Jiří Beneš

Overview of e-Bug: an antibiotic and hygiene educational resource for schools

Antibiotic resistance is an increasing community problem and is related to antibiotic use. If antibiotic use could be reduced, the tide of increasing resistance could be stemmed. e-Bug is a European project involving 18 European countries, partly funded by The Directorate-General for Health and Consumers (DG SANCO) of the European Commission. It aims to develop and disseminate across Europe a junior and senior school teaching pack and web site (hosting the lesson plans and complementary games) that teach young people about prudent antibiotic use, microbes, transmission of infection, hygiene and vaccines. The aim of e-Bug is to increase young peoples understanding, through enjoyable activities, of why it is so important to use antibiotics correctly in order to control antibiotic resistance, and to have good hand and respiratory hygiene to help reduce the spread of infection. Within the senior school pack the sexual transmission of infections has also been included, as the peak age of chlamydial infection is in 16-24 year olds. Teachers, young people and the consortium of 18 countries were closely involved with agreeing learning outcomes and developing the resource activities. Young people helped create the characters and microbe artwork. The resources have been translated, adapted for and disseminated to schools across 10 countries in Europe, and endorsed by the relevant government departments of health and education. The web site has been accessed from >200 countries. The resources will be translated into all European Union languages, and have been used to promote European Antibiotic Awareness Day and better hand and respiratory hygiene during the influenza pandemic in 2009.

Evaluation of e-Bug, an educational pack, teaching about prudent antibiotic use and hygiene, in the Czech Republic, France and England

OBJECTIVES e-Bug, a junior and senior school educational programme to decrease the spread of infection and unnecessary antibiotic use, was developed and consisted of eight sections providing information on the spread, treatment and prevention of infection as well as basic information on microbes, both useful and harmful. Each section comprised teacher background information, lesson plans and an interactive student activity, and extension activities were also available for more able students. This study aimed to evaluate the effectiveness of the e-Bug pack in improving childrens knowledge in these key areas, when used within the National Curriculum in England, France and the Czech Republic. METHODS Junior (9-11 years) and senior (12-15 years) school classes were divided into either control or intervention groups for evaluation of the resource. Students were required to complete identical knowledge questionnaires at three timepoints (before, immediately after and 6 weeks after teaching), to assess knowledge change and retention. Teaching, using the e-Bug pack, was given by junior and senior school teachers. RESULTS The junior e-Bug teaching pack demonstrated a significant improvement in students knowledge in all sections and there was no significant decrease in student knowledge observed after a 6 week period. Knowledge improvement with the senior e-Bug pack varied between regions, although consistent improvement was observed for Gloucestershire (England) and Ostrava (Czech Republic). CONCLUSIONS Although a success, modifications are required in both packs to further improve student knowledge and make the packs more appealing.

What are school children in Europe being taught about hygiene and antibiotic use

e-Bug is a pan-European antibiotic and hygiene teaching resource that aims to reinforce awareness in school children of microbes, prudent antibiotic use, hygiene and the transmission of infection. Prior to the production of the resource, it was essential to examine the educational structure across each partner country and assess what school children were being taught on these topics. A questionnaire was devised for distribution to each European partner (Belgium, Czech Republic, Denmark, England, France, Greece, Italy, Poland, Portugal and Spain), exploring their educational structure and examining educational resources or campaigns currently available. From the data collected it was evident that the majority of European schools have structured hand hygiene practices in place from a young age. The curricula in all countries cover the topic of human health and hygiene, but limited information is provided on antibiotics and their prudent use. School educational resources that link to the national curriculum and implement National Advice to the Public campaigns in the classroom are limited. The Microbes en question mobile health education campaign in France is an example of a successful childrens education campaign and an innovative programme. Evaluation of the impact of school education on attitude and change of behaviour is also limited throughout many European countries. Not enough is currently being done across Europe to educate school children on the importance of appropriate antibiotic use and antibiotic resistance. The data from this research were used to develop e-Bug, a European Union-funded antibiotic and hygiene teaching resource.

