ZNAČAJ KONTROLE MITOKSNA ZA LJUDSKU I ANIMALNU PREHRANU

Direktnom ili indirektnom kontaminacijom, mikotoksini mogu ući u lanac ishrane ljudi i životinja. Pored štetnih efekata na zdravlje ljudi i životinja, mikotoksini mogu imati i značajan negativan ekonomski uticaj. Zbog svoje stabilnosti, mikotoksini se dugo zadržavaju u biljnim i životinjskim proizvodima i potencijalno su velika opasnost po zdravlje ljudi i životinja u mnogim zemljama svijeta, posebno u zemljama u razvoju. Stoga je glavni cilj ovog rada prikazati značaj kontrole mikotoksina kroz procese skladištenja, transporta i obrade uzoraka za ishranu ljudi i životinja. Prema dobijenim rezultatima, 52% uzoraka namijenjenih ljudskoj ishrani ne zadovoljava referentne vrijednosti. Mikotoksini su otkriveni u 100% ispitivanih uzoraka hrane. Pouzdana metoda u prevenciji sinteze mikotoksina je sistem kontrole sigurnosti hrane u svim fazama proizvodnje i distribucije koji uključuje dobru praksu skladištenja, dobru higijensku praksu i dobru proizvodnu praksu

ZNAČAJ KONTROLE MITOKSNA ZA LJUDSKU I ANIMALNU PREHRANU

Direktnom ili indirektnom kontaminacijom, mikotoksini mogu ući u lanac ishrane ljudi i životinja. Pored štetnih efekata na zdravlje ljudi i životinja, mikotoksini mogu imati i značajan negativan ekonomski uticaj. Zbog svoje stabilnosti, mikotoksini se dugo zadržavaju u biljnim i životinjskim proizvodima i potencijalno su velika opasnost po zdravlje ljudi i životinja u mnogim zemljama svijeta, posebno u zemljama u razvoju. Stoga je glavni cilj ovog rada prikazati značaj kontrole mikotoksina kroz procese skladištenja, transporta i obrade uzoraka za ishranu ljudi i životinja. Prema dobijenim rezultatima, 52% uzoraka namijenjenih ljudskoj ishrani ne zadovoljava referentne vrijednosti. Mikotoksini su otkriveni u 100% ispitivanih uzoraka hrane. Pouzdana metoda u prevenciji sinteze mikotoksina je sistem kontrole sigurnosti hrane u svim fazama proizvodnje i distribucije koji uključuje dobru praksu skladištenja, dobru higijensku praksu i dobru proizvodnu praksu

Antibiotic resistance in Enterobacter cloacae strains with derepressed/partly derepressed/inducible AmpC and extended spectrum beta-lactamases in Zenica-Doboj Canton, Bosnia and Herzegovina

AIM: To investigate the prevalence of derepressed/partly derepressed/inducible and ESBL/AmpC-producing Enterobacter cloacae isolates and treatment options for infections associated with those isolates. ----- METHODS: Antibiotic susceptibility was determined by disc diffusion and broth microdilution according to CLSI guidelines. Doubledisk synergy test (DDST) was performed in order to screen for ESBLs and combined disk test with phenylboronic acid to detect AmpC β -lactamases. PCR was used to detect blaESBL/blacarb genes. Genetic relatedness of the strains was determined by pulsed-fieldgel-electrophoresis (PFGE). ----- RESULTS: Among 14 isolates with the ESBL positive E. cloaceae producing isolates, four (28.6%), nine (64.3%) and one (7.1%) isolates were derepressed/partly derepressed and inducible AmpC producers. Eleven (out of 14) isolates were resistant to cefotaxime, ceftazidime, ceftriaxone, aminoglycosides and fluoroquinolones. All isolates were susceptible to imipenem and meropenem, 79% to cefepime. Five (out of 14; 35.7%) isolates (four derepressed and one inducible AmpC carrying E. cloaceae) were negative in phenotypic test for ESBLs, but positive for broad spectrum TEM-1 β-lactamase. One (out of four derepressed) also produced CMY-2 β-lactamase. Four (out of nine) partly derepressed isolates were positive with the DDST, but did not yield PCR products with primers targeting TEM, SHV and CTX-M beta-lactamases. Four positive partly derepressed isolates carried a blaCTX-M-1 gene, two blaOXA-1 one blaCTX-M-15, OXA-1 and one blaCTX-M-28, OXA-1 (n=1). ----- CONCLUSION: Microbiology laboratories must be able to detect and recognize AmpC-carrying isolates in a timely manner, especially those that are falsely susceptible in vitro to drugs that may be consideredfor therapy of infected patients

