Cíl: Úraz elektrickým proudem z vysokého napětí je jedním z nejzávažnějších úrazů, se kterými se můžeme v moderní medicíně setkat. Často bývá spojený s více následky a vysokou náchylností k infekčním komplikacím. Tito pacienti jsou přijímáni do specializovaných popáleninových center a vyžadují rozsáhlou multidisciplinární spolupráci. V této studii se snažíme odhalit prevalenci, typy a charakteristiky mikrobiálních infekcí, které se vyvíjejí po vysokonapěťovém elektrotraumatu, a identifikovat rizikové faktory, které mohou přispívat k náchylnosti pacientů k infekcím. Materiál a metodika: Pro účely této publikace byla zpracována data všech 37 pacientů hospitalizovaných na jednotce intenzivní péče Kliniky popálenin a plastické chirurgie FN Brno s diagnózou úraz elektrickým proudem vysokým napětím v letech 2006–2016. Otisky a stěry z exfoliovaných oblastí byly opakovaně odebírány k mikrobiální analýze spolu s tracheobronchiálním aspirátem, sputem nebo bronchoalveolární laváží, močí a periferní krví. Získaná data byla zpětně analyzována. Výsledky: Mezi 37 pacienty byl medián věku 31,9 s průměrnou dobou hospitalizace 44,3 dne a úmrtností 8,1 %. Na umělé plicní ventilaci bylo závislých celkem 28 osob. Výskyt infekčních komplikací se v průběhu hospitalizace liší podle místa kultivace odběru a doby strávené v nemocnici. U 97,3 % pacientů se vyvinula infekce alespoň v jednom tělesném kompartmentu. V 88,8 % případů byla multipatogenní a ve 41,6 % se rozvinul septický stav. V naší studijní kohortě dominovaly G+ nad G-kmeny. Nejčastějšími zástupci z G+ spektra byli koaguláza negativní stafylokoky (97 %), Staphylococcus aureus (57 %), Enterococcus fecalis et faecium (51 %). V G-spektru bylo pořadí následující: Klebsiella pneumoniae (46 %), Pseudomonas aeruginosa (41 %), Escherichia coli (35 %) a Acinetobacter baumannii (18,9 %). Nejčastější pozorovanou infekcí byla infekce popálenin (BWI), následovaná infekcemi krevního řečiště (BSI), infekcemi dolních cest dýchacích (LRTI) a infekcemi močových cest (UTI), primárně způsobené G+ patogeny. Je pozoruhodné, že delší doba hospitalizace byla spojena s rostoucí prevalencí G-patogenů, zejména K. pneumoniae, P. aeruginosa a A. baumannii, které vykazovaly vysoký stupeň antimikrobiální rezistence. Závěr: Tato studie poskytuje podrobný pohled na výskyt a následky úrazů elektrickým proudem s vysokým napětím na Moravě v průběhu desetiletí. Faktory významně ovlivňující přežití a závažnost výsledků zahrnovaly celkovou plochu popálenin, popáleniny v celé tloušťce, inhalační poranění a potřebu tracheostomie. Studie je však limitována relativně malou velikostí vzorku, dlouhou dobou sběru dat s potenciálními změnami v klinické praxi a jednocentrovým designem, což může ovlivnit zobecnění nálezů. K ověření těchto výsledků a zpřesnění strategií prevence infekcí u této populace pacientů jsou zapotřebí další multicentrické studie.
