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The gut microbiota serves a crucial role in the development of host immunity. Immunocompromised patients are particularly vulnerable to dysbiosis not only by virtue of a defect in the immune system but also due to increased susceptibility to infection and multiple courses of antibiotic therapy. Fecal microbiota transplantation is by far the most effective option for restoring gastrointestinal homeostasis. However, it is contraindicated in patients with significant primary and secondary immunodeficiencies. This article presents the case of a 59-year-old patient with common variable immunodeficiency, after splenectomy at age 39 for primary immune thrombocytopenia, who manifested diarrhea of up to 10 stools per day accompanied by secondary malnutrition and cachexia. The patient was admitted to the hospital on multiple occasions due to this condition, with stool PCR tests confirming a HHV-5 (Cytomegalovirus, CMV) infection. Following the administration of valganciclovir, the patient's complaints diminished, although, upon cessation of the drug, the symptoms recurred. In addition, the patient had an intestinal infection with C. difficile etiology. Given that the patient's therapeutic options had been exhausted, after obtaining informed consent from the patient and approval from the bioethics committee to conduct a medical experiment, treatment of diarrhea was undertaken by fecal microbiota transplantation with the certified preparation Mbiotix HBI from the Human Biome Institute. The patient underwent two transplants, with a one-week interval between them. The initial procedure was performed using the endoscopic method, while the subsequent was conducted using the capsule method. Following the administration of the applied treatment, the patient's symptoms were successfully alleviated, and no adverse effects were observed. A microbiological analysis of the intestinal microbiota was conducted prior to and following transplantation via next-generation sequencing (NGS). No recurrence of symptoms was observed during the two-year follow-up period. To the best of our knowledge, this is the first fecal microbiota transplantation in an adult patient with primary and secondary immunodeficiency. [ABSTRACT FROM AUTHOR]

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Until now, Poland did not have uniform national guidelines for the prevention of surgical site infections (SSI) in the area of perioperative nursing care. Key criteria for effective SSI prevention are included in the current CDC recommendations. The aim of this document is to address activities undertaken by surgical nurses with respect to SSI prevention on the basis of up-to-date and reliable research results. The document contains 15 recommendations for postoperative prevention of SSI and complements the study focusing on the preoperative period. Integration of the recommendations into daily practice is expected to improve the quality of nursing care provided to patients, increase patient satisfaction with medical care and reduce costs. [ABSTRACT FROM AUTHOR]

Poland lacks uniform national guidelines for the prevention of surgical site infections (SSI) in the area of perioperative antibiotic and nursing care. Key criteria for effective SSI prevention are included in the current CDC recommendations. The present document contains a total of 13 recommendations that aim to organize scientific data collected to date, and address activities undertaken primarily by surgical nurses with respect to SSI prevention. The recommendations apply to the preoperative period. [ABSTRACT FROM AUTHOR]

We aimed to describe the clinical presentation, treatment, outcome and report on factors associated with mortality over a 90-day period in Clostridioides difficile infection (CDI). Descriptive, univariate, and multivariate regression analyses were performed on data collected in a retrospective case-control study conducted in nine hospitals from seven European countries. A total of 624 patients were included, of which 415 were deceased (cases) and 209 were still alive 90 days after a CDI diagnosis (controls). The most common antibiotics used previously in both groups were β-lactams; previous exposure to fluoroquinolones was significantly ( p = 0.0004) greater in deceased patients. Multivariate logistic regression showed that the factors independently related with death during CDI were older age, inadequate CDI therapy, cachexia, malignancy, Charlson Index, long-term care, elevated white blood cell count (WBC), C-reactive protein (CRP), bacteraemia, complications, and cognitive impairment. In addition, older age, higher levels of WBC, neutrophil, CRP or creatinine, the presence of malignancy, cognitive impairment, and complications were strongly correlated with shortening the time from CDI diagnosis to death. CDI prevention should be primarily focused on hospitalised elderly people receiving antibiotics. WBC, neutrophil count, CRP, creatinine, albumin and lactate levels should be tested in every hospitalised patient treated for CDI to assess the risk of a fatal outcome.

