Improving Vaccine Assessment Pathways and Decision Making in the Polish Immunization Program.

This study examines the vaccine market access pathway in Poland to evaluate its efficiency and propose recommendations for its improvement. The research spans a comprehensive analysis of the vaccine assessment process, ranging from pre-registration to sustainability, encompassing critical components such as national immunization technical advisory groups (NITAGs), health technology assessments, resource evaluations, and decision making. This investigation utilizes a multi-phase approach. Initial desk research aimed to collect accumulated evidence about each step of the vaccine access pathway. This constituted the background for an expert panel discussion (n = 13) and a final online questionnaire (n = 12), evaluating the timeframes, inclusiveness, transparency, and consistency of the elements of the process. Poland is a late adopter of new vaccines. The country faces budget constraints and lacks a formalized framework for the inclusion of vaccines into the national immunization program. Notably, NITAGs play a crucial role, yet their limited resources and dependence on public health stakeholders diminish their impact. A formal and well-supported advisory body may become a foundation for decision-making processes. The health technology assessment conducted by the national agency is recognized for its timeliness and transparency, though the absence of fiscal analyses in vaccine assessments is identified as a gap that limits the understanding of the value of vaccinations. Resources are key drivers of decision making, and recent changes in legislation offer increased flexibility in financing vaccines. Challenges in the procurement process include a limited consideration of non-acquisition costs and an increased absence of a documented general strategy for immunization program development in Poland, pointing to a need for strategic planning. In conclusion, this study recommends the establishment of a robust NITAG with enhanced resources, incorporating fiscal analyses, transparent resource allocation, and strategic planning for immunization program development. Addressing these recommendations is crucial for optimizing Poland's vaccine market access pathway, ensuring timely and efficient population-wide vaccine access.

Trust in Physicians in the Context of HPV Vaccination of Children from the Perspective of Social Exchange Theory: A Representative Study of Polish Parents.

The vaccination of children against human papillomavirus (HPV) effectively prevents HPV infection and HPV-related cancers in women and men. However, HPV vaccination programs are met with vaccine hesitancy, which varies between countries. The coverage in Poland is low, although introducing nationally funded HPV vaccination for girls aged 12-13 in mid-2023 may increase it. The uptake of the HPV vaccine in adolescents is highly affected by parental decisions, which in turn can be influenced by interactions with the physician. The present representative study aimed to analyze the acceptance of the HPV vaccine among Polish parents (n = 360) and the level of trust in HPV vaccination in the pediatrician/general practitioner who takes care of their children aged 9-15 years. The data were gathered in September 2022 using computer-assisted telephone interviews. Most surveyed parents reported trusting their child's physician regarding vaccine recommendations (89.2%) and vaccinated their child with all or most of the vaccines recommended by a national vaccination guideline (94.7%). However, 13.3% declared themselves as moderate or strong vaccine opponents, a group characterized by high (83.4%) distrust in physicians. There was no difference in the awareness of HPV in groups varying in trusting the physicians, but parents who trusted them were more frequently aware of the HPV vaccine. Parental willingness to vaccinate their child against HPV was highly differentiated by the level of trust in the child's physician. The results highlight that trust in physicians is a critical factor shaping decisions for children's vaccination, stressing a continuous need to improve strategies to communicate with patients.

Feminized vaccine? Parents' attitudes toward HPV vaccination of adolescents in Poland: A representative study.

In 2023, the process of gradually introducing universal, free HPV vaccination into the vaccination program for children in Poland began. For this reason, the attitudes of parents of adolescents toward these vaccinations were examined in this study. The survey was conducted among 360 parents of children (girls and boys) aged 9-15. To achieve the best possible representativeness of the sample, parents were selected for the survey using a random-quota method. The survey was carried out using the CATI. The surveyed parents declared a high level of knowledge about HPV and awareness of HPV vaccination (74.2% of parents had heard of HPV, and 61.4% had heard of the HPV vaccine). The study showed a statistically significant relationship between parents' education and knowledge of HPV infection - the higher the parent's (mother or father) education, the higher the declared knowledge. Education was also a statistically significant factor influencing the declaration of vaccinating a child against HPV. In addition to parental education, the gender of the child was also a significant factor influencing willingness to vaccinate against HPV. Parents of boys were significantly more likely - than parents of girls - to declare that they would not vaccinate their sons against HPV. A significant factor influencing declarations to vaccinate against HPV was the child's vaccination against COVID-19. The study results indicate a strong correlation between parental education and parental knowledge and attitudes about HPV and the HPV vaccine.

