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Zoqi H, Schmidt D, Sedlacek L, Rath PM, Steinmann J, Kirchhoff L. Establishment of a Novel Short Tandem Repeat Typing Method for Exophiala dermatitidis. Mycopathologia 2024; 189:5. [PMID: 38231292 PMCID: PMC10794339 DOI: 10.1007/s11046-023-00825-y] [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: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 01/18/2024]
Abstract
The opportunistic black yeast-like fungus Exophiala dermatitidis frequently colonizes the respiratory tract of cystic fibroses (CF) patients. Additionally, it can cause superficial, systemic, and cerebral forms of phaeohyphomycoses. The objective of this study was to develop and apply a microsatellite or short tandem repeat (STR) genotyping scheme for E. dermatitidis. In total, 82 E. dermatitidis isolates from various geographic origins (environmental = 9, CF = 63, invasive isolates = 9, melanin-deficient mutant = 1) were included in this study. After next-generation sequencing of a reference strain and sequence filtering for microsatellites, six STR markers were selected and amplified in two multiplex PCR reactions. The included isolates were discriminated in a genetic cluster analysis using the Pearson algorithm to reveal the relatedness of the isolates. The E. dermatitidis isolates clustered on basis of both, their source and their origin. The invasive isolates from Asia were unrelated to isolates from CF. Nearly all environmental isolates were grouped separately from patients' isolates. The Simpson index was 0.94. In conclusion, we were able to establish a STR genotyping scheme for investigating population genomics of E. dermatitidis.
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Affiliation(s)
- Hamide Zoqi
- Institute of Medical Microbiology, ECMM Center of Excellence in Clinical and Laboratory Mycology and Clinical Studies (Diamond Status), University Hospital Essen, University of Duisburg-Essen, 45122, Essen, Germany
| | - Dirk Schmidt
- Institute of Medical Microbiology, ECMM Center of Excellence in Clinical and Laboratory Mycology and Clinical Studies (Diamond Status), University Hospital Essen, University of Duisburg-Essen, 45122, Essen, Germany
| | - Ludwig Sedlacek
- Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover (MHH), Hannover, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, ECMM Center of Excellence in Clinical and Laboratory Mycology and Clinical Studies (Diamond Status), University Hospital Essen, University of Duisburg-Essen, 45122, Essen, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, ECMM Center of Excellence in Clinical and Laboratory Mycology and Clinical Studies (Diamond Status), University Hospital Essen, University of Duisburg-Essen, 45122, Essen, Germany
- Institute of Clinical Microbiology, Infectious Diseases and Infection Control, Klinikum Nürnberg, Paracelsus Medical University, 90419, Nuremberg, Germany
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, ECMM Center of Excellence in Clinical and Laboratory Mycology and Clinical Studies (Diamond Status), University Hospital Essen, University of Duisburg-Essen, 45122, Essen, Germany.
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Corbett C, Finger P, Heiß-Neumann M, Bohnert J, Eder IB, Eisele M, Friesen I, Kaasch AJ, Kehrmann J, Lang R, Rödel J, Roessler S, Schmidt A, Schneitler S, Schui D, Schuler F, Sedlacek L, Serr A, Sitaru AG, Steinmann J, Wagner D, Wichelhaus TA, Hofmann-Thiel S, Hoffmann H. Development of prevalence and incidence of non-tuberculous mycobacteria in German laboratories from 2016 to 2020. Emerg Microbes Infect 2023; 12:2276342. [PMID: 37883336 PMCID: PMC10769520 DOI: 10.1080/22221751.2023.2276342] [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: 07/23/2023] [Accepted: 10/24/2023] [Indexed: 10/28/2023]
Abstract
Numbers of non-tuberculous mycobacteria (NTM) pulmonary diseases (PD) have been repeatedly reported as increasing over the last decades, particularly in Europe. Sound epidemiological data are however missing for most European regions. This study calculated prevalence and incidence of NTM recovered from patients' lungs in Germany, the largest Central European country, over a five-year period. It furthermore determined regional particularities of NTM species and results from susceptibility testing. 22 German NTM laboratories provided their mycobacteriological diagnostic data of 11,430 NTM isolates recovered from 5998 pulmonary patients representing 30% of all notified NTM-PD cases of Germany from 2016 to 2020. NTM incidence and prevalence were calculated for every study year. The presented epidemiological indicators are particularly reliant as TB surveillance data were used as a reference and TB notification reaches almost 100% in Germany. Laboratory incidence and prevalence of NTM recovered from respiratory samples ranged from 4.5-4.9 and from 5.3-5.8/100,000 for the population of Germany, respectively, and did not change over the five-year study period. Prevalence and incidence were stable also when stratifying for facultative pathogenic NTM, M. avium/intracellulare complex (MAIC), and M. abscessus/chelonae complex (MABSC). The proportion of NTM with drug susceptibility testing (DST) increased from 27.3% (2016) to 43.8% (2020). The unchanging laboratory NTM prevalence/incidence in Germany represents a "ceiling" of possible NTM-PD notification when diagnostic strategies do not change in the coming years. A notable increase in NTM-DST may indicate better notification of NTM-PD and/or awareness of new clinical guidelines but still remains below clinical needs.
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Affiliation(s)
- Caroline Corbett
- Institute of Microbiology and Laboratory Medicine, Department IML red GmbH, WHO - Supranational Tuberculosis Reference Laboratory, Munich-Gauting, Germany
| | - Philipp Finger
- Institute of Microbiology and Laboratory Medicine, Department IML red GmbH, WHO - Supranational Tuberculosis Reference Laboratory, Munich-Gauting, Germany
| | - Marion Heiß-Neumann
- Department of Pneumology & Infectious Diseases, Asklepios Lung Clinic Munich-Gauting, member of the German Centre for Lung Research; Gauting, Germany
| | - Juergen Bohnert
- Friedrich Loeffler-Institute of Medical Microbiology, Greifswald, Germany
| | - Ines B. Eder
- Institute of Medical Microbiology and Virology, University Hospital Leipzig, Leipzig, Germany
| | - Melanie Eisele
- Institut für medizinische Mikrobiologie, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Inna Friesen
- Labor Berlin - Charité Vivantes GmbH, Berlin, Germany
| | - Achim J. Kaasch
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, University Hospital Magdeburg, Otto von Guericke University, Magdeburg, Germany
| | - Jan Kehrmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Roland Lang
- Institut für Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Jürgen Rödel
- Institute of Medical Microbiology, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Susann Roessler
- Institut für Medizinische Mikrobiologie und Virologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden Germany
| | - Annika Schmidt
- Institut für medizinische Mikrobiologie und Hygiene, Tübingen, Germany
| | - Sophie Schneitler
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
- Institute of Pneumology at the University of Cologne, Bethanien Hospital, Clinic for Pneumology and Allergology, Centre of Sleep Medicine and Respiratory Care, Solingen, Germany
| | - Daniela Schui
- Bioscientia Institut für Medizinische Diagnostik GmbH, Mikrobiologie, Ingelheim, Germany
| | - Franziska Schuler
- Institute of Medical Microbiology, University Hospital, Münster, Germany
| | - Ludwig Sedlacek
- Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
| | - Annerose Serr
- Institute of Medical Microbiology and Hygiene, University of Freiburg, Freiburg, Germany
| | | | - Joerg Steinmann
- Institute of Clinical Microbiology, Infectious Diseases and Infection Control, Paracelsus Medical University, Klinikum Nürnberg, Nürnberg, Germany
| | - Dirk Wagner
- Division of Infectious Diseases, Department of Internal Medicine II, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas A. Wichelhaus
- Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - the EpiNTM-Group
- Institute of Microbiology and Laboratory Medicine, Department IML red GmbH, WHO - Supranational Tuberculosis Reference Laboratory, Munich-Gauting, Germany
| | - Sabine Hofmann-Thiel
- Institute of Microbiology and Laboratory Medicine, Department IML red GmbH, WHO - Supranational Tuberculosis Reference Laboratory, Munich-Gauting, Germany
- SYNLAB Gauting, SYNLAB MVZ Dachau GmbH, Munich-Gauting, Germany
| | - Harald Hoffmann
- Institute of Microbiology and Laboratory Medicine, Department IML red GmbH, WHO - Supranational Tuberculosis Reference Laboratory, Munich-Gauting, Germany
- SYNLAB Gauting, SYNLAB MVZ Dachau GmbH, Munich-Gauting, Germany
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Meister TL, Kirchhoff L, Brüggemann Y, Todt D, Steinmann J, Steinmann E. Stability of pathogens on banknotes and coins: A narrative review. J Med Virol 2023; 95:e29312. [PMID: 38100621 DOI: 10.1002/jmv.29312] [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: 06/06/2023] [Revised: 08/28/2023] [Accepted: 11/25/2023] [Indexed: 12/17/2023]
Abstract
For the prevention of infectious diseases, knowledge about potential transmission routes is essential. Pathogens can be transmitted directly (i.e. respiratory droplets, hand-to-hand contact) or indirectly via contaminated surfaces (fomites). In particular, frequently touched objects/surfaces may serve as transmission vehicles for different clinically relevant bacterial, fungal, and viral pathogens. Banknotes and coins offer ample surface area and are frequently exchanged between individuals. Consequently, many concerns have been raised in the recent past, that banknotes and coins could serve as vectors for the transmission of disease-causing microorganisms. This review summarizes the latest research on the potential of paper currency and coins to serve as sources of pathogenic viral, bacterial, and fungal agents. In contrast to the current perception of banknotes and coins as important transmission vehicles, current evidence suggests, that banknotes and coins do not pose a particular risk of pathogen infection for the public.
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Affiliation(s)
- Toni Luise Meister
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital of Essen, Essen, Germany
| | - Yannick Brüggemann
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Daniel Todt
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
- European Virus Bioinformatics Center (EVBC), Jena, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital of Essen, Essen, Germany
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Eike Steinmann
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
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Bertram R, Naumann HT, Bartsch V, Hitzl W, Kinzig M, Haarmeyer GS, Baumgärtel M, Geise A, Muschner D, Nentwich J, John S, Sörgel F, Steinmann J, Höhl R. Clinical and demographic factors affecting trough levels of isavuconazole in critically ill patients with or without COVID-19. Mycoses 2023; 66:1071-1078. [PMID: 37700457 DOI: 10.1111/myc.13653] [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: 06/09/2023] [Accepted: 08/23/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND The broad-spectrum antifungal isavuconazole is administered to treat invasive aspergillosis and mucormycosis. OBJECTIVES Isavuconazole plasma concentrations in critically ill ICU patients with or without COVID-19 and invasive fungal infection were determined, and factors for sub-therapeutic drug levels (<1 μg/mL) were evaluated. PATIENTS AND METHODS Isavuconazole plasma levels were measured as part of therapeutic drug monitoring (TDM) in ICUs of a tertiary hospital. Concentrations determined 20-28 h after previous dosing were defined as trough (Cmin ) levels. A total of 160 Cmin levels from 62 patients with invasive fungal infections were analysed, 30 of which suffering from COVID-19. Patient characteristics included into univariable and multivariable analyses were gender, age, COVID-19 status, body mass index (BMI), sepsis-related organ failure (SOFA) score, renal replacement therapy (RRT) and extracorporeal membrane oxygenation (ECMO) requirement. RESULTS The mean Cmin of isavuconazole in all patients was 1.64 μg/mL (interquartile range 0.83-2.24 μg/mL, total range 0.24-5.67 μg/mL). In total, 34.4% of the Cmin values (corresponding to 46.8% of patients) were below a threshold concentration of 1 μg/mL. Drug concentrations between patients with or without COVID-19 did not differ (p = .43). In contrast, levels were significantly lower in patients with female sex (p = .0007), age ≤ 65 years (p = .002), BMI > 25 (p = .006), SOFA score > 12 (p = .026), RRT (p = .017) and ECMO requirement (p = .001). CONCLUSIONS Isavuconazole plasma levels can be negatively affected by patients' risk factors, supportive renal replacement and ECMO therapy. Future prospective studies analysing the relevance of isavuconazole drug levels in ICU patient outcome are urgently needed.
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Affiliation(s)
- Ralph Bertram
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Hans-Theodor Naumann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Vanessa Bartsch
- Study Program in Human Medicine, Paracelsus Medical University, Nuremberg, Germany
| | - Wolfgang Hitzl
- Department of Research and Innovation Management, Biostatistics and publication of clinical trial studies, Paracelsus Medical University, Salzburg, Austria
- Department of Ophthalmology and Optometry, Paracelsus Medical University, Salzburg, Austria
- Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Salzburg, Austria
| | - Martina Kinzig
- Institute for Biomedical and Pharmaceutical Research, Nuremberg-Heroldsberg, Germany
| | - Golo-Sung Haarmeyer
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Matthias Baumgärtel
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Arnim Geise
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Dorothea Muschner
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Jens Nentwich
- Department of Cardiology, Intensive Care Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Stefan John
- Department of Cardiology, Intensive Care Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Fritz Sörgel
- Institute for Biomedical and Pharmaceutical Research, Nuremberg-Heroldsberg, Germany
- Institute of Pharmacology, West German Heart and Vascular Centre, University of Duisburg-Essen, Essen, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Rainer Höhl
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
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Meister TL, Brüggemann Y, Todt D, Tao R, Müller L, Steinmann J, Steinmann J, Timm J, Drexler I, Steinmann E. Stability and Inactivation of Monkeypox Virus on Inanimate Surfaces. J Infect Dis 2023; 228:1227-1230. [PMID: 37129073 PMCID: PMC10629702 DOI: 10.1093/infdis/jiad127] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 01/25/2023] [Revised: 03/24/2023] [Accepted: 04/27/2023] [Indexed: 05/03/2023] Open
Abstract
The spread of nonzoonotic monkeypox virus (MPXV) infections necessitates the reevaluation of hygiene measures. To date, only limited data are available on MPXV surface stability. Here, we evaluate the stability of infectious MPXV on stainless steel stored at different temperatures, while using different interfering substances to mimic environmental contamination. MPXV persistence increased with decreasing temperature. Additionally, we were able to show that MPXV could efficiently be inactivated by alcohol- and aldehyde-based surface disinfectants. These findings underline the stability of MPXV on inanimate surfaces and support the recommendations to use alcohol-based disinfectants as prevention measures or in outbreak situations.
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Affiliation(s)
- Toni Luise Meister
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum
| | - Yannick Brüggemann
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum
| | - Daniel Todt
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum
- European Virus Bioinformatics Center, Jena
| | - Ronny Tao
- Institute of Virology, Medical Faculty, Heinrich-Heine-University, Düsseldorf
| | - Lisa Müller
- Institute of Virology, Medical Faculty, Heinrich-Heine-University, Düsseldorf
| | - Jochen Steinmann
- Dr. Brill + Partner GmbH, Institute for Hygiene and Microbiology, Bremen
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nuremberg
- Institute of Medical Microbiology, University Hospital of Essen, Essen
| | - Joerg Timm
- Institute of Virology, Medical Faculty, Heinrich-Heine-University, Düsseldorf
| | - Ingo Drexler
- Institute of Virology, Medical Faculty, Heinrich-Heine-University, Düsseldorf
| | - Eike Steinmann
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum
- German Centre for Infection Research, External Partner Site Bochum, Germany
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Klarczyk BR, Ruffert L, Ulatowski A, Mogrovejo DC, Steinmann E, Steinmann J, Brill FHH. Evaluation of temperature, drying time and other determinants for the recovery of Gram-negative bacterial pathogens in disinfectant efficacy testing. J Hosp Infect 2023; 141:17-24. [PMID: 37598903 DOI: 10.1016/j.jhin.2023.08.006] [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: 06/20/2023] [Revised: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND In the clinical setting, surface disinfection is an important measure to reduce the risk of cross transmission of micro-organisms and the risk of nosocomial infections. Standardized methods can be used to evaluate disinfection procedures, as well as the effectiveness of the active ingredients used for disinfection. However, despite standardization, the results of such methodologies are still determined by several factors, and incorrect results may lead to invalid assumptions about the effectiveness of a disinfectant, posing significant health risks for patients and health personnel. AIM The objective of this study was to evaluate several determinants for the recovery of Pseudomonas aeruginosa and other test organisms to establish their influence on the results of standardized disinfection methodologies, and to find Gram-negative strains that can be used as suitable replacements for P. aeruginosa. METHODS The effects of inoculum application method, drying time, temperature and carrier material on the survival and recovery of the test organisms were evaluated using Student's t-test, one-way analysis of variance and Tukey's multiple comparison test. FINDINGS AND CONCLUSIONS Temperature, drying time, application method and carrier material were found to affect the recovery of P. aeruginosa cells significantly, and therefore influence the outcome of the methodologies used. This study also showed thatP. aeruginosa could be replaced with the Gram-negative species Acinetobacter baumannii, a test organism used in many standardized methodologies, which responds better under the same circumstances and has a behaviour similar to that of P. aeruginosa in disinfectant efficacy tests.
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Affiliation(s)
- B R Klarczyk
- Dr. Brill und Partner GmbH Institut für Hygiene und Mikrobiologie, Hamburg, Germany
| | - L Ruffert
- Dr. Brill und Partner GmbH Institut für Hygiene und Mikrobiologie, Hamburg, Germany
| | - A Ulatowski
- Dr. Brill und Partner GmbH Institut für Hygiene und Mikrobiologie, Hamburg, Germany
| | - D C Mogrovejo
- Dr. Brill und Partner GmbH Institut für Hygiene und Mikrobiologie, Hamburg, Germany.
| | - E Steinmann
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - J Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
| | - F H H Brill
- Dr. Brill und Partner GmbH Institut für Hygiene und Mikrobiologie, Hamburg, Germany
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Meister TL, Friesland M, Frericks N, Wetzke M, Haid S, Steinmann J, Todt D, Pietschmann T, Steinmann E. Virucidal activity of oral, hand, and surface disinfectants against respiratory syncytial virus. J Hosp Infect 2023; 141:25-32. [PMID: 37625461 DOI: 10.1016/j.jhin.2023.08.009] [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: 06/30/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is known as a major cause of respiratory tract infection in adults and children. Human-to-human transmission occurs via droplets as well as direct and indirect contact (e.g. contaminated surfaces or hands of medical staff). Therefore, applicable hygiene measures and knowledge about viral inactivation are of utmost importance. AIM To elucidate the disinfection profile of RSV. METHODS The study evaluated the virucidal efficacy of oral rinses specifically designed for children, World Health Organization (WHO)-recommended hand-rub formulations, and ethanol, as well as 2-propanol against RSV in a quantitative suspension test (EN14476). The stability of RSV on stainless steel discs was assessed and its inactivation by different surface disinfectants (EN16777) investigated. FINDINGS All tested oral rinses except one reduced infectious viral titres to the lower limit of quantification. The two WHO-recommended hand-rub formulations as well as 30% ethanol and 2-propanol completely abolished the detection of infectious virus. Infectious RSV was recovered after several days on stainless steel discs. However, RSV was efficiently inactivated by all tested surface disinfectants based on alcohol, aldehyde, or hydrogen peroxide. CONCLUSION Oral rinses, all tested hand-rub formulations as well as surface inactivation reagents were sufficient for RSV inactivation in vitro.
