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Korzeniewski K.,Institute of Tropical Medicine | Nitsch-Osuch A.,Medical University of Warsaw | Konarski M.,Military Institute of Medicine | Guzek A.,Military Institute of Medicine | And 2 more authors.
Advances in Experimental Medicine and Biology | Year: 2013

Respiratory diseases are one of the most common health problems among service personnel assigned to contemporary military operations which are conducted in areas characterized by adverse environmental conditions. This article reviews the results of the studies into the prevalence of acute respiratory tract diseases among soldiers of the Polish Military Contingent deployed to Iraq and Afghanistan. The article also discusses a number of factors which increase the prevalence of diseases diagnosed in the population of soldiers on a military mission in different climatic and sanitary conditions. Retrospective analysis was based on medical records of Polish troops treated on an outpatient basis in Iraq in 2003-2004 (n = 871) and in Afghanistan in 2003-2005 (n = 400), 2009 (n = 2,300), and 2010 (n = 2,500). The intensity rates were calculated and were then used to calculate the prevalence of diseases per 100 persons in a given population of the military personnel. We found that acute respiratory tract diseases were one of the most common health problems treated in outpatient medical facilities in all four study populations. The incidence rate was 45.6 cases in Iraq in 2003-2004, and in Afghanistan it amounted to 61.8 in 2003-2005, 45.3 in 2009, and 54.8-100 persons in 2010. In conclusion, the prevalence of respiratory diseases was closely related to the environmental factors, such as sand and dust storms, extreme temperature changes, unsatisfactory sanitary conditions, and common disregard of basic principles concerning disease prevention. © 2013 Springer Science+Business Media Dordrecht.


Guzek A.,Military Institute of Medicine | Korzeniewski K.,Institute of Tropical Medicine | Nitsch-Osuch A.,Medical University of Warsaw | Rybicki Z.,Military Institute of Medicine | Prokop E.,St Family Maternity Hospital
Advances in Experimental Medicine and Biology | Year: 2013

Acinetobacter baumannii and Pseudomonas aeruginosa pathogens are the most common causes of fatal pneumonia among patients treated in Intensive Care Units (ICU). Carbapenems remain a group of antibiotics characterized by the highest effectiveness in treatment of heavy infections of the lower respiratory tract. This study compared in vitro sensitivity of A. baumannii and P. aeruginosa to three carbapenems: imipenem, meropenem and doripenem. The material was collected from 71 patients treated in the ICU from April 2009 to January 2010. Bronchial tree was the predominant source of samples. Fifty-four strains of A. baumannii and 17 strains of P. aeruginosa were analyzed. Sensitivity to carbapenems was interpreted in line with Clinical and Laboratory Standard Institute (CLSI) and European Committee for Antimicrobial Susceptibility Testing (EUCAST) criteria (imipenem and meropenem) or in compliance with the Food and Drug Administration (FDA) and CLSI guidelines (doripenem). We found that A. baumannii was significantly more often sensitive to imipenem than to doripenem and meropenem, but only according to the CLSI and FDA and not EUCAST criteria. The sensitivity of P. aeruginosa was higher to imipenem than to doripenem and meropenem, according to both CLSI and EUCAST criteria (64.7 %). We conclude that the EUCAST criteria demonstrate a higher rigor than those of CLSI and FDA in the determination of carbapenems sensitivity. Imipenem appears more effective than doripenem and meropenem in treatment of A. baumannii and P. aeruginosa infections. © 2013 Springer Science+Business Media Dordrecht.


Guzek A.,Military Institute of Medicine | Korzeniewski K.,Institute of Tropical Medicine | Nitsch-Osuch A.,Medical University of Warsaw | Rybicki Z.,Military Institute of Medicine | Prokop E.,St Family Maternity Hospital
Advances in Experimental Medicine and Biology | Year: 2013

Hospital-acquired infections (HAIs) pose a worldwide problem. They primarily concern intensive care, hematology-oncology, and surgical units. Coagulase-positive and coagulase-negative Staphylococci, especially their subgroups possessing the ability to develop resistance to methicillin, and Enterococci have a particular role in the etiology of HAIs. The aim of this study was to determine the therapeutic minimal inhibitory concentration (MIC) values for vancomycin and teicoplanin, two of the most commonly administered antibiotics in the treatment of infections caused by Staphylococci resistant to methicillin, and infections caused by Enterococci. The material analyzed included 200 bacterial strains collected from patients treated in the Intensive Care Unit, the Musculoskeletal Infections Unit, and Surgical Clinics of the Military Institute of Medicine in Warsaw, Poland. The study was conducted in accord with the European Committee for Antimicrobial Susceptibility Testing (EUCAST) criteria by means of the Etest® gradient strips. We demonstrate a full susceptibility of Staphylococci MSSA (methicillin susceptible Staphylococcus aureus), Staphylococci MRSA (methicillin resistant Staphylococcus aureus), and Enterococci to both antibiotics. Coagulase-negative Staphylococci had a higher sensitivity to vancomycin. Teicoplanin had a lower MIC than vancomycin against the analyzed strains of Enterococci. As regards the coagulase-negative Staphylococci, vancomycin had a lower MIC than teicoplanin. In conclusion, the study confirmed current recommendations on the use of vancomycin and teicoplanin in the treatment of infections caused by gram-positive bacteria, emphasizing the need for the determination of MIC values. © 2013 Springer Science+Business Media Dordrecht.