Behavioural and Cognitive Attitudes of Paediatricians towards Influenza Self-Vaccination-Partial Mediation Model.

(1) Background: This study aims to analyse the attitudinal components influencing paediatricians' self-vaccination. (2) Methods: The national-cross survey was conducted among paediatricians involved in childhood vaccination within the immunisation program. (3) Results: A hypothetical model indicating the influence of cognitive and behavioural factors on influenza vaccination among paediatricians was verified based on a survey of Polish paediatricians. A simple mediation model, based on Triandis' Theory of Interpersonal Behaviour, reflects a relationship in which knowledge and beliefs about outcomes contribute to whether paediatricians vaccinate against influenza. (4) Conclusions: The presented research shows that the pro-vaccination behaviours of paediatricians are not only influenced by cognitive factors but also the behavioural components of attitudes, which are equally important. The conclusions point to the pivotal role of shaping both knowledge and understanding of the effectiveness of immunisation programmes in building the pro-vaccination attitudes of paediatricians. (5) Practical Implications: This is the first representative study of Polish paediatricians to demonstrate how their attitudes and behaviour are related to self-vaccination. Its conclusions allow policymakers to develop programmes to support effective measures against the spread of infectious diseases through the self-vaccination of medical professionals.

BCG Moreau Polish Substrain Infections in Patients With Inborn Errors of Immunity: 40 Years of Experience in the Department of Immunology, Children's Memorial Health Institute, Warsaw.

Objective: We aimed to assess BCG (Bacillus Calmette-Guérin) complications in patients with Inborn Errors of Immunity (IEI), according to the inherited disorders and associated immunological defects, as well as the different BCG substrains. Material: We studied adverse reactions to the locally-produced BCG Moreau vaccine, analyzed in patients with IEI diagnosed between 1980 and 2020 in the Department of Immunology, Children's Memorial Health Institute (CMHI), Warsaw. These results were compared with previously published studies. Results: Significantly fewer disseminated BCG infections (BCGosis) were found in 11 of 72 (15%) SCID (Severe Combined Immunodeficiency) NK (Natural Killer)-phenotype patients, when compared with the 119 out of 349 (34%) (p = 0.0012) patients with SCID with BCG in other countries. Significantly fewer deaths caused by BCGosis were observed (p = 0.0402). A significantly higher number of hematopoietic stem cell transplantations (HSCTs) were performed in the CMHI study (p = 0.00001). BCGosis was found in six patients with Mendelian susceptibility to mycobacterial diseases (MSMD). Other patients with IEI prone to BCG complications, such as CGD (Chronic Granulomatous Disease), showed no case of BCGosis. Conclusion: The BCG Moreau substrain vaccine, produced in Poland since 1955, showed genetic differences with its parental Brazilian substrain together with a superior clinical safety profile in comparison with the other BCG substrains, with no BCGosis in patients with IEI other than SCID and MSMD. Our data also confirmed significantly fewer cases of BCGosis and deaths caused by BCG infection in patients with SCID with this vaccine substrain. Finally, they confirmed the protecting role of NK cells, probably via their production of IFN-γ.

Measles in Poland in 2020.

