The aim of this study was to evaluate the serum levels of calprotectin and calgranulin C and routine biomarkers in patients with bacterial sepsis (BS). The initial serum concentrations of calprotectin and calgranulin C were significantly higher in patients with BS (n = 66) than in those with viral infections (n = 24) and the healthy controls (n = 26); the level of calprotectin was found to be the best predictor of BS, followed by the neutrophil-lymphocyte count ratio (NLCR) and the level of procalcitonin (PCT). The white blood cell (WBC) count and the NLCR rapidly returned to normal levels, whereas PCT levels normalized later and the increased levels of calprotectin, calgranulin C, and C-reactive protein persisted until the end of follow-up. Our results suggest that the serum levels of calprotectin are a reliable biomarker of BS and that the WBC count and the NLCR are rapid predictors of the efficacy of antimicrobial therapy.

• MeSH
• bakteriální infekce krev   diagnóza   MeSH
• biologické markery krev   MeSH
• C-reaktivní protein analýza   MeSH
• dospělí MeSH
• kinetika MeSH
• leukocytární L1-antigenní komplex krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• neutrofily cytologie   MeSH
• počet leukocytů MeSH
• počet lymfocytů MeSH
• protein S100A12 krev   MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• sepse krev   diagnóza   MeSH
• virové nemoci krev   diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Infectious complications (IC) are one of the main causes of worsening prognosis after long-term ventricular assist device (LVAD) implantation. Procalcitonin (PCT) is widely used for diagnosis of a bacterial infection. The objective of this study was to assess PCT dynamics after LVAD surgery and their relationship to the infectious complications. METHODS: A total of 25 consecutive patients indicated for LVAD implantation as a bridge to heart transplant were included. Procalcitonin levels were prospectively assessed before surgery and during the postoperative period (day 1, 2, 14 and 30). Values were compared according to the presence of IC. RESULTS: Procalcitonin levels were low before surgery, raised significantly within 1st and 2nd day after operation and decreased in the 14th and 30th days back to the baseline. There was no significant difference in PCT values between patients with or without IC as well as with or without right ventricle assist device (RVAD). Acute renal failure (ARF) increased PCT significantly only 14 days after LVAD implantation. In patients with ARF and/or RVAD we observed significantly higher PCT values in the 2nd, 14thand 30thday after operation. In subjects with IC and/or ARF and/or RVAD we also observed significantly elevated PCT concentrations 2 and 14 days after surgery. CONCLUSIONS: Our data show that the ability of PCT to detect IC in patients after LVAD implantation is limited and its concentrations more likely correlate with postoperative complications in general.

• MeSH
• bakteriální infekce krev   etiologie   MeSH
• dospělí MeSH
• kalcitonin krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• podpůrné srdeční systémy * MeSH
• pooperační komplikace krev   MeSH
• pooperační období MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

• MeSH
• bakteriální infekce krev   MeSH
• herpetické infekce imunologie   krev   MeSH
• infekce krev   mikrobiologie   MeSH
• lidé MeSH
• sérologické testy * metody   MeSH
• Check Tag
• lidé MeSH

• Klíčová slova
• Erdomed,
• MeSH
• antibakteriální látky terapeutické užití   MeSH
• bakteriální infekce epidemiologie   farmakoterapie   krev   MeSH
• C-reaktivní protein účinky léků   MeSH
• diferenciální diagnóza MeSH
• dítě MeSH
• expektorancia farmakologie   terapeutické užití   MeSH
• infekce dýchací soustavy epidemiologie   farmakoterapie   mikrobiologie   MeSH
• lékové předpisy statistika a číselné údaje   MeSH
• lidé MeSH
• recidiva MeSH
• retrospektivní studie MeSH
• thiofeny farmakologie   terapeutické užití   MeSH
• thioglykoláty farmakologie   terapeutické užití   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• multicentrická studie MeSH
• pozorovací studie MeSH

The aim of our study was to analyse immune abnormalities in patients with chronic infected diabetic foot ulcers (DFUs) especially those infected by resistant microorganisms. Methods. 68 patients treated in our foot clinic for infected chronic DFUs with 34 matched diabetic controls were studied. Patients with infected DFUs were subdivided into two subgroups according to the antibiotic sensitivity of causal pathogen: subgroup S infected by sensitive (n = 50) and subgroup R by resistant pathogens (n = 18). Selected immunological markers were compared between the study groups and subgroups. Results. Patients with infected chronic DFUs had, in comparison with diabetic controls, significantly reduced percentages (p < 0.01) and total numbers of lymphocytes (p < 0.001) involving B lymphocytes (p < 0.01), CD4+ (p < 0.01), and CD8+ T cells (p < 0.01) and their naive and memory effector cells. Higher levels of IgG (p < 0.05) including IgG1 (p < 0.001) and IgG3 (p < 0.05) were found in patients with DFUs compared to diabetic controls. Serum levels of immunoglobulin subclasses IgG2 and IgG3 correlated negatively with metabolic control (p < 0.05). A trend towards an increased frequency of IgG2 deficiency was found in patients with DFUs compared to diabetic controls (22% versus 15%; NS). Subgroup R revealed lower levels of immunoglobulins, especially of IgG4 (p < 0.01) in contrast to patients infected by sensitive bacteria. The innate immunity did not differ significantly between the study groups. Conclusion. Our study showed changes mainly in the adaptive immune system represented by low levels of lymphocyte subpopulations and their memory effector cells, and also changes in humoral immunity in patients with DFUs, even those infected by resistant pathogens, in comparison with diabetic controls.

