Body Composition and Biochemical Markers of Nutrition in Non-dialysis-Dependent Chronic Kidney Disease Patients.

The aim of this study was to examine the body composition in stages 3b to 5 of chronic kidney disease. There were 149 patients included in the study, with the mean age of 65.5 ± 16.5 years, body mass index (BMI) of 29.4 ± 5.6 kg/m2, and estimated glomerular filtration rate (eGFR) of 23.2 ± 9.3/min/1.73m2. They remained with dialysis. Body composition was measured using bioimpedance spectroscopy, and handgrip strength was measured with a hydraulic dynamometer. The main biochemical markers assessed consisted of serum protein, albumin, prealbumin, high-sensitivity C-reactive protein (hsCRP), and interleukin (IL)-6 content. We found that 39% of patients were overweight and 41% were obese. Obesity was more prevalent in stage 3b of chronic kidney disease than in stages 4-5 in women and in patients older than 60 years of age. Thirty-eight percent of the study population were sarcopenic, of whom 20% presented a sarcopenic obesity phenotype. There were significant associations between lean tissue index (LTI) and serum prealbumin content and handgrip strength. Fat tissue index (FTI) was associated and hsCRP, serum protein, body mass index (BMI), waist-hip ratio, and waist-to-height ratio. There were inverse associations between FTI-LTI and LTI-age. We conclude that the prevalence of obesity in non-dialysis-dependent patients with chronic kidney disease is higher than that in the general population. Earlier stages of chronic kidney disease are associated with a higher prevalence of obesity.

Hemorrhagic fever with renal syndrome (HFRS) in Poland

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral zoonosis occurring due to the hantavirus infection. On the territory it constitutes the only case of viral hemorrhagic fever. The infections occurring in Poland are mainly caused by the Puumala and Dobrava serotypes. The pathogenetic influence of other Hanta serotypes such as Boginia, Nova and Seewis on humans is still unknown. The endemic territory of the occurrence of the hantavirus infections in Poland is the Podkarpacie region. The morbidity is not high and ranges between 0.02 and 0.14 in every 100 000 but professional literature suggests that the data concerning the territory of Poland is underestimated. So far hantavirus infections have not been reported in other areas of Poland yet the presence of the virus may be excluded. In view of literature and the significant occurrence of Hanta antibodies in patients included in the risk group, it may be claimed that the diseases caused by Hanta virus constitute a significant factor influencing the medical status of the group in focus all over the country.

Detection of Influenza and Other Respiratory Viruses Carried Out in the Influenza Project - Monitoring Vaccine Effectiveness (I-MOVE).

The project Influenza Vaccine Effectiveness-Monitoring (I-MOVE) is part of the European research carried out by the ECDC (European Center for Disease Prevention and Control), aimed at monitoring the effectiveness of vaccination in Europe during the growing incidence of flu and influenza-like illnesses in the coming epidemic seasons. Laboratory studies using molecular RT-PCR biology methods for detection of genetic material of influenza virus and other respiratory viruses were performed by Voivodeship Sanitary-Epidemiological Stations in Poland. The validation of the results of swabs taken from the nose and throat were carried out in the Department of Influenza Research, National Influenza Center in Warsaw. The study involved 210 samples from patients across Poland. Positive results were recorded for 72.4 % of the samples; influenza virus type A was detected in 43 and type B in 38 cases, whereas in 71 cases other respiratory viruses were detected, which included Human parainfluenza virus type 1-4; Human respiratory syncytial virus type A and B; Human coronavirus 229E/NL63, OC43; Human rhinovirus type A, B, and C; Human enterovirus; and Human adenovirus. The results show that although influenza viruses predominated in the 2010/2011 season in Poland, other flu-like viruses also abounded.

Progress in the Diagnosis and Control of Ebola Disease.

Ebola hemorrhagic fever is one of numerous viral hemorrhagic fevers. It is a severe, often fatal disease in humans and nonhuman primates (gorillas and chimpanzees). This article discusses the history of Ebola disease, already known routes of infection together with defining prevention methods and treatment trials. The importance of increasing awareness of the risk of disease among people who do not inhabit endemic regions is emphasized. This risk is associated especially with the increasing popularity of tourism to African countries, even to those where the virus is endemic. The research conducted over the years shows that three species of frugivorous bats are subjected to contamination by Ebola, but the infection is asymptomatic in them. It is believed that the saliva of these mammals and other body fluids may be a potential source of infection for primates and humans. In the laboratory, infection through small-particle aerosols has been demonstrated in primates, and airborne spread among humans is strongly suspected, although it has not yet been conclusively demonstrated. The importance of this route of transmission remains unclear. Poor hygienic conditions can aid the spread of the virus. These observations suggest approaches to the study of routes of transmission to and among humans.

