Epidemiologie Mikrobiologie Imunologie最新文献

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.

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.

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.

Human papillomavirus (HPV) is the most common sexually transmitted viral infection worldwide, which may result in the development in benign lesions or malignant tumors. The prevalence of HPV infection is twice as high in pregnancy as in non-pregnant women. Additionally, there is a risk of vertical transmission of HPV from mother to fetus during pregnancy or childbirth. Various studies have reported an increased risk of adverse pregnancy outcomes in HPV-positive women, including miscarriage, preterm birth, premature rupture of membranes, preeclampsia, fetal growth restriction, and fetal death. HPV vaccination is not currently recommended during pregnancy. On the other hand, there is no evidence linking HPV vaccination during pregnancy with adverse pregnancy outcomes and termination of pregnancy is not justified in this case.

Objectives: Given the lack of data on the seriousness of respiratory syncytial virus (RSV) infections in the Czech Republic, an analysis was made of available data on hospitalizations and the hospitalization risk was estimated by age group.

Methods: Data from the National 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 analyzed by age group.

Results: Over the six-year period, there were 6,138 hospitalizations with the above diagnoses, ranging between years from 307 to 2,162. The estimated overall hospitalization risk per 100,000 population and year for diagnoses J12.1, J20.5, and J21.0 was 9.64, varying between 2.87 (2020) and 20.56 (2021). Age-group analysis showed the highest risk for children under 6 months of age (891.6/100,000 population and year) and the lowest for 20-34-year-olds (0.1/100,000 population and year). Children under 1 year of age accounted for 63.1% of hospitalizations with the above diagnoses. For patients 65 years and older, the annual hospitalization rates varied between 3.3-15.3%. The most frequent cause of RSV-associated hospitalizations was bronchitis, diagnosed in 55.4% of patients. Among those hospitalized with diagnoses J12.1, J20.5, and J21.0, 38 deaths were reported, representing a case fatality rate of 0.62%. The highest case fatality rate (6.5%) was observed in the age group 35-49 years.

Conclusions: RSV-associated hospitalizations have been reported 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 could currently provide the basis for measures specifically tailored to the youngest age categories. Data on the hospitalization of adults, particularly senior citizens, must be improved and complemented with active surveillance.

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.

In a febrile patient admitted to the Adult Emergency Department, the haematology analyser detected the presence of erythrocytes infected with plasmodia. The finding was confirmed by thin smear and thick drop microscopy. A 43-year-old male patient was admitted to the Emergency Department with fever, vomiting, diarrhoea and pain in the upper abdomen. He reported a history of travel to Ethiopia and a short stay in Tanzania. The Sysmex XN series haematology analyser showed the activation of the iRBC flag signalling the presence of Plasmodium-infected erythrocytes. Thin smear and thick drop microscopy confirmed the presence of malaria plasmodia in erythrocytes.