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Füszl A, Schindler S, Heger F, Markowicz M, Indra A, Pietzka A, Hyden P, Cabal A, Wenzel RR. Recurrent, ICD-associated L. monocytogenes bacteraemia with multiple septic pulmonary embolisms over a 2-year period. Infection 2024:10.1007/s15010-024-02209-w. [PMID: 38446279 DOI: 10.1007/s15010-024-02209-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/05/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Listeria monocytogenes is a bacterial pathogen known for causing listeriosis, a foodborne illness with a wide spectrum of clinical presentations ranging from mild gastroenteritis to severe invasive disease, particularly affecting immunocompromised individuals, pregnant women, newborns, and the elderly. Successful treatment of patients with recurring listeria episodes due to colonised foreign material is often challenging, typically requiring a combination of antimicrobial treatment and surgical removal. CASE PRESENTATION Here, we present a particularly complex case of chronic invasive listeriosis with a total of six relapses. After extensive investigations, the patient's ICD device was identified as the focus of infection. CONCLUSION The confirmation of relapses through cgMLST analysis highlights the persistence of Listeria monocytogenes and the potential for recurrence even after apparent resolution of symptoms in patients with foreign material. It emphasises the necessity for a comprehensive assessment to identify and mitigate the risk of relapses, thereby ensuring optimal management and outcomes.
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Affiliation(s)
- Astrid Füszl
- National Reference Centre for Listeriosis, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria.
| | - Stefanie Schindler
- National Reference Centre for Listeriosis, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Florian Heger
- National Reference Centre for Listeriosis, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Mateusz Markowicz
- National Reference Centre for Listeriosis, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Alexander Indra
- National Reference Centre for Listeriosis, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
- Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Ariane Pietzka
- National Reference Laboratory for Listeria monocytogenes, Austrian Agency for Health and Food Safety (AGES), Graz, Austria
| | - Patrick Hyden
- Department of Statistics and Analytical Epidemiology, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Adriana Cabal
- National Reference Centre for Listeriosis, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - René R Wenzel
- Department of Internal Medicine (Cardiology & Nephrology), Tauernklinikum Zell am See, Salzburg, Austria
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Smith P, Le Devendec L, Jouy E, Larvor E, Lesne J, Kirschner AKT, Rehm C, Leopold M, Pleininger S, Heger F, Jäckel C, Göllner C, Nekat J, Hammerl JA, Baron S. Epidemiological cut-off values for non-O1/ non-O139 Vibrio cholerae disc diffusion data generated by standardised methods. Dis Aquat Organ 2023; 156:115-121. [PMID: 38095366 DOI: 10.3354/dao03766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
This work generates the data needed to set epidemiological cut-off values for disc-diffusion zone measurements of Vibrio cholerae. The susceptibility of 147 European isolates of non-O1/non-O139 V. cholerae to 19 antibiotics was established using a standardised disc diffusion method which specified incubation of Mueller Hinton agar plates at 35°C. Epidemiological cut-off values were calculated by analysis of the zone size data with the statistically based normalised resistance interpretation method. Cut-off values for 17 agents were calculated by analysis of the aggregated data from all 4 laboratories participating in this study. The cut-off values calculated were ≥18 mm for amoxicillin/clavulanate, ≥18 mm for amikacin, ≥19 mm for ampicillin, ≥27 mm for cefepime, ≥31 mm for cefotaxime, ≥24 mm for ceftazidime, ≥24 mm for chloramphenicol, ≥31 mm for ciprofloxacin, ≥16 mm for erythromycin, ≥ 27 mm for florfenicol, ≥16 mm for gentamicin, ≥23 mm for imipenem, ≥25 mm for meropenem, ≥29 mm for nalidixic acid, ≥28 mm for norfloxacin, ≥13 mm for streptomycin and ≥23 mm for tetracycline. For the other 2 agents the data from 1 laboratory was excluded from the censored aggregation because the data from that laboratory was considered excessively imprecise. The cut-off values for these 2 agents calculated for the aggregation of the data from 3 laboratories were ≥23 mm for trimethoprim and ≥24 mm for trimethoprim/sulfamethoxazole. These zone size data will be submitted to the Clinical Laboratory Standards Institute (CLSI) and European Committee for Antimicrobial Susceptibility Testing (EUCAST) for their consideration in setting international consensus epidemiological cut-off values for non O1/non-O139 V. cholerae.
