Klinicka mikrobiologie a infekcni lekarstvi最新文献_第3页

[Pneumothorax, pneumomediastinum and subcutaneous emphysema as complica-tions of COVID-19]. [新冠肺炎并发气胸、纵隔气肿和皮下肺气肿]。

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2022-03-01

Tereza Koníčková, František Puškáš, Eva Novotná, Aleš Chrdle

{"title":"[Pneumothorax, pneumomediastinum and subcutaneous emphysema as complica-tions of COVID-19].","authors":"Tereza Koníčková, František Puškáš, Eva Novotná, Aleš Chrdle","doi":"","DOIUrl":"","url":null,"abstract":"Spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema are serious complications of COVID-19 infection caused by SARS-CoV-2, occurring in approximately 1% of hospitalized patients. The risk increases with the accumulation of risk factors, namely moderate or severe illness, high-flow oxygen therapy and noninvasive ventilation. The pathophysiology may be contributed to by patient self-inflicted lung injury. Hypoxia-induced respiratory effort in patients with pneumonia puts an enormous load on certain parts of their lungs, leading to subsequent progression of lung tissue damage. These complications start with destruction of the alveolar membrane, accompanied by emergence of a pulmonary bulla. Rupture of the bulla results in air leaking to the pleural space (pneumothorax). In the case of pneumomediastinum, the air spreads within the peribronchial interstitium along the airways to the mediastinum and subcutaneous tissues (Macklin effect). While pneumomediastinum and subcutaneous emphysema resolve spontaneously in most cases, pneumothorax treatment depends on its magnitude. While small pneumothorax may be managed conservatively, large pneumothorax usually requires active treatment with an acute chest drain; the latter is also associated with worse prognosis and a higher chance of death. We report air-leak complications in nine COVID-19 patients, of whom seven had spontaneous pneumothorax and four of them died. Three patients developed spontaneous pneumomediastinum together with subcutaneous emphysema, with two of them surviving. One patient with combination of pneumothorax, pneumomediastinum and subcutaneous emphysema died. These complications may accompany moderate or severe COVID-19-associated pneumonia, mostly the late phase of the disease. They should be considered when patients complain of sudden chest or back pain or worsening respiratory insufficiency.","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"28 1","pages":"4-9"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40385974","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}

引用次数: 0

[Hepatitis D screening is important in the Czech Republic as well]. [D型肝炎筛查在捷克共和国也很重要]。

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2021-09-01

Petr Husa, Svatava Snopková, Petr Husa

引用次数: 0

[Bacterial complications in surgical management of esophageal cancer]. 食管癌手术治疗中的细菌并发症

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2021-09-01

Radek Vrba, Pavla Kučová, Lucie Ľubušká, Kateřina Fišerová, Milan Kolář

{"title":"[Bacterial complications in surgical management of esophageal cancer].","authors":"Radek Vrba, Pavla Kučová, Lucie Ľubušká, Kateřina Fišerová, Milan Kolář","doi":"","DOIUrl":"","url":null,"abstract":"One of the most common cancers is esophageal carcinoma. The basic therapeutic approach is esophagectomy, one of the most extensive procedures in general surgery, potentially leading to serious postoperative complications, in particular respiratory complications. The objective was clinical and microbiological characterization of patients after the surgical removal of the esophagus for carcinoma. In 2020, a total of 14 patients underwent the surgery. Respiratory complications occurred in 57 % of them, with pneumonia leading to respiratory failure and acute respiratory distress syndrome being noted in 21 %. The identified bacterial pathogens were strains of Acinetobacter johnsonii, Enterobacter cloacae, Serratia marcescens, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Enterococcus faecium. In one case, the patient's condition was complicated by fungal infection caused by Candida krusei. The study results warrant the need for close collaboration between the physician caring for a particular patient and a microbiologist that must be continuous and based on daily assessment of both microbiology test results and the patient's clinical condition.","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"27 3","pages":"93-97"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39803991","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}

引用次数: 0

[Draft recommendation for preparation of cumulative antibiograms in the Czech Republic]. [关于在捷克共和国编制累积抗生素图的建议草案]。

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2021-09-01

Václava Adámková

引用次数: 0

[Dual or triple combination antiretrovirals?] [双重或三重联合抗逆转录病毒药物?]

