Typhoid fever in the Czech Republic and an imported case after return from the Rainbow Gathering in Italy.

Typhoid fever is a disease caused by the highly virulent bacterium Salmonella Typhi. It is transmitted by the oral-faecal route. In the Czech Republic, 53 cases of typhoid fever were reported in 1997-2017. Only seven of these cases were autochthonous. In August 2017, an imported case of typhoid fever was recorded in a 25-year-old unvaccinated woman who participated in the Rainbow Gathering in Italy one week prior to the onset of the disease. During her stay in Italy, she slept in a tent, ate her own food, and drank unboiled water. Presenting with persisting cough, tiredness, muscle and joint pain, and fever up to 40 °C after her return, she was admitted to the Třebíč Hospital where she was diagnosed with S. Typhi. The epidemiological investigation identified six contacts. On discharge from hospital and at follow-up, the patient was tested negative. None of the contacts became ill.

Cases of Salmonella Urbana in Finland, the Czech Republic and Latvia, January-February 2010.

A cluster of 14 cases of Salmonella Urbana cases in Finland, the Czech Republic and Latvia were identified in January-February, 2010. The majority of cases (11) were male and children under 16 years of age. The investigation is currently ongoing and comparison of pulsed-field gel electrophoresis (PFGE) profiles of the isolates suggests that the cases may have a common source of infection.

[Prevalence and characteristics of Salmonella in selected localities of the Czech Republic--comparison of epidemiological and laboratory data]. / Výskyt a charakteristika salmonel ve vybraných lokalitách Ceské republiky--porovnání epidemiologických a laboratorních dat.

UNLABELLED: The study objectives were to characterize in detail human isolates of Salmonella in selected localities of the Czech Republic and to consider the actual epidemiological situation in the country based on the comparison with the reported cases of salmonellosis (source EPIDAT). METHODS: The source of the national epidemiological data was EPIDAT (communicable disease notification system). Laboratory data was obtained by analysis of Salmonella isolates from five clinical laboratories in Bohemia and Moravia. The isolates were collected at regular intervals from January to August and their numbers were indicative of the local epidemiological situation. The Salmonella strains were serotyped and those of serotypes Enteritidis and Typhimurium were phage typed. RESULTS: Epidemiological data analysis confirmed that the predominant causative serotype in the study period was Enteritidis, implicated in 5 329 (89.8%) of 5 934 reported cases of salmonellosis, followed by Typhimurium (302 cases, i.e. 5.1%). Laboratory data analysis revealed a lower incidence of the serotype Enteritidis (found in 231, i.e. in 84.6%, of 273 tested strains) and the same incidence of the serotype S. Typhimurium (14 strains, i.e. 5.1%). The most common phage types among strains of serotype Enteritidis were PT8, PT4, PT13a and PT6 while phage type DT104 was most often detected among strains of serotype Typhimurium. Moreover, the study revealed differences between the numbers of reported (EPIDAT) and laboratory diagnosed cases of salmonellosis. Within the study period, 111 (40%) cases of salmonellosis remained unreported in the study localities. CONCLUSION: The study has shown that the characteristics of Salmonella isolates (serotyping, phage typing and antimicrobial resistance data) relevant to the epidemiological data collection are either inaccurate or unavailable. Therefore, a national system needs to be created for the collection of Salmonella clinical isolates that should be further typed to obtain data for the monitoring at both the national and international levels.

Epidemiological role of arthropods detectable in health facilities.

