Irena Choroszy-Król

Respiratory infection caused by chlamydophila pneumoniae in children and adolescents in the lower silesia region of poland

ObjectiveTo assess the incidence of Chlamydia pneumoniae respiratory tract infection in children and adolescents in the Lower Silesia Region in Poland in 2009.Materials and methods641 throat swabs obtained from 326 girls and 315 boys, aged 11 months to 18 years, were assessed diagnostically. The patients enrolled into the study were treated on an outpatient basis due to various, non-specific respiratory ailments. The most common presenting clinical symptom of a respiratory problem was dry cough, which occurred in 295 studied subjects, followed by runny nose and cough with discharge in 176 subjects, and other minor symptoms in 35 subjects. The assessment was conducted by an indirect immunofluorescence antibody (IFA) Chlamydia Testing kit (Cellabs, Sydney, Australia).ResultsOverall, Chlamydia infection was detected in the respiratory tract in 43.1% (276/641) of the children, with no clear gender differences. Of the 295 subjects presenting with dry cough, 122 (41.4%) had positive tests for Chlamydia. Of the 176 subjects with runny nose and cough and the 35 subjects with other symptoms, 83 (47.2%) and 8 (22.9%) had positive tests for Chlamydia, respectively. In the asymptomatic children who had direct contact with a Chlamydia infected person, there were 29.6% (8/27) positively tested cases, whereas in the children presenting symptoms, the percentage of positive tests was 48.3% (29/60).ConclusionsIn children living in the Lower Silesia Region of Poland, there is a substantial ~50% rate of Chlamydia infection, transmitted via airborne droplets. The finding of Chlamydia infection should be the signal for testing other subjects from the childs closest environment.

Diagnosing Chlamydia Trachomatis Urinary Tract Infections--Preliminary Report.

BACKGROUND Chlamydia trachomatis is mentioned among the etiologic factors for urinary tract infections. Chlamydias are parasites inside a cell. A very significant problem of C. trachomatis infections is their asymptomatic character. The most frequent infections caused by these bacteria are inflammations of the urethra and bladder; of the vagina, cervix, vaginal cavity and adnexa in women; and of the epididymis, testicles and prostate in men. In the diagnosis of C. trachomatis infections, the following methods are used: immunofluorescent techniques, immunoenzymatic assays, serological examinations and genetic techniques (for example PCR). OBJECTIVES The aim of the study was to detect C. trachomatis among patients with symptoms of non-gonorrheal urethritis using diagnostic serologic methods and direct immunofluorescence. The purpose was to assess the connection between the incidence of urinary tract infections caused by C. trachomatis and symptoms that patients report as well as other data from interviews. MATERIAL AND METHODS Blood serum and urethral smears were taken from each of 57 patients. The ELISA method was used to mark specific IgG and IgGcHSP60 anti-chlamydia antibodies in the blood serum. In the urethral smear, antigens were marked using the direct immunofluorescence method. RESULTS Evidence for urinary tract infection caused by C. trachomatis was found in 15.79% of the examined patients using the immunofluorescence method. In the blood serum, positive results for IgGcHSP60 were obtained in 17.54% of the patients and for IgG in 8.77%. CONCLUSIONS The studies carried out so far suggest that C. trachomatis has a significant role in the etiology of urethritis in adults and children. Other serological tests should be conducted in all the patients in order to study the immune responses in infected individuals and to confirm C. trachomatis infection using genetic methods such as PCR.

Detection of Chlamydophila Pneumoniae and Typical Bacteria in Patients with Chronic Cough

The aim of research was to analyze the results of microbiological tests for typical and atypical bacteria in patients with symptoms of chronic cough. A total of 214 outpatients aged from 2 to 94 years (110 women, 64 men, and 40 children) with chronic cough were studied. Four hundred twenty eight throat swabs were examined for atypical bacteria antigen (Chlamydophila pneumoniae) (n = 214) and typical pathogens (n = 214). Chl. pneumoniae detection was performed using indirect immunofluorescence test. Classical microbiological culture was used for typical bacteria detection. Chl. pneumoniae antigen was detected in 55/214 (26.0 %) patients with chronic cough (in 31 (28.2 %) women, 14 (21.9 %) men, and 10 (25.0 %) children). Positive culture for typical pathogens was observed in 30 (27.3 %) women, 22 (34.4 %) men, and 21 (52.5 %) children. Simultaneous occurrence of Chl. pneumoniae and typical pathogens (Staphylococcus aureus strain MSSA, Streptococcus pyogenes, or Moraxella catarrhalis) was found in 16 (7.5 %) patients. The findings show that in patients with chronic cough Chl. pneumoniae infection, although less than that with typical pathogens, is rather frequent. Further, the performance of test for Chl. pneumoniae in throat swabs from patients with chronic cough is good and provides an efficient way to diagnose the infection and implement appropriate therapy.

Microbiological spectrum and susceptibility pattern of clinical isolates from the neonatal unit in a single medical center.

