DGHM
EINE STARKE GEMEINSCHAFT

Die DGHM prämiert Veröffentlichungen, die sich durch eine große Anwendungsrelevanz auszeichnen. Für diese Auszeichnung können Publikationen vorgschlagen werden, an denen ein DGHM-Mitglied als Erst- oder LetztautorIn beteiligt ist und die in den vorangegangenen 3 Monaten hochrangig publiziert wurden.

Aktuelles Highlight der Infektionsprävention und Klin. Mikrobiologie

Virus variant specific clinical performance of SARS-CoV-2 rapid antigen tests in point-of-care use, November 2020 to January 2022

Clinical Microbiology and Infection, 2022

Link zum vollständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/36028089/


Autorin: Isabel Wagenhäuser

Abstract:
Antigen rapid diagnostic tests (RDT) for SARS-CoV-2 are quick, widely available, and inexpensive. Consequently, RDT have been established as an alternative and additional diagnostic strategy to quantitative reverse transcription polymerase chain reaction (RT-qPCR). However, reliable SARS-CoV-2 virus variant of concern (VOC) specific clinical and large-scale performance data is limited, especially for Omicron VOC. The aim of the study is to compare RDT performance between different VOC.

Methods
This single-center prospective performance assessment compares RDT from three manufacturers (NADAL®, Panbio™, MEDsan®) with RT-qPCR including deduced standardised viral load from oropharyngeal swabs for detection of SARS-CoV-2 in a clinical point-of-care setting from November 2020 to January 2022.

Results
Among 35,479 RDT/RT-qPCR tandems taken from 26,940 individuals, 164 of the 426 SARS-CoV-2 positive samples tested true positive by RDT corresponding to a RDT sensitivity of 38.50% (95% CI 34.00%–43.20%) with an overall specificity of 99.67% (95% CI 99.60%–99.72%). RDT sensitivity depended on viral load with decreasing sensitivity accompanied by descending viral load. VOC dependent sensitivity assessment showed 42.86% (95% CI 32.82%–53.52%) for wild-type SARS-CoV-2, 43.42% (95% CI 32.86%–54.61%) for Alpha VOC, 37.67% (95% CI 30.22%–45.75%) for Delta VOC, and 33.67% (95% CI 25.09%–43.49%) for Omicron VOC. Sensitivity in samples with high viral loads ≥106 SARS-CoV-2 RNA copies per ml was significantly lower in Omicron VOC (50.00%, 95% CI 36.12%–63.88%) compared to wild-type SARS-CoV-2 (79.31%, 95% CI 61.61%–90.15%, p=0.015).

Conclusion
RDT sensitivity for detection of the Omicron VOC is reduced in infectious individuals with high viral load, which curtails the effectiveness of RDT. This aspect further limits RDT use although RDT are still an irreplaceable diagnostic tool for rapid, economic, point-of-care and extensive SARS-CoV-2 screening use.

Kommentar:
In der bisher weltweit größten veröffentlichten klinischen Studie zu SARS-CoV-2 Antigen-Schnelltests konnte erstmals ausgehend von 35 479 Antigen-Schnelltests mit paralleler PCR als Referenzmethode im Kontext der verschiedenen SARS-CoV-2 variants of concern, allen voran für die Omikron-Variante, untersucht werden. Von 426 SARS-CoV-2-positiven PCR-Proben waren im Schnelltest nur 164 positiv. Das entspricht einer Sensitivität von lediglich 38,50 Prozent. Bei der derzeit vorherrschenden Omikron-Variante schlugen sogar nur 33,67 Prozent an. Beim Wildtyp zeigten immerhin 42,86 Prozent der Schnelltests einen positiven Befund. Mit der präsentierten Analyse konnte somit die geminderte Antigen-Schnelltests Sensitivität gegenüber der Omikron-Variante, die zuvor bereits in Laboranalysen berichtet wurde, erstmalig in der klinischen Routine gezeigt werden, was mit hoher Übertragbarkeit im Rahmen der weiterhin dynamischen COVID-19 Pandemie von großer praktischer Relevanz ist.

Kontakt:
Isabell Wagenhäuser
Universitätsklinikum Würzburg
Zentrale Einrichtung Krankenhaushygiene und Antimicrobial Stewardship
Josef-Schneider-Str. 2 / E1
97080 Würzburg
wagenhaeu_i@ukw.de

Autor:inneninformationen:

  • 1 Infection Control and Antimicrobial Stewardship Unit, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 2 Institute for Virology and Immunobiology, University of Wuerzburg, Wuerzburg, Germany.
  • 3 Infection Control and Antimicrobial Stewardship Unit, University Hospital Wuerzburg, Wuerzburg, Germany; Institute for Hygiene and Microbiology, University of Wuerzburg, Wuerzburg, Germany.
  • 4 Department of General, Visceral, Transplantation, Vascular and Paediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 5 Department of Paediatrics, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 6 Department of Internal Medicine I, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 7 Department of Internal Medicine II, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 8 Department of Obstetrics and Gynaecology, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 9 Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 10 Department of Ophthalmology, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 11 Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 12 Department of Neurology, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 13 Department of Oral and Maxillofacial Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 14 Department of Dermatology, Venerology and Allergology, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 15 Department of Urology, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 16 Department of Neurosurgery, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 17 Department of Psychiatry and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 18 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 19 Department of Anaesthesia and Critical Care, University Hospital Wuerzburg, Wuerzburg, Germany.
  • 20 Institute for Hygiene and Microbiology, University of Wuerzburg, Wuerzburg, Germany.
  • 21 Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany.
  • 22 Institute for Hygiene and Microbiology, University of Wuerzburg, Wuerzburg, Germany; Leibniz Institute for Natural Product Research and Infection Biology-Hans-Knoell-Institute, Jena, Germany.
  • 23 Infection Control and Antimicrobial Stewardship Unit, University Hospital Wuerzburg, Wuerzburg, Germany; Institute for Hygiene and Microbiology, University of Wuerzburg, Wuerzburg, Germany; Department of Internal Medicine I, University Hospital Wuerzburg, Wuerzburg, Germany. Electronic address: krone_m@ukw.de.

August 2022
Molecular assessment of Staphylococcus aureus strains in STAT3 Hyper-IgE syndrome patients
Vera Schwierzeck1,2,3 Renate Effner1,2,Felicitas Abel1,2,Matthias Reiger2,5,Gundula Notheis1,2, Jürgen Held6,Valeska Simon7, Sebastian Dintner8, Reinhard Hoffmann7, Beate Hagl1,2, Johannes Huebner4, Alexander Mellmann3,4, Ellen D Renner1,2,9
J Clin Immunol. 2022 Jun 2.
Link zum vollständigen Artikel: link.springer.com/article/10.1007/s10875-022-01293-7

April/Mai 2022
Extensively Drug-Resistant Klebsiella pneumoniae Counteracts Fitness and Virulence Costs That Accompanied Ceftazidime-Avibactam Resistance Acquisition
Elias Eger1 , Michael Schwabe1 , Lukas Schulig2 , Nils-Olaf Hübner3 , Jürgen A Bohnert4 , Uwe T Bornscheuer5 , Stefan E Heiden1 , Justus U Müller1 , Fazal Adnan6 , Karsten Becker4 , Carlos L Correa-Martinez7 , Sebastian Guenther8 , Evgeny A Idelevich4,9 , Daniel Baecker2 , Katharina Schaufler1,10
Microbiology Spectrum, 2022, 18.04.22
Link zum voständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/35435751/

März 2022
A strict mask policy for hospital staff effectively prevents from nosocomial influenza infections and mortality: monocentric data from five consecutive influenza seasons
Ambrosch, Andreas*¹, Luber, Doris¹, Klawonn, Frank2,3 , Kabesch, Michael4,5
J Hospital Infection 2021 Dec 18;121:82-90. doi: 10.1016/j.jhin.2021.12.010
Link zum vollständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/34929232/

Februar 2022
Molecular Surveillance of Carbapenem-Resistant Gram-Negative Bacteria in Liver Transplant
Candidates
Tilman G. Schultze, Philip G. Ferstl, David Villinger, Michael Hogardt, Wolf O. Bechstein, Stephan Göttig, Thomas A. Wichelhaus, Stefan Zeuzem, Jonel Trebicka, Oliver Waidmann, Martin-Walter Welker* and Volkhard A. J. Kempf*
Front. Microbiol., 22 November 2021
Link zum vollständigen Artikel: https://www.frontiersin.org/articles/10.3389/fmicb.2021.791574/full

Januar 2022
Genomic Investigation and Successful Containment of an Intermittent Common Source Outbreak of OXA-48-Producing Enterobacter cloacae Related to Hospital Shower Drains
Dennis Nurjadi 1
Martin Scherrer 1 Uwe Frank 1 2 3 Nico T Mutters 1 3 Alexandra Heininger 1 4 Isabel Späth 1 Vanessa M Eichel 1 Jonas Jabs 1 3 Katja Probst 1 Carsten Müller-Tidow 5 Juliane Brandt 5 Klaus Heeg 1 Sébastien Boutin 1
Microbiol Spectr 2021 Dec 22;9(3):e0138021
Link zum vollständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/34817232/

Dezember 2021

Development and Validation of a Tool for the Prediction of VancomycinResistant Enterococci Colonization Persistence the PREVENT Score
Christian Boeing1, Carlos L Correa-Martinez1 , Franziska Schuler2, Alexander Mellmann1, André Karch3, Stefanie Kampmeier1cccc
Microbiology Spectrum, 2021, 9 (2): e00356-21
Link zum vollständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/34523992/

November 2021

Surveillance for Colonization, Transmission, and Infection with Methicillin-Susceptible Staphylococcus aureus in a Neonatal Intensive Care Unit
Dennis Nurjadi  1 Vanessa M Eichel  1 Patrik Tabatabai  2 Sabrina Klein  1 Katharina Last  1   3 , Nico T Mutters  1   4 Johannes Pöschl  2 Philipp Zanger  1   5 Klaus Heeg  1 Sébastien Boutin  1 JAMA Network Open. 2021 Sep 1;4(9):e2124938
Link zum vollständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/34515783/

Oktober 2021

Performance of Three SARS-CoV-2 Immunoassays, Three Rapid Lateral Flow Tests, and a Novel Bead-Based Affinity Surrogate Test for the Detection of SARS-CoV-2 Antibodies in Human Serum
Manuel Krone, Julia Gütling, Johannes Wagener, Thiên-Trí Lâm, Christoph Schoen, Ulrich Vogel, August Stich, Florian Wedekink, Jörg Wischhusen, Thomas Kerkau, Niklas Beyersdorf, Silvana Klingler, Simone Backes, Lars Dölken, Georg Gasteiger, Oliver Kurzai, Alexandra Schubert-Unkmeir
Journal of Clinical Microbiology 2021, 59(8): e00319-21
Link zum vollständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/33962959/

September 2021

Global Distribution Patterns of Carbapenemase-Encoding Bacteria in a New Light: Clues on a Role for Ethnicity
Claudio Neidhöfer1, Christian Buechler1, Guido Neidhöfer2, Gabriele Bierbaum1, Irene Hannet3 , Achim Hoerauf1, Marijo Parčina1
Frontiers in Cellular and Infection Microbiology, 2021, Volume 11, p. 532-550, doi: 10.3389/fcimb.2021.659753
Link zum vollständigen Abstract: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276097/

Juli/August 2021
Clinical performance evaluation of SARS-CoV-2 rapid antigen testing in point of care usage in comparison to RT-qPCR
Isabell Wagenhäuser, Kerstin Knies, Vera Rauschenberger, Michael Eisenmann, Miriam McDonogh, Nils Petri, Oliver Andres, Sven Flemming, Micha Gawlik, Michael Papsdorf, Regina Taurines, Hartmut Böhm, Johannes Forster, Dirk Weismann, Benedikt Weißbrich, Lars Dölken, Johannes Liese, Oliver Kurzai, Ulrich Vogel, Manuel Krone
EBioMedicine 2021, 69: 103455
Link zum vollständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/34186490/

Juni2021
Pet husbandry as a risk factor for colonization or infection with MDR organisms: a systematic meta-analysis
Carolin Hackmann¹ , Petra Gastmeier¹, Stefan Schwarz² , Antina Lübke-Becker², Peter Bischoff¹, Rasmus Leistner¹,³
J Antimicrob Chemother. 2021 May 12;76(6):1392-1405.doi: 10.1093/jac/dkab058.Link zum vollständigen Artikel: https://pubmed.ncbi.nlm.nih.gov/33864082/

April 2021
Prevalence of SARS-CoV-2 IgG antibodies in a large prospective cohort study of elite football players in Germany (May-June 2020): implications for a testing protocol in asymptomatic individuals and estimation of the rate of undetected cases
Dietrich Mack 1*Barbara Christine Gärtner 2*Annika Rössler 3Janine Kimpel 3Katrin Donde1Oliver Harzer 1Werner Krutsch 4Dorothee von Laer 3Tim Meyer(*are joint first authors)
Clinical Microbiology and Infection 202. Mar;27(3):473.e1-473.e4.
Link zum vollständigen Artikel: pubmed.ncbi.nlm.nih.gov/33285279/

Januar 2021
A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition”
Stefan E. Heiden*, Nils-Olaf Hübner*, Jürgen A. Bohnert, Claus-Dieter Heidecke, Axel Kramer, Veronika Balau, Wolfgang Gierer, Stephan Schaefer, Tim Eckmanns, Sören Gatermann, Elias Eger, Sebastian Guenther, Karsten Becker & Katharina Schaufler#
Genome Medicine, 2020, 12:113
Link zum vollständigen Artikel: pubmed.ncbi.nlm.nih.gov/33298160/