F Allerberger

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

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Publications (307)1086.01 Total impact

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    ABSTRACT: Antibiotic resistance genes may be considered as environmental pollutants if anthropogenic emission and manipulations increase their prevalence above usually occurring background levels. The prevalence of aph(3')-IIa/nptII and aph(3')-IIIa/nptIII - frequent marker genes in plant biotechnology conferring resistance to certain aminoglycosides - was determined in Austrian soils from 100 maize and potato fields not yet exposed to but eligible for GMO crop cultivation. Total soil DNA extracts were analysed by nptII/nptIII-specific TaqMan real time PCR. Of all fields 6% were positive for nptII (median: 150 copies/g soil; range: 31-856) and 85% for nptIII (1190 copies/g soil; 13-61600). The copy-number deduced prevalence of nptIII carriers was 14-fold higher compared to nptII. Of the cultivable kanamycin-resistant soil bacteria 1.8% (95% confidence interval: 0-3.3%) were positive for nptIII, none for nptII (0-0.8%). The nptII-load of the studied soils was low rendering nptII a typical candidate as environmental pollutant upon anthropogenic release into these ecosystems. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Environmental Pollution 07/2015; 206:342-351. DOI:10.1016/j.envpol.2015.07.028 · 4.14 Impact Factor
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    ABSTRACT: In May 2013, Italy declared a national outbreak of hepatitis A, which also affected several foreign tourists who had recently visited the country. Molecular investigations identified some cases as infected with an identical strain of hepatitis A virus subgenotype IA. After additional European Union/European Economic Area (EU/EEA) countries reported locally acquired and travel-related cases associated with the same outbreak, an international outbreak investigation team was convened, a European outbreak case definition was issued and harmonisation of the national epidemiological and microbiological investigations was encouraged. From January 2013 to August 2014, 1,589 hepatitis A cases were reported associated with the multistate outbreak; 1,102 (70%) of the cases were hospitalised for a median time of six days; two related deaths were reported. Epidemiological and microbiological investigations implicated mixed frozen berries as the vehicle of infection of the outbreak. In order to control the spread of the outbreak, suspected or contaminated food batches were recalled, the public was recommended to heat-treat berries, and post-exposure prophylaxis of contacts was performed. The outbreak highlighted how large food-borne hepatitis A outbreaks may affect the increasingly susceptible EU/EEA general population and how, with the growing international food trade, frozen berries are a potential high-risk food.
    Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 07/2015; 20(29). DOI:10.2807/1560-7917.ES2015.20.29.21192 · 5.72 Impact Factor
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    ABSTRACT: A prospective, noninterventional survey was conducted among Clostridium difficile positive patients identified in the time period of July until October 2012 in 18 hospitals distributed across all nine Austrian provinces. Participating hospitals were asked to send stool samples or isolates from ten successive patients with C.difficile infection to the National Clostridium difficile Reference Laboratory at the Austrian Agency for Health and Food Safety for PCR-ribotyping and in vitro susceptibility testing. A total of 171 eligible patients were identified, including 73 patients with toxin-positive stool specimens and 98 patients from which C. difficile isolates were provided. Of the 159 patients with known age, 127 (74.3 %) were 65 years or older, the median age was 76 years (range: 9-97 years), and the male to female ratio 2.2. Among these patients, 73 % had health care-associated and 20 % community-acquired C. difficile infection (indeterminable 7 %). The all-cause, 30-day mortality was 8.8 % (15/171). Stool samples yielded 46 different PCR-ribotypes, of which ribotypes 027 (20 %), 014 (15.8 %), 053 (10.5 %), 078 (5.3 %), and 002 (4.7 %) were the five most prevalent. Ribotype 027 was found only in the provinces Vienna, Burgenland, and Lower Austria. Severe outcome of C. difficile infection was found to be associated with ribotype 053 (prevalence ratio: 3.04; 95 % CI: 1.24, 7.44), not with the so-called hypervirulent ribotypes 027 and 078. All 027 and 053 isolates exhibited in vitro resistance against moxifloxacin. Fluoroquinolone use in the health care setting must be considered as a factor favoring the spread of these fluoroquinolone resistant C. difficile clones.
    Wiener klinische Wochenschrift 07/2015; 127(15-16). DOI:10.1007/s00508-015-0808-5 · 0.84 Impact Factor
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    ABSTRACT: Whole genome sequencing (WGS) has emerged today as an ultimate typing tool to characterize Listeria monocytogenes outbreaks. However, data analysis and interlaboratory comparability of WGS data is still challenging for most public health laboratories. Therefore, we have developed and evaluated a new L. monocytogenes typing scheme based on genome wide gene-by-gene comparisons (core genome multilocus sequence typing [cgMLST]) to allow for a unique typing nomenclature.Initially, we determined the breadth of the L. monocytogenes population based on MLST data with a Bayesian approach. Based on genome sequence data of representative isolates for the whole population, cgMLST target genes were defined and reappraised with 67 L. monocytogenes isolates from two outbreaks and serotype reference strains.The Bayesian population analysis generated five L. monocytogenes groups. Using all available NCBI RefSeq genomes (n=36) and six additionally sequenced strains, all genetic groups were covered. Pair-wise comparisons of these 42 genome sequences resulted in 1,701 cgMLST targets present in all 42 genomes with 100 % overlap and ≥ 90 % sequence similarity. Overall, ≥ 99.1 % of the cgMLST targets were present in 67 outbreak and serotype reference strains underlining the representativity of the cgMLST scheme. Moreover, cgMLST enabled clustering of outbreak isolates with ≤ 10 alleles difference and unambiguous separation from unrelated outgroup isolates.In conclusion, the novel cgMLST scheme not only improves outbreak investigations but also enables, due to the availability of the automatically curated cgMLST nomenclature, interlaboratory exchange of data that is crucial especially for rapid response during trans-sectorial outbreaks. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
