2019
Gemein, S; Gebel, J; Christiansen, B; Martiny, H; Vossebein, L; Brill, F H H; Decius, M; Eggers, M; Koburger-Janssen, T; Meckel, M; Werner, S; Hunsinger, B; Selhorst, T; Kampf, G; Exner, M
In: The Journal of hospital infection, Bd. 103, Nr. 1, S. 78–84, 2019.
@article{Gemein.2019,
title = {Interlaboratory reproducibility of a test method following 4-field test methodology to evaluate the susceptibility of Clostridium difficile spores},
author = {S Gemein and J Gebel and B Christiansen and H Martiny and L Vossebein and F H H Brill and M Decius and M Eggers and T Koburger-Janssen and M Meckel and S Werner and B Hunsinger and T Selhorst and G Kampf and M Exner},
doi = {10.1016/j.jhin.2019.04.011},
year = {2019},
date = {2019-01-01},
journal = {The Journal of hospital infection},
volume = {103},
number = {1},
pages = {78--84},
abstract = {BACKGROUND
Sporicidal surface disinfection is recommended to control transmission of Clostridium difficile in healthcare facilities. EN 17126 provides a method to determine the sporicidal activity in suspension and has been approved as a European standard. In addition, a sporicidal surface test has been proposed.
AIM
To determine the interlaboratory reproducibility of a test method for evaluating the susceptibility of a C.~difficile spore preparation to a biocidal formulation following the 4-field test (EN 16615 methodology).
METHODS
Nine laboratories participated. C.~difficile NCTC 13366 spores were used. Glutaraldehyde (1% and 6%; 15 min) and peracetic acid (PAA; 0.01% and 0.04%; 15 min) were used to determine the spores' susceptibility in suspension in triplicate.
FINDINGS
One-percent glutaraldehyde revealed a mean decimal log10 reduction of 1.03 with variable results in the nine laboratories (0.37-1.49) and a reproducibility of 0.38. The effect of 6% glutaraldehyde was stronger (mean: 2.05; range: 0.96-4.29; reproducibility: 0.86). PAA revealed similar results. An exemplary biocidal formulation based on 5% PAA was used at 0.5% (non-effective concentration) and 4% (effective concentration) to determine the sporicidal efficacy (4-field test) under clean conditions in triplicate with a contact time of 15 min. When used at 0.5% it demonstrated an overall log10 reduction of 2.68 (range: 2.35-3.57) and at 4% of 4.61 (range: 3.82-5.71). The residual contamination on the three primarily uncontaminated test fields was textless50 cfu/25 cm2 in one out of nine laboratories (0.5%) and in seven out of nine laboratories (4%).
CONCLUSION
The interlaboratory reproducibility seems to be robust.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Sporicidal surface disinfection is recommended to control transmission of Clostridium difficile in healthcare facilities. EN 17126 provides a method to determine the sporicidal activity in suspension and has been approved as a European standard. In addition, a sporicidal surface test has been proposed.
AIM
To determine the interlaboratory reproducibility of a test method for evaluating the susceptibility of a C.~difficile spore preparation to a biocidal formulation following the 4-field test (EN 16615 methodology).
METHODS
Nine laboratories participated. C.~difficile NCTC 13366 spores were used. Glutaraldehyde (1% and 6%; 15 min) and peracetic acid (PAA; 0.01% and 0.04%; 15 min) were used to determine the spores' susceptibility in suspension in triplicate.
FINDINGS
One-percent glutaraldehyde revealed a mean decimal log10 reduction of 1.03 with variable results in the nine laboratories (0.37-1.49) and a reproducibility of 0.38. The effect of 6% glutaraldehyde was stronger (mean: 2.05; range: 0.96-4.29; reproducibility: 0.86). PAA revealed similar results. An exemplary biocidal formulation based on 5% PAA was used at 0.5% (non-effective concentration) and 4% (effective concentration) to determine the sporicidal efficacy (4-field test) under clean conditions in triplicate with a contact time of 15 min. When used at 0.5% it demonstrated an overall log10 reduction of 2.68 (range: 2.35-3.57) and at 4% of 4.61 (range: 3.82-5.71). The residual contamination on the three primarily uncontaminated test fields was textless50 cfu/25 cm2 in one out of nine laboratories (0.5%) and in seven out of nine laboratories (4%).
CONCLUSION
The interlaboratory reproducibility seems to be robust.
Kagan, K O; Maier, V; Sonek, J; Abele, H; Lüthgens, K; Schmid, M; Wagner, P; Hoopmann, M
In: Fetal diagnosis and therapy, Bd. 45, Nr. 5, S. 317–324, 2019.
@article{Kagan.2019,
title = {False-Positive Rate in First-Trimester Screening Based on Ultrasound and Cell-Free DNA versus First-Trimester Combined Screening with Additional Ultrasound Markers},
author = {K O Kagan and V Maier and J Sonek and H Abele and K L\"{u}thgens and M Schmid and P Wagner and M Hoopmann},
doi = {10.1159/000489121},
year = {2019},
date = {2019-01-01},
journal = {Fetal diagnosis and therapy},
volume = {45},
number = {5},
pages = {317--324},
abstract = {OBJECTIVE
To determine whether screening for trisomy 21 based on first-trimester combined screening (FTCS) with assessment of nasal bone (NB), tricuspid flow (TCF), and ductus venosus flow (DVF) results in similar false-positive rates compared to ultrasound and cell-free DNA (cfDNA) screening.
METHODS
This is a subanalysis of a prospective randomized controlled trial which was performed between October 2015 and December 2016. Pregnant women with a normal first-trimester ultrasound examination at 11 to 13 weeks' gestation were randomized into two groups: (1) FTCS with assessment of the NB, TCF, and DVF (extended FTCS [eFTCS]), and (2) ultrasound + cfDNA screening. The false-positive rate in screening for trisomy 21 was defined as the primary outcome parameter.
RESULTS
The study population consisted of 688 women in each study arm. In the eFTCS group, the median delta fetal nuchal translucency thickness (NT) was 0.0 mm, free beta-hCG and PAPP-A were 0.96 and 1.11 MoM, and NB, TCF, and DVF PIV were abnormal in 0.9, 0.6, and 7.0% cases. In the ultrasound + cfDNA group, the median delta NT was 0.0 mm. In 10 pregnancies the cfDNA analysis was uninformative and the risk of trisomy 21 was based on eFTCS. There were no false-positive cases in the ultrasound + cfDNA group, whereas the false-positive rates were between 0.9 and 2.2% with eFTCS.
