Multilocus Sequence Typing von Borrelia burgdorferi sensu stricto und Borrelia afzelii Stämmen aus Europa und den USA: Populationsstruktur, Pathogenität und Patientensymptomatik

To understand the epidemiological and ecological context of vector borne diseases, precise typing of causative agents is necessary. Multilocus sequence typing (MLST) is a method in molecular biology for the fast, economic and unambiguous characterization of bacteria and other organisms. Lyme borreliosis (LB) is the most common tick borne disease in the Northern hemisphere caused by species of the Borrelia burgdorferi sensu lato complex. To better understand the epidemiological and clinical context of two Borrelia species frequently reported in LB, 133 Borrelia (B.) burgdorferi sensu stricto (s. s.) and Borrelia (B.) afzelii strains from patients and ticks in Europe were typed via MLST. MLST data from additional 744 B. burgdorferi s. s. and B. afzelii strains were downloaded from the MLST data bank. The population structure, clinical manifestations and human pathogenicity of B. afzelii in Europe as well as B. burgdorferi s. s. in Europe and the USA were compared. In addition, the invasiveness of sequence types (ST) and clonal complexes (CC) were analyzed in both species. Special attention was paid to the clinical manifestation of neuroborreliosis. Analysis of the population structure confirmed the hypothesis that B. afzelii shows a greater heterogeneity of ST (98 ST from n = 198 strains) compared to B. burgdorferi s. s. (112 ST from n = 677 strains). Moreover there was a greater prevalence of B. afzelii (ticks: 41.3 %, patients: 52.7 %) than B. burgdorferi s. s. (ticks: 13.2 %, patients: 13.7 %) in Europe. B. burgdorferi s. s. populations from Europe and the USA showed an overlap of two sequence types (ST1 and ST3) in patient isolates while there was no overlap of STs in ticks. Thus, it was hypothesized that the patients in Europe carrying ST1 or ST3 may have acquired their infection in the USA. B. burgdorferi s. s. infections in Europe were found to be more often associated with disseminated symptoms (93 %) and neuroborreliosis (odds ratio: 3.0) than B. afzelii infections (42 %) in Europe and B. burgdorferi s. s. infections in the USA (42 %), respectively it was noticed that some ST and CC might have greater human pathogenity than others (cf. ST1, ST3 and CC4 in Hanincova et al. 2013). Modern typing systems have already generated a huge data base for bacterial analyses. Nevertheless, further studies based on our data would be required to verify the differences of ST and CC in human pathogenicity and to get appropriate statistical data about differences of ST in Europe and the USA. In this context, our data can be relevant for further vaccine development

Multilocus Sequence Typing von Borrelia burgdorferi sensu stricto und Borrelia afzelii Stämmen aus Europa und den USA: Populationsstruktur, Pathogenität und Patientensymptomatik

