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A retrospective analysis of urine culture results was conducted for adult patients treated between 1 January 2017 and 31 December 2021 at the Department of Gastroenterology in Rzeszow (southern Poland). A total of 102 patients were sampled for microbiological tests during the analyzed period, with microbial growth found in 30 samples. The purpose of our study was to determine the predominant bacterial species present in the urine of patients hospitalized in the Department of Gastroenterology, as well as their drug susceptibility. The data obtained from medical records included, for example, urine culture results and the antibiotic susceptibility of the isolated microorganisms. The material for the study was collected according to the current procedures. During the analyzed period, urine was collected from a total of 102 patients, and 30 positive samples were found. The predominant pathogen was Escherichia coli (n = 10 (33.33% of all positive results), p < 0.001); the second most common microorganism was Enterococcus faecalis (n = 5 (16.67% of all positive results), p < 0.001). In vitro susceptibility testing showed E. coli, ESBL (ESBL strain with extended-spectrum beta-lactamase) (n = 2 (6.67% of all positive results), p = 0.055) and Klebsiella pneumoniae, ESBL (n = 3 (10% of all positive results), p = 0.005). Urinary tract infection (UTI) was an extremely common problem. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding the study which identifies mediated colistin resistance- (MCR-1) producing organism in Poland through polymerase chain reaction (PCR).

Proteus mirabilis strains ability to form biofilm is a current topic of a number of research worldwide. In this study the biofilm formation of P. mirabilis strains derived from urine of the catheterized and non-catheterized patients has been investigated. A total number of 39 P. mirabilis strains isolated from the urine samples of the patients of dr Antoni Jurasz University Hospital No. 1 in Bydgoszcz clinics between 2011 and 2012 was used. Biofilm formation was evaluated using two independent quantitative and qualitative methods with TTC (2,3,5-triphenyl-tetrazolium chloride) and CV (crystal violet) application. The obtained results confirmed biofilm formation by all the examined strains, except quantitative method with TTC, in which 7.7% of the strains did not have this ability. It was shown that P. mirabilis rods have the ability to form biofilm on the surfaces of both biomaterials applied, polystyrene and polyvinyl chloride (Nelaton catheters). The differences in ability to form biofilm observed between P. mirabilis strains derived from the urine of the catheterized and non-catheterized patients were not statistically significant.

Introduction: Next to official surveillance system in Poland, established by Public Statistic Act in 1995, other surveillance data collection system exists - historically connected with Ministry of Health Decree, which is not in force from 1995 y. Data in this system comes from National Sanitary Inspection laboratories and contains results of clinical samples examinations for Salmonella and Shigella presence., Material and Methods: Analysed data were collected since 2007 to 2014 y. Database has been created, which contains data - results of Salmonella / Shigella (SS) detection in faecal samples, rectal swabs, urine samples, blood samples collected from patients, people exposed in outbreaks, Salmonella carriers, food workers and other people., Results: The number of performed tests for SS in 2014 is 447033. Systematic decrease of this number has been observed since 2008. Most common material tested for SS was stool samples, then rectal swabs. Number of Salmonella identification going down each year during analysed time. The highest decrease in group of sick people has been observed. Most common serotype in 2008-2014 years was S. Enteritidis, then S. Typhimurium. Only in 2010 y. second most common serotype was S. Mbandaka. In 2014 y. highest number of S. enterica 1,4,[5],12:i:- has been observed (37 cases)., Conclusions: The reason of decreased number of performed SS test and positive Salmonella results is unclear. One of theories is decreased level of quality of SS diagnostic. From the other hand, decreased number of false-positive Salmonella identification outside of National Sanitary Inspection laboratories is observed. This demonstrates improving quality of Salmo nella diagnostic in laboratories performing such tests. High disproportion between number of Salmonella cases in described database and official notification system is observed. It comes from, that both systems collect different data. Both systems could exist independently and could supplement each-other.

