2021
Eggers, M; Baumann, A; Lilienthal, N; Steinmann, E; Steinmann, J; Hübner, NO; Rabenau, HF; Weinheimer, V; Schwebke, I
Desinfektionsmittel in der COVID-19-Pandemie: eine Herausforderung Artikel
In: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, Bd. 65, Ausg. 1, Nr. 86–95, 2021.
@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},
year = {2021},
date = {2021-11-03},
urldate = {2021-11-03},
journal = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz},
volume = {65},
number = {86\textendash95},
issue = {1},
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}
}
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 Desinfektionsmaßnahmen auch in Deutschland an Bedeutung gewonnen. Der erhöhte Bedarf an Desinfektionsmitteln zu Beginn der Pandemie erforderte es, vorübergehende rechtliche Regelungen zu treffen, um einerseits ausreichend Mittel für die notwendige Desinfektion im medizinischen Bereich und andererseits für den zusätzlichen Bedarf in der Bevölkerung zur Verfügung zu haben. Dazu wurden vom Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) und der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA) Allgemeinverfügungen erlassen, die in diesem Beitrag näher erläutert werden. Im Vordergrund stehen dabei die Maßnahmen für die hygienische Händedesinfektion. Aber auch weitere Anwendungen wie die Flächendesinfektion im Zusammenhang mit pandemischen Atemwegserkrankungen werden erörtert. Die Erfahrungen bei der Sicherstellung der Versorgung mit wirksamen und in der Anwendung sicheren Desinfektionsmitteln sollten für die Vorbereitung weiterer Pandemien genutzt werden.
ZUSAMMENFASSUNG
Durch die COVID-19-Pandemie haben Desinfektionsmaßnahmen auch in Deutschland an Bedeutung gewonnen. Der erhöhte Bedarf an Desinfektionsmitteln zu Beginn der Pandemie erforderte es, vorübergehende rechtliche Regelungen zu treffen, um einerseits ausreichend Mittel für die notwendige Desinfektion im medizinischen Bereich und andererseits für den zusätzlichen Bedarf in der Bevölkerung zur Verfügung zu haben. Dazu wurden vom Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) und der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA) Allgemeinverfügungen erlassen, die in diesem Beitrag näher erläutert werden. Im Vordergrund stehen dabei die Maßnahmen für die hygienische Händedesinfektion. Aber auch weitere Anwendungen wie die Flächendesinfektion im Zusammenhang mit pandemischen Atemwegserkrankungen werden erörtert. Die Erfahrungen bei der Sicherstellung der Versorgung mit wirksamen und in der Anwendung sicheren Desinfektionsmitteln sollten für die Vorbereitung weiterer Pandemien genutzt werden.
Hufbauer, M; Wieland, U; Gebel, J; Steinmann, J; Akgül, B; Eggers, M
Inactivation of Polyomavirus SV40 as Surrogate for Human Papillomaviruses by Chemical Disinfectants Artikel
In: Viruses, Bd. 13, Nr. 11, S. 2207, 2021.
@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}
}
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.
Devlieger, R; Buxmann, H; Nigro, G; Enders, M; Jückstock, J; Siklós, P; Wartenberg-Demand, A; Schüttrumpf, J; Schütze, J; Rippel, N; Herbold, M; Niemann, G; Friese, K
In: Fetal Diagnosis and Therapy, Bd. 48, Ausg. 8, S. 611–623, 2021.
@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},
year = {2021},
date = {2021-10-01},
urldate = {2021-10-01},
journal = {Fetal Diagnosis and Therapy},
volume = {48},
issue = {8},
pages = {611\textendash623},
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}
}
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.
Steinhauer, K; Meister, TL; Todt, D; Krawczyk, A; Paßvogel, L; Becker, B; Paulmann, D; Bischoff, B; Eggers, M; Pfaender, S; Brill, FHH; Steinmann, E
Virucidal efficacy of different formulations for hand and surface disinfection targeting SARS CoV-2 Artikel
In: The Journal of hospital infection, Bd. 112, S. 27-30, 2021.
@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}
}
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.
Kagan, K O; Enders, M; Hoopmann, M; Geipel, A; Simonini, C; Berg, C; Gottschalk, I; Faschingbauer, F; Schneider, M O; Ganzenmueller, T; Hamprecht, K
In: Ultrasound in obstetrics & gynecology, Bd. 57, S. 560-567, 2021.