Konarski M.,Military Institute of Medicine | Nitsch-Osuch A.,Medical University of Warsaw | Korzeniewski K.,Institute of Tropical Medicine | Prokop E.,St Family Maternity Hospital
Advances in Experimental Medicine and Biology | Year: 2013

Correct lung function is indispensible to perform work underwater. Thus, spirometric tests of lung function remain an important element in the process of selecting candidates for professional diving. Studies conducted in the population of divers identified the phenomenon called 'large lungs', which is often associated with spirometric indices characteristic of obstructive impairment of lung function. This study investigated selected parameters of lung function in the population of divers and candidates for professional divers. Fifty two male subjects were examined as part of the selection process. Basic spirometric tests: forced expiratory volume in 1 s (FEV1; dm3), forced vital capacity (FVC; dm3), forced expiratory flow in the range 25-75 % of FVC (FEF25-75; dm3 s-1), and FEV1/FVC (%) were compared with compared with the predicted reference values estimated by the European Coal and Steel Community. The results demonstrate differences in FVC and FEF25-75 in divers, which may correspond to functional hyperinflation. The effects of 'large lungs' observed in divers, if persisting for an extended period of time, may lead to lung ventilation impairment of the obstructive type. © 2013 Springer Science+Business Media Dordrecht.


Korzeniewski K.,Institute of Tropical Medicine | Nitsch-Osuch A.,Medical University of Warsaw | Nitsch-Osuch A.,St Family Maternity Hospital | Chcialowski A.,Military Institute of Medicine | Korsak J.,Military Institute of Medicine
Respiratory Physiology and Neurobiology | Year: 2013

Combat operations in contemporary theaters of war, as well as combat training, are carried out in all parts of the world, typically in a harsh environment. Specific environmental conditions, such as heat, cold, high-altitudes, desert climates, as well as chemical and biological pollution of both the atmosphere and soil, together with over-exertion, food restrictions, sleep deprivation, and psychological stress can all result in changes in the immune system and the occurrence of associated diseases. Respiratory diseases are one of the most common health problems among military personnel participating in combat training or deployed to operations in areas characterized by difficult climatic and sanitary conditions. They are, therefore, one of the main reasons for military personnel requiring ambulant and hospital treatment. The aim of the study was to discuss the influence of environmental factors and the conditions in which active duty is performed on changes in the immune system and the occurrence of respiratory tract diseases in a military environment. © 2013 Elsevier B.V.


Korzeniewski K.,Institute of Tropical Medicine | Skoczynska A.,Polish National Medicines Institute | Guzek A.,Military Institute of Medicine | Konior M.,Institute of Tropical Medicine | And 4 more authors.
Advances in Experimental Medicine and Biology | Year: 2015

Neisseria meningitidis, etiological factor of invasive meningococcal disease, is a human commensal that colonizes the nasopharynx. Colonization is usually asymptomatic, but it is a prerequisite for disease. Asymptomatic carriers are the major source of infection. In the present study, a survey of N. meningitidis carriage was conducted between January and March 2013 in a military unit in Poland. Single-time throat culture samples were collected from professional 559 soldiers (302 unvaccinated vs. 257 vaccinated individuals with the quadrivalent conjugate vaccine AC YW-135). Bacterial identification was performed with classic microbiological methods (culture, incubation, identification). Non-culture method (PCR) was used for confirmation of detected strains of N. meningitidis and determination of serogroups. We found 29 carriers in the group of unvaccinated soldiers (9.6 % of examined individuals) whereas among vaccinated soldiers only 3 persons were carriers of N. meningitidis (1.2 %). The most frequently identified serogroups among the carriers serving in the same military facility were serogroup B (28 %), followed by Y (25 %), and C (22 %). In conclusion, the initiation of mass vaccination with the quadrivalent conjugate vaccine ACYW-135 in the military environment seems an effective method of suppressing N. meningitidis carriage. © Springer International Publishing Switzerland 2014.


Guzek A.,Military Institute of Medicine | Rybicki Z.,Military Institute of Medicine | Korzeniewski K.,Institute of Tropical Medicine | Mackiewicz K.,Military Institute of Medicine | And 3 more authors.
Advances in Experimental Medicine and Biology | Year: 2014

Lower respiratory tract infections (LRTI) account for 20–30% of all hospital-acquired contagions. They are characterized by high mortality of hospitalized patients. The most serious form of LRTI is pneumonia, and the most common etiological factors in such cases are bacteria. The article gives the analysis of bacterial flora samples obtained from lower respiratory tract of hospitalized patients. In vitro susceptibility of pathogens to selected antibiotics has also been assessed. We carried out a retrospective analysis of 1,171 bacterial strains isolated from 1,171 patients treated in clinics of the Military Institute of Medicine in Warsaw, Poland. In most cases the samples were collected from an endotracheal or tracheostomic tube (71.5 %) and from bronchoalveolar lavage (21.7 %). The most commonly isolated pathogens included Acinetobacter baumannii (35.8 %), Staphylococcus aureus (27.6 %), Klebsiella pneumonia (19.4 %), and Pseudomonas aeruginosa (16.2 %). Multidrug-resistant gram-negative bacteria exhibited 100 % susceptibility to colistin only. Klebsiella pneumoniae ESBL+ and Acinetobacter baumannii were most susceptible to carbapenems, while Pseudomonas aeruginosa strains to ceftazidime. Methicillin-resistant Staphylococcus aureus were 100 % susceptible to vancomycin, linezolid, and tigecycline. In conclusion, identifying the etiological factors causing infections of the lower respiratory tract and determining their drug-susceptibility is of key importance in empirical treatment. © Springer International Publishing Switzerland 2014.

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