Infections of the 21st century (Zakażenia XXI wieku)

Issue 5, 2019

New microbiological aspects of fosfomycin

Nowe aspekty mikrobiologiczne fosfomycyny

MarÍa DÍez-Aguilar, Rafael CantÓn

Zakażenia XXI wieku 2019;2(5):205–216.

The discovery of fosfomycin more than 40 years ago was an important milestone in antibiotic therapy. The antibiotic’s usefulness, alone or in combination, for treating infections caused by multidrug-resistant microorganisms is clearer than ever. Both the European Medicines Agency and the US Food and Drug Administration have open processes for reviewing the accumulated information on the use of fosfomycin and the information from new clinical trials on this compound. The agencies’ objectives are to establish common usage criteria for Europe and authorize the sale of fosfomycin in the US, respectively. Fosfomycin’s single mechanism of action results in no cross-resistance with other antibiotics. However, various fosfomycin-resistance mechanisms have been described, the most important of which, from the epidemiological standpoint, is enzymatic inactivation, which is essentially associated with a gene carrying a fosA3-harboring plasmid. Fosfomycin has been found more frequently in Asia in extended-spectrum beta-lactamase-producing and carbapenemase-producing Enterobacterales. Although fosfomycin presents lower intrinsic activity against Pseudomonas aeruginosa compared with that presented against Escherichia coli, fosfomycin’s activity has been demonstrated in biofilms, especially in combination with aminoglycosides. The current positioning of fosfomycin in the therapeutic arsenal for the treatment of infections caused by multidrug-resistant microorganisms requires new efforts to deepen our understanding of this compound, including those related to the laboratory methods employed in the antimicrobial susceptibility testing study.

Prevention of inadvertent perioperative hypothermia as a factor increasing infectious complications

Prewencja niezamierzonej hipotermii okołooperacyjnej jako czynnika zwiększającego ryzyko powikłań, w tym powikłań infekcyjnych

Katarzyna A. Białowolska, Bartosz Horosz, Monika Grzelak, Małgorzata Malec-Milewska

Zakażenia XXI wieku 2019;2(5):219–223.

Inadvertent intraoperative hypothermia, when defined as a drop of core temperature below 36°C, is by far the most common complication of anaesthesia care. Perioperative drop in body temperature needs to be prevented, as it is a hazard to patients in terms of derangements in clotting and immunity, increased risk of cardiac events and postoperative infectious complications. Prevention of surgery-related hypothermia becomes a standard of modern perioperative care. In this paper we discuss the issue of anaesthesia-related hypothermia and methods that are effective in preventing this phenomenon.

Toxoplasmosis and schizophrenia – review of literature. Is there any link between contagion Toxoplasma gondii and schizophrenia
in humans?

Toksoplazmoza a schizofrenia – przegląd literatury. Czy istnieje związek między zarażeniem Toxoplasma gondii a schizofrenią u człowieka?

Maria Gicala

Zakażenia XXI wieku 2019;2(5):225–229.

Toxoplasma gondii is a widely distributed protozoan. There are about half a milliard seropositive individuals worldwide. Although that parasite infects so many people, it is not regarded as potentially dangerous to our health (except for pregnant women and immunocompromised individuals). The purpose of this article is to draw attention to a possible impact of latent toxoplasmosis on mental disorders. This is an attempt to systematize available knowledge on this topic.

About congenital toxoplasmosis again…

O toksoplazmozie wrodzonej raz jeszcze…

Marta Baryła, Jolanta Warzycha, Agata Janta, Marian Halkiewicz

Zakażenia XXI wieku 2019;2(5):231–235.

Congenital toxoplasmosis results from a primary infection with Toxoplasma gondii during pregnancy. The relationship between the probability of fetal infection and clinical changes is inversely proportional. The older the fetus, the greater risk of infection, but the severity of lesions is lower or the course is asymptomatic in the neonatal period. However, the symptoms appear later in life, in the form of: visual, hearing, neurological disorders or mental retardation. Education of pregnant women about the pathways of infection is the first line of defence. Then, systematic (optimally in every trimester in seronegative women) serological tests of pregnant women enabling early detection of the primary infection and implementation of treatment that improves prognosis in children infected intrauterine are required. The final stage should be an accurate interview and analysis of pregnancy cards as so-called the last „sieve”. They are tools in our hands which we can limit the occurrence of this serious illness.

