Mycobacterium tuberculosis exposure of livestock in a German dairy farm: implications for intra vitam diagnosis of bovine tuberculosis in an officially tuberculosis-free country.

Germany has been an officially bovine tuberculosis (bTB)-free (OTF) country since 1996. Gradually rising numbers of bTB herd incidents due to Mycobacterium bovis and M. caprae in North-Western and Southern Germany during the last few years prompted the competent authorities to conduct a nationwide bTB survey in 2013/2014. This led to the detection of a dairy herd in which as many as 55 cattle reacted positively to consecutive intra vitam testing. Test-positive animals lacked visible lesions indicative of bTB at necropsy. Extensive mycobacterial culturing as well as molecular testing of samples from 11 tissues for members of the M. tuberculosis complex (MTC) yielded negative results throughout. However, caseous lymphadenitis of Ln. mandibularis accessorius was observed during meat inspection of a fattening pig from the same farm at regular slaughter at that time. Respective tissue samples tested MTC positive by polymerase chain reaction, and M. tuberculosis T1 family were identified by spoligotyping. Four human reactors within the farmer's family were also found to be immunoreactive. As exposure of livestock to M. tuberculosis is not generally considered, its impact may result in regulatory and practical difficulties when using protocols designed to detect classical bTB, particularly in OTF countries.

[Treatment of drug dependent patients in a psychiatric department]. / Zur Behandlung Suchtkranker in einer psychiatrischen Abteilung.

The authors report their three years experience with treating addicts (both alcoholics and users of prescription and illegal drugs) in a specialized unit employing a low-threshold admission policy. Difficulties as well as advantages of the concept are discussed. For the common treatment of patients addicted to different groups of substances on the same ward to be successful certain prerequisites probably have to be met: A clearly structured daily routine respectively therapy-program and close professional cooperation within a multifunctional therapeutic team harbouring a basic attitude of acceptance towards their patients.