Since 1990 the number of glanders outbreaks in race, military and pleasure horses in Asia and Sou... more Since 1990 the number of glanders outbreaks in race, military and pleasure horses in Asia and South America is steadily increasing. Glanders, which is eradicated in Western Europe, Australia and Northern America, is currently considered a re-emerging disease. Consequently, the disease may be introduced into glanders-free regions by subclinical carriers at any time. The causative agent of glanders, Burkholderia (B.) mallei, is highly contagious and leads to chronic disease in horses whereas in donkeys and mules the disease is acute and often fatal. Occurrence of the disease leads to international trading restrictions and infected animals immediately have to be culled and safely disposed off. In humans B. mallei infection results in a severe clinical course, and is fatal without appropriate therapy. Its pathogenicity makes B. mallei a potential biological agent that may be used in bioterroristic attacks. Due to the eradication of glanders in the second half of the last century, veterinarians in western European countries are no longer familiar with its clinical presentation in solipeds. Having these facts in mind, this review describes the epidemiology, clinical signs, pathology and the current eradication strategy of this interesting zoonosis. Pictures of imported endurance horses infected with glanders taken during an eradication campaign in Dubai, United Arab Emirates, in 2004 illustrate most typical clinical findings.
Both Schistosoma spp. (species) and Leishmania spp. are prevalent in Ghana in West Africa. Howeve... more Both Schistosoma spp. (species) and Leishmania spp. are prevalent in Ghana in West Africa. However, little is known about their local occurrence in immunocompromised individuals. In the study presented here, the real-time PCR-(polymerase chain reaction-)based screening for repetitive DNA (deoxyribonucleotide acid) sequences from the genomes of Leishmania (L.) spp. and Schistosoma (S.) spp. was performed in the serum of HIV-(human immunodeficiency virus-)infected Ghanaian patients. In 1083 assessed serum samples from HIV-positive and HIV-negative Ghanian patients, Leishmania spp.-specific DNA was not detected, while the diagnostic accuracy-adjusted prevalence estimation suggested a 3.6% prevalence of the S. mansoni complex and a 0.5% prevalence of the S. haematobium complex. Associations of schistosomiasis with younger age, as well as with the male sex, could be shown but not with an HIV status. Weakly significant signals for the associations of schistosomiasis with an increased vira...
Supporting Information Table S1. Primers used for PCR screening of nasal S. aureus isolates obtai... more Supporting Information Table S1. Primers used for PCR screening of nasal S. aureus isolates obtained from Madagascan students and healthcare workers. (PDF 73Â kb)
Figure S1. Most commonly reported reasons for new medical consultations during the study interval... more Figure S1. Most commonly reported reasons for new medical consultations during the study interval for non-EUTM missions. Figure S2. Variation in the crude rate of reported disease categories year by year for non-EUTM missions. Figure S3. Variation in reported infectious disease events by category and year for non-EUTM missions. Figure S4. Variation in reported specific infectious diseases events by calendar week for non-EUTM missions. Figure S5. Reports of confirmed diseases in EUTM MLI during the study period. (DOC 2979 kb)
The SARS-CoV-2-infection can be seen as a single disease but also affects patients with relevant ... more The SARS-CoV-2-infection can be seen as a single disease but also affects patients with relevant comorbidities who may have an increased risk of a severe course of infection. In this report, we present a 77-year old patient with a heart transplant under relevant immunosuppressive therapy who was tested positive for SARS-CoV-2 after several days of dyspnoea, dry cough and light general symptoms. The CTscan confirmed an interstitial pneumonia. The patient received an antiviral therapy with hydroxychloroquine showing no further deterioration of the clinical state. After 12 days of hospitalisation the patient was released SARS-CoV-2 negative and completely asymptomatic.