CONCLUSION
Screening for trisomy 21 based on ultrasound + cfDNA has a lower false-positive rate than screening based on eFTCS.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
To determine whether screening for trisomy 21 based on first-trimester combined screening (FTCS) with assessment of nasal bone (NB), tricuspid flow (TCF), and ductus venosus flow (DVF) results in similar false-positive rates compared to ultrasound and cell-free DNA (cfDNA) screening.
METHODS
This is a subanalysis of a prospective randomized controlled trial which was performed between October 2015 and December 2016. Pregnant women with a normal first-trimester ultrasound examination at 11 to 13 weeks' gestation were randomized into two groups: (1) FTCS with assessment of the NB, TCF, and DVF (extended FTCS [eFTCS]), and (2) ultrasound + cfDNA screening. The false-positive rate in screening for trisomy 21 was defined as the primary outcome parameter.
RESULTS
The study population consisted of 688 women in each study arm. In the eFTCS group, the median delta fetal nuchal translucency thickness (NT) was 0.0 mm, free beta-hCG and PAPP-A were 0.96 and 1.11 MoM, and NB, TCF, and DVF PIV were abnormal in 0.9, 0.6, and 7.0% cases. In the ultrasound + cfDNA group, the median delta NT was 0.0 mm. In 10 pregnancies the cfDNA analysis was uninformative and the risk of trisomy 21 was based on eFTCS. There were no false-positive cases in the ultrasound + cfDNA group, whereas the false-positive rates were between 0.9 and 2.2% with eFTCS.
CONCLUSION
Screening for trisomy 21 based on ultrasound + cfDNA has a lower false-positive rate than screening based on eFTCS.
Enders, M
Zytomegalie, Ringelröteln und Co. - Pränatale Virus-Infektionen Artikel
In: Gynäkologie + Geburtshilfe, Bd. 24, Nr. 3, S. 28–34, 2019.
@article{Enders.2019,
title = {Zytomegalie, Ringelr\"{o}teln und Co. - Pr\"{a}natale Virus-Infektionen},
author = {M Enders},
doi = {10.1007/s15013-019-1729-6},
year = {2019},
date = {2019-01-01},
journal = {Gyn\"{a}kologie + Geburtshilfe},
volume = {24},
number = {3},
pages = {28--34},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Böttcher, S; Diedrich, S; Keeren, K
Increased detection of enterovirus A71 infections, Germany, 2019 Artikel
In: Eurosurveillance, Bd. 24, Nr. 39, S. 30005, 2019.
@article{Bottcher.2019,
title = {Increased detection of enterovirus A71 infections, Germany, 2019},
author = {S B\"{o}ttcher and S Diedrich and K Keeren},
doi = {10.2807/1560-7917.ES.2019.24.39.1900556},
year = {2019},
date = {2019-01-01},
journal = {Eurosurveillance},
volume = {24},
number = {39},
pages = {30005},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2018
Eggers, M; Koburger-Janssen, T; Eickmann, M; Zorn, J
In: Infectious diseases and therapy, Bd. 7, Nr. 2, S. 249–259, 2018, ISSN: 2193-8229.
@article{Eggers.2018,
title = {In Vitro Bactericidal and Virucidal Efficacy of Povidone-Iodine Gargle/Mouthwash Against Respiratory and Oral Tract Pathogens},
author = {M Eggers and T Koburger-Janssen and M Eickmann and J Zorn},
doi = {10.1007/s40121-018-0200-7},
issn = {2193-8229},
year = {2018},
date = {2018-01-01},
journal = {Infectious diseases and therapy},
volume = {7},
number = {2},
pages = {249--259},
abstract = {INTRODUCTION
Recent virus epidemics and rising antibiotic resistance highlight the importance of hygiene measures to prevent and control outbreaks. We investigated the in vitro bactericidal and virucidal efficacy of povidone-iodine (PVP-I) 7% gargle/mouthwash at defined dilution against oral and respiratory tract pathogens.
METHODS
PVP-I was tested against Klebsiella pneumoniae and Streptococcus pneumoniae according to bactericidal quantitative suspension test EN13727 and against severe acute respiratory syndrome and Middle East respiratory syndrome coronaviruses (SARS-CoV and MERS-CoV), rotavirus strain Wa and influenza virus A subtype H1N1 according to virucidal quantitative suspension test EN14476. PVP-I 7% gargle/mouthwash was diluted 1:30 with water to a concentration of 0.23% (the recommended concentration for textquotedblreal-lifetextquotedbl use in Japan) and tested at room temperature under clean conditions [0.3~g/l bovine serum albumin (BSA), viruses only] and dirty conditions (3.0~g/l BSA + 3.0~ml/l erythrocytes) as an interfering substance for defined contact times (minimum 15~s). Rotavirus was tested without protein load. A $geq$ 5 log10 (99.999%) decrease of bacteria and $geq$ 4 log10 (99.99%) reduction in viral titre represented effective bactericidal and virucidal activity, respectively, per European standards.
RESULTS
PVP-I gargle/mouthwash diluted 1:30 (equivalent to a concentration of 0.23% PVP-I) showed effective bactericidal activity against Klebsiella pneumoniae and Streptococcus pneumoniae and rapidly inactivated SARS-CoV, MERS-CoV, influenza virus A (H1N1) and rotavirus after 15~s of exposure.
CONCLUSION
PVP-I 7% gargle/mouthwash showed rapid bactericidal activity and virucidal efficacy in vitro at a concentration of 0.23% PVP-I and may provide a protective oropharyngeal hygiene measure for individuals at high risk of exposure to oral and respiratory pathogens.
FUNDING
Mundipharma Research GmbH \& Co. KG (MRG).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Recent virus epidemics and rising antibiotic resistance highlight the importance of hygiene measures to prevent and control outbreaks. We investigated the in vitro bactericidal and virucidal efficacy of povidone-iodine (PVP-I) 7% gargle/mouthwash at defined dilution against oral and respiratory tract pathogens.
