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  • 1.

    【2hr】Calculated parenteral initial treatment of bacterial infections: Introduction and antibiotics

    包量

    机译 经计算的肠胃外细菌感染的初始治疗：简介和抗生素
    摘要：This is the first chapter of the guideline “Calculated initial parenteral treatment of bacterial infections in adults – update 2018” in the 2 updated version. The German guideline by the Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG) has been translated to address an international audience.
  • 2.

    【2hr】S2k guideline Calculated parenteral initial treatment of bacterial infections in adults – update 2018 2nd updated version: Foreword

    包量

    机译 S2k准则成人细菌感染的肠胃外计算初始治疗– 2018年更新第二个更新版本：前言
    摘要：This guideline by the Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG) is an update of the “Recommendations on calculated parenteral initial therapy of bacterial diseases in adults” from 2010 [ ], [ ], [ ].
  • 3.

    【2hr】Immunology of urinary tract infections

    包量

    机译 尿路感染的免疫学
    摘要：The urinary tract is constantly exposed to different microorganisms that colonize the gastrointestinal tract and the urinary tract is normally well prepared to resist infections by these microorganisms. This resistance to infection is mainly accomplished by the versatility of the immune system in the urinary tract, with both innate and adaptive immune responses. With the increasing knowledge of how the immune system works in the urinary tract and also the recognition of the virulence attributes of uropathogens, several potentially effective and tailored strategies to contain or prevent urinary tract infections have emerged.
  • 4.

    【2hr】Evaluation of the SARS-CoV-2-IgG response in outpatients by five commercial immunoassays

    包量

    机译 用五种商业免疫测定的门诊患者SARS-COV-2-IgG反应的评价
    摘要：Commercially available immunoassays have been developed for sensitive and specific detection of antibodies against SARS-CoV-2. While high sensitivity has been reported in hospitalized COVID-19 patients, little is known about the performance of the assays in ambulatory patients. Therefore, we evaluated the SARS-CoV-2-IgG response in 51 SASR-CoV-2-PCR-confirmed outpatients with five commercial immunoassays. The sensitivity in serum samples, collected at a median of 24 days after onset of symptoms, detected by the Anti-SARS-CoV-2-ELISA IgG (Euroimmun), EDI™ Novel Coronavirus COVID-19 IgG ELISA (Epitope Diagnostics), Liaison® SARS-CoV-2 S1/S2 IgG (Diasorin), SARS-CoV-2 IgG on the Architect™ i2000 (Abbott), and Elecsys® Anti-SARS-CoV-2 (IgM/IgA/IgG) on the cobas™ e801 (Roche) was 84.3%, 78.4%, 74.5%, 86.3%, and 88.2%, respectively. The sensitivity in serum samples, collected >20 days after onset of symptoms, varied between 75.0% and 90.0%, and in samples, collected at least 28 days after onset of symptoms, did not increase, except in the Anti-SARS-CoV-2-ELISA IgG by Euroimmun (90.0%). There was not an obvious association between the type of the antigen (N versus S protein) and the overall sensitivity of the assays. Our results show significant individual differences of the IgG response against SARS-CoV-2, additionally confirmed in three patients with follow-up serum samples and seven asymptomatic but PCR-positive contact persons. In conclusion, our study shows that commercially available immunoassays detect SARS-CoV-2-IgG or total antibodies in outpatients with a satisfying sensitivity, but lower than that reported for hospitalized patients. In asymptomatic persons the SARS-CoV-2-IgG response may even be absent in a relevant percentage of persons.
  • 5.

    【2hr】Wound infection caused by Photobacterium damselae in a 32-year-old woman: case report and review of the literature

    包量

    机译 一名32岁女性的Photobacterium Damselae引起的伤口感染：案例报告和对文献的审查
    摘要：The case of a 32-year-old woman is reported, who was affected by a persisting wound infection caused by Photobacterium damselae after an accident in the Mediterranean Sea. Besides the clinical case, microbiological characteristics based on the phenotypic and genotypic description of the isolate (including whole genome data) are presented and discussed.
  • 6.

