Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare-associated Infections Surveillance Data, 2011-2017.

Objective: To describe the epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) healthcare-associated infections (HAI) in Egyptian hospitals reporting to the national HAI surveillance system. Methods: Design: Descriptive analysis of CRE HAIs and retrospective observational cohort study using national HAI surveillance data. Setting: Egyptian hospitals participating in the HAI surveillance system. The patient population included patients admitted to the intensive care unit (ICU) in participating hospitals. Enterobacteriaceae HAI cases were Klebsiella, Escherichia coli, and Enterobacter isolates from blood, urine, wound or respiratory specimen collected on or after day 3 of ICU admission. CRE HAI cases were those resistant to at least one carbapenem. For CRE HAI cases reported during 2011-2017, a hospital-level and patient-level analysis were conducted using only the first CRE isolate by pathogen and specimen type for each patient. For facility, microbiology, and clinical characteristics, frequencies and means were calculated among CRE HAI cases and compared with carbapenem-susceptible Enterobacteriaceae HAI cases through univariate and multivariate logistic regression using STATA 13. Results: There were 1598 Enterobacteriaceae HAI cases, of which 871 (54.1%) were carbapenem resistant. The multivariate regression analysis demonstrated that carbapenem resistance was associated with specimen type, pathogen, location prior to admission, and length of ICU stay. Between 2011 and 2017, there was an increase in the proportion of Enterobacteriaceae HAI cases due to CRE (p-value = 0.003) and the incidence of CRE HAIs (p-value = 0.09). Conclusions: This analysis demonstrated a high and increasing burden of CRE in Egyptian hospitals, highlighting the importance of enhancing infection prevention and control (IPC) programs and antimicrobial stewardship activities and guiding the implementation of targeted IPC measures to contain CRE in Egyptian ICU's .

Widespread antimicrobial resistance among bacterial infections in a Rwandan referral hospital.

BACKGROUND: Resistance among bacterial infections is increasingly well-documented in high-income countries; however, relatively little is known about bacterial antimicrobial resistance in low-income countries, where the burden of infections is high. METHODS: We prospectively screened all adult inpatients at a referral hospital in Rwanda for suspected infection for seven months. Blood, urine, wound and sputum samples were cultured and tested for antibiotic susceptibility. We examined factors associated with resistance and compared hospital outcomes for participants with and without resistant isolates. RESULTS: We screened 19,178 patient-days, and enrolled 647 unique participants with suspected infection. We obtained 942 culture specimens, of which 357 were culture-positive specimens. Of these positive specimens, 155 (43.4%) were wound, 83 (23.2%) urine, 64 (17.9%) blood, and 55 (15.4%) sputum. Gram-negative bacteria comprised 323 (88.7%) of all isolates. Of 241 Gram-negative isolates tested for ceftriaxone, 183 (75.9%) were resistant. Of 92 Gram-negative isolates tested for the extended spectrum beta-lactamase (ESBL) positive phenotype, 66 (71.7%) were ESBL positive phenotype. Transfer from another facility, recent surgery or antibiotic exposure, and hospital-acquired infection were each associated with resistance. Mortality was 19.6% for all enrolled participants. CONCLUSIONS: This is the first published prospective hospital-wide antibiogram of multiple specimen types from East Africa with ESBL testing. Our study suggests that low-resource settings with limited and inconsistent access to the full range of antibiotic classes may bear the highest burden of resistant infections. Hospital-acquired infections and recent antibiotic exposure are associated with a high proportion of resistant infections. Efforts to slow the development of resistance and supply effective antibiotics are urgently needed.

What about Urinary Tract Infections and its Antibiotic Resistance Bacteria in Ilam, Iran?

BACKGROUND: Because of the unknown situation of antibiotic resistance pattern in the main hospital in Ilam, Iran, we aimed to evaluate the antibiotic resistance pattern of uropathogenic bacteria obtained from referred patients to Imam Khomaini Hospital, Ilam, Iran. So, 114 bacteria were collected during 9-month period and evaluated for their antibiotic resistance patterns. RESULTS: Our results demonstrated that Escherichia coli as the dominant responsible for urinary tract infection. Our results demonstrated that 61.4 % (n = 70) of isolates were positive for E.coli, while lowest prevalence was observed for Staphylococcus aureus and Acinetobacter baumannii. The results also showed that 6.4% (n = 7) were metallo beta lactamase (MBL) producers. Our findings showed only 4 gram positive bacteria were obtained from patients with urinary tract infections including one methicillin resistant S. aureus (MRSA) and 2 vancomycin resistant Enterococcus faecalis (VRE). CONCLUSION: In conclusion, we strongly recommended to perform a perfect study among all hospitals in Iran to evaluate the situation of antibiotic resistance and make a real panel to control this issue.