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Affiliation(s)
- Peter Smith
- School of Natural Science, University of Galway, Galway H91 TK33, Ireland
| | - Laëtitia Le Devendec
- Anses, Ploufragan-Plouzané-Niort Laboratory, Mycoplasmology-Bacteriology and Antimicrobial Resistance Unit, 22440 Ploufragan, France
| | - Eric Jouy
- Anses, Ploufragan-Plouzané-Niort Laboratory, Mycoplasmology-Bacteriology and Antimicrobial Resistance Unit, 22440 Ploufragan, France
| | - Emeline Larvor
- Anses, Ploufragan-Plouzané-Niort Laboratory, Mycoplasmology-Bacteriology and Antimicrobial Resistance Unit, 22440 Ploufragan, France
| | - Jean Lesne
- École des Hautes Études en Sante Publique, Laboratoire d'Étude et de Recherche en Environnent et Sante, 35000 Rennes, France
| | - Alexander K T Kirschner
- Institute for Hygiene and Applied Immunology - Water Microbiology, Medical University Vienna, Kinderspitalgasse 15, 1090 Austria
- Division Water Quality & Health, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Interuniversity Cooperation Centre Water & Health, www.waterandhealth.at
| | - Carmen Rehm
- Institute for Hygiene and Applied Immunology - Water Microbiology, Medical University Vienna, Kinderspitalgasse 15, 1090 Austria
- Division Water Quality & Health, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Interuniversity Cooperation Centre Water & Health, www.waterandhealth.at
| | - Melanie Leopold
- Division Water Quality & Health, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Interuniversity Cooperation Centre Water & Health, www.waterandhealth.at
| | - Sonja Pleininger
- Institute for Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Austria, Waehringer Strasse 25A, 1094 Vienna, Austria
| | - Florian Heger
- Institute for Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Austria, Waehringer Strasse 25A, 1094 Vienna, Austria
| | - Claudia Jäckel
- Consultant Laboratory for Vibrio spp. in Food, Department Biological Safety, German Federal Institute for Risk Assessment, Max-Dohrn Str. 8-10, 1089 Berlin, Germany
| | - Cornelia Göllner
- Consultant Laboratory for Vibrio spp. in Food, Department Biological Safety, German Federal Institute for Risk Assessment, Max-Dohrn Str. 8-10, 1089 Berlin, Germany
| | - Jonas Nekat
- Consultant Laboratory for Vibrio spp. in Food, Department Biological Safety, German Federal Institute for Risk Assessment, Max-Dohrn Str. 8-10, 1089 Berlin, Germany
| | - Jens Andre Hammerl
- Consultant Laboratory for Vibrio spp. in Food, Department Biological Safety, German Federal Institute for Risk Assessment, Max-Dohrn Str. 8-10, 1089 Berlin, Germany
| | - Sandrine Baron
- Anses, Ploufragan-Plouzané-Niort Laboratory, Mycoplasmology-Bacteriology and Antimicrobial Resistance Unit, 22440 Ploufragan, France
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Rehm C, Kolm C, Pleininger S, Heger F, Indra A, Reischer GH, Farnleitner AAH, Kirschner AKT. Vibrio cholerae-An emerging pathogen in Austrian bathing waters? Wien Klin Wochenschr 2023; 135:597-608. [PMID: 37530997 PMCID: PMC10651712 DOI: 10.1007/s00508-023-02241-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/11/2023] [Indexed: 08/03/2023]
Abstract
Vibrio cholerae, an important human pathogen, is naturally occurring in specific aquatic ecosystems. With very few exceptions, only the cholera-toxigenic strains belonging to the serogroups O1 and O139 are responsible for severe cholera outbreaks with epidemic or pandemic potential. All other nontoxigenic, non-O1/non-O139 V. cholerae (NTVC) strains may cause various other diseases, such as mild to severe infections of the ears, of the gastrointestinal and urinary tracts as well as wound and bloodstream infections. Older, immunocompromised people and patients with specific preconditions have an elevated risk. In recent years, worldwide reports demonstrated that NTVC infections are on the rise, caused amongst others by elevated water temperatures due to global warming.The aim of this review is to summarize the knowledge gained during the past two decades on V. cholerae infections and its occurrence in bathing waters in Austria, with a special focus on the lake Neusiedler See. We investigated whether NTVC infections have increased and which specific environmental conditions favor the occurrence of NTVC. We present an overview of state of the art methods that are currently available for clinical and environmental diagnostics. A preliminary public health risk assessment concerning NTVC infections related to the Neusiedler See was established. In order to raise awareness of healthcare professionals for NTVC infections, typical symptoms, possible treatment options and the antibiotic resistance status of Austrian NTVC isolates are discussed.
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Affiliation(s)
- Carmen Rehm
- Division Water Quality and Health, Karl-Landsteiner University of Health Sciences, Krems, Austria
- Institute for Hygiene and Applied Immunology - Water Microbiology, Medical University Vienna, Vienna, Austria
- Interuniversity Cooperation Centre Water & Health
| | - Claudia Kolm
- Division Water Quality and Health, Karl-Landsteiner University of Health Sciences, Krems, Austria
- Interuniversity Cooperation Centre Water & Health
- Institute for Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics 166/5/3, Technische Universität Wien, Vienna, Austria
| | - Sonja Pleininger
- Institute for Medical Microbiology and Hygiene, National Reference Centre for Vibrio cholerae, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Florian Heger
- Institute for Medical Microbiology and Hygiene, National Reference Centre for Vibrio cholerae, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Alexander Indra
- Institute for Medical Microbiology and Hygiene, National Reference Centre for Vibrio cholerae, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
- Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Georg H Reischer
- Interuniversity Cooperation Centre Water & Health
- Institute for Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics 166/5/3, Technische Universität Wien, Vienna, Austria
| | - Andreas A H Farnleitner
- Division Water Quality and Health, Karl-Landsteiner University of Health Sciences, Krems, Austria
- Interuniversity Cooperation Centre Water & Health
- Institute for Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics 166/5/3, Technische Universität Wien, Vienna, Austria
| | - Alexander K T Kirschner
- Division Water Quality and Health, Karl-Landsteiner University of Health Sciences, Krems, Austria.
