Angelika Fruth

Robert Koch Institut, Berlín, Berlin, Germany

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Publications (125)524.96 Total impact

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    Full-text · Dataset · Jan 2016
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    Full-text · Dataset · Dec 2015
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    ABSTRACT: Clinically relevant ESBL-producing multi-resistant Escherichia coli have been on the rise for years. Initially restricted to mostly a clinical context, recent findings prove their prevalence in extra-clinical settings independent of the original occurrence of antimicrobial resistance in the environment. To get further insights into the complex ecology of potentially clinically relevant ESBL-producing E. coli, 24 isolates from wild birds in Berlin, Germany, and forty ESBL-producing human clinical E. coli isolates were comparatively analyzed. Isolates of ST410 occurred in both sample groups (six). In addition, three ESBL-producing E. coli isolates of ST410 from environmental dog feces and one clinical dog isolate were included. All ten isolates were clonally analyzed showing almost identical macrorestriction patterns. They were chosen for whole genome sequencing revealing that the whole genome content of these ten E. coli isolates showed a very high genetic similarity, differing by low numbers of single nucleotide polymorphisms only. This study gives initial evidence for a recent interspecies transmission of a new successful clone of ST410 E. coli between wildlife, humans, companion animals, and the environment. The results underline the zoonotic potential of clinically relevant multi-resistant bacteria found in the environment as well as the mandatory nature of the "One Health" approach.
    Full-text · Article · Dec 2015 · FEMS Microbiology Ecology
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    ABSTRACT: We studied the taxonomic position of five strains isolated from horse faeces which shared identical 16S rRNA gene sequences. The cells of all isolates are Gram-negative staining, obligate aerobic and individuals have a rod shaped appearance. The strains show highest 16S rRNA gene sequence similarities to A. lwoffii (98.3%), A. haemolyticus (98.0%), A. johnsonii (97.9%), and A. brisouii (97.9%). Whole genome sequencing of strain 114T and phylogeny reconstruction based on a core set of 1,061 Acinetobacter genes indicated A. bouvetii CIP 107468T as the closest relative among the Acinetobacter species for which whole genome sequences are available. The genomic G+C content of strain 114T is 34.9 mol%, which is lower than any other value reported for Acinetobacter. The predominant polyamine is 1,3-diaminopropane, which is typical for the genus Acinetobacter. The most abundant fatty acids are C16:1 ω7c and/or iso-C15:0 2-OH (36%) and C16:0 (28%). The proportion of C18:1 ω9c (7%) is distinctively low compared to most Acinetobacter species. Major ubiquinone of strain 114T is Q-9. Microscopic studies revealed the presence of pili and the absence of flagella. The capability of all five strains to utilize L-arabinose and gentisate as well as their lack of growth at temperatures of 41 °C and above provide sufficient criteria to distinguish them from all Acinetobacter species with validly published names. Strain 114T (=DSM 27228T=CCUG 65204T) is considered as type strain of a novel species within the genus Acinetobacter, for which the name Acinetobacter equi sp. nov. is proposed.
    No preview · Article · Nov 2015 · International Journal of Systematic and Evolutionary Microbiology
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    ABSTRACT: The increase of Escherichia coli producing extended-spectrum β-lactamases (ESBL) in hospitals and their emergence as intestinal colonisers of healthy humans is of concern. Transmission ways and the extent of spread of distinct E. coli clones or ESBL genes among humans and animals via the food chain or the environment is a matter of debate. In this study we determined ESBL genotypes in E. coli isolates (n=233) resistant to 3rd generation cephalosporins from hospitals and medical practices using PCR and sequencing. Bacterial strain typing was performed by PCR-based phylogrouping, multilocus sequence typing (MLST) and a ST131-specific PCR. Results showed that CTX-M-15 (50.4%), CTX-M-1 (28.4%) and CTX-M-14 (5.6%) were the most common ESBL types. Especially, CTX-M-15 was associated with E. coli ST131 of phylogenetic group B2, which was the dominant sequence type among our isolates (35.8%). MLST typing revealed 40 different sequence types (STs), with ST131, ST410, ST10 and ST38 as the most prevalent ones. Our findings give an overview of the current distribution of ESBL-producing E. coli isolates from humans in Germany. E. coli O25b:H4-ST131 was confirmed to be the most common clone, which is known for its successful dissemination worldwide. Although heterogeneity among the isolates was found, several successful clones previously described in animals (ST410, ST10) also occurred in our isolate collection. Further detailed investigations of ESBL-producing isolates from different habitats are needed to evaluate possible transfer ways.
