22 results on '"Miriam Wiese-Posselt"'
Search Results
2. Impact of public health interventions to curb SARS-CoV-2 spread assessed by an evidence-educated Delphi panel and tailored SEIR model
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Lilian Krist, Miriam Wiese-Posselt, Gabriele Rotter, Stefan N. Willich, Stephanie Roll, Miriam Ortiz, Hans-Peter Stricker, Thomas Reinhold, Beate Weikert, and Bernd Brüggenjürgen
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medicine.medical_specialty ,CoViD-19 ,Coronavirus disease 2019 (COVID-19) ,Pandemic ,business.industry ,SARS-CoV-2 ,Public health ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,030231 tropical medicine ,Public Health, Environmental and Occupational Health ,Delphi method ,Psychological intervention ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Delphi-panel ,Germany ,Epidemiology ,Medicine ,Original Article ,030212 general & internal medicine ,Duration (project management) ,business ,Model - Abstract
Aim To use a Delphi-panel-based assessment of the effectiveness of different non-pharmaceutical interventions (NPI) in order to retrospectively approximate and to prospectively predict the SARS-CoV-2 pandemic progression via a SEIR model (susceptible, exposed, infectious, removed). Methods We applied an evidence-educated Delphi-panel approach to elicit the impact of NPIs on the SARS-CoV-2 transmission rate R0 in Germany. Effectiveness was defined as the product of efficacy and compliance. A discrete, deterministic SEIR model with time step of 1 day, a latency period of 1.8 days, duration of infectiousness of 5 days, and a share of the total population of 15% assumed to be protected by immunity was developed in order to estimate the impact of selected NPI measures on the course of the pandemic. The model was populated with the Delphi-panel results and varied in sensitivity analyses. Results Efficacy and compliance estimates for the three most effective NPIs were as follows: test and isolate 49% (efficacy)/78% (compliance), keeping distance 42%/74%, personal protection masks (cloth masks or other face masks) 33%/79%. Applying all NPI effectiveness estimates to the SEIR model resulted in a valid replication of reported occurrence of the German SARS-CoV-2 pandemic. A combination of four NPIs at consented compliance rates might curb the CoViD-19 pandemic. Conclusion Employing an evidence-educated Delphi-panel approach can support SARS-CoV-2 modelling. Future curbing scenarios require a combination of NPIs. A Delphi-panel-based NPI assessment and modelling might support public health policy decision making by informing sequence and number of needed public health measures.
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- 2020
3. Impact of Public Health Interventions to Curb SARS-CoV-2 Spread by an Evidence-Educated Delphi-Panel and Tailored SEIR Model
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Lilian Krist, Miriam Wiese-Posselt, Gabriele Rotter, Thomas Reinhold, Hans-Peter Stricker, Stefan N. Willich, Bernd Brüggenjürgen, Beate Weikert, Miriam Ortiz, and Stephanie Roll
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medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Public health ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Psychological intervention ,Delphi method ,Hygiene ,Environmental health ,Pandemic ,medicine ,Closure (psychology) ,Duration (project management) ,business ,media_common - Abstract
Background: With the absence of immunization, public health interventions are the basis for curbing the spread of the SARS-CoV-2 virus. Evidence of impact of non-pharmaceutical interventions (NPI) on SARS-CoV-2 spread in Germany is scarce. The objectives of this study were to use a Delphi-panel based assessment of the effectiveness of different COVID-19 specific prevention measures in order to retrospectively approximate and to prospectively predict the SARS-CoV-2 pandemic progression via a SEIR model (SEIR: Susceptible - Exposed - Infectious - Removed). The SEIR model will be made available with a modifiable user interface. Methods: We applied an evidence-educated Delphi-panel approach to elicit the impact of NPIs being discussed in Germany on the SARS-CoV-2 transmission rate R0. Initial estimates were discussed and agreed upon in two Delphi stages resulting in a final set of average efficacy and compliance estimates for each NPI. Effectiveness was defined as the product of efficacy and compliance. A discrete, deterministic SEIR model with time step of 1 day, a latency period of 1.·8 days, duration of infectiousness of 5 days, and a share of the total population of 15% assumed to be protected by immunity was developed in order to estimate the impact of selected NPI measures on pandemic course. The model was populated with the Delphi-panel results and varied in sensitivity analyses. Results: Efficacy and compliance estimates were obtained as follows (ranked by effectiveness): test and isolate 49% (efficacy)/78% (compliance), keeping distance 42%/74%, personal protection masks (cloth masks or other face masks) 33%/79%, ban of large public events 26%/96%, contact reduction 33%/59%, closure of non-essential stores 10%/97%, closure of schools 10%/100%, working from home 12%/66%, closure of restaurants 8%/96%, and improved hand hygiene 7%/54%. Applying these NPI effectiveness estimates to the SEIR model resulted in a valid replication of reported occurrence of the German SARS-CoV-2 pandemic. Conclusion: Employing an evidence-educated Delphi-panel approach for generating NPI effectiveness estimates is feasible and could help to generate model simulations with close replication of reported infected cases in Germany. Future curbing scenarios require a combination of NPIs. A Delphi-panel based NPI assessment and modelling might support public health policy decision making by informing sequence and number of needed public health measures. Funding Statement: None. Declaration of Interests: None declared. Ethics Approval Statement: Not applicable.
