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Rath A, Kieninger B, Mirzaliyeva N, Schmid S, Mester P, Schneider-Brachert W. The genome-oriented surveillance of vancomycin-resistant enterococci shows a clear misclassification of nosocomial transmission events. Clin Microbiol Infect 2024:S1198-743X(24)00205-2. [PMID: 38663654 DOI: 10.1016/j.cmi.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 05/12/2024]
Affiliation(s)
- Anca Rath
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany.
| | - Bärbel Kieninger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Nilufarbayim Mirzaliyeva
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Stephan Schmid
- Department for Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Patricia Mester
- Department for Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Rath A, Kieninger B, Fritsch J, Caplunik-Pratsch A, Blaas S, Ochmann M, Pfeifer M, Hartl J, Holzmann T, Schneider-Brachert W. Whole-genome sequencing reveals two prolonged simultaneous outbreaks involving Pseudomonas aeruginosa high-risk strains ST111 and ST235 with resistance to quaternary ammonium compounds. J Hosp Infect 2024; 145:155-164. [PMID: 38286239 DOI: 10.1016/j.jhin.2024.01.009] [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: 10/23/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE Water-bearing systems are known as frequent Pseudomonas aeruginosa (PA) outbreak sources. However, many older buildings continue to have sanitary facilities in high-risk departments such as the ICU. We present two simultaneous prolonged multi-drug-resistant (MDR) PA outbreaks detected at the ICU of a pulmonology hospital, which were resolved by whole-genome sequencing (WGS). METHODS Outbreak management and investigations were initiated in August 2019 after detecting two patients with nosocomial VIM-2-positive MDR PA. The investigations involved weekly patient screenings for four months and extensive environmental sampling for 15 months. All patient and environmental isolates were collected and analysed by WGS. RESULTS From April to September 2019, we identified 10 patients with nosocomial MDR PA, including five VIM-2-positive strains. VIM-2-positive strains were also detected in nine sink drains, two toilets, and a cleaning bucket. WGS revealed that of 16 VIM-2-positive isolates, 14 were ST111 that carried qacE, or qacEΔ1 genes, whereas 13 isolates clustered (difference of ≤11 alleles by cgMLST). OXA-2 (two toilets), and OXA-2, OXA-74, PER-1 (two patients, three toilets) qacEΔ1-positive ST235 isolates dominated among VIM-2-negative isolates. The remaining seven PA strains were ST17, ST233, ST273, ST309 and ST446. Outbreak containment was achieved by replacing U-bends, and cleaning buckets, and switching from quaternary ammonium compounds (QUATs) to oxygen-releasing disinfectant products. CONCLUSION Comprehension and management of two simultaneous MDR PA outbreaks involving the high-risk strains ST111 and ST235 were facilitated by precise control due to identification of different outbreak sources per strain, and by the in-silico detection of high-level QUATs resistance in all isolates.
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Affiliation(s)
- A Rath
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany.
| | - B Kieninger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - J Fritsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A Caplunik-Pratsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - S Blaas
- Donaustauf Hospital, Centre for Pneumology, Donaustauf, Germany
| | - M Ochmann
- Donaustauf Hospital, Centre for Pneumology, Donaustauf, Germany
| | - M Pfeifer
- Donaustauf Hospital, Centre for Pneumology, Donaustauf, Germany; Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany; Hospital of the Merciful Brother Regensburg, Regensburg, Germany
| | - J Hartl
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany; Hospital of the Merciful Brother "St. Barbara", Schwandorf, Germany
| | - T Holzmann
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Caplunik-Pratsch A, Kieninger B, Donauer VA, Brauer JM, Meier VMK, Seisenberger C, Rath A, Loibl D, Eichner A, Fritsch J, Schneider-Brachert W. Introduction and spread of vancomycin-resistant Enterococcus faecium (VREfm) at a German tertiary care medical center from 2004 until 2010: a retrospective whole-genome sequencing (WGS) study of the molecular epidemiology of VREfm. Antimicrob Resist Infect Control 2024; 13:20. [PMID: 38355509 PMCID: PMC10865517 DOI: 10.1186/s13756-024-01379-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/07/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND In most of Europe and especially in Germany, there is currently a concerning rise in the number of hospital-acquired infections due to vancomycin-resistant Enterococcus faecium (VREfm). Therefore, there is a need to improve our understanding of the way VREfm spreads in hospitals. In this study, we investigated the molecular epidemiology of VREfm isolates from the first appearance at our university hospital in 2004 until 2010. There is only very scarce information about the molecular epidemiology of VREfm from this early time in Germany. METHODS Our analysis includes all available first VREfm isolates of each patient at our tertiary care center collected during the years 2004-2010. If available, additional consecutive VREfm isolates from some patients were analyzed. We used multilocus sequence typing (MLST) and core genome multilocus sequence typing (cgMLST) for the analysis and description of nosocomial transmission pathways as well as the detection of outbreaks. RESULTS VREfm isolates from 158 patients and 76 additional subsequent patient isolates were included in the analysis. Until 2006, detections of VREfm remained singular cases, followed by a peak in the number of VREfm cases in 2007 and 2008 with a subsequent decline to baseline in 2010. MLST and cgMLST analysis show significant changes in the dominant sequence types (STs) and complex types (CTs) over the study period, with ST192 and ST17 being responsible for the peak in VREfm cases in 2007 and 2008. The four largest clusters detected during the study period are comprised of these two STs. Cluster analysis shows a focus on specific wards and departments for each cluster. In the early years of this study (2004-2006), all analyzed VREfm stemmed from clinical specimens, whereas since 2007, approximately half of the VREfm were detected by screening. Of the 234 VREfm isolates analyzed, 96% had a vanB and only 4% had a vanA resistance genotype. CONCLUSIONS This retrospective study contributes significant knowledge about regional VREfm epidemiology from this early VREfm period in Germany. One remarkable finding is the striking dominance of vanB-positive VREfm isolates over the entire study period, which is in contrast with countrywide data. Analysis of cgMLST shows the transition from sporadic VRE cases at our institution to a sharp increase in VRE numbers triggered by oligoclonal spread and specific outbreak clusters with the dominance of ST192 and ST17.
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Affiliation(s)
- Aila Caplunik-Pratsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Bärbel Kieninger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Veronika A Donauer
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Johanna M Brauer
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Vanessa M K Meier
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Corinna Seisenberger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Anca Rath
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Daniel Loibl
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Anja Eichner
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Jürgen Fritsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
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Rath A, Kieninger B, Caplunik-Pratsch A, Fritsch J, Mirzaliyeva N, Holzmann T, Bender JK, Werner G, Schneider-Brachert W. Concerning emergence of a new vancomycin-resistant Enterococcus faecium strain ST1299/CT1903/vanA at a tertiary university centre in South Germany. J Hosp Infect 2024; 143:25-32. [PMID: 37852539 DOI: 10.1016/j.jhin.2023.10.008] [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: 08/08/2023] [Revised: 09/22/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND vanB-carrying vancomycin-resistant Enterococcus faecium (VREfm) of the sequence types 80 (ST80) and ST117 have dominated Germany in the past. In 2020, our hospital witnessed a sharp increase in the proportion of vanA-positive VREfm. AIM To attempt to understand these dynamics through whole-genome sequencing (WGS) and analysis of nosocomial transmissions. METHODS At our hospital, the first VREfm isolate per patient, treated during 2020, was analysed retrospectively using specific vanA/vanB PCR, WGS, multi-locus sequence typing (MLST), and core-genome (cg) MLST. Epidemiologic links between VRE-positive patients were assessed using hospital occupancy data. FINDINGS Isolates from 319 out of 356 VREfm patients were available for WGS, of which 181 (56.7%) fulfilled the ECDC definition for nosocomial transmission. The high load of nosocomial cases is reflected in the overall high clonality rate with only three dominating sequence (ST) and complex types (CT), respectively: the new emerging strain ST1299 (100% vanA, 77.4% CT1903), and the well-known ST80 (90.0% vanB, 81.0% CT1065) and ST117 (78.0% vanB, 65.0% CT71). The ST1299 isolates overall, and the subtype CT1903 in particular, showed high isolate clonality, which demonstrates impressively high spreading potential. Overall, 152 out of 319 isolates had an allelic cgMLST difference of ≤3 to another, including 91 (59.6%) ST1299. Occupancy data identified shared rooms (3.7%), shared departments (6.2%), and VRE-colonized prior room occupants (0.6%) within 30 days before diagnosis as solid epidemiological links. CONCLUSION A new emerging VREfm clone, ST1299/CT1903/vanA, dominated our institution in 2020 and has been an important driver of the increasing VREfm rates.
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Affiliation(s)
- A Rath
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany.
| | - B Kieninger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A Caplunik-Pratsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - J Fritsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - N Mirzaliyeva
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - T Holzmann
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - J K Bender
- Department of Infectious Diseases, Division of Nosocomial Pathogens and Antibiotic Resistances, Robert Koch Institute, Wernigerode, Germany
| | - G Werner
- Department of Infectious Diseases, Division of Nosocomial Pathogens and Antibiotic Resistances, Robert Koch Institute, Wernigerode, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Neumann B, Stürhof C, Rath A, Kieninger B, Eger E, Müller JU, von Poblocki A, Gerlitz N, Wollschläger P, Schneider-Brachert W, Schaufler K, Klaper K, Steinmann J. Detection and characterization of putative hypervirulent Klebsiella pneumoniae isolates in microbiological diagnostics. Sci Rep 2023; 13:19025. [PMID: 37923898 PMCID: PMC10624845 DOI: 10.1038/s41598-023-46221-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
Hypervirulent Klebsiella pneumoniae strains (hvKp) can cause invasive community-acquired infections in healthy patients of all ages. In this study, the prevalence of putative hvKp in a German tertiary center was investigated and hvKp were characterized by phenotypic and molecular assays. All K. pneumoniae isolates in routine microbiological diagnostics from a single center were screened by string-testing over a period of 6 months. String-test positive (≥ 0.5 mm) isolates were re-evaluated on different media and under various conditions (aerobe, anaerobe). For string-test positive isolates, genes (magA, iutA, rmpA and rmpA2) associated with hypermucoviscosity and hypervirulence were amplified by multiplex PCR. PCR-positive isolates were subjected to whole-genome sequencing and sedimentation and biofilm formation assays. From 1310 screened K. pneumoniae isolates in clinical routine 100 isolates (7.6%) were string test positive. From these, 9% (n = 9) were defined as putative hvKp (string-test+/PCR+). Highest rate of string-test-positive isolates was observed on MacConkey agar under aerobic conditions. Amongst these nine putative hvKp isolates, the international lineage ST23 carrying hvKp-plasmid pKpVP-1 was the most common, but also a rare ST86 with pKpVP-2 was identified. All nine isolates showed hypermucoviscosity and weak biofilm formation. In conclusion, 9% of string-positive, respectively 0.69% of all K. pneumoniae isolates from routine were defined as putative hypervirulent. MacConkey agar was the best medium for hvKp screening.
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Affiliation(s)
- Bernd Neumann
- Institute of Clinical Microbiology, Infectious Diseases and Infection Control, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany.
- Institute of Hospital Hygiene, Medical Microbiology and Infectious Diseases, Paracelsus Medical University, Nuremberg General Hospital, Prof.-Ernst-Nathan-Str. 1, 90419, Nuremberg, Germany.
| | - Claudia Stürhof
- Institute of Clinical Microbiology, Infectious Diseases and Infection Control, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Anca Rath
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Bärbel Kieninger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Elias Eger
- Department of Epidemiology and Ecology of Antimicrobial Resistance, Helmholtz Institute for One Health, Helmholtz Centre for Infection Research HZI, Greifswald, Germany
| | - Justus U Müller
- Pharmaceutical Microbiology, Institute of Pharmacy, University of Greifswald, Greifswald, Germany
| | - Alexander von Poblocki
- Institute of Clinical Microbiology, Infectious Diseases and Infection Control, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Nadja Gerlitz
- Institute of Clinical Microbiology, Infectious Diseases and Infection Control, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Paul Wollschläger
- Institute of Clinical Microbiology, Infectious Diseases and Infection Control, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Katharina Schaufler
- Department of Epidemiology and Ecology of Antimicrobial Resistance, Helmholtz Institute for One Health, Helmholtz Centre for Infection Research HZI, Greifswald, Germany
- Pharmaceutical Microbiology, Institute of Pharmacy, University of Greifswald, Greifswald, Germany
| | - Kathleen Klaper
- Division 18-Sexually transmitted bacterial Pathogens and HIV, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Jörg Steinmann
- Institute of Clinical Microbiology, Infectious Diseases and Infection Control, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
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Gaube S, Walton K, Kleine AK, Däumling S, Rohrmeier C, Müller S, Bonrath E, Schneider-Brachert W. Examining outpatients' hand hygiene behaviour and its relation to COVID-19 infection prevention measures. J Hosp Infect 2023; 141:55-62. [PMID: 37634601 DOI: 10.1016/j.jhin.2023.08.013] [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: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND The increasing demand for outpatient care is associated with a higher risk of infection transmission in these settings. However, there is limited research on infection prevention and control practices in ambulatory clinics, and none focuses on patients. AIM To examine outpatients' hand hygiene behaviours, their determinants, and their associations with other infection prevention measures during the COVID-19 pandemic. METHODS We observed the hand hygiene behaviour of one cohort of patients in one outpatient clinic and surveyed a separate sample in five clinics about their hand hygiene practice in outpatient facilities. A questionnaire based on the Theoretical Domains Framework (TDF) was used to examine predictors of the behaviour. Moreover, patients indicated their compliance with COVID-19 infection prevention measures, vaccination status, disease risk perception, and vaccine hesitancy. FINDINGS Observed hand hygiene rates among 618 patients were low (12.8%), while 67.3% of the 300 surveyed patients indicated sanitizing their hands upon entering the clinic. The TDF domains 'memory, attention, and decision processes' and 'emotions' significantly predicted both current (today's) and general hand hygiene behaviour in outpatient clinics. Hand hygiene behaviour and compliance with COVID-19 infection prevention showed a positive association; however, no significant connection was found with patients' vaccination status, suggesting different behavioural motivators. CONCLUSION Hand hygiene among outpatients should be improved through interventions focusing on helping patients remember to clean their hands. More research on infection prevention in outpatient facilities is needed to ensure patient safety.