METHODS
PVP-I was tested against Klebsiella pneumoniae and Streptococcus pneumoniae according to bactericidal quantitative suspension test EN13727 and against severe acute respiratory syndrome and Middle East respiratory syndrome coronaviruses (SARS-CoV and MERS-CoV), rotavirus strain Wa and influenza virus A subtype H1N1 according to virucidal quantitative suspension test EN14476. PVP-I 7% gargle/mouthwash was diluted 1:30 with water to a concentration of 0.23% (the recommended concentration for textquotedblreal-lifetextquotedbl use in Japan) and tested at room temperature under clean conditions [0.3~g/l bovine serum albumin (BSA), viruses only] and dirty conditions (3.0~g/l BSA + 3.0~ml/l erythrocytes) as an interfering substance for defined contact times (minimum 15~s). Rotavirus was tested without protein load. A $geq$ 5 log10 (99.999%) decrease of bacteria and $geq$ 4 log10 (99.99%) reduction in viral titre represented effective bactericidal and virucidal activity, respectively, per European standards.
RESULTS
PVP-I gargle/mouthwash diluted 1:30 (equivalent to a concentration of 0.23% PVP-I) showed effective bactericidal activity against Klebsiella pneumoniae and Streptococcus pneumoniae and rapidly inactivated SARS-CoV, MERS-CoV, influenza virus A (H1N1) and rotavirus after 15~s of exposure.
CONCLUSION
PVP-I 7% gargle/mouthwash showed rapid bactericidal activity and virucidal efficacy in vitro at a concentration of 0.23% PVP-I and may provide a protective oropharyngeal hygiene measure for individuals at high risk of exposure to oral and respiratory pathogens.
FUNDING
Mundipharma Research GmbH & Co. KG (MRG).
Eggers, M; Koburger-Janssen, T; Ward, L S; Newby, C; Müller, S
In: Infectious diseases and therapy, Bd. 7, Nr. 2, S. 235–247, 2018, ISSN: 2193-8229.
@article{Eggers.2018b,
title = {Bactericidal and Virucidal Activity of Povidone-Iodine and Chlorhexidine Gluconate Cleansers in an In Vivo Hand Hygiene Clinical Simulation Study},
author = {M Eggers and T Koburger-Janssen and L S Ward and C Newby and S M\"{u}ller},
doi = {10.1007/s40121-018-0202-5},
issn = {2193-8229},
year = {2018},
date = {2018-01-01},
journal = {Infectious diseases and therapy},
volume = {7},
number = {2},
pages = {235--247},
abstract = {INTRODUCTION
Standard in vitro and in vivo tests help demonstrate efficacy of hand hygiene products; however, there is no standard in vivo test method for viruses. We investigated the bactericidal and virucidal efficacy of povidone-iodine (PVP-I) 7.5% scalp and skin cleanser, chlorhexidine gluconate (CHG) 4% hand cleanser and the reference hand wash (soft soap) in 15 healthy volunteers following European Standard EN1499 (hygienic hand wash test method for bacteria), which was adapted for virucidal testing.
METHODS
Separate test series were performed for bactericidal (Escherichia coli) and virucidal [murine norovirus (MNV)] testing. After pre-washing and artificial contamination of hands with test organisms, volunteers underwent testing with 3 and 5~mL of each product for contact times of 15, 30 and 60~s according to a Latin-square randomization. The number of test organisms released from fingertips into sampling fluids was assessed before and after hand washing and mean log10 reduction factor (RF) was calculated. RFs (test-reference) were compared using a Wilcoxon-Wilcox multiple comparisons test per EN1499; efficacy was concluded if p $\leq$ 0.01.
RESULTS
PVP-I 7.5% and CHG 4% cleansers both passed EN1499 requirements against E. coli, with statistically significantly greater (p $\leq$ 0.01) mean log10 RFs compared with reference soft soap across all tests (PVP-I: 4.09-5.27; CHG: 4.12-5.22; soap: 2.75-3.11). The experimental design using EN1499 was applicable to testing with MNV as discriminatory and reproducible results were generated. Mean log10 RFs of MNV were statistically significantly greater for PVP-I (1.57-2.57) compared with soft soap (1.24-1.62), while mean log10 RFs with CHG (0.90-1.34) were lower than for soft soap across all tests.
CONCLUSION
PVP-I 7.5% cleanser showed superior efficacy against MNV compared to soft soap and CHG 4% cleanser, while both PVP-I and CHG were superior to soft soap against E. coli. The experimental set-up may be applicable to future testing for antiviral hand washes.
FUNDING
Mundipharma Manufacturing Pte Ltd. Plain language summary available for this article.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Standard in vitro and in vivo tests help demonstrate efficacy of hand hygiene products; however, there is no standard in vivo test method for viruses. We investigated the bactericidal and virucidal efficacy of povidone-iodine (PVP-I) 7.5% scalp and skin cleanser, chlorhexidine gluconate (CHG) 4% hand cleanser and the reference hand wash (soft soap) in 15 healthy volunteers following European Standard EN1499 (hygienic hand wash test method for bacteria), which was adapted for virucidal testing.
METHODS
Separate test series were performed for bactericidal (Escherichia coli) and virucidal [murine norovirus (MNV)] testing. After pre-washing and artificial contamination of hands with test organisms, volunteers underwent testing with 3 and 5~mL of each product for contact times of 15, 30 and 60~s according to a Latin-square randomization. The number of test organisms released from fingertips into sampling fluids was assessed before and after hand washing and mean log10 reduction factor (RF) was calculated. RFs (test-reference) were compared using a Wilcoxon-Wilcox multiple comparisons test per EN1499; efficacy was concluded if p $łeq$ 0.01.
RESULTS
PVP-I 7.5% and CHG 4% cleansers both passed EN1499 requirements against E. coli, with statistically significantly greater (p $łeq$ 0.01) mean log10 RFs compared with reference soft soap across all tests (PVP-I: 4.09-5.27; CHG: 4.12-5.22; soap: 2.75-3.11). The experimental design using EN1499 was applicable to testing with MNV as discriminatory and reproducible results were generated. Mean log10 RFs of MNV were statistically significantly greater for PVP-I (1.57-2.57) compared with soft soap (1.24-1.62), while mean log10 RFs with CHG (0.90-1.34) were lower than for soft soap across all tests.
CONCLUSION
PVP-I 7.5% cleanser showed superior efficacy against MNV compared to soft soap and CHG 4% cleanser, while both PVP-I and CHG were superior to soft soap against E. coli. The experimental set-up may be applicable to future testing for antiviral hand washes.
