F Kipp

Publications of F Kipp

• Cross-border comparison of the admission prevalence and clonal structure of meticillin-resistant Staphylococcus aureus.

  Authors: R Köck, L Brakensiek, A Mellmann, F Kipp, M Henderikx, D Harmsen, I Daniels-Haardt, C von Eiff, K Becker, M G R Hendrix, A W Friedrich

  The Journal of hospital infection. 02/2009;

  Since patient exchange between hospitals sharing a common catchment area might favour regional spread of meticillin-resistant Staphylococcus aureus (MRSA), the reliable detection of patientsSince patient exchange between hospitals sharing a common catchment area might favour regional spread of meticillin-resistant Staphylococcus aureus (MRSA), the reliable detection of patients colonised at admission is crucial. This, hospitals in the Dutch-German border area EUREGIO MRSA-net aim at synchronising their local MRSA standards in order to prevent unidentified inter-hospital as well as cross-border spread. This assumes enhanced knowledge of MRSA prevalence and risk factors associated with MRSA carriage at admission. We conducted nasal MRSA screening of all inpatients admitted to 39 German hospitals (in the period 1 November to 30 November 2006) and to one Dutch hospital (in the period 1 July to 30 September 2007) in the EUREGIO MRSA-net. A total of 390 MRSA cases were detected among 25 540 patients screened. The admission prevalence was 1.6 MRSA/100 patients (6.5% of all S. aureus) in the German and 0.5 MRSA/100 patients (1.4% of all S. aureus) in the Dutch part of the border region. Overall, the predominating S. aureus protein A gene (spa) sequence types were t003, t032 and t011. One isolate (t044) carried Panton-Valentine leukocidin (PVL) encoding genes. Altogether, 79% and 67% of all MRSA patients in the German and Dutch regions respectively, were identifiable by the classical nosocomial risk factors assessed. In patients lacking all risk factors assessed, spa types t011 and t034 were predominant (P<0.001).

• [The importance of MRSA in patient care. Epidemiology, prevention and therapy]

  Authors: C Hornberg, D Knoop, F Kipp

  Der Orthopäde. 12/2006; 35(11):1159-60, 1162-4, 1166-7.

  Methicillin-resistant Staphylococcus aureus (MRSA) has for several years been increasingly spreading at inpatient and outpatient health care facilities. This constitutes a great epidemiologicalMethicillin-resistant Staphylococcus aureus (MRSA) has for several years been increasingly spreading at inpatient and outpatient health care facilities. This constitutes a great epidemiological problem. Measures are needed for MRSA management, including screening, hygiene, containment, and sanitation as well as for a stricter control of antibiotic use. In order to be able to monitor and assess the MRSA problem in the future, there are surveillance systems which can provide approaches for continuously improving MRSA management and thus offer a long-term solution. In this context, regional networks for implementing MRSA prevention strategies are of particular importance. Their goal is reducing MRSA-caused infections in an area and stop circulation of MRSA between the various health care facilities. For the management of MRSA infections, interdisciplinary cooperation between the attending orthopedic specialist and the clinical microbiologist is very important for planning an effective treatment regimen to ensure a successful outcome, particularly in view of the growing shortage of resources in the healthcare system.

• [Significance of microbial colonisation in materials for orthopaedic technology. New insights]

  Authors: F Kipp, K Angermeier, A Koller, H H Wetz, C Hornberg

  Der Orthopäde. 12/2006; 35(11):1146, 1148-51.

  A great problem in the treatment of diabetes are infections of diabetic feet. A likely reservoir of microorganisms are contaminated orthopaedic materials. Insoles from 70 patients were examined forA great problem in the treatment of diabetes are infections of diabetic feet. A likely reservoir of microorganisms are contaminated orthopaedic materials. Insoles from 70 patients were examined for potential microbial colonisation. Commonly employed materials were contaminated in vitro under standardised conditions using known microorganisms. After treating with an alcoholic skin disinfectant, the organisms were counted semiquantitatively. In addition to pathogens, the surfaces showed mainly microorganisms present in the normal skin flora. In all materials tested, disinfection reduced the number of organisms by 4-5 log orders. It could be shown that simple disinfection (wiping) reduces the microorganisms present on orthopaedic materials to an acceptable number. Further studies are needed to determine whether this also reduces the incidence of diabetic skin and soft tissue infection.

• [Evidence-based infection control methods using spa genotyping for MRSA spread in hospitals]

  Authors: A Mellmann, A W Friedrich, F Kipp, F Hinder, U Keckevoet, D Harmsen

  Deutsche medizinische Wochenschrift (1946). 07/2005; 130(22):1364-8.

