Christina Forstner

Network of Interactions of a Novel Plant-specific Arg/Ser-rich Protein, atRSZ33, with atSC35-like Splicing Factors

Arg/Ser-rich (RS) proteins play a crucial role in splicing and are implicated in splice site selection in metazoa. In plants, intron recognition seems to differ from the one in animals due to specific factor requirements. Here we describe a new plant-specific RS-rich protein, atRSZ33, with a unique domain structure consisting of an RNA recognition motif (RRM), two zinc knuckles embedded in a basic RS region, and an acidic C-terminal domain. atRSZ33 was found to be a phosphoprotein that concentrates in nuclear speckles and is predominantly present in roots and flowers. In a yeast two-hybrid screen, atRSZ33 interacted with splicing factors atSRp34/SR1, anArabidopsis ortholog of human SF2/ASF; atRSZp21 and atRSZp22, which are similar to the human 9G8; and three novel SC35-like splicing factors termed atSCL28, atSCL30, and atSCL33/SR33. Two further members of the SCL family, namely SCL30a and the ortholog of mammalian SC35, atSC35, were also found to interact with atRSZ33. These interactions were verified by in vitro binding assays; furthermore, the transcriptional activity of atRSZ33 was found to overlap with the ones of its interacting partners. These specific interactions coupled with the many similarities of atRSZ33 to SR proteins suggest that its main activity is in spliceosome assembly. Mapping of regions necessary for protein-protein interaction between atRSZ33 and atSCL33/SR33 revealed that both zinc knuckles together with a small part of the RS and the RRM domain are required for efficient binding. However, the interacting domain is relatively small, allowing binding of additional proteins, a feature that is consistent with the proposed role of atRSZ33 in spliceosome assembly.

Impact of pneumococcal vaccination in children on serotype distribution in adult community-acquired pneumonia using the serotype-specific multiplex urinary antigen detection assay

The aim of the study was to compare the distribution of the vaccine-serotypes covered by pneumococcal conjugate vaccines (PCV7 and PCV13) in adult patients with pneumococcal community-acquired pneumonia in Germany between the periods 2002-2006 and 2007-2011 using a novel serotype-specific multiplex urinary antigen detection assay (SSUA). Vaccination of children started with PCV7 in 2007, which was replaced by PCV13 in 2010. Following confirmation of the accuracy of SSUA in long-term stored urine samples from 112 patients with confirmed pneumonia and known pneumococcal serotype, urine samples of 391 CAPNETZ patients with documented pneumococcal pneumonia (i.e. positive BinaxNOW) Streptococcus pneumoniae urine antigen test) but unknown serotype were tested for the 13 vaccine-serotypes using SSUA. The proportion of PCV7-serotypes significantly decreased in adult patients with pneumonia from 30.6% (2002-6) to 13.3% (2007-11, p < 0.001); in bacteremic pneumonia, PCV7-serotypes completely disappeared (3/14 versus 0/19, p = 0.058). Conversely, pneumococcal serotypes included by PCV13 remained stable during study period with a coverage of 61.5% (2002-06) and 59.7% (2007-11) in non-bacteremic pneumonia and 79% (for both periods) in bacteremic pneumonia, mainly due to an increase in pneumococcal serotypes 1, 3 and 7F during the second period. Thus, implementation of PCV7 in children in Germany in 2007 was associated with a significant decrease in vaccine-serotypes covered by PCV7 in adult patients with non-bacteremic pneumococcal pneumonia and with an elimination of PCV7 vaccine-serotypes in bacteremic pneumococcal pneumonia. PCV13 coverage remained high up to 2011, mainly due to an increase in serotypes 1, 3 and 7F.

Staphylococcus-aureus-Bakteriämie – eine eigene Entität

Bacteremia caused by Methicillin-sensitive (MSSA) and Methicillin-resistant (MRSA) Staphyloccus aureus strains are common and severe infections associated with high mortality rates and specific characteristics in disease course, complications and therapy. In this review, we discuss current recommendations for the diagnosis and treatment of MSSA and MRSA bloodstream infections. We also highlight why infectious disease consultation improves the treatment and outcome of patients with SAB and should be considered as a standard of care.

