Anti-Mold Protection of Textile Surfaces with Cold Plasma Produced Biocidal Nanocoatings.

The permanent anti-mold protection of textile surfaces, particularly those utilized in the manufacture of outdoor sporting goods, is still an issue that requires cutting-edge solutions. This study attempts to obtain antifungal nanocoatings on four selected fabrics used in the production of high-mountain clothing and sleeping bags, and on PET foil as a model substrate, employing the cold plasma technique for this purpose. Three plasma treatment procedures were used to obtain such nanocoatings: plasma-activated graft copolymerization of a biocidal precursor, deposition of a thin-film matrix by plasma-activated graft copolymerization and anchoring biocidal molecules therein, and plasma polymerization of a biocidal precursor. The precursors used represented three important groups of antifungal agents: phenols, amines, and anchored compounds. SEM microscopy and FTIR-ATR spectrometry were used to characterize the produced nanocoatings. For testing antifungal properties, four species of common mold fungi were selected: A. niger, A. fumigatus, A. tenuissima, and P. chrysogenum. It was found that the relatively best nanocoating, both in terms of plasma process performance, durability, and anti-mold activity, is plasma polymerized 2-allylphenol. The obtained results confirm our belief that cold plasma technology is a great tool for modifying the surface of textiles to provide them with antifungal properties.

The role of bronchoscopy in diagnosis of chronic cough in adults: a retrospective single-center study.

INTRODUCTION: Cough is one of the most frequent symptoms reported to pulmonologists. The role of bronchoscopy in the diagnostic work-up of chronic cough is not clearly defined. The aim of this study was to evaluate the utility of fiberoptic bronchoscopy (FOB) and additional testing of samples collected during FOB in the differential diagnosis of chronic cough in adults. MATERIAL AND METHODS: This was a single-center retrospective study. Out of 7115 conventional white light FOB examinations, we finally selected 198 with cough as the only indication. RESULTS: In 40.9% of bronchoscopic examinations, no visible cause of cough was found. Visual signs of chronic bronchitis (CB) were detected in 57.6% of reports. Only in 3 cases (1.5%) bronchoscopy revealed a potential cause of chronic cough other than CB. Mycobacterium tuberculosis or other mycobacteria were spotted in none of the samples. In 91.1% of bronchoalveolar lavage (BAL) cytologic examinations, at least one cell count abnormality was detected, but only in case of increased percentage of eosinophils, it might be considered clinically relevant. In 53% of bacteriological culture results, at least one potentially pathogenic bacterium was isolated. CONCLUSIONS: The present study results strengthen the evidence that FOB combined with additional testing of airway specimens obtained during FOB is not a powerful tool in the differential diagnosis of chronic cough, and FOB as a diagnostic tool may be overused. The appropriate timing and decision regarding referral for FOB and additional testing of achieved material requires careful clinical consideration.

Genotypic and Phenotypic Changes in Candida albicans as a Result of Cold Plasma Treatment.

We treated Candida albicans cells with a sublethal dose of nonequilibrium (cold) atmospheric-pressure He plasma and studied alterations in the genome of this fungus as well as changes in the phenotypic traits, such as assimilation of carbon from carbohydrates, hydrolytic enzyme activity, and drug susceptibility. There is a general problem if we use cold plasma to kill microorganism cells and some of them survive the process-whether the genotypic and phenotypic features of the cells are significantly altered in this case, and, if so, whether these changes are environmentally hazardous. Our molecular genetic studies have identified six single nucleotide variants, six insertions, and five deletions, which are most likely significant changes after plasma treatment. It was also found that out of 19 tested hydrolytic enzymes, 10 revealed activity, of which nine temporarily decreased their activity and one (naphthol-AS-BI- phosphohydrolase) permanently increased activity as a result of the plasma treatment. In turn, carbon assimilation and drug susceptibility were not affected by plasma. Based on the performed studies, it can be concluded that the observed changes in C. albicans cells that survived the plasma action are not of significant importance to the environment, especially for the drug resistance and pathogenicity of this fungus.

Etiology and bacterial susceptibility to antibiotics in patients with recurrent lower urinary tract infections.

