medical and biological sciences - Collegium Medicum - Uniwersytet ...

The benefits resulting from introduction of microbiological screening standard on the day of admitting a patient... 15appear during the passage of an infant throughdelivery channel [20].The factors causing infection in mother’s womb areoverruning deliveries, infection of amniotic fluid andpremature fracture of fetal bladder. Delivery channelmay be a starting point of lethal sepsis for an infant[20].Streptococcus agalactiae is a basic etiologic factorof infections in neonatal period and its carrying invagina of healthy women amounts to 50-75% [22]. Thefact of colonization in pregnant woman is a key riskfactor of infant infection [22]. It is believed that amongthe etiologic factors of bacterimia and neonate sepsis,the second place after coagulase-negative staphylococciis assigned to streptococci. It was proved thatinfections spreading out in a hospital were in thosedepartments, where there was a high level of carryingamong women giving birth [22].Infections from Streptococcus agalactiae inneonates and infants were characterized as 2 distinctsyndromes. Early syndromes appeared in neonates upto 7 days of life and its symptoms are sepsis,pneumonia, seldom meningitis.Mortality in such cases is very high and can amountto 50 % [17,18, 22]. Subsequent syndrome occur inneonates and infants between 7 days and 3 months oflife. It is manifested first of all by meningitis. In orderto prevent infant infection essential meaning isascribed to perinatal chemoprophylaxis in femalecarriers [22].In pregnant women or after delivery Streptococcusagalactiae is responsible for infection of urinal tracts,fetal membrane infection, uterus infection, septicinfection, seldom meningitis [17].In Poland there are still no epidemiological data,which would allow to evaluate the problem’s scale andto make coordinated efforts in aid of introducing theaction procedures in case of perinatal infection causedby Streptococcus agalactiae [17].Streptococcus pyogenes is a cause of hospital infectionsmainly in obstetric and infant wards. The sourceof those microorganisms may be respiratory paths,alimentary tract or vagina in women (carrying). Thecarrying factor may amount to 15-20% [22].Streptococcus pyogenes as a cause of septic infectionin parturients (so called postnatal fever) wasknown as early as in the 20th century. It may alsocause an infection in neonates.Those bacteria predominantly infect a stump ofumbilical cord and may be carried by the hands ofnursing personnel [22, 21].The decision of the hospital, which concerns performingtests for Streptococcus pyogenes in the patientsof obstetrical ward was caused among otherthings by the level of carrying and mainly by virulenceof those microorganisms, especially in the context ofknown septic infection incidents of such etiology followedby lethal effect.CONCLUSIONSA meticulous realization of all the activity encompassedby the standard of screening leads to:1. Identification of the infection source and introductionof antibiotic therapy, thanks to rapid microbiologicaldiagnosis .2. Introduction of active isolation of the patient.3. Cost reduction connected with antibiotic therapy.4. Cost reduction of treatment and consequentlyshortening of patient’s stay in hospital5. Improvement of the sanitary state of a hospital byreducing the number of hospital infections.6. Control of application of selected antibiotics, i.e.vancomycin, teicoplanin, imipenem7. Reduction of a hospital’s costs due to possiblecompensations resulting from infections and consequentlyan increase of insurance rates.REFERENCES1. Ozorowski T.: Postępowanie w przypadku identyfikacjiGram-dodatnich drobnoustrojów alarmowychw środowisku szpitalnym, SHL, 2005, 1-2/27, 5-8.2. Fleischer M.: Nadzór mikrobiologiczny w świetle wymagańprawnych, Aktualności bio Merieux 2007, 41, 21-25.3. Dzierżanowska D. i wsp.: Lekooporne drobnoustrojew zakażeniach szpitalnych, Post. Mikrobiol. 2004,43/1,81-105.4. Kramer A. i wsp.: Jak długo patogeny szpitalne mogąprzetrwać na powierzchniach nieożywionych? Przeglądsystematyczny, Zakażenia 2007, 7/4, 16-24.5. Brońska K.: W jaki sposób dochodzi do wprowadzeniaMRSA do szpitala i jego transmisji, Informator PolskiegoStowarzyszenia Pielęgniarek Epidemiologicznych2006, 2/25, 21-23.6. Młynarczyk A. i wsp.: Metycylinooporne gronkowcezłociste, molekularne typowanie szczepów MRSA wyhodowanychod studentów Akademii Medycznej w Warszawiew latach 1999-2003, Zakażenia 2003,4,75-80.7. Hartmann B. i wsp.: Computer keyboard and mouse asa reservoir of patogens in an intensive care unit, J ClinMonit 2004, 18,7.