A total of 161 arthropod specimens were collected from 55 sites in a health care facility during July and September 1990. Of the 116 bacterial isolates obtained from their body surfaces 6% were from parasites (mosquitoes), 59% from eusynanthropic arthropods (Tenebrionid beetles, flies, German cockroaches, wasps), 16% from hemisynanthropic arthropods (ants, spiders) and 19% from occasionally encountered insects (non-biting midges, moths, beetles). Most (88%) of the isolated bacteria were Gram-negative rods of the species E. coli, Enterobacter, Klebsiella, Citrobacter, Proteus, Serratia, Pseudomonas and Acinetobacter. Gram-positive cocci accounted for 13% of isolates and were primarily represented by coagulase-negative staphylococci. The highest isolation rates were from body surfaces of flies, German cockroaches, non-biting midges (Chironomids) and Tenebrionid beetles. About one third of all isolates were resistant to more than three antimicrobials using a standard disc diffusion assay. The presence of multiple resistance to antibiotics was observed in two thirds of Enterobacter isolates, namely those of Enterobacter cloacae from the body surface of Germany cockroaches, in 13% of Citrobacter spp and in 8% of Klebsiella spp as well as Acinetobacter calcoaceticus strains. Strains of Morganella and Hafnia species were very infrequent but all of them shared resistance to the antibiotics tested. In contrast, strains of Serratia spp were relatively antibiotic-sensitive. The group of isolated Gram-positive organisms was represented by two strains of Staphylococcus hominis and one strain of Enterococcus sp, all of them were multiply-resistant to antimicrobials.

Emergence of multidrug resistant Salmonella thyphimurium DT 104 in the Czech Republic.

The Czech Republic is a country in central Europe with a population of about 10 million inhabitants. Salmonellosis is the most commonly reported infectious intestinal disease. Until 1989 about 10 000 cases were reported each year, and similar numbers of S

Arthropods in a hospital and their potential significance in the epidemiology of hospital infections.

Synanthropic and other arthropods were collected and examined for microbes in the summer seasons of 1988 and 1990. The collection was performed in a Prague hospital with departments situated in separate buildings, each surrounded by a park. In 1988, the most attention was given to flies (35 species collected) found outside between the buildings. In 1990, all arthropods found inside the buildings (particularly in the departments of dermatology and urology) were studied. A total of 30 taxons were identified. The microbes found on the bodies of arthropods were isolated in both seasons. In 1990, the hospital environment and biological material from patients (urine, pus) were also examined for the presence of microbes. Altogether 108 strains (21 species) and 116 strains (25 species) were isolated from the arthropods' bodies in 1988 and 1990, respectively. The ecological characterization of the arthropods and results of microbiological studies show that synanthropic arthropods play a significant role in the epidemiology of hospital infections.

[Salmonellosis in children under 2 years of age]. / Salmonelózy u detí do dvou let veku.

The authors pay attention to the mode of transmission of salmonelloses in children under two years of age, where the highest specific morbidity was recorded. Using phenotypic (biochemical properties, sensitivity to antibiotics, phagotype) and genotypic properties (presence of plasmids) they examine five sporadic and seven epidemic incidences of salmonelloses in young children. The most frequent agent is Salmonella enteritidis, phagotype 8, plasmid 55 kb. Strains of S. enteritidis are isolated from the faeces of affected children, their family contacts, from food and the sick child's environment. Alimentary transmission by the incriminated food was detected from epidemic incidence where the vehicle were confectionery products contaminated by S. enteritidis. In sporadic cases in families also direct and indirect contact may have participated in the transmission of infection.

[Properties of Salmonella isolates in the Czech Republic]. / Vlastnosti salmonelových izolátu v Ceské republice.