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Affiliation(s)
- T L Meister
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - M Friesland
- Institute for Experimental Virology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - N Frericks
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - M Wetzke
- Clinic for Paediatric Pneumology, Allergology, and Neonatology, Hannover Medical School, German Center for Lung Research, Hannover, Germany
| | - S Haid
- Institute for Experimental Virology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany
| | - J Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nuremberg, Germany; Institute of Medical Microbiology, University Hospital of Essen, Essen, Germany
| | - D Todt
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany; European Virus Bioinformatics Center (EVBC), Jena, Germany
| | - T Pietschmann
- Institute for Experimental Virology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hannover, Germany; German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Hannover, Germany; Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| | - E Steinmann
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany; German Centre for Infection Research (DZIF), External Partner Site, Bochum, Germany.
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Ziegler R, Arnold H, Bertram R, Geißdörfer W, Pauschinger M, Fischlein T, Pollari F, Steinmann J. Microbiologic diagnostics and pathogen spectrum in infective endocarditis of surgically treated patients: a five-year, retrospective, monocentric study. Infection 2023; 51:1523-1530. [PMID: 37024627 DOI: 10.1007/s15010-023-02030-x] [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: 03/02/2023] [Accepted: 03/26/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE The spectrum of causative organisms in infective endocarditis (IE) has changed significantly in the last decades. Reliable pathogen detection is crucial for appropriate antimicrobial therapy for IE. The aim of the study was to evaluate the diagnostic value of microbiological methods for detecting the causative microorganism of IE and to analyze the spectrum of pathogens. METHODS A total of 224 cases (211 unique patients, some with multiple surgeries) were included into this retrospective study. Patients were diagnosed with IE according to the modified Duke criteria from January 2016 to July 2021 and underwent heart valve surgery in a tertiary hospital. Pathogen detection was performed by blood culture, microbiological culture and 16S rDNA PCR of explanted heart valve material. RESULTS A causative pathogen of IE was detected in 95.5% (n = 214) of cases. Blood cultures were positive in 83.3%, while a pathogen in the examined heart valve samples was identified in 32.6% by culture and in 88.2% by 16S rDNA PCR. A microorganism was identified by 16S rDNA PCR in 61.1% of blood culture negative cases but only in 19.4% by heart valve culture. The most common pathogens were Staphylococcus aureus (27%), viridans group streptococci (20%), enterococci (19%) and coagulase-negative staphylococci (CoNS 8%). Cutibacterium acnes (7%) was detected in prosthetic valve IE cases only. CONCLUSION Blood culture as a comparatively non-invasive and straightforward technique remains an important and reliable method for initial detection of the causative organism in IE. Diagnostic stewardship programs should broadly emphasize proper collection of blood cultures, particularly sampling prior to any antibiotic treatment. Additionally, molecular testing using 16S rDNA tissue PCR can be used with culture techniques to increase the diagnostic yield, especially in the case of a negative blood culture.
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Affiliation(s)
- Renate Ziegler
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany.
| | - Hendrik Arnold
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
- Department of Hematology and Medical Oncology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
| | - Ralph Bertram
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
| | - Walter Geißdörfer
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Pauschinger
- Department of Cardiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
| | - Theodor Fischlein
- Department of Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University Nuremberg, Klinikum Nürnberg, Nuremberg, Germany
| | - Francesco Pollari
- Department of Cardiac Surgery, Cardiovascular Center, Paracelsus Medical University Nuremberg, Klinikum Nürnberg, Nuremberg, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
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Overheu O, Lendowski S, Quast DR, Kühn D, Vidal Blanco E, Kraeft AL, Steinmann E, Kourti E, Lugnier C, Steinmann J, Reinacher-Schick A, Pfaender S. Longitudinal data on humoral response and neutralizing antibodies against SARS-CoV-2 Omicron BA.1 and subvariants BA.4/5 and BQ.1.1 after COVID-19 vaccination in cancer patients. J Cancer Res Clin Oncol 2023; 149:10633-10644. [PMID: 37300723 PMCID: PMC10257184 DOI: 10.1007/s00432-023-04961-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/02/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE The SARS-CoV-2 Omicron variant of concern (VOC) and subvariants like BQ.1.1 demonstrate immune evasive potential. Little is known about the efficacy of booster vaccinations regarding this VOC and subvariants in cancer patients. This study is among the first to provide data on neutralizing antibodies (nAb) against BQ.1.1. METHODS Cancer patients at our center were prospectively enrolled between 01/2021 and 02/2022. Medical data and blood samples were collected at enrollment and before and after every SARS-CoV-2 vaccination, at 3 and 6 months. RESULTS We analyzed 408 samples from 148 patients (41% female), mainly with solid tumors (85%) on active therapy (92%; 80% chemotherapy). SARS-CoV-2 IgG and nAb titers decreased over time, however, significantly increased following third vaccination (p < 0.0001). NAb (ND50) against Omicron BA.1 was minimal prior and increased significantly after the third vaccination (p < 0.0001). ND50 titers against BQ.1.1 after the third vaccination were significantly lower than against BA.1 and BA.4/5 (p < 0.0001) and undetectable in half of the patients (48%). Factors associated with impaired immune response were hematologic malignancies, B cell depleting therapy and higher age. Choice of vaccine, sex and treatment with chemo-/immunotherapy did not influence antibody response. Patients with breakthrough infections had significantly lower nAb titers after both 6 months (p < 0.001) and the third vaccination (p = 0.018). CONCLUSION We present the first data on nAb against BQ.1.1 following the third vaccination in cancer patients. Our results highlight the threat that new emerging SARS-CoV-2 variants pose to cancer patients and support efforts to apply repeated vaccines. Since a considerable number of patients did not display an adequate immune response, continuing to exhibit caution remains reasonable.
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Affiliation(s)
- Oliver Overheu
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany.
| | - Simon Lendowski
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Daniel R Quast
- Department of Internal Medicine, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Daniel Kühn
- Department of Molecular and Medical Virology, Ruhr University, Bochum, Germany
| | - Elena Vidal Blanco
- Department of Molecular and Medical Virology, Ruhr University, Bochum, Germany
| | - Anna-Lena Kraeft
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Eike Steinmann
- Department of Molecular and Medical Virology, Ruhr University, Bochum, Germany
| | - Eleni Kourti
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Celine Lugnier
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Anke Reinacher-Schick
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Stephanie Pfaender
- Department of Molecular and Medical Virology, Ruhr University, Bochum, Germany
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10
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Scharmann U, Verhasselt HL, Kirchhoff L, Furnica DT, Steinmann J, Rath PM. Microbiological Non-Culture-Based Methods for Diagnosing Invasive Pulmonary Aspergillosis in ICU Patients. Diagnostics (Basel) 2023; 13:2718. [PMID: 37627977 PMCID: PMC10453445 DOI: 10.3390/diagnostics13162718] [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: 07/19/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
The diagnosis of invasive pulmonary aspergillosis (IPA) in intensive care unit (ICU) patients is crucial since most clinical signs are not specific to invasive fungal infections. To detect an IPA, different criteria should be considered. Next to host factors and radiological signs, microbiological criteria should be fulfilled. For microbiological diagnostics, different methods are available. Next to the conventional culture-based approaches like staining and culture, non-culture-based methods can increase sensitivity and improve time-to-result. Besides fungal biomarkers, like galactomannan and (1→3)-β-D-glucan as nonspecific tools, molecular-based methods can also offer detection of resistance determinants. The detection of novel biomarkers or targets is promising. In this review, we evaluate and discuss the value of non-culture-based microbiological methods (galactomannan, (1→3)-β-D-glucan, Aspergillus PCR, new biomarker/targets) for diagnosing IPA in ICU patients.
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Affiliation(s)
- Ulrike Scharmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany (J.S.)
| | - Hedda Luise Verhasselt
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany (J.S.)
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany (J.S.)
| | - Dan-Tiberiu Furnica
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany (J.S.)
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany (J.S.)
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, 90419 Nuremberg, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany (J.S.)
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11
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Horch R, Rasp D, Dietz A, Ebbert R, Steinmann J, Schaible UE, Mamat U, Bertram R. tet-Dependent Gene Expression in Stenotrophomonas maltophilia. Microbiol Spectr 2023; 11:e0157623. [PMID: 37378537 PMCID: PMC10434252 DOI: 10.1128/spectrum.01576-23] [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: 04/13/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023] Open
Abstract
Stenotrophomonas maltophilia is increasingly recognized as an important nosocomial pathogen among the Gram-negative bacteria. Intrinsic resistance to different classes of antibiotics makes treatment of infections challenging. A deeper understanding of S. maltophilia physiology and virulence requires molecular genetic tools. Here, we describe the implementation of tetracycline-dependent gene regulation (tet regulation) in this bacterium. The exploited tet regulatory sequence of transposon Tn10 contained the tetR gene and three intertwined promoters, one of which was required for regulated expression of a target gene or operon. The episomal tet architecture was tested with a gfp variant as a quantifiable reporter. Fluorescence intensity was directly correlated with the concentration of the inducer anhydrotetracycline (ATc) applied and the duration of induction. Also, the expression of the rmlBACD operon of S. maltophilia K279a was subjected to tet control. These genes code for the synthesis of dTDP-l-rhamnose, an activated nucleotide sugar precursor of lipopolysaccharide (LPS) formation. A ΔrmlBACD mutant was complemented with a plasmid carrying this operon downstream of the tet sequence. In the presence of ATc, the LPS pattern was similar to that of wild-type S. maltophilia, whereas without the inducer, fewer and apparently shorter O-antigen chains were detected. This underscores the functionality and usefulness of the tet system for gene regulation and, prospectively, the validation of targets for new anti-S. maltophilia drugs. IMPORTANCE Stenotrophomonas maltophilia is an emerging pathogen in hospital settings and poses a threat to immunocompromised patients. Due to a high level of resistance to different types of antibiotics, treatment options are limited. We here adapted a tool for inducible expression of genes of interest, known as the tet system, to S. maltophilia. Genes relevant to producing surface carbohydrate structures (lipopolysaccharide [LPS]) were placed under the control of the tet system. In the presence of an inducer, the LPS pattern was similar to that of wild-type S. maltophilia, whereas in the "off" state of the system (without inducer), fewer and apparently shorter versions of LPS were detected. The tet system is functional in S. maltophilia and may be helpful to reveal gene-function relationships to gain a deeper understanding of the bacterium's physiology and virulence.
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Affiliation(s)
- Rebecca Horch
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
- Technische Hochschule Nürnberg Georg Simon Ohm, Faculty of Applied Chemistry, Nuremberg, Germany
| | - Diana Rasp
- Study Program in Human Medicine, Paracelsus Medical University, Nuremberg, Germany
| | - Annika Dietz
- Technische Hochschule Nürnberg Georg Simon Ohm, Faculty of Applied Chemistry, Nuremberg, Germany
| | - Ronald Ebbert
- Technische Hochschule Nürnberg Georg Simon Ohm, Faculty of Applied Chemistry, Nuremberg, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Ulrich E. Schaible
- Department of Cellular Microbiology, Program Area Infections, Research Center Borstel, Leibniz Lung Center, Leibniz Research Alliance INFECTIONS, Borstel, Germany
| | - Uwe Mamat
- Department of Cellular Microbiology, Program Area Infections, Research Center Borstel, Leibniz Lung Center, Leibniz Research Alliance INFECTIONS, Borstel, Germany
| | - Ralph Bertram
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
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12
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Bertram R, Hitzl W, Steinmann E, Steinmann J. Asymptomatic Healthcare Worker PCR Screening during SARS-CoV-2 Omicron Surge, Germany, 2022. Emerg Infect Dis 2023; 29. [PMID: 37352551 PMCID: PMC10370853 DOI: 10.3201/eid2908.230156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
During 2022, a total of 9,515 asymptomatic healthcare workers of a large hospital in Germany underwent SARS-CoV-2 PCR screening twice weekly. Of 398,784 saliva samples, 3,555 (0.89%) were PCR positive (median cycle threshold value 30). Early identification of infected healthcare workers can help reduce SARS-CoV-2 transmission in the hospital environment.
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13
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Furnica DT, Dittmer S, Scharmann U, Meis JF, Steinmann J, Rath PM, Kirchhoff L. In Vitro and In Vivo Effect of the Imidazole Luliconazole against Lomentospora prolificans and Scedosporium spp. Microbiol Spectr 2023; 11:e0513022. [PMID: 37017567 PMCID: PMC10269907 DOI: 10.1128/spectrum.05130-22] [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: 12/20/2022] [Accepted: 03/14/2023] [Indexed: 04/06/2023] Open
Abstract
Infections with Scedosporium spp. and Lomentospora prolificans have become a serious threat in clinical settings. The high mortality rates associated with these infections can be correlated with their multidrug resistance. The development of alternative treatment strategies has become crucial. Here, we investigate the in vitro and in vivo activity of luliconazole (LLCZ) against Scedosporium apiospermum (including its teleomorph Pseudallescheria boydii) and Lomentospora prolificans. The LLCZ MICs were determined for a total of 37 isolates (31 L. prolificans isolates, 6 Scedosporium apiospermum/P. boydii strains) according to EUCAST. Furthermore, the LLCZ antifungal activity was tested in vitro, using an XTT [2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide salt] growth kinetics assay and biofilm assays (crystal violet and XTT assay). In addition, a Galleria mellonella infection model was used for in vivo treatment assays. The MIC90 of LLCZ was determined to be 0.25 mg/L for all tested pathogens. Growth was inhibited within 6 to 48 h of the start of incubation. LLCZ inhibited biofilm formation in both preadhesion stages and late-stage adhesion. In vivo, a single dose of LLCZ increased the survival rate of the larvae by 40% and 20% for L. prolificans and Scedosporium spp., respectively. This is the first study demonstrating LLCZ activity against Lomentospora prolificans in vitro and in vivo and the first study showing the antibiofilm effect of LLCZ in Scedosporium spp. IMPORTANCE Lomentospora prolificans and S. apiospermum/P. boydii are opportunistic, multidrug-resistant pathogens causing invasive infections in immunosuppressed patients and sometimes in healthy persons. Lomentospora prolificans is panresistant against the currently available antifungals, and both species are associated with high mortality rates. Thus, the discovery of novel antifungal drugs exhibiting an effect against these resistant fungi is crucial. Our study shows the effect of luliconazole (LLCZ) against L. prolificans and Scedosporium spp. in vitro, as well as in an in vivo infection model. These data reveal the previously unknown inhibitory effect of LLCZ against L. prolificans and its antibiofilm effect in Scedosporium spp. It represents an extension of the literature regarding azole-resistant fungi and could potentially lead to the development of future treatment strategies against these opportunistic fungal pathogens.
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Affiliation(s)
- Dan-Tiberiu Furnica
- Institute of Medical Microbiology, Excellence Center for Medical Mycology (ECMM), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Silke Dittmer
- Institute of Medical Microbiology, Excellence Center for Medical Mycology (ECMM), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulrike Scharmann
- Institute of Medical Microbiology, Excellence Center for Medical Mycology (ECMM), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jacques F. Meis
- Department of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- Excellence Center for Medical Mycology (ECMM), Centre of Expertise in Mycology, Radboudumc/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Joerg Steinmann
- Institute of Medical Microbiology, Excellence Center for Medical Mycology (ECMM), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, Excellence Center for Medical Mycology (ECMM), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, Excellence Center for Medical Mycology (ECMM), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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14
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Wißmann JE, Brüggemann Y, Todt D, Steinmann J, Steinmann E. Survival and inactivation of hepatitis E virus on inanimate surfaces. J Hosp Infect 2023; 134:57-62. [PMID: 36746308 DOI: 10.1016/j.jhin.2023.01.013] [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: 12/07/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis, and mainly transmitted via faecal-oral contamination or consumption of contaminated food products. However, limited data on the surface stability and HEV sensitivity to chemical disinfectants are available. AIM To establish an HEV-based carrier assay to evaluate its surface stability and the virucidal activity of nine surface disinfectants. METHODS A recently developed robust HEV-3 cell culture system for an HEV-based carrier assay. FINDINGS Alcohol-based disinfectants were insufficient to eliminate HEV infectivity, whereas disinfectants based on aldehyde, peracetic acid, oxygen, and/or quaternary ammonium inactivated HEV. CONCLUSION These findings have strong implications for the recommendation of evidence-based hygiene guidelines to reduce HEV transmission.
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Affiliation(s)
- J E Wißmann
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Y Brüggemann
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - D Todt
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany; European Virus Bioinformatics Center (EVBC), Jena, Germany
| | - J Steinmann
- Institute for Hygiene and Microbiology, Bremen, Germany
| | - E Steinmann
- Department for Molecular & Medical Virology, Ruhr University Bochum, Bochum, Germany; German Centre for Infection Research (DZIF), External Partner Site, Bochum, Germany.
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15
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Meister TL, Tao R, Brüggemann Y, Todt D, Steinmann J, Timm J, Drexler I, Steinmann E. Efficient Inactivation of Monkeypox Virus by World Health Organization‒Recommended Hand Rub Formulations and Alcohols. Emerg Infect Dis 2023; 29:189-192. [PMID: 36394568 PMCID: PMC9796202 DOI: 10.3201/eid2901.221429] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Increasing nonzoonotic human monkeypox virus (MPXV) infections urge reevaluation of inactivation strategies. We demonstrate efficient inactivation of MPXV by 2 World Health Organization‒recommended alcohol-based hand rub solutions. When compared with other (re)emerging enveloped viruses, MPXV displayed the greatest stability. Our results support rigorous adherence to use of alcohol-based disinfectants.
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Abstract
S2.5 Rare yeasts, September 21, 2022, 3:00 PM - 4:30 PM The black yeast Exophiala dermatitidis is an opportunistic pathogen, causing phaeohyphomycosis in immunosuppressed patients, chromoblastomycosis, and fatal infections of the central nervous system in otherwise healthy Asian patients. In addition, it is also regularly isolated from respiratory samples from cystic fibrosis patients, with rates varying between 1% and 19%. Melanin, as part of the cell wall of black yeasts, is one major factor known to contribute to the pathogenicity of E. dermatitidis and increased resistance against host defense and anti-infective therapeutics. Further virulence factors, e.g., the capability to adhere to surfaces and to form biofilm were reported.
