Epidemiologie Mikrobiologie Imunologie最新文献

Objectives: Long-term monitoring of the mutual effects of chronic viral hepatitis C (VHC) treatment and tailored addiction treatment. In 2016, the World Health Organization (WHO) published an action plan to eliminate viral hepatitis C globally by 2030. People who inject drugs (PWID) are a key population that needs increased attention and care. Two decades before the announcement of the WHO plan for the global elimination of HCV (hepatitis C virus), the Remedis Medical Facility, where the study was conducted, established a “Comprehensive Care Program for patients with substance use disorders and addictive behaviour”.

Methods: We evaluated all patients who were in the methadone program as of 1 March 2020, regardless of OST duration, OST dosage, age or gender. Their epidemiological and demographic data obtained during a structured clinical interview and laboratory test results were analysed.

Results: Of 24 patients on methadone substitution therapy, 12 (50%) were anti-HCV negative before starting OST. None of them became newly infected with hepatitis C virus (HCV) during OST. The remaining 12 of the study patients were anti-HCV positive. Ten of them have already undergone successful treatment for viral hepatitis. Two patients were re-infected with HCV.

Conclusion: The presented work confirms the high efficacy of chronic VHC treatment among PWID in inducing suitable conditions. We consider combination of HCV infection treatment and targeted tailored addiction treatment as a starting point for achieving control over the HCV epidemic in the Czech Republic, with a possible positive impact on other blood-borne infections related to risky behaviour.

Objective:  The aim of this study was to evaluate attitudes towards the available preventive measures, risk behaviour and health problems in Czech travellers to tropical and subtropical regions.

Materials and methods:  The prospective study included patients of all ages with a history of recent travel to risky countries who presented to the post-travel clinic of the Hospital Na Bulovce in Prague within two months after return, from February 2009 to June 2018. The data were collec-ted through a questionnaire survey and from electronic medical records.

Results:  Nine hundred and thirty-four patients (473 M and 461 F, age median of 32 years, IQR 27-39) participated in the study. The most frequent destinations were South-East Asia (332; 35.5%), South Asia (176, 18.8%), and Sub-Saharan Africa (172; 18.4%). The most common reasons for tra-vel were tourism (772; 82.7%) and business (111; 11.9%). An underlying chronic disease was reported by 317 patients (33.9%). Pre-travel health consultation was sought by 415 travellers (44.4%); however, only 312 (33.4%) of the respondents were properly vaccinated. Preventive malaria chemoprophylaxis was indicated in a total of 151 travellers (16.2%) but was only received by 44/151 patients (29.1%). Risky eating or drinking behaviour was admitted by 832 (89.1%) respondents and low standard accommodation by 525 (56.2 %) travellers. The most commonly reported clinical syndromes were acute and chronic diarrhoea (266; 28.5%), febrile illness (240; 25.7%) and skin lesions (166; 17.8%). A total of 199 patients presented with tropical infection (21.3%) and 63 with a vaccine-preventable infection or malaria (6.7%).  Conclusions: The study shows that the adherence of Czech travellers to preventive measures is relatively low, and along with risky behaviours, has a significant impact on travel-related morbidity. However, vaccine-preventable infections only accounted for a small fraction of travel-related illness, which is in accordance with other epidemiological studies and points out the need for a more comprehensive interdisciplinary approach to pre-travel health consultations.

Aim: Achieving sufficient vaccination rate (and herd immunity respectively) is considered to be the most promising strategy for prevention of outbreaks of novel coronavirus disease in future. The main aim of this work was to compare willingness of university students to receive vaccine against COVID-19 with vaccines for adults against other well-known diseases. Another aim was to assess students´ opinion on growing trend of parents refusing to vaccinate children.

Methods: The online questionnaire shared with students consisted of 12 questions. It was distributed via university bulk emails and social media.

Results: 3,133 students responded to our questionnaire. Overall university response rate was 15.9%. Students of our university showed significantly much stronger interest in receiving vaccine against COVID-19 than vaccine against other diseases (p < 0.0001). Students also showed strong pro-vaccination attitude to vaccination of children.

Conclusion: The study showed very well sudden change of attitude of university students to vaccination of adults at the time of strong restrictive regulations. Most of university students had pro-vaccination attitude to vaccination of children.

The clinical course of the SARS-CoV-2 virus infection (COVID-19 disease) in paediatric patients is predominantly mild. However, in a small percentage of paediatric patients, the COVID-19 could lead to the development of with the Paediatric Inflammatory Multisystem Syndrome (PIMS) presenting as high fever, gastrointestinal symptoms, neurological symptomatology and even as multiorgan dysfunction. These three cases represent the first published report of critically ill paediatric patients with PIMS in the Czech Republic.

Aim: Presentation of the first results of the analysis of Neisseria meningitidis isolates from invasive meningococcal disease and from clinically and/or epidemiologically linked cases from 2010-2019. Whole genome sequencing (WGS) was used for the study.

Material and methods: The study set included 59 isolates of N. meningitidis from 2010-2019. Serogrouping was done by conventional serological methods and confirmed by RT-PCR. WGS was used for detailed molecular characterization, covering not only basic genes but also ribosomal and capsular genes, antibiotic resistance gene penA, and outer membrane protein gene porA.

