• Klíčová slova
• granadaene,
• MeSH
• bakteriální zoonózy etiologie   MeSH
• brouci mikrobiologie   patogenita   MeSH
• feces mikrobiologie   MeSH
• grampozitivní koky * chemie   izolace a purifikace   patogenita   MeSH
• jedlý hmyz * mikrobiologie   patogenita   MeSH
• Lactococcus chemie   izolace a purifikace   patogenita   MeSH
• Leontopithecus mikrobiologie   MeSH
• riziko MeSH
• střevní mikroflóra MeSH
• Publikační typ
• přehledy MeSH

OBJECTIVES: This study of 331 primary brain abscess (PBA) patients aimed to understand infecting agents, predisposing factors, and outcomes, with a focus on factors affecting mortality. METHODS: Data were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed. RESULTS: The patients had a mean ± SD age of 46.8 ± 16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with Viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI: 1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15). CONCLUSION: The risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality.

• MeSH
• absces mozku * mikrobiologie   mortalita   MeSH
• antibakteriální látky terapeutické užití   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• retrospektivní studie MeSH
• rizikové faktory 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
• multicentrická studie MeSH

PURPOSE OF THE STUDY The study aims to determine the incidence of fracture-related infection (hereinafter referred to as the FRI) at a Level I trauma centre over a three-year period. It also aimed to determine the risk factors, to observe confirmatory and suggestive criteria in line with the applicable recommendations, and to evaluate the bacterial spectrum in a diagnosed FRI. MATERIAL AND METHODS It is a retrospective-prospective study carried out through studying the documentation. The study included all patients diagnosed with FRI and treated between 2019 and 2021, except for the patients with hand fractures since minor phalangeal fractures of the fingers were largely treated by the outpatient department, no osteosynthesis was performed in the operating room, and these patients were not followed up at our department. RESULTS The FRI incidence was 2.33% of all osteosyntheses performed at the Level 1 trauma centre in the period 2019-2021. The FRI was most often caused by pyogenic cocci agents and the FRI developed most frequently within 6 months after osteosynthesis. The site at risk was the lower limb region. The FRI incidence was most often indicated by suggestive clinical criteria (redness, secretion, pain) and radiological criteria (delayed healing, non-union). Overall, 42.19% of treated nonunions were later diagnosed as FRI. At the time of FRI diagnosis, the CRP values were normal in 21.7% of patients. DISCUSSION The FRI incidence rate in 2019-2021 was 2.33%, which corresponds with the values reported in other papers focusing on the incidence of infectious complications after osteosynthesis. Fang and Depypere reported 1-2% of infectious complications. The most common risk factors are open fractures, which account for 20.16% in our cohort. Ktistakis and Depypere describe the incidence of osteomyelitis in 30% of treated open fractures. In our cohort, the incidence of FRI was significantly higher in lower limb fractures. Bezstarosti, Wang and Pesch published similar results, with some deviations. The time from osteosynthesis to final FRI diagnosis varied from a few weeks to several years. In more than half of the patients the FRI developed within 6 months after performed osteosynthesis. Metsemakers and Fang refer to the very same trend. The CRP levels in the study population varied a lot. Xing-qi Zhao describes CRP as a less sensitive (sensitivity 65.6%) but more specific marker (specificity 75.4%). According to the available literature, the most common agents causing infectious complications of osteosynthesis are gram-positive cocci, S. aureus in particular. In our study, G+ pyogenic cocci were clearly the most commonly detected, which is consistent with the results of studies by Fang and Depypere, focused on the incidence of infectious complications. The most common FRI clinical manifestations included wound secretion, redness, swelling and pain. Furthermore, suggestive radiological criteria, especially delayed healing and non-union also indicated the FRI occurrence. According to Fang, the most common clinical manifestations of infectious complications include pain, swelling, redness and wound dehiscence. Fang reports that the most common radiologic findings are the periosteal reaction, loosening of the implant and delayed healing or non-union, which is consistent with our cohort. In the cohort of non-unions surgically treated at our department, FRI was subsequently confirmed in 42.19% of cases. CONCLUSIONS The incidence of FRI at Level 1 trauma centre was 2.33% of operated fractures in 2019-2021, with pyogenic cocci being the most common infectious agents. The FRI usually developed within 6 months after osteosynthesis. The typical site for the FRI development was the lower limb region, the ongoing FRI was indicated by suggestive clinical criteria (redness, secretion, pain) and radiological criteria (delayed healing and a non-union). Overall, 42.19% of treated non-unions were later diagnosed as FRI. Key words: fracture-related infection, FRI, suggestive criteria, confirmatory criteria, FRI diagnosis, microbial, microbiology spectrum, osteosynthesis, complications, non-union.

