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Anorexia nervosa (AN) is the third most common disorder, after obesity and asthma, in the population of adolescents between 13-18 years of age. Food intake reduction is associated with whole body dysfunction, affecting its physical, psychological and social spheres. As a result of starvation, dysfunction develops in virtually all systems and organs. However, most frequently patients with AN complain of digestive symptoms, such as a feeling of fullness after meals, pain in the upper abdomen, dysphagia, nausea, bloating and constipation. They can have mild functional character, but may also reflect serious complications, including diseases requiring urgent surgical intervention. In addition, gastric complaints may hinder nutritional management of AN. Care of AN patients requires cooperation of many specialists in the field of psychiatry, psychology, paediatrics, internal medicine and nutrition. However, it is often difficult to organize such a team. Therefore, we decided to approach the issues of gastrointestinal symptoms and complications in the course of AN, and the rules of nutritional therapy.

Introduction: The prevalence of food allergy among children is high and constantly increasing, especially in urban environments. The aim of the study was to assess the prevalence of food hypersensitivity among children living in Opole., Material and Methods: The study included 450 children (224 girls and 216 boys), aged 7-10 years from elementary schools in Opole. A survey was conducted on the basis of the EuroPrevall international programme questionnaire and a self-designed questionnaire for collecting information. Data were analyzed with the Statistica 8 software package. The level of significance for all analyses was p < 0.05., Results: The questionnaire was completed by the parents of 440 (98%) children. 89% (n = 392) of the parents agreed to being contacted again. Adverse reactions following food consumption were reported in 205 children (46.05%), including 93 children (45.36%) with two to four reactions a month. The most common symptoms were as follows: rash (28.29%), diarrhoea (26.34%). The symptoms occurred after the consumption of cow's milk (35.12%), hen eggs (12.19%), strawberries (8.78%), dairy products (5.36%), nuts (5.36%), chocolate (4.87%), and cocoa (4.87%)., Conclusion: The study revealed a high reporting of food hypersensitivity among children in Opole.

Unlabelled: Irritable bowel syndrome (IBS) is one of the most common reason for gastroenterology consultations. The diverse in symptomatology of the disease comes from its rich etiopathogenesis. Recently studies talk about infectious etiology of IBS and because of that it is necessary to expand its diagnostics by small intestinal bacterial overgrowth (SIBO) test. The aim of this study was to evaluate the prevalence of small intestinal bacterial overgrowth in patients with constipation (IBS-C) and diarrhea (IBS-D) irritable bowel syndrome with regard to nutrition., Materials and Methods: The study involved 46 subjects (33 women and 13 men) in average age of 44 years, which were divided into two groups: diarrhea and constipation IBS. All patients underwent hydrogen breath test studying bacterial overgrowth in the small intestine. In addition, each person had fulfilled a feeding questionnaire., Statistical Analysis: Student's t-test, Pearson test., Results: It has been shown that there is no statistical significances between the prevalence of SIBO in form of diarrheal IBS and constipation IBS and gender. Average value of increments of hydrogen in breath during the test was higher in IBS-C in comparison with IBS-D, which was the highest in the intestine bacterial overgrowth in patients with IBS-C. STATISTICAL ANALYSIS showed that there is no relationship between the type and frequency of consumption of milk, meat, fruit and vegetables, sweets and coffee and the prevalence of SIBO in form of diarrhea and constipation IBS., Conclusions: The occurrence of constipation or diarrhea irritable bowel syndrome is not related to gender. SIBO is more common in patients with IBS-C than in IBS-D group. There is no relationship between the type of food consumed and the amount of SIBO in people with IBS. Type of food intake do not affect the status of the intestinal flora of people with IBS.

Campylobacter jejuni and Campylobacter coli are Gram-negative, microaerophilic bacteria which are worldwide in distribution, causing a zoonotic disease in humans called campylobacteriosis. These infections are mainly caused by eating contaminated food products, most often improperly prepared poultry meat. Campylobacteriosis usually takes the form of gastroenteritis, or inflammation of the intestines, and the characteristic symptoms are watery-mucous diarrhea often with the presence of blood in stool, nausea, vomiting, abdominal pain and fever. The epidemiological data suggest that in Europe, as well as in North America, bacteria of the genus Campylobacter, especially C. jejuni and C. coli, are the most commonly isolated pathogens in infections of the gastrointestinal tract in humans. Epidemiological data indicate that these organisms are a much more common cause of acute diarrhea, mostly in young children, than Salmonella and Yersinia. The lack of specific symptoms makes the diagnosis of campylobacteriosis necessary to carry out specialized microbiological diagnostics. Because so far these studies are performed in our country only in a few laboratories, the overwhelming number of cases of campylobacteriosis are not recorded in Polish epidemiological statistics. The purpose of this paper is to discuss issues related to the microbiological diagnosis of infections caused by C. jejuni and C. coli. It also describes the basic epidemiological and clinical data, as well as current treatment of campylobacteriosis.

