SeqNet.org: a European laboratory network for sequence-based typing of microbial pathogens.
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Bacteria↗
Biomedical subjects
W Hryniewicz
Publications and source records attributed to W Hryniewicz.
Staphylococcus aureus biofilm as a target for single or repeated doses of oxacillin, vancomycin, linezolid and/or lysostaphin.
Due to high resistance, standard chemotherapy of biofilm-associated staphylococcal infections is ineffective and a number of alternative approaches to antimicrobial treatment have been proposed. Minimum inhibitory concentration (MIC) and biofilm inhibitory concentration (BIC) of oxacillin (Oxa), vancomycin (Van), linezolid (Lzd) and lysostaphin (Lss) as well as the possible synergistic effect of the antibiotics and lysostaphin were determined. The Lss susceptibility of Staphylococcus aureus planktonic and bio-film cultures varied and was strain-dependent. The synergistic effect of sub-BIC(Lss)+Oxa was observed for methicillin-sensitive S. aureus (MSSa) and methicillin-resistant S. aureus (MrSa), but not for heterogeneously vancomycin-resistant S. aureus (V(h)Sa) biofilm. Van with sub-BICL(Lss) was effective against M(s)Sa and MrSa biofilm, when applied in three subsequent doses. Only sub-BICL(Lss)+Lzd combination, given as three cycles therapy, was effective in disruption of all 3 (M(s)Sa, M(r)Sa, V(h)Sa) biofilms.
Acetamides↗
First community-acquired methicillin-resistant Staphylococcus aureus (MRSA) strains in Croatia.
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Community-Acquired Infections↗
Characterisation of Neisseria meningitidis C:2b:P1.2,5 isolates in Poland.
This study aimed to characterise Neisseria meningitidis C:2b:P1.2,5 isolates from Poland, which have now become predominant among serogroup C isolates in this country. Overall, 44 isolates (25 invasive and 19 from contact carriers) were typed by whole-cell ELISA and pulsed-field gel electrophoresis. Additionally, the invasive isolates were analysed by multilocus sequence typing, which revealed that they all belonged to the ST-8 complex/cluster A4. The emergence of this clone in other countries has resulted in mass immunisation campaigns and has been associated with a higher level of decreased susceptibility to penicillin; however the present study detected only one isolate that was penicillin-non-susceptible.
Female↗
Report of working group 2: healthcare needs in the organisation and management of infection.
Clinical microbiology should have a physical presence, but not necessarily on-site diagnostic laboratory facilities, in each hospital to ensure a quality laboratory-based infection service and strong professional interaction with clinicians. The adoption of industrial practices and the introduction of new costly molecular techniques raise the possibility that non-microbiological functions of laboratory management could be left to management professionals. This remains highly controversial; the advantages must be contrasted with the potential to disrupt the traditional managerial responsibility of the microbiologist and the links between the laboratory and clinical staff. Managers and healthcare professionals must resolve this issue, perhaps with the support of the ESCMID. Views varied, according to current professional arrangements and size of the laboratory and population served, on whether there should be a common laboratory for microbiology and other pathology disciplines with joint access to new high-technology techniques, or whether microbiology must continue as a separate facility. Clinical microbiology and infection control were viewed as core services that must be present even in smaller hospitals. Larger community hospitals and teaching centres require a full complement of expertise in laboratory and clinical practice. Integration of these disciplines within a department of infection is an emerging concept. A concern was the shortfall in trained expertise because of the ageing nature of current specialists. The importance of recruiting talented new graduates was emphasised. The importance of this topic led to a recommendation that an ESCMID working party be established to investigate the current arrangements of infection services in Europe and to make recommendations for the future organisation.
Communicable Disease Control↗
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.
Anti-Bacterial Agents↗
Epidemiology and characterization of Bordetella parapertussis strains isolated between 1995 and 2002 in and around Warsaw, Poland.
The aim of the study presented here was to analyze parapertussis infections occurring in the region of Warsaw, Poland, between 1995 and 2002 and to characterize the Bordetella parapertussis isolates using macrorestriction digestion of genomic DNA. Fourteen of the 17 patients with confirmed Bordetella parapertussis infection were between the ages of 5 and 9 years, and 14 had documented vaccination with the diphtheria-tetanus-pertussis whole-cell vaccine; for the remaining three patients vaccination data was not available. DNA fingerprinting performed using recommended standard methodology revealed a close relationship between the examined strains and reference strain ATCC 9305, thus confirming the conservative nature of Bordetella parapertussis.
