{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:01:41Z","timestamp":1785391301679,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"\n Background<\/jats:title>\n Socioeconomic development as well as medical progress has led to a reduction in infectious diseases. The currently observed reappearance of alarming pathogens and the increasing microbial resistance indicate alarming infectious disease resurgence.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n The aim of this study was to evaluate the risk of infections with methicillin-resistant\n Staphylococcus aureus<\/jats:italic>\n (MRSA), vancomycin-resistant\n Enterococcus faecalis<\/jats:italic>\n and\n Enterococcus faecium<\/jats:italic>\n (VRE),\n Klebsiella<\/jats:italic>\n spp. producing extended-spectrum \u03b2-lactamases (ESBL), and\n Klebsiella pneumoniae<\/jats:italic>\n producing metallo-\u03b2-lactamases (MBL) as well as New Delhi metallo-\u03b2-lactamase (NDM) in intensive care units (ICUs) in Poland in the years 2020\u20132023 in comparison to the baseline year of 2019, using the standardized infection ratio (SIR).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The research material comprised aggregated annual epidemiological data gathered by the Chief Sanitary Inspectorate, which covered all ICUs in Poland in the period from 2019 to 2023, including the number of infections diagnosed after 72\u00a0h of hospitalization and the number of ICU person-days. SIR was subjected to an analysis relative to the reference year 2019, and the incidence rate was compared between years and voivodeships with application of the Kruskal\u2013Wallis test and\n post hoc<\/jats:italic>\n analyses.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the case of MRSA, elevated SIR values were observed in the Lublin, Subcarpathian, and Silesian Voivodeships. In the Lodz Voivodeship, compared to 2019, a sustained risk reduction was detected. The multiple increase in the risk of\n E. faecalis<\/jats:italic>\n VRE infections in the Lublin Voivodeship was particularly alarming, with SIR values exceeding the reference level several times between 2020 and 2023. With respect to\n E. faecium<\/jats:italic>\n VRE, the highest and long-term exceedances were noted in the Holy Cross Voivodeship. The most dynamic growth concerned MBL\/NDM-producing\n K. pneumoniae<\/jats:italic>\n on account of the fact that in the Lower Silesian and Silesian Voivodeships, SIR values reached levels several dozen times higher than those noted in the baseline year. The incidence analysis confirmed material differences between voivodeships, albeit the differences between years were significant primarily in the case of MBL\/NDM-producing\n K. pneumoniae<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In the years 2020\u20132023, significant changes in the risk of infection were observed in ICUs in Poland as well as clear regional variations compared to 2019. The largest and most alarming increases concerned infections caused by MBL\/NDM-producing\n K. pneumoniae<\/jats:italic>\n , indicating the need to strengthen epidemiological surveillance and infection control measures.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1822386","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:40:00Z","timestamp":1785390000000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk assessment of selected bacterial infections acquired in intensive care units in Poland in the years 2019\u20132023\u2014analysis with the application of the standardized infection ratio"],"prefix":"10.3389","volume":"16","author":[{"given":"Monika","family":"Filipkowska","sequence":"first","affiliation":[{"name":"Department of Epidemiology, District Sanitary and Epidemiological Station in Bialystok","place":["Bialystok, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magda","family":"Orzechowska","sequence":"additional","affiliation":[{"name":"Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok","place":["Bialystok, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukasz","family":"Wojcik","sequence":"additional","affiliation":[{"name":"IT Section, Voivodeship Sanitary and Epidemiological Station in Bialystok","place":["Bialystok, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Danilczuk","sequence":"additional","affiliation":[{"name":"UroClinic-Rogowski","place":["Bialystok, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Cybulski","sequence":"additional","affiliation":[{"name":"Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok","place":["Bialystok, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics12111600","article-title":"Impact of COVID-19 pandemic on healthcare-associated infections: a systematic review and meta-analysis","volume":"12","author":"Abubakar","year":"2023","journal-title":"Antibiotics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1016\/j.ajic.2021.07.004","article-title":"Outbreak of NDM-1-producing Klebsiella pneumoniae in the intensive care unit during the COVID-19 pandemic: Another nightmare","volume":"49","author":"Amarsy","year":"2021","journal-title":"Am. J. Infect. Control"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.823626","article-title":"The collateral effects of COVID-19 pandemic on the status of carbapenemase-producing pathogens","volume":"12","author":"Ayoub Moubareck","year":"2022","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1038\/s41586-019-1717-y","article-title":"A new twenty-first century science for effective epidemic response","volume":"575","author":"Bedford","year":"2019","journal-title":"Nature"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2538","DOI":"10.1093\/jac\/dkab207","article-title":"Dissemination of klebsiella pneumoniae ST147 NDM-1 in Poland, 2015\u201319","volume":"76","author":"Biedrzycka","year":"2021","journal-title":"J. Antimicrob. Chemother."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms11061491","article-title":"A review of carbapenem resistance in Enterobacterales and its detection techniques","volume":"11","author":"Caliskan-Aydogan","year":"2023","journal-title":"Microorganisms"},{"key":"B7","volume-title":"NHSN\u2019s Guide to the 2022 Baseline Standardized Infection Ratios","year":"2026"},{"key":"B8","doi-asserted-by":"publisher","first-page":"53946","DOI":"10.12775\/QS.2024.20.53946","article-title":"The issue of antibiotic-resistant bacterial infections in intensive care units (ICUs) \u2013 epidemiology, risk factors and prevention. Literature review","volume":"20","author":"Choi\u0144ski","year":"2024","journal-title":"Qual. Sport"},{"key":"B9","volume-title":"Protocol for the Surveillance of Healthcareassociated Infections and Prevention Indicators in European Intensive Care Units","year":"2025"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1056\/nejme2002387","article-title":"Covid-19 - navigating the uncharted","volume":"382","author":"Fauci","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics14111128","article-title":"Epidemiological