P. Kosina

Fakultní nemocnice Hradec Králové, Königgrätz, Královéhradecký, Czech Republic

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Publications (34)12.47 Total impact

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    ABSTRACT: The introduction of universal vaccination has led to significant decrease of infectious diseases incidence either of bacterial or viral origin, which had been a factor in increased morbidity and mortality of population. Measles, rubella and also mumps viruses are supposed to be future candidates for eradication similarly to smallpox due to their human-to-human transmission and antigenic stability. However, it is necessary to introduce vaccination in national immunization programs of countries where vaccination against measles, mumps and rubella is not established and improve immunization rate in countries with low vaccination coverage. Live attenuated vaccines against measles, mumps and rubella diseases have been available for more than 40 years and currently provide strong protection with minimum side effects.
    No preview · Article · Jan 2015

  • No preview · Article · Jan 2015 · Vakcinologie
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    ABSTRACT: Elimination of measles is one of the basic priorities of the World Health Organization in terms of action against preventable infectious diseases. Thanks to implementation of measles vaccination the incidence of measles significantly decreased worldwide as well as in Europe. Despite of improvement the epidemics of measles developed in recent years in Europe. These epidemics are associated mainly with local decrease of vaccination coverage of the population. There was an increase in the proportion of older children and young adults among the patients. The most affected countries were Bulgaria, France, Romania and Ukraine, but outbreaks have been reported in countries such as the Netherlands, Italy, Germany and United Kingdom. The stable situation in the Czech Republic was disrupted in 2014 by the development of a measles epidemic. Due to the current epidemics of measles in European countries it is likely that the goal of measles elimination in the European Region of the World Health Organization in 2015 will not be reached.
    No preview · Article · Jan 2014
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    ABSTRACT: Objective: Presented are the authors' own experiences with invasive pneumococcal diseases in a group of pediatric inpatients with pneumococcal meningitis treated in the Department of Infectious Diseases, University Hospital and Charles University Faculty of Medicine in Hradec Králové over the last 10 years. Material and methods: A group of patients aged 0-18 years and hospitalized in the above facility in 2002-2011 was retrospectively assessed. The patients' basic clinical characteristics and treatment outcomes are shown below. Results: Over the study period, 27 children with pneumococcal meningitis were treated; of those, 15 were boys and 12 were girls. The patients' ages ranged from 2 days to 17 years; seventeen children (63 %) were younger than 2 years. On admission, 11 children (40 %) had the infection in the middle ear or paranasal sinuses; intracranial complications were noted in 10 cases. Cerebrospinal fluid culture was positive for Streptococcus pneumoniae in 21 cases. In 6 patients, pneumococcal DNA was determined in the cerebrospinal fluid by PCR. None of the studied patients died. Eight children (29 %) were left with permanent damage; of those, seven had hearing impairment. Conclusion: Even today, pneumococcal meningitis in children remains a serious condition posing a risk of dangerous consequence or even death. To the maximum extent possible, prevention should include vaccination, especially in infants and children with the predisposing factors.
    No preview · Article · Dec 2013 · Klinicka mikrobiologie a infekcni lekarstvi
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    ABSTRACT: Pneumococcal infections continue to pose a serious medical problem. A broad range of serotypes, increasing resistance to antibiotics and high pathogenic potential of pneumococci are associated with development of various clinical forms of diseases. Some chronic diseases are an important predisposing factor for development of pneumococcal infections. The most common noninvasive forms of the disease are otitis, sinusitis, conjunctivitis; pneumonia is on the borderline between the invasive and noninvasive forms. Meningitis, sepsis, endocarditis and arthritis all belong to invasive pneumococcal diseases. The diagnosis is based on the so-called classic microbiological and molecular biology methods aimed at determining the pneumococcal serotype. The treatment recommendations are varied, depending on the resistance status in particular geographic regions. Prevention of the infections is primarily based on vaccination. In the past, only polysaccharide vaccine (PPSV23) was available; currently, there are conjugate vaccines (PCVs), either 10-valent (PCV10) or 13-valent (PCV13). Initially, PCVs were used exclusively in children; later, PCV13 was approved for selected indications in the adult population. Since 2013, it has been indicated for both children and adults of all ages. These facts have been incorporated into updated guidelines in various specialties. The future of pneumococcal infection prevention rests with the development of protein vaccines.
    No preview · Article · Dec 2013 · Klinicka mikrobiologie a infekcni lekarstvi
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    ABSTRACT: Impaired or lost function of the spleen (hyposplenism/asplenia) is associated with a lifelong risk of severe infections, mainly of bacterial aetiology. Streptococcus pneumoniae, Haemophilus influenzae Type B and Neisseria meningitidis are the most important aetiological agents. The clinical guidelines hereby presented were developed by a collective of specialists in infectious diseases, with the aim of standardising the treatment of patients with impaired or lost splenic functions (with the exception of haematological and haemato-oncological patients, who are normally tended to by specialists in haematology/haematooncology) in Czech Republic. Prevention based on adequate education and vaccination is particularly emphasized. The issues of antibiotic prophylaxis and standby antibiotic therapy are discussed in a separate section.
    No preview · Article · Jan 2013 · Vakcinologie
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    ABSTRACT: Vaccination represents an important opportunity to prevent serious infectious diseases. Increasingly in recent years, attention is focused on vaccination of adults. Emphasis is placed on vaccination of persons with chronic illnesses such as chronic obstructive pulmonary disease (COPD) and asthma. These patients are at higher risk of more severe course of a number of infections, but also are at risk of chronic disease acute exacerbation in cases of infection. Vaccination against selected infections should be considered for each of them.
    No preview · Article · Jan 2013 · Vakcinologie
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    ABSTRACT: Streptococcus suis is regarded to be a significant pathogen in swine with global prevalence and possible transmission of infection to humans. Sporadic cases of infection have been reported worldwide including Europe. Such infection in humans leads to development of various serious conditions, including, most frequently, meningitis and sepsis. The presented case report describes extensive clinical presentation of the infection, ranging from sepsis, spondylodiscitis and abscess formation in paravertebral muscles to osteomyelitis and hearing impairment. In our case, the disease led to several months of hospitalization and severe disability.
    No preview · Article · Jan 2013 · Ceska a Slovenska Neurologie a Neurochirurgie
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    Full-text · Article · Jun 2012 · International Journal of Infectious Diseases
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    ABSTRACT: More than 95% children under 5 years of age are infected at least once with rotavirus gastroenteritis (RVGE). The highest incidence is given an average age of 6-24 months. The first infection is usually clinically most serious, each other is more moderate. The most common complication is dehydration, which is more common than in the case of rotavirus negative acute gastroenteritis. Also the risk of hospitalization for RVGE is higher. Now, there are two live attenuated oral vaccines for specific prevention of RVGE in group of children older than 6 weeks of age. Vaccination is recommended for all children.
    No preview · Article · Jan 2012 · Pediatrie pro Praxi
  • R. Prymula · P. Kosina · J. Krausová
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    ABSTRACT: Tick-borne encephalitis is a life-threatening neuroinfection. In absence of a causal therapy prevention with immunization is the only effective way to control the disease. A single-blind, randomized, clinical trial in children 1 to 11 years of age investigated the immunogenicity and safety of both vaccines administered according to the conventional schedule. Geometric mean concentrations (GMC) measured either by IMMUNOZYM ELISA or Enzygnost ELISA were slightly higher in the FSME-IMMUN in comparison with Encepur group. Local reactions occurred in 12.7% and 8.7% after the 1st and 2nd vaccination with FSME-IMMUN and in 28.9% and 22.4% with Encepur. The rate of systemic reactions was comparable: 9.3% and 4.7% (FSME-IMMUN) and 11.8% and 5.3% (Encepur). Both the TBE vaccines showed high seropositivity rates in virus neutralization - and ELISA assays. Overall, a trend towards higher antibody responses in the younger age groups was observed.
    No preview · Article · Jan 2012 · Vakcinologie
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    ABSTRACT: Measles is highly contagious exanthemic infectious disease. Although vaccine exists the disease remains a major worldwide health problem. There are outbreaks of measles repeatedly reported in different European countries in recent years. That problem is associated with the accumulation of susceptible individuals due to low vaccination coverage. The situation is quite stable in our country. Only individual cases are reported annually. The part of that is made by imported cases. 98% level of immunization coverage with two doses of vaccine in Czech Republic works well.
    No preview · Article · Jan 2012 · Vakcinologie