Results: WGS analysis of N. meningitidis isolates resulted in a detailed molecular characterization. In a large part of the genes analysed, new mutated allelic variants were found. They were submitted to the PubMLST database and subsequently annotated by the curator. All 59 study isolates were assigned to BAST types, characterized by a unique combination of allelic variants of N. meningitidis B vaccine (MenB vaccine) antigen genes. Overall, 32 different BAST types were identified, and 10 isolates either carried an unknown combination of BAST loci or a new allelic variant in some of the BAST loci. Furthermore, the MenDeVAR index, which provides information on the functional effect of MenB vaccines on a given isolate, was determined.

Conclusions: The results obtained add to the body of knowledge of the transmission of invasive and non-invasive strains of N. meningitidis in the population. The WGS analysis provided detailed data on the coverage of these strains by new MenB vaccines.

Acute leukaemias are malignant diseases of haematopoiesis, traditionally classified according to the affected cell line as acute lymphoblastic and acute myelogenous leukaemia. In terms of incidence, acute leukaemias are rare diseases - in the Czech Republic, only 2-3 new acute myelogenous leukaemia cases/100 000 population are diagnosed annually and less than 1 new case of acute lymphoblastic leukaemia/100 000 residents. The causes of acute leukaemias are still poorly understood. The established risk factors are age, ionizing radiation or Downs syndrome. Moreover, a number of potential risk factors have been described to play a role in development of acute leukaemias and to multiply the risk, such as physical factors, chemicals, genetic and familial predispositions or other diseases. The presented review summarizes the knowledge of the aetiology of acute leukaemias published since 2000. It describes their epidemiological characteristics and risk factors and outlines the possibilities for their prevention.

Mumps is an infectious viral disease transmitted by droplets. It is vaccine preventable and thanks to the start of compulsory vaccination in 1987, there has been a significant reduction in cases. Nevertheless, over the years, occasional local outbreaks have occurred in the Czech Republic, especially in adolescents, while in Slovakia, since the beginning of vaccination, the situation has been kept under somewhat better control. This may be explained by the differences in the vaccination schedules between the countries and the consequent secondary vaccine failure, the so-called waning of immunity in Czech older children, adolescents, and young adults. The article summarizes current knowledge about mumps and data on its incidence in the Czech Republic and Slovakia.

Inflammatory diseases of the skin and soft tissues are an important group of human infections. The most common causes are the bacteria Staphylococcus aureus and Streptococcus pyogenes. Given the growing resistance of these pathogens to antimicrobials, the current research focuses on the search for novel therapeutic options that would be effective against infections refractory to conventional antimicrobials. A promising alternative is the use of enzyme-based antimicrobials (enzybiotics) that degrade the bacterial cell wall. They target the specific pathogen but do not affect the skin microbiome, thus helping the healing process. As enzymes can be poorly soluble, unstable, or subject to rapid elimination from the body, efforts are made to create biobetters, i.e., enzymes with improved characteristics. Emphasis is also put on the development of novel enzybiotic carriers or wound healing dressings with integrated enzymes.

Objective: The aim of this study was to analyse epidemiological and clinical characteristics of invasive pneumococcal disease (IPD) in adults before and after the introduction of the general childhood conjugate pneumococcal vaccination programme in the Czech Republic.

Material and methods: The retrospective observational sentinel study included adults with IPD admitted to the Na Bulovce Hospital in Prague from 1/2000 through 12/2019. A case of IPD was defined as isolation of Streptococcus pneumoniae from a primarily sterile site.

Results: A total of 304 IPD cases were diagnosed during the study period, with a male to female ratio of 1.49:1 and age median of 58 years (IQR 43-73). The most prevalent clinical forms were bacteraemic pneumonia (185 cases; 60.9%) and purulent meningitis (90; 29.6%). A total of 157/293 patients (53.6%) required intensive care, and the case fatality rate was 25.3% (n = 77). The serotype was determined in 292 (96.0%) isolates, the most prevalent being serotypes 3 (38; 12.5%), 4 (28; 9.2%), 7F (24; 7.9%), 8 (21; 6.9%), and 1 (18; 5.9%). Both clinical and epidemiological characteristics of IPD caused by the most prevalent serotypes differed considerably. Patients diagnosed with serotype 3 were older, more frequently required intensive care, and showed higher mortality. The proportion of IPD caused by non-PCV13 serotypes increased from 28.8% (19/66) in 2000-2005 to 54.8% (40/70) in 2015-2019 (p = 0.001).

Conclusion: The study demonstrated that invasive diseases caused by the most prevalent pneumococcal serotypes differ in their epidemiological and clinical characteristics and case fatality rate. During the study period, there was a significant increase in IPD caused by non-PCV 13 serotypes, limiting the effect of vaccination in adults.

Tick-borne encephalitis (TBE) is a febrile illness caused by tick-borne encephalitis virus (TBEV), frequently manifesting as inflammation of the central nervous system. TBEV is a typical arbovirus, i.e., belongs to a group of viruses transmitted by blood-sucking arthropods. Taxonomically, TBEV is a member of the genus Flavivirus, family Flaviviridae. The disease is endemic in North Eurasia, from western Europe to East Asia. The virus occurs in natural foci of the disease all over Czechia, where it is transmitted predominantly by the castor bean tick (Ixodes ricinus). This infection has a potential to cause significant long-term disability affecting the quality of the patients life. Vaccine is available; however, vaccination coverage in Czechia is still low (around 30% of the total population). Lately, attention has been focused on new possibilities for early diagnosis and specific treatment, which so far has only been symptomatic or empirical.