Predominance of Acinetobacter pseudolwoffii among Acinetobacter species in domestic animals in the Czech Republic.

The aim of this study was to map the spectrum of microorganisms belonging to the genus Acinetobacter in domestic animals with a specific focus on the prevalence of Acinetobacter pseudolwoffii. Additionally, the susceptibility of isolates to antimicrobial agents was determined. In the period from January 1, 2014, to August 31, 2015, a total of 9 544 samples originating from gross lesions and pathological processes of animals exhibiting clinical symptoms of the disease were examined across 41 districts in the Czech Republic. The examinations were carried out using culture methods involving meat-peptone blood agar and Endo agar under aerobic conditions at a temperature of 37 ± 1 °C for 18-24 hours. Isolates were confirmed using molecular phenotypic method MALDI-TOF MS with the MBT Compass Library Revision L 2020 covering 3 239 species/entries (9 607 MSP) from Bruker Daltonics company. Out of the 108 isolates (prevalence 1.13%), 14 species of Acinetobacter spp. were identified, with 5 isolates remaining unclassified as species. A. pseudolwoffii was the predominant species isolated in 25 cases (prevalence 0.26%). Antimicrobial susceptibility was determined for 12 antimicrobials by the disc diffusion method, with A. pseudolwoffii isolates exhibiting the lowest susceptibility to ceftazidime (32%) and co-trimoxazole (60%).

Effectiveness of anti-epidemic measures on ensuring indoor air quality of cleanrooms in a tertiary care hospital.

OBJECTIVES: Maintaining cleanrooms in a hospital is a key part of preventing healthcare-associated infections (HAIs). The aim of this work was to verify the effectiveness of anti-epidemic measures to ensure air quality in cleanrooms in a tertiary care hospital. METHODS: The study was based on the application of anti-epidemic measures and verification of their effectiveness by regular indoor air monitoring between the years 2014-2019. Monitoring was performed according to a recommended procedure based on European standards for cleanrooms. RESULTS: The results demonstrate a reduction in the number of airborne particles and the number of colonies, as well as the elimination of fungi and conditioned pathogens in air samples. CONCLUSIONS: The authors emphasize the importance of established anti-epidemic measures and regular monitoring for the prevention of HAIs.

Occurrence of virulence factors in Cronobacter sakazakii and Cronobacter malonaticus originated from clinical samples.

BACKGROUND: Cronobacter spp. are Gram-negative, facultative-anaerobic, non-spore forming, enteric coliform bacteria, which belongs to the Enterobacteriaceae family. Cronobacter spp. are opportunistic pathogens that have brought rare but life-threatening infections such as meningitis, necrotizing enterocolitis and bloodstream infections in neonates and infants. Information on the diversity, pathogenicity and virulence of Cronobacter species obtained from various sources is still relatively scarce and fragmentary. The aim of this study was to examine and analyse different pathogenicity and virulence factors among C. sakazakii and C. malonaticus strains isolated from clinical samples. METHODS: The thirty-six clinical Cronobacter strains have been used in this study. This bacterial collection consists of 25 strains of C. sakazakii and 11 strains of C. malonaticus, isolated from different clinical materials. Seven genes (ompA, inv, sip, aut, hly, fliC, cpa) were amplified by PCR. Moreover, the motility and the ability of these strains to adhere and invade human colorectal adenocarcinoma (HT-29) and mouse neuroblastoma (N1E-115) cell lines were investigated. RESULTS: Our results showed that all tested strains were able to adhere to both used cell lines, HT-29 and N1E-115 cells. The invasion assay showed that 66.7% (24/36) of isolates were able to invade N1-E115 cells while 83% (30/36) of isolates were able to invade HT-29 cells. On the average, 68% of the C. sakazakii strains exhibited seven virulence factors and only 18% in C. malonaticus. All strains amplified ompA and fliC genes. The other genes were detected as follow: sip 97% (35/36), hlyA 92% (33/36), aut 94% (34/36), cpa 67% (24/36), and inv 69% (25/36). CONCLUSIONS: C. sakazakii and C malonaticus strains demonstrate the diversity of the virulence factors present among these pathogens. It is necessary to permanently monitor the hospital environment to appropriately treat and resolve cases associated with disease. Furthermore, in-depth knowledge is needed about the source and transmission vehicles of pathogens in hospitals to adopt pertinent prevention measures.

