Byl proveden odhad výskytu infekce Clostridium difficile (CDI) v České republice na základě dat pocházejících z evropských epidemiologických studií (pracovní skupiny v rámci ESCMID, ECDC), z evropských a národních bodových prevalenčních studií a z národní databáze infekčních nemocí (pasivní hlášení). Počet případů CDI na národní úrovni lze odhadnout v rozmezí 5 000 až 10 000 ročně. Počet zemřelých na CDI lze odhadnout na 250 až 350 osob ročně (podle publikovaných údajů atributivní mortality udávané mezi 6-7%). Mikrobiologická surveillance včetně ribotypizace 460 kmenů Clostridium difficile odeslaných z 23 nemocnic v roce 2015 ukázala významný podíl kmenů vysoce virulentního PCR ribotypu 176 (24,3%). Aby mohla být zlepšena prevence a kontrola této ohrožující nemoci, je ve vztahu k těmto epidemiologickým datům zavedení evropské surveillance CDI v České republice vysokou prioritou. V textu je představen protokol evropské surveillance CDI a koordinace národního systému surveillance zajišťovaného Národním referenčním centrem pro infekce spojené se zdravotní péčí (Státní zdravotní ústav).

The estimation of the prevalence of Clostridium difficile infections (CDI) in the Czech Republic (CR) was done using data from several European epidemiological studies (ESCMID study groups, ECDC), European and national point prevalence surveys, and the national infectious diseases database (passive reporting). The numbers of CDI cases in the CR are expected to range from 5000 to 10 000 per year. The numbers of deaths associated with CDI are estimated to be from 250 to 350 per year (according to the published data on attributable mortality, ranging from 6 to 7%). Microbiology surveillance including PCR ribotyping of 460 Clostridium difficile strains referred from 23 Czech hospitals in 2015 assigned an important proportion of strains to highly virulent PCR ribotype 176 (24.3%). In the context of these background epidemiological data, the implementation of the European CDI surveillance is a high priority in the CR, a crucial step to achieve more effective prevention and control of this possibly life-threatening disease in Czech hospitals. The European CDI surveillance protocol and coordination of the national CDI surveillance system by the National Reference Centre for Healthcare-Associated Infections (National Institute of Public Health) are presented.

• MeSH
• Clostridioides difficile * izolace a purifikace   patogenita   MeSH
• epidemiologické monitorování MeSH
• infekce spojené se zdravotní péčí epidemiologie   prevence a kontrola   MeSH
• klostridiové infekce * epidemiologie   prevence a kontrola   MeSH
• lidé MeSH
• mezinárodní spolupráce MeSH
• organizace a řízení MeSH
• surveillance populace * metody   MeSH
• techniky typizace bakterií MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• tabulky MeSH
• Geografické názvy
• Česká republika MeSH
• Evropa MeSH

BACKGROUND: Clostridium difficile infection (CDI) is becoming a serious problem predominantly in geriatric patients, who are a significant risk group. The goal of this study was to evaluate the risk factors for mortality in CDI patients and to construct a binary logistic regression model that describes the probability of mortality in geriatric patients suffering from CDI. METHODS: In this retrospective study, we evaluated a group of 235 patients over 65 years of age with confirmed diagnoses of CDI, hospitalized at the Department of Internal Medicine, Geriatrics and General Practice, Brno, from January 2008 to December 2013. The examined group comprised 148 women (63 %) and 87 men (37 %). For the diagnosis of CDI, confirmation of A and B toxins in the patients' stool or an autopsy confirmation was crucial. RESULTS: The impact of antibiotic therapy on the increased incidence of CDI was clearly confirmed in our study group when examining patients' histories. Other risk factors included cerebrovascular disease, dementia, the presence of pressure ulcers, and immobility. Our new model consisted of a combination of the following parameters: the number of antibiotics used (from patients' history), nutritional status (Mini Nutritional Assessment short-form test), presence of pressure ulcers, and occurrence of fever. CONCLUSION: Our logistic regression model may predict mortality in geriatric patients suffering from CDI. This could help improve the therapeutic process.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• Clostridioides difficile * MeSH
• geriatrické hodnocení statistika a číselné údaje   MeSH
• incidence MeSH
• lidé MeSH
• míra přežití MeSH
• prognóza MeSH
• pseudomembranózní enterokolitida mikrobiologie   mortalita   terapie   MeSH
• rizikové faktory MeSH
• rozložení podle pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• věkové rozložení MeSH
• zlepšení kvality MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

