• MeSH
• HIV infekce komplikace   MeSH
• infekce dýchací soustavy etiologie   imunologie   klasifikace   komplikace   MeSH
• lidé MeSH
• oportunní infekce * etiologie   imunologie   klasifikace   komplikace   MeSH
• pneumocystová pneumonie diagnóza   etiologie   farmakoterapie   patologie   MeSH
• respirační syncytiální viry patogenita   MeSH
• transplantace plic škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: Vaccine-preventable diseases and opportunistic infections in pediatric inflammatory bowel disease (IBD) are increasingly recognized issues. The aims of this study were to evaluate vaccinations, immunization status, and consequent therapeutic management in children with IBD and to analyze the differences among patients diagnosed before (Group 1) and after June 2012 (Group 2). METHODS: This was a multicenter, retrospective cohort investigation. Between July 2016 and July 2017, 430 children with IBD were enrolled in 13 centers. Diagnosis, therapeutic history, vaccinations, and immunization status screening at diagnosis and at immunosuppressant (IM)/biologic initiation and reasons for incomplete immunization were retrieved. RESULTS: Vaccination rates at diagnosis were unsatisfactory for measles, mumps, and rubella (89.3%), Haemophilus influenzae (81.9%), meningococcus C (23.5%), chickenpox (18.4%), pneumococcus (18.6%), papillomavirus (5.9%), and rotavirus (1.9%). Complete immunization was recorded in 38/430 (8.8%) children, but specific vaccines were recommended in 79/430 patients (18.6%), without differences between the 2 groups. At IM start, 22% of children were tested for Epstein-Barr virus (EBV) status, with 96.2% of EBV-naïve patients starting azathioprine, without differences between Groups 1 and 2. Screening for latent tuberculosis (TB) before start of biologics was performed in 175/190 (92.1%), with up to 9 different screening strategies and numerous inconsistencies. CONCLUSIONS: We demonstrated a poor immunization status at diagnosis in children with IBD, which was not followed by proper vaccination catch-up. EBV status before IM initiation and latent TB before biologics were not adequately assessed. Thus, the overall impact of the current guidelines seems unsatisfactory.

• MeSH
• Crohnova nemoc farmakoterapie   imunologie   MeSH
• dítě MeSH
• dodržování směrnic MeSH
• idiopatické střevní záněty farmakoterapie   imunologie   MeSH
• imunosupresiva škodlivé účinky   MeSH
• infekce virem Epsteina-Barrové prevence a kontrola   MeSH
• latentní tuberkulóza prevence a kontrola   MeSH
• lidé MeSH
• Mycobacterium tuberculosis MeSH
• očkovací schéma MeSH
• oportunní infekce imunologie   prevence a kontrola   MeSH
• retrospektivní studie MeSH
• ulcerózní kolitida farmakoterapie   imunologie   MeSH
• vakcinace normy   statistika a číselné údaje   MeSH
• virus Epsteinův-Barrové MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BK virus nephropathy (BKVN) is a serious opportunistic infection threatening renal function especially during the first year after transplantation. Its incidence is now on the rise and is closely related to the level of the recipient's immune system inhibition. This is more intensive with current trends in transplantation medicine, where more potent immunosuppressive protocols are used and more aggressive antirejection therapy is applied. In the absence of BK virus (BKV) specific therapy and limited treatment options for advanced BKVN, active screening of BKV replication and subsequent preemptive adjustment of immunosuppression are essential measures to prevent BKVN. However, it remains unclear how to modify immunosuppressive protocols as well as how to address initial stages of BKV replication. This comprehensive review summarizes the currently applied and not completely uniform procedures for the detection, prophylaxis and therapy of BKV replication and BKVN. The pitfalls brought by reduced immunosuppression, as a typical response to a significant viral replication or a developed BKVN, are also mentioned, particularly in the form of graft rejection. The paper also outlines the authors' experiences, and lists currently ongoing studies on the subject. The perspectives of new, especially immune-based, procedures in the treatment of complications associated with BKV infections are highlighted. Different views on the management of patients indicated for kidney re-transplantation whose previous graft failed because of BKVN are also discussed.

• MeSH
• ABO systém krevních skupin MeSH
• antivirové látky terapeutické užití   MeSH
• časná diagnóza MeSH
• dárci tkání MeSH
• dospělí MeSH
• elektronová mikroskopie MeSH
• homologní transplantace MeSH
• imunosupresiva škodlivé účinky   MeSH
• lidé MeSH
• nekompatibilita krevních skupin MeSH
• nemoci ledvin imunologie   virologie   MeSH
• oportunní infekce diagnóza   imunologie   prevence a kontrola   MeSH
• polyomavirové infekce diagnóza   imunologie   prevence a kontrola   MeSH
• příjemce transplantátu MeSH
• přirozená imunita fyziologie   MeSH
• replikace viru MeSH
• T-lymfocyty imunologie   MeSH
• transplantace ledvin škodlivé účinky   MeSH
• virus BK * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• imunosupresiva škodlivé účinky   terapeutické užití   MeSH
• lidé MeSH
• oportunní infekce epidemiologie   imunologie   prevence a kontrola   MeSH
• roztroušená skleróza farmakoterapie   imunologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• novinové články MeSH

A case is described of severe acute hepatitis in 47-year-old woman with chronic psoriasis and psoriatic arthritis treated with infliximab. Although clinical, serological and laboratory results were compatible with acute EBV hepatitis, it was difficult to differentiate between EBV infection and other non-infectious causes of hepatitis. The patient gradually developed chronic hepatitis with liver steatosis and efficient treatment with adalimumab had to be stopped. This case presents an uncommon complication that may arise from the use of biologic therapy and calls for caution in long-term management of psoriatic patients with internal comorbidities.

