A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

Background

Automated urine technology providing standard urinalysis data can be used to support clinicians in screening and managing a UTI-suspected sample. Fully automated urinalysis systems have expanded in laboratory practice. Commonly used were devices based on digital imaging with automatic particle recognition, which expresses urinary sediment results on an ordinal scale. There were introduced fluorescent flow cytometry analyzers reporting all parameters quantitatively. There is a need to harmonize the result and support comparing bacteria and WBC qualitative versus semiquantitative results.

Methods

A total of 1,131 urine samples were analyzed on both automated urinalysis systems. The chemical components of urinalysis (leukocyte esterase and nitrate reductase) and the sediment results (leukocytes and bacteria) were investigated as potential UTI indicators. Additionally, 106 specimens were analyzed on UF-5000 and compared with culture plating to establish cut-offs that can be suitable for standard urinalysis requirements and help to guide on how to interpret urinalysis results in the context of cultivation reflex.

Results

The medians of bacteria counts varies from 16.2 (absence), 43.0 (trace), 443.5 (few), 5,389.2 (moderate), 19,356.6 (many) to 32,545.2 (massive) for particular digital microscopic bacteriuria thresholds. For pyuria thresholds, the medians of WBC counts varies from 0.8 (absence), 2.0 (0-1), 7.7 (2-3), 21.3 (4-6), 38.9 (7-10), 61.3 (11-15) to 242.2 (>30). Comparing the culture and FFC data (bacterial and/or WBC counts) was performed. Satisfactory sensitivity (100%), specificity (83.7%), negative predictive value (100%), and positive predictive value (75%) were obtained using indicators with the following cut-off values: leukocytes ≥40/µl or bacteria ≥300/µl.

Conclusions

Accurate urinalysis gives information about the count of bacteria and leukocytes as useful indicators in UTIs, in general practice it can be a future tool to cross-link clinical and microbiology laboratories. However, the cut-off adjustments require individual optimization.

Hospital Urinary Tract Infections in Healthcare Units on the Example of Mazovian Specialist Hospital Ltd

Microbiological diagnostics is of great importance in limiting the spread of nosocomial infections. The information on etiological agents of infections and their susceptibility to antibiotics enables a quick response in the case of a suspected epidemic outbreak. The aim of this study is to analyze the incidence of nosocomial urinary tract infections among patients hospitalized in hospital wards over a period of 2 years and to determine the predominant etiological agent depending on the method of clinical specimen collection. Data from the Mazovian Specialist Hospital (MSH) in Radom constitute the material for the preparation of this study. Urine was collected using two methods. The first one was the method of collecting urine from the central stream, while the second method was urine collected from patients with a urinary catheter in place. The statistical calculations were conducted using the statistical software. Based on hospital data, it was shown that 5,870 urine tests were performed during the period under review, of which 2,070 were positive. The number of positive results in 2021 decreased by 2.84% compared to that in 2020. On the basis of the statistical analysis, differences in the occurrence of multiple strains were observed between catheter-based and midstream urine collection. Differences were observed especially for Acinetobacter baumannii, Candida albicans, Escherichia coli, and Pseudomonas aeruginosa. A. baumannii, C. albicans, and P. aeruginosa were significantly more frequently found in urine samples collected through the catheter than from the midstream. Furthermore, E. coli (51.56%) and Enterococcus species (25.46%) were more frequent when collected from the middle stream than when urine was collected through a catheter. However, for the strain K. pneumoniae, the results were comparable when urine was collected from catheterized patients (13.83%) and from midstream (13.35%). Urinary tract infection among hospitalized patients of the Mazovian Specialist Hospital in Radom was diagnosed quite frequently. In 2021, 32 more urine cultures were performed than in 2020. In the analyzed period, among all ordered urine cultures, 35.27% of samples were positive.

Opportunistic Pathogens of Recreational Waters with Emphasis on Antimicrobial Resistance-A Possible Subject of Human Health Concern

Infections caused by exposure to opportunistic pathogens can cause serious health problems during recreational water use. The problem of diseases caused by microbes transmitted by water is a major public health challenge, especially in developing countries with economic problems and poor hygiene conditions. Moreover, the quality of water in natural reservoirs is often at a very low level in terms of microbiological water purity, which means that their use for recreational purposes, but also as a source of drinking water, may have serious health consequences. Recreational waters pose a threat to human health. Therefore, the quality of recreational waters is closely monitored in many jurisdictions. In this review, we summarize key information on the most common pathogens that can be water-based or waterborne. The issue of antimicrobial resistance among opportunistic pathogens remains equally important. It is important not only to fight pathogens, but also to take action to reduce chemical stressors (especially antibiotics) in the aquatic environment, and to understand the various mechanisms of the spread of antibiotic-resistant genes.

