Background/Objectives: This retrospective study analyzed soluble urokinase plasminogen activator receptor (suPAR) plasma levels alongside routine inflammatory markers, including the neutrophil-to-lymphocyte count ratio, C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), and D-dimers in COVID-19 patients hospitalized during the Omicron wave of the pandemic. Methods: We measured plasma suPAR levels using a suPARnostic® Quick Triage kit. We divided COVID-19 patients into two groups based on the severity of SARS-CoV-2 infection according to the National Institutes of Health (NIH) criteria. The logistic regression analysis tested the predictive value of the biomarkers. Results: We evaluated 160 consecutive COVID-19 patients hospitalized between January and August 2022. The cohort exhibited a high incidence of comorbidities, with an in-hospital mortality rate of 5.6%. Upon admission, the median suPAR plasma levels were not significantly different between patients with mild COVID-19 (n = 110) and those with moderate/severe disease (n = 50), with 7.25 ng/mL and 7.55 ng/mL, respectively. We observed significant differences (p < 0.01) between the groups for CRP and IL-6 levels that were higher in moderate/severe disease than in mild infection. Additionally, suPAR plasma levels were above the normal range (0-2.00 ng/mL) in all patients, with a significant positive correlation identified between suPAR levels and serum IL-6, PCT, and creatinine levels. Conclusions: These findings indicate that COVID-19 during the Omicron wave is strongly associated with elevated suPAR levels; however, these levels do not directly correlate with the severity of SARS-CoV-2 infection.

• Publikační typ
• časopisecké články MeSH

Although vaccines against COVID-19 are effective tools in preventing severe disease, recent studies have shown enhanced protection after vaccine boosters. The aim of our study was to examine the dynamics and duration of both humoral and cellular immune responses following a three-dose regimen of the BNT162b2 mRNA vaccine. In a longitudinal prospective study we enrolled 86 adults who received the BNT162b2 vaccine, 35 unvaccinated individuals with a history of mild COVID-19 and a control group of 30 healthy SARS-CoV-2 seronegative persons. We assessed the SARS-CoV-2-specific T cell responses and IgG production up to 12 months post the third BNT162b2 dose in 24 subjects. The vaccinated group had significantly higher IgG antibody levels after two doses compared to the convalescent group (p<0.001). After the third dose, IgG levels surged beyond those detected after the second dose (p<0.001). Notably, these elevated IgG levels were maintained 12 months post the third dose. After two doses, specific T cell responses were detected in 87.5% of the vaccinated group. Additionally, there was a significant decrease before the third dose. However, post the third dose, specific T cell responses surged and remained stable up to the 12-month period. Our findings indicate that the BNT162b2 vaccine induces potent and enduring humoral and cellular responses, which are notably enhanced by the third dose and remain persistant without a significant decline a year after the booster. Further research is essential to understand the potential need for subsequent boosters.

• MeSH
• COVID-19 * prevence a kontrola   MeSH
• dospělí MeSH
• imunita MeSH
• imunoglobulin G MeSH
• lidé MeSH
• messenger RNA MeSH
• prospektivní studie MeSH
• SARS-CoV-2 MeSH
• vakcína BNT162 MeSH
• vakcinace MeSH
• vakcíny proti COVID-19 MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Dysregulated systemic immune responses during infectious spondylodiscitis (IS) may impair microbial clearance and bone resorption. Therefore, the aim of the study was to examine whether circulating regulatory T cells (Tregs) are elevated during IS and whether their frequency is associated with alterations in T cells and the presence of markers of bone resorption in the blood. A total of 19 patients hospitalized with IS were enrolled in this prospective study. Blood specimens were obtained during hospitalization and 6 weeks and 3 months after discharge. Flow cytometric analysis of CD4 and CD8 T cell subsets, the percentage of Tregs and serum levels of collagen type I fragments (S-CrossLap) were performed. Out of 19 enrolled patients with IS, microbial etiology was confirmed in 15 (78.9%) patients. All patients were treated with antibiotics for a median of 42 days, and no therapy failure was observed. Next, a significant serum C-reactive protein (S-CRP) decrease during the follow-up was observed, whereas the frequencies of Tregs remained higher than those of controls at all-time points (p < 0.001). In addition, Tregs demonstrated a weak negative correlation with S-CRP and S-CrossLap levels were within the norm at all-time points. Circulating Tregs were elevated in patients with IS and this elevation persisted even after the completion of antibiotic therapy. Moreover, this elevation was not associated with treatment failure, altered T cells, or increased markers of bone resorption.

