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since 2016 Head of Infection Prevention and Control team at the Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf 2015-2016 Director of the Central Institute for Hospital Hygiene and Infection Prevention, Paracelsus Kliniken Deutschland GmbH & CoKG aA, Osnabrück, Germany 2006-2015 Vice Director of the Institute for Medical Microbiology and Hygiene, University Medical Center Schleswig-Holstein, Campus Lübeck ResearcherID: D-6456-2011
Summary Background The presence of coronaviruses on surfaces in the patient environment is a potential source of indirect transmission. Manual cleaning and disinfection measures do not always achieve sufficient removal of surface contamination. This increases the importance of automated solutions in the context of final disinfection of rooms in the hospital setting. Ozone is a highly effective disinfectant which, combined with high humidity, is an effective agent against respiratory viruses. Current devices allow continuous nebulization for high room humidity as well as ozone production without any consumables. Aim In the following study, the effectiveness of a fully automatic room decontamination system based on ozone was tested against bacteriophage Φ6 (phi 6) and bovine coronavirus L9, as surrogate viruses for the pandemic coronavirus SARS-CoV-2. Methods For this purpose, various surfaces (ceramic tile, stainless steel surface and furniture board) were soiled with the surrogate viruses and placed at two different levels in a gas-tight test room. After using the automatic decontamination device according to the manufacturer's instructions, the surrogate viruses were recovered from the surfaces and examined by quantitative cultures. Then, reduction factors were calculated. Findings The ozone-based room decontamination device achieved virucidal efficacy (reduction factor >4 log10) against both surrogate organisms regardless of the different surfaces and positions confirming a high activity under the used conditions. Conclusion Ozone is highly active against SARS-CoV-2 surrogate organisms. Further investigations are necessary for a safe application and efficacy in practice as well as integration into routine processes.
G. Franke; B. Knobling; F.H. Brill; B. Becker; E.M. Klupp; C. Belmar Campos; S. Pfefferle; M. Lütgehetmann; J.K. Knobloch. An automated room disinfection system using ozone is highly active against surrogates for SARS-CoV-2. Journal of Hospital Infection 2021, 112, 108 -113.
AMA StyleG. Franke, B. Knobling, F.H. Brill, B. Becker, E.M. Klupp, C. Belmar Campos, S. Pfefferle, M. Lütgehetmann, J.K. Knobloch. An automated room disinfection system using ozone is highly active against surrogates for SARS-CoV-2. Journal of Hospital Infection. 2021; 112 ():108-113.
Chicago/Turabian StyleG. Franke; B. Knobling; F.H. Brill; B. Becker; E.M. Klupp; C. Belmar Campos; S. Pfefferle; M. Lütgehetmann; J.K. Knobloch. 2021. "An automated room disinfection system using ozone is highly active against surrogates for SARS-CoV-2." Journal of Hospital Infection 112, no. : 108-113.
Gefion Franke; Birte Knobling; Florian H Brill; Britta Becker; Eva M Klupp; Cristina Belmar Campos; Susanne Pfefferle; Marc Lütgehetmann; Johannes K Knobloch. An automated room disinfection system using ozone is highly active against surrogates for SARS-CoV-2. 2021, 1 .
AMA StyleGefion Franke, Birte Knobling, Florian H Brill, Britta Becker, Eva M Klupp, Cristina Belmar Campos, Susanne Pfefferle, Marc Lütgehetmann, Johannes K Knobloch. An automated room disinfection system using ozone is highly active against surrogates for SARS-CoV-2. . 2021; ():1.
Chicago/Turabian StyleGefion Franke; Birte Knobling; Florian H Brill; Britta Becker; Eva M Klupp; Cristina Belmar Campos; Susanne Pfefferle; Marc Lütgehetmann; Johannes K Knobloch. 2021. "An automated room disinfection system using ozone is highly active against surrogates for SARS-CoV-2." , no. : 1.
So far, only a few reports about reinfections with SARS-CoV-2 have been published, and they often lack detailed immunological and virological data. We report about a SARS-CoV-2 reinfection with a genetically distinct SARS-CoV-2 variant in an immunocompetent female healthcare worker that has led to a mild disease course. No obvious viral escape mutations were observed in the second virus variant. The infectious virus was shed from the patient during the second infection episode despite the presence of neutralizing antibodies in her blood. Our data indicate that a moderate immune response after the first infection, but not a viral escape, did allow for reinfection and live virus shedding.
Thomas Brehm; Susanne Pfefferle; Ronald von Possel; Robin Kobbe; Dominik Nörz; Stefan Schmiedel; Adam Grundhoff; Flaminia Olearo; Petra Emmerich; Alexis Robitaille; Thomas Günther; Platon Braun; Gabriele Andersen; Johannes Knobloch; Marylyn Addo; Ansgar Lohse; Martin Aepfelbacher; Nicole Fischer; Julian Schulze Zur Wiesch; Marc Lütgehetmann. SARS-CoV-2 Reinfection in a Healthcare Worker Despite the Presence of Detectable Neutralizing Antibodies. Viruses 2021, 13, 661 .
AMA StyleThomas Brehm, Susanne Pfefferle, Ronald von Possel, Robin Kobbe, Dominik Nörz, Stefan Schmiedel, Adam Grundhoff, Flaminia Olearo, Petra Emmerich, Alexis Robitaille, Thomas Günther, Platon Braun, Gabriele Andersen, Johannes Knobloch, Marylyn Addo, Ansgar Lohse, Martin Aepfelbacher, Nicole Fischer, Julian Schulze Zur Wiesch, Marc Lütgehetmann. SARS-CoV-2 Reinfection in a Healthcare Worker Despite the Presence of Detectable Neutralizing Antibodies. Viruses. 2021; 13 (4):661.
Chicago/Turabian StyleThomas Brehm; Susanne Pfefferle; Ronald von Possel; Robin Kobbe; Dominik Nörz; Stefan Schmiedel; Adam Grundhoff; Flaminia Olearo; Petra Emmerich; Alexis Robitaille; Thomas Günther; Platon Braun; Gabriele Andersen; Johannes Knobloch; Marylyn Addo; Ansgar Lohse; Martin Aepfelbacher; Nicole Fischer; Julian Schulze Zur Wiesch; Marc Lütgehetmann. 2021. "SARS-CoV-2 Reinfection in a Healthcare Worker Despite the Presence of Detectable Neutralizing Antibodies." Viruses 13, no. 4: 661.
To evaluate the effectiveness of automated room decontamination devices, a common aerosolized hydrogen peroxide (aHP) as well as a recent gaseous ozone-based device, which produces the disinfectant reagent without the need of consumables, were tested under real-life conditions. Twenty-two contaminated surfaces were positioned in different areas in a patient room with adjacent bathroom and anteroom. Following the decontamination process bacteria were recovered and reduction factors were calculated after performing quantitative culture. Following the manufactures instructions, the ozone-based device displayed a bactericidal effect (log10 > 5), whereas the aHP system failed for a high bacterial burden and achieves only a complete elimination of a realistic bioburden (log10 2). After increasing the exposure time to 30 min, the aHP device also reached a bactericidal effect. Nevertheless, our results indicate, that further research and development is necessary, to get knowledge about toxicity, efficacy and safety by using in complex hospital conditions and achieve meaningful integration in cleaning procedures, to reach positive effects on disinfection performance.
