TY  - JOUR
AB  - BACKGROUND: Population-based serological studies allow to estimate prevalence of SARS-CoV-2 infections despite a substantial number of mild or asymptomatic disease courses. This became even more relevant for decision making after vaccination started. The KoCo19 cohort tracks the pandemic progress in the Munich general population for over two years, setting it apart in Europe. METHODS: Recruitment occurred during the initial pandemic wave, including 5313 participants above 13 years from private households in Munich. Four follow-ups were held at crucial times of the pandemic, with response rates of at least 70%. Participants filled questionnaires on socio-demographics and potential risk factors of infection. From Follow-up 2, information on SARS-CoV-2 vaccination was added. SARS-CoV-2 antibody status was measured using the Roche Elecsys® Anti-SARS-CoV-2 anti-N assay (indicating previous infection) and the Roche Elecsys® Anti-SARS-CoV-2 anti-S assay (indicating previous infection and/or vaccination). This allowed us to distinguish between sources of acquired antibodies. RESULTS: The SARS-CoV-2 estimated cumulative sero-prevalence increased from 1.6% (1.1-2.1%) in May 2020 to 14.5% (12.7-16.2%) in November 2021. Underreporting with respect to official numbers fluctuated with testing policies and capacities, becoming a factor of more than two during the second half of 2021. Simultaneously, the vaccination campaign against the SARS-CoV-2 virus increased the percentage of the Munich population having antibodies, with 86.8% (85.5-87.9%) having developed anti-S and/or anti-N in November 2021. Incidence rates for infections after (BTI) and without previous vaccination (INS) differed (ratio INS/BTI of 2.1, 0.7-3.6). However, the prevalence of infections was higher in the non-vaccinated population than in the vaccinated one. Considering the whole follow-up time, being born outside Germany, working in a high-risk job and living area per inhabitant were identified as risk factors for infection, while other socio-demographic and health-related variables were not. Although we obtained significant within-household clustering of SARS-CoV-2 cases, no further geospatial clustering was found. CONCLUSIONS: Vaccination increased the coverage of the Munich population presenting SARS-CoV-2 antibodies, but breakthrough infections contribute to community spread. As underreporting stays relevant over time, infections can go undetected, so non-pharmaceutical measures are crucial, particularly for highly contagious strains like Omicron.
AU  - Le Gleut, R.
AU  - Plank, M.*
AU  - Pütz, M.*
AU  - Radon, K.*
AU  - Bakuli, A.*
AU  - Rubio-Acero, R.*
AU  - Paunovic, I.*
AU  - Rieß, F.*
AU  - Winter, S.*
AU  - Reinkemeyer, C.*
AU  - Schälte, Y.
AU  - Olbrich, L.*
AU  - Hannes, M.*
AU  - Kroidl, I.*
AU  - Noreña, I.*
AU  - Janke, C.*
AU  - Wieser, A.*
AU  - Hoelscher, M.*
AU  - Fuchs, C.
AU  - Castelletti, N.
C1  - 68108
C2  - 54586
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - The representative COVID-19 cohort Munich (KoCo19): From the beginning of the pandemic to the Delta virus variant.
JO  - BMC Infect. Dis.
VL  - 23
IS  - 1
PB  - Bmc
PY  - 2023
SN  - 1471-2334
ER  - 

TY  - JOUR
AB  - BACKGROUND: In the 2nd year of the COVID-19 pandemic, knowledge about the dynamics of the infection in the general population is still limited. Such information is essential for health planners, as many of those infected show no or only mild symptoms and thus, escape the surveillance system. We therefore aimed to describe the course of the pandemic in the Munich general population living in private households from April 2020 to January 2021. METHODS: The KoCo19 baseline study took place from April to June 2020 including 5313 participants (age 14 years and above). From November 2020 to January 2021, we could again measure SARS-CoV-2 antibody status in 4433 of the baseline participants (response 83%). Participants were offered a self-sampling kit to take a capillary blood sample (dry blood spot; DBS). Blood was analysed using the Elecsys® Anti-SARS-CoV-2 assay (Roche). Questionnaire information on socio-demographics and potential risk factors assessed at baseline was available for all participants. In addition, follow-up information on health-risk taking behaviour and number of personal contacts outside the household (N = 2768) as well as leisure time activities (N = 1263) were collected in summer 2020. RESULTS: Weighted and adjusted (for specificity and sensitivity) SARS-CoV-2 sero-prevalence at follow-up was 3.6% (95% CI 2.9-4.3%) as compared to 1.8% (95% CI 1.3-3.4%) at baseline. 91% of those tested positive at baseline were also antibody-positive at follow-up. While sero-prevalence increased from early November 2020 to January 2021, no indication of geospatial clustering across the city of Munich was found, although cases clustered within households. Taking baseline result and time to follow-up into account, men and participants in the age group 20-34 years were at the highest risk of sero-positivity. In the sensitivity analyses, differences in health-risk taking behaviour, number of personal contacts and leisure time activities partly explained these differences. CONCLUSION: The number of citizens in Munich with SARS-CoV-2 antibodies was still below 5% during the 2nd wave of the pandemic. Antibodies remained present in the majority of SARS-CoV-2 sero-positive baseline participants. Besides age and sex, potentially confounded by differences in behaviour, no major risk factors could be identified. Non-pharmaceutical public health measures are thus still important.
