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Eur J Clin Microbiol Infect Dis
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Abstract Pneumococcal meningitis is a severe infectious illness of the central nervous system (CNS), with high rates of lethality and
morbidity, being that the microorganism and the host's inflammatory response are responsible for cerebral complications. Moreover,
the blood – brain barrier (BBB) itself secretes cytokines and, because of the bipolar nature of the BBB, these substances can
be secreted into either the CNS compartment or in the blood, so patients with acute bacterial meningitis frequently develop
sepsis. Therefore, the aim of this study was to evaluate the cytokine/chemokine levels in different vessels and the BBB integrity
after pneumococcal meningitis induction. Wistar rats were infected with Streptococcus pneumoniae, and the BBB integrity was investigated using Evan's blue dye. Also, blood from the carotid artery and jugular vein was collected
in order to perform tumour necrosis factor-alpha (TNF-a), interleukin-1 beta (IL-1ß), interleukin-6 (IL-60 and cytokine-induced
neutrophil chemoattractant-1 (CINC-1) analyses by enzyme-linked immunosorbent assay (ELISA). CINC-1 levels were increased
at 6 h in the arterial plasma and at 3 and 6 h in the jugular plasma. We observed BBB breakdown between 12 and 24 h in the
hippocampus and at 12 and 18 h in the cortex after pneumococcal meningitis induction. The increase of CINC-1 occurred prior
to the BBB breakdown. CINC-1 is a neutrophil chemoattractant and it may be related to early events in the pneumococcal meningitis
pathophysiology.
Content Type: Journal ArticleCategory ArticlePages 1-5DOI 10.1007/s10096-011-1533-2
Authors
T. Barichello, Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense, 88806-000 Criciúma, SC, BrazilJ. S. Generoso, Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense, 88806-000 Criciúma, SC, BrazilC. Silvestre, Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense, 88806-000 Criciúma, SC, BrazilC. S. Costa, Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense, 88806-000 Criciúma, SC, BrazilM. M. Carrodore, Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense, 88806-000 Criciúma, SC, BrazilA. L. Cipriano, Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense, 88806-000 Criciúma, SC, BrazilC. M. Michelon, Laboratório de Microbiologia Experimental and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense, 88806-000 Criciúma, SC, BrazilF. Petronilho, Laboratório de Fisiopatologia and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense, Criciúma, SC, BrazilF. Dal-Pizzol, Laboratório de Fisiopatologia and Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Unidade Acadêmica de Ciências da Saúde (UNASAU), Universidade do Extremo Sul Catarinense, Criciúma, SC, BrazilM. C. Vilela, Laboratório de Imunofarmacologia, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, BrazilA. L. Teixeira, Laboratório de Imunofarmacologia, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The purpose of this investigation was to analyze the clinical and epidemiological aspects of all cases of erysipelas and infectious
cellulitis admitted to a tertiary hospital during a period of five years. All patients admitted with the main diagnosis of
erysipelas or cellulitis to the Department of Dermatology of the author's institution from January 2005 to May 2010 were included.
Seventy patients were identified and their medical records were retrospectively reviewed so as to record the epidemiological
and clinical data. Univariate and multivariable analyses were performed to analyze variables that predicted longer length
of stay. The frequency of cellulitis in the lower limbs was higher in men and patients older than 65 years. Moderate/severe
cellulitis in patients with basal comorbidity followed by a poor response to oral antibiotic therapy for 48 h were the most
common reasons for admission. At arrival, four patients had abscessed areas. Fourteen patients developed local complications
and 18 cases developed general in-hospital complications. Most patients improved or were healed with intravenous amoxicillin – clavulanate
1 g – 200 mg/8 h. Intravenous amoxicillin – clavulanate 1 g – 200 mg/8 h may be a good choice for empiric treatment in our setting.
The development of in-hospital complications and the need for changing empiric antibiotic therapy were significant and independent
variables associated with longer length of stay.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-012-1549-2
Authors
M.-R. Perelló-Alzamora, Department of Dermatology, University Hospital of Salamanca, Paseo San Vicente, 58-182, 37007 Salamanca, SpainJ.-C. Santos-Duran, Department of Dermatology, University Hospital of Salamanca, Paseo San Vicente, 58-182, 37007 Salamanca, SpainM. Sánchez-Barba, CAIBER Research Unit, University Hospital of Salamanca, Salamanca, SpainJ. Cañueto, Department of Dermatology, Hospital Nuestra Señora de Sonsoles, Ávila, SpainM. Marcos, Department of Internal Medicine, University Hospital of Salamanca, Salamanca, SpainP. Unamuno, Department of Dermatology, University Hospital of Salamanca, Paseo San Vicente, 58-182, 37007 Salamanca, Spain
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The lipooligosaccharide (LOS) locus class was determined using polymerase chain reaction (PCR) in 335 Finnish Campylobacter jejuni strains isolated from humans, poultry and bovines with known multilocus sequence types. The results revealed an association
between clonal complexes/sequence types (STs) and LOS locus classes. Based on these results, we further predicted the LOS
locus classes distribution among the STs of 209 additional C. jejuni strains from Finnish human domestically acquired infections. Non-sialylated LOS locus classes were associated with STs that
comprised ˜55% of patient strains. Sialylated LOS locus classes A and B were associated with STs infrequently isolated, whereas
class C was correlated with the ST-21 complex, found in ˜14% of human strains. A combination of the LOS locus class and multilocus
sequence type may provide new information on the epidemiology and association of C. jejuni strains with certain disease outcomes.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-012-1556-3
Authors
J. Revez, Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, Agnes Sjöberginkatu 2, 00014 Helsinki, FinlandM.-L. Hänninen, Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, Agnes Sjöberginkatu 2, 00014 Helsinki, Finland
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Over the last decade, travel medicine was mainly focused on the epidemiology of diseases among travelers to developing countries.
However, less is known about travel-related morbidity in Europe. We evaluated the demographic and clinical characteristics
of foreign travelers to Greece during a 5-year period (01/01/2005 - 31/12/2009) who sought medical services from a network
of physicians performing house-call visits (SOS Doctors) in the area of Attica, Greece. Overall, 3,414 foreign travelers [children
(=18 years of age): 27%] were identified; 151 (4.4%) required transfer to a hospital. The most common clinical entities were:
respiratory disorders (34%), diarrheal disease (19%), musculoskeletal (12%), dermatologic (7%), non-diarrheal gastrointestinal
(6%), and genitourinary (5%) disorders. Respiratory disorders were the most frequent diagnosis during all seasons, followed
by diarrheal gastrointestinal and musculoskeletal disorders. Respiratory and dental conditions were observed significantly
more frequently in children. Respiratory disorders were observed significantly more frequently during winter (47%) compared
to spring (36.7%), summer (30.9%), and autumn (30.5%), (p?<?0.01). Despite the limitations of the retrospective methodology, our findings suggest that mild, self-limited respiratory
events may be the prevalent cause for seeking primary health care during travel to Greece. Our findings may be extrapolated
to other countries with similar climatic and socioeconomic status.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-012-1548-3
Authors
G. Theocharis, SOS Doctors, Athens, GreeceK. A. Polyzos, Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, GreeceE. K. Vouloumanou, Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, GreeceG. Peppas, SOS Doctors, Athens, GreeceT. Spiropoulos, SOS Doctors, Athens, GreeceS. G. Barbas, SOS Doctors, Athens, GreeceM. E. Falagas, Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The time to positivity (TTP) of blood cultures has been associated with increased mortality in bacteremia caused by several
microorganisms. The aim of this study is to evaluate the relationship between TTP and prognosis, clinical presentation and
extended spectrum B-lactamase (ESBL)-production in patients with Escherichia coli bacteremia. This is a retrospective observational study involving 226 adult patients with E. coli bacteremia. Data collected included underlying diseases, clinical presentation, prognosis factors, TTP, ESBL-production and
outcome. Thirty-one (14%) patients had severe sepsis and 29 (13%) septic shock at presentation. Thirty-three (14%) strains
were ESBL-producers. Thirty-nine (17%) patients died during admission and 17 (7.5%) within 48 hours. The median TTP was 8.3
hours (range, 0.42 – 76.5). It was significantly shorter in patients with septic shock (6.23 h, range 1.12 – 47.29 h vs. 8.51 h,
range 0.42 – 76.50 h; p?=?0.018). Rapid growth of E. coli, Pitt index >1.5, non-urinary source and Charlson score >2 were selected as independent risk factors of in-hospital mortality
by the multivariate analysis. ESBL-production was not associated with modifications in TTP. Lower TTP is an independent risk
factor for septic shock and poor outcome in episodes of E. coli bacteremia. The TTP in E. coli bacteremia is not significantly modified by ESBL-production.
Content Type: Journal ArticleCategory ArticlePages 1-5DOI 10.1007/s10096-012-1554-5
Authors
R. Álvarez, Clinical Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, University Hospital Virgen del Rocío, Seville, SpainL. Viñas-Castillo, Clinical Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, University Hospital Virgen del Rocío, Seville, SpainJ. A. Lepe-Jiménez, Clinical Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, University Hospital Virgen del Rocío, Seville, SpainE. García-Cabrera, Clinical Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, University Hospital Virgen del Rocío, Seville, SpainJ. M. Cisneros-Herreros, Clinical Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, University Hospital Virgen del Rocío, Seville, Spain
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The amino acid metabolism in patients with hepatitis B virus (HBV) infection is significantly changed. In this study, we analyzed
the relationship between the amino acid profiles and varying clinical stages of HBV infection, and investigated their significance.
The plasma amino acid concentrations in 115 patients with HBV infection and 32 healthy donors were detected and analyzed,
and the main indicators of liver function were measured. Correlation analysis was performed between the amino acid profiles
(Fischer's ratio, branched-chain amino acid to tyrosine ratio [BTR]) and the key indicators of liver function in patients
with HBV infection. Fisher's ratio and the BTR of patients with HBV infection was found to differ from that of the healthy
controls, and was also found to significantly correlate with the stage of HBV infection. Changes in the BTR were closely related
to the level of key indicators of liver function, and a significant relationship was detected between the Fischer's ratio
and the BTR (r?=?0.928, p?<?0.001). These results suggest that Fischer's ratio and the BTR can indirectly reflect the degree of liver cell injury.
Determining and tracking the plasma amino acid profiles could, therefore, be used for the diagnosis, treatment selection,
and prognosis of patients with varying stages of HBV infection.
Content Type: Journal ArticleCategory ArticlePages 1-8DOI 10.1007/s10096-011-1538-x
Authors
J. Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, People's Republic of ChinaJ. He, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, People's Republic of ChinaH. Cao, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, People's Republic of ChinaX. Zhao, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, People's Republic of ChinaS. Fu, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, People's Republic of ChinaH. Lu, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, People's Republic of ChinaY. Chen, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, People's Republic of ChinaX. Pan, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, People's Republic of ChinaL. Li, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, People's Republic of China
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Data from three different data sources were compiled to estimate the presence of Coxiella burnetii in the Belgian Limburg province for both humans and livestock. First, serological data of all samples sent to the Belgian
reference centre (2003 – 2010) for human Q fever were analysed, showing evidence for an acute Q fever infection in 1 – 5% of the
cases. Second, a multi-centre prospective survey was conducted in Limburg in 2010 to detect undiagnosed human cases; evidence
for a recent infection with Coxiella burnetii was found in three out of 100 patients from which clinicians suspected a Mycoplasma pneumoniae infection. Third, we analyzed data from the Belgian livestock screening program (2009 – 2010) which consisted of investigating
all reported abortions, sampling tank milk, and serological screening of cattle. The results suggest an endemicity in the
Limburgian livestock which seems to be especially high in cattle.