The SARS-CoV-2-infection can be seen as a single disease but also affects patients with relevant ... more The SARS-CoV-2-infection can be seen as a single disease but also affects patients with relevant comorbidities who may have an increased risk of a severe course of infection. In this report, we present a 77-year old patient with a heart transplant under relevant immunosuppressive therapy who was tested positive for SARS-CoV-2 after several days of dyspnoea, dry cough and light general symptoms. The CTscan confirmed an interstitial pneumonia. The patient received an antiviral therapy with hydroxychloroquine showing no further deterioration of the clinical state. After 12 days of hospitalisation the patient was released SARS-CoV-2 negative and completely asymptomatic.
Typhoidal and para-typhoidal Salmonella are major causes of bacteraemia in resource-limited count... more Typhoidal and para-typhoidal Salmonella are major causes of bacteraemia in resource-limited countries. Diagnostic alternatives to laborious and resource-demanding serotyping are essential. Fourier transform infrared spectroscopy (FTIRS) is a rapidly developing and simple bacterial typing technology. In this study, we assessed the discriminatory power of the FTIRS-based IR Biotyper (Bruker Daltonik GmbH, Bremen, Germany), for the rapid and reliable identification of biochemically confirmed typhoid and paratyphoid fever-associated Salmonella isolates. In total, 359 isolates, comprising 30 S. Typhi, 23 S. Paratyphi A, 23 S. Paratyphi B, and 7 S. Paratyphi C, respectively and other phylogenetically closely related Salmonella serovars belonging to the serogroups O:2, O:4, O:7 and O:9 were tested. The strains were derived from clinical, environmental and food samples collected at different European sites. Applying artificial neural networks, specific automated classifiers were built to di...
The suitability of incubated blood culture material for forensic molecular malaria diagnosis was ... more The suitability of incubated blood culture material for forensic molecular malaria diagnosis was assessed for non-endemic settings for cases in which the differential diagnosis malaria was initially overlooked. For the proof-of-principle assessment, residual blood culture materials from febrile patients from tropical Ghana were investigated by real-time PCR and compared with available historic microscopic results. In 2114 samples, for which microscopical results and real-time PCR results were available, microscopical results comprised 711 P. falciparum detections, 7 P. malariae detections, 1 microscopically not-further-discriminable Plasmodium spp. detection as well as 13 detections of mixed infections comprising 12 cases of P. falciparum/P. malariae co-infections and 1 case of a P. falciparum/P. ovale complex co-infection, while real-PCR indicated 558 P. falciparum detections, 95 P. malariae detections, 10 P. ovale complex detections, 1 P. vivax detection and 4 detected P. falcipar...
Two months after a vacation in Thailand, a 54-year-old alcohol-addicted diabetes patient was admi... more Two months after a vacation in Thailand, a 54-year-old alcohol-addicted diabetes patient was admitted to hospital presenting with a febrile, therapy-refractory urinary tract infection.Correct identification at the species level was achieved by 16S rRNA gene sequencing. Postmortem,Biochemical differentiation of bacteria of the genus
Background: Human brucellosis is characterized by focal complications, chronic courses, and thera... more Background: Human brucellosis is characterized by focal complications, chronic courses, and therapeutic failures. Methods: In a relapsed case of brucellosis after shortterm antibiotic therapy using doxycycline and ciprofl oxacin two Brucella strains were isolated, before and after treatment. In vitro susceptibilities of both isolates were determined by E tests ® including a great variety of antibiotics. In a killing rate experiment the bactericidal activities of doxycycline, streptomycin, rifampin and ciprofl oxacin as single agents and in combinations were determined. Results: Lowest MIC values were measured for doxycycline and ciprofl oxacin. MICs did not change under therapy. Streptomycin alone exhibited the most effective killing within 6 h, whereas the other single Received: September 23, 2004 Accepted after revision: May 2, 2005 Published online: October 14, 2005 Sascha Al Dahouk, MD Bundeswehr Institute of Microbiology, Department of Bacteriology Neuherbergstrasse 11, DE–8093...
