Klinicka mikrobiologie a infekcni lekarstvi最新文献

{"title":"[Clostridioides difficile infection: Current perspectives on diagnosis and therapy].","authors":"Gabriela Kroneislová, Jan Závora, Václava Adámková","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clostridioides difficile is an important opportunistic pathogen mainly linked to healthcare-associated infections, which arise when the intestinal microbiota is disrupted - most often due to antibiotic treatment. In recent years, however, its presence in the community has been reported more frequently. The incidence of C. difficile infection reflects both the quality of antibiotic policies and the rigor of infection control, while mortality remains substantial, especially among the elderly and patients with multiple comorbidities. The pathogenesis of the disease is based on the production of toxins A and B, which damage the intestinal epithelium and lead to the development of manifestations ranging from mild diarrhea to fulminant colitis. Diagnosis requires correlation of the clinical presentation with evidence of a toxigenic strain or its toxins while colonization alone, without clinical symptoms, is not an indication for treatment. The high rate of recurrence remains a significant problem. A rational antibiotic policy and strict hygiene measures play a crucial role in prevention. The treatment of C. difficile infection has undergone a significant shift in recent years. Current recommendations favor fidaxomicin as the first-line treatment for the initial episode due to a lower risk of recurrence; oral vancomycin is an alternative. For recurrent forms, an individualized approach is necessary, including the possibility of using fecal microbiota transplant or monoclonal antibodies. In the Czech Republic, oral vancomycin is still widely used; it is now also available in a standardized capsule form, which improves pharmaceutical safety and facilitates dosing. Keywords: Clostridioides difficile, fidaxomicin, oral vancomycin, antimicrobial stewardship.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 2","pages":"90-93"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Brucellosis part 1 - etiology, epizootiology, epidemiology, and laboratory diagnosis].","authors":"Jan Bardoň","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Brucellosis is a bacterial zoonosis characterized by a variable clinical presentation. The disease is endemic in many popular tourist destinations visited by Czech citizens. Approximately 300 cases of brucellosis are reported annually in Europe; in the Czech Republic, only a few cases are recorded each year, all of which are imported. The Czech Republic is free of brucellosis in livestock. However, Brucella suis still occurs in the country's wildlife, particularly in the European hare. Laboratory diagnosis of the disease relies primarily on serological tests, as direct identification of the pathogen from clinical material is less frequently successful. Serology offers a range of tests that differ in their diagnostic value for various stages of the disease and specific pathogen species. Today, the genus Brucella includes numerous species, but four representatives are of significance to human health: B. melitensis, B. abortus, B. suis, and B. canis. Keywords: zoonosis, imported infections, Brucella melitensis, Brucella abortus, Brucella suis Brucella canis.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 2","pages":"68-74"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Rabies post-exposure prophylaxis in travelers returning from endemic areas: A retrospective analysis of patients treated at Motol and Homolka University Hospital].","authors":"Milan Trojánek, Renáta Šindlerová, Veronika Jegorova, Martin Tulach, Samuel Martišík, Marek Štefan, Vyacheslav Grebenyuk, František Stejskal","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the demographic and exposure characteristics and management of rabies post-exposure prophylaxis (rPEP) among international travelers, and to identify deficiencies in pre-travel prevention, initial wound management, and subsequent post-exposure care.</p><p><strong>Material and methods: </strong>A retrospective observational study was conducted at the Department of Infectious Diseases and Travel Medicine, Motol and Homolka University Hospital. The study included patients evaluated between December 2022 and December 2024 following animal-related exposures. Demographic data, exposure characteristics, wound management, and details of rPEP, including rabies vaccination and rabies immunoglobulin (RIG) administration, were anayzed. Exposures were classified according to the World Health Organization (WHO) categories. Data were analyzed using descriptive statistical methods.</p><p><strong>Results: </strong>A total of 134 patients were included, with a median age of 31 years. Exposures predominantly occurred in Southeast Asia (35.1%) and Western Asia (25.4%), particularly in Türkiye, Thailand, and Indonesia. Dogs were the most frequently implicated animals (46.3%), followed by cats (23.9%) and monkeys (20.9%). Bites accounted for 66.4% of exposures, while 65.7% of cases were classified as WHO category III exposures. Initial wound management was frequently suboptimal; only 54.9% of patients reported immediate wound washing, and 76.1% applied a disinfectant. Preexposure rabies vaccination had been received by only 6.7% of travelers. rPEP was initiated abroad in 62.7% of cases. However, among patients indicated for RIG administration, 77.8% did not receive it. Deviations from recommended rabies vaccination schedules were documented in 38.2% of patients. Wound infections developed in 4.5% of cases.