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2021-09-01

Petr Husa, Svatava Snopková

{"title":"[Dual or triple combination antiretrovirals?]","authors":"Petr Husa, Svatava Snopková","doi":"","DOIUrl":"","url":null,"abstract":"Since the beginning of the antiretroviral therapy (ART) era, its extraordinary effect in terms of morbidity and mortality has been linked to a three-drug combination HIV treatment strategy, which has been perceived as a constant paradigm for many years. However, epidemiological studies over the past decade have clearly shown that ART does not result in complete normalization of all biomarkers, and some degree of systemic immune activation and inflammation, including endothelial dysfunction, persist. It is generally accepted that these pathophysiological processes are the cause of non-AIDS diseases, which are clinically manifested in people living with HIV on average 10 years earlier than in the general HIV-negative population. HIV treatment is not eradicative but only inhibitive and requires regular daily medication. This increases the risk of the cumulative impact of side effects and drug toxicity. In addition, it is expected that there will be a significant increase in the number of patients with various other non-AIDS comorbidities that will require multiple medication in the coming years. In particular, the higher genetic barrier of the new generation of drugs and an improved safety profile have raised the question of the effectiveness of two-drug combination regimens with the fundamental goal of reducing the burden on the human body by different drugs while maintaining high efficacy fully comparable to the current three-drug combination strategy. However, the question of whether dual combination regimens can sufficiently suppress the persistence of chronic inflammation and immune activation remains unanswered. To answer such a question, robust data from large prospective randomized studies are needed, which are still lacking. This review discusses the principle of systemic immune activation, its regenerative potential in ART, the expected causes leading to systemic immune activation, intervention options to influence it, as well as the limitations of studies to date.","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"27 3","pages":"116-123"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39803994","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}

引用次数: 0

[COVID-19: diagnosis and treatment]. [COVID-19:诊断和治疗]。

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2021-06-01

Marek Štefan, Aleš Chrdle, Petr Husa, Jiří Beneš, Pavel Dlouhý

{"title":"[COVID-19: diagnosis and treatment].","authors":"Marek Štefan, Aleš Chrdle, Petr Husa, Jiří Beneš, Pavel Dlouhý","doi":"","DOIUrl":"","url":null,"abstract":"The guidelines provide evidence-based recommendations for the management of COVID-19. The clinical manifestations of the disease are described and indication criteria for hospital admission of patients with COVID-19 are listed. Polymerase chain reaction and antigen testing are used in direct diagnostics. Indirect detection of infection by antibodies is currently of limited value. There are a number of hematological and biochemical laboratory test used to diagnose COVID-19. Pathological values of some laboratory parameters are associated with severity of COVID-19. Of the imaging studies, chest X-ray, chest computer tomography and lung ultrasound are used. COVID-19 therapy includes symptomatic and specific therapy (antivirals, immunotherapeutics and anticoagulants) and intensive care in the severe and critical forms of the disease. Remdesivir and favipiravir are available as antiviral agents. Immunotherapeutics include monoclonal antibodies (casirivimab/imdevimab, bamlanivimab/etesevimab), dexamethas one, baricitinib and tocilizumab. Low-molecular-weight heparin is a dominant form of anticoagulant therapy. The guidelines provide specific therapeutic recommendations for each stage of the disease. Antibiotics are recommended only if bacterial superinfection is suspected or demonstrated, which is not common in the early stages of the disease.","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"27 2","pages":"61-87"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39517267","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}

