•Bosnia and Herzegovina is an endemic for brucellosis in Southeastern Europe.•B. melitensis shows low rates of resistance to commonly used antimicrobials.•A high rate of resistance was observed with ...azithromycin in all three broth media.•The high rate of Brucella resistance to trimethoprim-sulfamethoxazole (T/S) is abolished in alternative broths.•Thymine- and thymidine-depleted broths should be used to test susceptibility for T/S.
Brucellosis is a ubiquitous emergent bacterial zoonotic disease causing significant human morbidity in Bosnia and Herzegovina. So far, a high rate of resistant Brucella has been found worldwide. This study prospectively analysed the rates of resistance among human Brucella melitensis strains isolated in Bosnia and Herzegovina.
This study included 108 B. melitensis isolates from 209 patients diagnosed at five medical centres in Bosnia and Herzegovina. The resistance profiles of the B. melitensis isolates for the 13 most commonly used antimicrobials were studied in standard Brucella broth (BB) and cation-adjusted Mueller-Hinton broth (CAMHB) supplemented with 4% lysed horse blood or 5% defibrinated sheep blood.
Of the 209 patients, B. melitensis blood cultures were positive for 111 (53.1%). Among the 108 isolates investigated, 91 (84.3%) were resistant to trimethoprim-sulfamethoxazole on BB, but not on either CAMHB. Nearly all isolates (>90%) were resistant to azithromycin on BB and both CAMHBs.
We observed a high rate of B. melitensis resistance to azithromycin. The high rate of resistance to trimethoprim-sulfamethoxazole that we observed was related to BB, so an alternative broth should be used, such as the enriched CAMHBs in this study, for evaluating resistance to trimethoprim-sulfamethoxazole. Whole-genome sequencing studies are needed to understand the development of antimicrobial resistance in B. melitensis strains isolated from humans.
Brucellosis is an emergent and endemic zoonotic disease in Bosnia and Herzegovina. In this report we have diagnosed the first case of human brucellosis in Bosnia and Herzegovina, using molecular and ...microbiological tests, caused by live attenuated Brucella melitensis Rev.1 strain. The infection was caused through unintentional exposure to vaccination of small ruminants in Bosnia and Herzegovina and without any prior accidental self-injection of vaccine suspension.
Cistična ehinokokoza (CE), koju uzrokuje E. granulosus, zoonotska je bolest koja se pojavljuje na gotovo svim kontinentima, a endemična je za područje Mediterana. Bolest se najčešće prezentira ...afekcijom jednog organa i solitarnom cistom, a kod manjeg broja bolesnika radi se o diseminiranoj bolesti koja pogađa višestruke organe. U ovom je radu prezentirana mlada žena s diseminiranom ehinokokozom kod koje su hidatidne ciste verificirane u jetrima, slezeni, plućima, bubrezima i perikardu. Zbog specifičnosti oblika bolesti, dobi bolesnice te zbog čestih relapsa bolesti nakon završetka terapije, liječena je albendazolom kroz duži vremenski period. Želimo prezentirati nešto drugačiji modus liječenja ehinokokokze koji je rezultirao povoljnom regresijom i kontrolom bolesti.
Background: Healthcare professionals, including medical and dental students, are at high risk of acquiring hepatitis B infection.Aim: The aim of this study was to examine and compare the knowledge ...and attitudes of the students of medicine and dental medicine of Faculty of Medicine, University of Mostar, about hepatitis B. Subjects and Methods: The examinees in this study were students of the first and second grade of medical studies and studies of dental medicine. The sample included 105 (71.4%) students of medicine and 42 (28.6%) students of dental medicine. The study was conducted at the Faculty of Medicine, University of Mostar, through the attached questionnaire. Results: Overall, the medical students and dental medicine students showed good knowledge about hepatitis B. Medical students showed much more positive attitudes towards hepatitis B positive patients than dental medicine students. Dental medicine students are more concerned about possible infections and general interactions with infected patients, and would statistically significantly reject to provide healthcare services to hepatitis B positive patients compared to the medical students.Conclusion: It was established that dental medicine students showed a little bit more understanding of the transmission patterns and symptoms of hepatitis B than the medical students. By contrast, medical students showed much more positive attitudes towards patients with hepatitis B than dental medicine students.
Pandemic influenza A virus (H1N1) 2009 causes a disease that is epidemiologically and clinically not significantly different from seasonal influenza, but there are differences. The aim of the study ...was to display and compare epidemiological and clinical characteristics of pandemic influenza in children. At Dr. Fran Mihaljević University Hospital for Infectious Diseases in Zagreb, in the first two seasons, the incidence of pandemic influenza virus A (H1N1) in particular was exhaustively analyzed only in patients with laboratory-confirmed pandemic influenza A virus (H1N1) 2009. In hospitalized children with documented influenza pandemic, moderate form of the disease predominated, which ultimately meant shorter hospital stay and fewer complications. Otitis media was the rarest complication in children in both seasons. In conclusion, children younger than 5 years, especially boys, were vulnerable groups for pandemic influenza, presenting as a mild disease with low mortality and few complications. Most of the affected children with influenza did not have important risk factors such as asthma and obesity, highlighted by other authors as significant risk factors.
