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Witte P, Arvand M, Barth S, Diel R, Friesen I, Gastmeier P, Häcker B, Hauer B, Kuhns M, Nienhaus A, Otto-Knapp R, Richter E, Wischnewski N, Ziegler R, Bauer T. [Tuberculosis Infection Control & Hygiene - Recommendations of the DZK]. Pneumologie 2023; 77:983-1000. [PMID: 37832577 DOI: 10.1055/a-2172-9575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Preventing the spread of the disease is an essential goal in the care and treatment of tuberculosis. In addition to early diagnosis and effective therapies, isolation of infectious patients and adequate hygiene measures are of particular importance for infection prevention. The present recommendations replace the previous recommendations "tuberculosis infection control" from 2012 and take into account the current national and international recommendations and as well as new scientific findings. After a description of the infection and the transmission pathways, the necessary prevention and hygiene measures in health care facilities are comprehensively presented. Since the last revision of the recommendations on infection prevention, international recommendations and the KRINKO recommendation on ending isolation have been changed. In accordance with this, under certain conditions in the case of sensitive tuberculosis, de-isolation in health care facilities can take place after 14 days without taking the sputum findings into account. The second part of the recommendations explains in detail the measures to be taken in special situations and areas, such as general practitioners, ambulance services and care facilities. Here, the recommendations on respiratory protection have been simplified; for staff, an FFP2 mask is now generally considered sufficient.
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Affiliation(s)
- Peter Witte
- Institut für Krankenhaushygiene, Universitätsklinikum JWK Minden, Minden
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
| | | | - Stefanie Barth
- Friedrich-Loeffler-Institut - Bundesforschungsinstitut für Tiergesundheit (FLI), Institut für molekulare Pathogenese, Jena
| | - Roland Diel
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
- Institut für Epidemiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
- Deutsches Zentrum für Lungenforschung, Airway Research Center North (ARCN), LungenClinic Großhansdorf, Großhansdorf
| | - Inna Friesen
- Nationales Referenzzentrum für Mykobakterien, Forschungszentrum Borstel, Leibniz Lungenzentrum, Borstel
| | - Petra Gastmeier
- Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin, Berlin
| | - Brit Häcker
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
| | | | - Martin Kuhns
- Nationales Referenzzentrum für Mykobakterien, Forschungszentrum Borstel, Leibniz Lungenzentrum, Borstel
| | - Albert Nienhaus
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg Eppendorf (UKE), Hamburg
| | - Ralf Otto-Knapp
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
| | | | | | - Renate Ziegler
- Institut für Klinikhygiene, Medizinische Mikrobiologie und Klinische Infektiologie, Universitätsinstitut der Paracelsus Medizinischen Privatuniversität, Klinikum Nürnberg, Nürnberg
| | - Torsten Bauer
- Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin
- Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin
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Butler KS, Carson BD, Podlevsky JD, Mayes CM, Rowland JM, Campbell D, Ricken JB, Wudiri G, Timlin JA. Singleplex, multiplex and pooled sample real-time RT-PCR assays for detection of SARS-CoV-2 in an occupational medicine setting. Sci Rep 2022; 12:17733. [PMID: 36273023 PMCID: PMC9587995 DOI: 10.1038/s41598-022-22106-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 10/10/2022] [Indexed: 01/18/2023] Open
Abstract
For workplaces which cannot operate as telework or remotely, there is a critical need for routine occupational SARS-CoV-2 diagnostic testing. Although diagnostic tests including the CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel (CDC Diagnostic Panel) (EUA200001) were made available early in the pandemic, resource scarcity and high demand for reagents and equipment necessitated priority of symptomatic patients. There is a clearly defined need for flexible testing methodologies and strategies with rapid turnaround of results for (1) symptomatic, (2) asymptomatic with high-risk exposures and (3) asymptomatic populations without preexisting conditions for routine screening to address the needs of an on-site work force. We developed a distinct SARS-CoV-2 diagnostic assay based on the original CDC Diagnostic Panel (EUA200001), yet, with minimum overlap for currently employed reagents to eliminate direct competition for limited resources. As the pandemic progressed with testing loads increasing, we modified the assay to include 5-sample pooling and amplicon target multiplexing. Analytical sensitivity of the pooled and multiplexed assays was rigorously tested with contrived positive samples in realistic patient backgrounds. Assay performance was determined with clinical samples previously assessed with an FDA authorized assay. Throughout the pandemic we successfully tested symptomatic, known contact and travelers within our occupational population with a ~ 24-48-h turnaround time to limit the spread of COVID-19 in the workplace. Our singleplex assay had a detection limit of 31.25 copies per reaction. The three-color multiplexed assay maintained similar sensitivity to the singleplex assay, while tripling the throughput. The pooling assay further increased the throughput to five-fold the singleplex assay, albeit with a subtle loss of sensitivity. We subsequently developed a hybrid 'multiplex-pooled' strategy to testing to address the need for both rapid analysis of samples from personnel at high risk of COVID infection and routine screening. Herein, our SARS-CoV-2 assays specifically address the needs of occupational healthcare for both rapid analysis of personnel at high-risk of infection and routine screening that is essential for controlling COVID-19 disease transmission. In addition to SARS-CoV-2 and COVID-19, this work demonstrates successful flexible assays developments and deployments with implications for emerging highly transmissible diseases and future pandemics.