INTRODUCTION: Measles is a disease under the elimination program coordinated by the World Health Organization (WHO). The elimination of measles in the country is possible provided that 95% of the population is vaccinated with two doses of the vaccine, the epidemiological situation is monitored, all suspected cases of measles are recorded, and laboratory diagnostics are conducted by the WHO Reference Laboratory. Polish Reference Laboratory is located at the Department of Virology NIPH NIH - NRI. OBJECTIVE: The aim of the article is to analyze the epidemiological situation of measles in Poland in 2020 with presenting the measles vaccination coverage and the progress of the measles elimination programme in Poland. MATERIAL AND METHODS: The epidemiological situation of measles in Poland was analyzed on the basis of the case-based questionnaires of cases suspected of measles sent to NIPH NIH - NRI by the Sanitary and Epidemiological Stations, data from the publications: "Infectious diseases and poisonings in Poland in 2020" and "Vaccinations in Poland in 2020". RESULTS: In 2020, 29 cases of measles were notified to the surveillance system in Poland (incidence 0.08 per 100,000 population). The highest incidence was observed in the aged 0-4 was estimated at 0.42 per 100,000 population. Out of all cases, 9 (31%) were hospitalized. No fatal cases due to the measles were reported. CONCLUSIONS: The epidemiological situation of measles in 2020 in comparison with the situation in 2019, has improvement. This was a trend in throughout Europe.

Rubella in Poland in 2020.

INTRODUCTION: Since 2005, rubella has been included in the eradication program coordinated by the World Health Organization (WHO). The elimination of rubella in the country is possible provided that it is achieved by min. 95% immunization status and monitoring of the epidemiological situation, including the recording all suspicions of rubella and conducting laboratory diagnostics in the WHO Reference Laboratory. AIM OF THE STUDY: The aim of the study is to assess the epidemiological situation of rubella in Poland in 2020, taking into account the assessment of rubella vaccination status and the degree of implementation of the WHO rubella elimination program in Poland. MATERIAL AND METHODS: Assessment of the epidemiological situation of rubella in Poland based on aggregated reports of suspected rubella cases sent to the National Institute of Public Health NIH - National Research Institute by the Voivodeship Sanitary and Epidemiological Stations, data from the bulletin "Infectious diseases and poisoning in Poland in 2020" and data from the Epibaza system and the bulletin "Preventive vaccination in Poland in 2020". RESULTS: In 2020, 98 cases of rubella were registered, 187 cases less than in 2019 (285 cases). There was also a decrease in the incidence to 0.26 per 100,000, compared to 0.74 per 100,000 in 2019. The highest incidence, iregardless of gender and place of residence, was recorded in the 0-4 age group (2.98 per 100,000). In 2020, no cases of congenital rubella syndrome were reported. In 2020, only one case (1.02%) was classified as a case confirmed in a laboratory test. The remaining 98.98% (97 cases) were diagnosed on the basis of clinical symptoms. SUMMARY AND CONCLUSIONS: In 2020, in Poland, a decrease in the number of rubella was observed. Rubella was registered in 99% on the basis of a general diagnosis, without the required laboratory confirmation, which means that other rash diseases can be registered as rubella.

The Impact of a Single Educational Lecture on the Vaccine Confidence among Pregnant Women and Young Mothers.

BACKGROUND: We investigated the impact of a single unstructured educational lecture about vaccinations on the vaccine confidence in volunteer participants. METHODS: We conducted a survey-based study during a series of open meetings related to pregnancy and parenting. Before and after the pediatrician's lecture related to vaccinations, listeners completed the visual analogue scales (VAS, 0-15 cm), evaluating (1) self-declared knowledge on vaccinations and (2) how they perceive the safety and efficacy of this preventive method. RESULTS: In total, 484 women aged 30 ± 4 years participated in the lecture (pregnant = 68%; ≥1 children = 56%). Participants declared to have more comprehensive knowledge on preventive vaccinations and perceived vaccines to be safer and more useful (the role for the immunity) after vs. before the lecture (median VAS: 10.4 vs. 7.2, 10.8 vs. 8.7, and 11.0 vs. 10.4 cm, all p < 0.001). Importantly, the prevalence of vaccine-related adverse events was also assessed as being higher after the lecture (median VAS: 9.9 vs. 8.0 cm, p < 0.001). The increase in self-declared knowledge on vaccinations and perceived need for vaccinations (delta VAS-VAS after minus before the lecture, expressed as % of baseline) was lower among participants who rated the lecture less vs. more useful. Importantly, both participants who liked vs. did not like the lecture comparably rated vaccines safer after vs. before the lecture (delta VAS (median, interquartile range): 16% (0-39%) vs. 18% (2-42%), p = 0.39). CONCLUSIONS: An educational lecture on vaccinations positively impacts vaccine confidence in young adult women. Irrespective of the subjective rating of the lecture, all listeners perceived vaccinations to be safer after vs. before the speech.

