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Selected aspects of immunopathogenesis of HIV infection
Bartovská, Zofia ; Holub, Michal (advisor) ; Boštík, Pavel (referee) ; Marešová, Vilma (referee)
Introduction: Virus-specific CD8+ T cells are crucial to suppress the viral replication in HIV infection. Their functional status is important as well. Also, the chronic nonspecific immune activation of T and B lymphocytes plays an important role in the immunopathogenesis of HIV infection. Aim of the study: To analyze the frequency and functional status of HIV-specific CD8+ T cells and the expression of nonspecific activation markers on B and T cells in HIV+ patients and to assess the effect of combined antiretroviral therapy (cART) on these parameters. Patients and methods: Our cohort included 80 HIV+ patients: 36 HIV+ patients on cART, 18 patients without therapy, in whom cART was introduced during our study, 9 patients without therapy, 10 patients with primary HIV infection, 3 long-term non-progressors and 4 patients initially on cART, in whom the therapy was discontinued. Control group consisted of 34 HIV- healthy individuals. We examined CD4+ a CD8+ T cell counts, viral load, expression of nonspecific activation markers on T cells and the frequency of HIV-specific CD8+ T cells by ELISpot method and flow cytometry using MHC tetramers and intracellular cytokine detection. Results: No significant differences in HIV-specific CD8+ T cells were found between treated and untreated HIV+ patients. The frequency...
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Penetration of B-lactam antibiotics into cerebrospinal fluid and its relationship to inflammatory markers during invasive bacterial infection
Prášil, Petr ; Buchta, Vladimír (advisor) ; Marešová, Vilma (referee) ; Boštík, Pavel (referee)
Penetration of β-lactam antibiotics into cerebrospinal fluid and its relationship to inflammatory markers during invasive bacterial infection Aim: The penetration of β-lactam antibiotics (ceftriaxone, crystalic penicillin G - potassium salt and cefotaxime) into the cerebrospinal fluid (CSF) was estabilished and the correlation between the penetration and laboratory markers of inflammation was evaluated. Materials and methods: Levels of β-lactam antibiotics in serum and CSF were determined in 24 patients (76 samples). In all patients (n = 24) the CSF/serum ratio for antibiotics was calculated and it was correlated with laboratory markers of inflammation (C-reactive protein, fibrinogen, and CSF numbers of neutrophils). Besides, CSF was examined by a modified bactericidal test in patients (n = 13) with positive bacterial culture. In 14 patients (28 samples) levels of serum antibiotic concentration, both before and after its administration, were measured. Results: Serum levels of ceftriaxone before and after administration (31.2 mg/l ± SD 12.29 and 300.0 mg/l ± SD 125.9, respectively) differed with a statistical significance (p = 0.000156). Further, a significant difference between value of inflammatory markers and value of CSF/serum ratio (Kl/s) of ceftriaxone was observed. Patients with ratio values...
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Prognostic indicators of risk of death and the consequences of purulent meningitis
Džupová, Olga ; Janovská, Daniela (advisor) ; Křížová, Pavla (referee) ; Marešová, Vilma (referee) ; Dostál, Václav (referee)
Purulent meningitis is a life-threatening acute infectious disease of the central nervous system. In preantibiotics period was almost one hundred percent fatality rate of disease, with the discovery of antibiotics and their introduction into medical practice in 30th-50th of the last century has decreased dramatically. In recent decades, despite the use of highly effective antibiotics and intensive care procedures, there was no significant reduction in mortality rate and consequences of the disease. Lethal course of the disease affects 15-30% of patients in adulthood. Although not a common infection diagnosis among the top ten infectious causes of death worldwide. The study was based on evaluation of their own group of patients to determine prognostic factors observed history, course of illness and laboratory characteristics of the clinical outcome of disease in adults.
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Clinical and cost effectiveness of antibiotic treatment of respiratory infections
Bártů, Václava ; Sechser, Tomáš (advisor) ; Homolka, Jiří (referee) ; Marešová, Vilma (referee)
Background. Respiratory tract infections belong among the most frequent inflammatory affections. They are mostly cured as outpatients. Cases with complicated or serious course have to be hospitalized. The aim of the projeet was to evaluate the procedures of physicians of pulmonary department in the diagnosis and therapy of respiratory infections including community acquired pneumonia of inpatients. The drug prescription and its adherence to the positive list were evaluated. Clinical effectivity of therapy was evaluated according to the acquired data and cost effectivity was followed up. Methods. The projeet included 200 patients who were examined and treated according recommended standard guidelines as "usually". All diagnostic and therapeutic activity depends only on the decision of the physician without any intervention. As the patient was accepted and received antibiotics, so immediately he entered the study. The projeet protocol consisted of usual questions on which physician had to response during his deciding diagnostic and therapeutic action. The projeet had non-intervention character. The results of all decisions and examinations were recorded so to the documents of patient as to the protocol of the projeet and at the same moment to the PATS in the order not to be changed. Conclusions. Data analysis...
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Diagnosis of invasive meningococcal disease using the PCR method
Bronská, Eva ; Marešová, Vilma (advisor) ; Rožnovský, Luděk (referee) ; Žemličková, Helena (referee) ; Novák, Ivan (referee)
lntroduction: lnvasive meningococcal disease continues to be a life-threatening condition. Rapid diagnosis is important for the administration of appropriate treatment. Our study focuses on evaluation of importance of PCR method for diagnosis of meningococcal disease. We describe in detail the dynamics of PCR method and its relationship to other diagnostic methods (LA, culture) and to the course of the disease. We also evaluated the influence of previously appl ied antibiotics therapy to results ofthese diagnostic methods. Methods: We have investigated cerebrospinal fluid and serum samples collected during the 1 sl week of hospitalization from patients hospitalized at the department of infectious diseases with laboratory confirmed invasi ve meningococcal disease. Bacterial DNA was isolated from biological material by Qiagen kit and one-step and seminested PCR method was used. PCR products were detected on the 2% gel electrophoresis. In parallel, we performed culture and LA methods. Results: The PCR positivity in cerebrospinal fluid and serum achieved 92 % and 46 %, respectively, LA positivity in cerebrospinal fluid, serum and urine achieved 47 %, 42 % and 24 %, respectively. Culture of CSF and blood was positive only in 35 % and 39 %, respectively. The latest PCR positivity was detected at Day 7 in...
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