@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}
}
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 $łeq$ 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.
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 $łeq$ 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.
Meier, T; Enders, M
High reproducibility of the interferon-gamma release assay T-SPOT.TB in serial testing Artikel
In: European journal of clinical microbiology & infectious diseases, Bd. 40, S. 85-93, 2021.
@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},
urldate = {2021-01-01},
journal = {European journal of clinical microbiology \& infectious diseases},
volume = {40},
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}
}
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.
Kramer, A; Eggers, M; Hübner, N; Walger, P; Steinmann, E; Exner, M
Virucidal gargling and virucidal nasal spray Artikel
In: GMS Hygiene and Infection Control, Bd. 16, Nr. Doc02, 2021.
@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}
}
Eggers, M; Schwebke, I; Suchomel, M; Fotheringham, V; Gebel, J; Meyer, B; Morace, G; Roedger, HJ; Roques, C; Visa, P; Steinhauer, K
In: Euro Surveillance, Bd. 26, Nr. 3, S. pii=2000708., 2021.
@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}
}
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.
Stathis, C; Victoria, N; Loomis, K; Nguyen, SA; Eggers, M; Septimus, E; Safdar, N
Review of the use of nasal and oral antiseptics during a global pandemic Artikel
In: Future microbiology, Bd. 16, Nr. 2, S. 119-130, 2021.
@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}
}
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.
Greiner, J; Götz, M; Malner-Wagner, W; Wendt, C; Enders, M; Durst, C; Michel, D; von Harsdorf, S; Jung, S
In: Cancer medicine, Bd. 10, Nr. 1, S. 237–246, 2021.
@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}
}
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.
Hufbauer, M; Wieland, U; Gebel, J; Steinmann, J; Akgül, B; Eggers, M
Inactivation of Polyomavirus SV40 as Surrogate for Human Papillomaviruses by Chemical Disinfectants Artikel
In: Viruses, Bd. 13, Nr. 11, S. 2207, 2021.
@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}
}
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.
2020
Reiter-Owona, I; Hlobil, H; Enders, M; Klarmann-Schulz, U; Gruetzmacher, B; Rilling, V; Hoerauf, A; Garweg, J G
In: European journal of medical research, Bd. 25, Nr. 59, 2020.
@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}
}
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.
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.
Schöfer, H; Enders, M; Esser, S; Feiterna-Sperling, C; Hagedorn, H-J; Magistro, G; Mayr, C; Münstermann, D; Hahn, K; Jansen, K; Klein, M; Krause, W; Maschke, M; Ochsendorf, F R; Osowski, S; Petry, K U; Potthoff, A; Rieg, S; Sing, A; Stücker, M; Weberschock, T; Werner, R N; Brockmeyer, N H
In: Der Hautarzt, Bd. 71, Nr. 12, S. 969–999, 2020.
@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}
}
Eggers, M; Benzinger, C; Suchomel, M; Hjorth, E
In: Future microbiology, Bd. 15, S. 1335-1341, 2020.
@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}
}
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.
Rabenau, HF; Schwebke, I; Blümel, J; Eggers, M; Glebe, D; Rapp, I; Sauerbrei, A; Steinmann, E; Steinmann, J; Willkommen, He; Wutzler, P
In: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, Bd. 63, Nr. 5, S. 645–655, 2020.
@article{Rabenau.2020,
title = {Guideline for testing chemical disinfectants regarding their virucidal activity within the field of human medicine : as of December 1st, 2014 Prepared by the German Association for the Control of Virus Diseases (DVV) and the Robert Koch Institute (RKI)},
author = {HF Rabenau and I Schwebke and J Bl\"{u}mel and M Eggers and D Glebe and I Rapp and A Sauerbrei and E Steinmann and J Steinmann and He Willkommen and P Wutzler},
doi = {10.1007/s00103-020-03115-w},
year = {2020},
date = {2020-01-01},
journal = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz},
volume = {63},
number = {5},
pages = {645--655},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hitz, D; Exler, S; Daiminger, A; Bartelt, U; Enders, M
Low-level positive results in the Liaison CMV IgG II assay may misclassify pregnant woman as immune Artikel
In: Diagnostic microbiology and infectious disease, S. 115029, 2020.
