W dobie oporności wielolekowej, w połączeniu z lukami w rozwoju nowych środków przeciwdrobnoustrojowych istnieją ograniczone możliwości terapeutyczne w leczeniu zakażeń wywołanych przez patogeny oporne na wiele dostępnych leków przeciwdrobnoustrojowych. Skojarzona terapia przeciwdrobnoustrojowa jest obiecującą strategią leczenia zakażeń wywołanych przez patogeny wielolekooporne. Istotne jest, aby móc w warunkach laboratoryjnych (in vitro) wykonywać testy do oceny efektywności przeciwbakteryjnej leków zastosowanych w skojarzeniach.
The members of the bacterial Enterobacteriaceae family play an important role in the aetiology of many hospital infections. Some of them are able to produce β-lactamase, an enzyme which induces the resistance of those bacteria to penicillins, cephalosporins and, in severe infections, to penicillins with β-lactamase inhibitors. In this situation, the carbapenems become the drugs of choice. The objective of this study was to analyse the in vitro efficacy of three carbapenems: ertapenem, imipenem and meropenem against bacterial species of the Enterobacteriaceae family.A total of 99 bacterial species (including ten bacterial species producing the ESBL mechanism), isolated between September 2011 and March 2012 from diagnostic material collected from patients of surgical clinics in the department of motoskeletal system infections and the critical care unit, hospitalised in the Military Institute of Medicine in Warsaw, were analysed. The values of MIC 50 and MIC 90 were recorded.All isolated bacterial species were susceptible to meropenem. One strain of Morganella morganii was resistant to imipenem, while one strain of Enterobacter cloaceae and one strain of Klebsiella pneumoniae were resistant to ertapenem. In the Enterobacteriaceae ESBL(-) group, the values of MIC 50 were 0.006 μg mL-1 for ertapenem, 0.19 μg mL⁻¹ for imipenem, and 0.032 μg mL⁻¹ for meropenem, and the MIC 90 values were: 0.25 μg mL⁻¹, 0.5 μg mL⁻¹ and 0.125 μg mL⁻¹, respectively. In the Enterobacteriaceae ESBL(+) group, the values of MIC 50 were 0.38 μg mL⁻¹, 0.25 μg mL⁻¹, 0.064 μg mL⁻¹, and the values of MIC 90 were 0.5 μg mL⁻¹, 0.25 μg mL⁻¹ and 0.125 μg mL⁻¹, respectively.All analysed carbapenems had high in vitro efficacy against both Enterobacteriaceae ESBL(-) and Enterobacteriaceae ESBL(+) bacterial species.
Seasonal outbreaks of respiratory syncytial virus are common among young children and represent an important clinical problem. The infection can affect all floors of the respiratory system. Respiratory syncytial virus is highly infectious and is the most common aetiological agent of bronchiolitis. It is estimated that 90% of children develop respiratory syncytial virus infection by the age of 2 years. In Poland and other countries of the northern hemisphere, these infections usually occur between October and May, with a peak in January–February. During the global COVID-19 pandemic, a significant change was observed in the epidemiology of respiratory syncytial virus infections in Europe and worldwide. The massive use of nonpharmacological interventions, such as closing nurseries, kindergartens, limited interpersonal contact, social distancing, strict hygiene rules and the use of protective masks, resulted in the absence or episodic occurrence of many seasonal infections, including those of respiratory syncytial virus aetiology, in 2020. In 2021, a so-called compensatory epidemic of syncytial virus aetiology was observed, i.e. a significant increase in the incidence associated with the extinction of collective immunity and an increasing proportion of susceptible individuals. The aim of the present study was to retrospectively analyse the incidence of respiratory syncytial virus infections in children hospitalised in the Department of Paediatrics, Paediatric Nephrology and Allergology of the Military Institute of Medicine in Warsaw in the years 2020–2021. We also discussed the prevention and treatment of infections, as well as the association of bronchiolitis with the development of asthma in children.
The efficacy of antiseptics against bacteria and fungi is different. The choice of optimal antiseptic solution is very important in prophylaxis of hospital infections.In this study the efficacy of different antiseptics against some pathogens (Klebsiella pneumoniae ESBL (+), Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus MRSA, Candida dublinensis) was analyzed. The disc diffusion, similar to the method used in antibiotic sensitivity testing was applied. We assumed that the size of inhibition zone of bacterial growth corresponds with the efficacy of antiseptic.The 2% alcoholic solution of chlorhexidine was the most effective antiseptic in our study.
Background The war in Ukraine led to migration of Ukrainian people. Early 2022, several European national surveillance systems detected multidrug-resistant (MDR) bacteria related to Ukrainian patients. Aim To investigate the genomic epidemiology of New Delhi metallo-β-lactamase (NDM)-producing Providencia stuartii from Ukrainian patients among European countries. Methods Whole-genome sequencing of 66 isolates sampled in 2022–2023 in 10 European countries enabled whole-genome multilocus sequence typing (wgMLST), identification of resistance genes, replicons, and plasmid reconstructions. Five bla NDM-1 -carrying- P. stuartii isolates underwent antimicrobial susceptibility testing (AST). Transferability to Escherichia coli of a bla NDM-1 -carrying plasmid from a patient strain was assessed. Epidemiological characteristics of patients with NDM-producing P. stuartii were gathered by questionnaire. Results wgMLST of the 66 isolates revealed two genetic clusters unrelated to Ukraine and three linked to Ukrainian patients. Of these three, two comprised bla NDM-1 -carrying- P. stuartii and the third bla NDM-5 -carrying- P. stuartii. The bla NDM-1 clusters (PstCluster-001, n = 22 isolates; PstCluster-002, n = 8 isolates) comprised strains from seven and four countries, respectively. The bla NDM-5 cluster (PstCluster-003) included 13 isolates from six countries. PstCluster-001 and PstCluster-002 isolates carried an MDR plasmid harbouring bla NDM-1, bla OXA-10 , bla CMY-16 , rmtC and armA , which was transferrable in vitro and, for some Ukrainian patients, shared by other Enterobacterales. AST revealed PstCluster-001 isolates to be extensively drug-resistant (XDR), but susceptible to cefiderocol and aztreonam–avibactam. Patients with data on age (n = 41) were 19–74 years old; of 49 with information on sex, 38 were male. Conclusion XDR P. stuartii were introduced into European countries, requiring increased awareness and precautions when treating patients from conflict-affected areas.