Introduction: The aim of this study was to use molecular methods to identify selected strains of C. difficile isolated from patients hospitalized at Independent Public Central Teaching Hospital [SP CSK] between 2008 and 2011 in order to demonstrate their toxicgenic character and to determine their epidemic potential, including the incidence of a suspected C. difficile strain 027/NAP1/B1., Material and Methods: Originally evaluated material consisted of freshly collected stool samples from patients who had developed diarrhea. Stool samples were assessed for toxins A and B via an immunoenzymatic method and for the presence of C. difficile via the first culture method. The isolated strains were stored on MICROBANK mediums, at -70 degrees C. From this sample collection, 48 strains isolated in 2008 and 28 strains isolated in 2011 were selected for molecular analysis., Results: Among the C. difficile isolates that underwent molecular analysis there were 6 strains 027/NAP1/BI out of the 48 evaluated strains isolated in 2008, which constituted 12.5% and 24 strains 027/NAP1/BI out of the 28 strains isolated in 2011, which constituted 85.7%., Conclusions: Identification of a possible hyperepidemic strain of C. difficile is crucial for undertaking any anti-epidemic activities in health care facilities, where such activities are more and more common and are responsible for nosocomial foci of infection.

The Aim of the Study: To assess the epidemiological situation of campylobacteriosis in Poland in 2011 as compared with the situation in 2010., Materials and Methods: The assessment was based on the results of the analysis of data from the annual bulletin "Infectious diseases and poisonings in Poland", 2010-2011 (MP Czarkowski et al., NIH and GIS), information from the forms of individual cases and epidemiological investigations forms on outbreaks of campylobacteriosis, which were sent by the Sanitary-Epidemiological Stations to the Department of Epidemiology and data from the Department of Demographic Studies of the Central Statistical Office. All cases were classified according to a surveillance case definition., Results: In 2011, number of campylobacteriosis cases registered in Poland was 354, the incidence rate was 0.92/100,000. All cases were reported as confirmed. No deaths were recorded. More than 61% of reported cases came from two provinces--Slaskie 112 (31%) and Warmińsko-mazurskie 104 (29%). The highest incidence was observed in Warmińsko-Mazurskie (7.16/100,000). Hospitalized were 57.5%. The lowest percentage of hospitalization (31.3%) was in Slaskie. In six provinces all reported cases were hospitalized. Campylobacter species was determinated in 282 patients (79.7%). It was found that 270 cases were caused by C. jejuni and 12 by C. coli. The majority of cases (264, 74.6%) occurred in the age group 0 - 4, Among the cases were 217 men and 127 women. In 2011, one family outbreak was caused by Campylobacter., Conclusion: In Poland, campylobacteriosis is rarely diagnosed and recorded. Routine diagnosis of infection with Campylobacter is done in two provinces only.

Aim: The aim of this work is to evaluate the epidemiological situation of Campylobacter in Poland in 2010., Material and Methods: The evaluation was based on results from analysis of: the yearly bulletin "Infectious Diseases and food poisoning in Poland" between the years 2009-2010 (MP Czarkowski i in., PZH i GIS), reports from individual cases and epidemiological investigations of outbreaks linked to Campylobacter, sent by Epidemiological Departments in Sanitary Stations to the Department of Epidemiology at NIZP-PZH. Data was also collected from the Department of Demographical Research based at the Central Statistics Office. All reported cases were verified in accordance with the case definition required for surveillance., Results: In 2010, 375 cases of Campylobacter were reported in Poland, yielding an incidence of 0.98 per 100,000 inhabitants. Of cases reported 367 were confirmed and 8 probable. No deaths were reported. Over, 46% (171) of all cases reported were from the Slaskie voivodship. The highest incidence of 4.76 per 100,000 was observed in Warmińsko-Mazurskie voivodship. Fifty-four per cent of people were hospitalized, the least in Warmińsko-Mazurskie voivodship (17.6%) and in 5 voivodships over 90% of their cases were hospitalized. Campylobacter was isolated in 305 people who were ill (approximately 81%). In 2010, 275 (73.3%) people were identified as being infected with C. jejuni and 27 (7.2%) with C. coli. Illness due to infection with C. coli was mainly reported in Małopolskie Voivodship, over 55% of all cases were infected with this species. The highest number of cases (292; 77.6%) was observed among children aged between 0-4 years. In terms of gender, a total of 209 men and 166 women were reported as ill. In 2010 4 family outbreaks caused by Campylobacter were reported. One outbreak was also reported among children attending a summer camp, where 78 people were exposed, 53 children of which were up to 14 years of age. A total of 12 children between 8-14 years became ill., Conclusions: Despite the increase in cases of Campylobacter reported, the disease remains underdiagnosed and under-reported. The species of Campylobacter responsible for diseases has been identified in a significant number of cases and has steadily increased in recent years.

Introduction: Enteroaggregative Escherichia coli are poorly discovered pathogenic subgroup of these microorganism. They can cause watery diarrhea witch is often persistent. It seems that infections due to EAEC could comprise significant epidemiologic problem, covered especially children from developing countries and travelers visiting these countries., Methods: To find out, whether EAEC could comprise a problem in Poland, we examine 382 E. coli strains isolated from stool samples from patients with diarrhea in Poland in years 1997-2011. Three genes (aggR, aap and aat) were marked by Multiplex-PCR method., Results: Six of examined strains (1.5%) were marked as EAEC and they were isolated equally from children and adults., Conclusions: It seems that EAEC could not comprise a significant problem in Poland but it should be taken in to account as a potential etiologic factor of diarrhea.

