonisation. Our results indicate that gravidity, as the risc factor for incidence of infection, has the signifi cant role in the incidence of vaginal candidosis.
Academy of Sciences and Arts of Bosnia and Herzegovina eBooks, 2020
At the end of 2019 the world became aware of the existence of a new virus stemming from the Coron... more At the end of 2019 the world became aware of the existence of a new virus stemming from the Coronaviridae family and causing a specific disease – COVID-19. In less than three months, the virus and its consequences, developed from being a local public health problem in China to a daunting global problem we all had to face. On March 11, 2020 the World Health Organization (WHO) declared a pandemic of COVID-19. On the international scale, even in Bosnia and Herzegovina (BiH), the response of the professionals and scientists has been rapid, although not always consistently efficient enough. Despite the selfless cooperation of scientists and practitioners worldwide, countries with developed economies, good public health and a strong scientific system have had the advantage in the fight against the disease over developing countries. Despite the fact that by these criteria BiH is not one of the most resilient countries, so far, its response to the pandemic has seemed to be satisfactory. The Academy of Sciences and Arts of Bosnia and Herzegovina (ANUBiH) was one of the first institutions of the science system to respond to the pandemic. On the initiative and under the leadership of academician Mirsada Hukić, on March 22, 2020 the development of the project "Epidemic Location Intelligence System (ELIS)" and its Geoportal began on a voluntary basis, with the task of permanently monitoring the spread of COVID-19. Theoretical and professional parts of the project in the areas of medicine, public health and informatics were completed by April 2, 2020. Thanks to the support to the project by the Chairman of the Presidency of Bosnia and Herzegovina, Mr. Šefik Džaferović, the expert system received additional hardware support and was filled in time with data from across the country. This enabled the system to become operational as early as on April 8, 2020. The results of all these efforts are visible in this publication. Initially, the ELIS project was important for the epidemiological and public health area. The abundance of collected data and obtained virus samples enabled the extension of the project idea to the sequencing of viruses found in BiH and their typology. The transition of research to the clinical aspects of COVID-19 is the next phase in the development of the ELIS project. ANUBiH has already started the work on examining the economic and pedagogical consequences of COVID-19 in order to look at this medical phenomenon in the broadest possible context. All the results of ANUBiH in response to the epidemic challenges of COVID-19 are achieved due to the synergistic action of numerous individuals and institutions in different fields of science and public health in cooperation with government. Therefore, I believe that the ELIS project has shown the way to go in solving the burning problems of our society which we will encounter in the future.
International journal of engineering research and technology, Aug 27, 2019
Biofilms have become a major issue in different spheres of medicine and industry. Source of the i... more Biofilms have become a major issue in different spheres of medicine and industry. Source of the issue revolves around increasing resistance of microorganisms towards conventional antibiotics which is even more elevated within biofilms that are difficult to eradicate by means of biocides and antibiotics. Multiple approaches were applied to deal with this issue amongst which green nanotechnology gave promising results and the search for molecules that "freeze bacteria" in the planktonic state. Since silver was used as an antimicrobial agent since ancient times. Considering this a study which deals with the effect of sub-inhibitory concentrations of silver nitrate and silver nanoparticles on biofilm forming capacity of bacteria would yield valuable information to evaluate the effect these substances have on the phenotypical expression of biofilm formation in bacteria as potential biofilm gene expression stoppers.
Bosnian Journal of Basic Medical Sciences, Aug 20, 2009
Brucellosis is an important public health problem in Bosnia and Herzegovina. Th e diagnosis of br... more Brucellosis is an important public health problem in Bosnia and Herzegovina. Th e diagnosis of brucellosis in the country without any experiences with this kind of infection may be very diffi cult. Th e aim of this study was to evaluate diagnostic methods: Rose Bengal test, blood cultures and ELI-SA IgM and IgG in the patients with brucellosis. Th e study included brucellosis patients in the period to . All the patients were treated at the Clinic for Infectious Diseases, University of Sarajevo Clinics Centre. Blood cultures were positive in / (, ) patients. Th is method often needs a long period of incubation and specimens need to be obtained early. Th ese limitations make serology the most useful tool for the laboratory diagnosis of Brucella infection. Rose Bengal is a rapid plate agglutination test, very sensitive irrespective of the stage of the disease. In our study, Rose Bengal test was positive in all patients / (, ). Brucella IgM antibodies with ELISA were positive in / (, ). Brucella IgG antibodies with ELISA were positive in / (). In order to determine the diagnostic value of the diff erent tests, we compared the sensitivity among test-methods: Rose Bengal test-., blood culture-., ELISA IgM-. and ELISA IgG-.. Sensitivity of test methods was diff erent in the diff erent stages of illness. It is necessary to use combination of diff erent tests such are blood culture, Rose Bengal test and ELISA in order to ensure the diagnosis. Rose Bengal test is excellent for the screening. Blood culture is a method of choice for the diagnosis acute infection. ELISA is a very good method for the diagnostic chronic disease and relapse.
