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

Authors

  • Amir Ibrahimagić Department for Laboratory DiagnosticsI, nstitute for Public Health and Food Safety Zenica, Bosnia and Herzegovina
  • Emina Idrizović Department for Laboratory Diagnostics, Institute for Public Health and Food Safety Zenica, Bosnia and Herzegovina
  • Edita Divjan Institute for Public Health and Food Safety Zenica, Bosnia and Herzegovina
  • Biljana Klimenta Health Center of Sarajevo Canton, Laboratory Novo Sarajevo, Bihaćka 2, 71000 Sarajevo

DOI:

https://doi.org/10.17532/jhsci.2016.337

Keywords:

ESBL, Water, Food, Antibiotic resistance

Abstract

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.

Downloads

Download data is not yet available.

Author Biographies

  • Amir Ibrahimagić, Department for Laboratory DiagnosticsI, nstitute for Public Health and Food Safety Zenica, Bosnia and Herzegovina
    Department for Laboratory Diagnostics, Laboratory for Sanitary and Clinical Microbiology
  • Emina Idrizović, Department for Laboratory Diagnostics, Institute for Public Health and Food Safety Zenica, Bosnia and Herzegovina

    Department for Laboratory Diagnostics, Institute for Public Health and Food Safety Zenica, Bosnia and Herzegovina

  • Edita Divjan, Institute for Public Health and Food Safety Zenica, Bosnia and Herzegovina

    Institute for Public Health and Food Safety Zenica, Bosnia and Herzegovina

  • Biljana Klimenta, Health Center of Sarajevo Canton, Laboratory Novo Sarajevo, Bihaćka 2, 71000 Sarajevo
    Health Center of Sarajevo Canton, Laboratory Novo Sarajevo, Bihaćka 2, 71000 Sarajevo

Downloads

Published

01.07.2016

Issue

Section

Research articles

How to Cite

1.
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. JHSCI [Internet]. 2016 Jul. 1 [cited 2024 Jul. 18];6(2):94-9. Available from: https://www.jhsci.ba/ojs/index.php/jhsci/article/view/542