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Background/Aim. The role of the complex sepsis-related immune response has not been fully clarified and remains a subject matter of investigation. Nowadays, sepsis is considered a dynamic syndrome characterized by many, often antagonistic phenomena, ranging from hyperinflammation to anergy and immunoparalysis. The aim of the study was to determine, based on the level of pro- and anti-inflammatory mediators in critically ill patients with secondary sepsis, whether the cytokine profile differs according to the type of bacterial causative agent, as well as to assess the prognostic value regarding the outcome. The outcome measure was in-hospital mortality. Methods. Blood serum samples were taken from 125 critically ill patients admitted to the Surgical Intensive Care Unit with severe secondary sepsis as a consequence of peritonitis, pancreatitis, or trauma. The average age of the patients was 57.7 ± 17.3 years. Of the total number of patients, 84 (67.2%) were males, and 41 (32.8%) were females. The levels of pro-inflammatory interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-12р70, IL-17А, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, IFN-γ-inducible protein-10 (IP-10), monocyte chemoattractant protein-1(MCP-1), macrophage inflammatory protein (MIP)-1α and MIP-1β, as well as anti-inflammatory mediators IL-4, IL-10, IL-13, IL-27, IL- 31, and IL-33, were determined at three time intervals – on the day of admission (the first day) and then on the third and fifth day. The type of the bacterial causative agent was determined using standard microbiological analyses. Results. On the third day of measurement, significant differences in the cytokine levels regarding the nature of bacteremia were determined in all pro- and anti-inflammatory cytokines, except for IL-8. In general, the lowest levels were observed in patients with polymicrobial blood cultures. On the first and fifth days of measurement, no significant differences in the cytokine levels regarding the nature of bacteremia were found. The only significant predictor of the fatal outcome on the first measurement day was IL-17А, Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.665 (95% confidence interval 0.519–0.791; р = 0.034) in the patients with secondary sepsis as a complication of peritonitis. Conclusion. According to the type of bacterial causative agent, the lowest levels of cytokines have been observed in patients with the polymicrobial blood culture. The low level of IL-17А on the first day of measurement is a good predictor of a fatal outcome in patients with peritonitis as an underlying condition of secondary sepsis. On the other hand, the levels of other cytokines correlated with the out-come only on the fifth day of measurement, and they were higher in survivors than in non-survivors.

Introduction: Urinary tract infections are one of the most common infections in young children. Febrile conditions in young children, without specific clinical signs and symptoms are often the result of ITU. Usually later diagnosed and treated. The most common cause of ITU is Escherichia coli. The main problem in the treatment of ITU is increasing resistance to antibiotics. AIM: To point out all the frequent resistance to antibiotics and to compare the frequency of the experimental periods. Material and methods: We performed a retrospective study in the period of 2010-2015. Urine samples for microbiological examination were taken before switching on antibiotics. Statistical analysis was performed in SPSS software. RESULTS: In our study found 183 patients with a diagnosis of ITU. Somewhat higher percentage were present, patients were female. The highest resistance to ampicillin was found in our results in the time period is 5 years, found a drop resistance Amoxicilin and Amoksiklav. DISCUSSION: Our results showed a strong similarity with the works on the same theme, which is Escherichia coli, the most common cause of ITU in young children. ITU are represented within the female population. CONCLUSION: It is important to continuously monitor the representation of urinary tract infections as well as their sensitivity to antimicrobial drugs, because of the increasing presence of the bacterial resistance to existing antibiotics.