Prevalence of co-existence genes and clonal spread of ESBL-producing isolates causing hospital and community-acquired infections in Zenica-Doboj Canton, Bosnia and Herzegovina

Introduction: Co-existence type of ESBL-producing isolates are serious problem in the public health world. Methods Antibiotic susceptibility was determined by disc diffusion and broth microdilution according to CLSI guidelines. Double-disk synergy test was performed in order to screen for ESBLs/pAmpC beta-lactamases. PCR was used to detect blaESBL/blaampC/blacarb genes. Genetic relatedness of the strains was determined by pulsed-field-gel-electrophoresis (PFGE). Results In this study 88 of the inpatient isolates (n=126; 10.0%) and 62 of the outpatient (n=184; 6.4%) Beta-lactamase-producing isolates were taken for the study. They included 50.0/29.0% K. pneumoniae, 12.5/30.6% E. coli, 11.4/4.8% A. baumannii, 8.0/14.5% K. oxytoca, 8.0/4.8% E. cloacae, 5.7/8.1% Proteus spp., and less than 3.5% of other isolates. Co-existence of more than two type of beta-lactamases was detected in 77.3% of inpatient and 45.2% of outpatient isolates. Among inpatient isolates, Klebsiella spp. and E. coli were the most frequent isolates which produce more than two type of genes; in ≈ 65% and ≈12% cases. Separately, combination of four: TEM+SHV+CTX-M+OXA-1 beta-lactamases in inpatient K. pneumoniae isolates were detected in 63.6% cases respectively. Differents in antimicrobial resistance were higher to cephalosporins agents in Klebsiella spp., and E. coli at inpatient and outpatient isolates which produce more than two types of beta-lactamases than in isolates which produce one type of beta-lactamases. Conclusion: This work demonstrates a progressively increasing prevalence of co-existence type of beta-lactamases expecially in inpatient isolates. Continous monitoring and surveillance and proper infection control and prevention practice will limit the further spread of these isolates

