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Yuu EY, Bührer C, Eckmanns T, Fulde M, Herz M, Kurzai O, Lindstedt C, Panagiotou G, Piro VC, Radonic A, Renard BY, Reuss A, Siliceo SL, Thielemann N, Thürmer A, Vorst KV, Wieler LH, Haller S. The gut microbiome, resistome, and mycobiome in preterm newborn infants and mouse pups: lack of lasting effects by antimicrobial therapy or probiotic prophylaxis. Gut Pathog 2024; 16:27. [PMID: 38735967 PMCID: PMC11089716 DOI: 10.1186/s13099-024-00616-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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 04/13/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Enhancing our understanding of the underlying influences of medical interventions on the microbiome, resistome and mycobiome of preterm born infants holds significant potential for advancing infection prevention and treatment strategies. We conducted a prospective quasi-intervention study to better understand how antibiotics, and probiotics, and other medical factors influence the gut development of preterm infants. A controlled neonatal mice model was conducted in parallel, designed to closely reflect and predict exposures. Preterm infants and neonatal mice were stratified into four groups: antibiotics only, probiotics only, antibiotics followed by probiotics, and none of these interventions. Stool samples from both preterm infants and neonatal mice were collected at varying time points and analyzed by 16 S rRNA amplicon sequencing, ITS amplicon sequencing and whole genome shotgun sequencing. RESULTS The human infant microbiomes showed an unexpectedly high degree of heterogeneity. Little impact from medical exposure (antibiotics/probiotics) was observed on the strain patterns, however, Bifidobacterium bifidum was found more abundant after exposure to probiotics, regardless of prior antibiotic administration. Twenty-seven antibiotic resistant genes were identified in the resistome. High intra-variability was evident within the different treatment groups. Lastly, we found significant effects of antibiotics and probiotics on the mycobiome but not on the microbiome and resistome of preterm infants. CONCLUSIONS Although our analyses showed transient effects, these results provide positive motivation to continue the research on the effects of medical interventions on the microbiome, resistome and mycobiome of preterm infants.
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Affiliation(s)
- Elizabeth Y Yuu
- Data Analytics & Computational Statistics, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Straße 2-3, 14482 , Potsdam, Germany
| | | | | | - Marcus Fulde
- Department of Mathematics and Computer Science, Freie Universität Berlin, 14195, Berlin, Germany
| | - Michaela Herz
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Oliver Kurzai
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
- Department of Microbiome Dynamics, Leibniz Institute for Natural Product Research and Infection Biology - Hans Knöll Institute, Beutenbergstraße 11A, 07745 , Jena, Germany
| | | | - Gianni Panagiotou
- Department of Microbiome Dynamics, Leibniz Institute for Natural Product Research and Infection Biology - Hans Knöll Institute, Beutenbergstraße 11A, 07745 , Jena, Germany
- Faculty of Biological Sciences, Friedrich Schiller University, 07745, Jena, Germany
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Vitor C Piro
- Data Analytics & Computational Statistics, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Straße 2-3, 14482 , Potsdam, Germany
- Department of Mathematics and Computer Science, Freie Universität Berlin, 14195, Berlin, Germany
| | | | - Bernhard Y Renard
- Data Analytics & Computational Statistics, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Straße 2-3, 14482 , Potsdam, Germany
| | - Annicka Reuss
- Robert Koch Institute, Berlin, Germany
- Ministry of Justice and Health, Schleswig-Holstein, Kiel , Germany
| | - Sara Leal Siliceo
- Department of Microbiome Dynamics, Leibniz Institute for Natural Product Research and Infection Biology - Hans Knöll Institute, Beutenbergstraße 11A, 07745 , Jena, Germany
| | - Nadja Thielemann
- Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | | | - Kira van Vorst
- Department of Mathematics and Computer Science, Freie Universität Berlin, 14195, Berlin, Germany
| | - Lothar H Wieler
- Data Analytics & Computational Statistics, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Straße 2-3, 14482 , Potsdam, Germany
- Robert Koch Institute, Berlin, Germany
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Näher AF, Krumpal I, Antão EM, Ong E, Rojo M, Kaggwa F, Balzer F, Celi LA, Braune K, Wieler LH, Agha-Mir-Salim L. Measuring fairness preferences is important for artificial intelligence in health care. Lancet Digit Health 2024; 6:e302-e304. [PMID: 38670737 DOI: 10.1016/s2589-7500(24)00059-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/15/2024] [Accepted: 03/08/2024] [Indexed: 04/28/2024]
Affiliation(s)
- Anatol-Fiete Näher
- Digital Global Public Health, Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam 14482, Germany; Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Ivar Krumpal
- Faculty of Social Science and Philosophy, University of Leipzig, Leipzig, Germany
| | - Esther-Maria Antão
- Digital Global Public Health, Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam 14482, Germany
| | - Erika Ong
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Marina Rojo
- Department of Public Health, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Fred Kaggwa
- Department of Computer Science, Faculty of Computing and Informatics, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Felix Balzer
- Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Leo Anthony Celi
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, MA, USA; Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Katarina Braune
- Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lothar H Wieler
- Digital Global Public Health, Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam 14482, Germany
| | - Louis Agha-Mir-Salim
- Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Berlin, Germany
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3
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Memish ZA, Blumberg L, Al-Maani AS, Baru R, Dube E, Gao GF, Jernigan DB, Leo YS, Peiris JSM, Masud JHB, McVernon J, Nonvignon J, Ogunsola FT, Reese H, Safdar RM, Ungchusak K, Wieler LH, Heymann D. Moving cholera vaccines ahead of the epidemic curve. Lancet 2024; 403:127-129. [PMID: 37863081 DOI: 10.1016/s0140-6736(23)02244-4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/05/2023] [Indexed: 10/22/2023]
Affiliation(s)
- Ziad A Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh 11553, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Kyung Hee University, Seoul, South Korea; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Lucille Blumberg
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Right to Care, South Africa; University of Pretoria, Hatfield, South Africa
| | - Amal Saif Al-Maani
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Rama Baru
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| | - Eve Dube
- Department of Anthropology, Laval University, Quebec, QC, Canada; Department of Biohazard, Quebec National Institute of Public Health, Quebec, QC, Canada
| | - George F Gao
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Center for Influenza Research and Early-warning, Beijing, China; CAS-TWAS Center of Excellence for Emerging Infectious Diseases, Beijing, China; University of Chinese Academy of Sciences, Beijing, China
| | - Daniel B Jernigan
- National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yee-Sin Leo
- National Centre for Infectious Diseases; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joseph Sriyal Malik Peiris
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | | | - Jodie McVernon
- Department of Infectious Diseases, and Victorian Infectious Diseases Reference Laboratory Epidemiology Unit, Royal Melbourne Hospital Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Justice Nonvignon
- School of Public Health, University of Ghana, Accra, Ghana; Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | - Helen Reese
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Kumnuan Ungchusak
- Department of Disease Control, Nonthaburi, Thailand; National Vaccine Institute of Thailand, Nonthaburi, Thailand
| | - Lothar H Wieler
- Hasso-Plattner-Institut für Digital Engineering gGmbH Digital Engineering, Brandenburg, Germany
| | - David Heymann
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Wieler LH, Antao EM, Hanefeld J. Reflections from the COVID-19 pandemic in Germany: lessons for global health. BMJ Glob Health 2023; 8:e013913. [PMID: 37748795 PMCID: PMC10533693 DOI: 10.1136/bmjgh-2023-013913] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023] Open
Affiliation(s)
- Lothar H Wieler
- Digital Global Public Health, Hasso Plattner Institute for Digital Engineering GmbH, Potsdam, Germany
- Robert Koch Institute, Berlin, Germany
| | - Esther-Maria Antao
- Digital Global Public Health, Hasso Plattner Institute for Digital Engineering GmbH, Potsdam, Germany
| | - Johanna Hanefeld
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
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Adrian G, Dietrich M, Esser B, Hensel A, Isermeyer F, Messner D, Mettenleiter TC, Paulini I, Riewenherm S, Schaade L, Tiesler R, Wieler LH. Together we can counter the effects of climate change. J Health Monit 2023; 8:3-5. [PMID: 37342427 PMCID: PMC10278369 DOI: 10.25646/11399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/24/2023] [Indexed: 06/22/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Ralph Tiesler
- Federal Office of Civil Protection and Disaster Assistance
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6
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Boender TS, Schneider PH, Houareau C, Wehrli S, Purnat TD, Ishizumi A, Wilhelm E, Voegeli C, Wieler LH, Leuker C. Establishing Infodemic Management in Germany: A Framework for Social Listening and Integrated Analysis to Report Infodemic Insights at the National Public Health Institute. JMIR Infodemiology 2023; 3:e43646. [PMID: 37261891 PMCID: PMC10273031 DOI: 10.2196/43646] [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] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND To respond to the need to establish infodemic management functions at the national public health institute in Germany (Robert Koch Institute, RKI), we explored and assessed available data sources, developed a social listening and integrated analysis framework, and defined when infodemic management functions should be activated during emergencies. OBJECTIVE We aimed to establish a framework for social listening and integrated analysis for public health in the German context using international examples and technical guidance documents for infodemic management. METHODS This study completed the following objectives: identified (potentially) available data sources for social listening and integrated analysis; assessed these data sources for their suitability and usefulness for integrated analysis in addition to an assessment of their risk using the RKI's standardized data protection requirements; developed a framework and workflow to combine social listening and integrated analysis to report back actionable infodemic insights for public health communications by the RKI and stakeholders; and defined criteria for activating integrated analysis structures in the context of a specific health event or health emergency. RESULTS We included and classified 38% (16/42) of the identified and assessed data sources for social listening and integrated analysis at the RKI into 3 categories: social media and web-based listening data, RKI-specific data, and infodemic insights. Most data sources can be analyzed weekly to detect current trends and narratives and to inform a timely response by reporting insights that include a risk assessment and scalar judgments of different narratives and themes. CONCLUSIONS This study identified, assessed, and prioritized a wide range of data sources for social listening and integrated analysis to report actionable infodemic insights, ensuring a valuable first step in establishing and operationalizing infodemic management at the RKI. This case study also serves as a roadmap for others. Ultimately, once operational, these activities will inform better and targeted public health communication at the RKI and beyond.
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Affiliation(s)
- T Sonia Boender
- Risk Communication Unit, Robert Koch Institute, Berlin, Germany
| | | | - Claudia Houareau
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Silvan Wehrli
- Centre for Artificial Intelligence in Public Health Research, Robert Koch Institute, Berlin, Germany
| | - Tina D Purnat
- Health Emergencies Programme, Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | - Atsuyoshi Ishizumi
- Health Emergencies Programme, Department of Pandemic and Epidemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | - Elisabeth Wilhelm
- School of Public Health Information Futures Lab, Brown University, Providence, RI, United States
| | | | - Lothar H Wieler
- Robert Koch Institute, Berlin, Germany
- Digital Global Public Health, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
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7
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Irrgang C, Eckmanns T, V Kleist M, Antão EM, Ladewig K, Wieler LH, Körber N. [Application areas of artificial intelligence in the context of One Health with a focus on antimicrobial resistance]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03707-2. [PMID: 37140603 PMCID: PMC10157576 DOI: 10.1007/s00103-023-03707-2] [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: 11/30/2022] [Accepted: 04/21/2023] [Indexed: 05/05/2023]
Abstract
Societal health is facing a number of new challenges, largely driven by ongoing climate change, demographic ageing, and globalization. The One Health approach links human, animal, and environmental sectors with the goal of achieving a holistic understanding of health in general. To implement this approach, diverse and heterogeneous data streams and types must be combined and analyzed. To this end, artificial intelligence (AI) techniques offer new opportunities for cross-sectoral assessment of current and future health threats. Using the example of antimicrobial resistance as a global threat in the One Health context, we demonstrate potential applications and challenges of AI techniques.This article provides an overview of different applications of AI techniques in the context of One Health and highlights their challenges. Using the spread of antimicrobial resistance (AMR), an increasing global threat, as an example, existing and future AI-based approaches to AMR containment and prevention are described. These range from novel drug development and personalized therapy, to targeted monitoring of antibiotic use in livestock and agriculture, to comprehensive environmental surveillance.
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Affiliation(s)
- Christopher Irrgang
- Zentrum für Künstliche Intelligenz in der Public Health-Forschung, Robert Koch-Institut, Wildau, Deutschland.
| | - Tim Eckmanns
- FG 37: Nosokomiale Infektionen, Surveillance von Antibiotikaresistenz und -verbrauch, Robert Koch-Institut, Berlin, Deutschland
| | - Max V Kleist
- Fachbereich für Mathematik und Informatik, Freie Universität Berlin, Berlin, Deutschland
- P5: Systemmedizin von Infektionskrankheiten, Robert Koch-Institut, Berlin, Deutschland
| | - Esther-Maria Antão
- Fachgebiet Digital Global Public Health, Hasso-Plattner-Institut, Potsdam, Deutschland
| | - Katharina Ladewig
- Zentrum für Künstliche Intelligenz in der Public Health-Forschung, Robert Koch-Institut, Wildau, Deutschland
| | - Lothar H Wieler
- Robert Koch-Institut, Berlin, Deutschland
- Fachgebiet Digital Global Public Health, Hasso-Plattner-Institut, Potsdam, Deutschland
| | - Nils Körber
- Zentrum für Künstliche Intelligenz in der Public Health-Forschung, Robert Koch-Institut, Wildau, Deutschland
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8
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Salzberger B, Mellmann A, Bludau A, Ciesek S, Corman V, Dilthey A, Donker T, Eckmanns T, Egelkamp R, Gatermann SG, Grundmann H, Häcker G, Kaase M, Lange B, Mielke M, Pletz MW, Semmler T, Thürmer A, Wieler LH, Wolff T, Widmer AF, Scheithauer S. An appeal for strengthening genomic pathogen surveillance to improve pandemic preparedness and infection prevention: the German perspective. Infection 2023:10.1007/s15010-023-02040-9. [PMID: 37129842 PMCID: PMC10152431 DOI: 10.1007/s15010-023-02040-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
The SARS-CoV-2 pandemic has highlighted the importance of viable infection surveillance and the relevant infrastructure. From a German perspective, an integral part of this infrastructure, genomic pathogen sequencing, was at best fragmentary and stretched to its limits due to the lack or inefficient use of equipment, human resources, data management and coordination. The experience in other countries has shown that the rate of sequenced positive samples and linkage of genomic and epidemiological data (person, place, time) represent important factors for a successful application of genomic pathogen surveillance. Planning, establishing and consistently supporting adequate structures for genomic pathogen surveillance will be crucial to identify and combat future pandemics as well as other challenges in infectious diseases such as multi-drug resistant bacteria and healthcare-associated infections. Therefore, the authors propose a multifaceted and coordinated process for the definition of procedural, legal and technical standards for comprehensive genomic pathogen surveillance in Germany, covering the areas of genomic sequencing, data collection and data linkage, as well as target pathogens. A comparative analysis of the structures established in Germany and in other countries is applied. This proposal aims to better tackle epi- and pandemics to come and take action from the "lessons learned" from the SARS-CoV-2 pandemic.