Pneumococcal vaccination for prevention of pneumonia

Aging of the immune system, so-called immunosenescence, is well documented as the cause of increased infection rates and severe, often complicated courses of infections in older adults. This is particularly true for pneumococcal pneumonia in older adults; therefore, the standing committee on vaccination of the Robert Koch Institute (STIKO) recommends a once only vaccination with 23-valent pneumococcal polysaccharide vaccine for all persons aged 60 years and over. Furthermore, the 13-valent pneumococcal conjugate vaccine is also available for administration in adults and is recommended by the STIKO for particular indications. The advantage of the pneumococcal conjugate vaccine is the additional induction of a T-cell dependent immune response that leads to good immunogenicity despite immunosenescence. Initial data from a recent randomized controlled trial, so far only presented at conferences, confirm that the conjugate vaccine also provides protection against non-bacteremic pneumococcal pneumonia, which is not provided by the polysaccharide vaccine. Thus, there are two vaccines for prevention of pneumococcal diseases: one with a broader range of serotype coverage but with an uncertain protection against non-bacteremic pneumococcal pneumonia and another one with less serotype coverage but more effective protection. Vaccination of children with the conjugate vaccine also leads to a rapid decrease of infections by the 13 vaccine serotypes even in adults because of herd protection effects. For prevention of pneumonia in older adults the additional benefit of a concurrent application of influenza vaccine and pneumococcal vaccine should be considered.ZusammenfassungDie Alterung des Immunsystems, die Immunseneszenz, führt zu einer Zunahme von Infektionen im Alter mit meist oligosymptomatischem und teils schwerem Verlauf. Dies gilt im Besonderen für die durch Pneumokokken verursachten Pneumonien im Alter. Die Ständige Impfkommission (STIKO) des Robert Koch-Instituts empfiehlt daher für 60-Jährige und Ältere die 23-valente Pneumokokkenpolysaccharidimpfung einmalig als Standardimpfung. Als Indikationsimpfung steht darüber hinaus der 13-valente Pneumokokkenkonjugatimpfstoff zur Verfügung. Dieser hat den Vorteil, eine zusätzliche T-Zell-abhängige Immunantwort zu induzieren. Dies führt trotz Immunseneszenz auch im Alter zu einer guten Immunogenität. Erste, auf Kongressen präsentierte Daten einer großen randomisierten, kontrollierten Studie belegen für den Konjugatimpfstoff auch eine Schutzwirkung gegen nichtbakteriämische Pneumokokkenpneumonien. Einen solchen Schutz bietet der Polysaccharidimpfstoff nicht. Somit stehen zur Impfung gegen Pneumokokkeninfektionen ein breiter wirksamer Impfstoff mit einer unsicheren Schutzwirkung bei nichtbakteriämischer Pneumokokkenpneumonie, insbesondere bei Älteren, und ein schmalerer, aber besser wirksamer Impfstoff zur Verfügung. Herdenprotektionseffekte durch die Impfung von Kindern mit der Konjugatvakzine führen derzeit zu einer rapiden Abnahme der Infektionen durch die 13xa0Impfserotypen auch beim Erwachsenen. Für die Pneumonieprävention bei Senioren sollte der additive Nutzen einer simultanen Impfung gegen Influenza und Pneumokokken unbedingt beachtet werden.AbstractAging of the immune system, so-called immunosenescence, is well documented as the cause of increased infection rates and severe, often complicated courses of infections in older adults. This is particularly true for pneumococcal pneumonia in older adults; therefore, the standing committee on vaccination of the Robert Koch Institute (STIKO) recommends a once only vaccination with 23-valent pneumococcal polysaccharide vaccine for all persons aged 60 years and over. Furthermore, the 13-valent pneumococcal conjugate vaccine is also available for administration in adults and is recommended by the STIKO for particular indications. The advantage of the pneumococcal conjugate vaccine is the additional induction of a T-cell dependent immune response that leads to good immunogenicity despite immunosenescence. Initial data from a recent randomized controlled trial, so far only presented at conferences, confirm that the conjugate vaccine also provides protection against non-bacteremic pneumococcal pneumonia, which is not provided by the polysaccharide vaccine. Thus, there are two vaccines for prevention of pneumococcal diseases: one with a broader range of serotype coverage but with an uncertain protection against non-bacteremic pneumococcal pneumonia and another one with less serotype coverage but more effective protection. Vaccination of children with the conjugate vaccine also leads to a rapid decrease of infections by the 13 vaccine serotypes even in adults because of herd protection effects. For prevention of pneumonia in older adults the additional benefit of a concurrent application of influenza vaccine and pneumococcal vaccine should be considered.