• MeSH
• antibakteriální látky terapeutické užití   metabolismus   MeSH
• biologické markery metabolismus   MeSH
• discitida * diagnóza   farmakoterapie   metabolismus   MeSH
• lidé MeSH
• prospektivní studie MeSH
• regulační T-lymfocyty * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVES: Staphylococcus aureus bacteremia (SAB) is one of the most frequent bloodstream infections. High mortality of SAB can be significantly reduced by regular infectious disease (ID) consultations and appropriate clinical management. Because the pandemic of coronavirus disease 2019 (COVID-19) has had a negative impact on hospital ID service, it can be assumed that it has also led to decreased quality of care for SAB patients. METHODS: This study enrolled all (n = 68) patients with proven SAB who were hospitalized in Military University Hospital, Prague, in 2019 and 2020 and the quality of care indicators for SAB patients were compared. RESULTS: A total of 33 and 35 patients with SAB were hospitalized in our hospital in 2019 and 2020, respectively. The significant difference between the pandemic year 2020 and year 2019 was in ID consultations performed (74% vs. 100%; p = 0.002) and fulfilment of all quality of care indicators (66% vs. 93%; p = 0.012). Next, higher in-hospital mortality was observed in 2020 than in 2019 (6% vs. 23%; p = 0.085). There was no significant difference in the percentages of patients with performed echocardiographic examinations (66% vs. 83%; p = 0.156) and collected follow-up blood cultures (85% vs. 94%; p = 0.428). In addition, there was no difference between the two years in the adequate antibiotic therapy, sources, and bacterial origin of SAB. CONCLUSIONS: The quality of care of SAB patients significantly decreased during the COVID-19 pandemic in our institution.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• bakteriemie * farmakoterapie   epidemiologie   mikrobiologie   MeSH
• COVID-19 * MeSH
• lidé MeSH
• pandemie MeSH
• retrospektivní studie MeSH
• stafylokokové infekce * farmakoterapie   epidemiologie   mikrobiologie   MeSH
• Staphylococcus aureus MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Bakteriémie vyvolaná Staphylococcus aureus (SAB) je velmi závažnou a často fatální infekcí s vysokou incidencí a letalitou. Při zjištění SAB je velmi důležité dodržet správný vyšetřovací a léčebný postup. Z hlediska správného managementu SAB je zásadní odhalit primární zdroj infekce, kterým může být infekce kůže a měkkých tkání, katétrová infekce, infekční endokarditida, osteomyelitida, pneumonie či absces s hematogenním šířením. Po zjištění SAB je pak klíčové určit správný vyšetřovací a léčebný postup v těsné spolupráci s infektologem, klinickým mikrobiologem a klinickým farmaceutem.

Staphylococcus aureus (SAB) bacteremia is very serious and often fatal infection with the high incidence and lethality. Diagnosis of SAB must be followed by an appropriate diagnostic and therapeutic process. From the point of view of proper SAB management, it is essential to find the primary source of infection, which can be skin and soft tissue infections, catheter infections, infectious endocarditis, osteomyelitis, pneumonia or abscesses with hematogenous spread. After the SAB has been identified, it is crucial to determine the appropriate examination and treatment procedure in close collaboration with an infectious disease specialist, clinical microbiologist and clinical pharmacist.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• bakteriemie * diagnóza   epidemiologie   farmakoterapie   MeSH
• kvalita zdravotní péče MeSH
• lidé MeSH
• stafylokokové infekce diagnóza   epidemiologie   farmakoterapie   MeSH
• Staphylococcus aureus * patogenita   účinky léků   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

Cíl studie: posouzení využitelnosti sérového kalprotektinu jako biomarkeru bakteriální infekce v rutinní praxi. Typ studie: prospektivní, observační studie. Název a sídlo pracoviště: Ústřední vojenská nemocnice – Vojenská fakultní nemocnice Praha Materiál a metody: do studie byli zařazeni všichni pacienti přijatí na Kliniku infekčních nemocí v období leden až březen 2020. Sérový kalprotektin byl stanoven pomocí systému EVOLIS™ Microplate a komerčně dostupné enzymoimunoeseje firmy Biovendor. Výsledky: celkem byla vyhodnocena data 36 nemocných (24 mužů a 12 žen s průměrným věkem 63,9 let), u kterých byla potvrzena diagnóza virové nebo bakteriální infekce. Nejčastějším zdrojem bakteriální infekce byly dýchací cesty (33,3 %), následované měkkými tkáněmi (25 %) a infekcemi urogenitálního a gastrointestinálního traktu (shodně 16,7 %). Virovou infekci nejčastěji představovala chřipka A (66,6 %). Medián sérové koncentrace kalprotektinu u bakteriální infekce byl 4,12 mg/L oproti 2,03 mg/L při infekci virové. U 12 nemocných s bakteriální infekcí a zvýšeným C-reaktivním proteinem (CRP), u kterých nebyl zvýšen prokalcitonin (PCT), byla zjištěna zvýšená hodnota sérového kalprotektinu. Naopak u osmi nemocných s potvrzenou bakteriální infekcí nebyl kalprotektin zvýšen, čtyři z těchto pacientů měli současně s CRP zvýšený i PCT a čtyři nemocní měli zvýšené pouze CRP. V souboru byl rovněž případ bakteriální infekce se zvýšeným kalprotektinem a negativním CRP i PCT. Závěr: výsledky naší studie naznačily význam sérového kalprotektinu jako doplňkového parametru pro diagnostiku bakteriální infekce.

