First insights in the variability of Borrelia recurrentis genomes

Background: Borrelia recurrentis is the causative agent of louse-borne relapsing fever, endemic to the Horn of Africa. New attention was raised in Europe, with the highest number of cases (n = 45) reported among migrants in 2015 in Germany and sporadically from other European countries. So far only one genome was sequenced, hindering the development of specific molecular diagnostic and typing tools. Here we report on modified culture conditions for B. recurrentis and the intraspecies genome variability of six isolates isolated and cultured in different years in order to explore the possibility to identify new targets for typing and examine the molecular epidemiology of the pathogen. Methodology/Principal findings: Two historical isolates from Ethiopia and four isolates from migrants from Somalia (n = 3) and Ethiopia (n = 1) obtained in 2015 were cultured in MPK-medium supplemented with 50% foetal calf serum. Whole DNA was sequenced using Illumina MiSeq technology and analysed using the CLC Genomics Workbench and SPAdes de novo assembler. Compared to the reference B. recurrentis A1 29-38 SNPs were identified in the genome distributed on the chromosome and plasmids. In addition to that, plasmids of differing length, compared to the available reference genome were identified. Conclusions/Significance: The observed low genetic variability of B. recurrentis isolates is possibly due to the adaptation to a very conserved vector-host (louse-human) cycle, or influenced by the fastidious nature of the pathogen and their resistance to in vitro growth. Nevertheless, isolates obtained in 2015 were bearing the same chromosomal SNPs and could be distinguished from the historical isolates by means of whole genome sequencing, but not hitherto used typing methods. This is the first study examining the molecular epidemiology of B. recurrentis and provides the necessary background for the development of better diagnostic tools

There is inadequate evidence to support the division of the genus Borrelia

There are surely scientific, genetic or ecological 60 arguments which show that differences exist between the relapsing fever (RF) spirochaetes and the Lyme borreliosis (LB) group of spirochaetes, both of which belong to the genus Borrelia. In a recent publication, Adeolu and Gupta (Adeolu & 63 Gupta, 2014) proposed dividing the genus Borrelia into two genera on the basis of genetic differences revealed by comparative genomics. The new genus name for the LB group of spirochaetes, Borreliella, has subsequently been entered in GenBank for some species of the group and in a validation list (List of new names and new combinations previously effectively, but not validly, published) (Oren & Garrity, 2015). However, rapidly expanding scientific knowledge and considerable conflicting evidence combined with the adverse consequences of splitting the genus Borrelia make such a drastic step somewhat premature. In our opinion, the basis of this division rests on preliminary evidence and should be rescinded

Resistance to the tetracyclines and macrolide-lincosamide-streptogramin group of antibiotics and its genetic linkage – a review

An excessive use of antimicrobial agents poses a risk for the selection of resistant bacteria. Of particular interest are antibiotics that have large consumption rates in both veterinary and human medicine, such as the tetracyclines and macrolide-lincosamide-streptogramin (MLS) group of antibiotics. A high load of these agents increases the risk of transmission of resistant bacteria and/or resistance determinants to humans, leading to a subsequent therapeutic failure. An increasing incidence of bacteria resistant to both tetracyclines and MLS antibiotics has been recently observed. This review summarizes the current knowledge on different tetracycline and MLS resistance genes that can be linked together on transposable elements

Resistance to the tetracyclines and macrolide-lincosamide-streptogramin group of antibiotics and its genetic linkage – a review

An excessive use of antimicrobial agents poses a risk for the selection of resistant bacteria. Of particular interest are antibiotics that have large consumption rates in both veterinary and human medicine, such as the tetracyclines and macrolide-lincosamide-streptogramin (MLS) group of antibiotics. A high load of these agents increases the risk of transmission of resistant bacteria and/or resistance determinants to humans, leading to a subsequent therapeutic failure. An increasing incidence of bacteria resistant to both tetracyclines and MLS antibiotics has been recently observed. This review summarizes the current knowledge on different tetracycline and MLS resistance genes that can be linked together on transposable elements

Mass gathering events and undetected transmission of SARS-CoV-2 in vulnerable populations leading to an outbreak with high case fatality ratio in the district of Tirschenreuth, Germany

In early March 2020, a COVID-19-outbreak occurred in the district of Tirschenreuth, Germany. The outbreak was characterised by a rapid increase in case numbers and a comparatively high crude case fatality ratio (CFR; 11%). Until the beginning of May 2020, 1122 cases were reported in the district. To investigate the outbreak, we analysed surveillance and other data available at the district health department, including data on cases living in care facilities and public health measures applied. Furthermore, we compared the number of tests performed in Tirschenreuth and in Germany as a whole. We interviewed the first 110 cases in order to investigate potential exposures at the beginning of the outbreak. We found that returning ski-travellers from Austria and Italy and early undetected community transmission likely initiated the outbreak which was then accelerated by Bavarian beer festivities. Testing of mainly acute cases in the district of Tirschenreuth resulted in a higher rate of positive tests compared to the whole of Germany. Despite adjustment for age, the CFR continued to exceed the German mean which was due to spread to vulnerable populations. Strict public health measures likely contributed to control the outbreak by mid-April 2020

Datteln als wahrscheinliches Vehikel in einem Hepatitis-A-Ausbruch unter Reiserückkehrern aus Marokko, 2018

Das Hepatitis-A-Virus wird häufig indirekt über kontaminiertes Wasser und Lebensmittel übertragen. Es ist vor allem in nicht-industrialisierten Ländern hoch endemisch, während industrialisierte Länder generell eine niedrige Prävalenz aufweisen. Im Jahr 2018 wurden dem RKI in der zweiten Aprilhälfte vermehrt Hepatitis-A-Fälle mit Marokko als vermutetem Infektionsort übermittelt. Es wurde eine Ausbruchsuntersuchung eingeleitet, deren Ergebnisse im Epidemiologischen Bulletin 25/2019 vorgestellt werden. Insgesamt konnten 39 Personen dem Ausbruch zugeordnet werden. Die Ergebnisse geben einen deutlichen Anhalt dafür, dass dieser Ausbruch durch kontaminierte Datteln verursacht wurde. Eine aktive HAV-Impfung vor einem Aufenthalt in Marokko ist reisemedizinisch indiziert.Peer Reviewe

Kontrolle eines COVID-19-Ausbruches im Landkreis Tirschenreuth, März bis Mai 2020

Die vorgestellten Analysen beruhen auf den vom Gesundheitsamt Tirschenreuth an das RKI übermittelten Meldedaten und machen den hohen Stellenwert deutlich, den diese Daten an der Aufklärung von Ausbruchsgeschehen haben. Die Untersuchungen zeigen, dass SARS-CoV-2 ohne effiziente Kontrollmaßnahmen zu großen Ausbrüchen mit hoher Fallsterblichkeit unter Risikogruppen und in Pflege- und Altenheimen führen kann. Kontrollmaßnahmen sind daher unabdingbar und bedürfen eines gut aufgestellten ÖGD, der Kooperationsbereitschaft der Bevölkerung und eines belastbaren Gesundheitssystems, das Erkrankte versorgen und nosokomiale Ausbrüche verhindern kann

Hepatitis A Outbreak in the General Population due to a MSM-Associated HAV Genotype Linked to a Food Handler, November 2017–February 2018, Germany

Hepatitis A (HAV) is a viral infection causing a range of symptoms, sudden onset of fever, malaise, diarrhea, and jaundice. It is mostly transmitted fecal-oral through contaminated food, with immediate household and sexual contacts having a higher risk of infection. Since 2016 an increased number of HAV infections, mostly affecting men who have sex with men (MSM) have been noticed worldwide, with three main genotypes circulating. We report here on the first spillover outbreak of the MSM-associated HAV genotype RIVM-HAV16-090 in the German general population in November 2017-February 2018. In total, twelve cases could be attributed to the outbreak with the index case and a coworker in a butchers shop being the most probable source of the outbreak. The identical HAV genotype was detected in two environmental samples in the premises of the butchers shop and in nine cases. Outbreak control measures included detailed contact tracing and stool examinations, several environmental investigations, thorough cleaning, and disinfection of the premises of the butchers shop. Post-exposure vaccination was recommended to all unprotected contacts during the investigation. Furthermore, although hand-washing facilities were in accordance with the required law, additional installment of soap and disinfectant dispensers and contactless faucets has been recommended

Übertragung von Hautdiphtherie innerhalb einer Familie – Erster Diphtherie-Ausbruch in Deutschland seit fast 40 Jahren

Im Epidemiologischen Bulletin 20/2019 wird der Fall einer Übertragung von Hautdiphtherie zwischen zwei Geschwistern geschildert, der erste Diphtherie-Ausbruch in Deutschland seit mehr als 30 Jahren. Das klinische Bild der Diphtherie kann das einer schweren Rachenentzündung annehmen (Rachendiphtherie), die durch toxinproduzierende Bakterien der Art Corynebacterium diphtheriae oder anderer Arten, z.B. C. ulcerans, hervorgerufen wird. Bei einer Hautdiphtherie werden toxinproduzierende Erreger in Wunden nachgewiesen.Peer Reviewe