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Stuttgart Mühlhausen, Germany

Johler S.,University of Zurich | Tichaczek-Dischinger P.S.,Chemisches und Veterinaruntersuchungsamt Stuttgart | Rau J.,Chemisches und Veterinaruntersuchungsamt Stuttgart | Sihto H.-M.,University of Zurich | And 3 more authors.
Foodborne Pathogens and Disease | Year: 2013

In 2008, 150 people gathered for a wedding celebration in Baden-Württemberg, Germany. Three hours after ingestion of a variety of foods including pancakes filled with minced chicken, several guests exhibited symptoms of acute gastroenteritis such as vomiting, diarrhea, fever, and ague. Twelve guests were reported to have fallen ill, with nine of these seeking medical care in hospitals. At least four patients were admitted to the hospital and received inpatient treatment, among them a 2-year-old child and a woman in the 4th month of pregnancy. Within 24 h of the event, an investigative team collected a variety of samples including refrigerated leftovers, food in the storage unit of the caterer, nasal swabs of the caterer, as well as 21 environmental swabs. Five stool samples from patients were provided by the hospitals. Staphylococcus aureus isolates were gathered from eight samples, among them nasal swabs of the caterer, food samples, and one stool sample. Fourier transform-infrared spectroscopy was used for species identification and for primary clustering of the isolates in a similarity tree. The isolates were further characterized by spa typing and pulsed-field gel electrophoresis, and a DNA microarray was used to determine the presence/absence of genes involved in virulence and antimicrobial resistance. We were able to match an enterotoxigenic strain from the stool sample of a patient to isolates of the same strain obtained from food and the nasal cavity of a food handler. The strain produced the enterotoxin SEA and the toxic shock syndrome toxin-1, and was also found to exhibit the genes encoding enterotoxins SEG and SEI, as well as the enterotoxin gene cluster egc. This is one of only a few studies that were able to link a staphylococcal food poisoning outbreak to its source. © 2013, Mary Ann Liebert, Inc. Source

Mertens M.,Institute for Novel and Emerging Infectious Diseases | Kindler E.,University of Bern | Emmerich P.,Bernhard Nocht Institute for Tropical Medicine | Esser J.,Labor Enzenauer und Kollegen | And 12 more authors.
Virus Genes | Year: 2011

Puumala virus (PUUV) is the predominant hantavirus species in Germany causing large numbers of mild to moderate cases of haemorrhagic fever with renal syndrome (HFRS). During an outbreak in South-East Germany in 2004 a novel PUUV subtype designated Bavaria was identified as the causative agent of HFRS in humans [1]. Here we present a molecular characterization of this PUUV strain by investigating novel partial and almost entire nucleocapsid (N) protein-encoding small (S-) segment sequences and partial medium (M-) segment sequences from bank voles (Myodes glareolus) trapped in Lower Bavaria during 2004 and 2005. Phylogenetic analyses confirmed their classification as subtype Bavaria, which is further subdivided into four geographical clusters. The entire N protein, harbouring an amino-terminal hexahistidine tag, of the Bavarian strain was produced in yeast Saccharomyces cerevisiae and showed a slightly different reactivity with N-specific monoclonal antibodies, compared to the yeast-expressed N protein of the PUUV strain Vranica/Hällnäs. Endpoint titration of human sera from different parts of Germany and from Finland revealed only very slight differences in the diagnostic value of the different recombinant proteins. Based on the novel N antigen indirect and monoclonal antibody capture IgG-ELISAs were established. By using serum panels from Germany and Finland their validation demonstrated a high sensitivity and specificity. In summary, our investigations demonstrated the Bavarian PUUV strain to be genetically divergent from other PUUV strains and the potential of its N protein for diagnostic applications. © 2011 Springer Science+Business Media, LLC. Source

Freudenmann M.,Landratsamt Alb Donau Kreis | Kurz S.,Landesgesundheitsamt Baden Wurttemberg | Von Baum H.,Universitatsklinik Ulm | Reick D.,Landratsamt Neu Ulm | And 9 more authors.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz | Year: 2011

