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Severe community-acquired pneumonia: Patient characteristics and reliability of the scoring systems
Bartoš, Hynek ; Džupová, Olga (advisor) ; Kieslichová, Eva (referee) ; Rožnovský, Luděk (referee)
Introduction: Even in the 21st century, pneumonia represents a serious medical problem with high morbidity and mortality. The aim of the clinical study was to describe the group of patients with severe community-acquired pneumonia and to evaluate the predictive efficiency of the applied scoring systems. Methods: A prospective multicenter observational study was carried out in the period 1/9/2017 - 1/7/2021 in three Czech ICU. Patients with community-acquired pneumonia requiring ICU admission within 48 hours of hospital admission were included in the study. Anamnestic data, clinical manifestations, etiological agent, antibiotic treatment, applied intensive care methods and treatment outcomes were recorded. A total of ten scoring systems were applied to describe the clinical severity of pneumonia and their reliability was evaluated in terms of predicting mortality and the need for intensive care. Due to the current covid-19 pandemic, patients with coronavirus infection were also included in the study; for analysis, the patients were divided into two groups - covid and non-covid. Results: A total of 315 patients, 68.3% men and 31.7% women, with the age range of 18-88 years and an average age of 61.1 ± 14.1 years, were included in the study. Fifty-nine percent of patients had at least one serious comorbidity,...
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Diagnostics of neuroinfection caused by human herpesviruses using nucleic acid amplification methods
Labská, Klára ; Marešová, Vilma (advisor) ; Rožnovský, Luděk (referee) ; Krbková, Lenka (referee)
of thesis Diagnostics of neuroinfection caused by human herpesviruses using nucleic acid amplification methods author: MUDr. Klára Labská supervisor: doc. MUDr. Vilma Marešová, CSc. In recent years, the diagnosis of neuroinfections has undergone a shift towards molecular biology methods. Our research focused on the predictive value of the capture of herpesvirus (HV) DNA in cerebrospinal fluid. In the first study, we examined the presence of DNA neurotropic herpes viruses (HSV1, HSV2, VZV and HHV6) in cerebrospinal fluid in immunocompetent patients with laboratory-confirmed tick-borne meningoencephalitis and enterovirus meningitis and meningoencephalitis. The control group consisted of patients with proven absence of an inflammation in the cerebrospinal fluid. Patients were followed for 6 months. The course of the disease and its consequences, including laboratory tests, were compared between groups of patients with and without the presence of HV DNA. In the second study, we tried to demonstrate the presence of HSV1 DNA in cerebrospinal fluid during its symptomatic reactivation in patients with purulent meningitis. In our group of immunocompetent patients with non-purulent inflammation in the cerebrospinal fluid, the proportion of HV DNA positive patients reached 7.5% (13 out of 173), we also...
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Clinical and epidemiological features of the most commonly imported febrile illnesses and preventive measures
Trojánek, Milan ; Marešová, Vilma (advisor) ; Rožnovský, Luděk (referee) ; Chlíbek, Roman (referee)
The objective of the presented thesis was to evaluate epidemiological and clinical characteristics of the most significant tropical febrile infections imported to the Czech Republic, which include dengue and chikungunya fever, malaria and enteric fever. This retrospective-prospective study included a total of 292 patients with fever after a stay in the tropics who were treated at the Department of Infectious, Parasitic and Tropical Diseases of Hospital Na Bulovce in the years 2006-2014. The most common illnesses were dengue fever (52.1%), followed by malaria (37.3%), enteric fever (6.2%) and chikungunya fever (4.4%). Dengue fever was imported in 88.2% cases from Southeast or South Asia and malaria in 63.3% from Sub-Saharan Africa. Typical clinical and laboratory findings in dengue fever included headache (72.4%), rash (71.7%), muscle (67.6%) and joint pain (62.1%), leukocytopenia (26.5%), thrombocytopenia (22.4%), and low CRP (57.1%). Presented study confirmed that laboratory parameters differ in the acute and early convalescent phase of dengue fever. A total of 62.7% patients with malaria reported hedache and other frequent symptoms were dyspepsia (45.1%), dehydration (30.4%) and tachycardia (28.4%). Laboratory findings included high CRP (71.4%), decreased platelet count (52.4%) and...
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Electron microscopy in the diagnosis of viral gastroenteritis in children less than five years old.
Arientová, Simona ; Marešová, Vilma (advisor) ; Rožnovský, Luděk (referee) ; Krbková, Lenka (referee)
Acute gastroenteritis is one of the most frequent diseases in children worldwide and remains the main cause of childhood morbidity and mortality, particularly in developing countries. Each year as many as 1.5 million children less than first five years die in the world from acute gastroenteritis. Our study has been aimed at demonstrating of the main role of viruses in the aetiology of acute gastroenteritis in children less than five years old and at pointing out the diagnostic potential of electron microscopy in viral gastroenteritis. A prospective study was conducted to analyse the aetiology of diarrhoeal diseases in children less than five years of age admitted to the Department of Infectious Diseases of the Na Bulovce Hospital, Prague, between September, 2006 and June, 2009. All children were tested by faecal culture for bacterial aetiology and by latex agglutination and electron microscopy for viral aetiology. A total of 1059 children were included in the study. The mean age of children was 1.9 years and the mean length of hospitalisation was 5.2 days. An aetiological agent was detected in 1051 children (95.9%). A bacterial aetiology was found in 22 (2.1%) children, bacterial-viral co-infection was found in 183 (17.3%) patients and viruses were detected in 810 (76.5%) patients. The main causes of viral...
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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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