Characterization of the pathogenicity of clinical Cronobacter malonaticus strains based on the tissue culture investigations.

Cronobacter malonaticus is a member of the genus Cronobacter which is considered an opportunistic pathogen. The significance of C. malonaticus has recently increased since it was documented to be involved in several serious neonatal infections. However, the virulence factors of C. malonaticus including their ability to adhere, invade and overcome host barriers have not been studied before. Unlike previous Cronobacter research, this study is mainly focused on C. malonaticus and is aimed to investigate its virulence characteristics that enable this species to cause adult and neonatal infections. Altogether, 20 strains were included in this study (19 clinical and one environmental strain). Our data showed that the clinical C. malonaticus has an ability to adhere and invade Caco-2, HBMEC, A549 and T24 cell lines. Moreover, the result showed that certain strains of C. malonaticus (including 1827 and 2018) were able to persist well in macrophages. However, ST7 strains 1827 and 2018 proved to be the most invasive strains among all used strains. The CDC strain 1569 (ST307) which was isolated from the blood of a fatal neonatal case showed also significant results in this study as it was able to invade all used human cells and survive and replicate within microphages. Finally, the findings of this study confirm the potential ability of C. malonaticus to cause serious infections in neonates or adults such as necrotising enterocolitis, meningitis, bacteraemia, pneumonia and urinary tract infection.

[Prevalence of strains of Staphylococcus epidermidis and other coagulase-negative staphylococci with biofilm-forming ability at a department of hemato-oncology].

OBJECTIVES: Staphylococcus epidermidis and coagulase-negative staphylococci generally are important causative agents of hospital-acquired infections. A significant role in this process is played by their common ability to form biofilm, a highly organized community of microorganisms adhering to inert surfaces. The study aimed to determine the prevalence of these bacterial strains and their ability to form biofilm at the Department of Hemato-Oncology, University Hospital Olomouc. MATERIAL AND METHODS: Over a period of 12 months, samples of air and swabs from surfaces and staff members were collected. The samples were subjected to standard microbiology tests; coagulase-negative staphylococci were identified. Staphylococcus epidermidis strains were confirmed by polymerase chain reaction and subsequently tested for biofilm formation. RESULTS AND CONCLUSIONS: Coagulase-negative staphylococci were found in 81 samples, most commonly swabs from staff members. S. epidermidis accounted for 60 % of all positive results; it was most frequently isolated from surface swabs. Almost half of S. epidermidis strains were able to form biofilm. These strains were found in the environment characterized by cleanliness classes FED-STD-209E (USA) - 10 000 and FED-STD-209E (USA) - 100 000. Thus, they pose a risk for immunocompromised patients staying there. Since coagulase-negative staphylococci were also found in healthcare staff of the department, the staff members may play a key role in the transmission of these microorganisms to patients.

[Prevalence of diphtheria, tetanus and pertussis in the world].

Diphtheria, tetanus and pertussis are very serious diseases threatening the lives of children and adults. However, these diseases are preventable by vaccination. After the World Health Organization was founded in 1946, its experts rapidly developed a vaccination schedule for the pediatric population. The former Czechoslovakia, a founding member of this organization, actively participated in the implementation of vaccination against many infectious diseases, including vaccinations against tetanus, diphtheria and pertussis. Mass vaccination of children could not be implemented in all countries of the European Region. The main problem was differences in the economic situation since the mass vaccination of the pediatric population represents a significant financial burden. It was only in the early 1970´s that the pediatric immunization program was initiated in developing countries. The article compares the impact of vaccination in different continents (Europe, Asia, Africa) since 1980. High immunization coverge is essential for a reduction in the incidence of the above infectious diseases. Cases of the diseases reported between 1980 and 2016 are cited in the article. Trends in these infectious diseases are related to the economic and political changes that occurred at the turn of the millennium.

Contribution of the thermotolerance genomic island to increased thermal tolerance in Cronobacter strains.

