Julia Hermes
Robert Koch Institute
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Featured researches published by Julia Hermes.
PLOS ONE | 2012
Birgit Walther; Julia Hermes; Christiane Cuny; Lothar H. Wieler; Szilvia Vincze; Yassmin Abou Elnaga; Ivonne Stamm; Peter A. Kopp; Barbara Kohn; Wolfgang Witte; Andreas Jansen; Franz Josef Conraths; Torsten Semmler; Tim Eckmanns; Antina Lübke-Becker
Background Since the relationship between dogs and their owners has changed, and dogs moved from being working dogs to family members in post-industrial countries, we hypothesized that zoonotic transmission of opportunistic pathogens like coagulase positive staphylococci (CPS) is likely between dogs and their owners. Methodology/Principal Findings CPS- nasal carriage, different aspects of human-to-dog relationship as well as potential interspecies transmission risk factors were investigated by offering nasal swabs and a questionnaire to dog owners (108) and their dogs (108) at a dog show in 2009. S. aureus was found in swabs of 20 (18.5%) humans and two dogs (1.8%), and spa types which correspond to well known human S. aureus lineages dominated (e.g. CC45, CC30 and CC22). Multilocus sequence typing (MLST) of the two canine strains revealed ST72 and ST2065 (single locus variant of ST34). Fifteen dogs (13.9%) and six owners (5.6%) harboured S. pseudintermedius, including one mecA-positive human isolate (MRSP). Pulsed field gel electrophoresis (PFGE) revealed that one dog/owner pair harboured indistinguishable S. pseudintermedius- isolates of ST33. Ten (48%) of the 21 S. pseudintermedius-isolates showed resistance towards more than one antimicrobial class. 88.9% of the dog owners reported to allow at least one dog into the house, 68.5% allow the dog(s) to rest on the sofa, 39.8% allow their dogs to come onto the bed, 93.5% let them lick their hands and 52.8% let them lick their face. Bivariate analysis of putative risk factors revealed that dog owners who keep more than two dogs have a significantly higher chance of being colonized with S. pseudintermedius than those who keep 1–2 dogs (p<0.05). Conclusions/Recommendations In conclusion, CPS transmission between dog owners and their dogs is possible. Further investigation regarding interspecies transmission and the diverse adaptive pathways influencing the epidemiology of CPS (including MRSA and MRSP) in different hosts is needed.
PLOS ONE | 2014
Szilvia Vincze; Ivonne Stamm; Peter A. Kopp; Julia Hermes; Cornelia Adlhoch; Torsten Semmler; Lothar H. Wieler; Antina Lübke-Becker; Birgit Walther
Staphylococcus (S.) aureus is an important cause of wound infections in companion animals, and infections with methicillin-resistant S. aureus (MRSA) are of particular concern due to limited treatment options and their zoonotic potential. However, comparable epidemiological data on MRSA infections in dogs, cats and horses is scarce, also limiting the knowledge about possible links to MRSA isolates from human populations. To gain more knowledge about the occurrence and genotypic variation of MRSA among wound swabs of companion animal origin in Germany we performed a survey (2010–2012) including 5,229 samples from 1,170 veterinary practices. S. aureus was identified in 201 (5.8%) canine, 140 (12.2%) feline and 138 (22.8%) equine swabs from a total of 3,479 canine, 1,146 feline and 604 equine wounds, respectively. High MRSA rates were identified with 62.7%, 46.4% and 41.3% in S. aureus of canine, feline and equine origin, respectively. Further genotyping including spa typing and multilocus sequence typing (MLST) revealed a comparable distribution of spa types among canine and feline MRSA with CC22 (47.6%; 49.2%) and CC5 (30.2%; 29.2%) as predominant lineages followed by CC398 (13.5%; 7.7%) and CC8 (4.0%; 9.2%). In contrast, the majority of equine MRSA belonged to CC398 (87.7%). Our data highlight the importance of S. aureus and MRSA as a cause of wound infections, particularly in cats and horses in Germany. While “human-associated” MRSA lineages were most common in dogs and cats, a remarkable number of CC398-MRSA was detected in horses, indicating a replacement of CC8-MRSA as the predominant lineage within horses in Germany. These data enforce further longitudinal epidemiological approaches to examine the diversity and temporal relatedness of MRSA populations in humans and animals to assess probable sources of MRSA infections. This would enable a sound risk assessment and establishment of intervention strategies to limit the additional spread of MRSA.
