Przeglad epidemiologiczny最新文献

COVID-19 is severe respiratory and systemic disease with complex pathogenesis and many clinical symptoms, including symptoms from respiratory system, immunology system, cardio-vascular system, haematopoietic system and neurological system. Severe character of the disease is associated with occurrence of respiratory failure, septic shock, multiple organ dysfunctions syndrome, which can lead to patients death due to cardiac arrest. Knowledge about interactions between the virus and human proteins as well as knowledge of immunological mechanisms against infection is a key to identifying the area of virus activity and severity factors of COVID-19. Multiple variants of genes encoding proteins involved in host cell invasion by SARS-CoV-2 virus have been identified: ACE2 i TMPRSS2, TMPRSS11A (HGNC:27954), ELANE (HGNC:3309) oraz CTSL (HGNC:2537), IL-6 rs1800795 variant associated with an increased risk of COVID-19, variant rs35705950:G>T located in the promoter of the MUC5B gene (11p15.5), encoding a protein that plays a key role in maintaining the proper function of the bronchoalveolar epithelium, having a protective effect against the form of the disease requiring hospitalization of the patient, as well as GC rs2282679 gene variant in the vitamin D binding protein associated with a more severe course of COVID-19. 48 of these variants were proved to be directly specific for some populations. Novel techniques of genome analysis enabled the research of the impact of specific polymorphism variants on the severity of various diseases including, COVID-19. Genetic factors analysis can permit understanding of disease pathogenesis, which is a chance to find effective treatment and prevention methods. Collected data from literature indicate that, in the case of COVID-19 disease, there are genes polymorphisms which affect the severity course.

Background: Gram-negative Salmonella bacilli are one of the most common bacterial causes of gastrointestinal infections. Well-selected and targeted microbiological diagnostics enable the detection and identification of the etiological agent of infection, however, standardized, routine and recommended methods do not always allow for the identification of the biological agent in an unambiguous manner. Next-generation sequencing has become an ideal tool for identifying microorganisms and tracking infection transmission in outbreaks for epidemiological purposes.

Objective: The aim of the study was to assess the genomic relatedness of Salmonella Enteritidis strains using whole genome sequencing in the foodborne outbreak in August-September 2023 in the Silesian Voivodeship.

Material and methods: The research material consisted of 11 strains of S. Enteritidis for which whole genome sequencing was performed using Illumina technology and the relationship between serotypes was assessed using bioinformatics tools.

Results: The genomes of all S. Enteritidis isolates were assigned to HC2_53128, which may indicate a very close relationship between the strains.

Conclusions: Whole genome sequencing enabled the assessment of the genomic relatedness of S. Enteritidis strains in the foodborne outbreak in August-September 2023 in the Silesian Voivodeship.

Background: Mumps, also known as Sudden parotitis, is a viral disease whose main source of infection is the sick/infected person. It posed a serious public health threat in Poland before the introduction of mandatory vaccination. In 2003, Poland introduced the Immunization Program, which included a two-dose vaccination against mumps as part of the MMR (measles, mumps and rubella) vaccine for all children.

Objective: The study aimed to assess the epidemiological situation of mumps in Poland in 2022 compared to previous years, including an analysis of the impact of the COVID-19 pandemic.

Material and methods: The analysis of the epidemiological situation of mumps in Poland in 2022 was based on the interpretation of data published in the annual bulletin: "Infectious Diseases and Poisonings in Poland in 2022" and "Vaccinations in Poland in 2022".

Results: In 2022, 922 cases of mumps were registered in Poland. This was a 90.5% increase compared to 2021 when 484 cases were recorded. The total incidence was 2.4 per 100,000 residents, 84.6% higher than in 2021. The highest incidence of 3.4 per 100 000 residents was registered in the Mazowieckie voivodeship, and the lowest, as in the previous year, was 1.0/100 000 residents in the Dolnośląskie voivodeship. The highest incidence (12.9/100 000) was recorded in children aged 0-4 and 5-9 (16.1/100 000). The incidence in men (3.0/100 000) was higher than in women (1.9/100 000). In 2022, the number of hospitalizations for mumps in Poland was 20, an increase of 122.2% compared to 2021, when 9 people were hospitalized.