Hantavirus-specific serology tests are the main diagnostic technique for detection of hantavirus ... more Hantavirus-specific serology tests are the main diagnostic technique for detection of hantavirus infection in Bosnia and Herzegovina. In order to enhance hantavirus infections monitoring a sensitive PCR based assay was developed to detect Dobrava (DOBV) and Puumala (PUUV) hantaviruses. Nested primer sets were designed within three different regions of the viral RNA (S and M segment of DOBV and M segment of PUUV) based on highly similar regions from a number of different European hantavirus strains. Assay conditions were optimized using cell cultures infected with DOBV Slovenia, PUUV Sotkamo and PUUV CG 18-20. This sensitive and specific assay has proven to be useful for detection of both Puumala and Dobrava hantaviruses.
Importance of the study: There is no similar published study regarding correlation of serum granu... more Importance of the study: There is no similar published study regarding correlation of serum granulysin level and clinical course and outcome of chickenpox. In most countries, vaccination for chickenpox is not available, so lot of immunocompetent adults who acquire chickenpox are in a great risk to develop severe and life-threatening clinical forms of illness. With granulysin, as early prognostic marker of the disease, physicians can predict what clinical form of chickenpox can be expected.
Brucellosis Matrix metalloproteinase Osteoarticular complications Objectives. Matrix metallop... more Brucellosis Matrix metalloproteinase Osteoarticular complications Objectives. Matrix metalloproteinases (MMPs) has been implicated in the pathogenesis of infective, cancer and autoimmune diseases. In this study, we investigated the serum level of MMPs and its clinical importance in human brucellosis. Patients and methods. This study included 60 brucellosis patients treated at the Clinic for Infectious Diseases, Clinical Centre, University of Sarajevo. Matrix metalloproteinases serum levels were quantified by ELISA. Results. The investigation involved three groups: 30 patients with complications, 30 patients without complications of brucellosis and 30 healthy control examinees. The complications of human brucellosis varied but osteoarticular involvement dominated (n=21/30; 70%). Matrix metalloproteinases serum levels in the patients with complications were highest. The serum level of MMP-1 in patients with complications was the highest at 9.45; in patients without complications it was 3.78 and in the control examinees it was lowest at 3.62 (p=0.001). The serum level of MMP-9 in patients with complications was the highest at 105.66; in patients without complications 64.67, and in the control examinees it was lowest at 37.32 (p=0.001). The serum level of MMP-13 in patients with complications was highest at 138.86; in patients without complications at 64.85; and in the control examinees it was the lowest at 29.55 (p=0.001). Pearson's coefficient showed a statistically significant positive correlation between levels of tested matrix metalloproteinases and development complications in human brucellosis (p=0.001). Conclusion. This study showed the diagnostic value and importance of detection of matrix metalloproteinases in human brucellosis. MMPs are a useful serum biomarker for assessment of disease activity
Bosnian Journal of Basic Medical Sciences, May 20, 2009
Diarrhoeal disease is a major cause of illness and death among infants and young children worldwi... more Diarrhoeal disease is a major cause of illness and death among infants and young children worldwide. Among the Escherichia coli (E. coli) causing intestinal diseases, there are six well-described categories: enteroaggregative E. coli (EAEC), diff usely adherent E. coli (DAEC), enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC), enterohaemorrhagic E. coli (EHEC) and enterotoxigenic E. coli (ETEC). Th e aim of the present study was to investigate the relative contribution of diff erent groups of diarrhoeagenic E. coli (DEC) in paediatric patients with diarrhoea. Clinical stool specimens from children with diarrhoea, with ages ranging from birth to < years, were selected for the study over a period of months (August to December ). Th e study showed that / children () had diarrhoea due to diarrhoeagenic E. coli. Th e most prevalent was enteropathogenic E. coli (EPEC) isolated from / paediatric patients (), followed by enterotoxigenic (ETEC) isolated from / (.), enterohaemorrhagic (EHEC) from / (.
Objectives. Serratia marcescens is a well-established as a nosocomial pathogen, resulting in cons... more Objectives. Serratia marcescens is a well-established as a nosocomial pathogen, resulting in considerable morbidity and mortality in immunocompromised patients. The aim of this study was to investigate an outbreak of Serratia marcescens at the Orthopaedic Clinic of the Clinical Center University of Sarajevo. Methods. A total of 96 strains from 79 patients were isolated. The isolates were identified by conventional methods. Susceptibility testing was performed by the discdiffusion method following CLSI guidelines. Results were confirmed by VITEC-2 Compact. Results. From January to December 2010, 96 strains from 79 patients were isolated at the Orthopaedic Clinic of the Clinical Center, University of Sarajevo.The strains were isolated from wound swabs, blood cultures and cerebrospinal fluid. The strains were identifed using current phenotypic methods as Serratia marcescens with identical biochemical characteristics and antibiotic susceptibility patterns. All strains were susceptible to imipenem, meropenem, amikacin, ciprofloxacin, levofloxacin and piperacillin/tazobactam. The infection control team was alerted and after investigation they discovered the same phenotype of Serratia marcescens in the anaesthetic vials used in procedures. This outbreak was extremely difficult to terminate, even with cohorting of patients, sterilisation of equipment, reinforcement of handwashing and deep-cleaning of facilities. The implementation of new control measures terminated the outbreak in February 2011. Conclusion. Continuous monitoring of nosocomial infections is indispensable. Phenotypic characterization of the isolates is useful for studying the relationship of microbial pathogens. The relationship of one clinical isolate to another during an outbreak is important in motivating the search for a common source or mode of transmission.
