F Allerberger

Österreichische Agentur für Gesundheit und Ernährungssicherheit, Wien, Vienna, Austria

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Publications (277)885.97 Total impact

  • Franz Allerberger, Steliana Huhulescu
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    ABSTRACT: Listeriosis during pregnancy usually presents as an unremarkable febrile illness in the mother but can be fatal for the fetus and newborn. Reliable laboratory testing for early diagnosis is lacking. Serological antibody tests and bacteriological stool tests are not helpful since Listeria-specific antibodies and stool cultures yielding the organism can be found in healthy pregnant women. Because early diagnosis is difficult, diagnosis is usually made by culturing the pathogen from blood, cerebrospinal fluid, placenta or meconium. The mortality rate for fetal and newborn listeriosis remains approximately 20%. Two to three cases of pregnancy-associated listeriosis are reported annually in Austria among approximately 79,000 births, 20-30 cases are reported annually in Germany among approximately 680,000 births and 50-100 cases are reported annually in the USA among approximately 4 million births. Although Listeria infections in pregnancy are rare, they should be considered as a cause of fever of unknown origin during pregnancy.
    Expert Review of Anti-infective Therapy 01/2015; · 3.06 Impact Factor
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    ABSTRACT: Contamination of surfaces by spores of Clostridium difficile is a major factor influencing the spread of healthcare-associated C. difficile infection. The aim of this study was to test the effect of an automated room disinfection system that provides an aerosol of 7.5 % hydrogen peroxide (H2O2) disinfectant, on spores of two different strains of C. difficile, and to evaluate the impact of biological soiling on the efficacy of H2O2 disinfection. The strains used were a C. difficile PCR ribotype 027 and a C. difficile ATCC 9689. Spore suspensions of each strain were applied to ceramic tiles and exposed to aerosolized H2O2 at different locations in a test room. Biological soiling was simulated by bovine serum albumin and sheep erythrocytes. At set time points spores were recovered, plated onto Columbia 5 % sheep blood agar, and surviving bacteria were counted as colony-forming units (cfu). No viable spores of either strain were recovered after a 3 h exposure to gaseous H2O2. Spores located inside a drawer showed recovery of approximately 1E5 cfu/ml for C. difficile ribotype 027 after 1 h. In the presence of organic matter, a more than fivefold log reduction compared with not exposed controls could be observed for spores of either strain tested. Appropriate decontamination of surfaces exposed to spores of C. difficile is challenging for conventional cleaning methods. Aerosolized H2O2 delivered by automated room disinfection systems could possibly improve surface decontamination and thereby reduce transmission of healthcare-associated C. difficile infection. Also in the presence of organic matter H2O2 disinfection appears to be an effective adjunct for decontamination of environmental surfaces.
    Wiener klinische Wochenschrift 12/2014; · 0.79 Impact Factor
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    ABSTRACT: The intestinal microbiota has a pivotal role in the maintenance of health of the human organism, especially in the defense against pathogenic microorganisms. Alterations in the microbiota, also termed dysbiosis, seem to be involved in the pathogenesis of a variety of intestinal and extraintestinal diseases. Fecal microbiota transplantation (FMT), also known as stool transplantation, is a therapeutic procedure aiming at restoring an altered intestinal microbiota by administration of stool microorganisms from a healthy donor into the intestinal tract of a patient. FMT is most commonly used for recurrent forms of Clostridium difficile infections (CDI). There are currently many cohort studies in a large number of patients and a randomized controlled trial showing a dramatic effect of FMT for this indication. Therefore FMT is recommended by international medical societies for the treatment of recurrent CDI with high scientific evidence. Other potential indications are the treatment of fulminant CDI or the treatment of inflammatory bowel diseases. In the practical utilization of FMT there are currently several open questions regarding the screening of stool donors, the processing of stool and the mode of FMT application. Different modes of FMT application have been described, the application into the colon has to be preferred due to less reported side effects than the application into the upper gastrointestinal tract. So far only very few side effects due to FMT have been reported, nevertheless the use and risks of FMT are currently intensely debated in the medical community. This consensus report of the Austrian society of gastroenterology and hepatology (ÖGGH) in cooperation with the Austrian society of infectious diseases and tropical medicine provides instructions for physicians who want to use FMT which are based on the current medical literature. © Georg Thieme Verlag KG Stuttgart · New York.
    Zeitschrift für Gastroenterologie. 12/2014; 52(12):1485-92.