- Institute for Hygiene and Applied Immunology - Water Microbiology, Medical University Vienna, Vienna, Austria.
- Interuniversity Cooperation Centre Water & Health, .
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Heger F, Schindler S, Pleininger S, Fueszl A, Blaschitz M, Lippert K, Hyden P, Hufnagl P, Mutschlechner D, Gremmel T, Hofer E, Markowicz M, Indra A. Three Cases of Tickborne Francisella tularensis Infection, Austria, 2022. Emerg Infect Dis 2023; 29:2349-2352. [PMID: 37877608 PMCID: PMC10617340 DOI: 10.3201/eid2911.230460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Tularemia is increasing in Austria. We report Francisella tularensis subspecies holarctica isolated from 3 patients who had been bitten by arthropods. Next-generation sequencing showed substantial isolate similarity. Clinicians should consider bloodstream F. tularensis infections for patients with signs/symptoms of ulceroglandular tularemia, and surveillance of potential vectors should be intensified.
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Schnetzinger M, Heger F, Indra A, Kimberger O. Bacterial contamination of water used as thermal transfer fluid in fluid-warming devices. J Hosp Infect 2023; 141:49-54. [PMID: 37385452 DOI: 10.1016/j.jhin.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Recent reports implicated heater-cooler units (HCUs), which are used for warming infusions, blood or in extracorporeal membrane oxygenation devices, as a possible origin of healthcare-associated infections (HAIs) with potentially pathogenic bacteria, such as non-tuberculous mycobacteria [1]. This represents a source of contamination in a usually sterile setting. AIM To analyse water from infusion heating devices (IHDs) for bacterial contamination, and to determine if IHDs are a potential source in the transmission of HAIs. METHODS Thermal transfer fluid (TTF; 300-500 mL) was collected from the reservoirs of 22 independent IHDs and processed on different selective and non-selective media for colony count and identification of bacteria. Strains of Mycobacterium spp. were analysed by whole-genome sequencing. RESULTS Bacterial growth was observed in all 22 TTF samples after cultivation at 22 °C and 36 °C. Pseudomonas aeruginosa was the most frequent pathogen identified, present in 13.64% (3/22) of samples at >100 colony-forming units/100 mL. Colonization with Mycobacterium chimaera, Ralstonia pickettii and Ralstonia mannitolilytica was detectable in 9.09% (2/22) of samples. Primary sequencing of the detected M. chimaera suggests a close relationship with a M. chimaera strain detected in an outbreak in Switzerland which led to the death of two patients. DISCUSSION Contamination of TTF represents a germ reservoir in a sensitive setting. Handling errors of IHDs may lead to the distribution of opportunistic or facultative bacterial pathogens, increasing the risk of transmission of nosocomial infections.
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Affiliation(s)
- M Schnetzinger
- Medical University of Vienna, Department of Anaesthesiology and Intensive Care, Vienna, Austria.
| | - F Heger
- Austrian Agency for Health and Food Safety, Department of Medical Microbiology, Vienna, Austria
| | - A Indra
- Austrian Agency for Health and Food Safety, Department of Medical Microbiology, Vienna, Austria
| | - O Kimberger
- Medical University of Vienna, Department of Anaesthesiology and Intensive Care, Vienna, Austria
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Werzowa J, Behanova M, Handisurya A, Heger F, Indra A, Holzer B, Dechat T, Spitzer S, Lederer S, Kraus DA, Zwerina J, Fritsch-Stork RDE. Response to Immunization against SARS-CoV-2 and Risk of Omicron Infection in Dialysis Patients: A Prospective Cohort Study. J Clin Med 2023; 12:4983. [PMID: 37568385 PMCID: PMC10419800 DOI: 10.3390/jcm12154983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
It is not well established to what extent previous immunizations offer protection against infections with the SARS-CoV-2 Omicron variant in dialysis patients. We aimed to define the relevant humoral response in dialysis patients using a SARS-CoV-2 IgG chemiluminescence microparticle immunoassay (CMIA) compared to the activity of neutralizing antibodies assessed by a virus neutralization test. Next, we aimed to determine differences in humoral and cellular response levels over time among patients infected or not infected by the Omicron variant of SARS-CoV-2. Immunological parameters of cellular and humoral response to SARS-CoV-2 were analyzed at baseline and after 3 (T3), 6 (T6) and 14 months (T14). In this monocentric cohort study, we followed 110 dialysis patients (mean age 68.4 ± 13.7 years, 60.9% male) for a median of 545 days. We determined an anti-SARS-CoV-2 IgG level of 56.7 BAU/mL as an ideal cut-off value with a J-index of 90.7. Patients infected during the Omicron era had significantly lower (p < 0.001) mean antibody levels at T0 (3.5 vs. 111.2 BAU/mL), T3 (269.8 vs. 699.8 BAU/mL) and T6 (260.2 vs. 513.9 BAU/mL) than patients without Omicron infection. Patients who developed higher antibody levels at the time of the basic immunizations were less likely to become infected with SARS-CoV-2 during the Omicron era. There is a need to adjust the cut-off values for anti-SARS-CoV-2 IgG levels in dialysis patients.
