The State of Microbiological Cleanliness of Surfaces and Equipment of an Endoscopic Examination Laboratory-Data from a Reference Tertiary Clinical Endoscopy Center in Southern Poland.

The increasing number of endoscopic procedures performed and their increasing invasiveness mean that endoscopy of the gastrointestinal tract is associated with the risk of transmitting pathogenic microorganisms through infected equipment or contact with other patients and medical staff. In order to ensure protection of the health of both patients and medical staff, endoscopy laboratories should meet high hygiene standards. The results of tests of the microbiological cleanliness of surfaces and equipment of an endoscopic examination laboratory performed in the period from January to December 2019 at the Provincial Clinical Hospital No. 2 in Rzeszow were assessed retrospectively. Samples for testing were collected by swabbing from places where microbiological contamination was the most likely and cleaning was the most difficult. In the analyzed period, a total of 86 samples were collected for microbiological tests, of which positive results accounted for 6.9%. Positive results were obtained mainly from swabs collected from wet surfaces (66.7%). Most of the isolated microorganisms were Gram-negative bacteria (66.7% of all positive tests) and they were: Acinetobacter junii, Ralstonia pickettii, and Achromobacter denitrificans. The condition of the microbiological cleanliness of the surfaces and equipment of the endoscopic examination laboratory was satisfactory. A very low level of microbiological contamination of the tested items indicates occasional shortcomings in the decontamination processes. Since microorganisms isolated from the collected samples may be the cause of infection in patients and medical personnel, it is necessary to verify the decontamination procedures applied and to continue periodic microbiological monitoring of their effectiveness.

Microbiological assessment of cleanliness of surfaces and equipment in a children's operating theatre on the example of a selected hospital.

INTRODUCTION: The operating theatre is one of the most important places in a hospital. Due to the presence of numerous reservoirs of microorganisms and the invasiveness of surgical procedures it is necessary to ensure high hygiene standards in these locations. OBJECTIVE: The aim of the study was to carry out a qualitative assessment of the microbiological cleanliness of the surfaces and equipment in an operating theatre. MATERIAL AND METHODS: The results of microbiological tests of the surfaces and equipment of the Children's Operating Theatre in Clinical Provincial Hospital No. 2 in Rzeszów, southeast Poland, during 2007-2012 were reviewed retrospectively. RESULTS AND CONCLUSIONS: For the analysis, a total of 1,819 swabs were collected, of which 1.05% were positive. Positive results were obtained mainly from samples taken from moist places (57.9%). Among the microorganisms isolated, Gram-negative bacteria constituted the majority (57.9%), Pseudomonas bacteria were found most frequently (31,6%). Isolated microbes can be the etiological agent of nosocomial infections.

Serum interleukin­17 levels predict inflammatory activity in patients with autoimmune hepatitis.

INTRODUCTION    The etiology of autoimmune hepatitis (AIH) is unclear, with molecular mimicry between host and viral/drug antigens being the most plausible mechanism initiating the immune cascade that induces hepatocyte injury. Finding a serologic parameter that closely relates to the liver histology would be beneficial for monitoring AIH activity and optimizing treatment. OBJECTIVES    We studied serum interleukin (IL)-17 levels and IL­17 activators (IL­6 and transforming growth factor ß1 [TGF-ß1]) in treatment-naive and immunosuppressed patients with AIH. We also analyzed the relationships between these cytokines and histological inflammation scores. PATIENTS AND METHODS    A total of 44 patients with confirmed AIH were enrolled to the study (22 treatment-naive patients and 22 patients in clinical remission after at least 3 years of immunosuppression). Liver biopsies were performed, and the histological grading of inflammatory activity was performed by a single pathologist. The control group comprised 30 healthy age- and sex­matched subjects. Serum IL­17, IL­6, and TGF­ß1 levels were measured by a quantitative sandwich enzyme immunoassay. RESULTS    Serum IL­17, IL­6, and TGF­ß1 levels were higher in treatment-naive patients compared with controls (23.2 pg/ml vs 15.3 pg/ml, P = 0.0001; 5.20 pg/ml vs 1.42 pg/ml, P = 0.0001; and 40.5 ng/ml vs 30.1 ng/ml, P = 0.04; respectively). In treatment-naive patients, serum IL­17 negatively correlated with hepatic inflammation (r = -0.63, P = 0.01). A reduced serum IL­17 concentration correlated with an increased TGF­ß1 concentration in patients in clinical remission (r = -0.51, P = 0.03). CONCLUSIONS    Serum IL­17 levels may be a useful parameter for assessing disease activity in patients with AIH.