Birte Knobling; Gefion Franke; Eva M. Klupp; Cristina Belmar Campos; Johannes K. Knobloch. Evaluation of the Effectiveness of Two Automated Room Decontamination Devices Under Real-Life Conditions. Frontiers in Public Health 2021, 9, 1 .
AMA StyleBirte Knobling, Gefion Franke, Eva M. Klupp, Cristina Belmar Campos, Johannes K. Knobloch. Evaluation of the Effectiveness of Two Automated Room Decontamination Devices Under Real-Life Conditions. Frontiers in Public Health. 2021; 9 ():1.
Chicago/Turabian StyleBirte Knobling; Gefion Franke; Eva M. Klupp; Cristina Belmar Campos; Johannes K. Knobloch. 2021. "Evaluation of the Effectiveness of Two Automated Room Decontamination Devices Under Real-Life Conditions." Frontiers in Public Health 9, no. : 1.
Objectives Investigation whether in depth characterization of virus variant patterns can be used for epidemiological analysis of the first severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection clusters in Hamburg, Germany. Methods Metagenomic RNA-sequencing and amplicon-sequencing and subsequent variant calling in 25 respiratory samples from SARS-CoV-2 infected patients involved in the earliest infection clusters in Hamburg. Results Amplikon sequencing and cluster analyses of these SARS-CoV-2 sequences allowed the identification of the first infection cluster and five non-related infection clusters occurring at the beginning of the viral entry of SARS-CoV-2 in the Hamburg metropolitan region. Viral genomics together with epidemiological analyses revealed that the index patient acquired the infection in northern Italy and transmitted it to two out of 134 contacts. Single nucleotide polymorphisms clearly distinguished the virus variants of the index and other clusters and allowed us to track in which sequences worldwide these mutations were first described. Minor variant analyses identified the transmission of intra-host variants in the index cluster and household clusters. Conclusions SARS-CoV-2 variant tracing allows the identification of infection clusters and the follow up of infection chains occurring in the population. Furthermore, the follow up of minor viral variants in infection clusters can provide further resolution on transmission events indistinguishable at a consensus sequence level.
Susanne Pfefferle; Thomas Günther; Robin Kobbe; Manja Czech-Sioli; Dominic Nörz; René Santer; Jun Oh; Stefan Kluge; Lisa Oestereich; Kersten Peldschus; Daniela Indenbirken; Jiabin Huang; Adam Grundhoff; Martin Aepfelbacher; Johannes K. Knobloch; Marc Lütgehetmann; Nicole Fischer. SARS Coronavirus-2 variant tracing within the first Coronavirus Disease 19 clusters in northern Germany. Clinical Microbiology and Infection 2020, 27, 130.e5 -130.e8.
AMA StyleSusanne Pfefferle, Thomas Günther, Robin Kobbe, Manja Czech-Sioli, Dominic Nörz, René Santer, Jun Oh, Stefan Kluge, Lisa Oestereich, Kersten Peldschus, Daniela Indenbirken, Jiabin Huang, Adam Grundhoff, Martin Aepfelbacher, Johannes K. Knobloch, Marc Lütgehetmann, Nicole Fischer. SARS Coronavirus-2 variant tracing within the first Coronavirus Disease 19 clusters in northern Germany. Clinical Microbiology and Infection. 2020; 27 (1):130.e5-130.e8.
Chicago/Turabian StyleSusanne Pfefferle; Thomas Günther; Robin Kobbe; Manja Czech-Sioli; Dominic Nörz; René Santer; Jun Oh; Stefan Kluge; Lisa Oestereich; Kersten Peldschus; Daniela Indenbirken; Jiabin Huang; Adam Grundhoff; Martin Aepfelbacher; Johannes K. Knobloch; Marc Lütgehetmann; Nicole Fischer. 2020. "SARS Coronavirus-2 variant tracing within the first Coronavirus Disease 19 clusters in northern Germany." Clinical Microbiology and Infection 27, no. 1: 130.e5-130.e8.
ObjectiveTo assess the effectiveness of multimodal infection control interventions in the prevention of SARS-CoV-2 infections in healthcare professionalsDesignSequential follow-up studySettingLargest tertiary care centre in northern GermanyParticipants1253 employees of the University Medical Center Hamburg-Eppendorf were sequentially assessed for the presence of SARS-CoV-2 IgG antibodies at the beginning of the covid-19 epidemic (20 March – 9 April), one month (20 April – 8 May), and another two months later (22 June – 24 July). Of those, 1026 were healthcare workers (HCWs) of whom 292 were directly involved in the care of covid-19 patients. During the study period, infection control interventions were deployed, those included i) strict barrier nursing of all known covid-19 patients including FFP2 (N95) masks, goggles, gloves, hoods and protective gowns, ii) visitor restrictions with access control at all hospital entries, iii) mandatory wearing of disposable face masks in all clinical settings, and iv) universal RT-PCR admission screening of patients.Main Outcome MeasuresSARS-CoV-2 IgG seroconversion rateResultsAt the initial screening, ten participants displayed significant IgG antibody ratios. Another ten individuals showed seroconversion at the second time point one month later, only two further participants seroconverted during the subsequent two months. The overall SARS-CoV-2 seroprevalence in the study cohort at the last follow-up was 1.8%, the seroconversion rate dropped from 0.81% to 0.08% per month despite a longer observation period. Amongst HCWs seropositivity was increased in those directly involved in the care of patients with SARS-CoV-2 infections (3.8%, n=11) compared to other HCWs (1.4%, n=10, P=0.025). However, after the adoption of all multimodal infection control interventions seroconversions were observed in only two more HCWs, neither of whom were involved in inpatient care.ConclusionMultimodal infection control and prevention interventions are highly effective in mitigating SARS-CoV-2 infections of healthcare professionals.
Thomas Theo Brehm; Dorothee Schwinge; Sibylle Lampalzer; Veronika Schlicker; Julia Kuechen; Michelle Thompson; Felix Ullrich; Samuel Huber; Stefan Schmiedel; Marylyn M Addo; Marc Luetgehetmann; Johannes K Knobloch; Julian Schulze Zur Wiesch; Ansgar W Lohse. High effectiveness of multimodal infection control interventions in preventing SARS-CoV-2 infections in healthcare professionals: a prospective longitudinal seroconversion study. 2020, 1 .
AMA StyleThomas Theo Brehm, Dorothee Schwinge, Sibylle Lampalzer, Veronika Schlicker, Julia Kuechen, Michelle Thompson, Felix Ullrich, Samuel Huber, Stefan Schmiedel, Marylyn M Addo, Marc Luetgehetmann, Johannes K Knobloch, Julian Schulze Zur Wiesch, Ansgar W Lohse. High effectiveness of multimodal infection control interventions in preventing SARS-CoV-2 infections in healthcare professionals: a prospective longitudinal seroconversion study. . 2020; ():1.
