• MeSH
• Acinetobacter účinky léků   MeSH
• antibiotická rezistence * MeSH
• bakteriální léková rezistence * MeSH
• Enterococcus účinky léků   MeSH
• epidemiologické studie MeSH
• Escherichia coli účinky léků   MeSH
• Klebsiella pneumoniae účinky léků   MeSH
• kontrola infekčních nemocí organizace a řízení   MeSH
• lidé MeSH
• mnohočetná bakteriální léková rezistence * MeSH
• Pseudomonas aeruginosa účinky léků   MeSH
• Staphylococcus aureus účinky léků   MeSH
• Streptococcus pneumoniae účinky léků   MeSH
• surveillance populace MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH
• Evropa MeSH

• MeSH
• Acinetobacter účinky léků   MeSH
• antibiotická rezistence * MeSH
• bakteriální léková rezistence MeSH
• Enterococcus účinky léků   MeSH
• epidemiologické studie MeSH
• epidemiologie * MeSH
• Escherichia coli účinky léků   MeSH
• interpretace statistických dat MeSH
• Klebsiella pneumoniae účinky léků   MeSH
• kontrola infekčních nemocí * organizace a řízení   trendy   MeSH
• lidé MeSH
• mnohočetná bakteriální léková rezistence MeSH
• Pseudomonas aeruginosa účinky léků   MeSH
• Staphylococcus aureus účinky léků   MeSH
• Streptococcus pneumoniae účinky léků   MeSH
• surveillance populace MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• Acinetobacter patogenita   účinky léků   MeSH
• bakteriální léková rezistence * MeSH
• Enterococcus patogenita   účinky léků   MeSH
• Escherichia coli patogenita   účinky léků   MeSH
• Klebsiella pneumoniae patogenita   účinky léků   MeSH
• lidé MeSH
• Pseudomonas aeruginosa patogenita   účinky léků   MeSH
• Staphylococcus aureus patogenita   účinky léků   MeSH
• Streptococcus pneumoniae patogenita   účinky léků   MeSH
• surveillance populace * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH

BackgroundAntibiotic resistance, either intrinsic or acquired, is a major obstacle for treating bacterial infections.AimOur objective was to compare the country-specific species distribution of the four Gram-negative species Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter species and the proportions of selected acquired resistance traits within these species.MethodWe used data reported for 2016 to the European Antimicrobial Resistance Surveillance Network (EARS-Net) by 30 countries in the European Union and European Economic Area.ResultsThe country-specific species distribution varied considerably. While E. coli accounted for 31.9% to 81.0% (median: 69.0%) of all reported isolates, the two most common intrinsically resistant species P. aeruginosa and Acinetobacter spp. combined (PSEACI) accounted for 5.5% to 39.2% of isolates (median: 10.1%). Similarly, large national differences were noted for the percentages of acquired non-susceptibility to third-generation cephalosporins, carbapenems and fluoroquinolones. There was a strong positive rank correlation between the country-specific percentages of PSEACI and the percentages of non-susceptibility to the above antibiotics in all four species (rho > 0.75 for 10 of the 11 pairs of variables tested).ConclusionCountries with the highest proportion of P. aeruginosa and Acinetobacter spp. were also those where the rates of acquired non-susceptibility in all four studied species were highest. The differences are probably related to national differences in antibiotic consumption and infection prevention and control routines.

• MeSH
• Acinetobacter účinky léků   MeSH
• antibakteriální látky farmakologie   MeSH
• bakteriální léková rezistence účinky léků   MeSH
• bakteriemie farmakoterapie   epidemiologie   MeSH
• cefalosporiny farmakologie   MeSH
• Escherichia coli účinky léků   MeSH
• Evropská unie MeSH
• fluorochinolony farmakologie   MeSH
• gramnegativní bakteriální infekce farmakoterapie   epidemiologie   MeSH
• gramnegativní bakterie účinky léků   MeSH
• karbapenemy farmakologie   MeSH
• Klebsiella pneumoniae účinky léků   MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• Pseudomonas aeruginosa účinky léků   MeSH
• sentinelová surveillance MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

Nozokomiální infekce jsou v současnosti považovány za významný indikátor kvality péče ve všech zdravotnických zařízeních. Jedná se o nežádoucí komplikaci poskytované zdravotnické péče s řadou negativních následků, jako jsou nárůst morbidity a mortality, prodloužení doby hospitalizace a vzestup nákladů. Jejich výskyt dnes mimo jiné souvisí i s narůstajícími, mnohdy invazivními technickými možnostmi diagnostiky i terapie. Dalším problémem v nemocnicích České republiky je nárůst rezistence některých bakterií k antibiotikům. Prakticky to znamená značně omezené možnosti léčby. Příspěvek přináší aktuální data o bakteriální rezistenci v Českých nemocnicích (evropský projekt EARS-Net – rok 2015).

Nosocomial, also known as hospital acquired infections, are today considered to be an important indicator of the quality of health care in all health establishments. They involve an undesirable complication of the provided health care with a number of negative consequences, such as increased morbidity and mortality, longer time of hospitalization and higher costs. Their incidence at present is also related, among other things, to the broadening, sometimes invasive technical possibilities of diagnosing and therapy. Another issue in Czech hospitals consists in the growing resistance of some bacteria to antibiotics. In practice this means considerably limited possibilities of treatment. The contribution brings the current data about the state of bacterial resistance in Czech hospitals (European project EARS-Net – year 2015).

