The emerging interest in RNA research is due to the discovery that bacterial non-protein-coding RNAs (npcRNAs; often referred to as “non-coding RNAs”) are central regulatory molecules. While single ...npcRNAs have been described in
Staphylococcus aureus
, mostly based on computational-based approaches, experimental data on npcRNAs and their impact on the formation of different phenotypes of
S. aureus
are missing. Consequently, two specialized cDNA libraries were constructed from total RNA collected from different growth phases of an isogenic clinical strain pair of
S. aureus
displaying both the normal and the small-colony variant phenotype. Overall, 142 candidates for novel npcRNAs were identified and their expression analyzed by Northern blot assays. Of these, the presence of 18 novel npcRNAs in
S. aureus
was experimentally confirmed. In fact, growth phase-specific regulation was detected for almost all of the novel npcRNAs, with different npcRNA expression patterns detectable for both phenotypes. Of particular interest,
S. aureus
phenotype-specific expression of four novel npcRNAs was documented. Thus, the presence of differentially expressed npcRNAs in
S. aureus
may help to understand the phenotypic variation and its associated pathogenicity.
•PCV recommendations differ for mature (2 + 1) and premature (3 + 1) infants.•In cohort 2018, only 47 % of premature but 77 % of mature infants obtained full PCV.•49 % of premature and 15 % of mature ...infants did not receive a booster dose.•5 % (premature) and 9 % (mature) remained unvaccinated and PCV was often delayed.•Higher acceptance of the reduced PCV schedule for mature infants is not proven.
In August 2015, the German Standing Committee on Vaccination (STIKO) changed the pneumococcal conjugate vaccination (PCV) schedule for mature infants from a 3+1 to a 2+1scheme. For premature infants, the 3+1schedule remained unchanged. Aim was to assess vaccination rates, completeness, and timeliness for PCV stratified by premature and mature infants before and after the recommendation change based on real-world data.
Retrospective claims data analyses were conducted using a comprehensive research database. The study population consisted of all mature and premature infants born in 2013, 2016, or 2018 with an individual follow-up of 24 months using ICD-10-GM codes P07.2 and P07.3 for premature infants. Hexavalent (HEXA) combination vaccination with a consistent 3+1recommendation for premature and mature infants was analyzed as a reference.
After follow-up of 24 months, rates of premature and mature infants receiving ≥1PCV and HEXA vaccination steadily increased since the change of STIKO’s recommendation. However, in 2018 (2016/2013), only 47 % (41 %/65 %) of premature but 74 % (72 %/68 %) of mature infants obtained the recommended 3+1 respectively 2+1 PCV doses. At the same age, a consistent increase in complete HEXA vaccination with 3+1 doses was observed over time in premature (2013/2016/2018: 66 %/68 %/70 %) and mature (2013/2016/2018: 69 %/72 %/73 %) infants. Timeliness of PCV and HEXA booster administration remained stable with ∼50 % of all premature and mature infants receiving the booster according to recommended timelines.
There is no proven evidence that the reduced PCV schedule for mature infants induced a higher acceptance of vaccination. The rate of unvaccinated infants remained at a considerable level and vaccinations were often delayed. Although the STIKO still recommends a 3+1 PCV schedule for premature infants in Germany, less than half of children showed a completed vaccination series. To protect these vulnerable groups, efforts are needed to increase adherence to the STIKO recommendation especially for premature infants.
•STIKO changed PCV recommendation (mature infants) from 3+1 to 2+1 scheme in 2015.•Almost 10% of children remained unvaccinated in 2013 and 2016.•The rate of the booster dose increased slightly ...(birth cohort 2013 vs 2016).•Nearly 25% of the infants born in 2016 did not receive a booster dose.•The PCV booster dose was administered on time in less than half of infants in 2016.
In August 2015, the German Standing Committee on Vaccination (STIKO) changed the pneumococcal conjugate vaccination (PCV) schedule for mature infants from a 3+1 scheme to a 2+1 scheme. It was expected that a reduction of doses would be associated with a higher acceptance of the vaccination. Aim of this study was to assess vaccination rates and adherence for PCV after the change of recommendation based on real-world data.
A retrospective claims data analysis using the InGef Research Database was conducted. The study population consisted of all mature infants born in 2013 (last birth cohort completely under 3+1 recommendation) or 2016 (first birth cohort completely under 2+1 recommendation) with an individual follow-up of 24 months. Hexavalent combination vaccination (HEXA) with a consistent 3+1 recommendation was analyzed as reference.
After follow-up of 24 months, 90.9% (91.2%) of the 2016 (2013) cohort received at least one dose of PCV. At the same age, 67.7% of the 2013 cohort received a booster dose according to the 3+1 schedule and 75.6% of the 2016 cohort received a booster dose presumably either according to the 2+1 (71.7%) or 3+1 (3.9%) schedule. Of those receiving the booster dose, only 46.3% (2016) and 45.1% (2013) received the booster dose on time as recommended. The HEXA vaccination rate increased from 88.9% (2013) to 91.6% (2016) with a full series completion in 69.1% (2013) vs 72.9% (2016). The proportion of infants receiving the booster vaccination on time rose to 50.0% in 2016 (47.8% in 2013).