@article{Hitz.2020,
title = {Low-level positive results in the Liaison CMV IgG II assay may misclassify pregnant woman as immune},
author = {D Hitz and S Exler and A Daiminger and U Bartelt and M Enders},
doi = {10.1016/j.diagmicrobio.2020.115029},
year = {2020},
date = {2020-01-01},
journal = {Diagnostic microbiology and infectious disease},
pages = {115029},
abstract = {The aim of this study is to report on the specificity in the low-positive range of the Liaison CMV IgG II assay for determination of cytomegalovirus immune status in pregnancy. Sera with test results between 12.0 and 40.0 U/mL were retested with the Enzygnost Anti-CMV/IgG assay. Enzygnost-negative samples were analyzed by the Serion ELISA classic Cytomegalovirus IgG assay and, if positive or equivocal, also with the Mikrogen recomLine CMV IgG assay. A total of 12,117 sera were tested with the Liaison assay. Sixty sera were equivocal (12.0-13.9 U/mL), and 400 of 4295 positive sera were low-positive (14.0-40.0 U/mL). Based on consensus, at least 14% of the low-positives and 1.3% of all Liaison-positives can be considered as misclassified. The proportion of misclassified sera increased with lower Liaison IgG results. We suggest that the range for equivocal results in the Liaison assay should be revised.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The aim of this study is to report on the specificity in the low-positive range of the Liaison CMV IgG II assay for determination of cytomegalovirus immune status in pregnancy. Sera with test results between 12.0 and 40.0 U/mL were retested with the Enzygnost Anti-CMV/IgG assay. Enzygnost-negative samples were analyzed by the Serion ELISA classic Cytomegalovirus IgG assay and, if positive or equivocal, also with the Mikrogen recomLine CMV IgG assay. A total of 12,117 sera were tested with the Liaison assay. Sixty sera were equivocal (12.0-13.9 U/mL), and 400 of 4295 positive sera were low-positive (14.0-40.0 U/mL). Based on consensus, at least 14% of the low-positives and 1.3% of all Liaison-positives can be considered as misclassified. The proportion of misclassified sera increased with lower Liaison IgG results. We suggest that the range for equivocal results in the Liaison assay should be revised.
Hübner, N-O; Eggers, M; Schwebke, I; Suchomel, M
Händedesinfektion unter den Bedingungen der SARSCoV- 2-Pandemie Artikel
In: Epidemiologisches Bulletin, Bd. 19, S. 13-19, 2020.
@article{Hubner.2020,
title = {H\"{a}ndedesinfektion unter den Bedingungen der SARSCoV- 2-Pandemie},
author = {N-O H\"{u}bner and M Eggers and I Schwebke and M Suchomel},
url = {https://edoc.rki.de/handle/176904/6774?show=full},
doi = {10.25646/6861},
year = {2020},
date = {2020-01-01},
journal = {Epidemiologisches Bulletin},
volume = {19},
pages = {13-19},
abstract = {Die aktuelle SARS-CoV-2-Pandemie f\"{u}hrt uns zum einen den Stellenwert der H\"{a}ndedesinfektion zum Schutz der Patienten und Besch\"{a}ftigten vor Augen. Zum anderen zeigt sie, wie wichtig die stete Verf\"{u}gbarkeit von H\"{a}ndedesinfektionsmitteln ist, deren Wirksamkeit, Qualit\"{a}t und Unbedenklichkeit nachgewiesen und die unter praktischen Bedingungen tauglich sind. Aussagen u. a. zu Bestandteilen, zur Deklaration der Wirksamkeit und zur Qualit\"{a}t von alkoholischen H\"{a}ndedesinfektionsmitteln werden im Epidemiologischen Bulletin 19/2020 n\"{a}her ausgef\"{u}hrt.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Die aktuelle SARS-CoV-2-Pandemie führt uns zum einen den Stellenwert der Händedesinfektion zum Schutz der Patienten und Beschäftigten vor Augen. Zum anderen zeigt sie, wie wichtig die stete Verfügbarkeit von Händedesinfektionsmitteln ist, deren Wirksamkeit, Qualität und Unbedenklichkeit nachgewiesen und die unter praktischen Bedingungen tauglich sind. Aussagen u. a. zu Bestandteilen, zur Deklaration der Wirksamkeit und zur Qualität von alkoholischen Händedesinfektionsmitteln werden im Epidemiologischen Bulletin 19/2020 näher ausgeführt.
