Publications by authors named "Axel Kola"

Background: Testing for (SA) colonization in emergency department (ED) patients may guide prevention strategies against hospital acquired infections (HAIs). This study determined the prevalence of SA carriers in a general ED population, characterized the population, and identified predictors for SA colonization.

Methods: A prospective monocentric observational cohort study in a tertiary care hospital collected nasopharyngeal swabs in 1000 adult patients.

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BackgroundCarriage of multidrug-resistant organisms (MDROs) in humans constitutes an important public health concern. Cross-transmission of bacteria between animals and humans has been demonstrated before.AimOur aim was to quantify the risk factor 'pet ownership' for MDRO colonisation in hospital patients.

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Introduction: The global increase of multidrug-resistant organisms (MDROs) is one of the most urgent public health threats affecting both humans and animals. The One Health concept emphasizes the interconnectedness of human, animal and environmental health and highlights the need for integrated approaches to combat antimicrobial resistance (AMR). Although the sharing of environments and antimicrobial agents between companion animals and humans poses a risk for MDRO transmission, companion animals have been studied to a lesser extent than livestock animals.

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Article Synopsis
  • - During the COVID-19 pandemic, a study in Berlin identified three outbreaks of carbapenem-resistant Acinetobacter baumannii (CRAB) across five intensive care units, highlighting an increase in multidrug-resistant infections in hospitals.
  • - The study employed a case-control design to determine risk factors for acquiring CRAB, analyzing data from August 2020 to March 2021, where cases were patients with hospital-acquired CRAB, and controls were matched patients without CRAB.
  • - Two significant risk factors were found: sharing a room with a CRAB patient increased infection risk over tenfold, and bronchoscopy procedures raised the risk by more than six times, emphasizing the need for stringent infection control measures. *
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Purpose: Data from the intensive care component of the German hospital infection surveillance system (KISS) was used to investigate the epidemiology of pathogens responsible for the most frequent device-associated infections and their development over time.

Method: The 10 most common pathogens were identified for ventilator-associated lower respiratory tract infections (VALRTI), catheter associated urinary tract infections (CAUTI), and central venous catheter associated bloodstream infections (CVC-BSI). The development over time was analyzed based on three five-year time periods: 2008-2012, 2013-2017, 2018-2022.

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Background: In recent years, an increasing number of linezolid-resistant enterococci (LRE) was recognized at the German National Reference Centre (NRC) for Enterococci. National guidelines on infection prevention recommend screening for LRE in epidemiologically linked hospital settings without referring to a reliable and rapid diagnostic method. Since 2020, CHROMAgar™ provide a chromogenic linezolid screening agar, LIN-R, suitable to simultaneously screen for linezolid-resistant staphylococci and enterococci.

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Background: Methicillin-resistant Staphylococcus aureus (MRSA) has become less common in Germany in recent years. In this paper, we report data from the MRSA module of the Hospital Infection Surveillance System (Krankenhaus-Infektionen- Surveillance-System, KISS) for the years 2006-2021. We also describe the association of MRSA rates with the frequency of patient screening for MRSA and discuss the findings.

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Objectives: The aim of this study was to quantify the time delay between screening and initiation of contact isolation for carriers of extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (ESBL-E).

Methods: This study was a secondary analysis of contact isolation periods in a cluster-randomized controlled trial that compared 2 strategies to control ESBL-E (trial no. ISRCTN57648070).

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The increase of Vancomycin-resistant (VREfm) in recent years has been partially attributed to the rise of specific clonal lineages, which have been identified throughout Germany. To date, there is no gold standard for the interpretation of genomic data for outbreak analyses. New genomic approaches such as split k-mer analysis (SKA) could support cluster attribution for routine outbreak investigation.

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Species within the Enterobacter cloacae complex (ECC) include globally important nosocomial pathogens. A three-year study of ECC in Germany identified Enterobacter xiangfangensis as the most common species (65.5%) detected, a result replicated by examining a global pool of 3246 isolates.

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Background: Serratia marcescens may cause severe nosocomial infections, mostly in very low birth weight infants. Since S. marcescens exhibits by far the highest adjusted incidence rate for horizontal transmission, it can cause complex outbreak situations in neonatal intensive care units.

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Objectives: Assessment of vancomycin-resistant Enterococcus faecium (VREfm) prevalence upon hospital admission and analysis of risk factors for colonization.

Methods: From 2014 to 2018, patients were recruited within 72 hours of admission to seven participating German university hospitals, screened for VREfm and questioned for potential risk factors (prior multidrug-resistant organism detection, current/prior antibiotic consumption, prior hospital, rehabilitation or long-term care facility stay, international travel, animal contact and proton pump inhibitor [PPI]/antacid therapy). Genotype analysis was done using cgMLST typing.

