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18. 20. ZÁŘÍ 2014 / 18
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SEPTEMBER 2014 / OLOMOUC
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Sobota 20. 9. 2014 / 10.00–13.00 / Sál Pegasus
Transmission of tuberculosis among people living
in border areas of Polish, Czech and Slovakia
Zientek J.
1
, Kozielski J.
2
, Augustynowicz-Kopeć E.
3
,
Kozińska M.
3
, Pasz P.
4
, Zientek A.
4
, Rączka J.
4
,
Muzyczuk-Sojka J.
5
, Bílková Fránková H.
6
,
Ulmann V.
6
, Roubec J.
7
, Payma J.
8
, Karczmarczyk J.
8
,
Vrba Z.
9
, Tudík I.
10
, Krupkova M.
11
, Solovic I.
12
,
Poľanová M.
12
, Tatárová A.
13
, Lachova A.
13
,
Rozborilová E.
14
, Benčova A.
14
1
Szpital Śląski, Oddział Chorób Płuc, Cieszyn, Poland
2
Zabrze Katedra i Klinika Chorób Płuc i Gruźlicy Śląska
Akademia Medyczna, Poland
3
Zakład Mikrobiologii. Krajowe Referencyjne
Laboratorium Prątka IgiChP, Warszawa, Poland
4
Szpital Śląski, Oddział Chorób Płuc, Cieszyn, Poland
5
Istebna Wojewódzkie Centrum Pediatrii, Poland
6
Zdravotní ústav, Centrum klinických laboratoří, Ostrava
7
Fakultní nemocnice, Ostravská univerzita, Lékařská
fakulta OU, Ostrava
8
Nemocnice s poliklinikou Karviná-Ráj
9
TRN odd. Krnov, Krnov SZZ, Krnov
10
Oddělení tuberkulózy a respiračních nemocí, Jablunkov
Sanatorium
11
Ambulance TBC a respir. nemoci, Bruntal
12
Národný ÚstavTuberkulózy, Pľúcnych Chorôb
a Hrudníkovej Chirurgie, Vyšné Hágy
13
Oddelenia Pneumológie a ftizeológie – Fakultná
nemocnica s poliklinikou Żylina
14
Univerzitna nemocnice, Klinika Pneumológie
a Ftizeológie, Martin
Czech Republic, Slovakia and Poland are different epidemio-
logical situation with regard to the incidence of tuberculosis.
These indicators also differ in the border areas, at the junction
of three states. We analyzed cross-border region of Silesia
provinces of Polish, Czech and Moravian Żyliński from Slovakia.
In this work, we addressed
Whether in the population of patients from these regions
took place transmission of tuberculosis?
whether the phenomenon is limited to individual countries?
whether they also observed between patients of different
nationalities? and
how much of the population tuberculosis strains isolated
from patients in the country represented the »national
types of molecular«, and which »dragged outside the bor-
ders«?
Were studied genetic relatedness among strains of M. tu-
berculosis cultured from patients with border areas of three
states. Material for analysis was a collection of 144 strains of
M. tuberculosis cultured from patients including 56 strains of
Polish, 31 from the Czech Republic and 57 strains from Slovakia
mainly from the above-mentioned region.
The study assumed that the group of patients with tu-
berculosis strains did not differ from the model in the field of
molecular tests made are associated with recently acquired
infection or are the result of transmission.
The analysis was performed in two steps. By spoligotyping
made a preliminary identification of the molecular families
stating dominance T1 53 family molecular characteristic of the
strains isolated in Europe. After the test was 72.9% spoligotyp-
ing strains forming clusters. This group of strains was analyzed
by IS6110-PCR Mtb2 Mtb1-yielding on both stages 50% of the
interest clustering.
20 clusters were found, and the sizes ranged from 2 to 13
(mean 3.36).
The country with the highest percentage of 54.4 %
clustering proved to Slovakia, slightly lower than 50% con-
cerned the strains of the Polish and the lowest 22.6% in the
Czech Republic. The proportion of fresh transmission within
individual countries ranged from 33.9% in Poland, 16.1% in
the Czech Republic to 36.8% in Slovakia, reaching an average
for the region at 36.1%.
«National molecular types» presented 89.28% of the strains
of Polish, 67.74% from 75.43% the Czech Republic and Slovakia
(the percentage of the population tuberculosis strains isolated
from patients only with a given country).
In the study population of patients from the borderlands
Polish, Czech and Slovakia took place transmission of tuber-
culosis. This phenomenon was observed between patients
in all countries. «Molecular type strains zawleczonych outside
the borders» (common to at least two countries) was found in
10.72% in Poland, the Czech Republic at 32.25% and 24.56%
in Slovakia.
The average percentage of fresh transmission between
all countries was 16.6%, however, concerned mainly the
border Czech Republic and Slovakia where it reached 20.4%.
Transmissions between the Polish and Czech and Polish
and Slovak were lower and amounted to 5.6% and 3.5%.
Approximately 3.5% (5) isolates were in the group consisting
of patients living in all three countries (multinational group).
In the study group were found in all three transmission
of epidemiological circles but there was no epidemiological
importance of the region to factors such as homelessness,
immigrants, positive HIV test result, infection with drug-resi-
stant strains.
Work is Poland›s first attempt to assess the transmission of
tuberculosis between citizens of different states in the border
region.
Diagnostika a léčba latentní tuberkulózní
infekce (LTBI) a léčba mykobakteriálních infekcí
u pacientů před a po transplantaci orgánů
Hricíková I., Vašáková M., Kopecká E., Homolka J.
Pneumologická klinika 1. LF UK v Praze, Thomayerova
nemocnice, Praha
Latentní tuberkulózní infekce (LTBI) vzniká po usídlení
tuberkulózních bacilů u exponovaného hostitele. Je cha-
rakterizována vytvořením specifických obranných mechani-