    【2hr】Biomarkers in urinary tract infections – which ones are suitable for diagnostics and follow-up?

    包量

    机译 泌尿道感染的生物标志物 - 哪些适合诊断和随访？
    摘要：Introduction: Urinary tract infections (UTIs) are one of the most common infections worldwide. Under special circumstances, clinicians must rely on laboratory findings, which might have a weak predicting value, misguiding the practitioners and leading to incorrect diagnosis and overuse of antibiotics. Therefore, there is an urgent need for reliable biomarkers in UTIs.
  • 7.

    【2hr】Clinical and economical improvements after introducing rapid identification of bacteria and early antibiotic susceptibility testing in sepsis and bloodstream infections. Results of the PHENOMENON study

    包量

    机译 在脓毒症和血流感染中介绍细菌和早期抗生素易感性测试后临床和经济改进。现象研究结果
    摘要：Background: Sepsis and bloodstream infections pose severe challenges in intensive care. Early reliable diagnosis is the key to successful therapy. The objective of the study presented here was to investigate the clinical and economical effects of the new PhenoTM BC test, which allows bacteria identification (ID) and antimicrobial susceptibility testing (AST) in approximately 7 hours after a blood culture becomes positive (BC+).
  • 8.

    【2hr】Evaluation of a new combined Western and line blot assay (EUROLINE-WB) for diagnosis and species identification of Echinococcus infection in humans

    包量

    机译 评价新的结合蛋白质印迹法和线印迹法（EUROLINE-WB）的诊断和鉴定人类棘球infection病
    摘要：Serological detection of echinococcosis is crucial for diagnosis and management. We evaluated the new blot assay Euroline-WB (ELB, Euroimmun) which consists of a Western blot with Echinococcus multilocularis (E.m.) vesicle antigens and a line blot part with recombinant antigens from E. granulosus (E.g., genus-specific EgAgB) and E.m. (species-specific Em18 and Em95), in comparison to a commercial Western Blot (EWB, LDBio) for detection and species differentiation of echinococcosis within routine laboratory diagnostics. Thirty-five serum samples from 35 patients classified according to a standardized classification were included in the analysis. Out of 24 cases of proven and probable infection with E.m. or E.g. 16 (66.7%) and 15 (62.5%) were correctly identified on species level by EWB and ELB, respectively. False Echinococcus species were assigned in two cases by EWB but none by ELB. Negative blot results in patients with proven infections were noticed in 8.3% (ELB) compared to 4.2% (EWB), but were limited to patients with antiparasitic therapy or post-surgery indicating a treatment-induced loss of antibody activity. Thus, identification of Echinococcus infection at least on the genus level was possible in 23/24 (95.8%) and 19/24 (79.2%) of patients by EWB and ELB (or 22/24 patients (91.7%) including borderline results of ELB), respectively. Recombinant Em18 and Em95 were highly specific for detection of E.m. infection but differed in sensitivity (Em18 56% and 80 %, and Em95 22% and 20% in proven and probable infections, respectively). Advantages of ELB are the standardized analysis of the banding pattern by EUROLineScan software and a faster turn-around-time.
  • 9.

    【2hr】Rhodotorula spp. in the gut – foe or friend?

    包量

    机译 红景天属。是直觉还是敌人？
    • 作者：Herbert Hof
    • 刊名：GMS Infectious Diseases
    • 2019年第-1期
    摘要：Rhodotorula spp. belong to the basidiomyceteous fungi. They are widespread in the environment. Transmission to humans occur mainly through air and food. Intestinal colonization is rather common, but an overgrowth is normally suppressed, since their optimal growth temperature is exceeded in the body. A massive presence in the gut indicates a disturbance of the balance of the microbial flora due to different causes. One particular reason will be the treatment with azoles because this will create an advantage for these azole resistant fungi. First of all, the finding of increased numbers of Rhodotorula in stool specimen is not alarming. In contrast, the colonized human will profit from such a situation since these fungi produce a lot of useful nutrients such as proteins, lipids, folate, and carotinoids. Furthermore, a probiotic effect due to regulation of multiplication of pathogenic bacteria and by neutralizing or destroying their toxins can be anticipated. On the other hand, their massive presence may increase the risk of fungemia and ensuing organ infections especially when the host defense system is hampered. Indeed, Rhodotorula spp. range among the emerging fungal pathogens in the compromised host. However, it can be doubted whether all these opportunistic infections reported originate primarily from the gut.
  • 10.

