Epidemiologie Mikrobiologie Imunologie最新文献

Aim: We aimed to determine the prevalence of SARS-CoV-2 infection, including both symptomatic and asymptomatic courses, and to identify predictors of asymptomatic or symptomatic SARS-CoV-2 infection in patients within seven months after allo-HSCT (allogenic hematopoietic stem cell transplantation) in the Omicron period.

Methods: Prevalence of the past SARS-CoV-2 infection was determined in patients within seven months after allo-HSCT in the Omicron period using the cellular and humoral immune response against the SARS-CoV-2 nucleoprotein (NCP).

Results: Positive markers of past infection were identified in 45.2% of patients (n = 42). The infection was asymptomatic in 68.4% of anti-NCP positive patients. The search for risk factors for symptomatic SARS-CoV-2 infection in allo-HSCT recipients revealed that a low level of B cell reconstitution was the only significantly associated risk factor.

Conclusion: A high proportion of allo-HSCT recipients who were asymptomatically infected within up to seven months after transplantation from 2022 to 2023 despite being immunosuppressed and unvaccinated indicates an attenuation of the circulating virus and may signal less risk for transplanted patients from SARS-CoV-2 infection in the Omicron period. Vaccination of these patients against SARS-CoV-2 was shown to be associated with a low but significant risk of exacerbation of cured chronic GVHD (graft versus host disease) and the risk of de novo GVHD. The low level of B-cell reconstitution was the only significant risk factor for symptomatic SARS-CoV-2 infection in HSCT recipients.

Objective: Observational study of patients diagnosed with severe community acquired pneumonia (sCAP) carried out to evaluate levels of interleukin 17A (IL-17A) and T helper 17 (Th17) lymphocyte count in peripheral circulation and bronchoalveolar lavage fluid (BALF) in the early course of sCAP of different etiology and to compare them with patient's characteristics and outcome.

Material and methods: Cohort of 74 patients with sCAP was analyzed and respective microbial etiology established. According to pathogens, 3 subgroups of patients were created: bacterial, viral and mixed etiology. Th17 count and IL-17A levels were measured using flow cytometry and ELISA in peripheral blood and BALF. Data were compared with respect to etiology and their correlation with 30and 90-day mortality was statistically analyzed.

Results: There was no statistically significant correlation in Th17 count and IL-17A levels in blood and BALF between etiological subgroups of CAP and no correlation was found with respect to measured parameters and 30and 90-day mortality. Nevertheless, increased Th17 cell count and IL-17A levels in peripheral blood, but not in BALF, in the early course of sCAP are correlated with increased relative risk of death from sCAP. Other factors increasing relative risk of death in patients with sCAP found in our cohort were male sex and advanced age.

Conclusions: Systemic Th17 count and IL-17A levels in the early course (up to 7 days from admission) of sCAP may be correlated with severity and outcome of sCAP.

Objective: The aim of our study was to describe and analyze HAI incidence, etiology and risk factors in pediatric intensive care unit (ICU).

Background: Intensive care patients are at high risk of hospital-acquired infections (HAI) due to their underlying diseases and exposure to invasive devices.

Methods: The study group consisted of patients admitted to children's hospital ICU for more than 2 days during a six-month period (267 patients, 1570 patient-days). We used the European Centre for Disease Prevention and Control standard protocol HAI-Net ICU v2.2 for data collection.

Results: HAI occurred in 17 (6.4%) included patients (10.8 infections per 1000 patient-days). The most frequent were catheter-related bloodstream infections (33%, 7.6 per 1000 catheter-days) and intubation-associated pneumonia (25%, 10.9 per 1000 intubation-days). Gram-negative bacteria (Pseudomonas aeruginosa, Klebsiella spp.) were identified as the most common etiological agents. Significantly higher risk of HAI had patients with central venous catheter (OR: 14.5, 95% CI 3.2-65.1), intubated (OR: 14.4, 95% CI 4.4-46.2), with Pediatric Index of Mortality score higher than 10 (OR: 17, 95% CI 2.7-111.5) and with previous bacterial or/ and fungal colonization (OR: 30.6, 95% CI 9.2-101.3).

Conclusions: Active surveillance identified unreported HAI cases and proved to be an effective tool of infection control.

Aim: To determine the occurrence of species of Babesia potentially pathogenic for humans in ticks and in the blood of dogs and deer in selected regions of the Czech Republic. To compare the prevalence of Babesia spp. in ticks with that of other tick-borne pathogens, such as Borrelia spp., Anaplasma spp., and Rickettsia spp.

