BACKGROUND: A multicomponent meningococcal serogroups ABCWY vaccine (MenABCWY) could provide broad protection against disease-causing meningococcal strains and simplify the immunisation schedule. The aim of this trial was to confirm the effect of the licensed meningococcal serogroup B (MenB) vaccine, 4CMenB, against diverse MenB strains, and to assess the breadth of immune response against a panel of 110 MenB strains for MenABCWY containing the antigenic components of 4CMenB and licensed serogroups ACWY vaccine, MenACWY-CRM, the non-inferiority of the immune response with MenABCWY versus 4CMenB and MenACWY-CRM, safety, and MenABCWY lot-to-lot consistency. METHODS: We conducted a phase 3 randomised, controlled, observer-blinded trial of healthy adolescents and young adults (age 10-25 years) across 114 centres in Australia, Canada, Czechia, Estonia, Finland, Türkiye, and the USA. Exclusion criteria included previous vaccination with a MenB vaccine or (within the last 4 years) MenACWY vaccine. Participants were randomly allocated (5:5:3:3:3:1 ratio) via a central randomisation system using a minimisation procedure to receive 4CMenB at months 0, 2, and 6 (referred to as 4CMenB 0-2-6 hereafter); or 4CMenB at months 0 and 6 (referred to as 4CMenB 0-6 hereafter); or MenABCWY (three groups, each receiving one production lot of the MenACWY-CRM component) at months 0 and 6; or MenACWY-CRM at month 0. Demonstration in the per-protocol set of the consistency of three MenACWY-CRM component lots of the MenABCWY vaccine was a primary objective (demonstrated with two-sided 95% CIs for the ratio of human serum bactericidal antibody [hSBA] geometric mean titres against each serogroup within predefined criteria [0·5-2·0]). The primary endpoints (breadth of immune response) for the MenB component of MenABCWY and 4CMenB were measured using the endogenous complement hSBA (enc-hSBA) assay against a panel of 110 diverse MenB invasive disease strains. For each serum sample, 35 strains from the 110 MenB strain panel were randomly selected for testing. The 4CMenB breadth of immune response data have been published separately. For MenABCWY, breadth of immune response was assessed in two analyses: a test-based analysis of the percentage of samples (tests) without bactericidal serum activity against MenB strains 1 month after two MenABCWY doses versus the percentage after one MenACWY-CRM dose in the per-protocol set, and a responder-based analysis of the percentage of participants (responders) whose sera killed 70% or more strains at 1 month after two MenABCWY doses in the full analysis set. A lower limit of two-sided 95% CI above 65% would demonstrate breadth of immune response. Other primary outcomes included non-inferiority (5% margin) of two MenABCWY doses versus two 4CMenB doses by enc-hSBA assay in the per-protocol set, non-inferiority (10% margin) of two MenABCWY doses versus one MenACWY-CRM dose in MenACWY vaccine-naive participants by traditional hSBA assay in the per-protocol set, and safety in all vaccinated participants. This trial is registered with ClinicalTrials.gov, NCT04502693, and is complete. FINDINGS: Between Aug 14, 2020, and Sept 3, 2021, 3651 participants were enrolled and randomly allocated (900 in the 4CMenB 0-2-6 group and 908 in the 4CMenB 0-6 group, 1666 in the three MenABCWY groups combined, and 177 in the MenACWY-CRM group). All primary objectives for MenABCWY were met. Consistency of immune responses against the three production lots of the MenACWY component of MenABCWY was demonstrated since two-sided 95% CIs for the ratios of hSBA geometric mean titres against serogroups A, C, W, and Y for each pair of lots were within the predefined equivalence criteria. The lot data were pooled for the remainder of MenABCWY endpoints. By enc-hSBA assay, breadth of immune response against the MenB strain panel was 77·9% (95% CI 76·6 to 79·2) in the test-based analysis and 84·1% (81·4 to 86·5; 687 of 817 participants) in the responder-based analysis. Non-inferiority of MenABCWY to 4CMenB was demonstrated by enc-hSBA assay: the difference in percentage of samples with bactericidal serum activity between the MenABCWY group (82·5% [95% CI 82·1 to 83·0]; 21 222 of 25 715) and 4CMenB 0-2 group (83·1% [82·7 to 83·6]; 22 921 of 27 569) was -0·61% (-1·25 to 0·03). Non-inferiority of two-dose MenABCWY to one-dose MenACWY-CRM was demonstrated by traditional hSBA assay, with differences between the MenABCWY group and MenACWY group in percentages of participants with a four-fold rise in hSBA titres of 11·3% (5·9 to 19·0) for serogroup A, 47·2% (38·1 to 56·3) for serogroup C, 35·3% (26·9 to 44·5) for serogroup W, and 27·0% (19·4 to 35·8) for serogroup Y. MenABCWY reactogenicity was mostly of mild or moderate severity and transient, with similar frequencies of adverse events in the MenABCWY and 4CMenB groups and no safety concerns were identified. INTERPRETATION: This study demonstrates breadth of immune response against a panel of 110 MenB strains for the MenB component of the investigational MenABCWY vaccine, when administered as a 0-6 months schedule to the target population of adolescents and young adults, with predefined criteria for success met for both breadth of immune response endpoints and for non-inferiority versus 4CMenB. This investigational vaccine could provide broad meningococcal serogroup coverage in a simplified immunisation schedule, thus aiding the public health attempt in preventing invasive meningococcal disease due to five Neisseria meningitidis serogroups in adolescents and young adults. FUNDING: GSK.

