Newborn Hospitalizations Before and During COVID-19 Pandemic in Poland: A Comparative Study Based on a National Hospital Registry

Objectives: There are limited data on the impact of the COVID-19 outbreak in Poland on newborn health. The aim of the study is to show recent information on hospitalizations of newborns in Poland in the pre-pandemic and COVID-19 pandemic era. Methods: A retrospective, population-based study was conducted using data from hospital discharge records of patients hospitalized in 2017-2021. Results: The data on which the study was based consisted of a substantial number of 104,450 hospitalization records. Annual hospitalization rate was estimated to be 50.3-51.9 per 1,000 in 2017-2019, 56 per 1,000 in 2020 and it rose to 77.7 per 1,000 in 2021. In comparison to the pre-pandemic period, in the COVID-19 era, we observed significantly more hospitalization cases of newborns affected by maternal renal and urinary tract diseases (p < 0.001), syndrome of infant of mother with gestational diabetes (p < 0.001), maternal complications of pregnancy (p < 0.001). In the COVID-19 era, the prevalence of COVID-19 among newborns was 4.5 cases per 1,000 newborn hospitalizations. Conclusion: The COVID-19 pandemic outbreak could significantly contribute to qualitative and quantitative changes in hospitalizations among newborns.

Inactivation of Spores and Vegetative Forms of Clostridioides difficile by Chemical Biocides: Mechanisms of Biocidal Activity, Methods of Evaluation, and Environmental Aspects

Clostridioides difficile infections (CDIs) are the most common cause of acquired diseases in hospitalized patients. Effective surface disinfection, focused on the inactivation of the spores of this pathogen, is a decisive factor in reducing the number of nosocomial cases of CDI infections. An efficient disinfection procedure is the result of both the properties of the biocidal agent used and the technology of its implementation as well as a reliable, experimental methodology for assessing the activity of the biocidal active substance based on laboratory models that adequately represent real clinical conditions. This study reviews the state of knowledge regarding the properties and biochemical basis of the action mechanisms of sporicidal substances, with emphasis on chlorine dioxide (ClO₂). Among the analyzed biocides, in addition to ClO₂, active chlorine, hydrogen peroxide, peracetic acid, and glutaraldehyde were characterized. Due to the relatively high sporicidal effectiveness and effective control of bacterial biofilm, as well as safety in a health and environmental context, the use of ClO₂ is an attractive alternative in the control of nosocomial infections of CD etiology. In terms of the methods of assessing the biocidal effectiveness, suspension and carrier standards are discussed.

Evaluating the Virucidal Activity of Disinfectants According to European Union Standards

The disinfection of surfaces in medical facilities is an important element of infection control, including the control of viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Preparations used for surface disinfection are typically characterized via their activity against test organisms (i.e., viruses, bacteria and fungi) in the laboratory. Typically, these methods use a suspension of the test organism to assess the bactericidal, fungicidal or virucidal activity of a given preparation. However, such suspension methods do not fully imitate real-life conditions. To address this issue, carrier methods have been developed, in which microorganisms are applied to the surface of a carrier (e.g., stainless steel, glass and polyvinyl chloride (PVC)) and then dried. Such methods more accurately reflect the applications in real-life clinical practice. This article summarizes the available methods for assessing the virucidal activity of chemical disinfectants for use in medical facilities based on the current European standards, including the activity against coronaviruses.

No-Touch Automated Room Disinfection after Autopsies of Exhumed Corpses

Autopsies of exhumed bodies pose a risk of infections with environmental bacteria or fungi, which may be life-threatening. Thus, it is important to use effective methods of disinfection in forensic pathology facilities. In this study, we investigated the effectiveness of no-touch automated disinfection (NTD) system after autopsies of exhumed bodies. Directly after 11 autopsies of exhumed bodies, we used an NTD system based on a peroxone vapor to disinfect the air and surfaces. We measured microbial burden in the air and on surfaces before and after NTD. The NTD system reduced the mean bacterial burden in the air from 171 colony forming units (CFU)/m³ to 3CFU/m³. The mean fungal burden in the air decreased from 221 CFU/m³ to 9CFU/m³. The mean all-surface microbial burden was 79 CFU/100 cm² after all autopsies, and it decreased to 2 CFU/100 cm² after NTD. In conclusion, the peroxone-based NTD system was effective for decontamination of the air and surfaces in a dissecting room after autopsies of exhumed bodies.