Content Type: Journal ArticleCategory ArticlePages 1-3DOI 10.1007/s10096-011-1539-9
Authors
R. Naesens, Jessa Hospital, Hasselt, BelgiumK. Magerman, Jessa Hospital, Hasselt, BelgiumI. Gyssens, Jessa Hospital, Hasselt, BelgiumA. Leenders, Jeroen Bosch Hospital, 's-Hertogenbosch, The NetherlandsJ. Meekelenkamp, Jeroen Bosch Hospital, 's-Hertogenbosch, The NetherlandsM. Van Esbroeck, Institute of Tropical Medicine, Antwerp, BelgiumG. Coppens, Hospital Oost-Limburg, Genk, BelgiumE. Oris, Hospital Oost-Limburg, Genk, BelgiumJ. Craeghs, Vesalius Hospital, Tongeren, BelgiumI. Thoelen, Vesalius Hospital, Tongeren, BelgiumP. Gabriëls, Sint Trudo Hospital, Sint-Truiden, BelgiumM. Vandevelde, Hospital Maas en Kempen, Maaseik-Bree, BelgiumA.-M. Forier, Flemish Agency for Care and Health, Hasselt, BelgiumL. Waumans, Jessa Hospital, Hasselt, BelgiumR. Cartuyvels, Jessa Hospital, Hasselt, Belgium
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Staphylococcal superantigens (SAg) could play an important role in sepsis by activating numerous T cells. We investigated
whether serum capacity to neutralize SAgs can be a prognostic factor in Staphylococcus aureus bacteremia (SAB). In a university hospital, 105 consecutive SAB patients were enrolled during a 12-month period. The earliest
serum samples prior to SAB onset were stored for a later T cell proliferation assay. Multiplex polymerase chain reaction (PCR)
for 19 SAg genes was performed for S. aureus blood isolates. To determine the serum capacity to neutralize SAgs, T cell proliferation by the culture supernatant of each
S. aureus isolate was measured in the presence and absence of the corresponding patient's serum. Twenty-six (24.8%) patients died within
4 weeks from SAB onset. Vascular catheter-related infection was associated with survival for =4 weeks. Unknown primary focus,
Simplified Acute Physiology Score-II (SAPS-II), and specific SAg genes (tst, sec, sel, or sep) were associated with the 4-week mortality. No variables related to T cell proliferation assay showed statistical significance.
In the multivariate analysis, SAPS-II =33 and tst were independently associated with the 4-week mortality. Serum capacity to neutralize SAg does not significantly affect SAB
outcome. SAPS-II =33 and tst are independent predictors of the 4-week mortality.
Content Type: Journal ArticleCategory ArticlePages 1-8DOI 10.1007/s10096-011-1541-2
Authors
J. Yi, Department of Laboratory Medicine, Pusan National University School of Medicine, Yangsan, KoreaJ. S. Park, Department of Laboratory Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 KoreaK.-H. Hong, Department of Laboratory Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 KoreaS.-H. Lee, Clinical Research Institute, Seoul National University Hospital, Seoul, KoreaE.-C. Kim, Department of Laboratory Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Korea
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract This study was focussed on identifying a cost-effective method for delimitation, monitoring and evaluation in bancroftian
filariasis. Finger prick blood samples were collected between 20.00 and 23.00 hours for the detection of microfilariae (mf)
from the available population in a village which was endemic for lymphatic filariasis. Simultaneously, from each individual,
four spots of 25-µl blood samples were collected on Whatman number 3 filter paper and air dried. Dried filter paper spots
were pooled in quantities of 1, 5, 10, 15, 20 and 25 on unknown and simulated mf and antigen prevalence. Pooled samples were
assayed for circulating filarial antigen (CFA) using TropBIO Og4C3 ELISA kits. The community mf and CFA rates were 3.4% and
25.9%, respectively. The pool sizes of 20 and 25 showed CFA positivity in all the above categories tested. The results of
the pooled blood spot samples suggest that, in areas with mf and CFA prevalence rates between 1 and 10%, pools of 20 or 25
could be considered as the ideal pool size for the detection of filarial infection in the community. CFA prevalence at the
level of 5 – 6% following desirable rounds of mass drug administration (MDA) indicates that the community mf prevalence is likely
to be at the 1% level.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-011-1542-1
Authors
L. K. Das, Vector Control Research Centre (VCRC), Indian Council of Medical Research (ICMR), Pondicherry, IndiaS. P. Pani, Vector Control Research Centre (VCRC), Indian Council of Medical Research (ICMR), Pondicherry, IndiaP. Vanamail, Vector Control Research Centre (VCRC), Indian Council of Medical Research (ICMR), Pondicherry, IndiaG. Vijayalakshmi, Vector Control Research Centre (VCRC), Indian Council of Medical Research (ICMR), Pondicherry, IndiaL. J. DeBritto, Vector Control Research Centre (VCRC), Indian Council of Medical Research (ICMR), Pondicherry, India
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Activated mast cells have been demonstrated to play a pivotal role in Pseudomonas aeruginosa lung infections. However, there is no report about the involvement of mast cells in P. aeruginosa lipopolysaccharide (LPS)-induced lung inflammation. This study aimed at evaluating the role of mast cells in P. aeruginosa LPS-induced lung inflammation in rats. Mast cells stabilization was carried out by intraperitoneal injections of cromolyn.
Lung inflammation was induced by the intratracheal instillation of P. aeruginosa LPS (5 µg/kg bw) and inflammatory status was evaluated 4 h post-LPS instillation. We found that activated mast cells could
constitute a pivotal source of several inflammatory cytokines, including TNF-a, IL-1ß, and IL-6. These cells might regulate
polymorphonuclear neutrophil (PMN) recruitment and be implicated in the alteration of alveolar – capillary permeability via
the release of TNF-a and IL-1ß. We also detected that activated mast cells could be involved in the alteration of the expression
of two epithelial tight junction proteins (claudin-1 and occludin) during the acute phase of inflammation. Our results suggest
that activated mast cells might play a critical role in P. aeruginosa LPS-induced lung inflammation. Therefore, mast cell stabilization may be a potential novel approach for the prevention and
treatment of P. aeruginosa-induced lung infections.
Content Type: Journal ArticleCategory ArticlePages 1-8DOI 10.1007/s10096-011-1530-5
Authors
B. V. Lê, Peritox Laboratory, EA4285-UMI 01, Faculty of Medicine, Picardy Jules Verne University, 3 rue des Louvels, 80036 Amiens, FranceH. Khorsi-Cauet, Peritox Laboratory, EA4285-UMI 01, Faculty of Medicine, Picardy Jules Verne University, 3 rue des Louvels, 80036 Amiens, FranceV. Bach, Peritox Laboratory, EA4285-UMI 01, Faculty of Medicine, Picardy Jules Verne University, 3 rue des Louvels, 80036 Amiens, FranceJ. Gay-Quéheillard, Peritox Laboratory, EA4285-UMI 01, Faculty of Medicine, Picardy Jules Verne University, 3 rue des Louvels, 80036 Amiens, France
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The identification of Pseudomonas stutzeri clinical isolates through conventional phenotypic methods was compared with identification through partial rpoD gene sequencing. We observed that commercial phenotypic systems easily confuse P. stutzeri with other Pseudomonas species. We also demonstrated that most of the clinical strains of P. stutzeri herein studied (79%) belonged to genomovar 1 of the species. We propose the use of partial rpoD gene sequence analysis as a complementary molecular tool for the precise routine identification and genomovar assignation
of P. stutzeri clinical isolates, as well as for typing and epidemiological studies.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-012-1547-4
Authors
C. Scotta, Microbiología, Departamento de Biología, Universidad de las Islas Baleares, 07122 Palma de Mallorca, Islas Baleares, EspañaM. Mulet, Microbiología, Departamento de Biología, Universidad de las Islas Baleares, 07122 Palma de Mallorca, Islas Baleares, EspañaD. Sánchez, Microbiología, Departamento de Biología, Universidad de las Islas Baleares, 07122 Palma de Mallorca, Islas Baleares, EspañaM. Gomila, Unidad de Investigación — Microbiología, Fundación Hospital Son Llàtzer, 07198 Palma de Mallorca, Islas Baleares, EspañaA. Ramírez, Servicio de Microbiología, Hospital Universitario Son Espases, 07010 Palma de Mallorca, Islas Baleares, EspañaA. Bennasar, Microbiología, Departamento de Biología, Universidad de las Islas Baleares, 07122 Palma de Mallorca, Islas Baleares, EspañaE. García-Valdés, Microbiología, Departamento de Biología, Universidad de las Islas Baleares, 07122 Palma de Mallorca, Islas Baleares, EspañaB. Holmes, National Collection of Type Cultures (NCTC), Health Protection Agency, Microbiology Services, London, NW9 5EQ UKJ. Lalucat, Microbiología, Departamento de Biología, Universidad de las Islas Baleares, 07122 Palma de Mallorca, Islas Baleares, España
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract To determine the profiles of susceptibility to antifungal and the genotypes of clinical isolates of Cryptococcus in Bahia, Brazil, 62 isolates were collected from cases of meningitis in the period from 2006 to 2010. Their susceptibilities
to fluconazole, itraconazole, amphotericin B and 5-flucytosine were determined by the broth microdilution technique described
by the Clinical and Laboratory Standards Institute and genotyping of the URA5 gene was accomplished by restriction fragment length polymorphism. C. neoformans accounted for 79% of the identified yeast and C. gattii represented the remaining 21%. Evaluation of the genotypes determined that 100% of the C. gattii isolates belong to the VGII genotype, and 98% of the C. neoformans isolates belong to the VNI genotype. Determination of susceptibility revealed isolates resistant to fluconazole (4.8%), 5-flucytosine
(1.6%) and amphotericin B (3.2%); the stratification of sensitivity results for each species showed significant differences
in susceptibility to azoles. This study is the first to describe the susceptibility profiles of molecular and clinical isolates
of Cryptococcus in Bahia, Brazil. The high percentage of C. gattii isolates belonging to the VGII genotype and its lower susceptibility to antifungal agents highlight the importance of knowing
which species are involved in cryptococcal infections in northeastern Brazil.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-011-1488-3
Authors
C. S. Matos, Graduate Program in Pharmacy, Faculty of Pharmacy, UFBA, Salvador, BrazilA. de Souza Andrade, Program for Scientific Initiation, Faculty of Pharmacy, UFBA, Salvador, BrazilN. S. Oliveira, Couto Maia Specialized Hospital, Salvador, BrazilT. F. Barros, Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, UFBA, Salvador, Brazil
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Epidemics of hand, foot, and mouth disease (HFMD) have been emerging and reemerging in recent years. This study aims to investigate
whether breastfeeding and other factors may affect the profile of fever and disease course in children with HFMD. Three hundred
seventy-two preschool children with HFMD were included. The demographics, environmental factors, and delivery- and feeding-associated
factors in the children were obtained and their effects on the profile of fever and disease course were analyzed. Of the 372
children, 139 (37.37%) had fever during the disease course. Gender, breastfeeding pattern, birth season and gestational age
were significantly different between the children with and without fever (p?=?0.034, p?<?0.0001, p?=?0.035 and p?=?0.013, respectively). After multivariate-adjusted analysis, prolonged exclusive breastfeeding (p?=?0.001, OR 0.401, 95% CI 0.229 – 0.704), autumn birth (p?=?0.007, OR 0.409, 95% CI 0.214 – 0.784) and higher gestational age (p?=?0.029, OR 0.089, 95% CI 0.010 – 0.781) were protective factors for the incidence of fever.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-012-1555-4
Authors
Q. Zhu, Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061 Shaanxi Province, ChinaY. Li, Department of Infectious Diseases, Central Hospital of Shangluo City, Shangluo, 726000 Shaanxi, ChinaN. Li, Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061 Shaanxi Province, ChinaQ. Han, Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061 Shaanxi Province, ChinaZ. Liu, Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061 Shaanxi Province, ChinaZ. Li, Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061 Shaanxi Province, ChinaJ. Qiu, Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, KS, USAG. Zhang, Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061 Shaanxi Province, ChinaF. Li, Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061 Shaanxi Province, ChinaN. Tian, Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061 Shaanxi Province, China
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The detection of Legionella pneumophila DNA in clinical specimens using quantitative real-time polymerase chain reaction (qPCR) combined with direct sequence-based
typing (SBT) offers rapid confirmation and timely intervention in the investigation of cases of Legionnaires' disease (LD).
We assessed the utility of a specific L. pneumophila qPCR assay targeting the macrophage infectivity potentiator (mip) gene and internal process control with three clinical specimen types from confirmed LD cases. The assay was completely specific
for L. pneumophila, as demonstrated by positive results for 39/39 strains from all subspecies and 16 serogroups. No cross-reaction was observed
with any of the 54 Legionella non-pneumophila (0/69 strains) or 21 non-Legionella (0/58 strains). All L. pneumophila culture-positive respiratory samples (81/81) were qPCR-positive. Of 80 culture-negative samples tested, 47 (58.8%) were qPCR-positive
and none were inhibitory. PCR was significantly more sensitive than culture for samples taken =2 days of hospitalisation (94.7%
vs. 79.6%), with the difference being even more marked for samples taken between 3 and 14 days (79.3% vs. 47.8%). Overall,
the sensitivity of the qPCR was ~30% greater than that of culture and direct typing on culture-negative PCR-positive samples
resulted in full 7-allele profiles from 23/46, 5 to 6 alleles from 8/46 and =1 allele from 43/46 strains.
