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.

Retrospektivno su analizirane klini~ke i epidemiolo{ke karakteristike bruceloze u 91 bolesnika koji su bili hospitalizirani u Klinici za infektivne bolesti u Tuzli od 1.1.2000. godine do 1.8.2008. godine. Definitivna dijagnoza bruceloze postavljena je na temelju pozitivnih rezultata hemokulture i/ili nekog od relevantnih serolo{kih testova (ELISA test, ROSE-BENGAL aglutinacija). Ve}ina bolesnika bila je iz 5 op}ina Tuzlanskog kantona: @ivinice, Tuzla, Lukavac, Kalesija, i Srebrenik, ukupno (81,3 %) bolesnika. Najve}i broj bolesnika (93 %) bio je iz ruralne regije. Bilo je znatno vi{e mu{karaca (82,4 %). Ve}ina bolesnika bila je u dobi od 20 – 29 godina i 50 – 59 godina po 25,3 %. Najvi{e bolesnika bilo je hospitalizirano u proljetnim mjesecima, travnju 24,1% i svibnju 23,0 %. Kontakt s inficiranim `ivotinjama registriran je kod 82,4 % bolesnika. Vode}i simptomi i znaci bolesti bili su povi{ena temperatura, bolovi u zglobovima, op}a slabost, no}no znojenje, glavobolja, hepatosplenomegalija, a najva`niji patolo{ki laboratorijski nalazi ubrzana sedimentacija eritrocita i povi{ena vrijednost C-reaktivnog proteina. Bolesnici su lije~eni kombinacijom streptomicina ili gentamicina s doksiciklinom u odraslih, ili gentamicinom i trimetoprim-sulfametoksazolom u djece, u trajanju 6 tjedana. Komplikacije su dokumentirane u 23,0 % mu{karaca i 1,1 % `ena. Orchiepididimitis je utvr|en u 6,5 %, pneumonija 4,3 %, periferni artritis 4,3%, spondilitis 3,2 %, sakroileitis 2,1 %, epiduralni absces u 2,1 % i spondilodiscitis u 1 % bolesnika. Relaps je zabilje`en u 13,1 % bolesnika. Svi bolesnici su izlije~eni. Bruceloza je rastu}i javno-zdravstveni problem u Tuzlanskom kantonu, ali i {ire u Bosni i Hercegovini.