Hitz, DA; Tewald, F; Eggers, M
Seasonal Bordetella pertussis pattern in the period from 2008 to 2018 in Germany Artikel
In: BMC infectious diseases, Bd. 20, Nr. 1, S. 474, 2020.
@article{Hitz.2020b,
title = {Seasonal Bordetella pertussis pattern in the period from 2008 to 2018 in Germany},
author = {DA Hitz and F Tewald and M Eggers},
doi = {10.1186/s12879-020-05199-w},
year = {2020},
date = {2020-01-01},
journal = {BMC infectious diseases},
volume = {20},
number = {1},
pages = {474},
abstract = {BACKGROUND
After the introduction of a vaccine against B. pertussis the seasonal pattern with the highest number of infections in the spring to summer months changed. Recent studies from around the world suggest that B. pertussis infections again follow a seasonal pattern with increased incidence in summer.The aim of this study was to investigate whether respiratory infections caused by B. pertussis in the period from January 2008 to December 2018 also seasonally spread in Germany and if so, when the B. pertussis activity peaked.
METHODS
We tested 19,031 samples, mainly from Southern Germany, collected in the period from January 2008 to December 2018 using a Multiplex PCR assay. We assessed the number and proportion of samples positive for B. pertussis, stratified by patient's age and month. The seasonal distribution was investigated by plotting the average proportion of positive samples for each month.
RESULTS
We observed a B. pertussis seasonality with the highest number of positive samples in the months from June until September. In contrast, testing of samples for B. pertussis was requested most frequently in the period from October until March. The proportion of positive samples increased earlier in adolescents (age 10 to 19) than in other age groups.
CONCLUSIONS
We found a seasonality of B. pertussis infections in Germany, which differs from the time when most samples are sent in for testing of B. pertussis. Our study suggests that clinicians should be more aware of B. pertussis infections in the months from June until September to prevent further transmission to vulnerable family members.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND
After the introduction of a vaccine against B. pertussis the seasonal pattern with the highest number of infections in the spring to summer months changed. Recent studies from around the world suggest that B. pertussis infections again follow a seasonal pattern with increased incidence in summer.The aim of this study was to investigate whether respiratory infections caused by B. pertussis in the period from January 2008 to December 2018 also seasonally spread in Germany and if so, when the B. pertussis activity peaked.
METHODS
We tested 19,031 samples, mainly from Southern Germany, collected in the period from January 2008 to December 2018 using a Multiplex PCR assay. We assessed the number and proportion of samples positive for B. pertussis, stratified by patient's age and month. The seasonal distribution was investigated by plotting the average proportion of positive samples for each month.
RESULTS
We observed a B. pertussis seasonality with the highest number of positive samples in the months from June until September. In contrast, testing of samples for B. pertussis was requested most frequently in the period from October until March. The proportion of positive samples increased earlier in adolescents (age 10 to 19) than in other age groups.
CONCLUSIONS
We found a seasonality of B. pertussis infections in Germany, which differs from the time when most samples are sent in for testing of B. pertussis. Our study suggests that clinicians should be more aware of B. pertussis infections in the months from June until September to prevent further transmission to vulnerable family members.
After the introduction of a vaccine against B. pertussis the seasonal pattern with the highest number of infections in the spring to summer months changed. Recent studies from around the world suggest that B. pertussis infections again follow a seasonal pattern with increased incidence in summer.The aim of this study was to investigate whether respiratory infections caused by B. pertussis in the period from January 2008 to December 2018 also seasonally spread in Germany and if so, when the B. pertussis activity peaked.
METHODS
We tested 19,031 samples, mainly from Southern Germany, collected in the period from January 2008 to December 2018 using a Multiplex PCR assay. We assessed the number and proportion of samples positive for B. pertussis, stratified by patient's age and month. The seasonal distribution was investigated by plotting the average proportion of positive samples for each month.
RESULTS
We observed a B. pertussis seasonality with the highest number of positive samples in the months from June until September. In contrast, testing of samples for B. pertussis was requested most frequently in the period from October until March. The proportion of positive samples increased earlier in adolescents (age 10 to 19) than in other age groups.
CONCLUSIONS
We found a seasonality of B. pertussis infections in Germany, which differs from the time when most samples are sent in for testing of B. pertussis. Our study suggests that clinicians should be more aware of B. pertussis infections in the months from June until September to prevent further transmission to vulnerable family members.
