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Background/Objectives: The genus Acinetobacter demonstrates resistance to antibiotics and has been shown to spread in the hospital environment causing epidemic outbreaks among hospitalized patients. The objectives of the present study was to investigate the antibiotic resistance, biofilm formation, and clonality among Acinetobacter baumannii strains. Materials and Methods: The study involved 6 (I Outbreak) and 3 (II Outbreak) A. baumannii strains isolated from patients hospitalized in vascular surgery unit. Results: All tested A. baumannii strains were extensively drug resistant (XDR) and all the isolates were carbapenem-resistant and among them, all carried the blaOXA-51 gene, the blaOXA-24 gene, as well as the blaOXA-23 gene. All of the investigated strains had the ability to form a biofilm, but all of them produced less biofilm than the reference strain. Multi-locus sequence typing (MLST) showed that all strains belonged to the ST2 clone. Pulsed-field gel electrophoresis (PFGE) divided the tested outbreak strains into two clones (A and B). Conclusion: This study shows a nosocomial spread of XDR A. baumannii ST2 having the blaOXA-51 gene, the blaOXA-24 gene, as well as the blaOXA-23 gene, low biofilm formers, that was prevalent in the vascular surgery unit. To identify the current situation of vascular surgery departments targeted epidemiological investigation was needed. Effective implementation of infection control prevented the spread of the epidemic outbreaks.

Background/Objectives: The genus Acinetobacter demonstrates resistance to antibiotics and has been shown to spread in the hospital environment causing epidemic outbreaks among hospitalized patients. The objectives of the present study was to investigate the antibiotic resistance, biofilm formation, and clonality among Acinetobacter baumannii strains. Materials and Methods: The study involved 6 (I Outbreak) and 3 (II Outbreak) A. baumannii strains isolated from patients hospitalized in vascular surgery unit. Results: All tested A. baumannii strains were extensively drug resistant (XDR) and all the isolates were carbapenem-resistant and among them, all carried the blaOXA-51 gene, the blaOXA-24 gene, as well as the blaOXA-23 gene. All of the investigated strains had the ability to form a biofilm, but all of them produced less biofilm than the reference strain. Multi-locus sequence typing (MLST) showed that all strains belonged to the ST2 clone. Pulsed-field gel electrophoresis (PFGE) divided the tested outbreak strains into two clones (A and B). Conclusion: This study shows a nosocomial spread of XDR A. baumannii ST2 having the blaOXA-51 gene, the blaOXA-24 gene, as well as the blaOXA-23 gene, low biofilm formers, that was prevalent in the vascular surgery unit. To identify the current situation of vascular surgery departments targeted epidemiological investigation was needed. Effective implementation of infection control prevented the spread of the epidemic outbreaks.

Background: The results of several studies in the area of infection control in Poland are disturbing. The situation may be shaped by many factors. However, the key factor for effective infection prevention and control is dedicated personnel, especially infection prevention and control nurses (IPCN). Nevertheless, based on the available published data and the authors&rsquo, experience, in many Polish hospitals infection control is not sufficiently appreciated by managers, it is consequently underfunded, and treated by medical staff as a nuisance. This may influence the nurses willingness to work as IPCN. The aim of the study was to assess the nursing students&rsquo, perception of the work of IPCN and their interest in employment in this position, as well as the potential reasons for choosing this particular specialization. Materials and methods: The study was conducted using the authors&rsquo, anonymous questionnaire conducted among nursing students of three Polish universities. The questionnaire was prepared by a panel of experts working in the field of infection control, including nurses working both as academic teachers and infection control nurses in hospitals. The design of the questionnaire was based on the authors&rsquo, own experience, knowledge, and exchanging information with the practitioners in infection control in Poland. The reliability of the questionnaire was confirmed by the Cronbach alpha test. The raw alpha values and 95% CI for two main questions concerning opinion were: 0.76 (0.72&ndash, 0.81) and 0.69 (0.63&ndash, 0.75). Results: The study was conducted among 253 students, mostly women (98%) of full-time (31.4%) and extramural (68.6%) studies. The age range of the respondents was 20&ndash, 58 years, median = 26 years, IQR = 19 years. To the key item in the questionnaire, i.e., &ldquo, Would you like to work as an IPCN?&rdquo, 84.6% (214 respondents, first group) of the respondents answered &ldquo, no&rdquo, and 15.4% (39 respondents, second group) answered &ldquo, yes&rdquo, The results revealed no significant differences between the two groups concerning the position responsibilities and appreciation by other medical staff. Additionally, for respondents willing to work as ICPN the most important issues were the influence on patient safety, expected salary, and possibility of professional development, for the respondents from the other group the most important issue was lack of contact with patients. The results concerning the students&rsquo, opinion on the perception of IPCN by medical personnel proved to be peculiar. About 80% of the respondents confirmed the IPCNs&rsquo, key role in ensuring patient and personnel safety, while only 31.6% declared their high standing in the hospital hierarchy. Conclusions: The obtained results indicate the necessity of thorough studies on the organization and structure of infection control in Polish hospitals, with a particular emphasis on building a positive perception of IPCNs by medical staff, as well as implementing an education campaign on infection control in the hospital environment.