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- 2020
4. Die STIKO empfiehlt die HPV-Impfung jetzt auch für Jungen
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Stefanie J. Klug, Ständige Impfkommission (Stiko) und Ag Hpv der Stiko, Anja Takla, Martin Terhardt, Fred Zepp, Ole Wichmann, Miriam Wiese-Posselt, Thomas Harder, Jörg J. Meerpohl, Marianne A B van der Sande, and Marianne Röbl-Mathieu
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Gynecology ,Cervical cancer ,medicine.medical_specialty ,business.industry ,Urology ,MEDLINE ,medicine.disease ,Vaccination ,03 medical and health sciences ,Papillomavirus Vaccines ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,030212 general & internal medicine ,business - Published
- 2018
5. Background paper for the recommendation of HPV vaccination for boys in Germany
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Fred Zepp, Marianne Röbl-Mathieu, Anja Takla, Miriam Wiese-Posselt, Thomas Harder, Jörg J. Meerpohl, Marianne A B van der Sande, Ole Wichmann, Martin Terhardt, and Stefanie J. Klug
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Male ,medicine.medical_specialty ,business.industry ,Public health ,Decision Making ,Papillomavirus Infections ,Vaccination ,Public Health, Environmental and Occupational Health ,MEDLINE ,Hpv vaccination ,Patient Acceptance of Health Care ,03 medical and health sciences ,0302 clinical medicine ,Germany ,030220 oncology & carcinogenesis ,Family medicine ,Humans ,Medicine ,Papillomavirus Vaccines ,030212 general & internal medicine ,business - Published
- 2018
6. Prevalence of third-generation cephalosporin-resistant Enterobacterales colonization on hospital admission and ESBL genotype-specific risk factors: a cross-sectional study in six German university hospitals
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Miriam Wiese-Posselt, Axel Hamprecht, Alexander Mischnik, Anna M Rohde, Friedemann Gebhardt, Axel Kola, Maria J G T Vehreschild, Frank J. Schwab, Petra Gastmeier, Christian Schneider, Michael Behnke, Janine Zweigner, Hannah Gölz, Susanne Feihl, Christiane Querbach, Winfried V. Kern, Evelina Tacconelli, Wiebke Schröder, Thorsten Wille, Silke Peter, Harald Seifert, and Publica
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0301 basic medicine ,Microbiology (medical) ,Adult ,medicine.medical_specialty ,Genotype ,medicine.drug_class ,Cross-sectional study ,030106 microbiology ,Antibiotics ,Cephalosporin ,Specific risk ,beta-Lactamases ,Hospitals, University ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Germany ,polycyclic compounds ,medicine ,Prevalence ,Humans ,Pharmacology (medical) ,Colonization ,030212 general & internal medicine ,Risk factor ,Genotyping ,Escherichia coli Infections ,Pharmacology ,business.industry ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,Cephalosporins ,Europe ,Infectious Diseases ,Cross-Sectional Studies ,business - Abstract
Objectives To assess the admission prevalence of third-generation cephalosporin-resistant Enterobacterales (3GCREB) and to assess whether risk factors vary by β-lactamase genotype. Methods Adult patients were recruited within 72 h of admission to general wards of six university hospitals in 2014 and 2015. Rectal swabs were screened for 3GCREB and isolates were analysed phenotypically and genotypically. Patients were questioned on potential risk factors. Multivariable analyses were performed to identify risk factors for 3GCREB colonization and for specific β-lactamases. Results Of 8753 patients screened, 828 were 3GCREB positive (9.5%). Eight hundred and thirteen isolates were available for genotyping. CTX-M-15 was the most common ESBL (38.0%), followed by CTX-M-1 (22.5%), CTX-M-14 (8.7%), CTX-M-27 (7.5%) and SHV-ESBL (4.4%). AmpC was found in 11.9%. Interestingly, 18 Escherichia coli isolates were AmpC positive, 12 of which (67%) contained AmpC on a gene of plasmid origin [CMY (n = 10), DHA (n = 2)]. Risk factors for 3GCREB colonization varied by genotype. Recent antibiotic exposure and prior colonization by antibiotic-resistant bacteria were risk factors for all β-lactamases except CTX-M-14 and CTX-M-27. Travel outside Europe was a risk factor for CTX-M-15 and CTX-M-27 [adjusted OR (aOR) 3.49, 95% CI 2.88–4.24 and aOR 2.73, 95% CI 1.68–4.43]. A previous stay in a long-term care facility was associated with CTX-M-14 (aOR 3.01, 95% CI 1.98–4.59). A preceding hospital stay in Germany increased the risk of CTX-M-15 (aOR 1.27, 95% CI 1.14–1.41), while a prior hospital stay in other European countries increased the risk of SHV-ESBL colonization (aOR 3.85, 95% CI 1.67–8.92). Conclusions The detection of different ESBL types is associated with specific risk factor sets that might represent distinct sources of colonization and ESBL-specific dissemination routes.