FUNDING
Mundipharma Manufacturing Pte Ltd. Plain language summary available for this article.
Kagan, K O; Sroka, F; Sonek, J; Abele, H; Lüthgens, K; Schmid, M; Wagner, P; Brucker, S; Wallwiener, D; Hoopmann, M
In: Ultrasound in obstetrics & gynecology, Bd. 51, Nr. 4, S. 437–444, 2018, ISSN: 0960-7692.
@article{Kagan.2018,
title = {First-trimester risk assessment based on ultrasound and cell-free DNA vs combined screening: a randomized controlled trial},
author = {K O Kagan and F Sroka and J Sonek and H Abele and K L\"{u}thgens and M Schmid and P Wagner and S Brucker and D Wallwiener and M Hoopmann},
doi = {10.1002/uog.18905},
issn = {0960-7692},
year = {2018},
date = {2018-01-01},
journal = {Ultrasound in obstetrics \& gynecology},
volume = {51},
number = {4},
pages = {437--444},
abstract = {OBJECTIVE
This was a randomized controlled trial to compare risk assessment by first-trimester combined screening (FTCS) with an approach that combines a detailed ultrasound examination at 11-13 weeks' gestation and cell-free DNA (cfDNA) analysis.
METHODS
Pregnant women with a normal first-trimester ultrasound examination at 11-13 weeks' gestation (fetal nuchal translucency (NT)~$\leq$ 3.5 mm and no fetal defects) were randomized into one of two groups. In the first group, risk of aneuploidy was assessed using FTCS based on the most recent UK Fetal Medicine Foundation algorithm. In the second group, risk assessment was based on ultrasound findings and cfDNA analysis. An additional tube of blood was collected for FTCS in case the cfDNA analysis was uninformative. Primary outcome was false-positive rate in screening for trisomy 21. A case was considered false positive if the karyotype was not trisomy 21 and if the risk for trisomy 21 was textgreater1:100, irrespective of the method of risk calculation. Results were compared using 95% CIs using the Clopper-Pearson method.
RESULTS
Between October 2015 and December 2016, 1518 women with singleton pregnancy underwent first-trimester screening. Thirty-one (2.0%) pregnancies were not eligible for randomization due to increased NT (textgreater 3.5 mm) and/or fetal defect. After exclusion of women who declined randomization (n~= 87) and cases of fetal death and loss to follow-up (n~= 24), 688 pregnancies were randomized into the FTCS arm and 688 into the ultrasound + cfDNA analysis arm. There were no differences in maternal and gestational age, maternal weight and BMI, ethnicity, use of assisted reproduction and cigarette smoking between the two arms. In the ultrasound + cfDNA analysis arm, median risk for trisomy 21 was 1 in 10 000. None of the cases had a risk above 1: 100 (95% CI, 0.0-0.5%). In the FTCS arm, the median risk for trisomy 21 was 1 in 3787 and in 17 cases, the risk was higher than 1:100, which corresponds to 2.5% (95% CI, 1.5-3.9%) of the FTCS study-arm population.
CONCLUSION
Our study has shown that first-trimester risk assessment for trisomy 21 that includes a detailed ultrasound examination as well as NT measurement and is followed by cfDNA testing is associated with a significant reduction in the false-positive rate compared with FTCS. This approach obviates the need for maternal serum free textgreekb-human chorionic gonadotropin and pregnancy-associated plasma protein-A in screening for fetal aneuploidy. Copyright copyright 2017 ISUOG. Published by John Wiley \& Sons Ltd.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This was a randomized controlled trial to compare risk assessment by first-trimester combined screening (FTCS) with an approach that combines a detailed ultrasound examination at 11-13 weeks' gestation and cell-free DNA (cfDNA) analysis.
METHODS
Pregnant women with a normal first-trimester ultrasound examination at 11-13 weeks' gestation (fetal nuchal translucency (NT)~$łeq$ 3.5 mm and no fetal defects) were randomized into one of two groups. In the first group, risk of aneuploidy was assessed using FTCS based on the most recent UK Fetal Medicine Foundation algorithm. In the second group, risk assessment was based on ultrasound findings and cfDNA analysis. An additional tube of blood was collected for FTCS in case the cfDNA analysis was uninformative. Primary outcome was false-positive rate in screening for trisomy 21. A case was considered false positive if the karyotype was not trisomy 21 and if the risk for trisomy 21 was textgreater1:100, irrespective of the method of risk calculation. Results were compared using 95% CIs using the Clopper-Pearson method.
RESULTS
Between October 2015 and December 2016, 1518 women with singleton pregnancy underwent first-trimester screening. Thirty-one (2.0%) pregnancies were not eligible for randomization due to increased NT (textgreater 3.5 mm) and/or fetal defect. After exclusion of women who declined randomization (n~= 87) and cases of fetal death and loss to follow-up (n~= 24), 688 pregnancies were randomized into the FTCS arm and 688 into the ultrasound + cfDNA analysis arm. There were no differences in maternal and gestational age, maternal weight and BMI, ethnicity, use of assisted reproduction and cigarette smoking between the two arms. In the ultrasound + cfDNA analysis arm, median risk for trisomy 21 was 1 in 10 000. None of the cases had a risk above 1: 100 (95% CI, 0.0-0.5%). In the FTCS arm, the median risk for trisomy 21 was 1 in 3787 and in 17 cases, the risk was higher than 1:100, which corresponds to 2.5% (95% CI, 1.5-3.9%) of the FTCS study-arm population.
CONCLUSION
Our study has shown that first-trimester risk assessment for trisomy 21 that includes a detailed ultrasound examination as well as NT measurement and is followed by cfDNA testing is associated with a significant reduction in the false-positive rate compared with FTCS. This approach obviates the need for maternal serum free textgreekb-human chorionic gonadotropin and pregnancy-associated plasma protein-A in screening for fetal aneuploidy. Copyright copyright 2017 ISUOG. Published by John Wiley & Sons Ltd.
Rauch, S; Doescher, A; Bald, R
D blocking phenomenon overcome Artikel
In: Transfusion, Bd. 58, Nr. 6, S. 1338–1339, 2018.
