Epidemiologie Mikrobiologie Imunologie最新文献

Streptococcus pneumoniae (pneumococcus) is a Gram-positive coccus causing both non-invasive and invasive infectious diseases. Pneumococcal diseases are vaccine preventable. Invasive pneumococcal diseases (IPD) meeting the international case definition are reported nationally and internationally and are subject to surveillance programmes in many countries, including the Czech Republic. An important part of IPD surveillance is the monitoring of causative serotypes and their frequency over time and in relation to ongoing vaccination programmes. In the world and in the Czech Republic, whole genome sequencing (WGS) is increasingly used for pneumococci, which allows for serotyping from sequencing data, precise analysis of their genetic relationships, and the study of genes present in their genome. Whole-genome sequencing enables the generation of reliable and internationally comparable data that can be easily shared. Sequencing data are analysed using bioinformatics tools that require knowledge in the field of natural sciences with an emphasis on genetics and expertise in bioinformatics. This publication presents some options for pneumococcal analysis, i.e., serotyping, multilocus sequence typing (MLST), ribosomal MLST (rMLST), core genome MLST (cgMLST), whole genome MLST (wgMLST), single nucleotide polymorphism (SNP) analysis, assignment to Global Pneumococcal Sequence Cluster (GPSC), and identification of virulence genes and antibiotic resistance genes. The WGS strategies and applications for Europe and WGS implementation in practice are presented. WGS analysis of pneumococci allows for improved IPD surveillance, thanks to molecular serotyping, more detailed typing, generation of internationally comparable data, and improved evaluation of the effectiveness of vaccination programmes.

Aim: Pinworm infection (known as enterobiasis or oxyuriasis) is one of the most common parasitic diseases globally and in the Czech Republic (CZ). The aim of this study is to analyse the available epidemiological data on the incidence of enterobiasis in the CZ from 2018-2022.

Methods: A descriptive analysis was done of enterobiasis (ICD-10 code B80) data reported to the electronic Infectious Disease Information System in the CZ from 2018 to 2022. Data processing and analysis were conducted using MS Excel 2016. Univariate and multivariate logistic regression analyses were performed to assess the association between the probability of hospitalization and categorical variables using STATA version 17. The ECDC Map Maker tool (EMMa) was used to create the incidence map.

Results: A total of 4,836 cases were reported during the study period, with an average annual incidence of 9.1 cases per 100,000 population. The highest number of cases occurred in 2019 (n = 1,174), and the lowest in 2021 (n = 780). The disease was most common in the paediatric population, with the highest average age-specific incidence rates observed in children aged 5-9 years (80.9 per 100,000 population) and 10-14 years (42.3 per 100,000 population). Of 14 administrative regions of the CZ, the Olomouc Region had the highest average annual incidence (28.7 per 100,000 population), while the Pilsen Region had the lowest (2.2 per 100,000 population). A total of 472 (9.8%) patients needed hospitalization, most of them in the categories 10-14 years (n = 200, 42.4%) and 5-9 years (n = 178, 38%). The highest hospitalization rate was found in the age group 75+ (36.4%). A significantly higher probability of hospitalization was found in the age groups 6-19 years and 65+ compared to working-age population with enterobiasis. A significantly lower probability of hospitalization was seen in 2020-2022 compared to 2019. No difference in the hospitalization rates was noted between genders. No enterobiasis-related death was reported during the study period. The disease occurs year-round. A decrease in reported cases was observed annually during the school summer holidays in July and August. Neither outbreak nor imported cases were noted.

Conclusion: Given that enterobiasis is often asymptomatic, many cases are not captured in the surveillance system. The Czech prevalence data indicate that it mainly affects the paediatric population. Therefore, preventive measures and programs should primarily target children.

Aim: Aim of the pilot was to increase HIV/HCV/syphilis testing and linkage to care of newly diagnosed persons, improve data collection and transfer using standard data collection tools in CBVCT services.

Methods: Integrated anonymous voluntary testing from blood for HIV, HCV and syphilis was realised using rapid tests in the period of 6 months (03/2019-08/2019). Participants with reactive results were advised to see a specialist for confirmatory testing and/or treatment.

Results: A total of 675 clients were tested for HIV, 410 for HCV, and 457 for syphilis. Participants' median age ranged from 24 to 35.6 (IQR: 24), 75.3% of them were men, 23.7% were women, and 0.6% identified as transgender. In terms of groups at risk 48.9 % of 675 clients were men who have sex with men (MSM), 0.3 % sex workers (SW), 9.0 % people who inject drugs (PWID), 2.4 % migrants (Mi) and the rest of clients (8.3 %) belonged to groups at combined risk. Pilot revealed HIV, HCV and T. pallidum infections in 0.4 %, 2.4 % and 1.8 % of clients, respectively. Just 2 clients, confirmed HIV-positive, were linked to care. The highest prevalence of HIV (4.2 %), HCV (30.8 %) and syphilis (7.1 %) was found among MSM/Mi, PWID and SW/PWID, respectively. Condomless intercourse with SW, PWID, MSM and HIV-positive person in the last 12 months was reported by 5/92, 41/82, 3/78 and 0/88 of responding clients, respectively. Core indicators were included in the yearly national epidemiological report.