This article presents the results of a preliminary study concerning cases of Chlamydia trachomatis infections among professional soldiers in the Polish Armed Forces. Soldiers who declared casual sexual contact with women were investigated in this study regarding the transmission of chlamydial infections by sexual activity. In total, 66 healthy, sexually active professional Polish soldiers, aged between 27 and 44, who didn't report any symptoms of urogenital infection were investigated. Urine samples taken from these patients were investigated using molecular methods (Cobas TaqMan, real-time PCR) in March-April 2012 in the Military Institute of Medicine, Warsaw, Poland. In the investigated group of 66 Polish soldiers, two 33-34 year old men were asymptomatic carriers of Chlamydia trachomatis (3.0%). They confirmed having casual sexual activity without prevention with many women. In the examined group of Polish soldiers the relatively low level of chlamydial infections found may result from the use of preventive measures during sexual activity. According to the examined men, the common use of condoms is mainly connected with the fear of HIV infection. Screening tests for Chlamydia trachomatis in the Polish Armed Forces are not performed, therefore incidence rates of chlamydial infections remain unknown. The authors plan further investigations with a larger group of professional soldiers.

Introduction: The objective of this study was to analyze the fungal infections in patients of an intensive care unit (ICU) in a long period (2002-2012) on the example of the Lodz Medical University Hospital No 1. This analysis was focused on the study of the effect of antimicrobial therapy on the level of these infections., Methods: A total of 291 strains of fungi were isolated from blood, tips of central intravenous catheters, lower respiratory tract, urine, wounds, pressure sores, and cerebrospinal fluid of 3177 patients. An automatic system Bactec 9050, Yeast ID Phoenix BD panels and E-tests (BioMerieux) were used for the fungi analysis., Results: The studies were mainly concentrated on the Candida infections, distinguishing cases caused by C. albicans and C. non-albicans pathogens. Changes in the number of these infections in consecutive years have been associated with epidemiological and therapeutic activities in the ICU. Particularly, relationships between the number of infections and the use ofceftazidime were discussed. A statistically significant positive correlation of the count of Candida infections and the ceftazidime consumption was found in the period to 2006. In the later years, the correlation was destroyed as a result of other important therapeutic factors (eg, immunosuppressive drugs)., Conclusions: It has been found that the number of Candida infections in the ICU depends on the consumption of antimicrobial drugs. This conclusion is based on quantitative example of ceftazidime. Only close cooperation between the ICU and microbiologists is able to provide a reduction in nosocomial fungal infections.

Introduction: Multidrug-resistant gram-negative non-fermenting bacilli are an important cause of nosocomial infection. Aim of this study was to analyze the prevalence and antimicrobial susceptibility of rods of the species Acinetobacter baumannii and Pseudomonas aeruginosa, belonging to multidrug-resistant alert pathogens., Methods: 105 (70%) strains of A. baumannii and 46 (30%) strains of P. aeruginosa were isolated from 125 patients hospitalized in the Specialistic Hospital in Krakow, in the years 2008-2010. Taken into account first isolate from the patient. The condition for inclusion in the study was the resistance or reduced susceptibility to selected groups of antibiotics, such as beta-lactams, aminoglycosides and fluoroquinolones. Bacterial identification and antimicrobial susceptibility testing were performed by automated system Vitek 2 Compact (bioMerieux, Poland). All strains were tested with phenotypic method Etest MBL (AB Biodisk, Sweden) for the presence of resistance mechanism associated with the production of metallo-beta-lactamases., Results: Bacilli of the species A. baumannii were isolated most frequently from patients from the Department of Anesthesiology and Intensive Care (52%) and Burn Therapy Unit (25%), with clinical materials collected from the respiratory tract (51%), the wound swabs (18%), urine (11%) and blood (11%). Production of metallo-beta-lactamases was found in 24 (22.9%) strains of A. baumannii. Drugs effective against multidrug-resistant isolates of A. baumannii were colistin and amikacin. Department of anesthesiology and intensive care (59%) and unit of internal medicine (11%) were the main source of multidrug-resistant strains of P. aeruginosa. Pathogens were mainly isolated from clinical specimens collected from the respiratory tract (61%), urine (15%) and wound swabs (13%). Seven (15.2%) strains of P. aeruginosa produced the metallo-beta-lactamases. With regard to colistin and piperacillin with tazobactam was noted the highest percentage of susceptible isolates., Conclusions: MDR bacteria belonging to alert pathogens are an important cause of many severe and difficult to treat infections which greatly increases the morbidity and mortality among hospitalized patients worldwide. Epidemiological studies and detection of local resistance patterns can provide useful information which can be used in the development of strategies to combat the rising tide of microbial antibiotic resistance.