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Affiliation(s)
- Johannes Werzowa
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1140 Vienna, Austria; (J.W.); (T.D.); (S.S.); (D.A.K.); (J.Z.)
- 1st Medical Department, Hanusch Hospital, 1140 Vienna, Austria; (A.H.); (S.L.)
| | - Martina Behanova
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1140 Vienna, Austria; (J.W.); (T.D.); (S.S.); (D.A.K.); (J.Z.)
| | - Ammon Handisurya
- 1st Medical Department, Hanusch Hospital, 1140 Vienna, Austria; (A.H.); (S.L.)
| | - Florian Heger
- Austrian Agency for Health and Food Safety (AGES), 1090 Vienna, Austria; (F.H.); (A.I.)
| | - Alexander Indra
- Austrian Agency for Health and Food Safety (AGES), 1090 Vienna, Austria; (F.H.); (A.I.)
| | - Barbara Holzer
- Institute for Veterinary Disease Control, Austrian Agency for Health and Food Safety (AGES), 2340 Moedling, Austria;
| | - Thomas Dechat
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1140 Vienna, Austria; (J.W.); (T.D.); (S.S.); (D.A.K.); (J.Z.)
| | - Silvia Spitzer
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1140 Vienna, Austria; (J.W.); (T.D.); (S.S.); (D.A.K.); (J.Z.)
| | - Sandra Lederer
- 1st Medical Department, Hanusch Hospital, 1140 Vienna, Austria; (A.H.); (S.L.)
| | - Daniel A. Kraus
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1140 Vienna, Austria; (J.W.); (T.D.); (S.S.); (D.A.K.); (J.Z.)
- 1st Medical Department, Hanusch Hospital, 1140 Vienna, Austria; (A.H.); (S.L.)
| | - Jochen Zwerina
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1140 Vienna, Austria; (J.W.); (T.D.); (S.S.); (D.A.K.); (J.Z.)
- 1st Medical Department, Hanusch Hospital, 1140 Vienna, Austria; (A.H.); (S.L.)
| | - Ruth D. E. Fritsch-Stork
- Medical Center Mariahilf of OEGK, 1060 Vienna, Austria;
- Medical Faculty, Sigmund Freud Private University, 1020 Vienna, Austria
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Traugott MT, Pleininger S, Inschlag-Tisch S, Eder B, Seitz T, Merrelaar A, Reiß-Kornfehl J, Fussi J, Schindler S, Blaschitz M, Heger F, Indra A, Karolyi M, Staudacher M, Oelschlaegel T, Hoepler W, Neuhold S, Wenisch C. Correction: A case of fulminant respiratory diphtheria in a 24-year-old Afghan refugee in Austria in May 2022: a case report. Infection 2023; 51:497-498. [PMID: 36639594 PMCID: PMC10042953 DOI: 10.1007/s15010-022-01964-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- M T Traugott
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria.
| | - S Pleininger
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - S Inschlag-Tisch
- Department of Internal Medicine, Cardiology and Nephrology, Hospital of Wiener Neustadt, Wiener Neustadt, Austria
| | - B Eder
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - T Seitz
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - A Merrelaar
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - J Reiß-Kornfehl
- Department of Otorhinolaryngology, Hospital of Wiener Neustadt, Wiener Neustadt, Austria
| | - J Fussi
- Department of Internal Medicine, Cardiology and Nephrology, Hospital of Wiener Neustadt, Wiener Neustadt, Austria
| | - S Schindler
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - M Blaschitz
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - F Heger
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - A Indra
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - M Karolyi
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - M Staudacher
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - T Oelschlaegel
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - W Hoepler
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - S Neuhold
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - C Wenisch
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
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Geusau A, Chromy D, Heissenberger D, Lippert K, Eder C, Heger F, Indra A, Willinger B, Pleininger S. Resistance profiles of Neisseria gonorrhoeae isolates in Vienna, Austria: a phenotypic and genetic characterization from 2013 to 2020. Int J Antimicrob Agents 2022; 60:106656. [PMID: 35988663 DOI: 10.1016/j.ijantimicag.2022.106656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/29/2022] [Accepted: 08/11/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES International surveillance data show a constant rise in the number of Neisseria gonorrhoeae infections and an increase in drug resistance of N. gonorrhoeae. As recent N. gonorrhoeae surveillance data in Austria are scarce, this study investigated phenotypic and genotypic antimicrobial resistance in N. gonorrhoeae isolates. METHODS In total, 440 N. gonorrhoeae samples were collected at the Medical University of Vienna, and the minimal inhibitory concentrations (MICs) for a range of different antibiotics were determined. Sampling sites and treatments were recorded, and whole-genome sequencing of N. gonorrhoeae isolates was performed using allele libraries to determine genotypic resistance. RESULTS The median MICs for ceftriaxone, cefixime, azithromycin, ciprofloxacin, tetracycline and penicillin were <0.002 µg/mL, <0.016 µg/mL, 0.25 µg/mL, 2.0 µg/mL, 1.5 µg/mL and 0.25 µg/mL, respectively. Annual comparison showed that MICs were generally stable for all antimicrobial agents except azithromycin, for which an increase in median MIC was observed from 2017 (0.25 µg/mL). There was no genetic resistance to ceftriaxone; 8% of samples displayed resistance mutations against cefixime, primarily located in the penA gene. Resistance to azithromycin increased from 2% in 2013 to 12% in 2020. MtrD mosaic had the highest impact on azithromycin susceptibility; 47% of the resistant isolates showed this mutation. The majority of cases of gonorrhoea were treated successfully with either ceftriaxone or a ceftriaxone/azithromycin regime. Two treatment failures occurred under monotherapy with doxycycline. Overall, genotypic resistance corresponded significantly to all respective MICs. CONCLUSIONS The resistance rate of N. gonorrhoeae to antibiotics has remained stable in Vienna over the last decade, except for azithromycin. The strong correlation found between genetic and phenotypic patterns in this study holds promise for future diagnostics of N. gonorrhoeae resistance based on genotypes.
