A systematic investigation of an outbreak of postoperative sepsis in nine patients following surgery in the operating rooms of a primary-type hospital between November 26 and 28, 2018 was conducted to determine the extent of the outbreak, the vehicle, and the route of transmission. The comprehensive investigation included epidemiological, microbiological, molecular biological, and environmental methods. A retrospective cohort study was used to find associations between individual exposure factors and outcomes, the respective septic conditions. Nine of 24 surgery patients were infected (AR 37.5 %). An identical strain of Acinetobacter calcoaceticus was found in biological specimens of two infected patients. The combined investigation did not reveal the vector or route of transmission. Immediate infection prevention and control measures avoided new cases of postoperative sepsis.

• Klíčová slova
• cohort study, outbreak, sepsis, sepsis mimics,
• MeSH
• Acinetobacter calcoaceticus izolace a purifikace   MeSH
• dospělí MeSH
• epidemický výskyt choroby * MeSH
• infekce bakteriemi rodu Acinetobacter epidemiologie   prevence a kontrola   MeSH
• infekce spojené se zdravotní péčí epidemiologie   prevence a kontrola   mikrobiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• operační sály * MeSH
• pooperační komplikace epidemiologie   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sepse * epidemiologie   mikrobiologie   etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

AIM: The aim of study was to evaluate completeness and estimate sensitivity of the measles surveillance using the new electronic version of the national notification system of infectious diseases (ISIN) in order to assess its performance. MATERIAL AND METHODS: The completeness of measles reporting in the ISIN for demographic characteristics (week and region of reporting, age and gender), date of onset, complications, hospitalisations, vaccination status, used laboratory methods and country of import from January 2018 to June 2019 was assessed. The register from National Reference Laboratory (NRL) and the ISIN were compared using the capture-recapture method (CRM). Cases were matched using unique personal identifier. The total number of measles cases in the population was assessed using the Chapmans formula. Sensitivity of reporting was calculated by dividing the number of reported cases by the CRM estimated true number of cases. RESULTS: In the ISIN, 765 measles cases were registered within specified time period. For many variables 100% completeness was found. The data were missing mainly for vaccination status (20%), serology results (55%) and used laboratory methods (8%). The NRL confirmed 653 patient samples in respected period. Within both registries (ISIN and NRL) the total 612 cases were matched. Estimated real number of measles cases using the CRM was 816 (95% CI: 809-823) compared to 806 reported cases. The estimated surveillance system sensitivity was 98.8%. Five percent (n = 41) of cases tested positively in the NRL were not reported to the ISIN. CONCLUSIONS: We found high level of reported measles data completeness in the ISIN for most variables. Estimated real and reported number of cases was in a good correlation and calculated sensitivity of the ISIN was on very high level. Though, the data sources used in the study were not independent on each other, therefore results may not be fully accurate. The technical changes (more mandatory fields and more logical syntax to check data) in the ISIN to improve data completeness are being recommended. Data providers should report all measles cases to the ISIN with maximum precision in entering individual variables and investigating laboratories should send samples for confirmation to the NRL in required cases.

• Klíčová slova
• analytical study, applied epidemiology, capture-recapture method, measles, surveillance,
• MeSH
• hlášení nemocí metody   MeSH
• laboratoře MeSH
• lidé MeSH
• spalničky * epidemiologie   MeSH
• surveillance populace * metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

• MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• očkovací programy statistika a číselné údaje   MeSH
• příušnice imunologie   prevence a kontrola   MeSH
• protilátky virové krev   MeSH
• sérologické testy MeSH
• vakcína proti příušnicím aplikace a dávkování   MeSH
• vakcína proti spalničkám, příušnicím a zarděnkám terapeutické užití   MeSH
• virus příušnic imunologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• dopisy MeSH
• komentáře MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• protilátky virové MeSH
• vakcína proti příušnicím MeSH
• vakcína proti spalničkám, příušnicím a zarděnkám MeSH

The Czech Republic has had a two-dose measles, mumps and rubella (MMR) vaccination programme since 1987. The last outbreak of mumps was reported in 2002, but an increase in the number of mumps cases was observed in 2005, starting in October that year. We analysed routinely collected surveillance data from 1 January 2005 to 30 June 2006 to show the magnitude of the increase and describe the most affected groups in order to better target prevention and control strategies. In the 18-month period examined, 5,998 cases of mumps were notified, with a peak incidence in May 2006. No deaths were recorded, but 21% of cases were hospitalised. Incidence was lowest in the Plzen region (1.9/100,000) and highest in Zlin (118.6/100,000). There were more male (61.8%) than female cases. The age of the cases ranged from 0 to 80 years. The highest incidence rate was observed in the age group of 15 to 19 years, in which 87% of cases had received two doses of mumps vaccine. The average age of unvaccinated cases was 22.9 years, while for cases vaccinated with two doses it was 14.5 years. Although vaccine effectiveness could not be calculated from the data available, possible reasons for highly-vaccinated cases occurring are discussed.