In western and eastern Africa, rickettsioses are one cause of fever in humans. Little is known re... more In western and eastern Africa, rickettsioses are one cause of fever in humans. Little is known regarding the presence of Rickettsia sp. in northern Cameroon. The present work was conducted in order to identify potential tick-borne spotted fever group Rickettsia in the Adamawa region of northern Cameroon, which may contribute filling some of the knowledge gaps of these pathogens. Ticks were collected from cattle in the municipal slaughterhouse of Ngaoundere in the Adamawa region of northern Cameroon. After morphological identification of tick species, extracted DNA was analyzed by PCR targeting the rickettsial ompB gene and the intergenic spacers dksA-xerC, mppA-purC and rpmE-tRNAfMet. Of the 316 adult ticks collected, 149 (47.1%) were Amblyomma variegatum, 92 (29%) Rhipicephalus spp. and 75 (23.7%) Hyalomma spp. Through the use of conventional PCR assays for the rickettsial ompB gene, rickettsial DNA was detected in 104 (32.9%) samples (85 Amblyomma sp., 14 Hyalomma spp. and 5 Rhipicephalus spp.). The ompB gene and the three intergenic were sequenced for 10 ticks in order to determine the rickettsial species. Rickettsia africae was detected in Amblyomma variegatum, Rickettsia aeschlimannii in Hyalomma rufipes and Hyalomma truncatum, Rickettsia sibirica in H. truncatum, Rickettsia massiliae in Rhipicephalus lunulatus and Candidatus Rickettsia barbariae in R. lunulatus. To the best of the author's knowledge, this report represents the first molecular evidence of rickettsial infection in ticks in the Adamawa region of northern Cameroon, which suggests a possible exposure of the human population in this region.
Background The relevance of Cryptosporidium infections for the burden of childhood diarrhoea in e... more Background The relevance of Cryptosporidium infections for the burden of childhood diarrhoea in endemic settings has been shown in recent years. This study describes Cryptosporidium subtypes among symptomatic and asymptomatic children in rural Ghana to analyse subtypespecific demographic, geographical, seasonal and clinical differences in order to inform appropriate control measures in endemic areas. Methodology/Principal Findings Stool samples were collected from 2232 children below 14 years of age presenting with and without gastrointestinal symptoms at the Agogo Presbyterian Hospital in the rural Ashanti region of Ghana between May 2007 and September 2008. Samples were screened for Cryptosporidium spp. by PCR and isolates were classified into subtypes based on sequence differences in the gp60 gene. Subtype specific frequencies for age, sex, location and season have been determined and associations with disease symptoms have been analysed within a case-control study. Cryptosporidium infections were diagnosed in 116 of 2232 (5.2%) stool samples. Subtyping of 88 isolates revealed IIcA5G3 (n = 26, 29.6%), IbA13G3 (n = 17, 19.3%) and IaA21R3 (n = 12, 13.6%) as the three most frequent subtypes of the two species C. hominis and C. parvum, known to be transmitted anthroponotically. Infections peak at early rainy season with 67.9% and 50.0% of infections during the months April, May and June for 2007 and 2008 respectively. C. hominis infection was mainly associated with diarrhoea (odds ratio [OR] = 2.4; 95% confidence interval [CI]: 1.2-4.9) whereas C. parvum infection was associated with both diarrhoea (OR = 2.6; CI: 1.2-5.8) and vomiting (OR = 3.1; 95% CI: 1.5-6.1).
