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1. Molecular characterization of vancomycin-resistant Enterococcus faecium isolates from two German hospitals

Author

Nürnberger, Laura, Schmidt, Dirk, Szumlanski, Tobias, Kirchhoff, Lisa, Ross, Birgit, Steinmann, Jörg, and Rath, Peter-Michael

Subjects
vre, mlst, pfge, molecular epidemiology, Medicine, Public aspects of medicine, RA1-1270, Microbiology, QR1-502
Abstract

Introduction: Vancomycin-resistant accounts for around 10–23% of nosocomial enterococcal infections and constitutes a relevant therapeutic problem due to its limited susceptibility to antibiotics. The resistance towards glycopeptide antibiotics is mediated by the so-called van genes. Currently, the most common resistance type in Germany is the -type. Little data are available on the molecular epidemiology in Germany. Therefore, an epidemiological typing of isolates with vanB-type resistance from two German hospitals in Essen and Nuremberg was performed. Two outbreaks and 104 sporadic cases were investigated. Methods: All 128 isolates with -type resistance were collected between 2011–2012 and 2017–2018. They were characterized using multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Results: ST 117 was the most common sequence type (ST) in both hospitals, especially since 2017. PFGE divided the isolates of this study into 68 PFGE types and showed a broad genetic diversity. Two epidemiologically assumed in-hospital outbreaks were genetically confirmed. Apart from that, in-hospital transmissions were rare events. Conclusion: The results obtained by MLST confirmed the previously described allocation of STs in Germany. PFGE showed a broad genetic diversity of VRE between the two hospitals and also within each hospital. In-hospital transmissions were rare, but outbreaks did occur. Our data supports the strategy to screen and isolate patients in transmission events in order to detect monoclonality indicating a common source or hygiene mismanagement.

Published
2021
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2. Attributable mortality of candidemia – Results from the ECMM Candida III multinational European Observational Cohort Study

Author

Salmanton-García, Jon, Cornely, Oliver A., Stemler, Jannik, Barać, Aleksandra, Steinmann, Jörg, Siváková, Alena, Akalin, Emin Halis, Arikan-Akdagli, Sevtap, Loughlin, Laura, Toscano, Cristina, Narayanan, Manjusha, Rogers, Benedict, Willinger, Birgit, Akyol, Deniz, Roilides, Emmanuel, Lagrou, Katrien, Mikulska, Malgorzata, Denis, Blandine, Ponscarme, Diane, Scharmann, Urlike, Azap, Alpay, Lockhart, Deborah, Bicanic, Tihana, Kron, Florian, Erben, Nurettin, Rautemaa-Richardson, Riina, Goodman, Anna L., Garcia-Vidal, Carolina, Lass-Flörl, Cornelia, Gangneux, Jean-Pierre, Taramasso, Lucia, Ruiz, Maite, Schick, Yael, Van Wijngaerden, Eric, Milacek, Christopher, Giacobbe, Daniele Roberto, Logan, Clare, Rooney, Emily, Gori, Andrea, Akova, Murat, Bassetti, Matteo, Hoenigl, Martin, and Koehler, Philipp

Published
2024
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4. European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study

Author

Arendrup, Maiken Cavling, Arikan-Akdagli, Sevtap, Jørgensen, Karin Meinike, Barac, Aleksandra, Steinmann, Jörg, Toscano, Cristina, Arsenijevic, Valentina Arsic, Sartor, Assunta, Lass-Flörl, Cornelia, Hamprecht, Axel, Matos, Tadeja, Rogers, Benedict R.S., Quiles, Inmaculada, Buil, Jochem, Özenci, Volkan, Krause, Robert, Bassetti, Matteo, Loughlin, Laura, Denis, Blandine, Grancini, Anna, White, P. Lewis, Lagrou, Katrien, Willinger, Birgit, Rautemaa-Richardson, Riina, Hamal, Petr, Ener, Beyza, Unalan-Altintop, Tugce, Evren, Ebru, Hilmioglu-Polat, Suleyha, Oz, Yasemin, Ozyurt, Ozlem Koyuncu, Aydin, Faruk, Růžička, Filip, Meijer, Eelco F.J., Gangneux, Jean Pierre, Lockhart, Deborah E.A., Khanna, Nina, Logan, Clare, Scharmann, Ulrike, Desoubeaux, Guillaume, Roilides, Emmanuel, Talento, Alida Fe, van Dijk, Karin, Koehler, Philipp, Salmanton-García, Jon, Cornely, Oliver A., and Hoenigl, Martin

Published
2023
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5. MixInYeast: A Multicenter Study on Mixed Yeast Infections

Author

Medina, Narda, Soto-Debrán, Juan Carlos, Seidel, Danila, Akyar, Isin, Badali, Hamid, Barac, Aleksandra, Bretagne, Stéphane, Cag, Yasemin, Cassagne, Carole, Castro, Carmen, Chakrabarti, Arunaloke, Dannaoui, Eric, Cardozo, Celia, Garcia-Rodriguez, Julio, Guitard, Juliette, Hamal, Petr, Hoenigl, Martin, Jagielski, Tomasz, Khodavaisy, Sadegh, Lo Cascio, Giuliana, Martínez-Rubio, María Carmen, Meletiadis, Joseph, Muñoz, Patricia, Ochman, Elżbieta, Peláez, Teresa, Perez-Ayala Balzola, Ana, Prattes, Juergen, Roilides, Emmanuel, Ruíz-Pérez de Pipaón, Maite, Stauf, Raphael, Steinmann, Jörg, Suárez-Barrenechea, Ana Isabel, Tejero, Rocío, Trovato, Laura, Viñuela, Lourdes, Wongsuk, Thanwa, Żak, Iwona, Zarrinfar, Hossein, Lass-Flörl, Cornelia, Arikan-Akdagli, Sevtap, and Alastruey-Izquierdo, Ana