Cronobacter spp. are opportunistic pathogens associated with serious infections in neonates. Increased stress tolerance, including the thermotolerance of some Cronobacter strains, can promote their survival in production facilities and thus raise the possibility of contamination of dried infant formula which has been identified as a potential source of infection. Some Cronobacter strains contain a genomic island, which might be responsible for increased thermotolerance. By analysis of Cronobacter sequenced genomes this determinant was found to be present in only 49/73 Cronobacter sakazakii strains and in 9/14 Cronobacter malonaticus strains. The island was also found in 16/17 clinical isolates originating from two hospitals. Two configurations of the locus were detected; the first one with the size of 18 kbp containing the thrB-Q genes and a shorter version (6 kbp) harbouring only the thrBCD and thrOP genes. Strains containing the thermotolerance island survived significantly better at 58 °C comparing to a C. sakazakii isogenic mutant lacking the island and strains with the longer version of the island were 2-10 times more tolerant than those with the shortened sequence. The function of the genomic island was further confirmed by its cloning into a low-copy vector and transforming it into the isogenic mutant. Different levels of rpoS, encoding for stress-response sigma factor, expression were also associated with variability in strain thermotolerance.

Monitoring of Microscopic Filamentous Fungi in Indoor Air of Transplant Unit.

AIM: The aim of the study was to control the microbial contamination of indoor air monitored monthly at the Transplant Unit of the University Hospital Olomouc from August 2010 to July 2011. METHODS: The unit is equipped with a three-stage air filtration system with HEPA filters. The MAS-100 air sampler (Merck, GER) was used. Twenty locations were singled out for the purposes of collecting a total of 720 samplings of the indoor air. Swabs of the HVAC diffusers at the sampling locations were always carried out after the sampling of the indoor air. RESULTS: In total, 480 samples of the indoor air were taken for Sabouraud chloramphenicol agar. In 11 cases (2.29%) the cultivation verified the presence of microscopic filamentous fungi. Only two cases involved the sanitary facilities of a patient isolation box; the other positive findings were from the facilities. The most frequent established genus was Aspergillus spp. (4x), followed by Trichoderma spp. (2x) and Penicillium spp. (2x), Paecilomyces spp., Eurotium spp., and Chrysonilia spp. (1x each). In 2 cases the cultivation established sterile aerial mycelium, unfortunately no further identification was possible. A total of 726 swabs of HVAC diffusers were collected (2 positive-0.28%). The study results demonstrated the efficacy of the HVAC equipment. CONCLUSIONS: With the continuing increase in the number of severely immunocompromised patients, hospitals are faced with the growing problem of invasive aspergillosis and other opportunistic infections. Preventive monitoring of microbial air contaminants is of major importance for the control of invasive aspergillosis.

Trends of cervical tumours amongst women from perspectives of demographic, socioeconomic and geographic indicators: retrospective ecological study in Czechia.

Introduction: For many infectious diseases, women are at higher risk and have a more severe disease course than men for many reasons, including biological differences, social inequalities, and restrictive cultural norms. The study focuses on infections with human papillomaviruses (HPV) in the form of cervical cancer as a gender-specific disease. The main goal is to evaluate cervical tumour incidence trends in the Czech female population in the HPV vaccination period 2012-2020 in relation to selected demographic, socioeconomic, and geographic indicators. Methods: This is a retrospective ecological study. Data from publicly available databases about the incidence and mortality of cervical tumours (C53 Malignant neoplasm of cervix uteri, D06 Carcinoma in situ of cervix uteri according to ICD 10) and HPV vaccination rate were analysed and compared with demographic, socioeconomic and territorial data. Associations were searched using correlation analysis. Results: There was a decreasing trend in the incidence of cervical cancer in the observed period. Regarding cervical tumours (C53, D06) and malignant neoplasm of cervix uteri incidence (C53), the decrease was approximately 11 and 20%, respectively. Differences between regions were observed in incidences and vaccination rates. Based on correlation analysis, indicators connected with urban/rural aspects, such as a share of urban population and population density, were statistically significant. The indicators related to higher cervical cancer incidence are the high unemployment rate of women, the high number of divorces, the high number of abortions, the high share of the urban population, the high number of students, and the high number of women with only primary education. On the other hand, the indicators related to lower cervical cancer incidence are the high gross domestic product (GDP), the high average gross monthly wage per employee, the high employment rate of women, the higher average age of mothers at birth, and the high number of women with tertiary education. Conclusion: Results underline the problem of economically disadvantaged regions and families. Increasing vaccination rates, promoting regular screening for cervical cancer, and supporting awareness in the population, especially in regions with higher incidence rates, should be priorities for public health efforts.