Chicago/Turabian StyleThomas Theo Brehm; Dorothee Schwinge; Sibylle Lampalzer; Veronika Schlicker; Julia Kuechen; Michelle Thompson; Felix Ullrich; Samuel Huber; Stefan Schmiedel; Marylyn M Addo; Marc Luetgehetmann; Johannes K Knobloch; Julian Schulze Zur Wiesch; Ansgar W Lohse. 2020. "High effectiveness of multimodal infection control interventions in preventing SARS-CoV-2 infections in healthcare professionals: a prospective longitudinal seroconversion study." , no. : 1.
ObjectivesWe used viral genomics to deeply analyze the first SARS-CoV-2 infection clusters in the metropolitan region of Hamburg, Germany. Epidemiological analysis and contact tracing together with a thorough investigation of virus variant patterns revealed low and high infection dose transmissions to be involved in transmission events.MethodsInfection control measures were applied to follow up contract tracing. Metagenomic RNA- and SARS-CoV-2 amplicon sequencing was performed from 25 clinical samples for sequence analysis and variant calling.ResultsThe index patient acquired SARS-CoV-2 in Italy and after his return to Hamburg transmitted it to 2 out of 132 contacts. Virus genomics and variant pattern clearly confirms the initial local cluster. We identify frequent single nucleotide polymorphisms at positions 241, 3037, 14408, 23403 and 28881 previously described in Italian sequences and now considered as one major genotype in Europe. While the index patient showed a single nucleotide polymorphism only one variant was transmitted to the recipients. Different to the initial cluster, we observed in household clusters occurring at the time in Hamburg also intra-host viral species transmission events.ConclusionsSARS-CoV-2 variant tracing highlights both, low infection dose transmissions suggestive of fomites as route of infection in the initial cluster and high and low infection dose transmissions in family clusters indicative of fomites and droplets as infection routes. This suggests (1) single viral particle infection can be sufficient to initiate SARS-CoV-2 infection and (2) household/family members are exposed to high virus loads and therefore have a high risk to acquire SARS-CoV-2.
Susanne Pfefferle; Thomas Guenther; Robin Kobbe; Manja Czech-Sioli; Dominic Nörz; René Santer; Jun Oh; Stefan Kluge; Lisa Oestereich; Kersten Peldschus; Daniela Indenbirken; Jiabin Huang; Adam Grundhoff; Martin Aepfelbacher; Johannes K. Knobloch; Marc Luetgehetmann; Nicole Fischer. Low and high infection dose transmissions of SARS-CoV-2 in the first COVID-19 clusters in Northern Germany. 2020, 1 .
AMA StyleSusanne Pfefferle, Thomas Guenther, Robin Kobbe, Manja Czech-Sioli, Dominic Nörz, René Santer, Jun Oh, Stefan Kluge, Lisa Oestereich, Kersten Peldschus, Daniela Indenbirken, Jiabin Huang, Adam Grundhoff, Martin Aepfelbacher, Johannes K. Knobloch, Marc Luetgehetmann, Nicole Fischer. Low and high infection dose transmissions of SARS-CoV-2 in the first COVID-19 clusters in Northern Germany. . 2020; ():1.
Chicago/Turabian StyleSusanne Pfefferle; Thomas Guenther; Robin Kobbe; Manja Czech-Sioli; Dominic Nörz; René Santer; Jun Oh; Stefan Kluge; Lisa Oestereich; Kersten Peldschus; Daniela Indenbirken; Jiabin Huang; Adam Grundhoff; Martin Aepfelbacher; Johannes K. Knobloch; Marc Luetgehetmann; Nicole Fischer. 2020. "Low and high infection dose transmissions of SARS-CoV-2 in the first COVID-19 clusters in Northern Germany." , no. : 1.
Birte Tröger; Mathias Heidemann; Ines Osthues; Dennis Knaack; Wolfgang Gopel; Egbert Herting; Johannes K.-M. Knobloch; Christoph Härtel. Modulation of S. epidermidis-induced innate immune responses in neonatal whole blood. Journal of Microbiology, Immunology and Infection 2020, 53, 240 -249.
AMA StyleBirte Tröger, Mathias Heidemann, Ines Osthues, Dennis Knaack, Wolfgang Gopel, Egbert Herting, Johannes K.-M. Knobloch, Christoph Härtel. Modulation of S. epidermidis-induced innate immune responses in neonatal whole blood. Journal of Microbiology, Immunology and Infection. 2020; 53 (2):240-249.
Chicago/Turabian StyleBirte Tröger; Mathias Heidemann; Ines Osthues; Dennis Knaack; Wolfgang Gopel; Egbert Herting; Johannes K.-M. Knobloch; Christoph Härtel. 2020. "Modulation of S. epidermidis-induced innate immune responses in neonatal whole blood." Journal of Microbiology, Immunology and Infection 53, no. 2: 240-249.
The treatment of psoriasis has been revolutionized by the development of biologic therapies. However, the pathogenesis of psoriasis, in particular the role of the cutaneous microbiome, remains incompletely understood. Moreover, skin microbiome studies have relied heavily on 16S rRNA sequencing data in the absence of bacterial culture. To characterize and compare the cutaneous microbiome in 20 healthy controls and 23 patients with psoriasis using metagenomic analyses and to determine changes in the microbiome during treatment. Swabs from lesional and nonlesional skin from patients with psoriasis, and from controls matched for site and skin microenvironment, were analysed using both 16S rRNA sequencing and traditional culture combined with mass spectrometry (MALDI-TOF) in a prospective study. Psoriasis was associated with an increased abundance of Firmicutes and a corresponding reduction in Actinobacteria, most marked in lesional skin, and at least partially reversed during systemic treatment. Shifts in bacterial community composition in lesional sites were reflected in similar changes in culturable bacteria, although changes in the microbiota over repeated swabbing were detectable only with sequencing. The composition of the microbial communities varied by skin site and microenvironment. Prevotella and Staphylococcus were significantly associated with lesional skin, and Anaerococcus and Propionibacterium with nonlesional skin. There were no significant differences in the amount of bacteria cultured from the skin of healthy controls and patients with psoriasis. Shifts in the cutaneous microbiome in psoriasis, particularly during treatment, may shed new light on the pathogenesis of the disease and may be clinically exploited to predict treatment response. What's already known about this topic? Alterations in the composition of the cutaneous microbiome have been described in psoriasis, although methodological differences in study design prevent direct comparison of results. To date, most cutaneous microbiome studies have focused on 16S rRNA sequencing data, including both living and dead bacteria. What does this study add? This prospective observational study confirms that changes in the composition of the cutaneous microbiome, detected by 16S rRNA sequencing, are consistent with those identified by bacterial culture and mass spectrometry. The changes in the microbiome during antipsoriasis therapy should be further investigated to determine whether these represent potential novel biomarkers of treatment response. What is the translational message? Characterization of cutaneous microbiota may ultimately move into the clinic to help facilitate treatment selection, not only by optimizing currently available treatments, but also by identifying new therapeutic targets.