Material and methods: Tick samples were individually homogenized. DNA was isolated from tick samples and animal blood. The detection of Babesia spp. was based on PCR of the 18S rRNA gene, and the identification to the species level was done by sequencing analysis of the PCR products.

Results: In 2014-2016, ticks and blood of dogs and deer collected in various areas of the Czech Republic were analyzed. In a set of 675 Ixodes ricinus ticks, the positivity rate for Babesia spp. varied from 0.0 to 3.3 %. The species Babesia venatorum, Babesia microti (both pathogenic for humans), and Babesia capreoli were identified in ticks by sequencing analysis. The prevalence of Babesia spp. in ticks compared to that of other pathogens such as Borrelia burgdorferi s. l. (29.3 %) or Anaplasma phagocytophilum (4.9 %) was lower and comparable to that of Rickettsia spp. (1.6 %). Co-infection with Borrelia burgdorferi s.l (B. venatorum - Borrelia garinii, Borrelia afzelii, and B. microti - B. afzelii) was found in a third of Babesia spp. positive ticks. Out of 109 dog blood samples, 3.7 % were positive for Babesia spp., specifically Babesia gibsoni and Babesia vulpes. Of 50 blood samples of wild deer from the natural ecosystem, the positivity rate reached 4.0 %. The species Babesia divergens, a major human pathogen, was identified. Out of 80 blood samples from farmed deer, 5.0 % were positive for the species Babesia odocoilei. Nucleotide sequences of the agents causing human babesiosis were deposited in the gene bank under accession numbers ON892053 (B. venatorum), ON892061 (B. microti), and ON892067 (B. divergens).

Conclusions: Using PCR of the 18S rRNA gene and amplicon sequencing, three species of Babesia causing human babesiosis were detected in the Czech Republic: B. divergens, B. venatorum, and B. microti. Babesia spp. pathogenic for humans pose a potential risk especially in asplenic and immunocompromised patients. The detected co-infections with Borrelia spp. can be the cause of a complicated course of the disease.

Tularemia is a zoonosis caused by Francisella tularensis, a gram-negative aerobic bacterium belonging to the class of Gammaproteobacteria and the family Francisellaceae. Despite its undeniable importance for human health, there is little data on the current distribution of F. tularensis in various hematophagous arthropods. The aim of this study was to perform a mass molecular screening of different possible hematophagous vectors: ticks (4348 ticks of the species Ixodes ricinus, Dermacentor reticulatus, and Haemaphysalis concinna), mosquitoes (4100 specimens of Aedes vexans), and blackflies (6900 specimens of the Simulium spp.) for the presence of F. tularensis in the Břeclav district in 2022. Only two specimens were positive for the specific DNA of Francisella tularensis subsp. holarctica. Both samples originated from D. reticulatus, one collected from infested roe deer and the other included in a pooled sample (n = 10). Both positive samples were sequenced, and the presence of F. tularensis subsp. holarctica was confirmed. In addition, the absence of F. tularensis in mosquitoes and black flies was documented.

The numbers of diagnosed and reported cases of infection with the SARS-CoV-2 virus causing the disease COVID-19, which grew into a global pandemic, have remained consistently low in all countries, including the Czech Republic, since May 2023, when the World Health Organization declared an end to the pandemic. However, it must be said that the measures implemented to control this infection did not meet all expectations. Although new mutations of the virus that can potentially cause disease, continue to emerge, it appears that most people have gradually learned to coexist with them. However, due to some unique properties of the SARS-CoV-2 virus and its variants, there will still be predisposed individuals who will develop illness and need hospitalization along with effective treatment to be supported and monitored by adequate laboratory tests. This article is a commentary on this issue and deals primarily with the diagnosis and care of early-phase COVID-19 patients. Author's translation of the article into English is available at: https://www.spadia.cz/media/2085/lessons fromthecovid-19pandemic.pdf.

A systematic investigation of an outbreak of postoperative sepsis in nine patients following surgery in the operating rooms of a primary-type hospital between November 26 and 28, 2018 was conducted to determine the extent of the outbreak, the vehicle, and the route of transmission. The comprehensive investigation included epidemiological, microbiological, molecular biological, and environmental methods. A retrospective cohort study was used to find associations between individual exposure factors and outcomes, the respective septic conditions. Nine of 24 surgery patients were infected (AR 37.5 %). An identical strain of Acinetobacter calcoaceticus was found in biological specimens of two infected patients. The combined investigation did not reveal the vector or route of transmission. Immediate infection prevention and control measures avoided new cases of postoperative sepsis.