Conclusions: Pilot revealed the need to support integrated CBVCT to overcome barriers in confirmatory testing and linkage to care and to integrate core data of monitoring and evaluation (M&E) testing framework at CBVCT services into a national surveillance and M&E systems in Slovakia.

Aims: Since December 2022, an increase in invasive disease caused by Streptococcus pyogenes has been observed in the Czech Republic, with a shift in the clinical presentation and age of patients. Unlike in previous years, invasive disease is more common in children and adolescents under 18 years of age and in previously healthy middle-aged adults. An increase has been noticed in the number of S. pyogenes isolates from primarily sterile sites such as haemoculture, cerebrospinal fluid, pleural effusion fluid, joint fluid, and postmortem specimens. Routine emm gene typing revealed emm1 to be the predominant emm type of S. pyogenes. Between January 2023 and July 2023, 46% of all S. pyogenes isolates from invasive cases were assigned to the emm1 type. The globally spread M1UK sublineage is characterized by differences in the expression of seven genes, including the streptococcal pyrogenic toxin A (speA) gene, compared to historical emm1 iGAS strains. The aim of this study is to determine whether the more toxigenic M1UK sublineage is associated with the increase in invasive disease in the Czech Republic.

Methods: Whole genome sequencing of 41 S. pyogenes isolates from patients with invasive disease recovered in the Czech Republic in 2018 and 2019 and from December 2022 to May 2023 was performed using the MiSeq instrument (Illumina). Bioinformatics analysis was performed using freely available online tools the Bacterial and Viral Bioinformatics Resource Center.

Results: Based on whole genome sequencing data of 41 emm1 isolates of S. pyogenes from patients with invasive infectious disease recovered in 2018 and 2019 and from December 2022 to May 2023, the M1UK sublineage was found to be predominant from December 2022 to May 2023.

Conclusion: The reason for the spread of the M1UK sublineage in the Czech Republic late in 2022 and in the first half of 2023 is not entirely clear, but it may be related to reduced immunity due to limited GAS transmission during lockdowns, especially in children. Another factor that may have contributed to the high incidence of invasive infectious diseases is the seasonal circulation of respiratory viruses.

Aim: Risk behaviour is typical of adolescence and young adulthood, but the consequences can persist for the rest of life - in all domains - physical, psychological, and social. Challenging situations, stress, as well as feelings of a lack of stimulation in an individual's life are considered to be triggers for risky behaviours. Prevention therefore plays a crucial role. The aim of the study was to analyse the current situation in addictive and risky sexual behaviours in a group of university students.

Material and methods: Between 2019 and 2022, students of universities in East Bohemia - University of Hradec Králové (UHK), Charles University (UK), University of Defence (UNOB), and University of Pardubice (UPCE) - were approached and asked to complete a questionnaire survey focused on addictive and risky sexual behaviours. Based on the search strategy, research hypotheses were constructed, which were subsequently developed into interview questions. The research hypotheses were tested using Pearson's test. The questionnaire return rate was 84%. After eliminating invalid responses, 157 participants were included in the survey - 64% female, 36% male, age range 19-32 years.

Results: In the area of addictive behaviours, the focus was on substance and non-substance addictions. In terms of addictive substances, a question addressed cigarette smoking, which was reported by 14.6% of the survey participants. This is 50% less than what we see in the general population of the same age (by general population we mean the group of people approached for the surveys conducted, chosen by stratified random sampling based on age). In contrast, significantly higher rates of university students reported the use of illicit substances - marijuana, sedatives/tranquilizers without a doctor's prescription, cocaine, or hallucinogens compared to the age-matched general population. In the area of risky sexual behaviours, a question was included       about sexual intercourse with casual acquaintances. It was experienced by one in four respondents. In 83.3%, this behaviour was influenced by the use of an addictive substance. The survey pointed to the high rates of salutoprotective factors (e.g. interest in sports was reported by 87.9% of respondents). Perceived social support from friends (reported by 74.5% of respondents) or family (reported by 72.6% of respondents) is a preventive factor for risky behaviours.

Conclusions: The aim of the survey was to determine the prevalence of high-risk addictive and sexual behaviours among university students and possible prevention measures. Salutoprotective factors during increased stress or awareness of social support seem to be of benefit. We assumed a protective effect of higher education, but this survey did not show it. On the contrary, the stress induced by university studies and the pressure on academic performance appeared to be a risk factor.

Aim: To analyse clinical, laboratory, and epidemiological data of a cohort of patients with acute hepatitis E treated at the Clinic of Infectology and Travel Medicine (CITM) in Košice.

Material and methods: Retrospective analysis of hospital information system data on patients diagnosed with acute hepatitis E who were examined or hospitalized at CITM in 2015-2023. Statistical evaluation of the available data with a focus on epidemiology, course, and complications.