Assessment of tolerability and acceptability of an alcohol-based hand rub according to a WHO protocol and using apparatus tests

Background

The effectiveness of alcohol-based hand rubs (ABHRs) depends substantially on their acceptability and tolerability. In this study, we assessed the acceptability and tolerability of a new ABHR (product EU 100.2018.02).

Methods

Among physicians, nurses, and cosmetologists who used the ABHR for 30 days, we assessed the product’s acceptability and tolerability according to a WHO protocol. Additionally, we used instrumental skin tests. Participants assessed the product’s color, smell, texture, irritation, drying effect, ease of use, speed of drying, and application, and they gave an overall evaluation. Moreover, they rated the tolerability, i.e. their skin condition, on the following dimensions: intactness, moisture content, sensation, and integrity of the skin. The tolerability was also assessed by an observer as follows: redness, scaliness, fissures, and overall score for the skin condition. Instrumental skin tests included transepidermal water loss, skin hydration, sebum secretion, and percentage of skin affected by discolorations. All assessments were made at baseline (visit 1), and 3–5 days (visit 2) and 30 days (visit 3) later.

Results

We enrolled 126 participants (110 [87%] women) with a mean age of 34.3 ± 11.65 years. Sixty-five participants (52%) were healthcare professionals (physicians, nurses), and 61 (48%) were cosmetologists. During visit 2 and visit 3, about 90% of participants gave responses complying with the WHO’s benchmark for acceptability and tolerability. Similarly, the ABHR met the WHO criteria for observer-assessed tolerability: on all visits, in more than 95% of participants, the observer gave scores complying with the WHO benchmark. Transepidermal water loss decreased from baseline to visit 3 (p < 0.001), whereas skin hydration, sebum secretion, and the percentage of skin affected by discolorations did not change significantly during the study (p ≥ 130).

Conclusions

The EU 100.2018.02 had both high acceptability and tolerability, meeting the WHO criteria. The WHO protocol proved useful in the analysis of acceptability and tolerability of ABHRs.

Polyarteritis nodosa: decreasing incidence in Poland

INTRODUCTION

There are many studies on the epidemiology of the orphan disease polyarteritis nodosa (PAN) in European countries. The use of a hospital morbidity database is an important element of epidemiological analysis. The study is the first such analysis in Poland and may provide an opportunity to compare the data in a European context.

MATERIAL AND METHODS

We conducted a retrospective, population-based study using hospital discharge records with a PAN diagnosis. PAN incidence was estimated based on data from a Polish hospital morbidity study carried out by the National Institute of Public Health. Data on all inpatients discharged from non-psychiatric hospitals in Poland were collected between 2008 and 2013. We identified 557 patients with first-time hospitalizations for PAN.

RESULTS

The sample consisted of 202 (36.3%) males and 355 (63.7%) females. The median and mean age was 53 and 50 years, respectively. The average annual incidence of PAN in Poland was estimated to be 2.4 per million. PAN incidence decreased significantly over time in Poland between 2008 and 2013 (3.3 per million vs 1.9 per million, p < 0.001) and it may be associated with a decrease in hepatitis B incidence observed in Poland.

CONCLUSIONS

Incidence of PAN in Poland was estimated to be 2.4 per million and was comparable to the incidence found in other European countries. PAN incidence decreased during 2008-2013. The decrease in PAN incidence may be related to environmental, infectious (hepatitis B) or other unknown factors. Future research is needed to identify the cause of the decrease and potential triggers of the disease.

