Seroprevalence of hantavirus antibodies among chronic hemodialysis patients in the Czech Republic.

A total of 348 serum samples were collected from 301 hemodialysis patients with chronic renal failure of four healthcare settings in Western Bohemia. The sera were screened for the presence of hantavirus antibodies using ELISA kits (PROGEN Biotechnik GmbH) with Hantaan and Puumala antigens. Specific anti-Puumala antibodies were detected in five patients (1.7%). Although hantaviruses are known to cause primarily acute renal damage (interstitial nephritis) in Eurasia, chronic effects of hantavirus infection and the detection of specific antibodies in hemodialysis patients have also been reported. Nonetheless, the detection of seropositivity is not proof of an etiological link between hantaviruses and chronic renal failure. The hantavirus seropositivity rate in hemodialysis patients was not significantly higher than that in the general population. Our findings are consistent with the literature data and do not contradict the contribution of hantaviruses to the pathogenesis of chronic renal damage in the Czech Republic.

Borreliae in immature Ixodes ricinus (Acari:Ixodidae) ticks parasitizing birds in the Czech Republic.

Of 411 forest birds of 33 species examined near Valtice, Czech Republic, 29% were infested with Ixodes ricinus (L.); 2.2% were parasitized by Haemaphysalis concinna Koch. Borreliae were detected in 5.1 and 11.7% of larval and nymphal I. ricinus, respectively. None of the 13 H. concinna tested was infected. In total, 3.2% of the birds examined were parasitized by I. ricinus immatures infected by borreliae. Borreliae-containing ticks parasitized European robin, Erithacus rubecula (L.); Eurasian blackbird, Turdus merula L.; Blackcap, Sylvia atricapilla (L.); Eurasian chiffchaff, Phylloscopus collybita (Vieillot); Great tit, Parus major L.; and Eurasian jay, Garrulus glandarius (L.). The isolate BR-34 from a nymphal I. ricinus off a Eurasian blackbird had a sodium dodecyl sulfate-polyacrylamide gel electrophoresis protein pattern, reactions to monoclonal antibodies, and fragments of HindIII digested DNA probed with fla and ospA genes that suggested to us that it belongs to the genospecies Borrelia garinii. Free-living birds may be involved in the circulation of B. burgdorferi sensu lato principally as disseminators of infected ixodid ticks to new area.

Effect of ascorbic acid prophylaxis on the frequency of chromosome aberrations, urine mutagenicity and nucleolus test in workers occupationally exposed to cytostatic drugs.

The genetic risk of workers occupationally exposed to a series of newly developed cytostatic drugs and the presumed antimutagenic potential of ascorbic acid (AA) were studied in a group of 38 chemical laboratory personnel examined for chromosome aberrations in lymphocytes, urine mutagenicity and nucleolar RNA activity before and after a 6-month prophylactic administration of AA at daily doses of 1 g for 5 days a week. Chromosome aberration tests revealed elevated aberrant cell (AB.C) rates both prior to and after AA supplementation (3.9% and 3.65% of AB.C., respectively). These values were significantly higher than those found in 18 non-exposed matching controls (1.05% of AB.C.). Tests for mutagenic activity in the urine of drug-exposed workers revealed 64% positive urine samples prior to vitaminization and 60% positive urine specimens after it; positive urine samples in the group of controls accounted for 21% of samples. In the nucleolus test, numbers of inactivated micronuclei in the exposed were initially higher than those of controls (33.4% versus 24.3%), but dropped to 20.5% after AA supplementation. These findings show that AA prophylaxis alone cannot substantially reduce the hazards associated with exposure to anti-cancer drugs.

Development of bacterial resistance to the third generation cephalosporins and their clinical use.