ZusammenfassungEin 54-jähriger Diabetespatient mit bekanntem Alkoholabusus wurde mit therapierefr... more ZusammenfassungEin 54-jähriger Diabetespatient mit bekanntem Alkoholabusus wurde mit therapierefraktärem, fieberhaftem Harnwegsinfekt nach Thailandaufenthalt stationär aufgenommen. Nach Fehldiagnose vonDie korrekte Spezies-Identifizierung erfolgte durch 16S rRNA-Gen-Sequenzierung. Zudem gelangDie biochemische Differenzierung von Bakterien des Genus
To perform PCR from serum for the diagnosis of visceral leishmaniasis is convenient and much less... more To perform PCR from serum for the diagnosis of visceral leishmaniasis is convenient and much less invasive than the examination of deeper compartments such as bone marrow. We compared three Leishmania-specific real-time PCRs with three different molecular targets (kinetoplast DNA, the small subunit-ribosomal RNA-(ssrRNA-)gene, the glucose-6-phosphate isomerase-(gpi-)gene) regarding their sensitivity and specificity in human serum. Residual sera from previous diagnostic assessments at the German National Reference Center for Tropical Pathogens Bernhard Nocht Institute for Tropical Medicine Hamburg and the Swiss Tropical and Public Health Institute were used. The sensitivities of kinetoplast DNA-PCR, ssrRNA-gene PCR, and gpi-PCR were 93.3%, 73.3%, and 33.3%, respectively, with 15 initial serum samples from visceral leishmaniasis patients, as well as 9.1%, 9.1%, and 0.0%, respectively, with 11 follow-up serum samples taken at various time points following anti-leishmanial therapy. Spec...
Rickettsiae may cause febrile infections in humans in tropical and subtropical regions. From Mada... more Rickettsiae may cause febrile infections in humans in tropical and subtropical regions. From Madagascar, no molecular data on the role of rickettsioses in febrile patients are available. Blood samples from patients presenting with fever in the area of the capital Antananarivo were screened for the presence of rickettsial DNA. EDTA (ethylenediaminetetraacetic acid) blood from 1020 patients presenting with pyrexia > 38.5 °C was analyzed by gltA-specific qPCR. Positive samples were confirmed by ompB-specific qPCR. From confirmed samples, the gltA amplicons were sequenced and subjected to phylogenetic analysis. From five gltA-reactive samples, two were confirmed by ompB-specific qPCR. The gltA sequence in the sample taken from a 38-year-old female showed 100% homology with R. typhi. The other sample taken from a 1.5-year-old infant was 100% homologous to R. felis. Tick-borne rickettsiae were not identified. The overall rate of febrile patients with molecular evidence for a rickettsia...
The study was performed to provide an overview of the molecular epidemiology of carbapenem-resist... more The study was performed to provide an overview of the molecular epidemiology of carbapenem-resistant Acinetobacter baumannii in Afghanistan isolated by the German military medical service during the Afghanistan conflict. A total of 18 isolates were collected between 2012 and 2018 at the microbiological laboratory of the field hospital in Camp Marmal near Mazar-e Sharif, Afghanistan, from Afghan patients. The isolates were subjected to phenotypic and genotypic differentiation and antimicrobial susceptibility testing as well as to a core genome multi-locus sequence typing (cgMLST) approach based on whole-genome next-generation sequence (wgNGS) data. Next to several sporadic isolates, four transmission clusters comprising strains from the international clonal lineages IC1, IC2, and IC9 were identified. Acquired carbapenem resistance was due to blaOXA-23 in 17/18 isolates, while genes mediating resistance against sulfonamides, macrolides, tetracyclines, and aminoglycosides were frequent...
The application of modern PCR approaches for the diagnosis of bacterial gastrointestinal pathogen... more The application of modern PCR approaches for the diagnosis of bacterial gastrointestinal pathogens is on the rise due to their rapidly available results combined with high sensitivity. While multiple studies describe the ongoing implementation of this technique for routine diagnostic purposes in laboratories in Western industrialized countries, reports on successful and also sustainable respective approaches in resource-poor tropical settings are still scarce. In order to shed light on potential reasons for this marked discrepancy, this narrative review summarizes identified challenges for the application of diagnostic PCR targeting bacterial gastrointestinal pathogens from stool samples in the tropics. The identified and discussed issues comprise the lack of generally accepted definitions for (1) minimum standards regarding sample acquisition, storage and transport time for diagnostic PCR analyses in the tropics, (2) nucleic acid extraction standards allowing an optimum detection o...