Infective endocarditis caused by unusual Gram-positive pathogens: Report of 4 patients

Of a total of 81 patients hospitalized in the infectious diseases department in 1990–2000 with infectious endocarditis caused by Gram-positive pathogen, unusual etiological agents were found in several cases:Streptococcus pyogenes, Streptococcus pneumoniae, Corynebacterium diphtheriae, andGemella morbillorum. Cardiac defects were present in the latter two patients: bicuspid aortic valve and tetralogy of Fallot. Two patients were successfully treated with antibiotics only and one patient with antibiotics and surgery. The patient withC. diphtheriae endocarditis died due to progressive sepsis and multiple organ failure.

Development of an educational resource on microbes, hygiene and prudent antibiotic use for junior and senior school children

Health promotion interventions aimed at children and young people have the potential to lay the foundations for healthy lifestyles. One such intervention, e-Bug, aims to provide schoolchildren with knowledge of prudent antibiotic use and how to reduce the spread of infection. Many children and schools approach learning in different ways; therefore, it is essential to research school needs and the variety of learning styles when creating any school resources. This article outlines the process involved during the development of a pan-European educational resource, and identifies the final pack layout, based on feedback from teacher focus groups, student questionnaires and European partner discussions.

Hydration and transparency of the rabbit cornea irradiated with UVB-doses of 0.25 J/cm(2) and 0.5 J/cm(2) compared with equivalent UVB radiation exposure reaching the human cornea from sunlight.

Purpose: Exposure of the cornea to UV radiation from sunlight evokes intraocular inflammation, photokeratitis. Photokeratitis is caused by UVB radiation. It is accompanied by changes of corneal hydration and light absorption. The aim of this study was to examine the effect of two UVB doses on corneal optics in rabbits and to compare these UVB doses with the equivalent exposure of UVB radiation reaching the human cornea from sunlight. Materials and Methods: Rabbit corneas were irradiated with a daily UVB dose of 0.25 J/cm2 or 0.5 J/cm2 for 4 days. One day after finishing the irradiations the rabbits were sacrificed and corneal light absorption measured using our spectrophotometrical method. Corneal hydration was examined using an ultrasonic Pachymeter every experimental day before the irradiation procedure and the last day before sacrificing the animals. Results: Changes in corneal optics appeared after the repeated exposure of the cornea to a UVB dose of 0.25 J/ cm2 and massively increased after the repeated exposure of the cornea to a UVB dose of 0.5 J/cm2. The first significant changes in corneal hydration appeared after a single exposure of the cornea to a UVB dose of 0.25 J/cm2. Conclusions: Changes in corneal hydration appeared after the exposure of the rabbit cornea to a single UVB dose equivalent to 2.6 hours of solar UVB radiation reaching the human cornea, as measured by UVB sensors embedded in the eyes of mannequin heads facing the sun on a beach at noon in July. Repeated exposure of the rabbit cornea to the same UVB dose evoked profound changes in corneal optics. Although comparison of experimental and outdoor conditions are only approximate, the results in rabbits point to the danger for the human eye from UVB radiation when short stays in sunlight are repeated for several consecutive days without UV protection.

Generation of focused shock waves by multi-channel discharges in water

A novel method for generation of focused shock waves in water has been developed. A cylindrical pressure wave created by a high voltage multi-channel discharge in water with an increased electrical conductivity is focused by a metallic parabolic reflector. The discharge is formed on a composite anode consisting of a cylindrical metallic electrode covered by a thin porous ceramic layer. In such arrangement the electric field on the anode reaches almost the value of E = U/d/sub c/, where U is the applied voltage and d/sub c/ is the thickness of the layer. For U = 30 kV and d/sub c/ = 0,3mm the electric field is of the order of 1 MV/cm that results in initiation of a large number of short discharge channels distributed almost homogeneously on the anode surface. Each channel creates a semi-spherical pressure wave, and by superposition of all of the waves a cylindrical wave is formed. Schlieren photography was used for visualization of the pressure field and the waveforms of the shock waves were measured by pressure sensors. When supplying the discharge by 1 /spl mu/F condenser bank charged to 30 kV, the amplitude of the shock wave reached 100 MPa at the focal point. A propagation of two shock waves generated by two subsequent discharges has been demonstrated. Preliminary experiments on interaction of the shock wave with biological objects have been done.