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Affiliation(s)
- Alexandra Geusau
- Department of Dermatology, Medical University of Vienna, Vienna, Austria.
| | - David Chromy
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | - Kathrin Lippert
- Institute for Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Claudia Eder
- Institute for Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Florian Heger
- Institute for Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Alexander Indra
- Institute for Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria; Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Birgit Willinger
- Department of Hygiene and Medical Microbiology, Division of Clinical Microbiology, Medical University of Vienna, Vienna, Austria
| | - Sonja Pleininger
- Institute for Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
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9
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Traugott MT, Pleininger S, Inschlag-Tisch S, Eder B, Seitz T, Merrelaar A, Reiß-Kornfehl J, Fussi J, Schindler S, Blaschitz M, Heger F, Indra A, Karolyi M, Staudacher M, Oelschlaegel T, Hoepler W, Neuhold S, Wenisch C. A case of fulminant respiratory diphtheria in a 24-year-old Afghan refugee in Austria in May 2022: a case report. Infection 2022; 51:489-495. [PMID: 36178603 PMCID: PMC10042955 DOI: 10.1007/s15010-022-01926-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/15/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE Raising awareness of respiratory diphtheria and for the importance of early antitoxin administration. METHODS Report of a case of fulminant, imported respiratory diphtheria in an otherwise healthy 24-year-old Afghan refugee in Austria in May 2022. RESULT This was the first case of respiratory diphtheria in Austria since 1993. Diphtheria antitoxin was administered at an already progressed disease stage. This delay contributed to a fulminant disease course with multiorgan failure and death. CONCLUSION In high-income countries with low case numbers, awareness of respiratory diphtheria and for the importance of early antitoxin administration must be raised.
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Affiliation(s)
- M T Traugott
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria.
| | - S Pleininger
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - S Inschlag-Tisch
- Department of Internal Medicine, Cardiology and Nephrology, Hospital of Wiener Neustadt, Wiener Neustadt, Austria
| | - B Eder
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - T Seitz
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - A Merrelaar
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - J Reiß-Kornfehl
- Department of Otorhinolaryngology, Hospital of Wiener Neustadt, Wiener Neustadt, Austria
| | - J Fussi
- Department of Internal Medicine, Cardiology and Nephrology, Hospital of Wiener Neustadt, Wiener Neustadt, Austria
| | - S Schindler
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - M Blaschitz
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - F Heger
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - A Indra
- Austrian Reference Centre for Diphtheria, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - M Karolyi
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - M Staudacher
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - T Oelschlaegel
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - W Hoepler
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - S Neuhold
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
| | - C Wenisch
- IV Medical Department with Infectious Diseases and Tropical Medicine, Clinic Favoriten, Kundratstraße 3, 1100, Vienna, Austria
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10
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Schaeffer J, Lippert K, Pleininger S, Stöger A, Hasenberger P, Stadlbauer S, Heger F, Eigentler A, Geusau A, Indra A, Allerberger F, Ruppitsch W. Association of Phylogenomic Relatedness among Neisseria gonorrhoeae Strains with Antimicrobial Resistance, Austria, 2016-2020. Emerg Infect Dis 2022; 28:1694-1698. [PMID: 35876744 PMCID: PMC9328923 DOI: 10.3201/eid2808.220071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated genomic determinants of antimicrobial resistance in 1,318 Neisseria gonorrhoeae strains isolated in Austria during 2016–2020. Sequence type (ST) 9363 and ST11422 isolates had high rates of azithromycin resistance, and ST7363 isolates correlated with cephalosporin resistance. These results underline the benefit of genomic surveillance for antimicrobial resistance monitoring.