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    ABSTRACT: The intestinal microbiome is essential for maintaining human health and defending against intestinal pathogens. Alterations of the intestinal microbiota, also termed dysbiosis, play a pivotal role in the pathogenesis of various human diseases. Fecal microbiota transplantation (FMT) aims on correcting these alterations by delivering fecal microorganisms from a healthy person to the intestines of a patient. Up to now, recurrent Clostridium difficile (CDI) infection is the only indication supported by solid scientific evidence, but many ongoing studies are investigating FMT in other dysbiosis-related diseases such as inflammatory bowel disease. As there are no systematic methodological investigations, several questions about techniques, donor screening and safety issues remain. This shortage of evidence, especially on long-term safety concerns, is leading to worldwide controversy on the use of FMT. Regulations by health care authorities vary among different countries. This review reflects the Austrian situation and its FMT guidelines concerning indications, techniques and donor screening, recently developed by local scientific societies.This article is protected by copyright. All rights reserved.
    Clinical Microbiology and Infection 10/2014; · 4.58 Impact Factor
  • Jürgen J Wenzel, Franz Allerberger
    The Lancet Infectious Diseases 10/2014; · 19.45 Impact Factor
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    ABSTRACT: We tested 19 sera from Austrian patients with acute hepatitis A. A serum from a 48-year-old female patient yielded HAV-nucleic acid that showed 99.7 % homology to the HAV-sequence obtained from samples taken during the current outbreak in several European countries, which is associated with consumption of frozen berries. So far, Austria was considered not to be affected by this hepatitis A outbreak.
    Food and Environmental Virology 09/2014; · 1.98 Impact Factor
  • Frauenheilkunde up2date 08/2014; 8(04):263.
  • Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 07/2014; 19(26). · 4.66 Impact Factor
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    ABSTRACT: Little is known about prevailing ribotypes of Clostridium difficile infection in Romania where CDI is not a mandatory notifiable disease.
    The Journal of Infection in Developing Countries 06/2014; 8(6):694-8. · 1.27 Impact Factor
  • B Springer, F Allerberger, C Kornschober
    Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 06/2014; 19(22). · 4.66 Impact Factor
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    ABSTRACT: In Europe animal and human infections due to Dirofilaria repens are increasing.
    Parasites & Vectors 05/2014; 7(1):226. · 3.25 Impact Factor
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    ABSTRACT: A cluster of 7 human cases of listeriosis occurred in Austria and in Germany between April 2011 and July 2013. The L. monocytogenes SV 1/2b isolates shared PFGE and fAFLP patterns indistinguishable from those from 5 food producers. The 7 human isolates, a control strain with a different PFGE/fAFLP profile, and 10 food isolates were subjected to whole genome sequencing (WGS) in a blinded fashion. A gene-by-gene comparison (MLST+) was performed and the resulting whole genome allelic profiles were compared using SeqSphere software version 1.0 (Ridom GmbH, Muenster, Germany). Analyzing 2298 genes, the 4 human outbreak isolates from 2012 and 2013 had different alleles at ≤6 genes, i.e. differed by ≤6 genes from each other; the dendrogram placed these isolates in between 5 Austrian unaged soft cheese isolates from producer A (≤19 genes difference to human cluster) and 2 Austrian ready-to-eat-meat isolates from producer B (≤8 genes to human cluster). Both food products appeared on grocery bills prospectively collected by these outbreak cases after hospital discharge. Epidemiological results on food consumption and MLST+ clearly separated the 3 cases in 2011 from the 4 2012/2013- outbreak cases (>48 differing genes). We showed that WGS is capable of discriminating L. monocytogenes SV 1/2b clones not distinguishable by PFGE and fAFLP. The listeriosis outbreak described, clearly underlines the potential of sequence-based typing methods in offering new perspectives of enhanced resolution and comparability of typing systems for public health applications.This article is protected by copyright. All rights reserved.
