SummaryBackground Gaps in the diagnostic capacity and heterogeneity of national surveillance and reporting standards in Europe make it diffi cult to contain carbapenemase-producing Enterobacteriaceae. We report the development of a consistent sampling framework and the results of the fi rst structured survey on the occurrence of carbapenemaseproducing Klebsiella pneumoniae and Escherichia coli in European hospitals.

Chemical composition and antimicrobial activity of needle essential oil, obtained by hydrodistillation from wild Pinus peuce Griseb. (Pinaceae), growing on three different locations in R. Macedonia were investigated in period 2008/2009. Carried out GC/FID/MS analysis, one hundred and three constituents were identified belonging to the six different classes of components: monoterpene hydrocarbons, oxygenated monoterpenes, sesquiterpene hydrocarbons, oxygenated sesquiterpenes, diterpenes and other non-terpene components, representing 88.61/94.04% of the entire oil. The most abundant constituents were α-pinene (12.89/27.34%), β-pinene (6.16/13.13%), limonene + β-phellandrene (2.09/6.64%) and bornyl acetate (2.92/11.67%) as well as trans-(E)-caryophyllene (4.63/7.13%) and germacrene D (8.75/20.14%). Antimicrobial screening of Pinus peuce needle essential oil was made by hole-plate diffusion and broth dilution method against 13 bacterial isolates of Gram positive and Gram negative bacteria and one strain of Candida albicans. The most sensitive bacteria against tested Pinus peuce essential oils were Streptococcus pneumonia encompassing Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus agalactiae, Acinetobacter spp. and Streptococcus pyogenes. Minimal inhibitory concentrations (MICs) of the oils ranged from 7.5 - 62.5 µl/ml.

Background: Campylobacter infections are typically self-limited, but in cases with severe enteritis, immuno-compromised system and bacteremia, an appropriate antimicrobial treatment is demanding. Our study aim was to determine the isolation rate of Campylobacter among patients with acute enteritis in the capital of North Macedonia and its antimicrobial susceptibility. Material and methods: A total number of 3820 patients clinically diagnosed as acute enteritis, were included in the study. Stool samples were collected and Campylobacter was isolated and identified by classical microbiological methods. Antimicrobial susceptibility of all isolates to Ceftriaxone, Amoxicillin-clavulonic acid, Erythromycin, Ciprofloxacin, Tetracycline and Gentamicin was determined by disc-diffusion technique. Additionally, minimal inhibitory concentrations of all Campylobacter isolates against erythromycin, ciprofloxacin and tetracycline were determined by Epsilon gradient tests. Results: Campylobacter species was isolated in 97 patients. Although the mean isolation rate of Campylobacter spp. during the whole study period was 2.53%, a statistically significant increase was detected in 2016 and 2017, in comparison with the data from previous four years of the study. The isolation rate of Campylobacter spp. didn’t reveal statistically significant difference between males and females (p > 0.05). 46.4 % of patients with Campylobacter enteritis were children at the age under 15 years. Forty-three C. jejuni isolates were susceptible to all six antibiotics, but the remaining 44 isolates revealed resistance to at least one antibiotic. C. coli isolates were resistant to 3 antibiotics simultaneously. Two C. coli isolates only, were susceptible to all 6 antibiotics. 40.90% of C. jejuni and 50% of C. coli isolates were resistant to beta-lactams, fluoroquinolones and tetracyclines, simultaneously. Conclusion: The increase of the isolation rate of Campylobacter from patients with acute enteritis indicates the need for permanent isolation and identification of Campylobacter from every clinically diagnosed patient, as acute enteritis. Erythromicin is the most effective antibiotic for treatment of Campylobacter enteritis in our patients. The high level of Campylobacter resistance to beta-lactams, fluoroquinolones and tetracyclines requires more rational approach in the treatment of Campylobacter enteritis

The aim of the study was to evaluate the association of drug resistance with β-lactamase gene types in ESBL positive E. coli and Klebsiella pneumoniae-Kp. Material and methods: A total of 251 ESBL-positive E. coli and Kp isolates obtained from urine, tracheal aspirate, wound swab and blood from patients hospitalised at the University Clinics in Skopje were detected using the ESBL set and automated Vitek 2 system. Vitek was also used for susceptibility testing (determination of MIC of 17 antimicrobial agents). Multiplex PCR was used to identify genes for different types of ESBLs in a 100 randomly selected, ESBL positive strains. Results: More of the 87 ESBL typeable isolates (61%) harbour two or more bla genes and the frequency of antibiotic resistance was high in these isolates, compared to those with a single gene. Isolates with ≥ 3 genes were highly resistant to beta-lactams and non-beta lactams used. The degree of resistance to 3rd generation cephalosporins was also high in these isolates (MIC ≥ 64). More of the ESBL-positive isolates showed higher resistance to cefotaxime than to ceftazidime. Conclusion: Identification of the genes is necessary for the surveillance of their transmission in hospitals. Surveillance of antibiotic resistance patterns are crucial to overcome the problems associated with ESBLs.