• MeSH
• dítě MeSH
• dospělí MeSH
• imunogenicita vakcíny * MeSH
• jednoduchá slepá metoda MeSH
• lidé MeSH
• meningokokové infekce * prevence a kontrola   imunologie   MeSH
• meningokokové vakcíny * imunologie   škodlivé účinky   aplikace a dávkování   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Neisseria meningitidis séroskupiny B imunologie   MeSH
• Neisseria meningitidis imunologie   MeSH
• protilátky bakteriální krev   MeSH
• zdraví dobrovolníci pro lékařské studie MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnocení ekvivalence MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH

BACKGROUND: Vaccination against 5 prominent meningococcal serogroups (A/B/C/W/Y) is necessary for broad disease protection. We report immunopersistence through 4 years after a 2-dose (6-month interval) pentavalent MenABCWY primary vaccine series and safety and immunogenicity of a booster administered 4 years after primary vaccination. METHODS: This randomized, active-controlled, observer-blinded study was conducted in the United States and Europe. In stage 1, healthy MenACWY vaccine-naive or -experienced 10- to 25-year-olds were randomized 1:2 to receive MenABCWY and placebo or MenB-fHbp and MenACWY-CRM. Eligible participants were randomly selected to participate in stage 2, which was an open-label immunopersistence and booster extension. Immunogenicity was assessed through serum bactericidal antibody using human complement (hSBA) assays with serogroups A/C/W/Y (MenA/C/W/Y) and 4 primary serogroup B (MenB) test strains. Immunogenicity endpoints included hSBA seroprotection rates through 48 months after primary vaccination and 1 month after the booster. Safety endpoints included booster reactogenicity events and adverse events (AEs). RESULTS: Of 1379 eligible participants, 353 entered stage 2; 242 completed the 48-month blood draw after primary vaccination and 240 completed the booster vaccination phase. MenA/C/W/Y seroprotection rates remained high for 4 years following a 2-dose MenABCWY primary series (MenACWY-naive, 62.0 %-100.0 %; MenACWY-experienced, 98.7 %-100.0 %) and trended higher than those after a single MenACWY-CRM dose (MenACWY-naive, 38.1 %-95.2 %; MenACWY-experienced, 89.7 %-100.0 %). Corresponding seroprotection rates against MenB remained stable and generally higher than baseline (MenABCWY, 18.2 %-36.6 %; MenB-fHbp, 16.2 %-31.9 % across strains). Following a booster, seroprotection rates against all 5 serogroups were ≥ 93.8 % across groups. Most booster dose reactogenicity events were mild or moderate in severity, and AEs were infrequent. CONCLUSIONS: Immune responses remained high for MenA/C/W/Y and above baseline for MenB through 4 years after the MenABCWY primary series, with robust responses for all 5 serogroups observed following a booster. The MenABCWY booster had an acceptable safety and tolerability profile consistent with the primary series. NCT03135834.