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11
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Pleininger S, Indra A, Golparian D, Heger F, Schindler S, Jacobsson S, Heidler S, Unemo M. Extensively drug-resistant (XDR) Neisseria gonorrhoeae causing possible gonorrhoea treatment failure with ceftriaxone plus azithromycin in Austria, April 2022. Euro Surveill 2022; 27. [PMID: 35713023 PMCID: PMC9205165 DOI: 10.2807/1560-7917.es.2022.27.24.2200455] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We describe a gonorrhoea case with ceftriaxone plus high-level azithromycin resistance. In April 2022, an Austrian heterosexual male was diagnosed with gonorrhoea after sexual intercourse with a female sex worker in Cambodia. Recommended treatment with ceftriaxone (1 g) plus azithromycin (1.5 g) possibly failed. Worryingly, this is the second strain in an Asian Neisseria gonorrhoeae genomic sublineage including high-level azithromycin-resistant strains that developed ceftriaxone resistance by acquisition of mosaic penA-60.001. Enhanced resistance surveillance and actions are imperative to prevent spread.
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Affiliation(s)
| | | | - Daniel Golparian
- WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Florian Heger
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | - Susanne Jacobsson
- WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Magnus Unemo
- Institute for Global Health, University College London, London, United Kingdom.,WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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12
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Reindl-Schwaighofer R, Heinzel A, Mayrdorfer M, Jabbour R, Hofbauer TM, Merrelaar A, Eder M, Regele F, Doberer K, Spechtl P, Aschauer C, Koblischke M, Paschen C, Eskandary F, Hu K, Öhler B, Bhandal A, Kleibenböck S, Jagoditsch RI, Reiskopf B, Heger F, Bond G, Böhmig GA, Strassl R, Weseslindtner L, Indra A, Aberle JH, Binder M, Oberbauer R. Comparison of SARS-CoV-2 Antibody Response 4 Weeks After Homologous vs Heterologous Third Vaccine Dose in Kidney Transplant Recipients: A Randomized Clinical Trial. JAMA Intern Med 2022; 182:165-171. [PMID: 34928302 PMCID: PMC8689434 DOI: 10.1001/jamainternmed.2021.7372] [Citation(s) in RCA: 82] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Fewer than 50% of kidney transplant recipients (KTRs) develop antibodies against the SARS-CoV-2 spike protein after 2 doses of an mRNA vaccine. Preliminary data suggest that a heterologous vaccination, combining mRNA and viral vector vaccines, may increase immunogenicity. OBJECTIVE To assess the effectiveness of a third dose of an mRNA vs a vector vaccine in KTRs who did not have antibodies against the SARS-CoV-2 spike protein after 2 doses of an mRNA vaccine. DESIGN, SETTING, AND PARTICIPANTS This was a single center, single-blinded, 1:1 randomized clinical trial of a third dose of vaccine against SARS-CoV-2, conducted from June 15 to August 16, 2021, in 201 KTRs who had not developed SARS-CoV-2 spike protein antibodies after 2 doses of an mRNA vaccine. Data analyses were performed from August 17 to August 31, 2021. INTERVENTIONS mRNA (BNT162b2 or mRNA-1273) or vector (Ad26COVS1) as a third dose of a SARS-CoV-2 vaccine. MAIN OUTCOMES AND MEASURES The primary study end point was seroconversion after 4 weeks (29-42 days) following the third vaccine dose. Secondary end points included neutralizing antibodies and T-cell response assessed by interferon-γ release assays (IGRA). In addition, the association of patient characteristics and vaccine response was assessed using logistic regression, and the reactogenicity of the vaccines was compared. RESULTS Among the study population of 197 kidney transplant recipients (mean [SD] age, 61.2 [12.4] years; 82 [42%] women), 39% developed SARS-CoV-2 antibodies after the third vaccine. There was no statistically significant difference between groups, with an antibody response rate of 35% and 42% for the mRNA and vector vaccines, respectively. Only 22% of seroconverted patients had neutralizing antibodies. Similarly, T-cell response assessed by IGRA was low with only 17 patients showing a positive response after the third vaccination. Receiving nontriple immunosuppression (odds ratio [OR], 3.59; 95% CI, 1.33-10.75), longer time after kidney transplant (OR, 1.44; 95% CI, 1.15-1.83, per doubling of years), and torque teno virus plasma levels (OR, 0.92; 95% CI, 0.88-0.96, per doubling of levels) were associated with vaccine response. The third dose of an mRNA vaccine was associated with a higher frequency of local pain at the injection site compared with the vector vaccine, while systemic symptoms were comparable between groups. CONCLUSIONS AND RELEVANCE This randomized clinical trial found that 39% of KTRs without an immune response against SARS-CoV-2 after 2 doses of an mRNA vaccine developed antibodies against the SARS-CoV-2 spike protein 4 weeks after a third dose of an mRNA or a vector vaccine. The heterologous vaccination strategy with a vector-based vaccine was well tolerated and safe but not significantly better than the homologous mRNA-based strategy. TRIAL REGISTRATION EudraCT Identifier: 2021-002927-39.
