Central Institute of the Bundeswehr Medical Service

Koblenz, Germany

Central Institute of the Bundeswehr Medical Service

Koblenz, Germany
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Faulde M.,Central Institute of the Bundeswehr Medical Service | Faulde M.,University of Bonn
Journal of Hospital Infection | Year: 2012

The moth fly . Clogmia albipunctata, formerly a Mediterranean species, is now present in Germany, at latitudes exceeding 53°N. Its synanthropic behaviour allows frequent, year-round infestations in hospital buildings. Hospital infestations have been most common in shower and rest rooms in patient wards, followed by cellar storage rooms, and then rest and shower rooms in hospital kitchens. Preferred breeding sites included hair-clogged sinks in patient shower cubicles, infrequently used toilets and urinals as well as water sources stemming from neglected leaking pipes, suggesting that enhanced hospital water and pest management are necessary for control. © 2012 The Healthcare Infection Society.

Faulde M.,Central Institute of the Bundeswehr Medical Service | Faulde M.,University of Bonn
Journal of Hospital Infection | Year: 2013

Background: The formerly Mediterranean moth fly species Clogmia albipunctata (Diptera: Psychodidae) is now present in Germany, where it has become a common, year-round pest in hospital buildings. Aim: To investigate the potential of C. albipunctata to transport and transmit bacterial pathogens in infested German hospitals. Methods: From June 2011 to May 2012, 271 adult C. albipunctata were collected from four infested hospitals and analysed qualitatively and, in part, quantitatively, for bacterial colonization. Antimicrobial susceptibility testing was performed for selected nosocomial pathogens. Findings: Forty-five bacterial species representing 40 genera were found to be colonizing C. albipunctata. Among the bacteria isolated were Acinetobacter baumannii, Aeromonas hydrophila, Alcaligenes faecalis, Bacillus cereus, Escherichia coli, Klebsiella pneumoniae ssp. pneumoniae, Pseudomonas aeruginosa, P. fluorescens and Stenotrophomonas maltophilia, with colonization rates of 0-17.5%, 0-16.7%, 0-12.5%, 0-62.1%, 0-2.5%, 0-4.1%, 0-12.5%, 0-7.6% and 0-10%, respectively. Additionally, one strain of both Yersinia frederiksenii and Nocardia spp. was detected. Unlike 11 strains of multi-drug-resistant (MDR) S. maltophilia collected from one hospital, no MDR Enterobacteriaceae were isolated. Acinetobacter spp. colonized C. albipunctata at rates from 2.9% to 36.8%, and revealed a high affinity for the exoskeleton, with up to 2080 colony-forming units per moth fly for A. baumannii. Conclusion: C. albipunctata is a potential mechanical vector of bacterial pathogens associated with nosocomial infections. © 2012 The Healthcare Infection Society.

Faulde M.K.,Central Institute of the Bundeswehr Medical Service | Faulde M.K.,University of Bonn | Nehring O.,Central Institute of the Bundeswehr Armed Forces Medical Service
Parasitology Research | Year: 2012

