Infections of the 21st century (Zakażenia XXI wieku)

Issue 6, 2018

Ocena ryzyka występowania Clostridium difficile w szpitalu wojewódzkim

Assessment of Clostridium difficile risk in the Provincial Hospital

Grzegorz Ziółkowski, Iwona Pawłowska, Sylwia Pełka, Jolanta Grabowska-Markowska, Tomasz Bielecki

Zakażenia XXI wieku 2018;1(6):271–275.

Clostridium difficile infection is the most common cause of antibiotic-associated antibiotic associated diarrhea (AAD). The goal of each healthcare provider is to properly manage the risk of nosocomial infections and to protect the health of patients. Risk management is first of all undertaking activities aimed at identifying and assessing anti-epidemic activities. The assessment of the risk of infection in the hospital is possible only on the basis of local prospective or retrospective epidemiological studies, and the incidence rate is the basic and most important method of assessing the state of health in infection control. Retrospectively, the results of stool examinations for Clostridium difficile (CD) in 2013-2017 were used to determine the risk of CD infection, by determining the incidence of CDI (Clostridium difficile infection) in the Provincial Specialist Hospital No. 5 St. Barbara Trauma Center in Sosnowiec (WSS5). The results of the diagnostic test show only the presence or absence of Clostridium difficile and its toxins (TcdA, TcdB). The performed microbiological examination was confronted with a clinical picture, whose main symptom was frequent and loose stools without blood, adjusting to the shape of the container for stool analysis, as a result of inflammation of the large intestine, fever and abdominal pain with bloating.

Terapie jednotabletkowe oparte  na emtrycytabinie/alafenamidzie tenofowiru oraz sofosbuwirze, stosowane u pacjentów z koinfekcją HIV/HCV – przegląd aktualnej wiedzy

Single-agent therapies based on emtricitabine / tenofovir alafenamide and sofosbuvir in the treatment of patients with HIV/HCV co-infection – review of current knowledge

Iwona Cielniak, Ewa Siwak

Zakażenia XXI wieku 2018;1(6):277–283.

Patients with HIV/HCV co-infection are at higher risk of hepatic failure. This population showed a higher level of HCV viral load in the blood, with a longer half-life of the virus. Epidemiological data suggest that there is a noticeable increase in the frequency of HCV seroconversions in the HIV infected MSM population. In the era of effective antiretroviral therapy, liver disease associated with HCV infection is one of the most common causes of mortality in this group. Eradication of HCV has been associated with improved survival and decreased risk of liver-related morbidity. Direct-acting antivirals have revolutionized modern treatment of HCV infection. Oral therapies, well tolerated, used for 8-12 weeks (sometimes 24 weeks) show 95% efficacy in patients infected with HCV, as well as with HCV/HIV co-infection. Treatment indication and regimens are to be the same in HCV/HIV coinfected as in HCV mono-infected patients. Therapy of HCV infection without considering potential interactions with ARV regimens may result in ineffective treatment of HCV infection as well as HIV infection. Better adherence to single-agent therapies based on emtricitabine/tenofovir alafenamide favours the effectiveness of ARV therapy and also improves the effectiveness of HCV treatment. Regimens sofosbuvir-velpatasvir (Epclusa) and ledipasvir/sofosbuvir (Harvoni) are used to treat HCV infection caused by all genotypes. High efficacy and safety have been observed in patients with types of HCV infection that traditionally have been difficult to treat.

 

Mukormykoza czy aspergiloza płucna? Trudności diagnostyczno-terapeutyczne u dwojga dzieci z ostrą białaczką limfoblastyczną

Pulmonary mucormycosis or aspergillosis? Therapeutic difficulties in two children treated for acute lymphoblastic leukaemia

Ninela Irga-Jaworska

Zakażenia XXI wieku 2018;1(6):285–290.

Invasive pulmonary fungal disease is a significant clinical problem in children treated for haematological malignancies. Differentiation between pulmonary aspergillosis and mucormycosis is crucial due to distinctive therapeutic strategy and methods of monitoring of treatment results. This paper presents diagnostic and therapeutic difficulties in two children treated for acute lymphoblastic leukaemia who were diagnosed with invasive pulmonary fungal disease.

Bezpieczeństwo i wykorzystanie nanocząstkowego srebra w zakażeniach o etiologii bakteryjnej

Safety and use of nanoparticle silver in diseases with bacterial etiology

Marta Pawłowska, Andrzej Stańczak, Łucja Pijarczyk, Izabela Papka, Przemysław Czajka, Piotr Hudemowicz, Marek Pięta, Anna M. Grudniak

Zakażenia XXI wieku 2018;1(6):291–294.

In the recent years, particular attention has been devoted to research on precious and semi-precious metals in the nano size range. It was found that substances transferred to this scale have excellent antimicrobial properties, in particular antibacterial properties. Many studies have shown that nanometals are effective already at very low concentrations, while showing no toxicity to human cells. The intensity of action, but also the possibility of long-term use, as well as the broad spectrum of action on microorganisms are the main advantage of nanometals. A multitude of processes of inactivation of microorganisms makes it difficult to create defense mechanisms for the operation of nanosilver. Silver nanoparticles may be a promising alternative to previously used chemotherapeutic agents in the treatment or prevention of infections.