Piper betle and its bioactive metabolite phytol mitigates quorum sensing mediated virulence factors and biofilm of nosocomial pathogen Serratia marcescens in vitro.

ETHNOPHARMACOLOGICAL RELEVANCE: Piper betle, a tropical creeper plant belongs to the family Piperaceae. The leaves of this plant have been well known for their therapeutic, religious and ceremonial value in South and Southeast Asia. It has also been reported to possess several biological activities including antimicrobial, antioxidant, antinociceptive, antidiabetic, insecticidal and gastroprotective activities and used as a common ingredient in indigenous medicines. In Indian system of ayurvedic medicine, P. betle has been well recognized for its antiseptic properties and is commonly applied on wounds and lesions for its healing effects. AIM OF THE STUDY: To evaluate the anti-quorum sensing (anti-QS) and antibiofilm efficacy of P. betle and its bioactive metabolite phytol against Serratia marcescens. MATERIALS AND METHODS: The P. betle ethyl acetate extract (PBE) was evaluated for its anti-QS efficacy against S. marcescens by assessing the prodigiosin and lipase production at 400 and 500µgml-1 concentrations. In addition, the biofilm biomass quantification assay was performed to evaluate the antibiofilm activity of PBE against S. marcescens. Besides, the influence of PBE on bacterial biofilm formation was assessed through microscopic techniques. The biofilm related phenomenons like exopolysaccharides (EPS) production, hydrophobicity and swarming motility were also examined to support the antibiofilm activity of PBE. Transcriptional analysis of QS regulated genes in S. marcescens was also done. Characterization of PBE was done by separation through column chromatography and identification of active metabolites by gas chromatography -mass spectrometry. The major compounds of active fractions such as hexadecanoic acid, eugenol and phytol were assessed for their anti-QS activity against S. marcescens. Further, the in vitro bioassays such as protease, biofilm and HI quantification were also carried out to confirm the anti-QS and antibiofilm potential of phytol in PBE. RESULTS: PBE inhibits QS mediated prodigiosin pigment production in S. marcescens, which confirmed its anti-QS potential against S. marcescens. At 500µgml-1 concentration, PBE significantly inhibited the production of protease, lipase, biofilm and EPS to the level of 71%, 68%, 65% and 43% in S. marcescens, respectively. Further, their antibiofilm efficacy was confirmed through microscopic techniques. In addition, PBE effectively inhibited the hydrophobicity and swarming motility. Additionally, the results of qPCR analysis validated the downregulation of QS genes. Chromatographic techniques the presence of hexadecanoic acid, eugenol and phytol in PBE and the potential bioactive compound with anti-QS activity was identified as phytol. In vitro assays with phytol evidenced the potent inhibition of QS-controlled prodigiosin, protease, biofilm and hydrophobicity in S. marcescens, without exerting any deleterious effect on its growth. CONCLUSION: This study demonstrates the promising anti-QS and antibiofilm activities of PBE and its active metabolite phytol, and confirms the ethnopharmacological applications of these leaves against S. marcescens infections.

Extended-spectrum beta-lactamase-producing Enterobacteriaceae in hospital urinary tract infections: incidence and antibiotic susceptibility profile over 9 years.

PURPOSE: Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are an increasing concern regarding antibiotic resistance and their potential to cause serious infections which are difficult to treat. The purpose of this surveillance programme was to assess the incidence of ESBL in adults amongst urinary isolates, identify risk factors, and detail the antibiotic susceptibility profile in order to guide empirical treatment. METHODS: From 2006 to 2014, we reviewed 21,414 positive urine cultures for E. coli and Klebsiella sp. from a University hospital in the UK and found 1420 ESBL-positive specimens. Susceptibility testing was performed by British Society of Antimicrobial Chemotherapy disc diffusion testing. ESBL screening was performed on samples resistant to cefpodoxime and confirmed by double disc diffusion (Oxoid Ltd, Basingstoke, UK). Patient gender, age, inpatient status, and catheterisation were assessed as risk factors. RESULTS: ESBL production amongst E. coli urine cultures increased 44 %, from 4.6 to 6.6 % of all E. coli isolates. ESBL-positive organisms were associated with increases in drug resistance, particularly amongst fluoroquinolones, trimethoprim, and cephalexin. Multidrug resistance was a feature with 75 % of ESBL+ Klebsiella sp.-resistant ≥6 antibiotic classes. ESBL producers remained largely susceptible to carbapenems. Male gender, urinary catheterisation, inpatient status, and increasing age were identified as risk factors for ESBL infection or colonisation. CONCLUSION: We demonstrate that the incidence of ESBL-producing E. coli in urine cultures is increasing and that such isolates are multidrug resistant. Carbapenems and nitrofurantoin for E. coli infections remain effective, which may guide empirical antibiotic therapy.