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Affiliation(s)
- Kimberly S. Butler
- grid.474520.00000000121519272Molecular and Microbiology Department, Sandia National Laboratories, Albuquerque, NM 87123 USA
| | - Bryan D. Carson
- grid.474520.00000000121519272Molecular and Microbiology Department, Sandia National Laboratories, Albuquerque, NM 87123 USA
| | - Joshua D. Podlevsky
- grid.474520.00000000121519272Molecular and Microbiology Department, Sandia National Laboratories, Albuquerque, NM 87123 USA
| | - Cathryn M. Mayes
- grid.474520.00000000121519272WMD Threats and Aerosol Science, Sandia National Laboratories, Albuquerque, NM 87123 USA
| | - Jessica M. Rowland
- grid.474520.00000000121519272Global Chemical and Biological Security, Sandia National Laboratories, Albuquerque, NM 87123 USA
| | - DeAnna Campbell
- grid.474520.00000000121519272Biological and Chemical Sensors Department, Sandia National Laboratories, Albuquerque, NM 87123 USA
| | - J. Bryce Ricken
- grid.474520.00000000121519272Molecular and Microbiology Department, Sandia National Laboratories, Albuquerque, NM 87123 USA
| | - George Wudiri
- grid.474520.00000000121519272Cooperative Nuclear Counterproliferation, Sandia National Laboratories, Albuquerque, NM 87123 USA
| | | | - Jerilyn A. Timlin
- grid.474520.00000000121519272Molecular and Microbiology Department, Sandia National Laboratories, Albuquerque, NM 87123 USA ,grid.474520.00000000121519272Computational Biology and Biophysics Department, Sandia National Laboratories, Albuquerque, NM 87123 USA
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Sun DJ, Li HT, Ye Z, Xu BB, Li DZ, Wang W. Gastrointestinal bleeding caused by syphilis: A case report. World J Clin Cases 2021; 9:7909-7916. [PMID: 34621845 PMCID: PMC8462228 DOI: 10.12998/wjcc.v9.i26.7909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/15/2021] [Accepted: 07/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Syphilis is a chronic, classic sexually transmitted disease caused by Treponema pallidum, which can invade almost all organs of the body and produce various symptoms and signs. Although there are some cases of colorectal bleeding caused by syphilis, small intestinal bleeding caused by syphilis is still rare.
CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years. Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions. During the same admission, multiple intestinal ulcers were found by capsule endoscopy, and syphilis was also diagnosed. With a history of atrial fibrillation and chronic pancreatitis, he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease. After anti-syphilis treatment, the melena and abdominal pain disappeared and his hemoglobin gradually increased. It is considered that gastrointestinal bleeding, chronic pancreatitis, atrial fibrillation, and heart valvular disease may have been caused by syphilis.
CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding. In addition, treatment of the disease requires both sexual partners to be treated. Finally, although syphilis is easy to treat, it is more important to consider that bleeding could be caused by syphilis.
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Affiliation(s)
- Dong-Jie Sun
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Hai-Tao Li
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Zhou Ye
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Bin-Bin Xu
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Da-Zhou Li
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
| | - Wen Wang
- Department of Digestive Diseases, 900th Hospital of Joint Logistics Support Force, Fuzhou 350025, Fujian Province, China
- Fuzhou General Clinical Medical College, Fujian Medical University, Fuzhou 350025, Fujian Province, China
- Oriental Hospital Affiliated, Xiamen University, Xiamen 350025, Fujian Province, China
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