Unlabelled: Clostridium difficile (CD) is one of the main factors of nosocomial infections both in children and adults and the number these infections is still growing. There is an increasing number of community-associated CDAD and CDIs with no exposure to antibiotics. Tests for CD among children are not routinely conducted because of high rate of carrying (from 13 to 70% infants). The objective of a study was to assess the frequency CDI among children with diarrhea, analysis of the risk factors of CDI and to compare the course of infection and the response to the treatment depending on type of bacteria toxigenic profile., Material and Methods: The retrospective analysis of the clinical case record was made on 16 children at the age of 9 months to 10 years with CDI. PCR tests (Xpert C.Difficile) were used to identify CD in stool specimens., Results: 1,6% children with diarrhea was diagnosed with CDI. It constituted 8,9 cases per 1000 admissions. All children with CDI received antibiotics before. Correlation between hospitalization and development of CDI was found in 56% children. In 62% children the toxin B-producing B strains were revealed whereas in the others hiperwirulent strains NAP1/B1/027 (38%). SIRS was found in 50% cases infected by NAP 1/B1/027., Conclusion: CD may be very important etiological factor of antibiotic-associated diarrhea in hospitalized children, especially with severe diseases and community-acquired CDs. CDI should be considered in all cases of prolonged or relapse of diarrhea.

Background: Rotavirus infections have been important health problem of Polish children both as primary cause of hospital admissions and nosocomial infections. Due to the lack of acquired immunity in first years of life, (96,7%) in hospitalized children reported in Poland in 2009. A high incidence of hospital infections is explained by mass excretion of rotaviruses in feces, as well as high infectivity and stability of the rotavirus in the environment. Pediatric departments are regarded as a favorable environment for rotavirus transmission. The exact number of nosocomial rotavirus gastroenteritis (RVHI) is unknown, but several publication concerning this problem are available. OBJECTIVES. The aim of the paper was a systematic review of epidemiologic situation regarding hospital rotaviral infections In Poland. MATERIAL AND METHODS. Systematic literature search within databases (Pubmed, CINAHL, Cochrane, EMBASE) using key words: "biegunka szpitalna" OR "zakazenie wewnatrzszpitalne" OR "zakazenie wewnatrz-oddziałowe" OR "hospital infection" OR "hospital diarrhea" OR "nosocomial infection" AND "Rotavirus" AND "Poland" was performed in August 2011. The searching was limited to period from January 1988 to August 2011. Data were also searched using traditional methods as reference analysis and contact with authors of found studies. A total of 18 publications describing epidemiology of RVHI were found. Seven studies were excluded due to the lack of necessary data and 11 studies describing epidemic situation in period 1981-2009 were selected to perform meta-analysis., Results: We estimated that 0,72% (95% CI 0,68-0,76%) of children In Poland acquired rotavirus infection during their stay in a hospital and RVHI accounted for 22,6% (95% CI 21,5-23,7%) of all rotaviral gastroenteritis in hospitalized children in Poland., Conclusions: Our meta-analysis confirmed frequent occurrence of RVHI in polish hospitals. Nosocomial rotavirus infections are responsible for the substantial proportion of rotaviral gastroenteritis in hospitalized children and are closely related to community infections. Due to susceptibility, hospital infections occur mainly in childrenwithin their first two years of life and prolong their stay in a hospital. The number of hospital rotaviral diarrhea episodes should be reduced with universal immunizations, prevention of rotavirus transmission and use of probiotics.

Rotavirus is the main etiological cause of intestinal infections in children. The voluntary rotavirus vaccines was included to Polish vaccination schedule in 2007. The aim of this study was assessment of epidemiological situation of intestinal infections in children up to two years in Malopolska Voivodeship regarding the population influence of rotavirus vaccinations on the number ofrotavirus infections. For entire area included to evaluation, despite the increasing vaccination coverage in children the number of notified rotaviruses infections revealed the rising trend, as well. The results have not showed the population influence of voluntary rotavirus vaccinations on the incidence of intestinal infections in the youngest children.

The total number of 360 campylabacteriosis cases were reported in 2008 in Poland. The incidence rate was 0.94 per 100 000 population. All reported cases met criteria of confirmed case of EU case definition. No death was reported. More than 58% of patients were hospitalized. The species of Campylobacter was determined in 283 cases (78,6%): 225 cases (62,5%) were caused by C. jejuni, 47 (about 13%) by C. coli and 11 (about 3%) by C. upsalenssis. Four family outbreaks were reported in 2009 in Poland.