Catheter-associated urinary tract infection in a surgical intensive care unit.

BACKGROUND/AIM: Because patients in intensive care units usully have an urinary catheter, the risk of urinary tract infection for these patients is higher than in other patients. The aim of this study was to identify risk factors and causative microrganisms in patients with catheter-associated urinary tract infection (CAUTI) in the Surgical Intensive Care Unit (SICU) during a 6-year period. METHODS: All data were collected during prospective surveillance conducted from 2006 to 2011 in the SICU, Military Medical Academy, Belgrade, Serbia. This case control study was performed in patients with nosocomial infections recorded during surveillance. The cases with CAUTIs were identified using the definition of the Center for Disease Control and Prevention. The control group consisted of patients with other nosocomial infections who did not fulfill criteria for CAUTIs according to case definition. Results. We surveyed 1,369 patients representing 13,761 patient days. There were a total of 226 patients with nosocomial infections in the SICU. Of these patients, 64 had CAUTIs as defined in this study, and 162 met the criteria for the control group. Multivariate logistic regression analysis identified two risk factors independently associated to CAUTIs: the duration of having an indwelling catheter (OR = 1.014; 95% CI 1.005-1.024; p = 0.003) and female gender (OR = 2.377; 95% CI 1.278-4.421; p = 0.006). Overall 71 pathogens were isolated from the urine culture of 64 patients with CAUTIs. Candida spp. (28.2%), Pseudomonas aeruginosa (18.3%) and Klebsiella spp. (15.5%) were the most frequently isolated microorganisms. CONCLUSIONS: The risk factors and causative microrganisms considering CAUTIs in the SICU must be considered in of planning CAUTIs prevention in this setting.

Usefulness of pneumococcal antigen urinary testing in the intensive care unit?

OBJECTIVES: The use of pneumococcal antigen urinary tests is substantially increasing and is associated with a significant cost. The relevant use of this test in the intensive care unit (ICU) should be better defined. Our aim was to define the role of this test in relation to other microbiological tests. We described a series of patients admitted to the ICU for an invasive pneumococcal disease (IPD). PATIENTS AND METHODS: We conducted a retrospective and descriptive study of the microbiological tests used to diagnose IPD in patients admitted to the ICU of the University Hospital in Bordeaux. Our aim was to measure the sensitivity of these bacteriological tests and of the BinaxNOWS. pneumoniae test. RESULTS: Between 2009 and 2013, 148 patients were admitted for an IPD. A lower respiratory tract infection was diagnosed in 96.6% of them (143 patients). The overall ICU case fatality rate was 17.6%. The sensitivity of the pneumococcal antigen urinary test, sputum bacteriological examination, and blood cultures was respectively 83%, 37.6%, and 29.7%. S. pneumoniae was isolated from at least one bacteriological sample in 48.6% of patients, but in 51.4%, the diagnosis was only based on the results of the pneumococcal antigen urinary test. CONCLUSION: We suggest performing a pneumococcal antigen urinary test when an IPD is suspected, only if the bacteriological tests are still negative after 48hours. This strategy would result in a substantial cost saving. Patients would not face any additional risks as the result of the pneumococcal antigen urinary test does not have any impact on the initially prescribed antibiotic therapy.

Prevalence and risk factors for highly resistant microorganisms in urinary isolates from newly admitted patients in the National Rehabilitation Center, Korea.

