The Prevalence of Alert Pathogens and Microbial Resistance Mechanisms: A Three-Year Retrospective Study in a General Hospital in Poland.

The development of antibiotic resistance mechanisms hinders the treatment process. So far, there is limited data on the problem of bacterial resistance in hospitals in Central and Eastern Europe. Therefore, this study aimed to assess the prevalence of resistance mechanisms and alert pathogens based on reports regarding cultures of samples collected from general hospital patients in Poland in the period 2019-2021. This study examined the prevalence of resistance mechanisms and alert pathogens and the structure of microorganisms, including the type of diagnostic material in the hospital department. The frequency of occurrence and the trends were analysed based on Cochran's Q-test, relative change and the average annual rate of change (AARC). Of all 14,471 cultures, 3875 were positive for bacteria, and 737 were characterised by resistance mechanisms (19.0%). Alert pathogens were identified in 983 cases (24.6%), including pathogens isolated from blood samples. The most commonlyisolated bacteria were Escherichia coli (>20% of positive cultures), Enterococcus faecalis (7%), and Klebsiella pneumoniae (6%) increasing over time; Staphylococcus aureus (13%) was also found, but its proportion was decreasing over time. Extended-spectrum ß-lactamase (ESBL) was the most frequent resistance mechanism in Internal Medicine (IM) (p < 0.001) and the Intensive Care Unit (ICU) (p < 0.01), as well as in ICU-COVID; this increased over the study period (AARC ↑34.9%). Methicillin-resistant Staphylococcus aureus (MRSA) (AARC ↓50.82%) and AmpC beta-lactamase (AARC ↓24.77%) prevalence fell over time. Also, the number of alert pathogens was dominant in the IM (p < 0.01) and ICU (p < 0.001). The most common alert pathogen was ESBL-positive E. coli. Gram-negative rods constitute a significant epidemiological problem in hospitals, especially the growing trend of ESBL in IM and ICU, which calls for increased control of sanitary procedures.

The Anti-Inflammatory and Antioxidant Impact of Dietary Fatty Acids in Cardiovascular Protection in Older Adults May Be Related to Vitamin C Intake.

Polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), α-linolenic acid (ALA), or linoleic acid (LA), have a particular role in counteracting cardiovascular diseases. They may regulate antioxidant potential and inflammatory reactions. Little is known whether other fatty acids, such as saturated fatty acids (e.g., short-chain fatty acids (SCFA) such as butyric or caproic acid) or monounsaturated fatty acids, may be involved and whether the level of Vitamin C intake may affect these processes. The purpose of this study was to assess the impact of fatty acid intake on plasma and salivary total antioxidant capacity (TAC), and the salivary inflammation marker C-reactive protein (CRP). Eighty older adults (60-79 years old) were divided into two groups with high (n = 39) and low (n = 41) Vitamin C intake. In the group with high Vitamin C intake SCFA, ALA, LA positively correlated with the plasma TAC indices, and in the group with low Vitamin C intake, the salivary TAC was decreased in subjects with a higher SCFA intake. Salivary CRP negatively corresponded to SCFA, EPA, and DHA in the whole study group (p < 0.05 for all). Fatty acids and Vitamin C intake may influence antioxidant potential and salivary CRP.

Blood Culture Contamination: A Single General Hospital Experience of 2-Year Retrospective Study.

In the event of blood culture contamination (BCC), blood culture (BC) needs to be repeated. This may delay appropriate treatment, prolong hospitalization and, consequently, increase its costs. The aim of the study was to assess the frequency of BCC and associated factors in a general hospital in Poland based on reports of BC in samples submitted for laboratory testing in 2019−2020. BCC is recognized when bacteria (especially those belonging to natural human microbiota) are isolated from a single sample and no clinical signs indicated infection. True positive BC is confirmed by the growth of bacteria in more than one set of blood samples with the corresponding clinical signs present. The structure of BC sets, microorganisms, and laboratory costs of BCC were analyzed. Out of 2274 total BC cases, 11.5% were true positive BC and 9.5% were BCC. Of all the BCC identified in the entire hospital, 72% was from Internal Medicine (IM) and Intensive Care Unit (ICU) combined. When single sets for BC were used in IM in 2020, the use increased to 85% compared with 2019 (p < 0.05). The predominant isolates were coagulase-negative staphylococci (84%). The estimated extra laboratory costs of BCC exceeded EUR 268,000. The BCC was a more serious problem than expected, including non-recommended using of single BC sets. Compliance with the BC collection procedure should be increased in order to reduce BCC and thus extra hospital costs.