• MeSH
• dítě MeSH
• dospělí MeSH
• imunogenicita vakcíny MeSH
• komplement imunologie   MeSH
• lidé MeSH
• meningokokové infekce * prevence a kontrola   imunologie   MeSH
• meningokokové vakcíny * imunologie   škodlivé účinky   aplikace a dávkování   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Neisseria meningitidis imunologie   MeSH
• protilátky bakteriální * krev   MeSH
• sekundární imunizace * metody   MeSH
• séroskupina MeSH
• vakcíny konjugované imunologie   aplikace a dávkování   škodlivé účinky   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Evropa MeSH
• Spojené státy americké MeSH

BACKGROUND: Bordetella pertussis isolates which do not express some of acellular pertussis vaccine (aPv) antigens, e.g. pertactin (PRN), have been increasingly reported in countries using aPvs. In Finland, primary pertussis vaccination with whole-cell vaccine was replaced by aPv containing pertussis toxin (PT) and filamentous hemagglutinin (FHA) in 2005 and then by aPv containing PT, FHA, and PRN in 2009. We aimed to study alterations in the expression of FHA, PRN, and PT, three antigens included in aPvs and adenylate cyclase toxin (ACT) not included in current aPvs, among Finnish isolates collected during 1991-2020. METHODS: Of 904 isolates collected by the Finnish Reference Laboratory for Pertussis during 1991-2020, 302 were randomly included. An adapted, monoclonal antibody based, antigen expression ELISA, including the culture of B. pertussis in Stainer-Scholte medium, was performed to quantify the expression of ACT, FHA, PRN, and PT of each isolate. ACT activity was also measured for 16 isolates. Arbitrary units were used for comparing levels of each antigen expression of isolates grouped in every five years. FINDINGS: Following the implementation of aPv in 2005, B. pertussis isolates exhibited a 1.75-fold increase for FHA (p < 0.001) and a 1.5-fold increase for ACT (p < 0.0041) expression until 2020. No FHA or ACT deficient isolates were detected. As the number of PRN deficient isolates has significantly increased with the time, the amount of PRN produced by the positive isolates has also started to decrease, especially after the use of aPv containing PRN. During this period, fluctuations in PT expression were observed. INTERPRETATION: The study demonstrated that in response to aPv-induced selection pressure, different types of selection of B. pertussis has occurred. For FHA and ACT, a steady increase in their production is observed, whereas the frequency of PRN deficient isolates is increased with time.

• MeSH
• acelulární vakcíny imunologie   MeSH
• adenylátcyklasový toxin imunologie   MeSH
• antigeny bakteriální * imunologie   MeSH
• bakteriální adheziny MeSH
• Bordetella pertussis * imunologie   izolace a purifikace   MeSH
• ELISA MeSH
• faktory virulence rodu Bordetella imunologie   MeSH
• lidé MeSH
• pertuse * prevence a kontrola   imunologie   mikrobiologie   MeSH
• pertusová vakcína * imunologie   aplikace a dávkování   MeSH
• pertusový toxin imunologie   MeSH
• proteiny vnější bakteriální membrány imunologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Finsko MeSH