Development of Gram-negative rods resistance to the third generation cephalosporins (cefotaxime, ceftazidime, cefoperazone) in connection with their application at the University Hospital in Olomouc was evaluated in this study. The highest increase in resistance to cefotaxime was detected in Enterobacter cloacae (from 22.9% in 1995 to 49.0% in 1997) and Enterobacter agglomerans strains (28.0% - 40.5%). In addition, increased resistance to ceftazidime in Acinetobacter baumannii (12.5% - 35.1%), Enterobacter aerogenes (7.4% - 20.9%), Enterobacter cloacae (16.7% - 47.2%) and Pseudomonas aeruginosa (4.0% - 26.3%) was observed. Finally, the greatest increase in frequency of strains resistant to cefoperazone was observed in E. aerogenes (18.4% - 30.1%), E. agglomerans (31.0% - 52.3%), E. cloacae (35.5% - 47.2%) and Providencia rettgeri (26.5% - 53.2%). A 23.5% increase in third generation cephalosporin use was evident by evaluation of RDDD(ATB) parameters in 1996 and 1997. Corresponding values for individual antibiotics were 26.5% cefotaxime, 20.7% ceftriaxone, and 40.3% ceftazidime increase. However, cefoperazone use decreased by 10.9%.

Environmental genotoxicity monitoring using Salmonella typhimurium strains as indicator system.

Screening for mutagens in environmental complex mixtures is gradually accepted as a routine methodology in the monitoring processes. Examination of 70 drinking water samples showed that the variations in the degree of mutagenicity was dependent on the location of the water source and the type of drinking water tested. Analogous screening for mutagens in river and waste waters may help better assess the potential genotoxic hazard from various types of industrial technology. The recommended methods are routinely used for monitoring the mutagenicity and for checking the effectiveness of preventive measures.

Biochemical properties and differentiation of coagulase-positive staphylococci from rooks and gulls.

Coagulase-positive staphylococci were found in the throats of 46 rooks (69 per cent) and 47 gulls (21 per cent) out of totals of 67 and 229 birds, respectively. Of 111 strains isolated from throat swabs 86 (77.5 per cent) were classified as Staphylococcus aureus and 25 strains (22.5 per cent) as Staphylococcus intermedius. Of the S aureus strains 82 per cent from rooks and 50 per cent from gulls were biotyped. Most of them were identified as biotypes D and B, only a few as biotype A, and none as biotype C. Moreover, among the 24 S intermedius strains (96 per cent) biotypes 1 and 2 could be differentiated according to the type of growth on crystal violet agar and their ability to produce acetoin and acid from maltose, mannitol and trehalose.

Phage typing coagulase-positive staphylococci from rooks and gulls.

Phage typing was performed on 86 strains of Staphylococcus aureus and 25 strains of Staphylococcus intermedius from rooks and gulls with human, bovine, chicken and canine phages. Eighty per cent of the S aureus strains and 64 per cent of the S intermedius strains were typable. The S aureus biotype D strains of rook origin were specifically lysed at routine test dilution (RTD) by chicken phages from groups I or I + IV, by human phages belonging to groups I and M, and partly by canine phage 58. The other rook and gull S aureus strains did not show characteristic phage patterns. The S intermedius strains isolated from both species of birds could be typed only with canine phages and this correlated with their classification into biotypes. All the biotype 1 strains tested but only two of 12 biotype 2 strains were lysed with canine phages at RTD.

Occurrence of variants with temperature-dependent susceptibility (TDS) to antibiotics among Stenotrophomonas maltophilia clinical strains.

Susceptibility to 20 antibiotics was tested in 104 Stenotrophomonas maltophilia strains at 37 and 30 degrees C by means of a dilution micromethod to verify the phenomenon of temperature-dependent susceptibility (TDS). Trimethoprim-sulfamethoxazole, pefloxacin and ofloxacin were the most active preparations at 37 degrees C (93, 90, and 86% of susceptible strains, respectively), whilst trimethoprim-sulfamethoxazole, cefoperazone-sulbactam and pefloxacin performed best at 30 degrees C (94, 94, and 76% of susceptible strains, respectively). Variants 37TDS (minimum inhibitory concentration, MIC, of tested antibiotics at least 4-times lower at 37 than at 30 degrees C) occurred in 60%. Variants 30TDS (at least 4-times lower value of MIC at 30 than at 37 degrees C) were found in 7.7%. Both variants in susceptibility to tested antibiotics appeared in 23.1%, whilst neither of them was observed in 9.6%. The 37TDS phenomenon was recorded most of all with gentamicin (51% of strains), amikacin (47), colistin (44) and tetracycline (34). The 30TDS phenomenon was found particularly with cefoperazone-sulbactam (16.0% of strains) and colistin (10.0%). The above phenomena may be due to changes in membrane permeability, temperature-dependent ribosomal changes, and insufficient adaptation to higher temperatures of some strains of the originally environmental species S. maltophilia.