Effects of two different types of single exercise modes on salivary C-reactive protein concentration, oxidative stress and antioxidant capacity in post-myocardial infarction patients.

OBJECTIVES: The aim of the study was to determine the effects of two different types of single cardiac rehabilitation (CR) exercise modes on the inflammation status, oxidative stress and total antioxidant capacity (TAC) of saliva. METHODS: The study involved two groups of CR patients: group A (n = 21) used a cycloergometer, and group B (n = 21) received breathing and balance exercises. C-reactive protein as an inflammatory biomarker, malondialdehyde (MDA) as a measure of the level of oxidative stress and salivary 2.2-diphenyl-1-picryl-hydrazyl (DPPH) as an index of TAC were performed twice: before the beginning of the CR exercise (pre-CR) and immediately after (post-CR). RESULTS: No significant changes were observed for the inflammatory response of saliva after CR exercise regardless of its type. MDA decreased (pre-CR: 39.7 ± 101.9 vs. post-CR: 16.8 ± 44.3 ng·mL-1; p < 0.01) and DPPH increased (pre-CR: 25.9 ± 16.7 vs. post-CR: 32.6 ± 14.0% reduction; p < 0.05) after CR exercise in the group B, with similar but not statistically significant changes in the group A. DISCUSSION: Two popular exercise modes, especially breathing and balance exercises, reduce salivary oxidative stress and enhance the antioxidant potential of saliva in CR patients. The approval of saliva as a non-invasive source of information about inflammation status, oxidative stress and antioxidant capacity in cardiac patients requires further studies.

Salivary and plasma native and non-urate total antioxidant capacity versus oral health status in older non-smoking adults.

OBJECTIVE: The aim of this study was to evaluate the salivary C-reactive protein and native and non-urate total antioxidant capacity (TAC) of saliva and plasma in relation to various oral health status indexes in older non-smoking adults. DESIGN: Oral health status indices involved the Decayed, Missing, Filled Teeth index, the number of decayed teeth, Approximal Plaque Index, Plaque Index and Community Periodontal Index with Treatment Needs. Sixty older patients (67.0 ± 4.5 years) with different levels of oral health were examined. Salivary C-reactive protein was assessed. The Ferric Reducing Ability of Saliva/Plasma (FRAS/FRAP) and 2.2-diphenyl-1-picryl-hydrazyl test of saliva/plasma (DPPHS/DPPH) were used to assess the native and non-urate salivary (FRAS, non-urate FRAS, DPPHS, non-urate DPPHS, and plasma TAC (FRAP, non-urate FRAP, DPPH, non-urate DPPH). RESULTS: Salivary C-reactive protein, native TAC and non-urate TAC did not correspond to any oral health status index. No relation was found for plasma native and non-urate TAC either. In multivariate analyses, age was the only independent predictor of DPPHS and salivary uric acid (p < 0.05) while non-urate DPPH was only negatively predicted by Body Mass Index (p < 0.001). None of oral health status indices was selected as an independent predictor of salivary and plasma TAC or C-reactive protein of saliva. CONCLUSION: Oral health status indexes did not appear to influence the native or the non-urate local antioxidant status of saliva, or the systemic antioxidant status of plasma; they had no local effect related to salivary C-reactive protein. However, lower plasma non-urate antioxidant potential was related to overweight/obesity.

The Influence of an Eight-Week Cycloergometer-Based Cardiac Rehabilitation on Serum Antioxidant Status in Men with Coronary Heart Disease: A Prospective Study.

Background and objectives: A body of evidence confirms the benefits of cardiac rehabilitation (CR) in coronary heart disease (CHD) patients, but it remains unclear whether it enhances the antioxidant potential. The aim of the study was to assess the influence of an eight-week aerobic cycloergometer-based CR program on serum total antioxidant capacity (TAC) and other CHD risk factors. Materials and Methods: The study involved 36 men with CHD (55.2 ± 9.0 years). TAC was assessed with two methods: ferric reducing ability of serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH). Aerobic capacity was evaluated during a submaximal exercise test. TAC and other anthropometric, biochemical and physical activity/fitness measures were performed twice: before the beginning and after termination of CR. Results: Aerobic capacity was higher (7.0 ± 2.6 vs. 8.0 ± 2.5 MET-metabolic equivalents; p < 0.01), but values of resting diastolic blood pressure were lower (81.9 ± 7.6 vs. 77.4 ± 8.9 mmHg; p < 0.01) after termination of CR. Other classic cardiometabolic, anthropometric, and biochemical measures did not change with CR. No difference in TAC-FRAS was found after CR, whereas TAC-DPPH was significantly lower (16.4 ± 4.0 vs. 13.2 ± 3.7% reduction; p < 0.01). Conclusions: Antioxidant potential measured as TAC-DPPH, but not as TAC-FRAS, decreased with the CR program. The recognized health benefits of CR are not related to augmented serum antioxidant status.