Cíl: Cílem studie byla analýza vlivu pandemie covidu-19 na epidemiologickou situaci invazivního meningokokového onemocnění (IMO) a na molekulární charakteristiky izolátů Neisseria meningitidis způsobujících IMO v České republice. Materiál a metody: Studie vycházela z dat surveillance IMO za období 2018–2024 (k 27. 5. 2024) a analyzovány celogenomovou sekvenací (WGS) byly všechny dostupné izoláty N. meningitidis z IMO z těchto let. Pro analýzu vlivu pandemie covidu-19 bylo sledované období rozděleno na tři srovnávané etapy: pre-covidové období (2018–2019), období pandemie covidu-19 (2020–2022) a post-covidové období (2023–2024). Výsledky: V důsledku zavedení epidemiologických opatření proti pandemii covidu-19 došlo v České republice, podobně jako v ostatních zemích, k poklesu počtu infekčních onemocnění přenášených vzdušnou cestou, včetně IMO. Po uvolnění těchto epidemiologických opatření však nedošlo v České republice k opětnému vzestupu počtu IMO, na rozdíl od řady jiných zemí. Charakterizace izolátů z IMO metodou WGS prokázala, že v průběhu covidového a post-covidového období došlo k postupné změně populace meningokoků, které v České republice působí IMO. U izolátů N. meningitidis séroskupin C, W a Y lze sledovat postupný a výrazný pokles celkové heterogenity – z deseti různých klonálních komplexů zachycených v pre-covidovém období na pouhé tři v post-covidových letech (cc11, cc23 a cc103). Zároveň byla zjištěna významná redukce izolátů N. meningitidis C; cc11. U izolátů N. meningitidis B lze naopak pozorovat nárůst celkové heterogenity během období pandemie covidu-19 a její opětovnou redukci na celkově nejnižší hodnoty v post-covidovém období. Závěr: V přetrvávajícím poklesu počtu IMO v České republice má roli i zavedení úhrady očkování MenB vakcínou a konjugovanou vakcínou A, C, W, Y pro malé děti (v květnu 2020) a pro adolescenty (v lednu 2022). K udržení nízkých počtů IMO v České republice je žádoucí pokračovat v očkování MenB vakcínou a konjugovanou vakcínou A, C, W, Y dle doporučení České vakcinologické společnosti ČLS JEP.

Objective: To analyse the impact of the COVID-19 pandemic on the epidemiological situation of invasive meningococcal disease (IMD) and molecular characteristics of Neisseria meningitidis isolates causing IMD in the Czech Republic. Material and Methods: The study was based on IMD surveillance data for 2018–2024 (as of 27 May 2024), and all available N. meningitidis isolates from IMD of these years were subjected to whole genome sequencing (WGS). To analyse the impact of the COVID-19 pandemic, the study period was divided into three parts: the pre-COVID period (2018–2019), the COVID-19 pandemic period (2020–2022), and the post-COVID period (2023–2024). Results: As a result of the implementation of the COVID-19 control measures, similar to other countries, there has been a decline in the incidence of air-borne infections including IMD in the Czech Republic. However, unlike many other countries, there has not been a resurgence of IMD in the Czech Republic following the release of these epidemiological measures. WGS characterisation of IMD isolates showed a gradual change in the population of meningococci causing IMD in the Czech Republic during the COVID-19 and post-COVID periods. For N. meningitidis isolates of serogroups C, W, and Y, a gradual and significant decline in overall heterogeneity can be observed – from ten different clonal complexes detected in the pre-COVID period to only three in the post-COVID years (cc11, cc23, and cc103). At the same time, a significant reduction was observed in N. meningitidis C isolates; cc11. In contrast, an increase in overall heterogeneity can be observed for N. meningitidis B isolates during the COVID-19 pandemic period, followed by its decline again to overall lowest values in the post-COVID period. Conclusion: The fact that MenB vaccine and conjugate vaccine A, C, W, Y started to be covered by health insurance for young children (in May 2020) and adolescents (in January 2022) also appears to play a role in the persistent decline of IMD in the Czech Republic. In order to maintain the low incidence of IMD in the Czech Republic, it is desirable to continue vaccination with MenB vaccine and conjugated vaccine A, C, W, Y in accordance with the recommendations of the Czech Society of Vaccinology of the Czech Medical Association of Jan Evangelista Purkyně.

