High Prevalence of Borrelia burgdorferi Antibodies in Jaworzno, Poland: A Retrospective Study Revealing Endemic Lyme Borreliosis.

BACKGROUND This retrospective study of 704 adult residents of Jaworzno, Poland, aimed to evaluate medical personnel awareness of episodes of Lyme borreliosis and serum antibody levels for Borrelia burgdorferi sensu lato. MATERIAL AND METHODS This study included 704 residents of Jaworzno, Poland, who had no more than 12 months between tick bite and screening. The study consisted of a self-designed questionnaire survey and an analysis of IgG and IgM antibodies against B. burgdorferi sensu lato using an enzyme-linked assay (ELISA) and Western blot analysis, when necessary, to confirm the results. RESULTS A total of 558 residents (79.3%) confirmed having contact with a tick, 84 (11.9%) responded that they did not remember having contact with a tick, and 62 (8.8%) denied having contact with a tick. Regarding IgG, the ELISA showed 183 (25.99%) positive, 440 (62.5%) negative, and 81 (11.5%) equivocal results. Regarding IgM, the ELISA showed 180 (25.57%) positive, 435 (61.79%) negative, and 89 (12.64%) equivocal results. Positive and equivocal results for the IgG and IgM classes using the ELISA test were confirmed in 36 cases (13.64%) for IgG and in 53 cases (19.70%) for IgM using Western blot analysis. CONCLUSIONS The ELISA method obtained similar values for positive, negative, and equivocal results in the serological test. This was reflected in the survey conducted on residents who reported a tick bite and later received a positive result in the ELISA test as well as an approximate time between the bite and removal of the tick.

Predictive value of the APACHE II, SAPS II, SOFA and GCS scoring systems in patients with severe purulent bacterial meningitis.

BACKGROUND: Scoring systems in critical care patients are essential for predicting of the patient outcome and evaluating the therapy. In this study, we determined the value of the Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Scale (GCS) scoring systems in the prediction of mortality in adult patients admitted to the intensive care unit (ICU) with severe purulent bacterial meningitis. METHODS: We retrospectively analysed data from 98 adult patients with severe purulent bacterial meningitis who were admitted to the single ICU between March 2006 and September 2015. RESULTS: Univariate logistic regression identified the following risk factors of death in patients with severe purulent bacterial meningitis: APACHE II, SAPS II, SOFA, and GCS scores, and the lengths of ICU stay and hospital stay. The independent risk factors of patient death in multivariate analysis were the SAPS II score, the length of ICU stay and the length of hospital stay. In the prediction of mortality according to the area under the curve, the SAPS II score had the highest accuracy followed by the APACHE II, GCS and SOFA scores. CONCLUSIONS: For the prediction of mortality in a patient with severe purulent bacterial meningitis, SAPS II had the highest accuracy.

Reasons for hospitalisation of HIV-infected patients in ICUs - a single-centre observational study.

BACKGROUND: There are no Polish data regarding the reasons for and incidence of ICU hospitalisations of HIV-infected patients. The aim of the study was to determine the reasons for and incidence of hospitalisations of HIV-infected patients in the Department of Anaesthesiology and Intensive Therapy of the Dr W. Bieganski Regional Specialist Hospital in Lódz in the years 2010-2014. METHODS: Preliminary research enabled to identify all the patients with laboratory-confirmed HIV, including those hospitalised in the ICU. Patients` medical records were analysed. Analysis involved epidemiological data, underlying diagnosis, coexisting diseases and conditions, as well as biochemical, hematologic, virusologic, bacteriologic, mycologic and immunologic tests. RESULTS: In the years 2010-2014, new HIV infections were diagnosed in 224 individuals; 8 of them required ICU hospitalization (10 hospitalisations) - 5 men (62.5%) and 3 women (37.5%). The age of patients ranged from 24 to 46 years. All the patients were diagnosed with AIDS. Three of them died. The patients with HIV constituted 1.30% of all patients hospitalised in the ICU over the period of 5 years. CONCLUSIONS: Low number of HIV-infected patients hospitalised in the ICU in the years 2010-2014 was associated with low HIV incidence rates in the Lódz province and generally available modern antiretroviral therapy rather than restrictive admission policy. Reasons for admission as well as coexisting diseases and conditions, including opportunistic infections, of patients hospitalised in the ICU in 2010-2014 are similar to those in West European countries and the United Stated.