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- 2019
7. S2k guideline: HPV-associated lesions of the external genital region and the anus - anogenital warts and precancerous lesions of the vulva, the penis, and the peri- and intra-anal skin (short version)
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Helmut Schöfer, Gerd Gross, Dominik Mestel, Karl Sotlar, Peter Schneede, Sara Hommel, Gerhard Weyandt, Miriam Wiese-Posselt, Klaus Püschel, Norbert H. Brockmeyer, K. U. Petry, Stefan Esser, Jürgen C. Becker, Thomas Meyer, Johannes Jongen, Andreas Plettenberg, Ricardo Niklas Werner, Alexander Nast, Ulrike Wieland, and Monika Hampl
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medicine.medical_specialty ,business.industry ,Peri ,Dermatology ,Guideline ,Anus ,Vulva ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,medicine ,Genital region ,030211 gastroenterology & hepatology ,business ,Penis - Published
- 2018
8. S2k-Leitlinie: HPV-assoziierte Läsionen der äußeren Genitalregion und des Anus - Genitalwarzen und Krebsvorstufen der Vulva, des Penis und der peri- und intraanalen Haut (Kurzfassung)
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Gerd Gross, Alexander Nast, Peter Schneede, Sara Hommel, Miriam Wiese-Posselt, Thomas F. Meyer, Norbert H. Brockmeyer, Johannes Jongen, Stefan Esser, Karl Sotlar, Monika Hampl, Dominik Mestel, Ulrike Wieland, Ricardo Niklas Werner, Jürgen C. Becker, Andreas Plettenberg, Gerhard Weyandt, K. U. Petry, Helmut Schöfer, and Klaus Püschel
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Gynecology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,medicine ,030212 general & internal medicine ,Dermatology ,business - Published
- 2018
9. Impfen bei Immundefizienz
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Miriam Wiese-Posselt, Tim Niehues, Fred Zepp, Thomas Mertens, Jane Hecht, and Christian Bogdan
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030203 arthritis & rheumatology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,Family medicine ,Vaccination coverage ,Public health ,Public Health, Environmental and Occupational Health ,medicine ,MEDLINE ,030212 general & internal medicine ,business - Published
- 2017
10. Incidence of healthcare-associated Clostridioides difficile infections and association with ward-level antibiotic consumption in a German university hospital: an ecological study
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Nayana Märtin, Caroline Isner, Minh Trang Bui, Anne-C Boldt, Miriam Wiese-Posselt, Tobias Kramer, Michael Behnke, Marina Kipnis, Janine Zweigner, Frank J. Schwab, Anna M Rohde, Miriam Stegemann, Petra Gastmeier, Georg Pilarski, and Luisa A. Denkel
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,genetic structures ,030106 microbiology ,Prevalence ,Rate ratio ,law.invention ,Hospitals, University ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,law ,Risk Factors ,Internal medicine ,Germany ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Risk factor ,Pharmacology ,Antiinfective agent ,Cross Infection ,business.industry ,Incidence (epidemiology) ,Incidence ,Ecological study ,Intensive care unit ,Drug Utilization ,Anti-Bacterial Agents ,Infectious Diseases ,Clostridium Infections ,business - Abstract
Objectives Clostridioides difficile infection (CDI) is one of the most important healthcare-associated infections. We aimed to describe the incidence density of healthcare-associated CDI (HA-CDI) in Germany’s largest hospital and to identify associations with ward-level antimicrobial consumption. Methods We used surveillance data on CDI and antimicrobial consumption from 2014 to 2017 and analysed a potential association by means of multivariable regression analysis. Results We included 77 wards with 404998 admitted patients and 1850862 patient-days. Six hundred and seventy-one HA-CDI cases were identified, resulting in a pooled mean incidence density of 0.36/1000 patient-days (IQR = 0.34–0.39). HA-CDI incidence density on ICU and haematological–oncological wards was about three times higher than on surgical wards [incidence rate ratio (IRR) = 3.00 (95% CI = 1.96–4.60) and IRR = 2.78 (95% CI = 1.88–4.11), respectively]. Ward-level consumption of third-generation cephalosporins was the sole antimicrobial risk factor for HA-CDI. With each DDD/100 patient-days administered, a ward’s HA-CDI incidence density increased by 2% [IRR = 1.02 (95% CI = 1.01–1.04)]. Other risk factors were contemporaneous community-associated CDI cases [IRR = 1.32 (95% CI = 1.07–1.63)] and CDI cases in the previous month [IRR = 1.27 (95% CI = 1.07–1.51)]. Furthermore, we found a significant decrease in HA-CDI in 2017 compared with 2014 [IRR = 0.68 (95% CI = 0.54–0.86)]. Conclusions We confirmed that ward-level antimicrobial use influences HA-CDI and specifically identified third-generation cephalosporin consumption as a risk factor.
