Additional file 1: of Infectious diseases during the European Union training mission Mali (EUTM MLI) – a four-year experience

Figure S1. Most commonly reported reasons for new medical consultations during the study interval for non-EUTM missions. Figure S2. Variation in the crude rate of reported disease categories year by year for non-EUTM missions. Figure S3. Variation in reported infectious disease events by category and year for non-EUTM missions. Figure S4. Variation in reported specific infectious diseases events by calendar week for non-EUTM missions. Figure S5. Reports of confirmed diseases in EUTM MLI during the study period. (DOC 2979 kb

Nasal Screening for MRSA: Different Swabs – Different Results!

<div><p>Objectives</p><p>Swab-based nasal screening is commonly used to identify asymptomatic carriage of <i>Staphylococcus aureus</i> in patients. Bacterial detection depends on the uptake and release capacities of the swabs and on the swabbing technique itself. This study investigates the performance of different swab-types in nasal MRSA-screening by utilizing a unique artificial nose model to provide realistic and standardized screening conditions.</p><p>Methods</p><p>An anatomically correct artificial nose model was inoculated with a numerically defined mixture of MRSA and <i>Staphylococcus epidermidis</i> bacteria at quantities of 4×10² and 8×10² colony forming units (CFU), respectively. Five swab-types were tested following a strict protocol. Bacterial recovery was measured for direct plating and after elution into Amies medium by standard viable count techniques.</p><p>Results</p><p>Mean recovered bacteria quantities varied between 209 and 0 CFU for MRSA, and 365 and 0 CFU for <i>S. epidermidis</i>, resulting swab-type-dependent MRSA-screening-sensitivities ranged between 0 and 100%. Swabs with nylon flocked tips or cellular foam tips performed significantly better compared to conventional rayon swabs referring to the recovered bacterial yield (p<0.001). Best results were obtained by using a flocked swab in combination with Amies preservation medium. Within the range of the utilized bacterial concentrations, recovery ratios for the particular swab-types were independent of the bacterial species.</p><p>Conclusions</p><p>This study combines a realistic model of a human nose with standardized laboratory conditions to analyze swab-performance in MRSA-screening situations. Therefore, influences by inter-individual anatomical differences as well as diverse colonization densities in patients could be excluded. Recovery rates vary significantly between different swab-types. The choice of the swab has a great impact on the laboratory result. In fact, the swab-type contributes significantly to true positive or false negative detection of nasal MRSA carriage. These findings should be considered when screening a patient.</p></div

Relative recovery of bacteria compared to inoculation dose after elution into Amies medium.

<p>Ratios were determined by comparison of viable counts of released bacteria to the inoculation dose, which was defined as 100%. Results from statistical analysis are shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0111627#pone.0111627.s003" target="_blank">Table S2</a>.</p

Qualitative MRSA detection.

<p>Legend: Artificial nose models were inoculated with bacterial suspensions of MRSA and <i>S. epidermidis</i> and defined as 100% MRSA positive. After swabbing with five swab-types (<i>n</i> = 15 swabs per type) MRSA detection rates were analyzed by direct plating or after elution of swab contents into Amies medium. Detection of >1 CFU MRSA on Columbia agar plates supplemented with 5% sheep blood was rated as a positive result. Results of sensitivity analysis are displayed as followed: number of positive results/number of maximal positive results (percentage).</p><p>Qualitative MRSA detection.</p

Recovery of bacteria in absolute numbers after direct plating.

<p>Viable counts of bacteria by direct plating of the displayed swab-types were determined by CFU counting as described in the methods section. CFU = colony forming units. Results from statistical analysis are shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0111627#pone.0111627.s002" target="_blank">Table S1</a>.</p

Relative recovery of bacteria compared to inoculation dose after direct plating.

<p>Ratios were determined by comparison of viable counts of released bacteria to the inoculation dose, which was defined as 100%. Results from statistical analysis are shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0111627#pone.0111627.s003" target="_blank">Table S2</a>.</p

Recovery of bacteria in absolute numbers after elution into Amies medium.

<p>Viable counts of bacteria after elution of the displayed swab-types into Amies medium were determined by CFU counting as described in the methods section. CFU = colony forming units. Results from statistical analysis are shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0111627#pone.0111627.s002" target="_blank">Table S1</a>.</p

MOESM2 of A comparison of two PCR protocols for the differentiation of Plasmodium ovale species and implications for clinical management in travellers returning to Germany: a 10-year cross-sectional study

Additional file 2. Oligonucleotides used in the P. ovale spp. differentiation PCR platforms

MOESM1 of A comparison of two PCR protocols for the differentiation of Plasmodium ovale species and implications for clinical management in travellers returning to Germany: a 10-year cross-sectional study

Additional file 1. Details of patients and samples

MOESM3 of A comparison of two PCR protocols for the differentiation of Plasmodium ovale species and implications for clinical management in travellers returning to Germany: a 10-year cross-sectional study

Additional file 3. Graphical distribution of P. ovale curtisi (red dots) and P. ovale wallikeri (yellow dots) cases according to countries in which infections were most likely acquired