Since 1990 the number of glanders outbreaks in race, military and pleasure horses in Asia and Sou... more Since 1990 the number of glanders outbreaks in race, military and pleasure horses in Asia and South America is steadily increasing. Glanders, which is eradicated in Western Europe, Australia and Northern America, is currently considered a re-emerging disease. Consequently, the disease may be introduced into glanders-free regions by subclinical carriers at any time. The causative agent of glanders, Burkholderia (B.) mallei, is highly contagious and leads to chronic disease in horses whereas in donkeys and mules the disease is acute and often fatal. Occurrence of the disease leads to international trading restrictions and infected animals immediately have to be culled and safely disposed off. In humans B. mallei infection results in a severe clinical course, and is fatal without appropriate therapy. Its pathogenicity makes B. mallei a potential biological agent that may be used in bioterroristic attacks. Due to the eradication of glanders in the second half of the last century, veterinarians in western European countries are no longer familiar with its clinical presentation in solipeds. Having these facts in mind, this review describes the epidemiology, clinical signs, pathology and the current eradication strategy of this interesting zoonosis. Pictures of imported endurance horses infected with glanders taken during an eradication campaign in Dubai, United Arab Emirates, in 2004 illustrate most typical clinical findings.
Both Schistosoma spp. (species) and Leishmania spp. are prevalent in Ghana in West Africa. Howeve... more Both Schistosoma spp. (species) and Leishmania spp. are prevalent in Ghana in West Africa. However, little is known about their local occurrence in immunocompromised individuals. In the study presented here, the real-time PCR-(polymerase chain reaction-)based screening for repetitive DNA (deoxyribonucleotide acid) sequences from the genomes of Leishmania (L.) spp. and Schistosoma (S.) spp. was performed in the serum of HIV-(human immunodeficiency virus-)infected Ghanaian patients. In 1083 assessed serum samples from HIV-positive and HIV-negative Ghanian patients, Leishmania spp.-specific DNA was not detected, while the diagnostic accuracy-adjusted prevalence estimation suggested a 3.6% prevalence of the S. mansoni complex and a 0.5% prevalence of the S. haematobium complex. Associations of schistosomiasis with younger age, as well as with the male sex, could be shown but not with an HIV status. Weakly significant signals for the associations of schistosomiasis with an increased vira...
Supporting Information Table S1. Primers used for PCR screening of nasal S. aureus isolates obtai... more Supporting Information Table S1. Primers used for PCR screening of nasal S. aureus isolates obtained from Madagascan students and healthcare workers. (PDF 73Â kb)
Figure S1. Most commonly reported reasons for new medical consultations during the study interval... more Figure S1. Most commonly reported reasons for new medical consultations during the study interval for non-EUTM missions. Figure S2. Variation in the crude rate of reported disease categories year by year for non-EUTM missions. Figure S3. Variation in reported infectious disease events by category and year for non-EUTM missions. Figure S4. Variation in reported specific infectious diseases events by calendar week for non-EUTM missions. Figure S5. Reports of confirmed diseases in EUTM MLI during the study period. (DOC 2979 kb)
The SARS-CoV-2-infection can be seen as a single disease but also affects patients with relevant ... more The SARS-CoV-2-infection can be seen as a single disease but also affects patients with relevant comorbidities who may have an increased risk of a severe course of infection. In this report, we present a 77-year old patient with a heart transplant under relevant immunosuppressive therapy who was tested positive for SARS-CoV-2 after several days of dyspnoea, dry cough and light general symptoms. The CTscan confirmed an interstitial pneumonia. The patient received an antiviral therapy with hydroxychloroquine showing no further deterioration of the clinical state. After 12 days of hospitalisation the patient was released SARS-CoV-2 negative and completely asymptomatic.