Rubella in Poland in 2019.

INTRODUCTION: Rubella has been included in the elimination program coordinated by the World Health Organization (WHO) since 2005. Elimination of rubella in the country is possible provided that min. 95% of the vaccination status of the population and monitoring the epidemiological situation, including recording all suspected rubella and conducting laboratory diagnostics at the WHO Reference Laboratory. AIM: The aims of the present article are to analyze the epidemiological situation of rubella in Poland in 2019 and to discuss the rubella vaccination coverage. MATERIAL AND METHODS: The assessment of the epidemiological situation of rubella in Poland was conducted on the basis of aggregated reports of suspected rubella cases sent to the National Institute of Public Health - National Institute of Hygiene by Voivodeship Sanitary and Epidemiological Stations, and data from the bulletin "Infectious diseases and poisoning in Poland in 2019" and "Vaccinations in Poland in 2019 ". RESULTS: In 2019, there was a decrease in the number of rubella cases with registered 285 cases (in 2018 - 37 cases), and a decline in incidence (from 1.1 per 100,000 to 0.74). The highest incidence rate, regardless of gender and the environment, was observed among children agded 0-4 years (6.4 per 100,000). In 2019, no cases of congenital rubella syndrome were registered. In 2019, only 3 (1.05%) cases were classified as laboratoryconfirmed cases. The remaining 98.9% (282 cases) were diagnosed on the basis of clinical symptoms. CONCLUSIONS: In 2019, there was a decrease in the number of rubella cases. In Poland rubella in reported exclusively on the basis of the clinical picture. The proportion of laboratory tests confirming/excluding rubella infection is still very low in Poland.

Measles in Poland in 2019.

INTRODUCTION: Since 1998 Poland has endorsed measles elimination programme which is coordinated by the World Health Organization (WHO). To accomplish measles elimination in the country, achievement of vaccination coverage at 95% in the population is needed, as is the monitoring of the epidemiological situation, i.e.: reporting on cases suspected of measles and conducting laboratory diagnostics in WHO Reference Laboratory. Polish Reference Laboratory is located at the Department of Virology NIPH NIH - NRI. OBJECTIVES: The aim of the article is to analyze the epidemiological situation of measles in Poland in 2019 with presenting the measles vaccination coverage and the progress of the measles elimination programme in Poland. MATERIAL AND METHODS: The epidemiological situation of measles in Poland was analyzed on the basis of the case-based questionnaires of cases suspected of measles sent to NIPH NIH-NRI by the Sanitary and Epidemiological Stations, data from the publications: "Infectious diseases and poisonings in Poland in 2019" and "Vaccinations in Poland in 2019". RESULTS: In 2019, 1,502 cases of measles were notified to the surveillance system in Poland (incidence 3.91 per 100,000 population, more than four times more than in 2018). The highest incidence was observed in the aged 35-39 was estimated at 11.36 per 100,000 population. Out of all cases, 772 (51.4%) were hospitalized. No fatal cases due to the measles were reported. In 2019 the maintenance of high vaccination coverage among children aged 2 and 12 years old was observed - from 92.6% to 99.5% (primary vaccination, children born in 2009-2017). CONCLUSIONS: The epidemiological situation of measles in 2019 in comparison with the situation in 2018, has deteriorated. This was a trend in throughout Europe.

Tetanus in Poland in 2018-2019.