Subjects
Vaccine Related, Biodefense, Prevention, Infectious Diseases, Antimicrobial Resistance, Infection, yeast, chrome agar, invasive candidiasis, Candida, mix infections, polymicrobial infections
Abstract

Invasive candidiasis remains one of the most prevalent systemic mycoses, and several studies have documented the presence of mixed yeast (MY) infections. Here, we describe the epidemiology, clinical, and microbiological characteristics of MY infections causing invasive candidiasis in a multicenter prospective study. Thirty-four centers from 14 countries participated. Samples were collected in each center between April to September 2018, and they were sent to a reference center to confirm identification by sequencing methods and to perform antifungal susceptibility testing, according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A total of 6895 yeast cultures were identified and MY occurred in 150 cases (2.2%). Europe accounted for the highest number of centers, with an overall MY rate of 4.2% (118 out of 2840 yeast cultures). Of 122 MY cases, the most frequent combinations were Candida albicans/C. glabrata (42, 34.4%), C. albicans/C. parapsilosis (17, 14%), and C. glabrata/C. tropicalis (8, 6.5%). All Candida isolates were susceptible to amphotericin B, 6.4% were fluconazole-resistant, and two isolates (1.6%) were echinocandin-resistant. Accurate identification of the species involved in MY infections is essential to guide treatment decisions.

Published
2021

6. MixInYeast: A Multicenter Study on Mixed Yeast Infections.

Author

Medina, Narda, Soto-Debrán, Juan Carlos, Seidel, Danila, Akyar, Isin, Badali, Hamid, Barac, Aleksandra, Bretagne, Stéphane, Cag, Yasemin, Cassagne, Carole, Castro, Carmen, Chakrabarti, Arunaloke, Dannaoui, Eric, Cardozo, Celia, Garcia-Rodriguez, Julio, Guitard, Juliette, Hamal, Petr, Hoenigl, Martin, Jagielski, Tomasz, Khodavaisy, Sadegh, Lo Cascio, Giuliana, Martínez-Rubio, María Carmen, Meletiadis, Joseph, Muñoz, Patricia, Ochman, Elżbieta, Peláez, Teresa, Perez-Ayala Balzola, Ana, Prattes, Juergen, Roilides, Emmanuel, Ruíz-Pérez de Pipaón, Maite, Stauf, Raphael, Steinmann, Jörg, Suárez-Barrenechea, Ana Isabel, Tejero, Rocío, Trovato, Laura, Viñuela, Lourdes, Wongsuk, Thanwa, Żak, Iwona, Zarrinfar, Hossein, Lass-Flörl, Cornelia, Arikan-Akdagli, Sevtap, and Alastruey-Izquierdo, Ana

Subjects
Candida, chrome agar, invasive candidiasis, mix infections, polymicrobial infections, yeast
Abstract

Invasive candidiasis remains one of the most prevalent systemic mycoses, and several studies have documented the presence of mixed yeast (MY) infections. Here, we describe the epidemiology, clinical, and microbiological characteristics of MY infections causing invasive candidiasis in a multicenter prospective study. Thirty-four centers from 14 countries participated. Samples were collected in each center between April to September 2018, and they were sent to a reference center to confirm identification by sequencing methods and to perform antifungal susceptibility testing, according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A total of 6895 yeast cultures were identified and MY occurred in 150 cases (2.2%). Europe accounted for the highest number of centers, with an overall MY rate of 4.2% (118 out of 2840 yeast cultures). Of 122 MY cases, the most frequent combinations were Candida albicans/C. glabrata (42, 34.4%), C. albicans/C. parapsilosis (17, 14%), and C. glabrata/C. tropicalis (8, 6.5%). All Candida isolates were susceptible to amphotericin B, 6.4% were fluconazole-resistant, and two isolates (1.6%) were echinocandin-resistant. Accurate identification of the species involved in MY infections is essential to guide treatment decisions.

Published
2020

7. Phenotypic and Transcriptomic Analyses of Seven Clinical Stenotrophomonas maltophilia Isolates Identify a Small Set of Shared and Commonly Regulated Genes Involved in the Biofilm Lifestyle

Author

Alio, Ifey, Gudzuhn, Mirja, García, Pablo Pérez, Danso, Dominik, Schoelmerich, Marie Charlotte, Mamat, Uwe, Schaible, Ulrich E, Steinmann, Jörg, Yero, Daniel, Gibert, Isidre, Kohl, Thomas A, Niemann, Stefan, Gröschel, Matthias I, Haerdter, Johanna, Hackl, Thomas, Vollstedt, Christel, Bömeke, Mechthild, Egelkamp, Richard, Daniel, Rolf, Poehlein, Anja, and Streit, Wolfgang R

Subjects
Biological Sciences, Biomedical and Clinical Sciences, Genetics, Microbiology, Medical Microbiology, Infectious Diseases, Rare Diseases, Emerging Infectious Diseases, Antimicrobial Resistance, 2.1 Biological and endogenous factors, Aetiology, 2.2 Factors relating to the physical environment, Infection, Biofilms, Europe, Gene Expression Profiling, Genes, Bacterial, Genetic Variation, Phenotype, Proteolysis, Stenotrophomonas maltophilia, Virulence, Stenotrophomonas, transcriptome, biofilms, Stenotrophomonas, Medical microbiology
Abstract

