[Antibiotic resistance in nontyphoidal salmonellae serovars in the Czech Republic]. / Antibiotická rezistence u netyfových sérovaru Salmonella spp. v Ceské republice.

STUDY AIM: To determine antibiotic resistance and incidence of multidrug resistance among Nontyphoidal salmonellae serovars isolated from humans. MATERIAL AND METHODS: Consecutive Salmonella isolates from patients, recovered in 48 microbiology laboratories in May 2012, were analyzed in the respective reference laboratories at the National Institute of Public Health. Strains were re-identified and differentiated into serovars. Their minimum inhibitory concentrations (MICs) to 11 antibiotics were determined by the microdilution method. RESULTS: Of 25 serovars identified among 637 strains of Salmonella enterica, the most frequent were Enteritidis (87.0 %), Typhimurium (4.9 %), and monophasic Typhimurium 4,[5],12:i:- (2.0 %) and Mbandaka (0.6 %); other serovars were rare. Altogether 558 strains (87.6 %) were susceptible to all antibiotics tested and the remaining 79 strains were resistant to one or more antibiotics. The prevalence rates of resistance to individual antibiotics among 637 study strains were as follows: ampicillin 8.5%, tetracycline 5.7%, sulfamethoxazole 5.2%, cipro-floxacin 3.8%, and chloramphenicol 2.5%. Resistance to gentamicin, trimethoprim, and third and fourth generation cephalosporins was rare ( 0.5%) and none of the study strains showed resistance to meropenem. Three producers of extended spectrum beta-lactamase were multidrug resistant and two of them recovered from twins exhibited a different pattern of resistance. Resistant strains were most often assigned to the following serovars: Enteritidis (49.4%), Typhimurium (26.6%), and monophasic Typhimurium (15.2%). While only 7% (39 of 554 strains) of Enteritidis strains were resistant, the serovars Typhimurium and its monophasic variant 4,[5],12:i:- showed high rates of resistance, i.e. 66.7 and 92.3%, respectively. Furthermore, resistance was revealed in all strains of the serovars Virchow (n = 3), Kentucky (n = 1), and Newport (n = 1), in two of three strains of the serovar Infantis, and in one of two strains of the serovar Stanley. All five blood isolates were assigned to the serovar Enteritidis and one of them showed resistance to ciprofloxacin. Of 79 resistant strains, 26.6% showed resistance to ampicillin only and 24.1% to ciprofloxacin only, with multidrug resistance, i.e. resistance to three or more antibiotics, confirmed in 43.0% of strains. CONCLUSION: Despite a relatively low prevalence of resistance to the antibiotics tested among 637 study strains, the following alarming findings were made: Detection of Salmonella enterica strains resistant to ciprofloxacin as the drug of choice or to higher generation cephalosporins and multidrug resistance revealed in two thirds of the strains of the serovar Typhimurium and in all but one strains of its monophasic variant 4,[5],12:i:-.

[Invasive candidiasis in selected heamatology departments in the Czech Republic and Slovakia - microbiological results of the CAN CELL project]. / Invazivní kvasinkové infekce na vybraných hematoonkologických oddeleních Czech Republic and Slovakia - microbiological results of the CAN CELL project]

BACKGROUND: The aim of our study was to analyze the spectrum and characteristic of invasive candidiasis in selected haematological departments in the Czech and Slovak Republics, and to compare minimum inhibitory concentrations (MIC) of some antifungal agents for isolates obtained. MATERIAL AND METHODS: Between 1 March 2009 and 31 October 2010, Candida strains from clinically important material obtained from patients with haematological malignancies were collected. Each isolate was biochemically identified and tested for in vitro susceptibility to three known echinocandins and amphotericin B and selected azoles using the E-test. Relevant clinical data were collected. RESULTS: The study included 63 isolates from 61 patients. The most frequently isolated species were C. albicans and C. glabrata (28 % and 19 %, respectively). However, after exclusion of isolates from bronchoalveolar lavage fluid, the percentage changed in favour of C. albicans and C. parapsilosis (25 % and 17 respectively). The MIC data showed a high susceptibility of yeasts to echinocandins and amphotericin B. Ten (16 %) strains were cross-resistant to azoles (mostly C. glabrata). CONCLUSION: Invasive candidiasis is not frequent infection complication in patients with haematological malignancies in the Czech Republic and Slovakia. Moreover, the spectrum of pathogens was similar to that described in recent international studies. However, identification of susceptible and resistant strains according to MIC could be beneficial for choice of antifungal treatment.

[Infectious complications of surgically treated musculoskeletal injuries: review of risk factors and etiological agents in years 2000-2005]. / Infekcní komplikace operacní lécby poranení pohybového aparátu: prehled rizikových faktoru a eiologických agens za roky 2000-2005.

PURPOSE: Infection is considered one of the most serious complications of the surgical treatment of musculoskeletal injuries. The aim of the study was to evaluate known risk factors and etiological agents of infectious complications in patients surgically treated for musculoskeletal injuries within 6 years. METHODS: In a group of 5 234 patients followed in 2000-2005 the early or delayed infectious complication developed in 65 patients (26 women, 39 men, age 22-83 years). In every patient with infectious complication the important risk factors related to personal history, type of the injury, surgery and other treatment were recorded and microbiological culture results were collected. RESULTS: In 60 patients (92.3%) at least one of the following risk factors was registered: diabetes mellitus, age above 75 years, abuse of alcohol and drugs, distant infectious focus or severe skin disease at the time of surgery, polytrauma requiring long-termed stay in intensive care unit, extensive soft tissue injury associated with closed or opened fracture. In 27 patients (41.5%) grampositive cocci and in 17 patients (26.2%) gramnegative bacteria were isolated, in 12 patients (18.5%) mixed bacterial flora was identified and 9 patients (13.8%) had negative cultures. The most severe findings from microbiological view occurred in patients with extensive soft tissue injury associated with fracture, diabetes or long-termed stay in intensive care unit. CONCLUSION: The infectious complications after the surgical treatment of musculoskeletal injuries occurred predominantly in patients with risk factors. The extensive soft tissue injury associated with fracture, diabetes and long-termed stay of the polytrauma patient in intensive care unit were identified as the most frequent risk factors. The patients of these risk groups also presented with the most serious microbiological findings.

Bacteriological monitoring in the Prague Burns Center.

The microbiological aspect of the prevention of nosocomial infections at the Burn Center consists primarily in the surveillance of bacterial flora and its antibiotical resistance. The Prague Burn Center is regularly monitoring the microbial flora. Patients are examined not only by the conventional methods of taking swabs of burned sites, but also by printing method, which allows a semiquantitative assessment of the colonization of burned areas. Simultaneously, investigation of bacterial contamination in the external environment of the department is carried out and the colonization of nursing staff is investigated. In all isolated strains the sensitivity to antibiotics is examined; this is significant from the point of view of current knowledge about therapeutic possibilities and for the antibiotic policy. The typing of bacterial strains makes possible to determine their epidemiological markers, and thus to investigate their spread within the department. The most frequent isolate is S. aureus and the prevalence of MRSA is relatively high. Among gramnegative rods the strains of P. aeruginosa, K. pneumoniae and E. cloacae are most often isolated. Various typing methods revealed endemic spread of particular strains of rarely isolated species (E. agglomerans, S. marcescens, A. baumannii, etc.).