Infections of the 21st century (Zakażenia XXI wieku)

Issue 3, 2018

Rekomendacje leczenia wirusowych zapaleń wątroby typu C w roku 2018 Polskiej Grupy Ekspertów HCV

Recommendations for the treatment of viral hepatitis C in 2018 by Polish Group of Experts for HCV

Polska Grupa Ekspertów HCV: Waldemar Halota, Robert Flisiak, Jacek Juszczyk, Piotr Małkowski, Małgorzata Pawłowska, Krzysztof Simon, Krzysztof Tomasiewicz

Zakażenia XXI wieku. 2018;1(3):105–113.

The goals of treatment is to eliminate HCV infection, stop or reverse histological changes, reduce the risk of hepatocellular carcinoma development and transmission of the infection to other individuals. According to the recommendation all patients with chronic HCV infection should receive treatment. Current recommendations provide guidelines to select optimal medication, assessment of liver fibrosis, treatment efficacy, dealing with resistance to direct acting antivirals, monitoring for hepatocellular carcinoma, management of HBV/HCV coinfection and drug interactions. It contains also advice on treatment of special patients populations such as renal failure, liver transplant and hepatic decompensation, as well as retreatment of patients which failed interferon free therapy. Moreover specific recommendations of management patients infected with different genotypes with currently reimbursed regimens or those expected to become available shortly in Poland are also included.

Zakażenia grzybicze na oddziale intensywnej terapii – empiryczne stosowanie echinokandyn u chorych z kałowym zapaleniem otrzewnej może dwukrotnie poprawiać przeżywalność

Fungal Infections in the Intensive Care Unit – empiric therapy with echinocandins in patients with faecal peritonitis may improve
the survival rate twofold

Małgorzata Symonides, Irena Kruczyk, Tomasz Olesiński, Angelika Bzowska

Zakażenia XXI wieku. 2018;1(3):115–119.

In view of the increasing number of colorectal cancer cases it is of importance to develop the safest possible treatment methods, especially considering the fact that surgery remains the mainstay of therapy in this pathology. The most dangerous complication is anastomotic dehiscence with faecal peritonitis and multiorgan failure. Material and methods: Between Jan 2015 and Dec 2017, 68 patients were treated for feacal peritonitis and septic shock in the ICU of the Maria Sklodowska-Curie Institute of Oncology in Warsaw. Those patients were initially treated surgically for colorectal cancer, sarcomas and gynaecological cancers. All the patients were admitted to the ICU directly after surgical treatment of the complication with symptoms of multiorgan failure. The predictive scales calculated on admission suggested an approx. 40% risk of death. Due to the presence of faecal peritonitis all patients received broad-spectrum empiric antibiotic therapy consisting of carbapenem, aminoglycoside, glycopeptide and echinocandin. Results: Despite poor prognosis on admission, overall mortality in the entire group was 19% (13 patients). Conclusions: Taking into consideration a highly multifactorial clinical setting, including patient age, cancer stage, type of malignancy etc., one may suppose that in view of standardised broad-spectrum antibiotic treatment, early onset of antifungal therapy may be associated with a significant decrease in mortality among patients with generalised infection in the course of faecal peritonitis.

Rola kwasu hialuronowego w ginekologii

Role of hyaluronic acid in alleviation of the symptoms of vaginal infection

Magdalena Bizoń, Aleksandra Zielińska, Włodzimierz Sawicki

Zakażenia XXI wieku. 2018;1(3):121–124.

Hyaluronic acid is an ingredient of many products used in dermatology, gynecology, gynecological oncology, aesthetic medicine and other branches of medicine. Physiologically, hyaluronic acid helps in hydration and makes tissue more flexible. Additionally, it stimulates keratinocytes being a component of an innate immune system to produce β-defensins against bacteria, viruses, protozoa and candidas. Thanks to its characteristics, hyaluronic acid is used in the treatment of vaginal infections.

Rola dezynfekcji i mycia rąk personelu medycznego – ręce jako rezerwuar drobnoustrojów – rola dozowników medycznych w zachowaniu higieny rąk

The role of disinfection and handwashing of medical personnel – hands as a reservoir of microorganisms – the role of medical dispensers in maintaining hand hygiene

Beata Denisiewicz

Zakażenia XXI wieku. 2018;1(3):125–128.

The hands are the most important pathway for the transmission of pathogenic microorganisms, therefore in the prevention of infections the basic principle is proper hand hygiene. Compliance with the principles of hand hygiene is low, i.e. from 16% to 81%, with a mean of 40%. Hand hygiene can be improved by hand washing and disinfection techniques, training of patients and colleagues, selection of a microbiologically safe dosing system with an ability to identify the dispenser contents by their color, and selection of appropriate hand hygiene products well tolerated by the skin and accepted by the users. In order to reduce the transmission of pathogenic microorganisms on patients and thus minimize the risk of spreading the infection, the guidelines recommend that non-health care professionals, for example, visit the same procedures as health professionals.

Polimyksyna E – „nowy” stary antybiotyk

The Polymyxin E – „new” old antibiotic

Łukasz Hońdo

Zakażenia XXI wieku. 2018;1(3):129–134

The use of antibiotics continues to cause a rapidly growing resistance. Despite the increasing social awareness and clear alarming messages from specialists to approach this matter with caution, the number of anti-infective used is increasing. We are forced to use higher doses and combinations of antibiotics which until recently were not covered by EBM (Evidence Based Medicine). Polymyxins are a group of peptide antibiotics against Gram-negative pathogens. Although these are old antibiotics and only one of them is used in practice, there still occur therapeutic problems in pharmacological practice.

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