Issue 2, 2019
Punkty krytyczne procesu dekontaminacji – ryzyko przeniesienia zakażeń krwiopochodnych
Critical points of decontamination process – the risk of transmission of blood-borne infections
Zakażenia XXI wieku 2019;2(2):55–59.
Decontamination is a process leading to the removal and destruction of pathogenic microorganisms. In order to understand the importance of actions taken in the sterilization room, one should be aware of what professional qualifications should be fulfilled by employees employed in such a unit. In addition, having a Central Sterilization Room in the structures of a hospital with a surgical profile guarantees the „recovery” of patient-safe, sterile medical devices that are safe, without unnecessary delay. The process of resterilization and its effectiveness depend on many variables. Their recognition and analysis allow to determine the critical points of the process and take action to minimize the risks.
Rekomendacje leczenia wirusowych zapaleń wątroby typu C w roku 2019 Polskiej Grupy Ekspertów HCV
Recommendations for the treatment of viral hepatitis C in 2019 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. 2019;2(2):61–69.
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 recommendations, all patients with chronic HCV infection should receive treatment. Current recommendations provide guidelines on 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. They contains also advice on the treatment of special patients’ populations such as patients with renal failure, liver transplant and hepatic decompensation, as well as on the retreatment of patients who failed interferon-free therapy. Moreover, specific recommendations on the management of patients infected with different genotypes with currently reimbursed regimens or those expected to become available shortly in Poland are also included.
Fluorescencyjna hybrydyzacja in situ w detekcji infekcyjnych powikłań przewlekłej stymulacji serca – badania pilotażowe
Fluorescent in situ hybridization in the detection of infectiouscomplications of permanent heartpacing – pilot study
Agnieszka Sroka-Oleksiak, Mateusz Ulman, Barbara Małecka, Małgorzata Bulanda
Zakażenia XXI wieku 2019;2(2):71–75.
Introduction. Permanent heart pacing is associated with the risk of later complications, including the most serious complication, i.e. the risk of Lead Dependent Infective Endocarditis (LDIE). Then, it is essential to introduce an appropriate therapy with an important stage being removal of all components of the pacing system, and also to identify as early as possible the etiological factor allowing for the use of targeted antibiotic therapy. Current diagnostic methods based on blood culture are characterized by low sensitivity and a long waiting time for test results. Alternative solutions are sought that could be implemented in hospital diagnostic conditions. Aim. The aim of the study was to determine the sensitivity and usefulness of fluorescence in situ hybridization (FISH) and to compare it with culture methods. Material and Methods. The analyzed material consisted of blood samples and/or swabs taken from patients with LDIE, which, after appropriate preparation were hybridized with fluorescent probes, specific to bacteria of the genus Staphylococcus and the family of Enterobacteriaceae. Results. The results were evaluated by fluorescence microscopy. The use of FISH allowed the identification of pathogens in 90% of cases, while using culture methods only in 30%. Conclusions. The sensitivity of fluorescent in situ hybridization is much higher than methods based on the blood culture. For comprehensive identification of pathogens, a fluorescent probe specific to Candida fungi should be studied in further research.
Miejsce amoksycyliny z kwasem klawulanowym w leczeniu ran kąsanych
Amoxicillin-clavulanate in the treatment of animal bites
Joanna Bednarek, Aleksander Garlicki
Zakażenia XXI wieku 2019;2(2):77–80.
Amoxicillin-clavulanate has a special place in skin and soft tissue infection treatment, especially in the management of animal bites. Scientific literature and clinical practice prove the effectiveness of this drug in the above-mentioned processes of wound healing. Amoxicillin-clavulanate’s high intensity of action as well as a good penetration of tissues and a broad spectrum of action on microorganisms are the main advantages of this drug. This paper highlights the role of amoxicillin-clavulanate in bite wound treatment, where it remains the medication of choice. Additionally, this work includes a case report of a patient treated after a cat bite with amoxicillin-clavulanate.
Mesalazyna – złoty standard w terapii wrzodziejącego zapalenia jelita grubego
Mesalazine – gold standard in the treatment of ulcerative colitis
Ariel Liebert, Maria Kłopocka
Zakażenia XXI wieku 2019;2(2):81–84.
Mesalazine is a drug indicated for the induction of remission in patients with active, mild to moderate ulcerative colitis, and for the maintenance of remission of ulcerative colitis. It occurs in many pharmaceutical forms allowing for the optimization of conducted therapies. In most cases, it is well tolerated and the occurring side effects are not dangerous to the patient’s life or health. It is important, however, that the patient adheres to the recommended dosage and recommended control tests. Mesalazine is also used as a chemopreventive treatment in inflammatory bowel diseases and in Crohn’s disease as prophylaxis of relapse after surgery of the small intestine.
Podstawowe procedury zapewniające bezpieczeństwo operowanym pacjentom
Basic procedures providing safety to the operated patients
Zakażenia XXI wieku 2019;2(2):85–91.
Each operated patient expects a high quality of medical services and securing their safety during the perioperative period. A number of factors, e.g. bed hygiene, patient’s body and mouth cavity hygiene, removal of hair in the operated area, disinfection of the operated area affect the safety of the operated patient.
Pasożyty jako czynniki etiologiczne zakażeń szpitalnych
Parasites as etiological factors of nosocomial infections
Zakażenia XXI wieku 2019;2(2):93–101.
Parasites are an important, albeit still underestimated, etiological factor responsible for hospital-acquired infections. This group of pathogens is characterized by its ability of being transmitted between humans without the involvement of intermediate hosts and includes cryptosporidia, gardiae, pinworms, lice, demodices, and scab mites. Parasitic infestations should be taken into consideration in differential diagnosis of hospital-acquired infections since they require appropriate treatment by the Hospital Infections Teams just as the more commonly diagnosed types of infections. Appropriate selection of laboratory diagnostic tests is an important element of diagnostic, therapeutic, and preventive management regimens. The awareness of the epidemiological status of parasitic diseases in a country may increase the awareness of potential risks associated therewith.
Clostridium difficile, diagnostyka i leczenie – przypadki kliniczne
Clostridium difficile – diagnostics and treatment – clinical cases
Zakażenia XXI wieku 2019;2(2):103–106.
Clostridium difficile is currently one of the most important aetiological factors of nosocomial infections. The main risk factors are age >65 years, antibiotic therapy, serious underlying disease, proton pump inhibitor use. However, in the diagnosis of these infections, attention should also be paid to parameters such as fever >38.5°C, leukocytosis >15×109/L, increase in creatinine level (increase 1.5× relative to baseline), decrease in albumin level <3 g/dL. The increase in these parameters is an important prognostic factor for severe infections [1, 2]. A severe infection should not be treated with metronidazole, vancomycin at the time is the first-line treatment. Treatment of severe infections and recurrences of infections caused by toxigenic strains of Clostridium difficile is not only antibiotic therapy but also fecal microbiota transplantation [1, 2] and a properly composed diet.