In Poland since 2002 it is required to report the cases of human cryptosporidiosis, but so far none has been recorded. The aim of this study was to present some preliminary results of a study on the incidence of Cryptosporidium as a pathogen in children and adults with diarrhoea of undetermined aetiology. In 36 out of 246 stool samples collected from hospitalized patients with diarrhoea of undetermined aetiology, invasive parasite oocysts were detected. All positive results were obtained in a group of children aged up to 4 years (47.5%). The percentage of invasion in this age group was statistically significantly higher than in the group of children aged 12 months and children over 48 months of age, which was respectively 16.2% (p = 0.0018) and 7.7% (p < or = 0.001). On the basis of Restriction Fragment Length Polymorphism (RFLP) it was found that oocysts isolated from stool samples belonged to species of Cryptosporidium parvum and/or Cryptosporidium hominis. In adults with diarrhoea, and among healthy children, no oocysts of Cryptosporidium were found. The analysis of the results demonstrated that Cryptosporidium is one of a cause of diarrhoea in young children in Poland. This is an indication for the introduction of tests for cryptosporidiosis to the schedule of routine diagnostics of gastrointestinal infections in children. This work has been partly founded by Med-Vet-Net. Workpackages 22 Met-Vet-Net is an EU-founded.

The analysis of published data concerning demographic and medical risk factors and clinical manifestation and outcome observed in Legionella pneumonia were presented in this study. The aim of this study was to discuss the problem of high diversity of symptoms of legionnaires' disease as well as risk factors frequency presented in patients with legionellosis. The different risk factors and clinical picture of Legionella pneumonia were presented, depending on kind of infection (sporadic/epidemic), populations and place of infection (travel-associated, nosocomial, community-acquired). The high percentage of patients with legionellosis and with digestive symptoms (15-70%) was pointed. The presence of digestive symptoms like: diarrhea, vomiting, nausea might cause problem in diagnosis because of suggestion of another etiological agent. Moreover, the hypothesis of M.Sabria et al. regarding the correlation between the exposure and kind and clinical manifestation of Legionella pneumonia was discussed.

In 1997, Poland experienced a flood of high-intensity. Some predicted major threats from communicable diseases caused by deterioration of the sanitary-epidemiological conditions. On the basis of data from 1997, in this article is presented range of counter epidemic measures recommended in the conditions of public health treats caused by natural disasters like floods. Fears regarding health effects of flood were confronted with surveillance data on infectious diseases reported in 1997.

The results of the epidemiological analysis of campylobacteriosis reported by Regional Laboratory of Sanitary Epidemiological Station in Bielsko-Biala (PSSE Bielsko-Biala), Silesia voivodeship in Poland are presented. From August 2006 to July 2009, stool samples from diarrhea cases were examined for the presence of Campylobacter spp. as well as Salmonella, Shigella, Yersinia, enteropathogenic (EPEC) and verotoxigenic (VTEC) E. coli. The most frequently isolated species of Campylobacter spp. was C. jejuni. Most of the Campylobacter spp. were isolated from children under the age of 2. The seasonal peak of campylobacteriosis was observed between July and December. All isolates of Campylobacter sp. were sensitive to erythromycin and gentamicin. It was observed that 71.4% C. jejuni isolates were resistant to ciprofloxacin. The comparison of the results obtained during the period of 2006-2009 shows that percentage of campylobacteriosis has increased. In the first year of studies (from August 2006 to July 2007), Campylobacter spp. were reported in 45.4% of 183 bacterial etiologic agents of gastroenteritis, isolated from 819 persons; in the second year (August 2007-July 2008) there were 46.6% of 176 bacterial etiologic agents isolated from 844 persons; and in the last year of study (August 2008-July 2009), Campylobacter spp. were reported in 51.5% of 196 bacterial etiologic agents isolated from 859 persons. The percentage of salmonellosis cases decreased by about 20% from 45.4 to 23% during that frametime.

Unlabelled: Postcholecystectomy syndrome (PCS) is a complex of symptoms from gastrointestinal tract that could develop and maintain after cholecystectomy. PCS usually consists of: abdominal pain or colic, dyspepsia, constipation or diarrhoea, nausea, bloating, fatty food intolerance. Regarding PSC as disease entity is still a point of many controversies., The Aim of the Study: To estimate the prevalence of PCS in patients after cholecystectomy performed in Department of General and Colorectal Surgery of Medical University in Lodz. Material and methods. From the cohort of 243 patients (pts) operated on due to symptomatic cholecystitis the group of 150 pts was surveyed. We included 86 pts who answered the questionnaire. The prevalence of PCS and intensity of symptoms were measured with the use of modified Gastrointestinal Symptoms Rating Scale (GSRS)--only 6 complaints commonly connected with pathology of biliary system were chosen (abdominal pain, rebounding, constipation, urgent diarrhea, nausea, bloating)., Results: After cholecystectomy gastric complains were revealed in 32 pts (37.2%). In a group of 12 pts (13.9%) symptoms were noted at the same level of intense. However in 20 pts (23.25%) either more intense or appeared as brand new manifestation. Excessive amount of intestinal gases (93.75%) and bloating (87.5%) were the most common symptoms unlike abdominal pain, heartburn and diarrhea., Conclusions: Gastric symptoms of PCS occur in one third of pts after elective cholecystectomies. Complete PCS develops after 3 months postoperatively what is likely connected with the change of diet. Excessive amount of intestinal gases, bloating, abdominal pain and diarrhea were the most common symptoms. The most intense complaint is persistent abdominal pain likely indicating comorbidities.