Substantial diagnostic impact of blood culture independent molecular methods in bloodstream infections: Superior performance of PCR/ESI-MS

This study analyzed the performance of different molecular technologies along with blood culture (BC) in the diagnosis of bloodstream infections (BSI) in patients from internal medicine wards - including intensive care units (ICUs) - and the emergency room. Patients with systemic inflammatory response syndrome were prospectively included. BCs and EDTA whole blood were obtained simultaneously. The latter was analyzed by PCR combined with electrospray ionization mass spectrometry (PCR/ESI-MS; IRIDICA BAC BSI assay, Abbott) and by SeptiFast (Roche). Cases were classified as BSI according to adapted European Centre for Disease Prevention and Control criteria. Out of 462 analyzed episodes, 193 with valid test results fulfilled the inclusion criteria and were further evaluated. Sixty-nine (35.8%) were classified as BSI. PCR/ESI-MS showed a significantly better overall performance than BC (pu2009=u20090.004) or SeptiFast (pu2009=u20090.034). Only in patients from the ICU the performance of SeptiFast was comparable to that of PCR/ESI-MS. Mainly due to the negative effect of antimicrobial pre-treatment on BC results, the cumulative performance of each of the molecular tests with BC was significantly higher than that of BC alone (pu2009<u20090.001). SeptiFast and in particular the broad-range pathogen detection system PCR/ESI-MS proved to be an essential addition to BC-based diagnostics in BSI.

Perceptions and attitudes regarding antibiotic resistance in Germany: a cross-sectoral survey amongst physicians, veterinarians, farmers and the general public

BackgroundnDrivers of antibiotic (AB) resistance (ABR) include outpatient treatment, hospital care and animal husbandry. During the first phase of the One Health project RAI (Responsible Antibiotic Use via Information and Communication) surveys were conducted in these sectors.nnnObjectivesnTo compare perceptions and attitudes towards ABR among general practitioners (GPs), hospital physicians, veterinarians, pig farmers and the general public.nnnMethodsnCross-sectional questions on AB use and ABR were integrated in group-specific surveys of GPs, hospital physicians, veterinarians, pig farmers and the German general population.nnnResultsnA total of 1789 participants (340 GPs, 170 hospital physicians, 215 pig farmers, 60 veterinarians and 1004 members of the public) responded. Each group tended to identify drivers of ABR as being from outside its own area of activity. Guidelines were shown to be an important information source for AB therapy for all prescriber groups, but the frequency of routine use differed (39% of GPs, 65% of hospital physicians and 53% of veterinarians). Regarding further information sources, hospital physicians preferred smartphone apps and e-learning, GPs preferred non-sponsored training and veterinarians preferred multidisciplinary networks and e-learning. Farmers were predominantly satisfied with existing solutions. Farmers had three times better basic knowledge of ABR and knew twice as many people with MDR organism problems than the general public. They also received information on ABR more often from their veterinarians than patients did from their doctors.nnnConclusionsnThis study reveals considerable differences in perceptions and attitudes to ABR among the groups investigated. The results can help to tailor future interventions. Furthermore, they promote mutual understanding and thus support the One Health approach.

Infektiologische Konsile bei Patienten mit Staphylococcus-aureus-Bakteriämie – eine retrospektive Beobachtungsstudie am Universitätsklinikum Jena

n u2002Staphylococcus aureus bacteraemia is frequently associated with complications and a high mortality. Recent retrospective studies provide evidence that infectious disease specialist consultations improve the outcome of patients with Staphylococcus aureus bacteraemia by increasing adherence to treatment standards.n u2002In this retrospective, single-centre observational study, we investigated the impact of infectious disease consultations on the outcome of patients with Staphylococcus aureus bacteraemia at the Jena University Hospital applying logistic regression and survival analyses. The primary endpoint was intra-hospital mortality.n u2002We analysed patients (≥u200a18 years) with Staphylococcus aureus bacteraemia between December 2012 and August 2015 (nu200a=u200a297), of whom 159 received infectious disease consultations. Specialist consultations were associated with lower intra-hospital mortality (23u200a% without consultations, 11u200a% with consultations; multiple regression analysis: odds ratiou200a=u200a0.27 [95u200a% confidence interval: 0.12u200a–u200a0.64]; pu200a=u200a0.003). Furthermore, the adherence to defined quality-of-care indicators differed. The complete implementation of all recommendations was associated with the lowest intra-hospital mortality rates.n u2002Infectious disease consultations in patients with Staphylococcus aureus bacteraemia were associated with a lower intra-hospital mortality rate.n

