Przegla̧d epidemiologiczny
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The paper presents contemporary definitions and guidelines for management of severe sepsis and septic shock in neonates. We discuss main directions of hemodynamic resuscitation, antibacterial and supportive treatment. Pathophysiological differences of septic shock in this group of patients were described.
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Currently, the Polish Society of Hospital Infections is coordinating a national program of active surveillance of nosocomial infections. One of its elements is the control of hospital acquired pneumonia (PNEU) on Intensive Care Units. This paper analyzes the epidemiology and etiology of hospital acquired pneumonia (PNEU) at the Intensive Care Units (ICU). ⋯ The average cumulative incidence of PNEU was 5.6% (median 4.9%), incidence density of Ventilator Associated Pneumonia (VAP) on average reached 17.9 per thousand (median 18.8 per thousand); mortality of patients with PNEU totaled 12.6% and for patients on ventilator and with coexisting infections 15.0% and 20%, respectively--it wasn't high enough to be statistically significant. Dominant etiologic factors of hospital acquired pneumonia in patients with a risk factor were Pseudomonas aeruginosa and Escherichia coli Methicillin-resistant Staphylococcus aureus(MRSA) comprised 21.1% of isolated S. aureus strains. The analyzes in this paper show that it's possible to effectively implement uniform methods of detection, qualification and analysis in relatively new settings at Polish hospitals, where tools of modern hospital epidemiology are only used since the mid 90-ties.
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Twenty mine cases of malaria were reported in Poland in 2004. All of them were imported: 22 from Africa, 2 from Asia and 3 from South America In 2 cases country of origin was unknown. In 14 cases P. falciparumn etiology was confirmed. ⋯ One death from falciparumn malaria was reported in Poland in 2004. In 11 cases some kind of chemoprophylaxis was documented. In other prophylaxis was not used or not documented.
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Controlled Clinical Trial
[Procalcitonin as a diagnostic marker in systemic inflammatory response syndrome (SIRS) and sepsis].
Evaluation the value of procalcitonin as a diagnostic and prognostic marker in septic patients and patients with systemic inflammatory response syndrome (SIRS). ⋯ Measurement of PCT level on the first, second and third day of hospitalization has no prognostic value. There is no significant difference in PCT level in sepsis caused by Gram positive and Gram negative bacteria. PCT is a useful marker in diagnosis of sepsis but its role in monitoring the severity of sepsis requires more clinical studies.
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Malopolskie voivodeship was established in 1999 from regions where alarming low vaccination coverage had place. It was necessary to introduce an improvement program of vaccination performance in this area. The vaccination coverage in Malopolska voivodeship in period 1999-2004 has been analyzed. The immunization coverage has improved during this time, but is very sensitive on any problems in organization of vaccination performance.