Plasmid-Mediated Fluoroquinolone Resistance Genes in Quinolone-Susceptible Aeromonas spp. Phenotypes Isolated From Recreational Surface Freshwater Reservoir

Aeromonas spp. are recognized as opportunistic pathogens causing diseases. Infections in humans can result mainly in gastrointestinal and wound diseases with or without progression to septicemia. Although Aeromonas spp. are not known uropathogens and they rarely cause urinary tract infection, we hypothesize that the presence of these bacteria in the water and the contact during, e.g., recreational and bathing activity can create the conditions for the colonization of the human body and may result to diseases in various locations, including the urinary tract. Our study presents the occurrence of aeromonad fluoroquinolone-susceptible phenotypes with the presence of plasmid-mediated fluoroquinolone resistance (PMQR) genes in a natural freshwater reservoir occasionally used for recreational activities. Sixty-nine isolates collected during the bathing period were identified by mass spectrometry and screened for the presence of fluoroquinolone-resistant phenotypes and genotypes. Fluoroquinolone susceptibility was determined as minimal inhibitory concentration values. PMQR qnr genes were detected by PCR. Isolates comprising eight species, namely, mainly Aeromonas veronii (50.7% isolates) and Aeromonas media (24.6% isolates) and rarely Aeromonas eucrenophila, Aeromonas caviae, Aeromonas bestiarum, Aeromonas ichthiosmia, and Aeromonas hydrophila, were selected. All isolates were phenotypically susceptible either to ciprofloxacin or levofloxacin. Unexpectedly, at least one to three of the PMQR genes were detected in 42.0% of the fluoroquinolone-susceptible Aeromonas spp. phenotypes. Mainly the qnrS (34.8% isolates) and qnrA (14.5% isolates) determinants were detected. In conclusion, the freshwater reservoir occasionally used for bathing was tainted with aeromonads, with a high occurrence of opportunistic pathogens such as A. veronii and A. media. MALDI‐TOF MS is a powerful technique for aeromonad identification. Our data reveals the mismatch phenomenon between fluoroquinolone-susceptible aeromonad phenotypes and the presence of plasmid-mediated qnr resistance genes. It suggests that phenotypically susceptible bacteria might be a potential source for the storage and transmission of these genes. The exposure during, e.g., a recreational activity may create the potential risk for causing infections, both diagnostically and therapeutically difficult, after expressing the resistance genes and quinolone-resistant strain selection.

Effect of Different Wavelengths of Laser Irradiation on the Skin Cells

The invention of systems enabling the emission of waves of a certain length and intensity has revolutionized many areas of life, including medicine. Currently, the use of devices emitting laser light is not only an indispensable but also a necessary element of many diagnostic procedures. It also contributed to the development of new techniques for the treatment of diseases that are difficult to heal. The use of lasers in industry and medicine may be associated with a higher incidence of excessive radiation exposure, which can lead to injury to the body. The most exposed to laser irradiation is the skin tissue. The low dose laser irradiation is currently used for the treatment of various skin diseases. Therefore appropriate knowledge of the effects of lasers irradiation on the dermal cells’ metabolism is necessary. Here we present current knowledge on the clinical and molecular effects of irradiation of different wavelengths of light (ultraviolet (UV), blue, green, red, and infrared (IR) on the dermal cells.

Rubber elastomeric nanocomposites with antimicrobial properties

In this paper we show an elastomeric nanocomposite that exhibits antibacterial and antifungal activity. It comprises a rubber blend matrix and a nanofiller, which is a modified bentonite clay (Nanobent® ZR2). We have developed innovative technology for the nanofiller incorporation into the rubber matrix. This new approach was successfully implemented in pilot production at the Polish chemical manufacturer Spoiwo (Spoldzielnia Pracy Chemiczno-Wytworczej 'Spoiwo', Radom, Poland). Here we reveal that addition of the functionalised bentonite affects the mechanical and thermal behaviour of elastomers. For example, by adding 1-3% of bentonite nanoparticles we strongly enhanced elongation and tensile stress at break, whereas stiffness remained unchanged. We observed improvement of the thermal properties of the nanocomposites yielded and extension of the temperature usage range (from -29 to 311°C). As a proof of concept we present the antimicrobial effect of elastomeric nanocomposites verified on a wide range of both pathogenic and opportunistic reference bacteria strains, as well as reference strains of yeasts. The proposed method of hydrophilic nanofiller introduction into the rubber elastomer is economically viable and enables fabrication of elastomeric elements with high added value. Their significant antibacterial and antifungal activity makes them desirable in medicine, biomedical engineering, and the food industry.