    No preview · Article · Nov 2015 · Veterinary Microbiology
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    ABSTRACT: Infections by intestinal pathogenic Escherichia coli (E. coli) are among those causing a high mortality and morbidity due to diarrheal disease and post infection sequelae worldwide. Since introduction of the Infection Protection Act in Germany 2001, these pathogens rank third among bacterial infections of the gastrointestinal tract. As a major pathovar Shiga toxin-producing E. coli (STEC) which include enterohemorrhagic E. coli (EHEC) play a leading role in occurrence of sporadic cases and disease outbreaks. An outstanding example is the large outbreak in spring 2011 caused by EHEC/EAEC O104:H4. To monitor and trace back STEC infections, national surveillance programs have been implemented including activities of the German National Reference Centre for Salmonella and other Enteric Bacterial Pathogens (NRC). This review highlights advances in our understanding of STEC in the last 20 years of STEC surveillance by the NRC. Here important characteristics of STEC strains from human infections and outbreaks in Germany between 1997 and 2013 are summarized.
    No preview · Article · Sep 2015 · International journal of medical microbiology: IJMM
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    ABSTRACT: The highly virulent Escherichia coli O104:H4 that caused the large 2011 outbreak of diarrhoea and haemolytic uraemic syndrome secretes blended virulence factors of enterohaemorrhagic and enteroaggregative E. coli, but their secretion pathways are unknown. We demonstrate that the outbreak strain releases a cocktail of virulence factors via outer membrane vesicles (OMVs) shed during growth. The OMVs contain Shiga toxin (Stx) 2a, the major virulence factor of the strain, Shigella enterotoxin 1, H4 flagellin, and O104 lipopolysaccharide. The OMVs bind to and are internalised by human intestinal epithelial cells via dynamin-dependent and Stx2a-independent endocytosis, deliver the OMV-associated virulence factors intracellularly and induce caspase-9-mediated apoptosis and interleukin-8 secretion. Stx2a is the key OMV component responsible for the cytotoxicity, whereas flagellin and lipopolysaccharide are the major interleukin-8 inducers. The OMVs represent novel ways for the E. coli O104:H4 outbreak strain to deliver pathogenic cargoes and injure host cells.
    No preview · Article · Aug 2015 · Scientific Reports
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    ABSTRACT: Thermophilic Campylobacter species colonize the intestine of agricultural and domestic animals commensally, but cause severe gastroenteritis in humans. In contrast to other enteropathogenic bacteria, Campylobacter have been considered to be non-glycolytic, a metabolic property originally used for their taxonomic classification. Contrary to this dogma, we demonstrate that several Campylobacter coli strains are able to utilize glucose as a growth substrate. Isotopologue profiling experiments with (13) C-labeled glucose suggested that these strains catabolize glucose via the pentose phosphate and Entner-Doudoroff (ED) pathways and use glucose efficiently for de novo synthesis of amino acids and cell surface carbohydrates. Whole genome sequencing of glycolytic C. coli isolates identified a genomic island located within a ribosomal RNA gene cluster that encodes for all ED pathway enzymes and a glucose permease. We could show in vitro that a non-glycolytic C. coli strain could acquire glycolytic activity through natural transformation with chromosomal DNA of C. coli and C. jejuni subsp. doylei strains possessing the ED pathway encoding plasticity region. These results reveal for the first time the ability of a Campylobacter species to catabolize glucose and provide new insights into how genetic macrodiversity through intra- and interspecies gene transfer expand the metabolic capacity of this food-borne pathogen. This article is protected by copyright. All rights reserved.
