• MeSH
• fibroblastový růstový faktor 2 * MeSH
• fibroblasty MeSH
• hojení ran MeSH
• lidé MeSH
• popálení * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH

• MeSH
• antibakteriální látky farmakologie   terapeutické užití   MeSH
• antiinfekční látky * farmakologie   MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus * MeSH
• mikrobiální testy citlivosti MeSH
• popálení * MeSH
• stafylokokové infekce * farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH

The aim of the study was to identify the most important systemic and local risk factors for the development of infectious complications in patients with toxic epidermal necrolysis (TEN). MATERIAL AND METHODOLOGY: This is a multicentric study that included all patients with TEN who were hospitalized between 2000-2015 in specialized centres in the Czech Republic and Slovakia. The total catchment area included a population of over 12.5 million inhabitants. The actual implementation of the project was carried out using data obtained from the CELESTE (Central European LyEll Syndrome: Therapeutic Evaluation) registry, wherein specific parameters related to epidemiological indicators and infectious complications in patients with TEN were evaluated as a retrospective analysis. RESULTS: A total of 38 patients (97%) of the group were treated with corticosteroids. The comparison of patients with different doses of corticosteroids did not exhibit a statistically significant effect of corticosteroid administration on the development of infectious complications (p=0.421). There was no effect of the extent of the exfoliated area on the development of infectious complications in this area. The average extent of the exfoliated area was 66% TBSA (total body surface area) in patients with reported infectious complications and 71% TBSA (p=0.675) in patients without infectious complications. In the case of the development of an infectious complication in the bloodstream (BSI), the increasing effect of the SCORTEN (SCORe of Toxic Epidermal Necrosis) value was monitored during hospitalization. Within 5days from the beginning of the hospitalization, the average SCORTEN value was 2.7 in 6 patients with BSI and 3.0 in 32 patients without BSI (p=0.588). In the period after the 15th day of hospitalization, 7 patients with BSI had an average SCORTEN value of 3.4, and 16 patients without BSI had an average SCORTEN value of 2.5 (p=0.079). In the case of low respiratory tract infection (LRTI), the effects of the necessity for artificial pulmonary ventilation and the presence of tracheostomy were monitored. The statistically significant effect of mechanical ventilation on the development of LRTI occurred only during the period of 11-15days from the beginning of the hospitalization (p=0.016). The effect of the tracheostomy on the development of LRTI was proven to be more significant. CONCLUSION: We did not find any statistically significant correlation between the nature of immunosuppressive therapy and the risk of developing infectious complications. We failed to identify statistically significant risk factors for the development of BSI. Mechanical ventilation and tracheostomy increase the likelihood of developing LRTIs in patients with TEN.

• MeSH
• bakteriální infekce epidemiologie   MeSH
• bakteriemie epidemiologie   MeSH
• cyklosporin terapeutické užití   MeSH
• dospělí MeSH
• fungemie epidemiologie   MeSH
• hormony kůry nadledvin terapeutické užití   MeSH
• imunologické faktory terapeutické užití   MeSH
• imunosupresiva terapeutické užití   MeSH
• infekce močového ústrojí epidemiologie   MeSH
• intravenózní imunoglobuliny terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mykózy epidemiologie   MeSH
• pneumonie epidemiologie   terapie   MeSH
• registrace * MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• Stevensův-Johnsonův syndrom epidemiologie   terapie   MeSH
• stupeň závažnosti nemoci MeSH
• tracheostomie MeSH
• umělé dýchání MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Slovenská republika MeSH