Munz, M; Wessendorf, S; Koretsis, G; Tewald, F; Baegi, R; Krämer, S; Geissler, M; Reinhard, M
Acute transverse myelitis after COVID-19 pneumonia Artikel
In: Journal of neurology, Bd. 267, S. 2196-2197, 2020.
@article{Munz.2020,
title = {Acute transverse myelitis after COVID-19 pneumonia},
author = {M Munz and S Wessendorf and G Koretsis and F Tewald and R Baegi and S Kr\"{a}mer and M Geissler and M Reinhard},
doi = {10.1007/s00415-020-09934-w},
year = {2020},
date = {2020-01-01},
journal = {Journal of neurology},
volume = {267},
pages = {2196-2197},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Anderson, DE; Sivalingam, V; Kang, A Eng Zheng; Ananthanarayanan, A; Arumugam, H; Jenkins, TM; Hadjiat, Y; Eggers, M
In: Infectious diseases and therapy, Bd. 9, Nr. 3, S. 669–675, 2020.
@article{Anderson.2020,
title = {Povidone-Iodine Demonstrates Rapid In Vitro Virucidal Activity Against SARS-CoV-2, The Virus Causing COVID-19 Disease},
author = {DE Anderson and V Sivalingam and A Eng Zheng Kang and A Ananthanarayanan and H Arumugam and TM Jenkins and Y Hadjiat and M Eggers},
doi = {10.1007/s40121-020-00316-3},
year = {2020},
date = {2020-01-01},
journal = {Infectious diseases and therapy},
volume = {9},
number = {3},
pages = {669\textendash675},
abstract = {INTRODUCTION
As of 22 June 2020, Severe Acute Respiratory Syndrome (SARS)-coronavirus (CoV)-2 has infected more than 8.95 million people worldwide, causing textgreater 468,000 deaths. The virus is transmitted through respiratory droplets and physical contact from contaminated surfaces to the mucosa. Hand hygiene and oral decontamination among other measures are key to preventing the spread of the virus. We report the in vitro virucidal activity of topical and oral povidone-iodine (PVP-I) products against SARS-CoV-2.
METHODS
Suspension assays were used to assess the virucidal activity of PVP-I against SARS-CoV-2. Products were tested at a contact time of 30~s for virucidal activity. Viral titres were calculated using the Spearman-K\"{a}rber method and reported as median tissue culture infectious dose (TCID50)/mL.
RESULTS
All four products [antiseptic solution (PVP-I 10%), skin cleanser (PVP-I 7.5%), gargle and mouth wash (PVP-I 1%) and throat spray (PVP-I 0.45%)] achieved $geq$ 99.99% virucidal activity against SARS-CoV-2, corresponding to $geq$ 4 log10 reduction of virus titre, within 30~s of contact.
CONCLUSION
This study provides evidence of rapid and effective virucidal activity of PVP-I against SARS-CoV-2. PVP-I-based products are widely available for medical and personal use for hand hygiene and oral decontamination, and could be readily integrated into coronavirus disease, COVID-19, infection control measures in hospital and community settings.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION
As of 22 June 2020, Severe Acute Respiratory Syndrome (SARS)-coronavirus (CoV)-2 has infected more than 8.95 million people worldwide, causing textgreater 468,000 deaths. The virus is transmitted through respiratory droplets and physical contact from contaminated surfaces to the mucosa. Hand hygiene and oral decontamination among other measures are key to preventing the spread of the virus. We report the in vitro virucidal activity of topical and oral povidone-iodine (PVP-I) products against SARS-CoV-2.
METHODS
Suspension assays were used to assess the virucidal activity of PVP-I against SARS-CoV-2. Products were tested at a contact time of 30~s for virucidal activity. Viral titres were calculated using the Spearman-Kärber method and reported as median tissue culture infectious dose (TCID50)/mL.
RESULTS
All four products [antiseptic solution (PVP-I 10%), skin cleanser (PVP-I 7.5%), gargle and mouth wash (PVP-I 1%) and throat spray (PVP-I 0.45%)] achieved $geq$ 99.99% virucidal activity against SARS-CoV-2, corresponding to $geq$ 4 log10 reduction of virus titre, within 30~s of contact.