• MeSH
• antivirové látky terapeutické užití   MeSH
• biopsie MeSH
• chronická hepatitida diagnóza   farmakoterapie   imunologie   virologie   MeSH
• hostitel s imunodeficiencí * MeSH
• imunologické faktory škodlivé účinky   MeSH
• indukce remise MeSH
• infekce virem Epsteina-Barrové diagnóza   farmakoterapie   imunologie   virologie   MeSH
• infliximab škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• oportunní infekce diagnóza   farmakoterapie   imunologie   virologie   MeSH
• pití alkoholu škodlivé účinky   MeSH
• psoriáza diagnóza   farmakoterapie   imunologie   MeSH
• rizikové faktory MeSH
• stupeň závažnosti nemoci MeSH
• TNF-alfa antagonisté a inhibitory   imunologie   MeSH
• virová hepatitida u lidí diagnóza   farmakoterapie   imunologie   virologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: Young age and thiopurine therapy are risk factors for lymphoproliferative disease among patients with inflammatory bowel disease (IBD). AIMS: The aims of this study were to evaluate the prevalence of seropositivity for the Epstein-Barr virus (EBV) and human cytomegalovirus (CMV) among children and adolescents with IBD, to assess the viral load of EBV, CMV, and BK and JC polyomaviruses (BKV, JCV) in these patients, and to assess the influence of different therapeutic regimens on seroprevalence and viral load. METHODS: Children who had been followed in our center were tested for EBV, CMV, BKV, and JCV in a cross-sectional study. One hundred and six children were included who had Crohn's disease (68%), ulcerative colitis (29%), and unclassified IBD (3%). RESULTS: We found that 64% of patients were EBV seropositive. The proportion of EBV seropositive patients increased during childhood. Azathioprine therapy (p = 0.003) was associated with EBV seropositivity in a multiple logistic regression model, after adjusting for gender, age, and disease activity at determination. We found a significant association between the number of polymerase chain reaction copies and infliximab dose (p = 0.023). We did not find any significant association between CMV serology and CMV, BKV, or JCV viral load, or any other therapeutic regimen or clinical characteristics. CONCLUSIONS: Treatment with azathioprine appears to be a risk factor for early EBV seropositivity in children with IBD, and the infliximab dose was associated with a higher EBV viral load.

• MeSH
• azathioprin škodlivé účinky   MeSH
• Crohnova nemoc diagnóza   farmakoterapie   epidemiologie   imunologie   MeSH
• cytomegalovirové infekce diagnóza   epidemiologie   imunologie   virologie   MeSH
• dítě MeSH
• hostitel s imunodeficiencí MeSH
• imunosupresiva škodlivé účinky   MeSH
• infekce virem Epsteina-Barrové diagnóza   epidemiologie   imunologie   virologie   MeSH
• infliximab škodlivé účinky   MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• multivariační analýza MeSH
• odds ratio MeSH
• oportunní infekce diagnóza   epidemiologie   imunologie   virologie   MeSH
• polyomavirové infekce diagnóza   epidemiologie   imunologie   virologie   MeSH
• předškolní dítě MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• séroepidemiologické studie MeSH
• sérologické testy MeSH
• ulcerózní kolitida diagnóza   farmakoterapie   epidemiologie   imunologie   MeSH
• věkové faktory MeSH
• virová nálož MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• antituberkulotika terapeutické užití   MeSH
• asymptomatické nemoci MeSH
• atypické mykobakteriální infekce diagnóza   farmakoterapie   imunologie   mikrobiologie   MeSH
• hostitel s imunodeficiencí * MeSH
• humanizované monoklonální protilátky aplikace a dávkování   škodlivé účinky   MeSH
• imunosupresiva aplikace a dávkování   škodlivé účinky   MeSH
• infekce dýchací soustavy diagnóza   farmakoterapie   imunologie   mikrobiologie   MeSH
• lidé MeSH
• Mycobacterium kansasii izolace a purifikace   MeSH
• oportunní infekce diagnóza   farmakoterapie   imunologie   mikrobiologie   MeSH
• relabující-remitující roztroušená skleróza diagnóza   farmakoterapie   imunologie   MeSH
• rozvrh dávkování léků MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• kazuistiky MeSH

