Risk factors associated with the development of secondary hyperparathyroidism in dialysis patients.

Aim To determine risk factors associated with the development and severity of secondary hyperparathyroidism in dialysis patients. Methods A cross-sectional study at the Clinical Centre of the University of Tuzla (March 2022) included 104 adult patients (males 51.9%, females 48.1%) with chronic kidney diseases under dialysis treatment. Based on parathyroid hormone (PTH) values, patients were divided into two groups: study group (45/104, PTH >792pg/mL) and control group (59/104, PTH 176-792 pg/ mL). The analysis aimed to resolve whether there was a connection between the duration of dialysis, the type of therapy treatment administered, the underlying kidney disease, and the presence of comorbidities with the values of PTH, and a wide spectrum of monitored laboratory parameters. Results The most common causes of chronic renal failure were undefined kidney diseases (32.7%), followed by diabetic nephropathy (18.3%) and chronic glomerulonephritis (16.3%). In the examined biochemical parameters, a significant difference was found in mean values of alkaline phosphatase (p<0.001). The correlation was proved between the duration of dialysis (p=0.028), the values of phosphorus (p=0.031), and alkaline phosphatase (p<0.001) with absolute values of PTH. The most common present comorbidity was hypertension (78.8%), followed by cardiovascular diseases (40.4%) and diabetes (22.1%). Conclusion A number of factors contribute to the development and severity of SHPT. Modulation of therapy and better control of risk parameters can prolong and reduce the frequency of SHPT in dialysis patients, as well as the occurrence of comorbidities.

Impact of COVID-19 vaccine on clinical characteristics and outcome of hospitalized COVID-19 patients during the fourth wave of the pandemic in Tuzla Canton, Bosnia and Herzegovina.

Aim To evaluate clinical and epidemiological characteristics and outcome of patients with COVID-19, and impact of vaccine against COVID-19 on them. Methods This retrospective study included 225 patients treated from COVID-19 in the period from 1 to 30 September 2021 at the Clinic for Infectious Diseases, University Clinical Centre Tuzla (UCC Tuzla). For the diagnosis confirmation of Covid-19, RTPCR was used. Patients were divided in two groups: fully vaccinated with two doses of vaccine, and non-vaccinated or partially vaccinated. Results Of 225 patients, 120 (53.3%) were females, and 105 (46.7%) males. Mean age was 65.6 years. There were 26 (11.6%) fully vaccinated patients. Most common symptoms in unvaccinated patients were fatigue (70.9%), cough (70.4%) and fever (69.8%), and in vaccinated fever (76.9%), fatigue (69.2%) and cough (46.2%). Cough was more common in unvaccinated patients (p=0.013). Fatal outcome happened in 84 (37.3%) patients. Transfer to the Intensive Care Unit (ICU) and older age had a higher risk of death (p<0.001). Older age patients were more likely to have comorbidities like atrial fibrillation (p=0.017), hypertension (p<001) and diabetes mellitus (p=0.002). Atrial fibrillation (p<0.001), hypertension (p<0.001), diabetes mellitus (p=0.009) and history of stroke (p=0.026), were related to fatal outcome in unvaccinated patients, also did a shorter duration of illness prior to hospitalization (p<0.001) and shorter length of hospitalization (p=0.002). Conclusion Older patients with comorbidities, as well as those who were not vaccinated against COVID-19, were at higher risk for severe form of the disease and poor outcome.

Knowledge, attitude and stigma towards HIV patients: a survey among medical students in Tuzla, Bosnia and Herzegovina.

INTRODUCTION: This survey aims to assess knowledge, attitude and stigma towards HIV patients, among medical students in Tuzla, Bosnia and Herzegovina. We also aimed to assess potential risk factors for HIV infection among fourth year medical students. METHODOLOGY: Data were collected from specific questionnaire that was completed by 171 students of the Faculty of Medicine, University of Tuzla. A multivariable logistic regression was performed. RESULTS: Majority of students (79%) had a good knowledge of HIV, (median value of correct answers was 9 (95%) with at least 6 correct responses). Also, majority of students (73.6%) had a positive attitude towards HIV patients and the median positive value was 6 (95% CI: 6-7). More than a third of students considered that all hospitalized patients should be tested for HIV. Total of 81% of students considered that they should inform the sexual partner of HIV positive patient, although she/he disagrees. 61.4% of students had a discriminatory attitude towards HIV, with the median values of 3 (95% CI: 3-3). Multivariate regression analysis identified positive attitude towards HIV patients as an independent predictor for a non-discriminatory attitude. Moreover, an overall attitude towards HIV patients defines student`s determination to work with AIDS population. Male gender, and older age, were identified as predictors of risky behavior. CONCLUSIONS: Preventive measures, including better HIV education, are crucial. Knowledge can increase awareness of HIV infection, decrease the incidence and reduce stigma towards HIV patients.

