This observational retrospective study aimed to analyze whether/how the spectrum of bacterial pathogens and their resistance to antibiotics changed during the worst part of the COVID-19 pandemic (1 November 2020 to 30 April 2021) among intensive care patients in University Hospital Olomouc, Czech Republic, as compared with the pre-pandemic period (1 November 2018 to 30 April 2019). A total of 789 clinically important bacterial isolates from 189 patients were cultured during the pre-COVID-19 period. The most frequent etiologic agents causing nosocomial infections were strains of Klebsiella pneumoniae (17%), Pseudomonas aeruginosa (11%), Escherichia coli (10%), coagulase-negative staphylococci (9%), Burkholderia multivorans (8%), Enterococcus faecium (6%), Enterococcus faecalis (5%), Proteus mirabilis (5%) and Staphylococcus aureus (5%). Over the comparable COVID-19 period, a total of 1500 bacterial isolates from 372 SARS-CoV-2-positive patients were assessed. While the percentage of etiological agents causing nosocomial infections increased in Enterococcus faecium (from 6% to 19%, p < 0.0001), Klebsiella variicola (from 1% to 6%, p = 0.0004) and Serratia marcescens (from 1% to 8%, p < 0.0001), there were significant decreases in Escherichia coli (from 10% to 3%, p < 0.0001), Proteus mirabilis (from 5% to 2%, p = 0.004) and Staphylococcus aureus (from 5% to 2%, p = 0.004). The study demonstrated that the changes in bacterial resistance to antibiotics are ambiguous. An increase in the frequency of ESBL-positive strains of some species (Serratia marcescens and Enterobacter cloacae) was confirmed; on the other hand, resistance decreased (Escherichia coli, Acinetobacter baumannii) or the proportion of resistant strains remained unchanged over both periods (Klebsiella pneumoniae, Enterococcus faecium). Changes in pathogen distribution and resistance were caused partly due to antibiotic selection pressure (cefotaxime consumption increased significantly in the COVID-19 period), but mainly due to clonal spread of identical bacterial isolates from patient to patient, which was confirmed by the pulse field gel electrophoresis methodology. In addition to the above shown results, the importance of infection prevention and control in healthcare facilities is discussed, not only for dealing with SARS-CoV-2 but also for limiting the spread of bacteria.
- Publikační typ
- časopisecké články MeSH
Increasing antimicrobial resistance in nosocomial pathogens, such as Acinetobacter baumannii, is becoming a serious threat to public health. It is necessary to detect β-lactamase-producing microorganisms in clinical settings to be able to control the spread of carbapenem resistance. This study was conducted to evaluate the presence of β-lactamases in a selected clinical isolate of A. baumannii of ST2P/ST195Ox and to characterize possible enzymes, as well as its β-lactam resistome, using PCR and whole-genome sequencing analysis. PCR and sequencing confirmed that the isolate harbored five bla gene alleles, namely, blaADC-73, blaTEM-1, blaOXA-23, blaOXA-58 and blaOXA-66, as well as aminoglycosides, macrolides, sulfonamides and tetracyclines resistance determinants, which were either chromosomally and/or plasmid located. Furthermore, a gene order comparison using MAUVE alignment showed multiple changes compared with the clinical isolate of Malaysian A. baumannii AC30 genome and 76 regions with high homology. This study suggests that resistance to β-lactams in this A. baumannii isolate is mainly due to an overproduction of β-lactamases in combination with other resistance mechanism (efflux pump system).