ASSESSMENT OF A STABLE COSMETIC PREPARATION BASED ON ENZYMATIC INTERESTERIFIED FAT, PROPOSED IN THE PREVENTION OF ATOPIC DERMATITIS

Atopic dermatitis is one of the most common skin disorders seen in infants, children and adults. Proper prevention might slow the atopic symptoms. The purpose of the work was a sensory analysis, an evaluation of moistening properties and stability of emulsions based on an enzymatic interesterified fat blend (mutton tallow and walnut oil) and homogenized at different revolutions and different contents of thickener. The emulsions were evaluated with respect to sensory and skin moisturizing properties by 78 respondents. Stability tests, particle size, distribution, dispersity index, morphology structure of the emulsions were determinated too. Taking into consideration all properties of the emulsions, emulsion IV (containing 0.9 g carboxymethyl cellulose and homogenized at 18000 rpm) and emulsion V (1.5 g of carboxymethyl cellulose and homogenized at 24000 rpm) were found to be of optimum composition. The emulsions exhibited good stability, were highly rated in sensory terms and displayed optimum moistening properties. It has been proven that model emulsions based on interesterified fats containing partial acylglicerols, with optimum carboxymethyl cellulose content and specific revolutions at the time of homogenization are an opportunity for developing preparations targeted at skins requiring special care (e.g., with atopic dermatitis or psoriasis). The work proved the use of enzymatic process to create the emulsifier, which represents the innovative contribution of this work. Also it showed an additional application of enzymatic interesterified fats which since has been used only in food industries.

Factors affecting decision concerning influenza vaccination among students of medical faculties

Influenza is one of the most common cyclic respiratory diseases in humans. Methods of prevention are multidirectional, but the most effective and most efficacious way to prevent influenza and its complications is through preventive vaccination. This work aims to determine different factors affecting the decision concerning influenza vaccine. The percentage of people vaccinated against the flu was evaluated, as well as their knowledge of post-influenza complications, etc. among full-time students and bridging studies of nursing and physiotherapy (full-time and part-time) at the University of Technology and Life Sciences in Radom, and students of medicine and pharmacy at the Medical University of Łódź. The research tool was the authors' questionnaire with 18 questions. The surveys conducted, consisting of multiple choice questions, were anonymous. In total, the survey involved 470 students. Overall, the number of people who were vaccinated against influenza in the 2012/13 epidemic season numbered 15 respondents, representing 5.84% of the total group of respondents. For the group of nursing students it was 6%, for physiotherapy students 5%, for students of medicine and pharmacy 14%. The percentage of respondents who said they would get vaccinated if the vaccinaton was free of charge was also low. Increasing the percentage of people vaccinated against influenza (immunization coverage) is a very important measure in preventing influenza epidemics. Therefore, it is necessary to identify the reasons why people are reluctant to be vaccinated against influenza, particularly among students who will work in the future in the health care services sector.

Factors affecting decision concerning influenza vaccination among students of medical faculties

Influenza is one of the most common cyclic respiratory diseases in humans. Methods of prevention are multidirectional, but the most effective and most efficacious way to prevent influenza and its complications is through preventive vaccination. This work aims to determine different factors affecting the decision concerning influenza vaccine. The percentage of people vaccinated against the flu was evaluated, as well as their knowledge of post-influenza complications, etc. among full-time students and bridging studies of nursing and physiotherapy (full-time and part-time) at the University of Technology and Life Sciences in Radom, and students of medicine and pharmacy at the Medical University of Łódź. The research tool was the authors' questionnaire with 18 questions. The surveys conducted, consisting of multiple choice questions, were anonymous. In total, the survey involved 470 students. Overall, the number of people who were vaccinated against influenza in the 2012/13 epidemic season numbered 15 respondents, representing 5.84% of the total group of respondents. For the group of nursing students it was 6%, for physiotherapy students 5%, for students of medicine and pharmacy 14%. The percentage of respondents who said they would get vaccinated if the vaccinaton was free of charge was also low. Increasing the percentage of people vaccinated against influenza (immunization coverage) is a very important measure in preventing influenza epidemics. Therefore, it is necessary to identify the reasons why people are reluctant to be vaccinated against influenza, particularly among students who will work in the future in the health care services sector.

[Possibility to use the lyophilization for the prolongation of the stability of biological compounds used in cosmetic production]

The investigations were conducted with using aquatic hydrolysate of protein 5%, 10%, 20% and 50%. Starting product to prepare solutions with different concentrations, exposed on lyophilisation was pork gelatin (Polonaise, Belgium). The aim of investigations was to determine on effect of lyophilization process on the microbiological and physico-chemistral stability of protein hydrolisate. Physical parameters of lyophilization of protein hydrolysate solutions of different concentrations and physical properties of the lyophilized hydrolysates were determined. Microbiological analysis demonstrated that lyophilization protected the hydrolysates stored at 4 degrees C and 22 degrees C for 60 or 100 days against bacterial contamination. On the other hand, the inhibition of the bacterial multiplication in nonlyophilized hydrolysates was obtained only during storage at -20 degrees C. A proper structure and good dissolubility of the lyophilizated of preparation were obtained for 5%, 10% and 20% hydrolisate and for of the maximum kinematical viscosity 2923 mm2/s.

[Experimental infections and colonization of porcine skin samples with B. anthracis]

In this study there was demonstrated the process of appearance and intensity of colonisation of the swine's skin samples by exposing them on agar plate cultures or immersed in liquid cultures of B. anthracis. The results of research were documented with photos of coloured histological preparations. As a result of the research there was demonstrated the possibility of infection and colonisation of skin consignment by B. anthracis from accidental located skin of died or killed animals because of anthrax. This colonisation may occur in the period 3 to 24 hours in optimal conditions. Anthrax bacteria are starting to penetrate and colonize the skin samples during 3 hours with exposing them from the hypodermic side; whereas penetration and colonisation from epidermis side appears after 24 hours. The results demonstrated that in natural conditions for optimal cultivation of B. anthracis there can be a possibility of infection and colonization of health parts of the skin's in storage skin for the longer period of time or longer transport.

[Survival of Bacillus anthracis spores in baths using modern technologic tannery processes]

The influence of skin tannery baths, according as wet-blue, wet-white and plant technology, on B. anthracis spores survival was investigated. As a result of this study there was explained that lime bath do not inactivated of all spores that are present in infected bath. As a result of these experiments the spores were inactivated completely not before pickle bath.

[The effect of tannery waste products on viability of selected bacteria from activated sludge]

In this study we have investigated the influence of sludge on the activity of bacteria strains: Acinetobacter baumannii, Aeromonas hydrophila and Pseudomonas cepacia. To our studies we have taken waste materials used in the chromium compound leather tanning process as well as materials from leather fat and waste materials, in general. It was confirmed that 1:20 dilution of chromium tanning leather waste, retanage and leather fat allowed the survivability of bacteria in all three strains. Through our research we were able to establish that general sewage with a decreased level of chromium practically did not effect the survivability of bacteria in a sewage environment. Both types of waste, city sewage as well as leather waste, were shown not to facilitate bacterial growth. If chromium waste flow into city sewage without treatment, bacteria can only survive at a dilution level of 1:20, which will not affect the survivability of bacteria used in biological waste treatment.

[The effect of selected tannery chemical compounds on selected bacteria of activated sludge]

Influence of tannery chemical compounds on the selected bacteria of the activated sludge was investigated. The chromium compounds must be diluted to 1:15-1:20 to loss its activity on the bacteria. Other compounds like: natrium chloratum, natrium formate and greased oils have any influence on the growth of the selected bacteria.

[Survival of Bacillus anthracis spores in various tannery baths]

The influence of tannery baths: liming, deliming, bating, pickling, tanning, retannage on the survival and on the germination dynamism of B. anthracis spores (Sterne strain) was investigated. The periods and the conditions of this influence were established according to technological process of cow hide tannage. Practically after every bath some part of the spores remained vital. The most effective killing of spores occurred after pickling, liming and deliming. Inversely, the most viable spores remained after bating and retannage process. The lack of correlation that was observed between survival and germination of spores after retannage bath can be explained by different mechanism of spores germination inhibition and their killing.