Age Distribution↗
European recommendations for antimicrobial resistance surveillance.
The problem of antimicrobial resistance surveillance in Europe has been debated extensively in many excellent documents issued by national committees that often assume the value of national guidelines. However, a comprehensive document addressing the whole matter from a European perspective, as well as reviewing its present status and drafting future perspectives, has been lacking. The present recommendations have been produced by the ESCMID Study Group for Antimicrobial Resistance Surveillance (ESGARS) through a consensus process involving all members of the Study Group. The recommendations focus on the detection of bacterial resistance and its reporting to clinicians, public health officers and a wider-and ever-increasing-audience. The leading concept is that the basis for resistance monitoring is microbiological diagnostics. The prerequisites for resistance monitoring are findings of adequate quality and quantity, which have been recorded properly and evaluated correctly. Different types of surveillance studies should fulfil different requirements with regard to data collection and reporting, the expected use of data, and the prerequisites for networking such activities. To generate relevant indicators, bacterial resistance data should be reported using adequate denominators and stratification. Reporting of antimicrobial resistance data is necessary for selection of empirical therapy at the local level, for assessing the scale of the resistance problem at the local, national or international levels, for monitoring changes in resistance rates, and for detecting the emergence and spread of new resistances types. Any type of surveillance study should conclude, where appropriate, with a proposal for intervention based on the data obtained.
Anti-Bacterial Agents↗
Identification of Neisseria meningitidis sequence type 66 in Poland.
Investigation of two cases of invasive meningococcal disease within a single family revealed the presence of isolates of Neisseria meningitidis phenotype C:2b:P1.2,P1.5 belonging to sequence type (ST) 66. The ST66 clone is a single-locus variant of the widely distributed ST8 complex, which has been observed previously in Spain, Belgium, Australia and New Zealand. This hypervariable meningococcal lineage has been responsible for local epidemics worldwide. This is the first report of ST66 meningococcal isolates of this phenotype from Poland.
Adult↗
Evaluation of the BD Phoenix automated identification and susceptibility testing system in clinical microbiology laboratory practice.
The Phoenix Automated Microbiology System (BD Biosciences, USA) is a new, fully automated system for the rapid identification and antimicrobial susceptibility testing of gram-positive and gram-negative bacteria. The objective of this study was to evaluate the quality of performance of the Phoenix system in the identification and antimicrobial susceptibility testing of 260 gram-negative ( n=174) and gram-positive ( n=86) isolates collected from Polish hospitals in recent years. Two Phoenix panel types for identification/antimicrobial susceptibility testing, NMIC/ID-5 for gram-negative rods and PMIC/ID-4 for gram-positive cocci, were used in the analysis according to the manufacturer's recommendations. The results produced by the system were compared with data obtained by reference or conventional microbiological methods. A high rate of agreement between the Phoenix and the conventional methods was observed for identification, ranging from 100% for gram-positive cocci to 96.0% for gram-negative nonfermenters and 92.5% for members of the family Enterobacteriaceae. Similarly, a high level of agreement characterized the antimicrobial susceptibility data obtained with the Phoenix and by the agar dilution method (2,361 test results). For staphylococci, enterococci and Enterobacteriaceae, the methods were 100% concordant in determining the category of susceptibility of isolates to the majority of the antimicrobial agents tested. A category agreement value of below 90% was found for the susceptibility of enterococci and gram-negative nonfermenters to ciprofloxacin (84.6% and 88.5%, respectively) and for susceptibility of Stenotrophomonas maltophilia to trimethoprim-sulfamethoxazole (80.0%).
Anti-Bacterial Agents↗
Activity of telithromycin and seven other agents against 1034 pediatric Streptococcus pneumoniae isolates from ten central and eastern European centers.
