Publikationen

@article{Kramer.2022,

title = {Ethanol is indispensable for virucidal hand antisepsis: memorandum from the alcohol-based hand rub (ABHR) Task Force, WHO Collaborating Centre on Patient Safety, and the Commission for Hospital Hygiene and Infection Prevention (KRINKO), Robert Koch Institute, Berlin, Germany},

author = {A Kramer and M Arvand and B Christiansen and S Dancer and M Eggers and M Exner and D M\"{u}ller and NT Mutters and I Schwebke and D Pittet},

doi = {10.1186/s13756-022-01134-7},

year  = {2022},

date = {2022-07-06},

urldate = {2022-01-01},

journal = {Antimicrobial resistance and infection control},

volume = {11},

number = {1},

pages = {93},

abstract = {BACKGROUND 

 

The approval of ethanol by the Biocidal Products Regulation has been under evaluation since 2007. This follows concern over alcohol uptake from ethanol-based hand rubs (EBHR). If ethanol is classified as carcinogenic, mutagenic, or reprotoxic by the European Chemicals Agency (ECHA), then this would affect infection prevention and control practices. 

 

AIM 

 

A review was performed to prove that ethanol is toxicological uncritical and indispensable for hand antisepsis because of its unique activity against non-enveloped viruses and thus the resulting lack of alternatives. Therefore, the following main points are analyzed: The effectiveness of ethanol in hand hygiene, the evidence of ethanol at blood/tissue levels through hand hygiene in healthcare, and the evidence of toxicity of different blood/tissue ethanol levels and the non-comparability with alcoholic consumption and industrial exposure. 

 

RESULTS 

 

EBHR are essential for preventing infections caused by non-enveloped viruses, especially in healthcare, nursing homes, food industry and other areas. Propanols are effective against enveloped viruses as opposed to non-enveloped viruses but there are no other alternatives for virucidal hand antisepsis. Long-term ingestion of ethanol in the form of alcoholic beverages can cause tumours. However, lifetime exposure to ethanol from occupational exposure textless 500~ppm does not significantly contribute to the cancer risk. Mutagenic effects were observed only at doses within the toxic range in animal studies. While reprotoxicity is linked with abuse of alcoholic beverages, there is no epidemiological evidence for this from EBHR use in healthcare facilities or from products containing ethanol in non-healthcare settings. 

 

CONCLUSION 

 

The body of evidence shows EBHRs have strong efficacy in killing non-enveloped viruses, whereas 1-propanol and 2-propanol do not kill non-enveloped viruses, that pose significant risk of infection. Ethanol absorbed through the skin during hand hygiene is similar to consumption of beverages with hidden ethanol content (textless 0.5% v/v), such as apple juice or kefir. There is no risk of carcinogenicity, mutagenicity or reprotoxicity from repeated use of EBHR. Hence, the WHO Task Force strongly recommend retaining ethanol as an essential constituent in hand rubs for healthcare.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kramer.2022b,

title = {Recommendation of the German Society of Hospital Hygiene (DGKH): Prevention of COVID-19 by virucidal gargling and virucidal nasal spray -- updated version April 2022},

author = {A Kramer and M Eggers and M Exner and N-O H\"{u}bner and A Simon and E Steinmann and P Walger and P Zwicker},

doi = {10.3205/dgkh000416},

year  = {2022},

date = {2022-07-01},

urldate = {2022-01-01},

journal = {GMS Hygiene and Infection Control},

volume = {17},

issue = {Doc13},

abstract = {The German Society of Hospital Hygiene develops guidelines, recommendations and standard operation procedures on a voluntary basis, published on the DGKH-website ([link:https://www.krankenhaushygiene.de/*https://www.krankenhaushygiene.de/]). 

 

 

 

The original German version of this recommendation was published in April 2022 and has now been made available to the international professional public in English. Evaluating the current data on the efficacy of virucidal gargle/mouthwash solutions and nasal sprays against SARS-CoV-2 in vitro and in clinical trials, conducted with preventive or therapeutic objectives, recommendations are given for the prevention of COVID-19. The following areas are considered: 

 

 

 

Protection of the community when regional clusters or high incidences of infection become known Protection of the community at low risk of infection Pre-exposure prophylaxis for the protection of healthcare workers Post-exposure prophylaxis 

 

Die Deutsche Gesellschaft f\"{u}r Krankenhaushygiene (DGKH) erarbeitet Leitlinien, Empfehlungen und Standardarbeitsanweisungen auf freiwilliger Basis, die auf der DGKH-Website ver\"{o}ffentlicht werden ([link:https://www.krankenhaushygiene.de/*https://www.krankenhaushygiene.de/]). 