• MeSH
• COVID-19 epidemiologie   MeSH
• lidé MeSH
• meningokokové infekce epidemiologie   MeSH
• Neisseria meningitidis * genetika   MeSH
• pandemie MeSH
• sekvenční analýza * MeSH
• vakcinace statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Taylorella equigenitalis is the causative agent of sexually transmitted contagious equine metritis. Infections manifest as cervicitis, vaginitis and endometritis and cause temporary infertility and miscarriages of mares. While previous studies have analyzed this organism for various parameters, the evolutionary dynamics of this pathogen, including the emergence of antibiotic resistance, remains unresolved. The aim of this study was to isolate contemporary strains, determine their genome sequences, evaluate their antibiotic resistance and compare them with other strains. We determined nine complete whole genome sequences of T. equigenitalis strains, mainly from samples collected from Kladruber horses in the Czech Republic. While T. equigenitalis strains from Kladruby isolated between 1982 and 2018 were inhibited by streptomycin, contemporary strains were found to be resistant to streptomycin, suggesting the recent emergence of this mutation. In addition, we used the collection dates of Kladruber horse strains to estimate the genome substitution rate, which resulted in a scaled mean evolutionary rate of 6.9×10-7 substitutions per site per year. Analysis with other available T. equigenitalis genome sequences (n = 18) revealed similarity of the Czech T. equigenitalis genomes with the Austrian T. equigenitalis genome, and molecular dating suggested a common ancestor of all analyzed T. equigenitalis strains from 1.5-2.6 thousand years ago, dating to the first centuries A.D. Our study revealed a recently emerged streptomycin resistance in T. equigenitalis strains from Kladruber horses, emphasizing the need for antibiotic surveillance and alternative treatments. Additionally, our findings provided insights into the pathogen's evolution rate, which is important for understanding its evolution and preparing preventive strategies.

• MeSH
• antibakteriální látky farmakologie   MeSH
• bakteriální léková rezistence genetika   MeSH
• fylogeneze MeSH
• genom bakteriální * genetika   MeSH
• koně mikrobiologie   MeSH
• molekulární evoluce MeSH
• nemoci koní * mikrobiologie   MeSH
• sekvenování celého genomu * MeSH
• Taylorella equigenitalis * genetika   MeSH
• zvířata MeSH
• Check Tag
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Bordetella pertussis is the causative agent of whooping cough in humans, a disease that has recently experienced a resurgence. In contrast, Bordetella bronchiseptica infects the respiratory tract of various mammalian species, causing a range of symptoms from asymptomatic chronic carriage to acute illness. Both pathogens utilize type III secretion system (T3SS) to deliver the effector protein BteA into host cells. Once injected, BteA triggers a cascade of events leading to caspase 1-independent necrosis through a mechanism that remains incompletely understood. We demonstrate that BteA-induced cell death is characterized by the fragmentation of the cellular endoplasmic reticulum and mitochondria, the formation of necrotic balloon-like protrusions, and plasma membrane permeabilization. Importantly, genome-wide CRISPR-Cas9 screen targeting 19,050 genes failed to identify any host factors required for BteA cytotoxicity, suggesting that BteA does not require a single nonessential host factor for its cytotoxicity. We further reveal that BteA triggers a rapid and sustained influx of calcium ions, which is associated with organelle fragmentation and plasma membrane permeabilization. The sustained elevation of cytosolic Ca2+ levels results in mitochondrial calcium overload, mitochondrial swelling, cristolysis, and loss of mitochondrial membrane potential. Inhibition of calcium channels with 2-APB delays both the Ca2+ influx and BteA-induced cell death. Our findings indicate that BteA exploits essential host processes and/or redundant pathways to disrupt calcium homeostasis and mitochondrial function, ultimately leading to host cell death.IMPORTANCEThe respiratory pathogens Bordetella pertussis and Bordetella bronchiseptica exhibit cytotoxicity toward a variety of mammalian cells, which depends on the type III secretion effector BteA. Moreover, the increased virulence of B. bronchiseptica is associated with enhanced expression of T3SS and BteA. However, the molecular mechanism underlying BteA cytotoxicity is elusive. In this study, we performed a CRISPR-Cas9 screen, revealing that BteA-induced cell death depends on essential or redundant host processes. Additionally, we demonstrate that BteA disrupts calcium homeostasis, which leads to mitochondrial dysfunction and cell death. These findings contribute to closing the gap in our understanding of the signaling cascades targeted by BteA.

