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Cytomegalovirus infection after kidney transplantation
Reischig, Tomáš ; Třeška, Vladislav (advisor) ; Viklický, Ondřej (referee) ; Zadražil, Josef (referee) ; Pazdiora, Petr (referee)
1 SUMMARY Cytomegalovirus (CMV) disease is a common infectious complication in patients after solid organ transplantation. The last decade witnessed major advances in CMV disease prevention. Use of universal prophylaxis or preemptive therapy resulted in a decrease in the incidence of CMV disease from 20-60% to 5-20%. However, the efficacy of preventive approaches in terms of indirect effects of CMV occurrence is problematic. Association with allograft rejection belongs to well documented and clinically extremely important indirect effects of CMV with a prolonged adverse impact on graft survival. Potential mechanisms include overexpression of major histocompatibility complex molecules, growth factors and cytokines, and upregulation of adhesion molecules. A number of questions remain to be answered in evaluating CMV as a risk factor for acute rejection. While CMV disease is associated with an increased incidence of acute rejection, data regarding the role of asymptomatic CMV viremia are controversial. In our research we evaluated the role of CMV in pathogenesis of allograft rejection in the era of modern immunosuppression and CMV prophylaxis as well as optimal preventive strategy to minimize impact of CMV. In the first trial, renal transplant (RTx) recipients were followed prospectively for 12 months to...
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Epidemiological aspect of pertussis in the Czech Republic
Fabiánová, Kateřina ; Kříž, Bohumír (advisor) ; Pazdiora, Petr (referee) ; Smetana, Jan (referee)
The aim was to document the trend in pertussis in the Czech Republic (CR) with regard to the infant population under one year of age, which is at highest risk for pertussis. Another point was to answer two questions: 1) whether the recent rise in pertussis cases in the CR is caused by new lineages of B. pertussis, against which the available vaccines are not effective, and 2) whether the circulating strains of B. pertussis are susceptible to antibiotics of choice. Data on pertussis cases were derived from the surveillance programme. Two hundred and sixty-five children under one year of age with laboratory confirmed pertussis, diagnosed between 1997 and 2013, were included in the study. B. pertussis isolates obtained within the surveillance of pertussis were examined by molecular biological methods - MAST (multiantigen sequence typing), MLVA (multilocus variable-number tandem-repeat analysis), and MLST (multilocus sequence typing). B. pertussis strains isolated from patients between 1967 and 2010 were tested for susceptibility to first-line antibiotics for the treatment of pertussis. The analysis of the epidemiological situation confirmed an upward trend in pertussis in the CR since the 1990s in all age categories, including children under one year of age. Nearly 77 % of children acquired pertussis...
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Infectious complications after kidney transplantation
Kačer, Martin ; Reischig, Tomáš (advisor) ; Pazdiora, Petr (referee) ; Seeman, Tomáš (referee)
3 Abstract Infectious complications after kidney transplantation In the general part of this work, the most common and typical infectious complications in renal transplant recipients are reviewed. The practical part presents results of our research on prevention of the most common infection in renal transplant recipients, cytomegalovirus infection. Globally, infection belongs amongst the main causes of morbidity of solid organ recipients and is the second leading cause of mortality in patients with a functioning kidney graft. In the first year post kidney transplant, approximately one half of recipients undergo a clinically apparent infectious complication and 20% of patients are hospitalized due to infection. Cytomegalovirus (CMV) is the most common viral infection in kidney transplant patients and its occurence is associated with serious negative consequences for both kidney and patient survival. Prevention of CMV is essential in renal transplant recipients. Valganciclovir, due to its efficacy and good bioavailability, is the most commonly used antiviral agent used in CMV prophylaxis. The only currently recommended alternative for the prevention of CMV in patients undergoing renal transplantation is valacyclovir. So far, studies comparing valacyclovir and valganciclovir for CMV prophylaxis in renal...
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Infectious complications after kidney transplantation
Kačer, Martin ; Reischig, Tomáš (advisor) ; Pazdiora, Petr (referee) ; Seeman, Tomáš (referee)
3 Abstract Infectious complications after kidney transplantation In the general part of this work, the most common and typical infectious complications in renal transplant recipients are reviewed. The practical part presents results of our research on prevention of the most common infection in renal transplant recipients, cytomegalovirus infection. Globally, infection belongs amongst the main causes of morbidity of solid organ recipients and is the second leading cause of mortality in patients with a functioning kidney graft. In the first year post kidney transplant, approximately one half of recipients undergo a clinically apparent infectious complication and 20% of patients are hospitalized due to infection. Cytomegalovirus (CMV) is the most common viral infection in kidney transplant patients and its occurence is associated with serious negative consequences for both kidney and patient survival. Prevention of CMV is essential in renal transplant recipients. Valganciclovir, due to its efficacy and good bioavailability, is the most commonly used antiviral agent used in CMV prophylaxis. The only currently recommended alternative for the prevention of CMV in patients undergoing renal transplantation is valacyclovir. So far, studies comparing valacyclovir and valganciclovir for CMV prophylaxis in renal...
