outbreak detection
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Bakterie komplexu Burkholderia cepacia vyvolávají u pacientů s cystickou fibrózou (CF) závažné plicní infekce. Riziko epidemického šíření infekce přimělo centra CF zavést přísná izolační opatření. Navíc je nutné správně a včas mikrobiálního původce identifikovat, k čemuž slouží postupy molekulární mikrobiologie. V posledním desetiletí nebyl v ČR diagnostikován žádný nový případ infekce způsobené epidemickým kmenem ST-32 druhu Burkholderia cenocepacia, který stál za velkou epidemií 90. let 20. století.
Bacteria from the Burkholderia cepacia complex cause severe lung infections in people with cystic fibrosis (CF). The risk of epidemic spread of the infection led the CF centres to implement strict isolation precautions. Furthermore, it was imperative to identify the microbial agent correctly and timely which was made possible thanks to the methods of molecular microbiology. No new Burkholderia cenocepacia infections, caused by the ST-32 strain which had been responsible for a large outbreak in 1990s, were diagnosed in the Czech Republic in the last ten years.
BACKGROUND: Once the outbreak with Burkholderia cenocepacia ST32 was identified in the Prague cystic fibrosis (CF) centre, molecular tools were implemented into diagnostic routine in order to complement infection control measures with as accurate as possible microbiological service. In addition, genotyping techniques were applied as part of an infection surveillance program to assign species and strain status in samples positive for Burkholderia cepacia complex (Bcc). We sought to evaluate a usefulness of Bcc-specific PCR in infection control and to map evolution of the outbreak. METHODS: Since 2001, 6109 respiratory samples from 299 CF patients were examined not only by conventional culture, but also by PCR, detecting Bcc directly in sputum. RESULTS: Diagnosis of Bcc infection was established by culture in 54 patients already prior to 2001. As 39 more patients were diagnosed by culture and/or PCR during 2001-2010, this represented annual prevalence of 18.5%-28.9%. Twelve of 39 patients were culture negative at the time of their first PCR positivity. Although 2/3 of them became subsequently culture positive, the time delay in diagnostics of the infection by culture ranged from 1 to 22 months. New cases of Bcc infection were detected every year, however a dramatic drop was observed for the epidemic strain ST32. CONCLUSION: A likely factor contributing to the end of ST32 epidemic was segregation of Bcc infected patients that included also patients with no culture, but PCR positivity. The diagnostic PCR led to timely identification of cases with 'culture-invisible' infection.
- MeSH
- Burkholderia cepacia komplex * genetika izolace a purifikace MeSH
- cystická fibróza * epidemiologie mikrobiologie MeSH
- dospělí MeSH
- epidemický výskyt choroby prevence a kontrola statistika a číselné údaje MeSH
- infekce bakteriemi rodu Burkholderia * diagnóza epidemiologie prevence a kontrola MeSH
- infekce dýchací soustavy epidemiologie mikrobiologie prevence a kontrola MeSH
- kontrola infekce metody MeSH
- lidé MeSH
- polymerázová řetězová reakce * metody statistika a číselné údaje MeSH
- sputum mikrobiologie MeSH
- techniky typizace bakterií MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: Group A beta-haemolytic streptococci (GAS), which are responsible for most cases of acute bacterial tonsillopharyngitis, are transmitted from person to person and may rarely cause foodborne outbreaks. This study aims to report the epidemic caused by GAS in our hospital and to draw attention to the explosive outbreaks of the bacteria. METHODS: Acute tonsillopharyngitis was seen in 201 of 450 hospital employees who ate in the hospital cafeteria on 4-5 June 2015. RESULTS: GAS was detected in 106 (68%) of 157 cases and in 40 (63.5%) of 62 throat culture samples. The attack rate was 44.7%. The most suspected source of the outbreak was a food handler who had been showing signs of streptococcal tonsillopharyngitis for six days, and perhaps the food prepared by these staff. CONCLUSION: It should not be forgotten that GAS can cause explosive outbreaks by infecting food through hand lesions or mouth secretions of food service personnel.
West Nile virus lineage 2 (WNV-2) was detected in the brain of 17 goshawks (Accipiter gentilis) that succumbed to neuroinvasive disease in the Czech Republic during 2018: twelve birds were captive and five wild. Furthermore, two wild sparrowhawks (Accipiter nisus) and three other captive birds of prey (golden eagle Aquila chrysaetos, hybrid saker falcon Falco cherrug × F. rusticolus and Harris's hawk Parabuteo unicinctus) also died due to WNV encephalitis. The 2018 outbreak in Czech raptors clearly reflects a new epidemiological situation and indicates an increasing risk of both raptor and human infection with WNV-2 in the country.
- MeSH
- epidemický výskyt choroby * MeSH
- některé rody čeledi Accipitridae mikrobiologie MeSH
- nemoci ptáků epidemiologie virologie MeSH
- veřejné zdravotnictví MeSH
- virus západního Nilu genetika MeSH
- západonilská horečka epidemiologie veterinární MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVES: To fill the existing research gap related to long-term costs of postacute care in methanol poisoning survivors, healthcare cost for 6 years after the outbreak has been modelled and estimated. DESIGN: In a prospective longitudinal cohort study, data collected from 55 survivors of the Czech methanol mass poisoning outbreak in 2012 were collected in four rounds (5 months, then 2, 4 and 6 years after the discharge) in the General University Hospital in Prague according to the same predefined study protocol. The collected data were used to inform the cost model. SETTING AND PARTICIPANTS: All 83 patients discharged from a hospital poisoning treatment after the 2012 methanol outbreak were informed about the study and invited to participate. Fifty-five patients (66%) gave their written informed consent and were followed until their death or the last follow-up 6 years later. The costs were modelled from the Czech healthcare service (general health insurance) perspective. MAIN OUTCOME MEASURES: Long-term national budget impact of the methanol poisoning outbreak, frequencies of sequelae and their average costs. RESULTS: The postacute cost analysis concentrated on visual and neurological sequelae that were shown to be dominant. Collected data were used to create process maps portraying gradual changes in long-term sequelae over time. Individual process maps were created for the central nervous system, peripheral nervous system, sequelae detected during eye examinations and sequelae concerning the visual evoked potentials. Based on the process maps the costs of the postacute outpatient care were estimated. CONCLUSIONS: In 2013-2019 the highest costs per patient related to postacute care were found in the first year; the average costs decreased afterwards, and remained almost constant for the rest of the studied period of time. These costs per patient ranged from CZK4142 in 2013 to CZK1845 in 2018, when they raised to CZK2519 in 2019 again.
- MeSH
- epidemický výskyt choroby MeSH
- lidé MeSH
- longitudinální studie MeSH
- methanol * MeSH
- náklady na zdravotní péči MeSH
- otrava * epidemiologie MeSH
- přežívající MeSH
- prospektivní studie MeSH
- subakutní péče MeSH
- zrakové evokované potenciály MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
An increased number of cases of salmonellosis caused by the rare serotype Mikawasima was noted in the years 2012 and 2013 in the Czech Republic. A potential on-going outbreak caused by this serotype in European countries has also been reported. Altogether 14 human and 1 environmental isolates from the year 2012 and 11 human isolates from the year 2013 from different locations of the Czech Republic were sent to our laboratory for typing. Macrorestriction analysis together with antimicrobial susceptibility testing and PCR for ESBL and plasmid-mediated quinolone resistance detection were performed to compare our isolates. Twenty-one isolates created two very similar clusters and 5 isolates had different profiles. Twenty-five isolates were fully susceptible to all agents used. One isolate showed resistance to 12 microbial agents and possessed blaTEM, blaSHV, blaOXA, blaCTX-M and qnrB genes.