</p><p><strong>Conclusion: </strong>This study highlights significant gaps in rabies prevention and post-exposure management among international travelers. Low uptake of pre-exposure vaccination, frequent deviations from recommended rPEP protocols, and limited access to RIG in rabies-endemic settings represent major barriers to optimal prevention. These findings underscore the importance of comprehensive pre-travel counseling and broader implementation of pre-exposure rabies vaccination among travelers at increased risk of animal exposure.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 2","pages":"56-64"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Tularemia with long-lasting alteration of cellular immunity: A case report].","authors":"Michal Holub, Matěj Hrnjica, Jaromír Astl, Daniel Kovář, Simona Arientová","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A case of a 31-year-old female with the oroglandular form of tularemia, most likely acquired by consuming vegetables from her own garden, is presented. Initial treatment of a condition presenting as acute tonsillitis did not lead to regression of cervical lymphadenopathy, prompting serological testing and subsequent diagnosis of tularemia. The patient was then treated with a combination of ciprofloxacin and gentamicin; however, due to progression of cervical lymph node involvement with central colliquation, surgical extirpation of the affected lymph node package was indicated. Following the procedure, the patient's clinical condition evolved without further complications, although wound healing was prolonged. During hospitalization, flow cytometry was used for the first time to determine the relative proportion of CD3+/CD4-/CD8- T-lymphocytes, which was initially 56.9%. This proportion remained elevated at 11.8% even three years after the acute illness. These findings illustrate the potential diagnostic value of the elevation of this T-cell subpopulation in the early phase of tularemia, even before seroconversion, and point to a long-term alteration of the immune system induced by Francisella tularensis. Keywords: tularemia, case report, cellular immunity, T-lymphocytes.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 2","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Brucellosis part 2 - clinical diagnosis, treatment and a case report of the chronic form with retroperitoneal lymphadenopathy].","authors":"Samuel Martišík, Vyacheslav Grebenyuk, Lukáš Kohout, Zuzana Uhříková, Ondřej Beránek, Barbora Píšová, Aneta Nyčová, Martin Vidlička, Grigorij Mesežnikov, Martin Tulach, Otakar Nyč, Elka Nyčová, Marek Štefan, Milan Trojánek","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Brucellosis, one of the most important zoonoses worldwide, has been eliminated in many countries including the Czech Republic through veterinary control measures. It now occurs only as an imported disease. Owing to its non-specific clinical presentation, brucellosis is classified among the so-called \"great imitators\" and may overlap in the differential diagnosis with lymphoma, tuberculosis, or systemic inflammatory diseases. We present the case of a 44-year-old woman with imported chronic brucellosis who presented with prolonged fever of unknown origin, arthralgias, hepatosplenomegaly, and bulky retroperitoneal and supraclavicular lymphadenopathy. FDG-PET/CT findings were initially suspicious for a lymphoproliferative disorder and prompted diagnostic lymph node excision. Histopathology revealed granulomatous necrotizing lymphadenitis, and Brucella spp. serology was concurrently positive, with a subsequent fourfold rise in antibody titer. Combination antibiotic therapy according to the Ioannina regimen (doxycycline and gentamicin) was initiated; due to persistently high antibody titers and the chronic nature of the disease, doxycycline therapy was extended to a total of six months. The patient achieved complete clinical cure and was discharged from follow-up after 12 months of monitoring. The discussion section addresses the clinical forms of brucellosis including neurobrucellosis, the role of imaging modalities (particularly FDG-PET/CT) in diagnosis and treatment monitoring, characteristic findings of non-specific laboratory diagnostic tests, and current principles of antibiotic therapy. This case illustrates the value of taking a targeted travel and exposure history in patients with prolonged febrile illness of unclear etiology and underscores the importance of including brucellosis in the differential diagnosis of fever of unknown origin even in non-endemic countries. Keywords: brucellosis, zoonosis, Brucella melitensis, fever of unknown origin, retroperitoneal lymphadenopathy, FDGPET/CT, doxycycline, travel medicine.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 2","pages":"75-84"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Possibilities and limitations of laboratory diagnosis of rabies in the Czech Republic].","authors":"Jan Bardoň","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This brief report outlines the history of rabies incidence and its control in animals within the Czech Republic. Furthermore, it provides information on laboratory diagnostic options for post-mortem examination of brain tissue to detect the rabies virus, which are available in the Czech Republic. It also summarizes the recommended procedures to be followed when a laboratory investigation of the central nervous system for rabies is indicated in an animal. Keywords: bat rabies, immunofluorescence test, RT-PCR, transport of samples to the laboratory, State Veterinary Institute.