Many identification and relatedness studies methods had been commonly used for epidemiological studies in microbiological laboratories. Apart from phenotypic methods, genotypic are also often used. The aim of this study was to compare, obtained by PFGE chromosomal DNA patterns of methicillin-resistant S. epidermidis strains isolated from clinical material. 46 methicillin-resistant S. epidermidis strains were included in this study. Most of them were isolated from wound swabs (65.2%) and catheters (19.6%) from different surgical clinics (76.1%). To identify strains and receive biochemical profiles, ID 32 Staph tests and GPI cards of Vitek 1 system were used. Pulsed-field gel electrophoresis and Tenover et al. interpretation were used to compare chromosomal DNA patterns of examined strains. 44 and 42 PFGE patterns of chromosomal DNA were received, using visual interpretation classifying two pairs of strains as the same, two pairs as closely related and three pairs as probably related. Strains classified as identical and similar in visual evaluation were indistinguishable in Molecular Analyst DST interpretation, probably due to tolerance in bands location pattern. Strains probably related in visual interpretation represent at least 96% similarity in Molecular Analyst DST but different susceptibility and biochemical profiles obtained by ID 32 Staph and Vitek 1. PFGE analysis had foremost capacity to distinguish methicillin-resistant S. epidermidis strains using visual interpretation and Molecular Analyst DST (Bio-Rad) program and seems to be useful method in epidemiological studies. Strains with the same PFGE pattern, had different susceptibility and biochemical profiles.

Many identification and typing methods has been commonly used in microbiological laboratories. Phenotypic methods are the most frequently used. The aim of this study was to compare biochemical profiles and susceptibility patterns ofmethicillin-resistant S. epidermidis strains isolated from clinical material. 46 methicillin-resistant S. epidermidis strains were included in this study. Most of them were isolated from wound swabs (65.2%) and catheters (19.6%) from different surgical clinics (76.1%). To receive biochemical profiles ID 32 Staph tests and GPI cards of Vitek 1 were used receiving 18 and 14 profiles, respectively. 28 susceptibility patterns were obtained by disc-diffusion method and automatic system Vitek 1 using GPS-527 cards. ID 32 Staph tests and Vitek GPI cards represented the lowest discriminate power for methicillin-resistant S. epidermidis strains and they should not be recommended for typing them. Estimation of the susceptibility patterns was far more sensitive among examined phenotypic methods. Groups of strains have often the same profile received in ID 32 Staph test and Vitek GPI cards but different susceptibility.

Doripenem, the newest carbapenem was approved in 2008 by the European Medicines Agency for the treatment of complicated intra-abdominal infections and complicated urinary tract infections. Its spectrum of activity is similar to that of meropenem and imipenem/cilastatin. The aim of this study was to compare in vitro activity of doripenem against nonfermentative Gram-negative rods. A total of 235 strains of Pseudomonas spp. (74.9%) and Acinetobacter spp. (25.1%) were included into the study. Strains were isolated in The Department of Clinical Microbiology of the University Hospital No 1 in Bydgoszcz and identified using ID GN tests (bioMérieux). To determine susceptibility to doripenem and other carbapenems disc-diffusion method was applied. Percentage of doripenem resistant strains reached 28.4% and 39.0% for Pseudomonas spp. and Acinetobacter spp, respectively. All doripenem sensitive or intermediate Acinetobacter spp. strains were simultaneously sensitive to imipenem and meropenem. Activity of imipenem and meropenem among doripenem resistant Acinetobacter spp. were represented by 60.9% and 56.5% strains, respectively. Activity of imipenem and meropenem among doripenem resistant Pseudomonas spp. strains were represented by 12.0% and 18.0%, respectively. Occurence of one doripenem sensitive Pseudomonas spp. strain simultaneously resistant to imipenem and meropenem was observed.

The aim of this study was to evaluate the influence of ciprofloxacin in a concentration of 0.25 microg/ml on the ability of synthesis of staphylococcin T (StT) Staphylococcus cohnii at 37 degrees C after 24 and 48 hours incubation. Ciprofloxacin in concentration of 0.25 microg/ml after 24 hours incubation inhibits antistaphylococcal activity StT produced by S. cohnii, while after 48 hour incubation, S. cohnii StT is excreted on the same level, in the presence and in the absence of ciprofloxacin.