- MeSH
- antibakteriální látky farmakologie MeSH
- beta-laktamová rezistence MeSH
- epidemický výskyt choroby * MeSH
- lidé MeSH
- Salmonella klasifikace účinky léků genetika izolace a purifikace MeSH
- salmonelóza epidemiologie mikrobiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
20 stran : grafy
- MeSH
- antigeny virové MeSH
- Betacoronavirus MeSH
- COVID-19 diagnóza MeSH
- epidemický výskyt choroby MeSH
- imunoanalýza metody MeSH
- klinické laboratorní techniky metody MeSH
- koronavirové infekce diagnóza MeSH
- testování na COVID-19 MeSH
- Konspekt
- Veřejné zdraví a hygiena
- NLK Obory
- infekční lékařství
- veřejné zdravotnictví
- NLK Publikační typ
- publikace WHO
In August 2017, an increased incidence of Salmonella Bareilly was detected in the Czech Republic. An investigation was conducted with Slovakia to confirm the outbreak and identify the source. Probable outbreak cases were defined as cases with laboratory-confirmed S. Bareilly reported in either of the national surveillance systems, and/or the Czech and Slovak National Reference Laboratory databases from July 2017. Confirmed cases had the pulsed-field gel electrophoresis (PFGE) outbreak pulsotype or up to 5 alleles difference from outbreak cluster members by core genome multilocus sequence typing (cgMLST). PFGE and whole genome sequencing were used for isolate comparison. The same trawling questionnaire was used in both countries. By the end of October 2018, 325 cases were identified. Among 88 human S. Bareilly isolates analysed by PFGE, 82 (93%) shared an identical pulsotype; cgMLST of 17 S. Bareilly human isolates showed 1-2 allele difference. The trawling questionnaire excluded consumption of unusual or imported foods. In September 2018, an isolate closely related to the outbreak isolates was identified in a powdered egg product. A spray dryer was recognised as the contamination source and the production plant was closed. Using molecular typing methods, we detected a diffuse cross-border outbreak caused by S. Bareilly.
- MeSH
- epidemický výskyt choroby * MeSH
- genom bakteriální MeSH
- lidé MeSH
- multilokusová sekvenční typizace MeSH
- pulzní gelová elektroforéza MeSH
- Salmonella * genetika MeSH
- sekvenování celého genomu MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
In spring 2016, Greece reported an outbreak caused by a previously undescribed Salmonellaenterica subsp. enterica serotype (antigenic formula 11:z41:e,n,z15) via the Epidemic Intelligence Information System for Food- and Waterborne Diseases and Zoonoses (EPIS-FWD), with epidemiological evidence for sesame products as presumptive vehicle. Subsequently, Germany, Czech Republic, Luxembourg and the United Kingdom (UK) reported infections with this novel serotype via EPIS-FWD. Concerned countries in collaboration with the European Centre for Disease Prevention and Control (ECDC) and European Food Safety Authority (EFSA) adopted a common outbreak case definition. An outbreak case was defined as a laboratory-confirmed notification of the novel Salmonella serotype. Between March 2016 and April 2017, 47 outbreak cases were notified (Greece: n = 22; Germany: n = 13; Czech Republic: n = 5; Luxembourg: n = 4; UK: n = 3). Whole genome sequencing revealed the very close genetic relatedness of isolates from all affected countries. Interviews focusing on sesame product consumption, suspicious food item testing and trace-back analysis following Salmonella spp. detection in food products identified a company in Greece where sesame seeds from different countries were processed. Through European collaboration, it was possible to identify and recall sesame spread as one contaminated food item serving as vehicle of infection and trace it back to its origin.
- MeSH
- epidemický výskyt choroby statistika a číselné údaje MeSH
- lidé MeSH
- otrava salmonelou epidemiologie MeSH
- Salmonella enterica klasifikace genetika izolace a purifikace MeSH
- salmonelóza epidemiologie MeSH
- sekvenování celého genomu MeSH
- séroskupina MeSH
- sérotypizace MeSH
- Sesamum mikrobiologie MeSH
- surveillance populace metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