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Affiliation(s)
- Joerg Steinmann
- Paracelsus Medical University Nuremberg , Nuremberg , Germany
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17
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Pranada AB, Cordovana M, Meyer M, Hubert H, Abdalla M, Ambretti S, Steinmann J. Identification of micro-organism from positive blood cultures: comparison of three different short culturing methods to the Rapid Sepsityper workflow. J Med Microbiol 2022; 71. [PMID: 35930326 DOI: 10.1099/jmm.0.001571] [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] [Indexed: 11/18/2022] Open
Abstract
Sepsis is one of the leading causes of death worldwide. The rapid identification (ID) of the causative micro-organisms is crucial for the patients' clinical outcome. MALDI-TOF MS has been widely investigated to speed up the time-to-report for ID from positive blood cultures, and many different procedures and protocols were developed, all of them attributable either to the direct separation of microbial cells from the blood cells, or to a short subculture approach. In this study, the Rapid Sepsityper workflow (MBT Sepsityper IVD Kit, Bruker Daltonics GmbH and Co. KG, Bremen, Germany) was compared to three different short subculturing methods, established into the routine practice of three different clinical microbiology laboratories. A total of N=503 routine samples were included in this study and tested in parallel with the two approaches. Results of the rapid procedures were finally compared to routine proceedings with Gram-staining and overnight subculture. Among monomicrobial samples, the Rapid Sepsityper workflow enabled overall the correct identification of 388/443 (87.6 %) micro-organisms, while the short subculturing methods of 267/435 (61.8 %). Except for the performance with Streptococcus pneumoniae, in each one of the three sites the Rapid Sepsityper workflow proved to be superior to the short subculture method, regardless of the protocol applied, and it delivered a result from 1 to 5 h earlier.
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Affiliation(s)
- Arthur B Pranada
- Department of Medical Microbiology, MVZ Dr. Eberhard & Partner Dortmund, Dortmund, Germany
| | | | | | | | | | - Simone Ambretti
- Operative Unit of Microbiology IRCSS Sant'Orsola, Bologna, Italy
| | - Joerg Steinmann
- Institute for Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nürnberg, Germany
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18
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Höhl R, Bertram R, Kinzig M, Haarmeyer GS, Baumgärtel M, Geise A, Muschner D, Prosch D, Reger M, Naumann HT, Ficker JH, Kubitz J, Steinmann J, Sörgel F. Isavuconazole Therapeutic Drug Monitoring in critically ill ICU patients - a monocentric retrospective analysis. Mycoses 2022; 65:747-752. [PMID: 35535740 DOI: 10.1111/myc.13469] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 02/10/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The broad-spectrum triazole isavuconazole is used for the treatment of invasive aspergillosis and mucormycosis. Data regarding human plasma concentrations in clinical routine of the drug are rare. OBJECTIVES Plasma concentrations of isavuconazole were determined in critically ill ICU patients while considering different patients' characteristics. METHODS Retrospective analysis of isavuconazole plasma concentrations were obtained as part of routine therapeutic drug monitoring (TDM) of ICU patients with invasive aspergillosis or other fungal infections treated with isavuconazole. Plasma levels 0-4h after last dosing were defined as peak levels (Cmax ), those 20-28h after last dosing as trough levels (Cmin ). RESULTS Overall, 223 isavuconazole levels of 41 patients were analysed, divided into 141 peak levels and 82 trough levels. The overall median Cmax was 2.36 μg/mL (mean 2.43 μg/mL, range 0.41 - 7.79 μg/mL) and the overall median Cmin was 1.74 μg/mL (mean 1.77 μg/mL, range 0.24 - 4.96 μg/mL). In total, 31.7% of the Cmin values of the total cohort were below the plasma target concentrations of 1 μg/mL, defined as EUCAST antifungal clinical breakpoint for Aspergillus fumigatus. Both peak and trough plasma levels of isavuconazole were significantly lower among patients with a body-mass-index (BMI) ≥ 25. In addition, a significant correlation was observed between isavuconazole trough levels and sepsis-related organ failure assessment (SOFA) score. CONCLUSIONS This study shows that isavuconazole plasma concentrations vary in critical ill ICU patients. Significantly lower isavuconazole levels were associated with elevated BMI and higher SOFA score indicating a need of isavuconazole TDM in this specific patient population.
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Affiliation(s)
- Rainer Höhl
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Ralph Bertram
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Martina Kinzig
- Institute for Biomedical and Pharmaceutical Research, 90562 Nuremberg-Heroldsberg, Germany
| | - Golo-Sung Haarmeyer
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Matthias Baumgärtel
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Arnim Geise
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Dorothea Muschner
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Doris Prosch
- Department of Anesthesiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Mira Reger
- Institute for Biomedical and Pharmaceutical Research, 90562 Nuremberg-Heroldsberg, Germany
| | - Hans-Theodor Naumann
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Joachim H Ficker
- Department for Respiratory Medicine, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Jens Kubitz
- Department of Anesthesiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Fritz Sörgel
- Institute for Biomedical and Pharmaceutical Research, 90562 Nuremberg-Heroldsberg, Germany
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19
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Behrendt P, Friesland M, Wißmann JE, Kinast V, Stahl Y, Praditya D, Hueffner L, Nörenberg PM, Bremer B, Maasoumy B, Steinmann J, Becker B, Paulmann D, Brill FHH, Steinmann J, Ulrich RG, Brüggemann Y, Wedemeyer H, Todt D, Steinmann E. Hepatitis E virus is highly resistant to alcohol-based disinfectants. J Hepatol 2022; 76:1062-1069. [PMID: 35085595 DOI: 10.1016/j.jhep.2022.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 12/23/2021] [Accepted: 01/11/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND & AIMS Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide and is mainly transmitted via the fecal-oral route or through consumption of contaminated food products. Due to the lack of efficient cell culture systems for the propagation of HEV, limited data regarding its sensitivity to chemical disinfectants are available. Consequently, preventive and evidence-based hygienic guidelines on HEV disinfection are lacking. METHODS We used a robust HEV genotype 3 cell culture model which enables quantification of viral infection of quasi-enveloped and naked HEV particles. For HEV genotype 1 infections, we used the primary isolate Sar55 in a fecal suspension. Standardized quantitative suspension tests using end point dilution and large-volume plating were performed for the determination of virucidal activity of alcohols (1-propanol, 2-propanol, ethanol), WHO disinfectant formulations and 5 different commercial hand disinfectants against HEV. Iodixanol gradients were conducted to elucidate the influence of ethanol on quasi-enveloped viral particles. RESULTS Naked and quasi-enveloped HEV was resistant to alcohols as well as alcohol-based formulations recommended by the WHO. Of the tested commercial hand disinfectants only 1 product displayed virucidal activity against HEV. This activity could be linked to phosphoric acid as an essential ingredient. Finally, we observed that ethanol and possibly non-active alcohol-based disinfectants disrupt the quasi-envelope structure of HEV particles, while leaving the highly transmissible and infectious naked virions intact. CONCLUSIONS Different alcohols and alcohol-based hand disinfectants were insufficient to eliminate HEV infectivity with the exception of 1 commercial ethanol-based product that included phosphoric acid. These findings have major implications for the development of measures to reduce viral transmission in clinical practice. LAY SUMMARY Hepatitis E virus (HEV) showed a high level of resistance to alcohols and alcohol-based hand disinfectants. The addition of phosphoric acid to alcohol was essential for virucidal activity against HEV. This information should be used to guide improved hygiene measures for the prevention of HEV transmission.
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Affiliation(s)
- Patrick Behrendt
- Institute for Experimental Virology, TWINCORE Centre for Experimental and Clinical Infection Research, A Joint Venture between the Medical School Hannover (MHH) and the Helmholtz Centre for Infection Research (HZI), Hannover, Germany; Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Germany; German Centre for Infection Research (DZIF), Hannover-Braunschweig, Germany.
| | - Martina Friesland
- Institute for Experimental Virology, TWINCORE Centre for Experimental and Clinical Infection Research, A Joint Venture between the Medical School Hannover (MHH) and the Helmholtz Centre for Infection Research (HZI), Hannover, Germany
| | - Jan-Erik Wißmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Volker Kinast
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Yannick Stahl
- Institute for Experimental Virology, TWINCORE Centre for Experimental and Clinical Infection Research, A Joint Venture between the Medical School Hannover (MHH) and the Helmholtz Centre for Infection Research (HZI), Hannover, Germany
| | - Dimas Praditya
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Lucas Hueffner
- Institute for Experimental Virology, TWINCORE Centre for Experimental and Clinical Infection Research, A Joint Venture between the Medical School Hannover (MHH) and the Helmholtz Centre for Infection Research (HZI), Hannover, Germany
| | - Pia Maria Nörenberg
- Institute for Experimental Virology, TWINCORE Centre for Experimental and Clinical Infection Research, A Joint Venture between the Medical School Hannover (MHH) and the Helmholtz Centre for Infection Research (HZI), Hannover, Germany
| | - Birgit Bremer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Germany
| | - Benjamin Maasoumy
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Germany; German Centre for Infection Research (DZIF), Hannover-Braunschweig, Germany; Centre for Individualised Infection Medicine (CIIM), Hannover, Germany
| | - Jochen Steinmann
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Britta Becker
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Dajana Paulmann
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Florian H H Brill
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Germany; Institute for Clinical Hygiene, Medical Microbiology and Infectiology, Clinic Nuernberg, Paracelsus Medical University, Nuremberg, Germany
| | - Rainer G Ulrich
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany and German Centre for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Insel Riems, Germany
| | - Yannick Brüggemann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Germany; German Centre for Infection Research (DZIF), Hannover-Braunschweig, Germany
| | - Daniel Todt
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany; European Virus Bioinformatics Center (EVBC), Jena, Germany
| | - Eike Steinmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany; German Centre for Infection Research (DZIF), External Partner Site, Bochum, Germany.
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Lackner M, de Hoog GS, Yang L, Ferreira Moreno L, Ahmed SA, Andreas F, Kaltseis J, Nagl M, Lass-Flörl C, Risslegger B, Rambach G, Speth C, Robert V, Buzina W, Chen S, Bouchara JP, Cano-Lira JF, Guarro J, Gené J, Fernández Silva F, Haido R, Haase G, Havlicek V, Garcia-Hermoso D, Meis JF, Hagen F, Kirchmair M, Rainer J, Schwabenbauer K, Zoderer M, Meyer W, Gilgado F, Schwabenbauer K, Vicente VA, Piecková E, Regenermel M, Rath PM, Steinmann J, de Alencar XW, Symoens F, Tintelnot K, Ulfig K, Velegraki A, Tortorano AM, Giraud S, Mina S, Rigler-Hohenwarter K, Hernando FL, Ramirez-Garcia A, Pellon A, Kaur J, Bergter EB, de Meirelles JV, da Silva ID, Delhaes L, Alastruey-Izquierdo A, Li RY, Lu Q, Moussa T, Almaghrabi O, Al-Zahrani H, Okada G, Deng S, Liao W, Zeng J, Issakainen J, Liporagi Lopes LC. Correction to: Proposed nomenclature for Pseudallescheria, Scedosporium and related genera. FUNGAL DIVERS 2022. [DOI: 10.1007/s13225-022-00505-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Kirchhoff L, Braun L, Schmidt D, Dittmer S, Dedy J, Herbstreit F, Stauf R, Steckel NK, Buer J, Rath PM, Steinmann J, Verhasselt HL. COVID-19-associated pulmonary aspergillosis in ICU patients in a German reference centre: phenotypic and molecular characterization of Aspergillus fumigatus isolates. Mycoses 2022; 65:458-465. [PMID: 35138651 PMCID: PMC9115305 DOI: 10.1111/myc.13430] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/22/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 01/08/2023]
Abstract
Background COVID‐19‐associated invasive pulmonary aspergillosis (CAPA) is associated with increased mortality. Cases of CAPA caused by azole‐resistant Aspergillus fumigatus strains have been reported. Objectives To analyse the twelve‐month CAPA prevalence in a German tertiary care hospital and to characterise clinical A. fumigatus isolates from two German hospitals by antifungal susceptibility testing and microsatellite genotyping. Patients/Methods. Retrospective observational study in critically ill adults from intensive care units with COVID‐19 from 17 February 2020 until 16 February 2021 and collection of A. fumigatus isolates from two German centres. EUCAST broth microdilution for four azole compounds and microsatellite PCR with nine markers were performed for each collected isolate (N = 27) and additional for three non‐COVID A. fumigatus isolates. Results welve‐month CAPA prevalence was 7.2% (30/414), and the rate of azole‐resistant A. fumigatus isolates from patients with CAPA was 3.7% with detection of one TR34/L98H mutation. The microsatellite analysis revealed no major clustering of the isolates. Sequential isolates mainly showed the same genotype over time. Conclusions Our findings demonstrate similar CAPA prevalence to other reports and a low azole‐resistance rate. Genotyping of A. fumigatus showed polyclonal distribution except for sequential isolates.
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Affiliation(s)
- Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, ECMM Centre of Excellence in Mycology, Germany
| | - Lukas Braun
- Institute of Medical Microbiology, University Hospital Essen, ECMM Centre of Excellence in Mycology, Germany
| | - Dirk Schmidt
- Institute of Medical Microbiology, University Hospital Essen, ECMM Centre of Excellence in Mycology, Germany
| | - Silke Dittmer
- Institute of Medical Microbiology, University Hospital Essen, ECMM Centre of Excellence in Mycology, Germany
| | - Jutta Dedy
- University Hospital Essen, Pharmacy, Germany
| | - Frank Herbstreit
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Essen, Germany
| | - Raphael Stauf
- Institute of Hospital Hygiene and Clinical Microbiology, Klinikum Dortmund gGmbH, Dortmund, Germany
| | - Nina Kristin Steckel
- Department of Bone Marrow Transplantation, West German Cancer Centre, University Hospital Essen, Essen, Germany
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, ECMM Centre of Excellence in Mycology, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, ECMM Centre of Excellence in Mycology, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, ECMM Centre of Excellence in Mycology, Germany.,Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Hedda Luise Verhasselt
- Institute of Medical Microbiology, University Hospital Essen, ECMM Centre of Excellence in Mycology, Germany
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22
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Sanders MI, Ali E, Buer J, Steinmann J, Rath PM, Verhasselt HL, Kirchhoff L. Antibacterial Activity of the Novel Drug Gepotidacin against Stenotrophomonas maltophilia—An In Vitro and In Vivo Study. Antibiotics (Basel) 2022; 11:antibiotics11020192. [PMID: 35203795 PMCID: PMC8868531 DOI: 10.3390/antibiotics11020192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 02/04/2023] Open
Abstract
Stenotrophomonas maltophilia is increasingly recognized as a nosocomial bacterial pathogen with a multi-drug resistance profile. In this study, the novel drug gepotidacin, the first compound of the novel triazaacenaphthylene topoisomerase inhibitor antibiotics class, was evaluated on its activity against clinical S. maltophilia isolates. Ninety-nine S. maltophilia isolates plus reference strain K279a (N = 100) were tested on their susceptibility towards gepotidacin in a broth microdilution. Additional susceptibility testing was performed towards the commonly applied combination trimethoprim/sulfamethoxazole (TMP/SXT), moxifloxacin, and levofloxacin. The time–kill kinetic of gepotidacin was observed in a time–kill assay. The greater wax moth Galleria mellonella was used to determine the activity of gepotidacin against S. maltophilia in vivo. Gepotidacin showed minimum inhibitory concentrations (MICs) between 0.25 and 16 mg/L (MIC50: 2 mg/L; MIC90: 8 mg/L), independently of its susceptibility towards TMP/SXT. The five TMP/SXT resistant strains exhibited gepotidacin MICs from 1 to 4 mg/L. The S. maltophilia strains resistant to the assessed fluoroquinolones showed in parts high MICs of gepotidacin. The time–kill assay revealed a time- and strain-dependent killing effect of gepotidacin. In vivo, injection of gepotidacin increased the survival rate of the larvae from 61 % to 90 % after 2 days. This study showed antimicrobial effects of gepotidacin towards S. maltophilia.
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Affiliation(s)
- Maike Isabell Sanders
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.I.S.); (E.A.); (J.B.); (J.S.); (P.-M.R.); (H.L.V.)
| | - Eyhab Ali
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.I.S.); (E.A.); (J.B.); (J.S.); (P.-M.R.); (H.L.V.)
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.I.S.); (E.A.); (J.B.); (J.S.); (P.-M.R.); (H.L.V.)
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.I.S.); (E.A.); (J.B.); (J.S.); (P.-M.R.); (H.L.V.)
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, 90419 Nuremberg, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.I.S.); (E.A.); (J.B.); (J.S.); (P.-M.R.); (H.L.V.)
| | - Hedda Luise Verhasselt
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.I.S.); (E.A.); (J.B.); (J.S.); (P.-M.R.); (H.L.V.)
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; (M.I.S.); (E.A.); (J.B.); (J.S.); (P.-M.R.); (H.L.V.)
- Correspondence: ; Tel.: +49-201-723-3505
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23
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Seidel D, Simon M, Sprute R, Lubnow M, Evert K, Speer C, Seeßle J, Khatamzas E, Merle U, Behrens C, Blau IW, Enghard P, Haas CS, Steinmann J, Kurzai O, Cornely OA. Results from a national survey on COVID-19-associated mucormycosis in Germany: 13 patients from six tertiary hospitals. Mycoses 2021; 65:103-109. [PMID: 34655486 PMCID: PMC8662289 DOI: 10.1111/myc.13379] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 09/27/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Most COVID-19-associated mucormycosis (CAM) cases are reported from India and neighbouring countries. Anecdotally cases from Europe have been presented. OBJECTIVE To estimate the disease burden and describe the clinical presentation of CAM in Germany. METHODS We identified cases through German mycology networks and scientific societies, and collected anonymised clinical information via FungiScope®. RESULTS We identified 13 CAM cases from six tertiary referral hospitals diagnosed between March 2020 and June 2021. Twelve patients had severe or critical COVID-19, eleven were mechanically ventilated for a median of 8 days (range 1-27 days) before diagnosis of CAM. Eleven patients received systemic corticosteroids. Additional underlying medical conditions were reported for all but one patient, five were immunocompromised because of malignancy or organ transplantation, three were diabetic. Eleven patients developed pneumonia. Mortality was 53.8% with a median time from diagnosis of mucormycosis to death of 9 days (range 0-214 days) despite treatment with liposomal amphotericin B and/or isavuconazole in 10 of 13 cases. CAM prevalence amongst hospitalised COVID-19 patients overall (0.67% and 0.58% in two centres) and those admitted to the intensive care unit (ICU) (1.47%, 1.78% and 0.15% in three centres) was significantly higher compared to non-COVID-19 patients (P < .001 for respective comparisons). CONCLUSION COVID-19-associated mucormycosis is rare in Germany, mostly reported in patients with comorbidities and impaired immune system and severe COVID-19 treated in the ICU with high mortality compared to mainly rhino-orbito-cerebral CAM in patients with mild COVID-19 in India. Risk for CAM is higher in hospitalised COVID-19 patients than in other patients.