    【2hr】Potential savings through single-dose intravenous Dalbavancin in long-term MRSA infection treatment – a health economic analysis using German DRG data

    包量

    机译 在长期MRSA感染治疗中通过单剂量静脉注射达巴万星可能节省的费用–使用德国DRG数据进行的健康经济分析
    摘要：Complicated infections such as osteomyelitis, skin and soft tissue infections or endocarditis often require antibiotic therapies that can last up to several weeks. The prolonged hospital length of stay (LOS) leads to a dramatic increase in costs. Single-dose intravenous Dalbavancin is a novel antimicrobial agent for the treatment of acute bacterial skin, skin structure and soft tissue infections (ABSSSI) that allows an earlier discharge of patients, resulting in potential savings. Joint, bone and prostheses infections (JBPI) are also related with long LOS. The aim of this study is to determine the economic effects of single-dose intravenous Dalbavancin in suitable patients with Methicillin-resistant infections in Germany. For this purpose, an analysis with real-world patient treatment data was performed, which was subsequently validated in a large German hospital. In total, ABSSSI patients with MRSA infections could stay 6.45 days shorter and 2,865 € could be saved while JBPI patients could be discharged eventually 10.6 days earlier and 3,909 € could be saved. Single-dose intravenous Dalbavancin is thus an option for patients with ABSSSI and JBPI who are eligible for discharge.
  • 11.

    【2hr】TGFβ depletion does neither modulate acute E. coli-induced inflammatory immune responses nor impair the protective effect by chronic filarial infection

    包量

    机译 TGFβ耗竭既不调节急性大肠杆菌诱导的炎症免疫反应也不损害慢性丝虫感染的保护作用
    摘要：TGFβ is an anti-inflammatory molecule that suppresses pro-inflammatory immune responses. Previously, we demonstrated that chronic filarial infection has a beneficial impact on -induced sepsis. In the present study, we investigated whether this protective effect is dependent on TGFβ signaling and whether depletion of TGFβ before challenge alters the early course of sepsis . depletion of TGFβ before challenge did not alter levels of pro-inflammatory cytokines/chemokines and did neither increase the bacterial burden nor worsen -induced hypothermia six hours post challenge. Similarly, in the co-infection model, despite TGFβ depletion, mice infected with the filarial nematode exhibited milder -induced hypothermia, reduced bacterial load and pro-inflammatory immune responses. Thus, we conclude that TGFβ is not essentially modulating the initial pro-inflammatory phase during sepsis and that the protective effect of a chronic filarial infection against sepsis is independent of TGFβ signaling.
  • 12.

    【2hr】Anti-tubercular activity of a natural stilbene and its synthetic derivatives

    包量

    机译 天然二苯乙烯及其合成衍生物的抗结核活性
    摘要：>Objectives: Tuberculosis (TB) and multidrug- and extensively drug-resistant TB in particular are remaining a major global health challenge and efficient new drugs against TB are needed. This study evaluated the anti-tubercular activity of a natural stilbene and its synthetic derivatives against M. tuberculosis.>Methods: Isopropylstilbene and its synthetic derivatives were analyzed for their anti-tubercular activity against M. tuberculosis ATCC 27294 as well as multidrug- and extensively drug-resistant M. tuberculosis clinical isolates by using MGIT 960 instrumentation and EpiCenter software equipped with TB eXiST module. Cytotoxic effects of drug candidates were determined by a MTT dye reduction assay using A549 adenocarcinomic human alveolar basal epithelial cells.>Results: Growth of M. tuberculosis ATCC 27294 was suppressed by the natural isopropylstilbene HB64 as well as synthetic derivatives DB56 and DB55 at 25 µg/ml. Growth of clinical isolates MDR and XDR M. tuberculosis was suppressed by HB64 at 100 µg/ml as well as by synthetic derivatives DB56 and DB55 at 50 µg/ml and 25 µg/ml, respectively. No anti-tubercular activity was demonstrated for synthetic derivatives DB53, EB251, and RB57 at 100 µg/ml. Toxicity in terms of IC50 values of HB64, DB55 and DB56 were 7.92 µg/ml, 12.15 µg/ml and 16.01 µg/ml, respectively.>Conclusions: Synthetical derivatives of stilbene might be effective candidates as anti-tubercular drugs. However, toxicity of these substances as determined by IC50 values might limit therapeutic success in vivo. Further investigations should address lowering the toxicity for parenteral administration by remodeling stilbene derivatives.
  • 13.