Compliance with Vaccination Against Influenza Among the Elderly.

Protective vaccination against influenza is one of the most beneficial methods of preventing this viral disease. The use of vaccines brings not only the health benefits but also has positive implications related to diminishing the costs of treatment, prolonged hospitalization or post-influenza complications. Promoting vaccinations against influenza among the elderly is especially important. The article concerns the perception of these vaccinations and evaluation of the general knowledge on influenza among listeners of a university of the third age in Warsaw, Poland. It aims also at assessing the potential to change opinions and decisions regarding vaccinations against influenza and widely understood influenza prevention among this target group. The research tool, apart from the scientific lecture-like presentation rich in examples, was a self-reported questionnaire designed by the authors specifically for this study purpose. This paper presents the results of survey conducted with the questionnaire completed by 29 persons over 60 years of age. We found that the recent vaccination rate against influenza was just was about 20% in the studied sample of the elderly. The study demonstrates that educational training through a professional lecture presentation facilitates the promotion of health and vaccination coverage against influenza in the elderly.

The influenza epidemic of 1889-90 in selected European cities--a picture based on the reports of two Poznan daily newspapers from the second half of the nineteenth century.

The largest nineteenth-century epidemic of influenza, called 'the Russian epidemic,' arrived in Europe from the east in November and December of 1889. It was one of the first epidemics of influenza that occurred during the period of the rapid development of bacteriology. It was the first epidemic to be so widely commented on in the intensively developing daily press. Daily Polish newspapers published in Poznan, a Polish city that was then under Prussian rule, also had a share in providing information on the epidemic. Press reports not only referred to the local spread of the disease, but also discussed the situation in numerous, often distant, European cities, such as Paris, London, Vienna, and Berlin. Apart from data about where and when the illness occurred, the reports provided: descriptions of symptoms, treatment methods, data on morbidity and mortality, effect on individual people of high rank in the country, information on the activities of public authorities, and impact of the epidemic on daily life. The 1889-1890 influenza epidemic had 2 faces: the real one, discovered while being afflicted with the disease, and the media one, discovered through the information available in the press.

Flow cytometry in the diagnosis of influenza.

Flow cytometry is used in the analysis of the multi-parameter optical properties of individual particles such as eukaryotic cells, prokaryotic cells, and viruses in the flow system. Virions, or complexes consisting of virus particles attached to the specific antibody in suspension are individually arranged in a linear stream, which flows through the detection device. The parameters measured by the flow cytometer include the volume of the particles or cells, the morphological complexity, the presence of pigments, RNA content, virion surface markers, and enzymatic activity. It is possible to collect two morphological parameters and one or more signals of the fluorescence of a single particle. Multi-parameter analysis provides for the definition a population of cells based on their phenotype. Flow cytometry is characterized by the automatic determination of the value of the parameter set for a large number of individual particles or cells in the course of each measurement. For example, 100,000 or more particles such as virus, bacteria, or fungal spores are analyzed one after another typically over a period of 1 min. The limit of detection in such studies is 100 fluorescing particles per cell. Theoretically, in the case of the influenza virus, this will be one copy of the virion combined in a complex with specific antibodies and with a built-in fluorescent label.

Virological monitoring of influenza activity and influenza-like illness in the epidemic season 2011-2012 in Poland.

Influenza and influenza-like illnesses are recorded in all latitudes and in every age group. In Poland, the number of cases varies between several thousand and several million depending on the epidemic season. These figures are probably underestimated since a great deal of patients avoids consulting the doctor. To some extent, this situation is caused by the fear of financial loss resulting from being on sick leave. Influenza virus is classified into three types A, B, and C according to antigenic differences in their nuclear and matrix proteins. Influenza viruses are characterized by their high changeability in terms of hemagglutinin (HA) and neuraminidase (NA). The changes may be referred to as antigenic drift that consists of point mutations in the genes encoding the HA and NA or sudden changes, referred to as antigenic shift that results from an exchange of gene segments encoding hemagglutinin and neuraminidase. Since there is an animal reservoir of influenza type A virus, reassortment of different subtypes of this virus may occur with type A virus strains which occur solely in the human. This can result in the creation of an entirely new strain with hemagglutinin and/or neuraminidase subtypes which have not been encountered in humans previously, to which a large part of the population will not be resistant and which therefore has a pandemic potential. Poland participates in the Global Influenza Surveillance System for influenza and influenza-like infection throughout the year and also during the epidemic season. The main objective of supervision is a continuous monitoring of the influenza situation in the country and the most rapid detection of the emergence of a new strain of influenza virus with pandemic potential.