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Affiliation(s)
- Bernd Salzberger
- Department for Infection Control and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Alexander Mellmann
- Institute for Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149, Münster, Germany.
| | - Anna Bludau
- Department for Infection Control and Infectious Diseases, University Medical Center (UMG), Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Victor Corman
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander Dilthey
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Tjibbe Donker
- Institute for Infection Prevention and Hospital Epidemiology, University Medical Center Freiburg, Freiburg, Germany
| | | | - Richard Egelkamp
- Next Generation Sequencing, Public Health Agency of Lower Saxony, Hanover, Germany
| | - Sören G Gatermann
- Department of Medical Microbiology, Ruhr University Bochum, Bochum, Germany
| | - Hajo Grundmann
- Institute for Infection Prevention and Hospital Epidemiology, University Medical Center Freiburg, Freiburg, Germany
| | - Georg Häcker
- Faculty of Medicine, Institute of Medical Microbiology and Hygiene, Medical Centre University of Freiburg, Freiburg, Germany
| | - Martin Kaase
- Department for Infection Control and Infectious Diseases, University Medical Center (UMG), Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany
| | | | - Mathias W Pletz
- Institute of Infectious Diseases and Infection Control, University Hospital, Jena, Germany
| | | | | | | | | | - Andreas F Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Simone Scheithauer
- Department for Infection Control and Infectious Diseases, University Medical Center (UMG), Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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Kaman* A, Erhart* M, Devine J, Reiß F, Napp AK, M. Simon A, Hurrelmann K, Schlack R, Hölling H, H. Wieler L, Ravens-Sieberer U. Two Years of Pandemic: the Mental Health and Quality of Life of Children and Adolescents. Dtsch Arztebl Int 2023; 120:269-270. [PMID: 37482701 PMCID: PMC10366960 DOI: 10.3238/arztebl.m2023.0001] [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] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Anne Kaman*
- *The two authors share joint first authorship
- Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Hamburg
| | - Michael Erhart*
- *The two authors share joint first authorship
- Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Hamburg
- Alice-Salomon-Hochschule, Berlin
| | - Janine Devine
- Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Hamburg
| | - Franziska Reiß
- Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Hamburg
| | - Ann-Kathrin Napp
- Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Hamburg
| | | | | | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Mental Health Unit, Robert Koch-Institute, Berlin
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Mental Health Unit, Robert Koch-Institute, Berlin
| | | | - Ulrike Ravens-Sieberer
- Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Hamburg
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Tiwari SK, van der Putten BCL, Fuchs TM, Vinh TN, Bootsma M, Oldenkamp R, La Ragione R, Matamoros S, Hoa NT, Berens C, Leng J, Álvarez J, Ferrandis-Vila M, Ritchie JM, Fruth A, Schwarz S, Domínguez L, Ugarte-Ruiz M, Bethe A, Huber C, Johanns V, Stamm I, Wieler LH, Ewers C, Fivian-Hughes A, Schmidt H, Menge C, Semmler T, Schultsz C. Genome-wide association reveals host-specific genomic traits in Escherichia coli. BMC Biol 2023; 21:76. [PMID: 37038177 PMCID: PMC10088187 DOI: 10.1186/s12915-023-01562-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/10/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Escherichia coli is an opportunistic pathogen which colonizes various host species. However, to what extent genetic lineages of E. coli are adapted or restricted to specific hosts and the genomic determinants of such adaptation or restriction is poorly understood. RESULTS We randomly sampled E. coli isolates from four countries (Germany, UK, Spain, and Vietnam), obtained from five host species (human, pig, cattle, chicken, and wild boar) over 16 years, from both healthy and diseased hosts, to construct a collection of 1198 whole-genome sequenced E. coli isolates. We identified associations between specific E. coli lineages and the host from which they were isolated. A genome-wide association study (GWAS) identified several E. coli genes that were associated with human, cattle, or chicken hosts, whereas no genes associated with the pig host could be found. In silico characterization of nine contiguous genes (collectively designated as nan-9) associated with the human host indicated that these genes are involved in the metabolism of sialic acids (Sia). In contrast, the previously described sialic acid regulon known as sialoregulon (i.e. nanRATEK-yhcH, nanXY, and nanCMS) was not associated with any host species. In vitro growth experiments with a Δnan-9 E. coli mutant strain, using the sialic acids 5-N-acetylneuraminic acid (Neu5Ac) and N-glycolylneuraminic acid (Neu5Gc) as sole carbon source, showed impaired growth behaviour compared to the wild-type. CONCLUSIONS This study provides an extensive analysis of genetic determinants which may contribute to host specificity in E. coli. Our findings should inform risk analysis and epidemiological monitoring of (antimicrobial resistant) E. coli.
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Affiliation(s)
- Sumeet K Tiwari
- Robert Koch Institute, Genome Sequencing and Genomic Epidemiology, Berlin, Germany
- Quadram Institute Bioscience, Gut Microbes and Health Institute Strategic Program, Norwich Research Park, Norwich, UK
| | - Boas C L van der Putten
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Thilo M Fuchs
- Friedrich-Loeffler-Institut, Institute of Molecular Pathogenesis, Jena, Germany
| | - Trung N Vinh
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Faculty of Veterinary Medicine, College of Agriculture, Can Tho University, Can Tho, Vietnam
| | | | - Rik Oldenkamp
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Institute for Life and Environment, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Roberto La Ragione
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, UK
- Department of Microbial Sciences, School of Biosciences, University of Surrey, Guildford, UK
| | - Sebastien Matamoros
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Ngo T Hoa
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Tropical medicine and global health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
- Microbiology- Parasitology Unit, Biomedical Research Center and Microbiology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Christian Berens
- Friedrich-Loeffler-Institut, Institute of Molecular Pathogenesis, Jena, Germany
| | - Joy Leng
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, UK
| | - Julio Álvarez
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| | | | - Jenny M Ritchie
- Department of Microbial Sciences, School of Biosciences, University of Surrey, Guildford, UK
| | - Angelika Fruth
- Robert Koch Institute, Enteropathogenic Bacteria and Legionella, Wernigerode, Germany
| | - Stefan Schwarz
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, Berlin, Germany
| | - Lucas Domínguez
- Tropical medicine and global health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7BN, UK
- Microbiology- Parasitology Unit, Biomedical Research Center and Microbiology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - María Ugarte-Ruiz
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain
| | - Astrid Bethe
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, Berlin, Germany
| | - Charlotte Huber
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Vanessa Johanns
- Robert Koch Institute, Advanced Light and Electron Microscopy, Berlin, Germany
| | - Ivonne Stamm
- Vet Med Labor GmbH, Division of IDEXX Laboratories, Kornwestheim, Germany
| | | | - Christa Ewers
- Institute of Hygiene and Infectious Diseases of Animals, Giessen, Germany
| | - Amanda Fivian-Hughes
- Department of Microbial Sciences, School of Biosciences, University of Surrey, Guildford, UK
| | - Herbert Schmidt
- Institute of Food Science and Biotechnology, Department of Food Microbiology and Hygiene, University of Hohenheim, Stuttgart, Germany
| | - Christian Menge
- Friedrich-Loeffler-Institut, Institute of Molecular Pathogenesis, Jena, Germany
| | - Torsten Semmler
- Robert Koch Institute, Genome Sequencing and Genomic Epidemiology, Berlin, Germany.
| | - Constance Schultsz
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
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11
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Offergeld R, Preußel K, Zeiler T, Aurich K, Baumann-Baretti BI, Ciesek S, Corman VM, Dienst V, Drosten C, Görg S, Greinacher A, Grossegesse M, Haller S, Heuft HG, Hofmann N, Horn PA, Houareau C, Gülec I, Jiménez Klingberg CL, Juhl D, Lindemann M, Martin S, Neuhauser HK, Nitsche A, Ohme J, Peine S, Sachs UJ, Schaade L, Schäfer R, Scheiblauer H, Schlaud M, Schmidt M, Umhau M, Vollmer T, Wagner FF, Wieler LH, Wilking H, Ziemann M, Zimmermann M, der Heiden MA. Monitoring the SARS-CoV-2 Pandemic: Prevalence of Antibodies in a Large, Repetitive Cross-Sectional Study of Blood Donors in Germany—Results from the SeBluCo Study 2020–2022. Pathogens 2023; 12:pathogens12040551. [PMID: 37111436 PMCID: PMC10144823 DOI: 10.3390/pathogens12040551] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
SARS-CoV-2 serosurveillance is important to adapt infection control measures and estimate the degree of underreporting. Blood donor samples can be used as a proxy for the healthy adult population. In a repeated cross-sectional study from April 2020 to April 2021, September 2021, and April/May 2022, 13 blood establishments collected 134,510 anonymised specimens from blood donors in 28 study regions across Germany. These were tested for antibodies against the SARS-CoV-2 spike protein and nucleocapsid, including neutralising capacity. Seroprevalence was adjusted for test performance and sampling and weighted for demographic differences between the sample and the general population. Seroprevalence estimates were compared to notified COVID-19 cases. The overall adjusted SARS-CoV-2 seroprevalence remained below 2% until December 2020 and increased to 18.1% in April 2021, 89.4% in September 2021, and to 100% in April/May 2022. Neutralising capacity was found in 74% of all positive specimens until April 2021 and in 98% in April/May 2022. Our serosurveillance allowed for repeated estimations of underreporting from the early stage of the pandemic onwards. Underreporting ranged between factors 5.1 and 1.1 in the first two waves of the pandemic and remained well below 2 afterwards, indicating an adequate test strategy and notification system in Germany.
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Affiliation(s)
- Ruth Offergeld
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Karina Preußel
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Thomas Zeiler
- German Red Cross Blood Service West, 58097 Hagen, Germany
| | - Konstanze Aurich
- Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, Sauerbruchstrasse, 17475 Greifswald, Germany
| | | | - Sandra Ciesek
- Institute for Medical Virology, German Centre for Infection Research, External Partner Site Frankfurt, University Hospital, Goethe University Frankfurt am Main, 39120 Frankfurt am Main, Germany
| | - Victor M. Corman
- Institute of Virology, German National Reference Laboratory for Coronavirus, Charité—University Medicine Berlin, 10117 Berlin, Germany
| | | | - Christian Drosten
- Institute of Virology, German National Reference Laboratory for Coronavirus, Charité—University Medicine Berlin, 10117 Berlin, Germany
| | - Siegfried Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Andreas Greinacher
- Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, Sauerbruchstrasse, 17475 Greifswald, Germany
| | | | | | - Hans-Gert Heuft
- Institute of Transfusion Medicine and Immunohaematology/Blood Bank, University Hospital Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | | | - Peter A. Horn
- Institute for Transfusion Medicine, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | | | - Ilay Gülec
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen, Sandhofstraße 1, 60528 Frankfurt am Main, Germany
| | | | - David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Monika Lindemann
- Institute for Transfusion Medicine, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Silke Martin
- Bavarian Red Cross Blood Service, Herzog-Heinrich-Str. 2, 80336 München, Germany
| | | | | | - Julia Ohme
- German Red Cross Blood Service NSTOB, Eldagsener Straße 38, 31832 Springe, Germany
| | - Sven Peine
- Institute of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Ulrich J. Sachs
- Center for Transfusion Medicine and Haemotherapy, University Hospital Giessen and Marburg, Langhansstr. 7, 35392 Giessen, Germany
| | - Lars Schaade
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Richard Schäfer
- Institute for Transfusion Medicine and Gene Therapy, Faculty of Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | | | - Martin Schlaud
- Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Michael Schmidt
- Institute of Transfusion Medicine and Immunohematology, German Red Cross Blood Transfusion Service Baden-Württemberg—Hessen, Sandhofstraße 1, 60528 Frankfurt am Main, Germany
| | - Markus Umhau
- Institute for Transfusion Medicine and Gene Therapy, Faculty of Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Tanja Vollmer
- Heart and Diabetes Centre NRW, Institute for Laboratory and Transfusion Medicine, Ruhr-University Bochum, 32545 Bad Oeynhausen, Germany
| | - Franz F. Wagner
- German Red Cross Blood Service NSTOB, Eldagsener Straße 38, 31832 Springe, Germany
| | | | | | - Malte Ziemann
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Ratzeburger Allee 160, 23538 Lübeck, Germany
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12
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Hövener C, Wieler LH. Migration and health: moving towards a diversity-oriented public health monitoring at the Robert Koch Institute. J Health Monit 2023; 8:3-6. [PMID: 37064419 PMCID: PMC10091037 DOI: 10.25646/11141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 04/18/2023]
Abstract
Summarizing categories, such as migration background or history of migration, do not reflect the diversity and heterogeneity of the population living in Germany and their health. A differentiated description of the health situation of people with a history of migration should consider migration-related, social, and structural determinants of health as well as their interactions. The findings obtained in the 'Improving Health Monitoring in Migrant Populations (IMIRA)' projects will help to improve the inclusion of people with a history of migration in future studies as well as in the RKI panel. This will enable an adequate description of the health situation of people with a history of migration and therefore of the general population in Germany. In future studies, the health status of people who have not been well included in health surveys so far, such as people who are not listed at the registration office, should be monitored. For this purpose, continuous development of sampling and survey methods is necessary.