Plasma and Salivary Non-Urate Total Antioxidant Capacity Does Not Depend on Dietary Vitamin C, E, or ß-Carotene Intake in Older Subjects.

The native Total Antioxidant Capacity (TAC) of plasma and saliva is generally determined by uric acid (UA). Several studies have assessed the impact of habitual dietary antioxidative vitamin intake on TAC, but it remains unknown whether it influences Non-Urate Total Antioxidant Capacity (Nu-TAC), i.e., TAC after enzymatic UA elimination. The purpose of this study was to assess whether the intake of antioxidative vitamins C, E, and ß-carotene, provided with usual daily food rations, affects plasma and salivary Nu-TAC. The study involved 56 older subjects (aged 66.9 ± 4.3 years), divided into two age- and sex-matched groups: group 1 (n = 28), with lower combined vitamin C, E, and ß-carotene intake, and group 2 (n = 28), with higher intake. A 24 h dietary recall was obtained from each individual. Nu-TAC was assessed simultaneously with two methods in plasma (Ferric Reducing Ability of Plasma­Nu-FRAP, 2.2-diphenyl-1-picryl-hydrazyl­Nu-DPPH) and in saliva (Nu-FRAS and Nu-DPPHS test). No differences were found in the Nu-TAC parameters between the groups, either in plasma (Nu-FRAP, Nu-DPPH) or in saliva (Nu-FRAS, Nu-DPPHS) (p > 0.05). No plasma or salivary Nu-TAC indices correlated with dietary vitamin C, E, or ß-carotene intake or with other nutrients. Habitual, not extra-supplemented dietary intake does not significantly affect plasma or salivary Nu-TAC.

A comparison of native and non-urate Total Antioxidant Capacity of fasting plasma and saliva among middle-aged and older subjects.

OBJECTIVES: As plasma and salivary total antioxidant capacity (TAC) is mainly contributed by uric acid (UA), the present study measures non-urate TAC (Nu-TAC). The aim of the study was to correlate plasma native TAC, Nu-TAC and UA with their salivary analogues, and compare the UA contribution in both body fluids using two different methods. METHODS: The study involved 55 middle-aged and older subjects (66.7 ± 4.5 years). TAC was determined simultaneously with two methods (ferric reducing ability of plasma - FRAP, 2.2-diphenyl-1-picryl-hydrazyl - DPPH and countertypes for saliva - FRAS and DPPHS test), with and without UA (native TAC and Nu-TAC, respectively). Plasma UA and salivary UA (SUA) were assessed. RESULTS: Subjects with increased FRAP, DPPH and UA had higher FRAS, DPPHS and SUA, respectively (P < 0.05). Plasma Nu-TAC indices did not correlate with salivary Nu-TAC. The contribution of UA to the plasma and salivary DPPH tests was similar: 75.7 ± 10.3% and 75.2 ± 14.0%, respectively. However, the contribution of UA to FRAS was higher than that for FRAP (71.6 ± 13.9% vs. 64.0 ± 8.1%; P < 0.001). DISCUSSION: Our findings suggest that saliva is a good predictor for native plasma TAC but not for Nu-TAC. UA level is comparably dominant in saliva and in plasma according to DPPH, but lower in plasma according to FRAP.

Dietary Vitamin C, E and ß-Carotene Intake Does Not Significantly Affect Plasma or Salivary Antioxidant Indices and Salivary C-Reactive Protein in Older Subjects.

It is not clear whether habitual dietary intake influences the antioxidant or inflammatory status. The aim of the present study was to assess the impact of antioxidative vitamins C, E, and ß-carotene obtained from daily food rations on plasma and salivary Total Antioxidant Capacity (TAC), uric acid and salivary C-reactive protein (CRP). The study involved 80 older subjects (66.9 ± 4.3 years), divided into two groups: group 1 (n = 43) with lower and group 2 (n = 37) with higher combined vitamins C, E and ß-carotene intake. A 24-h dietary recall was obtained from each individual. TAC was assessed simultaneously with two methods in plasma (Ferric Reducing Ability of Plasma-FRAP, 2.2-diphenyl-1-picryl-hydrazyl-DPPH) and in saliva (FRAS and DPPHS test). Lower vitamin C intake corresponded to higher FRAS. There were no other correlations between vitamins C, E or ß-carotene intake and antioxidant indices. Salivary CRP was not related to any antioxidant indices. FRAS was decreased in group 2 (p < 0.01) but no other group differences for salivary or for plasma antioxidant parameters and salivary CRP were found. Habitual, not extra supplemented dietary intake does not significantly affect plasma or salivary TAC and salivary CRP.

