Issue 3, 2019
Zakażenia u ciężarnych – czy TORCH nadal jest dominujący?
Infections in pregnancy – is TORCH still dominant?
Zakażenia XXI wieku 2019;2(3):107–113
Infectious disease during pregnancy is a complicated issue because many common infections that may cause mild to moderate symptoms in an adult can be transmitted to the fetus. These infections potentially result in moderate to severe complications for the developing fetus which may have long-term sequelae. This review will explore the possible short- and long-term perinatal outcomes of selected common infections in pregnancy. An acronym TORCH has been dissccussed as a too narrow definition of teratogenic infections.
Pozaustrojowe oczyszczanie krwi w sepsie
Extracorporeal blood purification in sepsis
Zakażenia XXI wieku 2019;2(3):115–119.
Extracorporeal blood purification is an acclaimed method of treatment in renal insufficiency or intoxications. Based on the clinical outcomes of this therapeutic management, a hypothesis has been formed that sepsis could be treated by removing inflammatory mediators which are released during immunological response to infection. Studies of various extracorporeal blood purification techniques were conducted, including: high-volume haemofiltration, high cut-off haemofiltration, haemoadsorption or combinations of these methods. Although multiple positive results were described, they usually presented insignificant evidential value. Multicenter, prospective randomized clinical trials did not show any significant decrease in mortality due to instituting these therapeutic methods. Currently there is insufficient evidence to recommend extracorporeal blood purification for causal treatment in sepsis.
Bakterie wielolekooporne – wyzwanie dla epidemiologii szpitalnej
Multi-drug resistant bacteria – the challenge for hospital epidemiology
Zakażenia XXI wieku 2019;2(3):121–124
Antibiotic resistance has emerged as one of the principal public health problems. It threatens the effective treatment and prevention of nosocomial infections. The lack of consistent strategies, and especially no consistency in their implementation and employment, results in an inadequate control of multi-drug resistant bacteria spreading. The necessity of coordination of every participant of the hospital care process creates a great challenge in the field of hospital epidemiology.
Rola penicylin w antybiotykoterapii – skuteczność i bezpieczeństwo stosowania „starych” antybiotyków
The role of penicillins in antibiotic treatment – effectiveness and safety of use of ‘old antibiotics’
Aleksandra Łata, Wojciech Barg
Zakażenia XXI wieku 2019;2(3):125–130
Penicillins are one of the most often used group of antibiotics. They are bactericidal antibiotics of high effectiveness against infections caused by numerous pathogens. Introduction of semisynthetic penicillins additionally widened the spectrum of their usage and raised their effectiveness. Although, it is a relatively safe group of medicines, there are some hypersensitivity reactions. However, penicillins still remain first-line antibiotics. Therefore self-reported allergic reactions each time should be confirmed by a detailed allergological diagnostics. Restrictions of prescribing penicillins due to an unproven allergy reaction leads to increasing drug resistance, as well as to increased cost of treatment.
Profile oporności na antybiotyki pałeczek Klebsiella pneumoniae wytwarzających karbapenemazy KPC i NDM
Antibiotic resistance profiles of KPC and NDM carbapenemases-producing Klebsiella pneumoniae
Dominika Ojdana, Paweł Tomasz Sacha, Anna Gutowska, Piotr Majewski, Piotr Wieczorek, Elżbieta Anna Tryniszewska
Zakażenia XXI wieku 2019;2(3):131–137
Introduction. Klebsiella pneumoniae is an important etiological factor of nosocomial infections, whose clinical significance has increased recently due to their increasing ability to produce carbapenemases. Aim of the study. The aim of the study was to determine antibiotic susceptibility profiles among K. pneumoniae strains that produce beta-lactamases of the KPC or NDM type. Material and methods. The study was carried out on 134 K. pneumoniae strains, including 39 of KPC-producing strains, and 95 of NDM–producing strains. The strains were isolated from clinical materials obtained from patients hospitalized at the University Hospital of Bialystok. The susceptibility to antibiotics was examined with the use of VITEK-2 automatic system. The carbapenemases production by the tested strains was confirmed by the methods recommended by EUCAST. Results. It was shown that KPC-positive strains presented the highest percentage of susceptibility, i.e. 87.2% and 61.1%, against gentamicin and colistin, respectively. Among NDM-positive strains, it was shown that colistin, trimethoprim with sulfamethoxazole and gentamicin were antibiotics with the highest percentages of susceptible strains, at a level of 93.2%, 66.3% and 44.7%, respectively. Susceptibility testing results showed that among the KPC-positive strains the most common resistance profile (15.4%) was resistance to cyprofloxacin, meropenem and trimethoprim with sulfamethoxazole, intermediate resistance to amikacin, imipenem, tigecycline and susceptibility to gentamicin and colistin. Among NDM-positive strains, the most common resistance profile was found in 32.9% of isolates and included resistance to cyprofloxacin, gentamicin, meropenem, imipenem, intermediate resistance to amikacin, tigecycline and susceptibility to colistin and trimethoprim with sulfamethoxazole. Conclusions. Summing up, all KPC- and NDM-positive K. pneumoniae strains demonstrated multi-drug resistance and significant differentiation of resistance profiles to antibiotics.
