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Larsen J, Petersen A, Sørum M, Stegger M, van Alphen L, Valentiner-Branth P, Knudsen LK, Larsen LS, Feingold B, Price LB, Andersen PS, Larsen AR, Skov RL. Meticillin-resistant Staphylococcus aureus CC398 is an increasing cause of disease in people with no livestock contact in Denmark, 1999 to 2011. ACTA ACUST UNITED AC 2016; 20:30021. [PMID: 26535590 DOI: 10.2807/1560-7917.es.2015.20.37.30021] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [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: 11/13/2014] [Accepted: 03/12/2015] [Indexed: 02/05/2023]
Abstract
Livestock constitutes a potential reservoir of meticillin-resistant Staphylococcus aureus isolates belonging to a recently derived lineage within clonal complex 398 (MRSA CC398-IIa). Since its discovery in the early 2000s, this lineage has become a major cause of human disease in Europe, posing a serious public health challenge in countries with intensive livestock production. To retrace the history of human colonisation and infection with MRSA CC398-IIa in Denmark, we conducted a nationwide, retrospective study of MRSA isolates collected from 1999 to 2011. Among 7,429 MRSA isolates screened, we identified 416 MRSA CC398-IIa isolates. Of these, 148 were from people with infections, including 51 from patients reporting no livestock exposure. The first cases of MRSA CC398-IIa infection in Denmark occurred in 2004. Subsequently, the incidence of MRSA CC398-IIa infection showed a linear annual increase of 66% from 2004 to 2011 (from 0.09 to 1.1 per 100,000 person-years). There were clear temporal and spatial relationships between MRSA CC398-IIa-infected patients with and without livestock exposure. These findings suggest substantial dissemination of MRSA CC398-IIa from livestock or livestock workers into the Danish community and underscore the need for strategies to control its spread both on and off the farm.
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Affiliation(s)
- Jesper Larsen
- Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
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Rasmussen LD, Fonager J, Knudsen LK, Andersen PHS, Rønn J, Poulsen MW, Franck KT, Fischer TK. Phylogenetic and epidemiological analysis of measles outbreaks in Denmark, 2013 to 2014. Euro Surveill 2015; 20:30027. [DOI: 10.2807/1560-7917.es.2015.20.39.30027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/22/2015] [Indexed: 11/20/2022] Open
Abstract
Despite the introduction of safe, effective vaccines decades ago and joint global public health efforts to eliminate measles, this vaccine-preventable disease continues to pose threats to children’s health worldwide. During 2013 and 2014, measles virus was introduced into Denmark through several independent importations. This resulted in a number of secondary cases (n = 7), with two clusters in 2013 and one in 2014. In total, there were 44 cases of measles. Most cases (n = 41) were laboratory confirmed by detection of measles virus genome by real-time reverse transcription (RT)-PCR and IgM antibodies. The viruses from confirmed cases were genotyped by sequencing. Only one genotype circulated each year, i.e. D8 and B3, respectively. Sequencing of measles virus from different clinical specimens from the same patients revealed that sequence variants of measles viruses might co-exist and co-transmit during an outbreak. The majority of the cases were unvaccinated (n = 27) or recipients of one dose of measles-mumps-rubella (MMR) vaccine (n = 7). In addition, two fully vaccinated adult cases were reported in 2014. We demonstrate the transmission of measles virus in a population in which the two-dose MMR vaccination coverage rate was 80% and how even vaccinated individuals may be at risk of contracting measles once transmission has been established.
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Affiliation(s)
- Lasse Dam Rasmussen
- Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen, Denmark
| | - Jannik Fonager
- Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen, Denmark
| | - Lisbet Krause Knudsen
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | | | - Jesper Rønn
- Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen, Denmark
| | | | | | - Thea Kølsen Fischer
- Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen, Denmark
- Centre for Global Health, University of Southern Denmark, Odense, Denmark
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St-Martin G, Knudsen LK, Engsig FN, Panum I, Andersen PHS, Rønn J, Fonager J, Fischer TK. Mumps resurgence in Denmark. J Clin Virol 2014; 61:435-8. [PMID: 25218244 DOI: 10.1016/j.jcv.2014.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 05/27/2014] [Revised: 08/11/2014] [Accepted: 08/16/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND The past decade has witnessed a resurgence of parotitisvirus (mumps) in several countries where seemingly good mumps control otherwise had been achieved through vaccination. Recently detection of mumps has increased in Denmark. OBJECTIVES To describe the age-specific changes and time trends of parotitisvirus detection in Denmark over a 10 year period. STUDY DESIGN Retrospective cohort study based on national laboratory data for parotitisvirus typing surveillance and national epidemiology data for mumps reporting. RESULTS The parotitisvirus detection rate has increased almost 10 times during the past 10 years from an incidence <0.1 per 100,000 in 2003 to 0.96 per 100,000 in 2013. The age distribution has shifted from children to young adults, and most cases are unvaccinated (54%) or vaccinated once (41%). The increase is due mainly to the existence of cohorts with low MMR vaccine coverage. CONCLUSION Analysis of mumps surveillance data from Denmark documents that the incidence of mumps is increasing, and that the resurgence of parotitisvirus is primarily occurring among young Danish adults. Almost half of the infected clinical mumps cases had received the first dose of MMR.
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Affiliation(s)
- Gry St-Martin
- Section for Virus Surveillance and Research, Department for Microbiological Diagnostics and Virology, Statens Serum Institut SSI, Copenhagen, Denmark
| | - Lisbet Krause Knudsen
- Department of Infectious Disease Epidemiology, Statens Serum Institut SSI, Copenhagen, Denmark
| | - Frederik Neess Engsig
- Department for Microbiological Diagnostics and Virology, Statens Serum Institut SSI, Copenhagen, Denmark
| | - Inge Panum
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Peter H S Andersen
- Department of Infectious Disease Epidemiology, Statens Serum Institut SSI, Copenhagen, Denmark
| | - Jesper Rønn
- Section for Virus Surveillance and Research, Department for Microbiological Diagnostics and Virology, Statens Serum Institut SSI, Copenhagen, Denmark
| | - Jannik Fonager
- Section for Virus Surveillance and Research, Department for Microbiological Diagnostics and Virology, Statens Serum Institut SSI, Copenhagen, Denmark
| | - Thea Kølsen Fischer
- Section for Virus Surveillance and Research, Department for Microbiological Diagnostics and Virology, Statens Serum Institut SSI, Copenhagen, Denmark.
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Petersen A, Stegger M, Heltberg O, Christensen J, Zeuthen A, Knudsen LK, Urth T, Sorum M, Schouls L, Larsen J, Skov R, Larsen AR. Epidemiology of methicillin-resistant Staphylococcus aureus carrying the novel mecC gene in Denmark corroborates a zoonotic reservoir with transmission to humans. Clin Microbiol Infect 2012; 19:E16-E22. [PMID: 23078039 DOI: 10.1111/1469-0691.12036] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated (HA), community-associated (CA) and livestock-associated (LA) infections. Recently, the discovery of human and bovine MRSA isolates carrying a new mecA gene homologue, mecA(LGA251) (now designated mecC), has caused concern because they are not detected by conventional, confirmatory tests for MRSA. Very little is known about their frequency, epidemiology and possible transmission between livestock and humans. In this study, the epidemiology of the mecC isolates in Denmark was investigated by screening the national collections of MRSA cases (from 1988 onwards) and S. aureus bacteraemia cases (from 1958 onwards). Isolates carrying mecC were only recovered infrequently before 2003 (n = 2) but now seem to be increasing, with 110 cases in 2003-2011. Clinical data on mecC-carrying MRSA demonstrated that mecC-MRSA were primarily community-acquired (CA-MRSA) and affected persons typically living in rural areas, being older than other CA-MRSA patients. Among 22 cases in Region Zealand, four reported contact with cattle and sheep. Two of these persons lived on farms with livestock positive for mecC-carrying MRSA, sharing spa type (t843), MLVA (MT429) and PFGE pattern with the human isolates. These observations indicate that mecC-carrying MRSA can be exchanged between humans and ruminants.
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Affiliation(s)
- A Petersen
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark.
| | - M Stegger
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
| | - O Heltberg
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - J Christensen
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - A Zeuthen
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark
| | - L K Knudsen
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - T Urth
- Department of Clinical Microbiology, Aalborg Sygehus, Aalborg, Denmark
| | - M Sorum
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
| | - L Schouls
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - J Larsen
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
| | - R Skov
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
| | - A R Larsen
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
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Håvik B, Ragnhildstveit E, Lorens JB, Saelemyr K, Fauske O, Knudsen LK, Fjose A. A novel paired domain DNA recognition motif can mediate Pax2 repression of gene transcription. Biochem Biophys Res Commun 1999; 266:532-41. [PMID: 10600536 DOI: 10.1006/bbrc.1999.1854] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The paired domain (PD) is an evolutionarily conserved DNA-binding domain encoded by the Pax gene family of developmental regulators. The Pax proteins are transcription factors and are involved in a variety of processes such as brain development, patterning of the central nervous system (CNS), and B-cell development. In this report we demonstrate that the zebrafish Pax2 PD can interact with a novel type of DNA sequences in vitro, the triple-A motif, consisting of a heptameric nucleotide sequence G/CAAACA/TC with an invariant core of three adjacent adenosines. This recognition sequence was found to be conserved in known natural Pax5 repressor elements involved in controlling the expression of the p53 and J-chain genes. By identifying similar high affinity binding sites in potential target genes of the Pax2 protein, including the pax2 gene itself, we obtained further evidence that the triple-A sites are biologically significant. The putative natural target sites also provide a basis for defining an extended consensus recognition sequence. In addition, we observed in transformation assays a direct correlation between Pax2 repressor activity and the presence of triple-A sites. The results suggest that a transcriptional regulatory function of Pax proteins can be modulated by PD binding to different categories of target sequences.
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Affiliation(s)
- B Håvik
- Department of Molecular Biology, University of Bergen, Bergen, N-5020, Norway
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