Background and Aim: High voltage electrotrauma is one of the most serious injuries we can encounter in modern medicine, often associated with multiple disabilities and high susceptibility to infectious complications. These patients are admitted to specialized burn centers and require extensive multidisciplinary collaboration. In this study, we aim to uncover the prevalence, types and characteristics of microbial infections that develop in the aftermath of high voltage electrotrauma and to identify risk factors that may contribute to patients’ susceptibility to infections. Material and Methods: For the purposes of this publication, data of all 37 patients hospitalized in the intensive care unit of the Department of Burns and Plastic Surgery of the University Hospital in Brno with a diagnosis of high-voltage electrical injury between 2006–2016 were processed. Imprints and swaps from exfoliated areas were repeatedly taken for microbial analysis, together with tracheobronchial aspirate fluid, sputum, or bronchoalveolar lavage, urine and peripheral blood. The obtained data were analysed retrospectively. Results: Among the 37 patients, the median age was 31.9, with an average hospital stay of 44.3 days and a mortality rate of 8.1%. A total of 28 individuals were dependent on artificial lung ventilation. The incidence of infectious complications varies during the hospitalization period according to the location of sampling cultivation and time spent at the hospital. 97.3% of patients developed infection in at least one body compartment. In 88.8% of cases, it was multipathogenic and in 41.6% a septic condition developed. In our study cohort, G+ dominated over Gstrains. Most common representatives from G+ spectrum were Coagulase negative Staphylococci (97%), Staphylococcus aureus (57%), Enterococcus fecalis et faecium (51%). In Gspectrum, the order was as followed: Klebsiella pneumoniae (46%), Pseudomonas aeruginosa (41%), Escherichia coli (35%) and Acinetobacter baumannii (18.9%). The most common infection observed was burn wound infection (BWI), followed by bloodstream infections (BSI), lower respiratory tract infections (LRTI), and urinary tract infections (UTI), primarily caused by G+ pathogens. Notably, an increased hospital stay duration was associated with a rising prevalence of Gpathogens, particularly K. pneumoniae P. aeruginosa and A. baumannii which exhibited a high degree of antimicrobial resistance. Conclusion: This study provides a detailed insight into the occurrence and consequences of high-voltage electrical injuries in Moravia over a decade. Factors significantly impacting survival and severity of outcomes included total burn surface area, full-thickness burns, inhalation injury, and the need for tracheostomy. However, the study is limited by its relatively small sample size, long data collection period with potential changes in clinical practice, and single-center design, which may affect the generalizability of the findings. Further multicentric studies are needed to validate these results and refine infection prevention strategies in this patient population.
BACKGROUND: Since the incidence of vancomycin-resistant enterococci (VRE) is increasing and treatment options remain limited, we aimed to investigate the epidemiology of vancomycin- and tigecycline-resistant enterococci in a university hospital using whole genome sequencing (WGS). METHODS: Between April and December 2021, 102 VRE isolates were collected from a single tertiary care hospital in the Czech Republic. Forty selected isolates underwent antimicrobial susceptibility testing and WGS (Illumina short reads and long reads with MinION in selected isolates). RESULTS: All Enterococcus faecium isolates were resistant to ampicillin, carrying the PBP5_Met485Ala, PBP5_Glu629Val, and fluoroquinolones carrying the GyrA_Ser83Ile and ParC_Ser80Ile substitutions. The vanA operon was found on pELF2-like plasmids and plasmids carrying rep17 and/or rep18b genes. The novel Tn1546 structural variants were identified in vanA-carrying isolates. The vanB operon was located on the chromosome within a Tn1549 structural variant. Linezolid resistance was detected in one isolate carrying the 23S rDNA_G2576T substitution. Twenty-two isolates were resistant to tigecycline (tet(L), tet(M) and rpsJ_del 155-166 or RpsJ_Lys57Arg). Discrepancies between phenotypic and genotypic resistance profiles were observed for daptomycin (RpoB_Ser491Phe), trimethoprim/sulfamethoxazole (dfrG gene), nitrofurantoin (NmrA_Gln48Lys substitution without the EF0404 and EF0648 genes) and tetracycline (truncated TetM). The two multilocus sequence typing (MLST) schemes identified different numbers of STs: 5 STs, with ST117 as the predominant one (n = 32, 80%), versus 10 STs, with ST138 (27.5%), ST136 (25%), and ST1067 (20%) being the most frequent, respectively. The whole genome MLST revealed clonal clustering (0-7 allele differences) among isolates of the same ST. When comparing ST117 isolates from our study with 2,204 ST117 isolates from 15 countries, only one Czech isolate clustered closely with strains from Germany and the Netherlands, differing by just 16 alleles. CONCLUSIONS: The spread of E. faecium isolates ST117 resistant to vancomycin and tigecycline was identified. The discrepancies between resistance genotypes and phenotypes highlight the importance of combining molecular and phenotypic surveillance in antimicrobial resistance monitoring.