Accuracy of rapid influenza detection test in diagnosis of influenza A and B viruses in children less than 59 months old.

Influenza burden among children is underestimated. Rapid influenza diagnostic tests (RIDTs) may be helpful in the early diagnosis of the disease, but their results should be interpreted cautiously. The aim of our study was to estimate the accuracy of the rapid influenza detection test BD Directigen™ EZ Flu A+B (Becton, Dickinson and Company, Sparks, MD) used among children with influenza-like illness (ILI) consulted in the ambulatory care clinics. A total number of 150 patients were enrolled into the study. The inclusion criteria were: age of the child less than 59 months, presentation of ILI according to CDC definition (fever >37.8 °C, cough, and/or sore throat in the absence of another known cause of illness), and duration of symptoms shorter than 96 h. In all patients two nasal and one pharyngeal swab were obtained and tested by RIDT, RT-PCR, and real time RT-PCR. For or influenza A(H1N1)pdm09, virus sensitivity of RIDT was 62.2 % (95 %CI 53.4-66.5 %), specificity 97.1 % (95 %CI 93.4-99 %), positive predictive value (PPV) 90.3 % (95 %CI 77.5-96.5 %), and negative predictive value (NPV) 85.7 % (95 %CI 82.4-87.3 %). For influenza B, virus sensitivity was 36.8 % (95 %CI 23.3-41.1 %), specificity 99.2 % (95 %CI 97.3-99.9 %), PPV 87.5 % (95 %CI 55.4-97.7 %), and NPV 91.5 % (95 % CI 89.7-92.1 %). We conclude that the RIDT immunoassay is a specific, but moderately sensitive, method in the diagnosis of influenza type A and is of low sensitivity in the diagnosis of influenza B infections in infants and children.

Clinical features and outcomes of influenza A and B infections in children.

The aim of the study was to describe the course of influenza among children aged 0-59 months. A total of 150 children with influenza-like symptoms (ILI): cough, fever >37.8 °C, and sore throat was included into the observation. All children were tested with both rapid influenza detection test (RIDT) BD Directigen™ EZ Flu A+B® and RT-PCR. Sixty four cases of influenza were diagnosed (incidence rate 40 %): 19 (30 %) cases of influenza caused by type B virus and 45 (70 %) cases caused by type A virus. Children with influenza required more often follow up visits (p < 0.05, OR 1.99, 95 % CI 1.03-3.85) and less often were administrated antibiotic therapy (p < 0.05, OR 0.25, 95 % CI 0.04-0.97). The logistic regression analysis revealed that only positive result of rapid influenza detection test, not any of clinical symptoms, could be found as an independent predictor of influenza (OR 4.37, 95 % CI 2.03-9.43). Patients with influenza type A more often reported muscle ache (p < 0.05) and complications (p < 0.05; OR 6.06, 95 % CI 1.20-60.38). Otitis media occurred more often among patients with than without influenza (p < 0.01; OR 15.50, 95 % CI 2.10-688.5). We conclude that although influenza infections among children younger than 59 months were generally mild and self-limited, pediatric burden of the disease was significant.

[Vaccination against influenza in pregnant women - safety and effectiveness]. / Szczepienia przeciwko grypie u kobiet ciezarnych - bezpieczenstwo i efektywnosc.