OBJECTIVE: To test the activity of telithromycin against 1034 Streptococcus pneumoniae isolates from pediatric patients in ten centers from ten central and eastern European countries during 2000-2001, and to compare it with the activities of erythromycin A, azithromycin, clarithromycin, clindamycin, and quinupristin-dalfopristin. METHODS: The minimum inhibitory concentrations (MICs) of telithromycin, erythromycin A, azithromycin, clarithromycin, clindamycin, levofloxacin, quinupristin-dalfopristin and penicillin G were tested by the agar dilution method with incubation in air, and mechanisms of resistance to macrolides and quinolones were investigated. RESULTS: Strains were isolated from sputum, tracheal aspirates, ear, eye, blood, and cerebrospinal fluid. Among S. pneumoniae strains tested, 36% had raised penicillin G MICs (>/= 0.12 mg/L). Susceptibilities were as follows: telithromycin, quinupristin-dalfopristin and levofloxacin, >/= 99%; clindamycin, 83%; and erythromycin A, azithromycin and clarithromycin, 78%. Of 230 (22.3%) erythromycin A-resistant S. pneumoniae strains, 176 (79.6%) had erm(B), 38 (16.1%) had mef(A), and 10 (4.3%) had mutations in 23S ribosomal RNA or in ribosomal protein L4. The rates of drug-resistant S. pneumoniae are high in all centers except Kaunas, Riga, and Prague. CONCLUSION: Telithromycin had low MICs against all strains, irrespective of macrolide, azalide or clindamycin resistance. Ribosomal methylation was the most prevalent resistance mechanism among all resistant strains, except in Sofia, where the prevalence of the efflux mechanism was higher.
Adolescent↗
Activity of telithromycin compared with seven other agents against 1039 Streptococcus pyogenes pediatric isolates from ten centers in central and eastern Europe.
In total, 1039 pediatric Streptococcus pyogenes isolates from Bulgaria, Croatia, the Czech Republic, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia and Slovenia were studied. All strains were susceptible to penicillin G, levofloxacin, and quinupristin-dalfopristin, 91-100% to telithromycin, and 82-100% to erythromycin, azithromycin, and clarithromycin, and 90-100% to clindamycin. Macrolide resistance occurred mainly in Slovakia (25%), the Czech Republic (17.3%), and Croatia (15.8%). Overall, 9.7% of S. pyogenes isolates were erythromycin resistant due to erm(B)- or erm(A)-encoded methylases (72.3%) or to a mef(A)-encoded efflux pump (25.7%). One strain had alterations of both 23S rRNA (A2058G Escherichia coli numbering) and ribosomal protein L22 (G95D).
Adolescent↗
Susceptibility to moxifloxacin and other antimicrobial agents of major pathogens responsible for community acquired respiratory tract infection in Poland.
The in vitro activity of moxifloxacin was compared with that of other antimicrobial agents against 470 bacterial strains isolated from patients with respiratory tract infection. Bacteria studied included 110 penicillin susceptible and 110 penicillin non-susceptible Streptococcus pneumoniae, 50 strains of S. pyogenes, 120 strains of Haemophilus influenzae and 80 strains of Moraxella catarrhalis. Moxifloxacin was the most active of the antimicrobials tested.
Anti-Bacterial Agents↗
Surveillance of resistance in bacteria causing community-acquired respiratory tract infections.
Bacterial resistance to antibiotics in community-acquired respiratory tract infections is a serious problem and is increasing in prevalence world-wide at an alarming rate. Streptococcus pneumoniae, one of the main organisms implicated in respiratory tract infections, has developed multiple resistance mechanisms to combat the effects of most commonly used classes of antibiotics, particularly the beta-lactams (penicillin, aminopenicillins and cephalosporins) and macrolides. Furthermore, multidrug-resistant strains of S. pneumoniae have spread to all regions of the world, often via resistant genetic clones. A similar spread of resistance has been reported for other major respiratory tract pathogens, including Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes. To develop and support resistance control strategies it is imperative to obtain accurate data on the prevalence, geographic distribution and antibiotic susceptibility of respiratory tract pathogens and how this relates to antibiotic prescribing patterns. In recent years, significant progress has been made in developing longitudinal national and international surveillance programs to monitor antibiotic resistance, such that the prevalence of resistance and underlying trends over time are now well documented for most parts of Europe, and many parts of Asia and the Americas. However, resistance surveillance data from parts of the developing world (regions of Central America, Africa, Asia and Central/Eastern Europe) remain poor. The quantity and quality of surveillance data is very heterogeneous; thus there is a clear need to standardize or validate the data collection, analysis and interpretative criteria used across studies. If disseminated effectively these data can be used to guide empiric antibiotic therapy, and to support-and monitor the impact of-interventions on antibiotic resistance.
Africa↗
The usage of antibiotics in Russia and some countries in Eastern Europe.
