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Hunfeld KP, Kraiczy P, Norris DE, Lohr B. The In Vitro Antimicrobial Susceptibility of Borrelia burgdorferi sensu lato: Shedding Light on the Known Unknowns. Pathogens 2023; 12:1204. [PMID: 37887720 PMCID: PMC10609913 DOI: 10.3390/pathogens12101204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/28/2023] Open
Abstract
Human Lyme borreliosis (LB) represents a multisystem disorder that can progress in stages. The causative agents are transmitted by hard ticks of the Ixodes ricinus complex that have been infected with the spirochete Borrelia burgdorferi sensu lato. Today, LB is considered the most important human tick-borne illness in the Northern Hemisphere. The causative agent was identified and successfully isolated in 1982 and, shortly thereafter, antibiotic treatment was found to be safe and efficacious. Since then, various in vitro studies have been conducted in order to improve our knowledge of the activity of antimicrobial agents against B. burgdorferi s. l. The full spectrum of in vitro antibiotic susceptibility has still not been defined for some of the more recently developed compounds. Moreover, our current understanding of the in vitro interactions between B. burgdorferi s. l. and antimicrobial agents, and their possible mechanisms of resistance remains very limited and is largely based on in vitro susceptibility experiments on only a few isolates of Borrelia. Even less is known about the possible mechanisms of the in vitro persistence of spirochetes exposed to antimicrobial agents in the presence of human and animal cell lines. Only a relatively small number of laboratory studies and cell culture experiments have been conducted. This review summarizes what is and what is not known about the in vitro susceptibility of B. burgdorferi s. l. It aims to shed light on the known unknowns that continue to fuel current debates on possible treatment resistance and mechanisms of persistence of Lyme disease spirochetes in the presence of antimicrobial agents.
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Affiliation(s)
- Klaus-Peter Hunfeld
- Institute for Laboratory Medicine, Microbiology & Infection Control, Northwest Medical Centre, Academic Teaching Hospital, Medical Faculty, Goethe University Frankfurt, Steinbacher Hohl 2-26, D-60488 Frankfurt am Main, Germany;
- INSTAND e.V., Gesellschaft zur Förderung der Qualitätssicherung in medizinischen Laboratorien e.V., Ubierstraße 20, D-40223 Düsseldorf, Germany
| | - Peter Kraiczy
- Institute for Medical Microbiology & Infection Control, University Hospital Frankfurt, Goethe University Frankfurt, Paul-Ehrlich Str. 40, D-60596 Frankfurt am Main, Germany;
| | - Douglas E. Norris
- W. Harry Feinstone Department of Molecular Microbiology & Immunology, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA;
| | - Benedikt Lohr
- Institute for Laboratory Medicine, Microbiology & Infection Control, Northwest Medical Centre, Academic Teaching Hospital, Medical Faculty, Goethe University Frankfurt, Steinbacher Hohl 2-26, D-60488 Frankfurt am Main, Germany;
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Šmit R, Wojtalewicz N, Vierbaum L, Nourbakhsh F, Schellenberg I, Hunfeld KP, Lohr B. Epidemiology, Management, Quality of Testing and Cost of Syphilis in Germany: A Retrospective Model Analysis. Front Public Health 2022; 10:883564. [PMID: 35558533 PMCID: PMC9086961 DOI: 10.3389/fpubh.2022.883564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background A multi-dimensional model can be a useful tool for estimating the general impact of disease on the different sectors of the healthcare system. We chose the sexually transmitted disease syphilis for our model due to the good quality of reported data in Germany. Methods The model included gender- and age-stratified incident cases of syphilis (in- and outpatients) provided by a German statutory health insurance company, as well as seroprevalence data on syphilis in first-time blood donors. Age standardized rates were calculated based on the standard German population. The test quality was assessed by extrapolating the number of false-positive and false-negative results based on data from Europe-wide external quality assessment (EQA) schemes. The model analysis was validated with the reported cases and diagnosis-related group (DRG)-statistics from 2010 to 2012. The annual direct and indirect economic burden was estimated based on the outcomes of our model. Results The standardized results were slightly higher than the results reported between 2010 and 2012. This could be due to an underassessment of cases in Germany or due to limitations of the dataset. The number of estimated inpatients was predicted with an accuracy of 89.8 %. Results from EQA schemes indicated an average sensitivity of 92.8 % and an average specificity of 99.9 % for the recommended sequential testing for syphilis. Based on our model, we estimated a total average minimal annual burden of €20,292,110 for syphilis on the German healthcare system between 2010 and 2012. Conclusions The linking of claims data, results from EQA schemes, and blood donor surveillance can be a useful tool for assessing the burden of disease on the healthcare system. It can help raise awareness in populations potentially at risk for infectious diseases, demonstrate the need to educate potential risk groups, and may help with predictive cost calculations and planning.