 

 

 

Die deutsche Originalfassung dieser Empfehlung wurde im April 2022 ver\"{o}ffentlicht und wird jetzt auf Englisch der internationalen Fach\"{o}ffentlichkeit zur Verf\"{u}gung gestellt. In Auswertung der aktuellen Datenlage zur Wirksamkeit viruzider Gurgel-/Mundsp\"{u}ll\"{o}sungen und Nasensprays gegen SARS-CoV-2 in vitro und in klinischen Studien, die mit pr\"{a}ventiver oder therapeutischer Zielsetzung durchgef\"{u}hrt wurden, werden Empfehlungen zur Pr\"{a}vention von COVID-19 gegeben. Dabei werden folgende Bereiche ber\"{u}cksichtigt: 

 

 

 

Schutz der Bev\"{o}lkerung bei Bekanntwerden regionaler Cluster oder hohem Infektionsgeschehen Schutz der Bev\"{o}lkerung bei geringem Infektionsrisiko Pr\"{a}expositionsprophylaxe zum Schutz des Personals im Gesundheitswesen Postexpositionsprophylaxe},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Eggers.2022,

title = {Antiviral activity of plant juices and green tea against SARS-CoV-2 and influenza virus},

author = {M Eggers and P Jungke and V Wolkinger and R Bauer and U Kessler and B Frank},

doi = {10.1002/ptr.7431},

issn = {0951-418X},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Phytotherapy Research},

abstract = {Phytotherapy Research 2021.0},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Eggers.2021b,

title = {Desinfektionsmittel in der COVID-19-Pandemie: eine Herausforderung},

author = {M Eggers and A Baumann and N Lilienthal and E Steinmann and J Steinmann and NO H\"{u}bner and HF Rabenau and V Weinheimer and I Schwebke},

doi = {10.1007/s00103-021-03457-z},

issn = {1436-9990},

year  = {2021},

date = {2021-11-03},

urldate = {2021-01-01},

journal = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz},

abstract = {Disinfection measures have become more important as a~result of the COVID-19 pandemic in Germany. The increased need for disinfectants at the beginning of the pandemic required temporary legal regulations in order to provide a~sufficient quantity of products for the necessary disinfection in the medical sector on the one hand and for the additional demand in the population on the other. For this purpose, the Federal Institute for Drugs and Medical Devices (BfArM) and the Federal Institute for Occupational Safety and Health (BAuA) issued a general ruling, which is explained in more detail in this article. The focus was on measures for hygienic hand disinfection. However, other applications such as surface disinfection in relation to pandemic respiratory diseases are also addressed. The experience gained in ensuring the supply of disinfectants that are effective and safe to use should be used to prepare for further pandemics. 

 

ZUSAMMENFASSUNG 

 

Durch die COVID-19-Pandemie haben Desinfektionsma\ssnahmen auch in Deutschland an Bedeutung gewonnen. Der erh\"{o}hte Bedarf an Desinfektionsmitteln zu Beginn der Pandemie erforderte es, vor\"{u}bergehende rechtliche Regelungen zu treffen, um einerseits ausreichend Mittel f\"{u}r die notwendige Desinfektion im medizinischen Bereich und andererseits f\"{u}r den zus\"{a}tzlichen Bedarf in der Bev\"{o}lkerung zur Verf\"{u}gung zu haben. Dazu wurden vom Bundesinstitut f\"{u}r Arzneimittel und Medizinprodukte (BfArM) und der Bundesanstalt f\"{u}r Arbeitsschutz und Arbeitsmedizin (BAuA) Allgemeinverf\"{u}gungen erlassen, die in diesem Beitrag n\"{a}her erl\"{a}utert werden. Im Vordergrund stehen dabei die Ma\ssnahmen f\"{u}r die hygienische H\"{a}ndedesinfektion. Aber auch weitere Anwendungen wie die Fl\"{a}chendesinfektion im Zusammenhang mit pandemischen Atemwegserkrankungen werden er\"{o}rtert. Die Erfahrungen bei der Sicherstellung der Versorgung mit wirksamen und in der Anwendung sicheren Desinfektionsmitteln sollten f\"{u}r die Vorbereitung weiterer Pandemien genutzt werden.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hufbauer.2021b,

title = {Inactivation of Polyomavirus SV40 as Surrogate for Human Papillomaviruses by Chemical Disinfectants},

author = {M Hufbauer and U Wieland and J Gebel and J Steinmann and B Akg\"{u}l and M Eggers},

doi = {10.3390/v13112207},

year  = {2021},

date = {2021-11-02},

urldate = {2021-01-01},

journal = {Viruses},

volume = {13},

number = {11},

pages = {2207},

abstract = {Human papillomaviruses (HPV) are non-enveloped DNA viruses infecting cutaneous and mucosal squamous epithelia. Sexually transmitted HPV-types that are carcinogenic to humans such as HPV16 can induce cervical and other anogenital cancers. Virus transmission through fomites such as inadequately disinfected gynecological equipment is a further potential transmission route. Since HPV cannot be easily grown in cell culture, polyomavirus SV40 has been used as a surrogate virus when testing the virucidal activity of chemical disinfectants. So far, studies that have compared the virucidal activity of different disinfectants against HPV and SV40 are lacking. Here, we evaluated the susceptibility of HPV16 pseudovirus and SV40 to seven active biocidal substances using quantitative suspension tests. Ethanol, glutaraldehyde (GTA), dodecyldipropylentriamin (DPTA), and ortho-phthalaldehydes (OPA) were able to reduce the infectivity of HPV16 pseudovirus textgreater99.99% after 5 min. In contrast, isopropanol, peracetic acid (PAA), and quaternary ammonium compounds with alkylamines (QAC) only led to a slight or no reduction in infectivity. Concerning SV40, only GTA (60 min contact time), PAA, and OPA had virus-inactivating effects. In conclusion, the virucidal activity of three out of seven disinfectants tested was different for HPV16 pseudovirus and SV40. In this study, SV40 was shown to be a reliable surrogate virus for HPV when testing isopropanol-, GTA-, QAC-, and OPA-based disinfectants.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Devlieger.2021,