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Affiliation(s)
- Danila Seidel
- Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Michaela Simon
- Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, Regensburg, Germany
| | - Rosanne Sprute
- Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Matthias Lubnow
- Department of Anesthesiology and Intensive Care, University Hospital Regensburg, Regensburg, Germany
| | - Katja Evert
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Claudius Speer
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Jessica Seeßle
- Department of Gastroenterology and Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Elham Khatamzas
- Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Uta Merle
- Department of Gastroenterology and Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher Behrens
- Department Medizinische Mikrobiologie und Technische Hygiene, Medizet, Städtisches Klinikum München GmbH, Munich, Germany
| | - Igor Wolfgang Blau
- Department of Hematology, Oncology and Cancer Immunology, Charité University Medicine Berlin, Berlin, Germany
| | - Philipp Enghard
- Department of Nephrology and Medical Intensive Care, Charité University Medicine Berlin, Berlin, Germany
| | - Christian S Haas
- Department of Internal Medicine, Nephrology and Intensive Care Medicine, University of Marburg, Marburg, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.,Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | - Oliver Kurzai
- National Reference Center for Invasive Fungal Infections, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knoell Institute, Jena, Germany.,Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Oliver A Cornely
- Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
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24
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Prattes J, Wauters J, Giacobbe DR, Salmanton-García J, Maertens J, Bourgeois M, Reynders M, Rutsaert L, Van Regenmortel N, Lormans P, Feys S, Reisinger AC, Cornely OA, Lahmer T, Valerio M, Delhaes L, Jabeen K, Steinmann J, Chamula M, Bassetti M, Hatzl S, Rautemaa-Richardson R, Koehler P, Lagrou K, Hoenigl M. Risk factors and outcome of pulmonary aspergillosis in critically ill coronavirus disease 2019 patients-a multinational observational study by the European Confederation of Medical Mycology. Clin Microbiol Infect 2021; 28:580-587. [PMID: 34454093 PMCID: PMC8387556 DOI: 10.1016/j.cmi.2021.08.014] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [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: 07/14/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 12/30/2022]
Abstract
Objectives Coronavirus disease 2019 (COVID-19) -associated pulmonary aspergillosis (CAPA) has emerged as a complication in critically ill COVID-19 patients. The objectives of this multinational study were to determine the prevalence of CAPA in patients with COVID-19 in intensive care units (ICU) and to investigate risk factors for CAPA as well as outcome. Methods The European Confederation of Medical Mycology (ECMM) conducted a multinational study including 20 centres from nine countries to assess epidemiology, risk factors and outcome of CAPA. CAPA was defined according to the 2020 ECMM/ISHAM consensus definitions. Results A total of 592 patients were included in this study, including 11 (1.9%) patients with histologically proven CAPA, 80 (13.5%) with probable CAPA, 18 (3%) with possible CAPA and 483 (81.6%) without CAPA. CAPA was diagnosed a median of 8 days (range 0–31 days) after ICU admission predominantly in older patients (adjusted hazard ratio (aHR) 1.04 per year; 95% CI 1.02–1.06) with any form of invasive respiratory support (HR 3.4; 95% CI 1.84–6.25) and receiving tocilizumab (HR 2.45; 95% CI 1.41–4.25). Median prevalence of CAPA per centre was 10.7% (range 1.7%–26.8%). CAPA was associated with significantly lower 90-day ICU survival rate (29% in patients with CAPA versus 57% in patients without CAPA; Mantel–Byar p < 0.001) and remained an independent negative prognostic variable after adjusting for other predictors of survival (HR 2.14; 95% CI 1.59–2.87, p ≤ 0.001). Conclusion Prevalence of CAPA varied between centres. CAPA was significantly more prevalent among older patients, patients receiving invasive ventilation and patients receiving tocilizumab, and was an independent strong predictor of ICU mortality.
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Affiliation(s)
- Juergen Prattes
- Medical University of Graz, Department of Infectious Diseases, Excellence Centre for Medical Mycology (ECMM), Graz, Austria
| | | | - Daniele Roberto Giacobbe
- San Martino Polyclinic Hospital IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Jon Salmanton-García
- University of Cologne, Medical Faculty and University Hospital Cologne, Department I of Internal Medicine, Excellence Centre for Medical Mycology (ECMM), Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | | | - Marc Bourgeois
- Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Bruges, Belgium
| | | | - Lynn Rutsaert
- Ziekenhusnetwerk Antwerp, Campus Stuivenberg, Antwerp, Belgium
| | | | | | - Simon Feys
- Algemeen Ziekenhuis Delta, Roeselare, Belgium
| | | | - Oliver A Cornely
- University of Cologne, Medical Faculty and University Hospital Cologne, Department I of Internal Medicine, Excellence Centre for Medical Mycology (ECMM), Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Tobias Lahmer
- Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - Maricela Valerio
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Laurence Delhaes
- Centre Hospitalier Universitaire de Bordeaux, ISERM U1045, Bordeaux, France
| | | | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
| | - Mathilde Chamula
- Manchester University NHS Foundation Trust, Wythenshawe Hospital and Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Matteo Bassetti
- San Martino Polyclinic Hospital IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Stefan Hatzl
- Medical University of Graz, Department of Internal Medicine, Intesive Care Unit, Graz, Austria
| | - Riina Rautemaa-Richardson
- Manchester University NHS Foundation Trust, Wythenshawe Hospital and Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Philipp Koehler
- University of Cologne, Medical Faculty and University Hospital Cologne, Department I of Internal Medicine, Excellence Centre for Medical Mycology (ECMM), Cologne, Germany
| | | | - Martin Hoenigl
- Medical University of Graz, Department of Infectious Diseases, Excellence Centre for Medical Mycology (ECMM), Graz, Austria; Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Clinical and Translational Fungal-Working Group, University of California San Diego, San Diego, CA, USA.
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25
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Meister TL, Fortmann J, Todt D, Heinen N, Ludwig A, Brüggemann Y, Elsner C, Dittmer U, Steinmann J, Pfaender S, Steinmann E. Comparable Environmental Stability and Disinfection Profiles of the Currently Circulating SARS-CoV-2 Variants of Concern B.1.1.7 and B.1.351. J Infect Dis 2021; 224:420-424. [PMID: 33993274 PMCID: PMC8243362 DOI: 10.1093/infdis/jiab260] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/11/2021] [Indexed: 12/27/2022] Open
Abstract
The emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern with increased transmission dynamics has raised questions regarding stability and disinfection of these viruses. We analyzed surface stability and disinfection of the currently circulating SARS-CoV-2 variants B.1.1.7 and B.1.351 compared to wild type. Treatment with heat, soap, and ethanol revealed similar inactivation profiles indicative of a comparable susceptibility towards disinfection. Furthermore, we observed comparable surface stability on steel, silver, copper, and face masks. Overall, our data support the application of currently recommended hygiene measures to minimize the risk of B.1.1.7 and B.1.351 transmission.
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Affiliation(s)
- Toni Luise Meister
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Jill Fortmann
- Materials Discovery and Interfaces, Institute for Materials, Ruhr University Bochum, Bochum, Germany
| | - Daniel Todt
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany.,European Virus Bioinformatics Center, Jena, Germany
| | - Natalie Heinen
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Alfred Ludwig
- Materials Discovery and Interfaces, Institute for Materials, Ruhr University Bochum, Bochum, Germany
| | - Yannick Brüggemann
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Carina Elsner
- Institute for Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulf Dittmer
- Institute for Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nuremberg, Germany.,Institute of Medical Microbiology, University Hospital of Essen, Essen, Germany
| | - Stephanie Pfaender
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Eike Steinmann
- Department for Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
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26
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Sprute R, Salmanton-García J, Sal E, Malaj X, Falces-Romero I, Hatvani L, Heinemann M, Klimko N, López-Soria L, Meletiadis J, Shruti M, Steinmann J, Seidel D, Cornely OA, Stemler J. Characterization and outcome of invasive infections due to Paecilomyces variotii: analysis of patients from the FungiScope® registry and literature reports. J Antimicrob Chemother 2021; 76:765-774. [PMID: 33254240 PMCID: PMC7879145 DOI: 10.1093/jac/dkaa481] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/26/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives To provide a basis for clinical management decisions in Paecilomyces variotii infection. Methods Unpublished cases of invasive P. variotii infection from the FungiScope® registry and all cases reported in the literature were analysed. Results We identified 59 cases with P. variotii infection. Main baseline factors were presence of indwelling devices in 29 cases (49.2%), particularly peritoneal catheters (33.9%) and prosthetic heart valves (10.2%), haematological or oncological diseases in 19 (32.2%), major surgery in 11 (18.6%), and diabetes mellitus in 10 cases (16.9%). The most prevalent infection sites were peritoneum (n = 20, 33.3%) and lungs (n = 16, 27.1%). Pain and fever were frequent (n = 35, 59.3% and n = 33, 55.9%, respectively). Diagnosis was established by culture in 58 cases (98.3%). P. variotii caused breakthrough infection in 8 patients. Systemic antifungals were given in 52 patients (88.1%). Amphotericin B was administered in 39, itraconazole in 15, and posaconazole in 8 patients. Clinical isolates were frequently resistant to voriconazole, whereas the above-mentioned antifungals showed good in vitro activity. Infections of the blood and CNS caused high mortality. Overall mortality was 28.8% and death was attributed to P. variotii in 10 cases. Conclusions P. variotii causes life-threatening infections, especially in immunocompromised and critically ill patients with indwelling devices. Patients undergoing peritoneal dialysis are at particular risk. Multidisciplinary management is paramount, including molecular techniques for diagnosis and treatment with efficacious systemic antifungals. Amphotericin B, itraconazole and posaconazole are regarded as treatments of choice. Combination with flucytosine may be considered. Surgical debridement and removal of indwelling devices facilitate favourable outcome.
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Affiliation(s)
- Rosanne Sprute
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Ertan Sal
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Xhorxha Malaj
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Iker Falces-Romero
- Clinical Microbiology and Parasitology Department, University Hospital La Paz, Madrid, Spain
| | - Lóránt Hatvani
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Melina Heinemann
- Division of Infectious Diseases, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nikolai Klimko
- Department of Clinical Mycology, Allergy and Immunology, North Western State Medical University, St Petersburg, Russia
| | - Leyre López-Soria
- Clinical Microbiology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Malik Shruti
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Joerg Steinmann
- Institute for Clinical Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Medical University, Nuremberg Hospital, Nuremberg, Germany
| | - Danila Seidel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.,University of Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Jannik Stemler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
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Kirchhoff L, Dittmer S, Weisner AK, Buer J, Rath PM, Steinmann J. Antibiofilm activity of antifungal drugs, including the novel drug olorofim, against Lomentospora prolificans. J Antimicrob Chemother 2021; 75:2133-2140. [PMID: 32386411 DOI: 10.1093/jac/dkaa157] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/12/2020] [Accepted: 03/23/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Patients with immunodeficiency or cystic fibrosis frequently suffer from respiratory fungal infections. In particular, biofilm-associated fungi cause refractory infection manifestations, linked to increased resistance to anti-infective agents. One emerging filamentous fungus is Lomentospora prolificans. Here, the biofilm-formation capabilities of L. prolificans isolates were investigated and the susceptibility of biofilms to various antifungal agents was analysed. METHODS Biofilm formation of L. prolificans (n = 11) was estimated by crystal violet stain and antibiofilm activity was additionally determined via detection of metabolically active biofilm using an XTT assay. Amphotericin B, micafungin, voriconazole and olorofim were compared with regard to their antibiofilm effects when added prior to adhesion, after adhesion and on mature and preformed fungal biofilms. Imaging via confocal laser scanning microscopy was carried out to demonstrate the effect of drug treatment on the fungal biofilm. RESULTS Antibiofilm activities of the tested antifungal agents were shown to be most effective on adherent cells whilst mature biofilm was the most resistant. The most promising antibiofilm effects were detected with voriconazole and olorofim. Olorofim showed an average minimum biofilm eradication concentration (MBEC) of 0.06 mg/L, when added prior to and after adhesion. The MBECs of voriconazole were ≤4 mg/L. On mature biofilm the MBECs of olorofim and voriconazole were higher than the previously determined MICs against planktonic cultures. In contrast, amphotericin B and especially micafungin did not exhibit sufficient antibiofilm activity against L. prolificans. CONCLUSIONS To our knowledge, this is the first study demonstrating the antibiofilm potential of olorofim against the human pathogenic fungus L. prolificans.
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Affiliation(s)
- Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Silke Dittmer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ann-Kathrin Weisner
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
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Steinmann J, Burkard T, Becker B, Paulmann D, Todt D, Bischoff B, Steinmann E, Brill FHH. Virucidal efficacy of an ozone-generating system for automated room disinfection. J Hosp Infect 2021; 116:16-20. [PMID: 34144097 DOI: 10.1016/j.jhin.2021.06.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
Besides conventional prevention measures, no-touch technologies based on gaseous systems have been introduced in hospital hygiene for room disinfection. The whole-room disinfectant device Sterisafe Pro, which creates ozone as a biocidal agent, was tested for its virucidal efficacy based on Association Française de Normalisation Standard NF T 72-281:2014. All test virus titres were reduced after 150 and 300 min of decontamination, with mean reduction factors ranging from 2.63 (murine norovirus) to 3.94 (simian virus 40). These results will help to establish realistic conditions for virus inactivation, and assessment of the efficacy of ozone technology against non-enveloped and enveloped viruses.
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Affiliation(s)
- J Steinmann
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - T Burkard
- Ruhr University Bochum, Faculty of Medicine, Department for Molecular and Medical Virology, Bochum, Germany
| | - B Becker
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - D Paulmann
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - D Todt
- Ruhr University Bochum, Faculty of Medicine, Department for Molecular and Medical Virology, Bochum, Germany; European Virus Bioinformatics Centre, Jena, Germany
| | - B Bischoff
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - E Steinmann
- Ruhr University Bochum, Faculty of Medicine, Department for Molecular and Medical Virology, Bochum, Germany
| | - F H H Brill
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany.
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Verhasselt HL, Buer J, Dedy J, Ziegler R, Steinmann J, Herbstreit F, Brenner T, Rath PM. COVID-19 Co-infection with Legionella pneumophila in 2 Tertiary-Care Hospitals, Germany. Emerg Infect Dis 2021; 27:1535-1537. [PMID: 33900187 PMCID: PMC8084497 DOI: 10.3201/eid2705.203388] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We describe screening results for detection of co-infections with Legionella pneumophila in patients infected with severe acute respiratory syndrome coronavirus 2. In total, 93 patients were tested; 1 was positive (1.1%) for L. pneumophila serogroup 1. Co-infections with L. pneumophila occur in coronavirus disease patients and should not be missed.
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Gits-Muselli M, White PL, Mengoli C, Chen S, Crowley B, Dingemans G, Fréalle E, L Gorton R, Guiver M, Hagen F, Halliday C, Johnson G, Lagrou K, Lengerova M, Melchers WJG, Novak-Frazer L, Rautemaa-Richardson R, Scherer E, Steinmann J, Cruciani M, Barnes R, Donnelly JP, Loeffler J, Bretagne S, Alanio A. The Fungal PCR Initiative's evaluation of in-house and commercial Pneumocystis jirovecii qPCR assays: Toward a standard for a diagnostics assay. Med Mycol 2021; 58:779-788. [PMID: 31758173 DOI: 10.1093/mmy/myz115] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [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: 05/27/2019] [Revised: 10/22/2019] [Accepted: 10/31/2019] [Indexed: 01/04/2023] Open
Abstract
Quantitative real-time PCR (qPCR) is increasingly used to detect Pneumocystis jirovecii for the diagnosis of Pneumocystis pneumonia (PCP), but there are differences in the nucleic acids targeted, DNA only versus whole nucleic acid (WNA), and also the target genes for amplification. Through the Fungal PCR Initiative, a working group of the International Society for Human and Animal Mycology, a multicenter and monocenter evaluation of PCP qPCR assays was performed. For the multicenter study, 16 reference laboratories from eight different countries, performing 20 assays analyzed a panel consisting of two negative and three PCP positive samples. Aliquots were prepared by pooling residual material from 20 negative or positive- P. jirovecii bronchoalveolar lavage fluids (BALFs). The positive pool was diluted to obtain three concentrations (pure 1:1; 1:100; and 1:1000 to mimic high, medium, and low fungal loads, respectively). The monocenter study compared five in-house and five commercial qPCR assays testing 19 individual BALFs on the same amplification platform. Across both evaluations and for all fungal loads, targeting WNA and the mitochondrial small sub-unit (mtSSU) provided the earliest Cq values, compared to only targeting DNA and the mitochondrial large subunit, the major surface glycoprotein or the beta-tubulin genes. Thus, reverse transcriptase-qPCR targeting the mtSSU gene could serve as a basis for standardizing the P. jirovecii load, which is essential if qPCR is to be incorporated into clinical care pathways as the reference method, accepting that additional parameters such as amplification platforms still need evaluation.
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Affiliation(s)
- Maud Gits-Muselli
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, Paris, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Université de Paris, Paris, France
| | - P Lewis White
- Public Health Wales, Microbiology Cardiff, UHW, Heath Park, Cardiff, UK
| | | | - Sharon Chen
- Clinical Mycology reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, and the University of Sydney, Australia
| | - Brendan Crowley
- Department of Virology, St James's Hospital, Dublin, Ireland
| | | | - Emilie Fréalle
- CHU Lille, Laboratoire de Parasitologie-Mycologie, F-59000 Lille, France & Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR8204-CIIL-Centre for Infection and Immunity of Lille, F-59000 Lille, France
| | - Rebecca L Gorton
- Regional UK Clinical Mycology Network (UK CMN) Laboratory, Dept. Infection Sciences, Health Services Laboratories (HSL) LLP, London, UK
| | - Malcom Guiver
- Public Health Laboratory, National Infection Service Public Health England, Manchester University NHS Foundation Trust, Manchester, UK
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands.,Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, China
| | - Catriona Halliday
- Clinical Mycology reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, and the University of Sydney, Australia
| | | | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, KU Leuven, and Department of Laboratory Medicine and National Reference Centre for Mycosis, Excellence Centre for Medical Mycology (ECMM), University Hospitals Leuven, Leuven, Belgium
| | - Martina Lengerova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Willem J G Melchers
- Radboud University Medical Centre, Department of Medical Microbiology, Nijmegen, The Netherlands
| | - Lily Novak-Frazer
- Mycology Reference Centre Manchester, Manchester University NHS Foundation Trust; and Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Riina Rautemaa-Richardson
- Department of Infectious Diseases and the Mycology Reference Centre Manchester, Manchester University NHS Foundation Trust; and Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Emeline Scherer
- Department of Parasitology-Mycology, University Hospital of Besançon, Besançon, France
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.,Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mario Cruciani
- Infectious Diseases Unit, San Bonifacio Hospital, Verona, Italy
| | | | | | - Juergen Loeffler
- University Hospital Wuerzburg, Medical Hospital II, C11, Wuerzburg, Germany
| | - Stéphane Bretagne
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, Paris, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Université de Paris, Paris, France
| | - Alexandre Alanio
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, Paris, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Université de Paris, Paris, France
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Wollschläger P, Todt D, Gerlitz N, Pfaender S, Bollinger T, Sing A, Dangel A, Ackermann N, Korn K, Ensser A, Steinmann E, Buhl M, Steinmann J. SARS-CoV-2 N gene dropout and N gene Ct value shift as indicator for the presence of B.1.1.7 lineage in a commercial multiplex PCR assay. Clin Microbiol Infect 2021; 27:1353.e1-1353.e5. [PMID: 34044153 PMCID: PMC8142743 DOI: 10.1016/j.cmi.2021.05.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [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: 03/23/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Detection and surveillance of SARS-CoV-2 is of eminent importance, particularly due to the rapid emergence of variants of concern (VOCs). In this study we evaluated if a commercially available quantitative real-time PCR (qRT-PCR) assay can identify SARS-CoV-2 B.1.1.7 lineage samples by a specific N gene dropout or Ct value shift compared with the S or RdRp gene. METHODS VOC B.1.1.7 and non-B.1.1.7 SARS-CoV-2-positive patient samples were identified via whole-genome sequencing and variant-specific PCR. Confirmed B.1.1.7 (n = 48) and non-B.1.1.7 samples (n = 58) were analysed using the Allplex™ SARS-CoV-2/FluA/FluB/RSV™ PCR assay for presence of SARS-CoV-2 S, RdRp and N genes. The N gene coding sequence of SARS-CoV-2 with and without the D3L mutation (specific for B.1.1.7) was cloned into pCR™II-TOPO™ vectors to validate polymorphism-dependent N gene dropout with the Allplex™ SARS-CoV-2/FluA/FluB/RSV™ PCR assay. RESULTS All studied B.1.1.7-positive patient samples showed significantly higher Ct values in qRT-PCR (Δ6-10, N gene dropout on Ct values > 29) of N gene than the corresponding values of S (p ≤ 0.0001) and RdRp (p ≤ 0.0001) genes. The assay reliably discriminated B.1.1.7 and non-B.1.1.7 positive samples (area under the curve = 1) in a receiver operating characteristic curve analysis. Identical Ct value shifts (Δ7-10) were detected in reverse genetic experiments, using isolated plasmids containing N gene coding sequences corresponding to D3 or 3L variants. DISCUSSION An N gene dropout or Ct value shift is shown for B.1.1.7-positive samples in the Allplex™ SARS-CoV-2/FluA/FluB/RSV™ PCR assay. This approach can be used as a rapid tool for B.1.1.7 detection in single assay high throughput diagnostics.
