The issue of patient safety during the provision of health services poses a key challenge in health policy. The number of hospital-acquired infections (also known as HAI -Healthcare Associated Infection) determines the level of quality of health services provided in a given health facility. Effective management reinforced by the awareness of a team of medical professionals allows not only reduction in the hospital's finances, but also the frequency of adverse events, which undoubtedly include hospital-acquired infections. Good cooperation between departments and a Hospital Infection Control Committee is one of the key aspects that translates to the rapid identification of new epidemic outbreaks. Infections caused by strains of Clostridium difficile (CDI, Clostridium difficile infection) are one of the main factors responsible for the prolonged hospitalization of patients. In the United States, Clostridium difficile causes almost half a million infections annually, and its treatment costs are estimated at nearly $ 4.8 billion per year. In Poland, the number of CDI cases in 2018 was 11.592 (for comparison, in 2013 the number of infections caused by this bacterium was 4.728). Hospital environment, inappropriate antibiotic therapy and development of multi-drug resistant strains increase the risk of infections. In order to improve the safety of hospitalized patients, infection risk management should be a systemic, formalized activity integrated with the overall process of managing a health facility. It is necessary that central units have interest in creating effective tools to enable successful epidemiological supervision and the implementation of strategic assumptions of health policy in this area.
This study presents the results of bioaerosol analyses conducted in the area of 9 wastewater treatment plants (WTTPs) in the Wielkopolska Region (Poland) with different capacities (from 500 to 200,000 m 3 /day). The abundance of mesophilic and psychrophilic bacteria, Staphylococcus, Actinobacteria, Pseudomonas fluorescens, coliform bacteria, and microscopic fungi in different plant sites and the control site were analysed. Microscopic fungi exhibited the highest contribution to air contamination and their highest median value was found in WWTP No. 5, which reached 6,700 colony forming units (CFU/m 3) of air. Psychrophiles and mesophiles were the most abundant bacterial groups. It was established that the highest concentration of bioaerosols was observed during the mechanical treatment of wastewater at sewage sludge treatment sites and near bioreactors. The R av parameter, which represents the ratio of average annual microbial abundance in the air to the average annual microbial abundance in the background at the control site, was a very good indicator of air contamination rate. This parameter may be analysed with respect to bacteria (R av B), microscopic fungi (R av F), and all microorganisms (R av M).
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