Aim: An analysis is presented of whole genome data of Streptococcus pneumoniae serotypes 8 and 22F isolated in the Czech Republic from invasive pneumococcal disease (IPD) in 2014-2020. New multivalent pneumococcal conjugate vaccines (PCVs) are effective against these serotypes. Recently, serotypes 8 and 22F have been among the leading causes of IPD in the Czech Republic. S. pneumoniae isolates from the Czech Republic were compared with those of the same serotypes recovered in other countries in the same period and available in the international database PubMLST.

Material and methods: Isolates from IPD of serotypes 8 (22 isolates) and 22F (21 isolates) recovered in the Czech Republic in 2014-2020 were subjected to whole genome sequencing (WGS). The genomes were analysed and compared using the international database PubMLST.

Results: Most of the studied Czech serotype 8 isolates belong to two main subpopulations. The first subpopulation, dominated by ST-53 isolates, is part of a highly abundant group of genetically close European and non-European isolates that are clearly separated on the phylogenetic network. The second subpopulation of Czech serotype 8 isolates (dominated by ST-404) is more genetically variable and forms a separate lineage on the global phylogenetic network, with no other European isolates. Czech isolates of serotype 22F are a homogeneous population with a clear predominance of ST-433, which belongs to a genetically close European population.

Conclusion: The analysis of WGS data of IPD isolates of serotypes 8 and 22F provided a detailed insight into the genetic relationships between the Czech populations of these serotypes. It also allowed comparison of the Czech populations with the matched populations from other European and non-European countries. The obtained results add to the body of knowledge about the spread of genetic lineages causing IPD in the Czech Republic in the post-vaccination period and provide a basis for considering whether the use of the new multivalent PCVs in the Czech Republic would be beneficial.

The novel personal protection equipment based on a face mask equipped with a nanofiber filter functionalized with povidone iodine has been developed and tested in a clinical trial. This nanofiber filter was characterized with a low flow resistance and, thus, allowed comfortable breathing. The performed study proved that the novel nanofiber filter with incorporated povidone-iodine was characterized with a slow release of iodine which minimized side effects but kept disinfection efficiency. Our clinical study performed on 207 positively tested SARS-CoV-2 patients wearing the PPE for 4-8 hours daily for 1 to 4 days has shown that even the iodine amount as low as 0.00028 ppm was sufficient to significantly decrease the reproduction number and, very importantly, to protect against severe course of disease.

The aim of the work: The aim of our work was to describe the current epidemiological situation of Hodgkin's lymphoma (HL) with a possible global prediction for the year 2040.

Methods: We obtained data on incidence and mortality of HL using the GLOBOCAN database. The rating was done specifically for men and women and together, with an age range of 0-85+ years. For the possibility of international comparison, the data are evaluated in the format of age standardized incidence/mortality (Age Standardized Rate - ASR) related to the world population - ASR (W).

Results: In the period 2000-2010, the incidence of the lowest values in the male population in Sweden reached 1.90 ASR (W), the highest values reached 3.45 ASR (W) in Italy. In the female population, the lowest incidence was reported in Malta 1.63 ASR (W), the highest in Italy 3.34 ASR (W). The lowest mortality in the male population was reported in Norway at 0.21 ASR (W), the highest value was in Bulgaria at 0.85 ASR (W). In the female population, the lowest mortality value was reported in Iceland 0.09 ASR (W), the highest value in Poland 0.43 ASR (W). In 2040, 19,788 new cases of HL will be reported in Europe (104,317 in the world), the number of deaths will be 4,633 deaths in 2040 (34,237 in the world).

Conclusion: HL in Europe shows a continuously increasing trend of incidence in the prescription period 2000-2010, but continuously decreasing trend in mortality. In 2020, within Europe, the lowest incidence value was reported in Central and Eastern Europe, the highest incidence value was reported in Southern Europe. In the same year, the lowest value of mortality was reported in Western Europe, the highest value was reported in Central and Eastern Europe. Modeling the epidemiology of the disease for the world for the year 2040 is important, as the disease will continue to be more common in the male population in the future.