Katarzyna Zycinska, M Cieplak, M Hadzik Blaszczyk, T Rusinowicz, Z Kur and K Wardyn
Medical University of Warsaw, Poland
Posters & Accepted Abstracts: Clin Microbiol
Bordetella Pertussis is a gram-negative aerobic coccobacillus causing contagious respiratory tract disease called the Whooping Cough. Its virulence factors consist of pertussis toxin (PT), filamentous haemagglutinin, fimbriae, Lipooligosaccharide (LOS) Adenylate Cyclase Toxin (ACT). The disease is causing a worldwide threat to public health despite high vaccination coverage. Retrospective analysis of 5 patients admitted to Internal Medicine Ward presented atypical and severe symptoms. Recognition was based on serological tests: serum concentration of specific antibodies against PT and/or sputum culture. We observed a wide spectrum of symptoms. From benign (sinus pain �?? 80%, headaches �?? 20%), throughout moderate (hemoptysis �?? 40%; chest pain 60%) to severe symptoms (cardiac arrhythmia - 40%; syncopes - 60 %). The course of the whooping cough in adults is frequently atypical, causing difficulty in diagnosis. It can cause life-threatening complications and exacerbation of concomitant chronic diseases. Most vaccination programmes cover only first few months of life, however booster doses should be considered in adults, especially those immunocompromised or with pneumological complications, but also healthcare workers, that are susceptible not only to acquire but also to spread the disease. Clostridium difficile infection due to pneumonia treatment - mortality risk model K Zycinska, M Chmielewska, B Lenartowicz, M Hadzik Blaszczyk, R Krupa, M Cieplak, Z Kur and K A Wardyn Medical University of Warsaw, Poland One of the most common gastrointestinal infection after antibiotic treatment of community as well as hospital acquired pneumonia is caused by an anaerobic spore Clostridium difficile, which is involved with a high mortality rate. The aim of this study is to assess the mortality model of Clostridium difficile infection (CDI) in patients treated for pneumonia. A retrospective analysis of 217 patients with CDI included 94 patients treated for pneumonia in the Internal Medicine Ward, Medical University of Warsaw was conducted. To create a mortality risk model in patients treated for pneumonia a logistic regression and a multivariate fractional polynomials (MFP) were performed. Patients' demographics, clinical features and laboratory values were taken under the statistical analysis. To estimate the influence of preceding infection, pneumonia severity scales were included in the study analysis. The analysis showed two statistically significant (p<0.05) and clinically relevant mortality models. The model with highest prediction strength, with the area under the receiver operating characteristic curve close to 1 (AUC = 0.97) included: CURB �?? 65 scale, intake of more than 1 antibiotic, serum creatinine and urea levels and altered mental status. Clostridium difficile infection is a common complication after antibiotic therapy. Its severity and mortality depends on several parameters making up for the mortality predicting model, which is crucial in the individual therapy choice.