INTRODUCTION: Recurrent urinary tract infections (UTIs) are a frequent health problem and a common reason for treatment resistance. OBJECTIVES: The purpose of the study was to evaluate the etiology of community­ acquired lower recurrent UTI and bacterial antibiotic susceptibility. PATIENTS AND METHODS: A total of 796 microbiological urine cultures from 332 patients (280 women and 52 men) treated in a single nephrology outpatient department in central Poland in years 2016 to 2018 were analyzed. The most frequent species responsible for recurrent lower UTI were identified and the susceptibility of all the microbes to specific antibiotics was assessed. The patients' kidney function and inflammation parameters were evaluated. RESULTS: The median (interquartile range [IQR]) age of the patients was 65 (59-77) years (women, 69 [57-78] years; men, 67 [62-77] years), median (IQR) glomerular filtration rate was 56.6 (40.2-81.3) ml/min/1.73 m2 with median (IQR) C­ reactive protein concentration of 3.2 (1.5-7.0) mg/l. There were 43 bacterial species identified: 24 gram­positive and 19 gram-negative. The analyzed urine cultures contained 977 microbial samples (563 gram­negative bacteria, 408 gram-positive, 6 fungi). The most common bacteria was Escherichia coli (39.6%) which showed 100% susceptibility to carbapenems, 98.9% to amikacin, 96.5% to piperacillin / tazobactam, and 94.3% to gentamicin. With regard to oral antibiotics, its highest susceptibility was to fosfomycin 95.5%, nitrofurantoin 85.5%, and cefuroxime 82.3%. In 39.9% of cases, E. coli was resistant to fluoroquinolones and in 46.6% to trimethoprim / sulfamethoxazole. CONCLUSIONS: The most frequently occurring bacteria causing recurrent lower UTI are characterized by significant resistance to the antimicrobial therapy recommended as the first­ line treatment: fluoroquinolones and trimethoprim / sulfamethoxazole. It seems that the first choice in the treatment of lower UTIs should be: fosfomycin, nitrofurantoin, or cefuroxime.

"Primary bacterial culture of bile and pancreatic juice in tumor related jaundice (TROJ) - is ascending cholangitis always our fault?"

INTRODUCTION: TROJ (tumor-related obstructive jaundice) is one of the most common indications for endoscopic retrograde choleopancreatography (ERCP) with endoscopic biliary stenting. Despite the effectiveness of this procedure, especially in palliative patients, it is not without flaws. Ascending bacterial cholangitis, a common stenting complication, occurs in about 0.5-1.7% of cases. The authors' intention was to investigate whether this complication occurs solely due to the procedure or whether it is a result of an underlying bacterial infection in the dilated, obstructed bile and pancreatic ducts. METHODS: Sixteen patients with painless obstructive jaundice related to a tumor located in or in the proximity of the bile duct were enrolled for this study. Prior to endoscopic palliative stenting we harvested bile and pancreatic fluid and the proceeded with the initial procedure. RESULTS: In 14 cases (87.5%) we managed to restore the patency of the bile duct endoscopically. Additionaly, we observed that in 13 cases (81.25%) bacteria were present in the bile and/or pancreatic fluid. The most common pathogen was Streptococcus mitis - present in 7 cases (43.75%). The most effective antibiotics for discovered S. mitis strains were cefuroxime and vancomycin. CONCLUSION: Primal bacterial pathogenes may be present in obstructed bile and pancreatic ducts prior to endoscopic intervention. The connection between Streptocccus mitis and TROJ needs further investigation.

[Inactivation of Candida species using cold atmospheric plasma on the way to a new method of eradication of superficial fungal infections]. / Inaktywacja grzybów z rodzaju Candida przy uzyciu zimnej plazmy atmosferycznej--na drodze ku nowej metodzie eradykacji grzybic powierzchniowych.

