RESUMO
The incidence of Chlamydia psittaci respiratory tract infections in humans has increased in Sweden in recent years. This study aimed to identify the transmission route by genotyping C. psittaci from infected humans and birds. 42 human C. psittaci samples and 5 samples from C. psittaci-infected birds were collected. Genotyping was performed using ompA sequencing, Multi-locus sequence typing, and/or SNP-based high-resolution melting-PCR. Epidemiological data was also collected, and a phylogenetic analysis was conducted. Analysis of ompA provided limited resolution, while the SNP-based PCR analysis successfully detected the Mat116 genotype in 3/5 passerine birds and in 26/29 human cases, indicating a high prevalence of this genotype in the human population. These cases were associated with contact with wild birds, mainly through bird feeding during winter or other outdoor exposure. Human cases caused by other genotypes (psittacine and pigeon) were less common and were linked to exposure to caged birds or pigeons. The SNP-genotype Mat116 is rare, but predominated in this study. The use of SNP-based PCR provided a better understanding of the C. psittaci transmission from birds to humans compared to ompA analysis. In Sweden, human psittacosis appears mainly to be transmitted from garden birds during bird feeding in the winter season.
Assuntos
Chlamydophila psittaci , Psitacose , Animais , Humanos , Chlamydophila psittaci/genética , Psitacose/epidemiologia , Psitacose/veterinária , Suécia/epidemiologia , Tipagem de Sequências Multilocus , Filogenia , Genótipo , Columbidae/genéticaRESUMO
Between June-September 2018, 20 hepatitis A cases were notified in six counties in Sweden. Combined epidemiological and microbiological investigations identified imported frozen strawberries produced in Poland as the source of the outbreak. Sequence analysis confirmed the outbreak strain IB in the strawberries with 100 % identity and the respective batch was withdrawn. Sharing the sequence information internationally led to the identification of 14 additional cases in Austria, linked to strawberries from the same producer.
Assuntos
Surtos de Doenças , Doenças Transmitidas por Alimentos/virologia , Fragaria/virologia , Frutas/virologia , Vírus da Hepatite A/genética , Hepatite A/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Criança , Surtos de Doenças/estatística & dados numéricos , Feminino , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/epidemiologia , Alimentos Congelados/virologia , Genótipo , Hepatite A/diagnóstico , Hepatite A/transmissão , Hepatite A/virologia , Vírus da Hepatite A/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/genética , Análise de Sequência , Suécia/epidemiologiaRESUMO
The prevalence of Candidatus Neoehrlichia mikurensis infection was determined in 102 persons bitten by ticks in Sweden. Two infected women had erythematous rashes; 1 was co-infected with a Borrelia sp., and the other showed seroconversion for Anaplasma phagocytophilum. Both patients had increased levels of Neoehrlichia DNA and serum cytokines for several months.
Assuntos
Candidíase Cutânea/diagnóstico , Citocinas/metabolismo , DNA Bacteriano/genética , Doenças Transmitidas por Carrapatos/diagnóstico , Carrapatos , Idoso , Animais , Candidíase Cutânea/patologia , Coinfecção/complicações , Feminino , Humanos , Pessoa de Meia-Idade , SuéciaRESUMO
BACKGROUND: In order to limit the use of broad-spectrum antibiotics, standardized empirical therapy against acute bacterial infections has been advocated. METHODS: Guidelines for acute bacterial infections recommending increased usage of benzylpenicillin and restricted use of fluoroquinolones and cephalosporins have been implemented in Kalmar County, Sweden. We evaluated this strategy by recording therapy in patients with bacteraemia, antibiotic requisition, and point prevalence surveys prior to this intervention and at 6 and 12 months after. RESULTS: Comparing the methods simultaneously, there was good agreement between them and an overall significant change in antibiotic usage. There was a significant shift from cefuroxime to cefotaxime and a borderline significant increase in the use of benzylpenicillin (p = 0.057). Based on the defined daily dose (DDD), a highly significant decrease in total cefotaxime and cefuroxime usage was observed that was not detected when applying the prescribed daily dose (PDD), which is adapted to local treatment practices. No change was found in mortality in Staphylococcus aureus bacteraemia or the incidence of Clostridium difficile infection. CONCLUSIONS: We conclude that the implementation of the new guidelines has resulted in a significant change in antibiotic usage, which could be conveniently monitored by antibiotic requisition if PDD is used in addition to DDD.