Objective – Research was undertaken with the aim of analyzing the frequency of causes of bacterial meningitis (BM) in children before and after introduction of the conjugate vaccine against Haemophilus influenzae type b (Hib vaccine), and to analyze the age of patients and disease outcome.  Materials and methods – Data from the medical records of patients, age 1 month to 14 years, who were treated for BM at the Infectious Diseases Clinic Tuzla, in the period from 01.05.1999 to 30.06.2009 were analyzed as a retrospective cohort study. In relation to the introduction of the Hib vaccine the patients were divided into prevaccinal and postvaccinal periods.  Results – 140 children were treated for BM. The most common pathogens were Haemophilus influenzae (13.6%), Neisseria meningitidis (8.6%) and Streptococcus pneumoniae (5.7%). In the prevaccinal period there were 94 and in the postvaccinal 46 children (13 of them had been vaccinated). The number of BM cases decreased from 17.1 (prevaccinal period) to 10.2 (postvaccinal period) per year. The number of children hospitalized with BM caused by Neisseria meningitidis significantly decreased in the postvaccinal period (Fisher’ exact test, p=0.009), and Streptococcus pneumoniae was the most common cause of BM in the postvaccinal period (Fisher’ exact test, p=0.015). The frequency of Haemophilus influenzae as a cause of BM also significantly decreased in the postvaccinal period (Fisher’ exact test, p=0.034). Eleven children were under one year, and eight children were from one to five years of age. Three children died.  Conclusion – The most common causes of BM in children aged 1 month to 14 years were Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumoniae. After the introduction of Hib vaccine the number of BM cases caused by Haemophilus influenzae and the total number of BM cases was reduced.

The countries of the Balkan Peninsula have become the region with frequent outbreaks of the emerging and re-emerging diseases during the last decade of the 20th and the first decade of the 21st century. The majority of outbreaks were wildlife zoonotic, and vector-borne diseases, such as brucellosis, leptospirosis, listeriosis, tularemia, Q-fever, Lyme disease, anthrax, rabies, viral hemorrhagic fevers, sandfly fever, tick-borne encephalitis and leishmainiasis. Epidemiological factors determined by ecology of causative agents are often the most useful diagnostic clues. The recognition of evolving problems of emerging and re-emerging diseases emphasizes the need for the development of better laboratory diagnostic methods for the surveillance and tracking of the diseases, and for continued research of factors contributing to the transmission of the organisms. The continuous occurrence of previously unidentified infections requires prospective national strategies for timely recognition of the syndromes, causative agent identification, establishment of criteria and methods for the diagnosis, optimization of the treatment regime, and determination of successful approaches to prevention and control. Wildlife diseases surveillance in the most of the Balkan countries has been coordinated by the WHO since 1992. Although new technology and communication have extremely improved in the last decade, there is a need for optimal communication lines among the Balkan countries, better exploitation of communication technologies like the Internet and other media in the field of emerging diseases.

There has never been a case of dirofiliriasis conjunctivae recorded in Bosnia and Herzegovina until now. It is true that German scientists described one case in the woman who stayed in the region of former Yugoslavia, Italy and Spain in 1984 and she might have been infected in one of these countries. The aim of this work is to present the first case of ocular Dirolfiliriasis in a female patient in Tuzla. Patient BD, born in 1946 was admitted to Ophthalmology department in Tuzla on May 10th 2007 with a diagnosis of: Conjunctivitis oc.dex., parasitosis subconjunctivae dex. On May 11th 2007 a parasite was removed, 105.6 mm long, 0.473 wide with cephalic part slightly curved and esophagus length of 15mm. It was concluded that the discovered parasite is the member of Filaridae family and Dirofilaria species. Eoosinophilia with 17% eosinophiles was found in the peripheral blood smear. The presented case indicates that Dirofilariosis can be found in the region of Bosnia Herzegovina.