Introduction: Gram-negative bacteria belonging to the family Enterobacteriaceae cause severe and difficult to treat nosocomial infections. Strains of different species that produce extended-spectrum beta-lactamases (ESBL) were classified as alert pathogens. The purpose of this study was to analyze the occurrence and determination of antimicrobial susceptibility patterns of 134 ESBL-producing Enterobacteriaceae strains., Methods: 96 (72%) isolates of Klebsiella pneumoniae and 38 (28%) isolates of Escherichia coli, were cultured from patients of Specialistic Hospital in Krakow, in the period from 2008 to 2010. Bacterial identification and antimicrobial susceptibility testing were performed by automated system Vitek 2 Compact (bioMerieux, Poland). Condition for inclusion in the study was the production by the strains of beta-lactamases with extended substrate spectrum (ESBL), which was confirmed using the automated method (Vitek 2 Compact system) and the disc-diffusion assay (DDST). Taken into consideration the first isolate from the patient., Results: Bacilli of the species K. pneumoniae ESBL(+) were mainly isolated from respiratory tract samples (46%), urine (27%) and blood (12%). The dominant divisions in terms of frequency of isolation of these pathogens were anesthesiology and intensive care (42%), neurology and brain strokes (16%) and internal medicine (11%). Drugs with the highest efficiency against K. pneumoniae ESBL(+), in our in vitro studies, were: imipenem (100%), meropenem (100%), amikacin (90%) and tetracycline (75%). E. coli ESBL(+) isolates derived from patients of Anesthesiology and Intensive Care Unit (32%), Internal Medicine Unit (16%) and Division of Hematology (13%). Among all tested strains majority were obtained from respiratory tract samples, urine, swabs from wounds and blood (respectively 24%, 24%, 21% and 18%). Isolates of E. coli ESBL(+) demonstrated the greatest susceptibility in case of amikacin (92%) and piperacillin with tazobactam (76%), which suggests the highest activity of that antimicrobials against infections caused by examined strains. None of the analyzed bacilli were resistant to carbapenems., Conclusions: Our study highlights the importance of characteristics of distribution of ESBL-producing K. pneumoniae and E. coli strains among hospitalized patient. Good antibiotic policies based on antibiotic resistant patterns can decrease the risk of ESBL infection.

Seven Proteus mirabilis strains from five Polish patients (five isolates from urea and two from feces) appeared to be a bacterial clone widespread in hospitals, most probably due to nosocomial infection and autoinfection. Enzyme-linked immunosorbent assay and Western blot showed that lipopolysaccharides from all strains studied are serologically identical to each other but distinct from Proteus lipopolysaccharides studied earlier and, hence, these strains could not be classified in any of the currently existing 77 Proteus O-serogroups. Accordingly, structural analysis of the O-polysaccharide of a representative strain 1B-m revealed a structure that is typical of Proteus O-antigens but is unique in detail. Based on these data, we propose to classify the strains studied as a new serogroup in the genus Proteus named O78.

The study was an analysis of the frequency of urine bacterial isolation in hospitalized children as well as an evaluation of their susceptibility to antibiotics used in urinary tract infections (UTI). The analysis focused on microbiological urine tests carried out between January 2006 and December 2008. Altogether, 311 strains were obtained, of which E. coli (50.8%) and E. faecalis (13.5%) were the most frequently isolates. The highest percentage of Enterobacteriaceae were sensitive to ceftazidime (92%); to a lesser degree to amoxicillin/clavulanic acid (85%), to trimethoprim/sulfamethoxazole (84%), to nitrofurantoin (82%), to cefuroxime (81%), to cefalotin (66%) whereas only 24% were sensitive to ampicillin. ESBLs were produced by 8% of all Enterobacteriaceae strains. P. aeruginosa strains were totally sensitive to ceftazidime; over 90% - to piperacillin and aminoglycosides, and 77% to carbenicillin. Staphylococci manifested 100% sensitivity to nitrofurantoin. Only 20% of S. aureus were sensitive to trimethoprim/sulfamethoxazole and to trimethoprim; in the case of S. epidermidis: 83% and 67% respectively. No resistant strains were found among S. agalactiae and E. faecalis. E. faecium strains, in turn, were resistant to ampicillin and often to nitrofurantoin (64%), to vancomycin (VanB; 45%) and to high aminoglycoside concentrations (HLAR; 45%).