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Affiliation(s)
- S Gaube
- Global Business School for Health, University College London, London, UK.
| | - K Walton
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A-K Kleine
- LMU Center for Leadership and People Management, LMU Munich, Munich, Germany
| | - S Däumling
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - C Rohrmeier
- Faculty of Medicine, University of Regensburg, Regensburg, Germany; HNO-Gemeinschaftspraxis, Straubing, Germany
| | - S Müller
- Clinic and Polyclinic for Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany; MKG-Praxis im Turm, Straubing, Germany
| | - E Bonrath
- Praxis für Chirurgie & Handchirurgie, Regensburg, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Geismann F, Handschuh S, Malfertheiner M, Salzberger B, Bauernfeind S, Hitzenbichler F, Simon M, Caplunik-Pratsch A, Schneider-Brachert W, Wiest C, Ruegamer T, Mohr A. Short report: impact of selective reporting of antibiotic susceptibility testing on antibiotic use in patients with bloodstream infection with Enterococcus faecalis. Infection 2023; 51:1557-1562. [PMID: 37217812 DOI: 10.1007/s15010-023-02045-4] [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: 02/17/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Bloodstream infections with Enterococcus faecalis are associated with relevant morbidity and mortality. Targeted antimicrobial therapy is essential. The choice of an adequate treatment may be challenging when susceptibility testing offers different options. Selective reporting of antibiotic susceptibility test results might lead to a more tailored antibiotic therapy and could therefore be an important antimicrobial stewardship program intervention. The aim of this study was to analyse whether the introduction of selective reporting of antibiotic test results leads to a more targeted antibiotic therapy in patients with bloodstream infection with Enterococcus faecalis. METHODS This study was performed as a retrospective cohort study at the University Hospital Regensburg, Germany. All patients with blood cultures positive for Enterococcus faecalis between March 2003 and March 2022 were analysed. In February 2014 selective reporting of antibiotic susceptibility test results omitting sensitivity results for agents not recommended was introduced. RESULTS 263 patients with blood cultures positive for Enterococcus faecalis were included. After introduction of selective reporting of antibiotic tests (AI) significantly more patients received ampicillin than before introduction of selective reporting (BI) (9.6% BI vs. 34.6% AI, p < 0.001). CONCLUSION Selective reporting of antibiotic susceptibility test results led to a significantly higher use of ampicillin.
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Affiliation(s)
- Florian Geismann
- Center for Pneumology, Donaustauf Hospital, Ludwigstraße 68, 93093, Donaustauf, Germany.
| | - Stefan Handschuh
- Center for Pneumology, Donaustauf Hospital, Ludwigstraße 68, 93093, Donaustauf, Germany
| | | | - Bernd Salzberger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Stilla Bauernfeind
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Florian Hitzenbichler
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Michaela Simon
- Institute for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Aila Caplunik-Pratsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Clemens Wiest
- Department of Internal Medicine 2, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Tamara Ruegamer
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Arno Mohr
- Center for Pneumology, Donaustauf Hospital, Ludwigstraße 68, 93093, Donaustauf, Germany
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Weber J, Henssler L, Zeman F, Pfeifer C, Alt V, Nerlich M, Huber M, Herbst T, Koller M, Schneider-Brachert W, Kerschbaum M, Holzmann T. Nanosilver/DCOIT-containing surface coating effectively and constantly reduces microbial load in emergency room surfaces. J Hosp Infect 2023; 135:90-97. [PMID: 36958698 DOI: 10.1016/j.jhin.2023.01.024] [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: 10/12/2022] [Revised: 01/13/2023] [Accepted: 01/23/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Colonization of near-patient surfaces in hospitals plays an important role as a source of healthcare-associated infections. Routine disinfection methods only result in short-term elimination of pathogens. AIM To investigate the efficiency of a newly developed antimicrobial coating containing nanosilver in long-term reduction of bacterial burden in hospital surfaces to close the gap between routine disinfection cycles. METHODS In this prospective, double-blinded trial, frequently touched surfaces of a routinely used treatment room in an emergency unit of a level-I hospital were treated with a surface coating (nanosilver/DCOIT-coated surface, NCS) containing nanosilver particles and another organic biocidal agent (4,5-dichloro-2-octyl-4-isothiazolin-3-one, DCOIT), whereas surfaces of another room were treated with a coating missing both the nanosilver- and DCOIT-containing ingredient and served as control. Bacterial contamination of the surfaces was examined using contact plates and liquid-based swabs daily for a total trial duration of 90 days. After incubation, total microbial counts and species were assessed. FINDINGS In a total of 2880 antimicrobial samples, a significant reduction of the overall bacterial load was observed in the NCS room (median: 0.31 cfu/cm2; interquartile range: 0.00-1.13) compared with the control coated surfaces (0.69 cfu/cm2; 0.06-2.00; P < 0.001). The nanosilver- and DCOIT-containing surface coating reduced the relative risk of a critical bacterial load (defined as >5 cfu/cm2) by 60% (odds ratio 0.38, P < 0.001). No significant difference in species distribution was detected between NCS and control group. CONCLUSION Nanosilver-/DCOIT-containing surface coating has shown efficiency for sustainable reduction of bacterial load of frequently touched surfaces in a clinical setting.
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Affiliation(s)
- J Weber
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - L Henssler
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany.
| | - F Zeman
- Center of Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - C Pfeifer
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany; Department of Orthopedic Trauma and Hand Surgery, Innklinikum Altötting-Mühldorf, Altötting, Germany
| | - V Alt
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - M Nerlich
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - M Huber
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - T Herbst
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - M Koller
- Center of Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - W Schneider-Brachert
- Institute of Medical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - M Kerschbaum
- Department for Trauma Surgery, University Hospital Regensburg, Regensburg, Germany
| | - T Holzmann
- Institute of Medical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
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Gaube S, Däumling S, Biebl I, Rath A, Caplunik-Pratsch A, Schneider-Brachert W. Patients with multi-drug-resistant organisms feel inadequately informed about their status: adverse effects of contact isolation. J Hosp Infect 2023; 133:89-94. [PMID: 36481686 DOI: 10.1016/j.jhin.2022.11.021] [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: 08/17/2022] [Revised: 10/25/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Contact isolation of patients with multi-drug-resistant organisms (MDROs) is an essential element of infection prevention strategies in hospitals worldwide. However, this practice may be associated with adverse side effects on patients' health and well-being. AIM This study was the first to assess mental health and well-being variables among isolated patients compared with non-isolated control patients in a German cohort. METHODS We conducted a matched case-control study among N = 267 patients admitted to a tertiary care teaching hospital in Germany. Their levels of anxiety, depression, loneliness, and dissatisfaction with their hospital experience were assessed using a questionnaire. Additionally, among isolated patients, it was evaluated how well they felt informed about their MDRO status. FINDINGS In our cohort, patients under contact isolation were significantly more dissatisfied than non-isolated control patients but did not show higher levels of anxiety, depression, and loneliness. A large proportion of patients felt insufficiently informed about their MDRO status. This lack of information was the strongest predictor of dissatisfaction among isolated patients. CONCLUSION These findings underline the importance of adequate patient communication. It is essential for patients' well-being to receive timely, relevant, and understandable information about the background and consequences of their infection or colonisation with MDROs.
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Affiliation(s)
- S Gaube
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany; LMU Center for Leadership and People Management, LMU Munich, Munich, Germany.
| | - S Däumling
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany; Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - I Biebl
- LMU Center for Leadership and People Management, LMU Munich, Munich, Germany; Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - A Rath
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A Caplunik-Pratsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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10
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Gaube S, Däumling S, Biebl I, Rath A, Caplunik-Pratsch A, Schneider-Brachert W. (Mis-)Judgment of infection risks is associated with additional workload among healthcare workers when treating isolated patients. J Hosp Infect 2023; 133:95-97. [PMID: 36496091 PMCID: PMC9727961 DOI: 10.1016/j.jhin.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022]
Affiliation(s)
- S Gaube
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany; LMU Center for Leadership and People Management, LMU Munich, Munich, Germany.
| | - S Däumling
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany; Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - I Biebl
- LMU Center for Leadership and People Management, LMU Munich, Munich, Germany; Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - A Rath
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A Caplunik-Pratsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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11
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Aloba BK, Kinnevey PM, Monecke S, Brennan GI, O'Connell B, Blomfeldt A, McManus BA, Schneider-Brachert W, Tkadlec J, Ehricht R, Senok A, Bartels MD, Coleman DC. An emerging Panton-Valentine leukocidin-positive CC5-meticillin-resistant Staphylococcus aureus-IVc clone recovered from hospital and community settings over a 17-year period from 12 countries investigated by whole-genome sequencing. J Hosp Infect 2023; 132:8-19. [PMID: 36481685 DOI: 10.1016/j.jhin.2022.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND A novel Panton-Valentine leukocidin (PVL)-positive meticillin-resistant Staphylococcus aureus (MRSA) clonal complex (CC)5-MRSA-IVc ('Sri Lankan' clone) was recently described from Sri Lanka. Similar isolates caused a recent Irish hospital outbreak. AIM To investigate the international dissemination and diversity of PVL-positive CC5-MRSA-IVc isolates from hospital and community settings using whole-genome sequencing (WGS). METHODS Core-genome single nucleotide polymorphism (cgSNP) analysis, core-genome multi-locus sequence typing (cgMLST) and microarray-based detection of antimicrobial-resistance and virulence genes were used to investigate PVL-positive CC5-MRSA-IVc (N = 214 including 46 'Sri Lankan' clone) from hospital and community settings in 12 countries over 17 years. Comparators included 29 PVL-positive and 23 PVL-negative CC5/ST5-MRSA-I/II/IVa/IVc/IVg/V. RESULTS Maximum-likelihood cgSNP analysis grouped 209/214 (97.7%) CC5-MRSA-IVc into Clade I; average of 110 cgSNPs between isolates. Clade III contained the five remaining CC5-MRSA-IVc; average of 92 cgSNPs between isolates. Clade II contained seven PVL-positive CC5-MRSA-IVa comparators, whereas the remaining 45 comparators formed an outlier group. Minimum-spanning cgMLST analysis revealed a comparably low average of 57 allelic differences between all CC5/ST5-MRSA-IVc. All 214 CC5/ST5-MRSA-IVc were identified as 'Sri Lankan' clone, predominantly spa type t002 (186/214) with low population diversity and harboured a similar range of virulence genes and variable antimicrobial-resistance genes. All 214 Sri Lankan clone isolates and Clade II comparators harboured a 9616-bp chromosomal PVL-encoding phage remnant, suggesting both arose from a PVL-positive meticillin-susceptible ancestor. Over half of Sri Lankan clone isolates were from infections (142/214), and where detailed metadata were available (168/214), most were community associated (85/168). CONCLUSIONS Stable chromosomal retention of pvl may facilitate Sri-Lankan clone dissemination.
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Affiliation(s)
- B K Aloba
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - P M Kinnevey
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - S Monecke
- Leibniz Institute of Photonic Technology (IPHT), Jena, Germany; Institut für Medizinische Mikrobiologie und Virologie, Uniklinikum Dresden, Dresden, Germany; InfectoGnostics Research Campus, Jena, Germany
| | - G I Brennan
- National MRSA Reference Laboratory, St. James's Hospital, Dublin, Ireland
| | - B O'Connell
- Department of Clinical Microbiology, St. James's Hospital, Dublin, Ireland
| | - A Blomfeldt
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
| | - B A McManus
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - J Tkadlec
- Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - R Ehricht
- Leibniz Institute of Photonic Technology (IPHT), Jena, Germany; InfectoGnostics Research Campus, Jena, Germany; Institute of Physical Chemistry, Friedrich-Schiller University, Jena, Germany
| | - A Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - M D Bartels
- Department of Clinical Microbiology, Amager and Hvidovre Hospital, Hvidovre, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - D C Coleman
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin, Ireland.
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12
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Kieninger B, Kilger M, Foltan M, Gruber M, Lunz D, Dienemann T, Schmid S, Graf B, Wiest C, Lubnow M, Müller T, Salzberger B, Schneider-Brachert W, Kieninger M. Prognostic factors for favorable outcomes after veno-venous extracorporeal membrane oxygenation in critical care patients with COVID-19. PLoS One 2023; 18:e0280502. [PMID: 36662898 PMCID: PMC9858373 DOI: 10.1371/journal.pone.0280502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Patients with COVID-19 and severe acute respiratory failure may require veno-venous extracorporeal membrane oxygenation (VV ECMO). Yet, this procedure is resource-intensive and high mortality rates have been reported. Thus, predictors for identifying patients who will benefit from VV ECMO would be helpful. METHODS This retrospective study included 129 patients with COVID-19 and severe acute respiratory failure, who had received VV ECMO at the University Medical Center Regensburg, Germany, between 1 March 2020 and 31 December 2021. Patient-specific factors and relevant intensive-care parameters at the time of the decision to start VV ECMO were investigated regarding their value as predictors of patient survival. In addition, the intensive-care course of the first 10 days of VV ECMO was compared between survivors and patients who had died in the intensive care unit. RESULTS The most important parameters for predicting outcome were patient age and platelet count, which differed significantly between survivors and non-survivors (age: 52.6±8.1 vs. 57.4±10.1 years, p<0.001; platelet count before VV ECMO: 321.3±132.2 vs. 262.0±121.0 /nL, p = 0.006; average on day 10: 199.2±88.0 vs. 147.1±57.9 /nL, p = 0.002). A linear regression model derived from parameters collected before the start of VV ECMO only included age and platelet count. Patients were divided into two groups by using receiver operating characteristics (ROC) analysis: group 1: 78% of patients, mortality 26%; group 2: 22% of patients, mortality 75%. A second linear regression model included average blood pH, minimum paO2, and average pump flow on day 10 of VV ECMO in addition to age and platelet count. The ROC curve resulted in two cut-off values and thus in three groups: group 1: 25% of patients, mortality 93%; group 2: 45% of patients, mortality 31%; group 3: 30% of patients, mortality 0%.
