Epidemiologie Mikrobiologie Imunologie最新文献

Objective: The aim of the study was to determine the prevalence of arterial hypertension and its awareness rate and control rate among diabetes mellitus (DM) patients in the Czech Republic between 25-64 years of age and to compare the results with those in age-matched non-diabetic patients.

Materials and methods: Blood pressure measurement data of 1 170 respondents (467 men and 703 women) obtained during the EHES study in 2014 were analysed. DM was diagnosed in 95 (8.2%) respondents (44 men and 51 women).

Results: Mean systolic blood pressure in DM patients was 130.7 ± 18.3 vs. 123.2 ± 16.8 mmHg in non-DM subjects (p < 0.001). The difference in diastolic blood pressure was on the borderline of statistical significance (82.2 ± 9.4 mmHg in DM vs. 80.0 ± 10.6 mmHg in non-DM subjects, p = 0.051). Among the study population, 69.5% of DM and 34.2% of non-DM subjects suffered from arterial hypertension (p < 0.001). The hypertension awareness rates were 87.9% in the DM group and 66.8 % in the non-DM group. (p = 0.001). The percentage of treated arterial hypertension was 94.8% in DM patients vs. 80.5% in the non-DM group (p = 0.010). The blood pressure target of < 140/90 mmHg was achieved in 47.3% of DM patients vs. 60.6% in non-DM subjects (p = 0.077). Using a blood pressure target of < 130/80 mmHg, adequate arterial hypertension control was achieved in only 29.1% of DM patients. When comparing the achievement of the blood pressure targets recommended for diabetic patients (< 130/80 mmHg) and non-DM patients (< 140/90 mmHg), the difference between these groups was statistically significant (p < 0.001) in favour of the non-diabetic group.

Conclusion: The study has shown the prevalence of arterial hypertension to be twice as high in DM patients aged 25-64 compared to the age-matched non-DM subjects in the Czech Republic. The adequate blood pressure control rate is significantly lower in DM patients than in the non-diabetic population. The study results indicate that the blood pressure targets recommended for diabetic patients (< 130/80 mmHg) are not always reached in clinical practice.

Background: The COVID-19 pandemic has affected substance use and other addictive behaviour, however detailed insight is lacking.

Material and methods: Online questionnaire survey on the sample of 3,000 respondents aged 15+ randomly selected from the Czech internet panel using socio-demographic quotas was performed shortly after the end of confinement measures in May 2020 (response rate 35.4%). Questions covered current prevalence and patterns of substance use (i.e. in the last 12 months) and other forms of addictive behaviours as well as changes in their behaviour during the confinement measures. Responses were provided on categorical scale; a factor of 0 to 2 was assigned to the categories to quantify the changes where 1 means no change.

Results: Respondents reporting the highest frequency of current use, especially the use of alcohol, cannabis and sedatives, further increased their intensity of use during the confinement measures by 5-10% on average, while less frequent users reduced it. The reduction of use during confinement measures increased with decreasing frequency of current use. Although the same correlation exists in tobacco smokers, decrease in intensity of use was observed also in daily smokers. On the population level, our results suggest a slight increase in total alcohol and sedatives consumption and a significant increase in the total consumption of gaming and social media. On the contrary, there was a significant reduction in the consumption of tobacco and online gambling (likely due to the ban on sports matches), and a slight reduction in the consumption of cannabis and other illicit drugs.

Conclusion: People with intensive patterns of substance use increased their use during confinement measures. The same concerns gaming and social media. Without this insight the overall picture suggests rather overall reduction of consumption. Addiction treatment system should prepare for the increase of treatment demand following COVID-19 epidemic.

Aim: To present the results of whole genome sequencing (WGS) analysis of Streptococcus pneumoniae serotype 19A and to compare them with the respective data from Europe. The vaccine serotype 19A is widely distributed in the Czech Republic.