P. aeruginosa rods are dangerous pathogens mainly responsible for nosocomial infections of different localization. Resistance to carbapenems, observed among them, is a serious threat due to ability to be transmitted between bacterial species. The aim of our study was to retrospectively evaluate the frequency of isolation and susceptibility to antibiotics of imipenem- and meropenem-resistant P. aeruginosa strains isolated between 1998 and 2009 from patients of University Hospital No 1 of dr A. Jurasz in Bydgoszcz. Study shows increasing number of isolation that type of strains from 19 in 1998 to 144 in 2009. Among all isolated P. aeruginosa strains majority was obtained from patients of the Intensive Care Units, Rehabilitation and Surgery Clinics. Examined strains of P. aeruginosa rods were mainly isolated from urine (20.5%), bronchoalveolar lavage (17.7%) and wound swabs (14.5%) samples. The isolates demonstrated frequently resistance to carbenicillin (> or 66.7%), ticarcillin (> or = 72.7%) and cefotaxime (> or = 75.6%). The lowest rate of resistant strains was observed in case of ceftazidime (< or = 68.8%), aztreonam (< or = 47.4%) and colistin (< or = 1.7%) suggesting the highest activity of that antimicrobials against infections caused by examined strains.

Proteus sp. rods are opportunistic human pathogens, isolated mainly from urinary tract infections. They are naturally susceptible to most antimicrobials. However, acquisition of genes for extended spectrum beta-lactamases on plasmids and irrational antimicrobial treatment increase amount of multidrug resistant strains and lead to their selection. The aim of this study was to evaluate production of ESBLs by double disc synergy test and antimicrobial susceptibility of P mirabilis strains by disc diffusion method. Strains included into the study were isolated from patients of dr A. Jurasz University Hospital No 1 in Bydgoszcz between 2007 and 2009. P mirabilis strains were isolated mainly from urine. In this study 10,4%, 18,7% and 14,4% ESBL(+) P mirabilis strains were isolated in 2007, 2008, 2009, respectively. Resistance to majority of the investigated antimicrobials was observed in ESBL(+) P mirabilis strains.

Background: the basis of urinary tract infection (UTI) diagnosis in children is based on positive results of microbiological tests. The selection of an antimicrobial drug for empirical treatment and prophylaxis of UTI is determined by the susceptibility of bacterial strains isolated from urine cultures., Aim: Determination of the etiology of urinary tract infections and drug sensitivity of the pathogen in hospitalized children., Materials and Methods: we performed quantitative analyses of 2522 urine cultures from children admitted to the Department of Paediatrics at Warsaw Bielany Hospital, from January 2004 to December 2006. We obtained 456 positive urinary cultures, which accounted for 18.1% of urinary samples (14.7%; 17.9%; 21.2% in successive years)., Results: in 392 (86%) cases the urinary infection was caused by one of the isolated pathogens: Escherichia coli, Klebsiella spp. or Proteus mirabilis. Escherichia coli was the most frequently isolated pathogen (70-74%). We noted that the frequency of isolating of Klebsiella spp. grew from 6 to 10%, whereas that of Proteus mirabilis fell from 10 to 2% in the same years. Likewise, in the period from 2004-2006 we observed the same level of the susceptibility of Gram-negative bacteria to nitrofurantoin (84-88%) and trimethoprim-sulfamethoxazole (90-91%), whereas we observed a non-statistically significant lowering of susceptibility to aminopenicillins, and aminopenicillins combined with beta-lactamase inhibitors (from 92 to 74%; p=0.2). There was a statistically significant decrease in drug susceptibility to nitrofurantoin (from 86 to 60%; p<0.05). However, because the groups of children treated with nitrofurantoin were small (6-8-11 in successive years) further studies are needed., Conclusion: studies into the etiology of UTI and drug susceptibility of the pathogens in hospitalized children could facilitate correct management of patients receiving empirical treatment and prophylaxis of UTI. Of concern is the noted decrease in the sensitivity of the most frequent pathogen, Escherichia coli, to aminopenicillins and aminopenicillins combined with beta-lactamase inhibitors.

