Twelve final effluent samples from four hospitals namely Al-Ansar, Al-Miqat, Al-Zahraa and Al-Dar in Al-Madina Al-Munnawara were collected in spring of 2007 and screened for bacterial counts. Gramnegative rods belonging to 21 different species and 13 genera represented the main bulk (65.2%) out of the 359 bacterial isolates followed by Gram-positive rods (31.8%) and Gram positive cocci (3.1%). The most common isolates were belonging to Escherichia coli (32.05%) followed by Enterobacter cloacae (17.9%). The 234 identified Gram-negative rods isolates were tested for their susceptibility for seven antibiotics at the commonly tested concentrations in hospitals and higher concentrations of the same antibiotics. Gentamicin was the most effective antibiotic, as only 2.6% of these isolates were resistant to 10µg/ml, while 2.1% were resistant up to 256µg/ml. The least effective antibiotic tested was sulphamethoxazole, as 82.9% of the isolates were resistant to 25µg/ml of this antibiotic, while 62.8% were resistant to 1024µg/ml. The second less effective antibiotic was ampicillin.

The final effluent for 5 hospitals (3 governmental and 2 private) was surveyed in order to study their bacterial population including, total viable bacteria (TVB) and total coliform (TC) counts / ml, macro and micro-morphology of the isolated and identification of the isolated and purified bacterial strains to the specific level confirmed using API strips and its code index matching computer program. Counts allover the study showed figures beyond the international permissible limits, ranging between 1x 10 3 -1 x 10 7 cfu/ml. Identification confirmed that the bacterial population is composed of 27 species belonging to 17 genera;

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