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Pedersen TR, Wessman M, Lindegaard M, Hallstrøm S, Westergaard C, Brock I, Dzajic E, Holmgaard DB, Jensen CS, Justesen US, Kornum JB, Søndergaard TS, Thomsen MK, Westh H, Østergaard C, Hoffmann S, Stegger M. Gonorrhoea on the rise in Denmark since 2022: distinct clones drive increase in heterosexual individuals. Euro Surveill 2024; 29:2400059. [PMID: 38362625 PMCID: PMC10986658 DOI: 10.2807/1560-7917.es.2024.29.7.2400059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/14/2024] [Indexed: 02/17/2024] Open
Abstract
A surge in gonorrhoea in Denmark has occurred since 2022, a 46% increase from 2021. National surveillance, leveraging mandatory reporting and epidemiological data, highlights three distinct clades linked to heterosexual transmission. Despite the rise, these exhibit high susceptibility, contrasting MSM-associated strains. Geographical hotspots and age-specific patterns further illuminate transmission dynamics. The combination of genomic and epidemiological data provides novel insights into the evolving landscape of gonorrhoea, indicating potential shifts in infection dynamics and transmissibility.
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Affiliation(s)
- Thomas Roland Pedersen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Maria Wessman
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Mikkel Lindegaard
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Søren Hallstrøm
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Casper Westergaard
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Inger Brock
- Department of Clinical Microbiology, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Esad Dzajic
- Clinical Diagnostic Department, University Hospital of Southern Denmark, Esbjerg, Denmark
| | | | - Christian Salgård Jensen
- Department of Clinical Microbiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ulrik Stenz Justesen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | | | | | - Marianne Kragh Thomsen
- Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Henrik Westh
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Claus Østergaard
- Department of Clinical Microbiology, University Hospital of Southern Denmark, Vejle, Denmark
| | - Steen Hoffmann
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Marc Stegger
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
- Antimicrobial Resistance and Infectious Diseases Laboratory, Harry Butler Institute, Murdoch University, Perth, Australia
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Banke G, Kjeldgaard P, Shaker SB, Sivapalan P, Søholm J, Back Holmgaard D, Thyssen Astvad KM, Bangsborg J, Brun Andersen M, Bonnesen B. Aspergilloma complicating previous COVID-19 pneumonitis - a case report. APMIS 2022; 130:397-403. [PMID: 35445461 PMCID: PMC9111481 DOI: 10.1111/apm.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/17/2022] [Indexed: 11/28/2022]
Abstract
Aspergillomas are found in pre‐existing cavities in pulmonary parenchyma. To the best of our knowledge, aspergilloma has not previously been reported in COVID‐19‐associated pulmonary architecture distortion combined with barotrauma from invasive mechanical ventilation therapy. We present a case of a 67‐year‐old woman, who suffered from severe COVID‐19 in the summer of 2020 with no suspicion of infection with Aspergillus in the acute phase. Ten months after discharge from her COVID‐related admission, she developed bilateral aspergillomas diagnosed by image diagnostics, bronchoscopy, and blood samples, and she now receives antifungal therapy. We would like to raise awareness on aspergilloma in post‐COVID‐19 patients, since it is an expected long‐term complication to COVID‐19 patients with pulmonary architectural distortion.