    【2hr】Influenza vaccination coverage of health care workers: a cross-sectional study based on data from a Swiss gynaecological hospital

    包量

    机译 医护人员的流感疫苗接种覆盖率：基于瑞士妇科医院数据的横断面研究
    摘要：>Background: Pregnancy is a risk factor for severe influenza and related complications. The vaccination has been recommended in healthcare workers as a strategy for preventing influenza in risk patients. The aim of this study was to analyze the influenza vaccination rate of the department of obstetrics and gynaecology of the Cantonal hospital St. Gallen in Switzerland.>Methods: A cross-sectional study was carried out to investigate the influenza vaccination rates of all staff members of the Department of obstetrics and gynaecology (n=259). The vaccination coverage was compared according to sociodemographic variables using Chi-squared test. Associations were determined using a logistic regression model. Possible reasons for and against vaccination coverage were then investigated.>Results: 200 questionnaires were included (valid response rate 77%). 15% reported being vaccinated against influenza (n=29). Reasons to be vaccinated are the belief of protection of patients (82%), oneself (75%) or family (61%). Reasons not to get vaccinated, including beliefs regarding the vaccine is not important (49%) and its ineffectiveness (44%). In the logistic regression analysis, the vaccination coverage among doctors (61% vaccinated) and nurses/midwives (4% vaccinated) is different from the vaccination coverage among the non-medical staff reference category (16% vaccinated; p=0.004, p=0.027), after controlling for the effect of other variables sex (p=0.807), age (p=0.438) and full time employment (p=0.298). >Discussion: This study showed that doctors have a higher vaccination rate compared to other job roles, whereas the nurses and midwives had very low vaccination rates, which indicate a significant public health communication gap that needs to be addressed.
  • 14.

    【2hr】Clinical characteristics of a large cohort of patients with positive culture of Fusobacterium necrophorum

    包量

    机译 大量坏死镰刀菌阳性培养患者的临床特征
    摘要：>Background: Fusobacterium necrophorum is a rare pathogen, mostly affecting young adults, causing infections of the head and neck, typically described as the Lemierre’s syndrome. Today this symptom complex has become increasingly rare and has almost turned to a ‘forgotten disease’. >Methods: We performed a retrospective, descriptive study to identify the clinical features of patients with positive culture of F. necrophorum. Additionally, the antibiotic susceptibility profile of the pathogens was analysed.>Results: During a period of 22 years 36 patients with at least one isolate of F. necrophorum were identified. Mostly tonsillar and peritonsillar abscesses were found, 10 patients were identified with bacteraemia, but only 4 patients presented with symptoms like sore throat, fever and swollen cervical lymph nodes, which may suggest Lemierre’s. Most of the isolates (33/35) showed sensitivity to all tested antibiotics.>Conclusion: Appropriate techniques are needed to detect F. necrophorum, especially from throat swabs, in the microbiological laboratory. Current clinical and microbiological practice may lead to under-diagnosis of infections caused by F. necrophorum. Further research is needed to define the colonization rate and to optimize methods for detection as well as identification of virulence.
  • 15.