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- 2019
11. Incidence of infections due to third generation cephalosporin-resistant
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Anna M, Rohde, Janine, Zweigner, Miriam, Wiese-Posselt, Frank, Schwab, Michael, Behnke, Axel, Kola, Birgit, Obermann, Johannes K-M, Knobloch, Susanne, Feihl, Christiane, Querbach, Friedemann, Gebhardt, Alexander, Mischnik, Vera, Ihle, Wiebke, Schröder, Sabina, Armean, Silke, Peter, Evelina, Tacconelli, Axel, Hamprecht, Harald, Seifert, Maria J G T, Vehreschild, Winfried V, Kern, Petra, Gastmeier, and Solvy, Wolke
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0301 basic medicine ,Male ,Carbapenem ,Cephalosporin ,Drug resistance ,Hospital-acquired infections ,Hospitals, University ,Medical microbiology ,Patient Admission ,Fluoroquinolone ,Germany ,Enterobacter spp ,Pharmacology (medical) ,Prospective Studies ,Cross Infection ,biology ,Incidence (epidemiology) ,Incidence ,Enterobacteriaceae Infections ,CRE ,Middle Aged ,University hospital ,Enterobacteriaceae ,Gram-negative ,Community-Acquired Infections ,Infectious Diseases ,Klebsiella spp ,Female ,medicine.drug ,Cohort study ,Microbiology (medical) ,medicine.medical_specialty ,medicine.drug_class ,030106 microbiology ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Internal medicine ,Drug Resistance, Bacterial ,medicine ,Humans ,lcsh:RC109-216 ,Aged ,business.industry ,Research ,Public Health, Environmental and Occupational Health ,E. coli ,biology.organism_classification ,Cephalosporins ,ESBL ,business - Abstract
Background Infections caused by third generation cephalosporin-resistant Enterobacteriaceae (3GCREB) are an increasing healthcare problem. We aim to describe the 3GCREB infection incidence and compare it to prevalence upon admission. In addition, we aim to describe infections caused by 3GCREB, which are also carbapenem resistant (CRE). Methods In 2014–2015, we performed prospective 3GCREB surveillance in clinically relevant patient specimens (screening specimens excluded). Infections counted as hospital-acquired (HAI) when the 3GCREB was detected after the third day following admission, otherwise as community-acquired infection (CAI). Results Of 578,420 hospitalized patients under surveillance, 3367 had a 3GCREB infection (0.58%). We observed a similar 3GCREB CAI and HAI incidence (0.28 and 0.31 per 100 patients, respectively). The most frequent pathogen was 3GCR E. coli, in CAI and HAI (0.15 and 0.12 per 100 patients). We observed a CRE CAI incidence of 0.006 and a HAI incidence of 0.008 per 100 patients (0.014 per 1000 patient days). Conclusions Comparing the known 3GCREB admission prevalence of the participating hospitals (9.5%) with the percentage of patients with a 3GCREB infection (0.58%), we conclude the prevalence of 3GCREB in university hospitals to be about 16 times higher than suggested when only patients with 3GCREB infections are considered. Moreover, we find the HAI and CAI incidence caused by CRE in Germany to be relatively low.