ASSESSMENT OF THE QUALITY AND ENERGY VALUE OF MEALS IN KINDERGARTEN AND NURSING HOMES

Važan uticaj na rast i razvoj, i usvajanje ispravnih prehrambenih navika imaju upravo jelovnici u dječjim vrtićima i u domovima lica treće dobi. Cilj istraživanja bio je ocijeniti kakvoću ishrane u 38 dječjih vrtića i 10 domova za stara lica na području Zeničko-dobojskog kantona. Primjenom standardnih analitičkih metoda analizirano je ukupno 38 cjelodnevnih obroka. Podaci o energetskoj vrijednosti i sadržaju prehrambenih supstanci (bjelančevina, masti i ugljikohidrata), komparirani su s obzirom na 75% dnevnih potreba predškolskog djeteta (bez večere), što korespondira s njegovim prosječnim dnevnim 8-satnim do 10-satnim boravkom u vrtiću. U odnosu na preporučenu dnevnu energetsku vrijednost za uzrast od 4 do 6 godina (bez večere – 3809,26 KJ), sedam obroka (18,4%) je pokazalo iznad prosječne preporučene energetske vrijednosti, dok su 22 (57,9%) obroka bila ispod prosječne preporučene vrijednosti. Rezultati energetske vrijednosti za doručak i užinu u odnosu na preporučenu energetsku vrijednosti (2000 KJ), iznose: n=5; 13,2% iznad prosječne i n=20; 52,6% ispod prosječne preporučene vrijednosti. Rezultati energetske vrijednosti za ručak pokazuju odstupanja u odnosu na preporučenu energetsku vrijednosti od približno 1800 KJ (n=8; 21,1% iznad i n=15; 39,5% ispod preporučene vrijednosti). Rezultati dnevne energetske vrijednosti u domovima za stara lica pokazala su odstupanja u odnosu na preporučenu dnevnu energetsku vrijednost koja obuhvata tri obroka doručak, ručak i večeru (8500 KJ) i to kod četiri uzorka iznad prosječne vrijednosti (40%) i četiri uzorka (40%) ispod prosječne preporučene energetske vrijednosti. Kvalitetna ishrana predškolske djece i rano usvajanje zdravih prehrambenih navika, te kvalitetna ishrana lica treće dobi je od javnozdravstvenog značenja, stoga je iz zdravstvenih, ekoloških i etičkih razloga značajna korekcija i kontrola jelovnika, te uvođenje novih namirnica u skladu sa preporučenim vrijednostima.Menus in kindergartens and homes for the elderly have an important influence on growth and development, and the adoption of correct eating habits. The research aimed to evaluate the quality of nutrition in 38 kindergartens and 10 homes for the elderly in the area of ZDK. A total of 38 all-day meals were analysed using standard analytical methods. Data on the energy value and content of food substances (protein, fat, and carbohydrates) were compared concerning 75% of the daily needs of a preschool child (without dinner), corresponding to his average 8- to 10-hour stay in kindergarten. About the recommended daily energy value for ages 4 to 6 years (without dinner - 3809.26 KJ), seven meals (18.4%) showed above the average recommended energy value, while 22 (57.9%) meals were below the average recommended value. The results of the energy value for breakfast and snacks about the recommended energy value (2000 KJ) amount to n=5; 13.2% above average and n=20; 52.6% below the average recommended value. The results of the energy value for lunch show deviations from the recommended energy value of approximately 1800 KJ (n=8; 21.1% above and n=15; 39.5% below the recommended value. The results of the daily energy value in homes for the elderly showed deviations concerning the recommended daily energy value, which includes three meals breakfast, lunch, and dinner (8500 KJ), in four samples above the average value (40%) and four samples (40%) below the average recommended energy value. Quality nutrition of preschool children and early adoption of healthy eating habits, as well as high-quality nutrition of people of the third age, is of public health importance, therefore, for health, ecological, and ethical reasons, it is important to correct and control the menu and introduce new foods following the recommended values

Arrival of carbapenem-hydrolyzing-oxacillinases in Acinetobacter baumannii in Bosnia and Herzegovina

Multidrug-resistant Acinetobacter baumannii (MDR-AB) is an important threat for critically ill patients. It can infect the respiratory tract, blood, soft tissues, urinary tract and central nervous system. Recently, carbapenem-resistance was observed in A. baumannii clinical isolates from Bosnia and Herzegovina. This prompted us to analyze these isolates with regards to genotypic diversity, antibiotic susceptibility and occurrence of acquired carbapenem resistance genes. Twelve carbapenem-resistant isolates were collected at a University hospital during two different periods of 2011 and 2015-2016: four isolates in 2011 and eight isolates 2015-2016 and compared to determine the dynamic changes in carbapenemase resistance mechanisms and population structure. All twelve isolates were positive for intrinsic blaOXA-51-like, nine for blaOXA-40-like and one for the blaOXA-23-like gene. ISAba1 was found upstream of blaOXA-51 in all and upstream of blaOXA-23-like gene in one isolate. Sequencing of the selected PCR products revealed the presence of OXA-72 β-\ud lactamase (strain 1) and OXA-23 β-lactamase (strain 41). WGS of the selected isolate (AB 5) revealed the presence of blaOXA-72, chromosomal genes blaOXA-69 and blaADC. Moreover, the aac (3)-1a and aadA1 genes encoding aminoglycoside resistance, and sul1encoding sulphonamide resistance were identified. PFGE and rep-PCR revealed two clones containing highly similar isolates positive for OXA-40-like; one from 2011 and the other from 2015- 2016. Implementation of hospital hygiene measures, screening of the patients on admission for carriage of MDR-AB, and the early and accurate detection, with restriction of antibiotic use should be recommended to control the spread of these important hospital pathogenes. To our knowledge, this is the first report of A. baumannii isolates producing carbapenem-hydrolyzing oxacillinases (CHDL) from Bosnia and Herzegovina