Influenza is a major cause of morbidity and mortality worldwide. During seasonal influenza epidemics and pandemics, pregnancy places otherwise healthy women at an increased risk of complications from influenza. The factors believed to increase the susceptibility of complicated influenza infection during pregnancy are linked to the physiologic changes, including immunologic changes (attenuation of the cell-mediated immune responses, selective suppression of T-helper 1 cell mediated immunity while the adaptive humoral immunity remains unimpaired), increased cardiac output and oxygen consumption and tidal volume. Pregnant women have similar incidence of seasonal influenza as the general population, however because of the physiological changes, they are at an increased risk of complications (including secondary pneumonia, acute respiratory insufficiency increased risk of stillbirth, premature deliveries) and death. Immunization of pregnant women against influenza is currently recommended in many countries. Vaccination against influenza with trivalent inactivated vaccine (TIV) has been proven to be safe and effective. Lack of harmful effect of TIV on pregnant women and newborns has been demonstrated in several studies: no increased risk of spontaneous abortions, preterm birth, low birth weight, congenital malformations, cesarean section have been reported. Vaccination against influenza has been proven to be effective in reducing rates and severity of the disease in vaccinated mothers and their children. Several studies revealed a decreased risk of influenza-like illnesses among mothers who were vaccinated during pregnancy but also a decreased risk of laboratory confirmed cases of influenza and hospitalizations due to influenza and its complications among newborns and infants born to vaccinated mothers. Currently available inactivated influenza vaccines are not licensed for use in infants younger than 6 months. Protection of young infants against the infection in early life thus requires a cocooning strategy to reduce the number of vulnerable individuals among care givers and contacts. Neonates and infants may be also protected against influenza directly by antibodies of maternal origin that cross the placenta or are transferred via breast milk. The duration of passively acquired antibodies depends on the initial blood concentration and is probably less than 6 months. Vaccine coverage among pregnant women rdmains low Possible explanations include lack of education by health care workers, the feeling among the general public that influenza is not a serious problem, and the failure of prenatal care providers to offer the vaccine. Overall, the most important factor for a woman to decide to be immunized during pregnancy was to have a clear recommendation from the health care provider Reasons evoked by obstetricians for not providing influenza vaccines included lack sufficient data on safety and efficacy concerns about the medical legal risks of vaccination during pregnancy and the perdeption that pregnant women would not want to be vaccinated. Educational intervention targeting health care workers in charge of pregnant women should be primary implemented to provide higher influenza vaccine coverage and to protect pregnant women and young infants from influenza related morbidity

Influenza vaccines and vaccinations in Poland - past, present and future.

Influenza causes seasonal infections worldwide that can lead to complications and deaths in every age group. The most effective and cheapest way to combat influenza is through vaccination. In many countries, including Poland, for each age group, the rate of vaccination against influenza is still at a very low level, which generates high social costs, not infrequently family tragedies in the case of irreversible complications of influenza, or death of a loved one. Regular vaccination should be part of good medical practice, as well as an individual's engagement in their own health and in that of their family. Based on numerous studies, it is estimated that the effectiveness of current inactivated influenza vaccine in reducing morbidity and mortality in high-risk groups ranges from 50-70%. According to data from the National Institute of Public Health-National Institute of Hygiene, the rate of vaccination in children in 2008 in Poland was very low. In the group of children aged from 6 months to 14 years, only 1.1-1.6% were vaccinated. Although influenza vaccination for people aged over 65 years was free of charge in many provinces in this group, only 13.4% of this population was immunized, while in the case of people with chronic diseases, only 11.1% were immunized. The vaccination rate among health care employees is an embarrassing 6.4%. More educational activities addressed to both medical professionals and patients are required in order to increase influenza vaccine coverage in Poland.

Accuracy of rapid influenza diagnostic test and immunofluorescence assay compared to real time RT-PCR in children with influenza A(H1N1)pdm09 infection.

INTRODUCTION: The influenza burden among children is underestimated. The aim of our study was to estimate the accuracy of the rapid influenza detection test (RIDT) BD Directigen™ EZ Flu A+B® and direct immunofluorescence assay (DFA) used among children with influenza-like illness (ILI) consulted in the ambulatory care clinic. MATERIAL/METHODS: A total of 150 patients were enrolled in the study. Inclusion criteria were: age less than 59 months, presentation of ILI according to the CDC (Centers for Disease Control and Prevention) definition (fever >37.8°C, cough and/or sore throat in the absence of another known cause of illness), duration of symptoms shorter than 96 hours. Two nasal swabs and one pharyngeal swab were obtained from patients and tested by RIDT, DFA and real time RT-PCR as the reference method. RESULTS: For influenza A (H1N1)pdm09 virus sensitivity of RIDT was 62.2% (95% CI 46.5-76.2%), specificity 97.1% (95% CI 91.8-99.4%), PPV 90.3% (95% CI 74.3-98%), NPV 85.7% (95% CI 78.1-91.5%), for DFA sensitivity was 60% (95% CI 51.9-63.2%), specificity 96% (95% CI 88.7-98.8%), PPV 93.1% (95% CI 80.5-98%), NPV 72.7% (95% CI 67.2-74.9%). Analysis of logistic regression revealed that the chance of receiving a true positive result of RIDT was twice as high when the test was conducted during the first 48 hours of symptoms (OR 0.40 vs OR 0.22). CONCLUSIONS: The accuracy of RIDT is comparable with DFA and both methods are very specific but moderately sensitive in diagnosis of influenza in young children. Both methods may be recommended for screening for influenza among children.

