Johannes Knobloch

Paracelsus Kliniken Deutschland · Zentralinstitut für Krankenhaushygiene

Emergency department (ED) management of the German STEC O104:H4 outbreak in 2011 was not limited to patients being truly infected with STEC. In parallel to spread of alarming news in public media, patients suffering from diarrhea due to other reasons fearfully presented, equally. We retrospectively characterized these two cohorts for anamnestic, cl...

Nachdem in den letzten Jahren bekannt wurde, dass die Clostridium-diffici/e-assoziierte Diarrhö (CDAD) weltweit und auch in Deutschland stetig zunahm, stellt sich die Frage, wie man als Hygieneverantwortlicher eines Krankenhauses mit dieser Information umgeht. Wir beschreiben hier, wie man sich einen Überblick über die hausinterne Epidemiologie von...

Description of diarrhea patients in emergency departments in Lübeck, Germany during the STEC O104:H4 outbreak in 2011

Background Shiga toxin-producing, enteroaggregative Escherichia coli was responsible for the 2011 outbreak of haemolytic uraemic syndrome (HUS). The present single-centre, observational study describes the 1-year course of the disease with an emphasis on kidney function. Outcome data after 1 year are associated with treatment and patient characteri...

Discovered in 1949, the antibiotic colistin was initially used for therapeutic purposes. Parenteral use of colistin was gradually abandoned because of its side-effect profile, especially its nephrotoxicity and neurotoxicity. Despite the risk of these potentially serious adverse effects, increasing resistance of Gram-negative bacteria has led to a r...

Purpose: To investigate the effects of Bruch's membrane (BrM) neutral lipid deposition in mouse models and its significance to aging and age-related macular degeneration, it is essential to reliably detect small quantities of neutral lipids including esterified cholesterol (EC). In chorioretinal sections and BrM wholemounts, we tested a novel fluo...

Introduction: One of the most common complications following breast augmentation is capsular contracture. The subclinical infection of the implant is often considered to be one of the main risk factors. It is believed that polyurethane (PU) implants, because of their larger foam-like surface, have lower capsular contracture rates due to better tis...

Marker genes identified in clinical strains and the patient strain during whole-genome sequencing assessment of the risk for development of Shiga toxin–producing Escherichia coli (STEC)–associated hemolytic uremic syndrome in long-term Shiga toxin–producing Escherichia coli infection.

Background Silicone implants have been used in breast augmentation for more than 45 years. Complications, in particular, capsular contracture, still occur with a high incidence. Titanium-coated polypropylene mesh (TCPM; TiLoop Bra®, pfm medical, Cologne, Germany) provides new opportunities for implant-based breast reconstruction. We investigated th...

Riemerella anatipestifer (RA) is an important avian pathogen with considerable impact on poultry production worldwide. However, the diagnosis of RA infections may be difficult, mainly due to problems with unequivocal differentiation of RA from other Flavobacteriaceae and a lack of standardized methods and reagents. The aim of the present study was...

Background: In May-July 2011, Germany experienced a large food-borne outbreak of Shiga toxin 2-producing Escherichia coli (STEC O104:H4) with 3842 cases, including 855 cases with hemolytic uremic syndrome (HUS) and 53 deaths. Methods: A multicenter study was initiated in 5 university hospitals to determine pathogen shedding duration. Diagnostics...

The acute disease antigen A (adaA) gene is believed to be associated with Coxiella burnetii strains causing acute Q fever. The detailed analysis of the adaA genomic region of 23 human- and 86 animal-derived C. burnetii isolates presented in this study reveals a much more polymorphic appearance and distribution of the adaA gene, resulting in a class...

In 2011, a large outbreak caused by a Shiga toxin producing E. coli (STEC) occurred in Northern Germany, with a satellite outbreak in Western France, including the highest number of hemolytic uremic syndrome (HUS) cases ever encountered during a STEC outbreak. The outbreak strain was characterized as an enteroaggregative E. coli of serotype O104:H4...

Coagulase-negative staphylococci, mainly Staphylococcus epidermidis, are currently the most frequent cause of hospital acquired infections in the USA. Mostly, but not exclusively, S. epidermidis infections are linked to the use of implanted medical devices like central venous catheters, prosthetic joints and heart valves, pacemakers, cardiac assist...

To evaluate the effect of different treatment strategies on enterohaemorrhagic Escherichia coli O104:H4 induced haemolytic uraemic syndrome. Multicentre retrospective case-control study. 23 hospitals in northern Germany. 298 adults with enterohaemorrhagic E coli induced haemolytic uraemic syndrome. Dialysis, seizures, mechanical ventilation, abdomi...

A group of eleven bacterial strains was isolated during microbiological investigations of pharyngeal swabs collected from domestic pigeons (Columba livia forma domestica). Phenotypical properties of the isolates closely resembled those of members of the genus Riemerella within the family Flavobacteriaceae. The genus presently contains two species,...

An outbreak of Shiga toxin-producing enteroaggregative Escherichia coli (STEC O104:H4) infection with a high incidence of hemolytic uremic syndrome (HUS) occurred in Germany in May 2011. Antibiotic treatment of STEC infection is discouraged because it might increase the risk of HUS development. However, antibiotic therapy is widely used to treat en...

Riemerella columbina (RC) and Riemerella anatipestifer (RA) belong to the genus Riemerella within the family Flavobacteriaceae. While RA is a well-described pathogen of waterfowl and other avian species, only little is known about RC. Previous work reporting the isolation of RC from internal organs of clinically diseased pigeons suggested a potenti...