INTRODUCTION: In recent years, nosocomial fungal infections are becoming an increasingly serious problem. More and more complications are observed in patients with high-risk groups resulting from the colonization of the skin and mucous membranes by Candida species. Thus, rapid and effective treatment of superficial fungal infections caused by Candida is a very important task for modern medicine. Unfortunately, with a clear increase in the number of fungal infections, the resistance to currently used antifungal drugs also increases seriously limited the effectiveness of treatment. An intensive search for new therapeutic solutions is therefore necessary. One of the promising solutions is the use of cold atmospheric plasma. The aim of this paper is to investigate the influence of this type of plasma on survival of Candida albicans. METHODS: As a source of cold atmospheric plasma, a linear microdischarge jet, called plasma razor, was used. Plasma was generated at 13.56 MHz, using He as a reactive gas. The gas flow rate and the discharge power were 1.9 L/min and 17 W, respectively. A schematic view of the experimental system is shown in Fig. 1. The reference strain of Candida albicans ATCC 10231 was used as a model material for investigations. The culture was prepared by spreading uniformly 100 µL phosphate buffered saline solution containing 5 x10(7) cells/mL on the surface of a Petri dish. Such a culture was exposed to the plasma at various times. The size of the zone of inhibition of fungal growth was estimated by densitometric method (Fig. 3). For more complete information about the plasma the optical emission spectra were measured. RESULTS: It was found that with increasing time of plasma treatment, the zone of inhibition clearly increases (Fig. 2). In Fig. 4, the experimental results of the size of the inhibition zone versus the treatment time are shown. These results were successfully fitted (p = 0.0058, r2 = 0.944) by a theoretical curve (Fig. 4), plotted according to Eq. (5), which was derived on the basis of a simple model of the spread of a killing agent from the plasma center. The study of the optical emission spectra confirmed a large variety of possible killing agents generated in the cold atmospheric plasma, such as UV, radicals, ions and energetic electrons. Further research will be focused on the determination of the main agent responsible for the process of the cell killing, and to determine the mechanism of this process. CONCLUSIONS: Cold atmospheric plasma generated by the plasma razor turns out to be a very effective tool for the killing of pathogenic fungi. Although the presented studies are only the initial stage of work on the effects of cold atmospheric microplasma on fungal cells, they provide hope for the possibility of using this technique as a method of eradication of superficial fungal infections.

[Fungal infections in patients of an intensive care unit analyzed on the example of the Lodz Medical University Hospital No 1 in the period of 2002-2012]. / Analiza zakazen grzybiczych u chorych leczonych na Oddziale Intensywnej Terapii Uniwersyteckiego Szpitala Klinicznego nr 1 w Lodzi w latach 2002-2012.

INTRODUCTION: The objective of this study was to analyze the fungal infections in patients of an intensive care unit (ICU) in a long period (2002-2012) on the example of the Lodz Medical University Hospital No 1. This analysis was focused on the study of the effect of antimicrobial therapy on the level of these infections. METHODS: A total of 291 strains of fungi were isolated from blood, tips of central intravenous catheters, lower respiratory tract, urine, wounds, pressure sores, and cerebrospinal fluid of 3177 patients. An automatic system Bactec 9050, Yeast ID Phoenix BD panels and E-tests (BioMerieux) were used for the fungi analysis. RESULTS: The studies were mainly concentrated on the Candida infections, distinguishing cases caused by C. albicans and C. non-albicans pathogens. Changes in the number of these infections in consecutive years have been associated with epidemiological and therapeutic activities in the ICU. Particularly, relationships between the number of infections and the use ofceftazidime were discussed. A statistically significant positive correlation of the count of Candida infections and the ceftazidime consumption was found in the period to 2006. In the later years, the correlation was destroyed as a result of other important therapeutic factors (eg, immunosuppressive drugs). CONCLUSIONS: It has been found that the number of Candida infections in the ICU depends on the consumption of antimicrobial drugs. This conclusion is based on quantitative example of ceftazidime. Only close cooperation between the ICU and microbiologists is able to provide a reduction in nosocomial fungal infections.

[Candida and Aspergillus infections in the light of a new list of alarm factors on the example of the Lodz Medical University Hospital No. 1]. / Zakazenia Candida oraz Aspergillus w swietle nowej listy czynników alarmowych na przykladzie uniwersyteckiego szpitala klinicznego nr 1 w Lodzi.