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Affiliation(s)
- Roman Reindl-Schwaighofer
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Andreas Heinzel
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Manuel Mayrdorfer
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Rhea Jabbour
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Thomas M Hofbauer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Anne Merrelaar
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Eder
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Florina Regele
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Konstantin Doberer
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Paul Spechtl
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Constantin Aschauer
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | | | - Christopher Paschen
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Farsad Eskandary
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Karin Hu
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Barbara Öhler
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Arshdeep Bhandal
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Sabine Kleibenböck
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Rahel I Jagoditsch
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Bianca Reiskopf
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Florian Heger
- Institute for Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Gregor Bond
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Georg A Böhmig
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Robert Strassl
- Division of Virology, Department of Laboratory Medicine, Medical University Vienna, Vienna, Austria
| | | | - Alexander Indra
- Institute for Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria.,Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Judith H Aberle
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | | | - Rainer Oberbauer
- Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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13
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Laferl H, Seitz T, Baier-Grabner S, Kelani H, Scholz E, Heger F, Götzinger F, Frischer PT, Wenisch C, Allerberger PF. Evaluation of RT-qPCR of mouthwash and buccal swabs for detection of SARS-CoV-2 in children and adults. Am J Infect Control 2022; 50:176-181. [PMID: 34718065 PMCID: PMC8552590 DOI: 10.1016/j.ajic.2021.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 12/19/2022]
Abstract
Background The use of nasopharyngeal (NP) swabs as a specimen collection method to diagnose SARS-CoV-2 infection is frequently perceived as uncomfortable by patients and requires trained personnel. In this study, detection rate of SARS-CoV-2 in mouthwash samples and buccal swabs were compared in both children and adults. Material and methods In patients admitted to hospital with confirmed COVID-19 within the previous 72 hours, NP and buccal swabs as well as mouthwash samples were collected. RT-qPCR was performed on all samples. Results In total, 170 samples were collected from 155 patients (137 adults and 18 children). Approximately 91.7% of the collected NP swabs were positive in RT-PCR compared to 63.1% of mouthwash samples and 42.4% of buccal swabs. Compared to NP swabs, the sensitivity of using mouthwash was 96.3% and 65.4% for buccal swabs in NP swab samples with a CT value <25. With increasing CT values, sensitivity decreased in both mouthwash and buccal swabs. The virus load was highest during the first week of infection, with a continuous decline observed in all three collection methods over time. Discussion Mouthwash presents an alternative collection method for detecting SARS-CoV-2 in the case of unfeasible NP swab sampling. Buccal swabs should not be used due to their low sensitivity.
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Legaria MC, Nastro M, Camporro J, Heger F, Barberis C, Stecher D, Rodriguez CH, Vay CA. Peptostreptococcus anaerobius: Pathogenicity, identification, and antimicrobial susceptibility. Review of monobacterial infections and addition of a case of urinary tract infection directly identified from a urine sample by MALDI-TOF MS. Anaerobe 2021; 72:102461. [PMID: 34626800 DOI: 10.1016/j.anaerobe.2021.102461] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 12/17/2022]
Abstract
Peptostreptococcus anaerobius is a gram-positive anaerobic coccus (GPAC) found in the gastrointestinal and vaginal microbiota. The organism is mainly found in polymicrobial and scarcely in monobacterial infections such as prosthetic and native endocarditis. Anaerobic bacteria have rarely been reported as the cause of urinary tract infection (UTI). Although GPAC are susceptible to most antimicrobials used against anaerobic infections, P. anaerobius has shown to be more resistant. Herein, we report a case of UTI caused by P. anaerobius from a 62-year-old man with a history of urological disease. Surprisingly, the microorganism was directly identified by Matrix-Assisted Laser Desorption-Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) from the urine sample. The isolate was successfully identified by phenotypic methods, MALDI-TOF MS, and 16S rRNA gene sequencing. P. anaerobius showed no β-lactamase-producing activity, was resistant to penicillin, ampicillin, ciprofloxacin and levofloxacin, and displayed intermediate susceptibility to ampicillin-sulbactam and amoxicillin-clavulanic acid. Successful treatment was achieved with oral amoxicillin-clavulanic acid. Antimicrobial susceptibility testing (AST) should be performed on P. anaerobius isolates due to their unpredictable AST patterns and because empirically administered antimicrobial agents may not be active. This report shows that MALDI-TOF MS, directly used in urine specimens, may be a quick option to diagnose UTI caused by P. anaerobius or other anaerobic bacteria. This review is a compilation of monobacterial infections caused by P. anaerobius published in the literature, their pathogenicity, identification, and data about the antimicrobial susceptibility of P. anaerobius.
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Affiliation(s)
- M C Legaria
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, Buenos Aires, Argentina.