[Personal experience with classification of yeast microorganisms. I. The combined biotyping method of Mencl and Otcenásek and typing using the "killer" phenomenon]. / Nase zkusenosti s klasifikací kvasinkovitých mikroorganismu. I. Kombinovaná biotypizacní metoda podle Mencla a Otcenáska a typizace s vyuzitím "killer" fenoménu.

Using a group of 150 isolates of Candida albicans, C. glabrata, C. krusei, C. tropicalis, C. parapsilosis a C. kefyr the differentiating capacity of two biotyping systems was tested-the combined method according to Mencl and Otcenásek, and typing using the so-called killer phenomenon. With the combined method comparable results with the original work of the authors were obtained. This applies to the number of biotypes as well as to the ratio of the dominant biotype. As regards the differentiating characteristics of different biotypes the two studies differed fundamentally. As to typing, using the "killer" phenomenon, its practical usefulness was tested, the differentiating capacity of the method was, however, very much influenced by the small number of available killer-positive yeast strains.

[Occurrence and characteristics of gram-negative rods with marginal sensitivity and resistance to ofloxacin]. / Výskyt a charakteristika gramnegativních tycek s hranicní citlivostí a s rezistencí k ofloxacinu.

In the submitted paper the authors focused their attention on the characteristics of Gram-negative bacteria with a marginal sensitivity and resistance to ofloxacin (MIC > or = 2 mg.l-1) isolated from clinical materials in the Olomouc Faculty Hospital. They give an account of their sensitivity (based on assessment of the minimal inhibitory concentration-MIC) to 20 other antibiotics and chemotherapeutic agents and the percentage ratio of different species according to department, clinical material and diagnosis.

[Comparison of the results of antibiotics sensitivity tests using the standard microdilution method on isolated bacteria and the direct disc method on positive hemocultures from the automatic BacT/Alert system]. / Porovnání výsledku testování citlivosti k antibiotikum standardní dilucní mikrometodou u izolovaných bakterií a "prímou" diskovou metodou u pozitivných hemokultur z automatického systému BacT/Alert.

During a six-month period 2,221 haemocultures obtained from patients hospitalized in the Faculty Hospital Olomouc were examined. In all 304 isolated bacteria the sensitivity was assessed by the standard dilution micromethod and moreover all positive haemocultures were examined the "direct" disc method. Agreement between the results of the two methods was proved in 84% of pairs of tests and within a range from 67 to 100%, depending on the type of antimicrobial preparation. Based on these findings it may be stated that assessment of the sensitivity by the "direct" method agrees significantly with assessment of the sensitivity according to minimal inhibitory concentrations (MIC). In patients with septicaemia this procedure makes it possible to change empirical antibiotherapy by 24 hours sooner to aimed therapy.

[Occurrence of Klebsiella pneumonia strains resistant to third-generation cephalosporins at the Pediatric Clinic of the Medical School Hospital in Olomouc]. / Výskyt kmenu Klebsiella pneumoniae rezistentních k cefalosporinum III. generace na Detské klinice Fakultní nemocnice v Olomouci.

The authors describe the high incidence of strains of Klebsiella pneumoniae resistant to cephalosporins of the IIIrd generation at the department of pathological neonates of the Paediatric Clinic of the Faculty Hospital in Olomouc. They discuss possible reasons for this adverse situation and the way how to resolve it. They emphasize the necessity of rational administration of antibiotics and continuous monitoring of resistance in the most frequent causal agents of bacterial infections.