The aim of this study was to evaluate the frequency of isolation and antimicrobial resistance testing of non-fermentative rods isolated from clinical specimens from patients hospitalized in Korczak Pediatric Center of Lower Silesia in Wrocław. The susceptibility of bacteria to selected antibiotics was determined. The commonest pathogens were Pseudomonas rods (81.8%) isolated from respiratory system and urine of patients hospitalized in unit intensive care. Variety of resistance patterns were detected in bacteria. ESBL were detected the most of S. maltophilia. Strains of Pseudomonas and Acinetobacter resistant to carbapenems were detected with a frequency of 5.5% and 35.9%.

We have analyzed 40 metallo-beta-lactamase (MBL)-producing isolates of Pseudomonas aeruginosa (n = 38), Pseudomonas putida (n = 1), and Acinetobacter genospecies 3 (n = 1) from 17 hospitals in 12 cities in Poland that were identified in 2000 to 2004. Pulsed field gel electrophoresis typing classified the P. aeruginosa isolates into eight types, with two types differentiated further into subtypes. Each of the types was specific either to a given center or to several hospitals of the same or neighboring geographic area. Almost all of the organisms produced beta-lactamase VIM-2; the only exceptions were several P. aeruginosa isolates from two centers which expressed VIM-4. The bla(VIM) genes resided exclusively within class 1 integrons, and these were located in either chromosomal or plasmid DNA. PCR-restriction fragment length polymorphism study of the variable regions of the integrons, followed by DNA sequencing, revealed the presence of eight different, mostly novel gene cassette arrays, six of which contained bla(VIM-2) and two of which contained bla(VIM-4). The occurrence of the integron variants correlated well with the geographic distribution of the MBL-producing organisms, and this suggested that their emergence in particular parts of the country had been likely due to a number of independent events. The following regional dissemination of MBL producers could be attributed to various phenomena, including their clonal spread, horizontal transmission of resistance determinants, or both. All of the data collected in this study revealed that even at this early stage of detection, the epidemiological situation concerning MBL producers in Poland has already been complex and very dynamic.

The aim of this study was to isolate, identify and determine a drug susceptibility of bacterial uropathogens cultured from outpatients in 2002-2003. In total, 4211 urine samples were examined, among which 1942 were positive. 2086 bacterial strains were cultured. Escherichia coli strains (1094) dominated, which were etiological agents of over a half of urinary tract infections (UTIs). Uropathogens isolated from outpatients were susceptible to many antibacterial agents.

Introduction: Over the last years, systemic fungal infections have dramatically increased in hospitalized patients. The Candida is the main pathogen caused nosocomial fungal infections., The Aim of the Study: The aim was to analyze frequency of occurrence of the yeast-like fungi in different biological materials isolated from the patients of an Intensive Care Unit of the University Hospital of Lodz in the period of 2000-2003., Material and Methods: 123 strains of fungi were analyzed with the use of API 20 C AUX test (bioMarieux)., Results: Among all the investigated Candida strains C. albicans accounted for 52.0%. Samples from respiratory system and urine most often contained the strains of C. albicans (56.3 and 60.5%, respectively); blood samples contained C. parapsilosis (44.8%). In patients who were untreated by bacterial antibiotics C. albicans was the most frequent species, whereas in patients who were ordered bacterial antibiotics it was C. parapsilosis that dominated., Conclusions: (1) Candida is the most frequent cause of fungal infections in patients hospitalized in an intensive care unit. (2) C. parapsilosis is the main pathogen caused bloodstream infections. This species is also more frequent in patients who were ordered antibacterial antibiotics over five days. (3). Species other than C. albicans become more and more frequent and dangerous.

The study consisted of microbiological urinalysis performed in 269 patients after renal transplantation who remained under medical care at the Outpatient Service of the Transplantation Institute in Warsaw. The patients enrolled into the study had undergone renal transplantation 6 to 72 months before urine samples were collected. 304 urinalysis were performed. In the group of 269 patients, 42 individuals had bacteria in their urine what was confirmed in 47 urine cultures. Cases of bacteriuria were divided into 5 groups: 5 cases of symptomatic urinary tract infection (5 individuals--2% of all studied patients), 27 cases of asymptomatic bacteriuria in 22 individuals (8% of all studied patients), 5 cases of insignificant bacteriuria in 5 patients (2%), 10 cases of involuntary urine contamination in 10 cases (4%). Eventually, urinary tract infection (UTI) was established in 27 patients (5 cases of symptomatic UTI and 22 cases of asymptomatic UTI) what makes out for 10% of all studied patients. In cases where urinalysis showed significant bacteriuria, following pathogens were detected in urine cultures: Escherichia coli: 22 strains, Enterococcus faecalis--4 strains, Enterobacter cloacae--2 strains and 1 strains of Ralstonia picketii, Streptococcus uberis, Pseudomonas aeruginosa and Proteus mirabilis. Over 90% of Gram-negative bacteria were susceptible to ceftriaxone and ceftazidime, as well as to amikacin and aztreonam which are the drugs usually administered intravenously in hospitalized patients. The only drug of similar efficacy, which could be administered orally in outpatients was fosfomycin.