Conclusions: The year 2022 showed an overall upward trend in registered mumps cases. The decrease in the number of mumps cases in 2021 was a result of the ongoing pandemic. The restrictions implemented during the pandemic period contributed to a decrease in the number of cases of various droplet-transmitted diseases, including mumps. Still, the observed number of mumps cases in 2022 remains below levels observed during the pre-pandemic COVID-19 period (2019).

Human papillomavirus (HPV) is one of the most common sexually transmitted infections and poses a significant public health concern due to its link with various cancers. Despite widespread awareness of HPV, actual knowledge about the virus remains limited, which limits the effectiveness of preventive measures such as vaccination. This article reviews the literature to evaluate how HPV knowledge influences attitudes toward vaccination. Studies indicate that access to education and healthcare is crucial in bridging knowledge gaps about HPV. To improve awareness, vaccination rates, and screening participation, targeted educational interventions and public health strategies are essential. Furthermore, changes in the education and training of healthcare providers are necessary for the successful implementation of public health initiatives, boosting vaccination uptake and increasing the performance of screening tests.

Artificial Intelligence (AI) has the potential to revolutionize medical diagnostics by offering new opportunities for accuracy, efficiency, and accessibility in healthcare. This article examines the benefits of implementing AI in diagnostics, such as enhanced diagnostic precision, faster clinical decision-making, cost reduction, and increased access to healthcare. It also discusses the challenges associated with AI implementation, including ethical, legal, and technical issues. The future of AI in medicine may bring further technological advancements and personalized therapy, but it also requires addressing regulatory and ethical concerns.

We present the case of a 71-year-old man who developed sepsis caused by Capnocytophaga canimorsus as a result of being bitten by his own dog. Positive blood cultures were obtained, but due to difficulties in determining the bacterial species, the patient was treated empirically with ceftriaxone and levofloxacin. After using the recommended empirical therapy, the patient's condition improved. Capnocytophaga canimorsus is difficult to identify, among others, due to its long growth time and specific development conditions (capnophiles). These Gram-negative bacilli cause a number of diseases in humans, ranging from infections of the skin and subcutaneous tissue, through peritonitis, to sepsis. The portal of infection with these bacteria is most often a wound caused by an animal bite. Additional risk factors that increase the risk of developing a severe infection and even death include older age, concomitant chronic diseases, and immunosuppression.

Background: Tularemia is a zoonotic disease caused by the bacterium Francisella tularensis. It may manifest itself in various clinical forms, but in Poland the ulcerative-glandular or glandular forms of tularemia predominate. One of the routes of infection with F. tularensis is through a tick or insect bite. A patient may show no symptoms or report flu-like symptoms and painful lumps adjacent to the bite site. The differential diagnosis of localized lymphadenopathy accompanied by flu-like symptoms should include tularemia, especially in endemic areas. Lymphadenitis usually requires surgical intervention and is often unsuccessfully treated with beta-lactam antibiotics before the diagnosis of tularemia is established.

Objective: The aim of the study was to analyze and present the epidemiology and clinical presentation of tularemia in a highly endemic area, in which ticks are an important vector of F. tularensis.

Material and methods: We have analyzed epidemiological and medical reports on the confirmed tularemia cases from Hajnówka County in 2014-2022. We describe three patients from the specific endemic area who were diagnosed with granular tularemia in 2022.

Results: We have found high local exposition to Francisella tularensis infection in the Narewka community, generally consistent with the seasonality of tick activity and human activity outdoors.

Conclusions: The medical practitioner in such endemic areas must be aware that tularemia should be considered when diagnosing of flu-like symptoms accompanied by lymphadenopathy in patients bitten by ticks or insects in the summer and early autumn months. Early diagnosis and targeted antibiotic therapy are the basis for effective treatment of tularemia.