• MeSH
• adaptivní imunita MeSH
• antibakteriální látky terapeutické užití   MeSH
• bakteriální infekce krev   farmakoterapie   imunologie   MeSH
• diabetická noha krev   farmakoterapie   imunologie   MeSH
• dospělí MeSH
• imunoglobuliny krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfocyty imunologie   MeSH
• počet lymfocytů MeSH
• přirozená imunita MeSH
• průřezové studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Práce pojednává o patofyziologických procesech zánětu vedoucích k syntéze C-reaktivního proteinu (CRP) a o jeho imunitních funkcích. Zvláštní důraz je kladen na pochopení možných infekčních i neinfekčních příčin indukujících syntézu CRP, dynamiky tvorby a degradace CRP a na úlohu zvýšené hodnoty CRP při indikaci antibiotické léčby.

The work is dedicated to the pathophysiology of inflammatory processes leading to the C-reactive protein (CRP) synthesis and to its immune functions. The understanding of possible infectious and non-infectious causes leading to CRP-synthesis as well as understanding of the dynamics of its synthesis and degradation and of the role of elevated CRP levels in the indication of antibiotic treatment are emphasized.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• autoimunitní nemoci krev   MeSH
• bakteriální infekce krev   MeSH
• biologické markery * krev   MeSH
• C-reaktivní protein * analýza   fyziologie   MeSH
• kardiovaskulární nemoci krev   MeSH
• lidé MeSH
• nádory krev   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

OBJECTIVES: Under environmental conditions, fish are simultaneously exposed to multiple stressors. This study provides new knowledge on the effects of controlled exposure to multiple stressors, namely cyanobacterial biomass and food contaminated with arsenic. METHODS: Rainbow trout were divided into six groups of 25 fish and exposed to different contaminant combinations for 30 days: 1) control group, 2) cyanobacterial biomass, 3 & 4) two groups exposed to arsenic at concentrations of 5 mg.kg(-1) and 50 mg.kg(-1) fish feed, and 5 & 6) two groups exposed to cyanobacterial biomass and arsenic combined. We then evaluated pathological, haematological and immunological parameters at 10, 20 and 30 days after exposure. RESULTS: Marked gross pathological findings were present in groups exposed to arsenic and arsenic/cyanobacteria after 30 days. A strong decrease in haemoglobin concentration was observed in all experimental groups receiving arsenic after 10 days exposure. Total leukocyte count increased markedly in fish exposed to cyanobacterial biomass, and to higher arsenic concentrations by the end of the experiment. Neutrophils decreased significantly at the end of exposure. Similarly, exposure to cyanobacteria and/or arsenic led to suppression of opsonised zymosan particle-induced neutrophil respiratory bursts. CONCLUSIONS: Our results demonstrate that the effects of exposure to toxic cyanobacterial biomass and arsenic on fish are enhanced when the contaminants are combined. In particular, long-term exposure led to disturbances in the white blood-cell count. Modulation of phagocytosis, which is the first line of defence against invading pathogens, suggests that the combined action leads to a decreased ability to control infection.