- Publikační typ
- kazuistiky MeSH
Cronobacter spp. have been recognized as causative agents of various severe infections in pre-term or full-term infants as well as elderly adults suffering from serious underlying disease or malignancy. A surveillance study was designed to identify antibiotic resistance among clinical Cronobacter spp. strains, which were isolated from patients of two hospitals between May 2007 and August 2013. Altogether, 52 Cronobacter spp. isolates were analyzed. Although MALDI-TOF mass spectrometry recognized all Cronobacter sakazakii and Cronobacter malonaticus strains, it could not identify Cronobacter muytjensii strain. Nevertheless, all strains were identified as Cronobacter spp. using multilocus sequence typing (MLST). Strains were tested against 17 types of antibiotics, using the standard microdilution method according to the 2018 European Committee on Antimicrobial Susceptibility Testing criteria. Three Cronobacter species were identified as C. sakazakii (n = 33), C. malonaticus (n = 18), and C. muytjensii (n = 1); all isolates were susceptible to all tested antibiotics. All strains were PCR-negative for blaTEM, blaSHV, and blaCTX-M β-lactamase genes, as well. Even though the results of this study showed that Cronobacter spp. isolates were pan-susceptible, continued antibiotic resistance surveillance is warranted.Cronobacter spp. have been recognized as causative agents of various severe infections in pre-term or full-term infants as well as elderly adults suffering from serious underlying disease or malignancy. A surveillance study was designed to identify antibiotic resistance among clinical Cronobacter spp. strains, which were isolated from patients of two hospitals between May 2007 and August 2013. Altogether, 52 Cronobacter spp. isolates were analyzed. Although MALDI-TOF mass spectrometry recognized all Cronobacter sakazakii and Cronobacter malonaticus strains, it could not identify Cronobacter muytjensii strain. Nevertheless, all strains were identified as Cronobacter spp. using multilocus sequence typing (MLST). Strains were tested against 17 types of antibiotics, using the standard microdilution method according to the 2018 European Committee on Antimicrobial Susceptibility Testing criteria. Three Cronobacter species were identified as C. sakazakii (n = 33), C. malonaticus (n = 18), and C. muytjensii (n = 1); all isolates were susceptible to all tested antibiotics. All strains were PCR-negative for blaTEM, blaSHV, and blaCTX-M β-lactamase genes, as well. Even though the results of this study showed that Cronobacter spp. isolates were pan-susceptible, continued antibiotic resistance surveillance is warranted.
- MeSH
- antibakteriální látky farmakologie MeSH
- Cronobacter sakazakii klasifikace účinky léků genetika MeSH
- Cronobacter klasifikace účinky léků MeSH
- genotyp MeSH
- gramnegativní bakteriální infekce mikrobiologie MeSH
- lidé MeSH
- mikrobiální testy citlivosti MeSH
- mnohočetná bakteriální léková rezistence MeSH
- multilokusová sekvenční typizace MeSH
- polymerázová řetězová reakce MeSH
- techniky typizace bakterií MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Polsko MeSH
BACKGROUND: Cronobacter spp. are Gram-negative, facultative-anaerobic, non-spore forming, enteric coliform bacteria, which belongs to the Enterobacteriaceae family. Cronobacter spp. are opportunistic pathogens that have brought rare but life-threatening infections such as meningitis, necrotizing enterocolitis and bloodstream infections in neonates and infants. Information on the diversity, pathogenicity and virulence of Cronobacter species obtained from various sources is still relatively scarce and fragmentary. The aim of this study was to examine and analyse different pathogenicity and virulence factors among C. sakazakii and C. malonaticus strains isolated from clinical samples. METHODS: The thirty-six clinical Cronobacter strains have been used in this study. This bacterial collection consists of 25 strains of C. sakazakii and 11 strains of C. malonaticus, isolated from different clinical materials. Seven genes (ompA, inv, sip, aut, hly, fliC, cpa) were amplified by PCR. Moreover, the motility and the ability of these strains to adhere and invade human colorectal adenocarcinoma (HT-29) and mouse neuroblastoma (N1E-115) cell lines were investigated. RESULTS: Our results showed that all tested strains were able to adhere to both used cell lines, HT-29 and N1E-115 cells. The invasion assay showed that 66.7% (24/36) of isolates were able to invade N1-E115 cells while 83% (30/36) of isolates were able to invade HT-29 cells. On the average, 68% of the C. sakazakii strains exhibited seven virulence factors and only 18% in C. malonaticus. All strains amplified ompA and fliC genes. The other genes were detected as follow: sip 97% (35/36), hlyA 92% (33/36), aut 94% (34/36), cpa 67% (24/36), and inv 69% (25/36). CONCLUSIONS: C. sakazakii and C malonaticus strains demonstrate the diversity of the virulence factors present among these pathogens. It is necessary to permanently monitor the hospital environment to appropriately treat and resolve cases associated with disease. Furthermore, in-depth knowledge is needed about the source and transmission vehicles of pathogens in hospitals to adopt pertinent prevention measures.
- MeSH
- bakteriální adheze MeSH
- bakteriologické techniky MeSH
- buněčné linie MeSH
- Cronobacter genetika izolace a purifikace patogenita MeSH
- cytologické techniky MeSH
- endocytóza MeSH
- enterobakteriální infekce mikrobiologie MeSH
- epitelové buňky mikrobiologie MeSH
- faktory virulence genetika MeSH
- lidé MeSH
- myši MeSH
- nemoci přenášené potravou mikrobiologie MeSH
- polymerázová řetězová reakce MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Východiska: Akutní leukemie (AL) je heterogenní skupina maligních onemocnění hematopoézy, rozděluje se na dva základní typy, a to akutní myeloidní leukemie (AML) a akutní lymfoidní leukemie (ALL). Pacienti s těmito onemocněními patří mezi těžce imunosuprimované a je u nich velké riziko vzniku závažných infekcí. Cílem studie bylo sledování výskytu enterobakterií - původců těchto infekcí - u pacientů s AL hospitalizovanými na Hemato-onkologické klinice Fakultní nemocnice v Olomouci a zjištění jejich antibiotické rezistence. Materiál a metodika: Do studie bylo zapojeno 49 pacientů s AL, z toho 37 s AML (16 žen a 21 mužů) a 12 s ALL (6 žen a 6 mužů); průměrný věk pacientů byl 50,5 roku. V průběhu 12 měsíců (od září 2015 do srpna 2016) by od těchto pacientů získávány vzorky klinického materiálu, které byly podrobeny základnímu mikrobiologickému vyšetření. Bakteriální kmeny byly identifikovány pomocí MALDI-TOF MS. Citlivost na antibiotika byla stanovena pomocí mikrodiluční metody. Výsledky: Celkově bylo od pacientů s AL získáno 292 vzorků, které byly dále podrobeny selekci na základě několika kritérií, aby bylo zamezeno zahrnutí identických kmenů získaných od téhož pacienta. Výsledkem byl výběr 146 klinických vzorků z 9 typů klinických materiálů (47x výtěr z krku, 40x stolice, 33x moč, 11x hemokultura, 5x výtěr z dutiny ústní, 4x perianální stěr, 3x; stěr z rány, 2x sputum, 1x punktát). Nejvíce prevalentní enterobakterií byla Escherichia coli (42x), dále zástupci Klebsiella spp. (46x), a to Klebsiella pneumoniae (34x) a Klebsiella oxytoca (12x), a Enterobacter cloacae (19x). Mnohé izoláty vykazovaly rezistenci na testovaná antibiotika. Závěr: Pacienti s hematoonkologickými onemocněními jsou kolonizováni rezistentními enterobakteriemi, což pro ně představuje potenciální nebezpečí vzniku závažných infekcí. Obecně je výskyt těchto rezistentních zástupců z čeledi Enterobacteriaceae v dnešní době závažným problémem se zvyšujícím se výskytem. Tato fakta a vysoká imunosuprese jsou faktory, které hematoonkologické pacienty řadí do zvlášť ohrožené skupiny, v níž je aktivní surveillance naprosto klíčová.