BACKGROUND Infections are a frequent and significant cause of morbidity and mortality in neonatal units. The bacterial pathogens and their susceptibility patterns should be monitored in hospital settings. The aim of the study was to describe the distribution of the bacterial agents and their antibiotic resistant and susceptibility patterns in the Special Neonatal Care Unit (SNCU). MATERIAL AND METHODS A retrospective analysis of results of microbiologically tested samples (blood, cerebrospinal fluid, urine, stool, eye excretions, external ear swabs, nasopharyngeal swabs and skin swabs) taken from newborns hospitalized in one SNCU in Warsaw (Poland) was conducted. The period analyzed was from July 1st, 2010 to December 31st, 2010. RESULTS A total of 838 cultured samples were collected in the period analyzed. Three hundred seventy three of them (44.5%) were positive. The majority of the cultured microorganisms were classified as colonization: 338/373 (91%) strains. Gram negative bacteria were predominant colonizing flora: 227/338 (67%) strains. Gram positive bacteria were predominant causative agents in newborns with infections: 26/35 (74%) strains. 57.9% of Escherichia coli isolates were resistant to amoxicillin and ampicillin. 100% of Klebsiella pneumoniae were resistant to amikacin and netilmicin. Staphylococcus aureus methicillin resistant strains were cultured in 2.7% of cases. CONCLUSIONS Gram negative species continue to be predominant agents of neonatal colonizing flora while gram positive bacteria remain important causative agents for symptomatic infections. Continuous monitoring of bacterial flora and its antibiotic susceptibility pattern is necessary to provide a successful antibiotic policy. Current results may be used for future national and international comparison.

Detection of Salmonella in Foods Using a Reference PN-ISO Method and an Alternative Method Based on Loop-mediated Isothermal Amplification Coupled with Bioluminescence

BACKGROUND Salmonella, one of the primary indicators of food safety, is a common cause of food poisoning of an epidemic nature around the world. These microorganisms can colonize the gastrointestinal tract of both people and animals, and next contaminate not only eggs, milk, meat and dairy products, but also vegetables, fruit, grains and even spices. OBJECTIVES The aim of this study was to analyze the frequency of detection of Salmonella spp. in food samples using a reference PN-ISO method and an alternative method based on loop-mediated isothermal amplification (LAMP) coupled with bioluminescence. MATERIAL AND METHODS Food samples were obtained in cooperation with the State Sanitary-Epidemiological Station in Wrocław. Dairy products, meat, fish, pastry and confectionery, vegetables, herbs and spices were analyzed. The food samples were examined using a standard culturing method according to PN-ISO 6579:2003 for Salmonella spp. and an alternative method based on the isothermal amplification and bioluminescence phenomenon using the 3M MDS device. RESULTS In 399 tested food samples in 8 materials, using both the reference and the alternative LAMP-based method, the presence of salmonella was confirmed. The results obtained show the 100% sensitivity, specificity and accuracy of the presented alternative, LAMP-based technique compared to the reference PN-ISO method. CONCLUSIONS The alternative method using isothermal amplification and bioluminescence makes it possible to detect Salmonella in foods in a much shorter time than the referential culturing method.

PCR diagnostics of Chlamydia trachomatis in asymptomatic infection by women

OBJECTIVES Chlamydial infection is often asymptomatic. The lack of symptoms may result in the infection developing into a chronic. Chlamydial infections of the genitourinary system in women can lead to serious complications like PID, fallopian tubes infertility, ectopic pregnancy, and chronic pelvic pain. An infection of the genitourinary system does not cause any lasting immune resistance and does not protect against re-infection. The aim of this research was to conduct tests for Chlamydia trachomatis on healthy women without any genital system symptoms and to estimate the frequency of asymptomatic infections. MATERIAL AND METHODS During preventive examinations a cervical smear was obtained from the patients n = 100. The aver-age age of the patients was 24.86 ± 3.15. The swabs were sampled by gynecologists. During the examinations Geneproof PathogenFree DNA isolation Kit and GeneProof Chlamydia trachomatis PCR kit which detects 16S rRNA conservative coding sequence, conservative region of cryptic plasmid DNA, including deletion mutation in cryptic plasmid (Swedish variant). RESULTS Swabs were sampled from 100 women aged 18-32 who had no symptoms of chlamydial genitourinary system infection. Within the study group 4% of women received a positive result, i.e. 4/100. CONCLUSIONS The study confirmed asymptotic infection in 4% of women. In own research it was not possible to confirm cor-relation between the presence of Chlamydia trachomatis and the number of partners or the number of sexual intercourses.