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Affiliation(s)
- Renata Šmit
- Northwest Medical Centre, Medical Faculty, Academic Teaching Hospital, Institute for Laboratory Medicine, Microbiology and Infection Control, Goethe University, Frankfurt, Germany
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
| | - Nathalie Wojtalewicz
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
| | - Laura Vierbaum
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
| | - Farzin Nourbakhsh
- Northwest Medical Centre, Medical Faculty, Academic Teaching Hospital, Institute for Laboratory Medicine, Microbiology and Infection Control, Goethe University, Frankfurt, Germany
| | - Ingo Schellenberg
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
- Center of Life Sciences, Institute of Bioanalytical Sciences (IBAS), Anhalt University of Applied Sciences, Bernburg, Germany
| | - Klaus-Peter Hunfeld
- Northwest Medical Centre, Medical Faculty, Academic Teaching Hospital, Institute for Laboratory Medicine, Microbiology and Infection Control, Goethe University, Frankfurt, Germany
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
| | - Benedikt Lohr
- Northwest Medical Centre, Medical Faculty, Academic Teaching Hospital, Institute for Laboratory Medicine, Microbiology and Infection Control, Goethe University, Frankfurt, Germany
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
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Werner R, Lohr B, Lodemann P, Chemnitz JM, Woehrle JC. Autoimmune basal ganglia encephalitis with hemolytic anemia. Ann Hematol 2022; 101:1857-1858. [PMID: 35449425 DOI: 10.1007/s00277-022-04848-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/16/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Ralph Werner
- Katholisches Klinikum Koblenz-Montabaur, Klinik Für Neurologie Und Stroke Unit, Kardinal-Krementz-Str. 1-5, 56073, Koblenz, Germany.
| | - Benedikt Lohr
- MVZ Für Laboratoriumsmedizin Und Mikrobiologie Koblenz-Mittelrhein, Viktoriastr. 39, 56068, Koblenz, Germany
| | - Peter Lodemann
- IFLb Laboratoriumsmedizin Berlin GmbH, Windscheidstraße 18, 10627, Berlin-Charlottenburg, Germany
| | - Jens Marcus Chemnitz
- Gemeinschaftsklinikum Mittelrhein, Standort Ev. Stift Koblenz, Hämatologie/Onkologie, Johannes-Mueller-Str. 7, 56068, Koblenz, Germany
| | - Johannes C Woehrle
- Katholisches Klinikum Koblenz-Montabaur, Klinik Für Neurologie Und Stroke Unit, Kardinal-Krementz-Str. 1-5, 56073, Koblenz, Germany
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Kaddu-Mulindwa D, Keuser L, Lesan V, Rissland J, Smola S, Werdecker V, Stilgenbauer S, Christofyllakis K, Thurner L, Bewarder M, Lohr B, Lutz J, Lohse S, Rieke A. IgG seroprevalence of COVID-19 among people living with HIV or at high risk of HIV in south-west Germany: A seroprevalence study. HIV Med 2021; 23:564-569. [PMID: 34811869 PMCID: PMC9011579 DOI: 10.1111/hiv.13207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/26/2021] [Accepted: 11/09/2021] [Indexed: 12/11/2022]
Abstract
Objectives Seroprevalence studies of SARS‐CoV‐2 have shown that there is a high number of undiagnosed missing cases. Seroprevalence of SARS‐CoV‐2 in people living with HIV (PLWH) is lacking. Therefore, we conducted a prospective cross‐sectional study to estimate the seroprevalence of SARS‐CoV‐2 among PLWH without known diagnosis of COVID‐19 in the south‐west of Germany. Methods Serological testing for SARS‐CoV‐2 immunoglobulin G (IgG) antibodies based on two assays was performed in PLWH who visited the outpatient HIV centre of two hospitals from April to June 2020. Additionally, patients had to answer questionnaires about possible COVID‐19‐related symptoms and predefined risk factors. Moreover, we tested 50 non‐HIV‐infected patients receiving post‐ or pre‐exposure (PEP/PrEP) HIV prophylaxis. Results In all, 594 (488 male, 106 female) PLWH (median age 51 years) and 50 PEP/PrEP‐users were included in the study. The estimated seroprevalence of the PLWH cohort was 1.85% (11/594), with 11 positive tested