Search

Background: New commercially available point-of-care (POC) immunodiagnostic tests are appearing, which may yield rapid results for anti-SARS-CoV-2 antibodies. The aim of this study was to evaluate the diagnostic accuracy of rapid antibody detection tests compared to a validated laboratory-based enzyme-linked immunosorbent assay (ELISA) and to investigate infections amongst healthcare workers (HCWs) after unprotected close contact to COVID-19 patients. Methods: Blood serum and whole blood of 130 participants were tested with NADAL COVID-19 IgG/IgM rapid test and mö-screen 2019-NCOV coronavirus test against a validated ELISA test. Infection status was evaluated using real-time polymerase-chain-reaction.Results: Acute COVID-19 infection was detected in 2.4% of exposed HCWs. Antibody tests showed an overall frequency of IgG and IgM in 5.3%, with 1.6% asymptomatic infections. The NADAL test showed a sensitivity (IgM/IgG) of 100% (100%/100%), a specificity (IgM/IgG) of 98.8% (97.6%/100 %), a PPV of 76.9% (57.1%/100%), an NPV of 100% (100%/100%), and a diagnostic accuracy of 98.8% (97.7%/100%). The mö-screen test had a sensitivity (IgM/IgG) of 90.9% (80%/100%), a specificity (IgM/IgG) of 98.8% (97.6%/100%), a PPV of 76.9% (57.1%/100%), an NPV of 99.6% (99.2%/100%), and a diagnostic accuracy of 98.5% (96.9%/100%). Conclusions: The frequency of COVID-19 infections in HCWs after unprotected close contact is higher than in the general population of a low-prevalence country. Both POC tests were useful for detecting IgG, but did not perform well for IgM, mainly due to false positive results.

Background: 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 . 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 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 , especially from throat swabs, in the microbiological laboratory. Current clinical and microbiological practice may lead to under-diagnosis of infections caused by . Further research is needed to define the colonization rate and to optimize methods for detection as well as identification of virulence.

Objective: The objective of this standardised experimental study was to investigate the antimicrobial efficacy of the combination of chlorhexidine digluconate (CHX) and the anti-inflammatory pro-vitamin dexpanthenol, which stimulates wound-healing, in the form of Bepanthen Antiseptic Wound Cream, in order to rule out possible antagonistic combination effects of CHX and the alcohol analogue of pantothenic acid (vitamin B5) dexpanthenol.Method: Testing was carried out using the quantitative suspension test at conditions simulating wound bio-burden. Test strains included (ATCC 10541) and (ATCC 10231) in accordance with the standard methods of the German Hygiene and Microbiology Society with the following three organic challenges: i) cell culture medium MEM with Earle’s salts, L-glutamine and 10% foetal calf serum (CCM); ii) 10% sheep’s blood; iii) or a mixture of 4.5% albumin, 4.5% sheep’s blood and 1% mucin. For methodological reasons, the wound cream was tested as a 55% dilution, prepared with 1% Tween 80 (equivalent to a content of 0.275% CHX instead of 0.5% as in the original preparation). CHX 0.275% was tested as control in an aqueous solution and in 1% Tween 80. Additionally, 1% Tween 80 was tested in order to rule out an interfering effect of the dilution medium. A combn of 3% Tween 80, 3% saponin, 0.1% histidine, 0.3% lecithin, 0.5% Na-thiosulphate and 1% ether sulphate was identified as the most appropriate neutraliser during the experiments.Results: Exposed to CCM or 10% sheep’s blood, the tested wound cream fulfilled the requirements for a wound antiseptic against both test species with ≥3 log reduction at 10 minutes. Even at the the worst-case challenge test with 4.5% albumin, 4.5% sheep’s blood and 1% mucin, the requirement for a ≥3 log reduction was met after 24 hours of exposure. Interestingly, the aqueous solution of 0.275% CHX tested as control did not achieve the antimicrobial efficacy of the combination of CHX and 5% dexpanthenol. 1% Tween 80 was ineffective against both test species.Conclusion: Bepanthen Antiseptic Wound Cream achieves the bactericidal and fungicidal efficacy required for a wound antiseptic under three different challenges, despite dilution to 55% of the original preparation. So far, the addition of dexpanthenol was intended to support wound healing. However, our results indicate that the antiseptic efficacy of CHX is synergistically increased by adding 5% dexpanthenol. Acknowledging the antimicrobial and residual efficacy of CHX, and bearing in the mind the contraindications to CHX (allergy and anaphylaxis), the tested wound cream should be regarded as better suitable to be used as wound antiseptic than preparations on basis of CHX alone.

Background: Manufacturers’ recommendations on cleaning of tracheostomy tubes focus on general warning information and non-specific manual cleaning procedures. The aim of this experimental study was to evaluate different reprocessing methods and to determine the mechanical integrity and functionality of tracheostomy tubes following reprocessing.Methods: Sixteen cuffed or un-cuffed tracheostomy tubes obtained from hospital in-patients were reprocessed using one of the following reprocessing methods: a) manual brushing and rinsing with tap water, brushing followed by disinfection with a glutaraldehyde solution, c) manual brushing followed machine-based cleaning in a dishwasher, and d) manual brushing followed by ultrasound cleaning in a commercially available ultrasound device. Microbial burden of the tubes before and after reprocessing was assessed by measurement of microbial colony-forming units per mL (CFU/mL) of rinsing fluid. After cleaning, tracheostomy tubes were investigated for loss of functionality. Findings: Manual brushing and rinsing with tap water reduced microbial colonization in average by 10 CFU/mL, but with poor reproducibility and reliability. Complete microbial reduction was achieved only with additional chemical or machine-based thermal disinfection. Ultrasound sonification yielded no further microbial reduction after manual brushing. Conclusion: Manual brushing alone will not result in complete eradication of microorganism colonising cuffed or un-cuffed tracheostomy tubes. However, manual cleaning followed by chemical or thermal disinfection may be regarded as safe and reproducible reprocessing method. If a machine-based reprocessing method is used for cuffed tubes, the cuffs’ ventilation hose must be secured in a safe position prior to thermal disinfection.