Stenotrophomonas maltophilia is one of the most frequently isolated multidrug-resistant nosocomial opportunistic pathogens. It contributes to disease progression in cystic fibrosis (CF) patients and is frequently isolated from wounds, infected tissues, and catheter surfaces. On these diverse surfaces S. maltophilia lives in single-species or multispecies biofilms. Since very little is known about common processes in biofilms of different S. maltophilia isolates, we analyzed the biofilm profiles of 300 clinical and environmental isolates from Europe of the recently identified main lineages Sgn3, Sgn4, and Sm2 to Sm18. The analysis of the biofilm architecture of 40 clinical isolates revealed the presence of multicellular structures and high phenotypic variability at a strain-specific level. Further, transcriptome analyses of biofilm cells of seven clinical isolates identified a set of 106 shared strongly expressed genes and 33 strain-specifically expressed genes. Surprisingly, the transcriptome profiles of biofilm versus planktonic cells revealed that just 9.43% ± 1.36% of all genes were differentially regulated. This implies that just a small set of shared and commonly regulated genes is involved in the biofilm lifestyle. Strikingly, iron uptake appears to be a key factor involved in this metabolic shift. Further, metabolic analyses implied that S. maltophilia employs a mostly fermentative growth mode under biofilm conditions. The transcriptome data of this study together with the phenotypic and metabolic analyses represent so far the largest data set on S. maltophilia biofilm versus planktonic cells. This study will lay the foundation for the identification of strategies for fighting S. maltophilia biofilms in clinical and industrial settings.IMPORTANCE Microorganisms living in a biofilm are much more tolerant to antibiotics and antimicrobial substances than planktonic cells are. Thus, the treatment of infections caused by microorganisms living in biofilms is extremely difficult. Nosocomial infections (among others) caused by S. maltophilia, particularly lung infection among CF patients, have increased in prevalence in recent years. The intrinsic multidrug resistance of S. maltophilia and the increased tolerance to antimicrobial agents of its biofilm cells make the treatment of S. maltophilia infection difficult. The significance of our research is based on understanding the common mechanisms involved in biofilm formation of different S. maltophilia isolates, understanding the diversity of biofilm architectures among strains of this species, and identifying the differently regulated processes in biofilm versus planktonic cells. These results will lay the foundation for the treatment of S. maltophilia biofilms.

Published
2020

8. Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study

Author

Tumbarello, Mario, Talento, Alida Fe, Ruiz, Alba C, Racil, Zdenek, Stoma, Igor, Calbacho, Maria, Van Wijngaerden, Eric, Henriques, Júlia, Jordan, Harriett, Ferroni, Valentina, Ozyurt, Ozlem Koyuncu, Milacek, Christopher, Krause, Robert, Zurl, Christoph, Backx, Matthijs, Li, Ang, Seufert, Raphael, Tomazin, Rok, Blankenheim, Yael, Dávila-Valls, Julio, García-Clemente, Paloma, Freiberger, Tomas, Buil, Jochem, Meis, Jacques F, Akyol, Deniz, Guegan, Hélène, Logan, Clare, Hoenigl, Martin, Salmanton-García, Jon, Egger, Matthias, Gangneux, Jean-Pierre, Bicanic, Tihana, Arikan-Akdagli, Sevtap, Alastruey-Izquierdo, Ana, Klimko, Nikolai, Barac, Aleksandra, Özenci, Volkan, Meijer, Eelco F J, Khanna, Nina, Bassetti, Matteo, Rautemaa-Richardson, Riina, Lagrou, Katrien, Adam, Kai-Manuel, Akalin, Emin Halis, Akova, Murat, Arsic Arsenijevic, Valentina, Aujayeb, Avinash, Blennow, Ola, Bretagne, Stéphane, Danion, François, Denis, Blandine, de Jonge, Nick Alexander, Desoubeaux, Guillaume, Drgona, Lubos, Erben, Nurettin, Gori, Andrea, García Rodríguez, Julio, Garcia-Vidal, Carolina, Giacobbe, Daniele Roberto, Goodman, Anna L, Hamal, Petr, Hammarström, Helena, Toscano, Cristina, Lanternier, Fanny, Lass-Flörl, Cornelia, Lockhart, Deborah E A, Longval, Thomas, Loughlin, Laura, Matos, Tadeja, Mikulska, Malgorzata, Narayanan, Manjusha, Martín-Pérez, Sonia, Prattes, Juergen, Rogers, Benedict, Rahimli, Laman, Ruiz, Maite, Roilides, Emmanuel, Samarkos, Michael, Scharmann, Ulrike, Sili, Uluhan, Sipahi, Oguz Resat, Sivakova, Alena, Steinmann, Joerg, Trauth, Janina, Turhan, Ozge, Van Praet, Jens, Vena, Antonio, White, P Lewis, Willinger, Birgit, Tortorano, Anna Maria, Arendrup, Maiken C, Koehler, Philipp, and Cornely, Oliver A

Published
2023
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9. Machine learning-based typing of Salmonella enterica O-serogroups by the Fourier-Transform Infrared (FTIR) Spectroscopy-based IR Biotyper system