The SARS-CoV-2-infection can be seen as a single disease but also affects patients with relevant ... more The SARS-CoV-2-infection can be seen as a single disease but also affects patients with relevant comorbidities who may have an increased risk of a severe course of infection. In this report, we present a 77-year old patient with a heart transplant under relevant immunosuppressive therapy who was tested positive for SARS-CoV-2 after several days of dyspnoea, dry cough and light general symptoms. The CTscan confirmed an interstitial pneumonia. The patient received an antiviral therapy with hydroxychloroquine showing no further deterioration of the clinical state. After 12 days of hospitalisation the patient was released SARS-CoV-2 negative and completely asymptomatic.
Typhoidal and para-typhoidal Salmonella are major causes of bacteraemia in resource-limited count... more Typhoidal and para-typhoidal Salmonella are major causes of bacteraemia in resource-limited countries. Diagnostic alternatives to laborious and resource-demanding serotyping are essential. Fourier transform infrared spectroscopy (FTIRS) is a rapidly developing and simple bacterial typing technology. In this study, we assessed the discriminatory power of the FTIRS-based IR Biotyper (Bruker Daltonik GmbH, Bremen, Germany), for the rapid and reliable identification of biochemically confirmed typhoid and paratyphoid fever-associated Salmonella isolates. In total, 359 isolates, comprising 30 S. Typhi, 23 S. Paratyphi A, 23 S. Paratyphi B, and 7 S. Paratyphi C, respectively and other phylogenetically closely related Salmonella serovars belonging to the serogroups O:2, O:4, O:7 and O:9 were tested. The strains were derived from clinical, environmental and food samples collected at different European sites. Applying artificial neural networks, specific automated classifiers were built to di...
The suitability of incubated blood culture material for forensic molecular malaria diagnosis was ... more The suitability of incubated blood culture material for forensic molecular malaria diagnosis was assessed for non-endemic settings for cases in which the differential diagnosis malaria was initially overlooked. For the proof-of-principle assessment, residual blood culture materials from febrile patients from tropical Ghana were investigated by real-time PCR and compared with available historic microscopic results. In 2114 samples, for which microscopical results and real-time PCR results were available, microscopical results comprised 711 P. falciparum detections, 7 P. malariae detections, 1 microscopically not-further-discriminable Plasmodium spp. detection as well as 13 detections of mixed infections comprising 12 cases of P. falciparum/P. malariae co-infections and 1 case of a P. falciparum/P. ovale complex co-infection, while real-PCR indicated 558 P. falciparum detections, 95 P. malariae detections, 10 P. ovale complex detections, 1 P. vivax detection and 4 detected P. falcipar...
Two months after a vacation in Thailand, a 54-year-old alcohol-addicted diabetes patient was admi... more Two months after a vacation in Thailand, a 54-year-old alcohol-addicted diabetes patient was admitted to hospital presenting with a febrile, therapy-refractory urinary tract infection.Correct identification at the species level was achieved by 16S rRNA gene sequencing. Postmortem,Biochemical differentiation of bacteria of the genus
Background: Human brucellosis is characterized by focal complications, chronic courses, and thera... more Background: Human brucellosis is characterized by focal complications, chronic courses, and therapeutic failures. Methods: In a relapsed case of brucellosis after shortterm antibiotic therapy using doxycycline and ciprofl oxacin two Brucella strains were isolated, before and after treatment. In vitro susceptibilities of both isolates were determined by E tests ® including a great variety of antibiotics. In a killing rate experiment the bactericidal activities of doxycycline, streptomycin, rifampin and ciprofl oxacin as single agents and in combinations were determined. Results: Lowest MIC values were measured for doxycycline and ciprofl oxacin. MICs did not change under therapy. Streptomycin alone exhibited the most effective killing within 6 h, whereas the other single Received: September 23, 2004 Accepted after revision: May 2, 2005 Published online: October 14, 2005 Sascha Al Dahouk, MD Bundeswehr Institute of Microbiology, Department of Bacteriology Neuherbergstrasse 11, DE–8093...