Aim: While the requirements for single-use gloves for staff protection are clearly defined, the conventional medical differentiation between “sterile surgical gloves” used during surgical procedures and “single-use medical gloves” used in non-sterile medical areas does not adequately define the different requirements in these two areas of use. Sterilization of single-use medical gloves is not performed if sterility is not required; thus, another terminology must be found to identify the safety quality of non-sterile single-use medical gloves. Therefore, the labeling of such gloves should reflect this situation, by introducing the term “pathogen-free” single-use glove. The hygienic safety of such a glove would be attainable by ensuring aseptic manufacturing conditions during manufacturing and control of pathogen load of batch controls after fabrication.Proposed recommendation: Because single-use gloves employed in non-sterile areas come into contact not only with intact skin but also with mucous membranes, no potential pathogens should be detectable in 100 mL of rinse sample. In order to declare such gloves as pathogen-free we suggest absence of the indicator species and . In addition, the total CFU count should be evaluated, since a high load indicates lack of optimal hygiene during the manufacturing process. Based on the requirements for potable water and findings obtained from investigations of the bacterial load of such gloves after manufacturing, the here suggested limit for the total bacterial count of of rinse sample per glove seems realistic.

[english] Background: The aim of this study was to characterise the epidemiology of isolated from cystic fibrosis (CF) patients at the Vienna General Hospital (VGH) by molecular genetic fingerprinting in order to understand transmission ways and to evaluate the established infection control protocols.Methods: The outpatient clinic for CF patients at the VGH cares for children and adolescents up to the age of 18 years. Among an average of 139 patients cared for at the clinic, 41 were tested positive for during the study period. Fifty isolates, obtained between August 2010 and March 2012 from routine examinations of CF patients, were subject to molecular characterization using the DiversiLab method.Results: 42 distinguishable molecular-biological patterns were identified, 7 of which were found multiple times. 40 out of 42 genotypes were retrieved from single patients only, while two patterns were present in two patients each.Nine patients presented with two or more phenotypically diverse isolates. In five of these cases the retrieved isolates belonged to the same genotype.Conclusion: The broad genetic heterogeneity of in the studied patient population suggests that the majority of CF patients cared for at the VGH acquire from environmental sources. It may be concluded that implemented infection control guidelines have been successful in preventing nosocomial transmission of among CF patients within the VGH and patient-to-patient transmission outside the hospital. Chronic polyclonal infection/colonization was rare in the study population.

[english] Introduction: The increasing microbial resistance against antibiotics complicates the therapy of bacterial infections. Therefore new therapeutic options, particularly those causing no resistance, are of high interest. Cold atmospheric plasma is one possible option to eradicate multidrug resistant microorganisms, and so far no resistance development against physical plasma is known.Method: We tested 6-fold repeated plasma applications on a strain embedded in biofilm and compared the reduction of the colony forming units between the different treatment periods to asses a possible development of resistance.Result: For all treatment periods, the control biofilms were reduced by plasma in average by 1.7 log CFU, and decreased from 7.6 to 5.8 log (CFU/cm) within 5 hours. The results demonstrated that repeated plasma doses not induce resistance or habituation against plasma applied within short time periods.Conclusion: The repeated application of cold plasma is a promising option for the treatment of infected wounds without the risk of development of resistance against plasma.

[english] Background: Paromomycin is used for selective bowel decontamination (SBD) in patients undergoing bone marrow transplantation in many hospitals, but there are no published resistance data for this compound in the recent medical literature. The aim of this study was to investigate the in vitro activity of paromomycin against the common intestinal bacteria and .Methods: 94 isolates and 77 isolates derived from clinical specimens were tested by broth microdilution against paromomycin and amikacin, respectively, following the CLSI recommendations for testing amikacin.Results: 86 of 94 isolates (91%) and 71 of 77 isolates (92%) showed in vitro susceptibility to amikacin (MIC90 for both compounds: 16 µg/ml, range: 1–32 µg/ml for and for). Paromomycin was active against 83/94 isolates (88%; MIC90: 32 µg/ml, range: 2–>128 µg/ml), but showed poor in vitro activity against (3/77 isolates susceptible [4%]; MIC90: >128 µg/ml, range: 2–>128 µg/ml).Conclusion: If SBD with inclusion of an aminoglycoside antibiotic is applied, paromomycin should not be used unless local resistance data provide evidence of a sufficient in vitro activity of this compound against .

We report on an HIV-negative but immunocompromised patient with disseminated acanthamoebiasis, granulomatous, amoebic encephalitis, and underlying miliary tuberculosis and tuberculous meningitis. The patient responded favorably to treatment with miltefosine, an [...]

AKACID Plus, a novel polymeric guanidine with broad antimicrobial activity against multiantibiotic-resistant bacterial strains is used as a room disinfectant in a study at concentrations of 0.1, 0.25, and 0.5% for 100 min. The findings indicate that nebulized AKACID Plus at a concentration of 0.5% is a potent substance for eradication of pathogenic organisms in the hospital setting.