İnterlökin-6'nın (IL-6) periodontal hastalık patogenezi ve periodontal doku yıkımındaki rolü geni... more İnterlökin-6'nın (IL-6) periodontal hastalık patogenezi ve periodontal doku yıkımındaki rolü geniş çapta ele alınmıştır. Çalışmanın amacı, evre IV periodontitis hastalarının tükürüklerindeki IL-6 seviyelerini değerlendirmektir. Gereç ve Yöntemler: Araştırmaya evre IV periodontitis teşhisi konulan 28 hasta ile 22 hastadan oluşan kontrol grubu dahil edildi. Hastaların tümü sistemik olarak sağlıklıydı. Tükürük örnekleri toplandı ve sondalama derinliği (SD), klinik ataşman seviyesi (KAS), papil kanama indeksi (PKİ), sondalamada kanama yüzdesi (SK %), plak indeksi (Pİ) ve diştaşı indeksini (Dİ) içeren klinik periodontal ölçümler kaydedildi. Her bir hastanın uyarılmamış tükürükleri, tükürük toplayıcı ile toplandı ve örneklerdeki IL-6 seviyesi enzim bağlı immünosorbent testi ile analiz edildi. Bulgular: Evre IV periodontitis hastalarının ortalama IL-6 değeri 22,18±5,96 pg/mL idi. Kontrol grubunun ortalama IL-6 değeri ise 2,23±2,17 pg/mL idi. Periodontitis Objective: The role of interleukin-6 (IL-6) in the pathogenesis of periodontal disease and tissue destruction at the periodontal site has been widely reported. This study aimed to evaluate the salivary IL-6 levels in patients with stage IV periodontitis. Materials and Methods: The study included 28 patients who were diagnosed with periodontitis stage IV and the control group of 22 periodontally healthy patients. All the patients were systemically healthy. Saliva samples were collected, and clinical periodontal measurements, including probing depth (PD), clinical attachment level (CAL), papilla bleeding index (PBI), the percentage of sites with bleeding on probing (BOP) %, plaque index (PI) and calculus index (CI), were recorded. The unstimulated saliva of each patient was collected by a saliva collector, and all samples were analysed using the enzyme-linked immunosorbent assay method for the detection of IL-6. Results: The mean value of salivary IL-6 in patients with periodontitis stage IV was 22.18±5.96 pg/mL. In the control group, the average measured value of IL-6 was 2.23±2.17 pg/mL. The periodontitis group had a significantly higher salivary IL-6 levels than the control group. A strong positive correlation was observed between the salivary IL-6 and clinical periodontal parameters (PD, CAL, PBI, BOP %, PI and CI) in patients with periodontitis stage IV (p<0.0001). Conclusion: We demonstrated a statistically significant relationship between periodontal parameters and salivary IL-6 in patients with periodontitis stage IV. New studies are needed to accurately establish salivary IL-6 potential as a biomarker for periodontal disease monitoring, including all stages and grades of periodontitis.
Tularemia is a vector-borne zoonosis with a complex epidemiology caused by Francisella tularensis... more Tularemia is a vector-borne zoonosis with a complex epidemiology caused by Francisella tularensis. F. tularensis is a non-motile, obligatory aerobic, facultative intracellular Gram-negative coccobacillus. The bacterium has a broad host range, i.e. mammals, birds and invertebrates. Two types (A, B) and four subspecies (F. tularensis subsp. tularensis (type A), F. tularensis subsp. holarctica (type B), F. tularensis subsp. mediasiatica and F. tularensis subsp. novicida.) are known today. Types A and B are of importance as they cause disease in humans and animals. Type A is present almost exclusively in North America and type B is found all over the Northern hemisphere. F. tularensis is considered to be a class A biological warfare agent, it is notoriously difficult to recognize infections in non-endemic regions and was produced as a weaponized agent by several countries in the 1960ties and 70ties. Humans can acquire tularemia by inhaling dust or aerosols contaminated with F. tularensis bacteria, this type of exposure can result in pneumonic tularemia, one of the most severe forms of the disease. especially farming involving machines that disperse remains of infected animals or carcasses. Rarely, water can become tularemia contaminated through contact with infected animals. Humans who drink contaminated and untreated water may contract oropharyngeal tularemia. The tularemia outbreak in B&H in 1995 showed an unusual number of oropharyngeal cases. As all aspects of this particular tularemia epidemic were not thoroughly investigated and the possible intentional use of agents of biological warfare remained a possibility, we reviewed all available data in order to assess whether the outbreak was natural.