    Clinical Microbiology and Infection 04/2014; · 4.58 Impact Factor
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    ABSTRACT: The prevalence of Coxiella burnetii, Francisella tularensis, Brucella abortus, and Brucella melitensis infections in Austria and the exposure risk of military personnel were assessed in an exploratory nationwide cross-sectional seroprevalence survey in 526 healthy adult individuals, 222 of which were soldiers and 304 were civilians. Screening for IgA/IgG antibodies to C. burnetii (Phase I) and IgG/IgM antibodies to C. burnetii (Phase II), and to F. tularensis was done with commercial enzyme-linked immunosorbent assays. To detect antibodies against B. abortus and B. melitensis, an in-house complement fixation test was used. Overall, 11 individuals (2.0%) showed antibodies to C. burnetii, 3 individuals (0.5%) were seropositive for F. tularensis, and one (0.3%) individual was borderline positive. All individuals positive or borderline for F. tularensis tested negative for antibodies against C. burnetii. All individuals tested negative for antibodies against B. melitensis/B. abortus. There were no significant differences between the seroprevalence of C. burnetii and F. tularensis among military personnel and civilians. Our data demonstrate serological evidence of a low rate of exposure to C. burnetii and F. tularensis among the Austrian adult population and military personnel.
    Ticks and Tick-borne Diseases 04/2014; · 2.88 Impact Factor
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    ABSTRACT: A large listeriosis outbreak occurred in Austria, Germany and the Czech Republic in 2009 and 2010. The outbreak was traced back to a traditional Austrian curd cheese called "Quargel" which was contaminated with two distinct serovar 1/2a Listeria monocytogenes strains (QOC1 and QOC2). In this study we sequenced and analysed the genomes of both outbreak strains in order to investigate the extent of genetic diversity between the two strains belonging to MLST sequence types 398 (QOC2) and 403 (QOC1). Both genomes are highly similar, but also display distinct properties: The QOC1 genome is approximately 74 kbp larger than the QOC2 genome. In addition, the strains harbour 93 (QOC1) and 45 (QOC2) genes encoding strain-specific proteins. A 21 kbp region showing highest similarity to plasmid pLMIV encoding three putative internalins is integrated in the QOC1 genome. In contrast to QOC1, strain QOC2 harbours a vip homologue, which encodes a LPXTG surface protein involved in cell invasion. In accordance, in vitro virulence assays revealed distinct differences in invasion efficiency and intracellular proliferation within different cell types. The higher virulence potential of QOC1 in non-phagocytic cells may be explained by the presence of additional internalins in the pLMIV-like region, whereas the higher invasion capability of QOC2 into phagocytic cells may be due to the presence of a vip homologue. In addition, both strains show differences in stress-related gene content. Strain QOC1 encodes a so-called stress survival islet 1, whereas strain QOC2 harbours a homologue of the uncharacterized LMOf2365_0481 gene. Consistently, QOC1 shows higher resistance to acidic, alkaline and gastric stress. In conclusion, our results show that strain QOC1 and QOC2 are distinct and did not recently evolve from a common ancestor.
    PLoS ONE 02/2014; 9(2):e89964. · 3.53 Impact Factor
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    ABSTRACT: Leptospirosis is one of the world's mostly spread zoonoses causing acute fever. Over years, leptospirosis has been reported to occur rarely in Austria and Germany (annual incidence of 0.06/100,000 in Germany). Only imported cases have been on the increase. Objectives of this case-series study were to retrospectively assess epidemiologic and clinical characteristics of leptospirosis illnesses in South-East Austria, to describe risk exposures for autochthonous infections, and to compare patients with imported versus autochthonous infection. During the 9-year period between 2004 and 2012, 127 adult patients (49 females, 78 males) who tested positive by rapid point-of-care test for Leptospira-specific IgM (Leptocheck®) were identified through electronic hospital databases. Follow-up telephone interviews were conducted with 82 patients. A total of 114 (89.8%) of the 127 patients enrolled had acquired leptospirosis within Austria and 13 (10.2%) had potentially imported infections. Most autochthonous cases were diagnosed during the months of June and July, whereas fewest were diagnosed during the winter months. Exposure to rodents, recreational activities in woods or wet areas, gardening, cleaning of basements or huts were the most common risk exposures found in autochthonous infection. Serogroups Australis (n = 23), Sejroe (n = 22), and Icterohaemorrhagiae (n = 11) were identified most frequently by MAT testing in autochthonous infections. Patients with imported leptospirosis were significantly younger, less likely to be icteric and had significantly lower liver transaminase levels (p = 0.004) than those with autochthonous infections. Leptospirosis is endemic in South-East Austria. In contrast to reports from other countries we found a relatively high proportion of leptospirosis cases to be female (39% vs. ∼10%), likely the result of differing risk exposures for South-East Austria.