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Affiliation(s)
- Bärbel Kieninger
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Regensburg, Germany
| | - Magdalena Kilger
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
| | - Maik Foltan
- Department of Cardiac, Thoracic and Cardiovascular Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Michael Gruber
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
| | - Dirk Lunz
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
| | - Thomas Dienemann
- Department of Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Stephan Schmid
- Department of Internal Medicine I, University Medical Center Regensburg, Regensburg, Germany
| | - Bernhard Graf
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
| | - Clemens Wiest
- Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany
| | - Matthias Lubnow
- Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany
| | - Thomas Müller
- Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany
| | - Bernd Salzberger
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Regensburg, Germany
| | - Martin Kieninger
- Department of Anesthesiology, University Medical Center Regensburg, Regensburg, Germany
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13
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Diefenbacher S, Plotzki C, Schneider-Brachert W, Ambrosch A, Keller J, Niesalla H, Gaube S, Gastmeier P, Sassenrath C, Kramer TS. Differences in observed and self-reported compliance with the 5 moments for hand hygiene as a function of healthcare workers' empathy. J Hosp Infect 2022; 128:39-46. [PMID: 35835285 DOI: 10.1016/j.jhin.2022.07.008] [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: 03/29/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hand hygiene at critical time-points (as established by the WHO model 'Five moments for hand hygiene') remains the leading measure for minimising the risk of healthcare-associated infections. While many interventions have been tested to improve hand hygiene compliance (HHC) of healthcare workers (HCWs), little is known about the relation between HHC and HCW empathy. AIM The aim of this study was to investigate the relation between moment-specific HHC rates and HCWs' empathy, at both individual and ward levels. METHODS HHC data was collected via observation and self-report, staffs' empathy levels were measured using an established questionnaire. The survey was conducted on 38 wards of three tertiary-care hospitals in Germany. Observation data was obtained via in-house observations which were conducted up to eight months before or after the survey. FINDINGS Evidence for the expected correlation between HCW empathy and moment-specific HHC was found for both observed HHC (Moment 1: r = .483, p = .031; Moment 2: r = 588, p = .006) and self-reported HHC (Moment 1: r = .093, p = .092; Moment 2: r = .145, p = .008). In analyses of variance the critical interaction effect between empathy (i.e., lower vs. higher empathy) and designated time-point of hand hygiene (i.e., before vs. after reference task) was also significant. CONCLUSION HCWs' empathy should be considered as an important factor in explaining differences between moment-specific HHC rates. In consequence, empathy comes into focus not only as a crucial factor for high-quality patient care, but as an important contributor to improving HHC, too.
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Affiliation(s)
- S Diefenbacher
- Department of Social Psychology, Ulm University, Germany.
| | - C Plotzki
- HARTMANN SCIENCE CENTER, BODE Chemie GmbH, Hamburg, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Germany
| | - A Ambrosch
- Institute for Laboratory Medicine, Microbiology, and Infection Control, Krankenhaus Barmherzige Brüder, Regensburg, Germany
| | - J Keller
- Department of Social Psychology, Ulm University, Germany
| | - H Niesalla
- HARTMANN SCIENCE CENTER, BODE Chemie GmbH, Hamburg, Germany
| | - S Gaube
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Germany; LMU Center for Leadership and People Management, Ludwig Maximilian University of Munich, Munich, Germany
| | - P Gastmeier
- Institute for Hygiene and Environmental Medicine, Charité University Medicine Berlin, Berlin, Germany
| | - C Sassenrath
- Department of Social Psychology, Ulm University, Germany
| | - T S Kramer
- Institute for Hygiene and Environmental Medicine, Charité University Medicine Berlin, Berlin, Germany
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14
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Bolik J, Krause F, Stevanovic M, Gandraß M, Thomsen I, Schacht SS, Rieser E, Müller M, Schumacher N, Fritsch J, Wichert R, Galun E, Bergmann J, Röder C, Schafmayer C, Egberts JH, Becker-Pauly C, Saftig P, Lucius R, Schneider-Brachert W, Barikbin R, Adam D, Voss M, Hitzl W, Krüger A, Strilic B, Sagi I, Walczak H, Rose-John S, Schmidt-Arras D. Inhibition of ADAM17 impairs endothelial cell necroptosis and blocks metastasis. J Exp Med 2022; 219:212921. [PMID: 34919140 PMCID: PMC8689681 DOI: 10.1084/jem.20201039] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/08/2021] [Accepted: 11/03/2021] [Indexed: 01/12/2023] Open
Abstract
Metastasis is the major cause of death in cancer patients. Circulating tumor cells need to migrate through the endothelial layer of blood vessels to escape the hostile circulation and establish metastases at distant organ sites. Here, we identified the membrane-bound metalloprotease ADAM17 on endothelial cells as a key driver of metastasis. We show that TNFR1-dependent tumor cell-induced endothelial cell death, tumor cell extravasation, and subsequent metastatic seeding is dependent on the activity of endothelial ADAM17. Moreover, we reveal that ADAM17-mediated TNFR1 ectodomain shedding and subsequent processing by the γ-secretase complex is required for the induction of TNF-induced necroptosis. Consequently, genetic ablation of ADAM17 in endothelial cells as well as short-term pharmacological inhibition of ADAM17 prevents long-term metastases formation in the lung. Thus, our data identified ADAM17 as a novel essential regulator of necroptosis and as a new promising target for antimetastatic and advanced-stage cancer therapies.
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Affiliation(s)
- Julia Bolik
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Freia Krause
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany.,Department of Biosciences, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Marija Stevanovic
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Monja Gandraß
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Ilka Thomsen
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | | | - Eva Rieser
- Centre for Cell Death, Cancer and Inflammation, UCL Cancer Institute, University College London, London, United Kingdom.,Institute for Biochemistry I, Medical Faculty, University of Cologne, Cologne, Germany
| | - Miryam Müller
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Neele Schumacher
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Jürgen Fritsch
- Institute of Immunology, Christian-Albrechts-University Kiel, Kiel, Germany.,Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Rielana Wichert
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Eithan Galun
- The Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Hospital, Ein Karem, Jerusalem, Israel
| | - Juri Bergmann
- Institute of Anatomy, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Christian Röder
- Institute for Experimental Cancer Research, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Clemens Schafmayer
- Department of General Surgery and Thoracic Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Jan-Hendrik Egberts
- Department of General Surgery and Thoracic Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany
| | | | - Paul Saftig
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Ralph Lucius
- Institute of Anatomy, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Roja Barikbin
- Institute of Experimental Immunology and Hepatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dieter Adam
- Institute of Immunology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Matthias Voss
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Wolfgang Hitzl
- Research Office (Biostatistics), Paracelsus Medical University, Salzburg, Austria.,Research Program for Experimental Ophthalmology and Glaucoma, Paracelsus Medical University, Salzburg, Austria.,Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Achim Krüger
- Institutes for Molecular Immunology and Experimental Oncology, Technical University of Munich, Munich, Germany
| | - Boris Strilic
- Department of Pharmacology, Max-Planck-Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Irit Sagi
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Henning Walczak
- Centre for Cell Death, Cancer and Inflammation, UCL Cancer Institute, University College London, London, United Kingdom.,Institute for Biochemistry I, Medical Faculty, University of Cologne, Cologne, Germany
| | - Stefan Rose-John
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Dirk Schmidt-Arras
- Institute of Biochemistry, Christian-Albrechts-University Kiel, Kiel, Germany.,Department of Biosciences, Paris-Lodron University Salzburg, Salzburg, Austria
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15
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Burgold-Voigt S, Monecke S, Simbeck A, Holzmann T, Kieninger B, Liebler-Tenorio EM, Braun SD, Collatz M, Diezel C, Müller E, Schneider-Brachert W, Ehricht R. Characterisation and Molecular Analysis of an Unusual Chimeric Methicillin Resistant Staphylococcus Aureus Strain and its Bacteriophages. Front Genet 2021; 12:723958. [PMID: 34868203 PMCID: PMC8638950 DOI: 10.3389/fgene.2021.723958] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 06/11/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Abstract
In the context of microarray-based epidemiological typing of the clonal organism Staphylococcus aureus/MRSA, a strain was identified that did not belong to known clonal complexes. The molecular analysis by microarray-based typing yielded signals suggesting that it was a mosaic or hybrid strain of two lineages. To verify this result, the isolate was sequenced with both, short-read Illumina and long-read Nanopore technologies and analysed in detail. This supported the hypothesis that the genome of this strain, ST6610-MRSA-IVg comprised of segments originating from two different clonal complexes (CC). While the backbone of the strain’s genome, i.e., roughly 2 megabases, belongs to CC8, a continuous insert of 894 kb (approx. 30% of the genome) originated from CC140. Beside core genomic markers in the normal succession and orientation, this insert also included the mecA gene, coding for PbP2a and causing methicillin resistance, localised on an SCCmec IVg element. This particular SCCmec type was also previously observed in CC140 MRSA from African countries. A second conspicuous observation was the presence of the trimethoprim resistance gene dfrG within on a prophage that occupied an attachment site normally used by Panton-Valentine Leucocidin phages. This observation could indicate a role of large-scale chromosomal recombination in the evolution of S. aureus as well as a role of phages in the dissemination of antibiotic resistance genes.
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Affiliation(s)
- Sindy Burgold-Voigt
- Leibniz Institute of Photonic Technology (Leibniz-IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Stefan Monecke
- Leibniz Institute of Photonic Technology (Leibniz-IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany.,Institute for Medical Microbiology and Virology, Dresden University Hospital, Dresden, Germany
| | - Alexandra Simbeck
- Department of Surgery, Asklepios Hospital Barmbeck, Hamburg, Germany
| | - Thomas Holzmann
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Bärbel Kieninger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Elisabeth M Liebler-Tenorio
- Friedrich-Loeffler-Institute (Federal Research Institute for Animal Health), Institute of Molecular Pathogenesis, Jena, Germany
| | - Sascha D Braun
- Leibniz Institute of Photonic Technology (Leibniz-IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Maximilian Collatz
- Leibniz Institute of Photonic Technology (Leibniz-IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Celia Diezel
- Leibniz Institute of Photonic Technology (Leibniz-IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Elke Müller
- Leibniz Institute of Photonic Technology (Leibniz-IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Ralf Ehricht
- Leibniz Institute of Photonic Technology (Leibniz-IPHT), Jena, Germany.,InfectoGnostics Research Campus, Jena, Germany.,Institute of Physical Chemistry, Friedrich Schiller University, Jena, Germany
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16
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Fritsch J, Frankenheim J, Marischen L, Vadasz T, Troeger A, Rose-John S, Schmidt-Arras D, Schneider-Brachert W. Roles for ADAM17 in TNF-R1 Mediated Cell Death and Survival in Human U937 and Jurkat Cells. Cells 2021; 10:3100. [PMID: 34831323 PMCID: PMC8620378 DOI: 10.3390/cells10113100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/06/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 12/04/2022] Open
Abstract
Signaling via death receptor family members such as TNF-R1 mediates pleiotropic biological outcomes ranging from inflammation and proliferation to cell death. Pro-survival signaling is mediated via TNF-R1 complex I at the cellular plasma membrane. Cell death induction requires complex IIa/b or necrosome formation, which occurs in the cytoplasm. In many cell types, full apoptotic or necroptotic cell death induction requires the internalization of TNF-R1 and receptosome formation to properly relay the signal inside the cell. We interrogated the role of the enzyme A disintegrin and metalloprotease 17 (ADAM17)/TACE (TNF-α converting enzyme) in death receptor signaling in human hematopoietic cells, using pharmacological inhibition and genetic ablation. We show that in U937 and Jurkat cells the absence of ADAM17 does not abrogate, but rather increases TNF mediated cell death. Likewise, cell death triggered via DR3 is enhanced in U937 cells lacking ADAM17. We identified ADAM17 as the key molecule that fine-tunes death receptor signaling. A better understanding of cell fate decisions made via the receptors of the TNF-R1 superfamily may enable us, in the future, to more efficiently treat infectious and inflammatory diseases or cancer.
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Affiliation(s)
- Jürgen Fritsch
- Department of Infection Prevention and Infectious Diseases, University Hospital of Regensburg, 93053 Regensburg, Germany; (J.F.); (T.V.); (W.S.-B.)
| | - Julia Frankenheim
- Department of Infection Prevention and Infectious Diseases, University Hospital of Regensburg, 93053 Regensburg, Germany; (J.F.); (T.V.); (W.S.-B.)
| | - Lothar Marischen
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Hospital of Regensburg, 93053 Regensburg, Germany; (L.M.); (A.T.)
| | - Timea Vadasz
- Department of Infection Prevention and Infectious Diseases, University Hospital of Regensburg, 93053 Regensburg, Germany; (J.F.); (T.V.); (W.S.-B.)
| | - Anja Troeger
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Hospital of Regensburg, 93053 Regensburg, Germany; (L.M.); (A.T.)
| | - Stefan Rose-John
- Institute of Biochemistry, Christian-Albrechts-Universität zu Kiel, 24105 Kiel, Germany;
| | - Dirk Schmidt-Arras
- Department of Biosciences, Paris-Lodron-University Salzburg, 5020 Salzburg, Austria;
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital of Regensburg, 93053 Regensburg, Germany; (J.F.); (T.V.); (W.S.-B.)