Pneumonieprävention durch Pneumokokkenimpfung

Aging of the immune system, so-called immunosenescence, is well documented as the cause of increased infection rates and severe, often complicated courses of infections in older adults. This is particularly true for pneumococcal pneumonia in older adults; therefore, the standing committee on vaccination of the Robert Koch Institute (STIKO) recommends a once only vaccination with 23-valent pneumococcal polysaccharide vaccine for all persons aged 60 years and over. Furthermore, the 13-valent pneumococcal conjugate vaccine is also available for administration in adults and is recommended by the STIKO for particular indications. The advantage of the pneumococcal conjugate vaccine is the additional induction of a T-cell dependent immune response that leads to good immunogenicity despite immunosenescence. Initial data from a recent randomized controlled trial, so far only presented at conferences, confirm that the conjugate vaccine also provides protection against non-bacteremic pneumococcal pneumonia, which is not provided by the polysaccharide vaccine. Thus, there are two vaccines for prevention of pneumococcal diseases: one with a broader range of serotype coverage but with an uncertain protection against non-bacteremic pneumococcal pneumonia and another one with less serotype coverage but more effective protection. Vaccination of children with the conjugate vaccine also leads to a rapid decrease of infections by the 13 vaccine serotypes even in adults because of herd protection effects. For prevention of pneumonia in older adults the additional benefit of a concurrent application of influenza vaccine and pneumococcal vaccine should be considered.ZusammenfassungDie Alterung des Immunsystems, die Immunseneszenz, führt zu einer Zunahme von Infektionen im Alter mit meist oligosymptomatischem und teils schwerem Verlauf. Dies gilt im Besonderen für die durch Pneumokokken verursachten Pneumonien im Alter. Die Ständige Impfkommission (STIKO) des Robert Koch-Instituts empfiehlt daher für 60-Jährige und Ältere die 23-valente Pneumokokkenpolysaccharidimpfung einmalig als Standardimpfung. Als Indikationsimpfung steht darüber hinaus der 13-valente Pneumokokkenkonjugatimpfstoff zur Verfügung. Dieser hat den Vorteil, eine zusätzliche T-Zell-abhängige Immunantwort zu induzieren. Dies führt trotz Immunseneszenz auch im Alter zu einer guten Immunogenität. Erste, auf Kongressen präsentierte Daten einer großen randomisierten, kontrollierten Studie belegen für den Konjugatimpfstoff auch eine Schutzwirkung gegen nichtbakteriämische Pneumokokkenpneumonien. Einen solchen Schutz bietet der Polysaccharidimpfstoff nicht. Somit stehen zur Impfung gegen Pneumokokkeninfektionen ein breiter wirksamer Impfstoff mit einer unsicheren Schutzwirkung bei nichtbakteriämischer Pneumokokkenpneumonie, insbesondere bei Älteren, und ein schmalerer, aber besser wirksamer Impfstoff zur Verfügung. Herdenprotektionseffekte durch die Impfung von Kindern mit der Konjugatvakzine führen derzeit zu einer rapiden Abnahme der Infektionen durch die 13xa0Impfserotypen auch beim Erwachsenen. Für die Pneumonieprävention bei Senioren sollte der additive Nutzen einer simultanen Impfung gegen Influenza und Pneumokokken unbedingt beachtet werden.AbstractAging of the immune system, so-called immunosenescence, is well documented as the cause of increased infection rates and severe, often complicated courses of infections in older adults. This is particularly true for pneumococcal pneumonia in older adults; therefore, the standing committee on vaccination of the Robert Koch Institute (STIKO) recommends a once only vaccination with 23-valent pneumococcal polysaccharide vaccine for all persons aged 60 years and over. Furthermore, the 13-valent pneumococcal conjugate vaccine is also available for administration in adults and is recommended by the STIKO for particular indications. The advantage of the pneumococcal conjugate vaccine is the additional induction of a T-cell dependent immune response that leads to good immunogenicity despite immunosenescence. Initial data from a recent randomized controlled trial, so far only presented at conferences, confirm that the conjugate vaccine also provides protection against non-bacteremic pneumococcal pneumonia, which is not provided by the polysaccharide vaccine. Thus, there are two vaccines for prevention of pneumococcal diseases: one with a broader range of serotype coverage but with an uncertain protection against non-bacteremic pneumococcal pneumonia and another one with less serotype coverage but more effective protection. Vaccination of children with the conjugate vaccine also leads to a rapid decrease of infections by the 13 vaccine serotypes even in adults because of herd protection effects. For prevention of pneumonia in older adults the additional benefit of a concurrent application of influenza vaccine and pneumococcal vaccine should be considered.

