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Treatment of infections by beta-lactamase-producing microorganisms is very difficult. Our aim was to determine the in vitro susceptibility of 430 ESBL-positive Escherichia coli strains isolated from urinary tract infections. All the microorganisms were isolated in the Microbiology Unit at the Ospedale dell'Angelo in Mestre (Venice) between May 2008 and September 2009 and were confirmed by the double-disk test. All microorganisms were sensitive to imipenem and meropenem, 98.4% to tigecycline, 95.1% to amikacin, 89.3% to nitrofurantoin, 67.5% to gentamycin and 63.2% to piperacillin/tazobactam. Only 22.6% were sensitive to cotrimoxazole, while fluoroquinolone (norfloxacin and levofloxacin) activity was found to be very low (6%).

An aetiology study was conducted into urinary tract infections (UTI) in order to compare hospital infections with those in outpatients identified from samples sent to the laboratory by general practitioners. Urine culture analysis was performed on 3,483 samples of which 740 came from hospital patients and 2,743 from outpatients. The diagnosis of UTI was based on new criteria: not only the assessment of bacterial proliferation but also clinical factors like sex, symptoms, sampling technique and urinary leucocyte count and the traditional threshold of 10 units forming colonies (UFC/ml) was ignored. In other words the following were all considered positive: all bacterial growths > or = 10(5) UFC/ml independent of other data, all those > or = 10(2) UFC/ml in symptomatic women, those > or = 10(3) UFC/ml in symptomatic men and those > or = 10(2) UFC/ml in catheterised patients. In cases supplied with incomplete anamnestic data bacterial proliferations in the 10(2)-10(5) UFC/ml range were considered positive if the leucocyte count was also significant. The frequency of the various micro-organisms isolated from the positive urine cultures of the two group was then assessed. The study revealed that among outpatients relatively innocuous bacterial like E. Coli, Klebsiella and Proteus accounted for over 75% of UTI cases, but less than 44% among hospital patients. By contrast, more "serious" bacteria like Pseudomonas, Acinetobacter and Serratia were identified in about 20% of hospital cases but only about 5% of outpatients. Finally a comparison was made between in- and outpatient multibacterial UTI which were found to be more common and more aetiologically heterogeneous in hospital patients than in outpatients.

11,829 urine cultures, coming from the Pediatrics Department of Florence and other hospital divisions for adults in the period 1st of July-31st of December 1990, have been examined in the Bacteriology and Virology Laboratory of the University Hospital of Florence. Besides illustrating various methods of drawing, preservation and transport of the urinary specimen, the authors showed the incidence of bacterial species responsible of urinary tract infections (U.T.I.). E. coli was showed to be the most frequently isolated bacterial strain, followed by Streptococcus faecalis and Proteus indole negative. The incidence of fimbriated E. coli infections was studied in pediatric and adult patients with urinary tract infections; a higher isolation frequency of fimbriated E. coli was showed in pediatric patients and in these patients the correlation was studied between the presence of fimbriated E. coli and the severity of infection (pyelonephritis, recurrent U.T.I.). The percentages of resistance of the isolated strains against the most common chemotherapies was also showed, studying their variations, for some chemotherapies, during about twenty years.

Fifty patients suffering from prostatic adenoma with asymptomatic bacteriuria, were admitted to an open non comparative trial. Enoxacin was administered at the daily dosage of 300 mg every 12 hours for 10 days. Three cycles of treatment were performed during three consecutive months. Treatment efficacy was established by assessing patient symptoms related to the infection such as pollakiuria , nocturia, decreased flow rate, stranguria, daily temperature. Cultural tests were also performed. All observations were collected at baseline and at the end of each cycle of therapy. Cure was obtained in 43 patients (87, 75%), 1 patient (2,04%) relapsed, 5 patients (10.2%) withdrew because of inefficacy of treatment and 1 patient died of heart failure. No side effects were observed. These results suggest that enoxacin may be successfully used in the treatment of asymptomatic bacteriuria.

