Klinicka mikrobiologie a infekcni lekarstvi最新文献

The presented case report illustrates a complicated clinical course of recurrent spondylodiscitis in a 60-year-old patient newly diagnosed with HIV infection. Initially delayed diagnosis due to non-specific symptoms and misleading radiological findings resulted in recurrent hospitalizations complicated by pneumonia, respiratory failure, spinal epidural abscess and the need for neurosurgical intervention. Antibiotic therapy was gradually modified and lasted a total of 164 days. Ultimately, the combination of fosfomycin and flucloxacillin administered over a period of 62 days led to resolution of psoas abscesses and normalization of spinal findings on magnetic resonance imaging. This case highlights the potential of fosfomycin as part of combination therapy for difficult-to-treat or recurrent vertebral infections caused by Staphylococcus aureus, particularly in patients with underlying HIV infection.

Antibiotics have been considered miracle drugs since the widespread introduction of penicillin, an antimicrobial substance with the potential to save millions of lives. Unfortunately, their excessive use, especially in agriculture and health care, has resulted in the selection and spread of resistant bacterial strains. The accelerated occurrence of antimicrobial resistance is currently a serious global problem, regardless of the level of economic development of individual countries. For this reason, great pressure is placed on developing new substances with an antimicrobial effect or modifying existing antimicrobials. A rational antibiotic policy and antibiotic stewardship are applied to preserve the effectiveness of current antibiotics for as long as possible. The article aims to introduce the readers to some of the newly developed antimicrobial agents that have the potential for possible clinical use: lipophosphonoxins, recently developed antimicrobial agents acting on the bacterial cytoplasmic membrane; silver nanoparticles and their antimicrobial effect on multidrug-resistant bacteria, either in their pure form or in combination with antibiotics or photodynamically active substances; and some phytoextracts, substances of plant origin with proven antibacterial activity.

Hepatitis E virus (HEV) is currently one of the most common causes of acute viral hepatitis. The Czech Republic is a region with a natural occurrence of genotype 3 HEV (HEV-3). The disease caused by this genotype has specific characteristics. The predominant route of transmission is zoonotic, through undercooked meat or offal from reservoir animals. Most infections are asymptomatic. Symptomatic hepatitis E may present as acute hepatitis with non-specific symptoms of viral infection and elevated serum aminotransferase activity, or it may lead to liver failure and death. Additionally, numerous extrahepatic manifestations and the potential for chronic hepatitis development in immunocompromised patients have been described. The article provides a comprehensive summary of current recommendations for the diagnosis and treatment of hepatitis E virus infections in the context of the Czech Republic.

The article reviews current options for the treatment of infections caused by carbapenemase-producing Enterobacterales, including the role of aztreonam/avibactam.

Objective: In early March 2020, the first cases of the disease caused by SARS-CoV-2 were confirmed in the Czech Republic. From April 2020 to the end of September 2022, more than 80,000 samples were examined in the microbiology laboratory of the Havlíčkův Brod Hospital. The article summarizes data obtained during the COVID-19 pandemic.

Material and methods: The catchment area of our laboratory included the towns of Havlíčkův Brod, Chotěboř, Světlá nad Sázavou, Ledeč nad Sázavou, Humpolec, and Pelhřimov. Viral RNA was isolated from the collected samples and detected by RT-PCR. Virus variants were determined by mutation detection using two methods (RT-PCR and melting curve analysis).

Results: Most of the examined persons belonged to the almost equally represented age groups 26-45 and 46-65 years. Two significant waves of the epidemic were recorded during the study period. The number of SARS-CoV-2-positive women and men was not statistically different, nor was there a difference in the number of hospitalized men and women; patients over 65 years of age predominated. Three variants of concern were detected: B1.1.7. (a), several sublineages of the variants B.1.617.2 and B.1.617.2.AY (δ, δ+), and several sublineages of the variant B.1.1.529.BA (ο). The variants differed in infectivity and virulence.

Conclusion: The SARS-CoV-2 pandemic significantly contributed to the development of the microbiology laboratory of the Havlíčkův Brod Hospital.

Besides Corynebacterium diphtheriae, C. ulcerans can cause diphtheria in humans, and its incidence has been increasing alarmingly in recent years. The source and reservoir of these infections are a wide range of domestic and wild animals, in which C. ulcerans is associated with both asymptomatic carriage and sometimes severe respiratory and skin infections. The review attempts to summarize new knowledge about the pathogenicity and epidemiology of this emergent zoonotic species.

