[Spoligotypes of Mycobacterium tuberculosis in the Czech population (methods and pilot study)]. / Spoligotypy ceských populací Mycobacteria tuberculosis (metodické principy a pilotní studie).

In the introduction the authors describe molecular genetic principles of spacer oligonucleotide typing of the M. tuberculosis complex and mention in detail the methodical procedure of implementation of this examination technique incl. computer analysis of results. In the pilot part of the study the authors describe examination of 71 strains of M. tuberculosis isolated from patients living in the capital of Prague and 37 strains from patients in the South Moravian region of the Czech Republic. In the group of Prague strains a total of 7 clusters was identified formed by 2-14 identical profiles of spoligotypes and 37 individually different profiles. In the South Moravian strains there were 6 clusters with 2-14 identical spoligotypes and 10 non-clustered profiles. In neither of the groups there were spoligotypes typical for the genetic family Beijing or Africa. The study is a preliminary molecular epidemiological analysis where DNA fingerprint RFLP profiles are compared with spoligotypes of strains of M. tuberculosis of patients from the capital of Prague and the South Moravian region of the Czech Republic.

[Human transmission of tuberculosis confirmed by DNA fingerprinting]. / Interhumánní prenos tuberkulózy potvrzený fingerprintingem DNA.

By means of fingerprinting based on detection of the insertive sequence IS6110 v DNA of M. tuberculosis predigested by the restrictive enzyme PVUII the authors proved epidemiological associations in three patients with bacillary tuberculosis. The primary source of infection was a 44-year-old man, alcoholic and homeless suffering from tuberculosis diagnosed during an episode of ethylic ebriety, discharged prematurely from hospital because of lack of discipline and drunkenness who died after 8 months with a finding of caseous pneumonia. The first contact person was a 53-year-old women suffering from diabetes and hypertension, an auxiliary worker in the laboratory where she probably was infected during manipulation of the patients infected sputum. The other patients was a 49-year-old man, alcoholic, unemployed where a symptomatic tuberculous finding was detected with general weakness, elevated temperatures and expectoration, who most probably was infected by a patient during accidental contact in his domicile. The profiles of RFLP strains of M. tuberculosis of all three patients had an identical appearance of the DF-1 clone formed by seven copies of IS6110. This profile was not found in any of the total of 98 strains of M. tuberculosis examined within the framework of the molecular epidemiological prevalence study of patients with bacillary tuberculosis notified in Prague in 1999.

Staphylococcus aureus at a maternity ward. I. Colonization of mothers and neonates and survival of various S. aureus types in colonized individuals.

Colonization by Staphylococcus aureus, characterized by phage type or production of enterotoxins and toxic-shock-syndrome-toxin, was followed in 50 mothers and their babies. Types or groups of staphylococci predominating during the particular period at the maternity department were evaluated according to survival rates in the colonized subjects. S. aureus frequently colonized nipples at the start of lactation and was found regularly on umbilical stump and in eye and mouth corners of the babies. During the second stage of the study phage untypable staphylococci producing enterotoxin C (NT/C) strongly predominated. These microorganisms colonized in the greatest extent both mothers and neonates. The majority of NT/C complex originated probably from one or two clones characterized, among others, by high biological activity.

Staphylococcus aureus at a maternity ward. II. Characterization of isolates by enterotoxigenicity and toxic shock syndrome toxin (TSST-1) production.

Tests for enterotoxins A, B, C, D, E and TSST-1 production were carried out on 775 S. aureus strains isolated from various sources (50 mothers and neonates studied periodically, mothers and infants treated for various acute inflammatory conditions, members of hospital staff, environmental swabs) during the period 1981-1983 at a maternity ward chosen for a 3-year systematic study and on additional 97 isolates obtained in 1985 from another maternity ward. This had contributed to a better classification of strains within certain phage type groups. It was found that the distribution of S. aureus types in the particular sub-sets varied, depending on the source of isolates. At the maternity ward followed for 3 years there was a clear-cut trend towards the spread of phage-untypable isolates producing enterotoxin C whereas at ward examined for comparative purposes B enterotoxin producers of phage type 95 were predominant. The tests for enterotoxigenicity has also proved to be useful as the epidemiological marker characterizing the predominantly circulating S. aureus strain. It has been confirmed that the majority role in the spread of maternity-ward-staphylococci is played by the neonates and the factors of hospital environment.

Effect of raised type-3 poliovaccine dose on virus excretion.

Excretion of attenuated polioviruses after controlled type 3 poliovaccine administration was studied in the district city of Cheb. The usual type 3 dose, 10(5) TCD50, was doubled in some vaccinees. A total of 972 stool samples collected from primary vaccinees and their family members were examined; three samplings were carried out in most of the subjects. At first sampling, 9 weeks after administration of type 1 + 2 mixture and 1 day before administration of type 3, all poliovirus types were isolated from primary vaccinees, but family members were negative. At second sampling, 14 days after type 3 administration, primary vaccinees displayed suppression of type 1 and 2 replication and a not very pronounced increase in type 3 excretion. Family contacts yielded all types, the least frequent being type 1. At sampling three, 5 months after type 3 administration, the not very clear-cut difference (at 2nd sampling) between vaccinees given the two different type 3 doses was completely obliterated; type 1 was not isolated; and type 2 isolations increased above the 2nd-sampling value. The number of type 1 and 3 isolations decreased in family contacts, in contrast to type 2, where an increase occurred. Excretion of types 1 and 2 at the time of type 3 administration did not demonstrably influence the subsequent excretion of type 3. Mothers were contact infected at a slightly higher rate than other family members. Only a part of excretors among family members of vaccinees excreted virus of the same type as the vaccinees (simultaneously or subsequently).

Presence of polioviruses and other enteral viruses in sewage: a survey in the Czech Socialistic Republic 1969-1976.

Monitoring polioviruses in sewage is a permanent task within the poliomyelitis vaccination control programme in Czechoslovakia. The results of sewage examination in certain localities of the CSR in the years 1969 to 1976 are reported. During the study years, nearly 3600 samples of sewage were examined. The yield was about 9 percent of samples positive for polioviruses and 22 per cent of samples positive for other viruses. The virus positivity rate was roughly the same in samples from municipal sewers and samples from children's facilities. The majority of polioviruses were detected within 3 to 4 months after mass vaccination campaigns, which in Czechoslovakia are carried out in spring. In some years types 2 and 3 polioviruses tended to occur in later months after vaccination as well. Antigenic characterization of the polioviruses isolated in Prague showed that polioviruses possessing an rct+ marker and antigenically related but not identical with the original vaccine strains were sometimes present late during the intervals between vaccination campaigns. It may be assumed that vaccine strains which have been in circulation for sufficiently long time are subject to a gradual change or that vaccine-like strains have been imported.

Excretion of attenuated polioviruses in children vaccinated with live oral poliovirus vaccine.

The excretion of attenuated polioviruses was studied in a group of nursery children vaccinated with 105TCD50 of each type of virus. The primovaccinated children were found to excrete type 1 poliovirus for 8 weeks, type 2 for 11 weeks after the vaccination with the type 1 + 2 bivaccine. Poliovirus type 1 as eliminated by 78% and type 2 by 98% of the vaccinees. The separately administered type 3 was detectable for 6 weeks and was isolated from 100% of the vaccinees. The highest per cent of children with type 1 excretion positivity was recorded at week 5, with type 2 positivity at week 1 and with type 3 positivity at week 2. The poliovirus excretion peaked early after the vaccination, the titres of the poliovirus type 2 were the highest. The children revaccinated next year with the type 1 + 2 bivaccine eliminated the respective types of virus 1 - 2 weeks; type 3 poliovirus was detectable for 6 weeks after revaccination and was excreted by the highest per cent of vaccines. The contact infections caused by the attenuated polioviruses developed in 9 from 22 children vaccinated previously. The excretion of polioviruses did not last longer than 1 week. The contact infections were most frequently caused by the poliovirus type 2. The examined children, particularly those vaccinated previously, turned out to excrete also other enteroviruses identified as Coxsakieviruses B 4 and B 5 and Echovirus 21. In the primovaccinated these viruses were isolated only from those with the negative excretion of polioviruses.

Comparison of poliovirus detection in sewage and stool samples; a study in a crèche in the third week after vaccination.

In a model experiment conducted in a Prague crèche, the detection rate for polioviruses in partially purified, non-concentrated sewage as sampled by means of gauze pads (Moore's method) was compared with that for individual stool samples. In the third week after the vaccination of children with live attenuated type 1 poliovirus (March 1975) and at an equal interval after their vaccination with a combination of types 2 and 3 (May 1975), corresponding poliovirus types were detected both in individual stool samples and sewage. The mean amount of sewage virus recovered during one week was directly proportional to the percentage of positive stool samples. After combined type 2 and 3 poliovirus administration, however, both types were only detected in one sewage sample, while in two samples type 3 only, and in one sample type 2 only, were identified. The results of the study indicate that poliovirus is detectable in sewage by the method employed if it is excreted by approximately one per cent of persons in the sewer catchment area of a small community. If a number of antigenic types are simultaneously present, their identification requires systematic examination of the sewage.

Presence of poliovirus and other enteroviruses in sewage. A survey in Czechoslovakia, 1969-72.

Samples of sewage, collected from 43 nurseries and 22 main town sewers in Czechoslovakia, showed the presence of polioviruses 6-7 months after vaccination with live oral poliovaccines. The presence of other enteroviruses in sewage followed their known prevalence in the community during the summer and autumn.

WHO collaborative study on the sero-epidemiology of rubella.

Under the auspices of WHO an investigation was made by 9 laboratories in different parts of the world on the distribution of rubella antibodies in girls and women of child-bearing age. In the first part of the study the objective was to determine the reliability and reproducibility of the tests employed. It was found that there were no significant differences in the variability of the titres obtained in different laboratories when the results were compared with those obtained by repeatedly testing the same sera in one laboratory.In the second part of the study sera were obtained from girls in schools and women attending clinics and health centres. They were not taken from random samples of the populations. In most of the studies the pattern of development of antibody was similar. About half the persons had antibody at 6-8 years of age and 80%-87% at 17-22 years of age, the percentage remaining relatively constant thereafter. The island populations of Trinidad and Jamaica and a rural area of Japan were, however, found to have significantly fewer women with antibodies than urban areas in Europe or the Americas.