引用次数: 0

[COVID-19: diagnosis and treatment outside hospital]. [COVID-19:诊断和院外治疗]。

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2021-06-01

Aleš Chrdle, Pavel Dlouhý, Marek Štefan

引用次数: 0

[Manual for physicians in COVID-19 units]. [COVID-19单位医生手册]。

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2021-06-01

Pavel Dlouhý, Marek Štefan, Aleš Chrdle, Hynek Bartoš

引用次数: 0

[Vaccination against COVID-19]. [COVID-19疫苗接种]。

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2021-06-01

Marek Štefan, Pavel Dlouhý, Lenka Bezdíčková

{"title":"[Vaccination against COVID-19].","authors":"Marek Štefan, Pavel Dlouhý, Lenka Bezdíčková","doi":"","DOIUrl":"","url":null,"abstract":"Vaccination is essential to manage the COVID-19 pandemic. Vaccination significantly protects against severe COVID-19, hospitalization and death; it also protects against symptomatic infection and reduces the risk of transmission to other people. Protection against the new SARS-CoV-2 variants may be lower, but protection against severe course and death remains high. Two mRNA vaccines (BNT162b2 and mRNA-1273) and two vector vaccines (AZD1222 and Ad26.COV2.S) are currently available in the Czech Republic. Vaccination of persons over 60 years of age and immunocompromised persons, who are demonstrably at the highest risk of a serious course of the disease, is of the utmost importance. In order to achieve adequate vaccination coverage, it is necessary to motivate other groups of people to be vaccinated, including children over 12 years of age and young adults. Vaccination is also recommended in pregnant women in the 2nd and 3rd trimesters and in breastfeeding women. For selected groups of vaccines, a third dose of vaccination is recommended (additional third dose 4 weeks after the second dose or a booster dose 8 to 12 months after the second dose). The side effects are usually mild, with serious complications (including anaphylaxis, thrombocytopenia with thrombosis syndrome, myocarditis, Guillain-Barré syndrome and capillary leak syndrome) being rare.","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"27 2","pages":"49-60"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39517266","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}

引用次数: 0

[Impact of outreach testing on elimination of hepatitis C]. [外展检测对消除丙型肝炎的影响]

Klinicka mikrobiologie a infekcni lekarstvi Pub Date : 2021-03-01

Petr Husa, Petr Husa

{"title":"[Impact of outreach testing on elimination of hepatitis C].","authors":"Petr Husa, Petr Husa","doi":"","DOIUrl":"","url":null,"abstract":"Objectives: Analysis of changes in a group of patients with chronic hepatitis C (CHC) treated with direct-acting antivirals (DAAs) with a special focus on risk factors for transmission. Evaluation of cooperation with organizations working with people who inject drugs (PWID) including the impact of outreach testing.Methods: A retrospective analysis and interannual comparison of CHC patients treated with DAAs at the Department of Infectious Diseases, University Hospital Brno, Czech Republic between 2018 and 2020.Results: A total of 291 (101 in the year 2018, 111 in 2019 and 79 in 2020) patients with CHC have been treated. Comparison of results from the years 2018, 2019 and 2020 demonstrated a significant rise in the proportion of PWID (46.5 %, 64.9 % and 65.8 %, respectively). Also the proportion of genotype 3a infection (23.8 %, 30.6 % and 35.4 %) increased at the expense of genotype 1b infection (52.5 %, 46.9 % and 38.0 %). By contrast, the median age (43, 40 and 38 years) and the proportion of patients with liver cirrhosis decreased (20.8 %, 15.3 % and 12.7 %). The percentage of patients started on DAA therapy within one year of diagnosis increased (47.5 %, 53.2 % and 62.0 %). And so did the proportion of patients receiving therapy as a result of cooperation with organizations and facilities working with PWID (5.9 %, 25.2 % and 25.3 %). The downside was high numbers of patients lost to follow-up (19.8 %, 23.4 % and 22.3 %). Those were mostly patients who completed their therapy as planned and were only lost to after receiving the final dose of DAAs.Conclusions: The fact that PWID have gradually become the dominant group of CHC patients is accompanied by a younger age of treated patients, a higher proportion of those with genotype 3a and less advanced liver damage. The changing spectrum of CHC patients makes medical professionals change their approach. Outreach testing and cooperation with organizations working with PWID have proved an effective way of improving the diagnosis and treatment of CHC.","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"27 1","pages":"13-17"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39517650","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}

引用次数: 0