Unlabelled: The aim of the study was to assess health hazards in Democratic Republic of Congo on the ground of diseases and traumas incidence among soldiers of Polish Military Contingent served in the stabilization mission EUFOR., Material and Methods: Epidemiological analysis was based on the medical documentation of patients treated from June to December 2006., Results: The main health problem among Polish soldiers were gastrointestinal tract diseases (56,0% of all diseases and traumas), respiratory tract (22,9%) and skin diseases (7,4%). Among them acute diarrheas were dominated (they appeared in case of 98 soldiers in 126 examined population). The laboratory examination of homebound Polish soldiers showed pathological results in case of 81 people. Among them, 44 patients had certified the prevalence of Yersinia antibodies IgM--2 people, and IgG--42 people (Y enterocolica or Y pseudotuberculosis). Bacteriological examination of stool in direction of Yersinia spp. was negative., Conclusion: Laboratory examination of Yersinia antibodies before departure of Polish soldiers to Congo was not performed, so it is impossible to certify if infection of yersiniasis appeared in Poland or during military mission abroad. Among any homebound soldiers of Polish Military Contingent contagious or parasitic disease was recorded.

Rotaviruses are the most common cause of acute diarrhoea in children. The disease often leads to hospitalization; it is also a source of intrahospital infections. In the last 10 years in Poland the incidence of rotavirus infections increased more than twofold In this study we analyse the etiopathogenesis, epidemiology, clinical course, diagnostic methods, treatment and prevention of rotavirus infections.

Over last decade problem of infectious diseases in Poland remains stable with trends of decreasing incidence of most reported infectious diseases. In particular there was observed decrease in incidence of tuberculosis and foodborne infections causes by Salmonella sp. On the other hand it was observed increase of reported foodborne infections caused by Campylobacter and Yersinia as well and viral ones caused by noroviruses and rotaviruses. Despite marked increase of diagnosed and reported cases sensitivity of reporting of those infections remains unacceptably low. Reported incidence of HIV infections remains relatively stable over last years. But increased fraction of heterosexually transmitted cases points to the problem of increased incidence out of so called "risk groups" among the general population. It was also noted worrisome increase of incidence of syphilis. The highest incidence was noted regarding influenza and other upper respiratory tract infections. Low level of vaccinations against influenza remains the problem which requires continuous health promotion efforts. The best epidemiological situation was observed among vaccine preventable diseases, which reflects effectiveness of vaccination program. Though widening of our program into several important infections included in vaccination programs of other EU countries would be needed in oncoming years. Infectious diseases caused 0.70% of deaths. Mortality from infectious diseases was 6.8/100,000 and was significantly higher among men (8.8) then among women. (5.0). In urban settings mortality from infectious diseases was higher (7.4/100,000) then in the country (5.8). In particular districts (voivodeships) mortality indices remained in the range of 5.2 (podlaskie) to 9.7 (slaskie). The highest number of deaths was caused by sepsis (41.1%, without neonatal sepsis).

Unlabelled: The aim of the study was an analysis of rotavirus diarrhea incidence in children within two age ranges: between 0-4 years and between 5-9 years. Into the analysis there were included children from the city of Kielce and from the Kielce administrative district suffering from diarrhea and admitted to the hospital, in the years 2002-2006., Methods: The Slidex Rota-Kit 2 tests were performed to confirm the rotavirus etiology of infection., Results: Throughout the 5 years period there were hospitalized 6980 children coming from whole Swietokrzyskie Province. Infection caused by rotavirus was diagnosed in 2064 (29.6%) children. Infection caused by Salmonella was diagnosed in 405 (5.8%) children. The etiology of diarrhea was not established in 4511 (64.6%) children. Into the next analysis there were included children only from the city of Kielce and from the Kielce administrative district. Infection caused by rotavirus was diagnosed in 1702. 1368 (80.4%) of children with diagnosis of rotavirus diarrhea were in the age group of 0-4 years, 334 (19.6%) of children were in the age group of 5-9 years. The highest incidence of rotavirus infection was observed in children aged 2 years--500 (29.4%). The prevalence of infection was not related to the sex of the patients. There was observed an increase in the rotavirus diarrhea prevalence during from autumn to spring season (Nov.- May) with peak incidence in February (13.6%). The prevalence of diarrhea in the urban area 54.2% was higher than in the rural area in both age groups.

The results of retrospective analysis of 97 children treated at Observation and Liver Diseases Unit in Bydgoszcz between 1st Jun and 30th Jun 2006 because of retrovirus diarrhea were presented. Those results took the liver activity into consideration. The age of children with hypertransaminazemia was assessed--the duration, intensity and date of occurrence of hypertransaminazemia was taken into consideration. In 25% of analyzed cases an increased activity of ALT (lasting from 7 days to 6 months) without other disturbance of liver activities was stated.