To understand the epidemiological and ecological context of vector borne diseases, precise typing of causative agents is necessary. Multilocus sequence typing (MLST) is a method in molecular biology for the fast, economic and unambiguous characterization of bacteria and other organisms. Lyme borreliosis (LB) is the most common tick borne disease in the Northern hemisphere caused by species of the Borrelia burgdorferi sensu lato complex. To better understand the epidemiological and clinical context of two Borrelia species frequently reported in LB, 133 Borrelia (B.) burgdorferi sensu stricto (s. s.) and Borrelia (B.) afzelii strains from patients and ticks in Europe were typed via MLST. MLST data from additional 744 B. burgdorferi s. s. and B. afzelii strains were downloaded from the MLST data bank. The population structure, clinical manifestations and human pathogenicity of B. afzelii in Europe as well as B. burgdorferi s. s. in Europe and the USA were compared. In addition, the invasiveness of sequence types (ST) and clonal complexes (CC) were analyzed in both species. Special attention was paid to the clinical manifestation of neuroborreliosis. Analysis of the population structure confirmed the hypothesis that B. afzelii shows a greater heterogeneity of ST (98 ST from n = 198 strains) compared to B. burgdorferi s. s. (112 ST from n = 677 strains). Moreover there was a greater prevalence of B. afzelii (ticks: 41.3 %, patients: 52.7 %) than B. burgdorferi s. s. (ticks: 13.2 %, patients: 13.7 %) in Europe. B. burgdorferi s. s. populations from Europe and the USA showed an overlap of two sequence types (ST1 and ST3) in patient isolates while there was no overlap of STs in ticks. Thus, it was hypothesized that the patients in Europe carrying ST1 or ST3 may have acquired their infection in the USA. B. burgdorferi s. s. infections in Europe were found to be more often associated with disseminated symptoms (93 %) and neuroborreliosis (odds ratio: 3.0) than B. afzelii infections (42 %) in Europe and B. burgdorferi s. s. infections in the USA (42 %), respectively it was noticed that some ST and CC might have greater human pathogenity than others (cf. ST1, ST3 and CC4 in Hanincova et al. 2013). Modern typing systems have already generated a huge data base for bacterial analyses. Nevertheless, further studies based on our data would be required to verify the differences of ST and CC in human pathogenicity and to get appropriate statistical data about differences of ST in Europe and the USA. In this context, our data can be relevant for further vaccine development

COVID-19-Impfung senkt das Risiko für Infektion, schwere Krankheitsverläufe und Tod

Im Mai 2021 kam es in einem Alten- und Pflegeheim in der Oberpfalz zu einem SARS-CoV-2-Aus-bruch mit einer hohen Anzahl von Impfdurchbrüchen, woraufhin serologische Untersuchungen und epidemiologische Daten der Bewohnerinnen und Bewohner und dem Pflegepersonal ausgewertet wurden. Ziel dieser Untersuchung war es, das Risiko von Hospitalisierung und Tod bei Geimpften im Vergleich zu Ungeimpften darzustellen.Peer Reviewe

Detection of the new SARS-CoV-2 variants of concern B.1.1.7 and B.1.351 in five SARS-CoV-2 rapid antigen tests (RATs), Germany, March 2021.

SARS-CoV-2 variants of concern (VOC) should not escape molecular surveillance. We investigated if SARS-CoV-2 rapid antigen tests (RATs) could detect B.1.1.7 and B.1.351 VOCs in certain laboratory conditions. Infectious cell culture supernatants containing B.1.1.7, B.1.351 or non-VOC SARS-CoV-2 were respectively diluted both in DMEM and saliva. Dilutions were analysed with Roche, Siemens, Abbott, nal von minden and RapiGEN RATs. While further studies with appropriate real-life clinical samples are warranted, all RATs detected B.1.1.7 and B.1.351, generally comparable to non-VOC strain

Borrelia burgdorferi sensu stricto and Borrelia afzelii: Population structure and differential pathogenicity

MultiLocus sequence typing (MLST) is considered a powerful method to unveil relationships within bacterial populations and it constitutes an economical and fast alternative to whole genome sequencing. We used this method to understand whether there are differences in human pathogenicity within and between different Borrelia burgdorferi sensu lato species. Therefore, 136 strains from human patients or ticks from Europe were included in MLST analyses. The scheme employed used eight chromosomally located housekeeping genes (i.e. clpA, clpX, nifS, pepX, pyrG, recG, rplB and uvrA). We investigated Borrelia afzelii, one of the predominant species in Europe, and B. burgdorferi sensu stricto (s.s.), because it allowed comparative analysis to strains from the USA. We typed 113 patient isolates as well as 23 tick isolates. For further comparative purposes an additional 746 strains from Europe and the USA were included from the MLST website http://borrelia.mlst.net. We observed an overlap of the B. burgdorferi s.s. populations from Europe and the USA isolated from human patients while there was no overlap of the populations found in tick vectors. Further results indicate that B. afzelii was significantly less associated with disseminated infection than B. burgdorferi s.s. and that B. burgdorferi s.s. from Europe caused neuroborreliosis to a significantly greater extent than B. afzelii or B. burgdorferi s.s. in the USA. Our data suggest that there may be an evolutionary basis of differential interspecies pathogenicity in Borrelia. This was not evident within Borrelia species: we found the same sequence types in patients with disseminated or localized symptoms when the number of strains was sufficiently high. We hypothesize that the finding that B. burgdorferi s.s. in Europe is much more associated with neuroborreliosis than in the USA maybe linked to factor(s) related to the human host, the tick vector or the bacterium itself (e.g. plasmid content and structure)

In Vitro Rapid Antigen Test Performance with the SARS-CoV-2 Variants of Concern B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), and B.1.617.2 (Delta)

Rapid antigen tests (RATs) are an integral part of SARS-CoV-2 containment strategies. As emerging variants of concern (VOCs) displace the initially circulating strains, it is crucial that RATs do not fail to detect these new variants. In this study, four RATs for nasal swab testing were investigated using cultured strains of B.1.1 (non-VOC), B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), and B.1.617.2 (Delta). Based on dilution series in cell culture medium and pooled saliva, the limit of detection of these RATs was determined in a laboratory setting. Further investigations on cross-reactivity were conducted using recombinant N-protein from seasonal human coronaviruses (hCoVs). RATs evaluated showed an overall comparable performance with cultured strains of the non-VOC B.1.1 and the VOCs Alpha, Beta, Gamma, and Delta. No cross-reactivity was detected with recombinant N-protein of the hCoV strains HKU1, OC43, NL63, and 229E. A continuous evaluation of SARS-CoV-2 RAT performance is required, especially with regard to evolving mutations. Moreover, cross-reactivity and interference with pathogens and other substances on the test performance of RATs should be consistently investigated to ensure suitability in the context of SARS-CoV-2 containment

Epidemiological and Serological Analysis of a SARS-CoV-2 Outbreak in a Nursing Home: Impact of SARS-CoV-2 Vaccination and Enhanced Neutralizing Immunity Following Breakthrough Infection

Background: Despite a vaccination rate of 82.0% (n = 123/150), a SARS-CoV-2 (Alpha) outbreak with 64.7% (n = 97/150) confirmed infections occurred in a nursing home in Bavaria, Germany. Objective: the aim of this retrospective cohort study was to examine the effects of the Corminaty vaccine in a real-life outbreak situation and to obtain insights into the antibody response to both vaccination and breakthrough infection. Methods: the antibody status of 106 fully vaccinated individuals (54/106 breakthrough infections) and epidemiological data on all 150 residents and facility staff were evaluated. Results: SARS-CoV-2 infections (positive RT-qPCR) were detected in 56.9% (n = 70/123) of fully vaccinated, compared to 100% (n = 27/27) of incompletely or non-vaccinated individuals. The proportion of hospitalized and deceased was 4.1% (n = 5/123) among fully vaccinated and therewith lower compared to 18.5% (n = 5/27) hospitalized and 11.1% (n = 3/27) deceased among incompletely or non-vaccinated. Ct values were significantly lower in incompletely or non-vaccinated (p = 0.02). Neutralizing antibodies were detected in 99.1% (n = 105/106) of serum samples with significantly higher values (p < 0.001) being measured post-breakthrough infection. α-N-antibodies were detected in 37.7% of PCR positive but not in PCR negative individuals. Conclusion: Altogether, our data indicate that SARS-CoV-2 vaccination does provide protection against infection, severe disease progression and death with regards to the Alpha variant. Nonetheless, it also shows that infection and transmission are possible despite full vaccination. It further indicates that breakthrough infections can significantly enhance α-S- and neutralizing antibody responses, indicating a possible benefit from booster vaccinations