Based on a grant project "Use and importance of epidemiological markers in Salmonella enteritidis and Salmonella typhimurium in the spread of salmonelloses in children under two years of age" implemented in 1995 to 1997, the authors investigated epidemiological markers in 1,186 salmonella isolates; the strains were isolated from faeces of 838 sick children, from 266 faeces of their contacts, from 49 specimens of incriminated foods and from 33 smears from the children's environment. Of 1,186 Salmonella isolates 999 were strains of S. enteritidis, 39 strains of S. typhimurium and 148 strains were not identified. The markers of Salmonella isolates were investigated from the aspect of biotyping--98% S. enteritidis were formed by the biovar Jena. 2% by biovar Essen; sensitivity to antibiotics--94.5% Salmonella strains were sensitive to 12 selected antibiotics, 2.9% were resistant and in 2.6% the resistance was in the intermediate zone; phagotyping--in 808 strains of S. enteritidis PT 8--88% predominated, in S. typhimurium DT 104 and DT 141; assessment of plasmid profiles--in strains of S. enteritidis plasmid 55 kb predominated, in three strains of S. typhimurium a plasmid size 95 kb; virulence--was compared in 43 strains isolated from hospitalized children with a severe clinical course with 39 strains from children treated at home. In vitro tests revealed that hospitalization of affected children was associated with virulence of the strains (SE phagotype 8) and not with age. The presented results are discussed with regard to the epidemiological situation in the Czech Republic and in the world.

Characterization of Salmonella enterica serotype typhimurium in the Czech Republic: phage types, antimicrobial and plasmid profiles.

In this study a collection of 547 S. Typhimurium strains isolated in the years 2000 and 2001 both of the human and non-human origin were analysed. 21 different phage types were detected, the most frequent one was DT104 (46%) followed by DT141 (28%) and DT68 (3%). Resistance to one or more antimicrobial agents was found mainly in DT104 (77.4%). S. Typhimurium isolates resistant to 5 and more antimicrobial agents were found in three phagetypes DT104 (57%), DT120 and DT155. Plasmid profiling of DT104 isolates showed 10 different profiles. Pattern A found in 30.5% of tested strains was predominant and carried serovar specific plasmid and one additional small plasmid of approx. 2.5 kb.

[Salmonellosis in the Czech Republic]. / Salmonelózy v Ceské Republice.

The submitted paper analyzes the treble increase of the annual incidence of salmonelloses in the Czech Republic in 1989-1991. It deals with the seasonal distribution of notified morbidity (it is highest in August, September, October), the age distribution (it is highest in 0-4-year-old children) and the geographical distribution (the most affected areas are the eastern Bohemian, southern Moravian and northern Moravian regions). The authors emphasize the high ratio of S. enteritidis in this rise (the ratio of S. E. increased from 55% in 1988 to 84% in 1991). They analyze the notified mass incidence of salmonelloses, where one third is accounted for by catering establishments of the so-called closed type; in 1989-1991 the highest ratio of salmonelloses was in works canteens. The authors confirm that the epidemic rise of salmonelloses in 1989-1991 is associated with the consumption of contaminated eggs, similarly as in other parts of the world. The most frequent vehicle of infection revealed in the Czech Republic are eggs, their products, in 1991 in particular confectionery and fancy cakes.

Detection of Salmonella spp. in stray dogs in Bursa Province, Turkey: first isolation of Salmonella Corvallis from dogs.

The prevalence and antimicrobial sensitivity of Salmonella spp. in stray dogs in Bursa province, Turkey were determined from a total of 82 faecal samples by bacteriological methods. Of the dogs, nine (11%) were positive for salmonellae-carrying. All Salmonella isolates were serotyped as S. Corvallis, and were sensitive to amoxycillin/clavulanic acid, ampicillin, cephalothin, chloramphenicol, enrofloxacin, gentamicin, kanamycin, nalidixic acid, neomycin, oxytetracycline and trimethoprim/sulphamethoxazole, while 66.7% of them were resistant to streptomycin. It was concluded that stray dogs could be an important carrier of salmonellae as well as a source of human salmonellosis in Turkey. Additional studies are needed to clarify the epidemiological relationship between S. Corvallis isolated from dogs and humans with regard to public health. This is the first report on the isolation of S. Corvallis from dogs in the country.

[Epidemic occurrence of alimentary bacterial infections in the Czech Republic 1979-1989]. / Epidemický výskyt alimentárních nákaz bakteriálního puvodu v Ceské Republice v letech 1979-1989.