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Affiliation(s)
- Paul Wollschläger
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Daniel Todt
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany; European Virus Bioinformatics Center (EVBC), Jena, Germany
| | - Nadja Gerlitz
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Stephanie Pfaender
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Thomas Bollinger
- Microbiology, Laboratory Medicine, Klinikum Bayreuth GmbH, Bayreuth, Germany
| | - Andreas Sing
- Bavarian Health and Food Safety Authority (LGL), Oberschleissheim, Germany
| | - Alexandra Dangel
- Bavarian Health and Food Safety Authority (LGL), Oberschleissheim, Germany
| | | | - Klaus Korn
- Institute of Clinical and Molecular Virology, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Armin Ensser
- Institute of Clinical and Molecular Virology, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eike Steinmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - Michael Buhl
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany.
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Gosch M, Altrichter D, Pflügner M, Frohnhofen H, Steinmann J, Schmude-Basic I, Adamek A, Johnscher I, Kandler U, Wunner C, Waller C, Speer R, Habboub B, Brons-Daymond S, Schadinger C, Singler K. [Long-term care facilities during the COVID-19 pandemic : Considerations on the way back to normality]. Z Gerontol Geriatr 2021; 54:377-383. [PMID: 33999311 PMCID: PMC8127853 DOI: 10.1007/s00391-021-01922-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/11/2021] [Indexed: 11/27/2022]
Abstract
Langzeitpflegeeinrichtungen (LPE) waren und sind von der COVID-19-Pandemie besonders betroffen. Die Dimension der Ausbrüche und die hohe Letalität unter den Bewohner(innen) (BW) führten zu massiven Einschränkungen, v. a. im Bereich der sozialen Kontakte und Aktivitäten, aber auch in Bereichen der medizinischen Versorgung. Mit dem Start der Impfungen und den verbesserten Testmöglichkeiten haben sich nun aber die Voraussetzungen geändert, und bestehende Beschränkungen müssen auf ihre Zweckmäßigkeit evaluiert werden. In einer interprofessionellen und interdisziplinären Expertengruppe wurden Überlegungen erstellt, wie ein Weg zurück in die Normalität für LPE ausehen kann.
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Affiliation(s)
- M Gosch
- Universitätsklinik für Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Prof.-Ernst-Nathan-Straße 1, 90419, Nürnberg, Deutschland.
| | - D Altrichter
- Gemeinschaftspraxis S. Hofius, St. Pühlhorn, Dr. D. Altrichter, Nürnberg, Deutschland
| | | | - H Frohnhofen
- Medizinische Universität Düsseldorf, Düsseldorf, Deutschland
| | - J Steinmann
- Institut für Klinikhygiene, Medizinische Mikrobiologie und Klinische Infektiologie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | | | - A Adamek
- NürnbergStift, Nürnberg, Deutschland
| | - I Johnscher
- Institut für Klinikhygiene, Medizinische Mikrobiologie und Klinische Infektiologie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - U Kandler
- Institut für Klinikhygiene, Medizinische Mikrobiologie und Klinische Infektiologie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - C Wunner
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - C Waller
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - R Speer
- Universitätsklinik für Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Prof.-Ernst-Nathan-Straße 1, 90419, Nürnberg, Deutschland
| | - B Habboub
- Universitätsklinik für Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Prof.-Ernst-Nathan-Straße 1, 90419, Nürnberg, Deutschland
| | - S Brons-Daymond
- Universitätsklinik für Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Prof.-Ernst-Nathan-Straße 1, 90419, Nürnberg, Deutschland
| | | | - K Singler
- Universitätsklinik für Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Prof.-Ernst-Nathan-Straße 1, 90419, Nürnberg, Deutschland
- Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen, Nürnberg, Deutschland
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Steinmann J, Schrauzer T, Kirchhoff L, Meis JF, Rath PM. Two Candida auris Cases in Germany with No Recent Contact to Foreign Healthcare-Epidemiological and Microbiological Investigations. J Fungi (Basel) 2021; 7:jof7050380. [PMID: 34066140 PMCID: PMC8151845 DOI: 10.3390/jof7050380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 04/18/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 01/02/2023] Open
Abstract
Candida auris has become a global fungal public health threat. This multidrug-resistant yeast is associated with nosocomial intra- and interhospital transmissions causing healthcare-associated infections. Here, we report on two C. auris cases from Germany. The two patients stayed in Germany for a long time before C. auris was detected during their hospitalization. The patients were isolated in single rooms with contact precautions. No nosocomial transmissions were detected within the hospital. Both C. auris isolates exhibited high minimum inhibitory concentrations (MICs) of fluconazole and one isolate additionally high MICs against the echinocandins. Microsatellite genotyping showed that both strains belong to the South Asian clade. These two cases are examples for appropriate in-hospital care and infection control without further nosocomial spread. Awareness for this emerging, multidrug-resistant pathogen is justified and systematic surveillance in European health care facilities should be performed.
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Affiliation(s)
- Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, 90419 Nuremberg, Germany;
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (L.K.); (P.-M.R.)
- Correspondence: ; Tel.: +49-911-3982-520; Fax: +49-911-398-3266
| | - Thomas Schrauzer
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, 90419 Nuremberg, Germany;
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (L.K.); (P.-M.R.)
| | - Jacques F. Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands;
- Centre of Expertise in Mycology Radboudumc, Canisius-Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany; (L.K.); (P.-M.R.)
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Sprute R, Salmanton-García J, Sal E, Malaj X, Ráčil Z, Ruiz de Alegría Puig C, Falces-Romero I, Barać A, Desoubeaux G, Kindo AJ, Morris AJ, Pelletier R, Steinmann J, Thompson GR, Cornely OA, Seidel D, Stemler J. Invasive infections with Purpureocillium lilacinum: clinical characteristics and outcome of 101 cases from FungiScope® and the literature. J Antimicrob Chemother 2021; 76:1593-1603. [PMID: 33599275 PMCID: PMC8120338 DOI: 10.1093/jac/dkab039] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/25/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To provide a basis for clinical management decisions in Purpureocillium lilacinum infection. METHODS Unpublished cases of invasive P. lilacinum infection from the FungiScope® registry and all cases reported in the literature were analysed. RESULTS We identified 101 cases with invasive P. lilacinum infection. Main predisposing factors were haematological and oncological diseases in 31 cases (30.7%), steroid treatment in 27 cases (26.7%), solid organ transplant in 26 cases (25.7%), and diabetes mellitus in 19 cases (18.8%). The most prevalent infection sites were skin (n = 37/101, 36.6%) and lungs (n = 26/101, 25.7%). Dissemination occurred in 22 cases (21.8%). Pain and fever were the most frequent symptoms (n = 40/101, 39.6% and n = 34/101, 33.7%, respectively). Diagnosis was established by culture in 98 cases (97.0%). P. lilacinum caused breakthrough infection in 10 patients (9.9%). Clinical isolates were frequently resistant to amphotericin B, whereas posaconazole and voriconazole showed good in vitro activity. Susceptibility to echinocandins varied considerably. Systemic antifungal treatment was administered in 90 patients (89.1%). Frequently employed antifungals were voriconazole in 51 (56.7%) and itraconazole in 26 patients (28.9%). Amphotericin B treatment was significantly associated with high mortality rates (n = 13/33, 39.4%, P = <0.001). Overall mortality was 21.8% (n = 22/101) and death was attributed to P. lilacinum infection in 45.5% (n = 10/22). CONCLUSIONS P. lilacinum mainly presents as soft-tissue, pulmonary or disseminated infection in immunocompromised patients. Owing to intrinsic resistance, accurate species identification and susceptibility testing are vital. Outcome is better in patients treated with triazoles compared with amphotericin B formulations.
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Affiliation(s)
- Rosanne Sprute
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Ertan Sal
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Xhorxha Malaj
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Charles University, First Faculty of Medicine, Institute of Clinical and Experimental Hematology, Prague, Czech Republic
| | | | - Iker Falces-Romero
- Clinical Microbiology and Parasitology Department, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Aleksandra Barać
- Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Guillaume Desoubeaux
- Department of Parasitology-Mycology-Tropical Medicine, Tours University hospital, France
| | - Anupma Jyoti Kindo
- Department of Microbiology, SriRamachandra Institute of Higher Education and Research, Chennai, India
| | - Arthur J Morris
- Clinical Microbiology Laboratory, LabPLUS, Auckland City Hospital, Auckland, 1023, New Zealand
| | - René Pelletier
- Laboratoire de Microbiologie, L'Hôtel-Dieu de Québec du Centre Hospitalier Universitaire de Québec, Québec, Canada
| | - Joerg Steinmann
- Institute for Clinical Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Medical University, Nuremberg Hospital, Nuremberg, Germany
| | - George R Thompson
- Department of Internal Medicine Division of Infectious Diseases, University of California Davis Medical Center, Sacramento, CA, USA
- Department of Medical Microbiology and Immunology, University of California Davis Medical Center, Sacramento, CA, USA
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Danila Seidel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Jannik Stemler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
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Brill FHH, Hambach J, Utpatel C, Mogrovejo DC, Gabriel H, Klock JH, Steinmann J, Arndt A. Biofilm reduction potential of 0.02% polyhexanide irrigation solution in several types of urethral catheters. BMC Urol 2021; 21:58. [PMID: 33836738 PMCID: PMC8034122 DOI: 10.1186/s12894-021-00826-3] [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: 08/11/2020] [Accepted: 03/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Long-term use of urethral catheters is associated with high risk of urinary tract infection (UTI) and blockage. Microbial biofilms are a common cause of catheter blockage, reducing their lifetime and significantly increasing morbidity of UTIs. A 0.02% polyhexanide irrigation solution developed for routine mechanical rinsing shows potential for bacterial decolonization of urethral catheters and has the potential to reduce or prevent biofilm formation. Methods Using an in vitro assay with standard market-leading types of catheters artificially contaminated with clinically relevant bacteria, assays were carried out to evaluate the biofilm reduction and prevention potential of a 0.02% polyhexanide solution versus no intervention (standard approach) and irrigation with saline solution (NaCl 0.9%). The efficiency of decolonization was measured through microbial plate count and membrane filtration. Results Irrigation using a 0.02% polyhexanide solution is suitable for the decolonization of a variety of transurethral catheters. The effect observed is significant compared to irrigation with 0.9% saline solution (p = 0.002) or no treatment (p = 0.011). No significant difference was found between irrigation with 0.9% saline solution and no treatment (p = 0.74). Conclusions A 0.02% polyhexanide solution is able to reduce bacterial biofilm from catheters artificially contaminated with clinically relevant bacteria in vitro. The data shows a reduction of the viability of thick bacterial biofilms in a variety of commercially available urinary catheters made from silicone, latex-free silicone, hydrogel-coated silicone and PVC. Further research is required to evaluate the long-term tolerability and efficacy of polyhexanide in clinical practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12894-021-00826-3.
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Affiliation(s)
- Florian H H Brill
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Stiegstück 34, 22339, Hamburg, Germany.
| | - Julia Hambach
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Stiegstück 34, 22339, Hamburg, Germany.,Institute of Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Utpatel
- Molecular and Experimental Mycobacteriology, Research Center Borstel - Leibniz Lung Center, Borstel, Germany
| | - Diana C Mogrovejo
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Stiegstück 34, 22339, Hamburg, Germany
| | - Henrik Gabriel
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Stiegstück 34, 22339, Hamburg, Germany
| | - Jan-Hendrik Klock
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Stiegstück 34, 22339, Hamburg, Germany
| | - Joerg Steinmann
- Klinikum Nürnberg, Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Andreas Arndt
- Department of Research and Development, B. Braun Medical Ltd., Sempach, Switzerland
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Brill FHH, Lenz J, Lach C, Radischat N, Paßvogel L, Goroncy-Bermes P, Gabriel H, Steinmann J, Steinhauer K. Improved method for tuberculocidal and mycobactericidal activity testing of disinfectants based on the European Standard EN 14348. J Hosp Infect 2021; 111:176-179. [PMID: 33582203 DOI: 10.1016/j.jhin.2021.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/29/2020] [Revised: 01/15/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
Safe measurements to prevent the transmission of (multidrug-resistant) mycobacteria such as disinfection are essential in healthcare settings. In Europe chemical disinfectants are tested for their tuberculocidal and mycobactericidal efficacy by the internationally accepted test procedure described in EN 14348. However, especially for amine-based disinfectants, invalid results may occur by this procedure due to insufficient neutralization. In this multi-laboratory study the procedure described in EN 14348 was optimized by a combination of chemical neutralization and membrane filtration in order to obtain a valid and secure method especially for amine-based disinfectants.
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Affiliation(s)
- F H H Brill
- Dr. Brill + Partner GmbH Institut für Hygiene und Mikrobiologie, Hamburg, Germany
| | - J Lenz
- Chemische Fabrik Dr. Weigert GmbH & Co. KG, Hamburg, Germany
| | - C Lach
- Chemische Fabrik Dr. Weigert GmbH & Co. KG, Hamburg, Germany
| | - N Radischat
- Department Research & Scientific Services, Schülke & Mayr GmbH, Norderstedt, Germany
| | - L Paßvogel
- Department Research & Scientific Services, Schülke & Mayr GmbH, Norderstedt, Germany
| | - P Goroncy-Bermes
- Department Research & Scientific Services, Schülke & Mayr GmbH, Norderstedt, Germany
| | - H Gabriel
- Dr. Brill + Partner GmbH Institut für Hygiene und Mikrobiologie, Hamburg, Germany
| | - J Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nürnberg, Germany
| | - K Steinhauer
- Department Research & Scientific Services, Schülke & Mayr GmbH, Norderstedt, Germany; Faculty of Mechanical Engineering, Kiel University of Applied Sciences, Kiel, Germany.
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Brill FHH, Becker B, Todt D, Steinmann E, Steinmann J, Paulmann D, Bischoff B, Steinmann J. Virucidal efficacy of glutaraldehyde for instrument disinfection. GMS Hyg Infect Control 2020; 15:Doc34. [PMID: 33391969 PMCID: PMC7745644 DOI: 10.3205/dgkh000369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Aim: Glutaraldehyde (GDA) is an active ingredient in many instrument disinfectants and is effective against a broad spectrum of microorganisms. In the past, the virus-inactivating properties of these products were mainly claimed based on quantitative suspension tests with different test viruses. Recently, however, a European Norm EN 17111:2018 has been published which allows examination of instrument disinfectants in a surface carrier test, simulating practical conditions. Therefore, it is of interest to evaluate GDA for the ability to inactivate the viruses used in this European Norm as test viruses. Methods: The virucidal efficacy of GDA as the active ingredient in instrument disinfectants was evaluated with 4 different test viruses in a method simulating practical conditions (EN 17111:2018). Results: With a fixed exposure time of five minutes at 20°C, 100 ppm GDA were necessary to inactivate vaccinia virus, classifying it as a limited spectrum virucidal activity for pre-cleaning products. For adenovirus, 125 ppm GDA were required, whereas for murine norovirus as a surrogate for human norovirus, 4,000 ppm GDA were required for a significant reduction of viral titres. Both non-enveloped viruses must be tested to prove virucidal activity in EN 17111:2018. But even 4,000 ppm were not enough to yield a 4 log10 reduction of the murine parvovirus at 20°C. This virus is only required as a test virus using this method if temperatures ≥40°C are used. Conclusion: GDA, as the active ingredient of many instrument disinfectants, shows virucidal efficacy at 20°C. The necessary concentrations are strongly dependent on the stability of the test viruses. Due to the high stability of murine norovirus, GDA levels of 4,000 ppm were required to inactivate this virus within the 5-minute exposure time.
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Affiliation(s)
- Florian H H Brill
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Britta Becker
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Daniel Todt
- Department for Molecular & Medical Virology, Ruhr-University Bochum, Bochum, Germany
| | - Eike Steinmann
- Department for Molecular & Medical Virology, Ruhr-University Bochum, Bochum, Germany
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, General Hospital Nürnberg, Nuremberg, Germany.,Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dajana Paulmann
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Birte Bischoff
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
| | - Jochen Steinmann
- Dr. Brill + Partner GmbH Institute for Hygiene and Microbiology, Bremen, Germany
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Kampf G, Brüggemann Y, Kaba H, Steinmann J, Pfaender S, Scheithauer S, Steinmann E. Potential sources, modes of transmission and effectiveness of prevention measures against SARS-CoV-2. J Hosp Infect 2020; 106:678-697. [PMID: 32956786 PMCID: PMC7500278 DOI: 10.1016/j.jhin.2020.09.022] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 12/19/2022]
Abstract
During the current SARS-CoV-2 pandemic new studies are emerging daily providing novel information about sources, transmission risks and possible prevention measures. In this review, we aimed to comprehensively summarize the current evidence on possible sources for SARS-CoV-2, including evaluation of transmission risks and effectiveness of applied prevention measures. Next to symptomatic patients, asymptomatic or pre-symptomatic carriers are a possible source with respiratory secretions as the most likely cause for viral transmission. Air and inanimate surfaces may be sources; however, viral RNA has been inconsistently detected. Similarly, even though SARS-CoV-2 RNA has been detected on or in personal protective equipment (PPE), blood, urine, eyes, the gastrointestinal tract and pets, these sources are currently thought to play a negligible role for transmission. Finally, various prevention measures such as handwashing, hand disinfection, face masks, gloves, surface disinfection or physical distancing for the healthcare setting and in public are analysed for their expected protective effect.
