Infections of the 21st century (Zakażenia XXI wieku)

Issue 4, 2019

Analysis of costs of antibiotic therapy implemented in the University Hospital No. 2 in Bydgoszcz in 2014–2018

Analiza kosztów antybiotykoterapii prowadzonej w Szpitalu uniwersyteckim nr 2 w Bydgoszczy w latach 2014–2018

Arkadiusz Kuziemski, Krystyna Frankowska, Ewa Gonia

Zakażenia XXI wieku 2019;2(4):171–174

The hospital antibiotic policy, which has been pursued since 2008, recognizes different antibiotics based on their accessibility, which can be unlimited (prevention, empirical therapy) or restricted (limited access for administrative reasons). Since 2008, the costs of antibiotic therapy – calculated accordingly to the antiobiotic’s share in the drug budget (excluding drug prescription programs) – were approximately 10%. Over the years 2014–2018 the analysis of costs was dependant on antibiotic access groups. The risks of antibiotic misuse in empiric therapy were subject to evaluation. This study aimed to analyze yearly costs of antibiotic therapy based on the accessibility of antibiotics. All summaries of antibiotic costs from 2014–2018 were included in this study. Respecting the rules of antimicrobial stewardship, which have been followed by the University Hospital No 2 in Bydgoszcz since 2008, it shall be recognized that antibiotics are divided into four groups: the ones classified in groups I, II and III are used in perioperative prophylaxis and empiric therapy, while group IV includes antibiotics of administratively limited access. Over the 2014–2018 period, the cost of antibiotics from empiric groups has decreased from 644 861 to 579 657, while the costs of antibiotics from restricted groups have increased from 754 640 to 1 089 572. The difference in costs in each year was: 2014 – 109 779; 2015 – 279 649; 2016 – 347 123; 2017 – 318 841; 2018 – 509 909, respectively. Conclusions: (1) administrative limitation of access to antibiotics has not generated a rise in costs of antibiotics from unrestricted access groups; (2) the costs of restricted antibiotics significantly exceeded the costs of antibiotics used in empiric therapy.

Gastrointestinal infections in the context of microbiological diagnostics in Poland

Zakażenia i zarażenia przewodu pokarmowego w kontekście diagnostyki mikrobiologicznej wykonywanej w Polsce

Diana Wierzbicka, Edyta Podsiadły

Zakażenia XXI wieku 2019;2(4):175–179.

Gastrointestinal infections are one of the main causes of morbidity and death of children under 5 years of age. In the world, most diarrheas are caused by viruses, mainly noroviruses. Campylobacter and Salmonella represent the greatest epidemic potential. Gardia intestinalis is considered the dominating factor among parasites. Epidemiology of infections in Poland differs from the one reported from other countries, due to other diagnostic standards in our country.

Surveillance and registration of surgical site infections: recommendations of the European Center for Disease Control
and Prevention

Nadzór i rejestracja zakażeń miejsca operowanego: rekomendacje Europejskiego Centrum ds. Zapobiegania i Kontroli Chorób (ECDC)

Anna Różańska

Zakażenia XXI wieku 2019;2(4):181–185.

European Center for Disease Control and Prevention (ECDC) recommends active and targeted surveillance of surgical site infections in selected surgical procedures, bearing in mind the consequences that such complications may have for patients and healthcare systems. Recommendations regarding the registration of surgical site infections include definitions and classification criteria, catalogue of risk factors, as well as structural and procedural indicators which are essential for establishing a reliable assessment of epidemiological situation. Uniform application of these guidelines in selected hospitals allows not only for carrying out analysis of epidemiological conditions in any given medical facility, but also for making comparisons on regional, national and international levels. The recommended supervision models enable performing epidemiological analyses with regard to the standardized risk score – in the context of organizing care for patients, including the improvement of infections control.

Professional exposures of health care workers. Lodging and implementation of post-exposure recommendations

Ekspozycje zawodowe pracowników opieki zdrowotnej. Zgłaszanie i realizacja zaleceń poekspozycyjnych

Dorota Gregorowicz-Warpas

Zakażenia XXI wieku 2019;2(4):187–192.

Health care workers are constantly exposed to risk at their work. It is evidenced that injuries caused by a syringe needle or any other sharp instrument are one of the most common and most serious dangers of health care workers. Moreover, such situations generate also high cost for health care systems and, what is also significant, for the whole society [1,2]. Despite professional preliminary and refresher trainings on instructions of dealing with exposures to infectious material, conducted not only by Safety Workers but also by the members of Hospital Infections Control Team, the problem with reporting and conduction of medical tests still exists among employees who were stuck with a needle or other sharp instrument during performance of their daily work activities.
In Poland there are legal regulations and recommendations of the medical society concerning prevention of and procedures in case of an injury caused by a sharp instrument in hospitals and health care system. Many scientific reports, international and Polish ones, clearly indicate which occupational groups are exposed to a potentially infectious material. The highest risk of needlestick injury is among nurses and doctors [2,3]. The latest study report, published in January 2019, on Implementation of the Council Directive 2010/32/UE in Polish hospitals, showed that 40% of individuals who suffered such an injury did not report this fact. This kind of behaviour contributes to the risk of occurrence of a blood-borne infection. That is why it so important to put as much effort as possible into education of the health care workers but also into monitoring of exposure notifications and post-exposure recommendations.

Prophylaxis of occupational exposure among employees of the Central Sterilization Department

Profilaktyka ekspozycji zawodowej pracowników centralnej sterylizatorni

Justyna Ewa Piwowarczyk

Zakażenia XXI wieku 2019;2(4):193–199.

Infection prevention is one of the greatest challenges of modern medicine. The increase in the number of occupational exposures among employees of Central Sterilisation Departments (CSD) due to the performed professional activities is influenced by many factors. The most dangerous biological material to which they are exposed is blood and its derivatives, therefore for many years, proper procedures have been created and adjusted to reduce the risk of professional exposure. The basic method of preventing infections among medical employees is to observe the rules of dealing with a potentially infectious material. CSD employees should know these preventive measures and apply the principles of occupational exposure prevention. The implementation of these methods and constant education can reduce the frequency of occupational exposures in 90%.

How to prolong the life of surgical instruments – maintenance and operation, storage and transport

Jak przedłużyć życie narzędzi chirurgicznych – konserwacja i eksploatacja, przechowywanie i transport

Katarzyna Domrzalska

Zakażenia XXI wieku 2019;2(4):201–204.

The work presents the circulation of surgical instruments used for the surgical procedure and the decontamination process with factors affecting its effectiveness. Special attention was paid to the so-called Critical places (e.g. grooves, teeth in automatic mechanisms, joints, handles), taking into account the manufacturer’s recommendations. The rules of maintenance and inspection of the equipment for correctness of their operation were discussed. The storage and transport of surgical instruments was described.




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