Physical Activity, Aerobic Capacity, and Total Antioxidant Capacity in Healthy Men and in Men with Coronary Heart Disease.

OBJECTIVE: The purpose of the study was to assess total antioxidant capacity (TAC) of blood serum in relation with habitual leisure time physical activity (LTPA) and aerobic capacity in a group of 90 men with coronary heart disease (CHD) aged 34.8-77.0 years and in 90 age-matched peers without CHD. METHODS: Two spectrophotometric methods were applied to assess TAC: Ferric Reducing Ability of Serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH) tests. Aerobic capacity was expressed as physical working capacity at 85% of the maximal heart rate (PWC(85%HRmax)). RESULTS: CHD patients had higher values of TACFRAS (1.37 ± 0.28 versus 1.27 ± 0.23 mmol FeCl2·L(-1); P < 0.05) but there were no group differences for TAC-DPPH and for uric acid (UA). Negative correlation was found between LTPA (also when calculated per kg of body mass) and TAC-DPPH in CHD patients. In CHD patients, TAC-FRAS and UA were lower in subjects with higher aerobic capacity expressed as PWC(85%HRmax/kg). Those associations were not found in healthy men. CONCLUSIONS: We conclude that TAC of blood serum is moderately adversely related to LTPA and aerobic capacity in patients with CHD. UA, as the main determinant of serum TAC, may be partially responsible for those associations.

Cardiovascular risk factors and total serum antioxidant capacity in healthy men and in men with coronary heart disease.

Whether the incidence of coronary heart disease (CHD) is related to a decrease in total antioxidant capacity (TAC) has not yet been completely clarified. We assessed TAC of blood serum in a group of 163 men with CHD aged 34.8-77.0 years and in 163 age-matched peers without CHD. Two spectrophotometric methods were applied to assess TAC: ferric reducing ability of serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH) tests. In the CHD group, multivariate analysis revealed that uric acid (UA), triglycerides, and systolic blood pressure contributed independently to the TAC-FRAS variance. TAC-DPPH was favorably predicted by UA concentration, but negatively so by current smoking and glucose levels. In men without CHD, UA was the only independent determinant of both TAC-FRAS and TAC-DPPH. Presence of CHD was not an independent predictor of TAC-observed between-group differences (higher TAC in CHD patients) disappeared after adjustment for other confounders. We conclude that UA is the main determinant of TAC of blood serum in men. TAC is not directly influenced by age or CHD but is related to several indices of overweight/obesity and laboratory measures of metabolic syndrome, especially in patients with CHD.

Physical activity and total antioxidant capacity across an adult lifespan of men.

PURPOSE: The aim of the study was to determine the association between the long-term physical activity (PA) and the total antioxidant capacity (TAC) of blood serum and their association with coexisting risk factors of cardiometabolic diseases in a group of relatively healthy men. METHODS: The research was conducted among 422 males age 19.2-89.8 yr, either sedentary or involved in recreational sports activities. Anthropometric measurements, lipid profile, and measurement of glucose and uric acid levels were performed in every man. Current PA, historical PA, and aerobic fitness (physical working capacity) were assessed. TAC was determined with two spectrophotometric methods: the ferric reducing ability of serum (TAC-FRAS) and 2,2-diphenyl-1-picryl-hydrazyl (TAC-DPPH) tests. RESULTS: TAC was not related to the age of the subjects. Higher current and historical PA were associated with a more favorable cardiometabolic risk profile but not TAC. In fact, current PA level was connected with lower values of TAC-FRAS. Values of both TAC-FRAS and TAC-DPPH decreased with an increase of aerobic capacity. Individuals with coexisting anthropometric and biochemical risk factors of cardiovascular diseases and with elevated values of arterial pressure had higher TAC. Values of both TAC-FRAS (r = 0.66) and TAC-DPPH (r = 0.39) were strongly positively correlated with uric acid level. CONCLUSIONS: Overweight, obesity, higher blood pressure, unfavorable blood lipid profile, and especially higher uric acid levels are connected with greater TAC of blood serum across an adult man's life. High PA and fitness are associated with a more favorable overall risk profile of cardiovascular and metabolic diseases but are related to lower TAC.