Vaccinations against COVID-19 in the opinion of medical services workers and the general social opinion

Introduction This study was devoted to getting to know the public opinion, including representatives of medical professions, regarding the presented views on vaccination against Covid-19, allowing to determine the most important issues related to the lack of acceptance of this preparation. Aim The aim of this study was to find out the social opinion regarding vaccination against Covid-19 (including the aspect of vaccination obligation, incidence of adverse post-vaccination reactions, vaccination among children and pregnant women) as well as the reasons for the attitude towards the fact of accepting the vaccine or rejecting the possibility of being vaccinated. Material and methods The study was conducted in a group of 510 people - practicing the medical profession and not related to the health service, who were over 18 years old. The method of a diagnostic survey was used with the use of a proprietary questionnaire containing single and multiple choice questions, the survey was conducted on-line using a Google form in October 2022. Results In the study group, the vaccination rate was 62.2%, women and medical professionals were more likely to be vaccinated. The decision to be vaccinated was mainly based on the desire to protect themselves against the severe course of a possible illness - 30.4% of respondents and to protect themselves and others against Covid-19 - 26.5%. In the represented group, unvaccinated persons accounted for 37.8% respectively, they did not decide to vaccinate mainly because of the belief that they were not protected against the disease - 19.8% of respondents, perceiving COVID-19 as a seasonal infection - 19.0%, and fear of long-term complications - 18.6%. The decision to vaccinate was accompanied by i.a. feelings such as: slight fear (36.3%), fear/anxiety (10.4%), strong fear/anxiety (3.7%). The study group was also asked about adverse post-vaccination reactions, 25.1% of the surveyed experienced complications, most of them did not report adverse post-vaccination reactions, and the percentage of reported cases was 1.6%. The vast majority of respondents - 74.5% were in favor of the lack of obligation to vaccinate. Opinions expressed about the safety of vaccinations: rather yes - 24%, rather not - 22% and definitely not - 21%, a significant part had no opinion - 24.3%. Conclusions This study confirms the significant problem of skepticism towards Covid-19 vaccination, as well as the high percentage of people expressing opposition to the obligation to vaccinate and the perception of the media campaign as propaganda, which confirms the existence of a significant social division regarding the acceptance of vaccination. The perception of vaccine safety is related to the knowledge of adverse post-vaccination reactions, but the problem observed among respondents is the fact that the number of reported adverse reactions is negligible

The incidence of healthcare-associated infections, their clinical forms, and microbiological agents in intensive care units in southern Poland in a multicentre study from 2016 to 2019

Introduction. Healthcare-associated infections (HAIs) are a serious problem of modern medicine. Patients hospitalized in intensive care units (ICUs) develop HAI significantly more often than patients in other hospital units. Materials and Methods. Analysis involved HAIs from three ICUs in southern Poland. The study was conducted in 2016–2019 on the basis of methodology recommended by the Healthcare-Associated Infections Surveillance Network (HAI-Net) and European Centre for Disease Prevention and Control (ECDC). The objective was to analyse HAIs, their clinical forms, and microbiological agents. Results. The study included 3028 patients hospitalized for 26,558 person-days (pds) in ICU. A total of 540 HAIs were detected; incidence per 100 hospitalizations was 17.8%, incidence density per 1000 pds was 20.3. The mortality of patients with HAI was 16%, and in Clostridioidesdifficile infection (CDI), the mortality was 28%. The most common clinical form of HAI was bloodstream infection (BSI): 209 cases (incidence rate 6.9%), followed by pneumonia (PN): 131 (incidence rate 4.3%), and urinary tract infection (UTI): 110 cases (incidence rate 3.6%). The most frequently isolated bacteria were Klebsiella pneumoniae 16.4%, Acinetobacter baumannii 14.4%, Staphylococcus aureus 11.8%, and Escherichia coli 11.4%. Conclusions. A two-fold higher incidence rate of BSI was detected compared to the average incidence in European countries. BSI of unknown source (BSI-UNK) was predominant. K. pneumoniae and A. baumannii bacteria were the most often isolated microorganisms causing HAI. Infection control based on incidence rate for each type of infection is necessary in ICU to assess the epidemiological situation

Risk factors and preventable strategies of ventilator-associated pneumonia: the role of nursing care and epidemiological surveillance

Mechanically ventilated patients are at risk of several complications, including ventilator-associated pneumonia (VAP). VAP is the most common nosocomial infection in this group of hospitalized patients. As a nosocomial infection, it is an undesirable event and is associated with prolonged hospitalization, high costs, and high mortality. To minimize the incidence and provide safe care for mechanically ventilated patients, it is recommended that VAP prevention procedures be developed and implemented, which take into account the general principles of infection prevention such as hand hygiene, isolation, and personal protective equipment, as well as risk factors associated with the treatment, which include, among others, patient position, nutrition, oral hygiene, and tracheobronchial toilet. Knowledge of ventilator operation and decontamination of medical equipment are also of great importance in the prevention of VAP. Collaboration between the patient care staff and the and the infection control team is equally important. Effective VAP surveillance systems can significantly reduce the risk of its occurrence. The aim of this study is to present the issues of VAP with particular emphasis on risk factors for the disease, nursing care, and epidemiological surveillance on the basis of a literature review. The work is dedicated to both epidemiological nurses employed in infection control teams and nurses working in intensive care units, where patients requiring mechanical ventilation are hospitalized, as well as representatives of other professions (e.g. physiotherapists, nutritionists) taking care of patients hospitalized in intensive care units (ICUs)

Healthcare-acquired infection surveillance in neurosurgery patients, incidence and microbiology, five years of experience in two Polish units

Introduction: Patients in neurosurgical units are particularly susceptible to healthcare-associated infections (HAI) due to invasive interventions in the central nervous system. Materials and methods: The study was conducted between 2014 and 2019 in neurosurgery units in Poland. The aim of the study was to investigate the epidemiology and microbiology of HAIs and to assess the effectiveness of surveillance conducted in two hospital units. Both hospitals ran (since 2012) the unified prospective system, based on continuous surveillance of HAIs designed and recommended by the European Centre for Disease Prevention and Control (protocol version 4.3) in the Healthcare-Associated Infections Surveillance Network (HAI-Net). In study hospitals, HAIs were detected by the Infection Prevention Control Nurse (IPCN). The surveillance of healthcare infections in hospital A was based mainly on analysis of microbiological reports and telephone communication between the epidemiological nurse and the neurosurgery unit. HAI monitoring in hospital B was an outcome of daily personal communication between the infection prevention and control nurse and patients in the neurosurgery unit (HAI detection at the bedside) and assessment of their health status based on clinical symptoms presented by the patient, epidemiological definitions, microbiological and other diagnostic tests (e.g., imaging studies). In hospital A, HAI monitoring did not involve personal communication with the unit but was rather based on remote analysis of medical documentation found in the hospital database. Results: A total of 12,117 patients were hospitalized. There were 373 HAIs diagnosed, the general incidence rate was 3.1%. In hospital A, the incidence rate was 2.3%, and in hospital B: 4.8%. HAI types detected: pneumonia (PN) (n = 112, 0.9%), (urinary tract infection (UTI) (n = 108, 0.9%), surgical site infection (SSI) (n = 96, 0.8%), bloodstream infection (BSI) (n = 57, 0.5%), gastrointestinal system infection (GI) (n = 13, 0.1%), skin and soft tissue (SST) (n = 9, 0.1%). HAI with invasive devices: 44 ventilator-associated pneumonia (VAP) cases (45.9/1000 pds with ventilator); catheter-associated urinary tract infection (CA-UTI): 105 cases (2.7/1000 pds with catheter); central venous catheter (CVC-BSI): 18 cases (1.9/1000 pds with CVC). The greatest differences between studied units were in the incidence rate of PN (p < 0.001), UTI (p < 0.001), and SSI (p < 0.05). Conclusions: The way HAIs are diagnosed and qualified and the style of work of the infection control team may have a direct impact on the unit epidemiology with the application of epidemiological coefficients. Prospective surveillance run by the infection prevention and control nurse in hospital B could have been associated with better detection of infections expressed in morbidity, especially PN and UTI, and a lower risk of VAP. In hospital A, the lower incidence might have resulted from an inability to detect a UTI or BSI and less supervision of VAP. The present results require further profound research in this respect