[Influenza in Poland in 2010]. / Grypa w Polsce w 2010 roku.

UNLABELLED: THE PURPOSE OF STUDY: To assess the epidemiological situation of influenza and influenza like illnesses in Poland in 2010 compared to the situation in 2009. MATERIALS AND METHODS: We analyzed the data involved in the annual bulletins, among others. "Infectious diseases and poisonings in Poland in 2010" and "Vaccinations in Poland in 2010" issued by the Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene and Chief Sanitary Inspectorate, Department of Prevention and Control of Infections and Infectious Diseases in Humans, reports of incidence of confirmed and suspected cases of influenza, sent to the Department ofEpidemiology, NIPH-NIH by the Provincial Sanitary-Epidemiological Stations. Information about the results of virological samples from patients that were performed at the Virus Research Institute, National Centre for Influenza NIPH - NIH and data on deaths of Demographic Surveys Division of the Central Statistical Office (GUS). RESULTS: Virological test results showed that among circulating influenza viruses in the population is dominant subtype is A/H1N1/pdm 09, and the flu-like virus, RSV, as compared to 2009, the share of the influenza virus type B incerased. Overall, recorded 551,054 cases of influenza-ATM 1443,0 per 100 thousand people was twice lower than in 2009, the reduction in the number of cases in each province was in the range from 3.1% to 95.3%. Incidence of influenza aged 0-14 years decreased by 38.7%. In 2010 vaccinated against influenza in Poland 1,168,432 people. CONCLUSIONS: The epidemiological situation of influenza in Poland in 2010. was typical for increased incidence post pandemic the year. It is necessary to improve the epidemiological surveillance of influenza, at least to the level of 2009 should increase the percentage of people vaccinated against influenza to the level achieved in other European countries.

[Seasonal influenza in children - the underestimated problem]. / Grypa sezonowa u dzieci - problem niedoceniany.

Influenza in children is an important clinical, epidemiological and economic problem - but underestimated problem. The aim of the paper was to describe a current knowledge concerning epidemiology of influenza in children, including situation in Poland, its impact on ambulatory visits and hospitalizations. The beneficial effect of vaccination against influenza on economic and clinical issues was also underlined. It is estimated that annually 10-40% cases of febrile respiratory infections have influenza aetiology. In Poland, similar to other countries, the incidence of the diseases among children younger than 14 years is higher compared to the general population. However, the influenza vaccine coverage among children younger than 5 years in Poland is extremely low (<2%). Vaccinations against influenza in children are effective and safe and protect against the disease and its complications not only vaccinated children but also persons from close contacts. The most important method of prevention of influenza among children and adolescents aged 6 months-18 years is vaccination. Vaccination against influenza has been recommended in Poland since 1994. More educational activities addressed for patients and medical professionals are required to increase the influenza vaccine coverage among children and adolescents in Poland.

The Clinical Manifestation of SARS-CoV-2 in Critically Ill Patients with Klebsiella pneumoniae NDM Hospitalized in the ICU of a Modular Hospital during the Third Wave of the Pandemic in Poland-An Observational Cohort Study.