• MeSH
• dítě MeSH
• dospělí MeSH
• epidemický výskyt choroby * MeSH
• kohortové studie MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• očkovací programy statistika a číselné údaje   MeSH
• předškolní dítě MeSH
• příušnice epidemiologie   prevence a kontrola   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• surveillance populace MeSH
• vakcína proti spalničkám, příušnicím a zarděnkám terapeutické užití   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství 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 epidemiologie   MeSH
• Názvy látek
• vakcína proti spalničkám, příušnicím a zarděnkám MeSH

• MeSH
• dítě MeSH
• dospělí MeSH
• epidemický výskyt choroby * MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• Listeria monocytogenes izolace a purifikace   MeSH
• listeriové infekce epidemiologie   prevence a kontrola   MeSH
• mladiství MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

The study objective was to determine the rate of failures to present for routine childhood immunization due to either parental vaccine refusal, failure to comply with the immunization schedule and real or false contraindications. The rate of use of alternative vaccines which can be provided within the routine immunization schedule either on parental request or when recommended by the physician was also determined. We analyzed records of 5,038 children born between January 1, 2000 and December 31, 2004 and registered with a sample of general practitioners. We identified 1,284 cases (25.5 %) of no, incomplete or alternative vaccination. Failure to present for immunization with at least one vaccine as scheduled due to contraindication was stated in 291 (5.8 %) children; a total of 436 contraindications were reported (more than 1 contraindication in some children). The most common contraindication was a CNS disorder (171 cases) such as encephalopathy, epilepsy or unspecified conditions. Sixty-nine children (1.4 %) remained nonvaccinated against at least one disease (due to parental vaccine refusal or failure to comply with the immunization schedule). Alternative vaccines were administered to 936 (18.5 %) children for the following reasons: contraindication in 275 (5.5 %) children and on parental request in 716 (14.2 %) children (cost incurred by parents), with 55 (1.1 %) children given alternative vaccines for both reasons. These results suggest that contraindications and the use of alternative vaccines are quite common and need to be monitored.

• MeSH
• dítě MeSH
• imunizace * psychologie   statistika a číselné údaje   MeSH
• kontraindikace MeSH
• lidé MeSH
• očkovací schéma MeSH
• odmítnutí účasti * MeSH
• souhlas rodiče * MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Surgery results in chronic pain in 7-80 percent. One of the most studied is chronic post-mastectomy pain. The prevalence was 40-50 percent in studies performed abroad. As this problem has not yet been studied in the Czech Republic, a retrospective prevalence study was performed to asses the extent of the problem and risk factors for development of chronic post-mastectomy pain. METHODS AND RESULTS: After ethic committee approval an anonymous questionnaire was developed and distributed in various oncology department and patients'organisations. Response rate was 100 percent, 330 questionnaires were processed. Chronic post-mastectomy pain (lasting longer than 3 months after surgery) was described by 69 (20.9 per cent) women. The pain was permanent in 17 and transient in 46 cases, not specified in 6 cases. The pain intensity was predominantly mild or moderate. Risk factors were younger age (below 55-60 years, p=0.0098), less extensive surgery (tumourectomy vs. mastectomy, p=0.0017), intensive post operative pain (p=0.0002) and radiotherapy (p=0.0174). Trend in chemotherapy (p=0.0778) was observed. CONCLUSIONS: The prevalence of chronic post-mastectomy pain was lower in our study comparing to studies in other countries. The reason remains obscure in spite of detailed analysis.

• MeSH
• chronická nemoc MeSH
• lidé středního věku MeSH
• lidé MeSH
• mastektomie * MeSH
• měření bolesti MeSH
• pooperační bolest etiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

Salmonellosis and campylobacteriosis are the most frequently reported acute enteric diseases of infectious origin in the Czech Republic. Epidemiological data on salmonellosis and campylobacteriosis have been reportable in this country since 1951 and 1984, respectively. In 2003, 53,486 cases of acute enteric infections were reported: 26,899 (52%) diagnosed as salmonellosis and 20,063 (almost 40%) diagnosed as campylobacteriosis. In 1989, the annual incidence of salmonellosis was three times as high as in the previous year, the upward trend continued until 1995 (528/100,000) and since 1998 the salmonellosis incidence rates have been declining. The incidence of campylobacteriosis showed a progressive increase since 1984 to peak in 2002 with a following slight decline in 2003. Morbidity from salmonellosis and campylobacteriosis is highest in the age group 0-4-year-olds. The most frequent causative agents are Salmonella Enteritidis (96%) and Campylobacter jejuni, respectively. Both infections are foodborne. Ready-to-eat meals, poultry, confectionery and eggs seem to be most frequently implicated in outbreaks of salmonellosis in public catering and families. Sporadic cases of campylobacteriosis are mostly associated with ingestion of poultry and chopped meat. The incidence rates of these two infections are positively correlated with the average daily temperatures.