[Bacterial contamination of the indoor air in a transplant unit]. / Bakteriální kontaminace vnitrního vzduchu transplantacní jednotky.

For one year (August 2010 to July 2011), microbial contamination of the indoor air in the Transplant Unit of the Haemato-Oncology Clinic, Olomouc University Hospital was monitored monthly. Twenty sampling sites were singled out and a total of 240 indoor air samples were collected. An MAS-100 air sampler (Merck, GER) was used, air flow rate of 100 liters per minute, 1 minute. The measured values of indoor air temperature were stable. The relative air humidity ranged from 17% to 68%. The highest average value of microbial air contamination was found in the "staff entry room" (1170 CFU/m3). The lowest microbial air contamination (150-250 CFU/m3) was measured in the patient isolation units. The most frequently isolated bacterial strains were coagulase-negative staphylococci (94.3%), followed by Micrococcus spp. (67%) and Bacillus subtilis (11%). It can be assumed that the -source of these airborne bacterial strains are both patients and medical staff. They are classified as -opportunistic pathogens and as such can cause hospital infections among haemato-oncology patients.

Potential determinants of vaccine hesitancy among celiac disease patients: a single cohort analysis.

Introduction: Though researchers and scholars have greatly emphasized addressing the influencing factors of vaccination hesitancy, little attention has been paid to patients with celiac disease. Addressing the variables hampering attitudes might help direct appropriate patient advocacy and doctor-patient communication endeavors to encourage vaccination among celiac disease patients. The present investigation seeks to explore the coverage against vaccine-preventable diseases, vaccination attitudes, and related possible factors among celiac disease patients in the Pakistani setting. Methods: A self-reported online survey was conducted in Islamabad, Pakistan, for celiac disease patients aged 18 and above. The questionnaire was completed by 226 participants, with a response rate of 43.8%. The influencing variables for vaccination hesitancy were examined, and 95% confidence intervals for the crude and adjusted odds ratios were computed. Results: Among the study population, the majority were females, with a ratio of 75.66%. A prominent proportion of 69.03% was observed for influenza vaccination, while 39.82% were unable to recall all of the vaccinations they had previously received. Only 7% of the patients were considered to have a negative attitude toward vaccination, compared to an estimated 76% who were in favor of it. The significantly positive influencing factors observed toward vaccination were being well-educated (graduate, master, or above), possible recurrence of vaccine-preventable diseases with declining vaccination coverage (adjusted OR: 13.36), and increased confidence in vaccines from health care experts compared to electronic media (adjusted OR: 8.41). Contrarily, practicing complementary and alternative medicines (adjusted OR: 5.59), willingness to get vaccinated again in the future (adjusted OR: 15.59), and prior negative perspectives (adjusted OR: 1.01) were the determinants with a significant negative association. Discussion: In conclusion, the outcomes of the current work raise the possibility that health practitioners may be accountable for inappropriately prescribing vaccines to this demographic since 77% of the participants had a favorable attitude toward vaccination. These findings could serve as a springboard for creating targeted immunization efforts to raise vaccination coverage against vaccine-preventive diseases among celiac disease patients.

A comparison of heart failure patients with reduced ejection fraction in the Moravian Midlands Registry with the LCZ696 patients in the Paradigm-HF trial.