@article{Rauch.2018,
title = {D blocking phenomenon overcome},
author = {S Rauch and A Doescher and R Bald},
doi = {10.1111/trf.14496},
year = {2018},
date = {2018-01-01},
journal = {Transfusion},
volume = {58},
number = {6},
pages = {1338--1339},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Wiesmann, F; Ehret, R; Naeth, G; Däumer, M; Fuhrmann, J; Kaiser, R; Noah, C; Obermeier, M; Schalasta, G; Tiemann, C; Wolf, E; Knechten, H; Braun, P
In: Journal of clinical microbiology, Bd. 56, Nr. 10, 2018, ISSN: 0095-1137.
@article{Wiesmann.2018,
title = {Multicenter Evaluation of Two Next-Generation HIV-1 Quantitation Assays, Aptima Quant Dx and Cobas 6800, in Comparison to the RealTime HIV-1 Reference Assay},
author = {F Wiesmann and R Ehret and G Naeth and M D\"{a}umer and J Fuhrmann and R Kaiser and C Noah and M Obermeier and G Schalasta and C Tiemann and E Wolf and H Knechten and P Braun},
doi = {10.1128/JCM.00292-18},
issn = {0095-1137},
year = {2018},
date = {2018-01-01},
journal = {Journal of clinical microbiology},
volume = {56},
number = {10},
abstract = {High accuracy and precision at the lower end of quantification are crucial requirements of a modern HIV viral load (VL) assay, since some clinically relevant thresholds are located at 50 and 200 copies/ml. In this study, we compared the performance of two new fully automated HIV-1 VL assays, Aptima HIV-1 Quant Dx and Cobas HIV-1 (Cobas 6800), with the established RealTime m2000 assay. Assay precision and accuracy were evaluated in a retrospective evaluation out of excess plasma material from four HIV-1+ individuals (subtypes B, C, CRF01_AE, and CRF02_AG). Native plasma samples were diluted to nominal concentrations at 50 and 200 copies/ml (according to the RealTime m2000 assay). All dilutions were tested in triplicate in five independent runs over 5 days and in three labs per system. Assay concordance was determined using 1,011 surplus clinical routine samples, as well as selected retrospective longitudinal samples from 7 patients on treatment. The three assays yielded highly concordant results for individual clinical samples (R2 textgreater 0.98; average difference, $\leq$0.2 log copies/ml) and retrospective longitudinal samples from patients on treatment. The Aptima and RealTime assays showed similar high precision, meeting the 5textgreeks criterion for the majority of samples across all labs and subtypes. The Cobas assay was less precise, missing the 5textgreeks criterion for the majority of samples at low concentrations. In this analysis, results from the Cobas assay appeared less reliable near the clinically relevant cutoff and should be interpreted with more caution in this context. Due to high precision, full automation, and high concordance with the RealTime assay, the Aptima assay represents a good alternative in routine VL monitoring.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Enders, G; Enders, M; Steller, J
Infektionen in der Schwangerschaft Buchabschnitt
In: Goerke, Kay; Steller, Joachim; Valet, Axel; Dormann, Arno; Axt-Fliedner, Roland (Hrsg.): Klinikleitfaden Gynäkologie, Geburtshilfe, S. 185–231, Elsevier Urban & Fischer, München, 2018, ISBN: 978-3-437-22205-4.
@incollection{Enders.2018,
title = {Infektionen in der Schwangerschaft},
author = {G Enders and M Enders and J Steller},
editor = {Kay Goerke and Joachim Steller and Axel Valet and Arno Dormann and Roland Axt-Fliedner},
isbn = {978-3-437-22205-4},
year = {2018},
date = {2018-01-01},
booktitle = {Klinikleitfaden Gyn\"{a}kologie, Geburtshilfe},
pages = {185--231},
publisher = {Elsevier Urban \& Fischer},
address = {M\"{u}nchen},
keywords = {},
pubstate = {published},
tppubtype = {incollection}
}
Härtel, C; Bialek, R; Enders, M; Gille, C; Handrick, W
Syphilis Buchabschnitt
In: Bialek, Ralf; Berner, Reinhard; Forster, Johannes; Härtel, Christoph; Heininger, Ulrich; Huppertz, Hans-Iko; Liese, Johannes G; Nadal, David; Simon, Arne (Hrsg.): DGPI-Handbuch, S. 764–769, Thieme, Stuttgart, 2018, ISBN: 978-3-13-240790-9.
@incollection{Hartel.2018,
title = {Syphilis},
author = {C H\"{a}rtel and R Bialek and M Enders and C Gille and W Handrick},
editor = {Ralf Bialek and Reinhard Berner and Johannes Forster and Christoph H\"{a}rtel and Ulrich Heininger and Hans-Iko Huppertz and Johannes G Liese and David Nadal and Arne Simon},
isbn = {978-3-13-240790-9},
year = {2018},
date = {2018-01-01},
booktitle = {DGPI-Handbuch},
pages = {764--769},
publisher = {Thieme},
address = {Stuttgart},
keywords = {},
pubstate = {published},
tppubtype = {incollection}
}
Enders, M
Röteln in der Schwangerschaft: Frauenärzte im Netz Sonstige
2018.
@misc{Enders.2018b,
title = {R\"{o}teln in der Schwangerschaft: Frauen\"{a}rzte im Netz},
author = {M Enders},
url = {https://www.frauenaerzte-im-netz.de/erkrankungen/roeteln-in-der-schwangerschaft/#c724},
year = {2018},
date = {2018-01-01},
abstract = {R\"{o}teln geh\"{o}ren zu den am meisten gef\"{u}rchteten Infektionen in der Schwangerschaft, da sie beim Embryo zu schweren Akut- und Folgesch\"{a}den (R\"{o}telnembryopathie) f\"{u}hren k\"{o}nnen. Zwar ist in Deutschland seit Jahren keine R\"{o}telnembryopathie mehr gemeldet worden, aber die Infektion kann aus anderen, auch europ\"{a}ischen Regionen nach Deutschland eingeschleppt werden. Aufgrund von Impfl\"{u}cken (haupts\"{a}chlich bei Jugendlichen und jungen Erwachsenen) muss deshalb auch weiterhin mit R\"{o}teln in der Schwangerschaft und R\"{o}telnembryopathien gerechnet werden.},
keywords = {},
pubstate = {published},
tppubtype = {misc}
}
Geipel, A; Enders, M
In: Geburtshilfe und Frauenheilkunde, Bd. 78, Nr. 06, S. 555–560, 2018, ISSN: 0016-5751.