Content Type: Journal ArticleCategory ArticlePages 1-12DOI 10.1007/s10096-011-1535-0
Authors
M. Mentasti, Respiratory and Systemic Infection Laboratory, Microbiological Services Division, Health Protection Agency, 61 Colindale Avenue, London, NW9 5EQ UKN. K. Fry, Respiratory and Systemic Infection Laboratory, Microbiological Services Division, Health Protection Agency, 61 Colindale Avenue, London, NW9 5EQ UKB. Afshar, Respiratory and Systemic Infection Laboratory, Microbiological Services Division, Health Protection Agency, 61 Colindale Avenue, London, NW9 5EQ UKC. Palepou-Foxley, Respiratory and Systemic Infection Laboratory, Microbiological Services Division, Health Protection Agency, 61 Colindale Avenue, London, NW9 5EQ UKF. C. Naik, Respiratory Diseases Department, Health Protection Services, Health Protection Agency, 61 Colindale Avenue, London, NW9 5EQ UKT. G. Harrison, Respiratory and Systemic Infection Laboratory, Microbiological Services Division, Health Protection Agency, 61 Colindale Avenue, London, NW9 5EQ UK
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Four phenotypic methods (three dimensional test, AmpC test, cloxacillin synergy test and cefotetan/cefotetan-cloxacillin E-test)
to detect plasmid-mediated AmpC ß-lactamases (pAmpC) were compared in 125 clinical Enterobacteriaceae isolates with AmpC profile: 74 E. coli (bla
CMY-2: 70; bla
DHA-1: 4), five K. pneumoniae (bla
CMY-2: 2; bla
DHA-1: 3), six P. mirabilis (bla
CMY-2: 6) and 40 negative isolates for pAmpC ß-lactamases. All evaluated methods showed a good sensitivity (>95%) but low values
of specificity (<60%) in E. coli, explained by an increase of AmpC expression caused by chromosomal ampC promoter/attenuator mutations (-42, -18, -1, +58, predominantly). The cefotetan/cefotetan-cloxacillin or cloxacillin synergy
test may be advocated as phenotypic screening test, and the AmpC test as confirmatory test for detection of pAmpC in isolates
that lack or minimally express chromosomally encoded AmpC ß-lactamases. In the case of E. coli, the phenotypic evaluated tests were not able to differentiate between chromosomal ampC overexpression or acquisition of plasmid-encoded ampC genes.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-011-1537-y
Authors
M. J. Gude, Departamento de Microbiología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, SpainC. Seral, Departamento de Microbiología, Hospital Clínico Universitario Lozano Blesa and Universidad de Zaragoza, Zaragoza, SpainY. Sáenz, Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, SpainM. González-Domínguez, Departamento de Microbiología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, SpainC. Torres, Área de Bioquímica y Biología Molecular and Área de Microbiología Molecular, Universidad de La Rioja and Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, SpainF. J. Castillo, Departamento de Microbiología, Hospital Clínico Universitario Lozano Blesa and Universidad de Zaragoza, Zaragoza, Spain
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract A new automated closed tube PCR assay, the GenomEra™ MRSA/SA Diagnose (Abacus Diagnostica Oy, Finland) was evaluated for rapid confirmation of methicillin-resistant Staphylococcus aureus (MRSA) from cultured screening specimens. The ability of the assay to detect genotypically different MRSA strains was studied
with a collection of 304 MRSA isolates covering 68 spa types. The specificity was investigated with a collection of 146 non-MRSA staphylococcus isolates. The usefulness of the
assay for clinical purposes was assessed by a sequential combination of MRSA screening culture and confirmation of the colonies
with the GenomEra MRSA/SA Diagnose assay. A total of 145 suspected MRSA colonies on chromogenic plates were analyzed this
way. All MRSA isolates from the culture collection and from the clinical screening specimens were confirmed as MRSA with the
GenomEra MRSA/SA Diagnose assay and none of the non-MRSA staphylococci caused false-positive results, which indicates both
sensitivity and specificity of 100%. The combination of GenomEra MRSA/SA Diagnose with preceding culture on selective MRSA
agar permitted MRSA confirmation within 24 h. This practice offers a reliable and quick detection of MRSA that is also suitable
in areas where several strain types cause epidemics.
Content Type: Journal ArticleCategory ArticlePages 1-8DOI 10.1007/s10096-011-1527-0
Authors
J. J. Hirvonen, Department of Clinical Microbiology, Vaasa Central Hospital, Hietalahdenkatu 2-4 B2, 65130 Vaasa, FinlandM. Nevalainen, Fimlab Laboratories, Pirkanmaa Hospital District, Biokatu 4, 33520 Tampere, FinlandP. Tissari, Division of Clinical Microbiology, HUSLAB, Helsinki University Hospital, Haartmaninkatu 3, 00029 Helsinki, FinlandS. Salmenlinna, Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare (THL), Mannerheimintie 166, P.O. Box 30, 00270 Helsinki, FinlandK. Rantakokko-Jalava, Clinical Microbiology Laboratory, Turku University Hospital, Kiinamyllynkatu 4 – 8, 20521 Turku, FinlandS.-S. Kaukoranta, Department of Clinical Microbiology, Vaasa Central Hospital, Hietalahdenkatu 2-4 B2, 65130 Vaasa, Finland
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Chronic non-healing wounds are a major health problem with resident bacteria strongly implicated in their impaired healing.
A rapid-screen to provide detailed knowledge of wound bacterial populations would therefore be of value and help prevent unnecessary
and indiscriminate use of antibiotics — a process associated with promoting antibiotic resistance. We analysed chronic wound
fluid samples, which had been assessed for microbial content, using 20 different fluorescent labelled peptide substrates to
determine whether protease activity correlated with the bacterial load. Eight of the peptide substrates showed significant
release of fluorescence after reaction with some of the wound samples. Comparison of wound fluid protease activities with
the microbiological data indicated that there was no correlation between bacterial counts and enzyme activity for most of
the substrates tested. However, two of the peptide substrates produced a signal corresponding with the microbial data revealing
a strong positive correlation with Pseudomonas aeruginosa numbers. This demonstrated that short fluorescent labelled peptides can be used to detect protease activity in chronic wound
fluid samples. The finding that two peptides were specific indicators for the presence of P. aeruginosa may be the basis for a diagnostic test to determine wound colonisation by this organism.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-012-1553-6
Authors
D. Wildeboer, Pharmaceutical Science Division, Analytical Sciences Research Group, School of Biomedical & Health Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH UKK. E. Hill, School of Dentistry, Tissue Engineering & Reparative Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY UKF. Jeganathan, Pharmaceutical Science Division, Analytical Sciences Research Group, School of Biomedical & Health Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH UKD. W. Williams, School of Dentistry, Tissue Engineering & Reparative Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY UKA. D. Riddell, School of Dentistry, Tissue Engineering & Reparative Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY UKP. E. Price, School of Medicine, Department of Wound Healing, Cardiff University, Heath Park, Cardiff, CF14 4XN, UKD. W. Thomas, School of Dentistry, Tissue Engineering & Reparative Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY UKP. Stephens, School of Dentistry, Tissue Engineering & Reparative Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY UKR. A. Abuknesha, Pharmaceutical Science Division, Analytical Sciences Research Group, School of Biomedical & Health Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH UKR. G. Price, Pharmaceutical Science Division, Analytical Sciences Research Group, School of Biomedical & Health Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH UK
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The objective of this prospective surveillance study was to quantify colonization with antimicrobial-resistant organisms (AROs)
and infections attributable to indwelling devices in skilled nursing facility (SNF) residents. The study was conducted in
15 SNFs in Southeast Michigan. Residents with (n?=?90) and without (n?=?88) an indwelling device were enrolled and followed for 907 resident-months. Residents were cultured monthly from multiple
anatomic sites and data on infections were obtained. The device-attributable rate was calculated by subtracting the infection
rate in the device group from the infection rate in the non-device group. A total of 197 new infections occurred during the
study period; 87 in the device group (incidence rate [IR]?=?331/1,000 resident-months) and 110 infections in the non-device
group (IR?=?171/1,000 resident-months), with a relative risk of 1.9 (95% confidence interval [CI]: 1.4 – 2.6). The attributable
rate of excess infections among residents in the device group was 160/1,000 resident-months, with an attributable fraction
of 48% (95% CI: 31 – 61%). Prevalence rates for all AROs were higher in the device group compared with the no-device group.
The prevalence of the number of AROs per 1,000 residents cultured increased from no-device to those with only feeding tubes,
followed by those with only urinary catheters and both these devices. In conclusion, the presence of indwelling devices is
associated with higher incidence rates for infections and prevalence rates for AROs. Our study quantifies this risk and shows
that approximately half of all infections in SNF residents with indwelling devices can be eliminated with device removal.
Effective strategies to reduce infections and AROs in these residents are warranted.
Content Type: Journal ArticleCategory ArticlePages 1-8DOI 10.1007/s10096-011-1504-7
Authors
L. Wang, Division of Geriatric Medicine, University of Michigan Medical School, Ann Arbor, MI, USAB. Lansing, Division of Geriatric Medicine, University of Michigan Medical School, Ann Arbor, MI, USAK. Symons, Infectious Diseases Section, University of Michigan School of Public Health, Ann Arbor, MI, USAE. L. Flannery, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USAJ. Fisch, Division of Geriatric Medicine, University of Michigan Medical School, Ann Arbor, MI, USAK. Cherian, Division of Geriatric Medicine, University of Michigan Medical School, Ann Arbor, MI, USAS. E. McNamara, Division of Geriatric Medicine, University of Michigan Medical School, Ann Arbor, MI, USAL. Mody, Division of Geriatric Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Extended spectrum beta-lactamase producing E. coli (ESBL-EC) are an emerging public health issue. In New Zealand (NZ), bla
CTX-M-14 and bla
CTX-M-15 are the most common ESBL genes. Although many studies describe risk factors for ESBL-EC, few describe risk factors for specific
ESBL genes. Between January 2006 and December 2007, we characterized 108 consecutive, non-duplicate isolates of ESBL-EC at
the Auckland Hospital laboratory. Demographic and clinical data were recorded. Of the 108, 54.6% (59) were CTX-M-15-EC, 26.9%
(29) were CTX-M-14-EC and 12.09% were CTX-M-9 (13). The remaining seven isolates carried CTX-M-3 (3; 2.7%), CTX-M-65 (2; 1.8%),
CTX-M-27 (1; 0.9%) and CTX-M-57 (1; 0.9%). CTX-M-15-EC were more likely than CTX-M-14-EC to be fluoroquinolone-resistant (86.4%
versus 32.4%; p?=?0.006) and to be non-susceptible to amoxicillin-clavulanate (84.7% versus 41.4%; p?=?0.0001). Patients with CTX-M-15-EC were more likely to be of Indian ethnicity (34.5% versus 0%; p?=?0.0012) and to have travelled recently (31.6% versus 4%; p?=?0.0088). Patients with CTX-M-14-EC were more likely to have Chinese or South-East Asian ethnicity (48.1% versus 5.2%; p?<?0.0001) and to have no history of either travel or prior hospital admission (44% versus 8.9%; p?=?0.0006). These data imply that CTX-M-15 and CTX-M-14 producing E. coli are associated with distinct demographic subgroups in NZ.
Content Type: Journal ArticleCategory ArticlePages 1-4DOI 10.1007/s10096-011-1540-3
Authors
J. T. Freeman, Department of Clinical Microbiology, Auckland City Hospital, Auckland District Health Board, Auckland, New ZealandD. A. Williamson, Department of Clinical Microbiology, Auckland City Hospital, Auckland District Health Board, Auckland, New ZealandH. Heffernan, Institute of Environmental Science and Research, Porirua, Wellington, New ZealandM. Smith, Department of Clinical Microbiology, Auckland City Hospital, Auckland District Health Board, Auckland, New ZealandJ. E. Bower, Department of Clinical Microbiology, Auckland City Hospital, Auckland District Health Board, Auckland, New ZealandS. A. Roberts, Department of Clinical Microbiology, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Carbapenemase-producing Klebsiella pneumoniae has recently spread rapidly throughout China. In this study, we characterized a carbapenem-resistant K. pneumoniae isolate that produced both KPC-2 and IMP-4 type carbapenemases. A clinical isolate of K. pneumoniae, resistant to both meropenem and imipenem, was recovered from a urine sample. Antibiotic susceptibility was determined using
the broth microdilution method and Etest (bioMérieux, France). Pulsed-field gel electrophoresis and multilocus sequence typing
(MLST) were used for gene type analysis. bla
KPC and the encoding genes of ESBLs and plasmid-mediated AmpC enzymes were polymerase chain reaction (PCR) amplified and sequenced.
Plasmids were analyzed by transformation, enzyme restriction and Southern blot. PCR analysis revealed that the isolate was
simultaneously carrying bla
KPC-2, bla
IMP-4, bla
TEM-1, and bla
OKP-B genes. MLST assigned the isolate to a novel sequence type, ST476. bla
KPC-2-harbouring plasmids of the isolate and comparative strains had similar EcoRI and HindIII restriction maps, while IMP-4-harbouring
plasmids had variable HindIII restriction maps. Coexistence of bla
KPC-2 and bla
IMP-4 was probably due to bla
IMP-4-harbouring plasmid transmission into KPC-2-producing K. pneumoniae (ST476). The concomitant presence of these genes is alarming and poses both therapeutic and infection control problems.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-011-1512-7
Authors
Y. Wang, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaW. Cao, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaX. Zhu, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaZ. Chen, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaL. Li, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaB. Zhang, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaB. Wang, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaL. Tian, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaF. Wang, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaC. Liu, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of ChinaZ. Sun, Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Immunochromatographic (IC) tests may play an important role in the future diagnosis of parasitic diseases because of their
speed and simplicity of use. A recently developed test to detect Cryptosporidium spp, Giardia duodenalis and Entamoeba histolytica was evaluated. Microscopy and PCR were the 'gold standard' reference techniques and the results of this IC test were compared
with those obtained with ELISA and IC single test for the three parasites. One hundred sixty stool samples were assayed. Using
microscopy, 22 samples were diagnosed as positive for Cryptosporidium spp., 31 for Giardia duodenalis, 41 for Entamoeba histolytica/dispar, and 68 had a negative diagnosis for the three parasites. Results of IC tests show sensitivities of 70 – 72% for Cryptosporidium, 90 – 97% for Giardia and 62.5% for Entamoeba histolytica. Specificities were of 93.6 – 94.9%, >99% and 96.1%, respectively. In all diagnoses, agreement with microscopy and PCR was
over 90%, except in the triple test and microscopy in E. histolytica detection that was 76.3%, due to the inability of microscopy to differentiate E. histolytica from nonpathogenic species such as E. dispar or E. moshkovskii. The triple stool immunoassays provide adequate sensitivities and specificities for use in outbreak situations, for screening
proposals and for massive assays in endemic areas where a large number of samples must be analysed or as complementary test
for individual diagnosis.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-012-1544-7
Authors
P. Goñi, Area of Parasitology, Department of Microbiology, Preventive Medicine and Public Health, Faculty of Medicine, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, SpainB. Martín, Operon S.A., Camino del Plano, 19, 50410 Cuarte de Huerva, Zaragoza, SpainM. Villacampa, Operon S.A., Camino del Plano, 19, 50410 Cuarte de Huerva, Zaragoza, SpainA. García, Area of Parasitology, Department of Microbiology, Preventive Medicine and Public Health, Faculty of Medicine, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, SpainC. Seral, Area of Microbiology, Department of Microbiology, Preventive Medicine and Public Health, Faculty of Medicine, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, SpainF. J. Castillo, Area of Microbiology, Department of Microbiology, Preventive Medicine and Public Health, Faculty of Medicine, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, SpainA. Clavel, Area of Parasitology, Department of Microbiology, Preventive Medicine and Public Health, Faculty of Medicine, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The aim of this study was to analyze serum changes in mediators of fibrogenesis and in non-invasive markers of liver fibrosis
among HIV/HCV-coinfected patients starting maraviroc (MVC)-based antiretroviral therapy. Patients included in this prospective
pilot study met the following criteria: (1) HIV-infection, (2) detectable serum HCV-RNA, and ((3) started MVC. Transforming
growth factor-ß1 (TGF-beta1), matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1)
were measured in serum samples at baseline and 6 months after starting MVC. AST-to-platelet ratio index (APRI) was assessed
at the same time points. Twenty-four patients were analyzed. Median (IQR) serum levels at baseline and after 6 months on MVC
of TGF-beta1 were 27,295 (20,562 – 36,844) and 33,753 (18,973 – 46,130) pg/mL (p?=?0.116), of MMP-2 were 216 (186 – 274) and 241 (194 – 306) ng/mL (p?=?0.247), and of TIMP-1 were 237 (170 – 284) and 216 (171 – 271) ng/mL (p?=?0.415). APRI levels were 0.99 (0.53 – 3.46) at baseline and 0.83 (0.48 – 2.34) at 6 months (p?=?0.16). Serum mediators of liver fibrogenesis and fibrosis do not change significantly in HIV/HCV-coinfected patients in
the short-term after starting MVC. As TGF-beta1 levels have been shown to increase over time in HCV infection and liver fibrosis
worsens rapidly in HIV/HCV coinfection, these parameters seem to evolve in a different way in MVC-treated patients.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-012-1546-5
Authors
J. Macías, Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. Bellavista s/n., 41014 Seville, SpainM. M. Viloria, Servicio de Bioquímica, Hospital Universitario de Valme, Seville, SpainA. Rivero, Unidad de Enfermedades Infecciosas, Hospital Universitario de Reina Sofía, Cordoba, SpainI. de los Santos, Unidad de Enfermedades Infecciosas, Hospital Universitario la Princesa, Madrid, SpainM. Márquez, Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de la Victoria, Malaga, SpainJ. Portilla, Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, SpainF. Di Lello, Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. Bellavista s/n., 41014 Seville, SpainA. Camacho, Unidad de Enfermedades Infecciosas, Hospital Universitario de Reina Sofía, Cordoba, SpainJ. Sanz-Sanz, Unidad de Enfermedades Infecciosas, Hospital Universitario la Princesa, Madrid, SpainG. Ojeda, Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de la Victoria, Malaga, SpainR. Mata, Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. Bellavista s/n., 41014 Seville, SpainJ. Gómez-Mateos, Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. Bellavista s/n., 41014 Seville, SpainJ. A. Pineda, Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Avda. Bellavista s/n., 41014 Seville, Spainon behalf of the FIBROCEL study group
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Chagas disease (CD) is an emergent disease in Europe that can behave as an opportunistic infection in HIV positive patients.
The objective of this study was to evaluate the implementation of a CD screening programme in an HIV unit. An immunochromatography
(ICT) of Trypanosoma cruzi was performed as a screening tool in HIV-positive patients born in CD endemic countries. ELISA and IFAT were used to confirm
the diagnosis. A total of 155 patients, 116 males and 38 females, were included. Mean age was 36.9 years (±8.4) and mean length
of stay in Spain at the screening was 7.1 years (±4.7). T. cruzi ICT was positive in four cases (2.6%), being confirmed (by ELISA and IFAT) in three of those (1.9%). Factors associated with
confirmed positive T.cruzi serology were: Bolivia origin (p?=?0.016), Bolivia or Argentina origin (p?=?0.002), Southern Cone origin (p?=?0.015), rural origin (p?=?0.023), previously living in an adobe-made (p?=?0.001) or thatch-roofed house (p?<?0.0001), having a previous CD test (p?=?0.015), previous knowledge about CD (p?=?0.019), about vector (p?=?0.009) or recorded seeing vectors at home (p?=?0.012). Units dealing with HIV patients from endemic areas of American trypanosomiasis should implement CD screening protocols.
Interviews of patients coming from endemic areas should include CD epidemiological questions.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-011-1531-4
Authors
J. Llenas-García, HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, SpainA. Hernando, Medical Specialties Department, European University of Madrid, Villaviciosa de Odón, Madrid, SpainS. Fiorante, HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, SpainD. Maseda, HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, SpainM. Matarranz, HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, SpainE. Salto, Microbiology Department, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, SpainR. Rubio, HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, SpainF. Pulido, HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid, Madrid, Spain
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract
Staphylococcus aureus is a leading cause of surgical site infections (SSIs). The association between S. aureus genotypes and the severity of illness is, however, incompletely understood. The aim of the study was to genotype S. aureus isolates from deep SSI in orthopaedic patients to identify molecular markers associated with invasive S. aureus infections. DNA microarray analysis was performed on S. aureus isolates collected from 60 patients with deep SSI following major orthopaedic surgery, while 57 isolates from nasal carriers
served as controls. Genes associated with antibiotic resistance, adhesion, immune evasion, tissue invasion and toxin production
were detected. The bone sialoprotein-binding protein gene (bbp) was more frequent in isolates from SSI patients compared to nasal carriers (95.0% vs. 82.5%), suggesting a role in invasive
disease. No major differences in other molecular virulence markers could be distinguished among isolates from the two clinical
groups, suggesting that any S. aureus strain may cause invasive infection. Our study reveals important genotypic information on isolates obtained from deep SSI
following orthopaedic procedures.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-011-1532-3
Authors
H. V. Aamot, Department of Clinical Molecular Biology and Laboratory Sciences (EpiGen), Akershus University Hospital, 1478 Lørenskog, NorwayA. Blomfeldt, Department of Clinical Molecular Biology and Laboratory Sciences (EpiGen), Akershus University Hospital, 1478 Lørenskog, NorwayI. Skråmm, Department of Orthopaedics, Akershus University Hospital, Lørenskog, NorwayF. Müller, Department of Microbiology, University of Oslo and Oslo University Hospital, Rikshospitalet, Oslo, NorwayS. Monecke, Institute for Medical Microbiology and Hygiene, Medical Faculty Carl Gustav Carus, Dresden, Germany
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract This study was conducted in order to characterize carbapenem-nonsusceptible Klebsiella pneumoniae isolates and to evaluate the impacts of recently lowered interpretative breakpoints for carbapenems for Enterobacteriaceae. Among 152?K. pneumoniae bloodstream isolates suspected as AmpC or extended-spectrum ß-lactamase (ESBL) producers, 58 (38.2%) isolates were currently
interpreted as nonsusceptible to ertapenem, imipenem, or meropenem, and 42 (72.4%) of them were categorized as carbapenem-susceptible
by the previous criteria. The high revision rate was associated with the predominance (79.3%) of DHA-1 among the carbapenem-nonsusceptible
isolates due to both polyclonal and clonal spread. ESBLs were common (~57%) in both ertapenem-susceptible and -nonsusceptible
isolates; however, 84.8% of the carbapenem-nonsusceptible isolates were also AmpC producers. The IMP-8 metallo-ß-lactamase
was detected in three isolates. Polyacrylamide gel electrophoresis suggested decreased OmpK35 expression in all but one ertapenem-nonsusceptible
isolate, and genetic disruptions of ompK35 and ompK36 were detected in 30 and six ertapenem-nonsusceptible isolates, respectively. A comparison between patients infected by AmpC-
or ESBL-producing ertapenem-susceptible (n?=?62) isolates and those with isolates revised as ertapenem-nonsusceptible (n?=?41) revealed more cases of malignancies (36.6% versus 14.5%; p?=?0.01) and higher Charlson score (p?=?0.033) among the patients with ertapenem-nonsusceptible isolates; however, the acquisition of an isolate revised as carbapenem-nonsusceptible
was not identified as an independent mortality risk factor.