E.A. Langan; A. Künstner; M. Miodovnik; D. Zillikens; D. Thaçi; J.F. Baines; Saleh Ibrahim; W. Solbach; J.K. Knobloch. Combined culture and metagenomic analyses reveal significant shifts in the composition of the cutaneous microbiome in psoriasis. British Journal of Dermatology 2019, 181, 1254 -1264.
AMA StyleE.A. Langan, A. Künstner, M. Miodovnik, D. Zillikens, D. Thaçi, J.F. Baines, Saleh Ibrahim, W. Solbach, J.K. Knobloch. Combined culture and metagenomic analyses reveal significant shifts in the composition of the cutaneous microbiome in psoriasis. British Journal of Dermatology. 2019; 181 (6):1254-1264.
Chicago/Turabian StyleE.A. Langan; A. Künstner; M. Miodovnik; D. Zillikens; D. Thaçi; J.F. Baines; Saleh Ibrahim; W. Solbach; J.K. Knobloch. 2019. "Combined culture and metagenomic analyses reveal significant shifts in the composition of the cutaneous microbiome in psoriasis." British Journal of Dermatology 181, no. 6: 1254-1264.
Infections caused by third generation cephalosporin-resistant Enterobacteriaceae (3GCREB) are an increasing healthcare problem. We aim to describe the 3GCREB infection incidence and compare it to prevalence upon admission. In addition, we aim to describe infections caused by 3GCREB, which are also carbapenem resistant (CRE). In 2014–2015, we performed prospective 3GCREB surveillance in clinically relevant patient specimens (screening specimens excluded). Infections counted as hospital-acquired (HAI) when the 3GCREB was detected after the third day following admission, otherwise as community-acquired infection (CAI). Of 578,420 hospitalized patients under surveillance, 3367 had a 3GCREB infection (0.58%). We observed a similar 3GCREB CAI and HAI incidence (0.28 and 0.31 per 100 patients, respectively). The most frequent pathogen was 3GCR E. coli, in CAI and HAI (0.15 and 0.12 per 100 patients). We observed a CRE CAI incidence of 0.006 and a HAI incidence of 0.008 per 100 patients (0.014 per 1000 patient days). Comparing the known 3GCREB admission prevalence of the participating hospitals (9.5%) with the percentage of patients with a 3GCREB infection (0.58%), we conclude the prevalence of 3GCREB in university hospitals to be about 16 times higher than suggested when only patients with 3GCREB infections are considered. Moreover, we find the HAI and CAI incidence caused by CRE in Germany to be relatively low.
Anna M. Rohde; on behalf of the DZIF-ATHOS study group; Janine Zweigner; Miriam Wiese-Posselt; Frank Schwab; Michael Behnke; Axel Kola; Birgit Obermann; Johannes K.-M. Knobloch; Susanne Feihl; Christiane Querbach; Friedemann Gebhardt; Alexander Mischnik; Vera Ihle; Wiebke Schröder; Sabina Armean; Silke Peter; Evelina Tacconelli; Axel Hamprecht; Harald Seifert; Maria J. G. T. Vehreschild; Winfried V. Kern; Petra Gastmeier. Incidence of infections due to third generation cephalosporin-resistant Enterobacteriaceae - a prospective multicentre cohort study in six German university hospitals. Antimicrobial Resistance & Infection Control 2018, 7, 159 .
AMA StyleAnna M. Rohde, on behalf of the DZIF-ATHOS study group, Janine Zweigner, Miriam Wiese-Posselt, Frank Schwab, Michael Behnke, Axel Kola, Birgit Obermann, Johannes K.-M. Knobloch, Susanne Feihl, Christiane Querbach, Friedemann Gebhardt, Alexander Mischnik, Vera Ihle, Wiebke Schröder, Sabina Armean, Silke Peter, Evelina Tacconelli, Axel Hamprecht, Harald Seifert, Maria J. G. T. Vehreschild, Winfried V. Kern, Petra Gastmeier. Incidence of infections due to third generation cephalosporin-resistant Enterobacteriaceae - a prospective multicentre cohort study in six German university hospitals. Antimicrobial Resistance & Infection Control. 2018; 7 (1):159.
Chicago/Turabian StyleAnna M. Rohde; on behalf of the DZIF-ATHOS study group; Janine Zweigner; Miriam Wiese-Posselt; Frank Schwab; Michael Behnke; Axel Kola; Birgit Obermann; Johannes K.-M. Knobloch; Susanne Feihl; Christiane Querbach; Friedemann Gebhardt; Alexander Mischnik; Vera Ihle; Wiebke Schröder; Sabina Armean; Silke Peter; Evelina Tacconelli; Axel Hamprecht; Harald Seifert; Maria J. G. T. Vehreschild; Winfried V. Kern; Petra Gastmeier. 2018. "Incidence of infections due to third generation cephalosporin-resistant Enterobacteriaceae - a prospective multicentre cohort study in six German university hospitals." Antimicrobial Resistance & Infection Control 7, no. 1: 159.
Transmission of bacteria from inanimate surfaces in healthcare associated environments is an important source of hospital acquired infections. A number of commercially available medical devices promise to fulfill antibacterial activity to reduce environmental contamination. In this study we developed a touch transfer assay modeling fingerprint transmission to investigate the antibacterial activity of surfaces, with confirmed antibacterial activity by a modified ISO 22196 (JIS Z 2801) assay to test such surfaces under more realistic conditions. Bacteria were taken up from a dry standardized primary contaminated surface (PCS) with disinfected fingers or fingers covered with sterile and moistened cotton gloves. Subsequently, bacteria were transferred by pressing on secondary contaminated surfaces (SCS) with or without potential antibacterial activity and the relative reduction rate was determined after 24 h. A stable transmission rate between PCS and SCS was observed using moistened sterile gloves. A copper containing alloy displayed at least a tenfold reduction of the bacterial load consistently reaching less than 2.5 cfu/cm2. In contrast, no significant reduction of bacterial contamination by silver containing surfaces and matured pure silver was observed in the touch transfer assay. With the touch transfer assay we successfully established a new reproducible method modeling cross contamination. Using the new method we were able to demonstrate that several surfaces with confirmed antimicrobial activity in a modified ISO 22196 (JIS Z 2801) assay lacked effectiveness under defined ambient conditions. This data indicate that liquid based assays like the ISO 22196 should be critically reviewed before claiming antibacterial activity for surfaces in the setting of contamination of dry surfaces by contact to the human skin. We suggest the newly developed touch transfer assay as a new additional tool for the assessment of potential antimicrobial surfaces prior utilization in hospital environments.
Johannes Karl-Mark Knobloch; Sabrina Tofern; Wladimir Kunz; Sara Schütze; Michael Riecke; Werner Solbach; Thomas Wuske. “Life-like” assessment of antimicrobial surfaces by a new touch transfer assay displays strong superiority of a copper alloy compared to silver containing surfaces. PLoS ONE 2017, 12, e0187442 -e0187442.
AMA StyleJohannes Karl-Mark Knobloch, Sabrina Tofern, Wladimir Kunz, Sara Schütze, Michael Riecke, Werner Solbach, Thomas Wuske. “Life-like” assessment of antimicrobial surfaces by a new touch transfer assay displays strong superiority of a copper alloy compared to silver containing surfaces. PLoS ONE. 2017; 12 (11):e0187442-e0187442.