  BACKGROUND AND OBJECTIVE: Isolation of methicillin resistant Staphylococcus aureus (MRSA) often implies rigorous infection control measures. The use of rapid and accurate typing is required toBACKGROUND AND OBJECTIVE: Isolation of methicillin resistant Staphylococcus aureus (MRSA) often implies rigorous infection control measures. The use of rapid and accurate typing is required to monitor their spread. Prompt identification of epidemic MRSA is crucial to control an outbreak, in order to avoid unnecessary interventions in patients and staff. In this study we evaluated protein A ( spa) gene repeat sequence analysis for MRSA typing in a hospital. METHODS: In 2003, all non-replicate MRSA-strains from staff and patients admitted to the University Hospital Münster (1480 beds), Germany, were spa typed. The spa types were assigned using the Ridom StaphType software. Typing results were correlated with the epidemiological findings of each MRSA isolate. RESULTS: Assignment of spa types was possible for all 175 MRSA isolates and provided rapid (mean, 2 days) typing results. spa typing method yielded 34 spa types. Synchronizing the sequencing results with a central database (http://www.spaServer.ridom.de) created a reproducible and uniform nomenclature for easy intra- and inter-hospital comparisons. CONCLUSION: spa typing makes continuous and fast MRSA typing possible for hospital isolates. The differentiation between outbreaks and accidental accumulations due to imported MRSA was easily possible and allowed implementation of focused and evidence-based infection control measures.

• [Candida- and Aspergillus-antibody-Elisa--expected positive antibody results in sera of the clinical-mycological routine diagnostics.]

  Authors: W Fegeler, F Kipp

  Mycoses. 02/2004; 47 Suppl 1:41-7.

  Based on the ELISA results of more than 15000 serum samples of clinical mycological routine diagnostics, the expected frequency of positive antibody ELISA results within the immunoglobulin classesBased on the ELISA results of more than 15000 serum samples of clinical mycological routine diagnostics, the expected frequency of positive antibody ELISA results within the immunoglobulin classes IgM, IgG and IgA was determined, to optimize the diagnostic assessment of first or single result of Candida or Aspergillus antibody ELISA. In general diagnostics the expected frequency of positive antibody ELISA results of the first sample within the immunoglobulin classes were as follows: Candida antibody IgM 6.1%; IgG 6.0%; IgA 2.1% and Aspergillus antibody IgM 11.4%; IgG 22.1% and IgA 5.1%, respectively. Using the Candida antibody ELISA as confirmation test only, percentages of positive antibody results in the first sample were 2.5 to 3 times higher than in general diagnostics. In follow-up examinations the Candida antibodies showed different kinetics within the immunoglobulin classes compared to those of the Aspergillus antibodies.

• Detection of Staphylococcus aureus by 16S rRNA directed in situ hybridisation in a patient with a brain abscess caused by small colony variants.

  Authors: F Kipp, W Ziebuhr, K Becker, V Krimmer, N Höbeta, G Peters, C von Eiff

  Journal of neurology, neurosurgery, and psychiatry. 08/2003; 74(7):1000-2.

  A 45 year old man was admitted to hospital with a right sided facial paralysis and three month history of seizures. Computed tomography showed a left temporal mass including both intracerebral andA 45 year old man was admitted to hospital with a right sided facial paralysis and three month history of seizures. Computed tomography showed a left temporal mass including both intracerebral and extracerebral structures. Ten years earlier the patient had undergone a neurosurgical intervention in the same anatomical region to treat a subarachnoid haemorrhage. In tissue samples and pus obtained during neurosurgery, Staphylococcus aureus was detected by a 16S rRNA-directed in situ hybridisation technique. Following long term cultivation, small colony variants (SCV) of methicillin resistant S aureus were identified. The patient was treated successfully with a combination of vancomycin and rifampin followed by prolonged treatment with teicoplanin, with no sign of infection on follow up nine months after discharge. This is the first report in which S aureus SCV have been identified as causative organisms in a patient with brain abscess and in which in situ hybridisation has been used to detect S aureus in a clinical specimen containing SCV. Antimicrobial agents such as rifampin which have intracellular activity should be included in treatment of infections caused by S aureus SCV.

• [Incidence and detection of nosocomial infections in technical orthopedics]

  Authors: C Homberg, A Koller, F Kipp, W Bühring, H H Wetz

  Der Orthopäde. 04/2001; 30(3):176-81.

  The significance of nosocomial infections is increasing. The reasons for this are a higher concentration of problematic patients in hospitals due to the increasing number of outpatient surgeries, theThe significance of nosocomial infections is increasing. The reasons for this are a higher concentration of problematic patients in hospitals due to the increasing number of outpatient surgeries, the increase of invasive therapeutic and diagnostic procedures, the growing share of immunodeficient patients as well as the increase in antibiotic-resistant and multiresistant pathogenic organisms. Basic changes in the medical system call for a systematic discussion about directed quality management. Surveillance, i.e., the systematic registration and evaluation of occurred diseases as well as the feedback to the personnel in charge is very important in this context, particularly when complemented by comprehensive hygienic measures. The growing significance of hospital infections increasingly triggered by multiresistant pathogenic organisms emphasizes the importance of general prevention. Each hospital has to determine which surveillance methods for the registration of nosocomial infections and multiresistant pathogenic organisms are the most appropriate under their respective conditions. To get a first idea of possible problem areas, prevalence studies are very suitable for the start before moving on to well-directed incidence studies in certain wards and for certain kinds of infection.

• [Pathogenesis, diagnosis and prevention of implant-associated infection]

  Authors: C von Eiff, F Kipp, G Peters

  Der Internist. 12/2000; 41(11):1180-2, 1184-8.