[Gastric MALT lymphoma - a case report]. / MALT lymfom zaludku - kazuistika.

Gastrointestinal tract is the most commonly (40 %) affected site of the extranodal forms of primary non-Hodgkin's lymphomas. Almost half of them are indolent lymphomas, mainly MALT lymphomas. The development of MALT lymphoma temporarily depends on antigen stimulation of Helicobacter pylori. More than 90 % of MALT lymphoma patients are positive for Helicobacter pylori antibodies, but the positivity of biopsy is present in only 60 % of them. Antibiotic therapy in Helicobacter pylori infection may lead to complete regression of the localized primary gastric lymphoma of the MALT type without any anti-tumour therapy. The aim of the case report is to present the disease in the context of possible antibiotic therapy of the tumour.

[The outcome of monitoring health care-associated bloodstream infections in Pardubice Regional Hospital]. / Výsledky sledování infekcí krevního reciste spojených se zdravotní pécí v pardubické krajské nemocnici, a.s.

OBJECTIVE: The aim of the study were to find out the incidence of health care-associated bloodstream infections in the Pardubice Regional Hospital (PRH) and to introduce a system of the regular monitoring of these infections. MATERIAL AND METHODS: In 2008 - 2009, the incidence of the laboratory-confirmed bloodstream infections (BSIs) was monitored in patients hospitalized in the PRH. In the case of positive blood culture, a protocol was set up in the department of clinical microbiology. The protocol was filled in with the data from the hospital information system and then closed after the evaluation of a physician and a member of the Infection Control Team. RESULTS: During prospective BSI monitoring in the entire PRH, 207 cases BSIs in 185 patients (incidence 0.5 cases per 1 000 patient-days) were monitored. Of these, 59.4 % were related to intensive care in the ICUs. Thirty-eight percent were catheter-associated infections. The most frequent source of secondary BSIs was the urinary system (26 %). A total of 230 pathogenic microorganisms were isolated, with 9.1 % of cases being polymicrobial. The most frequent pathogen was Staphylococcus aureus (17 %), followed by Klebsiella pneumoniae (14.3 %) and Serratia marcescens (13 %). The proportion of methicilin-resistant Staphylococcus aureus was 25,6 %. A total of 13 cultures per 1 000 patient-days were collected. CONCLUSION: The detected incidence BSIs is comparable to thet in foreign studies. The different representation of the most frequently isolated causative agents reflects the actual epidemiological situation and correlates with the outcomes of global monitoring of hospital microbial species.

Phaeohyphomycosis and onychomycosis due to Chaetomium spp., including the first report of Chaetomium brasiliense infection.

Chaetomium species have been rarely described as aetiological agents of invasive and dermatomycotic infections in humans. The majority of cases have been reported within the last two decades. Treatment failed in most of these cases. In this paper we present two cases in which Chaetomium spp. can be clearly identified as an aetiological agent in pathological conditions. In the first report, we describe a new aetiological agent, Chaetomium brasiliense, which was implicated in a case of otitis externa in a patient with spinocellular carcinoma basis cranii. The patient had been repeatedly treated for relapsing otitis externa and had previously undergone surgery several times for otitis media. The fungal aetiology was confirmed by repeated positive culture and histologic studies. The second case involved onychomycosis with strikingly brown nail discoloration due to Chaetomium globosum in an otherwise healthy patient. The nail lesion was successfully cured by oral terbinafine. The determination of both species was supported by sequencing of rDNA regions. The morphological aspect of Chaetomium spp. identification is also discussed. In vitro antifungal susceptibility tests demonstrated that both isolates were susceptible to terbinafine and azole derivates except fluconazole. Amphotericin B was effective only against the C. brasiliense strain. We review the literature to summarize clinical presentations, histologic findings, and treatment strategies.

[The evidence of Helicobacter pylori in gastric biopsy and stool samples]. / Prukaz Helicobacter pylori v bioptatu zaludku a ve stolici.

In the diagnosis of Helicobacter pylori infection, it is possible to use either invasive methods when it is essential to take biopsy samples from endoscopic examination or non-invasive methods which do not require endoscopy. The invasive tests include histological examination, culture, rapid urease test and molecular methods. The non-invasive methods are serological tests, stool antigen detection (HpsAg) and respiratory tests. The article compares biopsy culture with stool antigen detection in a group of 300 patients in whom stool samples were collected simultaneously with endoscopic examination.