BACKGROUND: Tetanus is an acute disease of the nervous system caused by tetanus toxin (neurotoxin) produced by tetanus bacilli (Clostridium tetani). This disease can be prevented by vaccination. In Poland, thanks to obligatory vaccinations of children and adolescents and high vaccination coverage, the disease has been practically eliminated. Less than 20 cases are recorded each year. AIM: The aim of the work is to analyze the epidemiological indicators of tetanus in Poland in 2018-2019. METHODS: The analysis of the Polish tetanus epidemiological situation in 2018-2019 was based on a review of data from the bulletins "Infections diseases in Poland in 2018", "Infections diseases in Poland in 2019" and the analysis of the population immunization was made on the basis of data from the bulletins "Protective Vaccination in Poland in 2018", "Protective Vaccination in Poland in 2019". RESULTS: There are 17 tetanus cases registered in 2019, in 2018 8 cases. The total incidence rate was 0.044 per 100 thousand population and was higher compared to 2018 (0.021). All reports involved hospitalized individuals. SUMMARY: The few cases of tetanus in Poland occur mainly in people over 60 years of age. These can be linked to the lack of tetanus booster vaccination of adults.

Exploring factors improving support for vaccinations among Polish primary care physicians.

In Poland, primary care physicians are the most used and most trusted source of information on immunisation. We aimed to explore factors influencing support for vaccinations among physicians employed in the childhood immunisation programme, in order to inform education of healthcare workers and programme organization. In June-July 2017, we carried out a national cross-sectional survey of physicians working in randomly selected primary healthcare practices, and interviewed them by telephone. We assessed support for vaccinations using an ordinal scale (0-6) comprised of three equally weighted questions on the respondent support of the programme and vaccination of self and family. We also created a scale (0-3) based on correct answers to vaccination myths. We used ordered logistic regression to investigate factors independently influencing support for vaccinations, reporting the proportional odds ratios and 95% confidence intervals for one unit increase in the support score. Of 2,609 respondents contacted, we interviewed 500 (19%). The median vaccination support score (0-6) was 5 (IQR 2). After adjusting for other variables, we did not find significant effects of sex, medical specialty, adhering to recommendations, attending a conference in previous year, using non-scientific sources of information and self-assessed knowledge on vaccination support score. Age over 60 years, correctly addressing vaccination myths and use of one or more than one scientific sources of knowledge, significantly improved support for vaccinations (aOR = 1.97, 1.57, 3.09 and 2.68, respectively). We recommend to increase the amount, quality and accessibility of evidence-based educational materials for primary care physicians working with childhood immunisations.

Rubella in Poland in 2018.

INTRODUCTION: Rubella is the disease subject to the elimination programme coordinated by the World Health Organization (WHO). Generally, rubella is an infection of mild course among children but in the case of pregnant women, who are not immunized, the probability of the occurrence of severe congenital abnormalities (congenital rubella syndrome) may amount to 95%. The strategy of the countries belonging to the WHO European Region is directed to the interruption of the rubella virus transmission in the environment in order to prevent the cases of congenital rubella syndrome (CRS). OBJECTIVES: The aims of the present article are to analyze the epidemiological situation of rubella in Poland in 2018 and to discuss the rubella vaccination coverage. MATERIAL AND METHODS: The epidemiological situation of rubella in Poland was analyzed on the basis of publications: "Infectious diseases and poisonings in Poland in 2018" and "Vaccinations in Poland in 2018". RESULTS: In 2018, there was a decrease in the number of rubella cases - with registered 437 cases (in 2017 - 476 cases) - and a decline in incidence (from 1.2 per 100 000 to 1.1). The highest incidence rate, regardless of gender and the environment, was observed among children aged 0-4 years (9.8 per 100,000). In 2018, no cases of congenital rubella syndrome were registered. SUMMARY AND CONCLUSIONS: In 2018, there was a decrease in the number of rubella cases. In Poland Rubella is reported exclusively on the basis of the clinical picture. The proportion of laboratory tests confirming/excluding rubella infection is still very low in Poland.

Measles in Poland in 2018.