The main aim of this study was to investigate the occurrence and ribotypes of Clostridium perfringens in broiler flocks reared in 2 European countries that apply European Union Regulation 1831/2003. A total of 1,532 cecum contents were collected between June 2005 and November 2006 from birds belonging to 51 intensively reared flocks produced in the Czech Republic and 41 intensive production, organic, and free-range flocks reared in Italy. Clostridium perfringens was detected in 64.7 and 82.9% of the Czech Republic and Italian flocks, respectively, at mean loads ranging between 3.65 and 4.77 log10 cfu per gram of cecum content. More than 1 ribotype was identified among isolates belonging to the same flock in 57.1 and 76.5% of the Czech Republic and Italian flocks, respectively. Moreover, common ribotypes were identified between strains belonging to 2 up to 8 different flocks. In particular, 4 ribotypes were shared between strains isolated in the 2 European countries. The results of this study report on C. perfringens occurrence and mean populations in broilers reared on diets devoid of antibiotic growth promoters. Moreover, these findings show for the first time the presence of common ribotyping profiles among isolates collected from birds reared more than 1,000 km apart.

• MeSH
• Clostridium perfringens klasifikace   izolace a purifikace   MeSH
• fylogeneze MeSH
• gastrointestinální obsah mikrobiologie   MeSH
• klostridiové infekce epidemiologie   mikrobiologie   veterinární   MeSH
• kur domácí * MeSH
• nemoci drůbeže epidemiologie   mikrobiologie   MeSH
• ribotypizace * MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Itálie MeSH

BACKGROUND: Ciprofloxacin prophylaxis used to be a standard precaution during autologous stem cell transplantation. Its benefit, with a high prevalence of fluoroqinolone resistance in the population, has recently been under scrutiny. OBJECTIVE: To evaluate the impact of cessation of ciprofloxacin prophylaxis during stem cell transplantation for multiple myeloma. PATIENTS AND METHODS: Data from 104 patients with multiple myeloma transplanted during the period from January 2013 to April 2015 were retrospectively reviewed. 67 received standard ciprofloxacin prophylaxis (group A) and 37 received no antibacterial prophylaxis (group B). RESULTS: Febrile episodes during neutropenia, bloodstream infection (BSI) and mortality in these two cohorts were evaluated. Gram negative BSI was assessed for the colonization of quinolone-resistant gram-negative pathogens. Secondary Clostridium difficile enterocolitis presence was determined in both cohorts. There were 42 (63%), 7 (10%), and 0 febrile episodes, BSI and gram-negative BSI respectively in group A, and 34 (92%), 12 (32%), and 4 (11%) respectively in group B. The differences in the number of febrile episodes (P=0.0011) and deaths (P=0.0427) were statistically significance. Mortality was 0 and 3 (8%) in group A and group B, respectively. There was no significant difference in colonization with quinolone-resistant gram negative pathogens (25 (37%) versus 11 (30%)) between groups. The occurrence of Clostridium difficile colitis was the same in both groups. CONCLUSION: We resumed ciprofloxacin prophylaxis for the following reasons. There was a significant reduction in febrile episodes, and consequently a sparing effect of antibiotics used for treatment of this condition. No difference in Clostridium difficile colitis occurred and the mortality rate of 8% in group B was unacceptably high.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• antibiotická profylaxe * MeSH
• autologní transplantace MeSH
• bakteriální infekce prevence a kontrola   MeSH
• bakteriální léková rezistence MeSH
• ciprofloxacin terapeutické užití   MeSH
• dospělí MeSH
• gramnegativní bakteriální infekce epidemiologie   MeSH
• gramnegativní bakterie fyziologie   MeSH
• infekce vyvolané Escherichia coli epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mnohočetný myelom terapie   MeSH
• přenašečství epidemiologie   MeSH
• pseudomembranózní enterokolitida epidemiologie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• stafylokokové infekce epidemiologie   MeSH
• transplantace kmenových buněk metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH