Publications by authors named "Johanna Kessel"

Purpose: Bloodstream infections caused by Pseudomonas aeruginosa (PABSI) in hematological patients are associated with high morbidity and mortality. We investigated the epidemiology, risk factors, and outcomes of PABSI at our center.

Methods: All adult hematological patients with PABSI between January 2013 and July 2023 were included.

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: Infectious endocarditis (IE) remains a critical condition despite all the medical advances in recent decades. Reliable pathogen identification is indispensable for precise therapy. The aim of this study was to evaluate the diagnostic and therapeutic benefit of additional polymerase chain reaction (PCR) in comparison with microbiological culture alone based on intraoperative tissue sampling for patients operated on due to IE.

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Background: Antimicrobial stewardship (AMS) programmes are established across the world to treat infections efficiently, prioritize patient safety, and reduce the emergence of antimicrobial resistance. One of the core elements of AMS programmes is guidance to support and direct physicians in making efficient, safe and optimal decisions when prescribing antibiotics. To optimize and tailor AMS, we need a better understanding of prescribing physicians' experience with AMS guidance.

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Background incidence of pyogenic spinal infections has increased in recent years. In addition to treating the spinal infection, optimal care also includes identifying the source of the pyogenic spinal infection and the presence of other infections. The aim of this study is to elucidate the prevalence of oral cavity infection (OCI) within this patient cohort.

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Cryptococcosis is the most prevalent fungal infection of the central nervous system worldwide. We performed a retrospective multicenter cohort study to gain insights into the epidemiology of cryptococcosis in Germany. We describe the use of diagnostic tests, clinical management and patient outcome.

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Article Synopsis
  • Airport malaria, while rare, is becoming more common in Europe and presents diagnostic challenges, as seen in a cluster of cases among employees at Frankfurt International Airport in 2022.
  • Three employees were diagnosed with malaria despite no recent travel to affected areas, with two cases occurring within a week and one after ten weeks, but all individuals fully recovered.
  • Investigations revealed flights from malaria-endemic countries and a parcel from Ghana, but efforts to identify the source were inconclusive; genomic analysis linked the cases and emphasized the need for effective outbreak response to prevent severe malaria.
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Purpose: Antistaphylococcal penicillins and cefazolin have been used as first line therapy in Methicillin-susceptible Staphylococcus aureus bloodstream infection. While efficacy of both regimens seems to be similar, the compounds may differ with regard to tolerability. This study aims to describe the clinical use of cefazolin and flucloxacillin, focussing on discontinuation or change of anti-infective agent due to adverse events.

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Objective: Outpatient parenteral antimicrobial therapy (OPAT) is a well-established and cost-effective method for improving the efficient use of healthcare resources. However, only a few centres in Germany perform it. Here we analysed OPAT for the treatment of patients with cranial infections in our neurosurgical department.

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  • Falciparum malaria is a serious disease mainly affecting travelers in Germany, with unclear rates of co-infection and insufficient rationale for antibiotic therapy alongside malaria treatment.
  • A study conducted on 264 malaria patients showed that 64% received antibiotics, but only 11% had significant bacterial co-infections, while severe malaria didn't correlate with higher co-infection rates.
  • The findings suggest that bacterial co-infections in malaria cases are uncommon but highlight the need for personalized risk assessments rather than a blanket approach to antibiotic use.
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  • Patients with open pulmonary tuberculosis (opTB) can be mistakenly cleared for isolation based on sputum smear microscopy, which is less sensitive than culture testing.
  • A study analyzed data from 118 opTB patients between January 2013 and December 2017 and found that 44.8% had at least one positive culture after initial treatment despite having negative smear tests.
  • The findings suggest that de-isolating these patients after negative smears may not ensure they are infection-free, indicating a need for further research on the clinical implications of smear-negative but culture-positive cases.
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Outpatient parenteral antimicrobial therapy (OPAT) is a cost-effective method of administering intravenous antimicrobial therapy. Although OPAT is well established in the UK and US healthcare systems, few centres in Europe perform it. Here we analysed OPAT for the treatment of patients with spinal infections at our institution.

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Objectives: Since 2013, heater-cooler unit (HCU) associated Mycobacterium chimaera infections linked to a global outbreak have been described. These infections were characterised by high morbidity and mortality due to delayed diagnosis, as well as challenges in antimycobacterial and surgical therapy. This study aimed to investigate the clinical characteristics and outcome of published cases of HCU-associated M.

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Background: The efficacy of antibiotic prophylaxis to prevent rebleeding or infection after variceal bleeding in patients with liver cirrhosis colonized with multidrug-resistant organisms (MDROs) is unknown.

Methods: In this retrospective study, patients with liver cirrhosis and endoscopically confirmed variceal bleeding who were treated at a tertiary care center in Germany and were screened for MDROs at the time of bleeding were eligible for inclusion. Efficacy of antibiotic prophylaxis was evaluated in patients stratified according to microbiological susceptibility testing.

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Invasive fungal infections are associated with increased mortality in hematological patients. Despite considerable advances in antifungal therapy, the evaluation of suspected treatment failure is a common clinical challenge requiring extensive diagnostic testing to rule out potential causes, such as mixed infections. We present a 64-year-old patient with secondary AML, diabetes mellitus, febrile neutropenia, and sinusitis.

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Article Synopsis
  • Mycobacterium genavense is a slow-growing bacterium primarily infecting immunocompromised individuals, particularly those with HIV, but also increasingly seen in non-HIV patients, resulting in difficult-to-treat infections.
  • A meta-analysis of 223 cases from 1992 to 2021 revealed gastrointestinal-related symptoms, such as abdominal pain and splenomegaly, as prominent clinical manifestations, with over 90% of patients receiving antimycobacterial treatment.
  • The study found high mortality rates associated with these infections, but indicated that regimens including macrolides might improve survival outcomes.
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Scores to identify patients at high risk of progression of coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may become instrumental for clinical decision-making and patient management. We used patient data from the multicentre Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) and applied variable selection to develop a simplified scoring system to identify patients at increased risk of critical illness or death. A total of 1946 patients who tested positive for SARS-CoV-2 were included in the initial analysis and assigned to derivation and validation cohorts (n = 1297 and n = 649, respectively).

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Introduction: Disseminated infection due to non-tuberculous mycobacteria has been a major factor of mortality and comorbidity in HIV patients. Until 2018, U.S.

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Background: HIV-infected patients with Pneumocystis-pneumonia (PCP) may develop paradoxical immune reconstitution inflammatory syndrome (IRIS), when combination antiretroviral therapy (cART) is started early during the course of PCP-treatment (PCPT). The aim of this study was to identify risk factors and predictors for PCP-IRIS and to improve individualized patient care.

Methods: An ICD-10 code hospital database query identified all Frankfurt HIV Cohort patients being diagnosed with PCP from January 2010 - June 2016.

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The incidence of pyogenic spinal infection has increased in recent years. In addition to treatment of the spinal infection, early diagnosis and therapy of coexisting infections, especially of secondary brain infection, are important. The aim of this study is to elucidate the added value of routine cerebral imaging in the management of these patients.

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Objectives: Vancomycin-resistant E. faecium (VRE) is a common cause of healthcare-associated infections. The emergence of VRE with tigecycline resistance (TVRE) is increasing but its impact on patient outcome is still not well defined.

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A 46-year-old male received total arch replacement with frozen elephant trunk for acute non-A/non-B aortic dissection. Two months later, he underwent emergency reoperation for contained rupture of the left common carotid ostium at its insertion on the aortic arch. Three months after the reoperation, he developed tracheoesophageal fistula and infection of the prosthesis in the region of the aortic arch and the proximal descending aorta.

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Objectives: Clostridioides difficile infections (CDI) are common in autologous (auto-HSCT) or allogenic hematopoietic stem cell transplant (allo-HSCT) recipients. However, the impact of CDI on patient outcomes is controversial. We conducted this study to examine the impact of CDI on patient outcomes.

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Two cases of presumably airport-acquired falciparum malaria were diagnosed in Frankfurt in October 2019. They were associated with occupation at the airport, and parasites from their blood showed genetically identical microsatellite and allele patterns. Both had severe malaria.

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