The authors analyze the epidemic incidence of alimentary infections of bacterial origin in two periods: 1979-1983 and 1984-1988 and 1989 resp., where in each period the number of notified epidemics of different infections equals 100%. During the period 1984-1988 as compared with 1979-1983, there was a decline in the number of epidemics of salmonelloses in health institutions from 42% to 14%, whereby almost half these epidemics were caused by Salmonella agona spread via dried milk. Conversely there was an increase in the number of epidemics of salmonelloses in communities from 14% to 23% and in works canteens from 9% to 14%. In 68% of the latter Salmonella enteritidis dominated. In 1989 there was a potent increase epidemics of salmonelloses. In 86% of the notified epidemics Salmonella enteritidis was the aetiological agent. A quarter of these epidemics developed in works canteens and half the affected subjects were ill. The transmission occurred via poultry meat and egg products. The annual incidence of bacillary dysentery after 1985 has a declining trend, the epidemics persist in nursery schools, summer camps for children and are increasing in institutes for social care. The number of alimentary intoxications is rising in recent years, in particular in school and works canteens. The number of 008 epidemics in 1984-1988 declined in health institutions from 52% to 20%. 17% of the epidemics developed in schools and camps for children.

Long-term yersiniosis surveillance project in Czechoslovakia.

The paper presents an epidemiological analysis of 8,232 cases of yersiniosis caused by Y. enterocolitica 03 over 1972-1988 as reported by Hygienic Stations. The steady epidemiological characteristics of yersiniosis were the prevalence of children and boys and a typical seasonal pattern with differences between the Czech and Slovak Republics. In the Czech Republic, there were several incidence peaks following, when summarized, the incidence curve of other alimentary infections, whereas in the Slovak Republic morbidity reached its peak during winter months. The numbers of isolated strains oscillated significantly between districts and by years. It appears that the number of positive findings in different districts is not only an objective value reflecting a mosaic-like pattern of incidence but also depends on the quality of microbiological diagnostics.

[Use of markers of hospital strains in studying the occurrence of nosocomial infections]. / Vyuzití markeru nemocnicních kmenu pri sledování výskytu nozokomiálních nákaz.

The submitted paper deals with one of the possible aspects of the investigation of nosocomial infections, i.e. investigations of the properties of hospital strains, their importance and possible use. The incidence of bacterial hospital strains was investigated in a surgical department of a district hospital of the North Bohemian region in October 1990; at the time of the survey 29 nosocomial infections (36.1%) were revealed by the prevalence method. Bacterial hospital strains were isolated from patients with a nosocomial infection, from the attending staff and the hospital environment. The following markers were investigated: biotyping, phagotyping, serotyping, toxin production, sensitivity to antimicrobial substances and sensitivity to disinfectants. Based on results of marking of hospital strains 7 incidences with a possible epidemiological association were detected where the hospital strain of equal or very similar properties dominated. The results of the investigation confirmed the important participation of the attending staff in the spread of nosocomial infections, in particular via contaminated hands, and drew attention to shortcomings as regards adherence to the hygienic and epidemiological regime in the investigated department.

[Bacterial contamination of arthropods in a health facility]. / Bakteriální kontaminace clenovcu ve zdravotnickém zarízení.

At 55 sites of a health institution in July and September 1990 a total of 161 specimens of arthropods were detected, 30 outdoors and 131 on the premises of the health institution. On their bodies 116 bacterial strains were isolated, mostly Gram-negative rods (more than 85%), in particular spp. Enterobacter, Acinetobacter, Klebsiella, Citrobacter and Pseudomonas. Gram-positive cocci accounted for cca 12%, in particular strains of S. haemolyticus and S. hominis. The greatest number of strains was detected on bodies of cockroaches, flies, Chironomus and Tenebrio. In about one third of strains the diffuse disk test revealed resistance to more than three antibiotics. The investigation was supplemented by microbiological examination of strains from a hospital environment (45 smears) and strains from biological material (82 specimens), from patients with nosocomial infections.