Objective: evaluation of clinical use of serum calprotectin as biomarker of bacterial infection Design: prospective, observational study Settings: Military University Hospital Prague Material and Methods: all patients admitted to the Department of infectious Diseases during the period between January and March 2020 were enrolled to the study. Serum calprotectin was analyzed using EVOLIS™ Microplate system and commercially available assay from the Biovendor company. Results: Altogether, data of 36 enrolled patients with proven bacterial or viral infection (24 males and 12 females with mean age 63.9 years) were evaluated. The most frequent source of bacterial infection was respiratory tract (33.3 %) followed by soft tissue (25 %) and infections of urogenital and gastrointestinal tracts (both 16.7 %). The most common viral infection was flu A (66.6 %). Median of calprotectin serum concentration in bacterial infection was 4.12 mg/L in comparison to 2.03 mg/L in viral infection. In 12 patients with bacterial infection with negative procalcitonin (PCT) levels, both C-reactive protein (CRP) and calprotectin were elevated. On the other hand, eight patients with proven bacterial infection had negative calprotectin serum levels. Four of these patients had elevated CRP and PCT and four CRP only. In addition, in the cohort with bacterial infection, there was one patient with calprotectin elevation only. Conclusion: the results of our study indicated serum calprotectin as additional parameter of bacterial infection.

• MeSH
• bakteriální infekce diagnóza   MeSH
• biologické markery * krev   MeSH
• leukocytární L1-antigenní komplex * analýza   krev   MeSH
• lidé MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH

BACKGROUND: Acute hepatitis B (AHB) can run a severe course, which sometimes leads to a fulminant disease with acute liver failure (ALF). Pro-coagulation factors are well-established markers of AHB severity, but less is known about the levels of anti-coagulation parameters in AHB. METHODS: In this study, we demonstrate that antithrombin (AT) plasma levels were associated with AHB severity in 161 patients. RESULTS: Nine (6%) patients had severe AHB (i.e. international normalized ratio [INR] ≥ 1.6 and total bilirubin ≥ 10 mg/dL). Coagulopathy (i.e. INR > 1.2 and/or AT < 80%) was observed in 65 (40%) AHB patients on admission. Low initial plasma AT levels (i.e. < 80%) were observed in 56 (35%) patients. In all, plasma AT levels decreased in 91 (57%) patients during their hospital stay. Both baseline and nadir AT levels were significantly lower in severe than in mild and moderate AHB. Moreover, the concentration of AT negatively correlated with INR, aspartate aminotransferase, and total and conjugated bilirubin levels. Interestingly, nadir AT levels positively correlated with the duration of hospitalization. CONCLUSIONS: These results indicate that plasma AT levels can be used as an additional marker of AHB severity.

• MeSH
• akutní nemoc MeSH
• antithrombiny krev   MeSH
• biologické markery krev   MeSH
• dospělí MeSH
• hepatitida B diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Bakteriémie vyvolaná Staphylococcus aureus (SAB) je nejčastější infekcí krevního řečiště s vysokou incidencí a letalitou. Při zjištění SAB je velmi důležité dodržet správný vyšetřovací a léčebný postup. Záměrem studie bylo posoudit klinické a epidemiologické charakteristiky případů SAB zachycených v ÚVN Praha a zhodnotit dodržení doporučených postupů v diagnostice a léčbě. Celkem bylo do retrospektivní studie zařazeno 65 pacientů, u nichž byl zachycen S. aureus v hemokultuře. V 60 případech (92 %) byla SAB vyvolána kmeny MSSA a u 5 pacientů (8 %) byly detekovány kmeny MRSA. Zdroj infekce se podařilo prokázat v 83 % případů. Průměrná smrtnost v analyzovaném souboru byla 28 %. Výsledky analýzy indikátorů kvality péče naznačily nedostatky v diagnostickém i léčebném postupu u 65 % pacientů. Studie podpořila nutnost konziliárních vyšetření odborníkem na infekční choroby u lůžka.

Staphylococcus aureus bacteremia (SAB) is the most common cause of severe bloodstream infections with high incidence and lethality. The diagnosis of SAB must be followed by an appropriate diagnostic and therapeutic management. The aim of the study was to identify clinical and epidemiological characteristics of SAB cases treated in the Central Military Hospital Prague and to assess compliance with the guidelines for diagnosis and therapy. A total of 65 patients with S. aureus blood culture positivity were enrolled in the retrospective study. Sixty SAB cases (92%) were caused by MSSA strains, and MRSA strains were detected in five patients (8%). The source of the infection was confirmed in 83% of patients. The average case fatality rate in the study cohort was 28%. The analysis of the quality of care suggested both diagnostic and therapeutic insufficiencies in 65% of SAB patients. Overall, the result of the study supports the importance of the role of infectious disease specialists played in the bedside management of patients with SAB.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• bakteriemie * diagnóza   etiologie   farmakoterapie   MeSH
• lidé MeSH
• retrospektivní studie MeSH
• stafylokokové infekce diagnóza   farmakoterapie   mortalita   MeSH
• Staphylococcus aureus * patogenita   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

• Publikační typ
• abstrakt z konference MeSH

• MeSH
• lidé MeSH
• pertuse * MeSH
• pertusová vakcína MeSH
• Check Tag
• lidé MeSH