In children with primary immunodeficiencies, the onset of symptoms precedes the diagnosis and the initiation of appropriate treatment by months or years. This delay in diagnosis is due to the fact that while these disorders are rare, some of the infections seen in immunodeficient patients are common. Defective antibody production represents the largest group among these disorders, with otitis, sinusitis and pneumonia as the most frequent initial manifestation. We performed a prospective study of humoral immunity in children hospitalized due to community-acquired pneumonia in tertiary care hospital. Out of 254 patients (131 boys, 123 girls, median age 4.5 years) recruited over 3 years, we found 2 boys (age 11 and 21 months) lacking serum immunoglobulins and circulating B cells. Subsequent genetic analysis confirmed diagnosis of X-linked agammaglobulinemia. Despite their immunodeficiency, the pneumonia was uncomplicated in both patients and did not call for immunological evaluation. However, the immunoglobulin screening at admission allowed for an early diagnosis of the immunodeficiency and timely initiation of immunoglobulin substitution, the key prerequisite for a favorable course of the disease.Simple and inexpensive immuno-globulin measurement during the manage-ment of hospitalized children with community-acquired pneumonia may help in early identification of patients with compromised humoral immunity and prevent serious complications.

• MeSH
• agamaglobulinemie diagnóza   genetika   imunologie   terapie   MeSH
• B-lymfocyty imunologie   MeSH
• bakteriální pneumonie diagnóza   genetika   imunologie   terapie   MeSH
• časná diagnóza MeSH
• centra terciární péče MeSH
• genetické nemoci vázané na chromozom X diagnóza   genetika   imunologie   terapie   MeSH
• genetické testování * MeSH
• imunoglobuliny krev   MeSH
• infekce získané v komunitě diagnóza   genetika   imunologie   terapie   MeSH
• kojenec MeSH
• lidé MeSH
• oportunní infekce diagnóza   genetika   imunologie   terapie   MeSH
• pasivní imunizace MeSH
• počet lymfocytů MeSH
• příjem pacientů * MeSH
• prognóza MeSH
• prospektivní studie MeSH
• pseudomonádové infekce diagnóza   genetika   imunologie   terapie   MeSH
• Pseudomonas aeruginosa * MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

We report a case of Alternaria alternata cutaneous and pulmonary infection in a 62-year-old man after heart transplantation treated by azole antifungals. Alternaria spp. belong to a group of opportunistic dematiaceous fungi with worldwide distribution. The cutaneous form of the infection in human is very rare and occurs predominantly among immunosuppressed patients. Therefore, diagnosis is often delayed or not reached at all. Appropriate treatment is not standardized and remains a matter of discussion. According to current studies, the best results are obtained with systemic azole antifungal therapy combined with surgical intervention.

• MeSH
• Alternaria účinky léků   imunologie   patogenita   MeSH
• alternarióza diagnóza   farmakoterapie   imunologie   mikrobiologie   MeSH
• antifungální látky aplikace a dávkování   MeSH
• dermatomykózy diagnóza   farmakoterapie   imunologie   mikrobiologie   MeSH
• hostitel s imunodeficiencí MeSH
• imunosupresiva škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• oportunní infekce diagnóza   farmakoterapie   imunologie   mikrobiologie   MeSH
• plicní mykózy diagnóza   farmakoterapie   imunologie   mikrobiologie   MeSH
• transplantace srdce škodlivé účinky   MeSH
• triazoly aplikace a dávkování   MeSH
• vorikonazol aplikace a dávkování   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

Despite the great importance of Aureobasidium pullulans in biotechnology, the fungus had emerged as an opportunistic human pathogen, especially among immunocompromised patients. Clinical detection of this rare human fungal pathogen presently relies on morphology diagnosis which may be misleading. Thus, a sensitive and accurate quantitative molecular assay for A. pullulans remains lacking. In this study, we presented the microscopy observations of A. pullulans that reveals the phenotypic plasticity of the fungus. A. pullulans-specific primers and molecular beacon probes were designed based on the fungal 18S ribosomal RNA (rRNA) gene. Comparison of two probes with varied quencher chemistry, namely BHQ-1 and Tamra, revealed high amplification efficiency of 104% and 108%, respectively. The optimized quantitative real-time PCR (qPCR) assays could detect and quantify up to 1 pg concentration of A. pullulans DNA. Both assays displayed satisfactory performance parameters at fast thermal cycling mode. The molecular assay has great potential as a molecular diagnosis tool for early detection of fungal infection caused by A. pullulans, which merits future study in clinical diagnosis.

• MeSH
• Ascomycota genetika   izolace a purifikace   MeSH
• biotest MeSH
• časná diagnóza MeSH
• DNA fungální analýza   MeSH
• DNA sondy chemie   genetika   MeSH
• fenotyp MeSH
• fylogeneze MeSH
• hostitel s imunodeficiencí MeSH
• kvantitativní polymerázová řetězová reakce metody   MeSH
• lidé MeSH
• mikroskopie MeSH
• molekulární sekvence - údaje MeSH
• mykózy diagnóza   imunologie   mikrobiologie   MeSH
• oportunní infekce diagnóza   imunologie   mikrobiologie   MeSH
• rhodaminy analýza   MeSH
• RNA ribozomální 18S analýza   MeSH
• sekvence nukleotidů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH