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Streszczenie Prawidłowo przeprowadzona procedura mycia i dezynfekcji rąk, wśród pracowników jednostek medycznych jest jedną z podstawowych zasad zapobiegania zakażeniom związanym z opieka zdrowotną, które znacznie wydłużają hospitalizację, generując większe koszty. Celem pracy było dokonanie przeglądu dostępnej literatury na temat źródeł szerzenia się zakażeń szpitalnych w kontekście higieny rąk personelu. Ocena, czy procedury te są wykonywane prawidłowo oraz czy ręce i paznokcie mają wpływ na rozprzestrzenianie się drobnoustrojów w środowisku szpitalnym. Literatury szukano w bazach danych PubMed oraz Google Schoolar, wpisując odpowiednie słowa kluczowe. Zebrane dane literaturowe jednoznacznie wskazują jak istotną rolę w przerwaniu łańcucha epidemiologicznego zakażeń szpitalnych ma prawidłowa procedura mycia rąk; krótkie oraz niepomalowane paznokcie a także brak biżuterii na rękach personelu szpitalnego.

A temperate siphovirus, phiCDKH01, was obtained from a clinical isolate of Clostridioides difficile. The phage genome is a 45,089-bp linear double-stranded DNA molecule with an average G+C content of 28.7%. It shows low similarity to known phage genomes, except for phiCD24-1. Genomic and phylogenetic analysis revealed that phiCDKH01 is a newly discovered phage. Sixty-six putative ORFs were predicted in the genome, 37 of which code for proteins with predicted functions. The phiCDKH01 prophage was localized in the host genome. The results of this study increase our knowledge about the genetic diversity of tailed phages. Supplementary Information The online version contains supplementary material available at 10.1007/s00705-021-05092-0.

Background: Clostridium spp. spores are resistant to many factors, including alcohol-based disinfectants. The presence of clostridial spores in a hospital environment may lead to infection outbreaks among patients and health care workers. Objective: This study is aimed to detect clostridial spores in the aurology hospital using C diff Banana Broth™ and assess the antibiotic sensitivity and toxinotypes of isolates. Methods: After diagnosing COVID-19 in medical staff and closing an 86-bed urology hospital in 2020 for H2O2 fogging, 58 swabs from the hospital environment were inoculated to C diff Banana Broth™, incubated at 37°C for 14 days, checked daily, and positive broths were sub-cultured anaerobically for 48 h at 37°C. After identification, multiplex PCR (mPCR) was performed for Clostridium perfringens, C. difficile toxin genes, and minimum inhibitory concentration (MIC) determination. Results: In this study, 16 out of 58 (~ 28%) strains of Clostridium spp. were cultured: 11 - C. perfringens, 2 - C. baratii, and 1 each of C. paraputrificum, C. difficile, and C. clostridioforme. 11 C. perfringens were positive for the cpa, 7 - the cpb2, 2 – cpiA, and 1 – cpb toxin genes. All isolates were sensitive to metronidazole, vancomycin, moxifloxacin, penicillin/tazobactam, and rifampicin. Two out of the 11 C. perfringens strains were resistant to erythromycin and clindamycin. Conclusions: Regardless of the performed H2O2 fogging, antibiotic-resistant, toxigenic strains of C. perfringens (69%) obtained from the urology hospital environment were cultured using C diff Banana Broth™, indicating the need to develop the necessary sanitary and epidemiological procedures in this hospital.

BACKGROUND Recent studies have shown that up to 25% of sepsis cases originate in the urinary tract. Urosepsis can be associated with cystitis, lower urinary tract infections (UTIs), and upper UTIs and is most commonly caused by gram-negative bacteria. This retrospective study from a urology center in southern Poland, was conducted between 2017 and 2020 and aimed to investigate the causes, microbiology laboratory findings, and management in 138 patients with UTIs and urosepsis. MATERIAL AND METHODS Records of patients with UTIs with urosepsis admitted to the Urology Department of the hospital in Silesia, Poland, between 2017 and 2020 were analyzed retrospectively, and clinical and laboratory data were evaluated. RESULTS The 138 included patients were admitted to the hospital between 2017 and 2020. The median age of patients was 67 (20-94) years, and 59.9% (82/137) were men. The most common reasons for admission to the Urology Department were hydronephrosis due to dysfunction of urinary drainage in 36.5% (50/137) of patients and hydronephrosis due to urolithiasis in 22.6% (31/137) of patients. The main etiological agents responsible for the development of urosepsis were strains of Enterobacteriaceae in 85% of patients, of which 41.4% (48/116) produced extended-spectrum beta-lactamases (ESBL), accounting for 35.0% (48/137) of patients with urosepsis. In 83.3% (80/96) of patients, the pathogen cultured from the urine was identical to that cultured from the blood. CONCLUSIONS The identification of an increasing prevalence of urosepsis associated with ESBL-producing gram-negative rods from this single-center study highlights the importance of infection monitoring, rapid diagnosis, and multidisciplinary patient management.