AU  - Radon, K.*
AU  - Bakuli, A.*
AU  - Pütz, P.
AU  - Le Gleut, R.
AU  - Guggenbüehl Noller, J.M.*
AU  - Olbrich, L.*
AU  - Saathoff, E.*
AU  - Garí, M.
AU  - Schälte, Y.
AU  - Frahnow, T.
AU  - Wölfel, R.*
AU  - Pritsch, M.*
AU  - Rothe, C.*
AU  - Pletschette, M.*
AU  - Rubio-Acero, R.*
AU  - Beyerl, J.*
AU  - Metaxa, D.*
AU  - Förster, F.*
AU  - Thiel, V.*
AU  - Castelletti, N.*
AU  - Rieß, F.*
AU  - Diefenbach, M.N.*
AU  - Fröschl, G.*
AU  - Bruger, J.*
AU  - Winter, S.*
AU  - Frese, J.*
AU  - Puchinger, K.*
AU  - Brand, I.*
AU  - Kroidl, I.*
AU  - Wieser, A.*
AU  - Hoelscher, M.*
AU  - Hasenauer, J.
AU  - Fuchs, C.
C1  - 62946
C2  - 51106
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - From first to second wave: Follow-up of the prospective COVID-19 cohort (KoCo19) in Munich (Germany).
JO  - BMC Infect. Dis.
VL  - 21
IS  - 1
PB  - Bmc
PY  - 2021
SN  - 1471-2334
ER  - 

TY  - JOUR
AB  - BackgroundUntil now, herpes zoster (HZ)-related disease burden in Germany has been estimated based on health insurance data and clinical findings. However, the validity of self-reported HZ is unclear. This study investigated the validity of self-reported herpes zoster (HZ) and its complication postherpetic neuralgia (PHN) using data from the pretest studies of the German National Cohort (GNC) in comparison with estimates based on health insurance data.MethodsData of 4751 participants aged between 20 and 69years from two pretest studies of the GNC carried out in 2011 and 2012 were used. Based on self-reports of physician-diagnosed HZ and PHN, age- and sex-specific HZ incidence rates and PHN proportions were estimated. For comparison, estimates based on statutory health insurance data from the German population were considered.ResultsEleven percent (95%-CI, 10.4 to 12.3, n=539) of the participants reported at least one HZ episode in their lifetime. Our estimated age-specific HZ incidence rates were lower than previous estimates based on statutory health insurance data. The PHN proportion in participants older than 50years was 5.9% (1.9 to 13.9%), which was in line with estimates based on health insurance data.ConclusionAs age- and sex-specific patterns were comparable with that in health insurance data, self-reported diagnosis of HZ seems to be a valid instrument for overall disease trends. Possible reasons for observed differences in incidence rates are recall bias in self-reported data or overestimation in health insurance data.
AU  - Caputo, M.*
AU  - Horn, J.*
AU  - Karch, A.*
AU  - Akmatov, M.K.*
AU  - Becher, H.*
AU  - Braun, B.*
AU  - Brenner, H.*
AU  - Castell, S.*
AU  - Fischer, B.*
AU  - Giani, G.*
AU  - Günther, K.*
AU  - Hoffmann, B.*
AU  - Jöckel, K.H.*
AU  - Keil, T.*
AU  - Klüppelholz, B.*
AU  - Krist, L.*
AU  - Leitzmann, M.F.*
AU  - Lieb, W.*
AU  - Linseisen, J.
AU  - Meisinger, C.
AU  - Moebus, S.*
AU  - Obi, N.*
AU  - Pischon, T.*
AU  - Schipf, S.*
AU  - Schmidt, B.*
AU  - Sievers, C.*
AU  - Steinbrecher, A.*
AU  - Völzke, H.*
AU  - Mikolajczyk, R.*
C1  - 55412
C2  - 46346
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Herpes zoster incidence in Germany - an indirect validation study for self-reported disease data from pretest studies of the population-based German National Cohort.
JO  - BMC Infect. Dis.
VL  - 19
IS  - 1
PB  - Bmc
PY  - 2019
SN  - 1471-2334
ER  - 

TY  - JOUR
AB  - BackgroundThe prevalence of extended-spectrum -lactamases (ESBLs) have been reported in clinical isolates obtained from various hospitals in Ethiopia. However, there is no data on the prevalence and antibiotic susceptibility patterns of CTX-M type ESBL produced by Gram-negative bacilli. The aim of this study was to determine the frequency and distribution of the bla(CTX-M) genes and the susceptibility patterns in ESBL producing clinical isolates of Gram-negative bacilli in Jimma University Specialized Hospital (JUSH), southwest Ethiopia.MethodsA total of 224 non-duplicate and pure isolates obtained from clinically apparent infections, were included in the study. Identification of the isolates was performed by MALDI-TOF mass spectrometry. Susceptibility testing and ESBL detection was performed using VITEK (R) 2, according to EUCAST v4.0 guidelines. Genotypic analysis was performed using Check-MDR CT103 Microarrays.ResultsOf the total 112 (50.0%) isolates screen positive for ESBLs, 63.4% (71/112) tested positive for ESBL encoding genes by Check-MDR array, which corresponds to 91.8% (67/73) of the total Enterobacteriaceae and 10.3% (4/39) of nonfermenting Gram-negative bacilli. Among the total ESBL gene positive isolates, 95.8% (68/71) carried bla(CTX-M) genes with CTX-M group 1 type15 being predominant (66/68; 97.1% of CTX-M genes). The bla(CTX-M) carrying Enterobacteriaceae (n=64) isolates showed no resistance against imipenem and meropenem and a moderate resistance rate against tigecycline (14.1%), fosfomycin (10.9%) and amikacin (1.6%) suggesting the effectiveness of these antibiotics against most isolates. On the other hand, all the bla(CTX-M) positive Enterobacteriaceae showed a multidrug resistant (MDR) phenotype with remarkable co-resistances (non-susceptibility rates) to aminoglycosides (92.2%), fluoroquinolones (78.1%) and trimethoprim/sulfamethoxazol (92.2%).ConclusionsThis study demonstrates a remarkably high prevalence of bla(CTX-M) genes among ESBL-producing isolates. The high level of resistance to -lactam and non--lactam antibiotics as well as the trend to a MDR profile associated with the bla(CTX-M) genes are alarming and emphasize the need for routine diagnostic antimicrobial susceptibility testing for appropriate choice of antimicrobial therapy.
AU  - Zeynudin, A.*
AU  - Pritsch, M.*
AU  - Schubert, S.*
AU  - Messerer, M.
AU  - Liegl, G.*
AU  - Hoelscher, M.*
AU  - Belachew, T.*
AU  - Wieser, A.*
C1  - 54562
C2  - 45632
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Prevalence and antibiotic susceptibility pattern of CTX-M type extended-spectrum -lactamases among clinical isolates of gram-negative bacilli in Jimma, Ethiopia.
JO  - BMC Infect. Dis.
VL  - 18
IS  - 1
PB  - Bmc
PY  - 2018
SN  - 1471-2334
ER  - 

TY  - JOUR
AB  - BACKGROUND: Nephropathia epidemica (NE) is a mild form of hemorrhagic fever with renal syndrome (HFRS) that is caused by the Puumala virus. Periodic outbreaks have been described in endemic areas, with a substantial number of previously healthy individuals developing acute kidney injury (AKI). There is a considerable diversity in the clinical course of the disease, and few patients require renal replacement therapy. METHODS: We tested whether urinary neutrophil gelatinase associated lipocalin (uNGAL), urine albumin/creatinine ratio (uACR), urine protein/creatinine ratio (uPCR), urine dipstick protein, C-reactive protein, procalcitonin, leukocyte and platelet count, determined on admission to the hospital, can predict the severity of AKI. Sixty-one patients were analyzed during admission in the emergency department. RESULTS: The variables most strongly associated with peak plasma creatinine concentration were uNGAL (β = 0.70, p <0.0001), uPCR (β = 0.64, p = 0.001), uACR (β = 0.61, p = 0.002), and dipstick proteinuria (β = 0.34, p = 0.008). The highest AUC-ROC to predict stage 3 AKI according to the acute kidney injury network's (AKIN) classification was seen for uNGAL (0.81, p = 0.001). CONCLUSION: uNGAL accurately predicts the severity of AKI in NE. This could help emergency room physicians predict disease severity and allow for initial risk stratification.
AU  - Bunz, H.*
AU  - Weyrich, P.*
AU  - Peter, A.
AU  - Baumann, D.*
AU  - Tschritter, O.*
AU  - Guthoff, M.*
AU  - Beck, R.*
AU  - Jahn, G.*
AU  - Artunc, F.*
AU  - Haering, H.
AU  - Heyne, N.*
AU  - Wagner, R.
C1  - 47317
C2  - 40528
SP  - 464
TI  - Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) and proteinuria predict severity of acute kidney injury in Puumala virus infection.
JO  - BMC Infect. Dis.
VL  - 15
PY  - 2015
SN  - 1471-2334
ER  -