Pneumonieprävention durch Pneumokokkenimpfung@@@Pneumococcal vaccination for prevention of pneumonia

Aging of the immune system, so-called immunosenescence, is well documented as the cause of increased infection rates and severe, often complicated courses of infections in older adults. This is particularly true for pneumococcal pneumonia in older adults; therefore, the standing committee on vaccination of the Robert Koch Institute (STIKO) recommends a once only vaccination with 23-valent pneumococcal polysaccharide vaccine for all persons aged 60 years and over. Furthermore, the 13-valent pneumococcal conjugate vaccine is also available for administration in adults and is recommended by the STIKO for particular indications. The advantage of the pneumococcal conjugate vaccine is the additional induction of a T-cell dependent immune response that leads to good immunogenicity despite immunosenescence. Initial data from a recent randomized controlled trial, so far only presented at conferences, confirm that the conjugate vaccine also provides protection against non-bacteremic pneumococcal pneumonia, which is not provided by the polysaccharide vaccine. Thus, there are two vaccines for prevention of pneumococcal diseases: one with a broader range of serotype coverage but with an uncertain protection against non-bacteremic pneumococcal pneumonia and another one with less serotype coverage but more effective protection. Vaccination of children with the conjugate vaccine also leads to a rapid decrease of infections by the 13 vaccine serotypes even in adults because of herd protection effects. For prevention of pneumonia in older adults the additional benefit of a concurrent application of influenza vaccine and pneumococcal vaccine should be considered.ZusammenfassungDie Alterung des Immunsystems, die Immunseneszenz, führt zu einer Zunahme von Infektionen im Alter mit meist oligosymptomatischem und teils schwerem Verlauf. Dies gilt im Besonderen für die durch Pneumokokken verursachten Pneumonien im Alter. Die Ständige Impfkommission (STIKO) des Robert Koch-Instituts empfiehlt daher für 60-Jährige und Ältere die 23-valente Pneumokokkenpolysaccharidimpfung einmalig als Standardimpfung. Als Indikationsimpfung steht darüber hinaus der 13-valente Pneumokokkenkonjugatimpfstoff zur Verfügung. Dieser hat den Vorteil, eine zusätzliche T-Zell-abhängige Immunantwort zu induzieren. Dies führt trotz Immunseneszenz auch im Alter zu einer guten Immunogenität. Erste, auf Kongressen präsentierte Daten einer großen randomisierten, kontrollierten Studie belegen für den Konjugatimpfstoff auch eine Schutzwirkung gegen nichtbakteriämische Pneumokokkenpneumonien. Einen solchen Schutz bietet der Polysaccharidimpfstoff nicht. Somit stehen zur Impfung gegen Pneumokokkeninfektionen ein breiter wirksamer Impfstoff mit einer unsicheren Schutzwirkung bei nichtbakteriämischer Pneumokokkenpneumonie, insbesondere bei Älteren, und ein schmalerer, aber besser wirksamer Impfstoff zur Verfügung. Herdenprotektionseffekte durch die Impfung von Kindern mit der Konjugatvakzine führen derzeit zu einer rapiden Abnahme der Infektionen durch die 13xa0Impfserotypen auch beim Erwachsenen. Für die Pneumonieprävention bei Senioren sollte der additive Nutzen einer simultanen Impfung gegen Influenza und Pneumokokken unbedingt beachtet werden.AbstractAging of the immune system, so-called immunosenescence, is well documented as the cause of increased infection rates and severe, often complicated courses of infections in older adults. This is particularly true for pneumococcal pneumonia in older adults; therefore, the standing committee on vaccination of the Robert Koch Institute (STIKO) recommends a once only vaccination with 23-valent pneumococcal polysaccharide vaccine for all persons aged 60 years and over. Furthermore, the 13-valent pneumococcal conjugate vaccine is also available for administration in adults and is recommended by the STIKO for particular indications. The advantage of the pneumococcal conjugate vaccine is the additional induction of a T-cell dependent immune response that leads to good immunogenicity despite immunosenescence. Initial data from a recent randomized controlled trial, so far only presented at conferences, confirm that the conjugate vaccine also provides protection against non-bacteremic pneumococcal pneumonia, which is not provided by the polysaccharide vaccine. Thus, there are two vaccines for prevention of pneumococcal diseases: one with a broader range of serotype coverage but with an uncertain protection against non-bacteremic pneumococcal pneumonia and another one with less serotype coverage but more effective protection. Vaccination of children with the conjugate vaccine also leads to a rapid decrease of infections by the 13 vaccine serotypes even in adults because of herd protection effects. For prevention of pneumonia in older adults the additional benefit of a concurrent application of influenza vaccine and pneumococcal vaccine should be considered.