Content Type: Journal ArticleCategory ArticlePages 1-10DOI 10.1007/s10096-011-1525-2
Authors
N. Y. Lee, Department of Internal Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan, 70428 TaiwanJ. J. Wu, Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 70101 TaiwanS. H. Lin, Research Center of Clinical Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan, 70428 TaiwanW. C. Ko, Department of Internal Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan, 70428 TaiwanL. H. Tsai, Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan, 70101 TaiwanJ. J. Yan, Department of Pathology, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan, 70428 Taiwan
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged during recent years in several intensive care units. The objective of our study was to determine the incidence
of CRKP and the risk factors associated with acquisition during intensive care unit (ICU) stay. This prospective cohort study
was conducted between May 2007 and April 2008 in a medical-surgical ICU at a tertiary medical center. Rectal surveillance
cultures were obtained from patients on admission and twice weekly. Of screened patients, 7.0% (21/299) were CRKP colonized
on admission to the ICU. One hundred eighty (81%) patients were screened at least twice. Of these, 48 (27%) patients acquired
CRKP during ICU stay. Of the 69 CRKP colonized patients (both imported and ICU acquired), 29% (20/69) were first identified
by microbiologic cultures, while screening cultures identified 49 patients (71%). Of these, 23 (47%) subsequently developed
clinical microbiological cultures. Independent risk factors for CRKP acquisition included recent surgery (OR 7.74; CI 3.42 – 17.45)
and SOFA score on admission (OR 1.17; CI 1 – 1.22). In conclusion, active surveillance cultures detected a sizable proportion
of CRKP colonized patients that were not identified by clinical cultures. Recent surgical procedures and patient severity
were independently associated with CRKP acquisition
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-011-1506-5
Authors
B. D. Debby, Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, 52621 IsraelO. Ganor, Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, 52621 IsraelM. Yasmin, Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, 52621 IsraelL. David, General Intensive Care Unit, Sheba Medical Center, Tel Hashomer, IsraelK. Nathan, Department of Microbiology, Sheba Medical Center, Tel Hashomer, IsraelT. Ilana, Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, 52621 IsraelS. Dalit, Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, 52621 IsraelG. Smollan, Department of Microbiology, Sheba Medical Center, Tel Hashomer, IsraelR. Galia, Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, 52621 Israel
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Legionnaires' disease (LD) is an acute pneumonia caused by the inhalation or aspiration of aerosols contaminated with the
Legionella bacteria. In the Netherlands, around 300 LD cases per year were reported between 2000 and 2008, but in 2009, the number dropped
to 251, which was the lowest number in the previous 5 years of surveillance. We investigated if this decrease could be explained
by the number of performed Legionella diagnostic tests in this year. We analyzed the number of tests performed between 2007 and 2009 in three large microbiological
laboratories in different geographical regions in the Netherlands. Our data showed that there was no decrease in the number
of patients for whom a diagnostic test for Legionella was performed in this period. These results are not in line with our hypothesis that the decrease in reported Legionella pneumonia patients in 2009 would be due to a decrease in patients for whom a diagnostic test was performed. We conclude that
it is more likely that other factors such as the influence of weather patterns might explain the sudden drop in reported Legionella pneumonia patients in 2009 compared to the previous years, and it would be interesting to investigate this for the period
described.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-011-1528-z
Authors
S. M. Euser, Regional Public Health Laboratory Kennemerland, Boerhaavelaan 26, 2035 RC Haarlem, The NetherlandsJ. P. Bruin, Regional Public Health Laboratory Kennemerland, Boerhaavelaan 26, 2035 RC Haarlem, The NetherlandsE. A. Mooi-Kokenberg, Department of Microbiology, Izore Centre for Infectious Diseases Friesland, Jelsumerstraat 6, Leeuwarden, The NetherlandsM. Peeters, Department of Medical Microbiology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, Tilburg, The NetherlandsH. Verbakel, Department of Medical Microbiology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, Tilburg, The NetherlandsE. P. Yzerman, Regional Public Health Laboratory Kennemerland, Boerhaavelaan 26, 2035 RC Haarlem, The NetherlandsJ. W. Den Boer, Regional Public Health Laboratory Kennemerland, Boerhaavelaan 26, 2035 RC Haarlem, The Netherlands
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract We study the clinical, management and outcome differences between respiratory syncytial virus (RSV) positive and negative
bronchiolitis. A retrospective review of the medical records of children = 2 years of age with acute bronchiolitis between
January 1995 and December 2006 was done. There were 2,384 patients hospitalized for acute bronchiolitis, and 1,495 (62.7%)
were RSV infections. Overall, hospitalization rate was 55/1,000 admissions. Mortality occurred in 0.08% of cases. Bronchiolitis
due to RSV was more frequent from November to March (97%). RSV bronchiolitis had longer hospital stays (6 vs. 5 days, P<0.0001), higher risk of intensive care unit (ICU) admission (OR 2.7; 95%CI 1.87 – 3.9) and more oxygen use (OR 2.2; 95%CI 1.8 – 2.6).
Infants < 2 months had longer median hospital stay (6 vs. 5 days, P <0.0001) and higher risk of ICU admission (OR 3.4; 95%CI 2.5 – 4.6). Prematures of < 32 gestational weeks, congenital heart
disease, and atelectasis/condensation were the main risk factors for ICU admission in both RSV and non-RSV bronchiolitis.
The introduction of palivizumab in prematures diminished hospitalization for RSV bronchiolitis, oxygen need, length of hospital
stay and mechanical ventilation. In conclusion, this study supports that RSV bronchiolitis seems to be a more severe disease
than that caused by other viruses.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-011-1529-y
Authors
D. Hervás, Son Dureta University Hospital, Palma de Mallorca, The Balearic Islands, SpainJ. Reina, Son Dureta University Hospital, Palma de Mallorca, The Balearic Islands, SpainA. Yañez, Son Dureta University Hospital, Palma de Mallorca, The Balearic Islands, SpainJ. M. del Valle, Son Dureta University Hospital, Palma de Mallorca, The Balearic Islands, SpainJ. Figuerola, Son Dureta University Hospital, Palma de Mallorca, The Balearic Islands, SpainJ. A. Hervás, Son Dureta University Hospital, Palma de Mallorca, The Balearic Islands, Spain
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract In this study, we associated the restriction modification (RM) tests to the polymerase chain reaction (PCR) detection of molecular
markers (SCCmec III, seh, agr II-SCCmec IV, and lukSF) for revealing the main methicillin-resistant Staphylococcus aureus (MRSA) clones circulating in Brazil. This simple and rapid approach allowed a precise classification of the MRSA analyzed
when compared with pulsed-field gel electrophoresis (PFGE) data.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-011-1534-1
Authors
C. O. Beltrame, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, Rio de Janeiro, RJ 21941-902, BrazilA. M. N. Botelho, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, Rio de Janeiro, RJ 21941-902, BrazilM. C. Silva-Carvalho, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, Rio de Janeiro, RJ 21941-902, BrazilR. R. Souza, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, Rio de Janeiro, RJ 21941-902, BrazilR. R. Bonelli, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, Rio de Janeiro, RJ 21941-902, BrazilM. S. Ramundo, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, Rio de Janeiro, RJ 21941-902, BrazilM. A. Guimarães, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, Rio de Janeiro, RJ 21941-902, BrazilL. R. Coelho, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, Rio de Janeiro, RJ 21941-902, BrazilA. M. S. Figueiredo, Instituto de Microbiologia Paulo de Góes, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, Rio de Janeiro, RJ 21941-902, Brazil
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The purpose of this investigation was to describe the first documented carbapenem-resistant Klebsiella pneumoniae (CRKP) outbreak in a tertiary care facility in Saudi Arabia. We initiated a prospective study to follow all cases of CRKP
as well as the active surveillance of patients in areas where cases were identified. We also conducted a retrospective review
of the microbiology database for any missed cases of CRKP. Pulsed field gel electrophoresis (PFGE) was conducted for the available
CRKP isolates. During March 2010, a cluster of eight CRKPs was detected primarily in the adult intensive care unit (ICU).
Patients with CRKPs were put under strict contact isolation, along with appropriate infection control measures. A retrospective
review of K. pneumoniae isolates over the previous 6 months revealed two more CRKPs. The PFGE results during the outbreak period showed that the
majority of strains were genetically indistinguishable or closely related. The majority of patients had prolonged hospital
stay (91%), indwelling devices (81%), surgical procedures (74%), carbapenem use (62%), and colonization/infection with other
multiple drug-resistant organisms (MDROs) (57%). Two-fifths of patients with CRKP had clinical infection and 38% died during
the current hospitalization. Contact isolation, hand hygiene, environmental cleaning, and staff education may control CRKP
outbreak in the acute care setting, but did not prevent endemicity.
Content Type: Journal ArticleCategory ArticlePages 1-9DOI 10.1007/s10096-011-1519-0
Authors
H. H. Balkhy, Department of Infection Prevention and Control, WHO Collaborating Center and GCC center for Infection Control, National Guard Health Affairs, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426 Kingdom of Saudi ArabiaA. El-Saed, Department of Infection Prevention and Control, WHO Collaborating Center and GCC center for Infection Control, National Guard Health Affairs, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426 Kingdom of Saudi ArabiaS. M. Al Johani, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaC. Francis, Department of Infection Prevention and Control, WHO Collaborating Center and GCC center for Infection Control, National Guard Health Affairs, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426 Kingdom of Saudi ArabiaA. A. Al-Qahtani, Department of Biological and Medical Research, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaM. N. Al-Ahdal, Department of Biological and Medical Research, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaH. T. Altayeb, King Abdullah International Medical Research Center, Riyadh, Saudi ArabiaY. Arabi, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaA. Alothman, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaM. Sallah, Department of Infection Prevention and Control, WHO Collaborating Center and GCC center for Infection Control, National Guard Health Affairs, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426 Kingdom of Saudi Arabia
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract
Enterobacter amnigenus (EA76) and Klebsiella pneumoniae (KP76) isolates with multidrug-resistant (MDR) patterns were identified from the same patient in the neurosurgery department
of our hospital. An outbreak of MDR K. pneumoniae had also occurred in this department. To characterize the resistance mechanism and molecular epidemiology of these isolates,
sequential experiments including antimicrobial susceptibility testing, polymerase chain reaction (PCR), plasmid analysis,
pulsed field gel electrophoresis (PFGE), and multilocus sequence typing (MLST) were performed. EA76 and KP76 were resistant
to all of the antibiotics tested, except colistin and tigecycline. bla
KPC-2, bla
TEM-1, bla
SHV-12, bla
CTX-M-3, bla
CTX-M-14, and rmtB genes were identified in both isolates, with bla
KPC-2, bla
TEM-1, bla
CTX-M-14, and rmtB being co-carried on one plasmid in each isolate. Further analysis showed different restriction patterns between the two KPC-carrying
plasmids. Of the 11 carbapenem-resistant isolates found in the outbreak, all were resistant to all of the ß-lactams tested,
with 63.64% (7/11) also exhibiting resistance to aminoglycosides and 72.73% (8/11) exhibiting resistance to quinolones. PCR
analysis and molecular typing of the 11 K. pneumoniae strains revealed that the seven aminoglycoside-resistant isolates shared the same antibiotic-resistant gene pattern and identical
or one-band-difference PFGE profiles relative to KP76. In addition, all of the eight aminoglycoside-resistant isolates, including
KP76, belonged to the national epidemic clone ST11. The overall results indicate the emergence of E. amnigenus and outbreak of ST11 K. pneumoniae, with both co-harboring bla
KPC and rmtB genes on a single plasmid in our neurosurgery wards.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-011-1481-x
Authors
J.-F. Sheng, State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 Zhejiang, People's Republic of ChinaJ.-J. Li, State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 Zhejiang, People's Republic of ChinaS. Tu, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of ChinaZ.-K. Sheng, Children's Hospital, Zhejiang University School of Medical College, Hangzhou, People's Republic of ChinaS. Bi, State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 Zhejiang, People's Republic of ChinaM.-H. Zhu, State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 Zhejiang, People's Republic of ChinaX.-M. Shen, State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 Zhejiang, People's Republic of ChinaL.-J. Li, State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 Zhejiang, People's Republic of China
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Automatic stop-orders (ASOs) have been utilized to discourage inappropriately prolonged antibiotic therapy. An ASO policy,
which required reordering of antibiotics after 7 days of therapy, had been in place at our institution prior to 2002, but
was revoked after instances of compromised patient care due to inadvertent and inappropriate interruption of antimicrobial
treatment. The objective of this study was to evaluate the impact of revoking the ASO policy on the duration of antibiotic
therapy, infection-related outcome (cure vs failure), relapsing infection, occurrence of resistant bacteria and superinfection
in patients with nosocomial pneumonia. A retrospective chart review of adult patients (= 18 years old) admitted to Sunnybrook
Health Sciences Centre with nosocomial pneumonia requiring antibiotic therapy was conducted. Duration of antibiotic therapy,
infection-related outcome (cure vs failure), rate of relapsing infection, resistant organisms and superinfection were determined
for each cohort. Forty-two eligible adults with nosocomial pneumonia per cohort were included. Duration of antibiotic therapy
was not significantly different in the pre- (11.4?±?3.8 days) compared with the post-ASO revocation cohort (10.8?±?4.1 days;
p?=?0.43). There were also no significant differences between the cohorts with regard to infection-related outcome (cure vs
failure), relapsing infection, or the occurrence of resistant bacteria or superinfection (p?>?0.5). Revocation of the ASO policy for antibiotics at our institution was not associated with a longer duration of antibiotic
therapy, or increased incidence of infection-related mortality, relapsing infection, resistant bacteria or superinfection
for patients with nosocomial pneumonia.