In western and eastern Africa, rickettsioses are one cause of fever in humans. Little is known re... more In western and eastern Africa, rickettsioses are one cause of fever in humans. Little is known regarding the presence of Rickettsia sp. in northern Cameroon. The present work was conducted in order to identify potential tick-borne spotted fever group Rickettsia in the Adamawa region of northern Cameroon, which may contribute filling some of the knowledge gaps of these pathogens. Ticks were collected from cattle in the municipal slaughterhouse of Ngaoundere in the Adamawa region of northern Cameroon. After morphological identification of tick species, extracted DNA was analyzed by PCR targeting the rickettsial ompB gene and the intergenic spacers dksA-xerC, mppA-purC and rpmE-tRNAfMet. Of the 316 adult ticks collected, 149 (47.1%) were Amblyomma variegatum, 92 (29%) Rhipicephalus spp. and 75 (23.7%) Hyalomma spp. Through the use of conventional PCR assays for the rickettsial ompB gene, rickettsial DNA was detected in 104 (32.9%) samples (85 Amblyomma sp., 14 Hyalomma spp. and 5 Rhipicephalus spp.). The ompB gene and the three intergenic were sequenced for 10 ticks in order to determine the rickettsial species. Rickettsia africae was detected in Amblyomma variegatum, Rickettsia aeschlimannii in Hyalomma rufipes and Hyalomma truncatum, Rickettsia sibirica in H. truncatum, Rickettsia massiliae in Rhipicephalus lunulatus and Candidatus Rickettsia barbariae in R. lunulatus. To the best of the author's knowledge, this report represents the first molecular evidence of rickettsial infection in ticks in the Adamawa region of northern Cameroon, which suggests a possible exposure of the human population in this region.
Background The relevance of Cryptosporidium infections for the burden of childhood diarrhoea in e... more Background The relevance of Cryptosporidium infections for the burden of childhood diarrhoea in endemic settings has been shown in recent years. This study describes Cryptosporidium subtypes among symptomatic and asymptomatic children in rural Ghana to analyse subtypespecific demographic, geographical, seasonal and clinical differences in order to inform appropriate control measures in endemic areas. Methodology/Principal Findings Stool samples were collected from 2232 children below 14 years of age presenting with and without gastrointestinal symptoms at the Agogo Presbyterian Hospital in the rural Ashanti region of Ghana between May 2007 and September 2008. Samples were screened for Cryptosporidium spp. by PCR and isolates were classified into subtypes based on sequence differences in the gp60 gene. Subtype specific frequencies for age, sex, location and season have been determined and associations with disease symptoms have been analysed within a case-control study. Cryptosporidium infections were diagnosed in 116 of 2232 (5.2%) stool samples. Subtyping of 88 isolates revealed IIcA5G3 (n = 26, 29.6%), IbA13G3 (n = 17, 19.3%) and IaA21R3 (n = 12, 13.6%) as the three most frequent subtypes of the two species C. hominis and C. parvum, known to be transmitted anthroponotically. Infections peak at early rainy season with 67.9% and 50.0% of infections during the months April, May and June for 2007 and 2008 respectively. C. hominis infection was mainly associated with diarrhoea (odds ratio [OR] = 2.4; 95% confidence interval [CI]: 1.2-4.9) whereas C. parvum infection was associated with both diarrhoea (OR = 2.6; CI: 1.2-5.8) and vomiting (OR = 3.1; 95% CI: 1.5-6.1).