Background The results of several studies in the area of infection control in Poland are disturbing. The situation may be shaped by many factors. But the key factor is the infection teams and especially infection control and prevention nurses (ICPNS) ability of influencing positive medical personnel attitudes and behavior in this area. Aim of the study The article presents the results of the study on nursing students’ perception of ICPNs work. Material and method The study was conducted using the author's anonymous questionnaire conducted among nursing students of three Polish universities. Results The results proved to be peculiar. About 80% respondents confirmed the ICPNs key role in ensuring patient and personnel safety, while only 31.6% declared its great authority among the hospital staff. Conclusions Obtained results indicate the necessity of thorough studies on the organization and structure of infection control in Polish hospitals, with particular emphasis of building its’ positive perception by wards staff as well as implementing education campaign on infection control in hospital environment.

The aim of the study was a molecular characterization of Staphylococcus aureus strains isolated from surgical site infections (SSIs) from patients in southern Poland, undergoing different surgical procedures, together with evaluation of the prevalence of antimicrobial resistance and the presence of virulence factors.In this laboratory-based, multicenter study, non-repetitive 162 samples from SSI were collected from hospitalized patients (12 hospitals, n=139) or outpatients (n=23) in southern Poland between January 1 and December 31, 2013. In all S. aureus isolates, we investigated antimicrobial susceptibility, the presence of selected virulence genes (lukE, pvl, tsst-l and eta), and also conducted spa typing.Patients with SSI had a median age of 61 years; 54.9% were male. Prevalence of MRSA (29 strains, 17.9%) SSI per surgery type was 8.7% in orthopaedic, 17.7% in general and 42.9% in vascular surgery. Over 20% of strains were resistant for erythromycin (27.2%), clindamycin (23.5%). No resistance was found for linezolid, glycopeptides or tigecycline. Gene of Leukocidin (lukE) was the most frequently found gene. Spa typing identified 10 spa types; the two dominant types were t003 (41.4%) and t138(17.2%).The results show that after vascular surgery, there was an unexpectedly high prevalence of MRSA in SSIs in southern Poland. Conversely, the prevalence of MRSA was unexpectedly low following orthopaedics procedures. The surprisingly observation was the low virulence of the S. aureus strains among older patients.

Introduction Among medical staff, nurses are particularly vulnerable to occupational exposure since they provide direct patient care and perform medical activities which often involve using sharps. Aim The objective of the study was to examine the frequency of injuries and their causes in nursing. Methods A diagnostic survey was employed using an original questionnaire. The study was carried out from 3rd March to 2nd April 2017. The study group comprised part-time nursing students. 107 respondents participating in the study worked in out-patient (28%) and in-patient (72%) healthcare. Most of the respondents were aged 41–50 (34.6%). Results 61.7% of the respondents were injured at work. The injury reporting rate was: 19.7% always, 22.7% often, 30.3% rarely, and 27.3% never. The most commonly mentioned types of injuries included: prick (51.5%), cut (28.8%), scratch (10.6%), prick and cut (9.1%). The incidence of injuries varied. 48.5% of the studied people declared fewer than 5 incidents, 31.8% quoted 5–10 injuries, 6.1% recalled 11–20, 13.6% did not remember such a situation. For nurses with longer seniority, there is a significant increase in injuries (p=0.029). Sources of injuries were most often: injection needle (35.9%), ampoule with medicine (23.3%), pen (7.8%). Conclusions Not all occupational exposure cases are reported by nurses. Seniority determines injury incidence among nurses. The longer the seniority, the more common the injuries. The needle causes injuries most frequently.

BACKGROUND In the Malopolska province, the first case of vancomycin resistant enterococci (VRE) occurrence was an outbreak in 2001 caused by strains of the genus E. faecium carrying the vanA operon. OBJECTIVES The aim of this study is to determine the antimicrobial resistance and the occurrence of virulence determinants among Enterococcus spp. in patients hospitalized in the Malopolska region in 2015. MATERIAL AND METHODS Antimicrobial susceptibility was determined by disc diffusion and the E test. The presence of aminoglycoside and glycopeptide resistance genes and virulence genes (asa1, gelE, cylA, esp, hyl) was investigated using multiplex polymerase chain reaction (PCR). Also, the presence of IS16 was investigated. The activity of gelatinase, cytolysin (hemolysin), and DNase was tested. RESULTS All E. faecalis were susceptible to ampicillin, vancomycin, teicoplanin, linezolid and tigecycline. All E. faecium strains were susceptible to quinupristin-dalfopristin. Resistance to ampicillin and vancomycin was detected among all E. faecium isolates from hospitals C and D. 87.32% of E. faecium presented high-level aminoglycoside-resistant (HLAR) phenotype, including 78.33% of strains from hospital C and 100% from hospital D. In hospital C (98.3%) and D (96%), resistance to ciprofloxacin, levofloxacin and norfloxacin was observed. Gene esp was detected in all E. faecium isolates and the majority of E. faecium isolates carried hyl (97%). In E. faecalis, different combinations of virulence genes were detected. All analyzed E. faecium strains showed the presence of IS16 insertion element. CONCLUSIONS E. faecalis isolates were more susceptible to antimicrobials than E. faecium, which were largely multidrug-resistant. E. faecalis strains have diverse virulence factors. E. faecium showed a high percentage of hyl and esp genes and the presence of IS16.