situation of antibiotic-resistant microorganisms identified in patients hospitalised at the University Teaching Hospital in Bialystok, Poland, in the 2020-2023 period","volume":"14","author":"Filipkowska","year":"2025","journal-title":"Antibiotics"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0208442","article-title":"What is epidemiology? Changing definitions of epidemiology 1978-2017","volume":"13","author":"Fr\u00e9rot","year":"2018","journal-title":"PloS One"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13020379","article-title":"The impact of the COVID-19 pandemic on the antibiotic resistance of Gram-negative pathogens causing bloodstream infections in an intensive care unit","volume":"13","author":"Golli","year":"2025","journal-title":"Biomedicines"},{"key":"B14","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.jhin.2023.05.010","article-title":"Impact of COVID-19 pandemic on healthcare-associated infections at intensive care units in South Korea: data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS)","volume":"138","author":"Lee","year":"2023","journal-title":"J. Hosp. Infect."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad649","article-title":"The global and regional prevalence of hospital-acquired carbapenem-resistant Klebsiella pneumoniae infection: a systematic review and meta-analysis","volume":"11","author":"Lin","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"B16","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1186\/s12866-025-04497-0","article-title":"Epidemiology and genomic characteristics of carbapenem-resistant Klebsiella pneumoniae in intensive care unit from 2021 to 2024","volume":"25","author":"Ma","year":"2025","journal-title":"BMC Microbiol."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2018.00004","article-title":"Colonization, infection, and the accessory genome of Klebsiella pneumoniae","volume":"8","author":"Martin","year":"2018","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.cnur.2019.02.006","article-title":"Emerging infectious diseases","volume":"54","author":"McArthur","year":"2019","journal-title":"Nurs. Clin. North. Am."},{"key":"B19","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1017\/s0950268818000572","article-title":"Updating the epidemiological transition model","volume":"146","author":"Mercer","year":"2018","journal-title":"Epidemiol. Infect."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14165688","article-title":"Clinical impact of New Delhi metallo-beta-lactamase-producing Enterobacterales in critically ill patients: Are we ready to face the challenge","volume":"14","author":"Montrucchio","year":"2025","journal-title":"J. Clin. Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1038\/nature02759","article-title":"The challenge of emerging and re-emerging infectious diseases","volume":"430","author":"Morens","year":"2004","journal-title":"Nature"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.680975","article-title":"Impact of social, economic, and healthcare factors on the regional structure of antibiotic consumption in primary care in Poland (2013\u20132017)","volume":"9","author":"Olczak-Pienkowska","year":"2021","journal-title":"Front. Public Health"},{"key":"B23","doi-asserted-by":"publisher","first-page":"161","DOI":"10.2307\/3349375","article-title":"The epidemiologic transition. A theory of the epidemiology of population change","volume":"79","author":"Omran","year":"1971","journal-title":"Bull. World Health Organ."},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2025.102729","article-title":"Impact of the COVID-19 pandemic on healthcare-associated infections and multidrug-resistant microorganisms in Italy: a systematic review","volume":"18","author":"Peconi","year":"2025","journal-title":"J. Infect. Public Health"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics14090916","article-title":"The impact of COVID-19 on the epidemiology of carbapenem resistance","volume":"14","author":"Sakagianni","year":"2025","journal-title":"Antibiotics"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v7.23574","article-title":"The development and experience of epidemiological transition theory over four decades: a systematic review","volume":"7","author":"Santosa","year":"2014","journal-title":"Glob. Health Action"},{"key":"B27","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.ijid.2020.12.072","article-title":"The impact of universal face masking and enhanced hand hygiene for COVID-19 disease prevention on the incidence of hospital-acquired infections in a Taiwanese hospital","volume":"104","author":"Shih-Hao","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"B28","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/s1473-3099(17)30753-3","article-title":"Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis","volume":"18","author":"Tacconelli","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens12121401","article-title":"The prevalence of alert pathogens and microbial resistance mechanisms: a three-year retrospective study in a general hospital in Poland","volume":"12","author":"Tenderenda","year":"2023","journal-title":"Pathogens"},{"key":"B30","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.ajic.2020.10.019","article-title":"Unintended consequences of infection prevention and control measures during COVID-19 pandemic","volume":"49","author":"Wee","year":"2021","journal-title":"Am. J. Infect. Control"},{"key":"B31","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1017\/ice.2021.362","article-title":"The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network","volume":"43","author":"Weiner-Lastinger","year":"2022","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"B32","first-page":"35","volume-title":"Antimicrobial Resistance: Global Report on Surveillance","year":"2014"},{"key":"B33","volume-title":"Prioritization of Pathogens to Guide Discovery, Research and Development of New Antibiotics for Drug-Resistant Bacterial Infections, Including Tuberculosis","year":"2017"},{"key":"B34","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.jhin.2024.03.003","article-title":"Healthcare-associated carbapenem-resistant Klebsiella pneumoniae infections are associated with higher mortality compared to carbapenem-susceptible K. pneumoniae infections in the intensive care unit: a retrospective cohort study","volume":"148","author":"Yao","year":"2024","journal-title":"J. Hosp. Infect."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1822386\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:40:01Z","timestamp":1785390001000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1822386\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":34,"alternative-id":["10.3389\/fcimb.2026.1822386"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1822386","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]},"article-number":"1822386"}}