title = {Serial Monitoring and Hyperimmunoglobulin versus Standard of Care to Prevent Congenital Cytomegalovirus Infection: A Phase III Randomized Trial},

author = {R Devlieger and H Buxmann and G Nigro and M Enders and J J\"{u}ckstock and P Sikl\'{o}s and A Wartenberg-Demand and J Sch\"{u}ttrumpf and J Sch\"{u}tze and N Rippel and M Herbold and G Niemann and K Friese},

doi = {10.1159/000518508},

issn = {1015-3837},

year  = {2021},

date = {2021-10-01},

urldate = {2021-10-01},

journal = {Fetal Diagnosis and Therapy},

pages = {1--13},

abstract = {Introduction: Nonrandomized studies support the potential of cytomegalovirus hyperimmunoglobulin (CMV-HyperIg) in preventing maternofetal CMV transmission, but prospective interventional studies show equivocal results. We pre­sent a prospective phase-III international randomized open-label trial on the potential effect of CMV-HyperIg following serial monitoring of CMV serostatus. Methods: CMV-seronegative pregnant women (gestational age [GA] <14 weeks) were 1:1 randomized to monthly CMV-serostatus monitoring and CMV-HyperIg upon seroconversion (treatment), or routine prenatal care with CMV-serostatus testing at end of pregnancy (control). Ethical considerations required that control subjects with confirmed seroconversion be offered CytotectcircledR. The primary endpoint was the proportion of fetuses/newborns with congenital CMV infection. Secondary endpoints included neonatal CMV disease and safety during the 24-month follow-up. Results: The treatment arm counted 4,800 randomized subjects: 52 seroconverted (median GA 24 [11--35] weeks), of which 45 completed follow-up. The control arm counted 4,735 randomized subjects: 42 seroconverted, of which 34 completed follow-up (evaluable data for 28 newborns) and 8 subjects chose off-label CytotectcircledR. Congenital CMV rates were 13/28 newborns (46.4% [CI 27.51; 66.13]) vs. 16/45 newborns (35.6% [CI 21.87; 51.22]) in control and treated arms, respectively (p = 0.46). Newborn CMV disease was mostly mild and spontaneously resolving. There were no major safety concerns. The target sample was not reached within an acceptable time frame. Conclusions: Serial monitoring of CMV serostatus with CMV-HyperIg treatment was associated with a mild nonsignificant reduction in the vertical CMV transmission rate. Studies on the optimal preventive strategy are hampered by epidemiological and ethical challenges and should focus on GA-dependent transmission rates and accurate dating of infection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Steinhauer.2021,

title = {Virucidal efficacy of different formulations for hand and surface disinfection targeting SARS CoV-2},

author = {K Steinhauer and TL Meister and D Todt and A Krawczyk and L Pa\ssvogel and B Becker and D Paulmann and B Bischoff and M Eggers and S Pfaender and FHH Brill and E Steinmann},

doi = {10.1016/j.jhin.2021.03.015},

year  = {2021},

date = {2021-06-01},

urldate = {2021-11-02},

journal = {The Journal of hospital infection},

volume = {112},

pages = {27-30},

abstract = {In the ongoing SARS CoV-2 pandemic effective disinfection measures are needed, and guidance based on the methodological framework of the European committee for standardization (CEN) can help to choose effective disinfectants on an immediate basis. This study aimed to elucidate whether disinfectants claiming textquotedblvirucidal activity against enveloped virusestextquotedbl as specified in the European Standard EN 14476 as well as in the german national DVV/RKI guideline are effectively inactivating SARS-CoV-2. Two commercially available formulations for surface disinfection and one formulation for hand disinfection were studied regarding their virucidal activity. Based on the data of this study the enveloped SARS-CoV-2 is at least equally susceptible compared to the standard test virus vaccinia used in EN 14476 or DVV/RKI guideline. Thus, chemical disinfectants claiming textquotedblvirucidal activity against enveloped virusestextquotedbl based on EN 14476 or DVV/RKI guideline will be an effective choice to target enveloped SARS-CoV-2 as a preventive measure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kagan.2021,

title = {Outcome of pregnancies with recent primary cytomegalovirus infection in first trimester treated with hyperimmunoglobulin: observational study},

author = {K O Kagan and M Enders and M Hoopmann and A Geipel and C Simonini and C Berg and I Gottschalk and F Faschingbauer and M O Schneider and T Ganzenmueller and K Hamprecht},

doi = {10.1002/uog.23596},

year  = {2021},

date = {2021-01-25},

urldate = {2021-01-25},

journal = {Ultrasound in obstetrics \& gynecology},

volume = {57},

pages = {560-567},

abstract = {OBJECTIVE 

 

In this study we set out to examine the efficacy of the hyperimmunoglobulin (HIG treatment in women with a recent primary CMV infection up to 14 weeks' gestation. 