Evaluation of the Bactericidal Activity of Didecyl Dimethyl Ammonium Chloride in 2-Propanol against Pseudomonas aeruginosa Strains with Adaptive Resistance to this Active Substance According to European Standards

This study evaluated the bactericidal activity of the cationic surface active compound didecyldimethylammonium chloride in 2-propanol against the two reference strains Pseudomonas aeruginosa and Pseudomonas aeruginosa (tetracycline-resistant) as well as their isolates adapted to this active substance. Individual phases and stages of European Standards which are intended to determine the bactericidal activity of disinfectants in medical areas were used. Disinfection parameters of the tested substance as determined by suspension methods were not sufficient to achieve the required bactericidal reduction in the carrier method for Pseudomonas aeruginosa and all its adapted isolates. Pseudomonas aeruginosa (tetracycline-resistant) and its adapted isolates were more sensitive to the tested active substance when the contact time was extended from 5 to 10/15 min. Adaptive resistance of Pseudomonas aeruginosa strains can be abolished by using increased concentrations of the tested substance and/or extended contact time.

Paget disease of bone among hospitalized patients in Poland

INTRODUCTION

Paget's disease (PDB) is a focal disorder of bone remodeling that occurs commonly in older people with decreasing prevalence reported in European countries. This disease is most often asymptomatic, but it can cause a variety of medical complications resulting in considerable morbidity and reduced quality of life. There is little information regarding the epidemiology of PDB in Poland. To the best of the authors' knowledge, this is the first large epidemiological analysis of this disease in Poland.

OBJECTIVE

The aim of this study was to analyze factors that may be related to the PDB epidemiology among hospitalized patients in Poland.

MATERIAL AND METHODS

The analysis was conducted on the basis of population-based administrative data, taken from a Polish hospital morbidity study carried out by the National Institute of Public Health between January 2008 - December 2014.

RESULTS

Analyzed data covered 662 hospitalization records. The final study sample comprised 94 (41.8%) male and 131 (58.2%) female patients with first-time hospitalizations for PDB, with a significant predominance of females (P<0.02), and the predominance of patients living in urban (73%) than in rural areas (27%), P<0.001. The average age of the sample was 56.8 years (CI: 54.3-59.3; SD 18.8; range 1-93 years). The number of PDB cases hospitalized in Poland significantly decreased during the analyzed period of time.

CONCLUSIONS

PDB is a rare disease with decreasing trends observed among hospitalized patients in Poland. The study results may suggest the existence of environmental risk factors for the development of PDB.

Behçet disease: a rare systemic vasculitis in Poland

INTRODUCTION    Behçet disease (BD) is an immune‑mediated small‑vessel systemic vasculitis, which is rarely seen in Poland. OBJECTIVES    The aim of this study was to evaluate the incidence and prevalence of BD, as well as to assess the sex and geographical distribution of BD in Poland during a 7‑year follow-up. To our knowledge, this is the first evaluation of this rare disease in Poland, based on a hospital morbidity database. PATIENTS AND METHODS    We analyzed population‑based administrative data obtained from a national hospital morbidity study conducted between January 2008 and December 2014 by the National Institute of Public Health in Poland. The annual incidence rates and point prevalence of BD were calculated using the number of patients with BD and corresponding census data for the overall Polish population.  RESULTS    Data included 316 hospitalization records. The final study sample comprised 130 patients (54 men [42%] and 76 women [58%]) with first‑time hospitalizations for BD. The mean (SD) age was 41.6 (18.7) years (95% confidence interval [CI], 38.3-44.8; range, 5-85 years). The incidence rate of BD was estimated at 0.5 per million persons per year (95% CI, 0.35-0.61). The point prevalence at the end of 2014 was 3.4 per million persons. The incidence rate of BD did not vary significantly between more urban and more rural regions, and BD was observed more often in women than in men. CONCLUSIONS    BD is endemic in Eastern and Central Asian countries, but is also seen in Poland. However, its incidence and prevalence rates are lower in Poland than in other European countries.