Material and methods: WGS was used in this study as the most powerful available method for detailed characterization of S. pneumoniae. Nineteen Czech isolates of S. pneumoniae 19A were analysed and compared with 415 European isolates included in the PubMLST database.

Results: S. pneumoniae serotype 19A causes all types of pathogen - host interaction, from carriage to noninvasive and invasive pneumococcal disease (IPD). In 2010 - 2019, 3872 cases of IPD were reported within the surveillance programme in the Czech Republic, with 323 of these caused by serotype 19A. WGS data of the Czech serotype 19A isolates show a numerous and genetically related subpopulation of three sequencing types: ST-199, ST-416, and ST-3017. Within this subpopulation, the largest is the cluster of nine ST-199 isolates. High relatedness of ST-199 isolates is also confirmed by the fact that all but one isolate, 117/2019 (novel rST- -137805), share the same ribosome sequencing profile - rST-11365. Outside the above-mentioned subpopulation, there are only four isolates that form three separate genetic lines of serotype 19A. A highly similar situation is observed across European countries, where about half of all serotype 19A isolates form a genetically closely related subpopulation (ST-199, ST-416, ST-450, ST-667, ST-3017, and ST-10360) while isolates which are not part of this subpopulation represent a large number of unrelated genetic lines.

Conclusions: The study has shown a mostly homogeneous population of S. pneumoniae serotype 19A to circulate in the post-vaccination era in both the Czech Republic and Europe, with some unrelated isolates located outside this population.

Non-O1/non-O139 vibrios refer to all vibrios except toxin producing Vibrio cholerae serogroups O1 and O139. The prevalence of illness caused by non-O1/non-O139 vibrios steadily increases all over the world in the last 20 years, which is very probably related to global warming. These infections are reported year-round from tropical and subtropical climate zones, but they were also detected in the mild climate zone of the United States of America and Europe. In mild climate, they have markedly seasonal occurrence, typically peaking in May to October. A human can be infected after ingestion of contaminated food, especially seafood and fish, or water or while bathing. In Europe, non-O1/non-O139 vibrios were detected in the Baltic Sea, North Sea and Mediterranean Sea but also in ponds and rivers. Depending on the pathogen entry route, the clinical manifestation may appear as gastroenteritis, otitis, wound infection or severe up to fatal illness, predominantly in immunocompromised patients. There is no specific prevention. Non-specific prevention includes good personal and food handling hygiene practices and avoiding contact of unhealed wounds with sea or surface swimming water. Given the severity and increasing frequency of infections caused by non-O1/non-O139 vibrios, they should be considered in differential diagnosis of gastrointestinal and wound infections, especially in patients with a history of consumption of fish and seafood or with a history of contact of unhealed wounds with sea or other open swimming water.

Aim: This study aims to determine the prevalence of latent tuberculosis infection (LTBI) in patients with moderate to severe rheumatoid arthritis (RA) who receive conventional and anti-cytokine therapy, to identify possible risk factors for tuberculosis (TB) and to evaluate the prophylactic treatment in positively screened patients.

Patient and methods: We conducted an observational, retrospective study in patients with RA, who underwent LTBI screening (chest X-ray, tuberculin skin test and interferon gamma release assay test - IGRA test).

Results: Out of 124 patients included, 7.25% of patients were diagnosed with LTBI during the treatment with conventional synthetic anti-rheumatic drugs in combination with glucocorticoids before initiation of anti-cytokine therapy. Another 21.77% were diagnosed during treatment with biologics or Janus kinase inhibitors. We confirmed the highest incidence of LTBI in TNF-treated group (66.66% LTBI positive patients), but also found positive screening in patients treated with other modalities. The mean LTBI detection time since the initiation of anti-cytokine therapy was 39.5 months (12-134 months). Active TB with clinical manifestation has occurred in one patient. Statistical analysis did not show an association between risk of LTBI and age, sex or treatment modality.