Author

Cordovana, Miriam, Mauder, Norman, Join-Lambert, Olivier, Gravey, François, LeHello, Simon, Auzou, Michel, Pitti, Monica, Zoppi, Simona, Buhl, Michael, Steinmann, Joerg, Frickmann, Hagen, Dekker, Denise, Funashima, Yumiko, Nagasawa, Zenzo, Soki, József, Orosz, László, Veloo, Alida C., Justesen, Ulrik S., Holt, Hanne M., Liberatore, Andrea, Ambretti, Simone, Pongolini, Stefano, Soliani, Laura, Wille, Andreas, Rojak, Sandra, Hagen, Ralf Matthias, May, Jürgen, Pranada, A.B., and Kostrzewa, Markus

Published
2022
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10. Hepatitis E virus is highly resistant to alcohol-based disinfectants

Author

Behrendt, Patrick, Friesland, Martina, Wißmann, Jan-Erik, Kinast, Volker, Stahl, Yannick, Praditya, Dimas, Hueffner, Lucas, Nörenberg, Pia Maria, Bremer, Birgit, Maasoumy, Benjamin, Steinmann, Jochen, Becker, Britta, Paulmann, Dajana, Brill, Florian H.H., Steinmann, Joerg, Ulrich, Rainer G., Brüggemann, Yannick, Wedemeyer, Heiner, Todt, Daniel, and Steinmann, Eike

Published
2022
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11. Risk factors and outcome of pulmonary aspergillosis in critically ill coronavirus disease 2019 patients—a multinational observational study by the European Confederation of Medical Mycology

Author

Debaveye, Yves, Miceli, Marisa H., Tudesq, Jean-Jacques, Paul, Gregor, Krause, Robert, Linhofer, Marina, Frost, Jonas, Zechner, Peter, Kochanek, Matthias, Eller, Philipp, Jenks, Jeffrey D., Volpi, Sara, Bellanger, Anne-Pauline, White, P.Lewis, Goldman, Gustavo H., Bowyer, Paul, Rokas, Antonis, Gago, Sara, Pelosi, Paolo, Robba, Chiara, Gangneux, Jean-Pierre, Lass-Floerl, Cornelia, Machado, Marina, Muñoz, Patricia, Prattes, Juergen, Wauters, Joost, Giacobbe, Daniele Roberto, Salmanton-García, Jon, Maertens, Johan, Bourgeois, Marc, Reynders, Marijke, Rutsaert, Lynn, Van Regenmortel, Niels, Lormans, Piet, Feys, Simon, Reisinger, Alexander Christian, Cornely, Oliver A., Lahmer, Tobias, Valerio, Maricela, Delhaes, Laurence, Jabeen, Kauser, Steinmann, Joerg, Chamula, Mathilde, Bassetti, Matteo, Hatzl, Stefan, Rautemaa-Richardson, Riina, Koehler, Philipp, Lagrou, Katrien, and Hoenigl, Martin

Published
2022
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13. Global guideline for the diagnosis and management of rare yeast infections: an initiative of the ECMM in cooperation with ISHAM and ASM

Author

Chen, Sharon C-A, Perfect, John, Colombo, Arnaldo L, Cornely, Oliver A, Groll, Andreas H, Seidel, Danila, Albus, Kerstin, de Almedia, Joao N, Jr, Garcia-Effron, Guillermo, Gilroy, Nicole, Lass-Flörl, Cornelia, Ostrosky-Zeichner, Luis, Pagano, Livio, Papp, Tamas, Rautemaa-Richardson, Riina, Salmanton-García, Jon, Spec, Andrej, Steinmann, Joerg, Arikan-Akdagli, Sevtap, Arenz, Dorothee E, Sprute, Rosanne, Duran-Graeff, Luisa, Freiberger, Tomas, Girmenia, Corrado, Harris, Michelle, Kanj, Souha S, Roudbary, Maryam, Lortholary, Olivier, Meletiadis, Joseph, Segal, Esther, Tuon, Felipe Francisco, Wiederhold, Nathan, Bicanic, Tihana, Chander, Jagdish, Chen, Yee-Chun, Hsueh, Po-Ren, Ip, Margaret, Munoz, Patricia, Spriet, Isabel, Temfack, Elvis, Thompson, Luis, Tortorano, Anna Maria, Velegraki, Aristea, and Govender, Nelesh P

Published
2021
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16. Umgang mit Schimmelbefall in Krankenhaus und Praxis.

Author

Hurraß, Kruse-Wehner, Eva-Brigitta, Engelhart, Steffen, Herr, Caroline E. W., Klimek, Ludger, Nowak, Dennis, Steinmann, Jörg, Steiß, Jens-Oliver, Zweigner, Janine, and Wiesmüller, Gerhard A.

Published
2024

17. Investigating the resistome of haemolytic bacteria in Arctic soils.

Author

Mogrovejo‐Arias, Diana C., Hay, Melanie C., Edwards, Arwyn, Mitchell, Andrew C., Steinmann, Jörg, Brill, Florian H. H., and Neumann, Bernd

Subjects
WHOLE genome sequencing, DRUG resistance in microorganisms, ERYTHROMYCIN, MACROLIDE antibiotics, ANTI-infective agents
Abstract