BACKGROUND AND AIMS: There are limited data on real clinical practice in heart failure patients in the Czech Republic. We analysed the clinical parameters from the Moravian Midlands Registry (MMR) and compared them to LCZ696 patients in the Paradigm-HF trial. The Moravian Midlands Registry is a retrospective patient database from two outpatient cardiology centres in the Czech Republic. The Paradigm-HF is a large-scale prospective randomized multicentre trial with more than 8000 individuals with stabilized chronic heart failure. METHODS: A retrospective analysis of heart failure with reduced ejection fraction patients from two outpatient cardiology centres in the Czech Republic from October 2016 to December 2019. RESULTS: Patients in the MMR were younger (60.5 ± 10.7 vs 63.8 ± 11.5 years, P<0.05), had a higher body mass index (30.3 ± 5.0 vs 28.1 ± 5.5, P<0.05) and higher serum creatinine level (101.9 ± 36.0 vs 99.9 ± 26.5 µmol/L, P<0.05). MMR patients had lower left ventricular ejection fraction (27.8 ± 6.9 vs 29.6 ± 6.1%, P<0.05). The serum N-terminal pro-B-type natriuretic peptide, [2563.5 (377-3536) vs 1631 (885-3154), was non significantly higher P=0.07]. Pharmacotherapy use differed for mineralocorticoid antagonist (91.4% in MMR vs 54.2% in Paradigm-HF), and digoxin (13.5% vs 29.2%). Beta-blocker use was similar (96.2% vs 93.1%) as was angiotensin-converting enzyme (ACE) inhibitors - (71.2% vs 78.0%) and angiotensin-receptor blockers - ARB (27.9% vs 22.2%). Dosages of the commonly used ACE inhibitors at the screening visit (Paradigm-HF) / before angiotensin receptor-neprilysin inhibitor administration (MMR) differed significantly only for ramipril (7.0 ± 3.1 mg vs 4.8 ± 2.9 mg, P<0.05), dosages of ARB were - losartan (67.1 ± 30.2 vs 39.6 ± 32.0 mg, P=0.09) and valsartan (181.5 ± 71.1 vs 130.9 ± 82.2 mg, P=0.07). There was a substantial difference in device-based therapy (ICD in 60.6%, CRT 25.9% in MMR vs 14.9% and 7.0% in Paradigm-HF). CONCLUSION: The differences between the groups for the majority of clinical parameters compared were minimal, except for younger age, higher body mass index and serum creatinine level and lower left ventricular ejection fraction and substantially lower dosage of administered ramipril prior to commencing sacubitril/valsartan therapy. There was a higher prevalence of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy (CRT) in the MMR group.

Screening of Antibiotic and Virulence Genes from Whole Genome Sequenced Cronobacter sakazakii Isolated from Food and Milk-Producing Environments.

The objective of this study was to use whole-genome sequencing (WGS) to screen for genes encoding for antibiotic resistance, fitness and virulence in Cronobacter sakazakii strains that had been isolated from food and powdered-milk-producing environments. Virulence (VGs) and antibiotic-resistance genes (ARGs) were detected with the Comprehensive Antibiotic Resistance Database (CARD) platform, ResFinder and PlasmidFinder tools. Susceptibility testing was performed using disk diffusion. Fifteen presumptive strains of Cronobacter spp. were identified by MALDI-TOF MS and ribosomal-MLST. Nine C. sakazakii strains were found in the meningitic pathovar ST4: two were ST83 and one was ST1. The C. sakazakii ST4 strains were further distinguished using core genome MLST based on 3678 loci. Almost all (93%) strains were resistant to cephalotin and 33% were resistant to ampicillin. In addition, 20 ARGs, mainly involved in regulatory and efflux antibiotics, were detected. Ninety-nine VGs were detected that encoded for OmpA, siderophores and genes involved in metabolism and stress. The IncFIB (pCTU3) plasmid was detected, and the prevalent mobile genetic elements (MGEs) were ISEsa1, ISEc52 and ISEhe3. The C. sakazakii isolates analyzed in this study harbored ARGs and VGs, which could have contributed to their persistence in powdered-milk-producing environments, and increase the risk of infection in susceptible population groups.

[The incidence of gram-negative bacteria in the environment of the Transplant Unit, Department of Hemato-oncology, University Hospital --Olomouc]. / Výskyt gramnegativních bakterií v prostredí transplantacní jednotky Hemato-onkologické kliniky FN Olomouc.

A study entitled "Surveillance of Infectious Complications in Hemato-oncological Patients", was conducted at the Department of Hemato-Oncology, University Hospital Olomouc from 1 July 2010 to 31 August 2011. During the study period, a total of 96 patients were hospitalized at that department and 63 stem cell transplants were performed, 43 autologous and 23 allogeneic. Microbial contamination was monitored in indoor air, on selected surfaces, and in health care providers (right hand smear, left and right nostril swabs and scalp hair smear). Opportunistic Gram-negative bacterial strains were selected from the cultures.