cases in the cohort. Among all patients, only five had COVID‐19‐related symptoms. One PCR‐positive patient did not show any antibody response in repeatedly carried out tests. None of the patients was hospitalized due to COVID‐19. Three PrEP users were tested positive. Three patients had been previously diagnosed with SARS‐COV‐2 infection before inclusion. The used questionnaire did not help to detect SARS‐CoV‐2 positive patients. Conclusions Despite the limitation of being only a snapshot in time because of the ongoing pandemic, to our knowledge this is the largest study so far on seroprevalence of SARS‐CoV‐2 in PLWH in Germany. Our study suggests that the seroprevalence of SARS‐CoV‐2 in PLWH is comparable to those previously reported for parts of the general German population and that the questionnaire used here might not be the best tool to predict COVID‐19 diagnosis.
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Affiliation(s)
- Dominic Kaddu-Mulindwa
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Lukas Keuser
- Gemeinschaftsklinikum Mittelrhein, Kemperhof Koblenz, Koblenz, Germany
| | - Vadim Lesan
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Jürgen Rissland
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany.,Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, Saarbrücken, Germany
| | - Victoria Werdecker
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Stephan Stilgenbauer
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | | | - Lorenz Thurner
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Moritz Bewarder
- Department of Medicine I, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Benedikt Lohr
- MVZ für Laboratoriumsmedizin und Mikrobiologie Koblenz-Mittelrhein, Koblenz, Germany
| | - Jens Lutz
- Gemeinschaftsklinikum Mittelrhein, Kemperhof Koblenz, Koblenz, Germany
| | - Stefan Lohse
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Ansgar Rieke
- Gemeinschaftsklinikum Mittelrhein, Kemperhof Koblenz, Koblenz, Germany
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Lohr B, Niemann D, Verheyen J. Bamlanivimab treatment leads to rapid selection of immune escape variant carrying E484K mutation in a B.1.1.7 infected and immunosuppressed patient. Clin Infect Dis 2021; 73:2144-2145. [PMID: 34009286 DOI: 10.1093/cid/ciab392] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Dirk Niemann
- Gemeinschaftsklinikum Mittelrhein - Ev. Stift St. Martin, 56068 Koblenz, Germany
| | - Jens Verheyen
- Institute of Immunology and Genetics, 67655 Kaiserslautern, Germany
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Abstract
This review is directed at physicians and laboratory personnel in private practice and clinics who treat and diagnose Lyme borreliosis (LB) in patients as part of their daily work. A major objective of this paper is to bring together background information on Borrelia (B.) burgdorferi sensu lato (s.l.) and basic clinical knowledge of LB, which is one of the most frequently reported vector-borne diseases in the Northern Hemisphere. The goal is to provide practical guidance for clinicians and for laboratory physicians, and scientists for a better understanding of current achievements and ongoing obstacles in the laboratory diagnosis of LB, an infectious disease that still remains one of the diagnostic chameleons of modern clinical medicine. Moreover, in bringing together current scientific information from guidelines, reviews, and original papers, this review provides recommendations for selecting the appropriate tests in relation to the patient's stage of disease to achieve effective, stage-related application of current direct and indirect laboratory methods for the detection of B. burgdorferi s.l. Additionally, the review aims to discuss the current state of the art concerning the diagnostic potential and limitations of the assays and test methods currently in use to optimize LB patient management and provide insight into the possible future prospects of this rapidly changing area of laboratory medicine.