OBJECTIVE: To determine the prevalence of, and risk factors for, highly resistant microorganisms (HRMO) in urinary isolates from newly admitted patients in a rehabilitation hospital. SUBJECTS: A total of 906 patients transferred to a rehabilitation hospital from other hospitals. METHODS: A screening study was performed from June 2012 through May 2013. Urine samples were collected from transferred patients on admission day. RESULTS: Of the total of 916 patients, 148 (16.2%) displayed growth of HRMO in urine cultures. Gram-negative species had a higher number and ratio of HRMO compared with Gram-positive species (141/325 (43.4%) vs 9/97 (9.3%)). Multivariate analysis revealed that age over 60 years, female sex, recent surgery, and use of urinary catheters were risk factors for HRMO among all admitted patients. Even among patients with bacteriuria, recent surgery and an indwelling urinary catheter were significant risk factors for HRMO colonization. The odds ratio for prevalence of HRMO in patients with 2 or more risk factors was 4.1 (95% confidence interval 2.7-6.1), compared with those with single or no risk factors. CONCLUSION: The prevalence of HRMO in rehabilitation patients was higher than expected. Routine screening of urine culture for HRMO is therefore recommended in rehabilitation patients with multiple risk factors.

[Relevance of the detection of Streptococcus pneumoniae antigen in human urine in the diagnosis of lower respiratory tract infections]. / Relevancia de la detección del antígeno de Streptococcus pneumoniae en orina en el diagnóstico de las infecciones de las vías respiratorias bajas.

BACKGROUND AND OBJECTIVE: Techniques membrane antigen immunochromatographic detecting in urine the pneumococcal polysaccharide C, have developed significantly, increasing requests for antigenuria to clinical microbiology laboratories. We evaluated the impact of the application of this test in the diagnosis of infections of lower respiratory tract. PATIENTS AND METHOD: Six hundred and sixteen determinations were performed by antigenuria BinaxNOW(®) S. pneumoniae in as many patients over 14 years admitted to the Hospital Universitario Virgen de las Nieves (Granada) between November 2010 and March 2011. RESULTS: In 91.1% of patients who were determined antigenuria the presence of respiratory symptoms justified the request. Only 8.4% of 616 antigenurias performed were positive. S. pneumoniae was isolated from the respiratory sample culture in 8 of these 52 patients. In 29.8% of patients the diagnosis of lower respiratory tract infection was based on clinical, radiological and/or analytical, as antigenurias were negative and did not involve any other additional microbiological test. CONCLUSIONS: We believe that this technique should be used in a complementary manner, and never to the detriment of other microbiological tests, especially in hospitalized patients.

Impact of laboratory-reported urine culture colony counts on the diagnosis and treatment of urinary tract infection for hospitalized patients.

Reducing health care-associated urinary tract infection (UTI) is a National Patient Safety Goal. The purpose of this investigation was to establish a colony count threshold to predict clinically significant UTIs that develop in hospitalized patients. A total of 185 cases were reviewed sequentially by 2 physicians. The information extracted included subjective complaints, presence of an indwelling urinary catheter, clinical signs and symptoms, WBC count, urinalysis, and urine culture results. The first reviewer recorded whether the patient was diagnosed and treated for a UTI by the clinician. The second reviewer determined if the patient met National Healthcare Safety Network guidelines for nosocomial UTI. Compared with patients with colony counts less than 100,000 colony-forming units per milliliter (CFU/mL), patients with colony counts 100,000 CFU/mL or more were 73.86 times more likely to have a clinically significant UTI (odds ratio, 73.86; 95% confidence interval, 24.23 ∼ 225.15; P < .0001; c-statistic, 0.859). Reporting positive results only for patients with 100,000 CFU/mL or more would have reduced the number of positive cultures by 38%. These data suggest that reporting colony counts less than 100,000 CFU/mL encourages treatment of non-clinically significant UTIs in hospitalized patients, causing inappropriate antibiotic use.

Evidence-based prescription of antibiotics in urology: a 5-year review of microbiology.