Content Type: Journal ArticleCategory ArticlePages 1-13DOI 10.1007/s10096-011-1507-4
Authors
J. Do, Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaS. A. N. Walker, Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaS. E. Walker, Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaW. Cornish, Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaA. E. Simor, Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The aim of this study was to compare the results of nine non-invasive serum biomarkers with liver biopsies to predict liver
fibrosis stage. HCV-RNA-positive, HCV genotype 1, treatment-naive patients with chronic HCV infections were included from
14 centers (n?=?77). The platelet count, AST/ALT ratio (AAR), cirrhosis discriminate score (CDS), FIB4, AST/platelet ratio index (APRI),
age-platelet (AP) index, Göteborg University cirrhosis index (GUCI), FibroTest, and ActiTest were calculated and compared
to histologic findings. All serum biomarkers, except AAR, were weakly or moderately correlated with liver biopsy results (ISHAK
fibrosis score). The mean scores of FibroTest, FIB4, APRI, and AP index were significantly different between F0-F2 and F3-F4
groups and the negative predictive values (NPVs) of the F3-F4 group were 95%, 85%, 85%, and 83%, respectively, for these serum
biomarkers. Our study suggests that serum biomarkers may help to diagnose significant fibrosis but inadequate to detect fibrosis
in early stages. Although liver biopsy is still the gold standard to diagnose liver fibrosis, FibroTest, FIB4, APRI, or AP
index may be used to exclude significant fibrosis with >80% NPV.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-011-1513-6
Authors
G. Usluer, Department of Infectious Diseases and Clinical Microbiology, Eskisehir Osmangazi University, Eskisehir, TurkeyN. Erben, Department of Infectious Diseases and Clinical Microbiology, Eskisehir Osmangazi University, Eskisehir, TurkeyN. Aykin, Department of Infectious Diseases and Clinical Microbiology, Eskisehir Yunus Emre State Hospital, Eskisehir, TurkeyO. Dagli, Department of Infectious Diseases and Clinical Microbiology, Gaziantep 25 Aralik State Hospital, Gaziantep, TurkeyO. Aydogdu, Department of Infectious Diseases and Clinical Microbiology, Bafra State Hospital, Bafra/Samsun, TurkeyS. Barut, Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University Health Research and Application Center, Tokat, TurkeyF. Cevik, Department of Infectious Diseases and Clinical Microbiology, Eskisehir Yunus Emre State Hospital, Eskisehir, TurkeyB. Ormen, Department of Infectious Diseases and Clinical Microbiology, Izmir Ataturk Training and Research Hospital, Izmir, TurkeyStudy Group (see Appendix)
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract To reduce the delay in diagnosis of Q fever, we have adapted the ultrasensitive immuno-PCR method for the detection of Phase
II IgM anti-Coxiella burnetii. We compared its performance to ELISA, IFA and PCR using 31 acute Q fever sera and 50 control sera. The best sensitivity
was obtained by iPCR (27 out of 31) followed by PCR (18 out of 31), ELISA (12 out of 31) and IFA (10 out of 31). A specificity
of 92% was found by iPCR (3 false positive out of 40), 92% for ELISA (3 false positive out of 40) whereas PCR and IFA exhibited
a specificity of 100%. Among the 31 Q fever sera, we compared the four methods for the detection of the early sera sampled
during the two first weeks after the onset of symptoms and found a sensitivity of 90% by iPCR, 55% for PCR, 35% for ELISA
and 25% for IFA. The results presented in this study suggest that iPCR is a promising, sensitive and specific method that
can be used for the early diagnosis of acute Q fever and more generally for acute infections where traditional methods lack
sensitivity.
Content Type: Journal ArticleCategory ArticlePages 1-10DOI 10.1007/s10096-011-1526-1
Authors
N. Malou, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UMR CNRS 6236/IRD 198, Université de la Méditerranée, Marseille, FranceA. Renvoise, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UMR CNRS 6236/IRD 198, Université de la Méditerranée, Marseille, FranceC. Nappez, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UMR CNRS 6236/IRD 198, Université de la Méditerranée, Marseille, FranceD. Raoult, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UMR CNRS 6236/IRD 198, Université de la Méditerranée, Marseille, France
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract In 1999, the costs of gastroenteritis in the Netherlands were estimated using data on hospitalizations from national registries,
together with data on etiology and self-reported data on health care resource use in a community-based study. Now, more information
on hospitalizations is available and these data were used to update the total costs of gastroenteritis in the Netherlands.
The costs of severe gastroenteritis in the Netherlands were estimated in more depth using a hospital-based study, with patient
questionnaires including a follow-up period of 6 months. The overall costs of gastroenteritis were calculated taking direct
medical costs, direct non-medical costs, and indirect non-medical costs into account. The costs for severe gastroenteritis
in 2009 were estimated at €2,203 per hospitalized child and €6,834 per hospitalized adult. The overall costs of gastroenteritis
in 2009 were estimated at €611 – 695 million, which is €133 – 151 per gastroenteritis case or €37 – 42 per inhabitant. The total
health care costs for gastroenteritis were about 50% higher in 2009 compared to 1999, which is mostly due to the rise in health
care costs. The costs per gastroenteritis episode in adults are higher compared to children, mainly due to differences in
the reasons for hospitalization and course of disease, and productivity losses.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-011-1518-1
Authors
I. H. M. Friesema, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The NetherlandsA. K. Lugnér, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The NetherlandsY. T. H. P. van Duynhoven, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The NetherlandsE. Duizer, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The NetherlandsL. M. Kortbeek, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The NetherlandsD. W. Notermans, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The NetherlandsM. P. G. Koopmans, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The NetherlandsR. F. de Boer, Department of Research and Development, Laboratory for Infectious Diseases, van Ketwich Verschuurlaan 92, 9721 SW Groningen, The NetherlandsA. M. D. Kooistra-Smid, Department of Research and Development, Laboratory for Infectious Diseases, van Ketwich Verschuurlaan 92, 9721 SW Groningen, The NetherlandsO. F. Norbruis, Isala Hospital, P.O. Box 10500, 8000 GM Zwolle, The NetherlandsD. D. L. Bezemer, Maasstad Hospital, P.O. Box 9100, 3007 AC Rotterdam, The NetherlandsA. Smeulders, Maasstad Hospital, P.O. Box 9100, 3007 AC Rotterdam, The NetherlandsP. L. A. Fraaij, Erasmus MC, Sophia Children's Hospital, P.O. Box 2040, 3000 CA Rotterdam, The NetherlandsJ. Bogerman, Erasmus MC, Sophia Children's Hospital, P.O. Box 2040, 3000 CA Rotterdam, The NetherlandsH. van Heerbeek, Catharina Hospital, P.O. Box 1350, 5602 ZA Eindhoven, The NetherlandsM. J. H. Pronk, Catharina Hospital, P.O. Box 1350, 5602 ZA Eindhoven, The NetherlandsJ G. van Enk, Gelderse Vallei Hospital, P.O. Box 9025, 6710 HN Ede, The NetherlandsJ. J. Uil, Gelderse Vallei Hospital, P.O. Box 9025, 6710 HN Ede, The NetherlandsR. N. J. van Andel, Onze Lieve Vrouwe Gasthuis, P.O. Box 95500, 1090 HM Amsterdam, The NetherlandsK. Brinkman, Onze Lieve Vrouwe Gasthuis, P.O. Box 95500, 1090 HM Amsterdam, The Netherlands
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Food-borne trematodiases constitute an important group of the most neglected tropical diseases, not only in terms of research
funding, but also in the public media. The Trematoda class contains a great number of species that infect humans and are recognized
as the causative agents of disease. The biological cycle, geographical distribution, and epidemiology of most of these trematode
species have been well characterized. Traditionally, these infections were limited, for the most part, in populations living
in low-income countries, particularly in Southeast Asia, and were associated with poverty. However, the geographical limits
and the population at risk are currently expanding and changing in relation to factors such as growing international markets,
improved transportation systems, and demographic changes. The diagnosis of these diseases is based on parasitological techniques
and only a limited number of drugs are currently available for treatment, most of which are unspecific. Therefore, in-depth
studies are urgently needed in order to clarify the current epidemiology of these helminth infections and to identify new
and specific targets for both effective diagnosis and treatment. In this review, we describe the biology, medical and epidemiological
features, and current treatment and diagnostic tools of the main groups of flukes and the corresponding diseases.
Content Type: Journal ArticleCategory ReviewPages 1-14DOI 10.1007/s10096-011-1515-4
Authors
R. Toledo, Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, Valencia, SpainJ. G. Esteban, Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, Valencia, SpainB. Fried, Department of Biology, Lafayette College, Easton, PA 18042, USA
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The purpose of this study was to determine the level of gingival inflammation and the prevalence of periodontopathogenic microorganisms
in adolescents with chronic gingivitis, as well as to compare the effectiveness of two approaches in gingivitis treatment-basic
therapy alone and basic therapy + adjunctive low-level laser therapy (LLLT). After periodontal evaluation, the content of
gingival pockets of 140 adolescents with gingivitis was analyzed by multiplex PCR for the presence of P. gingivalis, A. actinomycetemcomitans, T. forsythensis and P. intermedia. Subsequent to bacteria detection, the examinees were divided into two groups with homogenous clinical and microbiological
characteristics. Group A was subjected to basic gingivitis therapy, and group B underwent basic therapy along with adjunctive
LLLT. A statistically significant difference between the values of plaque-index (PI) and sulcus bleeding index (SBI) before
and after therapy was confirmed in both groups (p?<?0.001), though more pronounced in group B. Following therapy, the incidence of periodontopathogenic microorganisms decreased
considerably. The best result was obtained in P. gingivalis eradication by combined therapy (p?=?0.003). The presence of periodontopathogens in adolescents with gingivitis should be regarded as a sign for dentists to
foster more effective oral health programs. LLLT appears to be beneficial as adjuvant to basic therapy.
Content Type: Journal ArticleCategory ArticlePages 1-5DOI 10.1007/s10096-011-1520-7
Authors
M. Igic, Department of Children and Preventive Dentistry, Dental Clinic, Medical Faculty Nis, University of Nis, Bul dr Zorana Djindjica 52, 18000 Nis, SerbiaL. Kesic, Department of Oral Medicine and Periodontology, Dental Clinic, Medical Faculty Nis, University of Nis, Bul dr Zorana Djindjica 52, 18000 Nis, SerbiaV. Lekovic, Clinic of Periodontology and Oral Medicine, School of Dentistry, University of Belgrade, Dr. Subotica 8, 11000 Belgrade, SerbiaM. Apostolovic, Department of Children and Preventive Dentistry, Dental Clinic, Medical Faculty Nis, University of Nis, Bul dr Zorana Djindjica 52, 18000 Nis, SerbiaD. Mihailovic, Institute of Pathological Anatomy, Medical Faculty Nis, University of Nis, Bul dr Zorana Djindjica 52, 18000 Nis, SerbiaL. Kostadinovic, Department of Children and Preventive Dentistry, Dental Clinic, Medical Faculty Nis, University of Nis, Bul dr Zorana Djindjica 52, 18000 Nis, SerbiaJ. Milasin, Department of Human Genetics, School of Dentistry, University of Belgrade, Dr. Subotica 8, 11000 Belgrade, Serbia
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract
Mycobacterium abscessus [M. abscessus (sensu lato) or M. abscessus complex] comprises three closely related species: M. abscessus (sensu stricto), hereafter referred to as M. abscessus, M. bolletii and M. massiliense. We describe here an accurate and robust method for distinguishing M. chelonae from M. abscessus, M. bolletii and M. massiliense, using polymerase chain reaction (PCR) and the sequencing of house-keeping gene targets (hsp65 and rpoB). Sequencing of the sodA gene is of little additional value in discriminating between species, but M. massiliense can be rapidly identified by amplification of the truncated erm(41) gene without the need for amplicon sequencing. We have applied the method to 81 isolates from 40 patients from two hospitals,
the majority of whom were cystic fibrosis (CF) patients. Of these patients, 21 had previously been identified as M. chelonae and 59 as M. abscessus complex using commercial line probe assays. We identified these as 46?M. abscessus isolates, 20?M. massiliense isolates, five?M. bolletii isolates and nine?M. chelonae isolates and confirmed the one M. fortuitum isolate. This is the first study that has identified the individual members of the M. abscessus complex in a UK cohort of mainly CF patients.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-011-1510-9
Authors
C. Blauwendraat, Department of Microbiology, Virology and Infection Control, Great Ormond Street Hospital (GOSH) for Children NHS Trust, Great Ormond Street, London, WC1N 3JH UKG. L. J. Dixon, Department of Microbiology, Virology and Infection Control, Great Ormond Street Hospital (GOSH) for Children NHS Trust, Great Ormond Street, London, WC1N 3JH UKJ. C. Hartley, Department of Microbiology, Virology and Infection Control, Great Ormond Street Hospital (GOSH) for Children NHS Trust, Great Ormond Street, London, WC1N 3JH UKJ. Foweraker, Microbiology Laboratory, Papworth Hospital NHS Foundation Trust, Cambridge, UKK. A. Harris, Department of Microbiology, Virology and Infection Control, Great Ormond Street Hospital (GOSH) for Children NHS Trust, Great Ormond Street, London, WC1N 3JH UK
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The purpose of this study was to investigate the impact of fluoroquinolone resistance on the existence and dynamic of MRSA
clones. Resistance to ciprofloxacin was induced in strains of community-acquired (CA) MRSA from various sequence types and
the fitness cost suffered by mutant derivatives measured in a propagation assay. In addition, the fitness of fluoroquinolone
resistant health care-associated (HA) MRSA isolates from major clones prevalent in Hungary were compared with each other and
with those of the CA-MRSA derivatives. The genetic background of fluoroquinolone resistance and fitness cost in CA-MRSA was
investigated. The fitness cost observed in the CA-MRSA derivatives proved diverse; the derivatives of the ST30-MRSA-IV strain
suffered significantly greater fitness cost than those of the ST8-MRSA-IV and ST80-MRSA-IV isolates. Strains from the New
York – Japan (ST5-MRSA-II), South German (ST228-MRSA-I) and EMRSA-15 (ST22-MRSA-IV) HA-MRSA clones proved more viable than CA-MRSA
derivatives with similar MIC values to ciprofloxacin and HA-MRSA strains from the Hungarian/Brazilian clone (ST239-MRSA-III).
