Introduction: Healthcare workers in Poland received a booster dose of the BNT162b2 mRNA vaccine (Pfizer-BioNTech, Manufacturer: Pfizer, Inc., and BioNTech; Moguncja, Germany) at the beginning of October 2021. Here, we report on the preliminary results of an ongoing clinical study into the antibody response to SARS-CoV-2 of healthcare workers previously exposed to the virus, with or without evidence of past infection, in the Hospital for Infectious Diseases in Warsaw before and after the vaccine booster dose. Methods: Blood samples were collected on the day the vaccine booster dose was administered and again 14 days later. The levels of SARS-CoV-2 IgG antibodies (against the n-protein, indicative of disease) and S-RBD (indicative of a response to vaccination) were measured. Results: One hundred and ten health care workers from the Hospital for Infectious Diseases were included in the study. The percentage of subjects with a positive test for anti-n-protein IgG antibodies at both time points remained unchanged (16, 14%), while a statistically significant increase in the percentage of subjects producing high levels of S-RBD antibodies (i.e., >433 BAU/mL) was observed (from 23, 21% to 109, 99%; p = 0.00001). Conclusions: The results of the study indicate that the booster dose of the vaccine significantly increases the percentage of people with high levels of S-RBD antibodies, regardless of previous contact with the virus, which may indicate greater protection against both the disease and a severe course of COVID-19.

ACTIV-3/TICO Study Group* Background: Ensovibep (MP0420) is a designed ankyrin repeat protein, a novel class of engineered proteins, under investigation as a treatment of SARS-CoV-2 infection.Objective: To investigate if ensovibep, in addition to remdesivir and other standard care, improves clinical outcomes among patients hospitalized with COVID-19 compared with standard care alone.

Clostridioides difficile (C.difficile) is a Gram-positive, spore-forming, toxin-producing anaerobic bacillus, which is one of the most common causes of health-care-associated infection developed mainly by elderly patients. The objective of this study was to assess mortality among the patients of the Hospital for Infectious Diseases in Warsaw related to C.difficile infection. Analysis was conducted of 1638 records reporting the medical histories of patients hospitalized for the first time due to Clostridioides difficile infection (CDI) in the Hospital for Infectious Diseases in Warsaw from 2010 to 2017. The inclusion criteria were any (principal or secondary) discharge diagnosis code for CDI according to ICD-10 and being an adult (≥ 18 years). 108 out of 1638 (7%) of the patients died. The median age in this group was 83 years. The largest number of deaths (90%) occurred in the group of patients aged 65 years or older and 81–90 years old (53% of all the deaths). In the multivariate logistic regression model relevant only to the age groups, not to sepsis—age over 80 and over 90 were independent predictors of death, increasing the risk of death by 3.4 and 1.8 times, respectively. The result of the receiver operating curve (ROC) analysis determined the age of 77 years as the threshold value, indicating the increased risk of death (AUC 0.727, standard error 0.025, 95% CI 0.678–0.776, p < 0.0001). In addition, other quantitative variables, namely CRP, creatinine and leucocytes were studied and turned out to be independent death predictors as well. The diagnosis of sepsis increased the risk of death fourfold (OR = 4.042; 95% Cl 2.4–6.7; p < 0.001). Increased inflammatory parameters, namely CRP and white blood cell count, advanced age, particularly over the age of 80, as well as a diagnosis of sepsis are independent risk factors for death and could be used as predictive markers of poor outcome in CDI.

Background:The aim of the study was to determine the effect of chronic alcohol abuse on the course and outcome of bacterial meningitis (BM). Materials/methods:We analyzed records of patients with BM who were hospitalized between January 2010 and December 2017 in the largest neuroinfection center in Poland.Results: 340 adult patients (211 men and 129 women) were analyzed. Forty-five (13.2%) patients were alcoholics (39 men and 6 women). Compared to non-alcoholics, alcoholics were more likely to present with seizures (33.3% vs 12.6%, p<0.001), scored higher on the Sequential Organ Failure Assessment (SOFA) (median 3 vs 2, p<0.001) and lower on the Glasgow Coma Scale (GCS) (median 10 vs 12, p<0.001) and had worse outcome as measured by the Glasgow Outcome Score (GOS) (median 3 vs 5, p<0.001). Furthermore, alcoholics were less likely to complain of headache (23.3% vs 52.3%, p<0.001) and nausea/vomiting (11.4% vs 33.6%, p=0.005) and had lower concentration of glucose in cerebrospinal fluid (CSF) (median 0,58 mmol/L vs 1,97, p=0.025). In the multiple logistic regression analysis, alcoholism was independently associated with lower GCS (OR 0.716, 95% CI 0.523-0.980, p=0.036), presence of seizures (OR 4.580, 95% CI 1.065-19.706, p=0.041), male gender (OR 4.617, 95% CI 1.060-20.113, p=0.042) and absence of nausea/vomiting (OR 0.205, 95%CI 0.045-0.930, p=0.040). Furthermore, alcoholism (regression coefficient [-0.636], 95% CI [-1.21] -[-0.06], p=0.031), lower GCS score (regression coefficient 0.144, 95% CI 0.06-0.23, p=0.001) and higher urea blood concentration (regression coefficient [-0.052], 95% CI [-0.10] -[-0.01], p=0.018) were independently associated with worse outcome measured by GOS.Conclusions: Compared to non-alcoholics, chronic alcohol abusers are more likely to present with seizures, altered mental status, higher SOFA score and have an increased risk of unfavorable outcome. In multivariate analysis seizures and low GCS were independently 3 associated with alcoholism, while alcoholism was independently associated with worse outcome.

The aim of the study was to determine the effect of chronic alcohol abuse on the course and outcome of bacterial meningitis (BM). We analyzed records of patients with BM who were hospitalized between January 2010 and December 2017 in the largest neuroinfection center in Poland. Out of 340 analyzed patients, 45 (13.2%) were alcoholics. Compared with non-alcoholics, alcoholics were more likely to present with seizures (p < 0.001), scored higher on the Sequential Organ Failure Assessment (SOFA) (p = 0.002) and lower on the Glasgow Coma Scale (GCS) (p < 0.001), and had worse outcome as measured by the Glasgow Outcome Score (GOS) (p < 0.001). Furthermore, alcoholics were less likely to complain of headache (p < 0.001) and nausea/vomiting (p = 0.005) and had lower concentration of glucose in cerebrospinal fluid (CSF) (p = 0.025). In the multiple logistic regression analysis, alcoholism was associated with lower GCS (p = 0.036), presence of seizures (p = 0.041), male gender (p = 0.042), and absence of nausea/vomiting (p = 0.040). Furthermore, alcoholism (p = 0.031), lower GCS score (p = 0.001), and higher blood urea concentration (p = 0.018) were independently associated with worse outcome measured by GOS. Compared with non-alcoholics, chronic alcohol abusers are more likely to present with seizures, altered mental status, and higher SOFA score and have an increased risk of unfavorable outcome. In multivariate analysis, seizures and low GCS were independently associated with alcoholism, while alcoholism was independently associated with worse outcome.Electronic supplementary materialThe online version of this article (10.1007/s10096-019-03661-5) contains supplementary material, which is available to authorized users.