Bosnian Journal of Basic Medical Sciences, Aug 4, 2015
Staphylococcus aureus is a major cause of hospital-acquired infections worldwide. Increased frequ... more Staphylococcus aureus is a major cause of hospital-acquired infections worldwide. Increased frequency of methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients and possibility of vancomycin resistance requires rapid and reliable characterization of isolates and control of MRSA spread in hospitals. Typing of isolates helps to understand the route of a hospital pathogen spread. The aim of this study was to investigate and compare genotypic and phenotypic characteristics of MRSA samples on three different geography locations. In addition, our aim was to evaluate three different methods of MRSA typing: spa-typing, agr-typing and GenoType MRSA. We included 104 samples of MRSA, isolated in 3 different geographical locations in clinical hospitals in Zagreb, Mostar, and Heidelberg, during the period of six months. Genotyping and phenotyping were done by spa-typing, agr-typing and dipstick assay GenoType MRSA. We failed to type all our samples by spa-typing. The most common spa-type in clinical hospital Zagreb was t041, in Mostar t001, and in Heidelberg t003.We analyzed 102/104 of our samples by agr-typing method. We did not find any agr-type IV in our locations. We analyzed all our samples by the dipstick assay GenoType MRSA. All isolates in our study were MRSA strains. In Zagreb there were no positive strains to PVL gene. In Mostar we have found 5/25 positive strains to PVL gene, in Heidelberg there was 1/49. PVL positive isolates were associated with spa-type t008 and agr-type I, thus, genetically, they were community-associated MRSA (CA-MRSA). Dipstick assay GenoType MRSA has demonstrated sufficient specificity, sensibility, simple performance and low cost, so we could introduce it to work in smaller laboratories. Using this method may expedite MRSA screening, thus preventing its spread in hospitals.
Aim This cross-sectional study of a group of women with abnormal cytology and high-risk human pap... more Aim This cross-sectional study of a group of women with abnormal cytology and high-risk human papillomavirus (hrHPV) infection compared genotyping HPV DNA and mRNA assays according to two age categories of women (S1: ≤30 and S2: >30 years). Methods The hrHPV DNA positive results of 105 cervical samples of women were pooled and those harbouring HPV-16, 18, 31, 33 and/or 45 DNA were tested for the type specific HPV oncogene E6/E7 overexpression (mRNA). Results Although HPV DNA testing showed a higher proportion of women infected by any of five hrHPVs in S1 group, total agreement of hrHPV DNA and mRNA positive results was higher in S2 group of women (75.8% v. 83.9%). The most prevalent type in both age groups was HPV-16. A 100% agreement of positivity of both tests was noted for HPV-18 and 33 in S1 group, and for HPV-18 in S2 group. Increasing concordance of HPV-16 and 31 DNA and mRNA positive results with the severity of cervical cytology was observed in S1 group of women. Absolute matching (100.0%) of positivity of both diagnostic tests was recorded in S2ASCUS group (for HPV-16, 18 and 33), in S1HSIL (for HPV-16, 18, 31 and 33), in S1LSIL category (for HPV-18 and 33) and in S2HSIL group (for HPV-18). Conclusion The results indicate the possibility of predicting the risk of persistent infection only by HPV DNA typing test, with no need for additional RNA testing in categories of infected women showing a high (absolute) agreement of positivity of both tests.
Aim: To analyze the frequency and antimicrobial resistance of Acinetobacter baumannii isolated fr... more Aim: To analyze the frequency and antimicrobial resistance of Acinetobacter baumannii isolated from blood cultures. Methods: Blood cultures of all consecutive patients hospitalized in different departments of the University Clinical Centre of Sarajevo from January 2003 to December 2010 were processed by "BACTEC 9120" system. The isolates were identified by conventional methods. Susceptibility testing was performed by disc-diffusion method following guidelines from the Clinical Laboratory Standards Institute (CLSI). Results: A total of 93,215 blood cultures were examined, 6,338 (6.8%) were positive. Acinetobacter baumannii was isolated in 283 (4.5%) cases. Overall yearly resistance rates to antibiotics had an increasing trend during the eight year period: amicacin from 45.3% to 71.4%; gentamycin from 70.6% to 83.2%; ciprofloxacin from 60.6% to 85.8%; carbapenems (imipenem and meropenem) from 0% to 52.8%. Carbapenem-resistant Acinetobacter baumannii (CRAB) emerged in 2009 and was rapidly disseminated in intensive care units. Resistance to tobramycin and colistin was not detected. Conclusion: High resistance rates and an increase of Acinetobacter baumannii to all antimicrobials, especially to carbapenems, were noted. The dissemination of carbapenem-resistant isolate may indicate the appearance of untreatable infection by this organism. It points out the rationality in prescribing antimicrobial drugs.
Introduction: The prevalence of MRSA (Methicillin Resistant Staphylococcus Aureus) in haemodialys... more Introduction: The prevalence of MRSA (Methicillin Resistant Staphylococcus Aureus) in haemodialysis patients has increased dramatically during recent years. The aim of our study is to determine the prevalence of MRSA colonization among haemodialysis patients and medical staff. Material and methods: This prospective study included 235 patients undergoing haemodialysis therapy and 60 medical staff members, in the Center for Haemodialysis Sarajevo. Nasal and throat samples were taken (identification of MRSA was performed using standard microbiological methods). A total of 474 nasal and throat cultures from patients' samples and 120 cultures from medical staff samples were obtained. Results and discussion: The total number of sampled patients was 235 and colonies were found in 36 of the samples (15.3%). Among medical staff nasal carriage rate of MRSA was 11.6% (7/60). The mean age of haemodialysis patients with MRSA was 52.94:1:5.3. The patients aged between 55 and 64 had the highest prevalence of MRSA (11/36, 30.55%). Those aged 45-54 had the next highest prevalence of nasal carriage (10/36, 27.77%). Patients aged 65 years had middle prevalence of MRSA (6/36, 8.33%). Patients aged 25-34 had the lowest prevalence of nasal carriage. We did not have possibilities to isolate MRSA positive dialysis patients, and we used intensive antibacterial prophylaxis. We treated our patients with mupirocin ointment (three times a day for 5-14 days) and gained decolonization in 34 patients (94.4%). In the treatment period, positive medical staff did not come to work. Conclusion: The overall prevalence of MRSA colonization in our dialysis patients was higher (15.3%). Implementation of adequate strategies for prevention of MRSA with application of mupirocin among carriers, reduced prevalence of MRSA in our dialysis units.
Aim: To determine the occurrence of colonization and subsequent infection with multidrug-resistan... more Aim: To determine the occurrence of colonization and subsequent infection with multidrug-resistant organisms (MDROs) among patients in the neonatal intensive care unit and to assess the yield of surveillance cultures. Methods: Cultures of nose, throat and stool were obtained from 196 neonates admitted to the Neonatal Intensive Care Unit (NICU) at the Clinical Center of the University of Sarajevo in the six-month period upon admission and once a week if the length of stay was more than seven days. At the same time clinical relevant samples (blood, urine, CSF, wounds swabs, tracheal aspirates) were examined for presence of MDROs. Identification and antibiotic sensitivity pattern of organisms were determined according to the CLSI. Results: A total of 126 (64.3%) patients were identified as colonized and 50 (25.5%) as infected with MDROs. 44.4% (56) of patients were colonized on admission. Fecal carriage was most common with extended-spectrum beta lactamase (ESBL)-producing Klebsiella pneumonia, and nose/throat with Acinetobacter baumannii. The patients become colonized more often during the first week of hospitalization (31.7%; p less .001). The infection is more observed in patients who had previously been colonized than those who had not (78% vs. 22%; p less 0.05). The most common infection was the blood infection (bacteremia). The median length of stay in neonates with an infection was 3.5 weeks and without infection 1 week (p less than 0.001). Conclusion: An infection was more frequently observed in patients who had been previously colonized than those who had not. Microbial surveillance is necessary to detect colonized neonates when multidrug-resistant organisms become epidemic.
Bosnian Journal of Basic Medical Sciences, Feb 20, 2010
Pregnancy represents a risk factor in the occurrence of vaginal candidosis. e objectives of our s... more Pregnancy represents a risk factor in the occurrence of vaginal candidosis. e objectives of our study were: to make determination of the microscopic fi ndings of vaginal swab, frequency of Candida species in the culture of pregnant women and patients who are not pregnant, determine the Candida species in all cultures, and to determine the frequency and diff erences in the frequency of C. albicans and other non-albicans species. In one year study performed during year, we tested patients of Gynaecology and Obstetrics clinic of the Clinical Centre in Sarajevo and Gynaecology department of the General hospital in Sarajevo. woman included in the study were separated in two groups: pregnant (in the last trimester of pregnancy), and non-pregnant woman in period of fertility. Each vaginal swab was examined microscopically. e yeast, number of colonies, and the species of Candida were determined on Sabouraud dextrose agar with presence of antibiotics. For determination of Candida species, we used germ tube test for detection of C. albicans, and cultivation on the selective medium and assimilation tests for detection of non-albicans species. e results indicated positive microscopic fi ndings in the test group (,), as well as greater number of positive cultures (,). e most commonly detected species for both groups was C. albicans (test group . and control group ,). e most commonly detected non-albicans species for the test group were C. glabrata (, ) and C. krusei (,), and for the control group were C. glabrata (,) and C. parapsilosis (,). e microscopic fi ndings correlated with the number of colonies in positive cultures. In the test group, we found an increased number of yeasts (,), and the pseudopyphae and blastopores by microscopic examination as an indication of infection. In the control group, we found a small number of yeasts (,) , in the form of blastopores, as an indication of the candida colonisation. Our results indicate that gravidity, as the risc factor for incidence of infection, has the signifi cant role in the incidence of vaginal candidosis.
Academy of Sciences and Arts of Bosnia and Herzegovina eBooks, 2020
At the end of 2019 the world became aware of the existence of a new virus stemming from the Coron... more At the end of 2019 the world became aware of the existence of a new virus stemming from the Coronaviridae family and causing a specific disease – COVID-19. In less than three months, the virus and its consequences, developed from being a local public health problem in China to a daunting global problem we all had to face. On March 11, 2020 the World Health Organization (WHO) declared a pandemic of COVID-19. On the international scale, even in Bosnia and Herzegovina (BiH), the response of the professionals and scientists has been rapid, although not always consistently efficient enough. Despite the selfless cooperation of scientists and practitioners worldwide, countries with developed economies, good public health and a strong scientific system have had the advantage in the fight against the disease over developing countries. Despite the fact that by these criteria BiH is not one of the most resilient countries, so far, its response to the pandemic has seemed to be satisfactory. The Academy of Sciences and Arts of Bosnia and Herzegovina (ANUBiH) was one of the first institutions of the science system to respond to the pandemic. On the initiative and under the leadership of academician Mirsada Hukić, on March 22, 2020 the development of the project "Epidemic Location Intelligence System (ELIS)" and its Geoportal began on a voluntary basis, with the task of permanently monitoring the spread of COVID-19. Theoretical and professional parts of the project in the areas of medicine, public health and informatics were completed by April 2, 2020. Thanks to the support to the project by the Chairman of the Presidency of Bosnia and Herzegovina, Mr. Šefik Džaferović, the expert system received additional hardware support and was filled in time with data from across the country. This enabled the system to become operational as early as on April 8, 2020. The results of all these efforts are visible in this publication. Initially, the ELIS project was important for the epidemiological and public health area. The abundance of collected data and obtained virus samples enabled the extension of the project idea to the sequencing of viruses found in BiH and their typology. The transition of research to the clinical aspects of COVID-19 is the next phase in the development of the ELIS project. ANUBiH has already started the work on examining the economic and pedagogical consequences of COVID-19 in order to look at this medical phenomenon in the broadest possible context. All the results of ANUBiH in response to the epidemic challenges of COVID-19 are achieved due to the synergistic action of numerous individuals and institutions in different fields of science and public health in cooperation with government. Therefore, I believe that the ELIS project has shown the way to go in solving the burning problems of our society which we will encounter in the future.
International journal of engineering research and technology, Aug 27, 2019
Biofilms have become a major issue in different spheres of medicine and industry. Source of the i... more Biofilms have become a major issue in different spheres of medicine and industry. Source of the issue revolves around increasing resistance of microorganisms towards conventional antibiotics which is even more elevated within biofilms that are difficult to eradicate by means of biocides and antibiotics. Multiple approaches were applied to deal with this issue amongst which green nanotechnology gave promising results and the search for molecules that "freeze bacteria" in the planktonic state. Since silver was used as an antimicrobial agent since ancient times. Considering this a study which deals with the effect of sub-inhibitory concentrations of silver nitrate and silver nanoparticles on biofilm forming capacity of bacteria would yield valuable information to evaluate the effect these substances have on the phenotypical expression of biofilm formation in bacteria as potential biofilm gene expression stoppers.
Bosnian Journal of Basic Medical Sciences, Aug 20, 2009
Brucellosis is an important public health problem in Bosnia and Herzegovina. Th e diagnosis of br... more Brucellosis is an important public health problem in Bosnia and Herzegovina. Th e diagnosis of brucellosis in the country without any experiences with this kind of infection may be very diffi cult. Th e aim of this study was to evaluate diagnostic methods: Rose Bengal test, blood cultures and ELI-SA IgM and IgG in the patients with brucellosis. Th e study included brucellosis patients in the period to . All the patients were treated at the Clinic for Infectious Diseases, University of Sarajevo Clinics Centre. Blood cultures were positive in / (, ) patients. Th is method often needs a long period of incubation and specimens need to be obtained early. Th ese limitations make serology the most useful tool for the laboratory diagnosis of Brucella infection. Rose Bengal is a rapid plate agglutination test, very sensitive irrespective of the stage of the disease. In our study, Rose Bengal test was positive in all patients / (, ). Brucella IgM antibodies with ELISA were positive in / (, ). Brucella IgG antibodies with ELISA were positive in / (). In order to determine the diagnostic value of the diff erent tests, we compared the sensitivity among test-methods: Rose Bengal test-., blood culture-., ELISA IgM-. and ELISA IgG-.. Sensitivity of test methods was diff erent in the diff erent stages of illness. It is necessary to use combination of diff erent tests such are blood culture, Rose Bengal test and ELISA in order to ensure the diagnosis. Rose Bengal test is excellent for the screening. Blood culture is a method of choice for the diagnosis acute infection. ELISA is a very good method for the diagnostic chronic disease and relapse.