 

METHODS 

 

Ongoing observational study at the prenatal medicine departments of Tuebingen, Bonn, Cologne and Erlangen, Germany as well as the laboratory Prof. Gisela Enders and Colleagues in Stuttgart, Germany and the Institute for Medical Virology at the University of Tuebingen. Enrollment criteria were the presence of confirmed, very recent primary CMV infection in the first trimester and a gestational age at first HIG administration of $\leq$ 14 weeks. The following inclusion criteria indicated a recent primary infection: low anti-IgG levels, low anti-CMV-IgG avidity in the presence of a positive CMV IgM test and no or just seroconversion anti-gB2-IgG-reactivity. The HIG administration (Cytotect CPcircledR, Biotest, Germany) was started as soon as possible within few days after the first visit in the four units. HIG was administered at 200 IU per kilogram bodyweight intravenously and repeated every two weeks until about 18 weeks' gestation. Maternal-fetal transmission at the time of amniocentesis was considered as relevant primary outcome measure. Multivariate logistic regression analysis was used to determine significant covariates that could be used for the prediction of maternal-fetal transmission. 

 

RESULTS 

 

149 pregnant women and 153 fetuses were treated. Median maternal age and weight was 32.0 years and 65.0 kg, respectively. Median gestational age at the time of the first referral to one of the four centers was 9.4 weeks. Median anti-CMV-IgG levels, the anti-CMV-IgM index and the CMV IgG avidity was 5.7 U/ml, 2.5, and 22.3%, respectively. Treatment with HIG started at a median gestational age of 10.6 weeks and ended at 17.9 weeks. Within this time frame, HIGs were administered on average 4 times. Amniocentesis was carried out at a median gestational age of 20.4 weeks. In 143 (93.6%) of the 153 cases, the fetus was not infected. Maternal-fetal transmission occurred in 10 cases (6.5%, [95% CI 3.2 - 11.7]). In the uni- and multivariate logistic regression analysis, only the level of the anti-IgM index was significantly associated with maternal-fetal transmission at the time of the amniocentesis. However, only four (40.0%) of the 10 cases with maternal-fetal transmission had an anti-IgM level above 11.4 which corresponds to the 95th centile of the pregnancies without transmission. 

 

CONCLUSION 

 

HIG is a treatment option to prevent maternal-fetal transmission in a case of a primary CMV infection. However, treatment is only beneficial in women with a very recent primary infection in the first trimester or during the periconceptional period, a timely start and an appropriate treatment interval. This article is protected by copyright. All rights reserved.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hufbauer.2021,

title = {Inactivation of Polyomavirus SV40 as Surrogate for Human Papillomaviruses by Chemical Disinfectants},

author = {M Hufbauer and U Wieland and J Gebel and J Steinmann and B Akg\"{u}l and M Eggers},

doi = {10.3390/v13112207},

year  = {2021},

date = {2021-01-01},

urldate = {2021-01-01},

journal = {Viruses},

volume = {13},

number = {11},

pages = {2207},

abstract = {Human papillomaviruses (HPV) are non-enveloped DNA viruses infecting cutaneous and mucosal squamous epithelia. Sexually transmitted HPV-types that are carcinogenic to humans such as HPV16 can induce cervical and other anogenital cancers. Virus transmission through fomites such as inadequately disinfected gynecological equipment is a further potential transmission route. Since HPV cannot be easily grown in cell culture, polyomavirus SV40 has been used as a surrogate virus when testing the virucidal activity of chemical disinfectants. So far, studies that have compared the virucidal activity of different disinfectants against HPV and SV40 are lacking. Here, we evaluated the susceptibility of HPV16 pseudovirus and SV40 to seven active biocidal substances using quantitative suspension tests. Ethanol, glutaraldehyde (GTA), dodecyldipropylentriamin (DPTA), and ortho-phthalaldehydes (OPA) were able to reduce the infectivity of HPV16 pseudovirus textgreater99.99% after 5 min. In contrast, isopropanol, peracetic acid (PAA), and quaternary ammonium compounds with alkylamines (QAC) only led to a slight or no reduction in infectivity. Concerning SV40, only GTA (60 min contact time), PAA, and OPA had virus-inactivating effects. In conclusion, the virucidal activity of three out of seven disinfectants tested was different for HPV16 pseudovirus and SV40. In this study, SV40 was shown to be a reliable surrogate virus for HPV when testing isopropanol-, GTA-, QAC-, and OPA-based disinfectants.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Greiner.2021,

title = {Characteristics and mechanisms to control a COVID-19 outbreak on a leukemia and stem cell transplantation unit},