Results: The cohort consisted of 62 patients. Fifty-eight percent were male. The mean age was 56 years. Seventy-four percent of patients were hospitalized, with a mean length of hospital stay of 10 days. The most common clinical manifestation was jaundice (in 40% of patients). Six patients had stool HEV RNA testing and all were confirmed to have genotype 3. In 5% of patients, the infection was classified as imported (they did not have HEV RNA tested), and 95% of cases were autochthonous. A history of contact with an HEV infected person was reported by 26% of patients. A history of preexisting liver disease was noted in 13% of patients who were confirmed with higher bilirubin, GMT, and ammonia levels. No statistically significant differences were found for patients with a history of immune deficiency. One patient with preexisting liver disease developed fulminant infection resulting in death. Four hepatitis E patients with neurological symptoms had lower bilirubin levels.

Conclusions: The study cohort included predominantly older men. Genotype 3 was confirmed in all patients who underwent HEV RNA testing. Higher bilirubin, ammonia, and GMT levels were confirmed in patients with preexisting liver disease. Patients with neurological complications had lower bilirubin levels. One patient with preexisting liver disease died.

Objectives: Due to the lack of data on the frequency and seriousness of respiratory syncytial virus (RSV) infection in the Czech Republic among children under 1 year, an analysis was made of available data on hospitalizations and the risk of hospitalization was estimated for different age groups.

Methods: Data from the Registry of Reimbursed Health Services and the National Registry of Hospitalizations were used for the analyses. Hospitalizations and deaths due to RSV infection (diagnoses J12.1, J20.5, J21.0) from 2017-2022 were analysed by month of the first year of life.

Results: Over the study period, there were 4,356 hospitalizations with the above diagnoses, ranging between years from 172 to 1,445. The estimated overall hospitalization risk per 100,000 population and year for diagnoses J12.1, J20.5, and J21.0 was 656.26, varying between 156.29 (2020) and 1,294.12 (2021). Age-group analysis showed the highest risk for children under 6 months of age (953.97/100,000 population per year). They accounted for 72.7% of the total of hospitalizations in patients under 1 year of age, with the highest number of hospitalizations observed in 1-3-month-olds. The most frequent cause of hospitalizations with RSV infection was bronchitis, representing 55.4% of the above diagnoses. During the 6-year period, 3,771 full-term infants and 585 (13.4%) preterm infants were hospitalized. Among those 4,356 hospitalized with diagnoses J12.1, J20.5, and J21.0, 22 deaths (0.5%) were reported.

Conclusions: RSV-associated hospitalizations have been recorded in all age groups in the Czech Republic. The highest RSV-associated hospitalization risk in 2017-2022 was estimated among children under 6 months of age. Passive surveillance using the available registries can be currently considered as an appropriate basis for adopting targeted measures specifically tailored to the youngest age categories.

Aim: Whole genome sequencing (WGS) analysis of candidate virulence genes of epidemiologically and/or clinically related invasive and non-invasive isolates of Neisseria meningitidis from 2005-2021.

Material and methods: Seventy-nine isolates were selected for analysis from three different categories: cases of invasive meningococcal disease (IMD) and their healthy contacts, different clinical specimens from the same IMD case, and different clinical specimens from the same IMD case and their healthy contacts. WGS was used to analyse sequence variability in candidate N. meningitidis virulence factor genes, with more than 250 loci studied.

Results: The frequency of sequence changes in the candidate N. meningitidis virulence factor genes of invasive and non-invasive isolates varied widely. The highest level of variability was observed in the pilus genes, especially pilE and pglA. Our study detected variability in the opacity protein A (opaA) gene in more than half of the isolates analysed, with the frequency of opaA gene changes reaching almost 70% in MenC isolates. Higher frequency of changes were also observed in the genes for capsule production, especially in those of the D+D' capsular region.

Conclusions: The results obtained support the hypothesis that serogroup-specific genetic mechanisms are also involved in the pathogenicity of N. meningitidis. These data add to the body of knowledge necessary for the development of new effective IMD vaccines.

Rabies is a viral disease that occurs in more than 150 countries worldwide. According to the World Health Organisation, this zoonotic disease causes an estimated 59 000 human deaths each year, with 95% occuring in Africa and Asia. The most common route of transmission is through the bite of an infected dog. The disease is preventable by vaccination, and effective prophylaxis is also available after animal bite injury. However, if the patient develops clinical signs, the disease is almost always fatal. The aim of this brief report is to summarise information on the global impact of rabies and to present the Zero by 30 strategy, which aims to achieve the elimination of human deaths due to rabies transmission from infected dogs by 2030.

In 2006-2022, 958 cases of invasive meningococcal disease (IMD) were reported to the surveillance programme in the Czech Republic, of which 21 (2.19%) had a history of vaccination with one of the meningococcal vaccines. Data analysis shows that these vaccines provide a very good protection against IMD. It was found that vaccinated patients with IMD either were not vaccinated against the causative serogroup and/or did not receive a booster dose. The results of this analysis show the benefit of both vaccines available in the Czech Republic: recombinant vaccine containing meningococcal serogroup B antigens (MenB vaccine) and tetravalent conjugate vaccine containing antigens of four meningococcal serogroups A, C, W, Y (A, C, W, Y conjugate vaccine). The results also show the benefit of meningococcal vaccine booster doses and the need for giving MenB vaccine to young children as early as possible.