Hantavirus-specific serology tests are the main diagnostic technique for detection of hantavirus ... more Hantavirus-specific serology tests are the main diagnostic technique for detection of hantavirus infection in Bosnia and Herzegovina. In order to enhance hantavirus infections monitoring a sensitive PCR based assay was developed to detect Dobrava (DOBV) and Puumala (PUUV) hantaviruses. Nested primer sets were designed within three different regions of the viral RNA (S and M segment of DOBV and M segment of PUUV) based on highly similar regions from a number of different European hantavirus strains. Assay conditions were optimized using cell cultures infected with DOBV Slovenia, PUUV Sotkamo and PUUV CG 18-20. This sensitive and specific assay has proven to be useful for detection of both Puumala and Dobrava hantaviruses.
Importance of the study: There is no similar published study regarding correlation of serum granu... more Importance of the study: There is no similar published study regarding correlation of serum granulysin level and clinical course and outcome of chickenpox. In most countries, vaccination for chickenpox is not available, so lot of immunocompetent adults who acquire chickenpox are in a great risk to develop severe and life-threatening clinical forms of illness. With granulysin, as early prognostic marker of the disease, physicians can predict what clinical form of chickenpox can be expected.
Brucellosis Matrix metalloproteinase Osteoarticular complications Objectives. Matrix metallop... more Brucellosis Matrix metalloproteinase Osteoarticular complications Objectives. Matrix metalloproteinases (MMPs) has been implicated in the pathogenesis of infective, cancer and autoimmune diseases. In this study, we investigated the serum level of MMPs and its clinical importance in human brucellosis. Patients and methods. This study included 60 brucellosis patients treated at the Clinic for Infectious Diseases, Clinical Centre, University of Sarajevo. Matrix metalloproteinases serum levels were quantified by ELISA. Results. The investigation involved three groups: 30 patients with complications, 30 patients without complications of brucellosis and 30 healthy control examinees. The complications of human brucellosis varied but osteoarticular involvement dominated (n=21/30; 70%). Matrix metalloproteinases serum levels in the patients with complications were highest. The serum level of MMP-1 in patients with complications was the highest at 9.45; in patients without complications it was 3.78 and in the control examinees it was lowest at 3.62 (p=0.001). The serum level of MMP-9 in patients with complications was the highest at 105.66; in patients without complications 64.67, and in the control examinees it was lowest at 37.32 (p=0.001). The serum level of MMP-13 in patients with complications was highest at 138.86; in patients without complications at 64.85; and in the control examinees it was the lowest at 29.55 (p=0.001). Pearson's coefficient showed a statistically significant positive correlation between levels of tested matrix metalloproteinases and development complications in human brucellosis (p=0.001). Conclusion. This study showed the diagnostic value and importance of detection of matrix metalloproteinases in human brucellosis. MMPs are a useful serum biomarker for assessment of disease activity
Bosnian Journal of Basic Medical Sciences, May 20, 2009
Diarrhoeal disease is a major cause of illness and death among infants and young children worldwi... more Diarrhoeal disease is a major cause of illness and death among infants and young children worldwide. Among the Escherichia coli (E. coli) causing intestinal diseases, there are six well-described categories: enteroaggregative E. coli (EAEC), diff usely adherent E. coli (DAEC), enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC), enterohaemorrhagic E. coli (EHEC) and enterotoxigenic E. coli (ETEC). Th e aim of the present study was to investigate the relative contribution of diff erent groups of diarrhoeagenic E. coli (DEC) in paediatric patients with diarrhoea. Clinical stool specimens from children with diarrhoea, with ages ranging from birth to < years, were selected for the study over a period of months (August to December ). Th e study showed that / children () had diarrhoea due to diarrhoeagenic E. coli. Th e most prevalent was enteropathogenic E. coli (EPEC) isolated from / paediatric patients (), followed by enterotoxigenic (ETEC) isolated from / (.), enterohaemorrhagic (EHEC) from / (.
Objectives. Serratia marcescens is a well-established as a nosocomial pathogen, resulting in cons... more Objectives. Serratia marcescens is a well-established as a nosocomial pathogen, resulting in considerable morbidity and mortality in immunocompromised patients. The aim of this study was to investigate an outbreak of Serratia marcescens at the Orthopaedic Clinic of the Clinical Center University of Sarajevo. Methods. A total of 96 strains from 79 patients were isolated. The isolates were identified by conventional methods. Susceptibility testing was performed by the discdiffusion method following CLSI guidelines. Results were confirmed by VITEC-2 Compact. Results. From January to December 2010, 96 strains from 79 patients were isolated at the Orthopaedic Clinic of the Clinical Center, University of Sarajevo.The strains were isolated from wound swabs, blood cultures and cerebrospinal fluid. The strains were identifed using current phenotypic methods as Serratia marcescens with identical biochemical characteristics and antibiotic susceptibility patterns. All strains were susceptible to imipenem, meropenem, amikacin, ciprofloxacin, levofloxacin and piperacillin/tazobactam. The infection control team was alerted and after investigation they discovered the same phenotype of Serratia marcescens in the anaesthetic vials used in procedures. This outbreak was extremely difficult to terminate, even with cohorting of patients, sterilisation of equipment, reinforcement of handwashing and deep-cleaning of facilities. The implementation of new control measures terminated the outbreak in February 2011. Conclusion. Continuous monitoring of nosocomial infections is indispensable. Phenotypic characterization of the isolates is useful for studying the relationship of microbial pathogens. The relationship of one clinical isolate to another during an outbreak is important in motivating the search for a common source or mode of transmission.