[Development of a vaccine for treatment of urinary tract infections]. / Vývoj vakcíny pro lécbu zánetlivých onemocnení mocových cest.

Receiving uroinfections are predominantly treated with antibiotics and chemotherapeutics. An effective alternative treatment can be immunotherapy with inactivated bacteria. The authors have focused on the development of polybacterial vaccine with both specific and nonspecific immunostimulatory activity. The vaccine contains killed bacteria which most frequently occur as an etiological agent in urinary tract infections. Determining for the selection of particular strains for the vaccine preparation were their immunostimulatory properties evaluated after intraperitoneal application of killed cells to mice. The results were evaluated according to weight gain of liver and spleen and verified by histological examination of these organs. The final form of the vaccine URVAKOL contains immunogenically most active strains of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa and Enterococcus faecalis, representing specific effective part of the preparation, adjuvant activity is provided by Propionibacterium acnes. (Tab. 1, Fig. 2, Ref. 27.)

[Occurrence of gram-negative non-fermenting rods in hemocultures and their sensitivity to antimicrobial agents]. / Výskyt gramnegativních nefermentujících tycinek v hemokulturách a jejich citlivost na antimikrobní preparáty.

In the period from January 1993 to June 1996 were at the Department of Microbiology of the University Hospital in Olomouc 122 strains of Gram-negative nonfermentative rod-shaped bacteria isolated from haemocultures. The majority represented the group of 51 strains of the genus Acinetobacter (41.8%), complex A. calcoaceticus-baumannii (Acb complex). The second largest group were 21 strains (17.2%) of Pseudomonas aeruginosa. These were followed by 17 strains (13.9%) of Stenotrophomonas maltophilia, 8 strains (6.6%) of non-Acb complex acinetobacters, 6 strains (4.9%) of Pseudomonas putida and 5 strains (4.1%) of Alcaligenes xylosoxidans. The remaining species were represented only by 1-2 strains. In three isolations was the identification impossible. The majority of strains (24.6%) were from the Department of Haematology of the University Hospital in Olomouc. The most frequent diagnoses in patients with positive haemocultures were leukemias and lymphomas (24.6%). The most effective tested antimicrobial agents were ceftazidime (93.4% of sensitive strains) and ofloxacin (91.7%). From the total number of 80 strains detected using the equipment BacT/Alert 120, 22 (27.5%) were isolated repeatedly confirming their role in the etiology of bacteriemic or septic episodes. Because only one blood sample was obtained in 34 cases (58.6%) of the remaining 58 only once detected strains, it was impossible to confirm their etiologic role by repeated isolation. (Tab. 6, Ref. 22.)

[Characteristics of multiresistant gram-negative bacteria and their occurrence at the Medical School Hospital in Olomouc]. / Charakteristika multirezistentních gramnegativních bakterií a jejich frekvence ve Fakultní nemocnici v Olomouci.

Currently, a persistent growth of bacterial resistance to antibiotics takes place. Multiresistant bacterial strains thus represent a serious danger for therapy in practice. The aim of the study was to characterize the multiresistant Gram-negative bacteria and to judge their antibiograms by using the minimum inhibition concentrations (MIC). At the same time the study evaluates the relations to the most frequent diagnoses and epidemiologic data concerning the occurrence of these strains in different clinical cases treated at individual departments of the Faculty Hospital in Olomouc. Out of the total of 4.988 strains of Gram-negative rods, the number of isolated multiresistant strains reached 316 (6.3%). Individual bacterial species were isolated in the following order: Pseudomonas aeruginosa (28.8%), Enterobacter cloacae (23.4%) and Acinetobacter Baumannii complex (Acb complex) (18.7%). The most frequent occurrence of investigated bacteria was registered at the departments in the following order: urology (45.9%), internal medicine (18%), paediatrics (13.6%), and surgery (11.1%). The most frequent diagnoses based on positive cultivation of these bacteria were the infections of the urogenital tract (53.8%), postoperative infections (16.8%), and the infections of the upper respiratory ducts (7.3%). 64.2% of strains were cultivated from urine, 16.1% from pus, and 6.9% from swabs taken from the upper respiratory ducts. (Tab. 8, Ref. 18.).