Chicago/Turabian StyleJohannes Karl-Mark Knobloch; Sabrina Tofern; Wladimir Kunz; Sara Schütze; Michael Riecke; Werner Solbach; Thomas Wuske. 2017. "“Life-like” assessment of antimicrobial surfaces by a new touch transfer assay displays strong superiority of a copper alloy compared to silver containing surfaces." PLoS ONE 12, no. 11: e0187442-e0187442.
Background With several million microbes per square centimetre of skin, the task of mapping the physiological cutaneous microbiome is enormous. Indeed, the reliance on bacterial culture to identify cutaneous bacterial communities has led to a systematic underappreciation of cutaneous microbial diversity, potentially limiting our understanding of common inflammatory skin diseases, including psoriasis. However, based heavily on developments in molecular biology and bioinformatics, including next‐generation sequencing, the last decade has witnessed a marked increase in our understanding of the extent and composition of the cutaneous microbiome. It is already clear that skin‐specific (skin site and skin microenvironment), individual‐specific (hygiene, sex, age and hormonal status), disease‐specific (atopic eczema, acne) and genetic factors can all influence the cutaneous microbiome, albeit to varying and, as yet, ill‐defined extents. Objectives To investigate the role of the microbiome in psoriasis and to outline how microbiome studies can be harnessed to provide new insights into disease pathogenesis and treatment selection. Methods This review briefly describes the process of 16S ribosomal RNA sequencing and then charts our current understanding of the cutaneous microbiome in health and the alterations (dysbiosis) associated with chronic inflammatory diseases, with particular reference to psoriasis. Results The possibility and clinical relevance of intraindividual cross‐talk between the various microbiomes is discussed and potential mechanisms underpinning the interactions between resident skin flora and the immune system are highlighted. Conclusions Ultimately, in the age of personalized medicine, the integration of cutaneous microbiome signatures and comprehensive disease and drug response endotypes will herald a novel approach in the clinical management of chronic multisystem inflammatory diseases.
E.A. Langan; C.E.M. Griffiths; W. Solbach; Johannes Knobloch; D. Zillikens; Diamant Thaci. The role of the microbiome in psoriasis: moving from disease description to treatment selection? British Journal of Dermatology 2017, 178, 1020 -1027.
AMA StyleE.A. Langan, C.E.M. Griffiths, W. Solbach, Johannes Knobloch, D. Zillikens, Diamant Thaci. The role of the microbiome in psoriasis: moving from disease description to treatment selection? British Journal of Dermatology. 2017; 178 (5):1020-1027.
Chicago/Turabian StyleE.A. Langan; C.E.M. Griffiths; W. Solbach; Johannes Knobloch; D. Zillikens; Diamant Thaci. 2017. "The role of the microbiome in psoriasis: moving from disease description to treatment selection?" British Journal of Dermatology 178, no. 5: 1020-1027.
Objectives: As part of the multicentre Antibiotic Therapy Optimisation Study, MIC values of 19 non-β-lactam agents were determined for third-generation cephalosporin-resistant Escherichia coli, Klebsiella species and Enterobacter species (3GCREB) isolates collected in German hospitals. Methods: A total of 328 E. coli, 35 Klebsiella spp. (1 Klebsiella oxytoca and 34 Klebsiella pneumoniae) and 16 Enterobacter spp. (1 Enterobacter aerogenes and 15 Enterobacter cloacae) isolates were submitted to broth microdilution antimicrobial susceptibility testing with the MICRONAUT system. MICs of fluoroquinolones (levofloxacin and moxifloxacin), aminoglycosides (gentamicin, tobramycin, amikacin, streptomycin, neomycin and paromomycin), tetracyclines (tetracycline, minocycline and tigecycline), macrolides (erythromycin, clarithromycin and azithromycin) and miscellaneous agents [trimethoprim/sulfamethoxazole, chloramphenicol, nitrofurantoin, colistin and fosfomycin intravenous (iv)] were determined and reviewed against 2016 EUCAST breakpoints. Results: The MIC of levofloxacin was >2 mg/L for 128 of 328 E. coli and 8 of 35 Klebsiella spp., but only 1 of 16 Enterobacter spp. Rates of resistance to trimethoprim/sulfamethoxazole were high (>70%), except for Enterobacter spp. Rates of resistance to colistin and fosfomycin iv were still low. About 20% of the tested isolates were resistant to chloramphenicol. Only 1 (of 328) E. coli isolate had an MIC of amikacin >16 mg/L and only 33 of 328 E. coli and 1 of 35 Klebsiella spp. had an MIC of tobramycin >4 mg/L, whereas average gentamicin MICs were in general more elevated. A tigecycline MIC >2 mg/L was only found for 1 of 16 Enterobacter spp., but in none of the E. coli or Klebsiella spp. isolates. Conclusions: Our study gives insight into previously unreported non-β-lactam MIC distributions of 3GCREB isolates.
A. Mischnik; P. Baumert; A. Hamprecht; A. M. Rohde; S. Peter; S. Feihl; J. Knobloch; H. Gölz; A. Kola; B. Obermann; C. Querbach; M. Willmann; F. Gebhardt; E. Tacconelli; Petra Gastmeier; H. Seifert; W. V. Kern. In vitrosusceptibility to 19 agents other than β-lactams among third-generation cephalosporin-resistant Enterobacteriaceae recovered on hospital admission. Journal of Antimicrobial Chemotherapy 2017, 72, 1359 -1363.
AMA StyleA. Mischnik, P. Baumert, A. Hamprecht, A. M. Rohde, S. Peter, S. Feihl, J. Knobloch, H. Gölz, A. Kola, B. Obermann, C. Querbach, M. Willmann, F. Gebhardt, E. Tacconelli, Petra Gastmeier, H. Seifert, W. V. Kern. In vitrosusceptibility to 19 agents other than β-lactams among third-generation cephalosporin-resistant Enterobacteriaceae recovered on hospital admission. Journal of Antimicrobial Chemotherapy. 2017; 72 (5):1359-1363.
Chicago/Turabian StyleA. Mischnik; P. Baumert; A. Hamprecht; A. M. Rohde; S. Peter; S. Feihl; J. Knobloch; H. Gölz; A. Kola; B. Obermann; C. Querbach; M. Willmann; F. Gebhardt; E. Tacconelli; Petra Gastmeier; H. Seifert; W. V. Kern. 2017. "In vitrosusceptibility to 19 agents other than β-lactams among third-generation cephalosporin-resistant Enterobacteriaceae recovered on hospital admission." Journal of Antimicrobial Chemotherapy 72, no. 5: 1359-1363.
As part of the multicenter Antibiotic Therapy Optimisation Study—the largest study on the prevalence of third-generation cephalosporin-resistant Enterobacteriaceae carriage upon hospital admission—minimum inhibitory concentration values were generated for ampicillin/sulbactam, amoxicillin/clavulanic acid, piperacillin/tazobactam, mecillinam, mecillinam/clavulanic acid, and temocillin against third-generation cephalosporin-resistant Escherichia coli, Klebsiella species and Enterobacter species.
