Newborn Hospitalizations Before and During COVID-19 Pandemic in Poland: A Comparative Study Based on a National Hospital Registry.

Objectives: There are limited data on the impact of the COVID-19 outbreak in Poland on newborn health. The aim of the study is to show recent information on hospitalizations of newborns in Poland in the pre-pandemic and COVID-19 pandemic era. Methods: A retrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized in 2017-2021. Results: The data on which the study was based consisted of a substantial number of 104,450 hospitalization records. Annual hospitalization rate was estimated to be 50.3-51.9 per 1,000 in 2017-2019, 56 per 1,000 in 2020 and it rose to 77.7 per 1,000 in 2021. In comparison to the pre-pandemic period, in the COVID-19 era, we observed significantly more hospitalization cases of newborns affected by maternal renal and urinary tract diseases (p < 0.001), syndrome of infant of mother with gestational diabetes (p < 0.001), maternal complications of pregnancy (p < 0.001). In the COVID-19 era, the prevalence of COVID-19 among newborns was 4.5 cases per 1,000 newborn hospitalizations. Conclusion: The COVID-19 pandemic outbreak could significantly contribute to qualitative and quantitative changes in hospitalizations among newborns.

Inactivation of Spores and Vegetative Forms of Clostridioides difficile by Chemical Biocides: Mechanisms of Biocidal Activity, Methods of Evaluation, and Environmental Aspects.

Clostridioides difficile infections (CDIs) are the most common cause of acquired diseases in hospitalized patients. Effective surface disinfection, focused on the inactivation of the spores of this pathogen, is a decisive factor in reducing the number of nosocomial cases of CDI infections. An efficient disinfection procedure is the result of both the properties of the biocidal agent used and the technology of its implementation as well as a reliable, experimental methodology for assessing the activity of the biocidal active substance based on laboratory models that adequately represent real clinical conditions. This study reviews the state of knowledge regarding the properties and biochemical basis of the action mechanisms of sporicidal substances, with emphasis on chlorine dioxide (ClO2). Among the analyzed biocides, in addition to ClO2, active chlorine, hydrogen peroxide, peracetic acid, and glutaraldehyde were characterized. Due to the relatively high sporicidal effectiveness and effective control of bacterial biofilm, as well as safety in a health and environmental context, the use of ClO2 is an attractive alternative in the control of nosocomial infections of CD etiology. In terms of the methods of assessing the biocidal effectiveness, suspension and carrier standards are discussed.

Evaluating the Virucidal Activity of Disinfectants According to European Union Standards.

The disinfection of surfaces in medical facilities is an important element of infection control, including the control of viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Preparations used for surface disinfection are typically characterized via their activity against test organisms (i.e., viruses, bacteria and fungi) in the laboratory. Typically, these methods use a suspension of the test organism to assess the bactericidal, fungicidal or virucidal activity of a given preparation. However, such suspension methods do not fully imitate real-life conditions. To address this issue, carrier methods have been developed, in which microorganisms are applied to the surface of a carrier (e.g., stainless steel, glass and polyvinyl chloride (PVC)) and then dried. Such methods more accurately reflect the applications in real-life clinical practice. This article summarizes the available methods for assessing the virucidal activity of chemical disinfectants for use in medical facilities based on the current European standards, including the activity against coronaviruses.

No-Touch Automated Room Disinfection after Autopsies of Exhumed Corpses.

Autopsies of exhumed bodies pose a risk of infections with environmental bacteria or fungi, which may be life-threatening. Thus, it is important to use effective methods of disinfection in forensic pathology facilities. In this study, we investigated the effectiveness of no-touch automated disinfection (NTD) system after autopsies of exhumed bodies. Directly after 11 autopsies of exhumed bodies, we used an NTD system based on a peroxone vapor to disinfect the air and surfaces. We measured microbial burden in the air and on surfaces before and after NTD. The NTD system reduced the mean bacterial burden in the air from 171 colony forming units (CFU)/m3 to 3CFU/m3. The mean fungal burden in the air decreased from 221 CFU/m3 to 9CFU/m3. The mean all-surface microbial burden was 79 CFU/100 cm2 after all autopsies, and it decreased to 2 CFU/100 cm2 after NTD. In conclusion, the peroxone-based NTD system was effective for decontamination of the air and surfaces in a dissecting room after autopsies of exhumed bodies.

No-Touch Automated Disinfection System for Decontamination of Surfaces in Hospitals.

BACKGROUND: Hospital-acquired infections (HAIs) remain a common problem, which suggests that standard decontamination procedures are insufficient. Thus, new methods of decontamination are needed in hospitals. METHODS: We assessed the effectiveness of a no-touch automated disinfection (NTD) system in the decontamination of 50 surfaces in 10 hospital rooms. Contamination of surfaces was assessed with a microbiological assay and an ATP bioluminescence assay. Unacceptable contamination was defined as > 100 colony forming units/100 cm2 in the microbiological assay, and as ≥ 250 relative light units in the ATP assay. RESULTS: When measured with the microbiological assay, 11 of 50 surfaces had unacceptable contamination before NTD, and none of the surfaces had unacceptable contamination after NTD (p < 0.001). On the ATP bioluminescence assay, NTD decreased the number of surfaces with unacceptable contamination from 28 to 13, but this effect was non-significant (p = 0.176). On the microbiological assay taken before NTD, the greatest contamination exceeded the acceptable level by more than 11-fold (lamp holder, 1150 CFU/100 cm2). On the ATP bioluminescence assay taken before NTD, the greatest contamination exceeded the acceptable level by more than 43-fold (Ambu bag, 10,874 RLU). CONCLUSION: NTD effectively reduced microbiological contamination in all hospital rooms. However, when measured with the ATP bioluminescence assay, the reduction of contamination was not significant.

Assessment of tolerability and acceptability of an alcohol-based hand rub according to a WHO protocol and using apparatus tests.

Background: The effectiveness of alcohol-based hand rubs (ABHRs) depends substantially on their acceptability and tolerability. In this study, we assessed the acceptability and tolerability of a new ABHR (product EU 100.2018.02). Methods: Among physicians, nurses, and cosmetologists who used the ABHR for 30 days, we assessed the product's acceptability and tolerability according to a WHO protocol. Additionally, we used instrumental skin tests. Participants assessed the product's color, smell, texture, irritation, drying effect, ease of use, speed of drying, and application, and they gave an overall evaluation. Moreover, they rated the tolerability, i.e. their skin condition, on the following dimensions: intactness, moisture content, sensation, and integrity of the skin. The tolerability was also assessed by an observer as follows: redness, scaliness, fissures, and overall score for the skin condition. Instrumental skin tests included transepidermal water loss, skin hydration, sebum secretion, and percentage of skin affected by discolorations. All assessments were made at baseline (visit 1), and 3-5 days (visit 2) and 30 days (visit 3) later. Results: We enrolled 126 participants (110 [87%] women) with a mean age of 34.3 ± 11.65 years. Sixty-five participants (52%) were healthcare professionals (physicians, nurses), and 61 (48%) were cosmetologists. During visit 2 and visit 3, about 90% of participants gave responses complying with the WHO's benchmark for acceptability and tolerability. Similarly, the ABHR met the WHO criteria for observer-assessed tolerability: on all visits, in more than 95% of participants, the observer gave scores complying with the WHO benchmark. Transepidermal water loss decreased from baseline to visit 3 (p < 0.001), whereas skin hydration, sebum secretion, and the percentage of skin affected by discolorations did not change significantly during the study (p ≥ 130). Conclusions: The EU 100.2018.02 had both high acceptability and tolerability, meeting the WHO criteria. The WHO protocol proved useful in the analysis of acceptability and tolerability of ABHRs.

Polyarteritis nodosa: decreasing incidence in Poland.

INTRODUCTION: There are many studies on the epidemiology of the orphan disease polyarteritis nodosa (PAN) in European countries. The use of a hospital morbidity database is an important element of epidemiological analysis. The study is the first such analysis in Poland and may provide an opportunity to compare the data in a European context. MATERIAL AND METHODS: We conducted a retrospective, population-based study using hospital discharge records with a PAN diagnosis. PAN incidence was estimated based on data from a Polish hospital morbidity study carried out by the National Institute of Public Health. Data on all inpatients discharged from non-psychiatric hospitals in Poland were collected between 2008 and 2013. We identified 557 patients with first-time hospitalizations for PAN. RESULTS: The sample consisted of 202 (36.3%) males and 355 (63.7%) females. The median and mean age was 53 and 50 years, respectively. The average annual incidence of PAN in Poland was estimated to be 2.4 per million. PAN incidence decreased significantly over time in Poland between 2008 and 2013 (3.3 per million vs 1.9 per million, p < 0.001) and it may be associated with a decrease in hepatitis B incidence observed in Poland. CONCLUSIONS: Incidence of PAN in Poland was estimated to be 2.4 per million and was comparable to the incidence found in other European countries. PAN incidence decreased during 2008-2013. The decrease in PAN incidence may be related to environmental, infectious (hepatitis B) or other unknown factors. Future research is needed to identify the cause of the decrease and potential triggers of the disease.

Bactericidal Activity of Ready-To-Use Alcohol-Based Commercial Wipes According to EN 16615 Carrier Standard.

BACKGROUND: The effectiveness of ready-to-use disinfectant wipes was previously assessed in standardized suspension tests, which were inadequate because they ignored that the wipes are rubbed against a surface. Thus, we assessed the effectiveness of commercially available disinfectant wipes impregnated with an alcoholic solution according to the 16615 standard, which includes a test with mechanical action. METHODS: According to the EN 16615 standard, under clean conditions, four squares (5cm x 5 cm), placed next to one another, were marked on a test surface. Enterococcus hirae, Pseudomonas aeruginosa, and Staphylococcus aureus were inoculated on the leftmost square, and a wipe impregnated with an alcoholic solution was placed to the left of that square. Then, the wipe was pressed with a 2.5 kg weight and moved to the right and back to the left. After contact times of 1, 5, 10, or 15 minutes, we measured the reduction in bacterial load. RESULTS: Alcohol-based ready-to-use commercial wipes did not show sufficient bactericidal activity at the contact times of 1, 5, 10 and 15 minutes. Wipes containing propan-1-ol and a mixture of propan-1-ol and propan-2-ol were active against Pseudomonas aeruginosa at the contact times of 1 minute and 15 minutes. None of the examined wipes were active against Enterococcushirae or Staphylococcusaureus. CONCLUSION: Bactericidal parameters of ready-to-use disinfectant wipes should be determined in surface tests, in addition to suspension tests, because suspension tests do not simulate the conditions under which disinfectant wipes are used in practice.

Epidemiology of Pulmonary Aspergillosis in Hospitalized Patients in Poland During 2009-2016.

Aspergillus is one of the most prevalent airborne fungal pathogens in the developed countries that may cause fatal invasive pulmonary aspergillosis in immunocompromised patients. The epidemiological information on aspergillosis in Poland is scarce. This retrospective, population-based study evaluated the incidence of pulmonary and other forms of aspergillosis, and also gender distribution and territorial differences in the occurrence of aspergillosis in hospitalized patients in Poland during 2009-2016. The incidence of aspergillosis was estimated on the basis of a dataset provided by hospital morbidity study carried out by the National Institute of Public Health. The data consisted of 4206 hospitalization records of 2338 patients, with some patients being hospitalized more than one time due to disease remissions. Significant gender differences were observed (1484 females vs. 2722 males, p < 0.001). No statistical differences were found for the place of residence. The average annual incidence rates for all forms of aspergillosis, invasive pulmonary aspergillosis, and other pulmonary aspergillosis were 13.8 per million (95% CI: 11.3-16.3), 4.0 per million (95% CI: 3.0-5.0), and 4.4 (CI: 3.5-5.2) per million, respectively. Over time, a significant increase in the rate of hospitalization were observed for all forms of aspergillosis (10.7 per million in 2009 vs. 15.7 per million in 2016, p for trend <0.005), invasive pulmonary aspergillosis (2.3 per million in 2009 vs. 5.0 per million in 2016, p for trend <0.001), and other pulmonary aspergillosis (3.6 per million in 2009 vs. 4.9 per million in 2016, P for trend <0.02). During the period analyzed 283 patients (12.0%) died while hospitalized and 224 of them (9.6% of all patients) died during the first-time hospitalization. We conclude that the incidence of aspergillosis is on the rise in hospitalized patients in Poland.

Epidemiology of Granulomatosis with Polyangiitis in Poland, 2011-2015.

Granulomatosis with polyangiitis (GPA) is a form of vasculitis that affects small- and medium-sized vessels in many organs. The aim of the study was to describe the epidemiology of GPA in Poland in 2011-2015, including the incidence and prevalence rates. The authors conducted a retrospective, population-based study, using hospital discharge records with GPA diagnosis. GPA incidence was estimated on the basis of the data from the Polish hospital morbidity study carried out by the National Institute of Public Health. The final study group consisted of 1491 patients (749 females, 742 males) who were first time hospitalized with the diagnosis of GPA. The average annual incidence of GPA in Poland was 7.7/1,000,000 (95% CI, 4.1-11.4), and the point prevalence at the end of 2015 was 36/1,000,000. A statistically significant decrease in the GPA incidence was noticed in this study. A 1-year survival rate for GPA was 94%. In conclusion, the incidence and prevalence rates of GPA in Poland are similar to that reported in other European countries. The study provides recent epidemiological data on GPA in Poland, which may be useful for comparisons with other geographical regions.

