Antimicrobial resistance pattern of clinical isolates in a tertiary care hospital in Sarajevo, Bosnia and Herzegovina

AIM: To determine which resistance to which antibiotic of the isolated bacteria has emerged or increased in order to create a policy for its proper and effective use. BACKGROUND: Antimicrobial resistance (AMR) has emerged as one of the most important public health issues. Over 70% of infections caused by antibiotic-resistant bacteria are healthcare-associated infections. Resistance to antibiotics used as a last resort in infection therapy, such as carbapenems, has serious consequences for human health. METHODS: This study was conducted from January to December 2023. Standard laboratory procedures were used for isolation and identification. Testing for antibiotic susceptibility was done according to EUCAST guidelines. RESULTS: Out of a total of 2276 Enterobacterales, 895 (39,3%) were extended spectrum beta-lactamases (ESBL) producing. Predominant ESBL-producing isolate was Klebsiella pneumoniae (55,64%) and the highest increase in ESBL-producing isolates was observed in Enterobacter cloacae (12,97%). Out of a total of 1092 Enterobacterales, 281 (25%) were carbapenemase-producing Enterobacterales (CPE). The highest increase in CPE-producing isolates was observed in Klebsiella pneumoniae (11,38%). There was a high rate of resistance to all tested antibiotics for Acinetobacter baumannii (more than 95% isolates were resistant to 6 out of the 9 tested antibiotics) and an increase of 7,61 % in resistance to carbapenems in Pseudomonas aeruginosa. Out of a total of Enterococcus faecium isolates, 103 (44,78%) were Vancomycin-Resistant Enterococci (VRE). CONCLUSION: We can conclude that it is very important that every healthcare institution has an adequate antibiotic resistance monitoring and reporting system in order to prevent horizontal transmission of hospital isolates.