We report the results of a study carried out upon samples of urine from 19,021 patients in various departments of medical school in Sassari and in the hospitals of Alghero and Ozieri. The 34.7% of samples examined proved to be positive. Among these we isolated Escherichia coli (32%), Proteus spp. (24%), Staphylococcus (12%), Klebsiella-Enterobacter-Serratia (KES) spp. (9%), Pseudomonas spp. (5%). We found microbic associations in 11% of cases. We also studied the sensitivity of microorganisms to various chemoantibiotics, and the efficacy of therapy on 964 patients. In the various checks made, the results point out a persisting positivity (53%). E. coli strains show a major sensitivity to the various antibiotics (aminoglycosides, quinolones, cephalosporins, etc.); Proteus spp. and KES are less sensitive; Pseudomonas spp. strains are very resistant and respond mainly to norfloxacin and ceftazidime.

ABACTO-SCREEN is an automated turbidimetric system for rapid screening of bacteriuria composed by a multichannel photometric instrument and an original disposable. In this study the system has shown good sensitivity (6.9% of false negative results on the true positives) and specificity (22.4% of false positive results on the true negatives) when on assuming 100,000 colony forming units (CFU)/ml as a threshold of positivity. Comparison with Abbott MS-2 has revealed better performances for sensitivity and comparable specificity. False negatives analysis has revealed probable influence of anaerobic bacteria in the plate counting or slowing in culture broth growth cause by antimicrobial substances in urine samples.

The count of bacteria in fresh, unstained, uncentrifuged urine specimens, using a phase-contrast microscope, magnification X400, and a hemocytometer chamber, is a simple method to exclude urinary tract infection. The specificity of this method is 94%, while the sensibility is 66%. We exclude an urinary infection when the count is less than 5 bacteria/0.1 ml. If we add to bacteria the evaluation of pyuria, the sensibility of this method does not change. On the contrary what we observe is an increase of the false positives. Bacteria more easily identified in urine specimens are E. Coli and Klebsiellae; the bacterioscopy has confirmed respectively 82% and 100% of positive urinecultures. The corresponding values for Protei and Streptococci are 23% and 20% respectively. This method is very simple also for teaching; it requires only a few minutes and is inexpensive. Its most useful utilization is the exclusion of urinary tract infection when the concentration of bacteria in the urine is less than 5 bacteria/0.1 ml.

A comparison between direct and standardized disk diffusion tests was made on a total of 116 urine specimens containing greater than or equal to 10(5) organism/ml and on a total of 229 clinical specimens others than urine. The number of major discrepancies per organism tested in pure culture was 31 (39.7%) for urine and 102 (59.6%) for other specimens. Although this procedure may be of value in selected cases with pure cultures of organism, its use on a routine basis is not recommended.

Urinary infections often complicate the clinical course of hospitalised patients especially those with immunological diseases or under antibiotic treatment for other infectious pathologies. Urethral catheterisation is also a well known cause of such infections. The problem of urinary infections was examined in a general medical division. Over a three year period (1982-84), 384 urinary tract infections (UTI) with one infecting organism and 21 UTI with two bacterial species in urine cultures were found. UTI was more often found to be caused by gram negative than gram positive bacilli in both catheterised and non-catheterised patients and E. Coli accounted for most infections. Pseudomonas, Serratia and Acinetobacter were only found in catheterised patients and Enterobacter cloacae almost exclusively so. Among gram-positive bacilli, Enterococcus was the most common. Staphylococcus aureus was rare but created major pathogenetic and therapeutic problems. The results are discussed with particular reference to the high incidence of Escherichia coli and the significance of the different distribution of Pseudomonas, Serratia, Acinetobacter and Enterobacter cloacae between catheterised and non-catheterised patients. Finally the pathogenic and therapeutic problems of UTI caused by more than one germ are considered.