İnterlökin-6'nın (IL-6) periodontal hastalık patogenezi ve periodontal doku yıkımındaki rolü geni... more İnterlökin-6'nın (IL-6) periodontal hastalık patogenezi ve periodontal doku yıkımındaki rolü geniş çapta ele alınmıştır. Çalışmanın amacı, evre IV periodontitis hastalarının tükürüklerindeki IL-6 seviyelerini değerlendirmektir. Gereç ve Yöntemler: Araştırmaya evre IV periodontitis teşhisi konulan 28 hasta ile 22 hastadan oluşan kontrol grubu dahil edildi. Hastaların tümü sistemik olarak sağlıklıydı. Tükürük örnekleri toplandı ve sondalama derinliği (SD), klinik ataşman seviyesi (KAS), papil kanama indeksi (PKİ), sondalamada kanama yüzdesi (SK %), plak indeksi (Pİ) ve diştaşı indeksini (Dİ) içeren klinik periodontal ölçümler kaydedildi. Her bir hastanın uyarılmamış tükürükleri, tükürük toplayıcı ile toplandı ve örneklerdeki IL-6 seviyesi enzim bağlı immünosorbent testi ile analiz edildi. Bulgular: Evre IV periodontitis hastalarının ortalama IL-6 değeri 22,18±5,96 pg/mL idi. Kontrol grubunun ortalama IL-6 değeri ise 2,23±2,17 pg/mL idi. Periodontitis Objective: The role of interleukin-6 (IL-6) in the pathogenesis of periodontal disease and tissue destruction at the periodontal site has been widely reported. This study aimed to evaluate the salivary IL-6 levels in patients with stage IV periodontitis. Materials and Methods: The study included 28 patients who were diagnosed with periodontitis stage IV and the control group of 22 periodontally healthy patients. All the patients were systemically healthy. Saliva samples were collected, and clinical periodontal measurements, including probing depth (PD), clinical attachment level (CAL), papilla bleeding index (PBI), the percentage of sites with bleeding on probing (BOP) %, plaque index (PI) and calculus index (CI), were recorded. The unstimulated saliva of each patient was collected by a saliva collector, and all samples were analysed using the enzyme-linked immunosorbent assay method for the detection of IL-6. Results: The mean value of salivary IL-6 in patients with periodontitis stage IV was 22.18±5.96 pg/mL. In the control group, the average measured value of IL-6 was 2.23±2.17 pg/mL. The periodontitis group had a significantly higher salivary IL-6 levels than the control group. A strong positive correlation was observed between the salivary IL-6 and clinical periodontal parameters (PD, CAL, PBI, BOP %, PI and CI) in patients with periodontitis stage IV (p<0.0001). Conclusion: We demonstrated a statistically significant relationship between periodontal parameters and salivary IL-6 in patients with periodontitis stage IV. New studies are needed to accurately establish salivary IL-6 potential as a biomarker for periodontal disease monitoring, including all stages and grades of periodontitis.
Tularemia is a vector-borne zoonosis with a complex epidemiology caused by Francisella tularensis... more Tularemia is a vector-borne zoonosis with a complex epidemiology caused by Francisella tularensis. F. tularensis is a non-motile, obligatory aerobic, facultative intracellular Gram-negative coccobacillus. The bacterium has a broad host range, i.e. mammals, birds and invertebrates. Two types (A, B) and four subspecies (F. tularensis subsp. tularensis (type A), F. tularensis subsp. holarctica (type B), F. tularensis subsp. mediasiatica and F. tularensis subsp. novicida.) are known today. Types A and B are of importance as they cause disease in humans and animals. Type A is present almost exclusively in North America and type B is found all over the Northern hemisphere. F. tularensis is considered to be a class A biological warfare agent, it is notoriously difficult to recognize infections in non-endemic regions and was produced as a weaponized agent by several countries in the 1960ties and 70ties. Humans can acquire tularemia by inhaling dust or aerosols contaminated with F. tularensis bacteria, this type of exposure can result in pneumonic tularemia, one of the most severe forms of the disease. especially farming involving machines that disperse remains of infected animals or carcasses. Rarely, water can become tularemia contaminated through contact with infected animals. Humans who drink contaminated and untreated water may contract oropharyngeal tularemia. The tularemia outbreak in B&H in 1995 showed an unusual number of oropharyngeal cases. As all aspects of this particular tularemia epidemic were not thoroughly investigated and the possible intentional use of agents of biological warfare remained a possibility, we reviewed all available data in order to assess whether the outbreak was natural.
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