• MeSH
• arsen farmakologie   MeSH
• bakteriální infekce krev   imunologie   patologie   MeSH
• erytrocytární znaky účinky léků   MeSH
• fagocyty účinky léků   imunologie   MeSH
• karcinogeny farmakologie   MeSH
• Microcystis * MeSH
• mikrocystiny farmakologie   MeSH
• neutrofily účinky léků   imunologie   MeSH
• Oncorhynchus mykiss krev   imunologie   MeSH
• počet leukocytů MeSH
• sinice MeSH
• železo krev   MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Účel studie: Cílem je predikce dávkování gentamicinu (Ge) s účinkem závislým na plazmatické koncentraci (Cpl), k navození cílového rozsahu ustálené údolní Cpl Ctrough,3 (0,5–2,0 mg/l) a vrcholové Cpeak4 (5,0–10,0 mg/l), tj. 0,5 hod před čtvrtou a 1 hodinu po startu čtvrté 30minutové i.v. infuze. Cpeak určuje baktericidii, Ctrough snižuje neurotoxicitu a nefrotoxicitu. Metody: Analýza Ge fluorescenční polarizační imunoesejí (TDx Analyzer; Abbott Laboratories, Abbott Park Illinois). Fitováním parametrů 2kompartm. modelu se čtyřmi Cpl Ge byly odhadnuty: distribuční objem (Vd1) a systémová clearance (Cl1) pomocí MW-Pharm 3.15 (Mediware, Groningen, NL). Pokud simulace Cpl při standardním dávkování (4 mg/kg/24–48 hod podle GV a porodní hmotnosti) neprokázala cílové Cpl, dávkování počínaje intervalem po 2. infuzi bylo změněno podle kinetických parametrů. Ctrough,3 a Cpeak4 byly ověřeny analýzou. Výsledky: U 54 novorozenců (32 velmi nedonošených, GV <34. týden a 22 mírně nedonošených, GV <38. týden) Cpeak,1 (po první infuzi) dosáhla cílového rozmezí v 80 %, Ctrough,1 <2 mg/l u všech. Standardní dávkování bylo upraveno v 85 %, zejména snížením rychlosti (65 %). Cílová Cpeak,4 byla dosažena u 69 % velmi nedonošených a 68 % mírně nedonošených, Cpeak,4 <5 mg/l u 31 % velmi nedonošených a 32 % mírně nedonošených, cílová Ctrough,3 byla dosažena u všech s 1 výjimkou. Za příčinu rozdílu Cpeak,4 predikované a ověřené byla označena retence tekutin v čase od první do čtvrté infuze Ge. Při perzistujícím ductus arteriosus nabyla až +374,0 (45,1) ml/kg. Závěr: Kineticky řízená léčba Ge u septických novorozenců v prvním týdnu života na základě Cpl po první infuzi je žádoucí zejména u velmi nedonošených novorozenců. K dosažení baktericidní Cpeak,4 je třeba vycházet z retence tekutin, doprovázející kritický stav.

Objective: The aim of the study was to predict dosing with gentamicin (Ge) of which the effect is dependent on plasma concentrations (Cpl) more than on dosage, to achieve the target range of steady state through Cpl: Ctrough,3 (0.5–2.0 mg/l) and peak Cpeak,4 (5.0–10.0 mg/l), i.e. 0.5 h before the fourth and one h after the start of the fourth dose. Cpeak,4 determines bactericidal effect, Ctrough,3 predicts neurotoxicity and nephrotoxicity. Methods: The analysis was performed by Ge fluorescence polarization immunoassay; Abbott Laboratories, Abbott Park Illinois). Fitting the parameters in a two-compartment model with four Cpl Ge were estimated: volume of distribution (Vd1) and clearance (Cl1) by the MW-Pharm 3.15 (Mediware, Groningen, NL). If the simulation of Cpl with standard dosing (4 mg/kg/24–48 h according to GV and birth weight) did not achieve the target Cpl, the standard dosing after the second dose was changed according to the estimated kinetic parameters, Ctrough,3 and Cpeak,4, and verified by ongoing analysis. Results: In 54 newborns (32 very low preterm, gestational age below 34 weeks and 22 low preterm GA <38 weeks) Cpeak,1 (after the first infusion) reached the target range in 80% Ctrough,1 <2 mg/l in all newborns. The standard dosing was adjusted in 85% of them, mainly by decreasing the rate of infusion or do you mean number of dosages per 24 hours (65%). The target Cpeak,4 was reached in 69% of very low preterm and 68% of low preterm newborns, Cpeak,4 <5 mg/l was reached in 31% of very low preterm and 32% of low preterm newborns. The target Ctrough,3 was obtained in all except one subject. The difference of the predicted and verified Cpeak,4 was caused by retention of fluids between the first and the fourth infusion of Ge. In case of persistent ductus arteriosus it reached up to +374.0 (45.1) ml/kg. Conclusion: Kinetically guided therapy with Ge in septic newborns in the first week of life based on the Cpl after the first infusion is recommended in very low preterm newborns especially. In order to reach bactericidal Cpeak,4 the decision should be based on retention of fluids, accompanying the critical condition.