INTRODUCTION: Since 1998 Poland has endorsed measles elimination programme which is coordinated by the World Health Organization (WHO). To accomplish measles elimination in the country, achievement of vaccination coverage at 95% in the population is needed, as is the monitoring of the epidemiological situation, i.e.: reporting on cases suspected of measles and conducting laboratory diagnostics in WHO Reference Laboratory. Polish Reference Laboratory is located at the Department of Virology NIPH-NIH. OBJECTIVES: The aim of the article is to analyze the epidemiological situation of measles in Poland in 2018 with presenting the measles vaccination coverage and the progress of the measles elimination programme in Poland. MATERIAL AND METHODS: The epidemiological situation of measles in Poland was analyzed on the basis of the case-based questionnaires of cases suspected of measles sent to NIPH-NIH by the Sanitary and Epidemiological Stations, data from the publications: "Infectious diseases and poisonings in Poland in 2018" and "Vaccinations in Poland in 2018". RESULTS: In 2018, 359 cases of measles were notified to the surveillance system in Poland (incidence 2.94 per 100 000 population). The highest incidence was observed in the age 1 and was estimated at 4.06 per 100 000 population. Out of all cases, 209 (58.2%) were hospitalized. No fatal cases due to the measles were reported. In 2018 the maintenance of high vaccination coverage among children aged 2 and 12 years old was observed - from 92.9% to 99.3% (primary vaccination, children born in 2008-2016) and from 92.4% to 97.8% (booster vaccination, children born in 2005-2010). CONCLUSIONS: The epidemiological situation of measles in 2018 in comparison with the situation in 2017, has deteriorated. This was a trend in throughout Europe.

BCG Moreau Vaccine Safety Profile and NK Cells-Double Protection Against Disseminated BCG Infection in Retrospective Study of BCG Vaccination in 52 Polish Children with Severe Combined Immunodeficiency.

OBJECTIVES: The aim of the study was to estimate the rate of adverse reactions to live BCG Moreau vaccine, manufactured by Biomed in Poland, in severe combined immunodeficiency (SCID) patients. MATERIAL: The profiles of 52 SCID patients vaccinated at birth with BCG, hospitalized in Children's Memorial Health Institute, Warsaw (CMHI), in the years 1980-2015 were compared with those of 349 BCG-vaccinated SCID patients from other countries analyzed by Beatriz E. Marciano et al. in a retrospective study (Marciano et al. J Allergy Clin Immunol. 2014;133(4):1134-1141). RESULTS: Significantly less disseminated BCG infections (10 out of 52 SCID, 19%) occurred in comparison with Marciano study-119 out of 349, 34% (p = 0.0028), with no death in patients treated with SCID anti-TB drug, except one in lethal condition. In our study, disseminated BCG infection was observed only in SCID with T-B+NK- phenotype and significantly lower NK cell counts (p = 0.0161). NK cells do not influence on the frequency of local BCG reaction. A significantly higher number of hematopoietic stem cells transplantations (HSCT) were performed in CMHI study (p = 0.0001). Anti-TB treatment with at least two medicines was provided. CONCLUSION: The BCG Moreau vaccine produced in Poland, with well-documented genetic characteristics, seems to be safer than other BCG substrains used in other regions of the world. Importantly, NK cells seem to play a role in protecting SCID patients against disseminated BCG complications, which NK- SCID patients are more prone to. HSCT and TB therapy could be relevant due to the patients' survival and the fact that they protect against BCG infection.

The safety and effectiveness of vaccination against influenza and pertussis in pregnant women

In recent years a large amount of data has become available with regard to vaccinating women during pregnancy against influenza and against pertussis. The data comes from observational studies conducted when vaccine was administered as a part of a vaccination campaign, retrospective evaluations of databases and surveillance of the adverse post-vaccination events. Popularization of knowledge about the importance of immunization in this group and educating pregnant women about vaccination should be an essential element of health promotion and prevention programs.

Application of the MALDI-TOF for identification of Clostridium perfringens strains.