@article{Geipel.2018,
title = {241. Stellungnahme der Deutschen Gesellschaft f\"{u}r Gyn\"{a}kologie und Geburtshilfe (DGGG) zum Thema Zikavirus-Infektion w\"{a}hrend der Schwangerschaft, Auswirkungen auf den Feten und Empfehlungen zur \"{U}berwachung und Diagnostik},
author = {A Geipel and M Enders},
doi = {10.1055/a-0607-5411},
issn = {0016-5751},
year = {2018},
date = {2018-01-01},
journal = {Geburtshilfe und Frauenheilkunde},
volume = {78},
number = {06},
pages = {555--560},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Enders, M
Zytomegalie in der Schwangerschaft: Frauenärzte im Netz Sonstige
2018.
@misc{Enders.2018c,
title = {Zytomegalie in der Schwangerschaft: Frauen\"{a}rzte im Netz},
author = {M Enders},
url = {https://www.frauenaerzte-im-netz.de/erkrankungen/zytomegalie-in-der-schwangerschaft/#c856},
year = {2018},
date = {2018-01-01},
abstract = {Die Zytomegalie (Cytomegalie) ist eine Infektionserkrankung, die durch das Cytomegalievirus (abgek\"{u}rzt CMV) verursacht wird. Bei Schwangeren kann das Virus auf das ungeborene Kind \"{u}bertragen werden (kongenitale CMV-Infektion) und dort zu schweren Sch\"{a}digungen f\"{u}hren.},
keywords = {},
pubstate = {published},
tppubtype = {misc}
}
Modrow, S; Buxmann, H; Enders, M; Gembruch, U; Goelz, R; Hamprecht, K; Huzly, D; Kummer, P; Kagan, K O; Knuf, M; Mertens, T; Nennstiel-Ratzel, U; Roll, C; Wojcinski, M
Management der kongenitalen Zytomegalievirus-Infektion bei Neugeborenen Artikel
In: Frauenarzt, Bd. 59, Nr. 5, S. 394–402, 2018.
@article{Modrow.2018,
title = {Management der kongenitalen Zytomegalievirus-Infektion bei Neugeborenen},
author = {S Modrow and H Buxmann and M Enders and U Gembruch and R Goelz and K Hamprecht and D Huzly and P Kummer and K O Kagan and M Knuf and T Mertens and U Nennstiel-Ratzel and C Roll and M Wojcinski},
year = {2018},
date = {2018-01-01},
urldate = {2018-01-01},
journal = {Frauenarzt},
volume = {59},
number = {5},
pages = {394--402},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Chiaie, L Delle; Neuberger, P; Vochem, M; Lihs, A; Karck, U; Enders, M
In: Archives of gynecology and obstetrics, Bd. 297, Nr. 6, S. 1389–1395, 2018.
@article{DelleChiaie.2018,
title = {No evidence of obstetrical adverse events after hyperimmune globulin application for primary cytomegalovirus infection in pregnancy: experience from a single centre},
author = {L Delle Chiaie and P Neuberger and M Vochem and A Lihs and U Karck and M Enders},
doi = {10.1007/s00404-018-4703-y},
year = {2018},
date = {2018-01-01},
urldate = {2018-01-01},
journal = {Archives of gynecology and obstetrics},
volume = {297},
number = {6},
pages = {1389--1395},
abstract = {PURPOSE: To determine the frequency of obstetrical adverse events and clinical outcome in infants following antenatal hyperimmune globulin (HIG) treatment for primary cytomegalovirus (CMV) infection in pregnancy. METHODS: Data from 50 women including three twin pregnancies were retrospectively evaluated. Primary infection was defined by seroconversion or the presence of CMV-specific IgM and low IgG avidity. All women received two or more infusions of HIG (200 U/kg). Congenital CMV (cCMV) infection was diagnosed by detection of CMV in amniotic fluid and/or neonatal urine. We compared gestational age (GA) at birth, head circumference (HC) and birth weight (BW) of infants in our study cohort with those of live-born infants delivered in our clinic between 2015 and 2016. RESULTS: Median gestational age at time of maternal CMV diagnosis was 13 weeks. One-hundred-forty-one maternal HIG doses were given. No HIG-related severe adverse reactions occurred. Preterm birth rate was 4.2% (2/47) in singleton pregnancies. None of the neonates had birth weight or head circumference textless 3rd percentile (textless 3P) for gestational age. There was no statistically significant difference regarding GA, BW and HC between our study cohort and the total population of live-born infants. The frequency of CMV-related sequelae in infants with cCMV infection was 10.5% (2/19) (one with bilateral hearing loss and one with mild motoric delay), both cases following first trimester maternal infection. CONCLUSION: Antenatal HIG treatment was well tolerated and not associated with prematurity or decreased birth weight. HIG application might have a favorable effect on the clinical course of congenital CMV infection},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kagan, K O; Enders, M; Hoopmann, M; Hamprecht, K
Behandlungsoptionen bei einer vorgeburtlichen CMV-Primärinfektion Artikel
In: Frauenarzt, Bd. 59, Nr. 11, S. 854–858, 2018.
@article{Kagan.2018b,
title = {Behandlungsoptionen bei einer vorgeburtlichen CMV-Prim\"{a}rinfektion},
author = {K O Kagan and M Enders and M Hoopmann and K Hamprecht},
year = {2018},
date = {2018-01-01},
urldate = {2018-01-01},
journal = {Frauenarzt},
volume = {59},
number = {11},
pages = {854--858},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Modrow, S; Buxmann, H; Enders, M; Gembruch, U; Goelz, R; Hamprecht, K; Huzly, D; Kummer, P; Kagan, K O; Knuf, M; Mertens, T; Nennstiel-Ratzel, U; Roll, C; Wojcinski, M
Management der kongenitalen Zytomegalievirus-Infektion bei Neugeborenen Artikel
In: Kinder- und Jugendarzt, Bd. 49, Nr. 3, S. 107–117, 2018, ISSN: 1436-9559.
@article{Modrow.2018b,
title = {Management der kongenitalen Zytomegalievirus-Infektion bei Neugeborenen},
author = {S Modrow and H Buxmann and M Enders and U Gembruch and R Goelz and K Hamprecht and D Huzly and P Kummer and K O Kagan and M Knuf and T Mertens and U Nennstiel-Ratzel and C Roll and M Wojcinski},
issn = {1436-9559},
year = {2018},
date = {2018-01-01},
journal = {Kinder- und Jugendarzt},
volume = {49},
number = {3},
pages = {107--117},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Enders, M
Ringelröteln in der Schwangerschaft: Frauenärzte im Netz Sonstige
2018.