OBJECTIVE: To analyse the results of positive urine cultures over a 5-year period in a large hospital and urology department (amongst both inpatients and outpatients), assess the prevalence of different organisms and the resistance profiles of a range of antibiotics, and thus provide information on which organisms are likely to cause urosepsis. METHODS: The use of antibiotics should be based on knowledge of which pathogens are present and what resistance patterns are emerging, particularly relevant in surgical disciplines like urology, as antibiotics are now routinely administered peri-operatively, whereby evidence-based prescription is preferable to generic guidelines. We therefore examined almost 25,000 positive urine cultures in our hospital over a 5-year period, and focused on the infections encountered amongst urology patients during this time. RESULTS: A significant proportion of inpatient urinary infection (40%) is caused by Gram-positive bacteria such as Streptococcus faecalis, underlining the need for including Gram-positive cover during urological prophylaxis. The commonest pathogen remains Escherichia coli among both inpatients and outpatients. The ineffectiveness of common antibiotics such as ciprofloxacin and trimethoprim was identified, as was the increase in gentamicin resistance. CONCLUSION: We propose using an aminoglycoside with a penicillin for high-risk cases (e.g. endoscopic stone surgery) while low-risk cases (e.g. flexible cystoscopy with no risk factors) might be managed without such prophylaxis. Pathogenic patterns and resistance rates should be monitored regularly.

Epidemiology of antimicrobial resistance among gram-negative organisms recovered from patients in a multistate network of long-term care facilities.

We identified 1,805 gram-negative organisms in cultures of urine samples obtained over a 10-month period from residents of 63 long-term care facilities. The prevalence of fluoroquinolone resistance in Escherichia coli was 51% (446 of 874 isolates), whereas the prevalences of ceftazidime and imipenem resistance in Klebsiella species were 26% and 6% (84 and 19 of 323 isolates), respectively. The prevalence of resistance varied significantly by facility type, size, and geographic location.

[Nosocomial urinary tract infections in the geriatric hospital - pathogen spectrum and resistancies]. / Erregerspektrum und Resistenzanalyse von Harnwegsinfektionen im geriatrischen Akutkrankenhaus - eine Zweijahresanalyse.

We examined 834 isolates of urinary cultures (26 fungi and 808 isolates from 28 bacteria) in an academic geriatric teaching hospital for microbial spectrum and resistance analysis. Of the bacteria, 90% were associated to ten species. Detection rate of MRSA and ESBL was 1%, detection rate for pseudomonas aeruginosa, proteus species, coagulase negative staphylococci and klebsiella species were higher than in an university clinic (p < 0.001). Resistency rates were high for the 10 most frequent bacteria: 53.3% of cross-tabulations between bacterium and antibiotic agent (sulfamethoxazol-trimethoprim, amoxicillin-clavulanate, ciprofloxacin, moxifloxacin, cefuroxim, imipenem) showed resistency rate higher than 10%. We assume that specific factors of geriatric sample taking have an impact to our 2-year resistogram results. It is necessary to combine data analysis from comprehensive geriatric assessment and microbiological methods.

Discordance between perception and treatment practices associated with intensive care unit-acquired bacteriuria and funguria: a Canadian physician survey.

OBJECTIVE: To determine physician practice and perception about the management of intensive care unit (ICU)-acquired bacteriuria and funguria. DESIGN: Cross-sectional, self-administered, Web-based survey. SETTING: All provinces within Canada. PARTICIPANTS: Staff ICU physicians who are members of either the Canadian Critical Care Trials Group or the Canadian Critical Care Society. INTERVENTIONS: Survey items were developed by four ICU clinicians, and survey sensibility was assessed by five independent intensivists. Nonrespondents received three follow-up reminders. Participants were asked questions about general perceptions and practices regarding the management of ICU-acquired bacteriuria and funguria. Clinical scenarios were used to elicit management strategies, including antimicrobial prescriptions. MEASUREMENTS AND MAIN RESULTS: Ninety of 198 physicians (45%) responded. Bacteriuria was perceived by 63% of the respondents to be a frequent but low-morbidity problem. Most intensivists (98%) did not use a protocol for management. Traditional symptoms were rarely used to interpret the significance of bacteriuria. Presence of systemic inflammatory response syndrome (93%), presence of hemodynamic changes (91%), and urinalysis (69%) were used often. Within clinical scenarios, source control via urinary catheter change was not universal, ranging from 44% to 67% in the various scenarios, even in patients presenting with septic shock. Prescription of antimicrobials was common across scenarios despite the low-morbidity perception. In an asymptomatic patient, 19% of respondents would prescribe antimicrobials. Changing the species from fungus to bacteria and the presence of systemic inflammatory response syndrome or shock increased the likelihood of antimicrobial use up to 70% to 80%. CONCLUSIONS: ICU physicians perceive bacteriuria to have low morbidity. However, management approaches vary considerably, and systemic antimicrobials are frequently prescribed. Increased clinical instability and bacterial vs. fungal organisms isolated in urine cultures increased the use of antimicrobials. The considerable variability in practice and discordance between likelihood of urinary tract infection and antimicrobial prescription, highlights the need for additional clinical trials.