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Affiliation(s)
- G. Kampf
- University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Greifswald, Germany,Corresponding author. Address: University Medicine Greifswald, Institute for Hygiene and Environmental Medicine, Ferdinand-Sauerbruch-Strasse, 17475 Greifswald, Germany
| | - Y. Brüggemann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - H.E.J. Kaba
- Institute of Infection Control and Infectious Diseases, University Medical Center, Georg August University, Göttingen, Germany
| | - J. Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, General Hospital Nürnberg, Paracelsus Medical University, Nürnberg, Germany
| | - S. Pfaender
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
| | - S. Scheithauer
- Institute of Infection Control and Infectious Diseases, University Medical Center, Georg August University, Göttingen, Germany
| | - E. Steinmann
- Department of Molecular and Medical Virology, Ruhr University Bochum, Bochum, Germany
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Suchomel M, Steinmann J, Kampf G. Efficacies of the original and modified World Health Organization-recommended hand-rub formulations. J Hosp Infect 2020; 106:264-270. [PMID: 32800826 PMCID: PMC7423627 DOI: 10.1016/j.jhin.2020.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 08/07/2020] [Indexed: 11/23/2022]
Abstract
The World Health Organization (WHO) hand-rub formulations have been in use around the world for at least the past 10 years. The advent of coronavirus disease 2019 (COVID-19) has further enhanced their use. We reviewed published efficacy data for the original and modified formulations. Only efficacy data according to the European Norms (EN) were found. The bactericidal efficacy of the original formulations was, under practical conditions, partly insufficient (EN 1500, only effective in 60 s; EN 12791, efficacy too low in 5 min). The first modification with higher alcohol concentrations improves their efficacy as hygienic hand rub (effective in 30 s). The second (0.725% glycerol) and third (0.5% glycerol) modification improves their efficacy for surgical hand preparation (effective in 5 and 3 min). The original and second modified formulations were tested and demonstrate activity against enveloped viruses including severe acute resiratory syndrome coronavirus 2 (SARS-CoV-2) in 30 s. The ethanol-based formulation is also active against some non-enveloped test viruses in 60 s (suspension tests, EN 14476). In-vivo data on the formulations would provide a more reliable result on the virucidal efficacy on contaminated hands but are currently not available. Nevertheless, the most recent modifications should be adopted for use in healthcare.
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Affiliation(s)
- M Suchomel
- Institute of Hygiene and Applied Immunology, Medical University, Vienna, Austria
| | - J Steinmann
- Dr. Brill + Partner GmbH, Institute for Hygiene and Microbiology, Bremen, Germany
| | - G Kampf
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
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Scharmann U, Verhasselt HL, Kirchhoff L, Buer J, Rath PM, Steinmann J, Ziegler K. Evaluation of two lateral flow assays in BAL fluids for the detection of invasive pulmonary aspergillosis: A retrospective two-centre study. Mycoses 2020; 63:1362-1367. [PMID: 32885514 DOI: 10.1111/myc.13176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/02/2020] [Revised: 08/26/2020] [Accepted: 08/26/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Commonly, the application of radiological and clinical criteria and the determination of galactomannan (GM) in respiratory samples are used as a diagnostic tool for the detection of invasive pulmonary aspergillosis (IPA). MATERIALS/METHODS In this study, two lateral flow assays, OLM Aspergillus lateral flow device (LFD) and IMMY sōna Aspergillus Galactomannan lateral flow assay (LFA), were evaluated at two tertiary hospitals in Germany. A total of 200 bronchoalveolar lavage (BAL) samples from patients with suspicion of IPA were analysed retrospectively. LFD and LFA were evaluated against four different criteria: Blot, EORTC/MSG, Schauwvlieghe and extended Blot criteria and additionally against GM. RESULTS The evaluation of four algorithms for the diagnosis of IPA showed that there exist good diagnostic tools to rule out an IPA even before results of Aspergillus culture are available. Sensitivities and negative predictive values are generally higher for the LFA than for the LFD in all four criteria. Specificity and positive predictive values varied depending on the classification criteria. The total agreement between the GM and the LFA cube reader (cut-off = 1) was 84%. The correlation between the GM and LFA was calculated with r = 0.8. CONCLUSION The here presented data indicate that a negative LFA result in BAL fluid can reliable rule out an IPA in a heterogeneous group of ICU patients based on the original Blot criteria. LFA seems to be a promising immunochromatographic test exhibiting a good agreement with positive GM values.
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Affiliation(s)
- Ulrike Scharmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hedda Luise Verhasselt
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Katharina Ziegler
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
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Pelzer BW, Seufert R, Koldehoff M, Liebregts T, Schmidt D, Buer J, Rath PM, Steinmann J. Performance of the AsperGenius® PCR assay for detecting azole resistant Aspergillus fumigatus in BAL fluids from allogeneic HSCT recipients: A prospective cohort study from Essen, West Germany. Med Mycol 2020; 58:268-271. [PMID: 31111913 DOI: 10.1093/mmy/myz050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/15/2019] [Revised: 04/11/2019] [Accepted: 04/17/2019] [Indexed: 11/13/2022] Open
Abstract
In this study a commercially available multiplex real-time PCR (AsperGenius®) was evaluated for its efficacy in detecting Aspergillus fumigatus and azole resistance markers in comparison with conventional culture methods and galactomannan (GM) testing from BAL fluids in allogeneic HSCT recipients. Between January 2015 and May 2017 100 allogeneic HSCT recipients with pulmonary infiltrates and suspicion of invasive fungal infection were recruited to the study from a tertiary care center in Germany. BAL fluid was routinely assessed using the following diagnostic tests: AsperGenius® PCR assay, GM testing (cut-off: 1.0) and conventional culture. Susceptibility testing of azoles was performed by using Etest and, in case presenting elevated MICs, PCR for mutations in the cyp51A gene was carried out. Criteria of EORTC/MSG were used to classify the patients for invasive fungal disease. According to the EORTC/MSG criteria 23 patients presented with probable invasive aspergillosis (IA). Aspergillus PCR showed a sensitivity of 65% for probable IA cases. A combination of PCR and GM results in BAL displayed a sensitivity of 96% (22/23) and 100% specificity. Mutations in the cyp51A gene were detected by PCR in three cases (3/23; 13%) which were also found resistant with the culture method. In one case a Y121F/T289A mutation and in two cases a L98H were found. The combination of a commercial Aspergillus PCR assay and GM testing from BAL demonstrated a high sensitivity and specificity for diagnosing IA in allogeneic HSCT recipients. The Aspergillus PCR assay was not superior in detecting azole resistant A. fumigatus compared to culture.
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Affiliation(s)
- B W Pelzer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - R Seufert
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - M Koldehoff
- Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - T Liebregts
- Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - D Schmidt
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - J Buer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - P-M Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - J Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
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Scharmann U, Kirchhoff L, Schmidt D, Buer J, Steinmann J, Rath PM. Evaluation of a commercial Loop-mediated Isothermal Amplification (LAMP) assay for rapid detection of Pneumocystis jirovecii. Mycoses 2020; 63:1107-1114. [PMID: 32738076 DOI: 10.1111/myc.13152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/05/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Various tools are obtainable for the detection of Pneumocystis jirovecii, among them qPCR promising highest sensitivity. A novel molecular method is commercially available, the loop-mediated isothermal amplification (LAMP) assay. OBJECTIVES We compared the performance of the LAMP eazyplex® Pneumocystis jirovecii with the RealStar Pneumocystis jirovecii PCR 1.0 qPCR. MATERIAL/METHODS Overall, 162 lower respiratory tract specimens from 146 critically ill patients were investigated. LAMP assay and qPCR were carried out according to the manufacturer's recommendations. Positive results of the LAMP were described as time to positivity (TTP). The limit of detection (LOD) of the LAMP was analysed using 10-fold serial dilutions of a high positive P jirovecii respiratory sample. For each serial dilution, TTP of the LAMP was plotted against cycle threshold (Ct) values of the qPCR. RESULTS The LOD of the LAMP was determined to be approximately 4 × 103 copies/mL. While the LAMP revealed 28 (17%) positive signals from 20 patients, by using qPCR 41 (25%) positive samples from 28 patients were identified. Overall agreement with qPCR was 92%. Five false-negative, one false-positive and nine invalid results were detected by the LAMP. Positive and negative predictive values were 96% each, and sensitivity and specificity were 84% and 99%, respectively. There was a low correlation between the TTP and the fungal load. CONCLUSION The LAMP is a time-saving and easy-to-perform method. It can be used as an alternative diagnostic method. However, for quantification purposes the qPCR is still the gold standard.
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Affiliation(s)
- Ulrike Scharmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dirk Schmidt
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Kirchhoff L, Dittmer S, Buer J, Rath PM, Steinmann J. In vitro activity of olorofim (F901318) against fungi of the genus, Scedosporium and Rasamsonia as well as against Lomentospora prolificans, Exophiala dermatitidis and azole-resistant Aspergillus fumigatus. Int J Antimicrob Agents 2020; 56:106105. [PMID: 32721601 DOI: 10.1016/j.ijantimicag.2020.106105] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 05/14/2020] [Revised: 07/03/2020] [Accepted: 07/19/2020] [Indexed: 01/06/2023]
Abstract
In recent decades, invasive infections caused by fungal pathogens have been reported with increasing frequency. Concurrently, the rates of detected resistance mechanisms against commonly used antifungal agents in fungi are increasing. The need for novel antifungal drugs is thus imminent. In this study, the novel drug olorofim (F901318) was tested for its antifungal activity against the human fungal pathogens Lomentospora prolificans (n = 20), Scedosporium aurantiacum (n = 2), Scedosporium apiospermum (n = 6), Rasamsonia argillacea species complex (n = 23), Exophiala dermatitidis (n = 10) and azole-resistant Aspergillus fumigatus (ARAF) (n = 25) in an in vitro broth microdilution assay according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) recommendations. Whilst olorofim was ascertained to be effective against R. argillacea species complex [minimum inhibitory concentrations (MICs) of ≤0.008 mg/L], Scedosporium spp. (MICs of 0.032-0.5 mg/L), L. prolificans (MICs of 0.032-0.5 mg/L) and ARAF (MICs of ≤0.008-0.032 mg/L), the drug had an MIC of >4 mg/L against E. dermatitidis. These data demonstrate the antifungal activity of olorofim against a broad range of filamentous fungal pathogens.
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Affiliation(s)
- Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Silke Dittmer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany; Institute for Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nuernberg, Paracelsus Medical University, Prof.-Ernst-Nathan-Str. 1, 90419 Nuremberg, Germany.
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Scharmann U, Kirchhoff L, Chapot VLS, Dziobaka J, Verhasselt HL, Stauf R, Buer J, Steinmann J, Rath PM. Comparison of four commercially available chromogenic media to identify Candida albicans and other medically relevant Candida species. Mycoses 2020; 63:823-831. [PMID: 32449997 DOI: 10.1111/myc.13119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/24/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The number of invasive Candida infections has significantly increased in recent decades. For the successful treatment of fungal infections, rapid identification at the species level, particularly in polyfungal infections, is a key factor. In this study, four commercially available chromogenic media, CandiSelect™ 4 (CS4), chromID™ Candida Agar (CCA), BBL™ CHROMagar™ Candida Medium (BBL) and Brilliance™ Candida Agar (BCA) were evaluated for Candida identification. MATERIAL/METHODS Overall, 181 bronchial secretion samples from intensive care patients were analysed prospectively. In addition, 18 primarily sterile materials, previously tested positive for Candida, were investigated retrospectively. All samples were cultured as recommended by the manufacturer and visually inspected after 24 and 48 hours by three independent investigators. As a control, colonies were identified by MALDI-TOF MS. Specificity and sensitivity were determined for C albicans identification prospectively. RESULTS CS4 and BCA showed the best overall consensus with the identification results reached by MALDI-TOF MS for Candida albicans and species. A clear differentiation between the species could be ascertained via easily identifiable, species-specific coloration in contrast to BBL and CCA. Sensitivity for C albicans (n = 73) identification varied between 32% (BCA) and 69% (CS4 and CCA) after 24 hours and 68% (BBL) and 82% (BCA) after 48 hours incubation, while specificity ranged between 62% (BBL) and 81% (CCA) after 24 hours and 82% (BBL) and 85% (CS4) after 48 hours. CONCLUSION CS4 and BCA are recommended for routine identification of Candida species in human samples.
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Affiliation(s)
- Ulrike Scharmann
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | - Lisa Kirchhoff
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | | | - Jan Dziobaka
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | | | - Raphael Stauf
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Jan Buer
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany.,Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
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45
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Jenks J, Seidel D, Cornely O, Chen S, van Hal S, Kauffman C, Miceli M, Heinemann M, Christner M, Jover Sáenz A, Burchardt A, Kemmerling B, Herbrecht R, Steinmann J, Shoham S, Gräber S, Pagano L, Deeren D, Aslam S, Taplitz R, Revankar S, Baddley J, Mehta S, Reed S, Slavin M, Hoenigl M. Voriconazole plus terbinafine combination antifungal therapy for invasive Lomentospora prolificans infections: analysis of 41 patients from the FungiScope® registry 2008–2019. Clin Microbiol Infect 2020; 26:784.e1-784.e5. [DOI: 10.1016/j.cmi.2020.01.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/06/2020] [Accepted: 01/11/2020] [Indexed: 12/29/2022]
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Gröschel MI, Meehan CJ, Barilar I, Diricks M, Gonzaga A, Steglich M, Conchillo-Solé O, Scherer IC, Mamat U, Luz CF, De Bruyne K, Utpatel C, Yero D, Gibert I, Daura X, Kampmeier S, Rahman NA, Kresken M, van der Werf TS, Alio I, Streit WR, Zhou K, Schwartz T, Rossen JWA, Farhat MR, Schaible UE, Nübel U, Rupp J, Steinmann J, Niemann S, Kohl TA. The phylogenetic landscape and nosocomial spread of the multidrug-resistant opportunist Stenotrophomonas maltophilia. Nat Commun 2020; 11:2044. [PMID: 32341346 PMCID: PMC7184733 DOI: 10.1038/s41467-020-15123-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/15/2020] [Indexed: 02/06/2023] Open
Abstract
Recent studies portend a rising global spread and adaptation of human- or healthcare-associated pathogens. Here, we analyse an international collection of the emerging, multidrug-resistant, opportunistic pathogen Stenotrophomonas maltophilia from 22 countries to infer population structure and clonality at a global level. We show that the S. maltophilia complex is divided into 23 monophyletic lineages, most of which harbour strains of all degrees of human virulence. Lineage Sm6 comprises the highest rate of human-associated strains, linked to key virulence and resistance genes. Transmission analysis identifies potential outbreak events of genetically closely related strains isolated within days or weeks in the same hospitals. Multidrug resistance of the opportunistic pathogen Stenotrophomonas maltophilia is an increasing problem. Here, analyzing strains from 22 countries, the authors show that the S. maltophilia complex is divided into 23 monophyletic lineages and find evidence for intra-hospital transmission.
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Affiliation(s)
- Matthias I Gröschel
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany.,Department of Pulmonary Diseases & Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Conor J Meehan
- School of Chemistry and Bioscience, University of Bradford, Bradford, United Kingdom
| | - Ivan Barilar
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
| | - Margo Diricks
- bioMérieux, Applied Maths NV, Keistraat 120, 9830, St-Martens-Latem, Belgium
| | - Aitor Gonzaga
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany
| | - Matthias Steglich
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany
| | - Oscar Conchillo-Solé
- Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabell-Christin Scherer
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Uwe Mamat
- Cellular Microbiology, Research Center Borstel, Borstel, Germany
| | - Christian F Luz
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Katrien De Bruyne
- bioMérieux, Applied Maths NV, Keistraat 120, 9830, St-Martens-Latem, Belgium
| | - Christian Utpatel
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
| | - Daniel Yero
- Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isidre Gibert
- Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Daura
- Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | | | | | - Michael Kresken
- Antiinfectives Intelligence GmbH, Rheinbach, Germany.,Rheinische Fachhochschule Köln gGmbH, Cologne, Germany
| | - Tjip S van der Werf
- Department of Pulmonary Diseases & Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ifey Alio
- Department of Microbiology and Biotechnology, University of Hamburg, Hamburg, Germany
| | - Wolfgang R Streit
- Department of Microbiology and Biotechnology, University of Hamburg, Hamburg, Germany
| | - Kai Zhou
- Shenzhen Institute of Respiratory Diseases, the First Affiliated Hospital (Shenzhen People's Hospital), Southern University of Science and Technology, Shenzhen, China.,Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Thomas Schwartz
- Karlsruhe Institute of Technology, Institute of Functional Interfaces, Eggenstein- Leopoldshafen, Germany
| | - John W A Rossen
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maha R Farhat
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.,Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, MA, USA
| | - Ulrich E Schaible
- Cellular Microbiology, Research Center Borstel, Borstel, Germany.,German Center for Infection Research (DZIF), partner site Hamburg - Lübeck - Borstel - Riems, Cologne, Germany.,Leibniz Research Alliance INFECTIONS'21, Cologne, Germany
| | - Ulrich Nübel
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany.,Leibniz Research Alliance INFECTIONS'21, Cologne, Germany.,Germany Center for Infection Research (DZIF), partner site Hannover - Braunschweig, Cologne, Germany.,Braunschweig Integrated Center of Systems Biology (BRICS), Technical University, Braunschweig, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany.,German Center for Infection Research (DZIF), partner site Hamburg - Lübeck - Borstel - Riems, Cologne, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Medical Center Essen, Essen, Germany.,Medical Microbiology and Infection Prevention, Institute of Clinical Hygiene, Paracelsus Medical Private University, Klinikum Nürnberg, Nuremberg, Germany
| | - Stefan Niemann
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany. .,German Center for Infection Research (DZIF), partner site Hamburg - Lübeck - Borstel - Riems, Cologne, Germany. .,Leibniz Research Alliance INFECTIONS'21, Cologne, Germany.
