Epidemiology of vancomycin-resistant enterococci in the Hradec Králové University Hospital in 2017.

Vancomycin-resistant enterococci (VRE) have been a major public health concern for years. These pathogens are highly resistant, which facilitates their spread in health care settings where they may cause infections difficult to treat with antibiotics, particularly in immunocompromised patients. Over recent years, a considerable increase in VRE has also been observed in the Hradec Králové University Hospital. In 2017, 59 cases of VRE colonization or infection were newly diagnosed in inpatients. Based on a retrospective investigation, infected patients were identified, and from the hospital information system data, clinical and epidemiological factors possibly linked to VRE were analysed. It was concluded that one of the reasons behind the increase in VRE was poor compliance with the hygienic antiepidemic rules in general and with hand hygiene in particular, which was confirmed by the changed epidemiological situation the following year after more stringent rules were adopted. Raising awareness of health care workers about good practices to reduce the risk of the spread of resistant pathogens is crucial for the prevention of these infections.

In-vivo interspecies transmission of carbapenemase KPC in a long-term treated female patient.

The increasing incidence of multiresistant bacterial strains is currently a serious health concern. These pathogens are often the cause of nosocomial infections with limited treatment options and high fatality rates. A case report is presented of an uncommon detection of four different species (Citrobacter freundii, Klebsiella pneumoniae, Escherichia coli, and Morganella morganii) producing the same type of carbapenemase, KPC-2, in a female patient during her complicated long-term hospital stay. Resistance was probably spread to other species by horizontal transmission of plasmids carrying the blaKPC-2 genes. The implementation of strict anti-epidemic measures prevented further spread of these carbapenem-resistant bacteria.

Transportation dose and doses to extracranial sites during stereotactic radiosurgery with the Leksell Gamma knife.

Two dosimetric aspects of Leksell Gamma knife (LGK) treatment have been investigated in this study: (a) measurement of the small dose (transportation dose) which is absorbed during the patient's transportation into and out of the treatment position within the ionization chamber, and (b) measurements of the doses absorbed by the eyes, thyroid, breast, abdomen, gonads, knee and ankle during the treatment using thermoluminescent dosimetry (TLD). The transportation dose was 0.253 +/- 0.003 Gy, which represented 8.4% of the dose rate (3.005 Gy/min) during measurements. In vivo TLD measurements have been performed on 51 patients. The doses measured in organs and sites of interest were 0.223 +/- 0.168 Gy for the eyes, 0.081 +/- 0.050 Gy for the thyroid, 0.049 +/- 0.033 Gy for the breast, 0.024 +/- 0.18 Gy for the abdomen, 0.012 +/- 0.008 Gy for the gonads, 0.003 +/- 0.002 Gy for the knee and 0.002 +/- 0.002 Gy for the ankle. During LGK radiosurgery, doses to extracranial sites and organs depend mainly on the total target dose and the number of shots used for the treatment. These doses are generally low; the maximum dose was measured for the eyes (approximately 0.7% of the maximum target dose), and the doses to other body organs decrease with increasing distance from the isocenter of the LGK radiation unit.

Determination of beam output factors for the CGR Saturne 2+ linear accelerator beams.

The demands of a busy clinic require that basic machine calculations be performed as accurately, rapidly and simply as possible. Simple method of predicting X-ray and electron beam output factors for rectangular field sizes on machines that have collimation similar to the CGR Saturne 2+ have been described. The calculated field output factors for rectangular and square field sizes were in agreement with measured data to within +/- 1% for all energies.