- MeSH
- Anti-Bacterial Agents * pharmacology MeSH
- Bacterial Proteins genetics MeSH
- Enterococcus faecium * genetics drug effects isolation & purification classification MeSH
- Vancomycin-Resistant Enterococci * genetics drug effects isolation & purification MeSH
- Genome, Bacterial MeSH
- Gram-Positive Bacterial Infections * microbiology epidemiology MeSH
- Humans MeSH
- Microbial Sensitivity Tests MeSH
- Drug Resistance, Multiple, Bacterial genetics MeSH
- Multilocus Sequence Typing MeSH
- Vancomycin Resistance genetics MeSH
- Whole Genome Sequencing MeSH
- Tigecycline * pharmacology MeSH
- Vancomycin * pharmacology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND AND OBJECTIVE: Microbial selenium (Se) supplementation is an essential area of biotechnological research due to differences in the bioavailability and toxicity of different forms of selenium. To date, research has focused mainly on the use of selenized yeast. However, in recent years, scientific interest has also increased in other microorganisms, such as lactic acid bacteria (LAB), which have several unique properties that can affect the quality and bioavailability of selenium. LAB, unlike yeast, can also act as probiotics, which may bring additional health benefits related to improving the intestinal microbiota and supporting the health of the gastrointestinal tract. METHODS: This study investigates the in vitro bioaccessibility and bioavailability of Se from two lactic acid bacterial strains, Streptococcus thermophilus CCDM 144 and Enterococcus faecium CCDM 922 A. We evaluated Se accumulation, speciation, and stability during simulated gastrointestinal digestion and Se permeation through a Caco-2 cell monolayer model. RESULTS: Both strains accumulated Se, metabolizing it predominantly into selenium nanoparticles (SeNPs, 64-77 % of total Se), with only a minor fraction (<5 % of total Se) of organic Se species. Experiments revealed that while organic Se species had high bioavailability (up to 90 %), their bioaccessibility during digestion was very low (<0.1 % of total Se). In contrast, SeNPs showed high bioaccessibility (∼90 %) and moderate transport efficiency through the intestinal model (16-19 % after 4 hours). CONCLUSION: These results highlight the potential of SeNPs produced by lactic acid bacteria as a bioaccessible form of Se for dietary supplementation. Further research is required to explore the behavior of SeNPs within the human body to fully understand how they can be used safely and effectively in nutrition or other applications.
- MeSH
- Biological Availability * MeSH
- Models, Biological MeSH
- Caco-2 Cells MeSH
- Intestinal Barrier Function MeSH
- Lactobacillales metabolism MeSH
- Humans MeSH
- Permeability MeSH
- Selenium * metabolism MeSH
- Streptococcus thermophilus metabolism MeSH
- Digestion MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Antimicrobial lock therapy is recommended for preventing and treating catheter-related bloodstream infections, but different solutions have uncertain efficacy. METHODS: Two locks, 1.35% taurolidine and 4% ethylenediaminetetraacetic acid (EDTA), were tested on Staphylococcus epidermidis, Staphylococcus aureus, methicillin-resistant S. aureus, Pseudomonas aeruginosa, multidrug-resistant P. aeruginosa, vancomycin-resistant Enterococcus faecium, Klebsiella oxytoca (carbapenemase producing), K. pneumoniae (extended-spectrum β-lactamase producing), Candida albicans, and Candida glabrata. Broviac catheter segments were incubated with these organisms and then exposed to various lock solutions. Colony-forming units (CFUs) were counted after 2, 4, and 24 h of incubation. RESULTS: Taurolidine showed a significant decrease in CFUs after 2 h in S. aureus, S. epidermidis, methicillin-resistant S. aureus, vancomycin-resistant E. faecium, P. aeruginosa (both sensitive and multidrug-resistant strains), K. oxytoca, C. albicans, and C. glabrata. After 4 h, significant reductions were noted in S. aureus, S. epidermidis, methicillin-resistant S. aureus, P. aeruginosa, multidrug-resistant P. aeruginosa, K. pneumoniae, K. oxytoca, and C. albicans. Taurolidine was also effective after 24 h, especially against methicillin-resistant S. aureus and multidrug-resistant P. aeruginosa. Four percent EDTA acid showed a significant reduction in CFUs after 2 h in S. aureus, vancomycin-resistant E. faecium, P. aeruginosa, K. oxytoca, C. albicans, and C. glabrata. After 4 h, reductions occurred in P. aeruginosa, multidrug-resistant P. aeruginosa, K. oxytoca, and C. albicans and after 24 h in methicillin-resistant S. aureus, P. aeruginosa, and K. oxytoca. CONCLUSION: Taurolidine is more effective than 4% EDTA acid in eradicating Gram-positive and Gram-negative microorganisms and fungi.