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To analyse the epidemiology and population structure of third-generation cephalosporin-resistant (3GCR) and carbapenem-resistant (CR) complex isolates, patients were screened for rectal colonisation with 3GCR/CR complex on admission to six German university hospitals (2016-2019). Also collected were 3GCR/CR and susceptible isolates from patients with bloodstream infections (2016-2018). Whole-genome sequencing was performed followed by multilocus sequencing typing (MLST), core-genome MLST, and resistome and virulome analysis.

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Article Synopsis
  • Evaluating metagenomic software is crucial for enhancing the interpretation of metagenomes, and the CAMI II challenge focused on this by using complex datasets from numerous genomes and plasmids.
  • The analysis of 5,002 results from 76 software versions showed significant advancements in assembly, especially with long-read data, although challenges remained with related strains and genome recovery.
  • Findings indicated that while taxon profilers improved, they struggled with viruses and Archaea, highlighting the need for better reproducibility in clinical pathogen detection and guiding researchers in method selection based on efficiency and performance metrics.
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  • Skin and soft tissue infections (SSTI) caused by PVL-producing Staphylococcus aureus are common and often lead to recurrent abscesses, necessitating outpatient decolonization as a recommended treatment.
  • Despite the importance of topical decolonization in managing these infections, health insurance providers frequently do not fully cover the associated costs, which can pose challenges for patients seeking effective treatment.
  • A study conducted at a German university hospital examined the costs of outpatient versus inpatient treatment for recurring PVL-SA infections, revealing that most affected patients were treated as outpatients, emphasizing the need for better insurance reimbursement policies to support effective care.
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Objectives: We aimed to evaluate different interventions to reduce multidrug-resistant Enterobacteriaceae (MDR-E) infection/colonization.

Methods: A systematic review and meta-analysis evaluating interventions for prevention of MDR-E infection/colonization among hospitalized adult patients. The co-primary outcomes were mortality and MDR-E infections.

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Article Synopsis
  • A study was conducted to estimate the prevalence of vancomycin-resistant enterococci (VRE) colonization in patients admitted to non-intensive care units and identify risk factors associated with it.
  • Out of 4,013 patients screened, 1.2% were found to be colonized with VRE upon admission, and only one of those developed a VRE infection during their hospital stay.
  • Key risk factors for VRE colonization included increasing age, previous exposure to antibiotics, and prior colonization with multidrug-resistant organisms, highlighting the importance of cautious antibiotic use in outpatient settings to prevent VRE acquisition.
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The aim of this study is to analyze patient movement patterns between hospital departments to derive the underlying intra-hospital movement network, and to assess if movement patterns differ between patients at high or low risk of colonization. For that purpose, we analyzed patient electronic medical record data from five hospitals to extract information on risk stratification and patient intra-hospital movements. Movement patterns were visualized as networks, and network centrality measures were calculated.

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Objectives: To analyse the rectal carriage rate and the molecular epidemiology of vancomycin-resistant Enterococcus faecium (VREfm) recovered from patients upon hospital admission.

Methods: Adult patients were screened at six German university hospitals from five different federal states upon hospital admission for rectal colonization with VREfm between 2014 and 2018. Molecular characterization of VREfm was performed by WGS followed by MLST and core-genome MLST analysis.

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Background: In addition to an overall rise in vancomycin-resistant Enterococcus faecium (VREfm), an increase in certain strain types marked by sequence type (ST) and cluster type (CT) has been reported in Germany over the past few years. Outbreak analyses at Charité - Universitätsmedizin Berlin revealed the frequent occurrence of VREfm ST117 CT71 isolates in 2017 and 2018. To investigate whether ST117 CT71 have emerged in recent years or whether these strains have been circulating for a longer time, we retrospectively analyzed non-outbreak strains that occurred between 2008 and 2018 to identify frequent STs and CTs.

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Background: Recurrent skin abscesses are often associated with Panton-Valentine leukocidin-producing strains of S. aureus (PVL-SA). Decolonization measures are required along with treatment of active infections to prevent re-infection and spreading.

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Article Synopsis
  • - A study on 3GCREB in 8753 adult patients found a 9.5% prevalence, with CTX-M-15 being the most common β-lactamase genotype identified in isolates.
  • - Various risk factors for colonization were identified, such as recent antibiotic use and previous exposure to resistant bacteria, but differed depending on the β-lactamase type.
  • - Findings suggest that targeting specific risk factors could inform prevention strategies for different types of ESBLs in clinical settings.
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Background: The effectiveness of contact isolation for decreasing the spread of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) has been questioned. The aim of this study was to establish the benefits of contact isolation over standard precautions for reducing the incidence density of ESBL-E colonisation and infection in adult medical and surgical wards with an active surveillance culture programme.

Methods: We did a cluster-randomised crossover trial in adult wards in four European university hospitals.

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Limited therapy options due to antibiotic resistance underscore the need for optimization of current diagnostics. In some bacterial species, antimicrobial resistance can be unambiguously predicted based on their genome sequence. In this study, we sequenced the genomes and transcriptomes of 414 drug-resistant clinical Pseudomonas aeruginosa isolates.

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