• MeSH
• incidence MeSH
• lidé MeSH
• otevřené fraktury * MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• Staphylococcus aureus MeSH
• traumatologická centra MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

In this study, we have focused on a multiparametric microbiological analysis of the antistaphylococcal action of the iodinated imine BH77, designed as an analogue of rafoxanide. Its antibacterial activity against five reference strains and eight clinical isolates of Gram-positive cocci of the genera Staphylococcus and Enterococcus was evaluated. The most clinically significant multidrug-resistant strains, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant S. aureus (VRSA), and vancomycin-resistant Enterococcus faecium, were also included. The bactericidal and bacteriostatic actions, the dynamics leading to a loss of bacterial viability, antibiofilm activity, BH77 activity in combination with selected conventional antibiotics, the mechanism of action, in vitro cytotoxicity, and in vivo toxicity in an alternative animal model, Galleria mellonella, were analyzed. The antistaphylococcal activity (MIC) ranged from 15.625 to 62.5 μM, and the antienterococcal activity ranged from 62.5 to 125 μM. Its bactericidal action; promising antibiofilm activity; interference with nucleic acid, protein, and peptidoglycan synthesis pathways; and nontoxicity/low toxicity in vitro and in vivo in the Galleria mellonella model were found to be activity attributes of this newly synthesized compound. In conclusion, BH77 could be rightfully minimally considered at least as the structural pattern for future adjuvants for selected antibiotic drugs. IMPORTANCE Antibiotic resistance is among the largest threats to global health, with a potentially serious socioeconomic impact. One of the strategies to deal with the predicted catastrophic future scenarios associated with the rapid emergence of resistant infectious agents lies in the discovery and research of new anti-infectives. In our study, we have introduced a rafoxanide analogue, a newly synthesized and described polyhalogenated 3,5-diiodosalicylaldehyde-based imine, that effectively acts against Gram-positive cocci of the genera Staphylococcus and Enterococcus. The inclusion of an extensive and comprehensive analysis for providing a detailed description of candidate compound-microbe interactions allows the valorization of the beneficial attributes linked to anti-infective action conclusively. In addition, this study can help with making rational decisions about the possible involvement of this molecule in advanced studies or may merit the support of studies focused on related or derived chemical structures to discover more effective new anti-infective drug candidates.

• MeSH
• antibakteriální látky farmakologie   chemie   MeSH
• antiinfekční látky * farmakologie   MeSH
• Enterococcus MeSH
• methicilin rezistentní Staphylococcus aureus * MeSH
• mikrobiální testy citlivosti MeSH
• rafoxanid farmakologie   MeSH
• Staphylococcus aureus MeSH
• Staphylococcus MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

The emergence of antibiotic resistance in opportunistic pathogens represents a huge problem, the solution for which may be a treatment with a combination of multiple antimicrobial agents. Sodium salt of cobalt bis-dicarbollide (COSAN.Na) is one of the very stable, low-toxic, amphiphilic boron-rich sandwich complex heteroboranes. This compound has a wide range of potential applications in the biological sciences due to its antitumor, anti-HIV-1, antimicrobial and antibiofilm activity. Our study confirmed the ability of COSAN.Na (in the concentration range 0.2-2.48 μg/mL) to enhance tetracycline, erythromycin, and vancomycin action towards Staphylococcus epidermidis planktonic growth with an additive or synergistic effect (e.g., the combination of 1.24 μg/mL COSAN.Na and 6.5 μg/mL TET). The effective inhibitory concentration of antibiotics was reduced up to tenfold most efficiently in the case of tetracycline (from 65 to 6.5 μg/mL). In addition, strong effect of COSAN.Na on disruption of the cell envelopes was determined using propidium iodide uptake measurement and further confirmed by transmission electron microscopy. The combination of amphiphilic COSAN.Na with antibiotics can therefore be considered a promising way to overcome antibiotic resistance in Gram-positive cocci.

• Publikační typ
• časopisecké články MeSH

Infekce kůže a měkkých tkání jsou rozsáhlou skupinou onemocnění s širokým spektrem klinických projevů. Některé z těchto infekcí mohou bezprostředně ohrožovat život. V rámci etiologie se uplatňuje celá řada bakterií, mezi epidemiologicky privilegované patogeny patří bezesporu gram-pozitivní koky Staphylococcus aureus a Streptococcus pyogenes. V kazuistice prezentujeme komplikovaný případ mladé ženy s kožními defekty po fasciotomii řešenými aplikací dermální náhrady. U pacientky s výraznou nesnášenlivostí k celé řadě antimikrobiálních preparátů došlo k rozvoji mnohočetných infekčních komplikací v oblasti kůže a měkkých tkání s vysokým rizikem rozvoje flebitid. Dramatický obraz se podařilo zvládnout za pomoci intravenózního podání dalbavancinu, potentního baktericidního antibiotika reprezentujícího racionální možnost v léčbě SSTIs způsobených gram-pozitivními bakteriemi.

Skin and soft tissue infections (SSTIs) are a large group of diseases with a wide range of clinically different conditions, some of which can be immediately life-threatening. A number of bacteria play an important role in the etiology of SSTIs, especially gram-positive cocci Staphylococcus aureus and Streptococcus pyogenes. In this case report, a young woman with skin defects after a fasciotomy was treated using a dermal substitute application. Multiple infectious complications in the skin and soft tissues with a high risk of development of phlebitis and with significant intolerance to a variety of antimicrobials were observed. The dramatic SSTI was treated using intravenous administration of dalbavancin, a very potent bactericidal antibio tic representing a rational option in the treatment of SSTIs caused by gram-positive bacteria.

• Klíčová slova
• dalbavancin,
• MeSH
• antibakteriální látky terapeutické užití   MeSH
• dospělí MeSH
• grampozitivní bakterie účinky léků   MeSH
• infekce měkkých tkání * etnologie   farmakoterapie   MeSH
• lidé MeSH
• teikoplanin * analogy a deriváty   farmakologie   terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Hydrazide-hydrazones have been described as a scaffold with antimicrobial and cytotoxic activities as well as iodinated compounds. A resistance rate of bacterial and fungal pathogens has increased considerably. That is why we synthesized and screened twenty-two iodinated hydrazide-hydrazones 1 and 2, ten 1,2-diacylhydrazines 3 and their three reduced analogues 4 for their antibacterial, antifungal, and cytotoxic properties. Hydrazide-hydrazones were prepared by condensation of 4-substituted benzohydrazides with 2-/4-hydroxy-3,5-diiodobenzaldehydes, diacylhydrazines from identical benzohydrazides and 3,5-diiodosalicylic acid via its chloride. These compounds were investigated in vitro against eight bacterial and eight fungal strains. The derivatives were found potent antibacterial agents against Gram-positive cocci including methicillin-resistant Staphylococcus aureus with the lowest values of minimum inhibitory concentrations (MIC) of 7.81 μM. Four compounds inhibited also human pathogenic fungi (MIC of ≥1.95 μM). The derivatives had different degrees of cytotoxicity for HepG2 and HK-2 cell lines (IC50 values from 11.72 and 26.80 μM, respectively). Importantly, normal human cells exhibited lower sensitivity. The apoptotic effect was also investigated. In general, the presence of 3,5-diiodosalicylidene scaffold (compounds 1) is translated into enhanced both antimicrobial and cytotoxic properties whereas its 4-hydroxy isomers 2 share a low biological activity. N'-Benzoyl-2-hydroxy-3,5-diiodobenzohydrazides 3 have a non-homogeneous activity profile. Focusing on 4-substituted benzohydrazide part, the presence of an electron-withdrawing group (F, Cl, CF3, NO2) was found to be beneficial.

• MeSH
• antibakteriální látky chemie   farmakologie   MeSH
• antifungální látky chemie   farmakologie   MeSH
• Bacteria účinky léků   MeSH
• buňky Hep G2 MeSH
• houby účinky léků   MeSH
• hydraziny chemie   MeSH
• hydrazony chemie   MeSH
• lidé MeSH
• objevování léků MeSH
• protinádorové látky chemie   farmakologie   MeSH
• viabilita buněk účinky léků   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE: The characteristics and impact of bacteremia have not been widely investigated in immunocompromised patients with acute respiratory failure (ARF). METHODS: We performed a secondary analysis of a prospective cohort of immunocompromised patients with ARF (EFRAIM study). After exclusion of blood cultures positive for coagulase negative Staphylococci, we compared patients with (n = 236) and without (n = 1127) bacteremia. RESULTS: The incidence of bacteremia was 17%. Bacterial pneumonia and extra-pulmonary ARDS were the main causes of ARF in bacteremic patients. Bacteremia involved gram negative rods (48%), gram positive cocci (40%) or were polymicrobial (10%). Bacteremic patients had more hematological malignancy, higher SOFA scores and increased organ support within 7 days. Bacteremia was associated with higher crude ICU mortality (40% versus 32%, p = 0.02), but neither hospital (49% versus 44%, p = 0.17) nor 90-day mortality (60% versus 56%, p = 0.25) were different from non-bacteremic patients. After propensity score matching based on baseline characteristics, the difference in ICU mortality lost statistical significance (p = 0.06), including in a sensitivity analysis restricted to patients with pneumonia. CONCLUSIONS: We analyzed a large population of immunocompromised patients with ARF and an incidence of bacteremia of 17%. We could not demonstrate an impact of bacteremia on mortality after adjusting for baseline characteristics.

• MeSH
• bakteriemie * epidemiologie   MeSH
• imunokompromitovaný pacient MeSH
• jednotky intenzivní péče MeSH
• kritický stav MeSH
• lidé MeSH
• prospektivní studie MeSH
• respirační insuficience * epidemiologie   MeSH
• syndrom dechové tísně * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

Mezi ložisková zánětlivá nitrolební onemocnění řadíme epidurální absces, subdurální empyém, septickou nitrolební tromboflebitidu a mozkový absces (MA). MA je relativně vzácné, život ohrožující onemocnění s potenciálně závažnými dlouhodobými následky. Incidence MA je uváděna v rozmezí 0,3–1,8/100 000 obyvatel a rok; až 25 % případů spadá do dětského věku. Predisponujícími faktory vzniku MA v dětském věku mohou být akutní infekce ORL oblasti, záněty dýchacích cest, meningitida, infekční endokarditida asociovaná s vrozenými vývojovými vadami srdce, arteriovenózní malformace plicního řečiště, penetrující poranění hlavy a neurochirurgické výkony CNS. Zvláštní skupinu tvoří imunokompromitovaní pacienti. Nejčastějšími původci mozkového abscesu jsou bakterie; nejvíce se uplatňují grampozitivní koky rodu Streptococcus a Staphylococcus, ale i anaerobní a gramnegativní bakterie. V práci předkládáme teoretický přehled o tomto onemocnění ilustrovaný kazuistikami dvou dívek, u kterých se MA rozvinul jako komplikace akutního zánětu vedlejších nosních dutin (P1) a akutní faryngitidy (P2). Předchozí publikace kazuistiky "1" ve formě přednášky: 14. 12. 2016, Katedrální seminář, Dětská klinika Fakultní nemocnice Hradec Králové; 25.–27. 5. 2017, Kongres Pediatre pro praxi, IV. kongres pediatrů, Hradec Králové, Hotel Nové Adalbertinum