author = {J Greiner and M G\"{o}tz and W Malner-Wagner and C Wendt and M Enders and C Durst and D Michel and S von Harsdorf and S Jung},

doi = {10.1002/cam4.3612},

year  = {2021},

date = {2021-01-01},

urldate = {2021-01-01},

journal = {Cancer medicine},

volume = {10},

number = {1},

pages = {237--246},

abstract = {Immunosuppressed patients like patients with leukemia or lymphoma, but also patients after autologous or allogeneic stem cell transplantation are at particular risk for an infection with COVID-19. We describe a COVID-19 outbreak on our leukemia and stem cell transplantation unit (LSCT-Unit) originating from a patient with newly diagnosed acute myeloid leukemia. The patient was treated with intensive induction chemotherapy and we characterize the subsequent outbreak of COVID-19 on a LSCT-Unit. We describe the characteristics of the 36 contacts among the medical team, the results of their PCR and antibody tests and clinical aspects and features of infected employees. Of these 36 close contacts, 9 employees of the LSCT-Unit were infected and were tested positive by PCR and/or antibody-testing. 8/9 of them were symptomatic, 3/9 with severe, 5/9 with mild symptoms, and one person without symptoms. Due to stringent hygiene measures, the outbreak did not lead to infections of other patients despite ongoing clinical work. Moreover, we demonstrate that incubation period and clinical course of a COVID-19 infection in an immunosuppressed patient could be unusual compared to that of immunocompetent patients. Consistent PCR and antibody testing are helpful to understand, control, and prevent outbreaks. For the safety of health-care workers and patients alike, all employees wore FFP2 masks and were trained to adhere to several further safety guidelines. The implementation of rigorous hygiene measures is the key to controlling an outbreak and preventing infections of other patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Stathis.2021,

title = {Review of the use of nasal and oral antiseptics during a global pandemic},

author = {C Stathis and N Victoria and K Loomis and SA Nguyen and M Eggers and E Septimus and N Safdar},

doi = {10.2217/fmb-2020-0286},

year  = {2021},

date = {2021-01-01},

journal = {Future microbiology},

volume = {16},

number = {2},

pages = {119-130},

abstract = {A review of nasal sprays and gargles with antiviral properties suggests that a number of commonly used antiseptics including povidone-iodine, ListerinecircledR, iota-carrageenan~and chlorhexidine should be studied in clinical trials to mitigate both the progression and transmission of SARS-CoV-2. Several of these antiseptics have demonstrated the ability to cut the viral load of SARS-CoV-2 by 3-4 log10 in 15-30 s~in vitro. In addition, hypertonic saline targets viral replication by increasing hypochlorous acid inside the cell. A number of clinical trials are in process to study these interventions both for prevention of transmission, prophylaxis after exposure, and to diminish progression by reduction of viral load in the early stages of infection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Eggers.2021,

title = {The European tiered approach for virucidal efficacy testing - rationale for rapidly selecting disinfectants against emerging and re-emerging viral diseases},

author = {M Eggers and I Schwebke and M Suchomel and V Fotheringham and J Gebel and B Meyer and G Morace and HJ Roedger and C Roques and P Visa and K Steinhauer},

doi = {10.2807/1560-7917.ES.2021.26.3.2000708},

year  = {2021},

date = {2021-01-01},

journal = {Euro Surveillance},

volume = {26},

number = {3},

pages = {pii=2000708.},

abstract = {When facing an emerging virus outbreak such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a quick reaction time is key to control the spread. It takes time to develop antivirals and vaccines, and implement vaccination campaigns. Therefore, preventive measures such as rapid isolation of cases and identification and early quarantine of cases' close contacts-as well as masks, physical distancing, hand hygiene, surface disinfection and air control-are crucial to reduce the risk of transmission. In this context, disinfectants and antiseptics with proven efficacy against the outbreak virus should be used. However, biocidal formulations are quite complex and may include auxiliary substances such as surfactants or emollients in addition to active substances. In order to evaluate disinfectants' efficacy objectively, meaningful efficacy data are needed. Therefore, the European Committee for Standardisation technical committee 216 'Chemical disinfectants and antiseptics' Working Group 1 (medical area) has developed standards for efficacy testing. The European tiered approach grades the virucidal efficacy in three levels, with corresponding marker test viruses. In the case of SARS-CoV-2, disinfectants with proven activity against vaccinia virus, the marker virus for the European claim 'active against enveloped viruses', should be used to ensure effective hygiene procedures to control the pandemic.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kramer.2021,

title = {Virucidal gargling and virucidal nasal spray},

author = {A Kramer and M Eggers and N H\"{u}bner and P Walger and E Steinmann and M Exner},

doi = {10.3205/DGKH000373},

year  = {2021},

date = {2021-01-01},

journal = {GMS Hygiene and Infection Control},

volume = {16},

number = {Doc02},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Meier.2020,

title = {High reproducibility of the interferon-gamma release assay T-SPOT.TB in serial testing},

author = {T Meier and M Enders},

doi = {10.1007/s10096-020-03997-3},

year  = {2021},

date = {2021-01-01},

journal = {European journal of clinical microbiology \& infectious diseases},

volume = {40},

number = {1},

pages = {85-93},

abstract = {Longitudinal studies regarding the reproducibility of Interferon-gamma release assay (IGRA) T-SPOT.TB for the diagnosis of Mycobacterium tuberculosis (M. tb) infection in serial testing are limited. We retrospectively analysed results of serially tested subjects in a medical laboratory in Germany over a time period of 14~years. From October 2004 to December 2018, a total of 5440 subjects were identified with a second T-SPOT.TB test after a median time interval of 258~days (interquartile range [IQR] 62-665). Consistently negative (n = 4520) or positive results (n = 682) were observed in 5202 (95.6%) subjects, indicating a high degree of concordance in serial testing (textgreekk = 0.83). Test conversions occurred in 101 of 4621 (2.2%) subjects with initially negative tests. Of 819 subjects with initially positive test results, 137 (16.7%) had a test reversion which was associated with low spot numbers of the first test. Of 529 subjects retested within 1~year, only 60 (11.3%) displayed a test reversion. In subjects retested after more than 1~year, 77 of 290 (26.6%) tests reverted. This significantly higher rate of test reversions after more than 1~year was age-dependent and only observed in subjects above the age of 40~years. In the medical laboratory, the T-SPOT.TB test demonstrates a high reproducibility in serial testing.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{ReiterOwona.2020,

title = {Sulfadiazine plasma concentrations in women with pregnancy-acquired compared to ocular toxoplasmosis under pyrimethamine and sulfadiazine therapy: a case-control study},

author = {I Reiter-Owona and H Hlobil and M Enders and U Klarmann-Schulz and B Gruetzmacher and V Rilling and A Hoerauf and J G Garweg},

doi = {10.1186/s40001-020-00458-7},

year  = {2020},

date = {2020-11-23},

journal = {European journal of medical research},

volume = {25},

number = {59},

abstract = {BACKGROUND 

 

Dosing recommendations for the treatment of pregnancy-acquired toxoplasmosis are empirical and widely based on experimental data. There are no pharmacological data on pregnant women with acute Toxoplasma gondii infection under treatment with pyrimethamine (PY) and sulfadiazine (SA) and our study intends to tighten this gap. 

 

METHODS 

 

In this retrospective case-control study, we included 89 pregnant women with primary Toxoplasma infection (PT) treated with PY (50~mg first dose, then 25~mg/day), SA (50~mg/kg of body weight/day), and folinic acid (10-15~mg per week). These were compared to a group of 17 women with acute ocular toxoplasmosis (OT) treated with an initial PY dose of 75~mg, thereafter 25~mg twice a day but on the same SA and folinic acid regimen. The exact interval between drug intake and blood sampling and co-medication had not been recorded. Plasma levels of PY and SA were determined 14 $pm$ 4~days after treatment initiation using liquid chromatography-mass spectrometry and compared using the Mann-Whitney U test at a p textless 0.05 level. 

 

RESULTS 

 In 23 PT patients (26%), SA levels were below 20~mg/l. Fifteen of these 23 patients (17% of all patients) in parallel presented with PY levels below 700~µg/l. Both drug concentrations differed remarkably between individuals and groups (PY: PT median 810~µg/l, 95% CI for the median [745; 917] vs. OT 1230~µg/l [780; 1890], p = 0.006; SA: PT 46.2~mg/l [39.9; 54.4] vs. OT 70.4~mg/l [52.4; 89], p = 0.015) despite an identical SA dosing scheme. 

 

CONCLUSIONS 

 

SA plasma concentrations were found in the median 34% lower in pregnant women with PT compared to OT patients and fell below a lower reference value of 50~mg/l in a substantial portion of PT patients. The interindividual variability of plasma concentrations in combination with systematically lower drug levels and possibly a lower compliance in pregnant women may thus account for a still not yet supportable transmission risk. Systematic drug-level testing in PT under PY/SA treatment deserves to be considered.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Schofer.2020,

title = {Diagnostik und Therapie der Syphilis : Aktualisierung der S2k-Leitlinie 2020 der Deutsche STI-Gesellschaft (DSTIG) in Kooperation mit folgenden Fachgesellschaften: DAIG, dagn\"{a}, DDG, DGA, DGGG, DGHM, DGI, DGN, DGPI, DGU, RKI},

author = {H Sch\"{o}fer and M Enders and S Esser and C Feiterna-Sperling and H-J Hagedorn and G Magistro and C Mayr and D M\"{u}nstermann and K Hahn and K Jansen and M Klein and W Krause and M Maschke and F R Ochsendorf and S Osowski and K U Petry and A Potthoff and S Rieg and A Sing and M St\"{u}cker and T Weberschock and R N Werner and N H Brockmeyer},

doi = {10.1007/s00105-020-04672-6},

year  = {2020},

date = {2020-09-17},

journal = {Der Hautarzt},

volume = {71},

number = {12},

pages = {969--999},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Eggers.2020c,

title = {Virucidal activity of three ethanol-based handrubs against murine norovirus in a hand hygiene clinical simulation study},