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17
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Bäumler W, Eckl D, Holzmann T, Schneider-Brachert W. Antimicrobial coatings for environmental surfaces in hospitals: a potential new pillar for prevention strategies in hygiene. Crit Rev Microbiol 2021; 48:531-564. [PMID: 34699296 DOI: 10.1080/1040841x.2021.1991271] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Recent reports provide evidence that contaminated healthcare environments represent major sources for the acquisition and transmission of pathogens. Antimicrobial coatings (AMC) may permanently and autonomously reduce the contamination of such environmental surfaces complementing standard hygiene procedures. This review provides an overview of the current status of AMC and the demands to enable a rational application of AMC in health care settings. Firstly, a suitable laboratory test norm is required that adequately quantifies the efficacy of AMC. In particular, the frequently used wet testing (e.g. ISO 22196) must be replaced by testing under realistic, dry surface conditions. Secondly, field studies should be mandatory to provide evidence for antimicrobial efficacy under real-life conditions. The antimicrobial efficacy should be correlated to the rate of nosocomial transmission at least. Thirdly, the respective AMC technology should not add additional bacterial resistance development induced by the biocidal agents and co- or cross-resistance with antibiotic substances. Lastly, the biocidal substances used in AMC should be safe for humans and the environment. These measures should help to achieve a broader acceptance for AMC in healthcare settings and beyond. Technologies like the photodynamic approach already fulfil most of these AMC requirements.
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Affiliation(s)
- Wolfgang Bäumler
- Department of Dermatology, University Hospital, Regensburg, Germany
| | - Daniel Eckl
- Department of Microbiology, University of Regensburg, Regensburg, Germany
| | - Thomas Holzmann
- Department of Infection Control and Infectious Diseases, University Hospital, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Control and Infectious Diseases, University Hospital, Regensburg, Germany
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18
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Kieninger M, Mandlinger A, Doblinger N, Kieninger B, Bele S, Salzberger B, Schneider-Brachert W, Graf B, Zeman F, Holzmann T. Impact of the implementation of a standard for preanalytical handling of samples for microbiological diagnostics on the quality of results at a neurocritical care unit. Medicine (Baltimore) 2021; 100:e27060. [PMID: 34449497 PMCID: PMC10545238 DOI: 10.1097/md.0000000000027060] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Antibiotic stewardship (ABS) programs intend to improve outcomes of nosocomial infections and to counteract the emergence of further antimicrobial resistances. At the anesthesiologic-neurosurgical intensive care unit (ICU) of the University Medical Center Regensburg (Germany) we implemented a standard operating procedure (SOP) with clear instructions for the preanalytical handling and storage of microbiological samples. We intended to find out whether the instructions given in the SOP led to a higher rate of ideal material being sent to the laboratory and to overall better quality of the received results.We retraced retrospectively all samples taken in cases of suspected pneumonia, urinary tract infection, bloodstream infection, catheter infection associated with a central venous or arterial catheter and ventriculitis due to external ventricular drainage as well as all smears taken for the screening for multi-resistant bacteria within a time period of 1 year before to 1 year after the implementation of the SOP.In the case of suspected pneumonia and urinary tract infection, large amounts of ideal material were sent to the microbiological laboratory. A remarkable improvement after the implementation of the SOP, however, could only be observed regarding the number of urine samples taken from older urinary catheters, which was significantly lower in the "SOP group". Samples for microbiological diagnostics were taken much more often in the daytime, although storage of the probes did not lead to worse results.Concrete instructions enable adequate preanalytical handling of microbiological probes. However, we could not recognize substantial improvements probably due to a preexisting high process quality on the ICU. Microbiological diagnostics during the night shift has to be improved.
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Affiliation(s)
- Martin Kieninger
- Department of Anesthesiology, University Medical Center Regensburg, Germany
| | - Andreas Mandlinger
- Department of Anesthesiology, University Medical Center Regensburg, Germany
| | - Nina Doblinger
- Department of Anesthesiology, University Medical Center Regensburg, Germany
| | - Bärbel Kieninger
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Germany
| | - Sylvia Bele
- Department of Neurosurgery, University Medical Center Regensburg, Germany
| | - Bernd Salzberger
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Germany
| | - Bernhard Graf
- Department of Anesthesiology, University Medical Center Regensburg, Germany
| | - Florian Zeman
- Center for Clinical Studies, University Medical Center Regensburg, Germany
| | - Thomas Holzmann
- Department of Infection Prevention and Infectious Diseases, University Medical Center Regensburg, Germany
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19
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Earls MR, Steinig EJ, Monecke S, Samaniego Castruita JA, Simbeck A, Schneider-Brachert W, Vremerǎ T, Dorneanu OS, Loncaric I, Bes M, Lacoma A, Prat Aymerich C, Wernery U, Armengol-Porta M, Blomfeldt A, Duchene S, Bartels MD, Ehricht R, Coleman DC. Exploring the evolution and epidemiology of European CC1-MRSA-IV: tracking a multidrug-resistant community-associated meticillin-resistant Staphylococcus aureus clone. Microb Genom 2021; 7. [PMID: 34223815 PMCID: PMC8477393 DOI: 10.1099/mgen.0.000601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Indexed: 01/20/2023] Open
Abstract
This study investigated the evolution and epidemiology of the community-associated and multidrug-resistant Staphylococcus aureus clone European CC1-MRSA-IV. Whole-genome sequences were obtained for 194 European CC1-MRSA-IV isolates (189 of human and 5 of animal origin) from 12 countries, and 10 meticillin-susceptible precursors (from North-Eastern Romania; all of human origin) of the clone. Phylogenetic analysis was performed using a maximum-likelihood approach, a time-measured phylogeny was reconstructed using Bayesian analysis, and in silico microarray genotyping was performed to identify resistance, virulence-associated and SCCmec (staphylococcal cassette chromosome mec) genes. Isolates were typically sequence type 1 (190/204) and spa type t127 (183/204). Bayesian analysis indicated that European CC1-MRSA-IV emerged in approximately 1995 before undergoing rapid expansion in the late 1990s and 2000s, while spreading throughout Europe and into the Middle East. Phylogenetic analysis revealed an unstructured meticillin-resistant S. aureus (MRSA) population, lacking significant geographical or temporal clusters. The MRSA were genotypically multidrug-resistant, consistently encoded seh, and intermittently (34/194) encoded an undisrupted hlb gene with concomitant absence of the lysogenic phage-encoded genes sak and scn. All MRSA also harboured a characteristic ~5350 nt insertion in SCCmec adjacent to orfX. Detailed demographic data from Denmark showed that there, the clone is typically (25/35) found in the community, and often (10/35) among individuals with links to South-Eastern Europe. This study elucidated the evolution and epidemiology of European CC1-MRSA-IV, which emerged from a meticillin-susceptible lineage prevalent in North-Eastern Romania before disseminating rapidly throughout Europe.
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Affiliation(s)
- Megan R Earls
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland
| | - Eike J Steinig
- Australian Institute of Tropical Health and Medicine, Townsville, Queensland, Australia
| | - Stefan Monecke
- Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.,Institute for Medical Microbiology and Hygiene, Medical Faculty "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany
| | | | - Alexandra Simbeck
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Teodora Vremerǎ
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine and Pharmacy "Grigore T Popa", Iaşi, Romania
| | - Olivia S Dorneanu
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine and Pharmacy "Grigore T Popa", Iaşi, Romania
| | - Igor Loncaric
- Institute of Microbiology, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Michèle Bes
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Alicia Lacoma
- Microbiology Department, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, CIBER Enfermedades Respiratorias, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Cristina Prat Aymerich
- Microbiology Department, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, CIBER Enfermedades Respiratorias, Universitat Autònoma de Barcelona, Badalona, Spain.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | | | - Anita Blomfeldt
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
| | - Sebastian Duchene
- Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
| | - Mette D Bartels
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Ralf Ehricht
- Institute of Physical Chemistry, Friedrich-Schiller University, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany
| | - David C Coleman
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland
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20
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Gaube S, Schneider-Brachert W, Holzmann T, Fischer P, Lermer E. Utilizing behavioral theories to explain hospital visitors' observed hand hygiene behavior. Am J Infect Control 2021; 49:912-918. [PMID: 33428983 DOI: 10.1016/j.ajic.2021.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/21/2020] [Accepted: 01/02/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hand hygiene is essential for infection prevention. This study aimed to find a suitable theoretical model and identify critical facilitators and barriers to explain hospital visitors' hand hygiene practice. METHODS Visitors in 4 hospitals were observed and asked to give explanations for using or not using the hand rub dispenser. The written explanations of N = 838 participants were coded according to three theoretical models: Theory of Planned Behavior, Health Action Process Approach (HAPA), and Theoretical Domains Framework (TDF). RESULTS Self-reported hand hygiene behavior differed from observed behavior, with 15.75% wrongly claiming to have cleaned their hands. Critical facilitators for hand hygiene were attitude toward the behavior,subjective norm, outcome expectancies, risk perception, planning, action control, knowledge and skills, motivation and goals, and social influences. Key barriers included perceived behavioral control; barriers and resources; memory, attention, and decision processes; and environmental context and resources. CONCLUSIONS Visitors' self-reported hand hygiene behavior is over-reported. Both HAPA and TDF were identified as suitable theoretical models for explaining visitor's hand hygiene practice. Future behavior change interventions should focus on (1) visibility and accessibility of cleaning products; (2) informing laypeople about their role regarding infection prevention; and (3) leveraging social influence processes.
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21
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Fritsch J, Särchen V, Schneider-Brachert W. Regulation of Death Receptor Signaling by S-Palmitoylation and Detergent-Resistant Membrane Micro Domains-Greasing the Gears of Extrinsic Cell Death Induction, Survival, and Inflammation. Cancers (Basel) 2021; 13:2513. [PMID: 34063813 PMCID: PMC8196677 DOI: 10.3390/cancers13112513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/30/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/11/2022] Open
Abstract
Death-receptor-mediated signaling results in either cell death or survival. Such opposite signaling cascades emanate from receptor-associated signaling complexes, which are often formed in different subcellular locations. The proteins involved are frequently post-translationally modified (PTM) by ubiquitination, phosphorylation, or glycosylation to allow proper spatio-temporal regulation/recruitment of these signaling complexes in a defined cellular compartment. During the last couple of years, increasing attention has been paid to the reversible cysteine-centered PTM S-palmitoylation. This PTM regulates the hydrophobicity of soluble and membrane proteins and modulates protein:protein interaction and their interaction with distinct membrane micro-domains (i.e., lipid rafts). We conclude with which functional and mechanistic roles for S-palmitoylation as well as different forms of membrane micro-domains in death-receptor-mediated signal transduction were unraveled in the last two decades.
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Affiliation(s)
- Jürgen Fritsch
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany;
| | - Vinzenz Särchen
- Institute for Experimental Cancer Research in Pediatrics, Goethe-University, 60528 Frankfurt, Germany;
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany;
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22
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Rohrmeier C, Schneider-Brachert W, Kühnel T, Hitzenbichler F, Holzmann T, Bohr C. [Hygiene in ENT examination: Fluorescence study with overview of current recommendations]. Laryngorhinootologie 2021; 100:434-442. [PMID: 33851374 DOI: 10.1055/a-1408-7046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Increasing normative demands on patient safety and quality assurance measures, but also the problem of multi-resistant germs and pathogens with a high potential for infection, increase the need for hygienically correct work.In this study, hygienically relevant potential sources of contamination in ENT examinations were to be identified and possible improvement strategies examined.A complete ENT examination was performed by 5 examiners with different professional experience, whose gloves were wetted with fluorescent lotion prior to the examination. Contaminations especially on the examination unit and on the instruments were identified. The potential risk of transmission of pathogens to subsequent patients was assessed using a specially developed score. Various strategies to reduce identified contamination possibilities were developed and thought through.The score of the investigators was very high with an average of 87.4 points (±3.6). The implementation of individual hygiene measures during the examination process would lead to a significant reduction of the score and thus to an improvement in hygiene: No shaking of hands (81.8), additional disinfection of patient's chair (79.8), disinfection of important surfaces (69.8), provision of standard instruments (60.2) or all instruments (32.2), disinfection of all relevant surfaces and provision of all instruments (7.4).The results show very clearly that an ENT examination is a complex procedure from the point of view of hygiene. For reliable protection against possible transmission events, a structured bundling of hygiene measures is therefore necessary.
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Affiliation(s)
- Christian Rohrmeier
- XXXX PRIVATADRESSE XXXX, Straubing.,Fakultät für Medizin, Universität Regensburg, Regensburg.,HNO-Praxis, Straubing
| | - Wulf Schneider-Brachert
- Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Regensburg
| | - Thomas Kühnel
- Klinik für Hals-Nasen-Ohrenheilkunde, Universität Regensburg, Regensburg
| | - Florian Hitzenbichler
- Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Regensburg
| | - Thomas Holzmann
- Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Regensburg
| | - Christopher Bohr
- Klinik für Hals-Nasen-Ohrenheilkunde, Universität Regensburg, Regensburg
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23
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Heck AL, Mishra S, Prenzel T, Feulner L, Achhammer E, Särchen V, Blagg BSJ, Schneider-Brachert W, Schütze S, Fritsch J. Selective HSP90β inhibition results in TNF and TRAIL mediated HIF1α degradation. Immunobiology 2021; 226:152070. [PMID: 33639524 DOI: 10.1016/j.imbio.2021.152070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/23/2020] [Accepted: 01/31/2021] [Indexed: 12/17/2022]
Abstract
Signaling via TNF-R1 mediates pleiotropic biological outcomes ranging from inflammation and proliferation to cell death. Previous reports demonstrated that pro-survival signaling emanates from membrane resident TNF-R1 complexes (complex I) while only internalized TNF-R1 complexes are capable for DISC formation (complex II) and thus, apoptosis induction. Internalized TNF-R1 containing endosomes undergo intracellular maturation towards lysosomes, resulting in activation and release of Cathepsin D (CtsD) into the cytoplasm. We recently revealed HSP90 as target for proteolytic cleavage by CtsD, resulting in cell death amplification. In this study, we show that extrinsic cell death activation via TNF or TRAIL results in HSP90β degradation. Co-incubation of cells with either TNF or TRAIL in combination with the HSP90β inhibitor KUNB105 but not HSP90α selective inhibition promotes apoptosis induction. In an attempt to reveal further downstream targets of combined TNF-R1 or TRAIL-R1/-R2 activation with HSP90β inhibition, we identify HIF1α and validate its ligand:inhibitor triggered degradation. Together, these findings suggest that selective inhibition of HSP90 isoforms together with death ligand stimulation may provide novel strategies for therapy of inflammatory diseases or cancer, in future.