    Journal of clinical microbiology 07/2015; 53(9). DOI:10.1128/JCM.01193-15 · 3.99 Impact Factor
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    ABSTRACT: An Austrian boarding school reported a gastroenteritis cluster on 10 January, 2014. Environmental swabs from the school cafeteria and a nearby kebab restaurant tested positive for norovirus. We investigated the outbreak to identify its source(s). We defined an outbreak case as a student or staff with diarrhea or vomiting developed between 7-13 January. We collected food exposure via a self-administered questionnaire, calculated risk ratios (RR) and 95% confidence interval (CI). Norovirus from stool specimens in cases and asymptomatic kebab restaurant workers were genotyped. We identified 28 cases among 144 persons (attack rate: 19%). The outbreak emerged and peaked on 9 January, and ended on 12 January. Compared with those who did not eat kebab, those who ate kebab on 7, 8 or 9 January were 11 (95% CI: 4.2-28), 6.7 (95% CI: 3.4-13) or 9.3 (95% CI: 4.0-22) times more likely to develop disease within the following two days. Stool specimens from three cases and three restaurant workers were positive for norovirus GII.P21. The kebab prepared by norovirus-positive restaurant workers was the most likely outbreak source. We recommend that food handlers strictly comply with hand hygiene and avoid bare-handed contact with ready-to-eat food to minimize the risk of foodborne infection. Copyright © 2015. Published by Elsevier Ltd.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 06/2015; 37. DOI:10.1016/j.ijid.2015.05.021 · 1.86 Impact Factor
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    ABSTRACT: The detection of West Nile virus (WNV) nucleic acid in a blood donation from Vienna, Aus-tria, as well as in Culex pipiens pupae and egg rafts, sampled close to the donor's residence , is reported. Complete genomic sequences of the human-and mosquito-derived viruses were established, genetically compared and phylogenetically analyzed. The viruses were not identical, but closely related to each other and to recent Czech and Italian isolates, indicating co-circulation of related WNV strains within a confined geographic area. The detection of WNV in a blood donation originating from an area with low WNV prevalence in humans (only three serologically diagnosed cases between 2008 and 2014) is surprising and emphasizes the importance of WNV nucleic acid testing of blood donations even in such areas, along with active mosquito surveillance programs.
    PLoS ONE 05/2015; 10(5). DOI:10.1371/journal.pone.0126381 · 3.23 Impact Factor
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    ABSTRACT: The European, multi-centre, quarterly point prevalence study of community-acquired diarrhea (EUCODI) analyzed stool specimens received at ten participating clinical microbiology laboratories (Austria, Finland, France, Germany, Greece, Ireland, Italy, Portugal, Romania and United Kingdom) in 2014. On four specified days, each local laboratory submitted samples from ≤20 consecutive patients to the Austrian Study Centre for further testing using FilmArray® GI Panel (BioFire Diagnostics, Salt Lake City, Utah). Of the 709 specimens from as many patients received, 325 (45.8%) tested negative, 268 (37.8%) specimens yielded only one organism, and 116 (16.4%) specimens yielded multiple organisms. Positivity rates ranged from 41% (30/73 samples) in France to 74% (59/80 samples) in Romania. With the exception of Entamoeba histolytica and Vibrio cholerae, all of the 22 targeted pathogens were detected at least once. Enteropathogenic E. coli (EPEC), Campylobacter spp., toxigenic Clostridium difficile, enteroaggregative E. coli (EAEC), norovirus and enterotoxigenic E. coli (ETEC) were the six most commonly detected pathogens. When tested by local protocols, 7/128 positive samples (5.5%) yielded multiple organisms. Overall, the FilmArray® GI Panel detected at least one organism in 54.2% (384/709) of the specimens, as compared to 18.1% (128/709) when tested by conventional techniques locally. This underlines the considerable potential of multiplex PCR to improve routine stool diagnostics in community acquired diarrhea. Classical culture methods directed at isolation of specific pathogens are increasingly becoming second line tools, deployed when rapid molecular tests are positive. This optimizes yield from stool examinations and dramatically improves timeliness of diagnosis. Copyright © 2015. Published by Elsevier Ltd.
    Clinical Microbiology and Infection 04/2015; 32(8). DOI:10.1016/j.cmi.2015.04.007 · 5.77 Impact Factor
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    ABSTRACT: Methicillin-resistant Staphylococcus aureus is one of the most significant pathogens associated with health care. For efficient surveillance, control and outbreak investigation, S. aureus typing is essential. A high resolution melting curve analysis was developed and evaluated for rapid identification of the most frequent spa types found in an Austrian hospital consortium covering 2,435 beds. Among 557 methicillin-resistant Staphylococcus aureus isolates 38 different spa types were identified by sequence analysis of the hypervariable region X of the protein A gene (spa). Identification of spa types through their characteristic high resolution melting curve profiles was considerably improved by double spiking with genomic DNA from spa type t030 and spa type t003 and allowed unambiguous and fast identification of the ten most frequent spa types t001 (58%), t003 (12%), t190 (9%), t041 (5%), t022 (2%), t032 (2%), t008 (2%), t002 (1%), t5712 (1%) and t2203 (1%), representing 93% of all isolates within this hospital consortium. The performance of the assay was evaluated by testing samples with unknown spa types from the daily routine and by testing three different high resolution melting curve analysis real-time PCR instruments. The ten most frequent spa types were identified from all samples and on all instruments with 100% specificity and 100% sensitivity. Compared to classical spa typing by sequence analysis, this gene scanning assay is faster, cheaper and can be performed in a single closed tube assay format. Therefore it is an optimal screening tool to detect the most frequent endemic spa types and to exclude non-endemic spa types within a hospital.
    PLoS ONE 03/2015; 10(3). DOI:10.1371/journal.pone.0116713 · 3.23 Impact Factor
  • F Allerberger ·