There is limited information on the clinical characteristics of critically ill patients infected with SARS-CoV-2 and Klebsiella pneumoniae NDM. The objective of this study was to describe such a group of patients hospitalised in the intensive care unit of a large academic hospital during the third wave of the COVID-19 pandemic in Poland. Between 1 March and 30 June 2021, 103 patients were hospitalised, of whom 23 (22.3%) were positive for K. pneumoniae NDM; 14 (61%) of those patients died. Their hospitalisation time varied between 9 and 47 days. Five of the 23 patients (21.7%) were otherwise healthy. In contrast, the others suffered from cardiovascular problems (11, 47.8%), obesity (6, 26.1%), diabetes (5, 21.7%), neurological problems (4, 17.4%), or kidney disease (1, 4.3%); 4 (17.4%) were heavy smokers, and 1 (4.3%) had a history of alcohol abuse. K. pneumoniae NDM was isolated from urine samples of all patients. In 17 patients (73.9%), it was also isolated from other sources: from the respiratory tract in 10 (43.8%), from the blood in 2 (8.7%), and the central venous catheter was contaminated in 1 case (4.3%). Fourteen of the patients (60.9%) were colonised K. pneumoniae NDM. In four patients (17.4%), bacterial and fungal coinfection occurred. In one case (4.4%), two fungal species, Candida albicans and Candida glabrata, were isolated simultaneously. The most frequently administered antimicrobial agent was colistin (60.9%), followed by meropenem (47.8%), vancomycin (47.8%), ceftriaxone (34.8%), linezolid (30.4%), piperacillin/tazobactam (30.4%), and trimethoprim/sulfamethoxazole (30.4%). Other less-frequently administered agents included amikacin, amoxicillin/clavulanate, tigecycline, ciprofloxacin, fosfomycin, clindamycin, and cloxacillin. Fluconazole was administered in 14 patients (60.7%) and micafungin was administered in 2 (8.7%).

Bloodstream Infections in the Intensive Care Unit: a Single-Center Retrospective Bacteriological Analysis Between 2007 and 2019.

Hospital-acquired bloodstream infections are a severe worldwide problem associated with significant morbidity and mortality. This retrospective, single-center study aimed to analyze bloodstream infections in patients hospitalized in the intensive care unit of the Military Institute of Medicine, Poland. Data from the years 2007-2019 were analyzed. When the infection was suspected, blood samples were drawn and analyzed microbiologically. When bacterial growth was observed, an antimicrobial susceptibility/resistance analysis was performed. Among 12,619 analyzed samples, 1,509 were positive, and 1,557 pathogens were isolated. In 278/1,509 of the positive cases, a central line catheter infection was confirmed. Gram-negative bacteria were the most frequently (770/1,557) isolated, including Acinetobacter baumannii (312/770), Klebsiella pneumoniae (165/770; 67/165 were the isolates that expressed extended spectrum beta-lactamases (ESBL), 5/165 isolates produced the New Delhi metallo-ß-lactamases (NDM), 4/165 isolates expressed Klebsiella pneumoniae carbapenemase (KPC), and 1/165 isolate produced OXA48 carbapenemase), Pseudomonas aeruginosa (111/770; 2/111 isolates produced metallo-ß-lactamase (MBL), and Escherichia coli (69/770; 11/69 - ESBL). Most Gram-positive pathogens were staphylococci (545/733), mainly coagulase-negative (368/545). Among 545 isolates of the staphylococci, 58 represented methicillin-resistant Staphylococcus aureus (MRSA). Fungi were isolated from 3.5% of samples. All isolated MRSA and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) strains were susceptible to vancomycin, methicillin-sensitive Staphylococcus aureus (MSSA) isolates - to isoxazolyl penicillins, and vancomycin-resistant Enterococcus (VRE) - to linezolid and tigecycline. However, colistin was the only therapeutic option in some infections caused by A. baumannii and KPC-producing K. pneumoniae. P. aeruginosa was still susceptible to cefepime and ceftazidime. Echinocandins were effective therapeutics in the treatment of fungal infections.

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population.

Background: Automated urine technology providing standard urinalysis data can be used to support clinicians in screening and managing a UTI-suspected sample. Fully automated urinalysis systems have expanded in laboratory practice. Commonly used were devices based on digital imaging with automatic particle recognition, which expresses urinary sediment results on an ordinal scale. There were introduced fluorescent flow cytometry analyzers reporting all parameters quantitatively. There is a need to harmonize the result and support comparing bacteria and WBC qualitative versus semiquantitative results. Methods: A total of 1,131 urine samples were analyzed on both automated urinalysis systems. The chemical components of urinalysis (leukocyte esterase and nitrate reductase) and the sediment results (leukocytes and bacteria) were investigated as potential UTI indicators. Additionally, 106 specimens were analyzed on UF-5000 and compared with culture plating to establish cut-offs that can be suitable for standard urinalysis requirements and help to guide on how to interpret urinalysis results in the context of cultivation reflex. Results: The medians of bacteria counts varies from 16.2 (absence), 43.0 (trace), 443.5 (few), 5,389.2 (moderate), 19,356.6 (many) to 32,545.2 (massive) for particular digital microscopic bacteriuria thresholds. For pyuria thresholds, the medians of WBC counts varies from 0.8 (absence), 2.0 (0-1), 7.7 (2-3), 21.3 (4-6), 38.9 (7-10), 61.3 (11-15) to 242.2 (>30). Comparing the culture and FFC data (bacterial and/or WBC counts) was performed. Satisfactory sensitivity (100%), specificity (83.7%), negative predictive value (100%), and positive predictive value (75%) were obtained using indicators with the following cut-off values: leukocytes ≥40/µl or bacteria ≥300/µl. Conclusions: Accurate urinalysis gives information about the count of bacteria and leukocytes as useful indicators in UTIs, in general practice it can be a future tool to cross-link clinical and microbiology laboratories. However, the cut-off adjustments require individual optimization.