In 2005 numerous important modifications were introduced into surveillance of infectious diseases in Poland according to the requirements of European Union. The most important modification was introduction of European case definitions. Concerning list of infectious diseases, all positions recommended by EU are reported in Poland. Incidence of influenza, the most frequent infectious disease in Poland increased 117.7% to 733,234 cases (1921.4 /100,000). Number of cases of diarrhea among children 0-2 (viral, bacterial and of unknown origin) was 20,194 (2834.2 /100,000). Among them 6877 were viral. This number includes rotavirus infections as probably the dominant component. There was noted decrease of incidence of newly diagnosed cases of viral hepatitis B (4.5 /100,000) which dropped to the level below the incidence of viral hepatitis C (7.8 /100,000). Hepatitis A remains at the low level (0.14 /100,000) Level of newly diagnosed cases of AIDS (146 cases, 0.38 /100,000) is 15.6% lower then in the previous year. The major problem with HIV reporting is low fraction of reported risk factors. Infectious diseases caused 0.70% of deaths. Mortality from infectious diseases was 6.8 per 100,000 population and was significantly higher among men (8.9) then among women (4.8). In urban settings mortality from infectious diseases was higher (7.0 per 100,000) then in the country (6.3). In particular districts (voivodeships) mortality indices remained in the range of 4.7 (podlaskie) to 10.2 (lubuskie). With the decreasing trend of deaths due to tuberculosis and increased numbers of deaths from sepsis, for the first time in 2005 number of deaths from sepsis (967; 2.5/100,000, without neonatal sepsis) was bigger than number of deaths from tuberculosis (834; 2.2).

The Aim: of the study was to analyse the etiology of home acute diarrhea in children., Material and Methods: 2636 children with community-acquired acute diarrhea were included in the study. Stool samples were analysed for the presence of Salmonella spp, Shigella spp, rotaviruses and adenoviruses., Results: etiology of acute diarrhea was established in 1149 out of 2636 children (43.6%). Among the children with known etiology - rotaviral diarrhea was most frequently diagnosed (24.67%), whereas salmonellosis - in 7.06% of cases, EPEC C - 6.37%, EPEC B - 2.92%, EPEC A - 1.89%, adenoviral diarrhea in 0.68%. Mean age of children with bacterial acute diarrhea (Salmonella, EPEC A, B, C) was higher as compared to the mean age of children with rotaviral acute diarrhea (p < 0.002). Rotaviral acute diarrhea was more frequently diagnosed in girls (p < 0.025), whereas bacterial - in boys (p < 0.044). The highest prevalence of acute rotaviral diarrhea was found in winter/spring, with peak in April., Conclusions: commonly used diagnostic procedure does not allow to establish the etiology of acute home diarrhea in children in most cases. Rotavirus is found in the majority of diagnosed cases. It seems reasonable to expand the spectrum of diagnostic tests in cases of acute diarrhea in children.

Acute infections of the digestive tract, clinically presenting as acute gastroenteritis, may have different ethiologic basis. Both bacteria (Escherichia coli, Enterobacter spp., Salmonella spp.) and viruses (Rotaviruses, Adenoviruses) are frequently isolated ethiologic factors. In some cases the ethiologic factor cannot be detected.

Campylobacter jejuni is an important cause of food-borne gastroenteritis and enteritis in humans in many developed countries. Several C. jejuni virulence determinants have been identified. The purpose of our experiments was to determine the prevalence of virulence and toxin genes cadF, flaA, cdtA, cdtB, cdtC, cdtABC, virB11 among 102 C. jejuni isolates isolated in Poland between 2003 and 2005 from humans with diarrhea. The PCR analysis of the strains revealed the presence of the flaA and the cadF genes among all C. jejuni isolates. Detection rates for the cdtA, cdtB, cdtC and cdtABC cluster genes were 98, 96, 92 and 88% respectively. The virB11 gene was found in only 3% of the isolates. The high prevalence of cadF, flaA and cdt genes demonstrated that these genes may play an important role in C. jejuni virulence. Further research is necessary to clarify the importance of the virB11 gene in the pathogenesis of infections with C. jejuni strains in humans.

Dissertation is devoted to rotavirus infections in children 0-14 years of age hospitalized in the hospital of Zyrardów in 2000-2002. The first part of the work describes epidemiology of rotaviral infection in children, rotaviral vaccines and also presents data of rotaviral infections in the foreign and polish literature. The second part is concerning the data of rotaviral infection in children hospitalized in Zyrardów. Stool samples were examined in Bacteriological Laboratory of Powiatowa Stacja Sanitamo-Epidemiologiczna in Zyrardów for bacteria and for rotavirus by means of agglutination latex test Slidex Rota-Kit 2. All children with acute gastroenteritis rotaviral were hospitalized. The most of children were 0-4 years old. They had 89,1% of participation in the whole group of admitted children. In dissertation there were represented data in tables, concerning number of rotaviral diarrhea episodes in children 0-14 years with division into age groups, sex and urban-rural children, seasonality of infections and nosocomial rotaviral infections. The next part of the work is the anonymous survey containing five questions about social and family conditions of these children, which have fallen ill the rotaviral infection. The survey served to carry out the case-control research intending detection the risk factors for incidence of rotaviral infections in children. Conclusions of the survey: risk factors - sleeping with children in one room, more than three persons and improper sanitary conditions (lack of own bathroom in the apartment).