Background: Despite the fact that the last cases of fully-symptomatic diphtheria were recorded in Poland in 1996 and 2000, infections caused by non-toxin-producing strains of Corynebacterium still occur. According to the epidemiological reports from ECDC in the second half of 2022, there was an increase in the number of diphtheria cases in European Union countries. As a result, the current issue becomes the appropriate preparation of microbiological laboratories for the diagnosis of Corynebacterium microorganisms.

Objective: Reidentification of diphtheria bacilli isolated from clinical samples and to assess the drug susceptibility of C. diphtheriae strains isolated in Poland.

Material and methods: The subject of the research were 18 strains isolated from clinical samples in Poland in 2023. Microbiological and genetic methods were used for the reidentification of the strains. Drug susceptibility was assessed using the disk diffusion method, following the new EUCAST recommendations effective from 2023.

Results: It was confirmed that all examined strains belonged to the genus Corynebacterium. It was de-monstrated that C. diphtheriae strains proved to be susceptible to increased exposure to benzylpenicillin and cefotaxime. Results obtained using ciprofloxacin allowed categorizing the strains into the intermediate susceptibility category WZE, except for one strain which was resistant to this antibiotic. All tested bacterial strains were susceptible to erythromycin. The C. ulcerans strain exhibited a similar antibiotic resistance profile to penicillin, cefotaxime, and ciprofloxa-cin, with additional detection of resistance to clindamycin. The toxigenicity of the tested strains was excluded.

Conclusions: Based on epidemiological data regarding the emergence of new cases of infections caused by Corynebacterium strains, it is advisable to prepare theoretically and practically laboratories for diagnostics to detect potentially toxigenic diphtheria bacilli. Effective methods for the microbiological diagnosis of diphtheria bacilli are available. It is recommended to monitor the susceptibility to antimicrobial agents in all C. diphtheriae isolates.

Background: The paper describes a diagnostically challenging case of recurrent fever with an atypical course in a 55-year-old man. The authors highlight the significant difficulty in reaching a correct diagnosis, as well as the doubts and problems associated with the diagnostics. They suggest considering brucellosis as a diagnosis based on the patient's history and the course of the disease characterized by fluctuating, intermittent, and nocturnal fever.

Objective: The aim of the study was to present an atypical and diagnostically challenging case of recurrent febrile episodes in a 55-year-old man.

Material and methods: A comprehensive diagnostic workup, including laboratory tests, imaging, and specialist consultations, was conducted. The patient's medical history, physical examination, and various diagnostic tests were analyzed.

Results: In a patient with recurrent episodes of fever, an infection with Brucella spp. was detected, which was effectively treated with long-term antibiotic therapy. Imaging and laboratory diagnostics, along with specialist consultations, helped rule out other potential causes of the symptoms. The patient achieved lasting improvement following the treatment.

Conclusions: There is a high probability that the patient was infected with Brucella bacteria. Diagnostic challenges and the rarity of the disease, considered non-existent in Poland, hinder prompt confirmation or exclusion of infection. The authors aimed to highlight the possibility of a higher frequency of brucellosis in Poland. They suggest that Brucella bacteria may still be present, causing chronic, unrecognized, recurrent fevers. Based on the case analysis, the authors indicate that the frequent occurrence of this disease in Poland might be higher than reported by statistics.

Cerebral nocardiosis is an extremely rare and serious disease that mainly affects immunocompromised adults. Due to the non-specific clinical symptoms and difficult and long diagnostics, the diagnosis is often made late, often resulting in serious complications and patient's death. The case report presented below concerns a young patient whose complete recovery was achieved thanks to an accurate diagnosis and quick initiation of targeted treatment. The study aimed to present a rare infectious disease, drawing attention to the value of bacterioscopic examination and the special need for cooperation between a clinician, a microbiologist and a radiologist.