INTRODUCTION: In 2011, the Polish Ministry of Health introduced Candida sp. resistant to fluconazole and Aspergillus sp. to the list of Alarm Factors as alert pathogens. The purpose of this paper is to confirm the validity of continuous monitoring of fungal infections caused by the pathogens mentioned above. The role offluconazole therapy in the Candida sp. infections is also discussed. The analysis of the fungal infections is performed based on the results obtained in the University Clinic Hospital (UCH) No. 1 in Lodz in 2009-2011. METHODS: The swabs were plated on Sabouraud's agar. Body fluids and blood were incubated in an automated system Bactec 9050. Yeast ID Phoenix BD panels were used to determine the species of fungi. In turn, antimicrobial susceptibility testing was carried out by E-tests (bioMerieux). RESULTS: In the analysis of fungal infections occurring among patients in the UCH No. 1 in Lodz in 2009-2011, C. albicans, C. non-albicans and Aspergillus sp. infections are taken into account. This analysis is performed based on relations of the number of infections (per 100 patients) versus six-month periods. As one can see in Fig. 1, a clear, linear and statistically significant increase in the number of C. albicans and C. non-albicans infections is observed throughout the entire time period under discussion. On the other hand, the number of Aspergillus sp. infections remains at an almost constant low level. The more detailed analysis of fungal infections in the different hospital units, which are particularly exposed to this type of infections (Figs. 2-6), shows that there is a clear correlation between the number of C. non-albicans infections and the frequency of therapy with fluconazole. CONCLUSIONS: The results presented in this paper show in the example of the UCH No. 1 in Lodz that the number of infections caused by C. albicans and C. non-albicans resistant to fluconazole is clearly increasing in a hospital environment in recent years, which is a great clinical problem. Although the number of Aspergillus sp. infections is relatively much lower in comparison to that of Candidia sp., these infections also constitute a problem of clinical importance. In light of the presented analysis, it should be assessed positively the fact that Candida sp. resistant to fluconazole and Aspergillus sp. are considered to be alert pathogens that require the continuous monitoring.

[Influence of antibiotic-therapy on the selection of multi-drug resistant pathogens]. / Wplyw terapii antybiotykowej na selekcje wielolekoopornych szczepów bakteryjnych.

In this paper, relations between the number of nosocomial infections caused by multi-drug resistant pathogens and antibiotic-therapy were investigated. It was found that the number of MRSA infections is directly proportional to the amount of CAZ (ceftazidime) used in the therapy. It was also stated that CAZ, Amc (amoxicillin-clavulan acid) and IPM (imipenem) are strong inductors of ESBL. A good correlation between the number of infections caused by ESBL(+) strains and the total consumption of these antibiotics was found. A growing number of infections generated by Ps. aeruginosa and Acinetobacter spp. strains resistant to carbapenems as a result of IPM therapy is also an anxiety-provoking fact. In this case, the changes in the number of isolated IPM-R streins occur only after approx. half an year from the changes in the IPM consumption.

[Nosocomial infection control in intensive therapy]. / Zakazenia szpitalne w Oddziale Intensywnej Terapii Uniwersteckiego Szpitala Klinicznego.

BACKGROUND: Nosocomial infections are common among patients treated in ITU settings. The lower airway and genitourinary systems are frequently infected with multiresistant pathogens, and present a serious epidemiological problem. In 2002, at the Lódz Medical University Hospital, strict infection control measures were developed and introduced to minimize the risk of infections in the ITU. METHODS: Between 2002-2006, the prophylactic use of imipenem, amoxicillin and fluconazole was forbidden and the use of vancomycin and aminoglycosides was limited. Strict microbiological analysis became mandatory in all ITU patients. To achieve this, isolates from the lower airway and genitourinary track from 1330 ITU patients were analyzed using the disc-diffusion method and the E-test method (for MIC values). The VITEK (BioMerieux) automatic analyzing system was used. RESULTS: The number of nosocomial infections of the lower airway was reduced from 48.8/100 patients in 2002 to 19.0/100 patients in the period 2005-2006. Infections of the genitourinary, system decreased from 27.0/100 patients in 2002 to 4.7/100 patients in 2006. MRSA, Pseudomonas aeruginosa, Enterobacteriacae, and Acinetobacter species were the most commonly isolated pathogens. CONCLUSIONS: Although it is impossible to eliminate nosocomial infections, particularly in the ITU setting, close co-operation between clinicians and microbiologists, and monitoring of nosocomial infection patients can markedly reduce the frequency.

[Sepsis--a new life-threat or better defined old disease entity]. / Sepsa--nowe zagrozenie czy lepiej definiowana stara jednostka chorobowa.