    【2hr】Medical treatment for urogenital tuberculosis (UGTB)

    包量

    机译 泌尿生殖系统结核病（UGTB）的医学治疗
    • 作者：Christian Wejse
    • 刊名：GMS Infectious Diseases
    • 2018年第-1期
    摘要：Urogenital tuberculosis (UGTB) should in general be treated as pulmonary TB with a four-drug regimen of Isoniazid, Rifampicin, Ethambutol and Pyrazinamide for a total of 6 months, Ethambutol and Pyrazinamide only the first two months. Some patients may need longer treatment (cavitary disease, kidney abscess/malfunction, HIV co-infection). Treatment of multi-drug resistant tuberculosis (MDR-TB) requires use of long-term intravenous treatment with aminoglycosides and other drugs with considerable toxicity for 18–24 months. Complications such as urinary tract obstruction may occur and should be treated with corticosteroids or surgery.
  • 16.

    【2hr】Antibiotic consumption and resistance of gram-negative pathogens (collateral damage)

    包量

    机译 革兰氏阴性病原体的抗生素消耗和耐药性（附带损害）
    摘要：Antibiotics are commonly prescribed in community and hospital care. Overuse and misuse favors emergence and spread of resistant bacteria. The ATC/DDD methodology is commonly used for presenting the drug utilization data. In primary care, the consumption is usually expressed in DDD per 1,000 inhabitants per day, in hospital, preferably in DDD per 100 bed days and DDD per 100 admissions. The alternative metric is days of therapy (DOT), which needs IT support. Antibiotics have ecological adverse effects at individual and population level. Antibiotics select resistant bacteria among pathogens and normal flora. Broad-spectrum antibiotics, low dosage and prolonged antibiotic therapy favor the development of resistance. Although total use of antibiotics in hospital is much less than in the community, the intensity of use magnified by cross infection ensures a multitude of resistant bacteria in today’s hospitals. Reversal of resistance is complex and might persist for many years despite the introduction of antimicrobial containment and stewardship programs.
  • 17.

    【2hr】Comprehensive diagnosis and treatment of alveolar echinococcosis: A single-center long-term observational study of 312 patients in Germany

    包量

    机译 肺泡棘球cc病的综合诊断和治疗：德国312位患者的单中心长期观察性研究
    摘要：Alveolar echinococcosis (AE) is the most Iethal human helminthic infection. The malignancy-like disease is rare, but morbidity and treatment costs are high. Objective of the study was to identify factors at baseline and during specific AE therapy influencing the long-term outcome of the disease.All patients with AE seen at the specialized treatment unit in Ulm between January 1992 and December 2011 were included in the analysis.The data of 312 patients were analyzed; 108 were diagnosed before 2000 (series A), 204 since 2000 (series B); 290 received specific AE treatment. Patients of series B were more often symptom-free at diagnosis (44.1% vs. 21.3%), had lower disease stages (50.0% vs. 34.2%) and more complete resections (57.7% vs. 20.0%), but higher rates of side effects and drug toxicity (54.1% vs. 40.8%). In series B, more patients remained relapse- or progression-free after 5 years (90.5% vs. 82.8%); after 10 years, the ratio of relapses converged (70.3% vs. 66.9%, p=0.0507). Relapses or progression occurred more often after incomplete surgery or long treatment pauses. The 5-year and 10-year survival rates were 96.9% and 90.6%, respectively, and 17% of the patients were cured.We observed a shift towards early diagnosis, earlier initiation of specific therapy and more complete resections after 2000. Although diagnosis and treatment of AE pose a challenge, with an individual interdisciplinary management 88.8% of the patients have a favorable outcome.
  • 18.

    【2hr】Treatment of MRSA pneumonia: Clinical and economic comparison of linezolid vs. vancomycin – a retrospective analysis of medical charts and re-imbursement data of real-life patient populations