  • No preview · Article · Jan 2012 · Česká a Slovenská neurologie a neurochirurgie
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    ABSTRACT: Austrian syndrome refers to concomitant meningitis, pneumonia and endocarditis in a patient infected with Streptococcus pneumoniae. We present a case report of a 37-year old patient admitted to the hospital with pneumococcal meningitis. He subsequently developed respiratory insufficiency and infectious endocarditis leading to an aortal valve defect. This defect was temporarily fixed with surgical implantation of an artificial valve that, however, had to be subsequently removed due to early insufficiency and replaced with a homo-graft. The patient was discharged 90 days after the initial admission in a good clinical condition.
    No preview · Article · Jan 2012 · Ceska a Slovenska Neurologie a Neurochirurgie
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    ABSTRACT: We report a case of multi-recurrent herpes zoster in a 53-year-old Caucasian woman treated repeatedly at the Faculty Hospital Hradec Kralove, Czech Republic over the years 2009 - 2011. Specific PCR methods targeting single nucleotide polymorphisms (SNPs) in open reading frames (ORF) 38, 54 and 62 were utilized to determine vaccine or wild type varicella-zoster (VZV) strains followed by SNPs analysis using two amplicons in ORF 22 and/or ORF 21/ORF 50. Additional genotyping in ORF 1, 6, 9 and 28 was subsequently performed due to the unusual results. Three sets of clinical specimens from one patient (from hospital visits 2, 3 and 4) were analyzed and the presence of an unusual wild-type strain of VZV was discovered. The VZV strain isolated from the lesions bears a combination of markers characteristic both for Mosaic 2 (M2) and European 1 (E1) wild-type VZV strains. This is the first report of atypical wild-type VZV strain circulating currently in Czech Republic.
    Full-text · Article · Dec 2011 · Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
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    ABSTRACT: Monitoring of the varicella-zoster virus is becoming an important tool for analysis of the circulation of individual strains of VZV which differ not only at the genomic level, but show a variability in their clinical and epidemiological characteristics. Such data are not available on a large scale from the Czech population and could help understanding the epidemiological and evolutionary characteristics of the virus, as well as its potential for reinfection and increased pathogenesis in the population groups at higher risk for complications. The main aim of this study was detection and monitoring of wild-type or vaccine VZV strain isolates in the region of Eastern Bohemia and genotypic characterization of these isolates. A total of 273 clinical samples were obtained from patients exhibiting symptoms of varicella zoster virus (VZV) infection manifested as chickenpox or herpes zoster (HZ) treated in the Faculty Hospital of Charles University, Medical School in Hradec Kralove, Czech Republic. Characterization of individual short VZV DNA sequences was performed utilizing restriction fragment length polymorphisms (RFLPs), PCR and sequencing. Single nucleotide polymorphisms (SNP) in open reading frames (ORF) 21, 22 and 50 were used to identify individual VZV strains. All clinical isolates (97 from varicella, 176 from herpes zoster) were VZV positive wild-type strains. Sequencing analysis showed that 89 isolates were of the European E1 genotype, 180 were of the European E2 genotype and 2 were identified as the Mosaic M1 strain. In addition, for the first time in this region two unusual genotypes were identified, both representing a combination of E1 and M2 strain specific SNPs. Our prospective VZV genotyping study which is the first to monitor the VZV epidemiological situation in the Czech Republic using such a large set of clinical specimens, has provided valuable epidemiological data and identified two unique VZV recombinants.
    Full-text · Article · Dec 2011 · Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia

  • No preview · Article · Jan 2011 · Česká a Slovenská neurologie a neurochirurgie
  • R. Kračmarová · L. Ryšková · P. Kosina
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    ABSTRACT: Streptococcus pneumoniae is a rarely recognised cause of neonatal disorder, but outcome (mortality, neurological sequele) is particularly severe. Sepsis or meningitis are frequent clinical presentation. Possible mechanisms fetal or neonatal infection are: transplacentally to maternal bacteremia, ascending infection from the maternal genital tract, passage throug a colonized birth canal, or postpartum by respiratory spread. These infections are associated with prematurity, prolonged rupture of membranes and especially maternal vaginal colonization, which is the main risk factor. Maternal colonization is rare, but if it is found, it should not be undervalued.
    No preview · Article · Jan 2011 · Pediatrie pro Praxi
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    ABSTRACT: The recorded incidence of human infections caused by Nocardia spp. has increased over the past 20 years, both in response to improved diagnostic techniques and to rising numbers of immunocompromised patients. Nocardial infections primarily affect the skin and lungs, but the bacteria may disseminate to any organ, including the brain. The diagnosis and treatment of patients suffering from a Nocardia infection require an interdisciplinary approach. Here we describe two case reports of patients suffering from brain abscesses caused by Nocardia that required neurosurgical treatment.
    No preview · Article · Jan 2011 · Ceska a Slovenska Neurologie a Neurochirurgie
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    ABSTRACT: The majority of meningococcal diseases are caused by serogroups A, B, C, W-135, X and Y of bacteria Neisseria meningitidis, geographical distribution of which varies substantially. Neisseria meningitidis is fairly sensitive to the broad spectrum of antibiotics, but in some cases, even after timely initiation of proper antibiotic therapy, systemic inflammatory response may develop, which can lead to a severe multiorgan failure. Neisseria meningitidis can cause both invasive and noninvasive form of the disease. Noninvasive meningoccocal diseases include for example pharyngitis, pneumonia, bronchitis and others. Invasive meningococcal disease (IMO) is manifested as meningococcal septicemia, meningococcal meningitis and sepsis with meningitis. Antibiotic treatment aims to quickly eliminate the causative agent and thus, inter alia, to reduce the production of all cytokines or mediators involved in the development of sepsis. Neisseria meningitidis is sensitive to penicillin (PNC) in Czech Republic. During the initial empirical therapy cephalosporins of the 3rd generation are recommended. Several types of meningococcal vaccines are currently available in Czech Republic - polysaccharide vaccine, conjugate vaccine and monovalent conjugate tetravaccine. Due to the current epidemiological situation, where the highest morbidity in children under one year of age is caused by serogroup B, a registration of the new vaccine against meningococcal B is urgently needed.
    No preview · Article · Jan 2011 · Interni Medicina pro Praxi

Publication Stats

23 Citations
12.47 Total Impact Points

Institutions

  • 2006-2013
    • Fakultní nemocnice Hradec Králové
      Königgrätz, Královéhradecký, Czech Republic
  • 2008-2012
    • University of Hradec Králové
      Königgrätz, Královéhradecký, Czech Republic
  • 2010-2011
    • Charles University in Prague
      • Department of Infectious Diseases (Pilsen)
      Praha, Praha, Czech Republic