- MeSH
- Anti-Infective Agents * pharmacology MeSH
- Candida albicans drug effects MeSH
- Edetic Acid * pharmacology MeSH
- Catheter-Related Infections * prevention & control microbiology MeSH
- Humans MeSH
- Methicillin-Resistant Staphylococcus aureus drug effects MeSH
- Microbial Sensitivity Tests MeSH
- Colony Count, Microbial MeSH
- Pseudomonas aeruginosa drug effects MeSH
- Staphylococcus aureus drug effects MeSH
- Staphylococcus epidermidis drug effects MeSH
- Taurine * analogs & derivatives pharmacology MeSH
- Thiadiazines * pharmacology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Comparative Study MeSH
Enterococci are a group of microorganisms that have a controversial position from some scientific points of view. The species of the greatest clinical importance are E. faecalis and E. faecium, which are common agents of nosocomial infections. However, enterococci also have important applications in the dairy industry, as they are used as non-starter lactic acid bacteria (NSLAB) in a variety of cheeses, especially artisanal cheeses. The aim of this study was to determine the presence of representatives from the Enterococcus genus using PCR and MALDI-TOF MS methods on samples of raw milk, processing environment swabs, and cheese from four different artisanal dairy plants in Slovakia. Among the 136 isolates of enterococci, 9 species of genus Enterococci (E. faecalis, E. faecium, E. durans, E. devriesi, E. hirae, E. italicus, E. casseliflavus, E. malodoratus, and E. gallinarum) were identified and were tested for their antimicrobial resistance (AMR) to 8 antibiotics (amoxicillin, penicillin, ampicillin, erythromycin, levofloxacin, vancomycin, rifampicin, and tetracycline); most of them were resistant to rifampicin (35.3%), ampicillin (22.8%), and tetracycline (19.9%). A PCR analysis of vanA (4.41%) and tetM (14.71%) revealed that antimicrobial resistance genes were present in not only phenotypic resistant isolates of enterococci but also susceptible isolates. The investigation of antimicrobial resistance in enterococci during the cheesemaking process can be a source of valuable information for public health in the concept of "One Health".
- Publication type
- Journal Article MeSH
In the present study, the evolution of the physicochemical and microbiological characteristics of lactic acid bacteria (LAB) in traditional Kırklareli white brined cheese collected from 14 different cheese manufacturing facilities were investigated on different days of the 90-day ripening period. The obtained LAB within the species Lactococcus (Lc.) lactis, Latilactobacillus (Lt.) curvatus, Lactobacillus (Lb.) casei and Lb. plantarum, Enterococcus (E.) durans, E. faecium, E. faecalis, Streptococcus macedonicus, and Weissella paramesenteroides were characterized in terms of their influence on technological properties and their potential as starter cultures for traditional white brined cheese production. The results of the microbiological and physicochemical investigations showed that a few selected isolates of Lc. lactis, Lb. casei, and Lb. plantarum had certain functions as starter germs. Moderate acidification capacity, antibacterial activity and proteolytic activity, which are characteristic of their use as starter lactic acid bacteria, were found. Importantly, antibiotic resistance among selected Lc. lactis, Lb. casei, and Lb. plantarum isolates was extremely low, whereas some of these isolates demonstrated antibacterial activity against major foodborne pathogenic bacteria. Based on the results obtained in this study, selected Lc. and Lb. isolates can also be considered as starter culture in traditional cheese production.