Viral diarrheas are important clinical and epidemiological problem, especially in small children. In the years 2004-2005 in the Pediatric Ward of the SPZOZ in Hajnowka, among 218 children aged from 0 to 7 years hospitalized with symptoms of the acute diarrhea, rotavirus infection was confirmed in 35.8% and adenovirus in 5.1%. Hospital infections were observed in 0.96% of children hospitalized in the Pediatric Ward for reasons other than the acute diarrhea. The morbidity presented with seasonality characteristic for the temperate climate.

Candida species, predominantly Candida albicans strains, are part of the normal flora of gastrointestinal tract, but some authors suggest that faecal candida may cause diarrhoea. The aim of this study was to determine the prevalence of faecal Candida spp. isolates in 345 children with diarrhoea and 161 with other diseases, hospitalized in 2003. Overall 506 faecal specimens obtained before treatment and 98 after treatment of children for yeasts using routine culture method were examined. A total of 131 (101 before and 30 after treatment) strains isolated were identified as Candida albicans. Only 2 strains belonged to other species of Candida (C. parapsilosis and C. krusei). The sensitivity of Candida spp. strains to chemotherapeutic was also estimated. All strains of C. albicans were sensitive to nystatin. Incidence of faecal strains of C. albicans in children with acute diarrhoea (19,4%) and children with other disease (21,1%) was comparable (p>0,05). Candida albicans yeasts caused diarrhoea in small percent of studied children. Only in 2 (0,6%) children C. albicans as aetiological agent of diarrhoea was found. In 16 (16,3%) cases secondary fungal infections were acquired during hospitalization children (4 children with fungal diarrhoea). Resolution of diarrhoea caused by C. albicans in 6 children after treatment with nystatin was observed.

Rotavirus is the most common gastrointestinal pathogen in infants and young children. The aim of this study was to determine the role of rotavirus in acute diarrhea in children hospitalized in Pediatric Infectious Diseases Clinic in Bialystok. 658 children aged 0-7 years admitted to the ward: 466 children with gastroenteritis and another 192 without any diarrheic symptoms were tested for rotavirus infection by latex agglutination. Rotavirus was detected in 16.1% stool specimens collected from children with acute diarrhea. None of patients without diarrhea was positive for rotavirus on admission--2% of this patients acquired symptomatic rotavirus infection during hospitalization. This study delivers epidemiological data on rotavirus infection and shows the need of further study on etiology of viral gastroenteritis in children in our district.

In Poland there is no obligation of reporting and registration of the rotaviral infections in children. Therefore, data concerning number and incidence of rotaviral infections is unknown. Most of works devoted to rotaviral infections describes clinical course. In many works, Polish authors carry out the analysis of per cent participation of rotaviral infections in global number of children hospitalized due to diarrhea in Poland. The rotaviral part of diarrhea is 20%-80% of all diarrheas in Polish children. Mostly, rotaviral diarrheas take 40% to more than 50% of all diarrheas in children. Rotavirus is also accountable for rising of nosocomial infections. Summarizing, there is conclusion, that is necessary to implement the registration of rotaviral infections in Poland.

Previously found DNA sequence (iam), correlated with the invasiveness of Campylobacter strains, became a starting point for present investigation. Main goal of this study was to isolate number of Campylobacter strains from chicken carcasses, to determine their taxonomic position and to establish the presence of iam sequence in their genoms. It was found, that invasion associated marker is present in all Campylobacter coli strains and in majority but not all Campylobacter jejuni. This may confirm the idea that the marker is not only responsible for diarrhea in humans but also may be important in the colonization of chicken guts.

The aim of the studies was to establish the prevalence of Cryptosporidium parvum in children hospitalized with diarrhea. The group of 102 children has been examined from 2002-2003. A total of 8 (7.8%) cases of cryptosporidiosis was recorded in this period.

Rotaviral infections in children are the important problem occurring worldwide. Little children under 5 years of age with rotaviral diarrhea usually need stay in the hospital because of severe course: fever over 38 C, vomiting, diarrhea leading to dehydration and disturbances in electrolyte and acido-alkalic balance. These children are the source of the nosocomial rotaviral infection in the other children hospitalizing because of the other cause then diarrhea. Rotaviral nosocomial infections have 23.8%-43% of participation in the world and 4.5%-45.4% in Poland in all hospitalizing rotaviral infections. Transmission of infection inside the hospital ward happens by not-washing hands of the staff, mothers remaining with their children, disregarding hospital regime. Lack of the isolation of patients with diarrhea and prolonged stay in the hospital are also agents predestinating to nosocomial rotaviral infections. Elimination of these agents, implementation of supplementary diet with antibodies or Lactobacillus GG may limit account of nosocomial rotaviral infections but will not stop them. The only way of prevention of the rotaviral infections and nosocomial rotaviral infections is implementation of effective and save rotaviral vaccine, which will be suitable for infants and toddlers worldwide.