Background: Acute leukemia (AL) is a heterogeneous group of malignant hematopoietic diseases and is divided into two basic types: acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Patients with these diseases are highly immunosuppressed and therefore at a high risk of serious infections. This study aimed to perform active surveillance of enterobacteria, which cause these infections, and to determine their antibiotic resistance in patients with AL who were hospitalized at the Hemato-Oncology Center of University Hospital Olomouc. Materials and methods: This study involved 49 patients with AL, of whom 37 had AML (16 women and 21 men) and 12 had ALL (6 women and 6 men). The mean age of the patients was 50.5 years. Samples of clinical material were obtained over 12 months (September 2015 to August 2016) and subjected to standard microbiological examinations. Bacterial strains were identified by MALDI-TOF MS, and their antibiotic susceptibility was established by microdilution method. Results: A total of 292 samples were obtained from patients with AL. Some of these samples were excluded from analysis to prevent the inclusion of identical strains from the same patient. Consequently, 146 clinical samples obtained from the following nine types of clinical materials were analyzed - throat swabs (n = 47), stools (n = 40), urine (n = 33), hemocultures (n = 11), buccal swabs (n = 5), perianal swabs (n = 4), wound swabs (n = 3), sputum (n = 2), and puncture fluid (n = 1). The most prevalent enterobacteria was Escherichia coli (n = 42), followed by Klebsiella spp. (n = 46), specifically Klebsiella pneumoniae (n = 34) and Klebsiella oxytoca (n = 12), and Enterobacter cloacae (n = 19). The most of enterobacteria were highly resistant to many tested antibiotics. Conclusions: Antibiotic-resistant enterobacteria colonize patients with hemato-oncological diseases and can cause serious infections. These antibiotic-resistant microorganisms are a serious and frequent problem. These findings together with the high level of immunosuppression mean that patients with hemato-oncological diseases are at a high risk of developing serious infections and consequently active surveillance is crucial.
- MeSH
- akutní lymfatická leukemie * komplikace mikrobiologie MeSH
- akutní myeloidní leukemie * komplikace mikrobiologie MeSH
- antibakteriální látky klasifikace škodlivé účinky terapeutické užití MeSH
- bakteriální léková rezistence * účinky léků MeSH
- dospělí MeSH
- Enterobacteriaceae * klasifikace patogenita MeSH
- Escherichia coli patogenita MeSH
- infekce spojené se zdravotní péčí mikrobiologie patologie prevence a kontrola MeSH
- Klebsiella patogenita MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- výzkum MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Publikační typ
- abstrakt z konference MeSH
- MeSH
- bakteriální léková rezistence MeSH
- biofilmy MeSH
- infekce spojené se zdravotní péčí mikrobiologie prevence a kontrola MeSH
- koagulasa MeSH
- kontaminace zdravotnického vybavení prevence a kontrola MeSH
- lidé MeSH
- onkologická péče - zařízení MeSH
- prevalence MeSH
- stafylokokové infekce mikrobiologie prevence a kontrola MeSH
- Staphylococcus epidermidis * izolace a purifikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- hodnotící studie MeSH
- práce podpořená grantem MeSH
Diagnostika legionelóz, hlavne závažnejšej život ohrozujúcej formy, tzv. Legionárskej choroby je zložitá, najmä pre netypické príznaky infekcie, nie vždy dominujúcu atypickú pneumóniu a často veľmi dramatický septický priebeh ochorenia so zlyhávaním orgánov. Stanovenie diagnózy v akútnej fáze ochorenia je možné detekciou legionelového antigénu v moči a dôkazom DNA legionel v PCR/real-time PCR v sére, vzorkách z dolných dýchacích ciest a v moči. Kultivácia na špecifických pôdach zostáva zlatým štandardom, ale pre svoju náročnosť sa využíva málo. Sérologické vyšetrenie si vyžaduje párové vzorky, a tak je prínosom pre diagnostiku v neskoršej fáze infekcie, pričom asi 20 % pacientov vôbec netvorí protilátky. Veľký pokrok sa zaznamenal v typizačných metódach (RFLP, PFGE, metódy založené na PCR, sekvenačné metódy) a rýchlych identifikačných metódach (MALDI-TOF).