    PLoS ONE 01/2014; 9(1):e85974. · 3.53 Impact Factor
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    ABSTRACT: At the Romanian reference centre, routine characterization of Listeria monocytogenes isolates consists of: serotyping usingin-housemade reagents, describing adherence ability to HEp-2 cells and testing for eight virulence factors. We studied 22 L. monocytogenesisolates from 20 patientswith invasive listeriosis. The isolates were cultured from hospitalized patients in five regions of south-eastern Romaniafrom March 2010 to November 2012. NineteenListeria monocytogenesfood isolates originating from meat and dairy productswere included for comparison, collected in Romania between 2009 and 2012. Of the human isolates, 15 had been sent to the reference centre routinely; seven isolates were solicited actively in this catchment area. The 15 passively received human isolates and the 19 food isolates were tested for adherence to HEp-2 cells and for virulence factors; all but three human isolates and four food isolates exhibited ability to adhere. We were unable to correlate adhesion patterns to virulence. Fifteen of 19 food isolates but none of the human isolates were lipolytic. At the Austrian reference centre, 14 of the 41 (34.1%) isolates yielded PCR serotyping results discordant from those gained in Romania. While in most European countries listeriosis is primarily a disease of the elderly (≥65 years old) and of risk groups, more than half of our Romanian patients were less than 65 years old and eleven (79%) of 14 Romanian patients (other than the elderly and pregnant women) were without any known underlying disease. These findings point towards the occurrence of food products contaminated with high loads of Listeria monocytogenes.Pulsed-field gel electrophoresis revealed three tripletclustersamong human isolates, a finding which raises the suspicion of outbreaks of listeriosis in Romania.
    Romanian Biotechnological Letters, IF: 0.363. 01/2014; vol 19(3):9320-29.
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    ABSTRACT: The aim of this study was to detect the most important gaps in knowledge on food safety among food handlers in Vienna, Austria and to identify possible differences in levels of knowledge between food handlers from restaurants and catering companies. The survey was conducted from May 2011 to January 2012 in Vienna and 234 food handlers participated. The average knowledge score for all food handlers was 76%. We revealed no significant difference between the two sample groups; food handlers from catering businesses scored similar (75%) to those from restaurants (76%). Persons with a training at their current workplace (internal and external) scored significantly higher (82%) then persons without an on the job training (71%). Food handlers passing the mandatorily required yearly food safety training had a higher knowledge than persons without this on-the-job training (p � 0.001); 23% of the food handlers didn’t participate in any training during the last year. The study identified substantial knowledge gaps concerning correct temperatures for cooking, holding and storing foods. Data from this project underline the value of harmonized action in the field of food safety, but also indicate considerable potential for further improvement in Austria.
    Food Control 01/2014; 35(1):33-40. · 2.82 Impact Factor
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    ABSTRACT: Clostridium difficile infection is the leading cause of gastroenteritis-associated deaths in the industrialized world, followed by infection with norovirus. Using a cohort study design, we compared 90 inpatients with diarrhea due to C. difficile infection (CDI) with 180 inpatients with diarrhea due to other infectious agents (including 55% with norovirus infection) with respect to complications and all-cause mortality. The effects of age, severity of underlying diseases and additional infections were assessed by stratified analyses. Diarrhea recurrence occurred 8.9 (95%CI: 2.9-27.3) times more often in CDI independent of age and severity of comorbidities. The all-cause mortality in CDI patients pre-discharge and at 30 and 180 days, respectively, was 20.0%, 17.0% and 42.3% versus 7.2%, 6.7% and 22.5% in non-CDI diarrhea patients. Among those patients with low comorbidities, who were younger than 65 years and without additional infections, the all-cause pre-discharge, 30-day and 180-day mortality risks were significantly higher for the CDI diarrhea patients than the non-CDI diarrhea patients. This association was not observed among patients with an older age, more severe comorbidities or additional infections. CDI results in higher all-cause mortality than diarrhea due to other infectious agents in younger patients with low comorbidities.