    Clinical Microbiology and Infection 01/2015; 21(8). DOI:10.1016/j.cmi.2015.01.010 · 5.77 Impact Factor
  • 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; 13(3):1-9. DOI:10.1586/14787210.2015.1003809 · 2.25 Impact Factor
  • Franz Allerberger · Zoltán Bagó · Steliana Huhulescu · Ariane Pietzka ·
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    ABSTRACT: In contrast to most pathogenic bacteria, Listeria monocytogenes is psychrotrophic, capable of multiplying at low temperatures. In an era when food production and food storage heavily rely on refrigeration, this ability to grow (albeit slowly) in a cold environment has opened a new ecological niche for L. monocytogenes. Because of the severity of certain clinical manifestations (infections of the central nervous system, septicemia, and abortion), the high case-fatality rate (up to 30 % of cases), and the long incubation time, human listeriosis is now a zoonosis of major public health concern. L. monocytogenes causes invasive illness mainly in certain well-defined high-risk groups, including immunocompromised persons, pregnant women, neonates, and the elderly. However, listeriosis can occur in otherwise healthy individuals, particularly during an outbreak. The evolvement of silage as a dominant feed for ruminants constitutes another key factor, responsible for the emergence of listeriosis as a relevant animal disease. L. monocytogenes has been isolated from numerous species of mammals, birds, fish, crustaceans, and insects. Nevertheless, the primary habitats of L. monocytogenes are considered to be the soil and decaying vegetable matter, in which it survives and grows saprophytically.
    Zoonoses - Infections Affecting Humans and Animals, 01/2015: pages 249-286; , ISBN: 978-94-017-9456-5
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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; 127(11-12). DOI:10.1007/s00508-014-0682-6 · 0.84 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. DOI:10.1055/s-0034-1385562 · 1.05 Impact Factor
  • Patrizia K. Kump · Robert Krause · Franz Allerberger · Christoph Högenauer ·
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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; 20(11). DOI:10.1111/1469-0691.12801 · 5.77 Impact Factor
  • Jürgen J Wenzel · Franz Allerberger ·