[Interferon therapy in chronic viral hepatitis; an autoimmunity dilemma]. / Interferon w leczeniu przewleklych wirusowych zapalen watroby; problematyka autoimmunizacji.

The era of interferon (IFN) administration in the treatment of patients with chronic viral hepatitis creates an essential turning point for therapy of these diseases. Incessant progress of the new, more efficient and lower side effects of interferon causes decrease in treatment withdrawal. The side effects like myalgia, nausea, fatigue and loss of appetite, usually with good reaction for symptomatic treatment and intensity of the symptoms decreases during treatment continuation. Due to strong immuno-modulatory activities and long-lasting therapy, autoimmune diseases are observed in some cases. Therefore treatment process should be carefully and trifle monitored especially in autoantibodies appearance aspect. To the most common interferon mediated autoimmune diseases belong thyroiditis, autoimmune hepatitis and thrombocytopenia. Interstitial pneumonitis, systemic lupus erythematosus, type I diabetes mellitus, asthma and sarcoidosis exacerbation as well as glomerular diseases are observed rarely. In our paper we discus an issue of autoimmune diseases induction phenomena caused by interferon therapy administrated in the treatment of chronic viral hepatitis.

[Nonalcoholic steatohepatitis--current treatment options]. / Niealkoholowe stluszczeniowe zapalenie watroby--aktualne mozliwosci leczenia.

Nonalcoholic steatohepatitis (NASH) is the term used to describe the distinct clinical entity in which the liver biopsy findings are similar to that observed in alcoholic hepatitis, but patients lack a history of significant alcohol consumption. The most widely supported theory implicates insulin resistance as the key mechanism leading first to hepatic steatosis, and next to steatohepatitis. In spite of lacking proof by EBM (evidence based medicine) and effective therapy for NASH, modification of risk factors, such as obesity, hyperlipidemia, and good diabetic control is generally recommended. Although there is no consensus of treatment form, the new drugs which can be useful in NASH treatment are continously tested. The aim of our study is to present current knowledge about nonalcoholic steatohepatitis, focusing on present and being in various phases of clinical trials treatment options.

[Viral hepatitis during pregnancy]. / Wirusowe zapalenia watroby u ciezarnych.

Viral hepatitis is one of the most common liver diseases appearing during pregnancy. Prevention against hepatotropic viruses is restricted due to lack of vaccines being effective in induction of efficient immunization in the majority of these microorganisms. In general, there is no possibility of active immunization against hepatotropic viruses except type A and B viral hepatitis. An issue of viral hepatitis in pregnancy as an aspect of potential risk factor connected with infection of pregnant women and a fetus has been described in this paper. Furthermore, the most important topics in the field of the epidemiology, prophylaxis and possible treatment options of viral hepatitis A, B, C, D, E and G have been discussed. The newest reports of pregnant women lamivudine therapy as a preventive treatment against vertical transmission during delivery have been reviewed. Rarly diagnosed viral hepatitis caused by herpes simplex virus, cytomegalovirus, Epstein-Barr virus and adenoviruses have been characterized as well.

[Systemic lupus erythematosus (SLE)]. / Toczen rumieniowaty ukladowy u ciezarnych.

Systemic lupus erythematosus (SLE) is a connective tissue disease ranked as an autoimmune background illness. Due to the fact, that 90% of lupus suffering patients are women in childbearing age, SLE is relatively common in pregnancy. SLE exerts negative influence on pregnancy course and perinatal period, significantly increasing a risk of spontaneous abortions, intrauterine fetal growth restrictions, fetal mortality in second trimester and premature labour. The increase of perinatal mortality is usually a consequence of diffuse nephritis, hypertension or presence of antiphospholipid antibodies. Women with SLE belong to high-risk pregnancy group, need special care and delivery should take place in hospital conditions exclusively. In our paper we present an epidemiological aspect and complicated issue of diagnostic and therapeutic approaches of pregnant women suffering from SLE with special focus on current care standards and treatment recommendations.