Grzyby jako czynniki etiologiczne wybranych zakażeń szpitalnych
Fungi as causative agents of healthcare-associated infections
Paweł Marcin Krzyściak, Magdalena Skóra
Zakażenia XXI wieku 2019;2(3):139–149
The problem of fungal hospital-acquired infections was discussed. On the basis of the available literature data, current epidemiology of fungal nosocomial infections according to the European Center for Disease Prevention and Control (ECDC) classification was presented.
Rola Lactobacillus rhamnosus GG w nieswoistych zapaleniach jelit
The role of Lactobacillus rhamnosus GG in inflammatory bowel diseases
Zakażenia XXI wieku 2019;2(3):151–156.
Inflammatory bowel disease (IBD) is a heterogeneous group of gastrointestinal disorders, including two major subgroups such as Crohn’s disease (chL-C) and ulcerative colitis (UC). These diseases belong to the group of idiopathic, chronic and recurrent inflammatory states of the gastrointestinal tract, the incidence of which has been increasing in recent decades. Numerous studies have shown that intestinal microflora and interactions between microflora and the immune system are involved in the pathogenesis of IBD. There are also supportive therapeutic strategies in IBD based on intestinal microflora modulation, the most popular of which are therapies with the use of probiotics. The research conducted so far using Lactobacillus rhamnosus GG (LGG) in the group of patients with inflammatory bowel diseases does not confirm the therapeutic effectiveness of this strain. It is also underlined that the use of LGG in the active phase of IBD may lead to exacerbation of disease symptoms. However, animal studies confirm that the modification and isolation of specific surface molecules of LGG cells will allow the development of an effective form of therapy using these probiotics in IBD.
Czy rękawice są skuteczną barierą dla zakażeń związanych z opieką zdrowotną?
Are gloves an effective barrier to healthcare-associated infections?
Hanna Doleżych-Teister, Gajane Martirosian
Zakażenia XXI wieku 2019;2(3):157–162
As healthcare-associated infections relate to a significant percentage of patients, and the medical staff themselves are significantly exposed, all measures limiting this risk have medical and economic sense. Surgical gloves – an important element of personal medical protection and at the same time a measure to reduce the risk of patient infection, should be used in the most effective and rational way. Automatization of their production and packaging should lead to elimination of contact with a living employee and thus the elimination of the real – as it turns out – source of microbial contamination of the brand new gloves. Latex material itself should contain much less endotoxins than before. The double glove system, which is easy to insert and use – internal and often changing of the outer glove during surgical procedure, protects the patient and, by reinforcing the mechanical barrier, significantly reduces the risk of staff sticking. When the inner glove differs in color, it is a simple, visual way to signal the damage of the outer glove, giving an impulse for its preventive change.
Monitorowanie procesu sterylizacji
Monitoring of the sterilization process
Zakażenia XXI wieku 2019;2(3):163–170
Discrepancies between interpreting and acting in accordance with the indications included in the second edition (2017) of the improved and completed “General guidelines for all entities performing decontamination processes, including sterilization of medical devices and other reusable products which are used when providing health services or other procedures during which a transmission of infectious disease or infection may occur”, as well as common lack of acquaintance with legal acts, regulations and norms regarding the above mentioned Guidelines result in differences in the use of publicly available opportunities for monitoring of the sterilization process. The monitoring tools shall not be put to use solely on the base of general directives. While individuals responsible for performing sterilization and releasing sterilized devices proceed accordingly to their knowledge and as stated by in the current law regulations resulting from European directives, sometimes the internal policy of the health care facility also plays an important role in their actions. Definitions published by the European Commission serve as an open standard for reprocessing medical devices for reuse and releasing the sterilized items after the process. Moreover, they provide valuable description of methods for controlling decontamination processes which are a key factor in documenting procedures that guarantee obtaining a sterile product. This article attempts to define the relationship between the above mentioned legal conditions and daily practice in the production of sterile devices, as well as helps its readers to realize the simplicity of interpreting the guidelines.