Alexander Mischnik; Philipp Baumert; Axel Hamprecht; Anna Rohde; Silke Peter; Susanne Feihl; Johannes Knobloch; Hanna Gölz; Axel Kola; Birgit Obermann; Christiane Querbach; Matthias Willmann; Friedemann Gebhardt; Evelina Tacconelli; Petra Gastmeier; Harald Seifert; Winfried V. Kern; DZIF-ATHOS Study Group. Susceptibility to penicillin derivatives among third-generation cephalosporin-resistant Enterobacteriaceae recovered on hospital admission. Diagnostic Microbiology and Infectious Disease 2016, 87, 71 -73.
AMA StyleAlexander Mischnik, Philipp Baumert, Axel Hamprecht, Anna Rohde, Silke Peter, Susanne Feihl, Johannes Knobloch, Hanna Gölz, Axel Kola, Birgit Obermann, Christiane Querbach, Matthias Willmann, Friedemann Gebhardt, Evelina Tacconelli, Petra Gastmeier, Harald Seifert, Winfried V. Kern, DZIF-ATHOS Study Group. Susceptibility to penicillin derivatives among third-generation cephalosporin-resistant Enterobacteriaceae recovered on hospital admission. Diagnostic Microbiology and Infectious Disease. 2016; 87 (1):71-73.
Chicago/Turabian StyleAlexander Mischnik; Philipp Baumert; Axel Hamprecht; Anna Rohde; Silke Peter; Susanne Feihl; Johannes Knobloch; Hanna Gölz; Axel Kola; Birgit Obermann; Christiane Querbach; Matthias Willmann; Friedemann Gebhardt; Evelina Tacconelli; Petra Gastmeier; Harald Seifert; Winfried V. Kern; DZIF-ATHOS Study Group. 2016. "Susceptibility to penicillin derivatives among third-generation cephalosporin-resistant Enterobacteriaceae recovered on hospital admission." Diagnostic Microbiology and Infectious Disease 87, no. 1: 71-73.
The objectives of this study were to prospectively assess the rectal carriage rate of third-generation cephalosporin-resistant Enterobacteriaceae (3GCREB) in non-ICU patients on hospital admission and to investigate resistance mechanisms and risk factors for carriage. Adult patients were screened for 3GCREB carriage at six German tertiary care hospitals in 2014 using rectal swabs or stool samples. 3GCREB isolates were characterized by phenotypic and molecular methods. Each patient answered a questionnaire about potential risk factors for colonization with MDR organisms (MDROs). Univariable and multivariable risk factor analyses were performed to identify factors associated with 3GCREB carriage. Of 4376 patients, 416 (9.5%) were 3GCREB carriers. Escherichia coli was the predominant species (79.1%). ESBLs of the CTX-M-1 group (67.3%) and the CTX-M-9 group (16.8%) were the most frequent β-lactamases. Five patients (0.11%) were colonized with carbapenemase-producing Enterobacteriaceae. The following risk factors were significantly associated with 3GCREB colonization in the multivariable analysis (P < 0.05): centre; previous MDRO colonization (OR = 2.12); antibiotic use within the previous 6 months (OR = 2.09); travel outside Europe (OR = 2.24); stay in a long-term care facility (OR = 1.33); and treatment of gastroesophageal reflux disease (GERD) (OR = 1.22). To our knowledge, this is the largest admission prevalence study of 3GCREB in Europe. The observed prevalence of 9.5% 3GCREB carriage was higher than previously reported and differed significantly among centres. In addition to previously identified risk factors, the treatment of GERD proved to be an independent risk factor for 3GCREB colonization.
A. Hamprecht; A. M. Rohde; M. Behnke; S. Feihl; P. Gastmeier; F. Gebhardt; W. V. Kern; J. K. Knobloch; A. Mischnik; B. Obermann; C. Querbach; S. Peter; C. Schneider; W. Schröder; F. Schwab; E. Tacconelli; M. Wiese-Posselt; T. Wille; M. Willmann; H. Seifert; J. Zweigner; Sabina Armean; Dirk Busch; Gesche Först; Federico Foschi; Meyke Gillis; Dorothea Hansen; Georg Häcker; Markus Heim; Martin Hug; Klaus Kaier; Axel Kola; M. Fabian Küpper; Georg Langebartels; Andrea Liekweg; Hans-Peter Lipp; Mathias Nordmann; Luis-Alberto Penadiaz; Jan Rupp; Christine Schröder; Katrin Spohn; Michaela Steib-Bauert; Jörg J. Vehreschild; Ulrich Vor Dem Esche. Colonization with third-generation cephalosporin-resistant Enterobacteriaceae on hospital admission: prevalence and risk factors. Journal of Antimicrobial Chemotherapy 2016, 71, 2957 -2963.
AMA StyleA. Hamprecht, A. M. Rohde, M. Behnke, S. Feihl, P. Gastmeier, F. Gebhardt, W. V. Kern, J. K. Knobloch, A. Mischnik, B. Obermann, C. Querbach, S. Peter, C. Schneider, W. Schröder, F. Schwab, E. Tacconelli, M. Wiese-Posselt, T. Wille, M. Willmann, H. Seifert, J. Zweigner, Sabina Armean, Dirk Busch, Gesche Först, Federico Foschi, Meyke Gillis, Dorothea Hansen, Georg Häcker, Markus Heim, Martin Hug, Klaus Kaier, Axel Kola, M. Fabian Küpper, Georg Langebartels, Andrea Liekweg, Hans-Peter Lipp, Mathias Nordmann, Luis-Alberto Penadiaz, Jan Rupp, Christine Schröder, Katrin Spohn, Michaela Steib-Bauert, Jörg J. Vehreschild, Ulrich Vor Dem Esche. Colonization with third-generation cephalosporin-resistant Enterobacteriaceae on hospital admission: prevalence and risk factors. Journal of Antimicrobial Chemotherapy. 2016; 71 (10):2957-2963.
Chicago/Turabian StyleA. Hamprecht; A. M. Rohde; M. Behnke; S. Feihl; P. Gastmeier; F. Gebhardt; W. V. Kern; J. K. Knobloch; A. Mischnik; B. Obermann; C. Querbach; S. Peter; C. Schneider; W. Schröder; F. Schwab; E. Tacconelli; M. Wiese-Posselt; T. Wille; M. Willmann; H. Seifert; J. Zweigner; Sabina Armean; Dirk Busch; Gesche Först; Federico Foschi; Meyke Gillis; Dorothea Hansen; Georg Häcker; Markus Heim; Martin Hug; Klaus Kaier; Axel Kola; M. Fabian Küpper; Georg Langebartels; Andrea Liekweg; Hans-Peter Lipp; Mathias Nordmann; Luis-Alberto Penadiaz; Jan Rupp; Christine Schröder; Katrin Spohn; Michaela Steib-Bauert; Jörg J. Vehreschild; Ulrich Vor Dem Esche. 2016. "Colonization with third-generation cephalosporin-resistant Enterobacteriaceae on hospital admission: prevalence and risk factors." Journal of Antimicrobial Chemotherapy 71, no. 10: 2957-2963.
Testing for antibodies against hepatitis B core antigen (anti-HBc) was introduced to detect blood donors suffering from occult hepatitis B infection. Confirmation of specification of reactive results in the anti-HBc screening assay is still a challenge for blood donation services. Two different test strategies for confirmation of specification of reactive anti-HBc tests, one performed in our institute and one suggested by the German authority (Paul-Ehrlich-Institut (PEI)), were compared. The first strategy is based on one supplemental anti-HBc test, the other requires two supplemental anti-HBc tests. 389 samples from 242 donors were considered. Both test strategies yielded concordant results in 117 reactive samples termed 'true-positive' or 'specificity confirmed', in 156 reactive samples termed 'false-positive' or 'specificity not confirmed', and in 99 negative samples. In 17 samples obtained from 11 donors, both test strategies gave discrepant results ('false-positive' but 'specificity confirmed'). In 10 of 11 donors, a real HBV infection was very unlikely, one remained unclear. 30 donors considered 'false-positive' became negative in all anti-HBc tests after follow-up testing and thus eligible for donor re-entry. The test strategy suggested by the PEI yielded no additional information but induced an overestimation of HBV infections and unnecessary look-back procedures. Many anti-HBc-reactive donors can be regained after follow-up testing.
David Juhl; Johannes K.-M. Knobloch; Siegfried Görg; Holger Hennig. Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors. Transfusion Medicine and Hemotherapy 2015, 43, 37 -43.
AMA StyleDavid Juhl, Johannes K.-M. Knobloch, Siegfried Görg, Holger Hennig. Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors. Transfusion Medicine and Hemotherapy. 2015; 43 (1):37-43.
Chicago/Turabian StyleDavid Juhl; Johannes K.-M. Knobloch; Siegfried Görg; Holger Hennig. 2015. "Comparison of Two Test Strategies for Clarification of Reactive Results for Anti-HBc in Blood Donors." Transfusion Medicine and Hemotherapy 43, no. 1: 37-43.
Background Shiga toxin-producing, enteroaggregative Escherichia coli was responsible for the 2011 outbreak of haemolytic uraemic syndrome (HUS). The present single-centre, observational study describes the 1-year course of the disease with an emphasis on kidney function. Outcome data after 1 year are associated with treatment and patient characteristics at onset of HUS. Methods Patients were treated according to a standardized approach of supportive care, including a limited number of plasmapheresis. On top of this treatment, patients with severe HUS ( n = 35) received eculizumab, a humanized anti-C5 monoclonal antibody inhibiting terminal complement activation. The per-protocol decision—to start or omit an extended therapy with eculizumab accompanied by azithromycin—separated the patients into two groups and marked Day 0 of the prospective study. Standardized visits assessed the patients' well-being, kidney function, neurological symptoms, haematological changes and blood pressure. Results Fifty-six patients were regularly seen during the follow-up. All patients had survived without end-stage renal disease. Young(er) age alleviated restoring kidney function after acute kidney injury even in severe HUS. After 1 year, kidney function was affected with proteinuria [26.7%; 95% confidence interval (CI) 13.8–39.6], increased serum creatinine (4.4%, CI 0.0–10.4), increased cystatin C (46.7%, CI 32.1–61.3) and reduced (<90 mL/min) estimated glomerular filtration rate (46.7%, CI 32.1–61.3). Nine of the 36 patients without previous hypertension developed de novo hypertension (25%, CI 10.9–39.1). All these patients had severe HUS. Conclusions Although shiga toxin-producing Escherichia coli (STEC)-HUS induced by O104:H4 was a life-threatening acute disease, follow-up showed a good recovery of organ function in all patients. Whereas kidney function recovered even after longer duration of dialysis, chronic hypertension developed after severe HUS with neurological symptoms and could not be prevented by the extended therapy.
Inge Derad; Birgit Obermann; Alexander Katalinic; Nora Eisemann; Johannes K.-M. Knobloch; Friedhelm Sayk; Peter Wellhöner; Hendrik Lehnert; Werner Solbach; Sven Süfke; Jürgen Steinhoff; Martin Nitschke. Hypertension and mild chronic kidney disease persist following severe haemolytic uraemic syndrome caused by Shiga toxin-producing Escherichia coli O104:H4 in adults. Nephrology Dialysis Transplantation 2015, 31, 95 -103.
AMA StyleInge Derad, Birgit Obermann, Alexander Katalinic, Nora Eisemann, Johannes K.-M. Knobloch, Friedhelm Sayk, Peter Wellhöner, Hendrik Lehnert, Werner Solbach, Sven Süfke, Jürgen Steinhoff, Martin Nitschke. Hypertension and mild chronic kidney disease persist following severe haemolytic uraemic syndrome caused by Shiga toxin-producing Escherichia coli O104:H4 in adults. Nephrology Dialysis Transplantation. 2015; 31 (1):95-103.
Chicago/Turabian StyleInge Derad; Birgit Obermann; Alexander Katalinic; Nora Eisemann; Johannes K.-M. Knobloch; Friedhelm Sayk; Peter Wellhöner; Hendrik Lehnert; Werner Solbach; Sven Süfke; Jürgen Steinhoff; Martin Nitschke. 2015. "Hypertension and mild chronic kidney disease persist following severe haemolytic uraemic syndrome caused by Shiga toxin-producing Escherichia coli O104:H4 in adults." Nephrology Dialysis Transplantation 31, no. 1: 95-103.
One of the most common complications following breast augmentation is capsular contracture. The subclinical infection of the implant is often considered to be one of the main risk factors. It is believed that polyurethane (PU) implants, because of their larger foam-like surface, have lower capsular contracture rates due to better tissue integration. It remains unclear if bacterial contamination and biofilm formation result in higher capsular contracture rates under the condition of the increased surface of PU implants compared to textured silicone-gel implants. The effect of this bacterial contamination was examined in an animal-based study. A total of 80 mini implants (40 textured silicone-gel implants and 40 PU implants) were implanted in the dorsum of female Wistar rats. In each group, 20 implants were inoculated before implantation with a standard amount of Staphylococcus epidermidis. Capsules and implants were explanted after 60 days, followed by double-blind histological, immunohistochemical, and microbiological examinations. Macroscopic separation of the total capsule in the textured implant group was possible whereas the growth of surrounding tissue into the foam structure of PU implants made separation in that group difficult. After contamination, a thicker capsule could be observed in both groups without significant differences. Histologically, capsules around PU implants showed significantly lower expression of parallel myofibrils. We were able to describe a significant higher infiltration with inflammatory cells in capsules around PU implants both with and without contamination. Microbiological investigations revealed positive growth of S. epidermidis around one PU implant without related signs of capsular contracture. This study demonstrates that aside from the surface of silicone implants, bacterial contamination has major impact on the architecture of capsule formation. In our study, we were able to demonstrate that bacterial contamination leads to a thicker capsule and an increased tissue reaction with a higher amount of inflammatory cells. However, a resulting bacterial infection was only demonstrated in one case and had an insignificant influence on capsule architecture. The observed inflammatory reaction around PU implants was observed as a nonbacterial, granulomatose foreign body reaction. Level I: Evidence obtained from at least one properly designed randomized controlled trial.