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Affiliation(s)
- Benedikt Lohr
- a Institute for Laboratory Medicine, Microbiology & Infection Control , Northwest Medical Centre, Medical Faculty, Goethe University , Frankfurt/Main , Germany
| | - Volker Fingerle
- b Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL) , Oberschleissheim , Germany
| | - Douglas E Norris
- c W. Harry Feinstone Department of Molecular Microbiology & Immunology , Bloomberg School of Public Health, Johns Hopkins University , Baltimore , MD , USA
| | - Klaus-Peter Hunfeld
- a Institute for Laboratory Medicine, Microbiology & Infection Control , Northwest Medical Centre, Medical Faculty, Goethe University , Frankfurt/Main , Germany
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Lohr B, Pfeifer Y, Heudorf U, Rangger C, Norris DE, Hunfeld KP. High Prevalence of Multidrug-Resistant Bacteria in Libyan War Casualties Admitted to a Tertiary Care Hospital, Germany. Microb Drug Resist 2017; 24:578-584. [PMID: 29039717 DOI: 10.1089/mdr.2017.0141] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The ongoing Libyan conflict constantly causes victims among the military and civilian population. Cross-border transfer of patients represents a high risk of introducing multidrug-resistant organisms (MDROs), for example, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, and carbapenem-resistant gram-negative organisms (CROs), into the country of destination. This study assessed the MDRO status in Libyan war casualties (n = 67) admitted to Northwest Medical Centre in Frankfurt/Main, Germany, from August 2016 till January 2017. Identified multidrug-resistant nonfermenters and Enterobacteriaceae were subjected to molecular detection of β-lactamases and further mechanisms of resistance. All isolates were typed by enzymatic macrorestriction and subsequent pulsed-field gel electrophoresis. MDROs were found in 40 (60%) patients, including 25 (37%) positive for at least one CRO and 11 (16%) patients with MRSA. A total of 37 isolates of Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Enterobacter cloacae, and Serratia marcescens produced carbapenemases: NDM (n = 17), OXA-48 (n = 15), and OXA-23 (n = 9) in addition to other β-lactamases (with blaCTX-M-group-1 being most frequent) and plasmid-mediated quinolone resistance genes (qnrB, aac(6')Ib-cr). Bacterial strain typing revealed the presence of various clones. This high MDRO rate in Libyan war casualties demands awareness, appropriate screening, and containment measures for medical institutions involved in medical care to avoid patient-to-patient transmission.
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Affiliation(s)
- Benedikt Lohr
- 1 Institute for Laboratory Medicine , Microbiology & Infection Control, Northwest Medical Centre, Frankfurt/Main, Germany
| | - Yvonne Pfeifer
- 2 Nosocomial Pathogens and Antibiotic Resistance, Robert Koch-Institute , Wernigerode, Germany
| | - Ursel Heudorf
- 3 Division of Infectious Diseases and Hygiene, Public Health Department, Frankfurt/Main, Germany
| | - Christoph Rangger
- 4 Department for Orthopaedics and Trauma Surgery, Northwest Medical Centre , Frankfurt/Main, Germany
| | - Douglas E Norris
- 5 W. Harry Feinstone Department of Molecular Microbiology & Immunology, Bloomberg School of Public Health , Baltimore, Maryland
| | - Klaus-Peter Hunfeld
- 1 Institute for Laboratory Medicine , Microbiology & Infection Control, Northwest Medical Centre, Frankfurt/Main, Germany
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Lohr B, Hunfeld KP, Meltendorf C. Okuläre Herpesviridae-Infektionen – Labordiagnostik und Therapeutika. Augenheilkunde up2date 2016. [DOI: 10.1055/s-0041-111284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- B. Lohr
- Institut für Labormedizin, Mikrobiologie und Krankenhaushygiene, Krankenhaus Nordwest, Frankfurt a. M
| | - K.-P. Hunfeld
- Institut für Labormedizin, Mikrobiologie und Krankenhaushygiene, Krankenhaus Nordwest, Frankfurt a. M
| | - C. Meltendorf
- Universitätsaugenklinik, Universitätsklinikum Magdeburg
