Klinicka mikrobiologie a infekcni lekarstvi最新文献

Colorectal cancer is a very common malignancy with high mortality. Many factors influencing both the development and subsequent treatment, such as age, gender or genetic predisposition, are not modifiable. Others, such as stress, diet, physical activity or smoking, may be prevented by each individual. The gut microbiota is an important factor involved in both the development and treatment outcomes. With the advancing study of the gut microbiota, the relationship between its composition and various diseases is better understood. The proportions of members of the phyla Firmicutes (as beneficial microbiota) and Bacteroidetes (as mostly disease-associated microbiota) seem to be particularly important. Some studies suggest that certain bacteria may contribute to postoperative anastomotic leaks that prolong hospital stays, are a burden to patients, increase costs and may be fatal. Bacteria associated with the complication are, for example, enterococci, pseudomonads or bifidobacteria. Better understanding of the pathognomonic relationship between increased detection of certain bacteria and a complication may lead to individualized therapy aimed to reduce complications during surgical management of colorectal cancer.

This is a case report of sepsis caused by the species Actinobacillus suis/equuli in a male agriculture worker that ended fatally. The article also contains information on identification and results of antibiotic susceptibility testing. This is a rare case of human infection and probably the first case of a human being infected by this species in the Czech Republic.

Reflections on digitalization in clinical microbiology are presented. The advantages and limitations of digital processing of microbiological data for individuals and the human population are considered.

Colistin is a narrow-spectrum lipopeptide antimicrobial agent used to treat nosocomial infections caused by multidrug-resistant bacteria, especially in critically ill patients and those with cystic fibrosis. Colistin represents a concentration-time-dependent antibiotic with highly variable pharmacokinetics related to the heterogeneity of the target population and the necessity of bioactivation. Colistin is administered as the inactive prodrug colistimethate sodium. Nephrotoxicity and neurotoxicity are the most frequent adverse effects.

Poultry and poultry products are considered a potentially significant source of resistant E. coli strains and their determinants encoded by mobile genetic elements, such as genes for ESBL/AmpC beta-lactamases. Poultry also hosts extraintestinal pathogenic E. coli strains (ExPEC). The similarity of poultry avian pathogenic E. coli to human strains has led to the inclusion of ExPEC among bacteria with zoonotic potential. However, population diversity of E. coli pathotypes, host specificity and circulation of diverse strains and genetic determinants between populations are rather complex and the aforementioned risks cannot be addressed separately.

Background: We introduce a relatively new difficult-to-treat resistance (DTR) category to specialists. It significantly influences the predictability of morbidity and mortality in patients with invasive infections caused by DTR strains. Therefore, surveillance of DTR is an important tool of antimicrobial stewardship (AMS) and widely contributes to cooperation between microbiologists and clinicians. We also report the prevalence of strains meeting the criteria for the category in a teaching hospital.

Methods: This retrospective cohort single center study included invasive isolates of gram-negative rods from patients hospitalized in the General University Hospital in Prague in 2009-2013 and in 2017-2021.

Results: From a total of 1 732 (920 and 812, respectively) unique strains of gram-negative rods isolated from blood cultures in both periods, 6.6 % were carbapenem-resistant in 2009-2013 and 6.0 % in 2017-2021; 3.7 % were identified as DTR in both periods. Most of the DTR strains were A. baumannii (23.1 % and 45.0 %, respectively) and P. aeruginosa (22.2 % and 15.3 %, respectively). We identified no carbapenem-resistant E. coli and therefore no DTR E. coli.

Conclusion: Infections caused by bacterial strains with a DTR phenotype are grave complications and are tricky to manage. The prevalence of severe infections caused by these strains was relatively low in the studied facility. Antibiotics with anti-DTR effects should be considered the last resort, so it is very important to comply with AMS rules and examine the susceptibility of these agents.

Objectives: The COVID-19 pandemic has had a major impact on the healthcare system, which has been forced to manage large numbers of patients, including those with respiratory insufficiency and in need of oxygen therapy. Due to concerns about bacterial co-infection, antibiotic therapy was administered to many patients. The aim of the present study was to compare antimicrobial resistance in intensive care patients in the pre-pandemic and pandemic periods.

Material and methods: Patients hospitalized at the Department of Anesthesiology, Resuscitation and Intensive Care Medicine of the University Hospital Olomouc in the pre-COVID-19 period (2018-2019) and during the pandemic (2020-2021) were enrolled in the study. Clinical samples from the lower respiratory tract were routinely collected twice a week, with one strain of a given species first isolated from each patient being included in the study.

Results: While several bacterial species (Escherichia coli, Proteus mirabilis and Haemophilus influenzae) were found to occur less frequently, an increased occurrence was documented for Enterococcus faecium, Serratia marcescens and Klebsiella variicola. Overall, however, it can be concluded that there was no major change in the frequency of bacterial pathogens isolated from the lower respiratory tract during the COVID-19 period. Similarly, with only a few exceptions, antimicrobial resistance did not change significantly. More significant increases in resistance to piperacillin/tazobactam, cefotaxime, ciprofloxacin and gentamicin have been demonstrated for Serratia marcescens. However, a decrease in the resistance of Pseudomonas aeruginosa and Burkholderia cepacia complex to meropenem was also observed.

Conclusions: There was no significant change in the frequency of bacterial pathogens and their resistance to antibiotics during the COVID-19 pandemic. However, there was an increase or decrease in the percentage of some species and in their resistance.

The case reports describes detection of Trichomonas vaginalis in a 34-year-old patient with preterm prelabor rupture of membranes and a subsequent C-section in week 25 of her pregnancy, with the presence of T. vaginalis not being the only risk factor for preterm labor. Although a rare finding in pregnant women, the presence of this microorganism must be considered in such situations.

In the relatively short period of time since December 2019, hundreds of millions of people globally have been infected with SARS-CoV-2, irrespective of their age, gender or ethnicity. Over that time, numerous mutations of various degrees of virulence and pathogenicity have occurred. The course of COVID-19 infection, an acute disease caused by the virus, is rather varied, ranging from asymptomatic or symptoms of common viral respiratory diseases to critical, with multiorgan failure and high mortality in high-risk patients. The overall mortality of the disease is 1-2 %. Unlike other viral respiratory diseases, this infection is often associated with frequent and rather diverse clinical manifestations developing after the acute phase of the infection, that is, more than 28 days after its onset. These complications are observed in both individuals with mild illness treated at home and inpatients with severe to critical illness. They develop both early after acute infection and some time after recovering from the disease. This rather heterogeneous group of pathologies may affect various organs and organ systems, with respiratory tract involvement being the most common and one of the most serious complications. Severe respiratory post-COVID-19 complications often include respiratory tract infections, in particular pneumonia.

The article describes the use of the last-resort carbapenem antibiotic imipenem in combination with relebactam, a novel b-lactamase inhibitor, in the treatment of ventilator-associated pneumonia developing after SARS-CoV-2 infection in a young pregnant patient. The introduction briefly describes the mechanism and spectrum of activity of the antibiotic, including its dosage.