Although the rate for the PCV booster dose slightly increased, nearly a quarter of the infants born in 2016 did not receive a booster dose at all. Furthermore, vaccinations were still frequently delayed, and the rate of unvaccinated infants remained constant.
S
taphylococcus aureus
is one of the most common causes of both endemic and epidemic infections acquired in hospitals, which result in substantial morbidity and mortality. In U.S. hospitals in the ...National Nosocomial Infections Surveillance system,
S. aureus
accounted for up to 13 percent of isolates recovered from patients with nosocomial infections from 1979 through 1995, and the percentage has increased in recent years.
1
,
2
Community-acquired infections with
S. aureus
are also common.
2
,
3
Multidrug-resistant strains of staphylococci have been reported with increasing frequen-cy worldwide, including isolates that are resistant to methicillin, lincosamides, macrolides, aminoglycosides, fluoroquinolones, or combinations of these . . .
•In 2015, STIKO changed PCV recommendation for mature infants to a 2+1scheme.•For premature infants, the 3+1 scheme remained unchanged.•Comparing birth cohorts 2013 and 2016, less premature infants ...received full PCV.•Regarding birth cohort 2016, 60% of premature infants did not receive a PCV booster.•Almost 6% of premature infants remained unvaccinated.
In 2015, the German Standing Committee on Vaccination (STIKO) changed the pneumococcal conjugate vaccination (PCV) schedule for mature infants from a 3+1scheme (2, 3, 4, and 11–14 months of age) to a 2+1scheme (2, 4, and 11–14 months of age). For premature infants, the 3+1scheme remained. The aim of this study was to assess vaccination rates, completeness, and timeliness for PCV in premature infants before and after the modified recommendation.
A retrospective claims data analysis using the “Institut für angewandte Gesundheitsforschung Berlin” Research Database was conducted. Premature infants born in 2013 and 2016 with an individual follow-up of 24 months were included. Hexavalent combination (HEXA) vaccination with a consistent 3+1recommendation for mature and premature infants was analyzed as reference vaccination.
After 24 months, the PCV rate for at least one dose remained stable in premature newborns of 2016 compared to 2013, while the HEXA vaccination rate increased slightly. However, a significant decrease of a completed PCV schedule (4 doses) in premature infants was noted, whereas the completeness of HEXA vaccination did not change. The timeliness of PCV in premature newborns increased for the first and the booster PCV, while the timeliness of HEXA immunization did not change from 2013 to 2016.
Although STIKO still recommends a 3+1PCV schedule for premature infants in Germany, premature infants were vaccinated according to the changed recommendations for mature born infants. A substantial share of premature infants remained unvaccinated, and their vaccinations were often delayed.
Little information on the current burden of community-acquired pneumonia (CAP) in adults in Germany is available. We conducted a retrospective cohort study using a representative healthcare claims ...database of approx. 4 million adults to estimate the incidence rates (IR) and associated mortality of CAP in 2015. IR and mortality were stratified by treatment setting, age group, and risk group status. A pneumonia coded in the primary diagnosis position or in the second diagnosis position with another pneumonia-related condition coded in the primary position was used as the base cases definition for the study. Sensitivity analyses using broader and more restrictive case definitions were also performed. The overall IR of CAP in adults greater than or equal to18 years was 1,054 cases per 100,000 person-years of observation. In adults aged 16 to 59 years, IR for overall CAP, hospitalized CAP and outpatient CAP was 551, 96 and 466 (with a hospitalization rate of 17%). In adults aged greater than or equal to60 years, the respective IR were 2,032, 1,061 and 1,053 (with a hospitalization rate of 52%). If any pneumonia coded in the primary or secondary diagnosis position was considered for hospitalized patients, the IR increased 1.5-fold to 1,560 in the elderly greater than or equal to60 years. The incidence of CAP hospitalizations was substantially higher in adults greater than or equal to18 years with at-risk conditions and high-risk conditions (IR of 608 and 1,552, respectively), compared to adults without underlying risk conditions (IR 108). High mortality of hospitalized CAP in adults greater than or equal to18 was observed in-hospital (18.5%), at 30 days (22.9%) and at one-year (44.5%) after CAP onset. Mortality was more than double in older adults in comparison to younger patients. CAP burden in older adults and individuals with underlying risk conditions was high. Maximizing uptake of existing vaccines for respiratory diseases may help to mitigate the disease burden, especially in times of strained healthcare resources.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract The pathogen Staphylococcus aureus may use various strategies to resist antibiotic therapy. One of these strategies is the formation of small colony variants (SCVs), a naturally occurring, ...slow-growing subpopulation with distinctive phenotypic characteristics and pathogenic traits. SCVs are defined by mostly non-pigmented and non-haemolytic colonies ca. 10 times smaller than the parent strain. In the past decade, many reports and prospective studies have supported a pathogenic role for these variants in patients with persistent and/or recurrent infections. The tiny size of clinical and experimentally derived SCVs on solid agar is often due to auxotrophy for hemin and/or menadione, two compounds involved in the biosynthesis of electron transport chain components. The morphological and physiological features of SCVs present a challenge to clinical microbiologists in terms of recovery of organisms, their identification and susceptibility testing. Based on the knowledge that SCVs may persist intracellularly, treatment including antimicrobial agents with intracellular antistaphylococcal activity appears appropriate. SCVs potentially use the upregulated arginine deiminase pathway to produce ATP or, through ammonia production, to counteract the acidic environment that prevails intracellularly, as shown using a site-directed mutant with SCV phenotype in transcriptomic studies.
