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Objectives: To determine the prevalence and genetic background of methicillin-sensitive (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) obtained from healthy food handlers admitted to the

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The aim of this study was to determine the molecular characteristics and antibiotic resistance of 13 (10 inpatient and three outpatient) Acinetobacter baumannii beta-lactamase-producing isolates collected in Bosnia and Herzegovina between December 2009 and May 2010.Materials and methods: Susceptibility testing was performed by disk diffusion and broth microdilution methods. The modified Hodge and combined disk test with EDTA/phenylboronic acid was used to screen for carbapenemase production. Production of extended spectrum beta-lactamases (ESBLs) was determined by double-disk synergy test. PCR was used to detect blaESBL/blacarb genes.Results: Ten (22.2%) inpatient and three (13.6%) outpatient isolates produced beta-lactamases, ESBLs, or oxacillinases. More than 50% of the isolates showed multidrug resistance. Resistance rates to gentamicin and ciprofloxacin of the inpatients and outpatients were 80.0%, 60.0%, 75.0%, and 25.0%, respectively. MICs of carbapenems for resistant isolates ranged from 32 to >256 µg/mL. All imipenemresistant Acinetobacter baumannii strains contained bla OXA-51 . Three of the 10 inpatient isolates and one outpatient isolate containing bla OXA-51 additionally produced other beta-lactamases (TEM/CTX-M/OXA-1). None of the inpatient or outpatient isolates were positive for other carbapenemases, especially acquired oxacillinases (bla OXA-23 /bla OXA-24 /bla OXA-58 /bla OXA-143 ). Conclusion: Production of bla OXA-51 presents an emerging threat in imipenem-resistant Acinetobacter spp. from Bosnia and Herzegovina.

Purpose: To investigate the prevalence and antimicrobial resistance of Gram-negative isolates producing more than two types of beta-lactamases, obtained from in-and outpatient infections in Zenica-Doboj Canton, Bosnia and Herzegovina.Methods & Materials: Antibiotic susceptibility was determined by disc diffusion and broth microdilution methods according to CLSI guidelines. Double-disk synergy test was performed to screen for ESBLs and pAmpC beta-lactamases. PCR was used to detect bla ESBL , bla AmpC , bla carb genes. Genetic relatedness of the strains was determined by PFGE.Results: Among 88 inpatient (n=126; 10.0%) and 62 outpatient (n=184; 6.4%) beta-lactamase producing isolates, 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, respectively, were found. Sixty-eight (out of 88; 77.3%) inpatient and 28 (out of 62; 45.2%) outpatient isolates possessed more than two genes. Among inpatient isolates, Klebsiella spp. and E. coli was the most prevalent strain producing more than two types of genes, in 90.0% and 70% cases, respectively. The combination of blaTEM+blaSHV+blaCTX-M+blaOXA-1 were noticed in 34 (out of 68; 50.0%) inpatient isolates; blaCTX-M+blaSHV+blaOXA-1 in seven (10.3%); blaCTX-M+blaOXA-1 in six (8.8%). In outpatient isolates combination of blaTEM+blaSHV were noticed in seven (out of 28; 25.0%) and blaTEM+blaSHV+blaCTX-M+blaOXA-1 in six (21.4%) cases. The most prevalent combination of blaTEM+blaSHV+blaCTX-M+blaOXA-1 was noticed in 28 (out of 38; 73.7%) inpatient Klebsiella pneumonia. Prevalence of antimicrobial resistance were higher to all cephalosporins, amynoclicosides and piperacillin in Klebsiella spp., and E. coli inpatient isolates producing more than two types of beta-lactamases comparing to isolates producing only one type of beta-lactamase. PFGE showed no genetic relatedness between the isolates.Conclusion: High prevalence of Gram-negative isolates producing more then two types of beta-lactamases, especially in inpatient isolates were found. Continous surveillance, and implementation of infection control and prevention measures will help in limitation of further spread of these isolates.