The patterns of antibiotic use in 1998 in Russia and some other countries in Eastern Europe (Belarus, Poland, Slovakia, Hungary) were studied. Poland, Slovakia and Hungary were "more modern" users of antibiotics, consuming new and expensive drugs. Russia and Belarus were "conservative" having a lower level of total consumption and using lesser quantities of penicillins, cephalosporins, macrolides, quinolones, carbapenems but greater amounts of aminoglycosides and chloramphenicol. It is essential for "conservative" countries to establish a national surveillance system of antibiotic consumption to monitor the development of bacterial resistance to antimicrobial agents and to monitor individual antibiotic use.
Anti-Bacterial Agents↗
The prevalence of diphtheria immunity in healthy population in Poland.
The degree of seroprotection against diphtheria in Poland was evaluated by determination of IgG antibodies to Corymebacterium diphtheriae toxin (IgG-DTAb). The study population consisted of 4,829 healthy subjects aged from 1 day to 85 years from 7 regions of Poland. Serum samples collected between 1996 and 1998 were assayed for IgG-DTAb antibodies using a toxoid enzyme immunoassay. Neutralization of toxin in Vero cells was performed as a reference method with the WHO standard for human diphtheria antitoxin. The study revealed a lack of seroprotection (IgG-DTAb < 0.1 IU/ml) in 23% of individuals, basic seroprotection (0.1-1.0 IU/ml) in 64%, and effective seroprotection (> 1.0 IU/ml) in 13%. The non-protected group consisted of non-vaccinated children below 2 months of age (10%), individuals between 2 months and 18 years old (20%) and greater than 19 years old (70%). Of the adults, 32% were seronegative, 63% had basic seroprotection and only 5% were fully protected; 43% of adults between 30 and 64 years, who had not been vaccinated at least during the previous 10 years were not protected against diphtheria. The geometric mean titre (GMT) of IgG-DTAb was 0.25 IU/ml in the total population. Age-related GMTs differed significantly from each other and were higher (0.44 IU/ml) in individuals from 2 months to 18 years old, compared with 014 IU/ml and 0.17 lU/ml in children under 2 months and adults, respectively. No significant difference was found in the GMTs of men and women in all age groups. We conclude that the currently used vaccination programme in Poland is highly effective and assures protection against diphtheria in the majority of the population in the 10-year period following the last booster. However, a significant proportion of adults between 30 and 64 years lack protection and this indicates a need for booster immunization for this group.
Adolescent↗
Hospital infection control in Poland.
During the last 10 years, as in other areas of the public sector in Poland, the healthcare system has undergone important changes presenting a challenge for medical staff and healthcare managers alike. Since 1997, the Polish Government has undertaken important healthcare reforms. New regulations have introduced decentralization of management and a financing system for hospitals. These changes have provided favourable conditions in which to implement an infection control system for hospitals. The most important recent initiatives are training courses and workshops for hospital staff organized in co-operation with microbiologists and epidemiologists as well as preparation of recommendations and guidelines for hospitals. Several non-governmental organizations have been set up to improve hospital hygiene, infection control and monitoring of antimicrobial resistance.
Cross Infection↗
Antibiotic susceptibility of bacterial strains isolated from urinary tract infections in Poland.
Worldwide data show that there is increasing resistance among urinary tract pathogens to conventional drugs. The aim of this study was to obtain data on susceptibility patterns of pathogens responsible for urinary tract infections (UTIs) in Poland to currently used antimicrobial agents. A multicentre study of 141 pathogens from hospital-acquired infections and 460 pathogens from community-acquired infections was carried out between July 1998 and May 1999. The most prevalent aetiological agent was Escherichia coli (73.0%), followed by Proteus spp. (8.9%) and other species of Enterobacteriaceae (9.6%). Few community infections were caused by Gram-positive bacteria (2.2%). Gram-positive cocci were isolated more frequently from a hospital setting (14.1%) and the most common were Enterococcus spp. (8.5%). Pseudomonas aeruginosa was found only among hospital isolates and was responsible for 10.7% of infections. E. coli isolates from both community and hospital infections were highly susceptible to many antimicrobial agents with the exception of those isolates producing extended-spectrum beta-lactamases (ESBLs). Of all Enterobacteriaceae tested, 38 strains (6.9%) were capable of producing ESBLs.
Anti-Bacterial Agents↗