Candidemia and candiduria in critically ill patients admitted to intensive care units in France: incidence, molecular diversity, management and outcome.

OBJECTIVE: To determine the concomitant incidence, molecular diversity, management and outcome of nosocomial candidemia and candiduria in intensive care unit (ICU) patients in France. DESIGN: A 1-year prospective observational study in 24 adult ICUs. PATIENTS: Two hundred and sixty-two patients with nosocomial candidemia and/or candiduria. MEASUREMENTS AND RESULTS: Blood and urine samples were collected when signs of sepsis were present. Antifungal susceptibility of Candida strains was determined; in addition, all blood and 72% of urine C. albicans isolates were analyzed by using multi-locus sequence type (MLST). The mean incidences of candidemia and candiduria were 6.7 and 27.4/1000 admissions, respectively. Eight percent of candiduric patients developed candidemia with the same species. The mean interval between ICU admission and candidemia was 19.0 +/- 2.9 days, and 17.2 +/- 1.1 days for candiduria. C. albicans and C. glabrata were isolated in 54.2% and 17% of blood and 66.5% and 21.6% of urine Candida-positive cultures, respectively. Fluconazole was the most frequently prescribed agent. In all candidemic patients, the prescribed curative antifungal agent was active in vitro against the responsible identified strain. Crude ICU mortality was 61.8% for candidemic and 31.3% for candiduric patients. Seventy-five percent of the patients were infected with a unique C. albicans strain; cross-transmission between seven patients was suggested in one hospital. CONCLUSIONS: Candidemia is late-onset ICU-acquired infection associated with high mortality. No difference in susceptibility and genetic background were found between blood and urine strains of Candida species.

Purple urine bag syndrome in nursing homes: ten elderly case reports and a literature review.

Purple urine bag syndrome (PUBS) is a rare occurrence, in which the patient has a purple-colored urine bag following urinary catheterization for hours to days. Most of authors believe it is a mixture of indigo (blue) and indirubin (red) that becomes purple. Previous study showed that PUBS occurred predominantly in chronically catheterized, constipated women. We collected 10 elderly patients with PUBS in two nursing homes. The first two cases were identified by chart review in 1987 and 2003, and then later eight cases (42.1%) were collected among 19 urinary catheterized elderly in the period between January 2007 and June 2007. In the present report, PUBS probably can occur in any patients with the right elements, namely urinary tract infection (UTI) with bacteria possessing these enzymes, diet with enough tryptophan, and being catheterized. Associations with bed-bound state, Alzheimer's, or dementia from other causes are reflections of the state of such patients who are at higher risk for UTI, and hence PUBS occurred. Although we presented PUBS as a harmless problem, prevention and control of the nosocomial catheter-associated UTIs (CAUTIs) has become very important in the new patient-centered medical era. Thus, we should decrease the duration of catheterization, improve catheter care, and deploy technological advances designed for prevention, especially in the elderly cared for in nursing homes.

[Etiological agents of urinary tract infections in children treated at the Institute of Mother and Child]. / Czynniki etiologiczne zakazen ukladu moczowego u dzieci leczonych w Instytucie Matki i Dziecka.

BACKGROUND: Urinary tract is a common site of bacterial infections in children. The main etiological agents of infection are Gram negative bacteria from the Enterobacteriaceae in particular of intestinal origin. The uropathogenic strains may indicate resistance for many antibacterial drugs. AIM: The aim of this study was an analysis of urine samples from outpatient or hospitalized children treated at the Institute of Mother and Child in Warsaw, in the years 2006-2007. The frequency of individual bacterial species and antibiotic susceptibility were investigated. MATERIALS AND METHODS: In all, 2096 urine samples from patients treated at the Institute of Mother and Child were investigated. Bacteriuria was examined and antibiotics susceptibility was estimated. Biochemical tests were used for the identification of uropathogenic strains. Antibiotic susceptibility was examined using standard diffusion discs methods. RESULTS: During 2006-2007, in all 2096 urine samples were taken, of which 313 were positive (14.9%). E. coli was the most often isolated bacteria (54%) and enterococci dominated in Gram-positive bacteria. CONCLUSIONS: Enterobacteriaceae were the most frequently isolated bacteria. Most of the antibiotics used in the treatment of urinary tract infections had high antibacterial activity except for ampicillin.