Cytomegalovirus Infection in Pregnancy - Our Experiences.

INTRODUCTION: Cytomegalovirus (CMV) infection is ubiquitous. It affects all age groups, and its clinical picture ranges from mild to severe, especially as a congenital infection in neonates. AIM: To determine frequency of CMV infection in pregnant women in Tuzla Canton (TC) and the risk factors that lead to the infection. METHODS: This prospective study included 300 pregnant women from TC aged 18 to 42 years. CMV serology was performed on all participants, and in case of acute infection additionally IgG avidity test. Participants also completed the questionnaire on the risk factors for CMV infection. RESULTS: The median age of the 300 women was 28 ±4.97 years. There were 161participants (53.6%) who classified their environment as urban and 295 (98.33%) were married. More than half of the women had completed secondary school 168 (56%). Positive IgG antibodies to CMV had 280 (93.0%) women. Positive IgM and IgG antibodies had 9 (3.0%) participants, but all of them had high IgG avidity, which indicates reinfection or recurrent CMV infection. There was a statistically significant higher number of seropositive participants living in rural areas than those living in urban areas (p= 0.048). Also, there was significantly higher percentage of positive anti-CMV IgG in pregnant women with lower education (p=0.04). CONCLUSION: In our region there is high seropositivity rates of IgG antibodies to CMV in pregnant women. No case of primary CMV infection was proven. The risk factors for CMV infection have been proven to be rural environment and lower level of education.

Epidemiological Characteristics of the Accidental Exposures to Blood-Borne Pathogens Among Workers in the Hospital.

INTRODUCTION: The main route of acquiring infectious blood and body fluids in hospital conditions is accidental exposure to stinging incidents. AIM: The aim of this study was to determine the epidemiological characteristics of accidental exposures to blood-borne pathogens among different professional groups of health care workers (HCWs). MATERIALS AND METHODS: A cross-sectional study was conducted using the "Questionnaire on the HCWs exposure to blood and blood transmitted infections" at the University Clinical Centre Tuzla, Bosnia and Herzegovina, from the 1st of March to the 31st of December 2014. Study sample consisted of 1031 participants (65% of total employees) stratified into three occupational groups: doctors, nurses and support staff. RESULTS AND DISCUSSION: Exposure incident was recorded in 1231 participants (54.8%) at least once in the last 12 months. An average number of exposure incidents per HCWs in total years of service was 7.07± 8.041. Out of total sample, 70% reported at least one type of exposure incident. Nurses had a higher frequency of multiple contacts compared to doctors and support staff (χ2=37.73; df=4; p<0.001). The frequency of reported incidents among nurses at the surgical departments was almost two times higher (1.7). 75.5% (778/1031) of the participants, reported not having been exposed to these incident. Doctors were significantly less likely to report exposure incidents than nurses and support staff. There were significant differences in reporting rate (χ2=32,66; df=4; p<0.001). CONCLUSION: HCWs in hospitals have a high prevalence of occupational exposure to blood-borne infections. Seventy percent of the HCWs is periodically or constantly exposed to or contact related to blood. Nurses are most frequently exposed occupational group among HCWs, while the lowest reporting rate on an exposure incident is among doctors.

Diagnostic and prognostic value of procalcitonin in patients with sepsis.