Lower respiratory tract infections play an important role in the ambulatory and hospital health-care sectors. State-of-the-art diagnoses of lower respiratory tract infections and methods to differentiate bacterial lower respiratory tract infections from colonisation have been described in the first two parts of this review series. The present artic...

We report the exceptional case of a severe intraocular Abiotrophia defectiva infection which developed after cataract surgery. Retinal involvement as a complication of A. defectiva endophthalmitis or the combination of acute-onset endophthalmitis with infiltrative keratitis caused by this pathogen has not been described. Moreover, our report repres...

Lower respiratory tract infections rank among the leading causes of morbidity and mortality worldwide. In clinical practice, especially in the care of severely ill patients, discrimination between tracheobronchial colonisation with potentially pathogenic microorganisms and infection is a common diagnostic challenge. While prompt antibiotic treatmen...

Biofilm formation is a major pathogenetic factor of Staphylococcus epidermidis. In S. epidermidis the alternative sigma factor sigma B was identified to regulate biofilm formation in S. epidermidis 1457. In S. aureus sigma B dependent regulation plays a minor role, whereas sarA (Staphylococcus accessory regulator) is an essential regulator. Therefo...

Medical device-associated infections, most frequently caused by Staphylococcus epidermidis and Staphylococcus aureus, are of increasing importance in modern medicine. The formation of adherent, multilayered bacterial biofilms is crucial in the pathogenesis of these infections. Polysaccharide intercellular adhesin (PIA), a homoglycan of β-1,6-linked...

Background: Staphylococcus epidermidis causing infections display a high prevalence of icaADBC (ica) required for biofilm formation as well as mecA mediating methicillin resistance. In contrast, commensal isolates from healthy individuals display low prevalences for these genes suggesting a possible transmission of ica- and mecA-positive strains in...

Staphylococcal biofilm formation depends on the transcription factor sigma(B). We further investigated the role of sigma(B) in biofilm formation and persistence in vitro and in vivo in a subcutaneous rat model. As expected, expression of all sigma(B) operon genes was transiently higher in the first 6 h of biofilm formation compared to planktonic ba...

Staphylococcus epidermidis is a common pathogen in device-associated infections which is able to attach onto polymeric surfaces and develop multilayered biofilms. Attached S. epidermidis displays reduced susceptibility to antimicrobial agents. In this study we investigated the influence of ciprofloxacin and the group IV quinolones gatifloxacin, gem...

Mass spectrometry (MS), a general method for molecular detection and identification, has been in use for at least 50 years. New applications, such as MALDI-TOF-MS are currently under development, raising new prospects in different sectors of the Biosciences. The basic stages of the MALDI-TOF-MS method are the following: Ionization of macro-molecule...

Background: Recently, dramatically increasing nosocomial C. difficile associated disease (CDAD) infection rates were reported from many hospitals. Consequently the question of "how to prevent" is of utmost importance. Here, we show the effectiveness of a hospital-wide intervention program. Methods: Between May 2007 and April 2008 the following infe...

Der 51-jährige, männliche Patient wird nach einer Synkope unklarer Genese in der Klinik aufgenommen. Er berichtet über seit etwa 14 Tagen bestehende Beschwerden in Form von allgemeiner körperlicher Abgeschlagenheit, Fieber und Kälteschauern. Er deutet dies am ehesten als Zeichen eines grippalen Infekts. Weitere Beschwerden werden nicht angegeben. A...

Ein 14-jähriger Junge stellt sich wegen hochakut einsetzender allgemeiner Schwäche, Kopfschmerzen, Übelkeit und Brechreiz in der Notaufnahme einer Hamburger Klinik vor. Weiterhin klagt er über Brustschmerzen beim Atmen und ein Gefühl von Luftnot. Noch in der Notaufnahme kommt es zu einer schnellen Zunahme der Atemnot bis zur vollständigen respirato...

Eine 34 Jahre alte Patientin wird mit starken Schmerzen im Bereich der rechten Hüfte in der Klinik aufgenommen. Diese rühren von einem Sturz in der häuslichen Umgebung her und waren zunächst nur unter Belastung aufgetreten, schließlich jedoch auch in Ruhe. Bei der Patientin ist seit 1989 eine chronische Polyarthritis bekannt, die 1990 die Implantat...

Reporter gene systems are an invaluable tool for investigation of gene transcription activity in eukaryotes and prokaryotes. In order to analyze the temporal and spatial resolution of gene expression patterns in situ and for quantitatively investigating gene expression, the green fluorescent protein (GFP) appears to be especially useful. GFP has be...

Nosocomial staphylococcal foreign-body infections related to biofilm formation are a serious threat, demanding new therapeutic and preventive strategies. As the use of biofilm-associated factors as vaccines is critically restricted by their prevalence in natural staphylococcal populations we studied the distribution of genes involved in biofilm for...

Medical device-associated infections, most frequently caused by coagulase-negative staphylococci, especially Staphylococcus epidermidis, are of increasing importance in modern medicine. The formation of adherent, multilayered bacterial biofilms is the most important factor in the pathogenesis of these infections, which regularly fail to respond to...

Medical device-associated infections, most frequently caused by coagulase-negative staphylococci, especially Staphylococcus epidermidis, are of increasing importance in modern medicine. Regularly, antimicrobial therapy fails without removal of the implanted device. The most important factor in the pathogenesis of medical device-associated staphyloc...