The objective of this study was to isolate, identify, and assess the safety and functionality in vitro of putative probiotic bacterial strains. Isolation procedures were based on standard methods using elective and selective media. The isolates were identified by comparative 16S rRNA sequencing analysis while their safety was determined according to the safety tests recommended by the FAO/WHO such as antibiotic resistance, hemolysin, and biogenic amine production. Most of the isolates did not pass the in vitro safety tests; therefore, only Lactiplantibacillus plantarum (from ant intestine and cheese), Lacticaseibacillus paracasei (from goat milk and kimchi), Enterococcus faecium (from chili doenjang and vegetables with kimchi ingredients), Limosilactobacillus fermentum (from saliva), and Companilactobacillus alimentarius (from kimchi) were identified and selected for further studies. The isolates were further differentiated by rep-PCR and identified to the strain level by genotypic (16S rRNA) and phenotypic (Gen III) approaches. Subsequently, the strain tolerance to acid and bile was evaluated resulting in good viability after simulated gastrointestinal tract passage. Adhesion to mucin in vitro and the presence of mub, mapA, and ef-tu genes confirmed the adhesive potential of the strains and the results of features associated with adhesion such as hydrophobicity and zeta potential extended the insights. This study reflects the importance of fermented and non-fermented food products as a promising source of lactic acid bacteria with potential probiotic properties. Additionally, it aims to highlight the challenges associated with the selection of safe strains, which often fail in the in vitro tests, thus hindering the possibilities of "uncovering" novel and safe probiotic strains.
- MeSH
- Bacterial Adhesion MeSH
- DNA, Bacterial genetics MeSH
- Phylogeny MeSH
- Lactobacillales genetics isolation & purification classification metabolism MeSH
- Food Microbiology * MeSH
- Probiotics * isolation & purification MeSH
- RNA, Ribosomal, 16S * genetics MeSH
- Sequence Analysis, DNA MeSH
- Animals MeSH
- Check Tag
- Animals MeSH
- Publication type
- Journal Article MeSH
Antimicrobial resistance remains a global issue, hindering the control of bacterial infections. This study examined the antimicrobial properties of 2,3-N,N-diphenyl quinoxaline derivatives against Gram-positive, Gram-negative, and Mycobacterium species. Two quinoxaline derivatives (compounds 25 and 31) exhibited significant activity against most strains of Staphylococcus aureus, Enterococcus faecium, and Enterococcus faecalis tested, with MIC values ranging from 0.25 to 1 mg/L. These compounds also showed effective antibacterial activity against methicillin-resistant S. aureus (MRSA) and vancomycin-resistant E. faecium/E. faecalis (VRE) strains. They demonstrated comparable or superior activity to four current antibiotics (vancomycin, teicoplanin, daptomycin, and linezolid) against a wide range of clinically relevant isolates. Additionally, they were more effective in preventing S. aureus and E. faecalis biofilm formation compared to several other antibiotics. In summary, these two quinoxaline derivatives have potential as new antibacterial agents.