Hospital Urinary Tract Infections in Healthcare Units on the Example of Mazovian Specialist Hospital Ltd.

Microbiological diagnostics is of great importance in limiting the spread of nosocomial infections. The information on etiological agents of infections and their susceptibility to antibiotics enables a quick response in the case of a suspected epidemic outbreak. The aim of this study is to analyze the incidence of nosocomial urinary tract infections among patients hospitalized in hospital wards over a period of 2 years and to determine the predominant etiological agent depending on the method of clinical specimen collection. Data from the Mazovian Specialist Hospital (MSH) in Radom constitute the material for the preparation of this study. Urine was collected using two methods. The first one was the method of collecting urine from the central stream, while the second method was urine collected from patients with a urinary catheter in place. The statistical calculations were conducted using the statistical software. Based on hospital data, it was shown that 5,870 urine tests were performed during the period under review, of which 2,070 were positive. The number of positive results in 2021 decreased by 2.84% compared to that in 2020. On the basis of the statistical analysis, differences in the occurrence of multiple strains were observed between catheter-based and midstream urine collection. Differences were observed especially for Acinetobacter baumannii, Candida albicans, Escherichia coli, and Pseudomonas aeruginosa. A. baumannii, C. albicans, and P. aeruginosa were significantly more frequently found in urine samples collected through the catheter than from the midstream. Furthermore, E. coli (51.56%) and Enterococcus species (25.46%) were more frequent when collected from the middle stream than when urine was collected through a catheter. However, for the strain K. pneumoniae, the results were comparable when urine was collected from catheterized patients (13.83%) and from midstream (13.35%). Urinary tract infection among hospitalized patients of the Mazovian Specialist Hospital in Radom was diagnosed quite frequently. In 2021, 32 more urine cultures were performed than in 2020. In the analyzed period, among all ordered urine cultures, 35.27% of samples were positive.

Urine 11-Dehydro-Thromboxane B2 in Aspirin-Naive Males with Metabolic Syndrome.

Urine 11-dehydro-thromboxane B2 (11-dehydro-TXB2), an indirect measure of platelet activity, is elevated in cardiovascular diseases and diabetes. The purpose of our study was to determine whether urine 11-dehydro-TXB2 is elevated in aspirin-naive males with metabolic syndrome (MS) and to determine predictors of 11-dehydro-TXB2 levels. The secondary aim was to evaluate whether these MS patients could be potential candidates for the aspirin-mediated prevention of atherosclerotic cardiovascular diseases (ASCVDs). In 82 males with MS (76 hypertensive), anthropometric measures, urine 11-dehydro-TXB2, platelet count, creatinine, glucose, insulin, estimated insulin resistance, lipid parameters, high-sensitivity C-reactive protein (hs-CRP), adiponectin, homocysteine, and ten-year risk of fatal cardiovascular disease (SCORE) were assessed. Urine 11-dehydro-TXB2 levels were elevated (≥2500 pg/mg creatinine) in two-thirds of patients, including 11 high-risk patients (SCORE ≥ 5%). Homocysteine, adiponectin, hs-CRP, waist-to-hip ratio, and total cholesterol were found to be predictors of urine 11-dehydro-TXB2. In conclusion, there is a high incidence of elevated urine 11-dehydro-TXB2 in males with MS, including in some patients who are at a high or very high risk of ASCVDs. 11-dehydro-TXB2 levels are associated with hyperhomocysteinemia, inflammation, fat distribution, hypercholesterolemia, and adiponectin concentrations. Elevated 11-dehydro-TXB2 levels may support the use of personalised aspirin ASCVD prevention in high-risk males with MS. Giuseppe Patti.