    Journal of infection and public health. 11/2013;
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    ABSTRACT: The aminoglycoside phosphotransferase aph(3')-IIa is primarily inactivating kanamycin and neomycin, aph(3')-IIIa additionally amikacin. The aim of the study was to determine the frequency of both resistance genes in major human pathogens to obtain their baseline prevalence in the gene pool of these bacterial populations in Austria. In total, 10 541 Escherichia coli, Enterococcus faecalis, Enterococcus faecium, Pseudomonas aeruginosa, Salmonella enterica subsp. enterica and Staphylococcus aureus isolates were collected representatively without selection bias between 2008 and 2011. Isolates were analysed by aph(3')-IIIa/nptIII- and aph(3')-IIa/nptII-specific TaqMan real-time PCR. For positive strains MICs using Epsilon-tests were performed and resistance gene sequences were determined. The overall prevalence of aph(3')-IIIa/nptIII was 1.62% (95% confidence interval: [1.38%; 1.88%]). In E. coli, enterococci, S. aureus, P. aeruginosa, and Salmonella spp. the aph(3')-IIIa/nptIII prevalence was 0.47% [0%; 1.47%], 37.53% [32.84%; 42.40%], 2.90% [1.51%; 5.02%], 0% [0%; 0.32%], and 0% [0%; 0.037%], respectively. Eleven of a total of 169 carriers showed single nucleotide polymorphisms in the resistance allele. The overall prevalence of aph(3')-IIa/nptII was 0.0096% [0%; 0.046%]. E. coli [0%; 0.70%], enterococci [0%; 0.75%], S. aureus [0%; 0.73%], and P. aeruginosa [0%; 0.32%] did not carry aph(3')-IIa. A single Salmonella isolate was positive, resulting in an aph(3')-IIa prevalence of 0.013% [0%; 0.058%]. Aph(3')-IIIa/nptIII carriers were moderately prevalent in the strains tested except for in enterococci which appeared to be an important reservoir for aph(3')-IIIa. Aph(3')-IIa/nptII genes were detected at clinically irrelevant frequencies and played no significant role in the aminoglycoside resistance gene pool during the observation period.
    Journal of Medical Microbiology 11/2013; · 2.27 Impact Factor
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    ABSTRACT: On October 12, 2012, the provincial public health directorate of Salzburg reported a suspected norovirus (NV) outbreak among guests of a wedding-reception. The investigation aimed to confirm the causative agent, to identify the mode of transmission and to implement appropriate preventive measures. A probable outbreak case was defined as a wedding guest with diarrhoea or vomiting with disease onset from 7 to 10 October 2012 and who consumed food at the wedding dinner prepared by a hotel in the province Salzburg on 6 October 2012. A confirmed outbreak case fulfilled the criteria of a probable outbreak case and had a laboratory-confirmed NV infection. We conducted a cohort-investigation among the wedding guests. The case definitions were fulfilled in 26 wedding guests (25 %) including 2 confirmed cases. Females were 3.2 times more likely to develop disease (95 % CI 1.4-7.2) as compared to males. A mushroom dish was found to be associated with disease risk among females (risk ratio 2.3, 95 % CI 1.2-4.3). Two of 2 tested case-patients and 6 of 14 kitchen workers tested were positive for NV GII.4 Sydney. One kitchen staff-member worked during the wedding dinner despite diarrhoea. No food safety training was documented for the employees and the kitchen staff's restroom was lacking operational facilities for hand hygiene. We report the first investigated outbreak due to GII.4 Sydney, which was likely due to a symptomatic kitchen worker. Gender-specific eating behaviour may have posed female guests at higher risk of NV infection.
    Food and Environmental Virology 09/2013; 5(4). · 2.51 Impact Factor

Publication Stats

3k Citations
885.97 Total Impact Points


  • 2003–2014
    • Österreichische Agentur für Gesundheit und Ernährungssicherheit
      Wien, Vienna, Austria
  • 2011–2012
    • Medical University of Vienna
      Wien, Vienna, Austria
  • 2010–2012
    • Paracelsus Medical University Salzburg
      • University Institute of Medical Microbiology, Hygiene and Infectious Diseases
      Salzburg, Salzburg, Austria
  • 2009
    • Institut Pasteur
      Lutetia Parisorum, Île-de-France, France
  • 1989–2008
    • University of Innsbruck
      • Institute of Biochemistry
      Innsbruck, Tyrol, Austria
  • 2006
    • University of Veterinary Medicine in Vienna
      • Institut für Milchhygiene
      Vienna, Vienna, Austria
  • 1999–2005
    • University of Padova
      Padua, Veneto, Italy
  • 1992–2002
    • Medizinische Universität Innsbruck
      • • Department für Kinder- und Jugendheilkunde
      • • Univ.-Klinik für Neurologie
      Innsbruck, Tyrol, Austria
  • 1993
    • Johns Hopkins University
      Baltimore, Maryland, United States
  • 1991
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      Erlangen, Bavaria, Germany
    • Mayo Clinic - Rochester
      Rochester, Minnesota, United States