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- 2018
12. Varicella-zoster virus seroprevalence in children and adolescents in the pre-varicella vaccine era, Germany
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Andreas Sauerbrei, Hartmut Hengel, Miriam Wiese-Posselt, Christina Poethko-Müller, Anette Siedler, Annette Mankertz, and Ole Wichmann
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Male ,0301 basic medicine ,Herpesvirus 3, Human ,Pediatrics ,Varicella vaccine ,viruses ,Seroprevalence ,Antibodies, Viral ,medicine.disease_cause ,Chickenpox ,0302 clinical medicine ,Seroepidemiologic Studies ,Germany ,030212 general & internal medicine ,Child ,Antigens, Viral ,education.field_of_study ,Vaccination ,virus diseases ,Antibodies, Anti-Idiotypic ,Infectious Diseases ,Child, Preschool ,Population study ,Female ,Varicella vaccination ,Research Article ,medicine.medical_specialty ,Adolescent ,030106 microbiology ,Population ,Enzyme-Linked Immunosorbent Assay ,Elisa ,lcsh:Infectious and parasitic diseases ,Chickenpox Vaccine ,03 medical and health sciences ,medicine ,Humans ,lcsh:RC109-216 ,education ,business.industry ,Varicella zoster virus ,Infant ,FAMA ,Odds ratio ,medicine.disease ,Logistic Models ,Immunology ,Varicella-zoster virus ,business - Abstract
Background In 2004, universal childhood varicella vaccination was introduced in Germany. We aimed to determine the age-specific prevalence of anti-varicella zoster virus (VZV) IgG-antibodies among children in the pre-varicella vaccine era in Germany, to identify factors associated with VZV seropositivity, and to assess the suitability of a commercially available ELISA for VZV seroepidemiological studies by comparing it with an in-house fluorescent antibody to membrane antigen test (FAMA) as the gold standard. Methods Serum samples of 13,433 children and adolescents aged 1–17 years included in the population-based German Health Interview and Examination Survey for Children and Adolescents (KiGGS; conducted 2003–2006) were tested for anti-VZV IgG by ELISA. All samples with equivocal ELISA results and a random selection of ELISA-negative and -positive samples were tested by FAMA. Statistical analyses were conducted using a weighting factor adjusting the study population to the total population in Germany. Seroprevalences were calculated as percentages (%) with a 95% confidence interval (CI). Odds ratios (OR) were computed by multivariate logistic regression to determine the association between socio-demographic factors and VZV seropositivity. Results The VZV seropositivity rate was 80.3% (95% CI: 79.3–81.3) in varicella-unvaccinated children and adolescents. VZV seropositivity rates differed significantly between age groups up to age 6 years, but not by gender. Of 118 retested serum samples with an equivocal ELISA result, 45.8% were FAMA-positive. The proportion of samples tested as false-negative in by ELISA varied by age group: 2.6% in children aged 1–6 and 9% in children aged 7–17 years. Multivariate analyses showed that age, having older siblings, and early daycare start were associated with seropositivity in preschoolers; migration background reduced the chance of VZV seropositivity in schoolchildren (OR: 0.65; 0.43–0.99) and adolescents (OR: 0.62; 0.4–0.97). Conclusion In the pre-varicella vaccine era, most children in Germany contracted varicella by age six. Schoolchildren with a migration background and children without siblings have an increased risk of being VZV seronegative and should be targeted for catch-up vaccination, if they have no history of chickenpox. ELISAs are suitable for use in population-level serosurveys on VZV, but samples with equivocal ELISA results should be retested by FAMA.
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- 2017
13. Erratum zu: Impfen bei Immundefizienz
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Gerd Burchard, Miriam Wiese-Posselt, Tim Niehues, Stephan Ehl, Judith Koch, Jane Hecht, Jennifer Neubert, Johannes G. Liese, Fred Zepp, Ulrich Baumann, and Christian Bogdan
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,Public Health, Environmental and Occupational Health ,Medicine ,030212 general & internal medicine ,business ,030210 environmental & occupational health - Abstract
Erratum zu: Bundesgesundheitsbl 2018 https://doi.org/10.1007/s00103-018-2761-8 Die Originalveroffentlichung dieses Artikels enthielt einen Fehler in der Autorenliste, in der der beitragende Autor Herr Professor Johannes G. Liese fehlte. Die Autorenliste wurde nun …
- Published
- 2019
14. Background paper to the recommendation for routine rotavirus vaccination of infants in Germany
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Cornelius Remschmidt, Eva Hummers-Pradier, A Mas Marques, Ole Wichmann, H Oppermann, Joerg J Meerpohl, Judith Koch, Thomas Mertens, H Bertelsmann, Hartmut Hengel, Miriam Wiese-Posselt, R. von Kries, and E Garbe
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Male ,Pediatrics ,medicine.medical_specialty ,Vaccination schedule ,medicine.disease_cause ,Mass Vaccination ,Rotavirus Infections ,law.invention ,Randomized controlled trial ,law ,Germany ,Rotavirus ,Humans ,Medicine ,business.industry ,Incidence (epidemiology) ,Infant, Newborn ,Rotavirus Vaccines ,Public Health, Environmental and Occupational Health ,Infant ,Vaccination ,Systematic review ,Relative risk ,Practice Guidelines as Topic ,Female ,Observational study ,business - Abstract
Two rotavirus (RV) vaccines were introduced to the European market in 2006. To support the decision-making process of the German Standing Committee on Vaccination ("Standige Impfkommission", STIKO) regarding adoption of routine RV vaccination into the national vaccination schedule in Germany relevant scientific background was reviewed. According to STIKO’s Standard Operating Procedures for the development of evidence-based vaccination recommendations, a set of key questions was addressed and systematic reviews were performed with a focus on the efficacy, effectiveness, impact and safety of RV vaccines. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was applied to assess the quality of available evidence. Data from 5 randomized controlled trials demonstrated a high efficacy of RV vaccines in preventing severe RV-associated gastroenteritis (91%) and hospitalization (92%) in settings comparable to Germany. Post-marketing observational studies confirmed these findings. In several countries, impact studies suggest that age groups not eligible for vaccination might also benefit from herd effects and demonstrated a decrease in the number of nosocomial RV infections after RV vaccine introduction. The vaccines were considered safe, except for a slightly increased risk of intussusception shortly after the first dose, corresponding to 1-2 additional cases per 100,000 infants vaccinated (relative risk =1.21, 95% confidence interval [CI] 0.68-2.14). RV case-fatality is extremely low in Germany. However, RV incidence among children aged
- Published
- 2013
15. Rotaviren in Deutschland (2001–2006)
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Miriam Wiese-Posselt, C. Hülße, U. Lindlbauer-Eisenach, A Gilsdorf, and D. Matysiak-Klose
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Gynecology ,medicine.medical_specialty ,business.industry ,Pediatrics, Perinatology and Child Health ,medicine ,Surgery ,business - Abstract
Seit Februar bzw. Juni 2006 stehen in Deutschland 2 Rotavirusimpfstoffe zur Verfugung, deren Vertraglichkeit, Wirksamkeit und Sicherheit in grosen klinischen Studien nachgewiesen wurde. Die Standige Impfkommission (STIKO) hat die Impfung gegen Rotaviren fur Sauglinge bisher nicht generell empfohlen. Auf Grundlage der Meldedaten am Robert Koch-Institut sowie nationalen und internationalen epidemiologischen Studien kann die Relevanz von Rotaviruserkrankungen – insbesondere fur Sauglinge und Kleinkinder – eingeschatzt werden. Die Krankheitslast von Rotaviruserkrankungen in Deutschland ergibt sich dabei aus der Haufigkeit der Erkrankung und der Anzahl der Hospitalisierungen, jedoch nicht aus der Schwere der Erkrankung. Eine generelle Impfung gegen Rotaviren konnte zwar zu einer Minderung der Morbiditat von Sauglingen und Kleinkindern sowie zu einer Reduktion der entstehenden Kosten im Zusammenhang mit Rotaviruserkrankungen fuhren; sie ist aber bei den derzeitigen Impfstoffkosten nicht kostenneutral.
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- 2007
16. Epidemiology of rotavirus infections in children less than 5 years of age: Germany, 2001-2008
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Judith Koch and Miriam Wiese-Posselt
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Microbiology (medical) ,Male ,Rotavirus ,Pediatrics ,medicine.medical_specialty ,Cost-Benefit Analysis ,medicine.disease_cause ,Rotavirus Infections ,Germany ,Case fatality rate ,Epidemiology ,Medicine ,Humans ,Disease burden ,business.industry ,Incidence (epidemiology) ,Incidence ,Infant, Newborn ,Rotavirus Vaccines ,Infant ,Vaccination ,Hospitalization ,Infectious Diseases ,El Niño ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Viral disease ,business - Abstract
Background: Rotavirus (RV) infection is the leading cause of acute gastroenteritis in young children worldwide. In 2006, 2 live-attenuated RV-vaccines became available for use in infants ≤6 months of age. In Germany, a statutory notification system for RV infection has been in place since 2001 to monitor RV epidemiology. Our objective was to assess RV disease burden in German children
- Published
- 2010
17. Changes to the varicella and pertussis immunisation schedule in Germany 2009: Background, rationale and implementation
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Miriam Wiese-Posselt and Wiebke Hellenbrand
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Varicella vaccine ,Whooping Cough ,Epidemiology ,Vaccination schedule ,Comorbidity ,Disease Outbreaks ,Chickenpox Vaccine ,Chickenpox ,Germany ,Virology ,Health care ,medicine ,Humans ,Child Care ,Immunization Schedule ,Pertussis Vaccine ,business.industry ,Incidence ,Incidence (epidemiology) ,Public Health, Environmental and Occupational Health ,Infant ,Personnel, Hospital ,Vaccination ,Caregivers ,Immunization ,Child, Preschool ,Female ,business - Abstract
In July 2009, the German Standing Committee on Vaccination (STIKO) modified its recommendations for varicella and pertussis vaccination, based on newly available data on disease epidemiology, vaccine effectiveness (VE) and safety, and an evaluation of the feasibility of the recommended immunisation strategy. The recommendation for varicella vaccine now includes a routine two-dose schedule with the administration of the first dose at the age of 11 to 14 months and the second dose at the age of 15 to 23 months, with a minimum interval of four weeks between these doses. Furthermore, STIKO recommended adding a one-time pertussis booster to the adult vaccination schedule to expand the cocoon strategy in place since 2004. The recommendation of a booster vaccination with an acellular pertussis vaccine every 10 years for persons employed in the care of pre-school children and for healthcare personnel in paediatric, gynaecologic and obstetric health facilities was extended to persons employed in schools and in other institutions caring for older children, and to all healthcare personnel. These recommendations were based on available epidemiological data showing an increase in incidence from 7-10 cases per 100,000 inhabitants in 2002-2004 to over 30 by 2007. Moreover, the high burden of pertussis in infants at 94 hospitalised cases per 100,000 infants in 2007 suggested that the previous cocoon strategy was insufficient.
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- 2010
18. Needs and obstacles of uniform immunisation schedules in the European Union
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Sabine Reiter, Gérard Krause, Andreas Gilsdorf, and Miriam Wiese-Posselt
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Schedule ,medicine.medical_specialty ,Data collection ,Public economics ,business.industry ,Public health ,Member states ,Incidence ,Public Health, Environmental and Occupational Health ,Mass Vaccination ,Europe ,Economic situation ,Treatment Outcome ,Virus Diseases ,Vaccination coverage ,medicine ,media_common.cataloged_instance ,Humans ,European Union ,European union ,business ,Immunization Schedule ,Needs Assessment ,Childhood immunisation ,media_common - Abstract
Immunisation schedules are developed by national committees on immunisation and may differ considerably between the European Union (EU) member states (MS). The European Commission has launched an initiative for a council recommendation with the aim to establish a scientifically substantiated reference childhood immunisation schedule for the EU. In our view this initiative implies the establishment of one European childhood immunisation schedule, which could lead to the perception that this schedule is the only one scientifically justified. The expectations that one uniform immunisation schedule will facilitate mobility of EU residents, improve data collection and increase vaccination coverage are either quantitatively or qualitatively not relevant or even ethically problematic. Arguments that uniform schedules would lead to lower vaccine prices and reduce the need for clinical trials appear to be more relevant but could be addressed more effectively by other measures. On the other hand the following factors may differ substantially between MS and thus support different immunisation schedules, such as (a) values and goals, (b) epidemiological situation, (c) health care delivery system, (d) logistics of vaccine delivery and (e) economic situation. We argue that uniform schedules should not be perceived as a goal in itself but rather as a possibly desired by-product following increasing agreement on goals and values between MS and improved evidence base to be used by national committees on immunisation.
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- 2009
19. Comparative varicella vaccine effectiveness during outbreaks in day-care centres
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A. Siedler, Manuel Dehnert, Miriam Wiese-Posselt, Dorothea Matysiak-Klose, Ulrich Heininger, and M. Spackova
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Male ,Pediatrics ,medicine.medical_specialty ,Varicella vaccine ,viruses ,Day care ,Disease ,Severity of Illness Index ,Disease Outbreaks ,Chickenpox Vaccine ,Chickenpox ,Germany ,Medicine ,Humans ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Vaccination ,Public Health, Environmental and Occupational Health ,virus diseases ,Outbreak ,Child Day Care Centers ,Confidence interval ,Infectious Diseases ,Immunization ,Child, Preschool ,Immunology ,Molecular Medicine ,Female ,Viral disease ,business - Abstract
Routine varicella vaccination for children11 months was introduced in Germany in 2004 with three different vaccine brands available. In 2008 and 2009, we investigated seven varicella outbreaks in day-care centres (DCC).Varicella disease and vaccination status of 1084 children was reviewed to evaluate vaccination coverage (VC), brand-specific varicella vaccine effectiveness (VE), and risk factors of breakthrough varicella (BV,42 days after vaccination). A case was defined as a child with acute onset of varicella attending one of the respective DCC at the time of outbreak. Children with a previous history of varicella, age11 months, vaccinated at age11 months or42 days before disease onset or during the outbreak were excluded from VE and BV risk factors analyses (adjusted for gender, age and DCC).Of 631 children with available vaccination information, 392 (62%) were vaccinated at least once. Overall VE among 352 children eligible was 71% (95% confidence interval (CI) 57-81, p0.001) and differed significantly by disease severity and number of doses administered. Risk for BV was higher for 1 dose of Varilrix (RR=2.8, 95%CI 1.0-7.8, p=0.05) or Priorix-Tetra (RR=2.4, 95%CI 0.7-8.3, p=0.18) but lower for 2 doses of Priorix-Tetra (RR=0.5, 95%CI 0.1-2.7, p=0.41) than for 1 dose of Varivax.Enhanced efforts to increase VC in Germany and 2 doses varicella vaccine might be successful to reduce the risk for BV. The evidence that VE and risk of BV are associated with vaccine brand needs further investigation.