The presence of multiresistant pathogens in a hospital leads very often to a severe sepsis that threatens the patients' life. For this reason, in the interests of the patients in the Intensive Care Unite (ICU) of the Lodz Medical University Hospital No.1, a wide monitoring of the epidemiological situation and the rational antibiotic therapy, taking the resistance mechanisms of pathogens into account, have been started since 2002. Restrictive procedures of the insertion of central venous and dialysis catheters were elaborated as well as the permanent monitoring of the MRSA carrier state among the medical staff was undertaken. A procedure of the primary bacteriological examination for all new patients in the ICU was also introduced. All these actions resulted in a considerable, statistically significant (p=0.043), decrease in bloodstream infections from 14.2 infections per 100 patients in 2002 to 2.0 infections per 100 patients in 2006. A drop in the number of infections of central venous catheters was also observed: from 4.3 infections per 100 patients in 2002 to 1.9 infections per 100 patients in 2006 (p=0.025). Administration of ceftazidime and clavulanic acid, which are MRSA inductors, only in the events of guided therapy when other therapeutic options were failed as well as the reduction of the MRSA carrier state among the medical staff brought about a radical elimination of MRSA from the bloodstream infections. The obtained results show that the severe infections caused by multiresistant pathogens in hospitals can be effectively reduced due to cooperation between clinicians and microbiology laboratories.

[Analysis of the epidemiological situation and the resistance phenotype of pathogens isolated from patients in the intensive care unite of the Lodz Medical University Hospital No.1 in 2002-2006]. / Analiza sytuacji epidemiologicznej oraz fenotypu opornosci patogenów wyizolowanych od pacjentów oddzialu intensywnej terapii USK nr 1 w Lodzi w latach 2002-2006.

In the period of 2002-2006, total 5152 isolates were obtained from 1330 patients in the Intensive Care Unite (ICU) of the Lodz Medical University Hospital No.1. A detailed analysis of the epidemiological situation concerned, first of all, MRSA, Ps. aeruginosa, Acinetobacter and Enterobacteriacae. As a result of extended action aimed at reducing the infections caused by these pathogens, a permanent improvement of the epidemiological situation in the ICU was observed in 2005-2006. However, in spite of a decrease in the total number of the infections, the concentration of ESBL(+) and carbapene-resistant strains increased. These results are indicative of the need for cooperation between clinicians and microbiology laboratory towards a strictly controlled antibiotic policy in the hospital.

[The fungal infections in patients hospitalized in an intensive care unit]. / Zarazenia grzybicze u pacjentów hospitalizowanych na oddziale intensywnej terapii.

INTRODUCTION: Over the last years, systemic fungal infections have dramatically increased in hospitalized patients. The Candida is the main pathogen caused nosocomial fungal infections. THE AIM OF THE STUDY: The aim was to analyze frequency of occurrence of the yeast-like fungi in different biological materials isolated from the patients of an Intensive Care Unit of the University Hospital of Lodz in the period of 2000-2003. MATERIAL AND METHODS: 123 strains of fungi were analyzed with the use of API 20 C AUX test (bioMarieux). RESULTS: Among all the investigated Candida strains C. albicans accounted for 52.0%. Samples from respiratory system and urine most often contained the strains of C. albicans (56.3 and 60.5%, respectively); blood samples contained C. parapsilosis (44.8%). In patients who were untreated by bacterial antibiotics C. albicans was the most frequent species, whereas in patients who were ordered bacterial antibiotics it was C. parapsilosis that dominated. CONCLUSIONS: (1) Candida is the most frequent cause of fungal infections in patients hospitalized in an intensive care unit. (2) C. parapsilosis is the main pathogen caused bloodstream infections. This species is also more frequent in patients who were ordered antibacterial antibiotics over five days. (3). Species other than C. albicans become more and more frequent and dangerous.

[Selected risk factors of fungal infections in human populations]. / Wybrane czynniki sprzyjajace zarazeniom grzybami w populacji czlowieka.

For the past twenty years, invasive fungal infections have dramatically increased resulting in the high morbidity and mortality. The main reason of these infections is the development of invasive diagnostic and therapeutic technologies. Immunosuppression, neutropenia, broad-spectrum antibacterial agents, corticosteroids, chemotherapy, central intravascular catheter, total parenteral nutrition are the major risk factors of the invasive fungal infections. Most of these factors are very common for hospitalized patients. For example, patients with fungemia are more likely to die during hospitalization then those with bloodstream infection caused by nonfungal pathogens. Unfortunately, diagnosis and diagnostic methods of fungal infection are still difficult.