    包量

    机译 MRSA肺炎的治疗：利奈唑胺与万古霉素的临床和经济比较–回顾性分析病历和真实患者群体的报销数据
    摘要：>Objectives: To supplement the data collected in randomized clinical trials, the present study in patients with methicillin resistant Staphylococcus aureus (MRSA) pneumonia was conducted to explore the clinical effectiveness of linezolid and vancomycin in a routine clinical setting. Further, the overall costs of the patients' stay in the intensive care unit (ICU) were compared.>Methods: This was a retrospective analysis of medical and reimbursement data of adult patients who were treated for MRSA pneumonia with linezolid or vancomycin. Since the subjects were not randomly assigned to treatments, propensity score adjustment was applied to reduce a potential selection bias.>Results: In total, 226 patients were included; 95 received linezolid and 131 received vancomycin as initial therapy for MRSA pneumonia. Switches to another antibiotic were observed in 4 patients (4.2%) receiving linezolid and in 23 patients (17.6%) receiving vancomycin (logistic regression analysis; odds ratio linezolid/vancomycin: 0.183; 95% confidence interval [CI]: 0.052–0.647; p<0.01). All-cause in-hospital mortality was also lower in patients receiving linezolid (22 patients [23.2%] vs. 54 patients [41.2%]) (logistic regression analysis; odds ratio linezolid/vancomycin: 0.351; 95% CI: 0.184–0.671; p<0.01). The analysis of the total costs of stay in ICU did not reveal any major differences between the two treatment groups (cost ratio linezolid/vancomycin: 1.29; 95% CI: 0.84–1.98; p=0.24).>Conclusions: These findings confirm in a routine clinical setting that linezolid is a valuable therapeutic alternative to vancomycin for the treatment of MRSA pneumonia. However, prospective studies in real-life patient populations are warranted.
  • 19.

    【2hr】Decreased protein binding of moxifloxacin in patients with sepsis?

    包量

    机译 败血症患者莫西沙星的蛋白结合降低？
    摘要：The mean (SD) unbound fraction of moxifloxacin in plasma from patients with severe sepsis or septic shock was determined by ultrafiltration to 85.5±3.0% (range 81.9 and 91.6%) indicating a decreased protein binding of moxifloxacin in this population compared with the value of 58–60% provided in the Summary of Product Characteristics. However, previous investigations neglected the influence of pH and temperature on the protein binding of moxifloxacin. Maintaining physiological conditions (pH 7.4, 37°C) – as in the present study – the unbound fraction of moxifloxacin in plasma from healthy volunteers was 84%. In contrast, the unbound fraction of moxifloxacin was 77% at 4°C and 66–68% in unbuffered plasma or at pH 8.5 in fair agreement with previously published data. PK/PD parameters e.g. fAUC/MIC or ratios between interstitial fluid and free plasma concentrations, which were obtained assuming a protein binding rate of moxifloxacin of 40% or more, should be revised.
  • 20.

    【2hr】Influenza viruses – antiviral therapy and resistance

    包量

    机译 流感病毒–抗病毒治疗和耐药性
    • 作者：Susanne Duwe
    • 刊名：GMS Infectious Diseases
    • 2017年第-1期
    摘要：Influenza is a serious and frequently underestimated, but vaccine preventable disease. The adamantane derivates rimantadine and amantadine and the neuraminidase inhibitors zanamivir and oseltamivir are the only antiviral drugs currently approved in Europe for therapy and prophylaxis of influenza infections. Resistance to these drugs occurs due to mutations within the therapeutic target proteins M2 ion channel protein and viral neuraminidase. An unexpected occurrence of oseltamivir-resistant seasonal A(H1N1) viruses was detected in winter 2007/2008. The prevalence of these viruses increased rapidly and nearby all viruses circulating during the following seasons were resistant to oseltamivir. The A(H1N1)pdm09 viruses replaced the former seasonal A(H1N1) subtype during the 2009–2010 influenza season. Fortunately, resistance to neuraminidase inhibitors was detected in A(H1N1)pdm09, A(H3N2) and influenza B viruses only sporadically and was treatment related mostly. Comprehensive analyses of circulating viruses showed a high prevalence of A(H3N2) influenza viruses that are resistant to adamantane derivates since 2004/2005 and a progressive trend in the prevalence of resistant viruses up to 100% in following seasons. The M2 ion channel protein of A(H1N1)pdm09 viruses is associated with the Eurasian avian-like swine lineage and thus show “natural” resistance to adamantane derivates. Therefore, only neuraminidase inhibitors are recommended for influenza treatment today.This manuscript summarizes the occurrence and spread of antiviral resistant influenza viruses and highlights the importance for developing and/or approving new antiviral compounds.
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