The prospective study, which was made from Jan 1st 2009. till Dec 31st 2010. in the Clinic for Infectious Diseases within Clinical Hospital Mostar has been implemented in the areas of three ...southwestern cantons of the Federation of Bosnia and Herzegovina. We wanted to define the seroprevalence of the researched area using seroepidemiological testing of different groups of the population, based on the distribution by sex, age, education, residence and watersupply. The aim of this research was to prove the hypothesis that the decrease of seroprevalency of Hepatitis A has been directly related to the improvement of socio-economic conditions of life that at the end brought the decrease of the total prevalence in patients in younger age groups. The total of 420 examinees from the reasserted sample were analysed and they were classify into age groups. The first group was for the children up to 10 years. Then the group 11-20 follows and etc up to the last group, that complies examinees older than 60. In this way we have got seven groups of 60 examinees, from which the half of them was urban, and the other half was rural inhabitants. In every group analysed the half of examinees were females and the other half were males. The results we acquired with this research did not show any statistically relevant differences of seroprevalence of Hepatitits A between the urban and rural areas, between the sexes, nor between the populations which used different wattersupply objects. A statistically relevant difference was found between populations of different levels of education, but the most important difference was found between seroprevalency in different age groups. Seroprevalence in younger age groups was substantially low and increased in groups rising with age. Comparing this data to results from other similair researches from developed and undeveloped countries we concluded that the researched area, by the level of seroprevalency of Hepatitis A belongs to the category of developed countries.
Objective. The aim of this study was to evaluate an ongoing outbreak of brucellosis in southern region of Bosnia and Herzegovina (BIH) on the epidemiological, clinical and molecular level.Patients ...and methods. This study included 19 patients affected by brucellosis between 2015 and 2017, in Trebiševo (BIH). Out of 19 patients, 16 were admitted to and treated at the Department of Infectious diseases of the University Clinical Hospital Mostar, while three patients were treated in ambulatory care setting. Epidemiological, clinical and microbiological parameters were investigated. The Rose Bengal test (RBT) positive sera were serologically confirmed by complement fixation test (CFT). We also analyzed blood cultures, and isolates were additionally serotyped. Molecular analyses were performed with Bruce-ladder multiplex polymerase chain reaction (PCR) and multiple locus variable number of tandem repeat analysis of 16 loci (MLVA-16) assay.Results. Fifteen out of 19 patients had been professionally exposed to the bacterium, while four patients acquired brucellosis without prior contact with infected animals. In seven out of eight (87.5%) patients with localized form of brucellosis, we detected significantly higher values of C-reactive protein (CRP) or erythrocyte sedimentation rate (P<0.001). B. melitensis was isolated from 13/16 (81.3%) blood culture samples, and additionally serotyped as biovar 3. Using MLVA-16 assay, 11 isolates were genotyped. We observed complete genotype matches among 8/11 B. melitensis isolates, while 3/11 isolates differed in Bruce04 locus.Conclusion. Overall, our study confirms the usefulness of MLVA-16 method in the epidemiological and molecular research of brucellosis during epidemic that, most likely, originated from the same source.
The aim of this study was to determine the prevalence of chronic disease and the risk factors for herpes zoster infection. In this case-control study medical records were collected from 55 patients ...who presented with herpes zoster and 54 patients in a control group who presented with gastroenterocolitis. Both groups were treated at the Clinic for Infectious Diseases, University Clinical Hospital Mostar from January, 2005 to December, 2010. When we compared the herpes zoster group with the control group, we did not demonstrate any significant difference in the overall prevalence of chronic diseases. However, the prevalence of diabetes and cancer was statistically higher when compared to the control group. A statistically significant difference in the number of cigarette smokers was not observed, whereas the number who consumed alcohol in the herpes zoster group was significantly higher compared to the control group. The correlation between alcohol and herpes zoster could help in solving the reactivation mechanism of VZV.
Lyme borreliosis (LB) is caused by the spirochete Borrelia burgdorferi, which is transmitted to humans by ticks of the Ixodes ricinus complex. It is manifested by a variety of clinical symptoms and ...affects skin, joints, heart, and nervous system. Neurological manifestations are predictable and usually include meningoencephalitis, facial palsy, or radiculopathy. Recently, a dramatic rise in the number of diagnosed cases of LB has been observed on the global level. Here we show the first case of Lyme neuroborreliosis in southern Bosnia and Herzegovina, which was first presented by erythema chronicum migrans. Unfortunately, it was not recognized or well treated at the primary care medicine. After eight weeks, the patient experienced headache, right facial palsy, and lumbar radiculopathy. After the clinical examination, the neurologist suspected meningoencephalitis and the patient was directed to the Clinic for Infectious Disease of the University Hospital Mostar, where he was admitted. The successful antimicrobial treatment with the 21-day course of ceftriaxone was followed by normalization of neurological status, and then he was discharged from the hospital. This case report represents an alert to all physicians to be aware that LB is present in all parts of Bosnia and Herzegovina, as well as in the neighboring regions.
The aim of this study was to describe the situation and the development of Croatian Defense Council medical corps during the 1992-1995 war in Bosnia and Herzegovina. The paper provides an overview ...and describes the main events that lead to development of the medical care in the wartime conditions, with special emphasis on the public health system in Herzegovina region. This included the creation of three distinctive public health system settings: initial, integral and post-war period, all marked by certain specificities in organization and delivery of the public health and overall health care to both military and civilians. The knowledge and skills gathered during this period can be useful in situations that involve the need for fast public health actions, such as various natural disasters and disease outbreaks, and could be used for establishing highly mobile response public health teams. Furthermore, the experiences gathered during these periods may be useful during the planning phases of the health care reforms, all aiming to deliver the best possible health care to the entire population.
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