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Affiliation(s)
- Claudia Hövener
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
- Corresponding author Dr Claudia Hövener, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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13
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Scheithauer S, Dilthey A, Bludau A, Ciesek S, Corman V, Donker T, Eckmanns T, Egelkamp R, Grundmann H, Häcker G, Kaase M, Lange B, Mellmann A, Mielke M, Pletz M, Salzberger B, Thürmer A, Widmer A, Wieler LH, Wolff T, Gatermann S, Semmler T. [Establishment of genomic pathogen surveillance to strengthen pandemic preparedness and infection prevention in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:443-449. [PMID: 36811648 PMCID: PMC9945818 DOI: 10.1007/s00103-023-03680-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] [Indexed: 02/24/2023]
Abstract
The SARS-CoV‑2 pandemic has shown a deficit of essential epidemiological infrastructure, especially with regard to genomic pathogen surveillance in Germany. In order to prepare for future pandemics, the authors consider it urgently necessary to remedy this existing deficit by establishing an efficient infrastructure for genomic pathogen surveillance. Such a network can build on structures, processes, and interactions that have already been initiated regionally and further optimize them. It will be able to respond to current and future challenges with a high degree of adaptability.The aim of this paper is to address the urgency and to outline proposed measures for establishing an efficient, adaptable, and responsive genomic pathogen surveillance network, taking into account external framework conditions and internal standards. The proposed measures are based on global and country-specific best practices and strategy papers. Specific next steps to achieve an integrated genomic pathogen surveillance include linking epidemiological data with pathogen genomic data; sharing and coordinating existing resources; making surveillance data available to relevant decision-makers, the public health service, and the scientific community; and engaging all stakeholders. The establishment of a genomic pathogen surveillance network is essential for the continuous, stable, active surveillance of the infection situation in Germany, both during pandemic phases and beyond.
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Affiliation(s)
- Simone Scheithauer
- Institut für Krankenhaushygiene und Infektiologie, Universitätsmedizin Göttingen (UMG), Georg-August Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
| | - Alexander Dilthey
- Medizinische Mikrobiologie und Krankenhaushygiene, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Anna Bludau
- Institut für Krankenhaushygiene und Infektiologie, Universitätsmedizin Göttingen (UMG), Georg-August Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - Sandra Ciesek
- Institut für Medizinische Virologie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
| | - Victor Corman
- Institut für Virologie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Tjibbe Donker
- Institut für Infektionsprävention und Krankenhaushygiene, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | | | - Richard Egelkamp
- Next Generation Sequencing, Niedersächsisches Landesgesundheitsamt, Hannover, Deutschland
| | - Hajo Grundmann
- Institut für Infektionsprävention und Krankenhaushygiene, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Georg Häcker
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Martin Kaase
- Institut für Krankenhaushygiene und Infektiologie, Universitätsmedizin Göttingen (UMG), Georg-August Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
| | - Berit Lange
- Abteilung Epidemiologie, Helmholtz-Zentrum für Infektionsforschung, Braunschweig, Deutschland
| | - Alexander Mellmann
- Institut für Hygiene, Universitätsklinikum Münster, Münster, Deutschland
| | | | - Mathias Pletz
- Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| | - Bernd Salzberger
- Infektiologie, Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | | | - Andreas Widmer
- Abteilung für Infektiologie und Spitalhygiene, Universitätsspital Basel, Basel, Schweiz
| | | | | | - Sören Gatermann
- Institut für Hygiene und Mikrobiologie, Ruhr-Universität Bochum, Bochum, Deutschland
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14
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Maier BF, Rose AH, Burdinski A, Klamser P, Neuhauser H, Wichmann O, Schaade L, Wieler LH, Brockmann D. Estimating the share of SARS-CoV-2-immunologically naïve individuals in Germany up to June 2022. Epidemiol Infect 2023; 151:e38. [PMID: 36789785 PMCID: PMC10028997 DOI: 10.1017/s0950268823000195] [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] [Indexed: 02/16/2023] Open
Abstract
After the winter of 2021/2022, the coronavirus disease 2019 (COVID-19) pandemic had reached a phase where a considerable number of people in Germany have been either infected with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, vaccinated or both, the full extent of which was difficult to estimate, however, because infection counts suffer from under-reporting, and the overlap between the vaccinated and recovered subpopulations is unknown. Yet, reliable estimates regarding population-wide susceptibility were of considerable interest: Since both previous infection and vaccination reduce the risk of severe disease, a low share of immunologically naïve individuals lowers the probability of further severe outbreaks, given that emerging variants do not escape the acquired susceptibility reduction. Here, we estimate the share of immunologically naïve individuals by age group for each of the sixteen German federal states by integrating an infectious-disease model based on weekly incidences of SARS-CoV-2 infections in the national surveillance system and vaccine uptake, as well as assumptions regarding under-ascertainment. We estimate a median share of 5.6% of individuals in the German population have neither been in contact with vaccine nor any variant up to 31 May 2022 (quartile range [2.5%-8.5%]). For the adult population at higher risk of severe disease, this figure is reduced to 3.8% [1.6%-5.9%] for ages 18-59 and 2.1% [1.0%-3.4%] for ages 60 and above. However, estimates vary between German states mostly due to heterogeneous vaccine uptake. Excluding Omicron infections from the analysis, 16.3% [14.1%-17.9%] of the population in Germany, across all ages, are estimated to be immunologically naïve, highlighting the large impact the first two Omicron waves had until the beginning of summer in 2022. The method developed here might be useful for similar estimations in other countries or future outbreaks of other infectious diseases.
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Affiliation(s)
- Benjamin F Maier
- Robert Koch Institute, Berlin, Germany
- DTU Compute, Technical University of Denmark, Kongens Lyngby, Denmark
- Copenhagen Center for Social Data Science, University of Copenhagen, Copenhagen, Denmark
| | - Annika H Rose
- Robert Koch Institute, Berlin, Germany
- Institute for Theoretical Biology and Integrated Research Institute for the Life-Sciences, Humboldt University of Berlin, Berlin, Germany
| | - Angelique Burdinski
- Robert Koch Institute, Berlin, Germany
- Institute for Theoretical Biology and Integrated Research Institute for the Life-Sciences, Humboldt University of Berlin, Berlin, Germany
| | - Pascal Klamser
- Robert Koch Institute, Berlin, Germany
- Institute for Theoretical Biology and Integrated Research Institute for the Life-Sciences, Humboldt University of Berlin, Berlin, Germany
| | | | | | | | | | - Dirk Brockmann
- Robert Koch Institute, Berlin, Germany
- Institute for Theoretical Biology and Integrated Research Institute for the Life-Sciences, Humboldt University of Berlin, Berlin, Germany
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15
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Hajek A, De Bock F, Merkel C, Eitze S, Betsch C, Bosnjak M, Wieler LH, König HH. [Attitudes Toward Influenza Vaccination in Fall/Winter 2021: Results of the COSMO Study]. Gesundheitswesen 2023; 85:36-38. [PMID: 35562062 DOI: 10.1055/a-1791-0985] [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: 01/19/2023]
Abstract
AIM OF THE STUDY There is a lack of knowledge about attitudes to influenza vaccination in Germany in 2021/2022. Based on the COSMO survey ("COVID-19 Snapshot Monitoring"), the aim of this study was to shed some light on this topic. METHODS Wave 49 (August 10 and 11, 2021) of the COSMO survey (n=967; Germany-wide non-probabilistic quota sample; 18 to 74 years). RESULTS This year, about one-third of respondents (and health care workers) plan to get a flu shot, and among the at-risk group of people aged 60 and older (up to 74 years in our sample), more than half. Correlates (such as gender: women with a lower likelihood of a planned flu shot) were identified. CONCLUSION Physicians should inform women in particular about the advantages of influenza vaccination, especially during the pandemic, and communicate data on the proven protective effect of influenza vaccination as convincingly as possible (e. g., using existing brochures).
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Affiliation(s)
- André Hajek
- Institut für Gesundheitsökonomie und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Deutschland
| | - Freia De Bock
- Bundeszentrale für gesundheitliche Aufklärung, Köln, Deutschland
| | - Christina Merkel
- Bundeszentrale für gesundheitliche Aufklärung, Köln, Deutschland
| | - Sarah Eitze
- CEREB - Center of Empirical Research in Economics and Behavioral Sciences, Media and Communication Science, Universität Erfurt, Erfurt, Deutschland
| | - Cornelia Betsch
- Universität Erfurt, Erfurt, Deutschland.,ZPID, Leibniz-Institut für Psychologie, Trier, Deutschland
| | | | | | - Hans-Helmut König
- Institut für Gesundheitsökonomie und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Deutschland
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16
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Huber C, Wolf SA, Ziebuhr W, Holmes MA, Assmann J, Lübke-Becker A, Thürmer A, Semmler T, Brombach J, Bethe A, Bischoff M, Wieler LH, Epping L, Walther B. How to survive pig farming: Mechanism of SCC mec element deletion and metabolic stress adaptation in livestock-associated MRSA. Front Microbiol 2022; 13:969961. [PMID: 36504815 PMCID: PMC9728531 DOI: 10.3389/fmicb.2022.969961] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/04/2022] [Indexed: 11/24/2022] Open
Abstract
Previous research on methicillin susceptible Staphylococcus aureus (MSSA) belonging to livestock-associated (LA-) sequence type (ST) 398, isolated from pigs and their local surroundings, indicated that differences between these MSSA and their methicillin resistant predecessors (MRSA) are often limited to the absence of the staphylococcal cassette chromosome mec (SCCmec) and few single nucleotide polymorphisms. So far, our understanding on how LA-MRSA endure the environmental conditions associated with pig-farming as well as the putative impact of this particular environment on the mobilisation of SCCmec elements is limited. Thus, we performed in-depth genomic and transcriptomic analyses using the LA-MRSA ST398 strain IMT38951 and its methicillin susceptible descendant. We identified a mosaic-structured SCCmec region including a putative replicative SCCmecVc which is absent from the MSSA chromosome through homologous recombination. Based on our data, such events occur between short repetitive sequences identified within and adjacent to two distinct alleles of the large cassette recombinase genes C (ccrC). We further evaluated the global transcriptomic response of MRSA ST398 to particular pig-farm associated conditions, i.e., contact with host proteins (porcine serum) and a high ammonia concentration. Differential expression of global regulators involved in stress response control were identified, i.e., ammonia-induced alternative sigma factor B-depending activation of genes for the alkaline shock protein 23, the heat shock response and the accessory gene regulator (agr)-controlled transcription of virulence factors. Exposure to serum transiently induced the transcription of distinct virulence factor encoding genes. Transcription of genes reported for mediating the loss of methicillin resistance, especially ccrC, was not significantly different compared to the unchallenged controls. We concluded that, from an evolutionary perspective, bacteria may save energy by incidentally dismissing a fully replicative SCCmec element in contrast to the induction of ccr genes on a population scale. Since the genomic SCCmec integration site is a hot-spot of recombination, occasional losses of elements of 16 kb size may restore capacities for the uptake of foreign genetic material. Subsequent spread of resistance, on the other hand, might depend on the autonomous replication machinery of the deleted SCCmec elements that probably enhance chances for reintegration of SCCmec into susceptible genomes by mere multiplication.
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Affiliation(s)
- Charlotte Huber
- Advanced Light and Electron Microscopy (ZBS4), Robert Koch Institute, Berlin, Germany
| | - Silver A. Wolf
- Genome Sequencing and Genomic Epidemiology (MF2), Robert Koch Institute, Berlin, Germany
| | - Wilma Ziebuhr
- Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Mark A. Holmes
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Julia Assmann
- Advanced Light and Electron Microscopy (ZBS4), Robert Koch Institute, Berlin, Germany
| | - Antina Lübke-Becker
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Andrea Thürmer
- Genome Sequencing and Genomic Epidemiology (MF2), Robert Koch Institute, Berlin, Germany
| | - Torsten Semmler
- Genome Sequencing and Genomic Epidemiology (MF2), Robert Koch Institute, Berlin, Germany
| | - Julian Brombach
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Astrid Bethe
- Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Markus Bischoff
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Lothar H. Wieler
- Methodology and Research Infrastructure, Robert Koch Institute, Berlin, Germany
| | - Lennard Epping
- Genome Sequencing and Genomic Epidemiology (MF2), Robert Koch Institute, Berlin, Germany
| | - Birgit Walther
- Advanced Light and Electron Microscopy (ZBS4), Robert Koch Institute, Berlin, Germany,*Correspondence: Birgit Walther,
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17
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Neuhauser H, Rosario AS, Butschalowsky H, Haller S, Hoebel J, Michel J, Nitsche A, Poethko-Müller C, Prütz F, Schlaud M, Steinhauer HW, Wilking H, Wieler LH, Schaade L, Liebig S, Gößwald A, Grabka MM, Zinn S, Ziese T. Nationally representative results on SARS-CoV-2 seroprevalence and testing in Germany at the end of 2020. Sci Rep 2022; 12:19492. [PMID: 36376417 PMCID: PMC9662125 DOI: 10.1038/s41598-022-23821-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Pre-vaccine SARS-CoV-2 seroprevalence data from Germany are scarce outside hotspots, and socioeconomic disparities remained largely unexplored. The nationwide representative RKI-SOEP study (15,122 participants, 18-99 years, 54% women) investigated seroprevalence and testing in a supplementary wave of the Socio-Economic-Panel conducted predominantly in October-November 2020. Self-collected oral-nasal swabs were PCR-positive in 0.4% and Euroimmun anti-SARS-CoV-2-S1-IgG ELISA from dry-capillary-blood antibody-positive in 1.3% (95% CI 0.9-1.7%, population-weighted, corrected for sensitivity = 0.811, specificity = 0.997). Seroprevalence was 1.7% (95% CI 1.2-2.3%) when additionally correcting for antibody decay. Overall infection prevalence including self-reports was 2.1%. We estimate 45% (95% CI 21-60%) undetected cases and lower detection in socioeconomically deprived districts. Prior SARS-CoV-2 testing was reported by 18% from the lower educational group vs. 25% and 26% from the medium and high educational group (p < 0.001, global test over three categories). Symptom-triggered test frequency was similar across educational groups. Routine testing was more common in low-educated adults, whereas travel-related testing and testing after contact with infected persons was more common in highly educated groups. This countrywide very low pre-vaccine seroprevalence in Germany at the end of 2020 can serve to evaluate the containment strategy. Our findings on social disparities indicate improvement potential in pandemic planning for people in socially disadvantaged circumstances.
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Affiliation(s)
- Hannelore Neuhauser
- Robert Koch Institute, Berlin, Germany.
