Legionella spp. in dental unit waterlines.

OBJECTIVE: To determine the current presence of Legionella spp. in the output water of dental unit waterlines (DUWLs) and examine its mitigation by disinfection at the Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc. MATERIAL AND METHODS: The first stage of our survey involved collecting samples of DUWL output water from 50 dental chair units (DCUs), and 2 samples of the incoming potable water. In October 2015, a one-time disinfection (1 % Stabimed) of DUWLs was conducted. This was followed by collecting 10 control samples (survey stage 2). RESULTS: From the total of 50 samples (survey stage 1), 18 samples (36.0 %) tested positive for Legionella spp. Following the disinfection, nine of the ten samples no longer showed any presence of Legionella. CONCLUSION: Based on culture results, the one-time disinfection (1 % Stabimed) was effective. We are unable to comment on the duration of positive effect of disinfection on the occurrence of Legionella spp. in the outlet water. It was a one-time survey (Tab. 2, Ref. 32).

[The prevalence of nasal carriage of Staphylococcus aureus aureus and methicillin-resistant S. aureus (MRSA) among general medicine students of the Palacky University Olomouc]. / Prevalence výskytu nosního nosicství kmenu Staphylococcus aureus a meticilin rezistentních kmenu S. aureus (MRSA) u studentu vseobecného lékarství LF UP v Olomouci.

INTRODUCTION: Staphylococcus aureus is one of the major agents of both healthcare- and community-associated infections. Nasal carriage of S. aureus has been reported in approximately 37% of healthy persons. OBJECTIVES: 1. To investigate the prevalence of nasal carriage of S. aureus and MRSA in healthy persons of the age group 18-26 years (general medicine students of the Palacký University Olomouc). This type of information is not available in the Czech Republic. 2. To find whether the prevalence of nasal carriage strains of S. aureus and MRSA varies over the years of studies. 3. To compare the Year 1 (baseline) and Year 5 (after a long, close contact with the indoor environment of health-care facilities) general medicine students for nasal carriage of S. aureus and MRSA strains. MATERIALS AND METHODS: The prevalence study was conducted for over 12 months in 2012 and 2013. Nasal swabs were taken from the general medicine students participating in the study. Each subject was sampled once. RESULTS: In total, 307 samples were collected: 206 samples from the Year 1 students and 101 from the Year 5 students. Sixty-one (about 32%) Year 1 students and 32 (30%) Year 5 students were positive for S. aureus. Of them, 94 (30.6%) were males and 213 (69.4%) were females. CONCLUSIONS: The observed prevalence of nasal S. aureus carriage is consistent with the literature data. No statistically significant difference in the prevalence of nasal carriage of S. aureus was found between the Year 1 and Year 5 general medicine students.

[Epidemiological investigation in five dental offices of the Clinic of Dentistry, Faculty of Medicine, Palacký University, Olomouc and of the Olomouc University Hospital]. / Epidemiologické setrení v peti ambulancích Kliniky zubního lékarství LF UP v Olomouci a FN Olomouc.

UNLABELLED: The aim of this epidemiological investigation was to determine microbial contamination of surfaces, medical devices, and equipment in five outpatient dental offices of the Clinic of Dentistry, Faculty of Medicine, Palacký University, Olomouc and of the Olomouc University Hospital. The epidemiological investigation was carried out as a one-time detection of microbial contamination from selected at risk sites on the dental unit with chair and in its immediate surroundings that had been sampled before the staff and patients arrived in the morning. The rates of culture-negative results ranged from 6.0 % in the children's dental office to 17.3 % in the dental prosthetics office. No statistically significant difference in these rates was found between different types of dental offices. The most commonly identified microorganisms were coagulase-negative staphylococci and Bacillus sp. Pseudomonas aeruginosa often reported to be the cause of hospital infection was isolated from the spit-toon drain in most of the cases. No methicillin-resistant Staphylococcus aureus was cultured from the swabs. We believe that the microorganisms isolated from the at risk sites are indoor airborne pathogens initially present in aerosols and then deposited on surfaces during the time after working hours. KEYWORDS: dental office - bioaersol - contamination of surfaces - infectious agent.

Epidemiology of Cronobacter spp. isolates from patients admitted to the Olomouc University Hospital (Czech Republic).

UNLABELLED: The data on the incidence of Cronobacter spp. was collated from hospital records for the seven-year period 2005-2011. The majority of Cronobacter spp. isolates (n = 91) were from throat swabs (61), followed by urine (5), tracheal aspirates (5), bronchoalveolar lavage (4), cannulae (4), and sputum (3) samples. This is the first study which profiles the carriage of Cronobacter spp. according to patient age, based on seven years of clinical data from 2005-2011. It reveals a high recovery (63.7% of strains, n = 91) of the organism from children, 1-14 years in age. KEYWORDS: Cronobacter spp. - meningitis - nosocomial infection.

An outbreak of Burkholderia multivorans beyond cystic fibrosis patients.

Strains of the Burkholderia cepacia complex (Bcc) are opportunistic pathogens capable of causing serious infection in cystic fibrosis patients. Recently we identified a suspected outbreak of infection with Bcc strains at the University Hospital Olomouc. Seventy-four Bcc strains were isolated from 52 patients, most of whom (N = 48) did not suffer from cystic fibrosis. Most frequently (N = 46) Burkholderia multivorans was isolated and 24 (52.2%) of these strains were clonal. Fifteen of these strains were isolated from intensive care patients, five of whom died from hospital-acquired pneumonia. B. multivorans can cause serious outbreaks of infection beyond cystic fibrosis sufferers.

Isolation of Cronobacter spp. (formerly Enterobacter sakazakii) from nostrils of healthy stable horse--short communication.

Cronobacter spp. belongs to the family Enterobacteriaceae. It is a motile (peritricha) Gram-negative non-spore forming bacterium. At present, Enterobacter sakazakii is reported as a Cronobacter spp. species with 16 biogroups. It is a ubiquitous organism whose isolation used to be associated with a contaminated powdered infant formula and feed for neonates and infants. Information about the Cronobacter spp. species incidence in the environment, its potential dissemination and its vectors, is very limited. The authors have documented incidence of Cronobacter spp. in the nostril mucous membrane of a healthy stabled horse. The above points out at the absolutely insufficient and unsystematic information about the dissemination of the Cronobacter spp. strain in the environment of animals and the people who are in contact with them.

[Tetanus immunity in the elderly in the Czech Republic]. / Imunita proti tetanu u starsích osob v Ceské republice.

The study objective was to test immunity against tetanus in the elderly in the Czech Republic. Within serological surveys and in old people's homes, 776 persons aged 60 years or more were tested for antibodies against tetanus by an ELISA method. As many as 91 % of these persons had medium to high titers of antibodies against tetanus. Low but presumably still protective titers of antibodies against tetanus were detected in 9 % of the population tested. We documented good immunity against tetanus among the elderly in the Czech Republic as a result of a rich immunization history in this country as compared with some other countries in the world. The sporadic incidence of tetanus cases in the Czech Republic over the last 15 years indirectly indicates the efficacy of the immunization strategy used.

Genotypic characterisation of vancomycin-resistant Enterococcus faecium isolates from haemato-oncological patients at Olomouc University Hospital, Czech Republic.

This study describes the first molecular characterisation of clinical isolates of vancomycin-resistant enterococci (VRE) in the Czech Republic. Of 2647 patient isolates of Enterococcus spp. from 1997-2002, 121 (4.6%) were identified as VRE. The most common isolates were VanA+ Enterococcus faecium (78%) and VanB+ Enterococcus faecalis (10%). In addition, five VanA+ E. faecium isolates were obtained from environmental and staff sampling. Macrorestriction analysis of SmaI restriction fragment length polymorphism was performed for 54 VanA+ E. faecium clinical isolates and the five VanA+ E. faecium environmental isolates. Thirty-two unique restriction endonuclease patterns were identified, including two predominant clonal types represented by five or more isolates. Two environmental VanA+ E. faecium isolates were closely related to two patient isolates, which had an identical SmaI macrorestriction pattern. The results indicated potential survival of strains in the hospital environment and possible subsequent transmission to hospitalised patients.

Persistence of antibodies against tetanus upon revaccination.

To assess the interval since the last revaccination against tetanus the persistence of antibodies was determined using ELISA test in 128 subject. Levels of antibodies against tetanus higher than the protective level of 0.1 IU/ml were found not only in those revaccinated less than ten years ago, but also in those revaccinated more than ten years before. With increasing length of the interval since last revaccination the antibody levels against tetanus decreased gradually although they remained above the protective level. No basic dependence of that trend on gender or age has been found. In the whole series, antibodies against tetanus exceeded the protective level for up to 20-25 years post last revaccination. This finding together with a favorable epidemiological situation as regards the occurrence of tetanus could eventually enable to prolong the interval for revaccinating adults in the Czech Republic.

The 2001 serologic survey in the Czech Republic--tetanus.

In 2001, a serological survey of antibody against tetanus was carded out in the Czech Republic among 499 individuals aged between 40 and 64 years. It revealed that 2.8% of them had antibody titres below protective levels and 43.3% and 53.9% respectively had medium and high antibody titres, i.e. protective levels of antibodies. These results show a good immunity level against tetanus among the Czech population aged between 40 and 64 years, likely to be ascribed to the good immunization coverage achieved. The individuals with antibody titres below protective levels need revaccination.

Does low serum immunoglobulin level contribute to the origin of a brain abscess?

Nine patients operated on for a cryptogenic cerebral abscess and healed were studied for serum immunoglobulin levels. There was a control group of another 9 patients operated on in the past for a contusion injury of the brain or cerebral haematoma. All the patients were examined after complete healing, i.e. 6 months after surgery at least. Statistically significant differences in IgA concentrations could be proved for both the groups. There was a statistically significant difference in IgG values as well. No difference was found with IgM. The possible participation of immune mechanisms in the origin of a cryptogenic cerebral abscess is discussed.