@article{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_2017, volume={7}, url={https://www.jhsci.ba/ojs/index.php/jhsci/article/view/611}, DOI={10.17532/jhsci.2017.449}, abstractNote={<p><strong>Introduction:</strong> Co-existence type of ESBL-producing isolates are serious problem in the public health world.</p> <p><strong>Methods </strong>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 <em>bla</em><sub>ESBL</sub>/<em>bla</em><sub>ampC</sub>/<em>bla</em><sub>carb </sub>genes. Genetic relatedness of the strains was determined by pulsed-field-gel-electrophoresis (PFGE).</p> <p><strong>Results </strong>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% <em>K. pneumoniae</em>, 12.5/30.6% <em>E. coli</em>, 11.4/4.8% <em>A. baumannii</em>, 8.0/14.5% <em>K. oxytoca</em>, 8.0/4.8% <em>E. cloacae</em>, 5.7/8.1% <em>Proteus</em> 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, <em>Klebsiella</em> spp. and <em>E. coli</em> 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 <em>K.</em> <em>pneumoniae </em>isolates were detected in 63.6% cases respectively. Differents in antimicrobial resistance were higher to cephalosporins agents in <em>Klebsiella</em> spp., and <em>E. coli</em> at inpatient and outpatient isolates which produce more than two types of beta-lactamases than in isolates which produce one type of beta-lactamases.</p> <p><strong>Conclusion:</strong> 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.</p>}, number={2}, journal={Journal of Health Sciences}, year={2017}, month={Sep.}, pages={80–90} }