Microorganisms inhabiting hostile Arctic environments express a variety of functional phenotypes, some of clinical interest, such as haemolytic ability and antimicrobial resistance. We studied haemolytic bacterial isolates from Arctic habitats, assessing their minimum inhibitory concentration (MIC) against antimicrobials. We then performed whole genome sequencing and analysed them for features conferring antimicrobial resistance. MIC data showed that Micromonospora spp. belong to 33% non‐wild type (NWT) for erythromycin and penicillin and 22% NWT for tetracycline. Both Pseudomonas spp. belong to 43% NWT for nalidixic acid and streptomycin and 29% NWT for colistin. Finally, the Pedobacter isolate was in 80% NWT for antimicrobials tested. Whole‐genome sequencing analyses revealed that fluoroquinolones, tetracyclines, macrolides and penams were the most frequent drug classes against which genotypic resistance was found. Additionally, resistance genes to heavy metals and disinfectants were identified. Our research demonstrates the presence of antimicrobial resistance in bacteria from Arctic habitats and highlights the importance of conservation efforts in these environments, where anthropogenic influence is becoming more evident. Furthermore, our data suggest the possible presence of novel resistance mechanisms, which could pose a threat if the responsible genes are transferable between species or become widespread due to environmental stress and alterations brought about by climate change. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Robust hepatitis E virus infection and transcriptional response in human hepatocytes

Author

Todt, Daniel, Friesland, Martina, Moeller, Nora, Praditya, Dimas, Kinast, Volker, Brüggemann, Yannick, Knegendorf, Leonard, Burkard, Thomas, Steinmann, Joerg, Burm, Rani, Verhoye, Lieven, Wahid, Avista, Meister, Toni Luise, Engelmann, Michael, Pfankuche, Vanessa M., Puff, Christina, Vondran, Florian W. R., Baumgärtner, Wolfgang, Meuleman, Philip, Behrendt, Patrick, and Steinmann, Eike

Published
2020

19. Medizinisch klinische Diagnostik bei Schimmelpilzexposition in Innenräumen – Update 2023 (AWMF-Register-Nr. 161/001)

Author

Hurraß, Julia, additional, Heinzow, Birger, additional, Walser-Reichenbach, Sandra, additional, Aurbach, Ute, additional, Becker, Sven, additional, Bellmann, Romuald, additional, Bergmann, Karl-Christian, additional, Cornely, Oliver A., additional, Engelhart, Steffen, additional, Fischer, Guido, additional, Gabrio, Thomas, additional, Herr, Caroline E. W., additional, Joest, Marcus, additional, Karagiannidis, Christian, additional, Klimek, Ludger, additional, Köberle, Martin, additional, Kolk, Annette, additional, Lichtnecker, Herbert, additional, Lob-Corzilius, Thomas, additional, Mülleneisen, Norbert, additional, Nowak, Dennis, additional, Rabe, Uta, additional, Raulf, Monika, additional, Steinmann, Jörg, additional, Steiß, Jens-Oliver, additional, Stemler, Jannik, additional, Umpfenbach, Ulli, additional, Valtanen, Kerttu, additional, Werchan, Barbora, additional, Willinger, Birgit, additional, and Wiesmüller, Gerhard A., additional

Published
2024
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22. Incidence of Cyp51 A key mutations in Aspergillus fumigatus-a study on primary clinical samples of immunocompromised patients in the period of 1995-2013.

Author

Spiess, Birgit, Postina, Patricia, Reinwald, Mark, Cornely, Oliver A, Hamprecht, Axel, Hoenigl, Martin, Lass-Flörl, Cornelia, Rath, Peter-Michael, Steinmann, Jörg, Miethke, Thomas, Lauten, Melchior, Will, Silke, Merker, Natalia, Hofmann, Wolf-Karsten, and Buchheidt, Dieter

Subjects
Humans, Aspergillus fumigatus, Aspergillosis, Azoles, Cytochrome P-450 Enzyme System, Fungal Proteins, Antifungal Agents, Microbial Sensitivity Tests, Sensitivity and Specificity, Polymerase Chain Reaction, Drug Resistance, Fungal, Immunocompromised Host, Mutation, General Science & Technology
Abstract

As the incidence of azole resistance in Aspergillus fumigatus is rising and the diagnosis of invasive aspergillosis (IA) in immunocompromised patients is rarely based on positive culture yield, we screened our Aspergillus DNA sample collection for the occurrence of azole resistance mediating cyp51 A key mutations. Using two established, a modified and a novel polymerase chain reaction (PCR) assays followed by DNA sequence analysis to detect the most frequent mutations in the A. fumigatus cyp51 A gene conferring azole resistance (TR34 (tandem repeat), L98H and M220 alterations). We analyzed two itraconazole and voriconazole and two multi-azole resistant clinical isolates and screened 181 DNA aliquots derived from clinical samples (blood, bronchoalveolar lavage (BAL), biopsies, cerebrospinal fluid (CSF)) of 155 immunocompromised patients of our Aspergillus DNA sample collection, previously tested positive for Aspergillus DNA and collected between 1995 and 2013. Using a novel PCR assay for the detection of the cyp51 A 46 bp tandem repeat (TR46) directly from clinical samples, we found the alteration in a TR46/Y121F/T289A positive clinical isolate. Fifty stored DNA aliquots from clinical samples were TR46 negative. DNA sequence analysis revealed a single L98H mutation in 2010, two times the L98H alteration combined with TR34 in 2011 and 2012 and a so far unknown N90K mutation in 1998. In addition, four clinical isolates were tested positive for the TR34/L98H combination in the year 2012. We consider our assay of epidemiological relevance to detect A. fumigatus azole resistance in culture-negative clinical samples of immunocompromised patients; a prospective study is ongoing.

Published
2014

23. Virucidal Activity of World Health Organization–Recommended Formulations Against Enveloped Viruses, Including Zika, Ebola, and Emerging Coronaviruses

Author

Siddharta, Anindya, Pfaender, Stephanie, Vielle, Nathalie Jane, Dijkman, Ronald, Friesland, Martina, Becker, Britta, Yang, Jaewon, Engelmann, Michael, Todt, Daniel, Windisch, Marc P., Brill, Florian H., Steinmann, Joerg, Steinmann, Jochen, Becker, Stephan, Alves, Marco P., Pietschmann, Thomas, Eickmann, Markus, Thiel, Volker, and Steinmann, Eike

Published
2017

26. CHROMAgar™ LIN-R as an efficient screening tool to assess the prevalence of linezolid-resistant enterococci in German hospital patients—a multicentre study approach, 2021–2022

Author

Bender, Jennifer K, primary, Baufeld, Elsa, additional, Becker, Karsten, additional, Claus, Heike, additional, Dudakova, Anna, additional, Dörre, Achim, additional, Fila, Nikoletta, additional, Fleige, Carola, additional, Hamprecht, Axel, additional, Hoffmann, Armin, additional, Hogardt, Michael, additional, Kaasch, Achim J, additional, Kola, Axel, additional, Kriebel, Nancy, additional, Layer-Nicolaou, Franziska, additional, Marschal, Matthias, additional, Molitor, Ernst, additional, Mutters, Nico T, additional, Liese, Jan, additional, Nelkenbrecher, Claudia, additional, Neumann, Bernd, additional, Rohde, Holger, additional, Steinmann, Jörg, additional, Sörensen, Michael, additional, Thelen, Philipp, additional, Weig, Michael, additional, Zautner, Andreas E, additional, and Werner, Guido, additional

Published
2023
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27. Multicentre investigation of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in German hospitals

Author

Kaase, Martin, Schimanski, Sven, Schiller, Reinhold, Beyreiß, Bettina, Thürmer, Alexander, Steinmann, Jörg, Kempf, Volkhard A., Hess, Christina, Sobottka, Ingo, Fenner, Ines, Ziesing, Stefan, Burckhardt, Irene, von Müller, Lutz, Hamprecht, Axel, Tammer, Ina, Wantia, Nina, Becker, Karsten, Holzmann, Thomas, Furitsch, Martina, Volmer, Gabriele, and Gatermann, Sören G.

Published
2016
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30. European candidaemia is characterised by notable differential epidemiology and susceptibility pattern:Results from the ECMM Candida III study

Author

Arendrup, Maiken Cavling, Arikan-Akdagli, Sevtap, Jørgensen, Karin Meinike, Barac, Aleksandra, Steinmann, Jörg, Toscano, Cristina, Arsenijevic, Valentina Arsic, Sartor, Assunta, Lass-Flörl, Cornelia, Hamprecht, Axel, Matos, Tadeja, Rogers, Benedict R.S., Quiles, Inmaculada, Buil, Jochem, Özenci, Volkan, Krause, Robert, Bassetti, Matteo, Loughlin, Laura, Denis, Blandine, Grancini, Anna, White, P. Lewis, Lagrou, Katrien, Willinger, Birgit, Rautemaa-Richardson, Riina, Hamal, Petr, Ener, Beyza, Unalan-Altintop, Tugce, Evren, Ebru, Hilmioglu-Polat, Suleyha, Oz, Yasemin, Ozyurt, Ozlem Koyuncu, Aydin, Faruk, Růžička, Filip, Meijer, Eelco F.J., Gangneux, Jean Pierre, Lockhart, Deborah E.A., Khanna, Nina, Logan, Clare, Scharmann, Ulrike, Desoubeaux, Guillaume, Roilides, Emmanuel, Talento, Alida Fe, van Dijk, Karin, Koehler, Philipp, Salmanton-García, Jon, Cornely, Oliver A., Hoenigl, Martin, Arendrup, Maiken Cavling, Arikan-Akdagli, Sevtap, Jørgensen, Karin Meinike, Barac, Aleksandra, Steinmann, Jörg, Toscano, Cristina, Arsenijevic, Valentina Arsic, Sartor, Assunta, Lass-Flörl, Cornelia, Hamprecht, Axel, Matos, Tadeja, Rogers, Benedict R.S., Quiles, Inmaculada, Buil, Jochem, Özenci, Volkan, Krause, Robert, Bassetti, Matteo, Loughlin, Laura, Denis, Blandine, Grancini, Anna, White, P. Lewis, Lagrou, Katrien, Willinger, Birgit, Rautemaa-Richardson, Riina, Hamal, Petr, Ener, Beyza, Unalan-Altintop, Tugce, Evren, Ebru, Hilmioglu-Polat, Suleyha, Oz, Yasemin, Ozyurt, Ozlem Koyuncu, Aydin, Faruk, Růžička, Filip, Meijer, Eelco F.J., Gangneux, Jean Pierre, Lockhart, Deborah E.A., Khanna, Nina, Logan, Clare, Scharmann, Ulrike, Desoubeaux, Guillaume, Roilides, Emmanuel, Talento, Alida Fe, van Dijk, Karin, Koehler, Philipp, Salmanton-García, Jon, Cornely, Oliver A., and Hoenigl, Martin

Abstract

The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25–33%) while Italy and Turkey had the highest C. parapsilosis proportions (24–26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence., The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25–33%) while Italy and Turkey had the highest C. parapsilosis proportions (24–26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence.

Published
2023

32. Diagnosis and Treatment of Invasive Aspergillosis Caused by Non-fumigatus Aspergillus spp

Author

Stemler, Jannik, Többen, Christina, Lass-Flörl, Cornelia, Steinmann, Jörg, Ackermann, Katharina, Rath, Peter-Michael, Simon, Michaela, Cornely, Oliver Andreas, and Koehler, Philipp

Subjects
Medizin
Abstract

With increasing frequency, clinical and laboratory-based mycologists are consulted on invasive fungal diseases caused by rare fungal species. This review aims to give an overview of the management of invasive aspergillosis (IA) caused by non-fumigatus Aspergillus spp.—namely A. flavus, A. terreus, A. niger and A. nidulans—including diagnostic and therapeutic differences and similarities to A. fumigatus. A. flavus is the second most common Aspergillus spp. isolated in patients with IA and the predominant species in subtropical regions. Treatment is complicated by its intrinsic resistance against amphotericin B (AmB) and high minimum inhibitory concentrations (MIC) for voriconazole. A. nidulans has been frequently isolated in patients with long-term immunosuppression, mostly in patients with primary immunodeficiencies such as chronic granulomatous disease. It has been reported to disseminate more often than other Aspergillus spp. Innate resistance against AmB has been suggested but not yet proven, while MICs seem to be elevated. A. niger is more frequently reported in less severe infections such as otomycosis. Triazoles exhibit varying MICs and are therefore not strictly recommended as first-line treatment for IA caused by A. niger, while patient outcome seems to be more favorable when compared to IA due to other Aspergillus species. A. terreus-related infections have been reported increasingly as the cause of acute and chronic aspergillosis. A recent prospective international multicenter surveillance study showed Spain, Austria, and Israel to be the countries with the highest density of A. terreus species complex isolates collected. This species complex seems to cause dissemination more often and is intrinsically resistant to AmB. Non-fumigatus aspergillosis is difficult to manage due to complex patient histories, varying infection sites and potential intrinsic resistances to antifungals. Future investigational efforts should aim at amplifying the knowledge on specific diagnostic measures and their on-site availability, as well as defining optimal treatment strategies and outcomes of non-fumigatus aspergillosis. CA extern

Published
2023

33. Mid-term survival of geriatric patients with septic arthritis of the knee and risk factors affecting survival

Author

Geßlein, Markus, Haag, Nina, Rüther, Johannes, Steinmann, Jörg, Willauschus, Maximilian, Ziegler, Renate, and Bail, Hermann Josef

Subjects
Medicine and health, geriatric patients, knee, risk factors, septic arthritis, infection
Abstract

Objectives: Septic arthritis is common in older adults and related to joint surgery or hematogenous distribution. However, risk factors affecting survival are missing especially in an older population which is likely to suffer most from impaired mobility. This study aims to evaluate the effect of existing [for full text, please go to the a.m. URL]

Published
2022
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34. Inactivation of Hepatitis C Virus Infectivity by Human Breast Milk

Author

Pfaender, Stephanie, Heyden, Julia, Friesland, Martina, Ciesek, Sandra, Ejaz, Asim, Steinmann, Joerg, Steinmann, Jochen, Malarski, Angelika, Stoiber, Heribert, Tsiavaliaris, Georgios, Bader, Werner, Jahreis, Gerhard, Pietschmann, Thomas, and Steinmann, Eike

Published
2013

40. Low Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Transmission by Fomites: A Clinical Observational Study in Highly Infectious Coronavirus Disease 2019 Patients

Author

Meister, Toni Luise, primary, Dreismeier, Marielen, additional, Blanco, Elena Vidal, additional, Brüggemann, Yannick, additional, Heinen, Natalie, additional, Kampf, Günter, additional, Todt, Daniel, additional, Nguyen, Huu Phuc, additional, Steinmann, Jörg, additional, Schmidt, Wolfgang Ekkehard, additional, Steinmann, Eike, additional, Quast, Daniel Robert, additional, and Pfaender, Stephanie, additional

Published
2022
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43. German Multicenter Study Analyzing Antimicrobial Activity of Ceftazidime-Avibactam of Clinical Meropenem-Resistant Pseudomonas aeruginosa Isolates Using a Commercially Available Broth Microdilution Assay

Author

Manzke, Jana, primary, Stauf, Raphael, additional, Neumann, Bernd, additional, Molitor, Ernst, additional, Hischebeth, Gunnar, additional, Simon, Michaela, additional, Jantsch, Jonathan, additional, Rödel, Jürgen, additional, Becker, Sören L., additional, Halfmann, Alexander, additional, Wichelhaus, Thomas A., additional, Hogardt, Michael, additional, Serr, Annerose, additional, Hess, Christina, additional, Wendel, Andreas F., additional, Siegel, Ekkehard, additional, Rohde, Holger, additional, Zimmermann, Stefan, additional, and Steinmann, Jörg, additional

Published
2022
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44. Risk of SARS-CoV-2 transmission by fomites: a clinical observational study in highly infectious COVID-19 patients

Author

Meister, Toni Luise, primary, Dreismeier, Marielen, additional, Blanco, Elena Vidal, additional, Brüggemann, Yannick, additional, Heinen, Natalie, additional, Kampf, Günter, additional, Todt, Daniel, additional, Nguyen, Huu Phuc, additional, Steinmann, Jörg, additional, Schmidt, Wolfgang Ekkehard, additional, Steinmann, Eike, additional, Quast, Daniel Robert, additional, and Pfaender, Stephanie, additional

Published
2022
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45. The effects of melanization on cell wall constitution and on biofilm formation capability of melanized fungi

Author

Zoqi, Hamide, Rath, Peter-Michael, Scharmann, Ulrike, Steinmann, Jörg, and Kirchhoff, Lisa

Subjects
Medizin
Abstract

Introduction: Melanization and biofilm formation are major virulence factors in pathogenic melanized fungi, making them capable of causing recurrent and chronic infections resistant to treatment and immune response. We here evaluated the interplay between melanization, cell wall constitution, and biofilm formation in melanized fungi. Methods: Several biofilm-forming strains of C. neoformans (N = 10), A. fumigatus (N = 10), and E. dermatitidis (N = 26), including melanin-deficient mutants and their wild types were examined for their biofilm formation capability using crystal violet assay and confocal laser scan microscopy. Furthermore, dihydroxyphenylalanine (DOPA) as melanin inducer in Cryptococcus and tricyclazole (TCA) as DHN-melanin biosynthesis pathway inhibitor in E. dermatitidis and A. fumigatus were added to cultivation. To determine the effects of melanization on cell wall constitution, we analyzed cell wall electronegativity with zeta potential measurements and cell surface hydrophobicity with a microbial adhesion to hydrocarbons (MATH) assay. Results: Melanin-lacking-mutants formed less biofilm compared to their corresponding wild types. While L-DOPA strengthened biofilm formation in C. neoformans, TCA inhibited in E. dermatitidis and less in A. fumigatus. Correlation analysis between biofilm formation capability and the relative hydrophobicity of the cell surface showed A. fumigatus and C. neoformans strains with higher hydrophobicity are more likely to form biofilms than those with less hydrophobicity. Additionally, zeta potential values, having electronegativity, could be related to the forming of biofilms. Conclusion: The first results implicate that melanization in fungi increases the biofilm formation potential, and further that biofilm formation of human pathogenic fungi is positively associated with electronegativity and hydrophobicity of cell surfaces.

Published
2022

46. First two years of data curation by the German national candidemia surveillance network : New insights into epidemiology and resistance

Author

Aldejohann, A. M., Wallstabe, J., Reinhardt, M., Martin, R., Elias, J., Mattwich, C., Hamprecht, A., Held, J., Hess, C., Hogardt, M., Vorbeck, L., Rath, Peter-Michael, Verhasselt, Hedda-Luise, Wantia, N., Steinmann, Jörg, and Kurzai, O.

Subjects
Medizin
Abstract

Poster-Abstract Introduction: Invasive Candida infections are of public concern and could possibly act as a health threat to the community. Clinical and epidemiological data indicate a change of species spectra and resistance patterns in recent years. To monitor these dynamics and the distribution of certain pathogens, we established the first German surveillance network in 2020. Objectives: The surveillance network will monitor the species distribution and the development of antifungal drug resistance for invasive yeast infections in Germany. Materials and Methods: The network consists of ten German microbiological labs which collect relevant Candida species derived from blood cultures implicating invasive bloodstream infection. Epidemiological and resistance data are consequently curated by the NRZMyk. Data were assessed by Date and place of specimen, species ID, method of species ID, antimicrobial susceptibility testing (AST) results of a diverse range of antifungals and method of AST. Results: In the first two years, data sets of around 966 strains and 21 different species could be preserved (514 in 2020 and 452 in 2021). All Species-IDs were confirmed by MALDI-TOF. Around 5000 MIC-values were evaluated. In both years, ~6% of the isolates show secondary resistance against ≥1 antifungal substance (according to either EUCAST or CLSI). MDR-resistant strains were found. Interestingly, not all phenotypic echinocandin-resistant isolates harbour target gene mutations and lose reduced susceptibility upon retesting. Epidemiological data is currently assessed by each participating partner focussing on incidence and prevalence of candidemia. Conclusion: Data collection through this national surveillance network and a database with open access to all participating partners enables systematic research projects, epidemiological studies and active surveillance concerning the prevalence of fungal bloodstream infection and emergence of antifungal drug resistance.

Published
2022

47. Activity of the imidazole luliconazole (NND-502) against biofilms of azole-resistant Aspergillus fumigatus at different formation stages

Author

Furnica, D. T., Scharmann, Ulrike, Steinmann, Jörg, Rath, Peter-Michael, and Kirchhoff, Lisa

Subjects
Medizin
Abstract

Introduction: Invasive fungal infections with azole-resistant A. fumigatus isolates (ARAF) increased recently. These infections have become a significant threat in clinical settings. A factor known to contribute to increased resistances is the biofilm formation capability. Developing novel strategies for treatment of infections with ARAF has become crucial. Here, the activity of the imidazole luliconazole (LLCZ) against ARAF biofilms was investigated in vitro. Methods: The activity of LLCZ was assessed in a crystal violet and in an XTT assay. LLCZ concentrations of the previously identified MICs (according to EUCAST) were applied to ARAF biofilms at different formation stages, both in concentrations below the MIC (sub-MIC) and above the MIC (supra-MIC). Additionally, LLCZ activity was visualized in confocal laser scanning microscopy. Results: Biofilm formation was mostly inhibited in the pre-adhesion stages (0 h). Sub-MIC concentrations of LLCZ were sufficient for the disruption of early-stage biofilm formation (0 h and 4 h). In contrast, mature biofilms (24 h) were more resistant towards LLCZ treatment. These 24 h old biofilms could be only partially inhibited by LLCZ application of 256-times the strain specific MIC. Conclusion: In conclusion, LLCZ showed activity against early biofilms of ARAF when applied in concentrations below the MIC, while a substantially higher concentration of LLCZ is required for the inhibition of mature biofilms.

Published
2022

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