Bacterial meningitis in adults - principles of diagnosis and antibiotic treatment.

The emergence of antibiotic-resistant bacterial strains in recent years has necessitated the development of new strategies for empiric antimicrobial therapy for bacterial meningitis. Bacterial meningitis is associated with significant morbidity and mortality despite the availability of effective antimicrobial therapy. The management approach to patients with suspected or proven bacterial meningitis includes initiation of appropriate antimicrobial and adjunctive therapies and decides on the patients survival.

Management of bacterial skin and soft tissue infections.

Skin and soft tissue infections (SSTIs) are a group of diseases usually caused by bacteria, and connected with different clinical picture, course, and prognosis. The increasing incidence of SSTIs is associated mainly with aging of the population, the increasing number of metabolic diseases, especially diabetes mellitus, as well as cardiovascular diseases. Although SSTIs are often benign and usually does not require medical consultations, some of them may cause a systemic infection. In this situation, knowledge of the principles of diagnostic work-up and therapy is essential. The principles of recognition and treatment of skin and soft tissue infections, including new biocidal drugs, are presented.

Bacterial meningitis - principles of antimicrobial treatment.

Bacterial meningitis is associated with significant morbidity and mortality despite the availability of effective antimicrobial therapy. The management approach to patients with suspected or proven bacterial meningitis includes emergent cerebrospinal fluid analysis and initiation of appropriate antimicrobial and adjunctive therapies. The choice of empirical antimicrobial therapy is based on the patient's age and underlying disease status; once the infecting pathogen is isolated, antimicrobial therapy can be modified for optimal treatment. Successful treatment of bacterial meningitis requires the knowledge on epidemiology including prevalence of antimicrobial resistant pathogens, pathogenesis of meningitis, pharmacokinetics and pharmacodynamics of antimicrobial agents. The emergence of antibiotic-resistant bacterial strains in recent years has necessitated the development of new strategies for empiric antimicrobial therapy for bacterial meningitis.

Colonisation of the gastrointestinal tract by probiotic L. rhamnosus strains in acute diarrhoea in children.

Lactobacillus rhamnosus (573L/1-3) strains are considered effective in the treatment of rotaviral diarrhoea in children. The colonisation of the gastrointestinal (G.I.) tract by the Lactobacillus rhamnosus strains and the determining factors are discussed reporting data of a prospective, double-blinded, placebo-controlled randomized study in children between the 2nd month and 6th year of life with acute diarrhoea lasting not longer than 5 days. The examined strains were detected in 37/46 (80.43%) patients after 5 days and in 19/46 (41.3%) patients after 14 days since the start of the treatment. L. rhamnosus 573L/1 strain colonised the G.I. tract more persistently. L. rhamnosus strains are effective in colonising the G.I. tract during acute diarrhoea. Persistence of colonisation is dependent on the properties of administered probiotic strains.

[Medical applications of probiotics]. / Medyczne zastosowanie probiotyków.

Normal microflora of the digestive tract plays an important role in maintaining competence of the immune system. Imbalance of the flora may lead to the development of either diseases related to overgrowth of its selected constituents (post-antibiotic diarrhoea, travellers' diarrhoea or infection by external pathogens--rotavirus diarrhoea) or diseases resulting from altered immunological response (atopy, inflammatory bowel disease, neoplasmas). It is believed that application of probiotics may restore proper composition and functions of the microflora and thus bring new perspectives into prevention and treatment of these illnesses. Prospective studies on mechanisms of the probiotic activities may enable their new medical applications.

[Implementation of the Active Nosocomial Infections Surveillance System in Polish hospitals]. / Wdrazanie systemu Czynnej Rejestracji Zakazen Szpitalnych w Polskich szpitalach.

Characteristics the organisation of infection control in hospitals participating in the Active Nosocomial Infections Surveillance System in Poland. Analysis of the data obtained from a questionnaire on organization of nosocomial infections surveillance in hospitals participating in the Active Nosocomial Infections Surveillance System coordinated by the Polish Society of Hospital Infections. Analyzed data were obtained from 32 hospitals of different size number of hospital beds) and type of reference. Most questions focused on the structures of infection control, postdischarge surveillance and role of microbiological laboratory. NIs surveillance system is based on the work of infection control team consisting of epidemiological nurse and physician representing different specializations, but there is no specialist or doctor specializing in medical microbiology. Additionally, the Infection Control Committee exists in 25 hospitals. Only in 37.5% of those hospitals the postdischarge surveillance is performed, but related only to surgical site infections. There is no microbiological surveillance in 25% of the hospitals, which means that neither registration nor collecting of drug-resistant strains are performed. Implementation of the Active Nis Surveillance System is based on the common organizational structure, programme and definitions of infections. The postdischarge surveillance and microbiological surveillance are the main activities which still need improvement.