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Affiliation(s)
- A L Heck
- Institute of Immunology, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany
| | - S Mishra
- Department of Chemistry and Biochemistry, The University of Notre Dame, Notre Dame, IN 46556, United States
| | - T Prenzel
- Department of Infection Prevention and Infectious Diseases, University of Regensburg, 93053 Regensburg, Germany
| | - L Feulner
- Department of Infection Prevention and Infectious Diseases, University of Regensburg, 93053 Regensburg, Germany
| | - E Achhammer
- Department of Infection Prevention and Infectious Diseases, University of Regensburg, 93053 Regensburg, Germany
| | - V Särchen
- Institute of Immunology, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany
| | - B S J Blagg
- Department of Chemistry and Biochemistry, The University of Notre Dame, Notre Dame, IN 46556, United States
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University of Regensburg, 93053 Regensburg, Germany
| | - S Schütze
- Institute of Immunology, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany
| | - J Fritsch
- Institute of Immunology, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany; Department of Infection Prevention and Infectious Diseases, University of Regensburg, 93053 Regensburg, Germany.
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24
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Kheiroddin P, Schöberl P, Althammer M, Cibali E, Würfel T, Wein H, Kulawik B, Buntrock-Döpke H, Weigl E, Gran S, Gründl M, Langguth J, Lampl B, Judex G, Niggel J, Pagel P, Schratzenstaller T, Schneider-Brachert W, Gastiger S, Bodenschatz M, Konrad M, Levchuk A, Roth C, Schöner D, Schneebauer F, Rohrmanstorfer R, Dekens MP, Brandstetter S, Zuber J, Wallerstorfer D, Burkovski A, Ambrosch A, Wagner T, Kabesch M. Results of WICOVIR Gargle Pool PCR Testing in German Schools Based on the First 100,000 Tests. Front Pediatr 2021; 9:721518. [PMID: 34778127 PMCID: PMC8581236 DOI: 10.3389/fped.2021.721518] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Opening schools and keeping children safe from SARS-CoV-2 infections at the same time is urgently needed to protect children from direct and indirect consequences of the COVID-19 pandemic. To achieve this goal, a safe, efficient, and cost-effective SARS-CoV-2 testing system for schools in addition to standard hygiene measures is necessary. Methods: We implemented the screening WICOVIR concept for schools in the southeast of Germany, which is based on gargling at home, pooling of samples in schools, and assessment of SARS-CoV-2 by pool rRT-PCR, performed decentralized in numerous participating laboratories. Depooling was performed if pools were positive, and results were transmitted with software specifically developed for the project within a day. Here, we report the results after the first 13 weeks in the project. Findings: We developed and implemented the proof-of-concept test system within a pilot phase of 7 weeks based on almost 17,000 participants. After 6 weeks in the main phase of the project, we performed >100,000 tests in total, analyzed in 7,896 pools, identifying 19 cases in >100 participating schools. On average, positive children showed an individual CT value of 31 when identified in the pools. Up to 30 samples were pooled (mean 13) in general, based on school classes and attached school staff. All three participating laboratories detected positive samples reliably with their previously established rRT-PCR standard protocols. When self-administered antigen tests were performed concomitantly in positive cases, only one of these eight tests was positive, and when antigen tests performed after positive pool rRT-PCR results were already known were included, 3 out of 11 truly positive tests were also identified by antigen testing. After 3 weeks of repetitive WICOVIR testing twice weekly, the detection rate of positive children in that cohort decreased significantly from 0.042 to 0.012 (p = 0.008). Interpretation: Repeated gargle pool rRT-PCR testing can be implemented quickly in schools. It is an effective, valid, and well-received test system for schools, superior to antigen tests in sensitivity, acceptance, and costs.
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Affiliation(s)
- Parastoo Kheiroddin
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany
| | - Patricia Schöberl
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany.,Science and Innovation Campus Regensburg (WECARE) at the Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Michael Althammer
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany
| | - Ezgi Cibali
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany.,Institute of Laboratory Medicine, Microbiology and Hygiene, Hospital of the Order of St. John, Regensburg, Germany
| | - Thea Würfel
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany
| | - Hannah Wein
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany
| | - Birgit Kulawik
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany.,Science and Innovation Campus Regensburg (WECARE) at the Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Heike Buntrock-Döpke
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany.,Science and Innovation Campus Regensburg (WECARE) at the Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Eva Weigl
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany.,Science and Innovation Campus Regensburg (WECARE) at the Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Silvia Gran
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany.,Science and Innovation Campus Regensburg (WECARE) at the Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | | | - Jana Langguth
- Public Health Department Regensburg, Regensburg, Germany
| | - Benedikt Lampl
- Public Health Department Regensburg, Regensburg, Germany
| | | | | | | | - Thomas Schratzenstaller
- Medical Device Lab, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany.,Regensburg Center for Biomedical Engineering, University and OTH Regensburg, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Susanne Gastiger
- Microbiology Division, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Mona Bodenschatz
- Microbiology Division, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Maike Konrad
- Microbiology Division, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Artem Levchuk
- Microbiology Division, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Cornelius Roth
- Microbiology Division, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.,DATEV eG, Nürnberg, Germany
| | | | | | | | - Marcus P Dekens
- Research Institute of Molecular Pathology, Vienna BioCenter, Vienna, Austria
| | - Susanne Brandstetter
- Science and Innovation Campus Regensburg (WECARE) at the Hospital St. Hedwig of the Order of St. John, Regensburg, Germany.,University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany
| | - Johannes Zuber
- Research Institute of Molecular Pathology, Vienna BioCenter, Vienna, Austria.,Medical University of Vienna, Vienna BioCenter, Vienna, Austria
| | | | - Andreas Burkovski
- Microbiology Division, Department of Biology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Andreas Ambrosch
- Institute of Laboratory Medicine, Microbiology and Hygiene, Hospital of the Order of St. John, Regensburg, Germany
| | | | - Michael Kabesch
- Department of Pediatric Pneumology and Allergy, University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, Regensburg, Germany.,Science and Innovation Campus Regensburg (WECARE) at the Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
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Abstract
Awareness of the importance of working as aseptically as possible first emerged in the 19th century. In the meantime, there is an obligation to prevent transmission and further spread of pathogens, including adherence to the Infection Protection Act. Pathogens can also survive for a long time on inanimate surfaces, from where they can be transferred via the hands of personnel and thus lead to infections. Studies have shown that even contamination of untouched instruments after an otorhinolaryngological examination is not a rare occurrence. The Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) of the Robert Koch Institute gives recommendations for general hygiene measures (basic or standard hygiene). These must be adapted and implemented accordingly for the otorhinolaryngological examination. Due to the increasing development of resistance of nosocomial pathogens and the current pandemic, consistent implementation of these infection-prevention measures is important.
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Affiliation(s)
- C Rohrmeier
- Fakultät für Medizin, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
- HNO-Praxis, Bahnhofstr. 19, 94315, Straubing, Deutschland.
| | - W Schneider-Brachert
- Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - T Holzmann
- Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - C Bohr
- Klinik für Hals-Nasen-Ohren-Heilkunde, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - F Haubner
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum der Universität München, Campus Großhadern, 81377, München, Deutschland
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Monecke S, König E, Earls MR, Leitner E, Müller E, Wagner GE, Poitz DM, Jatzwauk L, Vremerǎ T, Dorneanu OS, Simbeck A, Ambrosch A, Zollner-Schwetz I, Krause R, Ruppitsch W, Schneider-Brachert W, Coleman DC, Steinmetz I, Ehricht R. An epidemic CC1-MRSA-IV clone yields false-negative test results in molecular MRSA identification assays: a note of caution, Austria, Germany, Ireland, 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32613938 PMCID: PMC7331142 DOI: 10.2807/1560-7917.es.2020.25.25.2000929] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We investigated why a clinical meticillin-resistant Staphylococcus aureus (MRSA) isolate yielded false-negative results with some commercial PCR tests for MRSA detection. We found that an epidemic European CC1-MRSA-IV clone generally exhibits this behaviour. The failure of the assays was attributable to a large insertion in the orfX/SCCmec integration site. To ensure the reliability of molecular MRSA tests, it is vital to monitor emergence of new SCCmec types and junction sites.
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Affiliation(s)
- Stefan Monecke
- These authors contributed equally.,InfectoGnostics Research Campus Jena, Jena, Germany.,Institute for Medical Microbiology and Hygiene, Medical Faculty 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Elisabeth König
- Diagnostic and Research Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.,These authors contributed equally
| | - Megan R Earls
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland.,These authors contributed equally
| | - Eva Leitner
- Diagnostic and Research Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Elke Müller
- InfectoGnostics Research Campus Jena, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Gabriel E Wagner
- Diagnostic and Research Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - David M Poitz
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - Lutz Jatzwauk
- Department of Hospital Infection Control, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - Teodora Vremerǎ
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine and Pharmacy 'Grigore T Popa', Iaşi, Romania
| | - Olivia S Dorneanu
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine and Pharmacy 'Grigore T Popa', Iaşi, Romania
| | - Alexandra Simbeck
- Department of Infection Control and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Andreas Ambrosch
- Institute of Laboratory Medicine, Microbiology and Hygiene, Barmherzige Brüder Hospital, Regensburg, Germany
| | - Ines Zollner-Schwetz
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Austria
| | - Werner Ruppitsch
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Wulf Schneider-Brachert
- Department of Infection Control and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - David C Coleman
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland
| | - Ivo Steinmetz
- Diagnostic and Research Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Ralf Ehricht
- Friedrich- Schiller University; Institute of Physical Chemistry, Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
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Bushuven S, Dettenkofer M, Sippel S, Koenig S, Bushuven S, Schneider-Brachert W. Speaking up behavior and cognitive bias in hand hygiene: Competences of German-speaking medical students. PLoS One 2020; 15:e0239444. [PMID: 32986726 PMCID: PMC7521694 DOI: 10.1371/journal.pone.0239444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/04/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Infection prevention and speaking up on errors are core qualities of health care providers. Heuristic effects (e.g. overconfidence) may impair behavior in daily routine, while speaking up can be inhibited by hierarchical barriers and medical team factors. Aim of this investigation was to determine, how medical students experience these difficulties for hand hygiene in daily routine. Methods On the base of prior investigations we developed a questionnaire with 5-point Likert ordinal scaled items and free text entries. This was tested for validity and reliability (Cronbach’s Alpha 0.89). Accredited German, Swiss and Austrian universities were contacted and medical students asked to participated in the anonymous online survey. Quantitative statistics used parametric and non-parametric tests and effect size calculations according to Lakens. Qualitative data was coded according to Janesick. Results 1042 undergraduates of 12 universities participated. All rated their capabilities in hand hygiene and feedback reception higher than those of fellow students, nurses and physicians (p<0.001). Half of the participants rating themselves to be best educated, realized that faulty hand hygiene can be of lethal effect. Findings were independent from age, sex, academic course and university. Speaking-up in case of omitted hand hygiene was rated to be done seldomly and most rare on persons of higher hierarchic levels. Qualitative results of 164 entries showed four main themes: 1) Education methods in hand hygiene are insufficient, 2) Hierarchy barriers impair constructive work place culture 3) Hygiene and feedback are linked to medical ethics and 4) There is no consequence for breaking hygiene rules. Discussion Although partially limited by the selection bias, this study confirms the overconfidence-effects demonstrated in post-graduates in other settings and different professions. The independence from study progress suggests, that the effect occurs before start of the academic course with need for educational intervention at the very beginning. Qualitative data showed that used methods are insufficient and contradictory work place behavior in hospitals are frustrating. Even 20 years after “To err is human”, work place culture still is far away from the desirable.
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Affiliation(s)
- Stefan Bushuven
- Institute for Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Hegau-Bodensee Hospital Singen and Hegau Jugendwerk Gailingen, Healthcare Association Constance (GLKN), Radolfzell, Germany
- Institute for Hospital Hygiene and Infection Prevention, Healthcare Association Constance (GLKN), Radolfzell, Germany
- Institute for Didactics and Educational Research in Medicine, Clinic of the University Munich, LMU Munich, Munich, Germany
- * E-mail:
| | - Markus Dettenkofer
- Institute for Hospital Hygiene and Infection Prevention, Healthcare Association Constance (GLKN), Radolfzell, Germany
| | - Sonia Sippel
- Institute of Medical Teaching and Medical Education Research, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Sarah Koenig
- Institute of Medical Teaching and Medical Education Research, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Stefanie Bushuven
- Clinic for Orthopedics, Hand- and Trauma surgery, Hegau-Bodensee-Hospital Singen, Healthcare Association Constance (GLKN), Radolfzell, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Control and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Zingler P, Särchen V, Glatter T, Caning L, Saggau C, Kathayat RS, Dickinson BC, Adam D, Schneider-Brachert W, Schütze S, Fritsch J. Palmitoylation is required for TNF-R1 signaling. Cell Commun Signal 2019; 17:90. [PMID: 31382980 PMCID: PMC6683503 DOI: 10.1186/s12964-019-0405-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/28/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Binding of tumor necrosis factor (TNF) to TNF-receptor 1 (TNF-R1) can induce either cell survival or cell death. The selection between these diametrically opposed effects depends on the subcellular location of TNF-R1: plasma membrane retention leads to survival, while endocytosis leads to cell death. How the respective TNF-R1 associated signaling complexes are recruited to the distinct subcellular location is not known. Here, we identify palmitoylation of TNF-R1 as a molecular mechanism to achieve signal diversification. METHODS Human monocytic U937 cells were analyzed. Palmitoylated proteins were enriched by acyl resin assisted capture (AcylRAC) and analyzed by western blot and mass spectrometry. Palmitoylation of TNF-R1 was validated by metabolic labeling. TNF induced depalmitoylation and involvement of APT2 was analyzed by enzyme activity assays, pharmacological inhibition and shRNA mediated knock-down. TNF-R1 palmitoylation site analysis was done by mutated TNF-R1 expression in TNF-R1 knock-out cells. Apoptosis (nuclear DNA fragmentation, caspase 3 assays), NF-κB activation and TNF-R1 internalization were used as biological readouts. RESULTS We identify dynamic S-palmitoylation as a new mechanism that controls selective TNF signaling. TNF-R1 itself is constitutively palmitoylated and depalmitoylated upon ligand binding. We identified the palmitoyl thioesterase APT2 to be involved in TNF-R1 depalmitoylation and TNF induced NF-κB activation. Mutation of the putative palmitoylation site C248 interferes with TNF-R1 localization to the plasma membrane and thus, proper signal transduction. CONCLUSIONS Our results introduce palmitoylation as a new layer of dynamic regulation of TNF-R1 induced signal transduction at a very early step of the TNF induced signaling cascade. Understanding the underlying mechanism may allow novel therapeutic options for disease treatment in future.
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Affiliation(s)
- Philipp Zingler
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Vinzenz Särchen
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Timo Glatter
- Facility for Mass Spectrometry and Proteomics, MPI for Terrestrial Microbiology, Marburg, Germany
| | - Lotta Caning
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Carina Saggau
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | | | - Dieter Adam
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Wulf Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany
| | - Stefan Schütze
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Jürgen Fritsch
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
- Department of Infection Prevention and Infectious Diseases, University of Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany
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Earls MR, Shore AC, Brennan GI, Simbeck A, Schneider-Brachert W, Vremerǎ T, Dorneanu OS, Slickers P, Ehricht R, Monecke S, Coleman DC. A novel multidrug-resistant PVL-negative CC1-MRSA-IV clone emerging in Ireland and Germany likely originated in South-Eastern Europe. Infect Genet Evol 2019; 69:117-126. [PMID: 30677533 DOI: 10.1016/j.meegid.2019.01.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/20/2018] [Accepted: 01/15/2019] [Indexed: 12/19/2022]
Abstract
This study investigated the recent emergence of multidrug-resistant Panton-Valentine leukocidin (PVL)-negative CC1-MRSA-IV in Ireland and Germany. Ten CC1-MSSA and 139 CC1-MRSA isolates recovered in Ireland between 2004 and 2017 were investigated. These were compared to 21 German CC1-MRSA, 10 Romanian CC1-MSSA, five Romanian CC1-MRSA and two UAE CC1-MRSA, which were selected from an extensive global database, based on similar DNA microarray profiles to the Irish isolates. All isolates subsequently underwent whole-genome sequencing, core-genome single nucleotide polymorphism (cgSNP) analysis and enhanced SCCmec subtyping. Two PVL-negative clades (A and B1) were identified among four main clades. Clade A included 20 German isolates, 119 Irish isolates, and all Romanian MRSA and MSSA isolates, the latter of which differed from clade A MRSA by 47-130 cgSNPs. Eighty-six Irish clade A isolates formed a tight subclade (A1) exhibiting 0-49 pairwise cgSNPs, 80 of which harboured a 46 kb conjugative plasmid carrying both ileS2, encoding high-level mupirocin resistance, and qacA, encoding chlorhexidine resistance. The resistance genes aadE, aphA3 and sat were detected in all clade A MRSA and the majority (8/10) of clade A MSSA isolates. None of the clade A isolates harboured any enterotoxin genes other than seh, which is universally present in CC1. Clade B1 included the remaining German isolate, 17 Irish isolates and the two UAE isolates, all of which corresponded to the Western Australia MRSA-1 (WA MRSA-1) clone based on genotypic characteristics. MRSA within clades A and B1 differed by 188 cgSNPs and clade-specific SCCmec characteristics were identified, indicating independent acquisition of the SCCmec element. This study demonstrated the existence of a European PVL-negative CC1-MRSA-IV clone that is distinctly different from the well-defined PVL-negative CC1-MRSA-IV clone, WA MRSA-1. Furthermore, cgSNP analysis revealed that this newly defined clone may have originated in South-Eastern Europe, before spreading to both Ireland and Germany.
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Affiliation(s)
- Megan R Earls
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland.
| | - Anna C Shore
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland.
| | - Gráinne I Brennan
- National MRSA Reference Laboratory, St. James's Hospital, James's Street, Dublin, Ireland.
| | - Alexandra Simbeck
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
| | - Wulf Schneider-Brachert
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
| | - Teodora Vremerǎ
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine & Pharmacy "Grigore T Popa", Iaşi, Romania.
| | - Olivia S Dorneanu
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine & Pharmacy "Grigore T Popa", Iaşi, Romania.
| | - Peter Slickers
- Abbott (Alere Technologies GmbH), Jena, Germany; InfectoGnostics Research Campus, Jena, Germany.
| | - Ralf Ehricht
- InfectoGnostics Research Campus, Jena, Germany; Leibniz Institute of Photonic Technology (IPHT), Albert-Einstein-Straße 9, 07745 Jena, Germany.
| | - Stefan Monecke
- InfectoGnostics Research Campus, Jena, Germany; Leibniz Institute of Photonic Technology (IPHT), Albert-Einstein-Straße 9, 07745 Jena, Germany; Institute for Medical Microbiology and Hygiene, Medical Faculty "Carl Gustav Carus", Technical University of Dresden, Dresden, Germany.
| | - David C Coleman
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland.
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Valenza G, Schulze M, Friedrich P, Schneider-Brachert W, Holzmann T, Nickel S, Lehner-Reindl V, Höller C. Screening of ESBL-producing Enterobacteriacae concomitant with low degree of transmission in intensive care and bone marrow transplant units. Infect Dis (Lond) 2017; 49:405-409. [PMID: 28071193 DOI: 10.1080/23744235.2016.1274420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are spreading worldwide in both hospital and community settings. In this study, the molecular epidemiology and the transmission modalities of ESBL-E in intensive care- and bone marrow transplant were investigated. METHODS All patients included in this study were screened for presence of ESBL-E on admission and weekly. Relevant β-lactamase genes were identified by PCR and sequencing. RESULTS A total of 669 patients were included in this study. On admission, ESBL-producing Escherichia coli were detected in 49 (7.3%) patients and ESBL-producing Klebsiella pneumoniae in one patient. The most common ESBL types among E. coli isolates were CTX-M-15 (38.8%) and CTX-M-1 (38.8%). Furthermore, 12 of 49 (24.5%) ESBL-producing E. coli could be assigned to the epidemic clone ST131. A single patient acquired ESBL-producing E. coli during the hospital stay but cross-transmission could not be demonstrated. Among 1095 environmental samples none revealed ESBL. CONCLUSIONS Our results suggest that early detection of ESBL-producing Enterobacteriaceae and consequent implementation of basic hygiene measures and contact isolation may reduce the transmission rate during the hospital stay.
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Affiliation(s)
- Giuseppe Valenza
- a Bavarian Health and Food Safety Authority , Erlangen , Germany.,b Microbiology Institute - Clinical Microbiology, Immunology and Hygiene , University Hospital of Erlangen , Erlangen , Germany
| | - Monika Schulze
- c Department of Hygiene and Environmental Medicine , Central Hospital of Augsburg , Augsburg , Germany
| | - Petra Friedrich
- c Department of Hygiene and Environmental Medicine , Central Hospital of Augsburg , Augsburg , Germany
| | - Wulf Schneider-Brachert
- d Institute of Clinical Microbiology and Hygiene , University Hospital of Regensburg , Regensburg , Germany
| | - Thomas Holzmann
- d Institute of Clinical Microbiology and Hygiene , University Hospital of Regensburg , Regensburg , Germany
| | - Silke Nickel
- a Bavarian Health and Food Safety Authority , Erlangen , Germany
| | | | - Christiane Höller
- e Bavarian Health and Food Safety Authority , Oberschleißheim , Germany
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Groesser L, Singer S, Peterhof E, Landthaler M, Heigl U, Schneider-Brachert W, Berneburg M, Hafner C. KRAS, HRAS and EGFR Mutations in Sporadic Sebaceous Gland Hyperplasia. Acta Derm Venereol 2016; 96:737-41. [PMID: 26804118 DOI: 10.2340/00015555-2351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/16/2022] Open
Abstract
Sporadic sebaceous gland hyperplasia (SGH) is a benign skin lesion, with a high prevalence in the general population. Although SGH has been attributed to both extrinsic and intrinsic factors, the underlying genetic changes have not yet been characterized. Recently, HRAS and KRAS mutations have been identified in sebaceous naevus, a hamartoma sharing histological characteristics with SGH. Therefore we screened 43 SGH for activating mutations in RAS genes and other oncogenes. We identified a wide spectrum of mutually exclusive activating HRAS (8/43), KRAS (11/43) and EGFR mutations (7/31) in altogether 60% of the lesions investigated. A RAS and EGFR wildtype status was found in 15 normal sebaceous glands in the head and neck area. Our findings indicate that activating HRAS, KRAS and EGFR mutations play a major role in the pathogenesis of sporadic SGH. These results support the concept that SGH is a true benign neoplasm rather than a reactive hyperplasia.
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Affiliation(s)
- Leopold Groesser
- Department of Dermatology, University of Regensburg, DE-93053 Regensburg, Germany.
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Rohrmeier C, Strutz J, Schneider-Brachert W. [Disinfection and recontamination of rigid endoscopes: improved safety using an immersion quiver system]. HNO 2015; 62:746-51. [PMID: 24867489 DOI: 10.1007/s00106-014-2873-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND In Otorhinolaryngology, rigid endoscopes are used daily at a high frequency. There is no consensus for reprocessing these medical instruments. Often immersion disinfection procedures are used. The present study examined the possible risk of recontamination by this disinfection method and investigated the possibility of avoiding this risk by using a new immersion quiver system. METHODS Using coloured markers, a possible contact of the endoscope with the top edges of quivers of different diameters during endoscope removal was tested for. In addition, it was evaluated whether Staphylococcus aureus transfer is possible via this route. The same methodology was applied to a new immersion quiver system. RESULTS Whenever removing the rigid endoscopes from the conventional quiver, these touched the top of the quiver, regardless of its diameter. A transfer of Staphylococcus aureus from the quiver to the endoscope via this route could be detected in five out of eight attempts. During endoscope removal from the new immersion quiver system, no contact of the endoscope with the outer quiver occurred in 20 passes. In none of eight trials was a transfer of Staphylococcus aureus from previously contaminated immersion quivers to the endoscope shown; all immersion quivers were sterile after disinfection. DISCUSSION After conventional immersion disinfection, recontamination of rigid endoscopes by a contaminated quiver edge is possible. An immersion quiver system can resolve this risk of recontamination easily, by decontaminating not only the endoscope, but also the immersion quiver (inner quiver) itself in the disinfectant solution.
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Affiliation(s)
- C Rohrmeier
- Klinik für Hals-Nasen-Ohren-Heilkunde, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland,
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Holzmann T, Schneider-Brachert W. [Microbiological diagnosis of periprosthetic joint infections]. Orthopade 2015; 44:344-8. [PMID: 25754927 DOI: 10.1007/s00132-015-3087-y] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prosthetic joint infection is a rare but serious complication after arthroplasty, leading to prolonged hospitalization and repeated surgical intervention. THEME In this article, successful strategies for the rapid and accurate microbiological diagnosis of infection are reviewed. In the case of clinical suspicion of a prosthetic joint infection, at least a comprehensive clinical review of the patient's postoperative history, a physical examination, routine blood tests including white cell count, erythrocyte sedimentation rate, and C-reactive protein, and further investigation of the synovial-fluid leukocyte count and microbial culture are needed. Depending of the clinical signs of infection additional blood culture samples should be taken. RESULTS The gold standard to confirm infection is a surgical procedure with at least 5-6 biopsies from suspected areas for both microbial culture and histopathological examination. Culture results may be negative because of previous antimicrobial therapy, a low number of culturable organisms in biofilm formations, inappropriate culture medium, and prolonged transport time. CONCLUSION In any of these conditions, diagnosis with highly sensitive diagnostic techniques such as polymerase chain reaction should be considered for the identification of the causative agent in order to establish the most appropriate antimicrobial treatment options.
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Affiliation(s)
- T Holzmann
- Institut für Klinische Mikrobiologie und Hygiene, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
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Mutters NT, Mersch-Sundermann V, Mutters R, Brandt C, Schneider-Brachert W, Frank U. Control of the spread of vancomycin-resistant enterococci in hospitals: epidemiology and clinical relevance. Dtsch Arztebl Int 2013; 110:725-31. [PMID: 24222791 DOI: 10.3238/arztebl.2013.0725] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 06/06/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND The spread of vancomycin-resistant enterococci (VRE), particularly E. faecium, in hospitals leads to many cases of colonization, but only sporadic infections. Detailed and valid risk assessment is needed so that patients at risk can be protected from VRE infection. The principal aims of risk assessment must include not only lowering VRE-associated morbidity and mortality in patients at risk, but also refraining from unnecessary anti-infective measures among those who are not at risk. METHODS We selectively searched the PubMed database for pertinent articles on the epidemiology and clinical relevance of VRE in order to derive a uniform and practical hygiene strategy from the available scientific evidence. RESULTS Only low-level evidence is available for the interventions studied to date, and most of the recommendations that have been issued can be characterized as expert opinion. As a rule, VRE are not highly pathogenic; they tend to have high rates of colonization, but low rates of infection. The risk factors for colonization with VRE include (among others) the administration of antibiotics and immunosuppressants, prior hospitalization, diarrhea, intubation, and other invasive treatments. The areas of highest risk are hematology/oncology wards, liver transplantation wards, dialysis units, and neonatology wards. CONCLUSION The chain of infection can be broken by improved and consistently applied standard hygienic measures (hand and surface disinfection). Some patients are nonetheless at elevated risk of VRE infection. In specific clinical situations, the optimal protection of these patients against VRE infection demands the obligatory enforcement of stricter hygienic measures (contact isolation).
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Affiliation(s)
- Nico T Mutters
- Heidelberg University Hospital, Department of Infectious Diseases, Medical Microbiology and Hygiene
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Tegtmeyer N, Rivas Traverso F, Rohde M, Oyarzabal OA, Lehn N, Schneider-Brachert W, Ferrero RL, Fox JG, Berg DE, Backert S. Electron microscopic, genetic and protein expression analyses of Helicobacter acinonychis strains from a Bengal tiger. PLoS One 2013; 8:e71220. [PMID: 23940723 PMCID: PMC3733902 DOI: 10.1371/journal.pone.0071220] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 06/26/2013] [Indexed: 12/21/2022] Open
Abstract
Colonization by Helicobacter species is commonly noted in many mammals. These infections often remain unrecognized, but can cause severe health complications or more subtle host immune perturbations. The aim of this study was to isolate and characterize putative novel Helicobacter spp. from Bengal tigers in Thailand. Morphological investigation (Gram-staining and electron microscopy) and genetic studies (16SrRNA, 23SrRNA, flagellin, urease and prophage gene analyses, RAPD DNA fingerprinting and restriction fragment polymorphisms) as well as Western blotting were used to characterize the isolated Helicobacters. Electron microscopy revealed spiral-shaped bacteria, which varied in length (2.5-6 µm) and contained up to four monopolar sheathed flagella. The 16SrRNA, 23SrRNA, sequencing and protein expression analyses identified novel H. acinonychis isolates closely related to H. pylori. These Asian isolates are genetically very similar to H. acinonychis strains of other big cats (cheetahs, lions, lion-tiger hybrid and other tigers) from North America and Europe, which is remarkable in the context of the great genetic diversity among worldwide H. pylori strains. We also found by immunoblotting that the Bengal tiger isolates express UreaseA/B, flagellin, BabA adhesin, neutrophil-activating protein NapA, HtrA protease, γ-glutamyl-transpeptidase GGT, Slt lytic transglycosylase and two DNA transfer relaxase orthologs that were known from H. pylori, but not the cag pathogenicity island, nor CagA, VacA, SabA, DupA or OipA proteins. These results give fresh insights into H. acinonychis genetics and the expression of potential pathogenicity-associated factors and their possible pathophysiological relevance in related gastric infections.
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MESH Headings
- Animals
- Bacterial Proteins/analysis
- DNA Fingerprinting
- Gene Expression Profiling
- Gene Expression Regulation, Bacterial
- Genes, Bacterial
- Helicobacter/genetics
- Helicobacter/isolation & purification
- Helicobacter/ultrastructure
- Helicobacter Infections/microbiology
- Helicobacter Infections/veterinary
- Microscopy, Electron
- RNA, Ribosomal, 16S/analysis
- RNA, Ribosomal, 16S/genetics
- RNA, Ribosomal, 23S/analysis
- RNA, Ribosomal, 23S/genetics
- Random Amplified Polymorphic DNA Technique
- Tigers/microbiology
- Urease/genetics
- Urease/metabolism
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Affiliation(s)
- Nicole Tegtmeyer
- Institute of Medical Microbiology, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | | | - Manfred Rohde
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Omar A. Oyarzabal
- Institute for Environmental Health, Inc., Seattle, Washington, United States of America
| | - Norbert Lehn
- Institute for Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Institute for Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Richard L. Ferrero
- Centre for Innate Immunity & Infectious Diseases, Monash Institute of Medical Research, Clayton, Australia
| | - James G. Fox
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Douglas E. Berg
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Steffen Backert
- Institute of Medical Microbiology, Otto von Guericke University Magdeburg, Magdeburg, Germany
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36
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Schneider-Brachert W, Heigl U, Ehrenschwender M. Membrane trafficking of death receptors: implications on signalling. Int J Mol Sci 2013; 14:14475-503. [PMID: 23852022 PMCID: PMC3742255 DOI: 10.3390/ijms140714475] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [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: 05/09/2013] [Revised: 06/19/2013] [Accepted: 06/27/2013] [Indexed: 12/22/2022] Open
Abstract
Death receptors were initially recognised as potent inducers of apoptotic cell death and soon ambitious attempts were made to exploit selective ignition of controlled cellular suicide as therapeutic strategy in malignant diseases. However, the complexity of death receptor signalling has increased substantially during recent years. Beyond activation of the apoptotic cascade, involvement in a variety of cellular processes including inflammation, proliferation and immune response was recognised. Mechanistically, these findings raised the question how multipurpose receptors can ensure selective activation of a particular pathway. A growing body of evidence points to an elegant spatiotemporal regulation of composition and assembly of the receptor-associated signalling complex. Upon ligand binding, receptor recruitment in specialized membrane compartments, formation of receptor-ligand clusters and internalisation processes constitute key regulatory elements. In this review, we will summarise the current concepts of death receptor trafficking and its implications on receptor-associated signalling events.
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Affiliation(s)
- Wulf Schneider-Brachert
- Institute for Clinical Microbiology and Hygiene, University of Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg 93053, Germany.
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37
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Eichner A, Gonzales FP, Felgenträger A, Regensburger J, Holzmann T, Schneider-Brachert W, Bäumler W, Maisch T. Dirty hands: photodynamic killing of human pathogens like EHEC, MRSA and Candida within seconds. Photochem Photobiol Sci 2013; 12:135-47. [PMID: 22855122 DOI: 10.1039/c2pp25164g] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hand hygiene is one of the most important interventions for reducing transmission of nosocomial life-threatening microorganisms, like methicillin resistant Staphylococcus aureus (MRSA), enterohemorrhagic Escherichia coli (EHEC) or Candida albicans. All three pathogens have become a leading cause of infections in hospitals. Especially EHEC is causing severe diarrhoea and, in a small percentage of cases, haemolytic-uremic syndrome (HUS) as reported for E. coli 104:H4 in Germany 2011. We revealed the possibility to inactivate very fast and efficiently MRSA, EHEC and C. albicans using the photodynamic approach. MRSA, EHEC and C. albicans were incubated in vitro with different concentrations of TMPyP for 10 s and illuminated with visible light (50 mW cm(-2)) for 10 and 60 s. 1 μmol l(-1) of TMPyP and an applied radiant exposure of 0.5 J cm(-2) achieved a photodynamic killing of ≥99.9% of MRSA and EHEC. Incubation with higher concentrations (up to 100 μmol l(-1)) of TMPyP caused bacteria killing of >5 log(10) (≥99.999%) after illumination. Efficient Candida killing (≥99.999%) was achieved first at a higher light dose of 12 J cm(-2). Different rise and decay times of singlet oxygen luminescence signals could be detected in Candida cell suspensions for the first time, indicating different oxygen concentrations in the surrounding for the photosensitizer and singlet oxygen, respectively. This confirms that TMPyP is not only found in the water-dominated cell surrounding, but also within the C. albicans cells. Applying a water-ethanol solution of TMPyP on ex vivo porcine skin, fluorescence microscopy of histology showed that the photosensitizer was exclusively localized in the stratum corneum regardless of the incubation time. TMPyP exhibited a fast and very effective killing rate of life-threatening pathogens within a couple of seconds that encourages further testing in an in vivo setting. Being fast and effective, antimicrobial photodynamic applications might become acceptable as a tool for hand hygiene procedures and also in other skin areas.
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Affiliation(s)
- Anja Eichner
- Department of Dermatology, Regensburg University Hospital, 93053 Regensburg, Germany
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38
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Parcina M, Miranda-Garcia MA, Durlanik S, Ziegler S, Over B, Georg P, Foermer S, Ammann S, Hilmi D, Weber KJ, Schiller M, Heeg K, Schneider-Brachert W, Götz F, Bekeredjian-Ding I. Pathogen-triggered activation of plasmacytoid dendritic cells induces IL-10-producing B cells in response to Staphylococcus aureus. J Immunol 2013; 190:1591-602. [PMID: 23325892 DOI: 10.4049/jimmunol.1201222] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Induction of polyclonal B cell activation is a phenomenon observed in many types of infection, but its immunological relevance is unclear. In this study we show that staphylococcal protein A induces T cell-independent human B cell proliferation by enabling uptake of TLR-stimulating nucleic acids via the V(H)3(+) BCR. We further demonstrate that Staphylococcus aureus strains with high surface protein A expression concomitantly trigger activation of human plasmacytoid dendritic cells (pDC). Sensitivity to chloroquine, cathepsin B inhibition, and a G-rich inhibitory oligodeoxynucleotide supports the involvement of TLR9 in this context. We then identify pDC as essential cellular mediators of B cell proliferation and Ig production in response to surface protein A-bearing S. aureus. The in vivo relevancy of these findings is confirmed in a human PBMC Nod/scid(Prkdc)/γc(-/-) mouse model. Finally, we demonstrate that co-operation of pDC and B cells enhances B cell-derived IL-10 production, a cytokine associated with immunosuppression and induction of IgG4, an isotype frequently dominating the IgG response to S. aureus. IL-10 release is partially dependent on TLR2-active lipoproteins, a hallmark of the Staphylococcus species. Collectively, our data suggest that S. aureus exploits pDC and TLR to establish B cell-mediated immune tolerance.
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Affiliation(s)
- Marijo Parcina
- Department of Infectious Diseases, Medical Microbiology, and Hygiene, University Hospital Heidelberg, D-69120 Heidelberg, Germany
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39
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Steinhäuser C, Heigl U, Tchikov V, Schwarz J, Gutsmann T, Seeger K, Brandenburg J, Fritsch J, Schroeder J, Wiesmüller KH, Rosenkrands I, Walther P, Pott J, Krause E, Ehlers S, Schneider-Brachert W, Schütze S, Reiling N. Lipid-labeling facilitates a novel magnetic isolation procedure to characterize pathogen-containing phagosomes. Traffic 2012; 14:321-36. [PMID: 23231467 DOI: 10.1111/tra.12031] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 11/28/2012] [Accepted: 12/11/2012] [Indexed: 02/03/2023]
Abstract
Here we describe a novel approach for the isolation and biochemical characterization of pathogen-containing compartments from primary cells: We developed a lipid-based procedure to magnetically label the surface of bacteria and visualized the label by scanning and transmission electron microscopy (SEM, TEM). We performed infection experiments with magnetically labeled Mycobacterium avium, M. tuberculosis and Listeria monocytogenes and isolated magnetic bacteria-containing phagosomes using a strong magnetic field in a novel free-flow system. Magnetic labeling of M. tuberculosis did not affect the virulence characteristics of the bacteria during infection experiments addressing host cell activation, phagosome maturation delay and replication in macrophages in vitro. Biochemical analyses of the magnetic phagosome-containing fractions provided evidence of an enhanced presence of bacterial antigens and a differential distribution of proteins involved in the endocytic pathway over time as well as cytokine-dependent changes in the phagosomal protein composition. The newly developed method represents a useful approach to characterize and compare pathogen-containing compartments, in order to identify microbial and host cell targets for novel anti-infective strategies.
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Affiliation(s)
- Christine Steinhäuser
- Division of Microbial Interface Biology, Research Center Borstel, Leibniz Center for Medicine and Biosciences, Borstel, 23845, Germany
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40
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Holzmann T, Frangoulidis D, Simon M, Noll P, Schmoldt S, Hanczaruk M, Grass G, Pregler M, Sing A, Hörmansdorfer S, Bernard H, Grunow R, Zimmermann R, Schneider-Brachert W, Gessner A, Reischl U. Fatal anthrax infection in a heroin user from southern Germany, June 2012. Euro Surveill 2012; 17:20204. [PMID: 22790532] [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: 06/01/2023] Open
Abstract
Blood cultures from a heroin user who died in June 2012, a few hours after hospital admission, due to acute septic disease, revealed the presence of Bacillus anthracis. This report describes the extended diagnosis by MALDI-TOF and real-time PCR and rapid confirmation of the anthrax infection through reference laboratories. Physicians and diagnostic laboratories were informed and alerted efficiently through the reporting channels of German public health institutions, which is essential for the prevention of further cases.
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Affiliation(s)
- T Holzmann
- Institute of Medical Microbiology and Hygiene, University Hospital of Regensburg, Germany.
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41
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Holzmann T, Frangoulidis D, Simon M, Noll P, Schmoldt S, Hanczaruk M, Grass G, Pregler M, Sing A, Hörmansdorfer S, Bernard H, Grunow R, Zimmermann R, Schneider-Brachert W, Gessner A, Reischl U. Fatal anthrax infection in a heroin user from southern Germany, June 2012. Euro Surveill 2012. [DOI: 10.2807/ese.17.26.20204-en] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Blood cultures from a heroin user who died in June 2012, a few hours after hospital admission, due to acute septic disease, revealed the presence of Bacillus anthracis. This report describes the extended diagnosis by MALDI-TOF and real-time PCR and rapid confirmation of the anthrax infection through reference laboratories. Physicians and diagnostic laboratories were informed and alerted efficiently through the reporting channels of German public health institutions, which is essential for the prevention of further cases.
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Affiliation(s)
- T Holzmann
- Institute of Medical Microbiology and Hygiene, University Hospital of Regensburg, Regensburg, Germany
| | | | - M Simon
- Institute of Medical Microbiology and Hygiene, University Hospital of Regensburg, Regensburg, Germany
| | - P Noll
- Krankenhaus der Barmherzigen Brüder, Regensburg, Germany
| | - S Schmoldt
- Bundeswehr Institute of Microbiology, Munich, Germany
| | - M Hanczaruk
- Bundeswehr Institute of Microbiology, Munich, Germany
| | - G Grass
- Bundeswehr Institute of Microbiology, Munich, Germany
| | - M Pregler
- District Health Office, Regensburg, Germany
| | - A Sing
- Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - S Hörmansdorfer
- Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - H Bernard
- Robert-Koch Institute, Berlin, Germany
| | - R Grunow
- Robert-Koch Institute, Berlin, Germany
| | | | - W Schneider-Brachert
- Institute of Medical Microbiology and Hygiene, University Hospital of Regensburg, Regensburg, Germany
| | - A Gessner
- Institute of Medical Microbiology and Hygiene, University Hospital of Regensburg, Regensburg, Germany
| | - U Reischl
- Institute of Medical Microbiology and Hygiene, University Hospital of Regensburg, Regensburg, Germany
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42
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Groesser L, Herschberger E, Ruetten A, Ruivenkamp C, Lopriore E, Zutt M, Langmann T, Singer S, Klingseisen L, Schneider-Brachert W, Toll A, Real FX, Landthaler M, Hafner C. Postzygotic HRAS and KRAS mutations cause nevus sebaceous and Schimmelpenning syndrome. Nat Genet 2012; 44:783-7. [DOI: 10.1038/ng.2316] [Citation(s) in RCA: 212] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 05/08/2012] [Indexed: 12/14/2022]
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43
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Klingseisen L, Ehrenschwender M, Heigl U, Wajant H, Hehlgans T, Schütze S, Schneider-Brachert W. E3-14.7K is recruited to TNF-receptor 1 and blocks TNF cytolysis independent from interaction with optineurin. PLoS One 2012; 7:e38348. [PMID: 22675546 PMCID: PMC3366936 DOI: 10.1371/journal.pone.0038348] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 05/03/2012] [Indexed: 11/18/2022] Open
Abstract
Escape from the host immune system is essential for intracellular pathogens. The adenoviral protein E3-14.7K (14.7K) is known as a general inhibitor of tumor necrosis factor (TNF)-induced apoptosis. It efficiently blocks TNF-receptor 1 (TNFR1) internalization but the underlying molecular mechanism still remains elusive. Direct interaction of 14.7K and/or associated proteins with the TNFR1 complex has been discussed although to date not proven. In our study, we provide for the first time evidence for recruitment of 14.7K and the 14.7K interacting protein optineurin to TNFR1. Various functions have been implicated for optineurin such as regulation of receptor endocytosis, vesicle trafficking, regulation of the nuclear factor κB (NF-κB) pathway and antiviral signaling. We therefore hypothesized that binding of optineurin to 14.7K and recruitment of both proteins to the TNFR1 complex is essential for protection against TNF-induced cytotoxic effects. To precisely dissect the individual role of 14.7K and optineurin, we generated and characterized a 14.7K mutant that does not confer TNF-resistance but is still able to interact with optineurin. In H1299 and KB cells expressing 14.7K wild-type protein, neither decrease in cell viability nor cleavage of caspases was observed upon stimulation with TNF. In sharp contrast, cells expressing the non-protective mutant of 14.7K displayed reduced viability and cleavage of initiator and effector caspases upon TNF treatment, indicating ongoing apoptotic cell death. Knockdown of optineurin in 14.7K expressing cells did not alter the protective effect as measured by cell viability and caspase activation. Taken together, we conclude that optineurin despite its substantial role in vesicular trafficking, endocytosis of cell surface receptors and recruitment to the TNFR1 complex is dispensable for the 14.7K-mediated protection against TNF-induced apoptosis.
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Affiliation(s)
- Laura Klingseisen
- Institute for Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Martin Ehrenschwender
- Institute for Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Ulrike Heigl
- Institute for Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Harald Wajant
- Division of Molecular Internal Medicine, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Hehlgans
- Institute of Immunology, University of Regensburg, Regensburg, Germany
| | - Stefan Schütze
- Institute of Immunology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Wulf Schneider-Brachert
- Institute for Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
- * E-mail:
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44
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Bulajic M, Panic N, Stimec B, Isaksson B, Jesenofsky R, Schneider-Brachert W, Löhr JM. PCR in Helicobacter spp. diagnostic in extragastric malignancies of digestive system. Eur J Gastroenterol Hepatol 2012; 24:117-25. [PMID: 22081011 DOI: 10.1097/meg.0b013e32834dfde1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Recognition of Helicobacter pylori as an important factor in genesis of gastric adenocarcinoma lead to a large number of studies concerning potential role of Helicobacter spp. in the development of extragastric digestive malignancies. The serological studies indicated possible localizations in the digestive system being from interest in enlightening Helicobacter spp. carcinogenic potential. The PCR obtruded itself as a gold standard in proving existence of actual correlation. In this review, the authors have examined studies conducted in the last 10 years examining Helicobacter spp. correlation with extragastric digestive carcinogenesis. Studies have been observed in four groups referring to hepatic carcinoma, bile duct cancer, pancreatic cancer, and colon cancer. The results of these researches have shown that there is a strong correlation between Helicobacter spp. colonization and primary liver tumors as well as bile duct tumors, whereas conclusions made by authors examining pancreatic cancer are contradictory and demands further investigation. No correlation between Helicobacter spp. and colon cancer have been proven. The PCR subtype most widely used in studies included in this review was nested PCR, whereas genes targeted most frequently for amplification are 16S rDNA of Helicobacter spp. and UreA gene or cagA gene of H. pylori. During the last 10 years PCR has proven itself as a sovereign method for Helicobacter spp. diagnostic in extragastric organs in the digestive system. Knowledge and experiences obtained in this domain could be encouraging for researchers in analogous fields of interest.
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Affiliation(s)
- Milutin Bulajic
- Medical Faculty of Belgrade, University Clinic Dr D. Misovic-Dedinje, Belgrade, Serbia
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45
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Miehlke S, Krasz S, Schneider-Brachert W, Kuhlisch E, Berning M, Madisch A, Laass MW, Neumeyer M, Jebens C, Zekorn C, Knoth H, Vieth M, Stolte M, Lehn N, Morgner A. Randomized trial on 14 versus 7 days of esomeprazole, moxifloxacin, and amoxicillin for second-line or rescue treatment of Helicobacter pylori infection. Helicobacter 2011; 16:420-6. [PMID: 22059392 DOI: 10.1111/j.1523-5378.2011.00867.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Triple therapy with a proton pump inhibitor, moxifloxacin, and amoxicillin has been proven effective in first-line treatment of Helicobacter pylori infection. AIM To explore 1, the value of triple therapy with esomeprazole, moxifloxacin, and amoxicillin in second-line or rescue treatment of Caucasian patients and 2, the impact of treatment duration on eradication success. METHODS H. pylori-infected patients with at least one previous treatment failure were randomized to oral esomeprazole 20 mg b.i.d., moxifloxacin 400 mg o.d., and amoxicillin 1000 mg b.i.d. for either 7 (EMA-7) or 14 days (EMA-14). Eradication was confirmed by 13C urea breath test. Antimicrobial susceptibility testing was performed in all patients at baseline and in patients who failed treatment. RESULTS Eighty patients were randomized, and 60% had ≥ 2 previous treatment failures. Pretreatment resistance against clarithromycin and metronidazole was found in 70.5 and 61.5% of cases, respectively. The intention-to-treat eradication rate was significantly higher after EMA-14 compared with EMA-7 (95.0 vs 78.9%, p = .036). No independent risk factor for treatment failure could be identified. There were no serious adverse events. Five of the EMA-14 patients (12.5%) compared with none of the EMA-7 patients discontinued prematurely because of adverse events (p = .031). Post-treatment resistance against moxifloxacin was found in one of seven patients with isolated organisms (14.3%). CONCLUSION Second-line/rescue H. pylori eradication therapy with esomeprazole, moxifloxacin, and amoxicillin is very effective and well tolerated. Fourteen days of treatment significantly increase the eradication rate but also the rate of adverse events.
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Affiliation(s)
- Stephan Miehlke
- Center for Digestive Diseases, Cooperation of Internal Medicine, Hamburg, Germany.
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46
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Miehlke S, Madisch A, Morgner A, Stolte M, Baretton G, Lehn N, Schneider-Brachert W. Relevanz von Yersinia-Outer-Membrane-Proteinen bei kollagener und lymphozytärer Kolitis. Z Gastroenterol 2011. [DOI: 10.1055/s-0031-1285429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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47
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Daller B, Müsch W, Röhrl J, Tumanov AV, Nedospasov SA, Männel DN, Schneider-Brachert W, Hehlgans T. Lymphotoxin-β receptor activation by lymphotoxin-α(1)β(2) and LIGHT promotes tumor growth in an NFκB-dependent manner. Int J Cancer 2011; 128:1363-70. [PMID: 20473944 DOI: 10.1002/ijc.25456] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [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: 11/07/2022]
Abstract
Lymphotoxin beta receptor (LTβR) activation on mouse fibrosarcoma cells (BFS-1) results in enhanced solid tumor growth paralleled by increased angiogenesis induced by the expression of pro-angiogenic CXCL2. In our study, we demonstrate that both functional ligands of the LTβR, namely LTα(1) β(2) and LIGHT, are involved in the activation of LTβR in solid fibrosarcomas. To identify whether the lymphocyte population is involved in the activation of LTβR in these fibrosarcoma tumors, we used conditional LTβ-deficient mice that specifically lack LTβ expression either on T cells (T-LTβ(-/-)) or on B cells (B-LTβ(-/-)). Solid tumor growth was reduced in both mouse strains when compared to tumor growth in wild-type mice, indicating the participation of both T and B host lymphocytes in the activation of LTβR in these tumors. Tumor growth was also reduced in LIGHT-deficient mice, suggesting a contribution of this ligand to the activation of LTβR in BFS-1 fibrosarcomas. LTβR signaling can involve IκBα and/or NFκB-inducing kinase (NIK) for subsequent NFκB activation in different types of cells. Expression of a dominant negative form of IκBα or of a dominant negative mutant of NIK resulted in decreased activation of NFκB signaling and reduced expression of pro-angiogenic CXCL2 in vitro. Moreover, expression of dominant negative form of NIK or an IκBα repressor in these fibrosarcoma cells resulted in reduced solid tumor growth in vivo, suggesting that both IκBα and NIK are involved in pro-angiogenic signaling after LTβR activation. Our data support the idea that the ablation of LTβR signaling should be considered for cancer treatment.
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Affiliation(s)
- Barbara Daller
- Institute of Immunology, University of Regensburg, Regensburg, Germany
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48
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Müller T, Lubnow M, Philipp A, Schneider-Brachert W, Camboni D, Schmid C, Lehle K. Risk of circuit infection in septic patients on extracorporeal membrane oxygenation: a preliminary study. Artif Organs 2011; 35:E84-90. [PMID: 21501183 DOI: 10.1111/j.1525-1594.2010.01185.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Extracorporeal membrane oxygenation (ECMO) is the ultimate treatment option to improve gas exchange and decrease the aggressiveness of mechanical ventilation in septic patients with uncontrolled severe lung failure. However, potential microbiological colonization of the artificial surfaces of membrane oxygenator (MO) remains a critical issue in patients with bacteremia. The current study investigates the risk of MO infection in 10 consecutive septic patients on long-term treatment with ECMO. The flushing fluids of all investigated MOs were sterile. After incubation with nutrient solution for 14 days in one MO Enterococci spp. were isolated. In the patient concerned, a diffuse, unaccountable bleeding diathesis had developed, which stopped after exchange of the MO. Analysis of clinical parameters showed that D dimers had increased and fibrinogen levels had decreased before exchange of this MO, but standard markers of infection had remained unremarkable. In conclusion, circuit infection may be a potential cause for unexplained clinical deterioration of patients on ECMO, which therefore should be considered as an indication for exchange of the device.
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Affiliation(s)
- Thomas Müller
- Department of Internal Medicine II, Institute for Medical Microbiology and Hygiene, University Medical Center of Regensburg, Franz-Josef-Strauss Allee 11, Regensburg, Germany.
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Resch M, Kurz K, Schneider-Brachert W, Tintelnot K, Birner C, Schichtl T, Lubnow M, Hart C, Jilek C, Bertz S, Hilker M, Riegger GAJ, Luchner A, Müller T. Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) in fulminant blastomycosis in Germany. BMJ Case Rep 2009; 2009:bcr07.2008.0392. [PMID: 21712860 DOI: 10.1136/bcr.07.2008.0392] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In fulminant blastomycosis with multiorgan failure, the earliest diagnosis possible is crucial for successful treatment. If severe acute respiratory distress syndrome (ARDS) develops, miniaturised veno-venous extracorporeal membrane oxygenation (ECMO) might provide a unique and efficacious possibility to prolong the time frame for diagnosis and the beginning of treatment. This is the first report on a case of fatal blastomycosis in Germany. It reminds us to add exotic infections to the differential diagnosis in patients with refractory pneumonia in the era of worldwide tourism.
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Affiliation(s)
- Markus Resch
- Regensburg University Medical Center, Department of Internal Medicine II, Franz-Josef-Strauss-Allee 11, Regensburg, 93053, Germany
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Buergers R, Schneider-Brachert W, Hahnel S, Rosentritt M, Handel G. Streptococcal adhesion to novel low-shrink silorane-based restorative. Dent Mater 2009; 25:269-75. [DOI: 10.1016/j.dental.2008.07.011] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Accepted: 07/21/2008] [Indexed: 12/18/2022]
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