    No preview · Article · Aug 2015 · Molecular Microbiology
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    ABSTRACT: Enterohemorrhagic Escherichia coli (EHEC) are causative agents of bloody diarrhea and extraintestinal sequelae in humans, most importantly the hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP). Besides the bacteriophage-encoded Shiga toxin gene (stx), EHEC harbor the locus of enterocyte effacement (LEE), which confers the ability to cause attaching and effacing lesions. Currently the vast majority of EHEC-infections are caused by strains belonging to five O-serogroups ("big five") that comprise, in addition to the most important EHEC O-serogroup O157, the O-serogroups O26, O103, O111, and O145. We hypothesize that these four non-O157 EHEC have different phylogenies.To test this hypothesis, by multilocus sequence typing (MLST) we analyzed a large collection of 250 isolates of these four O-serogroups, which were isolated from diseased as well healthy humans and cattle between 1952 and 2009.The majority of the EHEC isolates of O-serogroups O26 and O111 clustered into one sequence type complex, STC29. Isolates of O103 clustered mainly in STC20 and most isolates of O145 were found within STC32. In addition to these EHEC strains, STC29 also included stx-negative E. coli, termed atypical enteropathogenic E. coli (aEPEC), yet another group of intestinal pathogenic E. coli.The finding that aEPEC and EHEC isolates of non-O157 O-serogroups share the same phylogeny suggests an ongoing microevolutionary scenario, in which the phage-encoded Shiga Toxin gene stx is transferred between aEPEC and EHEC. In consequence, aEPEC of STC29 can be regarded as post- or pre-EHEC isolates. Therefore STC29 incorporates phylogenetic information useful for unraveling the evolution of EHEC. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
    Full-text · Article · Jul 2015 · Applied and Environmental Microbiology
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    ABSTRACT: In January 2013, the National Reference Centre for Salmonella (NRC) detected a salmonellosis cluster in Saxony-Anhalt, Germany, caused by uncommon O4 non-agglutinating, monophasic Salmonella (S.) Typhimurium DT193. Circulating predominant monophasic S. Typhimurium DT193 clones typically display resistance phenotype ASSuT. We investigated common exposures to control the outbreak, and conducted microbiological investigations to assess the strains' phenotype. We conducted a case-control study defining cases as persons living or working in Saxony-Anhalt diagnosed with the O4 non-agglutinating strain between January and March 2013. We selected two controls contemporarily reported with norovirus infection, frequency-matched on residence and age group, per case. We interviewed regarding food consumption, especially pork and its place of purchase. We calculated odds ratios (ORs) with 95% confidence intervals (95% CI) using logistic regression. The NRC investigated human and food isolates by PCR, SDS-PAGE, MLST, PFGE, MLVA and susceptibility testing. Altogether, 68 O4 non-agglutinating human isolates were confirmed between January and April 2013. Of those, 61 were assigned to the outbreak (median age 57 years, 44% female); 83% cases ≥ 60 years were hospitalized. Eating raw minced pork from butcheries within 3 days was associated with disease (31 cases, 28 controls; OR adjusted for sex: 3.6; 95% CI: 1.0-13). Phage type DT193 and MLST ST34 were assigned, and isolates' lipopolysaccharide (LPS) matched control strains. Isolates linked to Saxony-Anhalt exhibited PFGE type 5. ASSuT- and ACSSuT phenotype proportions were 34 and 39% respectively; 54% were resistant to chloramphenicol. Three pork isolates matched the outbreak strain. Raw minced pork was the most likely infection vehicle in this first reported outbreak caused by O4 non-agglutinating, mostly chloramphenicol-resistant S. Typhimurium DT193. High hospitalization proportions demand awareness on the risk of consumption of raw pork among elderly. LPS analysis indicated O4 expression; therefore, testing with antisera from different lots is recommendable in unexpected agglutination reactions.