Advances in medicine enable many patients to regain their health. But, at the same time, they become susceptible to hospital-acquired infections. The occurrence of vancomycin-resistant enterococci is a considerable problem in the modern health system. In order to limit the risk of VRE infection, proper patient care is vital, which is focused on compliance with relevant procedures (isolation, decontamination, education). Mutual cooperation between charge nurses and the ward sister and epidemiological nurse plays a major role in nursing surveillance of patients with VRE.

Summary Background Accumulated data indicate that meticillin-resistant Staphylococcus aureus (MRSA) infections are associated with a worse prognosis than methicillin-susceptible S. aureus infections. Aim To assess the epidemiological profile of S. aureus infections and the genetic diversity of clinical strains of MRSA in 12 hospitals in southern Poland. Methods Samples from bloodstream infections, pneumonia, and skin and soft tissue infections from adult patients were examined. S. aureus isolates were tested for MRSA and macrolide-lincosamide-streptogramin B (MLS B ) phenotypes. Staphylococcal cassette chromosome mec (SCC mec ) typing and S. aureus protein A ( spa ) typing were performed. Analysis of the genetic similarity was performed by pulsed-field gel electrophoresis. Results This study included 555 patients. An MRSA phenotype was detected in 15.1% of strains. The prevalence of MRSA infection was higher in patients aged >80 years. An MLS B phenotype was detected in 18.2% of strains. Analysis of Sma I profiles did not reveal a dominant clone. Spa typing showed 25 different spa types, and spa type t003 was the most common (49% of strains). Among MRSA strains, SCC mec II (49%) and SCC mec IV (27.4%) were predominant. Conclusion The characteristics of MRSA showed considerable heterogeneity. The results demonstrate the need for caution when drawing conclusions on direct epidemiological relationships between isolates based on a single typing method. As the cases of infection in this study were not associated with the hospital environment and horizontal transfer, a focus on screening at hospital admission, and appropriate infection control, may help to reduce the risk of MRSA infections.

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was investigated among infected diabetic foot ulcers in hospitalized and nonhospitalized patients in southern Poland to assess the virulence patterns and antimicrobial resistance among these strains. MRSA was detected in 10.3% of all studied isolates, from the hospitalized patients only. The rest of the isolates was methicillin susceptible. The minimal inhibitory concentration that inhibits 50% of bacterial isolates (MIC50) for vancomycin was 1.0 mg/mL. The mupA gene was detected in six (8.8%) isolates, in one MRSA strain and five methicillin-sensitive S. aureus (MSSA) strains. Among the mupA-positive strains, two were resistant to mupirocin (1 MRSA and 1 MSSA). Such results raise serious concern about the usage of mupirocin in MRSA decolonization. The pvl gene was not detected among the study isolates. The majority of isolates (70.6%) possessed the lukE gene, with no significant difference in prevalence between MRSA and MSSA isolates. An interesting finding was the presence of enterotoxin genes among the study isolates. Diabetic foot may therefore be a reservoir of bacteria, containing genes localized on mobile genetic elements that could be easily transferred to other non-pathogenic strains. The prevalence of MRSA was alarmingly high (as also suggested by others), as evaluated by the presence of the mup gene among strains, highlighting the importance of appropriate clinical management of MRSA infections in patients with diabetic foot ulcers. In this group of patients, screening of ulcer samples before antimicrobial therapy would enable informed choices regarding the selection of antimicrobial agents (e.g. octenidine, authorized for the treatment of chronic wounds) maximizing the chances of positive therapy.

The aim of this paper was to perform epidemiological and microbiological analyses of surgical site infections diagnosed in patients after vascular surgery in two highly specialist centers in the year 2005.The study was conducted in two highly specialist wards in 2005 and covered totally 413 procedures. SSI's detection was based on definitions developed according to CDC guidelines. Post-discharge detection was included in the study. Collected data enabled evaluation of incidence rates and, additionally, in one hospital, assessing detailed rates included standardized SSI risk index.Patients underwent analyzed procedures was mainly male (80%), aged 60 and more. In hospital I SSI incidence rate reached 2,6% and in the other (hospital II)--5,6%. Among the etiological factors isolated from patients with SSI staphylococci were the most common (45,5%) and it was mainly Staphylococcus aureus.The study which was performed showed the incidence of SSIs in patients undergoing vascular surgery at the level of 2.6 and 5.6%. It was shown that it is possible to introduce an effective post-discharge surveillance, which encompassed 50-66% diagnosed cases of SSI.