• MeSH
• bakteriální proteiny * metabolismus   genetika   MeSH
• Bordetella bronchiseptica genetika   metabolismus   účinky léků   MeSH
• Bordetella pertussis genetika   patogenita   metabolismus   účinky léků   MeSH
• buněčná smrt * účinky léků   MeSH
• endoplazmatické retikulum metabolismus   účinky léků   MeSH
• homeostáza * MeSH
• interakce hostitele a patogenu MeSH
• lidé MeSH
• mitochondrie metabolismus   účinky léků   MeSH
• sekreční systém typu III metabolismus   genetika   MeSH
• vápník * metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: To evaluate the efficacy and tolerability of a single dose of oral cefixime 800 mg plus oral doxycycline 100 mg twice a day for 7 days, compared with a recommended single dose of ceftriaxone plus single dose of oral azithromycin, for treatment of uncomplicated urogenital, rectal, or pharyngeal gonorrhoea. METHODS: A noninferiority, open-label, multicentre randomized controlled trial was conducted in Prague, Czech Republic. Some 161 patients, 18-65 years of age diagnosed with uncomplicated urogenital, rectal, or pharyngeal gonorrhoea by nucleic acid amplification test (NAAT) were randomized to treatment with single dose of cefixime 800 mg plus doxycycline 100 mg twice a day for 1 week or a single dose of ceftriaxone 1 g intramuscularly plus single dose of azithromycin 2 g. The primary outcome was the number of participants with negative culture and NAAT at 1 week and 3 weeks, respectively, after treatment initiation. RESULTS: In all, 161 patients were randomized and 152 were included in per-protocol analyses. All 76 (100%; 95% CI, 0.95-1.00) patients treated with ceftriaxone plus azithromycin achieved negative cultures and NAAT after treatment. In the cefixime plus doxycycline arm at week 1, culture was negative in all 76 (100%) patients; at week 3, culture was negative in 70 of the 76 patients (92%; 95% CI, 0.84-0.97) and NAAT negative in 66 of the 76 patients (87%; 95% CI, 0.77-0.94). At week 3, culture and NAAT were negative in 65 of the 76 patients (86%; 95% CI, 0.76-0.93). Per-protocol risk difference was 14.5%; 95% CI, 6.56-22.38. All treatment failures observed in the cefixime arm were pharyngeal gonorrhoea cases. DISCUSSION: The combination of cefixime and doxycycline did not achieve noninferiority to ceftriaxone and azithromycin for treatment of gonorrhoea when including pharyngeal gonorrhoea. It did, however, show high efficacy for urogenital and rectal gonorrhoea.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• azithromycin terapeutické užití   MeSH
• cefixim terapeutické užití   MeSH
• ceftriaxon * MeSH
• dospělí MeSH
• doxycyklin terapeutické užití   MeSH
• gonorea * farmakoterapie   mikrobiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Neisseria gonorrhoeae MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• hodnocení ekvivalence MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Pertussis, also known as whooping cough, is an acute respiratory illness primarily caused by Bordetella pertussis. Highly contagious, it poses significant morbidity and mortality risks, especially in infants. Despite widespread vaccination efforts, pertussis cases have recently resurged globally. This case report details possible complication in a 48-year-old woman, involving a cough-induced rib fracture and recurrent pneumothorax, highlighting the need for considering pertussis in patients with severe cough and back pain. CASE PRESENTATION: A 48-year-old female non-smoker with hypertension, treated with ACE inhibitor (perindopril), presented with a runny nose, productive cough, and back pain. Initial treatment for a common cold provided temporary relief. However, her symptoms worsened, and further examination revealed a fractured rib, pneumothorax, and subcutaneous emphysema. Laboratory tests confirmed elevated Bordetella pertussis toxin antibodies. She was treated with antibiotics, and despite recurrent symptoms, a conservative management approach was successful. Follow-up indicated resolution of symptoms, but significant anxiety related to her condition. CONCLUSION: This case emphasises the importance of considering pertussis in adults, as early symptoms resembling a common cold can lead to misdiagnosis. It also highlights the potential for significant musculoskeletal and pulmonary injuries due to intense coughing associated with pertussis. Prompt diagnosis and comprehensive management, including antibiotics and supportive care, are essential for favorable outcomes.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• Bordetella pertussis izolace a purifikace   MeSH
• fraktury žeber * komplikace   MeSH
• kašel etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pertuse * komplikace   farmakoterapie   MeSH
• pneumotorax * etiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