    Full-text · Article · Jun 2015 · PLoS ONE
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    ABSTRACT: A large outbreak of gastrointestinal disease occurred in 2011 in Germany which resulted in almost 4000 patients with acute gastroenteritis or hemorrhagic colitis, 855 cases of a hemolytic uremic syndrome and 53 deaths. The pathogen was an uncommon, multiresistant Escherichia coli strain of serotype O104:H4 which expressed a Shiga toxin characteristic of enterohemorrhagic E. coli and in addition virulence factors common to enteroaggregative E. coli. During post-epidemic surveillance of Shiga toxin-producing E. coli (STEC) all but two of O104:H4 isolates were indistinguishable from the epidemic strain. Here we describe two novel STEC O104:H4 strains isolated in close spatiotemporal proximity to the outbreak which show a virulence gene panel, a Shiga toxin-mediated cytotoxicity towards Vero cells and aggregative adherence to Hep-2 cells comparable to the outbreak strain. They differ however both from the epidemic strain and from each other, by their antibiotic resistance phenotypes and some other features as determined by routine epidemiological subtyping methods. Whole genome sequencing of these two strains, of ten outbreak strain isolates originating from different time points of the outbreak and of one historical sporadic EHEC O104:H4 isolate was performed. Sequence analysis revealed a clear phylogenetic distance between the two variant strains and the outbreak strain finally identifying them as epidemiologically unrelated isolates from sporadic cases. These findings add to the knowledge about this emerging pathogen, illustrating a certain diversity within the bacterial core genome as well as loss and gain of accessory elements. Our results do also support the view that distinct new variants of STEC O104:H4 repeatedly might originate from yet unknown reservoirs, rather than that there would be a continuous diversification of a single epidemic strain established and circulating in Germany after the large outbreak in 2011.
    Preview · Article · Apr 2015 · PLoS ONE
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    ABSTRACT: In 2011, the Shiga toxin- and extended-spectrum β-lactamase (ESBL)-producing Escherichia coli O104:H4 caused a serious outbreak of gastroenteritis in Germany. This strain carried blaCTX-M-15 and blaTEM-1 on an IncI1-ST31 plasmid. During screening of individuals at risk for acquisition of the epidemic E. coli O104:H4, we isolated another ESBL-producing and Shiga toxin-positive E. coli belonging to serotype O91:H14 from feces of a human patient. Interestingly, the patient also carried a further ESBL-producing but Shiga toxin-negative E. coli. Both strains harbored blaCTX-M-15 and blaTEM-1 on an IncI1-ST31 plasmid, which was indistinguishable regarding size and plasmid restriction pattern from the plasmid of the epidemic E. coli O104:H4 strain. The patient had traveled to India 6 months prior to the isolation of the E. coli strains. This is the first report of an ESBL-producing, Shiga toxin-positive E. coli of serogroup O91. Our data suggest a high propensity of the IncI1-ST31 plasmid to spread in the human and/or animal population. Copyright © 2015 Elsevier GmbH. All rights reserved.
    Full-text · Article · Mar 2015 · International journal of medical microbiology: IJMM
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    ABSTRACT: Salmonella (S.) Enterica serovars form a group of pathogens that differ widely in their host range within mammals, birds and reptiles. They can differ substantially in clinical manifestations, ranging from an asymptomatic state to severe illness . Serovars can be host-restricted (e.g S. typhi in humans), host-adapted (e.g. S. choleraesuis in pigs and infrequently in humans) and broad range infecting diverse avian and mammalian hosts with a wide range of diseases. Currently, the traditional Salmonella serotyping scheme according to White-Kauffmann-Le Minor is accepted worldwide as the “gold standard” for the classification of Salmonellae below the subspecies level and is widely used in surveillance of the pathogen . The use of serotyping within Salmonella as a typing method is so widely accepted that governmental agencies have formulated guidelines intended to reduce human salmonellosis by identifying the common serovars typhimurium and Enteritidis . The most common vehicles of transmission are meat, meat products, eggs and egg products that contain Salmonella serovars because animals are infected or because fecal contamination occurs during processing . The majority of human cases are caused by only a few non-typhoidal serovars. In 2012, approximately 20,000 cases of non-typhoidal salmonellosis are reported in Germany (http://www3.rki.de//survstat). In 1995 the dominance of only a few serovars is even more pronounced in Germany, where S. enteritidis (61 %) and S. typhimurium (23 %) accounted for more than 80 % of human isolates reported to the NRC at the Robert Koch Institute . In 2012 this percentage for both serovars were reduced to 62 %, each approx. 31 %. Other serovars of different vehicles were found in outbreaks and also serovar analysis showed that the spectrum of single cases in children changed. In this article we focus on the prevalence of Salmonella enterica in animal food and humans and its change of serotypes and subtypes over up to two decades.
