Archive for July 9, 2015

A variegated squirrel bornavirus associated with fatal human encephalitis.

N Engl J Med Jul 9, 2015 V.373 P.154-162

BRIEF REPORT

Bernd Hoffmann, D.V.M., Dennis Tappe, M.D., Dirk Höper, M.Sc., Christiane Herden, D.V.M., Annemarie Boldt, M.D., Christian Mawrin, M.D., Olaf Niederstraßer, M.D., Tobias Müller, M.D., Maria Jenckel, M.Sc., Elisabeth van der Grinten, D.V.M., Christian Lutter, D.V.M., Björn Abendroth, M.Sc., Jens P. Teifke, D.V.M., Daniel Cadar, D.V.M., Ph.D., Jonas Schmidt-Chanasit, M.D., Rainer G. Ulrich, Ph.D., and Martin Beer, D.V.M.

From the Institute of Diagnostic Virology (B.H., D.H., M.J., B.A., M.B.), Department of Experimental Animal Facilities and Biorisk Management (J.P.T.), and Institute of Novel and Emerging Infectious Diseases (R.G.U.), Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Bernhard Nocht Institute for Tropical Medicine, World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Hamburg (D.T., D.C., J.S.-C.), German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel

(D.T., D.C., J.S.-C.), Institute of Veterinary Pathology, Justus-Liebig-University Gießen, Gießen (C.H.), Department of Neurology, Bergmannstrost Hospital (A.B., O.N.), and Department of Neurology, University

Hospital Halle (Saale) (T.M.), Halle (Saale), Institute of Neuropathology, Otto-vonGuericke Universität, Magdeburg (C.M.), State Institute for Consumer Protection of Saxony-Anhalt, Department of Veterinary

Medicine, Stendal (E.v.d.G.), and Special Service for Veterinarian Affairs and Consumer Protection, Salzlandkreis, Bernburg (Saale) (C.L.) — all in Germany. Address reprint requests to Dr. Beer at the Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, OIE Collaborating Center for Zoonoses in Europe, Südufer 10, 17493 Greifswald-Insel Riems, Germany, or at martin.beer@fli.bund.de .

Between 2011 and 2013, three breeders of variegated squirrels (Sciurus variegatoides) had encephalitis with similar clinical signs and died 2 to 4 months after onset of the clinical symptoms. With the use of a metagenomic approach that incorporated next-generation sequencing and real-time reverse-transcriptase quantitative polymerase chain reaction (RT-qPCR), the presence of a previously unknown bornavirus was detected in a contact squirrel and in brain samples from the three patients. Phylogenetic analyses showed that this virus, tentatively named variegated squirrel 1 bornavirus (VSBV-1), forms a lineage separate from that of the known bornavirus species. (Funded by the Federal Ministry of Food and Agriculture [Germany] and others.)….

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1415627

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July 9, 2015 at 10:21 am

Prevalence of Klebsiella pneumoniae strains producing carbapenemases and increase of resistance to colistin in an Italian teaching hospital from January 2012 To December 2014

BMC Infectious Diseases June 27, 2015 V.15 P.244

Saverio Parisi, Andrea Bartolini, Erica Santacatterina, Elena Castellani, Roberto Ghirardo, Alessandro Berto, Elisa Franchin, Nicola Menegotto, Ettore De Canale, Tiziana Tommasini, Roberto Rinaldi, Monica Basso, Stefania Stefani, Giorgio Palù

Background

The aim of this study was to characterize the spread of carbapenemase-producing Klebsiella pneumoniae (CPKP) in a tertiary level hospital using ongoing active surveillance with rectal swab cultures. Furthermore, this study analyzed the presence of CPKP in the clinical samples (CS) of a single patient as well as the evolution of Colistin-sensitive strains (CoS) to Colistin-resistant strains (CoR).

Methods

This study was performed from January 1, 2012 to December 31, 2014. In 2012, a survey was conducted in the Intensive Care Department. In autumn 2013, active monitoring was extended to the Surgery Department, and since mid-2014, the surveillance has included the Medical Department as well. Only the first isolated strain from each patient was included. Antimicrobial susceptibility testing was performed on CPKP isolates: Klebsiella pneumoniae carbapenemase, oxacillinase-48, Verona integron-encoded metallo-β-lactamase and New Delhi metallo-β-lactamase were detected using a validated in-house PCR method, and multilocus sequence typing (MLST) was used to investigate the clonal transmission of strains.

Results

A total of 15,104 patients were included in the study, and 496 consecutive non-replicated strains of CPKP were collected: 149 strains were collected in 2012 (39 [26.2 %] from surveillance rectal swabs [SRS]), 133 strains were collected in 2013 (70 [52.6 %] from SRS) and 214 strains were collected in 2014 (164 [76.6 %] from SRS). We observed a significant increase in the percentage of positive SRS cases in 2014 relative to 2013 and 2012 (p=0.0001 and p=0.0172, respectively) and in the proportion of CPKP first isolated by SRS relative to those identified by CS (p<0.0001). Among all available samples, the number of CoR isolated from SRS was higher in 2013 and 2014 compared with 2012 (p=0.0019 and p=0.008, respectively). ST-258 and ST-512 were more prevalent in the tested specimens, and a new single locus variant (SLV) of ST-512 (ST-745) was isolated.

Conclusions

The results of this 3-year study of 15,104 patients highlight the clinical relevance of antimicrobial resistance as well as the drug-selection pressure of colistin therapy. The active surveillance in the three different departments increased the level of CPKP cases isolated by SRS.

PDF

http://www.biomedcentral.com/content/pdf/s12879-015-0996-7.pdf

July 9, 2015 at 10:18 am

Scabies – An ancient global disease with a need for new therapies

BMC Infectious Diseases July 1, 2015 V.15 P.250

Correspondence

Jackson Thomas, Greg M Peterson, Shelley F Walton, Christine F Carson, Mark Naunton, Kavya E Baby

Background

Scabies is an ancient disease (documented as far back as 2500 years ago). It affects about 300 million people annually worldwide, and the prevalence is as high as about 60 % in Indigenous and Torres Strait Islander children in Australia. This is more than six times the rate seen in the rest of the developed world. Scabies is frequently complicated by bacterial infection leading to the development of skin sores and other more serious consequences such as septicaemia and chronic heart and kidney diseases. This causes a substantial social and economic burden especially in resource poor communities around the world.

Discussion

Very few treatment options are currently available for the management of scabies infection. In this manuscript we briefly discuss the clinical consequences of scabies and the problems found (studies conducted in Australia) with the currently used topical and oral treatments. Current scabies treatment options are fairly ineffective in preventing treatment relapse, inflammatory skin reactions and associated bacterial skin infections. None have ovicidal, antibacterial, anti-inflammatory and/or anti-pruritic properties. Treatments which are currently available for scabies can be problematic with adverse effects and perhaps of greater concern the risk of treatment failure. The development of new chemical entities is doubtful in the near future. Though there may be potential for immunological control, the development of a vaccine or other immunotherapy modalities may be decades away.

Summary

The emergence of resistance among scabies mites to classical scabicides and ineffectiveness of current treatments (in reducing inflammatory skin reactions and secondary bacterial infections associated with scabies), raise serious concerns regarding current therapy. Treatment adherence difficulties, and safety and efficacy uncertainties in the young and elderly, all signal the need to identify new treatments for scabies.

PDF

http://www.biomedcentral.com/content/pdf/s12879-015-0983-z.pdf

July 9, 2015 at 10:14 am


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