EPIDEMIOLOGIE MIKROBIOLOGIE IMUNOLOGIE

[Streptococcus pneumoniae serotypes 8 and 22F causing invasive pneumococcal disease in the Czech Republic in 2014-2020: whole genome sequencing (WGS) analysis]
Kozáková J, Vohrnová S, Honskus M and Křížová P
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.
[Prevalence of the M1UK sublineage among emm1 Streptococcus pyogenes invasive strains isolated in the Czech Republic from December 2022 to May 2023]
Veselá R, Vohrnová S and Kozáková J
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.
[Analysis of patients with acute hepatitis E treated at the Clinic of Infectology and Travel Medicine in Košice]
Sekula J and Paraličová Z
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.
Povidone-iodine functionalized nanofibers are prophylactic and protect against dissemination of SARS-CoV-2 infection
Amler E, Vojáček V, Sopko B, Divín R, Pashchenko A, Varga J, Nečas A, Celer V, Filipejova Z, Urbanová L, Rulc J, Krajníková M and Jarošíková T
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.
[Infection of respiratory syncytial viruses (RSV) in the Czech Republic - analysis of hospitalizations and deaths in 2017-2022]
Pazdiora P, Šanca O and Dušek L
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.
Active surveillance of hospital-acquired infections in Pediatric Intensive Care Unit: a single center study
Fulová M, Kotrbancová M, Perželová J and Bražinová A
The aim of our study was to describe and analyze HAI incidence, etiology and risk factors in pediatric intensive care unit (ICU).
Asymptomatic SARS-CoV-2 infection in recipients of hematopoietic stem cells in the Omicron period
Šťastná-Marková M, Roubalová K, Hainz P, Kryštofová J, Labská K, Vosáhlová T and Němečková Š
We aimed to determine the prevalence of SARS-CoV-2 infection, including both symptomatic and asymptomatic courses, and to identify predictors of asymptomatic or symptomatic SARS-CoV-2 infection in patients within seven months after allo-HSCT (allogenic hematopoietic stem cell transplantation) in the Omicron period.
[Human papillomavirus infection (HPV) and pregnancy]
Sehnal B, Halaška MJ, Vlk R, Drochýtek V, Pichlík T, Hruda M, Robová H, Rob L and Tachezy R
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.
[An outbreak of septic conditions following surgery in the operating theatres of a primary hospital]
Prattingerová J, Poloprutská Š, Príkazský V, Smetana J and Valenta V
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.
[Occurrence of Francicella tularensis subsp. holarctica in haematophagous arthropods in the Breclav district in 2022]
Mravcová K, Zadražilová S, Vlčková I, Orlíková H, Malý M, Kynčl J, Mendel J, Hubálek Z, Šikutová S and Rudolf I
Tularemia is a zoonosis caused by Francisella tularensis, a gram-negative aerobic bacterium belonging to the class of Gammaproteobacteria and the family Francisellaceae. Despite its undeniable importance for human health, there is little data on the current distribution of F. tularensis in various hematophagous arthropods. The aim of this study was to perform a mass molecular screening of different possible hematophagous vectors: ticks (4348 ticks of the species Ixodes ricinus, Dermacentor reticulatus, and Haemaphysalis concinna), mosquitoes (4100 specimens of Aedes vexans), and blackflies (6900 specimens of the Simulium spp.) for the presence of F. tularensis in the Břeclav district in 2022. Only two specimens were positive for the specific DNA of Francisella tularensis subsp. holarctica. Both samples originated from D. reticulatus, one collected from infested roe deer and the other included in a pooled sample (n = 10). Both positive samples were sequenced, and the presence of F. tularensis subsp. holarctica was confirmed. In addition, the absence of F. tularensis in mosquitoes and black flies was documented.
Recurrent meningococcal infections as a sign of inborn error immunity
Molnár L, Bánovčin P, Prohászka Z, Petrovičová O, Markocsy A and Jeseňák M
Invasive meningococcal diseases (IMD) caused by Neisseria meningitidis are generally rare. They affect mostly selected age categories and risk groups of patients (in terms of age, comorbidities, or applied therapy), and the immune system and its defects may play an important modifying role. Meningococcal infections could be the first and only clinical sign of unrecognised immunodeficiency. IMD are a typical clinical presentation of inborn errors of immunity with low concentrations or dysfunction of the terminal components of complement cascade. Meningitis is present in approximately 40% of the patients with terminal complement components deficiencies and in 6% of the patients with properdin deficiency. Despite evident advances in the understanding of the pathogenesis of meningococcal infections and the mechanisms of immune defence against this pathogen, patients with defects in the alternative or terminal complement pathway are highly predisposed to invasive and recurrent meningococcal infections, usually with a mild course. Therefore, it is recommended that each patient with IMD, especially recurrent, should undergo an immunological examination to rule out complement deficiencies.
Comparison of procalcitonin levels with blood culture results and foci of infection in septic patients
Nejtek T, Müller M, Moravec M, Průcha M and Zazula R
Large number of studies proved undisputable role of procalcitonin (PCT) in sepsis diagnosis. Moreover, potential of procalcitonin to predict blood culture results according to Gram staining, different types of pathogens and foci of infection is discussed lately. The primary aim of our study was to compare the PCT levels in septic patients with documented Gram-positive and Gram-negative bacteraemia. We also evaluated the PCT levels according to different foci of infection and with different types of pathogens.
Kolařík L., Horáková D., Vlčková J., Matoušková I.: Epidemiological situation of Hodgkin's lymphoma with predictive modeling of global incidence and mortality in 2040
Kolařík L, Horáková D, Vlčková J and Matoušková I
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.
[Respiratory syncytial virus (RSV) infection among infants in the first year of life (Czech Republic, 2017-2022)]
Pazdiora P and Šanca O
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.
Th17 lymphocytes and Interleukin-17A during the course of severe community acquired pneumonia, comparison with etiology and outcome
Moravec M, Nejtek T, Ibrahimová M, Zazula R and Müller M
Observational study of patients diagnosed with severe community acquired pneumonia (sCAP) carried out to evaluate levels of interleukin 17A (IL-17A) and T helper 17 (Th17) lymphocyte count in peripheral circulation and bronchoalveolar lavage fluid (BALF) in the early course of sCAP of different etiology and to compare them with patient's characteristics and outcome.
[Lessons from the COVID-19 pandemic]
Lochman I, Thon V and Šíma P
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.
[Detection of Babesia spp. in ticks and in blood of dogs and red deer in the Czech Republic]
Lukavská A, Kybicová K, Míchalová P, Navrátil J, Lamka J and Schánilec P
To determine the occurrence of species of Babesia potentially pathogenic for humans in ticks and in the blood of dogs and deer in selected regions of the Czech Republic. To compare the prevalence of Babesia spp. in ticks with that of other tick-borne pathogens, such as Borrelia spp., Anaplasma spp., and Rickettsia spp.
[Posibilities for use of whole genome sequencing (WGS) for the analysis of Streptococcus pneumoniae isolates]
Vohrnová S and Kozáková J
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.
Piloting an integrated HIV, HCV and syphilis testing approach in community-based voluntary counselling and testing services in Slovakia
Valkovičová Staneková D, Wimmerová S, Fernàndez-López L, Hábeková M, Kovářová A, Takáčová M and Casabona J
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.
[Issues of risky behaviours in university students]
Spěváková B and Boštíková V
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.
Accidental detection of malaria by the haematology analyser in a patient at the Adult Emergency Department of the Motol University Hospital
Kolařík L, Koblížková E, Horáková D, Vlčková J and Matoušková I
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.