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BackgroundAntimicrobial resistance (AMR) is of public health concern worldwide. AimWe aimed to summarise the German AMR situation for clinicians and microbiologists. MethodsWe conducted a systematic review and meta-analysis of 60 published studies and data from the German Antibiotic-Resistance-Surveillance (ARS). Primary outcomes were AMR proportions in bacterial isolates from infected patients in Germany (2016–2021) and the case fatality rates (2010–2021). Random and fixed (common) effect models were used to calculate pooled proportions and pooled case fatality odds ratios, respectively. ResultsThe pooled proportion of meticillin resistance in Staphylococcus aureus infections (MRSA) was 7.9% with a declining trend between 2014 and 2020 (odds ratio (OR) = 0.89; 95% CI: 0.886–0.891; p 

Pneumonia -- IraqFollowing a surge in meningitis cases in Halabjah City and Sulaymaniyah governorate since mid-April 2023, an expert team from the World Health Organization (WHO) and the Ministry of Health was deployed to the affected areas to perform a joint epidemiological investigation of the reported cases and develop a swift response plan to curb the transmission of the disease.Preliminary laboratory results from 24 collected samples showed a mixture of bacterial (_Streptococcus pneumoniae_) and viral…

Hospital-Related Infection -- United StatesA bacterial outbreak at Virginia Mason Medical Center in Seattle has sickened 31 patients since October [2022]. Seven of them have since died, but it\'s unknown what caused those deaths -- the infection or the diagnoses that brought them to the hospital in the first place._Klebsiella pneumoniae_ is a bacterium usually found in health care settings, and often resistant to antibiotics. It can cause pneumonia, meningitis, and wound or bloodstream infections.Virginia Mason is working with…

Porcine Circovirus -- United StatesThe latest Swine Disease Reporting System report has some people scratching their heads. For the 1st time in recent memory, porcine circovirus type 2 (PCV2) jumped into the top 10 most-diagnosed diseases list at the Iowa State University Veterinary Diagnostic Lab. At No. 9, it surpassed porcine epidemic diarrhea virus and came in just behind _Mycoplasma hyopneumoniae_.Porcine-circovirus-associated disease (PCVAD) can be caused by any PCV2 strain. When PCVAD 1st showed up in the US in…

Meningitis -- NigeriaBetween 1 Oct 2022 and 16 Apr 2023, Nigeria reported a total of 1686 suspected cases of meningitis, including 124 deaths, for a case fatality ratio (CFR) of 7%.Meningitis is a serious infection of the meninges, the membranes covering the brain and spinal cord. It is a devastating disease and a major public health challenge. _Neisseria meningitidis_ (meningococcus), _Streptococcus pneumoniae_ (pneumococcus), _Haemophilus influenzae_ [serotype b or Hib] and _Streptococcus agalactiae_ (group…

Klebsiella pneumoniae -- United StatesFour patients at a downtown Seattle hospital are dead in connection to an outbreak of a bacterium often found in healthcare settings that has developed resistance to some antibiotics.The [31] infected patients, who contracted _Klebsiella_, were hospitalized in various departments, including inpatient medical beds, an ICU, and an operating room at Virginia Mason Medical Center, the hospital said in a statement released Wednesday [26 Apr 2023].Beginning in October 2022, hospital staff…

A hypervirulent Klebsiella pneumoniae SL218 (ST23-KL57), phylogenetically distinct from the classical hypervirulent SL23 (ST23-KL1) lineage, was transmitted between hospitalised patients in Denmark in 2021. The isolate carried a hybrid resistance and virulence plasmid containing blaNDM-1 and a plasmid containing blaOXA-48 (pOXA-48); the latter plasmid was horizontally transferred within-patient to Serratia marcescens. The convergence of drug resistance and virulence factors in single plasmids and in different lineages of K. pneumoniae is concerning and requires surveillance. …

Legionnaires' -- United StatesThe New Jersey Department of Health is conducting an investigation after 7 people contracted Legionnaire's disease -- and 2 have died -- in areas of Mercer County that are served by Trenton Water Works.In announcing the investigation on Monday [27 Mar 2023], officials said that, between October of last year [2022] and this month [March 2023], 7 people throughout Trenton, Ewing Township, Lawrence Township, and Hamilton Township have contracted the disease -- a type of pneumonia. Of the 7…

Meningitis - Strep/Pneumoccocal -- TogoIn a follow-up on the meningitis outbreak in Togo, the Togolese Ministry of Health now reports a total of 123 suspected cases of meningitis reported in the Oti Sud district [Savanes region], including 12 deaths, through 19 Mar 2023.The national reference laboratory confirmed the presence of _Streptococcus pneumoniae_ in 17 cases by polymerase chain reaction (PCR) and culture. Nearly 85% of the cases are over 10 years of age, individuals born before the introduction of the pneumococcal…

In Finland, all microbiology laboratories notify Legionella findings and physicians notify Legionnaires’ disease (LD) cases to the National Infectious Disease Register. All cases are interviewed, and water samples obtained from potential places of exposure. Legionella isolates from humans and water are compared by whole genome sequencing (WGS). In March 2021, Legionella pneumophila serogroup 1 (Lp 1) pneumonia cases increased in one Finnish city (120,000 inhabitants) where single LD cases are detected annually. We identified 12 LD cases, nine living in different residential buildings and three nosocomial, linked by identical human and/or water isolates. Three of these cases were from January 2020, October 2020 and February 2021 and identified retrospectively. Eleven were diagnosed by urinary antigen test, 10 by PCR and five by culture; age ranged between 52 and 85 years, and 10 had underlying diseases. Nine of 12 homes of LD cases and 15 of 26 water samples from the hospital were positive for Lp 1, with concentrations up to 640,000 cfu/L. Water samples from regional storage tanks were negative. Positivity in homes and the hospital suggested inadequate maintenance measures. Enhanced surveillance combined with WGS was crucial in detecting this unusual LD outbreak related to domestic and hospital water systems.…

Hospital-Related Infection -- United StatesIncreased water testing protocols are in effect at The Christ Hospital in Mt. Auburn after 3 patients recently tested positive for the presence of _Legionella_, according to a hospital spokesperson._Legionella_ is 'a common organism routinely found in the public water supply,' the spokesperson said late Friday [10 Mar 2023]. It isn't clear whether those patients are diagnosed with Legionnaires' disease, a serious type of pneumonia caused by _Legionella_ bacteria. The hospital has not…

Q Fever -- A large number of wild [see comment] goats, which have been a long-standing problem for the inhabitants of the small Adriatic island of Unije [of the Cres-Lošinj archipelago] are infected with Q fever.As 'Novi List' writes, tissue samples from dead or shot animals show this, with the note that this infection in humans can cause symptoms similar to flu or pneumonia, and in a small number of cases, damage to the heart, brain, liver, and lungs.According to estimates, there are about 400…

Equine Herpes Virus -- SpainNine horses are receiving 'close monitoring' in hospital in Valencia, 8 of which are showing neurological signs of equine herpesvirus (EHV-1).H&H reported that the organisers of the Mediterranean Equestrian Tour in Oliva Nova, Spain, had cancelled the 2nd part of the showjumping tour (7-26 Feb [2023]) as 4 horses on-site had tested positive for EHV-1. Ten horses, 6 of whom were showing signs of illness, were put in isolation on 21 Feb [2023]. Swabs were taken, 4 of which were positive, 4…

Toxoplasmosis -- United StatesFisk EA, Cassirer EF, Huggler KS, et al. Abortion and neonatal mortality due to _Toxoplasma gondii_ in bighorn sheep (_Ovis canadensis_). J. Wildl. Dis. 2023; . Epub ahead of print.Bighorn sheep have experienced disease driven impact for several years, and thus the health dimension is a very important aspect of their conservation. Many mortality episodes have been caused by bighorn sheep pneumonia, which is mainly caused by _Mycoplasma ovipneumoniae_ (Movi), an exotic disease agent for…

