TY - JOUR A1 - Bertram, Ralph A1 - Bartsch, Vanessa A1 - Sodmann, Johanna A1 - Hennig, Luca A1 - Müjde, Engin A1 - Stock, Jonathan A1 - Ruedig, Vivienne A1 - Sodmann, Philipp A1 - Todt, Daniel A1 - Steinmann, Eike A1 - Hitzl, Wolfgang A1 - Steinmann, Joerg T1 - Risk stratification of SARS-CoV-2 breakthrough infections based on an outbreak at a student festive event JF - Vaccines N2 - In early 2022, the Coronavirus disease 2019 (COVID-19) remains a global challenge. COVID-19 is caused by an increasing number of variants of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Here, we report an outbreak of SARS-CoV-2 breakthrough infections related to a student festive event with 100 mostly vaccinated guests, which took place in Northern Bavaria, Germany, in October 2021. The data were obtained by retrospective guest interviews. In total, 95 students participated in the study, with 94 being fully vaccinated and 24 reporting infection by the delta variant. Correlation analyses among 15 examined variables revealed that time spent at the event, conversation with the supposed index person, and a homologous viral vector vaccination regime were significant risk factors for infection. Non-significant observations related to higher rates of infection included time since last vaccination, shared use of drinking vessels, and number of individual person-to-person contacts at the event. Our data suggest that a high rate of breakthrough infections with the delta variant occurs if no preventive measures are practiced. To limit infection risk, high-quality testing of participants should be considered a mandatory measure at gatherings, irrespective of the participants' vaccination status. KW - COVID-19 KW - SARS-CoV-2 KW - outbreak KW - breakthrough infection Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-267270 SN - 2076-393X VL - 10 IS - 3 ER - TY - JOUR A1 - Bielaszewska, Martina A1 - Schiller, Roswitha A1 - Lammers, Lydia A1 - Bauwens, Andreas A1 - Fruth, Angelika A1 - Middendorf, Barbara A1 - Schmidt, M. Alexander A1 - Tarr, Phillip I. A1 - Dobrindt, Ulrich A1 - Karch, Helge A1 - Mellmann, Alexander T1 - Heteropathogenic virulence and phylogeny reveal phased pathogenic metamorphosis in Escherichia coli O2:H6 JF - EMBO Molecular Medicine N2 - Extraintestinal pathogenic and intestinal pathogenic (diarrheagenic) Escherichia coli differ phylogenetically and by virulence profiles. Classic theory teaches simple linear descent in this species, where non-pathogens acquire virulence traits and emerge as pathogens. However, diarrheagenic Shiga toxin-producing E.coli (STEC) O2:H6 not only possess and express virulence factors associated with diarrheagenic and uropathogenic E.coli but also cause diarrhea and urinary tract infections. These organisms are phylogenetically positioned between members of an intestinal pathogenic group (STEC) and extraintestinal pathogenic E.coli. STEC O2:H6 is, therefore, a 'heteropathogen,' and the first such hybrid virulent E.coli identified. The phylogeny of these E.coli and the repertoire of virulence traits they possess compel consideration of an alternate view of pathogen emergence, whereby one pathogroup of E.coli undergoes phased metamorphosis into another. By understanding the evolutionary mechanisms of bacterial pathogens, rational strategies for counteracting their detrimental effects on humans can be developed. KW - phased metamorphosis KW - phylogeny KW - heteropathogenicity KW - Shiga toxin-producing Escherichia coli KW - hemolytic-uremic syndrome KW - urinary-tract-infection KW - cytolethal distending toxin KW - shiga toxin KW - Crohns-disease KW - outbreak KW - genes KW - island KW - strains KW - parallel evolution KW - uropathogenic Escherichia coli Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-117254 SN - 1757-4684 VL - 6 IS - 3 ER - TY - THES A1 - Schmitz, Sabine T1 - Infektionen durch Mycoplasma pneumoniae in Franken in den Jahren 2000-2003 : Untersuchungen eines Ausbruches in Ebrach sowie stationärer Patienten der Universitätskinderklinik Würzburg T1 - Infections