The goal of our research was to determine the presence of bacterial vaginosis in sexually active women in Tuzla Canton area. Diagnosis determination for bacterial vaginosis was conducted on the basis of three out of four internationally accepted criteria according to Amsel and isolation and identification of Gardnerella vaginalis (G. vaginalis) by standard microbiological procedures. Bacterial vaginosis was diagnosed in 20,5 % (41/200) women who asked for gynaecologist's help due to their personal discomfort, since significantly higher percentage of diagnosed bacterial vaginosis of 48,80% (41/84) was determined in women with personal discomfort typical for this disease. All relevant factors, according to available literature, for genesis of bacterial vaginosis were processed in this research. In respect to the obtained outputs, bacterial vaginosis is significantly more frequent occurrence in women who are not married, since the number of sexual partners, the time of the first sexual intercourse, the use of intrauterine contraceptive device and smoking do not cause the genesis of bacterial vaginosis. According to Nugent, an increased vaginal discharge with unpleasant odour after sexual discourse, its pH>4,5, a positive amino odour test, an occurrence of clue cells in a direct microscopic concoction of vaginal discharge and assessment of the state of vaginal flora for bacterial vaginosis are significantly more frequent occurrences in women with individual discomforts. It was proved that G. vaginalis is a dominant micro organism in 95% of women with clinical signs of vaginosis although it was isolated from vaginal discharge in 40 to 50% of healthy women. In our research, G. vaginalis was isolated in 63,41% of examined women with all signs of bacterial vaginosis, in 36,59% of examined women with one or more clinical signs of bacterial vaginosis and in 2,58% of examined women of control group without clinical signs.

The natural habitat of Gardnerella vaginalis is a vagina since it could be located among 69% of women who have no signs of vaginal infection and in the vagina of as many as 13.5% girls. G. vaginalis is almost certainly identified among women diagnosed with bacterial vaginosis as well as in the urethra of their sexual partner. The increase in prevalence and concentration of G. vaginalis among patients diagnosed with this syndrome confirms that G. vaginalis plays a significant role in its pathogenesis. In our research, based on Amsel criteria for three or more clinical signs of bacterial vaginosis, it was diagnosed in 20.5% of women with subjective problems of vaginal infection, and in 48.80% of women with subjective symptoms characteristic of this disease. G. vaginalis was isolated from vaginal secretion of women without clinical signs characteristic of bacterial vaginosis. In 2.58% of cases it was solitary, while in 1.28% it was found in combination with other aerobic and anaerobic bacteria and, in 1.28% women combined with Candida albicans. The isolation of G. vaginalis was significantly increased (p<0.05) in the group of women with clinical signs of bacterial vaginosis in comparison to the group of women without these signs. Frequent recurrence of bacterial vaginosis, which is found in 20-30% of women within a three months treatment, is explained as reinfection with other biotype of G. vaginalis, different from a source biotype or as a consequence of wrong treatment. Following Piot biotype scheme, biotypes 2., 3. and 7. G. vaginalis are significantly more often isolated from women who suffer from bacterial vaginosis. Biotype 7. G. vaginalis, isolated from the group of women without clinical signs of bacterial vaginosis, accounted for 2.58% cases. Following Benit biotype scheme, biotypes IVa, IVc and IIc were identified in 12.90% cases, while biotypes IIIa, IIa, Ia, IVb, IIb were found in 6.45% cases. Lipase-positive isolates of G. vaginalis were significantly more frequently accompanied by the syndrome of bacterial vaginosis.

UNLABELLED Detection of enteroviruses in drinking water poses a very specific problem, since a very small number of particles have to be identified in huge water quantities. Currently, there are a number of methods to identify the concentration of virus particles and RNA templates to carry out RT-PCR, however, no standard method has yet been proposed. AIM The aim of this report is to suggest optimal methods for the preparation of RNA templates to carry out RT-PCR. MATERIAL AND METHODS In this experimental study, two different methods were employed on preparing RNA template. The concentration of virus particles in a large (10 L) and small (1 L) quantity of water was determined by use of the electropositive microporous virology filter (method 1 and method 2). Elution and flocculation of the virals particles were performed by organic extraction (method 1) and inorganic extraction (method 2). The sensitivity of the methods was assessed by testing the artificially contaminated water with 10(1) to 10(5) virus-particles using 1-L and 10-L containers of water. RESULTS Method 1 detected 10(5) and 10(4) virus particles, method 2 10(5), 10(4) and 10(3) virus particles from 10 L and 1 L of water, respectively, yielding a statistically significant difference (p<0.01; chi2 = 6.061). Using two-step RT-PCR with nested PCR method, enteroviruses were detected in 42/100 (42%) samples of surface drinking water and in 83% of the same samples using RT-PCR without nested PCR.