The focal inflammatory intracranial diseases comprise epidural abscess, subdural empyema, septic intracranial trombophlebitis and the brain abscess (BA). BA is a relatively rare, life-threatening disease with potentially serious lifelong sequelae. The BA incidency is given in the range of 0.3–1.8/100 000 of persons per year; up to 25% cases occur in the childhood. Predisposing factors of the BA development in children might be acute infections in the ENT area, respiratory tract infections, meningitis, infectious endocarditis associated with congenital heart malformations, arterio-venous malformations of the lung circulation, penetrating head injuries and brain neurosurgery. The immunocompromised patients represent a special group. The etiology of BA is mostly bacterial (Gram positive cocci Streptococcus and Staphylococcus, but also anaerobic and Gram negative bacteria). The theoretical overview about this disease illustrated by the case reports of two girls with the BA as a complication of paranasal sinuses inflammation (P1) and acute pharyngitis (P2) is presented in our work.

• Klíčová slova
• nitrolební komplikace akutní sinusitidy,
• MeSH
• absces mozku * diagnóza   etiologie   mikrobiologie   terapie   MeSH
• antibakteriální látky terapeutické užití   MeSH
• dítě MeSH
• faryngitida komplikace   MeSH
• lidé MeSH
• mladiství MeSH
• neurozobrazování metody   MeSH
• sinusitida komplikace   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Pterostilbene (PTE), a dimethylated analogue of resveratrol, mostly contained in Vitis vinifera leaves or in other plant sources is well-known for its antioxidant activity. Due to its bioavailability, low hydrophilicity and thus ability to penetrate hydrophobic biological membranes it was found to be an antimicrobial agent. These properties of PTE offer the possibility of its use in the treatment of microbial infections. The emergence of antibiotic resistance of microorganisms is often caused by their ability to form biofilm; new substances with antibiofilm activity are therefore sought. The representatives of opportunistic pathogenic gram-positive and gram-negative bacteria as well as fungi were used for the determination of minimum inhibitory concentrations (MIC50 and MIC80), minimum biofilm inhibitory concentrations (MBIC50 and MBIC80) and minimum biofilm eradication concentrations (MBEC50 and MBEC80) of PTE and commonly used antibiotics erythromycin, polymyxin B or antimycotic amphotericin B. Total biofilm biomass was investigated by crystal violet staining, and the results were confirmed using microscopic techniques. The most significant antibiofilm action was proved for gram-positive cocci, e.g., MBEC50 of PTE for all strains of Staphylococcus epidermidis tested was 25 mg/L. By contrast, the antibiotic ERM did not exhibit antibiofilm activity in most cases. The permeabilization of cell membranes of gram-positive cocci biofilm by MBIC50 and MBEC50 of PTE was confirmed by LIVE/DEAD staining using spinning disc confocal microscopy. PTE significantly influenced the ability of gram-positive cocci to form biofilm and it effectively eradicated pre-formed biofilm in vitro; its potential for the treatment of biofilm-associated infections of Staphylococcus spp. or Enterococcus faecalis is thus apparent.

• MeSH
• antibakteriální látky farmakologie   MeSH
• antioxidancia farmakologie   MeSH
• biofilmy účinky léků   růst a vývoj   MeSH
• Enterococcus faecalis účinky léků   MeSH
• gramnegativní bakterie účinky léků   MeSH
• grampozitivní bakterie účinky léků   MeSH
• grampozitivní koky účinky léků   MeSH
• listy rostlin chemie   MeSH
• mikrobiální testy citlivosti MeSH
• Pseudomonas aeruginosa účinky léků   MeSH
• rostlinné extrakty farmakologie   MeSH
• Staphylococcus epidermidis účinky léků   MeSH
• stilbeny farmakologie   MeSH
• Vitis chemie   MeSH
• Publikační typ
• časopisecké články MeSH