Philipp A. Bergmann; Georgious Tamouridis; Jörn A. Lohmeyer; Karl L. Mauss; Benedikt Becker; Johannes Knobloch; Peter Mailänder; Frank Siemers. The effect of a bacterial contamination on the formation of capsular contracture with polyurethane breast implants in comparison with textured silicone implants: An animal study. Journal of Plastic, Reconstructive & Aesthetic Surgery 2014, 67, 1364 -1370.
AMA StylePhilipp A. Bergmann, Georgious Tamouridis, Jörn A. Lohmeyer, Karl L. Mauss, Benedikt Becker, Johannes Knobloch, Peter Mailänder, Frank Siemers. The effect of a bacterial contamination on the formation of capsular contracture with polyurethane breast implants in comparison with textured silicone implants: An animal study. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2014; 67 (10):1364-1370.
Chicago/Turabian StylePhilipp A. Bergmann; Georgious Tamouridis; Jörn A. Lohmeyer; Karl L. Mauss; Benedikt Becker; Johannes Knobloch; Peter Mailänder; Frank Siemers. 2014. "The effect of a bacterial contamination on the formation of capsular contracture with polyurethane breast implants in comparison with textured silicone implants: An animal study." Journal of Plastic, Reconstructive & Aesthetic Surgery 67, no. 10: 1364-1370.
Discovered in 1949, the antibiotic colistin was initially used for therapeutic purposes. Parenteral use of colistin was gradually abandoned because of its side-effect profile, especially its nephrotoxicity and neurotoxicity. Despite the risk of these potentially serious adverse effects, increasing resistance of Gram-negative bacteria has led to a renaissance of intravenous use of colistin in the last few years. Local administration of colistin is an alternative method to minimise the risk of systemic toxicity. We present a case of extensively drug-resistant Pseudomonas aeruginosa osteomyelitis treated successfully with high-dose colistin- and tobramycin-impregnated bone cement as a drug delivery vehicle. For the first time, local colistin concentrations in drainage and synovial fluid were quantified in order to determine the optimal dose and to minimise serious side effects. Insertion of a bone cement spacer loaded with a high dose of tobramycin and colistin resulted in local colistin levels at the infection site that exceeded the minimum inhibitory concentration (MIC) of colistin against the isolated P. aeruginosa five-fold on Day 4. Thus, the treatment may be expected to exert a prolonged effect. Whereas systemic administration of colistin alone was not sufficient to treat the infection, combined local and parenteral therapy led to eradication of P. aeruginosa in this patient. Plasma colistin levels remained in the therapeutic range, which confirms the systemic safety of the method.
Jochen Krajewski; Stefanie M. Bode-Böger; Uwe Tröger; Jens Martens-Lobenhoffer; Thomas Mulrooney; Hagen Mittelstädt; Martin Russlies; Rainer Kirchner; Johannes Knobloch. Successful treatment of extensively drug-resistant Pseudomonas aeruginosa osteomyelitis using a colistin- and tobramycin-impregnated PMMA spacer. International Journal of Antimicrobial Agents 2014, 44, 363 -366.
AMA StyleJochen Krajewski, Stefanie M. Bode-Böger, Uwe Tröger, Jens Martens-Lobenhoffer, Thomas Mulrooney, Hagen Mittelstädt, Martin Russlies, Rainer Kirchner, Johannes Knobloch. Successful treatment of extensively drug-resistant Pseudomonas aeruginosa osteomyelitis using a colistin- and tobramycin-impregnated PMMA spacer. International Journal of Antimicrobial Agents. 2014; 44 (4):363-366.
Chicago/Turabian StyleJochen Krajewski; Stefanie M. Bode-Böger; Uwe Tröger; Jens Martens-Lobenhoffer; Thomas Mulrooney; Hagen Mittelstädt; Martin Russlies; Rainer Kirchner; Johannes Knobloch. 2014. "Successful treatment of extensively drug-resistant Pseudomonas aeruginosa osteomyelitis using a colistin- and tobramycin-impregnated PMMA spacer." International Journal of Antimicrobial Agents 44, no. 4: 363-366.
Purpose.: To investigate the effects of Bruch's membrane (BrM) neutral lipid deposition in mouse models and its significance to aging and age-related macular degeneration, it is essential to reliably detect small quantities of neutral lipids including esterified cholesterol (EC). In chorioretinal sections and BrM wholemounts, we tested a novel fluorescent cholesterol marker based on the bacterial toxin perfringolysin O (PFO) and compared results with those obtained with the classic cholesterol dye filipin. Methods.: An engineered plasmid containing the specific cholesterol binding domain (D4) of PFO fused to green fluorescent protein (GFP) was expressed in cultured E. coli , isolated, purified, and concentrated. A total of 150 BrM-choroid wholemounts and chorioretinal sections of 11- to 13-month-old ApoEnull mice were prepared and stained with PFO/D4-GFP or filipin for EC. Samples were examined by epifluorescence microscopy. Results.: The fluorescence intensity of PFO/D4-GFP was strong, stable, and, if small quantities of EC were present, superior to filipin. In all specimens, we could sharply locate the PFO/D4-GFP signal to BrM. A semiquantitative evaluation of BrM lipid deposition is possible by measuring PFO/D4-GFP fluorescence intensity. Conclusions.: The use of PFO/D4-GFP allowed a robust and direct detection of EC in aged murine BrM. In wholemount samples, its strong and stable fluorescence facilitated a semiquantitative evaluation of BrM-EC content over a large area. The patterns of EC deposition in murine BrM wholemounts are comparable with findings in human BrM wholemounts. Perfringolysin O/D4-GFP could be an important tool for investigating the effects of BrM lipid deposition in mouse models.
Martin Rudolf; Armin Mohi; Marie C. Dettbarn; Yoko Miura; Zouhair Aherrahrou; Mahdy Ranjbar; Bulent Mutus; Johannes K. M. Knobloch. Detection of Esterified Cholesterol in Murine Bruch's Membrane Wholemounts With a Perfringolysin O-Based Cholesterol Marker. Investigative Opthalmology & Visual Science 2014, 55, 4759 -4767.
AMA StyleMartin Rudolf, Armin Mohi, Marie C. Dettbarn, Yoko Miura, Zouhair Aherrahrou, Mahdy Ranjbar, Bulent Mutus, Johannes K. M. Knobloch. Detection of Esterified Cholesterol in Murine Bruch's Membrane Wholemounts With a Perfringolysin O-Based Cholesterol Marker. Investigative Opthalmology & Visual Science. 2014; 55 (8):4759-4767.
Chicago/Turabian StyleMartin Rudolf; Armin Mohi; Marie C. Dettbarn; Yoko Miura; Zouhair Aherrahrou; Mahdy Ranjbar; Bulent Mutus; Johannes K. M. Knobloch. 2014. "Detection of Esterified Cholesterol in Murine Bruch's Membrane Wholemounts With a Perfringolysin O-Based Cholesterol Marker." Investigative Opthalmology & Visual Science 55, no. 8: 4759-4767.