- MeSH
- Anti-Bacterial Agents * pharmacology MeSH
- Biofilms * drug effects growth & development MeSH
- Quinoxalines * pharmacology MeSH
- Enterococcus faecalis * drug effects MeSH
- Humans MeSH
- Methicillin-Resistant Staphylococcus aureus * drug effects MeSH
- Microbial Sensitivity Tests * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Our study describes the prevalence and spectrum of enterococci isolated from one-day-old chickens in the Czech Republic, their level of antimicrobial resistance, and the occurrence of multiresistance. Over a 24-month period from 1 August 2021 to 31 July 2023, a total of 464 mixed samples of one-day-old chicken organs were examined during routine inspections at 12 randomly selected poultry farms in the Czech Republic. The samples were processed via cultivation methods and suspected strains were confirmed using the MALDI-TOF Mass Spectrometry method. Antimicrobial susceptibility was determined using the MIC method for eight antimicrobials. A total of 128 isolates (prevalence of 27.6%) representing 4 species of enterococci were isolated, including Enterococcus faecalis, Enterococcus faecium, Enterococcus gallinarum, and Enterococcus hirae, with prevalence rates of 23.3%, 1.5%, 2.2%, and 0.6%, respectively. Susceptibility tests showed a high percentage of susceptible strains among E. faecalis, E. faecium, and E. gallinarum for penicillin-based antibiotics, sulfamethoxazole with trimethoprim, and florfenicol (80-100% susceptible strains). E. hirae was an exception, displaying complete resistance to enrofloxacin (0% susceptible strains) and a high degree of resistance to other tested antimicrobials (33.3% susceptible strains). Among the isolated strains, a total of 16 isolates (12.5%) showed resistance to 3 or more antimicrobials. Complete resistance to all eight antimicrobials simultaneously was observed in four isolates (3.1%). This research shows the possible sources of pathogenic enterococci and their virulence and resistance genes. The findings hold relevance for both veterinary and human medicine, contributing to a better understanding of enterococcal circulation in the human ecosystem and food chain, as well as the development of their resistance and multiresistance.
- Publication type
- Journal Article MeSH
Závěrečná zpráva o řešení grantu Agentury pro zdravotnický výzkum MZ ČR
nestr.
Infekce spojené se zdravotní péčí (ISZP) způsobené multirezistentními bakteriemi jsou častou komplikací provázející hospitalizaci. Jejich následkem dochází ke zhoršení kvality života pacientů, prodloužení doby hospitalizace a zvýšení nákladů na léčbu. Mezi nejzásadnější nemocniční patogeny patří Klebsiella pneumoniae produkující širokospektré betalaktamázy (ESBL KLPN) a karbapenemázy, methicilin-rezistentní Staphylococcus aureus (MRSA) a vankomycin-rezistentní Enterococcus faecium (VRE). Poznání způsobů jejich šíření v nemocničních zařízeních je klíčové pro zavedení účinných protiepidemických opatření. Molekulárně-biologické typizační metody slouží pro odlišení bakteriálních kmenů v rámci jednoho druhu a tím tvoří základní pilíř pro epidemiologické studie. Metodou s nejvyšší diskriminační schopností je v současnosti celogenomové sekvenování, které ve spojení s vhodnými bioinformatickými nástroji poskytuje informace nejen o příbuznosti bakteriálních kmenů izolovaných v nemocnicích, ale také genetické výbavě každého kmene a jeho patogenním potenciálu.; Healthcare associated infections (HAI) caused by multidrug-resistant bacteria are a frequent complication of hospitalization. It results in worsening patients' quality of life, prolonged hospitalization and a significant increase in treatment costs. The most important hospital pathogens include enterobacteria with the production of broad-spectrum betalactamases and carbapenemases, methicil-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium. Knowing the ways in which these dangerous pathogens are spread within hospital facilities is key to implementing effective anti-epidemic measures. Molecular typing methods are able to distinguish bacterial strains within one species and thus form the basis for epidemiological studies. The most discriminative method is currently whole-gene sequencing. In conjunction with appropriate bioinformatics tools, it provides information not only about the relatedness of bacterial strains isolated in hospitals, but also about the genetic content of each strain and its pathogenic potential.
- Keywords
- epidemiologie, epidemiology, Whole-genome sequencing, MDR bakterie, detekce outbreaků, MDR bacteria, outbreak detection, celogenomové sekvenopvání,
- NML Publication type
- závěrečné zprávy o řešení grantu AZV MZ ČR