BMJ Open | 2015
Sebastian Haller; Christoph Eller; Julia Hermes; Martin Kaase; Matthias Steglich; Aleksandar Radonić; Piotr Wojtek Dabrowski; Andreas Nitsche; Yvonne Pfeifer; Guido Werner; Werner Wunderle; Edward Velasco; Muna Abu Sin; Tim Eckmanns; Ulrich Nübel
Objective We aimed to retrospectively reconstruct the timing of transmission events and pathways in order to understand why extensive preventive measures and investigations were not sufficient to prevent new cases. Methods We extracted available information from patient charts to describe cases and to compare them to the normal population of the ward. We conducted a cohort study to identify risk factors for pathogen acquisition. We sequenced the available isolates to determine the phylogenetic relatedness of Klebsiella pneumoniae isolates on the basis of their genome sequences. Results The investigation comprises 37 cases and the 10 cases with ESBL (extended-spectrum beta-lactamase)-producing K. pneumoniae bloodstream infection. Descriptive epidemiology indicated that a continuous transmission from person to person was most likely. Results from the cohort study showed that ‘frequent manipulation’ (a proxy for increased exposure to medical procedures) was significantly associated with being a case (RR 1.44, 95% CI 1.02 to 2.19). Genome sequences revealed that all 48 bacterial isolates available for sequencing from 31 cases were closely related (maximum genetic distance, 12 single nucleotide polymorphisms). Based on our calculation of evolutionary rate and sequence diversity, we estimate that the outbreak strain was endemic since 2008. Conclusions Epidemiological and phylogenetic analyses consistently indicated that there were additional, undiscovered cases prior to the onset of microbiological screening and that the spread of the pathogen remained undetected over several years, driven predominantly by person-to-person transmission. Whole-genome sequencing provided valuable information on the onset, course and size of the outbreak, and on possible ways of transmission.
Veterinary Microbiology | 2017
Christiane Cuny; Phillippe Arnold; Julia Hermes; Tim Eckmanns; Jaishri Mehraj; Sonja Schoenfelder; Wilma Ziebuhr; Qin Zhao; Yang Wang; Andrea T. Feßler; Gérard Krause; Stefan Schwarz; Wolfgang Witte
This study reports on the emergence of linezolid-resistant coagulase-negative staphylococci (CoNS) containing the multiresistance gene cfr in veal calves and pigs, as well as in humans exposed to these animals. CoNS (Staphylococcus auricularis, Staphylococcus cohnii, Staphylococcus lentus, Staphylococcus kloosii, Staphylococcus sciuri, Staphylococcus simulans), but not Staphylococcus aureus, carrying the gene cfr were detected in samples of 12 out of 52 calves at three farms which had a history of florfenicol use. Nasal swabs from 10 humans living on these farms were negative for cfr-carrying staphylococci. Nasal swabs taken from 142 calves at 16 farms in the same area that did not use florfenicol were also negative for cfr-carrying staphylococci. 14 cfr-carrying CoNS (S. kloosii, S. saprophyticus, S. simulans) were detected in three of eight conventional pig farms investigated. One of 12 humans living on these farms harboured a cfr-carrying S. cohnii. Among the nasal swabs taken from 169 veterinarians from all over Germany, four (2.3%) were positive for cfr-carrying CoNS (three S. epidermidis, one S. saprophyticus), and three (1.1%) of 263 contact persons of this group also harboured cfr-carrying CoNS (one S. epidermidis, two S. saprophyticus). In vitro conjugation of cfr by filter mating to S. aureus 8325-4 was possible for 10 of 34CoNS and the cfr gene was associated with plasmids of 38-40kb. Moreover, a total of 363 humans of a German municipal community were investigated for nasal carriage of cfr-carrying staphylococci to get an idea whether such isolates are disseminated as nasal colonizers in non-hospitalized humans in the community, were all negative.