INTRODUCTION: Toxic epidermal necrolysis (TEN) is a rare, life-threatening autoimmune disease predominantly manifested in the skin and mucous membranes. Today, infectious complications have the dominant share in mortality of TEN patients. Due to the nature of the therapy and administration of immunosuppressive medications, a wide range of potentially pathogenic microorganisms, which cause infectious complications in different compartments in these patients, is not surprising. MATERIAL AND METHODOLOGY: This is a multicentric study, which included all patients with TEN hospitalized between 2000-2015 in specialized centres in the Czech Republic and Slovakia. The total catchment area was over 12.5 million inhabitants. The actual implementation of the project was carried out using data obtained from the registry CELESTE (Central European LyEll Syndrome: Therapeutic Evaluation), when specific parameters relating to epidemiological indicators and infectious complications in patients with TEN were evaluated in the form of a retrospective analysis. RESULTS: In total, 39 patients with TEN were included in the study (12 patients died, mortality was 31%), who were hospitalized in the monitored period. The median age of patients in the group was 63 years (the range was 4-83 years, the mean was 51 years), the median of the exfoliated area was 70% TBSA (total body surface area) (range 30-100%, mean 67%). SCORTEN was calculated for 38 patients on the day of admission. Its median in all patients was 3 (range 1-6; mean 3). Any kind of infectious complication in the study group was recorded in 33 patients in total (85%). In total, 30 patients (77%) were infected with gram-positive cocci, 27 patients (69%) with gram-negative rods, and yeast cells or fibrous sponge were cultivated in 12 patients (31%). A total of 32 patients (82%) were found to have infectious complications in the exfoliated area, 15 patients (39%) had lower respiratory tract infections, 18 patients (46%) urinary tract infections and 15 patients (39%) an infection in the bloodstream. The most common potentially pathogenic microorganism isolated in our study group was coagulase neg. Staphylococcus, which caused infectious complications in 24 patients. Enterococcus faecalis/faecium (19 patients), Pseudomonas aeruginosa (17 patients), Staphylococcus aureus (11 patients) and Escherichia coli (11 patients) were other most frequently isolated micro-organisms. CONCLUSION: The published data were obtained from the unique registry of TEN patients in Central Europe. In the first part, we have succeeded in defining the basic epidemiological indicators in the group of patients anonymously included in this registry. The study clearly confirms that infectious complications currently play an essential role in TEN patients, often limiting the chances of survival. The study also shows a high prevalence of these complications in the period after 15days from the start of hospitalization, when most patients already have completely regenerated skin cover.

• MeSH
• aspergilóza epidemiologie   mortalita   MeSH
• bakteriální infekce epidemiologie   mikrobiologie   mortalita   MeSH
• bakteriemie epidemiologie   mikrobiologie   mortalita   MeSH
• dítě MeSH
• dospělí MeSH
• Enterococcus faecalis MeSH
• Enterococcus faecium MeSH
• infekce močového ústrojí epidemiologie   mikrobiologie   mortalita   MeSH
• infekce vyvolané Escherichia coli epidemiologie   mortalita   MeSH
• kandidóza epidemiologie   mortalita   MeSH
• katétrové infekce epidemiologie   mikrobiologie   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mykózy epidemiologie   mikrobiologie   mortalita   MeSH
• pneumonie epidemiologie   mikrobiologie   mortalita   MeSH
• povrch těla MeSH
• předškolní dítě MeSH
• prevalence MeSH
• proporcionální rizikové modely MeSH
• pseudomonádové infekce epidemiologie   mikrobiologie   mortalita   MeSH
• Pseudomonas aeruginosa MeSH
• registrace * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stafylokokové infekce epidemiologie   mikrobiologie   mortalita   MeSH
• Staphylococcus aureus MeSH
• Stevensův-Johnsonův syndrom epidemiologie   mikrobiologie   mortalita   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Slovenská republika MeSH

• MeSH
• diferenciální diagnóza MeSH
• fyzikální vyšetření metody   MeSH
• kůže patologie   MeSH
• lidé MeSH
• Stevensův-Johnsonův syndrom diagnóza   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH

Toxic epidermal necrolysis is a rare condition involving the skin at the dermoepidermal junction, with possible inclusion of mucous membranes. The condition is associated with systemic toxicity and high mortality rates. Successful treatment requires optimization of local as well as systemic therapy. We report the case of a young woman who developed toxic epidermal necrolysis, possibly resulting from lamotrigine therapy. Local therapy included a combination of a biological cover and alginate together with a synthetic cover (Aquacel Ag®).

• Publikační typ
• časopisecké články MeSH

The aim of our study was to retrospectively evaluate the epidemiological characteristics of patients with high voltage electrical injury from 1999 to 2009. The Clinic of Burns and Reconstructive Surgery, Faculty Hospital Brno is located in a region of 2,505,000 inhabitants. In total 13,911 patients (including both children and adults, and outpatients as well as hospitalized patients) were treated at our burn center during the period of study. Of these patients, 1,030 were hospitalized for burns treatment. For the purposes of this study, we have included only patients with high voltage electrical trauma, of which there were 58, 2 of whom were female. Basic epidemiological indicators were gathered on these patients, including age, gender, place of accident, extent of trauma, mortality and whether the injury was occupational or non-occupational. Electrical burns (caused by both low-voltage and high-voltage electric current) made up 1.10% of all burns treated in our burn center and high voltage electrical injuries represented 0.42% of all burn injuries. The average incidence of high voltage electrical trauma was 0.21 cases/100,000 inhabitants. The average age of the patients was 28.59 years. Nine patients died and the mortality was fixed at 15.52%. The average length of hospitalization was 53.43 days. The average extent of burnt area was 35.01% TBSA. In our study, we were able to define the basic epidemiological parameters in 58 patients with high voltage electrical trauma. We also have to highlight the still disappointingly high number of non-occupational electrical injuries affecting those in the lower age groups, especially children. However, preventive programmes for educating specific risk groups have shown positive results.