• Klíčová slova
• European Antimicrobial Resistance Surveillance Network (EARS-Net),
• MeSH
• antibakteriální látky škodlivé účinky   terapeutické užití   MeSH
• bakteriální léková rezistence * MeSH
• beta-laktamová rezistence MeSH
• infekce spojené se zdravotní péčí * diagnóza   farmakoterapie   klasifikace   přenos   MeSH
• kolistin terapeutické užití   MeSH
• lidé MeSH
• mnohočetná léková rezistence MeSH
• pseudomonádové infekce diagnóza   farmakoterapie   přenos   MeSH
• Pseudomonas aeruginosa izolace a purifikace   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ventilátorová pneumonie diagnóza   farmakoterapie   mikrobiologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• kazuistiky MeSH
• přehledy MeSH

BackgroundInvasive infections caused by Staphylococcus aureus have high clinical and epidemiological relevance. It is therefore important to monitor the S. aureus trends using suitable methods.AimThe study aimed to describe the trends of bloodstream infections (BSI) caused by meticillin-resistant S. aureus (MRSA) and meticillin-susceptible S. aureus (MSSA) in the European Union (EU) and the European Economic Area (EEA).MethodsAnnual data on S. aureus BSI from 2005 to 2018 were obtained from the European Antimicrobial Resistance Surveillance Network (EARS-Net). Trends of BSI were assessed at the EU/EEA level by adjusting for blood culture set rate (number of blood culture sets per 1,000 days of hospitalisation) and stratification by patient characteristics.ResultsConsidering a fixed cohort of laboratories consistently reporting data over the entire study period, MRSA percentages among S. aureus BSI decreased from 30.2% in 2005 to 16.3% in 2018. Concurrently, the total number of BSI caused by S. aureus increased by 57%, MSSA BSI increased by 84% and MRSA BSI decreased by 31%. All these trends were statistically significant (p < 0.001).ConclusionsThe results indicate an increasing health burden of MSSA BSI in the EU/EEA despite a significant decrease in the MRSA percentage. These findings highlight the importance of monitoring antimicrobial resistance trends by assessing not only resistance percentages but also the incidence of infections. Further research is needed on the factors associated with the observed trends and on their attributable risk.

• MeSH
• Evropská unie MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus * MeSH
• methicilin farmakologie   MeSH
• sepse * MeSH
• stafylokokové infekce * diagnóza   farmakoterapie   epidemiologie   MeSH
• Staphylococcus aureus MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY This study aims to articulate regional guidelines for curative and suppressive antibiotic therapy of total joint replacement infections. MATERIAL AND METHODS When developing the standard, used as source materials were the published foreign guidelines for antibiotic therapy of prosthetic joint infections, the analysis of resistance of bacterial strains conducted in the Hospital in České Budějovice, a.s. and the assessment of strain resistance for the Czech Republic published by the European Antimicrobial Resistance Surveillance Network (EARS-Net). Considered was also the availability of individual antibiotics in the Czech Republic and restricted prescription according to the Summary of Product Characteristics as specified in the State Institute for Drug Control marketing authorisation. The expert group composed of orthopaedists, microbiologists and infectious disease specialists elaborated the basic antibiotic guideline for choosing an appropriate antibiotic/antifungal drug based on the usual susceptibility, its dose and dosage interval for initial and continuation therapy. The comments of individual specialists were gradually incorporated therein and in case of doubts majority rule was applied. The drafted document was sent for peer reviews to clinical orthopaedic, infectious disease and microbiological centres, whose comments were also incorporated and the finalised document was submitted for evaluation to specialised medical societies. RESULTS The outcome is the submitted guideline for antibiotic curative and suppressive therapy suitable for managing the prosthetic joint infections, which was approved by the committee of the Czech Society for Orthopaedics and Traumatology andthe Society for Infectious Diseases of the Czech Medical Association of J. E. Purkyně. DISCUSION Curative therapy of total joint replacement infections consists primarily in surgical treatment and has to be accompanied by adequate antibiotic therapy administered initially intravenously and later orally over a sufficient period of time. Bearing in mind the wide spectrum of pathogens that can cause infections of a joint replacement and their capacity to form a biofilm on foreign materials, the correct choice of an antibiotic, its dose and dosage interval are essential for successful treatment. Such standard should respect regional availability of antibiotics, regional pathogen resistance/susceptibility and ensure the achievement of sufficiently high concentrations at the requested location including anti-biofilm activity. CONCLUSIONS The submitted guideline is not the only treatment option for joint total replacement infections, but it makes the decisionmaking easier when treating these complications in the form of infections. The final choice of an antibiotic, its dose and duration of therapy shall be based on a critical assessment of results of microbiological (blood culture and molecular genetic) tests and reflect the patient s clinical condition. Since these are multidisciplinary issues, we consider useful for this guideline to be commented upon and approved by the committee of both the Society for Orthopaedics and Infectious Diseases so that it can become the starting point for treatment. Key words: total joint replacement infection, TEP, ATB, antibiotic therapy, consensus meeting, guideline.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• artroplastiky kloubů škodlivé účinky   přístrojové vybavení   MeSH
• infekce spojené s protézou diagnóza   etiologie   terapie   MeSH
• lidé MeSH
• protézy kloubů škodlivé účinky   MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH