| 51. |
- Osbjer, Kristina, et al.
(författare)
-
Risk factors associated with Campylobacter detected by PCR in humans and animals in rural Cambodia
- 2016
-
Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 144:14, s. 2979-2988
-
Tidskriftsartikel (refereegranskat)abstract
- Campylobacter are worldwide-occurring zoonotic bacteria, with the species Campylobacter jejuni and C. coli commonly associated with diarrhoea in children in low-income countries. In this cross-sectional study, the prevalence of C. jejuni and C. coli in human and livestock faecal samples was detected by PCR and zoonotic risk factors associated with human Campylobacter positivity were identified. In total 681 humans and 753 livestock (chickens, ducks, pigs, cattle) from 269 households were sampled. Children aged < 16 years were more frequently Campylobacter positive (19%) than adults (8%) and multilevel logistic models revealed that human C. jejuni positivity was associated with the following household practices: home-slaughtering [odds ratio (OR) 2.4, P = 0.01], allowing animals access to sleeping and food preparation areas (OR 2.8, P = 0.02), and eating undercooked meat (OR 6.6, P = 0.05), while frequent consumption of beef was protective (OR 0.9, P = 0.05). Associations were stronger for home-slaughtering (OR 4.9, P = 0.004) with C. jejuni infection in children only. Campylobacter was highly prevalent in pigs (72%) and chickens (56%) and risk factors associated with human Campylobacter positivity were identified throughout the meat production chain. The findings underline the importance of studying source attributions throughout the production chain and the need for upgraded understanding of Campylobacter epidemiology in low-income countries.
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| 52. |
- Palmgren, Helena, 1955-, et al.
(författare)
-
Salmonella in Black-headed gulls ( Larus ridibundus); prevalence, genotypes and influence on Salmonella epidemiology.
- 2006
-
Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 134:3, s. 635-644
-
Tidskriftsartikel (refereegranskat)abstract
- During a period of 3 years, 1998-2000, 1047 faecal swabs from Black-headed gulls were sampled at one location in Southern Sweden. Salmonella spp. was found in 28 individuals (2.7%) and the dominating serotype found was S. Typhimurium (83%). Twenty-five per cent of the Salmonella-infected gulls were later recaptured and re-sampled. We found that Salmonella infection in Black-headed gulls was of short duration, and that infection in this bird species was predominantly expressed as carriage without disease manifestations. All S. Typhimurium isolates were subjected to antibiotic resistance profiling and molecular characterization by pulsed-field gel electrophoresis and IS200 polymerase chain reaction. The S. Typhimurium gull isolates were compared to human and domestic animal isolates of the same serotype and phage type. We found genetic relatedness of S. Typhimurium DT195 isolates from gulls, domestic animals and humans, indicating that Black-headed gulls might play a role in the spread of S. Typhimurium in Sweden.
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| 53. |
- Palmgren, Helena, 1955-, et al.
(författare)
-
Salmonella in sub-Antarctica : low heterogeneity in salmonella serotypes in South Georgian seals and birds
- 2000
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 125:2, s. 257-262
-
Tidskriftsartikel (refereegranskat)abstract
- The number of human visitors to Antarctica is increasing rapidly, and with it a risk of introducing infectious organisms to native animals. To study the occurrence of salmonella serotypes in sub- Antarctic wildlife, faecal samples were collected from gentoo penguins, macaroni penguins, gray-headed albatrosses, black-browed albatrosses and Antarctic fur seals on Bird Island in the South Georgian archipelago during the austral summer of 1996 and 1998. In 1996, S. havana, S. typhimurium and S. enteritidis were isolated from 7% of gentoo penguins and 4% of fur seals. In 1998, however, 22% of fur seals were found to be infected with S. havana, S. enteritidis and S. newport. All isolates, except one, showed identical pulsed-field gel electrophoresis-patterns within each serotype, irrespective of sampling year and animal reservoir. No significant antibiotic resistance was found. The very low heterogeneity in the salmonella isolates found could either indicate a high genetic adaptation of the bacteria to the environment or a recent introduction of salmonella into the area.
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| 54. |
- Pini, A., et al.
(författare)
-
High added value of a population-based participatory surveillance system for community acute gastrointestinal, respiratory and influenza-like illnesses in Sweden, 2013-2014 using the web
- 2017
-
Ingår i: Epidemiology and Infection. - : CAMBRIDGE UNIV PRESS. - 0950-2688 .- 1469-4409. ; 145:6, s. 1193-1202
-
Tidskriftsartikel (refereegranskat)abstract
- In 2013-2014, the Public Health Agency of Sweden developed a web-based participatory surveillance system, Halsorapport, based on a random sample of individuals reporting symptoms weekly online, to estimate the community incidence of self-reported acute gastrointestinal (AGI), acute respiratory (ARI) and influenza-like (ILI) illnesses and their severity. We evaluated Halsorapport's acceptability, completeness, representativeness and its data correlation with other surveillance data. We calculated response proportions and Spearman correlation coefficients (r) between (i) incidence of illnesses in Halsorapport and (ii) proportions of specific search terms to medical-advice website and reasons for calling a medical advice hotline. Of 34 748 invitees, 3245 (9.3%) joined the cohort. Participants answered 81% (139 013) of the weekly questionnaires and 90% (16 351) of follow-up questionnaires. AGI incidence correlated with searches on winter-vomiting disease [r = 0.81, 95% confidence interval (CI) 0.69-0.89], and ARI incidence correlated with searches on cough (r = 0.77, 95% CI 0.62-0.86). ILI incidence correlated with the web query-based estimated incidence of ILI patients consulting physicians (r = 0.63, 95% CI 0.420-0.77). The high response to different questionnaires and the correlation with other syndromic surveillance systems suggest that Halsorapport offers a reasonable representation of AGI, ARI and ILI patterns in the community and can complement traditional and syndromic surveillance systems to estimate their burden in the community.
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| 55. |
- Pringle, Märit, et al.
(författare)
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Characterization and epidemiological relationships of Spanish Brachyspira hyodysenteriae field isolates
- 2010
-
Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 138, s. 76-85
-
Tidskriftsartikel (refereegranskat)abstract
- This research aimed to describe the genetic and phenotypic diversity of 74 Spanish Brachyspira hyodysenteriae field isolates, to establish epidemiological relationships between the isolates and to confirm the presence of tiamulin-resistant isolates in Spain. For these purposes, we performed biochemical tests in combination with diagnostic PCR analysis for the identification of Brachyspira spp. and for detection of the smpA/smpB gene. We also used antimicrobial susceptibility tests, random amplified polymorphic DNA (RAPD) and a new pulsed-field gel electrophoresis (PFGE) protocol. The combination of RAPD and PFGE allowed the study of epidemiological relationships. Both indole-negative and tiamulin-resistant isolates of B. hyodysenteriae are reported in Spain for the first time. The genetic analyses indicated a relationship between these Spanish isolates and indole-negative isolates previously obtained from Germany and Belgium.
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| 56. |
- Röckert Tjernberg, Anna, 1975-, et al.
(författare)
-
Coeliac disease and invasive pneumococcal disease : a population-based cohort study
- 2017
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 145:6, s. 1203-1209
-
Tidskriftsartikel (refereegranskat)abstract
- Severe infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0.15%) and 162/144 257 were controls (0.11%). This corresponded to a 46% increased risk for IPD [HR 1.46, 95% confidence interval (CI) 1.05-2.03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1.40, 95% CI 0.99-1.97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.
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| 57. |
- Rönnelid, Ylva, et al.
(författare)
-
Norovirus and rotavirus in children hospitalised with diarrhoea after rotavirus vaccine introduction in Burkina Faso
- 2020
-
Ingår i: Epidemiology and Infection. - : CAMBRIDGE UNIV PRESS. - 0950-2688 .- 1469-4409. ; 148
-
Tidskriftsartikel (refereegranskat)abstract
- Several studies report norovirus as the new leading cause of severe gastroenteritis in children after the global introduction of rotavirus vaccines. Burkina Faso introduced general rotavirus vaccination with the oral pentavalent vaccine RotaTeq in November 2013 and quickly reached a vaccine coverage of >90%. This study describes detection rates, clinical profiles and the molecular epidemiology of norovirus and rotavirus infections in 146 children aged <5 years with severe acute gastroenteritis in Ouagadougou, consecutively enrolled from a hospital between January 2015 and December 2015. Virus detection was performed with an antigen test or real-time polymerase chain reaction (PCR) and genotyping was performed by nucleotide sequencing or multiplex PCR. Rotavirus was found in 14% and norovirus in 20% of faecal samples. Norovirus infection was significantly more associated with severe dehydration compared to rotavirus (P < 0.001). Among genotyped norovirus samples 48% (12/25) belonged to GII.4 which caused significantly more diarrhoeal episodes than non-GII.4 genotypes (P = 0.01). The most common rotavirus genotypes were G2P[4] (30%), G12P[6] (25%) and G12P[8] (20%). Fifty percent of the rotavirus positive children were infected with fully or partly heterotypic strains. In conclusion, this study found a higher proportion of norovirus causing more severe symptoms in children with diarrhoea in Burkina Faso after the introduction of rotavirus vaccination.
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| 58. |
- Sannö, Axel, et al.
(författare)
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Presence of Salmonella spp., Yersinia enterocolitica, Yersinia pseudotuberculosis and Escherichia coli O157:H7 in wild boars
- 2014
-
Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 142, s. 2542-2547
-
Tidskriftsartikel (refereegranskat)abstract
- The European wild boar populations are growing and spreading to new areas, which might constitute a threat to public health, since wild boar can harbour pathogens with the potential to cause serious illness in humans. Tonsils, ileocaecal lymph nodes and faecal samples were collected from 88 Swedish wild boars and analysed for the presence of the zoonotic pathogens Salmonella spp., Yersinia enterocolitica, Y. pseudotuberculosis and enterohaemorrhagic Escherichia coli O157:H7 (EHEC). A combination of cultivation and polymerase chain reaction (PCR) analysis was used and overall, 20% of sampled individuals tested positive for Y. enterocolitica, 20% for Y. pseudotuberculosis and 10% for Salmonella spp. A total of 41% of sampled individuals tested positive for one or more of these three pathogens. No EHEC were detected. Samples PCR-positive for Salmonella spp. were cultivated further and six isolates were obtained, belonging to Salmonella enterica subspecies enterica and subspecies diarizone. The pathogens were most commonly detected in tonsil samples.
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| 59. |
- Schönberg-Norio, Daniela, et al.
(författare)
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Patient-reported complications associated with Campylobacter jejuni infection
- 2010
-
Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 138:7, s. 1004-1011
-
Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate the occurrence of complications, especially musculoskeletal symptoms, after sporadic Campylobacter jejuni enteritis of domestic origin in Finland. This multi-centre cross-sectional study was conducted during a seasonal peak in 2002. Questionnaires were sent to Campylobacter-positive patients, representing different geographical areas, 2 months after collection of positive stool samples. Medical records were viewed in several cases. Besides antimicrobial susceptibility testing C. jejuni isolates were serotyped. A total of 235 patients (58%) returned the questionnaire and 201 C. jejuni-positive patients were finally included in the study. Musculoskeletal symptoms associated with C. jejuni enteritis were frequent (39%); joint pain was most commonly reported (81%). The incidence of reactive arthritis was 4% and that of Achilles enthesopathy and/or heel pain was 9%. Stomach ache during enteritis was associated with the later development of joint pain. Antimicrobial treatment was common but did not prevent complications.
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| 60. |
- Silverlås, Charlotte, et al.
(författare)
-
Cryptosporidium spp. in calves and cows from organic and conventional dairy herds
- 2013
-
Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 141, s. 529-539
-
Tidskriftsartikel (refereegranskat)abstract
- A cohort study was performed to investigate cryptosporidial prevalence and species distribution in 13 organic and 13 conventional dairy herds. Faecal samples were collected from 221 calves and 259 cows. Management routines were recorded at farm inspection and through a questionnaire. Samples were concentrated using sodium chloride flotation and cryptosporidial oocysts were detected by epifluorescence microscopy. Molecular analysis was used to determine species and subtypes. A multivariable model for factors associated with calves being Cryptosporidium spp. positive was built. Cryptosporidium spp.-positive animals were identified in all herds. Prevalences were similar in organic and conventional calves (44.7% vs. 52.3%), as well as in cows (3.1% vs. 3.8%), P>0.05. Cryptosporidium bovis, C. ryanae and C. parvum were identified. C. ryanae was identified in a calf younger than the described prepatent period. The multivariable model included four significant variables; calf age, cleanliness of bedding, cleaning routines for group pens and farmers' attitudes towards biosecurity.
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| 61. |
- Spiteri, G., et al.
(författare)
-
The resurgence of syphilis in high-income countries in the 2000s : a focus on Europe
- 2019
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 147
-
Forskningsöversikt (refereegranskat)abstract
- Syphilis can cause severe complications and sequelae. Following a decrease in reported cases in European Union/ European Economic Area (EU/ EEA) and other high-income countries in the 1980s and 1990s as a result of the HIV epidemic and ensuing changes in sexual behaviour, trends started to increase in the 2000s in a number of EU/ EEA Member States with higher rates among men and a large proportion of cases reported among men who have sex with men (MSM), particularly HIV-positive MSM. Trends in EU/ EEA Member States vary however with some countries continuing to report decreases in the number of reported cases (mostly in the Eastern part of EU/ EEA) whereas many Western European countries report increasing numbers of cases. Increasing rates among women, although still relatively low, have been observed in a number of countries leading to concerns around mother-to-child transmission of syphilis and congenital syphilis. Similar overall trends are observed in other high-income countries with the exception of Japan where rates among heterosexual men and women have been rising at alarming levels. Control of syphilis requires use of comprehensive, evidence-based strategies which take into account lessons learned from previous control efforts as well as consideration of biomedical interventions.
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| 62. |
- Spreco, Armin, et al.
(författare)
-
Influenza detection and prediction algorithms: comparative accuracy trial in Ostergotland county, Sweden, 2008-2012
- 2017
-
Ingår i: Epidemiology and Infection. - : CAMBRIDGE UNIV PRESS. - 0950-2688 .- 1469-4409. ; 145:10, s. 2166-2175
-
Tidskriftsartikel (refereegranskat)abstract
- Methods for the detection of influenza epidemics and prediction of their progress have seldom been comparatively evaluated using prospective designs. This study aimed to perform a prospective comparative trial of algorithms for the detection and prediction of increased local influenza activity. Data on clinical influenza diagnoses recorded by physicians and syndromic data from a telenursing service were used. Five detection and three prediction algorithms previously evaluated in public health settings were calibrated and then evaluated over 3 years. When applied on diagnostic data, only detection using the Serfling regression method and prediction using the non-adaptive log-linear regression method showed acceptable performances during winter influenza seasons. For the syndromic data, none of the detection algorithms displayed a satisfactory performance, while non-adaptive log-linear regression was the best performing prediction method. We conclude that evidence was found for that available algorithms for influenza detection and prediction display satisfactory performance when applied on local diagnostic data during winter influenza seasons. When applied on local syndromic data, the evaluated algorithms did not display consistent performance. Further evaluations and research on combination of methods of these types in public health information infrastructures for nowcasting (integrated detection and prediction) of influenza activity are warranted.
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| 63. |
- Stark, Lisa, et al.
(författare)
-
Prevalence and molecular epidemiology of Staphylococcus aureus in Swedish nursing homes-as revealed in the SHADES study dagger
- 2014
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 142:6, s. 1310-1316
-
Tidskriftsartikel (refereegranskat)abstract
- Knowledge of carriage and population dynamics of Staphylococcus aureus is crucial for infection risk assessment and to reveal transmission patterns of strains. We report the prevalence and molecular epidemiology of S. aureus in elderly people (n=290) living in nursing homes in three cities in the south of Sweden. The overall carriage prevalence rate was 48% when results from nares (31%) and throat (34%) samples were combined. Common spa types were equally distributed but a frequent type, t160, was found only in one of the regions. Carriage of different spa types was detected in 23% of individuals and antimicrobial resistance rates were higher in S. aureus isolates from those carrying more than one spa type. Five of the 21 individuals who carried different spa types were colonized simultaneously with resistant and non-resistant strains. Seventeen per cent of the individuals carried S. aureus of the same spa type on all occasions. Methicillin resistance was not detected. In conclusion we found a high prevalence of S. aureus in this elderly population with a high rate of dual colonization with different spa types. We also found signs of institutional spread of one strain.
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| 64. |
- Steptoe, A, et al.
(författare)
-
Pathogen burden and cortisol profiles over the day
- 2009
-
Ingår i: Epidemiology and Infection. - New York : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 137:12, s. 1816-1824
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Tidskriftsartikel (refereegranskat)abstract
- Hypothalamic-pituitary-adrenocortical (HPA) regulation in adults is influenced by early psychosocial adversity, but the role of infectious disease history is poorly understood. We studied the association between cumulative pathogen burden and cortisol profile over the day in a sample of 317 healthy men and women aged 51-72 years. Cumulative pathogen burden was defined as positive serostatus for Chlamydia pneumoniae, cytomegalovirus (CMV) and herpes simplex virus 1 (HSV-1). Salivary cortisol was sampled repeatedly over the day. The cortisol slope was defined as the decrease across the day and evening. Age, gender, grade of employment, body mass index, smoking status, self-rated health, cardiovascular medication, depressed mood and time of waking were included as covariates. The pathogen burden averaged 1.76 (S.D. = 0.92). The cortisol slope was inversely associated with pathogen burden after controlling for covariates. When individual pathogens were studied, only CMV was associated with flatter cortisol rhythms in isolation. We conclude that pathogen burden is independently associated with flatter cortisol slopes over the day, and may contribute to disturbed neuroendocrine regulation.
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| 65. |
- Strömgren, Magnus, et al.
(författare)
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Place-based social contact and mixing : a typology of generic meeting places of relevance for infectious disease transmission
- 2017
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 145:12, s. 2582-2593
-
Tidskriftsartikel (refereegranskat)abstract
- This study aims to develop a typology of generic meeting places based on social contact and mixing of relevance for infectious disease transmission. Data was collected by means of a contact diary survey conducted on a representative sample of the Swedish population. The typology is derived from a cluster analysis accounting for four dimensions associated with transmission risk: visit propensity and its characteristics in terms of duration, number of other persons present and likelihood of physical contact. In the analysis, we also study demographic, socioeconomic and geographical differences in the propensity of visiting meeting places. The typology identifies the family venue, the fixed activity site, the family vehicle, the trading plaza and the social network hub as generic meeting places. The meeting place typology represents a spatially explicit account of social contact and mixing relevant to infectious disease modelling where the social context of the outbreak can be highlighted in light of the actual infectious disease.
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| 66. |
- Säll, Olof, 1980-, et al.
(författare)
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Atypical presentation of Neisseria meningitidis serogroup W disease is associated with the introduction of the 2013 strain
- 2021
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 149
-
Tidskriftsartikel (refereegranskat)abstract
- Since 2015, the incidence of invasive meningococcal disease (IMD) caused by serogroup W (MenW) has increased in Sweden, due to the introduction of the 2013 strain belonging to clonal complex 11. The aim of this study was to describe the clinical presentation of MenW infections, in particular the 2013 strain, including genetic associations. Medical records of confirmed MenW IMD cases in Sweden during the years 1995-2019 (n = 113) were retrospectively reviewed and the clinical data analysed according to strain. Of all MenW patients, bacteraemia without the focus of infection was seen in 44%, bacteraemic pneumonia in 26%, meningitis in 13% and epiglottitis in 8%, gastrointestinal symptoms in 48% and 4% presented with petechiae. Phylogenetic analysis was used for possible links between genetic relationship and clinical picture. The 2013 strain infections, particularly in one cluster, were associated with more severe disease compared with other MenW infections. The patients with 2013 strain infections (n = 68) were older (52 years vs. 25 years for other strains), presented more often with diarrhoea as an atypical presentation (P = 0.045) and were more frequently admitted for intensive care (P = 0.032). There is a risk that the atypical clinical presentation of MenW infections, with predominantly gastrointestinal or respiratory symptoms rather than neck stiffness or petechiae, may lead to delay in life-saving treatment.
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| 67. |
- Säll, Olof, 1980-, et al.
(författare)
-
Clinical presentation of invasive disease caused by Neisseria meningitidis serogroup Y in Sweden, 1995 to 2012
- 2017
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 145:10, s. 2137-2143
-
Tidskriftsartikel (refereegranskat)abstract
- Over the period 1995-2012, the incidence of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup Y (NmY) increased significantly in Sweden. This is mainly due to the emergence of a predominant cluster named strain type YI subtype 1, belonging to the ST-23 clonal complex (cc). The aim of this study was to examine the clinical picture of patients with invasive disease caused by NmY and to analyse whether the predominant cluster exhibits certain clinical characteristics that might explain the increased incidence. In this retrospective observational study, the medical records available from patients with IMD caused by Nm serogroup Y in Sweden between 1995 and 2012 were systematically reviewed. Patient characteristics, in-hospital findings and outcome were studied and differences between the dominating cluster and other isolates were analysed. Medical records from 175 of 191 patients were retrieved. The median age was 62 years. The all-cause mortality within 30 days of admission was 9% (15/175) in the whole material; 4% (2/54) in the cohort with strain type YI subtype 1 and 11% (12/121) among patients with other isolates. Thirty-three per cent of the patients were diagnosed with meningitis, 19% with pneumonia, 10% with arthritis and 35% were found to have bacteraemia but no apparent organ manifestation. This survey included cases with an aggressive clinical course as well as cases with a relatively mild clinical presentation. There was a trend towards lower mortality and less-severe disease in the cohort with strain type YI subtype 1 compared with the group with other isolates.
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| 68. |
- Säll, Olof, 1980-, et al.
(författare)
-
Prevalence and persistence of Neisseria meningitidis carriage in Swedish university students
- 2023
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 151
-
Tidskriftsartikel (refereegranskat)abstract
- The bacterium Neisseria meningitidis causes life-threatening disease worldwide, typically with a clinical presentation of sepsis or meningitis, but can be carried asymptomatically as part of the normal human oropharyngeal microbiota. The aim of this study was to examine N. meningitidis carriage with regard to prevalence, risk factors for carriage, distribution of meningococcal lineages and persistence of meningococcal carriage. Throat samples and data from a self-reported questionnaire were obtained from 2744 university students (median age: 23 years) at a university in Sweden on four occasions during a 12-month period. Meningococcal isolates were characterised using whole-genome sequencing. The carriage rate among the students was 9.1% (319/3488; 95% CI 8.2-10.1). Factors associated with higher carriage rate were age ≤22 years, previous tonsillectomy, cigarette smoking, drinking alcohol and attending parties, pubs and clubs. Female gender and sharing a household with children aged 0-9 years were associated with lower carriage. The most frequent genogroups were capsule null locus (cnl), group B and group Y and the most commonly identified clonal complexes (cc) were cc198 and cc23. Persistent carriage with the same meningococcal strain for 12 months was observed in two students. Follow-up times exceeding 12 months are recommended for future studies investigating long-term carriage of N. meningitidis.
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| 69. |
- Tham, Wilhelm, 1951-, et al.
(författare)
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A listeriosis patient infected with two different Listeria monocytogenes strains
- 2002
-
Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 128:1, s. 105-106
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Tidskriftsartikel (refereegranskat)abstract
- Normally, only one isolate of Listeria monocytogenes from a case of listeriosis is subjected to characterization. Here we show that two isolates from different sites of the body were not the same strain. Such a phenomenon may not have any clinical relevance, although it may confuse the epidemiologist trying to match infection source with infection target.
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| 70. |
- Tham, Wilhelm, 1951-, et al.
(författare)
-
Bacteriological quality of on-farm manufactured goat cheese
- 1990
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Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 104, s. 87-100
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Tidskriftsartikel (refereegranskat)abstract
- The bacteriological quality of 198 ripened soft or semi-soft goat cheeses obtained from dairy farms and the retail trade was investigated. The cheeses were examined for total counts of aerobic bacteria, coliform bacteria (37 and 44 °C respectively), enterocoeci, coagulase positive staphylococci,Bacillus cereusandClostridium perfringens.Cheeses obtained from dairy-farms were also determined for pH value. In terms of all tests performed, cheeses made of heat-treated milk with starter culture had the best prospects for fulfilling the criteria for 'fit for consumption '. Cheeses made of raw milk without starter culture made up the most unsatisfactory group from a food-hygiene point of view. Bacteriological guidelines for on-farm manufactured goat cheese are suggested.
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| 71. |
- Tham, Wilhelm, 1951-, et al.
(författare)
-
More than one variant of Listeria monocytogenes isolated from each of two human cases of invasive listeriosis
- 2007
-
Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 135:5, s. 854-856
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Tidskriftsartikel (refereegranskat)abstract
- Two variants of Listeria monocytogenes were isolated from blood cultures from each of two patients with listeriosis. Each variant displayed a two-band difference in DNA profile from the other by pulsed-field gel electrophoresis. Although this difference in profile is insufficient to distinguish clearly between the variants, the possibility of co-infection with different strains of L. monocytogenes needs to be considered. We suggest that more than one colony should be selected for molecular typing to aid interpretation during investigation of the sources and routes of Listeria infection.
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| 72. |
- Timpka, Toomas, et al.
(författare)
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Relevance of workplace social mixing during influenza pandemics : an experimental modelling study of workplace cultures
- 2016
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 144:10, s. 2031-2042
-
Tidskriftsartikel (refereegranskat)abstract
- Workplaces are one of the most important regular meeting places in society. The aim of this study was to use simulation experiments to examine the impact of different workplace cultures on influenza dissemination during pandemics. The impact is investigated by experiments with defined social-mixing patterns at workplaces using semi-virtual models based on authentic sociodemographic and geographical data from a North European community (population 136 000). A simulated pandemic outbreak was found to affect 33% of the total population in the community with the reference academic-creative workplace culture; virus transmission at the workplace accounted for 10·6% of the cases. A model with a prevailing industrial-administrative workplace culture generated 11% lower incidence than the reference model, while the model with a self-employed workplace culture (also corresponding to a hypothetical scenario with all workplaces closed) produced 20% fewer cases. The model representing an academic-creative workplace culture with restricted workplace interaction generated 12% lower cumulative incidence compared to the reference model. The results display important theoretical associations between workplace social-mixing cultures and community-level incidence rates during influenza pandemics. Social interaction patterns at workplaces should be taken into consideration when analysing virus transmission patterns during influenza pandemics.
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| 73. |
- Torres, O. R., et al.
(författare)
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Toxins and virulence factors of enterotoxigenic Escherichia coli associated with strains isolated from indigenous children and international visitors to a rural community in Guatemala
- 2015
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press (CUP). - 0950-2688 .- 1469-4409. ; 143:8, s. 1662-1671
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Tidskriftsartikel (refereegranskat)abstract
- Diarrhoea remains a common cause of illness in Guatemala, with children suffering most frequently from the disease. This study directly compared the frequency, enterotoxin, and colonization factor (CF) profiles of enterotoxigenic Escherichia coli (ETEC) strains isolated from children living in a rural community in Guatemala and from Western visitors to the same location during the same seasons, using similar detection methodologies. We found that ETEC accounted for 26% of severe cases of diarrhoea in children requiring hospitalization, 15% of diarrhoea in the community, and 29% of travellers' diarrhoea in visitors staying >= 2 weeks. The toxin and CF patterns of the ETEC strains isolated from both groups differed significantly (P < 0.0005) as determined by chi(2) = 60.39 for CFs and chi(2) = 35 for toxins, while ETEC phenotypes found in Guatemalan children were comparable to those found in children from other areas of the world.
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| 74. |
- Troell, Karin, et al.
(författare)
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Cryptosporidium parvum infections in a cohort of veterinary students in Sweden
- 2015
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 143, s. 2748-2756
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Tidskriftsartikel (refereegranskat)abstract
- In March 2013, a veterinary student tested positive for Cryptosporidium; four classmates reported similar gastrointestinal symptoms. We aimed to identify source(s) and risk factors for Cryptosporidium infection in university persons symptomatic between 21 January and 14 April 2013. Sixty-four (79%) students from a cohort of 81 fourth-year veterinary students completed questionnaires, identifying 13 cases; four were Cryptosporidium parvum GP60 subtype IIaA16G1R1b, two were IIdA24G1, seven did not submit stool samples. Thirteen cases attended the university's field clinic before symptom onset (13/37 attendees, 35%); 11 visited at least one of four farms where students recalled seeing calves with diarrhoea. C. parvum subtype IIaA16G1R1b was identified in calves at one of the farms. Entering pens of calves with diarrhoea [relative risk (RR) 7.6, 95% confidence interval (CI) 1.7-33.5] and eating in clinic cars (RR 9.1, 95% CI 1.3-65.8) were associated with being a case. Washing hands at least twice per farm visit (0 cases, P = 0.03) was protective. This outbreak investigation was notable for rapid and effective collaboration between public health, veterinary and environmental sectors, leading to swift identification of a microbiological and epidemiological link between cases, infected calves and their farms. We recommend frequent hand-washing using proper technique and dissuasion from eating in clinic cars to minimize possible exposure to contaminated surfaces.
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| 75. |
- Widén, Frederik, et al.
(författare)
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Molecular epidemiology of hepatitis E virus in humans, pigs and wild boars in Sweden
- 2011
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Ingår i: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 139, s. 361-371
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Tidskriftsartikel (refereegranskat)abstract
- Hepatitis E infections in humans are usually acquired in endemic countries in Asia or Africa. In Sweden 17 cases infected in Europe, between 1993 and 2009, were identified. All had clinical hepatitis E with unknown source of infection. Hepatitis E virus (HEV) was identified in faecal samples from 63 piglets in 12 pig farms in Sweden. HEV was also identified in blood from 13 out of 159 investigated Swedish wild boars from nine counties. Partial HEV genomes from humans, pigs and wild boars were sequenced and compared by phylogeny. The results showed close relatedness between HEY strains from piglets from the same farm and from wild boars from the same county. HEV strains from humans showed relatedness with strains from pigs and wild boars from the same county. This study showed that HEY strains form geographical clusters in the phylogenetic tree. The methods used in this study may thus be used for tracing the origin of an infecting strain. Furthermore, this study indicated that there are endemic sources of human HEY infections in Sweden.
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| 76. |
- Adlerberth, Ingegerd, 1959, et al.
(författare)
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High turnover rate of Escherichia coli strains in the intestinal flora of infants in Pakistan.
- 1998
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Ingår i: Epidemiology and infection. - 0950-2688. ; 121:3, s. 587-98
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Tidskriftsartikel (refereegranskat)abstract
- The Escherichia coli flora of infants in developed countries is dominated by one or a few strains which persist for prolonged periods of time, but no longitudinal studies have been performed in developing countries. To this end, we studied the rectal enterobacterial flora in 22 home-delivered Pakistani infants during their first 6 months of life. Three colonies were isolated and species typed on each of 11 sampling occasions. E. coli isolates were strain typed using electromorphic typing of cytoplasmic enzymes, and their O serogroups were determined. There was a very rapid turnover of enterobacterial strains in the rectal flora of individual infants. On average, 8.5 different E. coli strains were found per infant, and several biotypes of other enterobacteria. Less than 50% of the infants were colonized with E. coli from their mothers, but strains of maternal origin were four times more likely to persists in the infants' flora than other E. coli strains. Enterobacteria other than E. coli were always of non-maternal origin, and Enterobacter cloacae and Klebsiella pneumoniae biotypes recovered from contaminated feeds were later identified in the infants' rectal flora. An early colonization with klebsiella or enterobacter was significantly associated with diarrhoea during the neonatal period, although these bacteria were not likely to be the cause of the disease. The results suggest that poor hygienic conditions result in an unstable and diverse enterobacterial flora, which may influence infant health.
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| 77. |
- Adlerberth, Ingegerd, 1959, et al.
(författare)
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P fimbriae and other adhesins enhance intestinal persistence of Escherichia coli in early infancy.
- 1998
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Ingår i: Epidemiology and infection. - 0950-2688. ; 121:3, s. 599-608
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Tidskriftsartikel (refereegranskat)abstract
- Resident and transient Escherichia coli strains were identified in the rectal flora of 22 Pakistani infants followed from birth to 6 months of age. All strains were tested for O-antigen expression, adhesin specificity (P fimbriae, other mannose-resistant adhesins or type 1 fimbriae) and adherence to the colonic cell line HT-29. Resident strains displayed higher mannose-resistant adherence to HT-29 cells, and expressed P fimbriae (P = 0.0036) as well as other mannose-resistant adhesins (P = 0.012) more often than transient strains. In strains acquired during the first month of life, P fimbriae were 12 times more frequent in resident than in transient strains (P = 0.0006). The O-antigen distribution did not differ between resident and transient strains, and none of the resident P-fimbriated strains belonged to previously recognized uropathogenic clones. The results suggest that adhesins mediating adherence to intestinal epithelial cells, especially P fimbriae, enhance the persistence of E. coli in the large intestine of infants.
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| 78. |
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| 79. |
- Björk, Jonas, et al.
(författare)
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Surveillance of COVID-19 vaccine effectiveness : A real-time case-control study in southern Sweden
- 2022
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 150
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Tidskriftsartikel (refereegranskat)abstract
- The extensive register infrastructure available for coronavirus disease 2019 surveillance in Scania county, Sweden, makes it possible to classify individual cases with respect to hospitalisation and disease severity, stratify on time since last dose and demographic factors, account for prior infection and extract data for population controls automatically. In the present study, we developed a case-control sampling design to surveil vaccine effectiveness (VE) in this ethnically and socioeconomically diverse population with more than 1.3 million inhabitants. The first surveillance results show that estimated VE against hospitalisation and severe disease 0-3 months after the last dose remained stable during the study period, but waned markedly 6 months after the last dose in persons aged 65 years or over.
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| 80. |
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| 81. |
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| 82. |
- Cederwall, S., et al.
(författare)
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Respiratory adenovirus infections in immunocompetent and immunocompromised adult patients
- 2020
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 147
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Tidskriftsartikel (refereegranskat)abstract
- Adenovirus (AdV) can cause severe respiratory infections in children and immunocompromised patients, but less is known about severe AdV pneumonia in immunocompetent adults. In this retrospective study, we compared respiratory tract infections and pneumonia caused by AdV in immunocompromised and immunocompetent adult patients regarding clinical presentation and severity of infection. The results show that AdV can cause severe infections in both immunocompetent and immunocompromised patients, and the clinical presentation and need for hospitalisation, mechanical ventilation and antiviral treatment were equal in both groups. No underlying risk factors for severe AdV infection in healthy individuals were identified.
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| 83. |
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| 84. |
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| 85. |
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| 86. |
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| 87. |
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| 88. |
- Evengård, B, et al.
(författare)
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Low incidence of toxoplasma infection during pregnancy and in newborn in Sweden
- 2001
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 127:1, s. 121-127
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Tidskriftsartikel (refereegranskat)abstract
- To estimate the burden of disease due to congenital toxoplasmosis in Sweden the incidence of primary infections during pregnancy and birth prevalence of congenital toxoplasmosis in 40978 children born in two regions in Sweden was determined. Women possibly infected during pregnancy were identi®ed based on: 1, detection of speci®c IgG based on neonatal screening of the phenylketonuria (PKU) card blood spot followed by retrospective testing of stored prenatal samples to detect women who acquired infection during pregnancy and follow up of their children to 12 months; 2, detection of speci®c IgM on the PKU blood spot. The birth prevalence of congenital toxoplasmosis was 0±73}10000 (95% CI 0±15±2±14) (3}40978). The incidence of primary infection during pregnancy was 5±1}10000 (95% CI 2±6±8±9) susceptible pregnant women. The seroprevalence in the southern part was 25±7% and in the Stockholm area 14±0%. The incidence of infection during pregnancy was low, as the birth prevalence of congenital toxoplasmosis. Neonatal screening warrants consideration in view of the low cost and feasibility.
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| 89. |
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| 90. |
- Heyman, P, et al.
(författare)
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Tula hantavirus in Belgium
- 2002
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Ingår i: Epidemiology and infection. - 0950-2688. ; 128:2, s. 251-256
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Tidskriftsartikel (refereegranskat)
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| 91. |
- Holmqvist, M., et al.
(författare)
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Risk of bacteremia in patients presenting with shaking chills and vomiting - A prospective cohort study
- 2020
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 148, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Chills and vomiting have traditionally been associated with severe bacterial infections and bacteremia. However, few modern studies have in a prospective way evaluated the association of these signs with bacteremia, which is the aim of this prospective, multicenter study. Patients presenting to the emergency department with at least one affected vital sign (increased respiratory rate, increased heart rate, altered mental status, decreased blood pressure or decreased oxygen saturation) were included. A total of 479 patients were prospectively enrolled. Blood cultures were obtained from 197 patients. Of the 32 patients with a positive blood culture 11 patients (34%) had experienced shaking chills compared with 23 (14%) of the 165 patients with a negative blood culture, p=0.009. A logistic regression was fitted to show the estimated odds ratio (OR) for a positive blood culture according to shaking chills. In a univariate model shaking chills had an OR of 3.23 (95% CI 1.35-7.52) and in a multivariate model the OR was 5.9 (95% CI 2.05-17.17) for those without prior antibiotics adjusted for age, sex and prior antibiotics. The presence of vomiting was also addressed, but neither a univariate nor a multivariate logistic regression showed any association between vomiting and bacteremia. In conclusion, among patients at the emergency department with at least one affected vital sign, shaking chills but not vomiting were associated with bacteremia.
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| 92. |
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| 93. |
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| 94. |
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| 95. |
- Johansson, D, et al.
(författare)
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Thrombocytopenia in bacteraemia and association with bacterial species
- 2018
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 146:10, s. 1312-1317
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Tidskriftsartikel (refereegranskat)abstract
- Thrombocytopenia is common in patients with invasive bacterial infections. Bacteria can activate platelets, but it is unclear if this affects platelet count. The aim of this study was to examine whether bacteraemia with Staphylococcus aureus, which readily activate human platelets, was more likely to be complicated by thrombocytopenia than bacteraemia with Escherichia coli or Streptococcus pneumoniae with different abilities to activate platelets.We compared information from 600 adult patients with community-acquired bacteraemia with S. aureus (n = 140), E. coli (n = 420) and S. pneumoniae (n = 40) in Southern Sweden, 2012, linking information on positive blood cultures from microbiological databases and medical charts. The proportion of patients with thrombocytopenia (platelet count <150 × 109/ml) was calculated. Logistic regression was used to estimate the odds ratios (OR) for thrombocytopenia according to bacterial species adjusted for confounders.The proportion of thrombocytopenia was 29% in S. aureus, 28% in E. coli and 20% in S. pneumonia bacteraemia (P = 0.50), corresponding to an OR of 1.2 (95% confidence interval 0.7-1.9) for thrombocytopenia for S. aureus as compared with E. coli or S. pneumoniae, adjusted for confounders.This study indicates that platelet activation by bacteria is not a major causative mechanism in sepsis-associated thrombocytopenia.
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| 96. |
- Karlsson Söbirk, Sara, et al.
(författare)
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Imported leishmaniasis in Sweden 1993-2016
- 2018
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 146:10, s. 1267-1274
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, leishmaniasis is an imported disease and its epidemiology and incidence were not known until now. We conducted a retrospective, nationwide, epidemiological study from 1993 to 2016. Probable cases were patients with leishmaniasis diagnoses reported to the Swedish Patient registry, collecting data on admitted patients in Swedish healthcare since 1993 and out-patient visits since 2001. Confirmed cases were those with a laboratory test positive for leishmaniasis during 1993-2016. 299 probable cases and 182 confirmed cases were identified. Annual incidence ranged from 0.023 to 0.35 per 100 000 with a rapid increase in the last 4 years. Of 182 laboratory-verified cases, 96 were diagnosed from 2013 to 2016, and in this group, almost half of the patients were children under 18 years. Patients presented in different healthcare settings in all regions of Sweden. Cutaneous leishmaniasis was the most common clinical manifestation and the majority of infections were acquired in Asia including the Middle East, specifically Syria and Afghanistan. Leishmania tropica was responsible for the majority of cases (42%). A combination of laboratory methods increased the sensitivity of diagnosis among confirmed cases. In 2016, one-tenth of the Swedish population were born in Leishmania-endemic countries and many Swedes travel to these countries for work or vacation. Swedish residents who have spent time in Leishmania-endemic areas, could be at risk of developing disease some time during their lives. Increased awareness and knowledge are needed for correct diagnosis and management of leishmaniasis in Sweden.
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| 97. |
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| 98. |
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| 99. |
- Lindahl, Gunnar, et al.
(författare)
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Binding of IgA and/or IgG is a common property among clinical isolates of group A streptococci
- 1990
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 105:1, s. 87-93
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Tidskriftsartikel (refereegranskat)abstract
- Certain strains of group A streptococci are known to bind IgA and/or IgG via a cell surface receptor, which may act as a virulence factor. The distribution of such receptors among routine clinical isolates was studied, using a total of 225 strains and an assay based on the binding of radiolabelled immunoglobulins. Among 194 throat strains isolated during three different time periods in two different geographical areas of Sweden, 82% showed significant binding of IgA and/or IgG. Studies on 31 septicaemia strains, isolated over a period of more than 8 years, showed binding for 84% of the isolates. The binding strains were of several different T-types and could be subdivided into two groups, those binding both IgA and IgG and those binding IgG only. These data show that binding of IgA and/or IgG is a very common property among clinical isolates of group A streptococci.
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| 100. |
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