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany.
| | | | | | | | | | | | | | | | | | | | - Hans W Steinhauer
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | | | | | | | - Stefan Liebig
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
- SOEP & Department of Political and Social Sciences, Free University, Berlin, Germany
| | | | - Markus M Grabka
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
| | - Sabine Zinn
- Socio-Economic Panel, German Institute for Economic Research, Berlin, Germany
- SOEP & Department of Social Sciences, Humboldt University, Berlin, Germany
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18
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Wieler LH. Climate change - a burning topic for public health. J Health Monit 2022; 7:3-6. [PMID: 36134034 PMCID: PMC9479114 DOI: 10.25646/10387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Lothar H. Wieler
- Corresponding author Prof Dr Dr h c mult Lothar H. Wieler, Robert Koch Institute, President, Nordufer 20, 13353 Berlin, Germany, E-mail:
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Ghazisaeedi F, Meens J, Hansche B, Maurischat S, Schwerk P, Goethe R, Wieler LH, Fulde M, Tedin K. A virulence factor as a therapeutic: the probiotic Enterococcus faecium SF68 arginine deiminase inhibits innate immune signaling pathways. Gut Microbes 2022; 14:2106105. [PMID: 35921516 PMCID: PMC9351580 DOI: 10.1080/19490976.2022.2106105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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] [Indexed: 02/04/2023] Open
Abstract
The probiotic bacterial strain Enterococcus faecium SF68 has been shown to alleviate symptoms of intestinal inflammation in human clinical trials and animal feed supplementation studies. To identify factors involved in immunomodulatory effects on host cells, E. faecium SF68 and other commensal and clinical Enterococcus isolates were screened using intestinal epithelial cell lines harboring reporter fusions for NF-κB and JNK(AP-1) activation to determine the responses of host cell innate immune signaling pathways when challenged with bacterial protein and cell components. Cell-free, whole-cell lysates of E. faecium SF68 showed a reversible, inhibitory effect on both NF-κB and JNK(AP-1) signaling pathway activation in intestinal epithelial cells and abrogated the response to bacterial and other Toll-like receptor (TLR) ligands. The inhibitory effect was species-specific, and was not observed for E. avium, E. gallinarum, or E. casseliflavus. Screening of protein fractions of E. faecium SF68 lysates yielded an active fraction containing a prominent protein identified as arginine deiminase (ADI). The E. faecium SF68 arcA gene encoding arginine deiminase was cloned and introduced into E. avium where it conferred the same NF-κB inhibitory effects on intestinal epithelial cells as seen for E. faecium SF68. Our results indicate that the arginine deiminase of E. faecium SF68 is responsible for inhibition of host cell NF-κB and JNK(AP-1) pathway activation, and is likely to be responsible for the anti-inflammatory and immunomodulatory effects observed in prior clinical human and animal trials. The implications for the use of this probiotic strain for preventive and therapeutic purposes are discussed.
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Affiliation(s)
- Fereshteh Ghazisaeedi
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Centre for Infection Medicine, Free University of Berlin, Berlin, Germany
| | - Jochen Meens
- Institute for Microbiology, University of Veterinary Medicine, Hannover, Germany
| | - Bianca Hansche
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Centre for Infection Medicine, Free University of Berlin, Berlin, Germany,Sanofi-AventisGmbH, Berlin, Germany
| | - Sven Maurischat
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Centre for Infection Medicine, Free University of Berlin, Berlin, Germany,German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Peter Schwerk
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Centre for Infection Medicine, Free University of Berlin, Berlin, Germany
| | - Ralph Goethe
- Institute for Microbiology, University of Veterinary Medicine, Hannover, Germany
| | - Lothar H. Wieler
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Centre for Infection Medicine, Free University of Berlin, Berlin, Germany,Robert Koch Institute, Berlin, Germany
| | - Marcus Fulde
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Centre for Infection Medicine, Free University of Berlin, Berlin, Germany
| | - Karsten Tedin
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Centre for Infection Medicine, Free University of Berlin, Berlin, Germany,CONTACT Karsten Tedin Institute of Microbiology and Epizootics, Centre for Infection Medicine, Free University of Berlin, Robert-von-Ostertag-Strasse7, Berlin14163Germany
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20
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Schienkiewitz A, Jordan S, Hornbacher A, Perlitz H, Zeisler ML, Sandoni A, Kubisch U, Wess B, Kuttig T, Schaffrath-Rosario A, Damerow S, Rattay P, Varnaccia G, Loer AKM, Wormsbächer J, Cohrdes C, Wetzstein M, Albrecht S, Hey I, Michel J, Schrick L, Gößwald A, Allen J, Schlaud M, Busch MA, Butschalowsky H, Wernitz J, Otte im Kampe E, Buchholz U, Haas W, Schaade L, Wieler LH, Ziese T, Lampert T, Loss J. SARS-CoV-2 Transmissibility Within Day Care Centers-Study Protocol of a Prospective Analysis of Outbreaks in Germany. Front Public Health 2021; 9:773850. [PMID: 34976930 PMCID: PMC8717701 DOI: 10.3389/fpubh.2021.773850] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/05/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction: Until today, the role of children in the transmission dynamics of SARS-CoV-2 and the development of the COVID-19 pandemic seems to be dynamic and is not finally resolved. The primary aim of this study is to investigate the transmission dynamics of SARS-CoV-2 in child day care centers and connected households as well as transmission-related indicators and clinical symptoms among children and adults. Methods and Analysis: COALA ("Corona outbreak-related examinations in day care centers") is a day care center- and household-based study with a case-ascertained study design. Based on day care centers with at least one reported case of SARS-CoV-2, we include one- to six-year-old children and staff of the affected group in the day care center as well as their respective households. We visit each child's and adult's household. During the home visit we take from each household member a combined mouth and nose swab as well as a saliva sample for analysis of SARS-CoV-2-RNA by real-time reverse transcription polymerase chain reaction (real-time RT-PCR) and a capillary blood sample for a retrospective assessment of an earlier SARS-CoV-2 infection. Furthermore, information on health status, socio-demographics and COVID-19 protective measures are collected via a short telephone interview in the subsequent days. In the following 12 days, household members (or parents for their children) self-collect the same respiratory samples as described above every 3 days and a stool sample for children once. COVID-19 symptoms are documented daily in a symptom diary. Approximately 35 days after testing the index case, every participant who tested positive for SARS-CoV-2 during the study is re-visited at home for another capillary blood sample and a standardized interview. The analysis includes secondary attack rates, by age of primary case, both in the day care center and in households, as well as viral shedding dynamics, including the beginning of shedding relative to symptom onset and viral clearance. Discussion: The results contribute to a better understanding of the epidemiological and virological transmission-related indicators of SARS-CoV-2 among young children, as compared to adults and the interplay between day care and households.
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Affiliation(s)
- Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Susanne Jordan
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anselm Hornbacher
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Hanna Perlitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Marie-Luise Zeisler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anna Sandoni
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ulrike Kubisch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Barbara Wess
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Tim Kuttig
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Stefan Damerow
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Petra Rattay
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Gianni Varnaccia
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anne-Kathrin M. Loer
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jan Wormsbächer
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Carolin Cohrdes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Matthias Wetzstein
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Stefan Albrecht
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Isabell Hey
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Janine Michel
- Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Livia Schrick
- Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Antje Gößwald
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jennifer Allen
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Martin Schlaud
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Markus A. Busch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Hans Butschalowsky
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jörg Wernitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Eveline Otte im Kampe
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Udo Buchholz
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Walter Haas
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Lars Schaade
- Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Lothar H. Wieler
- Leadership Robert Koch Institute, Robert Koch Institute, Berlin, Germany
- Department of Methodology and Research Infrastructure, Robert Koch Institute, Berlin, Germany
| | - Thomas Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Thomas Lampert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julika Loss
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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21
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Thomas P, Abdel-Glil MY, Subbaiyan A, Busch A, Eichhorn I, Wieler LH, Neubauer H, Pletz M, Seyboldt C. First Comparative Analysis of Clostridium septicum Genomes Provides Insights Into the Taxonomy, Species Genetic Diversity, and Virulence Related to Gas Gangrene. Front Microbiol 2021; 12:771945. [PMID: 34956133 PMCID: PMC8696124 DOI: 10.3389/fmicb.2021.771945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Clostridium septicum is a Gram-positive, toxin-producing, and spore-forming bacterium that is recognized, together with C. perfringens, as the most important etiologic agent of progressive gas gangrene. Clostridium septicum infections are almost always fatal in humans and animals. Despite its clinical and agricultural relevance, there is currently limited knowledge of the diversity and genome structure of C. septicum. This study presents the complete genome sequence of C. septicum DSM 7534T type strain as well as the first comparative analysis of five C. septicum genomes. The taxonomy of C. septicum, as revealed by 16S rRNA analysis as well as by genomic wide indices such as protein-based phylogeny, average nucleotide identity, and digital DNA–DNA hybridization indicates a stable clade. The composition and presence of prophages, CRISPR elements and accessory genetic material was variable in the investigated genomes. This is in contrast to the limited genetic variability described for the phylogenetically and phenotypically related species Clostridium chauvoei. The restriction-modification (RM) systems between two C. septicum genomes were heterogeneous for the RM types they encoded. C. septicum has an open pangenome with 2,311 genes representing the core genes and 1,429 accessory genes. The core genome SNP divergence between genome pairs varied up to 4,886 pairwise SNPs. A vast arsenal of potential virulence genes was detected in the genomes studied. Sequence analysis of these genes revealed that sialidase, hemolysin, and collagenase genes are conserved compared to the α-toxin and hyaluronidase genes. In addition, a conserved gene found in all C. septicum genomes was predicted to encode a leucocidin homolog (beta-channel forming cytolysin) similar (71.10% protein identity) to Clostridium chauvoei toxin A (CctA), which is a potent toxin. In conclusion, our results provide first, valuable insights into strain relatedness and genomic plasticity of C. septicum and contribute to our understanding of the virulence mechanisms of this important human and animal pathogen.
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Affiliation(s)
- Prasad Thomas
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
- Division of Bacteriology and Mycology, ICAR-Indian Veterinary Research Institute, Izatnagar, India
| | - Mostafa Y. Abdel-Glil
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
- Institute for Infectious Diseases and Infection Control, Jena University Hospital – Friedrich Schiller University, Jena, Germany
- Department of Pathology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
- *Correspondence: Mostafa Y. Abdel-Glil,
| | - Anbazhagan Subbaiyan
- Division of Bacteriology and Mycology, ICAR-Indian Veterinary Research Institute, Izatnagar, India
| | - Anne Busch
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Jena, Jena, Germany
| | - Inga Eichhorn
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Lothar H. Wieler
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
- Robert Koch Institute, Berlin, Germany
| | - Heinrich Neubauer
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Mathias Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital – Friedrich Schiller University, Jena, Germany
| | - Christian Seyboldt
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
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22
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Abdel-Glil MY, Thomas P, Linde J, Jolley KA, Harmsen D, Wieler LH, Neubauer H, Seyboldt C. Establishment of a Publicly Available Core Genome Multilocus Sequence Typing Scheme for Clostridium perfringens. Microbiol Spectr 2021; 9:e0053321. [PMID: 34704797 PMCID: PMC8549748 DOI: 10.1128/spectrum.00533-21] [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: 07/19/2021] [Accepted: 09/16/2021] [Indexed: 12/31/2022] Open
Abstract
Clostridium perfringens is a spore-forming anaerobic pathogen responsible for a variety of histotoxic and intestinal infections in humans and animals. High-resolution genotyping aiming to identify bacteria at strain level has become increasingly important in modern microbiology to understand pathogen transmission pathways and to tackle infection sources. This study aimed at establishing a publicly available genome-wide multilocus sequence-typing (MLST) scheme for C. perfringens. A total of 1,431 highly conserved core genes (1.34 megabases; 50% of the reference genome genes) were indexed for a core genome-based MLST (cgMLST) scheme for C. perfringens. The scheme was applied to 282 ecologically and geographically diverse genomes, showing that the genotyping results of cgMLST were highly congruent with the core genome-based single-nucleotide-polymorphism typing in terms of resolution and tree topology. In addition, the cgMLST provided a greater discrimination than classical MLST methods for C. perfringens. The usability of the scheme for outbreak analysis was confirmed by reinvestigating published outbreaks of C. perfringens-associated infections in the United States and the United Kingdom. In summary, a publicly available scheme and an allele nomenclature database for genomic typing of C. perfringens have been established and can be used for broad-based and standardized epidemiological studies. IMPORTANCE Global epidemiological surveillance of bacterial pathogens is enhanced by the availability of standard tools and sharing of typing data. The use of whole-genome sequencing has opened the possibility for high-resolution characterization of bacterial strains down to the clonal and subclonal levels. Core genome multilocus sequence typing is a robust system that uses highly conserved core genes for deep genotyping. The method has been successfully and widely used to describe the epidemiology of various bacterial species. Nevertheless, a cgMLST typing scheme for Clostridium perfringens is currently not publicly available. In this study, we (i) developed a cgMLST typing scheme for C. perfringens, (ii) evaluated the performance of the scheme on different sets of C. perfringens genomes from different hosts and geographic regions as well as from different outbreak situations, and, finally, (iii) made this scheme publicly available supported by an allele nomenclature database for global and standard genomic typing.
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Affiliation(s)
- Mostafa Y. Abdel-Glil
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
- Department of Pathology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Sharkia Province, Egypt
| | - Prasad Thomas
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Jörg Linde
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Keith A. Jolley
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Dag Harmsen
- Department of Periodontology and Operative Dentistry, University Hospital Muenster, Muenster, Germany
| | | | - Heinrich Neubauer
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Christian Seyboldt
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
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23
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Thomas P, Abdel-Glil MY, Eichhorn I, Semmler T, Werckenthin C, Baumbach C, Murmann W, Bodenthin-Drauschke A, Zimmermann P, Schotte U, Galante D, Slavic D, Wagner M, Wieler LH, Neubauer H, Seyboldt C. Genome Sequence Analysis of Clostridium chauvoei Strains of European Origin and Evaluation of Typing Options for Outbreak Investigations. Front Microbiol 2021; 12:732106. [PMID: 34659160 PMCID: PMC8513740 DOI: 10.3389/fmicb.2021.732106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/31/2021] [Indexed: 01/08/2023] Open
Abstract
Black quarter caused by Clostridium (C.) chauvoei is an important bacterial disease that affects cattle and sheep with high mortality. A comparative genomics analysis of 64 C. chauvoei strains, most of European origin and a few of non-European and unknown origin, was performed. The pangenome analysis showed limited new gene acquisition for the species. The accessory genome involved prophages and genomic islands, with variations in gene composition observed in a few strains. This limited accessory genome may indicate that the species replicates only in the host or that an active CRISPR/Cas system provides immunity to foreign genetic elements. All strains contained a CRISPR type I-B system and it was confirmed that the unique spacer sequences therein can be used to differentiate strains. Homologous recombination events, which may have contributed to the evolution of this pathogen, were less frequent compared to other related species from the genus. Pangenome single nucleotide polymorphism (SNP) based phylogeny and clustering indicate diverse clusters related to geographical origin. Interestingly the identified SNPs were mostly non-synonymous. The study demonstrates the possibility of the existence of polymorphic populations in one host, based on strain variability observed for strains from the same animal and strains from different animals of one outbreak. The study also demonstrates that new outbreak strains are mostly related to earlier outbreak strains from the same farm/region. This indicates the last common ancestor strain from one farm can be crucial to understand the genetic changes and epidemiology occurring at farm level. Known virulence factors for the species were highly conserved among the strains. Genetic elements involved in Nicotinamide adenine dinucleotide (NAD) precursor synthesis (via nadA, nadB, and nadC metabolic pathway) which are known as potential anti-virulence loci are completely absent in C. chauvoei compared to the partial inactivation in C. septicum. A novel core-genome MLST based typing method was compared to sequence typing based on CRISPR spacers to evaluate the usefulness of the methods for outbreak investigations.
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Affiliation(s)
- Prasad Thomas
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Mostafa Y Abdel-Glil
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Inga Eichhorn
- Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | | | - Christiane Werckenthin
- Lower Saxony State Office for Consumer Protection and Food Safety (LAVES), Food and Veterinary Institute Oldenburg, Oldenburg, Germany
| | - Christina Baumbach
- State Office for Agriculture, Food Safety and Fisheries Mecklenburg-Western Pomerania, Rostock, Germany
| | - Wybke Murmann
- Chemical and Veterinary Investigations Office, Freiburg, Germany
| | | | - Pia Zimmermann
- Bavarian Health and Food Safety Authority (LGL), Laboratory of Food Microbiology, Oberschleißheim, Germany
| | - Ulrich Schotte
- Department A-Veterinary Medicine, Central Institute of the Bundeswehr Medical Service Kiel, Kronshagen, Germany
| | - Domenico Galante
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Foggia, Italy
| | - Durda Slavic
- Animal Health Laboratory, Laboratory Services Division, University of Guelph, Guelph, ON, Canada
| | - Martin Wagner
- Unit for Food Microbiology, Institute for Food Safety, Technology and Veterinary Public Health, University for Veterinary Medicine, Vienna, Austria
| | | | - Heinrich Neubauer
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
| | - Christian Seyboldt
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Jena, Germany
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24
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Ravens-Sieberer U, Kaman A, Erhart M, Otto C, Devine J, Löffler C, Hurrelmann K, Bullinger M, Barkmann C, Siegel NA, Simon AM, Wieler LH, Schlack R, Hölling H. Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study. Eur Child Adolesc Psychiatry 2021; 32:575-588. [PMID: 34636964 PMCID: PMC8506100 DOI: 10.1007/s00787-021-01889-1] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [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: 05/10/2021] [Accepted: 09/29/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic has disrupted the lives of children and adolescents worldwide. The German COPSY study is among the first population-based longitudinal studies to examine the mental health impact of the pandemic. The objective of the study was to assess changes in health-related quality of life (HRQoL) and mental health in children and adolescents and to identify the associated risk and resource factors during the pandemic. METHODS A nationwide longitudinal survey was conducted with two waves during the pandemic (May/June 2020 and December 2020/January 2021). In total, n = 1923 children and adolescents aged 7 to 17 years and their parents participated (retention rate from wave 1 to wave 2: 85%). The self-report and parent-proxy surveys assessed HRQoL (KIDSCREEN-10), mental health problems (SDQ with the subscales emotional problems, conduct problems, hyperactivity, and peer problems), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2) and psychosomatic complaints (HBSC-SCL). Mixed model panel regression analyses were conducted to examine longitudinal changes in mental health and to identify risk and resource factors. RESULTS The HRQoL of children and adolescents decreased during the pandemic, and emotional problems, peer-related mental health problems, anxiety, depressive and psychosomatic symptoms increased over time, however the change in global mental health problems from wave 1 to wave 2 was not significant, and some changes were negligible. Socially disadvantaged children and children of mentally burdened parents were at particular risk of impaired mental health, while female gender and older age were associated with fewer mental health problems. A positive family climate and social support supported the mental health of children and adolescents during the pandemic. DISCUSSION Health promotion, prevention and intervention strategies could support children and adolescents in coping with the pandemic and protect and maintain their mental health.
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Affiliation(s)
- Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ,Alice Salomon University of Applied Sciences, Berlin, Germany ,Apollon University of Applied Sciences, Bremen, Germany
| | - Christiane Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ,Argora Clinic, Psychosomatic Clinic and Outpatient Center, Berlin, Germany
| | - Constanze Löffler
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Monika Bullinger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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25
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Aavitsland P, Aguilera X, Al-Abri SS, Amani V, Aramburu CC, Attia TA, Blumberg LH, Chittaganpitch M, Le Duc JW, Li D, Mokhtariazad T, Moussif M, Ojo OE, Okwo-Bele JM, Saito T, Sall AA, Salter MWAP, Sohn M, Wieler LH. Functioning of the International Health Regulations during the COVID-19 pandemic. Lancet 2021; 398:1283-1287. [PMID: 34570995 PMCID: PMC8497022 DOI: 10.1016/s0140-6736(21)01911-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/13/2021] [Indexed: 12/02/2022]
Affiliation(s)
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Universidad del Desarrollo, Santiago, Chile
| | - Seif Salem Al-Abri
- Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - Vincent Amani
- Center for Disaster and Humanitarian Assistance Medicine, Nairobi, Kenya
| | - Carmen C Aramburu
- Delegation of the Spanish Government in Catalonia, Ministry of Health, Barcelona, Spain
| | | | - Lucille H Blumberg
- National Institute for Communicable Diseases of the National Health Laboratory Service and the Faculty of Veterinary Medicine, University of Pretoria, Pretoria, South Africa
| | | | | | - Dexin Li
- National Institute for Viral Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Talat Mokhtariazad
- National Influenza Centre, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamed Moussif
- Casablanca International Airport, Ministry of Health, Casablanca, Morocco
| | | | | | - Tomoya Saito
- Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo, Japan
| | | | | | - Myongsei Sohn
- College of Medicine, Yonsei University, Seoul, South Korea
| | - Lothar H Wieler
- Office of President, Robert Koch Institute, Berlin 13353, Germany.
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26
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Betsch C, Korn L, Burgard T, Gaissmaier W, Felgendreff L, Eitze S, Sprengholz P, Böhm R, Stollorz V, Ramharter M, Promies N, De Bock F, Schmid P, Renner B, Wieler LH, Bosnjak M. The four weeks before lockdown during the COVID-19 pandemic in Germany: a weekly serial cross-sectional survey on risk perceptions, knowledge, public trust and behaviour, 3 to 25 March 2020. Euro Surveill 2021; 26:2001900. [PMID: 34676821 PMCID: PMC8532505 DOI: 10.2807/1560-7917.es.2021.26.42.2001900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/05/2020] [Accepted: 05/17/2021] [Indexed: 12/23/2022] Open
Abstract
BackgroundDuring the COVID-19 pandemic, public perceptions and behaviours have had to adapt rapidly to new risk scenarios and radical behavioural restrictions.AimTo identify major drivers of acceptance of protective behaviours during the 4-week transition from virtually no COVID-19 cases to the nationwide lockdown in Germany (3-25 March 2020).MethodsA serial cross-sectional online survey was administered weekly to ca 1,000 unique individuals for four data collection rounds in March 2020 using non-probability quota samples, representative of the German adult population between 18 and 74 years in terms of age × sex and federal state (n = 3,910). Acceptance of restrictions was regressed on sociodemographic variables, time and psychological variables, e.g. trust, risk perceptions, self-efficacy. Extraction of homogenous clusters was based on knowledge and behaviour.ResultsAcceptance of restrictive policies increased with participants' age and employment in the healthcare sector; cognitive and particularly affective risk perceptions were further significant predictors. Acceptance increased over time, as trust in institutions became more relevant and trust in media became less relevant. The cluster analysis further indicated that having a higher education increased the gap between knowledge and behaviour. Trust in institutions was related to conversion of knowledge into action.ConclusionIdentifying relevant principles that increase acceptance will remain crucial to the development of strategies that help adjust behaviour to control the pandemic, possibly for years to come. Based on our findings, we provide operational recommendations for health authorities regarding data collection, health communication and outreach.
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Affiliation(s)
| | - Lars Korn
- University of Erfurt, Erfurt, Germany
- Department of Implementation Science, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Tanja Burgard
- Leibniz Institute for Psychology Information and Documentation, Trier, Germany
| | | | | | | | | | - Robert Böhm
- University of Copenhagen, Copenhagen, Denmark
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | | | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I. Dep. of Medicine University Medical Center, Hamburg-Eppendorf, Germany
| | | | | | | | | | | | - Michael Bosnjak
- Robert Koch Institute, Berlin, Germany
- University of Trier, Trier, Germany
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27
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Grill E, Eitze S, De Bock F, Dragano N, Huebl L, Schmich P, Wieler LH, Betsch C. Sociodemographic characteristics determine download and use of a Corona contact tracing app in Germany-Results of the COSMO surveys. PLoS One 2021; 16:e0256660. [PMID: 34473733 PMCID: PMC8412249 DOI: 10.1371/journal.pone.0256660] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 03/26/2021] [Accepted: 08/11/2021] [Indexed: 11/18/2022] Open
Abstract
During the SARS-CoV-2 pandemic mobile health applications indicating risks emerging from close contacts to infected persons have a large potential to interrupt transmission chains by automating contact tracing. Since its dispatch in Germany in June 2020 the Corona Warn App has been downloaded on 25.7 Mio smartphones by February 2021. To understand barriers to download and user fidelity in different sociodemographic groups we analysed data from five consecutive cross-sectional waves of the COVID-19 Snapshot Monitoring survey from June to August 2020. Questions on the Corona Warn App included information on download, use, functionality, usability, and consequences of the app. Of the 4,960 participants (mean age 45.9 years, standard deviation 16.0, 50.4% female), 36.5% had downloaded the Corona Warn App. Adjusted analysis found that those who had downloaded the app were less likely to be female (Adjusted Odds Ratio for men 1.16 95% Confidence Interval [1.02;1.33]), less likely to be younger (Adjusted Odds Ratio for age 18 to 39 0.47 [0.32;0.59] Adjusted Odds Ratio for age 40 to 64 0.57 [0.46;0.69]), less likely to have a lower household income (AOR 0.55 [0.43;0.69]), and more likely to live in one of the Western federal states including Berlin (AOR 2.31 [1.90;2.82]). Willingness to disclose a positive test result and trust in data protection compliance of the Corona Warn App was significantly higher in older adults. Willingness to disclose also increased with higher educational degrees and income. This study supports the hypothesis of a digital divide that separates users and non-users of the Corona Warn App along a well-known health gap of education, income, and region.
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Affiliation(s)
- Eva Grill
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians University München, München, Germany
| | - Sarah Eitze
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Freia De Bock
- Federal Centre for Health Education (Bundeszentrale für gesundheitliche Aufklärung (BZgA)), Cologne, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Lena Huebl
- University Medical Centre Hamburg-Eppendorf, I. Department of Medicine, Division Tropical Medicine, Hamburg, Germany
| | | | | | - Cornelia Betsch
- Media and Communication Science, University of Erfurt, Erfurt, Germany
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Rattay P, Michalski N, Domanska O, Kaltwasser A, De Bock F, Wieler LH, Jordan S. Bildungsunterschiede in Risikowahrnehmung, Wissen und Schutzverhalten bezüglich COVID-19 bei Frauen und Männern in Deutschland. Ergebnisse der COSMO-Studie (COVID-19 Snapshot Monitoring). Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | | | - F De Bock
- Bundeszentrale für gesundheitliche Aufklärung (BZgA)
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29
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Morgan OW, Aguilera X, Ammon A, Amuasi J, Fall IS, Frieden T, Heymann D, Ihekweazu C, Jeong EK, Leung GM, Mahon B, Nkengasong J, Qamar FN, Schuchat A, Wieler LH, Dowell SF. Disease surveillance for the COVID-19 era: time for bold changes. Lancet 2021; 397:2317-2319. [PMID: 34000258 PMCID: PMC8121493 DOI: 10.1016/s0140-6736(21)01096-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Oliver W Morgan
- Health Emergency Information and Risk Assessment, WHO, Geneva 1211, Switzerland.
| | - Ximena Aguilera
- Center for Epidemiology and Health Policy, Universidad del Desarrollo Chile, Santiago, Chile
| | - Andrea Ammon
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - John Amuasi
- Global Health and Infectious Diseases Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - David Heymann
- Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Eun-Kyeong Jeong
- Korea Disease Control and Prevention Agency, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Gabriel M Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | | | - John Nkengasong
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | - Anne Schuchat
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
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30
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Rattay P, Michalski N, Domanska OM, Kaltwasser A, De Bock F, Wieler LH, Jordan S. Differences in risk perception, knowledge and protective behaviour regarding COVID-19 by education level among women and men in Germany. Results from the COVID-19 Snapshot Monitoring (COSMO) study. PLoS One 2021; 16:e0251694. [PMID: 33979413 PMCID: PMC8116045 DOI: 10.1371/journal.pone.0251694] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [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: 01/30/2021] [Accepted: 05/03/2021] [Indexed: 12/23/2022] Open
Abstract
The main strategy for combatting SARS-CoV-2 infections in 2020 consisted of behavioural regulations including contact reduction, maintaining distance, hand hygiene, and mask wearing. COVID-19-related risk perception and knowledge may influence protective behaviour, and education could be an important determinant. The current study investigated differences by education level in risk perception, knowledge and protective behaviour regarding COVID-19 in Germany, exploring the development of the pandemic over time. The COVID-19 Snapshot Monitoring study is a repeated cross-sectional online survey conducted during the pandemic in Germany from 3 March 2020 (waves 1-28: 27,957 participants aged 18-74). Differences in risk perception, knowledge and protective behaviour according to education level (high versus low) were analysed using linear and logistic regression. Time trends were accounted for by interaction terms for education level and calendar week. Regarding protective behaviour, interaction terms were tested for all risk perception and knowledge variables with education level. The strongest associations with education level were evident for perceived and factual knowledge regarding COVID-19. Moreover, associations were found between low education level and higher perceived severity, and between low education level and lower perceived probability. Highly educated men were more worried about COVID-19 than those with low levels of education. No educational differences were observed for perceived susceptibility or fear. Higher compliance with hand washing was found in highly educated women, and higher compliance with maintaining distance was found in highly educated men. Regarding maintaining distance, the impact of perceived severity differed between education groups. In men, significant moderation effects of education level on the association between factual knowledge and all three protective behaviours were found. During the pandemic, risk perception and protective behaviour varied greatly over time. Overall, differences by education level were relatively small. For risk communication, reaching all population groups irrespective of education level is critical.
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Affiliation(s)
| | | | | | | | - Freia De Bock
- Federal Centre for Health Education, Cologne, Germany
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31
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Hoebel J, Michalski N, Wachtler B, Diercke M, Neuhauser H, H. Wieler L, Hövener C. Socioeconomic Differences in the Risk of Infection During the Second Sars-Cov-2 Wave in Germany. Dtsch Arztebl Int 2021; 118:269-270. [PMID: 34114548 PMCID: PMC8287075 DOI: 10.3238/arztebl.m2021.0188] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/16/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Jens Hoebel
- Abteilung für Epidemiologie und Gesundheitsmonitoring, RKI, Berlin
| | - Niels Michalski
- Abteilung für Epidemiologie und Gesundheitsmonitoring, RKI, Berlin
| | | | | | | | - Lothar H. Wieler
- Abteilung Methodenentwicklung und Forschungsinfrastruktur, Institutsleitung, RKI, Berlin
| | - Claudia Hövener
- Abteilung für Epidemiologie und Gesundheitsmonitoring, RKI, Berlin
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32
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Wieland T, Assmann J, Bethe A, Fidelak C, Gmoser H, Janßen T, Kotthaus K, Lübke-Becker A, Wieler LH, Urban GA. A Real-Time Thermal Sensor System for Quantifying the Inhibitory Effect of Antimicrobial Peptides on Bacterial Adhesion and Biofilm Formation. Sensors (Basel) 2021; 21:s21082771. [PMID: 33919962 PMCID: PMC8070953 DOI: 10.3390/s21082771] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 01/15/2023]
Abstract
The increasing rate of antimicrobial resistance (AMR) in pathogenic bacteria is a global threat to human and veterinary medicine. Beyond antibiotics, antimicrobial peptides (AMPs) might be an alternative to inhibit the growth of bacteria, including AMR pathogens, on different surfaces. Biofilm formation, which starts out as bacterial adhesion, poses additional challenges for antibiotics targeting bacterial cells. The objective of this study was to establish a real-time method for the monitoring of the inhibition of (a) bacterial adhesion to a defined substrate and (b) biofilm formation by AMPs using an innovative thermal sensor. We provide evidence that the thermal sensor enables continuous monitoring of the effect of two potent AMPs, protamine and OH-CATH-30, on surface colonization of bovine mastitis-associated Escherichia (E.) coli and Staphylococcus (S.) aureus. The bacteria were grown under static conditions on the surface of the sensor membrane, on which temperature oscillations generated by a heater structure were detected by an amorphous germanium thermistor. Bacterial adhesion, which was confirmed by white light interferometry, caused a detectable amplitude change and phase shift. To our knowledge, the thermal measurement system has never been used to assess the effect of AMPs on bacterial adhesion in real time before. The system could be used to screen and evaluate bacterial adhesion inhibition of both known and novel AMPs.
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Affiliation(s)
- Tobias Wieland
- Department of Microsystems Engineering (IMTEK)—Laboratory of Sensors, University of Freiburg, 79110 Freiburg, Germany; (H.G.); (K.K.); (G.A.U.)
- Correspondence: ; Tel.: +49-761-203-7268
| | - Julia Assmann
- Institute of Microbiology and Epizootics, Freie Universität Berlin, 14163 Berlin, Germany; (J.A.); (A.B.); (A.L.-B.); (L.H.W.)
- Robert Koch Institute, ZBS4 Advanced Light and Electron Microscopy, 13353 Berlin, Germany
| | - Astrid Bethe
- Institute of Microbiology and Epizootics, Freie Universität Berlin, 14163 Berlin, Germany; (J.A.); (A.B.); (A.L.-B.); (L.H.W.)
| | | | - Helena Gmoser
- Department of Microsystems Engineering (IMTEK)—Laboratory of Sensors, University of Freiburg, 79110 Freiburg, Germany; (H.G.); (K.K.); (G.A.U.)
| | | | - Krishan Kotthaus
- Department of Microsystems Engineering (IMTEK)—Laboratory of Sensors, University of Freiburg, 79110 Freiburg, Germany; (H.G.); (K.K.); (G.A.U.)
| | - Antina Lübke-Becker
- Institute of Microbiology and Epizootics, Freie Universität Berlin, 14163 Berlin, Germany; (J.A.); (A.B.); (A.L.-B.); (L.H.W.)
| | - Lothar H. Wieler
- Institute of Microbiology and Epizootics, Freie Universität Berlin, 14163 Berlin, Germany; (J.A.); (A.B.); (A.L.-B.); (L.H.W.)
- Robert Koch Institute, 13353 Berlin, Germany
| | - Gerald A. Urban
- Department of Microsystems Engineering (IMTEK)—Laboratory of Sensors, University of Freiburg, 79110 Freiburg, Germany; (H.G.); (K.K.); (G.A.U.)
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Abstract
The global COVID-19 pandemic poses challenges to the economy, politics and public health systems of developed and developing countries alike. However, the latter are less well placed to cope with adverse effects. In particular, important advances towards sustainable development might be reversed. Tackling the pandemic and its effects therefore requires global cooperation as well as solidarity in the form of development assistance. Yet, support for development assistance among donor publics might be dampened by individual health-related and economic worries as well as decreasing trust in government during the pandemic. Against this backdrop, we investigate the possible effect of pandemic-induced worries on public support for development assistance as well as the moderating role of moral considerations and trust in government. Drawing on literature on aid attitudes, and using survey data for Germany provided by the COVID-19 Snapshot Monitoring (COSMO) project from April 2020 (N = 1,006), our analyses show that neither health-related nor economic worries are associated with less support for providing development assistance during the first wave of the pandemic. However, we observe a marginal interaction between health-related worries and trust in government in predicting support for development assistance. For those with high levels of trust in government the effect of worry regarding the loss of friends or relatives on support for development assistance is positive, whereas it is close to zero for those with low levels of trust. We conclude that at the peak of the first wave of the pandemic there was little need for concern by policy-makers endorsing development assistance as neither form of worry correlated negatively with public support for development assistance and trust was high. However, when worries recur and trust in government simultaneously decreases, public support for global solidarity may wane.
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Affiliation(s)
- Sebastian H Schneider
- German Institute for Development Evaluation (DEval), Fritz-Schäffer-Str. 26, 53113 Bonn, Germany
| | - Jens Eger
- German Institute for Development Evaluation (DEval), Fritz-Schäffer-Str. 26, 53113 Bonn, Germany
| | - Martin Bruder
- German Institute for Development Evaluation (DEval), Fritz-Schäffer-Str. 26, 53113 Bonn, Germany
| | - Jörg Faust
- German Institute for Development Evaluation (DEval), Fritz-Schäffer-Str. 26, 53113 Bonn, Germany
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Abdel-Glil MY, Thomas P, Linde J, Busch A, Wieler LH, Neubauer H, Seyboldt C. Comparative in silico genome analysis of Clostridium perfringens unravels stable phylogroups with different genome characteristics and pathogenic potential. Sci Rep 2021; 11:6756. [PMID: 33762628 PMCID: PMC7991664 DOI: 10.1038/s41598-021-86148-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 06/08/2020] [Accepted: 03/11/2021] [Indexed: 12/16/2022] Open
Abstract
Clostridium perfringens causes a plethora of devastating infections, with toxin production being the underlying mechanism of pathogenicity in various hosts. Genomic analyses of 206 public-available C. perfringens strains´ sequence data identified a substantial degree of genomic variability in respect to episome content, chromosome size and mobile elements. However, the position and order of the local collinear blocks on the chromosome showed a considerable degree of preservation. The strains were divided into five stable phylogroups (I–V). Phylogroup I contained human food poisoning strains with chromosomal enterotoxin (cpe) and a Darmbrand strain characterized by a high frequency of mobile elements, a relatively small genome size and a marked loss of chromosomal genes, including loss of genes encoding virulence traits. These features might correspond to the adaptation of these strains to a particular habitat, causing human foodborne illnesses. This contrasts strains that belong to phylogroup II where the genome size points to the acquisition of genetic material. Most strains of phylogroup II have been isolated from enteric lesions in horses and dogs. Phylogroups III, IV and V are heterogeneous groups containing a variety of different strains, with phylogroup III being the most abundant (65.5%). In conclusion, C. perfringens displays five stable phylogroups reflecting different disease involvements, prompting further studies on the evolution of this highly important pathogen.
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Affiliation(s)
- Mostafa Y Abdel-Glil
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Naumburger Str. 96A, 07743, Jena, Germany. .,Department of Pathology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Sharkia Province, Egypt.
| | - Prasad Thomas
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Naumburger Str. 96A, 07743, Jena, Germany.,Division of Bacteriology and Mycology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, 243122, India
| | - Jörg Linde
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Naumburger Str. 96A, 07743, Jena, Germany
| | - Anne Busch
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Naumburger Str. 96A, 07743, Jena, Germany.,Department of Anaesthesiology and Intensive Care Medicine, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Lothar H Wieler
- Robert Koch-Institut, Nordufer 20, 13353, Berlin, Germany.,Institute of Microbiology and Epizootics, Department of Veterinary Medicine, Freie Universität, Robert-von-Ostertag-Str. 7-13, Building 35, 14163, Berlin, Germany
| | - Heinrich Neubauer
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Naumburger Str. 96A, 07743, Jena, Germany
| | - Christian Seyboldt
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Naumburger Str. 96A, 07743, Jena, Germany.
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Shuaib YA, Khalil EA, Wieler LH, Schaible UE, Bakheit MA, Mohamed-Noor SE, Abdalla MA, Kerubo G, Andres S, Hillemann D, Richter E, Kranzer K, Niemann S, Merker M. Mycobacterium tuberculosis Complex Lineage 3 as Causative Agent of Pulmonary Tuberculosis, Eastern Sudan 1. Emerg Infect Dis 2021; 26:427-436. [PMID: 32091355 PMCID: PMC7045825 DOI: 10.3201/eid2603.191145] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Pathogen-based factors associated with tuberculosis (TB) in eastern Sudan are not well defined. We investigated genetic diversity, drug resistance, and possible transmission clusters of Mycobacterium tuberculosis complex (MTBC) strains by using a genomic epidemiology approach. We collected 383 sputum specimens at 3 hospitals in 2014 and 2016 from patients with symptoms suggestive of TB; of these, 171 grew MTBC strains. Whole-genome sequencing could be performed on 166 MTBC strains; phylogenetic classification revealed that most (73.4%; n = 122) belonged to lineage 3 (L3). Genome-based cluster analysis showed that 76 strains (45.9%) were grouped into 29 molecular clusters, comprising 2–8 strains/patients. Of the strains investigated, 9.0% (15/166) were multidrug resistant (MDR); 10 MDR MTBC strains were linked to 1 large MDR transmission network. Our findings indicate that L3 strains are the main causative agent of TB in eastern Sudan; MDR TB is caused mainly by transmission of MDR L3 strains.
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Hoebel J, Busch MA, Grabka MM, Zinn S, Allen J, Göfêwald A, Wernitz J, Goebel J, Steinhauer HW, Siegers R, Schroder C, Kuttig T, Butschalowsky H, Schlaud M, Rosario AS, Brix J, Rysina A, Glemser A, Neuhauser H, Stahlberg S, Kneuer A, Hey I, Schaarschmidt J, Fiebig J, Buttmann-Schweiger N, Wilking H, Michel J, Nitsche A, Wieler LH, Schaade L, Ziese T, Liebig S, Lampert T. Seroepidemiological study on the spread of SARS-CoV-2 in Germany: Study protocol of the CORONA-MONITORING bundesweit' study (RKI-SOEP study). J Health Monit 2021; 6:2-16. [PMID: 35585914 PMCID: PMC8832365 DOI: 10.25646/7853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/20/2021] [Indexed: 01/29/2023]
Abstract
The SARS-CoV-2 coronavirus has spread rapidly across Germany. Infections are likely to be under-recorded in the notification data from local health authorities on laboratory-confirmed cases since SARS-CoV-2 infections can proceed with few symptoms and then often remain undetected. Seroepidemiological studies allow the estimation of the proportion in the population that has been infected with SARS-CoV-2 (seroprevalence) as well as the extent of undetected infections. The ‘CORONA-MONITORING bundesweit’ study (RKI-SOEP study) collects biospecimens and interview data in a nationwide population sample drawn from the German Socio-Economic Panel (SOEP). Participants are sent materials to self-collect a dry blood sample of capillary blood from their finger and a swab sample from their mouth and nose, as well as a questionnaire. The samples returned are tested for SARS-CoV-2 IgG antibodies and SARS-CoV-2 RNA to identify past or present infections. The methods applied enable the identification of SARS-CoV-2 infections, including those that previously went undetected. In addition, by linking the data collected with available SOEP data, the study has the potential to investigate social and health-related differences in infection status. Thus, the study contributes to an improved understanding of the extent of the epidemic in Germany, as well as identification of target groups for infection protection.
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Affiliation(s)
- Jens Hoebel
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Markus A Busch
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Markus M Grabka
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | - Sabine Zinn
- German Institute for Economic Research, Berlin, Socio-Economic Panel.,Humboldt University Berlin Faculty of Humanities and Social Sciences
| | - Jennifer Allen
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Antje Göfêwald
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jörg Wernitz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jan Goebel
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | | | - Rainer Siegers
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | - Carsten Schroder
- German Institute for Economic Research, Berlin, Socio-Economic Panel.,Freie Universität Berlin School of Business and Economics
| | - Tim Kuttig
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Hans Butschalowsky
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Martin Schlaud
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | | | | | | | - Hannelore Neuhauser
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Silke Stahlberg
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Antje Kneuer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Isabell Hey
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jörg Schaarschmidt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Julia Fiebig
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Hendrik Wilking
- Robert Koch Institute, Berlin Department of Infectious Disease Epidemiology
| | - Janine Michel
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens
| | - Andreas Nitsche
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens
| | - Lothar H Wieler
- Robert Koch Institute, Berlin Institute Leadership.,Robert Koch Institute, Berlin Methodology and Research Infrastructure
| | - Lars Schaade
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens.,Robert Koch Institute, Berlin Institute Leadership
| | - Thomas Ziese
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stefan Liebig
- German Institute for Economic Research, Berlin, Socio-Economic Panel
| | - Thomas Lampert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Eitze S, Felgendreff L, Korn L, Sprengholz P, Allen J, Jenny MA, Wieler LH, Thaiss H, De Bock F, Betsch C. [Public trust in institutions in the first half of the Corona pandemic: findings from the COVID-19 Snapshot Monitoring (COSMO) project]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:268-276. [PMID: 33512553 PMCID: PMC7844815 DOI: 10.1007/s00103-021-03279-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 09/30/2020] [Accepted: 01/07/2021] [Indexed: 11/30/2022]
Abstract
Hintergrund In der Coronaviruspandemie nehmen 2 Institutionen eine zentrale Rolle in der evidenzbasierten Einordnung des Geschehens für Politik und Bevölkerung ein. Das Robert Koch-Institut (RKI) koordiniert die Pandemiebekämpfung, erstellt fundierte Empfehlungen für medizinisches Fachpersonal, die Medien sowie die Bevölkerung und berät die Politik. Die Bundeszentrale für gesundheitliche Aufklärung (BZgA) informiert die Bevölkerung und Institutionen. Ziel der Arbeit Mit dem COVID-19 Snapshot Monitoring (COSMO) wird beobachtet, ob und wie sich das Vertrauen in Institutionen über die Pandemie verändert. Es wird untersucht, welche Bevölkerungsgruppen Vertrauen zeigen und wie dies mit Einstellungen, Risikowahrnehmung und Verhaltensweisen zusammenhängt. Material und Methoden In Querschnittstudien werden seit März 2020 die Risikowahrnehmung, das Verhalten und die Akzeptanz von Maßnahmen sowie das Vertrauen in Institutionen mit etwa N = 1000 Befragten pro Erhebung untersucht. Ergebnisse Das Vertrauen in RKI und BZgA war generell hoch, sank aber über den Verlauf der Pandemie. Höheres Vertrauen ging für beide Institutionen mit höherem Alter der Befragten, höherer Bildung, höherer Risikowahrnehmung und höherer Akzeptanz von Maßnahmen einher. Verhaltensweisen wie Abstandhalten und Händewaschen wurden häufiger gezeigt. Männer und chronisch Erkrankte zeigten geringeres Vertrauen. Diskussion Die Ergebnisse zeigen, dass Vertrauen weiter gefördert werden sollte. Dies könnte u. a. erreicht werden, indem in der Entwicklung und Begründung von Strategien und Maßnahmen auch die Sichtweise der Bevölkerung (z. B. durch COSMO) berücksichtigt wird. Kommunikationsstrategien und Handlungsempfehlungen sollten darauf abzielen, Personen mit hoher Risikowahrnehmung zu unterstützen und zu entlasten.
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Affiliation(s)
- Sarah Eitze
- CEREB - Center of Empirical Research in Economics and Behavioral Sciences, Media and Communication Science, Universität Erfurt, Nordhäuser Str. 63, 99089, Erfurt, Deutschland.
| | | | - Lars Korn
- Universität Erfurt, Erfurt, Deutschland
| | | | | | - Miriam A Jenny
- Robert Koch-Institut, Berlin, Deutschland.,Max-Planck-Institut für Bildungsforschung, Berlin, Deutschland.,Harding-Zentrum für Risikokompetenz, Universität Potsdam, Potsdam, Deutschland
| | | | - Heidrun Thaiss
- Bundeszentrale für gesundheitliche Aufklärung, Köln, Deutschland
| | - Freia De Bock
- Bundeszentrale für gesundheitliche Aufklärung, Köln, Deutschland
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Almond J, Hacker J, Harwood C, Pizza M, Rappuoli R, Ron EZ, Sansonetti P, Vanderslott S, Wieler LH. Development of vaccines at the time of COVID-19. ACTA ACUST UNITED AC 2020; 1:uqaa003. [PMID: 34235437 PMCID: PMC7798935 DOI: 10.1093/femsml/uqaa003] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/10/2020] [Indexed: 12/13/2022]
Abstract
In December 2019, a working group of the European Academy of Microbiology assembled to discuss various aspects of vaccines and vaccinations. The meeting was organised by Jörg Hacker and Eliora Z. Ron and took place in the offices of the Leopoldina (German National Academy of Sciences Leopoldina). Several important issues were addressed and a major part of the discussion focused on the need to develop new vaccines, especially to protect against pathogens that constitute a pandemic threat. Following the rapid and unpredicted spread of COVID-19 in the first seven months of 2020, the need to develop vaccines for pandemic viruses rapidly has been clearly established. Thus, this paper will concentrate on points that were highlighted by the recent COVID-19 pandemic and lessons learnt therefrom.
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Affiliation(s)
- Jeffrey Almond
- The Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, UK
| | - Jörg Hacker
- German National Academy of Science Leopoldina, Jägerberg 1, 06108 Halle, Germany
| | - Colin Harwood
- Centre for Bacterial Cell Biology, Biosciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK
| | | | - Rino Rappuoli
- GSK Vaccines, Via Fiorentina, 1, 53100 Siena SI, Italy
| | - Eliora Z Ron
- The Shmunis School of Biomedicine and Cancer Research, Faculty of Life Sciences, Tel Aviv University, PO Box 39040, Tel Aviv 6997801, Israel
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Johanns VC, Epping L, Semmler T, Ghazisaeedi F, Lübke-Becker A, Pfeifer Y, Eichhorn I, Merle R, Bethe A, Walther B, Wieler LH. High-Zinc Supplementation of Weaned Piglets Affects Frequencies of Virulence and Bacteriocin Associated Genes Among Intestinal Escherichia coli Populations. Front Vet Sci 2020; 7:614513. [PMID: 33392299 PMCID: PMC7772137 DOI: 10.3389/fvets.2020.614513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 10/10/2020] [Accepted: 11/20/2020] [Indexed: 12/22/2022] Open
Abstract
To prevent economic losses due to post-weaning diarrhea (PWD) in industrial pig production, zinc (Zn) feed additives have been widely used, especially since awareness has risen that the regular application of antibiotics promotes buildup of antimicrobial resistance in both commensal and pathogenic bacteria. In a previous study on 179 Escherichia coli collected from piglets sacrificed at the end of a Zn feeding trial, including isolates obtained from animals of a high-zinc fed group (HZG) and a corresponding control group (CG), we found that the isolate collection exhibited three different levels of tolerance toward zinc, i.e., the minimal inhibitory concentration (MIC) detected was 128, followed by 256 and 512 μg/ml ZnCl2. We further provided evidence that enhanced zinc tolerance in porcine intestinal E. coli populations is clearly linked to excessive zinc feeding. Here we provide insights about the genomic make-up and phylogenetic background of these 179 E. coli genomes. Bayesian analysis of the population structure (BAPS) revealed a lack of association between the actual zinc tolerance level and a particular phylogenetic E. coli cluster or even branch for both, isolates belonging to the HZG and CG. In addition, detection rates for genes and operons associated with virulence (VAG) and bacteriocins (BAG) were lower in isolates originating from the HZG (41 vs. 65% and 22 vs. 35%, p < 0.001 and p = 0.002, resp.). Strikingly, E. coli harboring genes defining distinct pathotypes associated with intestinal disease, i.e., enterotoxigenic, enteropathogenic, and Shiga toxin-producing E. coli (ETEC, EPEC, and STEC) constituted 1% of the isolates belonging to the HZG but 14% of those from the CG. Notably, these pathotypes were positively associated with enhanced zinc tolerance (512 μg/ml ZnCl2 MIC, p < 0.001). Taken together, zinc excess seems to influence carriage rates of VAGs and BAGs in porcine intestinal E. coli populations, and high-zinc feeding is negatively correlated with enteral pathotype occurrences, which might explain earlier observations concerning the relative increase of Enterobacterales considering the overall intestinal microbiota of piglets during zinc feeding trials while PWD rates have decreased.
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Affiliation(s)
- Vanessa C. Johanns
- Advanced Light and Electron Microscopy (ZBS-4), Robert Koch Institute, Berlin, Germany
| | - Lennard Epping
- Microbial Genomics (NG1), Robert Koch Institute, Berlin, Germany
| | - Torsten Semmler
- Microbial Genomics (NG1), Robert Koch Institute, Berlin, Germany
| | - Fereshteh Ghazisaeedi
- Center for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Antina Lübke-Becker
- Center for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Yvonne Pfeifer
- Nosocomial Pathogens and Antibiotic Resistance (FG13), Robert Koch Institute, Wernigerode, Germany
| | - Inga Eichhorn
- Center for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany
| | - Astrid Bethe
- Center for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Berlin, Germany
| | - Birgit Walther
- Advanced Light and Electron Microscopy (ZBS-4), Robert Koch Institute, Berlin, Germany
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Hajek A, De Bock F, Wieler LH, Sprengholz P, Kretzler B, König HH. Perceptions of Health Care Use in Germany during the COVID-19 Pandemic. Int J Environ Res Public Health 2020; 17:E9351. [PMID: 33327486 PMCID: PMC7764965 DOI: 10.3390/ijerph17249351] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 12/23/2022]
Abstract
This paper examined the determinants of perceived access to health care use during the COVID-19 pandemic in Germany using data from two waves (8 and 16) of the COVID-19 Snapshot Monitoring (COSMO). Descriptive and regression analysis were used. In wave 8, we found that about 60% of the individuals rather disagreed about having had problems accessing medical care. Furthermore, 73% of the individuals rather disagreed to having experienced health deteriorations due to restrictions on the availability of medical care. Moreover, 85% of the individuals were rather optimistic about future access to healthcare services. Overall, slightly better past and future access to healthcare services has been reported in wave 16. Several determinants were identified in regression analysis. In conclusion, data suggest that perceived past and future access to healthcare services during the COVID-19 pandemic is reasonably good.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (B.K.); (H.-H.K.)
| | - Freia De Bock
- Federal Centre of Health Education, 50825 Cologne, Germany;
| | | | - Philipp Sprengholz
- Department of Health Communication, University of Erfurt, 99089 Erfurt, Germany;
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (B.K.); (H.-H.K.)
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (B.K.); (H.-H.K.)
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Santos-Hövener C, Neuhauser HK, Rosario AS, Busch M, Schlaud M, Hoffmann R, Gößwald A, Koschollek C, Hoebel J, Allen J, Haack-Erdmann A, Brockmann S, Ziese T, Nitsche A, Michel J, Haller S, Wilking H, Hamouda O, Corman VM, Drosten C, Schaade L, Wieler LH, Lampert T. Serology- and PCR-based cumulative incidence of SARS-CoV-2 infection in adults in a successfully contained early hotspot (CoMoLo study), Germany, May to June 2020. Euro Surveill 2020; 25:2001752. [PMID: 33243353 PMCID: PMC7693167 DOI: 10.2807/1560-7917.es.2020.25.47.2001752] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [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: 10/06/2020] [Accepted: 11/25/2020] [Indexed: 11/20/2022] Open
Abstract
Three months after a coronavirus disease (COVID-19) outbreak in Kupferzell, Germany, a population-based study (n = 2,203) found no RT-PCR-positives. IgG-ELISA seropositivity with positive virus neutralisation tests was 7.7% (95% confidence interval (CI): 6.5-9.1) and 4.3% with negative neutralisation tests. We estimate 12.0% (95% CI: 10.4-14.0%) infected adults (24.5% asymptomatic), six times more than notified. Full hotspot containment confirms the effectiveness of prompt protection measures. However, 88% naïve adults are still at high COVID-19 risk.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Stefan Brockmann
- Department of Health Protection and Epidemiology, Baden-Wuerttemberg State Health Office, Stuttgart, Germany
| | | | | | | | | | | | | | - Victor M Corman
- National Consultant Laboratory for Coronaviruses, Berlin Institute of Virology, Charité - Universitätsmedizin, Berlin, Germany
- German Centre for Infection Research (DZIF), Berlin, Germany
| | - Christian Drosten
- National Consultant Laboratory for Coronaviruses, Berlin Institute of Virology, Charité - Universitätsmedizin, Berlin, Germany
- German Centre for Infection Research (DZIF), Berlin, Germany
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42
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Santos-Hövener C, Busch MA, Koschollek C, Schlaud M, Hoebel J, Hoffmann R, Wilking H, Haller S, Allen J, Wernitz J, Butschalowsky H, Kuttig T, Stahlberg S, Strandmark J, Rosario AS, Gößwald A, Nitsche A, Hamouda O, Drosten C, Corman V, Wieler LH, Schaade L, Lampert T. Seroepidemiological study on the spread of SARS-CoV-2 in populations in especially affected areas in Germany - Study protocol of the CORONA-MONITORING lokal study. J Health Monit 2020; 5:2-16. [PMID: 35146295 PMCID: PMC8734078 DOI: 10.25646/7053] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/06/2020] [Indexed: 01/04/2023]
Abstract
At a regional and local level, the COVID-19 pandemic has not spread out uniformly and some German municipalities have been particularly affected. The seroepidemiological data from these areas helps estimate the proportion of the population that has been infected with SARS-CoV-2 (seroprevalence), as well as the number of undetected infections and asymptomatic cases. In four municipalities which were especially affected, 2,000 participants will be tested for an active SARS-CoV-2 infection (oropharyngeal swab) or a past infection (blood specimen IgG antibody test). Participants will also be asked to fill out a short written questionnaire at study centres and complete a follow-up questionnaire either online or by telephone, including information on issues such as possible exposure, susceptability, symptoms and medical history. The CORONA-MONITORING lokal study will allow to determine the proportion of the population with SARS-CoV-2 antibodies in four particularly affected locations. This study will increase the accuracy of estimates regarding the scope of the epidemic, help determine risk and protective factors for an infection and therefore also identify especially exposed groups and, as such, it will be crucial towards planning of prevention measures.
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Affiliation(s)
| | - Markus A. Busch
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Carmen Koschollek
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Martin Schlaud
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jens Hoebel
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Robert Hoffmann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Hendrik Wilking
- Robert Koch Institute, Berlin Department of Infectious Disease Epidemiology
| | - Sebastian Haller
- Robert Koch Institute, Berlin Department of Infectious Disease Epidemiology
| | - Jennifer Allen
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jörg Wernitz
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Hans Butschalowsky
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Tim Kuttig
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Silke Stahlberg
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Julia Strandmark
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Antje Gößwald
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Andreas Nitsche
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens
| | - Osamah Hamouda
- Robert Koch Institute, Berlin Department of Infectious Disease Epidemiology
| | - Christian Drosten
- Charité – UniversitätsmedizinBerlin Institute of Virology, National Consultant Laboratory for Coronaviruses
| | - Victor Corman
- Charité – UniversitätsmedizinBerlin Institute of Virology, National Consultant Laboratory for Coronaviruses
| | - Lothar H. Wieler
- Robert Koch Institute, Berlin Institute Leadership
- Robert Koch Institute, Berlin Methodology and Research Infrastructure
| | - Lars Schaade
- Robert Koch Institute, Berlin Centre for Biological Threats and Special Pathogens
- Robert Koch Institute, Berlin Institute Leadership
| | - Thomas Lampert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Bedford J, Enria D, Giesecke J, Heymann DL, Ihekweazu C, Kobinger G, Lane HC, Memish ZA, Oh MD, Sall AA, Ungchusak K, Wieler LH. Living with the COVID-19 pandemic: act now with the tools we have. Lancet 2020; 396:1314-1316. [PMID: 33038947 PMCID: PMC7544497 DOI: 10.1016/s0140-6736(20)32117-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 02/03/2023]
Affiliation(s)
| | - Delia Enria
- Instituto Nacional de Enfermedades Virales Humanas "Julio Maiztegui" and CCWHO-OPS on Viral Haemorrhagic Fevers and Arboviruses, Buenos Aires, Argentina
| | | | - David L Heymann
- Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
| | | | - Gary Kobinger
- Infectious Disease Research Centre, Université Laval, Faculty of Medicine, Québec City, QC, Canada
| | - H Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Ziad A Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Myoung-Don Oh
- J W Lee Center for Global Medicine, SNU College of Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | | | - Kumnuan Ungchusak
- Ministry of Health, Department of Diseases Control, Bangkok, Thailand
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Ali A, Kolenda R, Khan MM, Weinreich J, Li G, Wieler LH, Tedin K, Roggenbuck D, Schierack P. Novel Avian Pathogenic Escherichia coli Genes Responsible for Adhesion to Chicken and Human Cell Lines. Appl Environ Microbiol 2020; 86:e01068-20. [PMID: 32769194 PMCID: PMC7531953 DOI: 10.1128/aem.01068-20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/09/2020] [Accepted: 08/02/2020] [Indexed: 12/13/2022] Open
Abstract
Avian pathogenic Escherichia coli (APEC) is a major bacterial pathogen of commercial poultry contributing to extensive economic losses and contamination of the food chain. One of the initial steps in bacterial infection and successful colonization of the host is adhesion to the host cells. A random transposon mutant library (n = 1,300) of APEC IMT 5155 was screened phenotypically for adhesion to chicken (CHIC-8E11) and human (LoVo) intestinal epithelial cell lines. The detection and quantification of adherent bacteria were performed by a modified APEC-specific antibody staining assay using fluorescence microscopy coupled to automated VideoScan technology. Eleven mutants were found to have significantly altered adhesion to the cell lines examined. Mutated genes in these 11 "adhesion-altered mutants" were identified by arbitrary PCR and DNA sequencing. The genes were amplified from wild-type APEC IMT 5155, cloned, and transformed into the respective adhesion-altered mutants, and complementation was determined in adhesion assays. Here, we report contributions of the fdtA, rluD, yjhB, ecpR, and fdeC genes of APEC in adhesion to chicken and human intestinal cell lines. Identification of the roles of these genes in APEC pathogenesis will contribute to prevention and control of APEC infections.IMPORTANCE Avian pathogenic E. coli is not only pathogenic for commercial poultry but can also cause foodborne infections in humans utilizing the same attachment and virulence mechanisms. Our aim was to identify genes of avian pathogenic E. coli involved in adhesion to chicken and human cells in order to understand the colonization and pathogenesis of these bacteria. In contrast to the recent studies based on genotypic and bioinformatics data, we have used a combination of phenotypic and genotypic approaches for identification of novel genes contributing to adhesion in chicken and human cell lines. Identification of adhesion factors remains important, as antibodies elicited against such factors have shown potential to block colonization and ultimately prevent disease as prophylactic vaccines. Therefore, the data will augment the understanding of disease pathogenesis and ultimately in designing strategies against the infections.
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Affiliation(s)
- Aamir Ali
- National Institute for Biotechnology and Genetic Engineering College, Pakistan Institute of Engineering and Applied Sciences (NIBGE-C, PIEAS), Faisalabad, Pakistan
- Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Rafał Kolenda
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Muhammad Moman Khan
- Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Jörg Weinreich
- Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Ganwu Li
- Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin, China
| | | | - Karsten Tedin
- Institute for Microbiology and Epizootics, Free University of Berlin, Berlin, Germany
| | - Dirk Roggenbuck
- Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- Faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology Cottbus-Senftenberg, the Brandenburg Medical School Theodor Fontane and the University of Potsdam, Potsdam, Germany
| | - Peter Schierack
- Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- Faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology Cottbus-Senftenberg, the Brandenburg Medical School Theodor Fontane and the University of Potsdam, Potsdam, Germany
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Zacher B, Haller S, Willrich N, Walter J, Abu Sin M, Cassini A, Plachouras D, Suetens C, Behnke M, Gastmeier P, Wieler LH, Eckmanns T. Application of a new methodology and R package reveals a high burden of healthcare-associated infections (HAI) in Germany compared to the average in the European Union/European Economic Area, 2011 to 2012. ACTA ACUST UNITED AC 2020; 24. [PMID: 31771703 PMCID: PMC6864977 DOI: 10.2807/1560-7917.es.2019.24.46.1900135] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundHealthcare-associated infections (HAIs) pose a major challenge to health systems. Burden of disease estimations in disability-adjusted life years (DALYs) are useful for comparing and ranking HAIs.AimTo estimate the number of five common HAIs, their attributable number of deaths and burden for Germany.MethodsWe developed a new method and R package that builds on the approach used by the Burden of Communicable Diseases in Europe (BCoDE) project to estimate the burden of HAIs for individual countries. We used data on healthcare-associated Clostridioides difficile infection, healthcare-associated pneumonia, healthcare-associated primary bloodstream infection, healthcare-associated urinary tract infection and surgical-site infection, which were collected during the point prevalence survey of HAIs in European acute-care hospitals between 2011 and 2012.ResultsWe estimated 478,222 (95% uncertainty interval (UI): 421,350-537,787) cases for Germany, resulting in 16,245 (95% UI: 10,863-22,756) attributable deaths and 248,920 (95% UI: 178,693-336,239) DALYs. Despite the fact that Germany has a relatively low hospital prevalence of HAIs compared with the European Union/European Economic Area (EU/EEA) average, the burden of HAIs in Germany (308.2 DALYs/100,000 population; 95% UI: 221.2-416.3) was higher than the EU/EEA average (290.0 DALYs/100,000 population; 95% UI: 214.9-376.9). Our methodology is applicable to other countries in or outside of the EU/EEA. An R package is available from https://CRAN.R-project.org/package=BHAI.ConclusionThis is the first study to estimate the burden of HAIs in DALYs for Germany. The large number of hospital beds may be a contributing factor for a relatively high burden of HAIs in Germany. Further focus on infection prevention control, paired with reduction of avoidable hospital stays, is needed to reduce the burden of HAIs in Germany.
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Affiliation(s)
- Benedikt Zacher
- These authors contributed equally to this work.,Robert Koch Institute, Berlin, Germany
| | - Sebastian Haller
- These authors contributed equally to this work.,Robert Koch Institute, Berlin, Germany
| | | | | | | | | | | | - Carl Suetens
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Neumann B, Bender JK, Maier BF, Wittig A, Fuchs S, Brockmann D, Semmler T, Einsele H, Kraus S, Wieler LH, Vogel U, Werner G. Comprehensive integrated NGS-based surveillance and contact-network modeling unravels transmission dynamics of vancomycin-resistant enterococci in a high-risk population within a tertiary care hospital. PLoS One 2020; 15:e0235160. [PMID: 32579600 PMCID: PMC7314025 DOI: 10.1371/journal.pone.0235160] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 11/22/2019] [Accepted: 06/09/2020] [Indexed: 02/07/2023] Open
Abstract
Vancomycin-resistant E. faecium (VRE) are an important cause of nosocomial infections, which are rapidly transmitted in hospitals. To identify possible transmission routes, we applied combined genomics and contact-network modeling to retrospectively evaluate routine VRE screening data generated by the infection control program of a hemato-oncology unit. Over 1 year, a total of 111 VRE isolates from 111 patients were collected by anal swabs in a tertiary care hospital in Southern Germany. All isolated VRE were whole-genome sequenced, followed by different in-depth bioinformatics analyses including genotyping and determination of phylogenetic relations, aiming to evaluate a standardized workflow. Patient movement data were used to overlay sequencing data to infer transmission events and strain dynamics over time. A predominant clone harboring vanB and exhibiting genotype ST117/CT469 (n = 67) was identified. Our comprehensive combined analyses suggested intra-hospital spread, especially of clone ST117/CT469, despite of extensive screening, single room placement, and contact isolation. A new interactive tool to visualize these complex data was designed. Furthermore, a patient-contact network-modeling approach was developed, which indicates both the periodic import of the clone into the hospital and its spread within the hospital due to patient movements. The analyzed spread of VRE was most likely due to placement of patients in the same room prior to positivity of screening. We successfully demonstrated the added value for this combined strategy to extract well-founded knowledge from interdisciplinary data sources. The combination of patient-contact modeling and high-resolution typing unraveled the transmission dynamics within the hospital department and, additionally, a constant VRE influx over time.
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Affiliation(s)
- Bernd Neumann
- Division of Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany
- * E-mail:
| | - Jennifer K. Bender
- Division of Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany
| | - Benjamin F. Maier
- Computational Epidemiology, Robert Koch Institute, Berlin, Germany
- Department of Physics, Humboldt University of Berlin, Berlin, Germany
| | - Alice Wittig
- Computational Epidemiology, Robert Koch Institute, Berlin, Germany
- Institute for Theoretical Biology, Humboldt University of Berlin, Berlin, Germany
| | - Stephan Fuchs
- Division of Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany
| | - Dirk Brockmann
- Computational Epidemiology, Robert Koch Institute, Berlin, Germany
- Institute for Theoretical Biology, Humboldt University of Berlin, Berlin, Germany
| | | | - Hermann Einsele
- Department of Internal Medicine II, University Hospital Würzburg, Wüzburg, Germany
| | - Sabrina Kraus
- Department of Internal Medicine II, University Hospital Würzburg, Wüzburg, Germany
| | | | - Ulrich Vogel
- Institute for Hygiene and Microbiology, Julius-Maximilians University Würzburg, Würzburg, Germany
| | - Guido Werner
- Division of Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute, Wernigerode, Germany
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Rexroth U, Hamouda O, Hanefeld J, Ruehe B, Wieler LH, Schaade L. Letter to the editor: Wide indication for SARS-CoV-2-testing allowed identification of international risk areas during the early phase of the COVID-19 pandemic in Germany. Euro Surveill 2020; 25. [PMID: 32553063 PMCID: PMC7403636 DOI: 10.2807/1560-7917.es.2020.25.23.2001119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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49
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Bedford J, Enria D, Giesecke J, Heymann DL, Ihekweazu C, Kobinger G, Lane HC, Memish Z, Oh MD, Sall AA, Schuchat A, Ungchusak K, Wieler LH. COVID-19: towards controlling of a pandemic. Lancet 2020; 395:1015-1018. [PMID: 32197103 PMCID: PMC7270596 DOI: 10.1016/s0140-6736(20)30673-5] [Citation(s) in RCA: 829] [Impact Index Per Article: 207.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 12/17/2022]
Affiliation(s)
| | - Delia Enria
- Instituto Nacional de Enfermedades Virales Humanas (INEVH) "Julio Maiztegui" and CCWHO-OPS on Viral Haemorrhagic Fevers and Arboviruses, Buenos Aires, Argentina
| | | | - David L Heymann
- Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
| | | | - Gary Kobinger
- Infectious Disease Research Centre, Université Laval, Faculty of Medicine, Québec City, Canada
| | - H Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Ziad Memish
- Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Myoung-Don Oh
- J W Lee Center for Global Medicine, SNU College of Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | | | - Anne Schuchat
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kumnuan Ungchusak
- Ministry of Health, Department of Diseases Control, Bangkok, Thailand
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50
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Tolksdorf K, Buda S, Schuler E, Wieler LH, Haas W. Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19). Euro Surveill 2020; 25:2000258. [PMID: 32186278 PMCID: PMC7096775 DOI: 10.2807/1560-7917.es.2020.25.11.2000258] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [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: 03/06/2020] [Accepted: 03/16/2020] [Indexed: 01/11/2023] Open
Abstract
Information on severity of coronavirus disease (COVID-19) (transmissibility, disease seriousness, impact) is crucial for preparation of healthcare sectors. We present a simple approach to assess disease seriousness, creating a reference cohort of pneumonia patients from sentinel hospitals. First comparisons exposed a higher rate of COVID-19 patients requiring ventilation. There were more case fatalities among COVID-19 patients without comorbidities than in the reference cohort. Hospitals should prepare for high utilisation of ventilation and intensive care resources.
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