Immunogenität und Effektivität von adenoviralen Vektor-Impfstoffen gegen das Respiratorische Synzytialvirus

Das Respiratorische Synzytialvirus (RSV) zählt zu den wichtigsten Erregern akuter Atemwegsinfektionen, wobei fulminante und komplikationsreiche Krankheitsverläufe auftreten können. Die Disease Burden von RSV ist mit der des Influenza-Virus vergleichbar, dennoch ist bisher kein Impfstoff verfügbar. Es wurden daher nun neue Impfstoffe hergestellt, indem verschiedene kodonoptimierte Gene für das RSV-F-Oberflächenprotein erstmals im adenoviralen Vektor verwendet wurden. Diese adenoviralen RSV-Impfstoffe wurden in einer speziellen Zellkultur produziert, in vitro hinsichtlich ihrer Funktionalität überprüft und anschließend entsprechend einer homologen Prime-Boost-Strategie im Rahmen verschiedenster Impfstudien im Mausmodell bezüglich ihrer Immunogenität und Effektivität analysiert. Insgesamt erwiesen sich die neuen Impfstoffe dabei als gut verträglich, hochimmunogen und protektiv, sodass sie äußerst vielversprechende Kandidaten für einen zukünftigen kommerziellen humanen RSV-Impfstoff sind

Analysis and presentation of cumulative antimicrobial susceptibility test data

$\bf Introduction$ Many clinical microbiology laboratories report on cumulative antimicrobial susceptibility testing (cAST) data on a regular basis. Criteria for generation of cAST reports, however, are often obscure and inconsistent. Whereas the CLSI has published a guideline for analysis and presentation of cAST data, national guidelines directed at clinical microbiology laboratories are not available in Europe. Thus, we sought to describe the influence of different parameters in the process of cAST data analysis in the setting of a German routine clinical microbiology laboratory during 2 consecutive years. $\textbf {Material and Methods}$ We developed various program scripts to assess the consequences ensuing from different algorithms for calculation of cumulative antibiograms from the data collected in our clinical microbiology laboratory in 2013 and 2014. $\bf Results$ One of the most pronounced effects was caused by exclusion of screening cultures for multi-drug resistant organisms which decreased the MRSA rate in some cases to one third. Dependent on the handling of duplicate isolates, i.e. isolates of the same species recovered from successive cultures on the same patient during the time period analyzed, we recorded differences in resistance rates of up to 5 percentage points for $\textit {S. aureus, E.coli}$ and $\textit {K. pneumoniae}$ and up to 10 percentage points for $\textit {P. aeruginosa.}$ Stratification by site of care and specimen type, testing of antimicrobials selectively on resistant isolates, change of interpretation rules and analysis at genus level instead of species level resulted in further changes of calculated antimicrobial resistance rates. $\bf Conclusion$ The choice of parameters for cAST data analysis may have a substantial influence on calculated antimicrobial resistance rates. Consequently, comparability of cAST reports from different clinical microbiology laboratories may be limited. We suggest that laboratories communicate the strategy used for cAST data analysis as long as national guidelines for standardized cAST data analysis and reporting do not exist in Europe

Resistance estimates dependent on the method of duplicate isolate removal.

<p>Resistance rates were calculated using different methods of duplicate isolate removal, as described in the text. Further details are given in the supporting information (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0147965#pone.0147965.s002" target="_blank">S2 Table</a>).</p

Resistance estimates dependent on the patient location.

<p>Resistance rates were calculated with data stratification according to the patient location (hospital and ward), as described in the text. Further details are given in the supporting information (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0147965#pone.0147965.s004" target="_blank">S4 Table</a>).</p

Resistance estimates dependent on the specimen type.

<p>Resistance rates were calculated with data stratification according to the specimen type (black columns: isolates recovered from blood cultures, grey columns: isolates recovered from other body sites), as described in the text. Further details are given in the supporting information (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0147965#pone.0147965.s005" target="_blank">S5 Table</a>).</p

Resistance estimates dependent on organism’s resistance characteristics.

<p>Resistance rates were calculated with data stratification according to cefotaxime-resistance (all isolates: dark grey columns, only resistant strains: black columns, only susceptible strains: light grey columns), as described in the text. Further details are given in the supporting information (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0147965#pone.0147965.s006" target="_blank">S6 Table</a>).</p

Resistance estimates dependent on the time-point of isolate recovery.

<p>Resistance rates were calculated with respect to early isolates (black columns) or late isolates (grey columns), as described in the text. Further details are given in the supporting information (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0147965#pone.0147965.s003" target="_blank">S3 Table</a>).</p

Community-acquired adult Escherichia coli\textit {Escherichia coli} meningitis leading to diagnosis of unrecognized retropharyngeal abscess and cervical spondylodiscitis

$\bf Background:$ $\textit {Escherichia coli}$ is a rare cause of community-acquired meningitis in adults unless predisposing factors are present (e.g., previous penetrating cranio-cerebral injury or neurosurgery, immunosuppression, chronic alcoholism, history of cancer, diabetes mellitus, advanced age). $\textbf {Case presentation:}$ We describe the case of a 53-year-old woman, resident in Germany, suffering from community-acquired bacterial meningitis caused by CTX-M-9 type extended spectrum $\beta$-lactamase producing $\textit {Escherichia coli}$. Because typical predisposing factors were not apparent, pathogen identification resulted in expanded diagnostics to exclude a distant or contiguous primary focus. By magnetic resonance tomography, a previously unrecognized large retropharyngeal abscess with cervical spondylodiscitis was detected. In retrospect, the patient had complained about neck pain for a few weeks prior to meningitis onset, but the symptoms were interpreted as being related to a herniated disk. Meningitis and osteomyelitis resolved completely under surgical treatment and meropenem therapy. $\bf Conclusion:$ In case of adult $\textit {Escherichia coli}$ meningitis, underlying diseases should always be carefully excluded, especially if predisposing factors are not apparent