Ixodes ricinus
is the most abundant tick species and an important vector of pathogens in Germany and in large parts of Europe. A few other ixodid tick species, e.g.,
Dermacentor reticulatus
, may ...also be of eco-epidemiological relevance. As ticks are not only found in natural but also in suburban areas (parks, gardens), the present study investigated whether ticks occur on and near football grounds thus posing a potential risk to players and visitors. Thirty-two football grounds from all 16 German federal states were selected, mainly situated adjacent to a green area (forest, park). Ticks were collected by the conventional flagging method in spring 2018, and nymphs and adults were counted and morphologically determined. Altogether 807 nymphal and adult ticks were collected from 29 football grounds: 714
I. ricinus
, 64
Ixodes inopinatus
, 2
Ixodes frontalis
, 24
Ixodes
sp. ticks, and 3
D. reticulatus
.
Ixodes inopinatus
was found in 13 out of 16 German states. Three ticks were even found on the turf of two football fields. It can be concluded that ticks occur quite frequently and sometimes in high abundance near football grounds situated close or adjacent to a forest or a park.
Pandemic community-acquired methicillin-resistant Staphylococcus aureus isolates (CA-MRSA) predominantly encode the Panton-Valentine leukocidin (PVL), which can be associated with severe infections. ...Reports from non-indigenous Sub-Saharan African populations revealed a high prevalence of PVL-positive isolates. The objective of our study was to investigate the S. aureus carriage among a remote indigenous African population and to determine the molecular characteristics of the isolates, particularly those that were PVL-positive.
Nasal S. aureus carriage and risk factors of colonization were systematically assessed in remote Gabonese Babongo Pygmies. Susceptibility to antibiotics, possession of toxin-encoding genes (i.e., PVL, enterotoxins, and exfoliative toxins), S. aureus protein A (spa) types and multi-locus sequence types (MLST) were determined for each isolate. The carriage rate was 33%. No MRSA was detected, 61.8% of the isolates were susceptible to penicillin. Genes encoding PVL (55.9%), enterotoxin B (20.6%), exfoliative toxin D (11.7%) and the epidermal cell differentiation inhibitor B (11.7%) were highly prevalent. Thirteen spa types were detected and were associated with 10 STs predominated by ST15, ST30, ST72, ST80, and ST88.
The high prevalence of PVL-positive isolates among Babongo Pygmies demands our attention as PVL can be associated with necrotinzing infection and may increase the risk of severe infections in remote Pygmy populations. Many S. aureus isolates from Babongo Pygmies and pandemic CA-MRSA-clones have a common genetic background. Surveillance is needed to control the development of resistance to antibiotic drugs and to assess the impact of the high prevalence of PVL in indigenous populations.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•Results show very low TBE vaccination uptake in Germany.•Vaccination uptake is higher in southern Germany.•Adherence to the vaccination schedule declines with each subsequent vaccination.•Simulated ...vaccination protection ranges from 10% to 51%, by federal state.
Tick-borne encephalitis (TBE) is an arboviral infection of the central nervous system. As there is no causal treatment of TBE, disease prevention by vaccination is especially important. Immunization consists of a three-dose primary vaccination schedule, followed by regular booster doses. In Germany, the Standing Committee on Vaccination (STIKO) at the Robert Koch-Institute recommends TBE vaccination for all those at high risk of contracting TBE. This includes individuals living in, traveling to and/or working in risk areas, and being exposed to ticks. To our knowledge, there are currently no reliable data on TBE vaccination rates in Germany available.
This retrospective cohort study based on anonymized German health claims data was conducted to determine vaccination rates of TBE primary immunization in 2012 to 2015 by federal state, compliance with the vaccination schedule, and TBE vaccination uptake for the 2011 birth cohort. Vaccination protection rates for each federal state were simulated based on a compartmental model.
Vaccination rates of an initiated primary immunization ranged from about 3% in the southern federal states to <1% in the northern federal states. Across all federal states, compliance with the vaccination schedule decreased with each subsequent vaccination. Slightly higher TBE vaccination uptake was determined in the 2011 birth cohort, as compared to the German school entry health examination statistics in 2017. Simulated vaccination protection rates for each federal state ranged from 10% in Hamburg to 51% in Baden-Wuerttemberg.
While there was an overall low vaccination uptake and a discrepancy between areas of high vs. low TBE risk, this study also indicates a concerning decline in vaccination compliance. Vaccinating physicians should address the importance of adherence upon initiation of TBE vaccination.
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