Prevalence and antimicrobial resistance of beta-lactamase-producing Gram-negative isolates from outpatient clinical and environmental samples in the Zenica-Doboj Canton, Bosnia and Herzegovina

Introduction: Infections due to extended-spectrum beta-lactamase (ESBL)-producing isolates in patients are hard to treat and cause high morbidity and mortality. ESBL-producing bacteria have been increasingly detected in environmental samples in different countries since 2002, and have gained considerable attention worldwide.Methods: Antibiotic susceptibility of all isolates was determined using the disk diffusion method. The production of ESBLs was determined by the double-disk synergy test.Results: Among the outpatient clinical samples, out of 2857 Gram-negative bacteria, 184 (6.5%) ESBL-producing bacteria were isolated. In this group, 143 (77.7%) were from urine samples, 26 (14.1%) from surgical wounds, 6 (3.3%) from umbilical swabs, and 9 (4.9%) from other patients sites (upper respiratory tract, cannula, eyes, genital swabs). Escherichia coli was isolated in 62 (33.7%), and Klebsiella spp. in 50 (27.8%) cases. Among the environmental samples, out of 381 Gram-negative bacteria, 52 (13.6%) were ESBL-producing isolates. In this group, 37 (71.2%) were sampled from water, 7 (13.5%) from food, and 8 (15.4%) from environmental surfaces. The most prevalent ESBL-producing bacteria isolated from the environmental samples were E. coli (isolated from 26 samples), Klebsiella spp. (10), non-fermenters (9), and other bacteria isolated from 7 samples. The clinical outpatient ESBL-producing isolates showed resistance to all cephalosporins, ranging from 25% (cefepime) to 100% (cefuroxime). The environmental ESBL-producing isolates showed resistance to cefuroxime, aztreonam, cefpodoxime, amoxicillin/clavulanate, and cefoxitin in the range of 65-100%.Conclusions: Prevalence of antibiotic resistance of ESBL-producing strains is high and requires routine detection of ESBL-producing isolates in the laboratories, designing of appropriate antibiotic prescribing policies and control of the risk factors

Prevalence and antimicrobial resistance of beta-lactamase-producing Gram-negative isolates from outpatient clinical and environmental samples in the Zenica-Doboj Canton, Bosnia and Herzegovina

Introduction: Infections due to extended-spectrum beta-lactamase (ESBL)-producing isolates in patients are hard to treat and cause high morbidity and mortality. ESBL-producing bacteria have been increasingly detected in environmental samples in different countries since 2002, and have gained considerable attention worldwide. Methods: Antibiotic susceptibility of all isolates was determined using the disk diffusion method. The production of ESBLs was determined by the double-disk synergy test. Results: Among the outpatient clinical samples, out of 2857 Gram-negative bacteria, 184 (6.5%) ESBL-producing bacteria were isolated. In this group, 143 (77.7%) were from urine samples, 26 (14.1%) from surgical wounds, 6 (3.3%) from umbilical swabs, and 9 (4.9%) from other patients sites (upper respiratory tract, cannula, eyes, genital swabs). Escherichia coli was isolated in 62 (33.7%), and Klebsiella spp. in 50 (27.8%) cases. Among the environmental samples, out of 381 Gram-negative bacteria, 52 (13.6%) were ESBL-producing isolates. In this group, 37 (71.2%) were sampled from water, 7 (13.5%) from food, and 8 (15.4%) from environmental surfaces. The most prevalent ESBL-producing bacteria isolated from the environmental samples were E. coli (isolated from 26 samples), Klebsiella spp. (10), non-fermenters (9), and other bacteria isolated from 7 samples. The clinical outpatient ESBL-producing isolates showed resistance to all cephalosporins, ranging from 25% (cefepime) to 100% (cefuroxime). The environmental ESBL-producing isolates showed resistance to cefuroxime, aztreonam, cefpodoxime, amoxicillin/clavulanate, and cefoxitin in the range of 65-100%. Conclusions: Prevalence of antibiotic resistance of ESBL-producing strains is high and requires routine detection of ESBL-producing isolates in the laboratories, designing of appropriate antibiotic prescribing policies and control of the risk factors