This paper attempts to determine the role of the hospital environment in the spread of Clostridioides/Clostridium (C.) difficile infections based on a review of studies published in the medical literature and in the light of the authors' own experiences. Clostridioides/Clostridium difficile has recently attracted more and more attention, not only as an etiological factor of pseudomembranous intestinal inflammation and antibiotic associated diarrhea, but also as an etiologic factor of healthcare-associated infections (HAI) because of the possibility to survive in the hospital environment for a long time. This is caused by the production of spores, whose eradication options are limited. Clostridioides/Clostridium difficile spores are present not only on bedding of infected patients and their other belongings, but also on medical equipment and the hands of medical personnel, constituting a potential source of infection for other patients and some of the staff. The introduction of appropriate procedures for hand hygiene as well as for cleaning and disinfection of hospital surfaces makes it possible to reduce the number of spores and/or eradicate them. These procedures must be strictly followed to reduce the occurrence of spores in the hospital environment and to prevent further spread of C. difficile infections (CDI). Monitoring the presence of the C. difficile spores in a hospital environment using appropriate media (C diff Banana BrothTM) provides additional opportunities for culturing of C. difficile strains and determining ribotypes, especially hyperepidemic ones, which is extremely important from an epidemiological point of view. Med Pr. 2019;70(6):739-45.

Monika Kaba&lstrok;a,1,&ast; Zygmunt Gofron,1,&ast; Ma&lstrok;gorzata Aptekorz,1 Krzysztof Sacha,1 Celine Harmanus,2 Ed Kuijper,2 Gayane Martirosian1 1Department of Medical Microbiology Medical University of Silesia in Katowice, Katowice, Poland; 2Department of Medical Microbiology Leiden University Medical Center, Leiden, the Netherlands&ast;These authors contributed equally to this workCorrespondence: Gayane MartirosianDepartment of Medical Microbiology Medical University of Silesia in Katowice, 18 Medyków str, Katowice, 40-752, PolandEmail gmartir@sum.edu.plObjective: The aim of this study was Clostridioides difficile outbreak investigation due to the emergence of rifampicin resistant ribotype 027 (RT 027) fecal isolates from patients of Polish tertiary care hospital between X. 2017 and II. 2018 using multilocus variable tandem repeat analysis (MLVA).Materials and Methods: Twenty-nine C. difficile fecal isolates from patients of tertiary care hospital in Southern Poland were ribotyped and analyzed by MLVA. Multiplex PCR (mPCR) for genes encoding GDH (gluD), toxins A (tcdA)/ B (tcdB), 16S rDNA and binary toxin genes (ctdA and ctdB) was performed. The antibiotic susceptibility profile was determined by E-test.Results: The A, B and binary toxins encoding genes were detected in all 29 C. difficile strains which were sensitive to metronidazole, vancomycin and were resistant to erythromycin, clindamycin, and moxifloxacin; resistance to imipenem demonstrated 97%, to rifampicin – 45% isolates. C. difficile strains could be grouped by MLVA into 5 distinct clusters, and the largest cluster II contains 16 strains. The comparison of rifampicin GM MIC of cluster II (n=16 strains) with all others (n=13) showed that strains from clusters I, III, IV and V possessed significantly (p < 0.005) higher GM MIC and were more resistant to rifampicin.Conclusion: MLVA analysis proved transmission and recognized outbreak due to multidrug-resistant RT 027 C. difficile among patients of tertiary care hospital in Southern Poland. The reason for this is probably the widespread occurrence of spores in the hospital environment, which includes, among others, neglect of hygienic procedures and epidemic supervision. High resistance to imipenem (97%) and to rifampicin (45%) among C. difficile RT 027 Silesian isolates is threatening and requires further studies to elucidate this phenomenon.Keywords: Clostridioides difficile, epidemiology, MLVA, RT 027, rifampicin resistance

A new temperate phiCDKH01 siphophage was obtained from clinical isolate of Clostridioides difficile. The phage genome is a 45,089 bp linear double-stranded DNA molecule with an average G + C content of 28.7%. It shows low similarity to known phage genomes except for phiCD24-1. Genomic and phylogenetic analysis revealed that phiCDKH01 is a novel phage. 66 putative ORFs were predicted in the genome, 37 of which code for proteins with predicted functions. The phiCDKH01 prophage has been localized in the host genome. Results of this study increases genetic diversity of known tailed phages.

116 environmental samples from a 504 bed clinical hospital obtained in 2017/19 were inoculated into C diff Banana Broth (TM). Six C. difficile and 12 C. pefringens strains were isolated. Antibiotic-resistant Clostridium spp. dominated in hospital environment. To determine Clostridium spp. in hospital environment suitable medium like C diff Banana Broth (TM) should be used. (C) 2021 Published by Elsevier Ltd.