The study aimed to summarize basic information on cancer screening in the Czech Republic. The study presents a list of screening programs for the early detection of selected cancers performed in the Czech Republic. It draws attention to the importance of systematic examination of asymptomatic patients to detect malignant diseases in their preclinical phase when the chance of complete healing is high. The role of general practitioners is pivotal in the implementation of the programs.
Alternative nicotine delivery products (ANDS) have gained popularity in recent years. Their potentially lower harm compared to traditional cigarettes and the possibility of using them as part of a harm-reduction strategy in tobacco addiction treatment have been discussed. Current epidemiological trends show a gradual increase in ANDS use by the general population, especially among adolescents and young adults, but also among non-smokers. The most comprehensive evidence regarding health effects is available for e-cigarettes, which suggests that their use does not increase cardiovascular risk, except for hypertension, compared to non-smokers, and reduces the risk of respiratory diseases compared to smoking traditional cigarettes; however, long-term data are lacking for older individuals. In the case of heated tobacco products, there is not enough reliable evidence on health risks compared to current smokers or non-smokers, while concerns remain about the potential toxicity of substances found in these products but absent in cigarette smoke. For nicotine pouches, there is a lack of reliable evidence on long-term effects. Electronic cigarettes are used as a smoking cessation tool in some countries, such as the UK. Existing evidence leans towards the potential use of e-cigarettes as a harm-reduction strategy, although there is currently no global consensus on their role in tobacco addiction treatment. Complete cessation of all tobacco and nicotine products remains the primary recommended approach.
Toxigenic strains of Staphylococcus aureus producing Panton-Valentine leukocidin (PVL) can cause life-threatening pneumonia in addition to skin and soft tissue infections. Pneumonia usually follows as a secondary bacterial infection after a respiratory virus infection. Between 2022 and 2024, the National Reference Laboratory for Staphylococci at the Centre for Epidemiology and Microbiology of the National Institute of Public Health in Prague confirmed PVL production in S. aureus isolates from 13 patients with invasive abscessing pneumonia. All of these patients deteriorated dramatically, needing critical care support. Nine of them died after a fulminant progression of the disease.
Introduction: Toxic epidermal necrolysis (TEN) is one of the most life-threatening skin exfoliative disorders. The disease is frequently misdiagnosed or diagnosed with a long delay. This, together with the unique pathology, leads to a high mortality of affected patients. The high risk of infections associated with extensive loss of skin and impaired function of the immune system is one of the most common complications in TEN patients.
Methods: All patients treated at our clinic with a diagnosis of TEN between January 1, 1996, and December 31, 2020, were included in this study. Basic epidemiological parameters, the incidence of infectious complications in individual compartments, clinical laboratory and microbiological parameters, and antimicrobial resistance of pathogens isolated during the hospital stay were collected.
Results: In total, 498 potentially pathogenic microorganisms (PPMs) were isolated in our patient group, i.e., on average more than 35 isolated PPMs per patient. Of these, 155 pathogens fell into the gram-positive spectrum (31.1%), and 331 into the gram-negative spectrum (66.5%). The effect of corticosteroid therapy on overall survival is also an interesting indicator. In patients with multifocal infection, the maximum corticosteroid dose was 965 mg of methylprednisolone, while in patients without multifocal infection, the maximum dose was 2.333 mg methylprednisolone (p = 0.032). Last but not least, we mapped the most frequently occurring pathogens, dominated by gram-negative bacteria, in particular Klebsiella sp. and Enterobacter sp. We also described the presence of antibiotic resistance in epidemiologically important pathogens in TEN patients with infectious complications.
Conclusion: We successfully identified basic epidemiological parameters in a cohort of patients treated with TEN along with the most frequent representatives of infectious complications. We were able to identify risk factors for the development of infectious complications and their impact on further complications of treatment as well as patient mortality.
Background: Sexually transmitted infections (STIs) are a serious health problem with global impact, more prominently in women. Their prevalence is increasing, and the preventive measure options are not being sufficiently innovated. The military environment is historically characterized by a higher incidence of STIs. A prospective cross-sectional study was conducted in order to analyze prevalence of common STIs in women of the Czech Republic armed forces.
Material and methods: Chlamydia trachomatis (C. trachomatis) and Neisseria gonorrhoeae (N. gonorrhoeae) detection was performed in 231 women between August 2020 and December 2023. Participants were divided into three groups according to their military status. Group A - recruits (n = 84), Group B - active soldiers (n = 43) and Group C - control civilian group (n = 104). Cervical smears were used to diagnose pathogens and data evaluating medical history and the occurrence of risk factors in women were obtained using a detailed questionnaire.
Results: Ch. trachomatis prevalence was 6.0% (5/84) in group A, 2.3% (1/43) in group B and 2.9% (3/104) in group C. There was no statistically significant difference between the groups (p = 0.601). No case of N. gonorrhoeae was recorded across the study (0/231). Regarding known STI factors, the groups differed significantly in age. The median age in group A was 26 years while it was 29 years in groups B and C similarly (p < 0.001). There was also significant in-between-groups difference in age of coitarche 16.0 vs. 16.0 vs. 17.0 years (p = 0,015). Women from group A reported more frequent absence from regular pap-smear attendance compared to other groups (12.0% vs. 16.3% vs. 3.9%) (p = 0.032).
Conclusion: This study did not show any significant difference in prevalence of C. trachomatis and N. gonorrhoeae in females of the Czech Republic Armed Forces compared to civilian women. Higher prevalence of selected STIs' risk factors were reported in recruits and active soldiers compared to civilian women. Although not conclusively, shown findings should be considered a reason to foster the research on STIs in the military environment and to enhance preventive measures among women in the armed forces to limit impact of known STIs' risk factors.
Aim: Whole Genome Sequencing (WGS) analysis of populations of Streptococcus pneumoniae of serotypes 10A, 11A, 12F, 15B, and 33F involved in invasive pneumococcal disease (IPD) in the Czech Republic (CR) in 2013-2023.
Materials and methods: The analysed serotypes of S. pneumoniae have been included in the recently registered pneumococcal conjugate vaccines (PCV): PCV15 and PCV20. The epidemiological analysis of the incidence of selected serotypes was based on nationwide IPD surveillance data from 2013-2023. WGS was used to analyse 177 isolates of S. pneumoniae of five serotypes: 10A, 11A, 12F, 15B, and 33F recovered from IPD in CR in 2013-2023. The Illumina MiSeq platform was used for WGS. The WGS data were analysed using tools of the PubMLST database where WGS data have been publicly accessible.
Results: Epidemiological analysis of the incidence of S. pneumoniae serotypes 10A, 11A, 12F, 15B, and 33F involved in IPD showed their increase after the vaccines PCV7, PCV10, and PCV13 had been introduced in CR. IPD cases caused by serotype 10A peaked in 2015 (17 cases), serotype 11A was the most frequent cause in 2018 (19 cases), serotype 12F predominated in 2015 (18 cases), serotype 15B in 2023 (11 cases), and serotype 33F in 2015 (6 cases). During the COVID-19 pandemic, IPD cases caused by the listed serotypes declined. In the post-pandemic period, the involvement of serotypes 10A and 11A in IPD cases increased again, as did that of serotype 15B. WGS data analysis showed a clear dominance of a large and genetically compact cluster of ST-1551 among Czech isolates of serotype 10A. Czech serotype 11A isolates were assigned primarily to ST-62 or other related sequencing types. Czech serotype 12F isolates were part of three major clusters unrelated to each other (ST-218, ST-989, and ST-8060). Czech serotype 15B isolates showed a high genetic heterogeneity and belonged to three major European clusters (ST-162, ST-199, and ST-1262) with a predominance of ST-162 isolates. In our study, serotype 33F was only represented by six isolates, four of which were of ST-100.
Conclusion: Both Czech and European populations of S. pneumoniae of different serotypes show considerable heterogeneity. They include serotypes in which related isolates of a single ST (11A) predominate, as well as serotypes that consist of several completely unrelated clusters (12F, 15B). The structures of these individual populations are continually changing over time and also differ within individual European countries. It is important to monitor S. pneumoniae populations as closely as possible and to use the data obtained to evaluate the possibilities for introducing new PCVs in the Czech Republic.
Aim: To describe the epidemiological situation of rotavirus gastroenteritis (RVGE) and the impact of vaccination on hospitalization for RVGE in the Czech Republic in 2018-2023.
Methods: A descriptive analysis was performed of anonymized RVGE cases reported under code A08.0 to the Infectious Diseases Reporting System (ISIN) in the Czech Republic in 2018-2023. The Chi-square test was used to analyse binary variables. The effect of vaccination on hospitalization was assessed using logistic regression with odds ratio (OR) and 95% confidence interval. Excel, STATA, and Datawrapper GmbH programs were used. The incidence of the disease was calculated per 100,000 population.
Results: In the monitored period, a total of 26,303 RVGE cases were reported in the Czech Republic (range 1,811-7,483 per year), which corresponds to an average annual incidence of 41.0 (range 16.9-69.6) per 100,000 population. Fifty-one percent of cases occurred in women. The average annual sex-specific incidence rates were comparable. Patients were aged 0-101 years (median 3 years, interquartile range [IQR] 1-8 years). The maximum numbers of cases were recorded in the months of March to June. In the pandemic years 2020 and 2021, the overall numbers of cases were lower, and therefore the seasonality was less expressed. The average annual specific incidence was highest in the Vysočina, South Bohemian and Olomouc Regions. A total of 18,693 (71.1%) cases of RVGE were hospitalized, most of them in the age groups 1-4 years (34.7%) and 5-9 years (11.9%). Vaccination data were available for 21,142 individuals with RVGE, of whom 304 (1.4%) were reported as vaccinated. The risk of hospitalization for RVGE was statistically significantly lower (p < 0.001) in vaccinated than in unvaccinated individuals. A total of 27 RVGE outbreaks were reported, with the largest one involving 152 cases. Two hundred and twenty-six cases were classified as imported.
Conclusions: After the introduction of RVGE vaccination in the Czech Republic, a reduction in RVGE cases, hospitalizations, and deaths was expected. However, a significant impact of vaccination on the RVGE burden has not yet been observed in the country. The main reason continues to be low RVGE vaccine coverage. We therefore recommend including this voluntary vaccination in the schedule covered by health insurance and also call for early communication of the appropriateness of such vaccination between the paediatric/adolescent medicine practitioners and children's parents.
Autoimmune encephalitis is a group of autoimmune-related diseases of the central nervous system with the predominant involvement of the cerebral cortex. It is a heterogeneous group of conditions manifested by newly emerging neurological and psychiatric deficits in previously healthy children. These disorders differ in severity, clinical course, and aetiology. Unlike the adult population, non-paraneoplastic encephalitis is prevalent in children. Antineuronal antibodies are the most critical prognostic and therapeutic indicators. Antibodies are directed either against surface antigens or intracellular antigens. Autoimmune diseases respond favourably to immunotherapy. Therefore, rapid diagnosis and timely treatment are essential and can lead to faster recovery and lower rates of relapses and cognitive deficits. This article focuses on the diagnostic and therapeutic experience with the most common types of autoimmune encephalitis and antibody-mediated demyelinating syndromes in childhood at the University Hospital Ostrava.
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