Aim of this research was to investigate diagnostic value of discovering of antibody on A60 antigen in patients who were tested for presents of Mycobacterium tuberculosis in there biological samples. We tested a samples of sputum, gastric juice, urine, cerebrospinal fluid and punctate from group of 353 patients who were suspected for tuberculosis. In all patients we were looking for antibodies classes A60 antigen. We used immune chromatographic "Hexagon TB" test, Germane company "Human Geselschaft fur Biochemica und Diagnostica". From 353 patients we found 58 (16.43%) patients with positive BK, 79/22,38%) patients with positive Lowenstein culture and 122 (34,55%) patients with antibody in sera on A60 antigen. Patients who were BK and Lowenstein positive, have had antibody in 94,23% cases, Patients who were BK negative and Lowenstein positive have had antibodies in 70,37% cases and patients who were BK negative and Lowenstein negative have had antibody in 19,03% cases. Patients with BK positive and Lowenstein negative results have had antibody in 50,00% cases. Difference between results is significant (p<0,01). From 122 patients with positive antibodies, 52 were BK positive and 68 have had positive Lowenstein cultures. From 231 patients with no antibody, just 6 were BK positive and 11 Lowenstein positive. In 62 patients with positive antibodies, were BK and Lowenstein negative. We confirmed that antibody on A60 antigen in microbiological positive patients are more often then in microbiological negative patients (p<0,001).

Aim of this work is to show the level of prevalence of patients infected with resistant strains Mycobacterium tuberculosis in Canton Tuzla. In the period of 1996-2003 year we tested 87,408 samples of different materials on existence of Mycobacterium tuberculosis. Among all samples there were 66,128 sputum, 14,599 urines, 3,817 gastric juice, 1,174 materials from broncholavage and 547 other samples. Microscopically it was found 4,380 smear-positive samples and 6,365 samples were positive on Loewenstein medium. Positive sputum had 1,917 patients, and positive culture had 3,018 patients. Resistance test was done on streptomycin, isoniazid, rifampicin and ethambutol with standard proportional method for 2,662 patients. Totally sensibile were 2,570 or 96.54%, and restant were 92 or 3.46% patients. Patients infected with mono-drug resistant strains Mycobacterium tuberculosis were 71 or 2.67%, and poli-drugs resitant 21 or 0.78%. There were 16 patients or 0.60% infected with multi-drugs resistant strains. Time of bacteriological negativization for the patients infected with resistant strains was in the average 8.19 months, for the patients infected with mono-drug resistant strains was 2.75 months and for infected with multi-drugs resistant strains was 32 months. It is concluded that region of Canton Tuzla has high level of bacteriological prevalence but low level of prevalence of patients infected with resistant strains Mycobacterium tuberculosis in the this period of time, and it is significantly lower then earlier periods, thanks to national tuberculosis control program and system of directly observed treatment.

The presence of waterborne enteric pathogens (bacteria, viruses and protozoa) in potable water represents a potential danger for people's health. While doing a microbiological examination of potable water on a regular basis, we obtain a constant control of presence of the bacteria that contaminate water. However, the water examination of the enteric viruses is done only when we have some large-scale hydrous epidemics. Finding the bacteria wich point to fecal contamination of drinking water is not a safe indicator of presence of the enteric viruses. After a two step RT/PCR examination on viruses in 84 samples of potable water, the enteroviruses were found in 53 out of 84 samples (63.09%), while the hepatitis A virus was not found after one step RT/PCR examination. In conclusion, we emphasize the need of standardizing the method of potable water viruses detection, in order to legalize the need of its regular application.

: The presence of waterborne enteric pathogens (bacteria, viruses and protozoa) in potable water represents a potential danger for people's health. While doing a microbiological examination of potable water on a regular basis, we obtain a constant control of presence of the bacteria that contaminate water. However, the water examination of the enteric viruses is done only when we have some large-scale hydrous epidemics. Finding the bacteria wich point to fecal contamination of drinking water is not a safe indicator of presence of the enteric viruses. After a two step RT/PCR examination on viruses in 84 samples of potable water, the enteroviruses were found in 53 out of 84 samples (63.09%), while the hepatitis A virus was not found after one step RT/PCR examination. In conclusion, we emphasize the need of standardizing the method of potable water viruses detection, in order to legalize the need of its regular application.