New and improved strategies for malaria control and prevention are urgently needed. As a contribution to an optimized personal protection strategy, a novel long-lasting insecticide and repellent-treated net (LLIRN) has been designed by binding combinations of permethrin plus N,Ndiethyl- m-toluamide (DEET), or insect repellent 3535 (IR3535), and etofenprox plus DEET, onto fibres of bed net fabric employing a new multi-layer polymer-coating technique. Protective repellent efficacy, toxicological effectiveness and residual activity of 12 LLIRN types have been evaluated by laboratory testing against adult Aedes aegypti. The novel multi-layer LLIRN design allowed simultaneous embedding at concentrations up to 5,930 mg/m2 for DEET, 3,408 mg/m2 for IR3535, 2,296 mg/m2 for permethrin and 2,349 mg/m2 for etofenprox, respectively. IR3535 layers prevented co-binding of additional pyrethroid-containing polymer layers, thus making pyrethroids plus DEET LLIRNs an ideal combination. All LLIRNs revealed synergistic insecticidal effects which, when measured against concentration controls of the isolated compounds, were significant in all LLIRN types designed. DEET in DEET plus permethrin LLIRNs significantly (p<0.0001) reduced the concentration-dependent permethrin 100 % knockdown (KD) time from 55 to 75 %, the corresponding 100 % kill time (p<0.0001) from 55 to 64 %. DEET in DEET plus etofenprox LLIRNs reduced the dose-specific 100 % knockdown (KD) time of etofenprox from 42 to 50 % (p=0.004), the 100 % kill time from 25 to 38 % (p<0.0001). Permethrin or etofenprox did not influence spatial repellency of DEET or IR3535 on LLIRNs. Vice versa, DEET and IR3535 increased spatial and excitatory repellency and reduced landing and probing frequency on LLIRNs resulting in strongly enhanced biting protection, even at low concentrations. One hundred percent biting and probing protection of stored LLIRNs was preserved for 83 weeks with the 5,930 mg/m2 DEET and 2,139 mg/m2 etofenprox LLIRN, for 72 weeks with the 5,002 mg/m2 DEET and 2,349 mg/m2 etofenprox LLIRN, for 63 weeks with the 3,590 mg/m2 DEETand 1,208 mg/m 2 permethrin LLRN, and for 61 weeks with the 4,711 mg/m2 DEET and 702 mg/m2 etofenprox LLIRN. Because 100 % bite protection with up to 75 % quicker contact toxicity of pyrethroids were documented, synergistic toxicological and repellent effects of multi-layer polymer-coating LLIRNs may overcome LLIN-triggered selection pressure for development of new kdr- and metabolic pyrethroid resistances while simultaneously increasing protective efficacy also against kdr- and metabolic pyrethroidresistant mosquitoes substantially due to the repellent-induced effects of LLIRNs thus indicating that this approach is a promising new candidate for future bed net, curtain, and window screen impregnation aiming at optimized prevention from mosquito-borne diseases. © Springer-Verlag 2012.

The Horn of Africa represents a region formerly known to be highly susceptible to mosquito-borne infectious diseases. In order to investigate whether autochthonous WNV transmission occurs in the Djibouti City area, in how far, and which of, the endemic Culex mosquito species are involved in WNV circulation activity,and whether sentinel site-enhanced near-real time surveillance (SSE-NRTS) may increase WNV detection sensitivity, mosquito vector monitoring was conducted from January 2010 to June 2012. Six monitoring locations, including two identified sentinel sites, considered most probable for potential anthroponotic and zoonotic virus circulation activity, have been continuously employed. Among the 20431 mosquitoes collected, 19069 (93.4%) were Cx. quinquefasciatus, and 1345 (6.6%) Cx. pipiens ssp. torridus. WNV lineage 2 circulation activity was detected between December 20th, 2010 and January 7th, 2011. Overall, 19 WNV RNA-positive mosquito pools were detected. Generally, urban environment-specific WNV-RNA circulation took place in Cx. pipiens ssp. torridus, whereas periurban and rural area-linked circulation was detected only in Cx. quinquefasciatus. Serological investigation data from 10 volunteers employed at the dislocated zoonotic WNV transmission sentinel site suggest that six persons (60%) had an acute, or recent, WNV infection. Results show that WNV should be considered endemic for Djibouti and sentinel site-enhanced near-real time surveillance is an elegant and highly effective epidemiological tool. In Djibouti, the endemicity level, public health impact and transmission modes of vector-borne diseases in concordance with locally optimized monitoring and control regimen deserve further investigation.

Faulde M.,Central Institute of the Bundeswehr Medical Service | Faulde M.,University of Bonn | Albiez G.,Central Institute of the Bundeswehr Medical Service | Nehring O.,Central Institute of the Bundeswehr Medical Service
Parasitology Research | Year: 2012