Incidence and prevalence of Systemic Sclerosis (SSc) in Poland - differences between rural and urban regions

[b] Abstract Introduction.[/b] Systemic sclerosis (SSc) is a rare and potentially severe connective tissue disease, characterized by skin fibrosis and involvement of internal organs. Because of its rarity and heterogeneous clinical presentation, reliable epidemiological studies on SSc have been particularly difficult to carry out. [b]Objectives[/b]. The purpose of this study was to present SSc epidemiology among hospitalized patients in Poland.

MATERIALS AND METHOD

The analysis was based on population-based administrative data, taken from a Polish hospital morbidity study carried out by the National Institute of Public Health between January 2008 - December 2012. [b]Results[/b]. Analyzed data covered 9,049 hospitalization records. The final sample comprised 3,653 patients with first-time hospitalizations for SSc. The average age of the sample was 53 years (SD 16.2; range 0-91 years); 84% of patients were female and 16% male. Based on hospitalization registers, the average SSc incidence was estimated to be 1.9/100,000 per year and peak age of incidence was 55 years. The point prevalence was estimated to be 9.4/100,000 at the end of 2012. SSc was more common in females, with F:M ratio ranging from 6.2:1-4.6:1 depending on the year. Analysis of hospitalization trends revealed that overall numbers of SSc hospitalizations increased, while first-time hospitalizations decreased between 2008-2012. Clusters of higher incidence were observed in more rural regions vs. urban regions. [b]Conclusion[/b]. Estimated incidence of SSc in Poland was comparable to reported incidence in other European countries. Analysis of demographic factors and reports of clusters of higher incidence may suggest the existence of environmental risk factors for the development of SSc. These observations may require further research.

Neutralization efficiency of alcohol based products used for rapid hand disinfection

BACKGROUND

Alcohols are the most commonly used active substances in preparations for quick hand disinfection. They should be bactericidal in very short contact time. PN-EN 13727 + A2: 2015-12 standard, for testing hygienic and surgical handrub disinfection preparations, provides mandatory test conditions of disinfectants in contact times with the range of 30 s to 60 s (hygienic handrub disinfection) and 60 s to 5 min (surgical handrub disinfection). A short contact times for hand hygiene products require a short time of neutralization process. For contact times less than or equal to 10 minutes, the estimated neutralization time is 10 s ± 1 s. Neutralization is a process that abolishes the action of disinfectants. Correct application of this process allows for proper use of disinfectants in practice and its biocidal effect. Objectives. Verification of the effectiveness of 10-second neutralization time of alcohol based preparations for hygienic handrub disinfection

MATERIALS AND METHOD

Neutralization of two products with different ethanol content (89% and 70%) for hygienic handrub disinfection according to PN-EN 13727 + A2: 2015-12 was investigated. The effectiveness of the neutralizer was assessed by determining toxicity of neutralizer, activity of residual effects of the tested products and their derivatives produced during neutralization (10 s) for test organisms (Staphylococcus aureus ATCC 6538; Pseudomonas aeruginosa ATCC 15442; Enterococcus hirae ATCC 10541; Escherichia coli K12 NCTC 10538)

RESULTS

The 10-second neutralization time was sufficient to eliminate the residual activity of products for hygienic handrub disinfection with differentiated ethanol concentration. The neutralizer used did not show toxicity to bacteria and did not produce toxic products with tested preparations after neutralization

CONCLUSIONS

Conclusions. The use of 10-second neutralization time allows in a precise way designate the contact times for hygienic handrub disinfection products

A simple and economical method for marking the EGG R-wave on film in cinefluorography

A new method for marking the R-wave of the EGG on ciné film was developed. The system utilizes the absence of one control pulse from the camera immediately after R-wave. The missing pulse causes one unexposed frame on the film, which in turn acts as a marker. The equipment costs about 500 Fmk. (similar to $132.00).