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ß-hemolytic, pyogenic Streptococci are classified according to type of major surface antigen into A (Streptococcus pyogenes), B (Streptococcus agalactiae), C (multiple species including Streptococcus dysgalactiae) and G (multiple species including Streptococcus canis) Lancefield groups. Group A Streptococcus causes each year hundreds of thousands deaths globally as a result of infections and post-infectional sequelae. An increasing number of severe, invasive infections is caused by selected, specialized pathogenic clones. Within the last 50 years, an increasing number of human infections caused by groups B, C and G Streptococcus (GBS, GCS, GGS) has been observed worldwide. GBS was first identified as animal pathogen but the spectrum of diseases caused by GBS quickly shifted to human infections. Groups C and G Streptococcus are still regarded mostly as animal pathogens, however, an increased number of severe infections caused by these groups is observed. The increasing number of human infections caused worldwide by GCS/GGS can be a sign of similar development from animal to human pathogen as observed in case of GBS and this group will gain much more clinical interest in the future.The situation in Poland regarding invasive infections caused by pyogenic streptococci is underestimated.
Antimicrobial resistance has been one of the biggest global current issues in medicine and public health. Overuse and imprudent use of antimicrobial agents are recognized as one of the leading causes of antibiotic resistance. The aim of this study was to analyze the attitudesof Polish physicians practicing at the community level towards antibiotics and antimicrobial resistance. The majority of physicians taking part in the survey believed that Polish people overuse antibiotics (98%). Most physicians (91%) considered that antimicrobial resistance is a major problem at present. The majority of physicians indicated the reasons for prescribing the antibiotic are related to health factors, such as optimal recovery (best effectiveness, least side effects) (80%), latest therapeutic guidelines (70%) and microbiological/epidemiological factors (63%). Knowledge of the National Recommendations for the management of Community-Acquired Respiratory Tract Infections 2010(NR-CA-RTI) developed within National Programme for Protection of Antibiotics was declared by 84% of respondents. Among those who are aware of the NR-CA-RTI, the majority follow them in their daily practice (91%). Among physicians, 62% are not familiar with the Centor/McIsaac scores used to differentiate bacterial and viral infections in patients presenting with a sore throat. Among physicians familiar with the scores, 90% use them in their daily practice. Rapid microbiological detection methods for Group A beta-hemolytic streptococcal pharyngitis are used only by 20% of respondents. Almost all of physicians declared readiness to use these tests. Main sources of information on antibiotics prescribing originate from Polish medical journals, scientific conferences organized by medical societies, pharmaceutical companies.
Enterococcus faecalis represents recently an important etiological agent of health care-associated infections (HAIs) and there is a need for evaluation and comparison of typing methods available for this microorganism. We tested multilocus VNTR (variable-number tandem repeats) analysis (MLVA) on a well-characterized collection of 153 clinical isolates of E. faecalis, corresponding to 52 multilocus sequence types and 67 pulsed-field gel electrophoresis (PFGE) profiles. MLVA showed high discriminatory power, discerning 111 different types (diversity index equal 98.9%). The concordance MLVA/MLST and MLVA/PFGE was 0.95 and 0.74, respectively. High discriminatory power of MLVA indicates its utility for local epidemiology such as outbreak investigation, and for differentiation of clones defined by other methods.
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