• Klíčová slova
• kineticky řízené dávkování,
• MeSH
• bakteriální infekce krev   MeSH
• bakteriální pneumonie terapie   MeSH
• biochemická analýza krve MeSH
• ductus arteriosus MeSH
• gentamiciny * aplikace a dávkování   farmakokinetika   terapeutické užití   MeSH
• gestační stáří MeSH
• jednotky intenzivní péče o novorozence MeSH
• klinické laboratorní techniky MeSH
• kombinovaná farmakoterapie MeSH
• komorbidita MeSH
• krevní plazma účinky léků   MeSH
• kritický stav terapie   MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• novorozenec nedonošený * MeSH
• novorozenec MeSH
• porodní hmotnost MeSH
• prospektivní studie MeSH
• sepse * farmakoterapie   MeSH
• vankomycin terapeutické užití   MeSH
• výběr pacientů MeSH
• výsledek terapie MeSH
• vztah mezi dávkou a účinkem léčiva * MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• práce podpořená grantem MeSH

PURPOSE: Serum procalcitonin (PCT) has become a routinely utilized parameter with a high prediction value of the severity of bacterial infectious complications and their immediate outcomes. Whereas the utility of PCT in differentiating between bacterial and viral infection is generally accepted, its significance in fungal infections has yet to be determined. The aim of the study was to determine the role of PCT testing in patients at high risk for invasive fungal infections. METHODS: Immunocompromised hematological patients undergoing cyclic chemotherapy treatment or allogeneic hemopoietic stem cell transplantation with infectious complications in which the infectious agents were identified during the disease course were evaluated. In patients with bacterial infection, positive hemocultures were documented, and in patients with fungal infection, the presence of either proven or probable disease was confirmed according to Ascioglu criteria. C-reactive protein (CRP) and PCT were prospectively assessed from the day following fever onset, for four consecutive days. RESULTS: Overall, 34 patients were evaluated, 21 with bacterial and 13 with fungal infections. Significant elevations of CRP concentrations (i.e., above the upper normal limit) were observed in all patients, with a tendency toward higher levels in bacterial (both gram-positive [Gr+] and Gr-negative [Gr-]) than in fungal infections. PCT levels were significantly elevated in patients with bacterial infections (e.g., predominantly in Gr- compared to Gr+), whereas in patients with fungal infections, we identified minimal or no PCT elevations, p < 0.01. For the fungal infections, according to constructed receiver operating characteristic curves, a combination of PCT <0.5 μg/L and CRP 100-300 mg/L offers the best specificity, sensitivity and positive and negative predictive values (81, 85, 73, and 89 %, respectively). CONCLUSION: Altogether, our data suggest that the finding of substantially elevated CRP combined with low PCT in immunocompromised patients may indicate systemic fungal infection. The use of this combination might simplify the diagnostic process, which otherwise can often be lengthy and arduous.

• MeSH
• bakteriální infekce krev   imunologie   MeSH
• C-reaktivní protein metabolismus   MeSH
• dospělí MeSH
• hematologické nádory krev   imunologie   mikrobiologie   MeSH
• horečka krev   imunologie   mikrobiologie   MeSH
• imunokompromitovaný pacient MeSH
• kalcitonin krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mykózy krev   imunologie   MeSH
• nemoc štěpu proti hostiteli krev   imunologie   mikrobiologie   MeSH
• prediktivní hodnota testů MeSH
• proteinové prekurzory krev   MeSH
• ROC křivka MeSH
• senioři MeSH
• transplantace hematopoetických kmenových buněk MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Routinely used biomarkers of bacterial etiology of infection, such as C-reactive protein and procalcitonin, have limited usefulness for evaluation of infections since their expression is enhanced by a number of different conditions. Therefore, several inflammatory cytokines and chemokines were analyzed with sera from patients hospitalized for moderate bacterial and viral infectious diseases. In total, 57 subjects were enrolled: 21 patients with community-acquired bacterial infections, 26 patients with viral infections, and 10 healthy subjects (control cohorts). The laboratory analyses were performed using Luminex technology, and the following molecules were examined: IL-1Ra, IL-2, IL-4, IL-6, IL-8, TNF- α , INF- γ , MIP-1 β , and MCP-1. Bacterial etiology of infection was associated with significantly (P < 0.001) elevated serum concentrations of IL-1Ra, IL-2, IL-6, and TNF- α in comparison to levels observed in the sera of patients with viral infections. In the patients with bacterial infections, IL-1Ra and IL-8 demonstrated positive correlation with C-reactive protein, whereas, IL-1Ra, TNF- α , and MCP-1 correlated with procalcitonin. Furthermore, elevated levels of IL-1Ra, IL-6, and TNF- α decreased within 3 days of antibiotic therapy to levels observed in control subjects. The results show IL-1Ra as a potential useful biomarker of community-acquired bacterial infection.

• MeSH
• antagonista receptoru pro interleukin 1 krev   MeSH
• bakteriální infekce krev   MeSH
• biologické markery krev   MeSH
• C-reaktivní protein metabolismus   MeSH
• chemokiny krev   MeSH
• cytokiny krev   MeSH
• dospělí MeSH
• infekce získané v komunitě krev   MeSH
• interleukin-2 krev   MeSH
• interleukin-4 krev   MeSH
• interleukin-6 krev   MeSH
• interleukin-8 krev   MeSH
• kalcitonin krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• proteinové prekurzory krev   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• TNF-alfa krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH