- Tüfweg 5, 8044 Gockhausen
Switzerland - +41764712890
Research Interests: Microbiology, Medicine, Biological Sciences, Colonization, Disease Outbreaks, and 15 moreProspective studies, Humans, Animals, Infant, Switzerland, Milk, Newborn Infant, Theophylline, Prevalence, Serratia marcescens, Neonatal Intensive Care Unit, Outbreak, Clinical Infectious Diseases, Medical and Health Sciences, and Cross Infection
necrotizing fasciitis due to Streptococcus pneumoniae after renal transplantation
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Background Infectious keratitis is a major cause of global blindness. We tested whether standalone photoactivated chromophore corneal cross-linking (PACK-CXL) may be an effective first-line treatment in early to moderate infectious... more
Background Infectious keratitis is a major cause of global blindness. We tested whether standalone photoactivated chromophore corneal cross-linking (PACK-CXL) may be an effective first-line treatment in early to moderate infectious keratitis, compared with standard antimicrobial treatment. Methods This is a randomized, controlled, multinational phase 3 clinical trial. Participants in five centers in Egypt, India, Iran, Israel, and China, aged ≥ 18 years, with infectious keratitis of presumed bacterial, fungal, or mixed origin, were randomly assigned (1:1) to PACK-CXL, or antimicrobial therapy. Outcomes measures included healing, defined as time to re-epithelialization of the corneal epithelial defect in the absence of inflammatory activity in the anterior chamber and clearance of stromal infiltrates. Treatment success was defined as the complete resolution of signs of infection. Results Between July 21, 2016, and March 4, 2020, participants were randomly assigned to receive PACK-CXL...
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Background Aeromonas hydrophila is a gram-negative facultative anaerobic coccobacillus, which is an environmental opportunistic pathogen. A. hydrophila are involved in several infectious diseases such as gastroenteritis, septicemia and... more
Background Aeromonas hydrophila is a gram-negative facultative anaerobic coccobacillus, which is an environmental opportunistic pathogen. A. hydrophila are involved in several infectious diseases such as gastroenteritis, septicemia and wound infections. However, gastroenteritis caused by Aeromonas spp. are rare and the clinical relevance of Aeromonas species in stool specimens is still under debate. Case presentation Our case concerns a 32-year-old woman who presented at hospital with a worsening watery diarrhea and fever requiring intensive care. A cholera-like illness was diagnosed. The patient had a past history of an anti-Hu syndrome with a myenteric ganglionitis. A molecular multiplex RT-PCR (QIAstat-Dx Gastrointestinal Panel, QIAGEN) covering a broad spectrum of diverse gastrointestinal pathogens performed directly from the stool was negative but the stool culture revealed growth of A. hydrophila. Further investigations of the A. hydrophila strain in cell cultures revealed the...
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Background Aspergillus spp. of section Usti (A. ustus) represent a rare cause of invasive aspergillosis (IA). This multicenter study describes the epidemiology and outcome of A. ustus infections. Methods Patients with A. ustus isolated... more
Background Aspergillus spp. of section Usti (A. ustus) represent a rare cause of invasive aspergillosis (IA). This multicenter study describes the epidemiology and outcome of A. ustus infections. Methods Patients with A. ustus isolated from any clinical specimen were retrospectively identified in 22 hospitals from 8 countries. When available, isolates were sent for species identification (BenA/CaM sequencing) and antifungal susceptibility testing. Additional cases were identified by review of the literature. Cases were classified as proven/probable IA or no infection, according to standard international criteria. Results Clinical report forms were obtained for 90 patients, of whom 27 had proven/probable IA. An additional 45 cases were identified from literature review for a total of 72 cases of proven/probable IA. Hematopoietic cell and solid-organ transplant recipients accounted for 47% and 33% cases, respectively. Only 8% patients were neutropenic at time of diagnosis. Ongoing ant...
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In a prospective survey, all transplant patients at the hospital of the University of Zurich were screened for cytomegalovirus (CMV) infection. CMV infections were detected in a total of 40 of 104 transplant recipients; 31 could be... more
In a prospective survey, all transplant patients at the hospital of the University of Zurich were screened for cytomegalovirus (CMV) infection. CMV infections were detected in a total of 40 of 104 transplant recipients; 31 could be diagnosed by CMV immunoglobulin M serology, 27 could be diagnosed by viremia, 11 could be diagnosed by antigenemia, and 13 could be diagnosed by the start of virus secretion. Combined application of serology and the detection of viremia showed the highest sensitivity (39 of 40 cases). Of the patients with severe clinical symptoms, six of seven had primary CMV infections caused by a positive transplant. Therefore, it is strongly indicated that patients with known risk factors should be regularly surveyed by a combination of methods.
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Helicobacter pylori is a major human pathogen that causes a wide range of gastrointestinal pathology. Progression of H. pylori induced gastritis to more severe disease has been found to highly correlate with the array of virulence factors... more
Helicobacter pylori is a major human pathogen that causes a wide range of gastrointestinal pathology. Progression of H. pylori induced gastritis to more severe disease has been found to highly correlate with the array of virulence factors expressed by the pathogen. The objective of this study was twofold: first, to characterize the genetic diversity of H. pylori strains isolated from 41 non-atrophic gastritis patients in Switzerland, an issue that has not been investigated to date. And second, to assess the prevalence and sequence variation of H. pylori virulence factors (cagA, vacA, iceA and dupA) and genes encoding outer membrane proteins (OMPs; babA, babB, sabA, sabB, hopZ, hopQ and oipA) by whole genome sequencing (WGS) using an Illumina MiSeq platform. WGS identified high genetic diversity in the analyzed H. pylori strains. Most H. pylori isolates were assigned to hpEurope (95.0%, 39/41), and the remaining ones (5.0%, 2/41) to hpEastAsia, subpopulation hspEAsia. Analysis of vir...
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Helicobacter pylori is a major human pathogen. Diagnosis of H. pylori infection and determination of its antibiotic susceptibility still mainly rely on culture and phenotypic drug susceptibility testing (DST) that is time-consuming and... more
Helicobacter pylori is a major human pathogen. Diagnosis of H. pylori infection and determination of its antibiotic susceptibility still mainly rely on culture and phenotypic drug susceptibility testing (DST) that is time-consuming and laborious. Whole genome sequencing (WGS) has recently emerged in medical microbiology as a diagnostic tool for reliable drug resistance prediction in bacterial pathogens. The aim of this study was to compare phenotypic DST results with the predictions based on the presence of genetic determinants identified in the H. pylori genome using WGS. Phenotypic resistance to clarithromycin, metronidazole, tetracycline, levofloxacin, and rifampicin was determined in 140 clinical H. pylori isolates by E-Test®, and the occurrence of certain single nucleotide polymorphisms (SNPs) in target genes was determined by WGS. Overall, there was a high congruence of >99% between phenotypic DST results for clarithromycin, levofloxacin, and rifampicin and SNPs identified ...
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ABSTRACTAggregatibacterspecies are commensal bacteria of human mucosal surfaces that are sometimes involved in serious invasive infections. During the investigation of strains cultured from various clinical specimens, we encountered a... more
ABSTRACTAggregatibacterspecies are commensal bacteria of human mucosal surfaces that are sometimes involved in serious invasive infections. During the investigation of strains cultured from various clinical specimens, we encountered a coherent group of 10 isolates that could not be allocated to any validly named species by phenotype, mass spectrometry, or partial 16S rRNA gene sequencing. Whole-genome sequencing revealed a phylogenetic cluster related to but separate fromAggregatibacter aphrophilus. The meanin silicoDNA hybridization value for strains of the new cluster versusA. aphrophiluswas 56% (range, 53.7 to 58.0%), whereas the average nucleotide identity was 94.4% (range, 93.9 to 94.8%). The new cluster exhibited aggregative properties typical of the genusAggregatibacter. Key phenotypic tests for discrimination of the new cluster from validly namedAggregatibacterspecies are alanine-phenylalanine-proline arylamidase,N-acetylglucosamine, and β-galactosidase. The nameAggregatibac...
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Breakthrough candidemia (BTC) on fluconazole was associated with non-susceptible Candida spp. and increased mortality. This nationwide FUNGINOS study analyzed clinical and mycological BTC characteristics. A 3-year prospective study was... more
Breakthrough candidemia (BTC) on fluconazole was associated with non-susceptible Candida spp. and increased mortality. This nationwide FUNGINOS study analyzed clinical and mycological BTC characteristics. A 3-year prospective study was conducted in 567 consecutive candidemias. Species identification and antifungal susceptibility testing (CLSI) were performed in the FUNGINOS reference laboratory. Data were analyzed according to STROBE criteria. 43/576 (8%) BTC occurred: 37/43 (86%) on fluconazole (28 prophylaxis, median 200 mg/day). 21% BTC vs. 23% non-BTC presented severe sepsis/septic shock. Overall mortality was 34% vs. 32%. BTC was associated with gastrointestinal mucositis (multivariate OR 5.25, 95%CI 2.23-12.40, p < 0.001) and graft-versus-host-disease (6.25, 1.00-38.87, p = 0.05), immunosuppression (2.42, 1.03-5.68, p = 0.043), and parenteral nutrition (2.87, 1.44-5.71, p = 0.003). Non-albicans Candida were isolated in 58% BTC vs. 35% non-BTC (p = 0.005). 63% of 16 BTC occu...
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Research Interests: Microbiology, Medical Microbiology, Biology, Helicobacter pylori, Medicine, and 11 moreHumans, Clarithromycin, Clinical Sciences, Anti-Bacterial Agents, Genotype, Feces, Microbial Sensitivity Tests, Medicine and Health Sciences, Adenocarcinoma, reverse transcriptase polymerase chain reaction, and Stomach neoplasms
Research Interests: Anesthesiology, Treatment Outcome, Medicine, Humans, Pain Medicine, and 10 moreClinical Sciences, Public health systems and services research, Intensive Care Medicine, Intensive Care Units, Candidemia, Central Venous Catheters, Catheter, Case Control Studies, Catheter-Related Infections, and Device Removal
Diagnosis of Propionibacterium acnes bone and joint infection is challenging due to the long cultivation time of up to 14 days. We retrospectively studied whether reducing the cultivation time to 7 days allows accurate diagnosis without... more
Diagnosis of Propionibacterium acnes bone and joint infection is challenging due to the long cultivation time of up to 14 days. We retrospectively studied whether reducing the cultivation time to 7 days allows accurate diagnosis without losing sensitivity. We identified patients with at least one positive P. acnes sample between 2005 and 2015 and grouped them into “infection” and “no infection.” An infection was defined when at least two samples from the same case were positive. Clinical and microbiological data, including time to positivity for different cultivation methods, were recorded. We found 70 cases of proven P. acnes infection with a significant faster median time to positivity of 6 days (range, 2 to 11 days) compared to 9 days in 47 cases with P. acnes identified as a contamination ( P < 0.0001). In 15 of 70 (21.4%) patients with an infection, tissue samples were positive after day 7 and in 6 patients (8.6%) after day 10 when a blind subculture of the thioglycolate bro...
Research Interests: Adolescent, Medicine, Clinical Microbiology, Biological Sciences, Humans, and 15 moreFemale, Plant tissue Culture Techniques, Male, Young Adult, Aged, Middle Aged, Adult, Retrospective Studies, Propionibacterium Acnes, Medicine and Health Sciences, Sensitivity and Specificity, Culture Media, Shoulder joint, Hip Joint, and Medical and Health Sciences
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Background: The use of probiotics as prophylaxis for necrotizing enterocolitis (NEC) in preterm infants is being increasingly practised. Objective: We report, for the first time, a case series of 3 preterm, very-low-birth-weight (VLBW)... more
Background: The use of probiotics as prophylaxis for necrotizing enterocolitis (NEC) in preterm infants is being increasingly practised. Objective: We report, for the first time, a case series of 3 preterm, very-low-birth-weight (VLBW) infants who developed bacteremia with Bifidobacterium longum on probiotic therapy with Infloran® containing viable B. longum. Methods: We retrospectively reviewed data of 3 infants (of gestational age <30 weeks and birth weight <1,230 g). They were admitted to the neonatal intensive care unit. Clinical data were retrieved from their medical records. Results: In infants 1 and 2, B. longum was isolated from the blood cultures when they were on probiotic therapy with Infloran or shortly after, respectively, and was interpreted as transient bacteremia. The clinical presentation of these infants did not require antibiotic treatment after the isolation of B. longum. Infant 3 developed an NEC despite probiotic therapy with Infloran and the blood cultur...
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The goal of this study was to evaluate prospectively the presence and impact of the gastric carcinogen Helicobacter pylori in the upper aerodigestive tract. Previous studies suggested it could represent a risk factor for head and neck... more
The goal of this study was to evaluate prospectively the presence and impact of the gastric carcinogen Helicobacter pylori in the upper aerodigestive tract. Previous studies suggested it could represent a risk factor for head and neck squamous cell carcinoma. Serology, rapid urease test, and quantitative polymerase chain reaction (qPCR) for H. pylori were performed in head and neck cancer patients (N=56) and cancer-free controls (N=90). Comparison between groups was done using logistic regression analysis. Rates of positive serology and rapid urease test did not differ between the two groups in logistic regression analysis (P=0.677 and P=0.633, respectively). Birth in a developing country and age above 50 years old were predictors of positive serology (P<0.001 and P=0.040, respectively). Using qPCR, no biopsy showed presence of H.pylori. This study challenges the concept that H. pylori may be a risk factor for head and neck squamous cell carcinoma. This article is protected by co...
Research Interests: Dentistry, Gastroenterology, Cancer, Helicobacter pylori, Medicine, and 15 moreLogistic Regression, Prospective studies, Humans, Internal Medicine, Head and Neck Cancer, Female, Male, Otorhinolaryngology, Head and neck squamous cell carcinoma, Clinical Sciences, Aged, Middle Aged, Adult, Logistic Models, and Head and neck neoplasms
Research Interests: Surgery, Death, Treatment, Kidney transplantation, Medicine, and 14 moreStreptococcus pneumoniae, Transplantation, Complication, Humans, Shock, Male, Bacteria, Switzerland, Clinical Sciences, Middle Aged, European Continental Ancestry Group, Plantar Fasciitis, Postoperative Complications, and Fatal outcome
This study compared three sample preparation methods (direct transfer, the direct transfer-formic acid method with on-target formic acid treatment, and ethanol-formic acid extraction) for the identification of Gram-positive cocci with... more
This study compared three sample preparation methods (direct transfer, the direct transfer-formic acid method with on-target formic acid treatment, and ethanol-formic acid extraction) for the identification of Gram-positive cocci with matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS). A total of 156 Gram-positive cocci representing the clinically most important genera, Aerococcus , Enterococcus , Staphylococcus , and Streptococcus , as well as more rare genera, such as Gemella and Granulicatella , were analyzed using a Bruker MALDI Biotyper. The rate of correct genus-level identifications was approximately 99% for all three sample preparation methods. The species identification rate was significantly higher for the direct transfer-formic acid method and ethanol-formic acid extraction (both 77.6%) than for direct transfer (64.1%). Using direct transfer-formic acid compared to direct transfer, the total time to result was increased by 22.6%, 1...
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Out of 3,081 animals studied, 24.9% of pigs, 4.7% of chickens, 6.3% of dogs, 10.5% of cats, and 7.1% of rodents were Staphylococcus aureus positive. Prevalence of methicillin-resistant S. aureus (MRSA) was high in pigs (animals, 21.3%;... more
Out of 3,081 animals studied, 24.9% of pigs, 4.7% of chickens, 6.3% of dogs, 10.5% of cats, and 7.1% of rodents were Staphylococcus aureus positive. Prevalence of methicillin-resistant S. aureus (MRSA) was high in pigs (animals, 21.3%; batches, 46.5%), with all MRSA isolates and most methicillin-sensitive S. aureus isolates belonging to clonal complex 9 (CC9) and being multidrug resistant. The predominant S. aureus CCs among dog and cat isolates were similar. Among rodent isolates, CC398 predominated, with spa t034 the most frequent spa type detected.
Research Interests: Microbiology, Biology, Medicine, Rodentia, Cats, and 15 moreClinical Microbiology, Biological Sciences, Dogs, Molecular typing, Animals, Antimicrobial, Clinical Sciences, Prevalence, Genotype, Chickens, Microbial Sensitivity Tests, Methicillin Resistant Staphylococcus Aureus, Staphylococcal protein A, Medical and Health Sciences, and Staphylococcal infections
Research Interests: Microbiology, Medical Microbiology, Biology, Medicine, Middle East, and 15 moreBiological Sciences, Humans, Europe, Cephalosporins, Antimicrobial chemotherapy, Antimicrobial, Gram Positive Bacteria, Microbial Sensitivity Tests, Linezolid, Cons, Teicoplanin, Cefepime, Medical and Health Sciences, Pharmacology and pharmaceutical sciences, and Broth Microdilution
Research Interests: Evolutionary Biology, Microbiology, Medical Microbiology, Biology, Medicine, and 15 morePhylogeny, Humans, Fatty acids, Gram Positive, Blood, Bacteria, Phenotype, Gram Positive Bacteria, Phylogenetic Tree, Gram, Culture Media, Ribosomal DNA, Molecular Sequence Data, Appendicitis, and Streptococcus sanguinis
Research Interests: Neurosurgery, Biomedical Engineering, Incidence Geometry, Adolescent, Medicine, and 15 moreLumbar spine, Humans, Female, Male, Clinical Sciences, Implant, Scoliosis, Retrospective Studies, Pseudarthrosis, Propionibacterium Acnes, lumbar vertebrae, Orthopedic Fixation Devices, Postoperative Complications, Antibiotic Therapy, and Device Removal
Research Interests: Medicine, France, Streptococcus pneumoniae, Antibiotic Resistance, Germany, and 11 moreHumans, Child, Switzerland, Antibiotics, Public health systems and services research, Respiratory Tract Infections, Medicine and Health Sciences, Haemophilus Infections Market, Haemophilus influenzae, Paediatrics and reproductive medicine, and Streptococcal infections
Despite vigorous attempts at eradication over the last 20 years, methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major nosocomial pathogen in Australian acute care institutions. The epidemiology of hospital spread is... more
Despite vigorous attempts at eradication over the last 20 years, methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major nosocomial pathogen in Australian acute care institutions. The epidemiology of hospital spread is now well characterized; infected and colonized patients provide the primary reservoirs, and transmission is mainly via hospital staff. The MRSA remains endemic in most of Australia's large urban teaching hospitals; occasional outbreak also occur, especially in intensive care areas. The level of MRSA infection is often indicative of the total rate of nosocomial infection within an institution and may reflect overcrowding, heavy workloads and under-staffing of wards. Standard precautions, isolation and cohorting of infected and colonized patients, screening of staff, hand washing campaigns, nasal eradication policies and increased staff education have all been tried, with variable success. There is no universal formula; local problems require local solutions plus commitment of local resources. Preventing surgical infection with MRSA requires the application of surgical first principles, and the routine use of vancomycin for prophylaxis is not recommended.
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This study compared the in vitro activities of the new long-half-life carbapenem ertapenem (also known as MK-0826 and L-749,345) with those of imipenem, amoxicillin-clavulanate, and ciprofloxacin against 5,558 recent clinical isolates... more
This study compared the in vitro activities of the new long-half-life carbapenem ertapenem (also known as MK-0826 and L-749,345) with those of imipenem, amoxicillin-clavulanate, and ciprofloxacin against 5,558 recent clinical isolates from 11 North American medical centers. We confirmed the greater activity of ertapenem than of imipenem against the Enterobacteriaceae and the greater activity of imipenem against pseudomonads and gram-positive bacteria.
Research Interests: Animal Studies, Clinical Trial, Australia, Biology, Clostridium difficile, and 15 moreAntibiotic Susceptibility Testing, Europe, Gram Positive, Anaerobic Bacteria, Bacteria, Enterobacteriaceae, Gram Positive Bacteria, Carbapenem, Antimicrobial agents, Carbapenems, Enterococcus faecalis, Ciprofloxacin, Imipenem, Bacteroides Fragilis, and High protein
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Background The skin commensal Cutibacterium avidum has been recognized as an emerging pathogen for periprosthetic joint infections (PJI). One currently assumes that the early occurring PJIs are a consequence of skin commensals... more
Background The skin commensal Cutibacterium avidum has been recognized as an emerging pathogen for periprosthetic joint infections (PJI). One currently assumes that the early occurring PJIs are a consequence of skin commensals contaminating the peri-implant tissue during surgery. We addressed whether standard skin antisepsis with povidone-iodine/alcohol before total hip arthroplasty (THA) is effective to eliminate colonizing bacteria with focus on C. avidum. Methods In a single-center, prospective study, we screened all patients for skin colonizing C. avidum in the groin before THA. Only in the patients positive for C. avidum, we preoperatively repeated skin swabs after the first and third skin antisepsis and antibiotic prophylaxis. We also obtained dermis biopsies for microbiology and fluorescence in situ hybridization (FISH). Results Fifty-one out of 60 patients (85%) were colonized on the skin with various bacteria, in particular with C. avidum in 12 out of 60. Skin antisepsis el...
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Introduction In contrast to countries where carbapenemase-producing Enterobacterales (CPE) are endemic, only sporadic cases were reported in Switzerland until 2013. An aggravation of the epidemiological situation in neighbouring European... more
Introduction In contrast to countries where carbapenemase-producing Enterobacterales (CPE) are endemic, only sporadic cases were reported in Switzerland until 2013. An aggravation of the epidemiological situation in neighbouring European countries indicated the need for a surveillance study in Switzerland. Aim We aimed to describe CPE distributions in Switzerland and identify epidemiological factors associated with changes in incidence. Methods Data on all human CPE isolates from 2013 to 2018 were collected by the Swiss Centre for Antibiotic Resistance (ANRESIS) and analysed for temporal and regional trends by Generalised Poisson regression. Isolates associated with infection or colonisation were included in a primary analysis; a secondary analysis included invasive isolates only. Statistical detection of regional clusters was performed with WHONET/SaTScan. Results We analysed 731 CPE isolates, of which 325 (44.5%) were associated with screenings and 173 (23.7%) with infections. Yea...
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Antibiotic-tolerant Staphylococcus aureus poses a great challenge to clinicians as well as to microbiological laboratories and is one reason for treatment failure. Antibiotic-tolerant strains survive transient antibiotic exposure despite... more
Antibiotic-tolerant Staphylococcus aureus poses a great challenge to clinicians as well as to microbiological laboratories and is one reason for treatment failure. Antibiotic-tolerant strains survive transient antibiotic exposure despite being fully susceptible in vitro .
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AIMS OF THE STUDY Invasive streptococcal infections affect more than half a million patients worldwide every year and have a high lethality. Little is known about the epidemiology and microbiological characteristics of streptococcal... more
AIMS OF THE STUDY Invasive streptococcal infections affect more than half a million patients worldwide every year and have a high lethality. Little is known about the epidemiology and microbiological characteristics of streptococcal infections in Switzerland. This case series study aims to describe the demographics, known risk factors for streptococcal skin and soft tissue infections, clinical presentations, treatment and outcomes of patients admitted to the University Hospital Zurich between 2000 and 2014 with invasive streptococcal infections caused by Streptococcus pyogenes (group A Streptococcus), Streptococcus dysgalactiae ssp. equisimilis or the Streptococcus anginosus group, as well as the microbiological characteristics of the clinical isolates. METHODS Data collected retrospectively from patients hospitalised between 2000 and 2014 with invasive streptococcal infections were analysed. M protein gene (emm) typing of the bacterial clinical isolates was carried out according to...
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Background Disc diffusion is a reliable, accurate and cost-efficient procedure for antimicrobial susceptibility testing (AST) but requires long (18–24 h) incubation times. Reading of disc diffusion after short incubation times (6–8 h) by... more
Background Disc diffusion is a reliable, accurate and cost-efficient procedure for antimicrobial susceptibility testing (AST) but requires long (18–24 h) incubation times. Reading of disc diffusion after short incubation times (6–8 h) by automated systems is feasible but should be categorized with time-adapted breakpoints to reduce errors. Objectives This study systematically compared early readings (6 and 8 h) of disc diffusion using an automated system with that of the standard 18 h EUCAST method. Time-adapted tentative breakpoints were proposed to discriminate susceptible from resistant isolates and areas of technical uncertainty were defined to minimize the risk of errors. Methods A total of 1106 Enterobacterales isolates with a wide variety of resistance mechanisms and resistance profiles were included. All isolates were analysed for susceptibility to amoxicillin/clavulanic acid, ceftriaxone, cefepime, meropenem, ciprofloxacin and gentamicin using the automated WASPLabTM system...
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Dysgonic fermenter 3 (DF-3)-associated bacteremia occurred in a febrile patient with acute myelocytic leukemia during aplasia. Another DF-3 isolate, identical by ribotyping, was grown 10 weeks later from stool collected in the absence of... more
Dysgonic fermenter 3 (DF-3)-associated bacteremia occurred in a febrile patient with acute myelocytic leukemia during aplasia. Another DF-3 isolate, identical by ribotyping, was grown 10 weeks later from stool collected in the absence of diarrhea. This is the first case in which DF-3 was isolated from blood and stool specimens from the same patient.
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Background A multitude of definitions determining multidrug resistance (MDR) of Gram-negative organisms exist worldwide. The definitions differ depending on their purpose and on the issueing country or organization. The MDR definitions of... more
Background A multitude of definitions determining multidrug resistance (MDR) of Gram-negative organisms exist worldwide. The definitions differ depending on their purpose and on the issueing country or organization. The MDR definitions of the European Centre for Disease Prevention and Control (ECDC) were primarily chosen to harmonize epidemiological surveillance. The German Commission of Hospital Hygiene and Infection Prevention (KRINKO) issued a national guideline which is mainly used to guide infection prevention and control (IPC) measures. The Swiss University Hospital Zurich (UHZ) – in absentia of national guidelines – developed its own definition for IPC purposes. In this study we aimed to determine the effects of different definitions of multidrug-resistance on rates of Gram-negative multidrug-resistant organisms (GN-MDRO). Methods MDR definitions of the ECDC, the German KRINKO and the Swiss University Hospital Zurich were applied on a dataset comprising isolates of Escherichi...
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Treatment failure in biofilm-associated bacterial infections is an important healthcare issue. In vitro studies and mouse models suggest that bacteria enter a slow-growing/non-growing state that results in transient tolerance to... more
Treatment failure in biofilm-associated bacterial infections is an important healthcare issue. In vitro studies and mouse models suggest that bacteria enter a slow-growing/non-growing state that results in transient tolerance to antibiotics in the absence of a specific resistance mechanism. However, little clinical confirmation of antibiotic tolerant bacteria in patients exists. In this study we investigate a Staphylococcus epidermidis pacemaker-associated endocarditis, in a patient who developed a break-through bacteremia despite taking antibiotics to which the S. epidermidis isolate is fully susceptible in vitro. Characterization of the clinical S. epidermidis isolates reveals in-host evolution over the 16-week infection period, resulting in increased antibiotic tolerance of the entire population due to a prolonged lag time until growth resumption and a reduced growth rate. Furthermore, we observe adaptation towards an increased biofilm formation capacity and genetic diversificati...
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Corynebacterium spp. are rarely considered pathogens, but data on Corynebacterium spp.
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We analyzed the diagnostic value of microorganisms cultured from negative-pressure-wound-therapy (NPWT) foam samples compared to that of microorganisms cultured from deep tissue samples from patients with vascular graft infections. The... more
We analyzed the diagnostic value of microorganisms cultured from negative-pressure-wound-therapy (NPWT) foam samples compared to that of microorganisms cultured from deep tissue samples from patients with vascular graft infections. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 58%, 86%, 81%, and 66%, respectively. The diagnostic value of microbiological cultures from NPWT foams was poor.
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Many bacteria causing systemic invasive infections originate from the oral cavity by entering the bloodstream. Recently, a novel pathogenic bacterium, Streptococcus tigurinus, was identified as causative agent of infective endocarditis,... more
Many bacteria causing systemic invasive infections originate from the oral cavity by entering the bloodstream. Recently, a novel pathogenic bacterium, Streptococcus tigurinus, was identified as causative agent of infective endocarditis, spondylodiscitis and meningitis. In this study, we sought to determine the prevalence of S. tigurinus in the human oral microbial flora and analyzed its association with periodontal disease or health. We developed a diagnostic highly sensitive and specific real-time TaqMan PCR assay for detection of S. tigurinus in clinical samples, based on the 16S rRNA gene. We analyzed saliva samples and subgingival plaque samples of a periodontally healthy control group (n = 26) and a periodontitis group (n = 25). Overall, S. tigurinus was detected in 27 (53%) out of 51 patients. There is no significant difference of the frequency of S. tigurinus detection by RT-PCR in the saliva and dental plaque samples in the two groups: in the control group, 14 (54%) out of 2...