    No preview · Article · Jan 2015
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    ABSTRACT: An exploratory study in five conventional pig production clusters was carried out to investigate the dynamic and diversity of Salmonella spp. within different production stages and sample site categories (pooled feces, direct and non-direct environment). Observing two production cycles per production cluster, a total of 1,276 samples were collected along the pig production chain. Following a microbiological examination via culture, 2,246 subcultures were generated out of 285 Salmonella positive samples and analysed by pheno- and genotyping methods. Based on a combination of serotyping, MLVA (multiple-locus variable-number tandem repeat (VNTR) analysis), PFGE (pulse-field gel electrophoresis) and MLST (multilocus sequence typing), an amount of 22.3% Salmonella positive samples were characterized in clonal lineages and its variants.
    No preview · Article · Dec 2014 · Veterinary Microbiology
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    ABSTRACT: Background The mutS-rpoS intergenic region in E. coli displays a mosaic structure which revealed pathotype specific patterns. To assess the importance of this region as a surrogate marker for the identification of highly virulent extraintestinal pathogenic E. coli (ExPEC) strains we aimed to: (i) characterize the genetic diversity of the mutS gene and the o454-nlpD genomic region among 510 E. coli strains from animals and humans; (ii) delineate associations between the polymorphism of this region and features such as phylogenetic background of E. coli, pathotype, host species, clinical condition, serogroup and virulence associated genes (VAG)s; and (iii) identify the most important VAGs for classification of the o454-nlpD region. Methods Size variation in the o454-nlpD region was investigated by PCR amplification and sequencing. Phylogenetic relationships were assessed by Ecor- and Multilocus sequence- typing (MLST), and a comparative analysis between mutS gene phylogenetic tree obtained with RAxML and the MLST grouping method was performed. Correlation between o454-nlpD patterns and the features described above were analysed. In addition, the importance of 47 PCR-amplified ExPEC-related VAGs for classification of o454-nlpD patterns was investigated by means of Random Forest algorithm. Results Four main structures (patterns I-IV) of the o454-nlpD region among ExPEC and commensal E. coli strains were identified. Statistical analysis showed a positive and exclusive association between pattern III and the ExPEC strains. A strong association between pattern III and either the Ecor group B2 or the sequence type complexes known to represent the phylogenetic background of highly virulent ExPEC strains (such as STC95, STC73 and STC131) was found as well. RF analyses determined five genes (csgA, malX, chuA, sit, and vat) to be suitable to predict pattern III strains. Conclusion The significant association between pattern III and group B2 strains suggested the o454-nlpD region to be of great value in identifying highly virulent strains among the mixed population of E. coli promising to be the basis of a future typing tool for ExPEC and their gut reservoir. Furthermore, top-ranked VAGs for classification and prediction of pattern III were identified. These data are most valuable for defining ExPEC pathotype in future in vivo assays.