Between December 2009 and the end of January 2010, the largest hitherto known outbreak of Legionella in Germany took place in the cities of Ulm and Neu-Ulm. Of a total of 64 patients involved, 60 patients had to be hospitalized, and 5 patients died from the infection. This event was caused by a wet cooling tower of a large air conditioning system in the city center of Ulm. The search for the source of the Legionella emission was extremely difficult, since these plants are neither notifiable nor subject to authorization in Germany. We report about the search for the source and the measures to control the outbreak. We also discuss communication and coordination during these investigations. Regulatory measures as proposed by the World Health Organization (WHO) and the European Network for Legionellosis (EWGLI) and already implemented in numerous other European countries would be desirable to prevent such outbreaks in the future. © 2011 Springer Medizin Verlag. Source

Rydzewski K.,Robert Koch Institute | Schulz T.,Robert Koch Institute | Brzuszkiewicz E.,University of Gottingen | Holland G.,Robert Koch Institute | And 4 more authors.
BMC Microbiology | Year: 2014

Background: Francisella isolates from patients suffering from tularemia in Germany are generally strains of the species F. tularensis subsp. holarctica. To our knowledge, no other Francisella species are known for Germany. Recently, a new Francisella species could be isolated from a water reservoir of a cooling tower in Germany. Results: We identified a Francisella sp. (isolate W12-1067) whose 16S rDNA is 99% identical to the respective nucleotide sequence of the recently published strain F. guangzhouensis. The overall sequence identity of the fopA, gyrA, rpoA, groEL, sdhA and dnaK genes is only 89%, indicating that strain W12-1067 is not identical to F. guangzhouensis. W12-1067 was isolated from a water reservoir of a cooling tower of a hospital in Germany. The growth optimum of the isolate is approximately 30 C, it can grow in the presence of 4-5% NaCl (halotolerant) and is able to grow without additional cysteine within the medium. The strain was able to replicate within a mouse-derived macrophage-like cell line. The whole genome of the strain was sequenced (∼1.7 mbp, 32.2% G+C content) and the draft genome was annotated. Various virulence genes common to the genus Francisella are present, but the Francisella pathogenicity island (FPI) is missing. However, another putative type-VI secretion system is present within the genome of strain W12-1067. Conclusions: Isolate W12-1067 is closely related to the recently described F. guangzhouensis species and it replicates within eukaryotic host cells. Since W12-1067 exhibits a putative new type-VI secretion system and F. tularensis subsp. holarctica was found not to be the sole species in Germany, the new isolate is an interesting species to be analyzed in more detail. Further research is needed to investigate the epidemiology, ecology and pathogenicity of Francisella species present in Germany. © 2014 Rydzewski et al.; licensee BioMed Central Ltd. Source

Reick D.,Landesgesundheitsamt Baden Wurttemberg | Weidenfeller P.,Landesgesundheitsamt Baden Wurttemberg | Buttner F.,Landesgesundheitsamt Baden Wurttemberg | Hartelt K.,Landesgesundheitsamt Baden Wurttemberg
Umweltmedizin in Forschung und Praxis | Year: 2014

The State Health Office of Baden-Württemberg developed of a strategy to prevent the spread of multiresistent microorganisms in 2008 on request of the Ministry of Labour and Social Affairs, Families, Women and Senior Citizens in Baden-Württemberg. A survey was started to obtain informations on how hospitals and nursing homes handle hygiene with respect to patients colonized or infected with multiresistent microorganisms. Thereafter, a pilot phase was started in five administrative districts where regional networks were established to discuss problems at the interface between stationary and ambulatory medical facilities. The regional networks were coordinated by the local health offices. During this phase a prevalence study was carried out in 22 hospitals to detect possible multiresistent Staphyococcus aureus strains from all patients who entered the hospital or who were in intensive care. The investigation period covered only one day per hospital. After one year, the pilot phase was successfully evaluated by an external expert so that other regional networks, coordinated by the local health offices, could follow step by step. Furthermore a round table was established between the team from the State Health Department and physicians specialized in microbiology or in laboratory medicine from hospitals near to Stuttgart. Together they developed recommendations related to multiresistent microorganisms for special target groups. Starting in July 2012, various health insurance agencies in Baden-Württemberg have come together to sponsor a coordination centre at the State Health Office of Baden-Württemberg for a three year period. This is aimed to provide professional support to the local health offices and help to establish regional networks all over the state. © ecomed Medizin, Verlagsgruppe Hüthig Jehle Rehm GmbH, Landsberg Source

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