CONCLUSION
This study provides evidence of rapid and effective virucidal activity of PVP-I against SARS-CoV-2. PVP-I-based products are widely available for medical and personal use for hand hygiene and oral decontamination, and could be readily integrated into coronavirus disease, COVID-19, infection control measures in hospital and community settings.
As of 22 June 2020, Severe Acute Respiratory Syndrome (SARS)-coronavirus (CoV)-2 has infected more than 8.95 million people worldwide, causing textgreater 468,000 deaths. The virus is transmitted through respiratory droplets and physical contact from contaminated surfaces to the mucosa. Hand hygiene and oral decontamination among other measures are key to preventing the spread of the virus. We report the in vitro virucidal activity of topical and oral povidone-iodine (PVP-I) products against SARS-CoV-2.
METHODS
Suspension assays were used to assess the virucidal activity of PVP-I against SARS-CoV-2. Products were tested at a contact time of 30~s for virucidal activity. Viral titres were calculated using the Spearman-Kärber method and reported as median tissue culture infectious dose (TCID50)/mL.
RESULTS
All four products [antiseptic solution (PVP-I 10%), skin cleanser (PVP-I 7.5%), gargle and mouth wash (PVP-I 1%) and throat spray (PVP-I 0.45%)] achieved $geq$ 99.99% virucidal activity against SARS-CoV-2, corresponding to $geq$ 4 log10 reduction of virus titre, within 30~s of contact.
CONCLUSION
This study provides evidence of rapid and effective virucidal activity of PVP-I against SARS-CoV-2. PVP-I-based products are widely available for medical and personal use for hand hygiene and oral decontamination, and could be readily integrated into coronavirus disease, COVID-19, infection control measures in hospital and community settings.
Boursillon, D; Kocics, J; Eggers, M; Elts, B
Reiniger mit Zusatz von Mikroorganismen (MARP) Artikel
In: Hygiene + Medizin, Bd. 45, Nr. 7/8, S. 98–101, 2020.
@article{Boursillon.2020,
title = {Reiniger mit Zusatz von Mikroorganismen (MARP)},
author = {D Boursillon and J Kocics and M Eggers and B Elts},
year = {2020},
date = {2020-01-01},
journal = {Hygiene + Medizin},
volume = {45},
number = {7/8},
pages = {98--101},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Eggers, M; Hitz, DA; Elts, B
Reinigung von Oberflächen - Eine mikrobiologische Untersuchung und Bewertung der Reinigung in öffentlichen Bereichen Artikel
In: Hygiene + Medizin, Bd. 45, Nr. 7-8, S. D102–D106, 2020.
@article{Eggers.2020,
title = {Reinigung von Oberfl\"{a}chen - Eine mikrobiologische Untersuchung und Bewertung der Reinigung in \"{o}ffentlichen Bereichen},
author = {M Eggers and DA Hitz and B Elts},
year = {2020},
date = {2020-01-01},
journal = {Hygiene + Medizin},
volume = {45},
number = {7-8},
pages = {D102--D106},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Eggers, M; Rabenau, H; Blümel, J; Fickenscher, H; Geisel, B; Glebe, D; Hengel, H; Marschang, R; Reiche, S; Steinmann, E; Steinmann, J; Schwebke, I
In: Epidemiologisches Bulletin, Nr. 36, S. 3–14, 2020.
@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}
}
Im Epidemiologischen Bulletin 36/2020 haben Mitglieder der Kommission für Virusdesinfektion der DVV/GfV eine Übersicht häufig verwendeter gentechnisch veränderter Organismen zusammengestellt, davon ausgehend werden Aspekte der Auswahl und Anwendung von Desinfektionsmitteln näher erörtert. Dabei wurden neben Vertretern von Bundesoberbehörden, wie des FLI, des PEI und des RKI, auch Vertreter des ÖGD und virologischer Institute aus Universitäten einbezogen.
Elts, B; Rager, A-M; Boursillon, D; Eggers, M
Aufbereitung von Reinigungstextilien in der Krankenhausreinigung Artikel
In: Hygiene + Medizin, Bd. 45, Nr. 7/8, S. D80–D89, 2020.
@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}
}
Kramer, A; Eggers, M
Prävention respiratorischer Virusinfektionen durch viruzide Schleimhautantiseptik bei medizinischem Personal und in der Bevölkerung Artikel
In: Hygiene + Medizin, Bd. 45, Nr. 9, S. D118–D124, 2020.
@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}
}