In this short communication we describe the phenomenon of multidrug-resistant HIV-1 infection, possible causes and treatment op-tions in these cases. The case report presents the successful use of a drug lenacapavir in a non-adherent patient with HIV infection trea-ted at the HIV center of the Clinic of Infectious Diseases, University Hospital Bulovka, Prague.

Influenza is an infectious disease caused by influenza A, B, and sometimes C viruses. The disease is preventable in all age groups thanks to annual seasonal vaccination. Population groups at high risk of severe illness with complications include seniors, pregnant women, and young children. As our case report shows, an unvaccinated person of working age in good health can suffer life-threatening complications with untreated influenza. The most common complications include bacterial pneumonia, respiratory insufficiency, and cardiovascular problems. Up to 645,000 flu-related deaths are estimated each year.

Objective: This study aimed to evaluate the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) at the University Hospital Olomouc (UHO) over a 10-year period (2013-2022).

Material and methods: Data was obtained from the ENVIS LIMS laboratory information system (DS Soft, Czech Republic, Olomouc) of the Department of Microbiology, UHO, for the period 1/1/2013-31/12/2022. Standard microbiological procedures using the MALDI-TOF MS system (Biotyper Microflex, Bruker Daltonics) were applied for the identification. Antimicrobial susceptibility was determined by the standard broth microdilution method according to EUCAST criteria. All Staphylococcus aureus strains were tested for methicillin resistance using selective diagnostic chromogenic media (ColorexTMMRSA, TRIOS) and an immunochromatographic test for PBP2a detection (PBP2a SA Culture Colony Test, AlereTM). Positive results were confirmed by mecA gene detection. Molecular typing to determine clonality/relatedness was performed on isolates from 2022 using pulsed-field gel electrophoresis (PFGE).

Results: The prevalence of MRSA at the UHO does not show an increasing trend and ranges between 3-6 %. The highest MRSA prevalence was detected in blood culture specimens (6 %), followed by lower respiratory tract specimens (5 %) and wound/abscess/aspirate specimens (5 %). The departments with the highest MRSA prevalence were the Geriatrics Department and the Second Internal Medicine Department. The antibiotic resistance patterns of MRSA were as follows: erythromycin 89 %, clindamycin 86 %, ciprofloxacin 80%, tetracycline 18 %, gentamicin 13 %, cotrimoxazole 7 %, and tigecycline 1 %. Resistance to antibiotics of choice for serious MRSA infections (vancomycin, ceftaroline, linezolid) was 0-1 %. Genetic analysis of selected MRSA isolates by PFGE revealed one cluster of five, two clusters of three, and two clusters of two isolates with indistinguishable restriction profiles.

Conclusion: The prevalence of MRSA at the UHO remains low, therefore oxacillin or possibly combined aminopenicillins (amoxicillin/clavulanic acid and ampicillin/sulbactam) or cefazolin can be relied upon for initial therapy of infections likely caused by Staphylococcus aureus.

Introduction: Staphylococcus aureus is a gram-positive, facultatively anaerobic coccus capable of causing infectious diseases in animals and humans. Especially dangerous are multidrug-resistant forms with poor or even no response to available treatments.

Objectives: The study aimed to verify the effect of enzybiotics on the healing of S. aureus-infected skin wounds in an experimental pig model.

Methodology: Two pigs were included in the experiment and wounds (10/pig) of 5 × 5 cm in size with 2 cm spacing were made by incision on their backs. The wounds were infected with a methicillin (oxacillin) and amoxicillin-resistant strain of S. aureus (MRSA). The experimental groups consisted of individual wounds that were infected with one sequence type of S. aureus at a concentration of 2 × 109 CFU/mL. Two wounds were left untreated (N), four wounds were using hydrogel with added lysostaphin, and four wounds were treated using hydrogel with added lysostaphin and endolysin. Subsequently, samples were taken from each wound on days 4, 7, 11, and 14. The material was processed using a standard histological technique of paraffin blocks and the sections were stained with hematoxylineosin.

Results: The results show that these defects present a full spectrum of reparative changes with re-epithelialization with alternating sections of necrosis and newly formed granulation tissue with an accompanying round cell inflammatory infiltrate in edematous tissue and surface scabs. On the surface of the wounds and also in smaller groups in the newly formed granulation tissue, coccoid formations corresponding to S. aureus are visible. Compared to untreated wounds, hydrogel dressings with added lysostaphin or lysostaphin and endolysin trapped greater numbers of S. aureus cocci colonies, which subsequently died off to a large extent.

Conclusion: Enzybiotics may have interesting potential in the topical therapy of MRSA-infected skin wounds.