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Affiliation(s)
- Gry Banke
- Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Peter Kjeldgaard
- Department of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Saher Burhan Shaker
- Department of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Pradeesh Sivapalan
- Department of Pulmonary Medicine, Zealand University Hospital Roskilde, Roskilde, Denmark
| | - Jacob Søholm
- Department of Infectious Diseases, Zealand University Hospital Roskilde, Roskilde, Denmark
| | - Dennis Back Holmgaard
- Department of Clinical Microbiology, Zealand University Hospital Roskilde, Roskilde, Denmark
| | | | - Jette Bangsborg
- Department of Clinical Microbiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Michael Brun Andersen
- Department of Radiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Barbara Bonnesen
- Department of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
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Bonnesen B, Sivapalan P, Naghavi H, Back Holmgaard D, Sloth C, Wiese L, Kolekar S. A unique case of Fusobacterium nucleatum spondylodiscitis communicating with a pleural empyema through a fistula. APMIS 2021; 129:626-630. [PMID: 34418158 DOI: 10.1111/apm.13171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 08/13/2021] [Indexed: 11/29/2022]
Abstract
Species (spp.) belonging to the genus Fusobacterium are anaerobic commensals colonizing the upper respiratory tract, the gastrointestinal tract, and the genitals. Infections with Fusobacterium spp. have been reported at many anatomical sites, including pneumonias and pleural empyemas; however, there are very few published cases of Fusobacterium spp. causing spondylodiscitis or fistulas. Bone infections with Fusobacterium can spread directly to surrounding muscular tissue or by hematogenous transmission to any other tissue including pleurae and lungs. Similarly, pleural infections can spread Fusobacterium spp. to any other tissue including fistulas and bone. Concomitant pleural empyema and spondylodiscitis are rare; however, there are a few published cases with concomitant disease, although none caused by Fusobacterium spp. A 77-year-old female patient was assessed using computed tomography (CT) scanning of the thorax and abdomen, as well as analyses of fluid drained from the region affected by the pleural empyema. A diagnosis of Fusobacterium empyema, fistula, bacteremia, and spondylodiscitis was made, and the patient's condition improved significantly after drainage of the pleural empyema and relevant long-term antibiotic treatment. We describe the first confirmed case with concomitant infection with Fusobacterium nucleatum as spondylodiscitis and pleural empyema connected by a fistula.
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Affiliation(s)
- Barbara Bonnesen
- Department of Pulmonary Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Pradeesh Sivapalan
- Department of Pulmonary Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Hadi Naghavi
- Department of Pulmonary Medicine, Zealand University Hospital, Roskilde, Denmark
| | | | - Carsten Sloth
- Department of Radiology, Zealand University Hospital, Roskilde, Denmark
| | - Lothar Wiese
- Department of Infectious Diseases, Zealand University Hospital, Roskilde, Denmark
| | - Shailesh Kolekar
- Department of Pulmonary Medicine, Zealand University Hospital, Roskilde, Denmark
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Thomsen K, Christophersen L, Lerche CJ, Holmgaard DB, Calum H, Høiby N, Moser C. Azithromycin potentiates avian IgY effect against Pseudomonas aeruginosa in a murine pulmonary infection model. Int J Antimicrob Agents 2020; 57:106213. [PMID: 33256950 DOI: 10.1016/j.ijantimicag.2020.106213] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 10/13/2020] [Accepted: 10/17/2020] [Indexed: 01/25/2023]
Abstract
Cystic fibrosis (CF) patients are at risk of acquiring chronic Pseudomonas aeruginosa lung infections. The biofilm mode of growth of P. aeruginosa induces tolerance to antibiotics and the host response; accordingly, treatment failure occurs. Supplemental azithromycin has proven beneficial in CF owing to potential immunomodulatory mechanisms. Clinical studies have demonstrated a reduction in exacerbations in CF patients by avian IgY anti-Pseudomonas immunotherapy. We hypothesise that azithromycin pre-treatment could potentiate the observed anti-Pseudomonas effect of IgY opsonisation in vivo. Evaluation of phagocytic cell capacity was performed using in vitro exposure of azithromycin pre-treated human polymorphonuclear neutrophils to IgY opsonised P. aeruginosa PAO3. A murine lung infection model using nasal planktonic P. aeruginosa inoculation and successive evaluation 24 h post-infection was used to determine lung bacteriology and subsequent pulmonary inflammation. Combined azithromycin treatment and IgY opsonisation significantly increased bacterial killing compared with the two single-treated groups and controls. In vivo, significantly increased bacterial pulmonary elimination was revealed by combining azithromycin and IgY. A reduction in the inflammatory markers mobiliser granulocyte colony-stimulating factor (G-CSF), macrophage inflammatory protein 2 (MIP-2) and interleukin 1 beta (IL-1β) paralleled this effect. Combination of azithromycin and anti-Pseudomonas IgY potentiated the killing and pulmonary elimination of P. aeruginosa in vitro and in vivo. The augmented effect of combinatory treatment with azithromycin and IgY constitutes a potential clinical application for improving anti-Pseudomonas strategies.