author = {M Eggers and C Benzinger and M Suchomel and E Hjorth},

doi = {10.2217/fmb-2020-0168},

year  = {2020},

date = {2020-09-01},

journal = {Future microbiology},

volume = {15},

pages = {1335-1341},

abstract = {Aim: We evaluated the efficacy of three ethanol-based handrubs against murine norovirus~in a proposed clinical simulation test (prEN 17430). Materials \& methods: Virucidal activity was determined in 18 volunteers using three~handrubs: ethanol 72.4~and 89.5% v/v solutions, and 86% v/v gel. Subjects underwent testing with each product (3/6~ml~for 15/30~s) and a reference solution (6~ml~70% v/v ethanol for 60~s). Results: Against murine norovirus, the reduction factors~(RF;~RF mean~$pm$ standard deviation~log10 reduction of postsampling) for ethanol gel 86% v/v (RF 1.96~$pm$~0.64), ethanol 89.5% v/v (RF 2.49~$pm$~0.59)~and ethanol 72.4% v/v (RF 2.61~$pm$~0.50), were all significantly superior to that of~the reference solution. Conclusion: All three handrubs passed the criteria set out in prEN 17430 and exhibited excellent virucidal efficacy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Rager.2020,

title = {Entwicklung eines neuen Bioindikatorsystems zur Pr\"{u}fung der Hygienewirkung von Geschirrsp\"{u}lverfahren unter besonderer Ber\"{u}cksichtigung von englumigem Sp\"{u}lgut},

author = {A Rager and M Eggers and B Eilts and A Klingshirn},

doi = {10.23782/HUWtextunderscore 10textunderscore 2020},

year  = {2020},

date = {2020-01-01},

journal = {Hauswirtschaft und Wissenschaft},

volume = {68},

pages = {1},

abstract = {Die Aufbereitung von Sp\"{u}lgut aus hygienisch sensiblen Bereichen stellt Einrichtungen wie z. B. Kindertagesst\"{a}tten und Pflegeheime vor Herausforderungen. In Einrichtungen, in denen Menschen mit noch nicht vollst\"{a}ndig ausgebildeter oder eingeschr\"{a}nkter Immunabwehr untergebracht sind, ist die Gew\"{a}hrleistung von hygienisch einwandfreiem Sp\"{u}lgut zur Vermeidung der \"{U}bertragung von Krankheitserregern sicherzustellen. Der Einsatz von Haushaltsgeschirrsp\"{u}lern in hygienisch sensiblen Bereichen wird von \"{U}berwachungsbeh\"{o}rden daher kritisch betrachtet. Mittels eines neuentwickelten Bioindikatorsystems soll die hygienische Aufbereitung von v. a. englumigem Sp\"{u}lgut in Geschirrsp\"{u}lmaschinen in diesen Einrichtungen untersucht werden.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Stenger.2020,

title = {Timing of Vaccination after Training: Immune Response and Side Effects in Athletes},

author = {T Stenger and A Ledo and C Ziller and D Schub and T Schmidt and M Enders and BC G\"{a}rtner and M Sester and T Meyer},

doi = {10.1249/MSS.0000000000002278},

year  = {2020},

date = {2020-01-01},

journal = {Medicine and science in sports and exercise},

volume = {52},

number = {7},

pages = {1603--1609},

abstract = {OBJECTIVES 

 

Influenza vaccination was used to assess whether induction of immunity or side effects are influenced by the timing of the last training session before vaccination. 

 

METHODS 

 

Forty-five healthy athletes (36 male, 23 $pm$ 8 yr, $geq$5 training sessions per week, predominantly national competition level) were vaccinated with the tetravalent influenza vaccine; blood samples were collected immediately before and 1, 2, and 26 wk after vaccination. Athletes were randomly assigned to vaccination within 2 h after the last training session versus after 24-26 h. Influenza-specific T cells were quantified after stimulation with the vaccine based on intracellular cytokine staining. Antibodies (IgA, IgG, IgM) were quantified by enzyme-linked immunosorbent assay and neutralization assay. Participants documented resulting side effects and training restrictions using a standardized diary. 

 

RESULTS 

 Both groups showed an increase in influenza-reactive CD4 T-cell levels, which peaked 1 wk after vaccination (fold changes to baseline; median (interquartile range), 3.7 (3.0-5.4; P textless 0.001) in the 2-h group; 4.6 (2.8-7.4; P textless 0.001) in the 26-h group) with no difference between groups (P = 0.52). Influenza-specific antibodies showed a significant increase after vaccination in both groups (at least 1.4-fold, each P textless 0.001, no group differences; P = 0.24-0.97 for different antibody types). Only antibodies toward the Brisbane strain showed a trend toward significant differences in neutralization titers between groups (4-fold (2-17.8) in the 2-h group, 16-fold (4-32.9) in the 26-h group; P = 0.06), whereas other specificities did not differ (P = 0.16-0.72). No intergroup differences were found for side effects; no athlete reported a loss of training time due to the vaccination or its side effects. 