Eurosurveillance | 2016
Jan Walter; Sebastian Haller; Julia Hermes; Mardjan Arvand; Muna Abu Sin; Tim Eckmanns
To the editor: Two recent publications by Reinheimer et al. and Heudorf et al. in Eurosurveillance, provided data on multidrug-resistant bacteria obtained from screening of different refugee populations and concluded that additional screening or surveillance for refugees at hospital admission in Germany should be undertaken [1,2]. The high number of people currently migrating to Europe from disaster areas has sparked a debate, whether or not refugees should be screened at hospital admission for colonisation with multidrug-resistant bacteria to limit spread of antibiotic resistance within Europe. The possible negative consequences of screening and lacking data make this a more complex issue than it may seem at first.
Eurosurveillance | 2015
Jan Walter; Sebastian Haller; Hans-Peter Blank; Tim Eckmanns; Muna Abu Sin; Julia Hermes
Voluntary surveillance systems in Germany suggest a recent decline in the incidence of infections (subsequent to at least 2010) with meticillin-resistant Staphylococcus aureus (MRSA) from various types of specimens and settings. We asked whether this decline is reflected by data from the mandatory national surveillance system for invasive MRSA infections. Our analysis is based on the population in Germany in 2010 to 2014. Cases were identified from passive reporting by microbiological laboratories of the diagnosis of MRSA from blood culture or cerebrospinal fluid. Respective clinical data were subsequently added to the notification. We calculated risk ratios (RR) between consecutive years, stratifying cases by sex, age and federal state of residence. The national incidence increased from 4.6 episodes per 100,000 persons in 2010 to 5.6 in 2012 (2011 vs 2010: RR: 1.13, 95% confidence interval (CI): 1.08-1.18; 2012 vs 2011: RR: 1.08, 95% CI: 1.04-1.13). It stagnated at 5.4 per 100,000 in 2013 (RR: 0.97, 95% CI: 0.93-1.01) before declining to 4.8 in 2014 (RR: 0.88, 95% CI: 0.84-0.91). This trend was observed in most, but not all federal states and strata of sex and age groups. Only 204 of 20,679 (1%) episodes of infection were notified as belonging to an outbreak. Our analysis corroborates previous findings that the incidence of invasive MRSA infections in Germany may be declining.
Influenza and Other Respiratory Viruses | 2011
Julia Hermes; Helen Bernard; Udo Buchholz; Michaela Spackova; Johann Löw; Gunther Loytved; Thorsten Suess; Wolfgang Hautmann; Dirk Werber
Please cite this paper as: Hermes et al. (2011) Lack of evidence for pre‐symptomatic transmission of pandemic influenza virus A(H1N1) 2009 in an outbreak among teenagers; Germany, 2009. Influenza and Other Respiratory Viruses 5(6), e499–e503.
Veterinary Microbiology | 2017
Jan Walter; Werner Espelage; Cornelia Adlhoch; Christiane Cuny; Susanne Schink; Andreas Jansen; Wolfgang Witte; Tim Eckmanns; Julia Hermes
There are only few data on the persistence and transmission of methicillin resistant Staphylococcus aureus (MRSA) of the clonal complex (CC) 398 among veterinarians and their household members. We therefore investigated the long-term colonisation with MRSA CC398 among participants of veterinary conferences in Germany in 2008/2009 and their household members. Forty-five initially MRSA CC398 positive and 180 initially MRSA CC398 negative conference participants were included in a longitudinal study. These persons and their household members were tested for nasal colonisation in 2011, 2012 and 2014. Of 31 continuously tested and initially MRSA CC398 positive participants only 8 (26%) were colonized with MRSA CC398at all 4 time points, 4 (13%) of them consistently with the same spa type. Among initially MRSA CC398 negative participants, 13 (7%) were tested MRSA CC398 positive at least once during the follow-up period. Data for household members at least at one time point were available for 185 households. Of these 21 (11%) households had one or more household member who tested positive for MRSA CC398at least once. The odds of household members to be MRSA CC398 positive was 12 times higher (95% confidence interval 4-37) when the conference participant tested MRSA CC398 positive in 2008/2009. This association remained strong when household members working in veterinary medicine or livestock farms were excluded. In summary, these data suggest that colonisation with MRSA CC398 is partially transient and that household members of MRSA CC398 colonized persons are at an increased risk of colonisation with MRSA CC398.