[Immunostimulating activity of vaccines in the treatment of recurrent urinary tract infections. I]. / Immunostimulacní aktivita vakcíny pro lécbu recidivujících uroinfekcí. I.

The authors inform about the immunomodulatory properties of the vaccine URVAKOL aimed for the treatment of recidiving urinary infections. The results of immunostimulatory activity of the preparation and its effects on cellular and humoral immunity in mice following intraperitoneal administration of the vaccine are presented. The vaccine markedly increases cytotoxic activity of adhering peritoneal cells and has protective effects in model infection induced by intracellular pathogen Francisella tularensis (strain 15 L). (Tab. 6, Fig. 6, Ref. 9.)

[Immunostimulatory activity of the vaccine used in the treatment of recurrent urinary infections. II]. / Imunostimulacní aktivita vakcíny pro lécbu recidivujících uroinfekcí. II.

The authors describe on the immunostimulatory properties of the vaccine URVAKOL aimed for the treatment of recurrent urinary infections. Detection of immunostimulatory activity of the preparation and its effects on the humoral and cellular immunity were performed after oral administration of the preparation. Important was the evidence of nonspecific immunity of mice against intracellular pathogen Francisella tularensis induced with URVAKOL strain 15L. (Tab. 4, Fig. 1, Ref. 8.)

[Immunomodulation of recurrent urinary tract infections with Urvakol vaccine]. / Imunomodulace recidivujících uroinfekcí vakcínou URVAKOL.

The authors present the results of the URVAKOL vaccine use in clinical practice. The vaccine was administered in the treatment of recurrent cystitis, persistent lower urinary tract infection, chronic pyelonephritis and prostatovesiculitis. The clinical efficacy of the vaccine was assessed by detection of bacteria and leukocytes in the urine, subjective complaints, skin tests and the assessment of selected specific and nonspecific immunity parameters in the urine and saliva. Significantly positive clinical and laboratory responses were observed in patients with uncomplicated cystitis. In the group of persistent urinary tract infections excellent responses were detected in one half of the patients. The remainder half stated disappearance of subjective complaints, but with persistence of pyuria or bacteriuria. Similar results of "improvement" were observed in 10 patients with chronic pyelonephritis. There were no changes of the clinical state observed in patients with chronic prostatitis. (Tab. 5, Fig. 2, Ref. 7.)

[Systemic administration of antibiotics in therapy of brain abscesses. Present trends and possibilities]. / Celková aplikace antibiotik pri lécbe mozkových abscesu. Soucasné trendy a moznosti.

The authors describe possibilities as regards selection of antibiotics in the general treatment of brain abscesses. They mention the most frequent aetiological agents of the disease in relation to predisposing factors and site. Systemic antibiotherapy along with surgery is considered by the authors decisive in the therapy of these conditions.

[Hepatitis C virus antibodies in persons on dialysis]. / Protilátky proti viru Hepatitidy C u dialyzovaných osob.

Using the ELISA method (generation II), the authors made a single examination of 172 dialyzed patients for the presence of antibodies against the virus of hepatitis C (VHC). Antibodies were detected in 82 subjects, i. e. 47.7%. The prevalence of antibodies in the examined subjects increased with the number of dialyses, no relationship was found with the number of transfusions. Of 104 subjects where during inclusion into the dialyzation transplantation programme a rise of ALT occurred 69, i. e. 66.3%, had antibodies. Antibodies were detected in 17 of 44 subjects (38.6%) to whom so far blood was not administered. A decisive place in the prevention of VHC transmission in dialyzed subjects is held by non-specific preventive measures, transfusions are most probably not the decisive vehicle.