In this work we presented a retrospective analysis of Salmonella infections in 163 children aged between 0-36 months. The children were treated in IV Department of Pediatrics at Medical University of Silesia (Poland) in years 1987-1998. We analyzed: clinical course, dependence between age of the patients and the type of Salmonella, number of infections and their seasonal incidence during 12 years of observation. These relations were compared with the group of 17 children with Salmonella infections treated in the Department of Pediatrics GCZDzM in Katowice in 2001.

Pseudomembranous colitis (PMC), antibiotic-associated diarrhoea (AAD), and colitis (AAC) caused by Clostridium difficile are recognized as complications of antibiotic treatment (cephalosporins, penicillins, clindamycin and others). Two groups are particularly at risk: older and immunocompromised patients. In recent years C. difficile has been recognized as a common nosocomial pathogen. To understand the epidemiology of the C. difficile infection, many outbreaks have been investigated by various methods. In the paper we reviewed different methods of C. difficile typing and discussed the epidemiology of C. difficile-associated infections in light of recent publications.

Unlabelled: The aim of this study was determination of the etiologic agents (bacterial, fungal or viral) of acute diarrheas in children from the Łódź region, suffering from acute diarrhoea during the period from October 1998 to February 2001. Rotaviruses were detected by the latex test. Other microorganisms belonging to the Enterobacteriaceae, Pseudomonadaceae and Vibrionaceae families, as well as the genera Listeria, Campylobacter, Candida, Staphylococcus were cultured on standard or selective culture media according to the NDH recommendations and identification by means of API system. Acute diarrhea in 155 small children below 6 years of age from the Łódź region were caused by rotaviruses (n = 42; 27%). Enteropathogenic strains of Escherichia coli (n = 25; 16.1%) occupied the third place after Salmonella bacteria (n = 30; 19.3%--second place). Among bacterial etiologic factors of diarrhea Campylobacter bacteria showed high frequency of occurrence (n = 22; 14.1%). The investigations enabled identification both the mixed infections (n = 25; 16.1%) and more rare etiologic agents of diarrhea., Conclusions: 1. Acute diarrhea in children from the region Łódź were most frequently caused by rotaviruses; 2. Modern microbiological diagnostics of acute diarrhea in children should be multilateral, taking account of the mixed infections and expanding the routine search for bacteria of the genus Campylobacter.

The aim of the study was a trial of establishing of the frequency of rotavirus infection and mixed bacterial-viral infections in children treated for diarrhoea in a hospital in the period from July 1 1996 to June 30 1997. Moreover, an attempt was made at establishing of the frequency of rotavirus colonization of the digestive tract in healthy newborns born in that hospital during the period of that study. The studies were done on feces samples from 169 children with diarrhoea from 4 days to 13 years, and from 30 healthy peers. In all samples rotaviruses were sought along with pathogenic Enterobacteriaceae Tests for rotaviruses were done with Slidex-Rota Kit 2 (Bio-Merieux) and for EPEC with the EPEC latex test (Biomex). In all, rotaviruses were found in 88 ill children (52.1%) including mixed bacterial-viral infections in 10 (5.1%) children. In 9 children beside rotaviruses enteropathogenic E. coli (EPEC) were disclosed, and in 1 child S. enteritidis. Moreover, in 1 child (0.6%) culture yielded simultaneously S. sonnei and E. coli 0127. No rotaviruses were found in any 30 healthy newborns, but from one of them E. coli 018 was cultured. The second most frequent aetiological factor in diarrhoea were EPEC organisms found in 17 (10.0%) children, the third factor were S. enteritidis strains in 6 children (3.6%). In one case S. sonnei and E. coli 0127 were obtained from faces. Rotavirus infection was most frequent in children aged from 2 months to 3 years, and EPEC infection in children up to 2 years. The incidence was highest in winter/spring, with peak in April when 27 cases of rotavirus diarrhoea were noted.

The clinical picture and the effects of treatment with intravenous immunoglobulins of 14 adult patients (4 women, 10 men) with common variable immunodeficiency are presented. In most patients the disease began in the second decade of life (17.4 years on average), and the diagnosis was delayed by 7.5 years. Mean observation time was 38.5 months. Recurrent sinopulmonary infections were the most significant clinical feature and were observed in all patients, although chronic diarrhea and viral hepatitis, predominant of B type, were also frequently seen (both in 57% of patients). The diagnosis was made according to following criteria: frequent bacterial infections of the respiratory tract, serum IgG levels reduced below 300 mg/dl, (mean, 60.7 mg/dl), normal numbers of circulating B lymphocytes and exclusion of the secondary type hypogammaglobulinaemia. After 6 months of treatment with fresh plasma 20 ml/kg or intravenous immunoglobulins 200-400 mg/kg, mean serum IgG levels rose to 654 mg/dl. Treatment was clinically efficacious and markedly reduced the number of infections of the respiratory tract. The delay of the diagnosis, resulted in high rate of irreversible damage of respiratory tract observed in our group of patients.