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Lohr B, Hunfeld KP, Meltendorf C. Okuläre Herpesviridae-Infektionen – Labordiagnostik und Therapeutika. Klin Monbl Augenheilkd 2016; 232:303-22. [DOI: 10.1055/s-0033-1358216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- B. Lohr
- Institut für Labormedizin, Mikrobiologie und Krankenhaushygiene, Krankenhaus Nordwest, Frankfurt a. M
| | - K.-P. Hunfeld
- Institut für Labormedizin, Mikrobiologie und Krankenhaushygiene, Krankenhaus Nordwest, Frankfurt a. M
| | - C. Meltendorf
- Universitätsaugenklinik, Universitätsklinikum Magdeburg
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Mai M, Müller I, Maneg D, Lohr B, Haecker A, Haberhausen G, Hunfeld KP. Real-time PCR-based identification of bacterial and fungal pathogens from blood samples. Methods Mol Biol 2015; 1237:139-147. [PMID: 25319787 DOI: 10.1007/978-1-4939-1776-1_14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Latest major contributions in the field of sepsis diagnostics result from advances in PCR technologies permitting new standards in speed and quality, given the fact that a timely diagnosis is the decisive factor to the survival of patients with bloodstream infections.Multiplex real-time PCR is a quantitative method for simultaneous amplification and detection of different targeted DNA molecules within hours. Nevertheless, various studies have shown a number of technical shortcomings as well as a high heterogeneity in sensitivity.The present method allows the standardized and rapid detection and identification of 25 common bacteria and fungi responsible for bloodstream infections from whole blood samples by using LightCycler(®) SeptiFast (LC-SF) test, based on real-time PCR.
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Affiliation(s)
- Madeleine Mai
- Institute of Laboratory Medicine, Microbiology and Infection Control, Northwest Medical Centre, Frankfurt/Main, Germany
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Dahms R, Carlson M, Lohr B, Beilman G. Selective digestive tract decontamination and vancomycin-resistant enterococcus isolation in the surgical intensive care unit. Shock 2000; 14:343-6. [PMID: 11028554 DOI: 10.1097/00024382-200014030-00018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Vancomycin-resistant Enterococcus (VRE) has emerged as a significant nosocomial pathogen in the surgical intensive care unit (SICU). We wished to test the hypothesis that the use of selective digestive tract decontamination (SDD) in the SICU affects the frequency of VRE isolation. A retrospective review of hospital records and the SICU database was performed using patients admitted to the SICU service for three or more days from January 1, 1996 to December 31, 1999 at our large tertiary-care teaching hospital. During this time use of SDD in selected patient populations decreased due to physician preference. Information gathered included length of SICU stay, presence of VRE infection or colonization, and use and duration of SDD protocol, vancomycin, and ceftazidime. There were 110 newly diagnosed VRE cases in the SICU during this time period. During the same time period 54 patients received SDD. Eight patients who received SDD had positive VRE cultures and seven had the initial positive culture after receiving SDD. Overall, 9.1% of eligible SICU patients received SDD, 18.5% of patients in the SICU for over 3 days had VRE, 7.3% of VRE patients received SDD, and 13.0% of the SICU patients who received SDD subsequently developed VRE. SDD use was not associated with VRE in univariate analysis. Logistic regression analysis showed higher odds ratios for SDD use in combination with vancomycin than for vancomycin use alone (OR=4.3 vs. 10.9). Odds ratios were over three times higher for SDD plus vancomycin plus ceftazidime use when compared to vancomycin plus ceftazidime use alone (OR=70.5 vs. 19.8). We conclude that administration of SDD alone did not correlate with increased VRE isolation, but that SDD use in conjunction with vancomycin and ceftazidime was associated with VRE isolation.