Peracetic acid in the decontamination of gastrointestinal tract endoscopes

Kwas nadoctowy w dekontaminacji endoskopów przewodu pokarmowego

Dorota Kudzia-Karwowska

Zakażenia XXI wieku 2019;2(5):237–240.

Recently, a very dynamic development of diagnostic and surgical endoscopy has been observed. The endoscopic equipment used for procedures posing a risk of tissue disruption should be sterile. Due to the diversity of materials, we cannot always apply the sterilization processes. This is when the high-level disinfection must be introduced. A wide range of disinfecting preparations available on the medical market leads to difficulties with choosing the most effective product on which the safety of equipment, patient and medical staff depends.

Evaluation of virucidal activity of disinfectants used in the medical area

Badanie aktywności wirusobójczej środków dezynfekcyjnych stosowanych w obszarze medycznym

Agnieszka Trzcińska

Zakażenia XXI wieku 2019;2(5):241–248.

The disinfection process is an important element of eradication of viral infections. The purpose of disinfection is both to prevent the occurrence and spread of infections, among others in medical facilities. The task of the disinfection process is to eliminate or reduce microorganisms to such a level that the object that was subjected to disinfection is no longer a source of infection with these microorganisms. To achieve the desired result of the disinfection procedure, the disinfectant used must meet a number of specific criteria, including a wide range of activity including bacteria, fungi, mycobacteria, viruses. A precise and reliable determination of the range of the virucidal activity of the disinfectant is closely related to the selection of a correct, well-designed test methodology. The article discusses the methodology for testing the virucidal activity of products used in the medical field described in the currently available phase 2/step 1 and phase 2/step 2 standards.

Professional solutions in the hygiene of the hands of the medical staff, increasing the effectiveness of fighting hospital infections

Profesjonalne rozwiązania w higienie rąk personelu medycznego zwiększające skuteczność walki z zakażeniami szpitalnymi

Małgorzata Cichońska

Zakażenia XXI wieku 2019;2(5):249–252.

Hand hygiene is the simplest, and at the same time the most effective and the most important method of preventing hospital infections. However, the importance of this procedure is underestimated by healthcare professionals, among whom the compliance with the principles of good hand hygiene ranges from 5% to 89%. The professional approach to hand hygiene includes numerous activities, i.a.: placing non-contact dispensers with a disinfectant preparation in diagnostic rooms, in patient rooms, in dirty rooms, in preparation rooms or administrative rooms. It seems important to provide access to water without having to touch the tap with dirty hands, to locate dispensers at all care points, to choose a closed dispensing system with disposable, replaceable packaging. It is important to choose the right, accepted by the staff, pH of hand hygiene preparations,, with short duration of action and appropriate alcohol content, and to take in to account the availability of hand care products. The basic manifestation of a professional approach to hand hygiene will be self-assessment of the procedure in the facility and implementation of monitoring through observation, calculation of consumption indicators per guest-night, or use of video monitoring or advanced real-time analysis and location software to assess the level of implementation. The basis confirming a professional approach to the field of hand hygiene is participation in programs promoting the idea of ​​clean hands, reporting the results obtained, providing feedback to medical staff and organizing a system for transferring knowledge and developing and strengthening habits in the field of hand hygiene. An interesting solution is also the introduction of colored dispensers and graphic elements. Hand hygiene should continue to be the goal of randomized, methodologically correct research to increase the relevance of the results obtained in assessing efficacy, economics and its impact on hospital infections.

Late HIV diagnosis in a patient presenting concomitant AIDS-defining diseases

Późne rozpoznanie zakażenia HIV u pacjenta prezentującego kilka chorób wskaźnikowych AIDS

Kamila Wójcik-Cichy

Zakażenia XXI wieku 2019;2(5):253–256.

Late HIV diagnosis results in an increased risk of opportunistic infections and increased incidence of Non-AIDS-defining diseases as cancers or cardiovascular diseases. Our paper presents a case report of a patient with a late HIV diagnosis, remaining under the care of a few medical centres. Late HIV diagnosis and concomitance of several opportunistic infections were associated with a poor disease outcome.




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