• Publikační typ
• časopisecké články MeSH

OBJECTIVE: The study aims to evaluate the impact of early and late tracheostomy on microbiological changes in the airways in severely burned children. MATERIALS AND METHODS: Early tracheostomy is sometimes performed within 3 days after the start of mechanical ventilation regular microbiological surveillance of the respiratory tract was done in all patients. From each sputum, tracheobronchial aspirate and bronchoalveolar lavage (BAL), a microscopic slide was made and the material was seeded in a culture medium. The standard culture media used for the growth of respiratory pathogens are blood agar, McConkey agar, VL agar and chocolate agar. The obtained values were statistically analysed. RESULTS: In the observed period, a total of 68 children underwent mechanical ventilation in our department. A total of 31 (45.59%) children had undergone surgical tracheostomy (18 patients with early tracheostomy and 13 patients with late tracheostomy). The most common bacterium isolated from the lower respiratory tract in patients with early and late tracheostomy was Acinetobacter baumannii (31.53% resp. 44.30% of all bacterial strains). In patients with early tracheostomy, the ratio of G+/G- during the 6-7th day of mechanical ventilation was 1.29:1 and during the 8-10th day, 1:1.43. In patients with late tracheostomy the G+/G- ratio was 1:2.25 and during the 8-10th day, 1:2.25. There was not any statistically significant deviation in the G+/G- ratio in patients with early and late tracheostomy in any of the monitored periods. CONCLUSION: The main reasons for performing early tracheostomy are: extent, localisation and depth of the burn. Difficult weaning in an uncooperative patient, failure of extubation with subsequent reintubation and other complications may be an indication for late tracheostomy. The study confirms that the use of appropriately indicated early tracheostomy provides a microbiological benefit for burned children.

• MeSH
• Bacteria izolace a purifikace   MeSH
• bakteriální infekce mikrobiologie   MeSH
• časové faktory MeSH
• dítě MeSH
• kojenec MeSH
• kvasinky izolace a purifikace   MeSH
• lidé MeSH
• mladiství MeSH
• nemoci dýchací soustavy mikrobiologie   MeSH
• popálení komplikace   chirurgie   MeSH
• předškolní dítě MeSH
• tracheostomie škodlivé účinky   metody   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

UNLABELLED: The aim of this study was to determine the basic epidemiological characteristics of severely burned children who were admitted to the intensive care unit (ICU), Department of Burns and Reconstructive Surgery Faculty Hospital Brno, Czech Republic in the years 1997-2009. METHODS: We collected and evaluated epidemiological data such as age, sex, burn etiology, length of hospitalization, duration of the ICU stay, surgical or conservative therapeutic strategies, the use of mechanical ventilation and its duration, day and month of injury and the extent of burned area. RESULTS: In total 383 children (253 boys, 130 girls) aged 0-14 years, underwent intensive care for at least 48h. Male to female ratio was 1.95:1. The average range of burn area in the group was 16.43±12.86% TBSA (total body surface area). During the reporting period, 16 children were admitted with burns over 50% TBSA. 328 children suffered burns indoors, with 55 children being burned outdoors. Indoor/outdoor ratio was set at 5.96:1. The most frequent etiological agent was scalding (hot water, soup, coffee, oil, tea). The total number of scalded children in this group was 312 (81.46%). Mechanical ventilation was used in 96 cases (25.07% of all the admitted patients). The duration of mechanical ventilation in these patients was 8.03±5.67 days in average. The average length of stay in ICU was 10.71±10.92 days and total length of hospital stay was an average of 21.55±14.55 days. A total of 184 patients (48.04%) were treated surgically and therefore required necrectomy and skin grafting. The other 199 (51.96%) patients were treated conservatively. During the reporting period 3 children died (0.78%). CONCLUSION: In our report we identify basic epidemiological data defined in the aim of this study for burned children requiring intensive care.

• MeSH
• délka pobytu MeSH
• dítě MeSH
• jednotky intenzivní péče pediatrické statistika a číselné údaje   MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• popálení epidemiologie   etiologie   MeSH
• popáleninové jednotky statistika a číselné údaje   MeSH
• předškolní dítě MeSH
• rizikové faktory MeSH
• rozložení podle pohlaví MeSH
• úrazy v domácnosti statistika a číselné údaje   MeSH
• věkové rozložení MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• Publikační typ
• abstrakt z konference MeSH