A novel long-lasting insecticide-treated net (LLIN) has been designed by embedding the pyrethroids deltamethrin, cyfluthrin, permethrin, or etofenprox, onto the fibres of bed net cotton fabric by transferring a new polymer-coating technique from clothing to netting material. EN ISO 6330, the more stringent European Norm for domestic washing and drying procedures for textile testing, has been newly employed to monitor and validate more precise wash durability and residual bioactivity of LLINs. Wash durability, residual insecticidal activity and mosquito landing/biting protection has been investigated and compared with four commercially available LLINs. The pyrethroid-embedding impregnation technique allows binding of high concentrations exceeding 8,000 mg permethrin/m 2 within one single-polymer layer. Recovery rates of 95.7±5.8%, 92.4±14.0%, 70.2±9.1%, and 64.2±6.3% for cyfluthrin; 32.4±11.4%, 32.4±12%, 35.1±16.2%, and 35.8±15.7% for deltamethrin; 75.3± 12.9%, 57.1±15.8%, 48.5±4.0%, and 35.6±4.7% for etofenprox; and 95.7±5.8%, 80.2±8.6%, 39.1±7.9%, and 34.1± 8.8% were measured after 1, 5, 10, and 20 launderings. Laundering resistance was highest with cyfluthrin> deltamethrin≈etofenprox≈permethrin. After one and five launderings, commercial LLINs revealed percentage pyrethroid recovery rates of 26.3±11.8% and 0.9±1.2% for the Care Plus® net; 31.8% and 28.9% for the Permanet® 2.0; 61.4% and 45.6% for the Net Protect®; and 80.4% and 68.3% for the Conmanet®. Recovery rates reveal that the polymer-coating method resulted in extended wash durability. Dose-dependent 100% knockdown rates were most effective with deltamethrin>cyfluthrin> permethrin≈etofenprox. LLINs tested at concentrations up to 8,000 mg permethrin/m 2 did not protect from mosquito bites. Results on longlasting efficacy and bioactivity of the polymer-coating technique show that this new LLIN technique is a highly promising potential candidate for future malaria control strategies. Standardized machine laundering and drying according to EN ISO 6330 is highly recommended to monitor and validate wash durability and residual activity of LLINs. © Springer-Verlag 2011.

Faulde M.K.,Central Institute of the Bundeswehr Medical Service | Faulde M.K.,University of Bonn | Rueda L.M.,U.S. Army | Khaireh B.A.,Epidemiology and Clinical Research
Acta Tropica | Year: 2014

Anopheles stephensi is an important vector of urban malaria in India and the Persian Gulf area. Its previously known geographical range includes southern Asia and the Arab Peninsula. For the first time, we report A. stephensi from the African continent, based on collections made in Djibouti, on the Horn of Africa, where this species' occurrence was linked to an unusual urban outbreak of Plasmodium falciparum malaria, with 1228 cases reported from February to May 2013, and a second, more severe epidemic that emerged in November 2013 and resulted in 2017 reported malaria cases between January and February 2014. Anopheles stephensi was initially identified using morphological identification keys, followed by sequencing of the Barcode cytochrome c-oxidase I (COI) gene and the rDNA second internal transcribed spacer (ITS2). Positive tests for P. falciparum circumsporozoite antigen in two of six female A. stephensi trapped in homes of malaria patients in March 2013 are evidence that autochthonous urban malaria transmission by A. stephensi has occurred. Concurrent with the second malaria outbreak, P. falciparum-positive A. stephensi females were detected in Djibouti City starting in November 2013. In sub-Saharan Africa, newly present A. stephensi may pose a significant future health threat because of this species' high susceptibility to P. falciparum infection and its tolerance of urban habitats. This may lead to increased malaria outbreaks in African cities. Rapid interruption of the urban malaria transmission cycle, based on integrated vector surveillance and control programs aimed at the complete eradication of A. stephensi from the African continent, is strongly recommended. © 2014 Elsevier B.V.

Scheid P.,Central Institute of the Bundeswehr Medical Service | Scheid P.,University of Koblenz-Landau
Current Opinion in Microbiology | Year: 2016

A lot of endocytobionts (or endosymbionts) have been discovered within free-living amoebae in recent years. In this article the results of a long lasting effort to derive valuable data about an extraordinary spore-like infectious microorganism (endocytobiont, endosymbiont) within host amoebae (Acanthamoeba sp.) recently isolated from the contact lens case of a patient with keratitis, are presented. It took some time until this endocytobiont could be attributed to the genus Pandoravirus following a publication of two other pandoraviruses isolated from aquatic environments. Consequently the molecular biological investigation led to the taxonomic affiliation of the endocytobiont with the genus Pandoravirus and to the description of a new Pandoravirus species, Pandoravirus inopinatum after whole-genome sequencing in 2015. The fact that it was isolated from a contact lens container of a keratitis patient gives another dimension to these findings showing paradigmatically, how readily these 'new' giant viruses get to humans. © 2016 Elsevier Ltd.

