Group A Streptococci (GAS) are the main causative agents of bacterial pharyngitis, which require antibiotic therapy. Rapid diagnostic tests detecting GAS combined with Centor/McIsaac score enable accurate differential diagnosis (viral vs. bacterial) and prompt commencement of targeted treatment. The aim of this study was to assess the specificity, sensitivity, PPV and NPV of QuikRead go® Strep A (Orion Diagnostica Oy, Finland) recommended for the detection of GAS in pharyngeal swabs. Quick diagnostic test results were compared with physical examination findings, Centor/McIsaac score and results of reference testing (conventional microbial cultures). The study group of 96 participants consisted of 44 women (46%) and 52 men (54%); children aged 3-14 years constituted 46% of the patients. S. pyogenes were cultured from 43 of 96 pharyngeal swabs. Almost half of all positive samples (47%, n = 20) were collected from children aged 3 to 14 years. Positive GAS cultures were confirmed in 33% of patients with Centor/McIsaac score of 2 points, 48% of patients with score of 3, and 50% of patients with score of 4-5. Microbial cultures confirmed the positive results of QuikRead go® Strep A test in 83% of cases. Test specificity and sensitivity were calculated for the entire study group, which were 85% and 91%, respectively. The PPV of the test was 83% and its NPV was 92%. Using quick tests to detect GAS antigens appears a good alternative to conventional microbial diagnosis of strep throat, as it enables making a diagnosis and deciding on treatment plan in one appointment.

a b s t r a c tObjective: To develop a consensus-based set of generic competencies in antimicrobial prescribing and stewardship for European prescribers through a structured consensus procedure. Methods: The RAND-modified Delphi procedure comprised two online questionnaire rounds, a face-toface meeting between rounds, and a final review. Our departure point was a set of competencies agreed previously by consensus among a UK multi-disciplinary panel, and which had been subsequently revised through consultation with ESCMID Study Group representatives. The 46 draft competency points were reviewed by an expert panel consisting of specialists in infectious diseases and clinical microbiology, and pharmacists. Each proposed competency was assessed using a nine-point Likert scale, for relevance as a minimum standard for all independent prescribers in all European countries. Results: A total of 65 expert panel members participated, from 24 European countries (one to six experts per country). There was very high satisfaction (98%) with the final competencies set, which included 35 competency points, in three sections: core concepts in microbiology, pathogenesis and diagnosing infections (11 points); antimicrobial prescribing (20 points); and antimicrobial stewardship (4 points). Conclusions: The consensus achieved enabled the production of generic antimicrobial prescribing and stewardship competencies for all European independent prescribers, and of possible global utility. These can be used for training and can be further adapted to the needs of specific professional groups. O.J. Dyar, Clin Microbiol Infect 2019;25:13

Aggregated data from the Polish Point Prevalence Survey of Healthcare Associated Infections and Antimicrobial Use (PPS HAI&AU) collected between 2012 and 2015 were used to describe the epidemiology of healthcare associated bloodstream infections (BSI) in Polish hospitals, in order to assess the rationale for introducing a BSI surveillance programme in our country and analyse selected risk factors. Data were collected according to the ECDC PPS HAI&AU protocol. Within four years, records for 71,039 patients were collected in 36 (2012), 32 (2013), 112 (2014), and 158 (2015) hospitals; representativeness was evaluated as good in 2012-2013, and excellent from 2014. HAI was found in 4,258 of these patients; laboratory confirmed BSI, including catheter related infections (CRI), and neonatal BSI accounted for 7.7% (329 cases). A representative control group was selected during a random selection process. Out of 329 cases of BSI, 48.9% were associated with vascular access, and 70.8% of them met the criteria of (CRI). The most frequently isolated microorganisms were Staphylococci with 150 isolates (45.6%). Most of them were coagulase-negative (64.4%) that usually caused CRI. Out of 53 S. aureus isolates 24.5% were methicillin-resistant. Enterobacteriaceae were responsible for 31.3% of BSI (n = 103), 50.0% of them were resistant to third generation cephalosporins and 6 (5.8%) to carbapenems. Since little is known about the epidemiology of BSI in Poland, introduction of a countrywide surveillance programme based on incidence is justified, in order to create national prevention initiatives based on local epidemiology, as well as bundle focusing on prevention of CRI.

We investigated pneumococcal carriage among unvaccinated children under five years of age at a time when the conjugate polysaccharide vaccine (PCV) was introduced in Poland into the national immunization program (NIP). Paired nasopharyngeal swab (NPS) and saliva samples collected between 2016 and 2020 from n = 394 children were tested with conventional culture and using qPCR. The carriage rate detected by culture was 25.4% (97 of 394), by qPCR 39.1% (155 of 394), and 40.1% (158 of 394) overall. The risk of carriage was significantly elevated among day care center attendees, and during autumn/winter months. Among isolates cultured, the most common serotypes were: 23A, 6B, 15BC, 10A, 11A. The coverage of PCV10 and PCV13 was 23.2% (23 of 99) and 26.3% (26 of 99), respectively. Application of qPCR lead to detection of 168 serotype carriage events, with serogroups 15, 6, 9 and serotype 23A most commonly detected. Although the highest number of carriers was identified by testing NPS with qPCR, saliva significantly contributed to the overall number of detected carriers. Co-carriage of multiple serotypes was detected in 25.3% (40 of 158) of carriers. The results of this study represent a baseline for the future surveillance of effects of pneumococcal vaccines in NIP in Poland.

We aimed to evaluate the knowledge-based attitudes of antibiotics and antibiotic resistance among medical students of Medical University of Warsaw using the questionnaire prepared by the study’s authors. In May–June 2018, we carried out a cross-sectional study among the students of all years, embracing 291 respondents. The students were divided into two groups: A (students in their first to third years) and B (students in their fourth to sixth years). Our study has shown that students are aware of the dangers of antibiotic resistance, seeing the leading cause as antibiotic misuse. We have shown that they are also aware of their insufficient knowledge and believe that more antibiotic therapy classes should be included in the curriculum of Medical University of Warsaw. Our questionnaire also focused on attitudes towards antibiotics based on knowledge. One in four respondents (23.7%), based on their knowledge, negated antibiotic therapy ordered by a doctor in the event of their illness, and four in ten (40.9%) in the occurrence of disease of a family member or friend. The vast majority of students (92.4%) would like to broaden their knowledge on antibiotic therapy. However, only one-fifth of students have heard about the European Antibiotic Awareness Day campaign. We recommend increasing the number of hours on antibiotic therapy and resistance education combined with topics on hand hygiene.