| | - Thomas A Kohl
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany.,German Center for Infection Research (DZIF), partner site Hamburg - Lübeck - Borstel - Riems, Cologne, Germany
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Abe K, Akutsu R, Ali A, Alt C, Andreopoulos C, Anthony L, Antonova M, Aoki S, Ariga A, Asada Y, Ashida Y, Atkin ET, Awataguchi Y, Ban S, Barbi M, Barker GJ, Barr G, Barrow D, Barry C, Batkiewicz-Kwasniak M, Beloshapkin A, Bench F, Berardi V, Berkman S, Berns L, Bhadra S, Bienstock S, Blondel A, Bolognesi S, Bourguille B, Boyd SB, Brailsford D, Bravar A, Bravo Berguño D, Bronner C, Bubak A, Buizza Avanzini M, Calcutt J, Campbell T, Cao S, Cartwright SL, Catanesi MG, Cervera A, Chappell A, Checchia C, Cherdack D, Chikuma N, Christodoulou G, Coleman J, Collazuol G, Cook L, Coplowe D, Cudd A, Dabrowska A, De Rosa G, Dealtry T, Denner PF, Dennis SR, Densham C, Di Lodovico F, Dokania N, Dolan S, Doyle TA, Drapier O, Dumarchez J, Dunne P, Eklund L, Emery-Schrenk S, Ereditato A, Fernandez P, Feusels T, Finch AJ, Fiorentini GA, Fiorillo G, Francois C, Friend M, Fujii Y, Fujita R, Fukuda D, Fukuda R, Fukuda Y, Fusshoeller K, Gameil K, Giganti C, Golan T, Gonin M, Gorin A, Guigue M, Hadley DR, Haigh JT, Hamacher-Baumann P, Hartz M, Hasegawa T, Hastings NC, Hayashino T, Hayato Y, Hiramoto A, Hogan M, Holeczek J, Hong Van NT, Iacob F, Ichikawa AK, Ikeda M, Ishida T, Ishii T, Ishitsuka M, Iwamoto K, Izmaylov A, Jakkapu M, Jamieson B, Jenkins SJ, Jesús-Valls C, Jiang M, Johnson S, Jonsson P, Jung CK, Kabirnezhad M, Kaboth AC, Kajita T, Kakuno H, Kameda J, Karlen D, Kasetti SP, Kataoka Y, Katori T, Kato Y, Kearns E, Khabibullin M, Khotjantsev A, Kikawa T, Kim H, Kim J, King S, Kisiel J, Knight A, Knox A, Kobayashi T, Koch L, Koga T, Konaka A, Kormos LL, Koshio Y, Kostin A, Kowalik K, Kubo H, Kudenko Y, Kukita N, Kuribayashi S, Kurjata R, Kutter T, Kuze M, Labarga L, Lagoda J, Lamoureux M, Laveder M, Lawe M, Licciardi M, Lindner T, Litchfield RP, Liu SL, Li X, Longhin A, Ludovici L, Lu X, Lux T, Machado LN, Magaletti L, Mahn K, Malek M, Manly S, Maret L, Marino AD, Marti-Magro L, Martin JF, Maruyama T, Matsubara T, Matsushita K, Matveev V, Mavrokoridis K, Mazzucato E, McCarthy M, McCauley N, McFarland KS, McGrew C, Mefodiev A, Metelko C, Mezzetto M, Minamino A, Mineev O, Mine S, Miura M, Molina Bueno L, Moriyama S, Morrison J, Mueller TA, Munteanu L, Murphy S, Nagai Y, Nakadaira T, Nakahata M, Nakajima Y, Nakamura A, Nakamura KG, Nakamura K, Nakayama S, Nakaya T, Nakayoshi K, Nantais C, Ngoc TV, Niewczas K, Nishikawa K, Nishimura Y, Nonnenmacher TS, Nova F, Novella P, Nowak J, Nugent JC, O'Keeffe HM, O'Sullivan L, Odagawa T, Okumura K, Okusawa T, Oser SM, Owen RA, Oyama Y, Palladino V, Palomino JL, Paolone V, Parker WC, Pasternak J, Paudyal P, Pavin M, Payne D, Penn GC, Pickering L, Pidcott C, Pintaudi G, Pinzon Guerra ES, Pistillo C, Popov B, Porwit K, Posiadala-Zezula M, Pritchard A, Quilain B, Radermacher T, Radicioni E, Radics B, Ratoff PN, Reinherz-Aronis E, Riccio C, Rondio E, Roth S, Rubbia A, Ruggeri AC, Ruggles CA, Rychter A, Sakashita K, Sánchez F, Schloesser CM, Scholberg K, Schwehr J, Scott M, Seiya Y, Sekiguchi T, Sekiya H, Sgalaberna D, Shah R, Shaikhiev A, Shaker F, Shaykina A, Shiozawa M, Shorrock W, Shvartsman A, Smirnov A, Smy M, Sobczyk JT, Sobel H, Soler FJP, Sonoda Y, Steinmann J, Suvorov S, Suzuki A, Suzuki SY, Suzuki Y, Sztuc AA, Tada M, Tajima M, Takeda A, Takeuchi Y, Tanaka HK, Tanaka HA, Tanaka S, Thompson LF, Toki W, Touramanis C, Towstego T, Tsui KM, Tsukamoto T, Tzanov M, Uchida Y, Uno W, Vagins M, Valder S, Vallari Z, Vargas D, Vasseur G, Vilela C, Vinning WGS, Vladisavljevic T, Volkov VV, Wachala T, Walker J, Walsh JG, Wang Y, Wark D, Wascko MO, Weber A, Wendell R, Wilking MJ, Wilkinson C, Wilson JR, Wilson RJ, Wood K, Wret C, Yamada Y, Yamamoto K, Yanagisawa C, Yang G, Yano T, Yasutome K, Yen S, Yershov N, Yokoyama M, Yoshida T, Yu M, Zalewska A, Zalipska J, Zaremba K, Zarnecki G, Ziembicki M, Zimmerman ED, Zito M, Zsoldos S, Zykova A. Search for Electron Antineutrino Appearance in a Long-Baseline Muon Antineutrino Beam. Phys Rev Lett 2020; 124:161802. [PMID: 32383902 DOI: 10.1103/physrevlett.124.161802] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/26/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
Electron antineutrino appearance is measured by the T2K experiment in an accelerator-produced antineutrino beam, using additional neutrino beam operation to constrain parameters of the Pontecorvo-Maki-Nakagawa-Sakata (PMNS) mixing matrix. T2K observes 15 candidate electron antineutrino events with a background expectation of 9.3 events. Including information from the kinematic distribution of observed events, the hypothesis of no electron antineutrino appearance is disfavored with a significance of 2.40σ and no discrepancy between data and PMNS predictions is found. A complementary analysis that introduces an additional free parameter which allows non-PMNS values of electron neutrino and antineutrino appearance also finds no discrepancy between data and PMNS predictions.
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Affiliation(s)
- K Abe
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - R Akutsu
- University of Tokyo, Institute for Cosmic Ray Research, Research Center for Cosmic Neutrinos, Kashiwa, Japan
| | - A Ali
- Kyoto University, Department of Physics, Kyoto, Japan
| | - C Alt
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - C Andreopoulos
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - L Anthony
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - M Antonova
- IFIC (CSIC & University of Valencia), Valencia, Spain
| | - S Aoki
- Kobe University, Kobe, Japan
| | - A Ariga
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - Y Asada
- Yokohama National University, Faculty of Engineering, Yokohama, Japan
| | - Y Ashida
- Kyoto University, Department of Physics, Kyoto, Japan
| | - E T Atkin
- Imperial College London, Department of Physics, London, United Kingdom
| | - Y Awataguchi
- Tokyo Metropolitan University, Department of Physics, Tokyo, Japan
| | - S Ban
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M Barbi
- University of Regina, Department of Physics, Regina, Saskatchewan, Canada
| | - G J Barker
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - G Barr
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - D Barrow
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - C Barry
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | | | - A Beloshapkin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - F Bench
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - V Berardi
- INFN Sezione di Bari and Università e Politecnico di Bari, Dipartimento Interuniversitario di Fisica, Bari, Italy
| | - S Berkman
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - L Berns
- Tokyo Institute of Technology, Department of Physics, Tokyo, Japan
| | - S Bhadra
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - S Bienstock
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - A Blondel
- University of Geneva, Section de Physique, DPNC, Geneva, Switzerland
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | | | - B Bourguille
- Institut de Fisica d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) Spain
| | - S B Boyd
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - D Brailsford
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - A Bravar
- University of Geneva, Section de Physique, DPNC, Geneva, Switzerland
| | - D Bravo Berguño
- University Autonoma Madrid, Department of Theoretical Physics, Madrid, Spain
| | - C Bronner
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - A Bubak
- University of Silesia, Institute of Physics, Katowice, Poland
| | - M Buizza Avanzini
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - J Calcutt
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - T Campbell
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - S Cao
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - S L Cartwright
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - M G Catanesi
- INFN Sezione di Bari and Università e Politecnico di Bari, Dipartimento Interuniversitario di Fisica, Bari, Italy
| | - A Cervera
- IFIC (CSIC & University of Valencia), Valencia, Spain
| | - A Chappell
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - C Checchia
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - D Cherdack
- University of Houston, Department of Physics, Houston, Texas, USA
| | - N Chikuma
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - G Christodoulou
- CERN European Organization for Nuclear Research, CH-1211 Genève 23, Switzerland
| | - J Coleman
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - G Collazuol
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - L Cook
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - D Coplowe
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - A Cudd
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - A Dabrowska
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
| | - G De Rosa
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - T Dealtry
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - P F Denner
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - S R Dennis
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - C Densham
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - F Di Lodovico
- King's College London, Department of Physics, Strand, London WC2R 2LS, United Kingdom
| | - N Dokania
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - S Dolan
- CERN European Organization for Nuclear Research, CH-1211 Genève 23, Switzerland
| | - T A Doyle
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - O Drapier
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - J Dumarchez
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - P Dunne
- Imperial College London, Department of Physics, London, United Kingdom
| | - L Eklund
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | | | - A Ereditato
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - P Fernandez
- IFIC (CSIC & University of Valencia), Valencia, Spain
| | - T Feusels
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - A J Finch
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - G A Fiorentini
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - G Fiorillo
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - C Francois
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - M Friend
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - Y Fujii
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - R Fujita
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - D Fukuda
- Okayama University, Department of Physics, Okayama, Japan
| | - R Fukuda
- Tokyo University of Science, Faculty of Science and Technology, Department of Physics, Noda, Chiba, Japan
| | - Y Fukuda
- Miyagi University of Education, Department of Physics, Sendai, Japan
| | - K Fusshoeller
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - K Gameil
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - C Giganti
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - T Golan
- Wroclaw University, Faculty of Physics and Astronomy, Wroclaw, Poland
| | - M Gonin
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - A Gorin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Guigue
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - D R Hadley
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - J T Haigh
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | | | - M Hartz
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- TRIUMF, Vancouver, British Columbia, Canada
| | - T Hasegawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - N C Hastings
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - T Hayashino
- Kyoto University, Department of Physics, Kyoto, Japan
| | - Y Hayato
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - A Hiramoto
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M Hogan
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - J Holeczek
- University of Silesia, Institute of Physics, Katowice, Poland
| | - N T Hong Van
- Institute For Interdisciplinary Research in Science and Education (IFIRSE), ICISE, Quy Nhon, Vietnam
- International Centre of Physics, Institute of Physics (IOP), Vietnam Academy of Science and Technology (VAST), 10 Dao Tan, Ba Dinh, Hanoi, Vietnam
| | - F Iacob
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - A K Ichikawa
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M Ikeda
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - T Ishida
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - T Ishii
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - M Ishitsuka
- Tokyo University of Science, Faculty of Science and Technology, Department of Physics, Noda, Chiba, Japan
| | - K Iwamoto
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - A Izmaylov
- IFIC (CSIC & University of Valencia), Valencia, Spain
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Jakkapu
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - B Jamieson
- University of Winnipeg, Department of Physics, Winnipeg, Manitoba, Canada
| | - S J Jenkins
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - C Jesús-Valls
- Institut de Fisica d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) Spain
| | - M Jiang
- Kyoto University, Department of Physics, Kyoto, Japan
| | - S Johnson
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - P Jonsson
- Imperial College London, Department of Physics, London, United Kingdom
| | - C K Jung
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - M Kabirnezhad
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - A C Kaboth
- Royal Holloway University of London, Department of Physics, Egham, Surrey, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - T Kajita
- University of Tokyo, Institute for Cosmic Ray Research, Research Center for Cosmic Neutrinos, Kashiwa, Japan
| | - H Kakuno
- Tokyo Metropolitan University, Department of Physics, Tokyo, Japan
| | - J Kameda
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - D Karlen
- TRIUMF, Vancouver, British Columbia, Canada
- University of Victoria, Department of Physics and Astronomy, Victoria, British Columbia, Canada
| | - S P Kasetti
- Louisiana State University, Department of Physics and Astronomy, Baton Rouge, Louisiana, USA
| | - Y Kataoka
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - T Katori
- King's College London, Department of Physics, Strand, London WC2R 2LS, United Kingdom
| | - Y Kato
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - E Kearns
- Boston University, Department of Physics, Boston, Massachusetts, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - M Khabibullin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - A Khotjantsev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - T Kikawa
- Kyoto University, Department of Physics, Kyoto, Japan
| | - H Kim
- Osaka City University, Department of Physics, Osaka, Japan
| | - J Kim
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - S King
- Queen Mary University of London, School of Physics and Astronomy, London, United Kingdom
| | - J Kisiel
- University of Silesia, Institute of Physics, Katowice, Poland
| | - A Knight
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - A Knox
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - T Kobayashi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - L Koch
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - T Koga
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - A Konaka
- TRIUMF, Vancouver, British Columbia, Canada
| | - L L Kormos
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - Y Koshio
- Okayama University, Department of Physics, Okayama, Japan
| | - A Kostin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - K Kowalik
- National Centre for Nuclear Research, Warsaw, Poland
| | - H Kubo
- Kyoto University, Department of Physics, Kyoto, Japan
| | - Y Kudenko
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - N Kukita
- Osaka City University, Department of Physics, Osaka, Japan
| | - S Kuribayashi
- Kyoto University, Department of Physics, Kyoto, Japan
| | - R Kurjata
- Warsaw University of Technology, Institute of Radioelectronics and Multimedia Technology, Warsaw, Poland
| | - T Kutter
- Louisiana State University, Department of Physics and Astronomy, Baton Rouge, Louisiana, USA
| | - M Kuze
- Tokyo Institute of Technology, Department of Physics, Tokyo, Japan
| | - L Labarga
- University Autonoma Madrid, Department of Theoretical Physics, Madrid, Spain
| | - J Lagoda
- National Centre for Nuclear Research, Warsaw, Poland
| | - M Lamoureux
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - M Laveder
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - M Lawe
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - M Licciardi
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - T Lindner
- TRIUMF, Vancouver, British Columbia, Canada
| | - R P Litchfield
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | - S L Liu
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - X Li
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - A Longhin
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - L Ludovici
- INFN Sezione di Roma and Università di Roma "La Sapienza", Roma, Italy
| | - X Lu
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - T Lux
- Institut de Fisica d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) Spain
| | - L N Machado
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - L Magaletti
- INFN Sezione di Bari and Università e Politecnico di Bari, Dipartimento Interuniversitario di Fisica, Bari, Italy
| | - K Mahn
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - M Malek
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - S Manly
- University of Rochester, Department of Physics and Astronomy, Rochester, New York, USA
| | - L Maret
- University of Geneva, Section de Physique, DPNC, Geneva, Switzerland
| | - A D Marino
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - L Marti-Magro
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - J F Martin
- University of Toronto, Department of Physics, Toronto, Ontario, Canada
| | - T Maruyama
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - T Matsubara
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - K Matsushita
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - V Matveev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - K Mavrokoridis
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | | | - M McCarthy
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - N McCauley
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - K S McFarland
- University of Rochester, Department of Physics and Astronomy, Rochester, New York, USA
| | - C McGrew
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - A Mefodiev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - C Metelko
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - M Mezzetto
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - A Minamino
- Yokohama National University, Faculty of Engineering, Yokohama, Japan
| | - O Mineev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - S Mine
- University of California, Irvine, Department of Physics and Astronomy, Irvine, California, USA
| | - M Miura
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - L Molina Bueno
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - S Moriyama
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - J Morrison
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - Th A Mueller
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - L Munteanu
- IRFU, CEA Saclay, Gif-sur-Yvette, France
| | - S Murphy
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - Y Nagai
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - T Nakadaira
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - M Nakahata
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - Y Nakajima
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - A Nakamura
- Okayama University, Department of Physics, Okayama, Japan
| | - K G Nakamura
- Kyoto University, Department of Physics, Kyoto, Japan
| | - K Nakamura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - S Nakayama
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - T Nakaya
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- Kyoto University, Department of Physics, Kyoto, Japan
| | - K Nakayoshi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - C Nantais
- University of Toronto, Department of Physics, Toronto, Ontario, Canada
| | - T V Ngoc
- Institute For Interdisciplinary Research in Science and Education (IFIRSE), ICISE, Quy Nhon, Vietnam
| | - K Niewczas
- Wroclaw University, Faculty of Physics and Astronomy, Wroclaw, Poland
| | - K Nishikawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - Y Nishimura
- Keio University, Department of Physics, Kanagawa, Japan
| | - T S Nonnenmacher
- Imperial College London, Department of Physics, London, United Kingdom
| | - F Nova
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - P Novella
- IFIC (CSIC & University of Valencia), Valencia, Spain
| | - J Nowak
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - J C Nugent
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | - H M O'Keeffe
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - L O'Sullivan
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - T Odagawa
- Kyoto University, Department of Physics, Kyoto, Japan
| | - K Okumura
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Research Center for Cosmic Neutrinos, Kashiwa, Japan
| | - T Okusawa
- Osaka City University, Department of Physics, Osaka, Japan
| | - S M Oser
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - R A Owen
- Queen Mary University of London, School of Physics and Astronomy, London, United Kingdom
| | - Y Oyama
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - V Palladino
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - J L Palomino
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - V Paolone
- University of Pittsburgh, Department of Physics and Astronomy, Pittsburgh, Pennsylvania, USA
| | - W C Parker
- Royal Holloway University of London, Department of Physics, Egham, Surrey, United Kingdom
| | - J Pasternak
- Imperial College London, Department of Physics, London, United Kingdom
| | - P Paudyal
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - M Pavin
- TRIUMF, Vancouver, British Columbia, Canada
| | - D Payne
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - G C Penn
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - L Pickering
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - C Pidcott
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - G Pintaudi
- Yokohama National University, Faculty of Engineering, Yokohama, Japan
| | - E S Pinzon Guerra
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - C Pistillo
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - B Popov
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - K Porwit
- University of Silesia, Institute of Physics, Katowice, Poland