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Affiliation(s)
- Kim Thomsen
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Henrik Harpestrengsvej 4A, 2100-DK Copenhagen, Denmark.
| | - Lars Christophersen
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Henrik Harpestrengsvej 4A, 2100-DK Copenhagen, Denmark
| | - Christian Johann Lerche
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Henrik Harpestrengsvej 4A, 2100-DK Copenhagen, Denmark
| | | | - Henrik Calum
- Department of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark
| | - Niels Høiby
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Henrik Harpestrengsvej 4A, 2100-DK Copenhagen, Denmark; Institute of Immunology and Microbiology, Costerton Biofilm Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Claus Moser
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Henrik Harpestrengsvej 4A, 2100-DK Copenhagen, Denmark
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Holmgaard DB, Marina D, Hansen F, Christensen JJ. Bacteremia and urogenital infection with Actinomyces urogenitalis following prolonged urinary retention. APMIS 2019; 128:20-24. [PMID: 31630449 DOI: 10.1111/apm.13000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/07/2019] [Indexed: 11/29/2022]
Abstract
A case of bacteremia with the fastidious bacteria Actinomyces urogenitalis following lengthy urinary retention is reported in a sixty-year-old man. In 2013, the first case of bacteremia due to A. urogenitalis was presented, secondary to a tubo-ovarian abscess following transvaginal oocyte retrieval. To the best of our knowledge, this is the first male bacteremic episode involving A. urogenitalis related to a urinary tract focus. The patient had no prior urogenital medical history. Extensive susceptibility testing was done on isolates from urinary and blood cultures. The organism exhibited fluoroquinolone resistance but was susceptible to most other antibiotics used in the treatment of urinary infections. Due to its unusual growth requirements infections with A. urogenitalis are most likely an underdiagnosed entity.
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Affiliation(s)
| | - Djordje Marina
- Department of Endocrinology, Hvidovre Hospital, Hvidovre, Denmark
| | - Frank Hansen
- Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Jens Jørgen Christensen
- Department of Clinical Microbiology, Slagelse Hospital, Slagelse, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Moestrup KS, Barfod TS, Holmgaard DB. [Two cases of leptospirosis with involvement of the central nervous system]. Ugeskr Laeger 2019; 181:V04190247. [PMID: 31610832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 26-year-old woman developed fever, myalgias and headaches two weeks after having been scratched by a rat, which she kept as a pet. She had limited renal involvement and marginal pleocytosis in the cerebrospinal fluid (CSF). A 51-year-old man had just returned from a holiday with water sports activities and was admitted with fever, severe headaches, neck pain, myalgias and signs of acute renal failure and pleocytosis in the CSF. Both patients had positive Leptospira DNA polymerase chain reaction in their CSF and were treated to full remission.
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Arici E, Evald A, Holmgaard DB, Quist L, Poulsen SD, Worm SW. [Amputation of an arm due to infection with Vibrio vulnificus after beach holiday]. Ugeskr Laeger 2017; 179:V05170403. [PMID: 29208199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Infection with Vibrio vulnificus is a rare condition with approximately 11 cases reported in the Danish literature. It is characterized by soft tissue infection/wound, necrotizing fasciitis and septicaemia. In this case report we present a patient admitted with a rapid progression and sepsis consistent with V. vulnificus infection but with no informa-tion of water exposure. The initial treatment was surgery and sepsis management including broad-spectrum antibiotics. On day eight the patient's right arm was amputated. On day 16 the patient was discharged from the intensive care unit, and on day 32 the patient was transferred to a local hospital.