    The Lancet Infectious Diseases 10/2014; 14(10). DOI:10.1016/S1473-3099(14)70897-7 · 22.43 Impact Factor
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    J J Wenzel · M Schemmerer · H Oberkofler · H Kerschner · P Sinha · C Koidl · F Allerberger ·
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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; 6(4). DOI:10.1007/s12560-014-9165-1 · 2.36 Impact Factor

  • Frauenheilkunde up2date 08/2014; 8(04):263. DOI:10.1055/s-004-27552
  • S Huhulescu · S Hirk · V Zeinzinger · P Hasenberger · H Skvara · R Mullegger · F Allerberger · A Indra ·

    Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 07/2014; 19(26). DOI:10.2807/1560-7917.ES2014.19.26.20845 · 5.72 Impact Factor
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    ABSTRACT: Introduction: Little is known about prevailing ribotypes of Clostridium difficile infection in Romania where CDI is not a mandatory notifiable disease. Methodology: We studied 64 non-duplicate C. difficile isolates from patients hospitalised at the National Institute of Infectious Diseases, Bucharest, Romania between March 2011 and March 2012. Results: Sixty-three of the 64 C. difficile isolates produced toxins A and B whereas 44 (69%) isolates produced a binary toxin. Ribotype 027 accounted for 43 (68%) of the 63 toxigenic strains. The remaining 20 isolates belonged to ribotypes 018 (n = 9), 012 (n = 3), and, with one isolate each, 014, 031, 081, 416, 433, 500, 507 and PR03035 (new ribotype). Information on hospital mortality was available for 62 of the 64 patients; among these 62 cases, 4 (6.4%) ended fatal. Recurrence was documented for 11 (18.3%) of the 60 patients for whom this information was available. Multilocus variable-number tandem repeat analysis of the 43 isolates of ribotype 027 yielded a unique cluster for the Romanian isolates when compared to Austrian or Italian isolates. Conclusion: Our findings sustain the hypothesis of a recent emerged outbreak of C. difficile PCR ribotype 027 infections in the area of Bucharest.
    The Journal of Infection in Developing Countries 06/2014; 8(6):694-8. DOI:10.3855/jidc.4435 · 1.14 Impact Factor
  • B Springer · F Allerberger · C Kornschober ·

    Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 06/2014; 19(22). DOI:10.2807/1560-7917.ES2014.19.22.20818 · 5.72 Impact Factor

Publication Stats

5k Citations
1,086.01 Total Impact Points


  • 2003-2015
    • Österreichische Agentur für Gesundheit und Ernährungssicherheit
      Wien, Vienna, Austria
  • 1997-2014
    • IST Austria
      Klosterneuberg, Lower Austria, Austria
  • 2011-2012
    • Paracelsus Medical University Salzburg
      • University Institute of Medical Microbiology, Hygiene and Infectious Diseases
      Salzburg, Salzburg, Austria
    • Elisabethinen Hospital
      Linz, Upper Austria, Austria
  • 1990-2009
    • University of Innsbruck
      • • Institute of Biochemistry
      • • Institute of Microbiology
      Innsbruck, Tyrol, Austria
  • 1996
    • University of Wuerzburg
      • Institute for Hygiene and Microbiology
      Würzburg, Bavaria, Germany
  • 1991
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      Erlangen, Bavaria, Germany
    • Mayo Clinic - Rochester
      Rochester, Minnesota, United States