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

The benefits resulting from introduction of microbiological screening standard on the day of admitting a patient... 13colonization may occur also in the throat, armpit,groins and anus [2].In a hospital, Methicillin-resistant Staphylococcusaureus is of particular importance. According to dataobtained from healthcare policy program of theMinistry of Health, realized by the Center ofMicrobiology and Infection Diseases of the NationalInstitute of Public Health, the percentage of MRSA inPolish hospitals ammounts to 10-13% of allStaphylococcus aureus strains [1].The most common source of MRSA infection inhospital conditions is an infected patient and medicalpersonnel (especially when inflammation process isgoing on, for instance pus formation on skin) and thereservoir is created on surfaces, apparatus, furniture orbedding. The main problem connected withtransmission of MRSA strains comes from hands ofmedical personnel. The percentage of MRSA strainscarriers amounts to 1-9% of population [6].As a part of infection prophylaxis it is essential toperform routine examination towards MRSA straincarriers among admitted patients and periodicalexamination of medical personnel [7, 8, 9, 10].In order to prevent cruciform transmission ofMRSA strains, up to the moment of obtaining theresult of microbiological examination, it isrecommended to aply contact isolation of a patient. If apresence of golden staph strain (resistant tomethiciline) is detected in the material coming fromthe patients, there is an obligation for a hospital tointroduce very restrictive rules in order to localize theinfection and prevent proliferation of dangerousstrains [11].TESTING FOR HEPATITIS BHepatitis B is an infection disease caused byhepatitis B virus (HBV) coming from aHepadnaviridae family [12]. In majority of cases thereare no symptoms but in case of 5-10% of sick personsthere is no HBV elimination and the disease transformsinto chronic state which in turn may lead to cirrhosisand primary liver cancer.In Poland spreading of HBV infecion is causedmainly by medical operations followed byinfridgement of tissue continuity. About 60% of HBVinfections take place in Health Service institutions. Themain cause of infection is lack of habits to obey therules of workplace safety by medical personnel, lack ofhabits to wash hands, incorrect dealing with medicalequipment, ineffective process of sterilization andinadequate hospital hygiene [12].“Each year there is a growing number ofcompensation cases against healthcare institutionscoming into Polish courts. The majority of them (above70%) concern claims for hospital infection caused byHepatitis B and C virus” – Prof. M. Nestorowicz.The statute of 6 th September 2001 (Dz.U. [Journalof Laws] No. 126, Item 1384) defines the meaning ofhospital’s infection as “an infection which wasacquired during patient’s presence in healthcareinstitution (..) and the one which was not in a state ofincubation in time of admitting a patient to thatinstitution”Infection is a typical reason for compensationclaims in civil process. Current court practice in casesconcerned with infection was created on the basis ofalleged fault of healthcare institution as for infectioninitiation (provisions of Art. 231 of Code of CivilProcedure. It means that the burden of proving thedetriment is transmitted from a patient (who normallyhad to prove it) to a defendant (hospital or a doctor).The last ones have to prove with a large probabilitylevel that the infection came into being in other placeand for different reason than their action or lack of it[13].The HBV tests performed while admitting a patientto a hospital may serve as a basis to refute allegation ofreal fault of which the hospital is responsible for incase of infection arising [13].TESTING FOR TREPONEMA PALLIDUMSyphilis is a widespread sexually transmitteddisease caused by the Treponema pallidum spirochete.In some countries of Western Europe, a number ofinfections has a growing tendency. In Poland in theyears between 1969 and 1999 an incidence rate forprimary siphilis decreased from 251,8 to 1,3 per 100thousand thanks to introduction of preventive program[14]. However, there is a serious threat due to veryhigh incidence rate in the neighbouring countries fromthe east, irregularities in healthcare functioning afterthe reform and lack of resources for prevention andhealth education. The highest incidence rate has provento be in people aged between 19 and 25 [14].In 2003 there was observed a series of negativephenomena; drastically low – in comparison with thenineties – number of serological examinations towardssyphilis; very low index of immediate treatment so-