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Holmgaard DB, Hansen F, Hasman H, Justesen US, Hammerum AM. Characterization of a novel blaIMP gene, blaIMP-58, using whole genome sequencing in a Pseudomonas putida isolate detected in Denmark. Diagn Microbiol Infect Dis 2017; 87:68-70. [DOI: 10.1016/j.diagmicrobio.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 09/21/2016] [Accepted: 10/04/2016] [Indexed: 11/30/2022]
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Sørensen AK, Holmgaard DB, Mygind LH, Johansen J, Pedersen C. Neutrophil-to-lymphocyte ratio, calprotectin and YKL-40 in patients with chronic obstructive pulmonary disease: correlations and 5-year mortality - a cohort study. J Inflamm (Lond) 2015; 12:20. [PMID: 25908927 PMCID: PMC4407303 DOI: 10.1186/s12950-015-0064-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 02/27/2015] [Indexed: 12/14/2022]
Abstract
Background Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and progressive decline in pulmonary function. Neutrophil-to-lymphocyte ratio (NLR), YKL-40 and calprotectin are biomarkers of inflammation and predict mortality in patients with different inflammatory diseases. We aimed to investigate the correlation between levels of these three biomarkers and neutrophil granulocyte and lymphocyte count in patients with moderate to very severe COPD stratified by use of systemic glucocorticoids. Furthermore, we studied the ability of these biomarkers to predict all-cause mortality. Methods 386 patients with moderate to very severe COPD were followed prospectively for 10 years. Patients were divided into two groups according to systemic glucocorticoid use at baseline. Correlations between biomarkers were assessed by Spearman’s Rho, and mortality was evaluated in uni- and multivariate Cox regression analyses with hazard ratios (HR) and 95% confidence intervals (CI). Results Plasma calprotectin was positively correlated with neutrophil granulocyte count and NLR. No significant association was found between plasma YKL-40 and the cellular biomarkers, irrespective of glucocorticoid treatment. In the group not treated with systemic glucocorticoids, plasma calprotectin [HR 1.002 (95% CI 1.000 – 1.004)], NLR [HR 1.090 (1.036 – 1.148)] and lymphocyte count [HR 0.667 (0.522 – 0.851)] were significantly associated with higher mortality. In the group treated with systemic glucocorticoids, higher plasma YKL-40 was significantly associated with mortality in univariate Cox regression analysis [HR 1.006 (1.003 – 1.008)]. Conclusions Calprotectin was related to neutrophil granulocyte count and NLR in patients with moderate to very severe COPD in stable phase and not in treatment with systemic glucocorticoids. Lymphopenia, higher plasma calprotectin and higher NLR were independent predictors of increased all-cause mortality in this group. Our data also suggests that treatment with systemic glucocorticoids has a significant impact on the ability of inflammatory biomarkers to predict all-cause mortality. Trial registration ClinicalTrials.gov NCT00132860.
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Affiliation(s)
| | | | - Lone Hagens Mygind
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Julia Johansen
- Departments of Medicine and Oncology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Court Pedersen
- Department of Infectious Diseases Q, Odense University Hospital, Odense, Denmark
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Holmgaard DB, Mygind LH, Titlestad IL, Madsen H, Fruekilde PBN, Pedersen SS, Pedersen C. Serum vitamin D in patients with chronic obstructive lung disease does not correlate with mortality--results from a 10-year prospective cohort study. PLoS One 2013; 8:e53670. [PMID: 23341971 PMCID: PMC3544862 DOI: 10.1371/journal.pone.0053670] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 12/03/2012] [Indexed: 12/27/2022] Open
Abstract
Background Recent studies have found vitamin D (25-OHD) deficiency and insufficiency to be common among patients with COPD. Serum level of 25-OHD seems to correlate to pulmonary function, COPD disease staging, and increased susceptibility to respiratory infections. We wanted to investigate whether vitamin D deficiency or insufficiency was associated with mortality rate in patients suffering from advanced COPD. Methods 25-OHD serum levels were measured in 462 patients suffering from moderate to very severe COPD. Patients were stratified into three groups according to serum levels of 25-OHD. Outcome measure was mortality in a 10 year follow-up period. Kaplan-Meier curves (KM) were plotted and mortality hazard ratios (HR) were calculated using Cox Proportional Hazard regression (Cox PH). Results Serum 25-OHD deficiency and insufficiency were prevalent. We were unable to demonstrate any association between baseline serum levels of 25-OHD and mortality rate. We found an association between mortality and age [HR 1.05 (CI 95%: 1.03–1.06)], Charlson score [HR 1.49 (CI 95%: 1.06–2.09)], increasing neutrophil count [HR 1.05 (CI 95%: 1.02–1.09)], severe [HR 1.41 (CI 95%: 1.06–1.86)]/very severe COPD [HR 2.19 (CI 95%: 1.58–3.02)] and a smoking history of more than 40 pack years [HR 1.27 (CI 95%: 1.02–1.70)]. Conclusions Serum level of 25-OHD does not seem to be associated with mortality rate, suggesting no or only a minor role of 25-OHD in disease progression in patients with moderate to very severe COPD.
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