• MeSH
• akutní nemoc MeSH
• Campylobacter jejuni MeSH
• enteritida epidemiologie   mikrobiologie   MeSH
• incidence MeSH
• kampylobakterové infekce epidemiologie   MeSH
• kojenec MeSH
• lidé MeSH
• nemoci přenášené potravou epidemiologie   mikrobiologie   MeSH
• otrava salmonelou epidemiologie   MeSH
• předškolní dítě MeSH
• Salmonella enteritidis MeSH
• salmonelóza epidemiologie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND: Multidrug-resistant (MDR) tuberculosis, defined as a disease caused by Mycobacterium tuberculosis strains, which are resistant to more antituberculous drugs (at least to isoniazid and rifampicin), is a problem frequently discussed in the Czech Republic. Cases of specific disease refractive to causal antituberculous therapy are associated with the risk of the spread of the causative agent among the population. METHODS AND RESULTS: The National Reference Laboratory for Mycobacteria collected 2813 Mycobacterium tuberculosis strains isolated by Czech mycobacteriological laboratories in 1999 to 2001. All strains were tested for susceptibility to basic antituberculous drugs and then the MDR strains were further tested for susceptibility/resistance to other antituberculous and antibacterial drugs. The MDR strains were studied by DNA analysis (DNA fingerprinting restriction analysis, RFLP-Restriction Fragment Length Polymorphism) as well. Thirty-nine patients who had MDR tuberculosis were excretors of 56 Mycobacterium tuberculosis strains. In average, MDR tuberculosis accounted for 1.96% (1.7-2.4) of all cases of bacillary tuberculosis. The most frequent type of the multidrug resistance was that resistant to four basic antituberculous drugs (isoniazid, rifampicin, ethambutol and streptomycin). It was confirmed in 48.2% multidrug resistant strains. CONCLUSIONS: Isepamicin, clofazimin, capreomycin and amikacin are considered to be the most promising antituberculosis drugs. Based on RFLP profiles, 61.5% of strains were placed into 8 clusters while the other strains remained unclustered. No significant differences in geographical distribution and population structure were found between the excretors of clustered strains and those of unclustered strains. Preliminary comparison with restriction profiles of the MDR Mycobacterium tuberculosis strains in the international database suggests the uniqueness of Czech strains showing the profiles not found elsewhere to date.

• MeSH
• DNA fingerprinting MeSH
• lidé MeSH
• mikrobiální testy citlivosti MeSH
• multirezistentní tuberkulóza epidemiologie   mikrobiologie   MeSH
• Mycobacterium tuberculosis účinky léků   genetika   MeSH
• polymorfismus délky restrikčních fragmentů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

In recent decades an increase in the number of fractures of the proximal femur was recorded in this country and world-wide. The majority of patients with this diagnosis is above 70 years of age and their treatment comprises in addition to the medical aspect also economic and social problems. The objective of the present work is to summarize briefly the results achieved during the five-year trial focused on socio-economic problems of treatment of patients with fractures of the proximal femur. The investigated group comprised 244 patients hospitalized at the Orthopaedic Department of the Third Faculty of Medicine Charles University in 1997 with 248 fractures of the proximal femur. Thirty-nine fractures were treated conservatively, 116 by internal fixation and in 93 cases an arthroplasty was implanted. In the course of the first year of treatment 85 patients died. The therapeutic results after one year were evaluated in 159 patients. The total annual costs of the investigated group were 15.9 million crowns. The mean annual costs of treatment of one fracture of the proximal femur was 64,000 crowns. The ratio of deaths rose with age (p = 0.003), it did not depend on the social background of the patient (p = 0.16) and the quality of locomotor activity before the injury (p = 0.16). No type of fracture was associated with a higher or lower mortality (p = 0.09). A statistically significant higher mortality was recorded in patients included in the higher class of the ASA score (p < 0.001) and in conservatively treated patients (p < 0.001). The type of anaesthesia did not affect the mortality. The functional results were significantly worse in patients living before the injury in a dependent position (0.01 < p < 0.05) and with restricted physical activity (p < 0.01). The type of fractures did not affect significantly the functional results (p > 0.05). Poorer functional results were recorded in patients with ischaemic heart disease (p < 0.001) and neurological disease in their history (p < 0.001). Also inclusion into a higher class of surgical risk according to the ASA score was associated with poorer functional results (p < 0.001). Different types of anaesthesia and different methods of surgical treatment did not affect the quality of functional results. However the functional results were better in operated patients as compared with conservatively treated patients (p < 0.001).

• MeSH
• fraktury kyčle ekonomika   chirurgie   MeSH
• hodnocení výsledků zdravotní péče MeSH
• lidé středního věku MeSH
• lidé MeSH
• náklady na zdravotní péči MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• socioekonomické faktory MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH