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Thomas Bodmer

Publications and source records attributed to Thomas Bodmer.

11 recordsLinked to original sources

Use of the immunodominant 18-kiloDalton small heat shock protein as a serological marker for exposure to Mycobacterium ulcerans.

While it is well established that proximity to wetlands is a risk factor for contracting Buruli ulcer, it is not clear what proportion of a population living in an area where the etiologic agent, Mycobacterium ulcerans, is endemic is actually exposed to this disease. Immunological cross-reactivity among mycobacterial species complicates the development of a specific serological test. Among immunodominant proteins recognized by a panel of anti-M. ulcerans monoclonal antibodies, the M. ulcerans homologue of the M. leprae 18-kDa small heat shock protein (shsp) was identified. Since this shsp has no homologues in M. bovis and M. tuberculosis, we evaluated its use as a target antigen for a serological test. Anti-18-kDa shsp antibodies were frequently found in the sera of Buruli ulcer patients and of healthy household contacts but rarely found in controls from regions where the infection is not endemic. The results indicate that only a small proportion of M. ulcerans-infected individuals contract the clinical disease.

Amino Acid Sequence↗

Dynamics of hemodialysis catheter colonization by coagulase-negative staphylococci.

OBJECTIVES: Catheter colonization is a necessary but poorly characterized step in the pathogenesis of catheter-related infections. Colonization dynamics of central venous hemodialysis catheters were studied with emphasis on coagulase-negative staphylococci (CoNS) and their population genetics, antibiotic resistance, and biofilm formation. The homogeneity of CoNS colony morphotypes was evaluated. DESIGN: Prospective, longitudinal study during 1,158 catheter-days with microbiological analysis of skin swabs, weekly catheter blood and brush samples, and catheter tips. SETTING: Hemodialysis unit of a university hospital. PATIENTS: Twenty-six patients with 24 non-tunneled and 5 tunneled catheters. RESULTS: Nineteen (65.5%) of the catheters became colonized, 17 by CoNS. CoNS colonization of the inner lumen was observed in 17.2% of the catheters and was first detectable after 3 weeks. Colonization of the outer surface occurred in 44.8% of the catheters within a minimum of 2 weeks. PFGE of 53 CoNS revealed 10 clones and 20 unique isolates. Isolates from clones were more frequent in catheter blood and brush cultures than were unique isolates (41% vs 15%), were resistant to more antibiotics (median, 7 vs 2), and tended to more often carry the icaA gene (64.1% vs 40%). Four (23.5%) of the catheters showed colonization with a mixture of CoNS based on PFGE. The time from catheter insertion to such mixed CoNS colonization was longer than that for colonization with one CoNS PFGE pattern only (42 vs 25 days). CONCLUSIONS: Colonization of hemodialysis catheters is dominated by multidrug-resistant, icaA-positive CoNS clones. Mixed CoNS colonization occurs, but is delayed, suggesting a process of sequential superinfection.

Adult↗

Evaluation of decontamination methods and growth media for primary isolation of Mycobacterium ulcerans from surgical specimens.

We evaluated four decontamination methods and one nondecontamination procedure in combination with four egg-based media for the primary isolation of Mycobacterium ulcerans from tissue specimens. With mycobacterial recovery and contamination rates of 75.6 and 2.4%, respectively, the combination of the oxalic acid decontamination method with Lowenstein-Jensen medium supplemented with glycerol yielded the best results.

Bacteriological Techniques↗

Multicenter evaluation of the MB/BACT system for susceptibility testing of Mycobacterium tuberculosis.

The reliability of the MB/BACT system for susceptibility testing of Mycobacterium tuberculosis to pyrazinamide, rifampin, isoniazid, streptomycin, and ethambutol was compared to the BACTEC 460TB system. The proportion method was used to resolve discrepant results by an independent arbiter. Two interpretative methods were used, with an undiluted control (direct control) and a diluted control (10(-1) control). As no significant difference was observed between the two controls, the method with the direct control was adopted as the most accurate one. One hundred sixty-six strains were tested, with an overall agreement of 98.3%. After resolution of the 18 discrepant results by the proportion method, the sensitivity and specificity of the MB/BACT system were 100% for rifampin, isoniazid, and pyrazinamide. For ethambutol, sensitivity was 92.3% at the critical concentration and 33% at the high concentration, and specificity was 100% at both concentrations. For streptomycin, sensitivity was 100% at the critical concentration and 80% at the high concentration, and specificity was 98.6% at the critical concentration and 100% at the high concentration. The rifampin, isoniazid, streptomycin, and ethambutol susceptibility test results were obtained in 6.6 days with the MB/BACT versus 5 days with the BACTEC 460TB. The pyrazinamide susceptibility test results were obtained in 7.8 days with the MB/BACT, versus 6.7 days with the BACTEC 460TB. These data demonstrate that the fully automated MB/BACT system is a very reliable method for rapid susceptibility testing of M. tuberculosis against rifampin, isoniazid, and pyrazinamide. Sensitivity results have to be improved for ethambutol and streptomycin, especially at the high concentration.

Antitubercular Agents↗

Nationwide surveillance of nasopharyngeal Streptococcus pneumoniae isolates from children with respiratory infection, Switzerland, 1998-1999.

The surveillance of pneumococcal antibiotic resistance and serotype distribution is hampered by the relatively low numbers of invasive pneumococcal infections. In Switzerland, a nationwide sentinel surveillance network was used to assess antibiotic resistance and serotype distribution among 1179 pneumococcal isolates cultured from 2769 nasopharyngeal swabs obtained from outpatients with acute otitis media or pneumonia during 1998 and 1999. The proportion of penicillin-susceptible pneumococcal isolates overall (87%) and among infants <2 years old (81%) was comparable to that of invasive isolates (90% and 81%, respectively). The high number of nasopharyngeal isolates allowed for the detection of a rapid increase in the number of penicillin-nonsusceptible pneumococcal (PNSP) strains in the West region of Switzerland, partly because of an epidemic caused by the 19F clone of Streptococcus pneumoniae. Clustering of risk factors for the carriage of PNSP isolates further explained the geographic variation in resistance rates. The nationwide sentinel surveillance of nasopharyngeal pneumococcus proved to be valuable for the monitoring of antibiotic resistance, risk factors for carriage of PNSP isolates, and serotype distribution and for the detection of the emergence of a new epidemic clone.

Acute Disease↗

Clinical implications of Mycobacterium kansasii species heterogeneity: Swiss National Survey.

Several subtypes of Mycobacterium kansasii have been described, but their respective pathogenic roles are not clear. This study investigated the distribution of subtypes and the pathogenicity of M. kansasii strains (n = 191) isolated in Switzerland between 1991 and 1997. Demographic, clinical, and microbiological information was recorded from clinical files. Patients were classified as having an infection according to the criteria of the American Thoracic Society. Subtypes were defined by PCR-restriction enzyme analysis of the hsp65 gene. Subtype 1 comprised 67% of the isolates (n = 128), while subtypes 2 and 3 comprised 21% (n = 40) and 8% (n = 15), respectively. Other subtypes (subtypes 4 and 6 and a new subtype, 7) were recovered from only 4% of patients (n = 8). M. kansasii subtype 1 was considered pathogenic in 81% of patients, while M. kansasii subtype 2 was considered pathogenic in 67% of patients and other subtypes were considered pathogenic in 6% of patients. The majority of patients with M. kansasii subtype 2 were immunocompromised due to the use of corticosteroids (21% of patients) or coinfection with HIV (62.5% of patients). Subtyping M. kansasii may improve clinical management by distinguishing pathogenic from nonpathogenic subtypes.

Adult↗

Comparison of phenotypic and genotypic methods for the detection of clarithromycin resistance in Mycobacterium avium.

The MICs of clarithromycin for 10 clinical isolates of Mycobacterium avium were determined using three methods: Bactec 460-TB, broth microdilution and Etest. The results were compared with the presence of resistance mutations in the 23S rRNA gene. Isolates were obtained from five AIDS patients who were treated with clarithromycin. Five isolates were recovered before and five during treatment. MICs were reproducible and comparable between the three methods. They were < or = 4 mg/L for pre-treatment isolates and > or = 128 mg/L for strains recovered during treatment. An MIC > or = 128 mg/L was associated with the presence of mutations in the 23S rRNA gene that were absent in the isolates exhibiting MIC < ro = 4 mg/L.

Anti-Bacterial Agents↗

Mycobacterium bohemicum cervical lymphadenitis.

A lymph node excision was performed on a 2-year-old child with right submandibular swelling not responding to oral cefaclor therapy. Histology revealed granulomatous, partly necrotizing lymphadenitis and a large number of acid-fast bacilli subsequently identified by molecular techniques as Mycobacterium bohemicum.

Antitubercular Agents↗

Disseminated Mycobacterium marinum infection with extensive cutaneous eruption and bacteremia in an immunocompromised patient.

Mycobacterium marinum can cause fish tank granuloma (or swimming pool or aquarium granuloma) in immunocompetent patients. Dissemination of Mycobacterium marinum-infection is a rare condition which occurs mainly in immunocompromised patients and can be life-threatening. We report the case of an 87-year-old woman who was treated with oral corticosteroids for polymyalgia rheumatica for many years and developed erythema nodosum-like lesions on the right forearm and arthritis of the right wrist. By increasing the steroid dosage and adding methotrexate only short-term remission was achieved. Seven months later painful erythematous nodules occurred on all extremities which became necrotic, ulcerative and suppurative. Ziehl-Neelsen staining revealed acid-fast bacilli and Mycobacterium marinum was cultured from skin biopsies, blood, and urine. The critically ill patient was treated with clarithromycin and ethambutol resulting in a dramatic improvement of the general condition. After four months, doxycycline had to be added because of new skin lesions. This case illustrates the impact of Mycobacterium marinum infection in immunocompromised patients.

Aged↗