@misc{Enders.2018d,
title = {Ringelr\"{o}teln in der Schwangerschaft: Frauen\"{a}rzte im Netz},
author = {M Enders},
url = {https://www.frauenaerzte-im-netz.de/erkrankungen/ringelroeteln-in-der-schwangerschaft/wichtige-hinweise/},
year = {2018},
date = {2018-01-01},
abstract = {Wichtige Hinweise zum Thema Ringelr\"{o}teln, wie z.B. bei Ringelr\"{o}teln im Umfeld sollte der Immunschutz der Schwangeren \"{u}berpr\"{u}ft werden. Dies ist eine Kassenleistung.},
keywords = {},
pubstate = {published},
tppubtype = {misc}
}
Schalasta, G; Börner, A; Speicher, A; Enders, M
In: Clinical chemistry and laboratory medicine, Bd. 56, Nr. 4, S. 634–641, 2018, ISSN: 1434-6621.
@article{Schalasta.2018,
title = {Evaluation of the Aptima HBV Quant assay vs. the COBAS TaqMan HBV test using the high pure system for the quantitation of HBV DNA in plasma and serum samples},
author = {G Schalasta and A B\"{o}rner and A Speicher and M Enders},
doi = {10.1515/cclm-2017-0701},
issn = {1434-6621},
year = {2018},
date = {2018-01-01},
journal = {Clinical chemistry and laboratory medicine},
volume = {56},
number = {4},
pages = {634--641},
abstract = {BACKGROUND: Proper management of patients with chronic hepatitis B virus (HBV) infection requires monitoring of plasma or serum HBV DNA levels using a highly sensitive nucleic acid amplification test. Because commercially available assays differ in performance, we compared herein the performance of the Hologic Aptima HBV Quant assay (Aptima) to that of the Roche Cobas TaqMan HBV test for use with the high pure system (HPS/CTM). METHODS: Assay performance was assessed using HBV reference panels as well as plasma and serum samples from chronically HBV-infected patients. Method correlation, analytical sensitivity, precision/reproducibility, linearity, bias and influence of genotype were evaluated. Data analysis was performed using linear regression, Deming correlation analysis and Bland-Altman analysis. RESULTS: Agreement between the assays for the two reference panels was good, with a difference in assay values vs. target textless0.5 log. Qualitative assay results for 159 clinical samples showed good concordance (88.1%; kappa=0.75; 95% confidence interval: 0.651-0.845). For the 106 samples quantitated by both assays, viral load results were highly correlated (R=0.92) and differed on average by 0.09 log, with 95.3% of the samples being within the 95% limit of agreement of the assays. Linearity for viral loads 1-7 log was excellent for both assays (R2textgreater0.98). The two assays had similar bias and precision across the different genotypes tested at low viral loads (25-1000 IU/mL). CONCLUSIONS: Aptima has a performance comparable with that of HPS/CTM, making it suitable for use for HBV infection monitoring. Aptima runs on a fully automated platform (the Panther system) and therefore offers a significantly improved workflow compared with HPS/CTM},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Spahr, C; Knauf-Witzens, T; Dahnert, L; Enders, M; Müller, M; Johne, R; Ulrich, R G
In: Epidemiology and infection, Bd. 146, Nr. 1, S. 119–124, 2018, ISSN: 0950-2688.
@article{Spahr.2018,
title = {Detection of HEV-specific antibodies in four non-human primate species, including great apes, from different zoos in Germany},
author = {C Spahr and T Knauf-Witzens and L Dahnert and M Enders and M M\"{u}ller and R Johne and R G Ulrich},
doi = {10.1017/S0950268817002606},
issn = {0950-2688},
year = {2018},
date = {2018-01-01},
journal = {Epidemiology and infection},
volume = {146},
number = {1},
pages = {119--124},
abstract = {The hepatitis E virus (HEV) has been described in humans and various animal species in different regions of the world. However, the knowledge on natural HEV infection in non-human primates and the corresponding risk of zoonotic transmission is scarce. To determine whether primates in captivity are affected by HEV infection, we investigated 259 individual sera of clinically healthy non-human primates of 14 species from nine German zoos. Using a commercial double-antigen-sandwich ELISA and a commercial IgG ELISA, 10 animals (3.9%) reacted positive in at least one assay. Three ape species and one Old World monkey species were among the seropositive animals: bonobo (Pan paniscus), gorilla (Gorilla gorilla gorilla), lar gibbon (Hylobates lar) and drill (Mandrillus leucophaeus). Testing for anti-HEV-IgM antibodies by commercial ELISA and for viral RNA by reverse-transcription real-time polymerase chain reaction resulted in negative results for all animals indicating the absence of acute HEV infections. In the past, no clinical signs of hepatitis were recorded for the seropositive animals. The results suggest that non-human primates in zoos can get naturally and subclinically infected with HEV or related hepeviruses. Future studies should evaluate potential sources and transmission routes of these infections and their impact on human health},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2017
Mueller, J; Dagenbach, S; Riecken, B; Klinger, C
Unklare Leberraumforderung und Fieber nach Türkeiaufenthalt Artikel
In: Der Internist, Bd. 58, Nr. 5, S. 503–506, 2017, ISSN: 0020-9554.
@article{Mueller.2017,
title = {Unklare Leberraumforderung und Fieber nach T\"{u}rkeiaufenthalt},
author = {J Mueller and S Dagenbach and B Riecken and C Klinger},
doi = {10.1007/s00108-017-0197-0},
issn = {0020-9554},
year = {2017},
date = {2017-01-01},
journal = {Der Internist},
volume = {58},
number = {5},
pages = {503--506},
abstract = {We report the case of a~76-year old female patient with a~hepatic mass after staying in eastern Turkey. There were no indices for malignancy or an infection with Echinococcus or Entamoeba histolytica. Finally we diagnosed a~Fascioliasis (liver fluke) and cured the patient successfully.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Rauch, S; Ritgen, J; Wißkirchen, M; Bauerfeind, U; Kohne, E; Weinstock, C
A case of anti-Rd causing fetal anemia Artikel
In: Transfusion, Bd. 57, Nr. 6, S. 1485–1487, 2017.
@article{Rauch.2017,
title = {A case of anti-Rd causing fetal anemia},
author = {S Rauch and J Ritgen and M Wi\sskirchen and U Bauerfeind and E Kohne and C Weinstock},
doi = {10.1111/trf.14078},
year = {2017},
date = {2017-01-01},
journal = {Transfusion},
volume = {57},
number = {6},
pages = {1485--1487},
abstract = {BACKGROUND
Rd (SC4) is a low-frequency antigen of the Scianna blood group system. Only very few reports on anti-Rd in pregnancy exist. Mild to moderate hemolytic disease of the newborn caused by anti-Rd has been reported. This report may add further information on the clinical significance of anti-Rd for the fetus.
CASE REPORT
In a case of severe fetal anemia (hemoglobin concentration, 3.0 g/dL) repeated intrauterine transfusions were required. The strongly positive direct antiglobulin test (DAT) of the fetal red blood cells led to the diagnosis of hemolytic disease. The routine antibody screen was negative, extended testing revealed a maternal anti-Rd with a titer of 256. Both the newborn and her father were confirmed to carry the SC*01.04 allele.
CONCLUSION
Anti-Rd can cause fetal anemia. Low-frequency antigens including Rd are normally not present on screening cells. Antibodies directed against low-frequency antigens will usually not be detected by routine antibody screening in pregnancy. Thus, in cases of fetal anemia the DAT should always be included in the diagnostic workup.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Rd (SC4) is a low-frequency antigen of the Scianna blood group system. Only very few reports on anti-Rd in pregnancy exist. Mild to moderate hemolytic disease of the newborn caused by anti-Rd has been reported. This report may add further information on the clinical significance of anti-Rd for the fetus.
CASE REPORT
In a case of severe fetal anemia (hemoglobin concentration, 3.0 g/dL) repeated intrauterine transfusions were required. The strongly positive direct antiglobulin test (DAT) of the fetal red blood cells led to the diagnosis of hemolytic disease. The routine antibody screen was negative, extended testing revealed a maternal anti-Rd with a titer of 256. Both the newborn and her father were confirmed to carry the SC*01.04 allele.
CONCLUSION
Anti-Rd can cause fetal anemia. Low-frequency antigens including Rd are normally not present on screening cells. Antibodies directed against low-frequency antigens will usually not be detected by routine antibody screening in pregnancy. Thus, in cases of fetal anemia the DAT should always be included in the diagnostic workup.
Regnath, T; Raecke, O; Enninger, A; Ignatius, R
In: Helicobacter, Bd. 22, Nr. 1, 2017.
@article{Regnath.2017,
title = {Increasing metronidazole and rifampicin resistance of Helicobacter pylori isolates obtained from children and adolescents between 2002 and 2015 in southwest Germany},
author = {T Regnath and O Raecke and A Enninger and R Ignatius},
doi = {10.1111/hel.12327},
year = {2017},
date = {2017-01-01},
journal = {Helicobacter},
volume = {22},
number = {1},
abstract = {BACKGROUND
Increasing antibiotic resistance has been reported for Helicobacter pylori, but data on the prevalence of antibiotic resistance of H.~pylori in pediatric patients and the development of resistance over time are sparse.
METHODS
Data for 610 H.~pylori isolates obtained between 2002 and 2015 from gastric biopsies of 582 (mainly treatment-na"ive) pediatric patients from southwest Germany were analyzed retrospectively regarding the antibiotic susceptibility determined by Etest and patients' characteristics.
RESULTS
Overall resistance to metronidazole, clarithromycin, and rifampicin was 28.7%, 23.2%, and 13.3%, respectively, while resistance to amoxicillin was rare (0.8%). Simultaneous resistance to metronidazole and clarithromycin was observed for 7.7% of the isolates, and 2.3% were resistant to metronidazole, clarithromycin, and rifampicin. Differences between primary vs secondary resistance existed for metronidazole (24.7% vs 38.8%},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Increasing antibiotic resistance has been reported for Helicobacter pylori, but data on the prevalence of antibiotic resistance of H.~pylori in pediatric patients and the development of resistance over time are sparse.
METHODS
Data for 610 H.~pylori isolates obtained between 2002 and 2015 from gastric biopsies of 582 (mainly treatment-na"ive) pediatric patients from southwest Germany were analyzed retrospectively regarding the antibiotic susceptibility determined by Etest and patients' characteristics.
RESULTS
Overall resistance to metronidazole, clarithromycin, and rifampicin was 28.7%, 23.2%, and 13.3%, respectively, while resistance to amoxicillin was rare (0.8%). Simultaneous resistance to metronidazole and clarithromycin was observed for 7.7% of the isolates, and 2.3% were resistant to metronidazole, clarithromycin, and rifampicin. Differences between primary vs secondary resistance existed for metronidazole (24.7% vs 38.8%
Guzmán, A Rueda; Slesak, G; Fleck, R; Ignatius, R; Oehme, R; Schäfer, J
Chronisches Ulkus nach Südostasienreise bei 24hbox-jährigem Mann Artikel
In: Der Internist, Bd. 58, Nr. 8, S. 859–862, 2017, ISSN: 0020-9554.
@article{RuedaGuzman.2017,
title = {Chronisches Ulkus nach S\"{u}dostasienreise bei 24hbox-j\"{a}hrigem Mann},
author = {A {Rueda Guzm\'{a}n} and G Slesak and R Fleck and R Ignatius and R Oehme and J Sch\"{a}fer},
doi = {10.1007/s00108-017-0215-2},
issn = {0020-9554},
year = {2017},
date = {2017-01-01},
journal = {Der Internist},
volume = {58},
number = {8},
pages = {859--862},
abstract = {Our report concerns a~24-year-old man with a~chronic exsudative skin lesion after a~journey to Southeast Asia. The diagnosis of melioidosis was made by the identification of Burkholderia pseudomallei from the ichor. The diagnosis was confirmed by polymerase change reaction. The patient was treated with meropenem i. v. for about 10~days and with trimethoprim/sulfamethoxazole for the following 12~weeks. Melioidosis is an endemic disease in Southeast Asia and North Australia which in some cases can run a~severe course and can have a~high fatality rate. The relevance of melioidosis becomes more important against the background of the increasing global movement of travelers and migration.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}