Sharma V.,Aix - Marseille University | Colson P.,Aix - Marseille University | Colson P.,Institut Universitaire de France | Chabrol O.,Aix - Marseille University | And 4 more authors.
Frontiers in Microbiology | Year: 2015

Nucleocytoplasmic large DNA viruses, or representatives of the proposed order Megavirales, belong to families of giant viruses that infect a broad range of eukaryotic hosts. Megaviruses have been previously described to comprise a fourth monophylogenetic TRUC (things resisting uncompleted classification) together with cellular domains in the universal tree of life. Recently described pandoraviruses have large (1.9-2.5 MB) and highly divergent genomes. In the present study, we updated the classification of pandoraviruses and other reported giant viruses. Phylogenetic trees were constructed based on six informational genes. Hierarchical clustering was performed based on a set of informational genes from Megavirales members and cellular organisms. Homologous sequences were selected from cellular organisms using TimeTree software, comprising comprehensive, and representative sets of members from Bacteria, Archaea, and Eukarya. Phylogenetic analyses based on three conserved core genes clustered pandoraviruses with phycodnaviruses, exhibiting their close relatedness. Additionally, hierarchical clustering analyses based on informational genes grouped pandoraviruses with Megavirales members as a super group distinct from cellular organisms. Thus, the analyses based on core conserved genes revealed that pandoraviruses are new genuine members of the 'Fourth TRUC' club, encompassing distinct life forms compared with cellular organisms. © 2015 Sharma, Colson, Chabrol, Scheid, Pontarotti and Raoult.

Scheid P.,Central Institute of the Bundeswehr Medical Service | Balczun C.,Ruhr University Bochum | Schaub G.A.,Ruhr University Bochum
Parasitology Research | Year: 2014

In this article, the results of a long effort to derive valuable phylogenetic data about an extraordinary spore-like infectious particle (endocytobiont) within host amoebae (Acanthamoeba sp.) recently isolated from the contact lens and the inflamed eye of a patient with keratitis are presented. The development of these endocytobionts has already been demonstrated with electron microscopic photo sequences, leading to a relevant model of its development presented here. The molecular biological investigation following the discovery of two other Pandoravirus species within aquatic sediments in 2013 led to the taxonomic affiliation of our endocytobiont with the genus Pandoravirus. A range of endocytobionts (intracellular biofilms) have been found in recent years, among which are several viruses which obligatorily proliferate within free-living amoebae. In human medicine, foreign objects which are placed in or on humans cause problems with microorganisms in biofilms. Contact lenses are especially important, because they are known as a source of a rapid formation of biofilm. These were the first Pandoraviruses described, and because this is additionally the first documented association with humans, we have clearly demonstrated how easily such (viral) endocytobionts can be transferred to humans. This case counts as an example of parasites acting as vectors of phylogenetically different microorganisms especially when living sympatric within their biocoenosis of biofilms. As the third part of the “Pandoravirus trilogy”, it finally reveals the phylogenetic nature of these “extraordinary endocytobionts” within Acanthamoebae. © 2014, Springer-Verlag Berlin Heidelberg.

Scheid P.,Central Institute Of The Bundeswehr Medical Service Koblenz Andernacherstr 100 | Hauroder B.,Central Institute of the Bundeswehr Medical Service | Michel R.,Central Institute Of The Bundeswehr Medical Service Koblenz Andernacherstr 100
Parasitology Research | Year: 2010

In this article, the results of investigations concerning a parasitic endocytobiont within the host amoebae (Acanthamoeba sp.) are presented. The endocytobiont was recently isolated from the contact lens and the inflamed eye of a patient with keratitis. Light microscopy and electron microscopy were performed to provide morphological details: Light microscopy revealed the presence of ovoid microorganisms developing and proliferating within the cytoplasm of the amoebic trophozoites. Details of the unusual development of these endocytobionts within the amoebae could be studied and demonstrated by means of electron microscopy. Foldings and morphological reorganization of the microorganisms took place exclusively within the host cytoplasm. The intracellularly aggregating organisms led to the rupture of the Acanthamoeba trophozoites after proliferation. Numerous microorganisms were released, which were infectious and were subsequently ingested by hitherto uninfected acanthamoebic trophozoites. To evaluate the in vitro growth of the isolated endocytobionts (without their hosts), they were transferred to several different culture plates. There was no growth of these unique organisms on five different common cultural plates suitable for the growth of bacteria and fungi. © 2010 Springer-Verlag.

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