[The incidence of nonfermentative gram-negative bacilli in the environment of the transplant unit, department of hemato-oncology, university hospital Olomouc]. / Výskyt gramnegativních nefermentujících bakterií v prostredí transplantacní jednotky Hemato-onkologické kliniky FN Olomouc.

A study entitled "Surveillance of Infectious Complications in Hemato-oncological Patients" was conducted at the Department of Hemato-Oncology, University Hospital Olomouc from 1 July 2010 to 31 August 2011. During the study period, a total of 63 patients were hospitalized at that department and 33 stem cell transplants were performed, 21 autologous and 12 allogeneic. Microbial contamination was monitored in indoor air, on selected surfaces, and in health care providers (right hand smear, left and right nostril swabs and scalp hair smear). Gram-negative bacteria detected by culture were identified biochemically. Special attention was paid to nonfermentative Gram-negative bacilli which, based on the recent literature, should be considered as emerging causative agents of hospital infections.

The importance of cleanrooms for the treatment of haemato-oncological patients.

The main purpose of cleanrooms in health care centres is to prevent hospital infections or leakage of a highly infectious agent (the source of haemorrhagic fevers, SARS, etc.) into the ambient environment and subsequently possibly threatening other individuals. Patients with haematological malignancies or after autologous or allogeneic haematopoietic stem cell transplantation (HSCT) rank among immunosuppressed individuals. Prolonged and deep neutropenia is considered a key risk factor of the occurrence of an exogenous infection. One of the possibilities of preventing an exogenous infection in these patients is to place them in a "cleanroom" for the crucial period of time. Cleanrooms are intensive care units with reverse isolation. The final part of the general article below provides an overview of the technology and types of cleanrooms for immunosuppressed patients in compliance with the current recommendations and technical standards.

Does the intubation timeline affect the in-hospital mortality of COVID-19 patients? A retrospective cohort study.

Background: Effective strategies for managing coronavirus disease 19 (COVID-19) patients suffering from acute respiratory distress are constantly evolving. The timeline and threshold for transitioning from non-invasive ventilation to intermittent mandatory ventilation in critical cases who develop COVID-19-related respiratory distress are undetermined. The present research intends to investigate if emergency room intubations in COVID-19 patients affect mortality. Methods: Between January 1, 2021 and June 30, 2021, we retrospectively reviewed chart analysis on all patients with confirmed positive COVID-19 screening and who underwent endotracheal intubation. Depending on when the intubation was performed; early in the emergency room or delayed outside the emergency room, patients were separated into two cohorts. In addition to comorbid clinical manifestations, the quick sequential organ failure assessment (qSOFA) score, and in-hospital mortality were all recorded as demographic and clinical information. Results: Fifty-eight of the 224 corona-positive patients who underwent intubation had their intubations performed in the emergency room. Age, sex, alcohol use, and smoking status did not significantly differ between the two categories at the baseline. The mean qSOFA score was higher in the early intubation cohort (3.5; p < 0.000) along with more underlying comorbidities (3.0; p < 0.000). When compared to the late intubation cohort (45.78%), patients treated with early intubation had a significantly greater death rate (67.24%). Conclusion: In summary, we discovered that patients who underwent intubation in the emergency units exhibited a high quick SOFA score as well as maximum co-morbid conditions than patients intubated somewhere else in the hospital. The findings of our investigation imply that intubating patients too early might be risky.

COVID-19 vaccine reluctance and possible driving factors: A comparative assessment among pregnant and non-pregnant women.