Laparoscopic cholecystectomy (LC) is "the method of choice" in the treatment of cholelithiasis and its' complications. LC is not devoid of complications, among others, surgical site infection (SSI) but as a result of minimalisation of surgical trauma and immunosuppression after surgery, percentage of SSI is lower than after conventional cholecystectomy. Skin disinfection carried out before operation is thought to minimalise risk of infective complications after LC. 150 patients who had laparoscopic cholecystectomy carried out, were included in prospective study. Efficacy of skin disinfection was based on microbiological assessment including swabs from the umbiliculus before and after skin disinfection, and samples of exsudate or discharge from surgical site (if any). There were 133 (88.6%) patients with positive result of the umbilical swab before the disinfection of the skin, whereas 26 (17.3%) patients had bacteria isolated from the umbilical swab after the disinfection. Among these 26 patients in 19 (73.1%) cases the same species of bacteria were isolated before and after skin disinfection. Among 19 patients with inefficient skin dissinfection in 2 cases we observed SSI. In one of them the same strains of bacteria were isolated from umbilical swab and surgical site. Analysis of drug sensitivity of these isolates showed strict correlation. There were 16 cases of SSI in the whole group and it's rate was 10,6%. Skin disinfection before LC is not fully efficient. Inefficiency of skin disinfection does not increase risk of SSI. Skin dissinfection reduce microbial flora but does not protect from SSI provoked by these microbials.

Multidrug resistant Gram-negative rods are increasingly isolated from clinical specimens, especially from hospitalized patients. The aim of this study was to evaluate the prevalence of imipenem resistant strains of Gram-negative rods isolated in dr. A. Jurasz University Hospital in Bydgoszcz between 1999 and 2005 and imipenem consumption in this period. Out of 109614 isolated microorganisms, Gram-negative rods were 28,5%, 637 (2,0%) of strains were resistant to imipenem. These strains were isolated mostly from patients hospitalized in intensive care and rehabilitation clinics. Among imipenem-resistant strains Pseudomonas aeruginosa prevailed (88,9%). P. aeruginosa strains were sensitive to colistin, 45,5% of them to aztreonam and 44,0% to ceftazidime. The imipenem consumption in the appropriate years included in this study was: 805,00; 1201,25; 940,00; 1390,00; 1660,00; 1341,25; 1841,25 DDD respectively, and was strictly connected with increasing imipenem-resistant Gram-negative rods isolation.

Unlabelled: The development of invasive medical procedures involves a decrease of prevalence of generalized infections. Hemodialysed patients are at higher risk of infection. The aim of this study was to analyze microorganisms isolated from blood samples of patients treated at the Department of Nephrology and Internal Diseases of the Medical University in Bydgoszcz., Material and Methods: The analysis was based on 959 blood samples obtained from 248 patients during the investigation period from 01.02.2001 to 30.11.2002. Among patients included in this analysis 52.0% were males, 48.0% females. The age oscillated between 18 and 95 years, average 58.6 +/- 17.6. Blood cultures were processed in the blood culture monitoring systems. Identification of isolated microorganisms was based on their morphological and biochemical features. Antibiotic sensitivity tests were conducted according to the recommendations of the NCCLS and National Reference Centre for Drug-Sensitivity of Microorganisms., Results: Positive culture results were obtained for 151 (15.8%) samples. 1114 (75.5%) strains of Gram(+) bacteria and 36 (23.8%) strains of Gram(-) bacteria and one Candida albicans strain were isolated. The results of antibiotic sensitivity tests are also presented. High prevalence of CNS strains in our research may suggest contamination of the samples with normal skin flora, since those strains were usually only isolated one time. It might also be the result of the profile of the Department., Conclusions: The prevention of vascular access-related septicaemia is a vital element of the care of the hemodialysed patient, as it is a well-established risk factor of generalized infections. Elaborating of local standards for empirical antibiotic therapy of generalized infections based on the epidemiological data of a particular department or hospital ward is necessary.

Bacterial cell surface hydrophobicity (CSH) may promote colonization. The aim of this study was evaluation of the influence of growth conditions and sensitivity to selected antibiotics on hydrophobic properties of multiresistant P. aeruginosa strains by means of salt aggregation test (SAT) and bacterial adhesion to hydrocarbons (BATH). 30 multiresistant P. aeruginosa strains were included in this study. The variables were: microbiological media type (trypticase-soy agar, trypticase-soy agar with 5% sheep blood and trypticase-soy broth), growth temperature (22, 30 and 37 degrees C) and growth time (24 and 48 h). Most of the investigated strains presented hydrophilic properties in both methods. Cultivation in trypticase-soy broth caused statistically relevant decrease of CSH. Growth temperature did not influence CSH. 48 hours of incubation caused statistically relevant drop of the CSH when compared with 24 h incubation. The sensitivity to selected antibiotics did not vary investigated strains, except form cefepime sensitive and intermediate sensitive strains.