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 2","pages":"65-67"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current trends in sepsis diagnosis - from classic culture to advanced molecular identification].","authors":"Pavel Sauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sepsis is a critical condition characterized by life-threatening organ dysfunction caused by a dysregulated host response to infection, where each hour of delay in initiating adequate therapy increases mortality by 7-10%. This paper summarizes current trends in microbiological diagnostics, moving from the gold standard of blood culture toward advanced molecular identification. The traditional culture-based process is limited by a time lag of 12-48 hours. Modern approaches include accelerating identification from positive blood cultures using MALDI-TOF MS and RAST methods, which reduce the time to targeted treatment. Significant innovation is represented by culture-independent technologies such as T2MR, SepsiTest-UMD, Cube Dx, and InfectID-BSI, enabling pathogen detection directly from whole blood within a few hours. The future of sepsis diagnosis is further enhanced by digital PCR for absolute quantification of bacterial load, metagenomic sequencing (mNGS) for identifying unexpected pathogens, and transcriptomics for assessing the host immune response. Integrating these technologies with artificial intelligence (AI) predictive models paves the way for precision medicine and personalized care for septic patients. Keywords: sepsis, blood culture, molecular diagnostics, PCR, mNGS, MALDI-TOF MS, artificial intelligence.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 1","pages":"24-29"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Bacterial sepsis from a clinical microbiology perspective].","authors":"Milan Kolář","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sepsis constitutes a major global health challenge associated with high mortality and a substantial economic burden. From a clinical microbiology perspective, bacterial sepsis is defined as life-threatening organ dysfunction resulting froma dysregulated host response to bacterial infection. The pathogens include both Gram-negative and Gram-positive bacteria, with the etiological spectrum often reflecting the site of the primary infection. Timely identification of the causative agent and initiation of appropriate antibiotic therapy, preferably within the first hour after diagnosis, are critical for improving outcomes. Diagnostic workflows traditionally rely on blood cultures, as well as phenotypic and, when necessary, genotypic susceptibility testing. Advanced methods, such as MALDI-TOF MS, PCR-based detection of antimicrobial resistance (AMR) genes, and rapid antimicrobial susceptibility testing (RAST) significantly shorten turnaround times and facilitate targeted therapy. However, AMR remains a major therapeutic limitation and is associated with increased mortality. A comprehensive strategy encompassing optimal clinical sample collection, rapid and accurate diagnosis, careful interpretation of results, and close collaboration between microbiologists and clinicians is essential to reduce sepsis-related morbidity and mortality. Keywords: bacteria, infections, sepsis, diagnosis.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Sepsis and septic shock - a comprehensive overview].","authors":"Michal Holub, Ondřej Beran, Simona Arientová","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sepsis and septic shock are complex pathological conditions that significantly influence patient prognoses and are among the leading causes of in-hospital mortality. This review focuses on current understanding of the pathophysiology, diagnosis, and treatment of sepsis and septic shock, with an emphasis on recent advances and innovations that have emerged in the past few years, as well as their practical impact on clinical care. A comprehensive view of sepsis is presented, with particular attention given to the dysregulation of inflammatory and immune processes, as well as vascular endothelial damage leading to multiorgan dysfunction. These pathological changes contribute not only to the high mortality of sepsis, but also to long-term morbidity and late mortality among survivors. This review aims to highlight the complexity and interconnectedness of these mechanisms. Based on current knowledge, potential directions for improving care for septic patients are outlined, focusing on timely intervention and high-quality follow-up care. Keywords: sepsis, septic shock, diagnosis, therapy, mortality, morbidity.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 1","pages":"10-17"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Low prevalence of viremia in COVID-19: Clinical implications].","authors":"Jiří Sagan, Martin Kutěj, Tereza Romanová, Michal Holub, Šárka Blahutová, Nela Chobolová, Jakub Mrázek, Filip Burša, Daniela Bartková, Petra Čížová, Jan Máca","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To detect the presence of SARS-CoV-2 ribonucleic acid (RNA) in blood (viremia) in hospitalized patients with COVID-19 at hospital admission, analyze the frequency of viremia, and assess its implications for the timing of convalescent plasma therapy.</p><p><strong>Methods: </strong>In a prospective, observational, multicenter study, plasma samples were evaluated for detection of SARS-CoV-2 RNA by reverse transcription quantitative polymerase chain reaction in hospitalized patients with confirmed COVID-19 and symptom duration of seven days or less who either received or did not receive convalescent plasma.</p><p><strong>Results: </strong>Fifty-one patients were included in the analysis, with viremia detected in three patients (5.9%). In the group receiving convalescent plasma (n = 28), viremia was detected in three patients (10.7%), while it was not detected in any patient in the group not receiving convalescent plasma (n = 23). All patients with documented viremia had critical disease. Viremia was detected exclusively between the third and fourth days from symptom onset.</p><p><strong>Conclusion: </strong>The results of the study suggest that the occurrence of viremia in COVID-19 is relatively low. This fact may represent one of the factors that could limit the full therapeutic potential of convalescent plasma or monoclonal antibodies.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"32 1","pages":"4-9"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}