Necrotizing pneumonia due to clonally diverse Staphylococcus aureus strains producing Panton-Valentine leukocidin: the Czech experience.

A prospective study (2007-2013) was undertaken to investigate clinical features and prognostic factors of necrotizing pneumonia caused by Staphylococcus aureus producing Panton-Valentine leukocidin (PVL) in the Czech Republic. Twelve cases of necrotizing pneumonia were detected in 12 patients (median age 25 years) without severe underlying disease. Eight cases occurred in December and January and the accumulation of cases in the winter months preceding the influenza season was statistically significant (P < 0·001). The course of pneumonia was very rapid, leading to early sepsis and/or septic shock in all but one patient. Seven patients died and mortality was fourfold higher in those patients presenting with primary pneumonia than with pneumonia complicating other staphylococcal/pyogenic infection elsewhere in the body. The S. aureus isolates displayed considerable genetic variability and were assigned to five lineages CC8 (n = 3), CC15 (n = 2), CC30 (n = 2), CC80 (n = 1), and CC121 (n = 3) and one was a singleton of ST154 (n = 1), all were reported to be associated with community-acquired infection. Four strains were methicillin resistant. The high case-fatality rate can only be reduced by improving the speed of diagnosis and a rapid test to detect S. aureus in the airways is needed.

Biological effects of tandem shock waves on soft animal tissues – preliminary “in vivo” experiments

We have investigated biological effects of two successive (tandem) shock waves focused to a common focal region on soft animal tissues, including cancer tissues “in vivo” and cancer cells “ex vivo”. The tandem shock waves have been produced by our formerly developed shock wave generator where two cylindrical pressure waves are focused by a metallic parabolic reflector to a common focal region1 and the second shock can be switched on with a different time delay after the first one. The idea on application of the tandem shock waves is to localize the action of the shocks at a predictable region in an initially acoustically homogenous medium such as cancer tissues are. The first shock creates in the tissue some acoustical non homogeneity and cavitations, and the second shock dissipate on it, similarly as it is in the case of the lithotripsy of kidney stones. We have found that at some time interval between the shocks (10–15 µs) the second, originally pressure wave, reaches the focus as a rarefaction wave that produces a large number of cavitations. Collapsing cavitations create secondary, very short wavelength shocks which can interact with cell scale structures.

Interaction of a Potential Anticancer Agent Hypericin and its Model Compound Emodin with DNA and Bovine Serum Albumin

Background/Aim: We report the incorporation of prospective anticancer agent hypericin into DNA and bovine serum albumin (BSA), respectively, with emphasis on comparison of the differences in interaction mode between hypericin and its model compound emodin. Materials and Methods: Spectrophotometric methods were used for determination of the binding constants of the drug complex with biomacromolecules. Differential scanning calorimetry was applied for evaluation of drug-macromolecule complex thermal stability. Results: The strength of interaction expressed by binding constants was found to be 4.0×104 l/mol for hypericin–DNA and 8.1×104 l/mol for emodin–DNA complex. Both molecules stabilize bovine serum albumin macromolecule and bind into the hydrophobic cavity in IIA subunit but their localization within the molecule is different. Conclusion: Anticancer agent hypericin and its derivative emodin interact with DNA with medium strength and are probably incorporated into the groove of DNA by hydrogen bonds. Bovine serum albumin can serve as a transport protein for hypericin since the binding force between both molecules is adequate.