@article{DickKraussHillenkampetal.2017, author = {Dick, Julia and Krauß, Patrizia and Hillenkamp, Jost and Kohlmorgen, Britta and Schoen, Christoph}, title = {Postoperative Tropheryma whipplei endophthalmitis - a case report highlighting the additive value of molecular testing}, series = {JMM Case Reports}, volume = {4}, journal = {JMM Case Reports}, doi = {10.1099/jmmcr.0.005124}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158823}, pages = {e005124}, year = {2017}, abstract = {Introduction. Tropheryma whipplei is the causative agent of Whipple's disease. Gastrointestinal and lymphatic tissues are affected in the majority of cases, resulting in diarrhoea, malabsorption and fever. Here, we report a rare case of ocular manifestation in a patient lacking the typical Whipple symptoms. Case presentation. A 74-year-old Caucasian female presented with blurred vision in the right eye over a period of 1-2 months, accompanied by stinging pain and conjunctival hyperaemia for the last 2 days. Upon admission, visual acuity was hand motion in the affected eye. Ophthalmological examination showed typical signs of intraocular inflammation. Diagnostic and therapeutic pars plana vitrectomy including vitreous biopsy and intravitreal instillation of vancomycin and amikacin was performed within hours of initial presentation. Both microscopic analysis and microbial cultures of the vitreous biopsy remained negative for bacteria and fungi. The postoperative antibiotic regime included intravenous administration of ceftriaxone in combination with topical tobramycin and ofloxacin. Due to the empirical therapy the inflammation ceased and the patient was discharged after 5 days with cefpodoxime orally and local antibiotic and steroidal therapy. Meanwhile, the vitreous body had undergone testing by PCR for the eubacterial 16S rRNA gene, which was found to be positive. Analysis of the PCR product revealed a specific sequence of T. whipplei. Conclusion. In our patient, endophthalmitis was the first and only symptom of Morbus Whipple, while most patients with Whipple's disease suffer from severe gastrointestinal symptoms. 16S rDNA PCR should be considered for any intraocular infection when microscopy and standard culture methods remain negative.}, language = {en} } @article{KohlmorgenEliasSchoen2017, author = {Kohlmorgen, Britta and Elias, Johannes and Schoen, Christoph}, title = {Improved performance of the artus Mycobacterium tuberculosis RG PCR kit in a low incidence setting: a retrospective monocentric study}, series = {Scientific Reports}, volume = {7}, journal = {Scientific Reports}, number = {14127}, doi = {10.1038/s41598-017-14367-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159248}, year = {2017}, abstract = {Tuberculosis (TB) and the spread of Mycobacterium tuberculosis complex (MTBC) strains resistant against rifampin (RIF) and isoniazid (INH) pose a serious threat to global health. However, rapid and reliable MTBC detection along with RIF/INH susceptibility testing are challenging in low prevalence countries due to the higher rate of false positives. Here, we provide the first performance data for the artus MTBC PCR assay in a low prevalence setting. We analyze 1323 respiratory and 311 non-respiratory samples with the artus MTBC PCR assay as well as by mycobacterial culture and microscopy. We propose retesting of specimens in duplicate and consideration of a determined cycle-threshold value cut-off greater than 34, as this significantly increases accuracy, specificity, and negative predictive value without affecting sensitivity. Furthermore, we tested fourteen MTBC positive samples with the GenoType MTBDRplus test and demonstrate that using an identical DNA extraction protocol for both assays does not impair downstream genotypic testing for RIF and INH susceptibility. In conclusion, our procedure optimizes the use of the artus MTB assay with workload efficient methods in a low incidence setting. Combining the modified artus MTB with the GenoType MTBDRplus assays allows rapid and accurate detection of MTBC and RIF/INH resistance.}, language = {en} } @article{ForsterKohlmorgenHaasetal.2022, author = {Forster, Johannes and Kohlmorgen, Britta and Haas, Julian and Weis, Philipp and Breunig, Lukas and Turnwald, Doris and Mizaikoff, Boris and Schoen, Christoph}, title = {A streamlined method for the fast and cost-effective detection of bacterial pathogens from positive blood cultures for the BacT/ALERT blood culture system using the Vitek MS mass spectrometer}, series = {PLoS ONE}, volume = {17}, journal = {PLoS ONE}, number = {4}, doi = {10.1371/journal.pone.0267669}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300213}, year = {2022}, abstract = {Background and objective Prompt pathogen identification of blood stream infections is essential to provide appropriate antibiotic treatment. Therefore, the objective of this prospective single centre study was to establish an inexpensive, fast and accurate protocol for bacterial species identification with SDS protein-extraction directly from BacT/Alert® blood culture (BC) bottles by VitekMS®. Results Correct species identification was obtained for 198/266 (74.4\%, 95\%-CI = [68.8\%, 79.6\%]) of pathogens. The protocol was more successful in identifying 87/96 (91.4\%, 95\%-CI = [83.8\%, 93.2\%]) gram-negative bacteria than 110/167 (65.9\%, 95\%-CI = [58.1\%, 73.0\%]) gram-positive bacteria. The hands-on time for sample preparation and measurement was about 15 min for up to five samples. This is shorter than for most other protocols using a similar lysis-centrifugation approach for the combination of BacT/Alert® BC bottles and the Vitek® MS mass spectrometer. The estimated costs per sample were approx. 1.80€ which is much cheaper than for commercial kits. Conclusion This optimized protocol allows for accurate identification of bacteria directly from blood culture bottles for laboratories equipped with BacT/Alert® blood culture bottles and VitekMS® mass spectrometer.}, language = {en} }