ZusammenfassungEin 54-jähriger Diabetespatient mit bekanntem Alkoholabusus wurde mit therapierefr... more ZusammenfassungEin 54-jähriger Diabetespatient mit bekanntem Alkoholabusus wurde mit therapierefraktärem, fieberhaftem Harnwegsinfekt nach Thailandaufenthalt stationär aufgenommen. Nach Fehldiagnose vonDie korrekte Spezies-Identifizierung erfolgte durch 16S rRNA-Gen-Sequenzierung. Zudem gelangDie biochemische Differenzierung von Bakterien des Genus
To perform PCR from serum for the diagnosis of visceral leishmaniasis is convenient and much less... more To perform PCR from serum for the diagnosis of visceral leishmaniasis is convenient and much less invasive than the examination of deeper compartments such as bone marrow. We compared three Leishmania-specific real-time PCRs with three different molecular targets (kinetoplast DNA, the small subunit-ribosomal RNA-(ssrRNA-)gene, the glucose-6-phosphate isomerase-(gpi-)gene) regarding their sensitivity and specificity in human serum. Residual sera from previous diagnostic assessments at the German National Reference Center for Tropical Pathogens Bernhard Nocht Institute for Tropical Medicine Hamburg and the Swiss Tropical and Public Health Institute were used. The sensitivities of kinetoplast DNA-PCR, ssrRNA-gene PCR, and gpi-PCR were 93.3%, 73.3%, and 33.3%, respectively, with 15 initial serum samples from visceral leishmaniasis patients, as well as 9.1%, 9.1%, and 0.0%, respectively, with 11 follow-up serum samples taken at various time points following anti-leishmanial therapy. Spec...
Rickettsiae may cause febrile infections in humans in tropical and subtropical regions. From Mada... more Rickettsiae may cause febrile infections in humans in tropical and subtropical regions. From Madagascar, no molecular data on the role of rickettsioses in febrile patients are available. Blood samples from patients presenting with fever in the area of the capital Antananarivo were screened for the presence of rickettsial DNA. EDTA (ethylenediaminetetraacetic acid) blood from 1020 patients presenting with pyrexia > 38.5 °C was analyzed by gltA-specific qPCR. Positive samples were confirmed by ompB-specific qPCR. From confirmed samples, the gltA amplicons were sequenced and subjected to phylogenetic analysis. From five gltA-reactive samples, two were confirmed by ompB-specific qPCR. The gltA sequence in the sample taken from a 38-year-old female showed 100% homology with R. typhi. The other sample taken from a 1.5-year-old infant was 100% homologous to R. felis. Tick-borne rickettsiae were not identified. The overall rate of febrile patients with molecular evidence for a rickettsia...
The study was performed to provide an overview of the molecular epidemiology of carbapenem-resist... more The study was performed to provide an overview of the molecular epidemiology of carbapenem-resistant Acinetobacter baumannii in Afghanistan isolated by the German military medical service during the Afghanistan conflict. A total of 18 isolates were collected between 2012 and 2018 at the microbiological laboratory of the field hospital in Camp Marmal near Mazar-e Sharif, Afghanistan, from Afghan patients. The isolates were subjected to phenotypic and genotypic differentiation and antimicrobial susceptibility testing as well as to a core genome multi-locus sequence typing (cgMLST) approach based on whole-genome next-generation sequence (wgNGS) data. Next to several sporadic isolates, four transmission clusters comprising strains from the international clonal lineages IC1, IC2, and IC9 were identified. Acquired carbapenem resistance was due to blaOXA-23 in 17/18 isolates, while genes mediating resistance against sulfonamides, macrolides, tetracyclines, and aminoglycosides were frequent...
The application of modern PCR approaches for the diagnosis of bacterial gastrointestinal pathogen... more The application of modern PCR approaches for the diagnosis of bacterial gastrointestinal pathogens is on the rise due to their rapidly available results combined with high sensitivity. While multiple studies describe the ongoing implementation of this technique for routine diagnostic purposes in laboratories in Western industrialized countries, reports on successful and also sustainable respective approaches in resource-poor tropical settings are still scarce. In order to shed light on potential reasons for this marked discrepancy, this narrative review summarizes identified challenges for the application of diagnostic PCR targeting bacterial gastrointestinal pathogens from stool samples in the tropics. The identified and discussed issues comprise the lack of generally accepted definitions for (1) minimum standards regarding sample acquisition, storage and transport time for diagnostic PCR analyses in the tropics, (2) nucleic acid extraction standards allowing an optimum detection o...
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