Bovine Pleuropneumonia -- UgandaBovine pleuropneumonia kills 300 cattle in Agago. The disease has been confirmed in 3 sub-counties; Paimol, Laimuto, and Omiya Pachwa, where the majority of farmers were advised to keep their animals in communal kraals [enclosures for cattle or other livestock], to protect them against Karamojong cattle rustlers.--Communicated by:ProMED Rapporteur Mahmoud Orabi['Contagious bovine pleuropneumonia (CBPP) is a disease of cattle and water buffalo caused by _Mycoplasma mycoides_ subsp.

BackgroundSince the beginning of the war in Ukraine in February 2022, Ukrainians have been seeking shelter in other European countries.AimWe aimed to investigate the prevalence and the molecular epidemiology of multidrug-resistant Gram-negative (MDRGN) bacteria and meticillin-resistant Staphylococcus aureus (MRSA) in Ukrainian patients at admittance to the University Hospital Frankfurt, Germany.MethodsWe performed screening and observational analysis of all patients from March until June 2022. Genomes of MDRGN isolates were analysed for antimicrobial resistance, virulence genes and phylogenetic relatedness.ResultsWe included 103 patients (median age: 39 ± 23.7 years), 57 of whom were female (55.3%; 95% confidence interval (CI): 45.2–5.1). Patients were most frequently admitted to the Department of Paediatrics (29/103; 28.2%; 95% CI: 19.7–37.9). We found 34 MDRGN isolates in 17 of 103 patients (16.5%; 95% CI: 9.9–25.1). Ten patients carried 21 carbapenem-resistant (CR) bacteria, five of them more than one CR isolate. Four of six patients with war-related injuries carried eight CR isolates. In six of 10 patients, CR isolates caused infections. Genomic characterisation revealed that the CR isolates harboured at least one carbapenemase gene, blaNDM-1 being the most frequent (n = 10). Core genome and plasmid analysis revealed no epidemiological connection between most of these isolates. Hypervirulence marker genes were found in five of six Klebsiella pneumoniae CR isolates. No MRSA was found.ConclusionHospitals should consider infection control strategies to cover the elevated prevalence of MDRGN bacteria in Ukrainian patients with war-related injuries and/or hospital pre-treatment and to prevent the spread of hypervirulent CR isolates.…

Strep -- United StatesAbstract---------'Based on a survey sent to 7 Dutch hospitals, we observed a substantial increase in invasive group A streptococcal infections in children in the Netherlands, comparing the pre-COVID-19 pandemic cohort of 2018-2019 to 2021-2022. The most affected age group were children between 0-5 years. Main diagnosis was pneumonia with empyema. Necrotizing fasciitis and streptococcal toxic shock syndrome were also reported in 11% and 7%, respectively. A significant number was admitted to…

Legionnaires' -- United StatesCamden County [New Jersey] and state health authorities on Friday [16 Dec 2022] reported a cluster of Legionnaires' disease, a type of pneumonia, in 4 Pennsauken residents.Camden County Health Officer Paschal Nwako said that officials are trying to determine how and where the people got infected so they can prevent further transmission. The source could be outside Pennsauken, he added.One person is hospitalized, while the other 3 are recovering at home, Nwako said. The 1st case was…

In 2022, German surveillance systems observed rapidly increasing numbers of NDM-1- and NDM-1/OXA-48-producing Klebsiella pneumoniae, which may in part reflect recurring pre-pandemic trends. Among these cases, however, a presence in Ukraine before diagnosis was frequently reported. Whole genome sequencing of 200 isolates showed a high prevalence of sequence types ST147, ST307, ST395 and ST23, including clusters corresponding to clonal dissemination and suggesting onward transmission in Germany. Screening and isolation of patients from Ukraine may help avoid onward transmission.…

Older adults who received the 13-valent pneumococcal conjugate vaccine were less likely to be hospitalized for pneumonia, a new study found. Medscape Medical News…