due to Mycoplasma pneumoniae between 2000-2003 in Franken, Bavaria, Germany N2 - Die Studie diente der retrospektiven Untersuchung des Ausbruches von Mp-Infektionen in Ebrach, Franken, der von Oktober des Jahres 2000 bis Februar 2001 andauerte. Ziel war es, die epidemiologischen Charakteristika, also Informationen zu Verteilung und Ausbreitungsweisen der Erkrankung, aber auch zu Symptomen und Befunden, Manifestationsformen und Komplikationen, Therapie und Diagnostik zu erhalten. Darüber hinaus sollten Erkenntnisse zu Patienten mit Mykoplasmeninfektionen, die in den Jahren 2000 bis 2003 in der Universitätskinderklinik Würzburg behandelt wurden, gewonnen und mit Daten der Patienten aus Ebrach verglichen werden. In Ebrach bestand bei 177 Patienten der Verdacht einer akuten Mykoplasmeninfektion. Ausgehend von einer dritten Grundschulklasse, die einige Tage geschlossen werden musste, da innerhalb von 16 Tagen 9 Schüler an einer Pneumonie und 3 Schüler an einer Bronchitis erkrankt waren, hatte sich die Infektion auf insgesamt 78 Personen, vor allem Familienmitglieder, aber auch Nachbarn und Freunde der betroffenen Schüler ausgebreitet. Die meisten Patienten klagten über Husten und Fieber. In erster Linie traten Entzündungen des unteren Respirationstraktes (50% Bronchitiden, 38,5% Pneumonien) auf. Bei 9 Patienten wurde ein Exanthem beobachtet. Eine Patientin musste wegen eines Guillain-Barré-Syndroms in der neurologischen Abteilung der Universitätsklinik Würzburg behandelt werden. In den Jahren 2000 bis 2003 bestand bei 125 Patienten der Universitätskinderklinik Würzburg der Verdacht auf Vorliegen einer Mp-Infektion. Bestätigt wurde dieser in 43 Fällen. Die Patienten waren zwischen 3 und 16 Jahre alt. Insgesamt waren etwas mehr Jungen betroffen, Komplikationen traten deutlich häufiger bei Mädchen auf. Die Patienten, die einer stationären Behandlung bedurften, wiesen schwerere Erkrankungsverläufe oder seltenere Manifestationsformen auf (65% Pneumonien, 34% Komplikationen). So wurden unter anderem 6 Patienten mit Mykoplasmen-assoziierter Fazialisparese, 4 Patienten mit Meningitis und jeweils ein Patient mit Enzephalitis, Trochlearisparese, Vestibularisausfall, Hörverlust, Perimyokarditis und Uveitis anterior und nephrotischem Syndrom beobachtet. Pathognomonische Befunde konnten weder unter den Ebracher Patienten noch in der Kinderklinik ausgemacht werden. Vielmehr spricht die Konstellation bestimmter Symptome und Untersuchungsergebnisse wie Husten, Fieber, relativ guter Allgemeinzustand bei radiologischem Pneumonienachweis oder Differenz der Blutsenkungsreaktion bei Raumtemperatur und 4°C für das Vorliegen einer Mykoplasmeninfektion. Eine deutliche Erhöhung der Inzidenz von Mykoplasmeninfektionen in der Kinderklinik im Zeitraum des Ausbruches von Ebrach war nicht zu verzeichnen. Dass Schüler als Überträger der Infektion in Familien und unter Spielkameraden fungieren, war bekannt, die Ausbreitung der Erkrankung innerhalb des Klassenzimmers ist jedoch selten in diesem Ausmaß beobachtet worden und verdient weitere Untersuchungen. Festzuhalten bleibt also, dass bei der Diagnose einer Mykoplasmeninfektion mittels serologischer Methoden mit einer verzögerten Immunantwort zu rechnen ist und deshalb häufig ein Direktnachweis der Erreger mittels PCR notwendig wird. Darüber hinaus ist die Bestimmung der Blutkörperchensenkungsgeschwindigkeit bei Raum- und Kühlschranktemperatur ein einfaches Mittel, welches aber diagnostisch zusätzlich wichtige Hinweise auf eine Infektion mit Mycoplasma pneumoniae liefern kann. Im Gegensatz dazu erbringt die klinische Untersuchung häufig keine aussagekräftigen, diagnostisch weiterführenden Ergebnisse. Wichtig bezüglich der Therapie ist die frühzeitige und ausreichend lange (10 bis 14 Tage) Gabe von gegen Mykoplasmen wirksamen Antibiotika wie vor allem Makrolid-Antibiotika. N2 - This is a retrospective study of an outbreak of Mycoplasma pneumoniae infections between october 2000 and february 2001 in Ebrach, Franken, Germany. We wanted to get information about epidemiologic characteristics, such as spread of infection, clinical manifestations and complications, as well as influence of therapy, and possibilities of diagnostics. Furthermore we monitored patients with Mycoplasma pneumoniae infections which led to hospitalisation in the pediatric department of Würzburg university hospital and compared them to the patients in Ebrach. In Ebrach a total of 177 patients were thought to have an MP infection. It started in year 3 of primary school, where within 16 days 9 pupils suffered from pneumonia due to MP and 3 children had MP bronchitis. For this reason the pupils where not allowed to attend school for a few days. Beginning with the school children the infection reached 78 persons, mainly parents of the children but also neighbours and friends for example from the football team. Most of them suffered from coughs and fever. Manifestations were infections of the lower respiratory tract (38,5% pneumonia, 50% bronchitis), 9 patients suffered from cutaneous symptoms (exanthema). One patient had to be hospitalized because of a Guillain-Barre-syndrom. Between 2000 and 2003, 125 patients of the pediatric department of the Würzburg university hospital were thought to have MP infections. In 43 cases the MP infection was diagnosed. Patients were between 3 and 16 years old, there were bit more cases amongst males but females got more complications. Hospitalized patients showed more severe manifestatons (65% pneumonia) or complications (34%). These were for example 6 children with Bells palsy, 4 children with menigitis and one of each of the following manifestations: encephalitis, cranial nerve palsy of trochlearis and vestibularis, hearing loss, permyocarditis, uveitis anterior, nephrotic syndrom. No special symptoms which could be said to be pathognomonic were found in either Ebrach or amongst the hospitalized patients. The special constellation of pathological findings much rather suggests a diagnosis of an MP infection: cough, fever, quite good clinical condition, radiographic evidence of pneumonia, different wsg results at 37°C and 4°C. The incidence of MP infections among hospitalized patients did not increase during the time of the outbreak in Ebrach. It is already known that pupils are possible vectors but such a spread of MP infection in the classroom has seldom been observed before and needs further investigation. Serologic diagnosis needs more time because of the delayed immune response of the host and this is why pcr is often necessary. Antibiotic treatment with effective drugs such as macrolides should be taken into consideration early and administered for a long enough period. KW - Mycoplasma pneumoniae KW - Mycoplasma KW - Bakterielle Infektion KW - Guillain-Barre-Syndrom KW - Schulklasse KW - Klassenzimmer KW - Komplikation KW - Atypische Pneumonie KW - Mycoplasma pneumonia KW - Ausbruch KW - Schule KW - Komplikationen KW - Guillain-Barre-Syndrom KW - Hirnnervenausfall KW - mycoplasma pneumoniae KW - outbreak KW - classroom KW - complications KW - Guillain-Barre-syndrom KW - cranial nerve palsy Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-51713 ER - TY - JOUR A1 - Tappe, D. A1 - Stich, A. A1 - Langeheinecke, A. A1 - von Sonnenburg, F. A1 - Muntau, B. A1 - Schaefer, J. A1 - Slesak, G. T1 - Suspected new wave of muscular sarcocystosis in travellers returning from Tioman Island, Malaysia, May 2014 JF - Eurosurveillance N2 - In May 2014, six patients presented in Germany with a Sarcocystis-associated febrile myositis syndrome after returning from Tioman Island, Malaysia. During two earlier waves of infections, in 2011 and 2012, about 100 travellers returning to various European countries from the island were affected. While the first two waves were associated with travel to Tioman Island mostly during the summer months, this current series of infections is associated with travel in early spring, possibly indicating an upcoming new epidemic. KW - infection KW - nesbitti KW - outbreak Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-116195 VL - 19 IS - 21 ER -