Recent trends in epidemiology of invasive pneumococcal disease in Poland.

The objectives of this study were to assess the current incidence of invasive pneumococcal disease (IPD) in Poland (2011-2013), where mass vaccination has not been implemented, and to characterize the Streptococcus pneumoniae isolates responsible for invasive infections by determining their serotype distribution and antimicrobial resistance patterns. For all isolates identification, serotyping and antimicrobial minimal inhibitory concentrations determination were performed based on routine techniques. The highest incidence rates were observed among adults older than 85 years old (4.62/100,000) and children under 1 year of age (4.28/100,000). The general case fatality ratio (CFR) was 25.4%, with the highest CFR in the age group ≥85 years old (59.7%). The most common serotypes were 3, 14, 19A, 4, 9V, 19F, 1, and 23 F (61.3% of all isolates). The 10- and 13-valent pneumococcal conjugated vaccines (PCV) covered 46.0 and 71.8% of all IPD cases, 61.4 and 79.5% of cases in children under two years, and 60.4 and 78.6% of cases involving children under five years of age, respectively. The PCV13 and 23-valent polysaccharide vaccine covered 68.7 and 86.0% of cases in adults >65 years old, respectively. Decreased susceptibility was noted for penicillin (24.8%), cefotaxime (10.0%), meropenem (5.0%), rifampicin (0.8%), chloramphenicol (4.3%), erythromycin (29.7%) and clindamycin (25.6%). Multi-drug resistance characterized 21.6% of the pneumococci tested. Despite deficiencies in the Polish surveillance system and strong underestimation of IPD cases, results of the study showed good theoretical coverage of PCV, which should encourage inclusion of anti-pneumococcal conjugate vaccine into the national immunization program.

Antimicrobial susceptibility patterns of Staphylococcus aureus in Poland obtained by the National Quality Assurance Programme.

As part of the Polish external quality assurance scheme, clinical laboratories were asked to send five consecutive isolates of Staphylococcus aureus and the corresponding susceptibility results to the national Centre of Quality Control in Microbiology. Of 1376 isolates submitted as S. aureus from 276 medical centres, 13 (< 1%) had been misidentified by local laboratories. Of 181 (13.5%) methicillin-resistant S. aureus (MRSA) isolates, most were identified correctly (c. 98% of laboratories). Although all MRSA isolates were fully susceptible to vancomycin, teicoplanin and linezolid, they were usually multiresistant; almost 23% were resistant to seven antimicrobial agents. Most (> 90%) MSSA isolates were susceptible to the tested antibiotics, except penicillin (21% susceptible) and tetracycline (62.4% susceptible). In addition to evaluating the proficiency of testing by local laboratories, the study yielded valuable information regarding the susceptibility patterns of S. aureus isolates in Poland.

[Chemiluminescence of granulocytes in response to Pseudomonas strains isolated from various materials]. / Chemiluminescencja granulocytów w odpowiedzi na szczepy Pseudomonas aeruginosa izolowane z róznych materialów.

The study was aimed at comparison of chemiluminescence of granulocytes during their incubation with suspensions of Pseudomonas strains isolated from various sources. The study was performed on 136 strains isolated from clinical material. The results were correlated with resistance of these bacteria to bactericidal activity of serum and their ability to produce proteolytic enzymes. It was found that strains isolated from blood and pus weakly activate granulocytes in contrary to bacteria isolated from urine and feces. Ability to pronounced activation of granulocytes was without relation to susceptibility of a given strain to action of serum. But it correlated negatively with ability to production of proteolytic enzymes. These observations indicate existence of relation between characteristics of strain and type of clinical material from which it was isolated.