Aim To investigate predictive value of procalcitonin in diagnosis of sepsis in predicting positive blood culture, and possibility to predict final outcome in septic patients. Method This prospective study involved 106 hospitalized patients who met two or more criteria for systemic inflammatory response syndrome (SIRS). In comparison to Sepsis Related Organ Failure Assessment score (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II score procalcitonin (PCT), C-reactive protein and lactate levels were used to predict final outcome in septic patients (recorded as 28-day survival or non-survival). Using Receiver operating characteristic (ROC) curve the area under the curve (AUC) was calculated for diagnostic value and accuracy of different parameters with the best sensitivity and specificity for given cut-off values. Result Fifty-two out of 82 patients with documented sepsis had positive blood culture. Procalcitonin showed the best predictive value for both diagnosis of sepsis and bacteraemia with the cut-off value of 0.57 ng/mL (AUC 0.99) and 4.68 ng/mL (AUC 0.94), respectively. Serum lactate level showed the best 28-day mortality predictive value with the cut-off value of 3.25 mmol/L (AUC 0.95), and procalcitonin with the cut-off value of 15.05 ng/mL (AUC 0.92), followed by SOFA (AUC 0.92), CRP (AUC 0.84) and APACHE II score (AUC 0.83). Conclusion Monitoring of PCT in SIRS-positive patients raises possibility to distinguish between patients with sepsis and those with non-infectious SIRS. A significant correlation between PCT and SOFA, and APACHE II score in non-surviving septic patients indicates that PTC combined with clinical score could be useful for assessing severity of infection.

Brucellosis in children in Bosnia and Herzegovina in the period 2000 - 2013.

AIM: To analyse clinical, laboratory and epidemiological characteristics of brucellosis in children in Bosnia and Herzegovina. METHODS: The study included 246 children aged 0-18 years, who were hospitalized in Clinics and Departments for Infectious Diseases in Tuzla, Sarajevo, Banja Luka, Zenica and Bihac in the period 2000-2013, in whom the diagnosis of brucellosis was established based on anamnestic data, clinical features and positive results from blood culture and/or positive results from one of the serological tests. RESULTS: In this period, a total of 2630 patients, 246 (9.35%) of whom were children, were treated from brucellosis at the Clinics and Departments in Bosnia and Herzegovina. In the majority of cases, the children were from rural parts of the country, 226 (91.87%);214 (87.04%) cases had direct contact with sick animals, sick family member or consumption of unpasteurized dairy products from farms where brucellosis had been already established. Male children predominated, 157 (63.82%). The most frequent clinical features in affected children were fever, 194 (78.86%) and joint pain, 158 (64.22%). The average duration of antimicrobial treatment was 42.85 ± 10.67 days. A total of 228 (92.68%) children were completely cured, while relapses occurred in 18 (7.32%) children. CONCLUSION: Since brucellosis is an endemic disease in Bosnia and Herzegovina, it is important that physicians in their daily practice consider brucellosis and establish proper diagnosis and therapy in children with prolonged fever, arthralgia, leukopenia and positive epidemiological data, especially in rural parts of the country.

Clinical and Epidemiological Characteristics of HIV Infection/AIDS in Hospitalized Patients.

INTRODUCTION: More than three decades after recognition of acquired immunodeficiency syndrome (AIDS) in the United States, the pandemic of human immunodeficiency virus (HIV) infection has dramatically changed the global burden of disease. AIM: The main goal of this research is retrospective analysis of epidemiological and clinical characteristics of 28 HIV infected patients, who were diagnosed and treated at the Clinic for Infectious Diseases in University Clinical Center Tuzla in the period from 1996 until the end of 2013. SUBJECTS AND METHODS: Retrospective analysis was performed using the medical records of 28 HIV-infected persons. Two rapid tests were used for HIV testing: OraQuick Advance test, Vikia HIV1/2, Elisa combo test, HIV RNA test. AIDS disease was determined by using the criteria from WHO. RESULTS: Among a total of 28 HIV-infected persons, 23 (82.14%) were males and 5 (17.86%) were females, with the male: female ratio of 4,6:1. In terms of the transmission route, a large proportion of cases were infected through heterosexual contact 19 (67.86%). At the time of the first visit, 16 (57.15%) patients showed asymptomatic HIV infection, 4 (14.28%) HIV infection with symptoms other than the AIDS defining diseases, and 8 (28.57) had AIDS. At the time of first hospital visit, the CD4 + cells count ranged from 40 to 1795/µl (conducted in 19 patients), and mean value of CD4 + cells was 365,31/µl, and mean HIV RNA titer was 287 118 copies/ml³. Of 28 HIV-infected persons 39 cases of opportunistic diseases developed in 12 patients (42.9%). In terms of the frequency of opportunistic diseases, tuberculosis (12 cases, 42.9%). Among a total of 28 HIV-infected patients, 6 (21.4%) of them died. CONCLUSION: This study characterizes the epidemiological and clinical patterns of HIV-infected patients in Tuzla region of Bosnia and Herzegovina to accurately understand HIV infection/AIDS in our region, in the hope to contribute in the establishment of effective HIV guidelines in the Tuzla region of B&H in the future.