 

CONCLUSION 

 

Infection prophylaxis in elite athletes by influenza vaccination seems to be effective and safe. Timing of vaccination after prior training does not seem to require specific constraints.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Russcher.2020,

title = {Diagnosis of intrauterine parvovirus B19 infection at birth - Value of DNA detection in neonatal blood and dried blood spots},

author = {A Russcher and A Enders and CS de Brouwer and D Oepkes and R Hahn and M Enders and AC M Kroes and A CTM Vossen},

doi = {10.1016/j.jcv.2020.104482},

year  = {2020},

date = {2020-01-01},

journal = {Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology},

volume = {129},

pages = {104482},

abstract = {BACKGROUND 

 

Diagnosis of congenital viral infection at birth is generally attempted by direct detection of the virus by PCR in various neonatal materials. How to reliably diagnose intrauterine infection with parvovirus B19 (B19 V) at birth is unknown. 

 

OBJECTIVES 

 

To evaluate the performance of B19 V DNA detection in cord blood (CB) or neonatal dried blood spots (DBS) in diagnosing fetal infection. 

 

STUDY DESIGN 

 

Two cohorts of children diagnosed prenatally with an intrauterine B19 V infection were included in this study. CB samples of intrauterine B19 V infections that were sent to a reference laboratory for congenital infections in Stuttgart, Germany in the period 1995-2014 were tested in triplicate for B19 V DNA by quantitative PCR. DBS from children with intrauterine B19 V infection that underwent IUT at the LUMC, Leiden, the Netherlands in the period 2009-2014 were tested for B19 V DNA by quantitative B19 V PCR in triplicate. 

 

RESULTS 

 

Fourteen of twenty (70 %) CB samples tested positive for B19 V DNA. The positivity rate was 40 % (4/10) in those with a prenatal diagnosis textless20 weeks gestation. When intrauterine B19 V infection was diagnosed thereafter, 100 % (10/10) samples were B19 V DNA positive. Of the thirteen available DBS, twelve (92 %) tested positive. Viral load in CB and DBS corresponded inversely with time from fetal diagnosis to birth. 

 

CONCLUSION 

 

B19 V DNA can be detected in neonatal blood samples of children following intrauterine B19 V infection, although the possibility of false-negatives, even in severe infections, should be considered. B19 V viral load at birth correlates with timing of infection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Rabenau.2020b,

title = {Comment on the significance, application and determination of the large volume plating (LVP) 2. Communication of the DVV/GfV Virus Disinfection Expert Committee on the DVV/RKI Guideline in the version of December 1st, 2014},

author = {HF Rabenau and I Schwebke and J Bl\"{u}mel and M Eggers and I Rapp and J Steinmann and H Willkommen},

doi = {10.1007/s00103-020-03117-8},

year  = {2020},

date = {2020-01-01},

journal = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz},

volume = {63},

number = {5},

pages = {657--659},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kramer.2020,

title = {Pr\"{a}vention respiratorischer Virusinfektionen durch viruzide Schleimhautantiseptik bei medizinischem Personal und in der Bev\"{o}lkerung},

author = {A Kramer and M Eggers},

year  = {2020},

date = {2020-01-01},

journal = {Hygiene + Medizin},

volume = {45},

number = {9},

pages = {D118\textendashD124},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Elts.2020,

title = {Aufbereitung von Reinigungstextilien in der Krankenhausreinigung},

author = {B Elts and A-M Rager and D Boursillon and M Eggers},

year  = {2020},

date = {2020-01-01},

journal = {Hygiene + Medizin},

volume = {45},

number = {7/8},

pages = {D80--D89},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Eggers.2020b,

title = {Einsatz geeigneter Desinfektionsmitteln bei gentechnisch ver\"{a}nderten Viren und viralen Vektoren -- Stellungnahme der Kommission f\"{u}r Virusdesinfektion der Deutschen Vereinigung zur Bek\"{a}mpfung der Viruskrankheiten (DVV) e. V. und der Gesellschaft f\"{u}r Virologie (GfV) e. V},

author = {M Eggers and H Rabenau and J Bl\"{u}mel and H Fickenscher and B Geisel and D Glebe and H Hengel and R Marschang and S Reiche and E Steinmann and J Steinmann and I Schwebke},

doi = {10.25646/7030},

year  = {2020},

date = {2020-01-01},

journal = {Epidemiologisches Bulletin},

number = {36},

pages = {3--14},

abstract = {Im Epidemiologischen Bulletin 36/2020 haben Mitglieder der Kommission f\"{u}r Virusdesinfektion der DVV/GfV eine \"{U}bersicht h\"{a}ufig verwendeter gentechnisch ver\"{a}nderter Organismen zusammengestellt, davon ausgehend werden Aspekte der Auswahl und Anwendung von Desinfektionsmitteln n\"{a}her er\"{o}rtert. Dabei wurden neben Vertretern von Bundesoberbeh\"{o}rden, wie des FLI, des PEI und des RKI, auch Vertreter des \"{O}GD und virologischer Institute aus Universit\"{a}ten einbezogen.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}