| | - M Nastro
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, INFIBIOC, Buenos Aires, Argentina
| | - J Camporro
- Universidad de Buenos Aires. Facultad de Medicina, Hospital de Clínicas José de San Martín, Servicio de Infectología, Buenos Aires, Argentina
| | - F Heger
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, Buenos Aires, Argentina
| | - C Barberis
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, INFIBIOC, Buenos Aires, Argentina
| | - D Stecher
- Universidad de Buenos Aires. Facultad de Medicina, Hospital de Clínicas José de San Martín, Servicio de Infectología, Buenos Aires, Argentina
| | - C H Rodriguez
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, INFIBIOC, Buenos Aires, Argentina
| | - C A Vay
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Laboratorio de Bacteriología, INFIBIOC, Buenos Aires, Argentina
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15
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Willschke H, Wochele-Thoma T, Atanasov AG, Klager E, Haslinger C, Kletecka-Pulker M, Laxar D, Ay C, Öhlinger T, Kimberger O, Steinrigl A, Holzer B, Heger F, Indra A. Can We Protect Those We Care for in A Pandemic? - Prevalence of Neutralizing Antibodies against SARS-CoV-2 in Nursing Homes. Aging Dis 2021; 12:710-717. [PMID: 34094636 PMCID: PMC8139192 DOI: 10.14336/ad.2021.0217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/17/2021] [Indexed: 01/08/2023] Open
Abstract
In December 2019, the People's Republic of China and the World Health Organization first reported on a cluster of pneumonia with an unknown cause. Nine months later more than 1.4 million people have died from COVID 19. In this work, the effects of the COVID 19 pandemic on five nursing homes in Austria, which cared for 889 residents in the first half of 2020, were examined. The research question was whether the measures taken were appropriate to prevent an outbreak within the individual facilities. To detect previously unrecognized infections, the present study evaluated the prevalence of neutralizing antibodies against the SARS-CoV-2 virus in residents and employees of the nursing homes. Following the analysis of blood samples, the prospectively collected data was connected to data from screening examinations and data from contact tracing. The present study demonstrated an overall prevalence of neutralizing antibodies against the SARS-CoV-2 virus in nursing homes of 3.7%. Whereas the prevalence in those facilities that have never been hit by an outbreak is 0%, the prevalence in those facilities with an outbreak is up to 4.9%. Neutralizing antibodies against SARS-CoV-2 were detected in 35 persons. A retrospective analysis of all 5 included nursing homes demonstrated that upon regular clinical screening in combination with PCRs an infection with SARS-COV-2 was detected in 66 residents and 24 employees from different professional groups. In only 25 of the 35 persons with neutralizing antibodies against SARS-CoV-2 an infection was proven in advance. This study suggests that specific measures can prevent transmission within a health care facility. Nevertheless, the results also show that a risk reduction to 0% cannot be achieved. In preparation for further pandemic waves there is still the need to reduce the probability of a transmission in nursing homes with specific test strategies.
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Affiliation(s)
- Harald Willschke
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Thomas Wochele-Thoma
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,3Caritas Erzdiözese Wien, Vienna, Austria
| | - Atanas G Atanasov
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,4Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Magdalenka, Poland.,5Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria.,6Department of Pharmacognosy, University of Vienna, Vienna, Austria
| | - Elisabeth Klager
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria
| | | | | | - Daniel Laxar
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Care Ay
- 2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Thomas Öhlinger
- 2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Oliver Kimberger
- 1Ludwig Boltzmann Institute of Digital Health and Patient Safety, Vienna, Austria.,2Department of Anaesthesia and General Intensive Care, Medical University Vienna, Austria
| | - Adi Steinrigl
- 8AGES - Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH, Institute for Veterinary Disease Control, Mödling, Austria
| | - Barbara Holzer
- 8AGES - Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH, Institute for Veterinary Disease Control, Mödling, Austria
| | - Florian Heger
- 9AGES - Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH, Institute for medical Microbiology and Hygiene Vienna, Vienna, Austria
| | - Alexander Indra
- 10Paracelsus Medical University of Salzburg, Salzburg, Austria
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Léonard D, Chevolot Y, Heger F, Martins J, Crout DHG, Sigrist H, Mathieu HJ. ToF-SIMS and XPS study of photoactivatable reagents designed for surface glycoengineering. Part III. 5-Carboxamidopentyl-N-[m-[3-(trifluoromethyl)diazirin-3-yl]phenyl-β-D-galactopyranosyl]-(1->4)-1-thio-β-D-glucopyranoside (lactose aryl diazirine) on diam. SURF INTERFACE ANAL 2001. [DOI: 10.1002/sia.1071] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Early and late postoperative findings in 78 cases of stapedial surgery with 0.6 mm Schuknecht Teflon Wire Pistons only, performed from 1983 to 1987, were analysed to evaluate the supposition of an inverse relationship of the size of the footplate fenestration and functional long-term results. In respect of the size of fenestration our surgical strategy resulted in 3 different situations: stapedotomy (26)--partial platinectomy (34)--stapedectomy (19). Mean air conduction thresholds for frequencies 0.5-4 kHz were evaluated preoperatively, one month and > 5 years postoperatively. The results were postoperatively significantly better in all 3 groups without significant intergroup differences. > 5 years postoperatively the best results were seen in the partial platinectomy group better than after stapedotomy and significantly better than in the stapedectomy group. With regard to overclosure, closure of the air bone gap and deterioration of bone conduction thresholds at 4 kHz for the same groups, no significant differences were noticed. In conclusion, the best long-term results were obtained after partial platinectomy, i.e. there was no inverse relation of the size of the footplate perforation and the best results. The perforation should be large enough to prevent tilting of the piston at the edge. Removal of larger parts should be omitted. In case of early mobilisation and stapedectomy good long-term results can still be expected.
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Affiliation(s)
- E Richter
- Fachabteilung für Ohren-, Nasen- und Halskrankheiten, Allgemeines Krankenhaus, Stadt Linz
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