INTRODUCTION: The anaerobic bacilli Closfridium perfringens are commonly found in soil and sewage and are also part of the gastrointestinal tract of humans and animals. Food poisoning caused by C. perfringens are regarded the most common diseases transmitted by contaminated food in the world. Bacteria of this species due to their pathogenic properties sustain the constant object of studies in order to elucidate mechanisms of toxinogenesis, to determine the roads of transmission and to develop better diagnostic tools. The objective of the study was to verify, the suitability of the MALDI-TOF method for the identification of C. perfringens species. METHODS: In order to identify anaerobic bacteria C. perfringens MALDI-TOF method, sequencing of 16S rRNA and detection of cpe and cpa gene by duplex PCR were used. RESULTS: MALDI-TOF confirmed C. perfringens identification in 39 isolates out of 41 archival isolates under study. The correctness of the results was verified by 16S rRNA sequencing and cpa gene detection. CONCLUSIONS: The study confirmed the usefulness of MALDI-TOF method in rapid identi- fication of anaerobic bacteria C. perfringens and thereby its applicability epidemiological investigations.

[Genotyping Clostridium perfringens strains isolated from patients with symptoms of food poisoning and food samples].

INTRODUCTION: Clostridium perfringens strains that produce enterotoxin often cause outbreaks of food poisoning or epidemic, therefore is essential to develop and adapt methods useful in epidemiological investigations. The aim of the study was to assess the genetic diversity of C. perfringens strains isolated from patients with symptoms of food poisoning and food samples. METHODS: In this study it has been determined the genetic diversity of the pilot group of epidemiologically non- related 39 C. perfringens strains using RAPD (Random Amplified Polymorphic DNA), rep-PCR (Repetitive DNA Element Based PCR) and PFGE (Pulsed Field Gel Electrophoresis) methods. RESULTS AND CONCLUSIONS: It has been obtained comparable results of differentiation of C. perfringens strains isolated from patients with symptoms of food poisoning and food samples using RAOD and rep-PCR methods. It has been also confirmed a wide genetic diversity among C. perfringens strains isolated from different sources epidemiologically non-related using PFGE.

Colonization of Bordetella pertussis clinical isolates that differ by pulsed field gel electrophoresis types in the lungs of naïve mice or mice immunized with the whole-cell pertussis vaccine used in Poland.

The goal of our study was to compare the elimination of Bordetella pertussis clinical isolates that differ according to pulsed field gel electrophoresis (PFGE), serotypes and genes encoding virulence factors from the lungs of naïve mice or mice immunized with commercial diphtheria-tetanus-whole-cell pertussis vaccine used in Poland. When a mixture of four isolates, given in equal proportions and harboring different PFGE profiles, serotypes, and alleles encoding virulence factors, was used to infect non-immunized mice, a single isolate, characterized by PFGE type IVγ, Fim2 phenotype and ptxA1-prn2-tcfA2-fim2-1-ptxP1-ptxC1-fim3-1 alleles, was found to be significantly predominant compared to the others. This PFGE profile is commonly found in B. pertussis isolates circulating in some European countries since the late 1990s, confirming its high fitness. The Polish commercial whole-cell pertussis vaccine induced an immunity effective at eliminating the B. pertussis isolates from the lungs. However, the elimination of the isolate harboring PFGE type C profile, Fim2,3 phenotype and ptxA1-prn1-tcfA2-fim2-1-ptxP1-ptxC1-fim3-1 alleles was delayed as compared to the others, suggesting phenotypic differences with the other isolates and vaccine strains. Nevertheless, the same isolate, when challenged into mice in the defined mixture of strains, lost the competition with the others, as measured by lung colonization efficiency. This PFGE profile represents 15 % of the isolates circulating in Poland between 2001 and 2012.

PCR-based genomic deletion analysis of RD-regions in the identification of mycobacteria isolated from adverse events following BCG vaccination or TB suspected cases.

Early identification of mycobacterial species is crucial for early diagnosis. PCR-multiplex method performed on randomly chosen 54 mycobacteria isolates originating from clinical samples was found to be an inexpensive, quick and reliable alternative for commercially available diagnostics tests. Although the results of gene probes identification performed by NTLDR were generally consistent with multiplex PCR, two mixed Mycobacterium bovis BCG/Mycobacterium tuberculosis infections and a single misdiagnosis of M. tuberculosis with M. bovis were found. The routine application of multiplex-PCR has the potential to make diagnostics surveillance studies feasible.