The diagnosis of legionellosis, especially of its severe, life-threatening form, Legionnaires' disease, is complicated, primarily because of non-typical symptoms of the infection, not always dominating atypical pneumonia, and often a very dramatic septic course of the disease with multiorgan failures. The diagnosis of the acute phase of the disease can be established by the detection of Legionella antigen in urine and by PCR/real-time PCR detection of Legionella DNA in serum and lower respiratory tract and urine samples. Cultivation on specific media remains the gold standard, but this very demanding method is rarely used. Serological testing requires paired samples and thus is relevant to the diagnosis at a later stage of infection, although it is to be noted that about 20% of patients do not produce the antibodies. Great progress has been made in typing methods (RFLP, PFGE, or PCR based and sequence based methods) and rapid identification methods (MALDI-TOF).
- MeSH
- analýza moči MeSH
- antibakteriální látky aplikace a dávkování terapeutické užití MeSH
- časná diagnóza MeSH
- diferenciální diagnóza MeSH
- incidence MeSH
- klinické laboratorní techniky metody MeSH
- legionářská nemoc * diagnóza farmakoterapie MeSH
- Legionella * izolace a purifikace klasifikace patogenita MeSH
- lidé MeSH
- nukleové kyseliny analýza MeSH
- sérologické testy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- souhrny MeSH
Leptospirózy sú celosvetovo rozšírené zoonózy vyvolané hydrofilnými baktériami rodu Leptospira. Človek sa môže infikovať kontaktom s chorým zvieraťom alebo nepriamo pri pobyte v kontaminovanom prostredí (voda, vlhká pôda), v prírodných ohniskách, pri práci alebo pri športových a voľnočasových aktivitách. Leptospirózy môžu prebiehať ako ľahšie chrípke podobné ochorenia alebo ako závažné febrilné stavy (meningitída, pľúcne hemoragie, hepato-renálny syndróm, myokarditida). V práci sa uvádza prehľad laboratórnych diagnostických metód leptospiróz s poukázaním na ich výhody a nevýhody. V praxi sa prednostne využíva sérologická diagnostika, najmä mikroaglutinačný test, ktorý tiež slúži ako konfirmačný test, menej často enzýmová imunoadsorbentná analýza. V priamej diagnostike sa pre rýchlu diagnostiku leptospiróz zavádzajú metódy molekulárnej biológie, najmä polymerázová reťazová reakcia a jej modifikácie, ktoré dokazujú ochorenie už v akútnom štádiu infekcie.
Leptospiroses are worldwide spread zoonoses caused by hydrophilic bacteria of the genus Leptospira. Humans can be infected by contact with an infected animal or indirectly via staying in a contaminated environment (water, wet soil), in natural foci, while working outdoors, or while doing outdoor sport and leisure activities. Leptospirosis may manifest as a mild flu-like illness or in a severe febrile form (meningitis, pulmonary haemorrhage, hepato-renal syndrome, or myocarditis). Presented are the laboratory diagnostic methods for leptospiroses with their advantages and disadvantages. In practice, serological diagnosis by the microscopic agglutination test, which is also a confirmatory test, and, less often, the enzyme-linked immunosorbent assay are used. Methods of molecular biology are being introduced for direct rapid diagnosis of leptospiroses, in particular the polymerase chain reaction and its modifications, which allow the detection of Leptospira infection in acute phase.
- Klíčová slova
- mikroaglutinační test, enzymová imunoadsorbentní analýza,
- MeSH
- diagnostické techniky molekulární MeSH
- incidence MeSH
- klinické laboratorní techniky MeSH
- Leptospira patogenita MeSH
- leptospiróza * diagnóza etiologie přenos MeSH
- lidé MeSH
- polymerázová řetězová reakce využití MeSH
- sérologické testy metody MeSH
- zoonózy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- souhrny MeSH
- Publikační typ
- abstrakt z konference MeSH