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Affiliation(s)
- R Dahms
- Department of Surgery, University of Minnesota, Fairview-University Medical Center, Minneapolis 55455, USA
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Amagai S, Dooling RJ, Shamma S, Kidd TL, Lohr B. Detection of modulation in spectral envelopes and linear-rippled noises by budgerigars (Melopsittacus undulatus). J Acoust Soc Am 1999; 105:2029-2035. [PMID: 10089620 DOI: 10.1121/1.426736] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Budgerigars were trained to discriminate complex sounds with two different types of spectral profiles from flat-spectrum, wideband noise. In one case, complex sounds with a sinusoidal ripple in (log) amplitude across (log) frequency bandwidth were generated by combining 201 logarithmically spaced tones covering the frequency region from 500 Hz to 10 kHz. A second type of rippled stimulus was generated by delaying broadband noise and adding it to the original noise in an iterative fashion. In each case, thresholds for modulation depth (i.e., peak-to-valley in dB) were measured at several different ripple frequencies (i.e., cycles/octave for logarithmic profiles) or different repetition pitches (i.e., delay for ripple noises). Budgerigars were similar to humans in detecting ripple at low spatial frequencies, but were considerably more sensitive than humans in detecting ripples in log ripple spectra at high spatial frequencies. Budgerigars were also similar to humans in detecting linear ripple in broadband noise over a wide range of repetition pitches. Taken together, these data show that the avian auditory system is at least as good, if not better, than the human auditory system at detecting spectral ripples in noise despite gross anatomical differences in both the peripheral and central auditory nervous systems.
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Affiliation(s)
- S Amagai
- Department of Psychology, University of Maryland at College Park 20742, USA
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Abstract
The treatment of Body Dysmorphic Disorder (BDD) has received little empirical attention despite evidence that BDD is a debilitating mental health problem. This open case series provides data on a new cognitive-behavioral treatment for BDD. Participants diagnosed with BDD were treated in small groups that met for 12 weekly 90-minute sessions. Patients improved significantly over the course of treatment, with reductions in both BDD and depression symptoms. This finding adds to a nascent literature documenting the potential efficacy of short-term cognitive-behavior therapy for patients suffering from BDD.
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Affiliation(s)
- S Wilhelm
- Massachusetts General Hospital, Charlestown, USA.
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15
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Lohr B, Dooling RJ. Detection of changes in timbre and harmonicity in complex sounds by zebra finches (Taeniopygia guttata) and budgerigars (Melopsittacus undulatus). J Comp Psychol 1998; 112:36-47. [PMID: 9528113 DOI: 10.1037/0735-7036.112.1.36] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Thresholds for detecting alterations in the timbre and harmonicity of complex harmonic signals were measured in zebra finches, budgerigars, and humans. The stimuli used in this experiment were designed to have particular salience for zebra finches by modeling them after natural zebra finch calls. All 3 species showed similar abilities for detecting an amplitude decrement in a single component of a harmonic complex. However, zebra finches and budgerigars were extraordinarily sensitive to the mistunings of single harmonics and exhibited significantly lower thresholds compared with humans at 2 different fundamental frequencies, 570 Hz and 285 Hz. Randomizing relative phases of components in a harmonic stimulus resulted in a significant increase in threshold for detecting mistunings in zebra finches but not in humans. Decreasing the duration of mistuned harmonic stimuli resulted in higher thresholds for both birds and humans. The overall superiority of birds in discriminating inharmonicity suggests that birds and mammals may use different strategies in processing these complex harmonic sounds.
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Affiliation(s)
- B Lohr
- Department of Psychology, University of Maryland, College Park 20742-4411, USA.
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Abstract
In the present experiments it was tested whether omega-agatoxin-IVA, a peptide blocking P-type voltage-dependent Ca2+ channels, inhibits the evoked release of newly synthesized [3H]acetylcholine from the rat phrenic nerve. Release of [3H]acetylcholine was evoked by electrical stimulation of the isolated phrenic nerve (100 or 750 pulses at 5 Hz). omega-Agatoxin-IVA inhibited evoked [3H]acetylcholine release in a concentration-related manner; inhibition started at a concentration of 30 nM with complete block occurring at 500 nM. In conclusion, the present experiments demonstrate that omega-agatoxin-IVA-sensitive P-type Ca2+ channels are critically involved in the regulation of stimulus-induced transmitter release at mammalian motor endplates.
