[Synantropic cockroaches (Blattella germanica L.) in hospital environment--microbiological hazard for patients and hospital infections risk assessment]. / Synantropijne karaczany (Blattella germanica l.) w srodowisku szpitalnym - narazenie mikrobiologiczne pacjentów i oszacowanie ryzyka zakazen szpitalnych.

OBJECTIVE: The aim of our study was to determine what a hazard for patients creates the presence of cockroaches in hospital environment. MATERIAL AND METHODS: The probable hospital infections cases in 9 hospitals in Warsaw were found in database of the Country Hospital Morbidity Register for the year 2004 and correlation between such factors as: drug resistance of bacteria isolated from external part of cockroach's bodies, their ability to biofilm building, adherence, resistance to disinfectants, resistance of cockroaches to insecticides, infestation level vs. infections of several body systems was examined. RESULTS: The microbiological hazard of cockroaches in hospital environment has been proven by our findings that some of bacterial strains carried on the body of cockroaches belonged to well known species responsible for hospital infections everywhere The strains resistant to several antibiotics used in hospital and the strains able to form virulence factors were found. Some correlation was found between resistance of cockroaches for biocides and higher infestation of the hospital environment. CONCLUSIONS: Cockroaches infected in hospital environment might be the active carrier of bacterial strains as well as indicator of the bacterial presence on the surfaces in the hospital building not enough treated with disinfectants. On the base of our findings we may suppose that in hospital infections the role of infected cockroaches are less important than the other factors but should be not completely neglected. Surveillance and control of hospital infections should be more completed, connected not only with continuous monitoring of resistance of bacterial strains to antibiotics but also to disinfectants used in hospital as well as evaluation of infestation of the hospital environment and resistance of cockroaches to biocides.

[Invasive aspergillosis (IA) in patients treated in the Institute of Tuberculosis and Chest Diseases in the years 1993-2005--diagnostic problems]. / Inwazyjna aspergiloza u chorych leczonych w Instytucie Gruzlicy i Chorób Pluc w latach 1993-2005--trudnosci diagnostyczne.

The aim of this study was to present the diagnostic problems in pts treated for invasive aspergillosis (IA) in the IIIrd Clinic of the Institute of Tuberculosis in the years 1993-2005. The material consisted of clinical documentation of 18 pts. 15 out of 18 pts (83,4%) died. In all those cases autopsy examination was done. In 13 pts IA was the main and in another 2 only the accessory cause of death. All pts were treated with corticosteroids and/or cytostatic drugs because of lung cancer (13 pts), haematologic disorders (1 pts), Wegener's granulomatosis (3 pts) and idiopathic pulmonary fibrosis (1 pts). In 13 out of 18 pts granulocytopenia was revealed (on an average from 0,008 x 10(9)/L to 0,95 x 10(9)/L) one month before death. In 13 pts IA was limited to the lungs, in 5 others there were also fungal lesions in brain, kidneys, liver, spleen, pleura, pericardium and heart. Pts with disseminated form of IA had significantly lower granulocyte count and were treated with higher doses of corticosteroids than others. Immunosupressive drugs and granulocytopenia can be regarded as predisposing factors. IA was diagnosed before death only in 5 out of 18 pts. This was mainly caused by the lack of the symptoms of infection (4 pts) and negative results of mycological (6 pts) and serological examination (8 pts). We should underline that mycological examination was only done in 11 pts and serological examination of blood for fungal antigen only in 6 pts. We conclude that mycological infection ought to be searched in all pts treated with high doses of corticosteroids and those with prolonged granulocytopenia, especially if they have the symptoms of infection which does not respond to antibiotic therapy.