Dominant causes of urinary tract infections at the Clinic for Infectious Diseases Tuzla.

AIM: To determine the prevalence and antimicrobial resistance of dominant causes of urinary tract infections (UTI) in patients treated at the Clinic for Infectious Diseases, University Clinical Center Tuzla during the period January 2010 to June 2011. METHODS: This prospective study included 438 patients divided into three groups: hospital-treated patients group (H-T), outpatient- treated group (O-T) and patients with hospital-acquired (H-A) UTI. Identification of UTI causes completed using standard microbiological methods; antimicrobial susceptibility was done by disc-diffusion method according to the CLSI. RESULTS: E. coli was significantly more commonly isolated in females H-T, 111 (68-1%) (p=0.012) and O-T, 148 (82.7%) (p=0.006) groups, as well as in females less than 65 years from the H-T, 87 (84.5%) (p=0.000) and H-A, four (40%) (p=0.044) groups. Klebsiella pneumoniae and Pseudomonas aeruginosa were significantly more commonly isolated in male H-T, 11 (29.7%) (p=0.000) and five (13.5%) (p=0.009), and O-T UTI, two (9.5%) (p=0.009) and three (14.3%) (p=0.000) groups. E. coli showed significantly higher prevalence of resistance to amoxycillin, coamoxiclav, cefuroxime, ceftriaxone, gentamicin and co-trimoxazole in the H-A group comparing to other two groups (p less than 0.05), as well as to ampicillin, amoxycillin and cefixime in the O-T comparing to H-T group (p less than 0.05). CONCLUSION: Empirical antimicrobial therapy should include coamoxiclav, nitrofurantoin, cefepime, and ceftazidime for females less than 65 years old in both H-T and H-A, cefalosporines, co-amoxiclav and nitrofurantoin in O-T UTIs; for females more than 65 years old, cefalosporines, aminoglicosides, and ciprofloxacin, in H-T and O-T UTIs. For H-A UTI in females more than 65 years as well as for all male patients antimicrobial susceptibility testing should be performed.

Clostridium difficile infection in hospitalized patients at university clinical center tuzla, bosnia and herzegovina: a 4 year experience.

INTRODUCTION: Clostridium difficile (C. difficile) is currently the leading cause of healthcare-associated diarrhea, but almost nothing is known about the extent of C. difficile infection (CDI) in Bosnia and Herzegovina. GOAL: We aimed to retrospectively analyze CDI in hospitalized patients at University Clinical Center (UCC) Tuzla, Bosnia and Herzegovina from January 2009 through June 2012. METHODS: We analyzed all patients (except children ages 0-2), diagnosed with CDI based on anamnestic and epidemiological, clinical picture and microbiological tests (proof of toxins in the stool by enzyme-linked immunosorbent assay). RESULTS: From a total of 989 patients tested for C. difficile toxin (60.2 per 10,000 inpatient days) 347 (35.08%) were positives. The mean incidence rate of CDI was 2.23 per 10,000 inpatient days (range 1.32-2.87). Annual rates of hospitalization were 15.68 per 10,000 admissions (range 8.99-20.35). Most patients had a previously identified risk profile of old age, comorbidity and recent use of antibiotics. 41/276 (14.86%) patients had died, and 11/41 (26.82%) were CDI-associated deaths. Complicated CDI were registered in 53/276 (19.21%) patients, and recurrent infections in 65/276 (23.55%). CONCLUSION: Our data suggest that CDI is largely present in our setting which represents a serious problem and points to the importance of international surveillance, detection and control of CDI.

Chateter-associated Urinary Tract Infections in Adults.