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- 2009
20. Incidence rate of nontuberculous mycobacterial disease in immunocompetent children: a prospective nationwide surveillance study in Germany
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Matthias an der Heiden, Irina Zuschneid, Annicka Reuss, Miriam Wiese-Posselt, Anette Siedler, Walter Haas, Rüdiger von Kries, Hermann Claus, and Barbara Weimann
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Microbiology (medical) ,Male ,medicine.medical_specialty ,Pediatrics ,Disease ,Mycobacterium ,Lymphadenitis ,Germany ,Epidemiology ,medicine ,Humans ,Cumulative incidence ,Prospective Studies ,Prospective cohort study ,Mycobacterium Infections ,biology ,business.industry ,Incidence (epidemiology) ,Incidence ,Age Factors ,Infant ,Mycobacterial disease ,biology.organism_classification ,Surgery ,Infectious Diseases ,El Niño ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Nontuberculous mycobacteria ,Female ,business - Abstract
An increasing incidence in disease caused by nontuberculous mycobacteria is being reported. We investigated the burden of disease in immunocompetent German children in a prospective nationwide study from April 2003 to September 2005. Ninety-seven percent of children presented with lymphadenitis; median age was 2.5 years. Using the capture-recapture method, we estimated a cumulative incidence rate of 3.1/100000 children.
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- 2009
21. Successful termination of a furunculosis outbreak due to lukS-lukF-positive, methicillin-susceptible Staphylococcus aureus in a German village by stringent decolonization, 2002-2005
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D Heuck, Miriam Wiese-Posselt, Andrea Ammon, Martin Mielke, Wolfgang Witte, Andreas Draeger, and Osamah Hamouda
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Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Staphylococcus aureus ,Adolescent ,Population ,Mupirocin ,Microbial Sensitivity Tests ,Skin infection ,medicine.disease_cause ,Disease Outbreaks ,Cohort Studies ,chemistry.chemical_compound ,Bacterial Proteins ,Leukocidins ,Risk Factors ,Internal medicine ,Germany ,Drug Resistance, Bacterial ,medicine ,Humans ,education ,Child ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,business.industry ,Infant, Newborn ,Outbreak ,Furunculosis ,Infant ,Middle Aged ,medicine.disease ,Anti-Bacterial Agents ,Infectious Diseases ,Treatment Outcome ,chemistry ,Nasal Swab ,Child, Preschool ,Immunology ,Female ,Methicillin Resistance ,Panton–Valentine leukocidin ,business ,Methicillin Susceptible Staphylococcus Aureus - Abstract
Background. Skin infections due to Staphylococcus aureus have recently become a public concern, mainly because of emerging resistance against widely used antibiotics and specific virulence determinants. Strains harboring the lukS-lukF gene (which codes for Panton-Valentine leukocidin) are frequently associated with severe furunculosis. Generally applicable strategies for the control of community outbreaks of furunculosis have not been defined. Methods. We report the investigation and successful termination of an outbreak of furunculosis due to lukSlukF–positive S. aureus in a German village ( ). Nasal swab specimens were obtained from village residents. n p 144 A retrospective cohort study was conducted. Nasally colonized persons, persons who had current furuncles or who had experienced relapsing furuncles since 2002, and their family members underwent stringent decolonization measures using mupirocin nasal ointment and disinfecting wash solution. Multiple nasal swab specimens were obtained to monitor the long-term outcome of decolonization measures. Results. From January 1998 through December 2004, 42 cases and 59 relapses of furunculosis were identified by active case finding. Of 140 participants tested, 51 (36%) were found to be nasally colonized with S. aureus .I n 9 participants, the strain was positive for lukS-lukF. No methicillin resistance was detected. Risk of furunculosis was associated with contact with case patients (relative risk, 6.8; 95% confidence interval, 3.2–14.3) and nasal colonization with a lukS-lukF–positive strain of S. aureus (relative risk, 3.6; 95% confidence interval, 2.3–5.9). Passive surveillance implemented in January 2005 did not detect any case of lukS-lukF–positive, S. aureus–associated furuncles in this village. Conclusion. This report describes a successful strategy for terminating the transmission of epidemic strains of S. aureus among a nonhospitalized population.
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- 2006
22. Prevalence of colonisation with third generation cephalosporin-resistant enterobacteriacae (3GCREB) on admission - a cross-sectional study in 6 university hospitals
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Miriam Wiese-Posselt, Janine Zweigner, Anna M Rohde, Axel Hamprecht, Winfried V. Kern, Harald Seifert, and Petra Gastmeier
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Microbiology (medical) ,medicine.medical_specialty ,Pediatrics ,business.industry ,medicine.drug_class ,Cross-sectional study ,Cephalosporin ,Public Health, Environmental and Occupational Health ,Drug resistance ,University hospital ,Third generation ,Colonisation ,Infectious Diseases ,Carriage ,Medical microbiology ,Emergency medicine ,Oral Presentation ,Medicine ,Pharmacology (medical) ,business - Abstract
This admission prevalence survey is part of the multicenter study ATHOS (antibiotic therapy optimisation study). ATHOS aims at collecting prevalence and incidence data for nosocomial carriage of multi-drug resistant organisms (MDROs) and to intervene in the inpatient and outpatient setting.
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