Clinical Infectious Diseases | 2016
Jan Walter; Werner Espelage; Christiane Cuny; Andreas Jansen; Wolfgang Witte; Tim Eckmanns; Julia Hermes
TO THE EDITOR—We congratulate Wardyn et al [1] for a well-conducted study on the association between swine farming and colonization with antibiotic-resistant Staphylococcus aureus. Similar to farmers, veterinarians are exposed to S. aureus in livestock. Several small studies from Europe have found a prevalence for colonization of veterinarians with livestockassociated methicillin-resistant S. aureus (LA-MRSA) between 1.4% and 44% [2]. We conducted a large cross-sectional study among participants of veterinary congresses in Germany in 2008 and 2009. Participants were sampled for LAMRSA colonization (as defined by attribution of isolates to clonal complex 398) by means of nasal swabs and asked to fill out a questionnaire. We calculated univariate and adjusted odds ratios using logistic regression modeling in STATA/SE13.1 (StataCorp, College Station, Texas). We tested all risk factors in the adjusted model that were significantly associated with the outcome in univariate analysis excluding apparently unrelated protective factors (ie, having a dog). We retained those that were significantly associated with LA-MRSA colonization. The study was approved by the ethical review board of the ethics committee of the Charité Hospital (Berlin, Germany) and conducted in accordance with the Helsinki Declaration. The participants provided written consent. Of 1453 participants, we excluded 18 (1%) who had missing questionnaires, 204 (14%) who were not veterinarians, and 536 (37%) who had not worked in herd health management within the previous year. This resulted in a final study population of 695 persons. In 64 (9%) of the participants, we found nasal colonization with LA-MRSA with the following co-resistances: tetracycline (98%), clindamycin (66%), erythromycin (64%), cotrimoxazol (42%), ciprofloxacin (22%), gentamicin (20%) and moxifloxacin (6%). None of the isolates from our study was resistant to glycopepetides, linezolid, or tigecycline. Factors associated with LA-MRSA include a number of occupational exposures, especially working with swine, but also a history of MRSA infection and contact with humanMRSA carriers (Table 1). Living in Lower Saxony, the German State with the highest pig density (http:// www.destatis.de); attending in pig farming; a history of MRSA infection; contact with a human MRSA carrier; and preferential use of tetracycline for group treatment, as well as fluorchinolones for individual animal treatment, remained independently associated with LA-MRSA in adjusted analysis (Table 1).
BMJ Open | 2013
Oliver Mohr; Julia Hermes; Susanne Schink; Mona Askar; Daniel Menucci; Corien Swaan; Udo Goetsch; Philip Monk; Tim Eckmanns; Gabriele Poggensee; Gérard Krause
Background Tracing persons who have been in contact with an infectious patient may be very effective in preventing the spread of communicable diseases. However, criteria to decide when to conduct contact tracing are not well established. We have investigated the available evidence for contact tracing with a focus on public ground transport aiming to give guidance in what situations contact tracing should be considered. Methods Relevant infectious diseases suitable for contact tracing in ground transport and a set of disease-specific epidemiological criteria were defined through literature search and structured multistep expert consultations. We developed continuous scales for each criterion to be rated for its relevance to contact tracing in ground transport. We used the Delphi method with an international expert panel to position the values of criteria on the respective scales. Results The study led to the development of the ‘Contact Tracing-Risk Assessment Profile’ (CT-RAP), a decision-making instrument, taking into account pathogen-specific as well as situation-specific criteria. This report describes the methodology of this instrument and presents two examples of ready-to-use CT-RAP for tuberculosis and for meningococcal disease in public ground transport. Discussion The systematic and transparent use of the CT-RAP for tuberculosis and meningococcal disease is likely to facilitate reasonable, efficient and user-friendly decisions with respect to contact tracing. New CT-RAPs for additional pathogens and different settings such as schools and kindergartens are being planned.