Our strains from the New York – Japan, South-German and EMRSA-15 clones seem to have a competitive edge over the tested CA-MRSA
isolates in the health care setting. The greater fitness observed in our New York – Japan and South-German strains could account
for the replacement by them of the Hungarian/Brazilian clone in Hungary about ten years ago. Alterations in relevant genes
were detected. The Ser80???Phe mutation in the grlA gene may have seriously compromised viability. Surprisingly silent nucleotide substitutions in the grlB gene seemed to impact fitness in derivatives of the ST30-MRSA-IV isolate.
Content Type: Journal ArticleCategory ArticlePages 1-8DOI 10.1007/s10096-011-1536-z
Authors
A. Horváth, Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, HungaryO. Dobay, Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, HungaryS. Kardos, Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, HungaryÁ. Ghidán, Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, HungaryÁ. Tóth, National Center for Epidemiology, Gyáli út 2 – 6, 1097 Budapest, HungaryJ. Pászti, National Center for Epidemiology, Gyáli út 2 – 6, 1097 Budapest, HungaryE. Ungvári, National Center for Epidemiology, Gyáli út 2 – 6, 1097 Budapest, HungaryP. Horváth, Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, HungaryK. Nagy, Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, HungaryS. Zissman, Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, HungaryM. Füzi, Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Tuberculosis (TB) remains an important public health problem and a leading infectious cause of death. Diagnosis and treatment
of latent tuberculosis infection (LTBI) is important for TB control and elimination. Nevertheless, the diagnosis of LTBI in
both adults and children remains complex, since there is no gold standard. The development of interferon gamma release assays
was a major breakthrough in the diagnosis of LTBI. The evaluation of IGRAs in the diagnosis of LTBI in children is proven
to be difficult since childhood TB differs from adults as immune responses vary with age. Separate studies assessing IGRAs
performance in children are still limited, and only a few of them divide results by narrow age groups Nevertheless, new approaches
are being exploited by the ongoing research for the development of more efficient diagnostic tools. It is likely that many
changes in both the diagnosis and management of LTBI will occur in the near future. We believe that better understanding of
the immunopathology of latency can ultimately lead to the development of more effective strategies in TB control. In the present
review we summarize current data on diagnosis of LTBI in children, underscoring the existing challenges and limitations.
Content Type: Journal ArticleCategory ReviewPages 1-10DOI 10.1007/s10096-011-1524-3
Authors
V. Amanatidou, Second Department of Pediatrics, 'P & A Kyriakou' Children's Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GreeceG. Syridou, Second Department of Pediatrics, 'P & A Kyriakou' Children's Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GreeceM. Mavrikou, First Department of Pediatrics, 'P & A Kyriakou' Children's Hospital, Athens, GreeceM. N. Tsolia, Second Department of Pediatrics, 'P & A Kyriakou' Children's Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Risk factors of severity (need for surgical intervention, intensive care or fatal outcome) were analysed in hospital-acquired
Clostridium difficile infection (CDI) in a 777-bed community hospital. In a prospective analytical cross-sectional study, age (=65 years), sex,
CDI characteristics, underlying diseases, severity of comorbidity and PCR ribotypes were tested for associations with severe
CDI. In total, 133 cases of hospital-acquired CDI (mean age 74.4 years) were identified, resulting in an incidence rate of
5.7/10,000 hospital-days. A recurrent episode of diarrhoea occurred in 25 cases (18.8%) and complications including toxic
megacolon, dehydration and septicaemia in 69 cases (51.9%). Four cases (3.0%) required ICU admission, one case (0.8%) surgical
intervention and 22 cases (16.5%) died within the 30-day follow-up period. Variables identified to be independently associated
with severe CDI were severe diarrhoea (odds ratio [OR] 3.64, 95% confidence interval [CI] 1.19 – 11.11, p?=?0.02), chronic pulmonary disease (OR 3.0, 95% CI 1.08 – 8.40, p?=?0.04), chronic renal disease (OR 2.9, 95% CI 1.07 – 7.81, p?=?0.04) and diabetes mellitus (OR 4.30, 95% CI 1.57 – 11.76, p?=?0.004). The case fatality of 16.5% underlines the importance of increased efforts in CDI prevention, in particular for
patients with underlying diseases.
Content Type: Journal ArticleCategory ArticlePages 1-8DOI 10.1007/s10096-011-1522-5
Authors
J. M. Wenisch, Department of Medicine, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, AustriaD. Schmid, Department of Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety, Vienna, AustriaH.-W. Kuo, Department of Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety, Vienna, AustriaE. Simons, Department of Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety, Vienna, AustriaF. Allerberger, Department of Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety, Vienna, AustriaV. Michl, Fourth Medical Department with Infectious Diseases and Tropical Medicine, Kaiser Franz Josef Hospital, Vienna, AustriaP. Tesik, Fourth Medical Department with Infectious Diseases and Tropical Medicine, Kaiser Franz Josef Hospital, Vienna, AustriaG. Tucek, Institute of Pathology and Microbiology, Kaiser Franz Josef Hospital, Vienna, AustriaC. Wenisch, Fourth Medical Department with Infectious Diseases and Tropical Medicine, Kaiser Franz Josef Hospital, Vienna, Austria
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Data from the German Antibiotic Resistance Surveillance system (ARS) and statutory notification of methicillin-resistant Staphylococcus aureus (MRSA) in blood cultures are presented. ARS is a voluntary laboratory-based surveillance system providing resistance data
of all clinical pathogens and sample types from hospitals and ambulatory care. Statutory notification includes MRSA detected
in blood and cerebrospinal fluid by microbiological laboratories. Resistance data from 2008 to 2010 and MRSA-bacteraemia incidences
from 2010 are presented. From 2008 to 2010, resistance data from 70,935 Staphylococcus aureus isolates were transferred to the national health institution. MRSA proportions in hospitals and outpatient care account for
19.2% and 10.6%, respectively. In hospital care high proportions of MRSA were found in nephrological, geriatric, neurological
general wards and surgical ICUs (49.4%, 45.8%, 34.2%, and 27.0%, respectively), while in community outpatient care urological
practices (29.2%) account for the highest values. In both healthcare settings urinary tract samples stand out with high proportions
of MRSA (hospitals, 32.9%; outpatients, 20.5%). In 2010, 3900 cases of MRSA bacteraemia were reported, accounting for an incidence
of MRSA bacteraemia of 4.8/100,000 inhabitants/year. Stratification by federal states shows considerable regional differences
(range, 1.0 – 8.3/100,000 inhabitants/year). Vulnerable areas in hospitals and outpatient care have been pointed out as subjects
for further inquiries.
Content Type: Journal ArticleCategory ArticlePages 1-11DOI 10.1007/s10096-011-1511-8
Authors
B. Schweickert, Robert Koch Institut, Berlin, GermanyI. Noll, Robert Koch Institut, Berlin, GermanyM. Feig, Robert Koch Institut, Berlin, GermanyH. Claus, Robert Koch Institut, Berlin, GermanyG. Krause, Robert Koch Institut, Berlin, GermanyE. Velasco, Robert Koch Institut, Berlin, GermanyT. Eckmanns, Robert Koch Institut, Berlin, Germany
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract In Italy fluoroquinolones (FQs) are extensively prescribed in empirical therapy of uncomplicated urinary tract infection (UTI)
despite recommendations in national guidelines and widespread antibiotic resistance in community. To survey the dissemination
of plasmid-mediated quinolone resistance in a peak area of FQs consumption, E. coli strains from 154 community and 41 local hospital patients were collected; low level ciprofloxacin resistance qnrA, qnrB, qnrS, and aac(6)'-Ib-cr genes were screened by PCR and patterns of transferable resistances were determined. Clinical ciprofloxacin resistance in
hospital doubled community value, while overall rates of FQ resistance genes were similar (31.6% and 27.8%). Prevalence of
aac(6')-Ib-cr gene was 11% in outpatients (21%, inpatients) and risk of harbouring this variant was significantly associated with gentamicin
resistance; linkage to ceftazidime resistance was significant (P?=?0.001) and six out of eight strains produced CTX-M-15 and TEM-1 beta lactamases. In transconjugants, the unique pattern
ampicillin/kanamycin-gentamicin/ ESBL + was associated with aac(6')-Ib-cr gene presence and with an increase of ciprofloxacin MIC value. Data highlight the need to monitor the resistance risk factors
in the local community to provide clinicians with well-grounded guidelines for UTI therapy.
Content Type: Journal ArticleCategory ArticlePages 1-5DOI 10.1007/s10096-011-1521-6
Authors
C. Longhi, Dipartimento di Sanità Pubblica e Malattie Infettive, Sezione Microbiologia, Università 'Sapienza', Rome, ItalyM. P. Conte, Dipartimento di Sanità Pubblica e Malattie Infettive, Sezione Microbiologia, Università 'Sapienza', Rome, ItalyM. Marazzato, Dipartimento di Sanità Pubblica e Malattie Infettive, Sezione Microbiologia, Università 'Sapienza', Rome, ItalyV. Iebba, Dipartimento di Sanità Pubblica e Malattie Infettive, Sezione Microbiologia, Università 'Sapienza', Rome, ItalyV. Totino, Dipartimento di Sanità Pubblica e Malattie Infettive, Sezione Microbiologia, Università 'Sapienza', Rome, ItalyF. Santangelo, Dipartimento di Sanità Pubblica e Malattie Infettive, Sezione Microbiologia, Università 'Sapienza', Rome, ItalyC. Gallinelli, Dipartimento di Sanità Pubblica e Malattie Infettive, Sezione Microbiologia, Università 'Sapienza', Rome, ItalyL. Pallecchi, Dipartimento di Biotecnologie, Sezione Microbiologia, Università di Siena, Siena, ItalyE. Riccobono, Dipartimento di Biotecnologie, Sezione Microbiologia, Università di Siena, Siena, ItalyS. Schippa, Dipartimento di Sanità Pubblica e Malattie Infettive, Sezione Microbiologia, Università 'Sapienza', Rome, ItalyA. Comanducci, Dipartimento di Sanità Pubblica e Malattie Infettive, Sezione Microbiologia, Università 'Sapienza', Rome, Italy
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract We investigated the performance of cefotaxime for the detection of extended-spectrum ß-lactamase (ESBL) or plasmid-mediated
AmpC ß-lactamase (pAmpC) and the clinical characteristics of cefotaxime-non-susceptible Escherichia coli or Klebsiella pneumoniae (CTXNS-EK) bacteraemia. All of the consecutive bloodstream isolates between 2005 and 2010 in a Japanese university hospital
were characterised using polymerase chain reaction (PCR). Risk factors and outcomes of CTXNS-EK were analysed by multivariate
logistic regression analysis. We identified 58 CTXNS-EK (15.6%) from 249 E. coli and 122?K. pneumoniae. Cefotaxime with a minimum inhibitory concentration (MIC) of >1 µg/mL had a sensitivity of 98.3% and a specificity of 99.7%
for the detection of ESBL or pAmpC. CTXNS-EK had increased from 4.5% in 2005 to 23% in 2009. Risk factors for CTXNS-EK were
previous isolation of multidrug-resistant bacteria, use of oxyimino-cephalosporins or fluoroquinolones, and high Sequential
Organ Failure Assessment (SOFA) score. Patients with CTXNS-EK bacteraemia less frequently received appropriate empirical therapy
than patients with cefotaxime-susceptible EK bacteraemia (81% vs. 97%, p?<?0.001) and died within 30 days (21% vs. 5%, p?=?0.001). Using the current breakpoints of the Clinical and Laboratory Standards Institute (CLSI) or the European Committee
on Antimicrobial Susceptibility Testing (EUCAST), cefotaxime alone can identify ESBL or pAmpC producers. CTXNS-EK is an important
and increasingly prevalent bacteraemia pathogen.
Content Type: Journal ArticleCategory ArticlePages 1-9DOI 10.1007/s10096-011-1523-4
Authors
Y. Matsumura, Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 JapanM. Yamamoto, Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 JapanA. Matsushima, Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 JapanM. Nagao, Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 JapanY. Ito, Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, JapanS. Takakura, Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 JapanS. Ichiyama, Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract In this study, we investigated the long-term trends in the epidemiology and susceptibility of bacterial enteropathogens among
children in a well-defined area of adequate health standards. The study included all children younger than 14 years of age
treated for enteritis at Heraklion University General Hospital on the island of Crete during the 18-year period from January
1993 to December 2010. Stool specimens were tested for Salmonella, Shigella, Campylobacter, enteropathogenic Escherichia coli (EPEC), Yersinia, and Aeromonas species. Of the 33,032 stool samples from patients of any age, 2,912 (8.82%) were positive for bacterial enteropathogens.
The 1,597 isolates from children were identified as S. enterica (42.3%), Campylobacter spp. (33.6%), EPEC (17.4%), Y. enterocolitica (5.82%), A. hydrophila (0.44%), and Shigella spp. (0.38%). A decline in prevalence was observed for all bacterial enteropathogens. Taken as a total, enteropathogens were
susceptible to gentamicin, ceftriaxone, ciprofloxacin, co-trimoxazole, and amoxicillin in 98.8%, 88.0%, 83.0%, 67.1%, and
59.6%, respectively. During the study period, the susceptibility rates decreased for co-trimoxazole (p?<?0.0001) and ciprofloxacin (p?<?0.001), and increased for amoxicillin (p?<?0.0001). Our findings suggest declining long-term trends in the prevalence of bacterial enteropathogens and changes in
susceptibility rates to first-line antibacterial agents. These changing trends in the long-term morbidity and susceptibility
call for ongoing surveillance and tailored management.
Content Type: Journal ArticleCategory ArticlePages 1-6DOI 10.1007/s10096-011-1517-2
Authors
S. Maraki, Department of Clinical Bacteriology, Parasitology, Zoonoses and Geographic Medicine, University Hospital of Heraklion, Crete, GreeceF. Ladomenou, Department of Paediatrics, University of Crete, 71003, Heraklion, GreeceG. Samonis, Department of Internal Medicine, University of Crete, 71003, Heraklion, GreeceE. Galanakis, Department of Paediatrics, University of Crete, 71003, Heraklion, Greece
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) can be reliably differentiated by flow cytometry when labeled with nucleic acid dyes. The purpose of this study was
to determine if this differentiation can be achieved while labeling with a S. aureus-specific anti-staphylococcal protein A antibody instead of nucleic acid dyes. A total of 103 S. aureus isolates were incubated for 4 h at 37°C in Mueller Hinton broth with and without oxacillin, then stained with anti-staphylococcal
protein A antibody, and analyzed by flow cytometry using the Micro PRO™ instrument. Dot plots (side scatter vs. fluorescence
intensity) of isolates exposed to oxacillin were examined to define two gates encompassing the majority of MSSA and MRSA signal
events, respectively. The ratio of signal event counts in the two gates was called the gate signal count ratio (GSCR), and
its performance was evaluated using receiver operating characteristic (ROC) curves. The GSCR could differentiate MRSA from
MSSA with 98% sensitivity and 100% specificity using a cut-off of 0.6868 when the two gates were defined as follows: gate
1, fluorescence intensity 2 – 10, side scatter 5 – 70; gate 2, fluorescence intensity 7 – 700, side scatter 70 – 500. MRSA and MSSA
can be accurately detected and differentiated by flow cytometry after 4 h of oxacillin exposure when labeled with anti-staphylococcal
protein A antibody.
Content Type: Journal ArticleCategory ArticlePages 1-4DOI 10.1007/s10096-011-1514-5
Authors
N. K. Shrestha, Department of Infectious Disease, Cleveland Clinic, 9500 Euclid Avenue/G-21, Cleveland, OH 44195, USAD. A. Wilson, Department of Clinical Pathology, Cleveland Clinic, Cleveland, OH, USAN. M. Scalera, Department of Infectious Disease, Cleveland Clinic, 9500 Euclid Avenue/G-21, Cleveland, OH 44195, USAA. Oppedahl, Advanced Analytical Technologies, Inc., Ames, IA, USAG. W. Procop, Department of Clinical Pathology, Cleveland Clinic, Cleveland, OH, USA
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Patients with pulmonary nontuberculous mycobacteriosis (pNTM) may have suboptimum response to conventional antimicrobial therapy.
Aerosolized amikacin (aeAmk) was given to nine patients who had failed standard combination oral antimycobacterial drugs.
A favorable toxicity profile, even in patients given aeAmk for an extended duration, median 75?±?85 (range, 18 – 277) days and
total cumulative dose 35,400?±?30,568 (range, 7,600 – 95,400) mg, was encouraging, as was the clinical response and resolution
of symptoms in 8 of 9 patients. The patient who failed therapy died due to complications arising from prior hematopoietic
transplantation. The feasibility and efficacy of aeAmk in combination with oral anti-NTM drug(s) for treatment-refractory
disease and, importantly, in primary therapy for pNTM requires validation randomized trials.
Content Type: Journal ArticleCategory ArticlePages 1-5DOI 10.1007/s10096-011-1516-3
Authors
A. Safdar, MD Anderson Cancer Center, Houston, TX, USA
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Antimicrobial-impregnated catheters are more expensive than standard catheters (S-C). A higher incidence of catheter-related
bloodstream infection (CRBSI) has been found in jugular venous access with tracheostomy than without tracheostomy. The objective
of this study was to determine central venous catheter (CVC)-related costs (considering only the cost of the CVC, diagnosis
of CRBSI, and antimicrobial agents used to treat CRBSI) using rifampicin – miconazole-impregnated catheters (RM-C) or S-C in
jugular venous access with tracheostomy. We performed a retrospective cohort study of patients admitted to the intensive care
unit (ICU) with tracheostomy who received one or more jugular venous catheters. RM-C showed a lower incidence of CRBSI compared
with S-C (0 vs. 20.16 CRBSI episodes/1,000 catheter-days; odds ratio?=?0.05; 95% confidence interval?=?0.001 – 0.32; p?<?0.001) and lower CVC-related costs (including the cost of the CVC, diagnosis, and treatment of CRBSI) (€11.46?±?6.25 vs.
€38.11?±?77.25; p?<?0.001) in jugular venous access with tracheostomy. The use of RM-C could reduce CVC-related costs in jugular venous access
with tracheostomy. The results of our study may contribute to clinical decision-making and selection of those patients who
could benefit from the use of antimicrobial-impregnated catheters.
Content Type: Journal ArticleCategory ArticlePages 1-4DOI 10.1007/s10096-011-1508-3
Authors
L. Lorente, Department of Critical Care, Hospital Universitario de Canarias, Ofra s/n. La Cuesta, La Laguna, 38320 Santa Cruz de Tenerife, SpainM. Lecuona, Department of Microbiology, Hospital Universitario de Canarias, Ofra s/n. La Cuesta, La Laguna, 38320 Santa Cruz de Tenerife, SpainM. J. Ramos, Department of Microbiology, Hospital Universitario de Canarias, Ofra s/n. La Cuesta, La Laguna, 38320 Santa Cruz de Tenerife, SpainA. Jiménez, Research Unit, Hospital Universitario de Canarias, Ofra s/n. La Cuesta, La Laguna, 38320 Santa Cruz de Tenerife, SpainM. L. Mora, Department of Critical Care, Hospital Universitario de Canarias, Ofra s/n. La Cuesta, La Laguna, 38320 Santa Cruz de Tenerife, SpainA. Sierra, Department of Microbiology, Hospital Universitario de Canarias, Ofra s/n. La Cuesta, La Laguna, 38320 Santa Cruz de Tenerife, Spain
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract The type III secretion system (TTSS) of Pseudomonas aeruginosa, associated with acute infection, facilitates the direct injection of cytotoxins into the host cell cytoplasm. Mab166, a
murine monoclonal antibody against PcrV, a protein located at the tip of the injectisome, has demonstrated efficacy against
P. aeruginosa infection, resulting in reduced lung injury and increased survival in murine models of infection. We hypothesised that the
administration of Mab166 in combination with an antibiotic would further improve the survival of P. aeruginosa-infected mice. A murine model of P. aeruginosa acute infection, three clinically relevant antibiotics (ciprofloxacin, tobramycin and ceftazidime) and the Mab166 antibody
were used for this study. Consistently, compared to other treatment groups (antibiotic or antibody administered in isolation),
the combination of Mab166 and antibiotic significantly improved the survival of mice infected with three times the lethal
dose (LD90) of the highly cytotoxic ExoU-secreting strain, PA103. This synergistic effect was primarily due to enhanced bactericidal
effect and protection against lung injury, which prevented bacterial dissemination to other organs. Hence, the combination
of Mab166 with antibiotic administration provides a new, more effective strategy against P. aeruginosa airway infection, especially when large numbers of highly virulent strains are present.
Content Type: Journal ArticleCategory ArticlePages 1-9DOI 10.1007/s10096-011-1509-2
Authors
Y. Song, Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USAM. Baer, KaloBios Pharmaceuticals, Inc., 260 East Grand Avenue, South San Francisco, CA 94080, USAR. Srinivasan, Department of Medicine, University of California, San Francisco, CA, USAJ. Lima, Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USAG. Yarranton, KaloBios Pharmaceuticals, Inc., 260 East Grand Avenue, South San Francisco, CA 94080, USAC. Bebbington, KaloBios Pharmaceuticals, Inc., 260 East Grand Avenue, South San Francisco, CA 94080, USAS. V. Lynch, Department of Medicine, University of California, San Francisco, CA, USA
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
Abstract Resins (rosin, pitch) are natural products of the coniferous trees and are antimicrobial against a wide range of microbes.
The antifungal effectiveness of resin, purified from Norway spruce (Picea abies), was studied against human pathogenic fungi and yeasts with the agar plate diffusion tests and electron microscopy (EM).
The fungistatic effect of these resin mixtures (resin salves) was tested against a set of Candida yeasts, dermatophytes, and opportunistic fungi. Transmission and scanning EM was done from samples of fungi (Trichophyton mentagrophytes). In agar diffusion tests, the resin was strongly antifungal against all dermatophytes tested, e.g., against all fungi of
the genus Trichophyton, but it was not antifungal against the Candida yeasts or against the opportunistic fungi tested. According to EM, resin caused damages in the cell hyphae and cell wall
structures. We conclude that, in the agar plate diffusion test, coniferous resins are strongly fungistatic against the dermatophytic
fungi only.
Content Type: Journal ArticleCategory ArticlePages 1-7DOI 10.1007/s10096-011-1502-9
Authors
M. Rautio, Division of Clinical Microbiology, HUSLAB, Hospital District of Helsinki and Uusimaa (HUS), 00029 Helsinki, FinlandA. Sipponen, Department of Orthopedics and Traumatology, Päijät-Häme Central Hospital, 15850 Lahti, FinlandJ. Lohi, Institute of Health Sciences, University of Oulu, 90014 Oulu, FinlandK. Lounatmaa, Lounatmaa Ltd., Helsinki, 00320 Helsinki, FinlandP. Koukila-Kähkölä, Division of Clinical Microbiology, HUSLAB, Hospital District of Helsinki and Uusimaa (HUS), 00029 Helsinki, FinlandK. Laitinen, Department of Public Health, Laboratory of Microbiology, Hjelt Institute, Helsinki University, 00014 Helsinki, Finland
European Journal of Clinical Microbiology & Infectious DiseasesOnline ISSN: 1435-4373Print ISSN: 0934-9723