Molecular epidemiology and antimicrobial susceptibility of AmpC- and/or extended-spectrum (ESBL) ß-lactamaseproducing Proteus spp. clinical isolates in Zenica-Doboj Canton, Bosnia and Herzegovina

Aim To investigate prevalence, antimicrobial susceptibility, molecular characteristics, and genetic relationship of AmpC- and/or extended spectrum beta lactamase (ESBL)- producing Proteus spp. clinical isolates in Zenica-Doboj Canton, Bosnia and Herzegovina. Methods Antibiotic susceptibility was determined by disc diffusion and broth microdilution methods according to CLSI guidelines. Double-disk synergy test was performed in order to screen for ESBLs, and combined disk test with phenylboronic acid to detect AmpC β -lactamases. PCR was used to detect blaESBL/blacarb genes. Genetic relatedness of the strains was determined by pulsed-fieldgel-electrophoresis (PFGE). Results Eleven ESBL-producing isolates were included in the study (six inpatients and five outpatients). Susceptibility rate to amoxicillin-clavulanic acid, imipenem and meropenem was 100%. Resistance rate to cefuroxime was 100%, gentamicine 90.9%, piperacillin/tazobactam 81.8%, cefotaxim, ceftriaxone and ceftazidime 72.7%, cefoxitine and ciprofloxacine 63.6% and to cefepime 45.5%. In five (out of 11) isolates multi-drug resistance (MDR) to cephalosporins, cefamicines, amynocligosides and fluoroquinolones was detected. Besides TEM-1 which was detected in all isolates, CTX-M+OXA-1 β-lactamases were detected in seven (out of 11; 63.6%) isolates (five blaCTX-M-1 and two blaCTX-M-15 genes), and CMY-2 β-lactamase in two isolates. PFGE showed no genetic relatedness. Conclusion Because of high prevalence of MDR strains in epidemiologically unrelated patients with AmpC- and/or ESBL producing Proteus spp. infection, further surveillance is needed. Molecular characterization and strain typing, or at least phenotypic test for AmpC/ESBL production is important for appropriate therapy and the detection of sources and modes of spread, which is the main step in order to design targeted infection control strategies

Methicillin-resistant S. aureus (MRSA), extended-spectrum (ESBL)- and plasmid-mediated AmpC ß-lactamase -producing Gram-negative bacteria associated with skin and soft tissue infections in hospital and community settings

AIM To investigate the characteristics of meticillin-resistant S. aureus (MRSA), extended-spectrum (ESBL), and plasmid-mediated AmpC beta-lactamase producing Gram-negative bacteria causing skin and soft tissue infections (SSTIs) in hospital and outpatient settings of Zenica-Doboj Canton, Bosnia and Herzegovina. ----- METHODS Antibiotic susceptibility was determined by disc-diffusion and broth microdillution methods according to CLSI guidelines. MecA gene was detected by PCR, and genetic characterization of MRSA was performed using spa-typing and the algorithm based upon repeat patterns (BURP). Double-disk-synergy test was used to screen for ESBLs. PCR was used to detect blaESBL alleles. Genetic relatedness of the strains was tested by PFGE. ----- RESULTS Seventeen in-patients with MRSA, 13 with ESBL-producing Gram-negative bacteria and three patients co-infected with both, were detected. Five MRSA and 16 ESBL-producing Gram-negative bacteria were found in outpatient samples. Klebsiella spp. was isolated in 11 in- and seven outpatients. MLST CC152 was the most prevalent MRSA. Seven (38.9%) Klebsiella spp. yielded amplicons with primers specific for SHV, TEM-1 and CTX-M group 1 β-lactamases. Eight K. pneumonia (44.4%) and 16 (64%) MRSA (including the in- and outpatient) strains were clonally related. ----- CONCLUSION The presence of MRSA and ESBL-producing organisms causing SSTIs in the community poses a substantial concern, due to the high morbidity and mortality associated with possible consequent hospital infections