Evidence for Infections by the Same Strain of Beta 2-toxigenic Clostridium perfringens Type A Acquired in One Hospital Ward.

This study conducts a comparative phenotypic and genetic analysis of C. perfringens strains isolated from two patients hospitalized at the same time in 2017 in the surgical ward of the Provincial Specialist Hospital in Wloclawek (Kujawsko-Pomorskie Province) who developed necrotizing soft tissue infections (NSTI). To explain the recurring cases of this infection, a comparative analysis was performed for these strains and the ones originating from infections recorded at the same hospital in three patients with gas gangrene in 2015. The two C. perfringens isolates studied in 2017 (8554/M/17 from patient No. 1 and 8567/M/17 from patient No. 2) had identical biochemical profiles. A comparison of research results using multiplex PCR from 2017 with a genetic analysis of strains from 2015 enabled us to demonstrate that the strains currently studied have the genes encoding the same toxins (α and ß2) as the two strains analyzed in 2015: no. 7143 (patient No. 3) and no. 7149 (patient No. 2). A comparative analysis of the strain profiles obtained with pulsed-field gel electrophoresis (PFGE) in 2017 with the results from 2015 has found one identical and genetically unique restriction profile, corresponding to one clone of C. perfringens comprising of two strains: no. 8567/M/17 (patient No. 2 in 2017) and no. 7143 (patient No. 3 in 2015). The epidemiological data and detailed analysis of the course of both events suggest that this clone of C. perfringens possibly survived in adverse conditions of the external environment in the operating block of this hospital for many months.This study conducts a comparative phenotypic and genetic analysis of C. perfringens strains isolated from two patients hospitalized at the same time in 2017 in the surgical ward of the Provincial Specialist Hospital in Wloclawek (Kujawsko-Pomorskie Province) who developed necrotizing soft tissue infections (NSTI). To explain the recurring cases of this infection, a comparative analysis was performed for these strains and the ones originating from infections recorded at the same hospital in three patients with gas gangrene in 2015. The two C. perfringens isolates studied in 2017 (8554/M/17 from patient No. 1 and 8567/M/17 from patient No. 2) had identical biochemical profiles. A comparison of research results using multiplex PCR from 2017 with a genetic analysis of strains from 2015 enabled us to demonstrate that the strains currently studied have the genes encoding the same toxins (α and ß2) as the two strains analyzed in 2015: no. 7143 (patient No. 3) and no. 7149 (patient No. 2). A comparative analysis of the strain profiles obtained with pulsed-field gel electrophoresis (PFGE) in 2017 with the results from 2015 has found one identical and genetically unique restriction profile, corresponding to one clone of C. perfringens comprising of two strains: no. 8567/M/17 (patient No. 2 in 2017) and no. 7143 (patient No. 3 in 2015). The epidemiological data and detailed analysis of the course of both events suggest that this clone of C. perfringens possibly survived in adverse conditions of the external environment in the operating block of this hospital for many months.

[Analysed yeast-like fungi isolated from blood of febrile neutropenic children with neoplastic disease]. / Grzyby drozdzopodobne izolowane z krwi goraczkujacych dzieci z choroba nowotworowa w okresie neutropenii.

The aim of the study was the analysis of frequency of yeast-like fungi as etiological agents of fungemias in 181 children suffering from cancer treated in the years 1997-2000 in the Pediatric, Hematology and Oncology Clinique of the State Clinical Hospital in Bydgoszcz. Peripheral blood samples an collected from vascular catheters were incubated in VITAL 200 (bio Mérieux). Positive blood samples were inoculated on Sabouraud medium with chloramphenicol (bio Mérieux), of cultivation from 24 hours at 37 degrees C, following two hours at 22 degrees C. Fungal strains were identified by standard mycological procedures using ID 32 strips (bioMérieux). The total number of positive blood cultures was 1032 (22,1%). There have been recognized 22 fungemia by the children with fever in neutropenia period. Among fungi isolated from peripheral blood samples Candida spp. (13.4%), C. tropicalis (8.2%), stranis dominated. From blood samples collected from vascular catheters most often Candida spp. (29.9%), Candida parapsilosis (14.4%) and C. tropicalis (9.3%) were isolated.

[Analysis of microorganisms isolated from febrile neutropenic children with neoplastic disease]. / Drobnoustroje izolowane z krwi goraczkujacych dzieci z choroba nowotworowa w okresie neutropenii.

The microbiological evaluation of the blood was carried out as a continued monitoring of the microorganism culture using the colourmetric system VITAL 200 (bio-Mérieux). There have been analysed 4660 bacteriological research results of the peripheral blood, blood from Broviac and from Broviac liquid of the children suffering from cancer treated in the years 1997-2000 in the Pediatric, Hematology and Oncology Clinique of the State Clinical Hospital in Bydgoszcz. There have been gained 1032 positive cultures from KZZ, KZB, PZB. There have been recognized 259 bacteremia and 22 fungemia by the children with fever in the neutropenia period. In the analysed four years in the blood dominated Gram-positive bacteria. Among Gram-positive bacteria there were mostly Staphylococcus spp. (42.5%), mostly CNS, fewer numerous were Streptococcus spp. (14.5%) and Corynebacterium spp. (5.9%). Among Gram-negative bacteria mostly were isolated Acinetobacter spp. (25.6%), Pseudomonas spp. (9.7%), E. coli (13.8%), Enterobacter spp. (13.9%), Klebsiella spp. (9.2%). There were observed few infections by strains resistant to many antibiotics, S. maltophilia, B. cepacia, E. faecium, S. haemolyticus. All strains Staphylococcus spp. were sensitive to vancomycin. There have not been found Enterococcus spp. resistant to glycopeptides. Most active against Gram-positive rods were carbapenems and aminoglycosides.