Clostridium difficile: nowości diagnostyczne i terapeutyczne

Clostridium difficile: diagnostic and therapeutic news

Gajane Martirosian, Monika Kabała

Zakażenia XXI wieku 2018;1(6):295–302.

Clostridioides (Clostridium) difficile infections (CDI) pose a serious medical, therapeutic and economic problem throughout the world. Since the beginning of the 21st century, we have been observing a new quality – infections are more severe and even fatal. Therefore, a decision was taken to standardize the diagnostics of these infections, as well as their treatment and epidemiological procedures. New recommendations regarding the diagnostics and treatment of CDI have been published in the USA, Europe, as well as in Poland. In this article, we will present the problems of diagnostics and treatment of CDI in the light of the recent recommendations.

Podchloryny w leczeniu ran przewlekłych

Hypochlorites in the treatment of chronic wounds

Mirosława Dzikowska, Katarzyna Wojtas, Maria Kózka

Zakażenia XXI wieku 2018;1(6):303–307.

Different medicaments are used in decubitus ulcer treatment. They enable cleaning the wound and support growth of granulation tissue and epidermization. Scientific literature proves the effectiveness of hypochlorites in the above mentioned processes of wound healing. The aim of the study was to assess the use of Microdacyn liquid for rinsing wounds and Microdacyn gel in decubitus ulcer treatment in two hospitalized patients on a conservative treatment ward. The research was based on the description of the cases of male and female patients hospitalized at Internal Medicine and Allergology Department of J. Dietl Specialist Hospital in Kraków in 2014. The following tools were used: author’s questionnaire, Torrance scale for ulcer’s degree assessment, „colourful” classification system for long-lasting wounds, ADL scale, BMI index and AMTS. As a result of activities according to the TIME concept, the wounds were cleaned with Microdacyn in both cases. A visible process of growth of granulation tissue and epidermisation as a next step of treatment was achieved for one patient, for whom it was possible to apply hydrocolloid dressing (Hydrocoll).

Zastosowanie jednorazowych operacyjnych zestawów wieloelementowych jako czynnika ograniczającego ryzyko zakażenia miejsca operowanego

Application of disposable multi-element surgical sets as a method to prevent SSI

Bianka Misiak, Regina Sierżantowicz, Jolanta Lewko

Zakażenia XXI wieku 2018;1(6):309–315.

Surgical site infections (SSI) are a current problem in health care facilities. Prevention of surgical site infections must be multidisciplinary. In operating theaters, the so-called procedural sets are being increasingly used lately, dedicated to a specific medical procedure and adapted to the needs of a specific operating suite. Each set may contain any components such as surgical drapes, surgical gowns, gloves or surgical dressings. The offer of the producers is very wide, thanks to which the quality of the products is systematically increasing. The use of such a solution saves time by increasing work efficiency and reducing costs. A lower number of packages (one package instead of a dozen or so of individual components) also means lower disposal costs. At the same time, it allows for standardization of the operating mode during surgeries and monitoring the consumption of materials used in operative fields.

Pielęgnacja pacjenta na OIT. Co jest ważne w zapobieganiu zakażeniom?

Patient care in ICU. What is important in preventing infection?

Urszula Zielińska-Borkowska, Anna Zdun

Zakażenia XXI wieku 2018;1(6):317–322.

Nosocomial infections are an important clinical issue. They are responsible for prolonged hospitalization, interfere with the treatment process, complication rates and patients’ survival. Treatment in the intensive care unit is one of the risk factors. ICU patients are dependent from the personnel, mainly from nurses who take care of them. Infection is so to say a part of the diagnostic process, invasive procedures and treatment in the ICU. Therefore prevention of nosocomial infections is a priority. It is a complex issue. One of the most important preventive factors is organization of work in the ICU.

Zagrożenia wynikające ze stosowania środków dezynfekcyjnych w centralnej sterylizatorni

Threats resulting from the use of disinfectants in central sterilization departments

Beata Zalewska

Zakażenia XXI wieku 2018;1(6):323–327.

The central sterilization department is a very important place in every hospital. This is where the tools used during medical procedures are delivered to. Here they must be disinfected, washed and sterilized. These processes are carried out by qualified employees with extensive knowledge of decontamination processes. Due to the fact that such tools can be a source of transmission of infections to both patients and employees, it is very important to take all precautions. Both the tools and the disinfectants pose a threat to the employees of the sterilization departments.

Zarządzanie dokumentacją w centralnej sterylizatorni

Management of documents in central sterilization departments

Aleksandra Garbusińska

Zakażenia XXI wieku 2018;1(6):329–337.

Sterilization departments in hospitals reprocessing medical devices used to provide health services are obliged to respect the principles and requirements contained in the Medical Device Directive and Medical Device Act. High quality of sterile products is a guarantee of patient’s safety. Specialized, repeatable and properly supervised sterilization processes should be documented in a sustainable manner. Nowadays, the documents in paper format are increasingly being replaced by electronic documentation stored on hospital servers. This is possible thanks to IT systems entering the market with applications adapted to the needs of central sterilization facilities. This article presents the most important aspects of working with an IT system in central sterilization departments, with particular emphasis on their importance in the management of the decontamination processes.

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