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Molekulární diagnostika septických stavů
Nekudová, Pavlína
Sepsis is a life-threatening condition that occurs because of the host's immune response to infection. Early and correct identification of the causative agent of sepsis is crucial for the survival of septic patients to initiate targeted therapy as soon as possible. Despite the advances in molecular biological methods used to detect pathogens, blood cultures remain the recommended standard for identifying the cause of sepsis. However, this method is time-consuming, so it does not significantly affect the initial therapy of sepsis. As part of this bachelor's thesis, research was written on the topic of sepsis and detection methods enabling the identification of sepsis agents. Emphasis was placed on molecular biological methods using the polymerase chain reaction. In the experimental part, the possibilities of pre-analytical processing of blood, which is the primary material for the detection of sepsis, were investigated. Approaches that could increase the sensitivity of detection or facilitate the handling of the sample in the diagnostic laboratory using the PCR-based method were evaluated. The use of the commercial MolYsis-Basic5 kit resulted in only a slight improvement in detection sensitivity. The use of plasma as a clinical material instead of blood is relevant. Unlike blood, we can freeze and store plasma. The time and cost of these approaches, together with the higher laboratory equipment requirements, are not balanced by the benefits in terms of increased detection sensitivity. Thus, the use of these pre-analytical approaches will not be further considered in the development of a system for rapid molecular diagnosis of sepsis.
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Bloodstream infection in patients during the COVID-19 pandemic in of General University Hospital in Prague
BAUER, Kristýna
Blood stream infection is one of the serious life-threatening conditions of hospitalized patients with coronavirus disease during the COVID-19 pandemic in the Czech Republic. This is the penetration of microorganisms into the bloodstream, which is accompanied by symptoms of a general infection. The most common consequence is the development of sepsis. The aim of the laboratory examination is to obtain a reliable blood culture result. Such a result can only be achieved if all procedures are followed, from the indication by the doctor to the process of sampling by the medical staff into the bottles directly intended for this purpose. Taking blood cultures confirms or excludes the presence of bacteria in the bloodstream. Blood cultures are the gold standard for diagnosing bloodstream infections. A detection culture is used for hemocultivation of the BacT/Alert 3D system, which is based on the colorimetric detection of CO2 produced by growing microorganisms in blood cultures.
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Artificial intelligence for predicting sepsis from clinical signals
Šidlo, David ; Chmelík, Jiří (referee) ; Vičar, Tomáš (advisor)
This bachelor thesis deals with the issue of predicting sepsis from clinical data using artificial intelligence methods. In the theoretical part, a literature research is made on the basic principles and functioning of various methods of artificial intelligence. Greater emphasis was placed on recurrent neural networks. The aim of the practical part was to implement a suitable method in the chosen programming environment. The LSTM network and the temporal convolutional network TCN were chosen as suitable methods. The best results of the normalized value of the utility score were achieved by TCN, namely 0.377 and seven-layer LSTM 0.356.
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Analysis of volatile organic compounds produced by monocytes during sepsis
Bártová, Adéla ; Řezáčová, Veronika (referee) ; Mravcová, Ludmila (advisor)
This thesis is focused on the possibility of analysis of volatile organic compounds produced by monocytes during sepsis. Method of comprehensive two-dimensional gas chromatography with mass spectrometric detection was chosen for this purpose. Content of the first part was the optimization of the method of two-dimensional gas chromatography for the determination of volatile organic compounds. In this part were gradually adjusted parameters of the gas chromatography method to achieve the maximum efficiency. Further were adjusted conditions of samples preparation. Content of the second part was the usage of already optimized method for the analysis of the samples set of monocytes. Samples were subjected to the action of different inhibitors of the immune system and stimulators simulating bacterial or yeast infection. Based on this analysis were identified some compounds, which are produced by monocytes under condition simulating the infection.
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Septic condition from the perspective of clinical microbiology
SZITAIOVÁ, Markéta
This thesis focused on the issue of bloodstream infections from the poin of view of clinical microbiology. Diagnostics using BACT/ALERT Virtuo automatic blood culture system. In the theoretical part of the thesis, there are mentions of diseases of the blood stream, the causative agents of sepsis, and the method of isolation. In the practical part of the thesis, data obtained in the Pilsen University Hospital are processed, focusing on the most common agents causing sepsis.
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The observance of nursing processes during the care of vascular inputs focusing on the prevention of catheter infections.
TŘEŠNIČKOVÁ, Nikola
This bachelor's thesis on the topic ,,The observance of nursing processes during the care of vascular inputs focusing on the prevention of catheter infections" consists of a theoretical and a research part. The theoretical part focuses on vascular access in general and on individual peripheral and central catheters. Firstly, it provides information on nursing care for vascular access. The thesis also deals with infections associated with health care. And finally, the work informs about catheter infections, sepsis and septic shock. The research part was processed in the formo f qualitative research. The aim was to find out how nurses following nursing processes during the care of vascular inputs with a focus on the prevention of catheter infections. Five research questions were identified for this purpose. Qualitative data collection was realized by semi-structured interviews and covert observation. The research group consisted of ten nurses working in internal departments. The selection of informants was intentional and carried out using the snowball method. The results show that nurses have experience in nursing care of peripheral venous catheters rather than central venous catheters. The results also show that nurses have theoretical knowledge of the specifics of nursing care. However, based on observations, it was found that some nurses do not follow the specifics of nursing care. The results of bachelor's thesis research can be beneficial for all nurses across all departments. But they can be also used as information materiál for medical students.