INTRODUCTION: Hospital-acquired Urinary tract infections make 35% of all the hospital-acquired infections, and about 80% of them are related to the catheterization of the urinary bladder. PURPOSE: To determine clinical characteristics and dominant etiologic factors of Urinary Tract Infections associated with urinary catheter (C-UTIs). METHODS: Determined clinical characteristics of C-UTIs were prospectively analyzed on 38 hospitalized patients in the Clinic for Infectious Diseases at the University Clinical Centre Tuzla, from January 1(st) 2011 to December 31(st) 2011. The control group constituted of 200 patients with community-acquired Urinary Tract Infections (Co-UTIs) hospitalized in the same period. RESULTS: It was registered on 22 (57.89%) of symptomatic infections, 14 (36.84%) asymptomatic bacteriuria and 2 (5.26%) other C-UTIs. Dominant etiologic factors were: E. coli, caused 14 (36.84%), Extended-Spectrum Beta-lactamase producing (ESBL) Klebsiella pneumoniae 7 (18.42%), Enterococcus faecium and Candida spp. 3 (7.89%) of C-UTIs. E. coli was significantly most common etiologic factor of C-UTIs in younger women (p=0.04). E. coli from C-UTIS showed significantly higher resistance to antimicrobial drugs. Inadequate antimicrobial therapy was significantly more common prescribed to patients from C-UTIs. Lethal outcome was significantly most common associated with certain clinical and laboratory findings. CONCLUSION: Initial antimicrobial therapy of those serious infections should be based on data from those research.

Predictors of the therapeutic response of patients with influenza A (H1N1) 2009 infection.

AIM: To determine a predictive potential of biochemical and clinical parameters, including independent predictors of the therapeutic outcome in patients with H1N1 influenza. METHODS: In this retrospective study, 119 patients treated at the Clinic for Infectious Diseases in Tuzla in the period July 2009 to February 2010 were included. They were at the age of 1 month up to 80 years. The patients showed clinical, epidemiological and biochemical parameters of the pandemic flu and they had also been positive for the virus A (H1N1), which was confirmed by the real time polymerase chain reaction (RT-PCR). RESULTS: One hundred and nineteen patients were positive to the virus A (H1N1), 60 (50.4%) were male, and 59 (49.6%) female patients. The average age of the patients was 26.74 years. The number of patients with co-morbidity was 53 (44.5%). There were 71 (59.7%) patients who had been admitted to the Intensive Care Unit. The complications of the flu had appeared in 45 (37.8%) patients. Pneumonia was recorded in 108 (90.8%), and reduced saturation in 62 (52.1%) patients. The highest number of cured patients was in the group of patients who had received the oseltamivir within 48 hours after the outbreak of the disease. CONCLUSION: The age, reduced saturation with oxygen, duration of the hospitalization, pregnancy and overweight were independent predictors of the severe form of the disease/lethal outcome. For an optimal therapeutic outcome, it is important to apply antiviral therapy as soon as possible.

Etiology of bacterial meningitis in children in Tuzla Canton.

INTRODUCTION: Bacterial meningitis is one of the most serious infectious diseases in childhood. AIM: To identify the most common causes of bacterial meningitis in children in Tuzla Canton. PATIENTS AND METHODS: This is a retrospective study which included 140 children, aged from 1 month to 14 years, treated at the Clinic for Infectious Diseases Tuzla, in the period 1999-2009, who had clinical and laboratory parameters of bacterial meningitis. RESULTS: In Tuzla Canton in ten year period were registered 140 cases of bacterial meningitis in children aged 1 month to 14 years. Prevalence was 1.53/1000. The average age of patients was 3.6 +/- 3.8 years. Male to female ratio was 1.3:1. April, May and November were the months with the most reported cases of bacterial meningitis (p = 0.02). Most affected were children 1-12 months of age (p < 0.001). The most common pathogens of bacterial meningitis were Haemophilus influenzae (13.6%), Neisseria meningitides (8.6%) and Streptococcus pneumoniae (5.7%) (p < 0.001). Mortality was 2.14%. CONCLUSION: Bacterial meningitis is present in Tuzla Canton, and three major pathogens are Haemophilus influenzae, Neisseria meningitis and Streptococcus pneumoniae. The most affected were children 1-12 months of age, and most cases of bacterial meningitis occurred in spring.

Etiology of peritonitis.