| | | | - A Pritchard
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - B Quilain
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - T Radermacher
- RWTH Aachen University, III. Physikalisches Institut, Aachen, Germany
| | - E Radicioni
- INFN Sezione di Bari and Università e Politecnico di Bari, Dipartimento Interuniversitario di Fisica, Bari, Italy
| | - B Radics
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - P N Ratoff
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - E Reinherz-Aronis
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - C Riccio
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - E Rondio
- National Centre for Nuclear Research, Warsaw, Poland
| | - S Roth
- RWTH Aachen University, III. Physikalisches Institut, Aachen, Germany
| | - A Rubbia
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - A C Ruggeri
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - C A Ruggles
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | - A Rychter
- Warsaw University of Technology, Institute of Radioelectronics and Multimedia Technology, Warsaw, Poland
| | - K Sakashita
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - F Sánchez
- University of Geneva, Section de Physique, DPNC, Geneva, Switzerland
| | - C M Schloesser
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - K Scholberg
- Duke University, Department of Physics, Durham, North Carolina, USA
| | - J Schwehr
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - M Scott
- Imperial College London, Department of Physics, London, United Kingdom
| | - Y Seiya
- Osaka City University, Department of Physics, Osaka, Japan
| | - T Sekiguchi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - H Sekiya
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - D Sgalaberna
- CERN European Organization for Nuclear Research, CH-1211 Genève 23, Switzerland
| | - R Shah
- Oxford University, Department of Physics, Oxford, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - A Shaikhiev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - F Shaker
- University of Winnipeg, Department of Physics, Winnipeg, Manitoba, Canada
| | - A Shaykina
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Shiozawa
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - W Shorrock
- Imperial College London, Department of Physics, London, United Kingdom
| | - A Shvartsman
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - A Smirnov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Smy
- University of California, Irvine, Department of Physics and Astronomy, Irvine, California, USA
| | - J T Sobczyk
- Wroclaw University, Faculty of Physics and Astronomy, Wroclaw, Poland
| | - H Sobel
- University of California, Irvine, Department of Physics and Astronomy, Irvine, California, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - F J P Soler
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | - Y Sonoda
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - J Steinmann
- RWTH Aachen University, III. Physikalisches Institut, Aachen, Germany
| | - S Suvorov
- IRFU, CEA Saclay, Gif-sur-Yvette, France
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | | | - S Y Suzuki
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - Y Suzuki
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - A A Sztuc
- Imperial College London, Department of Physics, London, United Kingdom
| | - M Tada
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - M Tajima
- Kyoto University, Department of Physics, Kyoto, Japan
| | - A Takeda
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - Y Takeuchi
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- Kobe University, Kobe, Japan
| | - H K Tanaka
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - H A Tanaka
- SLAC National Accelerator Laboratory, Stanford University, Menlo Park, California, USA
- University of Toronto, Department of Physics, Toronto, Ontario, Canada
| | - S Tanaka
- Osaka City University, Department of Physics, Osaka, Japan
| | - L F Thompson
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - W Toki
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - C Touramanis
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - T Towstego
- University of Toronto, Department of Physics, Toronto, Ontario, Canada
| | - K M Tsui
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - T Tsukamoto
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - M Tzanov
- Louisiana State University, Department of Physics and Astronomy, Baton Rouge, Louisiana, USA
| | - Y Uchida
- Imperial College London, Department of Physics, London, United Kingdom
| | - W Uno
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M Vagins
- University of California, Irvine, Department of Physics and Astronomy, Irvine, California, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - S Valder
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - Z Vallari
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - D Vargas
- Institut de Fisica d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) Spain
| | - G Vasseur
- IRFU, CEA Saclay, Gif-sur-Yvette, France
| | - C Vilela
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - W G S Vinning
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - T Vladisavljevic
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - V V Volkov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - T Wachala
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
| | - J Walker
- University of Winnipeg, Department of Physics, Winnipeg, Manitoba, Canada
| | - J G Walsh
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - Y Wang
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - D Wark
- Oxford University, Department of Physics, Oxford, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - M O Wascko
- Imperial College London, Department of Physics, London, United Kingdom
| | - A Weber
- Oxford University, Department of Physics, Oxford, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - R Wendell
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M J Wilking
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - C Wilkinson
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - J R Wilson
- King's College London, Department of Physics, Strand, London WC2R 2LS, United Kingdom
| | - R J Wilson
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - K Wood
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - C Wret
- University of Rochester, Department of Physics and Astronomy, Rochester, New York, USA
| | - Y Yamada
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - K Yamamoto
- Osaka City University, Department of Physics, Osaka, Japan
| | - C Yanagisawa
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - G Yang
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - T Yano
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - K Yasutome
- Kyoto University, Department of Physics, Kyoto, Japan
| | - S Yen
- TRIUMF, Vancouver, British Columbia, Canada
| | - N Yershov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Yokoyama
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - T Yoshida
- Tokyo Institute of Technology, Department of Physics, Tokyo, Japan
| | - M Yu
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - A Zalewska
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
| | - J Zalipska
- National Centre for Nuclear Research, Warsaw, Poland
| | - K Zaremba
- Warsaw University of Technology, Institute of Radioelectronics and Multimedia Technology, Warsaw, Poland
| | - G Zarnecki
- National Centre for Nuclear Research, Warsaw, Poland
| | - M Ziembicki
- Warsaw University of Technology, Institute of Radioelectronics and Multimedia Technology, Warsaw, Poland
| | - E D Zimmerman
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - M Zito
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - S Zsoldos
- Queen Mary University of London, School of Physics and Astronomy, London, United Kingdom
| | - A Zykova
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
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48
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Jenks JD, Seidel D, Cornely OA, Chen S, van Hal S, Kauffman C, Miceli MH, Heinemann M, Christner M, Jover Sáenz A, Burchardt A, Kemmerling B, Herbrecht R, Steinmann J, Shoham S, Gräber S, Pagano L, Deeren D, Slavin MA, Hoenigl M. Clinical characteristics and outcomes of invasive Lomentospora prolificans infections: Analysis of patients in the FungiScope ® registry. Mycoses 2020; 63:437-442. [PMID: 32080902 DOI: 10.1111/myc.13067] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 01/24/2020] [Revised: 02/10/2020] [Accepted: 02/14/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Invasive fungal infections caused by Lomentospora prolificans are associated with very high mortality rates and can be challenging to treat given pan-drug resistance to available antifungal agents. The objective of this study was to describe the clinical presentation and outcomes in a cohort of patients with invasive L prolificans infections. METHODS We performed a retrospective review of medical records of patients with invasive L prolificans infection in the FungiScope® registry of rare invasive fungal infections. Patients diagnosed between 01 January 2008 and 09 September 2019 were included in for analysis. RESULTS The analysis included 41 patients with invasive L prolificans infection from eight different countries. Haematological/oncological malignancies were the most frequent underlying disease (66%), disseminated infection was frequent (61%), and the lung was the most commonly involved organ (44%). Most infections (59%) were breakthrough infections. Progression/deterioration/treatment failure was observed in 23/40 (58%) of patients receiving antifungal therapy. In total, 21/41 (51%) patients, and 77% of patients with underlying haematological/oncological malignancy, had a fatal outcome attributed to invasive fungal infection. Combination antifungal therapy was frequent (24/40) and associated with improved survival. In particular, treatment regimens including terbinafine were significantly associated with higher treatment success at final assessment (P = .012), with a positive trend observed for treatment regimens that included voriconazole (P = .054). CONCLUSIONS Lomentospora prolificans infections were associated with mortality rates of 77% and above in patients with underlying haematological/oncological malignancies and those with disseminated infections. While combination therapy is the preferred option for now, the hope lies with novel antifungals currently under development.
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Affiliation(s)
- Jeffrey D Jenks
- Department of Medicine, University of California San Diego, San Diego, CA, USA.,Clinical and Translational Fungal Research Group, University of California San Diego, San Diego, CA, USA
| | - Danila Seidel
- Department I of Internal Medicine, ECMM Excellence Centre of Medical Mycology, CECAD-Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University Hospital Cologne, Cologne, Germany
| | - Oliver A Cornely
- Department I of Internal Medicine, ECMM Excellence Centre of Medical Mycology, CECAD-Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University Hospital Cologne, Cologne, Germany
| | - Sharon Chen
- Sydney Medical School, Centre for Infectious Diseases and Microbiology, Westmead Hospital, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sebastiaan van Hal
- Department of Microbiology and Infectious Diseases, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Carol Kauffman
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Marisa H Miceli
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Melina Heinemann
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Christner
- Department of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alfredo Jover Sáenz
- Territorial Unit of Nosocomial Infection and antibiotic policy (TUNI), University Hospital Arnau de Vilanova, Lleida, Spain
| | - Alexander Burchardt
- Department of Hematology, Hospital of Justus Liebig University, Giessen, Germany
| | - Björn Kemmerling
- Department of Hematology, Hospital of Justus Liebig University, Giessen, Germany
| | - Raoul Herbrecht
- Department of Oncology and Hematology, Strasbourg University Hospital, Strasbourg, France
| | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.,Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Shmuel Shoham
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sandra Gräber
- Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital Leipzig, Leipzig, Germany
| | - Livio Pagano
- Department of Hematology, Fondazione Policlinico A. Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Dries Deeren
- Department of Hematology, AZ Delta, Roeselare, Belgium
| | - Monica A Slavin
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, National Centre for Infections in Cancer, Melbourne, Vic., Australia
| | - Martin Hoenigl
- Department of Medicine, University of California San Diego, San Diego, CA, USA.,Clinical and Translational Fungal Research Group, University of California San Diego, San Diego, CA, USA.,Department of Medicine, ECMM Excellence Centre of Medical Mycology, Medical University of Graz, Graz, Austria
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49
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Abe K, Akutsu R, Ali A, Alt C, Andreopoulos C, Anthony L, Antonova M, Aoki S, Ariga A, Arihara T, Asada Y, Ashida Y, Atkin ET, Awataguchi Y, Ban S, Barbi M, Barker GJ, Barr G, Barrow D, Barry C, Batkiewicz-Kwasniak M, Beloshapkin A, Bench F, Berardi V, Berkman S, Berns L, Bhadra S, Bienstock S, Blondel A, Bolognesi S, Bourguille B, Boyd SB, Brailsford D, Bravar A, Berguño DB, Bronner C, Bubak A, Avanzini MB, Calcutt J, Campbell T, Cao S, Cartwright SL, Catanesi MG, Cervera A, Chappell A, Checchia C, Cherdack D, Chikuma N, Cicerchia M, Christodoulou G, Coleman J, Collazuol G, Cook L, Coplowe D, Cudd A, Dabrowska A, De Rosa G, Dealtry T, Denner PF, Dennis SR, Densham C, Di Lodovico F, Dokania N, Dolan S, Doyle TA, Drapier O, Dumarchez J, Dunne P, Eguchi A, Eklund L, Emery-Schrenk S, Ereditato A, Fernandez P, Feusels T, Finch AJ, Fiorentini GA, Fiorillo G, Francois C, Friend M, Fujii Y, Fujita R, Fukuda D, Fukuda R, Fukuda Y, Fusshoeller K, Gameil K, Giganti C, Golan T, Gonin M, Gorin A, Guigue M, Hadley DR, Haigh JT, Hamacher-Baumann P, Hartz M, Hasegawa T, Hassani S, Hastings NC, Hayashino T, Hayato Y, Hiramoto A, Hogan M, Holeczek J, Hong Van NT, Iacob F, Ichikawa AK, Ikeda M, Ishida T, Ishii T, Ishitsuka M, Iwamoto K, Izmaylov A, Jakkapu M, Jamieson B, Jenkins SJ, Jesús-Valls C, Jiang M, Johnson S, Jonsson P, Jung CK, Junjie X, Jurj PB, Kabirnezhad M, Kaboth AC, Kajita T, Kakuno H, Kameda J, Karlen D, Kasetti SP, Kataoka Y, Katori T, Kato Y, Kearns E, Khabibullin M, Khotjantsev A, Kikawa T, Kikutani H, Kim H, Kim J, King S, Kisiel J, Knight A, Knox A, Kobayashi T, Koch L, Koga T, Konaka A, Kormos LL, Koshio Y, Kostin A, Kowalik K, Kubo H, Kudenko Y, Kukita N, Kuribayashi S, Kurjata R, Kutter T, Kuze M, Labarga L, Lagoda J, Lamoureux M, Laveder M, Lawe M, Licciardi M, Lindner T, Litchfield RP, Liu SL, Li X, Longhin A, Ludovici L, Lu X, Lux T, Machado LN, Magaletti L, Mahn K, Malek M, Manly S, Maret L, Marino AD, Marti-Magro L, Martin JF, Maruyama T, Matsubara T, Matsushita K, Matveev V, Mavrokoridis K, Mazzucato E, McCarthy M, McCauley N, McElwee J, McFarland KS, McGrew C, Mefodiev A, Metelko C, Mezzetto M, Minamino A, Mineev O, Mine S, Miura M, Bueno LM, Moriyama S, Morrison J, Mueller TA, Munteanu L, Murphy S, Nagai Y, Nakadaira T, Nakahata M, Nakajima Y, Nakamura A, Nakamura KG, Nakamura K, Nakayama S, Nakaya T, Nakayoshi K, Nantais C, Naseby CER, Ngoc TV, Niewczas K, Nishikawa K, Nishimura Y, Noah E, Nonnenmacher TS, Nova F, Novella P, Nowak J, Nugent JC, O’Keeffe HM, O’Sullivan L, Odagawa T, Okumura K, Okusawa T, Oser SM, Owen RA, Oyama Y, Palladino V, Palomino JL, Paolone V, Pari M, Parker WC, Parsa S, Pasternak J, Paudyal P, Pavin M, Payne D, Penn GC, Pickering L, Pidcott C, Pintaudi G, Guerra ESP, Pistillo C, Popov B, Porwit K, Posiadala-Zezula M, Pritchard A, Quilain B, Radermacher T, Radicioni E, Radics B, Ratoff PN, Reinherz-Aronis E, Riccio C, Rondio E, Roth S, Rubbia A, Ruggeri AC, Ruggles CA, Rychter A, Sakashita K, Sánchez F, Santucci G, Schloesser CM, Scholberg K, Schwehr J, Scott M, Seiya Y, Sekiguchi T, Sekiya H, Sgalaberna D, Shah R, Shaikhiev A, Shaker F, Shaykina A, Shiozawa M, Shorrock W, Shvartsman A, Smirnov A, Smy M, Sobczyk JT, Sobel H, Soler FJP, Sonoda Y, Steinmann J, Suvorov S, Suzuki A, Suzuki SY, Suzuki Y, Sztuc AA, Tada M, Tajima M, Takeda A, Takeuchi Y, Tanaka HK, Tanaka HA, Tanaka S, Thompson LF, Toki W, Touramanis C, Towstego T, Tsui KM, Tsukamoto T, Tzanov M, Uchida Y, Uno W, Vagins M, Valder S, Vallari Z, Vargas D, Vasseur G, Vilela C, Vinning WGS, Vladisavljevic T, Volkov VV, Wachala T, Walker J, Walsh JG, Wang Y, Wark D, Wascko MO, Weber A, Wendell R, Wilking MJ, Wilkinson C, Wilson JR, Wilson RJ, Wood K, Wret C, Yamada Y, Yamamoto K, Yanagisawa C, Yang G, Yano T, Yasutome K, Yen S, Yershov N, Yokoyama M, Yoshida T, Yu M, Zalewska A, Zalipska J, Zaremba K, Zarnecki G, Ziembicki M, Zimmerman ED, Zito M, Zsoldos S, Zykova A. Constraint on the matter–antimatter symmetry-violating phase in neutrino oscillations. Nature 2020; 580:339-344. [DOI: 10.1038/s41586-020-2177-0] [Citation(s) in RCA: 188] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 03/03/2020] [Indexed: 11/09/2022]
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50
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Koehler P, Denis B, Denning DW, Gangneux JP, Hoenigl M, Kontoyiannis DP, Krause R, Lagrou K, Lass-Flörl C, Maertens J, Mareković I, Meis JF, Molina JM, Pleško S, Prattes J, Rath PM, Rautemaa-Richardson R, Richardson M, Segal E, Seidel D, Spriet I, Steinmann J, Verweij PE, Cornely OA. European confederation of medical mycology expert consult-An ECMM excellence center initiative. Mycoses 2020; 63:566-572. [PMID: 32181546 DOI: 10.1111/myc.13076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 03/10/2020] [Accepted: 03/13/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Difficult-to-treat invasive fungal infections require infectious diseases expert consultation to improve treatment outcome and increase survival rates. METHODS The European Confederation of Medical Mycology (ECMM) intends to provide expert help free of charge by a newly founded ECMM Expert Consultation Service for medical centres around the globe seeking advice when there is no fungal infection consultant available. The expert consult will provide recommendations and broad expertise on difficult-to-treat invasive fungal infections (eg azole-resistant Aspergillus species, Candida auris, mucormycosis) to improve diagnostic and therapeutic management and outcome. RESULTS The initiative plans global outreach through video conferencing between ECMM Excellence Centers and treating physicians. FungiScope® registries will be used to structure case information and to evaluate the impact of the collegial advice system at regular intervals. Advice will follow recent guidelines, and EQUAL Scores will be used to measure guideline adherence. CONCLUSIONS Infectious diseases expert consultation should be an integral component of care for patients with difficult-to-treat invasive fungal infections. The ECMM Expert Consult will attend to this matter on a global scale.
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Affiliation(s)
- Philipp Koehler
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Blandine Denis
- Department of Infectious Diseases, Excellence Center for Medical Mycology (ECMM), Saint Louis Hospital, APHP, University of Paris, Paris, France
| | - David W Denning
- Global Action Fund for Fungal Infections, Geneva, Switzerland.,The National Aspergillosis Centre, Manchester Academic Health Science Centre, Wythenshawe Hospital, The University of Manchester, Manchester, UK
| | - Jean-Pierre Gangneux
- Institut de Recherche en Santé, Environnement et travail, Inserm, CHU de Rennes, EHESP, UMR_S 1085, Université de Rennes, Rennes, France
| | - Martin Hoenigl
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.,Division of Infectious Diseases and Global Public Health, Department of Medicine, UCSD, San Diego, CA, USA
| | - Dimitrios P Kontoyiannis
- Division of Internal Medicine, Department of Infectious Diseases, M.D. Anderson Cancer Center, Infection Control and Employee Health, University of Texas, Houston, TX, USA
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Katrien Lagrou
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, Excellence Center for Medical Mycology (ECMM), KU Leuven, Leuven, Belgium.,Department of Laboratory Medicine and National Reference Center for Mycosis, Excellence Center for Medical Mycology (ECMM), University Hospitals Leuven, Leuven, Belgium
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Excellence Center for Medical Mycology (ECMM), Medical University of Innsbruck, Innsbruck, Austria
| | - Johan Maertens
- Department of Hematology, University Hospital Gasthuisberg, Gasthuisberg, Belgium.,Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | - Ivana Mareković
- Department of Clinical and Molecular Microbiology, Excellence Center in Laboratory Mycology (ECMM) University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Excellence Center for Medical Mycology (ECMM), Center of Expertise in Mycology Radboudumc/CWZ, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Jean-Michel Molina
- Department of Infectious Diseases, Excellence Center for Medical Mycology (ECMM), Saint Louis Hospital, APHP, University of Paris, Paris, France
| | - Sanja Pleško
- Department of Clinical and Molecular Microbiology, Excellence Center in Laboratory Mycology (ECMM) University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Juergen Prattes
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Peter-Michael Rath
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
| | - Riina Rautemaa-Richardson
- Department of Infectious Diseases and Mycology Reference Centre Manchester, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Malcolm Richardson
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Mycology Reference Centre Manchester, Excellence Centre for Medical Mycology (ECMM), Manchester University NHS Foundation Trust, Manchester, UK
| | - Esther Segal
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Danila Seidel
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Isabel Spriet
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.,Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, Essen, Germany.,Institute for Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
| | - Paul E Verweij
- Department of Medical Microbiology, Excellence Center for Medical Mycology (ECMM), Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | - Oliver A Cornely
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany.,Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
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