Conclusion: The results of this study confirm the necessity of LTBI screening and long-term monitoring in RA patients treated with any kind of anti-cytokine therapy. The currently used national recommendations are sufficiently sensitive to identify TB in these patients. There remains a question of screening and prophylactic antituberculosis therapy in patients treated with conventional synthetic anti-rheumatic drugs in combination with glucocorticoids.

Borrelia miyamotoi is an emerging tick-borne pathogen phylogenetically belonging to spirochaetes causing relapsing fever. It is primarily transmitted by ticks from the Ixodes ricinus complex, similarly to borreliae causing Lyme borreliosis. Small rodents can serve as reservoir hosts. It is widespread in mild climate areas of the northern hemisphere, with constant low prevalence in ticks, in the range of units of percent. To date more than 200 human cases have been described including five cases of meningoencephalitis in immunocompromised patients. Clinical features of illness are non-specific, characterized by fever, fatigue, chills, headaches, muscles and joint pains. It can be treated with antibiotics. The diagnostic approach includes mainly PCR and serological methods. This review summarizes current knowledge on B. miyamotoi with an emphasis on taxonomy, ecology of vectors and reservoir hosts, geographical distribution, diagnosis and treatment of the disease. The review also highlights the need for an accurate determination of the etiology of the disease and its differentiation from Lyme borreliosis and human granulocytic anaplasmosis.

The members of the viral family Polyomavirae are widespread in the human population. According to serological studies, almost all adults are infected with at least one of this group of viruses. The primary infection usually occurs in childhood without any clinical signs, and after the primary infection, the viruses establish a persistent infection accompanied by occasional reactivation and shedding of the virus. These viruses often reactivate in immunosuppressed individuals, but only in a minority of these patients, the reactivation results in disease development. This biological property of human polyomaviruses makes laboratory diagnosis considerably difficult. The paper provides an overview of methods for diagnosing human polyomaviruses, which are commonly used for screening, and methods that are still validated by research but have the potential to improve detection and to identify patients at risk of developing diseases associated with polyomavirus infection.

The dysregulated inflammatory process not only plays an important role in the development of chronic plaque psoriasis but also is a major pathogenetic mechanism behind the generalized pustular psoriasis (GPP) and other rare pustular forms of the disease. The key players in this process are the cytokines interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF), IL-12/23, IL-17A and especially IL-36. Their excessive activity or production in some GPP patients is due to mutations in genes that encode molecules involved in inhibiting the action of IL-36 (IL-36Ra) or in intracellular inflammatory signaling (CARD14, AP1S3). Knowledge about the pathological role of inflammatory cytokines in the development of pustular forms of psoriasis has also found application in their biological therapy with monoclonal antibodies that neutralize the action of IL-12/23, IL-17A, TNF or IL-1β. Other promising agents are monoclonal antibodies against the interleukin 36 receptor, which have already successfully gone through the first phases of clinical trials and are currently being tested for their long-term efficacy, safety and tolerability.

B cells play a vital role in the defence of the body against infectious agents. Apart from their ability to present antigen to T cells, B cells are mainly producers of antibodies. These play a crucial role in the effective elimination of infection and are also involved in the regulation of the immune response. The analysis of peripheral blood B cell subpopulations that makes it possible to monitor the development of B cells to the stage of antibody producing plasmablasts provides a valuable laboratory parameter which is important for both the study of the pathogenesis and diagnosis of some diseases. Laboratory analysis of B cell subpopulations is now a routinely available laboratory option thanks to the development of multicolour flow cytometry. This article summarizes the core knowledge which is currently applied to the analysis of B cell subpopulations in immunological laboratories.

The present paper analyses the development of invalidity in people living with HIV over a nine-year period from 2010 to 2018. The disability assessment criteria currently in place were introduced in 2010 and are legally regulated. The paper draws from the Czech Social Security Administration data to analyse the incidence of invalidity as a result of HIV infection compared to other diseases in the Czech population. The authors illustrate the invalidity assessment criteria with a case study. In the final part, updating the current assessment criteria is recommended, also because of the envisaged ICD-11 implementation in the Czech Republic.