The coronavirus disease of 2019 (COVID-19) constitutes a serious threat to pregnant women. One of the key strategies for preventing and managing the COVID-19 epidemic is vaccination. Herd immunity is significantly hampered by COVID-19 vaccine reluctance, which poses a potential threat to population health. Therefore, the present work intends to ascertain the incidence and severity of COVID-19 vaccine hesitancy among Pakistani pregnant women, the determinants driving their decision, and a comparative assessment with non-pregnant participants. This cross-sectional survey was carried out from November 2021 to February 2022. The validated vaccination attitude examination (VAX) scale about vaccination reluctance was undertaken by participants, who were also required to indicate whether they would be inclined to acquire the COVID-19 vaccine along with the reasons for reluctance. In comparison to the non-pregnant category with 353 participants, the group of 372 pregnant participants who responded to the questionnaire had a much greater proportion of hesitant respondents. Likewise, contrasted to 31% of non-pregnant participants, about 40% of them attributed their willingness to get vaccinated against coronavirus to social media. They also demonstrated a considerably stronger mean score on all subcategories of the VAX measure. The adjusted odd ratio findings showed that the independent factors for vaccine reluctance appeared to be trusting rumors on social media (adj OR: 2.58), not being afraid of covid-19 (adj OR: 2.01), not believing in COVID-19 existence (adj OR: 2.53), and not believing in vaccines (adj OR: 4.25). Uncertainty about the COVID-19 vaccine is very prevalent among expectant mothers. The investigation accentuates the pressing need to administer COVID-19 vaccination to the general public, including expectant mothers who might be anxious about the vaccine.

Genomic Characterization of Cronobacter spp. and Salmonella spp. Strains Isolated From Powdered Infant Formula in Chile.

This study characterized five Cronobacter spp. and six Salmonella spp. strains that had been isolated from 155 samples of powdered infant formula (PIF) sold in Chile and manufactured in Chile and Mexico in 2018-2020. Two strains of Cronobacter sakazakii sequence type (ST) ST1 and ST31 (serotypes O:1 and O:2) and one strain of Cronobacter malonaticus ST60 (O:1) were identified. All Salmonella strains were identified as Salmonella Typhimurium ST19 (serotype O:4) by average nucleotide identity, ribosomal multilocus sequence typing (rMLST), and core genome MLST (cgMLST). The C. sakazakii and C. malonaticus isolates were resistant to cephalothin, whereas the Salmonella isolates were resistant to oxacillin and ampicillin. Nineteen antibiotic resistance genes were detected in the C. sakazakii and C. malonaticus isolates; the most prevalent were mcr-9.1, blaCSA , and blaCMA . In Salmonella, 30 genes encoding for aminoglycoside and cephalosporin resistance were identified, including aac(6')-Iaa, ß-lactamases ampH, ampC1, and marA. In the Cronobacter isolates, 32 virulence-associated genes were detected by WGS and clustered as flagellar proteins, outer membrane proteins, chemotaxis, hemolysins, invasion, plasminogen activator, colonization, transcriptional regulator, survival in macrophages, use of sialic acid, and toxin-antitoxin genes. In the Salmonella strains, 120 virulence associated genes were detected, adherence, magnesium uptake, resistance to antimicrobial peptides, secretion system, stress protein, toxin, resistance to complement killing, and eight pathogenicity islands. The C. sakazakii and C. malonaticus strains harbored I-E and I-F CRISPR-Cas systems and carried Col(pHHAD28) and IncFIB(pCTU1) plasmids, respectively. The Salmonella strains harbored type I-E CRISPR-Cas systems and carried IncFII(S) plasmids. The presence of C. sakazakii and Salmonella in PIF is a health risk for infants aged less than 6 months. For this reason, sanitary practices should be reinforced for its production and retail surveillance.

Seroprevalence of Measles Antibodies in the Population of the Olomouc Region, Czech Republic-Comparison of the Results of Four Laboratories.

OBJECTIVES: Although the incidence of measles has decreased globally since the introduction of regular vaccination, its frequency has increased again in recent years. The study is focused on data from the Olomouc Region in the Czech Republic analyzed in four laboratories. The obtained results were compared with already published data. METHODS: The data were provided by individual laboratories in an anonymized form-age at the time of the examination, sex, and result of test. Samples were collected between June 2018 and September 2019 and evaluated on the scale positive-borderline-negative. RESULTS: A total of 7962 sera samples were evaluated using three different methods-two types of ELISA tests and CLIA. Positive result was issued in a total of 62.6 percent of samples, but the results of individual laboratories varied widely from 55.5 to 70.8 percent. However, the same trend with the highest levels of antibodies in people born before beginning of vaccination was observed. CONCLUSIONS: Data show significantly different results depending on the individual laboratories and the detection kits used. The underestimation of the proportion of positive results can cause problems in selecting individuals for revaccination with a live vaccine, which may fail in weakly positive individuals.