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Epidemiological aspect of pertussis in the Czech Republic
Fabiánová, Kateřina ; Kříž, Bohumír (advisor) ; Pazdiora, Petr (referee) ; Smetana, Jan (referee)
The aim was to document the trend in pertussis in the Czech Republic (CR) with regard to the infant population under one year of age, which is at highest risk for pertussis. Another point was to answer two questions: 1) whether the recent rise in pertussis cases in the CR is caused by new lineages of B. pertussis, against which the available vaccines are not effective, and 2) whether the circulating strains of B. pertussis are susceptible to antibiotics of choice. Data on pertussis cases were derived from the surveillance programme. Two hundred and sixty-five children under one year of age with laboratory confirmed pertussis, diagnosed between 1997 and 2013, were included in the study. B. pertussis isolates obtained within the surveillance of pertussis were examined by molecular biological methods - MAST (multiantigen sequence typing), MLVA (multilocus variable-number tandem-repeat analysis), and MLST (multilocus sequence typing). B. pertussis strains isolated from patients between 1967 and 2010 were tested for susceptibility to first-line antibiotics for the treatment of pertussis. The analysis of the epidemiological situation confirmed an upward trend in pertussis in the CR since the 1990s in all age categories, including children under one year of age. Nearly 77 % of children acquired pertussis...
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Cytomegalovirus infection after kidney transplantation
Reischig, Tomáš ; Třeška, Vladislav (advisor) ; Viklický, Ondřej (referee) ; Zadražil, Josef (referee) ; Pazdiora, Petr (referee)
1 SUMMARY Cytomegalovirus (CMV) disease is a common infectious complication in patients after solid organ transplantation. The last decade witnessed major advances in CMV disease prevention. Use of universal prophylaxis or preemptive therapy resulted in a decrease in the incidence of CMV disease from 20-60% to 5-20%. However, the efficacy of preventive approaches in terms of indirect effects of CMV occurrence is problematic. Association with allograft rejection belongs to well documented and clinically extremely important indirect effects of CMV with a prolonged adverse impact on graft survival. Potential mechanisms include overexpression of major histocompatibility complex molecules, growth factors and cytokines, and upregulation of adhesion molecules. A number of questions remain to be answered in evaluating CMV as a risk factor for acute rejection. While CMV disease is associated with an increased incidence of acute rejection, data regarding the role of asymptomatic CMV viremia are controversial. In our research we evaluated the role of CMV in pathogenesis of allograft rejection in the era of modern immunosuppression and CMV prophylaxis as well as optimal preventive strategy to minimize impact of CMV. In the first trial, renal transplant (RTx) recipients were followed prospectively for 12 months to...
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Toxoplasmosis-selected epidemiological characteristics and laboratory experience in Pilsen
Fajfrlík, Karel ; Pazdiora, Petr (advisor) ; Kodym, Petr (referee) ; Staňková, Marie (referee)
Toxoplasmosis is one the most prevalent protozoan diseases in the world. Some regions declare up to 80% presence of antibodies in human population. The prevalence in Czech Republic varies depending on the region between 25%-50%. The cause of this disease is protozoan Toxoplasma gondii. The final host is cat and other felines in which GIT the sexual cycle of this parasite takes place. Human together with other 350 animal species is the intermediate host. In those individuals parasite forms so called tissue cysts in which it could persist for its entire life. The infection is acquired through undercooked meat or organs of the intermediate host, manipulation with meat or organs of infected individuals, eating of food contaminated with cat feces and/or through contact with contaminated outside environment. Infection proceeds without any symptoms in 90% of immunocompetent patients. 10% patients display sometimes very various clinical symptoms. The disease is divided into different forms according to prevailing symptoms. This disease presents a great danger to immunosuppressed patients and pregnant females. In the first group it can cause a serious damage of CNS (Central Nervous System) and in some parts of the world it is one of the most frequent death causes in HIV positive patients. In pregnant females...
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