• MeSH
• antibakteriální látky aplikace a dávkování   škodlivé účinky   MeSH
• cefuroxim aplikace a dávkování   MeSH
• infekce bakteriemi čeledi Neisseriaceae * etiologie   farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• Neisseria gonorrhoeae patogenita   účinky léků   MeSH
• neúspěšná terapie MeSH
• otitida * etiologie   farmakoterapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Černý kašel je vysoce nakažlivé bakteriální onemocnění postihující řasinkový epitel respiračního traktu. Jedná se o kapénkovou infekci, která se snadno šíří především v populaci vnímavých jedinců (novorozenci, kojenci). Onemocnění se projevuje záchvaty dráždivého kašle, v dětském věku a u rizikových skupin (senioři, imunosuprimovaní, osoby s chronickým onemocněním plic) může mít komplikovaný až fatální průběh. Před objevem vakcíny byla tato infekce častou příčinou kojenecké morbidity a mortality, v současnosti je v České republice vakcína proti pertusi součástí povinného očkování v kojeneckém věku. V rámci ochrany nejmenších dětí, jež jsou infekcí nejvíce ohroženy, je také doporučeno přeočkování těhotných žen ve 3. trimestru gravidity. Jelikož je v letošním roce počet hlášených případů pertuse opět na vzestupu, je vhodné si zopakovat základní informace o infekci a seznámit se s aktuálními doporučeními.

Whooping cough is a highly contagious bacterial disease that affects the ciliated epithelium of the respiratory tract. The disease is transmitted by the inhalation of infected droplets and easily spreads mainly in the population of responsive subjects (newborns, infants). The disease manifests by a paroxysmal unproductive cough, in childhood, and in a high-risk group of people (seniors, immunosuppressed patients, and patients with chronic lung disease) can have a complicated or fatal course. This infection was a frequent cause of infant morbidity and mortality before the development of the vaccine, in present the vaccine against pertussis is a part of mandatory vaccination in infant age in the Czech Republic. In protection of the smallest children, which are mostly threatened by whooping cough, is also recommended a revaccination during pregnancy between 27 and 36 weeks gestation. Cause of the increase in pertussis cases this year, it's good to repeat basic information about the infection and also get to know current recommendations.

• MeSH
• antibakteriální látky aplikace a dávkování   terapeutické užití   MeSH
• Bordetella pertussis patogenita   MeSH
• lidé MeSH
• pertuse * diagnóza   epidemiologie   farmakoterapie   MeSH
• pertusová vakcína MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH