@article{KruegerLeskienSchulleretal.2021,
  author    = {Kr{\"u}ger, S{\"o}ren and Leskien, Miriam and Schuller, Patricia and Prifert, Christiane and Weißbrich, Benedikt and Vogel, Ulrich and Krone, Manuel},
  title     = {Performance and feasibility of universal PCR admission screening for SARS-CoV-2 in a German tertiary care hospital},
  series = {Journal of Medical Virology},
  volume    = {93},
  journal   = {Journal of Medical Virology},
  number    = {5},
  doi       = {10.1002/jmv.26770},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-238971},
  pages     = {2890 -- 2898},
  year      = {2021},
  abstract  = {Anamnestic screening of symptoms and contact history is applied to identify coronavirus disease 2019 (COVID-19) patients on admission. However, asymptomatic and presymptomatic patients remain undetected although the viral load may be high. In this retrospective cohort study, all hospitalized patients who received polymerase chain reaction (PCR) admission testing from March 26th until May 24th, 2020 were included. Data on COVID-19-specific symptoms and contact history to COVID-19 cases were retrospectively extracted from patient files and from contact tracing notes. The compliance to the universal testing protocol was high with 90\%. Out of 6940 tested patients, 27 new severe acute respiratory syndrome coronavirus-2 infections (0.4\%) were detected. Seven of those COVID-19 cases (26\% of all new cases) were asymptomatic and had no positive contact history, but were identified through a positive PCR test. The number needed to identify an asymptomatic patient was 425 in the first wave of the epidemic, 1218 in the low incidence phase. The specificity of the method was above 99.9\%. Universal PCR testing was highly accepted by staff as demonstrated by high compliance. The costs to detect one asymptomatic case in future studies need to be traded off against the costs and damage caused by potential outbreaks of COVID-19.},
  language  = {en}
}
@phdthesis{Krueger2021,
  author    = {Kr{\"u}ger, S{\"o}ren},
  title     = {Unterschiedliche Einfl{\"u}sse von Komplement auf Reaktionen neutrophiler Granulozyten auf die Infektion mit \(Neisseria\) \(meningitidis\)},
  doi       = {10.25972/OPUS-24969},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-249697},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {The gram-negative diplococcus Neisseria meningitidis (Nme) is a frequent human-specific, commensal bacterium of the upper respiratory tract. Under certain conditions especially in infants, meningococci can translocate into the bloodstream and cause invasive meningococcal disease (IMD) manifesting as meningitis or sepsis or a combination of both. IMD is feared for its rapid progression and high fatality rate if it remains untreated. IMD affects up to one million people annually causing substantial morbidity and mortality worldwide. It is well-established that the complement system is an important protective factor in meningococcal disease through opsonization of bacteria with C3b and the lytic activity of the membrane attack complex although the inflammatory C5a/C5aR1 axis can aggravate IMD. The role of neutrophil granulocytes in meningococcal infection is less clear despite their abundant recruitment throughout the course of disease. This study aimed to characterize neutrophil responses to Nme in vitro and the influence of complement on these responses. In infection assays with whole blood and isolated PMNs, effective binding, internalization and killing of Nme by neutrophils was demonstrated. A significant complement-dependence of neutrophil phagocytosis and oxidative burst was observed. The opsonizing and lytic pathway of the complement cascade were found to be most relevant for these responses since blockade of C3 using inhibitor Compstatin Cp20 reduced phagocytosis and oxidative burst significantly more than the blockade of the inflammatory branch with C5aR1-antagonist PMX53. Opsonization with specific antibodies could not replicate the effect of complement activation indicating that engagement of neutrophil complement receptors, particularly complement receptor 3, is involved. Other neutrophil effector functions such as degranulation and IL-8 release were activated in a complement-independent manner implying activation by other inflammatory signals. Considering existing evidence on the overall protective effect of PMNs, further studies investigating the contribution of each neutrophil effector function to infection survival in vivo are required. Ideally, this should be studied in a murine meningitis or sepsis model in the context of complement activation.},
  subject      = {Neisseria meningitidis},
  language  = {en}
}