The use of direct immunofluorescenceand nested polymerase chain reactionin diagnosing perinatal infections of Chlamydia trachomatis

BACKGROUND Chlamydia infection is the most frequently reported infectious, sexually transmitted disease (STD). Generally, Chlamydia trachomatis (C. trachomatis) infection of neonates is the result of perinatal exposure to the mothers infected cervix. OBJECTIVES The aim of the study was to estimate the frequency of infection caused by C. trachomatis in newborn infants. In this study of C. trachomatis perinatal infection, 107 infants born at the Wroclaw Medical University Clinic of Gynecology and Obstetrics (Poland) were tested to investigate whether C. trachomatis was present in swabs taken from the eyes and throats of children. MATERIAL AND METHODS Each specimen was tested using the direct immunofluorescence test (DIF) and the nested polymerase chain reaction (PCR) method. RESULTS The presence of C. trachomatis, irrespective of the origin of the swabs (ocular or from the throat), was confirmed in 62 newborns, amounting to 57.6% of the tested population. The occurrence of C. trachomatis in ocular swabs was confirmed in 35 children (32.7%). In the material taken from the throat, there were 48 newborns considered chlamydia-positive (44.9%). In the specimens taken from both the ocular and pharyngeal locations, there was a higher proportion of positive results while using the nested-PCR method in comparison to the DIF test. The specificity of the DIF method with reference to the nested-PCR was 67.9% for ocular swabs. In the material taken from the throat, the sensitivity of the DIF method with reference to the nested-PCR was 75.0% and the specificity was 62.1%. CONCLUSIONS Because of the importance of perinatal infections, it is recommended to perform a study among a larger group of patients in order to gain more reliable results.

Pathogens Causing Upper Respiratory Tract Infections in Outpatients

The aim of the present study was to determine the results of typical and atypical bacteria microbiological tests in patients with symptoms of chronic cough. We investigated 230 outpatients aged from 1 to 83 years (112 female, 72 male, and 46 children) who were free of any respiratory tract infection at the time of study. The material for the investigation consisted of pharyngeal swabs. Two hundred and thirty pharyngeal swabs were examined for Chlamydia pneumoniae antigen and for typical pathogens each. Chlamydia pneumoniae antigen was detected using an indirect immunofluorescence test and classical microbiological culture was used for the detection of typical bacteria. The antigen was found in 44/230 (19.1 %) patients with chronic cough (23 women, 13 men, and 8 children). Positive culture for typical pathogens was observed in 65/230 (28.3 %) patients (37 women, 14 men, and 14 children). Simultaneous occurrence of Chlamydia pneumoniae and typical pathogens such as Staphylococcus aureus, Streptococcus pyogenes, Moraxella catarrhalis, and Haemophilus influenzae, was observed in 11/230 (4.8 %) patients. The results show that in patients with chronic cough Chlamydia pneumoniae is detected less frequently than the typical pathogens are. A search for atypical bacteria in patients with chronic cough is needed to be able to conduct effective and sufficiently long therapy.

Detection of Chlamydophila Pneumoniae Antigens in Patients with Chronic Cough

The aim of this study was to analyze the rate of Chlamydophila pneumoniae infection in adults with symptoms of chronic cough. The study was conducted in 83 hospitalized patients aged 18-67 suffering of chronic cough. The control group consisted of 20 healthy age-matched subjects without any respiratory symptoms. Bacteriological tests on the presence of Chlamydophila pneumoniae antigen were performed in throat swabs by indirect immunofluorescence technique using monoclonal antibodies labeled with fluorescein isothiocyanate. The rate of Chlamydophila infected patients was examined in relation to age and gender. The Chlamydophila pneumoniae antigen was detected in 15 (18 %) out of the 83 patients; about equally in both genders. Furthermore, we found that the patients aged 28-37 constituted the age group that most frequently tested positive for Chlamydophila pneumoniae. Unraveling the presence of Chlamydia infection in chronic cough patients enables to introduce a timely implementation of effective therapy and thus can prevent distant complications.

Incidence of Chlamydophila Pneumoniae Infection in Children During 2007–2010

Chlamydophila pneumoniae is the etiological agent of pharyngitis, bronchitis, and pneumonia. The aim of the study was to evaluate the frequency of chlamydial respiratory infections in children in the Lower Silesia Region in Poland in 2007-2010. There were 2,733 throat swabs examined, obtained from hospitalized patients aged from 20 months to 18 years with various clinical symptoms such as dry cough, productive cough, and from asymptomatic ambulatory patients. An indirect immunofluorescence technique, based on monoclonal antibodies labeled with fluorescein isothiocyanate, was used for detection of Chl. pneumoniae antigen. Overall, there were 1,114, 503, 641, and 475 patients studied in the consecutive 2007, 2008, 2009, and 2010 years. There clearly were fewer patients each next year submitted for Chl. pneumoniae detection procedure, which stemmed from the declining severity of respiratory infections noted in children and thus less demanding diagnostic workup commissioned by physicians. The percentage of results positive for Chl. pneumoniae antigen amounted to 53.3, 41.6, 43.1, and 36.4 % in the consecutive years, respectively. Detection of chlamydial infections had thus a decreasing tendency in the period studied. There also were decreases in Chl. pneumoniae detection rate in cases stratified due to the presenting symptom: dry cough, productive cough, or in asymptomatic cases. A milder course of respiratory infections resulting in a decreased number of children examined for Chl. pneumoniae antigen in consecutive years, makes it difficult to draw definite conclusions on the factual incidence rate. Nevertheless, we believe we have shown, from the clinical standpoint, a dropping rate of Chl. pneumoniae detection in children with respiratory infections.