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Affiliation(s)
- I Wessler
- Department of Pharmacology, University of Mainz, Germany
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Affiliation(s)
- J Gabel
- University of Wisconsin's School of Business
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Gutierrez AP, Neuenschwander P, Schulthess F, Herren HR, Baumgaertner JU, Wermelinger B, Lohr B, Ellis CK. Analysis of Biological Control of Cassava Pests in Africa. II. Cassava Mealybug Phenacoccus manihoti. J Appl Ecol 1988. [DOI: 10.2307/2403755] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Althoff M, Braunschweig W, Kirschfink FJ, Lübelsmeyer K, Martyn HU, Peise G, Rimkus J, Rosskamp P, Sander HG, Schmitz D, Siebke H, Wallraff W, Fischer HM, Hartmann H, Hillen W, Jocksch A, Knop G, Köpke L, Kolanoski H, Kück H, Wedemeyer R, Wermes N, Wollstadt M, Burkhardt H, Eisenberg Y, Gather K, Hultschig H, Joos P, Koch W, Kötz U, Kowalski H, Ladage A, Lohr B, Lüke D, Mättig P, Notz D, Pyrlik J, Quarrie DR, Rushton M, Schütte W, Trines D, Wolf G, Xiao C, Fohrmann R, Hilger E, Kracht T, Krasemann HL, Leu P, Lohrmann E, Pandoulas D, Poelz G, Wiik BH, Beuselinck R, Binnie DM, Campbell AJ, Dornan PJ, Foster B, Garbutt DA, Jenkins C, Jones TD, Jones WG, McCardle J, Sedgbeer JK, Wan Abdullah WAT, Bell KW, Bowler MG, Brock IC, Cashmore RJ, Clarke PEL, Devenish R, Grossmann P, Llyod SL, Salmon GL, Thomas J, Wyatt TR, Youngman C, Hart JC, Harvey J, Hasell DK, Proudfoot J, Saxon DH, Woodworth PL, Barreiro F, Dittmar M, Holder M, Neumann B, Duchovni E, Karshon U, Mikenberg G, Mir R, Revel D, Ronat E, Shapira A, Yekutieli G, Barklow T, Caldwell A, Cherney M, Izen JM, Mermikides M, Rudolph G, Strom D, Venkataramania H, Wicklund E, Wu SL, Zobernig G. An improved measurement of electroweak couplings frome + e −→e + e − ande + e −→μ + μ −. ACTA ACUST UNITED AC 1984. [DOI: 10.1007/bf01577559] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bretschneider HJ, Hübner G, Knoll D, Lohr B, Nordbeck H, Spieckermann PG. Myocardial resistance and tolerance to ischemia: physiological and biochemical basis. J Cardiovasc Surg (Torino) 1975; 16:241-60. [PMID: 239002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This article is a short review of newer findings concerning the physiological and biochemical bases of the heart's tolerance to ischemia. The following themes are discussed. I. Energy-pool, energy-demand, and efficiency of anaerobic metabolism, the essential determinants of reanimation time and the heart's tolerance to ischemia. II. Experimental results of ischemic heart arrest and the heart arrest induced by a sodium-poor calcium-free, procaine-containing cardioplegic solution, developed by the author. III. Equivalents of function, metabolism and structure during the anaerobic period of the myocardium. IV. The myocardium's capability to recover in dependence on the metabolic state of ischemia and summary of the most important points of gaining a long time of tolerated ischemia. V. Survey and prospects.
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Lohr B, Braun U, Hellberg K, Knoll D, Nordeck E, Spieckermann PG. 79. Intramyokardialer pH-Wert als Indicator für die Wiederbelebbarkeit des künstlich stillgestellten Herzens. ACTA ACUST UNITED AC 1971. [DOI: 10.1007/bf01770496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Braun U, Hensel I, Kettler D, Lohr B. [Influence of methoxyflurane, halothane, dipiritramide, barbiturate and ketamine on the total oxygen consumption of the dog]. Anaesthesist 1971; 20:369-75. [PMID: 4940587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Spieckermann PG, Braun U, Hellberg K, Lohr B, Kettler D, Nordeck E, Bretschneider HJ. [Survival and resuscitation time of the heart during ketamine, barbiturates and halothane anesthesia]. Z Prakt Anasth 1970; 5:365-72. [PMID: 4256249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Eigler FW, Lohr B, Mittring G, Sachweh D. �ber den Widerstand und den Sauerstoffverbrauch von isolierten Hundenieren w�hrend der Perfusion mit k�nstlichen L�sungen bei 10 Grad C. Langenbecks Arch Surg 1965. [DOI: 10.1007/bf01449461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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