Paget disease of bone among hospitalized patients in Poland.

INTRODUCTION: Paget's disease (PDB) is a focal disorder of bone remodeling that occurs commonly in older people with decreasing prevalence reported in European countries. This disease is most often asymptomatic, but it can cause a variety of medical complications resulting in considerable morbidity and reduced quality of life. There is little information regarding the epidemiology of PDB in Poland. To the best of the authors' knowledge, this is the first large epidemiological analysis of this disease in Poland. OBJECTIVE: The aim of this study was to analyze factors that may be related to the PDB epidemiology among hospitalized patients in Poland. MATERIAL AND METHODS: The analysis was conducted on the basis of population-based administrative data, taken from a Polish hospital morbidity study carried out by the National Institute of Public Health between January 2008 - December 2014. RESULTS: Analyzed data covered 662 hospitalization records. The final study sample comprised 94 (41.8%) male and 131 (58.2%) female patients with first-time hospitalizations for PDB, with a significant predominance of females (P<0.02), and the predominance of patients living in urban (73%) than in rural areas (27%), P<0.001. The average age of the sample was 56.8 years (CI: 54.3-59.3; SD 18.8; range 1-93 years). The number of PDB cases hospitalized in Poland significantly decreased during the analyzed period of time. CONCLUSIONS: PDB is a rare disease with decreasing trends observed among hospitalized patients in Poland. The study results may suggest the existence of environmental risk factors for the development of PDB.

Neutralization efficiency of alcohol based products used for rapid hand disinfection

Background: Alcohols are the most commonly used active substances in preparations for quick hand disinfection. They should be bactericidal in very short contact time. PN-EN 13727 + A2: 2015-12 standard, for testing hygienic and surgical handrub disinfection preparations, provides mandatory test conditions of disinfectants in contact times with the range of 30 s to 60 s (hygienic handrub disinfection) and 60 s to 5 min (surgical handrub disinfection). A short contact times for hand hygiene products require a short time of neutralization process. For contact times less than or equal to 10 minutes, the estimated neutralization time is 10 s ± 1 s. Neutralization is a process that abolishes the action of disinfectants. Correct application of this process allows for proper use of disinfectants in practice and its biocidal effect. Objectives. Verification of the effectiveness of 10-second neutralization time of alcohol based preparations for hygienic handrub disinfection Materials and Method: Neutralization of two products with different ethanol content (89% and 70%) for hygienic handrub disinfection according to PN-EN 13727 + A2: 2015-12 was investigated. The effectiveness of the neutralizer was assessed by determining toxicity of neutralizer, activity of residual effects of the tested products and their derivatives produced during neutralization (10 s) for test organisms (Staphylococcus aureus ATCC 6538; Pseudomonas aeruginosa ATCC 15442; Enterococcus hirae ATCC 10541; Escherichia coli K12 NCTC 10538) Results: The 10-second neutralization time was sufficient to eliminate the residual activity of products for hygienic handrub disinfection with differentiated ethanol concentration. The neutralizer used did not show toxicity to bacteria and did not produce toxic products with tested preparations after neutralization Conclusions: Conclusions. The use of 10-second neutralization time allows in a precise way designate the contact times for hygienic handrub disinfection products

Behçet disease: a rare systemic vasculitis in Poland.

INTRODUCTION    Behçet disease (BD) is an immune­mediated small­vessel systemic vasculitis, which is rarely seen in Poland. OBJECTIVES    The aim of this study was to evaluate the incidence and prevalence of BD, as well as to assess the sex and geographical distribution of BD in Poland during a 7­year follow-up. To our knowledge, this is the first evaluation of this rare disease in Poland, based on a hospital morbidity database. PATIENTS AND METHODS    We analyzed population­based administrative data obtained from a national hospital morbidity study conducted between January 2008 and December 2014 by the National Institute of Public Health in Poland. The annual incidence rates and point prevalence of BD were calculated using the number of patients with BD and corresponding census data for the overall Polish population.  RESULTS    Data included 316 hospitalization records. The final study sample comprised 130 patients (54 men [42%] and 76 women [58%]) with first­time hospitalizations for BD. The mean (SD) age was 41.6 (18.7) years (95% confidence interval [CI], 38.3-44.8; range, 5-85 years). The incidence rate of BD was estimated at 0.5 per million persons per year (95% CI, 0.35-0.61). The point prevalence at the end of 2014 was 3.4 per million persons. The incidence rate of BD did not vary significantly between more urban and more rural regions, and BD was observed more often in women than in men. CONCLUSIONS    BD is endemic in Eastern and Central Asian countries, but is also seen in Poland. However, its incidence and prevalence rates are lower in Poland than in other European countries.

Incidence and prevalence of Systemic Sclerosis (SSc) in Poland - differences between rural and urban regions.

[b] Abstract Introduction.[/b] Systemic sclerosis (SSc) is a rare and potentially severe connective tissue disease, characterized by skin fibrosis and involvement of internal organs. Because of its rarity and heterogeneous clinical presentation, reliable epidemiological studies on SSc have been particularly difficult to carry out. [b]Objectives[/b]. The purpose of this study was to present SSc epidemiology among hospitalized patients in Poland. MATERIALS AND METHOD: The analysis was based on population-based administrative data, taken from a Polish hospital morbidity study carried out by the National Institute of Public Health between January 2008 - December 2012. [b]Results[/b]. Analyzed data covered 9,049 hospitalization records. The final sample comprised 3,653 patients with first-time hospitalizations for SSc. The average age of the sample was 53 years (SD 16.2; range 0-91 years); 84% of patients were female and 16% male. Based on hospitalization registers, the average SSc incidence was estimated to be 1.9/100,000 per year and peak age of incidence was 55 years. The point prevalence was estimated to be 9.4/100,000 at the end of 2012. SSc was more common in females, with F:M ratio ranging from 6.2:1-4.6:1 depending on the year. Analysis of hospitalization trends revealed that overall numbers of SSc hospitalizations increased, while first-time hospitalizations decreased between 2008-2012. Clusters of higher incidence were observed in more rural regions vs. urban regions. [b]Conclusion[/b]. Estimated incidence of SSc in Poland was comparable to reported incidence in other European countries. Analysis of demographic factors and reports of clusters of higher incidence may suggest the existence of environmental risk factors for the development of SSc. These observations may require further research.

Hospital Morbidity Database for Epidemiological Studies on Churg-Strauss Syndrome.

Churg-Strauss syndrome or more accurately eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel necrotizing vasculitis with a characteristic late-onset allergic rhinitis and asthma. The use of hospital morbidity database is an important element of the epidemiological analysis of this rare disease. The present study was undertaken to assess the incidence of EGPA and factors related to its epidemiology in Poland; the first analysis of the kind in Poland, enabling a comparison in the European context. This is a retrospective, population-based study using hospital discharge records with EGPA diagnosis, collected for a National Institute of Public Health survey covering the period from 2008 to 2013. The group consisted of 344 patients (206 females and 138 males) with the first-time hospitalization for EGPA. The major findings are that the annual incidence of EGPA in Poland was 1.5 per million (95% confidence intervals: 1.2-1.8), with the point prevalence of 8.8 per million at the end of 2013. A greater incidence of EGPA was observed in the regions with urban predominance. We conclude that discharge records may be a useful element of epidemiological studies on EGPA.

Rapid Influenza Diagnostic Tests Improve Suitability of Antiviral Treatment in Hospitalized Children.

Influenza may have a complicated course in young children. The aim of the study was to analyze the suitability of influenza treatment among children younger than 5 years hospitalized due to an influenza-like illness. We conducted a comparison of the treatment among children hospitalized in two consecutive years: 2015, when no rapid influenza diagnostic tests (RIDT) were in use, and 2016, when RIDT were implemented into a routine practice in the pediatric ward. In both seasons, nasopharyngeal swabs were collected and examined with real time qRT-PCR. In the 2015 season, influenza was diagnosed in 15/52 (28 %) children and none of them received oseltamivir, while 14/15 (93 %) patients received antibiotics. In the 2016 season, influenza was diagnosed in 11/63 (17 %) children, 7/11 (64 %) of them received oseltamivir and another 7/11 (64 %) received antibiotics. In four cases antibiotics overlapped oseltamivir. These differences in the use of oseltamivir and antibiotics were statistically significant (p < 0.05). We conclude that the implementation of RIDT improves the suitability of influenza treatment and decreases the frequency of antibiotic therapy. RIDT should be available in pediatric departments to optimize influenza treatment.