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Methods for detection of impaired immune response in cardiac-surgical patients
Kormundová, Nikola ; Koláčková, Martina (advisor) ; Filipp, Dominik (referee)
In patients after cardiac surgery, there is an increase in the level of molecules with both pro-inflammatory and anti-inflammatory effects. This increase is influenced by the patient's clinical condition, but also by the nature of the operation itself, which uses conventional extracorporeal circulation. This technique leads to damage to blood elements by direct contact with air and parts of the extracorporeal circulation, as well as to ischemia-reperfusion injury. The specifics of cardiac surgery then affect possible postoperative complications such as multiorgan failure or septic shock. The diploma thesis is divided into a theoretical and a practical part. The theoretical part describes the principle and influence of cardiopulmonary bypass on the human body and the complications that are associated with its use. Furthermore, IFN-γ is described herein as a potential marker of septic conditions that could reflect the clinical postoperative condition of patients. The practical part of the diploma thesis monitored the percentage change of selected cell populations and the production of IFN-γ in the peripheral blood of patients before and after cardiac surgery. Furthermore, the response of individual isolated populations of healthy volunteers to selected stimulators was investigated. The percentage of...
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Procalcitonin as an early marker of bacterial infection
Mikulová, Lenka ; Beránek, Martin (advisor) ; Drastíková, Monika (referee)
Introduction: Procalcitonin (PCT) is a 13 kD protein with a chain of 116 amino acids. It consists of parafollicularcells of the thyroid gland. Inflammatory procalcitonin is made up of 114 amino acids. Procalcitonin from plasma in the course of inflammatory process, does not consistof C-cells of the thyroid gland but it is generatedin the liver, and, to a lesser extent, in the lungs, kidneys, testes, prostate and small intestine. Objectives: 1. To compare the levels and the dynamics of C-reactive protein (CRP) and procalcitonin in the inflammatory process. in three patients with different diagnoses. To compare the number of examined PCT according to indicated VFN (General University Hospital) departments in the years 2009, 2012 and 2015. 3. To study the dynamics of the number of examined PCT in the years 2001- 2016. Methods: The levels of CRP and PCT were measured in the ÚLBLD laboratory of the General University Hospital in Prague in the period from May 20to June 17, 2016. The CRP was measured by immunoturbidimetricanalyzerUnicelDxC 880i. The PCT was measured by theCobas analyser using the electrochemiluminescence technology. In order to evaluate the data, graphs were processed with levels of bothanalytesfor 3 patients. Further, data needed for the evaluation of the above mentioned objectives no. 2...
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Determination of biochemical parameters and their diagnostic and prognostic value in sepsis
Jenčo, Jaroslav ; Dršata, Jaroslav (advisor) ; Boušová, Iva (referee)
Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biochemical Sciences Candidate: Bc. Jaroslav Jenčo Supervisor: prof. MUDr. Jaroslav Dršata, CSc. Consultant: Ing. Jana Netriová, PhD. Title of diploma thesis: Determination of biochemical parameters and their diagnostic and prognostic value in sepsis Sepsis is a relatively common complication that may be signed by the increased mortality of patients. It affects all ages, regardless of gender. Occurrence is more frequent in polymorbid and immunosuppressed patients. The most effective method to prevent the development of septic complications is quick and accurate diagnosis. In the period from 1.6.2012 to 01.4.2014, we observed 697 patients hospitalized due to the development of septic complications and we analyzed statistically tracked markers: presepsin, procalcitonin, C - reactive protein, interleukin - 6, lactate, D - dimer, fibrinogen and quantity of leukocytes to determine their predictive and diagnostic value. Largest correlation was observed between comparison of presepsin with procalcitonin and presepsin with C - reactive protein, which reflected rapidly changing status of patients. Moderate correlation was observed in lactate, interleukin - 6, D - dimer concentration and leukocyte count. Between the development...
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Sepsis in newborne
Baláčková, Šárka ; Voxová, Barbora (advisor) ; Paterová, Pavla (referee)
Author: Šárka Baláčková Title: Septic states of newborns Bachelor thesis Charles University in Prague, Faculty of Pharmacy in Hradec Králové Field of study: medical laboratory technician Background: The aim of the work was to sample information on the issue of septic states of newborns, to describe laboratory diagnosis of examining neonatal sepsis. To map rate of the most common pathogens causing this illness in Masarykova hospital in Ústí nad Labem. Method: Tracking of sampled blood cultures at neonatal department between years 2011- 2015. Comparison of total amount of blood cultures with the amount of positive blood cultures and the rate of particular pathogens causing neonatal sepsis. Results: During the reporting period were collected a 5271 blood cultures to total count. 1047 of those were positive, making it 20 %. The most prominent causes of neonatal sepsis is above all coagulase-negative Staphylococcus with the count of 801 occurrences, which is 76,5 %. Followed by Gram-negative facultative anaerobic rods with 103 occurrences (10,8 %), Anaerobic bacteria with 48 counts (4,6 %), Enterococcus species with 31 counts (3%), Staphylococcus aureus with 26 counts (2,5 %), Streptococcus species with 21 counts (2 %) and Yeasts with 7 counts (0,7 %). Conclusions: Neonatal septic state is a serious...
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