    Full-text · Article · Sep 2014 · Gut Pathogens
  • R. Hofmann · W. Rabsch · A. Fruth · B. Neubauer · A. Hahn

    No preview · Article · Sep 2014 · Neuropediatrics
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    ABSTRACT: Salmonella enterica serovar Kottbus has been continuously isolated from poultry and poultry meat, especially from turkey. We investigated by comparative molecular typing 95 S. Kottbus isolates obtained in Germany between 2000 and 2011 from poultry/poultry meat, pig/pork, cattle, reptiles, the environment as well as from human cases to identify potential infection sources for humans, especially the role of poultry and poultry products as vehicle in transmission of S. Kottbus isolates to humans. Multilocus sequence typing analysis detected three main genetic lineages. Most human isolates belonged to lineage 1 represented by sequence types ST212 and ST808. Part of the isolates isolated from cattle and pork were also linked to this lineage. Nevertheless, human isolates and especially isolates from poultry/poultry meat, and with less extend from other livestock, grouped in lineage 2 represented by ST582. Four additional isolates from reptiles and humans belonging to ST1669 represented the third lineage. The three lineages were also reflected by pulsed-field gel electrophoresis typing data and DNA microarray analysis of 102 pathogenicity genes. Antimicrobial resistance especially to nalidixic acid and ciprofloxacin was predominantly observed in isolates assigned to lineage 2, which contains predominantly resistant isolates compared to lineage 1 and 3. Sequencing of the quinolone resistance-determining region of gyrA revealed a point mutation in codon 83 or 87 responsible for nalidixic acid resistance and MIC values for ciprofloxacin between 0.125 and 0.25 mg/l. Overall, this study showed that in Germany a specific S. Kottbus lineage (ST582), which is well-established in poultry, can be transmitted to humans by poultry meat and, consequently, poses a risk for human health.
    Preview · Article · May 2014 · Veterinary Microbiology
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    ABSTRACT: The so far highest number of life-threatening hemolytic uremic syndrome was associated with a food-borne outbreak in 2011 in Germany which was caused by an enterohemorrhagic Escherichia coli (EHEC) of the rare serotype O104:H4. Most importantly, the outbreak strain harbored genes characteristic of both EHEC and enteroaggregative E. coli (EAEC). Such strains have been described seldom but due to the combination of virulence genes show a high pathogenicity potential. To evaluate the importance of EHEC/EAEC hybrid strains in human disease, we analyzed the EHEC strain collection of the German National Reference Centre for Salmonella and other Bacterial Enteric Pathogens (NRC). After exclusion of O104:H4 EHEC/EAEC strains, out of about 2400 EHEC strains sent to NRC between 2008 and 2012, two strains exhibited both EHEC and EAEC marker genes, specifically were stx2 and aatA positive. Like the 2011 outbreak strain, one of the novel EHEC/EAEC harbored the Shiga toxin gene type stx2a. The strain was isolated from a patient with bloody diarrhea in 2010, was serotyped as O59:H-, belonged to MLST ST1136, and exhibited genes for type IV aggregative adherence fimbriae (AAF). The second strain was isolated from a patient with diarrhea in 2012, harbored stx2b, was typed as Orough:H-, and belonged to MLST ST26. Although the strain conferred the aggregative adherence phenotype, no known AAF genes corresponding to fimbrial types I to V were detected. In summary, EHEC/EAEC hybrid strains are currently rarely isolated from human disease cases in Germany and two novel EHEC/EAEC of rare serovars/MLST sequence types were characterized.
    Preview · Article · Apr 2014 · PLoS ONE
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    Preview · Article · Mar 2014 · Journal of Antimicrobial Chemotherapy
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    ABSTRACT: We report on a 65-year-old male patient with a Shiga toxin-producing Escherichia coli O51:H49 gastrointestinal infection and sepsis associated with hemolytic uremic syndrome (HUS) with a fatal outcome. The strains isolated harbored stx2e and eae, a very unusual and new virulence profile for an HUS-associated enterohemorrhagic E. coli.
    Full-text · Article · Feb 2014 · Journal of clinical microbiology

Publication Stats

3k Citations
524.96 Total Impact Points

Institutions

  • 1995-2015
    • Robert Koch Institut
      • Department for Infectious Disease Epidemiology
      Berlín, Berlin, Germany
  • 2007-2012
    • University of Münster
      • • Institute of Hygiene
      • • Institute of Food Chemistry
      Muenster, North Rhine-Westphalia, Germany
  • 2006
    • Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit
      Erlangen, Bavaria, Germany