Proteus sp. are opportunistic microorganisms which cause urinary tract and wounds infections, bacteriaemia and sepsis. The aim of this study was analysis of prevalence of multidrug-resistant Proteus sp. strains in clinical specimens and evaluation of their susceptibility to selected antibiotics. The study was carried out of 1499 Proteus sp. strains were isolated in 2000-2003 from patients of departments and dispensaries of the University Hospital CM in Bydgoszcz UMK in Torun. The strains were identified on the basis of appearance of bacterial colonies on bloody and McConkey's agars, movement ability, indole and urease production and in questionable cases biochemical profile in ID GN or ID E (bio-Mérieux) tests was also included. Antibiotic susceptibility was tested by disk diffusion method. Isolated strains were regarded as multidrug-resistant when they were resistant to three kinds of antibiotics at least. Received Proteus sp. the most frequently belonged to P. mirabilis species (92.3%). Most of these bacteria were isolated from urine from patients of Rehabilitation Clinic. All of multidrug-resistant strains were resistant to penicillins and cephalosporins, 98.9% to co-trimoxazole, 77.7% to quinolones, 63.8% to tetracyclines, 38.5% to aminoglycosides, 19.3% to monobactams and 3.4% to carbapenems. Almost 25% multidrug-resistant Proteus sp. produced ESBL.

One of the most important reasons of complications after organ transplantation may be the infections. The aim of the present work was to analyse of microorganisms isolated from patients, which were the recipients for kidney transplantation in 2001 year. The diagnostic material contained 140 samples from 53 patients, 40 (22.2%) samples from Euro-Collins fluid used for kidney storage before the transplantation and 3 end-pieces of catheter. The positive cultures were found in 125 (69.4%) samples. Gram-positive bacteria constituted 58.4%, Gram-negative bacteria--34.2%, fungi--7.4%. 140 strains of microorganisms were isolated from pharyngeal swabs and 55 strains of bacteria were isolated from palm swabs. Most of them were considered as a physiological flora. It was found 4-time significant bacteriuria among positive cultures from urine samples. In the cultures of fluid used for kidney storage 12 (30.0%) positive samples were obtained, out of which 16 strains of microorganisms were isolated. Among the strains of Staphylococcus 35.3% were MR. Among 18 strains of Gram-negative rods one strain was multiresistant to antibiotics. None of analyzed strains was ES beta L-producing. A high percentage of positive cultures from fluid used for kidney storage suggests the possibility of contamination of the organ with bacteria coming from kidney donor or during the storage, transport and actions connected with taking the organ to the transplantation.

From 1992 till the end of 1994, three epidemics of Q fever among people have been recognised in Poland. In 1992 the outbreak of Q fever was detected at the farm near Jawor in Legnica district. Coxiella burnetii infection was recognized serologically in 25 persons (27 tested). Titres of serum antibodies ranged from 8 to 256. It has been found that cattle were the source of human infection. C. burnetii strain has been isolated from the bull semen. In the same year, Q fever was recognized among 18 workers of the tannery in Myślenice, in Kraków district. Antibodies to C. burnetii, in titres from 8 to 2048, were detected in all 18 persons who had a contract with imported skins of wild animals. Serological tests performed again in 1994 showed that elevated titres of serum antibodies persisted in 10 of 14 persons and 9 of them developed phase I antibodies also. Since 1993 several cases of Q fever have been observed among people living in various regions of the country. Epidemiological investigations have revealed that infected patients are seasonal workers employed during the shearing time in Spain. Specific serum antibodies reached titre 512. The strains of C. burnetii were isolated from urine and semen of 2 patients.