AIM: To determine the etiology of peritonitis, as well as the sensitivity of isolated bacteria to antibiotics. METHODS: Study was performed at the Surgical Clinic, Department of Anesthesiology and Reanimation, Department of Microbiology, Department of Clinical Pharmacology of University Clinical Centre (UCC) Tuzla. In a prospective study, starting from 1.6.2009. to 30.6.2010., was 60 patients analyzed who underwent surgery for acute peritonitis in the Surgical Clinic, UCC Tuzla. RESULTS: After microbiological processing of the content of the operative field, wound swabs and smears of drainage, we isolated Gram positive coccid bacteria: Coagulase-negative Staphylococcus in 18.36%, Staphylococcus aureus in 12.6%, while Enterococcus faecalis and Enterococcus faecum were found in 3.44% isolates. In the group of Gram-negative bacteria we isolated: Escherichia coli in 15.51%, and Pseudomonas aeruginosa and Klebsiella pneumoniae in 10.34% of the cases. The sensitivity of coagulase-negative Staphylococcus was largest to vancomycin (100%), and lowest to penicillin (10%) and Staphylococcus aureus sensitivity was largest to vancomycin and amoxicillin-clavulanate (100%) and lowest to penicillins (3.7%). Sensitivity of the facultative anaerobic Gram-negative bacilli was highest to carbapenems 95-100%, and lowest to penicillin preparations 0-56%. CONCLUSION: Based on the results of microbiological findings of 83.33% patients empirical antibiotic therapy was appropriately involved, and in 16.67% was inadequate and later changed, following the results of microbiological findings. This study indicates the importance and validity of microbiological diagnostics to determine the etiology of peritonitis and appropriate selection of antibiotics to treat these infections, with the required surgical treatment.

Human brucellosis in Tuzla Canton.

INTRODUCTION: The prevalence of human brucellosis in Bosnia and Herzegovina and the Tuzla Canton reached its peak in 2008, with a reported total of 994 cases within country, and with 104 cases within the Tuzla Canton. AIM: to analyze the clinical and epidemiological features of human brucellosis in patients hospitalized at the University Clinical Center Tuzla during the period from 01/01/2000 till the 31/12/2010. METHODS: We retrospectively analyzed the clinical symptoms, the laboratory and X-ray findings, the treatments, and the course and outcome of the disease. The diagnosis of brucellosis was based on anamnesis, clinical presentation, in correlation with a positive blood-culture, and/or serological tests. RESULTS: The majority of patients (93.18%) were from rural regions. There were more males (79.54%) than females. Most of the patients were aged between 30 to 39 years (21% cases). Contact with infected animals was registered for 83.40% of the patients. The main symptoms and signs were fever, joint-pains, night sweating, anorexia, headaches, and hepatosplenomegaly. The important laboratory findings were increased erythrocyte sedimentation rates, increased values of C-reactive protein, and anemia. Adult patients were treated with a combination of gentamicin or streptomycin with doxycycline, and the children with a combination of gentamicin, and trimethoprim-sulfametaxasol, over at least 6 weeks. Complications were documented in 20.45% of the patients. Relapses were observed in 14.20%, and a chronic form of brucellosis in 5.11% of patients. There were no cases with lethal outcomes. CONCLUSION: Brucellosis is a growing public health problem, not only within the Tuzla Canton, but throughout Bosnia and Herzegovina.

Clinical and laboratory characteristics of acute community-acquired urinary tract infections in adult hospitalised patients.

Urinary tract infections (UTI) cause a great number of morbidity and mortality. These infections are serious complications in pregnancy, patients with diabetes, polycystic kidneys disease, sickle cell anaemia, kidney transplant and in patients with functional or structural anomalies of the urinary tract. The aim of this investigation was to determine a dominant causative agents of UTI and some of the clinical and laboratory characteristics of acute community-acquired UTI in adult hospitalised patients. We studied 200 adult patients with acute community-acquired UTI hospitalised in the Clinic for Infectious Diseases Tuzla from January 2006 to December 2007. The patients were divided into two groups: a group of patients with E. coli UTI (147) and a group of patients with non-E. coli UTI (53). In these two groups, the symptoms and signs of illness, blood test and urine analysis results were analysed. Our results have shown that the patients with E. coli UTI frequently had fever higher than 38,5 degrees C (p<0,0001), chills (p=0,0349), headache (p=0,0499), cloudy urine (p<0,0001), proteinuria (p=0,0011) and positive nitrite-test (p=0,0002). The patients with non-E. coli UTI frequently had fever lower than 38,5 degrees C (p<0,0001) and urine specific gravity <1015 (p=0,0012). There was no significant difference in blood test results between patients with E. coli and non-E. coli UTI. These clinical and laboratory findings can lead us to early etiological diagnosis of these UTI before urine culture detection of causative agents, which takes several days. Early etiological diagnosis of the E. coli and non-E. coli UTI is necessary for an urgent administration of appropriate empirical antibiotic treatment. This is very important in prevention of irreversible kidney damage, prolonged treatment, complications, as well as recidives and chronicity of the illness.