A streep test has been employed for bacteriuria involving identification of nitrites in the urine and results are compared with those obtained with classical bacteriological techniques. Parallel performance of the nitrite test and urine culture showed that the latter cannot be replaced as far as diagnosis goes but it also proved the usefulness of the nitrite test for mass screening purposes.

Described the most important taxonomical, bacteriological, clinical and epidemiological aspects of microorganisms of Flavobacterium genus, the author refer about 8 strains of Flavobacterium odoratum isolated from urine (6), sputum (1), surgical exudate (1). In some cases, etiopathogenetic possible correlation between isolates and clinical disease discussed, the author emphasizes the large antibiotic resistance kind of this species of microorganism non fermenter.

Authors take into account the Salmonellae isolated at Gela in the microbiology's laboratory that is connected at the Division of infectious diseases of The Hospital V. Em. III of Gela, during period of two years. They notice how S. Wien is most diffuse and it presents some characteristic like the S. Wien isolated in Algeria. They suppose, so, the possibility that S. Wien is arrived to Gela from Algeria, because of the intense trade exchanges that this town has with North Africa. They argue, for an efficacious work of prophylaxis of the Salmonellosis, that in all hospitals rise some Microbiology's laboratories and that they can arrive, always, at the serologic classification of the Salmonellae.

Hundred-six-fifty-one samples of urine obtained from external (460 samples) and hospitalized (191 samples) patients with suspected urinary tract infections (UTI) were analysed for bacterial flora isolation, identification of microorganisms and evaluation of their sensitivity to antimicrobial agents. 89 and 215 bacterial strains were identified in samples obtained respectively from external and hospitalized patients. E. coli was the dominant cause of community acquired UTI (68.59%), while the causative agents of UTI in hospitalized patients were Streptococcus faecalis (18.61%) and E. coli (13.96%).

The authors illustrate a screening for bacteriuria performed on 348 samples of urine by patients occurred to observation in two Departments of Internal Medicine from October 1973 to October 1974. The technique to sampling urine has been the meadstream. Colony counts of over 10(5) germs per ml or urine were shown in 100 cases. Selective culture media were used for urinary bacteria identification. The AA. show a series of considerations on the pathogenetic significance of microbial cell concentration in urine and on the frequency of the isolated species. They consider the age, the sex and the concomitant diseases of the 100 cases occurred to their observation. Furthermore, the AA. reported the results of research on the antibiotic sensivity test and on the resistance to chemioantibiotics of urine bacterial flora. These bacterioloyical tests are finally suggested by the AA. as indispensable in the valuation and the therapeutic control of the urinary infections.

A study was made of 1050 urine specimens from the Nephro-Urological and Geriatric Departments of the Malpighi Hospital to see how many percent contained antibacterial substances and the incidence of bacteria species. 26.5% contained antibacterial substances. Proteus rettgeri was significantly more frequent in specimens containing such substances, whereas staphylococci were significantly more frequent in the remainder.

A further investigation on about 2700 urine samples for testing the presence of antimicrobial drugs (spot-test) has been carried out. Bacteriostatic agents were present in 35% of all samples analysed, Of these, 47% were urines producing no growth on culturing, 10% had a bacterial count of 10(4) and 43% of 10(5) or more. The frequency of the spot-test positive samples was correlated to the origin from the different Hospital Departments. Gram-positive bacteria were the most represented in the samples without antimicrobial agents, while the frequency of Pseudomonas aeruginosa rised in samples with antimicrobial drugs. Under both conditions no significant variation in the antibiotic-sensitivity pattern was noted in organisms isolated from the urines. Only indole-positive Proteus appeared to be more sensitive when isolated from samples containing no antimicrobial agents.

A randomized clinical study was conducted in order to compare the effectiveness of norfloxacin and cinoxacin in complicated urinary tract infections. Norfloxacin proved effective in 80% of the 40 patients treated, cinoxacin in only 60%.